PMID- 3264141 TI - Clastogenic factor in ischemia-reperfusion injury during open-heart surgery: protective effect of allopurinol. AB - The hypothesis tested was that free radicals generated following ischemia and reperfusion in cardiac operations can produce clastogenic factor that results in chromosomal aberration. Fourteen randomized patients undergoing coronary artery bypass grafting were divided into two groups. In Group 1 (7 patients), myocardial protection was achieved using a cardioplegic solution without allopurinol. In Group 2 (7 patients), 100 mg of allopurinol (xanthine oxidase inhibitor) was added to the solution. In both groups, blood samples were taken from the coronary sinus before the aorta was clamped and 20 minutes after myocardial reperfusion was achieved. The blood samples were used to study the patients' chromosomes. The results were given as the percentage of chromosomal aberrations observed in 100 mitoses. There were no significant differences between the preischemic values in both groups and the postischemic values in Group 2. On the other hand, there was a significant difference between the postischemic values in Groups 1 and 2 (p less than 0.01). In conclusion, reperfusion following myocardial ischemia in cardiac operations can produce clastogenic aberrations. This clastogenic activity can be reduced by adding allopurinol to the cardioplegic solution. PMID- 3264142 TI - A new regimen of interleukin 2 and lymphokine-activated killer cells. Efficacy without significant toxicity. AB - Adoptive immunotherapy with high-dose interleukin 2 and lymphokine-activated killer (LAK) cells has proved to be successful in the treatment of some patients with metastatic cancer, but not without a significant degree of associated toxic effects. The primary goal of this study was to substantially reduce the toxicity of this complex and expensive treatment, while maintaining or improving efficacy. To this end, 29 patients were treated with LAK cells in conjunction with a low dose regimen of interleukin 2 and a prolonged period of administration following LAK cell infusion. This protocol resulted in a considerable reduction in toxicity, as compared with that described in previous studies, without compromising the efficacy. This study offers further confirmation that adoptive immunotherapy of metastatic cancer can be clinically beneficial to patients for whom no other effective therapy is presently available. PMID- 3264143 TI - Fatal toxic epidermal necrolysis during prophylaxis with pyrimethamine and sulfadoxine in a human immunodeficiency virus-infected person. AB - The combination of pyrimethamine and sulfadoxine (Fansidar) has been reported to cause severe skin reactions including erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Recently, this drug combination has been used for prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. After two months of weekly prophylaxis with pyrimethamine and sulfadoxine, a 48-year-old homosexual man who was antibody positive for human immunodeficiency virus developed severe widespread erythema, blisters, and loss of skin in sheets, and subsequently died. To our knowledge, this is the first reported case of fatal toxic epidermal necrolysis occurring in a patient with acquired immunodeficiency syndrome-related complex. The lack of absolute safety of prophylaxis with pyrimethamine and sulfadoxine is emphasized in our case, and mandates cautious use and the consideration of less toxic prophylactic measures such as therapy with the recently introduced aerosolized pentamidine. PMID- 3264144 TI - The epidemiology of obsessive-compulsive disorder in five US communities. AB - The prevalence of obsessive-compulsive disorder was measured in five US communities among more than 18,500 persons in residential settings as part of the National Institute of Mental Health (Bethesda, Md)--sponsored Epidemiologic Catchment Area program. Lifetime prevalence rates ranged from 1.9% to 3.3% across the five Epidemiologic Catchment Area sites for obsessive-compulsive disorder diagnosed without DSM-III exclusions and 1.2% to 2.4% with such exclusions. These rates are about 25 to 60 times greater than had been estimated on the basis of previous studies of clinical populations. PMID- 3264145 TI - The prevalence of psychiatric disorders in a primary care practice. AB - Using a two-stage case identification process, patients from a rural primary care practice were assessed for psychiatric disorders (Research Diagnostic Criteria [RDC] categories) over a 15-month period. The prevalence of all psychiatric disorders was 26.5%; 10.0% were specific RDC depressive disorders, and 5.3% were disorders without depression, usually anxiety related. Another 11.2% of patients were thought to have a disorder with significant depressive symptomatology that could not be classified into a specific depressive disorder category, a finding that suggests restricted usefulness of specialty-based categories for the range of clinical presentations in primary care. The relationship of demographic variables to specific disorders was examined; there were age, sex, and marital status differences in the rates for certain disorders, although these findings need replication using large patient samples. The prevalence findings emphasize the need for research on outcome and treatment response for depression presentations in primary care. PMID- 3264146 TI - Psychiatric disorders in pediatric primary care. Prevalence and risk factors. AB - Children aged 7 to 11 years visiting their primary care pediatrician for a wide range of reasons were studied to determine the one-year prevalence of DSM-III disorders and the risk factors associated with them. Parents completing the Child Behavior Checklist about their children identified problems that placed 24.7% of 789 children in the clinical range. Detailed psychiatric interviews with 300 parents and children, using the Diagnostic Interview Schedule for Children, yielded a one-year weighted prevalence of one or more DSM-III disorders of 22.0% +/- 3.4%, combining diagnoses based on either the child or the parent interview. PMID- 3264147 TI - Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico. The use of combined measures. AB - A two-stage epidemiologic survey was carried out on a probability sample of the population aged 4 through 16 years in Puerto Rico. The survey used the Child Behavior Checklist as a screening instrument, and prevalence rates were estimated on the basis of clinical diagnoses and other measures provided by child psychiatrists during the second stage. Maladjustment was operationally defined through the use of combined measures, including DSM-III diagnosis and a scale of functional impairment. Data were provided on the demographic correlates of maladjustment and on the comorbidity of DSM-III diagnostic domains. The prevalence rates obtained vis-a-vis the availability of mental health services on the island reflected a major public health problem. PMID- 3264148 TI - Prevalence of Parkinson's disease in the Parsi community of Bombay, India. AB - A door-to-door survey was carried out to screen a community of 14010 people (Parsis living in colonies in Bombay, India) for possible neurologic diseases. High school graduates, social workers, and medical students administered a screening questionnaire that had been shown in a pilot survey to have a sensitivity of 100% for identifying those with Parkinson's disease. Neurologists used defined diagnostic criteria to evaluate individuals positive on the screening survey. There were 46 people (25 men, 21 women) who suffered from Parkinson's disease (328.3 cases per 1000 population). The age-specific prevalence ratios increased consistently with age. Age-adjusted prevalence ratios were slightly higher for men. PMID- 3264149 TI - Human cryptosporidiosis in North Queensland. AB - During a 12-month period, feces from 780 persons from the Townsville region were evaluated by the Kinyoun acid-fast strain, and 36 (4.6%) immunocompetent patients were found to have Cryptosporidium oocysts. Twenty-five index cases were identified; 13 (8.6%) cases from 151 patients were from Palm Island, an isolated Aboriginal community in the wet tropics and 12 (1.9%) cases from 629 patients were from the dry tropics of Townsville. All 11 secondary cases were associated with a person-to-person outbreak in the nursery of a Townsville day-care centre. Infection occurred mainly in two distinct age groups: the under five-year-old (27 cases), and the 25 to 35-year-old (six cases). A prodrome of dry cough, rhinorrhea and vomiting often preceded symptoms of fever, weight loss, abdominal pain, persistent cough and vomiting, and acute diarrhea with frequent, non bloodstained, watery, mucous stools. Although 13 patients were hospitalised because of their illness, the infection was self-limiting and all 36 patients recovered with symptomatic treatment. Cryptosporidium was the third most commonly identified enteric pathogen after Rotavirus and Giardia. Infection did not appear to depend on seasonal variation and no animal or environmental sources of infection were identified. Cryptosporidiosis in immunocompetent persons is endemic and common in North Queensland and routine investigations for this parasite in symptomatic patients are warranted. PMID- 3264150 TI - Influence of inoculation dose, inoculation schedule, chicken age, and host genetics on disease susceptibility and development of resistance to Eimeria tenella infection. AB - Various parasite- and host-related factors influencing disease susceptibility and development of protective immunity against Eimeria tenella infection were investigated in two inbred strains of chickens. Chickens that received a primary inoculation of 10(3), 10(4), or 10(5) oocysts showed a significant reduction in packed cell volume and produced significantly more oocysts than chickens inoculated with fewer oocysts. Younger chickens were as susceptible as older chickens to identical parasite doses. However, upon a secondary inoculation 5 weeks following primary inoculation, FP chickens 1 to 21 days old at the time of primary inoculation developed resistance to reinfection, whereas SC chickens less than 3 weeks old at the time of primary inoculation were highly susceptible to secondary infection. Flow cytometric analysis of spleen lymphocytes showed a substantial reduction in T-cell number in 1-day-old SC but not FP chickens. Furthermore, 1-week-old SC chickens showed depressed mitogenic responses to concanavalin A compared with 1-week-old FP chickens. There was no significant difference between SC and FP chickens in speen B-cell number, regardless of age. PMID- 3264151 TI - Mechanism of cellular effect of phorbol esters on action of arginine vasopressin and angiotensin II on rat vascular smooth muscle cells in culture. AB - The inhibitory effect of phorbol-12-myristate-13-acetate (PMA) on the Ca2+ mobilization mechanisms by arginine vasopressin (AVP) and angiotensin II (AII) was analysed in rat vascular smooth muscle cells (VSMC) in culture. PMA inhibited the Ca2+-mobilizing effect of both AVP and AII in a dose-dependent manner, including the rise in cytosolic free Ca2+ ( [Ca2+]i) and Ca2+ efflux. In addition, inositol trisphosphate (IP3) production induced by AVP or AII was more than 50% reduced by PMA. The involvement of protein kinase C was implicated by the diminution of the PMA effect by the specific protein kinase C inhibitor isoquinoline-sulphonyl-O-2-methylpiperazine (H7) and the lack of effect of an inactive phorbol. Thus, these results suggest that there is a blocking site that is common or similar for both AVP and AII signal transduction, and that it is a substrate for protein kinase C. This blocking action of protein kinase C occurred at least in part by inhibition of IP3 production and, subsequently, a reduction in cytosolic Ca2+ release. In the presence of ionomycin, which produces an increase in [Ca2+]i that is not altered by PMA, 45Ca2+ efflux was increased instead of inhibited by PMA, thus suggesting that protein kinase C activation also stimulates a Ca2+-extrusion mechanism in VSMC. PMID- 3264152 TI - Citrobacter diversus ULA-27 beta-lactamases. Improved purification and general properties. AB - Two chromosome-encoded beta-lactamases have been purified from Citrobacter diversus ULA-27. They exhibited slightly different isoelectric points (6.8 and 6.2) and very similar Mr values (congruent to 29,000). Their specificity spectrum was rather wide, since they hydrolysed some cephalosporins with kcat: values similar to those observed with the best penicillin substrates. Cloxacillin, methicillin and imipenem were hydrolysed very slowly. Hydrolysis of azthreonam could not be detected. PMID- 3264153 TI - Accumulation of acyl-enzyme intermediates during turnover of penicillins by the class A beta-lactamase of Staphylococcus aureus PC1. AB - The interaction of dansylpenicillin with the class A Staphylococcus aureus PCI beta-lactamase yielded an accumulating intermediate with fluorescence enhanced beyond that of the substrate. Acid quenching of the reaction mixture yielded a denatured enzyme with 1 molar equivalent of dansyl group covalently bound to it. A similar quenching experiment with the PC1 beta-lactamase and [14C]benzylpenicillin yielded an enzyme with 1 molar equivalent of 14C covalently bound. These data indicate that in turnover of S-type penicillins by the PC1 beta lactamase deacylation is rate-determining. This has not indicate previously been demonstrated for a class A beta-lactamase. PMID- 3264154 TI - A survey of the kinetic parameters of class C beta-lactamases. Penicillins. AB - The interaction between six class C beta-lactamases and various penicillins has been studied. All the enzymes behaved in a very uniform manner. Benzylpenicillin exhibited relatively low kcat. values (14-75 s-1) but low values of Km resulted in high catalytic efficiencies [kcat./Km = 10 X 10(6)-75 X 10(6) M-1.s-1]. The kcat. values for ampicillin were 10-100-fold lower. Carbenicillin, oxacillin cloxacillin and methicillin were very poor substrates, exhibiting kcat. values between 1 x 10(-3) and 0.1 s-1. The Km values were correspondingly small. It could safely be hypothesized that, with all the tested substrates, deacylation was rate-limiting, resulting in acyl-enzyme accumulation. PMID- 3264155 TI - A survey of the kinetic parameters of class C beta-lactamases. Cephalosporins and other beta-lactam compounds. AB - Various cephalosporins, cefoxitin, moxalactam, imipenem and aztreonam were studied as substrates of six class C beta-lactamases. Nitrocefin, cephaloridine, cefazolin, cephalothin and cephalexin were good substrates, with kcat. values ranging from 27 to 5000 s-1. Cefuroxime, cefotaxime and cefoxitin exhibited low kcat. values (0.010-1.7 s-1) and low Km values, which suggested a rate-limiting deacylation. Imipenem and aztreonam were even poorer substrates (kcat. 2 x 10(-4) 3 x 10(-2) s-1) and, in the presence of a reporter substrate, behaved as transient inactivators. With moxalactam, biphasic kinetics were observed, indicating a possible rearrangement of the acyl-enzyme. PMID- 3264156 TI - Design and biological activity of a new generation of synthetic C3a analogues by combination of peptidic and non-peptidic elements. AB - Based on published X-ray crystallographic data of the anaphylatoxic complement peptide C3a, we have synthesized a series of peptides with appropriate amino acid exchanges and a maximal length of 13 amino acids. N-terminal acylation of these optimized structures with epsilon-aminohexanoic acid and complex aromatic structures like fluorenylmethoxycarbonyl, 2-nitro-4-azidophenyl, fluoresceinyl and rhodaminyl leads to a dramatic increase in biological activity. The culmination of our synthetic efforts is a C3a analogue with 13 amino acid residues and a biological activity six times that of native C3a. PMID- 3264157 TI - Epidermal-growth-factor stimulation of gluconeogenesis in isolated rat hepatocytes involves the inactivation of pyruvate kinase. AB - Preincubation of rat hepatocytes with EGF (epidermal growth factor) caused a stimulation of gluconeogenesis from alanine. The effect was maximal after preincubation of 20 min, and a half-maximal effect of EGF was obtained at 10 nM. EGF also stimulated gluconeogenesis from lactate and asparagine, but not from glutamine or from proline. Preincubation of hepatocytes with EGF caused a stable inactivation of pyruvate kinase, which may account, at least in part, for the observed effects of EGF on gluconeogenesis. PMID- 3264158 TI - Nitrous oxide exposure reduces hepatic C1-tetrahydrofolate synthase expression in rats. AB - C1-tetrahydrofolate synthase (C1-THF synthase) is a trifunctional enzyme which catalyzes the interconversion of one-carbon units attached to the coenzyme THF. Nitrous oxide (N2O) inhalation is known to inactivate hepatic cobalamin-dependent methionine synthase leading to methionine deficiency and trapping of THF in the methyl-THF form. Liver tissue from rats exposed to N2O for 48 hours exhibited a coordinate decrease in all three activities of C1-THF synthase of approximately 25%. A corresponding 25% decrease in immunoreactive C1-THF synthase was also observed after 48 hours. Thus, the decrease in the concentration of C1-THF synthase accounted entirely for the decreases observed in the three activities. These results suggest that perturbations of hepatic THF pools by N2O affect the level of C1-THF synthase expression at a translational or pretranslational level. PMID- 3264159 TI - Inhibitory effect of transforming growth factor-beta on epidermal growth factor induced proliferation of cultured rat aortic smooth muscle cells. AB - This study was conducted to investigate the effect of transforming growth factor beta (TGF-beta) on the proliferation of cultured rat aortic smooth muscle cells (SMCs). DNA synthesis, measured by the incorporation of [3H] thymidine, and the cell number of monolayered SMCs were measured after incubation with TGF-beta (1 100 ng/ml) in the presence or absence of epidermal growth factor (EGF; 100 ng/ml). TGF-beta alone did not affect DNA synthesis of SMCs. EGF significantly increased both DNA synthesis and cell number, while TGF-beta inhibited the increase in both in a dose-dependent manner without accompanying the significant cellular damage. These results indicate that TGF-beta exerts an inhibitory effect on the proliferation of cultured SMCs provoked by EGF. PMID- 3264160 TI - Characterization of a recombinant murine interleukin-6: assignment of disulfide bonds. AB - Murine interleukin 6 (mIL-6) has been synthesized as a fusion protein using a lac operon inducible plasmid in Escherichia coli. The first 8 amino acids are from the N-terminus of bacterial beta-galactosidase and the last 175 amino acids are from residue number 12 to the end of native mIL-6. This fusion protein is equipotent with the native molecule in the hybridoma growth factor assay and has comparable receptor binding characteristics. The two disulfide bridges in mIL-6 have been identified by Staphylococcus aureus V8 protease peptide mapping and Edman degradation of cystine-containing peptides. It has been shown that there are disulfide bonds between Cys46-Cys52 and Cys75-Cys85. PMID- 3264161 TI - Characteristics of the transport of the quaternary ammonium 1-methyl-4 phenylpyridinium by chromaffin granules. AB - 1-Methyl-4-phenylpyridinium (MPP+), an active metabolite of the neurotoxin 1 methyl-4-phenyl-1,2,3,6-tetrahydropyridine which induces Parkinson's disease in man, is a substrate of the monoamine uptake system of chromaffin granules. It is accumulated without chemical modification by bovine chromaffin granule membrane vesicles in the presence of ATP. The transport is saturable and is characterized by a Km value of 0.8 microM at pH 8.0, similar to that of serotonin (5-HT). Transport occurs through the monoamine transporter since it is competitively inhibited by 5-HT and since MPP+ competitively inhibits [3H]5-HT uptake. Moreover, [3H]MPP+ uptake is blocked by the monoamine transporter inhibitors tetrabenazine and reserpine. Finally, MPP+ efficiently displaces [3H]reserpine and [3H]dihydrotetrabenazine from their binding sites on the transporter. In the pH range 6-8, the Km for [3H]MPP+ uptake and the EC50 of MPP+ for the displacement of [3H]dihydrotetrabenazine decrease logarithmically with the pH. MPP+ is the first quaternary ammonium salt shown to be a substrate of the monoamine transporter and it has the same pH-dependency as monoamines. PMID- 3264162 TI - Prostaglandin E2 modulation of rheumatoid factor synthesis. AB - We examined the influence of prostaglandin E2 (PGE2) on the in vitro synthesis of rheumatoid factor (RF) by purified human B and T lymphocytes stimulated with Staphylococcus aureus Cowan 1 or pokeweed mitogen (PWM). Supernatants were assayed for total IgM and RF. PGE2 at concentrations of 10(-7) M to 10(-9) M significantly inhibited RF and IgM secretion stimulated by S aureus Cowan 1, a cross-linker of B cell surface Ig. The magnitude of inhibition of RF production was significantly greater than that of total IgM at low PGE2 concentrations (P less than 0.05). In contrast, PWM-stimulated cultures were only minimally inhibited by PGE2 at all concentrations tested. Since cross-linking of surface Ig renders B cells more susceptible to inhibition by PGE2, heat-aggregated IgG (HAIgG) was added to the PWM-stimulated cultures in an attempt to increase the sensitivity of precursors of RF-secreting cells to the inhibitory effects of PGE2. Addition of HAIgG markedly increased PGE2-mediated inhibition of RF synthesis without significantly affecting IgM production. Inhibition could not be overcome by the addition of soluble T helper cell factors, indicating that PGE2 mediated suppression was not the result of an inhibitory action of T helper cells. When lymphocytes from patients with rheumatoid arthritis were examined, HAIgG was found to be unable to induce sensitivity to PGE2-mediated inhibition of responsiveness. These results suggest that down-regulation of RF synthesis requires both cross-linking of surface Ig and the influence of PGE2. Abnormalities in this immunoregulatory mechanism may explain the ongoing production of RF in patients with rheumatoid arthritis. PMID- 3264163 TI - Stimulation of interleukin-1 alpha and interleukin-1 beta release from human monocytes by cyanogen bromide peptides of type II collagen. AB - Pyrogen-free cartilage fragments from patients with fracture, osteoarthritis, or rheumatoid arthritis were found to stimulate the production of interleukin-1 alpha-like and interleukin-1 beta-like factor by peripheral blood mononuclear cells from healthy individuals and rheumatoid arthritis patients. The stimulatory cartilaginous component was type II collagen, and the major stimulatory determinant on type II collagen was found to be cyanogen bromide 11 peptide. These results suggest a possible pathogenic role of the intact cartilaginous component in interleukin-1-mediated joint destruction. PMID- 3264164 TI - Beneficial effects of leucovorin after methotrexate treatment in rheumatoid arthritis: a case report. PMID- 3264165 TI - Interleukin-2 inhibitor and measurement of interleukin-2 in synovial fluid of patients with rheumatoid arthritis. PMID- 3264166 TI - In vitro activity of the combination trimethoprim plus sulfamethoxazole compared with that of other chemotherapeutic agents. AB - For many years now, the combination trimethoprim plus sulfamethoxazole (active ingredients of Bactrim) has proved to be an effective chemotherapeutic agent with a broad spectrum of antibacterial activity against both gram-positive and gram negative organisms, including beta-hemolytic streptococci, staphylococci, pneumococci, Haemophilus influenza, Escherichia coli, Proteus mirabilis, Proteus vulgaris, Klebsiella, Enterobacter and Citrobacter. In this comparative study, the antibacterial activity of the combination against 2,229 gram-negative and 1,338 gram-positive strains encountered in domiciliary practice was tested and compared with that of other commonly used antimicrobials. Minimum inhibitory concentrations (MICs) were determined in microtitre plates using serial dilutions. With regard to the gram-negative strains, trimethoprim + sulfamethoxazole, with an MIC90 of less than 2 mg/l for most isolates, was the most active substance apart from norfloxacin. The combination also had a powerful inhibitory effect on gram-positive strains, the MIC90 being between 2 and 4 mg/l for all strains except Staphylococcus epidermidis. PMID- 3264167 TI - [The binding of oxicam derivatives to human serum albumin]. AB - The binding characteristics of several oxicam derivatives (tenoxicam, 4-hydroxy-2 methyl-N-phenyl-2H-1,2-benzothiazixine-3- carboxamide-1,1-dioxide (CP 14,304), 4 hydroxy-2-methyl-N-2-(3-methyl)-pyridyl-2H-1,2-benzothiazixine-3 -carboxamide- 1,1-dioxide (CP 16,460), piroxicam, meloxicam [corrected], isoxicam, 5-hydroxy piroxicam) to 2% and 4% human serum albumin (HSA) were determined using a modified ultrafiltration process. The binding properties to HSA were characterized by determining the overall binding constant, the apparent binding constant, the slope, the free reaction energy, and the unbound portion of the drug. The following results were obtained: 1. These oxicam derivatives show a high affinity to HSA. The unbound fraction amounts to 1-3%. 2. The affinity of the compounds to HSA decreases in the order mentioned above. 3. Doubling of the HSA concentration reduces the unbound fraction, to the half, with piroxicam being the only exception. PMID- 3264169 TI - Common prevalence of coronary and peripheral vascular disease. PMID- 3264168 TI - Immunosuppressive effects of the macrolide antibiotic bafilomycin towards lymphocytes and lymphoid cell lines. AB - The effects of bafilomycin macrolide antibiotics on primary lymphocytes and on tumor cell lines were investigated. Bafilomycin A markedly suppressed DNA, RNA, and protein synthesis in splenocyte cultures of several inbred mouse strains. Bafilomycins were also inhibitory towards cultures of concanavalin A- or lipopolysaccharide-activated murine spleen cells, and inhibited the mitogen induced differentiation of B lymphocytes into immunoglobulin-secreting plasma cells. Corresponding results were obtained in human cell cultures. A hydrolysis product of the bafilomycin molecule was inactive. Bafilomycin also inhibited the growth of various lymphoid cell lines, the B cell line BCL1, the macrophage cell lines J774 and P338D1, and the T cell line EL4. The sensitivity of the tumor cell lines increased when, simultaneously with bafilomycin, mitogens were applied to the cell cultures. The immunosuppressive action of cyclosporin A could be enhanced by bafilomycin, which could be of importance for the elucidation of the molecular mechanism of T cell suppression, and for applied medical research. PMID- 3264170 TI - [Migraine in the child. Clinical study of 212 patients]. PMID- 3264171 TI - [Pharmacokinetics of methotrexate in children with acute lymphoblastic leukemia]. PMID- 3264172 TI - A unique human immunodeficiency virus culture secreting soluble gp160. AB - A clone of the HUT78 cell line, chronically infected with the HIV-1 isolate HTLV III451, has been demonstrated to secrete unprocessed HIV-1 envelope precursor protein gp160 as well as mature gp120. Further, when grown in serum-free defined medium these cells released approximately five times the amount of virus compared with cultures in normal medium. These proteins corresponded in their immunologic reactivities with the respective envelope proteins of the HTLV-IIIB isolate. They formed high-affinity soluble complexes with the CD4 antigen and inhibited the syncytium formation induced by HTLV-IIIB on CD4-positive cells. This is the first description of an HIV-1 culture system capable of shedding into the medium native gp160 that is soluble in the absence of detergents. PMID- 3264173 TI - [Cerebral blood flow and oxygen metabolism in patients with Parkinson's disease]. AB - The distribution of cerebral blood flow and metabolism is related to neuronal activity. Cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), and oxygen extraction fraction (OEF) in ten patients with Parkinson's disease and five age-matched normal control subjects were measured with positron emission tomography (PET) using 15O2, C15O2 steady state inhalational technique to investigate functional changes of the cortex and the basal ganglia in Parkinson's disease. All patients had no history of cerebrovascular disease and CT scan showed no abnormal findings except for moderate cerebral atrophy in only one patient. When the level of clinical disability was related on the scale of Hoehn and Yahr, one patient was stage I, four were stage II, four were stage III, and one was stage IV. Psychic symptoms which include hallucination, depression, and dementia were recognized in four patients. One of these four patients was mildly demented. Four patients were newly diagnosed and had never been treated with antiparkinsonian medication before. Before the patients had their PET study their antiparkinsonian medication was discontinued for more than three days. But in two patients PET study was performed without discontinuity of antiparkinsonian medication. The values for regional CBF and regional CMRO2 were lower in the patients than in the normal control subjects, especially in the frontal cortex there was a significant decrease of CBF and CMRO2. There was no discrepancy between CBF and CMRO2 both in the patients and the normal control. CBF and CMRO2 in the cortex and the basal ganglia were not correlated with the severity of tremor, bradykinesia, and rigidity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264174 TI - Anticoagulant and membrane effects on humoral and cellular changes during plasmapheresis. AB - Heparin (H) and citrate (C) anticoagulation with cellulose acetate (CA) and polyvinyl chloride (PVC) membrane devices were evaluated on three myasthenia gravis patients. Changes of white blood cell (WBC) and platelet (PLT) counts, complement activation, granulocyte elastase, and interleukin-1 beta (IL-1 beta) were studied sequentially. Changes in WBC and PLT counts were more dependent on the membrane material and surface area. Changes of C3a and C5a were more related to the anticoagulant used, whereas changes of C4a were membrane-material dominant phenomenon. Systemic elastase levels did not show significant differences among the groups but module outlet values were elevated for Ca + H. IL-1 beta did not show changes in all schemes. CA + H was the most activating and PVC + C was the least activating combination. Both the membrane materials and anticoagulant must be considered in evaluating humoral and blood cellular changes in plasmapheresis. PMID- 3264175 TI - Flow cytometric study of immunocompetent cell phenotypes and phagocytosis in CAPD effluent. AB - The immunocompetent cells from peritoneal effluent in 22 stable CAPD patients were studied for surface phenotype distribution and for phagocytic properties by flow cytometry. The following monoclonal antibody couples were employed with direct dual color immunofluorescence: HLA-DR/CD 4, CD 8/CD 11c, Leu 7/CD 16, CD 14/CD 13, and Anti-Leucocyte/CD33. The phagocytic properties of peritoneal macrophages and polymorphs (PMN) were evaluated by the ingestion of 2.02 microns O fluoresceinated microspheres. The same analyses were also performed in peripheral blood. A FACStar laser-operated flow cytometer was employed. A remarkable heterogeneity of CAPD fluid cells was demonstrated, even in the absence of any obvious infection, suggesting the possible occurrence of aborted inflammatory processes. Activated T helper cells, T suppressors (CD8+/CD11+) and Fc gamma+ cells prevailed among lymphocytes, whereas variable amounts of monocytes and PMNs were present. The phagocytic activity of CAPD fluid phagocytes ranged from very depressed to normal values, whereas it was only moderately reduced in blood, suggesting local blocking phenomena, possibly due to interfering metabolites. Flow cytometry is the method of choice for a rapid and accurate analysis of phenotypic and functional properties of cells recovered from various body fluids. This study may be helpful in evaluating local immune response mechanisms in CAPD patients. PMID- 3264176 TI - Response of CAPD patients with a high incidence of peritonitis to intraperitoneal immunoglobulin therapy. AB - This study has demonstrated that in the majority of high-peritonitis-incidence (PI) CAPD patients the defective opsonic activity levels in the peritoneal dialysis effluent (PDE) are restored for 3 weeks by a 12 g IP injection of immunoglobulins (Ig). Further studies showed that in a minority of high-PI CAPD patients who also had low PDE IgG and opsonic activity levels, IP Ig therapy did not significantly reduce the PI. To evaluate this phenomenon we utilized this therapy in 20 high-PI CAPD patients undergoing IP Ig therapy for an average of 24 months daily for 3 weeks (12 g every 3 weeks) and analyzed: 1) PDE IgG levels; 2) PDE opsonic activity; 3) peritoneal macrophage (PM0) membrane-bound IgG; 4) PDE Interleukin-1 (IL-1) levels; 5) PM0 membrane Fc receptor number. The results showed that in the 15 patients in whom Ig therapy reduced PI, there were long lasting increases in the PDE IgG, opsonic activity and IL-1 levels, as well as a normal PM0 Fc receptor number and PM0 reversibly bound infused Ig. Conversely, the five patients in whom the IP Ig did not reduce the PI showed only transient increases in PDE IgG and opsonic activity levels, no PDE IL-1 increase, and the PM0 were deficient in Fc receptors and, therefore, unable to take up the infused Ig. We conclude that in high-PI CAPD patients there are different peritoneal immune defense abnormalities and that their identification is, therefore, important for the correct choice of therapy to improve these defects. PMID- 3264177 TI - Development of an interleukin-2 slow delivery system. AB - The authors developed a slow delivery system for interleukin-2 (IL-2) using highly purified bovine collagen to overcome the rapid clearance and side effects of IL-2; 1 X 10(6) microns of recombinant human IL-2 was successfully infused into needle-shaped "IL-2 mini-pellets". Pharmacokinetic study in C57BL/6 mice revealed that a single subcutaneous injection of an IL-2 mini-pellet could prolong IL-2 retention and decrease maximal concentration in the serum. Elimination half-life was 360 min for subcutaneously injected IL-2 mini-pellets, while it was 8 and 15 min, respectively, for intravenous and subcutaneous injections of aqueous IL-2. No side effects were observed throughout the experiment. This slow delivery system using collagen as a carrier proved to be effective and may be applicable to other kinds of drugs. PMID- 3264178 TI - 'Angina bullosa haemorrhagica: a complication of long-term steroid inhaler use'. PMID- 3264179 TI - Oral blood blisters in angina bullosa haemorrhagica secondary to trauma of eating and dental injection. PMID- 3264180 TI - Ultrastructural studies of a lysosomal enzyme during lymphocyte activation. AB - A post-embedding immunogold technique has been used for the ultrastructural localization of a lysosomal enzyme, beta-glucuronidase, in resting and activated T- and B-lymphocytes. The results presented here show that mitogen-induced stimulation of T- and B-cells was associated with an increase in the amount of enzyme in the Golgi complex and rough endoplasmic reticulum, organelles which were rarely present in the resting lymphocytes. PMID- 3264181 TI - Laboratory animal allergy in a pharmaceutical company. AB - A cross sectional survey was carried out on 138 workers exposed to laboratory animals. Sixty (44%) had symptoms in a self completed questionnaire that were consistent with laboratory animal allergy (LAA) of whom 15 (11%) had chest symptoms. There was a positive skin prick test to one or more animal urine extracts (rat, mouse, guinea pig, rabbit) in 13% and 38% had a positive radioallergosorbent test to urine extract. LAA chest symptoms were almost five times more common in atopic than non-atopic subjects (who were distinguished by skin test response to common, non-animal aeroallergens). A positive skin test to animal urine was associated with LAA chest symptoms and with atopy. Nose, eye, or skin symptoms without chest symptoms were not associated with atopy. There was an inverse relation between duration of employment at the firm and LAA chest symptoms, suggesting selection of affected people out of employment with animals. PMID- 3264182 TI - Smoking, atopy, and laboratory animal allergy. AB - This study examined data from three cross sectional surveys of 296 laboratory workers exposed to small mammals. Four indices of laboratory animal allergy were studied: symptoms suggestive of occupational asthma, symptoms suggestive of any occupational allergy, skin weals to animal urine extracts, and serum binding in radioallergosorbent tests with urine extracts. Pooled data from the three surveys showed an association between smoking and all indices except radioallergosorbent tests; the association was significant for symptoms of occupational asthma. One of the three surveys consistently showed a stronger association of allergy indices with smoking than with atopy (defined on skin tests with non-animal aeroallergens). Associations with smoking persisted after stratifying by atopic status, suggesting that smoking may be a risk factor for laboratory animal allergy. PMID- 3264183 TI - Immunological abnormalities 17 years after accidental exposure to 2,3,7,8 tetrachlorodibenzo-p-dioxin. AB - Eighteen workers were reviewed 17 years after accidental exposure to 2,3,7,8 tetrachlorodibenzo-p-dioxin (dioxin). Clinical assessment showed that they were in good health. A study of several biochemical and immunological parameters in these subjects and in 15 carefully matched controls showed no difference in serum concentrations of hepatic enzymes between exposed workers and controls. Although mean serum concentrations of cholesterol and triglyceride were higher in exposed subjects than in controls, the results did not reach statistical significance. Antinuclear antibodies and immune complexes were detected significantly more frequently in the peripheral blood of workers exposed to dioxin. There was no significant difference between exposed workers and controls in the number of T lymphocytes, B lymphocytes, and helper and suppressor T cell counts in peripheral blood, but the number of natural killer cells identified by the monoclonal antibody Leu-7 was significantly higher in workers exposed to dioxin. PMID- 3264184 TI - Structure-activity relationships of recombinant human interleukin 2. AB - Structure-activity relationships of recombinant human interleukin 2 were investigated by preparation, purification, and characterization of 21 missense mutants. A key role for residue Phe42 in the high-affinity interaction with receptor was indicated by (a) the reduction of 5-10-fold in binding affinity and bioactivity upon mutation of this residue to Ala and (b) the lack of evidence for conformational perturbation in Phe42----Ala in comparison with the wild-type protein as investigated by intrinsic fluorescence, second-derivative UV spectroscopy, electrophoresis, and reversed-phase HPLC, suggesting that the drop in binding is a direct effect of removal of the aromatic ring. In contrast, the conservative mutations Phe42----Tyr and Phe42----Trp did not cause significant reductions in bioactivity. UV and fluorescence spectra indicated approximately 60% overall exposure to solvent of tyrosines in the wild-type molecule, the tryptophan (residue 121) being buried; fluorescence data also showed that Trp42 in Phe42----Trp is likely to be within 1 nm of Trp121 and about 50% exposed to solvent. Phe44----Ala, Cys105----Ala, and Trp121----Tyr also exhibited reduced bioactivity, but these mutants are conformationally perturbed relative to wild type. None of the remaining mutants had detectably reduced bioactivity, even though several showed signs of altered conformation. Four mutants were recovered in very low yield, probably because of defective refolding. PMID- 3264185 TI - Organization of two genes encoding cytotoxic T lymphocyte-specific serine proteases CCPI and CCPII. AB - The genes encoding two recently described cytotoxic T cell proteases, CCPI and CCPII, have been isolated and sequenced. The organizations of the coding and noncoding portions of the two genes are very similar to each other and also to the gene encoding rat mast cell protease type II. Similarly to other serine protease genes, each of the active-site residues is contained on a separate exon; however, two introns were found in particularly interesting positions. One occurs within the postulated activation dipeptide and the other in a position close to the active-site Asp residue. This latter intron interrupts the amino acid sequence in the invariant core region of the protein. We believe that these genes represent a new subfamily of serine protease genes. PMID- 3264186 TI - The Ff gene 5 protein-d(pA)40-60 complex: 1H NMR supports a localized base binding model. AB - The interaction between Ff gene 5 protein (G5P) and d(pA)40-60 serves as an improved model system for a 1H NMR examination of the G5P-ssDNA interface under cooperative binding conditions. Selective deuteriation of aromatic residues enables individual Tyr (3,5)H and (2,6)H resonances to be monitored in spectra of high molecular weight nucleoprotein assemblies. Analysis of complexation-induced chemical shift changes and intermolecular NOEs indicates that Tyr 26 is the only tyrosine to interact directly with ssDNA. Tyr 41, which is immobilized upon binding, is implicated in a dimer-dimer contact role. These and other NMR data are consistent with a previously outlined model of the protein-DNA interface in which Phe 73', Leu 28, and Tyr 26 form components of a base-binding pocket or "dynamic clamp" fringed by a cluster of positively charged residues [King, G. C., & Coleman, J. E. (1987) Biochemistry 26, 2929-2937]. In the present version of this model, the Phe and Leu side chains are proposed to stack on either side of a single base, while there is the possibility that Tyr 26 may H-bond to the sugar phosphate backbone in addition to or instead of stacking. Chemical-exchange effects underscore the dynamic nature of binding at the pocket. A comparison of d(pA)40-60 and oligo(dA)-induced chemical shift changes suggests that poly- and oligonucleotide complexes have indistinguishable base-binding loci but appear to differ in their dimer-dimer interactions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264187 TI - Localization, implications for function, and gene expression of chymotrypsin-like proteinases of cytotoxic RNK-16 lymphocytes. AB - Rat RNK-16 leukemia cells kill YAC-1, which are the cells lysed by rodent natural killer lymphocytes. We found chymotrypsin-like proteinase ('chymase') activity in the RNK-16 dense granules that also contain cytolytic activity. The chymase activity hydrolyzed the thiobenzyl peptide substrate Suc-Phe-Leu-Phe-SBzl and, in comparison to RNK-16 tryptase activity, was selectively inhibited by three different types of serine proteinase inhibitors. The selective inhibitors were the fungal aldehyde chymostatin, the chloromethylketone Z-Gly-Leu-Phe-CH2Cl, and the mechanism-based or 'suicide' inhibitor 7-amino-4-chloro-3-(2 phenylethoxy)isocoumarin. These proteinase inhibitors also blocked RNK-16 granule mediated cytolysis. Chymostatin, a reversible inhibitor, delayed granule-mediated cytolysis, whereas the irreversible chloromethylketone and isocoumarin proteinase inhibitors completely abrogated granule-mediated cytolysis. The two irreversible inhibitors displayed biphasic inhibition of the chymase activity, indicating that at least two chymases are present in the granules. By Northern blot analysis, we found that RNK-16 mRNA hybridized strongly with a cDNA probe of CCPI, a mouse cytotoxic T lymphocyte serine proteinase gene. These data imply that chymase activity in the cytotoxic granules is important for cytolytic function and is likely to belong to a new subfamily of serine proteinases. PMID- 3264188 TI - Lymphatic microcirculation in frog lung. AB - Lymphatic microvessels were microscopically observed on the surface of frog lungs. Magnified images of lymphatic microvessels were recorded on video tapes. The lymphatic microcirculation was studied on a TV monitor at the magnification of 1500 times. 1) valves were observed in lymphatic microvessels, whose diameter was 15 micron, in frog lungs, 2) the valves were incompetent, 3) contained particles repeatedly flowed backwards and forwards in each lymphatic section, 4) after repetition of the movements, particles passed through the outlet valve, 5) particles seldom flowed back through the inlet valve into the preceding section of the lymphatic, 6) the peak flow velocity of particles attained 0.5 mm/sec, and 7) the mean flow velocity was 11 +/- 4 micron on an average and +/- SD, 8) the diameter of a localized portion of the lymphatic microvessels changed periodically. PMID- 3264189 TI - [Isolation and properties of interleukin 1 from human blood monocytes]. AB - Among different tested substances LPS-containing preparations were found to be most effective inducers of secretory interleukin-1 in human peripheral blood monocytes in vitro. IL-1 from supernatant of prodigiozan- + con A-stimulated monocytes had a MM of 18-20 KD and pI of 5.2-5.4 and 6.8 revealing an equal comitogenic activity and of 6.0 (minor peak). PMID- 3264190 TI - Quantification of plasma factor XIIa-Cl(-)-inhibitor and kallikrein-Cl(-) inhibitor complexes in sepsis. AB - Considerable evidence indicates that activation of the contact system of intrinsic coagulation plays a role in the pathogenesis of septic shock. To monitor contact activation in patients with sepsis, we developed highly sensitive radioimmunoassays (RIAs) for factor XIIa-Cl(-)-inhibitor (Cl(-)-Inh) and kallikrein-Cl(-)-Inh complexes using a monoclonal antibody (MoAb Kok 12) that binds to a neodeterminant exposed on both complexed and cleaved Cl(-)-Inh. Plasma samples were serially collected from 48 patients admitted to the intensive care unit because of severe sepsis. Forty percent of patients on at least one occasion had increased levels of plasma factor XIIa-Cl(-)-Inh (greater than 5 x 10(-4) U/mL) and kallikrein-Cl(-)-Inh (greater than 25 x 10(-4) U/mL), that correlated at a molar ratio of approximately 1:3. Levels of factor XII antigen in plasma and both the highest as well as the levels on admission of plasma factor XIIa-Cl(-) Inh in 23 patients with septic shock were lower than in 25 normotensive patients (P = .015: factor XII on admission; P = .04: highest factor XIIa-Cl(-)-Inh; P = .01: factor XIIa-Cl(-)-Inh on admission). No significant differences in plasma kallikrein-Cl(-)-Inh or prekallikrein antigen were found between these patients' groups. Elevated Cl(-)-Inh complex levels were measured less frequently in serial samples from patients with septic shock than in those from patients without shock (P less than .0001). Based on these results, we conclude that plasma Cl(-)-Inh complex levels during sepsis may not properly reflect the extent of contact activation. PMID- 3264191 TI - Interleukin-3 and interleukin-1 alpha allow earlier bone marrow progenitors to respond to human colony-stimulating factor 1. AB - By using human bone marrow cells enriched for early progenitors by selective immunoadsorption and plated at low cell density (10(3) to 10(4) cells/mL/9.6 cm2) in semisolid methylcellulose culture, we have analyzed the cooperative effects of human colony-stimulating factor 1 (CSF-1), granulocyte-macrophage-CSF (GM-CSF), interleukin-1 alpha (IL-1 alpha), and gibbon as well as human recombinant IL-3 on the formation of monocytic colonies. CSF-1 alone stimulated mature monocytic colony formation by human CFU-M. However, in the presence of IL-3 and erythropoietin, CSF-1 stimulated maximal immature monocytic colony formation at low concentrations and inhibited the formation of granulomonocytic, erythrocytic, and mixed colonies. Cultures with CSF-1 and IL-3 contained more immature monocytic colonies than did cultures with CSF-1 alone. IL-1 alpha alone had little effect. However, IL-1 alpha in combination with optimal concentrations of either CSF-1, GM-CSF, or IL-3 increased the number of colonies containing immature or mature monocytic colonies. PMID- 3264192 TI - Clinical response to deoxycoformycin in chronic lymphoid neoplasms and biochemical changes in circulating malignant cells in vivo. AB - Deoxycoformycin (DCF), an adenosine deaminase (ADA) inhibitor, has been shown to be active in lymphoid neoplasms. The mechanism of cytotoxicity might involve accumulation of deoxyadenosine triphosphate (dATP), depletion of the nicotinamide adenine dinucleotide (NAD) and ATP pool, induction of double-stranded DNA strand breaks, or inhibition of S-adenosyl homocysteine hydrolase (SAH-hydrolase). We have investigated the biochemical changes in the circulating malignant cells of patients with chronic leukemia/lymphoma who were treated with DCF (4 mg/m2 weekly). Blood samples were taken from 17 patients with 60% or more circulating leukemic cells before, 4, 24, and 48 hours and five days after the first administration of DCF. Leukemic cells were separated and studied for changes in ADA, dATP, ATP, NAD, and SAH-hydrolase levels and DNA strand breaks and the data analyzed according to clinical response. Inhibition of ADA activity was found in all except one patient at 4 to 24 hours after the first administration of DCF. dATP started to accumulate at four hours, reached a maximum level between 24 and 48 hours, and returned to base values on the fifth day. Intracellular ATP and NAD levels were transiently reduced in some of the patients. However, no correlation between these changes and a clinical response could be found. DNA strand breaks could be studied in 13 patients. A significant increase in DNA breaks at 24 to 48 hours was found in six of the seven responders but only in one of the six nonresponders. At 24 hours, SAH-hydrolase levels were reduced in all seven responders studied, but only in two of the seven nonresponders. The difference in inhibition of SAH-hydrolase was statistically significant (P = .0023). These results suggest that DNA strand breaks and inhibition of SAH-hydrolase correlate with clinical response. PMID- 3264193 TI - Aurin tricarboxylic acid: a novel inhibitor of the association of von Willebrand factor and platelets. AB - Shear stress activated platelets undergo aggregation in the presence of large or unusually large von Willebrand factor (vWF) multimers without the addition of ristocetin or any other exogenous chemical. This phenomenon may be analogous to the platelet aggregation that leads to thrombosis in the narrowed arteries and arterioles of patients with atherosclerosis or vasospasm. A triphenyl-methyl compound, aurin tricarboxylic acid (ATA), inhibits shear-induced, vWF-mediated platelet aggregation in platelet-rich plasma (PRP) in concentrations above 200 mumol/L and in buffer suspensions of washed platelets at a concentration of 0.1 mumol/L. In a concentration-dependent manner, ATA also inhibits ristocetin induced, vWF-mediated platelet clumping in both fresh and formaldehyde-fixed platelet suspensions. This inhibition can be overcome by increasing the concentration of vWF, following the kinetics of first order competitive inhibition. ATA prevents the attachment to platelets of the largest vWF multimeric forms found in normal plasma and of the unusually large vWF multimers derived from endothelial cells. The rate of aggregation and degree of inhibition by ATA is not accounted for by the binding of ristocetin or calcium. Arachidonic acid- and adenosine diphosphate (ADP)-induced aggregation are not inhibited by ATA. Platelets incubated with ATA can be easily separated from the compound. However, ATA binds to large vWF multimeric forms and inhibits their ristocetin induced interaction with platelet glycoprotein Ib. Because ATA also inhibits shear-induced, vWF-mediated platelet aggregation in vitro in the absence of ristocetin, it may be a useful prototype compound to impede the development of arterial thrombosis in vivo. PMID- 3264194 TI - Growth regulation of human acute myeloid leukemia: effects of five recombinant hematopoietic factors in a serum-free culture system. AB - The response of human acute myeloid leukemia (AML) cells to the distinct hematopoietic growth factors (HGFs), ie, recombinant interleukin-3 (IL-3), granulocyte-macrophage-CSF (GM-CSF), granulocyte-CSF (G-CSF), macrophage-CSF (M CSF), and erythropoietin (Epo) was investigated under well-defined serum-free conditions. Proliferative responses to these factors, when added separately as well as in combinations, were analyzed in 25 cases of human AML using 3H thymidine incorporation and colony assays. The 3H-thymidine uptake data revealed that IL-3, GM-CSF, G-CSF, and M-CSF were stimulators of AML proliferation in 19, 15, 13, and 4 cases, respectively. Epo only stimulated DNA synthesis in the cells of the single erythroleukemia case. GM-CSF stimulation was seen only in IL-3 reactive cases and GM-CSF, when combined with IL-3, could not further elevate the DNA synthesis evoked by IL-3 alone. On the other hand, in six cases, G-CSF enhanced the IL-3- or GM-CSF-stimulated thymidine uptake. These results suggest that subpopulations of AML cells that are activated by distinct CSFs (eg, IL-3/GM CSF-responsive cells and G-CSF-responsive cells) coexist. The 3H-thymidine incorporation assay was more sensitive for measuring CSF responses than methylcellulose colony cultures, since activation of DNA synthesis was more frequently seen than induction of colony formation. DNA synthesis experiments revealed eight different CSF response patterns among these 25 cases. CSF phenotyping may be a useful addition to the morphologic classification of AML, since these patterns directly reflect the ability of the proliferating subsets of AML cells to respond to the CSFs. PMID- 3264195 TI - Synergistic factors for stem cell proliferation: further studies of the target stem cells and the mechanism of stimulation by interleukin-1, interleukin-6, and granulocyte colony-stimulating factor. AB - Serial observations of blast cell colony development from spleen cells of mice treated with 5-fluorouracil (5-FU) four days earlier revealed that either form of human interleukin-1 (IL-1 alpha or IL-1 beta) hastens the emergence of interleukin-3 (IL-3)-dependent blast cell colonies. This activity was essentially indistinguishable from the effect of interleukin-6 (IL-6) or granulocyte colony stimulating factor (G-CSF) in the same system, an effect that we have ascribed previously to a shortening of the G0 period of the dormant stem cells. We also analyzed the time courses of colony formation from cultures of day-2 post-5-FU marrow cells supported by IL-1 alpha, IL-6, or G-CSF alone or in combination with IL-3. In the presence of IL-3, G-CSF and IL-6 but not IL-1 alpha hastened the development of colonies and increased the numbers of multilineage colonies relative to cultures of IL-3 alone. This observation, together with our previous data from the human system, suggests that the synergistic effect of IL-1 is likely due to induction of secondary growth factors, including IL-6 and G-CSF, by accessory cells in culture. The effect of IL-6 on G0 was confirmed by analysis of the cycling status of progenitor cells in short-term culture. While neither IL-3 nor IL-6 alone had any effect on the cycling status, the combination of factors resulted in a rapid recruitment of quiescent cells into cell cycle (within 48 hours) as represented by a twofold increase in the numbers of multipotential progenitors and a significant increase in the sensitivity of these cells to 3H thymidine with high specific activity. Combinational testing of all of these synergistic factors revealed that the target cell populations for the IL-1, IL-6, and G-CSF overlap considerably, suggesting that they all may act through a common mechanism. This is further supported by our finding that cells from blast cell colonies grown in the presence of a combination of any one of the synergistic factors with IL-3 replate with higher efficiency and yield more multilineage secondary colonies than those from colonies grown in IL-3 alone. These findings provide further evidence that IL-1, IL-6, and G-CSF serve to integrate the immediate host responses to infection through augmentation of effector cells and antibody production as well as the longer term host responses by recruitment of dormant hemopoietic stem cells into active cell cycling. PMID- 3264196 TI - Failure of recombinant human granulocyte-macrophage colony-stimulating factor therapy in aplastic anemia patients with very severe neutropenia. AB - Four patients with very severe aplastic anemia refractory to antilymphocyte globulin were administered recombinant human granulocyte-macrophage--colony stimulating factor (GM-CSF). One patient with minimal residual myelopoiesis responded transiently to two separate courses of GM-CSF at 4 and 8 micrograms/kg/d administered intravenously and another course at 4 micrograms/kg/d administered subcutaneously. Septicemia and bilateral pneumonia that had been resistant to conventional therapy resolved. Three patients with no evidence of residual myelopoiesis did not respond to GM-CSF. In one patient, the dose was increased to 32 micrograms/kg/d with no effect on hematopoiesis. Immediate side effects were minimal at GM-CSF doses up to 16 micrograms/kg/d. GM CSF may, however, have been involved in the pathophysiology of thrombosis of the inferior vena cava in the patient administered 32 micrograms/kg/d. We conclude that GM-CSF does not induce hematopoiesis in long-standing, severe, treatment resistant aplastic anemia with complete myelopoietic failure. However, in patients with minimal residual myelopoiesis, GM-CSF could be a promising adjuvant therapy for severe infection. PMID- 3264197 TI - Interleukin-1 inhibition of B lymphopoiesis is reversible. AB - Interleukin-1 (IL-1) has multiple effects on the hematopoietic system. The present data demonstrate that IL-1 and/or products induced by it reversibly suppress B-cell differentiation. Upon the addition of 50 U/mL (2.4 ng/mL) of recombinant IL-1 alpha (rIL-1 alpha) to lymphoid long-term bone marrow cultures at their initiation, very few B lymphocytes could be detected, and the majority of cells present were myeloid. This inhibition of B lymphopoiesis did not appear to be due to effects on proliferation of mature B cells because IL-1 did not affect the proliferative response of B cells to form B-cell colonies (CFU-B). The actions of the monokine were further examined by using myeloid and lymphoid long term bone marrow culture systems. The transfer of myeloid long-term bone marrow cultures to lymphoid conditions usually results in the cessation of myelopoiesis and initiation of B lymphopoiesis. Exposure of early B-cell precursors present under the myeloid conditions to 50 U/mL of RIL-1 did not affect their subsequent differentiation into B cells upon transfer of the cultures to lymphoid conditions. However, myelopoiesis was sustained, and B lymphopoiesis did not initiate if 50 U/mL of rIL-1 was added to myeloid bone marrow cultures at the time of their transfer to the lymphoid conditions and during biweekly feedings thereafter. Upon removal of IL-1, myelopoiesis ceased, and B lymphopoiesis initiated. Thus, the effects of IL-1 on inhibition of B lymphopoiesis are reversible. PMID- 3264198 TI - The myeloid blood cell differentiation-inducing protein MGI-2A is interleukin-6. AB - The mouse myeloid blood cell differentiation-inducing protein, macrophage and granulocyte inducer, type 2A (MGI-2A), was purified, and the amino acid sequence of a CNBr cleavage peptide (22 residues) was determined. This amino acid sequence is identical to the sequence found in positions 73 to 94 of mouse interleukin-6 (IL-6). Recombinant mouse IL-6 protein induces differentiation of mouse myeloid leukemic cells that are induced to differentiation by MGI-2, and monoclonal antimouse-MGI-2 antibody, which neutralizes MGI-2, also completely neutralizes this IL-6-induced differentiation. These results show that the major type of mouse myeloid differentiation-inducing protein (MGI-2A) and IL-6 are very similar and most likely identical proteins. Recombinant human IL-6 (also called interferon-beta 2 or B-cell differentiation factor), which shows only a 41% similarity to mouse IL-6, has 11 identical amino acid residues out of the 22 in the mouse MGI-2A peptide and also induces differentiation of the same myeloid leukemic cells. PMID- 3264199 TI - Effects of recombinant human granulocyte colony-stimulating factor on hematopoietic progenitor cells in cancer patients. AB - Hematopoietic progenitor cell levels were monitored in the peripheral blood and bone marrow of 30 cancer patients receiving recombinant human granulocyte-colony stimulating-factor (rG-CSF) in a phase I/II clinical trial. The absolute number of circulating progenitor cells of granulocyte-macrophage, erythroid, and megakaryocyte lineages showed a dose-related increase up to 100-fold after four days of treatment with rG-CSF and often remained elevated two days after the cessation of therapy. The relative frequency of different types of progenitor cells in peripheral blood remained unchanged. The frequency of progenitor cells in the marrow was variable after rG-CSF treatment but in most patients was slightly decreased. The responsiveness of bone marrow progenitor cells to stimulation in vitro by rG-CSF and granulocyte-macrophage colony-stimulating factor did not change significantly during rG-CSF treatment. In patients nine days after treatment with melphalan and then rG-CSF, progenitor cell levels were very low with doses of rG-CSF at or below 10 micrograms/kg/d, but equaled or exceeded pretreatment values when 30 or 60 micrograms/kg/d of rG-CSF was given. PMID- 3264200 TI - EGF binding is quantitatively related to growth in node-positive breast cancer. AB - Number of mitoses and EGF binding were determined in parallel in biopsies of 27 lymph-node positive and of 23 lymph-node negative breast cancer patients. For node-positive patients the parameters for cell growth and EGF binding were quantitatively correlated by the equation y = P3 + P1(1- exp(- P2x]. For node negative cases neither the non-linear model nor the linear approximation described the data unambiguously. The results strongly suggest that in node positive patients, growth of breast cancer is related to an EGF-dependent acceleration of cell division. PMID- 3264201 TI - Interaction between GABAergic neurotransmission and rat hypothalamic corticotropin-releasing hormone secretion in vitro. AB - Corticotropin-releasing hormone (CRH) has been considered a major coordinator of the overall physical and behavioral response to stress. Moreover, prolonged hypersecretion of CRH has been implicated in the pathogenesis of disorders characterized by anxiety and/or depression. Drugs acting through the gamma aminobutyric acid/benzodiazepine (GABA/BZD) receptor system have anxiolytic and/or antidepressant properties whereas benzodiazepine inverse agonists cause anxiety and stimulate the pituitary-adrenal axis in vivo. To examine the involvement of the GABA/BZD system in the regulation of hypothalamic CRH secretion, we studied the effects of various agonists and antagonists of GABAA and GABAB receptors using a sensitive rat hypothalamic organ culture with radioimmunoassayable CRH (IR-rCRH) as endpoint. The GABAA and GABAB receptor agonist GABA inhibited serotonin (5-HT)-induced IR-rCRH secretion from 10(-9) to 10(-6) M, but failed to do so at 10(-5) M. The GABAA receptor agonist muscimol was a weak inhibitor of 5-HT-induced IR-rCRH secretion, being effective only at the concentration of 10(-6) M. In contrast, the specific GABAB receptor agonist baclofen was able to inhibit 5-HT-induced IR-rCRH secretion from 10(-7) to 10(-5) M. The rank of potency was thus, GABA much greater than baclofen greater than muscimol. Bicuculline, a GABAA receptor antagonist, partially reversed the inhibitory effects of GABA. Diazepam, a classic benzodiazepine which interacts with the benzodiazepine-site of the GABAA receptor complex, inhibited 5-HT induced IR-rCRH secretion from 3.3 X 10(-9) to 10(-5) M, an effect that could be reversed by the BZD inactive ligand Ro15-1788.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264202 TI - [Determination of T lymphocyte subpopulations and their relation to HLA antigens in type 1 diabetes mellitus]. PMID- 3264203 TI - Caries experience, dental health behaviour and social status. A comparative study among Danish military recruits in 1972 and 1982. PMID- 3264204 TI - Comparison of whole-cell protein electrophoretic profiles of Haemophilus influenzae: implementation of a microcomputer mainframe linked system and description of a new similarity coefficient. AB - A microcomputer mainframe linked system is described which allows video camera data capture and storage of one-dimensional whole-cell protein electrophoresis gel images, processing of normalized traces to produce a similarity matrix, and analysis of the matrix using the commercial cluster analysis program CLUSTAN. A new similarity coefficient is introduced which takes into account both band position and intensity. Forty-five strains of Haemophilus influenzae, including the eight biotypes and six serotypes, were analyzed using this system. Results demonstrated groupings which are consistent with known genetic relationships. PMID- 3264205 TI - [Results of aortocoronary bypass surgery: long-term clinical and functional evaluation of patients surviving the operation. Personal experience]. PMID- 3264206 TI - Intermittent coronary sinus occlusion in humans: pressure dynamics and calculation of diagnostic quantities. AB - Pressure controlled intermittent coronary sinus occlusion (PISCO) was applied in 30 patients undergoing coronary artery bypass surgery. The occlusion and release times were manually adjusted according to visual control of the intraoperatively monitored coronary sinus pressure. In six patients the coronary sinus measurements were additionally digitised with a personal computer before postoperative mathematical analysis, which comprised automatic detection of systolic peaks, diastolic troughs, and the calculation of derived quantities. The purpose of the analysis was (a) to assess quantitatively human coronary sinus pressure dynamics, (b) to determine whether visual control and interpretation of coronary sinus pressure rise could be replaced by a mathematical model, and (c) to ascertain whether the occlusion and release cycle lengths were adequate. Numerical estimates for intraindividual and interindividual spread of calculated quantities were produced, the mathematically obtained results were related to a possible physiological interpretation, and the most efficient method of statistical analysis was ascertained. These results form the numerical basis for a closed loop adjustment of pressure controlled intermittent coronary sinus occlusion cycling. PMID- 3264207 TI - Immunoarchitecture of regenerated splenic transplants: influence of donor and host age on the regeneration of splenic compartments. AB - Inbred rats were used as a model to determine the influence of the age of the implanted splenic tissue and the age of the host on the structure of transplanted splenic tissue. Monoclonal antibodies against lymphocyte, macrophage and dendritic cell subsets were used to evaluate the different compartments of the spleen. Adult rats received implants from adult, weanling or fetal rats, weanling rats received splenic tissue from adult, weanling or fetal rats and neonatal rats received neonatal or fetal spleens. There were major differences in the structure and cellular composition of the regenerated splenic tissue. The younger the recipients and the donor spleens, the better the normalization of the splenic compartments and the less fibrous tissue was found 3 months after transplantation. The follicles regenerated in all transplants, but the marginal zone was only normally developed in wealing and neonatal hosts. The periarteriolar lymphatic sheath regenerated in a similar manner to the marginal zone. Whenever a compartment developed, its cellular composition was the same as in a normal spleen. The immunohistological techniques enabled splenic regeneration to be characterized revealing a far from normal histological splenic structure in many age groups. These findings suggest that splenic regeneration in children might result in splenic tissue with normal compartments, which would be in contrast to some data in adults. PMID- 3264208 TI - Immunocytochemical analysis of calcitonin gene-related peptide and vasoactive intestinal polypeptide in Merkel cells and cutaneous free nerve endings of cats. AB - Calcitonin gene-related peptide (CGRP)- and vasoactive intestinal polypeptide (VIP)-immunoreactivity were observed to coexist in Merkel cells of cats. No differences in peptide content were found between Merkel cells located in epithelia of the hard palate, in hairy and glabrous skin of the upper lip, and in vibrissae follicles. CGRP- and VIP-immunoreactive nerve fibres were also found near CGRP/VIP-immunoreactive Merkel cells. In the vibrissae follicles some CGRP- and VIP-immunoreactive nerve terminals end abutting on the glassy membrane. Other CGRP-immunoreactive nerve fibres penetrate the epithelium of the skin and end within it. Electron microscopy of vibrissae follicles revealed that Merkel cell neurites are not immunostained and that immunostained nerve fibres form unmyelinated bundles before ending freely. Thus, CGRP- and VIP-immunoreactive nerve fibres in cat skin do not end as Merkel cell neurites but as different kinds of free nerve endings. PMID- 3264209 TI - Development of follicular dendritic cells in lymph nodes of B-cell-depleted mice. AB - We have studied follicular dendritic cells (FDC) in lymph nodes of normal and thymus dysgeneic nude mice depleted of B-cells by chronic treatment with anti-IgM antibodies. We found that B cell depletion was accompanied by the absence of mature FDC as defined morphologically at the ultrastructural level. Only precursor FDC (p-FDC) could be demonstrated. Upon release of B-cell suppression, the repopulation of lymph nodes with B-cells was associated with the reappearance of fully differentiated FDC in primary follicles of nude mice and in secondary follicles of T-cell competent mice. We conclude that mature B-cells and/or B-cell products are required for the development of mature follicular dendritic cells in the mouse lymph node. PMID- 3264210 TI - Interaction between thymocytes and thymus-derived macrophages. I. Surface components participating in mutual recognition. AB - Incubation of C57BL/6 thymus-derived macrophages (TDM phi) with syngeneic thymocytes resulted in binding of thymocytes to macrophages and rosette formation. Up to 60% of the TDM phi formed rosettes with thymocytes after 6 hr of interaction at 4 degrees C. Rosette formation of the immature PNA+ thymocyte fraction was up to fivefold higher than that of PNA- and cortisone-resistant thymocytes. Pretreatment of PNA- thymocytes with neuraminidase enhanced thymocyte binding to macrophages up to sevenfold, whereas a marked reduction of rosette formation was seen following (1) incubation of thymocytes with tunicamycin; (2) incubation of macrophages with 20 mM D-galactose, GLCNaC, or GalNaC; (3) treatment of macrophages or thymocytes with trypsin; (4) treatment of macrophages with anti-1-Ab mAb and its F(ab')2 fragment; (5) treatment of thymocytes with anti-Lyt-2.2 mAb; and (6) addition of EDTA and EGTA to the interacted two cell populations. PMID- 3264211 TI - Interaction between thymocytes and thymus-derived macrophages. II. Engulfment of thymocytes by macrophages. AB - A high percentage (80-90%) of immature thymocytes were engulfed by syngeneic thymus-derived macrophages (TDM phi) following cocultivation for 3 days. Elimination occurred via internalization of thymocytes by the macrophages. We unequivocally demonstrated the presence of many live thymocytes inside the TDM phi by means of specific staining. Mature PNA- thymocytes were phagocytized to a lower degree than immature thymocytes, and T splenocytes were not eliminated at all. Bone marrow-derived macrophages internalized immature thymocytes to a degree similar to TDM phi. Since thymocyte survival was not at all affected by M phi culture supernatants alone, we conclude that cell to cell contact is necessary for thymocyte elimination. To identify the surface molecules which participate in internalization of thymocytes by the macrophages, both cell types were pretreated with a variety of agents. Treatment of thymocytes with tunicamycin (N glycosylation inhibitor) and anti-Lyt-2 mAb decreased their elimination by M phi. Similarly, treatment of M phi with neuraminidase, trypsin, and anti-Ia mAb markedly suppressed their capacity to engulf thymocytes. On the other hand, thymocyte elimination was unaffected by (1) cell cultivation in syngeneic serum rather than heterologous serum; (2) use of allogeneic rather than syngeneic thymocytes; and (3) use of X-irradiated M phi and LPS-activated M phi rather than nontreated M phi. PMID- 3264212 TI - A phenotypic and functional analysis of long-lived B and T lymphocytes. AB - The lymphocyte composition of spleen, lymph nodes, bone marrow, and thymus of mice submitted to hydroxyurea treatments for four consecutive days was studied. The treatment selects for small lymphocyte populations that represent between 4 and 20% of control numbers in the various organs. Spleen and bone marrow contain the same B cell population with a low IgM, high IgD, low I-E phenotype, which respond to LPS at control clonal frequencies. The T cell compartment is equally depleted, and the lymphocytes remaining contain frequencies of clonable cells in response to mitogens and IL-2 that are comparable to those detected in normal spleen cells. Overall, the results suggest that only a minor fraction of all lymphocytes in a normal young adult mouse have life spans longer than 4 days. PMID- 3264213 TI - Dissociation of TPA-induced down-regulation of T cell antigens from protein kinase C activation. AB - The tumor promotor 12-O-tetradecanoylphorbol-13-acetate (TPA) has diverse effects on lymphoid cell function. Two of the early effects were the induction of early activation antigen EA1 and the down-regulation of certain T cell differentiation antigens (CD3, CD4, CD7). The mechanisms of these TPA effects were investigated. It was confirmed that EA1 expression was dependent on protein kinase C (PKC) activation. Synthetic diacylglycerols were capable of inducing EA1 expression. In addition, inhibition of PKC by the kinase inhibitor, H7, led to the inhibition of EA1 expression induced by TPA and synthetic diacylglycerols. In contrast, down regulation of T cell differentiation antigens by TPA was not dependent on PKC activation. Synthetic diacylglycerols did not induce down-regulation of T cell antigens and H7 had no effect on the down-regulation of T cell antigens induced by TPA. These data would suggest that TPA exerted its effects on T cell function by mechanisms in addition to the activation of PKC alone. One possible mechanism would be the activation of the calmodulin-dependent pathway(s) since its inhibition resulted in the reversal of TPA-induced down-regulation of the T cell differentiation antigens. PMID- 3264214 TI - Studies on the influence of the internal environment on autoantibody production by B cells. AB - Purified splenic B cells from autoimmune NZB and nonautoimmune DBA/2 mice were transferred to unmanipulated H-2 compatible xid recipients. The number of autoantibody-secreting clones present in recipient mice was quantitated at varying times after transfer using a splenic fragment assay. We found that NZB and DBA/2 B cells expanded equally well in equivalent xid environments. Cells from either donor expanded significantly better in autoimmune-prone NZB.xid as compared with DBA/2.xid recipients. Moreover, clones producing antibodies reactive with T cell surface antigens, bromelain-treated mouse red cells, or DNA expanded more rapidly than did cells producing antibodies to the nonautoantigen TNP-KLH. Serum autoantibody levels rose in concert with the increased numbers of autoantibody-producing lymphocytes. We conclude that factors present in the internal milieu of autoimmune-prone NZB.xid mice, rather than an intrinsic B cell defect, facilitate the expansion of (auto)antibody-secreting B cells. PMID- 3264215 TI - Effect of growth and differentiation stimuli on the development of antigen responsive B cells in fetal liver. AB - The development of the B cell immune repertoire was studied using an in vitro fetal organ culture system. In order to analyze the mechanism by which B cell precursors clonally expand and diversify, fetal lymphoid tissues were incubated in the presence of several factors known to influence B cell differentiation: IL 1, IL-2, WEHI-3 culture supernatant containing IL-3, and a factor from a cyclic neutropenia patient (CNF). By analyzing the effect of exogenous factors on the frequency of antigen-responsive B cells, the ability of the factor to either inhibit or enhance clonal expansion was determined. It was found that the addition of IL-1, WEHI-3 supernatant, or CNF increased the frequency of DNP responsive B cells suggesting an enhancement of clonal expansion. IL-2, on the other hand, did not alter the frequency of antigen-responsive B cells. The effect of added factors on the kinetics of appearance of phosphorylcholine (PC) responsive B cells, which are known to be acquired in ontogeny about 2 weeks later than DNP-responsive B cells, was also analyzed. The data indicate that CNF, unlike IL-1, IL-2, and WEHI-3 culture supernatant, results in an earlier appearance of PC-responsive B cells. These results suggest that soluble factors may play a role in the generation of the B cell repertoire. PMID- 3264216 TI - CD4+ CD8+ cells are rare among in vitro activated mouse or human T lymphocytes. AB - The predominant cell type in the thymus expresses both of the function-associated T cell surface markers, CD4 and CD8, but CD4+ CD8+ cells are rare or absent outside the thymus. Double expression has therefore been assumed to be an indication of immaturity. However, recent reports have suggested that CD4+ CD8+ cells can appear in cultures of activated mature cells. We have therefore activated human peripheral blood lymphocytes and mouse spleen cells, lymph node cells, and cortisone-resistant thymocytes using a number of different stimulation regimes, and we have analyzed them at various times for CD4 and CD8 expression. In all cases, upon analysis of cultured cells by flow cytometry, CD4+ CD8+ cells were rare. A combination of microscopic analysis, cell sorting followed by microscopic analysis, and careful staining controls demonstrated that even when flow cytometry showed some CD4+ CD8+ cells, most of these were artifacts in the form of doublets or clumps of single positive cells or dead cells. Taking this into account, CD4+ CD8+ cells made up less than 1% in the mouse and less than 3% in the human T cell cultures at any time periods. We therefore found no evidence for the generation of large numbers of CD4+ CD8+ cells in cultures of mouse or human T cells. PMID- 3264218 TI - Impaired proliferation response after PDGF induction in fibroblasts from Hutchinson-Guilford Progeria syndrome. AB - Fibroblasts from a Hutchinson-Guilford Progeria Syndrome (HGPS) patient were compared to normal human fibroblasts to determine if differences existed in growth factor mediated cell proliferation. Cultures of progeric fibroblasts were exposed individually to platelet-derived growth factor (PDGF), epidermal growth factor (EGF), platelet poor plasma (PPP) and fetal bovine serum (FBS). Autoradiographic studies using 3H thymidine showed that progeric fibroblasts had similar labeling indices relative to controls after exposure to FBS and EGF. In contrast, progeric cells made competent with PDGF and later treated with 5% PPP had a significantly lower labeling index. This and preliminary observations on fos RNA accumulation suggests the possible existence of a genetic defect in HGPS fibroblasts. PMID- 3264217 TI - Lipopolysaccharide-induced murine B cell proliferation: a role of protein kinase C. AB - Lipopolysaccharide (LPS)-induced murine B cell proliferation was blocked by 1-(5 isoquinoline-sulfonyl)-2-methylpiperazine dihydrochloride (H7), an inhibitor of protein kinase C (PKC), in a dose- and time-dependent manner. The maximum inhibition of B cell proliferation was observed when H7 was added at the initiation of cultures. H7-induced inhibition was prolonged and irreversible. Furthermore, pretreatment of B cells with phorbol myristate acetate ester, a process that degrades membrane-associated PKC, rendered them unresponsive to LPS. These data strongly suggest that the activation of PKC is one of the mechanisms of LPS-induced murine B cell proliferation. PMID- 3264219 TI - [Gardnerella vaginalis in relation to the clinical syndrome of bacterial vaginosis]. PMID- 3264220 TI - [Comparative study of the rat paw edema test for evaluating the reactivity of combined vaccines containing a pertussis component]. PMID- 3264221 TI - [Vaccination of children with reactions to mixed vaccine against diphtheria, tetanus and whooping cough]. PMID- 3264222 TI - [Recurrent disease within the framework of serum immunoglobulin levels and anti proteinase activity in 6-year-old children]. PMID- 3264223 TI - [Comparative studies on the roots of wild and cultured Bupleurum chinense DC]. PMID- 3264224 TI - [Antipyretic and analgesic constituents of the leaves of Populus tomentosa Carr]. PMID- 3264225 TI - Neopterin estimation compared with the ratio of T-cell subpopulations in persons infected with human immunodeficiency virus-1. AB - We measured neopterin, a biochemical indicator for the activation of cell mediated immune reactions, in urines from 105 individuals at risk of infection with human immunodeficiency virus-1 (HIV-1), 83 of whom were seropositive for antibody to HIV-1. We compared absolute numbers of T-cell subsets (CD4+ helper/inducer T-cells, CD8+ suppressor/cytotoxic T-cells), and the ratio of CD4+ T-cells to CD8+ T-cells with the urinary neopterin concentrations. Concentrations of neopterin in urine were inversely correlated with absolute numbers of CD4+ T cells and with CD4+/CD8+ ratios in anti-HIV-1 seropositive subjects but not in those seronegative. Various statistical comparisons of the data further demonstrated that neopterin concentrations showed larger differences between anti HIV-1 seronegative and seropositive subjects than absolute numbers of CD4+ T cells or CD4+/CD8+ ratios. These results seem to indicate that neopterin concentrations increase earlier in the course of HIV-1 infection, before effects on T-cell subpopulations are detectable, and may further support the suggestion that neopterin measurement could be of use for monitoring infected subjects or predicting the progression of disease. PMID- 3264226 TI - Lactate dehydrogenase isoenzyme-1 in serum for detection of peri-operative myocardial infarction after cardiac surgery. AB - We prospectively studied changes in serum lactate dehydrogenase isoenzyme-1 (LD 1, EC 1.1.1.27) in 99 consecutive patients after either coronary artery bypass grafting (CABG, n = 61), isolated cardiac-valve replacement (n = 24), or the two procedures combined (n = 14); 86 of these had no clinical evidence of peri operative myocardial infarction (MI). Blood was sampled immediately after surgery and at 6-h intervals for up to 42 h thereafter. LD-1 was isolated by using the LD M-subunit antiserum. Samples from the non-MI patients were used to establish the reference intervals for LD-1. By 24 h after surgery, mean serum LD-1 values were higher (P less than 0.001) in non-MI patients who underwent isolated valve replacement (222 +/- 74 U/L) or combined CABG and valve replacement (266 +/- 58 U/L) than in 50 non-MI patients who underwent CABG alone (134 +/- 42 U/L). Separate reference intervals were determined for CABG and other patients at each sampling time. By 24 h after operation, LD-1 exceeded these reference intervals in the 10 CABG and two combined-procedure patients in whom other evidence of MI was present. Measurement of LD-1 24 to 42 h after cardiac surgery appears to be a useful test for the diagnosis of perioperative MI. PMID- 3264227 TI - Age-related changes in factor VII activation in healthy women. AB - 1. To investigate the age-related changes in factor VII activation in healthy women, a regular factor VII clotting assay (factor VIIc) was carried out simultaneously with a new enzyme immunoassay for the quantification of antigen factor VII (factor VIIag). 2. Both factor VIIc and factor VIIag levels were positively correlated with age (r = 0.79 and r = 0.62, respectively, n = 25, P less than 0.001). The rise with age in factor VIIc was steeper than in factor VIIag and the ratio of factor VIIc to factor VIIag (an indicator of the activity state of factor VII) increased with age (r = 0.42, P less than 0.05). 3. The results show that an increased conversion of native single-chain factor VII to the fully active double-chain form is associated with advancing age in women. 4. This finding is consistent with a possible role of activated factor VII in the pathogenesis of thrombo-occlusive vascular disease in women. PMID- 3264228 TI - Frog liver dolichols: separation and quantitative determination related to seasonality. AB - 1. The liver of female frogs shows a significantly higher dolichol content in May (134 micrograms/g) than in November (90 micrograms/g). The male frog liver (134 micrograms/g May; 119 micrograms/g November) does not show any significant change. 2. The rat liver does not show any significant change in dolichol content from May to November (30 micrograms/g). 3. The dolichyl-phosphate level was the same in male and female frog livers and in the rat liver. 4. Data is given of the distribution of dolichols according to the number of their isoprene residues. PMID- 3264229 TI - Isozymes of alpha-amylase in the porcine pancreas: population distribution. AB - 1. Three isozymes of pancreatic alpha-amylase, PPA 1, PPA 2, and PPA 3, were observed in a porcine population of 50 animals. 2. Isozyme PPA 2 was common to each pancreas. 3. Three phenotypic patterns were described as: (A) consisting of PPA 2 alone (20%); (B) consisting of PPA 1 and PPA 2 (78%); and (C) consisting of all three forms (2%). 4. Amylase isozymes were separated by anion exchange chromatography using DE53. 5. Individual isozymes corresponded to one of the three isozymes found in pancreatin. 6. Individual isozymes were inhibited equally by an amylase inhibitor from wheat. 7. Differences in amylase isozymes were attributed to genetically controlled mechanisms and not to artifacts of isolation. PMID- 3264230 TI - SPECT imaging of moyamoya disease using 99mTc-HM-PAO. Comparison with computed tomography findings. AB - 99mTc-HM-PAO was used to evaluate regional cerebral blood flow in a 26-year-old woman with Moyamoya disease. This patient had an 18-month history of recurrent neurologic deficits and had angiographic evidence of Moyamoya disease. She had used oral contraceptives and cigarettes, but had no other risk factors for stroke. Single photon emission computed tomographic images showed bilateral and asymmetric reductions in blood flow to anterior and lateral brain regions. These findings correlated better with clinical symptomatology and suggested more extensive brain involvement than did computed tomography. PMID- 3264232 TI - [Postpartum bleeding in intrahepatic cholestasis of pregnancy]. PMID- 3264231 TI - Soluble interleukin-2 receptor levels in patients with non-Hodgkin's lymphoma or with acute leukemia. AB - Enzyme-linked immunoabsorbent assay was used to study the serum levels of soluble interleukin-2 receptor (sIL-2R) in 30 patients with non-Hodgkin's lymphoma (NHL) (19, active disease; 11, complete remission) and 26 patients with acute leukemia (AL) (14, active disease; 12, complete remission). Thirty healthy age-matched volunteers were used as normal controls. The mean values of serum sIL-2R in NHL with active disease and complete remission (CR) were 1043 +/- 108 units/ml and 635 +/- 118 units/ml, respectively; these values are significantly higher than those in normal controls; 220 +/- 30 units/ml (p less than 0.001 and p = 0.001, respectively). The mean values of serum sIL-2R in AL with active disease and CR were 726 +/- 119 units/ml and 363 +/- 61 units/ml, respectively which were also significantly higher than those in the normal group (p less than 0.001 and p = 0.023 respectively). Comparing the active state with CR state in both diseases, sIL-2Rs in the latter state were significantly lower than those in active disease. Serum sIL-2R level might be a parameter of disease activity in NHL and AL. PMID- 3264233 TI - [Transvenous catheter ablation of a left-sided accessory pathway via coronary sinus in Wolff-Parkinson-White syndrome]. PMID- 3264234 TI - [Post-operative massive hemorrhage in acute necrotizing pancreatitis]. PMID- 3264235 TI - [Diagnosis and intraoperative localization of vascular abnormalities of the colon]. PMID- 3264237 TI - [Perioperative changes of complement (C1q, C3, C4) with cardiopulmonary bypass]. PMID- 3264236 TI - Primary lymphoma of the liver showing immunohistochemical evidence of T-cell origin. Successful management by right trisegmentectomy. AB - Primary malignant lymphomas of the liver are extremely rare. Thus far, 28 cases (1-13) of this entity have been described, but after careful clinical and histological staging, no other sites of extrahepatic involvement were demonstrated in 17 of these cases (2,3,5-13). We recently had the opportunity to investigate and manage a case of true primary malignant peripheral T-cell lymphoma of the liver in a 22-year-old man. To our knowledge this is the first reported case of a primary T-cell lymphoma of the liver. The patient was successfully treated with a right trisegmentectomy and no tumor recurrence has appeared after five years. PMID- 3264238 TI - Regulation of ovarian cell growth through the local production of transforming growth factor-alpha by theca cells. AB - The rapid proliferation of a tissue often requires the local production of a specific growth factor. The ovarian follicle is a rapidly growing tissue which contains two primary somatic cell types, granulosa cells and theca cells. Theca cells and granulosa cells were isolated from bovine ovaries and cultured to assess the possible local production of a growth factor within the ovarian follicle. Serum-free conditioned medium from theca cells, but not from granulosa cells, was found to contain a component that specifically bound to the epidermal growth factor (EGF) receptor. Therefore, theca cells appear to produce an EGF like substance as a potential regulator of follicle cell growth. This result provides physiological significance to the previous observation that granulosa cells contain EGF receptors and respond to EGF to increase cell proliferation. Transforming growth factor-alpha (TGF alpha) is a protein that is structurally and functionally related to EGF and binds to the EGF receptor. Using a molecular probe to TGF alpha, theca cells were found to express the TGF alpha gene, which is consistent with the presence of an EGF-like substance in conditioned medium, but granulosa cells had no detectable TGF alpha gene expression. Similar analysis with a molecular probe to EGF demonstrated the apparent lack of EGF gene expression in theca cells or granulosa cells. As previously demonstrated with granulosa cells, the data presented indicate that theca cells also contain high affinity EGF receptors. TGF alpha was found to stimulate the growth of both granulosa and theca cells. These observations imply that within the ovarian follicle TGF alpha is produced by theca cells, which can subsequently have both a paracrine and an autocrine role in regulating follicle cell proliferation. Results presented demonstrate production of TGF alpha by a normal adult mesenchymal tissue and provide an example of a growth factor-mediated mesenchymal epithelial cell interaction between theca cells and granulosa cells. PMID- 3264239 TI - The preovulatory prolactin surge: an evaluation of the role of dopamine. AB - This study examined the contribution of dopamine (DA) to the control of PRL secretion during the preovulatory PRL surge. Immature female rats were injected with PMSG on day 28. At selected times during the periovulatory period, rats were injected with different pharmacological agents, and jugular blood was collected at frequent intervals. Blood PRL levels in vehicle-treated rats were low on the morning of day 30, rose 15- to 20-fold to peak levels from 1400-1500 h, were maintained at a plateau from 1900-2300 h, and were reduced to basal levels on the morning of day 31. Haloperidol, a DA antagonist, induced a 20-fold rise in PRL before the surge, a 2-fold rise above peak PRL levels at 1500 h, and a 50-fold rise on the morning of day 31. In contrast, haloperidol failed to alter PRL release during the plateau phase. Apomorphine, a DA agonist, reduced PRL levels when injected during either the peak or the plateau phase. Injection of 5 hydroxytryptophan, a serotonin precursor, increased PRL levels at all times examined. Anterior pituitary PRL content was reduced to 30% and 10% of the presurge level during the peak and plateau phases, respectively, but increased on the morning of day 31. Basal PRL release by hemipituitaries incubated in vitro paralleled the anterior pituitary PRL content, with markedly less PRL secreted during the peak and plateau phases compared to the presurge period. However, the percent inhibition of PRL release by hemipituitaries incubated with 50 nM DA was similar at all times tested. These data indicate that the peak PRL surge occurs in spite of DA input to the anterior pituitary, a continued responsiveness to DA inhibition, and a diminishing pituitary PRL content. We conclude that a nondopaminergic mechanism, possibly involving a PRL-releasing factor, is responsible for the peak. The plateau phase probably results from an absence of DA input to the anterior pituitary together with a reduction in the releasable pool of PRL. The termination of the PRL surge is caused by the restoration of DA input. PMID- 3264240 TI - Direct effects of 1,25-dihydroxyvitamin D3 and 24,25-dihydroxyvitamin D3 on growth zone and resting zone chondrocyte membrane alkaline phosphatase and phospholipase-A2 specific activities. AB - 1,25-Dihydroxyvitamin D3 [1,25-(OH)2D3] and 24,25-(OH)2D3 differentially affect the specific activity of alkaline phosphatase (ALPase) and phospholipase-A2 (PLA2) of plasma membranes and extracellular matrix vesicles produced by costochondral reserve zone and growth zone cartilage chondrocytes in culture. In the present study, growth zone and cartilage and reserve zone matrix vesicles and plasma membranes were isolated from confluent chondrocyte cultures and incubated with hormone for 3 and 24 h in vitro. Addition of 1,25-(OH)2D3 to GC matrix vesicles and plasma membranes resulted in dose-dependent increases in ALPase and PLA2 specific activities in both membrane fractions. Addition of 24,25-(OH)2D3 to RC membrane fractions stimulated matrix vesicle ALPase at 10(-7) and 10(-8) M and plasma membrane ALPase at 10(-8) M only. However, 24,25-(OH)2D3 inhibited matrix vesicle and plasma membrane PLA2 activity. The effects of the vitamin D metabolites were noticed after both 3 and 24 h. Neither hormone metabolite had any effect on these enzymes in membrane fractions from cultures of neonatal rat muscle mesenchymal cells, which do not calcify their matrix in vivo. These data suggest that 1,25-(OH)2D3 and 24,25-(OH)2D3 can directly affect chondrocyte membrane enzymes without genomic influence or protein synthesis and that membrane response depends on the stage of chondrocyte differentiation. Changes in PLA2 activity may change membrane fluidity and may be a mechanism by which the hormones affect cell membranes. PMID- 3264241 TI - Chemical structure of the lipopolysaccharide of Haemophilus influenzae strain I 69 Rd-/b+. Description of a novel deep-rough chemotype. AB - The chemical structure of the lipopolysaccharide of a deep-rough mutant (strain I 69 Rd-/b+) of Haemophilus influenzae was investigated. The hydrophilic backbone of lipid A was shown to consist of a beta-(1',6)-linked D-glucosamine disaccharide with phosphate groups at C-1 of the reducing D-glucosamine and at C 4' of the non-reducing one. Four molecules of (R)-3-hydroxytetradecanoic acid were found directly linked to the lipid A backbone, two by amide and two by ester linkage (positions 2,2' and 3,3', respectively). Laser-desorption mass spectrometry showed that both 3-hydroxytetradecanoic acids linked to the non reducing glucosamine carry tetradecanoic acid at their 3-hydroxyl group, so that altogether six molecules of fatty acid are present in lipid A. The lipopolysaccharide was the first described to contain only one sugar unit linked to lipid A. This, sugar in accordance with a previous report [Zamze et al. (1987) Biochem. J. 245, 583-587], was shown to be a dOclA phosphate. The phosphate group was found at position 4, but the analytical procedures employed (permethylation and methanolysis followed by gas-liquid chromatography/mass spectrometry) also revealed dOclA 5-phosphate. Since a cyclic 4,5-phosphate could be ruled out by 31P-NMR, we conclude that, in this lipopolysaccharide, a mixture of dOclA 4- and 5-phosphate is present. By methylation analysis of the dephosphorylated, deacylated and reduced lipopolysaccharide the attachment site of the dOclA was assigned to position C-6' of the non-reducing glucosamine of lipid A. The anomeric linkages present in the lipopolysaccharide were assessed by 1H-NMR and 13C-NMR of deacylated lipopolysaccharide. The saccharide backbone of this Haemophilus influenzae lipopolysaccharide possesses the following structure: (Formula; see text) PMID- 3264242 TI - Spontaneous healing of Langerhans cell histiocytosis (histiocytosis X). AB - A 3-month-old male infant presented with pallor, hepatomegaly (4.5 cm), splenomegaly (1.5 cm), anaemia (Hb 6 g/dl) and thrombocytopenia (16 X 10(9)/l). A liver biopsy was diagnostic for Langerhans cell histiocytosis (histiocytosis X). The patient's lymphocytes, co-cultured with neonatal lymphocytes, were positive for virus-like particles without reverse transcriptase activity. The hepatomegaly diminished after 6 months and a second liver biopsy showed decreased histiocytic infiltration. A second viral blood culture remained negative. After 14 months, the hepatomegaly had disappeared completely and there were no more abnormal haematological or clinical findings. PMID- 3264243 TI - Neonatal screening for alpha-1-antitrypsin deficiency. AB - The results of a neonatal screening programme for alpha-1-antitrypsin deficiency are presented. Cord blood samples with an alpha-1-antitrypsin concentration below 1.628 mg/ml, as measured by an enzyme-linked immunosorbent assay method, were phenotyped by isoelectric focusing in polyacrylamide gels. Abnormal phenotypes were found in 51% of this group as compared with 11.3% in a control group (P much less than 0.0001). Twenty subjects detected by the initial quantitative alpha-1 antitrypsin determination had a highly pathogenic phenotype (PiZZ, PiSS, PiSZ). In the control group only moderately affected individuals were found (PiMS, PiMZ). PMID- 3264244 TI - Improvement of human ovulatory cervical mucus by alpha-amylase. Effect on spinability and crystallization in vitro. AB - Alpha-amylase can modify ovulatory cervical mucus in vitro, changing both its structure and an essential rheological parameter, spinability. After 5 min at alpha-amylase concentrations above 4.6 mg/ml, spinability was greatly reduced or even non-existent because of the total liquefaction of the mucus. These concentration levels also induced breakdown of the solid phase of the hydrogel, producing more or less marked abnormalities in mucus crystallization after air drying. In the presence of the highest alpha-amylase concentrations (greater than or equal to 37.5 mg/ml) dendrites could not be formed and only sodium chloride crystals were visible at high magnification under a scanning electron microscope. In the 75 to 1.2 mg/ml concentration range, where alpha-amylase has a significant action on cervical mucus, there was an overall decrease in average spinability as the enzyme concentration fell. The action of the enzyme was greater after 10 min than after 5 min reaction time. For the 10-min reaction time interval, the activity could be adjusted using a squared polynominal regression, whereas for the 5-min reaction time interval a linear regression was a suitable model of enzymatic activity. In the 4.6 to 1.2-mg/ml concentration range, adjustment on a linear model showed that there was a significant effect of alpha-amylase concentration and reaction time on mucus spinability. Statistical analysis of the dose-effect data was compatible with the structural changes in dried cervical mucus demonstrated by scanning electron microscopy. PMID- 3264245 TI - Pharmacokinetics of ketorolac tromethamine in humans after intravenous, intramuscular and oral administration. AB - The pharmacokinetics of ketorolac tromethamine, a potent non-narcotic analgesic agent used for relief of moderate to severe pain, has been studied in 15 healthy volunteers who received single 10 mg doses intravenously (i.v.), intramuscularly (i.m.) and orally (p.o.) in a three-way cross-over design. The kinetics of i.v. ketorolac were characterized by a terminal half-life of 5.09 h, a small plasma clearance (CL = 0.35 ml.min-1.kg-1) and a small tissue distribution (Vss = 0.11 l.kg-1, V beta = 0.17 l.kg-1; mean (SD). Following i.m. and p.o. administration, peak levels of approximately 0.8 microgram/ml were rapidly attained (tmax = 0.8 and 0.9 h, respectively) and the systemic bioavailability was essentially complete. PMID- 3264246 TI - Increase in outflow facility of aqueous humor in cats induced by calcitonin gene related peptide. PMID- 3264247 TI - Cerebral metabolism of parkinsonian primates 21 days after MPTP. AB - This study evaluates the changes in the local cerebral metabolic rate for glucose (LCMRg) in primates exposed to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). The LCMRg was evaluated 21 days following the last dose of MPTP. At this time, all MPTP-injected animals demonstrated parkinsonism and striatal dopamine was reduced to less than 3% of control values. The structures whose LCMRg was most affected were the motor cortex, the intermediate zone of the putamen, the external segment of the globus pallidus, the medial part of the ventrolateral nucleus of the thalamus (VLm), visual cortex, locus ceruleus, and the dorsolateral segment of the substantia nigra pars compacta. The structure whose increase in LCMRg correlated most closely to the clinical severity of parkinsonism was the external segment of the globus pallidus. PMID- 3264248 TI - Restoration of micturition using microelectric current in experimentally induced spastic urinary bladder in rabbits. AB - The 29 rabbits used in this study were divided into three groups, A (A1 and A2), B, and C. In subgroup A1, 4 animals were used in order to verify whether the contact of an electrode to the sacral nerves results in some abnormality of voiding reflex. In subgroups A1 and A2 (4 animals each) we further studied the micturition function using three parameters: (i) urinary bladder fluoroscopy and radiography, (ii) cystomanometry, and (iii) electromyography of the pelvic floor muscles (external sphinter). In group B (9 rabbits) spastic paraplegia and micturition disturbances resulted from spinal cord compression that was induced by inserting a balloon catheter into the T11-T12 intervertebral foramen. In this group the parameters studied revealed a spastic urinary bladder in all animals. Finally, the 12 animals of group C were rendered paraplegic as described in group B, and microelectrodes were placed over the sacral nerves as in subgroup A1. By applying a specific sequence of sacral nerve stimulation we succeeded in satisfactory urinary bladder emptying as confirmed by the micturition parameters studied: The urinary bladder pressure decreased from 65 +/- 3 to 28 +/- 3 mm Hg. The pelvic floor muscle amplitude was lowered from 130 +/- 7 to 20 +/- 3 microV, and finally the radiological bladder size also decreased from 38 cm2 before voiding to 18 +/- 3 cm2 after voiding. These results indicate that microelectric current stimulation of the sacral nerves, when applied under a specific sequence, could rather satisfactorily restore micturition disturbances, at least in this experimental animal. PMID- 3264249 TI - Biochemical and immunologic abnormalities in peripheral blood T lymphocytes of patients with hemophilia A. AB - Subset distribution, ecto-5'nucleotidase (5'NT) activity, and the generation of allospecific cytotoxic T lymphocytes (CTL) were investigated in peripheral blood T lymphocytes from 39 hemophilia A patients divided into three groups: group A and group B (HIV-patients with CD4:CD8 ratio less than 1 and greater than 1 respectively), and group C (HIV + patients). 5'NT activity was significantly decreased compared with healthy controls in groups B and C. In group B, this deficiency was attributable to expansion of CD8 + CD11 + suppressor cells. In group C, activated (HLA-DR+) CD8+ cells were also present and contributed to 5'NT deficiency. The suppressor cell expansion seemed to be mainly related to AHF infusions, whereas HLA-DR expression was related to HIV infection. CD11+ and HLA DR+ cells were also expanded in the CD4+ subpopulation of all three groups, whereas CD4+ CD28+ lymphocytes were significantly decreased in group C only. Lastly, alloreactive cytotoxicity was decreased in group B and was normal in groups A and C. PMID- 3264250 TI - Factors influencing release of granulocyte-macrophage colony-stimulating activity from human mononuclear phagocytes. AB - Mononuclear phagocytes play an important role in the regulation of hematopoiesis, not only by producing regulatory monokines such as prostaglandins, tumor necrosis factor and interleukin-1 (IL-1), but also by the production of colony-stimulating activity (CSA). Previously, we have demonstrated that granulocyte-macrophage CSA (GM-CSA) production by mononuclear phagocytes can be induced by IL-1. In the present study, the influence of culture conditions on the production of GM-CSA was studied. It was found that both human sera and fetal bovine sera contain constituents - at present undefined - that induce GM-CSA production. These factors are distinct from IL-1 and lipopolysaccharide. In selected experiments, no GM-CSA-inducing effect of serum was found, suggesting that the effect may be donor-related. GM-CSA release in the presence of serum could be reduced by 40% after incubation of mononuclear phagocytes at low cell concentrations in methylcellulose, indicating that intimate cell-cell contact is an additional factor that enhances GM-CSA release. PMID- 3264251 TI - Identification of EcoRV fragments spanning the N alpha-tubulin gene of Physarum. AB - The N alpha-tubulin gene of Physarum polycephalum has an EcoRV site at codons 252/253. EcoRV digestion of physarum DNA generated two EcoRV fragments per gene copy comprising both coding and flanking sequences. Hybridisation probes which included coding sequences upstream from the central EcoRV site cross-hybridised with another alpha-tubulin gene. Probes derived from either 5'- or 3'-flanking regions were gene-specific. These probes identified two EcoRV fragments in the haploid strain CLdAXE viz 5.4 kb (5'-fragment) and 6.2 kb (3'-fragment). The same two fragments were identified in EcoRV digests of DNA of the diploid strain M3CVIII, and a second form of the gene was also identified comprising two fragments viz 5.0 kb (5'-end) and 5.5 kb (3'-end). Both forms gave rise to an identical 4.65 kb HindIII fragment as judged by restriction mapping. PMID- 3264252 TI - Interleukin 1 and tumour necrosis factor increase phosphorylation of fibroblast proteins. AB - Interleukin 1 (IL1) or tumour necrosis factor (TNF) stimulated phosphorylation of a triad of 27 kDa phosphoproteins (pI 6.0, 5.7 and 5.5) in human dermal fibroblasts. The change was dependent on the dose of cytokine in the range 0.1-20 ng, was detectable between 3 and 5 min after stimulation and was maximal by 10 min. The proteins were found in the cytosol after subcellular fractionation. The 32P was removed from them by alkali, indicating the presence of phosphoserine and/or phosphothreonine. The results suggest that early changes in serine/threonine protein kinase activity may be involved in responses of fibroblasts to IL1 and TNF. PMID- 3264253 TI - [Haemophilus influenzae in genital cellulitis and ulcer]. PMID- 3264254 TI - Modulation of steroidogenesis in choriocarcinoma cells by cholera toxin, phorbol ester, epidermal growth factor and insulin-like growth factor I. AB - The effects of cholera toxin (CT), which stimulates adenylate cyclase, 12-O tetradecanoylphorbol 13-acetate (TPA), a protein kinase C activator, epidermal growth factor (EGF) and insulin-like growth factor I (IGF-I) on progesterone (P) and estradiol (E2) secretion by human choriocarcinoma JEG-3 cells were studied. During a 48 h incubation, CT, TPA and EGF stimulated P production in a concentration-dependent manner, whereas IGF-I was without effect. CT (1.0 ng/ml), TPA (10 ng/ml) and EGF (10 ng/ml) stimulated P production maximally 4.3-, 3.3- and 2.3-fold over basal, respectively. When added together with CT, TPA and EGF stimulated P production 10.0- and 5.0-fold over basal production showing that the effects of CT plus TPA were more than additive but those of CT plus EGF less than additive. Time-course studies indicated that the effects were detectable at 12 h, and continued to increase up to 48 h. The conversion of added dehydroepiandrosterone sulfate (DHEAS) to E2 was stimulated by CT and TPA and inhibited by IGF-I in a concentration-dependent manner. By contrast, EGF had no effect. The maximal responses in E2 production were 3.2- and 2.0-fold over unstimulated cells by CT (1.0 ng/ml) and TPA (10 ng/ml), respectively. When both agents were added together, their effects on E2 production were additive with 5.5 fold increase over unstimulated cells. IGF-I (30 ng/ml) inhibited maximally basal and CT-stimulated E2 production by 33% and 42%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264255 TI - Receptor-mediated endocytosis and degradation of bovine growth hormone in rat liver. AB - Receptor-mediated endocytosis of radiolabelled bovine growth hormone (125I-bGH) via somatogenic receptors in the liver was studied following in vivo intraportal injection. At different times after injection, subcellular membrane fractions involved in binding (plasma membranes), endocytosis (endocytic vesicles) and degradation (lysosomes) of peptide hormones were isolated by sucrose density gradient centrifugation. These fractions were evaluated for the time-course accumulation of radiolabelled bGH and for the presence of internalized 125I-bGH receptor complexes. These uptake studies indicate that after initial plasma membrane association of 125I-bGH, the ligand is transported in two successive endocytic compartments prior to arrival in lysosomes. The molecular weight of the somatogenic binders of male and female rat livers involved in internalization of 125I-bGH was determined to 95,000, 64,000, 55,000, 43,000 and 35,000, assuming a 1:1 binding of the hormone to the binder. These binders were seen in both endosomes and lysosomes, which suggests that growth hormone is transported to the lysosomes in a complex with its receptor. Binding and uptake of 125I-bGH was also compared in male and female rat livers, and endocytosis of 125I-bGH was compared to that of radiolabelled ovine prolactin (125I-oPrl). The specific uptake of 125I bGH appeared not to be sexually differentiated in contrast to that of 125I-oPrl which showed a 35-fold higher uptake in female rat liver. Degradation of 125I-bGH was studied under in vitro binding assay conditions. A distinct 15,000 Da fragment was generated by plasma membrane, endosomal and lysosomal fractions. Based on protease inhibitor studies, a non-trypsin-like serine protease is suggested to be involved in the degradation of bGH. The 15,000 Da proteolytic fragment of GH can be affinity cross-linked to somatogenic binders of similar molecular weights as those involved in the binding of intact GH. PMID- 3264256 TI - Effects of epidermal growth factor and insulin-like growth factor I on the levels of mRNA encoding aromatase cytochrome P-450 of human ovarian granulosa cells. AB - The effects of growth factors to regulate the activity of aromatase, as well as the synthesis of aromatase cytochrome P-450 (P-450AROM) have been studied in human ovarian granulosa cells obtained from women undergoing oocyte retrieval. Insulin-like growth factor I (IGF-I) increased aromatase activity as well as the synthesis of P-450AROM, in a concentration-dependent fashion. The levels of hybridizable mRNA species encoding cytochrome P-450AROM were also increased with IGF-I treatment. By contrast, epidermal growth factor (EGF) had no effect on these parameters when added alone, but markedly inhibited the action of follicle stimulating hormone (FSH) to stimulate aromatase activity, and the synthesis of cytochrome P-450AROM, as well as its ability to increase the levels of mRNA encoding the enzyme. It is concluded that these growth factors have opposite effects on aromatase activity, and that these actions reflect, in part, changes in the synthesis of cytochrome P-450AROM, which in turn are the consequence of changes in the levels of mRNA encoding this enzyme. PMID- 3264258 TI - [Normal finding of CT/air cisternography of the cerebellopontine angle and internal auditory canal]. PMID- 3264257 TI - Blue rubber bleb naevus disease: an uncommon cause of gastrointestinal tract bleeding. AB - A 23 year old woman presented with facial pain, a right parotid tumour and iron deficiency anaemia. She had several cutaneous venous swellings and tumours with a similar appearance were found in the large bowel. Histological examination of the parotid tumour and angiography of the skin and gut lesions confirmed that they were venous in origin. The aetiology, classification, and complications of disorders of the venous system and the importance of using a tourniquet to examine the peripheral veins is discussed. PMID- 3264259 TI - Molecular characterization of ataxia telangiectasia T cell clones. III. Mapping the 14q32.1 distal breakpoint. AB - To delimit the 14q32.1 recurrent breakpoint of ataxia telangiectasia clones, we performed an in situ hybridization study with various probes located on the 14q32 band. We thus mapped this breakpoint between the D14S1 and Pi loci. Furthermore, an interstitial duplication including D14S1 and a part of the IgH locus was demonstrated on a t(14;14) clone. PMID- 3264260 TI - Human interleukin-2 anti-idiotypes. AB - We describe the generation of a monoclonal anti-idiotypic (anti-id) antibody directed against affinity purified rabbit antibodies (id) to recombinant human IL 2. This monoclonal antibody, 6A12, has the ability to inhibit the neutralization of IL-2 activity by the id, suggesting that it may bind at or near the IL-2 neutralizing site on the id. 6A12 exhibits IL-2 agonist activity on PHA-activated human T cells. The purified IgG of 6A12 is also shown to bind to a purified soluble recombinant p55 subunit of the IL-2 receptor. Furthermore, purified 6A12 shows inhibition of IL-2 activity in an IL-2 dependent mouse T cell line (CTLL) and this inhibition can be reversed by excess IL-2. These results suggest that although 6A12 may not be an exact 'internal image' of the receptor binding site of IL-2, it may bind to at least the P55 subunit of the ligand binding site on the high affinity IL-2 receptor complex. PMID- 3264261 TI - A flexible, portable system for neuromuscular stimulation in the paralyzed upper extremity. PMID- 3264262 TI - Predicting distributed retinal source activity from ERG data--Part I: Field theoretic approach. PMID- 3264263 TI - Predicting distributed retinal source activity from ERG data--Part II: Multiple stimulus approach. PMID- 3264264 TI - Interleukin 1 as a tumor cytostatic mediator released from tumor ascites-treated macrophages. AB - Peritoneal macrophages from DBA/2 mice, elicited by injection of Corynebacterium parvum (C.p.), were in vitro activated to Eb tumor cytostasis by incubation with tumor-induced ascites that was harvested 7 days after intraperitoneal Eb injection. The active cytostasis-mediating compound was found to be interleukin 1 (IL 1). When tumor ascites was fractionated according to molecular weight size, the most active IL 1-inducing fraction was found to comprise molecules of greater than 100,000 daltons. The data show that tumor-bearing hosts are capable of producing compounds that induce a high IL 1 secretion which may enable macrophages to mount an antiproliferative effect against tumor cells. PMID- 3264265 TI - Delayed type hypersensitivity (DTH) in anti-IgM-treated B cell-depleted mice: analysis of induction and effector phase. AB - The induction and the effector phase of murine delayed type hypersensitivity (DTH) were evaluated in mice treated from birth with anti-IgM antibodies; these mice had no mature B cells and could not produce an antibody response. To study the effector phase, long-term cultured cloned helper T cells were injected subcutaneously together with the specific antigen into the hind footpad of normal and B cell-deficient mice. Antigen-specific DTH responses assessed by the local swelling reaction 24 h after transfer measured against a particulate antigen (sheep red blood cells, SRBC) as well as a soluble antigen (ovalbumin, OVA) were unaffected by the absence of B cells. To study the induction phase of DTH, 3-day immune in vivo primed lymphocytes from normal or B cell-depleted mice were adoptively transferred by subcutaneous injection into the hind footpad of naive syngeneic recipients. B cell depletion did not affect the induction of cells capable of responding to SRBC; in contrast, the response to soluble antigen (OVA) was significantly reduced, suggesting that B cells or their products participated in the induction of a DTH response to a soluble antigen. PMID- 3264266 TI - Endogenous corticosteroids mediate seasonal cyclic changes in immunity of lizards. AB - Endogenous corticosteroid (CS) blood levels were radioimmunoassayed in fresh, field-collected lizards Chalcides ocellatus at two week-intervals throughout the four consecutive seasons. These animals were used in parallel to investigate the splenic T and B lymphocyte level, lymphoproliferative responsiveness to concanavalin A and primary antibody production in vitro against rat erythrocytes (RRBC). The recorded data indicated that fully developed splenic lymphoid tissue and powerful immune responsiveness are coincident with a continuously low CS level, and characterize the period from spring through early autumn. On the other hand, the dramatic lymphocytic destruction and impairment of immune reactivity observed in autumn and winter are associated with not only a high, but above all sustained, rise in endogenous CS levels. Apparently, exposure of lizard lymphocytes to comparatively high, yet physiologic, levels of endogenous CS for prolonged periods of time lead to impairment of their immune functions. In support, long-term administration of exogenous hydrocortisone acetate (HC) to "summer" lizards resulted in a high and lasting elevation in blood CS levels that was associated with a considerable depletion of lymphoid elements and abrogation of immune reactivity, exactly as in normal lizards collected from the field in autumn through winter. In addition, pharmacologic inhibition of CS synthesis by administration of metyrapone at the beginning of autumn greatly modulated the lizard lymphocyte response to the autumn-related immunodepression. The study thus strongly suggests that the autumn/winter-dependent immunosuppression in lizards is essentially due to a high and lasting rise in levels of endogenous CS. The results are discussed from the perspective of the role played by CS in mediating the seasonal rhythms that affect reptilian immunity. PMID- 3264267 TI - Induction of responsiveness to IL 2 in Con A-stimulated rat lymphoid cells requires synergistic action of IL 1 and the accessory cell membrane. AB - Rat spleen or lymph node cells stimulated with Con A and cultured at a low density of 1 x 10(5) cells per ml proliferated in response to IL 2-containing supernatants and thus expressed receptors for IL 2. Cells depleted of accessory cells either by passage over a glassbead-column or by treatment with the lysosomotropic agent leucine methyl ester (Leu-OMe) did not proliferate in response to IL 2-containing supernatants. The diminished proliferative response after adherent cell depletion could be reconstituted by the addition of peritoneal exudate cells (PEC). Reconstitution could also be achieved by synergistic action of IL 1 and paraformaldehyde-fixed peritoneal exudate cells, indicating an important role for the accessory cell membrane in the induction of IL 2-mediated proliferation. PMID- 3264268 TI - Protein changes in skeletal muscle of toad, Bufo melanostictus under cathode polarity treatment. PMID- 3264269 TI - Karyotypes of human T-lymphocyte clones. AB - T-Lymphocyte clones from healthy males and females and from melphalan-treated ovarian carcinoma patients were studied with regard to sporadic chromosomal aberrations and clonal karyotype: 85% of the clones showed a normal, diploid karyotype, and sporadic aberrations were found to occur at about the same low frequency as in short-term lymphocyte cultures. An abnormal karyotype was found in 11 of the 72 clones studied. Loss of an X chromosome, which was the most frequent abnormality in female clones, was verified by densitometry of Southern blots of clonal DNA hybridized with a probe for the X-linked hprt locus. Abnormal karyotype due to chromosomal rearrangement was found in nine clones, and, in five of these, chromosome 12 was involved in the aberration. About 33% of the clones from melphalan-treated patients had an abnormal karyotype, in comparison with about 10% of clones from healthy control subjects. This difference indicated that melphalan treatment may induce stable chromosomal rearrangements that are compatible with cellular proliferation and clonal expansion. PMID- 3264270 TI - A pathological fracture of the femur through a histiocytic granuloma. AB - We present the first reported case of a fracture through a granuloma in the shaft of the femur of a child with histiocytosis X. This fracture united with conservative management but without resolution of the granuloma. PMID- 3264271 TI - The frequency of IgA-deficiency in the Austrian population. A protocol for large scale screening by ELISA and a study on 3056 blood donors. AB - A protocol for large scale screening of blood donors for IgA-deficiency with the help of an ELISA is described. The ELISA method proved to be fast and reliable, the obtained data can be managed by electronic data processing. Donors were regarded as IgA-deficient when their serum level was below 10 mg/dl (normal values 90 to 450 mg/dl). At this concentration ELISA shows acceptable reproducibility (within +/- 15% limits). We found 8 deficient donors, i.e. one in 382 or 0.26%. Seven of these donors were totally deficient by ELISA, 2 of them having a strong anti-IgA in their serum. We conclude that ELISA is a simple, reliable, and inexpensive method for screening blood donors for IgA-deficiency. PMID- 3264272 TI - Enzymuria in workers exposed to inorganic mercury. AB - Urinary excretion of beta-hexosaminidase (NAG = N-acetyl-beta-glucosaminidase) and albumin was examined in 41 chlor-alkali workers exposed to inorganic mercury and 41 age-matched controls. Either U-HG or B-Hg levels for these workers were available dating from the 1960s to the present. Increased U-NAG was seen in workers with a U-Hg today of more than 4 micrograms/mmol creat (about 50 micrograms/l: 35 ug/g creat). Multiple linear regression analysis showed that U NAG was correlated to U-Hg and integrated dose but not to the present B-Hg level. No albuminuria (detection limit 12.5 mg/l) was found in any of the subjects. In a longitudinal study, no decrease in U-NAG levels was seen in 15 chlor-alkali workers after their vacation (means = 20d). In five workers followed for ten months after a short exposure period, no definite time trend could be seen. The results show that there is a slight effect on renal tubules even at rather low levels of exposure to mercury vapour. The clinical significance of the enzymuria levels found here is, however, debatable. PMID- 3264273 TI - Pharmacokinetics of fosfosal after single and multiple oral doses in man. AB - Fosfosal is a new salicylic acid derivative used in analgesic and anti inflammatory therapy. In this study, pharmacokinetic evaluation of fosfosal after a single 2,400 mg and three different oral dose schedules (1,200 mg t.i.d., 2,400 mg b.i.d. and 2,400 mg t.i.d.) was carried out, in six healthy male volunteers, to assess which doses provide steady state plasma concentrations within the therapeutic range (150-300 micrograms/ml). Plasma concentrations of both fosfosal and its active metabolite, salicylic acid, were determined by means of an HPLC method. For the 2,400 mg t.i.d., Cmin-ss and Cmax-ss values were 184 micrograms/ml and 276 micrograms/ml, respectively, being significantly higher (p less than 0.02) than with the other regimes and, unlike the latter, falling within the anti-inflammatory therapeutic range. In addition, the 2,400 mg t.i.d. showed a significant prolongation (p less than 0.005) of salicylic acid t1/2, as well as a higher AUC-ss 0-8 h dosing interval compared to the other multidose schedules and to the AUC0-infinity for the single dose. As expected, both facts reflect that the highest daily dose of fosfosal has a nonlinear concentration dependent elimination rate. PMID- 3264274 TI - Increased capacity of lymphocytes to lyse tumor cells in vitro and production of lymphotoxins after cisplatin treatment. AB - Spleen lymphocytes from C3H/He mice when treated with cisplatin show increased cytostasis and cytotoxicity against Dalton's lymphoma cells in vitro. Cisplatin treatment of splenocytes does not render them cytotoxic/or cytostatic against normal splenocytes. Splenocytes on treatment with cisplatin also produce tumor cell-specific cytotoxic/cytostatic factors (lymphotoxins) which have cytolytic and cytostatic effect on Dalton's lymphoma cells. The increased cytotoxicity of splenocytes on treatment with cisplatin is reversed by the calcium channel blocker nifedipine and the calmodulin antagonist chlorpromazine, suggesting a role of calcium in cisplatin-activated lymphocyte-mediated cytotoxicity. PMID- 3264275 TI - Evidence that 8-methoxypsoralen (8-MOP) is a T-lymphocyte immunomodulatory agent. AB - This study was designed to characterize the effects of the anti-psoriatic compound 8-methoxypsoralen (8-MOP) on human lymphocyte function in vitro. Normal human peripheral blood mononuclear cells were stimulated with an optimal (1%) or a suboptimal (0.05%) concentration of phytohemagglutinin (PHA). At the optimal concentration of PHA, 8-MOP (140 microM) caused a delay in lymphocyte proliferation, interleukin-2 (IL-2) production/accumulation and IL-2 receptor expression. Addition of exogenous IL-2 to cultures stimulated with an optimal concentration of PHA did not overcome the delay of lymphocyte proliferation and IL-2 receptor expression. At the suboptimal concentration of PHA, 8-MOP (140 microM) caused a sustained inhibition of lymphocyte proliferation, IL-2 production/accumulation and IL-2 receptor expression. Addition of exogenous IL-2 under these conditions restored the magnitude of lymphocyte proliferation and IL 2 receptor expression. However, the responses displayed the delayed lymphocyte proliferation and IL-2 receptor expression typical of cells incubated with 8-MOP and an optimal concentration of PHA. PMID- 3264276 TI - Functional and morphologic effects of ioxilan, iohexol, and diatrizoate on endothelial cells. AB - The effects of a new contrast agent, ioxilan, on vascular endothelium were compared with those of iohexol and diatrizoate. Rabbit aortic rings were incubated in contrast medium (CM) (350 mgI/mL) or Krebs solution as a control agent, for 5 minutes. Scanning and transmission electron micrographs showed that iohexol and ioxilan produced irregularities in the cell borders and in some vesicles, whereas diatrizoate produced intercellular gaps and numerous vesicles containing myelin figures. The ability of the endothelial cells to release endothelium-derived relaxing factor was tested by measuring the dilator response to acetylcholine. Incubation of aortic rings in CM for 5 minutes caused no changes in responses. However, 15-minute contact with diatrizoate irreversibly reduced the dilator response to 49%, and contact with sucrose (2100 mOsm/kg) reduced it to 9%. After incubation for 60 minutes, iohexol reduced the dilator response to 43%, while ioxilan caused no change. Since the hydrophilicity of the nonionic compounds, ioxilan and iohexol, is similar, while ioxilan's osmolality is substantially lower, the endothelial changes detected by electron microscopy and induced by the CM are attributable to their chemical properties, whereas the loss of dilator response appears to be mediated by high osmolality. PMID- 3264277 TI - Effect of water-soluble iodinated contrast media on pressure-flow relationship of red cell suspension. AB - The effect of radiological contrast media on blood flow through a vascular network was investigated, taking physical and physiological conditions such as osmolality into account. The perfusion of the bullfrog's hind limbs was performed, with a slight modification of the vertical tube method. The effect of contrast media on red cell deformability was studied by perfusion with erythrocyte suspensions in glutaraldehyde-fixed hind limbs. The echinocytic shape change induced by metrizamide and hypertonic iothalamate solutions caused a marked increase in resistance to flow. When the perfusion with erythrocyte suspension was performed using intact hind limbs, the pressure-flow relationship was influenced by contrast media effects on both red cell deformability and the vascular bed. Ioxaglate had less rheologic effect on the pressure-flow relationship than metrizamide or iothalamate. It could be concluded that contrast media should be isotonic, of low viscosity and chemotoxicity, and that ioxaglate was preferable to metrizamide and iothalamate at equal iodine content. PMID- 3264278 TI - Epidemiology of migraine: a survey in 21 provinces of the People's Republic of China, 1985. PMID- 3264279 TI - Nucleolar eccentricity in trigeminal ganglion neurons. AB - The aim of this study was to determine if measuring trigeminal ganglion neuron profiles containing nucleoli in histological sections gave a reasonable estimation of cell size. Serial sections of ferret trigeminal ganglia were prepared, and neuron profiles traced with the aid of a camera lucida. The cross sectional area of the profiles was measured. Profiles containing nucleoli formed the upper part of the size spectrum and were significantly larger than the profiles that did not contain nucleoli. When serial profiles of individual neurons were examined the largest profile contained the nucleolus in 20 of 27 cases, and the mean sizes of 'largest' and 'nucleolus-containing' profiles did not differ significantly. Computer reconstructions of individual cells show the nucleolus to be central in almost all cells viewed from almost every projection. It is concluded that the nucleolus lies at, or very near to, the centre of the neuron and at its widest dimension. Measuring the size of profiles containing nucleoli gives a satisfactory representation of cell size. PMID- 3264280 TI - Obsessive compulsive disorder in adolescence: an epidemiological study. PMID- 3264281 TI - The binding in vitro of the intermediate filament protein vimentin to synthetic oligonucleotides containing telomere sequences. AB - The ability of the intermediate filament subunit protein vimentin to bind synthetic oligonucleotide telomere models containing repeat sequences from Oxytricha (T4G4), Saccharomyces (TGTGTG3), or Tetrahymena (T2G4) was investigated in vitro with a filter binding assay and a gel overlay assay. At low ionic strength, vimentin bound these oligonucleotides with high affinity. At higher ionic strength, the vimentin-oligonucleotide complex was less stable, such that approximately 30% of the initial binding remained at 150 mM KCl. One mole of vimentin tetramer bound approximately 1 mol of telomere oligonucleotide. Vimentin bound well oligonucleotides containing either a random duplex or random 3' overhang, but showed a reduced affinity for a blunt-ended oligonucleotide. A control random sequence oligonucleotide was not bound by vimentin. The oligonucleotide-binding site of vimentin was shown to be localized in the non alpha-helical N-terminal domain by assays employing purified proteolytic fragments of vimentin. Preliminary results in the gel overlay assay show that other members of the intermediate filament family, nuclear lamins A-C, all bind the synthetic oligonucleotide containing the telomere repeat sequence of Oxytricha. PMID- 3264282 TI - Regulation of type I collagen synthesis by 1,25-dihydroxyvitamin D3 in human osteosarcoma cells. AB - Synthesis of type I and III collagens has been examined in MG-63 human osteosarcoma cells after treatment with the steroid hormone, 1,25 dihydroxyvitamin D3 (1,25-(OH)2D3). Analysis of total [3H]proline-labeled proteins and pepsin-derived collagens revealed that 1,25-(OH)2D3 selectively stimulated synthesis of alpha 1I and alpha 2I components of type I collagen after 6-12 h. Consistent with previous reports (Franceschi, R. T., Linson, C. J., Peter, T. C., and Romano, P. R. (1987) J. Biol. Chem. 262, 4165-4171), parallel increases in fibronectin synthesis were also observed. Hormonal effects were maximal (2- to 2.5-fold versus controls) after 24 h and persisted for at least 48 h. In contrast, synthesis of the alpha 1III component of type III collagen was not appreciably affected by hormone treatment. Of several vitamin D metabolites (1,25-(OH)2D3, 25-dihydroxyvitamin D3, and 24R,25-dihydroxyvitamin D3) tested for activity in stimulating type I collagen synthesis, 1,25-(OH)2D3 was found to be the most active. Analysis of collagen mRNA abundance by Northern blot hybridization indicated that both types I and III procollagen mRNAs were increased 4-fold after a 24-h exposure to 1,25-(OH)2D3. Pro alpha 1I mRNA remained elevated through the 48-h time point while pro alpha 2I and pro alpha 1III mRNAs returned to control values. These results indicate that the regulation of collagen synthesis by 1,25-(OH)2D3 is complex and may involve changes in translational efficiency as well as mRNA abundance. 1,25-(OH)2D3 also caused at least a 20-fold increase in levels of the bone-specific calcium-binding protein, osteocalcin. These results are consistent with the hypothesis that 1,25-(OH)2D3 is stimulating partial differentiation to the osteoblast phenotype in MG-63 cells. PMID- 3264283 TI - Barley alpha-amylase genes. Quantitative comparison of steady-state mRNA levels from individual members of the two different families expressed in aleurone cells. AB - We have cloned and sequenced two barley alpha-amylase genes belonging to the high pI isozyme family, one of which, Amy6-4, corresponds to a cDNA previously characterized by our laboratory. A 750-base pair probe from Amy6-4, representing primarily the promoter/upstream sequences cross-hybridizes on genomic Southern blots under stringent conditions to five other genes or pseudogenes; this demonstrates that the promoter/upstream region in these different members of the gene family is highly conserved. In contrast, this probe hybridizes very poorly to the genomic fragment containing the other cloned high pI gene, Amy46, a finding consistent with substantial divergence of sequence about 200 base pairs upstream from the TATA box of each. We compared steady-state mRNA levels from these individual genes to levels for mRNAs from two low pI alpha-amylase genes and from the single copy gene for aleurain, a thiol protease, using quantitative S1 nuclease protection assays. We found, in RNA from aleurone cells treated with gibberellic acid for 19-24 h, that the two low pI alpha-amylase mRNAs are each about five times more abundant than Amy6-4 or aleurain, which are, in turn, about 10 times more abundant than Amy46. These results indicate that as many as seven closely related high pI genes are needed to provide mRNA levels approaching those from the two low pI genes. We speculate that the substantially lower level of expression of Amy46 may be related to its divergent sequence upstream from the promoter. PMID- 3264284 TI - Modulation of the amino acid control of hepatic protein degradation by caloric deprivation. Two modes of alanine co-regulation. AB - Intracellular protein degradation in perfused livers of fed rats has been shown to be directly regulated by 7 amino acids (Leu, Tyr, Gln, Pro, Met, His, and Trp) and co-regulated by alanine. Responses to graded increases of regulatory amino acids (individually or combined) are multiphasic and include (a) an initial inhibition at 0.5 times normal plasma concentrations, (b) a localized, zonal loss of inhibition at normal levels, and (c) suppression to basal rates at 4 times normal concentrations or greater; the zonal loss of inhibition is prevented by 0.5 mM (normal) alanine. In further perfusion studies carried out at the usual time (1100 h), we have occasionally observed a sharp decrease in proteolytic responsiveness at normal amino acid concentrations. The decrease, which occurred spontaneously in normal fed rats, was attributed to a nearly 90% loss in the sensitivity of alanine co-regulation. In all instances, alanine sensitivity was restored after 4 to 24 h of starvation. The cause of the insensitivity and the mechanism of its reversal by caloric deprivation are not presently known. Starvation for 24 h also appeared to alter the individual inhibitory effectiveness of Leu, Tyr, and Gln. On the other hand, inhibition by the full regulatory group at 4 times normal plasma levels was unchanged when compared with the complete plasma mixture except for a concentration shift in the peak zonal loss of proteolytic inhibition from 1.25 to 0.6 times plasma levels. Since the shift paralleled known changes in portal vein regulatory amino acids, it may have been adaptive in nature. As with fed animals, the zonal loss in starvation was abolished by 0.5 mM alanine, but not with high levels of lactate and pyruvate (10 mM), a finding consistent with the view that co-regulation is mediated by the recognition of alanine per se rather than its metabolism. PMID- 3264285 TI - T-cell-mediated cytolysis: analysis of killer and target cell deformability and deformation during conjugate formation. AB - T-cell-mediated cytolysis is initiated by the formation of strong adhesions between killer and target cells. The present work was aimed at determining whether T lymphocytes might exert some mechanical stress on targets during the binding process. Target S194 myeloma cells were thus conjugated to cytotoxic T lymphocytes (CTLs) raised by mixed lymphocyte culture or a cloned lymphoid line that was no longer cytolytic (TG2OUA2). After incubation periods of various lengths, conjugates were processed for electron microscopy and micrographs were digitized for computerized analysis: the cell surface curvature (at the micrometre level) and rugosity (at the submicrometre level) were quantified in free and adhesion-involved regions. Also, the size of cell interaction areas and the distribution of intermembrane distances were measured. Finally, TG2OUA2 and target cells were aspirated into glass micropipettes with calibrated pressure in order to assay their resistance to deformation by mechanical forces. The following conclusions were suggested. (1) Formation of extensive contact zones (with a linear size of several micrometres) with tight intermembrane adhesion (more than 30% of the membrane contours in adhesive zones were separated by an apparent distance lower than 500 A) was essentially completed within less than one minute. (2) CTLs or TG2OUA2 cells were more villous than their targets, and they seemed to deform in adhesive zones in order to adapt to the target contour, rather than imposing some deformation on the target. This may be a general feature of actively adherent cells. (3) Some CTLs, but no TG2OUA2 cells, exhibited conspicuous protrusions extending towards the bound target. In this case, the target cell but not the CTL displayed markedly increased roughness in the adhesion area. (4) TG2OUA2 cells were more resistant to mechanical deformation than S194 target cells, in accordance with previous reports suggesting that the membrane of CTLs was more resistant than that of target tumour cells. Hence, CTLs might transiently impose mechanical stress on the target membrane during the course of lethal-hit delivery. PMID- 3264286 TI - Chronic HIV encephalitis. PMID- 3264287 TI - T-cell subsets in the cerebrospinal fluid and blood of patients with multiple sclerosis. AB - The absolute numbers and ratios of helper/inducer (T4) and cytotoxic/suppressor (T8) T-cells were determined in cerebrospinal fluid (CSF) and blood of patients with multiple sclerosis (MS) and various other neurologic diseases (OND). In patients with MS, the T4:T8 ratio was higher in both blood and CSF, and the increase was significantly greater in CSF than in blood. These findings were due to an increased proportion of T4-lymphocytes in the CSF and to a decreased proportion of T8-cells in blood. These results indicate the need for additional studies of CSF lymphocytes in patients with MS. PMID- 3264288 TI - Growth hormone enhances hepatic epidermal growth factor receptor concentration in mice. AB - The effect of growth hormone (GH) on binding of epidermal growth factor (EGF) to liver membrane preparations was investigated in hypophysectomized mice and partially GH-deficient, genetic mutant "little" (lit/lit) mice. The EGF binding of normal male mice and testosterone-treated females was higher than in normal females. Due to diminished receptor concentration, hepatic EGF binding was decreased in male and female lit/lit mice to a level that was unaffected by gender or androgen treatment. GH replacement therapy by intermittent injections and continuous infusion restored the EGF binding of hypophysectomized mice to normal male and female levels, respectively, suggesting a role for the more pulsatile GH secretion in normal males. In lit/lit mice, however, both continuous and intermittent GH resulted in EGF binding levels comparable to those in normal females. In normal males continuous GH suppressed EGF binding. In conclusion, endogenous GH secretion induces EGF receptors in mice and this effect may be modulated by sex differences in GH secretion. PMID- 3264289 TI - Interleukin 1 administration in mice produces hypoferremia despite neutropenia. AB - To determine whether the hypoferremic response to inflammation requires neutrophils, we administered human recombinant IL-1 to mice made neutropenic with cyclophosphamide. With single intraperitoneal injections of IL-1 the plasma iron concentrations decreased significantly in mice with either normal neutrophil counts or neutropenia. After single injections transferrin concentrations were not significantly changed, but the decrease in serum iron lowered mean transferrin saturations from a baseline of 45 to 24-30% in nonneutropenic mice, and from 99 to 70-77% in neutropenic mice. Similar changes were observed after intraperitoneal injections of Escherichia coli. 4-d continuous infusions of IL-1 also led to reductions in serum iron concentrations, but transferrin concentrations doubled. The combination of a decrease in serum iron and an increase in transferrin concentration after chronic infusion in neutropenic mice led to a greater decline in mean transferrin saturations, from a baseline of 110 to 25%. In mice not given cyclophosphamide, chronic IL-1 infusion was associated with a reduction in mean hemoglobin concentrations from 14.7 to 13.5 g/dl, consistent with restricted availability of iron for erythropoiesis associated with low saturation of transferrin. We conclude that IL-1 can decrease the serum iron despite profound peripheral neutropenia and that transferrin in a positive acute phase reactant in the mouse. PMID- 3264290 TI - Interleukin 1 suppresses expression of cartilage-specific types II and IX collagens and increases types I and III collagens in human chondrocytes. AB - In inflammatory diseases such as rheumatoid arthritis, functions of chondrocytes including synthesis of matrix proteins and proteinases are altered through interactions with cells of the infiltrating pannus. One of the major secreted products of mononuclear inflammatory cells is IL-1. In this study we found that recombinant human IL-1 beta suppressed synthesis of cartilage-specific type II collagen by cultured human costal chondrocytes associated with decreased steady state levels of alpha 1 (II) and alpha 1(IX) procollagen mRNAs. In contrast, IL-1 increased synthesis of types I and III collagens and levels of alpha 1(I), alpha 2(I), and alpha 1(III) procollagen mRNAs, as we described previously using human articular chondrocytes and synovial fibroblasts. This stimulatory effect of IL-1 was observed only when IL-1-stimulated PGE2 synthesis was blocked by the cyclooxygenase inhibitor indomethacin. The suppression of type II collagen mRNA levels by IL-1 alone was not due to IL-1-stimulated PGE2, since addition of indomethacin did not reverse, but actually potentiated, this inhibition. Continuous exposure of freshly isolated chondrocytes from day 2 of culture to approximately half-maximal concentrations of IL-1 (2.5 pM) completely suppressed levels of type II collagen mRNA and increased levels of types I and III collagen mRNAs, thereby reversing the ratio of alpha 1(II)/alpha 1(I) procollagen mRNAs from greater than 6.0 to less than 1.0 by day 7. IL-1, therefore, can modify, at a pretranslational level, the relative amounts of the different types of collagen synthesized in cartilage and thereby could be responsible for the inappropriate repair of cartilage matrix in inflammatory conditions. PMID- 3264291 TI - Release of interleukin 1 inhibitory activity (contra-IL-1) by human monocyte derived macrophages infected with human immunodeficiency virus in vitro and in vivo. AB - Infection of monocyte-macrophages with human immunodeficiency virus may be central to the pathogenesis of the acquired immunodeficiency syndrome. The ability of infected macrophages to prime T cells through IL-1 production was investigated in vitro. Purified human monocytes maintained in suspension culture were infected with strain HIV-DV. Intracellular expression of virus p24 antigen increased from undetectable levels immediately after infection to 13-59% of cells by 10-14 d; infected macrophages remained viable for up to 60 d. Supernatants collected between 14 and 20 d after infection were examined in the murine thymocyte co-mitogenesis assay and demonstrated to contain a potent IL-1 inhibitor, designated contra-IL-1. Contra-IL-1 activity was present in all supernatants examined after 4 d of infection, and peaked coincident with peak p24 antigen expression. Inhibitory activity was not present in uninfected cells. Contra-IL-1 activity eluted after gel filtration with an approximate molecular weight of 9 kD. Inhibitory activity was removed by exposure to heat or acid pH, or by incubation with chymotrypsin or staphylococcal V8 protease. Contra-IL-1 did not inhibit IL-2- or IL-4-dependent proliferation of murine T cell lines. Despite its ability to inhibit IL-1 activity, contra-IL-1 did not interfere with the binding of recombinant IL-1 beta to a fibroblast cell line. Contra-IL-1 inhibited the proliferation of normal peripheral blood mononuclear cells to both concanavalin A and tetanus toxoid; inhibition could be attenuated by the addition of exogenous IL-1. Messenger RNA extracted from infected macrophages was examined by Northern analysis for the presence of message to IL-1 beta. No message was apparent, suggesting that the presence of contra-IL-1 was not obscuring the concomitant release of IL-1. Infected macrophages stimulated with endotoxin generated readily detectable message for IL-1 beta. Spleen macrophages purified from two patients with AIDS complicated by immune thrombocytopenia spontaneously expressed p24 antigen in vitro and released contra-IL-1 activity into the media. Contra-IL-1 may contribute to the immune dysfunction of AIDS. PMID- 3264292 TI - Effect of recombinant soluble CD4 on human peripheral blood lymphocyte responses in vitro. AB - We have previously demonstrated that recombinant soluble CD4 protein (rsT4) blocks both HIV-1 infection of CD4 bearing lymphocytes and syncytium formation in vitro. (Recombinant soluble CD4 is designated by rsT4). Hence, we suggested the use of rsT4 in therapy for AIDS or the prevention of HIV-1 infection in individuals with a known risk of exposure. However, concerns arose that rsT4 might be immunosuppressive because of its implicated role in the enhancement of certain lymphocyte activation events through its engagement of MHC class II molecules on target cells. We therefore assessed the effect of recombinant soluble CD4 upon a number of functional and activation parameters of lymphocytes, including cellular proliferation, IL-2 secretion, and cytolytic capability, after antigenic or mitogenic stimulation. We report here that rsT4, at 60-fold over the concentration needed to block acute HIV-1 infection in vitro, does not significantly inhibit the activation of human peripheral blood lymphocytes by either PHA, tetanus toxoid or allogeneic cells. These results indicate that rsT4 will potentially exert minimal immunosuppressive effects in vivo, thus supporting the feasibility of clinical trials of rsT4 in the treatment or prevention of AIDS. In addition, the implications of these results for the interactions between CD4 and MHC class II molecules during lymphocyte activation are discussed. PMID- 3264293 TI - The bleeding/plaque ratio in the treatment of periodontal disease. AB - The bleeding/plaque ratio has been suggested as a means of assessing susceptibility to periodontal disease, and as a prognosticator of periodontal breakdown. In this study, 100 males and 131 females were evaluated by means of the bleeding/plaque ratio to make a prognosis of the outcome of periodontal therapy. Initial plaque and gingival bleeding scores were used to calculate the bleeding/plaque of the subjects, and these ratios were compared with the resolution in the clinical parameters of plaque, gingival bleeding and severe and moderate pocketing. The subjects were divided into those showing higher bleeding incidence and lower bleeding incidence as assessed by post-treatment gingival bleeding. The bleeding/plaque ratios for the 2 groups were not significantly different, and therefore could not be used clinically for assessment of susceptibility to, or for prognostication of periodontal breakdown. 4 subjects were randomly selected from these 2 groups, and their data used to illustrate the limitations of the bleeding/plaque ratio. The bleeding/plaque ratios bore no relationship to the response to treatment in these 8 individuals, when evaluated in terms of reduction in plaque levels, gingival bleeding or pocketing. It is therefore concluded that the bleeding/plaque ratio in its present form is not of clinical value for making a prognosis of the likely outcome of treatment, and some suggestions as to how it may be improved are made. PMID- 3264294 TI - Effect of probing depth and bleeding tendency on the reproducibility of probing depth measurements. AB - The aim of this study was to determine the influence of the probing depth and the bleeding tendency on the reproducibility of probing depth measurements. Duplicate probing depth and bleeding tendency measurements were performed at 717 interproximal sites in 13 subjects. Analysis indicated that the factor probing depth had a larger effect on the accuracy of probing depth measurements than the factor bleeding tendency. PMID- 3264295 TI - Probing depth, attachment loss and gingival recession. Findings from a clinical examination in Ushiku, Japan. AB - The present investigation describes probing pocket depth, probing attachment level and recession data from 319 randomly selected subjects, aged 20-79 years, from Ushiku, Japan. The findings are reported as mean values, frequency distributions and percentile plots of the 3 parameters at buccal, interproximal and lingual surfaces of single rooted (incisors, canines, premolars) and molar teeth. Inter-as well as intra-examiner errors for probing pocket depth and probing attachment levels were assessed and found to be small. The data reported revealed that practically all subjects studied had one or more sites in the dentition affected by destructive periodontal disease and that the severity of disease increased with age. It was further observed that in each age group, molars had suffered more attachment loss than single rooted teeth and that the interproximal surfaces as a rule had lost more periodontal tissue support than corresponding buccal and lingual surfaces. The attachment loss difference observed between different surfaces of a given tooth or a group of teeth, however, was comparatively small. In the age groups between 20-59 years, advanced destructive periodontal disease was found in a small subgroup of the subject sample, while after the age of 60 years, widespread destructive periodontitis was common. An attempt was made to examine the progression of destructive disease with age by comparing the frequency distributions of sites with attachment loss of greater than or equal to 3 mm in subjects of different age groups. The data suggested that in younger subject groups, progression was confined to a subset of individuals, while in older age groups, more subjects and sites became involved. A major feature of destructive periodontal disease in older individuals was the accompaniment of attachment loss with recession at the gingival margin. Deep pockets were relatively infrequently detected, while advanced loss of attachment (with recession) occurred at many sites. PMID- 3264296 TI - Organization of calcitonin gene-related peptide-immunoreactive terminals in the primate dorsal horn. AB - The present paper is concerned with the arrangement of axons and synaptic terminals immunostained for calcitonin gene-related peptide (CGRP), a primary afferent marker, in the primate (Macaca fascicularis) dorsal horn. The CGRP axons and terminals are uniformly distributed in laminae I and II outer (o) but they are concentrated laterally and distributed intermittently in the reticulated region of lamina V. A prominent bundle of labeled axons is seen in the sacral cord dorsal to the central canal. Emphasis is given to the relation of CGRP immunoreactive terminals to other terminals, both labeled and unlabeled, in laminae I and IIo. In this regard, adjacent CGRP-immunoreactive terminals are often united by puncta adhaerentia. Of particular interest is the observation that CGRP-immunoreactive terminals can be found presynaptic to other terminals which sometimes resemble central primary afferent endings. In addition CGRP immunoreactive terminals end on other CGRP terminals. Both findings suggest that primary afferent terminals interact synaptically with other primary afferent terminals. PMID- 3264297 TI - Calm group. Prevalence of craniomandibular dysfunction in white children with different emotional states. AB - Malocclusion, oral parafunctions, dentofacial injuries, orthodontic treatment, and emotional states are factors that have been implicated in the etiology of craniomandibular dysfunction. In a sample of 386 white children, the number of children rated by their parents as calm was 250 (108 boys, 142 girls). Malocclusion and oral parafunctions are considered to be the causative factors in this group. PMID- 3264298 TI - The alcohol-impaired dentist: an educational challenge. AB - A cross-sectional survey of 370 dental practitioners, a 74% response rate, was conducted and data collected. Prevailing attitudes within the dental profession toward the alcohol abuser and the role of peer intervention were recorded. Data collectively indicated a need for further strengthening educational efforts and the need for further development of a peer-assistance network. PMID- 3264299 TI - Protective effect of a traditional Chinese medicine, xiao-chai-hu-tang (Japanese name: shosaiko-to), on Listeria monocytogenes infection in mice. AB - Lethal effect of Listeria monocytogenes (L. monocytogenes) in mice was prevented by an intraperitoneal (ip) injection of a traditional Chinese herbal medicine, xiao-chai-hu-tang (Japanese name: shosaiko-to), 4 days before ip bacterial infection. The numbers of bacteria in the peritoneal cavity and liver were smaller in shosaiko-to-treated mice from one day after the infection. Macrophage accumulation in the peritoneal cavity after ip inoculation of L. monocytogenes was observed in both untreated and shosaiko-to-treated mice. Although rates of such increases were almost the same between both groups, the absolute number of macrophages was larger in shosaiko-to-treated than in untreated mice because of a higher level of the macrophage number at 4 days after ip injection of shosaiko to. In untreated mice, bactericidal activity of peritoneal macrophages decreased from one day to 3 days after ip injection of killed L. monocytogenes. Such an activity was maintained at the same level from 1 to 3 days in shosaiko-to-treated mice. Augmented accumulation of macrophages and maintenance of their bactericidal activity may be main mechanisms of the augmented resistance in shosaiko-to treated mice. Augmented resistance against bacterial growth in the thigh muscle in ip shosaiko-to-treated mice may be caused by such mechanisms. The effect of shosaiko-to observed at an early stage of infection may be T cell-independent, since such an effect was observed in athymic nude mice and delayed footpad reaction could not be detected at such a timing in euthymic normal mice. PMID- 3264300 TI - Suppressive and enhancing effect of T-2 toxin on murine lymphocyte activation and interleukin 2 production. AB - T-2 toxin, a fungal metabolite shown previously to exert potent immunosuppressive effects, was examined for its effects on activation and interleukin 2 (IL 2) production by murine and rat splenocytes. Splenocytes (1 X 10(6) cells/well) were incubated with 1 microgram Concanavalin A (Con A) for 48 h at which time cellular protein and DNA synthesis by these cells were ascertained using radiolabeled precursors. IL 2 synthesis was determined from the cell supernatant using the IL 2-requiring cell line CTLL. Spleen cells from mice treated for 4 consecutive days with 2 mg/kg toxin exhibited a 50% reduction in in vitro Con A activation but the supernatant IL 2 levels from these cells was 4-fold higher than cells from control mice. In vitro exposure of Con A-activated normal spleen cells to various toxin doses for 48 h resulted in diminished protein and DNA synthesis at 0.4 ng toxin with maximum inhibition at 1 ng (50% inhibition (TCID50) = 0.5 ng). Enhanced synthesis of both products was observed at lower toxin concentrations. IL 2 production by these cells followed a similar toxin dose response. Rat splenocytes were slightly more resistant and CTLL cells were slightly more sensitive to T-2 toxin than mouse splenocytes. These results indicate the variable effects a cytotoxic agent can have on lymphoid cells and that dosage is an important parameter for these effects. PMID- 3264301 TI - Anti-Ig antibody inhibits the phorbol ester-induced stimulation of peritoneal B cells. AB - Peritoneal B cells are stimulated to enter S phase by phorbol esters acting alone, in the absence of a co-mitogen. Anti-Ig antibody inhibited the stimulation of peritoneal B cells induced by phorbol esters and this inhibition was apparent throughout the time course of PMA-induced stimulation. Assessment of inhibition after depletion of Ly-1+ B cells suggested that PMA-induced stimulation of both Ly-1+ and Ly-1- B cells was affected by anti-Ig. Inhibition produced by anti-Ig was substantially reduced after even a brief delay in the addition of antibody to PMA-stimulated B cells. Anti-Ig antibody may counteract early events triggered by PMA within minutes of peritoneal B cell stimulation. PMID- 3264302 TI - The 28-kDa/32-kDa activation antigen EA 1. Further characterization and signal requirements for its expression. AB - The tumor promoter PMA has been shown to induce the expression of a 28-kDa/32-kDa early activation Ag, termed EA 1, on resting T cells. Under nonreducing conditions, EA 1 was detected by SDS-PAGE as a diffuse band in the 60-kDa region. In this study, this diffuse band was resolved into 56-kDa and 60-kDa bands. Endoglycosidase F treatment of EA 1 resulted in the appearance of a single band with a Mr of 48 kDa. Upon reduction, the 48-kDa band was shown to be composed of 24-kDa peptides. Diagonal gel electrophoresis showed that the major band of EA 1 was composed of a series of disulfide-linked homodimers with subunits of the same 24-kDa core protein that were differentially glycosylated. This analysis also revealed in a minor population of the EA 1 molecules, the presence of proteins of different Mr associated with the core protein. The signal requirements for the induction of EA 1 were investigated. The putative cellular action of PMA is the activation of protein kinase C (PKC). To further investigate the role of PKC activation in the expression of EA 1, the synthetic diacylglycerol, 1,2-sn dioctanoylglycerol (diOG) was examined for its ability to substitute for PMA. DiOG induced EA 1 expression in a dose dependent manner. H-7, a relatively selective inhibitor of PKC, blocked diOG and PMA induced EA 1 expression. HA1004, a selective inhibitor of cAMP- and cGMP-dependent protein kinases, had no effect. In kinetic studies, EA 1 expression was seen as early as 1 h in diOG- and PMA activated T cells. However, diOG did not completely mimic PMA-induced EA 1 expression. By 18 h, diOG-induced EA 1 expression was markedly reduced, whereas PMA-induced EA 1 expression was persistent. The role of calcium in EA 1 expression was investigated. mAb against CD3 potentiated diOG-induced EA 1 expression. This potentiation appeared to correlate with the ability of the anti CD3 mAb to induce rises in intracellular calcium. Addition of EGTA to the media blocked the potentiation of diOG induced EA 1 expression by these mAb. The role of calcium in EA 1 expression was further demonstrated by the ability of ionomycin to potentiate EA 1 expression. These results demonstrate that PKC activation is the primary pathway for the induction of EA 1. However, calcium dependent pathways appear to have a secondary role. PMID- 3264303 TI - Clonal analysis of autoantibody-producing cell precursors in the preimmune B cell repertoire. AB - Evidence for anti-self-reactivity in the preimmune B cell repertoire has been well documented. The present study aimed to determine the frequency of antibody forming cell precursors in this repertoire whose Ig V regions impart reactivity to "self" or autologous Ag. Clones were activated in vitro with LPS and their secreted IgM antibody was assayed for reactivity by direct binding to cell surface or intracellular Ag. An IL-4-containing lymphokine mixture was added to the clonal cultures to induce the secretion of IgG1. The reactivity of secreted IgG1 with Ag would more closely resemble the binding required to activate B cells through their monomeric surface IgM and/or IgD. The results indicate a high frequency of precursors secreting IgM with reactivity to intracellular Ag, namely 1 in 37 +/- 6 B cells, with a marked paucity of response to cell surface molecules. The repertoire was markedly deficient in precursors secreting IgG1 able to bind to intracellular Ag, with only one clone detected by the screening of 3.0 x 10(6) spleen cells. No positives were detected for cell surface Ag. This suggested that the frequency of clones in the preimmune repertoire that express IgR with sufficient affinity to bind "self" molecules must be very low. PMID- 3264304 TI - T cell recognition of bovine ribonuclease. Self/non-self discrimination at the level of binding to the I-Ak molecule. AB - Bovine RNase A specific T-cell hybridomas were generated to study the recognition of foreign Ag by T lymphocytes. One hybrid, TS12, was shown to recognize RNase in association with I-Ak. This hybridoma required bovine RNase to be processed before recognition. The immunogenic determinant on the RNase molecule recognized by TS12 was localized to the tryptic fragment RNase(40-61). All of the stimulatory ability of this determinant was shown to be contained within the synthetic 14mer RNase(43-56). When this segment of bovine RNase was compared with the self murine sequence, only one amino acid difference was found, a substitution of a proline residue at position 50 for a serine residue. This substitution completely abolishes binding to the I-Ak molecule, as shown by both functional and direct binding assays. This finding shows that self/non-self discrimination not only occurs at the level of the T cell, but also can be caused by an inability of the self peptide to associate with a class II molecule. PMID- 3264305 TI - In vivo effects of hyperdiploid Ly-1+ B cells of NZB origin. AB - Cells with increased chromosome number and DNA content have been found in the spleens of old NZB mice. These hyperdiploid cells are of clonal origin and demonstrate discrete IgH chain gene rearrangements by Southern blot analysis. In this report, hyperdiploid cells were analyzed by three-color flow cytometric techniques and found to be Ly-1+ B cells which were dull for Ly-1 and bright for surface IgM. These cells, unlike typical diploid Ly-1+ B cells, were negative for B220/6B2 and surface IgD. Hyperdiploid Ly-1+ B cells were found to be the predominant splenic subpopulation in animals receiving a spleen cell transfer from donors which possessed hyperdiploid Ly-1+ B cells. (NZB x DBA/2)F1 recipients of NZB spleen cells demonstrated a 10- to 1000-fold increase in Ly-1+ B cells in the spleen but showed no increased levels of Ly-1+ B cells in the peritoneum. Nearly all the splenic Ly-1+ B cells were hyperdiploid with the phenotype of the NZB parent. Cytogenetic analysis revealed that all the hyperdiploid cells were NZB donor cells. These findings suggest that the increase in splenic Ly-1+ B cells in the F1 recipients was due to expansion of injected splenic hyperdiploid Ly-1+ B cells of NZB origin. All of the F1 recipients of NZB hyperdiploid Ly-1+ B cells demonstrated a significant decrease in endogenous B cells as well as decreased serum IgM and anti-ssDNA autoantibodies. These studies suggest that hyperdiploid Ly-1+ B cells are different from typical peritoneal Ly 1+ B cells both in the lymphoid organs to which they home and in their proliferative capacity. NZB hyperdiploid Ly-1+ B cells, which may arise as a natural consequence of hyperactive Ly-1+ B cells, may play an immunoregulatory role in the spleen. PMID- 3264306 TI - A possible ligand of serum origin for the kidney autoantigen of Heymann nephritis. AB - Earlier studies have localized the Heymann nephritis (HN) autoantigen (gp330) in the coated pits of the plasma membrane and multivesicular bodies of the glomerular epithelial cell. Because of these locations in the glomerular epithelial cells, it has been suggested that the HN Ag may be a receptor. The aim of our study was to search for a ligand which can bind the HN autoantigen. Normal rat serum was subjected to SDS-PAGE under reducing and non-reducing conditions followed by Western analysis of the separated polypeptides. A reaction was revealed directly by autoradiography using 125I labeled HN autoantigen as a probe and indirectly by enzyme immunodetection using unlabeled nephritogenic autoantibody (anti-gp330) eluted from glomeruli of diseased rats followed by biotinylated rabbit anti-rat IgG avidin-peroxidase complex. A polypeptide of 76 kDa Mr was identified under non-reducing conditions as a serum protein reacting with the HN autoantigen. Reactivity of the 76-kDa polypeptide was lost when serum was electrophoresed under reducing conditions. Direct binding of the 76-kDa polypeptide obtained from serum to the HN autoantigen obtained from kidney suggests that the 76-kDa polypeptide may be a ligand for the autoantigen. This is the first documentation of a possible ligand for the HN autoantigen. Not only does this polypeptide bind to the HN autoantigen but it also shows direct binding with the nephritogenic autoantibody eluted from glomerular deposits. This characteristic of the 76-kDa polypeptide indicates that this serum protein may potentially play a role in the development of the glomerular lesion of active HN. Further analysis of this serum component should assist in understanding the normal function of the HN autoantigen. PMID- 3264307 TI - Characterization of GP120 binding to CD4 and an assay that measures ability of sera to inhibit this binding. AB - There is evidence that the initial interaction between HIV-1 and the host that is essential for infection is the specific binding of the viral envelope glycoprotein, gp120, to the CD4 molecule found on certain T cells and monocytes. Most individuals infected with HIV develop antibodies against the gp120 protein. Although in vitro treatment of CD4+ T cells with mAb to a specific epitope of the CD4 molecule (T4a) blocks virus binding, syncytia formation, and infectivity, it is unclear if antibodies to gp120 from an infected individual that can inhibit the binding of gp120 to CD4 is in any way related to the clinical course of disease. Our present study characterizes the binding of 125I-labeled rgp120 to CD4+ cells, and describes an assay system that measures a potentially relevant form of immunity to HIV infection, i.e., the blocking of HIV binding to CD4+ cells. Optimal binding conditions included a 2-h incubation at 22 degrees C, 4 x 10(6) CD4+ cells, and 1 nM gp120. The dissociation constant (KD) for gp120 binding to cell surface CD4 was 5 nM, and was inhibited by soluble CD4 and by mAb to T4a but not to T3 or T4. For the binding inhibition assay, negative controls included healthy seronegatives, seronegatives with connective tissue diseases, patients with HTLV-1 disease, and patients infected with HIV-2. In studying over 100 sera, the assay was highly sensitive (98%) and specific (100%). The majority of HIV+ sera could inhibit binding at dilutions of 1/100 to 1/1000. No correlation was noted between binding inhibition (BI) titer in this assay and clinical stage of HIV infection. In addition, there was no correlation between BI titer and HIV neutralizing activity. The BI titer was correlated with the titer of anti-gp160 (r = 0.63) and the titer of anti-gp120 (r = 0.52) antibodies determined by Western blot dilution. As with neutralizing antibodies and other forms of immune response to HIV, it is unclear what role antibody blocking of HIV binding to CD4+ cells may play in active immunity to HIV in infected individuals. This activity may prove to have some value in protection against initial HIV infection and, thus, the assay may be of use in monitoring vaccine trials. PMID- 3264308 TI - Restricted expression of mitogen-induced high affinity IL-2 receptors in aging mice. AB - Several lines of indirect evidence suggest that the number and/or affinity of IL 2R expressed by activated T lymphocytes declines with age and that this decline is implicated in the age-related proliferative impairment of Ag or mitogen stimulated T cells. In an attempt to provide a direct demonstration of such a defect, various experimental approaches were used to analyze the expression of high and low affinity IL-2R as well as their functional properties in relation to age in purified populations of murine T lymphocytes. IL-2R were induced by Con A activation which involves a transmembrane signaling mechanism or by exposure to phorbol dibutyrate (PDBu) which bypasses such a pathway. Consistent with the previously reported age-related defect in signal transduction, a major deficiency in the expression of high affinity IL-2R was observed in mitogen-activated cells derived from aged animals. As expected, PDBu-induction circumvented the transmembrane signaling defect and resulted in the restoration of a measurable amount of high affinity IL-2R expressed by cells from aged mice early after activation. The functional properties of the IL-2R expressed as a consequence of Con A or PDBu induction were investigated by assessing the proliferative response induced through the high affinity IL-2R as compared to that mediated by the beta chain alone. Although Con A-induction resulted in a decreased expression of high affinity IL-2R by T lymphocytes derived from aged mice, the ability of these receptors as well as that of their beta-chain component to transmit a proliferative signal was identical in both age groups. In contrast, PDBu induced in both cell populations the expression of functionally aberrant IL-2R, unable to signal for proliferation unless excessively high concentrations of rIL-2 were available. The quantitative minimal estimate of the frequency of Con A-activated, IL-2-responsive cells showed a fourfold age-associated decrease, confirming the inability of a subpopulation of T lymphocytes from aged mice to express a sufficient density of high affinity IL-2R as a consequence of mitogenic activation. PMID- 3264309 TI - IL-2-PE40 is cytotoxic for activated T lymphocytes expressing IL-2 receptors. AB - IL-2-PE40 is a chimeric molecule in which IL-2 is attached to the amino end of modified Pseudomonas exotoxin molecule lacking cell recognition domain. This molecule was extremely toxic for Con A-stimulated spleen cells from mice. Moreover, IL-2-PE40 has suppressive effect against Ag-activated cells; it inhibits the generation of cytotoxic T lymphocyte activity in a MLC. IL-2-PE40 could be a useful agent in IL-2R targeting therapy including immunosuppressive therapy for allograft rejection or some autoimmune diseases. PMID- 3264310 TI - Functional analysis of mononuclear cells infiltrating into tumors. IV. Purification and functional characterization of cytotoxic cell-generating factor. AB - Rat cytotoxic cell-generating factor (CGF) was purified from cell-free supernatants of a T cell hybridoma (6B2-B8) that constitutively produces CGF. CGF activity was assessed by its ability to generate cytotoxic cells against 51Cr labeled T-9 cells from spleen cells of T-9-immunized rats. The purification scheme consisted of ammonium sulfate precipitation, AcA 54 gel permeation, Mono Q anion exchange chromatography, Superose 12HR 10/30 gel permeation, SDS-PAGE with subsequent electroelution, and ProRPC HR5/10 reverse phase column chromatography. Overall, CGF was purified approximately 13,000-fold, with a maximum 2.5% recovery of activity, and the sp. act. of the purified CGF was approximately 19,000 U/mg. The purified CGF is distinct from the other lymphokines such as IL-1, IL-2, IL-3, IL-4, T cell-replacing factor/IL-5, IL-6, and IFN-gamma. It is capable of promoting the generation of cytotoxic T cells from R1-10B5 (+) spleen cells of T 9-immunized rats and also stimulates a W3/25 (+) T cell hybridoma to express the IL-2R. The CGF has an apparent m.w. of 28,000 under non-reducing and 14,000 and 16,000 under reducing conditions. 125I-labeled CGF binds to normal thymocytes as well as splenic T cells. The highest level of binding of CGF was detected on splenic T cells derived from T-9-immunized rats that were previously shown to contain CTL precursors. The binding analysis with 125I-labeled CGF demonstrated that CGF binds to a specific cell surface molecule with an approximate m.w. of 60,000 to 70,000. PMID- 3264311 TI - Suppression of lymphokine-activated killer induction by neutrophils. AB - Peripheral blood polymorphonuclear neutrophils (PMN) suppressed the induction of PBL lymphokine-activated killer (LAK) function by rIL-2 in vitro. The suppression depended on the concentration of PMN in the IL-2 culture, and required intact PMN. However, PMN did not require treatment with immunoregulators such as IL-2, LPS, or TNF to express the suppressive activity, and no direct contact with PBL was needed for the suppression. Addition of anti-TNF antibodies had no effect on the suppression, suggesting that no endogenous TNF in the culture was involved in the suppression. PMN did not inhibit LAK function by preventing utilization of IL 2 by PBL or by selective depletion of NKH-1+ cells which constitute the majority of LAK precursors in PBL. The suppression was reversed by superoxide dismutase but not by catalase, suggesting that superoxide anion, not hydrogen peroxide, was involved in the suppression. No other suppressive factor was detectable in PMN culture supernates. Our results of PMN regulating LAK induction in vitro suggest that PMN may have a role in determining the outcome of immunotherapy with IL-2 in vivo. PMID- 3264312 TI - H-2Kb antigen expression has no effect on natural killer susceptibility and tumorigenicity of a murine hepatoma. AB - Recent reports suggested a correlation between decreased expression of tumor cell MHC class I Ag and increased susceptibility to NK cells. These studies led to the hypothesis that tumor cells displaying reduced levels of MHC class I Ag have reduced tumorigenicity in vivo because they are eliminated from the host by endogenous NK cells. The present studies use the murine hepatoma BW7756 and a spontaneous H-2Kb loss variant, Hepa-1, to test this hypothesis. The parental BW7756 tumor is highly malignant in syngeneic C57L/J hosts while Hepa-1 cells do not give rise to tumors, suggesting that the loss of H-2Kb Ag expression correlates with decreased tumorigenicity and NK susceptibility. Hepa-1 cells were therefore transfected with an H-2Kb gene to generate H-2Kb Ag expressing clones. The resulting clones were tested for tumorigenicity. Syngeneic or NK-deficient C57BL/6-beige/beige mice challenged with Hepa-1 or the H-2Kb transfectants rejected the cells, suggesting that reexpression of H-2Kb Ag does not restore tumorigenicity and that NK cells are not involved in Hepa-1 rejection. In vitro H 2Kb Ag-negative and -positive Hepa-1 cells are equally susceptible to tilorone boosted NK cells, indicating that MHC class I Ag expression also does not affect in vitro NK susceptibility. Tumor challenged athymic nude and sublethally irradiated syngeneic mice develop tumors demonstrating that T cells are probably responsible for rejection of the Hepa-1 tumor, and that H-2Kb Ag expression has no effect on rejection. Inasmuch as the expression of H-2Kb Ag on Hepa-1 cells does not effect tumorigenicity or in vitro NK susceptibility, the previously reported association between reduced MHC class I Ag levels and increased NK susceptibility is not universally applicable. PMID- 3264313 TI - In vitro assays to study role of T cell-derived factors on human B lymphocytes should take into consideration inhibiting effect of large granular lymphocyte subset (CD5-,CD16+) that can contaminate B cell preparations. AB - In these studies, the inhibitory role of a large granular lymphocyte (LGL) subset (CD5-,CD16+) on pokeweed mitogen (PWM)-induced B lymphocyte differentiation was examined. CD5-,CD16+ LGL cells are the predominant subset of LGL cells and are possibly distinct from other LGL subsets in that they lack B and T cell markers. CD5-,CD16+ LGL possess abundant FcIgG receptors and previous studies have clearly demonstrated that in the presence of insoluble immune complexes, this LGL subset will inhibit B lymphocyte differentiation in the presence of T cells. In the present studies, we analyzed the inhibiting role of CD5-,CD16+ LGL cells that had not been activated by immune complexes. B + L preparations obtained by removal of E rosette-forming T cells were further depleted of T lymphocytes by complement dependent lysis of T cells using a monoclonal antibody reactive to total T cells (Leu-1, CD5 antigen, Becton-Dickinson). B lymphocytes in such B + L preparations failed to differentiate into plasma cells containing intracytoplasmic immunoglobulin (Ig), in the presence of PWM, T cell-derived helper supernatants (THS), and interleukin-2 (IL-2). However, B cells differentiated under these conditions, when B + L preparations were further depleted of CD5-,CD16+ LGL cells by complement-dependent lysis using a monoclonal antibody (Leu-11) reactive to CD16 antigen of FcIgG receptors present on LGL cells. These studies indicated that CD5-,CD16+ cells unlike the CD8-positive T suppressor cell, will directly inhibit B lymphocyte differentiation into plasmacytoid cells containing intracytoplasmic Ig when T lymphocytes are not present. However, addition of a few T lymphocytes (less than 10%) to purified B + L preparations abrogated the CD5-,CD16+ LGL cell inhibition of B cell differentiation. PMID- 3264314 TI - Immunogenetic analysis of human tuberculosis. AB - An investigation was undertaken to determine if susceptibility and/or immune response to Mycobacterium tuberculosis was associated with histocompatible leukocyte antigen (HLA) phenotype frequencies of class I or II antigens. Comparisons of the HLA phenotypes of 51 Mexican-American patients with tuberculosis and 54 healthy subjects who differed in their skin-test reactivity to purified protein derivative (PPD) revealed that HLA-DR3 was significantly decreased in patients with tuberculosis, compared with healthy persons who were tuberculin skin-test positive. Although no association was observed between HLA phenotype and skin test reactivity to PPD in tuberculous patients, we did observe an increase in the HLA-A9-B40 phenotype in patients who manifested a strong in vitro proliferative response to PPD, whereas the HLA-B14-DR1 phenotype was increased in patients who exhibited a low proliferative response to this antigen. PMID- 3264315 TI - Glycoproteins of Pneumocystis carinii: characterization by electrophoresis and microscopy. AB - Glycoproteins are integral components of cell-surface structure and participate in adherence of pathogenic microbes to host cells. We have initiated studies of the glycoproteins of Pneumocystis carinii. Biotin-conjugated lectins, followed by reaction with avidin-peroxidase, were used to detect glycoproteins in electrophoretically separated proteins of P. carinii and on whole organisms when using light microscopy. Glycoproteins of P. carinii were clearly different from rat cell glycoproteins. Multiple glycoproteins were present in P. carinii and exhibited intense reactivity to both concanavalin A and wheat-germ agglutinin. Those lectins that reacted with the electrophoretically separated proteins also stained both alcohol-fixed P. carinii and the extracellular granular material present only in P. carinii preparations. In electron micrographs of P. carinii, which were stained with colloidal-gold-labeled concanavalin A, we found that the lectin bound to the outer surface of the organisms and to the tubular extensions emanating from the exterior surface. PMID- 3264316 TI - Carotid endarterectomy. Pre- and post-operative monitoring with cerebral SPECT. AB - In the pre-operative evaluation of carotid endarterectomy, the knowledge of ischemic areas may be helpful to reduce the operative risk. A positive CT scan is often correlated with an increased operative risk. The single photon emission computed tomography (SPECT) allows us to visualize ischemic areas not shown by the CT; these areas are almost always correlated to neurological symptomatology. In patients with positive CT scan, the ischemic areas shown by SPECT are generally larger, because this technique visualize the ischemic area surrounding the cerebral infarct (penumbra). After carotid EA, SPECT is useful to show the hemodynamic modifications induced by this operation. In a series of 15 patients we observed an improvement of the cerebral blood perfusion characterized by the normalization of the blood flow in 7/12 (58%) of the ischemic areas observed pre operatively), an improvement in 3/12 and a normalization or an improvement in the contralateral hemisphere in 5/7 of the areas. In conclusion SPECT is a useful technique to study the cerebral pathophysiology of both cerebrovascular disease and its surgical treatment. PMID- 3264317 TI - Effect of exercise on the leg distribution of C15O2 and 15O2 in normals and in patients with peripheral ischemia: a study using positron tomography. AB - In order to evaluate regional muscle blood flow and oxygen utilization, we study with positron emission tomography (PET) the distribution of C15O2 and 15O2 in 17 subjects: 5 normals (24 +/- 3 years) and 12 patients (63 +/- 13.5 years). C15O2 and 15O2 are inhalated with a steady-state technique. Positron tomograms are recorded in supine position at the greatest diameter of the leg. Exercise consists in simultaneous ankle flexions. In all normals, C15O2 and 15O2 are distributed homogeneously and symmetrically in both legs. At rest, they concentrate in the region of vascular pedicle. After exercise, C15O2 and 15O2 are electively distributed in the anterolateral region of the leg. In patients, this pattern of distribution is similar but asymmetrical. Moreover, the regional uptake of C15O2 and 15O2 often dissociates. In conclusion, C15O2 and 15O2 allow to study repeatedly muscle blood flow and oxygen utilization in patients with peripheral ischemia, both at rest and after exercise. The broad spectrum of pathological changes observed in this study needs further metabolic investigations. PMID- 3264318 TI - Loss of CD4 membrane expression and CD4 mRNA during acute human immunodeficiency virus replication. AB - Using mAbs and genomic probe to the CD4 molecule, the HIV receptor, we demonstrated that HIV replication induces the disappearance of its functional receptor from the cell surface by two distinct mechanisms. First, after being expressed onto the cell surface, HIV envelope gp110 will complex CD4, efficiently masking the CD4 epitope used by the virus to bind its receptor. This phenomenon occurs on the surface of each infected cell and is not due to the release of soluble gp110; infection with recombinant HIV/vaccinia viruses expressing a mutated HIV env gene designed to prevent gp110 release from the cell surface induces a similar gp/CD4 complexes formation. Second, virus replication induces a dramatic and rapid loss of CD4 mRNA transcripts, preventing new CD4 molecules from being synthesized. These two mechanisms of receptor modulation could have been developed to avoid reinfection of cells replicating the virus as well as to produce more infectious particles. These results suggest that the classical virus interference documented for other retroviruses might not only be due to receptor/envelope interaction, but might also depend on receptor gene expression. PMID- 3264319 TI - Monoreactive high affinity and polyreactive low affinity rheumatoid factors are produced by CD5+ B cells from patients with rheumatoid arthritis. AB - In patients with rheumatoid arthritis (RA), circulating CD5+ B lymphocytes, but not CD5- B lymphocytes, are increased in number and size, exist in an activated state, spontaneously proliferate, and secrete Ig that binds to the Fc fragment of IgG. By constructing continuous mAb-secreting cell lines from CD5+ B lymphocytes, the properties and dissociation constants (Kd) of these antibodies were determined. Two types of rheumatoid factors (RFs) with discrete reactivities were produced. The first type is polyreactive and binds with relatively low affinity (Kd, 10(-5) mol/liter) to the Fc fragment of IgG. These antibodies are similar to those produced by CD5+ B cells from healthy subjects. The second type of RF is monoreactive and binds with higher affinity (Kd, 10(-7) mol/liter) to the Fc fragment of IgG. These latter autoantibodies are produced by CD5+ B cells of RA patients, but not healthy subjects. Long-term longitudinal studies are needed to determine the role of these two types of RFs in the pathogenesis of RA. PMID- 3264320 TI - A second chain of human CD8 is expressed on peripheral blood lymphocytes. AB - Human CD8 has been thought to consist of disulfide-linked homodimers and homomultimers of a single polypeptide chain homologous to mouse and rat CD8 alpha. In contrast, mouse and rat CD8 are composed of disulfide-linked heterodimers of alpha and beta chains. We have now isolated and sequenced cDNA clones encoding a human homologue of mouse and rat CD8 beta. One such clone was inserted into an expression vector and its encoded product was shown to be expressed on the cell surface after cotransfection into L cells with the human CD8 alpha gene. A second form of human CD8 beta cDNA encoding a protein with an altered cytoplasmic tail was similarly transfected, but its product could not be demonstrated on the cell surface. CD8 beta was further shown to be expressed on the surface of almost all CD8+ human peripheral blood T cells. These data provide the first evidence that human CD8 is a heterodimeric protein. PMID- 3264321 TI - Strain variation in the frequency of Abelson murine leukemia virus-transformed fetal liver pre-B cells bearing complete immunoglobulin heavy chain rearrangements. AB - Fetal liver Abelson pre-B cell lines obtained from CBA/Tufts.xid and (CBA/Tufts.xid x CBA/Tufts)F1 mice have complete VDJH rearrangements on at least one allele. Such high frequencies of VDJH rearrangements have previously been observed in adult derived but not fetal liver derived Abelson pre-B cell lines. Genetic analyses suggest that CBA/Tufts.xid carries an autosomal dominant gene(s) that determines the predominance of VDJH rearrangements among transformants. This autosomal gene(s) might affect the intrinsic development of the early B cell lineage in the fetus or the fetal microenvironment, expanding pre-B cells of the "more mature" VDJH phenotype. PMID- 3264322 TI - Recognition of influenza A matrix protein by HLA-A2-restricted cytotoxic T lymphocytes. Use of analogues to orientate the matrix peptide in the HLA-A2 binding site. AB - CTL specific for the influenza A virus matrix peptide 57-68 and restricted by HLA A2 were studied. Their ability to recognize a set of analogue peptides, each of which differed from the natural peptide by a single amino acid, was analyzed. This revealed a core of five amino acids, 61-65, where one or more changes completely abrogated recognition. The glycine at position 61 was the only residue where no substitution was tolerated. Analogue peptides that did not induce CTL mediated lysis were tested as competitors with the natural peptide; those with substitutions at positions 60, 64, and 65 inhibited, identifying residues that interact with the TCR. Another approach was to test a set of four CTL clones on all of the analogues. Marked differences in recognition by individual CTL clones were observed for several substituted peptides. The data indicate that most of the analogues bind to HLA-A2 with possible differences in fine positioning of the peptide. An alpha helical orientation for the peptide is discussed. PMID- 3264323 TI - Expression of a functional CD3-Ti antigen/MHC receptor in the absence of surface CD2. Analysis with clonal Jurkat cell mutants. AB - To investigate the requirement for CD2 expression in activation of T lymphocytes via the CD3-Ti antigen/MHC receptor complex, we produced and characterized a series of CD2- Jurkat variants. These mutants lack detectable surface CD2 as determined by indirect immunofluorescence, immunoprecipitation analysis, and specific radiolabeled antibody binding assay, but nevertheless, expressed normal numbers of CD3-Ti receptors. As expected, the combination of anti-CD2 antibodies, termed anti-T112 and anti-T113, which are mitogenic for resting T lymphocytes, failed to stimulate activation of these variants. In contrast, triggering of their CD3-Ti components resulted in the normal set of T lymphocyte-associated activation events, including phosphoinositide turnover, elevation in intracellular free calcium, early gene-induction events, and IL-2 production. Assuming that the Jurkat cell line is representative of normal cycling human T lymphocytes, we conclude that the presence of the CD2 molecule on the plasma membrane is not in itself a requirement for an operational CD3-Ti-alpha/beta receptor. PMID- 3264324 TI - Interleukin 4 promotes the growth of tumor-infiltrating lymphocytes cytotoxic for human autologous melanoma. AB - Addition of IL-4 (1,000 U/ml) to either high or low concentrations of IL-2 augmented tumor-infiltrating lymphocytes (TIL) growth from human melanoma. Weekly restimulation with irradiated tumor cells in conjunction with IL-4 allowed enhanced growth of TIL. With low-dose IL-2 (10 U/ml) and IL-4, expanded TIL had little cytolytic activity against Daudi or allogeneic tumors. Further, IL-4 augmented the total lytic activity against autologous tumors in most cases. With high-dose IL-2 (1,000 U/ml), IL-4 addition decreased nonspecific killing activity against Daudi or allogeneic melanomas in many cases, and reciprocally augmented cytolytic activity against the autologous melanoma in many cases. This suggests the possible use of IL-4 in cancer therapy, especially in adoptive cellular immunotherapy using TIL or in conjunction with IL-2 administration. PMID- 3264325 TI - Deletion of potentially self-reactive T cell receptor specificities in L3T4-, Lyt 2- T cells of lpr mice. AB - The current study examines the possibility that the TCR repertoire of L3T4-, Lyt 2- cells in lpr/lpr mice is enriched for self-reactive specificities. T cells utilizing V beta 17a and V beta 8.1 gene products have been shown to be clonally eliminated in nonautoimmune mice expressing I-Ek and Mlsa/H-2k, respectively, because of their potential self reactivity. We quantitated these V beta specificities in lymph nodes and spleens of lpr/lpr mice. The results indicate that lpr-dependent L3T4-/Lyt-2- T cells, similar to normal peripheral T cells, have undergone a repertoire modification such that potential self-reactive V beta specificities have been eliminated. Evidence for tolerance in this population provides insight into the development of these aberrant cells, and may also have important implications for normal T cell development in the thymus. PMID- 3264326 TI - Macrophages phagocytose thymic lymphocytes with productively rearranged T cell receptor alpha and beta genes. AB - The thymus gland is important for the formation of competent T lymphocytes. However, there is long-standing evidence that greater than 95% of newly formed thymocytes do not emigrate to peripheral lymphoid tissues but instead die locally. We have identified a rapid and selective pathway for thymocyte turnover in vitro. The mechanism entails binding, uptake, and digestion by macrophages. The susceptible cells are a subpopulation of double-positive thymocytes. These thymocytes can be enriched by virtue of their high buoyant density in Percoll and prove to have low levels of surface CD3 and little or no surface TCR. However TCR alpha and -beta genes have undergone rearrangement, and full length alpha and beta transcripts are abundant. Therefore many double-positive cells rearrange and express TCR genes but do not have normal levels of TCR on the cell surface. We propose that thymocytes that undergo high turnover in situ are unable to form receptors that can be selected by MHC molecules in the thymus, and that these cells are recognized and cleared by the macrophage. PMID- 3264327 TI - Human peripheral blood lymphocytes bearing T cell receptor gamma/delta. Expression of CD8 differentiation antigen correlates with the expression of the 55-kD, C gamma 2-encoded gamma chain. AB - We analyzed the CD3-associated molecules present on peripheral blood-derived TCR gamma/delta+ clones that express CD8 surface antigens. Clones were derived by limiting dilution from CD3+WT31- FACS-purified populations derived from several donors. Eight of greater than 300 TCR-gamma/delta+ clones analyzed expressed CD8 and reacted with delta-TCS-1 mAb. Cell numbers suitable for more detailed analyses could be obtained from four clones, including one derived from thymus. Analysis of CD3-associated TCR molecules immunoprecipitated by anti-Leu-4 (anti CD3) mAb under conditions that preserve the CD3/TCR association (1% digitonin) showed a predominant 55-60-kD molecule both under reducing and nonreducing conditions. On the other hand, the delta-TCS-1-reactive molecules immunoprecipitated from 25 CD3+ delta-TCS-1+ CD8- clones, in all instances, displayed a 40-44-kD mol mass. In two-dimensional PAGE, TCR-gamma molecules precipitated from delta-TCS-1+ CD8+ clones appeared more acidic than those of BB3+ or delta-TCS-1+ CD8+ clones. Southern analysis confirmed that this type of non-disulphide-linked TCR-gamma/delta is also coded for by the C gamma 2 gene segment. PMID- 3264328 TI - Mitogen plus interleukin 4 induction of C epsilon transcripts in B lymphoid cells. AB - To elucidate the mechanism of IL-4-induced enhancement of IgE and IgG1 production, murine splenic B cells and A-MuLV-transformed cells were cultured with LPS and IL-4 and assayed for epsilon and gamma 1 transcripts. Concomitant treatment with IL-4 and LPS induced expression of C epsilon transcripts in both normal and transformed cells. Expression of these truncated C epsilon transcripts preceded accumulation of normal epsilon mRNA in treated cells. Consistent data were obtained with respect to gamma 1 RNA expression. These results suggest that IL-4 can direct class switching in the context of a mechanism associated with differential expression of germline constant region genes. PMID- 3264330 TI - Method comparison of two test kits for the determination of elastase/alpha 1 proteinase-inhibitor complex. AB - A method comparison of the 4 h-elastase/alpha 1-proteinase-inhibitor test kit with a newly developed 2 h-version was performed. The within-run and between-days coefficients of variation as well as the recovery of the assigned values were satisfactory for both test kits. Good agreement was found between the 2 h- and 4 h-test kits using specimens from 160 patients. In conclusion, the 2 h-test kit can be used as an alternative for the determination of elastase/alpha 1 proteinase-inhibitor complex. PMID- 3264329 TI - Graft-versus-host-related immunosuppression is induced in mixed chimeras by alloresponses against either host or donor lymphohematopoietic cells. AB - Graft-vs.-host (GVH)-related immunosuppression has previously been demonstrated in F1 rodent recipients of parental lymphoid cells, and has been thought to result from an immunologic attack of the donor against the host. Since all cells of such F1 recipients could potentially bear target class I MHC alloantigens, it has not previously been possible to determine precisely the target tissues responsible for development of GVH-related effects. In the present studies we have used mixed allogeneic chimeras as recipients of host or donor-strain lymphocyte inocula, and have made the surprising observation that "GVH-induced" immune unresponsiveness does not require GVH reactivity, per se, but develops in the presence of a one-way alloresponse against lymphohematopoietic cells in either the GVH or the host-versus-graft direction. PMID- 3264331 TI - Non-essential genes in the vaccinia virus HindIII K fragment: a gene related to serine protease inhibitors and a gene related to the 37K vaccinia virus major envelope antigen. AB - The complete nucleotide sequence of a cloned copy of the HindIII K fragment of the WR strain of vaccinia virus has been determined. Eight open reading frames (ORFs) have been identified, on the basis of size and codon usage. The predicted amino acid sequences of the putative genes have been compared to the Protein Identification Resource and to published vaccinia virus sequences. One gene, predicted to encode a 42.2K protein, is highly related to the family of serine protease inhibitors. It shows approximately 25% identity to human antithrombin III and 19% identity to the cowpox virus 38K protein gene which is also related to serine protease inhibitors. The product of another gene shows a similar high level of identity to the 37K vaccinia virus major envelope antigen. The existence of viable deletion mutants and recombinants containing foreign DNA inserted into both these genes indicates that they are non-essential. PMID- 3264332 TI - [An application of leukapheresis for a clinical trial of adoptive immunotherapy]. PMID- 3264333 TI - CD1c antigens are present in normal and neoplastic B-cells. AB - The immunohistochemical detection of CD1c antigen is described in mantle zone B cells of the tonsil, lymph node, and spleen, and also in the marginal zone B cells of the spleen. CD1c expression was observed in most cases of low-grade, but in only a single case of high-grade, B-cell non-Hodgkin's lymphoma. It was not detected in germinal centre cells, nor in Epstein-Barr virus-transformed or Burkitt's lymphoma B-cell lines. This distribution suggests that CD1c expression may occur preferentially in slowly proliferating B-cell populations and does not support previous suggestions that CD1c is a human equivalent of the mouse thymus leukaemia antigens. PMID- 3264334 TI - Protein-losing enteropathy detected by 99mTc-labeled human serum albumin abdominal scintigraphy. AB - 99mTc-labeled human serum albumin (HSA) abdominal imaging is a new way of demonstrating gastrointestinal protein loss. We present two children with hypoalbuminemia of obscure etiology in whom albumin loss was localized in the gastrointestinal tract with 99mTc-HSA scintigraphy and the loss correlated with abnormal fecal alpha 1-antitrypsin excretion. In the absence of gastrointestinal blood loss or contamination of the 99mTc-HSA with free pertechnetate, significant activity accumulating in the gastrointestinal tract and moving with its contents is thought to represent 99mTc-HSA leakage into bowel lumen. Abdominal imaging with 99mTc-HSA has a low radiation burden to the patient and is readily available, relatively inexpensive, and easily performed. It can be used as a screening test for the detection of protein-losing enteropathy. It also offers the potential of being able to localize the site of protein loss visually within the gastrointestinal tract. PMID- 3264335 TI - Enhancement of neonatal somatic and hepatic growth by orally administered epidermal growth factor in rats. AB - Previous studies have shown that orally administered epidermal growth factor (EGF) enhances neonatal intestinal growth and that it may be absorbed in the intestine and bound by other organs. This study investigated whether the ingestion of EGF would be associated with growth of nonintestinal organs. In short-term studies, 87 newborn rat pups were fed artificial formula containing various concentrations of EGF for 39 h. In long-term studies, suckling newborn pups were fed EGF or an equal volume of distilled water for 5 days. The pups fed formula containing EGF for 39 h had a significant increase in hepatic incorporation of [3H]thymidine into DNA compared with pups not fed EGF. By 5 days of age, 13 pups fed EGF had heavier livers that contained more DNA and RNA compared with 14 control pups. Moreover, EGF-fed pups had heavier hearts and kidneys than pups fed no EGF. These data suggested that ingestion of EGF is associated with the growth of nonintestinal organs. PMID- 3264336 TI - Procollagen type III peptide in asymptomatic children with alpha 1-antitrypsin deficiency. PMID- 3264337 TI - B cell activation in patients with active procainamide induced lupus. AB - Cellular immune abnormalities have been described in asymptomatic patients receiving procainamide therapy, but not in patients with active procainamide induced lupus. We tested patients with active procainamide lupus for evidence of T or B cell activation similar to that observed in idiopathic lupus. Symptomatic patients had a significant increase in spontaneous IgG synthesis, but T cells bearing activation markers were not significantly different from age matched controls. Our results demonstrate that patients with active procainamide lupus have evidence for B cell activation, similar to idiopathic lupus. PMID- 3264338 TI - The relationship of anticardiolipin antibodies to disease manifestations in pediatric systemic lupus erythematosus. AB - To determine the prevalence of anticardiolipin antibodies (aCL) in pediatric systemic lupus erythematosus (SLE) and their possible association with clinical manifestations, aCL were measured in sera of 32 patients with the onset of SLE before age 16. IgM and IgG aCL were determined by ELISA and values compared to those of 12 patients with juvenile rheumatoid arthritis (JRA), 15 age matched asthmatics, and 32 adult controls. aCL were demonstrated in sera of 16 of 32 (50%) children with SLE, 5 of 12 (42%) patients with JRA, 1 of 15 (7%) asthmatics, and in none of the 32 adult controls. Serial samples on 11 patients with SLE showed fluctuations in aCL levels that often corresponded to disease activity; the highest levels occurred in patients during periods of seizure activity and other neurologic events. The antibodies were not crossreactive anti DNA antibodies as shown by the failure of DNA to inhibit binding to cardiolipin. These data suggest that the prevalence of aCL is similar in pediatric and adult SLE and that aCL levels may vary with disease activity, especially neurologic disease. PMID- 3264339 TI - Nicardipine improves myocardial perfusion in systemic sclerosis. AB - Primary scleroderma myocardial disease may be due in part to myocardial ischemia caused by a disturbance of the coronary microcirculation. We evaluated the effect of the calcium channel blocker nicardipine on myocardial perfusion assessed by thallium-201 scanning in 16 patients with systemic sclerosis. Thallium-201 single photon emission computerized tomography was performed at baseline and 90 min after 40 mg of oral nicardipine. The mean (+/- SD) number of left ventricular segments with perfusion defects significantly decreased from 6.0 +/- 2.0 at baseline to 4.1 +/- 2.3 after nicardipine (p less than 0.01). The mean global perfusion score significantly increased from 10.2 +/- 1.9 at baseline to 11.9 +/- 2.6 after nicardipine (p less than 0.02). Our study demonstrates short-term improvement in thallium-201 myocardial perfusion with nicardipine in patients with systemic sclerosis. PMID- 3264341 TI - B7 crossreactive antigens in spondyloarthropathies. PMID- 3264340 TI - Immunoglobulin synthesis by peripheral blood lymphocytes in patients with ankylosing spondylitis. AB - Immunoglobulin synthesis by peripheral blood lymphocytes and serum IgA subclasses were investigated in patients with ankylosing spondylitis (AS) with and without accompanying microscopic hematuria, and HLA-B27 positive and negative healthy controls. An increase in serum IgA, restricted to subclass IgA1, was found in patients with AS, especially in those with microscopic hematuria. IgA synthesis was not increased, but a significant shift to subclass IgA1 was found. Our results resemble abnormalities previously noted in primary IgA nephropathy, and further support the pathogenetic role of IgA in AS. PMID- 3264342 TI - A comparison of health parameters in two different canine populations. Part II: Chemical pathology data. AB - Blood samples were collected on a random basis from 2 canine populations. A selection of serum enzymes, serum electrolytes, serum protein fractions and serum concentrations of iron, creatinine and urea were investigated in a population of kennelled dogs and a population of dogs from a rural township in a developing country. Significant differences between the 2 populations were found for 16 of the 26 constituents evaluated, although differences in variance and distribution made comparisons difficult for some of the tests. The dogs from the rural township had a low mean serum iron, a very low mean serum albumin and a very high mean serum gammaglobulin concentration compared to that of the kennelled dogs. It is postulated that these differences were caused by environmental factors of a biological, physical and social nature. PMID- 3264343 TI - Effect of anergy on in vitro sensitization with keyhole limpet hemocyanin of peripheral blood lymphocytes. AB - To investigate the cellular mechanisms underlying clinical anergy, studies were done to determine whether the T cells of anergic patients could be sensitized in vitro. Ten normal males and 20 male patients with peripheral vascular disease were skin-tested with seven antigens and their peripheral blood mononuclear leukocytes (PBL) isolated. The mononuclear cells were stimulated in vitro with keyhole limpet hemocyanin (KLH) for 10 days in serum-free medium (primary culture) and then restimulated with KLH for three days (secondary culture). None of the controls or patients had been sensitized previously with this antigen. Of the 30 different cell preparations we tried to sensitize, 21 responded with a stimulation index (S.I.) of 1.5 or greater after being stimulated with KLH in the secondary cultures. There was no correlation between the concentration of KLH in the primary culture, the concentration of KLH in the secondary culture, and the S.I. at the end of the secondary culture. Cell preparations from all subjects were stimulated by PHA in both the primary and secondary cultures. Whether or not a subject's PBL could be sensitized in vitro did not correlate with either the subject's response to the intradermal injection of antigens or whether the subject was a control or a patient. PMID- 3264344 TI - Fractionated extract of Astragalus membranaceus, a Chinese medicinal herb, potentiates LAK cell cytotoxicity generated by a low dose of recombinant interleukin-2. AB - Success with rIL-2 immunotherapy of human cancer appears to depend on the administration of high doses which are frequently associated with excessive toxicity. Future use of rIL-2 will require certain modifications based on the use of lower doses of rIL-2 without significant loss of antitumor efficacy. We tested in vitro the possibility of potentiating the activity of rIL-2 in terms of LAK cell generation. We hypothesized that co-incubation of LAK cell precursors with a Chinese herbal extract (F3) of Astragalus membranaceus, (an immune modulator currently under study in our laboratory), along with a low concentration of rIL 2, would generate levels of LAK cell activity equivalent to those generated by high concentrations of rIL-2 alone. We found (1) a 10-fold potentiation of rIL-2 activity manifested by tumor cell-killing activity of 80% resulting from LAK cell generation with F3 plus 100 u/ml of rIL-2 versus 76% generated by 1,000 u/ml of rIL-2 alone; (2) a significant reduction in the number of effector LAK cells required for equicytotoxic reaction following LAK cell generation with F3 plus rIL-2 compared to rIL-2 alone. We conclude that potentiation of antitumor activity mediated by rIL-2 in low concentrations is possible by the concomitant use of another immune modulator such as Astragalus membranaceus. PMID- 3264345 TI - In vitro production of interleukin-2 by lymphocytes in whole blood and isolated culture. AB - Interleukin-2 (IL-2) production was examined in mitogen stimulated human lymphocytes. Whole blood unseparated lymphocytes or Ficoll-Hypaque gradient purified lymphocytes were cultured. Lymphocytes in whole blood culture produced significantly greater amounts of IL-2 on a per cell basis than did Ficoll-Hypaque purified lymphocytes. Furthermore, the majority of IL-2 produced by lymphocytes in whole blood culture was shown by freeze-thaw lysis to be intracellularly located, while the majority of IL-2 produced by purified lymphocytes was detected extracellularly. The addition of 2-mercaptoethanol (2-ME) resulted in enhanced extracellular production of IL-2 in whole blood and Ficoll-Hypaque cultures. The use of whole blood culture, while not permitting a precise in vitro dissection of the cellular mechanisms governing IL-2 production, may more accurately reflect the mechanisms governing in vivo lymphocyte activation. PMID- 3264346 TI - The nylon wool adherence of rat mononuclear cells: physical, chemical and biological influences. AB - The application of mononuclear cell populations to a nylon wool (NW) column is a common early procedure in the selection of T lymphocytes for further study. The technique as presently employed in various laboratories does not appear to be standardized, and surprisingly little is known about the effects of physicochemical alterations and biologic mediators on the interaction of lymphocytes with the NW substrate. In this study the factors controlling the adherence of rat splenocytes to NW were examined. NW adherence was shown to be independent of loaded cell concentration, column packing or pH, but was very dependent on NW column size, wash volume, incubation time and ambient temperature. The addition of protein to media did not alter lymphocyte NW adherence, and the interaction did not appear to depend on intact cellular glycolysis or protein synthesis or on microtubular or microfilament function. Because of the theoretical importance of surface adherence to cell motility, the effects of various agents that alter lymphocyte migration were tested in the lymphocyte NW assay. Of the positive chemokinetic factors tested, only casein altered (decreased) NW adherence. Of the negative chemokinetic principles tested only the human lymphokine LyMIF altered (increased) NW adherence. The studies show that the NW-nonadherent cell pool may be a heterogeneous population depending on the physical conditions of the assay, and the NW adherence of rat splenocytes is not an all-or-none phenomenon but can be altered by physical and biological factors. This makes the standardization of the assay of critical importance, particularly if one wishes to compare results of subsequent experiments between laboratories. PMID- 3264347 TI - Immunologic effects of perinatal exposure of rats to dioctyltin dichloride. AB - Studies were conducted to determine the period of immune system development that was most sensitive to perturbation by the known immunotoxicant di-n-octyltin dichloride (DOTC). Fischer 344 rats were exposed prenatally, both pre- and postnatally, or postnatally to DOTC by oral gavage of pregnant and/or lactating females. At various ages, ranging from 3 to 16 wk of age, offspring were examined for a number of immune functions. These included body and lymphoid organ weights; lymphoproliferative responses to B- and T-cell mitogens; natural killer cell activity; and primary antibody response to sheep erythrocytes. Prenatal (10-20 of gestation), pre- and postnatal (d 11-20 of gestation and 2-11 d of age), or postnatal (2-13 d of age) oral dosing of dams with 20-50 mg/kg DOTC resulted in no consistent alteration in immune function in offspring. However, direct oral dosing of rat pups to 5-15 mg/kg DOTC, beginning at 3 d of age and then 3 times per week up to 24 d of age for a total of 10 doses, resulted in significant suppression of the lymphoproliferative response of splenocytes to a T-cell mitogen in 10-wk-old rats (i.e., 7 wk after the last exposure to DOTC). Lymphoproliferative responses returned to control levels by 12 wk of age. In comparison young adult (8 wk old) rats dosed with 10 or 20 mg/kg DOTC under an identical dosing schedule (i.e., 3 times per week for a total of 10 doses) showed no suppression in the mitogen response of splenocytes 4 wk after the last exposure to DOTC. These results suggest that direct dosing of pups during early postnatal life may be the most effective means of inducing immunosuppression with DOTC during immune system development. The results also provide evidence for the greater sensitivity of the developing immune system compared with the fully developed immune system for a known immunotoxicant. PMID- 3264348 TI - Altered expression of lymphocyte Il-2 receptors in burned patients. AB - Impairment of T-cell function is a consistent observation in burned patients. Concomitant with this impairment is an increase in serum factors which inhibit interleukin-2-mediated T-cell functions. These factors are heat labile and do not behave like endotoxins. Nonetheless, treatment of burned patients with endotoxin neutralizing regimens of polymyxin B reduces the levels of these factors, suggesting that they are generated in response to endotoxin exposure. In addition to factors which inhibit Il-2 responses burn serum contains increases of circulating soluble, cell-free Il-2 receptors. However, the level of Il-2R is not altered by polymyxin B treatment and does not appear to be a direct result of endotoxin exposure. These observations suggest that multiple causes contribute to T-cell impairment in burned patients. PMID- 3264349 TI - Rheumatic chorea: the experience of a regional hospital in Kuwait. PMID- 3264350 TI - [Two color analysis of peripheral lymphocyte subsets in patients with cancers during and after radiotherapy]. AB - Lymphocyte subsets of peripheral blood in patients with cancers were analyzed through two color analysis using FCM. Leu-2/Leu-3 and Leu-2+15+/Leu-8-3+ were compared during radiotherapy and periods of follow up in cases with uterine cervical ca. and lung ca. They did not show similar tendencies but just a opposite one in some cases. Both of them, on the other hand, did not appear to be related with the prognosis of patients. However, CTL and NK (potent) did show a relevance with it through the period of follow up. They might be indices which allow to predict the clinical course of Patients with cancers. Further study is now in progress. PMID- 3264351 TI - [Application of the immunohistochemical method as predictive assay in radiotherapy of squamous cell carcinoma]. AB - We analysed various subsets of lymphocytes infiltrated into cancer tissues from 15 patients (10 cases of oropharyngeal cancer and 5 of hypopharyngeal cancer) at pretreatment and at about 10 Gy and 30 Gy of irradiation by the method of biotin avidin-horseradish peroxidase using mouse monoclonal antibodies. In 3 cases, tumor infiltrating lymphocytes were remarkably increased at the delivery of small dose of irradiation: Two of them showed remarkable radiosensitivity, and the lymphocyte subpopulation of the cancer tissue was mainly composed of Leu3a + 3b positive, Leu-8 negative and Leu-HLA-DR positive lymphocytes (activated helper inducer T lymphocytes). On the other hand, the third one proved to be rather radioresistant and the lymphocyte subpopulation was mainly composed of Leu-14 positive lymphocytes (B lymphocytes). These findings indicate that the analysis of the lymphocyte subpopulation infiltrating into cancer tissues at the delivery of small dose of irradiation is applicable as a predictive assay in radiotherapy of squamous cell carcinoma of oropharynx and hypopharynx. PMID- 3264352 TI - Immunological mechanisms of antitumor activity of some kinds of Chinese herbs: Meth A-induced delayed type hypersensitivity. AB - In the present paper, we confirmed that a delayed type hypersensitivity response can be elicited against Meth A tumor (Meth A-DTH) in BALB/c mice bearing the primary tumor. This response was augmented by lipopolysaccharide. We examined the effects of 4 kinds of Chinese herbs including A. capillaris, S. doederleinii, A. macrocephala and S. subprostrata on the Meth A-DTH, and the results were compared with that of the herbs on picryl chloride-induced delayed type hypersensitivity (PC-DTH). All of the herbs examined augmented the Meth A-DTH 10 days after the primary tumor transplantation, and S. doederleinii, A. macrocephala and S. subprostrata prevented the decay of the response on the 20th day, but A. capillaris did not. On the other hand, none of the herbs affected the PC-DTH. When both DTH responses were caused simultaneously in the same mouse, Meth A-DTH decayed 20 days after the transplantation but PC-DTH did not. In this case, the effects of these 4 herbs on Meth A-DTH and PC-DTH were essentially the same as those seen in the case of separate experiments. The previous and present results suggest that A. capillaris shows antitumor activity mainly through a direct cytotoxicity, although this herb might have certain components to enhance Meth A DTH, and the other herbs display the activity through the enhancement of T cell mediated tumor immunity, particularly tumor specific DTH. PMID- 3264353 TI - Induction of antinuclear antibodies in rabbits by infection with rinderpest viruses with different degree of virulence. PMID- 3264354 TI - [The use of single-photon emission computed tomography in cardiology]. AB - The tomographic distribution of thallium 201 in the myocardium was studied with a gamma camera with 2 detectors (29 cms in diameter) with 37 photo multipliers each. The camera was connected to a PDP computer with a 256 Kbytes memory. Thallium 201 in a dose of about 74 MBq 2 mCi was used in normal subjects, patients with coronary artery disease and with cardiac hypertrophy. Tomographic sections were obtained every 1.2 cms in the sagittal and frontal projections. The distribution of the Thallium was uniform in normal and hypertrophic hearts. Focal defects were seen in C.A.D. Single-photon emission computerized tomography was instrumental in determining the extension of the damage of the myocardium to areas which appeared normal in the regular thallium 201 scintigrams. PMID- 3264355 TI - Immunological aspects of acute ureteral obstruction: immune cell infiltrate in the kidney. AB - Kidneys from rats subjected to bilateral ureteral obstruction (BUO), unilateral ureteral obstruction (UUO) and UUO with subsequent release were analyzed for leukocyte infiltration. A time-dependent influx of leukocytes, predominantly macrophages and suppressor T lymphocytes, occurred in both the cortex and medulla following obstruction, and disappeared with release of the obstruction. Glomerular macrophages declined following obstruction but increased to levels above control following release. The influx of leukocytes following obstruction was paralleled by an increase in thromboxane B2 excretion by the kidney and coincided with a decrease in glomerular filtration rate (GFR). This would suggest that an influx of immune cells is a prominent feature of the acute renal response to ureteral obstruction. These cells may modulate some of the post-obstructive alterations in renal function via the production of vasoactive substances, such as thromboxane A2. PMID- 3264356 TI - Transfer of experimental glomerulonephritis in chickens by mononuclear cells. AB - We have produced experimental autoimmune glomerulonephritis (EAG) in histocompatible SC chickens by immunization with different types of glomerular antigen. The development of EAG was time, but not antigen, dependent. Transfer of mononuclear cells from spleens and kidneys of nephritic animals resulted in EAG in naive recipients. Transferred EAG developed earlier than in immunized donors and was not associated with circulating or bound anti-GBM antibodies. Control recipients did not develop disease from control cells alone, soluble antigen, or antigen plus control cells. The cells which transferred EAG appeared morphologically by light and electron microscopy to be lymphocytes, sedimented as lymphocytes, were positive with anti-serum to thymocytes but negative with anti bursa anti-serum, stained as T-cells with monoclonal antibodies and underwent blast transformation in response to mitogen and GBM antigen. Other organ specific diseases have been transferred by cells alone; to our knowledge this is the first description of glomerulonephritis transferred by cells alone. This new pathogenetic process may play an important role in the development of glomerulonephritis in other animal models as well as in humans. PMID- 3264357 TI - In situ hybridization analysis of macrophage-derived tumor necrosis factor and interleukin-1 mRNA. AB - Tumor necrosis factor (TNF) and interleukin-1 (IL-1) play an intimate role in the initiation and maintenance of inflammatory reactions due to their pluripotent activities. In this paper, we describe the use of an in situ hybridization analysis as an effective means to probe for TNF and IL-1 mRNA levels in primary macrophage cultures and macrophage cell lines. A significant increase in lipopolysaccharide (LPS)-induced TNF mRNA accumulation was demonstrated by in situ hybridization using either a 35S-labeled synthetic oligonucleotide (30-mer) complementary to TNF mRNA or a 35S-randomly primed labeled TNF DNA probe. An augmentation in TNF mRNA accumulation, as assessed by increasing grains/cell, was demonstrated over a wide concentration range of LPS. This accumulation was shown using both immunologically elicited primary macrophage cultures and the macrophage cell line RAW 264.7. Interestingly, the RAW 264.7 constitutively produced TNF in the absence of specific stimulus and this tonic production was observed at the molecular level via in situ hybridization analysis. Specificity of the in situ hybridization technique was shown by a complete loss in binding of 35S-probe after either RNase digestion or competition with "cold-labeled" probe. beta-actin served as a 35S-labeled control probe where the number of actin specific grains/cell was not altered by stimulating macrophages with LPS. IL-1 alpha mRNA was also increased by LPS stimulation of macrophages as assessed by in situ hybridization. The LPS-dependent increase in macrophage mRNA for TNF and IL 1 alpha, as assessed by in situ hybridization, was confirmed by classical Northern blot analysis as well as the production of biologically-active protein. PMID- 3264358 TI - Multiple binding components for methyltrienolone in canine prostatic epithelial cells. AB - Using a whole cell assay system, the androgen binding capacity of canine prostatic epithelial cells was evaluated in relation to their function. Radiolabeled Methyltrienolone (R1881) was used as the ligand in the presence of an excess of Triamcinolone acetonide and the amount of [3H]R1881 bound to the cells at equilibrium was determined by either displacement or saturation studies. With immature cells in culture (3 days of attachment), displacement analysis revealed the presence of high affinity binding sites which were also present in cells cultured for 10 days. With freshly dispersed prostatic cells (mostly secretory epithelial cells) as well as with older cells in culture (17 and 24 days), only less specific binding sites were observed with both unlabeled R1881 and/or dihydrotesterone (DHT). In contrast, only the high affinity androgen receptor (AR) was present in cytosolic extracts prepared from normal glands. Displacement studies performed with cultured cells at different stages of growth also showed that the basal level as well as the degree of low affinity binding increased during the maturation of non-proliferating cells. The presence of multiple binding components was demonstrated by saturation studies performed with either cultured or freshly dispersed cells. The first component, that was saturated at 5 nM of [3H]R1881, was due to AR while the other two binding components, showing positive-cooperativity (Hill coefficients of 1.90 and 5.07, respectively), were saturated at concentrations of 15 and 30 nM of [3H]R1881. In contrast, the Hill coefficient for the AR was 0.88 indicating the presence of an independent component. It was calculated that only 11.4% of the total uptake of R1881 was attributed to AR binding, suggesting that the remainder may represent an intracellular pool of androgens. Thus, a whole cell binding assay represents a dynamic system for the detection, by saturation studies, of binding components that are not revealed using the conventional displacement studies or cell-free systems. It is proposed that these acceptor sites may play a role in differentiated prostatic function rather than in cell proliferation. PMID- 3264359 TI - Decreased expression of Ii-derived p25 and of P67/69 in hairy leukemic cells. AB - Hairy leukemic cells had altered expressions of accessory proteins (Ii, Ip, p70, p25) which associated intracellularly with class II MHC molecules. Immunoprecipitates from [35S]methionine, pulse-chase labeled leukemic cells, B lymphoblastoid cells, and Burkitt's lymphoma cells were examined after 2 dimensional, polyacrylamide gel electrophoresis. The class II MHC-associated Ii chain was present in all three cell types, but the Ii-derived p25 protein was not found in HCL cells. Ip, the sialic acid-derivatized form of Ii, was well expressed in BLCL and Raji cells, but weakly in HCL cells. P70 was strongly expressed in BLCL and Raji cells, but negligibly in HCL cells. These alterations might reflect deficient mechanisms for antigen processing and presentation by these leukemic cells. PMID- 3264360 TI - Modulation of mouse spleen natural killer (NK) cell activity by beta-interferon, interleukin-1, and prostaglandins. AB - By using CBA/J mice as a source of effector cells and Yac-1 lymphoma line as "target" cells, the natural killer (NK) cell activity was assayed following both in vivo and in vitro immunomodulation [beta-interferon (IF), interleukin-1 (IL 1), indomethacin (IND), prostaglandin-E2 (PGE)]. Only IF/IND and IL-1/IND mixed in vivo led to a significant augmentation of NK cell activity. If exposed in vitro to IF or to IL-1, control group-derived spleen NK cells exhibited increased cytotoxic activity whereas PGE-exposure only was followed by a lower cytotoxic level as expressed both in % cytotoxicity curves and in lytic units 20%/10(7) effector cells. On the other hand, PGE seemed to activate the "nonspecific suppressor" (NSS) cell subset in its inhibitory effect about NK cells as tested in vitro in several NK/NSS cell mixtures at different ratios. IF, but not IL-1 diminished the NSS-cell-induced suppressive activity. Pre-exposure of NK/NSS cell mixtures to IF followed by PGE exposure, did not prevent PGE-dependent NSS cell activation. PMID- 3264361 TI - The topography of mercurial lymphadenopathy in brown Norway rats. AB - Injection of mercuric chloride caused a progressive systemic lymphadenopathy and splenomegaly in Brown Norway (BN) but not in Lewis rats, as reported by others. We studied the number, duration and route of HgCl2 treatments and the topography of the resultant lymphadenopathy, as well as its age and strain dependency. Five injections of HgCl2 increased three-fold the weight of the lymph nodes which became considerably heavier than the spleen. Weanling rats were less susceptible than adults. A regional lymphadenopathy could not be produced. However, a synergistic interaction was observed when the systemic effects of HgCl2 were added to the regional lymphadenopathy produced by injections of metal powders, such that the lymph node mass approached 2% of body weight. PMID- 3264362 TI - Origin of the soluble interleukin-2 receptor in the serum of patients with hairy cell leukemia. AB - High levels of soluble IL-2 receptor (sIL-2R) are detectable in the serum of HCL patients. To determine the cell source of this molecule, we evaluated the presence of sIL-2R in the supernatants obtained from in vitro cultures of leukemic (hairy cell, HC) and non-leukemic lymphocytes from six untreated HCL patients and from an additional four patients under therapy with rIFN-alpha 2. We demonstrated that cultured HCs at resting conditions were able to spontaneously release the sIL-2R, whereas control enriched B cells did not. This phenomenon was present only when culturing HCs recovered from patients observed at the time of diagnosis but was not observed during treatment with rIFN-alpha 2. Following activation in vitro with a series of different stimulatory agents including BCGF, phorbol myristate acetate, and anti-human IgM antibody, cultured HCs increased their capability to shed the IL-2R molecules. On the other hand, the release of sIL-2R from enriched T cell populations from HCL patients did not significantly differ from the value obtained in controls. Taken together, these findings provide evidence that leukemic B cells represent the main source of sIL-2R in HCL patients and further emphasize the importance of evaluating this parameter as a relevant marker for monitoring the effectiveness of rIFN-alpha 2 therapy. PMID- 3264363 TI - Effect of recombinant GM-CSF on the metabolism of cytosine arabinoside in normal and leukemic human bone marrow cells. AB - Human recombinant GM-CSF (rGM-CSF) is under investigation as a growth-protective agent for normal hematopoietic elements in phase I trials of myelosuppressive chemotherapy and in bone marrow transplantation. We determined the effect of rGM CSF on the metabolism of high dose Ara-C in bone marrow mononuclear cells (BMMCs) from healthy volunteers and patients with ANLL. Cells were incubated with rGM-CSF alone, Ara-C alone, or a combination of the two drugs. Treatment with rGM-CSF alone yielded approximately a twofold increment in intracellular dCTP pools in normal BMMCs but not in leukemic blasts. Exposure to rGM-CSF in conjunction with Ara-C corrected Ara-C-mediated declines in dCTP levels and decreased cytosine arabinoside triphosphate (Ara-CTP) accumulation in normal BMMCs but not in their leukemic counterparts. Furthermore, when exposure to Ara-C was preceded by treatment with rGM-CSF for 18 hr, an even greater reduction in the Ara-CTP/dCTP pool ratio was observed in normal versus leukemic elements; however, this did not significantly change Ara-C DNA incorporation in the two cell types. The differential effect of rGM-CSF on the phosphorylation of Ara-C in normal BMMCs versus leukemic blasts has potential implications for the use of a regimen consisting of rGM-CSF and high dose Ara-C in the treatment of ANLL with chemotherapy or autologous bone marrow transplantation. PMID- 3264364 TI - Induction of B-cell lymphomas in athymic NIH Swiss nu/nu mice. AB - A B-cell lymphoma was induced in athymic NIH Swiss nu/nu mice by challenging the animals with NIH3T3 cells, previously transfected with a recombinant DNA carrying a human oncogene hhcM, ligated to an SV40 promoter with a neomycin-resistance marker. The gross pathology of the tumor-bearing animal revealed generalized lymphadenopathy and the histopathology indicated widespread infiltration of lymphocytes into organs, such as brain, liver, kidney and lung, in addition to the lymphoid tissues and spleen; the appearance was consistent with diffuse histiocytic lymphoma. Direct immunofluorescence assays with specific typing anti sera on live cells prepared from spleen and various lymph nodes in short-term culture, suggested the cells were B-cells. This B-cell lymphoma provides an experimental model, not only for studying possible oncogene activation but also for studying the various interactions involved in signal transduction essential for the activation of B-cell proliferation and differentiation. PMID- 3264365 TI - Chromosome damage induced in cord blood T-lymphocytes infected in vitro by HTLV I. AB - Experiments were carried out to investigate whether the human T-lymphotropic virus type I (HTLV-I), alone or in combination with a chemical mutagen such as mitomycin C (MMC), has the capacity to damage host chromosomes. Cord-blood T lymphocytes (CBL) were infected by co-cultivation with lethally irradiated HTLV-I producing cells. Infected and immortalized CBL were then studied for frequencies of sister chromatid exchanges (SCE), chromosome breaks and micronuclei. HTLV-I infected cells had statistically higher baseline SCE, chromosome aberrations and micronucleus values than the uninfected control CBL. While MMC treatment further augmented these values both in control and in infected lymphocytes, the latter did not show dose-related increases, most likely because of the more pronounced MMC-induced delaying effect on cell progression to mitosis. In view of similar previous observations in mouse lymphocytes carrying the Moloney murine leukemia virus, it is suggested that expression of a common retrovirus gene product, such as the pol endonuclease, might be responsible for the cytogenetic abnormalities observed. In addition to the IL-2 autocrine loop, the direct induction of chromosome damage by HTLV-I in target lymphocytes may be related to the pathogenesis of malignancies associated with HTLV-I infection. PMID- 3264366 TI - Modulation of functions of granulocytes by recombinant human GM-CSF and possible complications of GM-CSF therapy. AB - Besides its effect on bone marrow progenitors, GM-CSF is able to modulate functions of mature cells such as neutrophils. It inhibits random migration and chemotaxis through action on both cells and chemotactic factors, and stimulates oxidative metabolism as well as elastase release. Furthermore, it strongly enhances the response of the cells to the usual stimulants such as f-Met-Leu-Phe and phorbol esters. The role of neutral proteinases and activated oxygen species in different diseases such as ARDS, emphysema, coagulation defects, arthritis, and inflammation, is recognized. The remarkable in vitro release of neutral proteinases and activated oxygen species from granulocytes after GM-CSF stimulation may be of importance in vivo. This should be considered in clinical application of GM-CSF, particularly with high-dose therapy. PMID- 3264367 TI - Heterogeneity of childhood acute lymphoblastic leukemia (ALL): monoclonal antibodies phenotyping and induction of differentiation in vitro. AB - Fifty-eight pediatric patients with non-T acute lymphoblastic leukemia (ALL) were diagnosed and evaluated at the Sambur Center of Pediatric Hematology Oncology. At least six subtypes of non-T ALLs were identified, corresponding to the various stages of B-cell differentiation, by utilizing an extensive panel of monoclonal antibodies directed against T- B- and myeloid-cell differentiation antigens. Moreover, leukemic cells expressing the phenotype of early B cells could be driven to differentiate along the B- cell lineage to express CALLA and BL antigens and cytoplasmic and/or surface immunoglobulins (IgM). A unique phenotype of non-T ALL was also identified. These leukemic cells expressed B cell antigen exclusively, i.e., HLA/DR and B4 (CD19). Myeloid-cell antigens, however, were expressed on these cells spontaneously after a 24-hour incubation in culture medium in vitro. In addition, leukemic cells of four patients with a phenotype of HLA/DR, CD19, and CD10 expressed antigens of the T-cell lineage: CD7 (3AI) and CD2 (leu 5), and/or of the myeloid cell lineage (My7). These results provide confirming evidence for the wide scope of the heterogeneity of ALL. It stresses the validity of accurate classification of leukemia to identify biologically and clinically unique subtypes of ALL, which bears specific prognostic parameters; and designates therapeutic protocols. PMID- 3264368 TI - [Transcutaneous nerve stimulation in angina pectoris--effects on myocardial metabolism and hemodynamics]. PMID- 3264369 TI - [The great immunological adventure is over. The important discoveries are already made]. PMID- 3264370 TI - [Rheumatologic surgery in Sweden demands more resources]. PMID- 3264371 TI - [A cross-sectional study in Sundsvall. 90-year-old persons are healthier than expected. The majority live in their own flats]. PMID- 3264372 TI - [Coronary vessel surgery performed at the Sophiahemmet shortens waiting lists of patients]. PMID- 3264373 TI - [The ethical committee of the National Board of Health and Welfare and hashish testing--a clear example of state-controlled ethics]. PMID- 3264374 TI - Impact of MDT on leprosy as measured by selective indicators. PMID- 3264375 TI - Close-contact surveys and mass-screening studies for leprosy in Turkey. PMID- 3264376 TI - Leprosy in Turkey. PMID- 3264377 TI - Liver cirrhosis in histiocytosis X. AB - Cirrhosis of the liver was diagnosed in an 18-year-old man with histiocytosis X. Electron microscopy and immunohistochemistry revealed infiltration of the liver by the typical cellular elements of histiocytosis X. Endoscopic retrograde cholangiography showed alterations resembling those of sclerosing cholangitis. Sixteen months later, the patient died of recurrent variceal bleeding and cholangiosepsis. Autopsy confirmed that cirrhosis was the main manifestations of the underlying disease. Thus, cirrhosis of liver can be a main and potentially fatal manifestation of histiocytosis X beyond the pediatric age range. Histiocytosis X may lead to parenchymal infiltration of the liver and to changes of the major bile ducts resembling sclerosing cholangitis. The diagnosis of hepatic histiocytosis X can easily be missed without relying on appropriate electron microscopic and immunohistochemical investigations. PMID- 3264378 TI - Unexpected effects of absorbed normal rabbit serum and bovine serum albumin on survival of Haemophilus influenzae type b in the infant rat. AB - In the course of using the infant rat model to determine the ability of various rabbit antisera to protect against challenge by Haemophilus influenzae type b we made two unexpected observations. In these experiments 4-day-old rats were inoculated s.c. on the dorsum with either rabbit serum or physiological buffers (sham serum) and then were challenged the next day with H. influenzae type b injected i.p. Bacteremia, as a marker for disease, was measured 24 h later on day 6. We observed the following. (i) Pre-immune, i.e., normal rabbit serum, containing minimal levels of antibodies to outer membrane proteins and depleted of antibodies to capsule and lipopolysaccharide, nevertheless significantly (P less than 0.01) protected the rats from challenge with H. influenzae type b when compared to a sham inoculation of buffer; (ii) In the absence of a serum inoculation on day 4 (a buffer was used as a sham serum inoculation), the levels of bacteremia obtained after inoculation with bacteria on day 5 depended upon the composition of the buffer in which the H. influenzae inoculum was suspended. Use of phosphate buffered saline (PBS) resulted in higher levels of bacteremia than PBS containing 0.5% bovine serum albumin (PBS-BSA) (P less than 0.001), i.e. the BSA apparently acted to protect the rats from H. influenzae infection. In fact the use of PBS-BSA as an inoculum buffer masked the protective effect noted above of the absorbed normal rabbit serum. PMID- 3264379 TI - Treatment of refractory lymphoma with methotrexate, VM-26 (teniposide), procarbazine, and dexamethasone: Cancer and Leukemia Group B study 7902. AB - Seventy-eight individuals previously treated with chemotherapy for non-Hodgkin's lymphoma were enrolled in a phase II pilot study employing methotrexate 100 mg/M2 iv (day 1), calcium leucovorin 10 mg/M2 iv and/or po q6h (days 2-4), VM-26 (teniposide) 100 mg/M2 iv (days 2 and 9), procarbazine 100 mg/M2 po (days 2-15), and dexamethasone 15 mg/M2po (days 2-8) (MV26PD). Thirty percent of the 78 patients treated had a response to therapy (8% complete, 22% partial). Twenty four percent of patients with diffuse histiocytic (large cell) lymphoma had a response (12% complete, 12% partial). The estimated failure-free survival was 41% at 3 months and the median survival (death from any cause) was 4.5 months for the entire cohort. Two individuals, including one individual with diffuse histiocytic lymphoma, remain in a complete response for over 900 days. Significant hematologic toxicity and infectious complications were seen in this heavily pretreated group of patients. MV26PD represents an active combination of agents for the treatment of non-Hodgkin's lymphoma. The optimal dosing for MV26PD remains to be determined. PMID- 3264380 TI - Abnormal T-cell subsets in normal persons. PMID- 3264381 TI - HLA and IgA nephritis revisited 10 years later: HLA-B35 antigen as a prognostic factor. PMID- 3264382 TI - HLA and silicosis in Japan. PMID- 3264383 TI - Circulating interleukin-1 beta in patients with Kawasaki disease. PMID- 3264384 TI - Use of tumor-infiltrating lymphocytes and interleukin-2 in the immunotherapy of patients with metastatic melanoma. A preliminary report. AB - Lymphocytes extracted from freshly resected melanomas can be expanded in vitro and can often mediate specific lysis of autologous tumor cells but not allogeneic tumor or autologous normal cells. We treated 20 patients with metastatic melanoma by means of adoptive transfer of these tumor-infiltrating lymphocytes and interleukin-2, after the patients had received a single intravenous dose of cyclophosphamide. Objective regression of the cancer was observed in 9 of 15 patients (60 percent) who had not previously been treated with interleukin-2 and in 2 of 5 patients (40 percent) in whom previous therapy with interleukin-2 had failed. Regression of cancer occurred in the lungs, liver, bone, skin, and subcutaneous sites and lasted from 2 to more than 13 months. Toxic effects of interleukin-2 occurred, although the treatment course was short (five days); these side effects were reversible. It appears that in patients with metastatic melanoma, this experimental treatment regimen can produce higher response rates than those achieved with interleukin-2 administered alone or with lymphokine activated killer cells. It is too early to determine whether this new form of immunotherapy can improve survival, but further trials seem warranted. PMID- 3264385 TI - [Epidermal cysts of the cerebellopontile angle]. AB - The authors describe six cases of epidermoid cysts of the cerebellopontine angle. They insist on the progressive development, the variable duration and the polymorphism of the symptomatology. The imaging techniques relevant to diagnosis are reviewed. Among these computerized cisternotomography and N.M.R. are the methods of choice. It is suggested that surgical removal should be total whenever possible because of the risk of recurrence of these cysts but with great caution not to cause a vital or functional damage of the brain stem. PMID- 3264386 TI - [Intraventricular neurocysticercosis. Apropos of 3 cases]. AB - Cysticercosis cerebri is a rare neurological diagnosis in France. It is classically divided into four types: intraparenchymal, basilar cisternal, ventricular and diffuse. Three cases of intraventricular cysticercosis are reported. All patients had symptoms of increased intracranial pressure due to hydrocephalus and the authors emphasize the necessity of investigating for possible neurocysticercosis patients from endemics areas who presented such a clinical picture. They emphasize the interest of the E.L.I.S.A. test in order to detect anticysticercosis antibodies in blood and C.S.F. and the interest of Magnetic Resonance Imaging in order to visualise the cysts. Praziquantel do not affect intraventricular cysts and the surgical treatment is necessary to remove the cysts because the presence of an intraventricular parasite indicates an important risk of acute hydrocephalus and secondary of ependymitis source of irreversible neurological damages. PMID- 3264387 TI - In vivo metabolism of radiolabeled putrescine in gliomas: implications for positron emission tomography of brain tumors. AB - The in vivo uptake and metabolism of radiolabeled putrescine was examined in two glioma models: (a) the T9 gliosarcoma in the CD Fischer rat and (b) the U-87 MG human glioblastoma in the athymic (nude) mouse. Autoradiography after parenteral administration of [14C]putrescine revealed rapid and selective uptake by both tumors compared with normal brain. Polyamine analysis of the rat gliosarcoma demonstrated minimal conversion of labeled putrescine to its metabolites, spermidine and spermine, at 5 and 30 minutes after intravenous injection. The human glioblastoma also exhibited minimal polyamine conversion at 5 minutes, although there was a trend toward significant metabolism at longer time periods (30 and 45 minutes). In addition, the human glioblastoma produced nonpolyamine metabolites that suggest an alternative pathway of putrescine metabolism via gamma-aminobutyric acid. These in vivo findings are discussed in relation to the usefulness of putrescine as a marker for positron emission tomography of human gliomas. PMID- 3264388 TI - Short term efficacy of applied electric fields in the repair of the damaged rodent spinal cord: behavioral and morphological results. AB - The short term effects of electric fields applied exogenously to the contused rat spinal cord were studied in a blind experiment. A DC field using 3 microA was applied to the dorsal cord when the lesion was made, and rats were behaviorally tested weekly for up to 3 weeks on an inclined plane. The results show that the "cathode rostral" orientation group of animals performed statistically significantly better on the inclined plane than either the "anode rostral" or the "no current" group. Counts of axons in the dorsal funiculi rostral to the lesion in the "cathode rostral" group were statistically significantly greater than in other groups. The greater number of axons rostral to the lesion site coupled with the superior behavioral performance of the "cathode rostral" group suggest that this treatment may provide an environment suitable for axonal growth and can facilitate functional recovery in the damaged mammalian spinal cord. PMID- 3264389 TI - Characteristics of neurosecretory centers of the hypothalamus of rats which are associated with regulation of the function of the adrenal cortex. PMID- 3264390 TI - Ontogeny of the calcitonin gene-related peptide in the nervous system of rat brain stem: an immunohistochemical analysis. AB - The ontogeny of the calcitonin gene-related peptide in the neuron system of the rat brain stem was investigated by means of the indirect immunofluorescence technique. Calcitonin gene-related peptide-like immunoreactivity was first detected in the fibers of the nucleus of spinal tract trigeminal nerve on gestational day 18, and thereafter appeared gradually in various brain stem areas such as in the fibers of the solitary tract, gracile nucleus, cuneate nucleus, inferior colliculus, superior colliculus, medial geniculate nucleus and in the neurons of the hypoglossal nucleus, facial nucleus, superior olive, parabrachial area, superior colliculus and peripeduncular nucleus. In colchicine-untreated animals, the immunoreactive fibers increased in number and reached adult level by postnatal day 14, whereas the number of cells reached a maximum between postnatal days 2 and 6 and then decreased in number and immunoreactivity or disappeared, except in some areas such as the superior olive and peripeduncular nucleus, which showed the same immunoreactivity as for adult animals. With colchicine treatment, calcitonin gene-related peptide-like immunoreactive cells were found in more areas of the brain stem such as the abducens nucleus, parabigeminal nucleus, principal oculomotor nucleus, trochlear nucleus and central gray, along with the nuclei which had shown calcitonin gene-related peptide immunoreactivity in the untreated animals. However, the neurons in the inferior olive showed a different ontogenetical pattern of calcitonin gene-related peptide of immunoreactivity. Immunoreactivity disappeared completely by postnatal day 21 in both colchicine untreated and -treated animals. PMID- 3264391 TI - Experimental hemiparkinsonism in the rat following chronic unilateral infusion of MPP+ into the nigrostriatal dopamine pathway--I. Behavioural, neurochemical and histological characterization of the lesion. AB - 1-Methyl-4-phenylpyridinium ion (MPP+), the active metabolite of 1-methyl-4 phenyl-1,2,3,6-tetrahydropyridine, has been chronically infused (10 micrograms/24 h for 7 days) via osmotic minipumps into the left median forebrain bundle of the rat in order to determine whether it can induce permanent damage to the nigrostriatal dopamine system. Its effects were assessed over a period of 6 months post lesion. Four to 5 days following minipump implantation, all MPP+ treated animals displayed spontaneous ipsilateral postural bias indicating a marked imbalance in striatal dopamine and degeneration of the ipsilateral nigrostriatal dopamine pathway. After 3-5 weeks, MPP+-infused animals showed dose related ipsilateral and contralateral circling in response to methamphetamine (1 5 mg/kg i.p.) and apomorphine (0.05-0.25 mg/kg s.c.) respectively. In vivo, using bilateral monitoring of striatal dopamine in MPP+-infused animals at 2 and 4 months by push-pull perfusion, both basal and methamphetamine- (2.5 mg/kg i.p.) stimulated release of dopamine was undetectable in the ipsilateral striatum, indicating a complete loss of dopamine terminals. In contrast, in the contralateral striatum of these animals and in striata of saline-infused animals, there were 4-5-fold increases in dopamine release in response to methamphetamine. Six months after lesion, animals infused with MPP+ continue to exhibit robust rotational behaviour in response to methamphetamine and apomorphine. In the ipsilateral striatum of the MPP+-infused animals the tissue concentrations of dopamine and its metabolites, 3,4-dihydroxyphenylacetic acid and homovanillic acid, were all undetectable; however, the levels of noradrenaline, serotonin and its metabolite, 5-hydroxyindoleacetic acid, were not significantly different from control values. In contrast to the striatum, MPP+ had no significant effect on the levels of dopamine and its metabolites in the ipsilateral nucleus accumbens; in addition, the levels of noradrenaline and serotonin and its metabolite were comparable to control levels. Histological examination revealed a marked loss of cells and severe gliosis in the substantia nigra pars compacta of MPP+-infused animals. The present results provide evidence that direct infusion of MPP+ into the medial forebrain bundle of the rat can lead to a complete loss of dopamine neurons in the pars compacta of the substantia nigra with ensuing behavioural, neurochemical and biochemical changes characteristic of the lesion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3264393 TI - [Occurrence of subjective symptoms in patients after aortocoronary bypass surgery. A questionnaire-based study]. PMID- 3264392 TI - Experimental hemiparkinsonism in the rat following chronic unilateral infusion of MPP+ into the nigrostriatal dopamine pathway--II. Differential localization of dopamine and cholecystokinin receptors. AB - The autoradiographical localization of dopamine D1, D2 and cholecystokinin receptors has been investigated in rat brain 6 months following unilateral infusion of 1-methyl-4-phenyl pyridinium ion (MPP+) (10 micrograms/day for 7 days) into the nigrostriatal dopamine pathway. Treatment with 1-methyl-4-phenyl pyridinium ion produced a marked depletion of dopamine cell bodies in the substantia nigra together with greater than 95% loss of tyrosine hydroxylase immunoreactivity in the striatum. Measurement of specific [3H]spiperone binding to D2 receptors indicated a 38% increase (P less than 0.01) in the maximal binding capacity of [3H]spiperone to striatal membrane homogenates and a 13% increase (P less than 0.05) in specific [3H]spiperone binding to striatal tissue sections, verifying striatal D2 receptor denervation supersensitivity. In contrast, MPP+ lesion of the nigrostriatal tract had no effect on the autoradiographical localization of striatal D1 or cholecystokinin receptors. In addition, there was a 38% loss (P less than 0.05) of D2 receptor binding sites in the substantia nigra pars compacta, whilst D1 receptors remained unchanged. Similar changes in dopamine and cholecystokinin receptor number were found following 6-hydroxydopamine lesion of the nigrostriatal dopamine pathway. These results provide further evidence that 1-methyl-4-phenyl pyridinium ion treatment in rats produces extensive destruction of the dopaminergic nigrostriatal tract and supports the differential anatomical localization of striatal and nigral D1, D2 and cholecystokinin receptors. PMID- 3264394 TI - [Digestive emergencies in a general hospital. A clinico-statistical study]. PMID- 3264395 TI - Antinociception induced in rats by intrathecal administration of antiserum against calcitonin gene-related peptide. AB - To determine whether or not endogenous calcitonin gene-related peptide (CGRP) participates in pain transmission in the spinal dorsal horn, effects of an intrathecal injection of anti-CGRP antiserum on nociceptive threshold in the paw pressure test was examined in non-arthritic and adjuvant arthritic rats. An intrathecal injection of the antiserum increased the nociceptive threshold in non arthritic animals, while 0.9% saline, pre-immune serum and antiserum, previously absorbed by synthetic CGRP, were without effect. Adjuvant arthritic rats showed a hyperalgesia, and improvement occurred with intrathecal injection of the antiserum. Saline and absorbed antiserum were without effect on the hyperalgesia. These results suggest that the endogenous CGRP present in primary afferents probably has a facilitating function in nociceptive transmission in the spinal dorsal horn. PMID- 3264397 TI - [Electrostimulation of regeneration in the replacement of bone defects with carbon implants (experimental research)]. PMID- 3264396 TI - Intracellular picrotoxin blocks pentobarbital-gated Cl- conductance. AB - Using the 'inside-out' configuration of frog sensory neurons, we studied the effect of intracellular picrotoxin on the pentobarbital-gated single channel response of Cl- -current (iCl). The pentobarbital-induced iCl showed no voltage dependency and the single channel conductance (gamma Cl) was 16 +/- 3.1 pS (n = 6). Picrotoxin caused the pentobarbital-gated Cl- channels to react in a flickering pattern and then finally caused them to cease their opening altogether. This inhibitory action of picrotoxin was reversible. PMID- 3264398 TI - [Prevention and treatment of suppurative complications in open lesions using the preparation Tsimezol']. PMID- 3264399 TI - [Characteristics of subpopulations of t-lymphocytes taking part in the regulation of myelopoiesis during a stress reaction]. PMID- 3264400 TI - [Clinico-immunocytological characteristics of critical states of pneumonia in young children]. PMID- 3264401 TI - [Present-day etiological structure of hospital-acquired pneumonia and its treatment]. PMID- 3264402 TI - Ligand-induced stimulation of epidermal growth factor receptor mutants with altered transmembrane regions. AB - The epidermal growth factor (EGF) receptor is a transmembrane glycoprotein composed of a large extracellular ligand-binding region connected to the cytoplasmic kinase domain by a single transmembrane (TM) region. To explore the role of the TM region in the process of receptor activation, we have generated EGF-receptor mutants with altered TM regions by utilizing in vitro site-directed mutagenesis. The TM regions of two mutant receptors were either extended (designated i626-3) or shortened (designated d625.3) by three hydrophobic amino acid residues. In the other two mutant receptors, hydrophobic amino acids were substituted by charged residues--i.e., Val-627 was replaced by glutamic acid (designated V627E) or Leu-642 was replaced by an arginine residue (designated L642R). NIH 3T3 cells lacking endogenous EGF receptors were transfected with constructs encoding either wild-type or mutant receptors and shown to express the receptor molecules using 125I-labeled EGF binding and immunoprecipitation experiments. The mutant receptors were expressed on the cell surface as polypeptides of Mr 170,000 exhibiting typical high- and low-affinity binding sites for 125I-labeled EGF. Similar to its effect on wild-type receptors, phorbol 12-myristate 13-acetate abolished the mutant-receptor high-affinity binding sites for EGF. Moreover, EGF was able to stimulate the kinase activities of wild-type and mutant receptors both in vitro and in living cells. The mutant receptors were also able to undergo EGF-induced receptor dimerization as revealed by cross linking experiments with a bifunctional covalent cross-linking agent. These results are compatible with an intermolecular allosteric oligomerization model for receptor activation rather than with a model based on an intramolecular mechanism for receptor activation. PMID- 3264403 TI - Functional diversity of gro gene expression in human fibroblasts and mammary epithelial cells. AB - Previous studies of gro and related genes that are overexpressed in transformed fibroblasts suggest that gro may encode a specific growth regulator. However, DNA and protein sequence comparisons reveal relatedness to platelet factor 4 and other proteins involved in the inflammatory response. In this paper, both growth related and cytokine-induced responses in gro gene expression are described. Human foreskin fibroblasts are shown to express approximately 10-fold elevated gro, myc, and fos mRNAs in response to serum and to phorbol 12-myristate 13 acetate stimulation, with early response kinetics indicative of growth regulation. In response to interleukin 1, however, in growing cells gro mRNA is elevated at least 100-fold but myc remains constant and fos is not expressed, suggesting a second regulatory pathway. In normal cultured mammary epithelial cells, gro is constitutively expressed, and elevated mRNA levels are induced by phorbol 12-myristate 13-acetate, but not by interleukin 1. However, most carcinoma cell lines examined do not express gro mRNA, suggesting a third function of gro as a negative growth regulator in epithelial cells. PMID- 3264404 TI - Role of interleukin 1 in the activation of T lymphocytes. AB - The activation of T lymphocytes requires their stimulation via clonotypic antigen receptors as well as nonantigen-specific costimulators, the best defined of which is the cytokine interleukin 1 (IL-1). Recent studies have shown that murine CD4+ helper T lymphocytes consist of two nonoverlapping subsets that selectively utilize interleukin 2 (IL-2) or interleukin 4 as their autocrine growth factors and are called Th1 and Th2 cells, respectively. We now show that IL-1 functions as a costimulator for the proliferation of Th2 but not of Th1 clones and only Th2 cells express high-affinity receptors for IL-1. Secretion of autocrine growth promoting lymphokines by Th1 and Th2 cells occurs after stimulation via the antigen receptor-CD3 complex and is neither dependent on nor affected by IL-1. These findings suggest that the activation of T lymphocytes can be divided into two stages, lymphokine secretion and proliferation, and only proliferation requires costimulators such as IL-1. Moreover, the prevailing view that IL-1 functions as a costimulator by inducing secretion of IL-2 or expression of IL-2 receptors may not be generally applicable, because IL-2-producing Th1 clones do not express receptors for IL-1 and are insensitive to this cytokine. PMID- 3264405 TI - Prevention of diabetes in nonobese diabetic mice by anti-I-A monoclonal antibodies: transfer of protection by splenic T cells. AB - The nonobese diabetic (NOD) mouse has been developed as a model for insulin dependent diabetes. One gene required for the development of diabetes is associated with the major histocompatibility complex. This gene possibly could be linked to class II genes, which show a unique pattern in NOD mice. To evaluate the role of the I-A class II antigen expressed in NOD mice, we studied the effect of anti-I-A monoclonal antibodies on disease onset in vivo. Long-term treatment with anti-class II IgG2a antibodies specific for NOD I-A antigen prevented the spontaneous development of diabetes, as opposed to control antibodies shown not to react with NOD I-A antigen. Anti-class II antibodies apparently elicited active immune suppression, requiring a fully immunocompetent host, rather than passive blockade of class II antigen. Treatment with anti-class II antibody effectively prevented the adoptive transfer of diabetes produced by splenocytes from diabetic NOD mice into newborn mice but failed to prevent adoptive transfer into irradiated adult NOD recipients. Direct evidence for the induction of suppressor cells was obtained from the passive transfer of spleen cells from anti class II antibody-treated NOD donors. The injection of anti-class II antibody treated spleen cells collected from NOD donors prevented the development of diabetes, which normally follows transfer of diabetogenic spleen cells into irradiated 8-week-old male NOD recipients. Depletion experiments indicate that CD4+ cells are responsible for anti-class II-induced protection transferred by spleen cells. PMID- 3264407 TI - Inhibition of human T cell responses by hydrogen peroxide. PMID- 3264406 TI - Cytotoxic activity of an interleukin 6-Pseudomonas exotoxin fusion protein on human myeloma cells. AB - A chimeric toxin composed of human interleukin 6 (IL-6) attached to a portion of Pseudomonas exotoxin (PE) devoid of its own cell recognition domain has been produced in Escherichia coli. The fusion protein (IL-6-PE40) is cytotoxic to a human myeloma cell line expressing IL-6 receptors but has no effect on IL-6 receptor-negative cells. The specificity of IL-6-PE40 cytotoxicity was demonstrated through competition with excess IL-6 and neutralization with an antibody to IL-6. IL-6-PE40 may be useful in the selective elimination of myeloma cells and other cells with high numbers of IL-6 receptors. PMID- 3264408 TI - Problem-oriented system (continuing education credit). PMID- 3264409 TI - The peripheral nerve allograft: an assessment of regeneration across nerve allografts in rats immunosuppressed with cyclosporin A. AB - Lewis rats (RT1(1] were the recipients of 3-cm nerve grafts from syngeneic Lewis donors or allogeneic ACI (RT1a) donors. Microneurosurgical repair of the nerve graft to the transected sciatic nerve of the recipient animal was performed with 10-0 epineurial sutures. Recipients were randomly allocated to cyclosporin A (CsA) immunosuppressed or untreated groups. Cyclosporin A was administered in the minimal effective dosage to prevent nerve allograft rejection across this major histocompatibility disparity (5 mg/kg per day). Nerve regeneration across the nerve grafts was assessed by sciatic function index (SFI) and toe spread index (TSI) determinations serially and by electrophysiologic, histologic, and morphologic assessments 14 weeks after engraftment. Sciatic nerve regeneration across allogeneic nerve grafts in cyclosporin A immunosuppressed recipients was significantly superior compared to the untreated controls (p less than 0.008) and not significantly different from that across the syngeneic control animals. PMID- 3264410 TI - [Markers of bone pain in hemodialysis patients with renal insufficiency]. AB - The patients receiving maintenance hemodialysis were divided into two groups in the absence and the presence of bone pain and investigated the markers of bone pain in these patients. These results suggested that the duration of receiving hemodialysis, serum concentrations of alkaline phosphatase, osteocalcin and parathyroid hormone became to be the markers of bone pain. PMID- 3264411 TI - Interactions between immunological cells and the hypothalamus pituitary-adrenal axis: an example of neuroendocrine immunoregulation. PMID- 3264412 TI - Non-invasive evaluation of bone formation: measurements of serum alkaline phosphatase, whole body retention of diphosphonate and serum osteocalcin in metabolic bone disorders and thyroid disease. AB - Three noninvasive indices of bone formation, serum alkaline phosphatase (s-AP), 24-h whole body retention of diphosphonate (WBR), and serum osteocalcin (s-OC), the two lastnamed clearance-corrected, were compared in 121 patients with various bone disorders and in 50 patients with thyroid disease. In conditions with qualitatively normal matrix formation and mineralization, i.e. thyrotoxicosis, primary hyperparathyroidism, myxoedema and osteoporosis, the three indices deviated from average normal by about the same extent: 134%/128%/200%, 120%/113%/133%, 105%/100%/79% and 89%/86%/69%, respectively. A disproportionately marked deviation of s-AP was observed in states of abnormal matrix formation or mineralization, i.e. osteomalacia and Paget's disease: 430%/145%/282% and 348%/145%/202%, respectively. Furthermore, the formation indices correlate differently with s-calcium in hyper- and hypocalcaemic conditions. In primary hyperparathyroidism the respective r-values were 0.32/0.62/0.68, while an inverse pattern was observed in osteomalacia: -0.60/-0.51/-0.47. As very little is known about the secretion of AP and OC and their role in bone formation and mineralization, the cause(s) for the observed differences remain(s) uncertain. PMID- 3264413 TI - Colonoscopy in the diagnosis of colorectal cancer. AB - Many studies show that colonoscopy is the most accurate method available in the diagnosis of colorectal cancer. Furthermore, in some cases it makes it possible to treat malignant polyps adequately by simple polypectomy. Endoscopic removal of adenomas plays an important role in prevention of colorectal malignancies. It has also been shown that there is a high rate of synchronous premalignant and malignant lesions. PMID- 3264414 TI - Aspects of descriptive epidemiology and survival in colorectal cancer. AB - World-wide cancer of the colon and rectum emerges as the third most frequent form of cancer in males and the fourth in females. Patients with colorectal cancer suffer from a considerable excess mortality during the first six to eight years after diagnosis, and the cure rate, which is in the order of 35-40% in the Swedish population, has remained largely unchanged over several decades. The incidence rates show a steep rise with age, marked international differences, increasing incidence in developing countries, adjustments in cancer risk within few decades in populations who move from low- to high-risk areas, and no consistent differences in relation to race. In addition, the incidence rates display a complex network of relationship to age, sex, segment of the large bowel and secular trends. These observations indicate that environmental factors play a predominant role in the development of colorectal cancer, that such factors may have specific influences in certain segments of the large bowel, and that they modulate the risk even in adult life. PMID- 3264415 TI - Bovine aorta endothelial cell incubation with interleukin 2: morphological changes correlate with enhanced vascular permeability. AB - Interleukin 2 induced alterations in the morphology of bovine aortic endothelial cells in vitro. The changes observed in confluent cultures of bovine aortic endothelial cells included retraction and elongation of cells leading to enlarged gaps between cells quantified by image analysis. Purified IL-2 (1 U/ml medium) increased the gaps between endothelial cells 3-4-fold compared with control cultures. The effect was transient, since the cells reverted to their original morphology 6-12 hours after the removal of IL-2. Correlative scanning electron microscopy (SEM) studies using fresh bovine aorta showed a dose-dependent alteration of the endothelial surface by IL-2 characterized by rounding and elongation of endothelial cells and prominent perinuclear areas. Gaps between the endothelial cells were observed when aorta samples were incubated with 2 U of IL 2/ml of medium. This was confirmed by SEM, transmission electron microscopy and Evans blue dye staining. These results suggest that IL-2 caused morphological alterations in endothelial cells that enhanced the permeability of the vascular endothelium. PMID- 3264416 TI - Hematopoietic growth factors and human acute leukemia. AB - The study of myelopoietic maturation arrest in acute myeloblastic leukemia (AML) has been eased by availability of the human recombinant hemopoietic growth factors, macrophage colony stimulating factor (M-CSF), granulocyte-(G-CSF), granulocyte-macrophage-(GM-CSF) and multilineage stimulating factor (IL-3). Nonphysiological expansion of the leukemic population is not due to escape from control by these factors. Proliferation in vitro of AML cells is dependent on the presence of one or several factors in most cases. The pattern of factor dependency does not correlate with morphological criteria in individual cases, and may thus offer a new tool for classification of AML. Overproduction of undifferentiated cells is not due to abnormal expression of receptors for the stimulating factors acting at an immature level. Rather, autocrine secretion of early acting lymphokines maintains proliferation of the leukemic clone. When looking at causes of leukemic dysregulation, yet undefined inhibitors of differentiation probably are of equal importance as dysequilibrated stimulation by lymphokines. PMID- 3264417 TI - [Action of various growth factors on bone marrow cultures in acute myeloid leukemia (ALM)]. AB - In an attempt to detect residual leukemic cells during remission, we examined differences in the stimulatory capacity of colony stimulating factors (CSF) added to agar cultures of AML patients at diagnosis/relapse (group I) and in remission (II), or of normal controls (III). Supernatant from the human bladder carcinoma cell line 5637 and human recombinant granulocyte-macrophage-CSF were compared with supernatant from human placenta as standard. Group I showed wide patient-to patient variations. The stimulatory capacity of the 3 CSF produced significant differences within groups II and III, but not between those groups. In conclusion, our comparative investigations do not reveal residual leukemic cells in the marrow of AML patients in remission. PMID- 3264418 TI - [The treatment of acute urinary tract inflammation in the sow]. PMID- 3264420 TI - Case report 508: Histiocytosis X of the left femur-proximal segment. PMID- 3264419 TI - Neonatal hepatitis induced by alpha 1-antitrypsin: a transgenic mouse model. AB - Transgenic mouse lineages were established that carry the normal (M) or mutant (Z) alleles of the human alpha 1-antitrypsin (alpha 1-Pi) gene. All of the alpha 1-Pi transgenic mice expressed the human protein in the liver, cartilage, gut, kidneys, lymphoid macrophages, and thymus. The human M-allele protein was secreted normally into the serum. However, the human Z-allele protein accumulated in several cell types, but particularly in hepatocytes, and was found in serum in tenfold lower concentrations than the M-allele protein. Mice in one lineage carrying the mutant Z allele expressed high levels of human alpha 1-Pi RNA and displayed significant runting (50% of normal weight) in the neonatal period. This lineage was found to have alpha 1-Pi-induced liver pathology in the neonatal period, concomitant with the accumulation of human Z protein in diastase resistant cytoplasmic globules that could be revealed in the Periodic acid-Schiff reaction (PAS). The phenotype of mice in the strain expressing high levels of the Z allele is remarkably similar to human neonatal hepatitis, and this strain may prove to be a useful animal model for studying this disease. PMID- 3264421 TI - [Secondary immune deficits in psychoemotional stress]. PMID- 3264422 TI - [Fenibut treatment of a vascular lesion of the vestibular analyzer]. PMID- 3264423 TI - [Objective assessment of the regional muscle blood flow promoting effect of electrostimulation in paraplegic patients (studies with 201 thallium and 133 xenon)]. PMID- 3264424 TI - Multimeric composition of plasma von Willebrand factor in chronic myelocytic leukaemia. AB - We studied the multimeric composition of plasma von Willebrand factor (vWf) in 26 patients with chronic myelocytic leukaemia (CML); 13 in chronic phase, 8 in blast crisis, 5 in both chronic phase and blast crisis. The relative amount of large (multimer band greater than or equal to 11) multimers calculated by densitometer scan following SDS-agarose gel electrophoresis was 14.6 +/- 2.9% (mean +/- SD) in normal controls, 8.7 +/- 4.7% in chronic phase and 15.0 +/- 5.2% in blast crisis. CML patients in chronic phase (but not in blast crisis) had a significantly lower percentage of large multimers than normal controls (p less than 0.001). The relative amount of large multimers was positively correlated with a ratio of ristocetin cofactor/vWf antigen (p less than 0.005), and was negatively correlated with platelet count (p less than 0.001), WBC count (p less than 0.05) and granulocyte count (p less than 0.05). We conclude that some patients with CML, especially in chronic phase, lack large multimers. The negative correlation of the relative amount of large multimers with platelet and granulocyte count suggests that large multimers may be consumed in high platelet count states or degraded by protease(s) from increased blood cells. PMID- 3264425 TI - [Bleeding from the upper gastrointestinal tract]. PMID- 3264426 TI - Comparison of intraluminal and extraluminal inhibitory effects of hemoglobin on endothelium-dependent relaxation of rabbit basilar artery. AB - To determine whether extraluminal or intraluminal hemoglobin inhibits endothelium dependent relaxation, we measured the vascular responsiveness of rabbit basilar artery in an in vitro perfusion system and we performed immunohistochemical staining for hemoglobin. In the in vitro study, we applied agents from either the intraluminal or the extraluminal side of excised basilar arteries. KCl-induced contraction was the same with either application. Acetylcholine-induced maximal relaxations were 57.6 +/- 8.5% of the contraction induced by 10(-5) M 5 hydroxytryptamine for control, 3.3 +/- 0.3% for intraluminal, and 34.9 +/- 8.6% for extraluminal applications. Adenosine triphosphate-induced maximal relaxations were 64.2 +/- 4.1% of the contraction induced by 10(-5) M 5-hydroxytryptamine for control, 26.9 +/- 3.8% for intraluminal, and 42.2 +/- 6.0% for extraluminal applications. Hemoglobin's inhibition of acetylcholine- and adenosine triphosphate-induced relaxation was significantly greater with intraluminal than with extraluminal application (p less than 0.05). The immunohistochemical study revealed hemoglobin in the outer layer of the smooth muscle and in the adventitia when 10(-5) M hemoglobin was applied extraluminally for 5 minutes, whereas hemoglobin was observed on the surface of the endothelial cells after intraluminal application. Our findings suggest that hemoglobin inhibits acetylcholine- or adenosine triphosphate-induced relaxation by binding to endothelium-derived relaxing factor (EDRF) and by inhibiting production of EDRF. Hemoglobin's inhibitory effect on endothelium-dependent relaxation may be important in the pathogenesis of vasospasm after subarachnoid hemorrhage. PMID- 3264427 TI - Priming of cytotoxic T lymphocyte precursors by donor-specific transfusions and modulation post transplant in relation to steroid withdrawal. PMID- 3264428 TI - In vitro tests on macrophage prostaglandin E2 and thromboxane B2 production after blood transfusion. PMID- 3264429 TI - Protection of chickens from lethal influenza infection by vaccinia-expressed hemagglutinin. AB - To study the immune response of the chicken to specific influenza proteins, we have constructed a recombinant vaccinia virus containing the hemagglutinin gene of influenza A/Turkey/Ireland/1378/83 (H5N8). In mammalian cell culture the hemagglutinin expressed by this recombinant virus was full-length, cleaved into HA1 and HA2 in the absence of trypsin, and transported to the cell surface, confirming that other virus products are not required for cleavage activation. Chickens inoculated through the wing web with the live recombinant virus produced extremely low levels of hemagglutination-inhibiting or infectivity-neutralizing antibody. However, they were protected from lethal H5 influenza virus challenge. Protection extended to the antigenically distinct virulent H5 viruses, Chicken/Pennsylvania/1370/83 and Chicken/Scotland/59. Chemically bursectomized vaccinated chickens were not protected, whereas normal chickens with very low antibody levels (less than 10) obtained by passive transfer were protected in a dose-dependent fashion. This indicates that despite the low antibody titers induced by vaccination, protection was mediated by antibody. PMID- 3264430 TI - [AIDS in Austria]. AB - AIDS is a notifiable disease in Austria. In 1983, the first 6 cases were recorded. Thereafter, the numbers doubled approximately each year, reaching 182 on May 30, 1988. On the same date, a total of 2433 persons were found to be infected. The highest rates of AIDS patients and seropositive individuals were recorded in Vienna (72/1355), followed by Upper Austria (37/470) and the Tyrol (20/318). For the most part patients with AIDS are members of the classical risk groups (homo- or bisexual men: 49.5%, i.v. drug users: 26.4%). Since autumn of 1987, almost half of those persons who are found to be infected are i.v. drug addicts. Heterosexual transmission of HIV is still rare but appears to be increasing. Judging from the situation in Vienna legal prostitution does not seem to contribute to the spread of the virus. PMID- 3264431 TI - [What leads to urgent house calls at an emergency medical service?]. AB - Which are the signs the emergency service uses most to initiate an urgent home visit? What degree of diagnostic certainty can be attained at the telephone? These questions were answered by a study of the Vienna emergency doctor's service, a General Practitioner deputizing service operating during all the nights and on weekend days. The 3 diagnostic items leading to an urgent visit most frequently after a phone call were angina, bronchial asthma and dyspnoea. The doctor at the telephone decides in favour of an urgent visit, if a symptom relates to a prevalently dangerous group of diseases; he follows these signs urgently when the time of the day frequently relates to dangerous diseases containing such a symptom. The decision to do an urgent house call is more often made up in terms of diagnoses than by mere symptoms. PMID- 3264432 TI - [The extent of morbidity in the retirement and pre-retirement age]. PMID- 3264433 TI - [Evaluation of the analgesic effect of an improved method of local electroanesthesia using electrodes implanted in the wound]. PMID- 3264434 TI - [Accessory effect of human B lymphocytes in T cell mitogen responses]. PMID- 3264435 TI - Intraocular lymphoma. Cytologic diagnosis and the role of immunologic markers. AB - We retrospectively reviewed the cytology and immunohistochemistry of vitreous cells from 14 patients with benign or malignant intraocular diseases. Nine patients had intraocular lymphoma and five had benign forms of diffuse uveitis. The most useful cytologic criteria for lymphoma included an irregular nuclear outline, a coarse chromatin pattern and prominent nucleoli. In several cases, it was necessary to obtain more than one specimen to establish the diagnosis of lymphoma. When vitreous fluid was mixed with a balanced salt solution prior to processing, a resulting artifact interfered with interpretation of the specimen. A diagnosis of lymphoma was established by cytology in all nine patients; immunohistochemical techniques were less sensitive than was cytology. PMID- 3264436 TI - Carcinoma of the prostate with Cushing's syndrome. A case report with histochemical and chemical demonstration of immunoreactive corticotropin releasing hormone in plasma and tumoral tissue. AB - A case is described of a patient with a small-cell prostatic carcinoma containing immunoreactive CRH, in conjunction with ACTH-dependent Cushing's syndrome. The serum concentrations of CRH, ACTH, beta-endorphin and calcitonin were all found to be above normal. Post-mortem examination revealed a prostatic tumour with multiple metastases, and a diffuse hyperplasia of pituitary corticotropic cells and adrenal cortical cells. In sections of the primary prostatic tumour, immunoreactive cells were demonstrable with antisera raised against human CRH, TSH, calcitonin and somatostatin, but not with antisera against ACTH or beta endorphin. By radioimmunoassay the CRH-like material could also be demonstrated in extract of the prostatic tumour and the material from both plasma and tumour extract eluted at the position of human CRH on gel chromatography (Sephadex G 75). These findings provide support for the interpretation that the patient's Cushing's syndrome was due to a CRH-producing prostatic tumour. Finally, the origin and the clinical significance of the neuroendocrine cells in the prostatic carcinoma is discussed. PMID- 3264437 TI - Effect of iron on T-cell colony formation in patients with iron deficiency anemia. PMID- 3264438 TI - Effects of monoclonal antibodies (anti-CD3, 4, 8) under the presence of interleukin-2 (IL-2) on human T-cell colony formation derived from peripheral blood. PMID- 3264439 TI - Interleukin 3-producing T cell lines derived from a mouse with granulocytosis and characteristics of the colony stimulating activities. PMID- 3264440 TI - Establishment and characterization of a new human B lymphoblastoid cell line that responds to a B cell growth factor. PMID- 3264441 TI - Histiocytosis X presenting as multiple intrahepatic nodules. PMID- 3264442 TI - Effect of recombinant erythropoietin on human BFU-E in serum-free cultures. PMID- 3264443 TI - Prevention of cerebrospinal fluid rhinorrhea in translabyrinthine surgery. PMID- 3264444 TI - Postural hypotension--cochleo-vestibular hypoxia--deafness. AB - The postural hypotension syndrome i.e. a sudden fall in blood pressure as a result of sudden rising, leading to severe vertigo and fainting has been known for a very long time, but the diagnostic criteria for hypotension has changed recently. Medical textbooks claim that unless systolic B.P. falls more than 20 mm upon rising it is not hypotension. A recent British investigation employing radio active isotope tomography has shown that an orthostatic fall in B.P. of 10 mm in elderly persons may cause a 60% decrease in cerebral blood-flow lasting several minutes (2). It has been estimated that at least 30% of the patients in nursing homes suffer from vertigo. Last year 6000 elderly persons in Denmark were treated for fracture of the femoral neck. This study points out that concurrent with vertigo and fainting the cochlea does suffer from decreased blood supply, and hearing subsequently deteriorates. The reason why this has not been recognized until now is that while vertigo comes and disappears within minutes and is distinctly felt by the patient, the hearing loss develops nearly as slowly as does hearing loss caused by moderate noise exposure over many years. Axelsson et al. in a recent study point out that at least TTS is influenced by cochlear blood flow (4). PMID- 3264445 TI - Vestibular disturbances after neck muscle sectioning in rat. AB - The nystagmus response to rotatory acceleration was investigated in rats. The stimulus was exerted by a turntable accelerated 13.3%/sec2 for 9 seconds and after 1-2 minutes decelerated accordingly. Eye movements were recorded using the search coil technique. The duration of postrotatory nystagmus and speed of slow component velocity gain were recorded. After unilateral neck muscle sectioning no change appeared. After bilateral sectioning the nystagmus response was increased with a remaining high gain and prolonged response duration. The experiments show the influence by the muscles on the velocity storage mechanism. PMID- 3264446 TI - Excitatory and inhibitory behavioral responses to the pharmacological stimulation of serotonergic function in dorsalis raphe lesioned rats. AB - Neurotoxin-induced lesions of 5-HT neurons produce supersensitivity of 5-HT1 receptors without affecting 5-HT2 receptor binding in the brain. This model was used in the present work to analyze the role of 5-HT receptor subtypes in the mechanism controlling the excitatory and inhibitory behavioral responses to the pharmacological stimulation of 5-HT systems. Dorsalis raphe (DR) lesions were made by stereotaxic injection of kainic acid. At day 30 after injection DR-and control rats displayed similar baseline behavior in hole board tests. Three days later DR-and control rats received an ip injection of fluoxetine (5 or 10 mg/kg) 30 min before injecting ip 5-HTP(15 or 30 mg/kg). Immediately before and after each ip injection the excitatory response (myoclonic syndrome) was evaluated. DR and control-group showed similar scores of myoclonus in response to fluoxetine-5 HTP. The inhibitory response was investigated in hole board trials performed 30 min after the second ip injection. The DR lesion potentiated the behavioral depressive effect of fluoxetine-5-HTP. In agreement with data in the literature the DR lesion caused 74.9% loss of forebrain 5-HT and 75% increases of 3H-5HT binding in cortex membranes. Most components of the excitatory response, which remained unchanged in the DR-lesioned rats, might be related to 5-HT2 receptors. The increased inhibitory response to 5-HT stimulation in DR-lesioned rats would be due to the supersensitivity of 5-HT1 receptors. PMID- 3264447 TI - Biochemical evidence of disturbed bone metabolism and calcium homeostasis in two types of autosomal dominant osteopetrosis. AB - Biochemical markers of bone resorption and bone formation were measured in 14 patients with autosomal dominant osteopetrosis, and compared with age- and sex matched controls. There were eight patients with the radiological type I characterized by diffuse, symmetrical osteosclerosis with pronounced sclerosis of the skull and enlarged thickness of the cranial vault, and six patients with type II characterized by diffuse, symmetrical osteosclerosis, "Rugger-Jersey spine" and "endobones" (bone within a bone) in the pelvis. Serum levels of alkaline phosphatase and osteocalcin in types I and II did not differ from controls indicating normal bone formation. However, a significantly decreased fasting renal excretion of phosphate and hydroxyproline in both types compared with normal controls, suggests a reduced bone resorption. Serum levels of parathyroid hormone (PTH), albumin-corrected calcium, phosphate, and acid phosphatase were normal in type I. In type II serum levels of albumin-corrected calcium and PTH were significantly increased (p less than 0.05 and p less than 0.01). The level of acid phosphatase was markedly increased in this type (p less than 0.01). These findings suggest differences between the two types in calcium homeostasis and bone metabolism, and thus corroborate the evidence that the two radiological types reflect two different disorders of bone resorption. PMID- 3264448 TI - Gilbert's syndrome--does it exist? A study of the prevalence of symptoms in Gilbert's syndrome. AB - Liver function tests and prevalence of different symptoms generally said to occur in Gilbert's syndrome were analysed in male conscripts and in male and female participants in two cross-sectional population studies in Goteborg, in total 2395 subjects. The serum bilirubin levels showed a skew distribution without bimodality. We observed no tendency to higher prevalence of symptoms in subjects with high serum bilirubin levels, but normal alkaline phosphatase and aminotransferase values compared to subjects with normal bilirubin. The findings contradict the existence of a disease entity named "Gilbert's syndrome". PMID- 3264449 TI - Tobacco smoking and twinning. AB - In a case-control study an association was found between mothers' smoking habits and the frequency of dizygotic twinning. As cases were included all twins born in Denmark in 1984 and 1985. A random sample of 1.5% of mothers to singletons, born in the same period were selected as controls. Only live-borns, conceived after no hormonal treatment, were included in the study. The finding may be due to the well-known anti-estrogen effect of smoking. PMID- 3264450 TI - The cardiovascular risk factor profile in the study area Augsburg. Results from the first MONICA survey 1984/85. AB - The main objective of the first survey was the investigation of the prevalence and distribution of hypertension, hypercholesterolemia and cigarette smoking in the study area. The data-collection phase lasted from October 1984 to May 1985. A two-stage cluster sample of 5312 persons of German nationality was drawn from a population of 282,279 inhabitants, aged 25-64. The data were gathered through interview, physical examination and self-administered questionnaire. A response of 79% was achieved. Sixteen percent of men and 10% of women had high blood pressure (BP) values (greater than or equal to 160/95 mmHg). Only 16% of male and 34% of female hypertensives had controlled BP values. The prevalence of hypercholesterolemia (greater than or equal to 6.72 mmol/L = greater than or equal to 260 mg/dl) was 26% in men and 22% in women. Forty percent of men and 22% of women reported they were current cigarette smokers. Among participants, aged 25-44, cigarette smoking was the most prevalent risk factor in men and women. Thirty-seven percent of men and 52% of women, aged 25-64, had none of the three major risk factors. PMID- 3264451 TI - Monitoring of major cardiovascular diseases in Moscow, USSR. AB - Since 1984, suspected events of myocardial infarction and cerebral stroke have been registered and validated for residents of both sexes aged 25-64 in three Moscow administrative districts. The results of the myocardial infarction and stroke registers for 1985 are presented. In men, age-standardized attack rates per 100,000 population in the three districts were 310-400 for myocardial infarction, and 100-180 for stroke; the mortality due to myocardial infarction was 136-179, and the mortality due to stroke was 30-53. In women these rates were 70-90, 60-100, 24-35 and 24-32, respectively. PMID- 3264452 TI - Changes in size and cell populations in lymphoid organs during Plasmodium chabaudi infection in resistant and susceptible mice. PMID- 3264453 TI - Human non-interferon macrophage activating factor: biological and biochemical characterization. AB - A HTLV-1 transformed T cell line has been demonstrated to constitutively produce and secrete a lymphokine with macrophage activating properties. This lymphokine was biologically and biochemically distinct from interferon gamma, the interleukins, the colony stimulating factors and lymphotoxin. In vitro treatment of human monocytes with the partially purified lymphokine resulted in the acquisition of microbicidal and tumoricidal activities. The activity was associated with a protein with an apparent molecular weight of 55,000 daltons and an isoelectric point of 5.5. The potential for the efficacy of such a lymphokine in activating macrophages in vivo provides aspirations for its use in the therapy/prevention of opportunistic infections in immunocompromised hosts. PMID- 3264454 TI - Interaction of Legionella pneumophila with peritoneal macrophages from various mouse strains. PMID- 3264455 TI - Effect of salinomycin, flavomycin and avoparcin on some physiological traits of growing lambs, with particular respect to rumen fermentation. PMID- 3264456 TI - Workshop on the Immunogenetics of the Rheumatic Diseases. Proceedings of a symposium. Bethesda, Maryland, June 21 and 22, 1988. PMID- 3264457 TI - Genetic contributions to lupus-like disease in NZB/NZW mice. AB - In contrast to parental New Zealand Black (NZB) or New Zealand White (NZW) mice, (NZB x NZW)F1 mice exhibit a lupus-like disease characterized by high levels of immunoglobulin G (IgG) antinuclear antibodies in their serum and a fatal immune complex glomerulonephritis. At least three gene loci have been identified in NZW mice that could potentially contribute to a T cell-dependent autoimmune disease, including the T cell receptor alpha- and beta-chain gene complexes and the major histocompatibility complex (MHC). The NZW T cell receptor beta-chain complex appeared to be particularly unusual in that the C-beta-1, D-beta-2, and J-beta-2 gene segments have been deleted. Approximately one half of (NZB x NZW)F1 x NZB backcross mice developed severe renal disease and elevated levels of IgG antibodies to double-stranded deoxyribonucleic acid and histone, suggesting that only one dominant gene or closely linked group of genes accounts for the NZW genetic contribution to F1 disease. Despite the extremely unusual nature of the NZW T cell receptor beta-chain gene complex, we found no association of disease expression with the presence of this allele in the backcross mice. There was also no correlation of disease incidence with the presence of the NZW T cell receptor alpha-chain allele. In contrast, nearly 90 percent of the backcross mice with the NZW MHC expressed severe autoimmune disease compared with 12 percent of the mice that did not carry this haplotype. Thus, the NZW MHC or gene(s) linked to this locus appears to be the only dominant NZW genetic contribution to F1 disease. Recent preliminary studies mapping genes that are located centromeric and telomeric to the NZW MHC suggest that the disease-associated gene(s) lies within the MHC. PMID- 3264458 TI - T cell up-regulation of B cells via their idiotypes contributing to the development of systemic lupus erythematosus. A hypothesis. AB - A mechanism for sustained production of pathogenic autoantibody subsets in patients and mice with systemic lupus erythematosus may be centered on selective up-regulation of B cells bearing certain idiotypes. Public idiotypes are characteristic of some autoantibodies, including anti-DNA. Evidence is reviewed that suggests that immunoglobulins bearing certain public idiotypes, such as IdGN2, contain autoantibody subsets that are nephritogenic in human systemic lupus erythematosus and in New Zealand black/New Zealand white F1 mice. Up regulation of such cells could promote development of nephritis. Work from several laboratories has shown that production of immunoglobulin G antibodies to DNA depends upon T cell help. In New Zealand black/New Zealand white F1 mice, cloned T cells are dominated by autoreactive cells that produce B cell growth factors. We suggest that this sustained release of B cell growth factors combined with selection by T helper cells for B cells bearing IdGN2 are a major mechanism for sustained up-regulation of nephritogenic subsets of autoantibodies. PMID- 3264460 TI - Extensive changes in collagen synthesis and degradation during compensatory lung growth. AB - Unilateral pneumonectomy in rats causes compensatory growth of the remaining lung. This growth involves rapid production of collagen and noncollagen proteins, but the mechanisms for these changes have not been fully investigated. Rates of collagen metabolism were measured using previously validated in vivo methods. Six days after pneumonectomy, a threefold increase in the fractional rate of collagen synthesis was observed (control 11.8 +/- 0.9%/day, pneumonectomy 30.0 +/- 4.6%/day). Collagen degradation rates also increased but returned to normal more rapidly than the synthesis rates. These changes in synthesis and degradation resulted in a 75% increase in collagen content by 28 days. Although degradation of extracellular collagens was apparently increased, the fraction degraded intracellularly decreased by approximately 30%. Noncollagen protein synthesis and degradation rates both increased by approximately 80% (control 44.3 +/- 3.4%/day, pneumonectomy 80.3 +/- 10.2%/day) with a slightly greater increase in synthesis that led to an 85% increase in noncollagen protein content 28 days after pneumonectomy. The data obtained show dramatic changes in protein synthesis and degradation during compensatory lung growth and indicate extensive remodeling of structural elements in lung tissue. The changes for intracellular collagen degradation provide further evidence that this pathway may have an important role in regulating collagen deposition. PMID- 3264459 TI - The phenotype of human placental macrophages and its variation with gestational age. AB - The antigenic phenotype of human villous stromal macrophages (M phi s) from first and third trimester placentas was analyzed using a large number of monoclonal antibodies (MAbs) to monocyte (Mo)/M phi-associated cell membrane determinants. The purpose of this study was to investigate M phi phenotypic heterogeneity to create a database for the correlation of M phi phenotype with specific immunologic functions. The results showed that villous stromal mononuclear cells express many cell surface antigens found on Mo and M phi s and that they are morphologically diverse, ranging in appearance from classic Hofbauer cells to spindle-shaped cells with long cytoplasmic processes. Villous stromal M phi s were the numerically dominant cell type in this structure and exhibited some major phenotypic differences from M phi s in other tissues. Comparison of first- and third-trimester placentas revealed variation in antigen expression with increasing gestational age, in particular of class II major histocompatibility complex (MHC) determinants: HLA-DR and HLA-DP antigen density was low on first trimester villous M phi s and much higher on third-trimester M phi s while HLA-DQ was undetectable in the first trimester but present on cells in third trimester placentas. The CD1 (T6) antigen, found on Langerhans (LH) cells and cortical thymocytes, was detected on villous M phi s by two thirds of the MAbs directed against different epitopes on this determinant. Furthermore, comparison with similar studies of lymphoid tissues showed that villous M phi s and dendritic cells share the expression of a number of other cell surface antigens. Finally, it was shown that M phi s in first- and third-trimester villi exhibit strong reactivity with MAbs (Leu 3a,b) to the CD4 antigen that serves as the receptor for the human immunodeficiency virus (HIV), suggesting that these cells may be a portal of entry or reservoir for this virus in the fetuses of pregnant, HIV+ women. PMID- 3264461 TI - To what extent is microtubular network involved in antidiuretic response? AB - Antimitotic drugs markedly interfere with antidiuretic response, strongly implying that cytoskeleton integrity is essential to this function. This role of the cytoskeleton in controlling the epithelial transport has been seen as a necessary step in the translocation of the water channel containing particle aggregates and in their delivery to the apical membrane. We have now reexamined the exact role of the microtubular network by appropriate time course determinations, by the use of microtubule disruptive agents that lack of the side effects of colchicine, and by trying to visualize the apparent modifications of the microtubular network that accompany water permeability alterations using immunocytochemical techniques. Our results fully confirm that after microtubular network disruption, antidiuretic hormone-induced water permeability variations undergo typical alterations consisting in both a reduction in peak net water flow and a slowing down of its onset. At the same time, the microtubular network disappears in all the epithelial cells. We also show that colchicine-induced inhibition can still be observed in the presence of a prostaglandin synthetase inhibitor and that this inhibition is most likely to occur at a post-adenosine 3',5'-cyclic monophosphate level. These data, as well as results from other series with nocodazole, indicate that the reduction of the net water flow directly results from microtubular network disruption and not from side effects of the disrupting drugs. They also show that the hydrosmotic response is only partially dependent on the microtubular network, which probably has only a guidance role in the translocation of particle aggregates and their exocytotic fusion to the apical membrane. PMID- 3264462 TI - Renal tubular cells are potential targets for epidermal growth factor. AB - Epidermal growth factor (EGF) is a potent polypeptide mitogen with various receptor-mediated growth effects on cells from the skin, breast, and gastrointestinal tract. Recent studies indicate that EGF is produced in the kidney and is excreted in the urine, but the biological significance of renal EGF is uncertain. We demonstrate in vitro mitogenicity of EGF for LLC-PK1 cells, a tubular epithelial cell line derived from pig kidney cortex. Furthermore, when subconfluent monolayers of LLC-PK1 cells are exposed to EGF for 24 h, sodium dependent phosphate transport is stimulated (209-410% of control). These cells possess EGF-specific high-affinity binding sites at their surface (Kd 300-700 pM) but cannot synthesize the growth factor. EGF binding sites are not a peculiarity of the LLC-PK1 cell line, since similar sites are present on MDCK cells (derived from dog kidney distal tubule or collecting duct), primary cultures of mouse proximal tubular cells, and freshly prepared membrane fractions from mouse kidney. Cortical basolateral membranes are highly enriched in EGF binding sites, whereas EGF binding by brush-border membrane fractions is minimal and is compatible with contamination. PMID- 3264463 TI - pH and voltage dependence of INa recovery kinetics in atrial cells exposed to lidocaine. AB - Lidocaine blocks sodium channels during depolarizations. The rate of recovery (repriming) of drug-blocked channels between depolarizations is slowed by both membrane depolarization and by acidification. This modulation of recovery kinetics was studied using a single-electrode voltage clamp on atrial cells isolated from the bullfrog. The pH dependence of recovery from inactivation, in drug-free conditions, is opposite to that observed in myelinated nerves; recovery occurs faster at higher pH levels in these cardiac preparations. The combined pH dependence and voltage dependence of repriming kinetics during lidocaine treatment can be explained by assuming that channels occupied by neutral drug can reactivate most readily at a rate that appears to be coupled to recovery from channel inactivation. PMID- 3264464 TI - Immunohistochemical characterization of stromal leucocytes in nonpregnant human endometrium. AB - Stromal leucocytes in normal premenopausal human endometrium were characterised by an indirect immunoperoxidase technique employing a panel of monoclonal antibodies. T cells were scanty in proliferative endometrium but increased in frequency in the secretory phase of the menstrual cycle. An additional population of phenotypically unusual lymphocytes (CD2-positive, CD3-negative) was detected in the stratum functionalis in mid- and late secretory phase endometrium, particularly in areas exhibiting pseudodecidual change. The distribution of these unusual lymphocytes mirrored that of the so-called "endometrial stromal granulocytes," which have recently been shown to be granulated lymphocytes. Macrophages were common throughout the menstrual cycle. B lymphocytes were detected in lymphoid aggregates in the basalis but rarely in the functionalis. PMID- 3264465 TI - Venous complications of sclerotherapy for esophageal varices. AB - Although endoscopic sclerotherapy is effective in controlling bleeding from esophageal varices, the effects of sclerosing agents on the extrahepatic portal and splenic veins have not previously been investigated. This study of 21 men with portal hypertension and variceal bleeding compares the morphology of the portal and splenic veins in 11 who had received endoscopic sclerotherapy versus 10 patients who did not. The mean number of injections per patient was 11 +/- 5, the mean volume of 1.5 percent sodium tetradecyl injected was 23 +/- 15 ml, and the interval between the last injection and surgery was 15 +/- 6.5 days. Among the 11 patients who had endoscopic sclerotherapy, portal vein thrombosis occurred in 4 (36 percent). Two of these patients died from acute liver failure; the other two had shunt procedures. Histologic changes included intimal thickening and medial fibrosis in seven patients, thrombus in four patients, and destruction of the venous architecture in two patients. Of the 10 patients with portal hypertension who did not have endoscopic sclerotherapy, all had medial fibrosis of the portal vein, with thrombus and intimal thickening present in only 1. These findings suggest that endoscopic sclerotherapy for esophageal varices should be used cautiously in patients who may later require a shunt. Moreover, further studies are necessary to evaluate the long-term effects of injecting sclerosing agents into the portal circulation before widespread use of prophylactic sclerotherapy can be recommended. PMID- 3264466 TI - Effect of delayed operation for bleeding esophageal varices on Child's class and indices of liver function. AB - The charts of 38 patients managed with a period of intensive medical treatment (mean 7 days) prior to portosystemic shunting were examined. We found that the operative delay did not improve the Child's class or the indices of liver function. The operative mortality rates in these patients were 0 in Child's A patients, 13 percent in Child's B patients, and 50 percent in Child's C patients. Based on these findings, we began to operate on patients with bleeding esophageal varices as soon as they stabilized. The charts of 10 consecutive Child's C patients operated on without a period of intensive medical management (mean 3 days) were reviewed and compared with the charts of 8 Child's C patients with delayed operation. The two groups of patients were similar. We recommend that patients who need a shunt should be operated on as soon as possible after bleeding has ceased. PMID- 3264467 TI - [Histiocytosis X with involvement of the temporal bone. Apropos of a case]. PMID- 3264468 TI - Coronary vasospasm during percutaneous trigeminal rhizotomy. AB - A case of myocardial infarction as a result of coronary vasospasm during percutaneous trigeminal rhizotomy is presented. Potential consequences of the profound sympathetic response during this procedure are discussed. Invasive haemodynamic monitoring as well as prophylaxis with nitrates and calcium antagonists may be useful in patients prone to coronary vasospasm who undergo this procedure. PMID- 3264469 TI - A boy with an anterior mediastinal mass. AB - A 12-year-old boy presented for biopsy of a large mediastinal mass. General anaesthesia precipitated immediate severe airway obstruction. This was overcome by the insertion of two microlaryngeal tubes, one into each main bronchus. The anaesthetic management of patients with an anterior mediastinal mass is discussed and the importance of pre-operative assessment stressed. PMID- 3264470 TI - DDAVP and anaesthesia. PMID- 3264471 TI - A case of convulsion after propofol anaesthesia. PMID- 3264472 TI - Intensive care of patients with the acquired immunodeficiency syndrome: time for a reassessment? PMID- 3264473 TI - Survival and prognostic factors in severe Pneumocystis carinii pneumonia requiring mechanical ventilation. AB - Severe Pneumocystis carinii pneumonia (PCP) necessitating mechanical ventilation has been associated with a high mortality rate in several previous studies. This has discouraged physicians from recommending, as well as patients from accepting, mechanical ventilation when respiratory failure developed. Analysis of 19 records of patients with first episode PCP who were intubated and received mechanical ventilation showed a mortality of 57.8%. A constellation of clinical and laboratory findings was found that identified those patients more likely to survive, including a shorter duration of symptoms prior to admission, better arterial oxygenation on admission, deterioration of respiratory status soon after bronchoscopy, decrease in serum lactic acid dehydrogenase and rapid improvement in arterial blood gas determinations after institution of mechanical ventilation. Mean survival for the group that recovered from PCP after mechanical ventilation was not different from that of other patients with PCP who did not require mechanical ventilation. Thus, patients at risk for PCP should be advised to present to medical facilities as soon as symptoms of this disease develop and, when appropriate, should be encouraged to undergo intubation with respiratory support if it becomes necessary. PMID- 3264474 TI - Viral infections and respiratory muscle contractility. PMID- 3264475 TI - Dendritic cells from rat lung are potent accessory cells. AB - Accessory cells are required for the induction of lymphocyte proliferation in response to mitogens or antigens. Rat pulmonary cells were tested for the presence of accessory activity in lymphocyte proliferation induced by sodium periodate. Buffer-perfused lungs were excised, minced, and enzymatically digested. The resulting pulmonary cells (PC) were separated into high density (HD PC, 32 to 57%) and low density (LD-PC, 9 to 32%) fractions in a discontinuous density gradient of bovine plasma albumin (BPA). Both macrophages and dendritic cells were observed in the LD-PC by light microscopy. HD-PC, LD-PC, adherent LD PC, nonadherent LD-PC, and a purified preparation of pulmonary dendritic cells (DC-P) were tested for accessory activity in the presence of periodate-treated, lymph-node-derived lymphocytes as responders. Most of the accessory activity was found in the LD-PC. Increasing numbers of LD-PC stimulated proliferation of responder lymphocytes in a linear, dose-dependent manner; higher numbers had a suppressive effect. Nonadherent LD-PC containing dendritic cells also produced a dose-dependent increase in periodate-induced lymphocyte proliferation, whereas adherent LD-PC, morphologically identified as macrophages, were suppressive. Removal of phagocytic macrophages from nonadherent LD-PC resulted in an eightfold increase in both the percent of DC-P present and the amount of accessory activity in the LD-PC. We conclude that pulmonary dendritic cells are potent accessory cells for periodate-induced lymphocyte proliferation. PMID- 3264476 TI - Production of an interleukin-1 inhibitory factor by human alveolar macrophages from normals and allergic asthmatic patients. AB - In order to study the possible role of alveolar macrophages (AMs) in the development of local immune responses, we compared interleukin-1 (IL-1) production by peripheral blood monocytes and AMs from 17 allergic asthmatics and 32 controls. When stimulated by lipopolysaccharide, alveolar macrophages and blood monocytes from controls released IL-1 (127 +/- 74.6 and 178.8 +/- 120 IL-1 units/ml, respectively) in the same amounts as AMs and blood monocytes from allergic asthmatics (148 +/- 47.5 and 160.5 +/- 78.3 IL-1 units/ml, respectively). After stimulation by anti-IgE or the specific allergen, asthmatic blood monocytes released IL-1-like activity (71.8 +/- 46.4 and 45.4 +/- 25.9 IL-1 units/ml, respectively). In contrast, asthmatic AM supernatants contained no detectable IL-1-like activity after stimulation by allergen or anti-IgE. The same pattern was observed with monocytes and AMs from controls after passive cell sensitization with 20% of IgE-rich serum. In a second step, the effect of supernatants of IgE-dependent stimulated AMs was tested on thymocyte proliferation induced by a purified IL-1, permitting the demonstration of an IL-1 inhibitory factor released by the AMs while these supernatants didn't modify the IL-2-dependent proliferation of a CTL-L line. The use of indomethacin and assessment of PGE2 levels in AM supernatants made it possible to discard the role of prostaglandins in this inhibitory effect. Moreover this activity, which is resistant to heat and trypsin treatment, has a molecular mass between 40 and 50 kD and did not correspond to serum proteases, alpha-1-antiproteinase, and arginase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264478 TI - Molecular genetics in pulmonary emphysema. AB - A vast array of new methods in molecular genetics are providing insights into problems at the cell and molecular level. Their applications in lung disease is unbounded. However, they are only methods. They are the right methods for certain kinds of questions and the wrong methods for other kinds of questions. PMID- 3264477 TI - Interleukins in pulmonary sarcoidosis. Dissociative correlations of lung interleukins 1 and 2 with the intensity of alveolitis. AB - To investigate whether interleukins are involved in the formation of alveolitis in pulmonary sarcoidosis, interleukin-1 (IL-1) production by LPS-stimulated alveolar macrophages (AM) and interleukin-2 (IL-2) production by PHA-stimulated lung and blood T-cells were determined in 35 untreated patients with pulmonary sarcoidosis. The amount of IL-1 produced by AM (BAL IL-1) was significantly increased in patients with pulmonary sarcoidosis compared with that in 18 control subjects. BAL IL-1 showed a significant positive correlation with the intensity of alveolitis assessed by the proportion of lymphocytes in bronchoalveolar lavage fluid (BALF) and the absolute number of lymphocytes per milliliter of BALF. However, the amount of IL-2 produced by lung T-cells (BALT IL-2) showed a significant negative correlation with the intensity of alveolitis. BALT IL-2 was significantly lower than the amount of IL-2 produced by blood T-cells (PBT IL-2). There was no correlation between PBT IL-2 and the intensity of alveolitis. These results suggest that IL-2 contributes to the formation and maintenance of alveolitis in pulmonary sarcoidosis, whereas IL-2 production by lung T-cells is suppressed to down-regulate the enhanced immune processes at the site of disease. The possibility that this hyporesponsiveness of lung T-cells to PHA has resulted from the modulation of the T3-T cell receptor complex remains to be determined. PMID- 3264479 TI - Controversies in pulmonary medicine. Presumed Pneumocystis carinii pneumonia should be treated empirically in patients with the acquired immunodeficiency syndrome. PMID- 3264480 TI - Peripheral T-cell lymphoma presenting with angioedema and diffuse pulmonary infiltrates. AB - Peripheral T-cell lymphoma is becoming increasingly recognized as a clinical entity despite its protean clinical manifestations and morphological features. Pulmonary involvement is evident in 20% of patients at initial diagnosis and develops in a further 20% during the course of their disease. Angioedema resulting from immune-mediated complement depletion is a rare complication of B cell tumors. It has not been reported in T-cell lymphoma. We describe a patient with peripheral T-cell lymphoma who presented with angioedema and diffuse pulmonary infiltrates. Normal serum complement levels suggest that this patient developed angioedema independent of abnormalities in the complement cascade. PMID- 3264481 TI - Effects of phospholipase A2 and its hydrolytic products on alveolar epithelial permeability and elastase-induced emphysema. AB - To cause emphysema, proteases that are instilled into the air spaces must first be transported across the alveolar epithelium, a barrier that is normally quite impermeable to macromolecules. It was postulated that phospholipase A2 (PLA2) exposure would potentiate porcine pancreatic elastase (PPE)-induced epithelial solute permeability in a manner similar to that which was previously shown with lysophosphatidylcholine (lysoPC), a naturally occurring, membrane-perturbing agent that is formed principally through the hydrolysis of phosphatidylcholine by PLA2. Groups of hamsters were given intratracheal injections of PLA2 (0.3 units) or one of the expected hydrolytic products of PLA2 in equimolar concentrations, lysoPC (135 micrograms), arachidonic acid (AA) (100 micrograms), or palmitic acid (PA) (70 micrograms) with or without PPE (4 units). Epithelial permeability surface area products (PS) of the alveolar epithelium to [14C]sucrose and 125I labeled neutral dextran (MW, 70,000) were measured in isolated perfused lungs 30 min after instillation, and emphysema severity was assessed at 3 wk by pressure volume relationships and by mean linear intercepts. Additionally, the effects of lysoPC, PA, and AA on the functions of PPE and alpha 1-antiprotease (alpha 1 PI) in vitro were evaluated. Sucrose and dextran 70 PS differed significantly from controls only in those groups of hamsters that received PLA2 of lysoPC (p less than 0.05). LysoPC and PLA2 also potentiated the severity of PPE-induced emphysema to a similar degree (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264482 TI - Cobalt exposure and lung disease in tungsten carbide production. A cross sectional study of current workers. AB - A cross-sectional study of 1,039 tungsten carbide (TC) production workers was carried out. The purposes were (1) to evaluate the prevalence of interstitial lung disease (ILD) and work-related wheezing, (2) to assess correlations between cobalt exposure and pulmonary disease, (3) to compare lung disease in grinders of hard carbide versus nongrinders, and (4) to evaluate the effects of new and previous threshold limit values for cobalt of 50 and 100 micrograms/m3. We obtained medical and occupational histories, flow-volume loops, single breath carbon monoxide diffusing capacity (DLCO), and chest radiographs. Time-weighted average cobalt levels were determined at every step in the production process. Work-related wheeze occurred in 113 participants (10.9%). Profusion greater than or equal to 1/0 occurred in 26 (2.6%) and interstitial lung disease (defined as profusion greater than or equal to 1M, FVC or DLCO less than or equal to 70%, and FEV1/FVC% greater than or equal to 75) in 7 (0.7%). The relative odds of work related wheeze was 2.1 times for present cobalt exposures exceeding 50 micrograms/m3 compared with exposures less than or equal to 50 micrograms/m3. The relative odds of profusion greater than or equal to 1/0 was 5.1 times for average lifetime cobalt exposures exceeding 100 micrograms/m3 compared with exposures less than or equal to 100 micrograms/m3 in those with latency exceeding 10 yr. ILD was found in three workers with very low average lifetime exposures (less than 8 micrograms/m3) and shorter latencies. Grinders of hard carbide had lower mean DLCO than nongrinders, even though their cobalt exposures were lower.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264483 TI - Evaluation of the in vitro and in vivo effects of cyclosporine on the lung T lymphocyte alveolitis of active pulmonary sarcoidosis. AB - Pulmonary sarcoidosis is a granulomatous disorder characterized by the accumulation of activated helper/inducer T-lymphocytes in the lower respiratory tract, a process thought to be central to the pathogenesis of the disease. Because cyclosporine, a fungus-derived cyclic peptide, has specific inhibitory effects on T-lymphocyte activation, it should suppress activated sarcoid lung T cells, and thus it should theoretically be an ideal therapeutic agent for sarcoidosis. This was confirmed in vitro: the addition of cyclosporine to T-cells recovered from the lungs of patients with active sarcoid suppressed the spontaneous release of interleukin-2 (IL-2) and monocyte chemotactic factor by these cells and inhibited their exaggerated spontaneous replication. In contrast, the oral administration of conventional doses (10 mg/kg/day) of cyclosporine to eight of these patients over a 6-month period was not accompanied by suppression of sarcoid lung T-cell activation. On the average, the spontaneous release of IL 2 and monocyte chemotactic factor, the proliferation of lymphocytes, and the number of helper/inducer T-cells present in the lungs of these subjects remained elevated and similar to their pretherapy values. Consistent with this lack of effect on sarcoid lung T-cell activation, no improvement in lung function was observed over the trial period. Thus, although cyclosporine is effective in vitro in suppressing the exaggerated activation of sarcoid lung T-cells, it does not do so in vivo, suggesting this agent will not be useful in the therapy of active pulmonary sarcoidosis, at least when administered in a conventional fashion. PMID- 3264484 TI - Characterization of sheep alpha-1-proteinase inhibitor: important differences from the human protein. PMID- 3264485 TI - Human alveolar macrophage and blood monocyte inhibition of fibroblast proliferation. Evidence for synergy between interleukin-1 and tumor necrosis factor. AB - Stimulated human blood monocytes and alveolar macrophages are known to elaborate a soluble factor(s) that inhibits fibroblast proliferation by stimulating fibroblast prostaglandin (PG) production. However, the factor(s) mediating these effects has never been completely characterized and its relationship to known cytokines has never been fully defined. In this study, we demonstrate that this factor(s) is partially trypsin-sensitive, is between 16 and 24 kilodaltons molecular weight, and elutes between 0.13 and 0.25 M NaCl and 24 and 38% 1 propanol from anion exchange and reverse phase columns, respectively. In addition, we demonstrate that interleukin-1 (IL-1) and tumor necrosis factor (TNF) have similar patterns of elution and that the fibroblast growth-inhibiting and PGE-stimulating activities in monocyte and alveolar macrophage supernatants are partially reversed with neutralizing antibodies against IL-1-beta or TNF. However, this inhibition is not due to IL-1-beta or TNF, alone, because each has a mild stimulatory effect on fibroblast proliferation. In contrast, a dose dependent inhibition of fibroblast proliferation is noted when fibroblasts are simultaneously exposed to recombinant IL-1 and TNF. This inhibition is reversed when fibroblast PG production is blocked and appears to result from IL-1 and TNF synergistically stimulating fibroblast PGE production. Thus, the PG-mediated inhibition of fibroblast proliferation caused by stimulated human mononuclear phagocytes is not the result of a single cytokine but is instead at least partly mediated by an interaction of IL-1 and TNF. PMID- 3264486 TI - [Immunogenetics in the understanding of multiple autoimmune syndromes]. PMID- 3264487 TI - Vestibular atelectasis. AB - The temporal bone collection at the Massachusetts Eye and Ear Infirmary includes specimens from several cases in which the only reasonable explanation for vertigo is collapse of the walls of the ampullae and utricle, a disorder we have termed vestibular atelectasis. The clinical histories and temporal bone studies support the existence of a primary type that may have a paroxysmal or insidious onset, and a secondary type that occurs in association with other inner ear disorders. The principal clinical symptom is chronic unsteadiness, precipitated or aggravated by head movement, and sometimes associated with short episodes of spinning vertigo. It is presumed that the collapsed membranes interfere with the motion mechanics of the cupulae and otolithic membranes. PMID- 3264488 TI - Selective lesions of the vestibular labyrinth. AB - In attempts to decrease gentamicin ototoxicity, the round windows of guinea pigs were covered with fat before gentamicin was given through the middle ear cavity. Although ototoxicity to the cochlea was reduced, the desired effect on the vestibular sense organs also was reduced, because of the oval window's resistance to drug penetration. In another series of guinea pigs, simple opening of the lateral semicircular canal and covering it with a pledget of Gelfoam soaked with gentamicin was an excellent method for producing a selective vestibular lesion. It is expected to reduce the function of all vestibular sense organs without impairing cochlear function. PMID- 3264489 TI - [The value of tomodensitometry in histiocytic disorders of the base of the skull in children]. PMID- 3264490 TI - Population changes of indigenous murine Candida pintolopesii under various experimental conditions and routes of inoculation. AB - Fecal Candida pintolopesii population levels were found to be significantly affected by laparotomy-inoculation-Bollman apparatus restraint, laparotomy inoculation, and a milk diet. Gastrectomized rats could not support yeast populations; in intact animals, yeast cells failed to colonize the gastrointestinal tract distal to the stomach. Copraphagia contributed little to stomach yeast populations, supporting the notion that stomach yeast growth occurs at fairly rapid rates. PMID- 3264491 TI - Incidence of zinc and copper deficiency in Japan. PMID- 3264493 TI - [Hemangioma of Meckel's cavum: a case report]. AB - A case of haemangioma of Meckel's cave is reported. The rarity of the lesion is focused, as well as its symptomatology and the radiologic changes. PMID- 3264492 TI - [Treatment of rheumatic mitral stenosis in children and adolescents by a balloon catheter]. AB - Between April 1986 and August 1987, eight children, 9 to 18 years old, with rheumatic mitral valve stenosis underwent a percutaneous balloon valvotomy. Immediate results were good. By echocardiographic measurements, mean transmitral gradients went from 23.7 +/- 7.1 mmHg to 5.8 +/- 4.7 mmHg (p less than 0.001), diastolic pressure half-times went from 299.0 +/- 15.6 msec to 123.3 +/- 42.3 msec (p less than 0.001) and mitral valve areas measured by planimetry went from 1.00 +/- 0.15 cm2/1.73 m2 to 2.68 +/- 0.71 cm2/1.73 m2 (p less than 0.001). Hemodynamic measurements showed a decrease in mean pulmonary artery pressure from 48.3 +/- 13.2 mmHg to 32.5 +/- 5.7 mmHg (p less than 0.01), a decrease in the mean left atrial pressure from 26.1 +/- 6.3 mmHg to 14.6 +/- 4.7 mmHg (p less than 0.02) and an increase in calculated mitral valve area (Gorlin formula) from 1.07 +/- 0.31 cm2/1.73 m2 to 2.73 +/- 1.17 cm2/1.73 m2 (p less than 0.02). The only complication observed was a grade III mitral insufficiency in a child with marked subvalvular fibrosis. Six patients had a very good result and one kept a moderate mitral stenosis. Percutaneous balloon valvotomy gives probably better results in children than in adults and obtains at least as good results as surgical closed mitral commissurotomy. Presently, this technique is the treatment of choice for rheumatic mitral stenosis in children. Contra-indications are intra atrial thrombus and shortened, thickened subvalvular apparatus. PMID- 3264494 TI - Report of three cases with tricho-rhino-phalangeal syndrome type I (two cases) and type II (one case). PMID- 3264495 TI - Vitamin D metabolites and bioactive parathyroid hormone levels during Spacelab 2. AB - The purpose of this study was to determine whether plasma levels of the vitamin D hormone and parathyroid hormone (PTH), two potent activators of bone remodeling sites, were altered in four astronauts during the 8-day (d) Spacelab 2 mission (SL2). Increased circulating levels of either hormone could change calcium homeostasis and bone cell activity and, thus, contribute to bone loss in crewmembers in space. The vitamin D hormone was elevated in all astronauts at the end of the first inflight day but returned to normal by the seventh day. Biologically active PTH tended to be normal throughout the mission. Both hormones were within the normal range by the end of the 8-d flight of this SL2 crew. Plasma levels of 25OHD, 24,25(OH)2D, calcium, phosphorus, and albumin were essentially normal during the mission. PMID- 3264496 TI - Cases from the aerospace medicine residents' teaching file. Case #27. An aircrewman with a perilymph fistula. PMID- 3264497 TI - Characterization of inositol 1,4,5-trisphosphate-stimulated calcium release from rat cerebellar microsomal fractions. Comparison with [3H]inositol 1,4,5 trisphosphate binding. AB - The abilities of D-myo-inositol phosphates (InsPs) to promote Ca2+ release and to compete for D-myo-[3H]-inositol 1,4,5-trisphosphate [( 3H]Ins(1,4,5)P3) binding were examined with microsomal preparations from rat cerebellum. Of the seven InsPs examined, only Ins(1,4,5)P3, Ins(2,4,5)P3 and Ins(4,5)P2 stimulated the release of Ca2+. Ca2+ release was maximal in 4-6 s and was followed by a rapid re accumulation of Ca2+ into the Ins(1,4,5)P3-sensitive compartment after Ins(1,4,5)P3, but not after Ins(2,4,5)P3 or Ins(4,5)P2. Ca2+ re-accumulation after Ins(1,4,5)P3 was also faster than after pulse additions of Ca2+, and coincided with the metabolism of [3H]Ins(1,4,5)P3. These data suggest that Ins(1,4,5)P3-induced Ca2+ release and the accompanying decrease in intraluminal Ca2+ stimulate the Ca2+ pump associated with the Ins(1,4,5)P3-sensitive compartment. That this effect was observed only after Ins(1,4,5)P3 may reflect differences in either the metabolic rates of the various InsPs or an effect of the Ins(1,4,5)P3 metabolite Ins(1,3,4,5)P4 to stimulate refilling of the Ins(1,4,5)P3-sensitive store. InsP-induced Ca2+ release was concentration dependent, with EC50 values (concn. giving half-maximal release) of 60, 800 and 6500 nM for Ins(1,4,5)P3, Ins(2,4,5)P3 and Ins(4,5)P2 respectively. Ins(1,4,5)P3, Ins(2,4,5)P3 and Ins(4,5)P2 also competed for [3H]Ins(1,4,5)P3 binding, with respective IC50 values (concn. giving 50% inhibition) of 100, 850 and 13,000 nM. Comparison of the EC50 and IC50 values yielded a significant correlation (r = 0.991). These data provide evidence of an association between the [3H]Ins(1,4,5)P3-binding site and the receptor mediating Ins(1,4,5)P3-induced Ca2+ release. PMID- 3264498 TI - Appearance of hybridoma growth factor/interleukin-6 in the serum of mice bearing a methylcholanthrene-induced sarcoma. AB - Serum concentrations of hybridoma growth factor/interleukin-6 progressively increased in mice bearing a transplantable methylcholanthrene-induced sarcoma with tumor growth. Elevated HGF/interleukin-6 concentrations were also positively correlated with increased serum concentrations of the hepatic acute phase reactant protein, amyloid P. Daily Indomethacin treatment of sarcoma-bearing mice prolonged survival and reduced the magnitude of the serum amyloid P response, but failed to attenuate either tumor growth or serum HGF/interleukin-6 responses. Since previous studies have demonstrated that neither interleukin-1 nor tumor necrosis factor-alpha can be detected in the serum of these sarcoma-bearing mice, and that HGF/interleukin-6 is a principal mediator of the hepatic acute phase response, we conclude that circulating HGF/interleukin-6 may contribute significantly to the host responses which accompany experimentally-introduced cancer. Furthermore, prostanoid inhibition does not appear to regulate the synthesis and release of HGF/interleukin-6 during tumor growth. PMID- 3264499 TI - Rat testis P-450(17)alpha cDNA: the deduced amino acid sequence, expression and secondary structural configuration. AB - A complete amino acid sequence for rat testis P-450(17)alpha was deduced from nucleotide analysis of a cDNA clone isolated from a rat Leydig cell cDNA library. This DNA clone, containing initiation and termination codons and a polyA tail, translated a polypeptide in COS-1 cells that expressed both 17 alpha-hydroxylase and 17,20 lyase activities. It exhibited significant similarity to the nucleotide and deduced amino acid sequences of the bovine and human cytochrome P 450(17)alpha, particularly with respect to the highly conserved regions and secondary structure. The P-450(17)alpha appears to be anchored to the membrane of the endoplasmic reticulum through two transmembrane regions, specifically the N terminal insertion peptide and the stop-transfer sequence. Hydropathic analysis indicates that the remainder of the C terminus is associated with the membrane through four hydrophobic clefts, including the putative steroid binding site. PMID- 3264500 TI - Polymorphonuclear leukocytes regulate the plasminogen-activating system of cultured endothelial cells. AB - Exposure of bovine pulmonary artery endothelial cells (BEC) to polymorphonuclear leukocytes (PMN) (1 x 10(6)/ml) stimulated by opsonized zymosan (OZ-PMN) decreased plasminogen activator (PA) activity in conditioned medium by as much as 98% as compared to controls. Unstimulated PMN (U-PMN) (1 x 10(6)/ml), after an initial enhancement, decreased PA activity 95%. Low concentrations of U-PMN and OZ-PMN enhanced and high concentrations depressed PA activity. The decline in PA activity was not associated with an increased endothelial cell injury. The suppression of PA activity by OZ-PMN was associated with a 7-fold increase in activity of PA inhibitor 1 (PAI-1). PMN did not affect PA after its secretion, suggesting that modulation of endothelial cells by PMN changes the net activities of PA and PAI-1 in the conditioned medium. PMID- 3264501 TI - Cellular pharmacology of chloroquinoxaline sulfonamide and a related compound in murine B16 melanoma cells. AB - Chloroquinoxaline sulfonamide (CQS), a chlorinated derivative of sulfaquinoxaline (SQ), inhibited proliferation of murine B16 melanoma cells, but only when relatively high drug concentrations (1 mM) were used. The inhibition of cell growth by CQS was at least partially reversible by incubation in drug-free medium. Incubation of melanoma cells with CQS was associated with an arrest of the cell cycle in G0/G1 as measured by flow cytometry. The drug slightly decreased uptake of radiolabeled deoxyuridine and thymidine after 24- and 48-hr incubation periods but increased nucleoside incorporation at 72 hr. No evidence of intercalation with DNA was found. Because SQ previously was reported to inhibit an aspect of folate metabolism, we investigated the possibility that CQS limits tumor cell growth by altering folate homeostasis. This appears unlikely, however, in view of the following observations: (1) the cytotoxic effects of CQS could not be reversed by folinic acid; (2) deoxyuridine suppression of thymidine incorporation was not affected by CQS treatment; (3) CQS did not inhibit dihydrofolate reductase from mammalian or bacterial sources; and (4) CQS toxicity in mice was not reduced by folinic acid. Experiments performed with analogues modified in the quinoxaline and para-amino phenyl functions indicated that tumor cell inhibition did not require preservation of the conventional sulfonamide structure. PMID- 3264503 TI - Structural analogies between adhesive proteins and cysteine proteinase inhibitors. AB - Structural analogies were found between adhesive proteins, fibronectin and laminin, and a group of cysteine proteinase inhibitors. The sequences analogous with inhibitors occur in both adhesive molecules in the vicinity of their cell binding sites: they comprise residues 1112-1212 in fibronectin and residues 1538 1639 of B1 chain in laminin. Both adhesive molecules display the highest degree of analogy with stefin-type inhibitors. The structural analogies also exist between fibronectin, laminin and P21, the c-Ha-ras gene protein produced by Escherichia coli. PMID- 3264502 TI - Monoclonal antibody directed detection of cytochrome P-450 (PCN) in human fetal liver. AB - Monoclonal antibodies (MAbs) raised to rat liver cytochrome P-450s induced by phenobarbital, 3-methylcholanthrene, and pregnenolone-16 alpha-carbonitrile were used to detect these epitope specific P-450s in human abortion fetuses 14-24 weeks of age. This was performed using a Western blot technique. In parallel, ECOD was determined in the same tissue specimens. Of seven different MAbs used MAb PCN 2-13-1/C2 was the only one that immunodetected a cytochrome P-450 band with Western blot analyses of human fetal liver microsomes. This band was consistently detected in all fetal liver specimens studied although the intensity varied among samples. No bands were detected in microsomal preparations from adrenal and renal tissues obtained from the same fetuses. The human adult liver microsomal specimens also contained a MAb PCN 2-13-1/C2 identified cytochrome P 450 band. ECOD activity was detected in all but one of the human fetal livers and varied between 0.22 and 47.5 pmol min-1 mg protein-1, as compared to 113 to 489 pmol min-1 mg protein-1 in human adult livers. In all of the fetuses except one the adrenal ECOD activity (0.63-37.0 pmol min-1 mg protein-1) exceeded that in the liver. The renal ECOD activities were, however, low. The hepatic and adrenal ECOD activities correlated with each other (r = 0.95). Although the ECOD activity is a function of several different P-450s there was also a correlation (r = 0.78) between the ECOD activity and the MAb immunodetected protein band intensity in Western blots of human fetal liver microsomes. The presence of a MAb PCN 2-13 1/C2 identified band in fetal liver microsomes may be indicative of a steroid dependent effect in fetal life. PMID- 3264504 TI - Isolation of a sequence encoding human cystatin C. Conservation of exon-intron structure between members of the cysteine proteinase inhibitors superfamily. AB - The human cystatin C gene was cloned using a synthetic oligonucleotide predicted from a portion of its amino-acid sequence. The nucleotide sequence of the restriction fragment hybridizing with the oligonucleotide confirms the existence of one exon encoding amino acids 56-93 of human cystatin C and its relationship to kininogens. However the deduced amino-acid sequence differs in one position from the sequence of the cystatin C fragment deposited as amyloid fibrils in hereditary cerebral hemorrhage with amyloidosis of icelandic origin. PMID- 3264505 TI - Production of alpha 1-antichymotrypsin by the J111 cell line. AB - The J111 histiocytic cell line is capable of producing human alpha 1 antichymotrypsin (alpha 1 ACh) in culture. The protein is secreted rather than stored in the cell, has a similar size to plasma alpha 1 ACh (68 kDa) and can complex with human cathepsin G. Dexamethasone and culture supernatants from U937 monocyte-like cells and alveolar macrophages, but not bacterial lipopolysaccharide, stimulate alpha 1ACh secretion by J111 cells. The J111 cell line thus provides a useful tool for the study of factors controlling alpha 1ACh synthesis in vivo. PMID- 3264506 TI - Inhibitors of cysteine proteinases from potato. AB - Potato tubers contain considerable amounts of inhibitors of cysteine proteinases. The majority of inhibitory activity is due to low-molecular mass inhibitors differing in isoelectric points. Three of them were obtained in homogenous form, namely PCPIs (potato cysteine proteinase inhibitors) 6.6 (Mr 25,000), 8.3 and 9.4 (both Mr 22,000). They all appeared to be single-chain proteins. The amino-acid composition and the N-terminal amino-acid sequences show that at least two of them are homologous proteins, but so far no homology to the inhibitors of the cystatin super-family or to any other sequenced potato proteins is apparent. PCPIs inhibit papain and human cathepsins B, H, and L. The inhibitors interact with enzymes in apparently equimolar fashion, the interaction is of the tight binding type with Ki values ranging from 10(-6)M to 10(-11)M. PMID- 3264507 TI - Human cathepsin B and cysteine proteinase inhibitors (CPIs) in inflammatory and metabolic joint diseases. AB - Synovial fluid of patients with different inflammatory and metabolic joint diseases contains low-molecular CPIs (stefins and cystatins) and high-molecular CPIs (kininogens). An additional inhibitory fragment with a molecular mass of about 20 kDa, which is a part of the kininogen molecule, has been detected. Cathepsin B and cystatin C were determined by ELISA test in 47 patients with rheumatoid arthritis, seronegative spondylarthritis, osteoarthritis, undifferentiated arthritis and gout. A significantly higher amount of cathepsin B was found in patients with rheumatoid arthritis. The elevation of cathepsin B was accompanied by an increased amount of cystatin C. PMID- 3264508 TI - Chemotactic response of mesenchymal cells, fibroblasts and osteoblast-like cells to bone Gla protein. AB - Bone gla protein (BGP) and decarboxylated bone gla protein (dBGP) were tested for chemotactic activity against stage 24 chick limb bud mesenchymal cells, chick embryonic muscle-derived fibroblasts, murine Balb/C 3T3 cells, and two lines of rat osteosarcoma cells, ROS-17/2.8 and -25/1. Both BGP and dBGP were potent chemoattractants for all the cell types except 3T3 cells. The dose response curves were bell-shaped, with maximal chemotactic response ranging from 5 pg/ml for ROS 25/1 cells to 10 ng/ml for the stage 24 limb bud cells. dBGP was equally potent a chemoattractant as BGP for all cell types tested indicating that the gamma-carboxylation of the glutamic acid residues is not required for chemotactic activity. Given this chemotactic capability, it is possible that BGP acts in bone remodelling by attracting osteogenic cells to the sites of bone resorption where BGP may be liberated or exposed. PMID- 3264509 TI - A comparative study of the formation of chemically reactive drug metabolites by human liver microsomes. AB - 1. The metabolism of amodiaquine (A), ethinyloestradiol (E), mianserin (M), phenytoin (Ph), sulphanilamide (S) and paracetamol (Pa) to both stable and chemically reactive, i.e. irreversibly protein bound, metabolites was investigated using microsomes prepared from histologically normal human liver obtained from eight kidney donors. 2. All drugs, except amodiaquine, were metabolized by NADPH-dependent microsomal enzymes to chemically reactive metabolites. The degree of NADPH-dependent binding varied between drugs (E, 11.5 +/- 5.8% incubated drug; M, 3.0 +/- 1.9%; Ph, 0.10 +/- 0.09%; S, 0.57 +/- 0.38%; Pa, 1.2 +/- 1.2%; mean of eight livers +/- s.d.). 3. Inclusion of glutathione (1 mM) or ascorbic acid (1 mM) in the incubation reduced the NADPH-dependent binding for all substrates, indicating the involvement of electrophilic oxidation products. 4. Binding of M and Pa correlated with each other (Spearman's r = 0.86) and with total cytochrome P-450 content (r = 0.76 and 0.78 respectively). E binding also correlated with the binding of M (r = 0.79) and Pa (r = 0.81) but not with cytochrome P-450. Binding of Ph and S did not correlate with any of the other measured metabolic parameters. PMID- 3264510 TI - Elevated levels of interleukin 2 receptor in sera of patients with atopic dermatitis and psoriasis. AB - Elevated levels of serum interleukin 2 receptor (IL2R) represent an early measure of T cell activation. The concentration of IL2R was measured in the sera of patients with atopic dermatitis (n = 58) or psoriasis, without psoriatic arthritis, (n = 26), who had moderate to severe disease activity, and in non atopic healthy controls (n = 37) by an ELISA technique. Serum IL2R levels were found to be significantly elevated in both disease groups compared with the controls. The increase in serum IL2R may be due to T cell activation in the dermis. PMID- 3264512 TI - A clinical and microbiological study of Actinomycetes in oral and cervicofacial lesions. AB - A retrospective study of the incidence of cervicofacial actinomycosis in patients attending the Liverpool Dental Hospital from 1980-1983 was undertaken. A total of 86 patients were found which were divisable into three distinct presentations: acute painful swellings with a duration of less than 1 month; chronic long standing infections, duration greater than 3 months; unsuspected microbiologically-proven actinomycotic lesions. A prospective study from 1983 1986 also was divisable into three similar types of presentations. The most common presentation in both parts of the study was acute painful swellings associated with soft tissue abscesses secondary to dental lesions. Clinicians dealing with acute dentally-associated swellings should consider the possibility of actinomycosis as a possible diagnosis. PMID- 3264511 TI - Respiratory and allergic symptoms in wool textile workers. AB - An epidemiological study of 2153 workers in 15 West Yorkshire wool textile mills was conducted to determine relations between respiratory symptoms and exposure to inspirable wool mill dust. A questionnaire designed to elicit all the common respiratory symptoms was developed and tested, and administered to all workers willing to participate (85%). It was translated and administered in Urdu for the 385 workers from Pakistan whose English was not fluent. Symptoms investigated included cough and phlegm, wheezing and chest tightness, breathlessness and its variability, rhinitis, conjunctivitis, chills, nosebleeds, and chest illnesses. Additional questions were asked, where appropriate, about the times of day, days of the week, seasons, and places that the symptoms were worse or better than normal. An environmental survey was carried out at each mill, which included 629 measurements of inspirable dust, enabling estimates to be made of the airborne concentrations of inspirable dust usually experienced by each member of the workforce under current conditions. Overall symptom prevalences were: persistent cough and phlegm, 9%; wheeze, 31%; breathlessness on walking with others on level ground, 10%; persistent rhinitis, 18%; persistent conjunctivitis, 10%; persistent chills, 2%; ten or more nosebleeds a year, 2%; and three or more chest illnesses in past three years, 5%. After allowing for the effects of age, sex, smoking habit, and ethnic group, cough and phlegm, wheeze, breathlessness, rhinitis, conjunctivitis, and nosebleeds were found to be more frequent in those exposed to higher than to lower concentrations of dust. In some experiencing high concentrations (blenders and carpet yarn backwinders) cough and phlegm, wheeze, rhinitis, and conjunctivitis were related to the years worked in such jobs. Relative risks of each symptom in relation to inspirable dust concentrations were calculated by means of a logistic regression analysis. At concentrations of 10 mg/m3, the current United Kingdom standard for nuisance dusts, the risk of cough and phlegm relative to that of an unexposed worker was 1.37, that of wheeze 1.40, breathlessness 1.48, rhinitis 1.24, and conjunctivitis 1.70. Since some of these symptoms may be associated with functional impairment of the lungs, further studies of selected workers are being carried out to estimate the functional effects of exposure to dust in wool textile mills. PMID- 3264513 TI - Inherited C3 deficiency of the complement system. AB - 1. We report a patient homozygous for C3 deficiency and several heterozygotes from the same family. Upon follow-up, the homozygote was found to suffer several severe bacterial infections, whereas all the heterozygotes were clinically healthy. 2. C3 was undetectable in the homozygous patient, CH50 was very low and factor I was present. Serum capacity to generate chemoattractant stimuli for peripheral leucocytes was similar to that of normal adults as was also observed for one of the heterozygotes. Serum capacity to opsonize yeast was reduced in the presence of autologous and homologous (normal adult) cells. The CH50 levels of heterozygous patients were within the lower range of normality. 3. The parental consanguinity and the homozygosis state observed here are classical signs of recessive autosomal inheritance. However, the lower or below normal C3 levels detected in parents and relatives point to a co-dominant inheritance of gene S with respect to the "null" gene. 4. C3 polymorphism presented a predominantly "slow" pattern in most family members, which, together with the low C3 levels, indicates the expression of S-allotypes. PMID- 3264514 TI - Interleukin-1 mimics the hyperalgesia induced by a factor obtained by macrophage lysis. AB - 1. Lysis of rat thioglycolate-stimulated peritoneal macrophages releases a low molecular weight factor (0.5 less than MW less than 10 kD) into the supernatant. Bilateral hyperalgesia was observed when this factor, denoted macrophage hyperalgesic factor (MHF), was injected into one hind paw or into the peritoneal cavity of the rat. 2. Similar activity was detected in stimulated peritoneal and tumoral mouse macrophages (J774G8) but not in lysates of rat exudate neutrophils or in peritoneal resident (non-stimulated) macrophages. 3. The hyperalgesia induced by MHF was abolished by local intraplantar injection of indomethacin, thus suggesting a peripheral release of cyclo-oxygenase products. This suggestion was supported by the ability of MHF to release prostaglandin-like material when added to a guinea pig lung perfusate. 4. Peritonitis induced by the administration of carrageenin caused concomitant bilateral rat paw hyperalgesia and an MHF-like activity was demonstrable in peritoneal exudate 30 min after the carrageenin insult. 5. Purified human interleukin-1 (IL-1) given locally or systemically also produced bilateral hind paw hyperalgesia which was abolished by local administration of indomethacin. The possibility that MHF may be a fragment of IL-1 is discussed. PMID- 3264515 TI - Rheumatology: a way ahead. PMID- 3264516 TI - A comparison of autoantibodies and common DNA antibody idiotypes in SLE patients and their spouses. AB - In order to determine whether environmental influence per se might influence autoantibody production, sera from the spouses of 20 SLE patients were examined. No antibodies to cardiolipin, poly (ADP-ribose), or ENA were detected and none had detectable rheumatoid factor. One weakly positive ANA reaction was noted, one had anti-DNA antibodies (by RIA and ELISA) and in two sera the common DNA antibody idiotype 16/6 was found. The idiotype was not, however, present on either anti-DNA or anti-K30 antibodies. Although long-term analyses are required, it is evident that sharing the same environment with patients who commonly express a wide range of autoantibodies and common idiotypes rarely leads to their expression in non-autoimmune subjects. PMID- 3264517 TI - [Variation of the sterols from Kluyveromyces lactis and from a resistant mutant by culture in the presence of sublethal doses of amphotericin B]. AB - A mutant strain of Kluyveromyces lactis resistant to amphotericin B and weakly to nystatin has been isolated from subcultures of the wild strain grown in the presence of sublethal doses of amphotericin B. The mutant and the wild strain were equally sensitive to pimaricin, filipin, and candicidin. The efficacy of fungizone was very low. In comparison with the wild strain the level of sterols was two times lower in the resistant strain but the composition of these sterols was about the same in the two strains. The action of sublethal doses of amphotericin B on the composition of the sterols was the same in these two yeasts and brought a 40% decrease of the total sterol level and a modification in their distribution. This variation cannot fully explain the resistance of the yeast but it may be associated to other changes of the membranes. PMID- 3264518 TI - Different epidermal growth factor growth responses and receptor levels in human colon carcinoma cell lines. AB - The growth response to epidermal growth factor (EGF) and the numbers and types of EGF receptors were studied in three human colon tumor cell lines from each of two groups of cell lines that differ markedly in their growth properties and extent of differentiation. Aggressively growing and poorly differentiated colon cells (group I) did not respond to EGF alone, while less aggressively growing and more differentiated cells (group III) responded with increased growth when EGF was added to their chemically defined, serum-free medium. The average number of EGF receptors (EGF-R) measured at the surface of group III cell lines by radioligand binding assays, was eight-fold higher than that measured for group I cell lines. These observations provide evidence for possible autocrine mechanisms that maintain available EGF-R levels in more differentiated group III colon tumor cells and down-regulate EGF-R levels in group I colon tumor cells. PMID- 3264519 TI - Sialic acid content in mouse myeloma cells and derived B-cell hybridomas with different metastatic potentials. AB - In a previous work we have reported on the metastatic capacities of mouse myeloma cells (NSO) and of two hybridomas derived from them. The present study was designed to examine the sialic acid content of these cell types, their attachment to glass and their capping in the presence of wheat germ agglutinin (WGA). The results showed no significant differences in sialic acid content between NSO and Hybridoma A (Hy A) cells which are non and low metastatic, respectively, whereas Hybridoma B (Hy B), which is highly metastatic, contained 1.4-1.6-fold higher sialic acid compared to the other two cell types. NSO cells exhibited a high, Hy A a moderate and Hy B a negligible attachment to glass. Capping experiments showed a low response of NSO cells, a moderate response of Hy A and a high response of Hy B in the presence of WGA. The results are discussed with regard to the metastatic potential of these cell types taking into consideration the properties cell surface sialic acid is known to endow to cells, determining various aspects of their behaviour. PMID- 3264520 TI - [Diffuse idiopathic skeletal hyperostosis]. PMID- 3264521 TI - [Cross-sectional studies of nosocomial infections in a surgery workplace]. PMID- 3264522 TI - [Overall morbidity of chronic diseases in persons over 60 years of age]. PMID- 3264523 TI - [Pharmacologic studies on the root of Saposhnikovia divaricata (Turcz.) Schischk]. PMID- 3264524 TI - Reducing portal hypertension and variceal bleeding (continuing education credit). PMID- 3264525 TI - Blood lead and blood pressure: analysis of cross-sectional and longitudinal data from Canada. AB - Analysis of data collected during the Canada Health Survey of 1978-1979 indicated a positive relationship between blood lead and blood pressure, but so weak that the range of lead-related variation among members of the general public was estimated to be at most 3.0 mm Hg of diastolic pressure. Even so, a blood lead level in excess of the median value of 10 micrograms/dL entailed a 37% higher risk of having diastolic pressure above 90 mm Hg. In a longitudinal study of lead foundry workers, an association was found between short-term changes in an individual's blood lead level and contemporary changes in diastolic pressure; this remained significant after allowance for age (or time) trends and for effects attributable to changes in body weight. Short-term changes in urinary cadmium levels were similarly predictive of diastolic pressure. PMID- 3264526 TI - The source of urinary epidermal growth factor in humans. AB - To clarify the source of human urine EGF, we studied EGF renal clearance in 20 healthy, young adult subjects. Immunoreactive EGF was measured hourly in EDTA plasma, heparin plasma, serum and urine of 12 males and 8 females during a 3 h study period. Plasma and urine creatinine and creatinine clearance were measured and calculated hourly. Mean (and SEM) creatinine clearance was similar in males and females (118 +/- 12 vs 105 +/- 6 ml/min). EGF was not detectable in plasma, whereas relatively high levels were measured in serum (2.5 +/- 0.25 vs 1.5 +/- 0.18 ng/ml in males and females respectively p less than 0.05). Urine EGF excretion averaged 1641 +/- 233 ng/h in males and 1507 +/- 191 ng/h in females (p greater than 0.05). A significant correlation was observed between urine creatinine and urine EGF concentrations in both male (r = 0.98, p less than 0.01) and female (r = 0.94, p less than 0.01) subjects. EGF immunoreactivity in urine and serum eluted from G-75 sephadex columns similarly to recombinant 6000 Mr hEGF. Urine excretion of EGF approximated 1.5 micrograms/h or 25 ng/mg creatine. The high concentrations of EGF found in urine in the face of non-detectable levels of EGF in plasma favor the hypothesis that EGF in urine is derived from kidney synthesis and secretion. The significant positive correlation between urine creatinine and urine EGF suggests a functional correlation between glomerular filtration and the process of tubular EGF excretion. PMID- 3264527 TI - Pure homonymous hemiachromatopsia. Findings with neuro-ophthalmologic examination and imaging procedures. AB - The study describes neuro-ophthalmologic findings in two patients with brain infarction who developed homonymous hemiachromatopsia with resolution to pure homonymous achromatopsia in an upper quadrant. All other visual parameters were normal; only color perimetry was capable of demonstrating the visual disorder. The results are presented with special emphasis on the macular region. Computed tomography studies and magnetic resonance imaging revealed lesions in the caudal and medial occipitotemporal gyri as well as in adjacent cortical regions. The lesions were secondary to disordered circulation in a proximal occipitotemporal branch of the posterior cerebral artery. The anatomical findings and functional relations of color vision in man are discussed in the light of animal findings. PMID- 3264528 TI - The transfer of ketorolac tromethamine from maternal to foetal blood. AB - Thirty two women who were participating in an efficacy study comparing 10 mg ketorolac with 50 mg or 100 mg of pethidine in the relief of labour pain, underwent sampling of vein blood, for determination of plasma ketorolac concentrations. The sample was withdrawn at delivery and a sample of umbilical cord blood was withdrawn at the same time. The ratio of ketorolac concentrations in the cord blood sample: the maternal venous sample were calculated and plotted against the time elapsed between drug administration and sampling. Samples for one patient, withdrawn 24 min after dosing, had ketorolac concentrations below the quantification limit. The ratios in the remaining patients were all low and showed a tendency to increase with time. The mean ratio was 0.116 with a range of 0.04 in 2 patients, at 43 min and 1 h 6 min, to 0.25 at 6 h 34 min. PMID- 3264529 TI - Regulatory effects of human IgE-binding factors in the IgE synthesis by human and rat lymphocytes. AB - We have previously established human T cell hybridomas which produce IgE-binding factors. Incubation of one of the T cell hybridomas, 166A2, with human IgE dimer in the presence of 1 microgram/ml bradykinin resulted in the formation of IgE binding factors having affinity for lentil lectin. The factors selectively enhanced both IgE-forming cell responses of rat mesenteric lymph node (MLN) cells and spontaneous IgE synthesis by human peripheral blood B cells of atopic patients, without affecting the IgG response. The same factors that enhanced IgE synthesis of B cells from atopic patients also enhanced IgE synthesis induced under bystander conditions by activated alloreactive T cells. Fractionation of the affinity-purified IgE-binding factors by gel filtration revealed three molecular mass species, i.e., 60 kDa, 30 kDa and 15 kDa. The 60-kDa and 15-kDa IgE-binding factors selectively enhanced both the spontaneous IgE synthesis by B cells of atopic patients and IgE response of rat MLN cells. In contrast, the 30 kDa IgE-binding factors had only marginal enhancing effects on the IgE synthesis by both human B cells and rat MLN cells. When the 166A2 hybridoma cells were incubated with IgE dimer in the presence of glycosylation-inhibiting factor (GIF), essentially all IgE-binding factors formed by the cells had affinity for peanut agglutinin (PNA) but for neither lentil lectin nor concanavalin A. All of the 60-kDa, 30-kDa and 15-kDa species, having affinity for PNA, selectively suppressed the potentiating factor-enhanced IgE response of rat MLN cells. The factors also suppressed the IgE synthesis of human B cells from atopic patients when the synthesis was enhanced by IgE-potentiating factor. The results indicate that human IgE-binding factors regulate IgE synthesis by both human and rat lymphocytes. PMID- 3264531 TI - B lymphopoiesis on stromal cell clone: stromal cell clones acting on different stages of B cell differentiation. AB - B lymphopoiesis supporting activities of two stromal cell clones, MC3T3-G2/PA6 (PA6) and ST2, were compared. When normal bone marrow cells were cultured in these clones under Whitlock-Witte-type condition, mature B cells were generated only in the culture with the ST2 layer. The cells maintained on the PA6 layer, however, contained the precursor cells giving rise to mature B cells when transferred to the ST2 layer. Thus, PA6 is a stromal cell clone capable of supporting the early B progenitors but cannot support a further maturation step into pre-B cells. The immunoglobulin heavy chain gene configuration of B progenitors maintained on the PA6 layer diversified after their transfer onto ST2 layer. This suggests that they are actually the earliest progenitors. This marked difference in the stromal cell activities between PA6 and ST2 could also be distinguished by stromal cell-dependent pre-B cell lines. Among four ST2 dependent pre-B cell lines tested, two grew only on the ST2 layer, which is capable of supporting B lymphopoiesis, while the others grew both on the ST2 and PA6 layers. These results strongly suggest that the process of intra-marrow B cell development is controlled by more than one signal acting on different stages of B cell differentiation. PMID- 3264530 TI - Clonal analysis of human T cell activation by the Mycoplasma arthritidis mitogen (MAS). AB - Mycoplasma arthritidis produces an as yet undefined soluble molecule (MAS) that has a potent mitogenic effect on T cells of several species. We have used cloned human cytotoxic and proliferative T lymphocytes to dissect the molecular mechanism of T cell activation by this mitogen. Reactivity to MAS is clonally expressed among T cell receptor (TcR) alpha/beta chain-expressing T cell clones of CD4+ or CD8+ phenotype, as well as CD4-8- TcR alpha/beta chain-negative T lymphocyte clones expressing the CD3-associated TcR gamma chain. MAS is able to induce cytotoxicity and/or proliferation in these T cell clones. For triggering of these T cells, regardless of their phenotype of specificity, the presence of autologous, allogeneic or xenogeneic major histocompatibility complex (MHC) class II molecules on accessory cells or target cells is necessary. However, T cells do not immunologically recognize MAS on class II molecules, since a direct action of MAS on the T cells themselves can be demonstrated. Triggering of T cells by MAS can be blocked by monoclonal antibodies against CD2, CD3 and the TcR alpha/beta chain dimer. We discuss as a possible explanation that MAS is a functionally bivalent molecule cross-linking TcR and MHC class II molecules. Thus, the mechanism of T cell activation by MAS has striking similarities to the mechanisms by which Staphylococcal enterotoxins activate T cells. It is intriguing that a similar mitogenic principle has been developed by two evolutionary distinct pathogenic microorganisms. PMID- 3264532 TI - Antigen presentation by liposomes as model system for T-B cell interaction. AB - Using the earlier established liposome system for antigen presentation, in which liposomes bearing major histocompatibility complex (MHC)-class II molecules inserted into and protein antigen covalently linked to the membrane were found to be sufficient for an antigen-specific and MHC-restricted activation of T cells, the minimal requirements for T-B cell interaction were investigated. Liposomes carrying MHC class II molecules and antigen-specific monoclonal antibodies were constructed and tested for their ability to present soluble antigen to T cells. With the antigens lactate dehydrogenase B and pigeon cytochrome c, a specific stimulation of T cell clones and hybridomas could be obtained. These results demonstrate the possibility of a direct involvement of the immunoglobulins on the B cell surface in their interaction with T cells. PMID- 3264533 TI - Demonstration of two distinct forms of released low-affinity type interleukin 2 receptors. AB - The release of interleukin 2 (IL2)-binding proteins, derived from the 55-kDa low affinity IL2 receptor (IL2R; L chain), has been observed for virtually all L chain-bearing cells in either humans, the mouse or the rat. Based on the characterization of the released human L chain as a molecule 10 kDa smaller than the cell surface receptor, either proteolytic cleavage or differential splicing of the L chain-encoding mRNA have been suggested as mechanisms underlying the receptor release. Combining affinity labeling of the L chain with 125I-labeled IL2 and immunoprecipitation with L chain-specific monoclonal antibodies applied for the detection of soluble mouse IL2R revealed the existence of two classes of soluble receptors, one being of the same size as cell surface expressed L chain, the other of 45-kDa apparent molecular mass. These findings raise the possibility of mechanisms of receptor release other than those discussed for human L chain. PMID- 3264534 TI - B cell precursors in chick embryos surgically bursectomized at 72 h of incubation. AB - To determine the presence of precursor B cells in chick embryos surgically bursectomized at 72 h of incubation (E-Bx) we studied chick chimeras that were produced by establishing parabiotic connections between blood vessels of chorioallantoic membranes of normal and surgically bursectomized chick embryos. Using sex chromosomes and a B cell alloantigen (Bu-1a) as markers we showed that chick embryos bursectomized at 72 h of incubation contain B cell precursors capable of colonizing the bursa of Fabricius and developing into B lymphocytes. The repopulation capacity of 14-day-old embryonic spleen cells from E-Bx recipients was tested by transferring them into age-matched X-irradiated Bu-1 disparate embryos. The results show that B cell precursors are present in 14-day spleen of chick embryos bursectomized at 72 h of incubation. These precursors carry the Bu-1 B cell alloantigen, suggesting that commitment to the B cell lineage can take place in the absence of bursa. PMID- 3264535 TI - Experimental study on central effects of carboxyethyl-gamma-aminobutyric acid (CEGABA). AB - The central effects of carboxyethyl-gamma-aminobutyric acid (CEGABA) have been studied both in rabbits and in the guinea pig myoclonus model. This drug caused EEG synchronization and behavioural sedation both after intravenous (i.v.) and intracerebroventricular (i.c.v.) administration in a dose-dependent manner, in rabbits. CEGABA showed a protective action against myoclonus induced by means of L-5-HTP in young guinea pigs. These data substantiate the hypothesis that CEGABA is a drug active on the central nervous system and probably exerts its action by strengthening cortical inhibition and/or directly acting on lower brainstem. PMID- 3264536 TI - 3,3'-Di[1,3-thiazolidine-4-one]system. IV. Synthesis and pharmacological properties of 3,3'(1,2-ethanediyl)bis [2-aryl-1,3-thiazolidine-4-one 1,1-dioxide] derivatives. AB - The 1,1' disulfones obtained by oxidation of the corresponding dl and meso 3,3'(1,2-ethanediyl)bis [2-aryl-4-thiazolidinone] compounds previously investigated, were evaluated as anti-histamine, anti-inflammatory, analgesic and anti-pyretic agents. All 2,2' fluorophenyl compounds were found to be significantly active in inhibiting carrageenin-induced edema, whereas only para substituted derivatives were active on the histamine-induced bronchospasm in the guinea-pig. They also showed analgesic effects that reached and sometimes exceeded those of indomethacin and phenylbutazone used as reference drugs. PMID- 3264537 TI - Monoclonal antibodies which differentiate high- and low-affinity binding sites of interleukin-2. AB - Five monoclonal antibodies (L15, L20, L23, L34, and L61) against human recombinant interleukin-2 were tested for their effects on the interleukin-2 bioactivity and binding. Four of these monoclonal antibodies, L15, L20, L34, and L61, which had neutralizing activity, completely blocked interleukin-2 binding to the high-affinity receptor. On the other hand, L23, which had a very weak neutralizing activity, blocked interleukin-2 binding to the low-affinity receptor. These results suggest that there are at least two distinct binding sites on the interleukin-2 molecule; those for the high-affinity receptor and those for the low-affinity receptor. These monoclonal antibodies should be useful tools in the study of the interaction between interleukin-2 and interleukin-2 receptor. PMID- 3264538 TI - [Modulation of the nociceptive flexor reflex during electrostimulation of the segmental acupuncture points]. PMID- 3264539 TI - Immunohistochemical and morphometric analysis of calcitonin distribution in anuran ultimobranchial glands. AB - The presence and distribution of immunoreactive calcitonin (iCT) in the anuran (Rana pipiens) ultimobranchial gland was examined with a specific antiserum to salmon calcitonin. Improved resolution of the distribution of iCT within individual cells allowed recognition of a iCT-negative [iCT(-)] early maturing cell, the primary iCT-positive [iCT-(+)] secretory cell with accumulation of iCT within the basal and apical cytoplasm, an iCT(-) cell that lacks a basal accumulation of secretory material, and a iCT(-) cell that borders the central lumen. A morphometric analysis was made of the entire glandular basal secretory surface area and a calculation was made of the relative area that contained iCT(+) secretory material (expressed as a basal index (BI)). For frogs kept in fresh water, the total basal area of a single gland was 0.335 mm2, with a BI of 0.72 and a total iCT(+) secretory surface of 0.241 mm2. A second group of frogs kept in a high calcium medium for 12 days had a BI of 0.74 with no significant increase in parenchyma volume or total basal area and therefore no increase in the total iCT(+) secretory area. A third group was kept in a high calcium medium for 12 days and given a single oral dose of vitamin D3 (500 IU/g body wt). The BI of this group remained unchanged at 0.75; however, there was a significant glandular hypertrophy concomitant with an increase in secretory surface area to 0.462 mm2. This resulted in a 43% increase in the iCT(+) secretory area to 0.345 mm2. A model is proposed to explain the increase in iCT in the gland in response to a vitamin D and high calcium challenge. PMID- 3264540 TI - A proposal for standardization of psychiatric consultation-liaison data. AB - There is still a striking lack of homogeneity in the terminology and classifications used in the registration of psychiatric consultation-liaison (C L) data. Nowadays, the need for standardization of C-L data is greater than ever. Each registration consists of two components: the items and their categories. The present authors distinguish three levels of C-L data: fundamental, epidemiologic, and clinical-educational. A comprehensive proposal for standardization of such items and categories is presented, both on the fundamental and on the epidemiologic level. Data on 2657 consultations carried out by the Netherlands Consortium for C-L Psychiatry (NCCP) and from a literature review of 48 C-L reports serve to illustrate and as a supply for a large database. Various characteristics of the general hospital and of the C-L service are considered to be fundamental, that is, should be presented in each C-L publication. The epidemiologic data are divided into eight groups: sociodemographics, referral characteristics, history, diagnoses, diagnostic recommendations, ward management, discharge and aftercare management, and termination data. Finally, definitions and decision rules are given. PMID- 3264541 TI - [Genetic polymorphism of alpha 1-antitrypsin in green monkeys studied by isoelectric focusing and family analysis]. AB - 24 variants of alpha 1-antitrypsin (alpha 1-AT) were recognized in sera of 120 wild and capture-born African green monkeys by isoelectrofocusing in Ampholine PAG-plates (pH 4-6.5) and western blotting with antihuman alpha 1-AT serum. All variants had much more cathodal position than human alpha 1-AT and revealed very high microheterogeneity which was slightly different from the observed in human alpha 1-AT. The alpha 1-AT banding pattern allowed to postulate existence of 10 codominant alleles in the Pi locus of African green monkeys. The reality of 8 alleles was proved by family analysis which included 45 monkey birth cases. Two other alleles were absent in the parents available. Thus, alpha 1-AT is the most polymorphic among the known serum proteins of African green monkeys. The latter can be useful for molecular systematics of these primates. PMID- 3264542 TI - Octamer-binding proteins from B or HeLa cells stimulate transcription of the immunoglobulin heavy-chain promoter in vitro. AB - The B-cell-type specificity of the immunoglobulin (Ig) heavy-chain and light chain promoters is mediated by an octanucleotide (OCTA) element, ATGCAAAT, that is also a functional component of other RNA polymerase II promoters, such as snRNA and histone H2B promoters. Two nuclear proteins that bind specifically and with high affinity to the OCTA element have been identified. NF-A1 is present in a variety of cell types, whereas the presence of NF-A2 is essentially confined to B cells, leading to the hypothesis that NF-A2 activates cell-type-specific transcription of the Ig promoter and NF-A1 mediates the other responses of the OCTA element. Extracts of the B-cell line, BJA-B, contain high levels of NF-A2 and specifically transcribe Ig promoters. In contrast, extracts from HeLa cells transcribed the Ig promoter poorly. Surprisingly, addition of either affinity enriched NF-A2 or NF-A1 to either a HeLa extract or a partially purified reaction system specifically stimulates the Ig promoter. This suggests that the constitutive OCTA-binding factor NF-A1 can activate transcription of the Ig promoter and that B-cell-specific transcription of this promoter, at least in vitro, is partially due to a quantitative difference in the amount of OCTA binding protein. Because NF-A1 can stimulate Ig transcription, the inability of this factor to activate in vivo the Ig promoter to the same degree as the snRNA promoters probably reflects a difference in the context of the OCTA element in these two types of promoters. PMID- 3264543 TI - Infiltrate of syphilitic lesions before and after treatment. AB - An immunohistological study of skin biopsy specimens from patients with early syphilis was undertaken before and after treatment (one day after intramuscular administration of 2.4 MIU benzathine penicillin and eight days later, after a total administration of 3.6 MIU. In chancres from seronegative patients treatment with 3.6 MIU usually resulted in fewer immunocompetent cells in the infiltrate. In lesions of secondary syphilis treatment with 2.4 MIU benzathine penicillin produced a significant decrease in immunocompetent cells. After treatment with 3.6 MIU there was no further decrease. It was worth noticing that even eight to nine days after the initial pretreatment biopsy, when 3.6 MIU had been administered, the overall lymphohistiocytic infiltrate was not substantially diminished. Significantly more suppressor (T8+) cells were found in lesions of primary syphilis than of secondary syphilis, and they showed remarkable exocytosis. Activated local T8+ cells may release immunosuppressive lymphokines. PMID- 3264544 TI - High potassium diet augments endothelium-dependent relaxations in the Dahl rat. AB - Endothelium-dependent relaxations are reduced in hypertensive rats. High dietary potassium supplementation reduces the incidence of strokes in Dahl rats independently of blood pressure, thereby suggesting a direct protective effect of the diet. Endothelium-dependent relaxations and aortic vascular architecture were studied in Dahl salt-sensitive rats fed 8% NaCl, 0.1% NaCl, or 8% NaCl plus 3.6% potassium citrate for 8 weeks. Rats fed 8% NaCl or 8% NaCl plus 3.6% potassium citrate became hypertensive, while those fed 0.1% NaCl did not. Aortic rings with and without endothelium were suspended in organ chambers filled with physiological salt solution (37 degrees C) and aerated with 95% O2, 5% CO2. In rings contracted with norepinephrine, acetylcholine and adenosine 5'-diphosphate caused endothelium-dependent relaxations that were significantly reduced in rats fed 8% NaCl as compared with those fed 0.1% NaCl. Potassium supplementation (8% NaCl/3.6% potassium citrate) significantly enhanced relaxations to acetylcholine in salt-sensitive rats, while those to adenosine 5'-diphosphate and thrombin were either minimally affected or unchanged. Relaxations to sodium nitroprusside were similar in rats with or without potassium supplementation. Hypertension significantly increased aortic medial and intimal thickness. Dietary potassium had no significant effect on the vascular architecture. These results suggest that high potassium diet enhances endothelium-dependent relaxations in Dahl rats at least in part independently of changes in blood pressure. Thus, potassium may be important for its protective effect against stroke and renal damage in this animal model of hypertension. PMID- 3264545 TI - Demonstration of C3d and the terminal complement complex on thymic large granular lymphocytes and common thymocytes after incubation with naturally thymocytotoxic serum. AB - Guinea pig thymocytes were incubated in vitro with normal human or rabbit serum, which resulted in lysis of a major part of the cells, or with autologous serum causing lysis of a fraction (30%) of the cells. By using antibodies against human C3d and a neoepitope on the terminal complement complex (TCC), activation of both the initial and terminal part of the complement cascade was demonstrated on the surface of thymocytes incubated in the presence of serum. With human serum both types of antigen were detected. With rabbit serum only TCC was detected since immunoglobulins were bound to thymocytes and prevented specific demonstration of C3d by the antirabbit secondary antibody. With autologous serum only C3d was demonstrated, due to lack of cross-reactivity of the monoclonal anti-TCC antibody with guinea pig. Heat-inactivated sera or human serum devoid of IgM neither caused lysis nor resulted in complement activation. Addition of heat-inactivated serum restored the complement activating ability of IgM-depleted serum, indicating that heat stabile IgM is an obligate but sufficient requirement for complement activation in this system. The TCC epitope was also identified on a considerable number of granulated cells, on the basis of morphology classified as large granular lymphocytes. PMID- 3264546 TI - ELISA analysis of IgA subclass antibodies to dietary antigens. Elevated IgA1 antibodies in children with coeliac disease. AB - Enzyme immunoassays for the quantitation of IgA1 and IgA2 antibodies to dietary antigens were developed. Serum IgA1 antibodies to bovine serum albumin (BSA) were detectable in 2/30 healthy adults, in 3/26 healthy children, and at high levels in 8/11 children with coeliac disease, without relation to gluten exposure. IgA1 antibodies to ovalbumin (OA) and beta-lactoglobulin (BLG) at high titers were seen in one coeliac child but were otherwise low or absent. IgA2 antibodies to BSA were detectable in 28/48 healthy subjects and in 8/11 coeliac children. IgA2 antibodies to OA and BLG were measurable in a few samples from each group. IgA1 antibodies to the gluten component glycgli were found at low levels in 15/56 normal sera, and anti-glycgli antibodies of the IgA2 subclass in 14/48 sera from healthy persons, also at low levels. IgA1 anti-glycgli antibodies were measurable in 5/11 sera from CD patients on a gluten-free diet. Elevated levels of IgA1 anti glycgli antibodies were detected in all sera from CD patients challenged with gluten, except in 1 patient with a markedly reduced serum IgA level. In contrast, the IgA2 anti-glycgli antibody levels were unaffected. Thus, increased levels of IgA antibodies to dietary protein antigens in childhood coeliac disease were observed only within the IgA1 isotype. PMID- 3264547 TI - Different modulating effects of the monoamines adrenaline, noradrenaline, and serotonin on the DNA synthesis response of human peripheral blood T lymphocytes activated by mercuric chloride and nickel sulfate. AB - The influence of adrenaline, noradrenaline, and serotonin (5-hydroxytryptamine) was tested on the proliferative response of peripheral blood T lymphocytes of nickel-allergic subjects to mercuric chloride and nickel sulfate. With addition of the monoamines 1 h after mercuric chloride, there was a marked suppression with all the substances at 10(-4) M, while adrenaline also inhibited down to a concentration of 10(-5) M and serotonin down to 10(-7) M. At 3 days after mercuric chloride, adrenaline inhibited at 10(-4) M and serotonin also down to a concentration of 10(-5) M. With addition at 1 h after nickel sulfate, there was an inhibition by all the monoamines at 10(-4) M, while, in contrast, adrenaline at 10(-6) to 10(-8) M and serotonin at 10(-5) to 10(-6) M gave a stimulation of the response. These findings point at different modulating effects on the proliferative response induced by a polyclonal activator such as mercuric chloride and a monoclonal activator such as nickel sulfate. PMID- 3264548 TI - Plasma estrogens, androgens, and von Willebrand factor in men on chronic hemodialysis. AB - The role of sex hormones in atherogenesis has not been well defined. Since hemodialysis patients show signs of feminization and an increased propensity for atherosclerosis they are particularly suited to probe the relationship between estrogen, testosterone, and atherosclerosis. Therefore, we measured plasma total, free, and protein-bound estradiol (E2), testosterone (Te), and prolactin in 28 hemodialysis patients and in 30 age-matched controls. Von Willebrand factor (vWF) levels were also assayed. Total and free E2 as well as Te were significantly decreased in the patients (p less than 0.001). However, the E2/Te ratio was elevated in the patients (p = 0.05), as was vWF (p less than 0.01). No correlations were found between hormone levels and vWF, gynecomastia or vascular disease, but vWF and vascular disease were highly correlated. We conclude that in hemodialysis patients absolute estrogen levels are lower than normal, but that the estrogen/androgen ratio is shifted in favor of estrogen because of the coexistence of androgen deficiency. These findings suggest that an elevation in the estrogen/androgen ratio, rather than an increase in estrogen per se, may be a risk factor for atherosclerosis. PMID- 3264549 TI - Epidermal growth factor-induced growth retardation in the newborn rat: quantitation and relation to changes in skin temperature and viscoelasticity. AB - Somatic growth retardation was studied in neonatal Sprague-Dawley rats following treatment with exogenous epidermal growth factor (EGF). Dose-response data are presented for the first 2 days of postnatal life relating log EGF dose (range 50 to 1000 ng per gram body weight) to incremental daily weight gain. Regression analysis indicated that the effect of EGF to retard somatic growth was not cumulative, and, in fact, the same dose of EGF had less effect on the second day of life than on the first. Concomitant with its ability to retard growth, EGF elicited a transient cutaneous reaction characterized by a marked alteration in skin viscoelasticity and temperature. Neonatal rats treated with exogenous EGF exhibited: (1) a dose-dependent reduction in skin redundancy measured by decrease in the height of the dorsal skinfold; (2) a diminution in integumental water content determined by wet weight/dry weight ratios and relative tissue specific gravities; and (3) a rapid fall in midscapular skin temperature within 60 minutes of systemic administration of EGF. Both the EGF-elicited cutaneous reaction and the ability of EGF to retard somatic growth disappeared by the end of the second week of life. Administration of human biosynthetic EGF resulted in responses identical to the purified mouse protein. In summary, the pharmacological effects of EGF to retard somatic growth in the newborn rodent are confined to the immediate neonatal period and are preceded by transient alteration in skin temperature and cutaneous biomechanical properties. PMID- 3264550 TI - Frequency and localization of congenital anomalies of the middle and inner ears: a human temporal bone histopathological study. AB - This study investigated congenital anomalies occurring in the middle and the inner ears, with particular attention to their features, localizations, and frequencies. One hundred human temporal bones obtained from 73 individuals, aged 31 gestational weeks to 39 years, each of whom had anomalies of the middle ear and/or inner ear, were used for this study. The temporal bones had been removed at autopsy, fixed, dehydrated, embedded in celloidin, and sectioned horizontally or vertically at 20 microns. Every 10th horizontal section or every 20th vertical section was stained with hematoxylin and eosin, mounted and studied under a light microscope. In the middle ear the structure most often found to be anomalous was the facial nerve; in the inner ear it was the lateral semicircular canal. The implications of the anomalies observed are discussed as they relate to fetal development, dysfunction of the ear, and clinical interpretation of diagnostic radiological studies. PMID- 3264551 TI - Therapy of advanced solid tumors in mice using chemotherapy in combination with interleukin-2 with and without lymphokine-activated killer cells. AB - Adoptive immunotherapy with LAK-cells in conjunction with high-dose IL-2 has recently been introduced in the treatment of patients with advanced cancer. This therapeutic modality has thus far proved to be of limited efficacy, severe toxicity and entails complicated logistics. Our present study is aimed at establishing a model system to test for increasing efficacy and reducing toxicity by using AIT cojointly with chemotherapy. Mice implanted i.v. or i.p. with weakly immunogenic tumors (M109 lung carcinoma, MCA-105 sarcoma) were treated 7 to 20 days after tumor inoculation with or without CTX, with and without recombinant human IL-2, and with and without syngeneic/allogeneic LAK-cells. Whereas IL-2 or IL-2 + LAK-cells without CTX was largely ineffective, and CTX alone cured 0 to 20% of the animals with an i.p. tumor and only slightly reduced pulmonary tumor mass, the combination of CTX + IL-2 cured 50 to 80% of the mice bearing i.p. tumors and reduced pulmonary tumor growth by greater than or equal to 80%. The combination of CTX + IL-2 + LAK-cells proved no more beneficial than CTX + IL-2 without LAK-cells. Also relevant were the observations that murine LAK-cells are transiently sensitive to moderate doses of CTX (greater than or equal to 100 mg/kg body weight) and X-irradiation (greater than equal to 400 rad), and that administration of IL-2 by the i.v. or i.p. route variously affects LAK-cell activation in different tissues and eradication of growths localized at different sites. With the regimens used, no signs of toxicity were detected. It is proposed that instillation of IL-2 (and perhaps of additional immunostimulating cytokines as well) as an adjunct to chemotherapy (or chemoradiotherapy), each given at a subtoxic dose, is both safe and effective in the treatment of metastatic advanced tumors, and that the additional administration of LAK-cells may not be required. PMID- 3264552 TI - Killing of virus-induced thymic lymphoma cells obtained from primary and early transfers by activated macrophages. AB - Primary radiation leukemia virus-induced thymic lymphomas were susceptible to both stasis and lysis mediated by LPS-activated macrophages. During short in vitro cultivation the X-irradiation-induced lymphoma (PIR-2) cells were killed to the same extent (up to 99%) by LPS-activated macrophages as the RadLV lymphoma cells at effector:target ratios of 10:1 and 1:1. Since RadLV is not present in PIR-2 lymphoma cells, its presence is not required for susceptibility of the lymphoma cells to macrophage-mediated killing. Our data also disprove the assumption that artifacts of long-term cultivation in vitro are responsible for tumor susceptibility to cytostasis and cytolysis mediated by activated macrophages. PMID- 3264553 TI - Production of human B and T cell growth factors is enhanced by thymic hormones. AB - The thymic preparations thymosin fraction 5 (TF5) and synthetic thymosin alpha 1 (T alpha 1) were examined for their ability to enhance growth factor production by human peripheral blood mononuclear cells (PBMC). The results showed that both TF5 and T alpha 1 were capable of enhancing the production of a B cell growth factor (BCGF-12kD) and T cell growth factor (TCGF; IL-2). Enhancement by T alpha 1 could be obtained at 100-200-fold lower concentrations than that seen with TF5. In contrast, no enhancement of growth factor production was obtained with control preparations of non-thymic tissue extracts at any concentrations used. It was observed that stimulation of BCGF-12kD and IL-2 was most significantly obtained when the PBMC were activated with lectin. Furthermore, no direct effect of thymic hormones on test B and T cells was observed. These observations provide the first direct evidence that production of B cell growth factors can be enhanced by thymic hormones. In addition, these studies suggest that thymic hormones may regulate B cell responses by acting on mature activated T lymphocytes. PMID- 3264554 TI - Antibiotic susceptibilities and plasmid profiles of Haemophilus ducreyi isolates from southern Africa. AB - Thirty-eight strains of Haemophilus ducreyi isolated in southern Africa were tested in vitro against 15 antimicrobial agents including those frequently used for the treatment of chancroid. In addition, newer compounds which possess characteristics consistent with their possible use as single-dose therapy for the disease were tested. All isolates were found to be resistant to penicillin as a result of beta-lactamase production. The majority of strains were also resistant to tetracycline, sulphamethoxazole and trimethoprim, but susceptible to co trimoxazole, erythromycin, spectinomycin, ceftriaxone, ceftizoxime, cefodizime, ciprofloxacin, fleroxacin, rifampicin, rifabutin and FCE 22250. beta-Lactamase production appeared to be associated with the presence of low molecular weight plasmids (5.7 or 7 Md). Sulphonamide resistance appeared to be either chromosomally-mediated or due to the presence of a 4.9 Md plasmid. No evidence of plasmid-mediated tetracycline resistance was observed. PMID- 3264555 TI - Regional therapy of malignant liver tumors. PMID- 3264557 TI - Transcutaneous electric nerve stimulation (TENS) in the therapy of chronic facial pain. Preliminary report. AB - Chronic facial pain remains a therapeutic problem. We report on 29 patients (37 nerves involved), who were treated with transcutaneous electric nerve stimulation (TENS). Pain reduction was achieved in 27 patients (93%) while in 5 patients it was possible to stop the treatment because they were constantly free from pain. Two patients did not respond to TENS therapy. It was possible to reduce or discontinue the use of analgesics in 79% of the cases. There were no severe side effects. Therefore, TENS should be seen as a simple, safe and effective method of treatment for many forms of chronic facial pain, as opposed to other invasive surgical procedures. PMID- 3264556 TI - Amino acid sequence and domain structure of entactin. Homology with epidermal growth factor precursor and low density lipoprotein receptor. AB - Entactin (nidogen), a 150-kD sulfated glycoprotein, is a major component of basement membranes and forms a highly stable noncovalent complex with laminin. The complete amino acid sequence of mouse entactin has been derived from sequencing of cDNA clones. The 5.9-kb cDNA contains a 3,735-bp open reading frame followed by a 3'-untranslated region of 2.2 kb. The open reading frame encodes a 1,245-residue polypeptide with an unglycosylated Mr of 136,500, a 28-residue signal peptide, two Asn-linked glycosylation sites, and two potential Ca2+ binding sites. Analysis of the deduced amino acid sequence predicts that the molecule consists of two globular domains of 70 and 36 kD separated by a cysteine rich domain of 28 kD. The COOH-terminal globular domain shows homology to the EGF precursor and the low density lipoprotein receptor. Entactin contains six EGF type cysteine-rich repeat units and one copy of a cysteine-repeat motif found in thyroglobulin. The Arg-Gly-Asp cell recognition sequence is present in one of the EGF-type repeats, and a synthetic peptide from the putative cell-binding site of entactin was found to promote the attachment of mouse mammary tumor cells. PMID- 3264558 TI - Sexual assault and mental disorders in a community population. PMID- 3264559 TI - Stress, expectancies, and vulnerability to substance abuse: a test of a model among homosexual men. PMID- 3264560 TI - The relationship of serum IgA concentration to human immunodeficiency virus (HIV) infection: a cross-sectional study of HIV-seropositive individuals detected by screening in the United States Air Force. AB - Serum immunoglobulins were measured in 107 patients with human immunodeficiency virus seropositivity. Each patient was categorized by the Walter Reed staging classification and serum concentrations of immunoglobulins were compared with patient staging. Serum IgM concentrations were normal in all but nine patients. Serum IgG concentrations were elevated in 74 of 107 patients, with no significant differences noted between different stages of disease severity. Serum IgA concentrations were elevated in 38 of 107 patients, with a significant relationship noted between increasing staging category and increasing serum IgA concentration (p = 0.0001). Serum IgA concentrations in patients with human immunodeficiency virus seropositivity may be a useful marker of immunologic progression of disease. PMID- 3264561 TI - Human immunodeficiency virus infection in the United Kingdom: quarterly report 2. The epidemic to 31 December 1987, with special reference to children. AB - Up to 31 December 1987, 1227 cases meeting the World Health Organization Centers for Disease Control (U.S.A.) (WHO/CDC) definition of the acquired immune deficiency syndrome (AIDS) were reported in the U.K., of which 54 were in persons who came to the U.K. for diagnosis and treatment and 1173 in U.K. residents. In the same period there were 8003 laboratory reports of human immunodeficiency virus (HIV) antibody-positive tests. The upward trend in the number of AIDS cases by quarter changed in the last quarter of 1987, when there were only 163 new reports. Predictions were revised so that 1450 new reports are expected in 1988. During a temporary increase in the number of tests performed in the first quarter of 1987, associated with a publicity campaign, the testing threshold for members of the homosexual/bisexual male risk group fell. The proportion of HIV antibody positive homosexual/bisexual men who were ill when tested in 1985 was between 50 and 73 each quarter; after 1985, this proportion has varied between 38 and 49%. The concentration of AIDS cases in the four Thames regions was marked, whereas HIV antibody-positive reports were more widely distributed. Since 1985, the proportion of the total HIV antibody-positive reports from the Thames-regions increased from less than a half to two-thirds. Among HIV antibody-positive women, over half were IV drug abusers and over two-thirds were in the age group 15-29 years. There were 19 cases of AIDS in children aged 14 years or less, eight of which were in visitors to the U.K. Of the 11 cases in U.K. residents, seven were in children of mothers known to have, or to be at risk of, HIV infection. The distribution of the 253 HIV antibody-positive reports in children was different; most were in haemophiliacs or blood/components recipients aged 5-14 years. Most mothers who have infected their children in utero were either IV drug abusers or sexual partners of IV drug abusers. Lymphoid interstitial pneumonia was the commonest indicator disease at the time of diagnosing AIDS in children. The mean age at diagnosis was 2 years 4 months for those infected in utero and 3 years 7 months for those otherwise infected. Between 1985 and 1987 there were marked increases of children with AIDS, of HIV antibody-positive children of infected/at risk mothers and of reported HIV infections in women of child-bearing age. In the near future it is likely that many more pregnancies, particularly in Scotland, will be complicated by HIV infection. PMID- 3264562 TI - Meningitis due to beta-lactamase producing chloramphenicol resistant Haemophilus influenzae type b in Kuwait. PMID- 3264563 TI - T and B cells in borderline (BB) leprosy. AB - The response to standard Dharmendra lepromin and the circulating T, B cell numbers in the peripheral blood were quantitated in 15 patients with Borderline (BB) Leprosy. On the basis of lepromin response, the patients fall into three groups (a) negative (b) +/- reaction (c) rarely positive. No significant difference in the numbers of E-rosette and EAC rosette forming cells was observed in the BB patients in comparison to controls. PMID- 3264564 TI - Identification of the interleukin-2 receptor (IL-2R) on human leukemic T cells using colloidal gold and scanning electron microscopy. AB - Results of studies demonstrating the identification of the interleukin-2 receptor (IL-2R; i.e., anti-Tac) on the membrane ultra-structure of human leukemic T cells with an antibody carrying an electron dense colloidal gold microsphere (e.g., immunogold) that was visualized using a scanning electron microscope (SEM) are reported. Our IL-2R model system employed HTLV-1 retrovirus-infected lymphoblastoid cells of the long-term human leukemic T cell line HUT-102B2. The presence of the IL-2R on these cells was defined using a double antibody procedure that employed as the primary antibody a purified mouse monoclonal anti Leu-IL-2R antibody (mIgGlk, anti-Tac, CD25), and used as the secondary antibody a goat anti-mouse IgG (gamma-chain specific) antibody that had been covalently bonded to a 40 nm colloidal gold particle. More than 95% of the HUT-102B2 were IL 2R+, and there was a uniform distribution of the IL-2R over the surface of the cells. Corresponding controls were employed in all examinations and included IL 2R- Jurkat human leukemic T cells and isotype identical immunoglobulins. The primary and secondary antibody reagents contained whole human serum and bovine serum albumin, and there was no evidence of the non-specific binding of these antibodies. These studies are the first to demonstrate the presence of a lymphokine receptor on the surface architecture of a cell. We anticipate no difficulty in applying the immunogold/SEM technology to define both normal and malignant cell membrane receptors for other cytokines. PMID- 3264565 TI - Do electronic bone healing devices interfere with breath testing instruments? PMID- 3264566 TI - Positron emission tomography in cases of chorea with different underlying disease. PMID- 3264567 TI - Effect of D-penicillamine treatment on brain metabolism in Wilson's disease: a case study. AB - Sequential measurements of brain glucose metabolism were carried out in a patient with Wilson's disease, before and after successful treatment with D penicillamine. They demonstrate an evolution of regional metabolism consistent with clinical improvement. The first study showed marked hypometabolism in the putamen on both sides. The second analysis showed bilateral improvement, with predominant residual deficits in the right putamen, while clinical symptoms of striatal dysfunction persisted on the left side. This observation suggests that positron emission tomography is able to follow the neurological evolution in cases of Wilson's disease. PMID- 3264569 TI - Ostomy closure for recurrent stomal hemorrhage: an indication for prophylactic sclerotherapy in biliary atresia. AB - Two patients with failed drainage procedures for biliary atresia are presented in whom major hemorrhage from esophageal varices followed shortly after ostomy closure for recurrent stomal bleeding. Before ostomy closure is contemplated in these patients, evaluation for esophageal varices and their prophylactic obliteration with sclerotherapy is recommended. PMID- 3264568 TI - CNS changes in Usher's syndrome with mental disorder: CT, MRI and PET findings. AB - CNS changes in a case of Usher's syndrome associated with schizophrenia-like mental disorder were observed by CT, MRI and PET. The neuro-radiological findings of the case demonstrate the degenerative and metabolic alterations in various regions of cortex, white matter and subcortical areas in the brain. Mental disorder of the case is almost indistinguishable from that of schizophrenia, but the psychotic feature is regarded as an atypical or mixed organic brain syndrome according to the classification in the third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III). PMID- 3264570 TI - Systematic errors in estimating prevalence and severity of periodontal disease. AB - Partial-mouth scores are often used in epidemiologic studies to estimate the prevalence and severity of periodontal disease. Such estimates systematically underestimate the prevalence of disease, but the bias can be in either direction for disease severity. Three large data sets containing full-mouth examinations (mesiobuccal, midbuccal, distobuccal, and midlingual (MBDL) sites per tooth) for either attachment loss or probing pocket depths were used to investigate the magnitudes of systemic error that occur by employing four specific partial-mouth scores (M, MB, MBD, and MBDL sites per tooth), which are based on the random half mouth technique. For prevalence of disease the sensitivity of a partial score was a function of the disease level in the population. All four partial scores were sensitive enough to adequately portray true prevalence using the 2-mm demarcation value, the MBD and MBDL scores might still be considered adequate for the 4-mm value, but none of these partial scores were adequate for the 7-mm value. For disease severity the MBDL score produced unbiased estimates, the others were biased. The relative biases for the MB and MBD scores were all under 10% (in absolute value), but the M score produced severe relative biases, 24% for probing pocket depths and -12% for attachment loss. PMID- 3264571 TI - Actinobacillus actinomycetemcomitans and Bacteroides gingivalis activate human peripheral monocytes to produce interleukin-1 and tumor necrosis factor. AB - The effects of gram-negative bacteria clearly associated with juvenile and adult periodontitis on monokine production were assessed using standard in vitro assay techniques. Actinobacillus actinomycetemcomitans and Bacteroides gingivalis were able to activate human peripheral blood monocytes to produce significant amounts of interleukin-1 (IL-1) and tumor necrosis factor (TNF). These monokines are known to induce osteoclastic bone resorption. An oral gram-positive organism, Staphylococcus epidermidis, was able to induce only modest amounts of IL-1 and TNF, slightly above unstimulated monocyte levels. PMID- 3264572 TI - Histological characteristics associated with suppurating periodontal pockets. AB - The purpose of this study was to characterize histologically the gingival lesion associated with suppuration in advanced periodontitis. Thirty-three bleeding, suppurating (S) and 23 bleeding, nonsuppurating (NS) interproximal biopsies were obtained from nine patients and processed for light microscopy. Pocket depths (mean +/- SD) were 6.7 +/- 1.6 mm (S) and 5.4 +/- 2.2 mm (NS). Six-micron serial sections were stained with (1) hematoxylin/eosin and (2) van Gieson. Quantitative cell types were determined by a grid intersection counting technique at x 1000. Volumetric analysis of collagen-poor (inflammation) areas was conducted using a computer biometric system that revealed three histologic patterns: Type I sites showed mild to moderate inflammation (less than 50% infiltrate, S = 15, NS = 20); Type II sites showed intense inflammation (greater than 50% infiltrate, S = 17, NS = 3); and only one (S) site had a large connective tissue abscess (Type III). The mean percentage of collagen-poor area was significantly larger in suppurating (42.1 +/- 25.5%) versus nonsuppurating (27.7 +/- 20.4%) sites (P = 0.02). In both S and NS sites, plasma cells (means = 66%) and lymphocytes (means = 27%) predominated in the inflammatory infiltrates. Histologically, suppuration appeared to be associated with increased gingival inflammation and a slight increase in connective tissue neutrophils. PMID- 3264573 TI - Protective actions of corticotropin-releasing factor on thermal injury to rat pawskin. AB - Corticotropin-releasing factor (CRF), a 41-residue peptide, inhibits the edema and protein extravasation produced by heat applied to the rat pawskin. Here, the time course of CRFs actions against heat-induced swelling was investigated. The paws of pentobarbital-anesthetized rats were immersed in 58 degrees C water for 30 sec and the resultant swelling was measured by the fluid displacement method. Human/rat CRF, 28 micrograms/kg s.c., injected 0.5 to 2 hr before heat exposure reduced swelling by over 50%. Pretreatment at 4 hr before heat was also effective, but not at 12 or 24 hr. CRF, injected 28 micrograms/kg i.v. 0, 10 or 20 min after heat exposure, inhibited the progressive development of swelling immediately. Histological examination of skin showed that CRF, given before or after heat, reduced vesication, edema, epidermal necrosis and the disruption of tissue architecture produced by thermal injury. The alpha-helical CRF(9-41) antagonist administered alone, 92 micrograms/kg i.v., before or after heat did not affect heat injury. The antagonist, however, both prevented and reversed the inhibitory effects of CRF on the swelling produced by heat. The antagonist induced reversal occurred as late as 2 hr after CRF, 28 micrograms/kg s.c. Overall, these results suggested that CRF is a potent and efficacious agent in protecting skin against experimental thermal injury. PMID- 3264574 TI - Application of adjuvant-induced local hyperthermia for evaluation of anti inflammatory drugs. AB - A recently established method for determining the surface temperature of adjuvant inflamed rat's paw was used to examine the anti-inflammatory potencies of various nonsteroidal and steroidal anti-inflammatory drugs, which are currently in clinical use. The results were compared with those obtained by the carrageenin paw edema method and with the inhibitory potencies on prostaglandin E2 generation. The clinically effective single doses of the drugs were better correlated with the effective doses on local hyperthermia than with those on carrageenin paw edema, or with the inhibitory activities of the drugs on prostaglandin E2 generation from cultured rat synovial cells. Although care should be taken to avoid false-positive anti-inflammatory effects arising from vasoconstrictor activity or toxicity, determination of lowering effects on local hyperthermia in this inflammatory model may be useful for the evaluation of anti inflammatory compounds. PMID- 3264575 TI - Stimulation of human synovial fibroblast DNA synthesis by recombinant human cytokines. AB - The pronounced synovial hyperplasia often found in rheumatoid joints can be explained at least partially, by the interaction of monocyte-macrophage polypeptides (monokines) and lymphocyte polypeptides (lymphokines) with synovial fibroblast-like cells. We now report that purified recombinant human cytokines, interleukin-1 alpha, interleukin-1 beta, tumor necrosis factor alpha, tumor necrosis factor beta (or lymphotoxin) and, to a variable extent, interferon gamma, stimulate the DNA synthesis of human synovial fibroblast-like cells cultured in low (i.e., 1%) fetal bovine serum. With the exception of interferon gamma, the effects of the cytokines were generally elevated by indomethacin, suggesting inhibition of the DNA synthesis by an endogenously produced cyclooxygenase product(s). Consistent with this suggestion, exogenous prostaglandin E2 suppressed cytokine induced DNA synthesis. All of the cytokines studied might play a role in the synovial hyperplasia present in rheumatoid disease. PMID- 3264576 TI - Association of HLA-DR2/DR4 heterozygosity with systemic lupus erythematosus in Japanese patients. AB - The frequency of HLA-DR2/DR4 heterozygotes was significantly higher in 85 Japanese patients with systemic lupus erythematosus (SLE), compared with healthy controls. There was no difference in frequency of the heterozygotes of HLA DR2/non-DR4. The association with HLA-DR2/DR4 heterozygosity was highly significant in patients with SLE in whom the onset occurred under age 30 and there was no significant association in patients with SLE in whom the onset occurred at age over 30 years. The possible role of HLA-DR2/DR4 heterozygosity in the development of SLE is discussed. PMID- 3264577 TI - Acute gouty arthritis in 4 patients with systemic sclerosis. AB - Gout with rheumatoid arthritis or systemic lupus erythematosus is rarely reported. There has been only one previous case report of gout with systemic sclerosis. We report 4 patients with chronic systemic sclerosis who developed acute gouty arthritis. Gout does occur in systemic sclerosis although the incidence is unknown. Synovial fluid analysis may be necessary to differentiate gout from the arthropathy of systemic sclerosis. PMID- 3264578 TI - Abnormalities of the sacroiliac joints in diffuse idiopathic skeletal hyperostosis: demonstration by computed tomography. AB - Eight patients with classical spinal radiographic features of diffuse idiopathic skeletal hyperostosis (DISH) had pelvic radiographs which suggested sacroiliac joint abnormalities. No patient had clinical features of ankylosing spondylitis. Computed tomography of the sacroiliac joints revealed several abnormalities including asymmetric intraarticular partial fusion, osteophytes with or without bridging, and vacuum phenomenon. Sacroiliac joint disease can complicate DISH. PMID- 3264579 TI - Ankylosing spondylitis and multiple sclerosis: an apparent association? AB - The prevalence of HLA-B27 in 420 patients with multiple sclerosis (MS) was 43 (10.2%). Five of 20 B27 positive patients who were further assessed clinically and radiologically had ankylosing spondylitis (AS), a prevalence of between 12 and 25%, compared with previously established prevalence rates of B27 in members of the normal population of between 1 and 2% Sixteen patients with AS underwent brainstem auditory (BAEP), visual (VEP) and somatosensory (SSEP) evoked potential studies, with only minor, and predominantly peripheral, abnormalities of SSEP, except for one patient who developed MS during the study. Our data lend some support to an association between AS and MS but refute the possibility of a frequent subclinical MS-like syndrome in AS. They show there is unlikely to be any confusion when performing evoked potential studies in patients with AS. PMID- 3264580 TI - In vitro immunoglobulin production by lymphocytes of patients with juvenile rheumatoid arthritis: effects of Staphylococcus aureus Cowan I stimulation and monocyte depletion. AB - Pokeweed mitogen (PWM) and Staphylococcus aureus Cowan I (SAC) were used to stimulate in vitro IgG and IgM production by lymphocytes of 27 patients with juvenile rheumatoid arthritis (JRA). Twelve had reduced stimulation indices for PWM stimulated cultures of T and non-T cells. Stimulation with SAC resulted in increased IgM production in half (5/10); and partial removal of monocytes resulted in improved PWM induced IgM production in 5/7. IgG production was less easily improved. The results of our study suggest that while PWM induced Ig production may be reduced, B cells responding to SAC may function normally in some patients with JRA. In others, monocyte mediated suppression may account for reduced responses to PWM. PMID- 3264581 TI - Pneumatosis cystoides intestinalis and benign pneumoperitoneum in a patient with antinuclear antibody negative systemic lupus erythematosus. AB - A patient with antinuclear antibody (ANA) negative systemic lupus erythematosus (SLE) developed pneumatosis cystoides intestinalis and spontaneous pneumoperitoneum. The literature of pneumatosis cystoides intestinalis and spontaneous pneumoperitoneum is reviewed, the benignancy of these conditions is emphasized, and particular attention directed to their association with and implications in the collagen vascular diseases. This is the first reported case of pneumatosis cystoides intestinalis and pneumoperitoneum in a patient with ANA negative SLE. PMID- 3264582 TI - Sarcoidosis: atypical presentation associated with features of systemic lupus erythematosus. AB - A 52-year-old woman presented with rash, bilateral uveitis and polyarthritis of her hands. Laboratory tests were consistent with the diagnosis of systemic lupus erythematosus (SLE). Ten years later she developed dyspnea associated with bihilar lymphadenopathy. Lung function tests showed a restrictive pattern and bronchial biopsy revealed the presence of noncaseating granulomata. We report this rare concomitant appearance of SLE and sarcoidosis. PMID- 3264583 TI - A case study: nonsteroidal antiinflammatory drugs and gastrointestinal bleeding. AB - This paper describes a postmarketing drug surveillance study which examined the association of upper gastrointestinal (GI) bleeding and exposure to nonsteroidal antiinflammatory drugs (NSAID). The rate of upper GI bleeding was compared in 47,136 patients exposed to a NSAID and 44,634 unexposed patients. The risk of bleeding was 1.5 times higher in patients exposed to a NSAID (95% confidence interval, 1.2-2.0). Dose (p less than 0.01) and duration (p less than 0.001) response relationships were identified. The rate of upper GI bleeding was then compared among 88,044 patients exposed to only one NSAID. Sulindac was associated with the highest rate of upper GI bleeding. Control for multiple potential confounding variables did not change the results. These results suggest that NSAID are associated with upper GI bleeding, and that sulindac may lead to upper GI bleeding more frequently than other NSAID. PMID- 3264584 TI - Monitoring of nonsteroidal antiinflammatory drugs in populations. A clinician's point of view. AB - Nonsteroidal antiinflammatory drugs are widely used for increasingly broad indications. This article reviews the major issues encountered in the clinic in choosing and prescribing a specific agent to a given individual. A parallel view of the information available that would enable such decisions to be made logically reveals major gaps in the available database. The need for clinical consensus as to issues of priority for collaborative research is identified. PMID- 3264585 TI - Continuous autotransfusion after coronary bypass surgery. PMID- 3264586 TI - Mutually gratifying heterosexual relationship with micropenis of husband. AB - Three adult patients with micropenis are described: two genetic females, reared as boys, with congenital adrenocortical hyperplasia (CAH), and one male with anorchia. The patients had a male gender identity/role. All three had established a satisfying heterosexual relationship. For only one of the patients intravaginal intercourse was possible. In one patient (with CAH), penile reconstructive surgery was attempted but failed. Nevertheless, he developed a satisfactory sexual relationship with a woman friend. This report illustrates that for patients with micropenis, penile reconstructive surgery is not obligatory for the establishment of a satisfying sexual relationship. PMID- 3264587 TI - [Flow cytometric analysis of malignant cells in lymphocytic leukemias and lymphomas by monoclonal antibodies]. PMID- 3264588 TI - Immunodeficiency in preclinical smoldering adult T-cell leukemia. AB - We treated two Japanese patients with Pneumocystis carinii pneumonia. Inclusion bodies in both adrenal glands of patient no. 1 indicated a herpesvirus infection. The patient no. 2 recovered from the pneumonia upon sulfametoxazole-trimethoprim medication and high-dose methylprednisolone therapy. In both patients, anti-human T-cell leukemia virus type I (HTLV-I) antibodies were positive and anti-human immunodeficiency virus antibodies were negative. Peripheral leukocytes in patient no. 1 numbered 13.6 X 10(3)/microliter with 25% morphologically normal lymphocytes and 4% abnormal. Lymphocyte surface markers were 72.6%, CD4+, 13.6% CD8+ and 46.4% CD3+. In patient no. 2, leukocytes numbered 13.8 X 10(3)/microliter, including 18% lymphocytes, although no morphologically abnormal lymphocyte was evident. Lymphocyte markers were 36.6% CD4+, 16.8% CD8+ and 46.6% CD3+. Monoclonal integration HTLV-I proviral DNA in lymphocytes of patient no. 2 was demonstrated by Southern blotting. Thus, both patients must have had smoldering adult T-cell leukemia (ATL) without any cutaneous involvement, whereas the morphological diagnosis from peripheral blood smears was one of HTLV-I carrier status with a few atypical lymphocytes, i.e., the preclinical state of smoldering ATL. Pneumocystis carinii infections, a viral infection of the adrenals (no. 1), negative purified protein derivatives of the tuberculin reaction and suppressed blastogenesis of the peripheral lymphocytes indicated HTLV-I-induced impairment of the immune mechanism to have already occurred in both patients without there being a vast proliferation of ATL cells. PMID- 3264589 TI - B-cell lymphoma of probable thymic origin: case report. AB - A case of B-cell lymphoma of probable thymic origin is reported. A 34-year-old woman was found to have an anterior mediastinal tumor in November 1986. The surface lymph nodes were not palpable. A total resection of the tumor mass was performed. The tumor invaded the right pleura, the right lung and the pericardium. Histologically, normal thymus was found at the margin of the tumor tissue. The neoplasm was predominantly composed of large lymphoid cells, separated by rather thick fibrous bands of nodular fashion in some areas. Immunohistochemical staining demonstrated monoclonal cytoplasmic IgG and kappa chains in a small portion of the neoplastic cells in fixed tissue. The cells showed positive staining with cluster of differentiation (CD) 20 (B1) but negative staining with antibodies reactive with T-cells in unfixed tissue. "Malignant lymphoma, diffuse, large cell type (B)" was the diagnosis. The arrangements of immunoglobulin (Ig) and T cell receptor (TCR) beta genes were studied. Clonal rearrangement bands of IgH and Ig kappa genes were observed in the same sizes in both the tumor and the peripheral blood before chemotherapy. The patient received chemotherapy until September 1987, and is in complete remission at present (January 1988). The peripheral blood showed germ line patterns of IgH and Ig kappa genes in complete remission. No rearrangement bands of TCR beta genes were detected throughout. The B-cell lineage was proved both from gene arrangement analysis and with immunohistochemistry. PMID- 3264590 TI - [Surgical tactics and results of aortocoronary shunting in patients with chronic forms of ischemic heart disease and reduced left-ventricular ejection fraction]. AB - Two groups of patients whose ejection fraction was below 0.45, underwent aortocoronary shunting of one to five arteries: patients without myocardial scarry changes (group 1) and those with expansive intra- and transmural myocardial scarry changes (group 2). The latter group was more difficult in terms of coronary bed affection, myocardial contractility and a greater proportion of patients with circulatory insufficiency, which dictated the type of anesthesia, myocardial protection and the surgical techniques in these patients. Aortocoronary shunting is shown to be quite justified and effective in patients with reduced left-ventricular ejection fraction, particularly so in group 1, yet it requires careful selection of patients, provision of adequate myocardial protection and maintenance of myocardial activity at all stages of the intervention. PMID- 3264591 TI - [New approaches to the surgical treatment of coronary arteriosclerosis]. AB - A new combined approach to surgical treatment of coronary heart disease is recommended: direct myocardial revascularization (mammary-coronary and aorto coronary bypass) to recover coronary flow; partial ileo-shunting to control hyperlipoproteinemia, and Arnulf's plexectomy (heart denervation) to eliminate vasospastic component. The sequence of operations can be altered depending on the diagnostic findings. Each operation can be performed independently or in combination with others. Operations were performed in 315 patients. The follow-up covered up to 8 years. Long-term patency of mammary-coronary shunts was 93.5%, and that of autovenous shunts was 65%. Lipid composition showed a stable normalization and signs of coronary spasm disappeared. PMID- 3264592 TI - [Evaluation of the functional status of the heart during aortocoronary shunting]. AB - Direct recording of myocardial contractility and central hemodynamic measurements were made during volumetric load tests before and after the application of aortocoronary shunts in 12 coronary patients. Aortocoronary shunting is shown to lead to a considerable rise in threshold prestress values (end diastolic volume and end diastolic pressure) associated with emerging signs of myocardial ischemia. It is suggested that cardiac functional capacity is expanded as a result of coronary flow recovery. PMID- 3264593 TI - [Status of the coronary vessels and functional state of autovenous shunts in patients with ischemic heart disease at remote periods after aortocoronary bypass]. AB - Repeated coronarography in 89 coronary patients at late dates after aortocoronary shunting, including 74 (83%) patients with residual or recurrent angina and only 15 (17%) angina-free patients, demonstrated that the progress of atherosclerosis continued in both the shunted and intact coronary arteries after the operation. Thrombosis of autovenous shunts had a pronounced effect on clinical condition of the patients. Only 50% of the shunts were open in patients with residual or recurrent angina, while bypass patency was 81% in the absence of anginal attacks. PMID- 3264594 TI - [Left-ventricular function in patients with unstable stenocardia after pharmacological and surgical treatment]. AB - Left-ventricular function was assessed by sectional echocardiography in 250 patients with unstable angina on admission; the test was repeated after medication-produced-stabilization in 130 and after aorto-coronary shunting in 50 of those. Total and/or regional left-ventricular contractility disorders were detected in 82.4%, depending on the type and severity of coronary bed affection as well as the presence and magnitude of postinfarction cardiosclerosis. The nitroglycerin test improved left-ventricular function in 83% of cases where it was initially depressed. Left-ventricular function was improved after medication in 79% of patients and after surgery in 60%. Total left-ventricular ejection fraction increased by an average of 11.2 +/- 1.5%, whereas the ejection fraction of segments, connected with the shunted-artery blood supply network, increased by 19.5 +/- 2.3% (p less than 0.01). The efficiency of pharmacological treatment depended on the number of affected coronary arteries and the presence and severity of postinfarction cardiosclerosis, while surgical treatment also depended on the extent of myocardial revascularization for its efficiency. PMID- 3264595 TI - [New approach to the diagnosis and surgical treatment of patients with ischemic heart disease and ischemia of the lower extremities]. PMID- 3264596 TI - [Diagnostic potentials of computed tomography in cardiology]. PMID- 3264597 TI - Age-related changes of expression of IL-2 receptor subunits and kinetics of IL-2 internalization in T cells after mitogenic stimulation. AB - The age-associated changes of the expression of IL-2 binding molecules p55/Tac(alpha chain) and p70/75(beta chain) were examined after phytohemagglutinin (PHA) stimulation. The expressions of both p55/Tac molecules and p70/75 molecules were significantly reduced in the aged compared with those in the young persons. The amounts of p55/Tac and p70/75 molecules on T cells from the aged were 55% and 59% of those on young ones, respectively. The ratio of the amount of p70/75 to that of p55/Tac in aged T cells was 0.28 and that in young ones was 0.26. The ratio was somewhat higher in the aged but not significantly. We also examined the kinetics of IL-2 internalization mediated by its receptor. The calculated t1/2 of receptor-mediated IL-2 internalization was 17 min in the aged and 16 min in the young, respectively. There was no kinetic difference between the 2 groups. The percentage of the internalized IL-2 to the sum total was 58.2% in the aged and 73.4% in the young (P less than 0.02). the amount of internalized IL-2 in T cells from the aged was 48.6% of that from the young (P less than 0.01). PMID- 3264598 TI - [Hematopoietic growth factors--clinical applications]. PMID- 3264599 TI - [TNS in peripheral circulatory disorders]. PMID- 3264600 TI - [Effects of diphtheria-tetanus vaccination on natural killer cells]. PMID- 3264601 TI - [NSAIDs: a clinical pharmacological determination of their role in the drug treatment of rheumatic disorders]. PMID- 3264602 TI - Evoked potentials and electroencephalography in adolescents with phenylketonuria. AB - We studied the pattern-reversal VEP, the BAEP and the EEG with conventional and computerized analysis in 41 adolescents with hyperphenylalaninemia (24 HPA type 1, 12 HPA type 2, 4 HPA type 3, 1 DHPR deficiency) and 35 control persons. A prolongation of the P100 latency in the VEP, a greater interear difference of the I-V interwave latency in the BAEP and slowing of EEG background activity were found. Five per cent of the patients demonstrated spikes and 12.5% abnormal sharp transients in the EEG. The latency increase in the VEP corresponded to the compliance with the diet during the first decade of life. No influence of the actual Phe concentration at the time of the investigation was demonstrated. The BAEP- and EEG-findings were not related to the course of treatment. Thus the VEP changes in this cross sectional study refer to alterations of brain function that occurred during the early years of life. To investigate the value of evoked potentials and EEG in monitoring brain function after discontinuing the diet longitudinal data are needed. PMID- 3264603 TI - Acute transverse myelopathy as the initial manifestation of probable systemic lupus erythematosus in a child. AB - A 10-year-old girl was presented with acute transverse myelopathy. She had three mild relapses within one year. Systemic lupus erythematosus (SLE) was suspected on the basis of positive antinuclear antibodies (ANA), moderately decreased total hemolytic complement, antibodies to histone, immunological abnormalities of kidney and skin biopsy. Symptoms of SLE involving other organs were absent. PMID- 3264604 TI - Evaluation of the toxicity of the dopaminergic neurotoxins MPTP and MPP+ in PC12 pheochromocytoma cells: binding and biological studies. AB - This study was designed to investigate the toxicity of both MPTP and MPP+ using some simple cell systems, such as PC12 and C6 cultures, as models. Exposure of PC12 cells to 0.5 mM MPTP for 72 h resulted in a 50% cell loss with respect to the control cells, and clorgyline, a MAO-A inhibitor, antagonized this toxic effect. Higher concentrations of MPTP demonstrated only a weak cytostatic effect on C6 cells. Moreover, MPP+ showed a toxic effect which was 100 times more evident than MPTP toxicity in the PC12. We found a single, saturable class of [3H]MPP+ binding sites with a relatively high affinity both in PC12 and C6 cell lines. Moreover, the most susceptible cell line towards the toxic effects of both MPTP and MPP+, i.e. PC12, has the higher number of MPP+ binding sites. Our results suggest that MPTP can be toxic not only via MAO-B, but also via MAO-A activity and we propose PC12 as a model to study the intracellular mechanisms of MPTP and MPP+ toxicity. PMID- 3264605 TI - [Function of the photoreceptor mechanisms in patients with complete achromasia]. PMID- 3264606 TI - Expression of oncogenes in normal and transformed murine B lymphocytes. AB - Proliferating, lipopolysaccharide-stimulated murine B lymphoblasts and a number of transformed murine B cell lines representing various differentiation stages of B cell lineage all express the myc, H-ras and K-ras oncogenes. N-ras transcripts are also present in the B cell blasts and some of the cell lines. In addition, abl, fms, fos, myb, src, and yes are transcribed in some or all of the cell lines but not in the normal B cell blasts. Only myb is expressed in a differentiation stage-specific manner; transcripts are present in the pre-B cell lines and a few of the B lymphomas but not in any plasmacytomas tested. The erbB, fes, mos, and sis probes do not hybridize with mRNA from any of the 15 cell lines or normal B cells. ErbA is not detectable in transformed cells but is expressed in the normal B cell blasts at a low level suggesting its possible involvement in normal growth regulation. PMID- 3264607 TI - Production of lymphotoxin and tumor necrosis factor by human neonatal mononuclear cells. AB - Lymphotoxin (LT) and tumor necrosis factor (TNF) are cytokines with many common biologic effects including antiviral activity and induction of fever and the acute phase response; despite common effects, they are molecularly distinct. Because neonates are unduly susceptible to viral infection and frequently fail to mount a febrile response to infection, we hypothesized that neonatal cells would produce less LT and TNF than adult cells. We analyzed LT and TNF production by blood mononuclear cells and purified T cells using Northern blot analysis to detect specific messenger ribonucleic acid and specific assays to detect LT and TNF protein in culture supernatants. Compared to LT, TNF messenger ribonucleic acid and protein were produced more rapidly both by total mononuclear cells and by T cells in response to mitogen stimulation. Although there was intersubject variability, adult and neonatal mononuclear cells and T cells (n = 6) produced similar amounts of LT and TNF messenger ribonucleic acid and protein with similar kinetics. In experiments with phytohemagglutinin-stimulated mononuclear cells from ten additional subjects, supernatant LT was somewhat greater in neonatal cultures (neonatal = 62.8 +/- 60.5, adult = 13.2 +/- 10.7 units/ml, p less than 0.05), and TNF was somewhat greater in adult cultures (neonatal = 708 +/- 429, adult = 1987 +/- 392 pg/ml, p less than 0.01) at 24 h; results at 48 h and 72 h were similar. Thus, neonatal MC produced as much or more LT than did adult MC. Although the decreased production of TNF by neonatal MC was statistically significant, these cells did produce substantial amounts of this cytokine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264608 TI - [Is endogenous nitroglycerin discovered?]. PMID- 3264609 TI - A distinct octamer-binding protein present in malignant melanoma cells. AB - The octamer-binding proteins present in HeLa cells, B-cells and malignant melanoma cells were compared by a gel-electrophoresis DNA-binding assay. Using an extract from the malignant melanoma cells a complex was formed using a variety of octamer containing probes that was distinct from those found using either a HeLa or B-cell extract. DNAase 1 footprints and methylation interference patterns of the melanoma-specific octamer-binding protein were indistinguishable from those obtained with the HeLa factor NF-A1, except for preferential binding of the melanoma-specific factor to DNA methylated at two G residues 16 base-pairs 3' to the octamer motif. Competition analyses using a variety of wild-type and mutant probes showed that mutations affecting binding of NF-A1 similarly affected binding of the melanoma octamer-binding factor. These data also revealed the extreme flexibility of the octamer-binding site, with one probe sharing only 4 bases with the 8 base consensus sequence binding efficiently. PMID- 3264611 TI - [Rheumatologic manifestations of chronic inflammatory intestinal diseases]. PMID- 3264610 TI - Langerhans cell histiocytosis: clinical experience with 124 patients. AB - We cared for 124 pediatric patients with a histologic diagnosis of Langerhans' cell histiocytosis (histiocytosis X) over a period of 14 years. Clinical, laboratory, and radiographic findings were analyzed. The most frequent manifestations were bone lesions, lymph node involvement, and skin infiltration. Liver disease was noted in 50% of patients and lung disease in 23%; hematologic changes were also frequent. Dysfunction and involvement of these three organ systems, plus age of onset, distinguished the group of patients with the highest mortality. All patients with generalized disease or organ dysfunction were treated with systemic chemotherapy. The actuarial survival curve at 10 years was 63%. PMID- 3264612 TI - Application of multiple time series analysis to the estimation of pneumonia and influenza mortality by age 1962-1983. AB - We employed multiple time series analysis to estimate the impact of influenza on mortality in different age groups, using a procedure for updating estimates as current data become available from national mortality data collected from 1962 to 1983. We compared mortality estimates that resulted from a multivariate model for epidemic forecasting with those obtained from univariate models. We found more accurate prediction of deaths from all age groups using the multivarate model. While the univariate models show an adequate fit to the data, the multivariate model often enables earlier detection of epidemics. Additionally, the multivariate approach provides insight into relationships among different age groups at different points in time. For both models, the largest excess mortality due to pneumonia and influenza during influenza epidemics occurred among those 65 years of age and older. Although multiple time series models appear useful in epidemiologic analysis, the complexity of the modelling process may limit routine application. PMID- 3264613 TI - Examining neighbourhood confounding in a survey: an example using the National Health and Nutrition Examination Survey II. AB - This paper demonstrates a methodology for examining whether neighbourhood stratification lessens the confounding bias of some specific risk-factor/disease associations in analysis of the National Health and Nutrition Examination Survey II (NHANES II). The fortuitous clustering of the sample design of NHANES allows us to estimate risk-factor/disease associations with and without controlling for neighbourhood effects on the same population. We briefly discuss the implications of this methodology for neighbourhood matching in case-control studies. PMID- 3264614 TI - [Current treatment of acute ophthalmic herpes zoster (or, vive la difference!)]. PMID- 3264615 TI - TMP-SMZ in the treatment of brucellar meningitis. PMID- 3264616 TI - Ecology and epidemiology of raccoon rabies. AB - Two areas of the United States presently are experiencing epizootics of raccoon rabies, which have been followed by the development of an enzootic state. These include four southeastern and five mid-Atlantic states. Information was obtained from 1,610 raccoons submitted for rabies testing in four of the affected mid Atlantic states during 1982 and 1983 and from 798 raccoons from Virginia during 1984 and 1985. Analysis of the two sets of data provided an opportunity to characterize certain aspects of the epizootic. Raccoons collected during the day or at dusk and those that behaved abnormally were more likely to be rabid. Many human exposures to raccoons were preventable or may not have necessitated treatment. Eight (3%) of 291 serum samples from raccoons in an epizootic area had titers of antibody to rabies virus (complete neutralization) of greater than or equal to 1:25. Field trials of baiting systems incorporating an oral raccoon rabies vaccine are being conducted in Virginia, Washington, D.C., and Pennsylvania. PMID- 3264617 TI - [Pharmacology of calcium antagonists]. PMID- 3264618 TI - [Among the antinuclear antibodies in rheumatoid polyarthritis: antihistone antibodies detected by an immunoenzymatic technic]. PMID- 3264619 TI - [2 unusual localizations of apatite rheumatism. The concept of the annex muscular system]. PMID- 3264620 TI - The value of combining auditory brainstem responses and acoustic reflex threshold measurements in neuro-otological diagnosis. AB - Acoustic reflex thresholds (ART) and auditory brainstem responses (ABR) were measured in 69 patients referred to the Neuro-otological clinic on the suspicion of a retrocochlear lesion. The pure-tone selection criterion was an average hearing loss of less than 60 dB at 0.5, 1, 2, and 4 kHz, with no thresholds exceeding 70 dB and only one threshold exceeding 60 dB. Both tests proved independently to be most effective in the diagnosis of cerebello-pontine angle (CPA) tumours and to a lesser extent for brainstem lesions. The ABR was positive in 100% of CPA group and 90% in the brainstem group compared with 93% and 70% respectively for the ART. The combination of the two tests provides patterns of abnormality which are more disease specific. In the CPA cases the most common and consistent patterns of abnormality were the unilateral delay of Wave V or III and V of the ABR associated with a vertical ART pattern indicative of an abnormality of the ipsi and contralateral reflexes on stimulating the affected side. Intrinsic brainstem lesions most commonly resulted in bilateral ABR abnormalities combined with the full-house ART pattern indicative of bilateral abnormalities of both ipsi and contralateral reflexes. PMID- 3264621 TI - Amelogenesis imperfecta--clinical manifestations in 51 families in a northern Swedish county. AB - The clinical manifestations of amelogenesis imperfecta (AI) were described in 165 individuals from 51 families. The inheritance pattern for AI in these families had previously been investigated, and it was hypothesized that AI probably is solely an autosomal dominant (AD) or X-linked trait. To test this hypothesis the connection between clinical manifestation and inheritance pattern was studied. Eight different variants of AI were seen. In 33/51 families all affected individuals could be assigned to the same clinical variant. In 8/51 families those affected were assigned to different clinical variants. In the two families where an X-linked recessive (XR) inheritance pattern was found probable, the clinical manifestation differed between women and men. Except for one variant only seen as an AD trait, and the manifestation in women in families with an X linked recessive inheritance pattern, no connection was found between a specific inheritance pattern and a specific clinical manifestation. Accordingly it seems likely that AI is solely an AD or X-linked trait. The different clinical variants observed should be regarded as a varying expressivity of the gene and in the families with X-linked inheritance probably due to lyonization. In the remaining families the modifying mechanisms are not known. PMID- 3264622 TI - [Sternocostoclavicular hyperostosis. Association with pustular psoriasis and systemic vasculitis]. AB - A female patient with sternocostoclavicular hyperostosis has been followed for 14 years. The case merits special attention because of its association with psoriasis and with an episode of systemic vasculitis. Although patients with sternocostoclavicular hyperostosis usually lack the tissue type antigen HLA-B27, there are grounds for suspicion that the disease is related to the group of seronegative spondylo-arthritides. PMID- 3264623 TI - The role of interleukin-1 on proteoglycan metabolism of rabbit annulus fibrosus cells cultured in vitro. AB - The effects of human recombinant interleukin-1 alpha (IL-1 alpha) on proteoglycan (PG) metabolism of rabbit intervertebral disc were investigated morphologically and biochemically using rabbit annulus fibrosus (AF) cells in culture. AF cells could maintain their differentiated phenotype well in our primary culturing condition. In this situation, IL-1 alpha stimulated the cells and induced marked increase of PG release. Dose dependency of IL-1 alpha on PG release was seen in the concentration range between 5-50 U/ml. Caseinolytic activity produced and secreted into the medium by AF cells was assayed and it was found that IL-1 alpha enhanced the enzyme activities in the medium. The effects of IL-1 alpha on PG and DNA synthesis were also studied. Slight depression was observed in PG synthesis but there was no effect on DNA synthesis. These data suggest that IL-1 alpha may play an important role in PG metabolism of intervertebral disc cells, especially in the catabolic pathway of PG. PMID- 3264624 TI - Caries prevalence and distribution in individuals aged 3-20 years in Jonkoping, Sweden, 1973, 1978 and 1983. AB - In 1973, 1978, and 1983 epidemiological studies on dental health were performed in the community of Jonkoping, Sweden. Each investigation covered about 500 individuals evenly distributed in the age groups 3, 5, 10, 15 and 20 years. The subjects were examined clinically and radiographically. In the present study, caries prevalence and distribution are analysed too. The total number of DFS decreased by about 50 per cent between 1973 and 1983 in all age groups. Most of the changes occurred during the period 1973-1978. The largest percentage reduction in DFS had occurred on the buccal/lingual surfaces. The number of FS proximal showed a decrease in 1983 compared to 1973, while the number of DS proximal was almost unchanged during the period. A closer analysis of DS-proximal revealed that there was an increase in the proportion of lesions restricted to the enamel between 1973 and 1983. In the 3 and 5-year-olds, 29 and 32 per cent of the carious lesions were restricted to the enamel in 1973 compared to 58 and 53 per cent, respectively, in 1983. For the groups of 10, 15 and 20 year-olds the numbers were 84, 84 and 78 per cent respectively in 1973, and 89, 90 and 86 per cent in 1983. A change in distribution of individuals according to DFS was found in 1978 compared to 1973. This change was still more pronounced in 1983, most of the subjects showing a low number of DFS. The results of the study show that when caries prevalence is decreasing more refined diagnostic measures should be used in order to make it possible to follow changes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264625 TI - Caries prevalence and distribution in individuals aged 20-80 years in Jonkoping, Sweden, 1973 and 1983. AB - In 1973 an epidemiological study was performed in the community of Jonkoping, Sweden. The study covered 1000 individuals, evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60 and 70 years. In 1983 a new cross-sectional study was carried out on the age-groups 3-80 years. The aim of the present study was to compare and analyse in detail caries prevalence and distribution in the age-groups 20-80 years at the examinations in 1973 and 1983. The subjects were examined clinically and radiographically regarding number of teeth, caries, restorations, etc. The mean number of teeth increased between 1973 and 1983, especially in the older age-groups. During the same period, the percentage of DFS decreased in the age-groups 20, 30 and 70 years, and was unchanged in the age groups 40 to 60 years. There were only minor differences in DS in the respective age-group during the 10-year period. The distribution of subjects according to DFS showed that a large proportion of individuals in the age-groups 20 and 30 years had low DFS in 1983 as compared to 1973. For the age-group 40-years, the distribution was unchanged. For the 50, 60 and 70-year-olds, there was a change in distribution towards a larger proportion of individuals with high DFS values in 1983 as compared to 1973. The frequency distribution of individuals with primary and secondary carious lesions respectively was skewed, a small number of individuals having a high number of lesions in each age-group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264626 TI - [Disorders of purine metabolism as an etiological factor in renal pathology]. AB - Of 3200 patients admitted to the nephrology department within several years, hyperuricemia was detected in 696. Excluding from this number persons with signs of chronic renal insufficiency (146 persons) and patients who were treated by diuretics (89), the frequency of hyperuricemia was 16.2% which exceeded almost 2 fold (9.2%) the value determined during the examination of 594 healthy persons. The authors discussed a possibility of early development of renal pathology in purine metabolic derangement with hyperuricosuric and hyperuricemic stages characterized by certain clinical peculiarities, including a possibility of development of immune complex nephritis. PMID- 3264627 TI - [Technical aids for patients with rheumatism]. PMID- 3264628 TI - [Immunity against HIV infection]. PMID- 3264629 TI - [Survival after coronary surgery]. PMID- 3264630 TI - [New trends in coronary bypass surgery]. PMID- 3264631 TI - [Perforines. The killer proteins of the lymphocytes]. PMID- 3264632 TI - [Current news on cell membrane molecules. The significance for immune response]. PMID- 3264633 TI - [Report of the presentation veterinary immunological research]. PMID- 3264634 TI - [Disorders in humoral defense: clinical aspects, diagnosis and therapy]. AB - Clinical and immunological findings of 5 patients with distinct defects in either humoral immunity or in the complement system are described. The syndromes presented comprise examples of type I dysimmunoglobulinaemia, X-linked agammaglobulinaemia (XLA), familial deficiency of complement factor C1q and a patient with a selective deficiency in the synthesis of antibodies against pneumococcal polysaccharides. The patients with a defect in humoral immunity all showed recurrent bacterial infections of the respiratory tract. The XLA-patient developed a dermatomyositis-like syndrome and ECHO-virus encephalitis. Prior to the development of a SLE-like syndrome the two siblings with C1q deficiency showed recurrent respiratory tract infections, most probably on basis of a defect in the clearance of immune complexes. PMID- 3264635 TI - Immunomodulation of in vitro antigen presentation by cations. AB - The ability of various cations to alter an antigen-specific (ovalbumin) T cell activation system in vitro has been assessed. This in vitro system includes analysis of antigen capture, processing, and presentation by antigen presenting cells (APC) (splenocytes, B cells or macrophages) in a major histocompatibility complex (MHC) restricted fashion and the evaluation of the activation of a T-cell hybridoma, DO-11.10, which is specific for "processed" ovalbumin in association with I-Ad. Activation is determined by production of IL2 which is quantitated in a bioassay with HT-2 cells. Numerous metals (10 and 100 microM) were screened in the coculture assay (APC and DO-11.10 plus ovalbumin). Metals with inhibitory effects were Cd greater than Cu greater than Pb greater than Zn. Co and Cr had no modulatory effect and Ni had an enhancing effect (increased IL2 production). The effects of the modulatory metals were further assessed for influences on the individual cellular components of this system. Cd was toxic to all cell types whereas Cu was toxic only to irradiated splenocytes and Do-11.10. Pb was the only metal which was not toxic to any cell type but still inhibited antigen presentation. To prevent influences of metals on DO-11.10 or carryover into the bioassay, APC were preincubated with metals and then assessed for presentation capability. After preincubation, only Cd, Pb, and Cu were inhibitory. The inhibition by Cd was due to toxicity. Cu inhibited only irradiated splenocyte presentation and this effect was due to toxicity. Pb inhibition was due to a mechanism other than toxicity and its biochemical influences on APC are discussed. PMID- 3264636 TI - [A comparative study of neuroimaging technics and EEG in localization of a focus in partial epilepsy]. PMID- 3264637 TI - [Eye infections endangering the sight. A retrospective study from a 6-year period with special attention to the use of contact lenses]. PMID- 3264638 TI - [Tenoxicam]. PMID- 3264639 TI - Time trends in peptic ulcer surgery in Sweden. A preliminary report of a nation wide survey. AB - In order to establish time trends in surgical rates for peptic ulcer disease, we sent a questionnaire to every surgical department in Sweden. Eighty-two per cent of the departments responded. Since 1956 there was a marked and steady decline in elective procedures (-83%) and to a much lesser extent also in emergency procedures for perforations (-30%). The decline was most pronounced for duodenal ulcer in men. In 1986, the incidence was 1.2 and 0.65 operations per 10,000 inhabitants for elective and emergency operations, respectively. In the future, the few patients needing elective surgery for peptic ulcer may have to be served by a small number of specialized centers. PMID- 3264640 TI - [Changes in various indicators of the immune system in patients with diffuse toxic goiter after surgical treatment]. PMID- 3264641 TI - [Autoantibodies in systemic erythematosis. I. Incidence of antibodies against the CEM T-lymphocyte line]. PMID- 3264642 TI - [Levamisole in the combined treatment of patients with ischemic heart disease]. PMID- 3264643 TI - [Principles of a differentiated immunocorrective therapy]. PMID- 3264644 TI - [Serum osteocalcin level as a marker of the functional state of osteoblasts after oral calcium tolerance test]. AB - The results are presented of an oral calcium tolerance test with 1,000 mg calcium in 20 patients with recurrent renal calcium calculosis, a woman with primary hyperparathyroidism and incipient renal failure (serum creatinine 1.8 mg%), creatinine clearance 55 ml/min) and 9 healthy persons as controls. The serum osteocalcin level was determined before and after the oral test. The results show that the serum osteocalcin level alone is of no differential diagnostic value for differentiation of the various types of hypercalciuria in patients with recurrent renal calcium calculosis. As a marker of osteoblasts functional state however the determination of serum osteocalcin level is of great importance for the early diagnosis of osteoporosis. In 3 patients with renal hypercalciuria, often leading to general osteoporosis, an acute rise of serum osteocalcin level was found after the oral calcium tolerance test. High osteocalcin level was also found in the patient with primary hyperparathyroidism and incipient renal failure. PMID- 3264645 TI - [Chronic lymphocytic leukemia. II. Differentiation of various forms of chronic lymphocytic leukemia by cytological and immunological indicators]. AB - The authors present their studies on the cytologic and some immunologic features of leukemic cells which determine the specificity of lymphocyte population in the various forms of lymphatic leukemia. 133 patients who were treated in their clinic for the period 1980-1984 were studied. Four clinical forms were differentiated which had been published elsewhere. The morphologic and cytochemical differences of lymphatic leukemia cells in the different variants of the disease are pointed out. Applying the tests for rosette formation, blast transformation and immunofluorescence they have proved immunologic differences in the lymphocyte population of the different forms of the disease. PMID- 3264647 TI - [Substitution of alpha 1-antitrypsin in patients with pulmonary emphysema and alpha 1-antitrypsin deficiency]. PMID- 3264646 TI - [Frequency and clinical relevance of delta virus infection in HBsAg carriers in the Berlin area]. AB - The frequency of delta virus infection, immunoserological parameters and degree of liver inflammation were studied in 190 HBsAg carriers in the Berlin area from 1976 to 1986. Delta infection was detected in one of 50 HBsAg carriers (2%) in the period from 1976 to 1980. In contrast 19 of 140 HBsAg carriers (14%) with delta infection were found in the period from 1981 to 1986. This group included 12 Germans, 5 Turks and 2 Italians. Only 6 of these subjects belonged to a so called risk group: 3 drug addicts, 2 homosexuals and 1 hemophiliac. Eighteen of the 20 patients with HDV infection showed progressive liver disease in the follow up period. Nine cases developed complete liver cirrhosis over five years. Variable transaminase levels and elevation of immunoglobulin G were recorded. Humoral autoimmune phenomena were rarely observed. The increasing frequency of HDV infection in the Berlin area is presumably related to tourism, national origin and membership in specific risk groups. The data in our study underline the importance of effective prophylaxis by active immunization with HBsAg vaccines. PMID- 3264648 TI - Growth and aflatoxin production by Aspergillus parasiticus in a medium at different pH values and with or without pimaricin. AB - A glucose-yeast extract-salt medium containing 0, 5, 7.5, 10, 15 or 20 micrograms pimaricin/ml with an initial pH of 3.5 or 5.5 was inoculated with Aspergillus parasiticus WB 108 and incubated at 15 degrees or 28 degrees C. The pH, weight of mycelium and amount of aflatoxin produced were determined after 3, 7, and 10 days and after 14, 21, and 30 days when incubation was at 28 degrees or 15 degrees C, respectively. Increasing the concentration of pimaricin in the medium with an initial pH of 5.5 decreased the amounts of aflatoxin B1 and G1 produced after 3 days of incubation. When the initial pH of the medium was 3.5, no growth or toxin production occurred after 3 days of incubation in the medium containing 7.5 micrograms or more of pimaricin/ml. The presence of 20 micrograms of pimaricin/ml inhibited growth and toxin production after 7 days of incubation. When cultures were incubated at 15 degrees C, there was a lag phase which extended from 9 to 16 days, and the amounts of aflatoxin produced decreased with an increasing concentration of pimaricin. Pimaricin did not completely inhibit the growth and aflatoxin production by A. parasiticus. Pimaricin, in combination with a low pH, low temperature or 4% or 6% NaCl, initially caused slow mycelial growth and low toxin production, but the mold overcame the inhibitory effects and produced substantial amounts of mycelium and toxin. PMID- 3264649 TI - [The content and composition of gangliosides in brain subcellular fractions of the frog Rana temporaria]. AB - Ganglioside distribution in various frog brain subcellular fractions (myelin, microsomes, mitochondria, synaptosomes, plasma membranes of nerve endings and synaptic vesicles) was investigated. The synaptosomes and plasma membranes of nerve endings were found to be the main places of ganglioside localization, ganglioside concentration being 2.42 and 1.79 times higher than that in homogenates. Gangliosides were shown to be present in synaptic vesicles. The characteristic features of gangliosides from frog brain and its subcellular fractions are the predominance of polysialogangliosides with 3-5 sialic acid residues (up to 57.4%), low content of monosialogangliosides (not more than 7%) and the presence of disialogangliosides with short carbohydrate chain. The increase of ganglioside content per one nerve cell during phylogenetic development of vertebrates is discussed. PMID- 3264650 TI - [Toxic action of kanamycin on the internal ear of the frog Rana temporaria]. AB - It has been demonstrated that administration of kanamycin (0.25 and 0.5 g/ml) to the inner ear in the frog results into a rapid decrease in the microphonic response to clicks. PMID- 3264651 TI - [Immunoregulatory activity of the lungs in relation to corpuscular and soluble antigens]. AB - The immunoregulatory activity of the lungs in normal Wistar rats has been evaluated by difference between primary and secondary immune response to the same dose of the antigen introduced into the respiratory tract or intravenously. As shown in this investigation, intratracheal immunization with corpuscular antigens is accompanied by faintly pronounced antibody formation and a high degree of delayed hypersensitivity, while the introduction of soluble antigens into the respiratory tract leads to the active production of antibodies. The immunoregulatory activity of the lungs is T-dependent. The preliminary introduction of corpuscular or soluble antigen into the respiratory tract is accompanied by the formation of the local mechanism in the lungs for suppressing immune response to the subsequent intratracheal immunization. PMID- 3264652 TI - [Colony stimulating activity, colony inhibiting activity and immunological studies in a case of adult-onset cyclic neutropenia]. PMID- 3264653 TI - The relationship between caloric response, oculomotor dysfunction and size of cerebello-pontine angle tumours. AB - Seventy-nine consecutive patients, 70 patients with acoustic neurinomas (ACN) and 9 patients with cerebello-pontine angle tumours of other etiology (o-CPA) were analysed with respect to tumour size and the result of the caloric and oculomotor tests. The size of the tumour was judged by the largest diameter calculated from the computerized tomography. A highly significant linear relationship between tumour size and caloric side difference was found for the group of ACN patients who had normal oculomotor function. A unilateral loss of caloric response on the tumour side was found in 75% of the ACN patients with tumours larger than 20 mm, but not in any of the ACN patients with tumours smaller than 10 mm. Oculomotor dysfunction (OMD), defined as disturbed pursuit eye movements and/or gaze nystagmus was frequently found in the patients with ACN larger than 20 mm (77%), and was present in all but one of the o-CPA patients. However, the caloric response on the tumour side was significantly more impaired in the group of ACN patients with OMD than in the o-CPA group. A combined view of the oculomotor and caloric test results offers a possibility to obtain a rough estimate of tumour size as well as to distinguish ACNs from other types of tumours in the cerebello pontine angle. PMID- 3264654 TI - Geometrical array of the vestibular sensory hair bundle. AB - The stereometrical arrangement of the sensory hair bundles in vestibular epithelia of the guinea pig was studied with high-resolution scanning electronmicroscopy. Besides the previously known arrangement in tall and short hair bundles, a new morphological criterion dividing the hair bundles into two separate populations is described. Thus the hair bundles can be separated into a loose and a tight type, depending on the interrelationship between the individual stereocilia. The cilia in the loose hair bundle are arranged in longitudinal rows parallel with the cell's plane of polarization, so that the stereocilia increasing stepwise in height are compressed tightly together. The stereocilia in the tight hair bundle type are arranged in equally tall transverse rows in which the cilia are situated directly adjacent to each other. While all the stereocilia are connected by thin filaments along the entire course of their shafts, their bevelled tips are connected by a single tip link to the shaft of the adjacent, taller stereocilium. The tip link morphology differs between the two hair bundle types. It is assumed that these two different types of hair bundles have different mechanical properties, which could indicate a higher degree of selectivity on the hair cell level in the vestibular end organs. PMID- 3264655 TI - Anatomic distribution and localization of immunocompetent cells in normal mouse endolymphatic sac. AB - The distribution and anatomic localization of immunocompetent cells in normal mouse endolymphatic sac (ES) were examined by immunohistochemical methods. Antibodies against T cells (anti-Thy-1, -Lyt-1, -Lyt-2), macrophage (anti-Mac-1) and immunoglobulins (anti-IgM, -IgG, -IgA) were employed in an indirect technique utilizing strept-avidin-biotin complex. In the normal mouse ES, each of these cells could be detected by a difference in its frequency and distribution within and around the ES. Thy-1 positive (Thy-1+) cells are the most predominant in this tissue and can be seen throughout the ES. Lyt-1+ cells were found within the ES epithelium and in the perisaccular region, whereas Lyt-2+ cells were rarely present. Mac-1+ cells were present primarily in the lumen of the distal portion of the ES. IgM-bearing (IgM+) cells were seen in the subepithelial region, IgG+ cells were occasionally detected in the lumen and only a few IgA+ cells were present in the perisaccular region. This study revealed that the ES has the necessary immunological components for antigen processing and the generation of local immune responses within the inner ear. PMID- 3264656 TI - Cystic fibrosis in Denmark 1945 to 1985. An analysis of incidence, mortality and influence of centralized treatment on survival. AB - The entire population of cystic fibrosis (CF) patients in Denmark diagnosed in the period January 1, 1945, to June 30, 1985, comprised 514 persons of whom 62 were diagnosed at autopsy. Of the remaining 452 patients, 372 were probands and 80 were secondary cases. The effect of a centralized treatment on the prognosis was evaluated using a Cox's regression model. Furthermore an incidence analysis was performed using probands including autopsies. Centralized treatment had a significantly beneficial effect on the prognosis (p = 0.02), the death intensity (hazard rate) being decreased by a factor of 0.60. It was calculated that at present 1 out of 4,760 newborn Danes may be diagnosed as suffering from CF before the age of 15 years, and 3% of the Danish population are heterozygotes for CF. PMID- 3264657 TI - Prevalence of xerophthalmia in relation to nutrition and general health in preschool-age children in three regions of Tanzania. AB - Integrated nutrition/health surveys were carried out in Mbeya, Iringa and Kagera Regions in Tanzania in which a total of 12,880 children were examined for the presence of xerophthalmia. Xerophthalmia was found to be a problem of public health significance in two of the three regions surveyed where the prevalence of active corneal xerophthalmic lesions was above the criteria set by WHO. Because of clustering of the children with Bitot's spots, corneal xerosis/ulceration and corneal scarring, only certain villages or groups of villages could be regarded as areas where xerophthalmia is a problem. The results of the ophthalmological examinations are discussed in relation to the nutritional status of the children as measured by anthropometric indices, serum levels of retinol-binding protein and prealbumin, haematological parameters, and vaccination status. PMID- 3264658 TI - Haemophilus influenzae neonatal sepsis--what is appropriate initial therapy? PMID- 3264659 TI - [Pregnancy and nutrition: a case-control study in Ribeira de Pena]. PMID- 3264660 TI - Haematological abnormalities and reference intervals in the elderly. A cross sectional comparative study of three urban Swedish population samples aged 70, 75 and 81 years. AB - We compared three representative population samples aged 70 (n = 312), 75 (n = 486) and 81 (n = 404) years. Anaemia defined either as blood haemoglobin concentration below the corresponding health-related lower reference limits or according to WHO was, in the total study groups, more common at age 81. Anaemia of unknown cause was rare, but somewhat more common at age 81. Mean blood haemoglobin concentrations in subsamples without definable disorders were significantly lower at age 81 than at ages 70 and 75, whereas the lower health related reference limits did not differ significantly. White blood cell counts tended to be lower and iron deficiency was somewhat more common at age 81. No significant differences were found in platelet counts or in the prevalence of low plasma cobalamin concentrations. These results indicate a fall in blood haemoglobin with advancing age. The arbitrary WHO criteria for anaemia are clinically applicable at age 70-81. PMID- 3264662 TI - Performance of the standard pseudoisochromatic plate test. AB - The Standard pseudoisochromatic Plate (SPP) test was administered to 346 normals, 55 anomalous trichromats, and 46 dichromats. Its ability to detect and classify congenital color defectives was assessed. The performance of each plate was assessed separately and compared with its colorimetric properties. The test as a whole achieves a high level of accuracy in separating normals from color vision defectives [Youden's Index (YI) = 92.4%] and a high reliability (71.3%) in classification of the congenital color vision defectives. The performance of individual plates in separating color normals and color vision defectives of individual plates varies (YI ranges from 69.8 to 86.1%). A set of three plates can be chosen, which achieves a performance similar to that of the whole test. The test is found to be a reliable clinical screening method for congenital red green color vision defectives. PMID- 3264661 TI - Atrial arrhythmias--the dominating cardiac problem in three patients with HLA B27 associated rheumatic disorders. AB - Three young patients with atrial arrhythmias as the probable consequence of an HLA B27 associated inflammatory disease process are described. They are presented as an expansion of the spectrum of cardiac manifestations that can be seen in patients with HLA B27 associated rheumatic disorders, and as possible evidence of myocardial involvement of this disease process. PMID- 3264663 TI - SS-B/La antigen purification, and ELISA detection of anti-SS-B/La antibodies in sera from patients with inflammatory connective tissue diseases. AB - SS-B/La antigen was purified by immunoadsorbent columns with immunoglobulin from a patient with primary Sjogren's syndrome. Monitoring of the purification was facilitated by the fused rocket-immunoelectrophoresis technique. Technical ELISA variables for the detection of serum antibodies against the SS-B/La antigen were evaluated, and a recommended procedure is described. Prospective investigation of anti-SS-B/La antibodies in 103 blood donors and 131 patients with chronic inflammatory connective tissue diseases, including 43 patients with primary Sjogren's syndrome was performed. Anti-SS-B/La antibody concentrations were above normal in 65% of the patients with primary Sjogren's syndrome (verified by the strictly objective Copenhagen criteria for keratoconjunctivitis sicca and xerostomia) and 9% of patients with other chronic connective tissue diseases. The predictive value for primary Sjogren's syndrome among patients with increased levels of the anti-SS-B/La antibodies attending a rheumatology clinic was 78%. PMID- 3264664 TI - Immunomodulating properties of lymphocytes activated by farmer's lung associated bacterium Thermoactinomyces vulgaris in vitro. AB - Thermoactinomyces vulgaris, one of the aetiological agents of farmer's lung, was analysed for its ability to activate non-immune spleen lymphocytes from 10- to 14 week-old mice. The lymphocytes were found to exert both enhancing and suppressing signals after activation, depending on the secondary stimulation used. The enhancing effect is due to interleukin-2 secreted mainly by L3T4+ lymphocytes. The suppressive action is associated with Lyt2+ lymphocytes, which are probably activated by prostaglandins or histamine; but the suppression inducer action of L3T4+ lymphocytes may also be important. Genetic regulation, independent of H-2K and D, was also detected between different inbred strains of mice in response to T. vulgaris. The genetic regulation appeared associated with the different responsiveness of Lyt-2 positive lymphocytes between different strains. These results emphasize the importance of nonspecific activation in hypersensitivity disorders induced by microbiol antigens. PMID- 3264665 TI - Male genital tract inflammation associated with increased numbers of potential human immunodeficiency virus host cells in semen. AB - In this study we investigated whether elevated levels of the inflammatory mediator granulocyte elastase in seminal plasma were associated with increased numbers of CD4+ T helper/inducer lymphocytes and monocytes/macrophages in semen, the principal host cells of the human immunodeficiency virus (HIV). Semen samples were obtained from 105 men attending an infertility clinic. CD4+ lymphocytes, monocytes/macrophages and cells expressing the common leukocyte antigen (CD45) were identified by monoclonal antibodies (MAb's) in a biotinstreptavidin immunoperoxidase technique. Granulocyte elastase levels in seminal plasma were determined by an enzyme-linked immunosorbent assay. In 17 men, granulocyte elastase levels were higher than 1000 ng/ml seminal plasma, indicating male genital tract inflammation. Compared to men with low/normal granulocyte elastase levels in semen (less than 250 ng/ml), these men showed significantly higher mean numbers of total leukocytes, CD4+ lymphocytes and monocytes/macrophages in semen (P less than 0.001); median cell numbers for the group with high/inflammatory granulocyte elastase levels were increased 38-fold for total leukocytes (19,800,000 versus 520,625 per ejaculate), 19-fold for monocytes/macrophages (2,594,000 versus 134,565), and 6-fold for CD4+ lymphocytes (82,900 versus 14,100). Because of the increased numbers of potential HIV-host cells in inflammatory semen, male genital tract inflammation may be an important cofactor in the sexual transmission of the human immunodeficiency virus. PMID- 3264666 TI - Nosocomial enterococcal infections: association with use of third-generation cephalosporin antibiotics. AB - Enterococcal infections consistently account for approximately 10% of all nosocomial infections reported to the Centers for Disease Control. There is concern that an increase in nosocomial enterococcal infection is due to the increased severity of inpatient illnesses and to the widespread use of broad spectrum beta-lactam antibiotics. Nosocomial enterococcal infections were analyzed at our medium-sized community hospital over a time period spanning 9 years. A significant increase in the infection rate was detected during the latter half of 1986. This increase was due primarily to a disproportionate rise in the incidence of the urinary tract as a site of infection. There were no associated clusters of infection, no predilection for certain patient care areas, and no preceding change in the hospital infection control policies and procedures. Total hospital use of cephalosporins remained stable during the period of increased enterococcal infections, but use of third-generation cephalosporins almost doubled in 1986 compared with the 4 preceding years. Selective pressure of third-generation cephalosporin use appeared to be a factor in the increased incidence of nosocomial enterococcal urinary tract infection. PMID- 3264667 TI - Freeway space measurement using mandibular kinesiograph and EMG before and after TENS. AB - This investigation expands on a previous pilot study of the effects of TENS on the resting position of the mandible. The tendency is for an increase in freeway space, but the variability of results makes individual evaluation essential. PMID- 3264668 TI - The oral allergy syndrome. AB - We have studied 262 patients suffering from hay fever and oral allergy syndrome after fruit and vegetable ingestion. The history and the results of RAST and skin test for pollen showed a contemporary presence of systemic and local symptoms in most of the patients; a close connection between age of onset of hay fever and oral allergy syndrome; a frequent association between allergy to some pollens and some vegetables, such as between apple, carrot, pear, cherry with birch pollen and tomato, melon, watermelon with grass pollen. PMID- 3264669 TI - [CK-MB isoenzyme in the diagnosis of myocardial infarction after myocardial revascularization surgery]. AB - The usefulness of measuring serum MB creatine kinase activity (CK-MB) for the diagnosis of per- and postoperative myocardial infarction (MI) was assessed in 104 patients undergoing coronary artery bypass grafts. In each patient, 15 samples were taken during the week which followed the surgical procedure. New Q waves were considered to be a criteria of MI. 19 patients developed new Q waves (MI group), whereas 57 had no significant ECG changes (control group); 13 showed only ST changes, whilst 15 had unassessable recordings. In the MI group, CK-MB was greater than in the control group, both at the first peak (8 to 10 h after induction of anaesthesia) and at the greater peak (13 to 21 h after induction) (p less than 0.05). Significant differences were also seen between both groups between 8 and 32 h after induction, but there was also a large overlap. An area under the curve (AUC) greater than 50,000 IU.l-1.min-1 had a positive predictive value of 0.64, and an AUC less than 50,000 IU.l-1.min-1 a negative predictive value of 0.89 if all the groups of patients were taken into account. An AUC greater than 65,000 IU.l-1.min-1 was always seen in MI patients, but only 25% of MI patients had a value greater than this threshold. There were no significant differences between the patient groups in the first peak time, nor in the CK MB/total CK ratio. CK-MB appeared therefore as a less reliable criterium of per- and postoperative MI during coronary artery bypass operations than previously reported, especially when intermediate values are found. PMID- 3264671 TI - [Use of propofol (Diprivan) in a patient with intermittent porphyria]. PMID- 3264670 TI - [The course of blood concentrations of propofol administered at a constant rate, combined with fentanyl]. AB - The blood concentration of propofol was studied in 14 ASA 1 informed patients, who were to undergo orthopaedic or plastic surgery lasting at least 90 min. Anaesthesia was induced with a 2 mg.kg-1 bolus of propofol together with 0.86 microgram.kg-1 fentanyl. This was followed by a constant rate infusion of propofol and fentanyl, 5 mg.kg-1.h-1 and 3 micrograms.kg-1.h-1 respectively. The mean duration of propofol infusion was 153 +/- 63 min, with extremes of 90 and 315 min. Propofol concentration was measured using gas phase chromatography on total arterial blood; the lower limit of detection was 0.05 mg.l-1. During the infusion, blood concentrations were found between 2 and 4 mg.l-1. It was 2.25 mg.l-1 at the fifth min; this was 80% of the concentration found at the 120th min. There was in fact no statistically significant difference between the values found at the 90th, 120th and 150th min. On stopping the infusion, the concentrations fell rapidly during the first 5 min, and then more slowly. By the 30th min, it had reached a value 4.5 times less than that at the end of the infusion. However, individual variations were found, which could explain delayed recovery. The calculated pharmacokinetic parameters were: elimination half-life = 41.7 +/- 20 min, clearance = 2.14 +/- 0.55 l.min-1 and equilibrium distribution volume = 43.4 +/- 15.2 l. These results are discussed. It is therefore possible to give propofol continuously at a constant rate without having any accumulative effect. PMID- 3264672 TI - B-cell compartment in the thymus of patients with myasthenia gravis and control subjects. AB - An increased number of CD19, 20, and 22 positive B cells, compared to the number of Ig-positive cells, is regularly found in the thymic medulla of normal thymus, suggesting that a B-cell population normally resides in thymic medulla that lacks Ig expression. However, some of the CD20-positive cells seem to co-express keratin and MR19, suggesting an epithelial origin. The medullary B cells found in normal thymus could be precursors of the tumor cells in "mediastinal clear cell lymphomas of B-cell type." In follicular hyperplasia in MG, the medullary epithelial network is deformed and partly destroyed, and the interlobular/perivascular spaces are expanded. Follicles with follicular dendritic cells are found in both interlobular/perivascular spaces and "punched out" lesions in the medullary epithelium. The B cells are greatly increased in MG thymuses compared with control thymuses. These cells are found mainly in the follicles, but they are also dispersed in the medulla and the interlobular/perivascular spaces. The immunophenotype and distribution of B and T cells as well as the follicular dendritic cells in the hyperplastic follicles are similar to those of reactive follicles in lymph nodes. Our findings are consistent with the contention that in MG there is an autoimmune activation of B cells that normally reside in the thymic medulla. This activation leads initially to follicular hyperplasia in the medullary epithelium with destruction of medullary epithelial cells. The prolonged immune reaction in the autoimmune process induces a fibronectin-rich stroma formation and increased vascularization. The result is a remodeling of the thymic architecture with expansion of the perivascular/interlobular spaces replacing the destroyed medulla. PMID- 3264673 TI - Interleukin-2 blocks oligodendrocyte progenitor proliferation. PMID- 3264674 TI - Alterations in the pattern of MHC restriction of T cells in relapsing murine experimental allergic encephalomyelitis. PMID- 3264675 TI - T-cell clones specific to acetylcholine receptor, its subunits, and peptides. PMID- 3264676 TI - Glioblastoma-cell-derived T-cell suppressor factor (G-TsF). Sequence analysis and biologic mechanism of G-TsF. PMID- 3264677 TI - Expression of leukocyte antigens on an oligodendroglial cell line. PMID- 3264678 TI - Accessory cell competence of human glial cells in mitogenic activation of resting peripheral T cells. PMID- 3264679 TI - Responsiveness of myasthenia gravis lymphocytes to recombinant interleukin-2. PMID- 3264680 TI - Effect of lymphoid irradiation on clinical course, lymphocyte count, and T-cell subsets in chronic progressive multiple sclerosis. PMID- 3264681 TI - Suppression of experimental allergic neuritis by cyclosporin A. PMID- 3264682 TI - Low-dose cyclosporin A induces relapsing experimental allergic encephalomyelitis in the Lewis rat. PMID- 3264684 TI - Inhibition of experimental allergic encephalomyelitis by a new anti-inflammatory compound--SK&F 86002. PMID- 3264683 TI - Effects on experimental allergic neuritis in rats by in vivo treatment with monoclonal anti-T-cell antibodies. PMID- 3264685 TI - Anti-CD4 monoclonal antibody therapy of experimental allergic encephalomyelitis in longtailed macaques. PMID- 3264686 TI - Sera from patients with multiple sclerosis react with human T-cell lymphotropic virus-I GAG proteins: Western blotting and solid-phase radioimmunoassay analyses. PMID- 3264687 TI - Impaired measles-specific cytotoxic T-cell response in subacute sclerosing panencephalitis. PMID- 3264688 TI - Evidence for an immunosuppressive autoantibody in experimental allergic encephalomyelitis. PMID- 3264689 TI - Adoptive transfer experimental autoimmune encephalomyelitis. Evidence for central nerve and spinal root dysfunction. PMID- 3264690 TI - Interleukin-2 levels in serum and cerebrospinal fluid of multiple sclerosis patients. AB - A sensitive enzyme-linked immunosorbent assay method was employed to measure interleukin-2 (IL-2) levels in cerebrospinal fluid (CSF) and sera from 30 patients with multiple sclerosis (MS) and 8 patients with other neurological diseases. Detectable levels of IL-2 were found in 6 sera and 9 CSF samples of 21 patients with acute relapse of MS. However, only 3 patients showed measurable IL 2 both in CSF and in serum. IL-2 was not detected in specimens from 9 patients with chronic-progressive MS, whereas high levels were found in 2 CSF samples from patients with aseptic meningitis. Our data suggest that systemic activation of a T-cell population is present in some MS patients; moreover, an active immune mechanism involving IL-2 production takes place within the central nervous system. PMID- 3264691 TI - Lymphocytotoxic autoantibodies in progressive systemic sclerosis. AB - In 53 patients with progressive systemic sclerosis (PSS) the lymphocytotoxic activity of their serum was measured in a microlymphocytotoxicity assay. In 21 of the 53 patients the test reacted distinctly positively in the heterologous system, and in 9 of these 21 also in the autologous system. After preparation of the immunoglobulins from these positive sera, whole cytotoxic activity was detected only in the IgM fraction but not in the IgG fraction. When using prepared T lymphocytes as target cells in the microlymphocytotoxicity test, the cytotoxic activity of the positive PSS sera showed itself to be directed against this lymphocyte population. Further analysis using the Western-blot technique showed that the IgM autoantibody in PSS sera reacted with the cell surface of CD4+ lymphocytes. The cross reactivity with extractable nuclear antigens was rather improbable. These results suggest that lymphocytotoxic autoantibodies may play a role in immunological disturbances in PSS. PMID- 3264692 TI - Immunoglobulin allotype Gm(1,2;21) in ankylosing spondylitis with peripheral arthritis. AB - Frequencies of immunoglobulin G (Gm) allotypes were determined in 240 patients with ankylosing spondylitis (AS). The uncommon phenotype Gm(1,2;21) was increased in frequency in 55 patients with AS and peripheral arthritis (14.5% v 3.5% of healthy blood donors; p less than 0.05). In 16 patients with arthritis only of wrist/hand or ankle/forefoot, or both, the Gm(1,2;21) frequency was even higher (31.3%; p less than 0.0005). Patients with AS negative for the HLA antigen B27 (n = 28) differed from the B27 positive patients (n = 205) with regard to the frequency of the Gm(1,2,3;5,21) phenotype (39.3% v 9.3%; p less than 0.0005). These findings support the notion of genetic heterogeneity among patients with AS. PMID- 3264693 TI - Correlation of the activation of the fourth component of complement (C4) with disease activity in systemic lupus erythematosus. AB - Levels of C4d, a fragment of C4 generated during activation of the classical complement pathway, were measured in the plasma of 48 patients with systemic lupus erythematosus, 11 with inactive (group 1), 23 with mildly active (group 2), 14 with moderately/severely active disease (group 3), and 30 healthy subjects. Levels of C3d, C4, and C3 were also measured and the C4d/C4 and C3d/C3 ratios calculated. C4d levels correlated with the degree of disease activity, being higher in group 3 than in group 2, in group 2 than in group 1, and in group 1 than in controls. C4d/C4 gave a similar result. Activation indices of the common complement pathway, C3d and C3d/C3, also correlated with disease activity, but in a non-linear relationship, failing to discriminate between patient groups. C4 and C3 showed no correlation with disease activity. These results indicate that indices of C4 activation, C4d and C4d/C4, provide a laboratory measure of disease activity in lupus patients, for whom an objective assessment of the severity of the disease is not readily available. PMID- 3264694 TI - Clinical and autoantibody correlations in Orientals with systemic lupus erythematosus. AB - Serum samples from 94 patients with systemic lupus erythematosus (SLE) from a medical unit in Singapore were analysed for autoantibodies of 10 different specificities. The prevalence of antibodies to the following antigens was as follows: double stranded (ds) DNA (43%), histone (81%), Sm (26%), nuclear ribonuclear protein (nRNP) (32%), SS-A(Ro) (63%), SS-B(La) (12%), SL/Ki (9%), ribosomal RNP (rRNP) (16%), p70/p80 (5%), proliferating cell nuclear antigen (PCNA) (3%). Except for a higher prevalence of anti-SS-A(Ro), other autoantibodies were within the range reported from Western countries, indicating a high uniformity of autoantibody profiles in SLE in different countries. Patients with neuropsychiatric manifestations showed a higher plurality of antibodies per patient than patients without neuropsychiatric symptoms, 4.22 v 2.77. Patients with anti-Sm were more likely to have active lupus disease. There was no increased prevalence or specific type of autoantibody in those with renal manifestations. PMID- 3264695 TI - An evaluation of the dynamic qualities of isometric grip strength. AB - A strain gauged torsion dynamometer linked to a microprocessor was used to assess the dynamic qualities of isometric grip strength in patients with rheumatic diseases. Maximum grip strength, time to maximum grip, and percentage fatigue provide independent information on the grip. Time to maximum grip does not appear to be an objective correlate of subjective stiffness. The usefulness of these dynamic variables for the assessment of stiffness appears limited in arthritic disease, where pain may interfere with the maximum voluntary effort of the test. PMID- 3264696 TI - Ankylosing spondylitis without B27: no evidence for gene conversion. AB - Isoelectric focusing gel electrophoresis was used to look for variant HLA molecules in five patients with HLA-B27 negative ankylosing spondylitis (AS). The isoelectric points of the HLA-A and B antigens from these patients and HLA paired controls were identical. This implies that the HLA-A and B antigens from the patients with AS and the controls are similar. Gene conversion of a nucleotide sequence from a B27 positive gene is thus unlikely to be the explanation for the existence of AS in patients who are HLA-B27 negative by alloantisera typing. PMID- 3264697 TI - Mechanism of anaemia in rheumatoid arthritis: demonstration of raised interleukin 1 beta concentrations in anaemic patients and of interleukin 1 mediated suppression of normal erythropoiesis and proliferation of human erythroleukaemia (HEL) cells in vitro. AB - The pathogenesis of the anaemia associated with rheumatoid disease is unclear. It has previously been shown that the degree of the anaemia correlates with the severity of the inflammatory disease and that serum from patients with arthritis inhibits erythropoiesis. This study was designed to examine whether interleukin 1 could be a mediator of the anaemia in rheumatoid arthritis. Radioimmunoassay of interleukin 1 beta in serum showed that patients with rheumatoid arthritis and associated anaemia had significantly higher interleukin 1 beta concentrations than patients with rheumatoid arthritis without anaemia. Pure recombinant human interleukin 1 alpha and interleukin 1 beta, in concentration ranges similar to those found in the arthritic patients, markedly suppressed the colony formation of the erythroid, but not the granulocyte-macrophage progenitor cells in cultures of normal bone marrow. Natural human interleukin 1 and recombinant interleukin 1 beta, but not interleukin 1 alpha, suppressed in a dose dependent manner the proliferation of the human erythroleukaemia cell line (HEL) in cultures, suggesting that the interleukin 1 effect is a direct one. The results show that interleukin 1 is a humoral inhibitor of erythropoiesis and suggests that interleukin 1 is involved in the development of anaemia in association with rheumatoid arthritis. PMID- 3264699 TI - Inhibition of hepatic fatty acid oxidation by bezafibrate and bezafibroyl CoA. AB - The acute effect of the hypolipidemic agent bezafibrate on fatty acid oxidation was studied in rat hepatocytes and mitochondria. Bezafibrate caused a concentration-related inhibition of oleate oxidation in liver cells. In mitochondria bezafibrate inhibited the oxidation of palmitoyl CoA but had no effect on palmitoylcarnitine oxidation, suggesting the site of inhibition was the formation of the carnitine derivative. Bezafibrate and bezafibroyl CoA inhibited the overt carnitine palmitoyltransferase (I) in rat liver mitochondria with comparable potency but with distinct kinetics. The inhibition caused by bezafibrate was not prevented by omission of Mg++-ATP from the assay mixture, indicating activation of bezafibrate to bezafibroyl CoA was not required for inhibition. The data demonstrate that bezafibrate, like several other peroxisome proliferating agents, inhibits mitochondrial fatty acid oxidation in rat liver. The inhibition may be relevant to the mechanism of peroxisome proliferation. PMID- 3264698 TI - Outcome of pregnancy in patients with autoimmune rheumatic disease before the disease onset. AB - The outcomes of 419 pregnancies of 154 unselected patients with various auto immune diseases, including 390 pregnancies before the disease onset, were studied retrospectively. The patients comprised 40 with systemic lupus erythematosus (SLE), 72 with rheumatoid arthritis, 21 with primary Sjogren's syndrome (1 degree SS), 14 with progressive systemic sclerosis (PSS), and seven with mixed connective tissue disease. The histories of 267 pregnancies of 98 healthy, age matched women served as controls. Our data indicate that compared with healthy controls autoimmune patients do not experience a higher incidence of fetal loss. The incidence of fetal loss before disease onset in the various groups of autoimmune patients (as well as after disease onset in patients with SLE and RA) was not significantly different from that of controls. Spontaneous abortions in patients with 1 degree SS and PSS before disease onset occurred significantly more frequently (p less than 0.05) than in controls. Nevertheless, it should be noted that this was not the case when the incidence per woman was considered. On the other hand, patients with SLE, both before and after disease onset, experienced a higher incidence of premature deliveries (p less than 0.05). Finally, the analysis of autoantibody profiles, including antibodies to nuclear antigens, to Ro(SSA) cellular antigen, to double stranded DNA, and to cardiolipin, could not demonstrate any association of autoantibodies with any particular pregnancy outcome. PMID- 3264700 TI - Selective inhibition of cholesterol side-chain cleavage by potential pro-drug forms of aminoglutethimide. AB - Potential pro-drugs for aminoglutethimide (1) an agent used for the treatment of hormone-dependent breast cancer have been synthesized, namely the azo-(2), azoxy (3) and hydrazo-(4) derivatives. These compounds have been tested for inhibitory action towards the two main target enzymes for 1, aromatase and the cholesterol side-chain cleavage enzyme complex, P-450scc. None inhibited aromatase but 3 and 4 inhibited P-450scc, the respective IC50 values being about twice and one-half that for 1. Compounds 1 and 3 were also tested as inhibitors of the 17 alpha hydroxylase-C17,20 lyase complex in comparison with ketoconazole which acts against prostatic cancer by this mechanism. The azoxy-derivative 3 was a weak inhibitor but 1 was inactive. PMID- 3264701 TI - Isolation of an antiidiotypic antibody with acetylcholine-receptor-like binding properties from myasthenia gravis patients. AB - The network theory predicts that a subpopulation within the antiidiotypic (anti Id) antibody response will be the internal image of the priming stimulus. In myasthenia gravis, a portion of the anti-acetylcholine-receptor (anti-AChR) antibody repertoire is directed against the ligand-binding site. These antibodies would be expected to elicit an "anti-idiotype" which is the internal image of the receptor-binding site and hence may also bind cholinergic ligands. We have utilized this theoretical specificity to isolate anti-Id antibodies with AChR like ligand-binding properties from the serum of 4 myasthenia gravis patients using a choline affinity column. Affinity-purified antibodies from one patient were characterized and found to exhibit binding properties similar to the AChR for various cholinergic ligands. PMID- 3264702 TI - Some aspects of idiotypic networks: self/non-self discrimination, selection of available repertoires and broken mirrors. PMID- 3264703 TI - The start of an autoimmune disease: idiotypic network during early progression of myasthenia gravis. AB - Anti-acetylcholine-receptor antibodies of IgG and IgM classes and antiidiotypic antibodies were determined in patients with myasthenia gravis at various times after the start of the disease. Patients with a disease duration of less than one year had a higher prevalence of antiidiotypic antibodies (31/32) than patients who had had the disease for more than 5 years (49/79), and the concentration of antiidiotypic antibodies was also higher in patients with early disease (p less than 0.005). The concentrations of antiidiotypic antibodies decreased during progression of the disease concomittant with an increase in IgG anti-receptor antibodies. A change from IgM to IgG anti-receptor antibody production was also found. In two patients, who developed myasthenia after bone-marrow grafting and who were followed before start of disease, antiidiotypic antibodies appeared before anti-receptor antibodies and before symptoms of myasthenia were present. The high prevalence and concentration of antiidiotypic antibodies in early disease indicate that development and expression of antiidiotypic antibodies are important in early myasthenia gravis. PMID- 3264704 TI - Idiotypic analyses of anti-DNA antibodies in systemic lupus and monoclonal gammopathy. PMID- 3264705 TI - Genetics of the induction of antigen-specific immunity in anti-idiotype-treated mice and derivation of monoclonal Ab3 antibodies. AB - Antiidiotypic antibodies can be used as a means other than antigen of clone specific intervention in the immune system. In a number of cases, antiidiotypic antibodies induce potent, antigen-specific responses without exposure of the recipient animals to antigen, and a better understanding of such responses will aid in the application of idiotype manipulation to both immunological and practical problems. The Ia. 7 system expresses a major, cross-reactive idiotype on antibodies to an epitope of the mouse I-E antigen. Here, we examine genetic control of the I-E-specific response to anti-idiotype in this model system. Results demonstrate that both heavy chain allotype-linked and non-allotype-linked loci contribute to the control of this response. In addition, monoclonal antibodies representing the non-antigen-specific portion of the Ab3 response were derived. Two idiotype-positive clones were demonstrated to be of IgM isotype, contrasting with previous data showing that the serum Ab3 response is predominantly IgG1. PMID- 3264706 TI - Generation and removal of anaphylatoxins during hemofiltration with five different membranes. AB - The generation of anaphylatoxins (C3a and C5a) during hemofiltration with polysulfone (F60), acrylonitrile (AN69 HF), polyamid (FH77), polyacrylonitrile (PAN200) and cellulose-acetate (Duo-Flux) membranes were investigated. The 'net' production of C3a in the blood compartment during the treatment was 3,028 micrograms (Duo-Flux), 1,845 micrograms (FH77), 270 micrograms (F60), -2,388 micrograms (AN69 HF) and -5,189 micrograms (PAN200), the latter two negative values reflecting a high adsorption of C3a to the membrane material. Corresponding values for C5a were 185 micrograms (AN69 HF), 108 micrograms (F60), 83 micrograms (PAN200), 6 micrograms (FH77) and -133 micrograms (Duo-Flux). The sieving coefficient remained stable for C5a throughout the treatment, while it fell significantly for C3a with the F60 membrane (0.44-0.25) and increased significantly for the FH77 membrane (0.14-0.33). The cellulose-acetate membrane device produced the most pronounced drop in white blood cell counts and the acrylonitrile membrane the least. The Duo-Flux device was significantly less biocompatible than the other membranes investigated, while little differences were found between AN69 HF, F60, FH77 and PAN200. When hemodialysis is compared with hemofiltration employing the same membranes, the latter appears to be a more biocompatible treatment modality partly due to convective removal of activated complement from the blood compartment into the filtrate. PMID- 3264707 TI - Coronary endarterectomy: the long-term local effects. AB - The chronic effects of manual endarterectomy of coronary arteries are described. Nine male patients (age, 58-70 years) had undergone right coronary endarterectomy and bypass grafting 6-9 years prior to death and autopsy. One of the nine endarterectomized arteries had thrombosed soon after the procedure, while the other eight had maintained blood flow for up to eight years. These patent arteries had variable myofibrointimal proliferation ranging from mild to marked, the latter with significant stenosis. Recurrent atherosclerosis was present focally in two endarterectomized arteries. Death had occurred from causes unrelated to pathology in the endarterectomized vessels and provided a unique opportunity to assess the variable long-term effects of this form of arterial injury. PMID- 3264708 TI - Prolonged sedation with propofol in ICU patients: recovery and blood concentration changes during periodic interruptions in infusion. AB - Propofol (mean dose 2.85 mg kg-1 h-1) was administered for 4 days by continuous i.v. infusion for sedation in 14 agitated and restless ICU patients. This provided rapid control of the level of sedation. When the infusion was discontinued, adequate recovery with response to commands was obtained in most patients by 10 min. Recovery times and the decrease in blood propofol concentration were similar after 24, 48, 72 and 96 h of infusion. Cumulative effects, tachyphylaxis, or other untoward effects were not observed. PMID- 3264709 TI - Comparison of propofol and thiamylal for induction and maintenance of anaesthesia for outpatient surgery. AB - In an open, randomized study we have compared the safety and efficacy of propofol with thiamylal for induction and maintenance of anaesthesia supplemented by nitrous oxide in elective termination of pregnancy. Induction of anaesthesia was achieved with either propofol 2.5 mg kg-1 or thiamylal 4.0 mg kg-1 followed by maintenance with 70% nitrous oxide in oxygen and repeat boluses of 25% of the induction dose i.v. as indicated clinically. Both drugs induced and maintained anaesthesia reliably, with some minor differences. Recovery from propofol was significantly more rapid. The patients in the propofol group were alert and orientated early in the postoperative period, with less nausea or vomiting. Propofol has properties that are of particular benefit in anaesthesia for ambulatory surgery. PMID- 3264710 TI - Effect in man of aspirin, standard indomethacin, and sustained release indomethacin preparations on gastric bleeding. AB - 1. We have compared acute gastric bleeding caused by a new slow release preparation of indomethacin (indomethacin Continus) with that caused by aspirin and other indomethacin preparations. 2. In a randomized crossover study, blood loss into timed gastric aspirates was determined in 20 healthy volunteers after receiving, over 96 h, either placebo, aspirin (600 mg four times daily; 17 doses) indomethacin BP (50 mg three times daily; 13 doses), Indocid-R (75 mg twice daily; 9 doses) or indomethacin Continus (75 mg twice daily; 9 doses). A venous blood sample was also taken during each treatment period for subsequent determination of alpha 1-glycoprotein, and for drug assay. 3. Gastric bleeding on placebo was 1.4 (0.7-2.8) microliters 10 min-1 (mean, 95% confidence interval). Both aspirin and the indomethacin preparations caused significantly more bleeding (P less than 0.05). Rates of bleeding after aspirin, indomethacin BP, Indocid-R, and indomethacin Continus were respectively 22.0 (10.7-47.2) microliters 10 min 1, 4.4 (2.2-9.1) microliters 10 min-1, 10.8 (5.3-22.3) microliters 10 min-1, and 5.1 (3.0-10.6) microliters 10 min-1. 4. Rates of bleeding after indomethacin BP and indomethacin Continus, but not Indocid-R, were significantly less than after aspirin (P less than 0.01). 5. Salicylate or indomethacin was detectable in the plasma of all subjects after the active treatment periods, except for one instance involving a subject allocated indomethacin BP. Indomethacin levels were significantly higher 2 h after Indocid-R than with indomethacin BP or indomethacin Continus. 6. alpha 1-acid glycoprotein levels were not significantly affected by prior treatment with aspirin or indomethacin. PMID- 3264711 TI - Extended blood collection period required to define distribution and elimination kinetics of propofol. AB - The pharmacokinetics of propofol were investigated following bolus intravenous administration of 2-3 mg kg-1 of drug to eight surgical patients. Apparent elimination half-life, volume of distribution and systemic blood clearance of propofol correlated strongly with the sampling period, which ranged from 8 to 52 h, depending on the time taken for the propofol concentration to reach the detection limit of the assay. In the three patients in whom the sampling period exceeded 42 h, apparent elimination half-life (55.6 h) and apparent volume of distribution (1370 l) greatly exceeded previously published estimates and systemic blood clearance (1020 ml min-1) was much less than previous estimates. This suggests that previous estimates were biased by the relatively short duration of blood collection in those studies (8 to 12 h). PMID- 3264712 TI - Painless post-operative pancreatitis. PMID- 3264713 TI - Haemorrhagic-erosive gastritis, a study of 350 endoscopically identified cases. PMID- 3264714 TI - Efficacy of chemoimmunotherapy with cyclophosphamide, interleukin-2 and lymphokine activated killer cells in an intraperitoneal murine tumour model. AB - We have previously reported on the efficacy of intraperitoneal (i.p.) immunotherapy with interleukin-2 (IL-2) and adoptively transferred lymphokine activated killer (LAK) cells in an i.p. murine tumour model. Because of a dose limiting toxicity associated with IL-2, cures are seldom observed. The development of treatment strategies that combine components that augment or synergise with the antitumour activity of IL-2 is crucial for the successful use of IL-2 in a clinical setting. Because of the known toxicity of high-dose IL-2 or high dose cyclophosphamide (CY) treatment, the goal of our experiments was to investigate the efficacy of chemoimmunotherapy with low or moderate doses of cyclophosphamide (CY) in combination with low or moderate doses of IL-2 with or without adoptively transferred LAK cells. Assessment of i.p. tumour growth 14 days after tumour inoculation, using the peritoneal cancer index (PCI) scoring system, demonstrated that combination treatment of established (day 3) i.p. tumour was clearly superior to single modality treatment. The effect was further enhanced by a second dose of CY at the end of a course of IL-2. Combination treatment led to a significant survival benefit. About 25% of the mice were cured, even when the dose of tumour cells at inoculation was increased. These experiments demonstrate the efficacy of combined treatment with IL-2, LAK cells and CY. Further research should be directed at the design of treatment schedules based on repetitive courses of chemoimmunotherapy associated with little toxicity. PMID- 3264715 TI - Human ovarian carcinoma: evidence for patient-related differences in susceptibility to cytotoxic effectors that attack different cellular subpopulations within a tumour. AB - Human ovarian carcinoma cells obtained from ascites were tested for susceptibility to lysis by peripheral blood NK cells, alpha-interferon-activated NK cells, and interleukin 2-activated killer cells. Cryopreserved tumour cell preparations were used to allow repeated testing of the same target, and the tumour cells were fractionated using albumin density gradients to determine if fractions containing clonogenic (stem) cells were killed. Four tumour cell donors were studied and each showed a different pattern of susceptibility of unfractionated tumour to lysis by different effector cells. Using fractionated tumour cells, we found that NK and interferon-activated NK cells did not always lyse cells in the clonogenic fractions and that interferon activation could in some cases shift killing away from the clonogenic fractions and towards the peak of proliferating (but not self-renewing) colony forming cells. Interleukin 2 activated killer cells (LAK) however, killed the fractions containing clonogenic cells in all 4 cases. The magnitude of killing seen when fractions of the original tumour were tested were often striking when compared to lysis of the unfractionated cells. Apparent heterogeneity between patients and stem cell susceptibility to effector cells may be important determinants of the efficacy of treatment of patients with biologic response modifiers such as interferon and interleukin 2. PMID- 3264716 TI - Phenotypic and functional T cell subset abnormalities in patients with aplastic anaemia and hypogammaglobulinaemia. AB - We have investigated T cell abnormalities present in blood of two patients with aplastic anaemia and hypogammaglobulinaemia. There was a marked increase in class II, major histocompatibility complex, HLA-DR+ antigen, and interleukin-2 receptor (Tac+) bearing CD4+ helper/inducer T cells, and a concurrent reduction of CD8+ suppressor/cytotoxic T cells. These CD4+ T cells produced an elevated proliferative response to phytohaemagglutinin and concanavalin A. Interestingly, the T cell subset mainly responsible for elevated production of the lymphokine, interleukin-2, under the stimulus of phytohaemagglutinin, was characterized as belonging to a CD4+ T cell subset. Functional studies, using a pokeweed mitogen driven IgG, IgA and IgM synthesis, demonstrated a correlation between CD4+ T cell deficient helper function for B cell differentiation and the clinical finding of the patient's hypogammaglobulinaemia. PMID- 3264717 TI - Relationship between internalization and cytotoxicity of ricin A-chain immunotoxins. AB - Immunotoxins (ITs) appear to vary considerably in their killing efficiency towards antigen positive cells. In order to unravel the mechanisms underlying these differences, the parameters responsible for these variations were studied. The efficacy of the monoclonal antibodies (MoAbs) WT32 (CD3), OKT4 (CD4), T101 (CD5), WT1 (CD7) and WT82 (CD8) conjugated to ricin A-chain was expressed by the extent of protein synthesis inhibition of four leukaemic T cell lines (CEM, GH1, Jurkat and HPB-ALL). Large differences in cytotoxicity were observed. Efficient inhibition of protein synthesis was seen with anti-CD3 IT, anti-CD5 IT and anti CD7 IT. In these cases the cytotoxicity was related to the antigen density on the target cell membrane. Anti-CD4 IT inhibited poorly and anti-CD8 IT was ineffective, even on cell lines with a high expression of the corresponding antigen. When antigen density and cytotoxicity were plotted for all CD antigens, no correlation could be found. Subsequently, internalization was studied with 125Iodine-labelled antibodies. Anti-CD7 showed the fastest internalization rate, followed by anti-CD3 and anti-CD5. Anti-CD4 and anti-CD8 antibodies were respectively moderately and hardly internalized. When the absolute amount of internalized MoAb was calculated, a highly significant correlation with cytotoxicity was found. We conclude that the degree of antigen expression is not so important as the absolute amount of antibody internalized in predicting the efficacy of ITs. PMID- 3264718 TI - Plasminogen activator inhibitor (PAI-1) in plasma and platelets. AB - The distribution of PAI-1 in the plasma and platelets of normal individuals and of patients with platelet abnormalities was studied. An ELISA, capable of measuring PAI-1 in plasma at 1.5 ng/ml, and a functional assay of t-PA inhibition were used to assay platelet-free plasma (PFP), platelet-rich plasma in which the platelets were lysed (PRP) and serum. The PAI-1 concentration of normal PFP was 21.0 +/- 7.2 ng/ml (mean +/- SD) and those of PRP and serum were 282.6 +/- 68.0 and 270.3 +/- 71.9 ng/ml. The concentration of PAI-1 in PRP was proportional to the platelet count with 0.67 +/- 0.18 ng/10(6) platelets. Patients with thrombocytopenia had approximately normal PAI-1 concentrations in PFP; the extremely low concentrations in serum or PRP reflected the platelet count. A patient with grey platelet syndrome showed a comparable pattern, confirming that PAI-1 occurs in the platelet alpha-granules and indicating that the plasma concentration of PAI-1 is independent of the platelet pool of PAI-1. The median inhibitory activities towards t-PA were 1.6, 8.7 and 8.3 units/ml in normal PFP, PRP and serum respectively. PAI-1 in PFP had a median specific activity (units/mg PAI-1) about 5-fold higher than platelet PAI-1. Plasma and platelets represent two distinct pools of PAI-1, both of which should be considered in studies on the relationship between circulating PAI-1 and thrombotic disease. PMID- 3264719 TI - Pneumocystis carinii pneumonia as a complication of desferrioxamine therapy. PMID- 3264720 TI - False positive tests and serum sickness. PMID- 3264721 TI - Rapidly progressive cervical cancer: is it a real problem? AB - The appearance, in younger women, of a rapidly progressive form of cervical carcinoma has been suggested. This, together with evident deficiencies in the provision and technique of screening services, has been taken to indicate a need for more frequent screening. We show that a substantial increase in the observed number of such rapidly progressive cancers would be expected simply on the basis of changes in population structure, a general increase in cervical cancer rates and increases in the proportion of women screened. PMID- 3264722 TI - Fetomaternal macrotransfusion in the Yorkshire region. 1. Prevalence and obstetric factors. AB - The prevalence of fetomaternal macrotransfusion (FMMT), defined as fetomaternal haemorrhage (FMH) greater than or equal to 10 ml, was calculated in a series of 15,724 postpartum Kleihauer tests recorded in six hospitals. The mean prevalence in this retrospective survey, the largest published to date, was 0.83% (SEM 0.22) but values varied according to the technique used to quantify the volume of FMH. A number of obstetric factors that have been suggested as influencing the occurrence and extent of FMMT were examined. The frequencies of these factors in cases with FMMT were compared with those in a control group without FMMT selected from the same population. Manual removal of the placenta (P less than 0.0001) and fetal distress in labour (P less than 0.0001) occurred significantly more frequently in the case group. We are unable to confirm previous reports that other obstetric factors may influence the occurrence and extent of FMMT. PMID- 3264723 TI - Oligonucleotide N-alkylphosphoramidates: synthesis and binding to polynucleotides. AB - A few different methods for the preparation of oligonucleotide N alkylphosphoramidates were compared directly. One of these, involving the use of protected nucleoside phosphites as building blocks, provided the requisite N alkylphosphoramidates via oxidation of the intermediate dinucleoside methyl phosphites with iodine in the presence of the appropriate alkylamine. This method was found to have several attractive features, including the use of building blocks identical with those employed for the synthesis of DNA and compatibility with procedures and instruments employed for the stepwise synthesis of oligonucleotides by solution and solid-phase methods. This procedure was used to make several di-, tri-, and tetranucleotide N-alkylphosphoramidates derived from deoxyadenosine and thymidine; alkyl substituents included N,N-dimethyl, N-butyl, N-octyl, N-dodecyl, and N-(5-aminopentyl). The aminoalkyl derivative of d(TpT) (24) was used to demonstrate the feasibility of introducing an intercalative agent to the alkylphosphoramidate moiety of such derivatives. The oligonucleotide N-alkylphosphoramidates were separated into their component diastereomers and characterized structurally by a number of techniques including circular dichroism, high-field 1H NMR spectroscopy, FAB mass spectrometry, and enzymatic digestion to authentic nucleosides and nucleotides. Physicochemical characterization of several di- and trinucleotide alkyl-phosphoramidates revealed that the adenine nucleotide analogues formed stable complexes with poly (thymidylic acid). The stabilities of these complexes were found to increase with increasing chain length of the N-alkylphosphoramidate substituents. The finding that N-alkylphosphoramidate substituents can enhance the binding of certain oligonucleotides to their complementary polynucleotides suggests the existence of a novel source of polynucleotide affinity. PMID- 3264724 TI - Biological properties of two models of calcitonin gene related peptide with idealized amphiphilic alpha-helices of different lengths. AB - Previous studies on calcitonin gene related peptide (CGRP) have demonstrated that it has the characteristics of an amphiphilic peptide, and from an examination of the sequence, we have proposed that it contains an amphiphilic alpha-helix. We have synthesized two analogues of CGRP which have different lengths of idealized amphiphilic alpha-helical secondary structure. The first model, CGRM-1, has been substituted with residues generating an idealized amphiphilic alpha-helix in the region between residues 8 and 25, equivalent to approximately five turns of an alpha-helix. This peptide is not an agonist in any of our bioassays, but it does bind with low affinity to rCGRP receptors in crude liver membranes. Our second model, CGRM-2, has an idealized amphiphilic alpha-helix between residues 8 and 18, which is equivalent to approximately three turns of an alpha-helix. In an in vitro rat vas deferens assay, this peptide is an agonist with a potency one fourth that of the native hormone. However, the potency of CGRM-2 in an adenylate cyclase assay is much lower, only 1/140th the potency of CGRP. Both model peptides display amphiphilic characteristics commensurate with their design. We conclude that there is an amphiphilic alpha-helix in rCGRP between residues 8 and 18 and that this helix terminates in the vicinity of residue 18. PMID- 3264725 TI - Amino acid sequence and posttranslational modifications of human factor VIIa from plasma and transfected baby hamster kidney cells. AB - Blood coagulation factor VII is a vitamin K dependent glycoprotein which in its activated form, factor VIIa, participates in the coagulation process by activating factor X and/or factor IX in the presence of Ca2+ and tissue factor. Three types of potential posttranslational modifications exist in the human factor VIIa molecule, namely, 10 gamma-carboxylated, N-terminally located glutamic acid residues, 1 beta-hydroxylated aspartic acid residue, and 2 N glycosylated asparagine residues. In the present study, the amino acid sequence and posttranslational modifications of recombinant factor VIIa as purified from the culture medium of a transfected baby hamster kidney cell line have been compared to human plasma factor VIIa. By use of HPLC, amino acid analysis, peptide mapping, and automated Edman degradations, the protein backbone of recombinant factor VIIa was found to be identical with human factor VIIa. Neither recombinant factor VIIa nor human plasma factor VIIa was found to contain beta hydroxyaspartic acid. In human plasma factor VIIa, the 10 N-terminally located glutamic acid residues were found to be fully gamma-carboxylated whereas 9 full and 1 partial gamma-carboxylated residues were found in the corresponding positions of the recombinant factor VIIa molecule. Asparagine residues 145 and 322 were found to be fully N-glycosylated in human plasma factor VIIa. In the recombinant factor VIIa, asparagine residue 322 was fully glycosylated whereas asparagine residue 145 was only partially (approximately 66%) glycosylated. Besides minor differences in the sialic acid and fucose contents, the overall carbohydrate compositions were nearly identical in recombinant factor VIIa and human plasma factor VIIa.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264726 TI - Endosomes differ from plasma membranes in the phospholipid molecular species composition. AB - 125I-Labeled epidermal growth factor was incorporated into and highly concentrated in endosomes of Chinese hamster V79-UF cells during incubation at 37 degrees C for 8 min after binding to its receptors on the cell surface at 4 degrees C. From the labeled cells, endosomes were isolated by isopycnic centrifugation on a Percoll density gradient and then sucrose density gradients. The isolated endosomes were mostly free from contamination by Golgi, endoplasmic reticulum, lysosome, plasma membrane and mitochondria. Endosome membranes were found to differ from plasma membranes in the phospholipid composition. Sphingomyelin and phosphatidylserine were enriched in endosomes, compared with plasma membranes. Diacylphosphatidylcholine and diacylphosphatidylethanolamine were major phospholipids of the membranes in both organelles. The contents of molecular species of diacylphosphatidylcholine and diacylphosphatidylethanolamine with two monoenoic fatty acids were lower in endosomes than in plasma membranes. The differences in the polar head group and molecular species compositions of phospholipids between endosomes and plasma membranes did not change, regardless of whether or not the proportions of phospholipid molecular species in plasma membranes changed. The significance of the lipids in endosomes is discussed. PMID- 3264727 TI - Adenovirus DNA replication in vitro: duplication of single-stranded DNA containing a panhandle structure. AB - Adenovirus DNA replicates by displacement of one of the parental strands followed by duplication of the displaced parental single strand (complementary strand synthesis). Displacement synthesis has been performed in a reconstituted system composed of viral and cellular proteins, employing either the viral DNA-terminal protein complex as template or linearized plasmids containing the origin. Previously, evidence was obtained that in vivo complementary strand synthesis requires formation of a panhandle structure originating from hybridization of the inverted terminal repeats. To study the conditions for complementary strand synthesis in vitro, we have constructed an artificial panhandle molecule that contains a double-stranded inverted terminal repetition (ITR) region and a single stranded loop derived from the left and right terminal XmaI fragments of Ad2. Such a molecule appeared to be an efficient template and could initiate by the same protein-priming mechanism as double-stranded DNA, employing the precursor terminal protein. The efficiency of both types of template was comparable. Like for replication of the duplex molecule initiation of panhandle replication was stimulated by nuclear factors I and III, proteins that bind to specific double stranded regions of the ITR. The Ad DNA-binding protein is essential and the 39 kDa C-terminal domain of this protein that harbors the DNA-binding properties is sufficient for its function. These results support the hypothesis that panhandle formation is required for duplication of the displaced strand. PMID- 3264728 TI - Filament lattice of frog striated muscle. Radial forces, lattice stability, and filament compression in the A-band of relaxed and rigor muscle. AB - Repulsive pressure in the A-band filament lattice of relaxed frog skeletal muscle has been measured as a function of interfilament spacing using an osmotic shrinking technique. Much improved chemical skinning was obtained when the muscles were equilibrated in the presence of EGTA before skinning. The lattice shrank with increasing external osmotic pressure. At any specific pressure, the lattice spacing in relaxed muscle was smaller than that of muscle in rigor, except at low pressures where the reverse was found. The lattice spacing was the same in the two states at a spacing close to that found in vivo. The data were consistent with an electrostatic repulsion over most of the pressure range. For relaxed muscle, the data lay close to electrostatic pressure curves for a thick filament charge diameter of approximately 26 nm, suggesting that charges stabilizing the lattice are situated about midway along the thick filament projections (HMM-S1). At low pressures, observed spacings were larger than calculated, consistent with the idea that thick filament projections move away from the filament backbone. Under all conditions studied, relaxed and rigor, at short and very long sarcomere lengths, the filament lattice could be modeled by assuming a repulsive electrostatic pressure, a weak attractive pressure, and a radial stiffness of the thick filaments (projections) that differed between relaxed and rigor conditions. Each thick filament projection could be compressed by approximately 5 or 2.6 nm requiring a force of 1.3 or 80 pN for relaxed and rigor conditions respectively. PMID- 3264730 TI - Prognostic significance of splenic follicle size in splenectomized idiopathic thrombocytopenic purpura patients. AB - The prognostic significance of splenic follicle (B-lymphocyte compartment) size was studied in 62 patients splenectomized for idiopathic thrombocytopenic purpura (ITP). Patients with hyperplasia of splenic follicles (mean follicle diameter greater than 500 micron) were more likely to relapse or to develop additional autoimmune disorders than patients without hyperplastic splenic follicles (mean follicle diameter less than 500 micron) (p less than 0.01). The enlargement of splenic follicles had a positive predictive value of 27% and a negative predictive value of 100% for a poor outcome of splenectomy. Thus, the histological examination of spleens surgically removed for ITP seems to be an appropriate method to obtain the first indication of the possible long-term effect of splenectomy almost immediately after the operation. PMID- 3264729 TI - [Antibodies to the structural and nonstructural gag-coded proteins of type-D retroviruses in patients with lymphadenopathy]. AB - Screening of antibodies to structural and nonstructural gag gene-coded proteins in humans with lymphadenopathy and AIDS was performed by means of radioimmunoprecipitation (RIP) and western blotting. Pr78gag precursor of gag coded proteins of type-D retrovirus from Hep-2 cells served as an antigen in RIP tests. Total number of sera (of humans with lymphoadenopathy) under RIP analysis was 18 and one sera of AIDS patient. Six of them reacted with Pr78gag and one out of one AIDS serum. Over 80 sera samples of humans with lymphadenopathy have been tested by means of western blotting with proteins of Mason-Pfizer monkey virus as antigens. Antibodies to p27 (major internal protein of Mason-Pfizer monkey virus) were detected in 12 sera samples of those with lymphadenopathy (dilution 1:100) and in 9 out of 12 sera of AIDS patients (dilution 1:100-1:400). Results obtained make it possible to predict that type-D retroviruses are associated with acquired immunodeficiency syndrome and generalized lymphadenopathy and could play some role in development of this illness in humans. PMID- 3264731 TI - [Principles of treatment with cells called "LAK" cells]. AB - A novel approach for immunotherapy of cancer is presently under investigation. This treatment initially developed by Steven Rosenberg and colleagues is based on both the transfusion of autologous lymphocytes preactivated in vitro using interleukin 2 and the simultaneous infusion of the lymphokine in vivo. The two major limiting factors for these new protocols are, on the one hand, the heavy infrastructure necessary for in vitro cell treatment, and, on the other hand, the dose-dependent toxicity of IL2 infusions. Results of clinical trials are still preliminary; they suggest that the therapy may be of interest in melanomas and renal cell carcinomas. However, only a minority of patients with these relatively susceptible tumors display substantial responses. Thus, the protocols need to be improved which makes it critical to understand the biological mechanisms underlying tumor regression in vivo. The dominant working hypothesis is that IL2 enhances firstly in vitro and then in vivo the activity of certain lymphocytes able to destroy tumor cells via a direct cytotoxic effect. This view supported by murine experimental models remains to be demonstrated in the human. One way of testing it, is to infuse highly purified fractions of killer lymphocytes instead of the whole peripheral blood suspensions that are used presently. We are attempting to develop this approach and a trial is presently beginning at the Gustave-Roussy Institute in a series of patients with renal cell carcinoma. PMID- 3264732 TI - Cannabis and cognitive functions: a re-evaluation study. PMID- 3264733 TI - Inhibition by anti-inflammatory agents of contraction induced by epidermal growth factor-urogastrone in isolated longitudinal smooth muscle strips from guinea-pig stomach. AB - 1. Epidermal growth factor-urogastrone (EGF-URO) caused a concentration-dependent contractile response of longitudinal muscle strips from the gastric body of the guinea-pig stomach. The contractile response to EGF-URO was monophasic, with tension returning rapidly to baseline. Desensitization was evident in that further addition of EGF-URO to the organ bath did not cause a second contraction. 2. Preincubation with indomethacin, ibuprofen, naproxen and aspirin markedly inhibited the contractions induced by EGF-URO with an order of potency (indomethacin greater than naproxen greater than ibuprofen greater than aspirin) that reflected the ability of these agents to inhibit cyclo-oxygenase. 3. The data indicate that prostanoids mediate the action of EGF-URO in the longitudinal muscle preparation. 4. Auranofin (0.5 to 50 microM), a chrysotherapeutic agent with antiproliferative properties used for treating rheumatoid arthritis, also markedly inhibited the EGF-URO response; however, other gold-containing compounds (aurothioglucose or gold sodium thiomalate at 30 to 100 microM) failed to cause significant inhibition. 5. Preincubation of preparations for 2 h with 1 microM hydrocortisone, prednisolone or dexamethasone caused an inhibition of EGF-URO induced contraction of approximately 50%. However, steroids lacking either a 17 alpha-hydroxyl (corticosterone) or an 11 beta-hydroxyl (cortisone, deoxycorticosterone, prednisone) substituent did not inhibit the contraction caused by EGF-URO. For hydrocortisone, the inhibitory effect was half-maximal at 0.2 microM and was maximal at 1 microM. Cycloheximide (10 microM) blocked the inhibitory action of hydrocortisone and potentiated the contractile action of EGF URO. 6. The ability of a variety of steroidal and non-steroidal anti-inflammatory agents to interfere with the action of EGF-URO in a smooth muscle preparation suggests that these agents may also inhibit the action of EGF-URO mediated by prostanoids in other target tissues. 7. The data also point to a potential role for EGF-URO in regulating gastric motility. PMID- 3264734 TI - Endothelium-derived relaxing factor and the effects of acetylcholine and histamine on resistance blood vessels. AB - 1. The role of endothelium-derived relaxing factor (EDRF) in the action of vasodilator (acetylcholine, histamine, nitroprusside) and vasoconstrictor (noradrenaline, vasopressin) drugs on vascular resistance in the isolated perfused kidney and mesentery of the rat was studied. 2. Acetylcholine (EC50 = 0.18 +/- 0.05 nmol and 3.1 +/- 0.06 nmol, n = 8) and histamine (EC50 = 31.2 +/- 4.9 nmol and 46.2 +/- 3.9 nmol, n = 8) produced dose-related vasodilatation in noradrenaline-preconstricted (i.e. 'high tone') rat renal and mesenteric blood vessels. The response to both vasodilators (but not nitroprusside) was abolished by infusion of CHAPS (4.7 mg ml-1, 30 s). By use of an immunocytochemical staining procedure CHAPS was demonstrated to remove vascular endothelial cells lining intrarenal blood vessels. 3. Gossypol (3 microM), metyrapone (10 microM) and nordihydroguaiaretic acid, (NDGA, 30 microM), presumed inhibitors of EDRF biosynthesis, reduced or abolished the response to acetylcholine and histamine in perfused kidney and mesentery of the rat without affecting vasodilatation due to nitroprusside. Mepacrine (10 microM) similarly abolished the response to acetylcholine and histamine but in addition, reduced the response to nitroprusside in both preparations. 4. Methylene blue (100 microM), a presumed antagonist of the effect of EDRF, abolished vasodilatation due to acetylcholine and histamine and reduced the response to nitroprusside in perfused rat kidney and mesentery. Superoxide dismutase, SOD (15 u ml-1), was without effect. 5. While CHAPS treatment significantly augmented the vasoconstrictor response to both noradrenaline and vasopressin in perfused renal and mesenteric vessels this effect was not mimicked by metyrapone or gossypol suggesting that the enhanced effect of vasopressor agents in CHAPSperfused rat organs is due to the removal of a permeability barrier rather than impaired EDRF formation. 6. Responses to vasoconstrictor and vasodilator drugs in the perfused kidney and mesentery were obtained in the presence of indomethacin (8 microM) which produced in excess of 90% inhibition of prostacyclin (PGI2) release as measured by radioimmunoassay of 6-oxo-prostaglandin F1 alpha,. (6-oxo- PGF1 alpha) in the Krebs effluent. 7. We provide evidence that EDRF mediates the vasodilator response to acetylcholine and histamine in resistance blood vessels in perfused rat kidney and mesentery. The possibility that EDRF has a physiological role to play in regulating the calibre of resistance blood vessels is discussed. PMID- 3264735 TI - Slow channel inhibitor effects on brain function: tolerance to severe hypoxia in the rat. AB - 1. The protective effects of ten slow channel inhibitor drugs against severe progressive hypoxia were investigated in rats breathing spontaneously during light anaesthesia. Respiration, heart rate, electrocorticogram (ECoG) and/or electroencephalogram (EEG) were recorded. 2. Tolerance times were monitored from hypoxia onset until cessation of respiration, ECoG, EEG synchronization, and 'background-EEG'. Drugs were administered i.v. 5 min before the onset of hypoxia. 3. Verapamil, gallopamil, and nimodipine resulted in a significant increase of tolerance times; fendiline and bepridil showed a small increase (not significant); bencyclan and prenylamine were ineffective; cinnarizine and diltiazem slightly reduced tolerance times as did flunarizine at low doses. 4. At protective doses, verapamil, gallopamil, and nimodipine significantly raised the respiration rate but had little or no cardiac depressor effects. Bencyclan showed ventilatory drive but cardiocirculatory depression. A clear-cut ventilatory drive did not occur with the other ineffective slow channel inhibitors. 5. It is suggested that the protective actions observed were not due to slow channel inhibition per se, nor to spasmolytic potency or increased cerebral blood flow. Ventilatory drive associated with other cardiopulmonary actions which secondarily raise the brain oxygen supply are likely to be responsible for this effect. PMID- 3264736 TI - The mechanism by which monoamine oxidase inhibitors give rise to a non-calcium dependent component in the depolarization-induced release of 5-HT from rat brain synaptosomes. AB - 1. The effects of the monoamine oxidase inhibitors pargyline and nialamide on the Ca2+-dependency of [3H]-5-hydroxytryptamine release from superfused rat brain synaptosomes has been studied in order to evaluate the discrepancies that have occasionally been observed in studying transmitter release by in vivo and in vitro techniques. 2. The application of K+ pulses of low concentration (12.5-20 mM) caused an essentially Ca2+-dependent release of [3H]-5-HT. However, at K+ concentrations above 30 mM, a small non-Ca2+-dependent component appeared. 3. At high concentrations of K+ (30-55 mM), nialamide (18 microM) or pargyline (7 microM) increased the amount of [3H]-5-HT released which could be accounted for by an increase in the non-Ca2+-dependent component of release. 4. The elevation of the non-Ca2+-dependent component of release caused by the monoamine oxidase inhibitors was totally abolished by the inhibitors of the plasma membrane 5-HT carrier, chlomipramine (500 nM), citalopram (50 nM) and fluoxetine (1 microM). 5. The results suggest that the non-Ca2+-dependent component of release seen with high depolarizing concentrations of K+, particularly in the presence of monoamine oxidase inhibitors, is caused by the efflux of [3H]-5-HT through the plasma membrane carrier which seems to be activated during depolarization. 6. The significance of these findings to the physiological in vivo situation, and to the use of in vitro preparations in the study of transmitter release is discussed. PMID- 3264738 TI - Use of staplers on oesophagogastric varices. AB - Thirty-five gastrofundic devascularization procedures were performed with the side-to-side CF stapler of Chinese manufacture for obliteration of oesophagogastric varices. Four patients were operated on as emergencies, six patients 2-3 weeks after control of bleeding by tamponade and the remaining twenty-five electively (including four patients who had not bled). There were two operative deaths, an operative mortality of 6 per cent. In all, 30 patients have been followed, 20 for 1-3 years and 10 for less than 1 year. Twenty-five patients had postoperative barium meal examination. The varices were ameliorated in 19, not changed in 5 and exacerbated in 1. Nine patients rebled and of these, two died. The stapler is used in devascularization to interrupt intramural varices in the oesophagocardiac region. It must be emphasized that its use is only a part of the devascularization procedure. When used alone devascularization is not complete. The side-to-side stapler appears to be a convenient, safe and rational instrument for use in devascularization. PMID- 3264737 TI - The effects of endothelium-dependent vasodilators on cardiac output and their distribution in the anaesthetized rat: a comparison with sodium nitroprusside. AB - 1. The effects of sodium nitroprusside, acetylcholine and bradykinin on cardiac output and its distribution were studied in the anaesthetized, vagotomised rat preparation by use of 113Sn-labelled microspheres. 2. All three vasodilators lowered peripheral arterial blood pressure, but only bradykinin significantly reduced total peripheral resistance without reducing cardiac output. Bradykinin caused tachycardia, but this was offset by a reduction in stroke volume. These effects of bradykinin were not altered by indomethacin (4 mg kg-1). Acetylcholine and sodium nitroprusside both caused significant (P less than 0.05) reductions in stroke volume and cardiac output. 3. Bradykinin reduced vascular resistance in the liver, stomach, small intestine, large intestine, pancreas/mesentery, epididimides, skeletal muscle and fat. These responses were not affected by indomethacin, whereas, the reduction in vascular resistance in the brain induced by bradykinin was abolished by indomethacin. 4. Acetylcholine caused a reduction in renal vascular resistance, where bradykinin had no effect. However, acetylcholine did not cause any haemodynamic changes in the bradykinin-sensitive intestinal vasculature. 5. Acetylcholine caused vasoconstriction in the coronary and epididymal vasculature. Bradykinin in the presence of indomethacin induced vasoconstriction in the skin. 6. In conclusion, the data show that, with the possible exception of the brain and the skin, the vasodilator actions of bradykinin can adequately be transduced (presumably by endothelium-derived relaxing factor, EDRF) in the absence of prostacyclin synthesis. Additionally, these results indicate that the vasculature of the stomach, pancreas/mesentery, epididimides and skeletal muscle are equally sensitive to both acetylcholine and bradykinin, whereas the kidneys showed selectivity towards acetylcholine and the intestines towards bradykinin. These results may indicate differential receptor populations. PMID- 3264739 TI - Deficits in operant behaviour in monkeys treated with N-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP). AB - Six adult Macaca fascicularis monkeys were trained to perform an instrumentally conditioned, visually-guided forearm reaching task for fruit juice reinforcement. Once animals were overtrained on this task, they were given intravenous injections of N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (0.15 to 0.33 mg/kg). Animals were tested daily for performance in the previously learned behavioural task and were assessed daily for abnormalities in motor functioning. Monkeys developed deficits in operant task performance characterized by termination of responses after an initial series of responses and long pauses between responses. Once an animal stopped responding to the task, responses could often be reinitiated if the experimenter guided the monkey through the task. This type of performance deficit was seen both before and without the appearance of distinct parkinsonian motor signs. Animals which developed motor signs had extensive ventral mesencephalic cell loss while an animal with performance deficits but without motor signs had cell loss restricted to the ventral substantia nigra pars compacta. The results demonstrate that operant performance deficits can be observed in MPTP-treated monkeys independent of the appearance of motor deficits. PMID- 3264740 TI - Neurotoxicity of MPTP and MPP+ in vitro: characterization using specific cell lines. AB - The effects of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and its putative toxic metabolite 1-methyl-4-phenylpyridinium ion MPP+ were studied with specific neuronal and glial cell lines in vitro. MPTP had no morphological effect on actively growing neuroblastoma N2AB-1 cells or C6 glioma cells nor did it affect cell numbers. However, a low dose of MPP+ (33.7 microM) was cytotoxic to mitotic N2AB-1 cells inducing vacuole formation, cell lysis, and inhibiting cell growth over a 3-day period. Protein synthesis was inhibited in a dose-dependent fashion in MPP+ treated N2AB-1 cells after 24 h exposure while 33.7 microM of this toxin induced a 50% decrease in protein synthesis as early as 5 h after treatment of these cells. Differentiated, neurite-bearing N2AB-1 cells exhibited a loss of neurites and a change in cell size and shape following exposure to 0.33, 3.37 and 33.7 microM MPP+ after 24 h and some cells appeared to be mitogenically stimulated indicating MPP+ may act as a teratogen. C6 glioma cells, however, were resistant to MPP+. While mitotic N2AB-1 cells incubated with MPTP produced only traces of MPP+, C6 glioma cells generated significant amounts of this metabolite (3.6 microM). Moreover, although the morphology and cell number of cocultures did not change in the presence of MPTP, glioma-neuroblastoma cocultures produced 2.90 microM MPP+ which decreased protein synthesis by 18%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264741 TI - Ultrastructural localization of N-acetylaspartylglutamate in synaptic vesicles of retinal neurons. AB - Localization of N-acetylaspartylglutamate (NAAG) in a variety of central and peripheral neurons, as well as its receptor-mediated activation of membrane conductance have led to speculation that this peptide has a role in chemical neurotransmission. We previously identified NAAG in retinal neurons of several species, including the grass frog, and now have determined its ultrastructural distribution within the plexiform layers of this amphibian retina. NAAG immunoreactivity was localized within vesicles in synaptic endings of presumptive amacrine and bipolar neurons in the inner plexiform layer. Additionally, the peptide was present in vesicles within ribbon synapses in the outer plexiform layer, a result suggestive of release from photoreceptor cells. These data support the hypothesis that NAAG is secreted at points of synaptic contact between neurons, including retinal amacrine, bipolar and photoreceptor cells. PMID- 3264743 TI - Dendrites of mitral cell neurons contain microtubules of opposite polarity. AB - Axonal extensions of neurons show microtubules (MTs) with a uniform polarity indicating that they originate at or near the perikaryon. To obtain information on the polarity of dendritic MTs, a polarity assay was used to examine MTs in dendrites of interneurons (mitral cells) of the olfactory pathway of the bullfrog. The assay involved incubating pieces of olfactory lobe in a tubulin containing detergent medium which stabilized pre-existing MTs and provided for assembly of exogenous tubulin onto their surfaces as ribbon structures, which appear as 'hooks' on the MTs when seen in cross-section. The orientation of the ribbons in a clockwise or anticlockwise direction reflects the polarity of the wall lattice of the MT with which they are associated. Mitral cell dendrites show MTs with ribbons oriented in both directions, indicating two populations of MTs with opposite polarity. The two populations are seen in both the proximal and distal regions of dendrites, and the perikaryon, as expected, shows a mixed population of MTs as regards polarity. It is hypothesized that this is true for most neurons, and that dendritic MTs arise from organizing centers in the dendritic process. If this hypothesis is correct, the polarity of dendritic MTs would depend on the orientation of these centers, which remain to be identified. PMID- 3264742 TI - Clindamycin-induced alteration of ganglionic function. I. Direct effects on ganglion cell properties. AB - The influence of the lincosamide antibiotic, clindamycin, on the properties of bullfrog sympathetic ganglion B cells has been determined in vitro using conventional voltage recording methods or single microelectrode voltage-clamp recording techniques. Individual neurons were depolarized with both bath application or local perfusion of clindamycin. The amplitude of the depolarization was not altered by pretreatment with 50 microM (+)-tubocurarine, 10-microM atropine, or 1.5 microM tetrodotoxin (TTX), indicating that the clindamycin-induced depolarization does not result from either the activation of (1) nicotinic receptors, (2) muscarinic receptors, or (3) voltage-gated sodium channels. Clindamycin partially inhibited IM, an action which accounts for part of the clindamycin-induced depolarization. The duration of the hyperpolarizing afterpotential (HAP) following the action potential was decreased in the presence of clindamycin. Clindamycin decreased the amplitude and maximum rate of rise (MRR) of TTX-insensitive action potentials. As calcium influx is thought to contribute to the depolarizing phase of the TTX-insensitive spikes, we suggest that the decrease in HAP duration by clindamycin results from a decrease in the somal calcium current. Further, it is suggested that a decrease in IM and HAP duration may be responsible for the increased excitability exhibited during exposure to clindamycin. PMID- 3264744 TI - Inhibition of protein kinase C activity promotes the neurotrophic action of epidermal and basic fibroblast growth factors. AB - In primary neuronal cultures the activation of protein kinase C (PKC) by tumor promoting phorbol esters blocked growth factor-induced neuronal survival and neurite extension. Depletion of PKC markedly facilitated both epidermal growth factor and basic fibroblast growth factor-inducible neurite extension. Inhibition of PKC by H-7 also stimulated neurite extension. These results suggest that down regulation of PKC in neurons may be required for trophic factor action. PMID- 3264745 TI - Acceleration by stannous ion of the evoked release of transmitter from motor nerve endings in the frog. AB - Stannous ion (Sn2+, 30 microM) increased the amplitude of endplate potential (EEP) in the frog sartorius muscle, although the amplitude of miniature endplate potential (MEPP) or acetylcholine potential evoked by iontophoretic application of acetylcholine was unchanged. Sn2+ (10-100 microM) dose-dependently increased the quantal content of the EPP. MEPP frequency was not altered by 30 microM Sn2+. These findings indicate that Sn2+ may increase the EPP as a result of acceleration of the transmitter release evoked by nerve impulses. PMID- 3264747 TI - [Verification of the value of the ELISA test in the diagnosis of urogenital trichomoniasis]. PMID- 3264746 TI - Hemiparkinsonism in monkeys after unilateral caudate nucleus infusion of 1-methyl 4-phenyl-1,2,3,6-tetrahydropyridine (MPTP): behavior and histology. AB - Systematically administered 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is biotransformed into 1-methyl-4-phenylpyridinium ion (MPP+), which enters dopaminergic neurons via the dopamine uptake system to destroy nigral cells. Either MPP+ is retrogradely transported to the cell body after being taken up at the nerve terminals, or the dopamine uptake sites on the cell body and its dendritic processes are responsible for the toxin directly entering the neuron. Using a 200 microliter osmotic minipump, we administered 4 mg of MPTP HCl directly into the unilateral caudate nucleus, i.e., the dopamine nerve terminal area, of monkeys for 14 days. Persistent hemiparkinsonism began to appear in a week. Each monkey exhibited a flexed posture and hypokinesia of the contralateral limbs and circling toward the MPTP-treated side. These disturbances developed within 3 months and maintained a plateau for 3 months until the day of sacrifice. After treatment with apomorphine, there appeared a striking circling away from the MPTP-treated side. Selective cell loss in the MPTP-treated side of the substantia nigra pars compacta was found along the entire rostrocaudal extent relative to the untreated side. In conclusion, MPP+ uptake only at the dopamine nerve terminals and retrograde axonal transport to the cell body seemed sufficient to destroy nigral dopamine cells in the monkey. PMID- 3264748 TI - [Non-invasive evaluation of the effect of aortocoronary bypass on the function of the left heart ventricle]. PMID- 3264749 TI - [Use of the ELISA method in the determination of antibodies to Trichomonas vaginalis]. PMID- 3264750 TI - Urogenital surgery. PMID- 3264751 TI - Metabolic diseases of ruminant livestock. PMID- 3264752 TI - Milk fat depression and the influence of diet on milk composition. AB - Milk composition depends on inheritance, stage of lactation, age, infection, and diet. Fat is the most variable component of milk, and its concentration depends on the supply of acetate, butyrate, and performed fatty acids to the mammary gland. This supply depends on diet and competition among organs. Adequate, effective fiber is the critical dietary consideration. PMID- 3264753 TI - Pregnancy toxemia and ketosis of ewes and does. AB - Pregnancy toxemia of ewes and does appears to occur when the animal cannot meet the glucose demands of the fetal-placental unit and hypoglycemia develops. There is individual variation in susceptibility, and there may be basic differences in glucose metabolism between susceptible animals and nonsusceptible animals. Increased serum NEFA and ketone body concentrations accompany the disease, but clinical signs do not appear to develop in the absence of hypoglycemia. The diagnosis is based on history, clinical signs, and the finding of ketone bodies in the urine. Numerous metabolic abnormalities develop subsequent to hypoglycemia and hyperketonemia, and these affect the prognosis. Important secondary abnormalities include acidosis, dehydration, and renal failure. Therapy is frequently unsuccessful, but frequent administration of small doses of glucose appears to be beneficial, if the other abnormalities, such as acidosis and dehydration, are controlled. Prevention can be readily achieved by nutritional means and is far more rewarding than therapy. Ewes and does must be fed in relation to their changing energy needs throughout the reproductive cycle. PMID- 3264754 TI - Parturient paresis and hypocalcemia in ruminant livestock. AB - Parturient paresis (hypocalcemia) is most likely to affect dairy cattle around the time of parturition. It causes progressive neuromuscular dysfunction and flaccid paralysis. Older dairy cows, cows with a history of parturient paresis during a previous lactation, high-producing cows, and cows from the Jersey and Guernsey breeds are at highest risk for developing parturient paresis. Nonparturient hypocalcemia may also occur and is related to events other than parturition, such as severe stress, that temporarily overwhelm the mechanisms of calcium homeostasis. Beef cattle, sheep, and goats are affected less frequently by hypocalcemia than are dairy cows. Because these species are not as stressed for milk production as dairy cattle, nonparturient hypocalcemia makes up a higher proportion of cases in nondairy ruminants. Clinical signs of hypocalcemia in beef cattle, sheep, and goats tend toward hyperesthesia and tetany rather than the classic flaccid paralysis that occurs in dairy cattle with parturient hypocalcemia. Prompt and effective treatment of hypocalcemia helps to reduce the incidence of secondary complications, such as muscle damage or mastitis. The standard treatment regimen of 500 ml of 23 per cent calcium gluconate, administered intravenously, will elicit a favorable response in approximately 75 per cent of recumbent cows within 2 hours of treatment. Relapses following successful initial therapy are common and may be prevented in part by supplementation of intravenous treatment with an additional 500 ml of 23 per cent calcium gluconate administered subcutaneously. Proper nursing care following treatment speeds recovery and reduces the incidence of secondary complications owing to hypocalcemia. PMID- 3264755 TI - Increase of striatal dopamine turnover by stress in MPTP-treated mice. AB - The characteristics of motor function and brain dopamine (DA) metabolism in the 1 methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated mice after immersion immobilization stress were investigated. There was no significant difference in locomotor activities between MPTP-treated and saline-treated mice, but locomotor activities of MPTP-treated mice after stress decreased more remarkably than those of saline-treated mice. Immediately after stress, striatal DA concentrations of MPTP-treated mice were significantly lower than those of saline-treated mice. Striatal DA levels improved when 24 h passed after stress. The striatal and cortical (DOPAC + HVA)/DA ratios of MPTP-and stress-treated mice was significantly higher than that of saline-and stress-treated mice. It is due to the decreased DA level and the enhancement of DA turnover that MPTP-treated mice became remarkably akinetic after stress, and that L-DOPA therapy is not effective when the symptoms in patients with Parkinson's disease worsen due to stress. PMID- 3264757 TI - [Effect of recombinant interleukin 2 on peripheral blood lymphocytes in vitro. IV. Cytotoxicity of lymphocytes in patients with malignant tumors]. PMID- 3264756 TI - Synthesis of p-trifluoroacetamidophenyl beta-D-glucopyranoside 4-(D-ribit-5-yl phosphate) corresponding to the Haemophilus influenzae type A capsular antigen. AB - The synthesis is described of the title glycoside which corresponds to the Haemophilus influenzae type a capsular antigen. The hydrogenphosphonate method was used with 3,3'-(chlorophosphonylidene)bis(2-oxo-1,3-oxazolidene) as the condensing agent. PMID- 3264758 TI - Presence of serotonin in early chick embryos. AB - With biochemical analysis and with autoradiography based on injection of 5 [3H]hydroxytryptophan, it was possible to demonstrate the presence of serotonin (5-hydroxytryptamine) in early chick embryos as early as the pre-streak stage. The biochemical analysis which covered the early developmental period (0.5-6 days of incubation) revealed an elevated concentration of serotonin at gastrulation; from then it stayed at a lower and fairly even level. Autoradiographs of embryos at the pre-streak stage, the primitive streak stage, the head fold stage and the 4-6 somites stage indicated the presence of serotonin in intracellular yolk granules and in cell nuclei. Moreover, the amine appeared associated with microfilaments and microtubules, particularly in developing neural cells. Notably the elevated concentration of serotonin at gastrulation, but also the intracellular distribution of the amine during early organogenesis, indicates a prominent role for it in cell-shape changes and morphogenesis in the early chick embryo. PMID- 3264760 TI - [The effect of HLA-B27 antigen on chronic juvenile arthritis]. PMID- 3264759 TI - [Haplotype A 28, B 35, CW 4 in macular dystrophy]. PMID- 3264761 TI - [Follow-up of a group of children with severe reactions to mixed vaccine against diphtheria, tetanus and whooping cough from the aspect of their immunological profile]. PMID- 3264762 TI - Immunizing the children of the world: progress and prospects. PMID- 3264763 TI - The development of the WHO Recommended Classification of Pesticides by Hazard. AB - The WHO Recommended Classification of Pesticides by Hazard, which was originally intended as a tool to aid international harmonization of pesticide registration, is already 13 years old. Over the years, it has been refined, and it is now accepted by many countries and international organizations. The story of its development illustrates well an international approach to problems as they have arisen. PMID- 3264764 TI - Can the case-control method be used to assess the impact of water supply and sanitation on diarrhoea? A study in the Philippines. PMID- 3264765 TI - Towards the eradication of iodine-deficiency disorders in Brazil through a salt iodination programme. AB - Iodine-deficiency disorders have been a serious public health problem in Brazil because of the failure of a salt iodination programme established in 1953. The reasons for this failure were logistical, e.g., potassium iodide was not supplied to all salt-producers, iodination of salt was largely erratic, and part of the population at risk used only non-refined salt, which was not iodinated. In 1978 a task force was therefore formed to implement measures to eliminate iodine deficiency disorders from the country. For this purpose, potassium iodate was distributed, free-of-charge, to all salt mills and an iodate dosing spray was supplied without cost to small salt producers. Also, regional laboratories for determining iodine in salt were set up, inspectors made regular visits to the salt mills, and samples of salt from commerce and from the producers were analysed. More than 90% of the samples contained 10-30 mg iodine per kg. In three typical areas of the country with endemic goitre the urinary excretion of iodine increased from an average of less than 40 mug iodine to 125 +/- 38 mug iodine per g creatinine. In conclusion, the salt iodination programme was a complete success and could serve as a model for other countries with a high prevalence of iodine deficiency disorders. PMID- 3264767 TI - Birth weights in two rural hospitals in the United Republic of Tanzania. PMID- 3264766 TI - Causes of maternal mortality in rural Bangladesh, 1976-85. AB - Of a total of 1037 women of reproductive age who died during the period 1976-85 in the Matlab area that was under demographic surveillance, 387 (37%) were maternal deaths. The mean maternal mortality over the 10-year period was 5.5 per 1000 live births (101 per 100 000 women of reproductive age). Major causes of maternal death, which were assessed using a combination of record review and field interviews, included postpartum haemorrhage (20%), complications of abortion (18%), eclampsia (12%), violence and injuries (9%), concomitant medical causes (9%), postpartum sepsis (7%), and obstructed labour (6.5%). Deaths caused by postpartum haemorrhage were positively associated with both maternal age and parity, whereas those caused by eclampsia and injuries were more common among young and low-parity women. If maternal deaths arising from complications of abortion are disregarded, 20% of all maternal deaths occurred during pregnancy, 44% during labour and the two days following delivery, and 36% during the remaining postpartum period.These findings support the need to develop a service strategy to address the risks of childbearing and childbirth in areas such as rural Bangladesh, where almost all deliveries take place at home. This strategy must be based not only on preventive and educational interventions, including family planning and antenatal care, but also on systematic attendance at home deliveries by trained professional midwives, backed up by an effective chain of referral. PMID- 3264768 TI - Abnormal monocyte chemotaxis in patients with chronic purulent rhinosinusitis: an effect of retroviral p15E-related factors in serum. AB - Earlier we reported that about 60% of patients suffering from unexplained relapsing of chronic purulent rhinosinusitis show a defective T cell-mediated immunity to commensal microorganisms of the upper respiratory tract. The monocyte chemotactic responsiveness was assessed in 40 of these patients by means of the polarization assay. Impaired FMLP-induced monocyte polarization was found in 26 of the 40 patients tested. The defective chemotactic responsiveness could be explained by a p15E-related factor detectable in the serum of the patients: addition of serum fractions less than 25 kD to healthy donor monocytes resulted in an inhibition of polarization; a monoclonal antibody directed against p15E neutralized this inhibitory effect. In individual patients, a decreased monocyte polarization correlated well with the presence of this p15E-related factor in serum, as well as with defective T cell reactivity. PMID- 3264769 TI - Anti-idiotypic humoral and cellular responses to antibody to hepatitis B surface antigen in hepatitis B viral infections. AB - In order to investigate regulatory significance of humoral and cellular responses to the idiotypic (Id) determinants on the antibody to hepatitis B surface antigen (anti-HBs), they were studied in acute hepatitis B and in chronic HBV infection. The results were compared with humoral and cellular responses of the same patients to hepatitis B surface antigen (HBsAg). In acute hepatitis B, the responses to HBsAg, were delayed until 3-4 weeks after the onset of clinical symptoms. However, the leucocyte migration inhibition (LMI) and the lymphocyte transformation (LTT) responses to affinity purified anti-HBs were found to be evolved very early in the course of acute hepatitis B, though anti-Id antibodies were absent. The majority of chronic HBV carriers showed a poor humoral and cellular response to HBsAg. Ten out of 38 chronic carriers showed anti-Id antibodies which recognized a major cross-reactive idiotype (CRI) on the anti-HBs molecule. Twenty-five out of 38 chronic carriers also showed LMI response to the Id determinants on the anti-HBs. LMI response induced by anti-HBs could be blocked by a specific Balb/c anti-Id antibody which also recognized the CRI. Thus, in both acute and chronic HBV infections, the anti-Id humoral and cellular responses correlated with poor humoral and cellular responses to HBsAg, indicating regulatory significance. PMID- 3264770 TI - Interleukin-2 production in Brown-Norway rats with HgCl2-induced autoimmune disease: paradoxical in vivo versus in vitro findings. AB - In autoimmune diseases, mitogen-induced IL-2 production in vitro is generally considered to be diminished despite evidence of lymphoid hyperactivity in vivo. HgCl2 is known to cause T-dependent polyclonal B cell activation in Brown-Norway (BN) rats, resulting in autoimmune disease. We show here that the IL-2 producing capacity of cells from HgCl2-treated BN rats is low, but that HgCl2 treatment in vitro (10(-7) M) enhances IL-2 production of normal BN splenocytes. Lewis (LEW) rats are resistant to HgCl2-induced autoimmune disease. HgCl2 treatment of these rats in vivo does not significantly decrease the IL-2 production of their splenocytes. However, HgCl2 treatment of normal LEW splenocytes in vitro enhances their IL-2 production but this requires an HgCl2 concentration ten times greater (10(-6) M) in LEW than in BN rats. These findings are discussed in an attempt to resolve the paradox between the in vivo immune hyperactivity seen in HgCl2 treated BN rats, and the apparently low IL-2 production of their splenocytes in vitro. PMID- 3264771 TI - Heterogeneity of T cell receptor idiotypes in rheumatoid arthritis. AB - The nature of the T cell response in the rheumatoid synovium was investigated by using monoclonals MX9 and 42/1C1, which recognize the V beta 8 and V beta 5 T cell receptor gene families respectively. The blood and synovial T cells of ten patients with rheumatoid arthritis were compared. The majority (8/10) had different numbers of V beta 5 and V beta 8 cells in the joints from those in the blood, indicating that the T cells in the joints were not a sample of those in the blood. In three patients both V beta 5 and V beta 8 cells in the joint were augmented in number, suggesting that the T cells selectively retained in the joint were not members of a single clone, but derived from many clones. Some patients had increased levels of V beta 5 or V beta 8 alone in the joint indicating that heterogeneity existed between patients. These results are not consistent with the preferential or dominant use of a single V beta gene family in the T cells involved in the rheumatoid arthritic joints. PMID- 3264772 TI - B lymphocyte activation in systemic lupus erythematosus: spontaneous production of IgG antibodies to DNA and environmental antigens in cultures of blood mononuclear cells. AB - IgG antibodies to DNA, influenza virus haemagglutinin (HA), adenovirus hexon (HX) and mannan from Candida albicans (MN) have been determined in supernatants from 2 day unstimulated cultures of peripheral blood mononuclear cells from SLE patients and controls. Mean values were much higher in the SLE group, with from 20% (MN) to 85% (DNA) of patients giving values above the normal range. Although a significant correlation was observed between anti-DNA and anti-HA production, anti-HX and anti-MN showed no such correlations. The specificity of the ELISA assays was demonstrated by inhibition tests. It is concluded that a selective form of polyclonal activation in SLE results in the production of antibodies to foreign as well as to self antigens. PMID- 3264773 TI - Interleukin-1 and tumour necrosis factor mRNA expression in rheumatoid arthritis: prolonged production of IL-1 alpha. AB - In rheumatoid arthritis there is a chronic immune and inflammatory reaction which can lead to the destruction of the diseased joint. Cytokine gene expression was studied in synovial cells using cDNA probes specific for human interleukin 1 (IL 1), -alpha and IL-1 beta, tumour necrosis factor (TNF), -alpha and TNF beta (lymphotoxin); protein molecules which induce cartilage degradation and bone resorption. In all cases studied, IL-1 mRNA was present in freshly isolated synovial cells from fluid or membrane. Compared to levels of IL-1 mRNA found in optimally activated normal blood mononuclear cells, the levels of IL-1 alpha mRNA were high in seven of the nine patients studied, whereas IL-1 beta mRNA, the dominant form in blood, was relatively lower. TNF alpha and TNF beta mRNA were also detected. Rheumatoid synovial cells, cultured without any stimulus, continued to express high levels of IL-1 alpha mRNA for up to 5 days, compared to the 24 h response of activated blood cells; IL-1 beta mRNA in culture was also prolonged. Cultures of rheumatoid joint cells produced IL-1 bioactivity, with roughly equal amounts of IL-1 alpha and beta, as assessed using neutralizing antibodies. TNF bioactivity was also detected which may be of importance as TNF induces the production of IL-1. The finding of these mediators produced in large amounts in active rheumatoid synovial cells suggests that mutually stimulatory cell interactions, mediated by these molecules, may be important in the chronic inflammation and tissue destruction in rheumatoid arthritis. PMID- 3264774 TI - Defective interleukin-1 production in a familial monocyte disorder with a combined abnormality of mobility and phagocytosis-killing. AB - Monocytes in a familial monocyte disorder, a recently recognized primary immunodeficiency syndrome, with impaired phagocytic functions were studied for their ability to produce interleukin 1 (IL-1) as well as the surface property. Monocytes from two children (siblings) with the disorder possessed CD11b, CD13, CD14, CD33, Ia and LFA-1/Mac-1/p150,95 beta subunit antigens as determined by flow cytometry. Electron microscopic cytochemistry showed that the monocytes had surface glycoproteins reactive with four representative lectins. The IL-1 production by monocytes was assayed in the two patients and compared with that in six children with primary immunodeficiency syndromes and some monocyte abnormalities; three had congenital neutropenia, two had hyper-IgE syndrome, and one had defective monocyte chemotaxis. Monocyte culture supernatants were prepared with stimulation by lipopolysaccharide or silica, and their IL-1 activity was measured by the mouse thymocyte-proliferation assay. The patients' monocytes were defective in IL-1 production: the values were less than 1.0% of the control monocyte values (n = 12) and were in contrast with those of congenital neutropenia monocytes of 186.2% to 204.3%. These results demonstrate a familial monocyte disorder which is characteristic among the immunodeficiency syndromes with regard to the defective IL-1 production and the impaired phagocytic functions. PMID- 3264775 TI - A prevalence study of multiple sclerosis in L'Aquila, central Italy. AB - We report the results of an epidemiologic study in the Municipality of L'Aquila, Abruzzo, Central Italy, undertaken to estimate the prevalence rate of Multiple Sclerosis (MS). On December 31, 1984, the prevalence was 33.2 per 100,000 (34.2 when age and sex is standardized to the Italian population). In agreement with recent intensive surveys from different regions in the North and South of Italy, our data indicate that the prevalence of MS in Italy is higher than 30 per 100,000, and emphasize the importance of small population studies in the epidemiology of MS. Our findings suggest that in Italy the risk for MS is higher than recorded before. PMID- 3264776 TI - [Comparative studies of cerebral blood flow measurements and measurements of the size of the corpus callosum in patients with schizophrenia]. AB - In this study healthy subjects and schizophrenic patients of the so-called Type I and Type II subgroups were examined in each case with a morphological method to determine the size of the corpus callosum and with a method to measure a physiological functional parameter, namely, the regional cerebral blood flow (rCBF). MR and dynamic single photon emission CT were used (in our case as differential method). The study reveals for the first time classified into subgroups of the disease, scientifically measured differences both in the size of the corpus callosum and in the distribution pattern of the blood flow. Whereas the patients of type I had an enlarged corpus callosum and increased blood flow during the task with which they were confronted, these organs were mainly smaller in size with type II patients without an increase in the global blood flow during the relevant task. The statistical data--averaged over patient groups--show these differences clearly, but due to biological scatter it has so far not been possible to arrive at a diagnosis in individual cases. PMID- 3264777 TI - Increased spontaneous production of interleukin-1 together with inhibitory activity in systemic sclerosis. AB - 1. Increased spontaneous production of interleukin-1, measured as lymphocyte activating factor activity, was seen in unstimulated monocytes from systemic sclerosis patients. 2. Inhibitory activity to interleukin-1 was seen in both normal and patient monocyte supernatants. 3. Inhibitory activity was significantly higher in unstimulated and stimulated monocyte supernatants from systemic sclerosis patients. 4. The net effect was an apparent decrease in lymphocyte-activating factor activity in the monocyte supernatants from systemic sclerosis patients. 5. These findings suggest a possible mechanism by which collagen deposition could be enhanced, thereby giving rise to the extensive fibrosis characteristic of systemic sclerosis. PMID- 3264778 TI - The effect of interleukin 1 beta on proteoglycans synthesized by human gingival fibroblasts in vitro. AB - The effect of recombinant interleukin-1 beta (IL-1 beta) on proteoglycan synthesis by human gingival fibroblasts was investigated. IL-1 beta stimulated the gingival fibroblasts to proliferate. When compared to human foreskin fibroblasts, the gingival fibroblasts demonstrated a greater proliferative response at higher concentrations of IL-1 beta. The midpoint of the proliferation response for both cell types was in the 10(-11) M IL-1 beta range. The rate of [35S]-sulfate incorporation into proteoglycans by human gingival fibroblasts was enhanced by 40% at 10(-9) M IL-1 beta. This stimulatory effect appeared to be independent of cell proliferation and prostaglandin synthesis since blocking of these functions with hydroxyurea and indomethacin respectively, resulted in similar dose responses to IL-1 beta. Pulse chase experiments indicated the kinetics of degradation in the presence or absence of IL-1 beta were essentially identical. Therefore, the turnover rate of proteoglycans was not altered by IL-1 beta, no significant differences between molecular species, size or glycosaminoglycan composition of the proteoglycans synthesized in the presence or absence of IL-1 beta was noted. Thus, IL-1 beta can modulate extracellular matrix synthesis by human gingival fibroblasts and may therefore be partially responsible for the early events of healing following inflammatory episodes. PMID- 3264779 TI - Renal dopamine-1 defect in spontaneous hypertension. PMID- 3264780 TI - Sensitivity of clinical isolates from German hospitals to amoxicillin/clavulanic acid (Augmentin) compared with other antibiotics. AB - 17,244 pathogens isolated from clinical specimens of 24 hospitals in the Moers area (North-Rhine Westphalia, FRG) were tested in regard to their susceptibility to Augmentin (amoxicillin and clavulanic acid). For this purpose, minimal inhibitory concentrations were determined by use of microbroth dilution technique. 80% of Gram-negative, 98% of Gram-positive and 97% of anaerobic isolates were susceptible to Augmentin (breakpoint 4 mg/l amoxicillin in the presence of 2.5 mg/l clavulanic acid). In a second part of the study the susceptibility to Augmentin of 4.137 Gram-negative and 10.958 Gram-positive pathogens was compared to their sensitivity against benzylpenicillin, flucloxacillin, mezlocillin, erythromycin, clindamycin, fusidic acid, ampicillin, cefaclor and doxycyclin. PMID- 3264781 TI - Serum interleukin-2 receptor in systemic lupus erythematosus and rheumatoid arthritis. AB - Interleukin-2 receptor (IL-2R) is expressed on activated lymphocyte after stimulation with antigen or interleukin-2 (IL-2), meanwhile soluble form of the receptor is released. Using enzyme-linked immunosorbent assay, serum IL-2R levels were determined in 34 healthy controls, 61 patients with systemic lupus erythematosus (SLE) and 32 patients with rheumatoid arthritis (RA), yielding mean +/- SD values of 355 +/- 89, 807 +/- 453 and 567 +/- 210 U/ml respectively. In both SLE and RA patients, the active disease group had more markedly elevated serum IL-2R levels compared with those of the inactive group. In patients with SLE, elevated serum IL-2R is associated with lymphopenia, renal disorders, decreased C3 level and increased anti-DNA, thus make it a good parameter to monitor disease activity in SLE. PMID- 3264783 TI - [An applied anatomical study on the trigeminal ganglion and sensory root for radiofrequency controlled thermocoagulation]. PMID- 3264782 TI - [T-cell subpopulation of bronchoalveolar lavage fluid in patients of sarcoidosis and hypersensitivity pneumonitis--2 cases report]. AB - Diffuse interstitial lung diseases include more than 100 varieties. Even for a chest specialist differential diagnosis is difficult; accurate diagnosis without transbronchial lung biopsy or open lung biopsy was particularly hard. Bronchoalveolar Lavage (BAL) is a new diagnostic procedure which is relatively safe and repeatable. It takes about 30 minutes more, during the usual bronchoscopic examination, to obtain fluid and cells from the lower respiratory tract. These specimens aid differential diagnosis and an understanding of pathogenesis in the early stage of diffuse interstitial lung disease. Two cases are reported. One was sarcoidosis, as proved by mediastinoscopic lymph node biopsy; the other one was hypersensitivity pneumonitis by clinical impression. Both patients received bronchoscopic examination with bronchoalveolar lavage. The bronchoalveolar lavage fluid showed an increase in total cell count, lymphocyte count and lymphocyte percentage. In sarcoidosis, the main T-lymphocyte subpopulation was helper T-lymphocytes while, in hypersensitivity pneumonitis, the main T-lymphocyte subpopulation was suppressor T-lymphocytes. We concluded that, if the patients of diffuse interstitial lung diseases had increased lymphocyte count and percentage in bronchoalveolar Lavage fluid, examination of the lymphocyte subpopulation would help differential diagnosis. PMID- 3264784 TI - Conversion of logarithmic channel numbers into relative linear fluorescence intensity. AB - We describe a simple, reproducible, and generally applicable method to assess the performance of log amplifiers by using a fluorescent sample that provides multiple peaks of different intensities. The channel differences between multiple peaks are used to evaluate the logarithmic behavior of the fluorescence signal amplifier on the flow cytometer. A calibration curve can be created to correct the channel numbers for deviations from true logarithmic behavior and then convert data into relative linear intensities. By using these linear fluorescent intensities, we compared the capacity of different antisera against HIV-1 (human immunodeficiency virus type 1) peptides to inhibit the binding of HIV-1 to CEM, a CD4-positive T-cell line. A wide range of applications for this calibration procedure can be envisioned and the method is valuable for monitoring instrument performance over time. PMID- 3264785 TI - [High-dose methotrexate with citrovorum factor rescue (HD-MTX-CFR) in the treatment of malignant solid tumors--clinical analysis of 62 patients]. AB - From 1977 to 1982, 62 patients with various advanced malignant solid tumors were treated by HD-MTX-CFR therapy and totally 129 courses were given. Majority of the patients suffered from malignant lymphoma (10), osteogenic sarcoma (11), lung cancer (16), esophageal cancer (3), breast cancer (3) and malignant melanoma (4). All were confirmed by cytology or pathology except one primary liver cancer. There were clinically measurable lesions in 59 patients for evaluation of the treatment, and 3 osteogenic sarcoma patients without metastasis were given a postoperative adjuvant chemotherapy. 33 out of 62 had received chemotherapy and/or radiotherapy before. Dose of MTX ranged from 2 to 3 gm per course in most patients and dose of CF, from 9 to 12 mg every 6 hours for 3 days. 2 (3.4%) patients achieved complete remission (1 osteogenic sarcoma and 1 malignant lymphoma) and 8 (13.6%), partial remission (1 osteogenic sarcoma, 5 malignant lymphoma, 1 esophageal cancer and 1 breast cancer) with a total response rate of 15.9%. No response was observed in all 16 lung cancers. The main side effects of HD-MTX-CFR therapy were leukopenia, thrombocytopenia, elevation of SGPT, nausea, vomiting, mucositis, skin rash, fever and fatigue. All patients were followed more than 3 years. 4 patients are still alive (9, 9, 4 and 7 years, respectively), including 3 osteogenic sarcoma patients who received postoperative adjuvant chemotherapy and 1 mycosis fungoides. PMID- 3264786 TI - A novel 34-kd protein co-isolated with the IgM molecule in surface IgM-expressing cells. AB - Plasmacytoma cells, transfected with a vector encoding a membrane-bound IgM molecule, do not show cell surface IgM expression, although complete IgM molecules are assembled intracellularly. The isolation of a surface IgM-positive variant allowed us to analyse molecular requirements of surface IgM expression. Only in surface IgM-positive cells, a 34-kd protein (B34) was found to be associated with IgM. B34 is a glycoprotein which forms a disulphide-linked homodimer. The surface IgM-positive variant cell line expressing B34 also contains transcripts of the pre-B and B cell specific mb-1 gene. The data are discussed in the context of a possible IgM-antigen receptor complex. PMID- 3264788 TI - Semiquantifying regional cerebral blood flow by 123I-amphetamine (IMP) SPECT in cerebrovascular disorders: correlations with CBF indices by 133Xe inhalation method. AB - To examine the capacity of detecting regional cerebral blood flow (rCBF) disturbances in stroke, measurements with 133Xe inhalation and 123I-amphetamine (IMP) SPECT were performed within 1-2 days in 19 patients. IMP SPECT images in transverse sections consisting of outer and inner areas were correlated with 32 regions of 133Xe rCBF. 133Xe rCBF was assessed by ISI, CBF15, and F1. Inter hemispheric ratio correlation showed outer IMP uptake correlated better with 133Xe CBF indices than the inner one. With higher ratios of 133Xe rCBF. IMP uptake ratios were variable, suggesting less usefulness of this parameter in evaluation of mild ischemia. Values of IMP in outer regional hypo and hyperemic areas correlated better with those of 133Xe rCBF than the inner ones. In regional ratios of hypo and hyperemic areas from hemispheric mean, outer IMP uptake correlated with 133Xe CBF indices, reflecting regional disturbances of fast clearing tissue perfusion. Regression lines between ratios in 133Xe CBF and IMP uptake were located below one to one correlation, and dissociated more for hyperemic regions. IMP SPECT correlated better with 133Xe rCBF for tissues with reduced perfusion but underestimated hyperemic regions as measured with the 133Xe method. The data suggest outer cerebral IMP uptake evaluated by SPECT could reflect flow disturbances in the brain cortex. PMID- 3264787 TI - Germline antibody V regions as determinants of clonal persistence and malignant growth in the B cell compartment. AB - Antibody V gene expression was studied in a subpopulation of murine B cells (Ly1 B) which was enriched by cell transfer and had earlier been shown to persist in the immune system over long periods of time. Among 17 hybridomas derived from Ly1 B cells of two different mice, eight were progeny of only three different B cell precursors which apparently had expanded to clones of large size, in the absence of detectable somatic mutation of their antibody V regions. Furthermore, several clonally independent cells expressed identical, unmutated V genes. These data define a novel pathway of B cell development in which cells expressing a selected set of germline antibodies are continuously propagated in the organism. A Ly1 B cell leukemia derived from a similar transfer experiment expressed a VH gene that had been isolated in three independent Ly1 B cell hybridomas, suggesting that the leukemic cells had been equally selected in this pathway. PMID- 3264789 TI - Semiquantitative assessment of regional cerebral perfusion using 99mTc HM-PAO and emission tomography. AB - A method for the relative quantification of 99mTc-HM-PAO distribution in brain SPECT is described. The method, applied in 12 normal volunteers and 150 patients suffering from different cerebral diseases, uses circumferential profiles to quantify the relative radionuclide distribution in the brain tomograms as an angular function with the origin at the center of the brain slice. Abnormal 99mTc HM-PAO distribution is evaluated by comparing the count content of symmetrical selected parts of the profile curve and comparing each patient's profile with the corresponding limits of normal ones, determined from the pooled profiles of 12 normal subjects. This computerized method allows an accurate, reproducible and objective assessment of the relative HM-PAO distribution in the brain. PMID- 3264790 TI - The unfolded map using 201T1 myocardial SPECT. AB - The unfolded map is a new method to show the 201T1 distribution of left ventricle using SPECT. In 52 cases these maps were obtained at the stress study and 4 h later. The maximal count profiles of the perimeters for each short axis image were unfolded and were arranged from the apex to base of the left ventricle into a two dimensional map. All patients had chest pain and were suspected of coronary artery disease. The unfolded map had significant correlations between coronary arteriogram and exercise ECG findings. In conclusion, this method reflects the ischemic area of left ventricular myocardium, closer to the real left ventricular myocardium than Bull's eye display and is useful in the diagnosis of coronary heart disease. PMID- 3264791 TI - Histological signs of immune reactions against allogeneic solid fetal neural grafts in the mouse cerebellum depend on the MHC locus. AB - Using an immunocytochemical method, we examined the immunological responses of adult mice to intracerebellar syngeneic and allogeneic fetal mouse brainstem transplants (embryonic days 12-14). Syngeneic grafts and major histocompatibility complex (MHC)-compatible and non-MHC-incompatible allogeneic grafts survived well, showing no histological signs of rejection even 6 months after transplantation, and with no expression of MHC antigens being observed in any of the grafts. However, most cases of both MHC- and non-MHC-incompatible allografts showed rejection responses, such as marked neovascularization, cellular infiltration and necrosis, two weeks to one month after transplantation. In animals showing rejection, Class I MHC antigens were found on grafted neuronal tissue. An increased number of reactive astrocytes was also observed in the grafts. High levels of Class I antigen expression and prominent gliosis correlated with vigorous cellular infiltration. A quantitative analysis of T cell subsets in the animals showing rejection revealed that the L3T4/Lyt-2 ratio was 1.02 +/- 0.21 (mean +/- S.D.), indicating that helper/inducer and cytotoxic/suppressor T cells appeared equally in the rejection of MHC- and non MHC-incompatible allografts. We consider that in these experiments, the brain was not completely an immunologically privileged site, and that MHC- and non-MHC incompatible intraparenchymal neural transplants were not shielded from host immune surveillance. PMID- 3264792 TI - The effects of splenic irradiation on lymphocyte subpopulations in chronic B lymphocytic leukemia. AB - We describe the effect of splenic irradiation (SI) (0.5-1 Gy weekly) on lymphocyte subpopulations for 7 patients with progressive B chronic B-lymphocytic leukemia (B-CLL). Using specific cellular characteristics we could distinguish normal from abnormal cells. The irradiation resulted in a decrease of lymph node size, reduction in spleen volume and decrease in peripheral blood lymphocytes. The one exception was a patient with a prolymphocytoid transformation of B-CLL. For 3 patients SI had to be interrupted or stopped because of severe cytopenia. Quantitation of malignant B cells and normal T lymphocytes revealed that the total irradiation dose which resulted in a specific decrease of malignant lymphocytes varied from patient to patient. Normal T-cell subpopulations, which were increased before SI, decreased to normal or abnormally low values during SI. In previously untreated patients, natural killer (NK) cell numbers decreased more rapidly than T-cell subpopulations. For 2 patients refractory to chemotherapy an increase of NK cells was observed upon SI. PMID- 3264794 TI - Does the basal lamina contain interleukin 2 receptors? Observations in emerging psoriasis vulgaris lesions. PMID- 3264793 TI - [Correlation of Sm antibodies and clinical symptoms in systemic lupus erythematosus]. PMID- 3264795 TI - Phylogeny of lymphocyte heterogeneity: the thymus of the channel catfish. AB - The number of thymocytes (approximately 3 x 10(7)) that were recoverable from fingerling channel catfish remained constant from about 3 to 10 months of age, i.e. from September to April following hatching the previous June. Between 11 and 12 months, i.e. May and June, the thymus dramatically increased in size with 3 x 10(9) thymocytes being recoverable from the tissue of individual fish. The thymus remained enlarged for several months (throughout the summer) but at about 15 months (in September) began to involute such that by 17 months (November) no thymus tissue could be seen macroscopically. This natural involution could be accelerated by subjecting the fish to handling and transport stress. Thymocytes of channel catfish aged 4 to 16 months exhibited reactivity with monoclonal antibodies against peripheral T cells but not B cells. Thymocytes responded to the mitogen Concanavalin A only in the presence of added accessory cells (peripheral blood monocytes) or a monocyte-derived supernatant (presumably containing IL-1) at permissive temperatures (27 degrees C). Thymocytes could also be induced to divide at nonpermissive temperatures (17 degrees C) when incubated in the presence of the following combinations of stimulants, a) the phorbol ester 12-O-tetradecanoyl-phorbol-13-acetate (TPA) and the calcium ionophore A23187, b) TPA and ConA, or c) A23187 and ConA. In those cases where TPA or A23187 were used, accessory cells or their products were not needed. Collectively, these results support the notion that channel catfish thymocytes functionally mimic those lymphocytes in the peripheral blood previously designated as T cells. PMID- 3264796 TI - Internal iliac artery ligation in post-partum hemorrhage. AB - Between 1978 and 1986, internal iliac artery ligation was performed on eight patients undergoing treatment for severe post-partum hemorrhage, and disseminated intra-vascular coagulation (DIVC) combined with causal pathology was detected in five patients. This procedure was effective in controlling bleeding in eight patients and no hysterectomy was necessary. Post-operative follow-up was uncomplicated in six patients. One patient suffered from post-operative occlusion. Another patient suffered from renal failure, due to secondary cortical renal necrosis. Surgery is usually simple and does not pose any technical problems. This technique allows for the conservation of the reproductive functions, and two of the women became pregnant at a later stage. Obstetric hysterectomy can be avoided by using this technique. It is recommended in cases where DIVC does not respond to medical treatment and can furthermore be used by all surgeons. PMID- 3264797 TI - Roles of myo-inositol 1,4,5-trisphosphate and myo-diacylglycerol in vascular smooth muscles as second messengers: in relation to actions of acetylcholine. PMID- 3264798 TI - Human testis cytosol and ovarian follicular fluid contain high amounts of interleukin-1-like factor(s). AB - Human testicular cytosol and ovarian follicular fluid were analyzed for the presence of interleukin-1 (IL-1)-like factors. Both the follicular fluid and testis cytosol preparations exhibited significant IL-1-like activity as determined by the murine thymocyte proliferation bioassay. The dose-response lines obtained with the gonadal preparations were parallel to each other and to those obtained with monocyte-derived IL-1 and the activity of the gonadal IL-1 could be neutralized by specific IL-1 antibodies. After gel chromatography of human follicular fluid (hFF) and human testis cytosol (hTC) proteins, IL-1 activity was found in the molecular weight region between 30 and 50 kilodaltons (kDa). Chromatofocusing of IL-1 from hFF and hTC revealed that the major part of IL-1 in both cases exhibited similar charge properties (pI less than 6.0). However, two extra peaks (pI 7.0 and greater than 9.0, respectively) were observed in hFF preparations. After isoelectrofocusing (IEF), IL-1 activity of hFF was also found in two different pH regions; a broad area of activity was localized between pH 5.5 and 7.0, while a sharp peak was observed with an approximate pI value of 9.5. Re-chromatofocusing or IEF of alkaline IL-1-like activity resulted in a heterogeneous profile of IL-1-like activity suggesting that the alkaline material may represent either a precursor or an aggregated form of the acidic IL-1. None of the IL-1 peaks obtained from hFF or hTC exhibited IL 2 activity as assessed in a specific IL-2 bioassay. The results of the present study indicate that both gonads may produce high amounts of IL-1-like factor(s) which might play a regulatory role in normal gonadal function. PMID- 3264800 TI - Screening of IgA deficiency by ELISA: population frequency in Hungary. AB - The probability of the development of an anaphylactic shock in IgA deficient patients following repeated blood transfusion or the administration of any other IgA containing preparation is high. Since these individuals usually show mild, if any, clinical symptoms, the detection of deficiency and/or sensitisation is very important. We have developed an ELISA system suitable for both the rapid mass screening of IgA deficiency and for the detection of anti-IgA already present in the serum. Applying these methods for screening of serum IgA deficiency in healthy Hungarian population resulted in a similar pattern to that reported for other countries. Interestingly, the prevalence of IgA deficiency among Gipsies living in Hungary was significantly higher. We could detect anti-IgA only in one of our IgA deficient patients. PMID- 3264799 TI - [A method for selecting and preparing a venous autograft in operations for aortocoronary shunting]. PMID- 3264802 TI - [AIDS. No long-term solution]. PMID- 3264801 TI - Allergic contact sensitization potential of hydroxycitronellal in humans. AB - Hydroxycitronellal, an important ingredient in fragrances, was studied for its sensitizing potential in human skin. Fifteen human maximization tests were conducted with hydroxycitronellal obtained from four different sources at induction concentrations from 5 to 12%. No reactions were induced at 5% in two separate panels while 10% sensitized 2/25 panelists in one test but none in a second. Induction at 12% produced sensitization in 8 of 11 tests. Impurities do not appear to be a sensitizing factor. There is some evidence that the l stereoisomer is a less potent sensitizer than the d-stereoisomer. In an initial modified human repeat-insult patch-test two positive reactions to challenge were observed among 197 panelists, one at a concentration of 5% and the other at 7.5%. When 100 of the non-reacting panelists were re-exposed in the same way, allergic sensitization reactions appeared during the induction period with concentrations as low as 2.5%. When 28 sensitized panelists were exposed to 1% concentrations in a simulated use test, there were three reactors. A no-effect level for sensitization has not been determined although the lowest concentrations tested were in the product usage range. PMID- 3264803 TI - Immunostaining for alpha 1-antichymotrypsin and alpha 1-antitrypsin in gliomas. AB - Antisera to alpha 1-antichymotrypsin, alpha 1-antitrypsin and lysozyme were reacted with 20 cases of glioblastoma multiforme, seven anaplastic astrocytomas, eight astrocytomas, six oligodendrogliomas, four ependymomas and the cerebral cortex from six normal autopsy brains. In addition, two pleomorphic xantho astrocytomas and two heavily lipidized malignant gliomas were similarly examined. All astrocytic lesions were confirmed with anti-GFAP antisera. Thirty astrocytic tumours (77%), four oligodendrogliomas (67%) and three ependymomas (75%) reacted positively with anti-alpha 1-antichymotrypsin; 25 astrocytic tumours (64%), three oligodendrogliomas (50%) and three ependymomas (75%) showed positive staining for alpha 1-antitrypsin. The pattern of staining with either of these two markers did not correlate with tumour grading. None of the gliomas examined stained positively with anti-lysozyme. Non-neoplastic glial elements did not react with any of the three antisera. The results of this study suggest that staining for alpha 1-antichymotrypsin and alpha 1-antitrypsin is of little value in the differential diagnosis of neuroepithelial or mesenchymal lesions in the brain. PMID- 3264804 TI - Existence of both IL-1 alpha and beta in normal human amniotic fluid: unique high molecular weight form of IL-1 beta. AB - We investigated the possible existence of IL-1 in human amniotic fluid (AF). Since AF from most full-term deliveries appeared to contain an inhibitor(s) for thymocyte proliferation, AFs were fractionated by gel filtration prior to IL-1 assay. IL-1 activities eluted in two peaks at positions of 90,000-60,000 MW and 20,000-15,000 MW. Growth inhibitory activity eluted at the position of 70,000 50,000 MW, and its effect appeared to be non-specific because these fractions inhibited the growth of various cell lines. Using isoelectric focusing (IEF) techniques, pI values of 6.8-7.3 for the higher MW IL-1 as well as 4.9-5.5 and 6.7-7.0 for the lower MW IL-1 were obtained. Antibody against human IL-1 alpha partially neutralized the activity of the lower MW IL-1, though it exhibited little effect on the higher MW IL-1. In contrast, antibody against human IL-1 beta almost completely neutralized the activity of the higher MW IL-1 and partially neutralized the activity of the lower MW IL-1. These results suggest that most of the higher MW IL-1 is beta-type, and the lower MW IL-1 is a mixture of alpha and beta-types. IL-1 beta appeared to exist as a complex (combined with AF components) or as an aggregate of the lower MW IL-1 forms. These findings indicate that both IL-1 alpha and IL-1 beta are present in normal human AF from full-term deliveries, though IL-1 beta exists as a higher MW form aggregated with an unknown molecule. PMID- 3264805 TI - Autocrine regulation of T-lymphocyte proliferation: differential induction of IL 2 and IL-2 receptor. AB - Three stimuli were used to compare the signals necessary for interleukin (IL-2) receptor expression and IL-2 production: triggering of the T-cell antigen receptor/CD3 complex (Ti/CD3) by CD3 antibodies, activation of protein kinase C (PKC) by phorbol esters, and elevation of intracellular calcium levels by calcium ionophore. The salient observations were that IL-2 responsiveness, which reflects IL-2 receptor expression, and T-cell proliferation which requires both IL-2 production and IL-2 receptor expression, are not co-ordinately regulated. Firstly, a low threshold of CD3 activation or a brief (1 hr) exposure of T cells to maximal CD3 stimulation is sufficient to induce IL-2 responsiveness, but higher levels of activation for a prolonged period are necessary to ensure a T cell proliferative response. Secondly, in response to optimal T-cell stimulation there is a short (2-4 day) period of T-cell proliferation followed by a prolonged phase of IL-2 responsiveness (10-14 days). Differences in the kinetics and signalling requirements for IL-2 receptor expression and IL-2 production, regulated at the level of mRNA expression, provide a molecular basis for these observations. A major difference between induction of IL-2 production and IL-2 receptor expression is that the dual signals of calcium and PKC are necessary for IL-2 production, but a sole stimulus of PKC is sufficient for IL-2 receptor expression. Also, a low level stimulation of PKC will induce IL-2 receptor expression but higher levels of PKC stimulation are required for IL-2 production. As a consequence, triggering of a single receptor, namely the Ti/CD3 complex, results in IL-2 responsiveness, but an additional signal that activates PKC is necessary for IL-2 production. These observations suggest that a Ca2+/PKC dual signal model does not explain completely the signal transduction pathways that regulate T-cell growth. Moreover, precise regulatory mechanisms have evolved to control the homeostasis of the autocrine proliferative response of a T-cell population. PMID- 3264806 TI - Phorbol myristate acetate induces IL-2 secretion by HUT 78 cells by a mechanism independent of protein kinase C translocation. AB - The protein kinase C (PKC) inhibitor H-7 was used to study the role of PKC in IL 2 secretion. In Jurkat E6.1, a phenotypically non-activated human T-cell line, IL 2 secretion in response to a combination of PMA and the calcium ionophore, ionomycin, or to the mitogen phytohaemagglutinin (PHA) was completely inhibited by H-7. In contrast, HUT-78, a phenotypically activated T-cell line, secreted IL 2 in response to PMA alone, and IL-2 secretion was not inhibited by doses of H-7 that completely blocked PKC activity. We conclude that PMA can stimulate IL-2 secretion independent of the translocation of PKC activity, and suggest that there is an alternative mechanism of action for phorbol esters in activated T cells. PMID- 3264807 TI - Activation and proliferation of normal resting human T lymphocytes in serum-free culture: role of IL-4 and IL-6. AB - Purified human T lymphocytes, completely depleted of accessory cells [i.e. monocytes, large granular lymphocytes (LGL) and B lymphocytes], have been grown in serum-free culture in presence of a mitogenic lectin (phytohaemagglutinin, PHA) and different recombinant cytokines. Only IL-2 and IL-4 induced a marked stimulation of [3H] thymidine ([3H]TdR) uptake, cell proliferation and expression of activation markers [transferrin receptor (TrfR), IL-2R]. The other cytokines (IL-1 alpha, IL-1 beta, IFN-gamma, GM-CSF, TNF-alpha) had no significant effect, except for a moderate, but significant, stimulation of [3H]TdR uptake induced by IL-3. Simultaneous addition of IL-4 and anti-IL-2 neutralizing monoclonal antibodies (mAb) did not modify the effects induced by IL-4 alone. Furthermore, IL-2 was not detected in the supernatant of T cells grown in the presence of PHA and IL-4. Thus, our results indicate that IL-4 acts on T lymphocytes independently of IL-2. We also observed that IL-6 moderately activates DNA synthesis in PHA-stimulated T lymphocytes, but markedly potentiates the proliferative effect of suboptimal amounts of IL-2. In conclusion, the present study suggests that B-cell growth factors, in addition to IL-2, control the proliferation of normal circulating T lymphocytes. PMID- 3264808 TI - Specific inhibition of OKT3-driven T-cell mitogenesis by an anti HLA-class I monoclonal antibody. AB - Triggering of the T-cell receptor by anti-CD3 monoclonal antibodies (mAb), for example OKT3, induces accessory cell (AC)-dependent interleukin-2 (IL-2) and IL-2 receptor synthesis, and ultimately, T-cell proliferation. We report on the ability of a HLA-class I specific monomorphic mAb, namely FMC16, to inhibit OKT3 driven T-cell mitogenesis. FMC16 was apparently selective for OKT3 because it did not block Concanavalin A (Con A) or mAb Leu-4 induced proliferation. Moreover, this effect was not due to non-specific toxicity nor interference with OKT3 binding. Kinetic analysis showed that FMC16 was inhibitory when added up to 24 hr after initiation of culture. FMC16 drastically reduced both IL-2 production and IL-2 receptor expression, but did not interfere with IL-2 responsiveness. The inhibitory effects were not altered by the addition of exogenous IL-2 if FMC16 was present at the beginning of culture; however, IL-2 did restore proliferation if FMC16 was not added until 3 to 6 hr after initiation of culture. This coincided exactly with an IL-2 mediated increase in the level of TAC-positive cells. Furthermore, T-cell activation triggered by the synergistic action of OKT3 and a phorbol ester (TPA) in the absence of AC was also blocked by FMC16, suggesting that inhibition was not AC-dependent. Taken together, these results indicate that FMC16 interferes with early signals leading to IL-2 production and IL-2 receptor expression and suggest that HLA-class I determinants play an early role in T-cell activation. PMID- 3264810 TI - Analysis of cell division among subpopulations of lymphoid cells in sheep. I. Thymocytes. AB - The number, distribution and surface phenotype of dividing cells in the thymus, and differences between the cell cycle status of thymocyte subpopulations, were studied in fetal and post-natal lambs using double-labelling techniques. Dividing cells were labelled in vivo for various periods with 5-bromo-2-deoxyuridine (BrdU). The proportions of constituent thymocyte subpopulations that had synthesized DNA during the labelling period were measured by flow cytometry or immunohistochemistry using a panel of monoclonal antibodies (mAbs) specific for sheep lymphocyte differentiation antigens and MHC class I and class II antigens in conjunction with an anti-BrdU mAb. The proportion of thymocytes that incorporated BrdU during a 1-hr labelling period varied with age, and levels of 30%, 13% and 9% were measured, respectively, in 40- and 125-day-old fetuses and 8 week-old lambs. Eight percent of the thymocytes in lambs were synthesizing DNA, with 4% entering the G2 phase per hour, and a substantial number of thymocytes (21%) had a G2 + M phase DNA content. A small subset of thymocytes (1-3%) recognized by mAb E-79 localized to the subcapsular region of the cortex and displayed the highest level of BrdU incorporation. Cortical-type thymocytes (CD1+) comprised 50-70% of thymocytes; however, few of these incorporated BrdU and the proportion in the G2 + M phase of the cell cycle was higher than for other thymocyte subpopulations. The 197+CD4-CD8- T cells also showed no evidence of in vivo division. PMID- 3264809 TI - Adhesion of T and B lymphocytes to fibroblasts in tissue culture. AB - We have examined the direct interaction of lymphocytes with human fibroblasts in vitro. The results of our study, using radiolabelled lymphocytes, show that activated T cells rapidly adhered to the fibroblasts when the two types of cell were cultured together at 37 degrees, and that the residency time of lymphocyte fibroblast contact was approximately 30 min. Lymphoblast adhesion did not require the presence of divalent cations, but it was temperature-dependent. Although the binding of the lymphocytes was not prevented by the presence of monosaccharides or by treatment with exoglycosidases, it was highly sensitive to low concentrations of trypsin. Attachment was also inhibited partially in the presence of the sulphated fucose polysaccharide, fucoidan. These results suggest that at least two distinct receptors are involved in lymphocyte adhesion to fibroblasts. The binding of B lymphoblasts to fibroblasts was much greater than that of the activated T cells. Resting, non-stimulated, B and T lymphocytes both bound only very poorly, showing that only mature lymphocytes express high levels of functionally effective adhesion proteins. Moreover, the results of competition experiments suggest that different cell surface components mediate the interaction of T and B cells with fibroblasts. PMID- 3264811 TI - Analysis of cell division among subpopulations of lymphoid cells in sheep. II. Peripheral lymphocytes. AB - The number, distribution and surface phenotype of dividing cells in lymph nodes and blood and differences between the cell-cycle status of lymphocyte subpopulations were studied in lambs using double-labelling techniques. Dividing cells were labelled in vivo for various time periods with 5-bromo-2-deoxyuridine (BrdU). After removal of lymphoid tissues, the proportions of constituent lymphocyte subpopulations which had synthesized DNA during the labelling period were measured by flow cytometry or immunohistochemistry using a panel of monoclonal antibodies (mAbs) specific for sheep lymphocyte differentiation antigens and MHC class I and class II antigens in conjunction with an anti-BrdU mAb. There was a higher overall level of cell division in the ileocaecal lymph node than in either the prescapular or parathymic lymph nodes. In all three lymph nodes, the majority of lymphocytes which incorporated BrdU occurred in B-cell follicles or germinal centers. CD4+ and CD8+ T cells had a higher level of cell division (LI 5-14%) than those recognized by mAb 197 (CD4- CD8- subset) (LI less than or equal to 3%). PMID- 3264812 TI - Neonatal development of lymphoid organs and specific immune responses in situ in diabetes-prone BB rats. AB - Rats of the BB strain develop diabetes mellitus in a high percentage and display a severe T-cell lymphopenia. In order to investigate the role of micro environmental factors in the T-cell maturation in BB rats the postnatal development of macrophage subpopulations and T-lymphocyte subsets, in addition to the specific immune response in situ, were studied in thymus, spleen and lymph nodes of BB rats. Wistar rats were used as controls. From the day of birth on, a severe reduction was noticed in the macrophage subpopulations in the thymic cortex of BB rats, but not in spleen and lymph nodes, as compared to Wistar rats. The population of T-suppressor/cytotoxic cells (OX8-positive cells) did not increase any longer from Day 10 after birth in the thymic cortex and from Day 14 in spleen and lymph nodes. This is indicative for an intrathymic maturational defect of the OX8-positive cells in BB rats. No deviations could be observed in the development of the T-helper (ER2-positive) cell population. Young adult BB rats were as capable as Wistars of developing a specific immune response to thymus-independent (TI) antigens, but the response to a thymus-dependent (TD) antigen was delayed and decreased. Also the distribution pattern of the specific antibody-containing cells in a TD response in BB rats differed from that in Wistar rats. The ER2-positive cells, although present in normal numbers, may function insufficiently as T-helper cells in BB rats. PMID- 3264813 TI - Immunization with the Sm nuclear antigen induces anti-Sm antibodies in normal and MRL mice. AB - The spontaneous occurrence of antibodies against the Sm nuclear antigen is a highly specific marker for the diagnosis of SLE. We have previously shown that anti-Sm can be elicited by immunization of SLE-prone mice with purified Sm antigen. In the present study, this autoantibody was induced in normal mice by a similar immunization protocol. Anti-Sm produced by normal strains was predominantly IgG1, which is similar to the isotype distribution in Sm-immunized MRL mice, but unlike the IgG2a-dominated response seen for spontaneous anti-Sm. Anti-Sm raised by immunization in most strains recognized epitopes not seen by spontaneous human and murine SLE anti-Sm; of the eleven normal strains tested, only C3H and AKR, strains from which MRL was partially derived, responded to these determinants. Further, immunoblot analysis of anti-Sm generated by immunization of MRL and normal mice revealed that the same proteins recognized by spontaneous human and murine anti-Sm were also seen by these sera. This study shows that an autoantibody highly characteristic of SLE can be produced in normal and MRL mice after appropriate immunization, and that the fine specificity of such experimentally induced antibody can be similar to that of spontaneous anti Sm autoantibodies. The results imply a role for autoimmunization with Sm in the production of anti-Sm. PMID- 3264814 TI - Specific inhibition of the DNA-anti-DNA immune reaction by low molecular weight anionic compounds. AB - The structural features of the interaction between DNA and lupus anti-DNA antibodies were investigated by competition experiments with low molecular weight synthetic compounds. It was found that two correctly spaced chemical components, a substituted aromatic ring system and a negatively charged acidic residue, were required for the binding of most anti-DNA autoantibodies to their respective antigens. These chemical elements are combined in the structure of several anionic dyes, including some certified food colours. The dyes were found to interfere efficiently and specifically with the lupus DNA-anti-DNA immune reaction. Therefore, this family of compounds may serve as a basis for the development of a new approach to drug therapy in SLE. PMID- 3264816 TI - [A possible visceralization in a case of cutaneous T cell lymphoma under treatment with recombinant interferon alfa 2]. PMID- 3264815 TI - Mitogenic stimulation of human B lymphocytes via the inositol phospholipid 'dual pathway' of signalling requires persistent activation of both second messenger arms. AB - Highly purified resting tonsillar B lymphocytes mount an efficient mitogenic response on exposure to appropriate combinations of tumour-promoting phorbol esters and calcium ionophores, agents that mimic the biochemical second messengers generated through the cross-linking of surface immunoglobulins. By using agents that bind reversibly we show here that both signals need to be applied continuously in order for cells to proceed optimally to DNA synthesis. The data are consistent with the notion that, in the absence of 'help' from T lymphocytes or antigen-presenting cells, a chronic, persistent stimulation through antigen receptors is necessary to elicit a significant B-cell response. PMID- 3264817 TI - [Urodynamics for treating urinary incontinence]. PMID- 3264818 TI - Pathological gambling: estimating prevalence and group characteristics. AB - A problem which lies in the path of implementing policies designed to address the adverse effects of gambling is the lack of data on the size and composition of the compulsive gambler group. There is a pressing need, therefore, to develop a data base on gambling participation and its consequences. The present study sought to contribute to this goal by identifying the rate of pathological gambling among adults residing in a nine-county area of southeastern Pennsylvania and southern New Jersey. The study was designed as a scientific community survey employing behavioral criteria as the basis for identification of pathological gamblers. PMID- 3264819 TI - Modulation of antibody binding affinity by somatic mutation. AB - The affinity of hapten binding of monoclonal antibodies (MAbs) specific for 4 hydroxy-3-nitrophenylacetyl (NP) has been investigated at the molecular level by both site-specific mutagenesis and recombinant antibody construction, followed by expression in myeloma cells. We have shown that a single point mutation (trp--- leu at codon 33) in the variable region of the heavy chain (VH) is sufficient to endow a primary-response, germline-encoded antibody with an affinity for antigen typical of a secondary-response antibody carrying the same mutation. We have also demonstrated that mutations additional to the trp----leu exchange in the heavy chain and further mutations in the light chain are irrelevant to the high affinity phenotype of secondary-response antibodies. Since some of these are "parallel" mutations common to clonally unrelated antibodies, this suggests that the mutation rate is not constant across the entire immunoglobulin variable region. Although antibodies with a trp----leu exchange at position 33 are positively selected because of improved hapten binding affinity, we have found that, under rare circumstances, other patterns of mutations may be selected through particular D-JH combinations; we have demonstrated one case where this has generated an antibody with very efficient hapten binding ability. PMID- 3264820 TI - Tolerogenic conjugates of xenogeneic monoclonal antibodies with monomethoxypolyethylene glycol. I. Induction of long-lasting tolerance to xenogeneic monoclonal antibodies. AB - The therapeutic effectiveness of xenogeneic monoclonal antibodies (MAbs) (xIg) or their conjugates with toxins (xIg-Tx) is undermined because of their inherent immunogenicity. This complication may be overcome by converting the antigenic xIg to tolerogenic derivatives by coupling an appropriate number of monomethoxypolyethylene glycol (mPEG) chains (MW 6400) onto an xIg molecule. In our study, the test system consisted of inbred mice and human (myeloma) monoclonal immunoglobulins (HIgG) which were used in lieu of xIg; the immunizing antigen was heat-aggregated HIgG. The results of a variety of experimental protocols demonstrate that a long-lasting suppression (greater than 95%) of anti HIgG antibodies for periods in excess of 300 days was achieved by administration of tolerogenic HIgG(mPEG)n conjugates in spite of multiple injections of the immunizing antigen. Thus, pre-treatment of hosts with mPEG conjugates of xIg or of xIg-Tx is envisaged as a potential method for overcoming the antigenicity of these anti-tumour agents. PMID- 3264822 TI - The epidemiology of Perthes' disease in south India. AB - The incidence of Perthes' disease in parts of south India was estimated by means of a hospital survey, an incidence study and a prevalence survey. Based on the incidence study it was noted that the minimum incidence of Perthes' disease in Udupi Taluk on the western coastal plain of south India was 4.4 per 100,000 children aged 5 to 14 years, while the prevalence survey suggested that the incidence may be as high as 14.8 per 100,000 children. The studies showed that there is a marked geographical variation in the incidence of Perthes' disease in south India, the disease being much more common in the western coastal region than elsewhere. The age of onset of the disease was significantly higher than that reported from England and the disease appeared to be rural rather than urban. PMID- 3264821 TI - Epidemiology of toxoplasmosis among pregnant women in the Paris area. AB - A survey was performed using a sample of pregnant women selected at one of the biggest test centres in the Paris area. These women were serologically screened for toxoplasmosis between October 1981 and September 1983 (according to the prevention protocol for congenital toxoplasmosis established by the French health ministry). The prevalence rate of specific antibodies for toxoplasmosis was estimated from the 1074 women who were tested for the first time during the study. The prevalence rate among pregnant women in the Paris area was derived by direct standardization according to age and geographical origin. A standardized prevalence rate of 71% +/- 4% among French women, of 51.4% +/- 5% among immigrant women and a global adjusted prevalence rate of 67.3% +/- 3% for pregnant women in the Paris area was found. An incidence rate of 1.6% was estimated for the 2216 non-immune pregnant women included in the sample. There is no significant difference between the probabilities of seroconversion among French and immigrant women (2.3% +/- 1% and 1.6% +/- 0.8% respectively). Comparison of the data with previous study results show a decrease in the prevalence rate of specific antibodies for toxoplasmosis in the Paris area over the last 20 years that cannot be explained by changes in age and geographical origin. No data were available to support an aetiological hypothesis for a decrease in toxoplasma transmission to humans. Since immigration and a decrease in toxoplasma transmission to humans has led to a larger population of women at risk of infection during pregnancy in France, it is therefore important to perform studies to investigate risk factors and markers of acquired toxoplasmosis during pregnancy in order to improve the prevention of congenital toxoplasmosis. PMID- 3264823 TI - A seroepidemiological survey of HTLV-1 in the Philippines. AB - The prevalence of human T-lymphotropic retrovirus type-1 (HTLV-1) was examined in the Asian Pacific area to search for endemic foci outside Japan. A total of 1323 sera from healthy subjects in the Philippines including Filipino lowlanders, Mongoloid slash-and-burn agriculturalists and the Mongoloid aboriginal hunter gatherers (Aeta group and Mamanwa group) were examined for the presence of antibodies to HTLV-1 by the indirect immunofluorescence test and by the Western blot technique using HTLV-1 carrying cells. Nineteen out of 20 HTLV-1 antibody carriers found in the present study are clustered in the Aeta group of Mongoloid aboriginal hunter-gatherers who have until recently been isolated in the remote mountainous areas of Luzon Island since their arrival in the Philippines during the last glacial era (12,000-15,000 years ago). This finding supports the theory that HTLV-1 originated in Mongoloid racial groups during prehistoric times. PMID- 3264824 TI - The efficacy of pertussis vaccines under conditions of household exposure. Further analysis of the 1978-80 PHLS/ERL study in 21 area health authorities in England. AB - It has been reported that the efficacy of pertussis vaccines appears to be lower when assessed in household contact studies than when assessed in cohort analyses of general populations. This observation may be attributable in part to methodological factors in home contact studies, in particular to the inclusion of retrospectively ascertained cases and of households in which the primary case constituted a vaccine failure. These biases are illustrated using data from a study of the efficacy of pertussis vaccines carried out by the Public Health Laboratory Service Epidemiological Research Laboratory PHLS/ERL in England during 1978-1980. This analysis reveals several factors which should be considered in the design, analysis and interpretation of household contact studies for evaluation of vaccine efficacy. PMID- 3264825 TI - Sleep and cerebrospinal fluid interleukin-1-like activity in the cat. AB - Exogenous interleukin-1 (IL-1), applied intraventricularly, has been reported to enhance slow wave sleep. Here, we demonstrate that endogenous interleukin-1-like activity and IL-1 beta of the cat CSF increases during sleep in comparison to wake. PMID- 3264826 TI - Positron emission tomography in aging and dementia: effect of cerebral atrophy. PMID- 3264827 TI - Arylsulphatase activity in the oviduct of the frog Rana esculenta. II. Progesterone-induced changes following ovariectomy and hypophysectomy. AB - The effects of progesterone treatment on arylsulphatase activity were studied histochemically and biochemically in the frog oviduct under different experimental conditions. In ovariectomized animals, the hormone induced a large increase in enzyme activity, while in hypophysectomized ones there was a large decrease in this activity. These results indicate that the facilitatory and inhibitory effects of progesterone on arylsulphatase activity are influenced by the presence in situ of the gonad. Hypotheses are advanced to explain different effects of the progesterone treatment. PMID- 3264828 TI - In vitro antibacterial activity of FK482, a new orally active cephalosporin. AB - FK482 is a new orally active cephem antibiotic which offers some advantages over the commercially available oral beta-lactam antibiotics. It displayed a broad spectrum of activity in vitro against stock strains of Gram-positive and Gram negative aerobes and anaerobes. FK482 was more active in vitro than cefixime (CFIX), cefaclor (CCL) or cephalexin (CEX) against clinical isolates of Gram positive organisms such as methicillin-sensitive Staphylococcus aureus, coagulase negative Staphylococci including Staphylococcus epidermidis and strains of the Streptococcus group. Moderate activity was found against methicillin-resistant S. aureus and Enterococcus faecalis. Against clinical isolates of many Gram-negative species, including opportunistic pathogens, FK482 had good in vitro activity similar or slightly inferior to that of CFIX but superior to that of CCL or CEX. However, it was clearly inferior to CFIX in activity against Serratia marcescens, and was inactive against Pseudomonas aeruginosa. Strains of S. aureus resistant to methicillin were moderately susceptible to FK482. All tested strains of Klebsiella pneumoniae resistant to CCL and CEX were susceptible to FK482, as were all the strains of Escherichia coli, Proteus mirabilis, Haemophilus influenzae and Branhamella catarrhalis resistant to amoxicillin (AMPC). FK482, like CFIX, was relatively stable to all type of beta-lactamases except Bacteroides fragilis and its stability was superior to that of CCL or CEX. The antibacterial activity of FK482 against CSH2 strains containing ampicillin-resistance plasmids was not affected by the presence of the ampicillin resistance determinants. FK482 showed higher affinity for the penicillin-binding proteins (PBPs) (3, 2 and 1) of S. aureus than did CFIX, CCL and CEX. FK482 also showed very high affinity for the PBPs (2 and 3) of E. faecalis and PBPs (3, 1a, 4, 2 and 1 bs) of E. coli. The bactericidal activity of FK482 against S. aureus was almost as strong as that of AMPC and superior to that of CCL or CEX. Against Gram-negative bacteria such as E. coli, K. pneumoniae and P. mirabilis, FK482 was similar to CFIX and superior to CCL and CEX in bactericidal activity. PMID- 3264829 TI - Cochlear and vestibular functions of the rat after obliteration of the endolymphatic sac. AB - A combined morphological and physiological study on the effect of saccus obliteration on the cochlea and the vestibular labyrinth of the rat is presented. Endolymphatic hydrops was successfully induced in 49% of the animals. It was frequently associated with fistulae of the membranous wall and degenerative changes in the organ of Corti and spiral ganglion. In hydropic ears electrocochleography revealed a CAP threshold increase only in those cases where hydrops was associated with loss of hair cells and ganglion cells. In two of these animals also an increased negative SP was present. Static otolith reflexes were found to be normal in all hydropic ears despite severe lesions of the saccule in some of these. Abnormal canal reflexes measured by electronystagmography and cupulometry were established in animals with hydrops of the semicircular canals and in one animal with a fistula of the saccule. PMID- 3264830 TI - Distribution of beta-lactamases and phenotype analysis in clinical strains of Acinetobacter calcoaceticus. AB - One hundred clinical strains of Acinetobacter calcoaceticus isolated from 1981 to 1986 were screened for enzymatic resistance to beta-lactam antibiotics. Fourteen beta-lactam antibiotics were tested and four phenotypes were defined on the basis of enzymatic resistance and of susceptibility to the following beta-lactams: ticarcillin, piperacillin, cefotaxime, and ceftazidime. The resistance of A. calcoaceticus to beta-lactam antibiotics was predominantly due to beta lactamases, which were produced by 81% of the strains. In most (71%) of the beta lactamase producing strains, a penicillinase of the TEM type was observed; in 9% of the strains, all isolated since 1985, a CARB-type penicillinase with a pI 6.3 was observed. The presence of a cephalosporinase type enzyme was detected in acinetobacter strains isolated since 1981 and its incidence increased in 1986. Multiple beta-lactamases (penicillinase plus cephalosporinase) were observed in 32% of the strains. PMID- 3264831 TI - Therapeutic efficacy of chloramphenicol, co-trimoxazole (trimethoprim/sulphamethoxazole), cefmenoxime and ceftriaxone in experimental bacteraemia and meningitis caused by ampicillin-resistant Haemophilus influenzae type b. AB - Therapeutic efficacy of two newer cephalosporins, cefmenoxime and ceftriaxone, was evaluated in newborn rats with experimental bacteraemia and meningitis due to an ampicillin-resistant strain of Haemophilus influenzae type b, and the results were compared with those of ampicillin, chloramphenicol and co-trimoxazole (trimethoprim/sulphamethoxazole). Measured by MICs and MBCs, cefmenoxime and ceftriaxone were at least a hundred-fold more active in vitro than chloramphenicol. Co-trimoxazole was bacteriostatic in vitro. For in-vivo studies, the following daily doses were used: 200 mg/kg for ampicillin; 100 mg/kg and 200 mg/kg for chloramphenicol; 10/50 mg/kg, 20/100 mg/kg and 100/500 mg/kg for trimethoprim/sulphamethoxazole; 10 mg/kg and 50 mg/kg for cefmenoxime; and 10 mg/kg and 25 mg/kg for ceftriaxone. Cefmenoxime and ceftriaxone were highly efficacious, even at a dose of 10 mg/kg/day, in eradicating the organism from blood and CSF, preventing bacteriological relapse and improving the survival rate. In contrast, chloramphenicol was effective in reducing mortality, but failed to eradicate the organism or to prevent relapse, while co-trimoxazole was least effective in that all but one survivors suffered relapse with positive blood and CSF cultures. Ampicillin gave unexpected results in that the organism was eradicated in all survivors and bacteriological relapse was prevented in most animals (73-75%). PMID- 3264832 TI - Antibiotic resistance in anaerobic bacteria. AB - An improved understanding of the mechanisms of resistance and transfer in Bacteroides fragilis has been gained over the past decade. B. fragilis resistance to most penicillins is largely due to production of chromosomal beta-lactamases, although recent findings indicate these micro-organisms can acquire novel beta lactamases, which can even inactivate imipenem. Several of the beta-lactamases of B. fragilis are transferable. Most of our understanding of transferable antimicrobial resistance in Bacteroides spp. has been gained through studies of the clindamycin-erythromycin resistance determinant found on pBFTM10. This resistance is encoded on a transposon and is widely distributed among the naturally occurring clindamycin-resistant isolates. Recent studies have shown that DNA can be transferred from Escherichia coli to B. fragilis, from one B. fragilis to another, and from B. fragilis back to E. coli. Data from a large survey in the United States indicate that susceptibility patterns of B. fragilis differ in each of the eight participating centres. Overall, piperacillin and cefoxitin have been found to be the most active beta-lactam agents. PMID- 3264833 TI - A new human pancreatic carcinoma cell line developed for adoptive immunotherapy studies with lymphokine-activated killer cells in nude mice. AB - A human tumor cell line designated SU.86 has been established from a moderate-to poorly differentiated pancreatic carcinoma of ductal origin specifically for adoptive immunotherapy studies. This line was characterized as to its ability to be lysed in vitro by autologous and allogeneic lymphokine-activated killer (LAK) and natural killer cells and to grow in nude mice. SU.86 has been growing continuously in cell culture for more than 100 passages since 22 September 1986. Transplantation orthotopically and heterotopically into athymic Swiss nude mice showed that tumor take was 100% in the orthotopic position when young (4 to 6 wk old) mice were used and 0% when adult (8 wk old) mice were used (P = 0.004). In the heterotopic position (subcutaneous), tumor take was 100% in neonate (2 to 3 wk old) and young mice and 50% in adults. The rate of tumor growth was inversely correlated with age (P less than 0.001). The histologic pattern is similar to that observed in most human pancreatic carcinomas with pseudoglandular structures and frequent mitotic figures. SU.86 has a doubling time of 77 h in vitro and produces carcinoembryonic antigen, 594 ng/10(6) cells in 3 d. Chromosomal analysis shows heterogeneity with two notable cell subpopulations. The cell line is moderately sensitive to lysis by LAK cells in a standard, 4-h chromium-51 release assay (35.4 +/- 4.0%). When grown together with LAK cells in vitro, it is lysed completely in culture in 8 to 15 d, depending on the serum concentration. PMID- 3264834 TI - Myocardial revascularisation in patients over seventy five years. AB - A consecutive series of 73 patients aged 75 years and above underwent coronary artery bypass graft surgery during a 6 year period. Pre-operatively unstable angina (61.6%) and congestive heart failure (10.9%) were significant presenting features. Triple vessel disease accounted for 61.6% of cases while 26% had left main coronary obstruction. The mean number of grafts per patient was 3.2 +/- 0.9. Combined procedures such as valve replacement were done in 16.2% of patients. The hospital mortality rate was 2.7% and there was not a single recordable case of peri-operative myocardial infarction. Significant complications post-operatively were atrial arrhythmias (43.8%), segmental pulmonary atelectasis (43.8%) and renal problems (15%). Of the sixty patients followed up at an average of 27.7 months, 58 were in NYHA Functional Class I. Good patient selection and careful monitoring leads to encouraging results with coronary artery bypass grafting in the elderly. PMID- 3264835 TI - Internal mammary artery grafting: is this a benign procedure? AB - 2,784 patients had a primary coronary artery reconstruction, between 1977 and 1987. From 1984, one internal mammary artery (IMA) and later both IMAs were used as the grafts of choice, supplemented where necessary with a saphenous vein graft (SVG). As a result, 1,681 patients had SVG, 726 had a single internal mammary artery graft (SIMA), while 377 patients had a bilateral internal mammary artery reconstruction (BIMA). Comparison of the pre-operative data showed that patients who had a SIMA were similar to those who had a SVG except that they were older, had a more stable presentation and they had a higher incidence of myocardial infarction. Patients who had a BIMA reconstruction were younger, more frequently male, presented with more stable symptoms, and had better left ventricular function than patients who had a SVG alone. Despite these favourable findings, the incidence of peri-operative myocardial infarction was higher in the BIMA group, compared with the SVG group. The change from SVG grafting to SIMA grafting was also associated with a higher incidence of post-operative bleeding. The surgical mortality was similar in all 3 groups. These findings suggest that the change to IMA grafting is associated with a slightly increased morbidity and perhaps this operation should be performed on selected patients rather than used routinely. PMID- 3264836 TI - Cerebral perfusion defects, dysautoregulation and carotid stenosis. AB - Single Photon Emission Computed Tomography (SPECT), imaging of cerebral blood flow was carried out in ten patients with haemodynamically significant carotid stenosis. Before and after carotid endarterectomy each patient was investigated by 3--dimensional SPECT brain scanning using technetium--hexamethyl propyleneamine oxine (99 mTcHMPAO, ceretec). Brain blood flow was normal before and after operation in 3 patients whose autoregulation was kept intact. Seven patients received acetazolamide to limit cerebral vascular reactivity and in four of these, preoperative perfusion defects were visible. After carotid endarterectomy the ipsilateral perfusion defects were abolished and it is concluded that carotid stenosis can reduce perfusion in the dysautoregulation brain and that carotid reconstruction can restore normal flow. PMID- 3264837 TI - Positioning of actin filaments and tension generation in skinned muscle fibres released after stretch beyond overlap of the actin and myosin filaments. AB - Skinned fibres from frog semitendinosus muscle were stretched in relaxing solution from a sarcomere length of 2.5 microns to greater sarcomere lengths, and then shortened back to the original length. Fibres could be stretched up to sarcomere lengths of 3.3 microns, and reshortened fully. If the original stretch was to a sarcomere length greater than 3.3 microns, the extent of recovery was dependent on the magnitude of the stretch and the number of times the stretch/shorten cycle was repeated. When the original stretch was to sarcomere lengths beyond overlap of the thick and thin filaments, the thin filaments did not re-enter the thick filament array but buckled at the A-I junction. If these fibres were subsequently activated and contracted, the thin filaments re-entered the thick filament array, taking up approximately their former positions, and allowing reduced development of isometric tension. PMID- 3264838 TI - Effects of guanidinium on EC coupling and tension generation in frog skeletal muscle. AB - The effect of the chaotropic cation guanidinium on tension generation was investigated in voltage-clamped intact and mechanically skinned muscle fibres of the frog. When sodium was replaced by guanidinium in the solution a 20-mV shift of the sigmoidal activation curve towards less negative potentials was recorded. A similar shift in the voltage dependence of mechanical inactivation did not occur. The plateau phase of contractures activated by long-lasting depolarizations was significantly shortened in the presence of 77.5 mM guanidinium. In a second set of experiments, charge displacement currents were measured using the cut fibre preparation. Apparently, guanidinium had no effect on the voltage dependence of intramembrane charge movement. On the other hand, this cation caused a distinct increase in the amount of charge necessary to reach the contraction threshold at rheobase voltage from 12.4nC microF-1 to 23.4nC microF-1. Experiments on skinned fibres containing an operating sarcoplasmic reticulum demonstrated that 5 mM guanidinium diminished caffeine-induced tension development and substantially delayed the onset of the contractile response. However, guanidinium did not impair calcium-induced tension development of the contractile apparatus. These results suggest that the inhibitory action of guanidinium on excitation-contraction coupling is due to a depression of calcium release from the sarcoplasmic reticulum. PMID- 3264839 TI - Effects of kynurenate and other excitatory amino acid antagonists as blockers of light- and kainate-induced retinal rod photoreceptor disc shedding. AB - Photoreceptor disc shedding in the retina involves detachment of discs from distal outer segments and phagocytosis of those discs by adjacent pigment epithelial cells. The disc-shedding process balances the continuous renewal of photosensitive membrane. In amphibians, rod disc shedding normally is light stimulated. However, excitatory amino acids such as kainate stimulate disc shedding independent of a dark-light transition. Excitatory amino acid-induced disc shedding is accompanied by toxic changes within the retina. To evaluate the possible role of an endogenous excitatory amino acid in the regulation of light evoked disc shedding, we examined the effects of excitatory amino acid antagonists on kainate-induced and light-evoked disc shedding and on retinal toxicity. Using eyecups from Rana pipiens, we found that kynurenate, D-O phosphoserine, and cis-2,3-piperidine dicarboxylic acid (cis-PDA) all block both the neurotoxic and disc-shedding effects of kainate. Kynurenate and D-O phosphoserine, but not cis-PDA, also block light-evoked disc shedding. Our analysis suggests that kynurenate blocks the mechanism by which light "triggers" disc shedding rather than directly inhibiting disc detachment and phagocytosis. The observation that cis-PDA antagonizes the effects of kainate, but not light, suggests that the receptor mediating the kainate effect on disc shedding may not be involved in the normal initiation of the response by light. In contrast, our data on kynurenate suggest that it antagonizes an endogenous mechanism involved in the normal control of disc shedding. Thus, analysis of the differences between cis-PDA and kynurenate as antagonists in the retina may yield important insight into the mechanism by which light initiates disc shedding. PMID- 3264841 TI - I-bands of striated muscle contain lateral struts. AB - In electron micrographs of striated muscle, the I-band often shows a distinct cross-striation. The periodicity of this striation is near 40 nm and has been attributed to troponin, which is localized along the thin filament. However, the cross-striation is often so prominent as to be suggestive of physical structures running transversely across the I-band. We examined I-band ultrastructure using three independent methods: thin sections of chemically fixed specimens; freeze fracture; and freeze-substitution. With all three methods we found transverse structures distributed throughout the I-band, many of which bridged the gap between neighboring filaments. Such structures were observed in each of the several species studied. In fish muscle in particular, which has a highly regular lattice, it was obvious that these structures gave rise to the observed periodicity. PMID- 3264840 TI - Intrahypothalamic microinfusion of corticotropin-releasing factor elevates blood glucose and free fatty acids in rats. AB - Three experiments examined whether intrahypothalamic microinfusions of corticotropin releasing factor (CRF) can affect circulating levels of the metabolic fuels, glucose and free fatty acids. Infusions of CRF into the paraventricular nucleus dose-dependently increased serum glucose levels; greater increases were seen in acute than in chronic preparations. The greater effectiveness could not be accounted for by anesthetization per se. CRF infusion into the ventromedial nucleus did not affect serum glucose. Infusions into both sites, however, significantly increased serum free fatty acids. Neither glucose nor free fatty acids were altered by infusions into the lateral hypothalamus or the caudate-putamen. These data suggest that the previously identified CRF binding sites and CRF neuronal terminals in the paraventricular and ventromedial nuclei may be involved in the central regulation of metabolic fuel release. Additionally, it appears that the importance of CRF in the paraventricular nucleus in regulating serum glucose may be greater under some conditions than others. PMID- 3264842 TI - [A-C bypass grafting and ligation of coronary arteriovenous fistula in a patient with idiopathic thrombocytopenic purpura]. PMID- 3264843 TI - [Analysis of phasic flow characteristics in human coronary artery during bypass graft surgery by high frequency pulsed Doppler velocimeter]. PMID- 3264844 TI - [Effects of obesity and weight gain during pregnancy on obstetrical factors]. AB - The relationship between the body weight or weight gain during pregnancy and various obstetrical factors was investigated in 731 patients who delivered in San ikukai Hospital for in the year 1986. The patients were classified into three groups according to their body weight in non-pregnant states: slender (n = 214), ordinary (n = 379) and obese (n = 138), according to the standard for "The decision diagram for the estimation of obesity and emaciation in Japanese" published in 1986 by the Ministry of Health and Welfare, Japan. Each of these groups was further divided into two groups according to the degree of weight gain during pregnancy (more or less than 15kg). Then, the duration of labor, the blood loss during delivery, the birth weight, the placental weight and the obstetrical abnormalities (prolonged labor, arrested labor, blood loss of more than 500 ml, fetal distress and toxemia of pregnancy) were investigated in these groups. The blood loss, the neonatal birth weight and the placental weight in the obese groups were much greater than those in the ordinary or the slender group (p less than 0.005). However, there was no significant difference in the duration of the labor among these groups. The incidence of obstetrical abnormalities in the obese group was significantly higher than in the ordinary or the slender group (chi 2 = 4.37, p less than 0.05, chi 2 = 5.27, p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264845 TI - Augmentation of antitumor effect of recombinant interleukin-2 activated killer cells by the administration of rIL-2 and lentinan. PMID- 3264846 TI - [Augmentation of lymphokine-activated killer (LAK) cell activity by combination of low dose interleukin 2 and several kinds of biological response modifiers (BRMs)]. PMID- 3264847 TI - Impedance screening for otitis media with effusion in Nigerian children. AB - Tympanometry and acoustic reflex tests performed on 431 school children aged five to six years showed that eight per cent of the ears screened had type B or type C tympanograms suggestive of otitis media with effusion (1.2 per cent type B, and 6.8 per cent type C). Preliminary otoscopy revealed tympanic membrane appearances consistent with middle ear effusion in a correspondingly low proportion of ears (7.6 per cent), whilst acoustic reflex screening at 105 dB for three frequencies (0.5, 1 and 2 kHz) showed absent reflexes at one or more frequencies in 8.1 per cent of the ears. The findings indicate a relatively low prevalence of otitis media with effusion in children in Nigeria. Possible contributory factors are discussed. PMID- 3264848 TI - Lung function, smoking and survival in severe alpha 1-antitrypsin deficiency, PiZZ. AB - Lung function, smoking, age and mortality data in 158 adult severe alpha 1 antitrypsin deficient, PiZZ individuals, followed from 1963 to 1982 were analyzed. Low initial FEV1 value was significantly associated with increased mortality (p less than 0.005). A 3 yr mortality rate of 40% was found in individuals whose initial FEV1 values were less than 30% of that predicted. In contrast, the corresponding 3-yr mortality among those whose initial FEV1 values were between 30 and 65% of that predicted was only 7%. Smokers were found to have significantly lower FEV1 levels (p = 0.008) and higher mortality (p less than 0.005) than non-smokers. The difference between current and ex-smokers in mortality and FEV1 level were not statistically significant (p = 0.9 and p greater than 0.25, respectively). Cross-sectional analysis of the initial FEV1 values indicated a significant decline (p less than 0.005) of FEV1 with increasing age. This decline was greater among smokers than non-smokers. Longitudinal analysis of FEV1 rates of decline in 80 cases with follow-up FEV1 measurements failed to detect any significant differences between smokers and non smokers, but was performed late in the disease process. The application of these results to the planning of studies on replacement therapy, smoking intervention strategy and longitudinal follow-up is discussed. PMID- 3264849 TI - Is unified monitoring improving patient care? AB - We compared our standard method of data presentation in the operating room (i.e., using "front end" equipment) with a newly developed, computerized monitoring system called the data acquisition and display system. These two systems differed in that data presentation using the standard front-end equipment was scattered and poorly structured, whereas data obtained from the newly developed system were unified and integrated. To effect the comparison, we examined the "controllability" (i.e., the precision of control) by the anesthesiologist of hemodynamic variables: arterial systolic, mean, and diastolic pressures, mean pulmonary artery pressure, mean central venous pressure, and heart rate. Controllability was assumed to be an indictor of the quality of anesthesia. All perioperative data were stored every 15 seconds on a floppy disk, and these data were available for analysis. The controllability was quantified by calculating the surface area of the signal of a variable outside a defined control zone; the smaller this surface area, the greater the controllability. A Mann-Whitney Wilcoxon statistical test was done to test whether the two different data presentation systems would result in different levels of controllability (the first zero hypothesis). A Kruskal-Wallis test was done to examine the "inter anesthesiologist variability" between the two systems (the second zero hypothesis). Our data showed great variability. Looking for factors that might explain this, we found that if preoperative systolic blood pressure was greater than 160 mm Hg and diastolic pressure was greater than 95 mm Hg, hemodynamic variables fluctuated more widely. We could show no differences in controllability when the two systems were compared overall.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264850 TI - Use of the pacing pulmonary arterial catheter to detect endocardial electrical activity during hypothermic cardioplegic arrest. AB - The pacing Swan-Ganz catheter was evaluated for its ability to monitor atrial and ventricular electrical activity during cardioplegic arrest on cardiopulmonary bypass. This endocardial electrical activity was compared with the activity found on the standard electrocardiogram (ECG). The atrial electrodes detected activity that was noted also by visual inspection. The ventricular electrodes detected recurring electrical activity in 7 of 18 patients. Three of these 7 patients did not have simultaneous standard ECG activity, indicating that, in the usual monitoring circumstances, this ventricular electrical activity would not have been treated with repeat cardioplegia. If the pacing Swan-Ganz catheter is used for clinical care, it can be used also to monitor myocardial electrical activity during cardioplegic arrest. PMID- 3264851 TI - Clinical assessment of a flow-through fluorometric blood gas monitor. AB - We performed an observational study to evaluate a flow-through fluorometric instrument (Gas-STAT) that continuously measures the carbon dioxide tension (PCO2), oxygen tension (PO2), and pH of blood in the cardiopulmonary bypass circuit. Setup and calibration of the instrument typically required 20 minutes. During bypass, 129 blood samples were drawn from 16 patients for comparison with conventional measurements obtained with a blood gas machine. Data for each variable, within each sensor, were analyzed by linear regression. The ranges of the standard errors of the estimate were 0.7 to 4.2 mm Hg for PCO2, 18.3 to 78.7 mm Hg for the high PO2 range, 1.4 to 7.1 mm Hg for the low PO2 range, and 0.008 to 0.049 for pH. The regression lines differed from the identity line (P less than 0.05) in at least one variable in most patients, and large deviations from the line of identity in both slope and intercept were common. Among 58 sensors evaluated, failures occurred in 5 (2.9%) of the 174 optodes, and minor leakage occurred in 2 (3.4%) of the flow-through cells. We conclude that although this flow-through fluorometric instrument is an adequate monitor of trends in blood gases during cardiopulmonary bypass, it is not accurate enough to supplant conventional laboratory measurements. PMID- 3264852 TI - Maternal zinc deprivation and interleukin-1 influence metallothionein gene expression and zinc metabolism of rats. AB - The influence of maternal dietary zinc intake and recombinant human interleukin-1 alpha (rhIL-1 alpha) administration on metallothionein gene expression and the distribution of 65Zn were investigated. Pregnant rats were fed diets containing 1, 5, 30 or 180 mg Zn/kg diet in an equalized regime from d 13-20 of gestation. Metallothionein gene expression was examined by Northern blot and dot blot hybridization using combined 60-mer oligonucleotides specific for rat metallothionein-1 and -2 genes. Expression was progressively depressed in the fetal livers and livers and kidneys of dams fed diets marginal (5 mg/kg) and deficient (1 mg/kg) in zinc content. Administration of rhIL-1 alpha increased expression in maternal liver, placenta and in fetal liver of dams fed adequate or deficient diets. Kinetics of intravenously administered 65Zn showed that in response to rhIL-1 alpha, there was a higher uptake by the maternal liver and bone marrow with less 65Zn uptake by bone, intestine and plasma activity compared to controls. No change was observed in 65Zn taken up by the placenta or transferred to the fetus. Alteration of metallothionein gene expression could represent, in part, the mechanism whereby altered effects of zinc metabolism and function are mediated during fetal development. PMID- 3264853 TI - Neonatal complications in small-for-gestational age neonates. AB - A prospective case-control study was carried out in 118 severely small-for gestational age (SGA) infants and in 118 control infants born during 1985 in the catchment area of the University Central Hospital of Turku to investigate the neonatal complication rate in SGA infants during modern obstetric and neonatal care. All SGA infants had a birth weight below the 2.5th percentile in our fetal growth curve and the control infants were matched for gestational age and mode of delivery. Neonatal complications were found in 42% of SGA neonates compared to 18% of control infants. Hypoglycemia, polycythemia and abnormal neurologic symptoms were more frequently found in SGA neonates than in control neonates. Asphyxia was found in 16% of SGA infants and in 8.5% of control infants. A five fold risk for hypoglycemia and a eight-fold risk for abnormal neonatal neurologic signs in SGA infants were found. SGA boys had more often asphyxia (22% versus 12%) and hypoglycemia (25% versus 5%) than SGA girls. The antenatal diagnosis of SGA infant was made in 35 cases (30%). Of these diagnosed infants 14 were delivered by cesarean section (39%), while the cesarean section rate in all SGA infants was 27%. Although antenatal diagnosis of poor intrauterine growth did not decrease the neonatal complication rate, the antenatal diagnosis resulted in more active intervention during delivery. The SGA infants still run an increased risk for complications during delivery and neonatal period and need special attention. PMID- 3264854 TI - The evolution and outcome of cavitating periventricular leukomalacia in infancy. A study of 46 cases. AB - Forty six infants with the ultrasonic diagnosis of cavitating periventricular leukomalacia (CPVL) have been reviewed. Follow up examination results allow correlation between the ultrasound appearances and subsequent neurodevelopmental and neurological deficits. The highest incidence of this condition was found in infants at and below 27 weeks gestation, and occurred in 15% of very premature infants surviving 14 days or more. Cavities developed 15 days after the onset of periventricular echodensity (median time). Ventricular dilatation occurred in 24% of the infants who developed cavities. Follow up information was available in 27 infants and 18 of these (67%) had significant neurodevelopmental handicap. The location of echolucent cavities were described as involving anterior, middle or posterior cerebral zones or any combination of these. Cerebral palsy was closely related to the presence of cavities, but there was little association between cavities and developmental delay. Four factors were found to predict cerebral palsy: cavities within the occipital zone, the involvement of multiple regions of the brain, lesions greater than 1 cm in diameter and cavities associated with subcortical leukomalacia. Lesions confined to the anterior or middle zones were unlikely to be associated with significant handicap. The presence of cavities per se was not associated with a higher incidence of severe developmental delay. PMID- 3264856 TI - Serial assessment of left ventricular function following coronary bypass surgery by radionuclide angiocardiography. AB - The serial change in left ventricular function was investigated by radionuclide angiocardiography in 25 patients undergoing coronary artery bypass grafting (CABG). Multiple gated equilibrium blood pool imaging was performed at rest before, and at 1, 2 and 4 weeks after the operation and also during exercise on a supine bicycle ergometer before and 4 weeks after surgery. Global ejection fraction at rest was unchanged after CABG while peak ejection rate increased significantly at 1 and 2 weeks (p less than 0.01 and p less than 0.05 respectively) after the operation. Peak filling rate at rest was generally unchanged after surgery but peak filling rate during the first third of diastole at rest decreased significantly at 1 and 2 weeks (p less than 0.01 and p less than 0.05). After CABG, the increases in ejection fraction and peak ejection rate with exercise were significantly greater than those values measured before surgery. The increases, due to exercise, in peak filling rate and peak filling rate during the first third of diastole were unchanged after the operation. Radionuclide angiocardiography affords a safe, noninvasive, and highly reproducible procedure for serially assessing ventricular function in patients undergoing CABG. Our study revealed early diastolic dysfunction within 2 weeks of surgery and that CABG abolished abnormalities in left ventricular function induced by exercise. PMID- 3264855 TI - Psychological factors influence the success of coronary artery surgery. AB - Thirty-six patients with angina were investigated by treadmill exercise testing and coronary angiography prior to coronary artery surgery. Severity of angina was judged by interview and self-assessment visual analogue scale and all patients were psychiatrically assessed. Further physical and psychiatric assessments were made at 3 and 6 months postoperatively. Eleven patients (31%) had significant psychiatric morbidity preoperatively and these had worse symptom scores and exercise tolerance compared with non-psychiatric cases, despite equivalent coronary angiographic findings and left ventricular function. Post-operatively, exercise tolerance improved equally in both groups but psychiatric cases remained significantly more symptomatic. Psychiatric morbidity remained unchanged throughout the study. We conclude that almost one third of patients with severe angina have psychiatric morbidity which is associated with a poor symptomatic response to coronary artery surgery, despite objective improvement in exercise tolerance. Ways of improving the symptomatic response to surgery in patients with coexisting psychiatric morbidity should be studied. PMID- 3264857 TI - [LAK activity in gastrointestinal cancer patients and a new system of high yielding continuous cell culture]. PMID- 3264858 TI - [Epidemiological and clinical study of dementia in the elderly institutions]. PMID- 3264859 TI - [A study of coronary artery bypass graft patency in early postoperative period]. PMID- 3264860 TI - [A new catheter for arterial graft flushing]. PMID- 3264861 TI - Distribution of chicken globule leucocytes detected by anti-thymocyte serum. PMID- 3264862 TI - Decrease with aging of the function of canine lymphocyte blastformation by using the glucose consumption test. PMID- 3264863 TI - [A pediatric vaccination counseling service]. PMID- 3264864 TI - [Leiomyoma of the duodenum as a cause of intestinal hemorrhage]. PMID- 3264865 TI - [Clinical, secretory and immunologic studies in Terrien disease]. AB - The present paper begins with a description of the clinical picture of Terrien's disease. Using radionuclide dacryography (RND) to determine secretion, reduced tear secretion was found unilaterally in four patients and bilaterally in one (as indicated by the half-lives of the conjunctival drainage curves). In four patients RND failed to reveal any reduction in tear secretion on either side. The slightly elevated IgG values found in the tear fluid are in agreement with the clinically detected signs of inflammation. The serum parameters determined, such as iron, magnesium, and copper levels and the electrolyte, uric acid, and creatinine concentrations were normal. PMID- 3264866 TI - [Blue cone monochromasia: diagnosis, genetic counseling and optical aids]. AB - Cone and rod functions of three blue cone monochromats (age 13-20, male) from three different families were investigated. In contrast to rod monochromats, they lack prominent nystagmus. Color matches as determined using the Nagel anomaloscope came close to those of rod monochromats but the green primary appeared slightly brighter to them. In color discrimination tests (Farnsworth Munsell 100-hue and Panel D-15 desaturated), maximum confusion followed protan rather than scotopic axes. Measurements of spectral sensitivity revealed action spectra exclusively of blue sensitive cones, even under conditions that should isolate green- or red-sensitive cones. After 20 minutes of dark adaptation, rods determined the spectral sensitivity function. Transient tritanopia, which in normals results from the interaction between cones sensitive to short and long wavelengths, was completely absent in blue cone monochromats. Visual acuity (Snellen charts and contrast gratings) revealed values between 20/200 and 20/60. Recognition of high-spatial low-contrast gratings was improved by blue cut-off filters (Schott BG 28) and considerably worsened by yellow cut-off filters (Schott OG 510). Since alteration of visual acuity induced by cut-off filters was not found in rod monochromats, this two-filter test is a means of differentiating quickly between rod achromats and blue cone monochromats. As the mode of inheritance is autosomal recessive in rod achromats and x-linked recessive in blue cone monochromats, differential diagnosis is important for correct genetic counseling. PMID- 3264867 TI - [A computer program for registering all daily accumulated data at a school for vision disorders]. AB - Despite increasing medical use of the computer, many clinics have experienced only limited success (or none at all) in computerized registration of patient data. One important reason for this lies in the complicated user interfaces of most programs. The clinician has no time to familiarize himself with the complicated command sequences involved, while necessary acceptance of the new technology by administrative staff is often lacking. This paper shows that computerized registration and interpretation of patient data are well within the bounds of possibility, given the use of newly-developed user-friendly operating systems and suitable personal computers. A concrete example of computerized registration of data in a remedial center is given: a case with squint symptoms for which 176 parameters can be entered. PMID- 3264868 TI - Biochemical characterization of B cell stimulatory factors for lipopolysaccharide preactivated B cell blasts: distinction from other known lymphokines. AB - We have performed a biochemical characterization of B cell stimulatory factors (BSF) produced by Con A-stimulated mouse spleen cells that stimulate growth of lipopolysaccharide (LPS)-preactivated B cells (designated BSF-LPS). Two biochemically distinct forms of BSF-LPS were identified in preparative isoelectric focusing, one acidic form having a pI of 3.9-4.4 and a more basic form with a pI 5.2-5.9. The biochemical heterogeneity of the BSF-LPS activity from Con A-stimulated spleen cells was further demonstrated by ion exchange chromatographies using a fast protein liquid chromatography (FPLC) system. The acidic and the basic forms of BSF-LPS could be totally separated from each other and both are distinct from interleukin-2 (IL-2). Moreover, extending the characterization of the BSF-LPS, together with the use of various murine assay systems for BSF, we could formally exclude that IL-4 or IL-5 accounted for the BSF-LPS activities. In summary, our data provide evidence for the existence of heterogeneous BSF-LPS which maintain growth of LPS-preactivated B cell blasts, and show that these factors can be distinguished from the other lymphokines which have been involved in the control of the cell growth of murine B lymphocytes. PMID- 3264869 TI - The role of recombinant IL-2 and IL-1 in murine B cell differentiation. AB - This study was undertaken to compare and assess the relative contribution by IL-2 and IL-1 to the maturation into antibody-forming cells (AFC) of normal, mitogen activated, proliferating B cells. Antigen affinity-enriched B cells were cultured under conditions at which T cells and macrophages are limiting. B cells were induced to proliferate upon stimulation with lipopolysaccharide (LPS), but not to mature into AFC. Maturation into AFC of LPS-stimulated B cells required the presence of recombinant interleukin-2 (IL-2). B cells stimulated with IL-2 alone were neither induced to proliferate nor to differentiate into AFC. Recombinant interleukin-1 (IL-1), in the presence of LPS, failed to induce the B cells to differentiate into AFC. However, IL-1 strongly synergized with IL-2 in further enhancing the AFC response. Although it has been known for some time that IL-2 and IL-1 contribute to the B cell response, our results indicate that these lymphokines primarily control the maturation of proliferating B cells into AFC. PMID- 3264870 TI - Cytotoxic liposomes: membrane interleukin 1 presented in multilamellar vesicles. AB - Paraformaldehyde-fixed lipopolysaccharide (LPS)-activated human monocytes produced significant lysis of the human melanoma cell line A375. The cytotoxic activity was retained following treatment of the fixed monocytes with anti-tumor necrosis factor (anti-TNF) antibodies but was specifically inhibited by a mixture of anti-TNF and anti-interleukin 1 (anti-IL 1) antibodies. A375 cells were also killed by plasma membranes purified from LPS-activated human blood monocytes. This activity was specifically inhibited by anti-IL 1 alpha antibodies, but only partially inhibited by anti-IL 1 beta antibodies. CHAPS detergent-extracted plasma-membrane IL 1 in its soluble form or associated with lyophilized liposomes was also able to kill A375 cells, and this antitumor activity was inhibited by anti-IL 1 antibodies. These results suggest that membrane IL 1, primarily IL 1 alpha, was cytotoxic for the A375 cells. CKS-17, a peptide synthesized with homology to a highly conserved region of the immunosuppressive retroviral envelope protein P15E, when covalently bound to BSA partially inhibited the IL 1 activities of tumor cell cytotoxicity and T-cell clone proliferation, displayed by purified plasma membranes, detergent-extracted membrane IL 1, or membrane IL 1 associated with liposomes. These findings indicate that cytotoxic membrane IL 1 can be solubilized by detergent, bound to the surface of liposomes, and specifically inhibited by anti-IL 1 antibodies or the immunosuppressive peptide CKS-17. PMID- 3264871 TI - [The significance of slow flows for the caloric excitability of the vestibular organs in weightlessness]. AB - Barany's theory of caloric nystagmus is based on the assumption of fluid convection in the perilymph. It was a great surprise that caloric nystagmus could be demonstrated in weightlessness as well, i.e. under conditions in which thermoconvection cannot occur because of loss of gravity. This phenomenon was explained by different theories, each of which is bound to certain assumptions. Experimental investigations and mathematical approaches concerning fluid mechanics of the endolymph under calorisation, indicate that creeping flow must be an important factor. This flow--not taken into consideration so far--may explain caloric nystagmus in weightlessness as well as some difficult problems in caloric excitability on farth. PMID- 3264872 TI - [Pontine deafness--a new disease picture?]. AB - The clinical features of pontine deafness are demonstrated in six patients with typical findings in pure-tone audiogram and speech audiometry, in stapedial reflex recordings, in brainstem-evoked potentials and cortical evoked potentials. The results of positron emission tomography (PET), magnetic response tomography (MRT), electrocochleography and the promontory test are presented. Results of cerebral spinal fluid and antibody titres in the serum are given. Pontine deafness is characterised by an interruption of the central auditory pathway cranial to the olive. This deafness should be differentiated from other forms of sensorineural hearing loss. The pathogenesis of pontine deafness is still unknown. However we should take it into consideration in the diagnosis of sudden unilateral deafness. No medical treatment method is known to date. PMID- 3264873 TI - [Localization of the pathologic gene for 21-hydroxylase enzyme deficiency within the HLA system]. PMID- 3264875 TI - Interleukin 1 and rheumatoid arthritis. AB - The erosive changes seen in the joint structures of the rheumatoid arthritic patient can be attributed to the consequences of the action of interleukin 1. Mononuclear leukocytes have been much studied as a source of the interleukin 1, while polymorphonuclear leukocytes have been largely ignored. The hypothesis promulgated here is that polymorphonuclear leukocytes are the source of the interleukin 1 in the joint space in amounts to be arthritogenic in the susceptible patient. It is proposed that the role of the mononuclear leukocytes, which are activated in the systemic circulation, is to induce infiltration of polymorphonuclear leukocytes into the joint space. PMID- 3264874 TI - [Evaluation of various indicators of cellular immunity in persons exposed to work environment in the Masovian Refinery and Petrochemical Plants in Plock]. AB - In 137 workers of the Mazovian Refining Petrochemical Plant cellular immunity parameters were examined. The following tests were performed: number of E rosette forming cells (T lymphocytes), TG and TM lymphocytes, EAC rosette forming cells (B lymphocytes), MIF generation and suppressor and cytotoxic activity of T lymphocytes. Workers of Asphalt Oxidation Division exhibited most pronounced deviations of the test parameters, as compared to controls. PMID- 3264876 TI - Serum osteocalcin in primary hyperparathyroidism: short-term effect of surgery. AB - This study has been carried out in order to evaluate both serum osteocalcin levels in primary hyperparathyroidism and their changes following surgery. Twenty one consecutive patients were studied (12 females and 9 males, aged 46 +/- 17 years). Preoperatively, a better correlation was found between serum osteocalcin and serum alkaline phosphatase activity (r = 0.79, p less than 0.001) than between serum osteocalcin and the 24-hour urinary hydroxyproline/creatine ratio (r = 0.55, p less than 0.05). Following the surgical removal of hyperfunctioning parathyroid tissue, a modest but significant decrease was observed in the serum levels of osteocalcin; this reached a nadir during the 1st or 2nd day after the removal of the adenoma. The mean levels then tended to rise, so that the values measured on the 7th day after parathyroidectomy (12.4 +/- 2.5 ng/ml) were not significantly different in respect to basal values (13.6 +/- 2.7 ng/ml). A parallel pattern was also noted as concerns the serum alkaline phosphatase activity. On the contrary, mean values of serum immunoreactive parathyroid hormone (243 +/- 78 vs. 58 +/- 11 pmol/l; p less than 0.02) and serum calcium (12.4 +/- 0.5 vs. 9.2 +/- 0.3 mg/dl; p less than 0.01) were significantly reduced and mean values of serum phosphorus (2.4 +/- 0.2 vs. 3.1 +/- 0.2 mg/dl; p less than 0.001) significantly higher in comparison to basal values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3264877 TI - Differential processing of colony-stimulating factor 1 precursors encoded by two human cDNAs. AB - The biosynthesis of macrophage colony-stimulating factor 1 (CSF-1) was examined in mouse NIH-3T3 fibroblasts transfected with a retroviral vector expressing the 554-amino-acid product of a human 4-kilobase (kb) CSF-1 cDNA. Similar to results previously obtained with a 1.6-kb human cDNA that codes for a 256-amino-acid CSF 1 precursor, the results of the present study showed that NIH-3T3 cells expressing the product of the 4-kb clone produced biologically active human CSF-1 and were transformed by an autocrine mechanism when cotransfected with a vector containing a human c-fms (CSF-1 receptor) cDNA. The 4-kb CSF-1 cDNA product was synthesized as an integral transmembrane glycoprotein that was assembled into disulfide-linked dimers and rapidly underwent proteolytic cleavage to generate a soluble growth factor. Although the smaller CSF-1 precursor specified by the 1.6 kb human cDNA was stably expressed as a membrane-bound glycoprotein at the cell surface and was slowly cleaved to release the extracellular growth factor, the cell-associated product of the 4-kb clone was efficiently processed to the secreted form and was not detected on the plasma membrane. Digestion with glycosidic enzymes indicated that soluble CSF-1 encoded by the 4-kb cDNA contained both asparagine(N)-linked and O-linked carbohydrate chains, whereas the product of the 1.6-kb clone had only N-linked oligosaccharides. Removal of the carbohydrate indicated that the polypeptide chain of the secreted 4-kb cDNA product was longer than that of the corresponding form encoded by the smaller clone. These differences in posttranslational processing may reflect diverse physiological roles for the products of the two CSF-1 precursors in vivo. PMID- 3264878 TI - Expression and processing of a recombinant human macrophage colony-stimulating factor in mouse cells. AB - A human macrophage colony-stimulating factor encoded by a 4-kilobase cDNA was expressed with bovine papillomavirus vectors in mouse cells. Pulse-chase analyses revealed that the 62-kilodalton (kDa) translation product was glycosylated, cleaved, and efficiently secreted within 1 h of synthesis. The secreted product contained both N-linked and O-linked oligosaccharide chains. Macrophage colony stimulating factor was present extracellularly as an 80-kDa homodimer and as a multimeric species of greater than 200 kDa that may be associated with other glycoproteins. PMID- 3264879 TI - Abnormal intracellular sorting of O-linked carbohydrate-deficient interleukin-2 receptors. AB - The synthesis and intracellular sorting of the interleukin-2 (IL-2) receptor were studied with a line of mutant Chinese hamster ovary (CHO) cells with a reversible defect in protein O glycosylation. Under normal culture conditions the mutant ldlD cannot add N-acetylgalactosamine (Ga1NAc) to proteins. Ga1NAc is the first sugar of mucin-type O-linked oligosaccharides attached to protein. This O glycosylation defect is rapidly corrected when Ga1NAc is added to the culture mediu. An expression vector for the p55 human IL-2 receptor was transfected into wild-type CHO and ldlD cells and the structure, stability, and cell surface expression of the receptor were examined by immunoprecipitation and antibody binding assays. Essentially all of the mature form of the normally glycosylated IL-2 receptor in both wild-type CHO cells and ldlD cells incubated with Ga1NAc was expressed on the cell surface. The stability of O-linked carbohydrate deficient (Od) IL-2 receptors (in ldlD cells without Ga1NAc) was normal; however, missorting of the Od receptors resulted in very little cell surface expression. The sialidase sensitivity and endoglycosidase H resistance of mature Od IL-2 receptors suggest that Od receptor missorting occurred in or beyond the trans Golgi apparatus. The abnormal sorting of the Od IL-2 receptor is compared with the O-glycosylation dependence of the surface expression and stability of the low density lipoprotein receptor, decay-accelerating factor, and the major antigen envelope protein of Epstein-Barr virus. PMID- 3264880 TI - Induction of neuronal differentiation in PC12 cells by B-cell stimulatory factor 2/interleukin 6. AB - B-cell stimulatory factor 2 (BSF-2) is a lymphokine which induces the final maturation of B cells. BSF-2 acts on a variety of cells other than B cells, and moreover, expression of BSF-2 mRNA is detected in interleukin-1 beta-stimulated glioblastoma and astrocytoma cell lines. Here, we studied the function of BSF-2 on pheochromocytoma PC12 cells, a model system for induction of neuronal differentiation. PC12 cells possess specific receptors for BSF-2. The BSF-2 stimulated PC12 cells expressed the c-fos proto-oncogene transiently, and they began to change morphologically to neurite-extending cells after several days. The number of voltage-dependent Na+ channels was also increased. PMID- 3264881 TI - The fluid-phase binding of human C4 and its genetic variants, C4A3 and C4B1, to immunoglobulins. AB - Covalent binding of the fourth complement protein, C4, to immune complexes is an important first step in the complement mediated processing of the complexes. Many of the initial encounters between the proteins of the complement system and antigen and antibody occur in solution, and prior to this report, studies of the interactions between them have focused on complement binding to preformed immune precipitates that most likely are not found in vivo. We have characterized the covalent binding of C4b to immunoglobulin molecules in a fluid-phase system consisting only of antibody in solution and purified C4 and C1s. We demonstrate that human C4b binds to IgG in the fluid phase, that its covalent binding is predominantly to the heavy chain of IgG, and that the covalent linkage is by either amide or acyl ester bonds. In addition, we compare the covalent binding efficiencies of two genetic variants of C4, C4A3 and C4B1, to IgG. C4A3 binds 3-4 times more IgG than C4B1 over a range of C4 concentrations, and C4A3 has a higher binding efficiency than C4B1 for IgM, IgA, IgG2a and F(ab')2 as well as for a protein antigen, BSA. Furthermore, we found that whereas C4A3 is bound to immunoglobulins in the fluid-phase predominantly by amide linkage, C4B1 is bound by either amide or acyl ester bonds. The results presented here suggest that the covalent binding efficiency of C4A3 and C4B1 to IgG is similar to that reported for their covalent binding to small molecules. PMID- 3264882 TI - The esterase-like activity of covalently bound human third complement protein. AB - The acyl ester bond between the third complement protein, C3, and a variety of molecules is hydrolyzed spontaneously at neutral pH (Venkatesh et al., 1984). Modification of the free, single sulfhydryl group of bound C3 by thiol reagents suggested that a functional group other than the -SH acts as a "catalytic" group in this intramolecular hydrolytic reaction. Complete inhibition of the esterase like activity is observed with stoichiometric amounts of mercuric chloride, palladium chloride, and the bifunctional organic mercurial, 3,6-bis (acetoxymercuri)-o-toluidine [BAMT]. Since alkyl and aryl mercuric ions do not inhibit the esterase-like activity of C3-[3H]glycerol, it is conjectured that divalent mercury, palladium, and BAMT will form a complex with the -SH group and an atom of the "catalytic" group X having a lone pair of electrons. The structural features of C3 that are essential for the esterase-like activity remain intact after subjecting C3-[3H]glycerol to covalent chromatography on organomercurial agarose. Based on the observed effects of chemical reagents and the kinetic deuterium solvent isotope effect on the esterase-like activity, a general-base mechanism is proposed for the intramolecular hydrolysis of the acyl ester bond in covalently bound C3. The "catalytic" group X is located in the C3d region (residues 317-632 of the alpha chain), since C3d-[3H]glycerol also has esterase-like activity. A general-base mechanism mediated by the same "catalytic" group X may also apply to the formation of acyl ester bonds following the hydrolysis of the internal thiolester bond in native C3. PMID- 3264883 TI - Characterization of gp39, a B-lymphocyte associated differentiation antigen which is also present on granulocytes and macrophages. AB - The biosynthesis and biochemical characteristics of the 39,000 cell surface glycoprotein detected by Mab 41H.16 were investigated. Experiments utilizing tunicamycin, endoglycosidase H, endoglycosidase F and N-glycosidase F indicate that the mature molecule expressed at the cell surface is composed largely of N linked oligosaccharides of both the complex and high mannose types. When synthesized in the presence of tunicamycin, the molecule appeared on the cell surface with a Mr of 32,000. Digestion with both endoglycosidase H and endoglycosidase F yielded a single band of Mr 37,000. Parallel experiments with N glycosidase F revealed species of approx. 35,000 and 32,000. Synthesis in the presence of monensin yielded a 37,500 product. [3H]Glucosamine and [3H]mannose were incorporated into the molecule but no evidence for fucose incorporation could be found. Microheterogeneity of gp39 with respect to Mr and oligosaccharide structure was demonstrated by biosynthetic labelling and lectin chromatography. Biosynthetic pulse-chase labelling showed that the de novo synthesis of the 39,000 molecule occurs without detectable precursor formation. Results of temperature-dependent phase separation experiments were consistent with gp39 being an integral membrane protein. Two-dimensional electrophoresis showed heterogeneity of the isoelectric points associated with the N-linked oligosaccharides. Galactose oxidase/NaB[3H]4 labelling showed that a terminal sialic acid protects a galactose residue. All results are consistent with the conclusion that the gp39 molecule is an integral membrane glycoprotein composed of heterogeneous N-linked oligosaccharides of both the complex and high mannose types. PMID- 3264884 TI - Selection of class I MHC-restricted peptides with the strip-of-helix hydrophobicity algorithm. AB - A strip-of-helix hydrophobicity algorithm to predict class II MHC-restricted peptides, on the basis of their structural similarity to an amphipathic, alpha helix in Ii, also predicted peptides which were presented to cytotoxic T-cells by class I MHC molecules. This algorithm ranked peptides according to mean Kyte Doolittle hydrophobicity values of amino acids at positions n, n + 4, n + 7, n + 11, n + 14 and n + 18 in a sequence which when coiled as a putative alpha-helix, had the indicated residues in an axial strip along one side of the helix. Sequences selected for highly scoring, hydrophobic strips were required to have at least 1 of the 4 adjacent strips scoring more negatively than -1 in the strip of-helix hydrophobicity index and the entire sequence could contain no prolines. This algorithm predicted the class I MHC-restricted, T-cell-presented peptides in sequences of 4 proteins from which some class I MHC-restricted, T-cell-presented sequences had been experimentally determined. Since both class I and class II MHC restricted peptides could be identified with this algorithm, one can propose that: (1) foreign peptide-binding sites (desetopes) of the class I and class II MHC molecules are structurally similar; and (2) any one T-cell-presented peptide can be presented by some specific allele of both a class I and a class II MHC antigen. PMID- 3264885 TI - Biochemical properties of a novel rabbit thymocyte specific class I-like antigen. AB - Monoclonal antibody 5E2 identifies a new rabbit thymocyte specific cell surface molecule designated R-Ta. SDS-PAGE of molecules immunoprecipitated by 5E2 shows that R-Ta exists as a non-covalently associated hetero-dimer consisting of a light polypeptide chain (mol. wt approximately 12,000) and a bi-molecular species of a heavy chain (mol. wts of 45,000 and 40,000). The difference between the two forms of heavy chain can be attributed to different degrees of glycosylation. Each form of the R-Ta heavy chain has a polypeptide mol. wt of 34,000. At least three N-linked oligosaccharides and no significant O-linked sugars were found associated with R-Ta. Two dimensional electrophoresis of V8 protease peptide maps also indicate that the two forms of the heavy chains are similar, if not identical, in polypeptide primary structure. The light polypeptide was found to be serologically and structurally identical to beta-2-microglobulin. This was demonstrated in a previous study by reaction with goat anti-beta-2-microglobulin antisera. In this investigation the structural identity with beta-2-microglobulin was demonstrated by partial amino terminal sequence analysis. The partial amino acid sequence for 18 steps of the R-Ta heavy chain was also determined. A comparison of the amino acid sequence with other known sequences for the conventional Class I molecules of man, mouse and rabbit did not reveal any homology. Thus R-Ta is a new T-cell surface protein, and like human CD1, carries the unique distinction of thymocyte specificity, is beta-2-microglobulin associated, but is not Class I related. PMID- 3264887 TI - [Expression of gag gene of human immunodeficiency virus in recombinant vaccinia virus]. AB - A fragment of HTLV-IIIB gag-gene, coding for the first 441 amino acids of the p53 gag-precursor was expressed in the recombinant vaccinia virus, vC5. Two HIV specific proteins were detected by western blot in CV-1 cells infected with vC5. Their relative molecular masses were 50 and 35 Kd, pointing out that the first of the proteins is a full length expression product of the cloned sequence, while the second one is a result of processing or abortive translation. Possibilities of using such a strain as a vaccine or in Western blot conformation test are discussed. PMID- 3264886 TI - [Prospective one-year epidemiologic longitudinal study of air pollutants and the incidence of croup]. AB - Among a population of 18,175 children below 7 years of age in medium sized towns and rural areas in south-western Germany 552 (3.03%) cases of croup were registered during a 12 months period in 1984-85 by their physicians. Distributions according to months, sex and age at the onset of the disease were the same as in other recent investigations: The level of the air-pollution measured (SO2, NOx, CO, CO2, ozone and dust) was low (highest monthly means in microgram/m3: SO2 88, NO2 73, NO 119, dust 41). There was no relevant influence of the degree of air pollution on croup-frequency. The rise of croup-frequency shortly after a period of several days of higher pollution was accompanied by an influenza epidemic as proved by virus isolations. PMID- 3264888 TI - Trends in morbidity and use of health services by women veterans of Vietnam. PMID- 3264889 TI - [Potentiation concept in pharmacology]. PMID- 3264890 TI - [Prevalent and incident carcinomas diagnosed in a screening program for carcinoma of the breast]. PMID- 3264891 TI - [Audio-vestibular changes in patients with rheumatoid arthritis]. AB - A functional audio-vestibular investigation based on impedance metric techniques and electronystagmography was carried out in a group of patients with "classical" rheumatoid arthritis (RA) and with treated or untreated "definite" RA in various stages. Data obtained from these patients were compared with those obtained from a control group. Significant hypoacusis of the transmissive type was found in initial stages of RA while sensorineural or mixed type hypoacusis was found in later stages of RA. Significant vestibular alterations of the central type suggesting supratentorial involvement were found in several cases independently of the stage of RA and of the age of the patients. PMID- 3264892 TI - [Infection and digestive bleeding: late complications of aortofemoral bypass surgery]. AB - Graft-enteric fistulas and (the most uncommon) graft-enteric erosions are feared complications of aortic reconstructive surgery and infection and hemorrhage are their major clinical manifestations. A case considered unusual due to the simultaneous presence of two graft-enteric erosions: duodenal and sigmoid is reported. The first erosion was revealed by endoscopy performed for gastrointestinal bleeding. The role played by infection and mechanical factors in the pathogenesis of these complications is then discussed. PMID- 3264893 TI - Autoradiography of [14C]paraquat or [14C]diquat in frogs and mice: accumulation in neuromelanin. AB - The herbicide paraquat has been suggested as a causative agent for Parkinson's disease because of its structural similarity to a metabolite of 1-methyl-4-phenyl 1,2,3,6-tetrahydropyridine (MPTP), which may induce a parkinsonism-like condition. MPTP as well as its metabolite 1-methyl-4-phenylpyridine have melanin affinity, and the parkinsonism-inducing potency of MPTP is much stronger in species with melanin in the nerve cells. Autoradiography of [3H]MPTP in experimental animals has shown accumulation in melanin-containing tissues, including pigmented neurons. In the present whole body autoradiographic study accumulation and retention was seen in neuromelanin in frogs after i.p. injection of [14C]paraquat or [14C]diquat. By means of whole body autoradiography of [14C]diquat in mice (a species with no or very limited amounts of neuromelanin) a low, relatively uniformly distributed level of radioactivity was observed in brain tissue. Accumulation of toxic chemical compounds, such as paraquat, in neuromelanin may ultimately cause lesions in the pigmented nerve cells, leading to Parkinson's disease. PMID- 3264894 TI - Alpha-fodrin (brain spectrin) immunocytochemical localization in rat vestibular hair cells. AB - The presence of a spectrin-related protein in rat vestibular sensory receptors was demonstrated by immunocytochemistry and immunoblotting using affinity purified anti alpha-fodrin antibodies. Intense immunoreactivity was found in the apical pole of sensory hair cells where it seems to be concentrated in the cuticular plate. In contrast, alpha-fodrin immunoreactivity was absent from the stereocilia. We suggest that a spectrin-related protein participates in the organization of the cuticular plate of vestibular hair cells by cross-linking actin filaments as well as by anchoring the cuticular plate to the apical cell membrane. PMID- 3264895 TI - Fine structures of nerve fibers with corticotropin-releasing factor-like immunoreactivity in the rat lateral septum. AB - The fine structures of nerve fibers with corticotropin-releasing factor (CRF) like immunoreactivity in the rat lateral septum were investigated by means preembedding immunoelectron microscopy. A number of CRF axon terminals formed synapses with cell bodies of non-immunoreactive septal neurons. They occasionally had broad terminal bulges whose subregions showed little or no immunoreactivity for CRF. CRF axon terminals were also in synaptic contact with non-immunoreactive dendrites or dendritic spines. Some dendrites with CRF were postsynaptic to non immunoreactive axon terminals. PMID- 3264896 TI - High perilymphatic potassium and rubidium levels modulate the sensory resting discharge in the isolated frog labyrinth. AB - The effects of high perilymphatic K+ and Rb+ concentrations (20 mM) on the posterior canal resting discharge have been examined in the isolated frog labyrinth. Both K+ and Rb+ produced an increase in spike frequency which is sustained by a parallel increase in the excitatory postsynaptic potential (EPSP) emission rate. High K+ and Rb+ levels reduce the size of the afferent spike, broaden its time course but do not induce repetitive activity at the axon level. The K+ and Rb+ facilitation proved to be inversely related to the fibre's initial resting activity. The facilitation produced by increased K+ was usually larger than that in Rb+ solution. High sensitive and low sensitive units with similar low resting discharge were detected in relation to their response either to K+ or Rb+. The effects of both ions can be explained on the basis of their interactions with the presynaptic hair cell currents. PMID- 3264897 TI - Charting: how and why to document your care daily--and fully. PMID- 3264898 TI - Massive suprachoroidal hemorrhage. Follow-up and outcome of 30 cases. AB - The authors studied the records of 30 patients who suffered a massive suprachoroidal hemorrhage during cataract surgery. Immediate development of a retinal detachment (RD) is a very bad prognostic sign. In none of 12 such cases could the retina be reattached. Retinal complications developed in five of six patients who had vitreous incarceration and who did not have vitrectomy as opposed to only one of seven who underwent vitrectomy along with drainage of the hemorrhage. If vitreous is incarcerated in the cataract incision, drainage of the hemorrhage without vitrectomy is a dangerous procedure. PMID- 3264899 TI - Effect of magnification and field of view on reading speed using a CCTV. AB - Reading speeds were measured in 18 subjects with normal vision and 10 with low vision for each of 20 experimental conditions with different magnifications and field sizes on the Closed Circuit Television System (CCTV). There was a significant difference between the results for the two groups of subjects. These results suggested that in low-vision patients with faster reading speeds, minimum magnification for maximum field size on the CCTV would be valid advice. For low vision patients who read more slowly, reading speed may improve at higher magnifications despite reduced field size. PMID- 3264900 TI - Defective colour vision can impede information acquisition from redundantly colour-coded video displays. AB - Earlier findings showed that redundant colour coding decreased response times and reduced errors in carrying out various tasks that required information acquisition from the video display of an electronic flight instrument system. The results of this experiment showed that observers with defective colour vision have slower response times and higher error rates than normal observers for some of the tasks and that their performance is similar to that of colour-normal observers for a monochrome display. However, they were not disadvantaged when blue was used to colour code the target feature. Protanopes were shown to be especially disadvantaged in responding to a red 'fail' message. PMID- 3264901 TI - [Problems in the international comparison of infant mortality figures. 1. Comparison of raw infant mortality figures and perinatal mortality rates in selected countries]. PMID- 3264902 TI - [Problems in the international comparison of infant mortality figures. 2. Birth weight-specific and standardized infant mortality figures in selected countries]. PMID- 3264903 TI - Serum bactericidal activity against Haemophilus influenzae. AB - The requirement for an intact thiolester bond in C3 for assembly of the membrane attack complex and bactericidal activity was demonstrated in a system permitting only alternative pathway activation. Serum depleted of C3 and C4 by treatment with potassium bromide was reconstituted with forms of C3 with an intact (native C3) or disrupted (NH3.C3) thiolester bond, and bactericidal activity against Haemophilus influenzae b was determined. For strain 885 in high-antibody containing serum, reconstitution with native C3 was associated with marked bactericidal activity (log10 kill in 60 min 1.01 +/- 0.08) compared with reconstitution with NH3.C3 (log10 kill -0.04 +/- 0.19, p less than 0.001). Similar results were obtained with other strains of H. influenzae b. In serum lacking type-specific antibody no alternative pathway-mediated bactericidal activity was detected against any of the strains examined, even when native C3 was added to KBr serum. These experiments indicate how the biochemical structure of C3 directs its functions; only forms of C3 with an intact thiolester bond, which can covalently bind to bacterial surfaces, can serve as the C5 convertase and generate bacterial activity. In addition these experiments demonstrate an absolute antibody dependence for alternative pathway-mediated bactericidal activity against H. influenzae. PMID- 3264904 TI - Neonatal Gardnerella vaginalis infection. PMID- 3264905 TI - Rapid physical mapping of the Mycoplasma mobile genome by two-dimensional field inversion gel electrophoresis techniques. AB - A macrorestriction map of the 780 kbp Mycoplasma mobile (ATCC 43663) genome was constructed. Linking fragments were identified on two-dimensional pulsed-field electrophoresis gels. Either complete double restriction digests or partial and complete single digests were separated in the first and second dimension, respectively. 19 restriction sites of four enzymes could be assigned to the map. These rapid methods do not require DNA probes and are applicable to the long range restriction mapping of all genomes that yield resolvable patterns on two dimensional gels. PMID- 3264906 TI - Nucleotide sequence of rat invariant gamma chain cDNA clone pLR gamma 34.3. PMID- 3264907 TI - Specific amplification with PCR of a refractory segment of genomic DNA. PMID- 3264908 TI - [Preliminary results of the analysis of the epidermal growth factor in patients with amyotrophic lateral sclerosis]. PMID- 3264909 TI - Partial purification of a major type of rat prostatic growth factor: characterization as an epidermal growth factor-related mitogen. AB - The dorsolateral prostate of rats contains a mitogen that shares several properties with epidermal growth factor (EGF), which was designated as prostatic EGF-related mitogen (PEM). PEM was purified about 2,100-fold using molecular sieve and ion-exchange chromatography. Final preparation stimulated DNA synthesis in BALB/c 3T3 cells at a concentration as low as 1.5 ng/ml and competed with 125I EGF for binding to cell surface receptors. PEM had a molecular weight of about 14,000 and an isoelectric point of about 4.5, being heat- and acid-stable but inactivated by dithiothreitol. The primary cultured rat dorsolateral prostate epithelial cells required EGF for maximum growth. Partially purified PEM fully substituted for EGF in the primary culture system at a concentration as low as 90 ng/ml. However, the activity of PEM was hardly suppressed by antimouse EGF antiserum. These findings suggest that PEM is a member of the EGF family but has a higher molecular weight (high molecular weight EGF). PMID- 3264910 TI - [Elaboration of microcomputer programming for the analysis of the effect of the electric stimulation of the diaphragm on the respiratory system]. PMID- 3264911 TI - [The interleukin system and the energy enzyme activity in lymphocytes of patients with newly detected pulmonary tuberculosis]. PMID- 3264912 TI - [Relation between tuberculosis infection in children and their parents]. PMID- 3264913 TI - Differences between Ca2+- and Sr2+-activated gK+ in bullfrog sympathetic neurons. PMID- 3264914 TI - Liver slices: an in vitro system for determination of N-acetylation in human liver. PMID- 3264915 TI - A novel growth factor sensitive protein kinase in pheochromocytoma. PMID- 3264916 TI - Altered cardiovascular response to corticotropin-releasing factor in spontaneously hypertensive rats. PMID- 3264917 TI - Platelet plasma membrane calcium release by inositol 1,4,5-trisphosphate. PMID- 3264918 TI - A comparison of the discriminative stimulus properties of l-5-hydroxytryptophan in the presence of either citalopram or Ro 4-4602. AB - The establishment of stimulus control by 5-HTP, the amino acid precursor for serotonin (5-HT), has been reported previously [1-3]. In the present investigation, two groups of rats were trained with 5-HTP versus saline in a 2 lever discrimination procedure. Prior to the administration of 5-HTP, subjects were pretreated with either Ro 4-4602, an inhibitor of peripheral decarboxylase (R-HTP), or citalopram, a specific 5-HT reuptake inhibitor (C-HTP). Neither C-HTP nor R-HTP was antagonized completely by either pirenperone or pizotyline. When C HTP and R-HTP were tested in a third group of rats trained with LSD, complete generalization was not observed. The results of cross tests in the R-HTP and C HTP groups with LSD, TFMPP, 8-OH-DPAT, C-HTP, and R-HTP indicate that the stimuli induced by R-HTP and C-HTP are similar but not identical. Taken together, these data suggest that 5-HTP produces a compound stimulus that is not readily explained in terms of either 5-HT1 or 5-HT2 receptors alone. PMID- 3264919 TI - Correlation with 3H-MPP+ binding sites by debrisoquin and some analogues in mouse brain. PMID- 3264920 TI - [Death caused by a bolus at a psychiatric hospital]. AB - Among 2000 dead we found a frequency of death by bolus of about 1% in neuropsychiatric patients in the course of 17 years. Severe oligophrenia mostly combined with epilepsy was leading with almost 50% followed by depressive syndrome, schizophrenia and dementia. Organic cerebral lesion, disorders of activity and vigilance, longterm psychopharmacotherapy, alteration of condition by acute internal disease and perhaps disorders of the liver are considered to be risks of death by bolus. PMID- 3264921 TI - Validity of the type A construct: a reprise. PMID- 3264922 TI - Fluoxetine-induced reduction of body mass in patients with major depressive disorder. PMID- 3264923 TI - [Sternocostoclavicular hyperostosis: a space-occupying lesion of the superior thoracic aperture]. AB - Sternocostoclavicular hyperostosis is a rare disease characterized by soft-tissue ossifications and hyperostosis of the clavicles, anterior segments of the upper ribs and sternum. These changes may imitate other disorders and thus may be misinterpreted. We present the radiologic appearances of this entity and discuss the diagnostic value of computerized tomography, magnetic resonance imaging and scintigraphy. PMID- 3264924 TI - A simple technique to measure regional cerebral blood flow during intravascular balloon clamping. AB - A case of giant internal carotid ophthalmic aneurysm was presented. In order to clarify whether the patient could tolerate carotid occlusion, a balloon clamping test was performed. before surgery. The cerebral blood flow was measured using early imaging by single photon emission computed tomography (SPECT) with N isopropyl-(iodine-123)-p-iodoamphetamine (123I-IMP). When the balloon clamping test was performed the tracer was injected, and scanning was performed 35 minutes after removing the catheter. This tracer enabled a "memory of blood flow" during temporary ischemia to determine the character of quick diffusion and slow wash out, that could not be performed by other methods of cerebral blood flow measurement. SPECT with 123I-IMP can simplify the measurement of cerebral blood flow during the balloon clamping test. PMID- 3264925 TI - Autoantibodies in feline hyperthyroidism. AB - Thyroid autoantibodies have been demonstrated by indirect immunofluorescence in the sera of 10 of 29 (34 per cent) cats with hyperthyroidism. Antinuclear factor, rare in healthy cats, was found in a further four animals. Twenty-eight of the cats had a palpable goitre at first presentation. In 16 cases the goitre was unilateral, while in the others it was bilateral. Lymphocytic infiltration was present in nine of the 27 (33 per cent) thyroids examined histologically. Five of the sera gave a particularly strong reaction for thyroid antibodies. Four of these cases had bilateral goitres and lymphocytic infiltrations were found in four of the five thyroids (P less than 0.05). Twenty-one of the cats were followed up for a mean period of 11 months after operation, during which time three cats developed recurrent hyperthyroidism. Two had bilateral goitres with lymphocytic infiltration and the serum of both was strongly positive for thyroid microsomal antibodies. The third had unilateral goitre with lymphocytic infiltration and serum which was positive for antinuclear factor. In this case, the recurrence involved the lobe which had been previously operated on. Some cases of feline hyperthyroidism may be immunologically mediated and the condition is thus a potential model for some aspects of autoimmune thyrotoxicosis in man. PMID- 3264926 TI - Immune system of swine: dissection of mononuclear leucocyte subpopulations by means of two-colour cytofluorometric analysis. AB - Expression of the differentiation antigen 8/1, a porcine leucocyte marker for which no counterpart is known as yet in other species, was tested in relation to the expression of surface Ig and the monocyte marker 74-22-15. B lymphocytes and T lymphocytes can be typified by the exclusive expression of surface Ig and 8/1, respectively, while all monocytes defined by the expression of the 74-22-15 antigen co-express 8/1 with the highest staining density observed for this marker. 8/1+ T lymphocyte subsets defined by the expression of CD4 and CD8 cell surface antigens differed in the expression of 8/1 with the staining density being high in CD4+ T lymphocytes, intermediate in CD8+ as well as in CD4+CD8+ T lymphocytes, and low in the CD4-CD8- subset. Practically all mononuclear leucocytes present in peripheral blood are included in the subpopulations defined by this kit of reagents, and thus it can be predicted that if mononuclear leucocytes which do not belong to any of these subpopulations exist at all, these must be rare and will not be accessible to an analysis without enrichment. PMID- 3264928 TI - Diffuse idiopathic skeletal hyperostosis in a patient with right-sided aorta. AB - Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory disease with ossifications of paravertebral ligaments. It is normally located on the right side. We here present one patient with left-sided ossifications and a right sided aorta. PMID- 3264927 TI - [Surgical treatment of hemorrhagic portal hypertension. Comparative study: the Warren operation vs the Sugiura procedure]. PMID- 3264929 TI - Electroacupuncture in the treatment of headache. PMID- 3264930 TI - Methods of isolation and purification of bovine and rat osteocalcin. AB - Measurement of osteocalcin (a bone protein containing gamma-carboxyglutamic acid, GLA-P) in the biological liquids and tissues is of interest for studying the mechanisms of bone diseases. It is also helpful in making a diagnosis and in following up the patients with diseases in which the osseous system is affected. Methods have been worked out for isolation and purification of osteocalcin from bovine and rat femur in order to use the purified substance as a starting material for developing radioimmunoassay (RIA) systems for each of these osteocalcins. The work went through the following stages: the processing of the femur bone, preparation of the 200 microns bone powder, demineralization of the powder, and concentration of the bone extract, purification of the extract by molecular exclusion chromatography on Sephadex G-100 and repurification to the product by ion exchanger chromatography in NaCl linear gradient, on DEAE Sephadex A-25. The purity of the substance obtained was tested by disk electrophoresis in polyacrylamide gel. The bovine and rat osteocalcins obtained had the adequate purity for being used as RIA reagents. PMID- 3264931 TI - The serum osteocalcin levels in adult and aged hypothyroid patients. AB - Osteocalcin (OC) or the bone protein containing gamma-carboxyglutamic acid (BGP or Gla-P), is a specific and sensitive marker of bone turnover. A radioimmunoassay (RIA) system for human osteocalcin was developed with the sensitivity of 0.5 ng/ml. The osteocalcin was measured in sera from 33 hormonally and/or clinically hypothyroid patients: 12 adult and 21 aged patients. For comparison, blood samples were collected from 14 hormonally hyperthyroid adult patients in whom the OC levels were 16.23 +/- 7.57 ng/ml (mean +/- SD) and from hormonally euthyroid adult patients (previously treated hyperthyroid patients) having OC 9.76 +/- 5.32 ng/ml. Abnormal low OC levels were noted in the hypothyroid adult patients group: 1.04 +/- 0.23 ng/ml by comparison to the hypothyroid aged patients 3.76 +/- 2.38 ng/ml (p less than 0.001). Moreover, great variability of the OC serum levels was observed in the aged group, four patients hormonally eu- or hypothyroid having high OC levels in the range: 13.29 55.45 ng/ml and other three patients although hormonally euthyroid but clinically hypothyroid had low OC levels 0.88-2.27 ng/ml. The abnormalities of the OC levels in hypothyroid adult and aged patients are discussed. PMID- 3264932 TI - Association between HLA-DR2 and production of tumour necrosis factor alpha and interleukin 1 by mononuclear cells activated by lipopolysaccharide. AB - The production of tumour necrosis factor (TNF) and interleukin 1 (IL-1) by lipopolysaccharide-activated mononuclear cells from 39 healthy donors was studied in vitro by bioassay and ELISA. The donors were typed for HLA-A, -B, -C, -DR, and -DP antigens. There was no detectable production of TNF beta (lymphotoxin). The intracellular levels of bioactive TNF alpha were minimal or undetectable in all cases. Cells from HLA-DR2+ individuals secreted significantly lower amounts of TNF alpha than cells from HLA-DR2- donors [2 ng/ml (1.5-4.4) and 7.5 ng/ml (3.9 8.3) respectively (medians 25-75%); P less than 0.01]. The difference disappeared if the cells were preactivated for 2 days with 1000 U/ml of recombinant gamma interferon (rIFN-gamma). In some individuals, the TNF alpha response increased considerably after IFN-gamma priming, in particular in those possessing the HLA DR2 antigen. In contrast, there was no detectable difference in the production of IL-1 beta between the donors, and the IL-1 beta response decreased significantly after rIFN-gamma priming in HLA-DR2+ individuals [2.3 ng/ml (1.1-8.4) versus 7.2 ng/ml (5-7.9); P less than 0.05] and in HLA-DR2- individuals [3 ng/ml (1.1-5.3) versus 5.7 ng/ml (3.9-7.5); P less than 0.01]. There was no correlation between the TNF alpha and IL-1 responses and any of the other HLA-DR, -DP, or -B antigens. There was a significant positive correlation between the levels of TNF alpha measured by ELISA and by cytotoxicity assay. However, the TNF alpha containing supernatants from 9 out of 37 individuals appeared to contain inhibitor(s) of the biological activity of TNF alpha. The presence of inhibitor(s) was not associated with any HLA antigens. PMID- 3264933 TI - Susceptibility to tolerance induction of bursal and peripheral B cells. AB - We investigated cellular aspects of immunological tolerance to protein antigens in chickens by examining the immune responses of bursal and splenic cells from tolerant or normal chickens after transfer into cyclophosphamide (CP)-treated recipients. Newly-hatched chicks were made tolerant to bovine serum albumin (BSA) by injection of 100 mg of the antigen. When bursa cells from 4-day-old BSA unresponsive chicks were transferred into CP-treated recipients, the reconstituted birds were able to respond to a subsequent injection of BSA almost as well as normal birds, and as well as CP-treated birds that had been reconstituted with normal bursa cells. To investigate whether the presence of the BSA antigen might affect recovery from tolerance, we injected CP-treated recipients with BSA at the time of transfer of bursal cells. The presence of the antigen prevented the recovery of the anti-BSA response in reconstituted birds. When spleen cells from 6.5-week-old unresponsive chicks were transferred into CP treated recipients, no recovery of responsiveness to BSA could be demonstrated. A likely reason for the failure of splenic B cells to recover responsiveness on transfer is their inability to generate somatic variants of Ig genes in the same way as bursal stem cells. Thus, when the bursa involutes, the chicken's antibody repertoire may be frozen in a less adaptable state than that of a mammal. PMID- 3264934 TI - Neuroimaging and neuropathology. PMID- 3264935 TI - Immunoregulatory lymphokines in rheumatoid joints. III. B cell growth promoting activity of cells eluted from rheumatoid synovial tissue. AB - Synovial fluid (SF) from rheumatoid arthritis patients (RA) and culture supernatants of synovial tissue (ST) cells from RA patients and juvenile rheumatoid arthritis (JRA) patients were examined for their ability to promote B cell growth. SF was not suitable for studying B cell growth promotion because with the anti-mu driven assay system employed, all 15 samples strongly inhibited B cell proliferation. Supernatants of in vitro unstimulated ST cells from RA and JRA patients affected B cell growth in different ways, ranging from strong inhibition to moderate stimulation. Supernatants of unstimulated peripheral blood mononuclear cells (MNC) from healthy donors did not influence B cell proliferation. After phytohaemagglutinin (PHA) stimulation of the ST cells and normal MNC, culture supernatants of RA ST cells and normal MNC all stimulated B cell growth, while culture supernatants of PHA-stimulated JRA ST cells displayed a variable picture. The differences between PHA-supernatants from RA, JRA and normal MNC were not statistically significant. These results indicate that the inflamed synovia of JRA and RA patients contain cells that can produce soluble factors with B cell growth promoting activity. Some of the data in the study suggest that these factors are produced in vivo and thus might be responsible for the observed B-cell activation in joints of these patients. PMID- 3264936 TI - Histological and functional features of salivary glands in rheumatic patients with oral sicca symptoms. PMID- 3264938 TI - Living with your self. PMID- 3264937 TI - Health effects due to occupational exposure to cobalt blue dye among plate painters in a porcelain factory in Denmark. AB - Forty-six plate painters, heavily exposed to cobalt blue dye, took part in this cross-sectional study, and 51 top-glaze painters served as the referents. The study comprised a questionnaire, a health examination, a lung function test, and the determination of the blood and urinary cobalt levels. The plate painters were examined twice, at the end of a workfree period and after resuming work. More plate painters complained of irritation from the mucous membranes in the mouth and throat, cough, and expectoration than the referents. The symptoms increased after the plate painters resumed work. The cobalt level of the plate-painting group after six weeks off work was twice as high in the blood and five times higher in the urine than the corresponding values of the reference group. After the plate painters resumed work, the blood and urinary levels increased approximately 4 and 15 times, respectively. Increased airflow resistance was found in the plate group when compared with the referents, and signs of small airway obstruction increased after the plate painters resumed work. The pulse rate was higher among the plate painters, and minor changes in the red blood cell picture were observed. None of these adverse health effects were associated with the cobalt levels in the blood or urine. PMID- 3264939 TI - [Aging and immunological reactivity in lung pathology]. PMID- 3264940 TI - [Central electroanalgesia in the ambulatory treatment of hypertension in stages I and II]. PMID- 3264941 TI - Changes in miniature end-plate currents due to high potassium and calcium at the frog neuromuscular junction. AB - Elevation of extracellular potassium concentration ([K+]o) in cutaneous pectoris neuromuscular junction from 2 to 20 mM slowly increased the variability of the amplitudes of miniature end-plate currents (AMEPC-s), (coefficient of variation of AMEPC-s increased by 73%). Mean AMEPC-s, however, decreased but not markedly (by 14%). Comparable MEPC changes were observed when [K+] was raised in the presence of choline chloride (50 microM), arguing that MEPC changes were not primarily due to a lower and less uniform vesicular filling. Channel kinetics were not altered by high [K+]o, since the time constant of decay of miniature end plate currents (TMEPC-s) did not change. Acetylcholine clearance from the synaptic cleft, however, appeared to be faster in high [K+]o since with cholinesterase blocked throughout, TMEPC-s were shortened. The changes of spontaneous quantal discharge induced by high [K+]o can be almost entirely explained by altered spatial distribution of vesicular release if, as recent reports suggest, at high [K+]o, exocytosis appears randomly not only at but also in between the active zones. However, relatively greater frequency of large MEPCs suggests that in high [K+]o some, and possibly all, quanta are filled above normal levels. High [Ca2+]o appears to counteract, although not always completely, all changes in spontaneous quantal secretion induced by high [K+]o. It is possible that high [Ca2+]o reverses the changes in the spatial distribution of vesicular release induced by high [K+]o. However, high [Ca2+]o also leads to other pre- and postsynaptic changes. PMID- 3264942 TI - [Clinico-immunological characteristics of acute pneumonia in young patients]. AB - Altogether 103 patients with acute pneumonia and 50 healthy controls were examined. A wide range of clinical and immunological methods was applied. The data obtained were processed using statistical multivariate analyses. Differences of a clinical picture and the immune status were shown in primary patients and in patients with repeated pneumonia. An attempt was made to explain the pathogenesis of repeated pneumonia. The use of immunomodulating agents for therapy and prevention of acute pneumonia was substantiated. PMID- 3264943 TI - [Clinical and immunological comparisons of different patterns of croupous and focal pneumonia in miners in deep coal mines of the Donetsk region]. PMID- 3264944 TI - Psychosocial effects of screening for somatic risk: the Swedish alpha 1 antitrypsin experience. PMID- 3264945 TI - Bilateral empyema and purulent pericarditis due to Haemophilus influenzae capsular type b. AB - A previously fit woman developed a sore throat followed by bilateral empyema and pericarditis due to haemophilus influenzae capsular type b. She was treated successfully with antibiotics, bilateral thoracotomies, and pericardotomy. PMID- 3264946 TI - Refractory supra-ventricular tachyarrhythmias due to early posterior pericardial effusion following open-heart surgery. AB - Three cases are presented of supra-ventricular tachyarrhythmias following open heart surgery refractory to direct current cardioversion and pharmacological treatment. Echocardiography demonstrated a moderate to large posterior pericardial effusion in each case. Surgical evacuation of the effusion was followed by reversion to sinus rhythm. PMID- 3264947 TI - Pilot study on quality assurance in cardiac surgery. AB - In 1986 development, testing and improvement of a multi-center based quality assurance procedure has been started by the German Society for Thoracic and Cardiovascular Surgery supplied by a research fund of the Federal Ministry of Research and Technology. Initially five cardiac surgery units took part in defining quality related items, collecting associated data and establishing a common data base. In the first year of its existence this data base received about 3800 records of patients undergoing cardiac surgery procedures using ECC. Preoperative clinical state, intraoperative actions and postoperative results including unexpected events sum up to an average record length of 300 items per procedure. Evaluation and representation of quality related data ist done in two ways: an overall quality profile consisting of 17 so called quality indicators accompanied by six patient-mix indicators enables each cardiac surgeon to get a quick global reference within the multicentrical data context, and several problem oriented profiles assist building and testing of special quality-related hypotheses towards improvement of procedure standards and performance. PMID- 3264948 TI - NOD mice with high incidence of type 1 diabetes are not T lymphocytopenic. AB - An autoimmune pathogenesis has been indicated in insulin-dependent (type 1) diabetes mellitus (IDDM). Previously we reported that non-obese diabetic (NOD) mice as an animal model of spontaneously developing IDDM were immunologically characterized by T lymphocytopenia and impaired cellular immunities. The cumulative incidence of diabetes in the T lymphocytopenic female NOD mice was 10 20% by 24 weeks of age. On the other hand, the incidence of diabetes are 80-90% in the female NOD/Shi-Sendai (S), in whom proportion of lymophocyte subsets has not been known yet. Therefore, we examined the spleen cells of female NOD/Shi-S and female NOD/Shi with high incidence of diabetes, and of female Jcl:ICR as a control. Cell numbers, populations of T cells (Thy 1.2+, Lyt-1+ and Lyt-2+), B cells (surface-Ig+), NK cells (acialo GM1+) and responsiveness to Concanavalin A were analyzed as immunological parameters. In contrast to the T lymphocytopenic NOD, these immunological parameters were not impaired in the NOD/Shi-S and NOD/Shi in comparison to those of Jcl:ICR. The results indicate that there may be a positive association between the incidence of diabetes and T cell number and functions in female NOD mice. PMID- 3264949 TI - [Electronystagmography used in patients with chronic suppurative mesotympanitis]. PMID- 3264950 TI - [Electron microscopy and electron autoradiography examinations of the palatine tonsils in relation to age]. PMID- 3264951 TI - Diseases of the ear canal. PMID- 3264952 TI - Pathologic changes in otitis externa. AB - Otitic lesions must be evaluated in the context of the whole animal. Accurate historical and clinical assessments are important aids to the pathologist attempting to reach an accurate diagnosis. Primary lesions of the pinna, with or without involvement of the external ear canal, may be an extension of a more generalized dermatologic problem or may specifically involve the ear because of its unique gross and histologic characteristics. PMID- 3264953 TI - Evaluation of the patient with otitis externa. AB - This article considers the history, physical examination, cytologic evaluation of smears and fungal and bacterial culture and sensitivity testing, clinical interpretation of information obtained from a biopsy of the external ear canal, and ancillary aids for the evaluation of the patient with otitis externa. PMID- 3264954 TI - Cytologic evaluation of otic exudates. AB - The multifactorial nature of otitis externa requires accurate etiologic information to ensure therapeutic success. The collection and preparation of cytologic samples of otic exudates are simple to perform, and information of immediate diagnostic and therapeutic value can be attained. Evidence of epidermal hyperplasia and increased glandular secretory activity suggests a noninfectious cause. Large numbers of microorganisms and infiltrating leukocytes confirm the presence of infection. The presence of ear mites, particularly O. cynotis, is always significant. Abnormal epithelial cells that appear singly or in sheets and clusters support the diagnosis of neoplasia; the extent of cell differentiation determines malignancy. Inflammatory cells and acantholytic keratinocytes from vesicular otic lesions suggest autoimmune skin disease. PMID- 3264955 TI - Otopharmacology. AB - Therapy for diseases of the ear canal is, in most respects, similar to therapy for other diseases of dogs and cats. As a target for drug therapy, however, the unique anatomy of the external ear canal presents differences that are both advantageous and disadvantageous. This article will describe principles of therapy and pharmacologic properties from the perspective of topical therapy directed at the surface of the ear canal, the epidermis, and the dermis. PMID- 3264956 TI - Medical management of otitis externa. AB - Successful medical management of otitis externa requires attention to all of the following points: 1. Diagnose and treat systemic or underlying disease(s). 2. Carefully clean and examine the entire ear canal before starting therapy. This includes removal of foreign bodies, parasites, hair, and other obstructions. 3. Apply carefully chosen topical preparations based on gross and microscopic examination. 4. Educate clients as to the causes of the otitis externa and their role in treating the disease. 5. Schedule regular follow-up examinations until the disease is completely cured. 6. Recommend preventive procedures such as drying ears after swimming, corrective surgery, and so on. 7. Use systemic treatment when indicated by chronicity of disease or the owner's inability to treat the patient. PMID- 3264957 TI - Surgical management of otitis externa. AB - The surgical management of otitis externa is discussed in conjunction with failed medical management, primary causes, and proper case selection. The techniques of lateral ear canal resection and vertical ear canal ablation are described in detail. PMID- 3264958 TI - Surgical management of advanced ear disease. AB - With careful surgical technique and attention to underlying medical problems, most cases of advanced ear disease in small animals can be managed successfully. Specific techniques and therapy are described. PMID- 3264959 TI - Preventive ear care for dogs and cats. AB - Prevention of ear disease in dogs and cats depends on early detection of factors that predispose these animals to otitis externa. This article reviews the conditions and diseases that place the dog and cat at risk for otitis externa. Routine care of the ears is discussed, and otoscopic examination and techniques for cleaning the external auditory canals are described. Avoidance of potentially harmful therapeutic procedures and irritating or ototoxic pharmacologic substances is emphasized. PMID- 3264960 TI - Tumors of the ear canal. AB - This discussion will focus on the clinical presentation, diagnostic evaluation, expected biologic behavior, and therapeutic options for tumours of the ear canal in the dog and cat. Particular emphasis will be placed on neoplasia of the ceruminous glands, squamous cell carcinoma, and non-neoplastic mass lesions. PMID- 3264961 TI - Diseases of the pinna. AB - Many diseases can affect the pinna of the dog and cat. These diseases represent most categories of cutaneous disease, from infectious to neoplastic. Although some diseases affect primarily the pinna, most pinnal dermatoses occur in conjunction with other integumentary disorders. One should approach the diagnostic work-up of pinnal disease in an organized manner, obtaining first a thorough history and physical examination. A systematic approach is required in the diagnostic evaluation in order to arrive at a tentative or definitive diagnosis. Skin scrapings, cytologic examination, and culture for dermatophytes provide the minimum database. A variety of diagnostic tests, including hematology, serum biochemical profiles, urinalysis, serology, intradermal skin testing, hypoallergenic diet trials, histopathology, and direct immunofluorescence, may be necessary in some cases before a definitive diagnosis is reached. The ears are somewhat difficult to biopsy, although in many instances histopathologic examination is essential to the diagnosis. In this author's opinion, it is preferable to use a no. 15 scalpel blade rather than a punch biopsy when obtaining a pinnal biopsy. This allows the veterinarian to obtain an elliptical or wedge biopsy, which can frequently be sutured. In some instances, biopsies are required from the ear margin and a full ear thickness biopsy is obtained. Sutures may not hold in this situation, and cautery may be necessary for hemostasis. As in other situations in which the ear is bleeding (aural hematomas, vasculitis, fly bite dermatitis, and so on), bandaging and immobilization of the ear may be necessary to prevent further trauma. Although symptomatic therapy is sometimes helpful when treating pinnal diseases, a definitive diagnosis is preferred. This is especially important following the second or third presentation of an animal for ear disease. Although ear diseases are frequently viewed as a nuisance rather than a serious condition, anyone who has owned or worked closely with an animal suffering from chronic otitis externa should appreciate the animal's discomfort and the owner's frustration. All too frequently, the chronic otitis externa is the result of a hypersensitivity (either inhalant or food) that has been overlooked in the attempt to treat the subsequent infectious otitis. Thus, in animals with recurrent otitis externa, every attempt should be made to identify and treat the underlying etiology. PMID- 3264962 TI - Otitis media and otitis interna. Etiology, diagnosis, and medical management. AB - In this article, the etiologies, clinical signs, diagnostic aids, and treatments for otitis media and interna are discussed. A review of the anatomy and physiology of the middle and inner ear structures precedes each discussion. PMID- 3264963 TI - Surgical management of otitis media and otitis interna. AB - Surgical management of otitis media and otitis interna includes the following options: lateral bulla osteotomy, ventral bulla osteotomy, or curettage of the tympanic cavity. Because otitis media frequently accompanies chronic nonresponsive otitis externa, one of the above procedures may be combined with operative procedures of the external ear canal. Also, gentle selective curettage of the tympanic cavity may be combined with either lateral or ventral bulla osteotomy in the treatment of otitis media and interna. The choice of surgical procedure(s) should be based on the condition of the external ear canal (vertical and horizontal parts), the duration of clinical signs, response to previous surgery, and the familiarity of the surgeon with the different approaches and techniques. With the increased reporting of long-term results following surgical management of otitis externa, media, and interna, more meaningful conclusions concerning selection of surgical procedure may be made in the future. PMID- 3264964 TI - Electrodiagnostic evaluation of auditory function. AB - This article considers the types of deafness in small animals and how electrodiagnostic testing can aid in evaluating auditory dysfunction. PMID- 3264965 TI - [Familial occurrence of increased secretion of S alpha-amylase with recurrent swelling of the parotid glands in one member of the family]. PMID- 3264966 TI - [Dynamics of clinico-immunological indicators in children with neurodermatitis during climatotherapy]. PMID- 3264967 TI - [Experience in the treatment of patients with chronic atrophic gastritis by internal administration of cobamamide and sinusoidal modylated current]. PMID- 3264968 TI - [Erythrocyte coagulating and fibrinolytic activity in patients with torpid rheumatism]. PMID- 3264969 TI - [Physiotherapeutic immune correction in patients with a history of infectious allergic myocarditis]. PMID- 3264970 TI - [Bulgarian-Soviet Symposium on Rheumatology. Stara Zagora, October 9-10, 1987. Proceedings]. PMID- 3264971 TI - [Extracorporeal immunotherapy of rheumatic diseases]. PMID- 3264973 TI - [Comparison of the parameters of illness status in primary and intensive prenatal care]. PMID- 3264972 TI - Hallucinatory depression in the elderly: a community study. AB - The prevalence of hallucinatory depression and symptoms and the social and health status of hallucinatory depressives were studied in a Finnish population aged 60 years or over. The prevalence was 2 per 1,000 for men, 3 per 1,000 for women and 2 per 1,000 for both sexes. Hallucinatory depressions represented 0.9% of all depressions both in men and women, and 7.7% of major depressions in men, 5.7% in women, and 6.3% in both sexes. The hallucinations included visual and hearing hallucinations. Delayed insomnia and depersonalisation were more severe in hallucinatory depressives than in nonhallucinatory major depressives, but initial insomnia was more severe in nonhallucinatory major depressives. Depersonalisation, paranoid symptoms and delayed insomnia were more severe in hallucinatory depressives than in all nonhallucinatory depressives, but initial insomnia was more severe in all nonhallucinatory depressives. The physical health and functional capacity of hallucinatory depressives were good, but they had suffered from social stress factors before the onset of depression. The results gave some evidence that hallucinatory depression in old age is not a clinical entity separate from other forms of major depression. PMID- 3264974 TI - [Modification of cardiac pacemakers of the MCP and LCP series by electrodiagnostic and electrotherapy procedures]. AB - 47 patients with cardiac pacemakers of the MCP- and LCP-series were examined for influence by disturbances caused by devices of electrodiagnostics and electrotherapy used in the GDR. A general prohibition of such diagnostic and therapeutic methods cannot be maintained. Low frequency current therapy (apart from TENS-currents), hydrogalvanic baths and ultrasonic therapy could be applied without any danger. In the CP-current should be guaranteed a minimum distance of 50 cm, when it fell short of, however, only insignificant disturbances appeared. The same concerns the microwave therapy. Also electrodiagnostics was possible without endangering the pacemaker-patient. TENS-currents caused, depending on distance and frequency, no disturbances or dangerous ones (total inhibition). Short-wave repeatedly led to total inhibition or warming at the cardiac pacemaker and should therefore generally be forbidden. PMID- 3264975 TI - [Myocardial perfusion with 201-thallium tomography in the post-infarct phase: prognostic significance and 1-year follow-up]. AB - An individualized post-infarction risk stratification has impact on therapeutic decision making and prognosis after acute myocardial infarction. For evaluation of the cardiac risk profile 80 consecutive post-infarction patients were subjected to biphasic thallium-201 tomography after dipyridamole infusion for maximal coronary vasodilation. By correlating the extent and localization of reversible and irreversible perfusion defects with coronary angiography and one year follow-up data of 94% of the patients, several univariate parameters with prognostic implications for a risk profile were identified. A stepwise logistic regression model selected the combination of 1) an irreversible defect of greater than 30% of left ventricular myocardium with less than 25% redistribution in the total defect, and 2) a reversible defect of greater than 6% of myocardium with 25% redistribution in the total defect to give optimal sensitivity of 100% and a specificity of 97% for cardiac events such as recurrence of angina, reinfarction, interventional coronary revascularization, and death within one year post infarction. Thus, the semiquantitative tomographic analysis of post-infarction myocardial perfusion allows an efficient individual risk stratification with a non-invasive technique. PMID- 3264976 TI - [Therapeutic occlusion of an erroneously implanted aortocoronary venous bypass using transluminal balloon embolization]. AB - Today, therapeutic occlusion of blood vessels can be performed not only by surgical ligation, but also by various transluminal embolization techniques. The use of hardly steerable emboli (e.g. metal coils or gel foam) is, however, associated with the risk of embolic displacement into the circulation. The present case describes the embolization of an ACVB-graft erroneously implanted to a cardiac vein, by means of a catheter system with a detachable silicone-rubber balloon (Bard-Parker mini-balloon system). PMID- 3264977 TI - A simple method for determination of interleukin-2-inhibitory activity of serum or plasma. PMID- 3264978 TI - [Sex-specific utilization of medical aid. Results of the Munich Blood Pressure Study]. AB - Sex differences in the frequency of physician visits, participation in cancer screening tests, number of drugs consumed, intake of antihypertensive drugs, and participation in hypertension screening have been investigated with data from the Munich Blood Pressure Study I and II (MBS 1981 and 1982). The study population was a random sample of the adult population of Munich (30-69 yrs.). 2216 men and women participated in MBS I (response 69.3%). The results from descriptive analyses and multivariate logistic regression showed significant relationships between sex and the various types of medical care utilization described above, with the exception of participation in hypertension screening, that is participation in the Munich Blood Pressure Study. Also, after controlling for age, marital status, education, occupational position, subjective physical well being, number of chronic diseases, women went more often to the doctors and consumed more drugs than men. The sex differences were the largest in the participation of cancer screening tests (odds ratio 7.7), and the smallest in the frequency of physician visits (odds ratio 1.8) and participation in hypertension screening (not significant). Additionally, the sex differences in medical care utilization decreased with age. PMID- 3264979 TI - The use of health care resources by young adults with spina bifida. AB - Residents of Sheffield, U.K., aged 16-21 years with myelomeningocele were interviewed to ascertain morbidity in the preceding 12 mths., current and past use of hospital and community health care resources, and dependence on carers. Twenty-one patients, representing 49% of those known to paediatric services, responded. In the previous year, 71% of the group had been ill due to their spina bifida. 81% of subjects received hospital supervision, mostly by a urologist. Many hospital contacts had been lost, mostly by age 18 years. Little use was made of community health services or general practitioners. The majority of patients were dependent on their parents for management of incontinence, and care of skin vulnerable to pressure sores. 52% of respondents were dissatisfied with current provision of health care. Particular need was expressed for community nurses and physiotherapists. PMID- 3264981 TI - [Results of geriatric surgery in primary care]. AB - An analysis was made of surgical interventions from 1967 to 1987, with patients above 65 years of age accounting for something between 19 and 24 per cent. Detailed investigations were conducted into 1,346 operations, with most of these having been performed on patients aged 70 to 74 (27.9 per cent). The overall lethality amounted to 25.2 per cent. The lethality risk increased with leapwise significance beyond the 75th year of age for both elective and emergency operations. Urgency of intervention, concomitant diseases, and age were found to be the major factors to determine prognosis and lethality. Reference is made to improved medical action in the perioperative phase as well as to consideration of ethical aspects. PMID- 3264980 TI - [The incidence of kidney diseases in a pediatric kidney dispensary]. AB - 400 children (141 boys and 259 girls) in a renal disease care system were analyzed regarding their most frequent diagnoses of renal diseases and their age and sex distribution. Furthermore, the familiary situation, the time of observation, the number of consultations and the frequency of morphological changes of the kidney and the urinary tract were examined. 72% of the children suffered from urinary tract infection and in 10% a glomerulopathy and in 5.5% an urolithiasis were found. The symptoms of enuresis occurred in 22.2% of the patients. Infants were the most frequent age group (18%), 70% of which were boys. We found no differences in the incidence of renal diseases in comparison with other reports. PMID- 3264982 TI - [Acute complications of colorectal cancer]. AB - Surgery was applied to 152 cases for colorectal carcinoma at the Surgical Department of Friedrichshain Hospital through a period of two years (1986/1987). Emergency laparotomy had to be performed on 31 patients (20 per cent) for acute complications, with colonic ileus being the most common problem. Primary lethality amounted to 25.8 per cent. PMID- 3264983 TI - Effects of leukocidin from Fusobacterium necrophorum on bovine peripheral leukocytes in vitro. AB - Partially purified leukocidin from Fusobacterium necrophorum damaged bovine peripheral leukocytes as demonstrated by trypan blue staining. Granulocytes were most and T-lymphocytes least sensitive to the leukocidin. Heating for 30 min at 60 degrees C completely inactivated the leukocidin. The cytotoxicity of the leukocidin could be neutralized by homologous anti-leukocidin. Scanning electron microscopy of the exposed cells revealed an apparent destruction of the cell membranes, loss of the microvilli and smoothing of the cell surfaces. PMID- 3264985 TI - Prevalence and severity of incisal and occlusal tooth wear in an adult Swedish population. AB - The material consisted of 585 randomly selected dentate individuals from the community of Jonkoping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal or occlusal wear was evaluated for each single tooth in accordance with the following criteria: 0 = no wear or negligible wear of enamel; 1 = obvious wear of enamel or wear through the enamel to dentin in single spots; 2 = wear of dentin up to one-third of the crown height; 3 = wear of dentin more than one-third of the crown height and/or excessive wear of tooth restorative material. Among the 20-year-olds 35% of the subjects had no or slight incisal or occlusal wear. The corresponding figures for the 30- to 80-year age groups were 20%, 32%, 18%, 14%, 26%, and 23%, respectively. For the age groups 20-80 years, the percentage of teeth with incisal or occlusal wear in accordance with criteria 1-3 was 13%, 20%, 16%, 24%, 23%, 23%, and 23%, respectively. Men presented more teeth with wear than women, the difference being significant for all age groups except the 20- and 60-year olds. Among the 20-year-olds 6% had one or more teeth with wear scored 2. Among subjects aged 30 and 70 years 10% and 31%, respectively, showed tooth wear with score 2. Wear with score 3 was only found in 2% of the total population. There was an increase in the number of teeth with incisal or occlusal wear with age. With increasing age, there was also a change in distribution of wear within the dentition. PMID- 3264984 TI - [Electrostimulation of the phrenic nerves in neural resuscitation]. AB - Electrostimulation of the phrenic nerves (ESPN) on the cervical level was conducted by the transcutaneous and direct methods in 30 neurosurgical patients in the postoperative period. Hypoventilation, hypoxemia, as well as microfocal pneumonia were relieved rapidly in 10 patients after transcutaneous ESPN. In 10 patients in whom the generally applied therapeutic measures proved ineffective, ESPN made it possible to cope with severe, rapidly progressing confluent pneumonia in the shortest time. The authors discuss the possibility of applying ESPN for restoration of spontaneous ventilation in central respiratory disorders (8 patients) and note the inefficacy of ESPN in pathological types of respiration and division of the phrenic nerve. PMID- 3264986 TI - Continuous suction and intermittent irrigation for septic coxitis. AB - This prospective study was undertaken on 42 children with septic arthritis of the hip diagnosed within 5 days of onset of symptoms. The mode of treatment used was continuous catheter suction and intermittent saline irrigation of the hip joint together with parenteral antibiotics. All but 4 children responded to this treatment; 2 of these were less than 3 years old. We conclude that continuous suction-irrigation is effective in children older than 3 years very early in the course of the disease; the majority need not undergo arthrotomy. PMID- 3264987 TI - [Medico-legal evaluation of vestibular damage]. PMID- 3264988 TI - [Diagnostic and therapeutic protocol in otitis media in the 1st year of life]. PMID- 3264989 TI - [Vestibular functions in patients with idiopathic scoliosis]. PMID- 3264990 TI - Does interleukin-1 affect intracellular calcium in osteoblast-like cells (UMR 106)? AB - Interleukin-1 (IL-1) enhances bone resorption and formation in vitro, presumably through a primary action on osteoblasts, but the mechanism by which IL-1 activates bone cells is unknown. We investigated the possibility that the effect of IL-1 on osteoblasts is mediated through an increase in intracellular calcium [Ca++]i by studying the effects of purified human monocyte-derived IL-1 (hIL-1) and recombinant human IL-1 alpha (rhIL alpha) and beta (rhIL-1 beta) on [Ca++]i in the rat osteogenic sarcoma cell line UMR 106 using indo-1, a new-generation fluorescent Ca++-sensitive probe. hIL-1 (1 U/ml) resulted in an 85.5% rise in [Ca++]i over baseline that reached a peak after 30 seconds and returned to basal levels within 60 seconds. A similar transient rise in calcium was obtained upon exposure of the UMR cells to both the hIL-1 suspension buffer and to the concentration of fetal bovine serum present in the hIL-1 buffer. This effect was not abolished either by heat inactivation of both hIL-1 and serum or by pretreatment of hIL-1 with specific rabbit antihuman-IL-1 antibody. Moreover, exposure of the UMR cells to either rhIL-1 alpha or rhIL-1 beta or to a mixture of both at concentrations of 1 to 100 U/ml was not followed by any change in [Ca++]i. Our data do not support the idea that IL-1 can stimulate osteoblasts through a calcium-mediated pathway. PMID- 3264992 TI - Production of hemopoietic growth factors by bone tissue and bone cells in culture. AB - This study was carried out to determine whether bone might be a source of hemopoietic growth factors. Both neonatal murine calvaria and primary cultures of cells isolated from calvaria released, upon stimulation with lipopolysaccharide, an activity that stimulated the growth of the interleukin (IL) 3-dependent cell lines, 32D cl, 123, and NSF 60. Upon gel filtration, this activity eluted with a molecular weight of 30,000 kDa. Further characterization, however, revealed that the major activity in conditioned medium was not IL 3. Activity was absorbed by DEAE-Sephacel at low salt concentration, whereas IL 3 does not adhere. Furthermore, an IL 3-specific antiserum did not neutralize the activity from cells and only partly neutralized the activity generated by whole calvaria. After gel filtration, the 30-kDa activity stimulated the growth of very large colonies in semisolid medium consisting mainly of granulocytes with the remainder being macrophages. No colony types belonging to other hemopoietic lineages were found, indicating, again, that the activity was not identical to IL 3. Subsequently, conditioned medium was fractionated by hydrophobic chromatography on Phenyl Sepharose CL-4B, yielding two peaks of activity. Neutralization of activity with antisera to granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL 3 and use of colony assays showed that medium conditioned by whole calvaria contained GM-CSF and granulocyte CSF (G-CSF) in similar amounts together with a little IL 3, and medium conditioned with calvaria cells contained GM-CSF and little G-CSF. We conclude that bone releases hemopoietic growth factors that could contribute both to hemopoiesis and to the recruitment of osteoclasts from progenitors resident in the adjacent marrow. PMID- 3264991 TI - Effect of short-term glucocorticoids on serum osteocalcin in healthy young men. AB - Young healthy men were studied during brief treatment with prednisone to determine the rapidity of the effects of glucocorticoids on serum osteocalcin. Seven subjects were given 60 mg of prednisone orally at 8 a.m. on 5 consecutive days. Serum osteocalcin fell to 68% of the pretreatment level within 24 hours after the first dose was administered (p less than 0.01) and reached a nadir of 37% of baseline between 48 and 96 hours after treatment was begun (p less than 0.005). When prednisone was discontinued, serum osteocalcin returned promptly to pretreatment levels. Similar, though less marked, effects were found with lower doses of prednisone. Serum osteocalcin was not different from baseline after 5 mg of prednisone in five subjects, but after treatment of five subjects each with 10, 15, or 20 mg of prednisone, osteocalcin levels were 83%, 78%, and 74% of baseline, respectively (p less than 0.05). Serum osteocalcin levels fell rapidly with glucocorticoid administration, indicating that the effects of glucocorticoids on bone cells may be demonstrated long before clinical evidence of osteoporosis becomes apparent. PMID- 3264993 TI - Bone status of senescent male rats: chemical, morphometric, and mechanical analysis. AB - The bone status of male rats 6, 12, and 24 months of age (n = 10) was examined. Femur calcium (Ca), phosphorus (P), and osteocalcin contents; serum chemistry; and mechanical properties of the bone were measured and correlated. Diaphyseal Ca, P, and osteocalcin contents were not different in animals 6 and 12 months of age but decreased significantly at 24 months: -7.4% for Ca, -4.2% for P, and -24% for osteocalcin compared to 12 months. Femurs from 24-month-old (senescent) rats were characterized by a scalloped appearance of the midfemoral endosteal surface and by cortical porosities. These age-associated changes coincided with nearly two-fold increases in serum immunoreactive parathyroid hormone (PTH) and osteocalcin. Serum Ca did not change with age, whereas serum P decreased (-14.8%) from 6 to 24 months. Maximum breaking force required to fracture femurs at midshaft did not change with age. Hence, the strength of the femur as an intact organ was not compromised with age despite the loss of diaphyseal Ca and P in the senescent animal. However, ultimate stress, a parameter that normalizes for differences in bone geometry and size, decreased 35% in femurs from 12- compared with 24-month-old animals. These mechanical results might be explained by the morphometric finding that, in contrast to the small but progressive age associated increases in femur weight and length, the cortical and medullary areas increased at least two-fold. Therefore, the strength of the intact femur was maintained by architectural compensations, even though normalized tissue strength decreased with age. These findings suggest that bone status was compromised in the aged male rat. PMID- 3264994 TI - Bone resorption by isolated chick osteoclasts in culture is stimulated by murine spleen cell supernatant fluids (osteoclast-activating factor) and inhibited by calcitonin and prostaglandin E2. AB - The question of whether any of the agents known to activate bone resorption in vivo or in organ cultures acts directly on the osteoclast or via intermediate target cells that secondarily secrete locally paracrine factors is important for our understanding of bone remodeling. In an attempt to clarify this issue for some of the agents, we have taken advantage of the recent progress in obtaining and culturing relatively pure populations of osteoclasts. We performed an in vitro bone-resorbing assay in which isolated and partially purified chick osteoclasts were cultured on devitalized, paired and standardized bone disks prepared from rat calvaria prelabeled with both 45Ca and 3H-proline. Some of the isolated osteoclasts attached to the devitalized bone matrix, formed a ruffled border, and acidified the bone-resorbing compartment that they established with the matrix, thereby indicating that they resorbed bone in a physiologic manner. Salmon calcitonin added to these cultures (0.3 U/ml = 60 ng/ml) and prostaglandin E2 (PGE2) (10(-6) M) inhibited both basal and stimulated 45Ca and 3H-proline release. Neither parathyroid hormone (PTH) 1-34 (1 U/ml), 1,25-(OH)2-D3 (10(-8) and 10(-9) M), nor interleukin 1 (IL-1) (purified from P388D1 macrophage culture supernatant fluids or recombinant murine IL-1-alpha) (100 ng/ml) stimulated bone resorption in these cultures. In contrast, supernatant fluids from concanavalin A (Con-A)-activated murine spleen cell cultures (murine osteoclast-activating factor; OAF) consistently and significantly induced a 3- to 5-fold stimulation of bone resorption in this system. PMID- 3264995 TI - Human glioma cell lines: tumour associated antigens distribution and sensitivity to antibody-toxin or ligand-toxin conjugates. A preliminary report. AB - We have investigated the phenotype of seven human glioma cell lines established in vitro from primary tumour explants. Indirect immunofluorescence and flow cytofluorimetry revealed a heterogeneous distribution of surface GE 2 and CG 12 Tumour Associated Antigens (TAA). In one group of cell lines TAA were detected both at the cell surface and in the cytosol, whereas in a second group of glioma cell lines TAA were found only in the cytosol. We have also investigated the sensitivity of glioma-derived cell lines to antibody-toxin and ligand-toxin conjugates (Immunotoxins). Monoclonal antibodies anti GE 2 antigen linked to ricin toxin A subunit (RTA) showed poor cytotoxicity, which increased about 50 fold when the whole toxin was linked to anti GE 2 monoclonals. Treatment with human recombinant interferon gamma (IFN-gamma) greatly augmented the percentage of HLA-DR+ cells and the amount of HLA-DR antigens per cell. IFN-gamma treatment resulted in a net increase of sensitivity to anti HLA-DR Immunotoxins (IT). Human diferric transferrin linked to RTA exhibited a potent cytotoxic effect against human glioma-derived cells when used in the presence of the lysosomotropic carboxylic ionophore monensin. PMID- 3264997 TI - Neurophysiology of the vestibular system. Selected papers of the Barany Society Meeting. Bologna, June 1-4, 1987. PMID- 3264996 TI - Potentiation by GTP of Ins(1,4,5)P3-induced Ca2+ mobilization in permeabilized hepatocytes. PMID- 3264998 TI - A comparison between smooth pursuit and visual suppression. PMID- 3264999 TI - Development of righting reflexes, gross motor functions and balance in infants with labyrinth hypoactivity with or without mental retardation. PMID- 3265000 TI - Otolithic control of posture: vestibulo-spinal reflexes in a patient with a Tullio phenomenon. PMID- 3265001 TI - The examination of body sway in normal subjects and patients with Meniere's disease or cerebellar dysfunction. PMID- 3265002 TI - Influence of the vestibular stimulation on the activity of muscles of the lower limb in man. Electromyographic evidence. PMID- 3265003 TI - Comparison of caloric and OKAN tests in patients with vestibular deficits. PMID- 3265004 TI - Head rotation evoked EEG responses are governed by rate of angular acceleration change. PMID- 3265006 TI - Developmental modulation of vestibular-ocular function. PMID- 3265005 TI - Posterior fossa: correlations between anatomical slices and magnetic resonance imaging. PMID- 3265007 TI - High frequency rotation test: clinical and research application. PMID- 3265008 TI - Membrane currents in vestibular and cochlear hair cells. PMID- 3265009 TI - Vestibular-contingent voluntary saccades based on cognitive estimates of remembered vestibular information. PMID- 3265010 TI - The role of the vestibular system in eye-head coordination and the generation of vestibular nystagmus. PMID- 3265011 TI - Considerations on vestibular physiopathology with special reference to comparison of irritative state and paralytic state. PMID- 3265012 TI - The role of cervical inputs in compensation of unilateral labyrinthectomized patients. PMID- 3265013 TI - Familial head movement dependent oscillopsia. PMID- 3265014 TI - Vestibular involvement in spasmodic torticollis: an old hypothesis with new data from otolith testing. PMID- 3265015 TI - The relative effect of saccular and somatosensory information on spatial perception and control. PMID- 3265016 TI - Early symptoms of side effects due to aminoglycoside antibiotics. PMID- 3265017 TI - Vestibular autorotation testing of cisplatin chemotherapy patients. PMID- 3265018 TI - Caloric testing of the vestibular function during orbital flight. PMID- 3265019 TI - Inner ear blood flow in the rabbit after caloric stimulation. PMID- 3265020 TI - Modulation of microphonics: a new method to study the vestibular system. PMID- 3265021 TI - Statistical identification of the extent of a peripheral vestibular deficit using vestibulo-spinal reflex responses. PMID- 3265022 TI - [The effect of interleukin-2 eyedrops on the cytotoxic T lymphocyte activity in the cervical lymph nodes of mice with corneal herpes infection]. PMID- 3265023 TI - [Effects of pre-instilled mydriatics on the intraocular concentration and anti inflammatory action of topical 0.1% pranoprofen]. PMID- 3265024 TI - [The early receptor potential in different grades of abnormality in congenital red-green color deficiency]. PMID- 3265025 TI - Longitudinal patterns of cocaine use among adolescents. AB - Developmental patterns of cocaine use were examined in a longitudinal sample of 1,308 male and female adolescents. The data indicate that substantial increases in use occurred between 15 and 18 and between 18 and 21 years old. Although there were developmental changes, there were no significant increases over time for same aged individuals. Gender differences within age groups were not statistically significant, although some differences were apparent. Examinations of intraindividual changes in cocaine use among continuous users indicate significant individual increases in all measures of cocaine use over a 3-year period. While continuous users increased their use of cocaine, they experienced decreases in their frequency of use of alcohol, marijuana, and other drugs. Analyses also suggest that those individuals who initiated cocaine use between T1 and T2 were already different from their age peers in terms of their cigarette, alcohol, and marijuana use at T1. Overall, the findings suggest that patterns of cocaine use may be more dependent upon the number of years of use rather than on the age of the user. PMID- 3265026 TI - Substance use and abuse among mentally retarded persons: a comparison of patients and a survey population. AB - Substance abuse among mentally retarded persons, first described 55 years ago, has received little or no attention by specialists in mental retardation. With deinstitutionalization, this problem has reappeared, often followed by victimization (i.e., assault, rape, robbery). In this study the demographic characteristics, family and childhood history, substance use patterns, and substance-related problems of 40 mild mentally retarded persons are compared with those of 40 mild mentally retarded persons without substance abuse. Similarities with substance abusers who are not mentally retarded are noted. Recommendations for alleviating this serious problem among mentally retarded persons are made. PMID- 3265027 TI - Heroin use in The Netherlands. AB - This article describes developments in The Netherlands with a special focus on those issues that can be described as "typically Dutch": the divergent "opium act," the methadone buses, the Junkie League, and the plans for heroin maintenance. It also gives an impression of the important role of the Dutch Government in the organization of the relief work system. The article concludes that in some ways the Dutch have learned to live with certain developments, and that they have ceased to look for a one and only solution. PMID- 3265028 TI - Nitrite inhalants: patterns of abuse in Baltimore and Washington, D.C. AB - Nitrite inhalants, as drugs of abuse, have received a new prominence in the literature since their use has been associated with Kaposi's Sarcoma and possibly other manifestations of acquired immunodeficiency syndrome (AIDS). Changes in patterns and prevalence of use have not been investigated since the onset of the AIDS epidemic. We have examined the abuse patterns of nitrite inhalants (poppers) in several different groups. The use of poppers among drug abusers in the Baltimore-Washington, D.C. metropolitan area has remained constant over the past 5 years, with the prevalence of use being approximately 11% for recreational drug users and 22% for heavy abusers. Self-reported use by a homosexual group had decreased over the same time period. Sixty-nine percent of the homosexual sample had experience with nitrities, but only 21% had used them in the 6 months prior to being surveyed. The mean interval since last use was 25 months, and since peak use, 4.1 years. Among substance abusers, nitrites appear to be a drug whose use starts late, with the mean age of first use being 25.6 years compared to 14.6 years for glue, 17.6 years for marijuana, and 18.5 years for heroin. We found both heterosexual and homosexual groups utilize nitrites primarily to "get high," but homosexuals more often use them during overt sexual activity. Experience with amyl nitrite was much more prevalent than that with the butyl derivative in both populations. We conclude that the prevalence of nitrite abuse among drug users has not changed as a result of the AIDS epidemic, but such use appears to have decreased within the homosexual community. PMID- 3265029 TI - Inner-city substance abuse patterns: a study of psychiatric inpatients. AB - Multiple studies have reported about substance abuse in Blacks and Hispanics. However, little is known about substance-abusing psychiatric patients of these ethnic groups. This study reports the prevalence and patterns of substance abuse among 171 consecutive patients (90 Blacks and 81 Hispanics) admitted to the acute psychiatric unit of an inner-city general hospital. The lifetime prevalence was 63%. Within the month prior to admission, 48% had used the following substances: cannabis, 40%; alcohol, 37%; amphetamines, 20%; cocaine, 12%; phencyclidine (PCP), 12%; barbiturates and/or sedative-hypnotics, 10%; opioids, 9%; inhalants, 1%; hallucinogens, 1%. Those who abused alcohol were more likely to abuse barbiturates and/or sedative-hypnotics, and opioids. Logistic regression analysis showed that major depression, ethnicity, and schizophrenia each were significant predictors of particular types of abuse. Patients with major depression were less likely to use PCP, Blacks were more likely than Hispanics to use hallucinogens, and schizophrenics were less likely to use opioids. In all cases in which sex, age, and personality disorder were significant, males, the young adult group, and those with personality disorder were more likely to be abusers. These three variables were all strong predictors of both multiple and extensive substance abuse. Overall, our findings suggest that in the inner-city, a substantial number of young adult psychiatric inpatients are a high risk group for multiple substance abuse. The coexistence of substance abuse and other psychiatric disorders has clinical and treatment implications, and calls attention for changes within the conventional psychiatric milieu. PMID- 3265030 TI - Correlates of adolescent drug use by gender and geographic location. AB - We examined the correlates of self-reported lifetime use of alcohol, marijuana, amphetamines, and cocaine within a sample of almost 7,000 high school sophomores in Arizona and Utah. Correlates of drug use (including parental attachment, religious attachment, educational attachment, conventional values, and drug-using friends) showed very similar patterns by gender, with some interesting differences by location. Drug-using friends are by far the best predictor of drug use for both males and females in Arizona and Utah. PMID- 3265032 TI - [Effect of gestoses on the status of the immune and adrenal systems in newborn infants]. PMID- 3265031 TI - Impact of the revision of DUI legislation in Alabama. AB - On May 19, 1980, a major revision in the Alabama DUI laws went into effect which gave judges greater discretion in sentencing. This revision resulted in an increase in the proportion of DUI convictions, a reduction in the number of DUI citations reduced to reckless driving, a reduction in the proportion of offenders acquitted and/or dismissed, an increase in the proportion of revocations, and an increase in court referrals to an educational program on the first offense. However, the 1980 revision was accompanied by a significant increase in the percentage of alcohol-related accidents. Consequently, the Alabama legislature revised the 1980 law on July 29, 1983, the revision taking effect immediately. The more stringent penalties in the new law apparently had a positive effect on all six alcohol-related measures cited above. Most importantly, the latest revision was accompanied by a significant decrease (2.80%) in the proportion of alcohol-related accidents. PMID- 3265033 TI - [Immunologic methods of prognosis and diagnosis of late pregnancy toxemia]. PMID- 3265034 TI - [Use of diadynamic currents on the perirenal region in puerperants after late pregnancy toxemia]. PMID- 3265035 TI - [Prevention of thrombohemorrhagic complications in late pregnancy toxemias]. PMID- 3265036 TI - [Use of preformed physical factors in the complex prevention and treatment of gestoses]. PMID- 3265037 TI - Adult respiratory distress syndrome--how many cases in the UK? AB - Previously reported figures for the incidence of Adult Respiratory Distress Syndrome, based largely on American results, would suggest that the average British Health District of 200,000 people could expect to see 130 cases per year. This figure is greatly in excess of that expected from our clinical experience. We have undertaken a retrospective survey of patients within a British Health Region (population, 3,599,400). Results indicate an incidence of nine for an average Health District of 200,000 population, or 2.5% of all admissions to intensive therapy units, or 0.045 per 1000 resident population. PMID- 3265038 TI - Induction dose of propofol in children. AB - In a study of 144 children aged 1-12 years, attempts were made to assess the ED50 and ED90 of the intravenous induction agent, propofol. The doses required for loss of eyelash reflex and tolerance of facemask, in 50% of unpremedicated children, were 1.6 mg/kg and 2.5 mg/kg respectively. In children premedicated with oral trimeprazine the corresponding values of ED50 were 1.1 mg/kg and 2.0 mg/kg. Doses of 2.8 mg/kg in unpremedicated and 2.0 mg/kg for those who received trimeprazine were required for loss of eyelash reflex in 90% of children. This probably corresponds to an effective induction dose. Pain and movement on induction were common; the incidence was 27% and 21.5% respectively. PMID- 3265039 TI - Seizure duration and propofol. PMID- 3265040 TI - Pain on injection of propofol. PMID- 3265041 TI - Radioautographic demonstration of receptors for epidermal growth factor in various cells of the oral cavity. AB - Mouse iodinated epidermal growth factor (EGF) was localized by light and electron microscopic radioautography in basal cells of oral epithelium, papillary cells of the enamel organ, periodontal ligament fibroblasts, preodontoblast precursor cells, and preosteoblasts of the alveolar bone of 13-day-old Sprague-Dawley rats. The specificity of binding in these cells was suggested by an observed reduction of about 90% in the labeling when excess unlabeled EGF was injected along with the 125I-EGF. In contrast, fully differentiated cells, such as ameloblasts, odontoblasts, and osteoblasts, were only poorly labeled. Quantitative analysis of the light microscopic radioautographs revealed that the papillary cells had the highest level of labeling (5.5 grains per 100 micron 2 of cell area). The significance of the rather high labeling of the preosteoblasts of the alveolar bone and the fibroblasts of the periodontal ligament is unknown. However, the well-known effect of EGF in producing precocious eruption of teeth may be a consequence of an effect on these two cell types. PMID- 3265042 TI - Inflammation of rat molar pulp and periodontium causes increased calcitonin gene related peptide and axonal sprouting. AB - We have studied the response of nerve fibers containing calcitonin gene-related peptide immunoreactivity (CGRP-IR) to inflammation using a rate dental experimental system. Inflammation was induced by drilling tooth cusps to create pulpal exposures; the induced pulpitis and subsequent periapical lesions were studied 1-35 days later using standard CGRP immunohistochemistry and the avidin biotin peroxidase method. The injury and resulting inflammation caused a disruption of CGRP-IR nerve fiber location and arborization that varied depending on whether the initial injury was limited to the pulp tip or extended throughout the pulp horn. At shorter survival periods (24 hr, 3 days) nerve fibers were either decreased or bundled into the center of the pulp with sprouting along the wound border. At 6 days necrosis and acute inflammation had advanced to varying degrees, and CGRP-IR fibers were extensively sprouted in the surviving pulp; the pulp also stained specifically for CGRP within 1-2 mm of the inflamed tissue at 6 days. At 35 days, we found total pulp necrosis in most teeth and the development of periapical bone loss, granulomatous tissue, and periapical abscesses. There was also an extensive increase in CGRP-IR nerve fibers in the tissues surrounding sites of severe periodontal inflammation and necrosis. In some cases, macrophage like cells staining specifically for CGRP were near the abscesses. The results show important interactions between peptidergic nerve fibers and inflammatory cells, and are discussed in terms of the role of nerve fibers containing CGRP in neurogenic inflammation, mechanisms for intensification of CGRP immunoreactivity in affected fibers or neighboring cells, and implications for chronic inflammatory conditions, dental pain, and anesthesia. PMID- 3265043 TI - [Status of the sympathetic-adrenal, hypophyseal-adrenal and serotonin systems during surgery with the use of electro-acupuncture combined with amitriptyline and local anesthesia]. PMID- 3265044 TI - [Erythrophagocytic T-cell lymphoma: clinical entity similar to malignant histiocytosis. Role of immunology and study of the genetic rearrangement of T cells in determination of the diagnosis]. PMID- 3265045 TI - [Immunophenotype of 37 childhood acute lymphoblastic leukemia patients]. PMID- 3265046 TI - Total body and regional analysis by dual-photon absorptiometry in osteogenesis imperfecta. PMID- 3265047 TI - Diversity of rat brain cysteine proteinase inhibitors: isolation of low-molecular weight cystatins and a higher-molecular weight T-kininogen-like glycoprotein. AB - Conditions for extraction of rat brain soluble and particulate cysteine proteinase inhibitors (CPIs) were compared and an optimal one was selected to isolate low- and high-molecular-weight forms active toward papain or brain cathepsins B/L. The different forms were purified by affinity chromatography on alkylated papain, and identified on sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels by use of Schiff's reagent, or by immunoblots using antisera to monomer or polymeric forms of human urinary cystatin c, to a human plasma histidine-rich glycoprotein (HRG), or to rat plasma T-kininogen. In particulates containing nuclei (P1) or synaptosomes (P2) the predominant CPI was an 80-kDa glycoprotein cross-reacting to anti-HRG and shown to be a T-kininogen by treatment with TPCK-trypsin, and subsequent bioassay of the released kinins. The levels found in rat brain were approximately 0.5 nmol/g wet weight. The higher molecular-weight CPI potently inhibited cathepsin L hydrolysis of Leu-enkephalin at the Gly2-Gly3 bond with a Ki 10(-10) M. In contrast the low-molecular-weight CPIs were present in postmicrosomal fractions (S3) and cross-reacted with anti cystatin c, but not with anti-HRG, anti-lysozyme, anti-beta protein amyloid peptide, or anti-T-kininogen. The low-molecular-weight forms were present at approximately 1-1.5 nmol/g wet weight and resembled "cerebrocystatin" purified previously from rat brain cytosol by M. Kopitar, F. Stern, and N. Marks [1983) Biochem. Biophys. Res. Commun. 112, 1000-1006.). PMID- 3265048 TI - Proteolytic degradation of protein kinase C in the phorbol ester-induced interleukin-2 secreting thymoma cells. AB - Effects of phorbol 12-myristate 13-acetate (PMA) on the fate of protein kinase C in two mouse thymoma cell lines, which are either responsive (EL4) or unresponsive (IEL4) to PMA-induced interleukin-2 (IL-2) production, were investigated with polyclonal antibodies raised against rat brain enzyme. These antibodies immunoprecipitated completely the protein kinase C from both cell lines and detected mainly an 82-kDa protein by immunoblot analysis of the crude homogenates as well as the partially purified kinase preparations. PMA elicited a time- and dose-dependent redistribution of protein kinase C from cytosol to the particulate fraction and proteolytic degradation of the kinase from both cell lines. The dose of PMA required for half-maximum protein kinase C translocation and degradation was at least five times lower for EL4 than for IEL4. In the presence of 16 nM PMA the rates of protein kinase C translocation and degradation were faster in EL4 than in IEL4, and the half-lives of protein kinase C in EL4 and IEL4 were less than 5 min and greater than 2 h, respectively. Analysis of the tryptic fragments of the immunoprecipitated enzyme, previously phosphorylated in the presence of [gamma-32P]ATP, revealed minor structural differences between the protein kinase C from these two cell lines. In neither cell line did the PMA induced degradation of protein kinase C result in an accumulation of the Ca2+/phospholipid-independent kinase (catalytic unit) as analyzed by immunoblotting and gel filtration chromatography. Thus, activation of protein kinase C through the proteolytic conversion to the effector-independent catalytic unit plays little role in IL-2 production. The role of protein kinase C translocation and degradation in the PMA-induced responses in EL4 cells is unknown. However, IL-2 production in EL4 cells was reduced when PMA-induced degradation of protein kinase C was retarded by exogenously added protease inhibitors. PMID- 3265049 TI - [Labelling of B lymphocytes from the peripheral blood of swine]. PMID- 3265050 TI - [Digestive hemorrhage and bacterial overgrowth in children]. AB - Two cases of gastrointestinal bleeding due to bacterial overgrowth syndrome are presented. The microbial contamination was confirmed by quantitative studies of the intestinal microflora and by therapeutic test; the association colistin metronidazole could stop the digestive hemorrhage. PMID- 3265051 TI - Rheumatologic rehabilitation: a special interest for physiatrists? PMID- 3265053 TI - Complement activation produced by biomaterials. AB - The complement-activating potential of biomaterials may be defined by appropriate application of C3a and C5a anaphylatoxin radioimmunoassays. Studies performed with hemodialysis membranes demonstrate that blood contact with these model biomaterials results in complement activation that may be ascribed to specific properties of the material surface. Further delineation of these chemical and physical properties may permit design of biocompatible materials. PMID- 3265052 TI - Biological significance of the antibody response to HIV antigens expressed on the cell surface. AB - Human antibodies to HIV antigens expressed on the surface of infected cells may inhibit cell fusion with uninfected CD 4-positive cells and mediate killing of the infected cells by effector cells bearing the Fc receptor. Sequential sera from ten HIV-antibody seroconverted men, of which five progressed to ARC or AIDS (CDC stage IV) during the follow-up period of two years, were tested for the ability to inhibit CD 4-dependent cell fusion, (CFI) and to mediate antibody dependent cellular cytotoxicity (ADCC). Nine patients developed HIV-specific ADCC and seven CFI-antibodies using the HIV strain HTLV-IIIB as target antigen. These antibodies appeared approximately at the same time 2-12 months after primary infection, defined as antibody seroconversion or antigenaemia. ADCC antibodies were detectable at higher titers as compared to CFI-antibodies. All sera of asymptomatic individuals (CDC stage II and III) were CFI antibody positive and had a higher mean ADCC titer as compared to sera from patients progressing to AIDS or ARC. ADCC and CFI antibodies coincided in some cases in the complete absence of core antibodies. Because the relationship between ADCC and CFI was not exclusive it is concluded that distinct domains of the HIV envelope induce natural antibodies mediating ADCC and CFI. PMID- 3265054 TI - Molecular design of materials for cell separation. AB - There has been a strong demand in biomedical sciences to isolate viable cell populations with high yield and purity. An important facet of this work was to develop new polymeric adsorbent for the separation of lymphocyte subpopulations. Based on our strategy of separating cells through their differential ionic affinity toward multiphase-structured adsorbent with ionically derivatized microdomains, a series of poly(2-hydroxyethyl methacrylate)/polyamine graft copolymers (HA copolymers) was prepared. HA copolymer columns were found to show specific adsorption affinity toward B lymphocytes, and allows for separation of B and T lymphocytes in high yield and purity with a short operating time. Separation mechanism involved in the resolution of B and T lymphocytes by HA copolymer column is discussed in this paper. Further, photo-induced desorption of cells from the adsorbent derivatized with photo-responsive functional group (azobenzene group) was demonstrated to emphasize the feasibility of photo regulated chromatography as a novel tool in cell separation technology. PMID- 3265055 TI - The prevalence of fears, phobias and anxiety disorders and their relationship with depression in women attending family physicians. PMID- 3265056 TI - Biosynthesis, processing, and extracellular release of alpha-L-fucosidase in lymphoid cell lines of different genetic origins. AB - In humans, the quantity of alpha-L-fucosidase in serum is determined by heredity. The mechanism controlling levels of the enzyme in serum is unknown. Lymphoid cell lines derived from individuals with either low, intermediate, or high alpha-L fucosidase in serum were established. Steady-state levels of intracellular and extracellular alpha-L-fucosidase as well as rates of synthesis and secretion of enzyme overlapped among the cell lines. Thus, in vivo serum phenotypes were not expressed in this system. No appreciable differences in the qualitative processing of newly made alpha-L-fucosidase were observed among these lymphoid cell lines. Cells pulse-labeled with 35S-methionine from 0.25 to 2 hr had an intracellular form of enzyme with a Mr = 58,000. Cells pulsed for 1.5 hr and chased for 21 hr with unlabeled methionine had an intracellular form of Mr = 60,000 and an extracellular form of Mr = 62,000. All three enzyme forms were glycoproteins with a common polypeptide chain of Mr = 52,000 but with different carbohydrate moieties. No evidence for a high molecular mass precursor form of alpha-L-fucosidase was found. Fucosidosis is a rare, inherited disease in which alpha-L-fucosidase activity in tissues and body fluids is low or absent. The mutations for fucosidosis and the serum polymorphism map separately. Lymphoid cells from two siblings with fucosidosis had 8-fold to 341-fold less intracellular alpha-L-fucosidase protein with 11-fold to 56-fold lower specific activities than control cells. Residual mutant enzyme was a glycoprotein with a polypeptide chain virtually the same size (Mr = 52,000) as control enzyme. However, residual mutant enzyme was hypoglycosylated and hypersecreted as compared to control enzyme. PMID- 3265057 TI - Inositol 1,4,5-trisphosphate concentrations increase after adherence in the macrophage-like cell line J774.1. AB - Several properties of macrophages change when suspended cells become adherent. To determine the intracellular signals involved in these changes, concentrations of the second messenger inositol 1,4,5-trisphosphate [Ins(1,4,5)P3] were monitored during adherence of J774.1 cells, a macrophage-like cell line. When cells grown in suspension were allowed to adhere to a glass surface, there was a transient increase in InsP3 that reached a peak between 100 and 120 s after plating. Inositol mono- and bis-phosphate concentrations were also elevated 100 and 120 s after plating. Analysis of isomer distribution showed significant 3-fold increases in Ins(1,4,5)P3 and inositol 1,3,4,5-tetrakisphosphate [Ins(1,3,4,5)P4] at 100 s after plating. These values were maintained at 120 s, with the additional appearance of a 4-fold increase in inositol 1,3,4-trisphosphate. The adherence-induced generation of Ins(1,4,5)P3 was decreased, and Ins(1,3,4,5)P4 formation was blocked, in Ca2+-free medium. However, doubling intracellular [Ca2+] by addition of the Ca2+ ionophore ionomycin (1 microM) did not increase Ins(1,4,5)P3 in suspended cells. Adherence of J774.1 cells to fibronectin-coated glass also induced an increase in InsP3. PMID- 3265058 TI - New prodrugs of acyclic nucleosides with antiviral activity. AB - More than 130 acyclic purine and pyrimidine nucleoside derivatives have been synthesized. Structure-activity relationships among a selected group of 6- and 9 substituted guanine derivatives will be discussed. By introduction of secondary aliphatic (e.g. isopropyl or secondary butyl) ether groups into acyclic nucleosides such as aciclovir and ganciclovir new lipophilic prodrugs with modified physical and improved pharmacokinetic properties have been obtained. Several compounds with isopropylether groups in the side-chain and/or in the 6 position (among these the 6-deoxy derivative Hoe 602) of the purine moiety displayed excellent antiviral activity when tested in vivo against herpes simplex virus type 1 infection in mice. PMID- 3265059 TI - Aortic intimal lipid content and serum lipoproteins in patients undergoing coronary by-pass surgery as related to clinical prognosis. AB - Intimal lipid concentrations were determined in aortic biopsies obtained during coronary by-pass surgery. In addition serum lipoprotein and apolipoprotein levels were quantitated and their relationships to aortic intimal lipid concentrations were analysed. The possibility to use aortic intimal lipid and serum lipoprotein or apolipoprotein concentrations to predict clinical prognosis following the coronary by-pass operation was also evaluated. Intimal cholesterol, cholesterol ester, phosphatidylcholine and sphingomyelin were intercorrelated, whereas none of these lipid fractions correlated to aortic intimal triglyceride levels. Patients with hypertension had higher aortic intimal cholesterol ester levels than normotensive patients. There was a positive correlation between the number of stenosed coronary arteries and serum apo B or triglyceride levels. In addition there was a negative correlation between the number of stenosed arteries and HDL cholesterol. Prognosis after the operation was inversely correlated to serum apo A-I levels. Our data do not, however, support the notion that aortic intimal lipid levels can be used to evaluate prognosis after coronary by-pass surgery. PMID- 3265060 TI - Antibodies against monocytes and endothelial cells in the sera of patients with atherosclerotic peripheral arterial disease. AB - We looked for antibodies against endothelial cells, monocytes, fibroblasts, lymphocytes and Epstein-Barr virus transformed lymphocytes in the sera of 28 elderly and 18 middle-aged patients with atherosclerotic peripheral arterial disease and 13 controls. Inclusion criteria were symptomatic peripheral arterial disease with intermittent claudication and ankle/radial Doppler pressure ratio less than 0.7 in the patient group and greater than 1 in the controls. The sera were tested using a standard cytotoxic technique against a cell panel of monocytes, T and B lymphocytes from 5 donors, and against endothelial cells, fibroblasts and Epstein-Barr virus transformed lymphocytes from one umbilical cord vein and blood. The sera of 30 of 46 (65.2%) patients showed toxicity against monocytes from at least one member of the cell panel and 12 of 19 sera tested (63%) reacted with endothelial cells. Only one of the control sera was positive against monocytes and none reacted with endothelial cells. None of the sera of either patients or controls contained cytotoxic antibodies against T and B lymphocytes, Epstein-Barr virus transformed lymphocytes or fibroblasts. The selective cytotoxicity suggests that the antibodies detected are not against HLA antigens (which are expressed by normal lymphocytes and Epstein-Barr virus lymphocytes). Our results suggest that immune phenomena occur in atherosclerosis. PMID- 3265061 TI - Retrograde coronary sinus cardioplegia in patients with severe ventricular dysfunction. PMID- 3265062 TI - Non-steroidal anti-inflammatory drugs induced gastropathy: endoscopic findings in rheumatic patients. PMID- 3265063 TI - [Statistical evaluation of 60,000 blood alcohol findings 1964-1983. I. General epidemiologic data]. PMID- 3265064 TI - Investigational study of iodine-124 with a positron camera. AB - A case is presented where I-124 produced by a clinical cyclotron was used with a positron emission tomography camera for clinical usage. This represents the first report of the utilization of this modality with this radionuclide. We feel the increased spatial resolution of PET should be of value in looking at thyroid disease. PMID- 3265065 TI - 'Angina bullosa haemorrhagica: a complication of long-term steroid inhaler use'. PMID- 3265066 TI - Smoking habits after coronary artery bypass surgery. PMID- 3265067 TI - Iatrogenic oesophageal ulceration with massive haemorrhage and stricture formation. PMID- 3265068 TI - Accelerated vertebral bone loss in relation to the menopause: a cross-sectional study on lumbar bone density in 286 women of 46 to 55 years of age. AB - Bone mineral density (BMD) of the lumbar spine was measured in 286 women (46-55 years of age) using dual photon absorptiometry. The women were classified in three categories: premenopausal, perimenopausal and postmenopausal. The postmenopausal group was subdivided according to the number of years since the last uterine bleeding. With multiple linear regression analysis of lumbar BMD on age and menopausal status, an acceleration of bone loss was observed during the perimenopausal period and the following first two postmenopausal years. No significant bone loss was detected in relation to age or during the later postmenopausal years. Applying both an additive and a multiplicative model of bone loss, the mean perimenopausal bone loss was 0.061 gram-equivalents hydroxyapatite (geqHA)/cm2 and 6.4%, respectively. In the first 2 postmenopausal years the mean bone loss was 0.044 geqHA/cm2 and 5.1% per year. These results suggest a substantial menopause related acceleration of lumbar bone loss in a relatively short time span with its onset in the perimenopausal period. PMID- 3265069 TI - Large mechanical changes in the bullfrog olfactory bulb evoked by afferent fiber stimulation. AB - The isolated olfactory bulb of the bullfrog responds to olfactory nerve stimulation with large mechanical changes in the bulb. The sequence of these changes represents: (1) swelling of the bulb associated with action potential production in the secondary neurons; (2) shrinkage during powerful inhibition of the secondary neurons; and (3) swelling accompanied by repetitive firing of action potentials in the bulb. The effects of bicuculline and Cl-free Ringer on these mechanical changes were examined. The shrinkage of the bulb is closely related with the inhibitory postsynaptic potentials (IPSPs) in the mitral cells. PMID- 3265070 TI - MPP+-induced increases in extracellular potassium ion activity in rat striatal slices suggest that consequences of MPP+ neurotoxicity are spread beyond dopaminergic terminals. AB - MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) produces symptoms similar to idiopathic Parkinson's disease in primates. A metabolite of MPTP, MPP+ (1-methyl 4-phenylpyridinium), is actively accumulated by dopaminergic (DA) terminals and selectively destroys nigrostriatal DA neurons. The mechanism of this effect remains unknown but reports that MPP+ inhibits electron transport in isolated mitochondria and increases oxidation of cytochrome b in striatal slices suggest that depression of ATP production is involved. To relate metabolic effects of MPP+ with tissue electrophysiology, extracellular potassium ion activity [K+]o was measured by microelectrodes simultaneous to optical monitoring of reduction/oxidation (redox) activity of cytochrome b during superfusion of MPP+ onto rat striatal and hippocampal slices. MPP+ increased oxidation of cytochrome b and increased [K+]o in slices of striatum. These increases were greater than expected from a selective effect of MPP+ on DA terminals which likely comprise no more than 3% of the total striatal mass. These effects of MPP+ were slowed by a dopamine uptake inhibitor (mazindol) and did not occur in hippocampal slices. These findings indicate that MPP+ influences ion transport as well as metabolic activity and that these actions require the presence of functioning DA terminals. However, the large amplitudes of the MPP+-induced changes suggest that consequences of MPP+-neurotoxicity are not ultimately confined to DA terminals. Two hypothesis are proposed: that energy failure in DA terminals results in leakage of neurotoxic substances or metabolites altering membrane conductance properties of adjacent cells and thereby placing additional demand upon ion transport pumps and mitochondrial oxidative phosphorylation; or that there is secondary uptake of MPP+ leading to mitochondrial inhibition in cells neighboring DA terminals. PMID- 3265071 TI - Leukocytosis induced by microinjection of endogenous pyrogen or interleukin-1 into the preoptic and anterior hypothalamus. AB - We investigated the effect of microinjection of endogenous pyrogen or interleukin 1 (EP/IL-1) into 40 selected brain regions on the circulating leukocyte count in rabbits. The results show that injections into the rostral region of the hypothalamus, especially the preoptic and anterior hypothalamus, induce leukocytosis. PMID- 3265072 TI - Calcitonin gene-related peptide modulates calcium mobilization in synaptosomes of rat spinal dorsal horn. AB - Effects of synthetic human calcitonin gene-related peptide (hCGRP) on Ca2+ mobilization in crude synaptosomes prepared from rat spinal dorsal horn were studied using 45Ca2+ as a tracer. hCGRP promoted the influx of 45Ca2+ into synaptosomes of the spinal dorsal horn, in a dose dependent manner (at dose ranges from 10(-9) to 10(-6) M). The maximum effect of hCGRP on 45Ca2+ influx was achieved 5 min after addition of the peptide and was significantly inhibited by nifedipine. hCGRP did not alter the influx of 45Ca2+ into synaptosomes of the rat cerebral cortex, a brain area with reportedly few CGRP binding sites. In measurements of the 45Ca2+ efflux from synaptosomes of the spinal dorsal horn, 10(-7) M of hCGRP had no effect on the efflux of 45Ca2+ from the resting synaptosomes, but there was significant inhibitory effect on synaptosomes depolarized by 40 mM K+. The inhibitory effect of hCGRP on the efflux of 45Ca2+ was completely abolished by lowering the incubation temperature of the medium to 0 degrees C. The inhibitory effect of hCGRP on the efflux of 45Ca2+ was not observed in synaptosomes of the cerebral cortex. These findings suggest that hCGRP increases the levels of Ca2+ level in synaptosomes of the spinal dorsal horn, through interactions with its own receptors and the release of neurotransmitters from the nerve terminals is thus enhanced. PMID- 3265073 TI - Peptide immunoreactivity of the ciliary ganglion and its accessory cells in the rat. AB - By means of immunohistochemistry, calcitonin gene-related peptide, Leu-enkephalin and neuropeptide Y localize to rat ciliary and accessory ganglion cells. The proportion of ciliary and accessory neurons immunoreactive to each peptide is provided and compared to previous data for vasoactive intestinal peptide. These findings indicate considerable neurochemical complexity for a parasympathetic ganglion with a small cell population. PMID- 3265074 TI - The effects of axotomy on electrophysiological properties of B cells of bullfrog sympathetic ganglia conditioned by a previous lesion. AB - In bullfrog sympathetic B cells, axotomy decreases the amplitude and decay time of membrane afterhyperpolarization (AHP) and increases action potential (AP) duration. A second (test) axotomy, 7 days after an initial (conditioning) axotomy, did not amplify these changes. No recovery of AHP amplitude or AP duration occurred by 56 days post-axotomy, but AHP decay time recovered 21 days earlier than after test axotomy alone. Conditioning, previously shown to accelerate regeneration, speeds the return to normal of those membrane properties previously shown to recover after axotomy. PMID- 3265075 TI - Direct T-cell effects of minoxidil. PMID- 3265076 TI - In vivo and in vitro effects of a new macrolide antibiotic roxithromycin on rat liver cytochrome P-450: comparison with troleandomycin and erythromycin. AB - The effects of a new macrolide antibiotic (Roxithromycin) and one of its major metabolite (RU 39001) on rat hepatic drug metabolizing enzymes were compared to those of erythromycin, erythralosamine and troleandomycin (TAO) both in vitro and in vivo. In contrast to erythromycin, erythralosamine and TAO, roxithromycin and its metabolite RU 39001 exhibit: (i) a very poor affinity for rat liver cytochrome P-450, (ii) an unability to be metabolized into a stable inhibitory metabolite-cytochrome P-450 complex and (iii) a decreased ability to induce liver cytochrome P-450 PCNE, an isozyme implicated in drug associations involving some macrolide antibiotics. PMID- 3265077 TI - [An aspect of unilateral Cogan's microcystic dystrophy]. PMID- 3265078 TI - [Efficacy of acyclovir by oral route in ophthalmic herpes zoster: preliminary study of 20 cases]. PMID- 3265079 TI - [Endophthalmos in a patient with a lens implant: septic metastasis or local inoculation?]. PMID- 3265080 TI - [A case of Cladosporium endophthalmitis]. PMID- 3265081 TI - Arthropathy in acromegalic patients before and after treatment: a long-term follow-up study. AB - The medical records of 90 patients with acromegaly were reviewed. Arthralgias were noted in 76% of the patients with 17% having the onset of joint pain concomitant with the clinical onset of acromegaly. Of 47 patients followed prospectively for 5 or more years after pituitary irradiation, six (12.8%) were unaffected by arthralgias. A statistically higher mean baseline growth hormone level was found for the 19 (40.4%) radiotherapy patients who had severe and disabling arthropathy. Mean intervals between clinical onset of acromegaly and the development of arthropathic symptoms were shorter (4.1 years) for patients over 40 years of age and longer (9.7 years) for those under 31 years of age. Severely affected patients tended to have increased joint spaces in both weight bearing and non-weight-bearing joints followed by a progressive decrease in joint spaces. Arthropathy is a common complication of acromegaly and may progress independently of a fall in growth hormone, induced by any form of treatment, once significant cartilage overgrowth develops. Cartilage overgrowth is a predisposing factor in the development of an arthropathy associated with the wide range of growth hormone levels characteristic of acromegaly. PMID- 3265082 TI - Elevated serum elastase and alpha-1-antitrypsin levels in hemolytic uremic syndrome. AB - Clinical observations and experimental studies have pointed to a role for leukocytes in the pathogenesis of the typical or epidemic form of the hemolytic uremic syndrome. As a result of these observations we measured serum elastase levels and the levels of two protease inhibitors, alpha-1-antitrypsin and alpha-2 macroglobulin in 12 patients with this syndrome. The serum elastase levels were significantly elevated in patients compared with normal individuals (421 +/- 278 vs 91 +/- 27 mg/dl, p less than 0.005) and patients with renal diseases not caused by hemolytic uremic syndrome (191 +/- 254 mg/dl, p less than 0.025). The serum alpha-1-antitrypsin levels were also significantly elevated: hemolytic uremic syndrome vs normals (774 +/- 260 vs 285 +/- 98 ng/ml, p less than 0.0001); and in hemolytic syndrome compared with patients with renal diseases not caused by hemolytic uremic syndrome (774 +/- 260 vs 335 +/- 131 ng/ml, p less than 0.0001). There were no significant differences in the alpha-2-macroglobulin levels among the three groups. There was a significant correlation between the serum elastase levels and the total white cell counts as well as between the elastase and the polymorphonuclear cell counts but not among any of these values and the serum creatinine concentrations. These results provide additional evidence favoring the possibility that leukocytes are activated in patients with hemolytic uremic syndrome. PMID- 3265083 TI - [A deficiency of dihydrobiopterin synthesis. The effects of L-dopa, 5HTP and BH4]. PMID- 3265084 TI - Mechanisms in B-cell neoplasia. Workshop at the National Cancer Institute, National Institutes of Health, Bethesda, MD, USA, March 23-25, 1988. Proceedings. PMID- 3265085 TI - B cell proliferation in follicles, germinal centre formation and the site of neoplastic transformation in Burkitt's lymphoma. PMID- 3265086 TI - Recombinant interleukin-7 supports the growth of normal B lymphocyte precursors. PMID- 3265087 TI - B and T cell responses induced by interleukin-6. PMID- 3265088 TI - B cell precursors in bone marrow: in vivo proliferation, localization, stimulation by activated macrophages and implications for oncogenesis. PMID- 3265089 TI - Stimulation of the antigen receptor complex leads to transcriptional activation of the c-myc gene in normal human T cells. PMID- 3265090 TI - Regulation of c-myc gene transcription in B lymphocytes: mechanisms of negative and positive control. PMID- 3265091 TI - Disruption of the putative c-myc auto-regulation mechanism in a human B cell line. PMID- 3265092 TI - Abrogation of IL-3 dependence of myeloid FDC-P1 cells by tyrosine kinase oncogenes is associated with induction of c-myc. PMID- 3265093 TI - In vitro transformation of murine bone marrow cells with a v-raf/v-myc retrovirus yields clonally related mature B cells and macrophages. PMID- 3265094 TI - The Abelson protein is required for initiation and maintenance for transformation in murine pre-B cells. PMID- 3265095 TI - Genetic studies on Emu-myc transgenic mice. PMID- 3265096 TI - Electronic anesthesia garners approval from dental researchers. PMID- 3265097 TI - Profuse rectal bleeding--an unusual cause. PMID- 3265098 TI - Rarity of large vessel disease in African diabetics--the role of anti-thrombin III. PMID- 3265099 TI - Binding sites for epidermal growth factor in nuclear fraction from rat liver. AB - Binding sites for mouse epidermal growth factor (EGF) were observed in purified nuclear fraction from rat liver. The binding data yielded a curvilinear Scatchard plot which was decomposed into two binding components with different binding affinities. The binding component with higher affinity (Kd approximately 10(-10) M) represented approximately 15% of the total binding, while the high affinity binding sites were less than 5% of the total in the microsomes. The ligand dependent autophosphorylation, one of the characteristic features of EGF receptor in the plasma membrane, was not observed at the site of the receptor (170 KDa) in the nuclear fraction. The binding characteristics for EGF fluctuated during the course of liver regeneration after partial hepatectomy; the binding capacity in the nuclear fraction increased in contrast to the decrease in the microsomes. However, the binding sites in the nuclear fraction obtained in the early period after partial hepatectomy consisted only of low affinity ones. PMID- 3265100 TI - Cross-sectional growth study in patients with Turner's syndrome. AB - The body height, weight and growth velocity were investigated in 416 patients with Turner's syndrome whose age ranged from 3 to 17 years. They were all prepubertal at the time of the present study. The chromosomal analysis revealed 45, X monosomy in 148 cases, mosaicism in 208 cases, and nonmosaic structural abnormalities of X chromosome in 60 cases. There were no significant differences in height, growth velocity and weight between the patients with the 45, X karyotype and those with other chromosomal variants at any age. Combined mean heights at 3, 10 and 17 years of age were 86.0 +/- 3.5 (m +/- SD), 116.7 +/- 5.8 and 136.8 +/- 4.8 cm, respectively. These values were below -2.0 SD of normal Japanese girls. The growth velocity was 6.0 +/- 0.5 cm/year at 4 years of age, but decreased gradually and was 1.6 +/- 0.7 cm/year at 17 years of age. The degree of overweight was within +/- 10% of ideal body weight for height between the ages of 3 and 8, 10-20% between the ages of 9 and 10, and 20-30% above the age of 11 years. PMID- 3265101 TI - A comparison of Tc-99m HM-PAO and I-123 IMP cerebral SPECT images in Alzheimer's disease and multi-infarct dementia. AB - SPECT images of the brain can be obtained using either 123I labelled amines or 99mTc-hexamethylpropyleneamineoxime (HM-PAO). Both materials produce images which are blood flow dominated and so appear similar in normal subjects, although the respective mechanisms of uptake are not yet finally established. It seems likely, however, that the different mechanisms of uptake are responsible for recent reports of some differences seen in images obtained with the two types of agent in patients with cerebral pathology, mainly cerebrovascular disease. In this study, 12 demented patients, 6 with dementia of the Alzheimer type (DAT) and 6 with multi infarct dementia (MID), were imaged with 123I-isopropylamphetamine (IMP) and 99mTc-HM-PAO and the images compared. Significantly more lesions were seen with IMP than HM-PAO (P less than 0.02); out of a possible 120 sites, 41 lesions were seen with IMP compared to 28 with HM-PAO, 23 being seen with both agents. However, it is concluded that either agent can be used for the differential diagnosis of dementia, a task for which the new cerebral blood flow agents seem well suited. PMID- 3265102 TI - Gated cardiac tomography. AB - An ECG gated tomographic system is described and its application to routine diagnosis of cardiac wall dyskinesis discussed. The tomographic sections are gathered by a single section scanning system (Aberdeen Section Scanner). Technetium labelled red blood cells are used as the imaging agent. The time of the occurrence of the ECG R-wave is superimposed on the tomographic projection data stream and the gated images produced subsequently. The average patient study requires 15 min. Images at 8 phases of the cardiac cycle are generated at each of 5 levels, 16 mm apart, covering the length of the left ventricle. The images are stored as a three dimensional matrix and may be analysed in sections at any orientation. Fourier analysis of computer generated short axis sections are used to generate a set of coefficients describing the contraction of the left ventricle. The coefficients for each patient study are displayed as a series of two dimensional polar images, schematically displaying the spatial distribution of the coefficient over the left ventricle. These polar images are further analysed by comparison with distributions obtained from normal patient studies. The calculated deviations from the normal are then used to diagnose the magnitude and position of any dyskinesis. Initial results show that the tomographic system is capable of routinely detecting inferior cardiac wall dyskinesis, showing an advantage over non tomographic techniques. PMID- 3265103 TI - Non-stationary spatial filtering and accelerated curve fitting for parametric imaging with dynamic PET. AB - A non-stationary spatial low pass filter was developed and implemented in combination with an accelerated non-linear curve fitting routine to create low noise-high contrast images of physiological parameters with dynamic positron emission tomography. The method was applied to 18F-2-fluoro-2-deoxyglucose (FDG) studies, and images of local blood volume, kinetic rate constants, precursor pool volume and glucose metabolism were generated. Noise reduction and contrast preservation was demonstrated in a simulated pie phantom and a study of a patient with a recent brain infarct. Considerably improvement in quantitative accuracy of pixel parameter values was observed in the phantom study in comparison with unprocessed or conventionally smoothed images. PMID- 3265104 TI - SPECT using Bremsstrahlung to quantify 90Y uptake in Baker's cysts: its application in radiation synovectomy of the knee. AB - The use of SPECT with Bremsstrahlung radiation has been investigated in studies on patients undergoing 90Y therapy for persistent synovitis of the knee. In particular, its value in the estimation of 90Y uptake into Baker's cysts was assessed and, to this end, realistic 'knee phantoms' were employed in order to calibrate for cysts of different size. Problems associated with the measurement of the extensive Bremsstrahlung spectrum and the estimation of cyst volume have been discussed. It is shown that, although the apparent volume of a cyst is markedly dependent on the chosen count rate threshold, volumes greater than about 30 ml can be estimated with reasonable accuracy using a threshold of 50%. The uptake of 90Y in cysts, measured on 3 occasions within the first 2 days in 10 patients, showed wide variation (0%-40%) between patients and was poorly related to the size of cysts on arthrograms and to the clinical response to therapy. In these studies, the ability to analyse SPECT slices provided a distinct advantage over planar imaging for discriminating between 90Y uptake in cysts and adjacent sites. Retention of 90Y in the total knee was also widely variable, with losses of 2%-38% observed 2 days after injection which, in general, were not fully accounted for by uptake in liver or lymph nodes. The changing distribution of 90Y colloid in the knee during the first two days, as observed in some patients, might explain part of the discrepancy. PMID- 3265105 TI - Osteocalcin, parathormone and hypercalciuria. AB - Osteocalcin synthesis is dependent on the influence of the renal vitamin D metabolite, 1,25(OH)2D3. This metabolite is an etiological factor in some hypercalciurias, and osteocalcin may thus be a parameter for discovering them. In turn, parathormone, which stimulates 1,25(OH)2D3 synthesis, is also implicated in the hypercalciurias. Mean molecular parathormone, osteocalcin, 24-hour calciuria and the calcium/creatinine and hydroxyproline/creatinine ratios were determined in urine samples obtained after a 12-hour fast from 18 patients with absorptive hypercalciuria and 11 patients with renal hypercalciuria out of a total of 62 patients with renal lithiasis. No changes were observed in osteocalcin or parathormone, indicating that neither is valid for the diagnosis of hypercalciuria. Significant differences were only found in the Ca/Cr ratio (p less than 0.001), which was higher (0.31 +/- 0.07 vs. 0.13 +/- 0.04 mg/mg) in renal hypercalciuria than in absorptive hypercalciuria. No changes in osteocalcin have been reported in the hypercalciurias, but variations in parathormone have been reported, therefore requiring further study and thought to understand the processes involved. PMID- 3265106 TI - D-1/D-2 behavioural interactions in the rat involving striatal dopamine D-1 receptors. AB - Simultaneous systemic administration of SKF 38393 (1-15 mg/kg i.p.) and LY 171555 (0.625-20 mg/kg s.c.) showed clear evidence of dopamine D-1/D-2 behavioural interactions compared to either treatment given alone. Similar interactions were observed between an intermediate systemic dose of LY 171555 (5 mg/kg) and SKF 38393 (1-10 micrograms) microinjected bilaterally into the caudate-putamen, but not into the substantia nigra pars reticulata, suggesting that striatal dopamine D-1 receptors are the ones responsible for mediating the altered behavioural responses to D-2 agonists in the intact rat. PMID- 3265107 TI - In vivo dopaminergic neurotoxicity of the 2-beta-methylcarbolinium ion, a potential endogenous MPP+ analog. AB - The MPP+-like neurotoxicity of the 2-methyl-beta-carbolinium species, a possible endogenous condensation product structurally related to MPP+, has been assessed by an intracerebral microdialysis technique. Although much less potent, this compound appears to cause the selective and irreversible destruction of nigrostriatal nerve terminals in rat brain in a manner similar to that observed under comparable conditions with MPP+. PMID- 3265108 TI - Peptidyl arginine deiminase and endothelium dependent relaxation. PMID- 3265110 TI - Is epidural spinal cord electrical stimulation indicated in patients with severe lower limb ischaemia? PMID- 3265109 TI - In vitro regeneration of adult rat ganglion cell axons from retinal explants. AB - The potential for regeneration of adult rat ganglion cell (RGC) axons was investigated in vitro. Explants from RITC (rhodamine-B-isothiocyanate) retrogradely labeled and in vivo axotomized retinae were placed on dishes coated with various substrates. The retinal pieces were cultivated in a serum-free medium and incubated under 50 to 80% O2-enriched and 5% CO2-containing atmosphere. Under these conditions, massive outgrowth of fibers was observed as early as 24 h after explantation and over a period of time extending up to 7 days in culture. By various criteria, two main types of processes could be characterized: (1) Short, thick processes emerged from either migrated flat cells or from cells inside the retinal explant, and (2) long and thin processes emerged from cells in the ganglion cell layer (GCL). By immunohistochemistry, the short processes and the cells from which they had emerged, appeared to be glial acidic fibrillary protein (GFAP)-positive Thy 1 and L 1-negative, suggesting their glial nature. The second type of long, thin processes appeared to be GFAP-negative, L1- and Thy 1-positive, indicating that they were neuronal, probably RGC processes. Proof that long fibers emerged from RGCs was provided by retrograde labeling of RGCs with RITC prior to explanation. Numerous RITC-filled RGCs survived in vitro. Regrowing axons retransported part of the accumulated fluorescent dye in the orthograde direction and thus unequivocally permitted their identification as RGC axons. The fact that adult RGC axons can reelongate in vitro might provide a useful bioassay for investigations on the factors that either support or inhibit regrowth of axons from CNS neurons. PMID- 3265111 TI - Androgens and transforming growth factor beta modulate the growth response to epidermal growth factor in human prostatic tumor cells (LNCaP). AB - Treatment of LNCaP human prostatic cancer cells with 0.1 nM of the synthetic androgen, R1881, resulted in a three-fold stimulation of growth in 6 days. Of several growth factors tested (epidermal growth factor (EGF), platelet-derived growth factor, insulin-like growth factor, and insulin) only EGF (1 ng/ml) stimulated cell growth (two-fold). This stimulatory effect of EGF was inhibited for approximately 70% by 0.02 ng transforming growth factor beta (TGF beta)/ml. EGF (1 ng/ml) acted synergistically with R1881 (0.1 nM) on LNCaP cells to induce cell proliferation (seven-fold increase in cell growth). The synergistic effect of androgen and EGF was inhibited by TGF beta (0.05 ng/ml). IN CONCLUSION: human prostatic LNCaP cells are sensitive to EGF. Androgen increases and TGF beta decreases the growth response to EGF. This effect of TGF beta on an androgen responsive system has not been observed before. PMID- 3265112 TI - Plasminogen activator inhibitor type 1: cell-specific and differentiation-induced expression and regulation in human cell lines, as determined by enzyme-linked immunosorbent assay. AB - We have performed a comparative study of the regulation by glucocorticoids and phorbol 12-myristate 13-acetate (PMA) of the production of type 1 plasminogen activator inhibitor (PAI-1) by 12 human cell lines. A sandwich-type enzyme-linked immunosorbent assay (ELISA) for PAI-1 that measures free PAI-1 as well as complexes between PAI-1 and both types of plasminogen activators has been used. Basal PAI-1 accumulation varied more than 5000-fold between the cell lines. No correlation was found between the PAI-1 level and other characteristics of the cell lines, except that three lines of SV40-transformed fibroblasts produced more PAI-1 than two non-transformed fibroblast cell lines. Three out of the 12 cell lines responded to glucocorticoids by an increased PAI-1 production. Four cell lines responded to PMA by an increased PAI-1 production. In addition, PMA-induced differentiation of the monocyte cell line U937 and the promyelocytic cell line HL 60 into macrophage-like cells was found to be correlated with an up to 100-fold increase in PAI-1 accumulation. The PMA-dependent differentiation of HL-60 cells led to acquisition of glucocorticoid inducibility of PAI-1. These findings provide information for future studies of the molecular mechanism of cell specific expression and regulation of PAI-1. PMID- 3265113 TI - Regulation of human chorionic somatomammotropin gene expression in rat pituitary tumour cells. AB - A gene (hCS-1) coding for human chorionic somatomammotropin (hCS) was introduced stably into rat anterior pituitary tumour (GC) cells. These cells were treated with hormones, growth and other factors implicated in hCS production in the placenta. Levels of hCS-1 gene mRNA and hCS release were increased by thyroid hormone, dexamethasone, a cyclic adenosine monophosphate (cAMP) analogue (8-bromo cAMP), and phorbol ester, phorbol-12-myristate-13-acetate (PMA). No significant response to insulin, medium glucose levels, epidermal growth factor or insulin like growth factor II was observed. A hybrid gene containing the 5'-flanking sequences from the intact hCS-1 gene was also stably introduced into GC cells. These cells were tested to determine the contribution made by 5'-flanking DNA on the responses observed with the intact gene. Although expression of this hybrid gene was stimulated by thyroid hormone, no response to 8-bromo-cAMP or PMA was observed. These data suggest that sequences downstream of the transcription initiation site might play an important role in hCS gene expression and regulation. PMID- 3265114 TI - [Individual variability of vestibular sensitivity based on subjective perception and long-latent vestibular evoked potentials]. PMID- 3265115 TI - [Increased reactivity of microcirculation and T lymphocytes to adrenaline in sailors during long sea voyages]. PMID- 3265116 TI - [First-pass angiocardioscintigraphy in the evaluation of ischemic cardiopathy]. PMID- 3265118 TI - [Is the prevention of first digestive hemorrhage justified in cirrhotic patients?]. PMID- 3265117 TI - [Semiology of gastroduodenal ulcer proved by endoscopy: epidemiological analysis of 1,800 cases]. AB - The aim of this study was to describe the clinical and endoscopic signs, the nutritional status, the consumption of alcohol and tobacco, and other associated factors in a population of 1,800 patients with endoscopically proven gastric (n = 501) or duodenal ulcer (n = 1235) and then to identify the risk factors in comparison to the French population. Patients with gastric ulcer were older, more often widowed if male, otherwise more often female, were more frequently treated by non-steroid drugs, and had a lipid-rich nutrition more often in comparison to patients with duodenal ulcers. Patients with duodenal ulcer were more often native from the Magreb and their nutrition was more often rich in spices in comparison to patients with gastric ulcer. The associations between use of non steroidal drugs and consumption of spices disappeared after adjustment by multidimensional analysis. Patients with duodenal ulcer lived more frequently in the Ile de France area in comparison to patients with gastric ulcer. Patients with gastric ulcer worked more often as farmers in comparison to patients with duodenal ulcer and in comparison to the total French population. These differences remained after adjustment. The consumption of tobacco was higher in patients with gastric or duodenal ulcer in comparison to the mean consumption of the total French population. PMID- 3265119 TI - [Portal hypertension and hemorrhoids. Cause effect relationship?]. AB - The aim of this study was to compare the prevalence and the size of hemorrhoids with the degree of portal hypertension; 101 patients with intrahepatic portal hypertension documented by measuring wedged and free hepatic venous pressures before performing transjugular liver biopsy and 67 patients free of liver disease were investigated by proctoscopy. Portal hypertension was associated with a higher prevalence of hemorrhoids (93 p. 100 vs 76 p. 100); there was no relation between portal pressure and the size of haemorrhoids; no relation was found between the size of hemorrhoids and the grade of esophageal varices. PMID- 3265120 TI - [The content of lymphopoietic differentiation antigens on the membrane of blood lymphoid cells in patients with bone marrow hypoplasia studied using monoclonal antibodies]. PMID- 3265121 TI - [Prospects for the use of antiglobulin reagents in isoserology practice]. PMID- 3265122 TI - Degradation of adenosine by extracellular adenosine deaminase in the rat duodenum. AB - 1. Extracellular degradation of adenosine by adenosine deaminase was studied in the rat duodenum using high performance liquid chromatography (HPLC) and pharmacological techniques. 2. Relaxant responses to adenosine (1-10 microM) were potentiated in a concentration-dependent manner by erythro-9-(2-hydroxy-3 nonyl)adenine (EHNA) and deoxycoformycin, both of which are inhibitors of adenosine deaminase. 3. Breakdown of adenosine, determined by HPLC, due to incubation with segments of rat duodenum was inhibited by both EHNA and deoxycoformycin. Cytosolic sources of adenosine deaminase were excluded. 4. Relaxant responses to adenosine were also potentiated by the adenosine transport inhibitor dilazep, which did not inhibit adenosine deaminase activity. 5. The extracellular adenosine deaminase activity (4 units/g tissue) was high compared with activity previously determined in other organs. PMID- 3265123 TI - Periapical radiolucency. PMID- 3265124 TI - The B-cell-specific Oct-2 protein contains POU box- and homeo box-type domains. AB - Transcription of promoters of immunoglobulin genes is controlled by an octanucleotide sequence element. The sequence of a cDNA encoding a B-cell specific protein, Oct-2, has been determined. This protein specifically recognizes the octanucleotide element and is part of the previously identified NF A2 family of proteins. The DNA-binding domain of Oct-2 is structurally related to the homeo box consensus and thus contains a potential helix-turn-helix sequence. Oct-2 also possesses a potential 'leucine zipper' domain, where four leucines are each separated by exactly seven residues. Comparisons of Oct-2 with protein Oct 1, which also recognizes the octanucleotide element but is constitutively expressed in all cell types, show high sequence conservation through the 60 residue DNA-binding domain, as well as an adjacent tract of 75 residues. The latter conserved region is also found in regulatory genes expressed in pituitary cells and nematodes and has been termed a POU box. Because two different cDNAs were isolated, it is proposed that the oct-2 gene is expressed as multiple mRNAs that vary in splicing patterns. Most interestingly, the oct-2 cDNA contains a second overlapping open reading frame, 278 residues in length, which might also specify a protein important for B-cell development. PMID- 3265125 TI - Quantitative characteristics of immune proteins in mid-cycle cervical mucus of women with cervical erosion. PMID- 3265126 TI - Prevalence of delta antibodies among urban HBsAg-positive chronic liver disease patients in Egypt. AB - The prevalence of delta infection among urban Egyptians is reported for the first time. Sera of 44 HBsAg-positive chronic liver disease (CLD) patients and 48 asymptomatic HBsAg carriers were screened for antibodies to hepatitis delta antigen (anti-HD). Anti-HD was found in 21 (47.7%) of the patients compared with 4 (8.3%) of the asymptomatic carriers. The difference was statistically significant at the 0.001 level. Anti-HD was present in 14 out of 24 (58.3%) subjects with histological diagnosis of chronic active hepatitis, 4 of 9 (44.9%) with cirrhosis, and 3 out of 11 (27.2%) with chronic persistent hepatitis. This study points to a high prevalence of hepatitis delta virus in Egypt. PMID- 3265127 TI - Emergency treatment of the complications of giant liver hemangiomas. AB - The authors discuss the problems of emergency treatment of cavernous hemangiomas of the liver. Five cases were observed and treated with different techniques, ligation of the hepatic artery, excision of the mass, embolization of the hepatic artery. The results of these procedures were strongly influenced by the patient's previous state. Treatment was successful in three patients, while the procedure adopted was able to stop the hemorrage in the other two patients. The physical state was very important for the prognosis; the two patients arriving at our Institute in deep shock both died. PMID- 3265128 TI - The use of the rat hepatoma cell line MH1C1 to investigate the stimulus-secretion response of hepatic acute phase proteins. AB - The rat hepatoma cell line MH1C1 has been characterized to show a stimulated secretion of C-reactive protein in response to both leukocyte supernatant and a purified human interleukin-1 preparation. The time-dependency and dose-response relationship of CRP secretion were comparable to and somewhat more sensitive than the effects of leukocyte supernatant and purified human interleukin-1 on the proliferative rate of murine thymocytes; the proliferative rate of the hepatoma cell line MH1C1 was unchanged under these conditions. Agents which affect the thymocyte bioassay response to interleukin-1 namely interleukin-2, lipopolysaccharide, concanavalin A and phytohemagglutinin showed no effect on the C-reactive protein release of the MH1C1 cell line. These data strongly support the suitability of this cell line for the in vitro study of the hepatic acute phase stimulus-secretion response. PMID- 3265129 TI - Stressful events. PMID- 3265130 TI - In vitro activity of second and third generation cephalosporins against ampicillin susceptible and resistant haemophilus influenzae. AB - One hundred seventy-five clinical isolates of Haemophilus influenzae (including 74 beta-lactamase-producing strains) were examined for susceptibility to ampicillin, cefonicid, cefamandole, cefuroxime and cefotaxime. Cefonicid and cefamandole exhibited similar activity against ampicillin-susceptible strains (MIC90 = 0.2 mg/l for both antibiotics); cefuroxime was slightly less active (MIC90 = 0.01 mg/l). However, cefonicid, cefuroxime and cefotaxime were all more active against beta-lactamase-producing H. influenzae than cefamandole (MIC90 = 1.0 mg/l for cefonicid, MIC90 = 2.0 mg/l for cefuroxime, MIC90 = 0.01 mg/l for cefotaxime, MIC90 = 5.0 mg/l for cefamandole). One hundred twenty-five of the 175 isolates were also tested for susceptibility to cefonicid and cefamandole by disc diffusion technique and a plot of zone diameter vs. MIC was analyzed for the beta lactamase-producing strains. PMID- 3265131 TI - Biochemical events associated with inhibition of B-cell proliferation by phorbol diesters. AB - Phorbol myristate acelate (PMA), a potent tumor promoter, has a variety of effects on cells of the immune system resulting in altered patterns of cell proliferation and differentiation. Although PMA is mitogenic or co-mitogenic for human lymphocytes and murine T-cells, it inhibits proliferation of murine B-cells stimulated by LPS or anti-Ig. PMA, however, does not inhibit the ability of LPS or anti-Ig to activate B-cells, as evidenced by increased Ia antigen expression and RNA synthesis. In the present studies it was shown that inhibition of DNA synthesis by PMA coincided with qualitative and quantitative changes in phosphorylated proteins. In particular, PMA treatment resulted in a unique profile of phosphoproteins independent of LPS or anti-Ig treatment. Inhibition of DNA synthesis occurred over a wide range of PMA concentrations. At concentrations up to 10(-9) M, inhibition of proliferation correlated with decreased phosphatidylinositol turnover and decreased intracellular Ca2+ levels, suggesting that PMA affects the phosphoinositide signal transduction pathway. However, at PMA concentrations less than 10(-10) M, inhibition of anti-Ig- and LPS-mediated proliferation occurred without inhibition of the phosphoinositide transduction signal. At these concentrations, PMA-induced inhibition of DNA synthesis was highly sensitive to recombinant IL-2. These data suggest that the antiproliferative effects of PMA on B-cells stimulated by LPS or anti-Ig may be mediated by two mechanisms. At high concentrations, PMA causes a feedback regulation of the phosphoinositide-dependent messenger system, while at lower concentrations, PMA alters the response to specific growth factors. Since PMA induces unique phosphoproteins and both of these events can be regulated by protein phosphorylation, it is possible that these unique phosphoproteins are responsible for the antiproliferative effects of PMA. PMID- 3265133 TI - [Autologous blood collection in heart surgery. Quantitative and qualitative assessment of centrifuged autologous blood from heart-lung machines]. PMID- 3265132 TI - Patulin immunotoxicology: effect on phagocyte activation and the cellular and humoral immune system of mice and rabbits. AB - Patulin is a mycotoxin frequently found in rotten apples or molded corn. We have investigated the effect of sublethal doses of patulin on the immune system in mice and rabbits. A significant suppression of the chemiluminescence response of peritoneal leucocytes was observed in both species. Mouse spleen lymphocytes showed a decrease in absolute number, most pronounced for the B-cell population whereas the Ts population showed a relative increase after patulin treatment. The mitogenic response to PHA, Con A and, in particular, PWM was also depressed by patulin. This was paralleled by decreasing serum immunoglobulin levels in the mice and rabbits. The immunosuppressive effect of patulin is reversible and is probably due to interaction with cellular free SH groups since the action of patulin can be circumvented, at least partially, by the prior administration of cystein. Under natural circumstances, patulin may constitute a health risk for animals. PMID- 3265134 TI - [Myocardial revascularization in the patient over 70 years of age. Surgical risks and results]. PMID- 3265135 TI - Human monocyte/macrophage activation and interleukin 1 generation by biomedical polymers. AB - In vitro cell culture techniques were used to evaluate the effect of several clinically significant biomedical polymers on monocyte activation and Interleukin 1 (IL1) production. Isolated human peripheral blood monocytes were cultured in the presence of a panel of five biomedical polymers routinely used in a variety of clinical applications: Polyethylene (PE), silica-free poly-dimethylsiloxane (PDMS), woven Dacron fabric, expanded polytetrafluoroethylene (ePTFE) and the segmented polyurethane, Biomer. Monocytes generated IL1 in the presence of all five materials. Maximal levels of IL1 were generated at 24 h in monocyte-polymer cultures supplemented with serum and additionally stimulated with lipopolysaccharide (LPS). No difference was observed due to serum source. Results from cultures supplemented with fetal bovine serum were not significantly different from those obtained with human serum supplemented cultures. The thymocyte proliferative activity generated by monocytes in the presence of these biomedical polymers was neutralized by a specific polyclonal anti-IL1 antiserum. Statistically significant differences in IL1 production were observed between polymers, allowing their classification according to reactivity into high (Dacron, PE), intermediate (ePTFE) and low (Biomer, PDMS) reactive groups. PMID- 3265136 TI - First report of a Canadian epidemiological study of autistic syndromes. AB - This report describes an epidemiological investigation of the autistic syndrome using new research diagnostic criteria (Denckla, 1986). The focus here is on the methods of screening and follow-up, and on a description of the cases identified within a circumscribed region of Nova Scotia. Autism, as defined by social deviance, language impairment and repetitive or ritualistic behaviours, has a prevalence of 10 per 10,000 and a male to female ratio of 2.5:1. These findings are discussed relative to those reported previously. PMID- 3265138 TI - Temperamental factors associated with rapid weight gain and obesity in middle childhood. AB - Studies of the perplexing problem of childhood obesity have considered etiological factors in the child and environment, but have largely ignored the child's temperament or style of interaction with the environment. In this report, a significant relationship is demonstrated between temperament and both rapid weight gain and actual obesity in middle childhood. In a longitudinal study of 138 children, weight-for-height percentile gains between 4 to 5 years and 8 to 9 years were significantly correlated with eight of nine difficult temperament characteristics and with a cumulative "index of difficulty." A separate cross sectional study of 21 obese (greater than or equal to the 95th percentile weight for height) 6- to 12-year-old children found them to be significantly less rhythmical/predictable and lower in persistence/attention span than matched controls. These normal behavioral style characteristics, interacting with metabolic, dietary, and environmental factors, may predispose some children to inappropriate eating habits or make it harder to maintain a dietary plan to remedy the problem. PMID- 3265137 TI - Determination of mefloquine by electron-capture gas chromatography after phosgene derivatization in biological samples and in capillary blood collected on filter paper. AB - Mefloquine is determined in 100-microliter samples of whole blood, plasma and capillary blood collected on filter paper by gas chromatography with electron capture detection after derivatization with phosgene. Sample preparation for whole blood and plasma involves a protein precipitation step that uses a combination of zinc and acetonitrile, followed by simultaneous extraction with methylene chloride and derivatization with phosgene at pH 9.50. Filter paper spots are immersed for 12-24 h in 0.1 M hydrochloric acid, followed by simultaneous extraction with methyl tert.-butyl ether and derivatization. After evaporation of the organic phase and reconstitution with ethyl acetate, 1 microliter of the extract is injected into a megabore capillary column. Because of the high sensitivity of the method, mefloquine concentrations down to 25 nmol/l (9.5 micrograms/l) are determined in 100-microliters samples with a relative standard deviation of 12% at the 25 nmol/l level. Excellent precision was obtained over the range of concentrations tested, 0.10-3 mumol/l (45-1100 micrograms/l), in both plasma and whole blood and from filter-paper-collected capillary blood. The day-to-day relative standard deviation in plasma at the therapeutic level (1-3 mumol/l) was 4.5% (n = 8). PMID- 3265139 TI - Control of tectal cell number during larval development in Rana pipiens. AB - Cell production and cell deaths were determined in larval Rana pipiens both in control tecta and in tecta following unilateral eyeball removal in embryos and larvae. Such enucleations produce significantly reduced rates of cell division in the contralateral tecta for virtually the entire larval period (confirming studies with enucleation almost exclusively performed in embryos--Kollros: J. Exp. Zool. 123:153-187, '53, and J. Comp. Neurol. 205:171-178, '82). Significant numbers of cell deaths in all nonependymal tectal cell layers were also observed. Control cell division rates peak at stage X, while cell death peaks are reached in stages XIII-XX. Overall, about 10(6) nonependymal cells are produced in control tecta, and about 350,000 of them die by the end of metamorphosis. Control of cell numbers following enucleation is shown to depend mainly on reductions in cell division rates when the operation occurs early in development and mainly on increases in cell death rates when the operation occurs late in larval life. Such increases in death rates are invariably present within 1 day of the operation whereas the reduced division rates ordinarily require several more days to be seen. The modified rates, both of cell divisions and cell death, are limited to tectal areas to which optic nerve fibers have already extended. Maps of the positions of tectal cell divisions in many larval stages provide the basis for modifying the current dogma that tectal formation occurs as a series of newly formed mediocaudal wedges pushing previously produced wedges rostrolaterad. All such "old" wedges receive substantial cell additions for many stages, with the rate of addition decreasing rostrad earlier than caudad. PMID- 3265140 TI - Induction of premature delivery in sheep following infusion of cortisol to the fetus: the effect of maternal progestagen treatment on the C21-steroid-17 alpha hydroxylase, C-17,20 lyase and aromatase pathways. AB - Infusion of cortisol to the fetus of late pregnant sheep caused an increase in maternal and fetal plasma oestrone and oestrone sulphate concentration and subsequent delivery of the fetus. Administration of progesterone or medroxyprogesterone acetate to late pregnant sheep inhibited the induction of labour. The changes in maternal and fetal plasma concentrations of pregnenolone, 17 alpha-hydroxypregnenolone, dehydro-epiandrosterone and their respective sulphates were not significantly altered by the administration of progestagens during induction of delivery. Placental delta 5-3 beta-hydroxysteroid dehydrogenase was not, therefore, significantly inhibited by progestagen administration. Furthermore induction of 17 alpha-hydroxylase and C17-20 lyase by cortisol was not suppressed. Similarly, since the changes in maternal and fetal oestrone and oestrone sulphate concentrations were not affected by treatment of the ewe with either progesterone or medroxyprogesterone acetate, the increase in the activity of aromatase, observed during induced parturition, was not inhibited, not did the exogenous progesterone provide any further substrate for placental oestrogen production. Progestagen treatment is, however, able to inhibit delivery when administered in sufficient quantities to overcome the stimulatory effect of the oestrogens produced by the placenta from endogenous precursors. PMID- 3265141 TI - [Interleukin 2 (IL-2) production in patients with mixed connective tissue disease (MCTD) and its relevance to the diagnosis and clinical features]. PMID- 3265142 TI - The five horsemen of rheumatology. PMID- 3265143 TI - Cesarean childbirth rate among women in the New Orleans area. PMID- 3265144 TI - Intracellular pH controls cell membrane Na+ and K+ conductances and transport in frog skin epithelium. AB - We determined the effects of intracellular respiratory and metabolic acid or alkali loads, at constant or variable external pH, on the apical membrane Na+ specific conductance (ga) and basolateral membrane conductance (gb), principally due to K+, in the short-circuited isolated frog skin epithelium. Conductances were determined from the current-voltage relations of the amiloride-inhibitable cellular current pathway, and intracellular pH (pHi) was measured using double barreled H+-sensitive microelectrodes. The experimental set up permitted simultaneous recording of conductances and pHi from the same epithelial cell. We found that due to the asymmetric permeability properties of apical and basolateral cell membranes to HCO3- and NH+4, the direction of the variations in pHi was dependent on the side of addition of the acid or alkali load. Specifically, changing from control Ringer, gassed in air without HCO3- (pHo = 7.4), to one containing 25 mmol/liter HCO3- that was gassed in 5% CO2 (pHo = 7.4) on the apical side caused a rapid intracellular acidification whereas when this maneuver was performed from the basolateral side of the epithelium a slight intracellular alkalinization was produced. The addition of 15 mmol/liter NH4Cl to control Ringer on the apical side caused an immediate intracellular alkalinization that lasted up to 30 min; subsequent removal of NH4Cl resulted in a reversible fall in pHi, whereas basolateral addition of NH4Cl produced a prolonged intracellular acidosis. Using these maneouvres to change pHi we found that the transepithelial Na+ transport rate (Isc), and ga, and gb were increased by an intracellular alkalinization and decreased by an acid shift in pHi. These variations in Isc, ga, and gb with changing pHi occurred simultaneously, instantaneously, and in parallel even upon small perturbations of pHi (range, 7.1 7.4). Taken together these results indicate that pHi may act as an intrinsic regulator of epithelial ion transport. PMID- 3265145 TI - Role of Na+/H+ exchange in the control of intracellular pH and cell membrane conductances in frog skin epithelium. AB - Ion-sensitive microelectrodes and current-voltage analysis were used to study intracellular pH (pHi) regulation and its effects on ionic conductances in the isolated epithelium of frog skin. We show that pHi recovery after an acid load is dependent on the operation of an amiloride-sensitive Na+/H+ exchanger localized at the basolateral cell membranes. The antiporter is not quiescent at physiological pHi (7.1-7.4) and, thus, contributes to the maintenance of steady state pHi. Moreover, intracellular sodium ion activity is also controlled in part by Na+ uptake via the exchanger. Intracellular acidification decreased transepithelial Na+ transport rate, apical Na+ permeability (PNa) and Na+ and K+ conductances. The recovery of these transport parameters after the removal of the acid load was found to be dependent on pHi regulation via Na+/H+ exchange. Conversely, variations in Na+ transport were accompanied by changes in pHi. Inhibition of Na+/K+ ATPase by ouabain produced covariant decreases in pHi and PNa, whereas increases in Na+ transport, occurring spontaneously or after aldosterone treatment, were highly correlated with intracellular alkalinization. We conclude that cytoplasmic H+ activity is regulated by a basolateral Na+/H+ exchanger and that transcellular coupling of ion flows at opposing cell membranes can be modulated by the pHi-regulating mechanism. PMID- 3265146 TI - Antigen-tuftsin conjugate signals interleukin-1 synthesis and secretion. AB - The immunoglobulin heavy chain derived tetrapeptide, tuftsin (Thr-Lys-Pro-Arg), known for its phagocytosis-stimulating activity, was found to augment the antigen presenting capacity of macrophages in culture, when applied simultaneously with antigen. Injection of antigens or antigens admixed with tuftsin had no immunogenic effect in vivo. On the other hand, antigen-tuftsin covalent conjugates, injected in aqueous solution intramuscularly or intravenously, significantly augmented antibody production. Studying the mechanism underlying these immunogenic effects, we demonstrate that tuftsin, when applied to macrophages together with, or conjugated to, antigens, signals de novo synthesis of mRNA encoding for interleukin-1 (IL-1), and induces secretion of IL-1 from the cells. We suggest that triggering the immunogenic processes by tuftsin conjugates is a consequence of up-regulation of IL-1 synthesis and secretion. PMID- 3265147 TI - In vitro cytotoxicity of recombinant ricin A chain-antitransferrin receptor immunotoxin against human adenocarcinomas of the colon and pancreas. AB - The sensitivity of three human colon adenocarcinoma cell lines (LoVo, LS174T, and SW1116) and a human pancreatic adenocarcinoma cell line (Hs766T) to a recombinant ricin A chain-antitransferrin receptor immunotoxin was studied. In addition, the carboxylic ionophore monensin was used in conjunction with the immunotoxin to determine the possibility of increased cytotoxicity without loss of specificity. The immunotoxin, 454A12-rRTA, is composed of the monoclonal antibody 454A12 directed against transferrin receptor and of ricin A chain, which was produced by recombinant DNA techniques. In 18 h dose-response cytotoxicity assays, the median inhibitory dose (ID50) against LoVo, LS174T, and SW1116 was found to be 3 X 10( 10), 3.6 X 10(-11), and 3.6 X 10(-10) M, respectively; in the same assay, the ID50 for Hs766T was found to be 4 X 10(-10) M. In the presence of monensin, the ID50 for the adenocarcinoma cell lines was reduced 9-fold, 28-fold, and 5-fold, respectively. In cytotoxic kinetic assays, 50% of control protein inhibition was reached in immunotoxin-treated LS174T cells 12-fold faster in the presence of monensin than in its absence. Immunotoxin-treated LoVo cells reached 50% inhibition of control protein synthesis fivefold faster in the presence of monensin than in its absence. Furthermore, no toxicity of immunotoxin or potentiation by monensin was observed in either a control cell line (Swiss albino mouse 3T6) treated with specific immunotoxin or with a control immunotoxin assay. These results show the in vitro specificity and selectivity of 454A12-rRTA immunotoxin for human gastrointestinal and pancreatic cancer cell lines. PMID- 3265148 TI - Preclinical trials using an immunoconjugate of T101 and methotrexate in an athymic mouse/human T-cell tumor model. AB - We made an immunoconjugate (IC) using the anti-CD5 monoclonal antibody T101 and the chemotherapeutic drug methotrexate. Methotrexate was conjugated to T101 using an active ester intermediate, yielding a drug: antibody molar ratio of 12.4. Although T101 immunoreactivity was not significantly altered by conjugation, the IC did not demonstrate antigen-specific cytotoxicity in vitro. Methotrexate activity, assayed in vitro, decreased approximately 100-fold following conjugation. The IC was tested for in vivo efficacy in athymic mice bearing human T-cell (MOLT 4) xenografts. Experimental arms used in the study included i.p. injections of saline, T101, methotrexate, the IC, and a mixture of T101 and methotrexate. Doses ranged from 500 micrograms T101 (17.5 micrograms methotrexate) to 2 mg T101 (70 micrograms methotrexate). Injections were administered only after palpable tumors were established. In experiments at all doses, totaling 66 animals per arm, injection of the IC significantly inhibited tumor growth, and resulted in more tumor regressions and fewer animal deaths than the other four experimental arms. These data demonstrate that the IC promotes a potential advantage over the use of methotrexate through an increase in the therapeutic index. PMID- 3265149 TI - Tumoricidal activity of lymphotoxin (tumor necrosis factor beta) in vivo: its effects on macrophages. AB - We investigated the cytotoxic activity of recombinant human lymphotoxin (rHuLT) against Meth A sarcoma in vitro and in vivo. In direct cytotoxic assay, Meth A cells showed very low, if any, sensitivity to rHuLT. However, rHuLT was found to be strongly cytotoxic for subcutaneously implanted Meth A cells. In order to explain this discrepancy, we examined the indirect effects of rHuLT on Meth A cells particularly through macrophages. rHuLT showed macrophage chemotactic activity in vitro and also in vivo. Thus, injection of rHuLT into the mouse peritoneal cavity caused migration of macrophages to the peritoneal cavity. In addition, histologic analysis revealed that 6 h after intratumor injection of rHuLT, nonspecific esterase-positive cells started to migrate into Meth A tumor tissues, and after a further 24 h, a larger number of nonspecific esterase positive cells had migrated into the Meth A tumor tissues. Moreover, peritoneal exudate cells induced by rHuLT showed considerably higher cytotoxic activity against Meth A cells than proteose peptone- or phosphate-buffered saline-induced peritoneal exudate cells. Furthermore, the cytotoxic activity of peritoneal exudate cells was found to reside in macrophages. Investigation of the mechanism of macrophage activation by rHuLT revealed that rHuLT can activate macrophages for cytotoxicity synergistically with mouse interferon-gamma. These results strongly suggest that rHuLT, when injected into the tumor, can induce the migration of macrophages into the tumor and activate macrophages in situ to kill tumor cells. PMID- 3265150 TI - Analgesic action of amfenac Na, a non-steroidal anti-inflammatory agent. AB - Amfenac Na is a new non-steroidal analgesic anti-inflammatory drug which is clinically used for ailments such as rheumatoid arthritis and pain and/or inflamation after surgery. In this paper, amfenac Na is studied on the bradykinin induced-flexor reflex and the simultaneous recording of the cortical somatosensory-evoked response (SER) and the electromyogram of digastric muscle (d EMG) evoked by a tooth pulp stimulation. Amfenac Na at doses of 0.1-1 mg/kg p.o. suppressed hindlimb flexor reflexes induced by bradykinin infusion in the rat. This effect was the most potent among the drugs used; the order of potency was as follows: amfenac Na greater than floctafenine greater than loxoprofen much greater than piroxicam = emorfazone greater than mefanamic acid. Similarly, the intravenous injection of amfenac Na completely suppressed the flexor reflex with a dose as low as 0.1 mg/kg; the potency was almost equal to that of morphine. On the SER and d-EMG evoked by tooth pulp stimulation, a high dose (100 mg/kg i.v.) of amfenac Na showed very weak inhibition, whereas morphine (10 mg/kg i.v.) suppressed those responses. These data suggest that amfenac Na showed a very potent analgesic effect comparable to morphine, and that the site of action is mainly the periphery. PMID- 3265151 TI - Kaposi's sarcoma involving the lung in patients with the acquired immunodeficiency syndrome. AB - To determine the distinguishing features of pulmonary Kaposi's sarcoma (KS) in patients with the acquired immunodeficiency syndrome (AIDS), we compared three groups of patients, 16 with endobronchial KS, 15 with endobronchial KS and an opportunistic lung infection, and 40 with Pneumocystis carinii pneumonia (PCP) without concomitant pulmonary KS. The majority of pulmonary KS patients had extensive cutaneous disease at the time of pulmonary diagnosis, and the diagnosis of pulmonary KS was easily established by the characteristic appearance of the endobronchial lesions. Dyspnea, fever, and cough were common presenting symptoms, but occurred more commonly in association with accompanying opportunistic infection. Diffuse interstitial infiltrates were observed in most patients in both groups, but the findings of nodular parenchymal densities or pleural effusion were more commonly observed in patients with pulmonary KS than in those with PCP alone. Pulmonary uptake of gallium-67 citrate or a diffusing capacity less than 80% were unusual in patients with pulmonary KS alone, but common in those with accompanying opportunistic infection or with PCP alone. Median survival in patients with pulmonary KS was only 2 months, and most patients had complicating opportunistic infections at the time of death. Pulmonary KS is generally a late and often preterminal manifestation of AIDS. Chest radiographs, gallium lung scans, and pulmonary function testing may provide diagnostic information that is helpful in distinguishing pulmonary KS from opportunistic lung infections. PMID- 3265152 TI - HIV-1 infection abolishes CD4 biosynthesis but not CD4 mRNA. AB - In order to improve understanding of how HIV-1 infection down-modulates cell surface membrane expression of CD4, we have measured several parameters of CD4 expression in the human tumor T-cell lines CEM and MOLT-4 at different times after infection. Three independent HIV-1 isolates were used including one that encodes a truncated nef protein and another that appeared to be noncytolytic against CEM. The level of CD4 mRNA, the rate of biosynthesis of CD4 protein, and the percentage of CD4-positive cells were measured. With each viral isolate it was found that infection led to a specific and almost complete inhibition of CD4 protein biosynthesis. This substantially exceeded, at every time point after infection, a concomitant reduction in CD4 mRNA. Hence an inhibition of translation probably accounts for much of the decline in the rate of CD4 biosynthesis. This implicates a novel selective translational inhibition of host gene expression by HIV-1 as a factor in the disappearance of surface membrane CD4 from infected cultures. PMID- 3265153 TI - Prospects for HIV vaccines. AB - This article initially discusses the types of responses elicited by infectious agents, such as viruses and the role of each response in preventing, limiting, and clearing the infection. An important response is the generation of immunological memory, in both the B and T cell compartments. Generally, attenuated viral vaccines have been highly successful at inducing long-lived immunity but our understanding of the reasons for this comes from the study of model systems, such as murine influenza virus infections. Specific antibody may largely prevent infection and specific cytotoxic T cells and antibody-dependent cell cytotoxic reactions are the main mechanisms for clearing viral infections. Recent evidence shows that for some months after infection by HIV, a strong cytotoxic T (Tc) cell response occurs in infected, asymptomatic individuals; these cells are continuously generated by HIV-infected stimulator cells that most likely also serve as target cells in vivo. A low level of specific antibody is also formed and a number of reasons are listed to explain why HIV escapes antibody-mediated neutralization and infects cells expressing CD4 receptors. Cells of the macrophage/monocyte lineage are also infected and these express Fc and complement receptors; there is the strong possibility that infection of these cells occurred following the formation of complexes of infectious HIV with antibody to the surface antigen and attachment of complement components. The continuous presence of activated Tc cells that, in contrast to many other viral diseases, does not clear the infection strongly suggests that foci of infected cells sequestered from or resistant to immune control become established. These secrete virus that infects other (stimulator) cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265154 TI - Cell lines that express stably env gene products from three strains of HIV-1. AB - The products of the env gene of HIV-1 play critical roles in determining the host range of the virus and it cytopathicity, as well as forming an important focus of an infected individual's immune response to the virus. We describe the isolation and characterization of separate HeLa cell lines expressing the env gene products of three highly divergent strains of HIV-1. PMID- 3265155 TI - Improved HIV antiglycoprotein antibody detection by immunoblotting on a hydrophobic membrane. AB - Immobilon-P Transfer Membrane (IM), a hydrophobic membrane, has been tested as a substrate for immunoblotting (Western blotting) in a routine serological assay for human immunodeficiency virus (HIV). Comparison of IM to nitrocellulose (NC) has shown the following advantages: (a) better retention of total HIV antigens, (b) improved detection of antibodies to glycosylated envelope antigens, and (c) ease of membrane handling. As a direct result of these improvements, less HIV antigen is required for detection of HIV antibodies in immunoblotting using the IM. Additionally, in some cases, HIV infection can be confirmed earlier due to enhanced detectability of the envelope antigens. Sera from 444 subjects including 4 seroconversions and 4 AIDS patients were investigated. PMID- 3265156 TI - The possible role of corticosteroid therapy for pneumocystis pneumonia in the acquired immune deficiency syndrome (AIDS). AB - Twenty-one episodes of Pneumocystis carinii pneumonia (PCP) and the acquired immune deficiency syndrome (AIDS) were treated with corticosteroids in the form of intravenous methylprednisolone or oral prednisone. A standard dose of 80 mg/day x 5 days was given for 15 episodes, whereas 6 patients received variable doses of 20-120 mg/day x 4-20 days. All were treated with trimethoprim sulfamethoxazole (TMP-SMX). Comparison was made with 12 AIDS patients with PCP who were not treated with steroids. The steroid group was more severely ill than the controls as measured by alveolar-arterial oxygen difference but were otherwise comparable. Mortality from the pneumonia in the steroid group was 2/21 (10%) vs. 3/12 (25%) in the control group. Significant differences were seen in the following parameters: time to defervescence (1 day vs. greater than 9.3 days), the proportion of patients with pO2 greater than 70 mm Hg at day 5 [12/21 (57%) vs. 1/12 (9%)] and at day 10 [19/21 (90%) vs. 7/12 (58%)], and number of adverse drug reactions [4/21 (19%) vs. 9/12 (75%)]. There were fewer late relapses [1/19 (5%) vs. 2/9 (22%)] after a 5.5 month (mean) follow-up. All patients had improvements in their clinical status when initially given corticosteroid therapy but early relapses occurred when steroids were discontinued in five patients (24%). No other complications could be attributed to steroid therapy in this study. A brief course of high-dose corticosteroids appears to be beneficial in severely ill AIDS patients with pneumocystis pneumonia. This suggests the need for randomized, double-blind, placebo controlled trials to confirm these findings. PMID- 3265157 TI - Diagnosis and patterns of incidence of influenza, influenza-like illness and the common cold in general practice. AB - The incidence of influenza, influenza-like illness and the common cold during the influenza epidemics of 1972 and 1976 as reported to the weekly returns service of the Royal College of General Practitioners was examined by three regional areas and by age group. The results of a postal questionnaire concerned with diagnostic criteria used by participating doctors were also analysed. These two analyses were used to explore the validity of these diagnostic terms as reported in the weekly returns service.The two influenza epidemics peaked at about the same time throughout the country and in all age groups simultaneously, although the severity of the epidemic seemed to wane from south to north in 1976. The reported incidence of influenza-like illness and of the common cold was less in the central region than in the north and south during both the two epidemic years. Influenza incidence was maximal in age groups 15-44 and 45-64 years, whereas the reported incidence of influenza-like illness and the common cold was maximal in pre-school children.Additionally, influenza-like illness and the common cold appeared to a fairly uniform extent every winter whereas influenza was truly epidemic.From the questionnaire to general practitioners, the symptoms of rigors, malaise and myalgia and the recognition of an epidemic were the important criteria which differentiated influenza from influenza-like illness.We conclude that in general practice the distinction between influenza and influenza-like illness is reliably made and has validity in the clinical context and meaning of these diagnostic terms. PMID- 3265158 TI - A method for quick-freezing live muscles at known instants during contraction with simultaneous recording of mechanical tension. AB - We have developed a quick-freezing method, using a copper block cooled with liquid helium or nitrogen, which permits us to freeze muscles without any cryoprotectant at predetermined, precisely measured points in the recorded tension time-course of a single twitch or tetanus. Our aim is to arrest structural intermediates of the cross-bridge cycle for observation in the electron microscope. Chemically stimulated, demembranated muscles as well as electrically stimulated, live muscles can be frozen on the same apparatus. Good freezing of relaxed and contracting muscles has been obtained to a depth of 10-20 microns, with excellent structural preservation after freeze-substitution. PMID- 3265159 TI - Basic fibroblast growth factor and epidermal growth factor exert differential trophic effects on CNS neurons. AB - Epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) are potent mitogenic proteins capable of inducing cell division in a wide variety of cell types. In addition to their mitogenic properties, both proteins have recently been shown to enhance survival and process outgrowth from neurons of central nervous system origin. The full spectrum of neuronal subtypes responding to these factors has not been elucidated. In the present study, EGF was found to enhance survival and process outgrowth of primary cultures of cerebellar neurons of neonatal rat brain. This effect was dose-dependent and was observed with EGF concentrations as low as 100 pg/ml. In marked contrast, bFGF was ineffective in enhancing survival or neurite elongation from cerebellar neurons when tested in the range of 0.1 to 10.0 ng/ml. However, within this concentration range, bFGF did prove effective in stimulating an increase in [3H]thymidine incorporation into primary cultures of cerebellar astrocytes, demonstrating that bFGF was active and that cells in the cerebellum do respond to bFGF. These results suggest that EGF or an EGF-like peptide may act as a neurite elongation and maintenance factor for cerebellar neurons. EGF has now been shown to support striatal, cortical, and cerebellar neurons, suggesting that this factor may have trophic activity throughout the central nervous system. bFGF, in contrast, appears to exert its effects on limited populations of neurons. PMID- 3265161 TI - Brain macrophages synthesize interleukin-1 and interleukin-1 mRNAs in vitro. AB - Amoeboid microglial cells (brain macrophages) were purified from early post-natal mouse brain cultures. The percentage of cells stained with an anti-Mac-1 antibody was greater than 95%. Stimulation of these brain macrophages by lipopolysaccharides induced the synthesis of interleukin-1 (IL-1), which, in part, remained associated with the cell surface and, in part, was released into the culture medium. In contrast, pure primary astrocyte cultures and cell lines of transformed or immortalised astrocytes did not synthesise significant amounts of IL-1, demonstrating that amoeboid microglia and not astrocytes synthesise IL-1 in vitro. These physiological data were confirmed by RNA hybridisation studies showing that, on LPS treatment, brain macrophages synthesise significant amounts of IL-1 alpha and IL-1 beta mRNAs. PMID- 3265160 TI - Growth cone migration across extracellular matrix components depends on integrin, but migration across glioma cells does not. AB - To promote neurite elongation, nerve growth cones must adhere to other surfaces. A complex of integral membrane glycoproteins mediates cell binding to the extracellular glycoproteins fibronectin and laminin (Horwitz et al., J Cell Biol 101:2134-2144, 1985). The receptor complex, named integrin, binds to fibronectin by recognition of a specific peptide sequence, Arg-Gly-Asp-Ser (RGDS), in the fibronectin molecule (Pierschbacher and Ruoslahti, Proc Natl Acad Sci USA 81:5985 5988, 1984). We have used antibodies to integrin and an RGDS synthetic peptide to probe the functions of integrin in the migration of growth cones extended from sensory and spinal cord neurons of chick embryos. Analyses of time lapse videotapes of growth cone migration before and after adding RGDS indicated that 2 mM RGDS rapidly inhibits growth cone movement on substrata coated with fibronectin or a fragment of fibronectin containing the RGDS sequence. RGDS has no effect on growth cone movement on laminin or on a surface coated with material deposited from heart conditioned medium. However, a monclonal antibody to the integrin complex (10 micrograms/ml CSAT) completely blocks growth cone movement on substrata treated with fibronectin, laminin, or heart conditioned medium. Thus integrin may be involved in growth cone adhesion to several extracellular molecules, although the selective effects of RGDS indicate that the integrin complex may have heterogeneous sites for interaction with different components of the extracellular matrix. CSAT antibody has no discernible effect, however, on growth cone migration across the upper surfaces of C6 glioma cells. These data indicate that the surfaces of nerve growth cones contain multiple binding molecules that mediate different adhesive interactions during migration. PMID- 3265163 TI - Invited comment: the role of synthetic compounds in clinical nutrition. PMID- 3265162 TI - Secreted peptides as regulators of neuron-glia and glia-glia interactions in the developing nervous system. AB - Secreted peptides of the nervous system help to regulate neuron-glia and glia glia interactions during development. These regulatory factors, referred to as glia-promoting factors (GPFs), act on specific classes of glia and include oligodendroglia-stimulating peptides, interleukin-1 (IL-1), colony-stimulating factors (CSF), and fibroblast growth factor (FGF). The maturity of secretory and target cells determines, in part, the ability of a factor to influence glial proliferation, activation, or differentiation. During neural development, GPFs help to control such fundamentally important events as cell movement, neurite outgrowth, and myelination. PMID- 3265164 TI - [Massive splenic infarction in a case of CMML]. PMID- 3265165 TI - [Electrotherapy in ophthalmology. Low-frequency impulsed currents, diadynamic currents, high-frequency electric currents and microwave therapy]. PMID- 3265166 TI - Effect of plant polysaccharides on T and B lymphocytes in normal and tumor transplanted mice. PMID- 3265167 TI - Radioresistant pseudo-colony formation in the PHA-leukocyte feeder colony assay. AB - In the PHA-leukocyte feeder colony assay--a fluid assay on top of an agar underlayer--colonies might not be the product of clonogenic cells but rather from aggregates, as was already shown for hairy cell leukemia (Leukemia Res. 11, 911 (1987)). To study the role of aggregation in this colony assay in other B-cell malignancies, we irradiated cells from B-chronic lymphocytic leukemia, B-non Hodgkin's lymphoma and multiple myeloma. In nearly all cases, viable "colonies" were seen after irradiation, albeit in lower numbers. These data indicate that in the PHA-leukocyte feeder colony assay, a considerable percentage of colonies from a large variety of B-cell malignancies originate from aggregating rather than from proliferating cells. PMID- 3265168 TI - Sex differences in lectin-induced interleukin-2 synthesis in aging rats. AB - Several aspects of T cell-mediated immune responses decline with age, but it is not known how gender affects this decline. Using 3- and 26-month-old male and female Fischer 344 rats, we examined the effects of sex and age on four different immune events that normally decline during aging: antibody synthesis to a T dependent antigen, lectin-induced proliferative responses, IL-2 synthesis, and natural killer activity. We found that all these responses decreased with age. Spleen cells from aged females had higher spontaneous, phytohemagglutinin (PHA), and concanavalin A (Con A)-induced proliferative responses, and a two-fold increase in IL-2 synthesis than aged males, although no differences in these responses were evident between young males and females. Both natural killer (NK) activity and the ability to generate plaque-forming cells to sheep erythrocytes (SRBC) declined with age, but there were no differences between males and females for these responses in either age group. These data indicate that sex-associated differences in IL-2 synthesis and spontaneous and lectin-induced proliferative responses that are not detected in young animals become evident with advancing age. PMID- 3265169 TI - [Histiocytosis X with pulmonary involvement. Study of 14 cases]. PMID- 3265170 TI - Prolonged cholestasis and disappearance of interlobular bile ducts following chlorpropamide and erythromycin ethylsuccinate. Case of drug interaction? AB - A 52-year-old man, having been treated for 4 months with chlorpropamide for diabetes mellitus type II, developed severe cholestatic hepatitis following a short course of erythromycin ethylsuccinate. Despite prompt withdrawal of both drugs, the cholestatic picture worsened and was associated with morphological evidence of disappearing interlobular bile ducts. After a 2-year course of profound cholestasis complicated by steatorrhea and striking hyperlipidemia, the patient died of ischemic cardiomyopathy. It is believed that this is the first published case of irreversible cholestasis with disappearance of ducts potentially related to a metabolic interaction between erythromycin ethylsuccinate and chlorpropamide. PMID- 3265171 TI - Estimate of prevalence of glucose intolerance in chronic liver disease. Degree of agreement among some diagnostic criteria. AB - In patients with chronic liver disease, the reliability of various criteria generally used to diagnose impaired glucose tolerance and diabetes was evaluated. Twenty-one patients with chronic persistent hepatitis, 68 patients with chronic active hepatitis and 57 patients with liver cirrhosis were studied. All subjects underwent an oral glucose tolerance test (75 g). Impaired glucose tolerance and diabetes were diagnosed according to the criteria established by: the National Diabetes Study Group; Fajans and Conn; the European Diabetes Study Group; Deutsche Diabetes Gesellschaft; Kobberling & Creutzfeld criteria 1 and 2; Wilkerson; and the University Group Diabetes Program. The results obtained are in partial agreement with other reported data, showing a high prevalence of both impaired glucose tolerance and diabetes in chronic liver disease, with a positive correlation to the severity of hepatic involvement. However, our results show that the agreement among the criteria most frequently used for diagnosing impaired glucose tolerance and diabetes is still far from satisfactory. PMID- 3265172 TI - [Transcranial stimulation of the cortex in humans]. PMID- 3265173 TI - Interleukin-2 and increased natural killer activity in mice experimentally infected with Aspergillus niger. AB - The authors studied the production and effect of interleukin 2 obtained from T lymphocytes stimulated with Aspergillus niger on populations of LGL cells from the peripheral blood and spleen of infected and non-infected mice. The results show an increase in IL-2 production by T lymphocytes in the spleen. In addition, the data demonstrate an increase in LGL activity in the blood and spleen of infected mice. This was seen as the percentage of growth inhibition towards Aspergillus niger, around the tenth day of infection, and reached a maximum of activity on the fifteenth day. The NK activity of the LGL studied increases both in infected and non-infected mice when IL-2 from T lymphocytes of infected mouse blood and spleen is present. PMID- 3265174 TI - Immune responses of mice after conjunctival exposure to Chlamydia trachomatis serovar A. AB - CBA/J mice were inoculated in the lower conjunctival sac with live elementary bodies (EBs) of Chlamydia trachomatis serovar A. Recovery of chlamydia after exposure was done by culture of conjunctival swabs and draining lymph node (D-LN) cells in McCoy cells grown on coverslips in isolation vials. Cellular immune responsiveness was measured by lymphocyte proliferation assay of D-LN cells stimulated with irradiated EBs of serovars A, C, or L2. Humoral immunity was measured by enzyme-linked immunosorbent assay (ELISA) and immunoblot analysis. Chlamydia were consistently isolated from the conjunctiva and from the D-LN at 1 and 7 days after exposure respectively. Intermittent isolations were obtained from the conjunctiva up to day 4 and from the D-LN up to day 14 after a single exposure. Serovar A EB-stimulated lymphocyte proliferation was strong by 1 week after conjunctival exposure, but by 4 and 5 weeks, blastogenic responsiveness was very low. This lack of responsiveness may reflect a state of immunosuppression. Responses to serovars C and L2 EBs were consistently lower than to serovar A EBs. Serum IgG antichlamydia antibodies were not detected by ELISA until 2 weeks after exposure, peaked by 4-5 weeks, and decreased between 5 and 7 weeks after exposure. The IgM response was minimal at all times tested. There was, however, a modest increase in IgM antibodies at 3 and 5-7 weeks after exposure. Immunoblot analysis showed reactivity of mouse serum antibodies with polypeptide bands of 30, 41, and 52 kD at 3 and 4 weeks post exposure and predominantly with the 52 kD moiety at 5 weeks post exposure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265175 TI - [Stomach hemorrhage--a leading symptom of metastatic choriocarcinoma]. PMID- 3265176 TI - [Dental caries in childhood. A cross-sectional epidemiologic study and correlation with a breast-feeding program]. PMID- 3265177 TI - Effects of pH, reducing and alkylating reagents on the binding and Ca2+ release activities of inositol 1,4,5-triphosphate in the bovine adrenal cortex. AB - In a wide variety of cells, inositol 1,4,5-triphosphate (IP3) is a second messenger which interacts with specific intracellular receptors and triggers the release of sequestered Ca2+ from an intracellular store. When bovine adrenal cortex microsomes were incubated in the presence of dithiothreitol [(DTT) IC50 = 50 mM] or n-ethylmaleimide [(NEM) IC50 = 0.5 mM], they lost their IP3 binding capacity. Scatchard analysis of the binding data revealed that DTT decreased the affinity while NEM decreased the number of binding sites for IP3. The effect of DTT was reversible whereas the effect of NEM was permanent. pH variations between 6.5 and 9 increased the IP3 binding capacity of the microsomes. The effects of DTT, NEM, and pH on IP3-induced Ca2+ release from the microsomes were consistent with their effects on IP3 binding. Our data show that the binding sites for IP3 in the bovine adrenal cortex are proteins containing disulfide bridges and free sulfhydryl group(s) which are essential features for the recognition of IP3. These results also suggest that the binding sites for IP3 are the physiological receptors through which IP3 triggers the mobilization of Ca2+ in adrenal cortex in response to angiotensin II and other Ca2+ mobilizing ligands. PMID- 3265178 TI - A laboratory preparation mimicking human peptic ulceration: a chronic antral peptic ulcer postsection and reanastomosis at the antral-fundic junction in the rat. PMID- 3265179 TI - Leucovorin as a clinical potentiator of 5-fluorouracil toxicity and anticancer efficacy. PMID- 3265180 TI - The problem of diagnosing bacterial pneumonia in patients with chronic bronchitis. Bacteria in sputum and bronchial washings from patients with chronic bronchitis are antibody coated. PMID- 3265181 TI - Spinal anesthesia for the high-risk infant. PMID- 3265182 TI - Severe hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency and Epstein-Barr virus infection. PMID- 3265183 TI - Charcot shoulder as the initial symptom in Arnold-Chiari malformation with hydromyelia: case report. PMID- 3265184 TI - Hemophilia A and ulcerative colitis: case report. PMID- 3265185 TI - Endometrial carcinoma with uterus didelphys. PMID- 3265186 TI - Bronchoalveolar lavage in a patient with malignant histiocytosis and the adult respiratory distress syndrome. PMID- 3265187 TI - Clear-cell mucoepidermoid carcinoma arising in the nasal cavity: case report with ultrastructural observations. PMID- 3265188 TI - Ruptured oesophageal varices. PMID- 3265189 TI - [The treatment of hemorrhages from esophageal varices using endoscopic sclerotherapy]. PMID- 3265190 TI - [Suicide in the aged: changes in the suicide figures of elderly patients in West Germany in the time frame 1953 to 1986]. PMID- 3265191 TI - Trigeminal depressor response during percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. AB - Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia was performed 23 times on 21 patients. Significant abrupt drops in heart rate and blood pressure (P less than 0.0002) occurred when the needle entered the foramen ovale or upon balloon advancement or inflation. In 16 of 23 (70%) procedures, the heart rate fell abruptly to 60 or less, by a mean of 38%. Mean arterial blood pressure decreased transiently by 31% during 12 of 23 (55%) procedures. Our findings of transient bradycardia and hypotension upon mechanical stimulation or compression of the mandibular nerve or trigeminal ganglion show for the first time the presence of a trigeminal depressor response in humans. We recommend that heart rate and arterial blood pressure be monitored continuously during percutaneous microcompression of the trigeminal ganglion. Intravenous atropine should be available for immediate use, and an external pacemaker should be fitted preoperatively. PMID- 3265192 TI - Inhibition of the voltage-dependent calcium currents in isolated frog sensory neurons by GABA-related agonistic compounds. AB - Effects of GABAA-, barbiturate- and benzodiazepine receptor agonists and GABAB agonist, baclofen, on voltage-dependent Ca2+ current (ICa) were studied in isolated frog sensory neurons after suppression of Na+ and K+ currents using single-electrode voltage-clamp. GABA, muscimol, taurine and pentobarbital (PB) dose-dependently induced a transient Cl- current (ICl), while baclofen and diazepam (DZP) did not elicit any currents. With GABAA agonists such as GABA, muscimol and taurine, ICa was suppressed transiently, and the maximum inhibition of ICa occurred within 1 min. The suppression of ICa by all GABAA agonists was neither voltage dependent nor attenuated in the presence of either bicuculline or picrotoxin. In addition, there was no correlation between GABA- and baclofen induced suppressions of ICa. The results suggest that the inhibition of ICa by GABAA receptor agonists is not due to either GABAA or GABAB receptor activation at least. The inhibition of ICa by baclofen, PB and DZP was persistent. PB suppressed the amplitude of ICa and also facilitated the inactivation process, suggesting that PB behaves as a Ca channel blocker. However, the mechanisms of ICa suppression by baclofen and DZP are the subject for a future study. The potency order of the drugs in reducing ICa was muscimol greater than GABA = DZP greater than baclofen greater than PB greater than taurine. PMID- 3265193 TI - [Progress in electrophysiological studies of hearing, equilibrium and voice]. PMID- 3265194 TI - [Our clinical experience with electric stimulation of the auditory pathways]. PMID- 3265195 TI - [Directional preponderance in Meniere's disease]. PMID- 3265197 TI - [Problems of home and school environments of patients with hemophilia and other congenital hemorrhagic disorders in Olsztyn Province]. PMID- 3265196 TI - [Changes in the effect of thymocytes, fractionated by size, from adrenalectomized mice on the CFUc count in the bone marrow after irradiation]. PMID- 3265198 TI - [Immunologic disorder in children with hemophilia]. PMID- 3265199 TI - Melatonin production in organ cultured chicken pineal: modulation by adenosine and its analogs. AB - The effects of adenosine, of its non-metabolizable analogs, and of compounds related to its metabolism, were investigated in the photosensitive chicken pineal, maintained in static culture or in superfusion. Stimulation or inhibition of melatonin production was obtained, depending on the experimental conditions tested. Endogenous adenosine is involved in the regulation of the melatonin output. The effects of the nucleoside might depend on the balance between its intra- and extracellular pools; (re)uptake mechanisms are most probably involved. It is suggested that cell surface receptors mediate adenosine effects, but intracellular actions (P-site, transmethylation pathways) are not excluded. This investigation is a breakthrough in the field of pineal physiology which offers new perspectives in the study of the control of melatonin production. PMID- 3265200 TI - Current-voltage relations of Cs+-inhibited K+ currents through the apical membrane of frog skin. AB - The voltage-dependence of the inhibitory effect of mucosal Cs+ on the inward K+ current through the apical membrane of frog skin (Rana temporaria) was studied by recording transepithelial current-voltage relations. Experiments were performed with skins exposed to NaCl and KCl Ringer solutions on the serosal and mucosal side respectively (control skins), as well as with tissues incubated with K2SO4 Ringer solutions on both sides (depolarized skins). Studies of the dose dependence of the Cs+ block showed that under both experimental conditions the apparent affinity of Cs+ increased as the transepithelial potential was clamped at higher mucosal positive voltages. Under control conditions, the concentration of Cs+ required to block 50% of the K+ current (KCs) recorded while the transepithelial voltage was clamped at zero mV was 16 mmol/l. KCs decreased exponentially with mucosal positive voltages. The dependence of KCs on the membrane potential was analyzed with Eyring rate theory in which Cs+ was assumed to block the K+ transport by binding to a site within the channel. The analysis showed that this site is located at a relative electrical distance delta = 0.32 of the voltage drop across the apical membrane, measured from the cytosolic side. The Hill coefficient obtained from this analysis was n = 3.1. Experiments with K+ depolarized tissues showed that only inward K+ currents recorded with positive transepithelial voltages were depressed by external Cs+. Also under these conditions KCs showed an exponential dependence on the transepithelial potential. The analysis of these data with the rate theory revealed delta = 0.09 and n = 1.7.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265201 TI - Effects of pyruvate on post-ischemic myocardial recovery at various workloads. AB - In the present study the hemodynamic and metabolic effects of pyruvate (5 mM), added as cosubstrate to glucose (11 mM) perfused, transiently ischemic, isolated working rat hearts, were evaluated. During 2 h of normoxic perfusion pyruvate improved functional stability, prevented depletion of glycogen and triacylglycerol stores, and increased non-esterified fatty acid (NEFA) levels, even at relatively high workloads. The elevated NEFA levels are in line with the notion that pyruvate competes with endogenously produced fatty acids for oxidative energy production. After 45 min of global ischemia pyruvate was found (a) to affect markedly the relative contribution of ATP, ADP and AMP to the total adenine nucleotide content and (b) to stimulate the degradation of glycogen and to enhance the accumulation of lactate, suggesting enhanced anaerobic ATP production. After restoration of flow pyruvate reduced the incidence of fibrillation and markedly improved recovery of cardiac output at both normal and high workload. Pyruvate did neither attenuate the release of lactate dehydrogenase, a marker for cell death, nor improve the conservation of the total adenine nucleotide and ATP content of hearts reperfused for 30 min. The latter findings indicate that hemodynamic recovery during reperfusion in the presence of pyruvate is neither related to the absolute tissue content of ATP nor to a reduction of irreversible cell damage, and suggest that pyruvate exerts its advantageous hemodynamic effects rather by improving the condition of reversibly damaged cells during reperfusion. PMID- 3265202 TI - [180 degree versus 360 degree rotation in SPECT of bone]. AB - Opinions differ as to the advantages of the 180 degrees and the 360 degrees techniques concerning myocardial scintigraphy with 201Tl. Following our own encouraging experiences with the 180 degrees technique, we have looked for cases in bone scintigraphy where reconstructions from a semicircle could be advantageous over a full circle reconstruction. There were metastases and foci of osteomyelitis in spine, ribs and skull (especially in the skull base), to be seen better in reconstructions using images out of 180 degrees close to the object. In knee SPECT a closer radius of rotation can be chosen with single-head cameras so that, when using the 180 degrees technique, a better reproduction of the anatomical structures and pathological alterations is achieved. PMID- 3265203 TI - [HMPAO-SPECT in cerebral seizures]. AB - In nine patients with suspected psychogenic seizures and in three patients with proven epileptic seizures HMPAO-SPECT was performed prior to and during seizure. In the patients with later on-proven psychogenic seizures no, or only slight, changes of regional cerebral blood flow were found. Patients with proven epilepsy revealed partly normal findings interictally but during seizure a markedly increased circumscript blood flow was found in all patients. Even though PET is superior to SPECT with respect to spatial resolution, in the diagnosis of seizures HMPAO-SPECT has the advantage of enabling injection of the tracer during the seizure and the performance of the SPECT study subsequently. PMID- 3265204 TI - [The role of interleukin 2 in disorders of immunologic regulation in systemic lupus erythematosus]. PMID- 3265205 TI - [Various parameters of cellular immunity in persons exposed to petroleum derivatives]. PMID- 3265207 TI - [F.Riedel, C.H.L.Rieger: bronchial asthma in childhood]. PMID- 3265206 TI - Blocking AIDS. PMID- 3265208 TI - Alameda County redux: replication in Michigan. AB - This article describes an attempt to reproduce, in Michigan, cross-sectional findings concerning the relationship between health habits and health status previously obtained in Alameda County, California by Belloc and Breslow. Data for this study were gathered by a telephone interview of a state-wide sample of 3,259 adult Michigan residents. The ridit (relative to an identified distribution) analyses presented include a comparison of findings from the Michigan and Alameda County studies. In Michigan, as in Alameda County, health status was found to be associated with various health practices, both individually and in combination. Consistent relationships were found between physical health status and individual health practices regarding hours of sleep, eating breakfast, eating between meals, cigarette smoking, weight for height, and physical activity. Physical health status was also linked to the overall number of health practices individuals engaged in. When the confidence interval for each ridit value was taken into account, however, only some of the findings proved statistically reliable. PMID- 3265209 TI - [Mumie as a pathogenetic agent in the treatment of tuberculosis]. PMID- 3265210 TI - Desipramine subsensitizes nicotinic mechanism involved in regulating core temperature. AB - Desipramine HCl, 10 mg/kg i.p. twice daily, produced subsensitivity to the hypothermic effects of nicotine, 1 mg/kg, after 1 and 2 weeks of treatment in male Sprague-Dawley rats, Phenelzine sulfate, fluoxetine HCl, and bright artificial light produced the same effect. The capacity of three chemically distinct classes of anti-depressants and bright artificial light (a treatment for seasonal depression) to produce this result suggests that effects on nicotinic mechanisms may be involved in the mechanism of action of these treatments. PMID- 3265211 TI - The prevalence of endemic goitre among a rural population in some parts of Donga Mantung division, Cameroon. PMID- 3265212 TI - Abnormal postural control associated with peripheral vestibular disorders. PMID- 3265213 TI - Organization of leg-trunk-head equilibrium movements in normals and patients with peripheral vestibular deficits. PMID- 3265214 TI - Labyrinthine control of upright standing posture in humans. PMID- 3265216 TI - [Study of cellular immunity in patients with acute cholecystitis]. PMID- 3265215 TI - [Efficacy of elective endoscopic sclerotherapy of hemorrhage from esophageal varices. 2-year follow-up]. PMID- 3265217 TI - [Evaluation of dilated cardiomyopathy and coronary artery disease using positron CT (PCT)]. PMID- 3265218 TI - [Stenosis of the main trunk of the left coronary artery: diagnostic value of clinical and non-invasive assessment and results of bypass surgery]. PMID- 3265219 TI - An annualized analysis of drug related incidents in Rhode Island emergency rooms- calendar year 1987. PMID- 3265220 TI - Cancer mortality in Switzerland, 1951-1984: effects of age, birth cohort and period of death. PMID- 3265221 TI - [Trends in cancer mortality in Switzerland (1951-1984) and implications for the future]. PMID- 3265222 TI - Modulating activity of B lymphocytes on haemopoiesis (II)--the purification of proliferation amplifying factor (PAF). AB - In recent years we have done a series of observations on the haemopoietic modulation effects of lymphocytes. Now we report here, for the first time, the purification of a modulating factor (proliferation amplifying factor, PAE) with affinity chromatography and HPLC from supernatant conditioned by a lymphoma cell line M12.4.1. RAF exhibits on SDS-PAGE only one band, the molecular weight is about 31,000, the specific activity is 20,000 times that in the conditioned medium. It may provide a direct evidence that the B lymphocyte also possesses some haemopoietic modulation effects. PMID- 3265223 TI - [Chemotherapy in the treatment of primary malignant bone tumors]. PMID- 3265224 TI - [Rheumatologic causes of brachialgia and their treatment]. PMID- 3265225 TI - [Exercise therapy and physical therapy measures in the treatment of shoulder and arm pain]. PMID- 3265226 TI - Von Willebrand factor and mitral valve prolapse. AB - The levels of von Willebrand factor (vWF:Ag) were measured in 27 patients with mitral valve prolapse (MVP) and compared to 27 age matched controls. Decreased levels of vWF:Ag (less than 80%) were found in 59% (16/27) of those with MVP compared to only 7% (2/27) of the controls (p less than 0.001). Mean vWF: Ag levels were also significantly lower in those with MVP (68 +/- 30% versus 100 +/- 23%, p less than 0.001). In those with MVP and congestive heart failure secondary to rupture chordae tendineae, however, the mean level of vWF: Ag was not significantly different from control values (95 +/- 32). There was an increased incidence of recurrent nose bleeds in those with MVP and low levels of vWF:Ag. We conclude that there is a relationship between MVP and low levels of vWF:Ag which may explain the increased incidence of epistaxis in such patients. Increased release of vWF:Ag in those with MVP and concomitant congestive heart failure may account for the normal levels found in this subgroup. PMID- 3265227 TI - A new procedure for large scale production and freezing of lymphokine activated killer (LAK) cells to be used in adoptive immunotherapy of cancer. AB - A new procedure for activation of peripheral blood lymphocytes (PBL) with recombinant interleukin 2 (rIL2) is described. PBL obtained by leukapheresis were subjected to NH4Cl (ACK) treatment to clear erythrocyte contamination; Ficoll separation was not performed. PBL were subsequently seeded in 10-floor multitrays (Cell FactoryTM, CF), gasified and incubated at 37 degrees C for 3-4 days in a humidified 5% CO2 atmosphere. This procedure achieved an activation (evaluated as cytotoxicity and proliferation) comparable with that obtained by culturing PBL in small flasks. Optimal activation of PBL was achieved in CF even in the presence of granulocyte contamination of up to 40%. It was also possible to freeze, thaw and recover most of the frozen cells and their cytotoxic activity. With this procedure therefore large quantities of lymphokine activated killer cells (LAK) can be easily produced to be used in adoptive immunotherapy trials. PMID- 3265228 TI - Langerhans histiocytosis of the choledochus in an adult patient with a history of disseminated disease. AB - A 43 year-old man with a 15-year history of disseminated Langerhans histiocytosis (LH) in complete clinical remission was admitted with jaundice and abdominal pain. Pathological examination demonstrated LH in the choledochus associated with sclerosing cholangitis in the liver. Immunohistochemistry for S-100 protein and electron microscopy of the choledochus tissue showed Langerhans cell-like elements in the infiltrate. Our findings suggest that, in patients with disseminated Langerhans histiocytosis, liver function should be monitored, particularly, for signs of biliary obstruction, and demonstrate that such a finding is possible in adults. PMID- 3265229 TI - [Sports-related fractures of the facial skull in Austria]. AB - Details of injuries to the maxillo-facial region have been collected over a five year period. 635 fractures in this region were registered resulting from 24 different sports. Soccer was found as the most dangerous individual sport. There is no absolute safe kind of sport but we suggest that the number of fractures depends too on a local factor. PMID- 3265230 TI - [Immunocorrective therapy of herpetic keratitis]. PMID- 3265231 TI - Clinical pharmacology. PMID- 3265232 TI - Therapeutic drug monitoring in veterinary medicine. AB - This article presents some of the more important principles and concepts of therapeutic drug monitoring and when it might be an appropriate diagnostic procedure in veterinary medicine. PMID- 3265233 TI - Breakthrough in homeopathy? PMID- 3265234 TI - [The dose of sinusoidal modulated currents for children of various age groups]. PMID- 3265235 TI - [Effectiveness of the combined treatment of hemarthrosis in hemophiliac children using a UHF electrical field]. PMID- 3265236 TI - [Functional activity of the natural killers and macrophages in patients with breast tumors]. AB - The activity of natural killers (NK) and macrophages of peripheral blood was studied in 37 female donors, 40 patients with benign and 43 with malignant tumors of the breast of various stages prior to treatment. Also the effect of Soviet made recombinant interleukin-2 on NK activity was assessed. Natural killer activity (cytotoxic index) was 34.1 +/- 1.42 in healthy donors, 44.2 +/- 3.64 in cases of fibroadenomatosis, 43.1 +/- 5.6 in patients with stages I-IIa, 64.4 +/- 3.93--stage IIb, 45.8 +/- 6.32--stage III and 16.6 +/- 7.21% in cases of stage IV breast cancer, the scatter of values being greater in the tumor group. As many as 40% of patients with stages I-IIa and III cancer showed increased NK-activity values. An in vitro stimulating effect of NK activity of peripheral blood mononuclear cells by Soviet-made recombinant interleukin-2 was established. PMID- 3265237 TI - Large-scale production and properties of a solvent-detergent-treated factor IX concentrate from human plasma. AB - A human solvent-detergent (SD)-treated factor IX concentrate has been produced from cryoprecipitate-poor plasma using DEAE-Sepharose CL-6B and heparin-Sepharose CL-6B chromatography. The DEAE eluate was incubated with an SD mixture [0.3% tri(n-butyl) phosphate-1% Tween 80, 6-h at 24 degrees C] which was found to inactivate, in less than 1 h, more than 3.8 log10 of vesicular stomatitis virus and more than 4.8 log10 of Sindbis virus; the SD was removed by a subsequent heparin adsorption step. The specific activity of the concentrate was 10.9 +/- 1.3 IU factor IX: c/mg protein (n = 15). The factor IX coagulant to antigen ratio was 0.7 +/- 0.1. The concentrate was essentially free of factors II, VII and X, and protein C. The usual major contaminants of prothrombin complex concentrate (PCC) were absent: the concentrate contained about 94% alpha-1 proteins, and only 4 major proteins were resolved by SDS-PAGE (respective apparent molecular weight: 130, 86, 76 and 69 kilodaltons), and by crossed immunoelectrophoresis against an anti-PCC serum. The nonactivated partial thromboplastin time was equivalent to that of PCC; the product was devoid of factor IXa, of other activated procoagulant factors and of coagulant-active phospholipids (removed with SD in the heparin breakthrough fraction). Animal studies using the Wessler test and acute-toxicity test in rabbits revealed no adverse side effects. SD treatment could thus be used to inactivate viruses in factor IX concentrate and improve the safety of replacement therapy in hemophilia B. PMID- 3265238 TI - [Clinical diagnosis of legionellosis]. PMID- 3265239 TI - Triplet pregnancies at the University Hospital of the West Indies (1968-1987). PMID- 3265240 TI - [Complement-binding antibodies in women simultaneously infected with various species of Trichomonas]. PMID- 3265241 TI - [Immunologic changes in women and their sexual partners with urogenital Trichomonas infection]. PMID- 3265242 TI - [Interleukin-1 and liver cirrhosis]. PMID- 3265243 TI - [Intradermal test with Trichomonas vaginalis allergen in patients with urogenital Trichomonas infection]. PMID- 3265244 TI - [2 unusual responses of the myocardium in the frog Rana temporaria to acetylcholine]. AB - When studying seasonal variations in acetylcholine sensitivity of isolated frog ventricle, two forms of unusual responses have been observed: 1) tonic response induced by supermaximal concentration of acetylcholine, and 2) double response to the increasing acetylcholine concentrations with two different threshold and maximum doses (KAch values differ by 1-2 orders). The tonic response is blocked by mytolone. Both effects are of a seasonal nature. Similar pattern of these reactions in frogs and molluscs suggests a possibility of restoration of evolutionary more ancient form of cholinergic response, hormonal influences being involved into this process. PMID- 3265245 TI - [Effect of macroergic nucleotides and lysolecithin on the cholinergic reception of the heart muscle in the frog Rana temporaria]. AB - In experiments on isolated frog ventricle, it has been demonstrated that the dose response curve for negative inotropic reaction of the myocardium to acetylcholine exhibits a sigmoid form, Hill's coefficient (nH) of this reaction being more than 1. The value of nH depends on the interval from isolation of the ventricle and on the duration of perfusion of the latter with Ringer's solution. It was shown that ATP, UTP, UDP and GTP in physiological concentrations induce both the increase in nH and the increase of K50 (acetylcholine concentration evoking the effect which is equal to half of the maximal one) of the investigated physiological reaction. Similar effects are produced by lysolecithin. Possible causes of "physiological cooperativity" of negative inotropic reaction of the myocardium to acetylcholine and the role of energy-rich nucleotides in this process are discussed. PMID- 3265246 TI - [The specificity of the interaction of the cholinesterases in Far Eastern squid and certain vertebrates with reversible inhibitors]. AB - Studies have been made of the effect of three groups of ammonia reversible inhibitors on the activity of erythrocyte acetylcholinesterase, serum butyrylcholinesterase, cholinesterase from frog brain, as well as cholinesterases from the optical ganglia of the Pacific and three populations of the commander squids. Determination of kinetic parameters of the reversible inhibition of these enzymes revealed differences resulting from the specific structure of their catalytic centers. Tetramethylammonium assay confirmed different properties of cholinesterases in individuals of the commander squid from various habitats in the Bering Sea; this finding may be taken as an indication of intraspecific differentiation of these cephalopods. Certain similarity was noted in the inhibitory specificity of cholinesterases from the Pacific and "southern" commander squids with the overlapping habitats. PMID- 3265248 TI - [Effect of levamisole on the cellular and humoral immunity indices in patients with chronic brucellosis]. AB - In chronic brucellosis patients receiving levamisole and placebo the dynamics of quantitative and functional characteristics of cell-mediated and humoral immunity have been studied. The immunomodulating effect of levamisole, manifested only in the process of treatment by a rise in the number of circulating lymphoid cells, their functional capacity, a decrease in the disproportion of immunoregulatory cells and the amount of circulating immune complexes, has been established. The positive dynamics of immunological characteristics have been found to improve both immediate and remote results of the clinical effectiveness of levamisole. PMID- 3265247 TI - [Morphofunctional research on the interrenal gland of the frog Rana temporaria following arginine vasotocin administration]. AB - Studies have been made of the effect of injections of hypothalamic nonapeptide neurohormone, arginine vasotocin, on functional condition of the interrenal gland in mature frogs. In unoperated, sham-operated and in animals 10 days after hypophysectomy, single and especially three subsequent injections of arginine vasotocin (5 x 10(-9) M per 1 kg of the body weight) result in evident activation of glandular cells of the interrenal gland which is manifested in the increase of the volume of their nuclei and cytoplasmic area, as well as in the dilatation of the blood vessels. Activation of the interrenal gland in hypophysectomized frogs, which lack endogenous ACTH, indicate the direct para-adenohypophyseal influences of nonapeptide hypothalamic hormones on the activity of glandular cells in the peripheral endocrine glands, in particular, the interrenal gland of the grass frog. PMID- 3265249 TI - [Evaluation of lymphocyte cooperative interaction with neutrophils by the stimulation of lymphokine production in erysipelatous inflammation]. AB - In erysipelatous inflammation lymphocytes were found to secrete lymphokine, both spontaneously and in response to in vitro stimulation with streptococcal allergen. The secreted lymphokine enhanced the oxygen-dependent metabolism of neutrophils. The lymphokine formation observed in this study depended on the clinical form of the disease. The character of the effect produced by lymphokine was determined by the initial state of target cells (macrophages). PMID- 3265250 TI - [Surgical treatment of meningiomas of the posterior surface of the pyramid of the temporal bone]. AB - The authors examined 162 patients with meningiomas of the posterior surface of the pyramid of the temporal bone. The difficulty of surgical removal of meningiomas is associated with the difficult access to them, their closeness to the stem parts of the brain, and their direct connection with the cranial nerves and the vessels of the vertebrobasilar system. Since the meningiomas are located mainly within the limits of the pontocerebellar angle, the paramedian approach is the most adequate one. Microsurgical removal of meningiomas was carried out in 54 patients. PMID- 3265251 TI - The significance of some immunoserologic diagnostic tests in systemic diseases. AB - The sensitivity and specificity of immunoserologic tests included in the diagnostic criteria of systemic lupus erythematosus are shown. The frequencies of some rare autoantibodies (PCNA, PL-4, SL, PM-Scl, Scl-70, Jo-1) in systemic connective tissue diseases of mixed Yugoslav population are demonstrated. The results from different laboratories differ considerably and the possible reasons are described. PMID- 3265252 TI - Meningismus as main symptom in toxic shock syndrome. AB - A case of toxic shock syndrome (TSS) with meningismus as main symptom is presented. The case illustrates that, in cases of rigidity of the neck and back, not directly explainable, TSS should be considered as a possible diagnosis. Toxic syndrome (TSS) is a severe, acute infectious disease with great variations in symptomatology (1,2). Its lethality is approximately 5% (3). The prognosis depends on early diagnosis and treatment. PMID- 3265253 TI - Estimated prevalence of mullerian anomalies. AB - Among 167 women who underwent laparoscopic sterilization in the course of one year, 1.2% were found to have a bicornuate uterus. Of them, 111 were offered follow-up by hysterosalpingography (HSG), and the history of their menstrual pattern as well as reproductive potential was recorded. Evaluation of the HSG exposures revealed 3.6% moderately to severely septate uteri (H/L greater than 0.20), and a total of 15.3% had fundal anomalies (H/L greater than 0.10). In women who had always had normal fertility and menstrual cycles of less than 35 days, the corresponding frequencies of septate uterus were 1.2% and 11.8% respectively. Among women who had had oligomenorrheic periods exceeding one year in duration, the frequency of mullerian anomalies was significantly higher (21.1% at H/L greater than 0.20 and 36.8% at H/L greater than 0.10) than in the above mentioned groups. A control group of infertile oligomenorrheic women revealed that the material was comparable with previously published populations as regard the occurrence of minor mullerian anomalies. It is concluded that the HSG diagnosed prevalence of developmental uterine anomalies is in general somewhat higher than usually assumed. PMID- 3265254 TI - Acoustic neuromas. Diagnostic delay, growth rate and possible non-surgical treatment. AB - In spite of an intensive campaign to achieve early diagnosis of acoustic neuromas, our attempts have not been successful, since we have even more tumours measuring more than 40 mm in diameter among our latest 100 patients than among the first one hundred. It is demonstrated that both patients and physicians (otologists) are to some extent still ignoring the possible significance of a unilateral, progressive, sensorineural hearing impairment. Guidelines for improving this condition are given. We have been able to follow 21 patients for an average of 4 years, with repeated CT scans, and only in 3 of these patients did the tumour appear to be progressing to a size requiring surgical intervention. In the remaining 18 patients the tumour has not increased in size, as judged by the CT. Because of our complete lack of knowledge about the causes of tumour growth in some patients and absence of growth in others, a more differentiated attitude towards indications for surgery is needed, and in some, mostly elderly, patients a period of 'watchful waiting' is appropriate. PMID- 3265255 TI - Results of translabyrinthine removal of 300 acoustic neuromas related to tumour size. AB - The results from the Danish model of acoustic neuroma surgery are presented. In the period from 1976 to 1985, 300 patients with acoustic neuromas were operated upon using the translabyrinthine procedure. There were one small intrameatal tumour; 96 medium-sized tumours with an extrameatal diameter up to 25 mm; 85 large tumours, measuring 26-40 mm, and 118 very large tumours with a diameter exceeding 40 mm. The mortality rate was 2%, and CSF leak occurred in 11%, persisting for more than 2 weeks in 5% of the patients in whom the fistula had to be closed operatively. Facial nerve function was completely normal in 66%, slightly reduced in 17%, moderately reduced in 8% and abolished in 9%. The facial nerve was anatomically preserved in 95% of the patients. Reconstruction of the facial nerve, most often an XII-VII anastomosis, was performed in only 6% of the patients. Cerebellar symptoms, occurring in 45% preoperatively, were demonstrated in only 7% postoperatively. We find that a standardization of the measurement of tumor size and of the assessment of sequelae changes is urgently needed. PMID- 3265256 TI - Is preservation of hearing in acoustic neuroma worthwhile? AB - In a series of 300 translabyrinthine removals of acoustic neuromas, comprising almost all tumours operated on in Denmark during a period of 10 years, the preoperative hearing in the tumour ear and in the contralateral ear was analysed in 72 patients with tumours smaller than 2 cm in extrameatal diameter. These patients constitute likely candidates for a hearing preserving operation via the suboccipital approach. In the tumour ear in 4 patients there was a pure-tone average (PTA) of 0-20 dB and a discrimination score (DS) of 81-100%. Applying this criterion to the whole series, 1% of the patients would be candidates for a hearing preserving procedure. Changing the criterion to a PTA of 0-40 dB and a DS of 61-100%, the number of candidates would increase to 8 patients (3%), and with a PTA of 0-50 dB and a DS of 51-100% 14 candidates (5%) would have been found. In all of these patients, contralateral hearing was normal (SRT 0-20 dB, DS 95 100%). Since preservation of hearing would be achieved in only half of those subjected to suboccipital removal and since the hearing retained in patients with successful operations is generally poorer than the preoperative level, the number of patients obtaining serviceable hearing is so modest that preservation of hearing cannot be considered an argument in favour of suboccipital tumour removal. It should be borne in mind that contralateral hearing is normal in these patients and that, according to most reports, the mortality rate is higher and paralysis of the facial nerve more frequent with the suboccipital approach than with the translabyrinthine procedure. PMID- 3265257 TI - Vestibular and non-vestibular nystagmus in examination of dizzy patients. AB - Observation of nystagmus is of great importance in the otoneurologic examination. By means of electronystagmography it is possible to examine the nystagmus under different visual conditions such as in darkness or with eyes closed. Physiological nystagmus is characterized by miniature eye movements with an amplitude of 4-5 minutes of one degree. With fixation, the amplitude decreases and the frequency increases. Vestibular nystagmus is a biphasic eye movement with slow and rapid phases of opposite directions. The intensity increases when the eye bulb is directed in the same direction as the fast phase or when fixation is hampered by darkness or eye closure. Nystagmus in which the fast phase changes direction according to the direction of gaze, i.e. gaze (paretic) nystagmus, can be congenital, but is often a result of paralysis of the eye muscles, of infection, intoxication or, if asymmetric in amplitude, of an acoustic neurinoma. Fixation nystagmus, miner's nystagmus, and nystagmus latens, is called optic nystagmus, and is thought to be caused by defects in the fixation mechanism. The main characteristic is that it changes direction if one or both eyes are closed and often interferes with the vestibular nystagmus. In the diagnosis of dizzy patients with optic nystagmus, the examination of the vestibular system must be carried out with other methods than nystagmus recordings. PMID- 3265258 TI - Some considerations on caloric test results. AB - The caloric test procedure as suggested by Fitzgerald & Hallpike is still widely used. With a carefully standardized procedure it is well suited to identify the affected side in patients with unilateral vestibular impairments. By repeated testing it is also possible to follow the course of a vestibular affection. PMID- 3265259 TI - Pursuit eye movements. Methodological aspects. AB - A reduced smooth pursuit ability is often a sign of central vestibular pathology. Methodological aspects of stimulation, recording of eye movements and analysis of results in the evaluation of the smooth pursuit function are discussed. A method for evaluation of the smooth pursuit function over a broad frequency range is presented and the effects of target predictability and age on recorded parameters are shown. PMID- 3265260 TI - Clinical aspects of eye tracking test. AB - The eye tracking test is today a well established part of clinical otoneurological examination. In the present paper some applications of the test in evaluating of the level of lesion within the vestibular system are reviewed. PMID- 3265261 TI - Rotatory test in otoneurology. AB - A series of rotatory tests are described, by which it is possible to activate the ocolomotor system by visual as well as by vestibular stimuli, either separately or in combination. The visual-oculomotor system was studied by means of rotation with 10 degrees constant speed for 10 s in either direction. Pursuit movements and saccades were also studied. The vestibulooculomotor system was studied by acceleration behind closed eyes with 10 degrees/s2 up to 100 degrees, immediately followed by a similar deceleration. Normal and pathological cases are presented. A combined visual-vestibular stimulation was performed with the same kind of acceleration-deceleration but with eyes open. Acceleration demonstrated the summation effect of visual and vestibular input to the vestibular nuclei. The deceleration revealed the cerebellar ability to suppress the vestibular output. Normal and pathological cases are demonstrated. Finally, a combined rotation was introduced, informing us about the vestibular reaction, the visual-vestibular summation, the optokinetic reactions, and the cerebello-vestibular suppression. Normal and pathological cases are described. PMID- 3265262 TI - Broad-frequency rotatory testing. AB - The method of broad-frequency-band rotatory testing with results from normal subjects and patients with peripheral uni- and bilateral loss as well as central vestibular disorders are reviewed. The following conclusions are drawn: adequate testing of the vestibulo-ocular reflex including side detection of unilateral loss in light or in darkness can only be done with either random or high frequency (2.5-3 Hz) sinusoidal stimulation. Measurements of compensatory eye movements at lower frequencies where vestibular and non-vestibular signals interact are of interest for central vestibular diagnosis. A decreased ability to suppress vestibular nystagmus is not an uncommon finding in patients with large acoustic neuromas or pathology in the brainstem or cerebellum. PMID- 3265263 TI - Clinical considerations concerning horizontal optokinetic nystagmus. AB - During recent decades a vast amount of literature concerning horizontal optokinetic nystagmus has emerged, regarding which--and especially as regards our own work--this report is intended to consider the clinical value of optokinetic nystagmus. PMID- 3265264 TI - Presentation of a posturographic test with loading of the proprioceptive system. AB - Postural control is maintained by sensory feedback from visual, vestibular and somatosensory receptors. Recently several methods for evaluating postural control have been devised, utilizing an imposed perturbation. Most of these methods use stimuli which simultaneously affect more than one of the sensory feedback loops. In the present paper a posturographic technique is presented with specific loading of the proprioceptive system, using a computer controlled vibratory stimulus and computerized analysis of the results. PMID- 3265265 TI - Drop attacks in Meniere's disease. AB - An inner ear etiology for drop attacks is easily overlooked and seldom mentioned in the literature. Cardiovascular pathology is what generally is looked for, e.g. transitory ischemic attacks. Twenty-nine patients with frequent and severe Meniere attacks were treated with gentamicin intratympanally, when they had reached a stage of incapacitation due to vertigo and dread of further attacks and all medical treatments had failed. All but one patient were suffering from more or less frequent drop attacks. The attacks of vertigo were successfully cured in all patients except 2, who had recurrence of the inner ear problem. The drop attacks disappeared in all patients, which indicates that they had an inner ear origin. PMID- 3265266 TI - [Enzyme kinetics of cefotaxime hydrolysed by beta-lactamases extracted from gram negative bacilli]. PMID- 3265267 TI - [Effects of azimexon on interleukin 2 and interleukin 1 production in vitro]. PMID- 3265268 TI - Interleukin-1 enhances pain reflexes. Mediation through increased prostaglandin E2 levels. AB - Interleukin-1 (IL-1) has been shown to induce inflammatory reactions in part through increased prostaglandin production. Prostaglandins of the E- and I-type sensitize nociceptors in peripheral tissues. We have therefore investigated the effect of IL-1 perfusion in the isolated rabbit ear, a model which allows the assessment of peripheral pain. Natural IL-1 from human monocytes, IL-1 from glioblastoma cells as well as recombinant IL-1 alpha or beta, increased the pain reflex induced by acetylcholine in a concentration dependent manner. The PGE2 levels were measured in the perfusate and were found to be enhanced more than 10 fold after the infusion of IL-1 alpha or IL-1 beta. This effect was paralleled by the enhanced pain reflexes and persisted for at least one hour after cessation of the IL-1 perfusion. Both the increased pain reflexes as well as the enhanced PGE2 levels were abolished by addition of the cyclooxygenase inhibitor diclofenac-Na (Voltaren) to the perfusion fluid. These results show that besides the numerous known physiological functions of IL-1, it may also play a role in peripheral pain sensations. PMID- 3265269 TI - Antiinflammatory, analgesic, and antipyretic activities of methyl 7-butyl-4,5,6,7 tetrahydro-3-methylamino-4,6-dioxo-5-propyl-2H-pyrazol o[3, 4-d]pyrimidine-2 carboxylate (AA-2379), a novel non-acidic agent. AB - The antiinflammatory, analgesic, and antipyretic activities of methyl 7-butyl 4,5,6,7-tetrahydro-3-methylamino-4,6-dioxo-5-propyl-2H-pyrazolo[ 3, 4 d]pyrimidine-2-carboxylate (AA-2379), a novel non-acidic agent, were examined. 1. AA-2379 had a potent antiinflammatory activity; 3-25 mg/kg, p.o. of the compound inhibited rat carrageenin-, bradykinin-, trypsin-, formalin-, dextran-, and nystatin-induced paw edema; mouse traumatic edema; and rat croton oil pouch inflammation by about 30%. The compound at 25-50 mg/kg, p.o. also inhibited the vascular permeability induced by histamine, serotonin, and bradykinin. 2. AA-2379 had an analgesic activity; the ID50 values in mouse phenylquinone-induced writhing were 10.1 mg/kg, p.o. and the compound at 12.5 mg/kg, p.o. inhibited dog urate arthritis. 3. AA-2379 at 3-10 mg/kg, p.o. showed antipyretic activity in febrile rats and rabbits. 4. AA-2379, at 500 mg/kg, p.o. was not ulcerogenic in rats. 5. These data show that AA-2379 is more active than non-acidic antiinflammatory agents, such as tiaramide and aminopyrine. PMID- 3265270 TI - Cologne Atherosclerosis Conference No. 4: Cholesterol-homeostasis. Cologne, May 4 6, 1988. Proceedings. PMID- 3265271 TI - Rat LDL metabolism in the perinatal period. AB - In fetal rats at term LDL carries 75% of the total serum cholesterol, whereas in adult ones this value amounts to 20% only. Using a time-dependent two pool model the flux rates for LDL cholesterol can be calculated for the newborn. The data reveal that at birth the LDL cholesterol flux is 15-20 times higher than in the adult. During the first 2 h of postnatal life the FCR drops down from 0.4 at birth to values measured in the adult. Since at least 75% of LDL is of another origin than VLDL, a direct hepatic LDL synthesis is postulated for the newborn. The liver contributes to about 30% of the total LDL uptake which is mainly realized by a receptor-dependent mechanism, even though the fetus and the newborn exhibit markedly elevated LDL serum concentrations. PMID- 3265273 TI - Translational and post-translational processing in apolipoprotein metabolism. PMID- 3265272 TI - Comparison of sitosterol and sitostanol on inhibition of intestinal cholesterol absorption. PMID- 3265274 TI - Lipoprotein receptor domains in the plasma membrane of cultured cells. PMID- 3265275 TI - The significance of the hepatic LDL-receptor for the metabolism of exogenous cholesterol. PMID- 3265276 TI - The selective uptake of HDL cholesteryl esters and its role in reverse cholesterol transport. PMID- 3265277 TI - Biological modification of lipoproteins and its role in atherogenesis. PMID- 3265278 TI - Smooth muscle cell proliferation in atherosclerosis. PMID- 3265279 TI - In vivo and in vitro effects of copper(I)nicotinic acid complexes on lipids and lipoproteins. PMID- 3265280 TI - Processing of cholesteryl ester from low density lipoproteins in the rat: hepatic metabolism and biliary excretion after uptake by different hepatic cells. PMID- 3265281 TI - Orthogonal arrays of intramembrane particles in the supporting cells of the guinea-pig vestibular sensory epithelium. AB - Membrane specializations of the contact region between afferent nerve endings and supporting cells of the sensory epithelia of guinea-pig vestibular endorgans were examined by thin-section and freeze-fracture electron microscopy. The calyx-type nerve endings (C-endings) are separated from supporting cells (SC) by a 25-30 nm space. At irregular intervals along the upper lateral surface of supporting cells, the intercellular space narrows markedly to form special close contacts between the C-ending and SC plasma membranes. Freeze-fracture replicas reveal membrane specializations--orthogonal arrays of particulate units--in the region where the close intercellular contacts were found in sections. Orthogonal arrays consisting of from 5 to 20 units were observed on the cytoplasmic (P) fracture face of the lateral SC plasma membrane. These particulate units from a 12 x 12-nm square, and each unit is composed of four 6-nm subunits. Possible roles of the orthogonal arrays are discussed. PMID- 3265282 TI - Psychological aspects of people with headache undergoing percutaneous electrostimulation: preliminary data. AB - Percutaneous electrostimulation is performed in the treatment of headaches taking into account, after preliminary tests, the relative psychological symptom connected to headache. The authors suggest that a preliminary analysis is indispensable to the treatment of psychodynamic and psychopathologic mechanisms connected to headache. PMID- 3265283 TI - Social support in the workplace: tests of six theoretical models. AB - Six theoretical models of social support in relation to perceived job stress, burnout, and health were tested both cross-sectionally and longitudinally. Participants at Time 1 were state correctional officers (N = 262) who completed questionnaires in which multiple indicators of each construct were assessed. Time 2 participants (N = 177) were those officers from the Time 1 sample who completed the questionnaire again three months later. Structural equation analyses revealed that only one of the six models was supported by cross-sectional results. In this model a direct negative relationship between the WORKPLACE SOCIAL SUPPORT and BURNOUT latent variables was specified, along with direct, positive relationships between the JOB STRESS and BURNOUT latent variables and the BURNOUT and POOR HEALTH latent variables. However, none of the six models was supported by the longitudinal results. Thus, cross-sectional results were consistent with a model in which social support on the job influences positive health only through its direct and negative effect on burnout symptoms, but such causal connections were not validated longitudinally. PMID- 3265284 TI - Production of interleukin 1 in glomerular cell cultures from patients with rapidly progressive crescentic glomerulonephritis. AB - Interleukin 1 (IL-1) activity was measured in glomerular culture supernatants from 3 patients with rapidly progressive crescentic glomerulonephritis (RPGN). Macrophages were present in both capillary tufts and cellular crescents as identified by OKM1-positive cells on immunoperoxidase labelling. Glomeruli from 4 rejecting renal cadaver allografts were used as a disease control, in addition to glomeruli from a normal kidney. IL-1 activity as measured by the thymocyte proliferation assay was greater in the supernatants from cultured glomerular outgrowths of patients with crescentic GN than in those from rejected renal allografts and glomeruli isolated from the normal tissue. IL-1 production from cultured glomerular cells from patients with RPGN was detectable in the serum free conditioned media harvested after 3 days of culture and increased in a stepwise fashion over 28 days of culture. The prominent feature of the glomerular outgrowth of the glomeruli in the RPGN patients was the presence of large numbers of macrophages, which were not present in cultured control glomeruli. These findings indicate that the immunoregulatory aberration in patients with RPGN may in part be due to IL-1 production by activated macrophages. PMID- 3265285 TI - Acute granulomatous interstitial nephritis due to co-trimoxazole. AB - A 51-year-old man with diabetes mellitus and mild hypertension developed acute interstitial nephritis 4 days after starting a course of co-trimoxazole for bronchopneumonia. Following initial symptoms of overt hypersensitivity, he developed azotemia and renal tubular dysfunction with malaise and anorexia requiring hospitalization. Renal pathology demonstrated an acute granulomatous interstitial nephritis superimposed on chronic diabetic renal disease. PMID- 3265286 TI - [Enzymatic changes in experimental chronic salpingitis following exposure to sinusoidal modulating currents]. PMID- 3265287 TI - HIV antibody testing in Jefferson County, Alabama. The current picture and changes in time. PMID- 3265288 TI - Incidence of uterine cancer and precursor lesions in Alabama women in 1983. PMID- 3265289 TI - Tritium isotope effect in high-pressure liquid chromatography of vitamin D metabolites. AB - A significant chromatographic isotope effect is reported for 1,25 dihydroxyvitamin D3 in a wide variety of HPLC separation systems. The effect is also observed for 24,25-dihydroxyvitamin D3. Retention times differ from less than 1% up to 4% depending on the separation system and the degree and position of tritium substitution. Such an effect must be corrected for whenever both labeled and unlabeled vitamin D metabolites are used in HPLC cochromatography or assay recovery studies. PMID- 3265290 TI - [Orthostatic reactions of cerebral and systemic circulation in patients with tumors of the posterior cranial fossa operated on in a sitting position]. PMID- 3265291 TI - [Functional interaction of dopamine receptors and chronic treatment with dopamine antagonists]. PMID- 3265292 TI - Use of intravenous acyclovir for treatment of herpes zoster ophthalmicus in patients at risk for AIDS. AB - Patients who are homosexual, intravenous drug abusers, or have received multiple blood transfusions are at greater risk to contract the immunosuppressive disorders of acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC). These persons also have a greater chance of developing serious neurologic complications after an episode of Herpes zoster. We present two cases which emphasize the serious complications of Herpes zoster ophthalmicus in such patients. Since systemically administered acyclovir may shorten the disease course and reduce the complications of Herpes zoster in immunocompromised individuals, the authors favor treatment of all such patients who have Herpes zoster ophthalmicus with a seven-day course of high-dose (30 mg/kg/day) intravenous acyclovir. To minimize serious neurologic complications in such patients, treatment should be instituted immediately before the results of human immunodeficiency virus (HIV) testing are known. PMID- 3265293 TI - [Bacteriology of acute otitis, in current practice, in 1987. Therapeutic implications]. AB - After presenting the methodology of their study and the structure of their chain of swabs, the authors report the bacteriological results and therapeutic consequences which they imply. In this study, which was conducted in children between the ages of 3 months and 3 years, Haemophilus influenzae was the bacterium most frequently isolated, regardless of the age-group. It was followed by Streptococcus pneumoniae and Staphylococcus aureus. Neither the recurrent nature of the otitis nor the child's life style influenced the predominance of Haemophilus influenzae. 23% of the strains were beta-lactamase producers. The production of beta-lactamase prevented the use of amoxicillin. The increasingly frequent resistance of Streptococcus pneumoniae and the poor sensitivity of Haemophilus influenzae discourage the use of macrolids; the combination of amoxicillin-clavulanic acid obtained a better score with an efficacy of 89%. PMID- 3265294 TI - [Value of x-ray computed tomography in histiocytic involvements of the base of the skull in children]. PMID- 3265295 TI - Substance use and the resident physician: a national study. AB - A national study of substance use and abuse among resident physicians indicates that except for tranquilizers and barbiturates most illicit use of drugs began prior to medical school and residency. Relatively few residents were aware of substance abuse policies or educational programs in their institutions. PMID- 3265296 TI - Substance use and abuse among senior medical students in 23 medical schools. AB - The current study represents the first large-scale study of substance use and abuse among 2,046 senior medical students at 23 nationally distributed medical schools. With the exception of alcohol and tranquilizers, medical students use less of all such substances than do age-related cohorts from the general population. PMID- 3265297 TI - [Difficulties in distal splenorenal anastomosis]. PMID- 3265298 TI - The sauna and rheumatic diseases. AB - Although sauna bathing is a traditional means of treating rheumatism, its effects on rheumatic diseases have not been studied. Animal studies suggest that hyperthermia could have a favourable effect in cases of chronic rheumatic inflammation. More than fifty percent of patients find that sauna bathing alleviates rheumatic pain and improves joint mobility. The effect is similar in both inflammatory and non-inflammatory disorders. Nearly all men experience sauna bathing as helpful, whereas one-fourth of women find it detrimental. Rheumatic pain is exacerbated and joint mobility decreases on the day after a sauna. Exacerbation of pain is more obvious in non-inflammatory diseases, especially in fibromyalgia, than in inflammatory diseases, and more obvious in women than men. It can be prevented by proper cooling. PMID- 3265299 TI - Factors affecting suitability for coronary bypass surgery. AB - Factors responsible for unsuitability for bypass surgery were assessed prospectively in 324 consecutive patients with serious angina pectoris undergoing cardiac catheterization. One hundred patients were found to be unsuitable for surgery (31%). These patients usually had peripheral coronary atherosclerosis (44%), stenotic/occluded artery distributing to an infarcted (35%) or small area (25%), or reduced global left ventricular (LV) function (15%). Age over 65 years (p less than 0.05), female sex (p less than 0.05), previous myocardial infarction (p less than 0.05), 1-vessel disease (p less than 0.01) and a low LV ejection fraction (p less than 0.01) occurred more often in patients not accepted for surgery. Of the patients with 3-vessel disease 75% were referred for surgery while only 25% of patients with 1-vessel disease (p less than 0.001) Stepwise logistic regression analysis identified LV ejection fraction as an inverse predictor (p less than 0.001) and number of stenotic coronary arteries as a predictor (p less than 0.001) of suitability for surgery. Thus, peripheral coronary atherosclerosis and global LV function are the main factors determining unsuitability for coronary bypass surgery. PMID- 3265300 TI - Incidence and epidemiology of cleft lip/palate in Singapore. AB - This is an on-going study monitoring congenital malformations in all babies delivered in the Kandang Kerbau Hospital, Singapore. Cleft lip and cleft palate as well as a combination of both are among those conditions closely monitored. Up till December 1987, 24 months after the study commenced, a total of 30,411 newborn infants have been screened, out of which 53 infants presented with one of these conditions, an incidence of 0.17% (one per 574 births). There were 26 males and 27 females. During this period, 15,564 males and 14,847 females were delivered; incidence in males was 0.17% and females 0.18%. The incidence in Chinese was 0.20%, Malays 0.14% and Indians 0.09%. Of the 53 cases, 11 (20.7%) have isolated cleft lip, 18 (34.0%) isolated cleft palate and 24 (45.3%) both cleft lip and palate combined. Comparison with a set of controls matched with regards to place and time of delivery, maternal age, maternal parity and ethnic group was made. Analysis of the study and control groups demonstrated that early menarche, regular menstrual periods, and ingestion of traditional medicine were significantly associated with facial clefts. PMID- 3265301 TI - Classification of Chinese cancer patients by dialect group: is it still valid? AB - In Singapore, cancer incidence is documented separately for the different Chinese dialect groups, as a means of providing a possible insight into environmental or genetic factors which may be involved in the aetiological process. Thus, it would be useful to determine whether or not the Chinese population in Singapore still comprises distinct dialect groups. In view of this, an investigation into the dialect group of the parents of 792 hospital in-patients (cases and controls) was carried out. It was found that the vast majority of patients (94.2%), most of whom were born before 1940, had parents of the same dialect group. The percentages of within-dialect marriages were only slightly less for offspring born in Singapore or Malaysia as opposed to China, and decreases with time were small. Thus in 1985-87 Chinese cancer patients and controls in Singapore, of the ages represented in this study may indeed be classified according to their father's dialect and this is likely to be the case for at least the next decade or so. This finding will be of use to cancer epidemiologists as well as others studying Chinese dialect group variations in disease patterns. PMID- 3265302 TI - Types of alpha+ thalassemia in Southeast Asia refugees. AB - We have determined alpha+ deletional thalassemia among 143 Southeast Asia refugees (Cambodians, Laotians, and Vietnameses). Gene frequency of alpha+ deletional thalassemia in Vietnameses (0.035) was found lower than in Cambodians and Laotians (0.11). Bam H1 and Bg1 II analysis indicated that both rightward and leftward thalassemias are encountered, the -alpha 3,7 form is being by far more frequent than the -alpha 4.2 one. Only type I cross-over was found by Apa I digestion on -alpha 3.7 chromosomes. The Rsa I polymorphism, 5' to Z alpha 2 block, is associated with -alpha 3.7 type I haplotype and the site is present in 12 out of 23 chromosomes. All these data suggest at least three origins of alpha+ thalassemia in Cambodia and Laos. PMID- 3265303 TI - Frequency of deletional types of alpha-thalassemia in Kampuchea. AB - The frequency of deletional types of alpha-thalassemias in the Khmer population of Kampuchea (Cambodia) was estimated using DNA techniques. Among 58 healthy adult Kampucheans from rural areas, 17 had alpha-globin gene anomalies. There were 14 heterozygotes and two homozygotes for alpha(+)-thalassemia; the remaining test subject carried a deletion of both alpha-globin genes (alpha(0) -thalassemia of the Southeast Asian type) on one chromosome 16, and triple alpha-globin genes on the other. All of the 18 alpha(+)-thalassemia deletions were of the -alpha 3.7 type (17 subtype I, 1 subtype II). The restriction pattern obtained with the enzyme RsaI and comparison of the intensity of hybridization with alpha-globin and beta-globin gene probes yielded no evidence of total deletion of the alpha gene complex. The prevalence of deletional alpha(+)-thalassemia in Kampuchea is higher, and that of alpha(0)-thalassemia is lower than in neighbouring Thailand. PMID- 3265304 TI - Spontaneous chromosomal anomalies in lymphocytes from xeroderma pigmentosum. A study of ten patients. AB - A cytogenetic study of the lymphocytes from 6 classic and 4 variant forms of xeroderma pigmentosum is reported. This study performed on 978 R-banded metaphases shows that there is no specific chromosomal rearrangement in this disorder. In UDS-deficient forms, the rates of deletions, chromatid gaps and chromosome gaps are significantly increased. The preferential involvement of G bands is discussed. PMID- 3265305 TI - Genetic counselling, carrier detection, and prenatal diagnosis in hemophilia. A service experience. AB - Our experience over three years (1984-1986) is described in carrier detection and prenatal testing for hemophilia. We have analysed 50 families: 37 hemophilia A and 13 hemophilia B, 22 isolated cases and 28 familial. Eighty-three women belonging to this panel asked for a genetic risk. Pedigree and coagulation studies were performed to estimate genetic risks according to the Bayesian method. At this point, 40% of the females at risk were recognized carriers before the DNA analysis. Molecular biology allowed the detection of only 7% more carriers and the exclusion of 34%. In 19% of the cases, it was impossible to estimate the genetic risk because the families were uninformative for the DNA polymorphisms used. Twenty-two prenatal diagnoses were performed; 3 affected male fetuses were recognized by DNA analysis and pregnancies were terminated. Eleven healthy boys were born. PMID- 3265306 TI - CFC syndrome: a syndrome distinct from Noonan syndrome. AB - We report two children with a common pattern of birth defects. Both have very sparse, curly hair, nystagmus and mental retardation. The first one has Noonan syndrome habitus associated with keratosis plantaris and nystagmus; the second one has a slightly Noonan-like face, macrocephaly, keratosis pilaris, and hypertrophic cardiomyopathy. They represent the extreme of a spectrum of congenital defects recently reported independently as CFC syndrome by Reynolds and as "Noonan-like short stature syndrome with sparse hair" by Baraitser and Patton. The clinical features are reviewed and the autonomy of the syndrome with regards to Noonan syndrome, is disputed, since every sign seems to occur independently in Noonan syndrome. The father of the second case probably has a minor syndrome expression, pointing to probable autosomal dominant inheritance. PMID- 3265307 TI - Giemsa-11 technique elucidating three structurally altered nonfluorescent Y chromosomes: r (Y), idic (Yp), dir tan dup (Yp). AB - Three patients are presented in whom a structurally altered Y chromosome was finally diagnosed using Giemsa-11 technique. The first patient, a 19-year-old woman with primary amenorrhea and some features of Turner syndrome had ring (Y). The second patient, a 2-year-old boy with small stature and incomplete masculinization was found to have an isodicentric (Yp). In the third patient who was examined because of ambigous genitalia the chromosome abnormality, a nonfluorescent pseudodicentric (Y) was interpreted as a direct tandem duplication of the short arm, centromere, and a piece of the long arm, a rearrangement not described before. In each of the patients Q-, G-, and C-bandings failed to elucidate the kind of chromosome abnormality. Since clarification of a given Y structural rearrangement by cytogenetic methods cannot be avoided even in the era of molecular genetics, Giemsa-11 technique should be applied in the analysis of every dubious small sex chromosome. PMID- 3265308 TI - Aplasia of the thumbs and great toes as the outstanding feature of Yunis and Varon syndrome. A new entity. A new observation. AB - Aplasia of the thumbs and great toes, and aplasia of terminal and dysplasia of middle phalanges with absence of nails were noted in the child of related parents, who died at the age of 3 months from cardiorespiratory insufficiency. This is the 7th case of an (AR) genetic syndrome called after Yunis and Varon. PMID- 3265309 TI - A further 46,XYp- female. AB - A 24-year-old female with a Swyer syndrome phenotype was found to have a 46,X,del (Y) (p11) karyotype. This observation is consistent with the recently confirmed assignment of the testis-determining master gene to the deletion interval 1A of the Y (Page et al., 1987). Otherwise, it illustrates the etiological heterogeneity of the Swyer phenotype and allows to emphasize the de novo origin of XYp-females. PMID- 3265310 TI - A case of monosomy 21. AB - A new case of monosomy 21 was observed in a newborn male. Characteristic clinical features include: an antimongoloid eye slants, large and low set ears, flat nose bridge, hypoplastic nipples, cardiac anomalies, muscular hypotonia, retarded psychomotor development. The karyotypes of the parents were normal. PMID- 3265311 TI - [Ring chromosome 9. Case report and review of the literature]. AB - We report on a girl with ring chromosome 9, and review the 9 other cases of the literature. The main signs of this de novo chromosomal anomaly are: severe microcephaly, growth and psychomotor retardations, and heart malformations. Infectious complications occurs often. We found a decreased level of leucocyte interferon. PMID- 3265312 TI - Partial duplication 14q/deletion 2q in two sibs due to t(2;14) (q37.1;q31.2) pat. AB - Two siblings are described with duplication 14q/deletion 2q due to a paternal translocation (2;14) (q37.1;q31.2). The first one, a boy, born at term, lived 14 days. The second one, a female foetus, was born after induced labour when the anomaly was discovered by way of amniocentesis. They both had almost identical phenotypes. From a study of the literature it is inferred that a typical asymmetric head form, low set abnormal ears, micrognathia, long upper lip, rib anomalies, camptodactyly, long fingers and contractures are prominent features of the syndrome. PMID- 3265313 TI - [Interstitial deletion in the long arm of chromosome 7]. AB - An interstitial deletion of 7q (q31.2-q32.3) is reported. Main features of this boy included facial dysmorphy, psychomotor retardation and absence of language. PMID- 3265315 TI - Monoclonal antibodies IPO-3 and IPO-10 against human B cell differentiation antigens. AB - Monoclonal antibodies (mAbs) IPO-3 and IPO-10 were generated following immunization of a BALB/c mice with human cell lines RPMI-1788 and Daudi respectively. The reactivity of these mAbs was studied by indirect immunofluorescence technique with 10 human cell lines, blood cells of healthy persons and patients with the malignant lymphoproliferative diseases. Studies of normal and neoplastic B cells suggest that mAbs IPO-3 and IPO-10 which recognize antigens are B lineage restricted. The presence of an antigen defined by the mAb IPO-10 appears to include most but not all the stages of B cell differentiation, whereas IPO-3 detected antigen is not represented on resting B cells and has a very limited expression on activated B lymphocytes. The results obtained with mAbs IPO-3 and IPO-10 are discussed in relation to other known B cell surface markers. PMID- 3265314 TI - Interleukin-2 differentially affects the proliferation of a hormone-dependent and a hormone-independent human breast cancer cell line in vitro and in vivo. AB - Direct in vitro and in vivo effects of the lymphokine, interleukin-2 (IL-2), on hormone-dependent (MCF-7) and- independent (MDA-231) human breast cancer cell proliferation were investigated. In vitro, picomolar concentrations of IL-2 directly inhibited MCF-7 cell proliferation after 12 days of culture, while nanomolar doses of IL-2 significantly stimulated MCF-7 cell growth over the same time period. In addition, micromolar concentrations of IL-2 had virtually no effect on the in vitro proliferation of MCF-7 cells. In parallel in vitro growth experiments, the hormone-independent cells, MDA-231, were not affected by IL-2 regardless of concentration. IL-2 treatment of overiectomized, estrogen-treated nude mice, burdened with MCF-7 or MDA-231 tumors, inhibited MCF-7 tumor growth, but had no effect on MDA-231 tumors. Examination of T, B and natural killer (NK) cell function in these animals indicated that the interleukin-2-mediated effect on MCF-7 cell growth in vivo is independent of the proliferative abilities of these lymphoid cells, suggesting that IL-2 may directly affect the growth of these hormone-dependent human breast cancer cells. PMID- 3265317 TI - [Effect of ribonucleases on humoral immunity of experimental animals]. AB - The stimulating effect of RNAases on the humoral immune response was observed in experiments with animals. It was shown that the stimulation was mainly mediated by the system of T-lymphocytes. In the T-lymphocyte system positive sensitivity to the enzymes was attributed to the T-helper cell subpopulation. PMID- 3265316 TI - Trace metals, surface receptors and growth of human normal and leukemic lymphocytes. AB - To evaluate the modulatory effects of trace metals on lymphocyte growth and maturation, thymidine uptake (TU), protein, ATP, Fe, Cu, Zn, ferritin, CD3, CD4, CD8 antigens, surface transferrin receptors (TFR) and interleukin 2 receptors (IL2R) were assessed in normal and T cell leukemia human lymphocytes, cultured in media with varying Fe, Cu and Zn concentrations [Me]. In normal lymphocytes in media with optimal [Me], all values increased significantly after PHA stimulation, except for intracellular metal concentration and CD3+, CD4+, CD8+ cells which were unchanged. In media with low or high [Me], all parameters except for CD8+ cells were decreased. In unstimulated ALL lymphocytes grown in media with optimal [Me], TU, protein, ATP, CD4+, Fe, Cu and ferritin were higher and Zn and CD8+ lower than in unstimulated normal cells: they did not change after PHA stimulation, except in media with low [Me], in which they approached the values of stimulated normal lymphocytes. TFR and IL2R for ALL cells were high in all media: IL2R but not TFR increased after PHA stimulation. No relationship between IL2R and TFR was demonstrable in any media. We conclude that the response of normal lymphocytes to stimuli is sensitive to variation in trace metals, whereas this response, absent in ALL lymphocytes, reappears only in media with low [Me] and is independent from TFR. PMID- 3265319 TI - [Breda virus and hemorrhagic enteropathy. Reminder apropos of 1 case]. PMID- 3265318 TI - [Urachal cyst infection caused by Haemophilus influenzae]. AB - The case of a 5 year-old boy with urachal cyst infection due to Haemophilus influenzae is reported. The difficulties encountered in isolating this bacteria when the correct procedures are not used can explain the apparent rarity of such infections. Physiopathological mechanisms of this infection are discussed with respect to the characteristics of the strain. PMID- 3265320 TI - [Azo dye from 4-aminobenzoic acid and thymol--proof of 4-aminobenzoic acid as a degradation product of procaine]. PMID- 3265321 TI - [Computed tomography with thallium-201 and oral dipyridamole in the diagnosis of coronary artery disease]. PMID- 3265322 TI - Congenital adrenal hyperplasia in females with virilized genitalia: the problem of delayed diagnosis. AB - Six girls with the non-salt-losing form of congenital adrenal hyperplasia are described. Diagnosis was delayed in five, the range of ages of diagnosis being 19 months-7 years. In the sixth, despite early diagnosis and medical treatment, surgery was delayed electively until she was 3 years old. The five in whom diagnosis was delayed were all virilized with a markedly advanced bone age and reduced adult height prognosis. Diagnosis was delayed for a variety of reasons: misinterpretation of laboratory data (one), lack of availability of medical assistance (one), language problems (one), maternal inexperience (one), and failure of the doctor to recognize an obvious clinical abnormality (one). All six children came from immigrant families, and all except one was born in a major centre. None was born before 1979. PMID- 3265323 TI - Agar plating technique for enumeration of IL-2 producing cells in human peripheral blood mononuclear leukocytes. AB - An agar plating technique for detection and enumeration of IL-2 producing cells from human peripheral blood mononuclear leukocytes (PBML) has been developed. This method is based on the principle that PHA-stimulated PBML, as effector cells, secrete interleukin 2 (IL-2) into soft agar containing mouse 3-day Con A blasts as IL-2 dependent responder cells. The IL-2 dependent Con A blasts proliferating around the IL-2 producing cells form colonies or clusters of cells and are easily visualized under a dissecting microscope. The development of IL-2 producing cells was optimum when 1 X 10(6) cells/ml PBML were stimulated with 2 micrograms/ml PHA-P for 4 hours, and when 2.5 X 10(5) cells were co-cultured with 6 X 10(6) Con A blasts in soft agar for 5 days. The average number of IL-2 producing cells in 10 normal healthy controls were 754 +/- 94 (mean +/- S.E.M.) cells/10(6) PBML. The numbers of IL-2 producing cells and the levels of IL-2 produced were highly correlated (r = 0.929). The subpopulation of lymphocytes in the colonies was shown to be mostly murine T-cells, since they were mostly Thy 1.2 positive, CD3 negative and surface immunoglobulin negative. This technique is very simple to perform and provides an accurate and straightforward means to enumerate IL-2 producing cells from human PBML in a variety of human immunologic disorders. PMID- 3265324 TI - Interleukin-2 induced activation of natural killer cells in rats and mice: a comparative study. AB - Effects of interleukin-2 (IL-2) on the natural killer (NK) activities of BALB/c mouse and Wistar rat spleen cells were compared. While mouse spleen cells cultured alone rapidly lost NK activity, co-culture with IL-2 resulted in a marked enhancement of NK activity. In contrast, the levels of NK activity of rat spleen cells cultured alone increased and remained high for 3 days and declined thereafter. Addition of human recombinant IL-2 or purified rat IL-2 did not influence the NK levels in rat spleen cell bulk cultures. Both IL-2 preparations were however biologically active as shown by their capacities to induced proliferation in rat spleen cells. Rat spleen cells suppressed the IL-2 activation of mouse spleen cells in a dose dependent manner, indicating a suppressor influence generated by rat spleen cells. Culture supernatants of rat spleen cells cultured with or without IL-2 for 3 or 5 days could also suppress the mouse spleen NK activation in response to IL-2. The suppressor activity could be concentrated on a 5K MW cut-off Amicon filter indicating that the molecular weight of the factor is more than 5000. These results indicate that a suppressor of IL-2 induced NK activation of mouse spleen cells is released by cultured rat spleen cells. PMID- 3265325 TI - Acellular DTP vaccine produces fewer reactions. PMID- 3265326 TI - Studies mixed on efficacy of Haemophilus influenzae B vaccine. PMID- 3265327 TI - Translational control of alpha-amylase gene expression in Aspergillus awamori. PMID- 3265328 TI - [Open clinical trial of tenoxicam in parenteral form in patients with acute rheumatic pain]. PMID- 3265329 TI - Comparative analysis of gp41 antigens by enzyme-linked immunosorbent assays for detecting antibodies to human immunodeficiency virus type 1. AB - We have compared the antigenic qualities of human immunodeficiency virus type 1 (HIV-1) gp41 glycoprotein with a synthetic oligopeptide (peptide R21S) and a bacterially synthesized protein (protein 566), which are homologous with the N terminal region of gp41, in enzyme-linked immunosorbent assays (ELISA) for detecting antibodies to HIV-1 in sera of patients with the acquired immunodeficiency syndrome (AIDS) or the aids-related complex (ARC). Although the use of all three types of antigens readily allowed the detection of antibodies in human sera, ELISA employing purified gp41 glycoprotein and the protein 566 were more specific and sensitive than the peptide R21S ELISA. PMID- 3265330 TI - Selective cytotoxic activity of immunotoxins composed of a monoclonal anti-Thy 1.1 antibody and the ribosome-inactivating proteins bryodin and momordin. AB - The ribosome-inactivating proteins, bryodin, from Bryonia dioica, and momordin, from Momordica charantia, were coupled by a disulphide bond to a monoclonal anti Thy 1.1 antibody (OX7). Both immunotoxins were specifically cytotoxic to the Thy 1.1-expressing mouse lymphoma cell line AKR-A in vitro. The OX7-bryodin immunotoxins were the more powerfully toxic and reduced protein synthesis in AKR A cells by 50% at a concentration of 1-4 x 10(-11) M as compared with 1 x 10(-9) M for the OX7-momordin immunotoxins. Neither of the immunotoxins was toxic to mouse lymphoma EL4 cells, which lack the Thy 1.1 antigen, at concentrations up to 3 x 10(-8) M. Further, bryodin and momordin immunotoxins made from an antibody (R10) of irrelevant specificity were without effect on AKR-A cells. PMID- 3265331 TI - Cyclosporin A prevents the anti-murine antibody response to a monoclonal anti tumour antibody in rabbits. AB - Repeated therapy of cancer with mouse monoclonal antibodies frequently produces antibodies directed against the administered antibody. We have investigated the ability of cyclosporin A (CsA) and the use of ultracentrifuged antibody to prevent the formation of anti-antibodies in rabbits. Courses of CsA, 20 mgkg-1 day-1, were given intramuscularly for 6 days to rabbits and a mouse monoclonal anti-human chorionic gonadotrophin antibody was given intravenously on day 2 with or without ultracentrifugation to remove microaggregates. The whole course was repeated after an interval of two weeks. Rabbit anti-mouse antibody production was prevented in all 8 animals that were given CsA and ultracentrifuged preparation (non UC-W14). Anti-mouse antibody was produced by all the animals that were not given CsA. A further dose of mouse antibody eight weeks after CsA demonstrated that immunological recovery had occurred in all four animals re challenged with non UC-W14 but only 3/7 animals given an UC-W14 preparation. This suggests that CsA and ultracentrifugation facilitate the induction of immunological tolerance. The complete suppression of antibody production which could be achieved justifies a clinical trial of CsA and ultracentrifugation of antibody. PMID- 3265332 TI - Fucosylated forms of alpha-1-antitrypsin that predict unresponsiveness to chemotherapy in ovarian cancer. AB - We have discovered modified fucosylation of alpha 1-antitrypsin (F-AT) in the sera of ovarian cancer patients. This was detected by SDS/electrophoresis and silver-staining after extracting the sera with the fucose-binding lectin, Lotus tetragonolobus, and was identified as alpha 1-antitrypsin by Western blotting. Initially, high F-AT levels appeared to be related to the recurrence of cancer, but later measurements showed that elevated levels were also present in patients who did not respond to therapy. Using an arbitrary grading system, the level of F AT was assessed in pairs of sera from 29 ovarian cancer patients undergoing therapy; one specimen collected just after the start of therapy and the other on a later occasion. In 75% of the 15 non-responders, F-AT was higher when measured on a second occasion; whereas in 86% of the 14 responders the second measurement was either unchanged or lower, being frequently undetectable. F-AT levels were also low or undetectable in sera from healthy women. Eight responders were monitored for F-AT throughout cyclophosphamide chemotherapy. Despite a high tumour burden at the start of therapy, all patients had relatively low levels of F-AT and this was maintained throughout remission; the levels only becoming elevated with the recurrence of tumour growth. Increased F-AT expression did not appear to be particularly associated with the presence of liver metastases and frequently predated any clinical signs of a recurrence. The interesting characteristics of these molecules could make them useful in the management of ovarian cancer. PMID- 3265333 TI - Repeated antitumour antibody therapy in man with suppression of the host response by cyclosporin A. AB - Antibody targeted therapy of cancer results in anti-antibody production which prevents repeated treatment. Cyclosporin A (CsA) has been used to suppress this response in patients treated with a radiolabelled antibody to carcinoembryonic antigen (CEA). Patients with CEA producing tumours received a minimum of two courses consisting of an injection of radiolabelled antibody and CsA, 24 mg kg-1 day-1, for 6 days; each course was given at 2 week intervals. Two weeks after the completion of the second course the mean human antimouse antibody (HAMA) levels were 3.5 micrograms ml-1 (s.d. 2.7) in 3 patients receiving CsA and 1,998 micrograms ml-1 (s.d. 387) in 3 patients not receiving the drug. Clearance of antitumour antibody was accelerated and tumour localisation absent when HAMA levels exceeded 30 micrograms ml-1. With lower levels of HAMA in the CsA-treated patients, further antitumour antibody accumulated in the tumour after each dose. Further therapy with antitumour antibody and CsA lead to the development of HAMA, but this was less than 25% of the amount in patients not given CsA. In this preliminary study up to 4 times as many doses of antitumour antibody could be usefully given when CsA was used. This increases the potential for effective antibody targeted therapy of cancer. PMID- 3265334 TI - Diversity in migration of CD4 and CD8 lymphocytes in different microanatomical compartments of the skin in the tuberculin reaction in man. AB - The lymphocytes in the perivascular foci of tuberculin skin tests have a similar CD4:CD8 ratio to those in the peripheral blood, suggesting that these subsets do not show bias in their initial emigration. By contrast, the diffusely infiltrating lymphocytes show a relative preponderance of CD4 cells which is progressively greater in successive 250 micron layers into the dermis. A generally similar pattern is seen in healthy controls and in patients with untreated pulmonary tuberculosis, treated leprosy, haemophilia A and chronic obstructive lung disease (COLD) patients treated with prednisolone, but the gradient of increasing CD4:CD8 ratio with depth into the dermis is significantly less steep in patients with tuberculosis, haemophilia and prednisolone-treated COLD than in the healthy controls. Selective migration results in a relative preponderance of CD4 cells in the diffuse infiltrate and it is suggested that this is a mechanism likely to potentiate defensive reaction to Mycobacterium tuberculosis: any deficiency in selective migration may make immunological defences less effective and so contribute to the chronicity of the lesions of tuberculosis. PMID- 3265335 TI - Increased incidence of malignant melanoma of the skin in workers in a telecommunications industry. AB - In 1982 physicians at a hospital melanoma clinic in Montreal noticed that among their patients there had been seven men working in a single telecommunications company. This raised suspicions that working in that industry might be associated with development of malignant melanoma of the skin (MMS). A preliminary gross comparison with general population rates indicated that there was an increased risk in this working group. To estimate the risk of MMS more accurately, a standardised incidence ratio (SIR) was calculated based on the rates of MMS in the local population of the Greater Metropolitan Montreal Area for the years 1976 83. During that period, among workers in all plants for the company, 10 male cases of MMS were observed for an expected number of 3.7 (SIR = 2.7; 95% CI = 1.31-5.02). No cases were observed among female workers (expected = 1.3). The excess was significant among cases with a short latency (less than 20 years since beginning of employment). There was no apparent pattern of exposure based on job titles or departments. PMID- 3265336 TI - Characterization of the rat osteocalcin gene: stimulation of promoter activity by 1,25-dihydroxyvitamin D3. AB - Osteocalcin is an abundant noncollagenous protein in bone, and its synthesis is stimulated by 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]. In this study, the rat osteocalcin gene was isolated, sequenced, and found to be a single-copy gene that is highly conserved between human and rat. Northern blot analysis of RNAs from a number of rat tissues revealed osteocalcin mRNA only in calvariae, consistent with bone-specific expression of osteocalcin. In order to investigate promoter activity and its modulation by 1,25(OH)2D3, plasmids containing the osteocalcin promoter region linked to the reporter enzyme bacterial chloramphenicol acetyltransferase (CAT) were used to transfect rat osteosarcoma ROS 17/2.8 cells, which express osteocalcin endogenously, and UMR 106 cells, which lack osteocalcin expression. Transfected ROS 17/2.8 cells exhibited a higher basal CAT activity than UMR 106 cells. Moreover, 1,25(OH)2D3 stimulated the CAT expression 5-10-fold only in ROS 17/2.8 cells and not in UMR 106 cells. By use of unidirectional deletion analysis, a domain strongly responsive to 1,25(OH)2D3 was identified between bases -1035 and -871 upstream from the site of transcription initiation, while a weakly responsive region was found further downstream. PMID- 3265338 TI - The innervation of the immature rat ovary by calcitonin gene-related peptide. AB - Calcitonin gene-related peptide (CGRP) has been found in nerves that innervate the rat ovary. In this study we used indirect immunohistochemical methods to investigate the normal distribution of CGRP-immunoreactive fibers in the prepubertal rat ovary and to determine the route by which these fibers reach the gland. Additional experiments were performed to examine the possible colocalization of CGRP with immunoreactivities of substance P-, neuropeptide Y-, and tyrosine hydroxylase. Potential effects of CGRP on estradiol and progesterone secretion were explored with cultured granulosa cells and short-term incubation of whole ovaries in vitro. In ovaries with intact nerves, CGRP-labeled fibers were observed in dense plexuses surrounding the ovarian vasculature. Additional fibers were found occasionally in the interstitial tissue and in the vicinity of ovarian follicles. Surgical transection of the plexus nerve completely eliminated CGRP immunoreactivity. Section of the superior ovarian nerve or the abdominal vagal trunks had no discernible effect on CGRP labeling. Additional studies revealed coexistence of CGRP and substance P in several axons. Neither tyrosine hydroxylase nor neuropeptide Y-immunoreactivity was co-localized in CGRP containing fibers. CGRP (10(-10) - 10(-6) M) had no effect on the basal or follicle-stimulating hormone-stimulated release of estradiol or progesterone from ovaries of pregnant mare's serum gonadotropin-treated rats or from cultured granulosa cells from hypophysectomized, diethylstilbestrol-treated rats. We conclude that CGRP-containing nerves enter the ovary via the plexus nerve and are probably involved in the regulation of vasomotor function. PMID- 3265337 TI - Mitogenic signaling pathways regulating expression of c-myc and ornithine decarboxylase genes in bovine T-lymphocytes. AB - Expression of the c-myc and ornithine decarboxylase (ODC) genes is elevated early after mitogenic activation of T-lymphocytes, and regulation of the two genes seems to be coupled to transmembrane signaling pathways that are in part different. The evidence is consistent with protein kinase C (PKC) being both necessary and sufficient to induce expression of the ODC gene in response to treatment of T-cells with either the mitogen concanavalin A (Con A) or biologically active phorbol esters. Furthermore, there seems to be no involvement of events dependent on calmodulin (CaM) in the regulation of ODC in these cells. The situation with c-myc is more complex. In contrast to ODC, transcription of this gene is not stimulated by treatment of resting T-cells with phorbol esters alone, but the cells respond to phorbol esters in combination with the calcium ionophore ionomycin. Induction of the c-myc gene by Con A is inhibited by CaM antagonists. These results are consistent with a model in which transcriptional activation of the c-myc gene in resting T-lymphocytes requires two signals, one from PKC and the other involving CaM. PMID- 3265339 TI - Post-vasectomy sperm autoimmunogens in the Lewis rat. AB - Vasectomy was performed on inbred Lewis rats to induce anti-sperm autoantibodies and to identify their cognate autoantigens. Different detergent extracts of cauda epididymal spermatozoa were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), blotted to nitrocellulose, and probed with sera from pre-vasectomy, post-vasectomy, and hyperimmunized animals to detect isologous sperm antigens. Nonreduced SDS-soluble autoantigens at greater than 200, 86, 43, and 26 kDa were bound by post-vasectomy antisera. Reduction of SDS soluble antigens resulted in increased staining of the 86, 72-63, and 43 kDa autoantigens. Laemmli extraction of SDS insoluble pellets with beta mercaptoethanol generated the largest repertoire of autoantigens including several autoantigens found in SDS-soluble extracts. Therefore, to analyze the entire repertoire of post-vasectomy autoantigens, whole sperm were extracted with Laemmli buffer under reducing conditions. Autoantiserum from most vasectomized animals bound Laemmli-extracted reduced autoantigens of approximately 86 (89-78), 63, 43, and 20 (21-16) kDa. Testicular extracts, reduced and separated by SDS PAGE, contained autoantigens of 76, 60, and 42 kDa that were also recognized by hyperimmune and post-vasectomy antisera. The repertoire of sperm antigens recognized by pooled serum from hyperimmunized animals was similar to the cumulative repertoire recognized by post-vasectomy sera. These studies define several major sperm autoimmunogens recognized by post-vasectomy antisera and indicate that many of these peptide autoimmunogens are disulfide-bonded complexes. PMID- 3265340 TI - Gastrointestinal haemorrhage in elderly people. AB - The management of elderly patients with gastrointestinal haemorrhage is controversial. This review argues that early surgery may be appropriate for patients over the age of 60 but as they reach 75 and over it may be preferable for surgery to be delayed. PMID- 3265341 TI - Leucocyte infiltration and cartilage proteoglycan loss in immune arthritis in the rabbit. AB - 1. The relationship between phagocytic leucocyte infiltration and cartilage degradation in immune arthritis has been investigated in groups of normal and neutropenic rabbits. 2. Injection of antigen into the knee joints of sensitized control animals induced joint swelling, prostaglandin E2 (PGE2) synthesis, leucocyte accumulation and proteoglycan loss from articular cartilage. 3. Intravenous injection of nitrogen mustard caused a selective depletion of circulating neutrophils and monocytes with little or no effect on platelets or lymphocytes. In neutropenic animals challenged with antigen, there was virtually no joint swelling, PGE2 synthesis or leucocyte infiltration but cartilage proteoglycan loss was unchanged after 1 day and increased by day 4 compared to control animals. 4. The numbers of circulating leucocytes returned to normal 3-4 days after nitrogen mustard treatment and leucocyte infiltration occurred in antigen-challenged joints but this was not accompanied by joint swelling. Subsequent intra-articular injection of PGE2 did, however, cause swelling. 5. Lysosomal enzyme levels in arthritic joint fluids were measured. The levels of beta-glucuronidase, which is released by activated phagocytes, were decreased in neutropenic animals but the levels of N-acetyl-beta-glucosaminidase, which is a marker of tissue damage, were not changed by neutrophil depletion. 6. Intra articular injections of the cytokine interleukin-1 (IL-1) induced a pattern of leucocyte infiltration and cartilage proteoglycan loss similar to that seen in immune arthritis. In neutropenic animals, IL-1 did not cause significant accumulation of leucocytes in the joint but the loss of proteoglycan from cartilage was unimpaired. 7. These results indicate that both leucocyte infiltration and prostaglandin synthesis are required for joint swelling but that tissue degradation is mediated by resident cells. It is likely that release of IL 1 by synovial cells stimulates the synthesis and activation of metalloproteinases which initiate the process of tissue degradation. PMID- 3265342 TI - Detergent and methylene blue affect endothelium-dependent vasorelaxation and pressure/flow relations in rat blood perfused mesenteric arterial bed. AB - 1. The autoperfused superior mesenteric arterial bed of the rat was used to study the opposition by carbachol of pressor responses to noradrenaline and the effects of methylene blue, the detergent CHAPS and indomethacin on pressure/flow relations. 2. Carbachol (1 ng-3 micrograms) reduced the pressor response to 1 microgram noradrenaline in a dose-dependent manner with an ED50 = 25.5 +/- 6.0 ng and a maximum inhibition of 51.8 +/- 1.9%. Perfusion of the mesenteric bed with 0.3% CHAPS in saline for 150s abolished the reduction by carbachol of the noradrenaline pressor response. The effect of carbachol was also abolished by infusion of 1% methylene blue into the mesenteric vascular bed. Indomethacin (5 mg kg-1) was without significant effect on the carbachol opposition of noradrenaline pressor responses. None of the 3 treatments had any effect on the response to 1 microgram noradrenaline. 3. Perfusion with CHAPS before determination of pressure/flow relations, or infusion of methylene blue during their determination, steepened the regression of pressure upon flow to the same extent; at all the flow rates used (0.4-3.54 ml min-1) pressure was greater as a result of the treatment than in control animals. Pretreatment with indomethacin had no effect on pressure/flow relations. 4. It is concluded that carbachol opposition to noradrenaline pressor responses in the blood perfused superior mesenteric arterial bed of the rat shows the characteristics of being mediated by endothelium-dependent relaxing factor (EDRF). Since vascular resistance increases more rapidly than in controls when the endothelium is functionally inhibited by treatment with CHAPS or perfusion with methylene blue, it appears that EDRF has a role in vivo in the modulation of myogenic vascular tone. PMID- 3265343 TI - Influence of haemoglobin and erythrocytes on the effects of EDRF, a smooth muscle inhibitory factor, and nitric oxide on vascular and non-vascular smooth muscle. AB - 1. The relaxant action of endothelium-derived relaxing factor (EDRF), the smooth muscle inhibitory factor (IF) isolated from the bovine retractor penis (BRP), nitric oxide (NO) and sodium nitroprusside (NaNP) on four vascular and non vascular smooth muscle preparations has been examined. Their sensitivity to EDRF, the IF and NO was the same, suggesting all might be NO. Sodium nitroprusside produced complete relaxation of the rat anococcygeus at low doses, suggesting an action additional to the intracellular release of NO. 2. Haemoglobin added to solutions of EDRF, activated IF or NO completely removed their relaxant properties, consistent with all three acting by virtue of NO. 3. Suspensions of red blood cells with a haemoglobin concentration equivalent to to that used in the previous experiments were as effective as haemoglobin in abolishing the relaxant effect of EDRF or NO but were ineffective against the activated IF. 4. The similarity in sensitivity of a series of smooth muscles and the binding by haemoglobin are consistent with NO being the active principle of both EDRF and the acid activated IF. The abolition of the effect of EDRF by red blood cells (RBCs) is further confirmation for this hypothesis, but the ineffectiveness of RBCs against acid-activated IF suggests that either the latter is not NO or that it is bound in a way which makes it unable to diffuse through cell membranes. PMID- 3265344 TI - 99Tcm-HMPAO single photon emission tomography in the diagnosis of cerebral barotrauma. AB - Cerebral barotrauma, or the neurological manifestation of the "bends", is a relatively common disease of divers and aviators. To date, however, no-one has succeeded in demonstrating a cerebral or spinal cord lesion in vivo following a decompression incident, despite the presence of definitive clinical signs and symptoms of central nervous system involvement. This paper describes the use of 99Tcm-labelled hexamethylpropyleneamine oxime (99Tcm-HMPAO) with single photon emission tomography in a study of three individuals involved in driving accidents. All three suffered cerebral barotrauma during decompression and all exhibited clinical signs and symptoms of dysbarism to a varying degree. Imaging was performed at time intervals ranging from 2 h to several days following the incidents. The results showed well defined cerebral ischaemic lesions in all three subjects. We conclude that 99Tcm-HMPAO imaging provides a significant advance in locating and demonstrating cerebral lesions following barotrauma and will contribute greatly to our understanding of the pathophysiological processes involved. PMID- 3265345 TI - Three-dimensional shaded-surface images from positron tomography using MUP-PET. PMID- 3265346 TI - Experience with the Brindley anterior sacral root stimulator. AB - Brindley anterior sacral root stimulators have been implanted into 22 spinal cord injured patients from the spinal injury units in Cardiff and Sheffield. The group comprised 20 men and 2 women (15 paraplegics and 7 tetraplegics); 16 patients are using the implant, of whom 11 (68%) are continent. Of the remaining 5, 4, who empty completely, are incontinent because of inability to use the implant with sufficient frequency; 6 patients are not using their implant, though 4 are continent. Of 11 patients with detrusor/sphincter dyssynergia, sphincterotomy was necessary in 3 patients before implantation and in a further 3 after implantation. Of 4 patients with abnormal upper tracts prior to implantation, 2 resolved and 2 deteriorated, in the presence of dyssynergia; 1 patient developed hydronephrosis after implantation, having previously had normal upper tracts. Although erectile function with the stimulator was clinically adequate in 6 patients, in no patient has intercourse been achieved because of concurrent lower limb spasm. PMID- 3265347 TI - Effects of low dose perioperative interferon on the surgically induced suppression of antitumour immune responses. AB - General surgical procedures are followed by a period of generalized immunosuppression that may favour the deposition of metastases seeded at operation in patients with malignant disease. In an attempt to prevent the suppression of host-antitumour immune mechanisms following surgery we have studied the immunological effects of low-dose perioperative interferon-alpha (r HuIFN alpha). Patients were randomly allocated pre-operatively to the control (n = 15) or treatment group (n = 15). Patients in the treatment arm received a 1 week course of subcutaneous recombinant human interferon-alpha 2a (Roferon-A) at a dose of 2 megaunits daily starting on the evening before surgery. Natural killer cell, lymphokine activated killer cell cytotoxicities and endogenous interleukin 2 production were measured 1 day before surgery and on the first, third, fifth and tenth postoperative days. Treatment with r-HuIFN alpha did not prevent the postoperative impairment of interleukin 2 production or lymphokine activated killer cell cytotoxicity. However it prevented the fall in natural killer cell activity normally observed following surgery. This may have important consequences in controlling metastatic dissemination of tumour in this vulnerable period. PMID- 3265348 TI - Brain modulation of the immune system: association between lymphocyte responsiveness and paw preference in mice. AB - An association between handedness and immune disorders has been described in man, left-handers being more susceptible to autoimmune or allergic diseases. However, this correlation was established between handedness and clinical signs of immune disorders without studying immune functions. Using an animal model, we demonstrated for the first time an association between handedness and lymphocyte reactivity. Left-handed mice were shown to exhibit higher mitogen-induced T lymphocyte proliferation than right-handed animals. PMID- 3265349 TI - An increase in the expression of neuropeptidergic vasodilator, but not vasoconstrictor, cerebrovascular nerves in aging rats. AB - Perivascular nerve fibres containing noradrenaline (NA), serotonin (5-HT), substance P (SP), vasoactive intestinal polypeptide (VIP), neuropeptide Y (NPY) and calcitonin gene-related peptide (CGRP) were localized in whole-mount stretch preparations of the arteries of the rat circle of Willis using fluorescence and immunohistochemical techniques. Changes in the pattern and density of these perivascular nerves were studied from birth to 27 months of age. All perivascular nerve types reached a peak density of innervation at 1 month of age. This was followed by a general fall in the density of fluorescent nerve fibres. However, with aging, there was a decrease in the expression of vasoconstrictor neurotransmitters (NA and 5-HT) in cerebrovascular nerves, whereas the expression of vasodilator neurotransmitter (VIP and CGRP) in perivascular nerve fibres supplying the rat cerebral arteries was strikingly increased in old age. The density of NPY- and SP-containing nerve fibres was not significantly altered in old age. These changes are discussed in relation to the increased incidence of cerebrovascular disorders in the elderly. PMID- 3265351 TI - Stress and disease in cattle. PMID- 3265350 TI - [Heart surgery in 2 previously pneumonectomized patients]. AB - Two cases of cardiac surgery under cardiopulmonary bypass in previously pneumonectomized patients are reported. In one case a postoperative tension pneumothorax required an emergency drainage. No other complications occurred. The authors describe their technique and underline the value of an adequate pre operative respiratory preparation and a systematic drainage of the pleural cavity. PMID- 3265352 TI - Nutrient requirements of diseased, stressed cattle. AB - Cattle encounter numerous stressors during movement to feedlot or pastures for growing and finishing. Of utmost importance are diets that will be consumed and furnish the essential nutrients. Different diets and management systems may be required for different groups of cattle, and in this article, some nutrient requirements for these different groups are discussed. PMID- 3265353 TI - Adjusting rations for climate. AB - Cold conditions resulting from a combination of temperature, wind, and wetness result in increased energy required for maintenance. Constant levels of intake reduce energy available for production. Direct effects of cold include reduced rate and efficiency of growth and milk production. Indirect effects on measures of reproductive efficiency are well documented. Impacts on health and longevity are perhaps less obvious but are no doubt affected. Energy supplementation is an obvious need for cold-stressed animals. For maximum effectiveness, efforts should incorporate a systems approach and integrate the expertise of many disciplines into a logical decision-making process. The entire spectrum of animal response, not just short-term acute response, must be included in environmental management. PMID- 3265354 TI - Dust emissions in cattle feedlots. AB - Dust emissions were measured at three Texas cattle feedlots on 15 occasions in 1987 to determine concentrations of total suspended particulate matter (TSP) and dust with 10 microns or less aerodynamic particle size (PM-10). Net feedlot dust concentrations (downwind minus upwind) ranged from 15.7 to 1,700.1 micrograms per m3 and averaged 412.4 +/- 271.2 micrograms per m3, which is about 37 per cent less than was determined in feedlot dust research in California approximately 17 years earlier. Upwind concentrations averaged 22 per cent of the downwind concentrations. Feedlot dust concentrations were generally highest in early evening and lowest in early morning. Using the Wedding and Andersen-321A PM-10 samplers, the PM-10 dust concentrations were 19 and 40 per cent, respectively, of mean TSP concentrations in direct comparisons. There was good correlation between PM-10 and TSP concentrations. Although dust concentrations decreased with increasing moisture, the correlation coefficients were relatively low. Odor intensity appeared to increase with decreasing net dust concentrations, perhaps due to moisture influences. Mean particle sizes of feedlot dust were 8.5 to 12.2 microns on a particle volume basis and 2.5 to 3.4 microns on a population basis. Respirable dust (below 2 microns) represented only 2.0 to 4.4 per cent of total dust on a particle volume basis. Under conditions of these experiments, the feedlots often exceeded both state and federal (U.S. Environmental Protection Agency) standards for TSP concentrations and for PM-10 concentrations measured using the Andersen-321A sampler. However, feedlots were below the new U.S. Environmental Protection Agency standards when the Wedding PM-10 sampler was used for measuring dust emissions. PMID- 3265355 TI - Auricular electroacupuncture for postthoracotomy pain. PMID- 3265356 TI - Ventilatory threshold and training heart rate in exercising cardiac patients. AB - The purpose of this study was to determine the relationship between previously prescribed training heart rates (THR) for patients training for six months or more in a cardiac rehabilitation program (CRP), calculated Karvonen percentage heart rate reserve (THRk), and the ventilatory threshold (VT). In twenty male patients (ages 41-63) with documented coronary heart disease (CAD) [non medicated] mean training heart rate (THR, 75% HRmax) was determined by a telemetry during training sessions. Incremental treadmill testing for determinations of the gas-exchange VT VOE vs. (VO2, Excess CO2) was performed, and the HR at the VT (VTHR) was determined. VO2max was 35.57 +/- 5.57 mL.kg-1.min 1; the VT, expressed as a percentage of VO2max, was 54.45%. The mean THR (133.8 +/- 13.4 bpm) and calculated THRk (141.1 +/- 9.74 bpm) were significantly greater (p less than .05) than the VTHR (124.8 +/- 15.5 bpm), indicating that VT occurs below intensities determined by other methods. PMID- 3265357 TI - Sulphatides in the frog oviduct: response to estradiol stimulation. PMID- 3265358 TI - Acetylcholinesterase distribution and choline acetyltransferase and acetylcholinesterase activities in the optic tectum of the frog during metamorphosis. PMID- 3265359 TI - [Rehabilitation of diaphragm function in chronic obstructive pulmonary disease by external diaphragm pacing]. PMID- 3265360 TI - Antibiotics and immunity: effects of antibiotics on mitogen responsiveness of lymphocytes and interleukin-2 production. AB - The immunomodulating properties of antimicrobial drugs may have important implications in prescriptive practice. This is particularly so for patients whose immune system has been compromised. In this study, tetracycline, cephalothin, rifampicin, polymyxin B and nitrofurantoin reduced mitogen responsiveness of both B and T lymphocytes of mouse spleen cells and human peripheral blood lymphocytes in vitro in a dose-dependent fashion. Ampicillin, chloramphenicol, gentamicin, streptomycin and erythromycin had no effect. In the in vivo study none of the antibiotics affected mouse spleen cell transformation in response to mitogen. The addition of interleukin-2 (IL-2) did not prevent the effect of the antibiotics tested on human lymphocytes in vitro. Cephalothin, chloramphenicol and gentamicin decreased IL-2 production by mouse spleen cells in vitro. PMID- 3265361 TI - Fluorescence intensity of immunostained cells as a diagnostic aid in lymphoid leukemias. AB - The standardized fluorescence intensity (FI) of immunostained normal and malignant B-cells was measured as a method of evaluating cellular heterogeneity between lymphoid malignancies. Mature B-cells from peripheral blood lymphocytes (PBL) of different individuals demonstrated characteristic peaks of FI when specific monoclonal antibodies (MoAbs) were employed in standard flow cytometric procedures. Malignant cells from patients with lymphoid leukemias demonstrated FI that differed from that of normal B-cells with various MoAbs and that differed among categories of leukemia. By using a panel of MoAbs reactive with B-cells, as well as a T200 (CD45) antigen, a scheme of malignant cell differentiation may be produced that approximates stages of normal B-cell differentiation. When the FI of malignant cells differs from that of normal cells, or when atypical peaks (or additional peaks) of FI are present in flow cytometric histograms, the investigator should be alerted to the probability of abnormal cell populations. In addition, it is frequently possible to use this information to help classify malignancies, thereby contributing to identification of small numbers of malignant B-cells in otherwise equivocal situations. PMID- 3265362 TI - Marker discrepancy as a diagnostic criterion for lymphoid neoplasms. AB - Multimarker studies were conducted on 195 lymph node, 59 bone marrow, 44 peripheral blood, eight body fluid, and eight internal organ specimens. The markers were identified by fluorochrome-labeled antibodies quantified with flow cytometry. T-cell receptor gene rearrangements were used for the determination of T-cell clonality. These studies confirmed that CD 19 (B4, Leu 12) is highly sensitive for B-lymphoblastic leukemia, CD 7 (Leu 9) is highly sensitive for T lymphoblastic leukemia, and CD 5 (Leu 1) is highly sensitive for chronic lymphocytic leukemia. When these markers were compared to antigens of the same cell lineage (e.g., CD 19 to CD 20 [Leu 16] or to surface immunoglobulin, CD 7 to CD 3 [Leu 4], and CD 5 to CD 3), a marked discrepancy between them was diagnostic of the corresponding tumor. T-cell marker discrepancy (CD3 vs. CD 7) was demonstrated in T-cell lymphomas, but it was also shown occasionally in polyclonal T-cell populations. On the other hand, a marked discrepancy between the percentages of a B-lineage (CD 19 or CD 20)-positive and a surface immunoglobulin-positive population is a reliable phenotype for the diagnosis of a surface-immunoglobulin-negative B-cell lymphoma. PMID- 3265363 TI - Interleukin-2 receptor is functionally linked with in vitro activation of B cells isolated from non-Hodgkin's lymphomas. AB - Proliferation and differentiation of B cells can be promoted by a number of inducing factors, including interleukin-2 (IL-2). In vitro-stimulated normal B cells usually express IL-2 receptors (TAC). Furthermore, it has been reported that some minor sub-populations of B cells in normal lymphoid tissue also express TAC antigen, as do some leukemic B cells. In the present study, the reactivity of 20 specimens of non-Hodgkin's lymphoma or B-cell origin was examined for a wide panel of monoclonal antibodies (MAb), including an anti-TAC MAb. The ability of the isolated and purified B cells to proliferate in the presence of B-cell mitogens and culture supernatants (containing various growth factors, including IL-2) was also investigated. These experiments provided some evidence that the TAC-negative cells remained unreactive, whereas the TAC-positive cells entered the cell cycle and proliferated. IL-2 responsiveness of neoplastic B cells is therefore discussed. PMID- 3265364 TI - Radial artery pressures compared with subclavian artery pressure during coronary artery surgery. PMID- 3265365 TI - Anti-histone antibodies (ELISA and immunoblot) in canine lupus erythematosus. AB - In the canine systemic lupus erythematosus (SLE), anti-double stranded DNA (ds DNA) antibodies (enzyme linked immunosorbent assay (ELISA) or indirect immunofluorescence on Crithidia luciliae) are rare whereas anti-histone antibodies are often found: 61.7% with ELISA and 74% with immunoblot. In canine SLE the pattern of anti-histone antibodies on immunoblot is different from anti histone antibodies in human SLE. Indeed, histone fractions which are most often recognized by the canine antibodies are by order of frequency H3, H4 and H2A, whereas in man this order is H1, H2B then H3. In the diagnostic criteria of canine SLE, we suggest replacing the anti-ds-DNA antibodies by the anti-histone antibodies detected by immunoblot. PMID- 3265366 TI - Spontaneous Ig secretion and DNA synthesis in lymphoblastoid B cells appearing after surgery. AB - A state of immunosuppression or immunodeficiency has been described after surgical trauma. Cellular immune functions are more heavily affected. At present the relationship between these abnormalities and the increased incidence of infections in surgical patients has not been clarified. The activation of the humoral compartment and the appearance of lymphoblastoid B cells spontaneously secreting IgG and IgA have been observed in surgical patients. These cells are a marker of a recent antigenic exposure. In this study the kinetics of appearance of this B cell subset and the relationship between spontaneous Ig secretion and DNA synthesis have been analysed in six cholecystectomized patients. A peak of spontaneous IgG and IgA secretion is evident 5 and 7 days after the intervention. In some patients (two out of six) the appearance of lymphoblastoid B cells is cyclical. A second wave of spontaneous Ig secretion becomes evident 14 days after surgery. Double immunofluorescent staining of peripheral blood lymphocytes for BrdU and cytoplasmic Ig (cIg) was employed to demonstrate that a fraction of lymphoblastoid B cells is actively proliferating and that other cells negative for cIg but active in DNA synthesis appear in the circulation. These data confirm the signs of activation observed after elective surgery in otherwise healthy subjects. PMID- 3265367 TI - Paramyxovirus membrane protein augments the antibody response to actin in mice. AB - The production of anti-actin antibodies has been studied in mice. Not one of 10 mice immunized with native actin produced anti-actin antibodies, whereas seven out of 10 mice immunized with actin mixed with paramyxovirus membrane (M) protein produced a high titre of antibodies to actin. The enhancement of anti-actin antibody production by M protein is specific to actin since antibodies to protein purified derivatives (PPD) or gelatin were not enhanced by M protein. The enhanced anti-actin antibodies depended upon the interaction of actin and M protein since injection of M protein and actin in separate sites failed to produce anti-actin antibodies. Five Balb/c nude mice immunized with actin and M protein failed to produce anti-actin antibodies suggesting that cell-mediated immune response is also required for this response. PMID- 3265368 TI - [An analysis of lymphocyte surface markers in HTLV-I-associated myelopathy (HAM)]. PMID- 3265369 TI - Epidemiological survey of intestinal parasitic infections in children of Sabah, Malaysia. PMID- 3265370 TI - Ocular streptococcal infections. AB - Streptococcal infections are an important cause of corneal ulcers, endophthalmitis, conjunctivitis, and dacryocystitis. We retrospectively reviewed 53 ocular streptococcal infections diagnosed and followed at Wills Eye Hospital between January 1, 1984, and July 1, 1986. Corneal ulcers (23 of 53; 43%) and endophthalmitis (18 of 53; 34%) constituted a majority of the streptococcal infections in this series. Streptococcal infection was also a common cause of conjunctivitis, but clinical follow-up data were sufficient for inclusion in this series in only a small fraction of conjunctivitis patients (9 of 70; 13%). Streptococcal corneal ulcers and endophthalmitis were frequently associated with a poor visual outcome. When antibiotic sensitivity testing was done, approximately one third of the streptococcal isolates (13 of 38; 34%) were not sensitive to gentamicin. As topical gentamicin is frequently used by ophthalmologists, the possibility of streptococcal infection should be taken into account in the selection of antibiotics for conjunctivitis, corneal ulcers, endophthalmitis, and prophylaxis. PMID- 3265371 TI - The potential use of microcalorimetry in predictive tests of the action of antineoplastic drugs on mammalian cells. AB - The effect of methotrexate (MTX) on cultured T-lymphoma cells in a growing suspension was measured by microcalorimetry. The effect of the drug could be observed within 2 h after its injection into the calorimetric vessel. A dose response curve was constructed from the calorimetric results obtained with final concentrations of MTX in the range of 0.02-2.00 microM. In another series of experiments calorimetric values were determined after 8 h of MTX-cell interaction. These data were correlated with values for cell counts during an 18 h period following the removal of the drug. A clear correlation was found between the calorimetric and cytotoxicity data. Calorimetric results obtained within 8 h of MTX-cell interaction appear to be of value in predicting the antineoplastic effect of the drug. PMID- 3265372 TI - [Rheumatoid arthritis and HLA-DR4, antigen]. PMID- 3265373 TI - [Determination of anti polymyositis-1 antibody and its clinical significance]. PMID- 3265374 TI - [Postoperative adjuvant chemotherapy of high dose MTX for osteogenic sarcoma]. AB - There are still some controversy on the role of adjuvant chemotherapy in the treatment of osteogenic sarcoma, and no relevant report has been published in Chinese medical literature. In this paper 15 patients with osteogenic sarcoma treated from March 1982 to March 1986 by high dose MTX with citrovorum factor rescue after surgery are reported. Another 15 patients treated by surgical amputation alone during the same period served for comparison. The sex, age and site of the tumor in the two groups were comparable. In the treated group, MTX 0.7-1.4 g/m2, averaged 0.92 g/m2 were given intravenously, followed by citrovorum factor rescue, once a month for 2-12 injections. 12 patients (80%) in this group were given more than 4 injections. All patients tolerated the treatment well and no death was ascribed to the treatment. The patients were followed for 7-48 months, in the HD-MTX treated group, 1 patient was lost in the follow up, 9 died and 5 were still alive (35.7%). In the comparison group, 2 were lost, 11 died and only 2 were still alive (15.4%). The 2 year survival rate for the treated group was 57.1% and 30.8% for the comparison group (P greater than 0.05). The authors suggest that the dose of MTX be increased and combined with other cytostatic drugs like doxorubicin and cisplatin when necessary for better results. Adjuvant chemotherapy has definite value in the treatment of osteogenic sarcoma if adequate dose and protocols are used. However, the best adjuvant chemotherapy program for Chinese patients still remains to be studied. PMID- 3265375 TI - Comparative study on effects of 14- and 16-membered macrolides on gastrointestinal motility in unanaesthetized dogs. AB - Comparative studies on the effects of 14-membered and 16-membered macrolides on gastrointestinal motility were conducted in unanaesthetized dogs. Midecamycin acetate, a new 16-membered macrolide, and leucomycin, another 16-membered macrolide, did not disturb the gastrointestinal motility and no dogs showed any adverse effects. In contrast, erythromycin stearate, erythromycin ethylsuccinate and triacetyloleandomycin, 14-membered macrolides, caused adverse effects such as strong contractile motility, nausea, vomiting and diarrhoea. The adverse effects of macrolides on the gastrointestinal tract are related to their chemical structure. PMID- 3265376 TI - [The internal mammary artery and saphenous vein in coronary bypass grafting]. PMID- 3265377 TI - In vitro evaluations of aminopenicillin/beta-lactamase inhibitor combinations. AB - Sulbactam/ampicillin (Unasyn) possesses the antimicrobial activity of each drug plus the synergistic action and qualities of sulbactam used as a beta-lactamase inhibitor. The combination has a spectrum of activity against many Enterobacteriaceae, Haemophilus species, Branhamella catarrhalis, pathogenic Neisseria species, Acinetobacter anitratus, some pseudomonads, nearly all anaerobes (including Bacteroides), Staphylococcus species, streptococci, and the enterococci. Sulbactam/ampicillin was found to be bactericidal, and its minimum inhibitory concentrations (MICs) affected only by high inoculum concentrations (greater than 10(6) CFU/ml). Fixed ratio in vitro susceptibility tests appear to be preferred, since they best approximate clinical formulations and drug pharmacokinetics. The ratio of 1:1 has been studied, but other ratios such as 1:2 (sulbactam/ampicillin) should be evaluated to promote greater test accuracy. Separate interpretive criteria for most Gram-negative bacteria, Haemophilus, and staphylococci appear unnecessary for some tests. PMID- 3265378 TI - Sulbactam/ampicillin versus cefotaxime as initial therapy in serious soft tissue, joint and bone infections. AB - In an open, randomised comparative study, 23 patients with bone, joint or soft tissue infections were treated with ampicillin 2g plus sulbactam 1g 3 times a day or cefotaxime 2g 3 times a day as an initial 2-week therapy. Monoinfections with Staphylococcus aureus were the most common bone or joint infections. Clinical cure or improvement 2 weeks after the end of therapy was observed in all 13 patients treated with sulbactam/ampicillin and in 7 of the 8 patients evaluated for efficacy after treatment with cefotaxime. Most organisms identified before the onset of therapy were susceptible to the antibiotic randomly selected for therapy, although the majority of infections due to beta-lactamase-producing staphylococci could not have been treated with ampicillin without sulbactam. Treatment failed to eradicate S. aureus in 1 patient from each group. In addition, S. aureus infection recurred in 2 patients in the cefotaxime group within 2 weeks after the end of therapy. No serious side effects were observed. PMID- 3265379 TI - [Study of cell-mediated immune response to BCG and cholera vaccines in vitro in carriers of HLA-DR2 and HLA-DR3 antigens]. PMID- 3265380 TI - Effect of acute and repeated immobilization stress on food and water intake, urine output and vasopressin changes in rats. AB - In several experiments the rats were subjected to immobilization stress (IMO) for 150 min daily for 7 to 38 days and after each IMO they were placed into individual metabolism cages. A considerable decrease of food and water intake was found even after the first IMO and lasted up to the 7th IMO. This resulted in a decrease of body weight and of diurnal urine output, while the osmolality of urine increased. However, the expected corresponding increase in urinary excretion of vasopressin (AVP) did not occur. In contrast, AVP excretion after 6th and 7th IMO decreased by about 50 per cent. In some experiments the urine was collected during the period of IMO. It was found that the total urine output sharply increased and its osmolality decreased. Moreover, the excretion of AVP decreased and the excretion of calcium and Na :K ratio in urine were elevated. After repeated IMO (i. e. after 7th, 16th and 38th IMO) all mentioned changes were still more expressed. Thus, the urine output increased more than two fold. However, the administration of dDAVP (synthetic analogue of AVP) prior to IMO resulted either in the normalization of urine output or anuria, respectively, depending on the dose administered. When 30 min portions of urine excreted during 150 min IMO were collected, it was found that during the first period, when the level of AVP in plasma was increased, the urine output was almost zero. During the second period of IMO the level of AVP in plasma decreased even bellow the control values which was accompanied by water diuresis. Similar biphasic changes were found even previously. It is suggested that the increased AVP release during the first period might be due to the physical stress stimuli (manual squeezing of animals, pain etc.), while the inhibition of AVP release during the second period may be caused by a simultaneous activation of other endocrine mechanisms (endogenous opioids, steroids, catecholamines, atrial natriuretic peptides etc.). PMID- 3265381 TI - Effect of short-term androgen administration to rabbit females on their lipoprotein metabolism. AB - The changes of lipoprotein profile were studied in rabbit females administered 1 mg/kg testosterone propionate i.m. daily for 7 days. Under such conditions a decrease of cholesterol in serum and in LDL fraction was found together with the increase of that in VLDL fraction. The level of triacylglycerols was decreased in serum, in VLDL and HDL fractions. These results showed that even a short-term administration or testosterone in pharmacological doses resulted not only in a decrease of total cholesterol in serum, but also influenced favourably its level in LDL fraction. PMID- 3265382 TI - Effects of acetylsalicylic acid on reproductive organs of adolescent male rats. AB - The effects of acetylsalicylic acid (ASA) at a dose of 800 micrograms/day per rat for 7 days on some androgenic parameters such as organ weights, succinate dehydrogenase, acid phosphatase, fructose, cholesterol and protein of testis, epididymis, vas deferens and accesory glands in adolescent male rats were investigated. The semen characteristics and scanning electron microscopy (SEM) study on sperm morphology of cauda epididymis were also carried out. The results revealed that the treatment manifested a marked effect in altering the metabolism of testis, cauda epididymis, seminal vesicle and vas deferens. The androgen antagonistic and antianabolic effects were by and large transient and reversible by ascorbic acid administration. PMID- 3265383 TI - Progestin and estrogen receptors: characterization and localization in rat submandibular glands, with special reference to epidermal growth factor. AB - By using progestin (P) and estrogen (E), the localization and characterization of both steroid receptors were examined in the submandibular gland (SMG) of 6-week old immature castrated rats, with special reference to localization of epidermal growth factor (EGF). In the castrated male and female rats, both 3H-estradiol-17 beta (3H-E2 beta) and 3H-promegestone (3H-R5020) bound to SMG cytosol with high affinity and low capacity. These values were similar to those reported for other tissues. However, E-treatment after castration inhibited the specific binding. In sucrose density gradient ultracentrifugation, it was found that P receptors in both castrated males and females had a sedimentation coefficient of 7S, whereas E receptors had sedimentation coefficients of 4S and 7S. A histochemical study of the SMG of castrated male and female rats showed that the E-peroxidase complex (EPC)- and P-peroxidase complex (PPC)-stained cells were predominantly located in the epithelium of the duct system including the excretory duct and the granular convoluted tubules. Few cells were located in the intercalated duct, and none were found in the acinus. EGF-immunoreactive cells were also located in the epithelium of the same tissue region as in PPC- and EPC-stained sections. Moreover, E-treatment after castration inhibited the intensity of staining and immunoreactivity. These results clearly suggest that rat SMG contains specific P and E receptors which are mainly located in the epithelial cells of the duct system in which EGF-containing cells are identified. We discussed the possibility that P and E might affect EGF immunoreactivity, which reflects EGF production, through their receptors in the epithelium of the duct system. PMID- 3265384 TI - Depression of liver drug metabolism in sarcoma-bearing mice. Evidence for a circulating factor and dissociation from lipolytic activity. AB - Mice bearing the S-180 sarcoma displayed a depression of liver catalase and cytochrome P-450-dependent enzymes (ethoxycoumarin deethylase, ED) from day 6 following tumor implantation. Injection of serum obtained from tumor-bearing mice into normal mice caused depression of liver ED suggesting that a circulating factor was involved. Tumor-bearing mice did not show any significant change in serum triglycerides and food intake. By contrast, injection of endotoxin, interleukin-1 (IL-1) or tumor necrosis factor (TNF) caused not only a depression in liver ED but also a marked increase in serum triglycerides. To study the possible analogies between cancer-associated circulating factor and monokines, we studied the effect of dexamethasone (a known inhibitor of monokine synthesis) on liver ED activity in tumor-bearing mice. Dexamethasone (DEX) treatment increased (up to 60%) liver ED activity in tumor-bearing mice. We conclude that: (i) a circulating factor is involved in cancer-associated ED depression; (ii) that this mediator is not necessarily identical to TNF or IL-1 and (iii) that DEX reverses the depression of liver ED in cancer, possibly by inhibiting the synthesis, or the effects, of this factor. PMID- 3265385 TI - The specificity of the lymphocyte transformation test in a patient with hypersensitivity reactions to pyrazolone compounds. A 10-week follow-up study before and after rechallenge. AB - To evaluate the specificity of the lymphocyte transformation test (LTT) in the diagnosis of drug allergy we studied over 71 days an atopic woman with a past history of frequent adverse reactions to pyrazolone drugs. Rechallenge with the incriminated substances aminophenazone (aminopyrine) and propyphenazone was carried out on Days 11 and 31 respectively. An immediate type of hypersensitivity reaction was seen after 100 mg aminophenazone, while 100 mg of propyphanozone led to a serum sickness-like syndrome. We found two specifically sensitized lymphocyte populations using either the pure substance or sera containing metabolite in cell cultures. Stimulatory responses with indices ranging between 3 and 6 were seen 3-4 days after exposure, and the tests remained positive in both instances for 3-4 weeks. Specific sensitization was proven by positive skin tests and by a small but distinct lymphocyte proliferative response before challenge. Several lymphocyte function tests were performed over a period of 53 days and revealed a large fall in pokeweed mitogen-induced immunoglobulin synthesis and an increase in suppressor cell activity after rechallenge with aminophenazone. We conclude that the proliferative response observed in the presence of the offending drug is due to the activation of T memory cells and therefore highly suggestive of a true allergic reaction. PMID- 3265386 TI - Class I alloantigen is sufficient for cytolytic T lymphocyte binding and transmembrane signaling. AB - Based largely on antibody blocking studies, a number of surface "accessory" molecules on effector cytolytic T lymphocytes (CTL) have been implicated as having a role in mediating CTL binding and lysis of target cells, possibly via binding to ligands on the target cell surface. Despite this, cloned allogeneic CTL were able to specifically bind cell-size, artificial membranes (pseudocytes) bearing only class I alloantigen. This binding triggered CTL degranulation, as measured by serine esterase release. Thus, class I alloantigen alone is both a necessary and sufficient ligand for specific binding and effective transmembrane signaling to occur. PMID- 3265387 TI - Postnatal B cell development: influence of trinitrobenzenesulfonic acid treatment during pregnancy. AB - Prenatal treatment with a reactive hapten may be well suited for analyzing the establishment of self tolerance because the hapten binds ubiquitously to proteins and cells and persists for a long period in the developing organism. Based on this consideration, pregnant BALB/c mice were treated with 2,4,6 trinitrobenzenesulfonic acid (TNBS), searching for differences in 2,4,6 trinitrophenyl (TNP) responsiveness in their offspring as compared to litters of untreated mice. The frequency of TNP-specific T-independent B cells of litters from TNBS-treated mothers was very low at birth and remained below 10% of controls until the age of 42 days. On the contrary, in 8-day-old prenatally TNBS treated litters, the frequency of TNP-specific T-dependent B cells was higher than in controls. Expansion of TNP-specific B cells after antigenic stimulation of control mice started at the age of 3-4 weeks and expansion rates increased with age, while in prenatally TNBS-treated mice, significant expansion rates were seen at the age of 2 weeks only. Yet, after restimulation with TNP lipopolysaccharide or with a TNP-anti-TNP conjugate, but not after restimulation with TNP-ovalbumin, similar numbers of plaque-forming cells (PFC) were observed with spleen cells of prenatally untreated and TNBS-treated mice, the latter revealing an exceptional predominance of IgG PFC. Thus, TNP-specific B cells were not deleted, but prenatal TNBS treatment resulted in an altered composition of TNP-specific B cell subpopulations, their regulation differing qualitatively from the one observed in prenatally untreated mice. PMID- 3265388 TI - Glucocorticosteroid-dependent synergy between interleukin 1 and interleukin 6 for human B lymphocyte differentiation. AB - In order to analyze the effects of interleukin (IL) 6 on human in vitro Ig production B lymphocytes were activated by Staphylococcus aureus Cowan strain I (SAC) in the presence of low concentrations of IL2 (1 U/ml) and dexamethasone (10(-7) M). Previously we showed that this model of B cell response is completely monocyte dependent. We here demonstrate that, under these experimental conditions, IL6 is able to replace monocytes and stimulate Ig production provided IL1 is also present. Dose-effect curves show that these two monokines act synergistically. This synergy is demonstrable only in the presence of dexamethasone, when B lymphocytes are activated (by SAC) and when T cell help (provided by IL2) is present. It results in the production of both IgM and IgG. Both IL1 and IL6 have to be present during the first 48 h of culture to exert an optimal effect. These results show that IL6 may act on early (as well as on late) stages of normal B lymphocyte differentiation. Moreover, glucocorticosteroids potentiate the synergistic effect of IL1 and IL6 on their B lymphocyte target, an effect comparable to that exerted on hepatocytes. PMID- 3265389 TI - Identification of a novel monocyte cell surface molecule involved in the generation of antigen-induced proliferative responses. AB - A monocyte molecule, identified by a monoclonal antibody (mAb) named 24, is involved in the antigen-specific proliferation of T cells. Several types of antigen-induced responses are blocked by mAb24, but mitogen responses, even at low doses, are not. The 24 molecule is found on circulating monocytes and no other cell type. Normally only a proportion of monocytes express the 24 molecule but it can be induced rapidly on monocytes in culture, possibly from intracellular sources. The epitope is present on a heterodimer of 175 and 95 kDa which is similar to the leukocyte cell adhesion molecule (Leu-CAM) family. These findings suggest that although the 24 molecule shows some functional and biochemical similarities with the Leu-CAM family of molecules, it represents a novel structure primarily associated with mononuclear phagocytes. PMID- 3265390 TI - Processing requirements for T cell activation by Mycoplasma arthritidis-derived mitogen. AB - Mycoplasma arthritidis produces in culture a polyclonal mitogen which is active for murine and human T lymphocytes in the presence of accessory cells (AC). We studied the requirements for processing and presentation by AC of Mycoplasma arthritidis supernatant (MAS) mitogen to human T cells. As inhibitors of AC processing, several agents were used which inhibit lysosomal function: the weak bases chloroquine and NH4Cl, the cationic ionophore monensin and the competitive protease inhibitor leupeptin. When these agents were used to inhibit processing by presenting cells and washed out before T cells were added to culture, they inhibited lymphocyte activation and, therefore, we assume that they interfered with the presentation of the mitogen. Thus, if MAS requires a processing step, it appears to involve lysosomal proteolysis which can be blocked in vitro. PMID- 3265391 TI - New heterocyclic ring systems--V synthesis and pharmacological activity of 6H 1,3,4-thiadiazolo [3',2':1,2]-5-oxopyrimido [5,4-b] indole derivatives and of 1 phenyl-6H-1,2,4-triazolo [1',5':1,2]-5-oxopyrimido[5,4-b] indole. AB - As a part of a study on analgesic and antiinflammatory active condensed heterocyclic compounds containing the pyrimidinic ring, a number of 6H-1,3,4 thiadiazolo [3',2':1,2]-5-oxopyrimido [5,4-b]indole and 1-phenyl-6H-1,2,4 triazolo [1',5':1,2]-5-oxopyrimido [5,4-b] indole were synthesized and tested. The results of pharmacological assays are reported and discussed. PMID- 3265392 TI - [The effects of various cell growth factors and cyclosporin A, an immunosuppressive agent, on cloned osteoblastic cell line, MC3T3-E1 cells]. AB - Cloned MC3T3-E1 cells which have retained several osteoblast-like characteristics were derived from newborn mouse calvaria. In order to elucidate the function of osteoblasts, the effects of 1,25(OH)2D3, interleukin (IL)-1 beta, IL-3, interferon(INF)-gamma and epidermal growth factor(EGF) on the activity of alkaline phosphatase(Al-P'ase), DNA synthesis and the production of prostaglandin E2(PGE2) in MC3T3-E1 cells were studied. The influence of cyclosporin A(CSA), a potent immunosuppressive agent, was also studied. The following results were obtained: 1. 1,25(OH)2D3 increased the incorporation of [45Ca]Cl2 into matrix and accelerated the calcification of MC3T3-E1 cells. 2. Al-P'ase activity and the incorporation of [3H]-thymidine into MC3T3-E1 cells were increased by 1,25(OH)2D3 but decreased by IL-1 beta, INF-gamma, IL-3 and EGF. 3. IL-1 beta increased and INF-gamma decreased PG-E2 production by MC3T3-E1 cells. 4. CSA decreased either Al-P'ase activity or incorporation of [3H]-thymidine, and increased PG-E2 production in MC3T3-E1 cells. CSA which was simultaneously incubated with these various cell growth factors, showed a similar effect to that of CSA alone. These results suggest that cytokines produced from immune cells, could affect osteoblasts besides that of calcium regulating hormones like parathyroid hormone and 1,25(OH)2D3, implying a probability for the participation of immunocompetent cells in the regulation of bone metabolism. PMID- 3265393 TI - [Study on distribution of epidermal growth factor (EGF) in rat tissues]. AB - Tissue distribution of epidermal growth-factor (EGF) in rat was investigated using a human EGF (hEGF) radioimmunoassay system. Antisera generated against hEGF reacted with hEGF and [21Leu] hEGF but not with mouse EGF, fibroblast growth factor (FGF), nerve growth factor (NGF), platelet derived growth factor (PDGF), and endothelial cell growth supplement (ECGS). Similar amounts of EGF immunoreactivity (EGF-IR) were found in the rat submandibular gland (32.8 +/- 4.59 ng/g tissue, n = 5) and duodenum (39.9 +/- 18.7 ng/g tissue, n = 9), whereas little EGF was detected in other tissues. No sex difference was observed in submandibular and duodenal EGF-IR, being different from the case of mouse in which ten times higher concentration of EGF-IR was found in male submandibular gland. Sephadex G-50 gel chromatography of submandibular and duodenal extracts revealed that each consisted of at least three different immunoreactive forms. The predominant EGF-IR was coeluted with 125I-EGF, significant amounts of EGF-IR was observed in the void volume fractions, and only small peaks of EGF-IR were present near Vt. These data clarified the presence of EGF-IR in rat submandibular and duodenal tissues and the molecular heterogeneity of EGF-IR and suggest some important role of EGF in the gastrointestinal function. PMID- 3265394 TI - Colonic inflammation and nonsteroidal anti-inflammatory drug administration. An assessment of the frequency of the problem. AB - Over an 18-month period at a single clinic, 43 new cases of colonic inflammation have been diagnosed (19 proctitis only). Crohn's colitis has been excluded from this analysis. In all these subjects a careful drug history has been taken in a prospective manner and in 4 of these 43 patients colonic inflammation appeared to be directly related to non-steroidal anti-inflammatory drug (NSAID) administration (mefenamic acid, 2; piroxicam, 2). In all 4 patients there was a time interval (mean 3 months) between initiation of treatment with NSAID and presentation with diarrhoea and weight loss. Pathological findings were minor and biochemical changes insignificant, in contrast to the protracted troublesome symptoms. Resolution of symptoms was very rapid on discontinuation of NSAID medication but 2 patients experienced immediate return of symptoms following inadvertent rechallenge. Approximately 10% of newly diagnosed colitis may be related to NSAID administration. Subjects taking NSAID medications appear to be five times more likely to develop colonic inflammation than the general population. PMID- 3265395 TI - [Recurrent digestive hemorrhage after pancreatic duct-jejunum anastomosis]. PMID- 3265396 TI - [Crossed hepatotoxicity of erythromycin propionate and troleandomycin?]. PMID- 3265397 TI - FokI method of gene synthesis. AB - An accurate, fast and simple method is presented for synthesis of a gene, or any DNA fragment with a defined sequence. The method is based on the observation that large (approx. 100 bp long) inserts can be cloned into a plasmid using a technique of oligodeoxynucleotide (oligo)-directed double-strand (ds) break repair. The procedure involves transformation of Escherichia coli with a denatured mixture of an insert-carrying oligo and linearized plasmid DNA [Mandecki, Proc. Natl. Acad. Sci. USA 83 (1986) 7177-7181]. The nucleotide (nt) sequences are inserted between two FokI restriction nuclease sites in one of four pUC-derived plasmids. Since FokI makes a staggered ds break at a DNA site 9 and 13 nt away from its recognition site, upon cleavage of the plasmid DNA with FokI, a restriction fragment is liberated that by design contains unique 4-nt-long 5' protruding ends. The uniqueness of ends permits efficient and directed simultaneous ligation of several restriction fragments to form a gene. The method offers flexibility due to the modular-type assembly and does not require any restriction sites within the constructed gene. The sequence error rate is low: about one error per 4000 bp of DNA cloned. Synthetic DNA for only one DNA strand needs to be provided. The method was applied to the synthesis of a gene fragment encoding the N-terminal 143 amino acid residues of the human immunodeficiency virus transmembrane protein (p41). PMID- 3265398 TI - Human hypoxanthine-guanine phosphoribosyltransferase: a single nucleotide substitution in cDNA clones isolated from a patient with Lesch-Nyhan syndrome (HPRTMidland). AB - We have determined the molecular basis for hypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency in a patient, J.H., with Lesch-Nyhan syndrome. Radioimmunoassay of lysates of erythrocytes or cultured B-lymphoblasts showed that this patient had no detectable HPRT enzyme activity or HPRT protein. HPRT-specific mRNA levels were normal by Northern analysis. We created a cDNA library from mRNA isolated from cultured lymphoblasts derived from this patient. Nucleotide sequencing of full-length HPRT cDNA clones revealed a single nucleotide (nt) substitution: a T-to-A transversion at nt 389. We have designated this variant HPRTMidland. The predicted amino acid (aa) substitution in HPRTMidland is a valine to aspartic acid at aa 130. This substitution is within 2 aa of the amino acid substitution in a previously defined HPRT variant, HPRTAnn Arbor. Both mutations are within a highly conserved sequence in the putative 5 phosphoribosyl-1-pyrophosphate-binding domain. The amino acid substitution in HPRTMidland causes a significant perturbation in the predicted secondary structure of this region. The HPRTMidland mutation affects a different domain of HPRT than the HPRTFlint mutation located at 167 nt away. PMID- 3265400 TI - [Effect of occupational factors of deep coal mines on the immunological status of miners]. PMID- 3265399 TI - [Differentiated immunocorrective therapy of dust-induced bronchitis in machine builders]. PMID- 3265401 TI - [Surgical treatment and intensive therapy of diffuse purulent mediastinitis complicated by pyothorax and intestinal hemorrhage]. PMID- 3265402 TI - Altered gastrointestinal immune response in sarcoidosis. AB - Because of the possible clinical association between coeliac disease and sarcoidosis, the incidence of humoral sensitivity to dietary proteins was examined in patients with sarcoidosis. Raised concentrations of circulating IgG antibodies to alpha gliadin were found in 41/99 sarcoid patients whereas antibody levels to casein, beta lactoglobulin and ovalbumin were similar to normal controls. Subsequently, a group of 26 sarcoid patients were selected for small intestinal biopsy; 11 had raised and 15 normal alpha gliadin antibody (AGA) levels. One AGA positive patient had villous atrophy consistent with coeliac disease. Intraepithelial lymphocyte (IEL) counts were raised in AGA positive (median 30; 95% confidence limits 22-46) and AGA negative (median 24; 95% confidence limits 19-32) sarcoid patients when compared with a control group (median 13.5; 95% confidence limits 10-18) p less than 0.01. Serum IgG concentrations were raised in 11/52 patients tested but there was no correlation between IgG levels and the presence of IgG antigliadin antibodies. HLA Dr typing was done in 21 of the 26 biopsied patients. The coeliac disease associated antigen Dr3 was present in eight of 21 (38%) which is very similar to the prevalence in unselected blood donors (34%). There was no significant difference in IEL counts between Dr3 positive and Dr3 negative sarcoid patients. These findings suggest that in patients with sarcoidosis, there is an altered gastrointestinal mucosal immune response, accompanied in about 40% of patients by specific sensitisation to wheat protein. PMID- 3265403 TI - Same peculiar subset of HML1 + lymphocytes present within normal intestinal epithelium is associated with tumoral epithelium of gastrointestinal carcinomas. AB - The present study shows that the distribution of T lymphocytes in gastrointestinal carcinomas and their metastases mimic the distribution of T lymphocytes in normal intestine. The composition of the peritumoral reaction resembled that of normal lamina propria with a predominance of CD3 + CD4 + T cells. In contrast, lymphocytes located between carcinomatous cells showed phenotypical features similar to those of intraepithelial lymphocytes (IEL) in normal intestine; in particu(abstractlar they expressed the antigen defined by HML-1, a monoclonal antibody raised against normal human intestinal IEL which reveals 95% IEL but very few cells in lymphoid (abstractorgans and blood. As normal intestinal IEL, the majority of intratumoral lymphocytes had the CD3+ CD8+ phenotype. A panel of monoclonal antibodies and double immunostaining techniques permitted a better characterisation of minor subsets of IEL. Two subsets of HML1 + CD3 + CD4- CD8- and of HML1+ CD3- cells, representing 2% and 3% of normal intestinal IEL respectively, did not significantly increase in carcinomatous epithelium. In contrast, in carcinomatous epithelium, but not in normal intestinal epithelium, we observed the appearance of a few lymphocytes displaying the phenotype of activated T cells (CD25+) or of natural killer cells (NKHI+) or of suppressor cells (CD11+). Such cells may participate in antitumoral defence. Although a similar population of HML1+ lymphocytes is associated with normal and carcinomatous intestinal epithelium, some interactions between lymphocytes and epithelial cells may not be maintained in tumoral epithelium. It has previously been shown that HLA-DR expression by enterocytes is modulated by intraepithelial lymphocytes. In our study, no correlation could be shown between the degree of lymphocytic infiltration and the expression of HLA-DR antigens on carcinomatous cells. PMID- 3265404 TI - Pancreatic function testing: serum PABA measurement is a reliable and accurate measurement of exocrine function. AB - A comparison between the NBT-PABA/14C-PABA test (NBT-PABA, n-benzoyl-tyrosyl para aminobenzoic acid) using the PABA excretion index (PEI) and serum PABA estimation at 90 minutes has been made in 42 consecutive subjects attending for investigation of possible pancreatic disease to a District General Hospital (DGH). The PEI was unobtainable or incorrect on 38% of occasions compared with 9% for the serum test. Sensitivity, specificity, and efficiency for the PEI (n = 33 valid results) were 71%, 88%, and 79% respectively and for the serum PABA (n = 41 valid results), 95%, 90%, and 93% respectively. These results confirm that measurement of serum PABA is a simpler, more reliable, and a more accurate method of assessing pancreatic function. PMID- 3265406 TI - [Pneumonias in AIDS are in the foreground. Clinical symptoms are rarely typical- by no means waive therapy]. PMID- 3265405 TI - [Inhibitory effect of AD-1590, a non-steroidal anti-inflammatory drug, on allergic inflammation in mice and rats]. AB - Effect of AD-1590 on allergic inflammations was investigated. AD-1590 and indomethacin at an oral dosage as high as 32 mg/kg did not show any significant inhibitory activity on rat passive cutaneous anaphylaxis, a type-I allergy, although prednisolone and cyproheptadine produced strong inhibition. Against rat adjuvant arthritis, type-III and -IV allergies, AD-1590 showed potent prophylactic (2 and 4 mg/kg/day) and therapeutic (0.4-1 mg/kg/day) effects when given orally once a day for 3 weeks beginning from just before and for 1 week starting from 14 to 18 days after adjuvant inoculation, respectively; however, its prophylactic and therapeutic potencies were about one-fourth and one-fifth, respectively, that of indomethacin. The arthritis was strongly inhibited with prophylactic treatment of prednisolone (1 mg/kg/day) or cyproheptadine (40 mg/kg/day). On the other hand, prednisolone (ED50 = 0.0119 mg/ear, topical) showed strong activity in inhibiting mouse contact hypersensitivity to oxazolone (ear edema), a type-IV allergy, but cyproheptadine only had weak activity. AD 1590 (0.318 mg/ear) and indomethacin (0.699 mg/ear) produced rather strong inhibition; in particular, AD-1590 produced almost complete inhibition at high dosages, whereas most of the non-steroidal anti-inflammatory drugs (NSAID) tested showed weak inhibition or a partial inhibition of about 50% even at the highest dosage. The oral potency of AD-1590 was about 2 and 100 times those of indomethacin and ibuprofen, respectively. These results demonstrate that in allergic inflammation, the pharmacological properties of AD-1590 are somewhat different from those of other NSAID and different from those of prednisolone and cyproheptadine. PMID- 3265407 TI - Application of theophylline metabolite assays to the exploration of liver microsome oxidative function in man. AB - The effects on theophylline oxidative metabolism of 3 inhibitors of liver microsome activity--cimetidine, troleandomycin and ketoconazole--were investigated in 6 healthy volunteers. The 3 compounds increased plasma theophylline half-life by 73.6 +/- 15.6% (P less than 0.01), 107.8 +/- 9.7% (P less than 0.001) and 21.7 +/- 6.8% (P less than 0.02), respectively, and reduced plasma theophylline clearance by 38.3 +/- 4.8% (P less than 0.001), 51.4 +/- 2.4% (P less than 0.001), and 8.9 +/- 7.8% (NS), respectively. Troleandomycin inhibited to the same extent the 2 theophylline metabolism pathways: N demethylation resulting in the formation of 1-methyluric acid (1-MU) and 3 methylxanthine (3-MX), and 8-hydroxylation resulting in the formation of 1,3 dimethyluric acid (1,3-DMU). The production clearances of these metabolites were almost equally depressed by 60.2 +/- 3.9%, 60.2 +/- 2.1%, and 51.7 +/- 4.5%, respectively. Cimetidine predominantly inhibited the N-demethylation pathway; the production clearances of 1-MU and 3-MX were depressed by 58.5 +/- 4.0% and 57.5 +/- 4.1% (P less than 0.001), respectively, whereas the production clearance of 1,3-DMU was depressed by 38.3 +/- 6.1% (P less than 0.001). Ketoconazole had no significant effect on the produciton clearances of theophylline metabolites. Measurement of theophylline metabolite formation clearances might be a useful test to explore liver microsome oxidative function. PMID- 3265408 TI - Primary pulmonary lymphoma: a case diagnosed by bronchial cytology and immunocytochemistry. PMID- 3265409 TI - Chromosomal localization of the human interleukin 1 alpha (IL-1 alpha) gene. AB - The human interleukin 1 alpha gene was assigned to chromosome 2 using Southern transfer analysis of human-rodent somatic cell hybrid DNAs. The gene was regionally localized to 2q12-21 using in situ hybridization to metaphase chromosomes. These results indicate that the IL-1 alpha gene maps to the same general region on the long arm of chromosome 2 as the IL-1 beta gene, which has been previously assigned. PMID- 3265410 TI - Langer Giedion syndrome. PMID- 3265411 TI - Birth injuries--incidence, causative factors and outcome. PMID- 3265412 TI - TENS for post-surgical analgesia following gastroplasty. PMID- 3265413 TI - Interferential therapy for the treatment of stress and urge incontinence. PMID- 3265414 TI - Fecal alpha-1-antitrypsin excretion in acute diarrhea: relationship with causative pathogens. AB - Concentrations of alpha-1-antitrypsin (AT) in random fecal samples from 68 infants (92.7% outpatients) with acute diarrhea and 32 healthy controls were determined. The mean +/- s.d. for AT in infants with diarrhea was 2.07 +/- 1.88 mg/g dry stool (mg/g d.s.) compared with 1.29 +/- 0.72 mg/g d.s. (p less than 0.05) in controls. Fecal AT was significantly greater than that of the controls only for diarrhea caused by Rotavirus or Salmonella. Salmonella patients also had significantly higher fecal levels of AT than patients with diarrhea caused by Campylobacter. Fifty percent of the infants with Salmonella infections excreted more than 2.73 mg/g d.s. AT, which is above the control mean + 2 s.d. Fecal excretion of AT was highest in patients with macroscopic intestinal bleeding, but it still depended more on the causative agent than on bleeding per se. This finding of increased intestinal protein loss during acute diarrhea, even in the less severe diseases, emphasizes the necessity to rapidly restart adequate nutritional intake. PMID- 3265415 TI - Sensitivity of methicillin-resistant Staphylococcus aureus strains to some antibiotics, antiseptics and disinfectants. AB - The effects of antibiotics, antiseptics and disinfectants against some methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) Staphylococcus aureus strains have been studied. The MRSA and MSSA strains were equally sensitive to phenols, esters of para(4)-hydroxybenzoic acid and chlorhexidine but MRSA strains were slightly more resistant to quaternary ammonium compounds and considerably more so to dibromopropamidine isothionate. Some MRSA strains were also resistant to phenylmercuric nitrate (but not another organomercurial, thiomersal), mercuric chloride and cadmium chloride. All MRSA strains produced beta-lactamase. Strains from the Royal Free Hospital, London were highly resistant to beta-lactam antibiotics, erythromycin, trimethoprim and tetracyclines but were sensitive to other antibiotics. One strain from the University Hospital of Wales, Cardiff was resistant to gentamicin but sensitive to tetracycline and trimethoprim. PMID- 3265417 TI - Structure and expression of lck transcripts in human lymphoid cells. AB - The murine lck gene encodes a membrane-associated protein tyrosine kinase that has been implicated in lymphocyte oncogenesis. Here we report the structure of normal human lck transcripts and the pattern of expression of these transcripts in developing thymus and in peripheral T cell subsets. The human lck gene encodes a 509 amino acid polypeptide that is closely related to the murine lck-encoded protein throughout its length. Analysis of the deduced amino acid sequence of human p56lck demonstrates that an amino-terminal domain, widely divergent among the seven known src family members, has been conserved between murine and human p56lck, and thus probably includes sequences crucial to the lymphocyte-specific function of this molecule. Human lck transcripts were detected in CD4+ and CD8+ T cells, in partially purified B cells, and in Epstein-Barr virus-immortalized B cell lines, but not in monocytes, granulocytes, or in nonhematopoetic cell types. Human lck transcripts are readily detectable in fetal thymocytes at 70 days of gestation, but not at 57 days of gestation, indicating that lck expression appears coordinately with the appearance of lymphoid cells in the developing thymus. Thus lck gene expression is a marker for cells of the lymphocyte lineage in man. We conclude that the lck gene probably participates in a signal transduction pathway uniquely present in lymphoid cells. PMID- 3265416 TI - A search for EGF-elicited degradation products of the EGF receptor. AB - Epidermal growth factor (EGF) induces the degradation of EGF receptors in both human foreskin fibroblasts and A-431 cells. Similar degradation products of 125I EGF covalently linked to its receptor appeared at the same times in both A-431 cells and fibroblasts when the cells were exposed to a concentration of 10 ng/ml EGF. Although the products between the two cell types differed in molecular weight, this was at least partly caused by an actual difference in the receptor proteins from the two cell types (as shown by partial proteolysis) rather than from different pathways of receptor degradation. However, when EGF receptors were biosynthetically labeled, no receptor degradation products could be observed, even when the receptor was labeled with radioactive mannose or phosphate, molecules which would predominantly label the outside or inside face of the receptor, respectively. At 20 degrees C, degradation of the receptor slowed and a 150,000-dalton degradation product was observed. This degradation product has previously been observed in cell homogenates produced in the presence of calcium, mediated by calpain. Thus, calpain may play a role in the intracellular degradation of the EGF receptor. PMID- 3265418 TI - Cytochemical, histological, and phylogenetic distribution of a 38,000-dalton protein associated with transverse tubules. AB - A major protein in detergent extracts of skeletal muscle appears at 38,000 daltons in electrophoretic separations. Previous investigations have provided indirect evidence that a 38-kD skeletal muscle protein is membrane associated, and this inference has served as the basis for speculations on 38-kD protein function. In the present study, affinity purified, polyclonal antisera against 38 kD protein from skeletal muscle are produced for immunolocalization and biochemical assays. Immunoblots of two-dimensional electrophoretic separations show that this protein is heterogenously charged at pI approximately 6.4. This 38 kD protein is not extracted from muscle in low ionic strength or high ionic strength buffers, in isotonic buffers from pH 4 to pH 8 or in buffers containing 5 mM EGTA. The 38-kD protein is extracted, however, by isotonic, pH 7.0 buffer containing 1.0% Triton-X. Light microscope observations using indirect immunofluorescence of anti-38-kD labeled tissue show the protein distributed in a reticular pattern within cross-sectional muscle but not at the cell surface. Longitudinal sections show the protein concentrated in periodic, transverse bands. Purified fractions of muscle plasma membrane analyzed by immunoblotting contain 38-kD protein. Immunoblots using anti-38 kD show that this protein is present in all vertebrate skeletal muscle examined, however, the protein is present only in cardiac muscle that contains transverse tubules. The antibody does not recognize aldolase, another 38-kD striated muscle protein. PMID- 3265419 TI - High-performance liquid chromatographic assay for the simultaneous monitoring of mefloquine and its acid metabolite in biological samples using protein precipitation and ion-pair extraction. AB - A high-performance liquid chromatographic (HPLC) method is presented for the simultaneous determination of mefloquine and its acid metabolite in plasma and whole blood. Plasma and whole blood are deproteinized with a combination of zinc and acetonitrile before extraction. Mefloquine and its acid metabolite are extracted simultaneously at pH 4 by methyl tert.-butyl ether, where mefloquine is extracted as an ion pair with heptanesulphonate. After evaporation of the organic phase, the residue is dissolved in mobile phase and injected on to the chromatographic column. A reversed-phase column (Spherisorb ODS-1) is used with acetonitrile-phosphate buffer (0.1 mol/l, pH 2.5) (42:58) containing 40 mmol/l perchlorate as the mobile phase. N,N-Dioctylamine was added to the mobile phase to give a concentration of 0.1% and the pH was adjusted to 2.3-2.7 with concentrated phosphoric acid. The method permits the determination of 0.10 mumol/l (30 ng/ml) mefloquine and its acid metabolite in plasma. The coefficient of variation was 5-6% at the therapeutic level (mefloquine 1-4 mumol/l, its carboxylic metabolite 2-6 mumol/l) in 0.5-ml samples. An alternative method is also described with a similar clean-up procedure that uses protein precipitation with zinc-acetonitrile as a sample pretreatment for therapeutic monitoring of mefloquine and metabolite in plasma and whole blood. Using this method, 0.25 mumol/l mefloquine and its metabolite can be determined. The results from the two methods correlate well. PMID- 3265421 TI - Effect of pH and stimulus phase on work done by isolated frog sartorius muscle during cyclical contraction. AB - Work per cycle was calculated in isolated frog sartorius muscle by measuring force as the activated muscle was subjected to sinusoidal length changes. Work per cycle was calculated from the area of the loop formed when force was plotted against length. Measurements were made at 20 degrees C using physiological solutions with high pHe (7.9 or low pHe (6.6). Net work done per cycle was positive when the muscle was activated during the shortening phase of the length cycle. Maximum work done increased as excursion amplitude increased and was about 17Jkg-1 at a strain of 12% (i.e. Lo +/- 6%) at a cycle frequency of 2 Hz. Maximum power was 35 W kg-1 and was about 25% less at the lower pHe. Power measured in this way is much less than the value calculated from force-velocity curves. However, power calculated from force-velocity curves neglects the time that the muscle must be inactive during locomotion. Thus the measurements of the present study are realistic relative to actual mechanical power output during locomotion. PMID- 3265420 TI - Induction of circulating tumor necrosis factor (TNF alpha) as the mechanism for the febrile response to interleukin-2 (IL-2) in cancer patients. AB - Fever is frequently observed in cancer patients treated with high-dose recombinant human interleukin-2 (rIL-2). The preincubation of rIL-2 with polymyxin B, an antibiotic that inhibits the biologic effects of endotoxins, did not diminish the pyrogenicity of IL-2 in New Zealand rabbits, indicating that IL 2-induced fever is not due to contaminating endotoxins. In contrast to interleukin-1 (IL-1), tumor necrosis factor (TNF), and interferon alpha, which cause fever through their effects on arachidonic acid metabolism in the hypothalamus, IL-2 was unable to induce prostaglandin E2 synthesis in hypothalamic cells or fibroblasts in vitro, suggesting that IL-2 is not intrinsically pyrogenic. To determine if IL-2-induced fever is mediated indirectly through the generation of pyrogenic cytokines, culture supernatants from IL-2-stimulated human peripheral blood mononuclear cells were screened for the presence of pyrogens by direct injection into rabbits and by measuring the amounts of IL-1 alpha, IL-1 beta, and TNF alpha by specific radioimmunoassays (RIA). All three cytokines were readily detected by RIA in these supernatants, which in turn caused fever when injected into rabbits. Furthermore, in six of six cancer patients treated with rIL-2, elevated levels of TNF alpha were detected in the plasma by RIA 2 hr after IL-2 administration. Plasma TNF levels increased from pretreatment values of 14 +/- 7 to 765 +/- 150 pg/ml 2 hr after an IL-2 injection. These results strongly implicate IL-2-induced pyrogenic cytokines, in particular TNF alpha, as a major cause of the fever and possibly other aspects of the acute-phase response associated with IL-2 therapy. PMID- 3265422 TI - Distribution of corticotropin-releasing-factor-like immunoreactivity in brainstem of two monkey species (Saimiri sciureus and Macaca fascicularis): an immunohistochemical study. AB - Immunohistochemical methods were utilized to systematically map the distribution of corticotropin-releasing-factor-like immunoreactivity (CRF-LI) in the diencephalon, mesencephalon, and rhombencephalon of two monkey species (Saimiri sciureus and Macaca fascicularis). A primary antiserum directed against the human form of the peptide was utilized. Immunoreactive neuronal perikarya and processes were evident in numerous areas, and the distributions of these elements were similar for the two species. As previously reported for rats, monkeys, and human, intense immunoreactivity was evident in putative hypophyseal neurons in the parvicellular component of the paraventricular nucleus of the hypothalamus and in fibers extending from this area into the median eminence. The results for other brainstem regions, most of which have been previously examined for CRF-LI only in rats, indicate that many similarities exist between rats and monkeys in the distribution of this peptide in brainstem extrahypophyseal neuronal circuits, although substantial differences are also evident. For example, immunoreactive perikarya previously observed in other hypothalamic nuclei in rats were not evident in monkeys. Conversely, in monkeys, unlike rats, labeled perikarya were evident in several thalamic nuclei, especially in the intralaminar complex. Also, two large groups of immunoreactive neurons which have generally not been observed in rat studies were present in the mesencephalon and rhombencephalon. In the mesencephalon this consisted of a group of neurons just lateral to the mesencephalic tegmentum, extending throughout the rostral-caudal extent of the midbrain. In the rhombencephalon, labeled perikarya were observed throughout the inferior olive. Some of the differences between rats and monkeys in the locations of labeled perikarya may be due to differences in antiserum specificity and/or sensitivity, or they may result from the fact that colchicine pretreatment was not utilized in the present study. The distributions of immunoreactive fibers also exhibited similarities and differences between monkeys and rats. The most striking terminal fields observed in the present study which have not been previously described are a moderate-to-dense field within and adjacent to presumed dopamine-containing neurons in the substantia nigra pars compacta, a dense innervation of certain subdivisions of the interpeduncular nucleus, and a regionally and parasagittally organized distribution of fibers in the Purkinje cell and molecular layers of the cerebellar cortex.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3265423 TI - Stress factors, emotional stress and rheumatoid arthritis disease activity. AB - The purpose of this study was to determine the relationship between stress factors, emotional stress and rheumatoid arthritis (RA) disease activity. Subjects (n = 101) confirmed to have RA completed the Daily Hassles Scale (DHS) to identify daily stress factors and the State/Trait Anxiety Inventory (STAI) as well as a visual analogue (VA) to measure emotional stress levels. The investigator evaluated RA disease activity (RADA) and erythrocyte sedimentation rate (ESR). Pearson product-moment correlation was used for statistical evaluation. A statistically significant, positive correlation was found between RADA and both measures of emotional stress; STAI r2 = 0.16, VA r2 = 0.25, P less than 0.01. Utilizing a psychophysiological feedback loop model, it was hypothesized that emotional stress levels and RA disease activity each served as a driving force and a consequence, i.e. as emotional stress levels increased, RA symptoms intensified and, likewise, as RA symptoms intensified, emotional stress levels increased. Nursing interventions were identified which possibly would reduce emotional stress levels, and thus, perhaps, decrease the incidence and/or severity of RA disease activity. PMID- 3265425 TI - The effect of human urogastrone on lung phospholipids in fetal rabbits. AB - Previous in vivo studies have demonstrated that mouse epidermal growth factor (EGF) can enhance fetal lung maturation. We have examined the effect of urogastrone, the human equivalent of mouse EGF and a related growth factor, on the phospholipid profile of fetal rabbit lung lavage and its action on fetal rabbit Type II pneumocytes in culture. Urogastrone (1 or 8 micrograms) given i.p. to fetal rabbits on day 25 of gestation resulted in increased total phospholipid, phosphatidylcholine, phosphatidylinositol and phosphatidylethanolamine contents, increased phosphatidylinositol and phosphatidylethanolamine as a proportion of phospholipid and decreased sphingomyelin as a proportion of phospholipid in lung lavages on day 28. These changes were unaccompanied by alterations in body weight or lung weight, DNA or protein concentrations. Urogastrone (16 micrograms) resulted in increased fetal deaths. Phospholipid profiles on day 27 were unchanged after fetal administration of urogastrone (1 microgram) on day 25. Urogastrone (0.01 and 0.1 ng/ml) added to fetal rabbit Type II pneumocytes in culture for 24 h enhanced the incorporation of radiolabelled choline and thymidine into phosphatidylcholine and DNA respectively. These findings indicate that human urogastrone can alter the phospholipid composition of the rabbit lung in a similar manner to that which occurs during maturation of the lung surfactant system in late pregnancy. This effect can be achieved, at least in part, by a direct action on Type II pneumocytes. PMID- 3265424 TI - Pituitary and adrenal response to ovine corticotropin-releasing hormone in women with polycystic ovarian syndrome. AB - It has been hypothesized that there is an adrenal abnormality in the polycystic ovary syndrome (PCO). This study was undertaken to examine this hypothesis in a more physiological way, by enhancing the ACTH secretion in response to ovine corticotropin releasing hormone (oCRH) injection so that adrenal androgen and glucocorticoid responsiveness to endogenous stimulation could be examined. Plasma ACTH and the ACTH and cortisol (F) response to oCRH were normal. The plasma T and dehydroepiandrosterone (DHEA) responses were also normal. The androstenedione (A) response, however, was exaggerated. This study supports the hypothesis that the adrenal gland in patients with PCO produces increased amounts of androstenedione in response to ACTH stimulation. PMID- 3265427 TI - District programme to reduce smoking: can sustained intervention by general practitioners affect prevalence? AB - A total of 101 general practitioners in 27 practices in inner London took part in a quasi-experimental study designed to examine whether a brief intervention applied to all smokers seen by general practitioners and sustained on a continuous basis could in time have a cumulative effect and reduce the prevalence of smoking among their patients. Of 21 practices approached in our local district (Camberwell), seven were willing to undertake brief intervention with support from the smokers' clinic (SBI), four opted for intervention without support (BI), and six acted as usual care controls. A further 10 out of 12 practices approached in South Hammersmith provided an unselected group of usual care controls. A series of six cross-sectional surveys were conducted over a three-year period. Each survey consisted of all adult patients attending to see a doctor during a defined two-week period, sample sizes averaging just over 9000 per survey. The estimated decline in self-reported smoking prevalence over the 30-month period following the start of intervention was 5.5% (from 36.4% to 30.9%) in the SBI group compared with 2.1% for BI and 2.8% and 3.0% in the two usual care control groups, the decline in the SBI group being significantly greater than in the other groups which did not differ significantly between each other. These interim results provide encouraging evidence that brief intervention by general practitioners with support and back-up from a local smokers' clinic can, when sustained on a continuous basis, reach sufficient smokers to reduce smoking prevalence in their practice populations. However, firm conclusions must await longer periods of observation now that the other Camberwell practices have adopted the SBI procedures. PMID- 3265426 TI - Prevalence and long-term prognosis of mild hypertensives and hypertensives in a Japanese community, Hisayama. AB - The prognosis and outcome for mild hypertensives (90 mmHg less than or equal to diastolic pressure less than or equal to 104 mmHg) and hypertensives (diastolic pressure greater than or equal to 105 mmHg) was prospectively studied in Hisayama, Japan, and compared between 1621 subjects aged 40 years or over, recruited in 1961, and 2053 subjects recruited in 1974. Each cohort was studied in a follow-up which lasted 10 years. The pharmacological treatment of hypertension proved effective among residents recruited in 1974: the survival rate had favorably improved, and the rates of mortality from cerebral stroke and morbidity from intracerebral stroke and morbidity from intracerebral hemorrhage declined significantly in mild hypertensives and hypertensives in the more recently recruited population. The management of mild hypertension was considered more likely to be effective in reducing stroke than in reducing coronary heart disease in the Japanese general population. PMID- 3265428 TI - Outer-membrane permeability to beta-lactam antibiotics in Yersinia enterocolitica. AB - Two outer-membrane (OM) proteins of Yersinia enterocolitica YOMP-C and YOMP-F appear to function as porins. Mutants that were YOMP-C- and YOMP-F- exhibited changes in cephaloridine and [3H]glucose uptake and increased resistance to beta lactam antibiotics (especially cephalosporins) and tetracycline. Alterations in OM permeability may contribute to antibiotic resistance in Yersinia. PMID- 3265429 TI - The effect of hormones on Trichomonas vaginalis. AB - The hormonal milieu can alter susceptibility to infection. The effect of hormones on Trichomonas vaginalis was studied utilizing axenically cultured clinical isolates. Oestrogens, in physiological concentrations, decreased the growth of the organisms and their attachment to mammalian cells in vitro, and acted as a chemorepellent. The specificity of these effects was verified by their being blocked with anti-oestrogens, by the dose- and time-dependency of the responses, and by the lack of effect with other hormones. These results suggest that oestrogens may decrease the virulence of T. vaginalis; however, interactions between oestrogens and mammalian cells may promote the development of infection. Thus complicated interactions between hormones, micro-organisms and mammalian cells must determine whether exposure to oestrogens predisposes to or prevents the development of infection. PMID- 3265430 TI - Immunobiological properties of lipopolysaccharides isolated from Fusobacterium nucleatum and F. necrophorum. AB - Lipopolysaccharides (LPSs) were isolated from Fusobacterium nucleatum ATCC 10953 and F. necrophorum ATCC 25286 by the hot phenol/water procedure. F. nucleatum LPS was composed of 16% (w/w) carbohydrate, 10% (w/w) hexosamine and 40% (w/w) fatty acid, while F. necrophorum LPS was composed of 26% (w/w) carbohydrate, 12% (w/w) hexosamine and 28% (w/w) fatty acid. These LPS preparations induced mitogenic responses in spleen cells of BALB/c, BALB/c (nu/nu) and C3H/HeN mice, and these responses were suppressed by the addition of polymyxin B. The preparations also induced the polyclonal responses of C3H/HeN spleen cells. In addition, enhanced glucose utilization and interleukin-1 production by murine peritoneal macrophages were demonstrated. Neither spleen cells nor macrophages from the 'LPS nonresponsive' C3H/HeJ mouse were activated by LPSs from the Fusobacterium species. PMID- 3265431 TI - The prevalence of multiple sclerosis in south east Wales. AB - A population-based survey of multiple sclerosis in the county of South Glamorgan has demonstrated a prevalence of 441/376718 (117/10(5)). Eighty six per cent of the patients (101/10(5)) had definite or probable disease and 14% (16/10(5)) had suspected multiple sclerosis on 1 January 1985. The estimated average incidence is 5.41/10(5)/year for the period 1947-84 and it has risen significantly over four decades. The prevalence is similar to that found in a recent survey from the south east of England but significantly lower than revised figures from Scotland. PMID- 3265433 TI - [A bacteriologic study of beta-lactamase-producing organisms--drug resistance and clinical behavior]. PMID- 3265434 TI - [Histogenetic study of the vestibular ganglion cells in the chick embryo--in relation to the vestibular sensory organs]. PMID- 3265435 TI - Assessing the validity of self-reported adolescent cigarette smoking. PMID- 3265432 TI - Association of HLA-DR2 antigen with serum IgG antibodies against Borrelia burgdorferi in Bannwarth's syndrome. AB - The frequency of the HLA-DR2 antigen in 33 patients with clinical symptoms and signs of Bannwarth's syndrome was 33%, which was not significantly different from the 29% occurrence in 505 control subjects. However, all 11 HLA-DR2-positive patients had elevated serum levels of IgG antibodies against Borrelia burgdorferi, and these were present in 45% of 22 HLA-DR2-negative patients (P = 0.004). In the 21 patients with anti-B. burgdorferi antibodies the frequency of HLA-DR2 was 52%, which is significantly higher than the frequency in the control group (P = 0.04). The diagnosis of Bannwarth's syndrome was serologically confirmed by a positive indirect immunofluorescence assay (IFA). A negative test result does not exclude the diagnosis, as has recently been demonstrated with more sensitive techniques. The association between HLA-DR2 and a positive IFA suggests that the IFA selects a subgroup of patients with Bannwarth's syndrome and a different immune response. We could not demonstrate differences in the clinical spectrum and outcome between the two groups. PMID- 3265436 TI - Smokeless tobacco use among Ontario students. PMID- 3265437 TI - [Myocardial blood flow and glucose metabolism in patients with myocardial infarction evaluated by positron emission tomography: comparison with left ventriculography]. AB - Myocardial positron emission tomography (PET) using N-13-ammonia (NH3) and F-18 fluorodeoxyglucose (FDG) was performed in 16 patients with myocardial infarction to assess myocardial blood flow and glucose utilization. These PET data were also compared by left ventriculography. N-13-ammonia PET study was performed at rest and after supine ergometer exercise as a measure of myocardial blood flow, and the F-18-FDG PET study was performed at rest after more than five hours' fasting as a measure of glucose utilization. The N-13-ammonia PET study revealed hypoperfused regions in 15 of 16 patients (94%) corresponding to the infarct regions identified by electrocardiography and by cardiac catheterization. In 12 of 16 patients (75%) these hypoperfused regions expanded with exercise. FDG uptake was observed in the hypoperfused regions, especially in stress-induced ischemic ones. Increased uptake of FDG was more often observed in patients with mildly hypokinetic wall motion on left ventriculography. However, FDG PET studies demonstrated diffuse uptake of FDG in some of the akinetic and dyskinetic segments. PMID- 3265438 TI - [Utility of digital perfusion images of the lung in mitral stenosis: the pathophysiological significance of the distribution of pulmonary perfusion]. AB - The relationship between pulmonary hemodynamics (cardiac index; CI and the mean pulmonary artery wedge pressure; mPw) and the redistribution of pulmonary perfusion were studied in 300 patients with mitral stenosis using computerized Tc99m-MAA perfusion images (digital perfusion images: DPI), which consisted of isocount areas. Various types of DPI were obtained and were classified in six grades according to patterns of 100-70% of the isocount area in the right anterior DPI, i.e. grade-0 (normal), grade-1 (increased perfusion in the upper zone), grade-2 (uniform distribution), grade-3 (disappearance of the basal hyperperfusion area), grade-4 (apical hyperperfusion area) and grade-5 (decrease of perfusion at the lower zone). The mPw was thought to be one of the factors determining distribution. Thus, it was not adequate to estimate the mPw from DPI. In patients with the mPw less than 20 mmHg, an increase in perfusion at the upper zone and disappearance of the basal hyperperfusion might be noted, however, the mPw more than 20 mmHg was necessary to cause an apical hyperperfusion area. The predictive values of grades 0 and 1 for the mPw less than 20 mmHg were 70% (54/77) and those of grades 4 and 5 for the mPw less than 20 mmHg and the mPw less than 25 mmHg were 86% (110/128) and 56% (71/128), respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265439 TI - [Combined valvular disease with the scimitar triad: a case report]. AB - A case of combined valvular disease with the scimitar sign is reported. A 48-year old woman was admitted to our hospital for treatment of congestive heart failure due to combined valvular disease following an upper respiratory infection. Chest radiography revealed hypoplasia of the right lung, dextroposition of the heart and a curved vascular opacity adjacent to the right cardiac border having the appearance of a scimitar sign. The latter was better demonstrated by chest tomography. A lung scan showed a marked decrease in perfusion of the right lung. A CT scan of the thorax revealed hypoplasia of the right lung, dextroposition of the heart and an abnormal, curved and thickened right pulmonary vein which drained into a markedly enlarged left atrium. Right heart catheterization demonstrated elevated pressures in the right side of the heart. However, no shunt was demonstrated. A pulmonary angiogram revealed an anomalous pulmonary vein, having the appearance of a scimitar sign draining normally into the left atrium. Only five cases like the present case have been reported in the world literatures. The results in the present case indicate that patients with radiological evidence of the scimitar syndrome should be examined using computed tomography of the chest to rule out the "pseudoscimitar sign." PMID- 3265440 TI - [Infarct size related to the distribution and site of coronary artery lesions studied by the unfolded map technique using single photon emission computed tomography]. AB - To assess the relative importance of the anatomical characteristics of the coronary artery distribution and the sites of the arterial stenoses in relation to infarct size, 21 patients with old myocardial infarction and angiographically proven 90% or greater stenoses (AHA classification) of one of the major coronary arteries were studied. The infarct size was evaluated by a new quantitative method, the unfolded map, derived from single photon emission computed tomography (SPECT). Eleven patients had right coronary artery disease (Group RCA: segment 1; five patients and segment 2; six patients). Seven patients who had the large left anterior descending artery (LAD) which was distributed to the inferior portion of the apical area were defined as Small R, and four patients with large RCA as Large R. Ten patients each had a significant stenosis in the LAD (Group LAD: segment 6; six patients and segment 7; four patients). Four patients with significant stenosis proximal to segment 9 were defined as Pre-9, and seven patients with stenosis distal to the segment, as Post-9. Stress T1-201 scintigraphy with SPECT was performed and the unfolded map was obtained with data of the maximal count circumferential profiles in the redistribution image. Infarction was defined as a defect below 55% of the standard value. The necrotic area ratio expressed as percentage of the defect area to the entire map area was calculated and used as the indicator of infarct size. Although there was no significant difference in the necrotic area ratio between segment 1 and 2 lesions. Large R had the significantly larger necrotic area ratios (24.9 +- 4.6%) than did Small R (9.7 +- 4.4%; p less than 0.01). In the Group LAD, there was no significant difference in the necrotic area ratio between segment 6 and 7 lesions, but Pre-9 had the larger ratio (30.4 +- 3.3%) than did Post-9 (15.4 +- 7.7%; p less than 0.01). These data suggest that the factors related to infarct size are either the distribution of the coronary arteries in the apical area in the Group RCA or the sites of the stenotic lesions relative to the branching portion of the first diagonal branch in the Group LAD. PMID- 3265441 TI - Sri Lankan cleft lip and palate project: a preliminary report. AB - By means of a surgical expedition involving an independently financed team of surgeons, anaesthetists, nurses, orthodontists and speech therapists, 195 patients in Sri Lanka with cleft lip and palate were treated over a period of 4 weeks while over 300 patients were examined in detail to assess faciomaxillary growth, components of speech and the psychosocial impact of the untreated deformity in childhood and adult life. Lip surgery proved to be simple and safe but in certain older patients palatal closure was complicated by wide palatal shelf displacement, mucosal fibrosis and heavy bleeding. This is a preliminary report and much data has yet to be analysed but there is little doubt that impaired facial growth following palatal repair is predominantly an iatrogenic deformity. PMID- 3265443 TI - Spermiogenesis in the bullfrog (Rana catesbeiana): a study of cytoplasmic events including cell volume changes and cytoplasmic elimination. AB - The process by which spermatid cytoplasmic volume is reduced and cytoplasm eliminated during spermiogenesis was investigated in the bullfrog Rana catesbeiana. At early phases of spermiogenesis, newly formed, rounded spermatids were found within spermatocysts. As acrosomal development, nuclear elongation, and chromatin condensation occurred, spermatid nuclei became eccentric within the cell. A cytoplasmic lobe formed from the caudal spermatid head and flagellum and extended toward the seminiferous tubule lumen. The cytoplasmic lobe underwent progressive condensation whereby most of its cytoplasm became extremely electron dense and contrasted sharply with numerous electron-translucent vesicles contained therein. At the completion of spermiogenesis, many spermatids with their highly condensed cytoplasm still attached were released from their Sertoli cell into the lumen of the seminiferous tubule. There was no evidence of the phagocytosis of residual bodies by Sertoli cells. Because spermatozoa are normally retained in the testis in winter and are not released until the following breeding season, sperm were induced to traverse the duct system with a single injection of hCG. Some spermatids remained attached to their cytoplasm during the sojourn through the testicular and kidney ducts; however, by the time the sperm reached the Wolffian duct, separation had occurred. The discarded cytoplasmic lobe (residual body) appeared to be degraded with the epithelium of the Wolffian duct. It was determined that the volume of the spermatid was reduced by 87% during spermiogenesis through a nuclear volume decrease of 76% and cytoplasmic volume decrease of 95.3%. PMID- 3265442 TI - Odorant response of isolated olfactory receptor cells is blocked by amiloride. AB - Olfactory receptor cells were isolated from the nasal mucosa of Rana esculenta and patch clamped. Best results were obtained with free-floating cells showing ciliary movement. 1) On-cell mode: Current records were obtained for up to 50 min. Under control conditions they showed only occasional action potentials. The odorants cineole, amyl acetate and isobutyl methoxypyrazine were applied in saline by prolonged superfusion. At 500 nanomolar they elicited periodic bursts of current transients arising from cellular action potentials. The response was rapidly, fully and reversibly blocked by 50 microM amiloride added to the odorant solution. With 10 microM amiloride, the response to odorants was only partially abolished. 2) Whole-cell mode: Following breakage of the patch, the odorant response was lost within 5 to 15 min. Prior to this, odorants evoked a series of slow transient depolarizations (0.1/sec, 45 mV peak to peak) which reached threshold and thus elicited the periodic discharge of action potentials. These slow depolarizing waves were reversibly blocked by amiloride, which stabilized the membrane voltage between -80 and -90 mV. We conclude that amiloride inhibits chemosensory transduction of olfactory receptor cells, probably by blocking inward current pathways which open in response to odorants. PMID- 3265444 TI - Role of actin filaments in shape formation of mesenteric mesothelial cells of the bullfrog. AB - The role of actin filaments in the development of cellular shape in the mesenteric mesothelium of the bullfrog was studied by using a simple, new technique for making en face preparations of mesothelial sheets. By using these mesothelial cell preparations, the distribution of actin was determined by means of fluorescence microscopy with 7-nitrobenz-2-oxa-1,3-diazole (NBD)-phallacidin and that of myosin by means of immunofluorescence microscopy. Although fluorescence produced by both NBD-phallacidin and antimyosin staining was found exclusively along the margins of the cells, its intensity was altered in correspondence with changes in cell shape. For instance, tadpole-type mesothelial cells with either an irregular or very slender cell shape showed very weak fluorescence. On the other hand, frog-type mesothelial cells with a polygonal shape showed intense fluorescence at their margins and had circumferential bundles of actin filaments at their apices. Furthermore, intercellular junctions between the mesothelial cells developed as the cell shape became polygonal during metamorphosis. The present study showed that development of circumferential bundles of actin filaments and intercellular junctions may serve to establish and maintain the definitive polygonal cellular pattern in the mesenteric mesothelium of the bullfrog. PMID- 3265445 TI - [Bacteriological, pharmacokinetic and clinical studies on a rokitamycin dry syrup in the pediatric field]. AB - Bacteriological, pharmacokinetic and clinical studies were done on the effect of rokitamycin (RKM, TMS-19-Q) in the field of pediatrics. The results are summarized below. 1. Antibacterial activities Antibacterial activities of RKM against Staphylococcus aureus (including 50 methicillin-sensitive and 50 methicillin-resistant strains), 18 strains of Haemophilus influenzae and 50 strains of Campylobacter jejuni were studied comparatively with activities of josamycin (JM), midecamycin (MDM), erythromycin (EM) and cefaclor (CCL) or ampicillin. Minimum inhibitory concentrations (MICs) of the 5 antibiotics against methicillin-sensitive S. aureus showed a wide variation but RKM was somewhat superior among them. MIC80 of those antibiotics tested against methicillin sensitive S. aureus were as follows; RKM 1.56, JM 12.5, MDM 12.5, EM 6.25, and CCL 3.13 micrograms/ml. Among methicillin-resistant S. aureus (MRSA), ratios of strains highly resistant to these antibiotics (MIC greater than or equal to 100 micrograms/ml) to total number of strains tested were: 18% to RKM, and 26%, 34% and 48% to JM, MDM and EM, respectively, again showing the superiority of RKM and the proliferation of resistant organisms to EM. MICs of RKM against H. influenzae were distributed in a range between 0.78 and 12.5 micrograms/ml, which were similar to MIC range of CCL, and approximately twice as high as that of EM, but 4 folds lower than those of JM and MDM. Against C. jejuni, the MIC range of RKM was quite broad, 0.10-12.5 micrograms/ml, with a peak value of 0.20 micrograms/ml. The cumulative number of strains vs. MIC curve was similar to that of EM, and RKM was approximately 4 to 8 folds more effective than the other 3 antibiotics. 2. Absorption and excretion The absorption and the excretion of RKM were studied with its dry syrup preparations. Dose levels examined were 5 mg/kg in 2 cases, 10 mg/kg in 7 cases, 15 mg/kg in 2 cases and 20 mg/kg in 1 case. Peak concentrations of RKM in blood were not dose-dependent and were 0.16-0.23, 0.29-0.91, 0.35-0.46 microgram/ml and 0.53 microgram/ml, respectively, for the 4 dose levels. Most of drug levels dropped below the detection limit in 4 hours after the administration when dose levels up to 10 mg/kg were used, and when dose levels were at or above 15 mg/kg, 0.07-0.09 microgram/ml of RKM was detected in blood at 6 hours after the administration. Urinary recovery rates in 6 hours were between 0.19 and 3.31%.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3265446 TI - [Diagnosis of Alzheimer's disease with PET and SPECT]. PMID- 3265447 TI - [Recent topics on Alzheimer's disease. Immunological study of Alzheimer's disease]. PMID- 3265448 TI - [A case of chronic hepatitis B treated with IFN-alpha and IL-2]. PMID- 3265449 TI - [Three-dimensional functional imaging by deconvolution analysis in Tc-99m-PMT hepatobiliary dynamic SPECT imaging]. PMID- 3265450 TI - [Validity of positron emission tomography (PET) using 2-deoxy-2-[18F]fluoro-D glucose (FDG) in patients with renal cell carcinoma (preliminary report)]. PMID- 3265451 TI - [Studies of left ventricular volume estimation from single photon emission computed tomography]. PMID- 3265452 TI - [Semidecubitus position scanning method for thallium-201 cardiac single photon emission computed tomography]. PMID- 3265454 TI - [Cigarette smoking and lung metabolism--effect of cigarette smoking on plasma levels of complement C3a and C5a in healthy volunteers]. PMID- 3265453 TI - Time-course study of gastric damages in rats by anti-inflammatory drugs using a gastroscope and its quantification. AB - Time-course studies on gastric damages in rats caused by nonsteroidal anti inflammatory drugs (NSAIDs) were performed using a gastroscope, and the readings were quantified to obtain the Congestion-Hemorrhage Index (CHI) for evaluating the potencies of the damaging properties of NSAID. The correlation between CHI and Ulcer Index (UI), the quantified value obtained by the conventional methods, was highly significant at 6 and 24 hr after forced oral administration of NSAID. The peak CHIs of aspirin (300 mg/kg), indomethacin (60 mg/kg), mefenamic acid (300 mg/kg) and fenoprofen calcium (300 mg/kg) appeared approximately 24 hr after a single forced oral administration of drugs. Thus, it was suggested that an observation at 24 hr in addition to one at 6 to 7 hr might be necessary for the examination of damaged gastric mucosa. Under the present experimental conditions, fenoprofen calcium caused the greatest damages on gastric mucosa among the four NSAIDs. Mefenamic acid showed the least damaging potency on gastric mucosa, having a smaller CHI than that of aspirin. Indomethacin possessed a stronger damaging property than aspirin. PMID- 3265455 TI - [A case of sarcoidosis complicated by pleural effusion]. PMID- 3265456 TI - [An autopsy case of acquired immuno-deficiency syndrome associated with P. carinii pneumonia with a rapid clinical course resembling ARDS]. PMID- 3265457 TI - [A classification of intraocular bacteriologic findings following lens implantation]. AB - Findings in seven patients with intraoperative bacterial invasions are reported. These invasions were classified in three stages of severity: (1) According to the literature it may be assumed that clinically undetectable invasion occurs in more than 10% of all operations. The bacteria detected in one case may have been a secondary finding in an electron-microscopic study. (2) A benign endophthalmitis caused by Staphylococcus epidermidis was found in three patients. The symptoms initially prompted the incorrect diagnosis "toxic lens syndrome". Cells resembling leukocytes were detected on the lenses by light microscopy. Following explantation of the lens and the posterior capsule, patients' vision slowly recovered to an average of 0.8. (3) Of three patients with fulminant panophthalmitis caused by Enterococci and/or Staphylococcus epidermidis, only one patient re-attained 0.5 vision, after two weeks; in the second case vision remained restricted to "hand movements", and in the third the eye had to be enucleated. PMID- 3265458 TI - [Disorders of color perception in subtoxic and toxic digoxin and serum digoxin concentrations]. AB - Using the Farnsworth-Munsell 100-hue test, investigations were carried out in 14 patients with subtoxic to toxic serum concentrations of digoxin (greater than 2.0 ng/ml) and 13 patients with subtoxic to toxic serum concentrations of digitoxin (greater than 30 ng/ml), in order to detect color vision deficiencies related to serum levels of digitalis. As compared to the control group (n = 24) the total error scores were significantly increased for both glycosides and all serum level ranges. No evidence was found indicating that digoxin and digitoxin influence color vision differently. The FM 100-hue test indicated definite improvements in the digoxin group within one day of discontinuing the glycosides, while the digitoxin group only started to normalize a week later. The results are discussed, taking the different pharmacokinetics of the two digitalis glycosides into account. PMID- 3265459 TI - [Cerebral achromatopsia (symptoms, course, differential diagnosis and strategy of the study). I]. AB - To the patient, the sudden onset of cerebral achromatopsia is like switching to black and white on a color TV. As a rule, the defect arises due to bilateral ischemic infarction in the inferior occipitotemporal region. Bilateral upper homonymous quadrantanopsias usually leave the macula more or less unimpaired, so that visual acuity is largely preserved. Prosopagnosia and loss of topographic memory are often associated with central achromatopsia. Investigations of color vision must include color-naming procedures and largefield tests in addition to the conventional methods. Color-naming tasks are indispensable in differentiating cerebral achromatopsia from the aphasic and disconnective types of color anomia. The authors' recommended strategy for investigating color vision relies on records of a case of cerebral achromatopsia obtained six months and two years, respectively, after the onset of symptoms. In addition to the above-mentioned procedures, spectral increment thresholds on white and colored backgrounds were determined. For the first time in cerebral achromatopsia, examinations with large field spectral matches were performed using the projection anomaloscope. Large field tests are indispensable for monitoring recovery in cases of central achromatopsia. In the author's patient, recovery of blue-green discrimination was far more complete than that of red-yellow-green discrimination, and for both conditions large-field color vision was far superior to small-field. PMID- 3265460 TI - [Topographic relation of dislocated lenses to the ciliary body and vitreous base]. AB - There are three forms of lens dislocation in the posterior segment: intravitreal, prebasal, and intrabasal. The location of the dislocated lens depends on gravity and the condition of the vitreous body. As a rule the dislocated lens lies at the bottom of the vitreous cavity; it may be completely embedded in the vitreous substance or completely outside the vitreous body, or partially within the vitreous base. The topographic relations between dislocated lenses and the vitreous body cannot be determined by ophthalmoscopic examination, but biomicroscopy generally permits an accurate assessment. Biomicroscopic findings are described. PMID- 3265461 TI - Corneal dystrophy in Fischer 344 rats. AB - A spontaneous degenerative lesion of the cornea resembling calcific band keratopathy in man has been observed in 10-15% of the F-344 rats (aged 35-300 days) purchased from a private vendor's closed breeding colony. The lesion appears clinically as punctuate to linear superficial corneal opacities located in the interpalpebral fissure of one or both eyes. Occasional roughening, bleb formation, or pitting of the corneal surface resembling superficial ulcers may be observed. The lesion occurs in both sexes. It is rarely associated with inflammation or irritation. Histologically, it consists of mineral deposits along the epithelial basement membrane and Bowman's space, some of which are large enough to disrupt or destroy portions of the basilar epithelium. Energy dispersive X-ray analysis of the deposits proved them to be composed of calcium and phosphorus. Electron microscopic examination revealed a variety of extracellular laminated and crystalline arrays similar to those seen in humans with band keratopathy. The etiology of the lesion is as yet undetermined. A genetic-associated susceptibility due to hypercalcemia may be involved. PMID- 3265463 TI - Retrosternal hemorrhage: an experimental model for study of lymphatic leakage. AB - Courtice and colleagues observed that blood injected into the peritoneal cavity of rats occasionally leaked from retrosternal lymphatics. The present work shows that this leakage is determined by volume as well as dose of inoculum. The uniform occurrence of visible retrosternal hemorrhage after injection of diluted blood suggests its use as a model for lymphatic leakage. Leakage was prevented when the blood was instilled during the healing phase of a chemical peritonitis. PMID- 3265462 TI - Prevalence of Campylobacter in infant, juvenile and adult laboratory primates. AB - A cross-sectional study of Campylobacter spp. infection was conducted on 125 infant (Macaca nemestrina and Macaca fascicularis) in an infant primate nursery housing infants from birth to 18 months of age, and 145 M. nemestrina aged from 4 months to 15 years at another facility (Primate Field Station) housing animals from birth to aged adults. The objective was to determine the prevalence of Campylobacter spp. in various age groups and to investigate the correlation with diarrhea. In the Infant Primate Research Laboratory approximately 70% of infants were infected at 18 months-old. Campylobacter coli was isolated from approximately two-thirds of the infected infants. One-third were Campylobacter jejuni and occasional infants were infected with a naladixic acid resistant, hippurate negative (NAR) Campylobacter spp. At the Primate Field Station virtually all animals cultured in 4-6 month-old, 16-20 month-old, and 3-5 year old age groups were positive. Approximately one-third of middle-aged adults (10 15 years old) were positive with C. coli or NAR Campylobacter spp. Environmental factors such as location and movement of animals may provide an explanation for the prevalence data obtained in the two facilities and different age groups of animals. An etiologic role of Campylobacter spp. in diarrhea of laboratory primates was not established in this study. PMID- 3265464 TI - Epidermal cell thymocyte activity factor/interleukin 1 (ETAF/IL)-like activity in lymph drained from normal human skin. AB - Lymph derived from human skin contains lymphocytes which have a high rate of spontaneous blastic transformation in culture and are highly responsive to lectins. This phenomenon suggests that either a subpopulation of highly responsive lymphocytes is extravasated into skin, or skin tissue fluid and lymph contain humoral factors co-stimulating lymphocytes upon contact with tissue antigens. We sought to determine whether human prenodal lymph drained from normal leg skin possesses lymphokine activity. Significant augmentation of lectin induced thymocyte and autologous blood lymphocyte proliferation was produced by lymph. The augmenting activity was abrogated by incubation of lymph with anti-IL 1 antiserum. Supernatant from cultured lymph cells (lymphocytes, Langerhans cells) did not augment either thymocyte or autologous blood lymphocyte proliferation. No interleukin 2 activity was found in lymph. The data indicate that skin lymph possesses epidermal cell thymocyte activating factor/interleukin (ETAF/IL) 1-like activity which is not found in serum and that the main source of the putative lymphokine is epidermal and not migrating lymph mononuclear cells. PMID- 3265465 TI - Effects of cholera toxin on delayed-type hypersensitivity to sheep red blood cells inoculated intranasally into mice. AB - The effects of cholera toxin (CT) on delayed-type hypersensitivity (DTH) to sheep red blood cells (SRBC) were studied in mice sensitized by intranasal administration of SRBC. CT (1 microgram/mouse), given intranasally together with SRBC (2 x 10(7)/mouse), induced a maximally enhanced DTH response, which reached its peak around 7 days after sensitization, and also induced an accelerated DTH response upon a second administration of SRBC 28 days later. The ability of CT to enhance the DTH to SRBC was lost, either when CT was administered via the intraperitoneal or subcutaneous route, or when CT was introduced into the nasal site from which a large proportion of the SRBC was discharged 2 days after SRBC administration. These results indicate that the cells that are located in the nasal site and participate in the earlier events of DTH response were most affected by CT. The following effects of CT on the earlier events, which occur within 24 hr after the intranasal administration of both CT and SRBC, appeared to be involved in the mechanisms by which CT enhances DTH to SRBC: (i) facilitation of the penetration of the antigen into the nasal tissue; (ii) reinforcement of the migration of immunocompetent cells from the blood to the nasal tissues; (iii) promotion of the ability of Ia-positive macrophages to present the antigenic determinants to T cells; (iv) facilitation of the differentiation of primed T cells to DTH-effector T cells. PMID- 3265466 TI - [Irradiation as therapy in painful sternocostoclavicular hyperostosis]. PMID- 3265467 TI - [AIDS and the lung]. PMID- 3265468 TI - [Surgical treatment of the left main trunk and left main equivalent coronary artery disease]. AB - The comparative studies on operative and hemodynamic results following aorto coronary bypass grafting were performed in 9 patients with left main trunk (LMT) stenosis and 20 with left main equivalent (LME). One of 20 LME had bypass grafts occluded on the postoperative angiogram. There were two operative deaths, one in LMT, another in LME, and one late death. Following results were obtained in 8 LMT (Group I) and 15 LME (Group II) whose all bypass grafts were patent. There were significantly higher operative mortality rate and the incidence of perioperative myocardial infarction in Group I (11.1% versus 5.0%). Cardiac index and left ventricular ejection fraction significantly increased postoperatively in both groups. Mean Vcf and PLVSP/LVESV significantly increased postoperatively in Group II, but not in Group I. Left ventricular anterior segmental wall motion significantly increased in both groups and apical in Group I, whereas it did not in the postero-inferior segment. The completely revascularized patients had a better postoperative left ventricular function comparing with the incompletely revascularized patients. Angina disappeared postoperatively in all patients in Group I and 12 (75%) in Group II. In both groups, NYHA classification was improved from class III or IV preoperatively to class I or II postoperatively. Postoperative 8 years actuarial survival rate was 88.2% in Group I and 84.6% in Group II. In conclusion, it was suggested that much more strict perioperative management and complete revascularization were needed in the patient with LMT. PMID- 3265469 TI - [Mutations in the alpha-amylase gene of Bacillus amyloliquefaciens, leading to a decrease in the temperature of protein inactivation]. AB - Alpha-amylase genes of Bacillus amyloliquefaciens, coding proteins with reduced thermostability, had been obtained as a result of hydroxylamine mutagenesis. Temperature, pH and starch concentration dependences of two mutant alpha-amylases were investigated. The synthesis of the alpha-amylases by several B. subtilis strains with different levels of extracellular proteases was also studied. The mutation containing fragments were localized and the structures of the mutations were determined. It was found that the decrease of thermostability of mutant No 141 was due to Asp to Asn change at the position No 194 of the mature protein, and for mutant No 191--due to Glu to Lys change at the position No 185. PMID- 3265470 TI - Isolation and structural characterization of the human 4F2 heavy-chain gene, an inducible gene involved in T-lymphocyte activation. AB - The human 4F2 cell surface antigen is a 120-kilodalton (kDa) disulfide-linked heterodimer which is composed of an 80- to 90-kDa glycosylated heavy chain (4F2HC) and a 35- to 40-kDa nonglycosylated light chain (4F2LC). 4F2 belongs to a family of inducible cell surface molecules which are involved in T-lymphocyte activation and growth. To better understand the molecular mechanism(s) that controls 4F2HC gene expression in both resting and activated T cells, a 4F2HC human genomic clone was isolated and structurally characterized. The 4F2HC gene spans 8 kilobases of chromosome 11 and is composed of nine exons. The 5' upstream region of the gene displays several properties which are characteristic of housekeeping genes. It is G+C rich and hypomethylated in peripheral blood lymphocyte DNA and contains multiple binding sites for the Sp1 transcription factor while lacking TATA or CCAAT sequences. This region of the gene also displays sequence homologies with several other inducible T-cell genes, including the interleukin-2, interleukin-2 receptor alpha chain, dihydrofolate reductase, thymidine kinase, and transferrin receptor genes. A 255-base-pair fragment of the 4F2HC gene which contains 154 base pairs of the 5' flanking sequence was able to efficiently promote expression of the bacterial chloramphenicol acetyltransferase gene in human Jurkat T cells, indicating that it contains promoter or enhancer (or both) sequences. Analyses of chromatin structure in resting and lectin activated T cells revealed the presence of stable DNase I-hypersensitive sites within both the 5' flanking and intron 1 regions of the 4F2HC gene. Although the 4F2HC gene displayed many of the structural features characteristic of a constitutively expressed gene, lectin-mediated activation of resting peripheral blood T lymphocytes resulted in a dramatic increase in steady-state levels of 4F2HC mRNA. PMID- 3265471 TI - Regulation of 4F2 heavy-chain gene expression during normal human T-cell activation can be mediated by multiple distinct molecular mechanisms. AB - The 4F2 molecule belongs to the set of cell surface antigens which is induced following lectin- or antigen-mediated T-cell activation. The increase in 4F2 cell surface expression following lectin-mediated stimulation has been shown to be accompanied by a parallel increase in the steady-state levels of 4F2 heavy-chain (4F2HC) mRNA. The studies described in this report were designed to further elucidate the molecular mechanisms responsible for induction of 4F2HC gene expression following activation of normal resting human peripheral blood T cells. The low levels of mature 4F2HC mRNA in resting T cells were shown to be the result of a block to transcription elongation within the exon 1-intron 1 region of the 4F2HC gene rather than promoter inactivity. Phorbol myristate acetate stimulation of resting T cells resulted in a 20-fold increase in steady-state 4F2HC mRNA levels which was mediated by removal of this block to transcription elongation. The phorbol myristate acetate-induced increase in 4F2HC gene expression is distinct from previously described AP-1-mediated, phorbol ester induced gene expression in that it requires new protein synthesis. Treatment of resting T cells with ionomycin plus PMA resulted in a 60-fold increase in 4F2HC mRNA levels. This induction was mediated by both an increase in promoter utilization and removal of the block to transcription elongation. Finally, by increasing the half-life of 4F2HC mRNA, cycloheximide treatment of resting T cells induced an approximately five fold increase in the levels of 4F2HC gene expression, although the physiologic significance of this mechanism remains unclear. These results demonstrate that the level of 4F2HC gene expression in normal peripheral blood T cells can be regulated by at least three distinct molecular pathways: (i) changes in promoter utilization, (ii) modulation of a block to transcription elongation, and (iii) alteration in mRNA stability. PMID- 3265472 TI - Transcriptional and posttranscriptional regulation of CSF-1 gene expression in human monocytes. AB - Regulation of CSF-1 gene expression was investigated in human monocytes. CSF-1 transcripts were at low or undetectable levels in resting monocytes. However, in monocytes treated with 12-O-tetradecanoylphorbol-13-acetate (TPA), CSF-1 mRNA was increased by 3 h and reached maximal levels by 12 h of drug exposure. When nuclear run-on assays were used, CSF-1 gene transcription was also at low or undetectable levels in resting monocytes but was activated after TPA exposure. TPA-treated monocytes exposed to actinomycin D further demonstrated that the half life of the CSF-1 mRNA is 0.9 h. The results also demonstrated that the protein synthesis inhibitor, cycloheximide (CHX), increases CSF-1 mRNA levels in both resting and TPA-treated monocytes. These effects of CHX occurred in the absence of detectable increases in CSF-1 gene transcription. Moreover, treatment of monocytes with CHX and actinomycin D demonstrated that inhibition of protein synthesis is associated with stabilization of the CSF-1 transcript. Taken together, these findings indicated that CSF-1 gene expression is controlled at both transcriptional and posttranscriptional levels in human monocytes. PMID- 3265473 TI - Homologous sequences in steroidogenic enzymes, steroid receptors and a steroid binding protein suggest a consensus steroid-binding sequence. AB - The amino acid sequences of two steroidogenic enzymes, P450c17 (steroid 17 alpha hydroxylase/17,20 lyse) and P450c21 (steroid 21-hydroxylase), are only 28.9% identical. However, these proteins share a region of 21 amino acids bearing 17 identical residues, which we previously suggested may represent the steroid binding site. We assembled a sequence database of known steroid-binding proteins and searched this with the sequence of this 21 amino acid region. The steroidogenic enzymes, P450c17, P450c21, P450scc (the cholesterol side-chain cleavage enzyme), and P450c11 (steroid 11 beta/18-hydroxylase) share a subregion of 17 amino acids having at least 15 identical residues. Related sequences were identified in a computerized search of the available sequences of steroid hormone receptors and binding proteins. These sequences were invariably found within larger domains previously associated with steroid binding. From these we propose a more general consensus sequence of LPLLL +/- 000KDRE0LKRL +/- PV, where +/- refers to any charged amino acid, and 0 refers to an uncharged amino acid. This consensus sequence predicts 147 or 187 total amino acids in 11 human proteins examined (78.6%). An equivalent degree of sequence identity, 178 of 221 amino acids (80.5%) was found among 13 animal homologs of these human proteins. The ability of this consensus sequence to predict 325 of 408 amino acids (79.7%) strongly suggests this sequence is necessary, if not sufficient, for a steroid binding site in many proteins. Lecithin-cholesterol acetyl transferase, cholesterol ester transfer protein, and steroid sulfatase did not have sequences similar to our consensus sequence. PMID- 3265474 TI - The C1q receptor. PMID- 3265475 TI - Role of proteinkinase C and phosphatidylinositol metabolism in lipopeptide induced leukocyte activation as signal transducing mechanism. AB - Synthetic lipopeptides are potent B-lymphocyte and macrophage activators. The role of phosphatidylinositol metabolism and proteinkinase C in lipopeptide induced leukocyte activation were investigated. In murine B-lymphocytes and in bone marrow derived macrophages, lipopeptide failed to induce phosphatidylinositol breakdown, whereas in the macrophage cell line P388D1 formation of inositolphosphates was increased. Translocation of proteinkinase C from a cytosolic to a membrane compartment was only observed in the cell line P388D1 indicating that in the other cells tested lipopeptide acts via different signal transduction pathways. PMID- 3265476 TI - Targeted cytotoxic cells as a novel form of cancer immunotherapy. PMID- 3265477 TI - Structure and function of membrane IL-1. AB - Both interleukin-1 alpha (IL-1 alpha) and IL-1 beta are initially translated as approximately Mr 30,000 polypeptides, lacking hydrophobic or signal sequence that could facilitate transmembrane translocation and release of mature IL-1 (Mr 17,500). The current study utilizes an antiserum specific for murine IL-1 alpha in order to investigate membrane associated IL-1 alpha polypeptides and possible postsynthetic modifications of the IL-1 alpha precursor, that might account for its intracellular transport. Cell surface iodination of endotoxin stimulated murine macrophages allowed the detection of IL-1 molecules in size similar to the IL-1 alpha precursor (Mr 33,000). Membrane bound IL-1 alpha was sensitive to degradation by serine esterase activity to yield IL-1 peptides of Mr 16,000 to 18,000. Endotoxin stimulated macrophages, but not unstimulated cells, incorporated 32PO4 into the IL-1 alpha precursor. The phosphate label of the IL-1 alpha precursor is resistant to hydroxylamine and alkaline phosphatase treatment. Released IL-1 is not phosphorylated. Approximately 10% of the phosphorylated IL-1 alpha precursor is membrane bound and associated with fractions enriched in lysosomal vesicles. These data are consistent with a model for mIL-1 expression, in which pro IL-1 alpha is post-synthetically modified to achieve intracellular transport and further suggest that mIL-1 may be a prerequisite for the release of IL-1. PMID- 3265478 TI - The high affinity interleukin 2 receptor: evidence for three distinct polypeptide chains comprising the high affinity interleukin 2 receptor. AB - Low and high affinity receptors for interleukin 2 were investigated on interleukin 2 (IL-2) receptor bearing cells by chemical cross-linking of 125I labelled IL-2 to its receptor, or membrane proteins associated with the IL-2 binding sites. SDS-PAGE analysis of the cross-linked complexes of the murine CTLL 16 cells and human T-blasts, which bear high and low affinity IL-2 receptors, showed three distinct bands. The fastest of those three bands ran in parallel to the single band of 65-70 kDa found on the only low affinity receptor bearing mouse T-lymphoma Eb, which is thought to be one beta-chain (55 kDa IL-2 binding protein) and one IL-2. Both upper bands ran in parallel with those produced by the 2C8 clone of the NK-like cell line YT which lacks the 55 kDa binding protein and bears only a single class of receptors with an intermediate affinity. Internalisation studies using CTLL 16 cells revealed that all three bands disappeared under conditions allowing receptor internalisation. Low and high affinity binding sites of CTLL 16 cells were destroyed by trypsinisation and the IL-2 binding properties of the cells were regenerated in parallel with the reappearance of all bands. These results show in addition to the beta-chain (55 kDa binding protein) and the alpha-chain 75 kDa binding protein, an IL-2 membrane protein complex with an apparent mol. wt of 115 kDa in CTLL 16 cells. They are the first direct indication of a putative gamma-chain of the high affinity IL-2 receptor. PMID- 3265479 TI - Interleukin-2 secretion in vivo and in vitro by synovial fluid lymphocytes in rheumatoid arthritis. PMID- 3265480 TI - Autoreactive B-cell repertoire in mice with chronic graft versus host disease. AB - A quantitative analysis of the frequencies of autoantibody producing B-cells has been undertaken by producing and analyzing random hybridoma collections generated in fusions with activated B-cells. Activated B-cells were derived from mice injected with LPS and SRBC and normal mice. They were compared to those derived from mice undergoing chronic GVHD. The frequencies of successful fusion events correlate well with the number of activated B-cells used in the fusions, so that it is reasonable to conclude that the hybridoma collections reflect the activated B-cell repertoires in the different animals. The frequencies of hybridomas producing autoantibodies as well as their specificities for self-antigens, were not significantly different between the different collections of hybridomas. Moreover, no difference in VH gene family expression was found in the different collections of autoantibody producing hybridomas. So, the activated autoreactive B-cell repertoires in GVHF1 mice and in normal mice is similar. In contrast to the normal activated autoreactive B-cell repertoires, which make predominantly IgM antibodies, the GVH-activated autoreactive B-cells make predominantly antibodies of the IgG class. Therefore, we conclude that T-cell mediated graft versus host activation does not generally lead to selective expansion of autoreactive B-cells, but appears to play a crucial role in the switch from IgM to IgG production. PMID- 3265481 TI - The murine T-lymphocyte response to tyrosine-azobenzenearsonate. Characteristics of a low responder haplotype T-cell clone. AB - An I-Ab-restricted, L3T4+ Ly2- T-cell clone, 5R-4F3, specific for ABAtyr was established in culture from a B10.A(5R) mouse. Since b haplotype mice respond weakly to ABAtyr compared to other haplotypes, this is a candidate clone of low responder phenotype. In support of this contention, 5R-4F3 grew very poorly under conditions that supported the vigorous growth of E beta bE alpha k-restricted T cell clones from the same mouse. The I-A (low responder) and I-E (high responder) restricted T-cell clones also differed in their responses to apc pre-pulsed with antigen, compared to apc with antigen present continuously during culture. The low and high responder clones responded comparably to IL-2. Attempts to elevate the response of C57BL/6 mice to ABAtyr in vivo by injecting them with human recombinant IL-2 and antigen together were only partially successful: C57BL/6 mice treated in this way showed a 3-5-fold increase in their proliferative responses to ABAtyr, which was at best only one quarter of the level of response shown by high responder A/J mice to the same antigen dose. PMID- 3265482 TI - [How many newborn infants have an increased risk of atopic disease?]. AB - Children of atopic parents as well as newborns with an increased cord blood IgE level have a increased risk to develop atopic symptoms later in childhood under the influence of certain environmental factors. Out of 1203 newborns there were 3% with a biparental history of atopy and 9% with a cord blood IgE higher than 0.9 kU/l. Boys showed elevated cord blood IgE-concentrations more frequently than girls. There were no differences in IgE-levels between Turkish and German neonates. The effectiveness of preventive measures against atopic diseases should be studied in defined high risk groups, before a screening for atopy is considered. PMID- 3265483 TI - [Effect of various weather parameters on the incidence of inpatient treated children with stenosing laryngotracheitis (pseudocroup)]. AB - A total of 1470 hospitalized children with croup in the cities of Bochum and Herne were examined over a period of 19 years, with the aim of checking whether there was any relationship between croup incidence and changes in different weather parameters such as temperature, air pressure, absolute and relative air humidity, and wind speed. The incidence of croup was seasonal, being higher in the months of January, February, and March and from September to December. Statistical evaluation by discriminant analysis, t-test and chi 2-test showed a significant correlation (alpha greater than or equal to 0.95) between croup incidence and individual weather parameters in some months. The results seem to indicate a higher frequency of croup after decreases in temperature and influx of dry air masses (decreases in absolute humidity). In some months an increased incidence of hospitalized children with croup was observed after decreases in air pressure and during weather with extremely high (w greater than 4.5) or low (w less than 1.5) wind speed. In summary, no clear and consistent relationship between incidence of croup and particular weather parameters could be found. PMID- 3265484 TI - [Alternating hemiplegia in childhood. Clinical report and single photon emission computed tomography study]. AB - From 6 months of age on this girl experienced frequent episodes of hemiplegia involving both sides of the body and lasting up to 8 days. The attacks were often precipitated by tonic deviation of the head and/or the eyes to one side and nystagmus. At this stage the girl used to cry. Squinting, tonic stiffening of body and extremities, and dystonic posturing also occurred. Autonomic dysfunctions such as paleness of the skin, sweating, respiratory embarrassment, tachycardia, and mydriasis were associated features of the attacks. Motor and mental development of the girl is delayed. Improvement concerning severity, duration and frequency of the attacks has been achieved by permanent treatment with flunarizine in combination with acetazolamide and acetylsalicylic acid. If the child falls asleep immediately after rectal application of chloral hydrate at the onset of an attack there is no hemiplegia after awakening. PMID- 3265485 TI - Tracheobronchitis and pneumonia due to herpes simplex virus (HSV) infection. PMID- 3265486 TI - A mechanism by which human breast carcinoma cells escape the host immune system. AB - The experiments described in this study examined cell membrane oligosaccharides, malignancy-related cell phenotypes and tumor cell susceptibility to the killing effect of human cytotoxic cells. Short term breast carcinoma (BCa) cell lines were prepared from biopsies obtained from patients at each of the pathological Stages I, II, III and from patients with disseminated liver metastasis. Five patients at each stage donated the tissue. To obtain large enough quantities, the cells were cultured as monolayers for a brief period, then transferred to roller bottles using serum-free hormone defined medium. Natural killer (NK) cells, lymphokine (IL-2)-activated killer (LAK), tumor-infiltrating lymphocytes (TIL) and peripheral cytotoxic lymphocytes (CTL) from patients with BCa at PS I were used as the effector cells. Susceptibility of the tumor cells to the killing effects of the effector cells was monitored by the well established 4 h 51Cr release assay technique. Growth factor expression, oncogenicity in athymic female mice and colonigenicity in soft agar were used as parameters to monitor breast carcinoma cell malignancy phenotypes. The cell membrane oligosaccharides were determined from the carbohydrate elution profiles from BioGel P-6 columns. The results indicate a correlation between progression of malignancy from PS I to the metastatic stage PS IV, and the magnitude of malignancy phenotypes, resistance to the host killer cells and oligosaccharide profile shift to a higher molecular size with increased sialylation and fucosylation of the carbohydrate moieties. PMID- 3265487 TI - Dialysate leucocytosis in CAPD patients without clinical infection. PMID- 3265488 TI - Immunophenotyping of leukaemias and non-Hodgkin's lymphomas. Immunological markers and their CD codes. PMID- 3265489 TI - The electrophoretic pattern of urinary protein in in situ immune complex glomerulonephritis. AB - Urinary protein excreted in active in situ immune complex glomerulonephritis (ICGN) was qualitatively analyzed by the comparison of sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) patterns of urinary proteins from rats with Masugi GN, active Heymann GN (AHGN), and chronic serum sickness GN (CSSGN). In the SDS-PAGE analysis of urinary protein excreted in the active in situ ICGN and Masugi GN models, 200- and 145-kD macromolecules and low molecular weight components around 12 kD were excreted in large quantities at the full development stage (greater than 100 mg/24 h urinary protein). These findings, however, were obscure or lacking in CSS-GN and AHGN at the peak of proteinuria. Electrophoretic patterns of urinary proteins including lower molecular weight proteins could be divided into two groups: either active in situ ICGN and Masugi GN or AHGN and CSSGN. These two groups corresponded to the differences of morphologic expression such as proliferative changes rather than degree of proteinuria. The location of immune complex formation and deposition, probably different among the experimental models, may play an important role for determining the mediation and nature of glomerular injury. PMID- 3265490 TI - Patterns of cerebral glucose metabolism using 18FDG and positron tomography in the neurologic investigation of the full term newborn infant. AB - 18F fluorodeoxyglucose (18FDG) and positron tomography (PT) were used in 20 full term babies with seizures or hypotonia to describe regional cerebral glucose metabolism. Among babies with seizures, birth asphyxia was the most common cause. PT was performed at age 6-17 days. One hour before PT, 18FDG (50-100 microCi/kg) was injected intravenously. Ten or more PT sections were obtained in each infant. The areas of the brain that were metabolically the most active were the cortex and the thalami. Six cortical areas and a white matter reference area were selected for analysis of relative rates of glucose metabolism as indicated by relative rates of fluorine-18 activity. Cortical fluorine-18 activity was highest in the pericentral (sensorimotor) regions and lowest in the frontal regions. The overall cortex/white matter ratio for fluorine-18 activity averaged 1.78 +/- 0.44 (SD). Four patterns of regional cerebral glucose metabolism were distinguished: 1) bilateral symmetry, 2) loss of metabolic definition, 3) hemispheral asymmetry, 4) focal hyper- or hypometabolism. Patterns 1) and 2) correlated with a history of birth asphyxia, a diagnosis of hypoxic-ischemic encephalopathy and the absence of focal echoes on cranial ultrasound. Hypodense areas on CT could be associated with either high or low fluorine-18 relative activity on PT. The prognostic significance of the presently reported patterns of cerebral glucose metabolism remains to be determined. PMID- 3265491 TI - Very low-birth weight infants: five years experience of a regional perinatal program. PMID- 3265492 TI - On the origin and course of sympathetic nerve fibers in the fungiform papillae of the frog's tongue. PMID- 3265493 TI - Esophageal apoplexy. PMID- 3265494 TI - [Killer activity and lymphocytotoxicity of the blood serum in children with pyelonephritis]. PMID- 3265495 TI - [Means of optimal administration of drugs in acute respiratory viral infections in children]. PMID- 3265496 TI - [Transcatheter arterial embolization for gastric and duodenal arterial bleeding]. PMID- 3265497 TI - [Anti-tumor activities of direct current (DC) therapy combined with fractionated radiation or chemotherapy]. PMID- 3265498 TI - Chronic B-lymphocytic leukemia--expression of B cell activation markers in relation to activity of the disease. AB - Two-color FACS analysis was used to study phenotypic subset and activation markers on circulating B (tumor) cells of 21 patients with chronic B-lymphocytic leukemia (B-CLL). Patients with clinically active (progressive) disease differed from patients with stable disease: B cells from the former patient category showed a significantly increased expression of the activation antigen 1D11 and FN99(CD9), and a decreased expression of the FN1 B subset marker. No clinical associations were observed using the CD23, CD25, 4F2, Ba, Bac-1 or FN50 markers. Functional studies showed that the B cells from both clinical categories of patients responded equally well with DNA synthesis when optimally triggered and supplied with T cell factors. However, B-CLL cells from patients with progressive disease secreted significantly higher levels of IgM in response to phorbol ester. The present experiments thus show that differences exist in the activation of B CLL cells in vivo and that these patterns are correlated with disease activity. Further, the maximal in vitro proliferative capacity of individual tumor cells is similar, whereas differences in accessory T cell functions may exist between patients. PMID- 3265499 TI - Comparative analysis of normal and malignant CD5+ B lymphocytes. AB - The T-cell related CD5 molecule is expressed by the major B cell population which forms primary follicles in fetal lymph nodes and spleen and circulates in cord blood but decreases to a numerically minor proportion (5-10% of all B cells) in adults [1, 3-5, 8, 9, 12, 14, 16]. The CD5 molecule is also expressed by the monoclonal B cells of B-chronic lymphocytic leukemia (B-CLL: reviewed in [5]). Even if there is no proof that CD5+ B cells are the target of the transforming events which lead to B-CLL, they are regarded as the normal counterpart of B-CLL. Therefore, the aim of the present work was the analysis of the phenotype, the cell cycle control and the cytoskeleton organization of normal CD5+ B lymphocytes in comparison with the data obtained on malignant CD5+ cells from B-CLL patients. PMID- 3265500 TI - Use of a cross reacting anti-idiotype to identify normal counterparts of neoplastic cells. AB - We have established that 9G4, a cross reacting monoclonal anti-idiotype identifies an epitope close the binding site of anti-I cold agglutinins. 9G4 positive lymphocytes comprise around 5% of B cells and are widely represented in all lymphoid tissue. They may be detected in 15 week fetal spleen at the time of the earliest appearance of B cells and thus form part of the basic B cell repertoire. Such antibodies are derived largely from CD5 positive B cells. 9G4 is thus a useful tool to investigate the normal counterpart of the CLL cell. PMID- 3265501 TI - Effects of tumour necrosis factor and alpha interferon on chronic B cell malignancies. AB - Tumour necrosis factor (TNF) induces the lysis of many malignant cells in vitro and regression of some tumours in vivo. However, TNF is also a growth factor for normal fibroblasts, T cells and B cells and we have recently shown that TNF can also act as a growth factor for chronic B cell neoplasms, including hairy cell leukaemia and B-CLL. In these cells it promotes proto-oncogene expression, RNA and DNA synthesis and increases overall cell survival. Stimulation appears to be autocrine in nature since exposure of the neoplastic cells to recombinant TNF protein induces the corresponding messenger RNA and synthesis of the protein itself. TNF induced proto-oncogene expression and DNA synthesis occur over a substantially longer time period than when the cells are stimulated with agents such as TPA and Calcium ionophore (2), but we have no evidence that the delay represents the time taken to generate TNF dependent secondary cytokines such as IL-1 and IL6. Alpha interferon opposes TNF mediated activation and our recent data indicate that this effect is independent of alpha interferon down regulation of TNF receptors. It appears to be related instead to a decreased accumulation of TNF mRNA which occurs contemporaneously with an alpha interferon induced rise in 2-5 A synthetase. If TNF dependent growth is important for the survival of B-CLL cells, then agents which mimic alpha interferon or which block TNF induced autocrine growth would be predicted to be of therapeutic benefit. PMID- 3265502 TI - Decreased production of IL-6 by peripheral blood mononuclear cells of patients with chronic lymphocytic leukemia and related disorders. AB - The present study has shown a decreased production of IL-6 by LPS-stimulated mononuclear cells of B-CLL blood. This decrease with attributed to an abnormality of either monocytes or T lymphocytes. A similar decrease was seen in HCL and NHL. Experiments with mixtures of normal and CLL cells suggest that the decreased IL-6 production in CLL is due neither to an inhibition of normal blood mononuclear cells IL-6 production by B-CLL lymphocytes nor to the absence in CLL blood of cell(s) or cytokine(s) needed for IL-6 production. PMID- 3265504 TI - CD1 expression in B-CLL cells. AB - The peripheral blood from 38 B-CLL patients was studied by flow cytometry with 25 clustered or not clustered monoclonal antibodies (moAbs) in order to characterize the cell surface phenotype of lymphoid cells. All moAbs were chosen since they detected B or CD1-8 T cell differentiation antigens or MHC class II antigens. The results showed a heterogeneity in the leukemic cell reactivity with the various moAbs and between patients. The restricted B cell antigens recognized by BL14, Y2955 and anti-class II moAbs were constantly expressed in leukemic cells, while B-cell antigens reacting with FMC7 and BL13 moAbs were variably detected. In addition to CD5 antigens, other T cell markers including several epitopes of the CD1 group were also found to be present on the leukemic cell surface in several cases. To further extend these data, 6 cases were selected for labelling with a battery of 6 CD1a, 2 CD1b and 1 CD1c moAbs. These results suggested that CD1a,c epitopes can be detected on leukemic B cells in addition to other T cell differentiation antigens. PMID- 3265503 TI - Immunohistochemical study of bone marrow sections in CLL. AB - T lymphocytes and dendritic reticulum cells (DRC) were studied in frozen-cut bone marrow sections of 35 patients with chronic lymphocytic leukemia (CLL) (infiltration patterns: interstitial 8, nodular 6, mixed 9, diffuse 12) and 13 cases of low grade non Hodgkin's lymphoma (NHL) (centroblastic/centrocytic 7, centrocytic 3, lymphoplasmacytoid 3) with bone marrow involvement. In contrast to the usual findings in normal bone marrow, in CLL and low grade NHL CD4 positive cells were more numerous than CD8 positive cells. Whereas in NHL CDR were large and occupied all the nodule, in CLL were small and located in the center of the nodule. These findings can be of interest in the study and differential diagnosis of lymphoproliferative disorders. PMID- 3265505 TI - CD4, CD8 and NK subsets in B-CLL. AB - Although B-CLL is a hematological disorder characterized by clonal proliferation of B-cells, in most cases an increase in absolute numbers of T cells is observed. This increase is probably polyclonal in nature, since most data indicate that T lymphocytes are not progeny of the malignant clone in B-CLL. As CD4, CD8 and NK cells correspond to heterogeneous populations, in this work we tried to better define these subpopulations. Thus, CD4 subpopulations were displayed by using double labelling techniques into helper inducer subset (CD4+CDW29+) and suppressor inducer subset (CD4+CD45R+). CD8 subpopulations were delineated according to density expression of CD8 and reactivity with CD16 and CD11b in: suppressive cells defined by high density (HD) CD8 and reactivity with CD11b; NK cells defined by low density (LD) CD8 and binding to CD16; CTL cells by LD or HD CD8 and absence of expression of CD16 and CD11b. Our results concerning 47 normal control donors and 27 B-CLLs indicated that: although percentages of cells expressing CD3, CD4, CD8 and NK markers are decreased, absolute values of these subpopulations were increased; there exists an imbalance concerning CD4 and CD8, given by a more important increase of CD8 than CD4 subpopulations, but both are significantly augmented when compared to the normal range; within CD4 subpopulations, there is an important increase of CD4 CDW29 subset (helper inducer) whereas the CD4 CD45R (suppressor inducer) is not augmented in stage A patients and decreases in stage C patients; all the 3 identified CD8 subpopulations (NK, suppressors and CTLs) appeared to be increased; in 3 cases of clonal remission CLL studied, all T cell and NK subpopulations were recovering to normal percentages. PMID- 3265506 TI - T-cell chronic lymphocytic leukaemia: the spectrum of mature T-cell disorders. AB - Mature (post-thymic) T-cell malignancies comprise a heterogeneous group of diseases with distinct clinical, morphological and immunophenotypic features. As some of these features overlap in the various disorders, it is essential to use a number of diagnostic criteria to define the clinicopathological entities, namely: membrane markers, morphology by light and electron microscopy, clinical features, seroepidemiology of HTLV-I, histopathology, cytogenetic studies and DNA analysis. The latter, which is necessary to document clonality and confirm T-lineage, examines the rearrangement of the T-cell receptor beta, gamma and delta genes. By means of this multiparameter approach, it is possible to distinguish within the post-thymic leukaemias 4 disease entities: T-chronic lymphocytic leukaemia or large granular lymphocyte leukaemia, T-prolymphocytic leukaemia, adult T-cell leukaemia/lymphoma and Sezary syndrome. PMID- 3265507 TI - Lymph node biopsy in chronic lymphocytic leukemia: prognostic significance of histopathological, morphometry and immunohistological findings. AB - The morphological patterns of 20 lymph node biopsies from well differentiated lymphocytic proliferation (CLL and DWDL) were studied using conventional morphology and morphometric technics; immunohistochemistry analysis were performed in 12 cases. Four subtypes of histological patterns were described according to the number and the distribution of large lymphoid cells. These aspects were compared to the nuclear area distribution curve and clinical staging. Patients with numerous large lymphoid cells had a right deviation of the curve and were clinically stage C. In stage B patients, the analysis of nuclear area distribution curve individualized patients with a worse prognosis. In 12 cases immunohistochemical technics were applied to determine SmIg, B cell differentiation antigens (CD19, CD20, CD21, BL14, FmC7) and T cells subsets (CD2, CD3, CD4, CD8) the quantification of the various T cell subsets showed that CD3, CD4, positive T cell were lower in advanced stages of CLL. PMID- 3265508 TI - Clinical implication of chromosomal aberrations in chronic B-lymphocytic leukaemia cells. AB - Chromosome analysis was made on mitogen-activated leukemic cells from 99 patients with B-cell chronic lymphocytic leukaemia. Fifty-three patients had clonal chromosome aberrations. Nine patients had trisomy 12 as the sole abnormality, 15 had trisomy, 12 together with other chromosomal aberrations, and 29 had other clonal abnormalities. Four patients had t(11;14), whereas 6 had 14q+ and five 11q as the result of other translocations than t(11;14). Structural aberrations involving chromosomes 6, 12, and 13 were involved in 7, 4, and 5 patients, respectively. Patients with clonal aberrations had poor survival compared to those with normal karyotype, and patients with single trisomy 12 had poor survival as compared to patients with other single aberrations. PMID- 3265509 TI - Evidence for tumor reduction in refractory or relapsed B-CLL patients with infusional interleukin-2. AB - Recombinant interleukin-2 (rIL-2) is a biologic response modifier that is capable of enhancing or restoring the cytolytic capacity of large granular lymphocytes (LGL). We utilized this biologic response modifier in the treatment of B-chronic lymphocytic leukemia (B-CLL), a disease frequently characterized by deficient or absent natural killer activity. B-CLL (n = 12) patients previously refractory to chemotherapy or with progressive disease post cessation of chemotherapy were eligible. rIL-2 was given as i.v. infusion (2 x 10(6) units/m2) over 2 h 5 times per week for 3 weeks as induction. Responding patients were placed on maintenance therapy. Although there were no complete or partial responses (by ECOG criteria) there was clear evidence of tumor reduction. Seven of 10 evaluable patients had a reduction of the peripheral blood B cell clone, 3 had node reduction and 2 had reduction in their splenomegaly. All patients experienced mild to moderate toxicity and 1 patient died while on induction therapy. Three B-CLL patients following induction rIL-2 treatment were placed back on chemotherapy because of progressive disease. Interestingly, these 2 B-CLL patients achieved extremely rapid and complete responses to chemotherapy which had previously been ineffective. These data suggest a possible role for rIL-2 in treatment of B-CLL. PMID- 3265510 TI - Multiple peptide hormone producing adenocarcinoma of lung with neurotensin and CRF-like immunoreactivity. AB - A pulmonary cancer of a 43 year-old-man was classified according to WHO-criteria as a poorly differentiated adenocarcinoma because of demonstration of mucinous substances in tumor cells and in rarely occurring acinar lumina. Immunohistochemical reactivity for several peptide hormones was detected in the predominant solid parts of the carcinoma. In many tumor cells an immunoreactivity to neurotensin, bombesin and - according to the elevated serum levels - to ACTH, CRF and calcitonin was found. Therefore the present lung cancer must be defined as a combined carcinoma composed of mucous producing and endocrine cell types. Because peptide hormone production is not restricted to the classical "neuro" endocrine lung tumors, the histogenesis of this heterogeneous lung cancer is discussed. PMID- 3265511 TI - Angio-immunoblastic lymphadenopathy (AIL) or T-cell malignant lymphoma of AIL type. A histopathological, immunohistochemical and ultrastructural study of 8 cases. AB - Eight cases of AIL-type T-cell malignant lymphoma are reported. The clinical symptoms are the same as those described in AIL: fever, malaise, weight loss, skin rashes, polyadenopathy, and splenomegaly. However, some differences can be noted: the absence of hepatomegaly in all cases but one, the absence of polyclonal hypergammapathy in all cases but one, and predominance in females. The lymph node modifications comprise diffuse infiltrations of lymphoid cells with irregular nuclei and pale cytoplasm, associated with a large number of immunoblasts and plasma cells. Some eosinophilic granulocytes and epithelioid cells can be seen. Hyperplasia of the vessels and remnants of follicles, sometimes with proliferation of follicular dendritic cells, are prominent features. The immunolabelling study demonstrates the presence of an important T cell population all expressing a high predominance of CD 4 phenotype. These findings are in accordance with those published in Europe and in contrast with those of some of the Japanese cases, particularly the first patients published by Shimoyama et al. The differential diagnosis with AIL is based on the presence of clusters of mainly large cells with a pale cytoplasm, on the loss of expression of one T cell marker, as in 3 cases of our series, and on the presence of a high percentage of lymphoid cells engaged in the mitotic cycle as demonstrated with the Ki 67 monoclonal antibody. However, to draw a clear cut difference between AIL-type T-cell lymphoma and AIL considered as a prelymphomatous dysimmune lymphadenopathy, only the demonstration of cytogenetic abnormalities, as in one of our cases or of rearrangement of the genes coding for beta and/or gamma chain of the antigen receptor of T-cell are valuable criteria. The follow-up of our series is not long enough to appreciate the prognosis. Three patients died, one from a glioma. All the other cases, treated with polychemotherapy show total remission with an evolution of 10 to 39 months. PMID- 3265513 TI - Effect of a single intravenous dose of verapamil on some immune parameters in duodenal ulcer patients. AB - The effect of a single intravenous dose of calcium channel blocking agent verapamil (VER) on immune parameters in humans remains uncertain. In this study the effects of VER on lymphocyte subpopulations, interleukin 1 (IL-1) and 2 (IL 2) production in vitro, autologous mixed lymphocyte reaction (AMLR), IL-2 receptor expression (Tac positive cells) and natural killer (NK) cell activity were assessed. The investigations were undertaken on 12 hospitalized men, aged 19 23 years, with small abdominal complaints. None of them had active duodenal ulcer disease, while in the remaining no signs of organic disease were found. VER was given intravenously in a dose of 0.15 mg/kg and examinations were performed on peripheral blood mononuclear cells (PBL) drawn before and 30 and 150 min following VER injection. The single VER dose induced a significant, but transient increase in T, T helper, T suppressor lymphocytes and monocytes, and decrease in IL-1 and IL-2 generation as well as diminished Tac antigen expression. These data provide evidence that calcium channel blockers may transiently disturb immunoregulation. PMID- 3265512 TI - Characterization of extracellular matrix in non-Hodgkin's lymphomas. AB - Basement membrane proteins laminin, type IV collagen and aminoterminal propeptide of type III collagen (type III pN-collagen) are important components of extracellular matrix of normal lymph nodes; they are present in reticular fibres and in the walls of blood vessels and sinuses. We have studied the distribution of these proteins in 45 cases of non-Hodgkin's lymphomas representing different types of Kiel classification. Light microscopic immunohistochemistry was used on sections from formalin fixed, paraffin embedded biopsy specimens. Reticular cells were identified by using antibodies against S-100 protein, a marker for dendritic and interdigitating reticulum cells, and against cystatin A for the demonstration of follicular dendritic reticulum cells. The findings of the immunohistochemical stainings were generally similar in the different lymphoma types. Thus the method for the demonstration of extracellular matrix proteins could not give obvious aid for lymphoma classification. BM stainings proved to be efficient in the demonstration of sinuses. Marginal and medullary sinuses of the nodal cases were either totally or partly spared and open also in the cases in which there was extracapsular growth. The fibre content was variable, but generally the distribution of all the three extracellular matrix proteins was comparable with each other and mainly corresponded with the pattern seen in conventional Gomori's reticulin stain. This also holds for the tumor tissue infiltrated through the capsule and for extranodal cases. Areas of sclerosis of some cases contained only type III pN-collagen. Reticular fibres were at places seen to be closely associated with cells of spindle or dendritic shape. A few reticulum cells could be found to show cytoplasmic staining for laminin, type IV collagen and type III pN collagen. This finding suggests that the cells are synthetizing these proteins. The amount of cells staining for cystatin A or S-100 protein did not generally correlate with the amount of fibres, and most of the stained cells were not closely associated with fibres. The results show that in non-Hodgkin's lymphomas basement membrane proteins and type III pN-collagen are important components of reticular fibres. Results also indirectly support the main role of fibroblastic reticulum cells in the production of the fibres. PMID- 3265514 TI - Genetic analysis of immunocompetence measures in a White Leghorn chicken line. AB - Immunocompetence of the Iowa State University S1 White Leghorn chicken line was studied. This line was divided into eight sublines based upon erythrocyte antigen B (Ea-B) allele (B1B1 or B19B19), antibody response to glutamic acid60-alanine30 tyrosine10 (GAT) (high or low), and response to Rous sarcoma virus-induced tumors (progression or regression). Antibody responses to Pasteurella multocida (PM), Mycoplasma gallisepticum (MG), and infectious bursal disease virus vaccines were evaluated by enzyme-linked immunosorbent assay. Phagocytic activity and T cell mediated response were measured by carbon clearance and phytohemagglutinin (PHA) injection assays, respectively. Significant haplotype (subline) differences and sire family differences were observed in all three measurements. Significant sex differences were observed in phagocytic activity and T cell-mediated responses. Haplotypes with high antibody responses to GAT had significantly higher antibody titers to PM and MG vaccines than haplotypes with low antibody responses. Significant positive correlations were observed between antibody levels to the two vaccines. A significant negative correlation was seen between phagocytic activity and T cell-mediated response of females. The data suggest that the total immunocompetence profile of an individual must be considered to select for optimum immune responsiveness. PMID- 3265515 TI - Effect of oncogenes on chondrogenesis. PMID- 3265516 TI - [Electric stimulation of the muscles in hypokinesia in patients with osteoarticular tuberculosis]. PMID- 3265517 TI - [Epidemiologic danger of a meager and one time shedding of bacteria from newly detected cases of tuberculosis]. PMID- 3265519 TI - Increased suicidality in depression: group or subgroup characteristic? AB - A lifetime history of depressive episodes and suicide attempts was ascertained from 172 depressed patients admitted to a psychiatric inpatient service. Fifty five of these patients had made at least one suicide attempt. The correlation of depressive episodes and the total number of suicide attempts for this group was close to zero. However, when the data were converted into rate measures (number of episodes or attempts per year), the correlations were very high and significant. It appears that approximately one-third of severely depressed, hospitalized patients have a history of suicide attempts and, once a suicide attempt has occurred, the patient is at high risk for more suicide attempts if future depressions occur. Within the group of depressives with a history of suicide attempt, the risk of suicidal behavior is evenly distributed. No evidence in favor of a "hypervulnerable" subgroup was found. PMID- 3265518 TI - Effect of anti-neoplastic therapy on dental hard tissues and saliva in children and adolescents. A clinical and experimental study. PMID- 3265520 TI - Smokeless tobacco on campus. PMID- 3265521 TI - Rates of personal violence (suicide and homicide), traffic fatalities, and alcohol consumption. PMID- 3265522 TI - A fixed interval momentary sampling method for assessing on-going behaviours induced by dopamine receptor agonists. AB - 1. An observational recording procedure for the objective measurement of unconditioned behaviour is described. 2. During an observation period an auditory cue (e.g. the click of a metronome) spaced at regular intervals (e.g. every 10 seconds) signals the observer to rate the presence or absence of target behaviours at the precise instant of the cue. 3. Practical and methodological considerations of the use of this technique are discussed. 4. This method has been used to compare behaviours elicited by the dopamine agonists apomorphine, LY 171555 and SK&F-38393. 5. These behaviours were also assessed using a stereotypy rating scale and these results are contrasted with those obtained using the time sample method. PMID- 3265523 TI - Age, cellular immunity and the HP axis in major depression. AB - 1. To assess the effect of age on cellular immune status and the HP axis in patients with major depression, we examined peripheral blood mononuclear cells (PBMC) and measured the plasma level of four neurohormones. 2. In 36 subjects, decreasing T lymphocyte response to con A covaried with age. Percent of lymphocytes labeled as T8 lymphocytes tended to decrease and T4/T8 ratio tended to increase with increasing age. 3. Hamilton and Beck scores were significantly different between the two sex and race matched groups of 18 depressed patients and 18 control subjects, and plasma prolactin was significantly higher in depressed subjects. 4. Increasing age correlated with decreasing T lymphocyte response to con A in the combined group of all subjects, and in the control group, but not in the patient group. 5. Hamilton and Beck scores correlated inversely with T lymphocytes response in the combined group of all subjects. 6. Differences in mitogen responsiveness between patient and control groups were not found, having been obscured by the effect of age. 7. These findings indicate the need to age match subjects when studying the interaction between depression and immune cell function. PMID- 3265524 TI - Major depression and immunity: preliminary evidence of decreased natural killer cell populations. AB - 1. Alterations in cellular immunity have been suggested to occur in major depressed patients. 2. To investigate the populations of B-cells, T-cells and T cell subsets in major depression, the authors utilized monoclonal antibody techniques to enumerate the number of total lymphocytes, B-cells and T-cell subpopulations in recently admitted patients with major depression or non affective disorders. 3. The authors also studied the relationship between the immune state and hypercortisolism as measured by post-dexamethasone serum cortisol. 4. The preliminary findings from this pilot study suggest that major depressed patients may have altered cellular immunity as demonstrated by lower numbers of natural killer cells. 5. Further study will be necessary to confirm the trend for lower numbers of T-cell lymphocytes and T-cell subpopulations including helper cells, suppressor cells and natural killer cells in patients with non-suppression of serum cortisol following dexamethasone. PMID- 3265525 TI - The effects on performance of two antidepressants, alone and in combination with diazepam. AB - 1. Ninety healthy adult men participated in a study of the effects on performance of 60 mg fluoxetine, 50 mg amitriptyline or placebo, alone and in combination with 5 mg diazepam or placebo. 2. In a 2X3 factorial design study, groups of 15 Ss received one of six possible treatment combinations. 3. Ss were tested with a battery of laboratory tests at two post-dosing times. 4. Amitriptyline impaired the performance of all tasks. When diazepam was added to the amitriptyline treatment, the impairment of three tasks increased. Diazepam alone produced impairment on two measures. 5. Fluoxetine alone impaired no task; some impairment occurred with the fluoxetine-diazepam combination. PMID- 3265526 TI - [Immunologic disorders in patients with recurrent herpes simplex]. PMID- 3265527 TI - [Continuous sedation for regional anesthesia with propofol (Disoprivan) and midazolam (Dormicum). A comparative study]. AB - Propofol was compared to midazolam with regard to its quality as a sedative in regional anesthesia. 81 patients undergoing varicose-vein stripping under epidural anesthesia were divided into two groups: 39 were given propofol and 42 were given midazolam. Both groups were then subdivided into 3 subgroups. 30 min after epidural block, a bolus of propofol 1 mg/kg or midazolam 0.03 mg/kg was given followed by infusion of equipotent solutions: propofol 1.0, 1.5, or 2.0 mg/kg/h or midazolam 0.03, 0.045, 0.06 mg/kg/h. Continuous registration of blood pressure, respiratory rate, and end-expiratory pCO2 was carried out and blood gas analysis was performed every 30 min. RESULTS: Clinically unimportant changes of circulatory and respiratory parameters were seen. Blood gas analyses showed hypercapnia greater than 50 mmHg in some patients. Brief apnea occurred after bolus propofol in 7.7% of cases and pain during injection in 66.6%. Restlessness: propofol 28.2%, midazolam 9.5%. Upper airway obstruction: propofol 30.8%, midazolam 57.1%. Recovery time after infusion ranged from 130 s with propofol to 26 min with midazolam. Postoperative evaluation included the following questions and responses: Sedation pleasant? propofol 97.5%, midazolam 100%. Sleep during surgery? propofol 94.8%, midazolam 83.5%. Prolonged tiredness? propofol 25.6%, midazolam 69%. Postoperative nausea? propofol 38.5%, midazolam 14.2%. Vomiting? propofol 17.9%, midazolam 11.9%. Our study showed that propofol is highly suitable as a sedative for regional anesthesia in spite of injection pain and frequent postoperative nausea. It is superior to midazolam because of the significantly shorter recovery time, providing improved control-lability and reduced posthypnotic sleep. PMID- 3265528 TI - Malaria infection in rats with stimulated splenic red pulp: the blood flow and protective effect in normal and transplanted splenic tissue. AB - After splenic autotransplantation both weight and blood flow of the regenerated splenic tissue are decreased. In addition, the protective function of the transplant is less compared to that of the normal spleen. In the present study, the red pulp of normal and transplanted splenic tissue was stimulated by injections of phenylhydrazine to increase the weight, the blood flow, and the protective function. After stimulation, the weight of the normal spleen increased to 900 +/- 70 mg (control 530 +/- 20 mg) and the transplanted tissue to 240 +/- 70 mg (control 70 +/- 20 mg). This enlargement was caused by an increase in the splenic red pulp. However, the relative blood flow decreased in both the normal spleen and the transplant to 50% of the normal value. To evaluate the protective function of the stimulated splenic tissue, normal, splenectomized and transplanted rats were infected with Plasmodium berghei. Despite the dramatic increase in the red pulp, neither the normal nor the transplanted animals showed a survival rate superior to that of the splenectomized animals. The mass of splenic tissue obviously does not correlate with the protective effect of the spleen in parasitic infections. PMID- 3265529 TI - Therapy of Aujeszky's disease (pseudorabies) in naturally infected and artificially inoculated piglets using BW B759U (9-[1,3-dihydroxy-2-propoxymethyl] guanine). AB - Two experimental porcine models of Aujeszky's disease (AD) were compared for assessing the efficacy of potential antiviral compounds. While signs were the same following intranasal inoculation and in-contact transmission of the causal herpesvirus, SHV-1 (Suid herpesvirus), the time-course of the disease was different. There was less variation in clinical signs between pigs following artificial infection, but the disease was more severe, making this a consistent but also more stringent test system. A nucleoside analogue, BW B759U (9-[1,3 dihydroxy-2-propoxy-methyl] guanine), was administered intramuscularly in divided twice daily doses at 50 mg kg-1 to three-week-old piglets in these two SHV-1 disease models. In artificially infected animals, in which treatment was begun 1.5 hours preinfection and continued for six days, there was a delay in the onset of clinical signs (4.8 compared with 3.2 days), a 1 log10 reduction in virus shedding, and a 1 to 2 log10 reduction in virus recovered from tissues, but all the treated piglets died from AD. In contrast, none of the BW B759U-treated piglets in the in-contact model system died during the eight-day medication period, although two piglets died subsequently. Mean serum concentrations of BW B759U two hours after intramuscular dosing were about 45 microM, at nine hours 15 to 20 microM and at 17 hours 3.5 microM. The in vitro IC50 of BW B759U against SHV-1 varies from 1.5 to 80 microM depending on the cell line in which the assay is carried out. There were no overt signs of BW B759U toxicity in the treated piglets. PMID- 3265530 TI - [The effect of pregnancy on viral hepatitis]. PMID- 3265531 TI - [A case from practice (124). Patient: Mr. B. S., born 1949, buyer]. PMID- 3265532 TI - [Anemia in inhabitants of Caceres/MT and its relation to per capita income]. PMID- 3265533 TI - [Nutritional status indicators in the Polonoroeste area. III. Clinico-nutritional study]. PMID- 3265535 TI - [Differentiation and physiology of T lymphocytes]. PMID- 3265534 TI - [Arterial hypertension and control procedures in the urban population of Caceres/MT]. PMID- 3265536 TI - [Diagnostic and therapeutic use of monoclonal anti-T lymphocyte antibodies]. PMID- 3265537 TI - [Primary T lymphocyte immune deficiencies]. PMID- 3265539 TI - [T cell lymphoid blood diseases]. PMID- 3265538 TI - [AIDS and other acquired T cell immunodeficiency syndromes]. PMID- 3265540 TI - Effect of folic and folinic acid on cytopenia occurring during co-trimoxazole treatment of Pneumocystis carinii pneumonia. AB - 12 AIDS/ARC patients with or suspected of Pneumocystis carinii pneumonia were treated with co-trimoxazole and received supplementary folic or folinic acid to avoid peripheral blood cytopenia. Most patients developed decreased numbers of neutrophils and hemoglobin while receiving co-trimoxazole. Supplementary folate/folinate could not abolish the drug-induced cytopenia. Routine prescription of folinic acid is not recommended. Folic acid is cheap and may be beneficial and should be prescribed. PMID- 3265541 TI - A case of moyamoya disease with progressive involvement from unilateral to bilateral. AB - A case of Moyamoya disease in a child starting with unilateral lesion and developing into bilateral involvement is reported. Angiographic findings at onset showed unilateral involvement, hence, it was filed as a "probable" case according to the diagnostic criteria of the Japanese Cooperative Research Committee. The carotid angiograms, on the other side were totally normal. Three years later the occlusive lesion became bilateral, to meet the criteria as a "definite" case. Clinical manifestations, angiograms, electroencephalograms, and positron emission tomograms in this case are presented, and the relation between the probable and definite cases is discussed. PMID- 3265542 TI - [Clinico-immunological parallels in patients with iron-deficiency anemia]. AB - The main parameters of humoral and cellular immunity as well as indices of nonspecific body resistance were studied in 70 patients with iron deficiency anemia. A decrease in the content of the main classes of immunoglobulins and an increase in the CIC level were noted. Routine therapy brought about a tendency toward the restoration of indices of humoral immunity. With respect to cellular immunity, a relative increase in the level of B-lymphocytes and a decrease in the number of 0-lymphocytes were observed. A relative and absolute decrease in the level of T-helpers was revealed. Certain correlation between some clinical and immunological indices was observed. PMID- 3265543 TI - [X-ray diagnosis of histiocytosis X]. AB - The results of a dynamic x-ray study of 27 patients suffering from histiocytosis X with lung involvement were analyzed; the study was supplemented by CT in 4 cases. X-ray semiotics of the disease was investigated with relation to its stage. X-ray symptom complexes were defined: interstitial, interstitial granulomatous, and focal (tumorous). The authors have emphasized the fact that the small focal-cystic and pneumothoracic x-ray variants of the disease, described in literature, are not nosological entities but reflect only its stage and complications. PMID- 3265544 TI - [Current approaches to selecting patients with ischemic heart disease for aortocoronary shunting surgery]. PMID- 3265545 TI - [Our judgements on the potential for surgical treatment of patients with liver cirrhosis and portal hypertension]. AB - The results of surgery of 267 patients with liver cirrhosis and portal hypertension were analyzed. Operation was indicated in actual danger of bleeding from varicose dilated esophageal and gastric veins; surgical intervention should be limited to selective portocaval anastomoses or to direct operation on esophageal and gastric veins. Indications for splenectomy in such patients should be limited. Analysis of the results of treatment of 80 patients with decompensated liver cirrhosis was indicative of some progress in therapy of patients with ascites resistant to drug therapy. PMID- 3265546 TI - [A rare case of rupture of a syphilitic aortic aneurysm into the esophagus]. AB - A case of the rupture of a syphilitic aortic aneurysm into the esophagus in a woman aged 64 with cured breast cancer was observed. A clinical picture, autopsy and microscopy findings were described. The authors underlined the rarity of the case, difficulty of intravital and morphological diagnosis which could be attributed to syphilis pathomorphosis. Of great importance for diagnosis are a detailed life history, clinical symptoms, instrumental methods of investigation, especially in oncological practice where differential diagnosis with exophytic esophageal cancer seems difficult. PMID- 3265547 TI - [Urinary tract infections in childhood]. PMID- 3265548 TI - HLA-DP antigens provide the proliferative impetus for the generation of cytotoxic T lymphocytes. AB - Investigating HLA-A, -B, -C, -DR and -Dw antigens and MLR, CML, and PLT reactivity in two unrelated persons, it was found that, despite their HLA-D/DR identity, cytotoxic T lymphocytes (CTL) could be induced in the CML assay. The HLA-DP antigens proved to provide the proliferative impetus for the generation of CTL. PMID- 3265549 TI - [Treatment of appendicular infiltrates]. PMID- 3265550 TI - [Effect of a constant electric current and wound irrigation in the complex treatment of chronic osteomyelitis]. PMID- 3265551 TI - [Double resection of the intestines]. PMID- 3265552 TI - [Disorders of immunologic reactivity in patients with destructive pancreatitis with functional insufficiency of the liver]. AB - Results of the investigation of immunological status in 62 patients with destructive pancreatitis complicated by hepatic insufficiency are presented. An extremely severe degree of immunodepression in the given contingent of patients was shown. It was established that the degree of inhibition of the cellular and humoral immunity in patients with destructive pancreatitis had direct relation to the degree of the functional insufficiency of the liver. A conclusion was made about the necessity to include immunocorrecting measures in the complex therapy. PMID- 3265553 TI - [Circulating E receptor in the peripheral blood of patients with lung cancer]. PMID- 3265554 TI - [Analysis of diagnostic errors in hematogenic osteomyelitis in children]. PMID- 3265555 TI - [Infection-induced morbidity in school-age children]. PMID- 3265557 TI - [Effects of air quality in relation to morbidity in basic pediatric care]. PMID- 3265556 TI - [Significance of accidents on preserving the health of children]. PMID- 3265558 TI - [Regulation of immunoglobulin A response by lymphokines]. PMID- 3265559 TI - [A dried nutrient medium made from the fermented hydrolysates of a microorganism biomass for isolating Trichomonas vaginalis]. PMID- 3265560 TI - [Workshop 88. Perspectives on topical therapy using non-steroidal antiphlogistics/analgesics. Frankfurt/Main, 23 January 1988]. PMID- 3265561 TI - [Intrauterine growth retardation--CTG findings in pre-partum oxygen respiration and transcutaneous nerve stimulation]. AB - In 33 pregnant women with sonographic diagnosis intrauterine growth retardation (IUGR) 75 O2-mask respirations or, for a comparison, 63 transcutaneous electric paravertebral nerve stimulations (TENS) were carried out between 30 to 39 weeks of gestation. Before, during and after these measures the fetus was monitored by means of continuous CTG-registration. Both in the O2-inhalations and in the TENS the dominant CTG-changes were the rise of the acceleration frequency (in about 41% respectively 49% of the measures) and the increase of the fetal movements (in about 35% respectively 64% of the measures). In the case of some O2-respirations prognostically unfavourable CTG-changes occurred, like fetal tachycardia (in 9 experiments) and firstly occurring decelerations (in 8 experiments), Spikes not being taken into consideration. As those CTG-changes were also seen in some cases with TENS it is concluded that these findings were caused by retardation and that most probably O2-respiration cannot be charged with. Additionally a report is given on nuclearmedical measurements of the uteroplacental blood circulation and on determinations of the concentration of the serumal oxytocinase. The present study shows that by O2-respiration in connection with IUGR obviously no acute risk for the fetus exists which could be proved in the CTG. However it permits no conclusion on the therapeutic effect. PMID- 3265562 TI - Immune-mediated pathogenesis of Borna disease. AB - Borna disease is an endemic progressive encephalomyelitis of horses and sheep prevalent in central Europe. A wide variety of animal species, ranging from chickens to primates can be infected experimentally with the causative virus, which is only poorly characterized. Furthermore, BD virus-specific antibodies have been detected in sera and cerebrospinal fluids of psychiatric patients. Our studies on the pathogenesis of BD have shown that-at least in rats-the disease is not caused by the infecting virus itself, but by a virus-induced immunopathological reaction. Thus, after intracerebral infection immunoincompetent rats do not get the disease despite persistent virus replication in cells of the central nervous system. However, after adoptive transfer of immune cells from diseased rats, immunoincompetent rats exhibit full blown BD. Recently, we have been successful in establishing a virus-specific T cell line of the helper/inducer phenotype (CD4+). This T cell was shown to play an important role in the pathogenesis of BD, suggesting that the disease is caused by a delayed type hypersensitivity reaction. PMID- 3265563 TI - Immunity assessment in the early stages of amyotrophic lateral sclerosis: a study of virus antibodies and lymphocyte subsets. AB - Serum and CSF from 32 patients with idiopathic ALS, 30 age-matched controls and 30 MS patients were investigated regarding immunoglobulin concentration and virus specific antibodies, the lymphocytes in the peripheral blood and lymphocyte subsets were also investigated. ALS patients' results were compared with findings in MS and controls. The ALS patients had significantly higher IgG concentration in serum than the controls, marked lymphopenia, reduction of CD2, CD8 and Leu 7 positive cells and increase of the CD4/CD8 ratio and of SIg-positive lymphocytes. Compared with the MS patients, the ALS patients showed similarity in T-subset distribution with a lower standard deviation. No HTLV-I and HIV antibodies were found in any group and no significant differences in antibody distribution to Toxoplasma G, herpes simplex, cytomegalovirus, measles and mumps viruses were evident. All ALS patients were investigated at an early disease stage, therefore, our findings seem to support the conclusion that the immune alterations are related to the mechanisms of the disease and not to complications of its evolution. PMID- 3265564 TI - Diagnostic value of elastase-alpha 1-proteinase inhibitor in cerebrospinal fluid. AB - In this report we introduce CSF Elastase-alpha 1-Proteinase inhibitor as a valuable indicator for differentiating bacterial meningitis from aseptic meningitis and other neurological disorders. All patients (n = 26) with bacterial meningitis had increased CSF concentrations of E-alpha 1-PI above the range of normal (range of reference values: 0.0-2.3 micrograms/l, n = 79; bacterial meningitis: 30-3490 micrograms/l, n = 26). Concentrations of E-alpha 1-PI in bacterial meningitis were significantly elevated when compared with those in aseptic meningitis (0.0-194 micrograms/l, n = 37), polyneuropathy (0-23 micrograms/l, n = 24) and cerebrovascular attack (0-23.2 micrograms/l, n = 17). PMID- 3265566 TI - Otitis media with effusion and the nasopharynx. A bacteriological and immunological study. AB - The adherence of Haemophilus influenzae to nasopharyngeal mucosal cells was investigated in vitro. Secretory IgA antibody activity and the content of fibronectin in nasopharyngeal secretion were determined by enzyme-linked immunosorbent assay. Adherence was greater in children than in adults; and was significantly greater in children with otitis media with effusion than in control children. Secretory IgA and fibronectin in nasopharyngeal secretion were considered to influence adherence of H. influenzae to nasopharyngeal mucosa. PMID- 3265565 TI - Immune response of tonsillar B lymphocytes. PMID- 3265567 TI - Interaction of bacteria with the immune system of Waldeyer's ring in otitis media with effusion. AB - An in vitro assay was used to study the adherence of Haemophilus influenzae (HI) to human nasal, nasopharyngeal, and buccal mucosal cells from patients with otitis media with effusion (OME). Adherence of unencapsulated HI was stronger than that of type b HI. HI adherence to both nasal and nasopharyngeal mucosal cells is stronger than that of buccal ones, indicating the presence of an important route of HI infection from the nose to the nasopharynx in OME. Specific antibodies against outer membrane vesicles (OMV) of HI were also examined using enzyme-linked immunosorbent assay. No significant correlation could be observed between specific secretory IgA or IgG titers and HI adherence to the nasopharyngeal mucosal cells, which suggests that HI adherence to the mucosal cells seems to depend on various factors including the local immunological defense system in OME patients. Anti-OMV IgA antibody producing cells were identified in the adenoid using the three-step immunoperoxidase method. These results suggest that non-typable strains of HI adhere more readily to epithelial cells and consequently are better suited to colonize the nasopharynx or to cause local infections. PMID- 3265568 TI - A study on the adjuvant activity of palatine tonsil. AB - The involvement of non-specific factors in the onset of focal infection should never be ignored. We pay attention to the adjuvant activity of tonsil as one of various kinds of nonspecific factors. We confirmed the presence of such substances with adjuvant activity as lipopolysaccharides and muramyl dipeptide in the lacunar debris of tonsil. Then, using experimental animals with adjuvant induced arthritis, the study was made to determine whether the lacunar debris actually exerts adjuvant activity. We demonstrated the presence of adjuvant activity in the lacunar debris. PMID- 3265569 TI - Development and functional anatomy of the human tonsilla palatina. AB - The tonsilla palatina, belonging to the gut-associated lymphoepithelial organs (GALT), shows close morphological and functional correlation between the lymphatic tissue of mesenchymal origin and the endodermal epithelium of the second pharyngeal pouch. During the 4th fetal month epithelial crypts grow down into the connective tissue and are infiltrated by non-epithelial cells. In the underlying lymphoid tissue the first primary follicles with precursors of follicular dendritic reticulum cells can be localized already in the 14th fetal week post conceptionem (p.c.). The parafollicular areas develop into T-cell regions. Interdigitating cells in these regions as well as within the crypt epithelium express the HLA-DR antigen. They were frequently found in close contact with T-helper cells. This fact is discussed as an indication of the tonsillar crypt epithelium partly serving as T-cell region. But also B-cells and macrophages invade the crypt epithelium in great numbers with a distinctly different distribution. Natural killer (NK) cells (Leu-7-positive) are localized within the crypt epithelium. Small Leu-7-positive lymphocytes (probably precursors) have been found to be numerous in the germinal centers. The interaction of specific stationary cells in the T-cell and B-cell regions is obviously an important factor for the maturation of different subpopulations of immunocompetent lymphoid cells. PMID- 3265570 TI - Indication of tonsillectomy for recurrent tonsillitis. AB - The indication of tonsillectomy for recurrent tonsillitis was discussed from the standpoint of clinical immunology. Elevated serum IgG was observed in 29.8% of the patients under 8 years of age preoperatively. In contrast, in 25% of patients between 9-15 years of age, serum IgG was low preoperatively. In the patients over 16 years of age no abnormal serum IgG was found, and the elevated serum IgG returned to normal after tonsillectomy. The patients with normal serum IgG preoperatively retained normal values postoperatively. The low preoperative IgG level group still remained low postoperatively. As to postoperative improving symptoms, high and low grade fever improved most (100%), followed by cervical lymphadenopathy (93%), frequent absence from school (93%), sore throat (88%) and recurrence of bronchitis (85%). The patients with recurrent tonsillitis for 8 years showing high serum IgG had indications for tonsillectomy. PMID- 3265571 TI - Presynaptic site of action of the toxic component AgTx from the venom of the Pit viper (Agkistrodon halys (PaII.)) on the frog nerve-muscle preparation. PMID- 3265572 TI - [Knowledge and drug abuse among students in Brasilia, Brazil]. AB - A survey on how much students know about drug use was conducted among State-owned schools in Distrito Federal: 994 primary school pupils and 829 high school students were screened up altogether with 351 graduate school students from the University of Brazilia. A 56-question anonymous questionnaire was administered on social-demographical information, acquaintance with drugs, motivation for use and its frequency, and supply sources. It was found out that, indeed, pupils and students alike knew a great deal about drugs, their information, in general, originating in the mass media. Alcohol is the most widely used "legal" drug. Medical drugs, inhalants, marijuana and cocaine follow on. Among medical drugs, tranquilizers are second to none, and generally gotten through a doctor's prescription. This, coupled to the inhalant boom, deserves a top priority attention on the part of authorities. The research suggests that, instead of emphasizing on danger-oriented divulgation, prevention campaigns should reinforce and accurate the youths' knowledge on drugs so that they are made fully aware of what drug has in store for them. At the same time, campaigns should instruct adults (i.e teachers, professionals, and parents) that drug abuse problems are better dealt with when resorting to appropriate attitudes, instead of giving up in despair. PMID- 3265573 TI - Female independence in Portugal: effect on suicide rates. AB - The greater incidence of suicide among males could be ascribed to the distinct roles still attributed to each sex. Progress towards female independence could reduce this different incidence. We analysed the following in Portugal: male and female suicide rates; profiles; and male/female suicide ratio before (1955-1969) and after the development of a movement for women's independence (1970-85). Concomitant with progress towards female independence there is a significant rise in female suicide and a decrease in male/female suicide ratio. The highest rates are among professional/technical women living in urban areas. In professional groups there is significant correlation between deaths caused by suicide and by liver cirrhosis. It is concluded that alcoholism often leads to suicide; in women, taboos about alcoholism and suicide explain a higher incidence of suicide among culturally freer professional groups; female independence will catalyse a rise in alcoholism, which together with other factors resulting from that independence will lead to a predictable increase of suicide among Portuguese women and a reduced difference in rates of suicide between the sexes. PMID- 3265574 TI - A comparison between patients admitted to psychiatric hospitals in Botswana and South Australia. AB - Cohorts of patients admitted to psychiatric hospitals in Botswana and South Australia were compared. The psychiatric hospital in Botswana was used almost entirely for the care of patients with psychotic disorders, whilst one third of the patients in South Australia had either a neurotic or personality disorder diagnosis. A higher proportion of patients in Botswana than South Australia had had only a brief period of illness prior to admission. Violence was equally common amongst Tswana and Australian patients, but was directed outwards towards property and other people in Botswana and inwards towards the self in Australia. It was tentatively concluded that in both countries there was a group of severely ill patients who could not be handled without containment. PMID- 3265575 TI - Importance of cell surface marker to the prognosis of non-Hodgkin's lymphoma. AB - We studied the correlation between the cell surface markers and prognosis of non Hodgkin's lymphoma (NHL) patients treated in the Shikoku Cancer Center Hospital from 1980 to 1986. Thirty-one cases were selected on the basis of having a lymphnode as a primary lesion, having been immunophenotyped before chemotherapy, being in the intermediate histologic grade and being in stage II, III or IV. Thirteen cases of the T-cell type (T-lymphomas) and 18 cases of the B-cell type (B-lymphoma) were identified. The complete remission rate was 54% among T lymphoma patients and 78% among B-lymphoma patients. The median length of survival was 12+ months in T-lymphoma and 26+ months in B-lymphoma. The survival rate of T-lymphoma patients was significantly lower than that of B-lymphoma patients. The importance of making surface marker studies was reappraised in our study. PMID- 3265576 TI - The effects of muscle-building exercise on vitamin D and mineral metabolism. AB - Exercise and muscle strength are important determinants of bone mass. Studies were carried out in normal young adult white males to determine the effects of exercise on vitamin D and mineral metabolism. Fourteen men who had engaged in regular muscle-building exercises for at least 1 year and 14 age-matched controls (age range, 19-36 year) were hospitalized on a metabolic ward and were given a constant daily diet estimated to contain 400 mg of calcium, 900 mg of phosphorus, 110 mEq of sodium, 65 mEq of potassium, and 18 mEq of magnesium. Body weight averaged 78 +/- 3 kg in the exercisers and 72 +/- 2 kg in the controls (NS). Serum calcium, ionized calcium, phosphate, magnesium, somatomedin-C, and immunoreactive parathyroid hormone (PTH) were not different in the two groups, whereas serum Gla-protein (39 +/- 5 vs. 24 +/- 2 ng/ml, p less than 0.01), 25 hydroxyvitamin D (23 +/- 2 vs. 16 +/- 2, p less than 0.05) and 1,25 dihydroxyvitamin D [1,25(OH)2D] (40 +/- 2 vs. 29 +/- 2 pg/ml, p less than 0.01) were higher in the exercisers than in the controls. Urinary calcium, phosphorus, sodium, potassium, creatinine clearance, and norepinephrine were not different in the two groups, whereas urinary magnesium (12.6 +/- 1.0 vs. 9.4 +/- 0.5 mEq/d, p less than 0.01) and urinary cyclic adenosine 3',5'-monophosphate (cyclic AMP) (2.52 +/- 0.19 vs. 1.72 +/- 0.20 nM/dl glomerular filtrate, p less than 0.01) were higher in the exercisers than in the controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265577 TI - Further biochemical and molecular characterization of primary rat parietal bone cell cultures. AB - Primary bone cell cultures are used widely to examine the regulation of bone metabolism by growth factors and hormones. Characterization of this model system is now being conducted at the molecular level to define modulation of gene expression. Cells were obtained from rat parietal bone by sequential collagenase digestions. Cell populations were evaluated for bone-related products, including collagen isoform expression and mRNA levels, alkaline phosphatase activity, and osteocalcin production. Serum-deprived, confluent cultures of the first and second collagenase-released populations produced a lower percentage of total protein as collagen than the third, fourth, and fifth populations, while co culturing the third through fifth populations resulted in the highest level. Collagen typing on SDS-polyacrylamide gels revealed an abundance of mature type I collagen in all cell populations; type III collagen synthesis was undetectable by this method. This is in contrast to the presence of cytoplasmic mRNA for both type I and type III collagen in all cell populations, suggesting post transcriptional modulation of type III collagen synthesis. The expression of alkaline phosphatase and osteocalcin was highest in cultures of later released cells, indicating that these cell populations display phenotypic characteristics associated with cells of the osteoblast lineage. PMID- 3265578 TI - The influence of vitamin D metabolites on the calcification of cartilage matrix and the C-propeptide of type II collagen (chondrocalcin). AB - The influence of vitamin D metabolites (at 1 X 10(-10) M) on the calcification of cartilage matrix (measured by 45Ca2+ uptake) and the C-propeptide of type II collagen (measured by radioimmunoassay) has been studied using organ cultures and chondrocytes isolated from growth plates of vitamin D-deficient and -sufficient 11-day-old rats. Vitamin D-deficient rats had reduced amounts of C-propeptide in their serum and freshly isolated growth plate chondrocytes. In all chondrocytes cultured from vitamin D-deficient animals, the C-propeptide content was maximal at 24 hr whereas calcification continued to increase for up to 72 hr. In organ and chondrocyte cultures of tissue from vitamin D-sufficient rats, both 1,25 dihydroxycholecalciferol (1,25(OH)2D3) and 24,25-dihydroxycholecalciferol (24,25(OH)2D3) were required for maximal stimulation of calcification and maximal increases in C-propeptide content. In these D-replete tissues, 24,25-(OH)2D3 had a less stimulatory effect on both calcification (organ and cell cultures) and C propeptide (organ cultures only), while 1,25(OH)2D3 alone had no effect in cell cultures but an inhibitory effect in organ cultures. Studies of cells or tissue from growth plates of vitamin D-deficient rats demonstrated that 24,25(OH)2D3 alone produced maximal calcification and maximal increases in the C-propeptide content. 1,25(OH)2D3 generally had an inhibitory effect on both calcification and C-propeptide when used alone. In the presence of 1,25(OH)2D3, the stimulatory effect of 24,25(OH)2D3 was partly abrogated. Maximal stimulation of calcification and increases in C-propeptide by 24,25(OH)2D3 were observed at 1 X 10(-9) M and 1 X 10(-10) M. In none of these studies was there any effect on proteoglycan content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265579 TI - Bone status of senescent female rats: chemical, morphometric, and biomechanical analyses. AB - The bone status of female rats, 6, 12, and 24 months of age was examined. Femur Ca, Pi, and osteocalcin contents, as well as biomechanical properties, were measured and correlated to physical indices and serum chemistry. Diaphyseal Ca, Pi, and osteocalcin did not change significantly with increasing age. Serum Ca and Pi concentrations were not altered in the aged rat. Immunoreactive parathyroid hormone (PTH) levels increased significantly with age, when analyzed by linear regression. Serum osteocalcin decreased progressively from 6 to 12 months (-21%) and from 12 to 24 months (-23%). Maximum breaking force required to fracture femurs at midshaft did not change with senescence. Hence, the strength of the femurs as an intact organ was not compromised in aging. However, ultimate stress, a parameter that normalizes for differences in bone geometry and size, decreased 14% from 12 to 24 months. Changes in other biomechanical parameters, including yield and ultimate deformation, strain, and modulus of elasticity, were relatively small, but statistically significant, or were negligible. Morphometric measurements indicated a progressive age-related increase in second moment of area and cortical area. Medullary area did not change with age. Therefore, strength of the intact femur was maintained by architectural compensations, although normalized tissue strength decreased in senescence. The bone status and Ca/Pi homeostasis of the female rat were compared to similar findings, reported previously, for the male animal. The results suggest that bone status and mineral metabolism were compromised in the aged female rat, but the magnitude of change was less than that found for the senescent male rat. PMID- 3265580 TI - Potential therapeutic use of autologous human lymphocytes in metastatic melanoma: in vivo interleukin 2-activated peripheral blood lymphocytes and in vitro activated peripheral blood and tumor-infiltrating lymphocytes. PMID- 3265581 TI - Current approaches to the adoptive immunotherapy of cancer. AB - Interleukin 2 has provided the means of generating activated lymphocytes from the tumor-bearing host which show in vitro anti-tumor activity. These cells can be derived either from a ubiquitous null cell precursor population, exhibiting promiscuous lysis of nearly all tumors after culture in IL2 (ie. the LAK cell) or from a T cell precursor population infiltrating tumors and showing some relative specificity for lysis of the autologous tumor following activation (ie. TIL). When utilized in murine cellular adoptive immunotherapy models, both LAK cells and TIL are able to display marked anti-tumor effects against established micrometastatic tumor. LAK cells have been subsequently employed in adoptive immunotherapy against metastatic human tumors and in a limited number of cases have been able to mediate the regression of advanced cancers of differing histologies. The role of adoptive immunotherapy as standard therapy of human tumors will depend on refinement of the methodology and progress toward increased efficacy and reduced toxicity. TIL may possess theoretical advantages in these areas and efforts are currently proceeding to evaluate these new anti-tumor reagents in the the treatment of patients with cancer. PMID- 3265582 TI - Reactivity of human lymphocyte clones to autologous metastatic melanoma cells. PMID- 3265583 TI - Postoperative activation of tumor specific T cells by immunization with virus modified tumor cells and effects on metastasis. PMID- 3265584 TI - Exogenous and endogenous regulations of human megakaryocytopoiesis. PMID- 3265585 TI - Detection of a human hematopoietic progenitor cell capable of forming blast cell containing colonies in vitro. AB - A progenitor cell CFU-B1 (blast cell colony forming unit) present in human bone marrow and capable of producing blast cell containing colonies in vitro was detected using a serum containing semisolid culture system. The CFU-B1 has the capacity not only to undergo self-renewal, but also commitment to a number of hematopoietic lineages. This progenitor cell therefore has characteristics which suggest that it is identical to or closely related to the human pluripotent hematopoietic stem cell. Pretreatment of marrow cells with 5 fluorouracil facilitated detection of CFU-B1 derived colonies. The formation of CFU-B1 derived colonies was dependent upon the addition of media conditioned by the human bladder carcinoma cell line 5637. The ability of 5637 CM (conditioned media) to support blast cell colony formation was in part but not totally ablated by pretreatment of the CM with an IL-1 alpha (interleukin-1) neutralizing antibody. This data suggests that IL-1 alpha plays a role in the regulation of primitive events occurring during human hematopoiesis. IL-1 alpha might be exerting these effects by either acting directly on the CFU-B1, causing marrow accessory cells to elaborate other cytokines or by synergizing with cytokines already present in 5637 CM. PMID- 3265586 TI - Studies of murine megakaryocyte colony size and ploidization. PMID- 3265587 TI - Serine proteases promote human CFU-GM in methylcellulose culture systems. PMID- 3265588 TI - Molecularly characterized factors governing the growth of murine multipotent stem cells in serum-depleted marrow cultures. AB - The growth requirements of normal murine marrow-derived multipotent stem cells (CFU-GEMM) in a simple clonal cell culture system substantially devoid of exogenous serum proteins was assessed. The ability of murine interleukin-3 (Il 3), recombinant human erythropoietin (rEPO), and a crystalline preparation of the protoporphyrin hemin to support colony growth in "serum-free" cultures was examined by titration. The results suggest that both Il-3 and hemin are limiting for multipotential colony growth in "serum-free" cultures, but that EPO is not. In addition, the 'sensitivity' of CFU-GEMM to each growth factor appeared to increase in the "serum-free" environment as evidenced by a "shift-to-the-left" in all the titration curves. Nearly half of the GEMM colonies grew to full maturity in the absence of exogenous EPO. Given the optimal concentration of each growth factor, high colony growth was consistently observed in the "serum-free" cultures, with a range from 65% to 119% of the serum control level. It is therefore concluded that supplementation of murine marrow cultures with Il-3 and hemin alone may provide the necessary setting for studying the factors which modulate the growth of multipotent stem cells in a serum-free environment. PMID- 3265589 TI - A comparison of methods for analysis of mRNA in hematopoietic cells: conventional and clonal northern analysis and in situ hybridization. AB - Three methods for the detection of mRNA in hematopoietic cells are addressed, and examples using these techniques to examine human leukemic cells' genetic response to chemical and biological response modifiers shown. The limitations and specific applications of the three techniques are discussed. PMID- 3265590 TI - Epidermal growth factor binding in the presence of ethanol. AB - Epidermal growth factor (EGF) is a mitogen which has been shown to stimulate maxillo-facial growth and DNA synthesis. Ethanol has been reported to inhibit cell regeneration in vivo and in vitro and to produce diminished maxillo-facial development in fetal alcohol syndrome. Recent findings from this laboratory have elucidated rapid metabolic changes in the hepatic content of some of the glycolytic intermediates resulting from injection of EGF, ethanol or EGF combined with ethanol in vivo. An immediate effect of EGF in vivo is to increase hepatic tissue content of 3-phosphoglycerate and phosphoenolpyruvate 1.2-1.3 fold when compared to saline treatment. Ethanol however causes a marked fall in the hepatic content of 3-phosphoglycerate and phosphoenolpyruvate 3.2-3.7 fold below saline treated levels. Ethanol in combination with EGF decreases hepatic values for 3 phosphoglycerate and phosphoenolpyruvate 2.0-2.3 fold from saline treated, but elevates the content of phosphoenolpyruvate 1.6 fold over ethanol treatment alone. Such metabolite changes occurring with ethanol treatment have been attributed alternately to redox shifts or to membrane perturbations. We wished to determine whether dimunition of 3-phosphoglycerate and or phosphoenolpyruvate below certain levels perhaps critically necessary for normal mitogenic action of EGF was due in this case to ethanol effects of binding of EGF to the cell membrane. PMID- 3265591 TI - Non-opioid (OTC) analgesics--risks/benefits in perspective. PMID- 3265592 TI - Over-the-counter analgesics: rational developments in the future. PMID- 3265593 TI - Responses of deaf high school students to an 'Attitudes Toward Alcohol' scale: a national survey. PMID- 3265594 TI - Stiles-Burch two-degree color mixture data. AB - The 2 degree color mixture data of Stiles and Burch have been analyzed to study the differences between individual subjects and the lack of precision at the blue end of the spectrum. The luminous efficiency data have been compared to those of Judd's 1951 observer and the 1931 standard observer. The mixture data have been compared to those of Wright and Guild and have been related to mixture data of dichromats. One of the ten observers was found to have a luminous efficiency curve similar to that of a protanope and was excluded from the average data. PMID- 3265595 TI - Visual decrement with deposit accumulation of HEMA contact lenses. AB - The vision decrement associated with deposit accumulation on hydroxyethyl methacrylate (HEMA) contact lenses was assessed in 51 patients presenting consecutively to a large clinic. Both high contrast visual acuity (HCA) and low contrast visual acuity (LCA) (logMAR) decreased with increased deposition (Rudko classification). Apart from being consistently lower than HCA, LCA offered no additional useful information. Both HCA and LCA worsened with lens age, whilst lens deposition increased with lens age (p less than 0.001). No associations between any of the above measures and patient symptoms were revealed. In general, unacceptable vision decrement and deposit formation occurred after 12 months or 4,000 h of daily lens wear. Clinicians can use the data presented in this paper to reconcile vision loss with deposit formation in patients wearing HEMA lenses. PMID- 3265596 TI - Actions of steroids and prostaglandins secreted by the placenta and uterus of the cow and ewe on lymphocyte proliferation in vitro. AB - Prostaglandins, steroids, and their metabolites that are known to be produced by the conceptus, maternal endometrium, and placenta of the cow and sheep were tested for their ability to inhibit in vitro blastogenesis of bovine and ovine lymphocytes. Prostaglandin E2 (PGE2) suppressed PHA- and mixed lymphocyte reaction-induced blastogenesis in a log-linear, concentration-dependent manner, exerting its inhibitory effect at a final concentration of 10(-8) M and higher. PGE2 also inhibited IL-2-dependent proliferation of lymphocytes, but to a lesser degree than for PHA-treated cultures. Progesterone and estradiol-17 beta also inhibited [3H] thymidine incorporation into PHA-stimulated lymphocytes, but only at a pharmacological concentration of 10(-5) M. No synergy between PGE2 and progesterone in inhibiting lymphocyte proliferation was observed. Estrone, PGF2 alpha, 15-keto-13,14-dihydro-PGF2 alpha, and two metabolites of progesterone (5 beta-pregnane-3,20-dione and 5 beta-pregnane-3,20-diol) had no effect on lymphocyte proliferation. By virtue of its continual production at the fetal maternal interface throughout pregnancy, PGE2 may be an important local immunoregulatory agent to protect the allogeneic fetus from maternal immunological attack in the cow and ewe. PMID- 3265597 TI - Hydatidiform mole macromolecules inhibit interleukin-2-mediated murine lymphocyte proliferation in vitro. AB - Macromolecules extracted from hydatidiform mole trophoblast inhibit mitogen induced lymphocyte proliferation. To characterize the mechanism of this immunomodulation, we determined the effects of hydatidiform mole vesicle fluid (HMF) and tissue extracts (HME) on lymphokine function in vitro. Utilization of interleukin-1 (IL-1) and interleukin-2 (IL-2) were determined by using a lymphoma cell line (LBRM-33-1A5) and a murine T cell line (CTLL2), respectively. HMF suppressed (P less than .05) IL-2-dependent CTLL2 cell proliferation at 500 (36.4% of controls) and 50 (74.9% of controls) micrograms/ml. HME also suppressed CTLL2 proliferation (P less than .05) at 500 (46.0% of controls), 100 (67.2% of controls), 50 (71.5% of controls), and 10 (85.4% of controls) micrograms/culture ml. In contrast, HMF exhibited no effect on IL-1-stimulated LBRM-33-1A5 production of IL-2. However, 500 micrograms/ml of HME inhibited (P less than .05) IL-2 production (63.0% of controls) in the IL-1 utilization assay. This suppressive effect was probably due to a carry over of HME from the LBRM-33-1A5 culture to the target cells (CTLL2) used to measure IL-2 production. Molecular weight chromatography of an HME sample eluted an IL-2 inhibitor in a low molecular weight (35-50 kd) and high molecular weight (greater than 250 kd) fraction. These data suggest that one way in which macromolecules derived from hydatidiform mole could interfere with in vitro immunologic responses is by modulating interleukin-2 function. PMID- 3265598 TI - Delineation between T- and B-suppressive molecules from human seminal plasma: I. Partial characterization of a 180-kD protein inhibiting the B response to T independent antigens. AB - The immunosuppressive activity of fractionated human seminal plasma (SP) was investigated both in vitro (on human lymphocytes) and in vivo with Balb/c mice. SP fractionation by dialysis allowed delineation of the major suppressor factors according to their respective sizes--small (less than 12 kD) or large (greater than 12 kD). In vitro, large molecules were found to suppress the B-cell proliferative response induced by the Nocardia mitogen, while small molecules suppressed the T-cell proliferation induced by phytohemagglutinin. In vivo, immunosuppression was obtained almost exclusively on T-independent responses after preliminary treatments either with unfractionated SP or with large SP molecules. Both type 1 and type 2 T-independent responses were suppressed, as evidenced by plaque-forming cells and antibody assays. In contrast, no immunosuppression was found in vivo after treatment by small SP molecules. Purification of the B-cell suppressor by gel filtration and high-performance liquid chromatography, as well as by preparative isofocusing, indicated that its molecular weight was 180 kD and its isoelectric charge was between pH 5 and 6. This factor is a protein, as evidenced by pronase digestion. A possible role for this molecule in the protection of sperm against the female immune system is discussed. PMID- 3265599 TI - [Combined endotracheal anesthesia with nitrous oxide in conjunction with electroanalgesia during cesarean section in pregnant women with cardiovascular pathology]. PMID- 3265600 TI - The 2-stage neuroskeletal pathomechanism of developmental deformities of the limb skeleton. A contribution to the discussion on the McCredie-McBride hypothesis. AB - Experimental skeletal deformities produced in laboratory birds and in frog tadpoles and examined with Williams' technique (1943) suggest a selective inhibitory effect of various teratogens upon the vulnerable growth of peripheral nervous trunks. The exaggerated osteoneural growth differential resulting therefrom is compensated for by adaptive deformities (buckling, achondroplasic stunting, dislocation) of otherwise normally growing bones which, though independent of innervation under normal conditions, have to "respect" the growth insufficiency of the nervous trunks and to accommodate along them during the proximo-distal development of the limb, even at the cost of a gross deformity. The McCredie-McBride hypothesis, on the other hand, is aimed at explanation of skeletal defects by an early neuroskeletal (neurotrophic) disturbance within the limb bud. Aneurogenic limbs produced experimentally do not necessarily militate against the existence of neuroskeletal relations in the early limb bud postulated, above all, by the McCredie-McBride hypothesis. These relations have been firmly established during the phylogenetic history so that artificial aneurogenic limb, never evolved by Nature, may grow up by (phylo)genetic inertia even without any neural involvement during the individual ontogenesis. PMID- 3265601 TI - The number of frog sciatic axons increases continually during body growth. AB - Frog sciatic nerves show a continuing addition of new myelinated and nonmyelinated fibers with body growth. Along with increases in fiber number there are also marked changes in axon calibers and in the relative thickness of the myelin sheaths. Our data show that frog nerves, as opposed to mammalian nerves, are composed of fibers of different ages, stages of growth and stages of myelination. PMID- 3265602 TI - Simultaneous determination of mefloquine and chloroquine in biological fluids using high-performance liquid chromatography. AB - A high-performance liquid chromatography (HPLC) method for the simultaneous determination of mefloquine and chloroquine in biological fluids is described. Methaqualone is used as an internal standard. After a single-step extraction, achieved from alkalinized samples with diethyl ether, a separation is obtained using a mu-Bondapak phenyl column with a mobile phase of acetonitrile and sodium acetate buffer. Detection is done at 305 nm. The lower detection limits are 3 and 10 micrograms/l for mefloquine and chloroquine, respectively. Thus, this method appears to be simple, rapid, very sensitive and applicable in pharmaco-clinical, toxicological and forensic analyses. PMID- 3265603 TI - [Micronodular generalized familial angiomatosis (generalized essential telangiectasia): clinical cases; ultrastructural study]. AB - Six patients of the same family present with micronodular and generalized familial angiomatosis. Four of them have been investigated. Their problem is purely esthetic; however an asymptomatic form of von Willebrand disease has been found in a female and one of her daughters. The light microscope reveals a network of dilated capillaries in the superficial dermis. Electron microscope investigation of the endothelium demonstrates on abundance of Weibel-Palade bodies, the presence of osmiophilic inclusions within clear vacuoles, the occurrence of long spacing collagen fibrils in the vicinity of endothelial and perithelial cells; furthermore, cytoplasmic projections within the lumen constitute the most dramatic and constant feature: there are many villosities, loops, coils, tufts and entanglements in all four cases. PMID- 3265604 TI - Clinical observations on nail changes in psoriasis. AB - 410 cases of psoriasis [282 males (68%) and 127 females (31%)] were interviewed and examined to study the nail changes. The prevalence of nail changes was 78.0% (males = females). Common changes were pitting (67.5%) and onycholysis (67.2%). Dystrophy of varying degrees occurred in 35.0%, subungual hyperkeratosis in 24.7%, discoloration in 18.4%, loss of nails in 2.8% and pustulation in 1.3%. Pitting and onycholysis was the most common combination (45.6%). Nail changes were significantly more common in patients who have moderate to severe psoriasis as compared with patients with mild psoriasis; in patients who have psoriasis for greater than 5 years as compared with patients who have psoriasis for less than 5 years; and in patients older than age 50 as compared with those aged less than 50. A definite correlation was found between the prevalence of nail changes and the presence of scalp and periungual psoriasis, and the presence of joint involvement. PMID- 3265605 TI - The epidemiology of cutaneous amyloidosis in Jakarta (Indonesia). AB - An analysis of cutaneous amyloidosis cases during a five year period, from January 1, 1983 to December 31, 1987, showed that of 78 cases suffering from lichen amyloidosis, 9 patients (11.5%) were male and 71 patients (80.5%) female. Macular skin amyloidosis was observed. Sixty patients (76.9%) were found in the age range of 20-50 years. Forty-nine patients (62.8%) suffered from the disease for 2 years or less. Skin changes were mainly located on the shin areas, the posterior part of the lower thighs and posterior part of the forearms. Treatment with strong topical corticosteroids and keratolytic agents (salicylic acid ointment in higher than 3%) proved to be unsatisfactory. The literature mentions higher incidence of lichen amyloidosis in Chinese, Malaysians and Indonesians than in Caucasians. PMID- 3265606 TI - Lichen planus: a study of 72 cases in Singapore. AB - Seventy-two patients attending this hospital with a diagnosis of lichen planus were examined. There was a striking predominance of Indians (69%) and a surprisingly low incidence of Chinese (24%) and Malays (4%) in the study population, compared to the racial composition of the general clinic population. The age distribution curve of the study population was bimodal with peaks at age groups 21-30 (22%) and 41-60 (33%) years. The most common morphologic variant was lichen planus vulgaris (common type) which we observed in 46 (64%) patients, followed by lichen planus hypertrophicus in 8 (11%) and lichen planus atrophicus in 2 (3%). Lichen planus confined to the skin was observed in 49 (68%) patients. Mucous membrane involvement was seen in 21 (29%)-17 (24%) had oral mucosa membrane involvement and 4 (6%) genital mucous membrane involvement. In 16 (22%) cases, mucous membranes were exclusively involved--12 (17%) had oral mucous membrane involvement and 4 (6%) genital mucous membrane involvement. Nail changes were only observed in 2 (3%) patients. Eight (11%) patients had associated diabetes mellitus. Overall, lichen planus appeared to pursue a protracted course with only 4 (6%) patients clearing completely after a disease duration of 5-12 months. PMID- 3265607 TI - Hypertension in IgA nephropathy. AB - Among 151 patients with IgA nephritis, 18/151 (12%) had hypertension at presentation and 50/151 (33%) were hypertensive after an interval of 65 +/- 40 (Mean +/- SD) months. Hypertensive patients (n = 50) had a higher incidence of glomerulosclerosis, medial hypertrophy of blood vessels, tubular atrophy, poorly selective proteinuria and extension of immunodeposits to peripheral capillary walls compared to normotensive patients (n = 101). Chronic renal failure occurred more commonly among hypertensives compared to normotensive patients (42%) versus 14%. However, the time taken for patients to reach renal impairment or end stage renal failure was not significantly different. The cumulative renal survival for the hypertensive group was 78% after 8 years compared to 91% in the normotensive group (p less than 0.05). In the second part of the study, patients who were hypertensive at presentation (n = 18) were compared with those who developed hypertension on follow up (n = 32). Apart from a shorter duration of follow up for patients with hypertension and a higher incidence of glomerulosclerosis, there were no significant differences in their clinical presentation, laboratory indices or other histological parameters. The incidence of chronic renal failure and the time taken to reach end stage renal failure were not different. Uncontrolled hypertension was an important cause for rapid deterioration to end stage renal failure within 3 years, compared to 8 years when hypertension was controlled. PMID- 3265608 TI - [Oto-palato-digital type I syndrome in five generations. Relationship to the type II form]. AB - Three cases of oto-palato-digital syndrome (OPD) are described. They are from the same family, in which the syndrome is an X linked recessive disorder, transmitted through five generations. These cases are classified rather in the OPD type I. The limit between OPD I and II is discussed. The hypothesis of two allelic genes is suggested. PMID- 3265609 TI - Acetylation phenotypes in patients with bladder carcinoma. AB - The present study was done to evaluate the possible association of bladder carcinoma with the slow acetylator phenotype in a portuguese population. 49 patients with bladder carcinoma were compared to a normal control group of 84 individuals. No statistically significant association was detected. But when subdividing the group of slow acetylators it is found that in the subgroup with 12-36% acetylation there is a higher percentage of patients, which is statistically significant. These results are in agreement with two other studies, using populations of similar ethnic origin. PMID- 3265610 TI - Partial duplication of 17 long arm. AB - Three subjects from 2 unrelated families with partial duplication of 17q, derived from a reciprocal parental translocation between chromosomes 11 and 17 with different breakpoints, are described. A female patient from one family with a 46,XX,-11,+der(11),t(11;17)(q24;q23.2)pat chromosome complement had died at 2 months of age. In the second family, a male propositus and a subsequent fetus, identified by cytogenetic prenatal diagnosis, showed a 46,XY, 11,+der(11),t(11;17)(q2505,q24.3) mat chromosome complement. Twelve other cases involving partial duplication of chromosome 17 have been reported, 11 of these derived from a balanced translocation, and 1 was a duplication. All these cases showed psychomotor and mental retardation, cranial contour anomalies, micrognathia, bulbous nose, short neck, skeletal anomalies, and CNS defects. The phenotypic and clinical observations in the three subjects of this report are compared with previously reported findings. PMID- 3265611 TI - Deletion 1q42.3----qter in a girl with psychomotoric retardation and multiple dysmorphisms. AB - A de novo deletion 1q42.3----qter in a 10-month-old girl with psychomotoric retardation and multiple dysmorphic signs is reported. The patient's symptoms are in accordance with a recently described distal 1q deletion syndrome. PMID- 3265612 TI - Transsexualism and anatomic sex ratio reversal in Poland. AB - Transsexualism has been described in numerous papers as a condition appearing, on the average, four times as often with somatic males than with somatic females. Against this background we consider the situation in Poland, where, during three consecutive observation cycles over 6 years, the results obtained were reversed. Among our transsexuals the ratio was 5.5:1, with the majority being somatic females. PMID- 3265613 TI - [Forms of hepatic disease in alcoholic patients in Salvador, BA]. AB - This study was carried out to evaluate the relative importance of various patterns in liver in patients followed with chronic ethylism at the Hepatology Unit Care Service of the Hospital Prof. Edgard Santos--University Federal of Bahia, Brazil. Ninety six individuals were submitted to liver biopsy. Of those, 69 (71.9%) presented with alcoholic lesions and 27 (28.1%) had other histologic features of liver disease not commonly related to alcoholism. These data suggested that the presence of other types of liver diseases are prevalent in alcoholic patients in Bahia and showed that, in addition to clinic and laboratorial evaluation, it is essential to perform the histological study to complete the diagnostic of the patients, and detect other liver diseases not associated to alcohol. PMID- 3265614 TI - [Study of circulating lymphocytes by monoclonal antibodies in myasthenia gravis]. AB - A significant decline of CD3 cell detected by rosettes and a significant increased of B cell populations were observed. The total CD3+, helper CD4+ and suppressor CD8+ T-cell subsets showed no significant variation em relation to sex, age thymectomy and corticotherapy by monoclonal antibodies. PMID- 3265615 TI - [Headache in childhood: diagnosis and therapy. A prospective study of 77 cases]. AB - Seventy seven cases of migraine in children were studied. Age average was 9 years +/- 2; there were any sex differences. The frontal localization was found in roughly 49% of cases, whereas hemicrania was just found in 9% of cases. The most frequent factors associated were nausea, vomiting and dizziness. The most common triggering factor was the stress. Family history of migraine occurred in 76.5%. Out of 36 patients suffering migraine, 31 underwent a prophylactic treatment with pizotifen or propranolol. There was satisfactory clinical responses in roughly 90% of cases. PMID- 3265616 TI - [Cerebrovascular disorders: analysis of 190 autopsy cases]. AB - A retrospective study of 190 postmortem examinations of cerebrovascular disease from the Department of Pathology was carried out. We found 94 cases (49.47%) of hemorrhage, 67 (35.26%) of infarction and 29 patients (15.26%) with hemorrhage and infarction; both were more frequent in males. Among the hemorrhagic cerebral vascular disease the intracerebral hemorrhage was more frequent. The cerebral infarction was more frequent in the territory of the middle cerebral artery. Arterial hypertension was the most common cause of cerebral hemorrhage and the cause in the great majority of the cerebral infarction cases was atherosclerosis. PMID- 3265617 TI - Blood blisters on the soft palate in angina bullosa haemorrhagica. Case reports. PMID- 3265618 TI - Transmodulation of the epidermal-growth-factor receptor in permeabilized 3T3 cells. AB - Binding of murine epidermal growth factor (EGF) to its high-affinity receptor can be modulated by a variety of structurally unrelated mitogens. The transmodulation, however, is temperature-dependent and has not been observed in isolated membranes. We report here the transmodulation of high-affinity EGF receptors by platelet-derived growth factors (PDGF) and tumour-promoting phorbol esters in 3T3 cells even when they are rendered incapable of fluid-phase endocytosis by treatment with phenylarsine oxide or by permeabilization with lysophosphatidylcholine. The relative affinity of the EGF receptors in the absence of modulating agents is not significantly altered by phenylarsine oxide treatment. Thus the difference in affinity between the two classes of EGF receptors seems to be unrelated to dynamic membrane changes or to differential rates of internalization. In permeabilized cells, non-hydrolysable GTP analogues transmodulate the high-affinity EGF receptor; however, the effects of these analogues are blocked by the protein kinase C inhibitor chlorpromazine. In contrast, transmodulation by PDGF is not blocked by chloropromazine. Thus the high-affinity EGF receptor can be transmodulated by both protein kinase C dependent or -independent pathways, and the transmodulation processes do not require fluid-phase endocytosis. PMID- 3265619 TI - Characterization of Ca2+ fluxes in rat liver plasma-membrane vesicles. AB - Inside-out plasma-membrane vesicles isolated from rat liver [Prpic, Green, Blackmore & Exton (1984) J. Biol. Chem. 259, 1382-1385] accumulated a substantial amount of 45Ca2+ when they were incubated in a medium whose ionic composition and pH mimicked those of cytosol and which contained MgATP. The Vmax of the initial 45Ca2+ uptake rate was 2.9 +/- 0.6 nmol/min per mg and the Km for Ca2+ was 0.50 +/- 0.08 microM. The ATP-dependent 45Ca2+ uptake by inside-out plasma-membrane vesicles was about 20 times more sensitive to saponin than was the ATP-dependent uptake by a microsomal preparation. The 45Ca2+ efflux from the inside-out vesicles, which is equivalent to the Ca2+ influx in intact cells, was increased when the free Ca2+ concentration in the medium was decreased. The Ca2+ antagonists La3+ and Co2+ inhibited the 45Ca2+ efflux from the vesicles. Neomycin stimulated the Ca2+ efflux in the presence of either a high or a low free Ca2+ concentration. These results confirm that polyvalent cations regulate Ca2+ fluxes through the plasma membrane. PMID- 3265620 TI - Structural characterization of a high-molecular-mass form of calcitonin [procalcitonin-(60-116)-peptide] and its corresponding N-terminal flanking peptide [procalcitonin-(1-57)-peptide] in a human medullary thyroid carcinoma. AB - Four peptides derived from procalcitonin were isolated in high yield from an extract of a human medullary thyroid carcinoma. The peptides were identified as procalcitonin-(1-57)-peptide, procalcitonin-(60-91)-peptide (calcitonin), procalcitonin-(60-116)-peptide and procalcitonin-(96-116)-peptide (katacalcin). Determination of the amino acid sequence of procalcitonin-(1-57)-peptide has demonstrated that the Ala25-Ala26 bond in preprocalcitonin is the site of cleavage of the signal peptide. Procalcitonin-(60-116)-peptide represents calcitonin extended from its C-terminus by the sequence Gly-Lys-Lys-Arg katacalcin, and its formation is indicative of an aberrant pathway of procalcitonin processing in the tumour cells. PMID- 3265621 TI - Interleukin-3-stimulated haemopoietic stem cell proliferation. Evidence for activation of protein kinase C and Na+/H+ exchange without inositol lipid hydrolysis. AB - Interleukin 3 (IL-3) is an important regulator of haemopoietic stem cell proliferation both in vivo and in vitro. Little is known about the possible mechanisms whereby this growth factor acts on stem cells to stimulate cell survival and proliferation. Here we have investigated the role of intracellular pH and the Na+/H+ antiport in stem cell proliferation using the multipotential IL 3-dependent stem cell line, FDCP-Mix 1. Evidence is presented that IL-3 can stimulate the activation of an amiloride-sensitive Na+/H+ exchange via protein kinase C activation. IL-3-mediated activation of the Na+/H+ exchange is not observed in FDCP-Mix 1 cells where protein kinase C levels have been down modulated by treatment with phorbol esters. Also the protein kinase C inhibitor H7 can inhibit IL-3-mediated increases in intracellular pH. This activation of Na+/H+ exchange via protein kinase C has been shown to occur with no measurable effects of IL-3 on inositol lipid hydrolysis or on cytosolic Ca2+ levels. Evidence is also presented that this IL-3-stimulated alkalinization acts as a signal for cellular proliferation in stem cells. PMID- 3265622 TI - Invertebrate vitellogenin is homologous to human von Willebrand factor. PMID- 3265623 TI - The heparin-catalysed inhibition of human factor XIa by antithrombin III is dependent on the heparin type. AB - The effect of various well-characterized heparin preparations on the inactivation of human Factor XIa by human antithrombin III was studied. The heparin preparations used were unfractionated heparin and four heparin fractions obtained after anion-exchange chromatography. Inactivation of Factor XIa was monitored with S2366 as chromogenic substrate and followed pseudo-first-order reaction kinetics under all reaction conditions tested. Enhancement of the rate of inhibition of Factor XIa in the presence of unfractionated heparin correlated to the binding of antithrombin III to heparin. From the kinetic data a binding constant of 0.1 microM was inferred. The maximum rate enhancement, achieved at saturating heparin concentrations, was 30-fold. The rate enhancement achieved in the presence of each of the heparin fractions could also be correlated to the binding of antithrombin III to the heparin. The binding constant inferred from the kinetic data varied from 0.10 to 0.28 microM and the number of binding sites for antithrombin III varied from 0.06 to 0.74 site per heparin molecule. The maximum rate enhancements, achieved at saturating heparin concentrations, were strongly dependent on the type of heparin used and varied from 7-fold for fraction A to 41-fold for fraction D. Therefore, although the stimulation of Factor XIa inactivation by antithrombin III could be quantitatively correlated to the binding of antithrombin III to heparin, the heparin-catalysed inhibition of Factor XIa is dependent not only upon the degree of binding of antithrombin III to heparin but also upon the type of heparin to which antithrombin III is bound. PMID- 3265625 TI - Injuries from single-vehicle crashes and snow depth. AB - Swedish official statistics on road traffic accidents shows a remarkable variability among different winter seasons in single-vehicle crashes resulting in personal injuries--one of the major causes of personal injury in road traffic. This study presents results from analyses investigating the role played by snow as an injury-reducing factor. The regression model specified implies, when applied to Swedish data, that an increase in snow depth by 1 cm--for snow depths less than 40 centimetres--reduces the number of crashes with occupant injury by 3%. This finding has implications for assessing trends in traffic safety through the use of routine statistics on motor vehicle occupant injuries and also shows that roadside design is a decisive factor in the generation of injury to the individual in single-vehicle crashes. PMID- 3265624 TI - [Studies of the pharmacokinetics and bioavailability of a new trimethoprim/sulfamethoxazole preparation in healthy volunteers]. AB - The objective of this study was to determine both the pharmacokinetic parameters and the bioavailability of a newly developed trimethoprim/sulfamethoxazole preparation (cotrimoxazole, Kepinol forte, 160 mg of trimethoprim/800 mg of sulfamethoxazole) in comparison with a reference preparation customary in trade and registered according to the AMG 1976, after single oral administration. For this purpose the test and the reference preparation were examined in a randomized 2-way crossover design (Latin square) in 12 volunteers each. Both dosage forms led to maximum plasma levels of approx. 1250 ng/ml of trimethoprim and about 40 micrograms/ml of sulfamethoxazole 1.5-2 h after application; the plasma half lives were about 9 h for trimethoprim and around 8.5 h for sulfamethoxazole. The statistical comparison (ANOVA, confidence intervals according to Westlake, Pratt Wilcoxon test) of the pharmacokinetic parameters found in the study resulted in bioequivalence of the newly developed trimethoprim/sulfamethoxazole preparation and the reference preparation. Furthermore, after the administration of both preparations no marked side effects worth mentioning were observed, suggesting a good and comparable clinical tolerability of the two preparations. PMID- 3265626 TI - Historical changes in motor vehicle death rates among the elderly. AB - Motor vehicle death rates among the elderly decreased substantially between 1940 and 1980, while the number of registered motor vehicles in the United States increased fourfold and death rates from motor vehicle injury changed little for the entire population. The annual death rate per 100,000 males aged 75-79 declined from 120 in 1940 to 41 in 1980. Much of the decrease can be attributed to reduced pedestrian deaths. Rates for other elderly age and sex groups showed similar patterns but the rates were lower and the changes smaller. Displaying age specific motor vehicle death rates by birth cohort provides a graphic demonstration that these death rates have decreased markedly for all age groups 60 and older. Implications and possible causes of this decrease are discussed. PMID- 3265627 TI - Fatal home accidents--a product database. AB - A computer-based "Home Accident Deaths Database" has been developed to permit analysis of the consumer products and articles or features of the home involved in fatal domestic accidents in England and Wales. It makes use of information already recorded for other purposes, which is either manually coded or converted by computer to a standard format. Rapid interrogation and analysis (in the form of tables or easily readable case listings) is possible, and the format of the database permits direct comparison with statistics for nonfatal hospital-treated accidents recorded by the Home Accident Surveillance System. Such comparison reveals considerable differences between the products and articles most frequently involved in fatal accidents and those most common in nonfatal cases, so that neither provides an adequate indication of hazards on its own. There are some limitations, including a variation in the level of detail recorded between different types of accident, less than perfect matching of sources for deaths in fires, and a long delay in getting cases onto the database, but with the experience that has now been gained it is hoped to develop a new reporting system that will overcome these problems and will, additionally, cover "leisure" accidents. PMID- 3265628 TI - [Positron emission tomographic study in patients with MELAS]. PMID- 3265629 TI - [Distribution of epidermal growth factor receptor in glioma]. AB - A monoclonal antibody (Amersham) to epidermal growth factor receptor (EGFR) was used for immunohistochemical study to confirm the presence of EGFR in the glioma tissue. Fresh surgical material was stored at -80 degrees C, and frozen sections were stained. Positive staining was demonstrated in 8 of 9 gliomas. In 2 of 8, more than 50% of tumor cells were positively stained. In 4 of 8, positive cells were seen scattered in the tissue. In the remaining 2 gliomas, few tumor cells were positively stained. The most representative staining was seen on the cytoplasmic membrane. But there were also nuclear and cytoplasmic stainings. The distribution of EGFR in the glioma cells suggests possible role of the epidermal growth factor in the proliferation of gliomas. PMID- 3265630 TI - [Clinical evaluation of an isolated fourth ventricle]. AB - Since the introduction of the CT scan in 1976, we have experienced 6 cases of the isolated fourth ventricle among 244 hydrocephalic patients (2.5%). Age at diagnosis of the isolated fourth ventricle ranged from 1 year 8 months to 13 years (mean age, 8 years, 6 months). The time interval between the first shunting procedure and the diagnosis of the isolated fourth ventricle varied from 1 year 5 months to 7 years 4 months (mean interval, 4 years 1 months). The prior hydrocephalus were due to intraventricular hemorrhage in two patients, meningomyelocele in a patient and brain tumor in three patients. Two patients had history of cerebrospinal fluid (CSF) infection and five cases underwent multiple shunt revisions. Posterior fossa signs were evident in all cases. It was quite easy to make a diagnosis of the isolated fourth ventricle with CT scan, which demonstrated a large rounded or pear-shaped midline cyst in the posterior fossa. Slit-like lateral ventricles were noted in three cases, while the remaining three had enlarged lateral ventricles. Ventriculography confirmed the isolation of the fourth ventricle in 5 cases. Metrizamide which had been injected into the fourth ventricle was diluted when CT scan was performed 48 hours later, and contrast medium disappeared since then. Magnetic resonance imaging (MRI) well showed the characteristic findings of the isolated fourth ventricle: cystic dilatation of the fourth ventricle, compression and distortion of the brain stem, upward tentorial herniation, occlusion of the aqueduct, downward displacement of the occipital lobe, septum formation of the fourth ventricle and accompanied anomalies such as, Chiari malformation or syringomyelia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265631 TI - [Study on adoptive immunotherapy for experimental brain tumor]. AB - Adoptive immunotherapy for the experimental murine brain tumor has been investigated using LAK cells generated in vitro from normal spleen cells with IL 2 and immune spleen cells from Fischer rats immunized against syngenic gliosarcoma, T9. IL-2 inhibitor(s) activity in serum was also studied. LAK cells and immune spleen cells were adoptively transferred to the rats intravenously or intratumorally on the 7th day after the inoculation of T9 into the right basal ganglia. Then the survival rate and necrotic foci were compared between the groups treated with those cells and the control. The survival rate of the groups treated with LAK cells was significantly higher than that of the control (administrated intravenously; P less than 0.01, administrated intratumorally; P less than 0.05). But the treatment with immune spleen cells was not effective. The incidence and area of necrotic foci in the tumors treated with LAK cells were greater than those of the others. Microautoradiography was also performed using 3H-TdR labeled LAK cells, which were administrated intravenously to the model. It was revealed that LAK cells accumulated in lung shortly after the administration, then in liver and spleen, especially in the white pulp. IL-2 inhibitor activity of the sera from the tumor-bearers was greater than that of normal rats, while it was depressed markedly by cyclophosphamide (60 mg/kg i.p.). In conclusion, the adoptive transfer of LAK cells can be one of the effective and attractive treatments of the brain tumor. In order to make immunotherapy more effective it should be necessary to clarify the nature of IL-2 inhibitor(s). PMID- 3265632 TI - Cardiac surgery for patients aged 65 years and older: a long term survival analysis. AB - Between January 1973 and December 1984, 562 patients aged greater than or equal to 65 had cardiac surgery at Papworth Hospital. Most had mitral or aortic valve replacements (coronary artery bypass grafting was not introduced for this age group at Papworth until 1977). The overall operative mortality, defined as death within thirty days or death before leaving hospital, was 7.3%. There were no early deaths in patients undergoing coronary artery bypass grafting surgery. Questionnaires sent to general practitioners in East Anglia traced 86.0% of the patients who survived to leave hospital. The longer term survival rates for all patients were 88.0%. (95% confidence interval (CI) 85 to 91) at one year and 74.4% (95% CI 69 to 79) at five years. The rates for those patients who survived the initial few months were 96.3% (95% CI 94 to 98) at one year and 81.5% (95% CI 77 to 86) at five years and these rates were no different from those in the general population aged greater than or equal to 65. PMID- 3265633 TI - A cytotoxic agent can be generated selectively at cancer sites. AB - Attempts to improve the selectivity of anti-cancer agents by conjugating them to antibodies directed at tumour associated antigens have demonstrated tumour localisation but only limited therapeutic success. We report here the advantage of a 2-stage approach in which the first component combines the selective delivery of antibody with a capability to generate a cytotoxic agent from a second subsequently administered component. A bacterial enzyme, carboxypeptidase G2 (CPG2) was conjugated with F(ab')2 fragment of a monoclonal antibody directed at beta subunit of human chorionic gonadotrophin (beta-hCG) and injected into nude mice bearing hCG producing CC3 xenografts of human choriocarcinoma. Time was allowed for the conjugate to localise at tumour sites and clear from blood before injecting para-N-bis (2-chloroethyl) aminobenzoylglutamic acid. Cleavage of the glutamic acid moiety from this molecule by CPG2 released a benzoic acid mustard. Growth of the tumour which is resistant to conventional chemotherapy was markedly depressed by a single course of treatment. This demonstrates for the first time the potential of an antibody directed enzyme to activate an alkylating agent and to eradicate an established human cancer xenograft. PMID- 3265634 TI - Somatic changes in B-lymphoproliferative disorders (B-LPD) detected by DNA fingerprinting. PMID- 3265635 TI - [The action of the venom of the spider Eresus niger on the neuromuscular synapses of the frog]. AB - The effect of Eresus niger spider venom on frog neuromuscular preparations has been studied using the intracellular microelectrodes. The spider venom has been found to block both spontaneous and elicited transmitter release and possesses the phospholipase activity. It has been suggested that the venom blocking synaptic transmission results from its phospholipase activity by analogy with the action of snake presynaptic neurotoxins. PMID- 3265636 TI - [Thyroid homeostasis in animals with iodine deficiency]. AB - The content of total iodine, its hormonal and nonhormonal fractions as well the level of protein-bound iodine in blood and basic tissue targets in representatives of 4 classes of animals: Esox lucius L., Rana esculenta, Streptopelia decaocto Priv., Lepus europaeus Pall. inhabiting the mountain regions with iodine deficiency in environment and in the lowlands of Transcarpathia with higher iodine provision have been investigated. A considerable decrease of general and hormone iodine level in the animal tissues of the mountain area accompanied by the suppression of the thyroid function has been stated. The utilization of thyroid hormones under the iodine deficiency condition is increased in the majority of cases and the level of protein-bound iodine is lowered that testifies to the transition of animal organism in the iodine-deficient areas to the lower level of thyroid homeostasis. PMID- 3265638 TI - Reactions in rat gluteal muscle to titanium implants. AB - A new approach to the analysis of tissue-implant interaction is presented using rat gluteal muscle as implantation site and using monoclonal antibodies to identify and quantify cells around the implant. The method can be used for comparative studies on biocompatibility. In this methodological investigation, pure titanium (Ti) was studied, revealing an initial response of macrophages, followed by the formation of a fibrous membrane, in which, even at 50 and 70 d, la-expressing cells and suppressor T-lymphocytes were present. PMID- 3265637 TI - Synovial macrophage response to aluminium oxide ceramic and cobalt-chrome alloy wear particles in rats. AB - The tissue response to intra-articular injection into rat knees of similar concentrations of sterile cobalt-chrome (Co-Cr) alloy and aluminium oxide (AL2O3) ceramic prosthesis wear particles was assessed at 1, 4 and 13 wk. A semiquantitative method of histological assessment showed a correlation between the numbers of particles and macrophage response in the tissues, and a difference in the response to different concentrations of Co-Cr particles. At 1 wk, the macrophage response to Co-Cr particles was significantly greater (p less than or equal to 0.01) than that to AL2O3 particles but no difference was detected at 4 and 13 wk. The difference may be due to necrosis of macrophages induced by Co-Cr particles. PMID- 3265639 TI - Heat changes during transient tension responses to small releases in active frog muscle. AB - Tension and heat production were measured in frog sartorius muscles in response to small shortening ramps (releases) at high and moderate speed. Transient tension responses to fast releases (0.1 to 0.4 mm in 1 or 4 ms) were similar to the tension transients length-clamped single fibers. Tension time courses during releases at 25 mm/s were like fiber responses calculated from the first two phases of the step responses (Ford et al., 1977). We conclude that similar crossbridge transitions produce tension transients observed in whole muscles and single fibers. Heat was absorbed during rapid tension recovery after fast releases and during the later part of releases at 25 mm/s. Variation of heat absorption with release size was compared with that of crossbridge movement predicted by the Huxley-Simmons hypothesis of force generation (Huxley and Simmons, 1971). Agreement between the two supports the conclusion that heat is absorbed by the crossbridge transitions responsible for rapid tension recovery after release. The results indicate that the entropy change of these transitions is positive. PMID- 3265640 TI - Competitive induction of erythroid progenitors by relative concentration of BPA to erythropoietin: possible existence of intermediate compartment between BFU-E and CFU-E. AB - Crude preparations of erythropoietin (Epo) have been found to contain burst promoting activity (BPA) as a contaminant. When anti-Epo antiserum was added to the culture of erythroid progenitor cells stimulated in vitro with crude Epo, the number of colonies derived from late erythroid progenitors (CFUe) was reduced, while that from early erythroid progenitors (BFUe) was increased. On the other hand, when the culture was stimulated with BPA-free Epo, which was purified from human urine, addition of anti-Epo antiserum enhanced neither BFUe nor CFUe. These results suggest that the ratio of BPA and Epo may be crucial in the assay of erythroid progenitors. Addition of anemic mouse spleen-conditioned medium (AMSCM) to the culture as a source of BPA resulted in the increase of BFUe and the reduction of CFUe under various concentrations of Epo. These findings might be explained by the existence of intermediate compartment of erythroid progenitors depending on both BPA and Epo. PMID- 3265641 TI - Activation of secretion and surface alteration of cytolytic T-lymphocytes interacting with target cells. AB - Cells obtained in mixed lymphocyte culture (MLC) and memory cells adsorbed on the surface of target cells (TC) were examined using scanning and transmission electron microscopy depending on the time of interaction with TC. Three types of lymphocytes were revealed: type I - cells of spherical shape with a smooth surface or an insignificant amount of microvilli; predominantly small and medium sized lymphocytes contacting TC with non significant involvement of their surface or by several microvilli; type II - oval or round-shaped lymphocytes evenly covered with microvilli with considerably enlarged region of contact; type III cells - predominantly large lymphocytes and lymphoblasts flattened (spread) on TC, with multiple microvilli, ridge-like projections, and ruffles on their surface. TEM revealed activation of the secretory apparatus in the cytoplasm of such lymphocytes. With increased time of interaction, type III cells increase in number (from 8.6% after 10 min to 90.2% after 60 min of incubation). Memory cells show no morphologic signs of secretion in correlation with the absence of lysis of TC on which they are adsorbed. The surface of the lymphocytes adsorbed on the substrate with poly-L-lysin is not noticeably altered. It is suggested that 3 morphological types of lymphocytes correspond to 3 stages of secretion activation. Lymphocyte contact with TC surface is evidently a specific stimulus for activating secretory apparatus of CTL. SEM can be used for quantitation of activated lymphocytes. PMID- 3265642 TI - Problem drinking in a military endoscopy clinic. PMID- 3265643 TI - Buprenorphine abuse among opiate addicts. PMID- 3265644 TI - Maudsley Hospital Survey: prevalence of alcohol problems and other psychiatric disorders in a hospital population. PMID- 3265645 TI - Effects of an inhibitor of the synaptic vesicle acetylcholine transport system on quantal neurotransmitter release: an electrophysiological study. AB - The drug 2-(4-phenylpiperidino)cyclohexanol (AH5183), which potently inhibits the active transport of acetylcholine (ACh) into synaptic vesicles, was used as a pharmacological tool to study the functional role of synaptic vesicles in quantal transmitter release. Using microelectrode recording techniques, miniature endplate potentials (mepps) and nerve-evoked endplate potentials (epps) were recorded from frog cutaneous pectoris neuromuscular junctions in low Ca2+/high Mg2+ Ringer solution, and in normal Ringer with added D-tubocurarine (D-TC). Stimulation in the presence of AH5183 caused a 40% reduction in quantal size (mepp amplitude), depressed tetanic potentiation, and decreased the number of quanta released with each nerve impulse in the presence of D-TC. All of these effects appeared gradually and only after extended stimulation of the nerve, during which several hundred thousand quanta were released. Consequently, these findings suggest a serial one-time usage of vesicles, with little or no re-entry of recycled vesicles until after a large fraction of the original vesicles has been exhausted. The results primarily show that filling of synaptic vesicles with ACh is crucial for sustaining synaptic transmission, and gives further evidence that the ACh released by nerve impulses originates from these organelles. PMID- 3265646 TI - Computed tomography of the internal auditory canals. PMID- 3265647 TI - Insulin autoimmune syndrome in methimazole or carbimazole treated Chinese patients of Graves' disease. PMID- 3265648 TI - Tumor-infiltrating lymphocytes: in vitro characterization of morphological and phenotypical changes. AB - Mononuclear cells (tumor-infiltrating lymphocytes [TIL]) that invade tumor tissue in fresh surgical specimens were examined and characterized. Such cells were seen in virtually all 52 tumor specimens analyzed and were found to be physically attached to the tumor cells. The morphology of these cells is described with scanning and transmission electron microscopy. Phenotype analysis of these tumor infiltrating lymphocytes was also performed. In the fresh surgical specimens, while the tumor cells are viable, TIL cells are mostly null cells (except for weak positivity for Leu-1 antigen). As the culture ages in vitro, the TIL phenotype changes drastically to a wide variety of both T and B cells as well as monocyte-macrophage lineage. While these phenotype changes occur, the tumor cells to which the TIL are attached display progressive signs of necrosis and cell death. Tumor cells without attached TIL cells are not affected by necrotic changes. It is speculated that these described changes in the phenotype and morphology of TIL may be related to acquiring cytotoxic activity against the tumor cells. An attempt to control these changes may possibly be useful for clinical application in cancer immunotherapy. PMID- 3265649 TI - Strychnine decreases the voltage-dependent Ca2+ current of both Aplysia and frog ganglion neurons. AB - 1. The effects of strychnine on the voltage-dependent Ca2+ current (ICa) were studied in physically isolated Aplysia neurons and enzymatically dissociated frog sensory neurons of the dorsal root ganglion. Neurons were studied under the internal perfusion and the voltage clamp condition. 2. Strychnine decreased the ICa with threshold concentrations for effect at 1 to 10 microM. The depression of ICa increased with strychnine dose without effects on the current-voltage relation of ICa. The effects of low concentrations of strychnine were reversible, but recovery was incomplete at higher concentrations. The potency of strychnine was about 10 times less than that of diltiazem, an organic Ca2+ antagonist. At 100 microM the ICa of Aplysia neurons was reduced to about half of the control. This concentration of strychnine also reduced the peak amplitude of ICa of frog sensory neurons. 3. These results indicate that, in addition to its actions on transmitter responses and on Na+ and K+ currents, strychnine has effects on ICa that have not previously been appreciated. PMID- 3265650 TI - Effect of urogastrone on intestinal regeneration is dose-dependent. AB - Urogastrone (UG) increases the rate of intestinal regeneration in intestinal defects patched with adjacent serosal surfaces by increasing the rate of epithelial cell migration and proliferation. It also inhibits contraction of the patched intestinal defect. The purpose of this study was to determine the effect of the dose of UG on these processes. Twenty male New Zealand white rabbits (1.9 2.9 kg) had 2 x 5 cm ileal defects patched with adjacent caecal serosal surface. Group I (n = 6) served as the control group. Group II (n = 5), Group III (n = 5) and Group IV (n = 4) received UG 0.15, 1.5 and 4.5 micrograms/kg/h i.v. via mini osmotic pumps. Seven days after patching, both epithelialization of the patched defect and neomucosal surface area were significantly increased by UG and the increases were dose-dependent. Contraction was not inhibited by the lowest dose of UG but was diminished by 1.5 micrograms/kg/h. Proliferative activity in both neomucosa and adjacent normal mucosa were increased in UG-treated animals with the greatest increase in rabbits receiving 1.5 and 4.5 micrograms/kg/h UG. The effect of UG on both epithelialization and contraction of patched intestinal defects is dose-dependent. Since the lowest dose of urogastrone increased epithelialization without increasing proliferative activity, stimulated cell migration appears to be the earliest effect of UG. PMID- 3265651 TI - Cloning and sequence analysis of an XbaI fragment of rainbow trout mitochondrial DNA. AB - A 2.4 kbp XbaI fragment of rainbow trout mitochondrial DNA was cloned into pTZ18R. DNA sequence analysis reveals that this segment of the genome encodes URF3, tRNA(Arg), URF4L and URF4 in the same orientation as other vertebrate mitochondrial genomes. Comparison of these segments of the rainbow trout mitochondrial genome with the corresponding sequences in human mitochondrial DNA shows that approximately 60% of the nucleotides are the same in both species. PMID- 3265652 TI - Human recombinant IL-4 suppresses the induction of human IL-2 induced lymphokine activated killer (LAK) activity. AB - The effect of recombinant human interleukin 4 (rhIL-4) on the induction in vitro of human lymphokine activated killer cell (LAK) activity was investigated. Peripheral blood mononuclear cells (PBMC) from normal healthy donors were incubated for 4 days with or without recombinant human interleukin-2 (rhIL-2) in the presence or absence of rhIL-4. LAK activity was measured against the NK resistant colon adenocarcinoma cell line SW742, and NK mediated cytotoxicity was determined using NK sensitive K562 cells. Unlike previous reports using mouse effector cells, rhIL-4 neither induced LAK activity nor augmented the cytotoxic response induced by rhIL-2. In four out of six experiments there was a significant reduction of rhIL-2 induced LAK in the presence of rhIL-4, accompanied by a reduction of Tac antigen expression by rhIL-2 activated cells. Recombinant hIL-4 failed to influence the effector phase of the activated PBMC against SW742 or K562 targets. PMID- 3265653 TI - Interleukin-3 and interleukin-4 each strongly inhibit the induction and function of human LAK cells. AB - We have examined some of the factors which may regulate the generation and function of human lymphokine-activated killer (LAK) cells. In particular we have studied the effect of cytokines other than interleukin-2 on the ability of human LAK cells to kill human tumour cells. By exposing human tumour cells to human LAK cells in the presence and absence of interleukin-3 or interleukin-4, we were able to demonstrate that each of these cytokines was able to severely reduce the amount of tumour cell killing. Additionally, we examined the effect of interleukin-3 or interleukin-4 on the production in vitro of human LAK cells by including these materials with interleukin-2 while LAK-cells were being induced. These results showed that not only were these cytokines able to inhibit human LAK cell function, but they were also able to strongly reduce the ability of interleukin-2 to generate human LAK-cells. PMID- 3265654 TI - Non-productive infection of human newborn blood mononuclear cells with herpes simplex virus: effect on T cell activation, IL-2 production and proliferation. AB - Proliferative responses by T cells from newborn cord blood stimulated with PHA or CD3 were reduced following infection with live (but not killed) herpes simplex virus in vitro although activation (measured by calcium flux) and IL-2 production were unaffected. The impairment of proliferation was not reversed by exogenous IL 2, phosphonoacetic acid, indomethacin or anti-alpha or anti-gamma interferon antibodies. HSV DNA was detected by hybridization in DNA extracted from unseparated MNC and from subsets sorted for CD3+ and for HLA DR+ expression. HSV DNA replication was not detected by thymidine uptake and only small amounts of virus were recovered in an infectious centre assay, suggesting that infection was non-permissive. Nevertheless, in-vitro synthesis of a limited range of HSV proteins including ICP4 was detected by metabolic labelling. PMID- 3265655 TI - Stimulation of mucosal T cells in situ with anti-CD3 antibody: location of the activated T cells and their distribution within the mucosal micro-environment. AB - Mucosal T cells in explants of human fetal small intestine (17-20 weeks gestation) in organ culture were activated in situ using monoclonal anti-CD3 antibody. Changes in the distribution of T cells within the mucosa, and their phenotype, were monitored by immunohistochemistry on frozen sections. Anti-CD3 stimulated T cells (as determined by expression of CD25) were predominantly in the lamina propria and were rarely seen in the epithelium. In control cultures, after 72 h, CD3+ IEL decreased to low numbers compared to day zero. However, in cultures treated with anti-CD3, IEL numbers were maintained and in some experiments significantly increased compared to day zero levels. At onset of culture 50-60% of CD3+ IEL were CD4-, 8-, and virtually all were HML-1+. The T cell infiltrate into the epithelium induced by activation of lamina propria T cells with anti-CD3 was also mostly CD3+, 4-, 8-, HML-1+. These experiments provide strong evidence that increases in IEL numbers can be a consequence of lamina propria T cell activation. PMID- 3265656 TI - The IgG antibody reactivity of sera from patients with active chronic hepatitis to a crude liver antigen and liver specific protein (LSP): analysis by ELISA and immunoblotting. AB - The antibody reactivity to liver specific protein (LSP) and a crude liver antigen of sera from patients with chronic active hepatitis (CAH) were studied along with other related diseases and healthy individuals. CAH sera containing liver reacting antibodies were selected using an ELISA with a crude liver preparation as antigen and subsequently the specificity was analysed by immunoblotting of SDS PAGE-separated LSP. The incidence of IgG antibodies to the crude liver antigen and LSP in sera from 15 patients with CAH was 94% and 55% respectively. In the healthy control group (n = 30) the corresponding figures were 3% and 17%. Sera from patients with other autoimmune conditions with considerable reactivity in the crude liver ELISA test were those with antibodies against extractable nuclear antigens (ENA) and thyroid gland antigens, while the anti-nuclear antibody (ANA) group as a whole did not differ from the control group. In immunoblotting of SDS PAGE-separated crude liver and LSP antigens, the IgG binding pattern of ELISA IgG positive CAH sera and sera from patients with thyroid disease was distinct, with bands corresponding to antigens of molecular weights of 38, 45 and 50 kD which were not observed in ELISA negative CAH sera or in sera from patients with other diseases and among healthy controls. PMID- 3265657 TI - Selective T cell subset depletion with anti-CD4 and anti-CD8 intact ricin immunotoxins. AB - In the present study we have comparatively analysed the specific activity of a panel of immunotoxins (ITs) prepared by coupling Ricin to several monoclonal antibodies (MoAbs) directed against the CD3, CD4 and CD8 T cell membrane molecules. Peripheral blood and bone marrow mononuclear cells (PBMC and BMMC) were incubated with the different ITs for 2 h, in the presence of 0.1 M lactose, washed and subsequently stimulated with either phytohemagglutinin (PHA) or an anti-CD3 MoAb. Our results indicate that the proliferative response of PBMC to both stimuli was specifically inhibited (greater than 95%) by either anti-CD3 IT or a combination of anti-CD4 and CD8 ITs, at concentrations comparable to those previously used for ex vivo T cell depletion (300 ng/ml). When used individually at the same dose, anti-CD8 and anti-CD4 ITs inhibited the PHA-induced PBMC proliferative response 40 and 70% respectively. When either anti-CD4 or anti-CD8 IT-treated cells were activated with PHA and cultured for 14 days in the presence of IL-2, less than 2% of the blasts expressed the corresponding antigens as assessed by flow cytometry analysis. Similar results were observed when BMMC were treated with the different ITs. In contrast, the growth of CFU-GM was minimally affected (0-25% inhibition). Our data indicate that ITs directed against T cell subsets are highly active and specific reagents that may be potentially useful for pre-transplant bone marrow purging. PMID- 3265659 TI - Synthesis of type II collagen is decreased in cartilage cultured with interleukin 1 while the rate of intracellular degradation remains unchanged. AB - The effect of interleukin 1 (IL1) on the synthesis and degradation of collagen was examined in explants of cultured cartilage. IL1 induced a reversible, dose dependent (10-100 pM) inhibition of type II collagen synthesis. The proportion of collagen produced decreased selectively from 7% to 1.2% of total protein after 72 h exposure to IL1 (100pM). There was no change in the rate of degradation of newly synthesized collagen. Analysis of newly synthesized material showed that the type II collagen synthesized in the presence of IL1 had the same characteristics as that extracted from unstimulated cartilage. The relative amounts of type II procollagen mRNA were estimated by Northern blot hybridization. The levels were decreased in cartilage cultured with IL1 to a similar extent as that seen for the type II collagen protein. Exposure to IL1 (10 350pM) for 3 days did not induce increased resorption of extracellular collagen in the cultured explants. These data demonstrate that decreased collagen production in cartilage exposed to IL1 is due primarily to decreased amounts of type II procollagen mRNA. PMID- 3265658 TI - Comparative use of cold blood potassium cardioplegia in coronary bypass patients necessitating long (2.5-6 h) versus short (less than 1.5 h) aortic cross-clamp times. AB - In symptomatic patients with severe diffuse multivessel coronary disease undergoing bypass surgery, complete revascularization with multiple bypass grafts using saphenous vein and internal mammary conduits, and multiple endarterectomies may be necessary. Such complex surgeries may require long aortic cross-clamp times in excess of 2.5 h. To evaluate the myocardial preservation provided by cold potassium blood cardioplegia, two groups of consecutive patients using nearly similar surgical techniques were compared. Group A consisted of 100 patients who received an average of 3.8 grafts per patient and had a mean aortic cross-clamp time of 66 (range 15-90) min. Group B was comprised of 100 patients who received an average of 9.3 grafts per patient and had a mean cross-clamp time of 187 (range 150-351) min. Operative mortality and perioperative myocardial infarction were low (0-2%) and were not significantly different between the groups. In addition, the postoperative creatine kinase-MB isoenzyme levels, use of pharmacologic and/or mechanical (i.e., intra-aortic balloon) support, and follow-up exercise treadmill tests were not significantly different in the two groups. These findings suggest that cold potassium blood cardioplegia is equally protective of the myocardium during surgical revascularization in patients with short aortic cross-clamp times (less than 1.5 h) as in those with severe diffuse multivessel coronary artery disease requiring long cross-clamp times exceeding 2.5 h and up to 6 h. PMID- 3265660 TI - Comparative studies of the haemagglutination of adult and umbilical cord erythrocytes by animal lectins. AB - 1. The sugar specificities of four lactose-binding lectins were studied through the agglutination of adult and/or umbilical cord human erythrocytes (AHRBC and/or CHRBC). 2. Rana catesbeiana egg lectin specifically agglutinated both intact blood group A-AHRBC and intact blood group A-CHRBC. 3. Rana catesbeiana liver lectin agglutinated intact A-AHRBC much more strongly than intact A-CHRBC. 4. Xenopus laevis skin lectin nonspecifically agglutinated AHRBC and CHRBC. 5. Plecoglossus altivelis egg lectin specifically agglutinated intact B-AHRBC, but weakly agglutinated intact B-CHRBC. 6. Comparative studies of lectin-induced AHRBC or CHRBC agglutination clarified the sugar-binding specificities of these lectins. PMID- 3265661 TI - Determination of hemoglobin expression patterns in erythroid cells of Rana catesbeiana tadpoles. AB - 1. Rana catesbeiana (bullfrog) tadpoles are heterogeneous in the relative amounts of four major tadpole hemoglobins (Hbs), as well as in the relative amounts of two tadpole red blood cell types in the peripheral blood. 2. Previous work has shown that this heterogeneity is present at all stages of larval development and growth. 3. Although some tadpoles lack one of the Hbs in their peripheral blood (i.e. the electrophoretically slowest form, Td-4), the missing Hb can be found in the erythropoietic organ from which it emanates (the kidneys), indicating that the heterogeneity results from quantitative differences in gene expression. 4. We wished to know whether this in vivo regulation is subject to external environmental perturbation and report that tadpoles of known Hb phenotypes regenerate precisely the pre-anemia Hb profile during early as well as late stages of recovery from phenylhydrazine-induced anemia. 5. These and other results indicate that the in vivo mechanism for regulating the pattern of Hb expression has become firmly determined in the erythropoietic system by the earliest larval stage of development. PMID- 3265662 TI - Influence of epidermal growth factor on growth of bovine mammary tissue in athymic nude mice. AB - Bovine mammary tissue obtained from midpregnant Holstein heifers by surgical biopsy was transplanted subcutaneously to ovariectomized athymic nude mice (n = 5 heifers). After 3 weeks recovery, mice were either sham operated or sialoadenectomized (submandibular salivary glands removed). After an additional week, mice were injected with saline or 17 beta-estradiol + progesterone (1 microgram + 1 mg/day) for 2 days. In addition, half of the sialoadenectomized mice were injected with epidermal growth factor (5 micrograms/day). Grafted tissue was removed and rate of deoxyribonucleic acid (DNA) synthesis estimated by incorporation of 3H thymidine. Estradiol + progesterone increased the incorporation of 3H thymidine from 77 +/- 20 dpm/micrograms DNA to 472 +/- 53 dpm/micrograms DNA. In sialoadenectomized mice, DNA synthesis was increased from 88 +/- 16 dpm/micrograms DNA (saline treated) to 360 +/- 29 dpm/micrograms DNA (estradiol + progesterone treated). In sialoadenectomized mice treated with epidermal growth factor, DNA synthesis in estradiol + progesterone treated mice was 529 +/- 36 dpm/micrograms DNA, compared to 112 +/- 30 dpm/micrograms DNA in sialoadenectomized mice treated with epidermal growth factor. These data indicate that sialoadenectomy of athymic nude mice decreased the ability of transplanted bovine mammary tissue to increase DNA synthesis in response to estradiol and progesterone. This inhibition was removed by epidermal growth factor treatment. These data suggest a physiological role of epidermal growth factor in regulating development and hormone responsiveness of bovine mammary tissue. PMID- 3265663 TI - Ocular leprosy in Kenya. PMID- 3265664 TI - Prevalence of migraine in Udo, a rural community in southern Nigeria. PMID- 3265665 TI - Dietary intakes and nutritional status of old people with dementia living at home in Oslo. AB - A nutritional study was carried out of 16 independent-living elderly (9 women, 7 men) suffering from dementia and a control group matched for sex and age. The study consisted of interview (with participants or relatives/home helps), a 3-d weighed dietary record and biochemical determinations of blood components. No significant difference in mean daily energy intake between demented elderly (women 7.2 +/- 2.0 MJ, men 8.6 +/- 1.2 MJ) and controls (women 6.9 +/- 0.7 MJ, men 9.4 +/- 2.0 MJ) was found. The women with dementia had lower dietary intakes of protein (P less than 0.05), thiamin (P less than 0.05) and vitamin C (P less than 0.01) than female controls. For both sexes in both groups the nutrients most lacking were vitamin D and thiamin. Dietary supplements were more frequently used among elderly with dementia (50 per cent) than among controls (13 per cent) (P less than 0.05). Except for vitamin D, supplements did not reduce the number of demented elderly with low intakes (less than two-thirds of the recommendations) because generally those in most need were non-users. The demented elderly had lower levels of haemoglobin and folic acid (blood and plasma) (P less than 0.05) but better thiamin status (alpha-transketolase) than controls (P less than 0.05). No difference in mean levels of protein, 25-hydroxyvitamin D, vitamin E, vitamin B12 in serum was found. Individuals with blood or serum levels of nutrients below reference values were more frequently found among the demented elderly than among controls. In the dementia group 2 individuals with low levels of 25 hydroxyvitamin D also had clinical evidence of osteomalacia. PMID- 3265667 TI - Bacteraemic Haemophilus influenzae pneumonia. AB - Bacteraemia with Haemophilus pneumonia is uncommon. To determine its incidence and features case notes of patients in whom Haemophilus spp. were isolated from blood and pleural fluid over a five-year period were reviewed. Eight adult patients with H. influenzae bacteraemia were identified, five of whom had pneumonia on clinical and radiographic criteria. Only one patient had a predisposing factor, chronic obstructive lung disease. Two patients had beta lactamase producing isolates, one of whom developed an empyema, following treatment with ampicillin, which required surgical drainage. Four patients were elderly, aged 69-80 yrs and were clinically in shock at the time of diagnosis. Seven of the eight patients survived. PMID- 3265666 TI - Control from the brainstem of synchrony of discharge between gamma motoneurones in the cat. AB - An assessment has been made of the effect of partial and complete section of the spinal cord on the discharges of gamma motoneurones to hind limb muscles in the decerebrated cat. The degree to which the discharges of pairs of individual gamma motoneurones exhibit short-term synchrony and the variability in interspike intervals of the discharge in individual neurones was measured. Variability of discharge was assessed as coefficient of variation of interspike intervals and degree of synchronization assessed from cross correlation analysis. The discharges of gamma motoneurones in the decerebrated cat with intact spinal cord are regular (low coefficient of variation) and show no tendency to synchrony for up to 24 h following decerebration. Section of the more medial part of the dorsolateral funiculus, on either side of the thoracic spinal cord, resulted in a less regular discharge and the development of short-term synchrony between gamma motoneurones. A dependence of synchrony on variability of discharge was established. The synchrony and increased variability in the spinal cat persisted for at least 24 h. Both were markedly reduced following administration of the precursors of monoamines (either L-Dopa or 5-HTP). We conclude that a bilateral, monoaminergic pathway descending in the dorsolateral funiculus from the brainstem controls synchrony of gamma motoneurone discharge in the decerebrated cat. The possibility is discussed that synchrony of discharge between alpha motoneurones may be controlled by a similar pathway. PMID- 3265668 TI - Phenotypes of peripheral blood lymphoid cells in patients with asbestos-related pleural lesions. AB - Asbestos-related parietal pleural plaques develop slowly and are of little clinical significance. Other asbestos-related pleural reactions, for example acute exudative pleurisy and progressive pleural fibrosis, are of clinical importance. The pathogenesis of these reactions is unknown, but one hypothesis is that immunological disturbances are involved. To investigate this hypothesis a phenotypic characterization of lymphoid cells was performed in the peripheral blood of 45 patients with asbestos-related pleural lesions; 20 with pleural plaques (PP), 15 with diffuse pleural fibrosis (DPF), and 10 with benign asbestos pleural effusion (BAPE). Twenty-four healthy blood donors were used as controls. All asbestos groups together had a significantly higher percentage of B-cells than the controls. The percentage number of "helper/inducer" T-cells was significantly lower in the BAPE and DPF groups than in the control and PP groups. Thus, significant aberrations in peripheral blood lymphoid cells were found in patients with DPF and BAPE. This differed from patients with PP only who were similar to normals. PMID- 3265669 TI - [Comparison of the binding nature of mibolerone to androgen receptor of human prostate with that of R1881]. AB - The authors examined the binding nature of mibolerone in cytosols of hypertrophic prostates from 15 patients to androgen receptor using Dextran-charcoal assay, analyzed it by the method of Scatchard, and compared it with that of R1881. The addition of triamcinolone acetonide into the incubation medium induced specific single binding of mibolerone to androgen receptor with high affinity as well as R1881. The receptor contents obtained with mibolerone were higher than those of R1881, and both of them correlated well. The dissociation constants of both ligands showed good correlation and no significant differences. Mibolerone seems to be as suitable a ligand as R1881 for measuring the androgen receptor. PMID- 3265670 TI - Evolution of DNA sequence specificity in type I restriction enzymes. PMID- 3265671 TI - The three-dimensional structure of interleukin-1 beta. AB - The three-dimensional structure of human recombinant interleukin-1 beta has been determined at 0.24 nm resolution by X-ray crystallographic techniques. The partially refined model has a crystallographic R-factor of just under 19%. The structure is composed of 12 beta-strands forming a complex network of hydrogen bonds. The core of the structure can best be described as a tetrahedron whose edges are each formed by two antiparallel beta-strands. The interior of this structure is filled with hydrophobic side-chains. There is a 3-fold repeat in the folding of the polypeptide chain. Although this folding pattern suggests gene triplication, no significant internal sequence homology between topologically corresponding residues exists. The folding topology of interleukin-1 beta is very similar to that described by A. D. McLachlan [(1979) J. Mol. Biol. 133, 557-563] for soybean trypsin inhibitor. PMID- 3265672 TI - Preparation of monoiodinated interleukin-1 beta and its use in a radioimmunoassay. AB - Polyclonal anti-interleukin-1 beta (IL-1 beta) sera raised in sheep and in rabbits bound to unlabelled IL-1 beta. IL-1 beta radioiodinated using chloramine T or Bolton-Hunter procedures was bound by the anti-IL-1 beta sera but was not displaced by unlabelled IL-1 beta suggesting that IL-1 beta was damaged during iodination procedures, resulting in alterations to the immunological properties of the tracer. Iodination using the mild oxidant N-bromosuccinimide, followed by extensive tracer purification to remove the unlabelled IL-1 beta, produced a tracer with a specific activity of 89 microCi/micrograms (0.83 atoms iodine/molecule IL-1) which was fully displaced by unlabelled IL-1 beta, allowing the development of a sensitive and specific radioimmunoassay for IL-1 beta. The radioimmunoassay has been used to quantify intracellular IL-1 beta and IL-1 beta release by peripheral blood monocytes stimulated with endotoxin. PMID- 3265673 TI - Studies on interleukin-1-induced arthritis. AB - IL-1 induces PMN and monocyte infiltration when injected into rabbit knee joints (1). This transient synovitis is associated with depletion of proteoglycan from the articular cartilage matrix. However, it is not clear whether the cartilage proteoglycan depletion is dependent on the infiltrating leucocytes. Consequently, we have investigated the effect of intra-articular injection of interleukin-1 in rabbits depleted of circulating PMN and monocytes with nitrogen mustard. PMID- 3265674 TI - Assay of pyrogenic contamination in pharmaceuticals by cytokine release from monocytes. AB - In 1984 it was reported that a batch of human recombinant growth hormone which had passed the rabbit pyrogen test and a Limulus amoebocyte lysate (LAL) test was pyrogenic in man (1). Further, it was shown that the growth hormone caused human monocytes to release leukocyte pyrogen which evoked fevers in rabbits (1). Leukocyte pyrogen is believed to comprise of a mixture of (at least) 2 lymphokines with potent pyrogenic and inflammatory activities, interleukin-1 (IL 1) and Tumour Necrosis Factor (TNF), which are synthesized and released by activated peripheral blood monocytes. The development at NIBSC of sensitive and specific bioassays and immunoassays of IL-1 (2) and TNF (3) have permitted a new type of pyrogen test based on the in vitro release by human monocytes of the lymphokines IL-1 and TNF. Studies are underway to evaluate the suitability of monocytic cell lines, rather than human monocytes, since these require a time consuming and labour intensive preparation. Investigations are in progress to evaluate the suitability of the above "monocyte test" for pyrogen to replace or complement the rabbit pyrogen test which is routinely applied to biological medicines. The new method has already proved useful in detecting pyrogenic contamination of a large volume parenteral medicinal product which passed the rabbit pyrogen test but caused adverse reactions in patients. PMID- 3265675 TI - The involvement of tumor necrosis factor-alpha (TNF-alpha) in immunomodulation and in septic shock. PMID- 3265677 TI - Induction of hybridoma growth factor (HGF), identical to IL-6, in human fibroblasts by IL-1: use of HGF activity in specific and sensitive biological assays for IL-1 and IL-6. AB - Human hybridoma growth factor (HGF) has been purified to homogeneity and identified with the 26kDa protein, interferon-beta 2 (IFN-beta 2), B-cell stimulatory factor-2 (BSF-2) and hepatocyte stimulatory factor (HSF). This factor, renamed interleukin-6 (IL-6), can be induced in fibroblasts by IL-1, while other cytokines are less active or inactive as inducers. The possible use of this IL-6 induction as an alternative indirect assay system for IL-1 is considered. Also, the direct HGF activity as a test IL-6 has been compared with the other biological activities of IL-6. It was concluded that the HGF assay is the most sensitive, specific and convenient test for IL-6. PMID- 3265676 TI - Interleukin-5: an eosinophil growth and activation factor. AB - A mouse lymphokine stimulating eosinophil differentiation has been identified and characterized. This factor was found to be identical to B cell growth factor II, and is now called interleukin-5 (IL5). Although this murine factor stimulated human eosinophil differentiation and activation, it had no detectable activity on human B cells. Following the cloning of the mouse factor, the human gene was cloned and expressed. Like the mouse factor human IL5 stimulates the production and activation of human eosinophils. However, unlike mouse IL5 which has a readily detectable activity on murine B cells, the human factor was negative when tested in a variety of assays on human B cells. PMID- 3265678 TI - B-cell growth and differentiation factors. AB - The number of recombinant factors which have been shown to regulate B cell activation, proliferation, and differentiation now stands at nine (IL-1, IL-2, IL 4, IL-5, IL-6 (BSF-2), BCGFLOW, IFN-alpha and gamma, and TNF). Several others have been described but are not yet fully characterized or available as recombinant gene products and will not be discussed. Recent work with these factors, especially IL-4, has revealed a remarkable diversity of function. Most of them seem able to act at more than one stage of B cell activation, proliferation and differentiation, thus invalidating the concept of a single unique factor controlling each discrete step of normal B cell responses. In addition, these factors are not B cell specific, but have a wide range of cell types as targets. The functional diversity of these factors has important implications for their potential as therapeutic agents, and for the design of standardization protocols. PMID- 3265679 TI - Molecular biology of T cell-derived lymphokines: structure and biology of interleukin 4. PMID- 3265680 TI - Responses of human B-cells to recombinant lymphokines. AB - The effects of recombinant or purified cytokines on the growth and differentiation of human B-cells from a variety of sources were evaluated. The results suggest that IL-1, BCGF and BSF-2 have either "growth-factor" or "differentiation-factor" activity and that only IL-2 has both these functions. In addition, evidence is presented that the two forms of human IL-1 affect B-cell growth differently. Finally, the separation of human normal and leukaemic B-cells into subsets defined by their buoyant cell density, is described. PMID- 3265681 TI - BCGFLMW-sensitivity of human B-cell lines in the MTT-cleavage assay. PMID- 3265682 TI - Establishment of dye-uptake method (A375 assay) for quantitative measurement of IL-1: correlation with LAF assay. AB - The dye-uptake method (A375 assay) for quantitative measurement of biological activity or recombinant human interleukin-1 (IL-1) was established based on the cytostatic activity of IL-1 on human melanoma A375 cells. Although various factors, e.g., incubation temperature, inoculum cell size and cell growth phase, were found to influence the titration to some degree, the assay-to-assay fluctuation in the observed titers determined by this method could be made minimum after normalization with the observed titer of a standard IL-1. A good correlation was observed between A375 and LAF assays. Thus, A375 assay was shown to be a stable and reliable method and could be replaced with LAF assay for quantitative measurement of recombinant human IL-1. PMID- 3265683 TI - Geographic and temporal variations of sugar and margarine consumption in relation to Crohn's disease. AB - Patients with Crohn's disease show an increased consumption of refined sugar compared to controls. It was speculated that the frequent occurrence of Crohn's disease in developed countries might be related to a high intake of refined sugar. In contrast, others suggested margarine consumption to play a role in the etiology of Crohn's disease, the hypothesis being based on the seemingly simultaneous onset of margarine consumption and the first reports of granulomatous ileitis and the similarities in their geographic distribution. Both hypotheses, however, have not been subjected to a rigorous epidemiologic analysis. In the present study, the per capita consumption of refined sugar and margarine were correlated with the incidence and mortality of Crohn's disease from different countries. The time trends of mortality from Crohn's disease were compared to those of sugar and margarine intake. Two weak correlations were found between the geographic distribution of sugar and margarine consumption and mortality from Crohn's disease, the correlations resulting from the difference between two types of countries. Compared to Canada, the United States and most countries from Northern Europe on one side, Japan and most Mediterranean countries on the other side were characterized by low consumption of the two nutrients as well as low mortality from Crohn's disease. No consistent pattern was found, however, within each group of countries. No significant correlation was found between sugar or margarine consumption and the incidence of Crohn's disease. The time trends of Crohn's disease in different countries were not matched by similar time trends of either sugar or margarine consumption. The different epidemiologic behavior of the two nutrients and Crohn's disease indicates that variations in their dietary intake were not responsible for the geographic and temporal patterns of Crohn's disease. Other factors must be sought to explain the characteristic epidemiology of Crohn's disease. PMID- 3265684 TI - Excess morbidity from prostate cancer in a small community: a study in general practice. AB - This study was an attempt to account for the excess morbidity from prostate cancer found in a small rural community. Information about the men concerned was gathered by examining the medical records at the local hospital and at the municipal health centres. It was found that the excess morbidity was greatest in the youngest age groups among the older men and that one particular parish and several trades appeared to be more affected by prostate cancer than had been expected. PMID- 3265685 TI - Management of streptococcal pharyngitis: the conundrum of acute rheumatic fever. AB - The incidence of acute rheumatic fever in the residents of three counties in Ontario (population 507,300) from 1975 to 1986 inclusive was 0.17 hospitalized cases per 100,000 population (0.4 per 100,000 for 5- to 19-year-olds). Indigent patients (0.6 per 100,000) and North American Indians (2 per 100,000) had substantially higher rates. This experience is in marked contrast to recent outbreaks of acute rheumatic fever in areas of the United States, but is similar to experience in the United Kingdom. The implications of this data on the current management of the streptococcal sore throat is reviewed, showing the complexities of real-life prevention of acute rheumatic fever. PMID- 3265686 TI - A simple method for locating methylated bases in DNA, as applied to detect asymmetric methylation by M.FokIA. AB - Class-IIS restriction enzymes, which cut the DNA outside their recognition sequence, could be used for locating the bases methylated by a DNA-modification methylase. This is possible because methylation of the class-IIS cut sites does not interfere with the cleavage. The method consists of (i) selection of a nucleotide sequence with appropriate overlap between the methylase recognition site and the class-IIS enzyme cut site, (ii) methylation using S adenosylmethionine as [3H]methyl donor, (iii) cleavage of the methylated sequence with the class-IIS enzyme, (iv) separation of the cleavage products and identification of the 3H-labelled fragment. Using this simple and straightforward method, we have shown that M.FokIA is an adenine methylase and methylates asymmetrically one strand of the FokI recognition site, resulting in the (Formula: see text) sequence. In addition, it was observed that another class-IIS restriction enzyme, SfaNI, is completely inhibited by methylation of its recognition site, (Formula: see text), by M.FokIA. PMID- 3265687 TI - Nucleotide sequence of the gene coding for ovine corticotropin-releasing factor and regulation of its mRNA levels by glucocorticoids. AB - The ovine gene CRF, coding for corticotropin-releasing factor, has been isolated and the nucleotide sequence determined. The degree of nucleotide sequence homology between the ovine and human CRF genes is unusual, in that the 5' flanking regions are more highly conserved than the protein-coding regions. This striking degree of homology would indicate that a strong selective pressure is being exerted over an extensive area of the 5' flanking region, which could include transcriptional control elements. The 5' flanking region of the ovine CRF gene contains five elements which share homology with the glucocorticoid receptor DNA binding sequence. Also Northern blot analysis indicates that hypothalamic CRF mRNA levels are negatively regulated by glucocorticoids. Dexamethasone treatment halves the CRF mRNA content of the hypothalamus, whereas adrenalectomy causes a three- to four-fold increase in CRF mRNA levels. PMID- 3265689 TI - [The incidence of heterophorias]. PMID- 3265690 TI - [Congenital disorders of color perception are revealed in pattern electroretinography]. PMID- 3265688 TI - Molecular cloning of a cDNA for human pregnancy-specific beta 1 glycoprotein:homology with human carcinoembryonic antigen and related proteins. AB - Human pregnancy-specific beta 1-glycoprotein (SP1) plays an essential role in normal pregnancy. It is also a well-characterized oncodevelopmental antigen, expressed aberrantly by all trophoblastic tumors and some other malignant cell types. Here we report the identification of a human placental cDNA encoding the SP1 polypeptide sequence. The coding sequence shows 95% identity at the nucleotide level with a distinct, recently published SP1 cDNA sequence (PSG16). Unexpectedly, the sequence is also highly homologous to the published sequence of human carcinoembryonic antigen (CEA). SP1, CEA and CEA-related nonspecific cross reacting species thus belong to a group of closely related though antigenically diverse tumor-associated glycoproteins. Comparison of the deduced amino acid sequence of the SP1 cDNA with that of CEA provides insight into the modular nature of these related proteins. This may have implications for the genomic organization and evolution of the CEA gene family. PMID- 3265691 TI - [Visual assessment in reduced background illumination and glare]. PMID- 3265692 TI - The adjuvanticity of gamma inulin. AB - Gamma-inulin (g-IN) is a polymorph identified as the active component of inulin preparations that specifically activates the alternative pathway of complement (APC). The APC is central to many leucocyte functions, including B cell activation. We show here that g-IN, when formulated as a pure, endotoxin-free, fine suspension insoluble at 37 degrees C and given at 50-100 micrograms per mouse, is a potent adjuvant for both humoral and cell-mediated responses to a variety of antigens. g-IN increased secondary IgG responses five- to 28-fold (P less than 0.001), using as antigen phosphorylcholine coupled to keyhole limpet haemocyanin; subclasses IgG 2a, 2b, and 3 were boosted several hundred-fold, IgG 1 10-fold. IgM and IgA were increased four- to six-fold. Delayed hypersensitivity, by footpad swelling after secondary challenge with sheep red blood cells (SRBC), was increased more than two-fold (P less than 0.001) if g-IN was included with the primary SRBC, equivalent to increasing primary doses 10 fold. g-IN was equally active if given 5 days before the primary SRBC. Thus it is an immune stimulant rather than a depot or vehicle for antigen. Mice primed subcutaneously with 30-300 HA units of H2N2 influenza virus (strain A/JAP) and challenged intranasally with a lethal dose of H1N1 virus (strain A/WSN) all died, but if g-IN was given with the primary antigen 50% of the mice survived (P less than 0.001), a deduced but not proven boost to cytotoxic T cell-mediated immunity. Unpublished work has shown that g-IN has no adverse effects at adjuvant active doses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265693 TI - In vivo studies of whole ricin monoclonal antibody immunoconjugates for the treatment of murine tumours. AB - Ricin is a highly potent toxin which binds to cells via galactose binding sites on the B chain; the toxicity is manifest by the A chain and most studies with immunotoxins have used ricin A chain-antibody conjugates. We have previously described a method for the coupling of whole ricin to monoclonal antibody (MoAb) so that the galactose binding sites on the B chain are blocked; these conjugates are not non-specifically toxic. Whole ricin-MoAb conjugates were examined in vivo for their stability, clearance rates and toxicity, and these were compared with modified ricin-MoAb conjugates produced by periodate treatment of ricin. First, the biological half-life of whole ricin or modified ricin was determined and indicated that while ricin was rapidly cleared from the circulation (t 1/2 = 4.5 +/- 0.5 min) compared with modified ricin (t 1/2 = 17 +/- 1 min), covalent linkage of native ricin to MoAb increased the blood circulation time of the toxin (t 1/2 = 22 +/- 1 min). Immunotoxins synthesized with the Ly-2.1 MoAb using native or modified (deglycosylated) ricin were compared in vivo. In two different models anti-Ly-2.1 immunotoxins could be shown to be effective in vivo: (i) intraperitoneal tumours, thymomas grown in the peritoneal cavity could be completely eradicated by ricin-MoAb; (ii) subcutaneous tumours, mice with tumours approximately 0.75 cm in diameter received intravenous doses of the whole ricin MoAb and a substantial reduction in tumour size was achieved. Thus whole ricin antibody conjugates made with the galactose binding site blocked combine the advantage of high potency with high specificity (which was previously lacking in intact ricin conjugates) and can be successfully used in vivo to treat tumours. PMID- 3265694 TI - Host cellular response in bancroftian filariasis. PMID- 3265695 TI - Incidence of antibodies to nuclear antigens, platelets & circulating immune complexes in leukaemias. PMID- 3265696 TI - Accidental poisoning. PMID- 3265697 TI - Ambulatory computer system for recording and controlling locomotion. AB - Description of an original miniature computer system capable of recording biomechanical parameters during locomotion, providing auditory signals which can be used in biofeedback locomotor learning, and triggering functional electrical stimulation of nerves and muscles at preselected moments in the locomotor cycle. The system, which is worn on the patient's back, is connected to appropriate gauges with which it is possible to measure knee angle and to record the time of heel contact with the ground. The relevant data are stored in the system memory and can be transferred to a microcassette and later displayed as a function of time on a video screen or printed on paper. The same data can be used on-line to provide a patient with a sound signal as a basis for biofeedback training. This kind of training has been successfully used to correct knee hyperextension during locomotion in hemiplegic patients. The system can also be used to trigger a stimulator and thus constitutes a valuable tool for investigations and treatments involving functional electrical stimulation. Many other applications may be developed, both in basic research and in various fields where motor training is required. PMID- 3265698 TI - Rehabilitation treatment for vertigo. AB - Vestibular Habituation Training (VHT), an exercise treatment for vertigo, has become an accepted therapeutic approach. However, a good insight into the basic mechanisms as well as into the indications is required in order to treat it correctly. Only vertigo of the provoked type and produced by a stable peripheral vestibular dysfunctional state can be influenced. The basic mechanism of VHT is the stimulation of the development of adaptation by a repeatedly eliciting positional vertigo. In this way, exercises are selected individually and have to elicit vertigo. The procedure for selection of exercises is described. The results obtained by this treatment show a net favourable effect. It develops progressively, as might be expected from the assumed action of habituation. Typical vertigo is more easily influenced than atypical forms, and fewer cases with unilateral canal deficiency have a complete result. PMID- 3265699 TI - Smoking-adjusted incidence of lung cancer among Swedish men in different occupations. AB - The Swedish Cancer-Environment Register was used to study the relation between occupation and lung cancer risk during the period 1961-79 in 1.6 million men aged 30-64 years in 1960. By adding information concerning smoking habits from a sample of 1% of the Swedish population, smoking-adjusted standardized incidence ratios (SIR) were estimated for different occupational categories according to the population census of 1960. Smoking-adjusted excess risks (p less than 0.01) were found in assemblers and machine erectors, drivers, miners, packers and longshoremen as well as in sheetmetal workers. Significantly fewer lung cancer cases than expected were seen in artists and writers, chemical and cellulose workers, farmers, farm workers, forestry workers, public administrators and in teachers. As a result of a high prevalence of smoking, the smoking-adjusted SIR was markedly lower than the unadjusted SIR in artists and writers, drivers, mechanics and repairmen, members of the armed forces and painters. The opposite situation was seen for clergy, farmers and forestry workers. PMID- 3265700 TI - Village and household clustering of xerophthalmia and trachoma. AB - The clustering of xerophthalmia in villages and in households was assessed among preschool children surveyed in the Lower Shire Valley, Malawi, and in Aceh province, Indonesia. Trachoma clustering was similarly assessed among the same children in Malawi. Trachoma clustered much more than xerophthalmia among villages and among households. The impact of xerophthalmia clustering on sample size considerations for future surveys or interventions was similar in Malawi and Indonesia. Village clustering of xerophthalmia would necessitate a twofold increase in sample size. Household clustering in the absence of village clustering would have almost no impact on sample size. Village clustering of trachoma would necessitate a ninefold increase in sample size. Household clustering would increase sample size requirements by 26%. PMID- 3265701 TI - A variation on single-stage cluster sampling used in a survey of elderly people in Shanghai. PMID- 3265702 TI - Human amnion membrane as a model for studying the host-parasite relationship in trichomoniasis. PMID- 3265703 TI - A demographic analysis of 252 patients with anorexia nervosa and bulimia. PMID- 3265704 TI - Silybin inhibition of human T-lymphocyte activation. AB - Silybin, a 3-oxyflavone occurring in the thistle Silybum marianum, displays a dose-dependent inhibition of in-vitro lymphocyte blastogenesis induced by lectins (phytohaemagglutinin, Concanavalin A and pokeweed) and by anti-CD3 monoclonal antibody. The drug has no effect on cell viability and spontaneous 3H-thymidine incorporation, suggesting that the inhibitory activity is not due to aspecific toxicity. Since all the T-cell responses investigated require cell-membrane associated events, the effect of silybin is probably at the level of the cell membrane, as for other flavonoids. Addition of CuSO4 prevents the inhibitory activity of silybin on PHA-induced proliferative response, indicating that the drug could exert its activity also by virtue of a chelation mechanism. PMID- 3265705 TI - Cell surface biochemical and metastatic properties of Lens culinaris hemagglutinin-binding variants of a murine large cell lymphoma. AB - Using a low metastatic potential parental (P) line of the murine large cell lymphoma RAW117 and a highly metastatic in vivo-selected liver-colonizing subline (H10), we examined the relationship between cell surface glycoprotein expression and metastasis. The highly metastatic H10 cells showed loss of the major RNA tumor virus envelope glycoprotein gp70 and increased expression of a concanavalin A and Lens culinaris hemagglutinin (LcH)-binding glycoprotein of Mr approximately 15,000 (gp150) by lectin affinity chromatography and 125I-lectin staining of isolated RAW117 glycoproteins. When the amounts of cell surface LcH-binding components were determined on P and H10 cells, the mean amount of cell-bound LcH on H10 cells was significantly greater than on P cells. RAW117-P cells were sorted for low (PLcH-low) or high (PLcH-high) LcH binding using a fluorescence activated cell sorter, or for binding to immobilized LcH, and the resulting cell sublines were analyzed for their metastatic properties by intravenous injection into BALB/c mice. The parental P cells formed few liver tumor nodules (median 0; range 0-8), as did the PLcH-low cells (median 0; range 0), whereas the high LcH adherent P cells and the cells sorted for increased LcH binding, PLcH-high, were highly metastatic to the liver (median 200; range 156 to 200+). Analyses of gp150 and gp70 contents indicated higher amounts of gp150 but lower quantities of gp70 on PLcH-high cells than on PLcH-low or P cells. The results suggest that the amounts of cell surface gp150 and gp70 are important in determining the metastatic properties of RAW117 cells. PMID- 3265706 TI - Prevalence of parathyroid insufficiency after thyroidectomy: study of 1037 cases. AB - In 1037 patients undergoing total (827 cases) or partial thyroidectomy (52 cases of subtotal thyroidectomy, 108 of hemithyroidectomy, 50 of enucleation and resection) for each study group the incidence of hypoparathyroidism, its possible causes and technical factors favouring the onset, were examined. In this series postoperative prevalence of hypoparathyroidism was 16.6%. It seems to be directly proportional to the extent of surgery thus confirming the necessity to locate and preserve the parathyroid glands during surgery. This should be as conservative as possible according to the prognosis of the thyroid disease. PMID- 3265707 TI - Sex hormones, CD5+ (Lyl+) B-cells, and autoimmune diseases. PMID- 3265708 TI - Modified general affinity adsorbent for large-scale purification of penicillinases. AB - N-Acetyl-D-(-)-penicillamine as a stable second-generation biospecific affinity ligand has previously been suggested for purification of Bacillus cereus 569/H beta-lactamase I. A complex spacer arm is coupled with the matrix by using epichlorohydrin and phloroglucinol doubly activated with divinyl sulphone in the meta position. Coupling of D-(-)-penicillamine ligand resulted in an active affigel. However, we found that two affinity ligands in close proximity prevents simultaneous binding of two penicillinase molecules, therefore one ligand is superfluous. Our results show that: (1) shortening the spacer arm by direct activation of the matrix with divinyl sulphone is satisfactory to produce the affinity material with N-acetyl-D-(-)-penicillamine; (2) incorporation of 15 mumol of N-acetyl-D-(-)-penicillamine per ml of wet Sepharose 4B satisfies the maximum binding capacity requirements of the affigel (about half of the originally incorporated amount of ligand); (3) our simplified affinity adsorbent is generally applicable for large-scale purification of penicillinases to homogeneity from various bacterial sources by the convenient batch method without prior concentration of these enzymes; (4) reacetylation for four/five times can regenerate the original binding capacity of the affigel. PMID- 3265709 TI - Cerebral metabolic effects of a verbal fluency test: a PET scan study. AB - Sixteen normal volunteers were studied with [F-18] fluorodeoxyglucose and positron emission tomography scans during behavioral activation with a verbal fluency test, and 35 age-matched controls were studied with resting-state scans. There was an overall increase of the cerebral glucose metabolic rate of 23.3% during verbal fluency activation, compared to the resting state, with the greatest activation in bilateral temporal and frontal lobes. A negative correlation between test performance scores and indices of metabolism was found in frontal, temporal, and parietal regions. Damage to the left frontal lobe maximally affects scores on verbal fluency tests, but performing the test activates a network of regions, of which the left frontal lobe is only one. Proficient performance in verbal fluency seems to require less metabolic activation than poor performance, perhaps because of the efficiency of cognitive strategies employed. PMID- 3265710 TI - Longitudinal study of the early neuropsychological and cerebral metabolic changes in dementia of the Alzheimer type. AB - To examine the progression of neuropsychologic and metabolic changes in the early stages of dementia of the Alzheimer type (DAT), we studied 11 midly demented patients longitudinally. Three aspects of neuropsychological function were measured: memory, attention to complex sets and abstract reasoning, and lateralized functions, i.e., language and visuoconstruction. Regional cerebral metabolic rates for glucose were measured in frontal, parietal, and temporal association cortices. Our results show that, in general, memory deficits are the first neuropsychological impairments to occur in DAT, followed by problems with attention to complex cognitive sets and abstract reasoning, which are followed in turn by deficits in language and visuospatial abilities. In addition, neocortical metabolic abnormalities usually precede impairment of neocortically mediated attention and abstract reasoning by 8 to 16 months, and precede impairment of neocortically mediated language and visuospatial function by 12 to 37 months. These findings suggest that the first nonmnestic neuropsychological consequence of neocortical physiological dysfunction in DAT is a loss of attentional capacity. Since neocortical metabolic changes generally precede the appearance of neocortically mediated neuropsychological dysfunction, physiologic dysfunction may exist for some time before cognition is affected. PMID- 3265711 TI - Masking patterns in the bullfrog (Rana catesbeiana). II: Physiological effects. AB - Responses of individual eighth-nerve fibers in the bullfrog (Rana catesbeiana) were measured to tone bursts at best frequency against a background of continuous, broadband masking noise. These data were used to calculate critical masking ratios to describe the fibers' responses to tones embedded in noise. In the frequency response range of the amphibian papilla (100-1000 Hz), critical ratios increase with tone frequency. Critical ratios of basilar papilla fibers (1000-2000 Hz) are generally higher than those of amphibian papilla fibers. Critical ratios are also significantly related to fiber threshold such that fibers with high thresholds, regardless of their best frequencies, have higher critical ratios and are thus less selective to signals embedded in noise. Critical ratios based on neural responses show a somewhat different frequency dependent trend than do critical ratios based on psychophysical data presented previously for this species [A. M. Simmons, J. Acoust. Soc. Am. 83, 1087-1092 (1988a)]. In addition, these neural critical ratios do not appear to be level independent, as are psychophysical critical ratios. The data suggest that frequency selectivity of hearing in the bullfrog as measured behaviorally is probably not mediated solely by spectral filtering in the auditory periphery. PMID- 3265712 TI - Studies on the goiter endemia in Sicily. PMID- 3265714 TI - Augmentative effect of lentinan on immune responses of pelvic lymph node lymphocytes in patients with uterine cervical cancer. PMID- 3265713 TI - Influence of bone marrow-derived Ia-bearing cells on the selection of the T-cell repertoire. AB - We have presented the results of studies using chimeric animals to examine the role of distinct cell subsets in shaping the TCR repertoire. Examination of specificity and TCR expression in antigen-specific long-term T-cell lines derived from these chimeras suggests that bone marrow-derived APC play a role in the selection of T cells for MHC restriction during development, and also profoundly influence the expansion of the TCR repertoire following antigen priming. An understanding of the molecular mechanisms that govern TCR repertoire maturation may await the development of effective in vitro model systems of T-cell differentiation. PMID- 3265715 TI - Oesophageal carcinoma: endoscopic and clinical findings in 258 patients. AB - During the 10-year period 1971-1980, oesophagoscopy was carried out on a total of 3235 patients in the Department of Otolaryngology, Turku University Central Hospital, Finland. Oesophageal carcinoma was diagnosed in 258 patients, 113 (44 per cent) men and 145 (56 per cent) women. The diagnosis was verified in 228 cases (88.4 per cent) by using an optical rigid oesophagoscope and in 30 cases (11.6 per cent) by a fibreoptic endoscope. The most common and earliest symptom was difficulty in swallowing in 50 per cent of cases. In 44 per cent of patients the symptoms persisted over six months before diagnosis. Upper and middle thoracic portions of the oesophagus were the sites of origin of the carcinoma in 57 per cent of the patients. The macroscopic picture obtained by oesophagoscopy was regarded as malignant in 83 per cent of patients and extraoesophageal spread of the tumour was estimated to be present in 48 per cent of patients by the time of diagnosis. Histological studies showed the tumour to be squamous cell carcinoma in 62 per cent of patients and in 24 per cent well differentiated. Squamous cell carcinoma was seen more often in men than in women. In patients with carcinoma in situ, alcohol and tobacco were regarded as aetiological factors in 53 per cent of cases. The need for repeated oesophagoscopy in patients with symptoms related to swallowing is stressed. PMID- 3265716 TI - Incidence and survival rates for cancer in Atlanta, 1975-1985. PMID- 3265717 TI - Disease patterns in experimental allergic neuritis (EAN) in the Lewis rat. Is EAN a good model for the Guillain-Barre syndrome? AB - Lewis rats develop experimental allergic neuritis (EAN) when injected with bovine dorsal root (BDR) emulsified in complete Freund's adjuvant (CFA). In this study the susceptibility to EAN and subsequent relapse was studied in animals ranging from 4 to 25 weeks of age. Older animals exhibited a severe acute illness which was monophasic over the period of observation, whereas younger animals developed a less severe and frequently relapsing illness. Very young animals often relapsed more than once and sometimes to a more severe degree than shown in their first attack. Older animals which were in the late recovery stage of EAN (44 days after injection with BDR/CFA) were completely resistant to a second challenge with antigen. Young adult animals also developed resistance but not as strongly as the older animals. Animals first injected at weaning developed resistance as in the adults, but the analysis is complicated by the occurrence of spontaneous relapses. Because of differences in disease pattern between EAN and acute inflammatory polyneuropathy (Guillain-Barre syndrome) in man, caution should be exercised in drawing too close a parallel between the animal model and the human disease. The affinities may be closer to chronic relapsing inflammatory polyradiculopathy in man. PMID- 3265718 TI - Vasoactive intestinal polypeptide inhibits the expression of the MHC class II antigens on astrocytes. AB - The brain has been traditionally viewed as an immunologically privileged site. However, recent findings suggest that the brain is in fact equipped with its own immune circuitry. Astrocytes and microglia have been considered the most likely candidates to assume the role of intracerebral antigen presenting cells (APC). Using the techniques of immunofluorescence cytochemistry and flow cytometric analysis, we observed that vasoactive intestinal polypeptide (VIP) can significantly inhibit gamma-interferon (IFN-gamma)-induced Ia expression on astrocytes derived from newborn Lewis rats. Further, we analyzed a number of neuropeptides and transmitters for their ability to exert a similar inhibitory modulation on IFN-gamma induced Ia expression or for the ability to induce or augment Ia expression on rat astrocytes. Our results showed that only norepinephrine (NE), a major brain neurotransmitter, and VIP, a ubiquitous brain peptide, have the ability to inhibit Ia expression on Lewis rat astrocyte cultures. Alternately, we report that cholecystokinin (CCK), a brain/gut peptide, has the ability to induce Ia on about 5-10% of the cells analyzed. These findings suggest that endogenous brain substances have the ability to modulate intracerebral immune responses by regulating the expression of Ia on astrocytes. PMID- 3265719 TI - The effects of type beta transforming growth factor on proliferation and epidermal growth factor receptor expression in a human glioblastoma cell line. AB - Type beta transforming growth factor (B-TGF) is a potent growth inhibitor to many human tumor cell lines. Very little is known about the mechanism for this growth inhibitory action of B-TGF. We here report the effect of B-TGF on proliferation and epidermal growth factor receptor (R-EGF) expression in a human glioblastoma cell line named T-MG1. B-TGF inhibit the soft agar growth of T-MG1 cells. Maximum inhibition was 70%, achieved with 0.5 units B-TGF. B-TGF had no effect on monolayer growth of T-MG1 cells. T-MG1 cells contained abundant R-EGF, which could be divided into two subpopulations, one high affinity and one low affinity population of R-EGF. Treatment with B-TGF caused an initial decrease (0-6 h) in EGF-binding, followed by an increase in EGF-binding which reached maximum after 24 h exposure to B-TGF. Since addition of EGF to agar cultures gave no additional increase in inhibition by B-TGF and EGF alone had no inhibitory effect, we believe that binding of EGF to its receptor is not part of the pathway mediating the inhibitory effect of B-TGF. All neoplastic cells have lost some measure of growth control and the cellular elements involved are growth factors, growth factor receptors and oncogenes. T-MG1 cells contain abundant R-EGF and this may partly explain their malignant nature (malignant nature is here defined as ability to proliferate in agarose). Type alpha transforming growth factors, which in some cancer cells act as uncontrolled autocrine growth factors, were not found in protein extracts from T-MG1 cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265720 TI - Type beta transforming growth factor and epidermal growth factor suppress the plasminogen activator activity in a human glioblastoma cell line. AB - In the human glioblastoma cell line, T-MG1, plasminogen activator activity (PA activity) was demonstrated by using the chromogenic substrate S-2251. Using monoclonal antibodies against human urokinase type PA (u-PA) and human tissue type PA (t-PA), only u-PA activity was found in T-MG1 cell extracts. The u-PA activity in T-MG1 cells was suppressed in a dose-dependent manner by B-TGF and EGF after 24 hours of exposure to these growth factors. Twenty units of B-TGF caused a decrease in PA-activity of 80%, while 10 ng/ml EGF gave a decrease in PA activity of 60%. The suppressive effects of B-TGF and EGF were observed after 2 hours and 4 hours of incubation, respectively and sustained for at least 24 hours. The effects of B-TGF and EGF were not antienzymatic, but rather mediated through regulatory mechanisms. In view of the capacity of invasive growth of gliomas and the potential role of PA in invasive growth, the suppression of PA activity in gliomas by B-TGF and EGF may be of importance. PMID- 3265721 TI - Symptomatic trigeminal neuralgia. AB - In four cases with trigeminal neuralgia an intracranial neoplasm was detected. In the first two cases a meningioma of the cerebellopontine angle was producing symptomatic trigeminal neuralgia almost identical to the essential one. In the other two cases with a tumor in the gasserian ganglion area the facial pain was of a more atypical nature. In all four cases associated sensory trigeminal deficits were present. The causative factors which may produce symptomatic trigeminal neuralgia are especially discussed in this paper. PMID- 3265722 TI - Distinguishing avascular necrosis from segmental impaction of the femoral head following an acetabular fracture: preliminary report. AB - To distinguish segmental impaction from avascular necrosis of the femoral head, 26 consecutive patients who sustained an acute displaced acetabular fracture were assessed preoperatively with routine radiographs, computed tomography, and radionuclide imaging using pinhole collimation and single photon emission computed tomography (SPECT). The diagnostic criterion for avascular necrosis was a photopenic defect of the femoral head, whereas, the criterion for segmental impaction was an area of impaction of at least 1 cm2 noted at the time of surgery. Of this series, 3 incurred a segmental impaction while 1 showed evidence consistent with avascular necrosis on SPECT imaging. None of the patients possessed diagnostic features of both complications. The distinction between these two complications of an acetabular fracture should contribute to the application of appropriate surgical techniques to correct segmental impaction and avascular necrosis. PMID- 3265723 TI - Age-related changes in the morphology and immunophenotype of spontaneous lymphomas of SJL/N mice. AB - Forty-four SJL mice were killed at intervals to follow the spontaneous development of lymphomas. These were detected in 28 of 38 mice aged 24 weeks or more. Immunoperoxidase stains were applied on cryostat sections of lymphomas from various sites (spleen, mesenteric lymph nodes, Peyer's patches, and other lymph nodes), sampled from 19 mice of different age groups, to study tumour immunophenotype in correlation with histological features. With a panel of antibodies against Thy 1.2, Lyt 1, and Lyt 2, and the mouse immunoglobulin heavy and light chains, all the 19 tumours were shown to be B-cell derived. This was further supported by the detection of Ia antigens on the tumour cells. Six mice had plasmacytoid or predominantly plasmacytoid tumours expressing gamma kappa. Three mice had mixed plasmacytoid and pleomorphic tumours which also showed gamma kappa positivity. The ages of these nine mice ranged from 24 to 44 weeks with a median of 36 weeks. Pleomorphic tumours were found in ten mice (age range = 36-52 weeks, median = 44 weeks). These tumours were more heterogeneous, expressing either alpha, mu, or gamma, or with loss of heavy chain expression altogether. These age-related changes are probably a sign of progressive loss of differentiation in B lymphomas. PMID- 3265724 TI - Human gingival Langerhans cells as accessory cells in mitogen induced T cell responses. AB - Peripheral blood and gingival tissue was collected from patients undergoing surgery for the treatment of periodontal disease. Both unfractionated peripheral blood mononuclear cells and a T cell-enriched, monocyte-depleted lymphocyte population were isolated from the blood samples while a gingival epithelial cell suspension was prepared from the oral aspect of the gingival tissue. The blood cells (1 X 10(5)) were then co-cultured with the gingival epithelial cells (1 X 10(5) and 1 X 10(4)) in 200 microliters aliquots in microtitre trays for three days to see if the epithelial cells could act as accessory cells in the lymphocyte response to the mitogen, phytohaemagglutinin (PHA). Lymphocyte proliferation was assessed by measuring the uptake of [6-3H] thymidine during the last 18 hours of culture. Removal of monocytes from peripheral blood mononuclear cells led to a significant, but not total, reduction in the proliferative response to PHA. When gingival epithelial cells were added to the T cells they restored their response to PHA in a dose dependent fashion. As Langerhans cells were the only potentially immunocompetent cells seen in the epithelial cell suspensions, it is concluded that these cells are acting as accessory cells in the T cell response to PHA. PMID- 3265725 TI - A study of the incidence of pedal pathology in children. PMID- 3265726 TI - [Vestibular function under weightlessness conditions]. PMID- 3265727 TI - Emergency endoscopy in upper gastrointestinal haemorrhage: evaluation of 885 patients. PMID- 3265728 TI - Methimazole treatment of 262 cats with hyperthyroidism. AB - The efficacy and safety of the antithyroid drug methimazole were evaluated over a 3-year period in 262 cats with hyperthyroidism. In 181 of the cats, methimazole was administered for 7 to 130 days (mean, 27.7 days) as a preoperative preparation for thyroidectomy. The remaining 81 cats were given methimazole for 30 to 1,000 days (mean, 228 days) as sole treatment for the hyperthyroid state. After 2 to 3 weeks of methimazole therapy (10 to 15 mg/d), the mean serum thyroxine (T4) concentration decreased significantly (P less than 0.001) from a pretreatment value of 12.1 micrograms/dl to 2.1 micrograms/dl. The final maintenance dose needed to maintain euthyroidism in the 81 cats that were given methimazole as sole treatment for hyperthyroidism ranged from 2.5 to 20 mg/d (mean, 11.9 mg/d). Clinical side effects developed in 48 (18.3%) cats (usually within the first month of therapy), which included anorexia, vomiting, lethargy, self-induced excoriation of the face and neck, bleeding diathesis, and icterus caused by hepatopathy. Mild hematologic abnormalities developed in 43 (16.4%) cats (usually within the first 2 months of treatment), which included eosinophilia, lymphocytosis, and slight leukopenia. In ten (3.8%) cats, more serious hematologic reactions developed including agranulocytosis and thrombocytopenia (associated with bleeding). These hematologic abnormalities resolved within 1 week after cessation of methimazole treatment. Immunologic abnormalities associated with methimazole treatment included the development of antinuclear antibodies in 52 of 238 (21.8%) cats tested and red cell autoantibodies (as evidenced by positive direct antiglobulin tests) in three of 160 (1.9%) cats tested.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265729 TI - Interleukin-2 production by human fetal lymphocytes. AB - IL-2 production by PHA-stimulated human lymphocytes in umbilical blood was studied ontogenetically. Lymphocytes from the 16-week-old fetus produced appreciable amounts of interleukin-2 (IL-2). In 16- to 36-week-old fetuses the IL 2 production rate was found to be significantly higher than that in adults. When signal transduction, which is mediated by high affinity IL-2 receptors (IL-2R), was studied after adding exogenous IL-2 to PHA-blast lymphocytes, the response of the 24-week-old fetus was similar to that of adults. These results indicate that the attainment of IL-2 production and the function of IL-2 receptors are completed at a relatively early stage of fetal development. PMID- 3265730 TI - Voltage dependence of cellular current and conductances in frog skin. AB - Knowledge of the voltage dependencies of apical and basolateral conductances is important in determining the factors that regulate transcellular transport. To gain this knowledge it is necessary to distinguish between cellular and paracellular currents and conductances. This is generally done by sequentially measuring transepithelial current/voltage (It/Vt) and conductance/voltage (gt/Vt) relationships before and after the abolition of cellular sodium transport with amiloride. Often, however, there are variable time-dependent and voltage dependent responses to voltage perturbation both in the absence and presence of amiloride, pointing to effects on the paracellular pathway. We have here investigated these phenomena systematically and found that the difficulties were significantly lessened by the use of an intermittent technique, measuring It and gt before and after brief (less than 10 sec) exposure to amiloride at each setting of Vt. I/V relationships were characterized by these means in frog skins (Rana pipiens, Northern variety, and Rana temporaria). Cellular current, Ic, decreased with hyperpolarization (larger serosa positive clamps) of Vt. Derived Ic/Vt relationships between Vt = 0 and 175 mV (serosa positive) were slightly concave upwards. Because values of cell conductance, gc, remained finite, it was possible to demonstrate reversal of Ic. Values of the reversal potential Vr averaged 156 +/- 14 (SD, n = 18) mV. Simultaneous microelectrode measurements permitted also the calculation of apical and basolateral conductances, ga and gb. The apical conductance decreased monotonically with increasing positivity of Vt (and Va). In contrast, in the range in which the basolateral conductance could be evaluated adequately (Vt less than 125 mV), gb increased with more positive values of Vt (and Vb). That is, there was an inverse relation between gb and cellular current at the quasi-steady state, 10-30 sec after the transepithelial voltage step. PMID- 3265731 TI - Effect of taurine on the isolated retinal pigment epithelium of the frog: electrophysiologic evidence for stimulation of an apical, electrogenic Na+-K+ pump. AB - The apical surface of the retinal pigment epithelium (RPE) faces the neural retina whereas its basal surface faces the choroid. Taurine, which is necessary for normal vision, is released from the retina following light exposure and is actively transported from retina to choroid by the RPE. In these experiments, we have studied the effects of taurine on the electrical properties of the isolated RPE of the bullfrog, with a particular focus on the effects of taurine on the apical Na+-K+ pump. Acute exposure of the apical, but not basal, membrane of the RPE to taurine decreased the normally apical positive transepithelial potential (TEP). This TEP decrease was generated by a depolarization of the RPE apical membrane and did not occur when the apical bath contained sodium-free medium. With continued taurine exposure, the initial TEP decrease was sometimes followed by a recovery of the TEP toward baseline. This recovery was abolished by strophanthidin or ouabain, indicating involvement of the apical Na+-K+ pump. To further explore the effects of taurine on the Na+-K+ pump, barium was used to block apical K+ conductance and unmask a stimulation of the pump that is produced by increasing apical [K+]o. Under these conditions, increasing [K+]o hyperpolarized the apical membrane and increased TEP. Taurine reversibly doubled these responses, but did not change total epithelial resistance or the ratio of apical-to-basal membrane resistance, and ouabain abolished these responses. Collectively, these findings indicate the presence of an electrogenic Na+/taurine cotransport mechanism in the apical membrane of the bullfrog RPE. They also provide direct evidence that taurine produces a sodium-dependent increase in electrogenic pumping by the apical Na+-K+ pump. PMID- 3265732 TI - Influence of serosal Cl on transport properties and cation activities in frog skin. AB - The effects of serosal substitution of isosmotic Na2SO4-Ringer solution for NaCl Ringer solution were studied in the short-circuited frog skin (Rana pipiens, Northern variety). Despite prompt changes of transepithelial measurements, initial cellular effects were slight. After 30 to 45 min, however, the transcellular current had decreased and the cell electrical potential had depolarized, in association with decrease of the apical membrane fractional resistance and basolateral membrane conductance. Apical membrane slope conductance was unaffected. Similar effects were obtained with isolated epithelia. With the use of gluconate or NO3 in place of Cl, the effects on cellular current and conductance were minimal or insignificant, despite changes of the cell potential, fractional resistance, and basolateral conductance similar to those seen with sulfate. Following prolonged exposure to serosal SO4-Ringer, the extent of depolarization induced by raising the serosal K concentration decreased, indicating diminution of basolateral K conductance and the existence of other basolateral conductances. Equilibration in serosal gluconate-Ringer enhanced polarization on serosal restoration of Cl or removal of Na, again indicating a time-dependent change in the basolateral conductance pattern. Depolarization on removal of serosal Cl was not attributable to inhibition of the pump. Nor was it the result of decrease of the K equilibrium potential EK: exposure to serosal SO4-Ringer decreased cell K activity aKc from 104 +/- 6 to 58 +/- 4 mM (n = 5), but EK was reduced only slightly; exposure to serosal gluconate increased aKc and EK. Serosal sulfate lowered the cell Na activity aNac, but the electrochemical potential difference for Na across the apical surface was unaffected. The concurrent decrease of both aKc and aNac following serosal substitution of SO4 for Cl raises questions concerning mechanisms of osmoregulation. PMID- 3265733 TI - Determination of the complete three-dimensional structure of the alpha-amylase inhibitor tendamistat in aqueous solution by nuclear magnetic resonance and distance geometry. AB - The complete three-dimensional structure of the alpha-amylase inhibitor Tendamistat in aqueous solution was determined by 1H nuclear magnetic resonance and distance geometry calculations using the program DISMAN. Compared to an earlier, preliminary determination of the polypeptide backbone conformation, stereo-specific assignments were obtained for 41 of the 89 prochiral groups in the protein, and a much more extensive set of experimental constraints was collected, including 842 distance constraints from nuclear Overhauser effects and over 100 supplementary constraints from spin-spin coupling constants and the identification of intramolecular hydrogen bonds. The complete protein molecule, including the amino acid side-chains is characterized by a group of nine structures corresponding to the results of the nine DISMAN calculations with minimal residual error functions. The average of the pairwise minimal root-mean square distances among these nine structures is 0.85 A for the polypeptide backbone, and 1.52 A for all the heavy atoms. The procedures used for the structure determination are described and a detailed analysis is presented of correlations between the experimental input data and the precision of the structure determination. PMID- 3265734 TI - [Emergency angiography]. PMID- 3265735 TI - [Lymphocyte proliferation test to Dermatophagoides farinae in patients with atopic dermatitis]. PMID- 3265736 TI - [Estimation of the volume and percent uptake of the liver and spleen by SPECT]. PMID- 3265737 TI - [Clinical significance of PFD test and fecal chymotrypsin test in postoperative pancreatic exocrine insufficiency]. PMID- 3265738 TI - [Automatic determination of the site of myocardial infarction and coronary perfusion territory with SPECT]. PMID- 3265739 TI - [Imaging and quantitative analysis of regional cerebral blood volume by ring type SPECT: normal volunteer studies]. PMID- 3265740 TI - [Basic and clinical study of the measurement of left ventricular end-diastolic volume using ECG-gated and non-gated single photon emission tomography]. PMID- 3265741 TI - [Evaluation of SPECT with N-Isopropyl[I-123]-p-Iodoamphetamine (IMP) in epileptic patients]. PMID- 3265742 TI - [Fourier analysis in ECG gated blood pool emission computed tomography--a basic study using cardiac phantoms and its clinical application]. PMID- 3265743 TI - [Incidence of pulmonary thromboembolism in Japan]. PMID- 3265744 TI - [Power staple fixation of the sternum after refractory mediastinitis following A C bypass; key points of sternal fixation]. PMID- 3265745 TI - [IABP--insertion via ascending aorta]. PMID- 3265746 TI - [Analysis of the status of the surgical treatment of coronary disease in Poland 1983-1986]. PMID- 3265747 TI - [Incidence of ischemic heart disease in relation to major risk factors among Moscow male residents aged 20-29 years]. AB - A representative random sample of 3,308 male residents aged 20-59 years from a Moscow district was examined. Only 74% of them participated in the study. Routine epidemiological methods were used to identify various forms of coronary heart disease (CHD). The prevalence of CHD was 9.7% in the population with the incidence of definite CHD of 5% and possible CHD of 4.6%. The prevalence of CHD was significantly associated with age, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, hypoalphacholesterolemia, and obesity. The findings should be borne in mind while planning preventive measures in the population of working age. PMID- 3265748 TI - [Endoscopic occlusion of esophageal varices in patients with portal hypertension]. PMID- 3265750 TI - An age-related loss of the isogeneic barrier to the successful passive cell transfer of antimicrobial immunity in mice. AB - The results of this study show that an isogeneic barrier to the successful adoptive immunotherapy of Mycobacterium tuberculosis infected mice is progressively lost as these animals age. This was shown in this study by the demonstration that increasing levels of transferred acquired specific resistance could be conferred on normal old recipients of greater than 22 months of age, whereas in young recipients such transfers were unsuccessful without the prior exposure of recipients to sublethal levels of whole-body ionizing gamma irradiation. These data indicate that strategies of adoptive immunotherapy in the elderly may not have to overcome the age-related isogeneic physiological barrier to this procedure. PMID- 3265749 TI - [Effect of adaptive biofeedback on the severity of vestibulo-autonomic symptoms of experimental motion sickness]. AB - The effect of biofeedback control on motion sickness symptoms was investigated in 27 test subjects with different susceptibility who had been trained to regulate their skin resistance and skin temperature. The efficacy of two schemes was compared: scheme 1 - transfer of controlling abilities, and scheme 2 - application of biofeedback during vestibular stimulation. Use of either scheme inhibited significantly the severity of motion sickness symptoms in moderate susceptibility individuals; in other words, this decreased respiratory arrhythmia, skin galvanic response, heart rate and objective motion sickness manifestations, i.e. nausea, paleness, perspiration. This caused vestibular tolerance to increase by 50% to 150% as compared to the baseline. Biofeedback control proved ineffective in high susceptibility individuals. Scheme 2 was found to be more effective than scheme 1. Biofeedback control of skin resistance had a stronger inhibitory effect than that of skin temperature. These results suggest that the prophylactic effect of biofeedback control is associated with the regulation of a component of the complex autonomic reaction triggered as a single program during motion sickness. PMID- 3265751 TI - [Psychogenic rheumatism]. PMID- 3265753 TI - MRI of pulsatile CSF motion within arachnoid cysts. AB - Flow void due to pulsatile motion of cerebrospinal fluid (CSF) has recently been demonstrated by a variety of magnetic resonance techniques with sensitivity to slow flow. It has been suggested that within fluid collections not communicating with the physiologic CSF space, there is less signal loss than with the physiologic CSF spaces. Utilizing the SSFP MR technique, which is sensitive to flow as slow as 1 mm/sec, we evaluated three patients with isolated arachnoid cysts. Irregular signal loss consistent with fluid motion was noted within all of the cysts, as well as within the physiologic CSF spaces. Definitive anatomic evaluation of these lesions, though, required ventriculography, an invasive technique. PMID- 3265752 TI - Possible involvement of the GABAergic system in dopaminergic-cholinergic interactions in electroacupuncture-induced analgesia. AB - The involvement of the GABA system in dopamine-acetylcholine interactions in electroacupuncture induced analgesia (EAA), measured in terms of tail flick latency (TFL) test, was studied with administration of the GABA receptor agonist, muscimol (1 mg/kg, i.p.); antagonist, bicuculline (2 mg/kg, i.p.); GABAmimetic drug, ethanolamine-O-sulfate (EOS) (2 mg/kg, s.c.) or the drugs stimulating or inhibiting acetylcholine and dopamine receptors activity to rats exposed to electroacupunture (EA). All the drugs were administered prior to EA (10 Hz, 1 volt) exposure (2-15 min). Results observed under the above conditions suggest that the cholinergic system has a direct inhibitory role on EAA and the dopaminergic system mediates its action via the cholinergic system. A decrease in EAA with both the GABA receptor agonist and antagonist and tremendous increase of EAA with the gabamimetic drug, EOS, showed that GABA receptors may not be directly involved in EAA. Further (a) gradual withdrawal of muscimol, bicuculline or physostigmine induced decrease in EAA with the increase in duration of EA exposure; (b) the characteristic changes in EAA observed with the coadministration of (i) L-DOPA + carbidopa + muscimol (ii) atropine + muscimol; and (c) no significant change in bicuculline + physostigmine induced inhibition of EAA with the increase in duration of EA exposure suggest that some inhibitory substance(s) may be released during EA which may inhibit the GABA system and finally cholinergic activity through the activation of dopaminergic neurone. PMID- 3265755 TI - [Effects of non-immune interferons and interleukin-2 on the activity of natural killer cells in patients with hairy cell leukemia]. PMID- 3265756 TI - Experimental glomerulonephritis. PMID- 3265754 TI - [Prognostic value of cerebrovascular circulation in acute ischemic stroke]. PMID- 3265757 TI - C3, C5 components and C3a, C4a, and C5a fragments of the complement system. PMID- 3265758 TI - Cultural construction of the menopausal syndrome: the Japanese case. AB - Europe and North America have been the focus of most research on the menopause and its symptoms. In this study, in the course of in-depth interviews Japanese physicians and women were asked to describe the menopausal experience. A cross sectional survey concerning women and their health at midlife was then distributed to 1738 women. The analysis in this paper is based on the replies received from 1141 non-hysterectomized women aged 45-55. Factor analysis was used to group the symptoms these women had experienced in the previous 2 wk. After constructing an index based on the factor scores, one-way analysis of variance was used to examine the relationship between symptom experience and the epidemiological menopausal status as well as the self-defined menopausal status. Symptom experience was always significantly related to self-defined menopausal status. PMID- 3265759 TI - Lyme disease in Missouri. PMID- 3265760 TI - Electrophysiological and morphological correlation of frog retinal ganglion cell classes. PMID- 3265762 TI - Acquired immunodeficiency syndrome in dialysis. PMID- 3265761 TI - Effects of dietary modulations of protein intake on the progression of glomerulosclerosis in unilaterally nephrectomized rats with passive Heymann nephritis. AB - This study was undertaken to investigate the effects of dietary protein intake on renal function and pathology in unilaterally nephrectomized rats with passive Heymann nephritis (PHN). 60 Lewis rats were unilaterally nephrectomized and half of them were injected with anti-Fx1A antibody to induce PHN. The rats were divided into four groups of 15 rats each as follows: group A-high-protein diet (HPD 30%) and PHN, group B-high-protein diet (HPD 30%) with no PHN, group C-low protein diet (LPD 6%) and PHN and group D-low-protein diet with no PHN. These rats were observed for a 30-week period. The rats in group A showed persistent massive proteinuria with eventual deterioration of renal functions. Renal pathology revealed severe glomerulosclerosis with interstitial changes. In addition, marked hypertrophy and hyperplasia of tubular cells were noted. The rats in group B showed only mild and segmental glomerulosclerosis without significant proteinuria and decreased renal functions. The rats in group C exhibited moderate proteinuria in the early experiment stages which completely remitted in the stages thereafter. Renal pathological changes included only deposition of immune complexes in the glomerular basement membrane (GBM). The rats in group D did not show any abnormalities both pathologically and functionally. From these results, HPD enhanced the permeability of GBM which had been already damaged immunologically, leading to glomerulosclerosis of high severity with deterioration of renal functions. On the contrary, LPD ameliorated those changes. Although the role of anti-Fx1A antibody in the pathogenesis of human membranous nephropathy has still been the subject of debate, it is possible that ad libitum ingestion of dietary protein will have adverse effects on the clinical course of human membranous nephropathy, especially in the reduced number of functional nephrons. PMID- 3265763 TI - Intracranial arteriovenous malformation: relationships between clinical and radiographic factors and ipsilateral steal severity. AB - Intracranial arteriovenous malformations (AVMs) are high flow shunts that may jeopardize the perfusion of adjacent tissue. Clinical and radiographic data from 62 patients were analyzed to determine their relationship to the severity of steal measured by single photon emission computed tomography (SPECT). The ipsilateral steal index [ISteal(i)] was determined by dividing regional cerebral blood flow (rCBF) values within hand-drawn regions of hypoperfusion in the ipsilateral hemisphere by total brain flow, which was calculated as the average rCBF of each hemisphere. Of the patients, 40% were less than 30 years of age, 45% were 30 to 50 years old, and 15% were over 50. Forty-eight per cent presented with hemorrhage and 34% presented with progressive deficits. There was angiographic steal in 37%, and postoperative hyperemic complications developed in 21%. All patients had ipsilateral regions of hypoperfusion. The ISteal(i) was less than 0.7 in 23 (37%), 0.7 to 0.8 in 20 (32%), and greater than 0.8 in 19 (31%). The ISteal(i) was significantly less severe in the patients over 50; 78% of these patients had an ISteal(i) of greater than 0.8 (P less than 0.01). A history of hemorrhage was associated with less severe steal than that in patients who had not bled (P = 0.088). Patients presenting with a history of progressive deficits had increased severity of steal compared with those without progressive deficits (P less than 0.05). A trend toward decreased severity of steal was noted in patients with unfavorable outcomes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265764 TI - Enhancement of growth of primary metastatic fresh human tumors of the nervous system by epidermal growth factor in serum-free short term culture. AB - Using the adhesive tumor cell culture system, we studied the effect of epidermal growth factor (EGF) on 16 primary and 7 metastatic fresh human tumors of the nervous system cultured in serum-free and serum-supplemented media at low cell density. In serum-free conditions, EGF significantly enhanced the growth of glial tumor cells. This positive effect was less pronounced for metastases to the brain. No significant enhancement was observed for the other tumor types (primitive neuroectodermal tumors and various tumors of neuroepithelial/mesenchymal origin). The addition of serum obscured this effect of EGF, even at the lowest cell densities. In 7 tumors, the simultaneous addition of platelet-derived growth factor did not enhance the EGF response. Subtypes of brain tumors respond to EGF in vitro under serum-free conditions. PMID- 3265765 TI - CT demonstration of a 5th ventricle--a finding to KO boxers? AB - The reported prevalence of 5th ventricles based on air studies varies from 1-12% and ranges up to 60% as an autopsy finding. The prevalence of what is usually an incidental anomaly has not been determined by computed tomography (CT). 5th ventricles are however known to be more common in brain damaged boxers and with the introduction of compulsory CT scanning for certain boxers it is necessary to know what significance to attach to the finding of a cavum in these individuals. To ascertain the prevalence and morphology of 5th ventricles as detected by CT in the population, a thousand consecutive scans were analysed for the presence or absence of a 5th ventricle and other associated midline developmental abnormalities and correlations made with any pathology found. A 5th ventricle was present in 5.5% of the group and in most cases was less than 3 mm wide. An apparent association with other pathology was found only in patients under the age of 15. A 6th ventricle was found in 0.5% while a cavum velum interpositum was present in 9.5%. The isolated finding of a small 5th ventricle on the CT scan of a young active boxer almost certainly represents a persistent congenital anomaly of no significance. PMID- 3265766 TI - Single photon emission computed tomography in motor neuron disease with dementia. AB - Single photon emission computed tomography with [123 I] isopropylamphetamine was carried out on a patient with motor neuron disease with dementia. [123 I] uptake was decreased in the frontal lobes. This would reflect the histopathological findings such as neuronal loss and gliosis in the frontal lobes. PMID- 3265768 TI - [A rare case of lymphatic cyst of the gastric wall]. PMID- 3265767 TI - Bilateral anterior opercular syndrome: localizing value of SPECT and MRI. AB - Bilateral anterior opercular syndrome is clinically characterized by facio pharyngo-glossomasticatory diplegia due to bilateral opercular lesions. Reported cases of the syndrome have been relatively rare probably because of difficulty in determining opercular damage on clinical symptoms alone. We report a case of this syndrome in whom bilateral opercular damage could be detected not by CT, but suggested by SPECT, and confirmed by MR imaging. PMID- 3265769 TI - Reduction of aromatic L-amino acid decarboxylase activity in clonal pheochromocytoma PC12h cells by culture in the presence of N-methyl-4 phenylpyridinium ion (MPP+). AB - Rat clonal pheochromocytoma PC12h cells were cultured in the presence of N-methyl 4-phenylpyridinium ion (MPP+) and the activity of aromatic L-amino acid decarboxylase (AADC) was reduced after 3 and 6 days of culture. AADC activity in control cells was increased markedly by addition of pyridoxal 5-phosphate (PLP) to the reaction mixture, but that in the cells cultured in the presence of MPP+ was not increased by addition of PLP. After 6 days culture, AADC activity was almost negligible in the cells cultured in the presence of 1 mM MPP+, but PLP concentration in the cells was not reduced. AADC in the cells cultured in the presence of MPP+ reduced the affinity to PLP, but the affinity to a substrate, L DOPA, did not change. Intracellular concentration of AADC protein was not reduced, as shown by an immunobinding assay with anti-AADC antibody. These data indicate that MPP+ may induce conformational changes in AADC protein and reduces its affinity to the cofactor, PLP. PMID- 3265770 TI - The neurotoxicant MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) increases glial fibrillary acidic protein and decreases dopamine levels of the mouse striatum: evidence for glial response to injury. AB - The neurotoxicant MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), administered to male or female mice, decreased striatal dopamine content and increased the levels of the astrocyte intermediate filament protein, glial fibrillary acidic protein (GFAP). The rise in GFAP was evident as early as two days following the last dose of MPTP, was maximal 7 days after the toxicant and returned to control levels by two months, post MPTP. Striatal dopamine content was decreased post-MPTP administration, showing a slight recovery between one and two months after the toxicant. No differences were observed among male and female mice in their responses to the toxicant. Hippocampal noradrenaline content was not affected by the toxicant, neither was the GFAP content altered by MPTP in this structure. Additionally, pargyline pretreatment prevented both the rise in GFAP and the decrease in dopamine in striatum. MPTP produced a smaller elevation in GFAP levels within a midbrain section of tissue containing the substantia nigra, without significantly decreasing the dopamine content of this structure, suggesting neurotoxic involvement at the level of dopamine perikarya. The toxicant did not affect the molecular radius of the protein detected by the antibody to GFAP, as determined by immunoblot analysis. PMID- 3265772 TI - Dietary calcium modulates spinal cord content of calcitonin gene-related peptide in the rat. AB - This study was undertaken to determine if calcium status modulates calcitonin gene-related peptide (CGRP) neuronal content. In two separate experiments, young, growing rats and mature rats were placed on low, normal, and high calcium diets for four weeks. CGRP immunostaining was localized immunocytochemically in laminae I and II of the upper thoracic spinal cord in young rats and in the upper thoracic and lumbar spinal cord in mature rats. Low calcium intake decreased dorsal horn CGRP content in young, growing rats, while high calcium diet significantly increased CGRP content, as determined by computer-assisted image processing, in both young and adult rats. A significant positive correlation was found between the serum ionized calcium and CGRP content in laminae I and II. Thus, calcium balance appears to modulate neuronal CGRP content. PMID- 3265771 TI - A new device for the quantitative assessment of dopaminergic drug effects in unilateral MPTP-lesioned monkeys. AB - Non-human primates exposed to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) have been employed to study the clinical features of parkinsonism. Monkeys lesioned by unilateral intracarotid administration of MPTP display spontaneous and drug responsive turning behavior. However this seems to correlate poorly with their clinical deficits. We describe an objective measurement of arm movement velocity, applied in 4 cynomolgus monkeys before and after unilateral administration of MPTP. Reduced movement velocities correlated with clinical signs of unilateral flexed arm posture, rigidity, tremor and bradykinesia and could be reversed with L-DOPA therapy. This measurement technique has advantages for the quantitative assessment of parkinsonian deficits and will permit the evaluation of dopaminergic therapy and transplantation in non-human primates. PMID- 3265773 TI - Trigeminal motoneurons in frogs develop a new dendritic field during metamorphosis. AB - During metamorphosis neural systems that regulate larval behavior are altered to adult patterns. Identified strategies used to produce this alteration include neuronal deletions, neuronal additions, and the reconfiguration of existing neural circuits. This investigation focused on the structural alterations that occur in frog trigeminal motoneurons during metamorphic climax. These neurons are of special interest because they mediate the vastly different muscular activities associated with larval and adult food capture. We examined the development of the trigeminal motoneurons in anuran larvae, devoting special attention to the elaboration of different dendritic fields during metamorphic climax. When horseradish peroxidase (HRP) back-filled motoneurons in adults were scrutinized by Sholl analysis, they were found to have two spatially discrete dendritic domains, one extending ventrally and laterally, the other projecting dorsomedially into the periventricular cells. The ventrolateral dendritic field alone is represented in the motoneurons of premetamorphic larvae. The dorsomedial dendritic field first appears at the beginning of metamorphic climax and is rapidly elaborated during the terminal stages of larval development. PMID- 3265775 TI - The incidence of vision loss in a diabetic population. AB - The 4-year incidence of blindness and vision loss was examined in a population based study of diabetes mellitus. In subjects participating in baseline and 4 year follow-up examinations, the rate of blindness was 1.5, 3.2, and 2.7% in younger onset persons, older onset persons taking insulin, and older onset persons not taking insulin, respectively. The rate of blindness increased with increasing age, increasing diabetic retinopathy severity, and lower baseline visual acuity in all three groups. Blindness increased with increasing duration of diabetes in younger onset persons and older onset persons taking insulin. The incidence of vision loss, as measured by a doubling of the visual angle, was associated with older age, more severe retinopathy, and presence of macular edema in the three groups. It was also associated with duration of diabetes, presence of proteinuria, and higher glycosylated hemoglobin in younger onset and older onset persons taking insulin. PMID- 3265774 TI - Localization of calcitonin gene-related peptide (CGRP) at a neuronal nicotinic synapse. AB - The localization of calcitonin gene-related peptide (CGRP) in the parasympathetic cardiac ganglion of the frog was investigated with an immunofluorescence method. By doubly staining the whole ganglion with antibodies against a synaptic-vesicle antigen and anti-CGRP antibodies, we found that all of the boutons at the nicotinic synapses on the postganglionic neurons contained immunoreactivity against this peptide. In contrast, neither the muscarinic nor the adrenergic terminals of the postganglionic fibers on the cardiac muscle contained CGRP immunoreactivity. This suggests that CGRP is involved in the functions of the neuronal nicotinic synapses. PMID- 3265777 TI - Teaching ophthalmology residents about rehabilitation. AB - Ophthalmology is a medical specialty which deals with large numbers of patients who have irreversible impairments. A survey of all ophthalmology residency programs in the United States found that most programs require that residents receive training in low vision aids and devices, but they do not require training in seven other topics concerning the rehabilitation of visually impaired and blind patients. Those programs that do offer training in rehabilitation rely heavily on clinical training. Since practicing ophthalmologists themselves have an incomplete knowledge of the rehabilitation system, it is unlikely that the clinical model will provide residents with sufficient information about rehabilitation. Ophthalmologists need formal training about the rehabilitation process in order to ensure that their patients receive adequate referrals. PMID- 3265776 TI - Coagulase-negative staphylococcal endophthalmitis. Increase in antimicrobial resistance. AB - The predicted sensitivities of common organisms guide initial antibiotic therapy in endophthalmitis. The authors suspected a change in the expected sensitivity of coagulase-negative staphylococci when three cases of endophthalmitis due to multiply resistant organisms failed to respond to intravitreal cefazolin and gentamicin. The authors reviewed 48 cases from 1982 to 1986, compared these with 28 cases from 1973 to 1981, they found increased resistance to gentamicin (35 versus 0%, P less than 0.05) and increased resistance to methicillin (27 versus 19%). Eight cases were resistant to both antibiotics, including the three clinical failures. Final vision was unrelated to antimicrobial resistance. Since cephalosporins may be ineffective clinically against methicillin-resistant staphylococci, concomitant gentamicin resistance may render intravitreal cefazolin and gentamicin inadequate for their treatment. No isolates were resistant to vancomycin. Vancomycin and aminoglycoside, used intravitreally in the initial management of endophthalmitis, would be anticipated to provide better coverage than cefazolin and aminoglycoside for endophthalmitis due to the staphylococci, as well as for infections due to streptococcal and bacillus species. PMID- 3265778 TI - [Trans-cochlear neurectomy of the vestibular part of the cochlear nerve]. PMID- 3265779 TI - [Incidence of congenital cysts and lateral fistulas of the neck in the last decade]. PMID- 3265780 TI - AIDS cases up 100 according to latest record. PMID- 3265781 TI - [Epidemiology of ingestion accidents in children]. PMID- 3265782 TI - [Organophosphate poisonings--accidental and with suicidal intention]. PMID- 3265783 TI - The cerebellar-vestibular basis of learning disabilities in children, adolescents and adults: hypothesis and study. AB - This paper provides a description of the cerebellar-vestibular-determined (CV) neurological and electronystagmographic (ENG) parameters characterizing 4,000 patients with learning disabilities. Of this sample, 1465 or 36.6% were children, 1156 or 28.9% adolescents, and 1379 or 34.5% adults. Using a set of diagnostic methods and criteria, the incidence of CV-dysfunction in this diverse sample was statistically equivalent to that reported by neurologists and neurotologists in a prior "blind" analysis of 115 dyslexic children. Over 94% of both the learning disabled and the dyslexic samples showed two or more abnormal neurological or ENG parameters indicating a CV-dysfunction whereas less than 1% evidenced hard neurological signs of a cerebral disorder. These and related data suggested that: (1) learning disabilities and dyslexia may be cerebellar-vestibular-based and reflect a single disorder and that (2) the varying academic, speech, concentration, activity, and related symptoms characterizing learning disabled persons seem to be shaped by a diverse group of cerebellar-vestibular-determining mechanisms rather than distinct neurophysiological disorders; also, (3) cerebellar-vestibular dysfunctioning and learning disabilities may secondarily trigger altered and/or compensatory cerebral processing and dominance mechanisms. (4) The cerebral cortex apparently plays a vital, compensatory role in shaping the final symptoms. A cerebellar-vestibular basis of learning disabilities is proposed. This conceptualization is consistent with, encompasses, and/or readily explains most of these clinical diagnostic, therapeutic, and research data as well as the many and varied hypotheses. PMID- 3265784 TI - Molecular basis of the immune response. PMID- 3265785 TI - [Prevalence of smoking and its motivation among students of 2 institutions of higher learning in Bialystok]. PMID- 3265786 TI - Central nervous system action of calcitonin gene-related peptide to inhibit gastric emptying in the conscious rat. AB - The central nervous system action of rat alpha-calcitonin gene-related peptide (alpha-CGRP) on gastric emptying of a liquid, noncaloric, methylcellulose solution was assessed in 24-hr fasted, conscious rats using phenol red method as a marker. Intracisternal injection of alpha-CGRP (0.75-250 pmol) dose-dependently inhibited gastric emptying by 27-94% as measured 20 min after oral administration of the solution. The ED50 was 6.2 pmol. alpha-CGRP injected intravenously at 250 pmol delayed gastric emptying by 71% whereas a lower dose (75 pmol) was inactive. Intracisternal alpha-CGRP-induced inhibition of gastric emptying was completely abolished by bilateral adrenalectomy and partially suppressed by subdiaphragmatic vagotomy or coeliac/superior mesenteric ganglionectomy. Adrenalectomy or vagotomy in saline-treated animals did not significantly modify the rate of gastric emptying whereas coeliac/superior mesenteric ganglionectomy caused a significant 29% inhibition as compared to the nonoperated group. These results demonstrate that alpha-CGRP is a potent centrally acting inhibitor of gastric emptying of a nonnutrient liquid. The inhibitory effect of intracisternal injection of CGRP appears to be mediated by the adrenal gland and in part by the sympathetic and parasympathetic nervous system. PMID- 3265787 TI - Capsaicin-sensitive structures as potential target sites for neurotensin and bradykinin in guinea pig atria. AB - We tested the influence of capsaicin (CAP) desensitization on the positive chronotropic and inotropic effects of neurotensin (NT), bradykinin (BK), calcitonin gene-related peptide (CGRP) and noradrenaline (NA) in guinea pig isolated atria. The positive chronotropic and inotropic effects of NT and BK were completely inhibited, whereas those elicited by CGRP and NA were either slightly reduced (CGRP) or unaffected (NA), in CAP-desensitized compared to control atria. Cross-desensitization studies using CAP, NT and BK showed that the positive chronotropic and inotropic effects of CAP are slightly affected, whereas those evoked by BK are markedly reduced in NT-desensitized atria. On the other hand, the positive chronotropic and inotropic effects of CAP and NT were similar in BK desensitized and control atria. The results were interpreted as an indication that NT, BK and CAP produce their excitatory effects in guinea pig atria by interacting with a common population of CAP-sensitive sensory nerve fibers (presumably substance P (SP)- and CGRP-containing nerve fibers). The absence of cross-desensitization between NT or BK and CAP, or between NT and BK, suggests that the activation and desensitization of atrial, CAP-sensitive sensory nerve fibers by the latter agents involve different receptors and/or mechanisms. PMID- 3265788 TI - Effects of Ro 15-4513, fluoxetine and desipramine on the intake of ethanol, water and food by the alcohol-preferring (P) and -nonpreferring (NP) lines of rats. AB - The effects of the IP administration of RO 15-4513 (1, 2 and 4 mg/kg), fluoxetine (5 and 10 mg/kg) and desipramine (5 and 10 mg/kg) on the intake of 10% ethanol, H2O and food were determined in the selectively bred alcohol-preferring (P) and nonpreferring (NP) lines of rats with daily access to fluids being limited to single 2-hour sessions. The imidazobenzodiazepine Ro 15-4513 (a partial inverse benzodiazepine agonist) significantly reduced the intake of 10% ethanol by the P rats to 50-60% of control levels in the first 30 minutes without altering food or H2O intake. The attenuating actions of 2 mg/kg Ro 15-4513 on ethanol intake could be completely blocked by the central benzodiazepine receptor antagonist Ro 15 1788 (10 mg/kg). Ro 15-1788, by itself, produced no effects on alcohol and H2O consumption. The 5 mg/kg dose of fluoxetine significantly reduced 10% ethanol intake by the P rats to 20% of control values without altering either H2O or food consumption. The 10 mg/kg dose of fluoxetine further reduced ethanol intake by the P rats, but this dose also reduced daily food intake to approximately 70% of normal. Desipramine at both doses significantly (p less than 0.05) reduced both ethanol and food uptake by the P rats and had a tendency to reduce H2O consumption as well. In general, the three drugs had effects in the NP rats similar to those observed for the P group, although the effects on 10% ethanol intake were difficult to compare because of the low, variable intake of alcohol by the NP group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265789 TI - Lack of generalization of nisoxetine with amphetamine in the rat. AB - Rats were trained to discriminate between the stimulus properties of intraperitoneally administered d-amphetamine (0.8 mg/kg) and its vehicle in a two lever, food-motivated operant task. Once trained, doses of the norepinephrine reuptake inhibiting agent nisoxetine, ranging from 10 to 20 mg/kg, were administered to investigate if the amphetamine-trained rats would generalize to this agent. This did not, however, occur. Thus, it would seem that noradrenergic mechanisms have a negligible role in the production of the amphetamine-induced discriminative stimulus cue in the rat. Previous evidence that indicated a noradrenergic mediation of amphetamine discrimination in the mouse contrasted with the present results in rats and this discrepancy should warrant caution in comparing results of discriminative studies in these two species. PMID- 3265791 TI - Behaviorally conditioned suppression of murine T-cell dependent but not T-cell independent antibody responses. AB - The aversive and immunosuppressive effects of cyclophosphamide (CY, 250 mg/kg IP), an unconditioned stimulus (UCS), were paired with the presentation of a novel saccharine flavored drinking solution (SAC), a conditioned stimulus (CS), in female Balb/c mice. The objective was to determine the temporal relationship between presentation of the CS (SAC) and immunization with sheep red blood cell (SRBCs), a T-cell dependent antigen, and type III pneumococcal polysaccharide (S3), a T-cell independent antigen, on subsequent antibody responses. Reexposure to the CS or UCS occurred on days -4, -2, 0, +2, or +4 relative to immunization. Primary antibody responses in each group were measured six days following immunization. A strong association between the CS and the UCS developed, producing flavor aversions as evidenced by decreased SAC consumption. CY administration by itself consistently suppressed both types of antibody responses. CS presentation (i.e., SAC) had no significant effect on anti-S3 antibody response. However, the anti-SRBC response was significantly depressed following CS exposure. Exposure to the CS only on days -4 or +2 relative to immunization resulted in statistically significant suppression of antibody response to SRBC's while exposure on days -2, 0, and +4 resulted in anti-SRBC antibody suppression that did not reach significance. These results support the hypothesis that conditioning of antibody responses is relatively specific for T cell dependent antigens, and that the timing of CS presentation relative to immunization is important in conditioning a suppression of antibody responses. PMID- 3265790 TI - ICV-CRH alters stress-induced freezing behavior without affecting pain sensitivity. AB - Freezing is an adaptive response often induced by stressful, fear-eliciting stimuli. Three experiments with rats investigated the effects of intracerebroventricular (ICV) administration of corticotropin-releasing hormone (CRH) on freezing behavior and pain sensitivity. Experiments 1 and 3 demonstrated that ICV-CRH (300 ng) enhanced shock-elicited freezing. In Experiment 1, ICV-CRH also enhanced recovery from shock-elicited freezing, suggesting that the peptide has a biphasic effect. Experiments 2 and 3 established that CRH-induced freezing was not caused by heightened pain sensitivity. Interestingly, in Experiment 2, hot-plate exposure produced increased freezing that was attenuated by ICV-CRH. Thus, the direction of the ICV-CRH effect on freezing was found to depend on the nature of the stressor. These results suggest that endogenous CRH systems modulate stress-induced freezing. PMID- 3265792 TI - Persistent depression in coronary bypass patients reporting sexual maladjustment. PMID- 3265793 TI - Holiday factitial disorder: management of factitious gastrointestinal bleeding. PMID- 3265794 TI - [Pleiotropic functions of BSF-2/IL-6]. PMID- 3265795 TI - Participation of primary health care personnel in the Stockholm Health of the Population Study--a preliminary report. AB - The 1984/85 Stockholm Health of the Population Study (HPS) was a cross sectional study including a questionnaire and a health examination. It was conducted through the ordinary health personnel of four Primary Health Care (PHC) districts in the Stockholm County. The main objective was to broaden the scope for planning health care. One of the goals of the study was to involve those working in PHC in planning their activities after local needs and to use more time for prevention work. The main effort to reach this objective was through involvement of the PHC personal from the early planning phase. This strategy was very time consuming but, on the other hand experiences from the HPS have led to both new screening activities of e.g high consumers of alcohol and the elderly, and preventive work aimed at those with smoking and overweight problems in the local PHC area. In the implementation process and through education the scientific approach level and interest in primary health care increased. A keen interest of survey data for local planning is obvious. PMID- 3265796 TI - Definitive treatment for the elderly person with cancer. PMID- 3265797 TI - The vestibular aqueduct in clinical radiography. AB - The gross morphology of the vestibular aqueduct and its clinical significance are better understood against the background of the endolymphatic duct and sac, which is still a matter of hypotheses. They are concerned with functions of the endolymphatic sac like secretion and absorption of endolymph, desintegration of cells and other debris from the inner ear and phagocytosis. The endolymphatic sac in the vestibular aqueduct is also thought to have a pressure regulation function for the labyrinth and also to deal with the metabolism of the inner ear and the desintegration of otoconia. Pathology in this area is also a matter of vital discussion. The indications for surgical intervention are consequently a matter of controversary. Radiographic research has concentrated both on the normal radioanatomy of the aqueduct and its appearances in cases of Meniere's disease and of inner ear malformations. Digression from the normal appearance can be demonstrated with multidirectional tomography and CT. PMID- 3265798 TI - Spect-studies of the brain with stimulation of the auditory cortex. AB - The radiopharmaceutical N-isopropyl-p-J-Amphetamin (IMP) permits a new approach in the study of cerebral perfusion and function. We advanced the hypothesis for an increased IMP-uptake on auditory cortex during stimulation by white noise. Auditory stimulation activates the auditory cortex. This is marked by an increased IMP-uptake. IMP-uptake by the auditory region on the left side during stimulation on the right ear is another evidence of the crossing of central auditory pathways to the contralateral side. PMID- 3265799 TI - Surgical management of left ventricular aneurysm and diffuse coronary artery disease: immediate and long term results in patients receiving three or more grafts. AB - Because little information is available concerning the outcome of surgery for left ventricular aneurysm when multiple concurrent coronary grafts are required, we have reviewed 35 consecutive patients undergoing aneurysm surgery and multiple (greater than or equal to 3) grafts between December 1973 and April 1984. There were 6 operative deaths (17%). All occurred amongst those (16) undergoing LV plication procedures with no deaths amongst those (19) undergoing aneurysm resection (p less than 0.01). Operative mortality was not influenced by preoperative functional status, left ventricular end diastolic pressure, completeness of revascularisation, endarterectomy (13 patients) or whether cold crystalloid cardioplegia or intermittent aortic cross clamp with ventricular fibrillation was used. Overall 5-year actuarial survival was 70% with survival beyond surgery being 84% to 5 years and independent of the type of aneurysm procedure. Of the survivors, 16 were improved by 1-3 functional classes, 3 were unchanged and one was worse. Surgery in this group of patients offers the prospect of good symptomatic improvement and survival figures which at least equal the results of less complex ventricular aneurysm surgery and exceed those reported for medical management. PMID- 3265800 TI - Endothelial cells of the cardiac microvasculature during and after cold cardioplegic ischaemia. Comparison of endothelial and myocyte damage. AB - Ultrastructural changes in endothelial cells of the myocardial microvasculature were studied in 18 patients who underwent aortocoronary bypass surgery under cold ischaemic cardioplegia. Biopsy specimens for electron microscopy were taken from the right atrium before and at the end of aortic cross-clamping and after 20 and 60 min of reperfusion. At the end of the cold ischaemic cardioplegia, the endothelial cells showed reduced numbers of pinocytotic vesicles, moderate intracellular oedema and slight nuclear changes. During reperfusion the endothelial changes became more pronounced and interstitial oedema developed. These changes persisted, or even increased in the first 60 min of reperfusion, in contrast to the myocytic changes, which tended to regress. The endothelial cells of the myocardial microvasculature thus appeared to be more vulnerable than the myocytes to cold ischaemic cardioplegia and reperfusion. Focally reduced blood reperfusion due to endothelial swelling and interstitial oedema did not seem to be the main cause of the focal postischaemic myocytic damage. PMID- 3265801 TI - Transcapillary fluid balance in subcutaneous tissue of patients undergoing aortocoronary bypass with extracorporeal circulation. AB - Colloid osmotic pressure in plasma (COPpl) from a cubital vein and in interstitial fluid (COPif) in the subcutaneous tissue at heart level, and interstitial fluid pressure (Pif) at the same level, were measured in 18 healthy subjects and in 28 patients requiring aortocoronary bypass. Interstitial fluid was collected via subcutaneously implanted double nylon wicks and Pif was measured with the 'wick-in-needle' technique. Measurements were made preoperatively and 1 1/2 to 8 hours (mean 4 hours) after termination of extracorporeal circulation. Pif rose to 2.3 mmHg above the pre-bypass level. COPpl concomitantly fell from 22.2 to 14.4 and COPif from 12.4 to 10.1 mmHg. These changes were statistically significant. Although the relatively large COPpl drop resulted in a net rise of 3.2 mmHg in filtration pressure, the incidence of pulmonary complications was low and no subcutaneous edema was discernible. The fall in COPif and rise in Pif may be regarded as important edema-preventing mechanisms. PMID- 3265802 TI - The misuse of intravenous cannulae. AB - The use of indwelling venous cannulae is commonplace and of undoubted value. However, they are associated with complications, notably thrombophlebitis and infection. This study seeks to show that they may now have become overused and abused, especially in general wards. It is recommended that the indications for them be more critically examined, that they must be routinely heparinised and regularly inspected, and be removed without unnecessary delay. PMID- 3265803 TI - Illness behaviour in Sri Lanka: results of a survey in two Sinhalese communities. AB - Although cosmopolitan medicine plays an increasingly important role in developing countries, people still use indigenous medicines. A 1983 survey in two Sinhalese communities in Sri Lanka investigated the patients' use of cosmopolitan or traditional treatments for various illnesses. It appears that for acute complaints, or when a child seems seriously ill, people use cosmopolitan medicine. For common ailments which are known to be self-limiting, people use traditional home remedies and consult Ayurvedic practitioners. In chronic complaints some patients use cosmopolitan medicine, while others prefer the Ayurvedic system or use both kinds of medicine. For a 'snakebite' or a 'fracture' people prefer the local specialists and for mental illnesses they consult the adura and Buddhist clergy; as a last resort they turn to the cosmopolitan facility. Ayurvedic medicine does not play a role of any importance in the treatment of mental disease. The aduras in the rural areas and the Buddhist monks and priests in the more urban areas have a clear function in the management of mental disease. Institutionally trained Ayurvedic practitioners have a less clear function, since they often dispense cosmopolitan medicines. PMID- 3265804 TI - [Immunologic parameters in burns]. PMID- 3265805 TI - [Immunological aspects of hyperplastic processes, precancerous conditions and cancer of the endometrium during the post-menopausal period]. PMID- 3265806 TI - [Functional activity of neutrophils and lymphocytes in hypertension]. PMID- 3265807 TI - [Management of patients with unstable stenocardia in a cardiosurgical hospital]. PMID- 3265808 TI - [Complex therapy of suppurative wounds with jet-aerosol ultrasonic treatment and transcutaneous electro-neurostimulation]. PMID- 3265809 TI - Isoenzyme patterns of isolates of Trichomonas vaginalis from Vancouver. AB - Isoenzyme patterns of 63 isolates of Trichomonas vaginalis obtained in Vancouver were evaluated by use of thin-layer starch-gel electrophoresis. We attempted to use eight enzymes, but only four gave reproducible and interpretable results. There were four patterns with malic enzyme, two with malate dehydrogenase, one with hexokinase, and four with lactate dehydrogenase. The isoenzyme patterns of the 63 isolates were classified into 15 groups, but 49 (78%) fell into five groups and 14 (22%) fell into ten groups. There was no obvious correlation between groups and magnitude of symptoms and signs, past history of trichomoniasis, or likelihood of treatment failure. Results were consistent for isolates obtained from the same patient on different days. This system will allow differentiation of isolates into groups, a procedure that could be useful. However, groups do not appear to correlate with clinical or historical features or with outcome of treatment. PMID- 3265810 TI - [Difficulties in the immunologic and clinical control of nonspecific immunotherapy of bronchial asthma]. PMID- 3265811 TI - Serological survey of hepatitis B in northern Rwanda. AB - To assess the importance of perinatal transmission of hepatitis B virus and the risk of infection in different age groups in Northern Rwanda, filter paper dried blood samples from 350 subjects were examined for HBsAg and anti HBs. The study shows that vertical transmission is not very frequent in this area, and that the risk of infection increases with age. These results indicate that vaccination against hepatitis B in children could be delayed and included in the standard immunization programme. PMID- 3265813 TI - Occurrence of some blood and intestinal parasites in dogs in Curacao, Netherlands Antilles. AB - In August 1986, 133 dogs at the Veterinary Service of the Netherlands Antilles and the SPCA of Curacao were examined for microfilaremia and for evidence of gastrointestinal parasitism. Microfilariae of Dipetalonema reconditum were present in 27.8% of the dogs examined with no significant difference in the infection rate between domestic and feral dogs. Microfilariae of the canine heartworm Dirofilaria immitis were found in 9% of the dogs with a significantly higher rate of infection in domestic (pet) dogs (13.5%) than in feral dogs (3.4%). Of the intestinal parasites observed Ancylostoma sp. was present in the highest percentage of dogs (68.4%) followed by Toxocara sp. (7.5%). Other parasites were present in less than 5% of the dogs examined and included, in decreasing order of prevalence, Spirocerca sp., Giardia sp., coccidia, Taenia sp. and Trichuris sp. The present paper presents the first evidence of Di. reconditum on Curacao and suggests the introduction of D. immitis to the island within the 10 years preceeding this report. The persistently high rate of infection with Ancylostoma underscores the continuing risk of cutaneous larva migrans to human beings in the region. PMID- 3265812 TI - Seasonal variation in respiratory syncytial virus infections in children in Benin City, Nigeria. AB - The seasonal variation in respiratory syncytial virus (RSV) infections in children was examined in Benin City. Nasopharyngeal washes were obtained from children under 3 years hospitalised for acute lower respiratory infections during two seasons - rainy season (June-August) and dry season (December-February). RSV surface antigen was identified by ELISA. 54% of patients in the rainy season were ELISA positive for RSV compared to 8.8% during the dry season. Clinical features in the RSV infected patients were not different between the two seasons and were similar to that reported from temperate climates. It is concluded that RSV infections occur all year round with a peak during the rainy season. PMID- 3265814 TI - Intussusception in infancy and childhood. AB - Intussusception is the commonest cause of intestinal obstruction in childhood in Trinidad. A review of 94 consecutive cases seen at the General Hospital, Port-of Spain, over a 12-year period (1974-1985) indicates that there had been a very rapid increase in incidence of intussusception in the last 4 years. The majority were under 1 year of age (87%) and there was a predominance in the Negro child (62%). Male to female ratio was 1.2:1. A high misdiagnosis rate (55%) lead to inappropriate treatment and delay in surgical intervention. This resulted in a high case fatality (6.4%) and complication rate. In order to minimize morbidity and mortality from intussusception steps must be taken to ensure earlier diagnosis and treatment. PMID- 3265815 TI - Wilson's disease in the Arabian Peninsula. PMID- 3265816 TI - [Changes in the causes of blindness in recent time]. PMID- 3265817 TI - [Ultrastructural changes in the vestibular receptors of the labyrinth after exposure to acceleration]. PMID- 3265818 TI - [Evaluation of the Fitzgerald-Hallpike caloric test in patients with lesions of the cerebellar hemispheres]. PMID- 3265819 TI - [Evaluation of the efficacy of reflexotherapy of vestibular functional disorders]. PMID- 3265820 TI - [Prevention of hearing and vestibular disorders]. PMID- 3265821 TI - Two major subgroups of human T-cell leukemia virus-1 in Japan. AB - T lymphocytes of patients with human T-cell leukemia virus type 1 (HTLV-1) associated myelopathy (HAM) were cultured. After cultivating for several months, HAM-derived cell lines were tested for the presence of HTLV-1 proviral genome. We have found two major subgroups, the SacI type and the PstI type, of HTLV-1 by the restriction map analysis. They were almost equally distributed among HAM patients. We have also found two types of the provirus in DNA derived from fresh peripheral blood lymphocytes (PBL) or lymph node cells of adult T-cell leukemia/lymphoma (ATL) patients. The PstI type proviruses were predominant in ATL patients. It was concluded that two major subgroups of HTLV-1 exist in Japan and both types have an ability to cause either of two diseases, ATL or HAM. PMID- 3265822 TI - Intestinal parasites in southeast Asian refugees two years after immigration. AB - We collected stool specimens from 2,520 Southeast Asian refugees who had resided in the United States for an average of 2.1 years. More than half reported receiving prior treatment of parasites. At least one parasite was discovered in 32%, and multiple parasites were found in 8% of patients. Hookworm, Giardia, Strongyloides, and Hymenolepis nana were most commonly found. In comparison to studies done at the time of immigration, all parasites had decreased in frequency, but Giardia, hookworm, and H nana remain common. Although initial screening efforts may have failed to identify substantial numbers of infected refugees, poor compliance with treatment may also explain the persistence of intestinal parasites in our patients. The continued presence of Giardia and H nana, especially among children, may be explained by person-to-person transmission or autoinfection. PMID- 3265823 TI - Intraluminal thrombosis of coronary arteries in fatal myocardial infarctions and in failed aortocoronary saphenous vein grafts. AB - A review of autopsies of 648 patients who died of acute myocardial infarction showed the presence of intraluminal thrombi in 314 (48%). The left anterior descending coronary artery was principally involved in 172 cases, the left circumflex in 30, and the right coronary in 112. The length of survival after admission was identical for patients with thrombotic occlusion and those with atherosclerotic occlusion or severe stenosis: 28% of the former and 29% of the latter died during the first 24 hours after admission. The incidence of intraluminal thrombotic occlusion of surgically excised, failed aortocoronary vein grafts was 42 (66%) in 64 patients with nonfibrotic, patent grafts. Most of these vessels were severely atherosclerotic. The presence of intraluminal thrombi in about half of patients who died of acute myocardial infarction and in two thirds of excised, nonfibrotic, previously patent vein grafts indicates how many patients may benefit from thrombolytic therapy. PMID- 3265824 TI - Recent trends in lung and breast cancer mortality in California women. PMID- 3265825 TI - Serum lactic dehydrogenase predicts mortality in patients with AIDS and Pneumocystis pneumonia. AB - Serum lactic dehydrogenase (LDH) activity was compared with mortality in patients with the acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia during the first four days of admission to assess the test's predictive value. In 30 admissions, 29 patients who survived an episode of Pneumocystis pneumonia had a mean LDH value of 385 IU, with five values greater than 520 IU. Eight with pneumonia who died had a mean value of 926 IU: all had values higher than 520 IU. The mean LDH values for 20 patients with AIDS (35 admissions) who survived and 4 who died of non-Pneumocystis disease were 240 IU and 350 IU, respectively; these patients were the control population. The positive and negative predictive values for survival using 520 IU as the threshold are 61% and 100%. Thus, LDH measurements in the first days of admission for P carinii pneumonia predict mortality and are useful in guiding future management. PMID- 3265827 TI - [Health status and general performance]. PMID- 3265826 TI - [Correlation of air quality and biometeorologic effects and the incidence of acute respiratory diseases in the Magdeburg district]. PMID- 3265828 TI - [Stomatologic studies of Mozambique children. Dental status, caries, dysgnathias]. PMID- 3265829 TI - Further studies with the segmented filamentous intestinal bacteria of mice; effects of physical and chemical factors on survival and the effects of milk diet, para-aminobenzoic acid and mouse strain on colonization. PMID- 3265830 TI - [Epidemiologic study of changes in vaginal biozoonoses in patients of the Greifswald gynecologic university clinic in the last 25 years]. AB - During a period of 25 years vaginal smears of 96.022 patients of the Gynaecological Clinic of the E.-M.-Arndt-Universitat Greifswald were investigated bacterioscopically. As basis for the estimation of the vaginal biocoenosis and for the differentiation between eubiosis and dysbiosis as well as for its graduation (vaginal smear gradings) we used the Gram's staining technique. From 1962-1986 eubiosis increased from 18.8% to 37.9%, whereas the dysbiosis decreased from 81.2% to 62.1%. The reduction of the dysbiotic vaginal flora depends on the continuous decrease of the trichomoniasis from 27.2% to 3% caused by the consequent therapy with metronidazol including the sexual partner. Possibilities for a lowering of the therapy needing dysbiotic bacterial flora are discussed. PMID- 3265831 TI - Varicocele and puberty. A transversal and longitudinal survey. AB - The interest for varicocele in the determination of male infertility has increased during the last decades. Most researchers consider varicocele as the primary cause of male infertility, but recently another group of authors give it a secondary role in the alteration of spermatogenesis. We think that the major part of the controversy depends on an absence of a systematic approach to the problem. We give a primary importance to an accurate epidemiological evaluation which consists in a transversal and longitudinal survey of male subjects in puberal age. Our data show that left varicocele is practically inexsistent before the onset of puberty; the percentage incidence of this alteration increases progressively with puberal maturity and the tends to decrease slightly when maturity is complete. By correlating this pathology with puberty we can obtain more precise informations than when it is correlated to the regestrated age. The young patients who result suffering from varicocele, must be controlled carefully and periodically for the evaluation of the period and the opportunity of a therapeutic treatment. PMID- 3265832 TI - Carbon monoxide poisoning at a lowered myocardial adaptation capacity: animal ECG models. AB - Two animal models for testing foreign substances for the hypoxic type of cardiotoxicity proved to be valid and reproducible: i.e. decreased reserve capacity of the heart in rats recovered from the calciferol cardiopathy and increased heart work provoked by isoproterenol (5 mg/kg i.p.). In both cases obvious hypoxic ECG changes appeared at lower levels of exposure to carbon monoxide (500 ppm, 572 mg.m-3) and carboxyhemoglobin (18%), when compared with nonpretreated animals. The models have shown, that injured or overloaded heart displays a substantially increased sensitivity to CO poisoning. PMID- 3265833 TI - Alpha-naphthyl-acetate-esterase activity in cerebrospinal fluid cells. AB - Mono-histiocytes and T-lymphocytes were assessed by the cytochemical alpha naphthyl-acetate-esterase (ANAE) stain in 50 CSF samples of patients with various neurological diseases. The ANAE-activity of lymphocytes was decreased in multiple sclerosis and subacute sclerosing panencephalitis, while the activity of mono histiocytes was increased in the group of infarctions and bacterial and viral infections of the central nervous system. In bacterial meningitis and viral meningo-encephalo-radiculitis the number of ANAE-positive lymphocytes increased after treatment and clinical improvement. ANAE staining appears to be a useful additional tool in CSF cytology in these conditions. PMID- 3265835 TI - Pressure transmission properties from the externa ear canal to the inner ear. An experimental study using guinea pigs. AB - The inner ear pressure (PIE) in response to pressure changes in the external ear canal was measured in guinea pigs while alternatively opening and closing the perforation of the otic bulla. When the bulla was opened, only a transient degree of applied pressure was transmitted to the inner ear and the amplitude of the PIE was smaller than that of the corresponding PIE when the bulla was closed. This was because the applied pressure was exclusively transmitted to the inner ear via the ossicular chain. When the otic bulla was closed, the pressure was transmitted not only via the ossicular chain but also via the round window (RW) through the middle ear cavity. When the bulla was closed, the amplitude of PIE was larger by a positive pressure load than by the corresponding negative one. The amplitude of PIE showed a linear relationship to ear canal pressure of at least within the +/- 200 mmH2O range, as long as pressure was slowly applied to the ear canal. When the loading pressure was abruptly changed, a bouncing response, possibly reflecting elasticity of the RW, was evoked, which diminished or disappeared when the round window was artificially ruptured. PMID- 3265836 TI - The impact of mother's depression on her nursing experiences and attitudes during breastfeeding. AB - Mother's depression during postpartum is rather common and it has an impact on the mother-child relationship. As breast-feeding is an important situation for the early mother-child interaction, the impact of mother's depression on her breast-feeding and nursing attitudes and experiences was decided to be studied. In this pilot study 119 healthy primipara mothers filled in Beck's Depression Inventory, breast-feeding and childrearing attitude scales and other questionnaires. The prevalence of depression was 8%. The depressed mothers had more difficulties during breast-feeding than other mothers. The attitudes of the depressed mothers were more positive during pregnancy, but more negative during breast-feeding than those of the non-depressed mothers. The results might be clinically meaningful, although we need more detailed information about the correlations between depression and breast-feeding experiences. PMID- 3265834 TI - Growth effects of epidermal growth factor (EGF) and a monoclonal antibody against the EGF receptor on four glioma cell lines. AB - Epidermal growth factor (EGF) has been shown to stimulate DNA synthesis and cell division in normal glia. At least half of malignant human gliomas (MHG) express high levels of the EGF receptor (EGFR), which are above those detected in normal brain. The demonstration that antibodies against the EGFR inhibit the growth of squamous cell carcinoma line A-431, with large numbers of EGFR, in vitro and in vivo raises the possibility that these agents could be used therapeutically against malignant human gliomas either alone or conjugated to other agents. We have measured the growth effects of EGF and an anti-EGFR monoclonal antibody, 528 (Ab-528), on four well-characterized human malignant glioma cell lines, D-263 MG, D-247 MG, U-343 MGa Cl 2:6, and D-37 MG, with 2.9 x 10(4), 1.5 x 10(5), 8.6 x 10(5) and 1.59 x 10(6) EGFRs per cell, respectively. EGF significantly increased cell number in D-263 MG and D-37 MG by 65% and 74%, respectively, had no effect on D-247 MG, and significantly decreased cell number in U-343 MGa Cl 2:6 by 39%. U-343 MGa Cl 2:6 growth was inhibited 19% by Ab-528, but Ab-528 had no effect on growth of the other MHG lines. Ab-528 significantly inhibited all EGF-mediated growth effects. These studies demonstrate that, although Ab-528 alone has little antiproliferative activity on MHG, it successfully competes with EGF to reduce the biological effects of EGF-EGFR binding. Therefore, this antibody could potentially be used to target radioisotopes to MHG via the EGFR for diagnosis and therapy. PMID- 3265837 TI - The consequences of fibre heterogeneity on the force-velocity relation of skeletal muscle. AB - The consequences of fibre heterogeneity on the collective force-velocity properties of bundles of parallel fibres were examined in a simulation model. The model was tested by comparing the actual force-velocity curve of a bundle of three fibres, each of which had been individually characterized, with the force velocity curve predicted by the model for the bundle based on the individual fibre properties. The predicted and measured force-velocity curves were in excellent agreement. The curvature of the force-velocity relation for a muscle, as indicated by a/P0 in Hill's (1938) hyperbolic equation, increases with increasing heterogeneity in the maximum shortening velocities (Vmax(i] of the individual fibres in the muscle. In a muscle that is heterogeneous with respect to Vmax(i), the maximum shortening velocity determined by the slack test method (V0) can be expected to represent the fastest fibre(s) in the muscle. The maximum velocity of shortening (Vm), determined by extrapolation from a hyperbola that is fitted to force-velocity data at finite loads, is substantially lower than V0. The difference in estimates of V0 and Vm is a function of: (i) the degree of heterogeneity of the muscle with respect to Vmax(i) and the curvature of the force-velocity relationship of the individual fibres, and (ii) the force range used to establish the hyperbola from which Vm is derived. The ratio of Vm to V0 can be used as an index to estimate the degree of variability in the maximum velocity of shortening among individual fibres in a muscle. PMID- 3265838 TI - The calcitonin gene-related peptide (CGRP) response to intravenous calcium is related to blood pressure. PMID- 3265840 TI - Chronic nicotine treatment partly protects against the 1-methyl-4-phenyl-2,3,6 tetrahydropyridine-induced degeneration of nigrostriatal dopamine neurons in the black mouse. PMID- 3265839 TI - GM1 ganglioside protects against the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine induced degeneration of nigrostriatal dopamine neurons in the black mouse. PMID- 3265841 TI - Human granulopoiesis in vitro--medium-dependent growth regulation by a granulocyte-derived inhibitor. AB - A number of reports have indicated that mature blood granulocytes produce regulators that inhibit proliferation of progenitor cells in the bone marrow. However, this concept of negative feedback of granulopoiesis is still controversial. To examine whether conflicting results may depend upon the experimental set-up, we have compared colony formation by human bone marrow cells in different growth media. Unmodified McCoy's medium, which in feeder layer cultures supports the formation of large numbers of colonies, was a poor growth medium in cultures supplied with crude or recombinant colony stimulating factor (CSF). The colony formation improved when the medium was supplemented with defined additives. In CMRL 1066 cultures, granulocyte extract (GRE) consistently caused a strong inhibition of colony formation. In contrast, with unmodified McCoy's medium, granulocyte extract enhanced colony formation in a dose-dependent manner. The enhancing effect of granulocyte extract coincided with low colony numbers in the control cultures. The stimulatory effect of granulocyte extract in McCoy's medium, switched to strong inhibition when thymidine, a component of CMRL 1066 medium, was added. The inhibitory and stimulatory activities were found in the same molecular weight fractions (30-60 kD) after gel filtration. Both modulators in granulocyte extract appeared to be independent of monocytes and T lymphocytes in the bone marrow, as shown by removal of these cells with magnetic microspheres coated with specific monoclonal antibodies. The present work shows that regulation of cell proliferation in vitro depends strongly on culture conditions, such as choice of medium. It appears that thymidine acts as co-factor for the inhibitor in granulocyte extract. PMID- 3265842 TI - The analgesic effect of peripheral nerve stimulation in various tests of nociception in rats. AB - The present study examines analgesic properties of 2 Hz peripheral nerve stimulation in four different tests of nociception: the tail-flick, hot-plate, jump-response and formalin tests. Radial, sciatic and trigeminal nerve stimulation produced decreased response amplitudes to weak electrical foot shocks in the jump-response test. The fact that all three nerves produced the same effect suggests the involvement of general, non-segmental mechanisms. The nerve stimulation produced a characteristic after-effect, lasting several minutes, suggesting the involvement of supraspinal mechanisms. The radial nerve stimulation resulted in the most pronounced reduction in jump responses. Sciatic nerve stimulation also produced analgesia in the formalin test but had no effect on the responsiveness to a brief stimulus at threshold level in the hot-plate or the tail-flick tests. It is concluded that analgesia by peripheral nerve stimulation in animals is most readily detected by tests allowing a quantitative evaluation of responses to above-threshold noxious stimuli and not only measuring reactions occurring at the threshold for nociception. PMID- 3265843 TI - Prevalence of depression in an elderly population in Finland. AB - The prevalence of depression by sex, age and certain sociodemographic variables was investigated in a sample of elderly Finns (60 years or over) living in the semi-industrialized municipality of Ahtari (n = 1529). The study was carried out in two phases. In the first phase, depressive symptoms were screened with the Zung Self-rating Depression Scale (ZSDS). In the second phase, persons scoring greater than or equal to 40 points in the ZSDS and a random sample of persons scoring less than 40 ZSDS points were examined by a general practitioner. The prevalence of depression was determined on the basis of DSM-III criteria. The estimated prevalence for men was 22.4%, and for women 29.7%. The estimated prevalence for different categories of depression was as follows: dysthymic disorder, men 17.2% and women 22.9%; major depression, men 2.6% and women 4.5%; atypical depression, men 2.2% and women 2.5%; and cyclothymic disorder, men 0.4% and women 0%. No cases of bipolar disorder were found. A high risk of depression was associated with female sex, widowhood and being in long-term institutional care or receiving home nursing and/or home help. The occurrence of depression was not related to age, education or occupation. PMID- 3265844 TI - Correlates of alcohol-related casualty in Kuwait. AB - This paper reports the extent to which alcohol consumption is associated with casualties in a country in which alcohol is prohibited religiously and culturally. Selective screening of particular casualty groups by blood test established qualitative evidence of alcohol use in 107 out of 1058 patients (10%) examined at a general hospital and a traumatology hospital in Kuwait. The rate of alcohol-associated casualty was significantly higher in traumatology hospital patients (15%) than in general hospital (7%), stressing the association between alcohol and trauma. Absence of differences by place of casualty disproves lay beliefs that motor vehicle casualty is the major alcohol-associated risk in Kuwait. Other casualties, particularly work and domestic injuries, should be regarded as being affected by alcohol consumption. Statistically significant high alcohol-associated casualty rates characterized Kuwaitis (14%), the unemployed/retired (20%) and coma cases (22%) suggesting that these categories may suffer from serious alcohol problems. PMID- 3265845 TI - Projected increases in the number of dementia cases for 29 developed countries: application of a new method for making projections. AB - A method is described for making projections of increases in dementia cases over a given base year. The method is based on a statistical model relating dementia prevalence to age that is derived from the results of all published prevalence studies. This method was applied to United Nations population projections for 29 developed countries to arrive at expected increases in number of dementia cases in each country for the period 1980 to 2025. PMID- 3265846 TI - The prevalence of transsexualism in Singapore. AB - The prevalence of transsexualism in Singapore was estimated by counting all the patients who sought sex-reassignment surgery and were subsequently diagnosed as transsexuals by psychiatrists. Up to 1986, there were a total of 458 Singapore born transsexuals, of which 343 were males and 115 were females. This was a prevalence of 35.2 per 100,000 population age 15 and above (or 1/2900) for male transsexualism, and 12.0 per 100,000 (or 1/8300) for female transsexualism. The sex ratio was about 3 males to 1 female. The main reason for the high prevalence was the availability of sex-reassignment surgery. PMID- 3265848 TI - Behavioural disorders in children from different cultures. AB - Behaviour disorders in children of different ages have been studied in three different countries, Sweden, Sudan and Nigeria. In each country both urban and rural areas were included. The same methods and procedures were applied. The similarities of frequencies of behaviourally disturbed children were more striking than the differences. Rural children generally had less behaviour problems than urban ones. The frequencies of various stress factors known to co vary with behaviour problems in children in the different localities could not alone explain the results. Specific stress-reducing, supportive factors in the cultures of the two African areas were discussed. PMID- 3265847 TI - Distribution of major mental disorders in an US metropolis. AB - This paper reviews the evolution of psychiatric nosologies in North America and the major epidemiological surveys of Mental Disorders culminating with the recently completed National Institute of Mental Health Epidemiologic Catchment Area project (NIMH-ECA). The NIMH-ECA examined the prevalence of diagnosable (DSM III) Mental disorders in 5 U.S. communities utilizing a highly structured diagnostic interview, the Diagnostic Interview Schedule (DIS). Data from the Los Angeles ECA, one of five study sites are presented with particular emphasis on cross-cultural comparison (Mexican Americans versus Non Hispanic Whites). Overall, there were only a few cross-cultural differences in prevalence of specific diagnoses. Mexico-born Mexican Americans showed a lower prevalence for most disorders examined than their U.S. born counterparts, and a subgroup of Mexican-American women (those over the age of 40) showed higher rates of phobic and dysthymic disorders as well as a greater number of functional somatic symptoms than other groups. PMID- 3265850 TI - Neuropathological lesions after microinfusion of paraquat and MPP+ into different areas of the rat brain. PMID- 3265849 TI - Psychiatric admissions of the elderly. AB - In 1955 Ole J. Rafaelsen performed an analysis of the admissions of elderly patients to the Aarhus Psychiatric Hospital during the preceding decade. On the basis of nation-wide statistics the changing role since then of the elderly in the Danish psychiatric hospital system is described. PMID- 3265852 TI - [Light and electron microscopic study of gelatinous drop-like corneal dystrophy with deeper stromal involvement]. PMID- 3265853 TI - [Pseudomonas endophthalmitis in rabbits--intravitreal inoculation of two pseudomonal strains]. PMID- 3265851 TI - Preclinical and clinical evidence for the involvement of corticotropin-releasing factor in the pathogenesis of depression. PMID- 3265854 TI - [Choroidal circulation in experimental autoimmune uveoretinitis II. Choroidal blood flow in experimental autoimmune uveoretinitis induced by interphotoreceptor retinoid-binding protein]. PMID- 3265855 TI - Action of 2'-deoxycoformycin on mitogen-induced lymphoproliferation in the neonatal period. AB - The effect of 2'deoxycoformycin (dCF), a potent inhibitor of adenosine deaminase (ADA), on the proliferation of mononuclear cells from cord blood and from healthy controls as a response to the two mitogenic agents PHA and ConA was studied. The addition of dCF simultaneously with the mitogen did not modify cell proliferation either in neonates or in controls. Added 20 min before the mitogens, dCF induced in adults lymphocytes a significant inhibition in the response to PHA (68.11 +/- 10.40% of response in control cultures) and to ConA (58.78 +/- 26.23%). By contrast, in the neonatal period it induced a stimulatory effect on this response, both when PHA (117.64 +/- 26.48% of basal response) and ConA (108.18 +/ 21.72%) were employed. The possibility is discussed that this different function in lymphocyte behaviour in the newborn might contribute to the immunologic abnormality which children affected with ADA deficiency may exhibit at this age and also to the delay in the onset of clinical manifestations of immunodeficiency due to the defect in this enzyme. PMID- 3265856 TI - Determination of cell membrane bound IgE in allergic patients and healthy controls. A new technology. AB - Cell membrane bound IgE was determined in 44 allergic patients and 34 healthy controls with a radiobinding technique using I-125 labeled anti-IgE as a marker. The technique possesses an intraassay variability of 10% and an interassay variability of 20%. Owing to the possibility that anti-IgE may bind to the cell membrane via the Fc receptor, IgE was detached from the membrane by gradually reducing pH to 4 and quantitating bound anti-IgE. This procedure led to an 83 +/- 14.23% drop in I-125 anti-IgE uptake. However, other cell markers tested (OKT-3, OKT-4, IgG) as well as cell viability remained unchanged, thus demonstrating the high degree of specific labeled anti-IgE uptake by IgE molecules on the cell membrane. The results presented to date support the usefulness of the technique described. Hence, bound IgE was determined in allergic subjects and controls, and correlated to the free serum levels of IgE. The results show that greater quantities of IgE are found on the cell membranes of allergic patients in comparison to the control population. In 81% of the former, uptake surpassed 3% of the total amount of isotope added, whereas 85% of the control subjects showed less than 3% uptake. No statistically significant correlation was obtained between serum IgE (UI/ml) and bound IgE levels in allergic subjects. Double immunofluorescence assays demonstrated the presence of cells with surface-bound IgE (s IgE +) which also expressed HLA class II (DR) molecules. Protein synthesis blocking studies showed IgE on the cell membrane to have a predominantly carrier role. PMID- 3265857 TI - Effect of exposure to ethylene glycol ethers on shipyard painters: III. Hematologic effects. AB - Hemoglobin, hematocrit, red cell indices, total and differential white blood cell counts, and platelet count were measured in shipyard painters and control subjects as part of a cross-sectional, observational study of the effects of ethylene glycol ethers. Although the means of all variables were comparable between the groups, a significant proportion of painters were anemic (10%) and granulocytopenic (5%); none of the controls were affected. Review of company records documented that most of these abnormalities were acquired during employment; preexisting disease and other exposure could not explain the findings. These findings are consistent with prior animal studies and human case reports. Potential biases and confounding of the data are discussed. PMID- 3265858 TI - Psychiatric disorders in adopted children: a controlled study. AB - The number of adopted children referred to a Canadian psychiatric service was found to be greater than warranted by their ratio in the community. They presented more with conduct disorders and less with anxiety disorders and were significantly more impaired than the controls. PMID- 3265859 TI - Experimental induction of middle ear cholesteatoma in rats. AB - We induced cholesteatoma in two groups of rats by instilling different concentrations of propylene glycol into the middle ear cavity. Fifteen rats were exposed to 50% propylene glycol (group I), while pure propylene glycol was applied to six others (group II). The group I rats were killed 1 month after instillation. Seven of the 15 showed cholesteatoma in the middle ear with accumulation of keratin debris. The group II rats were killed 3 months after instillation. All six animals showed inflammation in the experimental ears, and five of the six experimental ears showed cholesteatoma in the middle ear cavity. Six experimental ears in group I and five in group II revealed retraction of the tympanic membrane, possibly due to eustachian tube obstruction. Bone resorption was seen along with cholesteatoma and inflammatory cells and osteoclasts in the middle ear of all 11 of these rats. The seventh cholesteatoma of group I can be classified as a microcholesteatoma, a pearl-like cyst within the tympanic membrane. The microcholesteatoma was formed by an invasion of basal cells from the tympanic epidermis and the proliferation of these cells in the fibrous layer of the tympanic membrane. Our findings suggest that cholesteatoma in the middle ear cavity is a response to the inflammation produced by high concentrations of propyleme glycol. PMID- 3265860 TI - An inner ear anomaly in golden hamsters. AB - A new mutation of the inner ear was discovered in golden hamsters raised in our laboratories. Although scanning electron microscopy showed a normal arrangement of individual stereocilia on the first row of outer hair cells, the entire bundle of stereocilia were irregular in orientation and scattered in several directions. Seventy per cent to 85% of the stereociliary bundles were found to be abnormal throughout the cochlea, with no apparent difference between the right and left sides. Transmission electron microscopy showed that the cuticles of the first row of the outer hair cells were dislocated, but no dislocation due to this mutation was apparent in the lower portions. This mutation of the inner ear was already present in the basal turn four days after birth. The kinocilium was located outside of the stereocilia in the first row of outer hair cells, but sensory hairs were scattered in every direction, as in the adult animals. A comparison of auditory brainstem response tests revealed no difference between the abnormal and normal hamsters. PMID- 3265861 TI - Nuclear contour irregularity correlates with Leu-9-, Leu-8- cells in benign lymphoid infiltrates of skin. An ultrastructural morphometric and quantitative immunophenotypic analysis suggesting the normal T-cell counterpart to the malignant mycosis fungoides/Sezary cell. AB - The purpose of the present study was to determine if a nonmalignant skin associated T-cell might exhibit nuclear irregularity and represent the normal counterpart to the malignant Sezary T-cell found in mycosis fungoides (MF) and the Sezary syndrome (SS). Punch skin biopsies from ten benign lymphoid infiltrates of skin were subjected to ultrastructural morphometric analysis and quantitative immunohistochemistry (on serial frozen sections) using a battery of monoclonal antibodies. Form factor (FF) (4 pi A/p2) was used to assess nuclear contour irregularity. The lymphoid infiltrates were morphometrically heterogeneous (range of FF values: 0.482-0.704). Immunophenotypically, there was marked variation in host response to the variety of antigens presented. Linear regression analysis was used to determine if nuclear contour irregularity showed any statistical relationship to immunophenotypically defined lymphocyte subpopulations. It was determined that nuclear contour irregularity (mean FF values) did not correlate with the presence of any surface antigen tested. This included the antigens Leu-2a, Leu-3a + b, Leu-4, Leu-6, Leu-7, Leu-8, Leu-9, Leu 14, and Ia. There was, however, significant correlation of increased nuclear contour irregularity with the presence of Leu-9- and Leu-8- cells (r = 0.7 and 0.6, respectively), lymphocyte subsets reportedly deficient in MF and the SS. This finding leads to the speculation that the Leu-9-, Leu-8- reactive T-cell with an irregular nucleus might represent the normal counterpart to the malignant clonally expanded T-cell found in MF and the SS. It was also determined that helper to suppressor ratios varied 68-fold from 0.2 to 13.5 among these ten benign lymphoid infiltrates of skin. This finding underscores the futility of using helper to suppressor ratios as a diagnostic tool in defining T-cell malignancies. PMID- 3265862 TI - Cerebral hypometabolism in progressive supranuclear palsy studied with positron emission tomography. AB - Progressive supranuclear palsy (PSP) is characterized by supranuclear palsy of gaze, axial dystonia, bradykinesia, rigidity, and a progressive dementia. Pathological changes in this disorder are generally restricted to subcortical structures, yet the type and range of cognitive deficits suggest the involvement of many cerebral regions. We examined the extent of functional impairment to cerebral cortical and subcortical structures as measured by the level of glucose metabolic activity at rest. Fourteen patients with PSP were compared to 21 normal volunteers of similar age using 18F-2-fluoro-2-deoxy-D-glucose and positron emission tomography. Glucose metabolism was reduced in the caudate nucleus, putamen, thalamus, pons, and cerebral cortex, but not in the cerebellum in the patients with PSP as compared to the normal subjects. Analysis of individual brain regions revealed significant declines in cerebral glucose utilization in most regions throughout the cerebral cortex, particularly those in the superior half of the frontal lobe. Declines in the most affected regions of cerebral cortex were greater than those in any single subcortical structure. Although using conventional neuropathological techniques the cerebral cortex appears to be unaffected in PSP, significant and pervasive functional impairments in both cortical and subcortical structures are present. These observations help to account for the constellation of cognitive symptoms in individual patients with PSP and the difficulty encountered in identifying a characteristic psychometric profile for this group of patients. PMID- 3265863 TI - Motor dysfunction in olivopontocerebellar atrophy is related to cerebral metabolic rate studied with positron emission tomography. AB - We compared the severity of motor dysfunction with local cerebral metabolic rates for glucose (lCMRGlc) and the degree of tissue atrophy in 30 patients with olivopontocerebellar atrophy (OPCA). We devised a scale to quantitate the degree of ataxia in the neurological examinations. lCMRGlc was measured with 18F-2 fluoro-2-deoxy-D-glucose and positron emission tomography (PET). Tissue atrophy was assessed by visual rating of computed tomographic scans. PET studies revealed marked hypometabolism in the cerebellar vermis, cerebellar hemispheres, and brainstem of OPCA patients compared with 30 control subjects. A significant correlation was found between severity of motor impairment and lCMRGlc within the cerebellar vermis, both cerebellar hemispheres, and the brainstem. A significant but weaker relationship was noted between the degree of tissue atrophy in these regions and clinical severity. Partial correlation analysis revealed that motor dysfunction in OPCA correlated more strongly with lCMRGlc than with the amount of tissue atrophy. These results suggest that the clinical manifestations of OPCA are more closely related to the metabolic state of the tissue than to the structural changes in the cerebellum. PMID- 3265864 TI - Successful treatment of cherry red spot-myoclonus syndrome with 5 hydroxytryptophan. AB - A 14-year-old Saudi boy with cherry red spot-myoclonus syndrome and documented neuraminidase deficiency responded well to titrated doses of 5-hydroxytryptophan as an add-on treatment. PMID- 3265865 TI - [Immunotropic properties of lipopolysaccharides of gram-negative bacteria]. PMID- 3265866 TI - Presynaptic actions of beta-carboline on the spinal cord. PMID- 3265867 TI - [Anti-IgE autoantibody in patients with parasite infection]. PMID- 3265868 TI - [Various killer activities in pregnant women and the effects of sera and several hormones]. PMID- 3265869 TI - The changing pattern of severe neonatal staphylococcal infection: a 10-year study. AB - Forty-two cases of severe staphylococcal infection occurring over a 10-year period in the neonatal unit at Queen Mary Hospital are described. There was a 4.5 fold increase in incidence in the latter half of the study period, when methicillin-resistant Staphylococcus aureus (MRSA) emerged. The isolated MRSA were also resistant to gentamicin, but sensitive to vancomycin, fusidic acid, co trimoxazole and amikacin. Comparison between MRSA and methicillin-sensitive cases showed that the former was associated with a longer hospital stay after diagnosis. Overall mortality was 9.5%. Two cases with meningitis died. MRSA is at least as virulent as its methicillin-sensitive counterparts. The treatment implications of severe neonatal staphylococcal infection are discussed. PMID- 3265870 TI - Diagnosis of 21-hydroxylase deficiency in newborn infants by GC-MS of urinary steroids. AB - In a study using gas chromatography-mass spectrometry (GC-MS) on urine specimens from 16 normal infants and 16 infants with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (aged 1 day to 4 weeks), the major steroids recognized in all infants were: 16 alpha-hydroxy-dehydroepiandrosterone, 16 beta hydroxy-dehydroepiandrosterone, 16-oxo-androstenediol, androstenetriol, 15 beta,17 alpha-dihydroxy-pregnenolone and 16 alpha-hydroxy-pregnenolone. Pregnanetriol was detectable in three normal infants (aged 3, 6 and 15 days) but the levels seen in 15 CAH patients were in a higher range. Pregnanetriolone, 5 beta-17-hydroxy-pregnanolone and 15 beta,17 alpha-dihydroxy-pregnanolone were present in the urine of 15 CAH patients, but were not detectable in any of the normal infants. The older the patient, the higher the level was of each of these four steroids. The results indicate that, even on day 1, patients with CAH due to 21-hydroxylase deficiency may be positively identified using GC-MS of urine specimens. This does not preclude the possibility that a minority of patients with CAH, most likely those with mild 21-hydroxylase deficiency, may not exhibit the characteristic GC-MS findings on day 1, as seen in one of the 16 CAH patients. PMID- 3265871 TI - A new technique for closure of the uterus at caesarean section. AB - A new method of closure of the uterus at Caesarean section is described. The technique which comprised suturing the uterine incision in a single layer was employed in 100 patients, in all of whom there was also a valid indication for sterilization. Apart from being simple, safe and effective the main advantage of the technique appeared to be saving operating time. A noteworthy feature was that the incidence of postoperative complications was no higher compared with the standard 3-layer suture of the uterus. PMID- 3265872 TI - [Detection of interleukin 1 activity in synovial fluid in rheumatoid arthritis and osteoarthritis]. PMID- 3265873 TI - [HLA-B27 as a genetic marker of extra-articular manifestations of ankylosing spondylitis]. PMID- 3265874 TI - Effects of fluoxetine on the intragastric self-administration of ethanol in the alcohol preferring P line of rats. AB - Rats of the alcohol-preferring P line (n = 7) were trained to self-administer ethanol (20% v/v) and water via an intragastric IG catheter. Food was available ad lib. Ethanol intakes averaged approximately 5-6 g/kg body wt./day. Treatment with the serotonin (5-HT) uptake inhibitor fluoxetine (10 mg/kg/day; IG) for seven consecutive days produced a marked decrease in ethanol self-administration on the first day, which was sustained throughout the seven days of treatment to values as low as 1 g/kg/day. Concomitant with the decrease in ethanol intake, the self-infusion of water gradually increased during the period of fluoxetine treatment. Total caloric intake (ethanol plus food) was moderately reduced during fluoxetine treatment; the decrease in food consumption was consistent but not statistically significant. When fluoxetine treatment was terminated, ethanol self administration quickly returned to the prefluoxetine levels, while water intake began to decrease. Since no ethanol was consumed orally, the IG ethanol was not self-administered for its taste or smell, but apparently for its postingestive pharmacological effects. The robust reduction of ethanol self-infusion that occurred with fluoxetine treatment suggests that the 5-HT systems are involved in the reinforcing effects of ethanol in the P line of rats. PMID- 3265875 TI - The assessment of alpha 1 proteinase inhibitor form and function in lung lavage fluid from healthy subjects. AB - The form and function of alpha 1 proteinase inhibitor in lung lavage fluid from healthy smoking and non smoking individuals has been accurately assessed using critically appraised techniques. The present study demonstrated that it is possible to accurately assess alpha 1 PI function in unconcentrated lavage fluid but that sample collection, storage and subsequent processing may all affect the results. Absolute levels of alpha 1 PI were elevated in subjects who smoke and a substantial quantity of inactive protein was found in both smokers and non smokers. The proportion of inactive alpha 1 PI was similar for both groups, which by inference implies that normal smoking subjects do not have decreased protection by this inhibitor at the bronchoalveolar level. Physicochemical analysis of the alpha 1 PI in these normal subjects showed that it was different from alpha 1 PI previously reported from patients with established disease and this may have important implications regarding the pathogenesis of their condition. Western immunoblotting of bronchoalveolar lavage fluid (BALF) showed that all of the alpha 1 PI was present in the native molecular mass form (54,000 Da). Pre-incubation of samples with methionine sulphoxide peptide reductase restored alpha 1 PI function only by approximately 10% suggesting the presence of little reversibly oxidised alpha 1 PI in either group. Anion exchange HPLC of BALF revealed the presence of two alpha 1 PI species, one of which co-eluted with native, oxidised or proteolyzed forms and the other which was more cationic and did not inhibit porcine pancreatic elastase. Finally, thirteen out of sixteen BALF samples inhibited more neutrophil elastase than could be accounted for by the amounts of functional alpha 1 PI present, suggesting that the presence of other inhibitors is a feature of normal lavage fluids. PMID- 3265877 TI - Synergistic interaction between interleukin-6 and interleukin-3 in support of stem cell proliferation in culture. AB - Interleukin-6 (Il-6), also known as B cell stimulatory factor 2/interferon beta 2, has been found to support colony formation by murine granulocyte-macrophage progenitors. We have reported that Il-6 also acts synergistically with interleukin-3 (Il-3) in the support of the proliferation of multipotential stem cells in the quiescent, Go phase of the cell cycle. Our serial observations (mapping studies) of the development of blast cell colonies from spleen cells harvested from mice 4 days after the injection of 150 mg/kg 5-fluorouracil revealed that the blast cell colonies appeared earlier in culture in the presence of Il-6 and Il-3 than with either factor alone. Because the combination of factors did not alter the rate of growth of the colony, this effect must result from an early exit from Go. In the human system using purified, My-10+ bone marrow progenitors in a culture system with delayed addition of growth factors, the combination of Il-6 and Il-3 yielded twice as many colonies as did Il-3 alone. The human blast cell colonies also appeared at earlier times when grown in the presence of Il-6 and Il-3 as compared to either factor alone. These results suggested that human Il-6 acts synergistically with Il-3 in the support of the proliferation of human and murine hemopoietic stem cells in Go and that part of the effect appears to be a shortening of the Go residence time of the hemopoietic stem cells. PMID- 3265876 TI - Drug distribution in dog brain studied by positron emission tomography. AB - We used positron emission tomography to monitor the distribution of radioactivity in dog brain and muscle following i.v. administration of 11C-labelled antipyrine, imipramine, and quinidine. Twenty-five sequential scans of a transaxial slice of the head were performed within 90 min; radioactivity in plasma was measured in a gamma-counter. Following i.v. injection of [11C]antipyrine (50 mg kg-1; 9-68 mCi; n = 10), the decay of plasma activity was accompanied by rapid uptake in brain and variable uptake in muscle, immediately followed by a redistribution leading to equalization of the radioactivity in the tissues. Administration of [11C]imipramine (4 mg kg-1; 30-110 mCi; n = 8) was followed by a rapid build-up of a sustained gradient between high brain, and low plasma and muscle radioactivity. After i.v. injection of [11C]quinidine (1 mg kg-1; 11-87 mCi; n = 10), radioactivity in brain was low, with higher activity in plasma and muscle throughout the experiment. Positron emission tomography thus revealed for each drug a distinct pattern of distribution consistent with established properties of the compounds. This technique seems promising for the study of early drug distribution, notwithstanding certain limitations. PMID- 3265878 TI - Inhibition of hemopoiesis in murine marrow cell cultures by recombinant murine tumor necrosis factor alpha: evidence for long-term effects on stromal cells. AB - The addition of recombinant murine tumor necrosis factor alpha (rmTNF-alpha) to serum-free methylcellulose cultures inhibited macrophage colony formation stimulated by purified colony stimulating factor-1 (CSF-1), recombinant granulocyte-macrophage-CSF (rmGM-CSF), and recombinant interleukin 3 (rmIl-3). The concentration of rmTNF-alpha inhibiting colony formation by 50% (IC50) was between 2 and 20 ng/ml. Erythroid colony formation in cultures with erythropoietin (EPO) alone or EPO, rmIl-3, and rmGM-CSF in combination were reduced to a much lesser extent. In established long-term marrow cultures (LTMC), addition of 20 and 200 ng/ml of rmTNF-alpha resulted in release of cells from the adherent layer during the first week. Treatment of cultures with rmTNF-alpha for 4 consecutive weeks led to prolonged inhibition of cell production lasting up to 8 weeks after cessation of treatment. One day after addition of a low dose of TNF (2 ng/ml), "fat" cells were no longer observed in the adherent layer. Our results indicate that TNF inhibition of hemopoiesis occurs both at the progenitor cell and stromal cell levels. PMID- 3265879 TI - Regulation of gene expression of M-, G-, GM-, and multi-CSF in normal and malignant hematopoietic cells. AB - Colony stimulating factors (CSFs) are produced by a variety of cell types, including T-lymphocytes (T cells) and mononuclear phagocytes; both cell types are known to cooperatively interact to elaborate CSFs, although the specific cellular source of CSF species and mechanisms of intercellular communications in this regard are poorly understood. In this report, we investigate the specific origin of various CSF species in peripheral blood mononuclear cells (PBMC), purified T lymphocyte and monocyte (Mo) populations. Furthermore, we assess the conditions required for stimulation of purified cell cultures to express CSF messenger RNAs (mRNAs) and proteins. In the absence of exogenous activation stimuli, human PBMC, T cells and Mo failed to produce transcripts for CSF for macrophages (M-CSF or CSF-1), for granulocytes (G-CSF), for granulocytes/macrophages (GM-CSF), and for multilineage CSF (multi-CSF or Il-3). However, after stimulation with phorbol myristate acetate (PMA) and phytohemagglutinin (PHA), mRNAs for M-, G-, GM-CSF, and multi-CSF became detectable in PBMC as early as 6 hours after initiation of cultures. Identical culture conditions resulted in synthesis of G-, and M-CSF mRNA by Mo, whereas T-lymphocytes produced GM-CSF and multi-CSF mRNA. More physiologically, when Mo were activated with interferon (IFN)-gamma or tumor necrosis factor-alpha (TNF-alpha) and T-lymphocytes were stimulated in an Mo independent pathway, that is via triggering of the 50 kd sheep erythrocyte receptor protein employing monoclonal antibodies (mo ab) to the Tll-2- and Tll-3- defined epitopes, similar kinetics of mRNA expression were obtained. Similarly, when interleukin-1 (Il-1) receptive T cells were stimulated with Il-1, T cells transcribed functionally active GM-CSF and multi-CSF. Maximum peak activity of GM , G-, and M-CSF protein secretion was identical for all CSF species investigated, and occurred in culture 48-72 hours after specific induction. Constitutive expression of CSFs not found in unactivated normal hematopoietic cells was, however, frequently observed in blast cell populations of patients with acute myeloblastic leukemia. Of 49 AML samples, 15 revealed G-CSF transcripts; 11, GM CSF mRNA; and 6 samples synthesized M-CSF mRNA. Employing specific bioassays, 12 of 15 G-CSF-mRNA-producing cell populations, 8 of 11 GM-CSF-mRNA-producing cell populations, and 1 of 6 M-CSF-mRNA-synthesizing samples, demonstrated release of the respective functionally active CSFs into their culture supernatants.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3265880 TI - T cells and myeloid progenitors in patients with severe aplastic anemia (SAA). AB - This report summarizes some of our past and present studies on T cells and hemopoietic progenitors obtained from patients with severe aplastic anemia (SAA). Two main issues are discussed: enhancement of colony growth by manipulation of accessory cells, or by the addition of patients' plasma, and the role of suppressor T cells in the pathogenesis of the disease and response to antilymphocyte globulin (ALG). A complex network of interactions exists. The identification of cells and soluble factors capable of enhancing or suppressing colony formation promises to help us better understand the events leading first to the development of aplasia and then eventually to hematologic recovery. PMID- 3265881 TI - Obstetric practice in St Kitts and the Homerton Hospital, London. AB - Corinne Hayes and Karen Walker won 1000 pounds in last year's Student Elective Award competition for the protocol of their project. Here, they give an account of their work, the aims of which were to compare the incidence of low birthweight (less than 2.5 kg) and very low birthweight (less than 1.5 kg) babies in the UK and the Caribbean, to assess the outcome of these babies and to compare obstetric practice and the incidence of risk factors for low birthweight in the two populations. PMID- 3265884 TI - Acetaminophen (paracetamol) in the management of burned children with fever. AB - Acetaminophen (paracetamol 12 mg/kg p.o.) was administered on a total of 33 occasions to 12 children (13-36 months of age) during the first 60 h after burn injury covering 10-44 per cent of the body surface area (BSA). The drug was effective in lowering rectal temperature on most (80 per cent) occasions; failure to elicit a response was not restricted to particular patients or patterns of injury. There was no evidence of tachyphylaxis to the antipyretic effects of acetaminophen. The pattern of change in the rectal and toe temperature after acetaminophen suggested that it may be acting by either increasing heat loss or by lowering heat production, both of which are consistent with a reduction in thermoregulatory setpoint mediated by inhibition of prostaglandin synthetase. PMID- 3265883 TI - Cognitions and perceptions of health and exercise. AB - The impact of exercise on health is potentially significant yet relatively few people exercise. The paper reports two exploratory, community-based, cross sectional retrospective surveys which investigated the cognitions of aerobic exercisers and non-exercisers. Specifically, an analysis was undertaken of differences between exercisers and non-exercisers, between males and females, and between those under 40 and those over 40 years of age on health beliefs, exercise cognitions, knowledge and attributions. Results from Study 1 (N = 433) showed clear differences between exercise, age and gender groups on health beliefs, knowledge and attributions with exercisers having a more positive cognitive profile. Non-exercisers, contrary to the Health Belief Model, were characterised by perceptions of vulnerability to general and cardiac ill-health. Study 2 (N = 468) supported these results and also showed that older people had more negative beliefs and worries about exercise than younger people. Discussion of the results centres on the need for further research on the causality and prediction of exercise and other health-related behaviours from cognitive factors. PMID- 3265882 TI - An in vitro model of 1-methyl-4-phenyl-pyridinium (MPP+) toxicity: incubation of rabbit caudate nucleus slices with MPP+ followed by biochemical and functional analysis. AB - 1. Slices of rabbit caudate nucleus were preincubated for up to 24 h in vitro in the presence of the neurotoxic compound 1-methyl-4-phenyl-pyridinium (MPP+). Subsequently the levels of endogenous monoamines in the slices were determined by h.p.l.c. with electrochemical detection. MPP+, in concentrations higher than 32 nM significantly diminished the dopamine levels within the slices in a concentration- and time-dependent manner; at 32 microM the depletion was more than 95%. The concentration of the major metabolite of dopamine, dihydroxyphenyl acetic acid (DOPAC) was decreased at concentrations of MPP+ that did not alter dopamine levels. Thus, MPP+ increased the dopamine/DOPAC ratio. 2. In contrast, both 5-hydroxytryptamine (5-HT) levels and 5-HT/5-hydroxyindolacetic acid (5 HIAA) ratios were increased at nanomolar concentrations of MPP+. 5-HT was significantly reduced only at 32 microM. 3. The dopamine uptake inhibitor nomifensine reduced the depletory effect of MPP+ on dopamine and DOPAC content. 4. Following 24 h pretreatment with MPP+, the uptake of [3H]-dopamine into rabbit caudate nucleus slices was either enhanced (at 0.32 microM, 1 microM and 3.2 microM MPP+) or reduced (at 32 microM MPP+). 5. Preincubation of slices with 10 microM MPP+ for only 1 h increased their 3H-labelling (in contrast to 24 h pretreatment) whereas after 9 h no net increase was detectable. After 1 and 9 h MPP+ pretreatment, much less deaminated metabolites of [3H]-dopamine were found in the incubation medium of MPP+ treated slices than in the medium of control slices. These findings suggest that MPP+ strongly inhibits the enzyme monoamine oxidase (MAO) within dopaminergic (and 5-hydroxytryptaminergic) terminals before destroying them. 6. To validate the proposed in vitro model functionally, the electrically evoked release of [3H]-acetylcholine ([3H]-ACh) was investigated in MPP+ treated slices and controls. MPP+ reduced both the facilitatory effect of the D2-receptor antagonist domperidone and the inhibitory effect of the catecholamine uptake inhibitor nomifensine on [3H]-ACh release; effects compatible with a diminished inhibitory dopaminergic input on cholinergic neurones. 7. These findings also show that the terminal region of dopaminergic neurones, the caudate nucleus, is a site for MPP+ toxicity. The present in vitro model may be useful for investigating the effects of MPP+ and its interaction with other drugs under defined conditions. PMID- 3265885 TI - The effects of vitamin E on immune regulation after thermal injury. AB - Studies were conducted on four groups of rats, each group consisting of 10 rats with burn + vitamin E, burn + saline solution, control + vitamin E and control + saline solution. Before and after burning 250 mg (2 cm3) of vitamin E was given intramuscularly. On the same days 2 cm3 of saline solution was given to the controls. The rats were burned over 30 per cent of their body surface area and then inoculated intraperitoneally with 40 units of tetanus toxoid. Complement fixation and acid phosphatase tests were carried out on the days 15 and 21 postburn. On day 21, the rats were killed and the spleens removed and weighted. In the groups that received vitamin E, the spleen weight and complement fixation test increased significantly while the acid phosphatase in serum decreased. In the clinical study, 17 burned patients with over 20 per cent deep partial or full skin thickness burns and eight healthy persons were studied. Nine of the 17 burned patients received vitamin E on 3 consecutive days, on day 4 blood was taken for analysis. The results showed that the number of T-cells decreased significantly in burn patients (P less than 0.05) whereas they increased significantly (P less than 0.05) in burn patients who received vitamin E. It is concluded from these experimental and clinical studies that vitamin E stimulates both cellular and humoral immunity. Therefore, the use of vitamin E in combination with conventional therapy in burn patients can be recommended. PMID- 3265887 TI - [Cutaneous specific antigen in rats]. PMID- 3265886 TI - A comparison of Biobrane vs. homograft for coverage of contaminated burn wounds. AB - An evaluation was made comparing homograft to Biobrane for the coverage of excised burn wounds using a rat model which had been contaminated with 1 x 10(5) Pseudomonas aeruginosa 1244. The homograft and Biobrane were then covered with either silver sulphadiazine cream, a 5 per cent mafenide acetate solution, or no topical antibacterial agent. Five days later the wounds were examined to determine the percentage of graft take. The homograft was found to have a superior graft take in this model. It is therefore recommended that a surgeon using Biobrane for the first time ensures the wound is at least as free of bacterial contamination as he would if he were using homograft. PMID- 3265888 TI - [The application of oncogene probes to studying the activation of Ha-ras in stomach cancer cells]. PMID- 3265889 TI - Comprehensive assessment of cardiac anatomy in anesthetized patients by transesophageal echocardiography. AB - Transesophageal echocardiography (TE) is a new imaging modality which provides a unique acoustic window to assess cardiac structures. The feasibility of using TE to obtain eight tomographic views of the heart was examined prospectively in 25 patients within 4 h following cardiac surgery. With the exception of the left ventricular apical view, which was not obtainable in 32% of patients, all views were present in each patient. Thus, TE not only provides a comprehensive assessment of cardiac anatomy, but also allows detailed left ventricular regional wall motion evaluation in the majority of patients. PMID- 3265890 TI - Infectious crystalline keratopathy. AB - Crystalline deposits developed in the anterior third of the stroma in a 60-year old woman. The deposits resolved only after aggressive treatment with intravenously given penicillin and topical erythromycin and vancomycin hydrochloride. Review of reported cases indicated that infectious crystalline keratopathy is caused by chronic colonization of the stroma by bacteria, usually streptococci of the viridans group. Local tissue trauma, concomitant use of topical corticosteroids, an intact overlying epithelium and use of a bandage-type soft contact lens are factors in the development of the infection. Patients with crystalline formations in this setting should undergo early lamellar biopsy for histologic examination, culture and sensitivity testing, followed by aggressive therapy with appropriate antibiotics. PMID- 3265891 TI - Intracellular pH recovery from lactic acidosis of single skeletal muscle fibers. AB - Intracellular pH (pHi), measured with H+-selective microelectrodes, in quiescent frog sartorius muscle fibres was 7.29 +/- 0.09 (n = 13). Frog muscle fibres were superfused with a modified Ringer solution containing 30 mM HEPES buffer, at extracellular pH (pHo) 7.35. Intracellular pH decreased to 6.45 +/- 0.14 (n = 13) following replacement of 30 mM NaCl with sodium lactate (30 mM MES, pHo 6.20). Intracellular pH recovery, upon removal of external lactic acid, depended on the buffer concentration of the modified Ringer solution. The measured values of the pHi recovery rates was 0.06 +/- 0.01 delta pHi/min (n = 5) in 3 mM HEPES and was 0.18 +/- 0.06 delta pHi/min (n = 13) in 30 mM HEPES, pHo 7.35. The Na+-H+ exchange inhibitor amiloride (2 mM) slightly reduced pHi recovery rate. The results indicate that the net proton efflux from lactic acidotic frog skeletal muscle is mainly by lactic acid efflux and is limited by the transmembrane pH gradient which, in turn, depends on the extracellular buffer capacity in the diffusion limited space around the muscle fibres. PMID- 3265892 TI - [The effect of interleukin-2 on peripheral lymphocytes and monocytes. III. Proliferative and cytotoxic effects in vitro in patients with systemic erythematosus and progressive polyarthritis]. PMID- 3265893 TI - [Epidemiological investigation of an outbreak of rubella in the urban area of Yan tai city]. PMID- 3265894 TI - [A study on the relationship between smoking and hypertension by using life table analysis]. PMID- 3265897 TI - Genetics of rheumatic diseases. PMID- 3265895 TI - Prolonged selective urokinase infusion in totally occluded coronary arteries and bypass grafts: two case reports. AB - Reports are presented demonstrating a technique for dissolving thrombus in coronary arteries and bypass grafts by using prolonged selective infusion of urokinase via an infusion wire. This allows one to pass a steerable guide wire through the culprit stenosis and perform angioplasty on a distal lesion which could not be previously seen. PMID- 3265896 TI - Late thrombotic occlusion of saphenous vein grafts: successful recanalization using thrombolytic therapy. AB - We report two cases in which thrombosis was the primary cause of vein graft occlusion many years after bypass surgery. Both displayed minimal thrombolysis immediately after a selective infusion of streptokinase but were patent when reimaged hours later. Such therapy may be helpful when graft occlusions are associated with a large volume of thrombus. PMID- 3265898 TI - [Personal experience with therapeutic stimulation in epileptic seizures]. PMID- 3265899 TI - Serum IgG anti-native type II collagen antibodies in rheumatoid arthritis: association with HLA DR4 and lack of clinical correlation. AB - Serum anti-type II collagen antibodies were measured in 85 rheumatoid arthritis patients before and after treatment with disease modifying drugs. These patients were also serotyped for HLA class II antigens. High anti-type II collagen antibodies (anti-CII) were detected in 35% and 29% of patients at onset and completion of study, respectively. Eighty percent of patients with high anti-CII initially had HLA DR4 (p less than 0.05). There was no correlation of anti-CII levels with severity of disease or response to treatment. PMID- 3265900 TI - Effect of high/low dietary linoleic acid levels on the function and fatty acid composition of T-lymphocytes of normal and diabetic rats. AB - T-lymphocytes play a central role in the initiation, regulation and effector functions of immune responses. Changes in membrane composition can alter the membrane fluidity, receptor distribution and consequently function of these cells. Altered immune response in the diabetic state may be attributed partly to diabetes induced alterations in the metabolism of essential fatty acids. We have investigated the effect of dietary linoleic acid on T cell membrane composition and T cell mediated immune responses in normal and diabetic rats. Streptozotocin induced diabetes was found to produce lower T cell proliferative responses in mixed lymphocyte reactions and upon mitogen stimulation. Feeding of a diet rich in linoleic acid did not improve these responses. Feeding a diet low in linoleic acid further lowered the T cell dependent immune responses. We also found lower levels of 18:2 omega 6 fatty acids in the membrane phospholipids of these T cells. Levels of 20:4 omega 6 fatty acids were altered as a result of diabetes and diet composition. These fatty acids are the precursors of prostaglandins which are known to influence immune responses. It is concluded that diabetes results in significant alterations in T cell membrane composition and function in a manner that can be manipulated by modifications of the fatty acid composition of the diet. The present study suggests that diet fat modification may be important in regulating T cell-mediated immunity in insulin dependent diabetes mellitus. PMID- 3265901 TI - Increased soluble interleukin-2 receptor levels in the sera of type 1 diabetic patients. AB - Recently, the presence of a soluble form of IL-2 receptor (IL-2RS) in human sera and in supernatants of PHA-stimulated lymphocytes has been demonstrated. It has been suggested that autoimmune diseases could be characterized by a defect in production of IL-2RS, unlike immunoproliferative disorders which are characterized by overproduction. Our aim was to investigate serum IL-2RS levels in 35 newly diagnosed Type 1 diabetic patients, in 25 age-matched healthy blood donors and in five patients with Hodgkin's disease. We found that newly diagnosed diabetic patients have higher IL-2RS levels (424.8 +/- 203 U/ml) than normal controls (252.4 +/- 38.4 U/ml) (p less than 0.005). In 22 out of 35 patients (62.8%) the IL-2RS values were above the higher 95% tolerance limit of controls. Furthermore, the persistence of high IL-2RS levels was observed in 18/35 diabetic patients six months after diagnosis (470 +/- 195.6 U/ml). The increased levels were not correlated with glycaemic and HbA1c levels and patients' age. Our findings suggest a potentially significant role for the released IL-2R in the regulation of IL-2 dependent lymphocyte functions in Type 1 diabetes. The study of IL-2RS in Type 1 diabetes may provide a new tool for the knowledge of cytokine involvement in the disease. PMID- 3265903 TI - Second International Symposium for Health Professionals in Rheumatology. Pellenberg, 7-10 September 1988. Abstracts. PMID- 3265902 TI - Serum osteocalcin (bone Gla-protein) following corticosteroid therapy in postmenopausal women with rheumatoid arthritis. Comparison of the effect of prednisone and deflazacort. AB - In 28 postmenopausal women with rheumatoid arthritis, serum osteocalcin (OC) concentration decreased from 5.2 +/- 1.9 ng/ml to 3.0 +/- 1.6 ng/ml after 6 months therapy with corticosteroids (p less than 0.005). No differences, however, were found in a control group of 13 patients treated for 6 months with nonsteroidal anti-inflammatory drugs. In those patients with serial OC measurements, changes in serum OC were already evident within the first month of therapy. This suggests that a suppressed osteoblast function may be detectable early during corticosteroid therapy in rheumatoid arthritis. Fifteen patients treated with prednisone (5-25 mg once daily, mean 12.33 mg/day) showed a more marked decrease in serum OC than 13 patients treated with equivalent doses of deflazacort (p less than 0.005). Prednisone therapy at doses higher than 10 mg/day resulted in a severe suppression of OC values in most cases. The effect of deflazacort was, however, mild in the majority of patients treated with doses of up to 30 mg/day. PMID- 3265904 TI - Prospective evaluation of bacterial antigen detection in cerebral spinal fluid in the diagnosis of bacterial meningitis in a predominantly adult hospital. AB - The results of all CSF latex agglutination (LA) tests performed in a large predominantly adult hospital over 1 yr are reviewed. Eight cases of bacterial meningitis were recognized during this time, and of these only three were due to organisms detectable by commercially available LA kits. In one case, the LA was uninterpretable, and in the second the LA was not performed because less than 5 x 10(6) WBC/L were seen in the CSF. In the third case the Gram stain was positive. No cases of partially treated meningitis were diagnosed. In this setting, the LA test did not contribute significantly to patient management. PMID- 3265905 TI - Time trends in upper alimentary tract cancer rates and alcohol and tobacco consumption in Australia. PMID- 3265906 TI - Estimates of the number of regular illegal opiate users in South Australia: an update and evaluation. PMID- 3265907 TI - Coronary events in the population of six districts of the Czech Socialist Republic. AB - In 1984, 640 coronary events were registered in six districts of the Czech Socialist Republic in a population of 164, 185 men aged 25 to 64 years; in a population of 166, 651 women of the same age-group there occurred 162 coronary events. 695 coronary events were according to criteria of the MONICA project (Monitoring of Cardiovascular Diseases and their Risk Factors) confirmed as definite or possible myocardial infarction (MI). The incidence of MI per 100,000 inhabitants amounted in 1984 to 347.7 in men and to 74.4 in women aged 25 to 64 years. The death-rate up to the 28th day of the disease is in men and women the same: one third of patients with a coronary event die within 4 weeks after the onset of symptoms. Death occurs in 75.8% of men and in 69.2% of women during the first 24 hours. Of all subjects with fatal MI, 35.4% of men and 56.1% of women died in hospital. PMID- 3265908 TI - Induction of keratouveitis by capsaicin. AB - The nervous system has profound modulatory influences on many inflammatory processes, particularly within the eye. These properties are in part mediated via neuropeptides. The neurotoxin, capsaicin, has been utilized as a valuable experimental tool to study the role of neuropeptides in many organ systems. Retrobulbar injection of capsaicin into rats results in the loss of sensory nerve function with rapid onset of inflammation (6-12 hours) which is confined to the the anterior segment. The hallmark of the acute response at 24-48 hours is marked polymorphonuclear leukocyte (PMN)/mononuclear cell influx and opacification of the corneal stroma with degeneration and loss of the central epithelium. PMN/mononuclear cell infiltration was also evident within the angle, the anterior chamber, and the iris. The corresponding posterior segments were normal. There was extensive corneal neovascularization between 7 and 14 days. This keratouveitogenic response in rats was age-dependent and can be attenuated by prior systemic pretreatments with capsaicin. This model should prove to be useful in the study of mechanisms of intraocular neurogenic inflammation. PMID- 3265909 TI - Expression of a cloned human interleukin-2 cDNA is enhanced by the substitution of a heterologous mRNA leader region. AB - A cloned interleukin-2 (IL-2) cDNA was poorly expressed in transfected eukaryotic cells. This low expression was only partly relieved by removal of the homopolymer tail present in the 5' leader region of the encoded IL-2 mRNA. However, replacement of the natural IL-2 mRNA 5' noncoding region with a leader element derived from the efficiently translated rat preproinsulin II mRNA resulted in an mRNA molecule that was utilized effectively by the transfected cell. The enhanced expression of this chimeric IL-2 mRNA did not appear to be due to changes in the sequence near the translation initiation codon. These results suggest that the leader elements of efficiently translated mRNAs may be able to confer a higher translational efficiency on heterologous protein coding regions when present in cis. PMID- 3265910 TI - Incomplete congenital stationary night blindness: electroretinogram c-wave and electrooculogram light rise. AB - Three cases of congenital stationary night blindness are reported. In all patients a negative electroretinogram was recorded by single bright flash stimulation and changed to positive on sequential reduction of the stimulus intensities. Oscillatory potentials were recognized. Biphasic dark adaptation curves and moderate elevation of the relative logarithmic final threshold of dark adaptation were also found. Values of critical flicker fusion frequency were reduced to a mild or moderate extent. VEP latency was prolonged beyond the normal range in two cases. In all three the electroretinogram c-wave was extinguished despite a normal electrooculogram light-dark ratio. It is hypothesized that in congenital stationary night blindness some disorder may exist in the apical membrane of the retinal pigment epithelium but not in the basal membrane in view of dissociation between the c-wave response and the light rise in the electrooculogram. PMID- 3265911 TI - [Effect of retirement on the risk factors of coronary heart disease]. PMID- 3265912 TI - Some immunological aspects in Nigerian patients with essential hypertension. PMID- 3265914 TI - Chronic intestinal bleeding caused by congenital arteriovenous malformations. AB - A case of vascular malformation over the entire length of the colon and small intestine in a 41-year-old male with an almost life-long history of gastrointestinal hemorrhage, is presented. The patient's history, in connection with the findings at colonoscopy and surgery, was highly suggestive of congenital arteriovenous malformations. The long-term effect of segmental surgical resection in these cases is unknown. In view of the extent of the abnormalities, no resection was performed. PMID- 3265913 TI - Subchronic metabolic effects and toxicity of a simulated pulp mill effluent on juvenile lake trout, Salmo trutta m. lacustris. AB - Juvenile lake trout (Salmo trutta m. lacustris) were exposed for 7 weeks to 0.05X and 0.2X 96-hr LC50 concentrations of simulated bleached kraft pulp mill effluent (KME - Sa + CP). A sulfate soap preparation, composed mainly of resin and fatty acids, with added chlorophenols (CP, tri-, tetra-, and penta-CP) was used as the toxicant mixture. Concentrations of free CP in plasma and free and conjugated CP in bile were proportional to their concentrations in the water. The greatest total gradient between bile and water CP was 5.2 X 10(4) for pentachlorophenol. The activity of a liver polysubstrate monooxygenase (PSMO) system, assayed with three model substrates, increased 40 to 67% due to KME - Sa + CP. However, the increase was not directly dependent on the exposure concentration. In contrast to PSMO, activities of conjugating enzymes (p-nitrophenol UDP-glucuronosyl and glutathione transferases) were decreased in the liver. Increased concentration of glutathione was noted in the liver and kidney. In addition, a small (9%) but significant decrease in blood hemoglobin concentration was observed at the higher exposure concentration. Although growth rate of lake trout was markedly decreased due to KME - Sa + CP, hydromineral balance and carbohydrate metabolism in fish were unaffected, indicating possible physiological compensation. On the other hand, lethality tests with lake trout preexposed to KME - Sa + CP at 0.2 X LC50 revealed decreased tolerance, whereas at the lower exposure concentration it was unchanged. We therefore conclude that various physiological adjustments in trout during subchronic exposures were not adaptive in terms of short-term tolerance. PMID- 3265915 TI - Gastric antral vascular ectasia and primary biliary cirrhosis. PMID- 3265916 TI - Improvement in transient and 'persistent' perfusion defects on early and late post-exercise thallium-201 tomograms after coronary artery bypass grafting. AB - In order to assess the changes in the number and severity of transient and persistent myocardial perfusion defects before and after coronary artery bypass grafting (CABG), early and late post-exercise thallium-201 (tl-201) tomography was performed in 25 patients, on average 10 days before and 2.5 months after CABG. Six patients had a previous Q wave myocardial infarction. Comparing the pre and post-CABG exercise test data (symptom limited bicycle ergometry) showed an improvement in working capacity (from 129 +/- 34 to 145 +/- 35 W, P less than 0.05) and a reduction in exercise induced angina from 77 to 9% of the patients (P less than 0.001). From the tomographic data, six short axis and three sagittal cross-sections of the left ventricular myocardium were reconstructed. In each patient study, a total of 51 myocardial segments were defined and analysed in a semi-quantitative manner by means of a five point scoring method indicative of the severity of a defect (from 0 = normal tl-201 uptake to 4 = absence of tl-201 activity). In this patient population the total number of segments with transient tl-201 perfusion defects decreased from 11.0 +/- 7 segments per patient (mean +/- SD) before surgery to 4.9 +/- 4 after surgery (P less than 0.01); the number of segments with 'persistent' tl-201 defects decreased as well, from 7.5 +/- 6 to 3.9 +/- 4 segments per patient (P less than 0.03).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265917 TI - Subocclusion of the left anterior descending artery following blunt chest trauma. AB - A 54-year-old man complained of severe angina shortly after a blunt chest trauma and coronary angiography showed an isolated subtotal occlusion of the mid-left anterior descending artery. Bypass grafting was uneventful. Posttraumatic angina or supposed myocardial contusion may be due to coronary injury for which a specific treatment can be given to limit the extent of myocardial necrosis. PMID- 3265918 TI - Pyrogenic immunomodulators increase the level of prostaglandin E2 in the blood simultaneously with the onset of fever. AB - Blood prostaglandin E2 (PGE2) levels, estimated by radioimmunoassay, and body temperatures of conscious rabbits were measured simultaneously during fever in response to polyinosinic: polycytidylic acid, lipopolysaccharide and interleukin 1/endogenous pyrogen. The effects of the antipyretic agent ketoprofen on both parameters was also studied. Significant rises (in the order of 6- to 8-fold) in the PGE2 level were observed after injection of either of the three pyrogens and occurred simultaneously with the rise in temperature. Ketoprofen given after the onset of fever in response to the pyrogens produced an immediate defervescence and a simultaneous decrease in plasma PGE2. Ketoprofen given before the pyrogens prevented any rise in either body temperature or plasma PGE2 level. When animals were subjected to an environmental temperature of 34 degrees C a hyperthermia was observed without any change in the blood PGE2 level. These results suggest that an increase in the blood PGE2 level may contribute to the pathogenesis of fever. PMID- 3265919 TI - Arginine is a physiological precursor of endothelium-derived nitric oxide. AB - ATP dose dependently stimulated the formation and release of nitric oxide (NO) from perfused rabbit aorta. L-Canavanine, an inhibitor of various L-arginine utilizing enzymes, abolished basal and ATP-induced NO formation and release. ATP increased the accumulation of presumably NO-derived NO2- in the medium of primary cultures of bovine aortic endothelial cells. 15NO, 15NO2- and 15NO3- formation was found when L-[guanido-15N2]arginine was added to the culture medium. We conclude that the terminal guanidino nitrogens of L-arginine are the physiological precursors of endothelium-derived NO. PMID- 3265920 TI - [Effect of tubocurarine on the quantum release of acetylcholine during the infrequent stimulation of a motor nerve]. AB - The effect of d-tubocurarine on quantal release of acetylcholine elicited with nerve pulses 0.5 to 1 Hz was studied in the frog isolated cutaneous pectoris muscle. The muscle twitches were prevented either by lowering Ca++ and raising Mg++ or by cutting the muscle fibers. In none of these cases d-tubocurarine (3.10(-7) to 5.10(-6) M) was found to affect quantal release of acetylcholine. PMID- 3265921 TI - Effect of maternal ketorolac administration of platelet function in the newborn. AB - Ketorolac is a potent analgesic agent with antiplatelet properties which is known to cross the placenta. The aim of this study was to determine whether maternal administration of ketorolac in labour had any effect on neonatal platelet function as compared with maternal administration of pethidine and prochlorperazine. Eighteen parous women were studied in labour, twelve received pethidine (control) and six received ketorolac for analgesia. Immediately after delivery, blood was taken from the umbilical vein and anticoagulated with citrate. Platelet aggregation in whole blood was studied. Ketorolac significantly inhibited aggregation in response to arachidonic acid and collagen but not ADP. These findings confirm that ketorolac crosses the placenta. The antiplatelet effects are likely to be related to ketorolac's inhibitory effect on TxA2 production which is required for arachidonic acid and collagen-induced aggregation, but not the primary aggregation response induced by ADP. These effects suggest that ketorolac should be used with caution in patients whose neonates are at risk of haemostatic problems. PMID- 3265922 TI - Anti-tumor efficacy of interleukin-2-activated killer cells in human neuroblastoma ex vivo. AB - We studied the ex vivo sensitivity of continuously cultured neuroblastoma cells from 3 different patients towards interleukin-2-induced cell-mediated cytotoxicity. A mean (+/- SD) target cell lysis (4 h 51Cr release) of 49 +/- 11, 46 +/- 8, and 32 +/- 11% in SMS-SAN, LA-N-1, and SK-N-BE2 cell lines, respectively, was achieved when neuroblastoma cells were co-cultured at an effector-to-target (E:T) ratio of 50:1 with peripheral blood mononuclear cells (PBMC) that had been preincubated for 4 days in the presence of recombinant interleukin-2 (rIL-2; 100 U/ml). Under identical conditions, 93 +/- 9% of Daudi cells (a standard target for rIL-2-activated killer cells) were lysed. Preincubation of rIL-2-induced PBMC cultures in the presence of irradiated neuroblastoma targets (LA-N-1, SK-N-BE2) resulted in a significant cytolytic augmentation. At E:T ratios of 50:1 and 10:1, day-4 rIL-2/LA-N-1-stimulated PBMC produced 69 +/- 7 and 41 +/- 11% lysis of LA-N-1 cells, as compared to 46 +/- 8 and 22 +/- (mean +/- SD) 7% lysis by untargeted PBMC that were preincubated with rIL-2 (100 U/ml) in the absence of LA-N-1 target cells (p less than 0.05). Co incubation of rIL-2-induced PBMC preparations with irradiated LA-N-1 and SK-N-BE2 cells, respectively, did not significantly enhance the cytolytic activity against other neuroblastoma targets and the standard Daudi cell line (p greater than or equal to 0.3).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265924 TI - [Homocystinuria in Israel]. PMID- 3265923 TI - Megakaryocyte colony-stimulating factor and burst-promoting activity in LPS treated mouse spleen cell-conditioned medium. AB - In order to clarify the mechanism(s) of increased splenic hematopoiesis noted in lipopolysaccharide (LPS)-injected mice, the effects of spleen cell-conditioned medium (SPCM) on megakaryocyte colony (CFU-meg) formation and early erythroid (BFU-e) differentiation were investigated. After spleen cells from LPS-injected mice were incubated for 3 days, the SPCM was assayed for megakaryocyte colony stimulating factor (Meg-CSF) in CFU-meg assay and for burst-promoting activity (BPA) and erythropoietin (Epo) in erythroid colony assays (i.e., CFU-e, BFU-e). Colony formation of CFU-meg and BFU-e peaked with the addition of 30 and 10-15% SPCM, respectively. Spleen cells from LPS-injected mice produced Meg-CSF and BPA when compared with controls. However, conditioned medium from spleen cells depleted of phagocytic cells had low Meg-CSF and BPA. SPCM did not contain detectable quantities of Epo. It appears likely that local splenic production of Meg-CSF and BPA may affect proliferation of CFU-meg and erythroid progenitor cells in the spleen. PMID- 3265925 TI - Multiple pregnancies among adolescents: incidence and correlates. AB - The study of adolescent fertility traditionally has focused on understanding and predicting the occurrence of an initial adolescent pregnancy. The complex problem of multiple pregnancies among teenagers is explored. Current knowledge regarding the incidence and correlates of repeated pregnancy is summarized and reviewed. Intervention strategies and directions for further research are suggested. PMID- 3265926 TI - [Factors influencing blood pressure in adolescents and young adults with special reference to parental history of hypertension. Cross-sectional and prospective population survey in Hisayama Town]. PMID- 3265927 TI - Early postoperative complications after (sub)total pancreatoduodenectomy: the AMC experience. AB - The postoperative course is described in 70 patients who underwent pancreatic resection for a tumor of the head of the pancreas and peri-ampullary region: 64 patients had malignant disease. Subtotal pancreatoduodenectomy was carried out in 52 patients and total pancreatoduodenectomy in 18 patients. The overall 30-day mortality was 4.3% (3 patients died: one after subtotal, 2 after total pancreatoduodenectomy). Major complications required surgical reintervention in 15 patients. Another 24 patients developed minor complications, and responded well to conservative treatment. Infective complications were the main cause of post-operative morbidity, occurring in 29 patients. Dehiscence of the pancreatico jejunostomy required surgical reintervention in one patient. This patient died. Leakage of the pancreatico-jejunostomy was radiologically demonstrated in 10 other patients. Four of these 10 patients presented with clinical symptoms: one needed surgical intervention and 3 responded to conservative management. The results of this study confirm the present trend of decreasing mortality after pancreatoduodenectomy. Postoperative morbidity remains high. Usually, leakage of the pancreatic anastomosis was not associated with serious postoperative complications and subsided without the need of treatment in the majority of cases. PMID- 3265928 TI - Defining the homeless mentally ill: a methodological note. PMID- 3265929 TI - Murine hybrid cell lines expressing the NLDC-145 dendritic cell determinant. AB - Dendritic cells play an important role as accessory cells in the immunological defense system. Investigations into the biological functions of this population have been limited by the difficulties encountered in isolating sufficient numbers of cells, and therefore different approaches have been described to immortalize accessory cell populations. In this report, four murine hybrid cell lines (H1-H4) are described that were produced by fusion of in vitro isolated dendritic cells and a tumor cell. The hybrid lines are characterized by the expression of the dendritic cell specific marker NLDC-145, Ia expression and the absence of macrophage or T cell markers. The cell lines have no phagocytic activity and are functionally active as accessory cells. The expression of the NLDC-145 antigen in vitro was found to be inducible. These NLDC-145-positive cell lines will be useful for the further characterization of the NLDC-145 antigen and in the study of dendritic cell and lymphocyte interactions. PMID- 3265931 TI - Suppression of human IgA-B-cell maturation by IgA-binding factors requires T cells. AB - IgA-binding factors (IgA-BFs) prepared from human peripheral blood mononuclear cells selectively decrease the generation of cytoplasmic IgA-positive cells in peripheral blood mononuclear cell cultures stimulated by pokeweed mitogen or by Nocardia opaca delipidated cell mitogen. In N. opaca delipidated cell mitogen stimulated cultures, the suppressive effect of IgA-BFs was no longer demonstrable after removal of sheep erythrocyte rosetting T cells or after depletion of CD8+ cells, but it was not altered by depletion of CD4+ cells. In pokeweed mitogen stimulated cultures of T-depleted peripheral blood mononuclear cell suspensions, IgA-BFs were ineffective when irradiated (12 Gy) instead of control T cells were used for reconstitution. The data indicate that radiosensitive and CD8+ T cell subsets may be required for IgA-BFs to suppress the generation of IgA-containing B cells after polyclonal activation of human peripheral blood mononuclear cells. PMID- 3265930 TI - Kinetics of cellular cytotoxicity mediated by cloned cytotoxic T lymphocytes. AB - Kinetic methods can provide significant information concerning the mechanism of cellular cytotoxicity reactions. Previous kinetic studies of cytotoxic T lymphocytes (Tc) have been hampered by the heterogeneity of the effector cell population tested. We therefore examined the kinetics of lysis mediated by cloned, IL 2 and antigen-dependent murine Tc cells with strong cytotoxic activity that is restricted to distinct tumor-associated antigens on P815 mastocytoma target cells. Initial velocity measurements for cytotoxicity mediated by these clones fit a simple Michaelian kinetic model. Specific activity values obtained from these initial rate measurements are compared to those obtained for polyclonal Tc preparations, NK cells, and activated killer cells. Whereas the initial rate of lytic programming mediated by these cloned cells was very rapid, the rate of cytolysis mediated by the cloned cells decreased significantly within one hour. Since this decrease was observed over a wide range of E:T ratios, it is unlikely to result from product inhibition or a significant decrease in the concentration of unlysed target cells, but may be due to a decrease in the rate of programming and/or effector cell recycling. These results indicate that a simple Michaelian kinetic model is not adequate for tumor cell cytolysis by Tc cells in vitro. PMID- 3265932 TI - IgE-dependent killing of Schistosoma mansoni schistosomula by human platelets: modulation by T cell products. AB - The in vitro stimulation of T lymphocytes is known to induce the release of factors that possess distinct biological activities. In the present report, we describe the presence, in supernatants of Schistosoma mansoni antigen stimulated T cells from S. mansoni infected patients, of a factor able to inhibit the IgE dependent platelet cytotoxicity of the same individuals toward the young larvae of S. mansoni. PMID- 3265933 TI - Binding of mercuric chloride to nuclear proteins in human peripheral blood T lymphocytes. AB - The binding of labelled (203Hg) mercuric chloride to nuclear proteins of human peripheral blood T lymphocytes was studied by using polyacrylamide gel electrophoresis and autoradiography. Most of the nuclear proteins were found to be able to bind mercuric chloride; however, 4 of the proteins were heavily labelled. Of these 4 proteins, 2 migrated in the histone region, 1 comigrating exactly with histone H3. The other 2 proteins were non-histone proteins with molecular weight of approximately 25 and 43 kD. PMID- 3265934 TI - Production of interleukin-1 in macrophage cultures from rats with nephrotoxic serum nephritis. AB - To investigate the role of cell-mediated immunity in the pathogenesis of experimental glomerulonephritis, we examined interleukin-1 (IL-1) activity in the culture supernatant of lipopolysaccharide-stimulated peritoneal macrophages from rats with an accelerated autologous form of nephrotoxic serum nephritis (NTSN). Modified NTSN was produced by an intravenous injection of nephrotoxic serum (NTS) into the rats which had previously been immunized with rabbit IgG and Freund's complete adjuvant. It was found that the NTSN rats had significantly increased levels of IL-1 activity when compared to the values obtained with normal controls and the other control group, consisting of pre-immunized rats (rabbit IgG), then given normal rabbit globulin instead of NTS. The administration of a rabbit anti rat macrophage serum reduced the production of IL-1 activity in the NTSN rats. In this experimental model IL-1 synthesis by peritoneal macrophages is present early in the disease process and may be an important mediator of glomerular immune injury. PMID- 3265936 TI - Pagetoid reticulosis: a T-cell lymphoproliferative disorder of the skin. PMID- 3265935 TI - Pattern of epidemics of donovanosis in the "nonendemic" region. AB - Of the 432 genital ulcer cases seen in 1985, 36 had donovanosis, thus forming an incidence of 8.33%. In contrast, 42 (6.38%) cases of donovanosis were diagnosed among a total of 658 cases of genital ulcers in 1983. The majority of patients in both epidemics were young unmarried men who contracted the disease through extramarital sexual intercourse. Perianal lesions were seen primarily in those who had a history of sodomy. The disease chiefly affected illiterate persons of low socioeconomic strata. The incubation period varied from 1 to 90 days. Twenty (62.50%) patients in the 1985 epidemic had an incubation period of less than 7 days, in contrast to only 9 (34.61%) in the 1983 epidemic. The epidemics occurred from autumn to the start of winter. Duration of the disease varied from 1 day to 6 years. The clinical features and sites of afflication were usual; however, pseudobubo and pseudoelephantiasis were conspicuous in a significant minority. PMID- 3265938 TI - Smooth muscle tumors of the stomach. AB - Six cases of smooth muscle tumors of the stomach are reported. These comprise one leiomyosarcoma and five leiomyomas, observed over a period of five years. Clinical presentation, diagnosis difficulties and the method of treatment are discussed and the literature is reviewed. PMID- 3265937 TI - Intravitreal liposome-encapsulated drugs: a preliminary human report. AB - Intravitreal liposome-encapsulated antibiotics and antiviral drugs were used in patients with acute toxoplasmosis retinochoroiditis, presumed propionibacterium acne endophthalmitis after cataract surgery, and presumed cytomegalovirus retinitis associated with AIDS. A single intravitreal dose was effective in the treatment of all the conditions. Intravitreal liposomes may prove to be an advantageous drug delivery system for the treatment of chronic intraocular inflammatory disorders. PMID- 3265939 TI - Immunohistochemical examination of Peyer's patches in autoimmune mice. AB - The distribution of T-cells and B-cells in Peyer's patches was examined in three autoimmune model mice, MRL/Mp-lpr/lpr, BXSB, NZBWF1/J mice and normal BALB/c mice, between one and ten months old. A multiple layering technique was used for immunohistochemical detection of lymphocyte surface antigens of T-cells (Thy1.2, Lyt1, Lyt2) and B-cells (surface IgM) and peanut agglutinin receptor for germinal center cells. The T-cell population of female MRL/Mp-lpr/lpr mice increased markedly with age, and the B-cell population of the male BXSB mouse tended to increase. However, little change was observed with age in the NZBWF1/J mice. The immunohistochemical properties of the Peyer's patches in the three autoimmune model mice were different. PMID- 3265941 TI - [Current indications and results of elective truncal portacaval shunt. Apropos of 97 cases]. AB - The authors analyse the results of a series of 97 cases of elective porto-caval anastomoses for ruptured oesophageal varices and compare them with those of the literature. Elective porto-caval anastomosis satisfactorily prevents haemorrhagic recurrence (3%) at the cost of an operative mortality of 10% (nil over the last five years). Porto-caval encephalopathy was observed in 36% of cases with an incapacitating form (stage II or III) in 21% of operated patients and always represented the major disadvantage of surgery. However, the place of truncal porto-caval anastomosis is still intact in the prevention of recurrent haemorrhage from ruptured oesophageal varices. Warren's operation, the reference surgical technique, cannot be performed systematically because of technical reasons and/or because of rigorous selection. Endoscopic sclerotherapy represents a fundamental therapeutic procedure during the haemorrhagic period. Permanent haemostasis is more difficult to obtain and requires surgery in about 25% of cases. The mortality and morbidity associated with the endoscopic method are compared with the surgical results in two series of patients belonging to Child's groups A and B. PMID- 3265940 TI - The production of a "universal developer" for the immunological detection of human IgG and its application in immunodiagnostics. AB - This study describes the development of a biospecific monoclonal antibody capable of the simultaneous recognition of horseradish peroxidase (HRP) and human IgG. This antibody, coded McC2, has been applied in a novel manner as a universal developing reagent for the detection of human IgG. McC2 cross-reacts with all human IgG subtypes and was found to recognise an epitope on the Fc portion of human IgG. McC2 does not cross-react with human IgM or IgA. This bi-specific antibody belongs to the mouse IgG1 subclass. McC2 was used for the detection of human IgG in a simple one step enzyme-linked immunosorbent assay (ELISA). Use of this bi-specific antibody in this assay resulted in an excellent signal to noise ratio with background in negative control wells virtually nonexistent. McC2 was also applied in a clinical diagnostic test for the detection of auto anti-nuclear antibodies in patient sera. McC2 was substituted, in a blind study, for a HRP conjugated second antibody supplied with the test kit. All sera were tested both with the kit's second antibody and McC2. When using McC2, we obtained no false positive results whereas five false positives were obtained when using the kit's second antibody. However, one false negative result was obtained with the use of McC2 as a developing reagent while none were noted with the use of the kit's second antibody.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3265943 TI - Differential projections of B and C sympathetic axons in peripheral nerves of the bullfrog. AB - Accumulating evidence indicates that electrophysiologically distinct subsets of sympathetic neurons selectively innervate different classes of targets. The organization of this system may therefore be reflected in the sympathetic fiber contents of peripheral nerves. To test this possibility, we have mapped the pathways followed by three groups of postganglionic sympathetic axons in the bullfrog by recording compound action potentials and by retrograde tracing with horseradish peroxidase (HRP). The axons that were studied arise from fast B, slow B, and C-type neurons in ganglia 9 and 10 at the lumbar end of the paravertebral sympathetic chain. They project to peripheral targets primarily by way of the sciatic nerve and can be distinguished by the velocities with which they conduct action potentials. Action potentials were recorded with suction electrodes from isolated preparations composed of paravertebral chain ganglia 7-10, the sciatic nerve, and branches of the sciatic nerve that supply striated muscles, skin, and the bladder. Preganglionic B fibers were selectively activated by stimulating the paravertebral chain rostral to ganglion 7, and preganglionic C fibers were selectively activated by stimulating spinal nerves 7 and 8 at points central to their rami communicantes. Compound action potentials recorded from the sciatic, peroneal, tibial, and sural nerves and from the primary trunk of the pelvic nerve were each found to contain three components produced, respectively, by fast B, slow B, and C-type sympathetic axons. Similarly, action potentials recorded from cutaneous branches of the sciatic tree were found to contain three sympathetic components. By contrast, when compound action potentials were recorded from branches of the sciatic tree that directly enter and innervate striated muscles and also the bladder, the sympathetic responses were found to arise solely from C type axons. HRP was used to label the sympathetic neurons that project to the sartorius muscle and into the cutaneous lateral crural nerve. Retrograde transport of HRP from the sartorius muscle labeled 17 +/- 4 (mean +/- s.d.) sympathetic neurons and 27 +/- 3 spinal motoneurons while transport from the lateral crural nerve labeled 68 +/- 47 sympathetic neurons but no spinal neurons. The average somatic diameter of ganglion cells projecting to the sartorius muscle was significantly smaller than that of cells projecting to the lateral crural nerve. The electrophysiological results indicate that fast B and slow B sympathetic axons in the sciatic trunk and its primary branches project selectively into cutaneous nerves while sympathetic C axons project into all peripheral nerves.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3265942 TI - Development of serum antibodies of the immunoglobulin G class and subclasses against the capsular polysaccharide of Haemophilus influenzae type b in children and adults with invasive infections. AB - The development of total immunoglobulin G (IgG) antibodies and antibodies of the four IgG subclasses in serum against Haemophilus influenzae type b capsular polysaccharide (CPS) was studied in 24 children and 11 adults with invasive Haemophilus influenzae type b infections, by using an enzyme-linked immunosorbent assay. None of the 8 children aged 10 months or younger had increases in the IgG class or in any of the IgG subclasses. In contrast, 14 of 16 children between 10 months and 6 years of age and 10 of 11 adults had significant increases in total IgG, IgG1, or IgG2 antibodies in various combinations, but none of them had increases in IgG3 or IgG4 antibodies. The increases in IgG1 and IgG2 antibodies in the children were of similar magnitudes. Of 11 adult patients, 9 had significant increases in IgG2 antibodies, while only 4 had increases in IgG1 antibodies. In conclusion, this study shows that children younger than approximately 1 year have no IgG response to H. influenzae type b CPS, while individuals above this age have a mixed IgG1 and IgG2 response. PMID- 3265944 TI - [Maternal mortality caused by hemorrhage in developing countries. What policy is proposed?]. AB - Maternal mortality in the third world is fifty to two hundred times higher than in developed countries. Haemorrhage following birth or abortion is one of the leading causes of maternal mortality and a specific analysis of this can clarify the problems. The incidence of maternal death by haemorrhage is not clearly documented and fluctuates between 6 and 90 per cent. Patients predicted to be at high risk for haemorrhage in the third trimester should be automatically referred for a higher level of medical care. In fact, many cases of haemorrhage cannot be predicted and death depends on the rate of blood loss and on the pre-existing anaemia. Better nurses' and mid-wives' training, better ante natal care, and the treatment of anaemia should decrease maternal mortality. PMID- 3265945 TI - Estrogen-progesterone treatment of Osler-Weber-Rendu disease. AB - A 56-year-old woman with Osler-Weber-Rendu disease had longstanding iron deficiency anemia from recurrent melena. Since neither laser photocoagulation nor surgery were successful in stopping the increasing transfusion need, combined estrogen-progesterone therapy was started. Except for slight bleeding from a temporary ileostomy, the bleeding and need for transfusion terminated promptly. This experience confirms that estrogen-progesterone therapy may promote cessation of bleeding gastrointestinal telangiectasias and indicates the need for controlled investigations. PMID- 3265947 TI - Gastrointestinal hemorrhage due to choriocarcinoma involving the duodenum. PMID- 3265946 TI - Bleeding colonic ulcers secondary to atheromatous microemboli after left heart catheterization. AB - Atheromicroembolism after aortic or cardiac catheterization is frequently found at autopsy but rarely recognized in life, perhaps because many cases are asymptomatic. We report two patients who, after left heart catheterization, developed gastrointestinal hemorrhage from a solitary colonic ulcer caused by occlusive atheromicroemboli in submucosal vessels. We briefly review the spectrum and pathogenesis of atheromicroembolic injury to the gastrointestinal tract. Atheromicroemboli, which occlude vessels too small to be visualized by angiography, should be considered in the differential diagnosis of gastrointestinal bleeding in patients who have undergone aortic instrumentation. PMID- 3265949 TI - Evolution of functional imaging in nuclear medicine. PMID- 3265948 TI - Effect of hydrocortisone and interleukins 1 and 2 on eosinophil progenitors in hypereosinophilic states. AB - The growth of eosinophil progenitors (CFU-Eo) and its modulation by hydrocortisone (HC), mononuclear cells, interleukin 1 (IL-1), and interleukin 2 (IL-2) in three cases of eosinophilia are reported in this paper. One microM HC decreased the proportion of CFU-Eo in each of these three patients, and in each case, the addition of autologous mononuclear cells at a 1:1 ratio abrogated the effect of HC on CFU-Eo. As studied in two of the three cases, IL-1 and IL-2 were able to prevent the effect of HC. Further studies showed no effect of HC when monocyte T cell-depleted marrow cells were used as the target population. These results suggest that CFU-Eo production in eosinophilic states is subject to modulation by HC and T lymphocytes. PMID- 3265950 TI - Pneumoconiosis in iron ore surface mining in Labrador. AB - A cross-sectional survey of the work force at an iron ore surface mine and beneficiation plant in Labrador identified cases with a radiologic diagnosis compatible with simple pneumoconiosis by the International Labour Organization (ILO) classification (1980). Their distribution by ILO categories 1, 2, and 3, after excluding those with confounding diagnoses for pneumoconiosis, was 30, 10, and 2 cases, respectively. ILO category was related to age, duration of current employment, and cumulative respirable dust and quartz levels, as well as to decrement in ventilatory function. PMID- 3265951 TI - Cancer incidence of workers exposed to dimethylformamide and/or acrylonitrile. AB - This study was to determine whether exposure to dimethylformamide (DMF) and acrylonitrile (ACN) separately or in combination, was associated with increased cancer incidence. Workers exposed to DMF and/or ACN were observed from 1956 through 1984 for cancer incidence. The workers exposed to DMF but not ACN showed significant excesses in incidence for buccal cavity and pharynx cancer and malignant melanoma. A significant excess of prostate cancer incidence was observed among workers exposed to DMF and ACN. No dose-response relationships were observed between DMF or ACN exposure and cancer incidence. The significant excesses in cancer incidence among employees exposed to DMF and/or ACN could be due to statistical chance or other factors, such as tobacco and alcohol consumption. Further studies are warranted. PMID- 3265952 TI - Mortality study of workers exposed to dimethylformamide and/or acrylonitrile. AB - Workers exposed to dimethylformamide (DMF) and/or acrylonitrile (ACN) were observed from 1950 through 1982 for mortality. The wage-roll workers exposed to DMF showed significant excess in total deaths attributable mainly to ischemic heart disease and external causes when compared with rates from E. I. Du Pont de Nemours & Co. However, there were no significant excesses in mortality when expected numbers were based on US or local statistics. No dose-response relationships were observed between DMF or ACN exposure and mortality. The significant excesses in mortality among employees exposed to DMF and/or ACN could be due to statistical chance or life-style factors PMID- 3265953 TI - Gouty arthritis. A case report. PMID- 3265954 TI - Surgical technique for managing a subluxed posterior chamber lens implant. PMID- 3265955 TI - Technique for fixating a subluxated posterior chamber lens. PMID- 3265956 TI - Incidence and management of diarrhea during longterm auranofin therapy. AB - The incidence, severity, and management of diarrhea during longterm administration of auranofin (AF)--up to 33 months--were evaluated prospectively in 137 patients with active rheumatoid arthritis. At least 1 episode of diarrhea was reported in 101 patients (74%), but the rate of occurrence/patient-months of therapy was 24% (569 events/2,370 patient-months of treatment). The monthly prevalence declined from a range of 30-40% during the initial 6 months to about 10% for patients treated for 18-24 months. Most diarrhea was intermittent and mild; only 11 patients (8%) discontinued treatment because of diarrheal symptoms. No intervention was required in 46 of the 101 patients affected. In 44 others, loose stools were successfully managed with antidiarrheal medications, a reduction in dosage, or both. Although diarrhea is a common event during AF administration, particularly early in therapy, for most patients it usually does not significantly interfere with treatment. PMID- 3265957 TI - Anticentromere antibodies--clinical correlates. AB - We tested 11,594 consecutive sera for antinuclear antibodies and 1,502 were found to be positive; 68 patients (72 sera) had anticentromere antibodies. A retrospective analysis of the clinical characteristics and diagnoses of patients found to have anticentromere antibodies were correlated and showed a diverse array of findings. The association of anticentromere antibodies and the CREST variant of scleroderma may be less specific than originally thought when used as a screening test in an unselected population with rheumatic disease. Anticentromere antibody was present in patients with drug induced lupus, a finding not previously reported. PMID- 3265958 TI - IgG subclass distribution of anticardiolipin antibody in patients with systemic lupus erythematosus. AB - IgG subclass distributions of anticardiolipin (aCL), anti-ssDNA, and anti-dsDNA antibodies in sera of patients with systemic lupus erythematosus were determined by an enzyme linked immunoassay (ELISA) method, using mouse monoclonal antihuman IgG subclass antibodies. IgG aCL activity consisted mainly of the IgG1 subclass, and to some extent, the IgG3 subclass. Definite amounts of aCL activity were also detected in IgG2 in sera from 25% of the patients. Anti-ssDNA antibody activity was relatively equally distributed among IgG1, IgG2 and IgG3, but was poorly distributed in IgG4. In contrast, anti-dsDNA antibody activity consisted mainly of IgG1 and IgG3. PMID- 3265959 TI - Cardiolipin antibodies and null alleles of C4 in black Americans with systemic lupus erythematosus. AB - Twelve of 44 black American patients with systemic lupus erythematosus (SLE) (27%) studied during periods of disease activity had increased levels of IgG antibodies against cardiolipin (IgG aCL). IgG aCL occurred almost exclusively in patients who had a partial genetic deficiency of C4A or C4B. Eleven of 29 patients (38%) with a C4A or C4B deficiency allele had IgG aCL, compared with 1/15 patients (7%) who did not have C4A or C4B deficiency allele (p = 0.04). During periods when SLE was less active clinically, IgG aCL levels returned to normal in 10/12 patients. Active SLE, rather than null alleles, appeared to be associated with low C4 levels in patients with IgG aCL. PMID- 3265960 TI - A survey of current prescribing practices of antiinflammatory and urate lowering drugs in gouty arthritis in the province of Ontario. AB - We recently conducted a cross-sectional survey of the prescribing practices of rheumatologists and a random sample of family physicians. While in general there was agreement as to the preferred management of gout, family physicians were (a) more likely to use phenylbutazone, (b) more liberal in their use of allopurinol, (c) less likely to cover the introduction of allopurinol with antiinflammatory agents or to titrate the dose against the serum uric acid, or to adjust the dose according to the serum creatinine. A small number of physicians continued to routinely use urate lowering drugs in the treatment of entirely asymptomatic hyperuricemia. PMID- 3265962 TI - Pauciarticular juvenile rheumatoid arthritis presenting in an adult. AB - Type I pauciarticular juvenile rheumatoid arthritis (PA-JRA) is characterized by a female predominance, chronic iridocyclitis and a positive antinuclear antibody (ANA) test. In contrast, patients with type II PA-JRA are usually male, have a negative ANA test, but are HLA-B27 positive. We report a patient with longstanding iridocyclitis who presented at age 20 with oligoarthritis, whom we believe has Type I PA-JRA. Slit lamp examination should be considered in patients with oligoarthritis; the detection of asymptomatic chronic iridocyclitis may aid in the diagnosis. Untreated, this condition may cause irreversible ocular damage. PMID- 3265963 TI - Studies on the in vitro effects of auto-anti-IgE. Inhibition of total and specific serum IgE detection by a human IgG autoantibody to IgE. AB - We isolated a human IgG anti IgE autoantibody by affinity chromatography on a myelomatous IgE (N.D.) coated Sepharose column, from the serum of a patient with atopic eczema, and probed its ability to inhibit IgE recognition by heteroantisera to IgE used in commonly available assays for serum total and specific IgE determinations (Paper radio-immunosorbent test--PRIST and Phadezym radioallergosorbent test--RAST, both from Pharmacia, Uppsala--Sweden). Our results indicate that IgG anti IgE decrease total IgE results by 10-90% according to its weight ratio to IgE molecules present in samples devoid of endogeneous anti-IgE. Sera with high content of specific IgE to house dust mite (RAST class 3 or 4) are less affected by this autoantibody, but RAST class 2 may be significantly lowered when purified IgG anti IgE is added. These data imply that anti IgE can affect both total and specific IgE determinations. PMID- 3265961 TI - Complete C4B deficiency in black Americans with systemic lupus erythematosus. AB - We report 3 black American patients with systemic lupus erythematosus (SLE) in whom C4B was completely deficient in plasma. They all exhibited antibody against the nucleoprotein antigen SSA (Ro), as well as cutaneous involvement, features that have been previously associated with complement deficiency states. IgG antibody against cardiolipin was also present in 2 patients, in association with a biologic false positive test for syphilis in one patient, and with thrombocytopenia in another. This is the first description of the clinical presentation of complete C4B deficiency in blacks with SLE. PMID- 3265964 TI - [Brain necrosis following intraoperative radiation therapy or interstitial brachytherapy]. AB - We have experienced 8 cases of radiation necrosis which occurred following radiation therapy of malignant brain tumors. In all 8 cases, necrosis developed in the brain tissue adjacent to the tumor after intraoperative radiation or interstitial radiation therapy. Considering that the extent of necrosis usually coincides with the extent of the radiation therapy, this type of necrosis is thought to be the expected result of radiation therapy. A differential diagnosis between radiation necrosis and the recurrence of a brain tumor has been thought to be difficult to achieve. Yet with the use of a dynamic CT or an Xe-enhanced CT, differential diagnosis between these two lesions was clearly accomplished. PMID- 3265965 TI - [A primary malignant lymphoma of the vulva--a case report]. AB - Malignant lymphoma is a rare entity in the neoplasms of the female genital tract, and thus a case of malignant lymphoma of the vulva is reported in this paper. On admission, the patient, a 37-year-old, Japanese female, had complained of vulvar swelling and pain that had persisted for one month. Stage IV tumors were noted in the vulva and bladder and a histological diagnosis indicated non-Hodgkin's lymphoma with diffuse, large cell and B cell types, according to the classification of the Lymphoma Study Group. The patient thus was treated with CH* OP therapy, which consisted of Cyclophosphamide, Aclarubicin Vincristine (Oncovin), and Prednine , and given brain irradiation. Unfortunately her condition has rapidly deteriorated during the 5 months since her admission. PMID- 3265966 TI - [The biological nature of vascular endothelial cells in cutaneous tissues. Third Report: Immunohistochemical studies using MoAb against VWF]. PMID- 3265967 TI - Requirement of Ia-positive nylon wool adherent cells for activation of cytotoxic T-lymphocytes specific to melanocyte-associated antigens in patients with Vogt Koyanage-Harada's disease. AB - Involvement of Ia-positive nylon wool adherent cells (AC) for the expression of cytotoxic T-lymphocyte (CTL) activity specific to melanocyte-associated antigens (MAA) was studied. Although unseparated peripheral blood lymphocytes (PBL) from several patients with Vogt-Koyanagi-Harada's (VKH) disease showed significant cytotoxic activity against SK-MEL-28 (P-36) human melanoma cells which carried cross-reactive surface antigens with normal melanocytes, the cytotoxic activity of nylon wool column passed nonadherent cells (NAC) against the same target cells markedly decreased in the absence of Ia-positive nylon wool AC. The reduced cytotoxic activity of the NAC was reconstituted not only by the addition of Ia positive AC from the same VKH patient, but also by the addition of allogeneic IA positive AC mismatched with human leukocyte antigen (HLA) complex-DR region haplotype. Moreover, the cytotoxic activity of nylon wool NAC was augmented by the addition of interleukins instead of DR-positive AC. The data indicate that the primed CTL in patients with VKH would be stimulated nonspecifically by factors from Ia-positive cells, presumably to differentiate the precursor CTL (CTL in memory state) into mature CTL (effector cells). PMID- 3265968 TI - Intraoperative evaluation of coronary bypass grafts by measuring myocardial blood flow using the electrolytic hydrogen clearance method. AB - The regional myocardial blood flow (MBF) was measured in 33 patients who underwent coronary bypass graft surgery in order to evaluate the efficiency of coronary bypass grafts in restoring MBF. MBF was measured by the electrolytic hydrogen clearance method during the coronary bypass surgery. The mean prebypass MBF was 161 +/- 19, 162 +/- 12, 80 +/- 12, 43 +/- 14, 104 +/- 18 ml/min/100 g in segments supplied by the left anterior descending coronary artery (LAD) showing less than or equal to 50 per cent, 75 per cent, 90 per cent, 99 per cent, and 100 per cent stenosis with collaterals, respectively. After bypass grafting of the LAD, the mean MBF increased from 70 +/- 13 and 126 +/- 12 ml/min/100 g to 133 +/- 14 and 163 +/- 9 ml/min/100 g in the segments with and without infarction, respectively. The mean postbypass MBF was 149 +/- 10 and 152 +/- 14 ml/min/100 g in the segments supplied by the LAD bypassed with saphenous vein grafts and mammary artery grafts, respectively. Postbypass MBF was dependent upon the magnitude of myocardial infarction. Measurement of MBF by the electrolytic hydrogen clearance method made it possible to quantitatively evaluate myocardial perfusion at the time of operation. It also provided direct information about the effectiveness of myocardial revascularization. PMID- 3265969 TI - Decreased interleukin generation in patients with cancer of the digestive system. A correlation between interleukin 1 and interleukin 2 production. AB - The generating capacity of interleukin 1 (IL-1) and interleukin 2 (IL-2) by peripheral blood mononuclear cells (PBMNC) was measured in 40 patients with digestive cancer (20 localized and 20 disseminated) and 20 age- and sex-matched control subjects. The localized carcinoma patients showed normal IL-1 production and a significantly depressed IL-2 production (p less than 0.05) when compared to the healthy individuals. The disseminated carcinoma patients exhibited a significant impairment of both IL-1 and IL-2 production in comparison with the healthy controls (IL-1: p less than 0.001, IL-2: p less than 0.001) and the localized carcinoma patients (IL-1: p less than 0.001, IL-2: p less than 0.001). A significant correlation was observed between IL-1 and IL-2 generation in all the cancer patients (r = 0.458, p less than 0.01). These results suggest that progressive tumor growth may result in decreased interleukin production by the host PBMNC, and that related mechanisms, which are more susceptible to lymphocytes than monocytes, may be involved in the impairment of both IL-1 and IL 2 production. PMID- 3265970 TI - [The role of hemostasis and rheologic properties of blood in stable and progressive exertion-induced stenocardia]. AB - Patients with angina of effort, both its stable and progressive variants, show hypercoagulative hemostatic shifts and a deterioration of blood rheologic properties, the changes being more pronounced in progressive angina. Vascular wall changes, dependent on the level of plasma Willebrand's factor, are closely related to clinical severity of angina of effort. The latter is also related to changes in blood rheology (increased erythrocyte aggregation, reduced erythrocyte deformation and high platelet adhesion). PMID- 3265971 TI - [Immunocorrection using low-intensity laser radiation in the surgical treatment of patients with obstructive jaundice]. PMID- 3265972 TI - [Clinico-immunologic characteristics of patients with suppurative complications of acute cholecystitis]. PMID- 3265973 TI - [Cellular immunity in chronic nonspecific lung diseases]. PMID- 3265974 TI - An immunogold cell labelling method for rat T lymphocytes. AB - A method using monoclonal antibodies in conjunction with an immunogold procedure was adapted for labelling T lymphocytes in blood samples obtained from male Wistar rats. The monoclonal antibodies W3/25, MRC/OX8 and W3/13 were used. Changes in the percentages of positively labelled cells were observed in rats dosed with the immunosuppressant cyclosporin. PMID- 3265975 TI - [Long-term study of survival and hemorrhagic recurrence in elective sclerotherapy of esophageal varices]. PMID- 3265976 TI - [Study of immune response in pregnancy. I. Lymphocyte populations]. PMID- 3265977 TI - Crime amongst heroin, alcohol and cannabis users. PMID- 3265978 TI - Orthotopic knee grafts in rats: a model for growth plate transplantation. AB - A model for orthotopic whole knee transplantation in syngeneic Lewis rats is presented. The donor knee was isolated on the femoral vessels 1 cm superior and inferior to the knee joint. A minimal muscle cuff was left attached to ensure adequate circulation to the graft via the popliteal vessels. The graft was transplanted to the recipient animal and secured in an orthotopic position by two intramedullary Kirschner wires. The graft pedicle was anastomosed to the recipient's femoral vessels and the muscular elements sutured. Preliminary results are reported, and future implications on growth plate autograft transplantation are discussed. PMID- 3265979 TI - [Immunologic changes in patients with lupus activity and renal involvement]. PMID- 3265980 TI - Enhancement of antigen-presenting function of dendritic cells with culture supernatants of mouse peritoneal macrophages stimulated with certain particulate substances. AB - The production from murine resident peritoneal macrophages (M phi) of a soluble factor, which was capable of enhancing the antigen-presenting (AP) function of dendritic cells (DC), was examined. The supernatants of peritoneal M phi (M phi sup) were prepared by culturing peritoneal M phi with particles, i.e., zymosan A, latex, and sheep red blood cells (SRBC), or antigen-antibody (Ag-Ab) complexes such as keyhole limpet hemocyanin (KLH)-anti-KLH, ovalbumin (OVA)-anti-OVA, and SRBC-anti-SRBC complexes. When exposed to M phi sup during antigen pulsing DC induced a marked antigen-specific T cell proliferation, relative to DC treated with the supernatants from M phi cultured without stimuli (control sup). On the other hand, M phi sup-treated splenic M phi stimulated antigen-specific T cell activation to almost the same extent as did splenic M phi treated with control sup. These results indicated that peritoneal M phi elaborated a soluble factor which preferentially enhanced the AP capacity of DC when stimulated with particles or Ag-Ab complexes. Analytical gel filtration of M phi sup revealed that the factor had an apparent molecular weight of 27,000 daltons which was distinct from interleukin 1. PMID- 3265982 TI - Industrial health care complexes--basic institutions of the working population health care system in Poland. PMID- 3265981 TI - Induction of murine B cell proliferation and immunoglobulin synthesis by some bacterial ribosomes. AB - Ribosomal preparations from Klebsiella pneumoniae, Haemophilus influenzae, Streptococcus pyogenes, and Streptococcus pneumoniae were investigated with respect to their activating capacity towards murine lymphoid cells. The proliferation of BALB/c spleen cells was induced in a dose-dependent fashion (from 1 to 100 micrograms/ml) by ribosomes of K. pneumoniae, H. influenzae, and S. pyogenes with a peak activity at 48 or 72 hr of culture. The majority of the blast cells induced by these ribosomal preparations were positive for surface immunoglobulin (S-Ig) and negative for Thy 1.2. Furthermore, K. pneumoniae, H. influenzae, and S. pyogenes ribosomes induced the synthesis of IgM and some IgA. Cell proliferation and induction of IgM production were also demonstrated with the 3 ribosomal preparations using spleen cells from athymic nude (nu+/nu+) mice, Lyb-5-defective CBA/N spleen cells, B cell-enriched and T cell-depleted BALB/c spleen cell suspensions, as well as spleen cells from the Ips gene-deficient C3H/HeJ strain. Cell culture supernatants contained specific anti-ribosome IgM antibodies. Antibodies of other specificities (anti-sheep erythrocytes) were also demonstrated in supernatants from K. pneumoniae-stimulated cultures. Evidence against a possible role of contamination of K. pneumoniae and H. influenzae ribosomes by lipopolysaccharide- or lipid A-associated proteins in this effect is discussed. Ribosomes from S. pneumoniae did not induce 3H-thymidine incorporation nor Ig production. None of the 4 ribosomal preparations was found to stimulate T cell blastogenesis or to induce interleukin-2 production by naive BALB/c spleen cells. Finally, ribosomes from H. influenzae, S. pyogenes, S. pneumoniae but not those of K. pneumoniae stimulated interleukin-1 production by adherent spleen cells, from BALB/c mice. PMID- 3265983 TI - [Labelling of interleukin 2 with 123 iodine and its administration to animals susceptible to diabetes for the visualization of lymphocytic infiltration in the pancreas]. PMID- 3265984 TI - [Human epidermal growth factor (h-EGF) in gastric carcinomas]. AB - Two hundred and twenty one gastric carcinomas were immunohistochemically stained for h-EGF and we examined the correlation between h-EGF immunoreactivities and histologic findings. Regarding macroscopic and histologic types, incidence of h EGF immunoreactivities in infiltrating type and in poorly differentiated type was significantly higher than those in localized type and in differentiated type, respectively. In addition, h-EGF producing carcinomas showed high positive rate in prognostic serosal involvement and scirrhous type in stroma. Prognosis in patients with h-EGF producing tumors was poorer than that in those with h-EGF non producing tumors, especially in stages II and III. These results suggest that h EGF immunoreactivities serves as a biological marker of high malignancy. PMID- 3265986 TI - Polymyositis and dermatomyositis. PMID- 3265985 TI - [Monoclonal antibody-defined phenotypes of tumor-infiltrating-lymphocyte subpopulations of esophageal cancer--compared with intra-noncancerous esophageal tissue and peripheral blood: preliminary report]. PMID- 3265987 TI - Amino-acid composition and mycology of Sekete, a fermented product from Zea mays L. AB - The local procedure for preparing Sekete is described. The isolated microfungi, Aspergillus flavus Link., Cladosporium cladosporioides (Fres.) de Vries, and Alternaria tenuissima (Kunze) Wiltshire, were examined for various aspects of their physiology and biochemistry. Sekete is rich in important amino acids as alanine, leucine, tyrosine, and lysine, though proline and arginine are lacking. All the mycoflora isolated exhibited good secretion of extracellular enzymes. Pullulan, starch, soyabean meal, and corn steep liquor encouraged alpha-amylase production. PMID- 3265988 TI - L-5-hydroxytryptophan alone and in combination with a peripheral decarboxylase inhibitor in the treatment of depression. AB - In an open study 25 depressed patients were treated with L-5-hydroxytryptophan (L 5-HTP) either alone or in combination with a peripheral decarboxylase inhibitor. The therapeutic efficacy of L-5-HTP was considered as equal to that of traditional antidepressants. There was no difference in efficacy between the two treatments. Best results were obtained in patients with an anxious-agitated depressive syndrome and in patients with an endogenous depression if the illness had been acute. The onset of action was rapid (within 3 or 5 days). Gastrointestinal side effects proved to be dose-dependent and occurred more frequently in patients receiving L-5-HTP alone, whereas psychopathological side effects (especially acute anxiety states) have mainly been reported in patients receiving L-5-HTP in combination with a peripheral decarboxylase inhibitor. PMID- 3265989 TI - Topographic brain mapping of EEG before and after open-heart surgery. AB - The brain function of 60 patients undergoing open-heart surgery (36 patients receiving coronary artery bypass, 21 patients valve replacements, 3 both) was investigated before and 10 days after the operation utilizing topographic brain mapping of the electroencephalogram (EEG). The postoperative EEG changes were characterized by a slight delta-theta increase, an alpha decrease [especially in the fast alpha (10.5-13 Hz) band] and a beta increase in the relative power. The total power and the absolute power of the delta-theta, alpha and beta showed a decrease, the dominant frequency a significant slowing from 9.7 to 9.3 Hz. The centroid of alpha and beta activity decreased as well. These results are similar to findings obtained in patients with organic brain syndrome. The EEG changes were prominent over the left hemisphere, which may be of particular clinical relevance. PMID- 3265990 TI - [Treatment of upper digestive hemorrhage in gastroduodenal pathology]. PMID- 3265991 TI - [Incidence of recurrences in inguinal hernioplasty. Comparison of technics]. PMID- 3265992 TI - [Angiographic diagnosis of digestive hemorrhage. Remarks on 39 cases]. PMID- 3265993 TI - Adaptational change in cone-mediated electroretinogram in human and carp. PMID- 3265994 TI - A monoclonal antibody specific for a subpopulation of retinal bipolar cells in vertebrates. PMID- 3265995 TI - Crohn ileitis and massive rectal bleeding. PMID- 3265996 TI - Acute massive rectal bleeding as a presenting sign of Crohn disease. PMID- 3265997 TI - Cavitation as an unusual roentgenographic manifestation of Pneumocystis carinii pneumonia in a patient with acquired immunodeficiency syndrome. PMID- 3265998 TI - [Primary differentiation of the axial structures in amphibians. 1. The equifinal variants of craniocaudal differentiation]. PMID- 3265999 TI - Epidemiology of severe eye injuries in childhood. AB - The authors conducted a cross-sectional study of all ocular injury cases admitted to a children's hospital between January 1978 and December 1984. Of 222 injuries reviewed, 77 (35%) resulted in some visual deficit. Males were significantly overrepresented in all age groups with an average male:female ratio of 3.5:1. The distribution of injuries was: contusions, 114 (51%); penetrating lacerations, 62 (28%); foreign bodies and burns, 11 (5%); and nonpenetrating lacerations, 35 (16%). Sixteen (7%) ocular injuries were associated with BB gun pellets and six of these children (42%) were blinded in the injured eye as a result. Two other cases of blindness resulted from ocular penetration by homemade "Jinsang Stars," underscoring the adverse influence of media on children's games. Adult supervision could have potentially prevented most cases of permanent visual deficit. The authors suggest that legislation restricting the use of BB guns be passed and that a program of adult and child eye safety education including "eye watch" warnings on potentially hazardous toys be developed. PMID- 3266000 TI - Acute multifocal hemorrhagic retinal vasculitis. AB - The authors present a series of seven patients with acute visual loss associated with mild anterior uveitis, multifocal retinal vasculitis, retinal capillary nonperfusion, retinal hemorrhage, disc swelling, and vitreitis. Oral prednisone was of some benefit in these patients and oral acyclovir was generally ineffective. Neovascular complications including retinal, disc, choroidal, and iris new vessels were common, requiring photocoagulation in five patients. Horseshoe tears developed in two patients in zones of uninvolved retina but retinal detachment did not occur. The etiology remains unknown, although it may represent either a localized ocular form of Behcet's disease or other systemic syndrome, infection with a herpes group virus other than zoster varicella virus, or a manifestation of an undefined infectious agent. PMID- 3266001 TI - Clinical and serum lipid findings in a large family with autosomal dominant retinitis pigmentosa. AB - Retinitis pigmentosa, of unknown cause, has recently been associated with decreased amounts of the polyunsaturated fatty acid, docosahexaenoic acid, in the plasma of affected as compared with unaffected relatives. It has been suggested that this finding may serve as a marker for the disease and might indicate alterations in photoreceptor cell metabolism. The authors studied 54 members of a family with dominantly inherited retinitis pigmentosa in five generations. In addition to the typical clinical findings of retinitis pigmentosa, eight persons also had a bull's eye maculopathy, and four persons had uni- or bilateral optic nerve drusen. When the authors determined the plasma fatty acid and lipid contents, they saw the expected age-related effect on cholesterol and triglycerides, but an unexpected, significant reduction in fatty acids in the unaffected controls as compared with persons with retinitis pigmentosa. The authors' results emphasize the heterogeneity of phenotypic expression of retinitis pigmentosa within a single family. PMID- 3266002 TI - Multidisciplinary approach to the management of complex bony and soft tissue orbitocranial disorders. AB - Orbital reconstructive surgery is entering a new age as progress in surgical techniques and diagnostic imaging are applied to the patient with severe acquired orbital and periorbital deformities. The authors present a series of six patients with orbitocranial neoplasms and congenital and traumatic deformities whose management involved a multidisciplinary approach. Particular emphasis is placed on the use of reformatting two-dimensional orbital scans into three-dimensional images and surgical techniques using composite flaps and periorbital microsurgical vascular anastomoses. Advancements in technology and sophisticated reconstructive surgical techniques have exciting potential. Ophthalmologists can play an important role in this expanding field since they frequently serve as the entry point or provide long-term follow-up to patients with these complex problems. PMID- 3266003 TI - Hemifacial spasm due to intracranial tumor. An international survey of botulinum toxin investigators. AB - Hemifacial spasm (HFS) due to intracranial mass lesions is rare. Most cases are thought to be due to compression of the facial nerve by small vessels near the root of the facial nerve. A survey was undertaken of all botulinum toxin investigators to determine the incidence of imaged mass lesions causing HFS. Responders contributed information on 1676 patients with HFS. Of this group, nine tumors were reported for an incidence of 0.54% of patients. However, of this group only 52.5% underwent computed tomography (CT) or magnetic resonance (MR) scanning so the incidence of tumor causing HFS could be as high as 1.0%. No one tumor type was predominant, and most patients were women older than 50 years of age. The incidence compares with another large series of HFS patients in which one tumor was found in 367 patients. The authors also report as an illustrative case a 26-year-old man with HFS due to a presumed lipoma of the cerebellopontine angle. This diagnosis can be made with increased certainty with MR scanning. If the incidence of unsuspected diagnostically significant mass lesions is 1 in 200 patients with HFS referred for botulinum toxin injection, the cost of detecting one such lesion would be $100,000 at an average imaging cost of $500 per MR imaging or CT examination. Although mass lesions are uncommon, any patient with HFS whose general clinical course could justify intervention should be considered for imaging studies to rule out treatable conditions other than vascular compression. PMID- 3266004 TI - Clinical manifestations of ectopia lentis et pupillae in 16 patients. AB - The largest known series of patients with ectopia lentis et pupillae (ELeP) was clinically evaluated. Sixteen patients from eight families were characterized with respect to ocular anomalies. Variability between eyes of the same patient and among different patients was marked. In addition to the well-known but inconstant displacement of the lens and pupil, other characteristics of this protean syndrome included severe axial myopia (and associated fundus abnormalities), poor vision, retinal detachment (RD), enlarged corneal diameters, cataract, abnormal iris transillumination, poor pupillary dilatation, persistent pupillary membranes, iridohyaloid adhesions, and prominent iris processes in the anterior chamber angle. PMID- 3266005 TI - Comparison of active and combined passive/active immunization of Navajo children against Haemophilus influenzae type b. AB - In a high risk Navajo population we compared the immunogenicity of a new Haemophilus influenzae type b mutant-diphtheria toxic conjugate vaccine (HbOC) with simultaneous active (HbOC) and passive immunization with bacterial polysaccharide immunoglobulin prepared from adults immunized with H. influenzae b, pneumococcal and meningococcal vaccines. Only 7 of 26 (27%) 2-month-olds had an increase in H. influenzae b capsular polysaccharide antibody after a single dose of HbOC, a proportion similar to that of saline controls (9 of 25, 36%). After a second HbOC dose at 4 months 88% had antibody concentrations of 0.15 microgram or more, and after a third dose at 6 months all had antibody levels greater than or equal to 0.15 microgram/ml. The group receiving both HbOC and bacterial polysaccharide immunoglobulin at 2 months uniformly had H. influenzae b CP antibody concentrations of greater than or equal to 0.15 microgram/ml at 4 months (P less than 0.001 relative to "HbOC alone" group) and subsequently responded similarly to second and third doses of HbOC vaccine as did also the "HbOC alone" group. We conclude that combined passive/active immunization with bacterial polysaccharide immunoglobulin and HbOC at 2 months maintains antibody at concentrations thought to be protective (greater than or equal to 0.15 microgram/ml) without interfering with the active antibody response to second and third doses of HbOC at 4 and 6 months of age. PMID- 3266007 TI - Primary suppurative myositis associated with Haemophilus influenzae type b septicemia. PMID- 3266006 TI - Counterimmunoelectrophoresis and latex particle agglutination in the etiologic diagnosis of presumed bacterial pneumonia in pediatric patients. AB - A commercial latex agglutination (LA) kit (Wellcogen, Wellcome Diagnostics) used to detect bacterial polysaccharide antigens (Haemophilus influenzae type b and Streptococcus pneumoniae) was compared with a modified counterimmunoelectrophoresis technique and blood culture for etiologic diagnosis of presumptive bacterial pneumonia requiring hospitalization in 60 infants and children. Serum, urine and either sputum or nasopharyngeal secretions were collected during the first 5 days of therapy for antigen detection. Blood culture was positive in 6 of 52 (11.5%) of cases. Antigens were detected by counterimmunoelectrophoresis and/or LA in 13 of 60 (21.7%) serum samples, 2 of 16 (12.5%) unconcentrated urine samples, 19 of 42 (45.2%) urine samples concentrated 25-fold and 21 of 45 (46.7%) sputum or nasopharyngeal secretions. Antibiotic treatment for 5 days did not affect the antigen detection rate. Counter immunoelectrophoresis was more sensitive than LA in serum and urine but not in sputum. However, because false positive reactions were frequently obtained with LA on nasopharyngeal secretions of an age-matched control group, this test appears unreliable. PMID- 3266008 TI - [Single photon emission computed tomography (SPECT) with N-isopropyl-p-(123I) iodoamphetamine in epilepsy]. PMID- 3266009 TI - Contact and photocontact allergy to glyceryl para-aminobenzoate. AB - High-purity glyceryl para-aminobenzoate was produced from a commercial source of the chemical by using a chromatographic technique. Negative test reactions to this purified substance were obtained when it was patch/photopatch-tested on 2 patients with contact and photocontact allergy to a nonpurified batch of glyceryl para-aminobenzoate. PMID- 3266010 TI - Immunostaining in atypical fibroxanthoma of the skin. AB - We have studied 12 cases of cutaneous atypical fibroxanthoma using immunohistochemistry to demonstrate lysozyme, alpha-1-antitrypsin, S-100-protein, receptors for peanut agglutinin, and intermediate filaments. Results were compared with immunostaining in 24 cases of other so-called fibrohistiocytic tumours. In addition 2 cases of atypical fibroxanthoma and 6 cases of fibrohistiocytic tumours were stained by monoclonal antibodies specific for the monocyte cell lineage (Ki-M1, Ki-M2, Ki-M6, Ki-M7, Ki-M8, OKM-1 and Leu-M1) and double-stained by monocyte-markers and Ki-67. The immunophenotype of atypical fibroxanthoma was rather similar to the marker profile found in malignant fibrous histiocytoma. All atypical fibroxanthomas were positive for vimentin and negative for epithelial markers. Monocyte lineage-specific determinants could be demonstrated in varying amounts in cells suggestive of being reactive. In contrast proliferating--Ki-67 positive--cells did not express monocyte/macrophage related antigens in atypical fibroxanthoma and malignant fibrous histiocytoma both. As to the histogenesis of these tumours our findings speak in favour of a derivation from primitive mesenchymal cells rather than from histiocytes. PMID- 3266011 TI - Clinical implications of sudden infant death syndrome epidemiology. AB - The diagnosis of sudden infant death syndrome (SIDS) is less than 100% certain in any given instance. Approximately 90% of all SIDS have occurred by age 6 months. A visual aid consisting of 1,000 dots helps in communicating numerical information such as 'rates' to parents (and others as well). The annual and seasonal occurrence patterns are independent of so-called SIDS risk factors. A single, major gene defect cannot account for SIDS but the root cause may be genetic (polygenic). Recent estimates of sibling risk to SIDS indicate that earlier estimates were inflated. Use of apnea monitors to prevent SIDS has no basis in fact but may provide emotional support. DTP immunization does not cause SIDS. PMID- 3266012 TI - Flow cytometric analysis of normal B lymphoid development. AB - Identification of the antigens expressed on marrow B lineage cells can be used to develop a model for the sequential acquisition of cell surface antigens during B lymphocyte development. The data suggest that the surface antigen expression is highly controlled during the development of B cells with the coordinated acquisition of multiple cell surface antigens during the maturational process. The developmental scheme in figure 6 is inferred from the expression of cell surface antigens on single samples. Confirmation of the progression from one stage to the next requires the isolation of a particular stage with subsequent induction to the next stage in-vitro. These data suggest that the development of B lymphoid cells may be discrete rather than continuous. The most immature cells identifiable in the bone marrow express CD34+ as well as HLA-DR. The earliest recognizable B lineage cells (CD19+, bright CD10+) also express CD34+. These cells are smaller by forward light scattering when compared to the cells which express only CD34+ (precursor of myeloid cells). Cells within stage I also express TdT in the nucleus and are proliferating. As the cells progress from stage I to stage II, the B lineage cells lose cell surface CD34 and nuclear TdT. At this time the density of HLA-DR and CD45 increases while the amount of CD10 decreases. These changes occur with no detectable change in cell size as assessed by forward light scattering. HLA-DP is first detected on the cells at this time. The progression of cells from stage II to stage III is marked by the acquisition of CD20, HLA-DQ, and sIgM. The amount of CD45 increases further in the transition between stage II and stage III. The acquisition CD21 and CD22 as well as the loss of CD10 distinguishes stage IV from stage III. Once the cellular composition of normal marrow has been defined, perturbations from homeostasis can be identified. Since marrow is the tissue most sensitive to injury by most antineoplastic chemotherapy and radiotherapy regimens, a means of quantifying the changes from the normal state can provide an assessment of the cytotoxic injury produced in individual patients. By monitoring the return to normal, it may be possible to more precisely individualize therapy for each patient. With a clear understanding of normal hematopoiesis, it should also be possible to identify maturational blocks which occur in hypoplastic marrow states. This may provide a means of identifying the regulatory points for each lineage and provide strategies for overcoming the inhibition of development.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3266013 TI - [Phagocytic activity of neutrophils in children with positive reactions to tuberculin]. PMID- 3266014 TI - Resonance Raman spectra and normal mode descriptions of a bacteriochlorophyll a model complex. PMID- 3266015 TI - Obesity in Italy. PMID- 3266016 TI - Distribution of i.v. administered epidermal growth factor in the rat. AB - The distribution of i.v. injected 125I-labeled epidermal growth factor (EGF) was examined in the rat. The uptake of radioactivity was examined for the following tissues: liver, kidney, skin, stomach, small intestine, colon, brain, submandibular gland, lung, spleen, and testis. 125I-EGF was cleared from the circulation within minutes. At 2.5 min after the injection only 7% of the label was left in the blood. Most of the label was found in the liver (52%), the kidneys (14%), the small intestine (11%) and the skin (7%). The other organs examined contained 1% or less of the radioactivity. The uptake of 125I-EGF per g tissue was markedly higher for the liver and kidneys than for the rest of the organs. By autoradiography 125I-EGF was found in the peripheral parts of the classical liver lobule, in the proximal tubules of the kidneys, in the surface epithelium of the stomach, and in the surface epithelium of the villi in the small intestine. In conclusion the present study showed that small doses of homologous EGF was cleared from the circulation of rats within minutes, mainly by the liver, the kidneys, and the small intestine. PMID- 3266017 TI - [Progressive lengthening of the ulna in children using Wagner's technic. Apropos of 14 cases]. PMID- 3266018 TI - [The prevalence of emaciation in 2 populations (nomadic herdsmen and sedentary agricultural workers) of the Gao region in Mali]. AB - A cross-sectional survey using a cluster sampling method made it possible to calculate the Weight-for-Height index of 1830 children aged 0-5 years. With the index, we were able to compare the distribution and prevalence of emaciation between the population of nomadic herdsmen of the Adrar of Iforas and the population of sedentary agriculturalists of the Region of Gao in Mali. The results show that the nutritional status of both populations stands below the reference population; the prevalence of emaciation (Z-score less than or equal to -2 standard deviations) is significantly higher among the agriculturalists than among the pastoralists (34% and 9% respectively). The results stress the usefulness of functional classification as a tool for identifying vulnerable groups in the context of nutritional aid programs. PMID- 3266019 TI - Multifocal eosinophilic granuloma. AB - A 22-year-old black male presented with progressive dyspnea, a nonproductive cough, and new skin lesions. He was severely hypoxic, and had a severe restrictive defect on pulmonary function testing. A 2-cm lytic defect was noted on skull radiographs. A lung biopsy demonstrated pulmonary fibrosis. A biopsy of a skin lesion was consistent with a diagnosis of multifocal eosinophilic granuloma, or disseminated histiocytosis X. The case presents several unusual features of this uncommon disorder. PMID- 3266020 TI - The intensity of sarcoidosis alveolitis is related to albumin and IgG levels in BAL. AB - To define whether the levels of immunoglobulins and albumin in bronchoalveolar lavage (BAL) fluid are related to the intensity of sarcoidosis alveolitis, 49 patients affected with pulmonary sarcoidosis were studied. To distinguish between high- and low-intensity alveolitis, two parameters were used: the percentage of T lymphocytes and the CD4+/CD8+ ratio in BAL fluid. The results showed an increase of albumin and of the IgG/albumin ratio (p less than 0.05) in patients with high intensity alveolitis as assessed by both criteria. Moreover, an increase (p less than 0.05) of albumin concentration related to T lymphocyte alveolitis was found. We conclude that: albumin is a reliable index of inflammation; the increase of the IgG/albumin ratio is the expression of local production of IgG as well as of inflammation; the evaluation of albumin and of the IgG/albumin ratio should be useful because they both correlate with the intensity of the alveolitis: the former express inflammatory damage and the latter, immunological activity. PMID- 3266021 TI - Experimental intravitreal ketoconazole in DMSO. AB - Ketoconazole is a weakly dibasic synthetic imidazole with a broad spectrum of antifungal activity. Topical, subconjuctival, and systemic administrations provide poor concentrations in the vitreous. To determine the ocular toxicity of intravitreal ketoconazole, the authors injected doses varying between 15 micrograms to 2240 micrograms dissolved in 0.1 ml of 100% DMSO into the vitreous bodies of 24 rabbits. Doses of 540 micrograms or less resulted in no toxicity to the eyes. Doses of 720 micrograms revealed electroretinographic abnormalities and photoreceptor degeneration by electron microscopy. Doses of 2,240 micrograms resulted in severe histopathologic and electroretinographic alterations. This study suggests that a single intravitreal dose of 540 micrograms or less of ketoconazole in DMSO may be safely used in the treatment of fungal endophthalmitis. PMID- 3266022 TI - Peptic ulcer and non-ulcer dyspepsia--a disease and a disorder. AB - In a cross-sectional survey for coronary risk factors, 14,390 middle-aged men and women answered a questionnaire concerning life-style, diet and disease, including peptic ulcer (PU) and dyspeptic symptoms. The overall lifetime prevalence of reported PU was 5.3% in men and 2.1% in women. The prevalence of reported dyspeptic symptoms, consistent with non-ulcer dyspepsia (NUD), was 22.6% in men and 18.1% in women. Reporting of both PU and NUD was significantly associated with sex and age, NUD less marked than PU. PU and NUD differed substantially with respect to associations with psychologic, social, life-style, and dietary variables. PU was strongly associated with age, a family history of peptic ulcer, body mass index, and smoking. NUD, on the other hand, showed closest association to psychological factors and social conditions. This difference between PU and NUD might be of aetiological and therefore clinical significance, and calls for therapeutic trials in NUD patients with interventions different from the traditional peptic ulcer treatments. PMID- 3266023 TI - T-cell response to purified protein derivative after removal of Langerhans' cells from epidermal cell suspensions containing keratinocytes expressing class II transplantation antigens. AB - In a previous study we observed that human epidermal cell (EC) suspensions containing HLA-DR-expressing keratinocytes showed an amplified T-cell response to purified protein derivative (PPD). To evaluate further the possible immunological importance of class II transplantation antigens on keratinocytes we have compared the T-cell response to PPD in the presence of the following stimulator cells: EC suspensions from normal skin, or EC from tuberculin-reactive skin with or without removal of Langerhans' cells. The proliferation of purified T lymphocytes from peripheral blood in response to PPD in the presence of various concentrations of autologous EC was measured by [3H]thymidine incorporation on day 6. In 3 experiments out of 4 the EC from tuberculin-reactive skin, containing 28-76% HLA DR-expressing cells as judged by immunocytochemistry (which also revealed fairly numerous HLA-DQ/-DP-expressing keratinocytes and a slight increase in CD36- and CD4- but not CD1-expressing cells), induced a more pronounced T-cell response to PPD than did normal EC. This was not the case in the fourth experiment, in which a small number of HLA-DR-(15%) and few if any HLA-DQ-/-DP-expressing keratinocytes were found. Immunomagnetic removal of CD1-reactive Langerhans' cells from the tuberculin-reactive EC suspensions resulted in a reduction of the T-cell response to PPD, in most cases down to background level (T cells alone + PPD). This study does not support the hypothesis that HLA-DR-expressing keratinocytes can in themselves act as antigen-presenting cells. PMID- 3266024 TI - Suppression of in vitro production of anti-U1-ribonucleoprotein antibody by monoclonal anti-idiotypic antibody to anti-U1-ribonucleoprotein antibody. AB - We produced monoclonal anti-idiotypic antibody against immunoaffinity purified anti-U1-ribonucleoprotein (RNP) antibody from a patient (K.T.), by the cell fusion procedure. The specificity of monoclonal anti-idiotypic antibody (IgG1, kappa) was determined by inhibition studies. With the monoclonal anti-idiotypic antibody, cross-reactive idiotypes on anti-U1-RNP antibodies from unrelated patients with anti-U1-RNP antibody was detected in 57% of the samples. The anti idiotypic antibody specifically suppressed the in vitro production of anti-U1-RNP antibody by lymphocytes from the patient K.T., and unrelated patients with a cross-reactive idiotype, in whom idiotype-reactive T cells were demonstrated. The results indicate that anti-idiotypic antibody may modulate the regulation of in vitro anti-U1-RNP antibody production. PMID- 3266025 TI - Identification of alpha beta and gamma delta T cell receptor-positive cells. AB - Two lineages of T lymphocytes bearing the CD3 antigen can be defined on the basis of the nature of the heterodimeric receptor chain (alpha beta or gamma delta T cell receptor (TCR) expressed. Precise identification of alpha beta and gamma delta TCR+ cells is essential when studying the tissue distribution and function of these different T cells. In immunofluorescence studies gamma delta TCR+ cells have been identified as CD3+WT-31- or CD3+CD4-CD8- cells. However, this may not be the optimal procedure because gamma delta TCR+ cells are weakly WT-31+, and some are CD8+. The aim of this study was to evaluate a panel of monoclonal antibodies (MoAb) directed against different chains of the TCR-T3 complex for a more precise identification of alpha beta+ and gamma delta TCR+ cells in flow cytometric studies. We found that the MoAb anti-Ti-gamma A and delta-TCS-1, recognizing the TCR-gamma and the TCR-delta chain respectively, only reacted with a subpopulation of gamma delta TCR+ cells, whereas another TCR-delta chain recognizing MoAb anti-TCR-delta 1 reacted with all gamma delta TCR+ cells. All MoAb reported to belong to the CD3 group reacted with both alpha beta TCR+ and gamma delta TCR+ cells as expected. Our results indicate that all gamma delta TCR+ cells can be identified with the MoAb anti-TCR-delta 1. Because no MoAb recognizing the TCR-alpha or TCR-beta chains at the cell surface of intact cells are yet available, we suggest that alpha beta TCR+ cells could be identified as CD3+ anti-TCR-delta 1-cells. PMID- 3266026 TI - Monoclonal antibodies against leucoagglutinin-reactive human T-lymphocyte surface components. I. Characterization of cellular binding sites. AB - The binding specificities of three biologically active anti-lymphocyte monoclonal antibodies (MoAb) (K46M, K3G, and 3-19-2) produced against human T-cell surface components reactive with the mitogenic lectin leucoagglutinin from Phaseolus vulgaris (La) were analysed. K46M is a strong T-cell mitogen, while K3G and 3-19 2 inhibited cell-mediated cytotoxicity. Resting peripheral blood lymphocytes (PBL) contained 4-16% K46M+ cells, 8-35% K3G+ cells, and less than 0.3-4% 3-19-2+ cells. After stimulation with T-cell mitogens the proportion of K46M+ and 3-19-2+ cells increased markedly (mean 59 and 30% positive cells, respectively), while the increase in K3G+ cells was less prominent (38%). K46M-reactive structures were expressed on mature T cells and probably also on B cells. K3G reacted with B and T cells while 3-19-2 showed a broader specificity reacting also with erythrocytes. All three MoAb reacted with lipid extracts of resting and activated PBL as well as with purified neutral glycolipids of lymphoid origin. In addition 3-19-2 reacted with lipid extracts of erythrocytes. K46M immuno-precipitated four surface peptides from lectin-stimulated PBL. Their apparent molecular weights were 53,000, 42,000, and 16,000 (doublet). The 53,000 and 42,000 MW peptides were identified as the alpha and beta chains of the T-cell antigen receptor. The identity of the 16,000 MW peptides is presently unknown. K3G and 3-19-2 did not specifically precipitate any lymphocyte surface peptide. PMID- 3266027 TI - Monoclonal antibodies against leucoagglutinin-reactive human T-lymphocyte surface components. II. Studies on the mechanism of K46M-induced activation and determination of the frequency of responding cells. AB - A monoclonal antibody, K46M (IgM kappa), obtained after immunization with leucoagglutinin (La)-reactive T-cell surface components, stimulated human lymphocytes to proliferate. It induced maximal proliferation at greater than 20 micrograms IgM/ml after 3-4 days of culture. Cells stimulated by K46M produced interleukin 2 (IL-2) and gamma interferon (IFN-gamma) and expressed receptors for IL-2 and transferrin. The majority of the activated cells were phenotypically T cells as defined by monoclonal antibodies against CD3 and CD2, and an increase in the K46M-positive cells was also observed during the activation period. K46M activated cells display major histocompatibility complex (MHC)-unrestricted cytotoxicity against several cultured target cells. The frequencies of the cytotoxic and of the proliferative precursor cells were determined using a limiting dilution assay. K46M seems to activate a larger fraction of cytotoxic precursor cells against Molt 4 than against K562, but the statistical significance of these observations requires further exploration. Both K46M or La activated 40% of PBL to proliferate, whereas 70% of PBL were induced by OKT3. However, the frequency of K46M-activated cells was 40% only when the lymphocytes were plated at low cell densities, i.e. less than 0.5 cells per well. At higher densities an inhibition of proliferation was seen that resulted in a biphasic response curve, indicating that the activation of PBL by K46M was not a single hit event. This was not found with either La or OKT3. Whether K46M, in contrast to OKT3 and La, activates a subpopulation with suppressor activity remains to be established. PMID- 3266028 TI - Contrast between epidemiological and clinical concepts of rheumatoid arthritis. PMID- 3266029 TI - Implications from the occurrence of Reiter's syndrome and related disorders in association with advanced HIV infection. AB - Information bearing on the prevalence and character of Reiter's syndrome and allied disorders as they occur in a setting of HIV infection was reviewed. Based on the frequency of infections by organisms capable of inducing reactive arthritis and the presence of HLA-B27 in 71% of the individuals, it was concluded that the disorder strongly resembled Reiter's syndrome occurring in the non-HIV infected group. Preliminary evidence suggested an enhanced penetrance of susceptibility among HLA-B27 individuals. In view of the preservation of CD8 lineage T cells and functional loss of CD4 lineage T cells in HIV-infected patients, it was suggested that a specific immune recognition event is at the center of the pathogenesis of this syndrome which involves preservation of an unknown antigen in the context of HLA-B27 to CD8 lineage suppressor/cytotoxic T cells. PMID- 3266030 TI - Radiographic assessment in relation to clinical and biochemical variables in rheumatoid arthritis. AB - Radiographs of hands and feet were obtained from 125 consecutive patients with rheumatoid arthritis (RA) and the degree of destruction was assessed numerically on a 200-point scale using Larsen's standard radiographs as reference. The method is shown to possess a satisfactory degree of reproducibility. In 96 of these 125 patients, values of another 15 simultaneously determined clinical and biochemical variables were obtained. On applying linear and quadratic multiple regression analysis to this set as well as to the male and female subsets, an 'automatic' selection procedure (stepwise regression) proved duration of disease to be the most important factor relating to the 'Larsen index'. The 96 patients were therefore ranked with respect to duration of disease and divided into 4 subsets of equal magnitude. In the 3 subsets with duration of disease less than 21 years, stepwise regression produced in the final step linear or quadratic combinations not containing duration of disease but correlating quite well with the 'Larsen index' (R = 0.64-0.96). A similar result was obtained upon performing an analogous procedure in the female subset. In all instances, positive contributions of varying degree were obtained from Ritchie's index, ESR, a antitrypsin (A1-AT), orosomucoid, fibrinogen, and IgM, while negative correlations were associated with ceruloplasmin, IgG, and IgA. PMID- 3266031 TI - Interleukin-6 (IL-6) in synovial fluid and serum of patients with rheumatic diseases. AB - Interleukin-6 (IL-6) is a monokine with a number of biological activities, which are intimately related to inflammatory responses. We have measured IL-6 levels in synovial fluid (SF) and serum (Se) of patients with rheumatic diseases. SF-IL-6 levels were a thousand-fold higher than corresponding Se levels and a positive correlation was found between SF and Se levels suggesting that Se-IL-6 is derived from IL-6 produced in the joint. Se levels of IL-6 were also positively correlated to C-reactive protein (CRP) levels, supporting the in vitro experiments showing that IL-6 stimulates hepatocytes to produce CRP. Finally we observed a positive correlation between SF-IL-6 levels and the local activity score. PMID- 3266032 TI - Behaviour of von Willebrand factor antigen in follow-up of polymyalgia rheumatica/giant cell arteritis. PMID- 3266034 TI - Beta-lactamases: a major cause of antibiotic resistance. PMID- 3266033 TI - Effect of vibratory stimulation on experimental and clinical pain. AB - The effect of vibratory stimulation on experimental pain of the skin overlying the right and left extensor carpi radialis longus muscle induced by electrical stimulation was studied in 16 healthy subjects and in 18 patients suffering from chronic epicondylalgia of the right elbow. In the healthy subjects there were no side differences whereas in the patients, the skin pain threshold over the painful right muscle was lower than that on the left unaffected side under resting conditions. After vibratory stimulation, the skin pain threshold increased bilaterally by 1.1-1.6 times the pre-stimulation threshold in the healthy subjects and by 1.2-2.3 times this threshold in the patients. In 8 of the healthy subjects there was an increase in peripheral blood flow during stimulation and in 8 there was a small decrease. In 13 patients the change in pain threshold was seen in phase with the local increase and peripheral decrease in peripheral blood flow. In all individuals, the pain thresholds were regained within 45 min of cessation of stimulation. This was in contrast to the general subjective pain in the patients; 12 patients reported that the relief of pain lasted for a period of 1-7 hours. PMID- 3266035 TI - Seasonal control for an endemic disease with seasonal fluctuations. AB - In diseases exhibiting seasonal fluctuations, it may make sense to exploit the seasonality when devising control strategies. In this paper, the effect of using a seasonal screening program to control gonorrhea is examined. Ordinary differential equation models are analyzed with perturbation methods and an optimum seasonal control strategy is determined. PMID- 3266036 TI - Analytical threshold and stability results on age-structured epidemic models with vaccination. AB - This paper examines mathematical models for common childhood diseases such as measles and rubella and in particular the use of such models to predict whether or not an epidemic pattern of regular recurrent disease incidence will occur. We use age-structured compartmental models which divide the population amongst whom the disease is spreading into classes and use partial differential equations to model the spread of the disease. This paper is particularly concerned with an analytical investigation of the effects of different types of vaccination schemes. We examine possible equilibria and determine the stability of small oscillations about these equilibria. The results are important in predicting the long-term overall level of incidence of disease, in designing immunisation programs and in describing the variations of the incidence of disease about this equilibrium level. PMID- 3266037 TI - Oscillations and chaos in epidemics: a nonlinear dynamic study of six childhood diseases in Copenhagen, Denmark. AB - Using traditional spectral analysis and recently developed non-linear methods, we analyze the incidence of six childhood diseases in Copenhagen, Denmark. In three cases, measles, mumps, rubella, the dynamics suggest low dimensional chaos. Outbreaks of chicken pox, on the other hand, conform to an annual cycle with noise superimposed. The remaining diseases, pertussis and scarlet fever, remain problematic. The real epidemics are compared with the output of a Monte Carlo analog of the SEIR model for childhood infections. For measles, mumps, rubella, and chicken pox, we find substantial agreement between the model simulations and the data. PMID- 3266038 TI - Improvement in cardiac performance and exercise tolerance after left ventricular aneurysm surgery--a prospective study. AB - Forty two patients were studied prospectively by rest and exercise radionuclide ventriculography before and after (10 +/- 4 months) left ventricular aneurysm resection. Functional classification (NYHA) improved from 3.0 +/- 0.6 to 2.3 +/- 0.5 (p less than 0.0001) with an increase in double product (p less than 0.01) and total exercise workload (p less than 0.04) over preoperative values. End diastolic volume was significantly reduced (p less than 0.0001) and resting global left ventricular ejection fraction (LVEF) improved significantly (p less than 0.03) after surgery, as did regional ejection fractions of the lateral/inferior wall (p less than 0.01). Cardiac index (CI) at rest, however, remained unchanged. Under exercise, improvement of global (p less than 0.0003) and regional ejection fractions (p less than 0.02) was more pronounced and a significant increase was also observed for CI (p less than 0.003). Improvement in left ventricular performance occurred both in patients with single and multiple vessel disease, but was more distinct in the latter group who additionally received coronary artery bypass grafts. These patients were furthermore postoperatively able to increase global LVEF at exercise (p less than 0.05). We conclude that aneurysm resection with or without coronary bypass relieves cardiac symptoms and improves exercise tolerance and left ventricular function at rest and on exercise in most patients. PMID- 3266039 TI - A microwell assay for anchorage independent cell growth. AB - We describe modifications of the conventional assay for anchorage independent growth of fibroblasts that enable the assay to be carried out in microwell plates, as opposed to the conventional Petri dishes. The microwell assay is a good discriminator of final EGF concentrations in the range 10-100 picograms/ml, and can be used to detect absolute amounts of EGF below 2 pg. Addition of TGF beta to EGF enhances colony formation in the microassay in the usual manner. We describe the use of this microassay to identify and map local production of transforming growth factor activity by the component pieces of individual chick embryos. Transforming activity was identified in all the stages tested (Hamburger and Hamilton stages 13-23). Highest levels were found near the mid-line of the embryo. No clear differences in the cranio-caudal axis have so far been identified. This technique will enable the spatial and temporal distribution of transforming activity throughout vertebrate embryos to be completely mapped. It seems likely that this mapping process will help elucidate the normal role of transforming growth factors in embryos. PMID- 3266040 TI - [Aspects of cognitive functioning in the aged. A transversal study]. AB - In the context of a WHO study on psychosocial needs of the elderly, a sample of 519 subjects from the region of Louvain was psychometrically tested. This sample consisted of men and woman between 55 and 94 years of age, most of them living at home. The test battery was composed of ten verbal and nonverbal tests and tasks currently used in psychogeriatric clinical practice but lacking validation and normative data for those aged populations. This study (psychometric testing took place in 1979-1980) was intended as a first step in a follow up program to gather more definite information about mental deterioration. Up to now it can be considered however as a cross-sectional study, providing normative data for the assessment of cognitive functioning in aged individuals up to 94 years. The decline in performances, found on all these tests, reflect generation as well as aging effects; the increasing proportions of aged subjects failing on the tests however, seem to indicate a high occurrence of partial or global cognitive deficits in elderly people beyond the eighth decade. PMID- 3266041 TI - Histocompatibility and immunological studies in giardiasis. PMID- 3266042 TI - Increased level of soluble interleukin-2 receptor in advanced solid tumors: a preliminary study. AB - Both activated normal and transformed lymphocytes produce not only cell associated but also cell-free IL-2R. Evidence of high serum concentrations of IL 2R appears to serve as a tumor marker in patients with lymphomas On the contrary, the role of soluble IL-2R in solid neoplasms has still to be defined. This investigation was carried out to analyze soluble IL-2R production in human solid tumors. The study included 35 patients with solid tumors (12 without and 23 with metastases), 58 healthy subjects and 6 lymphoma patients. Among cancer patients, lung and breast carcinoma were the two most frequent neoplasms. In each subject or patient, serum levels of IL-2R were measured by using an enzyme immunoassay. Moreover, in 14/23 patients with metastatic solid tumors, lymphocyte subpopulations were also evaluated. Serum levels of IL-2R were significantly higher in the cancer patients than in the normal subjects. The patients with metastatic solid tumors showed significantly higher mean levels than those without metastases, and similar to those observed in the lymphoma patients. Finally, there was no correlation between serum levels of IL-2R and the T4/T8 ratio, which was reduced in 5/14 cancer patients. Further studies will be needed to establish if elevated concentrations of IL-2R in the serum can contribute to the immunoincompetence of patients with disseminated solid neoplasms. PMID- 3266043 TI - Cutaneous remnants of the vitellointestinal duct: a clinico-pathological study of 19 cases. AB - The presence of cutaneous vitellointestinal duct remnants was confirmed histologically in 19 cases in the period 1970-1984. These lesions occurred mostly in males (16 males, 3 females), and 80% in children under the age of five years. One case was identified in an adult, suggesting that these lesions may in some cases cause little inconvenience, and that their true incidence is underestimated. PMID- 3266044 TI - Acute epiglottis: a case cluster. PMID- 3266045 TI - [HLA-B8 antigen as a possible risk factor for developing illnesses accompanied by an autoimmune component]. PMID- 3266046 TI - [Ascorbic acid level and the indicators of cellular immunity in patients with hepatitis A during pathogenetic therapy]. AB - Ascorbic acid content was assayed in plasma and neutrophils of peripheral blood in 260 patients with virus hepatitis A during acute period of the disease. The data obtained have evidenced C-hypovitaminosis in these patients, that was more pronounced in the winter-spring period, according to the disease severity 300 mg of ascorbic acid for 1.5 g of galascorbin/day have proved to be the most optimal dose for vitamin C deficiency elimination. A significant decrease in T-lymphocyte level and an increase in 0-cell content were recorded in the acute period of virus hepatitis A. Ascorbic acid drugs promoted more rapid recovery of T lymphocyte content in the peripheral blood that has confirmed the necessity of vitamin C administration in combined pathogenetic therapy of patients with virus hepatitis A. PMID- 3266047 TI - In-vitro sensitivity of organisms causing urinary tract infections to four common oral antibiotics and to pivmecillinam. PMID- 3266048 TI - Propofol: a new intravenous anaesthetic. PMID- 3266049 TI - [Total incidence of malignant neoplasms among men and women in the Katowice province 1975-1985]. PMID- 3266050 TI - [Brain tumors in children and adolescents up to 18 years of age]. PMID- 3266051 TI - [Sensitivity of Trichomonas vaginalis to desiccation]. PMID- 3266052 TI - [Atherosclerosis--development and mortality in advanced age in the People's Republic of Bulgaria]. AB - This report is based on a 9-year thorough epidemiological study of the lethality of atherosclerosis among people older than 45 years in Bulgaria. PMID- 3266053 TI - [Gaucher disease and pregnancy]. AB - Two pregnancies in a patient with Gaucher's disease type I are reported. Anemia and thrombocytopenia were augmented during pregnancy, but no effect on the spleen and liver was observed. The first delivery was associated with a severe post partum haemorrhagia (platelet count 56,000/mcl, hemoglobin before delivery 10.2 g/100 ml, postpartum 5.5 g/100ml). At the end of the second pregnancy the platelet count was 33,000/mcl. Platelet transfusions were given after induction of preterm labor and no bleeding complications were observed. The obstetric aspects of Gaucher's disease are reviewed. Post partum haemorrhagia is associated with thrombopenia and is observed in patients with platelet counts under 100,000/mcl. Platelet infusions are recommended before delivery in these patients. Thrombocytopenic patients should be carefully monitored during labor with crossmatched blood on standby. PMID- 3266054 TI - [Characteristics of the development of drug addiction and toxicomania in adolescents]. AB - The study involved 152 adolescents which had abused narcotic and toxic substances once, occasionally or regularly. Males aged 15 to 16 years displayed highest occurrence rate of the abuse. Drug addiction and toxicomania were established in 6% of subjects. Volatile stuff and tranquilizers were most frequent in use. Microsocial adversities were experienced by all the subjects. Besides, an "altered background" is characteristic of drug addicts and toxicomania patients. The fact of narcotic and toxic substances usage as euphorigenic agents deserves due attention of narcologists, pedagogues, sociologists. Biologically conditioned risk factors conducive to drug addiction and toxicomania should be investigated. PMID- 3266055 TI - Continuous infusion of midazolam or bolus of diazepam for postoperative sedation in cardiac surgical patients. AB - Sedation and recovery were studied in 14 patients requiring overnight ventilation in the ICU after aortocoronary bypass surgery performed under high-dose fentanyl anesthesia (120 micrograms/kg). Patients received either IV bolus of diazepam (group D) or a combination of IV bolus with a continuous infusion of midazolam (group M). In the 2 groups, an on-demand mode of administration was used to provide optimal sedation. In the ICU, dosages of plasma catecholamines and serum benzodiazepines were performed. After cessation of benzodiazepine administration at midnight, the rapidity of recovery and time of extubation were recorded. Results showed that in the 2 groups, the association of a high-dose fentanyl anesthesia with a profound postoperative sedation maintained the epinephrine and norepinephrine concentrations at low levels during the whole postoperative period. After benzodiazepine discontinuation, recovery and extubation were faster in group M, which correlated with the significant decrease (p less than 0.05) in blood concentration of midazolam observed the first postoperative day whereas at the same time the blood concentration of diazepam did not fall significantly. PMID- 3266056 TI - Calcitonin gene-related peptide and tachykinins in relation to local sensory control of cardiac contractility and coronary vascular tone. AB - The possible role of peptides locally released from sensory nerves in the control of cardiac contractility and the coronary vascular tone was investigated in the present study. Immunohistochemical investigations revealed that calcitonin gene related peptide (CGRP) -like immunoreactivity (-LI) was colocalized in sensory ganglia and in nerve fibres in the heart with substance P (SP) -LI. CGRP-LI was associated with myocardial cells, blood vessels and epicardia and endocardia in the atria while in the ventricles, CGRP-LI was mainly seen close to blood vessels and very few fibres were present in the myocardium. The level of CGRP-LI was three to four times higher in the right atria than in the ventricles. The tissue content of CGRP-LI was markedly reduced by systemic pretreatment with capsaicin, suggesting a sensory origin. Activation of capsaicin-sensitive cardiac C-fibres by K+, nicotine, bradykinin, ouabain and ischaemia was associated with a release of CGRP as indicated by an increased overflow from the isolated perfused guinea pig heart. In addition, K+ and capsaicin induced the release of neurokinin A. Nicotine and K+ evoked the release of neuropeptide Y, which is present in sympathetic nerves. CGRP induced a prolongation of the action potential plateau phase in atrial myocytes, increased the velocity of relaxation and evoked positive chronotropic and inotropic effects. Capsaicin induced electrophysiological and contractile effects similar to those of CGRP. Furthermore, specific high affinity binding sites for CGRP were demonstrated in the rat heart and in the atrium CGRP stimulated adenylate cyclase activity. The capsaicin effects were abolished after systemic capsaicin pretreatment, which did not influence the stimulatory effects of CGRP or noradrenaline (NA), however. Repeated administration of CGRP to the same atrial preparation induced tachyphylaxis. After CGRP tachyphylaxis the stimulatory effects of capsaicin but not of NA were absent. The stimulatory actions of capsaicin on atrial contractility therefore seem to be evoked by CGRP. The inhibitory effects of capsaicin on ventricular contractility were not dependent on mediators released from capsaicin-sensitive sensory nerves. CGRP, SP and capsaicin induced coronary vasodilatation in the pig in vivo and in vitro. The vasodilatory effect of SP was subject to rapid tachyphylaxis and endothelium-dependent. Neither the CGRP- nor the capsaicin-induced relaxation was influenced by SP tachyphylaxis or removal of the endothelium. It is therefore suggested that CGRP is a more likely candidate than SP as a causative agent in the vasodilatory response seen upon activation of cardiac sensory nerves.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3266057 TI - Intimacy and mental disorder in late middle age. Report of the TURVA project. AB - This study, which was carried out as part of the TURVA project on psychosocial adaptation in old age, is concerned with the significance of social support to people approaching retirement age. The population consisted of 200 urban dwellers and 189 rural dwellers, who were studied at the age of 62. The subjects were either about to retire in the near future or had already retired, and it was assumed that this event causes a certain amount of stress, which may lead to mental disturbance regardless of the amount of social support available to the individual. Intimate relationship and close friendship served as the measures of social support. Mental disturbances were assessed on the basis of the General Health Questionnaire (36-item version) and the number of psychic and especially depressive symptoms. The prevalence of mental disturbance and depressive symptoms was lowest in those people who lived in a close marital relationship and who also described their spouse as empathic. Psychic symptoms were most common in those people who said their relationship to their spouse was distant and who described them as unempathic. The subjects who were not married fell in-between these 2 groups regardless of whether they had an intimate relationship with someone of the opposite sex. A positive marital relationship seemed to provide a shield against depression, while a negative marital relationship tended to make the individual more vulnerable to depression. The role of a close non-marital friendship depended on the respondent's sex. In women, it was associated with a high prevalence of depressive symptoms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266058 TI - Brain morphology in schizophrenia: a 2- to 5-year CT scan follow-up study. AB - In order to investigate whether structural brain changes in schizophrenia are static or progress in time, 17 schizophrenic patients were examined by computed tomography (CT) between 2 and 5 years after the initial scan. There was no change in cerebral ventricular size or degree of cortical atrophy over this period. The stability of CT scan measures of cerebral atrophy in individual schizophrenic patients confirms the hypothesis of the early appearance of structural brain abnormalities in schizophrenia as formulated in previous cross-sectional studies. Furthermore, the pathological process responsible for the CT finding of cortical or central atrophy does not seem to progress nor to reverse itself in young schizophrenic patients. PMID- 3266059 TI - Youth suicide: a cross-cultural perspective. AB - Changes in the suicide rate of teenagers and young adults internationally from 1970 to 1980 were examined. Twenty-three nations experienced an increase (with Norway experiencing the largest percentage increase), while six experienced a decrease. Unlike general suicide rates, teenage suicide rates were not related to the quality of life in the nations surveyed. PMID- 3266060 TI - Asbestos-related pleural plaques and lung function. AB - The present study examines the association between asbestos-related pleural plaques and lung function in a group of workers with occupational exposure to asbestos. Exposure, smoking, and respiratory histories, chest radiographs, flow volume loops, and single breath DLCOs were obtained on 383 railroad workers. A score based on the ILO-1980 classification system was used to quantify the extent of plaquelike thickening. In order to eliminate potential confounders, we excluded from final analysis subjects with diffuse pleural thickening (n = 10) or small irregular opacities classified as profusion 0/1 or greater (n = 6) on chest radiograph. Definite pleural plaques were observed in 22.6%. The single breath DLCO was similar in the groups with and without plaques (p = 0.0550). Decrement in FVC and the occurrence of pulmonary restriction were associated with the presence of definite plaques (p = 0.0306 and 0.0431, respectively) and with quantitative pleural score (p = 0.0135 and 0.0126), controlling for duration of asbestos exposure and smoking. A test for trend revealed an association between level of diagnostic certainty (none, suspect, definite) for pleural plaques and these measures of lung function (p less than 0.02). Our findings reveal an association between asbestos-related pleural plaques and decrement in lung function as measured by FVC and criteria for pulmonary restriction. PMID- 3266061 TI - [Status of central hemodynamics in puerperants with postpartum hemorrhage in relation to the characteristics of infusion therapy]. PMID- 3266062 TI - [Pathogenesis of hemovascular disorders in puerperants with massive hemorrhage]. PMID- 3266063 TI - Is propofol a safe agent in porphyria? AB - A case is presented of the use of a propofol infusion for anaesthesia in a patient with known variegate porphyria. Urinary screening for porphyrins demonstrated a marked increase after this anaesthetic, but there were no clinical symptoms. PMID- 3266065 TI - [Socioeconomic status and growth in school children]. AB - We admit that somatic growth depends on genetic and nutritional factors, and that the latter are related to social and economic status of the population. To test the hypothesis that social and economic status is associated with growth, we have carried out in Madrid a cross-sectional study among 2,983 school children aged 6 to 14 years old. It shows a consistent positive association in all age brackets between socio-economic status and growth among school girls, suggesting a need for nutrition educational programs in this population subgroup. PMID- 3266064 TI - Propofol during cardiopulmonary bypass in a patient susceptible to malignant hyperpyrexia. PMID- 3266066 TI - Low-vision aids in Stargardt's disease. AB - Fifteen patients with juvenile macular degeneration fitted with low-vision aids were followed up for a period of two to three years. About 80% of the patients equipped with visual aids used their devices successfully. It appears that in Stargardt's disease, low-vision aids are more useful than in other maculopathies. PMID- 3266067 TI - Zoster-related bilateral acute retinal necrosis syndrome as presenting sign in AIDS. AB - The acute retinal necrosis (ARN) syndrome has recently been associated with intraocular infections with one or more members of the herpesvirus family. There have been 14 cases in the literature linking ARN with a preceding or subsequent herpetic dermatitis. We report the development of bilateral ARN (BARN) after unilateral Herpes zoster ophthalmicus as the presenting sign of acquired immunodeficiency syndrome (AIDS) in a previously healthy man. The development of BARN after diffuse Herpes simplex dermatitis in AIDS patients is also discussed. These cases further illustrate the central role of the herpes-virus family in the etiology of ARN and alert the clinician to a new presenting sign for AIDS. PMID- 3266068 TI - Low molecular weight IgM in juvenile chronic arthritis. AB - Low molecular weight IgM, the monomeric subunit of pentameric IgM, was clearly detected by immunoblotting and filtration chromatographic techniques in six patients with juvenile chronic arthritis and in trace quantities in a further eight of 24 patients studied. This low molecular weight IgM moiety contributed up to 33% of the total circulating IgM and was strongly associated with raised serum concentrations of IgM and the presence of antinuclear antibodies, extractable antinuclear antibodies, and rheumatoid factor. Immunoblot analysis of positive serum samples showed small quantities of other low molecular weight oligomers of IgM in addition to monomeric IgM. It is postulated that the presence of low molecular weight IgM in the serum of patients with juvenile chronic arthritis reflects a disorder of the intracellular assembly of IgM subunits during a stimulated IgM immune response. The pathogenetic role of low molecular weight IgM remains uncertain. PMID- 3266070 TI - Propranolol enhances acetylcholine-induced relaxation in the various arterial segments of rabbit. AB - The effect of propranolol on acetylcholine-induced relaxation and vasodilatation was studied in the isolated rabbit aortic strips, aortic rings and whole perfused carotid, femoral arteries precontracted by phenylephrine. Acetylcholine produced a concentration-dependent relaxation and vasodilatation in all investigated endothelium-intact arterial segments. The relaxing and vasodilator effects of acetylcholine were completely prevented after the removal of endothelium and prior addition of methylene blue to the incubation medium in endothelium intact segments. Addition of propranolol to the medium significantly enhanced the relaxing activity of acetylcholine. Acetylsalicylic acid failed to inhibit the potentiating effect of propranolol on acetylcholine-induced relaxation. From these results it was concluded that the potentiation by propranolol of the vascular relaxing effect of acetylcholine is probably mediated through the increased release of EDRF from vascular endothelium. The possible mechanisms of this effect are discussed. PMID- 3266071 TI - A contribution to mathematical modelling of immunological tolerance. AB - The original simple mathematical model describing the kinetics of B cell tolerance was extended by the inclusion of Th cell tolerance. It anticipates the existence of two compartments of B and Th cells reactive to the antigen--the immature cells and the mature ones. It is assumed that tolerance is induced by irreversible inactivation of the antigen-reactive cells and the escape from tolerance is due to their differentiation from the precursors. There is also considered the situation, where two categories of Th cells cooperate with the same B cells. Besides that, suppressive activity on Th cells is included in the model. The simulated values are compared with experimental data. PMID- 3266069 TI - Alpha 1-proteinase inhibitor in psoriasis: reduced activity in symptom-free patients and during flare. AB - The aim of this study was to quantitate the active fraction of the alpha 1 proteinase inhibitor (alpha 1-PI) in psoriasis. Serum proteinase inhibitory capacity was measured vs porcine pancreatic elastase of a known active fraction against its specific substrate (Suc-Ala3-pNA). The inhibitory capacity was determined in 21 symptom-free patients, 134 patients with skin lesions, and 23 healthy volunteers. Alpha 1-PI was found to be significantly decreased in symptom free patients and in those with stationary lesions, in a manner similar to the reduced activity of neutrophil proteinases, elastase, and cathepsin G. The synthesis of alpha 1-PI was stimulated during the appearance of active psoriatic lesions, but to a much lesser degree in patients with early onset (less than or equal to 21 years) than in patients with late onset of psoriasis (greater than 21 years). The early onset subgroup differed by a more frequent familial occurrence of psoriasis and a more severe course of the disease. The data indicate that the regulation of the proteinase-alpha 1-PI system in psoriasis is abnormal and this may contribute to the pathogenesis of the disease. The decreased alpha 1-PI during flare may be responsible for the disease activity, at least in patients with early onset of psoriasis. PMID- 3266072 TI - An evaluation of transcutaneous electrical nerve stimulation for pain relief in labour. AB - The effectiveness of transcutaneous nerve stimulation (TENS) for pain relief in labour was evaluated by randomizing 280 patients in early labour into 2 groups. Inoperative sham machines were applied to patients in the control group and active units to those in the test group. Neither patients nor attending labour ward staff were aware of which group the patient was in. The intensity of low back pain and abdominal pain was assessed by the patient each hour on a visual analogue pain scale. Each patient served as her own control by switching off the machine for 2 contractions every hour and then recording the intensity of pain. The amount of conventional analgesia each patient received was recorded by labour ward staff. There was no difference in the intensity of pain recorded by each group. Nor was there any difference between the 2 groups in the change of pain experienced when the machine was switched off. Moreover there was no difference in the amount of other analgesia required. Some differences were found when those with little low back pain were excluded from the study. We conclude that TENS is ineffective as a routine method of pain relief in labour. It is likely to benefit only those with severe back pain and then only to a modest degree. PMID- 3266073 TI - Reflex sympathetic dystrophy syndrome in children. AB - We report 3 children with reflex sympathetic dystrophy syndrome, review the literature, and discuss current concepts of diagnosis and management. In this disorder, pain, tenderness, swelling, vasomotor instability, and dystrophic skin changes frequently develop after minor injury. The clinical diagnosis is supported by osteopenia detected on radiographs and either increased or decreased radionuclide uptake on bone scan of the affected extremity. Treatment with a graduated program of physical therapy and transcutaneous electrical nerve stimulation is beneficial in almost all patients. In contrast to adults, the prognosis of childhood reflex sympathetic dystrophy syndrome is favorable; most children recover completely after one episode. PMID- 3266074 TI - Synthesis of deacetylthymosin beta 11 and its effect on the impaired T lymphocytes of a uremic patient with common variable immunodeficiency. AB - The untetracontapeptide corresponding to the entire amino acid sequence of deacetylthymosin beta 11 was synthesized by assembling six peptide fragments via the azide followed by deprotection with 1 M trifluoromethanesulfonic acid thioanisole in trifluoroacetic acid in the presence of dimethylselenide. The synthetic peptide was tested for its effect on the impaired blastogenic response of phytohemagglutinin-stimulated T-lymphocytes of a uremic patient with common variable immunodeficiency. The synthetic peptide had some restoring activity on the impaired blastogenic response of T-lymphocytes in the one patient tested. PMID- 3266075 TI - Substrate flux through methylenetetrahydrofolate dehydrogenase: predicted effects of the concentration of methylenetetrahydrofolate on its partitioning into pathways leading to nucleotide biosynthesis or methionine regeneration. AB - Folic acid exists in mammalian cells with a poly-gamma-glutamate tail that may regulate the flux of folates through the various cellular pathways. The substrate polyglutamate specificity of methylenetetrahydrofolate dehydrogenase from pig liver has been examined by using a competitive method and measuring apparent tritium kinetic isotope effects on Vmax/Km for methylenetetrahydrofolate. This competitive method yields very accurate ratios of Km values for alternate substrates of an enzyme and may also be applied to reactions with no isotope effect. In combination with published data from our own and other laboratories, the kinetic parameters of methylenetetrahydrofolate dehydrogenase were used to calculate the initial velocities of pig liver methylenetetrahydrofolate dehydrogenase, thymidylate synthase, and methylenetetrahydrofolate reductase, at physiological concentrations of substrates and enzymes. These calculations suggest that the cellular concentration of methylenetetrahydrofolate may regulate the flux of this metabolite into the pathways leading to nucleotide biosynthesis and methionine regeneration. An increase in the cellular level of methylenetetrahydrofolate would permit more one-carbon units to be directed toward nucleotide biosynthesis. PMID- 3266076 TI - Cognitive function and platelet membrane fluidity in Alzheimer's disease. AB - Increased platelet membrane fluidity, as reflected by a decrease in the fluorescence anisotropy of diphenylhexatriene in labeled membranes, identifies a clinically distinct subgroup of approximately 50% of patients at our center who meet NINCDS-ADRDA clinical criteria for Alzheimer's disease. In the current study, we compared the cognitive impairments of patients in this subgroup to those observed in the residual subgroup of patients with Alzheimer's disease who had normal platelet membrane fluidity. No significant differences in the number or distribution of deficits in six cognitive domains were observed between the two subgroups. However, in the subgroup with increased platelet membrane fluidity, there were significantly more patients who exhibited dissociation of deficits on tests related to left and right parietal lobe function than in the residual subgroup. Moreover, the cases with dissociation of deficits consisted almost entirely of patients with deficits on tests reflecting left parietal lobe function and no deficit on tests of right parietal lobe function. PMID- 3266077 TI - Salivary cortisol and adrenal function. PMID- 3266078 TI - [Electrotherapy of flaccid paralysis]. PMID- 3266080 TI - Hematon: a multicellular functional unit in primary hematopoiesis. AB - Bone marrow aspirates from healthy donors contain a fraction of low density multicellular spheroids, 100-500 microns in diameter. They are organized in a three-dimensional network consisting of central preadipocytes/adipocytes, mesenchymal and reticular cells, and resident macrophages that are closely associated with myeloid, erythroid and megakaryocyte progenitor cells and with their progenies. These spheroids are 2- to 5- fold more abundant in progenitor cells compared with the whole bone marrow as estimated by monoclonal antibody markers My 10 and T 9, by analysis of granulocyte--macrophage colony forming cells (GM-CFC) and by cytological techniques. They produce terminally differentiated cells in organotypic microcultures. We suggest that a multicellular spheroid may represent the fundamental unit of primary hematopoiesis; we therefore name it hematon. Here we show that the presence of hematons in bone marrow aspirates correlated positively with homeostatic blood cell production: they were present in normal bone marrow (BM) (19/25), and absent in myelodysplasic syndromes (MDPS) (8/21), in acute nonlymphocytic leukemias (ANLL) (3/22) and in chronic myeloid leukemia (CML) (2/28). The hematons were recovered under hematological remission in MDPS and in ANLL, suggesting that they may be dispersed reversibly in certain disease conditions. The hematons represent a unifying model around which the variability in some bone marrow cell functions can be explored. PMID- 3266081 TI - Lifetime and six-month prevalence of psychiatric disorders among sentenced female offenders. AB - The authors determined the six-month and lifetime prevalence of psychiatric disorders among 100 consecutively admitted female offenders to a prison, using Diagnostic Interview Schedule (DIS Version III) and found high prevalence rates of schizophrenia, major depression, substance use disorders, psychosexual dysfunction, and antisocial personality disorders. The prevalence rates of these disorders were significantly higher than those of the general population. The authors note the implications of their findings for treatment of women within the correctional system. PMID- 3266079 TI - Myoplasmic binding of fura-2 investigated by steady-state fluorescence and absorbance measurements. AB - Binding of the fluorescent Ca2+ indicator dye fura-2 by intracellular constituents has been investigated by steady-state optical measurements. Fura-2's (a) fluorescence intensity, (b) fluorescence emission anisotropy, (c) fluorescence emission spectrum, and (d) absorbance spectra were measured in glass capillary tubes containing solutions of purified myoplasmic proteins; properties b and c were also measured in frog skeletal muscle fibers microinjected with fura 2. The results indicate that more than half, and possibly as much as 85%, of fura 2 molecules in myoplasm are in a protein-bound form, and that the binding changes many properties of the dye. For example, in vitro characterization of the Ca2+ dye reaction indicates that when fura-2 is bound to aldolase (a large and abundant myoplasmic protein), the dissociation constant of the dye for Ca2+ is three- to fourfold larger than that measured in the absence of protein. The problems raised by intracellular binding of fura-2 to cytoplasmic proteins may well apply to cells other than skeletal muscle fibers. PMID- 3266082 TI - Shock-induced modulation of lymphocyte responsiveness and natural killer activity: differential mechanisms of induction. AB - The present study was designed to determine the influence of signaled shock on splenic natural killer (NK) activity and nonspecific T-lymphocyte mitogenic responsiveness. Furthermore, experiments were conducted to examine possible mechanisms mediating this suppression. The results demonstrate that a single session of signaled shock induces suppression of splenic NK activity and T-cell response to the mitogens concanavalin A (Con A) and phytohemagglutinin (PHA). However, the suppression of mitogenic responsiveness was attenuated after five daily sessions of shock, while NK activity remained suppressed. The suppression of NK function was prevented by administration of naltrexone prior to the shock session indicating mediation by opiate receptors. However, naltrexone did not prevent the shock induced suppression of mitogenic responsiveness to Con A or PHA. Diazepam was not effective in preventing the shock-induced suppression of mitogenic responses or NK activity. Collectively, these results demonstrate that mononuclear cell populations in the spleen are differentially affected by the same stressor and that the immune alterations are mediated via different pathways. PMID- 3266083 TI - Drinkers at risk in Western Australia. PMID- 3266085 TI - Singapore: a study of university students' drinking behaviour. PMID- 3266084 TI - Alcohol consumption and casualties: a comparison of two emergency room populations. PMID- 3266086 TI - Epidemic cocaine abuse: America's present, Britain's future? PMID- 3266087 TI - Trends in drinking problems and attitudes in the United States: 1979-1984. PMID- 3266088 TI - Follow-up of heroin addicts in Spain (EMETYST project): results 1 year after treatment admission. PMID- 3266089 TI - Korner rejects diagnoses. PMID- 3266090 TI - Planar relations of semicircular canals in awake, resting turtles, Pseudemys scripta. AB - As part of a project aimed at elucidating mechanisms of vestibulocollic control in the red-eared turtle Pseudemys scripta, we have calculated the planar relations of its semicircular canals using principal-components analysis. This information is prerequisite to understanding the pattern of canal activation that is set up by head movement of any spatial form. In addition, we have developed a method for monitoring canal orientation in an awake, behaving animal, and we have used this technique to assess canal position in resting turtles. Our results indicate that ipsilateral canals in Pseudemys are not mutually orthogonal, nor are complementary canals precisely coplanar, although they approach this idealized condition more closely than do the canals of several other vertebrates for which quantitative data exist. One significant departure from the perfectly orthogonal configuration is that both verical canals are rotated slightly toward the frontal plane; thus, Pseudemys should be somewhat more sensitive to head roll than to head rotation in other planes. Radiographic analyses of awake, resting turtles indicate that the anterior interparietal suture is held aligned with the earth horizontal and midsagittal plane. The horizontal canal is pitched up (open anterior) 3-4 degrees relative to the earth horizontal. PMID- 3266091 TI - Interleukin-1 induces conditioned taste aversion in rats: a possible explanation for its pituitary-adrenal stimulating activity. AB - To investigate the possible aversive stimulus properties of peripherally administered interleukin 1 (IL-1), rats received two pairings of ingestion of a saccharin solution with various doses of recombinant rat interleukin 1 in a conditioned taste aversion paradigm, using 20 mg/kg lipopolysaccharide endotoxin as a positive control. Rats treated with 1 and 10 micrograms IL-1 showed a dose dependent reduced preference for saccharin together with dose-dependent impairments in weight gain. Since these effects were obtained within the range of doses that has been previously reported to stimulate the release of ACTH, it is proposed that this last action of IL-1 is likely to be secondary to the aversive effects of IL-1. PMID- 3266092 TI - The geographic distribution of child abuse in an inner city borough. AB - The reported incidence of child abuse continues to rise. Present funding constraints make the introduction of child abuse intervention programs of proven effectiveness very difficult. This difficulty may lead to a change in direction away from population screening which looks for individuals at risk, towards the identification of geographic areas where child abuse is persistently concentrated (target areas). The method of plotting on a large scale map all registered cases of child abuse in an inner London borough is compared to three more complicated methods in its ability to accurately identify target areas. The geographic plotting of cases is favored because of its simplicity and our ability to update it annually as well as identify smaller areas such as housing estates. PMID- 3266093 TI - Prevalence of dementia in a Norwegian sample aged 75 years and over and living at home. AB - The prevalence of dementia in the age group 75 and over was studied in a random sample of elderly living at home. The MMS and the GMS were used as screening instruments, supplemented by medical history and a physical examination. The dementia diagnosis was confirmed by psychogeriatric assessment and a follow-up after 18 months. The prevalence of dementia in this sample was 10.5%; for severe dementia 3.8%, and for mild dementia 6.7%. Its occurrence was found to be unrelated to gender, marital status, domestic status, and duration of schooling. PMID- 3266094 TI - Prevalence and severity of coronary atherosclerosis in males living in Mexico City: the Mexico City project. AB - The current prevalence of coronary atherosclerosis was investigated in 174 necropsic studies performed on males who died violently between 1984 and 1986 in Mexico City. In young adults, coronary atherosclerosis was found in 35% of the cases, 5% of whom had significant obstruction in one coronary vessel. In subjects aged 50-69 years, coronary atherosclerosis occurred in 69% of the cases and obstructive disease in 24%. Current figures suggest an increase in the severity of coronary atherosclerosis in this population which may be linked with nutritional changes. This makes further investigations, as well as the design of a program for ischemic heart disease prevention in Mexico City imperative. PMID- 3266095 TI - Effects of thymosin on soybean lectin responsiveness of thymic small lymphocyte subsets from streptozotocin-induced diabetic rats. PMID- 3266096 TI - Authentication of a human lymphoblastoid cell line producing a retrovirus and the infectivity of human T-cell and B-cell lines with the virus. PMID- 3266097 TI - Epidermal growth factor (EGF)-induced morphological changes in the basement membrane of chick embryonic skin. An electron-microscopic study. AB - The effect of epidermal growth factor (EGF) on the basement membrane structure of chick embryonic skin cultured in a chemically defined medium (BGJb) containing 20 mM hydrocortisone, and EGF at 10, 50, or 100 ng/ml supplemented with 5% delipidized fetal calf serum, was examined by electron microscopy. During development of the epidermis in vitro, EGF (100 ng/ml) caused striking changes to occur in the basement membrane structure and in the keratinization process. The basement membrane frequently became discontinuous with many gaps apparent in section, and occasionally became folded following detachment from the basal surface of the epidermis and protruded into the underlying dermis. In the basal and intermediate cells of EGF-treated epidermis, tonofilament bundles were decreased in number, while desmosomes and hemidesmosomes revealed no significant changes in morphology. PMID- 3266100 TI - Laboratory diagnosis of chancroid. PMID- 3266099 TI - Alterations in the morphology of ganglion cell dendrites in the adult rat retina after optic nerve transection and grafting of peripheral nerve segments. AB - Transected ganglion cell axons from the adult retina are capable of reinnervating their central targets by growing into transplanted peripheral nerve (PN) segments. Injury of the optic nerve causes various metabolic and morphological changes in the retinal ganglion cell (RGC) perikarya and in the dendrites. The present work examined the dendritic trees of those ganglion cells surviving axotomy and of those whose served axons re-elongated in PN grafts to reach either the superior colliculus (SC), transplanted SC, or transplanted autologous thigh muscle. The elaboration of the dendritic trees was visualized by means of the strongly fluorescent carbocyanine dye DiI, which is taken up by axons and transported to the cell bodies and from there to the dendritic branches. Alternatively, retinofugal axons regrowing through PN grafts were anterogradely filled from the eye cup with rhodamine B-isothiocyanate. The transection of the optic nerve resulted in characteristic changes in the ganglion cell dendrites, particularly in the degeneration of most of the terminal and preterminal dendritic branches. This occurred within the first 1 to 2 weeks following axotomy. The different types of ganglion cells appear to vary in their sensitivity to axotomy, as reflected by a rapid degeneration of certain cell dendrites after severance of the optic nerve. The most vulnerable cells were those with small perikarya and small dendritic fields (type II), whereas larger cells with larger dendritic fields (type I and III) were slower to respond and less dramatically affected. Regrowth of the lesioned axons in peripheral nerve grafts and reconnection of the retina with various tissues did not result in a significant immediate recovery of ganglion cell dendrites, although it did prevent some axotomized cells from further progression toward posttraumatic cell death. PMID- 3266098 TI - C1q production and C1q-mediated immune complex retention in lymphoid follicles of rat spleen. AB - Involvement of C1q in retaining immune complexes in germinal centers in rat spleen was studied in vivo and in vitro. C1q production was found in fibroblastic reticulum cells in the peripheral mantle zone, in follicular dendritic cells in germinal centers, and in transitional forms between these two cells in the inner mantle zone. In passively immunized animals, immune complexes were found transiently on fibroblastic reticulum cells, then on the transitional forms and follicular dendritic cells. Extracellular C1q was detected by the presence of immune complexes on both the transitional forms and follicular dendritic cells, but not on fibroblastic reticulum cells. Thus, the fibroblastic reticulum cell appeared to trap immune complexes but not to retain either immune complexes or C1q. The morphology and function of the fibroblastic reticulum cell and the follicular dendritic cell suggest that they belong to the same lineage. Immune complexes were bound in vitro to germinal centers in cryostat spleen sections in the same manner as those retained in vivo. The binding required no complement in the incubation medium and was inhibited by C1q-suppressing factors. The extracellular C1q originating from the follicular cells may therefore play a role in retaining immune complexes in the germinal center. PMID- 3266102 TI - National Advisory Committee on Immunization (NACI). PMID- 3266101 TI - Immunization status of 1986 school entrants--Newfoundland. PMID- 3266103 TI - Invasive haemophilus influenzae disease in Canada. PMID- 3266104 TI - [Preliminary analysis on the causes of prevalent tuberculous meningitis in Heilungjiang province]. PMID- 3266105 TI - [Elastase activity of the sputum and the functional activity of serum alpha 1 antitrypsin in patients with chronic obstructive pulmonary disease]. PMID- 3266106 TI - Effect of changing the light/dark schedule, the time of onset of the light or dark period, or the daylength, on rhythms of epidermal cell proliferation. AB - Rhythms of labeling and mitotic indices were studied in the hindlimb epidermis of the anuran tadpole Rana pipiens under different light/dark (LD) cycles and daylengths in order to examine the role of the various parameters of the lighting regimen in setting the periods of the rhythms and the timing of the cell proliferation peaks. Altering the time of, or inverting, the 12 h light period on a 24 h day resulted in phase shifting of basically bimodal circadian rhythms with peaks in the light and dark. Thus the cell proliferation rhythms were entrained to the LD cycle. These rhythms also entrained to noncircadian schedules since they lengthened on a 15L:15D cycle and shortened on a 9L:9D cycle, although the bimodal characteristic of a peak in the light and a peak in the dark remained. Studies of 18L:6D and 6L:18D cycles in which either the time of onset of light or dark was changed relative to the 12L:12D control indicated that the onset of dark may regulate the timing of the labeling index peaks while the onset of light may determine the time of occurrence of mitotic index peaks. Control of the timing of labeling and mitotic index peaks by different parameters of the LD cycle suggests a mechanism for cell cycle regulation by the environmental lighting schedule. Analysis of the rhythms on all the cycles studied suggested that labeling index rhythms equal the length of, or twice the length of, the dark period. Mitotic index rhythms equal the daylength or a multiple of the length of the dark period. PMID- 3266107 TI - Seasonal variation of menarche in Sri Lanka. PMID- 3266108 TI - Endoscopic Nd-YAG laser therapy in upper gastrointestinal tract. AB - Forty-seven patients with gastrointestinal bleeding, benign tumor and malignancy were treated by YAG-laser therapy from 1980 to 1987. For active bleeding, laser coagulation was effective in inducing hemostasis. This therapy was also effective for the potential bleeding lesions. Benign sessile lesions such as polyp and adenoma were completely treated by laser vaporization. In cases with malignancy, the small-sized early gastric cancer (less than 15 mm in diameter) could be effectively treated. Among them, one case was followed up for as long as 82 months without any sign of recurrence. On the other hand, poor results were obtained in the cases suffering from early esophageal cancer due to incomplete laser irradiation resulting from the fear of penetration through the thin-walled esophageal mucosa. However, for the malignant stricture, the laser therapy was useful to relieve the lesion due to the regression of the tumor size. After the treatment, the patient was able to take meals orally. The above data demonstrate that the laser therapy is useful for the treatment of bleeding, sessile lesions, small-sized early gastric cancers and malignant strictures induced by advanced cancer. PMID- 3266109 TI - World health situation and trend assessment from 1948 to 1988. PMID- 3266110 TI - Vitamin A supplementation for refugees and famine victims. AB - Reports about recent famine victims and refugees have described the occurrence of xerophthalmia and resultant blindness related to severe vitamin A deficiency. These populations are subject to high prevalences of childhood protein-energy malnutrition and infectious diseases, pre-existing marginal vitamin A status, and inadequate levels of vitamin A in relief rations. In order to prevent unnecessary morbidity and mortality when any of these risk factors arise, famine victims or refugees should receive vitamin A supplements as an early and essential component of the nutritional support provided by relief agencies. Such supplementation should not await the results of nutrition or blindness surveys but rather should be a standard component of the maternal and child health care provided to the affected population until sufficiency of dietary vitamin A has been clearly established. PMID- 3266111 TI - Persistent diarrhoea in children in developing countries: memorandum from a WHO meeting. AB - This Memorandum summarizes current knowledge of the epidemiology, etiology, and pathophysiology of persistent diarrhoea and describes current approaches to its management. A number of research topics are presented which focus especially on improving understanding of the causes of persistent diarrhoea and on developing more effective methods for treatment and prevention. PMID- 3266112 TI - Role of non-human primates in malaria vaccine development: memorandum from a WHO meeting. AB - This Memorandum discusses the coordination and standardization of malaria vaccine research in non-human primates to encourage optimum use of the available animals in experiments that are fully justified both scientifically and ethically. The requirements for experimentation in non-human primates, the availability of suitable animals for malaria vaccine studies, and the criteria for testing candidate vaccines are considered. The policy and legislation relevant to the use of non-human primates in biomedical research are also briefly discussed. The Memorandum concludes with eight recommendations. PMID- 3266114 TI - Detection of all human Plasmodium species by a telomeric DNA fragment cloned from Plasmodium berghei. AB - A telomeric DNA fragment that was cloned from Plasmodium berghei was used to detect the genomic DNA of P. falciparum, P. vivax, P. malariae, and P. ovale. The fragment hybridized to the DNA of all four of these human Plasmodium species and can be used as an interspecific probe to detect human malaria. PMID- 3266115 TI - Effect of oral contraceptive steroids on the clinical course of malaria infection and on the pharmacokinetics of mefloquine in Thai women. PMID- 3266116 TI - Sex-difference in reporting allergic symptoms. PMID- 3266113 TI - Safety of oral poliomyelitis vaccine: results of a WHO enquiry. PMID- 3266117 TI - Production of interleukin 1 in the joint during the development of antigen induced arthritis in the rabbit. AB - Antigen-induced arthritis in the rabbit closely resembles rheumatoid arthritis. The levels of interleukin 1 (IL-1) in the synovial fluid and the synthesis of IL 1 by infiltrating cells in synovial fluid and by the synovial lining from control and inflamed joints has been assessed during the first month of this disease. A number of biological assays have been used to measure rabbit IL-1. Of these, only the assay using the murine thymoma cell line (EL-4 NOB-1) was able to detect IL-1 activity in the synovial fluid of arthritic joints, which was present only in the very early lesion. The leucocytes infiltrating the synovial cavity produced little IL-1 ex vivo in the acute lesion but released large amounts when arthritis was established. A similar finding was made with respect to the production of IL 1 by the synovial lining. PMID- 3266118 TI - Interleukin 2 receptor expression by macrophages in inflammatory bowel disease. AB - The expression of interleukin 2 receptor by macrophages from normal and inflamed terminal ileum and colon has been studied by using two monoclonal antibodies. In tissue sections from normal ileum and colon, scattered positive lymphocytes and only occasional weakly positive macrophages were seen. In ileal and colonic Crohn's disease or ulcerative colitis many positive macrophages and lymphocytes were seen in the lamina propria. These findings were confirmed by staining cytospin preparations of isolated intestinal mononuclear cells. The isolated macrophages were able to phagocytose opsonized zymosan and the majority were able to undergo a respiratory burst when triggered with opsonized zymosan or phorbol myristate acetate (PMA), suggesting that they were activated. Stimulation with interferon-gamma or lipopolysaccharide did not increase the number of macrophages staining with the antibodies to the interleukin 2 receptor. Therefore we postulate that a large majority of the macrophages expressing interleukin 2 receptor in inflammatory bowel disease are a recently recruited population of cells. PMID- 3266120 TI - Laboratory investigations in clinical immunology: methods, pitfalls and clinical indications. A second IUIS/WHO report. PMID- 3266121 TI - [A case of neoplastic angioendotheliosis with B cell lymphoma]. PMID- 3266119 TI - Studies on the interaction between alpha-gliadin and HLA and T cell receptor molecules in coeliac disease. AB - Coeliac disease has a known strong linkage with the HLA complex and has also recently been linked to the T cell receptor genes but the mechanism whereby these genes confer susceptibility is not known. This study has examined two possible mechanisms: (i) direct, lectin-like binding of alpha-gliadin (the causative agent of CD) to HLA or TcR molecules and (ii) antigenic cross-reactivity between alpha gliadin and HLA or TcR molecules. A flow cytometer was used to assess interactions between alpha-gliadin, anti-alpha-gliadin antibodies (raised in both coeliac patients and in rabbits) and EBV-transformed B cell lines from coeliac patients and HLA-matched and mismatched normal controls. The B cell lines were shown to express HLA-DP, -DQ and -DR antigens which are also found on coeliac intestinal epithelial cells. After incubating B cell lines with alpha-gliadin over a wide range of concentrations, no binding of alpha-gliadin to any of the cell lines could be detected with either of the gliadin-specific antibodies. This suggests that HLA molecules do not bind to alpha-gliadin in a lectin-like fashion. In contrast to the B cell lines, alpha-gliadin binding to peripheral blood monocytes could be demonstrated. This binding occurred equally to patient and control monocytes and was not influenced by HLA allotype. The second possibility tested was that alpha-gliadin and the disease-associated HLA molecule bear antigenic similarities. However, neither rabbit anti-gliadin serum nor purified human alpha-gliadin antibody bound directly to the B cell lines. Using peripheral blood T cells similar results were obtained; no binding of alpha gliadin or antibodies to alpha-gliadin was found. Thus this study shows that the HLA and TcR associations with CD are not explained by the direct binding of alpha gliadin to these molecules nor by a sharing of antigenic determinants between alpha-gliadin and these molecules. PMID- 3266122 TI - [Regional cerebrocerebellar perfusion imaging in spinocerebellar degeneration using technetium-99m-HM-PAO]. PMID- 3266123 TI - Sequential dose injections. A new technique for technetium-99m colloid gastrointestinal bleeding studies. AB - For Tc-99m colloid bleeding studies to be positive, the patient must be actively bleeding while the colloid is circulating in the blood pool. A simple technique of sequential dose injections (SDI) is presented where five injections of 2 mCi each are made at 5-minute intervals. Image acquisition is performed after each injection. This technique results in an increase in the effective plasma residence time of the colloidal particles from 10-15 minutes to 35-40 minutes. A case report is presented in which the bleeding site was identified only after the fifth serial injection of a fractionated dose of Tc-99m microaggregated albumin colloid. PMID- 3266124 TI - Postcholecystectomy bile leak. Serial hepatobiliary imaging and percutaneous drainage. AB - In addition to diagnosing acute cholecystitis, hepatobiliary imaging offers a noninvasive, physiologic, highly sensitive, and apparently underutilized technique for the evaluation of biliary leaks. As this case report illustrates, radionuclide imaging can play an important role in the diagnosis and follow-up of postcholecystectomy biliary leaks, particularly those treated by percutaneous catheter drainage. PMID- 3266125 TI - Abdominal hemangiopericytoma scintigraphically simulating an accessory spleen. AB - Hemangiopericytoma is a soft tissue tumor composed histologically of pericytes of Zimmerman, which line capillaries. These neoplasms have been observed throughout the body in soft tissue and bone. Presented here is a case of abdominal hemangiopericytoma proven histologically that simulated an accessory spleen on a number of studies including Tc-99m sulfur colloid imaging. PMID- 3266126 TI - Major histocompatibility complex extended haplotypes in systemic lupus erythematosus. AB - In a study of 32 white patients with systemic lupus erythematosus from 28 families, 60 unique chromosome 6 haplotypes were defined. The MHC extended haplotype HLA-B8, -DR3, SC01, GL02 was strongly disease-associated (0.09 patients, 0.02 controls, RR = 4.5, C.I. = 1.6-12.4, P less than 0.05), while the corresponding haplotype with the GL01 specificity was not increased in frequency (0.05 in both patients and controls). In the present data, the increase in the haplotype bearing GL02 accounted entirely for the association between HLA-DR3 and SLE. Furthermore, the phenotype of complete C4A deficiency was also strongly disease-associated (patients 0.14, controls 0.02, RR = 8.5, C.I. = 1.8-37.0, P less than 0.05). The only other MHC association in these patients was an increased occurrence of the HLA-B17, -DR7, SC61 haplotype (patients 0.07, controls 0.01, RR = 6.0, C.I. = 1.8-20.6, P corr. less than 0.05). The relationship between MHC markers and autoimmune disease appears to be a result of an association with MHC extended haplotypes and complete complement component deficiencies rather than with individual alleles. It is important that future studies include family members so that such haplotypes can be defined. PMID- 3266127 TI - Diminishing bioavailability of oral leucovorin calcium. PMID- 3266128 TI - Amputations in diabetic patients--a review of rates, relative risks and resource use. PMID- 3266129 TI - Clinical writing and the documentary construction of schizophrenia. AB - Psychiatric practice involves writing as much as it involves talking. This study examines the interpretive processes of reading, writing and interviewing which are central to the clinical interaction. It is part of a broader ethnographic study of an Australian psychiatric hospital (which specializes in the treatment of patients with a diagnosis of schizophrenia). The paper examines two major types of written assessment of patients--the admission assessment and the 'complete work-up.' Writing is analyzed as performance, thereby focusing on the transformations that are effected in patients, their perceptions of their schizophrenia, and their total identity. One crucial transformation is from 'person suffering from schizophrenia' to 'schizophrenic.' The paper aims to show that as much as psychiatry is a 'talking cure' it is also a 'writing cure.' PMID- 3266130 TI - Indomethacin inhibition of IL-2-induced splenocyte proliferation. PMID- 3266131 TI - [Malocclusion prevalence among 3055 Tibetans in Lhasa]. PMID- 3266133 TI - [A survey of Entamoeba gingivalis and Trichomonas buccalis in Xian]. PMID- 3266132 TI - [Preliminary analysis on the relation of saliva and gingivitis in 383 pupils]. PMID- 3266134 TI - Endophthalmitis after Nd:YAG laser capsulotomy. AB - A 63-year-old patient underwent a Nd:YAG laser capsulotomy, 5 months after an extracapsular cataract extraction. One day later endophthalmitis had developed. Staphylococcus epidermidis was cultured from the vitreous. We assume that this micro-organism, a pathogen of low virulence, had been sequestered in the capsular bag and was released into the vitreous after Nd:YAG capsulotomy. PMID- 3266135 TI - Chlamydia ophthalmia neonatorum in Cameroon. AB - In the Ndoungue Hospital in Cameroon 449 new-born babies were examined for a month to check on the occurrence of ophthalmia neonatorum. Silver nitrate eyedrops 1% were applied at birth. The incidence of ophthalmia neonatorum was 19.4%; Chlamydia was found in 8 cases (incidence 1.8%) and gonococci in 4 cases (0.9%). Chemical conjunctivitis was suspected in 13 cases (2.9%). Slight conjunctivitis was seen in 68 cases and severe conjunctivitis in 19 cases (4.2%). A sexually transmitted agent was demonstrated in 6% of the slight cases and in 42% of the severe cases. Ophthalmia neonatorum due to Chlamydia was significantly more frequently severe and without specific features than those due to other agents. Although silver nitrate is still considered to be one of the most effective prophylactic measures for gonococcal ophthalmia neonatorum, in 4 cases this disease still developed. Silver nitrate is ineffective against Chlamydia and is also often the cause of a chemical conjunctivitis. The search is advocated for more efficient medicines in Africa which are effective against both Chlamydia and resistant gonoccoci. PMID- 3266137 TI - Serum alpha 1-protease inhibitor in diabetes mellitus: reduced concentration and impaired activity. AB - We investigated possible alterations in serum alpha 1-protease inhibitor (alpha 1 PI) concentration and activity from insulin-dependent diabetic subjects (IDDs) and in vitro in serum samples containing high glucose concentrations. The in vivo measurements were compared to others taken from normal reference subjects and the in vitro measurements were performed in serum samples containing 0, 10, 20, and 40 mmol/l of glucose. The diabetics had a significantly lower mean alpha 1-PI concentration in their serum than did the reference subjects (1.74 +/- 0.1 g/l vs. 2.1 +/- 0.1 g/l, P less than 0.05), as well as a lower total alpha 1-PI inhibitory activity (201 +/- 0.7 vs. 246.9 +/- 13.5 U/l, P less than 0.02). Addition of glucose to the serum samples in the in vitro study significantly reduced the mean alpha 1-PI concentrations (P less than 0.01 in the case of 10 mmol/l glucose, and P less than 0.001 in the cases of 20 and 40 mmol/l). Added glucose also significantly reduced the mean serum alpha 1-PI activity as determined by the percentage of elastase inhibition in 1, 2, and 3 microliters of reference serum (P less than 0.02 in the case of 10 mmol/l glucose, P less than 0.01 in 20 mmol/l, and P less than 0.001 in 40 mmol/l). Hyperglycaemia thus impaired serum alpha 1-PI concentration and activity both in vivo and in vitro. While the underlying mechanisms and clinical implications of these observations are unknown, the abnormally low alpha 1-PI activity in diabetics may worsen the severity and contribute to the chronicity of their infections. PMID- 3266138 TI - Complements in diabetes mellitus: activation of complement system evidenced by C3d elevation in IDDM. AB - To characterize insulin-dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM) in terms of the complement system, some components of the system as well as the related substances and indices were studied. CH50, C3, C4 and C3bINA significantly increased in both IDDM and NIDDM compared with non-diabetic healthy controls. ACH50 was also elevated in NIDDM, whereas it was similar in IDDM and controls. Besides, the serum concentration of C3d, a breakdown product of C3, was higher in IDDM than in NIDDM and healthy controls, but that in NIDDM did not differ significantly from the control. B1Hg1 was not different among IDDM, NIDDM and non-diabetic controls. These observations suggested that there is a high level of complements in both types of diabetes mellitus, but the complement activation seems to be much enhanced in IDDM compared with NIDDM. PMID- 3266139 TI - [1-Oxovanadatrane--an inhibitor of experimental cholesterolemia]. PMID- 3266136 TI - Primary angle-closure glaucoma among Alaskan Eskimos. AB - An epidemiological study of the occurrence of angle-closure glaucoma was made under the Eskimos population of the Norton Sound and Bering Straits region of Alaska. Among 1673 Alaskan Natives examined 14 cases (0.8%) of angle-closure glaucoma were found, in 0.5% of the men and 1.2% of the women; for persons above the age of 40 years these figures were 2.1% and 5.5% respectively. Angle-closure glaucoma was found in 11.8% of women above the age of 60 years. A shallow anterior chamber was seen twice as frequently in women as in men. Above the age of 30 years the chamber angle was considered to be occludable in 2% of men and 7.5% of women on gonioscopic examination. The average intra-ocular pressure of the right eyes of men was 11.7 mm Hg (s.d. 3.3) and of women 12.0 mm Hg (s.d. 3.4). Primary open-angle glaucoma was not seen in the population being studied. PMID- 3266140 TI - [The effect of nucleotides on the sedimentation properties of contracted sheath of bacteriophage T4]. PMID- 3266141 TI - [Effect of immunoactive substances on sensitivity of the retina to light]. PMID- 3266142 TI - [Progression of coronary artery disease after coronary artery bypass graft surgery]. PMID- 3266143 TI - Occurrence and patterns of driving behavior for alcoholics in treatment. AB - The purpose of this study was to investigate the driving behaviors of male alcoholics. Two hundred and fifty-eight male alcoholics receiving treatment for alcoholism completed a self-administered questionnaire about their driving behaviour and official driver records were accessed. On average, the surveyed individuals drank and drove about 8.6 days per month at the legal level of impairment in Canada (i.e., 80 mg%). Evidence showed that about 88.3% of the sample had driven while impaired. The probability of being arrested for impaired driving was estimated to be about one in 1168 impaired driving events. People were divided into three groups according to their number of Driving While Impaired (DWI) arrests in the previous 10 years, as determined by self-reports and official driving records: zero DWI arrests, one DWI arrest, and multiple DWI arrests. Those with multiple DWI arrests drove while impaired more frequently and with more risky styles of driving than people with zero arrests. Those with two or more arrests also reported that they enjoyed driving under a greater variety of situations as compared to those with zero arrests. Multiple offenders had significantly more total collisions than zero time offenders; however, there were no significant differences among the three DWI groups for collisions without alcohol involvement or other types of traffic violations. Results showed that the number of DWI arrests was generally not related to worse driving when sober. PMID- 3266144 TI - The demographic distribution of drinking patterns in 1984. AB - The demographic distribution of drinking and heavy drinking in a 1984 survey are presented to provide updated prevalence estimates for these phenomena. Several measures of drinking patterns are used, including: the frequency of drinking, the monthly volume consumed, the frequency of drinking five or more drinks on an occasion, the frequency of drinking eight or more drinks in a day, and the frequency of self-reported drunkenness. In most cases, the present results confirm earlier findings. However, the present data give better information on Black and Hispanic drinking patterns than was available in earlier surveys. Results not consistent with earlier studies are that there are contradictory findings regarding the relationship between socio-economic status and drinking and that the drinking patterns of divorced and separated men diverge from those of divorced and separated women. PMID- 3266145 TI - A comparison of alcohol and drug use patterns of homosexual and heterosexual men: the San Francisco Men's Health Study. AB - Very high prevalence rates for problem drinking and/or alcoholism have been estimated for homosexual male populations. Populations characterized by high prevalence rates for problematic drug or alcohol use are of special interest since study of such groups may help to provide insights regarding the processes associated with problematic substance use. However, prevalence estimates for problematic substance use within gay male populations have most typically relied on convenience samples and generally contain an over-representation of bar patrons. This study reports data from a large scale random household sample of homosexual and heterosexual men who live in an urban district of San Francisco, California. Few differences were noted in the drinking patterns of these men, although important differences were found in the prevalence of drug use over a 6 month period. Differences in the prevalence of at least weekly drug use were comparatively minor, however. Health policy implications of these findings are discussed. PMID- 3266146 TI - Aerosol pentamidine for Pneumocystis carinii pneumonia. PMID- 3266147 TI - T-cell responses in hydatid disease patients. PMID- 3266148 TI - [Effect of manganese dichloride on the graft vs host activity of splenic lymphocytes in mice]. PMID- 3266149 TI - Do children on macrobiotic diets show catch-up growth? A population-based cross sectional study in children aged 0-8 years. AB - Children who are fed alternative and especially macrobiotic diets have been reported to be smaller and weigh less than their peers fed omnivorous diets. To answer the questions: at what age does growth in children on macrobiotic diets slow down, and is there any return to standards later in childhood, a cross sectional anthropometric study was performed in the Dutch macrobiotic child population aged 0-8 years (n = 243). Addresses were obtained from macrobiotic organizations and from families already participating in the study. Food habits were checked by a structured food frequency questionnaire. Anthropometric measurements included weight, height, mid-upper arm circumference and triceps and subscapular skinfolds. For each sex, age curves were constructed in comparison to standards. For selected age intervals, standard deviation scores (SDS) were tested for differences from the reference after accounting for confounding variables in a multiple regression model. Reported birth weight was 150 g lower than the Dutch reference; birth weight was positively associated with the consumption frequency of dairy products and fish. During the first 6-8 months of life, SDS were not different from the standard except for arm circumference and skinfolds. From 6-8 months onwards, growth stagnation occurred in both sexes, but was most marked in girls. A minimum level of 1 to 1.5 SD below the P50 of the reference was reached by the age of 18 months. Between 2 and 4 years a partial return towards the P50 occurred for arm circumference and, in boys only, for weight and skinfolds, but not for height. SDS of weight, height and arm circumference were higher in children from families with regular consumption of dairy products than in children from families avoiding dairy products. PMID- 3266150 TI - Separation accuracy of free flow electrophoresis as proved by flow cytometry. AB - The separation accuracy of the free flow electrophoresis ACE 710 device was proved by immunological methods. Several cell populations of human peripheral blood were purified using physical cell isolation methods such as countercurrent centrifugal elutriation and cell electrophoresis. The purified cell fractions were treated with fluoresceinisothiocyanate-labelled antibodies. The percentages of cells in each fraction binding the antibodies of interest were determined by flow cytometry. The analyses revealed that with the help of free flow electrophoresis, given cell populations of human peripheral blood can be highly enriched and that preenrichment of minor cell populations enhances the efficacy of a flow cytometer. PMID- 3266151 TI - Effect of magnesium hydroxide on the absorption of tolfenamic and mefenamic acids. AB - The effect of various antacids on the absorption of tolfenamic and mefenamic acids has been investigated in three separate crossover studies, each consisting of four phases. Single doses of magnesium hydroxide (85 mg, 425 mg and 1700 mg) or of water (150 ml) were given by mouth to 6 healthy volunteers immediately after tolfenamic acid 400 mg (Study 1), and, using an identical study design, after mefenamic acid 500 mg (Study 3). In Study 2 sodium bicarbonate 1 g, aluminium hydroxide 1 g, an antacid preparation containing both aluminium and magnesium hydroxides, or water alone were ingested with tolfenamic acid 400 mg. Plasma concentrations of tolfenamic and mefenamic acids and their cumulative excretion in urine were determined up to 24 h. Magnesium hydroxide greatly accelerated, in a dose-dependent manner the absorption of both tolfenamic and mefenamic acids. The peak times in plasma were shortened by about 1 h by 425 mg and 1700 mg magnesium hydroxide, and the peak plasma concentrations of both fenamates were elevated up to 3-fold. The area under the plasma concentration time curve between 0 and 1 h of tolfenamic acid was increased up to 7-fold and that of mefenamic acid up to 3-fold. The total bioavailability of tolfenamic and mefenamic acids was only slightly increased. Aluminium hydroxide alone and in combination with magnesium hydroxide significantly retarded the absorption and lowered the peak plasma concentration of tolfenamic acid. Sodium bicarbonate had no significant effect on its absorption. The interaction with magnesium hydroxide leads to higher and earlier peak plasma concentrations of the fenamates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266152 TI - Single and multiple dose pharmacokinetics of tenoxicam in the elderly. AB - Fourteen elderly subjects (10 women, 4 men) with a mean age of 81 (SD 6.7) years and in need of anti-inflammatory drug treatment were given a single dose of 20 mg tenoxicam. After a drug-free interval of 5 weeks, multiple dose treatment with 20 mg tenoxicam once daily for 56 days was initiated. The single and multiple dose kinetics of tenoxicam were investigated after HPLC determination of tenoxicam in the plasma. The elimination half-life of tenoxicam ranged from 44 to 132 h (mean 71.9 h) with no significant difference between the single and multiple dosage regimens. Tenoxicam reached maximum plasma concentrations after 1.4 and 1.1 h, with values of 3.6 and 15.5 micrograms.ml-1, for the single and multiple dosage regimen respectively. The corresponding trough values (24-h values) were 1.8 and 11.7 micrograms.ml-1. A mean accumulation ratio of 5.1 was calculated. The mean increase in the area under the plasma concentration time curves at steady-state was 21% more than predicted from the initial single dose. This deviation from linearity was considered to be of minor clinical significance. The kinetics of tenoxicam in elderly were similar to that published for young healthy volunteers. PMID- 3266153 TI - Analogue separates biological effects of salmon calcitonin on brain and renal cortical membranes. AB - The conformation-activity relationship of salmon calcitonin in kidney and brain was investigated with regard to effects on membrane binding and adenylate cyclase activity. Since an amphipathic alpha-helical conformation on the calcitonin molecule is associated with high potency in lowering serum calcium, the activity of the parent peptide was compared to that of [Gly8, D-Arg24]des-Leu16-salmon calcitonin, a calcitonin analogue (CTA) with less helix forming potential. The results indicate that while salmon calcitonin possesses similar potency in brain and kidney, CTA is effective only in brain. Furthermore, CTA did not inhibit the binding of 125I-labeled human calcitonin gene-related peptide (HCGRP) to brain membranes. Our findings suggest that the specific binding and effects of salmon calcitonin on adenylate cyclase activity in brain do not depend on conformational features in the middle region of the molecule, although the alpha-helical structure in this region does appear to be an important property for salmon calcitonin binding to renal cortical membranes. PMID- 3266154 TI - Endothelium-derived relaxing factor inhibits platelet aggregation in human whole blood in vitro and in the rat in vivo. AB - Carbachol (0.03-10 microM) or histamine (0.06-10 microM) challenge of indomethacin-pretreated rat aortic rings inhibited ADP-induced aggregation of platelets suspended in anticoagulated human whole blood. The maximum inhibition of platelet aggregation achieved with either drug was approximately 50%. No such inhibition was observed in rat aortic rings rubbed to remove endothelial cells or in intact vessels preincubated with nordihydroguaiaretic acid (NDGA, 10 microM), mepacrine (10 microM) or methylene blue (100 microM). Intravenously (i.v.) injected carbachol (0.5-5 micrograms/kg) also inhibited ADP-induced accumulation of 111indium-labelled platelets in the pulmonary circulation of urethane anaesthetised rats. This effect of carbachol was inhibited by i.v. injected methylene blue (10 mg/kg) but unaffected by indomethacin (3 mg/kg) or hexamethonium (10 mg/kg) suggesting that PGI2 or adrenaline release did not account for the inhibition of platelet activation observed. Similarly, the platelet inhibitory effect of carbachol in vivo was not related to increased pulmonary vascular blood flow (assessed by accumulation of 111indium-labelled erythrocytes) or blood fibrinolytic activity (measured by euglobulin clot bioassay). The present results suggest that endothelium-derived relaxing factor or a like substance inhibits human platelet aggregation in vitro and rat platelet aggregation in vivo. PMID- 3266155 TI - Household composition choices of older unmarried women. AB - This article extends previous research on the household composition of older unmarried women, using a statistical model that treats each of a woman's surviving children as a distinct potential provider of a shared household. Additional possibilities--living alone, living with other nuclear-family relatives, and living with others--are also recognized, providing a varied range of household-structure opportunities for older women. The approach allows us to identify individual child attributes associated with the propensity to coreside with the older unmarried mother. The results confirm earlier findings regarding the importance of income, age, and disability status as determinants of the household composition of older women. We find, however, that unmarried children, especially sons, are more likely to share a household with an elderly mother than are married children. Working reduces the likelihood that a married daughter will live with her older mother. Overall, the findings suggest that the attributes, more so than the sheer numbers, of living children influence the household structure of their mothers. PMID- 3266156 TI - Lymphocyte function tests in cirrhotic patients under treatment with spironolactone and potassium canrenoate. AB - This controlled study in cirrhotic patients investigated whether two antialdosteronic steroids, spironolactone (100-200 mg/day; n = 12 patient pairs) and potassium canrenoate (50-100 mg/day, n = 32 patient pairs) which are reported to bind to intracellular membranes and modify cytochrome P-450, could also produce nuclear changes. The model used was the response of peripheral lymphocytes to blastogenic agents by studying lymphocyte sub-populations. No changes occurred in the B- and T-lymphocyte sub-populations or in the helper and suppressor sub-types. The response to the blastogenic agents, phytohaemagglutinin and purified protein derived from mycobacteria, did not change significantly from before entry into the study to the follow-up (18.1 +/- 2.9 months). All control patients (n = 44 patient pairs) had slightly greater mitogenic activity compared with patients treated with spironolactone; no difference was found when control patients were compared with patients given potassium canrenoate. The difference between spironolactone and potassium canrenoate might be due to toxicity caused by the thio group of spironolactone. Overall, however, both drugs may be regarded as safe, in terms of effects on lymphatic tissue, occurring during the course of cirrhosis. PMID- 3266157 TI - The effect of zinc status on the immune function of diabetic rats. AB - To evaluate the role of zinc status in immune system dysfunction in diabetic animals, the interleukin-2 production and the lymphocyte mitogenic response to phytohaemagglutinin, concanavalin A and lipopolysaccharide were measured in streptozotocin-induced diabetic rats, diabetic rats treated with insulin and their non-diabetic controls maintained on low zinc, normal zinc and high zinc diets for 3 weeks. Unstimulated lymphocyte proliferation was significantly lower in diabetic rats compared to nondiabetic control rats maintained on normal zinc diet (1505 +/- 318 vs 3447 +/- 497 cpm) (p less than 0.005) or low zinc diet (546 +/- 191 vs 4011 +/- 628 cpm) (p less than 0.005). High zinc diet attenuated the difference between the diabetic rats (2404 +/- 833 cpm) and control rats (3929 +/ 713 cpm). Insulinised diabetic rats were similar to control rats. Phytohaemagglutinin-stimulated lymphocyte proliferation was not significantly altered with dietary zinc changes, but diabetic rats on low zinc diet had significantly lower (p less than 0.025) values compared to control rats on the same diet (41470 +/- 7874 vs 72308 +/- 8895 cpm). Insulinisation did not normalise phytohemaegglutinin-stimulated lymphocyte proliferation (40711 +/- 3666 cpm). Similarly, cells from diabetic rats on low zinc diet, unlike their controls, failed to respond to concanavalin A stimulation. Compared to control rats the diabetic rats on either low or normal zinc diets had lower lipopolysaccharide-stimulated lymphocyte proliferation. High zinc diet or insulinisation normalised mitogenic response of lymphocytes to lipopolysaccharide. Unlike the diabetic rats alterations in dietary zinc intake did not significantly affect the lymphocyte proliferation in control rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266158 TI - Continuity of care: incorporating patient perceptions. AB - Continuity of medical care has been conceptualized by some researchers as an attitude on the part of the patient and provider rather than as a succession of visits to the same provider. A perception of continuity (PC) scale containing 23 statements was developed to empirically test this conceptualization. A cross sectional, random sample survey of adult patients in an established suburban family practice utilized a chart review and mailed patient questionnaire to assess the potential value of this scale. The PC scale had a high degree of internal reliability and a greater correlation with patient satisfaction than two commonly used provider continuity measures, even after controlling for demographic variables. The cost of ambulatory primary medical care was not significantly related to any of the continuity measures. The measurement of patient attitudes to define continuity provided information distinct from provider continuity formulas. PMID- 3266159 TI - [Postoperative changes in perfusion scintigraphic picture in patients with previous myocardial infarct]. AB - In 44 patients with previous MI who underwent CABG, we studied the effect of surgical reperfusion by comparing the different patterns of Thallium uptake after effort or dipyridamole test. For each patient, 9 myocardial segments were classified either normal or abnormal for reversible or irreversible uptake defect, both before and after surgery. CABG (complete in 77% of patients) reduced the incidence of angina (16% vs 77% pre-CABG, p less than 0.001) and of significant (greater than 1 mm) ST-segment depression during the test (20% vs 78%, p less than 0.001). Of 235/496 abnormal segments, 111 (47%) normalised or improved after CABG while an impairment was observed in 34/277 (12%) normal segments or with reversible defect at pre-CABG scan (p less than 0.001). Reversible defects showed a far better outcome relative to irreversible defects: an improvement was achieved in 68% of the former instances, vs only in 27% of the latter (p less than 0.001). Among the 264 myocardial segments which can be ascribed consistently to the territory of some particular coronary vessel, a significantly greater incidence of post-CABG improvement was found in revascularized segments (60/195 vs 5/69, p less than 0.0005). On the contrary it was not possible to correlate the surgery outcome with the presence of ECG Q waves in the segment. Thus the presence of reversible Thallium defects in post MI patients predicts the improvement of regional perfusion pattern after CABG, regardless of the presence of Q waves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266160 TI - [Left paraduodenal hernia disclosed by digestive hemorrhage]. PMID- 3266161 TI - Which endoscopic sclerotherapy technique is preferable to control and then prevent variceal hemorrhage? PMID- 3266162 TI - [Plasma glycosaminoglycans in the pathogenesis of congenital hemorrhagic diathesis]. PMID- 3266163 TI - [Forms of congenital coagulopathies]. PMID- 3266164 TI - [Monoclonal antibodies of the ICO series]. PMID- 3266165 TI - [Use of neutralizing antibodies against tumor necrosis factor for determining the activity of colony-stimulating hematopoietic factors in cultures containing macrophages]. PMID- 3266166 TI - [Monoclonal antibodies BCA-16 against surface T-cell antigen in healthy persons and in patients with leukemia]. PMID- 3266167 TI - [Effectiveness of formation of murine B-hybridomas by using various polyethylene glycols]. PMID- 3266168 TI - Membrane responses to large hyperpolarizations in trabecles and single cells of frog atrium. AB - Atrial trabeculae (studied in voltage-clamping conditions and in the presence of 0.5 mmol/l BaCl2 to abolish gK1) responded to 1 s hyperpolarizations to beyond approximately E = -140 mV (from HP of about E = -80 mV) with an inwardly directed current increasing with time. Quite similar results were obtained with enzymatically dissociated frog atrial cells studied in whole cell voltage clamp with a patch-clamp pipette. This behaviour could be accounted for by assuming the presence of an "if" current at this quite negative range of potentials or by the fact that the cell membrane may undergo reversible electropermeabilization when its potential is brought to values negative to about -140 mV (Stampfli 1958). When a brief (1 ms) and large (150 mV) hyperpolarization was applied 1 s before the test pulse, an inwardly directed current increasing with time was elicited by test pulses to beyond approximately E = -120 mV. This current was neither abolished in the presence of 1 mmol/l CsCl nor greatly reduced in the absence of Na+ ions, unlike "if" (Di Francesco 1981). We conclude that this current having a time course similar to that of "if" is of different nature and we argue that it might be accounted for by electropermeabilization of the membrane (reversible within about 2.5 min) due to the electrical shock represented by a brief and large hyperpolarization. PMID- 3266169 TI - [Effect of non-pathogenic yeast-like fungi of the genus Candida on the process of forming immediate hypersensitivity to heterologous protein in guinea pigs]. PMID- 3266170 TI - [The most important aspects of preventing noise and vibration-induced pathology in coal mines]. PMID- 3266172 TI - [Analysis of the development of perinatal mortality in Austria in the last 25 years]. PMID- 3266171 TI - [Experience using immunocorrecting agents in workers engaged in the manufacture of graphite and asbestos products]. PMID- 3266174 TI - [The significance of intrauterine fetal death for perinatal mortality--analysis of 315 cases]. PMID- 3266173 TI - [Perinatal mortality in the last 12 years at the Innsbruck University Obstetrics Clinic--analysis and consequences]. PMID- 3266175 TI - [Epidemiology of vulvar cancer in Austria]. PMID- 3266176 TI - [Electroanalgesia in labor]. PMID- 3266177 TI - [The prognostic significance of various immunologic parameters in EPH gestosis]. PMID- 3266178 TI - [The activation of natural killer cells. A new approach to adoptive immunotherapy of tumors]. PMID- 3266179 TI - [Heart operations in dialysis patients. Aortocoronary bypass operations and heart valve surgery--chronic dialysis patients]. PMID- 3266180 TI - [Multiple sclerosis in the Bern canton (Switzerland). An epidemiologic study]. AB - We conducted a study on the prevalence of multiple sclerosis in the canton of Berne (Switzerland) at the Department of Neurology (inpatient and outpatient sections) of the Inselspital hospital (University of Berne) in Berne. The canton of Berne is a heterogeneous region, geographically speaking, extending from the foot of the Jura mountains to high Alpine regions. There are approximately 920,000 inhabitants in an area of 6,000 square kilometers. Sources of our study were, besides the Department of Neurology of the University and the practising neurologists of Berne, the Association of Swiss Hospitals (VESKA) and the Swiss Multiple Sclerosis Society. For ensuring a safe diagnosis we employed a diagnosis score suggested by C. M. Poser et al (1983). This covered only safely established and probable cases of MS. To make sure of the actual residence of the retrospectively assessed patients we conducted a checkup with the relevant authorities. Besides personal data it was also possible, in a majority of patients, to obtain data on the onset and course of the disease. On 1, 1, 1986 1,016 MS patients were residents in the canton of Berne, according to our investigations. This corresponds to a prevalence rate of 110 MS patients for every 100.000 inhabitants. The sex ratio (female/male) is about 1.8: 1. The average age of the MS patients covered by the study was 50 years with an average duration of the disease of 18 years. From the data concerning the course of the disease our study was able to gain further pointers on the beginning of the disease, on the pattern of symptoms, course of the disease, and progression of multiple sclerosis. PMID- 3266181 TI - [Immunological studies on peripheral blood lymphocytes from patients with chronic liver diseases. Especially on T cell functions]. PMID- 3266182 TI - [Studies on B cell function and non-specific B cell activation in patients with chronic liver diseases]. PMID- 3266183 TI - Adolescent growth in stature among Sinhalese males: preliminary results of a cross-sectional study. PMID- 3266184 TI - Genetic characterization and origin of Tunisian Berbers. AB - Blood samples from 120 Tunisian Berbers of Gallala village were typed for Gm and Km immunoglobulin allotypes, alpha-1-antitrypsin variants and AB0 blood groups. The results were compared with those of other Berber groups. The combined data, considered in the light of sociological, historical and paleontological data, support the hypothesis that the Berbers are native to North Africa and their ancestors, the first modern man (Homo sapiens) of North Africa, were the founders of the European populations. The ancestors of the Berbers could have been an intermediate population between H. sapiens from Europe and from South Africa. PMID- 3266185 TI - Human hybridoma suppressor factor (HSF) inhibits IL2 production in addition to suppressing immunoglobulin production. AB - The human thymus cell hybridoma, 8E-24, secretes a potent immunosuppressive factor(s), HSF, which inhibits polyclonal immunoglobulin (Ig) production. Our current studies reveal that this suppression is monocyte dependent in that its suppressive activity for Ig production was not observed in monocyte-depleted lymphocyte cultures but was restored by addition of monocytes. The requirement for monocytes was equally satisfied by autologous or allogeneic monocytes or monocyte conditioned media. Although the suppression mediated by HSF required the presence of monocytes, the mechanism for monocyte participation appears to be different from that reported for suppression mediated by soluble immune response suppressor (SIRS) in that general oxygen free radical scavengers did not inhibit this activity. Further information on the mechanism of action of HSF was obtained from studies on its suppressive effect on the phytohemagglutinin(PHA)-induced proliferative response. In this system HSF significantly suppressed PHA induced interleukin 2(IL2) production of peripheral blood mononuclear cells (PBMC) in a dose dependent fashion without inhibiting the proliferative response of CTLL-20 target cells to IL2. Interleukin 1 (IL1) production by monocyte cultures was also not suppressed by HSF. These results indicate that HSF interferes with IL2 production and not its induction by IL1 or its interaction with the IL2 receptor. To investigate the role of HSF-induced IL2 suppression in the pokeweed mitogen (PWM) antibody synthesis assay, the time course of IgG, IgM, IL1, and IL2 production of PWM stimulated PBMC cultures was examined. Results showed that the peak of IL2 production occurred on the second day of culture and was significantly suppressed by HSF while IL1 production was not affected during the seven day culture period. Similar suppression of IL2 and IgM production was observed in cultures of B cells and T4+ cells. Reconstitution of the IL2 levels in these cultures with recombinant IL2 completely restored antibody production. These results suggest that HSF in the presence of monocytes modulates the function of T4+ cells by inhibiting IL2 production. The inhibition of IL2 production by HSF appears to be responsible for the suppression of antibody production. PMID- 3266186 TI - Up-regulation of receptors for IgA on activated human B lymphocytes. AB - Expression of receptors for the Fc part of IgA (Fc alpha R) by T lymphocytes was recently shown to be up-regulated after activation by T cell mitogens in the absence of IgA. We describe a similar increase on activated human B lymphocytes. Fc alpha R were determined by labelling with human secretory IgA (0.5 mg/ml) and flow cytometry analysis after staining with fluoresceinated goat anti-IgA or goat anti-secretory component F(ab')2 fragments. B-enriched cell suspensions were prepared from peripheral blood or tonsils and activated by Staphylococcus aureus Cowan I, anti-IgM antibodies or E. coli lipopolysaccharide. All three activators increased the percentage of Fc alpha R positive cells although only the former induced significant DNA synthesis. Finally recombinant interleukin 1 (10 nM) and interleukin 2 (10 IU/ml) but not interleukin 4 (300 units/ml) nor low-molecular weight B cell growth factor induced an increase of Fc alpha R expression. The data show that Fc alpha R can be up-regulated on human B cells in the absence of exposure to IgA. PMID- 3266187 TI - Interleukin 1 (IL-1) and tumour necrosis factor synergise in the induction of IL 1 synthesis by human vascular endothelial cells. AB - We have demonstrated that recombinant interleukin 1 (IL-1) induces IL-1 alpha and IL-1 beta production by human vascular endothelial cells (EC) in vitro. The effect of IL-1 on EC was dose-dependent and not due to contamination by endotoxin or secondary to the production of tumour necrosis factor (TNF). Thymocyte co mitogenesis was shown to be due to IL-1 by treating EC supernatants with neutralising antibodies specific for IL-1 alpha and IL-1 beta. Recombinant TNF alpha synergised with IL-1 in the induction of IL-1 secretion by EC. Synergy was particularly striking at concentrations of IL-1 and TNF which, when used alone, had no effect - 2 U/ml IL-1 with 10 U/ml TNF. Thus we provide more evidence that EC play an important role in the perpetuation or possibly even initiation of chronic inflammation by amplifying cytokine production initiated by small numbers of infiltrating leucocytes. PMID- 3266188 TI - Dendritic cells and viruses. AB - Dendritic cells (DC) are potent at presenting viral antigens in the initiation of both primary and secondary responses. DC in the lymph nodes draining the site of infection with HSV express surface antigen and can stimulate proliferation of sensitised lymphocytes. In secondary stimulation, nonresponsiveness in cytotoxic T cell assays of cells from mice primed to Moloney virus was also overcome by stimulation in vitro with virus-pulsed DC. Marked primary proliferative and cytotoxic T cell responses were previously found only to alloantigens and to haptens, both presented on the surface of DC However, DC exposed in vitro or in vivo to influenza virus stimulated primary proliferative and cytotoxic T cell responses in normal syngeneic lymphocytes in 20-microliters hanging drop cultures (Macatonia, Taylor, Knight and Askonas, in press). This provides a method for analysing primary responses to viruses in vitro without the necessity of using pre-sensitised donors. Although DC may present HIV antigens to lymphocytes the DC are also susceptible to infection with HIV. This occurs in vivo as evidenced by the infection of Langerhans cells in AIDS patients. This infection of DC may not only compromise their function in antigen presentation but also act as a reservoir of virus which is handed on to T cells during the close clustering of the presenting cells with the T cells during the initiation of the immune response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266189 TI - Effects of colony stimulating factors on the interaction of monocytes and the human immunodeficiency virus. PMID- 3266190 TI - Experimentally induced cutaneous leishmaniasis: are L3T4+ T cells that promote parasite growth distinct from those mediating resistance? AB - A considerable body of evidence from various laboratories indicates that specific T cell responses generated during infection with Leishmania parasites play an important role both in the resolution and progression of cutaneous leishmaniasis. Recent data, summarized in this article, indicate that resolution of lesions and promotion of disease not only result from the activity of functionally distinct parasite-specific L3T4+ T cells but could also be mediated by functionally similar L3T4+ T cells differing only in their fine antigenic specificity. This contention is based on observations which suggests that (a) the induction of T cell tolerance to parasite antigens present during the early phase of infection is beneficial to the host, and (b) the specificity of L3T4+ T cell lines and clones capable of exacerbating the development of lesions is different from that of T cells mediating protection. PMID- 3266191 TI - Autoreactive T cell hybridoma-derived B cell stimulatory factor(s) governing IgA isotype immunoglobulin production by murine Peyer's patch B cells. AB - In the present study we investigated whether autoreactive T cells derived from murine Peyer's patches (PP) have the capacity to regulate mucosal B cell differentiation to IgA-producing plasma cells in vitro. We also examined whether B cell development is mediated by lymphokines from immunoregulatory T cells - that is, B cell stimulatory factors (BSF) and cofactors (coBSF) - which include B cell growth factor (BCGF), putative alpha B cell immunoglobulin (Ig) heavy chain switch factor (BSWF alpha), and B cell differentiation factor (BCDF), as well as interleukin-2 (IL-2). To this purpose we developed in vitro a variety of BSF (especially putative BSWF alpha)-producing autoreactive (self-class II molecules responsive) T cell hybridoma cell clones from murine PP, and studied the functional activity of the BSF, especially a putative alpha Ig heavy chain switch (mu----alpha) factors(s). These T hybridome cell lines possessed the surface phenotypes of Thy 1.2, CD4+, CD5+ and CD8- and produced a variety of BSF, including two kinds of BCGF (IL-5, and a BCGF that did not require additional costimulators to induce proliferation of preactivated B cells), putative BSWF alpha/gamma, BCDF, and/or IL-2. The results strongly support the view that the autologous T cell plays an important role not only in B cell proliferation and terminal maturation, but also in alpha heavy chain switching in PP. This T-B cell interation is mediated at least in part through BSF lymphokines elaborated by the autoreactive T cell, probably activated in situ in the lymphoid tissue microenvironment. PMID- 3266192 TI - Presentation of antigen to T lymphocytes by non-immune B-cell hybridoma clones: evidence for specific and non-specific presentation. AB - Non-immune SJL (H-2s) spleen cells were fused with (H-2d) Balb/c 653-myeloma cells and the hybridomas were cloned by two limiting dilutions. The resulting hybrid B- cell clones were tested for their antigen presentation capability to SJL T-cell lines that were specific for either lysozyme or myoglobin. In proliferative assays, 53% of the antigen presenting B-cell clones were able to present both myoglobin and lysozyme (general presenters) while the other 47% presented specifically either myoglobin or lysozyme (specific presenters). The ability to selectively present either myoglobin or lysozyme indicates that antigen presentation at the clonal level can be specific or non-specific depending on the particular B-cell clone. PMID- 3266193 TI - Simultaneous occurrence of a chronic myeloid leukemia and a malignant T-cell lymphoma. PMID- 3266195 TI - Assessing patterns of drug use in local jurisdictions. AB - Knowledge of drug use patterns is necessary for policy formulation and implementation, especially in terms of law enforcement strategies, treatment, and educational programs. Unfortunately it is usually impossible to accurately assess the overall extent of drug use and abuse. Instead, data are collected from a variety of sources to provide estimates used in policy planning. In this paper drug-related data from three sources are compared to determine similarities and differences in drug use among three population groups: those who come into contact with law enforcement agencies, high school students, and those enrolled in treatment programs. The uses of these data for policy and program planning are suggested. PMID- 3266194 TI - Ontogeny and cellular origin of an interleukin-1-like factor in the reproductive tract of the male rat. AB - We have recently isolated an interleukin-1 (IL-1)-like factor from the rat testis, which originates from the seminiferous tubules and is a protein with an MW of 17,000 and a pI of 5-6. This paper reports on the appearance of the IL-1 like factor during postnatal development and investigates its cellular origin further. IL-1 activity was measured by a murine thymocyte proliferation assay. Very low IL-1 activity was present in culture medium conditioned by seminiferous tubules from rats aged 10 or 20 days. From 30 days of age, increasing amounts were detected, reaching a maximum level in adult animals (60-90 days). No IL-1 activity was found in medium conditioned by peritubular cells. Sertoli cell enriched seminiferous tubules obtained from experimentally cryptorchid or from prenatally irradiated rats produced much higher levels of IL-1 activity than did those obtained from intact testes. IL-1 activity was detected in efferent duct fluid after ligation of the efferent ducts for 24 h, indicating that the IL-1 like factor was secreted into the tubular lumen. Low levels of IL-1 activity were detected in extracts of epididymal tissue and epididymal sperm, whereas ejaculated seminal plasma, seminal vesicle fluid and extracts of seminal vesicles (together with the coagulating glands) and ventral and dorsolateral prostate lacked IL-1 activity. Instead, seminal plasma inhibited testicular IL-1 activity dose-dependently without affecting cell viability in the thymocyte cultures. Although its biological function remains to be defined, our results indicate that the testicular IL-1-like factor is produced by Sertoli cells and that its appearance during development coincides with the initiation of active spermatogenesis in the rat testis. PMID- 3266196 TI - The use of solvents and other drugs among children and adolescents from a low socioeconomic background: a study in Sao Paulo, Brazil. AB - This paper describes the pattern of solvent and other drug use among a sample of 1,836 students from a low socioeconomic background, aged 9-18 years. Nearly 24% of the respondents reported lifetime use of solvents and 4.9% used them within the past 30 days. The more common ones were a mixture of chloroform and ether popularly known as "lanca-perfume" (35.9%), acetone (33.9%), gasoline (31.9%), fingernail polish (30.3%), and glue (25.2%). The use of solvents was associated with poor academic performance, being employed, and heavy alcohol consumption among close relatives. Marijuana was the next most often used drug, followed by tranquilizers (3.6% and 2.6%, respectively). Males, compared to females, were more likely to report the use of solvents and marijuana. The use of sedatives was more common among females. PMID- 3266197 TI - Construction of rating scales for measuring attitudinal and psychological characteristics of drug abusers. AB - The purpose of the paper is to show the construction of 8 Likert-type rating scales for measuring 8 attitudinal and psychological characteristics of drug abusers. They are: attitude toward drug taking, interpersonal relationships, self concept, personal values, risk-taking tendency, motivation, rebelliousness, and pleasure seeking. A random sample of 20 drug abusers and their 20 nondrug controls individually matched for sex, approximate age, race, educational stream, and neighborhood was employed. The procedure of construction is discussed in detail, which includes definition of rating scales, review and comments of judges, item selection, and validation of rating scales. The final form of these 8 rating scales with 12 items each was obtained. They are shown to have presumably satisfactory face validity and content validity as well as high reliability ranging from .83 to .98. PMID- 3266198 TI - Cell-mediated immunity to chemically xenogenized tumors--III. Generation of monoclonal antibodies interfering with reactivity to novel antigens. AB - To develop monoclonal antibodies (MAbs) recognizing drug-mediated tumor antigens on a chemically xenogenized murine lymphoma, hybridomas were constructed with splenocytes from histocompatible mice hyperimmunized with L5178Y cells antigenically altered by triazene treatment in vivo (clone D, derived from a polyclonal L5178Y/DTIC subline). Screening of supernatants with parental and xenogenized cells showed that nine MAbs displayed exclusive or preferential reactivity with clone D cells as detected by immunofluorescence, and failed, as a rule, to bind normal or unrelated malignant cells of the same or different haplotype. Moreover, no reactivity was displayed to the triazene-xenogenized variants of antigenically unrelated tumors. All nine MAbs, however, were capable of binding a panel of L5178Y/DTIC clones in addition to clone D. When the ability of these antibodies to interfere with the development of cell-mediated immunity to clone D cells in vitro was tested, it was found that the proliferative reaction and generation of cytolytic activity by syngeneic lymphocytes were inhibited by addition of several MAbs to the tumor--lymphocyte co-cultures. PMID- 3266199 TI - The effect of RU 41740 on the in vitro maturation of human B-cells. AB - We have tested the effect of a Klebsiella pneumoniae extract, RU 41740, and its lipopolysaccharidic fraction (LPS-LAP) on the in vitro activation of human B cells. Two models have been used: the polyclonal activation induced by pokeweed mitogen and the specific antibody production to mannan, a polysaccharide extracted from the cell wall of Candida albicans. We have shown that RU 41740, and especially its lipopolysaccharidic fraction, significantly increases the production of immunoglobulins and specific antibodies. This effect is mediated by T-lymphocytes, since preincubation of isolated T-cells, but not of non-T-cells, resulted in the same effect. Together with the known enhancing effect of LPS-LAP on T-cell proliferation, these data strongly suggest that LPS-LAP increases the production of B-cell-activating lymphokines by T-cells. PMID- 3266200 TI - Immunopotentiating activities of a low molecular weight lipopeptide, RP 56 142- studies in infectious models. AB - RP 56 142, N2-[N-(N-lauroyl-L-alanyl)-gamma-D glutamyl] L,L-2,6-diaminopimelamic acid belongs to a family of immunomodulating lipopeptides. Its structure is directly derived from that of lauroyltetrapeptide RP 40 639 which is a mixture of two stereoisomers, one of which (with D,D-2,6 diaminopimelamic acid) is totally devoid of in vivo activity. RP 56 142 displayed potent protective activities against bacterial infections such as K. pneumoniae, L. monocytogenes or S. typhimurium (at doses ranging between 0.03 and 100 mg/kg s.c., i.p., i.v.). In combined treatment protocols, suboptimal doses of RP 56 142 given preventively (day-1) or curatively (day 0 + 4h) significantly protected mice receiving antibiotics at doses which were ineffective when administered by themselves. Given s.c. 1 or 2 days before infectious challenge, RP 56 142 was able to normalize and even enhance significantly the resistance of mice previously immunocompromised by lomustine, 5-fluorouracile or hydrocortisone. These results correlated with the stimulation of the clearance of a virulent Salmonella typhimurium strain and with an important production of colony-stimulating factor in RP 56 142-treated mice. PMID- 3266201 TI - Kinetics of interleukin-1 production by macrophages during infection with Listeria monocytogenes. AB - Production of interleukin-1 (IL-1) by peritoneal macrophages from mice inoculated intravenously with Listeria monocytogenes was measured at increasing intervals of infection. IL-1 activity in the 24 h macrophage supernatants was determined by using the thymocyte PHA co-mitogenesis assay. IL-1 production increased as the infection progressed, reached a peak on the 9th or 10th day and then declined progressively to approach normal values by the 20th day. Our data on the kinetics of IL-1 levels during an acute infection with L.monocytogenes are discussed in relationship to the development of cell-mediated immunity and its regulation by macrophages. PMID- 3266202 TI - Bactericidal activity of middle ear effusion on a single isolate of non-typable Haemophilus influenzae. AB - Bactericidal activity of middle ear effusion (MEE) from children with otitis media with effusion (OME) on one strain of non-typable Haemophilus influenzae was measured and was compared with that of normal human serum. H. influenzae culture negative MEEs had a bactericidal activity on one strain of non-typable H. influenzae (P less than 0.01), and the activity of serous effusions was significantly stronger than that of mucoid ones (P less than 0.01). The bactericidal activity of 20% pooled MEE was almost equal to that of 4% normal human serum. Heat treatment (56 degrees C, 30 min) abolished this activity of both pooled MEE and normal human serum. Addition of fresh guinea pig serum (GPS) as a complement source to the heat-treated pooled MEE restored this activity, while its addition to the heat-treated normal human serum failed to do so. These results suggest that complement factor is important in the bactericidal activity of MEE. PMID- 3266203 TI - Admission to general hospital psychiatric wards in Italy. 1. A comparison between two catchment areas with differing provision of outpatient care. AB - Epidemiological comparisons carried out in Italian settings regarded very different areas. In this paper, we investigate the effects on the hospital activity of two different organizational models of care in two neighbouring areas in Northern Italy, Cremona and Mantua, very similar in sociodemographic features. Cremona is hospital oriented, while Mantua has well developed community services. All the patients of the catchment areas admitted during 1986 were studied. Age distribution for males, marital status, education and percentage of employed were very similar in the two samples. However, age distribution and mean age at the time of the first ever psychiatric admission for females were different, as well as the percentage of patients living alone and the percentage of patients discharged home. But the cogent finding was the number of admissions, much higher in Cremona than in Mantua, especially for some age groups. Some explanations of this strong difference, regarding two neighbouring and similar areas, are discussed. PMID- 3266204 TI - Admission to general hospital psychiatric wards in Italy. 2. Inpatient characteristics. AB - In Italy the 1978 Reform Law established that all psychiatric admissions had to take place in the General Hospital Psychiatric Wards (GHPW). In 1984 a national survey found a national rate of 0.05 GHPW beds per thousand population. However, for several reasons, in Italy very few studies have been carried out on the inpatient population. In this paper we analyse all the patients admitted to the two GHPWs in Cremona, Lombardy Region, during 1986. Males were generally younger than females. The large majority of patients studied lived with relatives and had completed only elementary education; 1/3 of all the inpatients were employed, 1/3 retired or with social security disability and 1/4 housewives. About 25% of them were at the first ever psychiatric admission, and a significant difference was found for the age of the first admission, being higher in females. Concerning the diagnosis, a significant sex difference was found only for depressive neurosis and alcohol related disorders. The need for a better understanding of the role and the functions of the new GHPWs in the Italian psychiatric scene is emphasized. PMID- 3266206 TI - [Lymphocyte transformation test following stimulation with a protein factor from neutrophilic granulocytes (PMNL) in psoriasis patients]. AB - The lymphocyte transformation test (LTT) was given to 20 healthy subjects and 43 patients with generalized psoriasis vulgaris: it was given right after stimulation with PHA (spontaneous) and after stimulation with allogenic and autogenic protein factor (NPF). NPF was isolated from secondary lysosome granules of peripheral blood neutrophils. The results were analyzed using computer statistic tests. No distinct differences were noticed between the spontaneous transformation test in psoriatic patients compared to the controls. After stimulation with PHA, the percentage of blast cells was significantly lower in patients with psoriasis. When allogenic and autogenic NPF was used for stimulation, the LTT values were significantly higher in the psoriasis group than in the control subjects. This fact points out the increase in sensitivity of lymphocytes to NPF in active psoriasis and the possibility of abnormal neutrophil lymphocyte interactions in vivo. This phenomenon may be intensified when under the influence of bacterial or viral agents, or medicaments; the degranulation of secondary lysosome granules of neutrophils occurs, causing the release of NPF. These investigations support our opinion that psoriasis is a systemic disease and that NPF plays a considerable role in the psoriatic reaction. PMID- 3266205 TI - Immune mechanisms and molecular mediators of glomerular injury in experimental nephritis. Summary of current results and continuing studies. AB - Despite a growing body of evidence on the importance of macrophage accumulation in renal glomeruli to the subsequent injury in experimental immune nephritis, exact mechanisms of the monocyte/macrophage recruitment and phenomena leading to tissue damage are not completely clarified. Our experiments indicate that neutral proteinases released in situ by activated macrophages may, at least in part, be responsible for the development of autoimmune nephrotoxic glomerulonephritis in rats. Accordingly, apart from the well-established features of glomerular hypercellularity and basement membrane damage, a new mechanism of direct cytolysis by macrophage-derived proteinases is postulated to be of potential relevance to the nephritic glomerular injury. PMID- 3266207 TI - Syngeneic antiidiotypic monoclonal antibodies to the murine anti-HLA-DR,DP monoclonal antibody CR11-462. AB - Two out of 625 hybridomas constructed with splenocytes from a Balb/c mouse immunized with the murine anti-HLA-DR, DP monoclonal antibody CR11-462 secrete antiidiotypic antibodies. Binding assays with a panel of 12 anti-HLA class I, 14 anti-HLA class II, and 9 anti-human melanoma-associated antigen MoAbs showed that the idiotopes recognized by MoAb F3-C25 and F3-B6 are not expressed by any of the tested antibodies, even those which inhibit the binding of MoAb CR11-462 to cultured B lymphoid cells. Crossblocking experiments showed that the two idiotopes are distinct and spatially distant. Both idiotopes require the association of heavy and light chain of MoAb CR11-462 for their expression. The idiotope recognized by MoAb F3-B6 is an alpha idiotope, since it is located outside the antigen combining site of MoAb CR11-462. The idiotope recognized by MoAb F3-C25 is a gamma idiotope, since it is antigen inhibitable but does not possess an internal image of the antigen. Interestingly the MoAb F3-C25 displays a differential inhibitory effect on the binding of MoAb CR11-462 to lymphoid cells that express different HLA phenotypes or share the HLA-DRw6 allospecificity. These results suggest that antiidiotypic antibodies may sharpen our ability to dissect the heterogeneity of HLA class II antigens. PMID- 3266209 TI - Effects of an exercise and stress management program on cardiac patients' psychosocial and vocational status: preliminary study. PMID- 3266208 TI - Analysis of DR and DQ gene products of the DR4 haplotype in patients with IDDM: possible involvement of more than one locus. AB - Fifteen DR4-bearing haplotypes from twelve patients with insulin-dependent diabetes mellitus (IDDM) were analyzed serologically, cellularly, and biochemically. The HLA-Dw composition of these DR4-positive haplotypes was Dw4 (46%), Dw14 (22%), and Dw10 (33%). The biochemical analysis by two-dimensional electrophoresis (2D-PAGE) of the DR beta chains showed that each Dw specificity is characterized by a specific DR4 beta chain that appears to be identical in normal and diabetic individuals. Analysis of DQ beta chains in the DR4-bearing haplotypes revealed that certain Dw specificities such as Dw4 are characterized by the presence of either the DQw7 (formerly DQw3.1) or DQw8 (formerly DQw3.2) alleles, which generate the Dw4.1 or Dw4.2 subtypes, respectively. Others such as Dw14 and Dw10 are characterized by the presence of the DQw8 allele. In our sample of 12 patients the Dw4.2 (Dw4, DR4 beta I-4 DQw8) and Dw10 (Dw10, DR4 beta I-1, DQw8) subtypes were predominant. It is concluded that individual DR beta and DQ beta gene products from the DR4-bearing haplotype of IDDM patients are identical to those of normal control subjects and that Dw14 as well as Dw10 are involved in disease susceptibility. We suggest that disease susceptibility may be influenced by more than one locus within the HLA-D region. PMID- 3266210 TI - Tumor necrosis factor and human hematopoiesis: I. Kinetics and diversity of human bone marrow cell response to recombinant tumor necrosis factor alpha in short term suspension cultures in vitro. AB - The response of normal human bone marrow-derived granulocyte macrophage progenitor cells (GM-CFC) to human recombinant tumor necrosis factor alpha (TNF alpha) was studied in short-term suspension cultures, in the presence or absence of human placenta-derived colony-stimulating factors (CSF). The effect of rTNF alpha on GM-CFC was correlated with its influence on more mature progeny, as defined by standard morphological criteria, and was related to both dose of rTNF alpha and length of exposure. After very short-term exposure (2 h), "inactivation" of a substantial number of GM-CFC was observed only in the presence of very high rTNF-alpha doses (1 x 10(4) ng/ml). When the exposure was prolonged to 16 h, a significant killing of both day 8 (GM-CFC8d) and day 14 (GM CFC14d) progenitor cells was detected in the presence of 10 ng of rTNF-alpha/ml. Exposure for 5 days resulted in a further increase in the GM-CFC killing. Presence of yet unknown factor(s) in human placenta-conditioned medium sensitized GM-CFC to the action of rTNF-alpha. By morphological analysis of marrow cells, it was found that rTNF-alpha inhibited growth and/or recruitment of granulocytic precursor cells and caused inhibition of their differentiation. This effect was not dose dependent above 1 x 10(1) ng/ml. The presence of rTNF-alpha slightly promoted dose-dependent differentiation along the macrophage pathway. rTNF-alpha appeared to promote eosinophilic differentiation, also in a dose-dependent manner. PMID- 3266211 TI - Serum alpha 1 antitrypsin levels. PMID- 3266212 TI - Expression of two kinds of cytochrome P-450(11 beta) mRNA in bovine adrenal cortex. AB - Using pcP-450(11 beta)-2 cDNA (Morohashi et al. (1987) J. Biochem. 102, 559-568) as the probe, a different cDNA clone, pcP-450(11 beta)-3, was isolated from a cDNA library of bovine adrenal cortex. The restriction enzyme map of pcP-450(11 beta)-3 was highly homologous but not identical with that of pcP-450(11 beta)-2. Nucleotide sequence determination revealed the substitutions of 14 nucleotides and 3 amino acids between pcP-450(11 beta)-2 and -3. Blotting analysis involving two different oligonucleotide probes specific to these two cDNAs indicated that at least two kinds of P-450(11 beta) mRNA were expressed in individual animals and that at least two kinds of P-450(11 beta) genes exist in the bovine genome. PMID- 3266213 TI - A sex-specific form of cytochrome P-450 catalyzing propoxycoumarin O depropylation and its identity with testosterone 6 beta-hydroxylase in untreated rat livers: reconstitution of the activity with microsomal lipids. AB - Characteristics of a typical male-dominant reaction, dealkylation of n propoxycoumarin, in rat livers were studied in relation to microsomal testosterone 6 beta-hydroxylase. The depropylation was more than 10-fold higher in the liver of male than female adult rats, but the sex-related difference was eliminated by neonatal castration. Hypophysectomy of adult male rats, which decreased the rates of male-specific P-450-male-dependent reactions, increased the depropylation of propoxycoumarin, while the rate was decreased by either intermittent injection or continuous infusion of human growth hormone to hypophysectomized rats. With regard to age-related difference, microsomal depropylation was detectable at neonate and reached a maximal level at 14 to 20 d of age, but was abruptly diminished only in female rats at puberty. These changes are in good agreement with those of testosterone 6 beta-hydroxylation and the content of a male-specific P-450(6)beta-1/PB-1. In reconstituted systems using extracted microsomal lipids, P-450(6)beta-1/PB-1 and P-450-male catalyzed the depropylation of propoxycoumarin. However, the microsomal depropylation was inhibited by antibodies which recognize P-450(6)beta-1/PB-1, but not P-450-male. These results indicate that microsomal depropylation of propoxycoumarin is catalyzed mainly by a male-specific P-450(6)beta-1/PB-1 in livers of untreated rats. PMID- 3266214 TI - Site-specific mutagenesis of the human interleukin-1 beta gene: the role of arginine residue at the N-terminal region. AB - Using the expression system for site-specific mutagenesis in Escherichia coli, we have made deletion mutants at the N-terminal or C-terminal region of human interleukin-1 beta (IL-1 beta) consisting of 153 amino acids. The truncated mutants showed that at least 147 amino acids (numbers 4-150) in IL-1 beta are necessary for the exertion of biological activity. When we changed the arginine at the 4th position (Arg4) in IL-1 beta to other specific amino acids, there was a marked difference in the relative extent of biological and receptor binding activities among the mutants. The order of the mutants was Arg4 = Lys4 greater than Gln4 greater than Gly4 = des-Arg4 greater than Asp4. Our results demonstrate that the arginine residue at the 4th position in IL-1 beta is important, but not essential, for IL-1 beta to exhibit its biological and receptor binding activities, and the positive charge at this site plays a key role for IL-1 beta to exert the activities. PMID- 3266215 TI - Medium-scale ligand-affinity purification of two soluble forms of human interleukin-2 receptor. AB - Recombinant technology has facilitated the production of two soluble forms of human interleukin-2 receptor (IL-2R) in Chinese hamster ovary cells. We have developed a ligand-affinity method for the medium-scale purification of these two IL-2Rs, based on the biochemical interactions between the matrix-bound ligand (interleukin-2) and its soluble receptor. The affinity-purified IL-2R is further purified by anion-exchange chromatography followed by gel filtration. This method has provided enough highly pure IL-2R for structure and function studies and for use in practical applications such as high-flux drug screening assays and the receptor-affinity purification of human recombinant interleukin-2. PMID- 3266216 TI - High-performance liquid chromatographic determination of 6-amidino-2-naphthyl [4 (4,5-dihydro-1H-imidazol-2-yl) amino]benzoate dimethanesulphonate and its metabolites in biological fluids. AB - 6-Amidino-2-naphthyl [4-(4,5-dihydro-1H-imidazol-2-yl) amino]benzoate dimethanesulphonate has been developed for the therapy of pancreatitis. A reversed-phase high-performance liquid chromatographic assay of the levels of this drug and its metabolites in biological fluids was investigated. Fluorescence detection with post-column alkaline degradation was used for the determination of the intact drug and the amidinonaphthol moiety metabolite, and ultraviolet detection at 254 nm was used to determine the levels of the benzoic acid moiety metabolite. Satisfactory recoveries and variabilities of the intact drug and its metabolites from biological fluids were obtained. The detection limits for the intact drug and amidinonaphthol were 0.5 ng/ml at a signal-to-noise ratio of 12 in plasma and 10 ng/ml at a signal-to-noise ratio of 32 in urine and homogenized faeces, and those of benzoic acid were 5 ng/ml at a signal-to-noise ratio of 3 in plasma and 50 ng/ml at a signal-to-noise ratio of 7 in urine and homogenized faeces. PMID- 3266217 TI - Reversed-phase high-performance liquid chromatographic assay for the determination of the in vitro acetylation of p-aminobenzoic acid by human whole blood. PMID- 3266218 TI - Use of mobile phase modifiers to alter retention and stereoselectivity on a bovine serum albumin high-performance liquid chromatographic chiral stationary phase. PMID- 3266219 TI - Separation and detection of DNA by capillary electrophoresis. AB - The use of capillary electrophoresis for the separation and detection of nucleic acids has been investigated. Lab-model instruments have been built, using commercially available UV absorbance and fluorescence detectors which were modified for use with 50-100 microns I.D. fused-silica capillary tubing. The sensitivity of these instruments (signal-to-noise ratio = 3) was measured as 15 micrograms/ml for fluorescence detection of ethidium bromide-stained herring sperm DNA and 3 micrograms/ml for UV absorbance detection. With the former instruments a variety of strategies has been used to attain rapid separations of bases, oligonucleotides, restriction fragments and whole phage, viral and plasmid DNAs. PMID- 3266220 TI - Optimal conditions for recovery of the human immunodeficiency virus from peripheral blood mononuclear cells. AB - Optimal conditions for demonstrating the presence of infectious human immunodeficiency virus in peripheral blood mononuclear cells (PMCs) from seropositive individuals involved cocultivation of infected cells with phytohemagglutinin-stimulated PMCs from seronegative donors in the presence of 2 micrograms of Polybrene per ml. The size of the culture vessel also influenced the results; smaller numbers of infected cells were detected under conditions of increased cell density. In addition, an increased normal donor/patient PMC ratio was helpful. The cocultivation approach permitted identification of human immunodeficiency virus in over 90% of seropositive individuals with different clinical conditions. Moreover, reconstruction experiments indicated that this method allows detection of one productively infected CD4+ cell in a population of over 10(6) PMCs. PMID- 3266221 TI - Relationship between in vitro susceptibility test results for chloramphenicol and production of chloramphenicol acetyltransferase by Haemophilus influenzae, Streptococcus pneumoniae, and Aerococcus species. AB - Haemophilus influenzae, Streptococcus pneumoniae, and Aerococcus species were tested for susceptibility to chloramphenicol by standard broth microdilution and disk-diffusion methods. MICs and zone diameter breakpoints were correlated with production of chloramphenicol acetyltransferase (CAT). A comparison of MICs and zone diameters indicated that the interpretative criteria for H. influenzae and S. pneumoniae should be an MIC of less than or equal to 4 micrograms/ml or a zone diameter greater than or equal to 25 mm for susceptible strains and an MIC of greater than or equal to 8 micrograms/ml or a zone diameter of less than or equal to 20 mm for resistant strains; for Aerococcus species, interpretative criteria should be an MIC of less than or equal to 8 micrograms/ml or a zone diameter of greater than or equal to 20 mm for susceptible strains and an MIC of greater than or equal to 32 micrograms/ml or a zone diameter of less than or equal to 12 mm for resistant strains. All but four strains of H. influenzae and one strain of S. pneumoniae that were resistant to chloramphenicol by these criteria produced CAT. For Aerococcus species, however, chloramphenicol-resistant strains were negative for CAT as determined by a commercially available disk test. When comparing susceptibility results with CAT production, thiamphenicol was a better indicator of the presence of the enzyme than chloramphenicol and may be useful in assaying resistance to chloramphenicol. PMID- 3266222 TI - Fluoxetine induces elevation of desipramine level and exacerbation of geriatric nonpsychotic depression. PMID- 3266223 TI - [Completeness of revascularization in triple vessel coronary disease]. PMID- 3266224 TI - [EGF receptor and effects of EGF on growth and tumor marker secretion in uterine cervical cancer cells]. AB - Effects of EGF on proliferation and tumor marker secretion of cervical cancer cells are reported together with the characteristics of EGF receptors on the cells. TA-4 producing cell line (OMC-1) originating from cervical squamous cell carcinoma and CA-125 producing cell line (OMC-4) originating from cervical adenocarcinoma, were used. Scatchard plot of EGF binding to OMC-1 indicated a single class of binding sites with a dissociation constant (Kd) of 360pM, whereas that of OMC-4 was curvilinear suggesting two classes of binding sites with a Kd of 170pM and 510pM. The theoretical maximum number of binding sites of OMC-1 and OMC-4 was 2.4 X 10(4) and 1.6 X 10(5), respectively. Effects of EGF on growth were studied by monitoring cell number and the incorporation of 3H-thymidine into the DNA of the cells. OMC-1 was stimulated by EGF at low concentrations (0.01 0.1nM) and inhibited at higher concentrations. OMC-4 was not stimulated by EGF. The TA-4 secretion of OMC-1 was slightly stimulated by EGF at low concentrations (0.01-1nM) and significantly stimulated at high concentration (10nM). The CA-125 secretion of OMC-4 was not stimulated by EGF. These results suggest that there are some differences between cervical squamous cell carcinoma and adenocarcinoma in the mechanisms of regulation of proliferation and tumor marker secretion by EGF. PMID- 3266225 TI - [A case of familial hypercholesterolemia associated with Schnyder's corneal dystrophy]. PMID- 3266226 TI - [Primary intestinal lymphangiectasia with epileptic episodes as the initial symptom of the disease]. PMID- 3266227 TI - [Primary non-Hodgkin's lymphoma, small lymphocytic type, in the spleen complicating myelodysplastic syndrome]. PMID- 3266228 TI - [Antithymocyte globulin and antilymphocyte globulin treatments in two cases of severe aplastic anemia]. PMID- 3266229 TI - [A case of subclinical Sjogren's syndrome associated with multiple cranial neuropathies as an initial manifestation]. PMID- 3266230 TI - [Reiter's syndrome found in father and son]. PMID- 3266231 TI - Aortic valve replacement combined with myocardial revascularization: early surgical results and late mortality. PMID- 3266232 TI - Differential effects of tetracaine on charge movements and Ca2+ signals in frog skeletal muscle. AB - The effects of tetracaine on charge movements and on antipyrylazo III signals monitoring intracellular delta [Ca2+] were compared in cut frog semitendinosus muscle fibers in a single vaseline gap-voltage clamp. Low tetracaine concentrations (25-40 microM) markedly reduced delta [Ca2+] signals and shifted the rheobase. However, they neither influenced charge movement nor that peak delta [Ca2+] value associated with the contractile threshold. Higher tetracaine concentrations (100-200 microM) partly inhibited charge movements in cut fibers. They separated a steeply voltage-sensitive charge, some of whose features resembled 'q gamma' reported in intact fibers, and whose movement preceded delta [Ca2+] signals at threshold. These findings: (a) directly confirm an earlier suggestion that tetracaine acts on steps in excitation-contraction coupling rather than myofilament activation; (b) show that tetracaine at low concentrations can directly interfere with sarcoplasmic reticular calcium release without modifying charge movement; (c) show that the tetracaine-sensitive charge, first found in intact fibers, also exists in cut fibers; and (d) make it unlikely that tetracaine-sensitive charge transfer is a consequence of Ca2+ release as suggested on earlier occasions. PMID- 3266233 TI - Neurotoxic damage to the nigrostriatal system in rats following intranigral administration of MPDP+ and MPP+. AB - Unilateral intranigral administration of the oxidative metabolites of 1-methyl-4 phenyl-1,2,3,6-tetrahydropyridine (MPTP), 1-methyl-4-phenyl-dihydropyridine (MPDP+) or 1-methyl-4-phenylpyridine (MPP+) produced dose-dependently a depletion of dopamine in the ipsilateral striatum of rats two weeks following treatment. d Amphetamine and apomorphine induced circling toward the lesioned side in these unilaterally treated animals. No contralateral circling behavior was observed after challenging with apomorphine. This dopamine lesioning effect of MPP+ was not blocked by pretreatment of animals with a dopamine uptake blocker, GBR 12909. Furthermore, MPP+ increased the 45Ca accumulation into cells at the site of injection and produced "nonspecific" cell membrane and/or cytotoxic damage seen by histological procedures. These results indicate that MPDP+ and MPP+ produced localized cytotoxic damage to nigrostriatal neurons, caused a decrease in striatal dopamine, and disrupted the nigrostriatal system's functioning following intranigral administration to rats. It is postulated that the cationic surfactant properties of MPDP+ and MPP+ might contribute to its neurotoxic effects. PMID- 3266234 TI - A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981-86. 1. Methodology, demography and incident cases of first-ever stroke. AB - A prospective study of acute cerebrovascular disease in a community of about 105,000 people is reported. The study protocol combined rapid clinical assessment of patients with accurate diagnosis of the pathological type of stroke by CT or necropsy, whether or not they were admitted to hospital. The study population was defined as those people who were registered with one of 50 collaborating general practitioners (GPs). Referrals to the study were primarily from the GPs though, to ensure complete case ascertainment, hospital casualty and admission registers, death certificates and special data from the Oxford Record Linkage Study were also scrutinized. Six hundred and seventy five cases of clinically definite first ever in a lifetime stroke were registered in four years yielding a crude annual incidence of 1.60/1,000 or 2.00/1,000 when adjusted to the 1981 population of England and Wales. The age and sex specific incidence rates for first stroke showed a steep rise with age for both sexes. The odds of a male sustaining a first stroke were 26% greater than those of a female. Ninety one per cent of patients were examined in a median time of four days after the event by a study neurologist and 88% had cerebral CT or necropsy. PMID- 3266236 TI - The frequency, characteristics and prognosis of epileptic seizures at the onset of stroke. PMID- 3266235 TI - Autoimmune optic neuropathy: evaluation and treatment. AB - Fourteen patients, 12 of whom were women, with an age range from 26 to 56 years, presented with progressive or recurrent optic neuropathy, despite conventional doses of corticosteroid, and laboratory evidence of collagen vascular disease. The visual loss was severe and most had an acuity less than 20/200. Megadose corticosteroid therapy improved the vision in 11 of the 12 patients. Continued oral prednisone and cytotoxic drugs were necessary to maintain vision in nine patients. Patients with autoimmune optic neuropathy must be differentiated from cases with idiopathic optic neuritis or multiple sclerosis to facilitate the appropriate therapy. PMID- 3266237 TI - Dietary assessment of maternal vitamin D intake and correlation with maternal and neonatal serum vitamin D concentrations at delivery. AB - Maternal and cord blood 25-hydroxy vitamin D concentrations are positively and significantly correlated. If an easily obtainable maternal dietary history could be used to predict maternal and secondarily cord blood vitamin D status, it would be a useful means of assessing the vitamin D adequacy of the newborn. Therefore, a single assessment of maternal dietary vitamin D intake during the last trimester of pregnancy was correlated with maternal and newborn serum vitamin D concentration. Neither the correlation between maternal dietary history of vitamin D intake and maternal serum 25-hydroxy vitamin D level nor between maternal dietary history and cord blood 25-hydroxy vitamin D level was significant. These data indicate that a single maternal dietary history is an inadequate method of predicting neonatal vitamin status at delivery. PMID- 3266238 TI - Multiparity and stressful events. PMID- 3266239 TI - Immune therapy of cancer. PMID- 3266240 TI - Reye syndrome: current trends. PMID- 3266241 TI - [Study of head and neck cancer treatment by administration of autologous cytotoxic lymphocyte induced by stimulation with tumor cell--effect of adoptive immunotherapy by intra-arterial infusion of killer cells stimulated by autologous tumor in patients with maxillary carcinoma]. PMID- 3266242 TI - [Study of head and neck cancer treatment by administration of autologous cytotoxic lymphocyte induced by stimulation with tumor cell--induction of killer cells by stimulation with allogeneic tumor cell]. PMID- 3266243 TI - [Study of head and neck cancer treatment by administration of autologous cytotoxic lymphocyte induced by stimulation with tumor cell--effect of adoptive immunotherapy by intra arterial infusion of killer cells stimulated by allogeneic tumor in patients with lingual and maxillary carcinoma]. PMID- 3266244 TI - Endoscopic esophageal varix ligation: technique and preliminary results in children. AB - A technique for treating esophageal variceal hemorrhage in children using endoscopically placed rubber ligatures was evaluated in six children. The method offers a major advantage over chemical obliteration of varices by sclerosants in the absence of systemic, local, or distant organ reactions and, perhaps, in the avoidance of esophageal motor dysfunction. PMID- 3266246 TI - Tranquilizer use before and after coronary bypass operation. AB - High rates of tranquilizer use in coronary disease have been previously reported. In patients being evaluated for coronary disease, tranquilizer use has been related to myocardial infarction, angina pectoris, neurotic traits, employment and the use of cardioactive and other medications. In this study, responses of 1046 male patients to a questionnaire assessing biological, psychological and social variables before and after coronary bypass surgery were related to tranquilizer use. The effect of CABG was to decrease tranquilizer use. Tranquilizer use prior to coronary bypass operations was related to neuroticism, myocardial infarction and taking cardiac and analgesic medication. Similar findings were noted after coronary bypass operations except that angina pectoris was added as a contributor to tranquilizer use. The multivariate analysis tended to confirm the univariate findings, except that neurotic traits did not make an independent contribution. These results indicate that in patients undergoing coronary evaluations, cardiac disease variables other than coronary atherosclerosis determine tranquilizer use. Neurotic traits play a secondary role. Relief of angina pectoris appears to be particularly important in reducing tranquilizer use. The finding of angina pectoris after coronary bypass operation may have special significance for the continuation of tranquilizer use. PMID- 3266247 TI - Isolation and partial characterization of an interleukin-1-like factor from rat testis interstitial fluid. AB - Testicular interstitial fluid (ISF) was collected by in vivo perfusion of rat testes and analyzed for the presence of interleukin-1 (IL-1) activity by utilizing a murine thymocyte proliferation assay. IS obtained from nine rats were all positive with dose-response curves of IL-1 activity similar to those produced by rat testicular aqueous extracts, rat macrophage IL-1 and human recombinant IL 1 alpha. Chromato-focusing of pooled ISF revealed a single peak of IL-1 activity with an estimated isoelectric point of 6.1-6.3. HPLC size exclusion chromatography demonstrated two active peaks with apparent molecular ratios Mr of 15,000-18,000 and 5000-7000, respectively. The molecular properties of the 15,000 18,000 Mr component are very similar to those of an IL-1-like factor previously isolated from seminiferous tubules. Our results indicate that the testicular IL-1 like factor is secreted by the seminiferous tubules into the interstitial tissue. Its function in the testicular interstitium is unknown but it might be relevant for the tendency to testicular relapse of childhood lymphocytic leukemia. PMID- 3266248 TI - Rheumatoid adherent synovial cells produce B cell differentiation factor activity neutralizable by antibody to B cell stimulatory factor-2/interleukin 6. AB - B cell differentiation factor (BCDF) activity assayed on SKW6-CL4 cells was found in adherent synovial cell (ASC) conditioned medium. ASC of patients with RA (n = 8) produced significantly larger amounts of BCDF than those of patients with osteoarthritis (n = 5) (219.0 +/- 212.1 vs 25.5 +/- 12.4 units/microgram.DNA, p less than 0.01). ASC clones, established by the limiting dilution technique, also produced this factor. Experiments with several neutralizing antibodies revealed that this BCDF is inhibited by anti-B cell stimulatory factor-2/interleukin 6 antibody (anti-BSF-2/IL-6 ab) up to 90%, but not by antiinterleukin 1, antiinterleukin 2 or antiinterferon-r antibodies. Our data suggest that ASC could participate in the B cell differentiation process in joint space by producing a molecule which has a similar active site to BSF-2/IL-6. PMID- 3266245 TI - Effect of alpha-latrotoxin on the frog neuromuscular junction at low temperature. AB - 1. alpha-Latrotoxin (alpha-LTx) was applied to frog cutaneous pectoris muscles bathed at 1-3 degrees C in either Ringer solution, Ca2+-free Ringer solution with 1 mM-EGTA and 4 mM-Mg2+ or Ringer solution plus 4 mM-Mg2+, and its effects on miniature end-plate potential (MEPP) frequency, nerve terminal ultrastructure and uptake of horseradish peroxidase (HRP) were studied. 2. Large concentrations (2 micrograms/ml) of alpha-LTx increased MEPP rates to levels above 100/s at all junctions, but the time course of the increases depended upon the divalent cation content of the bathing solution. However, similar numbers of MEPPs (0.3-0.7 x 10(6] were recorded at all junctions during 2 h of secretion. 3. Nerve terminals exposed to alpha-LTx for 2 h lost 60-75% of their synaptic vesicles and were swollen; their presynaptic membranes were deeply infolded and they often contained many large vesicular structures. Terminals in Ringer solution retained the largest number of synaptic vesicles; terminals in Ringer solution plus Mg2+ swelled the least and contained the largest number of coated vesicles. The average number of synaptic vesicles lost was approximately equal to the average number of MEPPs recorded. 4. Few vesicles became loaded with HRP when this extracellular tracer was present in the bathing solution and the muscles were fixed near the peak of secretion. 5. When the terminals were warmed to 20 degrees C, those in the Ca2+-free solution with Mg2+ secreted additional quanta and lost almost all their residual vesicles; those in Ringer solution without Mg2+ secreted few additional quanta and retained most of their residual vesicles. 6. These results suggest that recycling was blocked at these terminals and that for each quantum secreted a vesicle became permanently incorporated into the axolemma. PMID- 3266249 TI - Diflunisal pharmacodynamics in experimental arthritis in rats. AB - The analgesic response-serum concentration relationship (pharmacodynamics) of a representative nonsteroidal antiinflammatory drug, diflunisal, was examined after an acute dose in adjuvant arthritic and control rats. The analgesic response was 2-fold higher in the arthritic animals compared to controls. In parallel with this, there was a 2-fold increase in the serum free concentrations of diflunisal in the arthritic rats. Thus, the increase in diflunisal analgesic response in arthritis may be attributed to pharmacokinetic perturbations, resulting from alterations in serum protein binding and not to changes in drug pharmacodynamics. Endogenous binding inhibitors in adjuvant arthritis may contribute to the observed decreased in diflunisal protein binding. PMID- 3266251 TI - Acute septic arthritis in chronic osteonecrosis of the hip. AB - Osteonecrosis is not well documented as a predisposing factor of septic arthritis despite such a relationship having obvious clinical significance. We report 4 patients with involvement of 5 hips with septic arthritis in established osteonecrotic joints. The etiologies of the osteonecrosis in our study included corticosteroid therapy, sickle cell disease and one case of idiopathic osteonecrosis. Osteonecrosis appears to render the hip more susceptible to hematogenously derived bacterial infection. In some cases, removal of the necrotic tissue may be necessary to cure the infection. PMID- 3266250 TI - HLA antigens in ankylosing spondylitis associated with Crohn's disease. Increased frequency of the HLA phenotype B27,B44. AB - In a consecutive case study 231 patients with Crohn's disease were investigated for ankylosing spondylitis (AS) and HLA-A, B, C, DR antigen association. Eighteen patients (7.8%) had definite AS according to the New York criteria; 13 (72%) were HLA-B27 positive. The phenotype B27,B44 was seen in 8 patients (44%) compared to only 3 (1%) of 300 controls (p less than 10(-7), and 1 (0.5%) of 213 patients with Crohn's disease without AS (p less than 10(-7). We conclude that patients with the phenotype B27,B44 are highly at risk (relative risk = 68.8) for the common manifestation of Crohn's disease and AS. PMID- 3266252 TI - Cross-sectional study of beer consumption and blood pressure in middle-aged men. AB - Alcohol consumption in the week prior to examination was assessed in 352 men (average age 52.5 years) selected randomly from a cohort of employees of an industrial plant. Men drinking more than 350 g ethanol per week, largely in the form of a local beer, did not differ in respect of BP but they smoked more cigarettes and had lower serum magnesium levels and immunoreactive insulin levels than the rest of the sample. In a multiple linear (step-wise) regression analysis, body mass index, age, immunoreactive insulin two hours after glucose load and serum total cholesterol contributed directly to the BP value but the weekly ethanol intake did not. Smoking contributed negatively to the BP value after an a priori exclusion of total cholesterol, HDL cholesterol, magnesium and results of glucose tolerance tests. Only immunoreactive insulin and age were related significantly to ethanol consumption. No significant association of alcohol consumption with BP was found. PMID- 3266253 TI - 2,3,7,8-Tetrachlorodibenzo-p-dioxin causes an increase in protein kinases associated with epidermal growth factor receptor in the hepatic plasma membrane. AB - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), administered to male rats at a single intraperitoneal (IP) injection dose of 25 micrograms/kg causes down-regulation of epidermal growth factor (EGF) receptor in the plasma membrane of rat liver which starts after two days and continues throughout the experimental period (20 days). Using monoclonal antibody to EGF receptor, it was determined that TCDD-caused EFG receptor down-regulation in the rat liver was accompanied by increased protein kinase activity. Such an increase in the protein kinase activity involves, at least in part, an activation of protein tyrosine kinase. Examination of serum samples from control and treated rats revealed no detectable difference in the level of EGF itself or EGF receptor-reacting substances (eg, hormones and other growth factors). In vivo TCDD caused early eye opening and tooth eruption and poor body weight gain and hair growth in mouse neonates similar to those observed with exogenously administered EGF. The results indicate that such EGF receptor mediated effect of TCDD has some toxocilogical significance in vivo. Although TCDD causes significant reduction in [125I]-EGF binding in the hepatic plasma membrane in susceptible strains of mice, it has only modest effects in tolerant strains. The results are consistent with the idea that the action of TCDD on the EGF receptor is mediated through the cytosolic/nuclear TCDD receptor, which is known to be regulated by the Ah locus. PMID- 3266256 TI - [Heat-killed Lactobacillus casei, LC-9018, as an interferon inducer]. PMID- 3266255 TI - Four- and five-year follow-up results from four seventh-grade smoking prevention strategies. AB - Recent studies have suggested that a prevention program that addresses the social influences that encourage smoking can be effective in deterring cigarette use by adolescents. This study presents 4- and 5-year follow-up results from two studies which evaluated three variations of this social influences model and compared them to a health consequences program and an existing-curriculum condition. The results suggest that a seventh-grade program, built around the social influences model and taught jointly by same-age peer leaders and local classroom teachers, may reduce 4-year weekly- and daily-smoking cumulative incidence rates, providing the first evidence for any long-term effects for the social influences model. However, the results also suggest that any long-term effects from such interventions are probably limited and may depend heavily on the manner in which the social influences model is translated during the intervention. Additional follow-up studies are needed to clarify the long-term effects of these intervention programs. PMID- 3266257 TI - [LAK-adoptive immunotherapy with cytapheresis]. PMID- 3266254 TI - Overreporting of smokeless tobacco use by adolescent males. AB - This study evaluates the impact of a pipeline assessment (salivary cotinine determination) on the accuracy of self-reported use of cigarettes and smokeless tobacco by 160 rural seventh- and eighth-grade males ranging in age from 12 to 16. Half of them were randomly assigned to complete a questionnaire on tobacco use prior to revealing the biochemical validation materials and collecting samples. The others had the samples collected prior to receiving and completing the questionnaires. The questionnaire-first group reported significantly greater smokeless tobacco use than did the pipeline-first group. Only for the latter were their self-reports significantly corroborated by the cotinine results. These results suggest that the utilization of a biochemical pipeline not only can improve self-reported tobacco use but also may help identify perceptions about the social desirability of using harmful substances. PMID- 3266258 TI - [Ovarian bleeding in patients with congenital bleeding tendency]. PMID- 3266259 TI - [Pneumocystis carinii pneumonia in a HTLV-I carrier terminating with acute type of adult T-cell leukemia]. PMID- 3266260 TI - [Basic and clinical evaluation of regional cerebral perfusion scintigraphy of 99mTc-HM-PAO]. PMID- 3266261 TI - [Increased iodine-123 amphetamine (IMP) uptake in two cases of meningioma]. PMID- 3266262 TI - [A case of leiomyosarcoma of the jejunum with effective hemostasis in massive hemorrhage by continuous intraarterial vasopressin injection]. PMID- 3266263 TI - [Successful TAE in duodenal bleeding under redistribution using two balloon catheters]. PMID- 3266264 TI - [The functional maturation of Langerhans cells in CTL induction during tissue culture]. PMID- 3266265 TI - Aniridia, ectopia lentis, abnormal upper incisors and mental retardation--an autosomal recessive syndrome. AB - A 13-year-old boy presented with bilateral aniridia, ectopia lentis, two palatally placed upper incisors which may be supernumerary teeth or may be malpositioned lateral incisors, and mental retardation. The cause is very probably a single autosomal recessive gene defect although the mental state may have a separate, genetic cause. Since his parents, who are normal, are second cousins and his father's and his mother's parents are also full cousins, the coefficient of inbreeding is 1/64 which is only 25% of the coefficient for full cousinhood of parents alone (1/16). No biochemical correlate has been identified. PMID- 3266266 TI - A new perimetric color vision analyzer. AB - A new apparatus was developed for mapping the extrafoveal color vision, the perimetric color vision analyzer. A yellow test object with varying degrees of saturation is presented on a cathode ray tube color display in a random sequence at one of 10 points around the fixation spot. The background is a mosaic pattern consisting of gray spots of the same size and shape as the test object, with various luminances. Background patterns with or without a test object are presented alternately. The subject is instructed to press a key when he detects a yellow object in the background pattern. The luminance of the test object is in the same range as the background gray spots. Since the luminance of background spots is changed synchronously at random when the test object appears, the subject can detect the test object only by the difference in color saturation. The results show the color contrast sensitivity at every designated point in the central visual field. The clinical application of the perimetric color vision analyzer revealed extrafoveal color defects which could not be evaluated with conventional color vision tests. It also showed that in some chorioretinal and optic nerve disorders the topographic pattern of color contrast sensitivity disagrees with that of luminance contrast sensitivity measured with automated static perimetry. PMID- 3266268 TI - Drug dependence: health and socio-economic consequences. PMID- 3266267 TI - [Characterization of human peripheral blood lymphocytes cultured with recombinant interleukin 2]. PMID- 3266269 TI - [Status of the coronary arteries and possibilities of reconstructive surgery in patients with newly developed stenocardia]. AB - The state of coronary arteries was assessed by means of angiography, and coronary bed tendency to spastic response was assessed by the ergometrin test in 76 patients with angina of new onset (several days to 2 months since the first symptoms). It is suggested that coronary spasm as well as the rate and extent of development of collateral anastomoses in response to stenosing events in the coronary arteries are as important as the anatomical factor in the pathogenesis of angina. Aorto-coronary shunting is possible in most of such patients. PMID- 3266270 TI - [Step-by-step surgical treatment of ischemic heart disease with an arteriosclerotic lesion of the bifurcation of the abdominal aorta]. PMID- 3266271 TI - [Endophthalmitis and toxic lens syndrome. Differential diagnosis and therapy]. AB - Inflammatory reactions following cataract extraction and implantation of an intraocular lens are rare complications. In a group of 10,000 patients the incidence of toxic lens syndrome was 0.15%; infections were seen in 0.07% of the cases. Except for two patients with toxic lens syndrome associated with cystoid macular edema, all ultimately had good visual acuity. While toxic lens syndrome is seen in the first postoperative week or recurs at a later date and responds very well to corticosteroids, bacterial endophthalmitis usually develops on the first postoperative day, with fulminant progress. Mycotic infections occur after a longer interval and temporarily respond better to corticosteroids. The endophthalmitis should be treated early with a vitrectomy to eliminate micro organisms and toxic agents, and to achieve a high intraocular level of antibiotics and antimycotics. From June 1982 to June 1987, thirteen patients with endophthalmitis after cataract extraction were vitrectomized. Navigating visual acuity was ultimately achieved in eight cases. Two patients developed a phthisis bulbi and one a recurrent mycosis. Thus, altogether, an inflammation-free eye with navigating visual acuity can be achieved in over 50% of cases. PMID- 3266272 TI - [The effect of posterior chamber lenses or YAG laser capsulotomy on sensitivity to glare and twilight vision in comparison to phakic control groups (corrected)]. AB - Patients who had undergone extracapsular cataract extraction with implantation of a posterior chamber intraocular lens, and normal subjects of corresponding age and vision were examined with the mesoptometer and nyktometer to compare their twilight vision and glare sensitivity. All the results were poorer in patients with intraocular lenses. Statistically, some of the differences in the results of examinations performed in the two groups were highly significant. As the controls were strictly matched in age and visual acuity, these results confirm other studies with similar objectives. Additionally, some patients with posterior chamber lenses were examined who had also undergone YAG laser capsulotomy for secondary cataract. Although the number of cases was too small for statistical evaluation, it appeared that in this group twilight vision and glare sensitivity could not be improved in the same way as daylight visual acuity by means of this treatment. These findings indicate that since intraocular lenses are increasingly being implanted in younger patients, special attention should also be paid to scotopic vision and glare sensitivity during examinations for drivers' licenses, particularly in cases of good daylight vision. Special examinations, e.g., with the mesoptometer or nyktometer, should be carried out in all such cases. Increased glare sensitivity in eyes with lens implants should also be taken into consideration with regard to the increasing importance of computer and TV screens. PMID- 3266273 TI - Severe multiple cartilaginous exostoses--a case report. PMID- 3266274 TI - The curative properties of electric pulses. PMID- 3266275 TI - Treatment of delayed- and non-union of fractures using pulsed electromagnetic fields. AB - A prospective series of 32 consecutive patients, with 33 long-bone fractures suffering from delayed- or non-union were treated by pulsed electromagnetic fields (PEMF) or by PEMF with surgery. The management regime for the PEMF treatment was simpler and less rigid than that reported by Bassett et al. and our stimulation waveform was also different. Nineteen fractures (100%) treated with surgery and PEMF united within nine months of the commencement of PEMF treatment. Fourteen fractures were treated with PEMF alone. Twelve (86%) united within ten months and two failed to unite. The results of this study suggest that the stimulating waveform is less critical than is claimed by Bassett et al. and that a simpler and easier management regime for PEMF treatment can be just as effective. Alternatively PEMF may have no effect on fracture healing. PMID- 3266276 TI - Above- and below-lesion EMG pattern mapping for controlling electrical stimulation of paraplegics to facilitate unbraced walker-assisted walking. AB - We describe and evaluate above- and below-lesion EMG control of functional electrical stimulation (FES) in upper motor neuron paraplegics, in order to provide them with a patient-responsive system for walking with a walker support. Control is considered in terms of a combination of above-lesion EMG control and below-lesion response-EMG control. The above-lesion EMG is used to control the activation of limb functions involved in standing up and walking with FES, control being accomplished by analysing raw surface-EMG time-series patterns to discriminate between upper-trunk muscle contraction patterns, which in turn, are correlated with intended lower-limb functions involved in walking, so that natural and instinctive balance changes in paraplegics are controlled by the patient from above the lesion. The below-lesion response-EMG is the EMG produced in response to the FES pulses at the stimulation sites, for adjusting stimulation levels as needed when contractions weaken due to muscle fatigue. Above-lesion EMG is a stochastic (random-like) signal, being a response to unsynchronized motor neuron firings, whereas the below-lesion EMG is a deterministic signal responding to synchronized firings that result solely from the FES pulses. We also discuss the merits and difficulties of EMG control, and evaluate patient performance under such control, noting that FES-activated walking without adequate and patient-responsive control is of very limited use to paraplegics. PMID- 3266277 TI - Pulsed electromagnetic field treatment failure in radius non-united fracture healing. AB - Pulsed electromagnetic field (PEMF) treatment is a non-invasive technique which has wide use in promoting healing of delayed union and non-union of bone. According to reports in the literature, PEMF has a 'success' of about 70%, but with no clear-cut reason to explain the failures. Our tests were carried out on 11 patients with radius non-unions and delayed unions; the results suggest that PEMF failure is associated with implanted metallic plates. In our view, this can be explained because the conducting plates create a uniform bone biopotential around the fracture and thus prevent the negative polarization which stimulates callus formation. Although further controlled and randomized clinical tests are needed, our results indicate that it may be necessary to remove the plates before PEMF application. PMID- 3266278 TI - A comparison of alcoholic and nonalcoholic drug abusers. AB - A group of 329 hospitalized drug abusers were evaluated for a current or past diagnosis of alcoholism. The alcoholic drug-dependent patients (n = 169, 51.4%) were then compared with the nonalcoholic patients (n = 160, 48.6%) with regard to sociodemographic, clinical and family history characteristics. The alcoholics were significantly more likely to receive a DSM-III diagnosis of major depression, with melancholia; other Axis I diagnoses were equally distributed between the two groups. Antisocial personality disorder was also significantly more prevalent among the alcoholic patients. The alcoholics had somewhat longer drug histories and more vivid memories of their first drinking experiences; polydrug abuse, however, was no more common in this group. Finally, the first degree relatives of the alcoholics had significantly more alcoholism than the first-degree relatives of the nonalcoholic patients. Implications regarding the relationship of alcoholism and other forms of substance abuse are discussed. PMID- 3266279 TI - Age-related changes in the proportion of types I and III collagen. AB - Previous studies of the age-related changes in interstitial collagens, have suggested that the proportion of type III collagen compared with type I decreases with age. In this study collagen concentration and the proportion of types were measured in heart, lung and skin of male Lewis rats aged between 1 day and 2 years. Collagen concentration, based on hydroxyproline levels, increased in all tissues up until 6 months of age, thereafter it increased in heart and lung, yet decreased in skin. The relative proportions of types I and III collagen were assessed after cyanogen bromide digestion of the tissue and separation of the resultant peptides by sodium dodecyl sulphate polyacrylamide gel electrophoresis. At 2 weeks of age collagen type III represented about one-third of types I and III in all tissues. After this age the proportion of type III increased up to 1 year in both heart (53.9 +/- 1.8%) and lung (47.7 +/- 2.8%), whereas it decreased in skin (18.6 +/- 1.5%). These data show that there are age-related changes in both collagen concentration and the relative proportions of types I and III collagen, but that the direction of these changes differs between tissues. PMID- 3266281 TI - [Epidemiology and means of transmission of HIV infection]. AB - Epidemiological features of HIV infection and the AIDS pandemic are described in this review. The number of AIDS cases will continue to rise for several years, despite enormous efforts to slow the spread of HIV via sexual and parenteral exposure, since virtually all adult patients who will develop AIDS within the next 3-5 years are already infected. Careful examination of AIDS patients without identified risk factors and results obtained from anonymous testing sites for HIV infection have failed to disclose any new forms of HIV transmission. The risk for health care workers to become infected through occupational exposure appears to be very small (0.1-0.4% per documented parenteral HIV-positive blood exposure). Universal precautions against mucocutaneous blood exposure are likely to reduce this risk even further. PMID- 3266280 TI - [Activity of total complement and concentration of its components C1q, C3, C4 and C1-inactivator in cancer]. PMID- 3266282 TI - [Acute diverticulitis]. AB - A retrospective study of 310 patients from 1978 to 87 showed emergency operations for peritonitis, acute obstruction (5%) and massive hemorrhage (3%) in 22% of the patients and various procedures for abscesses, such as delayed emergency in 14% and elective resections in 41%. Conservative treatment was given to 23% of patients with acute diverticulitis without further symptoms. During followup 68% had no symptoms, while 7% required resection for complications. The death rate for diffuse peritonitis has fallen: from 33 to 16% with Hartmann operation, and for perforations without and with abscesses from 4 to 0% and 12 to 4%, and from 1.2 to 0.6% in elective primary resection. PMID- 3266283 TI - [Results of simultaneous radio-polychemotherapy in advanced inoperable cancer of the head and neck]. AB - Sixty untreated patients with advanced carcinoma of the head and neck (stages III = 11 and IV = 49) were treated simultaneously with three cycles of polychemotherapy and radiation. Chemotherapy consisted of cisplatinum (DDP) 60 mg/m2 after prehydration with saline and mannitol, 5-fluorouracil (5-FU) 350 mg/m2 and folinic acid (FA) 50 mg/m2 on day 2 as a bolus and a continuous infusion of 5-FU 350 mg/m2/24 h and folinic acid (FA) 100 mg/m2/24 h from day 2 5. Concomitantly, accelerated hyperfractionated radiation was administered from day 3-11. Two fractions per day with 1.8 Gy each were given, 13 fractions in 9 days. This cycle was repeated two times on day 22 and 44 with an interval without treatment from day 16-21 and 34-43. Total radiation dose was 70.2 Gy in 51 days. Acute toxicities (WHO grade II and III) consisted mainly of leucopenia (75%), thrombopenia (15%), weight loss (mean 5.8 +/- 3.7%) and mucositis (66%). Grade IV was never reached. Except for 3 patients, who died during treatment due to fatal tumor bleeding or carotid rupture, all were able to finish the treatment with reduction in chemotherapy in only 95% (DDP) and 98% (5-FU) with no changes in the radiation protocol. Evaluation of tumor response at 3 months after end of treatment showed 68% complete and 32% partial responses. 5 patients developed distant metastases. Survival with local control after 12 months was 80.8% and 71.3% after 24 months. 1 and 2 years disease-free survival was 70.8% and 62.1%. Total survival irrespective of cause of death was 77.9% and 57.2% after 1 and 2 years. This particular simultaneous radio-polychemotherapy protocol appears to be well tolerable and highly effective in terms of tumor control and survival of advanced stages of head and neck cancer. PMID- 3266284 TI - Viral determinants of virulence for Rift Valley fever (RVF) in rats. AB - Rift Valley fever viral strains or variants (RVFV) were compared with respect to (a) virulence for Wistar-Furth rats; (b) in vitro sensitivity to rat and human interferon; (c) ability to form plaques in primary hepatocyte cultures from genetically resistant or susceptible rat strains, and (d) replicative potential in continuous rat cell lines. Egyptian strains were highly virulent for Wistar Furth rats; relatively resistant to rat interferon-alpha/beta; capable of producing plaques in primary hepatocyte monolayers; and, in general, replicated more rapidly than the low-virulent, sub-Saharan strains. Virtually all strains from sub-Saharan Africa were sensitive to rat interferon and did not form plaques in rat hepatocyte monolayers. An exception was the 2269/74 strain from Zimbabwe, which had characteristics of the Egyptian strains including increased virulence for Wistar-Furth rats. The relative virulence of RVFV strains for rats did not correlate with interferon sensitivity when human recombinant interferon-alpha was tested on A-549 cells. Thus, several in vitro phenotypic characteristics of RVFV strains tend to correlate with virulence for Wistar-Furth rats and with geographical origin of the viral strains. PMID- 3266285 TI - Alpha 1-antitrypsin. PMID- 3266287 TI - Major congenital anomalies in livebirths in Alor Setar General Hospital during a three-year period. PMID- 3266286 TI - Endogenous pyrogens. PMID- 3266289 TI - [Aorto-duodenal fistula as a cause of acute gastrointestinal hemorrhage]. PMID- 3266288 TI - The prevalence of endemic goitre among Penans of the Baram. PMID- 3266290 TI - HIV prevalence in the military. PMID- 3266291 TI - Synthetic peptide inhibitors of complement serine proteases--I. Identification of functionally equivalent protease inhibitor sequences in serpins and inhibition of C1s and D. AB - Sequence homology comparisons between serum serine protease inhibitors led to the prediction that the C-terminal sequences are functionally equivalent and represent an essential protease binding domain. Inhibition of complement serine protease D cleavage of factor B and of C1s cleavage of C4 by synthetic peptides containing sequences from the C-termini of three serum serine protease inhibitors supports this prediction. These functionally equivalent peptides represent a new class of inhibitors of D and C1s as well as other serum serine proteases. PMID- 3266293 TI - Inhibition of lymphocyte protease granzyme A by antithrombin III. AB - T-lymphocytes contain a cytoplasmic granule associated homo-dimeric protease designated granzyme A. Upon T-cell target cell interaction, the granules undergo exocytosis and granzyme A, and other granule constituents, are released. Here we show that granzyme A secreted into plasma is immediately inactivated by antithrombin III. The rate of complex formation is enhanced 400-fold in the presence of heparin. Two different complexes are generated: granzyme A antithrombin III and granzyme A-(antithrombin III)2, respectively, indicating that both active centers of granzyme A are functional. Thus, the proteolytic activity of lymphocyte protease granzyme A, whose physiologically relevant function is unknown, is well regulated in plasma. PMID- 3266292 TI - Synthetic peptide inhibitors of complement serine proteases--II. Effects on hemolytic activity and production of C3a and C4a. AB - Synthetic peptides based on the amino acid sequence at the site of cleavage of C3 by classical and alternative pathway convertases were found to be poor inhibitors of hemolysis except at concns of 1 mM and higher. Synthetic peptides of a second type, based on the C-terminal sequence of antithrombin III, were more effective; the best among them caused significant inhibition of hemolysis at a concn of 5 microM. A hybrid peptide composed of the sequence at the site of cleavage of C4 by C1s attached to an antithrombin III sequence was selective, inhibiting the classical pathway with no effect on the alternative pathway at a concentration of 25 microM. Several of the antithrombin III peptides that inhibited hemolysis did not inhibit C4 activation by the classical pathway or activation of C3 by the classical and alternative pathways suggesting that these peptides affect hemolysis by inhibiting enzymes other than C1s and C4b2a of the classical pathway and C3bBb of the alternative pathway. PMID- 3266294 TI - The activation of C3 and C4 in human serum by immune complexes containing mouse monoclonal antibodies of different isotype and affinity: effects on solubilisation. AB - Radioimmunoassays for C3a and C4a have been used to measure the activation of complement in human serum by immune complexes containing DNP-BSA and each of 11 mouse anti-DNP monoclonal antibodies of varied isotype and affinity. When preformed complexes were added to serum, those containing IgG2 or IgM were potent activators of C4, whilst IgG1 complexes were less efficient. C3 activation in normal serum was similar for complexes containing IgG1, IgG2a, IgG2b or IgM. IgA complexes did not activate C3 or C4. Solubilisation of complexes was greatest for IgM and IgG2b and least for IgG2a and IgA. In serum containing Mg2+ EGTA C4 activation was abolished and the amount of C3 activation was lower for all IgG and IgM complexes. Antibodies of the same isotype did not necessarily activate complement to the same extent. Unexpectedly, three of the four IgMs activated C3 in EGTA. For IgMs, neither complement activation nor solubilisation correlated with affinity. For IgG1 antibodies, solubilisation was inversely proportional to affinity. C3 or C4 activation did not correlate with affinity. PMID- 3266295 TI - Ovarian-tumor-infiltrating lymphocytes: phenotype and antitumor activity. PMID- 3266296 TI - Uncommon CT patterns of subdural hematomas managed nonsurgically. PMID- 3266297 TI - Risks of lumbar puncture in the presence of intracranial mass lesions. PMID- 3266298 TI - Mediastinoscopy: its changing role. PMID- 3266299 TI - An unusual concurrence of myotonia congenita and Wilson's disease. PMID- 3266300 TI - Histopathology of the breasts of 12 women receiving long-term exogenous androgen therapy. PMID- 3266301 TI - Fatal cerebrovascular thrombosis in a young woman: an unusual complication associated with hypochromic anemia and thrombocytosis following surgery. PMID- 3266302 TI - Carcinoma of the ureter with isolated lower-extremity swelling. PMID- 3266303 TI - Fibrovascular polyp of the esophagus. PMID- 3266304 TI - Isolated tongue hemiatrophy. PMID- 3266305 TI - Osteochondrosarcoma of the sternum: 29-year cure by radical surgery. PMID- 3266306 TI - The association of papilledema with syringomyelia: case report. PMID- 3266307 TI - Megacolon and volvulus complicating progressive systemic sclerosis. PMID- 3266308 TI - Lung function and health attitudes and habits in professional wind musicians and vocalists. PMID- 3266309 TI - Plasma interleukin-1 activity during hemodialysis: the influence of dialysis membranes. AB - Plasma interleukin-1 (IL-1) activity was measured in 7 stable ESRD patients on regular hemodialysis for no less than 5 months. Predialysis levels were significantly raised compared to 8 normal control subjects. During hemodialysis with four different membranes, plasma IL-1 activity rose with Cuprophan and Hemophan and was unchanged or reduced with Gambrane and Polysulfon. In spite of these differences, body temperature rose in all forms of hemodialysis. Factors responsible for the predialysis elevation included the absence of renal function and/or the repeated stimulus of human blood monocytes by hemodialysis. In view of the uniform increase of body temperature during hemodialysis, the differences in changes of plasma IL-1 activity observed with the various membranes may not be caused by a variable stimulation of monocytes but rather by the presence or absence of the membrane's ability to remove and/or absorb IL-1. Thus, the consequences of monocyte hemodialysis stimulation may be obtained locally, even in the presence of unchanged or reduced plasma IL-1 activity. PMID- 3266310 TI - Altered interleukin-1 production in patients undergoing hemodialysis. AB - The capacity of peripheral blood mononuclear cells (PBMC) to undergo spontaneous and induced interleukin-1 (IL-1) production was examined in 10 healthy controls and in 10 patients undergoing intermittent hemodialysis (HD) using cuprophane membranes. Extracellular and cytoplasmic IL-1 activity was assayed by biologic and radioimmunologic methods. Spontaneous extracellular IL-1 activity was low in the patient and the control groups. However, spontaneous cytoplasmic IL-1 activity was greatly increased in the patients. Both assays gave comparable results. In contrast, the IL-1 response to lipopolysaccharide was significantly decreased in PBMC from the patients compared to controls. From these results we conclude that PBMC from HD patients show functional signs of activation, but an impaired response to exogenous stimuli, such as endotoxin. PMID- 3266311 TI - In vivo effect of 1 alpha-hydroxyvitamin D3 on interleukin-2 production in hemodialysis patients. AB - The immunoregulatory effect of 1 alpha-OHD3, a precursor form of active vitamin D3 1,25 (OH)2D3, was examined in hemodialysis patients. Peripheral blood mononuclear cells (PBM) from hemodialysis patients produced significantly less interleukin-2 (IL-2) than those from normal controls. Four weeks of oral administration of 0.5 micrograms/day of 1 alpha-OHD3 enhanced the IL-2 production of PBM from the patients. This fact suggests that 1 alpha-OHD3 therapy may be useful for the restoration of IL-2 production in hemodialysis patients, and that the vitamin D3 deficiency may be responsible for the impairment of cellular immunity associated with IL-2 production disorder in hemodialysis patients. PMID- 3266312 TI - Beneficial effect of aluminum hydroxide on progress of adriamycin-induced nephropathy in rats. AB - To investigate the effect of phosphate binder on adriamycin (ADR)-induced nephropathy, serial changes in renal histology and renal hemodynamics were compared between ADR rats treated with aluminum hydroxide (ADR-AH group) and those without AH (ADR group) for 24 weeks. Urinary protein excretion was less marked in the ADR-AH group than in the ADR group. Serum creatinine in the ADR group increased progressively from week 20, while in the ADR-AH group the increase was less. There were no significant differences in glomerular filtration rate or renal plasma flow between the both groups until week 12 but these parameters decreased to the significantly lower levels at week 24 in the ADR group. Vacuolative degeneration in glomerular epithelium, which was determined as an initial renal lesion, was more marked in the ADR group compared to the ADR-AH group. Glomerular sclerosis and tubulointerstitial changes developed progressively in the ADR group at the later stages. These changes were lessened in the ADR-AH group. In conclusion, AH prevents the progress in ADR-induced nephropathy. The beneficial effects appeared as the preservation of glomerular epithelial cells. PMID- 3266313 TI - Glomerular annular-tubular immune deposits in adult hemolytic uremic syndrome. AB - An 82-year-old female developed hemolytic uremic syndrome (HUS) after a prodromal illness of bloody diarrhea. No specific enteric pathogen was isolated. A renal biopsy performed 5 days after the onset of azotemia revealed typical thrombotic microangiopathy. By electron microscopy, massive annular-tubular deposits admixed with fibrillar fibrin were demonstrated in glomerular capillaries. Immunofluorescent staining of the intracapillary material was positive for IgG, IgM, C3, C1q and fibrin-related antigens. No evidence of plasma cell dyscrasia, cryoglobulinemia or systemic lupus erythematosus was found, and the patient recovered renal function uneventfully in 2 months. Organized immune deposits appear to have played a role in the pathogenesis of HUS in this patient. PMID- 3266314 TI - Unusual CT-dense transtentorial epidermoid cyst. AB - CT-dense dermoids and epidermoids are rare. We report a case of CT-dense trans tentorial epidermoid cyst associated with a chronic calcified subdural haematoma. PMID- 3266315 TI - Trochlear nerve meningioma in von Recklinghausen's disease. AB - A trochlear nerve meningioma in a patient with von Recklinghausen's disease is reported. The tumour appeared to have originated from the trochlear nerve itself, having no connection either with the neurinomas present in the adjacent regions, or with the tentorium. Histological examinations revealed that the tumour was a meningotheliomatous meningioma and the trochlear nerve fibres were placed in the periphery of the tumours. It was noteworthy that diplopia was not detected either before or after the resection of the trochlear nerve with the tumour. PMID- 3266316 TI - Adaptogenic significance of serotonin in dogs emerging from experimental neurosis. PMID- 3266317 TI - [Use of a sinusoidal modulated pulsed current for improving ocular accommodation capacity in the combined treatment of progressive myopia in school-age children]. PMID- 3266318 TI - [An analysis of treatment results in perforating eye wounds not requiring primary surgical care]. PMID- 3266319 TI - [Electric conductivity at the biologically active eye points in local autonomic dysfunction of the eye]. PMID- 3266320 TI - Cytotoxic factor produced from lymphokine-activated killer (LAK) cells. PMID- 3266321 TI - [Directional preponderance in post-traumatic vestibular syndrome]. PMID- 3266322 TI - [Characteristics of vestibular deprivation in postnatal growing rabbits]. PMID- 3266323 TI - [Effect of the course of pregnancy and labor and socio-familial conditions on the morbidity of children]. PMID- 3266324 TI - [Increased incidence of Pneumocystis carinii pneumonia in infants with congenital adrenal hyperplasia]. PMID- 3266325 TI - [Evaluation of SPECT with 67Ga and 201Tl in patients with primary lung cancer]. PMID- 3266327 TI - [EDRF--endothelium-derived relaxant factor: its properties and biological significance]. PMID- 3266326 TI - The Liverpool Congenital Malformations Registry. AB - Data collection and validation for the Liverpool Congenital Malformations Registry (LCMR) are described. Founded in 1960, the LCMR increased its area of surveillance in 1979 to include five health districts in Liverpool and its environs with approximately 20,000 births per annum. The LCMR is now one of the members of the European Congenital Anomalies Register (EUROCAT). Multiple sources of ascertainment are employed, the most useful of these being OPCS notifications, hospital discharge letters and data from specialised paediatric units. In spite of several difficulties encountered in data collection the data base is an invaluable tool both for routine monitoring of prevalence rates and as a starting point for epidemiological research. PMID- 3266329 TI - Effect of hypophysectomy on 17 alpha-hydroxylase activity in theca cells of the ovarian follicle in the Japanese quail. AB - The activity of 17 alpha-hydroxylase, a key enzyme for progesterone metabolism in avian follicles, was measured in cell-free homogenates of isolated theca cells of Japanese quail. Kinetic studies revealed that differences in enzyme activity in the largest and the second largest follicles were mainly due to differences in Vmax values. In order to investigate the mechanism of regulation of 17 alpha hydroxylase activity, quail were hypophysectomized at various time periods during the ovulatory cycle, and 17 alpha-hydroxylase activity in theca homogenates was measured 4 h after surgery. Hypophysectomy at 8 h before the predicted time of ovulation, which is the time when the preovulatory luteinizing hormone (LH) surge is initiated, resulted in a significant decrease in enzyme activity. In contrast, activity was increased when the pituitary was removed 20 h before ovulation. Hypophysectomy 24 h before ovulation had no effect on enzyme activity. PMID- 3266328 TI - Aminoacetyl derivatives of 1,5-benzodiazepin-2-one. AB - A series of six compounds, 5-chloroacetyl-4-methyl-1H-tetrahydro-1,5 benzodiazepin-2-one and 5-dialkilaminoacetyl derivatives of 4-methyl-1H tetrahydro-1,5-benzodiazepin-2-one, have been synthesized. 5 Diizobutylaminoacetyl-4-methyl-1H-tetrahydro-1,5-benzodiazepi n-2-one showed weak analgesic and antiinflammatory activity. PMID- 3266331 TI - Autolymphocyte therapy: previous experience and future prospects. AB - Autolymphocyte therapy is outpatient medical treatment for selected patients, in which a relatively small amount of white blood cells is removed temporarily from the patients, modified in the laboratory through sophisticated biotechnology, and returned to the patient for the purpose of enhancing the immune system and contributing to improved health. We suggest that autolymphocyte therapy might be a useful approach in the prevention or treatment of several diseases. Previous work with autolymphocyte therapy in the treatment of metastatic renal cell carcinoma has demonstrated that this approach is minimally toxic and biologically active. Further clinical trials are justified and currently taking place. PMID- 3266332 TI - [Infectious and neoplastic lesions of the eye in AIDS]. PMID- 3266330 TI - Presence of pteridine pigments in isolated iridophores. PMID- 3266333 TI - [Dynamics of clinico-immunologic indices in patients with endocrine ophthalmopathy undergoing treatment with the preparation parlodel]. AB - The immune status and the time course of ophthalmological indices were studied in 54 patients with endocrine ophthalmopathy during bromocriptine therapy. Twelve weeks after the onset of therapy indices of the immune status returned to normal in parallel with the regression of ophthalmological symptoms. In the control group (20 patients with endocrine ophthalmopathy who did not receive bromocriptine) significant improvement of the clinicoimmunological status was unnoticed. An increase in the number of T-lymphocytes, a decrease in the number of B-lymphocytes, an increase in the level of IgG, and a decrease in the levels of IgA and IgM were observed during bromocriptine therapy. The time of the immunity indices could serve as a criterion of bromocriptine therapeutic efficacy in patients with endocrine ophthalmopathy. PMID- 3266334 TI - Burkitt's-like lymphoma of T-cell type. AB - Over an 8-yr period, we studied 29 cases of Burkitt's/Burkitt's-like lymphoma and unexpectedly found 2 Burkitt's-like cases of the T-cell type. One case presented as diffuse adenopathy in a 35-yr-old male. A second case presented as a jaw mass in a 2-yr-old girl with Down's syndrome. Histologically, each case demonstrated usual Burkitt's-like morphology (intermediate-size cells with high nuclear/cytoplasmic ratio, 1 to 3 prominent nucleoli, high mitotic rate, basophilic cytoplasm, and cytoplasmic vacuolation). Ultrastructural morphometric data corroborated the Burkitt's-like nature of these neoplasms. Immunologically, the neoplasms were of "novel" T-cell phenotype, as seen in peripheral T-cell lymphoma (PTL). The cases showed variable expression of activation antigens (e.g., Ia) and weak to moderate expression of proliferation antigens as measured by Ki-67. This modest proliferative activity (less than 25% Ki-67 expression) contrasts with Burkitt's-like lymphomas of the B-cell type which usually show greater than 80% Ki-67 expression. The jaw tumor also demonstrated positivity for human progenitor cell antigen (HPCA) as commonly found in leukemia. Both cases mimic granulocytic sarcoma by virtue of their eosinophilic/myelocytic recruitment -a phenomenon previously reported in association with PTL. The patients have survived 62 wk and 20 wk, respectively, surpassing the survival rates seen in our concurrent B-cell Burkitt's-like lymphomas (12 wk). Burkitt's-like lymphoma of the T-cell type appears to be a distinctive immunological subset of potential clinical and prognostic relevance. PMID- 3266335 TI - Monoclonal antibodies marking B-cell non-Hodgkin's lymphoma in paraffin-embedded tissue. AB - Traditional methods for the immunophenotypic analysis of the non-Hodgkin's lymphomas require fresh or snap-frozen tissue for flow cytometric or immunohistochemical studies. The monoclonal antibodies LN1, LN2, and L26 have been recently developed to recognize B-cell-specific antigens that survive routine tissue processing and paraffin embedding. In this study, the ability of these three antibodies to mark the neoplastic cells in 160 cases of paraffin embedded non-Hodgkin's lymphoma relative to frozen section immunophenotype (42 T cell, 118 B-cell), manner of fixation (B5 versus 10% buffered formalin), and histological subtype was examined. With B5-fixed tissue, the percentages of B cell lymphoma marking with the antibodies were as follows: L26, 96.6%; LN1, 88.2%; LN2, 93.7%. With formalin-fixed tissue, the percentages of B-cell lymphoma reacting with the antibodies were: L26, 89.1%; LN1, 26.2%; LN2, 57.8%. Each of the antibodies marked a small percentage of paraffin-embedded T-cell lymphomas: L26, 4.7%; LN1, 4.7%; LN2, 7.1%. LN2, and to a lesser extent LN1, stained Reed Sternberg cells, a feature not seen with L26. Nor did L26 mark nonlymphoid neoplasms, a feature previously reported with LN1 and LN2. Since a high percentage of B-cell lymphomas react with these antibodies and they are relatively specific for B-cells, they should prove highly useful for the evaluation of both diagnostic and experimental pathology specimens. L26 offers the distinct advantage of working well in both B5 and formalin-fixed tissues and seemingly not marking epithelial neoplasms. PMID- 3266336 TI - Prostaglandin synthesis by osteoid osteoma and osteoblastoma. AB - Osteoid osteomas are characterized clinically by a pattern of nocturnal pain which is exquisitely sensitive to salicylates. Etiology for the pain has been ascribed by previous investigators to the presence of nonmyelinated nerve fibers or to the effect of prostaglandins. In an effort to corroborate the potential role of prostaglandins in mediating the pain associated with this tumor, we have determined the concentration of prostaglandins E2, F2 alpha, 6-keto-F1 alpha, and thromboxane B2 utilizing radioimmunoassay of extracts of homogenated tumor tissue. Results were compared with similar extracts of normal bone and a variety of other osseous tumors. The increased concentrations of prostaglandin E2 found in cases of osteoid osteoma and osteoblastoma confirm studies of explants of these tumors previously recorded in the literature. PMID- 3266337 TI - Hodgkin's disease, lymphocyte-predominant type: immunoreactivity with B-cell antibodies. AB - Utilizing the monoclonal antibodies L26 (a new antibody possessing immunoreactivity with B-lymphocytes in paraffin-embedded tissue), LN1, LN2, and Leu-M1, 44 cases of Hodgkin's disease (HD) were examined for the presence of immunoreactivity in Reed-Sternberg (R-S) cells by the avidin-biotin-peroxidase complex (ABC) technique. In 16 cases of lymphocyte-predominant Hodgkin's disease (LPHD), the L&H variants of R-S cells exhibited a different pattern of staining compared to R-S cells in other histologic types (total, 28 cases: 11, mixed cellularity; 8, nodular sclerosing; 6, lymphocyte depleted; 3, unclassified). L&H variants in LPHD were immunoreactive for L26 and LN1 in 15 and 14 cases, respectively, whereas R-S cells in the remaining types were negative or rarely positive (3, L26; 2, LN1). Leu-M1 was strongly positive in 27 of 28 cases of non LPHD versus only 4 of 16 in LPHD. LN2 was reactive in virtually all cases (43 of 44). These findings suggest the possibility that the R-S cells of LPHD are derived from a different lineage than R-S cells in other histologic types of HD or that the latter have somehow lost the ability to express the antigens defined by L26 and LN1. Finally, based on immunologic and morphologic findings in this study, the similarities seen between the nodular and diffuse subtypes of LPHD are felt to favor a close relationship between the two subtypes. PMID- 3266339 TI - The effects of continuous administration of murine interleukin-1 alpha in the rat. AB - Recombinant murine IL-1 alpha was administered continuously to rats by means of osmotic pumps implanted intraperitoneally. Continuous infusion of rIL-1 alpha in a range between 0.12 and 12.0 micrograms/day for four days was found to produce concentration-dependent weight loss. Behavioral parameters were continuously monitored and recorded at the 3.0 micrograms/day concentration in electronically monitored activity cages during Days 2 through 5 of rIL-1 alpha administration. Parameters were separated into those affected during the dark phase (active period) or the light phase (resting period). Eating activity was found to be significantly reduced during each dark period through day 5, when compared with either untreated or PBS vehicle-infused animals. During the fourth and fifth days of infusion, however, eating behavior in animals infused with rIL-1 alpha began to increase toward control level in the latter, but not the earlier, half of the dark period. In contrast, drinking behavior was found to be significantly elevated only during the light periods. Continuous infusion of rIL-1 alpha also produced significant reductions in both horizontal locomotor activity (crossovers) and vertical locomotor activity (rears). However, in contrast to the trend toward a return of normal eating behavior, locomotor activity remained decreased through the fifth day of rIL-1 alpha infusion. These results suggest changes that could be produced by IL-1 in chronic inflammatory disease and infection. PMID- 3266338 TI - Differential effects of calcium channel blockade and intracellular calcium antagonism on endothelium-dependent responses of the rat aorta to drugs. AB - The actions of many vasoactive drugs are mediated through, or modified by, the endothelium-derived relaxing (EDRF) and constricting (EDCF) factors. While EDRF appears to be nitric oxide, EDCF is a peptide or cyclooxygenase product. Using verapamil (a calcium channel blocker), propyl methylenedioxyindene (pr-MDI; an intracellular calcium antagonist), and sodium nitroprusside (which liberates nitric oxide from its molecular structure) as EDRF-independent pharmacological probes in rat aortic rings with and without endothelium, we attempted to provide additional insight into the role of extracellular [( Ca]o) and intracellular [( Ca]i) calcium in EDRF and EDCF release and action, and to explain some mechanisms underlying the modulatory effects of these endothelial factors on the actions of vasoactive drugs. The findings suggest that (1) the [Ca]o required for evoked EDRF release does not enter endothelial cells through verapamil-sensitive calcium channels; (2) mobilization of endoplasmic reticular [Ca]i by [Ca]o entering the endothelial cell may be the trigger for evoked EDRF release; (3) spontaneous release of EDRF appears to depend more on mobilization of [Ca]i than on influx of [Ca]o; (4) the action of EDRF on smooth muscle either does not require Ca or does not involve the mobilization of [Ca]i by [Ca]o; (5) Both EDRF and EDCF can modulate the actions of vasoactive drugs; (6) the EDCF of the rat aorta is not a cyclooxygenase product, and (7) the action of EDCF on vascular smooth muscle, and possibly its release from endothelial cells, are Ca-dependent. PMID- 3266340 TI - Prevalence of binge-eating and bulimia among adolescent women in Japan. AB - This study examined by questionnaire the prevalence of binge-eating and bulimia among 220 women at a school of nursing and 236 women at a junior college, all from 18 to 21 years old, in two different areas of Japan. Binge-eating more than once a week was found in 14 (6.5%) of the nursing school students and 21 (9.1%) of the college women. Self-induced vomiting and use of purgatives were found in 19 (8.7%) and 12 (5.5%) of the nursing school students, and 19 (8.1%) and 9 (3.8%) of the college women, respectively. The difference between these two groups was not significant. The prevalence of binge-eating more than once a week, together with self-induced vomiting or purgative use, was 3.6% in the nursing school students, 2.1% in the college women, and 2.9% in the total sample. These women appeared to meet both DSM-III criteria for bulimia and Russell's criteria for bulimia nervosa. PMID- 3266341 TI - Neurophysiological aspects of auditory hallucinations. 99mTc-(HMPAO)-SPECT investigations in patients with auditory hallucinations and normal controls--a preliminary report. AB - In a symptom-oriented study 17 patients suffering from chronic auditory hallucinations were investigated by means of 99mTc-HMPAO-SPECT and compared with healthy controls. The results confirm the relative frontal hypoactivity in junction with a relative hyperactivity in the basal ganglia and mesial limbic structures in both hemispheres found in a previous pilot study in auditorily hallucinating patients. Our results should fortify the symptom-oriented approach in psychiatric research. PMID- 3266342 TI - Psychoneuroses and psychophysiological disorders: prevalence, courses and strategies for prevention. PMID- 3266343 TI - [Incidence of syphilis among drug addicts. Report II]. PMID- 3266344 TI - Bombesin and its analogues inhibit interleukin-2-induced proliferation of CTLL-2 cells. AB - Specifically interleukin-2 (IL-2)-dependent CTLL-2 cells were incubated in short term culture in the presence of IL-2 together with bombesin and two analogues, [Lys3]bombesin and [Tyr4]bombesin in different concentrations. Cell proliferation, determined by [3H]thymidine incorporation was significantly inhibited by 35.6 +/- 5%, 39.0 +/- 5.6% and 57.0 +/- 11% (mean +/- S.E.M. of 3 independent experiments). A typically U-shaped dose-response relationship was observed, showing a maximum effect between 10(-12) and 10(-10) M. Our data support the hypothesis that this effect is mediated by a specific receptor for bombesin and closely related peptides on CTLL-2 cells. As IL-2 plays a critical role in the clonal expansion of activated lymphocytes, antagonism of the effect of IL-2 is of high biological significance. PMID- 3266345 TI - [Incidence of stomach cancer in Panama]. PMID- 3266346 TI - [Linear fractures of the skull as a risk factor for intracranial hematoma]. PMID- 3266348 TI - [Gammagraphy with thallium-201 and isotopic ventriculography during exertion in patients after coronary revascularization surgery]. PMID- 3266347 TI - [Adult respiratory distress in a patient with acquired immunodeficiency syndrome]. PMID- 3266349 TI - [Evaluation of myocardial perfusion with tomography quantified by photon emission with thallium-201]. PMID- 3266350 TI - [Absolute biventricular volumes and cardiac output by isotopic ventriculography]. PMID- 3266351 TI - [Exercise stress thallium-201 myocardial imaging in hypertrophic cardiomyopathy with ventricular tachycardia]. PMID- 3266352 TI - Psychosocial predictors of optimal rehabilitation post-coronary artery bypass surgery. PMID- 3266353 TI - Response to "Psychosocial predictors of optimal rehabilitation post-coronary artery bypass surgery". PMID- 3266355 TI - [Pulmonary infections in HIV infection]. PMID- 3266354 TI - [Status asthmaticus following administration of drugs]. PMID- 3266356 TI - Serum IgG4 anti-Fab antibodies in rheumatoid arthritis are constitutively expressed. AB - IgG4 comprises a significant proportion of the total anti-Fab antibody (aFABA) response in many but not all patients with rheumatoid arthritis (RA). Analyses of the dynamics of IgG aFABA subclass expression in 11 RA patients for periods of up to 11 months demonstrated that IgG4 aFABA was restricted to 6 of the 11 RA patients' sera initially studied and comprised approximately 25% (or more) of the total IgG aFABA response. Quantities of IgG4 aFABA in subsequent, serially obtained serum samples from these patients remained stable throughout the study period, whereas the remaining RA patients whose initial sera possessed small quantities of serum IgG4 aFABA failed to generate any augmented IgG4 aFABA response during the study. Elevated expression of IgG4 aFABA did not appear to be a consequence of a generalized polyclonal gammopathy or a generalized increase in autoantibody expression, though patients with higher total IgG4 serum levels expressed significantly greater quantities of IgG4 aFABA. These results indicate that the differential expression of IgG4 aFABA among RA patients reflects constitutive production within a subset of RA patients in whom IgG4 appears to comprise a significant proportion of the total IgG aFABA response. PMID- 3266357 TI - Fibroblast-activating factor production by interleukin (IL)-2 dependent T-cell clones from rheumatoid arthritis patients and normal donors. AB - T cells spontaneously responsive to interleukin (IL)-2 were cloned from the peripheral blood (PBL) or synovial fluid (SFL) lymphocyte populations obtained from patients with rheumatoid arthritis (RA) or from normal PBL. The clones were compared for their capacities to produce fibroblast-activating factors (FAFs) which support the growth of RA synovial fibroblasts. Clones derived from all sources produced FAFs following mitogen stimulation, but SFL clones synthesized significantly higher levels of FAF activity. Physicochemical characterization of the FAFs suggested that SFL- and PBL-derived clones produced similar factors. It was also demonstrated that interferon-gamma and IL-2 did not contribute to the FAF activity of the clone supernatants. These results demonstrate that a subpopulation of activated lymphocytes which are present in increased numbers in the rheumatoid joint can produce factors which influence rheumatoid synovial cell growth. PMID- 3266358 TI - Presence of interferon and anti-interferon in patients with systemic lupus erythematosus. AB - Sera from 61 patients with systemic lupus erythematosus (SLE) were serially screened over a period of at least 2 years for IFN and anti-IFN antibodies. IFN concentrations were measured both with a cytopathic effect assay and a more sensitive radioimmunoassay. Of the patients 15% (9/61) had IFN in their serum at one or more occasions as measured in the bioassay (greater than or equal to 6 IU/ml); employing a RIA (greater than or equal to 1 IU/ml) 28% (17/61) of the patients studied were positive for IFN-alpha. Fifteen patients had a measurable interferonemia over 2-16 months; only two patients had detectable IFN in their serum at only one occasion. In five patients, hourly and daily variations of the IFN titer as measured by RIA were found to amount to less than 80%. The IFN activity found in these sera was characterized as IFN-alpha by means of acid stability, cross-reactivity on heterologous cells, trypsin sensitivity, and neutralization by homologous and heterologous antisera. IFN antibodies were quantified with a neutralization bioassay, an ELISA, and a radioimmunoassay. Of the 61 patients 5% (3) possessed high titers of anti-IFN antibodies which persisted over 2 years. The IFN-alpha antibody positive patients had an inactive form of the disease over years without visceral involvement but decreased serum complement levels (C4, C3, CH50) and repeated episodes of Quincke-like edema. PMID- 3266360 TI - Epidemiological and genetic aspects of IgM rheumatoid factors. AB - The occurrence of IgM rheumatoid factors (RF) was studied in a random sample of 8807 persons aged between 20 and 50 years in Tromso, North Norway. Seropositivity for IgM RF was defined as a Waaler titre of 40 or more. A total prevalence of IgM RF of 1.36% was found, and a prevalence between 0.48-0.94% was found among the healthy persons, with no sex difference. Approximately 50% of IgM Rf positives are thus healthy. Only 11% of those with IgM RF suffered from rheumatoid arthritis. The majority of RF positive sera from healthy persons were low titred, and 81% of them converted to seronegativity in the course of 3.5 years. A low titred IgM RF appears rather harmless, while a high titre indicates a specific disease process. No association between IgM RF and DR4 could be found in healthy persons. The frequencies of Gm-allotypes a, b, e, f-n and x in healthy, RF positive individuals did not differ from the RF positive patients with RA, suggesting that the Gm-allotypes are not involved in the genetic pre-disposition for RA. PMID- 3266359 TI - Quantitative analysis of precursors frequency of rheumatoid factor (RF) producing human B cells. AB - Recently, a new culture system has been devised which leads to activation, proliferation and differentiation into antibody secreting cells of at least 90% of human peripheral blood B-lymphocytes. The system uses mutant EL-4 thymoma cells of mouse origin for B cell activation and T cell/macrophage supernatant as source of cytokines (L. Wen et al., Eur. J. Immunol. 17, 887, 1987). By an ELISA system with Fc fragments as antigen and the F(ab)2 fragment of antibodies against human IgM labelled with alkaline phosphatase, we analysed the frequencies of B cells producing IgM-RFs. The mean frequency of IgM-RF producing cells in normal controls was 1/3100 (s.d. = 0.2 log; n = 5) of circulating B cells. In 2 patients with seropositive rheumatoid arthritis (RA) the frequencies were higher (1/492; 1/262), but in 2 other seropositive patients a normal (1/5540) or even a decreased (1/20000) frequency was observed. The possible relation between circulating and synovial RF producing B cells is currently being investigated. PMID- 3266362 TI - What is seronegative rheumatoid arthritis? AB - Between classical, erosive, seropositive rheumatoid arthritis (RA) on one hand, and typical, axial ankylosing spondylitis (AS) on the other, there is a variety of seronegative polyarthritides, which are often difficult to diagnose, classify and also to distinguish from each other. During our studies of HLA antigens and their associations with rheumatic diseases, and particularly that of DR4 with RA, we became increasingly concerned with the problem of defining properly patients with seronegative RA. Both the statement of seronegativity with regard to rheumatoid factors (RF), the diagnosis of RA, and particularly the exclusion of cases of seronegative arthritis other than RA were difficult. We felt that such problems might explain the conflicting opinions as to the association between RF and HLA-DR4 in patients with RA. As a basis for discussing these problems, a set of criteria for RF seronegative RA are presented. PMID- 3266361 TI - Circulating IgM rheumatoid factors in patients with primary Sjogren's syndrome. AB - The importance of circulating rheumatoid factors (RF) in primary Sjogren's syndrome (primary SS) was evaluated retrospectively by examining medical case records of 80 consecutive patients. Increased levels of IgM RF, determined by the Waaler test, the latex fixation test and/or the ELISA test, were found in 47 patients (59%). Follow-up examination of the 41 patients in whom more than one (mean 4.9 (2-12)) RF determination over at least a two-year period (mean 5.6 (2 13) was present, showed that 12/41 patients (29%) were permanently RF-negative, 7/41 (17%) exhibited both positive and negative RF values and 22/41 (54%) were permanently RF positive. Variations in IgM RF levels were unrelated to disease duration. Except for involvement of joints, extraglandular manifestations were more common in patients with increased levels of RF. This finding, however, was only significant within the group of more rarely occurring extraglandular manifestations (serositis, interstitial nephritis, cutaneous vasculitis, lymphoproliferative disorders and intermittent fever) (p less than 0.01). IgM RF levels were likewise positively correlated (p less than 0.001) to positivity of IgG antinuclear antibodies as well as to the plasma concentrations of immunoglobulins. PMID- 3266363 TI - Recombinant interleukin 1 and tumor necrosis factor acting in synergy to release thromboxane, 6-KETO-PGF1 alpha and PGE2 by human neutrophils. AB - The cyclooxygenase pathway promotes formation of an endoperoxide that is the precursor of prostaglandins (PG), thromboxanes (Tx) and prostacyclins (PGI2), all of which have important biologic activities. In this study, we examined the ability of human polymorphonuclears (PMN) to synthesize TRxA2, 6-KETO-PGF1 alpha and PGE2 in response to human recombinant interleukin 1 (IL1) and tumor necrosis factor (TNF) alone and in combination. Blood was obtained from healthy donors and whole blood was centrifuged over Ficoll-Hypaque in 2% dextran for 30 min. PMNs were resuspended in Gey's buffer, exposed to the IL1 and TNF at 300 ng/ml and 0.5 ng/ml concentrations, and incubate for 30 min. at 10(6) cell/ml. Results indicate that IL1 and TNF alone have little or no effect on human neutrophils to synthesize TxA2, 6-KETO-PGF1 alpha and PGE2 production. This effect was completely inhibited by two non-steroidal anti-inflammatory drugs (i.e. indomethacin and proglumetacin). PMID- 3266365 TI - Are idiotypic peptides from variable domains critical for T-dependent production of rheumatoid factors? AB - Studies from this laboratory have indicated that isologous myeloma protein 315 (M315, isotype IgA, lambda 2) elicits T helper cells which recognize processed forms (peptides) of its V-domains and that recognition is controlled by H-2 linked immune-response (Ir) genes (J Exp Med 1982; 155:1587-96; Eur J Immunol 1986; 16:889-93). We now report that adjuvant-free soluble M315, particularly the mildly reduced and alkylated form, stimulates a T-dependent antibody response mainly specific for M315's paired V-domains. A small subset of the antibodies appeared to recognize the C-region of IgA, thus being analogous to rheumatoid factors (RF). On the basis of these observations, we propose that one pathway to RF production depends on T helper cells that interact directly with RF-producing B cells across peptide-MHC bridges. These peptides are envisaged to be derived from hypervariable regions of IgG V-domains, and they are therefore called "idiotypic peptides". This hypothesis assumes that the number of different idiotypic peptides is so large that the immune system has not developed tolerance to all of them. PMID- 3266364 TI - Cellular expression of rheumatoid factor cross-reactive idiotype in patients with seropositive and seronegative rheumatoid arthritis. AB - A study has been made of the presence of the major rheumatoid Factor cross reacting idiotype (RCRI) in the serum of patients with seropositive and seronegative rheumatoid arthritis as well as in the cytoplasm of plasmacells induced by cultivation of peripheral blood leucocytes (PBL) from the same RA patients and from normal humans. The PBL were stimulated in vitro with two different B cell mitogens, namely pokeweed mitogen (PWM) or Staph Auerus Cowan strain I (SAC). The RCRI was detected in the serum of seropositive RA patients and in the serum of four out of twenty seronegative RA patients. In these four, however, the seronegative condition was only apparent, since all four had hidden rheumatoid factors that could be shown after dissociation from IgG. The expression of the RCRI in the cytoplasm of PWM-stimulated PBL from seronegative RA patients was concordant with the expression in the serum. Thus the majority of truly seronegative RA patients also appear not to express the RCRI neither in the serum nor in the cytoplasm of plasmacells induced by PWM stimulation of PBL. An unexpected finding was the detection of the RCRI in plasmacells obtained by SAC stimulation of PBL from normal individuals. Up to 40% of RCRI-positive plasmacells were seen in many of these cultures, as opposed to an average of 2% in cultures stimulated with PWM from PBL of the same individuals. High percentages of RCRI-positive plasma-cells have previously been detected by us in PWM cultures only if these were from PBL from RA patients. Our working hypothesis is that PWM is a non-selective stimulator of B cells and that RCRI + precursors are in high frequency in RA patients, whereas SAC selectively stimulates these precursors even in normal PBL populations, where their frequency is not abnormally high. PMID- 3266366 TI - Ion microscopy: a new approach for subcellular localization of labelled molecules. AB - Secondary ion mass spectroscopy (SIMS) was used to obtain images representing the intracellular distribution of molecules labelled with carbon 14. Deoxyadenosine labelled with carbon 14 was added to a cultured human fibroblast cell medium, and the intracellular distribution of this molecule was studied using three different SIMS instruments: the CAMECA IMS 3F and SMI 300 ion microscopes and the UC-HRL scanning ion microprobe. Carbon 14 distribution images obtained by this method show that deoxyadenosine U-C14 is present in the cytoplasm as well as the nucleus, with a higher concentration in the nucleoli. Our study clearly demonstrates that ion microscopy is well suited for carbon 14 detection and localization at the subcellular level, permitting a wide variety of microanalytical tracer experiments. PMID- 3266367 TI - Lymphoid microenvironments in the thymus and lymph node. AB - The three-dimensional architecture of the thymus and mesenteric lymph node reveals several different stromal cell types important in the development and function of T cells. In the thymic cortex, T cells proliferate and differentiate in a meshwork of epithelial-reticular cells. They then migrate towards the medulla where they may interact with interdigitating cells. T cells migrate from the thymus through perivascular spaces, surrounding large vessels at the cortico medullary boundary. In this area also large thymic cystic cavities are found, their function remains at present unclear. Mature "selected" T cells leave the thymus most probably by the venous bloodstream, to enter peripheral lymph nodes. Upon entering the lymph node they cross the wall of high endothelial venules. On the other hand, lymph enters the node by afferent lymphatics draining into various types of sinuses. Here, macrophages are strategically located to phagocytose and process antigen. These cells then expose antigen to T cells and B cells within the lymph node parenchyma, thus creating a microenvironment for the onset of an immune response. The various microenvironments important in T cell development and T cell function are shown in this paper using scanning electron microscopy as a dissecting tool. We discuss our morphological findings in the light of recent data on the physiology of T cell differentiation and function. PMID- 3266368 TI - [Endoscopic sclerotherapy and esophageal varices]. AB - 60 consecutive patients underwent sclerotherapy for hemorrhage from ruptured esophageal varices. Sclerosis was always started within the first 48 hours. 12 patients (20%) died during initial hospitalization, but only 5 from recurrent bleeding. Of 48 survivors, 22 (46%) did not rebleed during a mean 18-month follow up, whereas 26 (54%) had recurrences, 27 of these bleeding episodes occurred early (within 4 months) and 17 late (mean 16.5 months). Eradication of the varices was achieved in 29 patients (60%) with a mean of 6.2 sessions and within a mean of 6 months. Of these 48 patients 2 have been lost to follow-up, 25 (52%) are alive after a mean follow-up of 29 months, and 21 (44%) died (though only 2 from variceal bleeding). The survival curve (Kaplan-Meier) of these 60 bleeders is 45% and 37% at 2 and 4 years respectively. Sclerotherapy caused no death and only minor adverse effects. These results confirm those in the literature. We advocate endoscopic sclerosis as first choice in the treatment of ruptured esophageal varices. PMID- 3266369 TI - [Immunotherapy of tumors using interleukin-2 and lymphokine-activated killer cells]. AB - The tolerance and effectiveness of an interleukin-2 analog (rIL-2) in combination with lymphokine activated killer (LAK) cells has been studied. 14 patients with metastatic solid tumors, including 8 renal cell carcinomas, 3 melanomas and 3 extragonadal germ cell tumors refractory to standard therapy, were treated for a 3-week period. rIL-2 was administered as a bolus at 30,000 U/kg every 8 hours on days 1-5 and days 12-19. Leukapheresis was done on days 8-12, and lymphocytes were incubated with rIL-2 for 3-4 days in vitro and reinfused on days 12, 13, and 15. rIL-2 dose and schedule were adjusted according to toxicity. The major side effects were constitutional symptoms and a capillary leak syndrome with hypotension and impaired renal function. Partial responses were documented in 2/8 renal cell carcinomas and 1/3 melanomas. The response durations were 1, 5 and 6 months. PMID- 3266370 TI - Prevalence of Chlamydia trachomatis among women attending an antenatal clinic in Bangkok. AB - Cervical swabs from 140 Thai pregnant women were cultured for Chlamydia trachomatis twice during the first and the third trimester. Serum samples for antichlamydial antibodies was also studied from 126 women; 12 of women were culture positive on both occasions. Chlamydia was isolated from 24% of women aged 20-24 years, compared to only 9% of women 25-30 years. Antibody were detected to the genital serotypes (D-K) in 31 (25%) of 126 women who were tested. 70% of women who were culture positive had antibody titer greater than or equal to 1:64 compared to 7% of women who were culture negative. PMID- 3266371 TI - [Prevalence of smoking among faculty members of the medical institute]. PMID- 3266372 TI - [Cellular and humoral immunity and systemic and regional fibrinolysis in patients with chronic suppurative bronchitis]. AB - The state of cellular and humoral immunity, systemic and regional fibrinolysis was studied in 47 patients with chronic purulent bronchitis of a moderately severe and severe course. The suppression of cellular immunity, expressed in the reduction of the number and function of T-cells, the reduction of the number of theophylline-resistant cells with the unchangeable level of theophylline sensitive lymphocytes was revealed. An additional study of O-cells made it possible to reveal an increase in the number of precursor and blocked T-cells, the prevalence of the fraction of suppressor-killer lymphocytes in T-lymphocyte subpopulation. The detected shifts lead to disturbance of T-B-cell cooperation, antibody genesis, and breakage of fibrinolysis immune regulation which determine progression of inflammatory changes in the bronchopulmonary system. Their detection and elimination form the basis of modern pathogenetic therapy of purulent forms of chronic bronchitis. PMID- 3266373 TI - [Subpopulations of immunocompetent cells in patients with liver cirrhosis studied using monoclonal antibodies]. PMID- 3266374 TI - Chondrodystrophic mice with coincidental agnathia: evidence for the tongue obstruction hypothesis in cleft palate. AB - Mice homozygous for either of two mutations, chondrodysplasia (cho) or cartilage matrix deficiency (cmd), have short-limbed chondrodystrophy. This phenotype includes retrognathia, relative macroglossia, and cleft palate. It has been postulated that the cleft palate in these mice is the result of tongue obstruction during palatogenesis. Agnathia associated with microglossia is an independent spontaneously occurring defect in the strains bearing these mutations. The coincidental occurrence of agnathia-microglossia with chondrodystrophy lends itself to the study of the mechanism of cleft palate formation. We examined approximate midsagittal histological sections of normal and chondrodystrophic newborn mice, both with and without agnathia. Mandibular measurements and examinations of palate closure and tongue structure were made from photographic prints. Typical chondrodystrophic mutants with cleft palates had a mean mandibular length that was 66% of normal and a tongue that appeared large relative to the shortened mandible. Chondrodystrophic mutants with agnathia and microglossia had a mean mandibular length that was further reduced to 30% of normal, yet had a closed palate. We also observed two nonagnathic chondrodystrophic mutants that had slightly decreased mandibular lengths, microglossia, and closed palates. These observations suggest that tongue obstruction during palatogenesis is the pathogenetic mechanism of cleft palate in chondrodystrophic mice. A similar tongue obstruction hypothesis has been proposed as the mechanism of cleft palate formation in the human Pierre Robin sequence, which consists of retrognathia, glossoptosis, and cleft palate. This mechanistic hypothesis has been challenged, but our findings support the tongue obstruction hypothesis in the Robin cleft. PMID- 3266375 TI - Peripheral stimulator implant for treatment of causalgia caused by electrical burns. PMID- 3266376 TI - Control of pain by electrical stimulation. PMID- 3266377 TI - Conditioning of the diaphragm by phrenic nerve pacing in primary alveolar hypoventilation. AB - A patient with respiratory muscle weakness due to alveolar hypoventilation was treated with nocturnal bilateral phrenic nerve pacing for one year. Treatment was associated with a progressive increase in diaphragmatic strength and endurance. PMID- 3266379 TI - Haemostatic effects of ketorolac with and without concomitant heparin in normal volunteers. AB - Ketorolac is a potent cyclo-oxygenase inhibitor used for the treatment of postoperative pain. It is known to have anti-platelet properties. The aim of this study was to determine the effect of ketorolac on haemostasis both alone and in combination with low dose heparin in 12 healthy male volunteers. Each volunteer received the following drug combinations in a double blind, placebo controlled, cross over manner: ketorolac placebo/heparin placebo, ketorolac active/heparin placebo, ketorolac active/heparin active and ketorolac placebo/heparin active. Ketorolac significantly prolonged bleeding time, inhibited platelet aggregation to arachidonic acid and collagen and platelet thromboxane production. Heparin had no effect on bleeding time or platelet function, but significantly prolonged the kaolin cephalin clotting time and increased anti-Xa levels. Ketorolac had no effect on the kaolin cephalin clotting time or anti-Xa levels and no interaction was found between ketorolac and heparin in any of the investigations. The prolongation of bleeding time seen with ketorolac is unlikely, to be of any major clinical significance as almost all subjects remained within the normal range; however, it should be used with caution in subjects with haemostatic problems. PMID- 3266380 TI - Abnormality of the N-terminal portion of von Willebrand factor in type IIA and IIC von Willebrand disease. AB - We have established a new analytical method which allows the characterization of von Willebrand factor (vWF) degradation fragments in minute amounts (10 microliters) of plasma, without the need for immunopurification of vWF. Plasma vWF was hydrolysed by S aureus V-8 protease (V-8 protease) and the cleaved fragments separated by SDS-agarose gel electrophoresis followed by staining with 125I-labeled polyclonal or monoclonal antibodies against vWF and autoradiography. Quantification of the amount of each product was estimated by counting the incorporated radioactivity following excision. V-8 protease limitedly hydrolysed vWF in normal as well as type I von Willebrand disease (vWD) plasma and produced two distinct fragments with identical electrophoretic and antigenic characteristics to those produced from purified vWF, i.e. a C-terminal SpII and a series of N-terminal SpIII fragments (SpIIIa, b and c). The method was applied to further characterize the molecular abnormalities of vWF in eighteen patients with type II vWD. In seven individuals with type IIA and five patients with type IIC, SpIII appeared significantly modified as compared to normal. In type IIA, there was a marked decrease or absence of SpIIIa and an increase of SpIIIb and c. In type IIC, SpIIIb was lacking. In three patients with type IIB and in three patients with type IID, there was no significant modification of SpIII. In all cases, SpII was apparently not modified. In conclusion, the molecular abnormality of vWF in type IIA and IIC vWD appears to reside in SpIII, the N-terminal portion of the vWF-subunit (residues 1 to 1,365). PMID- 3266381 TI - The benefit patients derive from aortocoronary reoperation. AB - There is an increasing incidence of aorto coronary reoperation necessitated by intractable angina which averages 2% of 4676 initial bypass procedures. Graft obliteration, graft stenosis or progression of disease led to recurrence of symptoms in 96 patients (84 male, 12 female) who underwent a second operation. Not all occluded or stenotic bypasses were feasible for reoperation. Hospital mortality (30 days) was higher than after initial CABG, but could be reduced from 12.1% to 4.8%. Subjective and objective follow-up investigations were obtained in 77 of 84 survivors and demonstrate that successful reoperation is about 10% lower in patients with a malignant form of atherosclerosis (60%) than in patients who only suffer from occluded grafts or new proximal significant stenoses in previously unbypassed vessels (70%). PMID- 3266378 TI - Defective cell mediated immunity in sarcoidosis: effect of interleukin-2. AB - Interleukin-2 has been reported to enhance the immune response in diseases characterised by defective cell mediated immunity. The effect of exogenous recombinant interleukin-2 was studied on the proliferative and cytotoxic responses of peripheral blood mononuclear cells from 39 patients with sarcoidosis and 14 healthy control subjects. The proliferative response to purified protein derivative was smaller in patients than in control subjects (p less than 0.001) whereas the response to 80 U interleukin-2 alone and to purified protein derivative and interleukin-2 did not differ significantly between the two groups. In addition, in eight patients but no control subjects tritiated thymidine incorporation induced by the combination of purified protein derivative and interleukin-2 was more than twice the sum of that induced by purified protein derivative and interleukin separately. Cytotoxic activity occurring spontaneously and induced by purified protein derivative and interleukin-2 in blood mononuclear cells was significantly less for patients with sarcoidosis than for control subjects (p less than 0.05 spontaneous, less than 0.001 purified protein derivative induced, less than 0.02 interleukin induced). Synergism between antigen and interleukin did not occur with respect to the cytotoxic response in either patients or controls. Defective interleukin-2 production may contribute to, but does not entirely explain, the functional abnormalities of peripheral blood lymphocytes from patients with sarcoidosis. PMID- 3266382 TI - Absence of IL-1 inhibitor in psoriatic scale extracts. AB - In the previous report we found that IL-1-like activity in horny tissue extracts from patients with psoriasis vulgaris and related sterile pustular dermatoses was remarkably low as compared to that in orthokeratotic horny tissue extracts prepared from non-inflammatory skin. In this report we studied the inhibitory activity of lesional horny tissue extracts from three psoriatics on recombinant IL-1-induced thymocyte proliferation in order to search for a possible coexistence of substances which may inhibit thymocyte proliferation. However, we failed to demonstrate any remarkable IL-1 inhibitory activity in each fraction after gel filtration high-performance liquid chromatography of the psoriatic scale extracts or in that of extracts from the plantar callus. We conclude that IL-1 stores are decreased in the pathologic horny layers of psoriatic lesions. PMID- 3266383 TI - Gap junction and its cytoskeletal undercoats as involved in invagination endocytosis. AB - Plasmamembrane and its cytoskeletal undercoat were characterized by electron microscopy in gap junctions (GJs) of steroidogenic cells of the guinea pig and bullfrog adrenal glands. In both species GJs varied in shape considerably and measured 0.1-4 microns in diameter. Planar GJs were not provided with any distinct form of the undercoat. In contrast, variably invaginating GJs had a network of actin-containing microfilaments located in the protruding cytoplasm arising from either one of adjoining cells. In the deeper invaginations, on the contrary, parallel arrays of actin-containing microfilaments formed a submembranous sheath in the withdrawing cytoplasm. The microfilaments were arranged at right angles for the long axis of the invagination. In completely internalized GJs, the network and sheath became less organized or obscured. A mechanical force driving the invagination-endocytosis involving GJ areas is presumably generated by the microfilament network and sheath, organized differently in forms, but working in concert together. It is also likely that there is another dissolving process for GJs via clathrin-coated vesicles. PMID- 3266384 TI - Production of antibodies and development of a radioimmunoassay for okadaic acid. AB - An okadaic acid immunogen, prepared by conjugation of okadaic acid to bovine albumin with carbodiimide, was used to immunize two rabbits. The rabbits responded by producing antibodies that neutralized okadaic acid's stimulation of arachidonic acid metabolism and this neutralization increased during the course of immunization. The immune sera bound 3H-okadaic acid and this binding also increased with repeated immunization. After absorption of the rabbit IgG with a goat anti-rabbit IgG, binding was reduced greater than 99%. The binding of okadaic acid to the antibodies in one antiserum was inhibited by as little as 0.2 pmoles of unlabelled okadaic acid. The apparent association constant for binding with this antiserum was 4.17 x 10(9) M-1 (35 degrees C). Maitotoxin, teleocidin, 12-O-tetradecanoylphorbol-13-acetate, aplysiatoxin, palytoxin and brevetoxin B when tested at 29, 228, 168, 169, 3.7 and 112 pmole levels, respectively, did not inhibit binding. The serologic and biological activities of okadaic acid after incubation for 60 min in 0.01 N HCl at 35 degrees C or at 100 degrees C at pH 7.2 were unaffected. PMID- 3266385 TI - [Coronary and peripheral arterial occlusive disease. Concomitant prevalence and risk factors]. PMID- 3266387 TI - Lessons from longitudinal studies. PMID- 3266386 TI - A retrospective evaluation of the rectal pull-through technique. Procedure and postoperative complications. AB - Ten animals (8 dogs and 2 cats) with distal rectal lesions were treated by surgically resecting the affected segment of the rectum by the rectal pull through technique. There were four malignant tumors, three benign tumors, two inflammatory lesions, and one malignant tumor that extended histologically to the margins of a previous surgical excision. Postoperative complications were tenesmus (7 animals), fecal incontinence (4 animals), rectal bleeding (4 animals), and abscess formation (1 animal). Dehiscence and stricture were not observed. The four animals with malignant tumors survived less than 12 months after surgery. One of the four animals still living has persistent fecal incontinence. The rectal pull-through technique is described and illustrated. PMID- 3266389 TI - Platelet transfusion reaction associated with interdonor HLA incompatibility. AB - An HLA-compatible platelet transfusion was followed by chills, fever, and severe respiratory distress in a multitransfused patient with chronic lymphocytic leukemia. During the previous 7 days the patient had received blood products without incident, including 8 units of red blood cells (RBC), 24 units of pooled random donor platelet concentrates, and five HLA-compatible platelet pheresis products. The patient had no demonstrable RBC, HLA lymphocytotoxic, platelet or granulocyte antibodies. The platelet donor, a multiparous female, had no granulocyte or RBC antibodies but had lymphocytotoxic antibodies against HLA-A2 CREG (cross-reacting group A2, A28, A23, A24) which reacted not with lymphocytes of the patient but with lymphocytes of the donor whose RBC were transfused 24 h prior to the platelet transfusion reaction and whose HLA type is A23, A24; B44, B57. No RBC donors had HLA lymphocytotoxic, granulocyte, or platelet antibodies against the platelet donor. The patient received three subsequent platelet transfusions from the same donor after removal of the antibody-laden plasma with no adverse reaction. These data suggest an interdonor reaction caused by the presence of cells from the RBC donor received by the patient 24 h prior to the transfusion of donor lymphocytotoxic antibody to HLA-A2 CREG antigens. PMID- 3266388 TI - [24,25-Dihydroxyvitamin D3 modulates the effect of 1alpha-hydroxyvitamin D3 on B lymphocyte maturation in chickens]. AB - Patterns of calcium metabolism and maturation of lymphocytes in chicken Fabricius bursa were studied in presence of various doses of I alpha-hydroxy vitamin D3 and 24,25-dihydroxy vitamin D3 administered separately and at various combinations. 24,25(OH2)D3 was distinctly less effective in the antirickets activity as compared with I alpha (OH)D3. A decrease in mass of Fabricius bursa and inhibition of lymphocytes maturation within early steps were observed in the birds with rickets. A toxic dose of I alpha (OH)D3 caused pseudohypertrophy of Fabricius bursa. Small doses of these drugs administered simultaneously exhibited higher effect both on rickets and on stimulation of B lymphocytes maturation. 24,25(OH)2D3 attenuated the negative effect of either subtoxic (0.65 nmol/day) or toxic (1.3 nmol/day) doses of I alpha (OH)D3 on an increase in body mass, calcemia, ash content of bones, content of small lymphocytes in Fabricius bursa. PMID- 3266390 TI - [Effect of immunoglobulin on the microbial flora of the tonsils in patients with rheumatism]. PMID- 3266391 TI - [Alpha-amylase activity in patients with malignant neoplasm of the lungs]. PMID- 3266393 TI - [Bronchologic studies in East Germany: current status and perspectives]. AB - Within a period of 8 years (1979 to 1986) there were performed in 21 centres of the German Democratic Republic 15,049 bronchoscopic investigations (in 49.6 per cent combined with a subsequent bronchography) in 11,717 children, including 2,054 (17.5 per cent) up to one year of age. The detailed analysis shows important trends, which allow a reasonable prognosis of the perspectives of pediatric bronchology in the GDR. PMID- 3266392 TI - Gynecology and sexuality in middle-aged women. AB - In Sweden and other Western societies, the number of women above the age of 40 is increasing and health and well-being of middle-aged women is an increasing matter of concern. This study examines menstrual histories, gynecological operations, urinary incontinence, and reproductive functions in a representative sample of middle-aged women, as well as the frequency of climacteric symptoms and how to predict the women at risk for acquiring these symptoms. The sexuality of the mature woman as also explored. Women aged 37 to 66 years were randomly selected from the Census Register in Goteborg, Sweden. The bulk of information was obtained by means of questionnaires. Among the findings are that the median age for natural menopause was 50.9 years. Forty percent of the postmenopausal women reported frequent vasomotor symptoms. The occurrence of climacteric complaints is strongly connected to psychosocial variables. Every tenth woman reported frequent urinary leakage. Fifty-three percent of the women had undergone a D&C and 9% were hysterectomized. The woman around 40 reported few sexual partners (median 3) and her first intercourse occurred at age 18. Extramarital sex was uncommon. The masturbation rate was low and the frequency of homosexuality was extremely low. The majority of women had experienced orgasm. PMID- 3266394 TI - [Associated glomerulonephritis in immunocytoma]. AB - It is reported on a 43-year-old patient in whom a mesangio-proliferative glomerulonephritis with nephrotic syndrome was diagnosed 7 months before manifestation of an immunocytoma. Under the treatment of the tumourous disease with chemotherapy and radiation a complete remission of the glomerulonephritis developed. The patient died of a generalized herpes zoster after 2 years 10 months. At the postmortem examination no pathological changes on the kidneys could be proved. After a survey of cases with tumour-associated glomerulonephirits published up to now possible pathogenetic mechanisms and clinical data of the glomerulonephritis as paraneoplastic syndrome are discussed. PMID- 3266395 TI - [Personal experiences with the use of the argon laser in gastroenterology]. AB - The argon laser was used in 30 persons with various lesions of the alimentary canal. Of 17 patients with an intensive haemorrhage (gastric or duodenal ulcer, gastric erosions, haemorrhage after an endoscopic polypectomy) the treatment was successful in 15 cases. In 8 patients the basis of an endoscopically removed malignant rectosigmoid polyp was treated: in one case a recidivation developed, in the remaining 7 cases during the following 13 to 24 months no local recidivation was to be observed. Of the 4 patients with an obturating carcinoma (oesophagus, rectum) we were only once successful in removing the tumour masses and thus again rendering possible the passage. In the last patient in question a recidivation of a rectum carcinoma in the anastomosis was concerned, in which the prominuing tumour mass could be removed; after 20 months no other recidivation could be established. PMID- 3266396 TI - [Diabetes mellitus and the intestinal nervous system]. AB - Lack of release of vasoactive intestinal polypeptide and calcitonin gene-related peptide during electrical stimulation of enteric nerves in streptozotocin diabetic rats. PMID- 3266397 TI - [Condylomata acuminata and HIV infection--an epidemiologic study]. AB - Within a period of 15 months, 134 patients suffering from condylomata acuminata were investigated with regard to simultaneous infection with HIV. 3 of these patients--2 showing warts in the anal region, 1 on the glans penis--were found positive for anti-HIV antibodies. PMID- 3266398 TI - [Decrease in left ventricular stroke performance following bypass of a significant main coronary artery stenoses]. AB - Hemodynamic parameters and left ventricular function were assessed 14 +/- 4 (means +/- SEM) days preoperatively and 101 +/- 5 days after aortocoronary bypass surgery in eight men (51-65 years of age) with left main coronary stenosis (greater than or equal to 75%). Working capacity on bicycle exercise stress test increased from 43 +/- 7 to 68 +/- 7% of age-, and body-surface matched normals; at the same time cardiac output (thermodilution) decreased from 5.7 +/- 0.5 to 4.7 +/- 2 l/min (p less than 0.05), stroke volume decreased from 78 +/- 6 to 63 +/- 3 ml (p less than 0.01), stroke work from 1.16 +/- 0.10 to 0.89 +/- 0.07 Joule (p less than 0.001), and stroke power from 4.0 +/- 0.3 to 3.4 +/- 0.2 Joule/s (p less than 0.01) postoperatively. Left ventricular volumes decreased postoperatively but not significantly, ejection fraction remained unchanged (57 +/- 13/59 +/- 13%). A control group (PTCA of LAD) showed no significant changes of these parameters. As all patients had a good postoperative result, decrease of stroke work after aortocoronary bypass surgery is not necessarily an expression of postoperative deterioration, since it can coincide with good left ventricular function, angiographically successful revascularization, and an increase in working capacity. PMID- 3266399 TI - [Coronary spasm immediately following coronary revascularization]. AB - Of 2,600 coronary operations performed from August 1983, to December 1988, two ischemic reactions of the inferior wall immediately after operation were observed. In both patients the right coronary artery was either dissected or revascularized intraoperatively. Under the diagnosis of postoperative spasm both patients had reangiography three hours after surgery. Right coronary artery spasm was demonstrated in both patients. After intracoronary injection of calcium channelblockers the spasm resolved completely. Patient 1 demonstrated a small inferior infarction during control angiography, patient 2 remained free of a myocardial infarction. The possible causes of coronary spasm during or after surgery are discussed. The diagnosis and an approach to therapy are outlined. PMID- 3266400 TI - [A new device for long gap esophageal atresia]. AB - A new mechanical device is presented which approximates the two oesophageal pouches in long gap oesophageal atresia and possibly creates an anastomosis. The principle is similar to magnetic bougienage, only that purely mechanical force is employed instead. This offers several advantages: the instrument is considerably less bulky, technically simple, inexpensive, light and therefore easy to transport. Only normal electrical current is necessary. The tensile forces applied are easier to control. The child does not have to be placed inside a tube and is not restrained in its movements. The device has been experimentally tested in 6 dogs. PMID- 3266401 TI - [Anal hemorrhage caused by tubular rectal duplication with ectopic gastric mucosa]. AB - Case report of an extremely rare retrorectal duplication, containing gastric mucosa folds with a fistula to the rectum in a 10-year-old boy with myelodysplasia syndrome, anal stenosis and a sacral defect. Persistent tar-like stools prompted detailed investigations, followed by extirpation of the doubling. The combination of anorectal malformations, presacral masses and sacrococcygeal defect may point to a Currarino triad, an autosomal dominant hereditary syndrome which can be simply detected or identified by x-ray examination of the os sacrum. PMID- 3266402 TI - Drug abuse in Denmark (Jutland and Funen). A forensic study based upon drugs seized in 1982-1987. AB - Two thousand fifty-three samples submitted to forensic chemical analysis during the period 1982-1987 were characterized according to their content of narcotics and the year of seizure. Heroin and cannabis dominated the material, but a significant decrease in the number of heroin samples was observed in 1987. Amphetamine, on the contrary, hardly seen during the period 1982-1984, accounted for half of the narcotics submitted in 1987. The misuse of morphine, especially in the form of poppy capsules, was a problem for some years, whereas cocaine has not yet been a drug of abuse in Denmark. The mean concentrations of the heroin and the amphetamine samples were 30% and 44%, respectively, both for retail drugs and the entire material. PMID- 3266403 TI - [Rheumatology in the interdisciplinary conflict]. PMID- 3266404 TI - [Cellular immune response and glomerulonephritis--their detection with the Tetamun intracutaneous test]. AB - In the considerations of the pathogenesis of glomerulonephritis more importance is attributed to cellular immune reactions. The cell-mediated immune response was examined by means of the Tetamun intracutaneous test in 37 patients with histological verified glomerulonephritis, in 18 patients with non-glomerular renal diseases, and in 25 healthy probands. The influence of main disease, renal insufficiency, nephrotic syndrome and immunosuppressive therapy on the test results could be determined by proper group formation. A significant diminution of cell-mediated immune reactions by the glomerulonephritis was verified. The importance of this finding in the pathogenetic routes and a possible model are discussed. PMID- 3266405 TI - Prophylactic distal splenorenal shunt for child's class A and B patients at high risk of bleeding. AB - During recent 17 years, prophylactic distal splenorenal shunt was carried out on 29 patients. Patients were composed of 18 males and 11 females. Age ranged from 34 to 66 years with an average of 52.4. All patients had risky esophagogastric varices; varices larger than 5 mm in diameter and or varices with red color signs such as cherry red spots endoscopically. Underlying liver disease were cirrhosis of the liver in 27, chronic hepatitis in one, and idiopathic portal hypertension in one. Twenty-three patients were in Child's class A and six were in class B. Thirteen patients underwent the original Warren shunt but the remaining 16 had modified distal splenorenal shunts with expanded polytetrafluoroethylene interposition. Portal-azygos disconnection was routinely performed. One patients (3.4%) died of hepatic failure on the 6th postoperative day. Four patients (14.3%) developed hepatic encephalopathy of mild to moderate degree but no patients have suffered from variceal bleeding until now. The 5-, 10-, and 15-year survival rates were all 85.5 per cent. It is concluded that distal splenorenal shunt is a safe and reliable method to prevent variceal bleeding in a selected group of patients. PMID- 3266406 TI - [The surgical treatment concept in acute intestinal hemorrhage]. AB - A clinically developed and prospectively verified therapeutic concept for acute intestinal bleeding is presented in this paper. Emphasis is laid on orthograde lavage likely to enable sooner and more effective use of diagnostic means and to provide optimal conditions for surgical therapy. Prognosis can be further improved by differentiated use of therapeutic endoscopy and early elective surgery. The effectiveness of this new therapeutic concept has been successfully verified on 81 patients, between 1975 and 1986. Lethality amounted to five per cent. PMID- 3266407 TI - Changes of serum proteins in patients with malignant gynaecological tumours. AB - The changes of 13 serum proteins in 53 ovarian tumour patients were studied by the radial immunodiffusion method from the beginning of treatment, during the course of disease. As to the course of the disease, in 6 of them characteristic and significant changes were observed. These were prealbumin, alpha 1-anti trypsin, orosomucoid, coeruloplasmin, transferrin and haptoglobin. Although the differences could be evaluated as an average of investigations, the value of the examinations is greatly reduced by the very high scatter of the individual values. PMID- 3266408 TI - New criteria to increase the reliability of systolic time intervals in left bundle branch block and right ventricular pacing. AB - We measured the systolic time intervals (STI) in 14 patients (pts) with intermittent left bundle branch block (LBBB) in order to find correlations and comparisons in their values which might pertain to the individual patients, with (b) and without (a) LBBB. QS2I, PEP and the PEP/LVET ratio increased significantly (b) while the LVET I did not change. STI correlation was significant and improved further when the QS2 (b) was corrected by subtracting from it the QRS prolongation (b) in msec. All 7 pts with a PEP/LVET ratio (b) greater than 0.65 had an (a) ratio greater than 0.42 (normal limits for our laboratory), sensitivity 100%. Six of 7 patients with a PEP/LVET (b) less than 0.65 had an (a) ratio less than 0.42 (specificity 87.5%). For the individual patient with LBBB his STI can be quite accurately assessed by subtracting from his QS2 (b) the prolongation of the QRS (b) greater than 80 msec the length of the normal QRS duration. The above data were prospectively evaluated in 10 pts to whom intermittent right ventricular pacing was applied. We found that the correction of the QS2 interval for QRS prolongation permitted a very reliable calculation of the STI. PMID- 3266409 TI - Ventricular and supraventricular arrhythmias in clinically silent right ventricular infarction. AB - To study the relationship between clinically silent right ventricular infarction and the incidence of a-v block, atrial and ventricular arrhythmias, 100 patients with inferior wall myocardial infarction underwent equilibrium gated radioisotopic angiocardiography. Fifty-four of them had radioisotopic evidence of right ventricular involvement and 43 (80%) of them had a-v block and/or supraventricular arrhythmias during the acute phase of the infarct, while only 10 (22%) of the 46 patients without right ventricular involvement did. As regards the incidence of ventricular tachyarrhythmias, 14 (26%) patients with right ventricular involvement had ventricular tachycardia and/or fibrillation, while only one patient without right ventricular involvement had ventricular tachycardia, and no patients had ventricular fibrillation. Moreover, V4R precordial lead showed a sensitivity in predicting the risk of developing a-v block/supraventricular arrhythmias and ventricular tachyarrhythmias of 0.84 and 0.79, respectively. Therefore, right ventricular involvement should be suspected when atrial arrhythmias, a-v block and ventricular tachyarrhythmias are found in early acute inferior wall myocardial infarction. On the other hand, when right precordial lead V4R in early acute inferior infarction shows ST-elevation and/or a QS pattern, the sudden occurrence of these arrhythmias should be suspected, and possibly prevented. PMID- 3266410 TI - Consistency of circadian blood pressure pattern assessed by non-invasive monitoring and cosinor analysis in hospitalized hypertensive patients. AB - Non invasive blood pressure monitoring using an automatic Nippon Colin recorder was performed in 20 hospitalized hypertensive patients every 15 min during a 4 day study period. A chronobiologic analysis of the data was performed in order to test the consistency of the whole-day blood pressure pattern. Halberg's method of single cosinor was used to determine the values and the confidence limits of the following parameters of 24-hour rhythmic changes: mesor (rhythm-adjusted 24-hour average), amplitude (24-hour variability estimate), acrophase (clock hour of maximum BP level). The variation of the above parameters during the four 24-hour periods was found to be within 9 mmHg for the systolic mesor, 6 mmHg for the diastolic mesor, 5 mmHg for the systolic amplitude, 4 mmHg for the diastolic amplitude, 55 min for the systolic acrophase, 60 min for the diastolic acrophase. The same parameters were also calculated in 48-hour, 72-hour and 96-hour long time series, and with different sampling periods (30, 60, 120 min). The length of the monitoring span did not influence significantly the values of the rhythm parameters only when 15-min or 30-min sampling periods were used. The widths of the 95% confidence limits of amplitude and acrophase were significantly narrower in the 2-day than in the 1-day series. Further lengthening of the monitoring span from 2 to 4 days resulted in a much smaller additional narrowing of the confidence limits. Sampling periods longer than 30 min caused a loss of sensitivity in rhythm detection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266411 TI - Diastolic coronary artery narrowing due to left ventricular dilatation. AB - A 56 year old man with a large anterior myocardial infarction and diffuse left ventricular hypocontractility and dilatation was found to have narrowing of the distal part of the left anterior descending coronary artery in diastole. This most unusual finding was ascribed to diastolic compression of the vessel by the enlarged left ventricle. Only 3 similar cases have been found in the literature up to now. PMID- 3266412 TI - Body surface mapping: a practical cardiac imaging tool? PMID- 3266413 TI - Unusual electrocardiographic manifestations in conditions with increased intrathoracic pressure. AB - Clinical, electrocardiographic and haemodynamic findings of 10 patients suffering from intrathoracic conditions were analyzed. Three patients suffering from left spontaneous pneumothorax, three from large left pleural effusion, three from traumatic rupture of the left diaphragm and one from sliding hiatus hernia were found to have electrocardiographic alternation, while their central venous pressure and pulmonary capillary wedge pressure were increased. With the correction of the condition the electrocardiographic alternation disappeared and the pressures returned to normal. The increase in direct or indirect pressure exerted on the global surface of the heart, as it is reflected in pulmonary capillary and venous pressures, seems to be the cause of the electrical alternation observed in these patients. PMID- 3266414 TI - Sudden death in hypertrophic cardiomyopathy, a guideline to prevention in daily life. AB - To establish guidelines for individuals with hypertrophic cardiomyopathy (HCM) to follow in their daily lives and minimize the chance of sudden death (SD), circumstances of SD in 24 autopsied definite HCM cases were compared with those with 905 autopsied cases of other heart diseases. Circumstances of symptoms experienced in daily activities of 35 age-matched surviving HCM cases were also studied. In the autopsied HCM cases, SD occurred during exertion more frequently (79.2%) than in the other autopsied cardiac patients (22.7%). Sudden changes in pace or movement accompanied by mental excitement, such as hurrying to board a train, were more frequent causes of SD in HCM (47.4%) than in other cardiac patients (8.3%). In the surviving HCM cases, symptoms of distress occurred frequently during very hard work or with sudden rapid movement. Thus, one probable daily guideline for HCM sufferers would appear to be not only to eliminate very hard work but also to lead mentally and physically quiet and relaxed life. PMID- 3266416 TI - Multiple antimicrobial resistance in Haemophilus influenzae isolates from invasive infections in Belgium (1983-1987). PMID- 3266415 TI - The relation between supraventricular tachyarrhythmias and left ventricular dysfunction after acute myocardial infarction. AB - The clinical characteristics of supraventricular tachyarrhythmias (SVTA) and their relation to left ventricular dysfunction were assessed in 208 consecutive patients with recent myocardial infarction. Arrhythmias were quantified on hospital discharge by 24 hour electrocardiographic recording. All the variables were evaluated between the second and the fourth week after infarction. SVTA occurred in 113 (54%) patients: Supraventricular premature beats (SVPB) in 49 (24%), frequent or repetitive SVPB in 37 (18%), atrial or junctional tachycardia in 23 (11%), atrial flutter or fibrillation in 4 (2%). Most of these arrhythmias occurred in the absence of symptoms, and the most complex forms were always selflimiting. No relation was found among the presence of different forms of SVTA and sex, coronary risk factors, previous history of ischemic heart disease, type or site of acute myocardial infarction, NYHA functional class. Age, left atrial dimension (LAD), cardio-thoracic ratio (CTR) and left ventricular ejection fraction (LVEF) at rest differed significantly among three groups of patients: those without SVTA, those with SVPB less than 100 per hour and those with frequent-repetitive SVPB or atrial-junctional tachycardia. The more SVTA complexity, the worse LAD, CTR, LVEF and the higher the age. Multivariate discriminant analysis showed that CTR was directly and LVEF inversely related to the occurrence of SVPB less than 100 per hour, while the presence of frequent repetitive SVPB or supraventricular tachycardia was closely related to increasing age, LAD, CTR and decreasing LVEF. Patients with atrial fibrillation always showed the worst values of LAD, CTR, LVEF and age. The results of the present study show that different types of SVTA occurring at discharge from hospital after myocardial infarction are clinically benign, but always suggestive of different degrees of left ventricular dysfunction. PMID- 3266417 TI - Trifluoperazine stimulated sodium transport through the apical surface of isolated frog skin. AB - When added to the apical solution of isolated frog skin, the calmodulin antagonist trifluoperazine (TFP)* stimulated the short-circuit current (SCC) in a dose-dependent manner. The increase in SCC was due to an enhanced active transepithelial Na transport. After addition of TFP (15 microM) the intracellular voltage depolarized, showing that TFP acts by increasing the sodium (Na) permeability of the apical membrane. The TFP-induced increase in SCC was not accompanied by an increase in prostaglandin E2 release from the skins as observed by basolateral addition of TFP. When the apical Na concentration in fast-flow experiments was changed from 0 to 50 mM, the SCC increased promptly and then reclined. The presence of TFP in the apical solution abolished this recline. The apparent inhibition constant for amiloride changed in the presence of TFP from 1.42 +/- 0.12 microM to 0.38 +/- 0.05 microM (n = II) and TFP abolished the inhibition of SCC caused by high apical Na concentrations. These observations indicate that TFP acts by abolishing the Na self-inhibition of the Na channels. Calmidazolium and chlorpromazine stimulated the SCC to the same degree and in the same concentration range as TFP, suggesting that the effect of TFP was not mediated by the Ca2+-calmodulin complex. PMID- 3266418 TI - Calcitonin gene-related peptide (CGRP) and transcutaneous electrical nerve stimulation (TENS) increase cutaneous blood flow in a musculocutaneous flap in the rat. AB - The effect of blood flow on transcutaneous electrical nerve stimulation (TENS) and injection of calcitonin gene-related peptide (CGRP) was studied in a musculocutaneous flap of the rat, using laser Doppler flowmetry. The circulatory border was estimated before and after treatment. It was shown that repeated treatments with TENS gradually increased the blood flow, moving the circulatory border distally more than 100% after three treatments. Injection of NaCl into the dorsal central vein of the flap resulted in no increase in blood flow, whereas CGRP 10(-10) M increased the blood flow, so that the circulatory border moved distally 70% and 60%, respectively. PMID- 3266419 TI - Transcutaneous electrical nerve stimulation (TENS) increases survival of ischaemic musculocutaneous flaps. AB - The effect of transcutaneous electrical nerve stimulation (TENS) on the survival of a dorsal musculocutaneous flap was studied in the rat. Postoperative TENS treatment significantly increased the flap survival area in groups of rats receiving different modes of TENS. The flap survival area was up to 95% in the TENS-treated groups compared with 33-45% in the control groups. Repeated (3 days) high intensity (20 mA), high-frequency (80 Hz) TENS applied segmentally at the base of the flap was shown to be the most effective treatment in increasing the flap survival. Preoperative TENS did not increase flap survival area compared with untreated controls. It is concluded that postoperative TENS treatment markedly increases the experimental flap survival area and may be of clinical value for treatment of local ischaemia. PMID- 3266420 TI - Eradication of syngeneic tumor (Meth A fibrosarcoma) from mice by adoptive immunotherapy of immunized spleen cells induced by Corynebacterium parvum pyridine extract residue. AB - Eradication of immunologically-syngeneic tumors was achieved by adoptive chemotherapy using effector cells induced by Corynebacterium parvum-Pyridine Extract Residue (CP-PER). A mixture of 2 X 10(6) Meth A cells and 0.1 mg CP-PER was subcutaneously inoculated into the back of donor BALB/c mice, with the result that their spleen cells showed an antitumor effect 10 to 13 days after the inoculation. These cells were used as immune cells. Recipient mice were inoculated with 1 X 10(6) Meth A cells, and 2 days later were administered cyclophosphamide. On the following day, 1 X 10(8) immune cells were adoptively transferred into the recipient mice. As a result, the tumor began to regress 7 to 12 days after the adoptive transfer. An immuno-histochemical study of the donors' spleens and the recipients' regressing tumors revealed that the ratio of L3T4+ T cells to Lyt-2+ T cells in the donors' spleens was increased and that the infiltrating cells in the recipients' tumors were mainly composed of L3T4+ T cells. This confirmed that the transfer of L3T4+ T cells led to the infiltration of L3T4+ T cells into the recipients' tumors, causing their eradication. PMID- 3266421 TI - Frequency of different types of von Willebrand's disease in the GDR. AB - The frequency of different types of von Willebrand's disease (vWD) was studied in the southern part of the GDR and during investigations of relatives of already diagnosed patients. Among 111 patients diagnosed, vWD was found to be type I in 85 cases, type II in 13 cases and severe recessive type in 13 cases. The patients with type I belonged to 46 different families. Two families with type II had the II A variant and another a variant similar to II C. No patients with type II B were diagnosed. The incidence of severe recessive vWD was estimated to be lower than in Sweden but higher than in Italy and France. PMID- 3266423 TI - Risk and success of reoperations after coronary artery bypass surgery. PMID- 3266422 TI - [Syndromic structure of mental illness in London and Cantabria]. PMID- 3266424 TI - Surgical management of end stage coronary disease. PMID- 3266425 TI - Late results after coronary reoperation. PMID- 3266426 TI - Follow-up results after aortocoronary reoperation. PMID- 3266427 TI - Reoperation for recurrent coronary artery disease. PMID- 3266428 TI - Surgical treatment of evolving and sustained myocardial infarction. PMID- 3266430 TI - Immediate bypass surgery for evolving myocardial infarction. PMID- 3266429 TI - Emergency aortocoronary bypass surgery: late effects on infarct size and ventricular function. PMID- 3266431 TI - Emergency coronary artery reperfusion for acute evolving myocardial infarction. PMID- 3266432 TI - Early and late results of coronary endarterectomy in 3,369 patients. PMID- 3266433 TI - Coronary endarterectomy: an old technique and new controversies. PMID- 3266434 TI - Endarterectomy in patients with diffuse coronary artery disease. PMID- 3266435 TI - Laser technique for coronary endarterectomy. PMID- 3266436 TI - Prerequisite coronary endarterectomy for coronary artery bypass grafting. PMID- 3266438 TI - Coronary bypass grafting with multiple coronary endarterectomies. PMID- 3266437 TI - Use of endarterectomy as an adjunct to coronary artery bypass. PMID- 3266439 TI - [The epidemiology of dermatoses in childhood and adolescence]. PMID- 3266440 TI - Falls by elderly people at home: prevalence and associated factors. AB - Of 1042 individuals aged 65 years and over who were successfully interviewed in a community survey of health and physical activity, 35% (n = 356) reported one or more falls in the preceding year. Although the overall ratio of female fallers to male fallers was 2.7:1, this ratio approached unity with advancing age. Mobility was significantly impaired in those reporting falls. Asked to provide a reason for their falls, 53% reported tripping, 8% dizziness and 6% reported blackouts. A further 19% were unable to give a reason. There was no association between falls and the use of diuretics, antihypertensives or tranquilizers, but a significant association between falls and the use of hypnotics and antidepressants was found. Discriminant analysis of selected medical and anthropometric variables indicated that handgrip strength in the dominant hand and reported symptoms of arthritis, giddiness and foot difficulties were most influential in predicting reports of recent falls. PMID- 3266441 TI - The effect of age upon the affinity of microsomal mono-oxygenase enzymes for substrate in human liver. AB - Although the clearance of many oxidized drugs falls with age, a corresponding fall in the maximal activities of drug metabolizing enzymes has not been noted. The possibility of a fall in enzyme affinity for substrate with age, which could account for the observed changes, has not previously been investigated in human liver. We have studied the kinetics of the microsomal mono-oxygenase 7 ethoxycoumarin-O-de-ethylase in 17 human liver biopsy specimens. No correlation was observed between age and microsomal protein recovery, maximal enzyme activity or apparent enzyme affinity. Since microsomal mono-oxygenase activities and affinities appear not to change in human liver, other factors such as a fall in liver volume or blood flow must be responsible for the decline in clearance of many oxidized drugs which occurs with ageing. PMID- 3266443 TI - [Intravitreal injection of human anti-pseudomonas globulin in pseudomonas endophthalmitis in rabbits]. PMID- 3266442 TI - Hypothesis: senile purpura is a prognostic feature in elderly patients. AB - In a consecutive series of 1125 elderly Chinese patients admitted acutely into the geriatric unit of a general hospital over a 6-month period, 53 (5%) had senile purpura (SP). The prevalence of SP increased exponentially with age and was higher in men than in women. The mean hospital stay of patients with SP was significantly longer than in the non-SP group. SP may have prognostic significance in the elderly. PMID- 3266444 TI - [The efficacy of recombinant interleukin 2 in local treatment of superficial bladder tumors]. AB - The present study was undertaken to assess the efficacy of recombinant Interleukin 2 (rIL-2: S-6820) in treatment of superficial bladder tumors. Three intratumor injections at a dose of 5 x 10(5) units/day via urethra, were performed every other day under endoscopic control in 12 patients with superficial bladder cancer. On the 15th day after completion of the series of injections, the tumor had disappeared in one patient and 50% regression over was observed in two other patients. Therefore, the response rate to the rIL-2 treatment in our study was 25.0%. Each tumor which responded to the therapy, was single, small and low grade. In the peripheral blood of the 12 patients, an increase in IL-2 receptor-positive lymphocytes and augmentation of natural killer activity were detected after the rIL-2 intratumor injection. There were no serious side effects except for moderate fever in our study. PMID- 3266445 TI - Genital/Chlamydia trachomatis infection. PMID- 3266446 TI - Acute metabolic alkalosis with hypokalemia and azotemia following massive upper gastrointestinal hemorrhage in a 54-year-old alcoholic man with cirrhosis. PMID- 3266447 TI - Changes of lymphocyte subsets in normal pregnant and postpartum women: postpartum increase in NK/K (Leu 7) cells. AB - Changes in lymphocyte subsets in whole blood of normal pregnant and postpartum women were examined by flow cytometry with an automated leukocyte differential system. From the first trimester and throughout pregnancy, the absolute counts of T(CD3) and B(CD20) and T-cell subsets (CD4, CD8) decreased with a decrease in the absolute lymphocyte count, although the proportions of these cells remained unchanged except for a decrease in the percentage of T helper-inducer (CD4) cells in the first trimester. On the contrary, the percentage of NK/K (Leu 7) cells, but not of NK/K (CD16) cells, increased in the first trimester and then both gradually decreased in the second and third trimesters. In the postpartum period, the percentages and absolute counts of T(CD3) and NK/K (Leu 7) cells, but not of other cells, increased transiently. These changes of lymphocyte subsets may indicate suppression of immunological activity during pregnancy and its "increase" in the postpartum period. PMID- 3266448 TI - [Characteristics of the course of hemorrhagic syndrome during pregnancy and labor in women with von Willebrand's disease]. PMID- 3266449 TI - [Effects of atropine in coronary heart disease]. AB - For the detection of atropine effects the hemodynamic changes of 50 patients with coronary heart disease being premedicated intramuscularly with pethidine/diazepam have been registered 3 and 6 minutes after intravenous atropine application (0.01 mg/kg). All patients showed an increase of the heart rate, but only 80% demonstrated an increase of cardiac index at the same time. 20% of these patients exhibited a decrease of the stroke volume, whereas in 5 cases out of this group the patients complained ischemic pain. In a second part of this investigation the results of an induction of neuroleptanalgesia have been compared with another group of 50 patients with the same disease. The function of the right and left ventricle was significantly depressed in the patients with atropine application before the induction of anaesthesia. The results are discussed as an important argument against the routine use of atropine for premedication purposes. PMID- 3266450 TI - Comparison of sensory nerve conduction velocities in horses versus ponies. AB - Normal sensory nerve conduction velocity (SNCV) values in 8 ponies and 8 horses were compared by use of a percutaneous signal-averaging technique. Nerve fibers evaluated included those in the medial and lateral palmar and plantar digital nerves. Mean SNCV values were significantly slower (P less than 0.0002) for horses, compared with those values for ponies. Animal height and nerve segment length were inversely related to SNCV consistently. The SNCV values were affected by surface skin temperature by a factor of approximately 1.2 m/s change for 1 degree C change in temperatures from 35 C. The ability to calculate warning limits to define those SNCV values in normal and abnormal ranges were developed from these data for both ponies and horses. PMID- 3266451 TI - Representation of three-dimensional space in the vestibular, oculomotor, and visual systems. A symposium of the Barany Society. Bologna, Italy, June 3, 1987. Proceedings. PMID- 3266452 TI - [Virilization caused by 21-hydroxylase deficiency and axillary sweat gland hyperplasia]. PMID- 3266453 TI - [Eosinophilic pustular folliculitis disclosing high-grade rapidly fatal T lymphoma]. PMID- 3266454 TI - Trichomonas vaginalis: preliminary characterization of a sperm motility inhibiting factor. AB - This study determined the effects of Trichomonas vaginalis trophozoites, subcellular fractions, and medium from axenic T. vaginalis cultures on human sperm motility and viability. Spent medium (pH 7.0) caused complete cessation of sperm motility after 15 minutes incubation. Trophozoite soluble fraction or formalin-killed trophozoites caused a 50 percent reduction in sperm motility, compared to 25 percent reduction caused by the trophozoite particulate fraction or the sterile medium and three percent by saline (control). Spent medium from T. vaginalis cultures reaching stationary growth phase produced the greatest reduction in sperm motility, suggesting that potency was related to time in culture and trophozoites per ml. The T. vaginalis spermicidal activity was heat stable, trypsin-sensitive, and had a molecular weight of 12-15,000 by gel filtration. This proteinaceous substance was present in and secreted by T. vaginalis trophozoites during normal growth in axenic culture. Since this T. vaginalis byproduct rapidly killed sperm in vitro, its effects in humans may contribute to infertility in infected couples. PMID- 3266455 TI - Borrelia burgdorferi--specific and autoreactive T-cell lines from cerebrospinal fluid in Lyme radiculomyelitis. AB - In 3 patients with Lyme radiculomyelitis, cellular immune reactions of cerebrospinal fluid (CSF) lymphocytes were analyzed. Phenotypic analysis of CSF cells demonstrated that the majority were T cells (CD3+) of the helper/inducer subset (CD4+). These T cells were directly expanded from the CSF by limiting dilution. A total of 505 T-cell lines were tested for Borrelia burgdorferi (Bb) specific proliferation and also partly tested for reactivity to a panel of central and peripheral nervous system antigens. Proliferative assays revealed 33 of them to be Bb specific, 16 to be specific for myelin basic protein, 16 to be specific for peripheral myelin, 1 to be specific for cardiolipin, and 2 to be specific for galactocerebrosides. The antigen-specific proliferation was restricted by autologous human leukocyte antigen (HLA) class II molecules. The majority of CSF-derived T-cell lines stained positively for CD3, CD4, and HLA class II antigens and negatively for CD8 (cytotoxic/suppressor subset). One T cell line provided help for the production of specific IgG by autologous B cells and secreted gamma-interferon upon stimulation with Bb antigen in the presence of autologous antigen-presenting cells. These data show that in patients with severe neurological manifestations of late Lyme disease, not only Bb-specific T-cell lines but also T cells reactive to central or peripheral nervous system autoantigens can be found. PMID- 3266456 TI - Dual-label immunocytochemistry of the active multiple sclerosis lesion: major histocompatibility complex and activation antigens. AB - Fresh-frozen autopsy material containing active inflammatory lesions from 9 different patients with multiple sclerosis (MS) was analyzed by immunocytochemistry using a panel of monoclonal antibodies, and a dual-label immunocytochemical method was developed which permitted the simultaneous detection of two different surface markers on a single cell. We now report the following. (1) The predominant T-cell phenotype within MS lesions is CD2,3,8. This phenotype marks the suppressor-cytotoxic subset. (2) These cells do not express the natural killer cell marker NKH-1, which is present on a subset of CD8 positive cells in peripheral blood. (3) The infiltrating cell expresses class I (HLA A, B, C), but not class II (DR and DQ), major histocompatibility complex (MHC) molecules. (4) Other T-cell surface molecules, including the activation antigens interleukin-2 receptor, Ta1, and T11-3, as well as the marker 2H4, are largely not expressed. (5) Endothelial cells express both class I and class II MHC molecules and the 4B4 molecule in both MS and control tissue. (6) Astrocytes within the vicinity of MS lesions are predominantly class II MHC-negative. These results demonstrate that the T-cell infiltrate present in MS tissue on autopsy has a restricted phenotypic profile, but they also raise the possibility that, within this population, few activated effector cells are present. PMID- 3266457 TI - Bypass surgery: families' perceptions. PMID- 3266458 TI - Epidermal growth factor and its receptor in human ovarian follicles. An immunohistochemical study. PMID- 3266459 TI - [Systemic scleroderma in children]. AB - A new case of systemic scleroderma in a child is reported. The frequency of this disease is much lower than focal scleroderma and than other connective diseases in childhood. Kidney and heart involvement is much less common than in adults. Raynaud's phenomenon and scleroderma however, as in this case, are often severe. The appropriate treatment has to be efficient towards sclerosis (D-penicillamine, corticosteroids), Raynaud's phenomenon (protection from cold, nifedipine) and other manifestations (prevention of gastric ulceration, physical therapy) and should consider every possible adverse effect on a growing organism. PMID- 3266460 TI - Mitogenic stimulation of mouse lymphoid cells by Aleuria aurantia agglutinin. AB - An investigation was undertaken to determine if an agglutinin isolated from Aleuria aurantia possesses a mitogenic activity. Proliferation response of mouse lymphoid cell cultures was measured by 3H-thymidine uptake. The results revealed that Aleuria aurantia agglutinin at the concentration of 1 microgram/ml is mitogenic for Thy-1+ splenocytes and cortisone-resistant thymocytes. PMID- 3266461 TI - A survey of patients in a regional geriatric psychiatry inpatient unit. AB - The functioning is described of a regional geriatric psychiatry unit with inpatient beds supplemented by an active community team. Data were collected on 100 consecutive patients admitted between November 1985 and July 1986. Eighty seven per cent of patients were discharged during the course of the study, the majority (66%) to their own homes or to special accommodation houses, 9% to nursing homes, 7% to general hospitals for treatment and 5% to other psychiatric hospitals for social reasons. The patients were characterized by multiple psychiatric and physical disorders, 26% receiving multiple major psychiatric diagnoses. Fifty-two per cent suffered from significant previously recognized physical disorders and 47% had significant physical illnesses diagnosed for the first time during their admission. At the conclusion of the study 7% remained in long-term wards. PMID- 3266462 TI - Colony stimulating factors--CSF. International symposium. Garmisch-Partenkirchen, West Germany, November 30 to December 2, 1987. Proceedings. PMID- 3266463 TI - Interleukin 6: identification as a hematopoietic colony-stimulating factor. AB - Interleukin 6 is a multifunctional cytokine that exerts a variety of effects on different cell types. These effects include differentiation of B cells and cytotoxic T cells, growth promotion of hybridomas and activation of hepatocytes and mitogen-stimulated helper T cells. We identified and molecularly cloned a cDNA encoding a novel myeloid colony-stimulating activity from a human T cell line. This cytokine proved to be identical to the factor currently known as IL-6, thereby demonstrating effects of IL-6 with hematopoietic target cells. In addition to its ability to support murine granulocyte-macrophage colony formation, IL-6 was found to act synergistically with IL-3 in both the murine and human systems in support of colony formation by the primitive blast cell colony forming cell. This multitude of biologic activities suggests that IL-6 plays a prominent role within a network of cytokines in integrating the different arms of the host response to infection. PMID- 3266464 TI - Constitutive expression of hematopoietic growth factor genes by acute myeloblastic leukemia cells. AB - Blast cell populations of forty nine individuals with acute myeloblastic leukemia (AML) were investigated for constitutive expression of genes for various hematopoietic growth factors. Fifteen samples constitutively exhibited messenger (m) RNA for colony stimulating factor for granulocytes (G-CSF). Eleven AML specimens produced mRNA specific for CSF for granulocyte and macrophages (GM CSF). When probed for CSF for macrophages (M-CSF or CSF-1) specific hybridization signals became detectable in six samples. Five out of six blast cell populations transcribing M-CSF, synthesized G-, and GM-CSF mRNA's simultaneously, whereas another five leukemias transcribed G-, and GM-CSF genes exclusively. Furthermore, when specific bioassays were performed to detect secretion of biologically active CSF proteins by these leukemic blast samples, twelve out of fifteen G-CSF mRNA producing cell populations, eight out of eleven GM-CSF mRNA producing cell populations and one out of six M-CSF mRNA synthesizing samples, demonstrated release of the respective, functionally active CSF's into their culture supernatants. Our results show that gene transcription and protein secretion of hematopoietic growth factors are features that are frequently detected in leukemic myeloid blast cells and involve G-, GM-, and M-CSF. With respect to recent findings of receptiveness of leukemic colony forming cells (L-CFC) for proliferative stimuli provided by various hematopoietic growth factors, our findings point out a potential role of autocrineously produced CSF's in the pathophysiology of autonomous proliferation in AML. PMID- 3266465 TI - The molecular cloning of interleukins 4, 5 and 6: multifunctional hemopoietic growth factors. AB - We summarize here our recent studies on the cloning and characterization of three lymphokines which are produced by activated T cells. Interleukins 4, 5 and 6 are involved in the regulation of B cell activation, proliferation and differentiation. IL-4 can activate resting B cells, while IL-5 stimulates the proliferation of activated B cells. Both of these factors also have a role in regulating the isotype of immunoglobulin produced by cultures of D cells. IL-6 appears to induce the differentiation of B cells to secrete high levels of immunoglobulin. In addition, each of these factors is involved in the regulation of other lineages of hemopoietic cells. Thus, T cells control multiple lineages of myeloid and lymphoid cells through the diverse actions of multiple lymphokines. IL-6 is exceptional because it is produced by a variety of cell types, and its action is not restricted to hemopoietic cells. PMID- 3266466 TI - Synergistic interaction of hematopoietic colony stimulating and growth factors in the regulation of myelopoiesis. AB - Synergistic interactions in the regulation of myelopoiesis have been noted in vitro and in vivo and are discussed. Moreover, data is presented to highlight such synergistic interactions in vitro and in vivo. It is shown that purified recombinant human B-cell stimulating factor-1/interleukin-4 (rh BSF-1/IL-4) synergizes with rh Granulocyte (G)-Colony Stimulating Factor (CSF), but not with rh Granulocyte-Macrophage (GM)-CSF, rh IL-3, or rh Macrophage CSF (CSF-1) to enhance colony formation in vitro by normal human bone marrow cells. This synergism is restricted to granulocyte progenitors. Also, it is shown that rh G CSF or rh CSF-1 enhance the proliferation of granulocyte-macrophage progenitor cells (CFU-GM) in vivo in mice pretreated with human lactoferrin, and when added together these preparations of CSF act synergistically. It is apparent that a true understanding of how myeloid blood cell production is regulated requires insight into how molecules collaborate with or antagonise one another. PMID- 3266467 TI - The biology of the colony stimulating factors. AB - Previous in vitro studies with recombinant human Interleukin 3 (IL-3) in serum replete culture conditions suggested that IL-3 induced the complete differentiation of multipotent and both, erythroid and myeloid progenitor cells. In contrast, serum-free cultures have shown that alone, IL-3, and to a lesser extent granulocyte-macrophage colony-stimulating factor (GM-CSF), are inadequate differentiation stimuli. However, in combination with the lineage-specific growth factors, erythropoietin, granulocyte colony stimulating factor (G-CSF), and macrophage CSF (M-CSF), complete recovery of erythroid, granulocyte, and macrophage colonies, respectively, was obtained. GM-CSF is produced by a variety of mesenchymal cells as well as monocytes and T lymphocytes; in contrast, IL-3 production appears to be restricted to lectin stimulated T lymphocytes. These studies indicate that the CSFs may be more effective in vivo when used as combinations rather than as single factors. The restricted production of IL-3 by activated T cells suggests that IL-3 may be released during infections and may play an important role during stress. PMID- 3266468 TI - Calorimetric study of thermal denaturation of vertebrate visual pigments. AB - The thermostability of visual pigments in bovine, rat and frog rod outer segments (ROS) has been studied by means of differential scanning calorimetry and thermal gel analysis methods. Use of the two different methods has allowed to assign calorimetric peaks to rhodopsin and opsin denaturation. The denaturation enthalpy changes for rhodopsin in bovine, rat and frog ROS are 630 kJ/mole (Td = 347 degrees C), 416 kJ/mole (Td = 340 degrees K) and 410 kJ/mole (Td = 340 degrees K), respectively. Corresponding values for opsins are 490 kJ/mole (Td = 332 degrees K), 269 kJ/mole (Td = 320 degrees K) and 158 kJ/mole (Td = 319 degrees K). The free energy of stabilization of the rhodopsin native structure is not very large and practically similar to that for native water soluble globular proteins. PMID- 3266469 TI - Polyclonal IgG synthesis of mononuclear cells induced by the homopolymer of 4,6 dideoxy-4-formamido-alpha-D-mannopyranosyl units isolated from Brucella melitensis. AB - Brucella melitensis attaches selectively to B lymphocytes. The bacterium induces in vitro only a slight proliferation of mononuclear cells and inhibits the spontaneous IgG synthesis. In order to characterize these effects, the O-chain of the lipopolysaccharide of Brucella melitensis (a polysaccharide consisting of poly-4,6-dideoxy-4-formamido-alpha-D-mannoside) was prepared and its influence on lymphocyte functions tested. This compound had no effect on blast transformation whereas IgG synthesis of the cells was stimulated more than tenfold by the addition of the Brucella polymannoside. PMID- 3266470 TI - [Clinical immunosorbents on a basis of polymeric matrices]. AB - Immobilization of anti-IgE on space-network polymers containing aliphatic amino- and hydrazido groups as a way of producing clinical immunosorbents has been studied. Influence of active group concentration on the specific activity of the immobilized antibodies and sorption dynamics of IgE from plasma of patents are investigated. Immunosorbents can be sterilized by gamma-irradiation without any loss of capacity. It is shown that the immunosorbents can be reused after regeneration. Basing on the results obtained, acrylonitrile- divinylbenzene copolymer with hydrazido groups is considered as the most perspective for production of clinical immunosorbents. PMID- 3266471 TI - Effects of protein kinase inhibitors on growth factor-stimulated DNA synthesis in cultured rat vascular smooth muscle cells. AB - The effects of H-7 and ML-9, inhibitors of protein kinase C and myosin light chain kinase, respectively, on DNA synthesis stimulated by platelet-derived growth factor (PDGF) and epidermal growth factor (EGF) were studied in cultured rat vascular smooth muscle cells (VSMC). H-7 and ML-9 significantly inhibited PDGF-stimulated DNA synthesis in lower concentrations, while both compounds were only effective in inhibiting EGF-induced DNA synthesis in higher concentrations. These data suggest that protein kinase C and myosin light-chain kinase activated by PDGF play a more important role in cell proliferation of VSMC than EGF. PMID- 3266472 TI - Prevalence of different types of anemia in Ecuador. AB - 1. We present the results of a study of the prevalence of anemia and its causes in the population of Ecuador. The following parameters were used: blood cytology, reticulocyte count, serum iron, iron binding capacity, ferritin, folic acid and vitamin B 12 concentration. 2. The study was carried out on 4 groups: 426 individuals of both sexes and all ages from the rural population of the lowlands, with a warm and humid climate; 226 individuals from the highlands, with a cold and dry climate; 1000 individuals of the urban working group from the lowlands; and 1000 individuals of the urban working group from the highlands. All subjects were chosen randomly. 3. The prevalence of anemia was 31.4% in the rural group from the lowlands, 27.9% in the rural group from the highlands, 5.5% in the urban group from the lowlands, and 2.7% in the urban group from the highlands, with an overall estimated prevalence of 20.6% for the population of Ecuador as a whole. Iron deficiency was the most frequent cause of anemia (91.3%; 18.7% of the total population), followed by bone marrow failure (6%; 1.2% of the total population), hemolysis (2.2%; 0.5% of the total population), and finally megaloblastic anemia (0.5%; 0.1% of the total population). 4. Since iron deficiency with and without anemia is very frequent, we believe it is justified to establish mechanisms for food iron enrichment for liable groups such as children and pregnant women from marginal areas. PMID- 3266473 TI - Effects of calcium blockers on ventricular fibrillation during acute myocardial infarction. AB - 1. The effects of the calcium blockers bepridil and verapamil on latency time to ventricular fibrillation (VF) and VF incidence were assessed in 109 anesthetized dogs, submitted to coronary occlusion and reperfusion. 2. In 19 dogs (Group I) submitted to global left ventricular ischemia, both bepridil and verapamil significantly (P less than 0.05) prolonged latency time as compared to 14 untreated controls. However, VF was not prevented by any of these drugs. Both drugs were given 15 min before coronary ligation. 3. In 76 dogs (Group II) submitted to regional myocardial ischemia (left anterior descending coronary artery (LAD) occlusion for 2 hours followed by 30 min reperfusion), VF incidence during occlusion was significantly reduced by verapamil as compared to controls (0/21 vs 10/25; P less than 0.05) but not by bepridil (10/25 vs 12/30; P = ns). During reperfusion, however, neither drug affected fibrillation incidence or latency time. 4. No correlation was observed between anti-arrhythmic drug effects and infarct size as measured by triphenyl tetrazolium chloride. 5. We conclude that both bepridil and verapamil significantly delayed the occurrence of fibrillation in acute ischemia due to coronary ligation. However, only verapamil prevented fibrillation and this effect was restricted to the occlusion phase. In contrast, during reperfusion, neither drug prevented fibrillation. Thus, VF during occlusion and reperfusion is likely to be mediated by different mechanisms. PMID- 3266475 TI - Synthesis of human thymopoietin (hTP) and examination of its immunological effect on the impaired blastogenic response of T-lymphocytes of uremic patients. PMID- 3266474 TI - Endoscopic sclerotherapy for oesophageal variceal bleeding. PMID- 3266476 TI - Studies on peptides. CLXII. Synthesis of chicken calcitonin-gene-related peptide (cCGRP) by application of sulfoxide-directed disulfide-bond-forming reaction. PMID- 3266477 TI - [Retino-vitreous problems posed by vitreous inflammation after implantation of artificial lenses]. PMID- 3266478 TI - [Fuchs' gyrate atrophy and ornithine aminotransferase deficiency]. PMID- 3266479 TI - [Dystrophy of aniridia in patients with coloboma]. PMID- 3266480 TI - [A technic of extraction in lens dislocation and subluxation]. PMID- 3266481 TI - [The age-dependent development of exostoses]. PMID- 3266482 TI - Pediatrics academy issues recommendations on use of Haemophilus influenzae type b conjugate vaccine. PMID- 3266483 TI - Acetic acids bearing the 1-phenyl-1H-indazole nucleus with analgesic and antiinflammatory activity. AB - The synthesis of [(1-phenyl-1H-indazol-4-yl)oxy]acetic acid (IV), (1-phenyl-1H indazol-4-yl)acetic acid (IX) and (1,5,6,7)tetrahydro-1-phenyl-4H-indazol-4 iminooxy)acetic acid (XIII) starting from 1,5,6,7-tetrahydro-1-phenyl-4H-indazol 4-one (I) is described. These compounds showed a good antiinflammatory activity in rats, and an analgesic activity in mice similar or comparable to that of indomethacin. PMID- 3266485 TI - Analysis of epidermal growth factor and epidermal growth factor receptor expression in human renal carcinoma cell cultures. AB - In cells derived from two human renal carcinomas only the precursor form of epidermal growth factor (EGF) was found. The binding assay revealed a high level of EGF receptor expression in both cell types tested. However, these receptors are not involved in the growth activity of the cells under in vitro conditions used. The source of DNA synthesis-stimulating activity found in conditioned media of the cells tested is discussed with respect to possible participation of TGF beta. PMID- 3266484 TI - [Synthesis and pharmacologic activity of 9-R-octahydroindolo[2,3-a]quinolazine]. AB - By acid induced cyclization of quinolizidin-1-one 4-R-phenylhydrazones several derivatives of 1,2,3,4,6,7,12,12b-octahydroindolo[2,3-a]quinolizine (1), bearing a substituent on position 9, were prepared. When R = Cl this reaction gave rise also to a red-orange compound to which the structure (V) of 1-(p-chloro)phenylazo 3,4,6,7,8,9-hexahydroquinolizine was assigned. Substances (1 b)-(1-f) were tested for spontaneous locomotor, muscle relaxant, analgesic, antiinflammatory, diuretic and cardiovascular activities and for influence on pentylentetrazole and sodium pentobarbital actions. Interesting levels of activity were exhibited in several cases. PMID- 3266487 TI - Serotonin stimulates gonadotropin release in female and male goldfish, Carassius auratus L. AB - Effects of serotonin (5-HT) on serum gonadotropin (GtH) levels were studied in female and male goldfish, Carassius auratus L. Intraperintoneal (ip) administration of 5-HT (10 micrograms/g) produced a significant increase in serum levels of GtH at 0.5, 1, and 2 hr but not at 3-4 hours, after the drug was injected. Administration of different concentrations of 5-HT into the brain third ventricle (iv) did not affect serum GtH levels. In both sexes, the intraperitoneal administration of different doses of 5-HT (2.5-20 micrograms/g) caused a dose-dependent increase in serum GtH levels in fish at different gonadal stages; the greatest responses occurred in mature (= prespawning) fish. Fluoxetine (10 micrograms/g; ip), a 5-HT reuptake inhibitor, potentiated the stimulatory effects of 5-HT on GtH secretion. Ketanserin (10 micrograms/g; ip), a 5-HT antagonist, did not modify basal GtH levels; however, ketanserin blocked the 5-HT induced release of GtH. These results indicate that 5-HT has a stimulatory effect on GtH release in goldfish, most likely at the level of the pituitary gland. PMID- 3266486 TI - Serum osteocalcin levels in diabetes mellitus: analysis of the type of diabetes and microvascular complications. AB - Recent studies indicate that serum levels of osteocalcin, a 49-aminoacid bone matrix protein, are a biochemical marker of bone formation. In order to study bone metabolism in diabetes mellitus, in 28 patients with Type 1 (insulin dependent) diabetes mellitus, in 38 patients with Type 2 (non-insulin-dependent) diabetes mellitus and two control groups, matched for Type 1 and Type 2 diabetic patients, respectively, serum levels of osteocalcin, parathyroid hormone and 25 hydroxy vitamin D were measured by radioimmunoassay. Whereas in Type 1 diabetic patients and control subjects serum levels of osteocalcin and 25 hydroxy vitamin D were not statistically different, serum osteocalcin and 25 hydroxy vitamin D levels were significantly decreased in Type 2 diabetic patients when compared with corresponding control subjects (p less than 0.03 and p less than 0.001, respectively). Independent of the type of diabetes, serum parathyroid hormone levels were comparable in diabetic patients and matched control subjects. Serum osteocalcin levels were significantly lower in Type 1 diabetic patients with retinopathy and/or proteinuria than in Type 1 diabetic patients without microangiopathy (p less than 0.05). Whereas serum parathyroid hormone levels in Type 2 diabetic patients with retinopathy and/or proteinuria were significantly increased (p less than 0.02), 25 hydroxy vitamin D levels were decreased (p less than 0.02) when compared with Type 2 diabetic patients without microangiopathy. Our data give evidence of a vitamin D deficiency and a decreased bone formation in patients with Type 2 diabetes mellitus. In Type 1 diabetes mellitus bone formation as reflected by serum osteocalcin levels is influenced by the presence or absence of microangiopathic complications. PMID- 3266488 TI - Intracellular site of Sr2+ and Ba2+ accumulation in frog twitch muscle fibres as determined by electron probe X-ray microanalysis. AB - Strontium and barium can substitute for calcium at different levels of the excitation-contraction-relaxation cycle. The problem of sequestration of these ions in cellular microcompartments may be settled only by direct evidence obtained with analytical methods. Isolated frog twitch muscle fibres were perfused with increasing concentrations of potassium in Ca-free solution supplemented with Sr2+ (10 mmol/l) or Ba2+ (5 mmol/l). After equilibration in a Ca-free Ringer with Sr2+ or Ba2+ for 30 to 60 min the fibres were frozen in liquid propane (at 80 K) to immobilise ions. Ultrathin (150 nm) cryosections were cut at 170 K, freeze-dried, carbon-coated and analysed in an electron microscope equipped with an X-ray spectrometer. The ultrastructure of the superficial layer of the fibres was satisfactorily preserved. The terminal cisternae (t.c.) of the sarcoplasmic reticulum (SR) were dark and contained various amounts of Sr or Ba in addition to Ca. In Sr loaded fibres the longitudinal SR occasionally showed electron dense content with significant amounts of Ca; no Sr was present. The results suggest that t.c. is the common sequestering compartment for Ca, Sr and Ba. Essentially the same distribution pattern of Sr was found following precipitation of Sr with a solution containing digitonin and Koxalate. PMID- 3266489 TI - Cloning and characterization of the 5-aminolevulinate synthase gene(s) from Rhodobacter sphaeroides. AB - The 5-aminolevulinate synthase gene (hemA) from Rhizobium meliloti was used to probe a genomic lambda bank derived from Rhodobacter sphaeroides DNA. Two phage clones were found to bear homology to the Rhizobium probe. Southern hybridization analysis of the two lambda phage clones, which we designated lambda Hem 10 and lambda Hem 12, showed that the homology to the Rhizobium hemA gene was localized to a 3.1-kb SalI fragment derived from lambda Hem 10 and a 7.0-kb SalI fragment derived from lambda Hem 12. Each of the SalI fragments was subsequently cloned into the multiple cloning site of pUC19 in both orientations relative to the lac promoter. Restriction analysis confirmed that each SalI fragment was unique. It was also shown from Southern hybridization analysis that the regions of homology within each of the R. sphaeroides restriction fragments and the Rhizobium probe were different. Further, we have tentatively concluded that each R. sphaeroides hemA gene shows a relatively low degree of homology to the other. Data obtained from in vitro transcription-translation studies in a homologous R. sphaeroides cell-free system, and complementation of hemA mutations of both Escherichia coli and R. sphaeroides by either of the putative hemA clones suggested the presence of a gene encoding 5-aminolevulinate synthase on each DNA sequence. The fact that 5-aminolevulinate synthase activity could be demonstrated in mutant strains complemented in trans with either cloned DNA fragment further supported this conclusion. PMID- 3266491 TI - The dilemma of the elderly rheumatic patient. Proceedings of the Satellite Symposium of the XIth European Congress of Rheumatology. Athens, Greece, July 1, 1987. PMID- 3266490 TI - Molecular cloning and characterization of cellular genes whose expression is repressed by the adenovirus E1a gene products and growth factors in quiescent rat cells. AB - Several cDNA clones of cellular genes, whose expression is repressed by the adenovirus type-12 E1a gene products, were isolated from a rat 3Y1 cell cDNA library by differential plaque hybridization with labeled cDNA probes prepared from 3Y1 and the derivative cell line expressing the E1a gene constitutively. The changes in the levels of these gene transcripts during cell-cycle progression from G0 to G1 to S phase were analyzed with 3Y1 cells and gMA cell lines, derived from 3Y1 cells, in which the expression of the E1a gene or its 13S, 12S cDNA can be switched on by the addition of dexamethasone. Quantitation of the transcripts by Northern-blot hybridizations and by nuclear run-on experiments revealed the following. (i) The level of clone-53 mRNA (which turned out to be the fibronectin (FN)-coding mRNA) is very high in resting gMA cells and decreased rapidly after switching on of the E1a gene or its 13S, or 12S cDNA. (ii) The addition of serum or platelet-derived growth factor to resting 3Y1 cells also resulted in a rapid decrease in the FN mRNA level, but the addition of epidermal growth factor (EGF) had little or no effect. (iii) The level of clone-56 mRNA in gMA cells was not affected by the induction of the E1a gene expression; however, the addition of EGF to resting gMA or 3Y1 cells resulted in a decrease of this mRNA after a 12- to 16-h lag period. Induction of the E1a gene expression in gMA cells treated with EGF shortened the lag period. The addition of serum to resting 3Y1 cells decreased the clone-56 mRNA level without a significant lag period. PMID- 3266492 TI - Epidemiologic considerations of the geriatric population. AB - In the free-living population, approximately 30% of men and 53% of women over the age of 55 years have peripheral joint complaint. Neck and low back complaints occur in 25% of men and 40% of women in the corresponding age group. One third of free-living elderly people suffer from rheumatism. About 25% have shortness of breath, and another 25% have hypertension. Diabetes ranks seventh among self reported diseases. Approximately 40% of elderly people report a poor health condition, 20-50% cannot perform all activities of daily life, and about 30% are physically handicapped. An examination of problems seen by general practitioners reveals that overweight ranks first (prevalence, 20% of visits per year), osteoarthritis second (19% of visits per year), and hypertension third (17.5% of visits per year); diabetes, however, ranks thirteenth among problems seen during annual visits to the general practitioner. Only 20-50% of people suffering from osteoarthritis or entesopathies soft-tissue rheumatisms visit their general practitioners, while three quarter do so in the case of rheumatoid arthritis. For people older than 55 years of age, 40-60% of men, and 55-82% of women use drugs daily. Analgesics and antirheumatic drugs are used daily by 15% of women and 5% of men over 55 years old. In view of our aging population, it can be anticipated that soon after the year 2000, the percentage of elderly people will be doubled in most European countries reaching 25% of the total population, while 40% will be older than 55 years of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266493 TI - Leadership role of the rheumatologist: toward reaching a consensus. AB - The rheumatologist is in the position to take a leading role in organizing interdisciplinary activities to unravel the confusion about treatment of rheumatologic disorders. Patients realize that all drugs carry some risk of side effects, but they are confused by input from conflicting sources - family members, neighbors, media, and nonmedical 'alternative' practitioners - as well as differing views from general practitioners, orthopedic surgeons, and rheumatologists. Only the rheumatologist is in a position to deal with the confusion, information, and misinformation. The rheumatologist understands that 'risk' is an expression of drug toxicity, patient expectation, and potential for improvement. Specifically, it is the rheumatologist who can best appreciate the benefits that many patients experience with nonsteroidal antiinflammatory drug (NSAID) therapy. In deciding whether to use an NSAID, the rheumatologist must decide for whom such agents are effective, when treatment should begin, which agent to use, and for how long therapy should continue. Relevant risk and benefit analysis is necessary for such decisions. The rheumatologist has to take the initiative in organizing interdisciplinary discussions and take active steps to educate society in general, the media, government, and colleagues. Only then will the approach to a vast problem be a sensible one. PMID- 3266494 TI - [Antinuclear autoantibodies in pregnancy]. PMID- 3266495 TI - Cellular composition of bronchoalveolar lavage fluid in patients with pulmonary tuberculosis. PMID- 3266496 TI - Investigation of the active site of human salivary alpha-amylase from the modes of action on modified maltooligosaccharides. AB - The modes of action of two isozymes of human salivary alpha-amylase on phenyl alpha-maltopentaoside, phenyl alpha-maltotetraoside, and their derivatives which have an iodo or an amino or a carboxyl group at their first or penultimate glucopyranosyl residues from the non-reducing-end were examined. It is conceivable that the active site of this enzyme is composed of tandem subsites (S4,S3,S2,S1,S1',S2', and S3') geometrically complementary to several glucose residues, and that the glucosidic bonds of the substrates are split between S1 and S1'. Product analysis of each digest strongly suggested the presence of a hydrophobic amino acid residue at subsite S3 in the active site of the enzyme. No difference in the modes of action on the substrates was found between the two isozymes, indicating that the three-dimensional structures of their active site areas are, at the least, similar. PMID- 3266497 TI - Primary malignant lymphoma of the deep tissues of the hand. AB - A 39-year-old tailor was seen initially with primary extranodal malignant lymphoma of the deep soft tissues of the right hand. The diagnosis was confirmed by immunocytochemical staining technique on the biopsy material. Review of the literature showed that this is a rare presentation. The prognosis is related to histologic grading. The patient received radiotherapy and the lesion responded rapidly. He was free of the disease 1 year later. PMID- 3266498 TI - Total peripheral lymphocyte count and T-cell percentage in patients with breast cancer. PMID- 3266499 TI - [Cardiac radionuclide imaging]. PMID- 3266501 TI - [A case of bulbar palsy associated with Sjogren syndrome]. PMID- 3266500 TI - [Clinical, virological and immunological studies of human T-lymphotropic virus type-I-associated myelopathy (HAM)]. PMID- 3266502 TI - Indirect calorimetry in cardiac patients. AB - Nineteen patients following open heart surgery were studied for the influence of cardiac function on metabolism. Diminished cardiac index was associated with the following changes in metabolism: lowering of the energy expenditure, an increase in respiratory quotient and conversion from fat to carbohydrate metabolism. Protein metabolism remained unaltered. The changes are attributed to decreased oxygen transport to the cell ('stagnant hypoxia'). For the estimation of energy expenditure without calorimetry assessment of cardiac function is essential. A formula for predicting resting energy expenditure is given. PMID- 3266503 TI - Surgical repair of ventricular septal defect following acute myocardial infarction. PMID- 3266505 TI - Postinfarction ventricular aneurysm: surgical results of aneurysmectomy and concomitant coronary artery bypass grafting. PMID- 3266504 TI - [Family study of ankylosing spondylitis]. PMID- 3266506 TI - Number of T-lymphocytes in the remnant liver after partial hepatectomy in rats. PMID- 3266507 TI - Vascular smooth muscle cell hyper-responsiveness to growth factors in hypertension. AB - To understand the intrinsic mechanisms of vascular smooth muscle cell proliferation, we studied the growth of cultured rat aortic smooth muscle from spontaneously hypertensive rats (SHR) and their normotensive controls, Wistar Kyoto rats (WKY), under basal conditions and after stimulation. Cell growth was assessed by the determination of cell number, and incorporation of 3H-thymidine into newly-synthesized DNA. We demonstrated that vascular smooth muscle cells from SHR proliferate faster and grow to a greater density, regardless of the initial plating number. The growth difference was not due to different plating efficiencies. Significantly higher 3H-thymidine incorporation was observed in vascular smooth muscle cells from SHR when the cells were stimulated by calf serum, platelet-derived growth factor or epidermal growth factor. Exposure to calf serum elicited an excessive expression of c-myc and c-fos in the first hour after stimulation. These results provide evidence of the hyper-responsiveness of vascular smooth muscle cells from SHR aortae to growth stimuli. PMID- 3266508 TI - [Antimicrobial activities of sultamicillin against clinical isolates from upper respiratory tract infections]. AB - Sultamicillin (SBTPC) is a mutual prodrug in which ampicillin (ABPC) and a potent beta-lactamase inhibitor sulbactam (SBT) are ester-bound in an equimolar ratio. SBTPC is hydrolyzed during absorption after oral administration to provide ABPC and SBT for systemic circulation. In the present study, the antimicrobial activities of SBTPC against 50 isolates each of 6 species (Staphylococcus aureus, Klebsiella pneumoniae subsp. pneumoniae, Branhamella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes) of bacteria freshly obtained from upper respiratory tract infections were examined in relation to their bacterial beta-lactamase producing abilities. beta-Lactamase producing strains were identified using the acidometry disc method with benzylpenicillin (PCG) of cefazolin (CEZ) as a substrate, and their frequencies of appearance were calculated as follows: S. aureus 86%; K. pneumoniae subsp. pneumoniae 100%; B. catarrhalis 68%; H. influenzae 24%. Fourteen per cent of S. aureus strains examined were beta-lactamase positive using both PCG and CEZ acidometry discs. SBTPC, however, demonstrated excellent antimicrobial activities even against these beta-lactamase producing strains. Good activities were observed especially against those bacterial strains producing penicillinase (PCase). Average MIC80 values of SBTPC were 3.13 micrograms/ml for S. aureus and K. pneumoniae subsp. pneumoniae, 0.39 micrograms/ml for B. catarrhalis and H. influenzae, 0.05 micrograms/ml for S. pneumoniae and 0.025 micrograms/ml for S. pyogenes. As SBTPC was shown to possess excellent antimicrobial activities against PCase producing strains, the enhancement in activities of SBTPC compared to ABPC alone can be attributed to the inhibition of beta-lactamase by SBT which, as noted above, is a component of SBTPC in an equimolar ratio to ABPC. PMID- 3266510 TI - [Functions and structure of complement inactivators in plasma. 1). C1 inhibitor]. PMID- 3266509 TI - [Biochemistry of the physiopathologic and clinical aspects of free radicals in cerebral degenerative diseases such as Alzheimer's and Parkinson diseases]. PMID- 3266511 TI - [Functions and structure of complement inactivators in membrane proteins. 3). Membrane cofactor protein]. PMID- 3266512 TI - [Immunologic defense mechanism of complement-derived inflammatory chemical mediators]. PMID- 3266513 TI - [Immunohistochemical analysis of coronary arteriosclerotic lesions in man]. PMID- 3266514 TI - [Histological study of magnesium deficiency dermatitis in hairless rats]. PMID- 3266515 TI - [Recurrent erythema associated with immunological abnormalities: anti-SS-B recurrent erythema]. PMID- 3266516 TI - Alteration of regional cerebral metabolic rate for glucose at interictal and ictal stages in a case of epilepsy with electrical status epilepticus during slow sleep. PMID- 3266517 TI - Regional cerebral blood flow in adult partial epilepsy measured by SPECT using 123I-IMP--regional discrepancy between EEG and SPECT findings at interictal stage in temporal lobe epilepsy. PMID- 3266518 TI - [The regulation of lung fibroblast proliferation by alveolar macrophages--studies on the difference in the fibroblast culture conditions]. PMID- 3266520 TI - Congenital retinoschisis. PMID- 3266519 TI - [The accessory cell function of human alveolar macrophages in antigen-induced T lymphocyte proliferative responses]. PMID- 3266522 TI - [The prevalence of visual impairment in Kuala Selangor]. PMID- 3266523 TI - The spectrum of rheumatic diseases seen at the Rheumatology Clinic, University Kebangsaan Malaysia. PMID- 3266521 TI - Endoscopy in upper gastrointestinal haemorrhage. PMID- 3266524 TI - Effect of chronic oral nicotine on dopaminergic function in the MPTP-treated mouse. AB - Although epidemiological studies have suggested a lower incidence of Parkinson's disease in cigarette smokers, repeated exposure to cigarette smoke or nicotine does not protect against neurotoxicity induced by 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP). Since there is some evidence that nicotinic antagonists, nicotine, and neurotransmitters may have tropic effects on neurite outgrowth, the present study examined the effects of chronic nicotine administration for 16 weeks (in drinking water; 5 mg/kg consumed per day) on the rate of terminal recovery after striatal lesioning with MPTP (2 x 30 mg/kg, s.c.). Terminal recovery, as measured by the rate of recovery in the level of striatal dopamine, was not affected by nicotine. Monoamine oxidase-B activity was not reduced by MPTP, nor did nicotine affect its activity in striatal homogenates. PMID- 3266525 TI - Food intake suppression by growth factors and platelet peptides by direct action in the central nervous system. AB - Intracerebroventricular (i.c.v.) microinfusion of epidermal growth factor (EGF), basic fibroblast growth factor (bFGF) and platelet factor 4 (PF4) suppressed 2 h and nighttime food intake in rats. The following daytime food intake did not change or increased. I.c.v. infusion of platelet-derived growth factor (PDGF) suppressed only 2 h food intake. I.c.v. infusion of bovine serum albumin (BSA), nerve growth factor (NGF), or inactivated EGF, bFGF and PF4 had no effect. Intraperitoneal (i.p.) administration of EGF, bFGF, PF4 and PDGF in doses equivalent to or higher than those administered centrally had no effect. The results suggest a central action of growth factors and platelet peptides on feeding regulation. PMID- 3266527 TI - Alpha 1 antitrypsin deficiency in two population groups in north Italy. AB - We determined the PiM, PiS and PiZ gene frequencies by isoelectric focusing in 9128 newborns from two major ethnic groups, an Italian and a German one, in the Northern part of Italy. In the Italian group the PiS allele frequency is 0.032, the PiZ = 0.015, in the German one 0.015 and 0.019 respectively. Nine ZZ, 2 SS, 10 SZ, 314 MZ and 307 MS were detected. In our two population groups the PiS reflects better than other alleles a close genetic relationship between our German population and studied groups in Austria and Germany. PMID- 3266526 TI - Immune system associated antigens expressed by cells of the human central nervous system. AB - HLA-DR, HLA-DQ and HLA-DP are class II major histocompatibility complex (MHC) antigens necessary for T cell binding and antigen presentation. Interleukin-2 is a lymphokine used by the immune system to signal proliferation of cells in the immune response. Using unfixed tissue and free-floating immunohistochemistry, we show profuse immunoreactivity for these immune antigens in white and gray matter samples from normal and Alzheimer's (AD) disease patients. On morphologic grounds, immunoreactive cell types appear to include astrocytes, microglia, macrophages, and endothelial cells or pericytes. PMID- 3266528 TI - [Study of the risk of analgesic-antipyretic drugs in children]. AB - Poisonings by analgesic-antipyretic drugs in childhood in our country need specific prevention measures because of their incidence and clinical severity. We analysed the clinical-epidemiologic data of 114 cases of poisonings in children under 16 years of age and the results of a questionnaire answered by 507 adults to identify risks factors. The most of these poisonings happened at home; the esposition was accidental in younger children, even if it often depended from therapeutic mishaps; it was more frequently voluntary at the age of 10. Disinformation on risks and lack of appropriate store in the house are the main factors. The prevention therefore must be based either on the education and the use of safe child resistant containers, besides other passive preventive measures. PMID- 3266529 TI - [Problems in adjuvant therapy with corticosteroids in AIDS-associated Pneumocystis carinii pneumonia]. PMID- 3266530 TI - [Protein fractions in workers with vestibular disorders]. AB - Study is performed on 133 patients with vestibular disturbances with no data for inflammatory diseases. Their age group is from 30 to 60, divided into three clinical syndromes: peripheral, central and combined. The otoneurological examination is carried out after the classic clinical scheme; and the blood test is taken in the morning before breakfast. It was established some tendencies between the rate of the pathological changes in the blood protein formula, the duration of the disease and the age. Considerable dynamic changes are registered in young patients, tendency for relative hypoalbuminemia, relative hypergammaglobulinemia etc. The changed coefficient albumin/globulins which in our patients is under the average norm is analyzed. The low values of this coefficient respond to the observed tendency for hypoalbuminemia in patients with vestibular disturbances. PMID- 3266531 TI - Cultures of glial cells release purines under field electrical stimulation: the possible ionic mechanisms. AB - Dissociated primary cultures of glial cells released a remarkable amount of purines, at rest and during field electrical stimulation. The HPLC identification of labelled compounds derived from 3H-Adenosine (3H-Ado) (employed to preload the cultures) indicated that nucleotides and nucleosides were represented in the superfusate in equivalent proportions (43.86% and 56.14% respectively). Very much higher amounts of unlabelled purines prevalently constituted by nucleotides compounds (91.10%) were also released and detectable in the superfusate. In all the experimental conditions their evoked release did not result frequency dependent. Since: a linear increase related to the stimulation frequencies was found for the released labelled compounds; no labelled purines were assayed in 5 x 10-5M Dipyridamole-treated cultures; any significant presence of labelled nucleotides, inosine and hypoxantine was not found in cultures simultaneously treated with 1 x 10-5M 2'-deoxycoformycin and 1 x 10-4M 1-(-5 isoquinolinsulfonyl)-2-methylpiperizine (H7) (3H-Ado amounts resulted more than doubled in these experimental conditions); labelled compounds have been assumed as tracers of a glial purine rate whose release can be connected to electrically evoked action potentials. Purine outflow from glial cells is not sodium dependent, in fact TTX (5 x 10-7M) did not affect their basal or electrically evoked release. A remarkable calcium-dependence was also evidentiated by the 1 x 10-4M Verapamil-induced inhibition of basal and evoked release. TEA (1 x 10-2M), a specific inhibitor of potassium efflux throughout calcium-mediated specific channels, strongly reduced the evoked purine outflow and any additive effect of its was not detectable when administered simultaneously to the calcium antagonist. These findings indicate that the frequency-dependent purine release from cultured glial cells is linked to ionic mechanisms, which calcium and potassium are mainly involved in. PMID- 3266533 TI - [Blakemore or Linton gastric balloon catheters (1)]. PMID- 3266532 TI - Design and early clinical evaluation of selective inhibitors of monoamine oxidase. AB - 1. Selective inhibitors of the monoamine oxidase (MAO) isoenzymes, types A and B, are of potential therapeutic utility. Brain selectivity would overcome the risk of tyramine interactions which have been shown to occur with selective MAO-A but not MAO-B inhibitors. 2. (E)-3-Fluoroallylamines of general structure, FHC = C(R)CH2NH2 have been designed as enzyme-activated, irreversible inhibitors of these enzymes. Two compounds, MDL 72145 (R = 3,4 dimethoxyphenyl) and MDL 72974 (R = 4-fluorophenethyl), are selective and irreversible inhibitors of MAO type B which in vivo show high inhibitory potency against the rat brain enzyme (ED50 0.35 and 0.18 mg/kg p.o., respectively). In animals, these inhibitors do not potentiate the cardiovascular effects of tyramine and have no amphetamine-like effects. However, they do potentiate the central effects of L-Dopa and prevent the neurotoxic effects of MPTP in both mice and monkeys. 3. In early clinical studies, MDL 72145 has been shown to be a potent, long-acting inhibitor of MAO type B. Doses of 16 mg per patient totally inhibit platelet enzyme without potentiating the cardiovascular effects of oral tyramine. Compounds of this type should prove useful in Parkinson's disease. 4. Selective inhibition of brain MAO A can be achieved by using the bioprecursor amino acid MDL 72394 (E-beta fluoromethylene-m-tyrosine). This amino acid is decarboxylated by aromatic L amino acid decarboxylase (AADC) to liberate MDL 72392 (R = 3-hydroxyphenyl), a potent irreversible inhibitor of MAO-A. Combination of MDL 72394 with a peripherally selective inhibitor of AADC (e.g., carbidopa) restricts MAO inhibition to the brain. Consequently, under these conditions, there is a greatly reduced propensity to potentiate the cardiovascular effects of tyramine. 5. This has been confirmed in human volunteers; MDL 72394 (8 mg), combined with carbidopa, substantially decreased urinary MHPG and plasma DHPG concentrations with minimal potentiation of the cardiovascular effects of i.v. tyramine. These results predict that such therapy has potential in the treatment of affective disorders. PMID- 3266535 TI - Early and late complications of endoscopic oesophageal varices sclerotherapy. AB - We report the complications of perendoscopic sclerotherapy observed during treatment of oesophageal varices in 104 patients and 409 sclerotherapy sessions. Complications were related to each individual session and to the aim of the treatment (therapeutic or prophylactic). Major complications occurred in 17.3% of the patients treated: 13 cases of severe bleeding and 5 of oesophageal stricture. Conservative therapy stopped haemorrhage in all but 4 patients, who died of uncontrolled bleeding (3.8%). Three oesophageal strictures recovered spontaneously, while the remaining two required endoscopic dilations. Minor complications occurred after 102/409 sessions (24.9%). Epigastric and/or retrosternal pain developed after 17.6% of the sessions, oesophageal ulcerations after 12.5%, fever after 11.7% and transient dysphagia after 3.7%. Bleeding was observed only in Child's category C patients who underwent therapeutic treatment. The risk of bleeding remained unchanged until complete eradication of varices was achieved. The incidence of minor complications did not correlate with the progression or the aim of the treatment. PMID- 3266534 TI - [Possible mechanisms of autoimmunization in a protracted course of yersiniosis]. PMID- 3266536 TI - Lymphocyte subpopulations and serum immunoglobulin E (IgE) levels in ascariasis. PMID- 3266537 TI - [Modulation of immunologic response by parasitic invasion]. PMID- 3266538 TI - A new metabolite of diclofenac sodium in human plasma. AB - 1. Among the phenolic metabolites of diclofenac in human plasma, an unknown compound (metabolite VI) was detected by h.p.l.c. and g.c. methods. This was also found in baboon plasma. 2. Metabolite VI was identified as 3'-hydroxy-4'-methoxy diclofenac by mass and n.m.r. spectroscopic analysis. Comparison with synthetic reference compound confirmed its structure. 3. In plasma, metabolite VI persists much longer than do unchanged diclofenac and the other phenolic metabolites. In urine, metabolite VI and its conjugates are excreted in trace amounts only. 4. A synthetic sample of metabolite VI was shown to be virtually inactive in animal models of inflammation and pain. PMID- 3266539 TI - [Results of electrocoagulation of Gasser's ganglion in 250 patients with idiopathic trigeminal neuralgia]. AB - In 250 patients with tic doulourex an percutaneous radiofrequency coagulation of the gasserian ganglion has been performed. In 92.2% of the cases the patients were post-operatively painfree. The follow-up extended in 122 cases over 7 years. In these patients a pain recurrency was noted in 27%. On behalf of low invasivity of the procedure the radio-frequency coagulation of the gasserian ganglion is a recommendable operation with low risk and high efficiency especially in old patients. PMID- 3266540 TI - Studies on hepatic hemopoiesis induced by immunization with syngeneic liver extracts in mice. AB - After a 9-week immunization period, all the livers in inbred C57BL 6 mice immunized with syngeneic crude liver protein (LSN) in Freund's complete adjuvant showed histological changes mainly in the portal areas. Morphological features and the subsequent in vitro and in vivo data suggested that the principal histological changes were due to extramedullary hemopoiesis and not to autoimmune hepatitis. This is the first description of extramedullary hemopoiesis in studies concerning experimental autoimmune hepatitis. The significance of our findings is, first, that the occurrence of hepatic hemopoiesis induced by the usual immunization method necessitates morphologically distinct evidence of inflammation to be a prerequisite in studies of experimental autoimmune hepatitis. Without this proof, subsequent investigations would be confusing. Second, immunization can be added to a variety of conditions to induce hepatic hemopoiesis. This would provide a convenient and interesting tool for application to further studies of hemopoiesis. PMID- 3266541 TI - Oral challenge test with sodium metabisulfite in steroid-dependent asthmatic patients. AB - Oral challenge tests were carried out with sodium metabisulfite solution doses of 0.5, 1, 10, 25, 50 mg and encapsulated doses of 100 and 200 mg, as well as with lactose-placebo, on 44 non-atopic patients with steroid-dependent bronchial asthma, without clinical evidence of intolerance to these agents. Only those patients with an acceptable and not very labile pulmonary function were tested. A single-blind challenge protocol was performed in 22 patients (sodium metabisulfite solutions at pH 2.2 to 2.6) and the positive responses were confirmed by double-blind challenge. The other 22 were tested directly in a double-blind manner (pH4). Initially, 6/44 presented a positive reaction. However, a careful analysis and the confirmation by double-blind challenge of the positive responses obtained with the single-blind test, allowed us to identify 4 false positive responses. Thus, the true prevalence of sulfite sensitivity in our population is 4.5%. A patient with intolerance to sulfite agents also suffered aspirin-induced asthma. The labile tendency of the pulmonary function of the asthmatic patients may have contributed to some false positive reactions and probably explain the very high prevalence found in some studies. It does not appear that the variations of pH decisively influence the result of the challenge test. PMID- 3266542 TI - Serum osteocalcin concentration in patients with prostatic cancer. AB - Fifty-four subjects were studied: 36 advanced prostatic adenocarcinoma patients in stage D and 18 normal age-matched male controls. Serum alkaline phosphatase, serum acid phosphatase, plasma osteocalcin, 24-h urinary hydroxyproline excretion, and 24-h whole-body retention of [99mTc]-methylene diphosphonate were measured in all subjects before and 3, 6, and 9 weeks after the start of treatment. Skeletal metastases were identified by radiography and/or [99mTc] methylene diphosphonate bone scan. The results confirm that acid phosphatase is a significant marker in prostatic cancer; serum alkaline phosphatase may be useful in the evaluation and monitoring of bone metastases but it is not always specific; urinary excretion of hydroxyproline is an index of osteoclastic activity; serum osteocalcin may be considered more specific in the evaluation and monitoring of osteoblastic bone metastases in prostatic cancer. PMID- 3266543 TI - [Determining the level of trophoblastic beta 1-glycoprotein for the diagnosis of early pregnancy and the control of the treatment of early abortion]. PMID- 3266544 TI - [Effect of turinal and progesterone combined with chorionic gonadotropin on cellular immunity during the treatment of threatened abortion in the first and second trimesters]. PMID- 3266545 TI - [Value of various indicators of maternal immunologic response in the preclinical diagnosis and evaluation of the severity of late pregnancy toxemia]. PMID- 3266547 TI - [Pregnancy and labor in severe hereditary factor VII deficiency]. PMID- 3266546 TI - [Immunological changes in parturients in relation to different types of labor activity]. PMID- 3266548 TI - [Prevention of hemorrhage caused by disorders of uterine contractility]. PMID- 3266549 TI - [Arrest of hypotonic and atonic hemorrhages in the early postpartum period by using a cryokoagulator]. PMID- 3266550 TI - [Presence of immunocompetent cells in human fetal brain]. PMID- 3266552 TI - The role of percutaneous lung aspiration in the bacteriological diagnosis of pneumonia in adults. AB - In a prospective study of 175 adults with acute pneumonia, percutaneous lung aspiration (PLA) was performed in 144 in an attempt to obtain a bacteriological diagnosis. Positive cultures were obtained from PLA in 90/144 cases (62.5%). The most common organisms isolated were Streptococcus pneumoniae (60%) gram-negative bacilli including Hemophilus influenzae (26%) and Staphylococcus aureus (11%). In 39% of those patients with positive PLA cultures, the same organism was isolated on blood cultures. Complications of PLA were uncommon, with hemoptysis in 4% and chest wall hematoma in 0.7% of patients. The incidence of post-aspirate pneumothorax was not determined in this study. PLA was found to be a safe and effective method of obtaining a bacteriological diagnosis in adult patients with pneumonia. PMID- 3266551 TI - Prevalence of respiratory symptoms, bronchial hyperresponsiveness and atopy in schoolchildren living in the Villawood area of Sydney. AB - Respiratory symptoms, bronchial hyperresponsiveness (BHR) and atopic status were measured in 1,217 schoolchildren, aged 8 to 12 years, living in the Villawood area of the city of Sydney. The findings are compared to those from studies previously conducted, using identical protocols, in the inland town of Wagga Wagga and in the coastal town in Belmont, NSW. There was a higher prevalence of respiratory symptoms in Villawood and Wagga Wagga (40%) than in Belmont (29%). The prevalence of BHR was 15% in Villawood and Belmont and 20% in Wagga Wagga. However, the distribution of severity of BHR was similar in each study town, reflecting the same pattern of responsiveness. The percentage of children who were atopic was higher in Villawood (44%) than in inland Wagga Wagga (39%) or coastal Belmont (40%). Children in the three areas differed in their reactions to the predominant allergen groups. There were more children who were reactive to grass pollens in the inland area and more children who were reactive to house dust mites in the coastal area. Children in Villawood had a high prevalence of reactivity both to house dust mites and to grass pollens. The Villawood children who were born in Australia had a higher prevalence of respiratory symptoms, of BHR and of atopy than the foreign-born children. PMID- 3266553 TI - Recurrent and non-recurrent croup: an epidemiological study. AB - A community-based study investigating the natural history of recurrent and non recurrent croup is described. Daily temperature data were collected during 1977 83, in order to analyse seasonal variation and the effect of atmospheric temperature on the number of croup episodes per calendar month. A case-control study of 137 cases--consisting of 75 children with recurrent croup and 45 children with non-recurrent croup--and 236 controls matched by age and sex was also conducted. It aimed to study associations between croup and other selected diseases in the patients and their families. Recurrent croup differed from non recurrent croup in its natural history in a number of ways. There was a winter and autumn peak in the number of episodes per month. These episodes occurred on days with significantly lower maximum and minimum temperatures. Recurrent croup was significantly associated with a patient history of asthma and wheezy bronchitis and a family history of croup. In contrast, non-recurrent croup showed an autumn peak only, as well as no association with atmospheric temperature or other disease in the patients and their families. This study confirms and extends observations indicating that recurrent croup involves a persistent and inherited airways hyper-reactivity that is triggered by viral and other stimuli, including those related to temperature. PMID- 3266555 TI - Inactivation of serine proteinase inhibitors (serpins) in human plasma by reactive oxidants. AB - Activated polymorphonuclear neutrophils (PMN) and macrophages generate oxidizing agents similar to or identical with N-chloroamines. Mimicking this oxidation in normal human plasma by usage of chloramine T (CT), we observed an oxidant concentration-dependent inactivating effect on plasma alpha 2-plasmin inhibitor (alpha 2-PI), antithrombin III (AT III), and alpha 1-proteinase inhibitor (alpha 1-PI). 20-50 mumol CT/ml plasma are necessary for almost complete inactivation of alpha 2-PI and AT III-activity, i.e. about 2-5 times the dose necessary for inactivation of alpha 1-PI which has already been classified as "oxidant sensitive". The inactivation of alpha 1-PI, alpha 2-PI and AT III in plasma by oxidants is the result of a specific oxidative damage since C1-inhibitor, serine proteinases and complexes of plasmin and alpha 2-PI were chloramine resistant under the conditions used. According to our results, the amount of chloramines released by 1 x 10(6) activated PMN, namely ca. 10 nmol (see Weiss et al. Science 222 625-628, 1983) would be sufficient to destroy alpha 1-PI and alpha 2-PI activity of 1.5 and 0.4 microliter of human plasma, respectively. Consequently, activated leukocytes may be able to create a microenvironment in which elastase as well as plasmin and thrombin can display their proteolytic activity unchecked by their regulator proteins. Oxidation may provide a general basis for altering enzyme/inhibitor balances. PMID- 3266554 TI - Obstructive hydrocephalus-induced parkinsonism. I: Decreased basal ganglia regional blood flow. AB - A 17-year-old male developed acute parkinsonism after obstruction of a ventriculoperitoneal shunt with subsequent hydrocephalus. Following a previous shunt replacement, he developed florid parkinsonism which was associated with Parinaud syndrome. The initial single-photon emission computed tomography of the brain using 99mTc-hexamethylpropylenamine oxime demonstrated decreased cerebral blood flow in the regions of the left caudate and putamen. The patient underwent shunt revision with minimal improvement and therefore levodopa/carbidopa (Sinemet 100/25) was administered. Subsequently, he experienced almost complete recovery which may have been correlated with probable improvement of the basal ganglia regional cerebral blood flow. Parkinsonism associated with ventriculoperitoneal shunt obstruction is a rare but reversible disorder that is responsive to shunt replacement and antiparkinsonian drug administration. Cerebral perfusion studies may prove to be of value in delineating the pathophysiology of this complication. PMID- 3266557 TI - 1H NMR studies of human C3a anaphylatoxin in solution: sequential resonance assignments, secondary structure, and global fold. AB - The spin systems that comprise the 1H nuclear magnetic resonance (NMR) spectrum of the complement fragment C3a (Mr 8900) have been completely identified by an approach which integrates data from a wide range of two-dimensional NMR experiments. Both relayed and multiple quantum experiments play an essential role in the analysis. After the first stage of analysis the spin systems of 60 of the 77 residues were assigned to the appropriate residue type, providing an ample basis for subsequent sequence-specific assignments. Elements of secondary structure were identified on the basis of networks of characteristic sequential and medium-range nuclear Overhauser effects (NOEs), values of 3JHN alpha, and locations of slowly exchanging backbone amide protons. Three well-defined helical segments are found. Gradients of increasing mobility in distinct segments of the C3a polypeptide are observed, with very high mobilities for several residues near the C- and N-termini, including the complete C-terminal receptor binding site pentapeptide LGLAR. The NMR data, combined with known disulfide linkages and a small number of critical long-range NOEs, provide the global folding pattern of C3a in solution. Identical solution structures were found for both the intact active protein and the largely inactive physiologic product des-Arg77 C3a.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266556 TI - Human alpha-calcitonin gene-related peptide (CGRP) is a potent vasodilator in human mesenteric vasculature. AB - 1. The effect of human alpha-calcitonin gene-related peptide (CGRP) and sodium nitroprusside have been measured on human isolated mesenteric vasculature and on rings of human superior mesenteric artery and saphenous vein. 2. When noradrenaline (10(-5) M) was used as the vasoconstrictor in preparations perfused with Krebs solution at constant flow, human alpha-CGRP was 10 times more potent than sodium nitroprusside in evoking dose-dependent falls in perfusion pressure. 3. Human alpha-CGRP and sodium nitroprusside were about equipotent at relaxing rings of superior mesenteric artery contracted by noradrenaline (10(-6) M). When the tone of saphenous vein rings was raised by noradrenaline (10(-6) M), human alpha-CGRP did not relax the vascular smooth muscle. 4. The results show that human alpha-CGRP is a potent vasodilator in human arterial preparations and may act preferentially on arterioles rather than large arteries. PMID- 3266558 TI - Elastic properties of relaxed, activated, and rigor muscle fibers measured with microsecond resolution. AB - Tension responses due to small and rapid length changes (completed within 40 microseconds) were obtained from skinned single-fiber segments (4- to 7-mm length) of the iliofibularis muscle of the frog incubated in relaxing, rigor, and activating solution. The fibers were skinned by freeze-drying. The first 500 microseconds of the responses for all three conditions could be described with a linear model, in which the fiber is regarded as a rod composed of infinitesimally small identical segments, containing an undamped elastic element, two damped elastic elements and a mass in series. An additional damped elastic element was needed to describe tension responses of activated fibers up to the first 5 ms. Consequently phase 1 and phase 2 of activated fibers can be described with four apparent elastic constants and three time constants. The results indicate that fully activated fibers and fibers in rigor have similar elastic properties within the first 500 microseconds of tension responses. This points either to an equal number of attached cross-bridges in rigor and activated fibers or to a different number of attached cross-bridges in rigor and activated fibers and nonlinear characteristics in rigor cross-bridges. Mass-shift measurements obtained from equatorial x-ray diffraction patterns support the latter possibility. PMID- 3266559 TI - 2-deoxy-D-glucose modulation of T-lymphocyte reactivity: differential effects on lymphoid compartments. AB - This study was designed to evaluate the effect of glucoprivation, as induced by 2 deoxy-D-glucose (2-DG) administration, on lymphocyte mitogen reactivity in Sprague-Dawley rats. The results showed that a single injection of 2-DG decreased reactivity in both whole-blood and spleen lymphocytes, as determined by mitogenic stimulation to concanavalin A (Con A) and phytohemagglutinin (PHA). However, the suppressed reactivity for the spleen lymphocytes attenuated with repeated injections, but the whole-blood lymphocytes did not show attenuation. Mitogen assessments of lymphocytes obtained from the thymus indicated that a single injection did not induce suppressed reactivity, but repeated injections induced a pronounced suppression of responsiveness. Furthermore, mitogen assessments of mesentery lymph nodes did not show any effect of 2-DG injections. These results corroborate other findings using electric shock as the stressor, namely that different compartments of the immune system are differentially affected by a stressor. PMID- 3266561 TI - Fast atom bombardment mass spectral search for the amino terminus of genetically engineered alpha 1-antitrypsin. AB - Protein structure determination of genetically engineered alpha 1-antitrypsin was carried out using the technique of 'fast atom bombardment (FAB) MAPPING'. CNBr, tryptic and chymotryptic FAB MAPS were produced. The anticipated amino terminal region of the molecule was not mapped at the expected mass, raising the possibility of post-translational modification. A specific experiment was designed to isolate and identify this region by FAB mass spectral screening of high-performance liquid chromatography separated peptides. A signal at m/z 1231 was observed which could not be assigned to any sequence in the molecule using the computer program. Following CNBr treatment, this signal disappeared completely, giving rise to a new signal at m/z 1058. The amino terminus was thus found to be extended by the presence of an N-acetyl methionine residue, and this discovery is the subject of the present paper; another modification within the sequence will be reported elsewhere. Combining the FAB MAPPING data, the overall structural confirmation achieved was 93% of the recombinant alpha 1-antitrypsin molecule. PMID- 3266560 TI - Interleukin-1 induces changes in norepinephrine metabolism in the rat brain. AB - Interleukin-1 (IL-1) is a hormone that, apart from playing a key role in immune and inflammatory processes, can also affect mechanisms under brain control. To gain a better understanding of the action of this cytokine on the CNS, its effects on the contents of norepinephrine (NE), dopamine (DA) and serotonin (5 HT), and their main metabolites and precursors, were evaluated in different regions of the forebrain, brain stem, and spinal cord. Following administration of human recombinant IL-1 (beta form) to rats, a modest decrease in the content of NE was observed in the hypothalamus as well as in the dorsal posterior brain stem. However, the most relevant finding was that 3-methoxy-4 hydroxyphenylethylene glycol (MHPG), the main NE metabolite, and the relation MHPG/NE were increased in all the regions studied, revealing a stimulatory effect of IL-1 on NE metabolism in the CNS. This effect seems to be specific for NE since no comparable changes in the brain content of DA, 5-HT, or its metabolite, 5-hydroxyindole acetic acid, were detected after administration of the cytokine. However, tryptophan was significantly increased in all brain regions and in the cervical spinal cord. The capacity of IL-1 to affect the metabolism of NE, a neurotransmitter involved in the control of a variety of brain functions, provides further proof for the relevance of this cytokine in brain-immune interactions. PMID- 3266562 TI - Splenic immune responses following treadmill exercise in mice. AB - The in vitro proliferation response to lipopolysaccharide and pokeweek mitogen by splenic lymphocytes and the effect on the total splenic lymphocyte number were examined in C57BL/6J mice following an 8-week treadmill training program (30 m/min, 8 degrees slope, 30 min/day, 5 times/week) and after a single bout of exhaustive exercise (50% stepwise increases in final running speed for 10-min intervals). Plasma corticosterone levels were also measured to evaluate whether changes in adrenocortical activation were associated with exercise-induced immunomodulation. In comparison to sedentary controls, trained mice had an increase of 35% in succinate dehydrogenase activity per unit of protein in the quadriceps femoris muscle. Trained mice showed an increase in splenic lymphocyte proliferation to both mitogens which was evident 72 h after completion of the final training session, relative to sedentary controls. Immediately following exercise, however, lymphocyte proliferative responses were depressed compared with the training and the control values. The exercise regimen resulted in a reduction in total number of mononuclear cells per spleen. Changes in plasma corticosterone levels after exercise were not clearly associated with immunodepression or immunoenhancement of splenic lymphocyte mitogenesis. Taken together, the data suggest that moderate endurance training augments splenic B lymphocyte mitogenesis and further, that the immediate effects of exercise on splenic immune function vary with the duration and intensity of the work. PMID- 3266564 TI - Epidemiology of cancer of the connective tissue in Canada during the period 1950 1985. AB - Canadian patterns of morbidity and mortality from malignancies of the connective tissue were examined for the periods 1970-1982 and 1950-1985, respectively. Age standardized morbidity rates have risen significantly during 1970-1982 in males (P = 0.005), whereas the increase noted in females was of borderline significance (P = 0.055). Examination of age-specific morbidity rates during this period revealed that rates for the eight age groups studied in males have increased, with rates of increase for males aged 65-74 attaining statistical significance (P = 0.0006), whereas increases for males aged 0-24 and 75-84 years were of borderline significance (P less than 0.08). Age-standardized mortality rates during 1950-1985 have risen significantly for both males (0.013 additional new deaths per 100,000 population per year; P less than 0.0001) and females (0.008 additional new deaths per 100,000 population per year; P less than 0.0001). Significant rates of increase were noted in age-specific mortality rates for seven of the eight age groups studied in males (P less than 0.03) and for five of the eight age groups studied in females (P less than 0.04). The rate of increase for women aged 35-44 years was of borderline significance (P = 0.06). Rates of increase in age-specific mortality rates were greatest in males and females aged 75-84 years at 0.113 and 0.059 additional new deaths per 100,000 population per year, respectively. PMID- 3266563 TI - Cerebral circulation and oxygen metabolism in moyamoya disease of ischemic type in children. AB - Cerebral rCBF, rOEF, rCMRO2, and rCBV in moyamoya disease were studied by means of positron emmission tomography (PET), using 15O as a tracer. Steady-state methods with C15O2 and 15O2 were used to obtain the functional images of rCBF, rCMRO2, and rOEF. The 15O single-inhalation method was used to obtain the rCBV image. Five children (two boys and three girls) with mean age of 11 years and eight normal volunteers with mean age of 31 years were included in the study. The symptoms of moyamoya disease were due to cerebral ischemia, such as transient ischemic attack (TIA), reversible ischemic neurological deficit (RIND), and minor stroke. The interval between the latest ictus and PET scan ranged from 3 days to 3 years 6 months. Physiological parameters (rCBF, rCMRO2 etc.) in cerebral gray matter, cerebral white matter and basal ganglia were calculated from the single functional images. Any, low density areas appearing in X-ray-CT performed just prior to the PET study were carefully excluded from the analysis. The parameters of moyamoya disease were statistically compared with normal control parameters. Though the value of rCBF was slightly higher in moyamoya disease, this difference was not statistically significant. On the other hand, in moyamoya disease rCBV increased significantly in gray matter, white matter, and basal ganglia. The ratio of CBF to CBV is considered to be the index of perfusion pressure and reciprocal of cerebral mean transit time under the normal autoregulation of CBF. This ratio was calculated and compared with the normal value for each tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266565 TI - Cancer mortality and mortality trends in Henan, China, 1974-1985. AB - Promotion of cancer control programs requires accurate data on cancer incidence and mortality from population-based cancer registries. Currently, there are 12 institutions that register cancer deaths in the respective 12 counties and cities. The data thus obtained show that cancer of the esophagus, stomach, and liver in both sexes and cervical cancer in females are the leading causes of all cancer deaths. During the period of 1974-1985, marked changes have taken place in the Henan province in cancer mortality rates of certain sites. Some description and discussion of these changes are presented in this paper. PMID- 3266566 TI - Proportion attributable to medical care of the reduction in stomach cancer deaths in Miyagi, Japan. AB - To estimate the contribution of medical care to the reduction in stomach cancer deaths, the trends of incidence and death rates were compared from 1960 to 1970 and from 1970 to 1980 in Miyagi, Japan. The mortality data were derived from the reports by Miyagi Prefectural Government. The incidence data from the Miyagi Prefectural Cancer Registry were used after being adjusted by the proportion of DCO (death certificate only), which is one of the indices of the reliability of the cancer registry. The time lag of 1.2 years was considered when these trends were compared. The proportion attributable to medical care of the reduction from 1960 to 1970 was estimated to be 13.6% for males and 8.2% for females in those 40 years of age or older. The proportion from 1970 to 1980 was estimated to be 17.9% for males and 11.0% for females. Medical care reduced stomach cancer deaths, to be 17.9% for males and 11.0% for females. Medical care reduced stomach cancer deaths, which exceeded the decrease in the total incidence, although it was not possible to estimate the proportions attributed to early detection and to improvement of the treatment methods. PMID- 3266567 TI - Risk factors in renal cell carcinoma. II. Medical history, occupation, multivariate analysis, and conclusions. AB - Potential risk factors in renal cell carcinoma (RCC) were studied in a case control study of 315 RCC cases and 313 hospital and 336 population controls. Risk factors included medical history, radiation exposure, predominant lifetime occupation, exposure to high-risk industries, and summary of important risk factors by a linear logistic regression model based on the comparison of RCC cases and controls selected from hospitals and the general population for 33 variables. A significant increase in urologic, cardiovascular, malignant, digestive, and metabolic disease was observed among cases over population controls. Exposure to radiation increased the risk, especially in females. A predominant lifetime occupation as a professional decreased the risk, whereas work as an operative increased the risk significantly. Work in petroleum-related and dry-cleaning industries were associated with elevated risk. Multivariate analysis comparing cases with each of the control groups for males and females identified obesity as the most important risk factor in RCC. Weight control at an early age might help to prevent the occurrence of a significant proportion of this rare but increasing malignant disease. PMID- 3266568 TI - [Echocardiographic indicators of contractility in patients after aortocoronary bypass]. PMID- 3266569 TI - Botulism in Canada--summary for 1987. PMID- 3266571 TI - Laboratory evidence of influenza in Canada. PMID- 3266570 TI - Adverse local reactions to fourth and fifth doses of DPT vaccine--Alberta. PMID- 3266573 TI - Q fever, 1979-1987--Nova Scotia. PMID- 3266572 TI - Illness due to molluscan shellfish--England and Wales. PMID- 3266574 TI - Q fever, 1982-1986--Ontario. PMID- 3266575 TI - Diphtheria in Canada, 1977-1987. PMID- 3266576 TI - Serodiagnosis of HIV in Manitoba. PMID- 3266578 TI - Rabies and post-exposure rabies prophylaxis in Canada, 1986. PMID- 3266577 TI - Sexually transmitted disease in Canada--1986. PMID- 3266579 TI - Cholera in 1987. PMID- 3266580 TI - HIV-1 infections in the Canadian Atlantic provinces. PMID- 3266581 TI - Pertussis vaccine and permanent brain damage. PMID- 3266583 TI - AIDS surveillance--worldwide. PMID- 3266582 TI - AIDS surveillance in Canada. PMID- 3266584 TI - Laboratory evidence of human viral and selected non-viral infections in Canada 1987. PMID- 3266585 TI - A summary of influenza activity in Canada, 1987-1988 season. PMID- 3266586 TI - [Diagnostic value of computer tomographic pneumomeatocisternography]. PMID- 3266587 TI - [Seroepidemiological survey of human cysticercosis in the Nehe County of Heilongjiang Province]. PMID- 3266588 TI - Serum osteocalcin and other indices of bone formation: an 8-decade population study in healthy men and women. AB - In a study of 435 healthy men and women aged 17-97 yr, serum osteocalcin and alkaline phosphatase were measured together with 99TcMDP retention in women. In women, serum osteocalcin falls to a nadir at 35-39 yr, and the mean then rapidly rises 2-fold to a plateau from 50-75 yr. 99TcMDP retention falls to a minimum at 40-45 yr and then rises steadily with increasing age. Serum alkaline phosphatase rises in an indeterminate fashion from 20-25 yr onwards. Osteocalcin in men fell until age 60-70 yr and hardly changed thereafter, whereas serum alkaline phosphatase reached a minimum at age 30-40 yr and thereafter rose with age, as in women. PMID- 3266589 TI - The region of medial forebrain bundle is involved in tonic maintenance of arterial pressure and heart rate. AB - The role of the medial forebrain bundle (MFB) in central regulation of cardiovascular system was studied in freely moving rats. Injection of lidocaine into the ventral, but not other portions of the MFB, produced transient (approximately ten minutes) pressor and tachycardic responses. These responses resulted from an increase in sympathetic tone, since they were abolished by ganglionic blockade. The pressure response was attenuated by alpha-adrenoceptor blockade and both pressor and tachycardic responses were diminished by beta adrenoceptor blockade. Electrolytic lesion of the same site caused long lasting pressor and tachycardic responses. Injection into the MFB of the excitatory amino acids, kainate (KA) and N-methyl-D,L-aspartate (NMDA) produced pressor and tachycardic responses accompanied by behavioral excitation, whereas no effects were produced by L-glutamate. The cardiovascular responses induced by KA and NMDA were abolished by ganglionic blockade. These results suggest that a selective region of MFB contains fibers of passage and/or cell bodies, with receptor specificity for excitatory amino acids, that are capable of influencing sympathetic sympathetic control of arterial pressure. PMID- 3266590 TI - Regulation of gene expression by the intracellular second messengers IP3 and diacylglycerol. AB - In Dictyostelium, extracellular cAMP interacts specifically with cell-surface receptors to promote the accumulation of a variety of intracellular second messengers, such as 3'-5' cyclic adenosine monophosphate (cAMP) and 1,4,5 inositol trisphosphate (IP3). We and others have shown that activation of the cell-surface cAMP receptor can also modulate the expression of the Dictyostelium genome during development. In at least one instance, synthesis of intracellular cAMP is required for appropriate gene regulation. However, the induction of most cAMP-dependent gene expression can occur in the absence of receptor-mediated activation of adenylate cyclase and a consequent accumulation of intracellular cAMP. These results suggest that other intracellular second messengers produced in response to receptor activation may potentially act as signal transducers to modulate gene expression during development. In vertebrate cells, IP3 and diacylglycerol (DAG) are intracellular activators of specific protein kinases; they are produced in equimolar amounts by cleavage of phosphoinositol bisphosphate after a receptor-mediated activation of a membrane-bound phosphodiesterase. IP3 and, thus, by inference, diacyl-glycerol are synthesized in Dictyostelium as a response to cAMP interacting with its cell-surface receptor. Using defined conditions to inhibit the accumulation of extracellular cAMP, we have examined the effects of these compounds on the expression of genes that require cAMP for their maximal expression. Our results suggest that intracellular IP3 and DAG may in part mediate the action of extracellular cAMP on the expression of the Dictyostelium genome. PMID- 3266591 TI - Spontaneous intramural oesophageal haematoma. AB - Six cases of spontaneous submucosal dissection of the oesophagus are described. This rare entity should be considered in patients presenting with chest pain, usually of sudden onset, associated with dysphagia and haematemesis. Barium swallow or endoscopy are needed to confirm the diagnosis and the characteristic features are described. PMID- 3266592 TI - [The preliminary clinical report of coronary artery bypass grafting in 111 patients]. PMID- 3266593 TI - [Clinical application of intra-aortic balloon pumping in cases with coronary artery bypass graft in the emergency room]. PMID- 3266594 TI - Fine-needle aspiration cytology of histiocytosis X: a case report. AB - The cytologic features of a case of histiocytosis X diagnosed by fine-needle aspiration biopsy of a right cervical lymph node in a 15-mo-old girl are reported. Characteristic reticuloendothelial cells with abundant cytoplasm and grooved nuclei were observed. Electron microscopy of the aspiration-derived specimen revealed Birbeck granules. The cytologic pattern and electron microscopic demonstration of Birbeck granules allowed definite diagnosis of lymph node involvement by histiocytosis X, negating the need for open biopsy. The cytologic differential diagnosis and current diagnostic criteria for histiocytosis X are discussed. PMID- 3266595 TI - Application of immobilized pH gradient isoelectric focusing to forensic hemogenetics: a survey on a three year experience with the transferrin (TF) and alpha 1-antitrypsin (PI) systems. AB - The subtypes of transferrin (TF) and alpha 1-antitrypsin (PI), first discovered using isoelectric focusing, are now mostly determined in immobilized pH gradient gels. We report on our experience in the parentage expertise with both polymorphisms over a period of three years. The complexity of the technology was compensated by the fact that most subtypes of TF and PI could be more reliably recognized. The PI alleles PI*M1, M2, M3, S, F, T, and Z and TF alleles TF*C1, C2 and C3, and in addition four further rare TF alleles were observed. The allele frequencies from non-related individuals did not deviate from the Hardy-Weinberg equilibria and corresponded well to known frequencies from West Germany and other Caucasoid populations. With the TF system 36 accused men, and with the PI system 54 were excluded from paternity from a total of 344 (TF) respectively 347 (PI) cases. From the data presented here isoelectric focusing in immobilized pH gradient gels appears to be a major improvement over carrier ampholyte generated pH gradients in the distinction of TF and PI phenotypes. PMID- 3266597 TI - Return to work after rehabilitation in coronary bypass patients. Role of the occupational medicine specialist during rehabilitation. AB - The aim of the study was to assess the role of the occupational medicine specialist in improving return to work (RTW) after coronary bypass graft (CABG) surgery, with an early intervention in the rehabilitation programme of the patients. There were 57 patients (56 male, 1 female, mean age was 50.7 years), sent for rehabilitation 22 days after surgery (49% of them had a prior myocardial infarction, and the ejection fraction (EF) was greater than or equal to 0.55 in 67%, 0.30 less than EF less than 0.55 in 25%, or less than or equal to 0.30 in 8%; myocardial revascularization was complete in 47% of the patients). Jobs required a high level of physical activity in 52.5% of the patients, a medium or low level in 44% and 3.5% of the patients were unemployed. At 7 months follow-up, 73.2% out of the 56 alive patients had returned to work with a mean delay of 109.9 +/- 84 days after surgery. The causes of non-return to work were social and economical factors (46.6%), psychological factors (40%) and medical reasons (13.4%). No clinical data were correlated with return to work (age, EF, extent of revascularization, or results of the stress tests), but return to work varied with the energy requirement in jobs with 97.3% return to work in case of low physical level, and 46.7% in case of high physical level (P less than 0.001). The comparison with a previous study performed in 1984 in 45 rehabilitation patients (with non-systematic vocational counselling), showed an increase in return to work in cardiac patients from 51% to 78% (P less than 0.05) after intervention of the occupational physician. So, the different ways of improving return to work in post-CABG patients are complementary: exercise training and secondary prevention are important, but must be completed with individual vocational counselling that should be included in every rehabilitation programme. PMID- 3266598 TI - The long-term work record of post-infarction patients subjected to an informal rehabilitation and secondary prevention programme. AB - The St Vincent's Cardiac Rehabilitation Programme is based on an out-patient non institutionalized service with long-term follow-up and home-based exercise programmes. Return to work rates of more than 90% in the 1960s and 1970s were reported but these rates have not been sustained in the past seven years. These secular changes in return to work rates are attributed to recent changes in the social and economic climate in Ireland. Medical, social, demographic, and psychological factors which may influence successful return to work were studied. The previously employed, young patients and those in the higher social groups, patients with less severe attacks and those free from post-infarction angina, reported the best return to work rates. Reasons for failure to return to work could be attributed equally to organic and functional causes. Factors affecting secondary preventive measures, including smoking cessation, desirable dietary and weight changes, and aerobic exercise programmes, were also studied. These changes were best achieved by young patients, white-collar workers, the better educated and urban dwellers. It is concluded that informal out-patient rehabilitation programmes aimed at early return to a normal life, active secondary prevention measures and home-based exercise programmes, are effective and safe in the great majority of patients recovering from myocardial infarction and coronary bypass surgery. PMID- 3266596 TI - Surface location and high affinity for calcium of a 500-kd liver membrane protein closely related to the LDL-receptor suggest a physiological role as lipoprotein receptor. AB - We describe a cell surface protein that is abundant in liver and has close structural and biochemical similarities to the low density lipoprotein (LDL) receptor. The complete sequence of the protein containing 4544 amino acids is presented. From the sequence a remarkable resemblance to the LDL-receptor and epidermal growth factor (EGF) precursor is apparent. Three types of repeating sequence motifs entirely account for the extracellular domain of the molecule. These are arranged in a manner resembling four copies of the ligand binding and the EGF-precursor homologous region of the LDL-receptor. Following a proline-rich segment of 17 amino acids are found six consecutive repeats with close homology to EGF. A single membrane-spanning segment precedes a carboxy-terminal 'tail' of 100 amino acids. This contains two seven-amino acid sequences with striking homology to the cytoplasmic tail of the LDL-receptor in the region that contains the signal for clustering into coated pits. The mRNA for this protein is most abundant in liver, brain and lung. By using an antibody raised against a 13-amino acid peptide corresponding to the deduced amino acid sequence of the carboxy terminus of the protein we have demonstrated its existence on the cell surface and its abundance in liver. Like the LDL-receptor this protein also strongly binds calcium, a cation absolutely required for binding of apolipoproteins B and E to their receptors. We propose that this LDL-receptor related protein (LRP) is a recycling lipoprotein receptor with possible growth-modulating effects. PMID- 3266599 TI - A fully automated contour detection algorithm the preliminary step for scatter and attenuation compensation in SPECT. AB - Contour detection is an important step in information extraction from nuclear medicine images. In order to perform accurate quantitative studies in single photon emission computed tomography (SPECT) a new procedure is described which can rapidly derive the best fit contour of an attenuated medium. Some authors evaluate the influence of the detected contour on the reconstructed images with various attenuation correction techniques. Most of the methods are strongly affected by inaccurately detected contours. This approach uses the Compton window to redetermine the convex contour: it seems to be simpler and more practical in clinical SPECT studies. The main advantages of this procedure are the high speed of computation, the accuracy of the contour found and the programme's automation. Results obtained using computer simulated and real phantoms or clinical studies demonstrate the reliability of the present algorithm. PMID- 3266600 TI - Iodomethylated fatty acid metabolism in mice and dogs. AB - The myocardial uptake of fatty acids labeled with radioactive iodine and injected i.v. can only be evaluated with SPECT if their oxidation kinetics is slow enough. For this reason, we evaluated different iodomethylated fatty acids in mice and dogs to determine which of them shows the highest myocardial uptake and the slowest oxidation. The most suitable was found to be 16-iodo-3-methyl hexadecanoic acid (mono beta) since its myocardial fixation was the same as that of the reference, i.e. 16-iodo-9-hexadecenoic acid (IHA), whereas it was degraded more slowly. Thirty min after injection of mono beta into dogs, the decrease in myocardial activity with respect to the maximum was two fold less than after IHA injection. The myocardial uptake of the two dimethylated fatty acids studied, i.e. 16-iodo-2,2-methyl hexadecanoic acid and 16-iodo-3,3-methyl hexadecanoic acid, was less than that of IHA in mice and dogs. In the latter, the myocardial uptake was so small that we were unable to study the time course of its activity. Consequently, these dimethylated fatty acids are not suitable for the study of the myocardial uptake of fatty acids in man. PMID- 3266601 TI - [Changes in the bioelectrochemical activity of the neurosecretory hypothalamic nuclei in fever caused by endogenous pyrogen/interleukin-1]. AB - Bioelectrochemical potentials of the rabbit hypothalamic supraoptic, paraventricular, suprachiasmatic nuclei, and medial preoptic area changed in a similar way in fever induced with i.v. administration of leucocytic pyrogen/interleukin I in all the structures due, probably, to their compact localization. The dynamics of bioelectrochemical activity coincided with that of rectal temperature derivative. The alterations of bioelectrochemical activity seem to reflect hypothalamic metabolic changes closely associated with effector mechanisms of thermoregulation in fever rather than with the temperature itself. The differences in the reaction patterns of neurosecretory nuclei are compared with changes in their vasopressin-synthetizing function during fever. PMID- 3266602 TI - Simulation analysis of the mechanism of escape from immunoglobulin suppression. AB - The mathematical model of B cell tolerance was applied to idiotype and isotype suppression of short duration induced in mice by neonatal application of monoclonal antibodies specific for the respective immunoglobulin determinants. Suppressor cells play an important role in chronic idiotype or isotype suppression, but these suppressions of short duration seem to be caused by direct elimination of B cells by the injected antibodies. The recovery from suppression of short duration starts, when the injected antibody is eliminated from the organism and is caused by differentiation from stem cells of new B lymphocytes possessing the respective immunoglobulin markers. This mechanism is analogous to that assumed for immunological tolerance in the mathematical model except that the injected monoclonal antibody plays the role of tolerance-inducing antigen. However, satisfactory agreement of simulated values with the experimental ones could not be obtained, if experimentally observed elimination rate of the injected antibody was used for calculations. A better fit was obtained with elimination rate values decreasing with age which do not correspond to the actual ones of the injected antibody. At present, we do not know which mechanism is described by these "virtual" elimination rates. PMID- 3266603 TI - Selection of Plasmodium yoelii nigeriensis resistant to triple drug combination (sulphadoxine/pyrimethamine/mefloquine) and its response to other antimalarials. PMID- 3266605 TI - [Changes in the immune system in long-term carbon tetrachloride poisoning]. PMID- 3266604 TI - A model for the structure and functions of iron-responsive elements. AB - Most eukaryotic cells express two proteins, whose biosynthetic rates are determined by the intracellular iron status. The genes for both these proteins, ferritin and the transferrin receptor (TfR), are regulated at the post transcriptional level, but by entirely different mechanisms. Ferritin mRNA levels are not affected by acute changes in iron availability. Ferritin biosynthesis is regulated translationally via a defined element contained within the 5' untranslated region (UTR) of the ferritin mRNA. This element has been highly conserved during evolution and has been termed an iron-responsive element (IRE). In contrast to ferritin, the regulation of TfR biosynthesis is mirrored by equivalent changes in TfR mRNA levels. The genetic information for this regulation is mostly located in the region of the gene encoding the 3' UTR of the TfR mRNA. Five elements that closely resemble the ferritin IRE are contained within the region which is critical for TfR regulation. The IRE is suggested to function by forming a specific stem-loop structure that interacts with a transacting factor in an iron-dependent fashion. We present a model that accommodates the mediation of distinct post-transcriptional regulatory phenomena via IREs. PMID- 3266607 TI - [Electron microscopic observation on spleen T lymphocyte in animal model of lepromatous leprosy]. PMID- 3266606 TI - [Effect of the nonsteroidal anti-inflammatory drug 480156-S on hepatic drug metabolizing activity and pharmacological action of diazepam and pentobarbital in rats]. AB - Effect of the nonsteroidal anti-inflammatory drug 480156-S on liver drug metabolizing activity was studied in rats, and its effect was compared with that of cimetidine. Cytochrome P-450-dependent 7-alkoxycoumarin O-dealkylase activity was not affected by a single administration of 480156-S, but the activity, especially the O-demethylase but not the O-depropylase, was suppressed dose dependently by multiple administrations. Pretreatment of rats with phenobarbital caused a diminution of the inhibitory action of 480156-S. Treatment of rats with cimetidine resulted in a marked decrease in the activity, although it recovered 24 hr later. After the pretreatment of animals with 480156-S or reference drugs, the pharmacological action of diazepam was determined using muscle relaxation and inhibitions of electroshock-induced convulsion and pentetrazole-induced clonic convulsion as the indicators. Prolonged pharmacological activity of diazepam was observed when liver drug-metabolizing activity was lowered by the pretreatment. On the other hand, pentobarbital-induced anesthesia was prolonged by the pretreatment of rats with cimetidine, but the anesthesia was not modified by the administration of 480156-S. These results suggest the inhibitory action of 480156 S on a specific form(s) of P-450 isozyme. PMID- 3266608 TI - [Accessory effect of mouse B lymphocytes in Con-A response]. PMID- 3266609 TI - Phenotypic heterogeneity of B cell chronic lymphocytic leukaemia. AB - The peripheral blood lymphocytes from 39 patients from the Latvian S.S.R.T., U.S.S.R. with chronic lymphocytic leukaemia (CLL) have been phenotyped with various monoclonal antibodies representing the major clusters of differentiation (CD) used for phenotyping B cells. A clear delineation of two groups of patients was evidenced. The major group (33/39) possessed leukaemic cells bearing surface immunoglobulins (SIg) at a low density, Class II HLA, and CD5, CD24 and CD37 molecules but not CD21, CD22 and CD35. CD23 antigen was seen only once under microscope examination, but could be visualized by flow cytometry. CD6 antibody reacted with cells from about 1/3 of this group of patients. In the six patients of the second group the leukaemic phenotype was SIg+, Class II HLA+, CD5+, 24+, 37+, 21+, 22+, 35+, 23+ and 6-. The main finding is the concomitant expression of CD22, CD21 (CR2) and CD35 (CR1) molecules, all involved in B cell activation. It is not yet known whether these observations correlate with different clinical evolutions of the disease. PMID- 3266610 TI - Local administration of cells containing an inserted IL-2 gene and producing IL-2 inhibits growth of human tumours in nu/nu mice. AB - We have prepared a retroviral expression construct, pPS-IL-2, in which human IL-2 cDNA has been inserted into the polylinker region, and have used the retroviral vector to introduce the functional IL-2 gene into a fibroblast cell line, RAT-1. Peritumoral administration of IL-2-producing RAT-1 cells into congenitally athymic (nu/nu) mice carrying subcutaneous transplants of human carcinoma cells inhibited the growth of the human tumour xenografts. PMID- 3266612 TI - Antibodies to a short synthetic peptide cross-react with human recombinant interleukin 1 alpha. AB - An antiserum to human interleukin 1 alpha has been prepared by immunizing a sheep with a short synthetic peptide (Mr 1427) conjugated to keyhole limpet haemocyanin using the heterobifunctional cross-linking agent N-succinimidyl bromoacetate. The peptide was selected from a highly hydrophilic region corresponding to residues 169-179 of the cDNA-derived sequence. Two additional peptides corresponding to residues 194-207 and 224-233 failed to elicit cross-reacting antibodies. PMID- 3266611 TI - Interaction of tumor necrosis factor and lymphotoxin with model lipid membranes. AB - TNF and LT are two pleiotropic lymphokines produced mainly by activated macrophages and lymphocytes. TNF has recently been shown to damage liposome membranes. Here, we have tested recombinant TNF and LT (rTNF and rLT) on high resistance planar lipid bilayers and assessed changes in transmembrane current. Under the conditions tested (pH range 4.5-8), membrane permeability was not altered by these cytokines alone or in combination with gamma-interferon, in marked contrast to previously published results. Moreover, less than 5% of rTNF and rLT bound to liposomes even under low pH conditions. These results suggest TNF and LT must interact with other cellular factors (perhaps receptors) in order to mediate their activity. PMID- 3266613 TI - Pinocchio cells: morphologically atypical immunologically heterogeneous lymphocytes induced by treatment with interleukin 2. AB - We describe a novel cell type, the Pinocchio cell, that appears in the peripheral blood of all patients receiving treatment with interleukin 2, up to 20,000 cells/microliter. This cell is characterized by a prominent and granular proboscis with which it attaches to tumor cells and mediates tumor cell lysis. Pinocchio cells are immunologically heterogeneous and express antigens of both T and NK cells; Pinocchio cells are adherent in culture and are more cytolytic than non-adherent cells against NK-sensitive and resistant tumor cells. Incubation of normal whole human blood for 1 h induces Pinocchio morphology of mononuclear white blood cells. PMID- 3266614 TI - Gangliosides suppression of murine lymphoproliferation and interleukin 1 production. AB - Studies were carried out to determine whether inhibition of gangliosides on lymphoproliferation was related to interleukin (IL)-1. The results showed that gangliosides, GM1 and GT1b were able to inhibit the proliferation of spleen lymphocytes from C57BL/6J mice in dose-dependent fashion, whereas asialo-GM1 was not inhibitory. However, gangliosides, GM1 and asialo-GM1 did not suppress the production of IL-1 in Salmonella typhosa lipopolysaccharide (LPS)-induced peritoneal adherent cells. Various types of LPS including S. enteritidis, S. minnesota and Escherichia coli 055:B5 were used to stimulate the production of IL 1 in adherent cell cultures. The IL-1 production was not affected by gangliosides, GD1a and GD1b. Although GT1b suppressed IL-1 production of human monocytes to 82% of control level it did not, however, affect the IL-1 production of murine adherent cells. Thus, the inhibitory mechanism of gangliosides on murine immune cells remains unclear, and warrants further study. PMID- 3266615 TI - Functional & phenotypic studies on leukaemic T cells from acute lymphoblastic leukaemia. PMID- 3266616 TI - Infant feeding practices--a survey. PMID- 3266617 TI - Congenital malformations in 2000 consecutive births. PMID- 3266618 TI - Familial, interpersonal, and intrapersonal correlates of drug use: a longitudinal comparison of adolescents in treatment, drug-using adolescents not in treatment, and non-drug-using adolescents. AB - This study examined familial, interpersonal, and intrapersonal factors associated with adolescent drug use from both developmental and etiological perspectives. Retrospective case-control and prospective longitudinal designs were used. A multivariate analysis of variance with repeated measures design was conducted to examine changes over time and differences between groups of adolescents in treatment for alcohol and drug problems, drug-using adolescents not in treatment, and non-drug-using adolescents, on 16 measures of familial, interpersonal, and intrapersonal variables. Significant differences were found between adolescents using drugs (clinical or nonclinical) and those not using drugs and alcohol. No differences were found in any of the variables between clinical adolescents and those using drugs but not in treatment. PMID- 3266619 TI - Permeability to beta-lactams in Bacteroides fragilis. AB - Bacteroides fragilis strains TAL2480 and TAL3636 were used to assess outer membrane permeability to various beta-lactam compounds. These strains were chosen because they possess beta-lactamases capable of hydrolysing all commonly employed beta-lactams except monobactams. The beta-lactamases are located in the periplasmic space and could be released by sonication and osmotic shock. Permeability was calculated by the method of Zimmerman & Rosselet (1977, Antimicrobial Agents and Chemotherapy 12, 368-72). The rank order of permeative ability (from fastest to slowest) was as follows: cephaloridine, imipenem, cefotaxime, cefoxitin, cefoperazone, nitrocefin, cephalothin, and latamoxef. Our results showed that ionic charge, hydrophobicity, and molecular weight influenced beta-lactam drug uptake by B. fragilis. These results are similar to findings for Escherichia coli, where increased negative charge and increased molecular weight are associated with decreased drug uptake. However, unlike E. coli, increased drug hydrophobicity, for a given charge and molecular weight of the drug, was associated with increased uptake by B. fragilis. PMID- 3266620 TI - Inactivation of beta-lactamases from Enterobacter cloacae by monophosphams. AB - Amongst the monocyclic beta-lactam antibiotics, selected monophosphams were potent mechanism-based inactivators of the P99 and E2 cephalosporinases of Enterobacter cloacae. Inhibition of these enzymes was time-dependent with second order rate constants for inactivation of 100,000 to 20,000,000 l/mol/min. After incubation for 24 h at least 99% of the enzymatic activity was inhibited when enzyme was exposed to a ten-fold excess of inactivator. Amongst the monophosphams three classes of inhibitors were seen: irreversible inactivators as described above, transient inactivators and competitive (inhibitory) substrates. PMID- 3266621 TI - In-vitro and in-vivo studies of trimethoprim-sulphamethoxazole against multiple resistant Staphylococcus aureus. AB - Methicillin and gentamicin resistant strains of Staphylococcus aureus (MRSA) remains a cause of significant morbidity and mortality. Vancomycin is usually effective against these strains, but toxicity and expense are significant drawbacks. Resistance to the new quinolones has been demonstrated in vitro and during clinical therapeutic trials. Trimethoprim-sulphamethoxazole has proved to be effective in vitro against staphylococcal strains that are resistant to gentamicin, methicillin, and quinolones. As determined by time-kill kinetic studies, trimethoprim-sulphamethoxazole was rapidly bactericidal. Clinical evaluation of trimethoprim-sulphamethoxazole against MRSA in patients with osteomyelitis is under study. We believe that our data support the use of trimethoprim-sulphamethoxazole as a potentially economical and effective alternative for the treatment of infections caused by MRSA. PMID- 3266622 TI - The reliability of methods for detecting chloramphenicol resistance in Haemophilus influenzae. AB - Eighty-eight strains of Haemophilus influenzae were examined for resistance to chloramphenicol by various techniques. Methods compared were a rapid chemical assay for chloramphenicol acetyltransferase (CAT), an agar dilution minimum inhibitory concentration (MIC) method, disc diffusion tests with 10, 30, and 50 micrograms discs, and a microbiological technique for detecting CAT. Fifty-eight chloramphenicol-sensitive strains had MICs less than or equal to 0.5 mg/l, while 30 resistant strains had MICs greater than or equal to 4 mg/l. The chemical CAT assay clearly distinguished resistant from sensitive strains, was simple to perform and provided results within 30 min. By disc diffusion, the lower the disc content the clearer the distinction between sensitive and resistant populations. Difficulties were encountered in interpretating the microbiological CAT assays as some sensitive strains appeared resistant. The chemical CAT assay is recommended for use when a rapid result is required. Rare chloramphenicol-resistant, CAT negative strains have been described in the USA and these strains would only be detected by a disc diffusion or MIC test. PMID- 3266623 TI - Studies on the physical states of human platelet myosin in crude extracts. AB - The physical properties of human platelet myosin in crude extracts were studied by means of Sepharose 4B gel filtration and sucrose density gradient centrifugation in the presence or absence of Mg-ATP. Platelet myosin extracted with a buffer containing 0-0.15 M KCl gave a Stokes radius of about 12.0-12.5 nm irrespective of the presence or absence of Mg-ATP. The sedimentation coefficients obtained in the presence of Mg-ATP were about 10-11 and 8.5S at 0.05-0.10 and 0.15 M KCl, respectively, whereas the values obtained in the absence of Mg-ATP were about 16, 9-12, and 8.5S at 0.05, 0.10, and 0.15 M KCl, respectively. The apparent molecular weight in the presence of Mg-ATP, therefore, was about 500,000 and 420,000 at 0.05-0.10 and 0.15 M KCl, respectively, while the molecular weight in the absence of Mg-ATP was about 790,000, 460,000-620,000, and 440,000 at 0.05, 0.10, and 0.15 M KCl, respectively. The purified monomeric platelet myosin that had been solubilized with Mg-ATP at 0.10 M KCl had a Stokes radius of about 12.5 nm, a sedimentation coefficient of about 9S, and an apparent molecular weight of 460,000. On the other hand, while crude platelet myosin extracted at 0.6 M KCl with Mg-ATP gave a Stokes radius of about 20 nm, a sedimentation coefficient of about of 6S, and an apparent molecular weight of about 490,000, each of these physical parameters obtained in the absence of Mg-ATP was much larger than that obtained in the presence of Mg-ATP because the myosin was associated with F actin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266625 TI - [The prevalence of dental caries in Provence in 6-15-year-old children]. AB - An epidemiological study of the oral conditions of 771 schoolchildren aged 6 to 15 years was conducted in 5 departments of South of France (Alpes de Haute Provence, Hautes Alpes, Bouches du Rhone, Corse and Vaucluse). The DMFT and DMFS indices were slightly higher than the national means. The children had a mean DMFT of 0.66 at 6 years and 7 at 15 years. The periodontal conditions were relatively good. PMID- 3266624 TI - Inspection of human salivary alpha-amylase action by its transglycosylation action. AB - The course of the action of human salivary alpha-amylase (HSA) on a substrate was examined taking advantage of its transglycosylation action. IG5 phi (IG-G-G-G-G phi), IG4 phi (IG-G-G-G-phi), and GIG4 phi (G-IG-G-G-G-phi) were used as the substrates and p-nitrophenyl alpha-glucoside (GP, G-P) as the acceptor. HSA hydrolyzes IG5 phi, IG4 phi, and GIG4 phi to IG3 (IG-G-G) and G2 phi (G-G-phi), to IG3 and G phi (G-phi), and to GIG3 (G-IG-G-G) and G phi, respectively. In the presence of GP, a part of the glycon residues, IG3 and GIG3, were transferred to the acceptor to give IG4P (IG-G-G-G-P) and GIG4P (G-IG-G-G-G-P), respectively. Whenever the enzyme attacks the substrate, G phi or G2 phi is liberated in both transglycosylation and hydrolysis. The extent of transglycosylation can be, therefore, estimated from the molar ratio of the transfer product to the liberated aglycon, G phi or G2 phi. HPLC analysis of the reaction mixtures revealed that the value of IG4P/G phi in the digest of IG4 phi was nearly equal to that of GIG4P/G phi in the digest of GIG4 phi and these values were ten times larger than that of IG4P/G2 phi in the digest of IG5 phi. These data suggested that G phi residue would fall away from aglycon binding site more rapidly than G2 phi residue after the cleavage of the alpha-1,4-glycosidic linkage to offer GP more chance to attack to the activated glycon and also indicated that the space of the glycon binding site corresponds to three glucose residues. PMID- 3266626 TI - [The oro-dental status of a population of school children in the southeast of France]. AB - This cross-sectional investigation, part of a national epidemiological survey, studied the oral conditions of schoolchildren, aged 6 to 15 years, of the South East of France. This region is mainly urban and the drinking water has a low fluoride content. The highest dft and dfs indices were observed respectively at 6 and 8 years from when they decreased. The DMFT and DMFS indices increased progressively from 6 years on. This study confirmed a North-South difference in caries prevalence since the observed values of the caries indices were similar to those of other mediterranean countries like Greece and Italy. The observed caries indices were higher than the mean indices of France and the rest of Europe. This South East region of France therefore needs special care from the dental profession and the french authorities. PMID- 3266627 TI - [The dental health of the children of Lorraine and Haute-Saone in 1987]. AB - The oral health of a representative sample of 964 schoolchildren aged 6 to 15 years from primary schools and secondary teaching colleges of Lorraine and Haute Saone were examined. The gingival, plaque and calculus indices as well as the DMFT, DMFS, dft and dfs, indices were used. A standardized presentation of the results allowed comparisons with other similar surveys. The DMFT of 12 year old children was 3,82 slightly lower than the national mean value. Comparison of caries indices of permanent teeth according to sex showed girls to have a higher prevalence than boys of similar age. Children from rural zones were more affected by caries than those of urban origin. PMID- 3266628 TI - [Epidemiologic study of dental caries in the school population of the provinces of Ille-et-Vilaine, Eure, Orne, Calvados and Manche]. AB - An epidemiological study of 1,063 schoolchildren aged 6 to 15 years, from the Departments of Ille et Vilaine, Eure, Orne, Calvados and Manche was conducted of dental caries prevalence and incidence according to sex and urban or rural origin of the children. The DMFT index was respectively 0.34, 2.02, 3.85 and 6.51 at the age of 6, 9, 12 and 15 years. The DMFS index was 0.52 at 6 years and 11.32 at 15 years. At the age of 6, 84.5% of the children were free of caries whereas this percentage was only of 5.1% at the age of 15. PMID- 3266629 TI - [Frequency of dental caries in 1987 in western Brittany (Finistere, Morbihan, Cotes du Nord]. AB - An epidemiological study of dental caries prevalence in 711-schoolchildren was conducted in 1987 in three departments of Western Brittany: Finistere, Cotes du Nord and Morbihan. The dft and dfs indices indicated a high caries prevalence in the deciduous dentition. In permanent teeth caries appeared soon after eruption affecting an increasing number of teeth and surfaces with age. Fissure caries were the predominant affected tooth surface. The effects of sex and urban-rural residence on differences in caries prevalence were analysed. The plaque, calculus and gingival indices underline the need for improvement in oral hygiene demonstrating discrete gingival inflammatory changes in children. PMID- 3266630 TI - [Survey of the frequency of dental caries in children 6-15-years of age in the greater central region]. AB - A study of the prevalence of dental caries in schoolchildren aged 6 to 15 years living in of the Center of France showed that the disease appeared soon after eruption with a high prevalence in both the deciduous and permanent teeth. The periodontal condition, studied by the plaque, calculus and gingival indices, showed a moderate degree of inflammation. PMID- 3266631 TI - Direct plasma injection using internal surface reversed-phase high-performance liquid chromatography: feasibility study using propofol as a model compound. PMID- 3266632 TI - Large-scale purification of the chromosomal beta-lactamase from Enterobacter cloacae P99. AB - Homogeneous beta-lactamase (beta-lactam hydrolase, E.C. 3.5.2.6) from Enterobacter cloacae P99, an enzyme that has an important function in antibiotic resistance, was prepared using a single cation-exchange chromatographic step with CM-Sepharose fast-flow. A 6-g amount of the enzyme was isolated from 5 kg of cell paste, with 84% of the enzyme activity in the cell homogenate being recovered by the single cation-exchange step. The specific activity of the beta-lactamase was 587 U/mg protein. The relative molecular mass of the enzyme was determined to be 45 kDa by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulphate and the isoelectric point was 8.95. PMID- 3266633 TI - [The free-radical level in various biochemical fractions in anuran embryogenesis]. PMID- 3266634 TI - [Evaluation of the toxic and allergenic properties of para-aminobenzoic acid]. PMID- 3266635 TI - Prevalence of late-onset 11 beta-hydroxylase deficiency in hirsute patients. AB - Serum levels of 11-deoxycortisol were determined in 182 hirsute women. Three patients presented high basal 11-deoxycortisol levels and an exaggerated response of this steroid to ACTH stimulation. A fourth patient had normal basal 11 deoxycortisol but was hyperresponsive to ACTH stimulation. Therefore diagnosis of late-onset 11 beta-hydroxylase deficiency was made in 4 out of 182 hirsute women with a prevalence of 2.2% in the group studied. In these patients, clinical findings and other hormonal patterns were not different from those of other women suffering from hirsutism. PMID- 3266636 TI - [Immunology in internal medicine. 1. Autoantibodies and diseases]. PMID- 3266638 TI - [Clinical studies of primary Sjogren's syndrome]. PMID- 3266637 TI - [Immunology in internal medicine. 4. Cytokines and diseases]. PMID- 3266639 TI - [Histiocytosis X with cholestasis in an adult developed liver cirrhosis]. PMID- 3266640 TI - [A case of pulmonary infiltration with eosinophilia syndrome with pleural effusion which contained eosinophil chemotactic factor and eosinophil colony stimulating factor]. PMID- 3266641 TI - Prevalence of signs and symptoms of mandibular dysfunction among adults aged 25, 35, 50 and 65 years in Ostrobothnia, Finland. AB - The prevalence of objective signs and subjectively perceived symptoms of mandibular dysfunction were studied in a sample comprising 1600 subjects, 400 each aged 25, 35, 50 and 65 years. Eighty per cent of the subjects were examined clinically. The prevalence figures were higher among the females than among the males, and a slight tendency for higher frequencies of clinical signs was observed with increasing age. In view of the severity of clinical signs preference should be given for a total of 27% of the subjects when considering the need of treatment. The number of remaining teeth in subjects with natural teeth and no additional removable dentures had no marked influence on the prevalence of mandibular dysfunction, but subjects with complete dentures had signs and symptoms of dysfunction more often than those with natural dentition. The sex and age differences can partly be explained by the higher frequency of complete dentures in females than in males and in the older age groups. PMID- 3266642 TI - Sodium and blood pressure: positive associations in a north London population with consideration of the methodological problems of within-population surveys. AB - Blood pressure (BP) and 24-hr urinary sodium (Na) and potassium (K) excretion were measured in 58 men and women aged 40 and above who were selected randomly from the age-sex register of a general practice in North London. All 58 urine collections were reported as complete, but only 28/56 (50%) were classified as 'complete' by the excretion of a biological marker, p-aminobenzoic acid (PABA). Reliability of Na excretion estimated from repeated urine collections was 0.86, indicating that variability of Na excretion within individuals in this middle aged and elderly population was low. Systolic blood pressure (SBP) was significantly related to 24-hr Na excretion and to 24-hr Na/creatinine ratio. After adjustment for age, sex and body mass index, a SBP-Na regression coefficient of 0.091 mmHg/mmol Na (P = 0.02) was observed. On simple regression analysis, a significant association was also found between diastolic blood pressure and Na (P = 0.04). In the sub-group classified as 'complete' collectors by PABA excretion, BP-Na regression coefficients were larger than in analyses of the sample as a whole. BP was not significantly related to K or Na/K. PMID- 3266643 TI - [Evaluation of sunscreens by quantitative analyses of sunburn cell formation]. PMID- 3266644 TI - [Immunoreactive human epidermal growth factor in the bile from patients with hepatobiliary disease]. PMID- 3266645 TI - [Relationship between anti-glycolipid antibodies and alternative complement pathway in pediatric renal glomerular diseases]. PMID- 3266646 TI - [Properties of LAK cell activity and LAK-generation in PBL isolated from patients with renal cell carcinoma]. PMID- 3266648 TI - Magnesium content and concentration of mononuclear and T lymphocyte blood cells. AB - The magnesium content of mononuclear blood cells (MBCs) may be a better indicator of intracellular or total body Mg status than either serum or red blood cell Mg. However, MBCs are a heterogeneous population composed primarily of lymphocytes and monocytes. A significant difference in the Mg concentration or content between lymphocytes and monocytes could alter the results for MBC Mg. We produced monocyte-poor MBCs (MPMBCs) by treating MBCs with carbonyl iron particles. We purified T lymphocytes from MPMBCs [antihuman F(ab)2 monolayer procedure]. The purity of T lymphocytes (T + NK cells) was 98% by flow-cytometric analysis. The mean (+/- SEM) Mg content and concentration of MPMBCs were 61.9 +/- 3.0 fg/cell and 10.6 +/- 0.4 mmol/l, respectively, and of T lymphocytes 60.8 +/- 2.7 fg/cell and 11.8 +/- 0.4 mmol/l, respectively. There was no significant difference in Mg content between MPMBCs and T lymphocytes. The Mg concentration of T lymphocytes was significantly higher (p less than 0.001) than MPMBCs. However, the difference is small and does not justify the increased complexity of the assay for T lymphocytes. We conclude that the cell composition of MBCs may affect the result for Mg concentration. PMID- 3266647 TI - [Use of allopurinol for the protection of the myocardium from ischemia during aortocoronary bypass]. PMID- 3266649 TI - Alpha 1-antitrypsin (alpha 1-proteinase inhibitor) concentration in the patients with neoplastic disease. PMID- 3266650 TI - [Autoimmunity and AIDS. I. Correlation between anti-cardiolipin antibodies and Pneumocystis carinii pneumonia]. PMID- 3266651 TI - [Evaluation of humoral immunity in children with growth hormone deficiency]. PMID- 3266652 TI - [Possible interpretation errors of serum levels of osteocalcin]. PMID- 3266653 TI - [Noradrenaline and interleukin-1 stimulate CRF secretion from human placental cells in culture]. PMID- 3266654 TI - Postinflammatory increase of lymphatic absorption from the peritoneal cavity: role of diaphragmatic stomata. AB - During the healing phase of a chemical peritonitis in rats, absorption of various inocula from the peritoneal cavity into the draining lymph nodes is increased. Heretofore, this phenomenon has been attributed to fibrosis and shrinkage of the greater omentum. The loss of the sequestering function of the omentum allows the inoculum more ready access to the lymphatic vessels in the diaphragm where it is absorbed. In the present work, it is demonstrated that the chemical peritonitis also widens the stomata in the roofs of the diaphragmatic lymphatic lacunes. Both increased access and larger openings contribute to enhanced lymphatic absorption in the postinflammatory state. PMID- 3266655 TI - Expression of T-cell receptor alpha-chain genes in transgenic mice. AB - To examine the influences responsible for shaping the T-cell repertoire in vivo, we have introduced T-cell receptors of defined specificity into mice. In this report, we analyze transgenic mice carrying a T-cell receptor alpha-chain gene from a pigeon cytochrome c-reactive T-cell line. A variant of this construct, which has the immunoglobulin heavy-chain enhancer inserted into the JC intron, was also introduced into mice. Addition of the enhancer increased the steady state level of transgene-encoded mRNA three- to fivefold in cultured T cells, leading to a two- to threefold increase in surface expression. In vivo, the difference between these two constructs was even more significant, increasing the number of transgene-positive cells from approximately 5 to 70% and the T-cell receptor surface density two- to threefold. Surprisingly, while surface expression of either type of transgene was limited to T cells, we found little tissue specificity with respect to transcription. In T cells expressing the alpha chain from the enhancer-containing construct, immunoprecipitation with a 2B4 alpha-specific monoclonal antibody revealed the expected disulfide-linked dimer. Costaining of these T cells with the 2B4 alpha-specific monoclonal antibody versus anti-CD3 indicated that expression of the transgene-encoded alpha chain precludes expression of endogenous alpha chains on the majority of cells; in contrast, 2B4 alpha-chain expression from the construct lacking the enhancer is inefficient at suppressing endogenous alpha-chain expression. In mice of the enhancer lineage, Southern blot analysis indicated suppression of endogenous alpha-chain rearrangements in T-cell populations, consistent with the observed allelic exclusion at the cellular level. Interestingly, newborn, but not adult, mice of this lineage also showed an increase in retention of unrearranged delta chain loci in thymocyte DNA, presumably resulting from the suppression of alpha chain rearrangements. This observation indicates that at least a fraction of alpha:beta-positive T cells have never attempted to produce functional delta rearrangements, thus suggesting that alpha:beta and gamma:delta T cells may be derived from different T-cell compartments (at least during the early phases of T cell differentiation). PMID- 3266656 TI - Species-related differences in the capsaicin-sensitive innervation of the rat and guinea-pig ureter. AB - 1. Comparison of the tissue content of calcitonin gene-related peptide (CGRP) immunoreactivity (IR) and tachykinin (TK)-IR in the rat and guinea-pig ureter showed that in the rat tissue levels of CGRP-IR were 33-fold higher than those of TK-IR. In the guinea-pig ureter, both peptides were present in nearly the same concentration. 2. The in-vitro release of neuropeptides from guinea-pig and rat ureters was investigated using capsaicin as a stimulus for afferent neurons. Capsaicin induced the simultaneous release of CGRP-IR and TK-IR from the guinea pig ureter while in the rat only the release of CGRP-IR was detectable. 3. It is known that TK potently stimulate and CGRP inhibits ureteric smooth muscle contractions. When the effect of capsaicin on ureteric motility was investigated in guinea-pig and rat, only in the guinea-pig ureter a stimulatory action ascribable to capsaicin-induced TK release was observed thus supplementing the results obtained by radioimmunoassay. 4. The results show that considerable species differences exist concerning the ratio of CGRP and TK which is stored and released from ureteric afferent nerve terminals. As a consequence, different functional responses are obtained in both species upon stimulation of these neurons by capsaicin. In the rat ureter, the capsaicin-sensitive innervation seems to be only inhibitory while in the guinea-pig stimulatory and inhibitory transmitters are released. The physiological significance of the simultaneous release of transmitters with opposing effects needs further investigation. PMID- 3266658 TI - [Use of magnetic resonance imaging (MRI) in diagnosis of diseases of the abdominal aorta]. PMID- 3266657 TI - Endothelium-dependent hyperpolarization of smooth muscle cells in rabbit femoral arteries is not mediated by EDRF (nitric oxide). AB - Acetylcholine elicits an endothelium-dependent hyperpolarization of vascular smooth muscle cells. The experiments reported here tested the hypothesis that this hyperpolarization is mediated by the endothelium-derived relaxant factor (EDRF) identified as nitric oxide. Membrane potential was recorded with standard glass microelectrodes in smooth muscle cells in segments of rabbit femoral arteries. In endothelium-intact vessels, smooth muscle cells (resting potential: 67.0 +/- 1.3 mV) hyperpolarized significantly (P less than 0.001) by 5.7 +/- 0.9 mV in response to acetylcholine (1 microM). Inhibition of EDRF, either in the presence of hemoglobin or by pretreatment with gossypol, attenuated the relaxation elicited by acetylcholine in endothelium-intact segments precontracted with 0.1 microM noradrenaline but had no significant effect on either the control membrane potential (-62.2 +/- 1.9 mV and -68.5 +/- 2.1 mV, respectively) or the hyperpolarization in response to acetylcholine (5.0 +/- 1.6 mV and 5.8 +/- 1.6 mV, respectively). In contrast, in vessel segments with the endothelium removed, the hyperpolarization in response to acetylcholine was abolished although the control membrane potential (-68.0 +/- 5.1 mV) was not significantly different from that in endothelium-intact vessels. Sodium nitroprusside, an endothelium dependent vasodilator and exogenous analog of EDRF, also had no significant effect on membrane potential. The lack of response to acetylcholine was not merely the result of nonspecific damage to the smooth muscle cells: vessel segments without endothelium were still able to hyperpolarize in response to various other vasodilators. These results suggest that the endothelium-dependent hyperpolarization of vascular smooth muscle cells in response to acetylcholine is not mediated by EDRF. PMID- 3266659 TI - [Effects of different methods of extracorporeal circulation on intracellular energy, acid-base and water-electrolyte metabolism in patients subjected to aortocoronary bypass]. PMID- 3266660 TI - [Coilocytitoc CIN III in a patient with T-cell lymphoma and HTLV I positive]. PMID- 3266661 TI - [Diagnostic and prognostic significance of the contents of Willebrand factor in Lyell's and Stevens-Johnson syndromes]. PMID- 3266662 TI - Prevalence of epilepsy in schoolchildren of Rome. PMID- 3266663 TI - Urotensin I- and CRF-like peptides in Catostomus commersoni brain and pituitary- HPLC and RIA characterization. AB - Two distinct neuronal systems, containing urotensin I-like immunoreactivity (UI LI) and CRF-LI respectively, have previously been demonstrated immunocytochemically in the brain and pituitary of the teleost Catostomus commersoni. In the present studies, we used HPLC followed by UI- and CRF-RIA to further characterize these UI- and CRF-LI substances. HPLC of Catostomus brain extracts (including extracts modified by dilute H2O2 oxidation or dilute acid cleavage) suggests that the major form of brain UI-LI is very likely identical to the previously characterized urophysial UI; the small amount of pituitary UI-LI is not yet fully characterized. The behavior of brain CRF-LI on reversed phase (RP) extraction suggests that it may exist largely in precursor form. Pituitary CRF-LI, however, behaved as expected for a peptide on RP extraction, and eluted from HPLC as essentially a single (though somewhat broad) peak. The HPLC behavior of pituitary CRF-LI, and its crossreactivity with various CRF antisera, suggest that it represents authentic fish CRF, apparently similar to (but not identical with) human/rat CRF. PMID- 3266664 TI - Intracisternal injection of CRF antagonist blocks surgical stress-induced inhibition of gastric secretion in the rat. AB - The effects of intracisternal injection of CRF antagonist, alpha-CRF 9-41, on the inhibition of gastric acid secretion elicited by intracisternal injection of corticotropin-releasing factor (CRF) and stress were investigated in conscious pylorus-ligated rats. Intracisternal injection of the alpha-helical CRF 9-41 (50 micrograms) did not influence basal gastric secretion, but injected concomitantly with intracisternal CRF (5 micrograms), completely blocked CRF (5 micrograms) induced inhibition of gastric secretory volume, acid concentration and output. Intracisternal injection of alpha-helical CRF 9-41 (3, 10, 50 micrograms) produced a dose-related reversal (0, 52 and 100%) of brain surgery-induced inhibition of gastric acid output. By contrast intravenous injection of CRF antagonist (50 micrograms) did not inhibit gastric hyposecretory response to brain surgery. These data suggest that endogenous CRF in the brain may mediate stress-induced gastric hyposecretion in the rat. PMID- 3266665 TI - Renal hemodynamic response to intrarenal infusion of calcitonin gene-related peptide in dogs. AB - The renal hemodynamic and excretory effects of intrarenal infusions of synthetic beta-human calcitonin gene-related peptide (beta-hCGRP) were examined in normal sodium replete dogs (Group 1, n = 6), in sodium replete dogs pretreated with indomethacin (Group 2, n = 6), and in sodium deplete dogs (Group 3, n = 5). In all groups of anesthetized dogs beta-hCGRP was infused at 5 and 10 ng.kg-1.min-1 for 50 min periods each. In the sodium replete group, beta-hCGRP infusions strikingly increased renal blood flow, but this response was markedly attenuated in the other 2 groups. During beta-hCGRP infusions, the clearance of creatinine also increased significantly in the sodium replete and deplete groups, but not in the indomethacin pretreated animals. No consistent changes in urinary sodium excretion or plasma renin activity were observed with beta-hCGRP infusions in any of the 3 groups of dogs. These results indicate that beta-hCGRP is a potent renal vasodilator and can increase renal blood flow and glomerular filtration. The data also suggest that the renal hemodynamic actions of beta-hCGRP are partially mediated by renal prostaglandins, and that the vasodilatory effects of beta-hCGRP may be antagonized by high circulating levels of endogenous angiotensin II in sodium-volume depletion. Finally, beta-hCGRP does not appear to have significant actions on urinary sodium excretion or plasma renin activity under the experimental conditions of the present study. PMID- 3266666 TI - [Monitoring of methotrexate treatment of children with proliferative diseases of the hematopoietic system]. PMID- 3266667 TI - Drug transport from thin applications of topical dosage forms: development of methodology. AB - There are presently no standards for in vitro research dealing with the release and delivery of drugs from semisolid dosage forms, largely because of inherent experimental difficulties. Among the problems, it has proven difficult to apply dosage forms to membranes mounted in in vitro diffusion cells in facsimile to the manner in which the dosage forms are applied clinically. In the present studies, methodology has been developed which allows films with thicknesses approaching clinical dimensions to be spread evenly over silicone rubber membranes. Using methyl p-aminobenzoate as a test permeant and gelled water and water/propylene glycol solvent systems as test vehicles, it has proven possible to spread films as thin as 75 microns, yielding highly reproducible delivery profiles. Using this application technique, it has been shown how the diffusive clearance of drug from films of fixed composition placed over a resistant membrane is dependent on the thickness of application. For a given medium and thickness of application, when the vehicle composition is enriched in propylene glycol, partitioning into the membrane is suppressed, resulting in a lessening of the absolute rate of delivery and, consequently, a prolongation of the period over which drug is released. Increasing the membrane's resistance, i.e., increasing the membrane's thickness, likewise slows down the absolute delivery rate, extending the effective period of total clearance of drug from the applied film. PMID- 3266668 TI - Alcohol and breast cancer. AB - We examined breast cancer incidence in a cohort of about 69,000 women who answered detailed questions about alcohol consumption from 1979 to 1984. Among women with no prior cancer, breast cancer had developed in 303 by the end of 1984 for an age-adjusted incidence of 1.3/1,000 person years of follow-up. In analysis controlling only for age there was a progressive increase in breast cancer incidence corresponding to each higher level of reported alcohol consumption. In multivariate analyses controlling for age, race, body mass, and smoking, the relative risk at 1-2 drinks/day was 1.5 (95% confidence interval (CI) 1.0-2.3), at 3-5 drinks/day was 1.5 (95% CI 0.8-2.8), and at 6 or more drinks/day was 3.3 (95% CI 1.2-9.3). Past drinkers tended to have been heavier drinkers than current drinkers and had a relative risk of 2.2 (95% CI 1.2-3.9). Study of wine, beer, and liquor use did not suggest that any particular alcoholic beverage was responsible. Significant associations with heavy alcohol consumption were strongest among white and postmenopausal women. This study adds support to the growing evidence that alcohol may be a risk factor for development of breast cancer. PMID- 3266669 TI - [Antibacterial drugs and their tolerance in children with tuberculosis]. PMID- 3266670 TI - Suppression of food intake in rats by fluoxetine: comparison of enantiomers and effects of serotonin antagonists. AB - R- and S-enantiomers of fluoxetine lowered food intake in meal-fed rats and in 2 deoxyglucose-induced hyperphagic rats. In both feeding paradigms, the S enantiomer was slightly more potent. The potency of the two enantiomers of fluoxetine in producing anorectic effects paralleled their potency as inhibitors of 5-hydroxytryptamine (5HT) uptake in vivo. Both enantiomers were selective inhibitors of 5HT uptake in vitro and showed only weak affinity for 5HT-1, 5HT-1A and 5HT-2 receptors or for other receptors in rat brain. The anorectic effect of fluoxetine in meal-fed rats was not reversed by either centrally or peripherally acting 5HT-2 receptor antagonists (ritanserin, LY53857, xylamidine, BW 501C67) or a nonspecific 5HT receptor antagonist, metergoline. However, the serotonergic mechanism involved in the anorexic effect of fluoxetine is discussed. PMID- 3266671 TI - The association between psychopathological aspects and CT measurements in affective disorders. PMID- 3266672 TI - 1H-nuclear magnetic resonance (NMR) spectroscopic study of B lymphocytes stimulated with lipopolysaccharide (LPS). AB - 1H-nuclear magnetic resonance (NMR) spectroscopy was applied to the study of glucose metabolism of B lymphocytes (B cells) activated with lipopolysaccharide (LPS) in a complex medium. The glucose in the medium is degraded to produce lactic acid by B cells activated with LPS to a far larger extent than by non activated cells. PMID- 3266673 TI - Ultrastructural observations on the transectioned end of frog skeletal muscle cells. AB - A progressive "clot" formation has been reported to occur at the transected end of frog skeletal muscle fibers. It has been claimed that the transected fiber end does not form a membrane over the cut surface but ultrastructural evidence for this has not previously been offered. Transmission electron microscopic examination of longitudinal sections through the cut surface confirms the lack of formation of a membrane over the cut fiber ends when followed up to 2 hrs post transection. The data also show a rapid localized contracture of sarcomeres at the cut surface which spreads several sarcomeres away from the cut surface. A temporal loss of sarcomere organization occurs adjacent to the cut muscle surface. PMID- 3266675 TI - [Punctate transcutaneous electrical nerve stimulation in migraine therapy]. AB - Pharmacotherapy of migraine is not satisfying at present, especially in case of frequent attacks of headache. Therefore alternative methods of treatment gain increasing relevance. Based upon many years of experience with specific reflexotherapy and conventional stimulation therapy for treatment of pain we started a clinical study in migraine applying the punctual transcutaneous electrical nerve stimulation (PuTENS) performed with self-made pocket electrostimulators (TRG I-III). The study includes self-treatment of patients at home. After more than 6 months PuTENS was prophylactically effective in 225 out of 282 patients, i.e. in 80% of cases the frequency of attacks and the use of drugs were reduced to at least 50%. In 90 patients treated by the physician the rate of improvement was 86% compared to 76% in 192 patients, which performed self treatment according to the physician's instruction and under medical supervision. 96 out of 160 patients with migraine could alleviate their acute headache by PuTENS applying the pocket electrostimulator at home. In conclusion, PuTENS is superior to drug therapy and conventioned electrotherapy in the treatment of migraine. Its effectiveness is similar to needle acupuncture. The method can therefore be regarded as a valuable alternative and help for patients with frequent headache. PMID- 3266676 TI - Correlation between carcinogenic potency of chemicals in animals and humans. AB - Twenty-three chemicals were selected for comparison of the carcinogenic potencies estimated from epidemiological data to those estimated from animal carcinogenesis bioassays. The chemicals were all those for which reasonably strong evidence of carcinogenicity could be found in humans or animals and for which suitable data could be obtained for quantifying carcinogenic potencies in both humans and animals. Many alternative methods of analyzing the bioassay data were investigated. Almost all of the methods yielded potency estimates that were highly correlated with potencies estimated from epidemiological data; correlations were highly statistically significant (p less than 0.001), with the corresponding correlation coefficients ranging as high as 0.9. These findings provide support for the general use of animal data to evaluate carcinogenic potential in humans and also for the use of animal data to quantify human risk. PMID- 3266674 TI - The kinetics of swelling in muscle exposed to hypertonic glycerol solution. AB - In frog skeleton muscle treated with glycerol, the efflux of the slow potassium fraction is four times faster than the hydration of macromolecules being a little faster than the total swelling process. The slow K fraction is assumed to exist in special salt linkages called intra- and intermolecular K bridges for describing the correlation between the solubilization of proteins and K release. Conformational change involving helix-coil transition and cooperative effects in the K release could produce together the time-lag between the efflux of slow K fraction and swelling of the muscle. PMID- 3266677 TI - [Lethal effect of polychromatic light of near ultraviolet light (325-400 nm) on Haemophilus influenzae Rd and its mutants uvr1 and rec1]. PMID- 3266678 TI - [Incidence of chromosome abnormalities in a population referred for cytogenetic evaluation]. PMID- 3266679 TI - [Neutropenia and granular T lymphocytosis in a patient with Sjogren's syndrome]. PMID- 3266680 TI - [Pneumocystis carinii pneumonia radiologically simulating tuberculosis]. AB - The authors report a case of Pneumocystis carinii pneumonia simulating tuberculosis. Predominant upper lobes involvement is rarely seen but should be considered in immunocompromised patients. PMID- 3266681 TI - Serum level of parathyroid hormone in certain rheumatic diseases. AB - The mechanism of joint destruction in rheumatic diseases is a complex and not fully known phenomenon in which many factors probably take part. The hormones which regulate the bone metabolism may be engaged in this process. In this study the serum level of the parathyroid hormone was correlated with the degree of joint destruction observed in rheumatoid arthritis, ankylosing spondylitis and osteoarthritis. Besides the degree of joint changes (radiologic aspects) the extension of the pathological process and duration of disease were also considered and the serum and urine level of calcium and phosphorus was analyzed. Similar patterns of the parameter investigated were observed in the rheumatic diseases studied and in healthy persons. PMID- 3266682 TI - Bypass blues. PMID- 3266684 TI - [Use of physical agents in the treatment of constipation in children]. PMID- 3266683 TI - Bleeding colonic varices controlled by propranolol. AB - A 64-year-old man with hepatic cirrhosis developed severe haemorrhage from oesophageal varices. He underwent a course of sclerotherapy injections which successfully obliterated the oesophageal varices and prevented further oesophageal bleeding. He later developed serious bleeding from a site in the region of the ascending colon; angiography and radionuclide imaging suggested that varices were present in that region. Therapy with oral propranolol was effective in preventing any recurrence of gastrointestinal bleeding. PMID- 3266685 TI - Cone activation delaying recovery time of rod sensitivity after flash exposure. AB - The recovery time of rods to the fully dark adapted state after flash exposure was psychophysically and electrophysiologically measured. The recovery time increased abruptly once cones were activated. This abrupt increment was not found for the receptor component (P III) of the frog electroretinogram. It was suggested that the cone activation results in inhibitory influence upon the recovery process of the rod sensitivity. PMID- 3266686 TI - Effect of immunoglobulin preparation on course of AIDS-related complex (ARC). AB - Relatively low dose treatment (150 mg/kg, once per two weeks) of a intravenous immunoglobulin (IVI) preparation has shown a beneficial effect on CD4/CD8 ratio and CD4 cell counts in two patients with AIDS-related complex (ARC). Since ARC generally progresses to AIDS with a marked reduction of CD4 cells or a marked inversion of CD4/CD8 ratio, this type of IVI treatment seems to be effective for obstructing or at least delaying the progression from ARC to AIDS. PMID- 3266687 TI - Characterization of the in vitro interaction between thymocytes and a medullary thymic epithelial cell line. AB - T-cell differentiation is known to be mediated by lympho-stromal interactions. However, the precise role of cellular complexes formed during this process is far from clear. We have previously established a thymic medullary epithelial cell line, E-5, and have shown the adherence of thymocytes by a receptor-mediated mechanism. We report here that the thymocytes able of complex-formation with E-5 cells appear at day 16 of gestation. Moreover, while the proportion of such thymocytes is constant throughout post-natal life, their absolute number decreases with thymic involution. We have also investigated the influence of the genetic background of thymocytes on adherence and found that polymorphic regions of H-2 genes were not involved in contact recognition. Therefore, this type of lympho-stromal interactions is unlikely to participate in the education to self MHC-restriction. However, thymocytes from B6/lpr mice, which spontaneously develop systemic lupus erythematosus (SLE) and have impaired T-cell differentiation, were shown incapable of adhering to E-5 cells. These results are interpreted as showing that interaction between thymocytes and medullary epithelial cells reflect a discrete stage of T-cell differentiation. PMID- 3266688 TI - [Molecular weights of the hetero-organic NHCP antigens of kidney origin associated with rat hepatomas]. AB - The narrow NHCP protein fractions, possessing a proper phosphoprotein kinase activity, were isolated from kidney of intact rats, hepatoma tissue and liver cells of rats treated with hepatocarcinogen in the process of phosphocellulose gradient chromatography by elution of 0.4-0.5 M NaCl. The gel filtration on Sephadex G-75 and SDS-PAAG electrophoretic data demonstrate that all the NHCP protein fractions mentioned above include a general molecular component with the mass of 23 kD, and display identical antigenic properties. Thus, in accordance with the data obtained, the role of the hetero-organic NHCP protein antigen of kidney origin associated with hepatoma may be played by the general molecular component of NHCP protein fractions possessing properties of a specific chromosomal phosphoprotein kinase. PMID- 3266689 TI - [Allogeneic lymphocyte induction in vivo of highly active T-killers specific for the molecule of the H-2 class-I complex and the detection of their receptors in vitro]. AB - The optimal conditions are found for in vivo irradiated lymphocyte induction of high cytotoxic T lymphocytes (CTL) specific to the H-2Kb molecule with a subsequent monoculture differentiation. B10.D2(R101) CTL have a pronounced excess as compared to B10.A (4R) CTL, with respect to lysis intensity of the same target cells (TC), and requires a lower term of the monoculture incubation in spite of their specificity to the same H-2Kb molecule. As the susceptibility of TC for CTL lysis is higher (M phi as compared to EL-4 thymoma cells), CTL are much more inactivated with the monoclonal antibodies to Lyt-2 and Lyt-3 antigens without complement. Anti-H-2Kb CTL differentiated in the monoculture cross react to TC bearing third-party H-2 molecules (Kk, Dq, Dk). Unlike a stable CTL adherence to the donor M phi monolayer, nonspecific CTL adherence to the syngeneic M phi monolayer declines in the presence of EGTA, and as a result of repeated detachment of lymphocytes. The findings give rise to study receptor affinity expressed on the in vivo induced CTL surface, the CTL receptor monoclonal antibody and the CTL differentiation factor. PMID- 3266690 TI - [Lymphopoietic characteristics in acute hypobaric hypoxia]. AB - 10 healthy men were examined, that underwent a 48 hours hypobaric (acute) hypoxia in the climate chamber "Tabai", with conditions corresponding to those at an altitude of 4,000 m. The "ascent" and "descent" were performed correspondingly within 30 minutes. Increased share of dying lymphocytes and frequency of chromosomal aberrations in these were found in addition to an elevated activity of nucleolar organizers and to changed morphological patterns of argentophilic nucleoli. T- and B-lymphocyte contents remained unchanged. The role of the lymphopoietic alterations in autoimmune complications and of hemopoietic disorders in the mountains is discussed. PMID- 3266691 TI - [Changes in the cell surface and cytoskeleton of A-431 cells under the action of epidermal growth factor]. AB - Certain changes in human carcinoma A-431 are found by scanning electron microscopy. The early cell response to growth factor (after 10 minutes) involves a disappearance of microvilli, an appearance of ruffles and rounded cells, along with a decrease in cell attachment to the substrate. The cell surface changes correlate with the state of cytoskeleton elements: the material stained with iron hematoxylin is accumulated in ruffle formation sites. Retractional fibrils filled with the cytoskeleton material result from a decrease in the cell area. PMID- 3266692 TI - [Endocytosis and intracellular transport of epidermal growth factor after destruction of the actin cytoskeleton by cytochalasin B]. AB - Endocytosis of the epidermal growth factor (EGF) was investigated in three cell lines--A431, 3T6 and Swiss 3T3--after their incubation with cytochalasin B (CB). CB was introduced into culture medium (10 mkg/ml) 1.5-2 hours before addition of 125I-EGF (20-40 ng/ml). The label uptake rate was measured after a 35-40 minutes incubation of cells with 125I-EGF. It appeared that disorganization of microfilamentous network caused by CB exerted no influence on the binding of EGF to the surface membrane receptors and its internalization. Nevertheless, the experiments performed on A431 cells using a fluorescent label--rhodamine--bound to EGF (EGF-R) indicate that CB, though not influencing the initial steps of endocytosis, inhibits the next step--the intracellular transport of EGF-receptor complexes from the trans-Golgi region to lysosomes. As was shown elsewhere (Barkan, Nikol'sky, 1986), CB inhibits the mitogenic effect of EGF on resting Swiss 3T3 cells. So, the process of EGF-receptor uptake and delivery to the trans Golgi region is evidently not enough to stimulate the cell proliferation; next steps of transport and degradation of ligand-receptor complexes are presumably needed. PMID- 3266693 TI - [Effect of microwaves on the expression by thymocytes of various surface membrane markers]. AB - A study was made of the effects of microwave irradiation of different intensity within decimeter and centimeter ranges in vitro on the guinea-pig thymocyte induced receptor expression to their own and rabbit erythrocytes. Besides, effects of decimeter waves on mice thymocyte-induced expression of Thy-1 antigen were studied. Microwaves were found to modulate the thymocyte-induced expression of the membrane surface markers under study. PMID- 3266694 TI - [Electrostimulation in the combined treatment of patients with facial neuritis]. PMID- 3266695 TI - The metabolism of chlorpromazine N-oxide in the rat. AB - 1. The metabolism of chlorpromazine N-oxide was studied in female rats after a 20 mg/kg single oral dose. 2. Metabolites identified in both urine and faeces were chlorpromazine, 7-hydroxychlorpromazine, chlorpromazine sulphoxide, N desmethylchlorpromazine and N-desmethylchlorpromazine sulphoxide. 3. Metabolites were separated by h.p.l.c. or g.l.c. prior to mass spectrometric analysis. The structures of the metabolites were confirmed by direct comparison of their mass spectra and chromatographic behaviours with those of authentic compounds. 4. Chlorpromazine N-oxide and any metabolite which retained the intact N-oxide function, such as chlorpromazine, N,S-dioxide, could not be identified in any of the extracts. 5. When 3H-chlorpromazine N-oxide was administered under the same conditions; approximately twice as much radioactivity was excreted in the faeces (52.1 +/- 9.7%) as in the urine (26.9 +/- 7.2%). PMID- 3266696 TI - Cardiac surgery at Yonsei University Medical Center--a 30-year review. PMID- 3266697 TI - Sternocostoclavicular hyperostosis. PMID- 3266698 TI - [Proliferative retinopathies in diabetes mellitus--cross sectional study in the Erfurd city and rural district]. AB - Among the 9,173 diabetics of the city and the district of Erfurt (4.3% of the population) 37 patients with a proliferative retinopathy (0.4% of all diabetics) were found. The impairment of vision was very different: 9 patients had still a full vision, 7 patients were completely blind and only able for light perception, respectively. On the group average the 3rd degree retinopathy developed after 19 years of diabetes. In comparison to the type 1 diabetics (n = 17) the type 2 diabetics (n = 15) showed the more progressing courses. The period from the appearance of the first ophthalmologically provable retinal changes (R I) up to R III was in these cases about 5 years shorter than in the type 1 diabetics. The cause for the proliferative retinopathy is multifactorial. Our results plead for the fact that among the risk factors for the retinal microangiopathy apart from the duration of the disease the quality of metabolism and the arterial hypertension are decisive determinants both in type 1 and in type 2 diabetics. In order to avoid and to delay, respectively, severe impairments of vision, from the beginning of diabetes metabolism and blood pressure should be stabilized as well as possible and by means of regular short-term ophthalmoscopic controls well timed light and laser coagulations should be striven for. PMID- 3266699 TI - [What role do intestinal T-lymphocytes play in the pathogenesis of hyperregenerative (sprue-typical) changes in the intestinal mucosa?]. PMID- 3266700 TI - [Experimental and clinical basis of a method for electrostimulation in spinal cord damage]. AB - In order to assess the advantages of spinal cord electrostimulation at the level below its lesion as a therapeutic intervention restoring motor and autonomic function, experiments were performed in 54 cats with spinal lesions at D11-D12 level. Seven patients with cervical and dorsal lesions were clinically investigated. Both in humans and animals electrostimulation of the spinal cord was applied below the lesioned site all the day round for 30 to 40 days. Early electrostimulation proved effective as a means to recover the motor and autonomic functions, though it had some limitations. In severe lesions of the spinal cord, despite its stimulation, muscular atrophy increased with concomitant decrease in the amplitude of the slow wave electrical activity (SWEA) which was due to spontaneous rhythmical micromovements (SRM). Tissue SRM is essential for the normal functioning of any organ. Thus, interventions stimulating muscular SRM are as necessary as the early electrostimulation. PMID- 3266702 TI - [The structure of organs around nephron--the shape of active microcirculatory vessels around nephron]. PMID- 3266701 TI - Remission from insulin dependence induced by continuous subcutaneous insulin infusion (CSII) in type I, newly diagnosed diabetics: role of some hormonal and immunologic factors. AB - Optimal and early control of recent onset, type I diabetes by intensive insulin therapy has been reported to allow insulin withdrawal in about two thirds of subjects treated. We used continuous s.c. insulin infusion (CSII) in the attempt to induce a temporary remission of insulin dependence in 18 newly diagnosed young adult diabetics. After 10 days of optimized glycometabolic control, insulin infusion was stopped and patients were switched to glibenclamide (15 mg/die) plus metformin (1 g/die). Diabetics were considered in remission of insulin dependence when their metabolic control fulfilled the following criteria for at least 3 months: absence of glycosuria, pre- and post-prandial blood glucose less than or equal to 120 and 180 mg/dl, respectively, HbA1c less than or equal to 7%. Insulin therapy could be discontinued for periods of over three months in 11 subjects (61%) and for as long as 18 months in one case. Insulin requirement during CSII was slightly higher in nonremitters (NR) than in remitters (R): 0.36-0.64 vs 0.26 0.41 U/kg/die. After 24 months from CSII, R still showed lower insulin requirement (0.35-0.42 U/kg/die) than NR (0.55-0.75 U/kg/die). Further, the role of some hormonal and immunologic factors was investigated. Plasma C-peptide and glucagon were measured, fasting and 2h after each meal, both on admission and immediately after CSII, when patients were switched to oral therapy. No difference in hormone levels could be detected on admission, whereas, after CSII, mean post-prandial increase of C-peptide over basal was significantly higher in R than in NR (1.18 +/- 0.37 vs 0.22 +/- 0.16 ng/ml, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266703 TI - Staphylococcus aureus and Staphylococcus epidermidis strains differ in interleukin 2 inducing activity. AB - Heat-killed preparations of different Staphylococcus aureus and Staphylococcus epidermidis strains were compared for interleukin 2 (IL-2) inducing activity in cultures of human mononuclear cells (MNC). S. aureus strains exhibited a strong individual variation, but they induced considerably more IL-2 than did S. epidermidis strains. Enterotoxin production, coagulase production, pigment formation and the phage type of the staphylococci showed no strict correlation of any of these properties with the IL-2 inducer activity. The results indicate that the IL-2 inducing activity may be a differential feature of S. aureus and S. epidermidis. PMID- 3266704 TI - [Meatotomy by the retrosigmoid approach to the cerebellopontile angle: an anatomo surgical study]. PMID- 3266705 TI - Functional studies of human secretory leukocyte protease inhibitor. PMID- 3266706 TI - Role of factors derived from activated macrophages in regulation of muscle protein turnover. PMID- 3266708 TI - Elastase-alpha 1-proteinase inhibitor: an early indicator of septicemia and bacterial meningitis in childhood. PMID- 3266707 TI - Neutrophil elastase and cathepsin G: structure, function, and biological control. AB - When neutrophils invade inflamed areas of the body to remove either dead or foreign components they inadvertently release potent enzymes which can, if not properly controlled, cause severe damage to healthy tissue. This can lead to a myriad of diseases including emphysema, rheumatoid arthritis, and glomuerlopnephritis, all of which are really problems of abnormal connective tissue turnover due to uncontrolled protelysis by neutrophil elastase and cathepsin G. An important step in elucidating the functions of both elastase and cathepsin G has been made by virtue of the fact that the amino acid sequence of each has been determined. Furthermore, the crystal structure of one, neutrophil elastase, is now understood. With this knowledge in mind and with the potential for a similar understanding of the mechanism of action of cathepsin G, it should soon be possible to produce synthetic inhibitors of each enzyme which can act as adjunct inhibitors to those naturally circulating in the blood or present in other tissues. As a result there is great hope for reducing the severity of injury produced by these enzymes and, therefore, in decreasing the risk for development of the debilitating diseases associated with abnormal proteolysis by neutrophil proteinases. PMID- 3266709 TI - The T cell specific serine proteinase TSP-1: biochemical characterization, genetic analysis, and functional role. PMID- 3266710 TI - Alpha 1-antitrypsin and alpha 1-antichymotrypsin serum level in relation to staging and postoperative clinical course of human colorectal cancer. PMID- 3266711 TI - Inhibition of human chymotrypsin-like proteases by alpha 1-proteinase inhibitor and alpha 1-antichymotrypsin. PMID- 3266712 TI - [Treatment of advanced cancer of the urinary tract with interleukin-2 (IL-2)]. AB - Eight patients with advanced cancer of the urinary tract were treated with recombinant interleukin-2(IL-2) at our department between December, 1985 and September, 1987. Patients were given 5 x 10(5)-4 x 10(6) units of IL-2 by intravenous drip infusion daily. One of five patients who received IL-2 for over 28 days showed 62% regression in size of hepatic metastasis of bladder cancer on computed tomography and another showed marked improvement of Performance Status. The upward tendency of natural killer and lymphokine-activated killer activity of peripheral blood was observed during treatment. Fever, mental disturbance, hypotension and eosinophilia and others were recognized during administration of IL-2, and cardiac failure and disturbance of renal function were also recognized as severe side effect. PMID- 3266713 TI - [Studies on nephrotoxicity of cyclosporin. II. Nephrotoxicity in rats receiving cyclosporin and sulfamethoxazole-trimethoprim]. AB - A cyclosporin (CS) has a serious nephrotoxic effect which is synergistic with sulfamethoxazole-trimethoprim (ST) on renal allograft recipients. The effects of CS and ST on renal function and structure, were examined biochemically and morphologically in rats. Male Wistar rats each weighing 250 g were given various dose regimens (CS 50 mg/kg + ST 600 mg/kg, CS 25 mg/kg + ST 600 mg/kg, CS 10 mg/kg + ST 600 mg/kg) orally for 21 days, and were killed and examined on the 22nd day. Blood urea nitrogen (BUN), serum and urinary creatinine, and urinary N acetyl-s-D-glucosaminidase (NAG) were measured before administration and on the 7th, 14th and 21st day after administration. The serum levels of CS, sulfamethoxazole (SMX) and trimethoprim (TMP) were measured on the 21st day after administration. Kidneys were examined by light and electron microscopy. All rats that had received 50 mg/kg CS and 600 mg/kg ST died within 9 days after a severe loss in body weight. Rats that had received 25 mg/kg CS and 600 mg/kg ST had lost weight. A high dose CS and ST caused a significant elevation of BUN. The level of serum creatinine was significantly elevated only in rats that had received 25 mg/kg CS and 600 mg/kg ST. Decrease in creatinine clearance was not significant and the urinary NAG activity was not altered significantly during the experimental course. Morphological alterations were confined to the proximal tubuli and they consisted of PAS positive globules, loss of nuclei, tubular cell vacuolation and increased number of lysosomes. However, these alterations were mild and not related to the dose of CS and ST.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266714 TI - An electron microscopic study of the acupuncture or moxibustion stimulated regional skin and lymph node in experimental animals. AB - Ultrastructures of the electro-acupuncture or moxibustion stimulated skin and regional lymph nodes in experimental animals were examined by scanning and transmission electron microscopy. In the scanning electron microscopy, small numbers of infiltrating erythrocytes and lymphocytes were found in the vicinity of the penetrated acupuncture needle in the acupuncture-stimulated skin, whereas moxibustion-treated instances revealed a large number of immunocyte infiltrations in the region. Transmission electron microscopically revealed that immunocytes consisted of lymphocytes, monocytes and some granulocytes and mast cells. In addition, the moxibustion-stimulated regional lymph nodes increased in weight after the stimulation and induced numerous immunocyte influx through afferent lymphatics. The acupuncture-stimulated nodes, however, revealed no remarkable change in the weight and morphology. A functional significance of the acupuncture and moxibustion-stimulated skin and regional nodes was discussed in reference to previous immunohistological descriptions of immune-reacted lymph node of the same animals. PMID- 3266716 TI - [The endogenous diurnal rhythm of specific beta 1-glycoprotein]. PMID- 3266715 TI - Antinuclear autoantibodies in sera of healthy pregnant women and their offspring. AB - The presence of autoantibodies in the fetus has previously been investigated in the offspring of mothers with autoimmune diseases, but not in the offspring of healthy pregnant women. Employing the ELISA method, we examine four SLE associated auto-antibodies (anti-dsDNA, anti-ssDNA, anti-poly(I), and anti cardiolipin) in sera obtained from 196 healthy pregnant women and their offspring. All detected autoantibodies in maternal and blood cord sera were of the IgM isotype. Thirty-four maternal sera (17.3%) were positive for one or more tested autoantibodies: 16 (8.1%) for one autoantibody alone, 17 (8.6%) for two autoantibodies, and one (0.5%) for three autoantibodies; 1.5%, 5.6%, 9.6%, and 10.2% of the maternal sera were positive for autoantibodies against dsDNA, ssDNA, poly(I), and cardiolipin, respectively. In only one blood cord serum sample was an autoantibody (IgM anti-ssDNA) detected. This infant was born to a healthy seronegative mother. The finding that all offspring of IgM seropositive mothers are IgM seronegative is not surprising since maternal IgM autoantibodies do not cross the placenta. The finding of an IgM seropositive infant born to an IgM seronegative mother may indicate that the fetus is capable of self-production of autoantibodies. PMID- 3266717 TI - [Circulating tissue antibodies in healthy pregnant women and in women with EPH gestosis]. PMID- 3266718 TI - A normal phase high-performance liquid chromatography system for steroid 17 alpha hydroxylase/C17-20 lyase (cytochrome P-450 21scc) assays. AB - A normal phase HPLC system has been developed which is applicable to all of the steroid separations involved in the assay of steroid 17 alpha-hydroxylase (EC 1.14.99.9) and C17-20 lyase activities, in both the delta 4 (progesterone) and delta 5 (pregnenolone) pathways. A hexane-tetrahydrofuran (THF) gradient system is used with silica stationary phase and a flow cell radioactivity detector having a high efficiency for tritium. Folch extraction produces uniform extraction of substrates and products from the microsomal incubates, and this uniformity is maintained through HPLC separation and measurement. The hexane-THF mobile phase is convenient for product isolation and substrate purification and should be adaptable to other steroid separations. The system is especially useful for steroid enzyme assays utilizing radiolabeled substrates, since internal standards are not required for measuring recoveries of substrates and products. PMID- 3266719 TI - The analysis of recombinant interleukin-2 by thermospray liquid chromatography mass spectrometry. AB - The complete sequence of recombinant human interleukin-2 expressed in Escherichia coli has been confirmed by thermospray liquid chromatography-mass spectrometry (TS-LC-MS) of a tryptic digest derived from 100 micrograms (7 nmol) of reduced carboxymethylated interleukin-2. The preparation was shown by this method to contain predominantly unprocessed N-terminal initiator Met, with some authentic N terminal Ala; the rest of the protein was as predicted from the DNA sequence, though some deamidated material was noted. TS-LC-MS proved to be a rapid and efficient method for surveying the protein tryptic peptide products allowing all the data to be collected in one chromatographic run; all tryptic fragments were identified by their molecular ions including those for the larger peptides (Mr 1500-3500) which, due to the presence of doubly and triply charged molecular ions, were brought within the mass range of the instrument (1800 Da). It is proposed that TS-LC-MS is a good general method for analyzing recombinant protein digests with respect to sequence confirmation, processing, and post-translational modification, and since each chromatographic peak is identified allows for subsequent monitoring of the protein by LC using uv detection. The method suffers from the disadvantages that all the sample is consumed during the experiment and that no fragment (sequence) ions are generally observed. PMID- 3266720 TI - [The pathogenesis of myocardial infarct after aortocoronary shunting]. PMID- 3266721 TI - [Use of transcutaneous peripheral electrostimulation in anesthesiologic support of surgical operations]. PMID- 3266722 TI - [Rheumatologic manifestations of Lyme disease]. AB - The characteristics of 15 patients with Lyme disease have been retrospectively reviewed; 12 patients had lymphocytic meningitis with mono or polyradiculitis including facial neuritis; 5 patients had mono or oligo-arthritis; 4 patients had inflammatory enthesopathy-like complaints which were the only expression of the disease in 2 of them. All the patients received antibiotic treatment. A dramatic clinical improvement was noted in all patients within four days. A rapid response to treatment seems to be a useful diagnostic criteria which could be added to the recognized ones, i.e., clinical manifestations or significant rise of antibody titres. PMID- 3266723 TI - Early cellular responses to the activation of a mitogenic/oncogenic viral K-RAS protein. PMID- 3266724 TI - Active Ca2+ accumulation in the endoplasmic reticulum of different hepatomas: stimulation by phosphates and Ca2+-releasing effect of IP3. PMID- 3266725 TI - Functional characterization of a potential receptor for growth factor of human B and Reed-Sternberg cells. PMID- 3266726 TI - Membrane structures involved in the proliferation and differentiation of T-cell precursors. PMID- 3266727 TI - CRGF: an autocrine growth factor associated with colorectal carcinomas. PMID- 3266728 TI - Role of beta-lactamase and different testing conditions in oxacillin-borderline susceptible staphylococci. AB - A group of staphylococcal isolates for which oxacillin MICs were intermediate (1 to 4 micrograms/ml) were studied to establish the role of beta-lactamase in this phenomenon. MICs and MBCs of oxacillin and penicillin with and without clavulanic acid or sulbactam (4 or 16 micrograms/ml, respectively) were determined for 11 Staphylococcus aureus and 2 coagulase-negative Staphylococcus isolates for which oxacillin MICs were 1 to 4 micrograms/ml. The susceptibility studies were done with incubation at 35 and 30 degrees C, and the MICs were read at 24 and 48 h. Of the 13 isolates, 4 became resistant when longer incubation or 30 degrees C incubation was used, and the MICs for 9 remained in the intermediate range. Only three of these strains were susceptible to penicillin, and beta-lactamase was not detected. For 6 of 10 beta-lactamase-positive strains, there was a greater-than twofold-dilution reduction in oxacillin MICs with the addition of clavulanic acid or sulbactam. Of the four strains that became resistant with incubation at the lower temperature, a clavulanic acid effect was observed in three but only at 35 degrees C. The oxacillin MIC for one of the beta-lactamase-negative strains was also reduced with clavulanic acid; however, this strain was inhibited by 1 microgram of clavulanic acid per ml alone. Bactericidal activity was observed with two or four times the oxacillin MIC in eight strains tested at both temperatures, and the combination with clavulanic acid was bactericidal at higher than four times the MIC in five of the strains at 30 degrees C. Our results suggest that oxacillin intermediate MICs for staphylococcal isolates are due not only to beta-lactamase hyperproduction but also some other unidentified factor. The reduction in oxacillin MIC observed when clavulanic acid was added to one strain was probably due to the intrinsic inhibitory activity of clavulanic acid. PMID- 3266729 TI - High frequency of antimicrobial resistance in human fecal flora. AB - The frequency of resistance to seven different antimicrobial agents was examined in the aerobic gram-negative gut flora of over 600 individuals from hospitals, from laboratories where antibiotics were used, and from urban and rural communities. In a majority (62.5%) of fecal samples from people without a recent history of taking antibiotics, 10% or more of the total organisms were resistant to at least one of the antibiotics. In about 40% of the samples, resistance to more than one drug was present at this level. More than one-third of the samples contained resistant organisms comprising 50% or more of the total flora examined. Organisms with coresistance to multiple drugs were found frequently. Individuals taking antibiotics produced more samples with a higher proportion (greater than 50%) of resistant bacteria, and these samples also had a significantly greater number of different resistance determinants. This extensive study revealed a high prevalence of resistant bacteria in the gut flora of ambulatory and hospitalized individuals whether or not they were taking antibiotics. PMID- 3266730 TI - Mechanism of action of cephalosporins and resistance caused by decreased affinity for penicillin-binding proteins in Bacteroides fragilis. AB - The susceptibilities of 52 clinical isolates of Bacteroides fragilis to five monoanionic cephalosporins were examined. Cefoperazone showed the highest antibacterial activity, followed by ceftezole, cefazolin, cefamandole, and cephalothin. There were two groups of resistant strains: one group (ca. 15%), of which B. fragilis G-232 was a typical sample, was resistant to ceftezole (MIC, 100 micrograms/ml), cefazolin (MIC, 100 micrograms/ml), and cephalothin (MIC, 200 micrograms/ml) but not cefoperazone (MIC, 6.25 micrograms/ml) or cefamandole (MIC, 25 micrograms/ml). On the basis of studies of stability to beta-lactamase, outer membrane permeation, and affinity for penicillin-binding proteins (PBPs), we conclude that decreased affinity for PBP 3 may play an important role in the resistance to ceftezole, cefazolin, and cephalothin in B. fragilis G-232. Another group (also ca. 15%), of which B. fragilis G-242 was a representative, was resistant to all five cephalosporins (MIC, 100 to 400 micrograms/ml) and produced a high amount of beta-lactamase. Similar broad-spectrum resistance was seen in a mutant of strain G-232 that had a greater-than-30-fold increase in beta-lactamase production. PMID- 3266731 TI - [Conduction disorders after cardiac surgery with extracorporeal circulation]. AB - Two-hundred-fifty-eight patients who had cardiac surgery with extracorporeal circulation were studied to determine the frequency and significance of conduction disturbances. Fifty-eight (34%) developed new postoperative conduction defects. Seventeen patients developed new conduction alterations after coronary artery bypass graft. The most common disturbance was transient bifascicular block (right bundle branch block and anterior subdivision block of the left bundle branch of His) (p less than 0.01). After valvular surgery twenty-one patients developed conduction defects. Of those the most common disturbance was high degree AV block (57%). The authors found no relation between the AV block and the number of valves operated on or type of valvular surgery. After congenital heart surgery, twenty patients developed conduction defects. The most common defect was high degree AV block. The frequency of complete heart block was higher after the closure of atrial septal defects (P less than 0.01). None of the conduction defects were related to the amount of time the patient was exposed to extracorporeal circulation or to postoperative myocardial infarction. All conduction defects were transient except complete heart block in some patients with ventricular septal defect surgery. In this study there were no hemodynamic complications or mortality associated with the conduction disturbances. PMID- 3266733 TI - Interleukin-1 stimulates proteoglycan and hyaluronic acid production by human gingival fibroblasts in vitro. PMID- 3266732 TI - [Strategies for improving the therapeutic patterns used in acute diarrhea in primary medical care units. III. Etiology and clinical picture of the cases studied]. PMID- 3266734 TI - A case of cerebello-pontine angle infarction found by vertebral angiography. AB - A patient was admitted complaining of sudden vertigo. Otoneurological examinations, electronystagmography (ENG), and vertebral angiography (VAG) showed constriction of vertebral artery and anterior inferior cerebellar artery, and basilar artery obstruction. Based on these findings, we diagnosed the case as posterior cranial fossa infarction. Computed tomography (CT) and magnetic resonance imaging (MRI) findings were negative. The authors conclude that VAG should be performed in certain cases of vertigo thought to be of central nervous origin when CT and MRI findings are both negative. PMID- 3266735 TI - ATP-Mg2+ reversal of the salt activation of membrane bound carnitine palmitoyltransferase activities of liver mitochondria. AB - The carnitine palmitoyltransferase (CPT) activities of the outer and the inner membranes of rat liver mitochondria were markedly activated by increase in the ionic strength of the assay medium. ATP at physiological concentrations in the presence of Mg2+ effectively reversed the above effect with octanoyl-CoA, but not with palmitoyl-CoA, as a substrate. Other nucleotides were unable to substitute for ATP. This ATP-Mg2+ effect on the CPT activity was not seen with mitochondria of heart or of skeletal muscles. The remarkable nucleotide, substrate and tissue specificity of these effects indicate that the above phenomenon may be functional in vivo to regulate the ability of liver mitochondria to utilize medium chain fatty acids via the carnitine-dependent route. PMID- 3266737 TI - [Use of cytokines in the therapy of hematologic diseases]. PMID- 3266736 TI - Effects of drugs on aminophylline elimination in rats. AB - Effects of phenobarbital, phenytoin, carbamazepine, cimetidine, erythromycin, combination of sulfamethoxazole + trimethoprim (5:1), and rifampicin (rifampin) on the elimination of aminophylline were examined in female rats. Aminophylline was administered i.p. in a dose of 13.33 mg/kg. Blood samples were collected 0.5, 2, 4 and 7 h after the administration of the injection; one measurement was performed from one blood sample. Plasma aminophylline levels were measured by a modified HPLC method. The elimination half-life of the untreated control group (n = 27) was 4.62 h. The pretreatments with drugs examined were carried out by a gastric tube. The half-life of aminophylline after phenobarbital (10 mg/kg, 7 days, n = 29) was 2.09 h; after phenytoin (10 mg/kg, 7 days, n = 29), 2.47 h; after carbamazepine (400 mg/d, 7 days, n = 25), 2.19 h; after cimetidine (in cimetidine-treated group the blood samples were collected 0.5, 4 and 7 h after the aminophylline injection) (40 mg/kg, 7 days, n = 13), 1.77 h; after erythromycin (800 mg/d, 7 days, n = 28), 2.51 h; after the combination of sulfamethoxazole + trimethoprim in ratio of 5:1 (50 mg/kg, 7 days, n = 23), 2.85 h; and after rifampicin (300 mg/kg, 21 days, n = 23), 2.74 h. Sulfamethoxazole presumably interfered with the HPLC examination of aminophylline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266738 TI - SPECT imaging of the lumbosacral spine and pelvis. AB - This is a prospective comparison of SPECT versus planar imaging of the lumbosacral spine and pelvis, performed in order to assess which technique was more useful in clinical practice. One hundred adults were studied with both techniques, and abnormalities uncovered by either imaging method were graded 1-4 based on the lesion's relative uptake intensity. SPECT imaging significantly improved lesion detection, especially in conditions resulting in only low grade tracer uptake on planar studies. Precision in anatomic localization furthermore improved the quality and usefulness of diagnostic information resulting from SPECT imaging compared to planar examinations. SPECT is recommended for routine imaging of the lumbosacral spine and pelvis in symptomatic patients, especially when planar examinations are normal or equivocal. PMID- 3266739 TI - Improved specificity of prone versus supine thallium SPECT imaging. PMID- 3266741 TI - Effect of cannulation site on the primary determinants of myocardial oxygen consumption during left heart bypass. PMID- 3266740 TI - HLA antigens in palindromic rheumatism. An Italian study. AB - Forty-four patients with typical palindromic rheumatism were typed for HLA-A,B,C and DR antigens. The mean duration of follow-up of our patients was 4.0 yrs. (range 1-12 yrs.). During this time 27% of patients showed a seropositivity; 22% of patients developed polyarthritis, 1 patient revealed a Sjogren syndrome and 3 patients showed a spontaneous improvement. The HLA-B16 antigen was increased in patients compared with controls, but the difference was not statistically significant. A, C and other B antigens were found with normal frequencies. The HLA-DR antigens did not reveal any differences between patients' and controls' values, either 40% of patients who developed RA carried the HLA DR4 antigen. PMID- 3266742 TI - [Diverticulosis of the sigmoid and hemorrhage]. PMID- 3266743 TI - Clinical and microbiological effects of in vivo miocamycin therapy on oral infections and in surgical prophylaxis. AB - Periodontal disease is a chronic irregularly progressing condition, posing many therapeutic problems. Difficulties arise particularly when antibiotic therapy is to be added to mechanical and surgical therapy because, in these cases, pharmacotherapy must be long-lasting. For such reasons the antibiotic of choice must have high activity but low toxicity, in order to avoid side-effects. Antibiotic therapy is also used in both marginal and apical acute phlogistic cases, so that the ideal compound should have high diffusion in gingival tissues and alveolar bone. Miocamycin shows all of these features and it can thus be considered the antibiotic of choice in the therapy of acute periodontal infections and in stomatological surgery. In this clinical study the efficacy of miocamycin has been evaluated in 120 cases of acute periodontal phlogosis and in the treatment of advanced periodontal diseases. Patients were microbiologically monitored for the identification of aerobic and anaerobic bacteria all through the study. In acute cases very good results were obtained, both concerning the reduction of pathological signs (94.1% of the cases) and the occurrence of side effects (10% of the cases). Among the patients who underwent surgical therapy, only 11 out of 80 showed small problems (slight fever and swelling). PMID- 3266744 TI - Myoblast migration specifically inhibited in the chick embryo by grafted CSAT hybridoma cells secreting an anti-integrin antibody. AB - We report a teratological method in which mouse hybridoma cells are grafted into a chick host. CSAT (Cell Substratum ATtachment) hybridoma was used. It produces an antibody directed against the avian integrin complex. The grafts were performed during the second and third days of incubation either at the level of the somites or in the coelom of the chick embryo. The anomalies were revealed by means of a monoclonal antibody that recognizes myogenic cells as soon as they become committed in the myotome. When embryos were grafted at the level of the somites, body wall muscles failed to develop on the side of the graft only. After coelomic grafting, total agenesis of abdominal muscles was induced. The anomalies were specific since the engraftment of three control hybridoma clones induced no change in muscle formation. These control hybridomas produce antibodies directed against the same molecular complex but not against the same epitope as CSAT. The injection of hybridoma cells in an embryo appears as a method of general interest to determine the long-term consequences of perturbing a specific developmental process. PMID- 3266745 TI - Exercise training, cardiac rehabilitation and return to work in patients with coronary artery disease. AB - Few studies have analysed the influence of exercise training or cardiac rehabilitation on return to work in patients with coronary artery disease. In a consecutive series of 41 men less than 60 years of age admitted for acute myocardial infarction, 19 participated in a comprehensive rehabilitation programme focused on physical training, and 22 received standard care. The baseline clinical and social variables of the two groups were comparable except for left ventricular ejection fraction which was significantly lower in the intervention group. Work resumption was not significantly different between the two groups (9/19, 47% in the intervention group vs 17/22, 77% in the control group); after three years, 42% and 73%, respectively, were still employed. These results are in keeping with that of most controlled studies of cardiac rehabilitation after myocardial infarction or coronary artery surgery, which fail to demonstrate a significant improvement in work resumption. Psychosocial factors are probably more important determinants of work resumption than is exercise training. PMID- 3266746 TI - Incidence of silent myocardial ischaemia in patients with cerebral ischaemia. AB - In order to assess the incidence of silent myocardial ischaemia, 190 consecutive patients with cerebral ischaemia and without symptoms or electrocardiographic signs of ischaemic heart disease, underwent a maximal exercise treadmill test. Patients with a positive exercise test were submitted to exercise thallium myocardial scintigraphy. Results were compared with those obtained in a control group of 113 healthy subjects submitted to the same study protocol. An adequate exercise test was obtained in 140 patients with cerebral ischaemia. The exercise test was positive in 36 cases (26%). The end points were exhaustion in 24 patients, ST segment depression greater than or equal to 3 mm in seven and systolic blood pressure greater than or equal to 240 mmHg in five. The exercise thallium myocardial scintigraphy was normal in three and abnormal in 33: reversible perfusion defects were detected in 26 cases and fixed defects in seven. In the control group, matched for age and sex, the exercise test was positive in only seven cases (6%; P less than 0.01); the exercise myocardial scintigraphy was normal in five and abnormal in two subjects. In conclusion, in a remarkable proportion of middle-aged patients with cerebral ischaemia, silent myocardial ischaemia can be detected by means of noninvasive cardiologic investigations. PMID- 3266747 TI - Silent ischaemia following myocardial infarction: frequency, characteristics and prognosis. AB - Pre-discharge exercise tests were performed in 359 survivors of an acute myocardial infarction to determine the frequency, characteristics and prognostic implications of silent ischaemia. Tests were negative in 152 patients (42%), silent ischaemia was observed in 103 (29%) and painful ischaemia in 82 (23%). Heart rates at the development of ischaemia and the final double products were similar in both ischaemic groups but patients with silent ischaemia were able to exercise for longer (13.1 +/- 0.5 min) than those with painful ischaemia (9.3 +/- 0.5 min; P less than 0.0001). The 12 month mortality rose from 2% in patients with a negative test, to 4% in those with silent ischaemia and to 8% in those with painful ischaemia. Re-infarction rates increased similarly across the groups (3%, 8% and 18% respectively). Patients with silent ischaemia subsequently developed angina more frequently (47%) than those with negative tests (16%; P less than 0.001). These results suggest that exercise-induced silent ischaemia following myocardial infarction was common, occurring in 29% of patients. Although the final myocardial oxygen consumption was similar in both ischaemic groups those with silent ischaemia were able to exercise for longer. Finally silent ischaemia conferred an intermediate risk of death or re-infarction and was a strong predictor of subsequent angina pectoris. PMID- 3266748 TI - Four-year prognostic value of exercise-induced angina and painless ST segment depression early after myocardial infarction. AB - The aim of this study was to establish if angina pectoris and silent ST segment depression during pre-discharge exercise tests are predictive of 4 years survival after myocardial infarction. Accordingly, 377 consecutive hospital survivors of myocardial infarction underwent symptom-limited bicycle ergometry at hospital discharge. Sixty-eight patients had angina during exercise, 124 patients had silent ST segment depression and 184 had neither angina nor ST depression. The baseline demographic profile, exercise capacity during ergometry and radionuclide left ventricular ejection fraction were comparable in the three groups. The total mortality within 4 years in the three groups was 15%, 21% and 22%, and mortality due to reinfarction or sudden death was 10%, 17% and 14%. When patients on digitalis were excluded, the incidence of mortality due to reinfarction or sudden death in the group with painless ST segment depression was 11%. Coronary artery bypass grafting or percutaneous transluminal coronary angioplasty due to recurrent symptoms was performed in 41%, 20% and 18% respectively of the three groups. It is concluded that conditional upon modern treatment, including secondary prevention with beta-blockers and revascularization procedures in selected patients with symptoms refractory to medical therapy, exercise-induced angina and painless ST segment depression do not identify a group of patients at higher risk of sudden death or fatal reinfarction during the 4 years after myocardial infarction. PMID- 3266749 TI - Incidence and prognostic significance of asymptomatic ischaemia in patients with sustained ventricular arrhythmias. AB - The role of ischaemia in the natural history of sustained monomorphic ventricular tachycardia not related to acute myocardial infarction is not well documented. We examined 38 patients (mean age 60 years, mean ejection fraction 33%) with programmed electric stimulation and thallium scintigraphy to study the presence of perfusion defects and to assess its prognostic significance. Reversible perfusion defects (RPD), alone or in combination, were seen in 17 patients (44.7%), persistent perfusion defects (PPD) in 31 (81.5%), and RPD and PRD combined existed in 14 patients (37%). Normal scintigrams were obtained in only four patients. Segmental analysis gave a mean 'infarction score' (number of PPDs on a total of 15 segments) of 4.2; the mean 'ischaemia' score (number of RPDs) was 1.2. Recurrence of tachycardia or sudden death was observed in 14 patients during a follow-up of 17 +/- 13 months. The predictive value (PV) of the presence of a RPD for recurrence was 63%, the PV of its absence was 82%; the predictive accuracy was 74% (P = 0.0069). This was as important as the data obtained with the drug studies (+PV 83%; -PV 86%; overall PV 83%, P = 0.002). The mean ischaemia score was 3.3 in the group with recurrence and 2 in the patients without recurrence. As pharmacological studies are only feasible in a subgroup with inducible tachycardia, thallium scintigraphy is of benefit to a larger group for predicting effective drug therapy and the risk of recurrence. PMID- 3266750 TI - ST segment monitoring before, three weeks and six months after aortocoronary bypass surgery. AB - ST segment monitoring by Holter ECG was conducted in 80 consecutive patients 2-4 weeks before aortocoronary bypass surgery and three weeks and six months after surgery. Preoperatively, all patients were under maximal medical therapy. In 31 out of 80 patients medical therapy could be stopped and thus 24-h ST monitoring could also be conducted without medication. Preoperative and early postoperative (three weeks) examinations were performed under hospital conditions. At 6 months after surgery the patients were monitored at home during their everyday activities. Twenty-eight per cent of patients waiting for aortocoronary bypass surgery under full medication showed transient ischaemic episodes in 24-h Holter ECG. Seventy-eight per cent of these episodes were asymptomatic. Without medication, 55% of patients had transient ischaemia. The exercise ECG data partly predicted the Holter ECG data. Patients with ST segment depression greater than 0.1 mV during exercise ECG had on Holter monitoring more and longer lasting ischaemic episodes than those with ST segment depression less than or equal to 0.1 mV. In patients with asymptomatic ST segment depression during exercise ECG the relation of silent episodes to symptomatic episodes on Holter monitoring was 5.3:1 while in patients with symptomatic ST segment depression during exercise ECG this relation was 2.3:1. Three weeks after operation the informative value of the Holter ECG was very restricted due to changes in the resting ECG caused by the operation and because patients do not exert themselves much at this time. Six months after surgery, Holter ECG is more informative, especially when conducted at home.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266751 TI - [Detection of interleukin-2 and growth factor activity of B-lymphocytes of the cerebrospinal fluid in patients with various lesions of the central nervous system]. PMID- 3266752 TI - Cloning, characterisation and regulation of an alpha-amylase gene from Streptomyces venezuelae. AB - The alpha-amylase gene (aml) of Streptomyces venezuelae ATCC15068 was cloned in Streptomyces lividans TK24 using the plasmid vector pIJ702. Sub-cloning and exonuclease III deletion experiments localised the sequences required for alpha amylase production to a segment of 2.05 kb. Low-resolution nuclease S1 mapping revealed a aml transcript of approx. 1.7 kb, and the extracellular form of alpha amylase was estimated by SDS-polyacrylamide gel electrophoresis to be 59 kDa, suggesting that aml mRNA is monocistronic. The nucleotide sequence of aml was determined and high-resolution nuclease S1 mapping experiments identified transcripts that appeared to initiate at a promoter identical to that of the alpha-amylase gene of Streptomyces limosus [Long et al., J. Bacteriol. 169 (1987) 5745-5754]. Transcription of aml in S. venezuelae, and of the cloned gene in Streptomyces coelicolor A3(2), was induced by maltose and repressed by glucose. Glucose repression in S. coelicolor A3(2) depended on a functional glucose kinase gene. The predicted amino acid sequence of the extracellular enzyme was very similar (75% identity) to the alpha-amylase of S. limosus and shared with this enzyme a strong susceptibility to tendamistat, a potent inhibitor of mammalian alpha-amylases. Sequence inspection revealed a putative signal sequence of 28 amino acids that preceded the probable signal peptidase cleavage site. PMID- 3266753 TI - Alpha-1-antitrypsin and transferrin null alleles in the Portuguese population. AB - In a Portuguese family, a null allele was found in the Pi system. An apparent 'exclusion' of the mother was found to be due to the presence of null alleles in mother and child. A transferrin (Tf) null allele was found in a case of disputed paternity. The mother and putative father were heterozygous for Tf null alleles and the child was homozygous (TfQ0) and presented hypotransferrinemia. PMID- 3266755 TI - [Molecular genetic analysis of steroid 21-hydroxylase (P-450(C21)) deficiency]. PMID- 3266754 TI - The effect of a calf thymus acid lysate on bone marrow cell growth in vitro. AB - Granulocyte-macrophage colony forming units (CFU-GM) were studied in cultures of bone marrow from 16 apparently healthy normal controls, 9 patients with the myelodysplastic syndrome, 5 patients with myeloproliferative disease and 2 with myeloma. Supernatants from non-stimulated 72 hr cultures of nonadherent mononuclear blood cells ("lymphocytes") stimulated the forming of an average of 38.4 colonies per 100,000 cells from normal marrow. The addition of GIBCO's commercial conditioned medium or of a medium produced by lymphocytes stimulated with different concentrations (5, 10 and 20 mcg/ml) of an acid lysate of thymus (thymomoduline), increased growth to 65.2 - 55.4 colonies (p less than 0.001 to 0.05). Similarly, a significant increase (p less than 0.05) was found in the number of clusters and colonies formed in cultures of marrow from patients with the myelodysplastic syndrome. In contrast, no growth was found when the thymus acid lysate was added directly to the bone marrow cultures, suggesting that the lysate induces the production of colony stimulating activity by lymphocytes, but does not contain it. Similarly no significant increase was found as regards the initially high number of colonies from the five patients with myeloproliferative disease, or as regards the initially low number in the two myeloma patients. PMID- 3266756 TI - H-2 restriction: should we have known it earlier? PMID- 3266757 TI - Radiological and neurological changes in the drug abuse patient: a study with MRI. AB - Chronic abuse of drugs may lead to pathological changes within the nervous system. In this article we present the neurological and Magnetic Resonance Imaging (MRI) findings in a group of seven drug abuse patients. The MRI for three of the patients showed areas of demyelination in white matter. Of the four patients with normal MRI, two showed seventh nerve paresis, one showed abnormal cerebral blood flow when measured with Positron Emission Tomography and one patient had no evidence of neurological impairment. We hypothesize that some of the neurologic and psychiatric complications of drug abuse may be due to its effects on the cerebral circulation. PMID- 3266758 TI - [Colony promoting activity in porcine kidney extract]. PMID- 3266759 TI - [Anti-inflammatory, analgesic, antipyretic and gastrointestinal ulcerogenic activities of metabolites of bermoprofen (AD-1590), a non-steroidal anti inflammatory agent]. PMID- 3266760 TI - Interleukin 2 production, proliferative response, and receptor expression by cord blood mononuclear cells. AB - To analyze the elements of the interleukin 2 (IL-2) system in newborns, the proliferative responsiveness to, production of, and expression of cell surface receptors for IL-2 were quantitated in cord blood mononuclear cells (CBMC) from 25 normal, full-term newborns and were compared to results in peripheral blood mononuclear cells (PBMC) from 15 juveniles and 28 adults in order to examine the IL-2 system as a function of age. Proliferative responsiveness of purified cord blood T lymphocytes to a saturating amount of human, recombinant IL-2 was significantly greater (p less than 0.05) than that of T lymphocytes from juveniles or adults at all three cell concentrations used. Similarly, phytohemagglutinin (PHA)--induced IL-2 production by CBMC was significantly greater (p less than 0.05) than that produced by PBMC from juveniles or adults with a mean value of 20.3U/ml compared to 11.1U/ml and 11.2U/ml for juveniles and adults, respectively. However, the proportion of CBMC and PBMC from juveniles expressing cell-surface IL-2 receptors (IL-2R) following PHA stimulation was equivalent. These results indicate a significantly enhanced proliferative responsiveness to, and production of, IL-2, but equivalent IL-2R expression, by cord blood T lymphocytes as compared to normal children and adults demonstrating that full-term newborns possess a fully competent IL-2 system at birth. PMID- 3266761 TI - Local xenogeneic graft-versus-host reaction: a measure of T-cell function in asymptomatic HBsAg carriers. AB - The local xenogeneic graft-versus-host reaction was used as a bioassay to assess T lymphocyte function in 31 asymptomatic HBsAg carriers and 40 healthy controls. Positive local gvh reaction was found in all normal subjects and in only 12 of the carriers tested. Analysis of persistence of HBsAg positivity demonstrated that patients with protracted carrier state (1-5.5 years) mostly exhibited negative local gvh reaction. Controversely, patients with a short duration of carrier state (6-12 months) showed positive local gvh reaction, similar to the range of the healthy subjects. Also, no correlation was observed between the magnitude of local gvh reaction and T-rosette percentage. PMID- 3266762 TI - Effect of cortisol on the native and in vitro induced non-MHC restricted cytotoxicity of large granular lymphocytes. AB - Natural Killer (NK) activity has been shown to be depressed under stressful conditions. Glucocorticoids, which are known to increase during stress, seem to negatively regulate the activity of NK cells. In the present study we have explored the effect of cortisol (hydrocortisone, HC) on NK activity. A significant inhibitory effect could be observed as early as 6 hr after the addition of HC at the concentration of 0.5 microM, corresponding to the upper physiological circulating level. Both the lysis and the binding of the K562 target cells were affected by HC, indicating that the hormone acts on the target recognition phase. The HC-mediated inhibition of the NK activity was fully reversed after 6 hr incubation in a HC-free medium. The observation of comparable levels of NK-inhibition using unseparated PBL or purified LGL, show that HC acts directly on LGL to inhibit their cytotoxic function. The effect of HC on the responsiveness of NK cells to the modifiers beta-interferon (beta-IFN) and recombinant interleukin 2 (rIL2) was also studied. Pre-incubation with HC did not alter the enhancement of the activity induced by beta-IFN, demonstrating that the HC- and beta-IFN-mediated effects occur in separate NK subsets. By contrast the increase of NK cytotoxicity induced by rIL2 was lower in the HC-treated compared to the untreated cell cultures (35.8 +/- 6.2 and 20.7 +/- 4.3% respectively, p less than 0.05) which could indicate that a portion of the cells triggered by rIL2 belong to the HC-sensitive NK subpopulation. PMID- 3266764 TI - [Reactivity of monoclonal antibodies LN-1 and LN-2 in non-Hodgkin's lymphoma]. PMID- 3266763 TI - [Phenotypes of leukemic cells from chronic B cell leukemia and their proliferative responses to several kinds of mitogens or lymphokines: PHA or phorbol ester (TPA) induces a high responsibility to B cell growth factor (BCGF) in the leukemic cells]. PMID- 3266765 TI - [Age-associated changes in immune functions]. PMID- 3266766 TI - [Expression of ras gene product p21 in human lung adenocarcinoma]. PMID- 3266768 TI - The clinical efficacy of intratumoral OK-432 administration in advanced cancer patients. AB - The clinical efficacy of intratumoral (IT) OK-432 immunotherapy in advanced cancer patients was investigated. Furthermore, the infiltration of lymphocyte subsets into the tumor tissues after the IT administration of OK-432 was also immunohistologically examined in order to analyze the mechanism of action of OK 432 immunotherapy. Forty-four patients with advanced cancer were treated with IT OK-432 immunotherapy. Ten KE (1 mg) of OK-432 was given either daily or on every second day and repeated as often as possible, the mean frequency of OK-432 injections being 18.1 +/- 14.5 times, ranging between 5 and 25 administrations. Thirty-one of the 44 patients were evaluable, 3 of whom (9.7 per cent) developed a partial response and 5 (16.1 per cent) a minor response. Intratumoral OK-432 immunotherapy, however, did not necessarily prolong the survival time. Leu 1, 3 and 7 reactive cells infiltrated into the tumor tissues treated by OK-432 injection, more frequently, when compared with cells which had been treated by recombinant TNF injection. Thus, it was suggested that IT OK-432 immunotherapy might be effective for the local control of tumor growth through the host mediated action, and that, in combination with systemic therapy, may enhance the clinical effects and prolong the survival time in advanced cancer patients. PMID- 3266767 TI - Urine human epidermal growth factor (hEGF) levels following surgery. AB - In order to investigate the contribution of growth factors in conditions of postoperative stress, we measured the blood and urine hEGF levels in patients with various surgical disorders. While the levels of serum and plasma hEGF did not change significantly after surgery, urine hEGF (u-hEGF) stayed at the base level followed by a single peak within a postoperative period of two weeks. The peak day of u-hEGF in patients with more than 1000 ml of intraoperative bleeding was later than that in patients with bleeding of less than 1000 ml. In patients with postoperative renal failure or dysfunction, u-hEGF levels dropped and did not rise until the recovery of renal function. The changing pattern of u-hEGF levels was an indicator of operative bleeding volume and renal function. PMID- 3266769 TI - [The effect of angiotensin II on the accessory function of BALF macrophages in the cases of sarcoidosis of long duration]. PMID- 3266770 TI - [Lung perfusion scintigraphy with 99mTc-MAA in 46 patients with chronic airway disease]. PMID- 3266771 TI - [Evaluation of the elastase/alpha 1-antitrypsin balance in normal smokers using bronchoalveolar lavage]. PMID- 3266773 TI - Exocrine pancreatic function in diabetic dogs. PMID- 3266774 TI - [Treatment of herpes simplex keratitis by local hyperthermia]. PMID- 3266772 TI - [LAK (lymphokine activated killer) cells induced from peripheral blood lymphocytes in patients with bladder tumors]. PMID- 3266775 TI - [Long-term observation of the optic disk pit]. PMID- 3266777 TI - Effect of plant polysaccharides on T and B lymphocytes in tumor transplanted mice irradiated by X-ray. PMID- 3266776 TI - Electroimpulse acupuncture treatment of 110 cases of abdominal pain as a sequela of abdominal surgery. PMID- 3266778 TI - Electric stimulation of acupoints in alleviating hemogram abnormality due to cyclophosphamide injection in animals. PMID- 3266779 TI - Epidemiological study of leprosy in Malwani suburb of Bombay. PMID- 3266780 TI - The Lepra Evaluation Project (LEP), an epidemiological study of leprosy in northern Malawi. II: Prevalence rates. PMID- 3266781 TI - Incidence and etiology of aplastic anemia in a defined population of Argentina (1966-1977). PMID- 3266782 TI - [The prevalence of hypertension in La Plata]. PMID- 3266783 TI - [Upper digestive hemorrhage: the Mallory-Weiss syndrome]. PMID- 3266784 TI - [Characteristics of bone regeneration after osteosynthesis using electrets]. PMID- 3266785 TI - [Value of quinolones in ophthalmology. Rational approach to systemic treatment of bacterial endophthalmitis]. PMID- 3266787 TI - Primary non-epithelial tumours of the small intestine presenting with gastrointestinal bleeding. PMID- 3266786 TI - [Specific immunologic treatment of uveitis associated with the HLA-B27 group in ankylosing spondylarthritis]. PMID- 3266788 TI - [The role of HLA-B27 in chronic juvenile arthritis and ankylosing spondylitis in children]. PMID- 3266789 TI - [Juvenile chronic arthritis with initial involvement of few joints in the light of our observations]. PMID- 3266790 TI - Correlation between the levels of antinuclear antibodies, anti-DNA antibodies, and complement in systemic lupus erythematosus. AB - Antinuclear antibody (ANA) titres, anti-native DNA levels, serum haemolytic complement (CH50), and complement components C3 and C4 were determined in 550 serum samples taken from patients with active (311 samples) or inactive (239) systemic lupus erythematosus (SLE). Increased anti-DNA levels were shown in 82% of the samples from patients with active and in 57.8% of those from inactive, disease. Decreased levels of CH50, and C3, C4 were found in 37, 50, and 80% of the samples taken from active and in 22, 29, and 67% of those from inactive, disease, respectively. Positive ANA test was found in 94.7% of the patients with active and 87.9% of those with inactive, disease. Significant differences were found between the two groups for all parameters. The correlations were close between the values of anti-DNA antibodies and CH50, as well as between the levels of CH50 and C3. Relationship between anti-DNA antibodies and C3 levels, as well as between CH50 and C4 levels was also demonstrated. Six subgroups for expressing the positivity of five parameters, 32 patterns of positive parameters were found and their possible application were suggested. In combining these parameters and using appropriate patterns, their determination may be helpful not only for the diagnosis but also for the assessment of disease activity. PMID- 3266791 TI - Influence of long-term treatment with hydrazinophthalazines on the activity of lysosomal exoglycosidases in rat tissues. AB - Serum antinuclear antibodies were induced in rats by treatment with hydralazine or todralazine, given in daily dose of 25 mg/kg of body wt. for 12 months. An increased activity of alpha-glucosidase, beta-glucosidase, beta-galactosidase, alpha-fucosidase, beta-xylosidase was found in heart muscle, liver, kidney and lung. Hydralazine produced a more significant increase in the enzyme activity than todralazine. The obtained results suggest drug-induced connective tissue damage, probably of an inflammatory type. The mechanism of this phenomenon and its relationship to immunological alterations remain unclear. PMID- 3266793 TI - [Problem-oriented medical documentation]. PMID- 3266792 TI - Epidermal growth factor receptors in the canine antrum. AB - In this study we localized receptor binding sites for 125I-human epidermal growth factor (hEGF) in the antrum of the adult canine stomach. High levels of specific 125I-hEGF binding sites were observed over the mucosa and muscularis mucosa, whereas specific binding sites were not detectable over the submucosa, external circular and longitudinal muscle or myenteric neurons. These results are in agreement with previous studies which indicated that EGF stimulates the proliferation of cultured epithelial cells and inhibits gastric acid secretion. This suggests that EGF may be a useful therapeutic agent in the healing of gastric ulcers. PMID- 3266794 TI - Physical stability of a recombinant alpha 1-antitrypsin injection. AB - Physical stability of a recombinant alpha 1-antitrypsin (rAAT) injection solution, namely, loss of rAAT to particulate formation was studied. The rAAT injection solution (1.0 mg/ml, pH 7.5, triple buffer of phosphate, Tris, and glycine, 0.075 M each) was filtered through a 0.2-micron filter and packaged in individual vials with rubber stoppers and aluminum seals. The vials were stored at 90, 80, 60, 45, 35, and 25 degrees C, and samples taken at predetermined time intervals for each storage condition. Each sample was then filtered through a 0.2 micron filter to remove particulates. The filtrate was then assayed for total protein by the biuret-phenol method. A typical first-order loss of rAAT was observed. Data were fitted to a first-order kinetics, and the shelf life (defined as t90, the time for the product to reach 90% remaining) was calculated from the resultant rate constant. The shelf lives were plotted against reciprocals of storage temperatures (a modified Arrhenius plot). A linear regression line (r = 0.9831) was drawn through the data points and extrapolated to 4 degrees C. At 4 degrees C, the predicted shelf life of the rAAT solution is 5.1 months. In real life, a batch of the rAAT solution showed that 61% of the rAAT remained in the filtrate after 18 months of storage at 4 degrees C. The observed stability compares fairly well with the predicted value of 69% for the same duration of storage at 4 degrees C. From the slope of the linear regression line, the activation energy for the particulate formation of the rAAT was calculated to be 19 kcal. This value is comparable to the activation energy of 20 kcal for ovalbumin denaturation reaction reported by Simpson and Kauzmann. PMID- 3266795 TI - Percutaneous absorption of nicardipine and ketorolac in rhesus monkeys. AB - Vehicle effects on the percutaneous absorption of nicardipine base, nicardipine hydrochloride, ketorolac acid, and ketorolac tromethamine were determined using the rhesus monkey as an in vivo model for human skin penetration. Vehicles investigated included blends of propylene glycol, trimethylene glycol, ethanol, Azone, Tween 20, water, and long-chain fatty acids. Formulations were prepared such that the compound dose, application area, and percentage saturation of the compound in the vehicle were held constant. Variations in absorption of the compounds were therefore attributable to vehicle effects. Each formulation was applied to three monkeys for a period of 24 hr using 10 Hill Top Chambers. Plasma samples were taken at appropriate intervals for 36 to 48 hr. The results indicated that trimethylene glycol and Tween 20 did not enhance absorption of the test compounds despite claims by other investigators. Azone and ethanol provided moderate enhancement of both the rate and the extent of absorption, while long chain fatty acids in combination with propylene glycol significantly enhanced penetration. In general, higher fluxes were observed with the more lipophilic compounds nicardipine base and ketorolac acid as compared to the hydrochloride and tromethamine salts. PMID- 3266796 TI - An epidemiological comparative study of hypertension and its risk factors in 10 populations of China--a report of the baseline phase. PMID- 3266797 TI - Anti-inflammatory and peripheral analgesic activity of esculetin in vivo. AB - Esculetin determined a reduction in oedema and granulocyte infiltration in the Croton oil ear test in vivo. The drug was able to inhibit Acethylcholine-writhing test and showed a LD50 of 1450 mg/kg i.p. and greater than 2000 mg/kg by mouth. In our experimental conditions, esculetin has an anti-inflammatory and analgesic effect. PMID- 3266798 TI - [The prevention of thromboembolic disease by physical means. Use of an external electric stimulator. Initial results obtained during hip surgery]. AB - The authors report their preliminary results using an external electric stimulator in hip surgery. One group received electric stimulation and the control group did not. There were 75 patients in each group and each patient underwent a total hip replacement. In the non-stimulated group, there were 15 DVT's (20%) and in the stimulated group 3 (4%). These results are discussed. PMID- 3266799 TI - Retinal transplants into adult eyes affected by phototoxic retinopathy. PMID- 3266800 TI - Enhancement of adult dorsal root regeneration by embryonic spinal cord transplants. PMID- 3266801 TI - A phenotypic analysis of T lymphocytes isolated from the brains of mice with allogeneic neural transplants. PMID- 3266802 TI - Fetal dopamine neural grafts: extended reversal of methylphenyltetrahydropyridine induced parkinsonism in monkeys. PMID- 3266804 TI - [Lymphokine and hemopoietic cell differentiation]. PMID- 3266803 TI - Recovery of dopaminergic fibers in striatum of the 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine-treated mouse is enhanced by grafts of adrenal medulla. PMID- 3266805 TI - [Establishment of mouse cell lines which constitutively secrete large quantities of interleukin 2, 3, 4 or 5, using high-copy cDNA expression vectors]. PMID- 3266806 TI - [Correlations between arterial hypertension and the social situation of the population of Ochota 1978-1984. I. Analysis of single variables]. PMID- 3266807 TI - [Correlations between arterial hypertension and the social situation of the population of Ochota 1978-1984. II. Results of multivariate analysis]. PMID- 3266808 TI - [Search for specific factors in culture media of embryos]. AB - Mitogenic activity of culture media having contained either unfertilized or cleaved embryos have been studied. In these media human eggs have been cultured for one day, beginning 20 hours following in vitro insemination. B-lymphocyte proliferation was estimated by thymidine incorporation following 3 day culture in the presence of eggs or embryo culture media. No reproducible effect on B lymphocyte proliferation was observed. Therefore the viability of embryos could not be ascertained by the mitogenic activity of their culture media. PMID- 3266809 TI - Somatosensory evoked potentials and peripheral nerve conduction velocities in patients on long-term carbamazepine therapy. AB - The motor and sensory conduction velocities were measured, and the somatosensory evoked potentials were recorded on median nerve stimulation in 20 epileptics on long-term carbamazepine therapy. The plasma drug levels were monitored and found to be consistently within therapeutic range. The electrophysiological study showed that the motor and sensory conduction velocities in the lower limbs were significantly lower than in age-and sex-matched controls, while no significant variation was found in the somato-sensory evoked potentials. There was no correlation between the neurophysiological data and any of the pharmacological data, such as duration of treatment, plasma levels and dose of drug per Kg of bodyweight per day. PMID- 3266810 TI - In vivo induction of malignant transformation of nude mouse B lymphocytes by a human multiple myeloma. AB - The bone marrow puncture fluid of human multiple myeloma was inoculated subcutaneously in BALB/C/nu nude mice. After passage of the xenograft from nude mice in vitro, a murine malignant lymphosarcoma cell line was unexpectedly established, which was named NLB-SK. The murine NLB-SK cell line has been cultivated in vitro over 72 passages for 10 months. Repeated cryopreservation showed that the murine NLB-SK cell line revived satisfactorily. Based on cell biological characteristics the malignant transformation might be attributed to horizontal oncogenesis between human malignant tumor cells and nude mouse normal somatic cells. PMID- 3266811 TI - [Bronchial asthma combined with a congenital deficiency of alpha 1-proteinase inhibitor]. AB - Some data on the determination of proteinase alpha 1-inhibitor phenotypes in children and adults with chronic non-specific pulmonary diseases were described. In pediatric patients the frequency of detection of heterozygotes PI MZ, PI MS did not exceed that in a healthy population whereas in adult patients heterozygotes were detected twice as more frequently. Among 149 adult patients one case of PI ZZ and one case of PI SS were detected. A patient with bronchial asthma had the MI ZZ phenotype. A possible frequency of the prevalence of PI ZZ phenotypes in a population and appropriateness of determination of blood levels and phenotypes of proteinase alpha 1-inhibitor in patients with bronchial asthma and other chronic nonspecific pulmonary diseases were considered. PMID- 3266813 TI - [Exocrine function of the pancreas in patients with ulcerative colitis]. PMID- 3266814 TI - [Vestibular hyperactivity in patients with damaged cerebellar hemispheres]. PMID- 3266812 TI - Pulmonary disease at autopsy in patients with the acquired immunodeficiency syndrome. AB - To characterize the postmortem pulmonary disease and analyze the effectiveness of antemortem diagnosis, we examined the clinical records and autopsy material from 54 patients who died of the acquired immunodeficiency syndrome. At autopsy, all patients had pulmonary disease. One or more specific diagnoses were made in 53, including opportunistic infection, nonopportunistic infection, and Kaposi's sarcoma. Multiple postmortem pulmonary diagnoses were established in 37. Respiratory failure was the most common cause of death. Of the 97 pulmonary disorders discovered at autopsy, only 31 were diagnosed before death. The frequency with which infections were diagnosed during life varied according to the organism, and was significantly higher for Pneumocystis carinii than for cytomegalovirus or bacterial agents. Pulmonary Kaposi's sarcoma was diagnosed in only 7% of patients with autopsy documentation. The yield of diagnostic procedures also varied according to the disease present. Sputum culture was relatively effective in detecting Cryptococcus neoformans and Mycobacterium avium intracellulare, fiber-optic bronchoscopy was extremely useful for diagnosing P Carinii, and one or more diagnoses were provided in 4 of 7 patients who underwent thoracotomy, but significant disease including cytomegalovirus infection and pulmonary Kaposi's sarcoma was frequently missed. Although the spectrum of lung disease found at autopsy is similar to that observed during life, the frequency of some pathologic processes including cytomegalovirus infection and Kaposi's sarcoma may be underrepresented in antemortem series. PMID- 3266815 TI - Gender differences in the relationship of widowhood and psychological well-being among low income elderly. AB - The present study examined the influence of widowhood on the psychological well being of low income elderly women and men while controlling for a number of mediating variables. Both widows and widowers were found to have lower psychological well-being than their married counterparts once health and social network differences were controlled. Health status and social networks were the major predictors of psychological well-being. Married women reported many more stress related ailments than any other group. Among women, friends contributed more to psychological well-being than family contact. Among men, family rather than friends were more highly correlated with psychological well-being. Implications for clinical practice and future research are discussed. PMID- 3266816 TI - [Health indicators and screening of military recruits]. PMID- 3266817 TI - Transfection of IL-3 gene to a factor-dependent murine myeloid cell line (FDC P2). PMID- 3266818 TI - [Combination of 5-fluorouracil and high doses of folinic acid in the treatment of recurrent and persistent spinocellular carcinoma of the head and neck. A phase II study]. PMID- 3266820 TI - The expanding role of folates and fluoropyrimidines in cancer chemotherapy. Proceedings of an international symposium. April 28-29, 1988, Buffalo, New York. PMID- 3266819 TI - [Characteristics of 2 strains of yeasts, producers of protein, cultured on a complex medium with whey]. PMID- 3266821 TI - The treatment of metastatic breast cancer with 5-fluorouracil and leucovorin. PMID- 3266822 TI - The natural and unnatural diastereomers of leucovorin: aspects of their cellular pharmacology. PMID- 3266823 TI - High-dose weekly oral leucovorin and 5-fluorouracil in previously untreated patients with advanced colorectal carcinoma: a phase I study. PMID- 3266824 TI - Pharmacodynamics of 5-fluorouracil and leucovorin. PMID- 3266825 TI - Distribution and metabolism of calcium leucovorin in normal and tumor tissue. PMID- 3266826 TI - Progress report on a phase II trial of 5-fluorouracil plus citrovorum factor in women with metastatic breast cancer. PMID- 3266827 TI - 5-Fluorouracil/folinic acid/cisplatin-combination and simultaneous accelerated split-course radiotherapy in advanced head and neck cancer. AB - In advanced inoperable head and neck cancer radiotherapy alone is unsatisfying. Better results can be obtained by simultaneous 5-Fluorouracil/Cisplatin chemotherapy and irradiation. The cytotoxicity of 5-Fluorouracil can be enhanced synergistically by adding Folinic Acid in excess. In a clinical phase II trial 62 previously untreated patients suffering from unresectable AJCC-stage III (4 pts.) and IV (58 pts.) squamous cell carcinoma of the head and neck were treated with a simultaneous chemoradiotherapy consisting of high-dose Folinic Acid in addition to a 5-Fluorouracil/Cisplatin combination and of accelerated split-course radiotherapy. As results, three pts. died from tumor arrosion bleeding during the treatment. Median follow up time of the surviving pts. is 27 + months (range 18 44 months). 48/62 pts. (77%) achieved complete remission, 11/62 pts. (18%) partial remission. Presently, 32 pts. (52%) are without evidence of disease. Actuarial three years overall survival rate (Kaplan-Meier method) out of 62 pts. in 53%. Actuarial disease free survival and local tumor control rates at three years are 58% and 72%. Mucositis was severe but tolerable, bone marrow depression was moderate to marked. In conclusion, this combined simultaneous modality approach is highly effective in locally advanced head and neck cancer. It seems to provide superior survival and local control rates as compared to conventional radiotherapy or sequential chemo-radiotherapy or as compared to simultaneous 5 Fluorouracil/Cisplatin and non-fractionated radiotherapy. A comparative phase III study is required. PMID- 3266828 TI - Role of dose, schedule and route of administration of 5-formyltetra-hydrofolate: preclinical and clinical investigations. PMID- 3266829 TI - Pharmacokinetic analysis of (6S)-5-formyltetrahydrofolate (1-CF), (6R)-5 formyltetrahydrofolate (d-CF) and 5-methyltetrahydrofolate (5-CH3-THF) in patients receiving constant i.v. infusion of high-dose (6R,S)-5 formyltetrahydrofolate (leucovorin). PMID- 3266830 TI - Selectivity of CF and 5-fluorouracil: critical role of polyglutamylation. PMID- 3266831 TI - Correlation between B-cell mitogenicity and immunosuppressor effects of a protein released by porcine monocytes infected with African swine fever virus. AB - Virus-free supernatants of cultured swine monocytes infected by African swine fever virus (ASFV) suppressed in vitro proliferation of porcine and human blood mononuclear cells in response to phytohemagglutinin and the in vivo primary immune response of C57BL/6 mice against sheep RBC. The supernatants were fractionated by discontinuous ion-exchange chromatography and subfractionated by double-step preparative isoelectric focusing. The pool of the most purified active subfractions (F5'EP-ASFV) is made up of heat-unstable material, can be stained by silver nitrate, and has an isoelectric point of 3.88, a maximal optical density at 280 nm, and a mass of 36,000 daltons. In vivo kinetic studies in nonimmunized C57BL/6 mice were performed on days 1, 2, 3, 5, and 7 after injection with 50 micrograms of F5'EP-ASFV protein. Compared with the untreated mice, the treated mice had a noticeable increase in nonspecific immunoglobulin secreting splenic plaque-forming cells (PFC) with the following isotype profile: IgG2a greater than IgG2b greater than IgG3 greater than IgG1 congruent to IgM. Three days after treatment with the active material, specific IgM PFC against sheep RBC increased up to 23-fold. In C57BL/6 mice immunized against sheep RBC 2 days after treatment with F5'EP-ASFV, the increase in nonspecific PFC was followed by a suppression of specific PFC response in the respective isotype. When C57BL/6 mice were treated after priming with sheep RBC, however, there was little or no suppression of specific PFC and the increase in nonspecific PFC was considerably lower than that in the other F5'EP-ASFV-treated mice. In this case, kinetic curves of specific vs nonspecific PFC of each isotype were mirror images. Mice treated with 200 micrograms of F5'EP-ASFV protein died with hemorrhagic diastasis. PMID- 3266833 TI - [Antipyretics in pediatric practice]. PMID- 3266832 TI - Biochemical indicators of bone formation in foals after transfer from pasture to stables for the winter months. AB - Serum alkaline phosphatase activity and serum concentrations of osteocalcin, free thyroxine, protein, and cholesterol were measured in 14 foals monthly from birth to 1 year of age. A transient decrease (P less than 0.05) in alkaline phosphatase activity and osteocalcin, free thyroxine, and cholesterol concentrations was found in November after transferring the horses from pasture to stables for the winter months. During the 2 subsequent months, serum alkaline phosphatase activity and osteocalcin concentration increased slightly. Protein concentration was highest in late fall and decreased (P less than 0.001) in April and May, suggesting inadequate protein nutrition during the winter months. The data were interpreted to indicate a substantial slowdown of bone formation in foals after transfer from pasture to stables. Factors influencing bone formation may include a decrease in physical activity and in serum free thyroxine concentration. PMID- 3266834 TI - [Plasma exchange in polyradiculoneuritis in AIDS]. AB - Plasma exchange was used in three cases of peripheral neuropathy of polyradiculoneuritis type in patients with AIDS. The neurologic lesion in the first case was due to a cytomegalovirus, and plasma exchange appeared to provide additional benefits (to antiviral treatment) during the first attack of polyradiculoneuritis. The peripheral neurologic disorders were probably related to the HIV itself in the other two cases, and plasma exchange was carried out only briefly because of the seriousness of the situation, which was unaffected. Although plasma exchange is possible, if particular technical precautions are taken, in patients with AIDS, the present series is too small for valid scientific evaluation. PMID- 3266835 TI - [Treatment using lymphocytapheresis of severe forms of Crohn's disease. Preliminary results]. AB - We report our experience in the treatment of severe Crohn's disease by lymphocytapheresis (LCTPH). Twelve patients with severe Crohn's disease unresponsive to prednisone for two years were treated by twelve sessions of LCTPH over a three-week period. Approximately 4.5 x 10(9) lymphocytes were removed at the end of each session, total lymphocyte removal per patient ranging from 1.9 to 10.7 x 10(8)/kg. Sessions were well tolerated. Clinical improvement was observed in all patients at the end of their LCTPH courses. However only fifty per cent of these patients achieved clinical remission of three months and for two of them the remission lasted 8 and 9 months. We examined the immediate effects of cytapheresis on peripheral blood lymphocytes and monocytes. No correlation was noted between the clinical efficacy of LCTPH and the quantity of lymphocytes (T3, T4, T8, NK) and/or monocytes removed. The only significant change was a partial recovery of NK activity in the good responders. The optimal modalities of depletion and the advantages of this treatment in severe Crohn's disease have to be defined in multicentric controlled studies. PMID- 3266836 TI - [Electrical stimulation of the fenestra ovale. Perspectives]. AB - Amongst the various sites for stimulation of the internal ear, in monocanal-extra cochlear system, the fenestra ovale has virtually never been used. The authors suggest a cup-shaped electrode placed at the end of an incudo-vestibular prosthesis, such as a teflon piston, after stapedectomy and interposition of connective tissue. The immediate advantage of such a method is the fixation of the electrode. Tolerance is excellent and electrical impedance remained stable at very satisfactory levels. The future perspective appearing most promising is based upon simultaneous use of electrical and acoustic stimulation. PMID- 3266837 TI - Immunological response in the mouse brain: II. Experimental immunotherapy model against transplanted mouse lymphoma in the brain. PMID- 3266839 TI - Sterno-costoclavicular hyperostosis. A report of two new cases and review. PMID- 3266838 TI - Cervical involvement of diffuse idiopathic skeletal hyperostosis with dysphagia and rhinolalia. AB - Osteophytosis in degenerative joint diseases of the cervical spine may result in dysphagia. Recently, diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease has also been identified as a cause of dysphagia. A case of DISH with cervical involvement producing dysphagia and rhinolalia is presented. The symptomatology, radiographic features and treatment of DISH involving the cervical region are discussed. The diagnosis of DISH is exclusively radiographic. Recognition of this disorder, unfamiliar to many clinicians, may avoid an unnecessary biopsy procedure of a suspected pharyngeal tumor. Once the diagnosis of DISH is made, a supplemental barium esophagram should be performed to exclude possible coexisting neoplasms. Endoscopy has a definite risk for inducing an inadvertent esophageal perforation and should be avoided, if at all possible. A conservative therapeutic approach is advocated by the authors. PMID- 3266840 TI - [Comparison of chemical and thermal stability of soluble and immobilized alpha amylases from B. licheniformis and A. oryzae]. AB - alpha-Amylases from B. licheniformis and A. oryzae, which differ in their thermal stability, were studied with respect to their resistance to chemical denaturants as guanidine hydrochloride, urea, aliphatic alcohols, and formaldehyde. Moreover, the thermal and chemical stabilities of both enzymes were compared after their covalent binding to gamma-aminopropyl silica. The thermolabile alpha-amylase (A. oryzae) as well as the thermostable alpha-amylase (B. licheniformis) are remarkably stabilized by immobilization. Therefore, the high thermal resistance of the thermophilic enzyme may be further increased. Soluble and immobilized alpha-amylases from B. licheniformis are more resistant to guanidine hydrochloride, urea, methanol, ethanol, propranol, and t-butanol than the alpha amylases from A. oryzae. Obviously, the high intrinsic stability of the thermophilic enzyme is also valid for chemical denaturation. An exception is given by the effect of formaldehyde, which may result in chemical modifications of the protein molecule. Enzymes from B. licheniformis are more sensitive against formaldehyde than those from A. oryzae. As in thermal inactivation, immobilization protects alpha-amylase from A. oryzae against denaturation by guanidine hydrochloride and urea, but fails in the denaturation by alcohols. Therefore, stabilizing effects in immobilized enzymes are dependent on the kind of denaturant. PMID- 3266841 TI - [Determination of the peripheral field of several trigeminal afferent fibers present in the oculomotor nerve]. PMID- 3266842 TI - [Separation and functional analysis of tumor-infiltrating lymphocytes in brain tumor tissues]. AB - Separation of tumor-infiltrating lymphocytes (TIL) from surgical specimen of fourteen gliomas and 6 metastatic brain tumor tissues was achieved by discontinuous density gradients. Comparison of phenotypes between separated lymphocytes and TIL in situ was examined by immunohistochemical method using monoclonal antibodies. The cytotoxic activity of these separated lymphocytes was also examined in short-term 51Cr release assay against fresh autologous tumor cells. Immunohistochemical staining of separated lymphocytes revealed the preservation of cell surface antigens of the lymphocytes. Most of separated lymphocytes were T lymphocytes and both phenotypes cytotoxic/suppressor and helper/inducer T lymphocytes were found. The Leu-3a/2a ratio of separated lymphocytes were compared with TIL in situ in the same patients and these values were almost equal in both lymphocytes. Cell number of separated lymphocytes were 1.2 x 10(5)-2.1 x 10(5)/g in glioma and 1.1 x 10(5)-3.8 x 10(5)/g in metastatic patients. Cytotoxicity against autologous tumor cells was detected in 5 out of 12 glioma and 2 out of 6 metastatic patients. There was no correlation between the cytotoxicity and cell number of separated lymphocytes or HLA-DR antigen expression on tumor cells. PMID- 3266843 TI - [Measurement of cerebral blood flow in normal subjects by 133Xenon inhalation and single photon emission computerized tomography]. AB - Cerebral blood flow (CBF) was studied tomographically in 40 normal volunteers between 25 and 82 years of age in the resting state by single photon emission computerized tomography (Tomomatic 564) accompanied by inhalation of 133Xenon. In order to investigate the reproducibility, five of these received a second examination within 1 hour of the first (group I). Six others received a second examination 7 to 26 days after the first examination (group II). In addition, 123I-IMP SPECT was performed in five out of 40 subjects to compare the difference between 123I-IMP SPECT and 133Xe SPECT. The Tomomatic 564 (Medimatic Inc. Denmark) gives 5 slices of 2 cm thickness simultaneously and its spatial resolution (full width at half maximum, FWHM) as measured with a 133Xenon line source in water was 1.6 cm in the center of each slice. CBF was calculated according to the early picture method and the sequence of picture method described by Kanno and Lassen. Subjects were positioned in the tomograph so that the five transverse sections were located at 1, 3, 5, 7 and 9 cm above and parallel to the orbito-meatal line (OML). Cerebellar flows were obtained from a slice 1 cm above the OML (slice 1) and mean hemispheric flows were obtained from slices 3 cm (slice 2), 5 cm (slice 3), 7 cm (slice 4) and 9 cm (slice 5) above the OML.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266844 TI - Effect of metronidazole on the cell surface charge of Trichomonas vaginalis and Tritrichomonas foetus. AB - 1. The effect of metronidazole, a drug used in the treatment of trichomoniasis, on the surface charge of both Trichomonas vaginalis and Tritichomonas foetus was analyzed by cell electrophoresis. 2. Incubation of the parasites under anaerobic conditions for 2 or 120 min in the presence of 2.0 micrograms/ml metronidazole, a concentration which inhibits cell growth by about 50%, led to a marked decrease in the net surface charge of the parasites. 3. The metronidazole analogue, 1 hydroxyethyl-2-methyl-1-4-nitroimidazole, inhibited protozoan growth but had no effect on net surface charge. 4. These observations indicate that, in addition to its effect on intracellular structure, such as hydrogenosomes, metronidazole alters the surface of trichomonads. PMID- 3266845 TI - Acute changes in extracellular fluid volume modify the antroduodenal flow of saline in dogs: a possible physiological role. AB - The antroduodenal (AD) flow of saline was measured in anesthetized dogs following two different protocols of acute changes in extracellular fluid (ECF) volume. ECF expansion by iv infusion of saline before or after hemorrhage decreased the AD flow; conversely, hemorrhage before or after expansion increased flow. These alternating modifications in the AD flow are independent of the sequence of volemic changes and may constitute part of the homeostatic responses of the gut to confront life-threatening situations such as accidental hyperhydration or hemorrhage. PMID- 3266846 TI - Primary immunodeficiency diseases: a presentation of 6 cases. AB - The peripheral blood leukocytes of 6 children with clinical data suggestive of primary cellular immunodeficiencies were studied in an attempt to define the cellular basis of these disorders. The phenotype and function of T and B cells were investigated. According to the clinical and laboratory features, the patients were classified as one case of severe combined immunodeficiency (SCID), two of ataxia-telangiectasia (AT), one of Wiskott-Aldrich syndrome (WAS), one of DiGeorge syndrome (DSG), and one of cellular immunodeficiency (CID). The laboratory investigations together with the clinical manifestations permitted a diagnosis of primary immunodeficiency diseases. PMID- 3266847 TI - [Influence of opposing needles on the rheoencephalogram of rabbits suffering from acute experimental cerebral ischemia]. PMID- 3266849 TI - [Clinical management of postpartum hemorrhage]. PMID- 3266848 TI - Gene sequences coding for S-adenosylmethionine decarboxylase are present on human chromosome 6 and the X and are not amplified in colon neoplasia. AB - Sequences for human S-adenosylmethionine decarboxylase, an enzyme involved in polyamine biosynthesis, which is elevated in tumors, have been localized on chromosome 6 and the X. PMID- 3266850 TI - [The clinical significance of antinuclear autoantibodies in systemic lupus erythematosus]. PMID- 3266851 TI - [HLA typing of nasopharyngeal carcinoma in Hunan province]. AB - 114 normal individuals and 60 NPC patients in Hunan province were randomized for HLA typing in our laboratory in 1982 and 1986. All the NPC patients were confirmed by pathology. The HLA typing was performed before the treatment had been started. The results showed that the frequency of DRw8 in the NPC group was significantly higher than the normal group, but the frequencies of DR1 and Bw6 of the former were significantly lower than those of the latter in 1982. It was observed that Cw7 and DR4 were significantly higher in NPC group than that in the normal, but Bw6 and Cw1 were significantly lower in the former than the latter in 1986. It was found that DRw8 and Cw7 in the NPC group were still much higher than that in the normal, but DR1 in the former was much lower than that in the latter after analysing the data of 1982 and 1986. There is no information about the increase of HLA-DR or decrease of DR1 in NPC patients. It was found, however, DRw8 of NPC group was significantly higher than that of the normal, but DR1 in the former was significantly lower than that in the latter as observed in our laboratory. PMID- 3266852 TI - [Effects of allogeneic LAK cells on the function of immune system of the recipients]. AB - SHR rats, 1 week of age, were i.p. inoculated with allogeneic JB LAK cells generated by 3-day incubation of spleen cells of JB rats in CM-IL 2. The spleens were removed 4 and 12 weeks later and their cells were tested for proliferative potential to mitogens and their response and production of IL2. The results demonstrated that the allo-LAK recipients showed no signs of acute or chronic GvH disease but showed immune response equivalent to or higher than the normal controls. Severe functional defects were observed in the newborn SHR rats after i.p. inoculation of allogeneic fresh spleen cells from JB rats. The results strongly suggest that allogeneic LAK cells be ineffective in terms of induction of GvH disease or GvH associated immunodeficiencies (GvHID). Therefore, this might be promising in clinical trials on cancer adoptive immunotherapy with allogeneic, instead of autologous, LAK cells. PMID- 3266853 TI - In vitro and clinical evaluation of ofloxacin in urinary tract infection and enteric fever. AB - During 1984 to 1988, 35 patients with urinary tract infection (UTI) and 37 patients with enteric fever were treated successfully with 400 mg ofloxacin twice a day for 7 to 10 days. Clinical cure or improvement was observed in 31 of the 35 patients with UTI; 32 patients were bacteriologically assessed and eradication was achieved in all of them. Ofloxacin was particularly effective in the treatment of enteric fever in 35 patients; eradication was achieved in all of them; 34 patients were clinically cured within 4 days, however, one patient with bacteraemia due to Salmonella paratyphi A subsequently died, due to his underlying disorder. The MIC90 of the Enterobacteriaceae including Salmonella was less than 0.12 micrograms/ml. Interestingly, beta-lactamase-producing strains of Salmonella and other Enterobacteriaceae in the present study were 28% and 29%, respectively. Ofloxacin therefore offers an effective b.i.d. dosage schedule for enteric fever and UTI due to beta-lactamase-producing bacteria. PMID- 3266854 TI - The role of growth factors on the expression of differentiated functions of the ovary and placenta. PMID- 3266855 TI - [Study of myocardial perfusion at rest using technetium Tc 99m methoxy isobutylisonitrile: comparison with labeled microspheres and thallium 201]. AB - In order to evaluate the potential usefulness of 99m technetium (Tc)-methoxy isobutyl-isonitrile (MIBI) as a myocardial perfusion tracer in man, its myocardial distribution at rest was compared with that of 201thallium (TI). Perfusion images obtained with 99mTc-labelled microspheres, whose myocardial distribution is exclusively coronary flow dependent, were used as reference. The study was performed on twelve patients (10 males and 2 females, mean age 55.4 +/- 6.4) with suspected effort angina and without a history of previous myocardial infarction. In the space of two weeks patients underwent rest and exercise 99mTc MIBI myocardial scintigraphy, exercise-redistribution 201TI myocardial scintigraphy, 99mTc-labelled microsphere scintigraphy after microsphere injection in the left ventricle at rest during catheterization before performing left ventriculography and coronary angiography. The comparison with microsphere distribution was limited to rest 99mTc-MIBI scintigraphy and redistribution 201TI images. Single photon emission tomography (SPECT) was employed. SPECT was performed using a double-head Rotacamera with a 360 degrees rotation arc. Ninety projections of 20 seconds each were acquired; subsequently image reconstruction was performed using an iterative algorithm. To evaluate regional perfusion the left ventricular wall was divided into 18 segments; the uptake pattern of each segment was graduated according to a qualitative score (0: severe defect; 1: moderate defect; 2: normal uptake). The quality of tomographic myocardial 99mTc MIBI and 99mTc-microspheres images was higher than that of 201TI tomograms in account of the different physical characteristics of the two radionuclides.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266856 TI - [Prevalence of pulmonary valve insufficiency in healthy children: a Doppler color study]. AB - One hundred patients, institutionalized for mental retardation, aged between 3 and 14 years (mean age 12.2 +/- 3) and free from cardiovascular and pulmonary diseases, were studied using Doppler technique (pulsed wave-continuous wave and color-coded Doppler), to evaluate the prevalence of pulmonary regurgitation. The authors, utilizing a triple method (diastolic turbulence above pulmonary valve detected by pulsed wave Doppler or diastolic flow detected by continuous wave Doppler, presence of regurgitant pulmonary color-jet, from short axis view, toward the right ventricular outflow tract, and presence of the same feature in the color m-multigate) to detect the presence or absence of pulmonary regurgitation found 73% positivity. There were no differences between the two sexes and the size of the pulmonary artery was in the normal range. The characteristics of regurgitation were: No holodiastolic. The regurgitant max velocity jet was not greater than 1.50 m/s. Beat to beat variability. Max length of color-jet was not more than 2 cm. Rapidly decreasing Doppler profile. We can conclude that pulmonary regurgitation is very frequent in children and is not significant if it has the above-named characteristics. This latter fact is further confirmed by other authors. PMID- 3266858 TI - Investigation of sequence homology in a group of type-II restriction/modification isoschizomers. AB - We have dissected the cloned PstI M and R genes to make DNA hybridization probes spanning most of the sequence. These subclones, and also the intact sequence, were used to search for nucleic acid homology by Southern blot in the DNA from twelve organisms which produce PstI isoschizomers. One of these probes, a 206-bp fragment from the N-terminal domain of the endonuclease, showed significant hybridisation in four strains (Escherichia coli strains RFL48, RFL49 and RFL83, and Streptomyces albus P). No significant hybridisation was detected with other parts of the PstI sequences. We have used computer similarity searches to look for homology between the PstI proteins and the known sequences of other type-II systems that recognise different sites. We postulate a possible recognition domain within the M.PstI methyltransferase based on similarity to the M.PaeR7 and M.TaqI methyltransferases. PMID- 3266857 TI - Cytosine methylation as an effector of right-handed to left-handed DNA structural transitions. AB - Cytosine methylation has energetic and structural influences on left-handed Z-DNA formation in supercoiled plasmids. The restriction and modification enzymes from Haemophilus haemolyticus (HhaI and M.HhaI) provide a system to locate and analyze small segments of Z-DNA in large supercoiled plasmids. An approach is outlined that uses M.HhaI as an in vivo conformational probe for the detection of unusual DNA structures in a living cell. Also, characteristic features of the M.HhaI gene and protein are discussed. PMID- 3266859 TI - Nomenclature for bacterial genes coding for class-II restriction endonucleases and modification methyltransferases. PMID- 3266860 TI - The characterization and cloning of the EagI restriction-modification system. PMID- 3266861 TI - How TaqI endonuclease recognizes its cognate sequence. PMID- 3266862 TI - RsrI restriction-modification enzymes from Rhodobacter sphaeroides. PMID- 3266863 TI - Use of bacterial virus T7 as a tool for the study of DNA methylation. PMID- 3266864 TI - [Analytical research on cellular immunity in HBV carrier state: studies on the AMLR and T cell subsets]. PMID- 3266865 TI - [The role of central noradrenergic neurons in the hypothalamic-pituitary adrenocortical axis of rats: with special reference to feeding cycle and biological rhythm]. AB - It is well established that plasma corticosterone levels in rats increase just prior to the meal (prefeeding peak), when animals are subjected to restricted feeding, in which daily food and water supply is restricted to a few hours at a fixed time of day. A self-sustained oscillatory mechanism is suggested underlying the prefeeding hormone peak, but its mechanism is different in origin from that involved in the light-entrainable circadian rhythm; the former dose not depend on the suprachiasmatic nucleus (SCN) but the latter dose. The purpose of the present study is to elucidate roles of the central noradrenergic system in the prefeeding corticosterone peak under restricted feeding. Male rats were bilaterally injected with 6-hydroxydopamine (6-OHDA) into the ventral noradrenergic ascending bundle (VNAB) and hypothalamic nuclei, the SCN, the paraventricular nucleus (PVN), the ventromedial hypothalamic nucleus, the lateral hypothalamic nucleus and the median eminence to examine effects of the catecholamine depletion on the circadian corticosterone rhythm under ad libitum feeding condition and the prefeeding corticosterone peak under restricted feeding. Blood samples were obtained from individual rats successively and plasma corticosterone was determined by competitive protein binding assay. Noradrenaline contents were measured in the individual hypothalamic nuclei by high performance liquid chromatograph to attest the effects of 6-OHDA injection. The prefeeding corticosterone peak was suppressed by 6-OHDA injected into the PVN and VNAB, but was not by 6-OHDA into the other brain regions. On the other hand, the circadian rhythm of plasma corticosterone was not affected by 6-OHDA injection into the PVN. These findings suggested that the noradrenergic projection to the PVN is responsible for the manifestation of the prefeeding corticosterone peak, but is not for the circadian rhythm of plasma corticosterone. PMID- 3266866 TI - [The immunohistological study of the lymphoid malignancy using cell surface or differentiating markers and cell proliferating nuclear marker]. AB - This research was the study of hemato-malignancy to clarify their cell origin and biological character by 14 monoclonal antibodies, which were 13 antibodies as surface or differentiate markers and Ki-67 as cell proliferating nuclear marker. Ki-67 recognizes PC-antigen in nuclear. 23 cases of lymphoid malignancy were selected out of 104 cases of hemato-lymphoid disorders, which were consulted to the second department of pathology of Hokkaidou University for marker study or histologic investigation. 21 cases was malignant lymphoma (primary biopsy, 18 cases non-Hodgkin's lymphomas, 3 cases Hodgkin's lymphoma), And 2 cases were myeloma (one autopsy case, multiple myeloma; another biopsy case, solitary myeloma of the thoracic bone). By the result of this study, the strong correlation was found the expression of surface or differentiate markers between the cyto-histomorphology of the lymphoid malignancy. Especially, the result of Ki 67 did clarify more vividly the biological character of these lymphoid malignancy than that of surface or differentiate markers. The results obtained by western blotting and immuno-electron microscopy of Ki-67 showed that PC-antigen was one of the preribosomal granules in granular component of nucleolar and it's MW was about 30 KD. I discussed this point from the morphological aspect in this paper and concluded that the fact which PC-antigen was one of preribosomal granules is the reason of Ki-67 serving as the cell proliferating nuclear marker. PMID- 3266867 TI - Lactational amenorrhea in urban poor women and its implications for use of contraception. PMID- 3266868 TI - Prevalence of post-polio residual paralysis in under-five children in a PHC in Haryana. PMID- 3266869 TI - Hemophilus influenzae pericarditis in an adult. PMID- 3266871 TI - [A case of coronary artery bypass using saphenous vein for LMT lesion in a patient with systemic lupus erythematosus]. PMID- 3266870 TI - Lack of correlation after reperfusion between ventricular function and infarct size estimated by thallium single-photon emission computed tomography. AB - In 32 patients with acute myocardial infarction, who had undergone successful intracoronary thrombolysis, the results of regional wall motion measured from contrast cineangiograms 10 to 21 days after thrombolysis were related to the results of thallium single-photon emission computed tomography (SPECT) after intravenous dipyridamole. Wall motion was measured by means of the centerline method, and thallium defect size was estimated by comparing the patient's circumferential profile with that of 20 normals. No correlation was found between ejection fraction or regional wall motion and thallium defect size. The time from symptom onset to thrombolysis was inversely correlated with the degree of hypokinesis (r = -0.51) but not with thallium defect size. In patients treated within 3 hours, hypokinesis was significantly less than in patients treated later (-1.1 +/- 0.6 SD vs -2.2 +/- 0.8 SD, p less than 0.01) whereas thallium defect size was not significantly different in both groups. It is concluded that, in patients after thrombolysis, thallium defect size determined by SPECT does not reflect the degree of left ventricular dysfunction. PMID- 3266872 TI - [An analysis of phasic flow patterns and study of reserve flow capacity in the graft in patients with aortocoronary bypass]. PMID- 3266873 TI - [Effect of aortocoronary bypass surgery on left ventricular function and coronary sinus blood flow during exercise in patients with good collateral circulation]. PMID- 3266874 TI - [An experimental study on the in vivo induction of lymphokine activated killer (LAK) cells by the continuous infusion of interleukin 2 (IL-2) through the splenic artery]. PMID- 3266875 TI - Silicosis among mortar and pestle workers in northern Thailand: cross-sectional study. PMID- 3266876 TI - Interleukin-1 production from monocyte induced by urate crystals. PMID- 3266877 TI - Guidance of regenerating motor axons in larval and juvenile bullfrogs. AB - The segmental distribution of regenerating bullfrog motor axons was mapped in advanced tadpoles and juvenile frogs by stimulating selected muscle nerves and recording from the distal ends of the 3 lumbar ventral roots (VRs) that innervate the hindlimb. When motoneurons were axotomized by VR transection, they reestablished their original innervation fields, rarely, if ever, growing beyond the territory normally supplied by their spinal segment. However, when motoneurons were axotomized in the spinal nerves at the level of the hindlimb plexus, some of them regenerated into limb nerves that lay outside the axons' normal segmental boundaries, and many regenerated into the medial femoral cutaneous nerve, a pathway normally limited to sensory axons. These observations suggest that the ultimate destinations of regenerating axons are largely determined by structures the axons encounter as they penetrate the distal nerve stumps. Thus, axons regenerating from a severed VR grow into that root's own distal stump and reinnervate the hindlimb in a manner that is segmentally appropriate; axons transected near the plexus have access to the pathways of sensory, as well as motor, axons in all 3 lumbar segments, and establish innervation fields that are inappropriate for their segment of origin and their motor function. PMID- 3266879 TI - [Treadmill exercise echocardiography: quantitative analysis of regional left ventricular wall motion by computer graphics]. AB - To detect significant coronary lesions based on exercise-induced reversible asynergy, two-dimensional echocardiograms were recorded before and immediately after treadmill exercise test in 15 patients with angina pectoris (AP) and six patients with neurocirculatory asthenia (NCA). Short-axis views of the left ventricle were analyzed quantitatively, using the following indices: segmental area change (%A); segmental wall thickness change (%Th); and relative curvature (rC) which was the product of curvature of each segment multiplied by end diastolic circumference. The results were compared with those of coronary angiography, T1-201 myocardial emission computed tomography, and exercise electrocardiography. 1. The results of comparisons of quantitative analysis by %A, %Th, and rC with qualitative (visual) analysis were as follows: the sensitivities were 57%, 74% and 91%; the specificities were 75%, 75% and 90%; and the accuracies were 68%, 75% and 90%, respectively. 2. To detect coronary stenosis of more than 75%, visual assessments and assessments by rC were superior to assessments by %Th or %A. The accuracies were 93%, 91%, 73% and 61%, respectively. 3. In five cases with three-vessel disease, all diseased coronary arteries were detected by treadmill exercise echocardiography using rC as an index. However, by treadmill exercise T1-201 myocardial emission computed tomography, the diagnosis of three-vessel disease was possible in only one case. 4. The results of treadmill exercise electrocardiography were positive in 11 of 15 the AP patients and in all six NCA patients. The results of exercise echocardiography using rC as an index were normal in all NCA patients and abnormal in 14 of the 15 AP patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266878 TI - [Graft patency and myocardial viability after aorto-coronary bypass surgery evaluated by exercise 201T1 myocardial SPECT]. AB - To evaluate graft patency and myocardial viability after aorto-coronary (AC) bypass surgery, 58 patients (29 with old myocardial infarction and 29 with effort angina) underwent symptom-limited exercise 201T1 myocardial SPECT using a bicycle ergometer before and after surgery. The results were as follows: 1. The overall angiographic graft patency was 87% (97 of 112 grafts). 2. According to the stress SPECT images, graft patencies were 98% for areas with postoperative improvement by 201T1 uptakes, 79% for areas with unchanged patterns, and 53% for areas with worsened patterns. In spite of patent grafts, among cases with worsened 201T1 uptakes the etiologies included perioperative infarction, anastomotic strictures, and poor run-off distal to the anastomoses. 3. Following patency of grafts, postoperative normalized perfusion patterns were observed in 69% (27 of 39 segments) of segments with persistent preoperative low uptakes and 25% (4 of 16 segments) of segments with persistent preoperative defects. Thus, exercise 201T1 myocardial SPECT proved a useful diagnostic means of assessing graft patency and effectiveness. However, after AC bypass surgery, 25% of the regions which had persistent defects before surgery exhibited normal perfusion patterns. These findings suggest that persistent defects may represent hypoperfusion of viable myocardium, and that we should carefully diagnose myocardial scars. PMID- 3266880 TI - [Tricuspid regurgitation in mitral valve prolapse studied by two-dimensional color flow mapping]. AB - To assess the incidence of tricuspid regurgitation (TR) in mitral valve prolapse (MVP), 96 patients with MVP and 23 normal control subjects were studied. Subjects in the MVP group were further classified as a group with mitral regurgitation (MR(+) group: 61 cases), and MR(-) group (35 cases). The presence of TR in each group was studied by two-dimensional color flow mapping using a Toshiba SSH-65A apparatus. The incidence of TR was 49% in the MR(+) group and 34% in the MR(-) group, and both (35 cases). The presence of TR in each group was studied by two dimensional color flow mapping using a Toshiba SSH-65A apparatus. The incidence of TR was 49% in the MR(+) group and 34% in the MR(-) group, and both values were statistically greater than 9% in the control group (p less than 0.001 and p less than 0.05, respectively). A female preponderance was observed only in the MR(+) group. Tricuspid valve prolapse was observed in six cases (10%) in the MR(+) group, two cases (6%) in the MR(-) group, and none in the control group. The mean tricuspid ring dimension did not differ significantly among the three groups. The female patients in MR(+) group had statistically greater measurements than the normal female subjects (p less than 0.01). In conclusion, the incidence of TR was statistically greater in female patients in the MR(+) group than in females in the other groups. It is suspected that functional or pathological changes which induce MVP are likely to progress to the tricuspid ring in female patients. PMID- 3266881 TI - [Left ventricular volume curve analysis using gated blood pool emission computed tomography]. AB - Analysis of the left ventricular volume curve was performed using gated blood pool emission computed tomography (SPECT) in six patients with old myocardial infarction (MI), five with hypertrophic cardiomyopathy (HCM), three with dilated cardiomyopathy (DCM), and five normal controls (N). Image collection was synchronized with the QRS complex, and each cardiac cycle was divided into nine to 10 frames. In each frame, left ventricular volume was determined based on the number of voxels above the threshold level (50% cut-off level), and the volume curve was fitted to the third harmonics of Fourier analysis. From the fitted curve, the peak ejection rate (PER), the peak filling rate (PFR), end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were calculated. 1. There were good correlations between SPECT and the conventional gated blood pool (MUGA) for PER (r = 0.694, p less than 0.005), PFR (r = 0.527, p less than 0.025) and EF (r = 0.682, p less than 0.005). 2. PER in MI (2.21 +/- 0.55, mean +/- SD) was lower than in N (3.68 +/- 0.80, p less than 0.05) and HCM (4.85 +/- 2.39, p less than 0.05), and EF in MI (36.6 +/- 6.4) was lower than in HCM (68.7 +/- 23.7, p less than 0.05). 3. There were good correlations between EDVs (y = 1.11x + 5.71, r = 0.877, p less than 0.01), and ESVs (y = 1.05x - 3.88, r = 0.876, p less than 0.01) estimated by MUGA and SPECT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266882 TI - [Influence of sultamicillin on intestinal bacterial flora]. AB - Effects of sultamicillin (SBTPC) fine granules, a new oral beta-lactam antibiotic, on the intestinal bacterial flora were studied in tetra-contaminated mice and in pediatric patients. SBTPC was administered at a dose of 100 mg/kg once a day for 5 consecutive days to mice contaminated with 4 different species of organisms: Escherichia coli, Enterococcus faecalis, Bacteroides fragilis and Bifidobacterium breve. In all of the 4 species, bacterial populations in feces were markedly reduced on days 4 to 5 after the start of the treatment. Subjects in the pediatric study were 5 children with bacterial infections (4 boys and 1 girl) at ages from 1 year 3 months to 10 years 8 months and with their body weight ranging from 11.8 kg to 35.0 kg. SBTPC fine granule was administered at a dose of 10 mg/kg 3 to 4 times a day for 4 to 7 days. Although there were some variations in the fecal bacterial flora noticed among these subjects during the treatment, populations of main aerobes and anaerobes such as Enterobacteriaceae, Enterococcus, Bacteroides and Bifidobacterium decreased markedly in all cases. These decreases were more pronounced for anaerobes and total numbers of anaerobes were markedly reduced in all cases. Glucose non-fermenting Gram-negative rods and fungi tended to increase with administration of SBTPC fine granule. Although these changes tended to return to pre-dosing state after the cessation of the treatment with SBTPC fine granule, attention must be paid to possible occurrences of diarrhea, superinfection or bleeding tendency when treatment with the drug is continued for a long period of time. Fecal concentrations of both ampicillin and sulbactam during SBTPC fine granule treatment showed relatively high values except 1 sample with a high beta-lactamase activity in feces. These high concentrations suggest the possibility of biliary excretion of absorbed drugs and the possibility of hydrolysis of SBTPC in the intestine due to high pH. Fecal concentrations of the drug also appeared to be closely related to beta-lactamase activity in feces. PMID- 3266883 TI - [Antimicrobial activity of sultamicillin against clinical isolates from upper respiratory tract infections II]. AB - In an attempt to examine the effect of sulbactam (SBT) on beta-lactamase activity, three hundred clinical isolates from the infected upper respiratory tract were tested for MICs and disk sensitivities of ampicillin (ABPC) and sultamicillin (SBTPC). beta-lactamase production was tested using the acidometry disk method (beta-Check, Taito Pfizer Co.). For strains such as Klebsiella spp. which form mucoid type colonies, we used the SS culture medium which, by reducing the influence of huge amounts of capsular material, allows a better reaction to the acidometry disk. Penicillinase, produced by Branhamella catarrhalis, Haemophilus influenzae, Neisseria spp., etc. was detected clearly by direct application of portions of colonies onto acidometry disks. For cephalosporinase, however, a direct application of such fractions resulted in weak reactions. We, therefore, used fractions which had undergone the enzyme induction, and obtained better reactions. Sensitivities of tested bacteria to ABPC and SBTPC were inversely related to MIC values. beta-Lactamase-producing strains showed weaker sensitivity to ABPC than non-producing strains. To SBTPC, however, beta-lactamase producing strains and non-producing strains showed very similar sensitivity. We thus confirmed that the inhibitory action of SBT to beta-lactamase can well be demonstrated using the disk sensitivity method. PMID- 3266884 TI - [Function of carbohydrate chains serving as tumor-markers and differentiation markers]. PMID- 3266885 TI - [Changes in the bone turnover markers for various diseases]. PMID- 3266886 TI - [N-isopropyl I-123 p-iodoamphetamine (IMP) brain SPECT in dementia]. PMID- 3266887 TI - [Estimation of total liver uptake and liver uptake per unit of liver volume of Tc 99m(Sn)-N-pyridoxyl-5-methyltryptophan (Tc-99m-PMT) using SPECT]. PMID- 3266888 TI - [Clinical evaluation of Tl-201 single photon emission computed tomography in patients with suspected bronchogenic carcinoma]. PMID- 3266889 TI - [Clinical investigation of 18F-fluorophenylalanine for brain tumor imaging- comparison with 11C-methionine]. PMID- 3266890 TI - [The relation between the localization of H. influenzae and inflammatory cells in patients with diffuse panbronchiolitis and other chronic lower respiratory tract infections]. PMID- 3266892 TI - [Regulation of alpha-amylase biosynthesis in Bacillus diastaticus mutants with various levels of enzyme synthesis]. AB - The regulation of alpha-amylase biosynthesis was studied in Bacillus diastaticus mutants with different levels of the enzyme synthesis (by two orders of magnitude). The enzyme biosynthesis was shown to be regulated by induction and catabolite repression. Maltose, starch and methyl-alpha,D-glucoside (which cannot be metabolised) induced the synthesis while glucose and fructose acted as catabolite repressors. PMID- 3266891 TI - [Aspects of bronchoalveolar lavage cells in 7 cases with farmer's lung and home humidifier lung]. PMID- 3266893 TI - [Effect of microwave irradiation and temperature on the spontaneous impulse activity of the ventral spinal roots in the frog]. AB - The rate of spontaneous aperiodic activity in ventral roots of isolated, sagittally hemisected frog spinal cord varied from several hundreds up to 4-6 thousand spikes per minute. This rate was the lowest at temperature of 7-11 degrees C; at higher or lower temperatures the activity augmented. Short-term reactions occurred with changes in the temperature: while heating the cord, the activity decreased, and during cooling it intensified. Microwave irradiation (6.45 GHz, specific absorption rates: 0.1, 0.4 and 2 W/g, action duration: 5 min) had no influence on the spike rate if the temperature remained constant. VHF heating of the preparation and elevation of the superfusing fluid temperature caused the same changes in the activity. The results obtained evidence for the thermal mechanism of neurotropic influence of microwaves. PMID- 3266894 TI - [Evaluation of the vestibular system in patients with migraine]. AB - Fifty women with migrainous headaches were studied. The state of the vestibular system was assessed by ENG, including recording of spontaneous nystagmus, positional, thermal and kinetic nystagmus, recording of following of pendulum movements with eyes, and optokinetic nystagmus. ENG investigations were done in all cases between migrainous attacks, and in 20 cases also during migraine attack. During the attack in 18 women changes in the time of visual stimuli predominated, between the attacks ENG changes were observed in 24 cases. PMID- 3266895 TI - Measurements of the photodegradation of PABA and some PABA derivatives. AB - The photodegradation of 4-aminobenzoic acid, 2-ethylhexyl N,N-dimethyl 4 aminobenzoate (Escalol 507) and 1-glyceryl 4-aminobenzoate (Escalol 106), resulting from irradiation by sun lamps, was examined by UV spectroscopy. 2 ethylhexyl N,N-dimethyl 4-aminobenzoate showed the longest half-life, indicating the highest photostability. PMID- 3266896 TI - Colonic bleeding due to rupture of an isolated iliac artery aneurysm into a caecal carcinoma. AB - We describe a case of a fistula between an atherosclerotic aneurysm of the right common iliac artery and a caecal carcinoma, causing massive colonic bleeding. A fistula between a true aneurysm and a carcinoma of the colon has not to our knowledge been previously reported. Various aspects of this case are discussed from a pathogenetic point of view. PMID- 3266897 TI - Habituation and dishabituation to repeated mild cold exposures in C57BL/6J mice. AB - Every two weeks for 12 weeks four groups of C57BL/6J male mice, initially 12 months old, were subjected to three-hour cold stress tests, which consisted of a partial physical restraint at an ambient temperature of 10 degrees C. The control group experienced six consecutive tests; one experimental group skipped the cold exposure during test No. 4 but was physically restrained at room temperature; the other two experimental groups omitted test No. 4. One of these groups spent the four weeks between test No. 3 and test No. 5 in their home cages, while the other was subjected to daily, 30-minute sessions of electrical stimulation of the hypothalamus through electrodes implanted in the "rewarding" area of the medial forebrain bundle. All animals in this group showed self-stimulating behavior in the test session which preceded cold stress test No. 1. During test No. 3, all four groups showed an improvement of cold tolerance relative to their first tests; body mass and colonic temperature prior to cold exposure remained unchanged. The two experimental groups that were not exposed to cold during test No. 4 and did not receive brain stimulation, demonstrated a significant worsening of cold tolerance during the subsequent test. Their body mass and baseline colonic temperatures did not change. The control group and the group which was subjected to brain stimulation during the interval between tests No. 3 and No. 5 did not demonstrate any changes in cold tolerance. These data demonstrated habituation to repeated mild cold exposures and dishabituation after interruption of cold exposures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266898 TI - [Complicated colonic cancer. Clinical and therapeutic aspects]. PMID- 3266899 TI - [Blood complement in blood donors carrying hepatitis B surface antigens]. PMID- 3266902 TI - Interleukin 2--quo vadis? PMID- 3266901 TI - [An improved paw-pressure test for nociception]. PMID- 3266900 TI - Effect of recent antibacterial agents against bacteria causing diarrhoea. AB - The susceptibility of 424 bacterial isolates causing diarrhoea were tested by agar dilution technique on Mueller-Hinton Agar against amoxicillin, ampicillin, ceftriaxone, chloramphenicol, co-trimoxazole, ciprofloxacin, doxycycline, norfloxacin and ofloxacin. The bacterial species included were Aeromonas hydrophila, Edwardsiella tarda, Pleisomonas shigelloides, Salmonella spp., Shigella spp., Vibrio cholerae and Vibrio parahaemolyticus. The most active compounds were the fluorinated 4-quinolones studied, that is, ciprofloxacin, norfloxacin and ofloxacin, and ceftriaxone. The other antibacterial agents were considerably less active; a substantial portion of tested isolates were resistant to them. PMID- 3266903 TI - Immunological aspects of etiopathogenesis of rheumatoid arthritis. PMID- 3266904 TI - [Action mechanism of cyclosporin A, immunomodulator in the treatment of MRL/lpr lupus mice]. PMID- 3266905 TI - Thymus histogenesis in C3H mice. AB - The histogenesis of the mouse thymus was studied by means of light and electron microscopy in an attempt to clarify the simultaneous development of stromal and lymphoid cell populations. On the twelfth day of embryonic life, the thymus primordium was composed principally of undifferentiated epithelial cells and some lymphoblasts. In the developing cortical regions, lymphoblasts accumulated rapidly, stretching the epithelial cells which became stellate in shape. The latter contained multivesicular bodies and, from the sixteenth day on, also typical clear vacuoles. Medullary regions were prefigurated as soon as day 13 by several areas wherein lymphoblasts were sparse and epithelial cells were closely associated, with numerous desmosomes and abundant tonofilaments. On the sixteenth day, some epithelial cells in these regions were differentiated into globular cells, or formed Hassall's corpuscles and intra- or extracellular cysts. On the seventeenth day, the presence of interdigitating cells in the medullary areas completed cortico-medullary differentiation. On the eighteenth day, small cortical thymocytes differentiated and the thymus possessed all characteristics of an adult thymus. Thus, at birth, the histogenesis of the mouse thymus was achieved and the only further modification consisted in a gain of weight. PMID- 3266906 TI - The effect of flunarizine and nimodipine on rotatory evoked potentials in rabbit. AB - Rotatory evoked potentials were recorded in 6 normal albino rabbits before and after administration of flunarizine and nimodipine. Latencies of REP were unchanged by the Ca-antagonists whereas their amplitudes showed some characteristic alterations. There was a significant lowering of amplitude in those peaks which had previously been shown to be of vestibular origin. The peaks that reflect somatosensory activity were amplified by the drugs. Flunarizine showed a more marked effect on the vestibular part of the response than nimodipine. A selective action of Ca-antagonists on brainstem nuclei is suspected. PMID- 3266907 TI - Improvement of vestibular plasticity in the guinea pig with a calcium entry blocker. AB - The influence of flunarizine on vestibular compensation was investigated in hemilabyrinthectomized guinea pigs. The results showed that the vestibular deficits from hemilabyrinthectomy disappeared more rapidly in the treated animals than in the controls. To elucidate the mechanism by which the drug could affect the compensatory process, further studies on the spontaneous and evoked activity of vestibular nuclei were performed in normal, labyrinthectomized and labyrinthectomized-cerebellectomized animals. These electrophysiological data implied that flunarizine improved the vestibular compensation by inhibiting the receptor and nuclear activities of the intact labyrinth. The drug excited the cerebellar cortex, which modulated the activity of the vestibular nuclei of both sides, restoring the balance disrupted by hemilabyrinthectomy. PMID- 3266908 TI - Calcitonin gene-related peptide in nerves of the hamster cheek pouch. PMID- 3266910 TI - A new marker of T lymphocyte activation in type I diabetes. PMID- 3266909 TI - Regulatory T cell control of autoimmune destruction of beta cells in the BB rat. PMID- 3266911 TI - Studies of prediabetes in the spontaneously diabetic BB rat. PMID- 3266912 TI - Evaluation of low-intensity transcutaneous electrical nerve stimulation in combination with aspirin for reduction of controlled thermal sensation. AB - Reductions in cutaneous thermal sensation produced by placebo, aspirin, transcutaneous electrical nerve stimulation, and transcutaneous electrical nerve stimulation plus aspirin were compared in 60 normal volunteers. The combination of transcutaneous electrical nerve stimulation plus aspirin produced a statistically significant reduction as compared with placebo. The results suggest this treatment combination may provide levels of analgesia useful for completion of minor dental procedures. PMID- 3266913 TI - [Analgesic, anticonvulsant and anti-inflammatory activities of 1H, 3H quinazolinediones-2,4]. PMID- 3266914 TI - Effect of levamisole on the course of experimental leishmaniasis in guinea-pigs and mice: haematological and immunological findings. AB - The effects of levamisole on the course of Leishmania enriettii infection in guinea-pigs and L. major in mice were investigated. It was demonstrated that levamisole-treated guinea-pigs either did not develop an ulcerative lesion or developed a much smaller lesion than untreated animals. Moreover, metastases which are commonly produced in approximately 50% of animals receiving 2 x 10(6) L. enriettii did not occur in levamisole-treated guinea-pigs. Leishmania enriettii infection usually causes leukopenia and eosinophilia in guinea-pigs approximately two to three weeks after infection. These haematological changes did not occur in animals receiving levamisole. The percentage of rosette T-cells which diminished in the L. enriettii infection was normalized in the group of levamisole-treated and infected guinea-pigs. The severity of Leishmania infection in mice receiving levamisole was lower in comparison to a control group of the animals. PMID- 3266915 TI - Azimexone and cysteine hydrazide in the treatment of allergic encephalomyelitis. AB - In the course of allergic encephalomyelitis (EAE) in chickens, azimexone suppressed the production of the specific IgM immunoglobulins. Moreover, it decreased the level of haptoglobin and sialic acid but stimulated the activity of antitrypsin. It was also observed to reduce the production of the plasmatic cells in the spleen. L-cysteine hydrazide hydrochloride decreased the level of sialic acid in EAE; intensified the activity of trypsin inhibitor and exerted no effect upon the level of antimyelin antibodies. PMID- 3266916 TI - Studies on the effect of superoxide dismutase (peroxinorm) on interleukin-1 activity. AB - The experiments were undertaken to determine the effect of Peroxinorm (superoxide dismutase) on the activity of interleukin-1 in vitro. The results give evidence that the influence of the drug examined on the activity/production of interleukin 1 can take different forms, relative to the concentration applied. At higher dilution (10(-7)) Peroxinorm suppressed the activity of Il-1, whereas at lower dilutions it was devoid of this effect. A conceivable mechanism of its activity in the treatment of the inflammations is also discussed. PMID- 3266917 TI - Studies on aziridine derivatives. III. Synthesis and immunopharmacological activity of aziridine derivatives of propionic acid. AB - Several new aziridine derivatives of propionic acid were synthesized (10-15, 19, 20). o-, m-, p-Chloroanilide of chloroacetic acid 1-3 and chloride of 3-/p chlorobenzoyl/acrylic acid 16 were the substrates. The compounds 1-3 in reaction with nicotine aldehyde or p-chlorobenzaldehyde were transformed into appropriate anilides of 2,3-epoxypropionic acid 4-9. These, in turn reacted with ethylenimine giving the appropriate 3-aziridine derivatives 10-15. Acid chloride 16 in reaction with amines gave the appropriate amides 17 and 18 which formed 2 aziridine derivatives 19 and 20 when under the influence of ethylenimine. Pharmacological analysis revealed that the aziridine derivatives 12-15, 19 and 20 modulate some immunological reactions with the prevailing effect of the suppressive component (PFC, RFC, IgM level, cellular response to SRBC). The stimulatory effect was observed with some compounds on the level of circulating IgG and GvH reaction. The mechanism of these compounds consists in their interference with the activity of Ts cells and mediators of the immunological reactions. PMID- 3266918 TI - In vivo activation of murine peritoneal macrophages by intraperitoneal administration of cisplatin. AB - A single intraperitoneal injection of cisplatin (10 mg/kg body weight) in C3H/He mice increases the total number of peritoneal exudate cells (PEC) and macrophages (m phi) within 24 to 48 h. The total number of PEC from untreated mice ranged from 4 to 5 x 10(6) cells/ml containing 2.5 to 3 x 10(6) macrophages, whereas in cisplatin treated mice total number of PEC ranged up to 25 x 10(6) cells/ml. These PEC contained up to 16 x 10(6) m phi. The macrophages obtained from cisplatin injected mice show enhanced cytotoxicity, cytostasis and binding to Dalton's lymphoma cells in vitro. These activated macrophages release into the culture medium factors having cytolytic and cytostatic effect on Dalton's lymphoma cells. The activated macrophages also show enhanced capacity to release superoxide anions, hydrogen peroxide, lysozyme, arginase and interleukin-1. PMID- 3266919 TI - Mouse T-T hybridomas expressing receptors for syngeneic erythrocytes. AB - The report describes generation of mouse T-T hybridomas expressing receptors for murine erythrocytes. The obtained cell lines form 30-85% rosettes with mouse red cells without any preference for H-2 compatible erythrocytes. They do not bind xenogeneic erythrocytes. The role of Thy 1 antigen in constitution of receptors for erythrocytes was excluded since anti-Thy 1 monoclonal antibodies had no influence on rosetting activity. Rosette formation is inhibited by certain sugars showing the same pattern of inhibition as in the case of autologous rosette formation by CBA mouse thymocytes. PMID- 3266920 TI - Effect of retinol on murine epidermal dendritic cells. PMID- 3266921 TI - Primary postpartum haemorrhage in Tasmania 1982-1986. AB - Primary postpartum haemorrhage remains a significant problem in modern obstetric practice. The incidence and factors associated with postpartum haemorrhage in Tasmania over a 5-year period were studied. The mode of delivery, anaesthesia, birth-weight, induction and augmentation of labour, multiple pregnancy, antepartum haemorrhage and hypertension were found to be important factors. The incidence of retained placenta was not considered in this study. PMID- 3266923 TI - Clastogenic factor in ischemia-reperfusion injury: protective effect of allopurinol. PMID- 3266922 TI - Role of active oxygen in paraquat and 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP) cytotoxicity. PMID- 3266924 TI - The synergistic effects of anti-IgM and monoclonal anti-Ia antibodies in induction of murine B lymphocyte activation. AB - MHC class II molecules on murine B lymphocytes have been shown to serve as recognition molecules in B cell-T cell interaction. The demonstration that a variety of B-cell stimuli such as anti-Ig, lipopolysaccharide, and interleukin-4 induce hyper-Ia expression has led to the proposal that Ia molecules may serve a role in B-cell activation. However, the question remains whether Ia molecules play a direct or indirect role in B-cell activation. In the present study it has been shown that Ia molecules may play a direct role in providing growth signals to B cells. Affinity purified monoclonal anti-Ia antibodies against both IA (MKD6) and IE (14.4.4) region encoded Ia molecules were able to enhance anti-mu induced B-cell proliferation in a synergistic manner. Anti-Ia antibodies alone had minimal effects on B-cell proliferation. Second, not all monoclonal anti-Ia antibodies, such as the anti-IA antibody 10.3.6.2, can induce this synergy. Third, the synergistic effects of anti-Ia on anti-mu activation can be demonstrated under serum-free culture conditions. Finally, the effects of anti-Ia antibodies on B-cell activation are not due to induction of interleukin-1 secretion in the cultures nor are due to interaction with the Fc receptors. Since such positive stimulatory effects of anti-Ia antibodies were not reported previously, rigorous steps were taken to demonstrate the reproducibility and specificity of the phenomenon. In over 20 experiments utilizing serum-free culture conditions, we have been able to consistently demonstrate that anti-Ia antibodies augmented anti-mu induced B-cell proliferation by 2.6 fold, on the average. In addition, the anti-Ia antibody induced augmentation of B-cell proliferation is also allele specific and does not require participation by T cells and adherent cells. All antibody preparations used in this study were also shown to be free of endotoxin as demonstrated by the Limulus Amebocyte Assay. The synergistic effects are specific to anti-Ia and anti-mu antibodies, since antibodies to Lyb2 failed to augment the response to anti-mu. The synergy between anti-Ia and anti-mu can be demonstrated with monoclonal (BET2) anti-mu or affinity purified goat anti-mu or (Fab)2 fragments of the anti-mu antibodies. These results suggest that B-cell surface Ia molecules may function as signal transducer molecules as well as recognition molecules which are important for B cell activation. PMID- 3266925 TI - Regulation of B-cell differentiation: anti-mu antibodies have opposite effects on differentiation stimulated by bacterial lipopolysaccharide and 8 mercaptoguanosine. AB - The mechanisms by which proliferation and differentiation are independently regulated are among the most interesting and complex problems in cell biology. Polyclonal activation of mouse B cells by bacterial lipopolysaccharide (LPS) has served as a useful model for study of these phenomena. Treatment of LPS stimulated cells with high concentrations of bivalent antibodies to the IgM receptor uncouples these normally linked processes, enhancing proliferation while suppressing differentiation. A consensus summary of recent results from several laboratories suggests that modulation of the IgM receptor greatly reduces mRNA levels for mu and k chains, primarily by blocking the increased rate of transcription usually triggered by LPS. The expression of other differentiation linked proteins, for example J chain and endogenous retroviral proteins, is similarly downregulated. Basal transcription of the mu-delta complex and other constitutively expressed genes, such as Class I and Class II MHC genes, is not affected. Both suppression of differentiation and enhancement of proliferation in this system depend upon the simultaneous presence of anti-mu and LPS--cells treated with saturating concentrations of anti-mu, washed, and then cultured in LPS are not suppressed, while cells pulsed briefly with both agents before culture with LPS are suppressed. These observations have led us to examine interactions of anti-mu antibody with another potent polyclonal B cell activator, 8-mercaptoguanosine (8SGuo). In this report, we show that anti-mu antibodies have polar effects on B-cell differentiation induced by 8SGuo and LPS. Differentiation induced by the former is strongly enhanced, while that induced by the latter is suppressed. The signal induced by co-stimulation with LPS and anti-mu is dominant, as suppression occurs when LPS is added to cells stimulated with 8SGuo and anti-mu at initiation or as late as 48 hours of a 96-hour culture. We present preliminary evidence that augmented B-cell differentiation caused by combined stimulation with 8SGuo and anti-mu is dependent upon a soluble factor released during the first 24 hours of culture. These results provide additional evidence that suppression of LPS-driven B-cell differentiation is an active process, probably mediated by a trans-acting repressor of transcription. The mechanisms by which 8SGuo and anti-mu interact to enhance B-cell differentiation remain to be determined. PMID- 3266926 TI - Brain imaging and treatment response in spasmodic torticollis. AB - A patient with spasms of the neck, occurring when he turned his head to the left, responded to treatment with benzhexol. Cerebral blood flow imaging demonstrated reduced uptake in the right corpus striatum compared with the left. The study demonstrates the presence of an abnormality in the basal ganglia; it also illustrates response to drug treatment. Cerebral blood flow imaging may be useful in the detection of basal ganglia abnormalities in spasmodic torticollis and assist in the selection of cases which should be targeted for treatment with drugs. PMID- 3266927 TI - Progress in antidepressant therapy. Fluoxetine: a comprehensive overview. Proceedings of a symposium. Telfs, Austria, 16-18th October 1987. PMID- 3266928 TI - A pharmacological profile of fluoxetine and other antidepressants on aspects of skilled performance and car handling ability. PMID- 3266929 TI - [Effect of Chinese herbal drugs on T-cell subsets and immune function in chronic senile bronchitis]. PMID- 3266930 TI - [Ophthalmic zona in a LAV+ infant]. PMID- 3266931 TI - [T cell subsets in peripheral blood and spleen in malignant hepatoma bearing rats]. AB - T cell subsets in rat peripheral blood and spleen were analysed longitudinally by flow cytometer and MAbs in a murine intrahepatic implanted tumor model. In the peripheral blood. OX-19+ cells (pan T cell) and W3/25+ cells (Th/i cell) were reduced with the tumor growth in hepatoma bearing rats, giving a significant difference as compared with the control group. No significant changes were found in OX-8+ cells (Ts/c cell). Hence, W3/25+/OX-8+ cell ratio in hepatoma bearing rats was lower than control group. Meanwhile, on day 17 following tumor implantation, in the hepatoma bearing rats with intrahepatic or peritoneal metastasis, there were less W3/25+ cells and more OX-8+ cells than those of hepatoma bearing rats without metastasis (P less than 0.01). In the spleen, the phenotypes of lymphocyte markers showed less OX-8+ cells and more OX-12+ cells (B cell) in hepatoma bearing rats. It was suggested that, in the tumor bearing host, not only was the T cell immune function inhibited, but also there was abnormal distribution of T cell subsets. It seems that there is a close relationship between tumor growth and its spread and Th cells reduction and Ts cells increase. PMID- 3266932 TI - [I-131-LYM-1 MoAb radioimmunotherapy and LYM-1 MoAb immunotherapy in implanted nude mice model]. AB - Experimental studies of I-131-LYM-1 MoAb radioimmunotherapy (RIT) and LYM-1 MoAb immunotherapy (IT) were performed in 23 implanted nude mice model. 1 x 10(7) human B-cell lymphoma cells (Raji Burkitt's cells) were injected subcutaneously into the thigh. Three weeks later, they were divided into four groups: Group A (N = 6), as control group; Group B (N = 5), received LYM-1 MoAb 60 micrograms, as IT group; Group C (N = 7), received I-131-LYM-1 MoAb 120 mu ci; and Group D (N = 5), received I-131-LYM-1 MoAb 240 mu ci. Radioimaging was performed on day 7,8,9 postinjection. Tumor growth after 30 days was as follows: Group A, from 0.040 +/- 0.091 CM3 to 7.638 +/- 5.925; Group B, from 0.326 +/- 0.315 to 4.498 +/- 2.572; Group C, from 0.632 +/- 0.449 to 3.330 +/- 4.875; Group D, from 0.490 +/- 0.531 to 2.352 +/- 2.188. When converted to Relative Increase of Tumor Volume (Times X): The tumor in Group A increased 4346.19 X; in Group B 312.68 X; in Group C 15.94 X; and in Group D 8.36 X. Significant differences were noted between Groups A and B (p less than 0.05), A and C (p less than 0.025), A and D (p less than 0.025), B and C (p less than 0.025) and B and D (p less than 0.025). The difference between Group C and D was insignificant (p greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266933 TI - [Immunohistochemical study of alpha-1-antichymotrypsin and GFAP in glioma]. AB - GFAP is a specific antigen of glial element, but Alpha-1-antichymotrypsin has not been reported in the literature Alpha-1-antichymotrypsin was guided by GFAP using PAP method to the astrocytes of 137 gliomas. 120 (87%) gliomas were positive for Alpha-1-antichymotrypsin. Of these 120 gliomas, 86 (72%) gave diffuse distribution, 17 (14%) gave focal distribution, and 17 (14%) gave scattered distributions. Alpha-1-antichymotrypsin in glioma tissue may be an important tumor marker for diagnosis. PMID- 3266934 TI - [A new principle for the design of immunotherapeutic compounds of directed action. Physiologically active substances reversibly screened with target recognizing macromolecules]. PMID- 3266935 TI - Provocation of a paradoxical growth hormone response to corticotropin-releasing hormone by pretreatment with metoclopramide in patients with acromegaly and normal subjects. AB - Two of 7 patients with acromegaly and one of 7 normal subjects exhibited a paradoxical rise in growth hormone (GH) to human corticotropin-releasing hormone (CRH) when pretreated with metoclopramide, although CRH alone did not induce an increase in GH. In one of these two patients with acromegaly, the GH increase to metoclopramide alone also reached the criteria of a paradoxical response. These two acromegalic patients showed a GH increase to metoclopramide pretreatment before and up to two months after surgery. In another acromegalic patient, whose GH level remained high 5 months after surgery, metoclopramide induced an increase in GH level, while in a patient who had an above-normal GH level 18 months after surgery, the resumption of physiological GH secretion after surgery was evidenced by a postoperative absence of a GH response to metoclopramide. It is suggested from these results that the GH response to metoclopramide and the metoclopramide provoked GH response to CRH in patients with acromegaly result from the secretion of GH from nonadenomatous cells of the pituitary. PMID- 3266936 TI - [Molecular analysis of 21-hydroxylase gene of simple-virilizing 21-hydroxylase deficiency]. PMID- 3266937 TI - [Studies on rheumatoid factors in chronic liver diseases]. PMID- 3266938 TI - Analysis of blood spot 17 alpha-hydroxyprogesterone concentration in neonates. AB - Blood spot 17 alpha-hydroxyprogesterone (17-OHP) concentrations were measured in 515 infants aged from the 4th to the 81st day of life, using a fluorescence enzyme immunoassay method, and the values obtained were analyzed with respect to birth weight, gestational age at birth and sampling age, to obtain accurate reference ranges and to decide appropriate cut-off limits in a neonatal mass screening for steroid 21-hydroxylase deficiency. The results obtained indicate that the blood spot 17-OHP values in neonates should be interpreted using several different reference ranges obtained on the basis of the equivalent age of gestation at blood sampling. In the mass screening, therefore, the cut-off limits for recall are decided by these reference ranges as follows: (1) for blood resampling, 120, 30 and 25 nmol/l for the equivalent sampling ages of 31 weeks or less, 32-41 weeks and 42 weeks or more, respectively, and (2) for rapid confirmation of the disease by means of physical and laboratory examinations, 210, 60 and 60 nmol/l, respectively. PMID- 3266939 TI - Effect of a new antirheumatic drug (CGS10787B) on antibody formation and delayed type hypersensitivity in BALB/c mice. AB - The effect of CGS10787B on antibody formation and cell-mediated (delayed-type) hypersensitivity in BALB/c mice was examined by using the haemolytic plaque forming cell assay and the delayed-type footpad reaction with the assay of T-cell subsets. CGS10787B at doses of 5, 25 and 100 mg/kg p.o. enhanced spleen haemolytic plaque-formation on day 4, and spleen rosette-formation on day 5 after immunization. In the assay of T-cell subsets, CGS10787B at the dose of 100 mg/kg reduced the Lyt-23 positive cell subset. In type III hypersensitivity, CGS10787B at doses of 5, 25 and 100 mg/kg p.o. for 6 days reduced dose-relatedly the footpad swelling of the immunized mouse. In type IV hypersensitivity, CGS10787B at doses of 5, 25 and 100 mg/kg p.o. for 6 days diminished dose-dependently the footpad swelling augmented by cyclophosphamide pretreatment. In the assay of T cell subsets, CGS10787B at doses of 25 and 100 mg/kg increased the Thy-1 positive cell subset. These findings suggest that CGS10787B has an influence on the immune systems, acting on the function of T lymphocytes as well as on the inflammatory process in immunized animals. PMID- 3266940 TI - [Epidemiology of Bietti's keratopathy. Study of risk factors in Central Africa (Chad)]. AB - Climatic Droplet keratopathy (synonyms: spheroidal degeneration, Bietti's keratopathy) is a corneal degeneration characterized by an opacification at the level of the Bowman's membrane in the area of the palpebral fissure. It is particularly common in areas of bright sunlight and in Labrador; ultraviolet light thus being thought at its genesis. Two objectives were included in this study: studying the Climatic Droplet Keratopathy (CDK) prevalence by looking for the influence of the climatic factor; looking for possible association with three other degenerative ocular diseases: cataract, open-angle, glaucoma and exfoliation syndrome. A random cluster sampling survey was carried out in different climatic areas in Chad (N = 3,241 people). The resulting analysis showed a significant relation between the CDK prevalence and the kind of climate: the more the climate is dry; the more the higher the frequency: subdesert area = 1.57%, Sahelian area = 0.73%, tropical area = 0.18% (p less than 0.0001, rate standardized to age). The CDK occurs earlier in the subdesert area (mean age = 60.0) than in the Sahelian one (mean age = 66.7) (p less than 0.05). The CDK only exists among people age 40 or older, and is more frequent among males than females (p less than 0.005). The cataract is more frequent among individuals having a CDK than among those without it: relative risk = 4.3 (C.I.: 2.3-7.9 p less than 0.00001) (Mantel-Haenszel's method with adjustment to climate, age and sex). As for open-angle glaucoma, it is more frequent among individuals suffering from CDK: relative risk = 4.2 (p = 0.05). Finally, we noticed that the exfoliation syndrome was 5 times more frequent among chadians suffering from a CDK (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266941 TI - [T cell colony formation and interleukin-1,2 productivity in patients with chronic renal failure]. PMID- 3266942 TI - [A case of systemic lupus erythematosus developing malignant lymphoma]. PMID- 3266943 TI - [Inhibitory effects and spectral changes in pig testicular cytochrome P-450(17 alpha-hydroxylase/lyase) by 20 beta-hydroxy-C21-steroids]. PMID- 3266944 TI - Augmented release of human leucocyte lactoferrin (and elastase) during coagulation. AB - Lactoferrin, an iron binding protein, present in specific granules of neutrophils has been shown to be released concomitantly with elastase, when neutrophils are activated in vitro. Using enzyme-linked immunosorbent assay, lactoferrin release has been studied during blood coagulation, a more physiological system for studying the in vivo neutrophil activation in vitro. The assay has a lower detection limit of 1.0 ng/ml with intra and interassay coefficients of variation of 8 and 14% respectively. Median plasma and serum lactoferrin levels were 144 and 705 ng/ml respectively. The difference was statistically significant at p less than 0.0001. The median elastase proteinase inhibitor complex (EPIC) levels in plasma and serum were 85 and 176.5 ng/ml respectively. This difference was also highly significant at p less than 0.0001. There was no correlation between these parameters in the plasma samples. However, there was a statistically significant correlation between these measurements in sera at p less than 0.001 (Kendall's rank correlation). Release of lactoferrin and elastase-A1PIC during coagulation reflects the activation of neutrophils in vivo, especially during inflammation. PMID- 3266945 TI - The tonsils are superior to the peripheral blood as sources of mononuclear cells for B-cell purification. AB - Various methods for B-cell purification from mononuclear cells of the peripheral blood and tonsils were evaluated. L-leucine methyl ester was found to be the best method for monocyte depletion when B cells were isolated. Purification of B cells by negative selection methods from peripheral blood mononuclear cells (PBMCs) resulted in cell populations containing less than 40% B cells. This was partly due to significant increase in the relative number of large granular lymphocytes during the purification procedures. However, when T cells and monocytes were depleted from tonsillar mononuclear cells (TMCs), 84.6% of the remaining cells were B cells. The cell populations isolated from PBMCs and TMCs by negative selection methods differed from each other also in their responsiveness to pokeweed mitogen. Positive selection methods, such as panning and cell sorting by flow cytometer, resulted in good purities with both PBMCs and TMCs. However, the cell yields with the positive selection methods were always very low. It is concluded that the tonsils should be favoured as sources of B cells when negative selection methods are used. When peripheral blood B cells are wanted, positive selection methods should be favoured. PMID- 3266946 TI - The development of a C1q anti-C1q immunoadsorbent for removal of immune complexes from plasma. AB - An immunoadsorbent based on immobilized C1q has been developed to remove possibly pathogenic immune complexes from plasma deriving from patients suffering from systemic lupus erythematosus or rheumatoid arthritis. Traditional immobilization procedures based on, e.g., cyanogen bromide activation could not be used to produce an efficient adsorbent. However, by using antibodies directed towards C1q as handles for the immobilization of C1q it was possible to make an adsorbent that efficiently bound immune complexes in plasma. The capacity of the C1q anti C1q adsorbent to bind artificial immune complexes such as aggregated human globulins or immune complexes from various plasma samples was evaluated. Both batch and column experiments were conducted. The typical capacity in batch was about 1 mg immune complexes/ml gel when incubated with patient plasma samples with high titers of immune complexes. Special attention has to be paid to leakage of undesirable components from the adsorbent. It was found that leakage of C1q occurred but it was not more than after covalent immobilization procedures such as cyanogen bromide. PMID- 3266947 TI - Does cyclosporin A adversely affect Pneumocystis carinii infection? AB - Fourteen immunosuppressed patients with Pneumocystis carinii infection presented in two clusters that were separated by 2 years. The diagnosis in all cases was made early by alveolar lavage with cytology. The first group of seven patients was immunosuppressed with cyclophosphamide or azathioprine and prednisolone. All recovered with high dose co-trimoxazole. The second group of seven patients was on prednisolone and cyclosporin A. Despite identical treatment three patients died and a further two who survived lost their grafts from rejection. Our data suggest that cyclosporin A adversely affects the prognosis from Pneumocystis carinii infection and raises the question of prophylactic co-trimoxazole in these patients. The clustering of Pneumocystis carinii infection suggests the possibility of nosocomial transmission although in this study we were unable to implicate person-to-person spread of infection. PMID- 3266948 TI - [Tuberculosis in children]. PMID- 3266949 TI - Abnormalities of T cell activation in the rheumatoid synovium detected with monoclonal antibodies to CD3. AB - The chronic inflammation of rheumatoid arthritis (RA) is associated with hypofunction of synovial fluid (SF) T cells. We studied the mechanisms leading to this abnormality using a mitogenic monoclonal antibody specific for the T cell receptor-associated CD3 complex. We found that SF cells are defective in their response to anti-CD3 antibodies as measured by proliferation, generation of natural cytotoxicity, and induction of the Tac (p55) component of the IL2 receptor. Nevertheless, these cells do bear functional IL2 receptors and are more responsive to IL2 than are resting peripheral blood T cells. In searching for a mechanism to explain the reduced IL2 production, we found that polyamines (whose oxidation products can down-regulate proliferation and IL2 production) are elevated in RA cells from both blood and SF. We postulate that the chronic activation of RA T cells triggers this feedback loop which constitutes a defensive mechanism aimed at reducing the T cell driven autoimmune and inflammatory process. PMID- 3266950 TI - [Blood levels of osteocalcin in hemodialysis patients. Significance and relations with uremic osteodystrophy]. PMID- 3266952 TI - Image analysis of cell proliferation in rat thymus throughout development. AB - A System for Analytical Microscopy in Biological Applications (SAMBA 200) was used to digitize, process and statistically analyze the cell proliferation of rat lymphoid cells throughout thymus development. This cytometric study shows that lymphoid cell proliferation starts in 14-day-old embryos, remains high throughout embryogenesis with a maximum around day 18, decreases after birth then rises again in 21-day-old rats, after which proliferation decreases gradually with age, this decrease appears even before the onset of the sexual maturation, and is very marked in 2-year-old animals. Image cytometry analysis makes it possible to distinguish 5 lymphoid cell subpopulations (lymphoid stem-cells, lymphoblasts, large lymphocytes, medium lymphocytes, and small lymphocytes), and to discriminate in each cycling and non-cycling cells. The S-fraction of the lymphoid stem-cells decreases in 16-day-old rats, while the S-fraction of the lymphoblasts increases rapidly during the embryonic period. The large lymphocytes show the highest S-fraction at the stage E18, while the medium lymphocytes show the more stable S-fraction. The S-fraction variation for small lymphocytes can be divided into three periods: 1. up to E16 (S-fraction increases rapidly); 2. between newborn and 21 days (S-fraction increases slowly and irregularly); 3. after 21 days (S-fraction decreases progressively). PMID- 3266951 TI - The effects of leukemosuppressive immunotherapy on thymic infectious cell centers in AKR mice. AB - Although cortical thymocytes were found to be the predominant ecotropic and MCF virus producers in the thymus of leukemia prone AKR mice the initial ecotropic retrovirus producing cells have been detected among a low density subpopulation of thymocytes including both PNA(+) and PNA(-) cells. Leukemosuppressive anti viral treatment of these animals results in several important changes in the AKR thymus, including the elimination of virus producing cells, the induction of cellular phenotypic alterations, a decreased ability to bind ecotropic and MCF virus, a resistance to challenge with leukemogenic exogenous retroviruses, and the apparent elimination of a population of virus producing radioresistant cells. In addition, complement-mediated depletion with anti-viral IgG resulted in the complete elimination of proliferating thymocytes. These results suggest that passive anti-viral immunotherapy effectively eliminates a population of thymocytes which serve as the neonatal source of endogenous retroviruses and interferes with the earliest stages of leukemogenesis in AKR mice. PMID- 3266953 TI - Tumor necrosis factor alpha and interleukin-1 stimulate bone resorption in vivo as measured by urinary [3H]tetracycline excretion from prelabeled mice. AB - Tumor necrosis factor alpha (TNF-alpha) and interleukin-1 (IL-1) have been shown to stimulate bone resorption in vitro. We have now investigated whether these cytokines also cause a similar action when administered in vivo. This was made possible by the adaptation of a newly developed technique that enables the continual assessment of bone resorption in vivo in mice by measuring urinary excretion of 3H from [3H]tetracycline-prelabeled animals. Experiments using maneuvers known to influence bone resorption, such as a change in dietary calcium or administration of parathyroid hormone or dichloromethylenebisphosphonate, indicate that the technique is reliable and sensitive in mice. Daily intravenous administration of either recombinant human or recombinant murine TNF-alpha, as well as subcutaneous administration of recombinant human IL-1 alpha, were found to stimulate bone resorption in a dose-dependent manner. The effect was maximal within 2 days. Thus, exogenous TNF-alpha and IL-1 alpha can stimulate bone resorption in vivo, suggesting that these cytokines may also exert a systemic effect on bone. PMID- 3266954 TI - A differentiation-inducing factor produced by the osteoblastic cell line MC3T3-E1 stimulates bone resorption by promoting osteoclast formation. AB - We have reported that the differentiation-inducing factor (DIF) is present in conditioned medium of mouse osteoblast-like cell (MC3T3-E1) cultures. In the present study, the DIF from conditioned medium of MC3T3-E1 cells was partially purified and its biologic activity was examined. The DIF was purified by monitoring the induction of phagocytic activity of mouse myeloblastic leukemia cells (M1). The DIF induced differentiation of not only M1 cells but also mouse myelomonocytic cells (WEHI-3). Furthermore, the DIF increased the in vitro bone resorbing activity and the osteoclast number in mouse calvaria. The increases were inhibited by the addition of either salmon calcitonin or indomethacin. When mouse bone marrow cells were cultured with the DIF for 8 days, formation of osteoclast-like multinucleated cells was stimulated dose dependently. The DIF from MC3T3-E1 cells appeared to be different from interleukin-1 (IL-1), tumor necrosis factor (TNF), and transforming growth factor beta (TGF-beta). These results suggest that the DIF partially purified from osteoblast-like cell cultures stimulates osteoclastic bone resorption by promoting differentiation and fusion of osteoclast progenitors to form multinucleated osteoclasts. PMID- 3266955 TI - [A case report of clinical application of left ventricular assist device for a profound left ventricular heart failure after open heart surgery]. PMID- 3266956 TI - HLA product expression and lymphocyte subpopulations in jejunum biopsies of children with idiopathic protracted diarrhoea and enterocyte autoantibodies. AB - Mature enterocytes from normal human small intestine express HLA Class II molecules, whereas the immature enterocytes of the crypts are devoid of these products. By the use of the Avidin/Biotin immunofluorescence technique, we examined HLA Class I and II expression on cryostat sections of jejunum biopsies from 10 children with idiopathic protracted diarrhoea (IPD) and circulating enterocyte autoantibodies (Ec-Abs). The results were compared with those obtained on gut specimens from nine children with protracted diarrhoea but no evidence of circulating Ec-Abs and from one child affected by gluten-sensitive enteropathy. HLA Class I expression was similar in control and pathological specimens but jejunum biopsies from children with IPD and high titres of Ec-Abs (greater than or equal to 1:64) showed 'inappropriate' Class II molecule expression in the crypt epithelial cells. This was in contrast with normal or only mildly increased Class II reactivity in the mature villi enterocytes. Conversely, jejunum biopsies from children with IPD but with low levels of Ec-Abs (less than or equal to 1:4) possessed a moderate but distinct decrease of Class II expression in mature enterocytes with a decreased number of CD3 and CD8 intraepithelial lymphocytes. It is speculated that quantitative and qualitative variations of HLA product expression in the gut epithelium of children with IPD could reflect the severity of the autoimmune process underlying the clinical picture and point to heterogeneities within the autoimmune enteropathy syndrome. PMID- 3266957 TI - Assessment of brain dopamine metabolism from plasma HVA and MHPG during debrisoquin treatment: validation in monkeys treated with MPTP. AB - Homovanillic acid (HVA) is formed from dopamine that escapes conversion to norepinephrine in noradrenergic neurons throughout the body as well as from dopamine synthesized in dopaminergic neurons that are mainly in brain. Debrisoquin has been used to diminish peripheral formation of dopamine to enhance the value of plasma HVA as an index of brain dopaminergic activity. This enhancement may be improved if the residual HVA formed in noradrenergic neurons could be estimated. By use of simultaneously measured plasma levels of the major metabolite of norepinephrine, the degree of residual catecholamine formation in noradrenergic neurons can be estimated. By extrapolating to zero MHPG levels the linear relationship of plasma HVA to plasma MHPG, an estimate of HVA formed solely from brain dopaminergic neurons can be obtained. This method was tested by administering debrisoquin to monkeys before and after destruction of brain dopaminergic neurons with MPTP. After MPTP treatment there were decreases in plasma HVA that were relatively greatest when considered in relation to MHPG. The results support the view that the plasma HVA levels at extrapolated zero MHPG levels improves precision in assessing brain dopamine metabolism. PMID- 3266958 TI - Physical therapy in the symptomatic management of pain. PMID- 3266959 TI - Effects of thalamic parafascicular stimulation on the periaqueductal gray and adjacent reticular formation neurons. A possible contribution to pain control mechanisms. AB - To investigate the mechanism of analgesic effect of electrical stimulation of the thalamic parafascicular nucleus (Pf), we studied modulations of neuronal activities in the periaqueductal gray (PAG) and the adjacent reticular formation (RF) in response to Pf electrical and peripheral noxious stimulations in the rat. Extracellular single unit activities were recorded from 129 neurons in the PAG and adjacent RF under light halothane anesthesia. Pf stimulation caused neuronal responses in approximately 80% of the PAG and adjacent RF neurons, and noxious stimulation in 75%, with predominant excitatory responses to either stimulation. When the responses to the two stimuli were tested in the same neurons (n = 69), 91% responding to noxious stimuli also responded to Pf stimuli, again with predominant excitatory responses to either stimulation. The PAG and adjacent RF neurons that were verified antidromically to project to the nucleus raphe magnus (NRM), showed a similar pattern of response (n = 20). These results suggest that a sizeable population of neurons in the PAG and adjacent RF receives excitatory effects from the Pf and noxious afferents, and that part of these neurons projects to the NRM, which inhibits the dorsal horn cells of the spinal cord (the descending pain suppression system). Thus, part of the mechanism of the analgesic effects of Pf stimulation is due to activation of the descending pain suppression system by exciting the PAG and adjacent RF neurons. A possible role of noxious afferents on the negative feedback to pain mediation through this descending system also has to be considered. PMID- 3266960 TI - Sodium fluoride stimulates osteocalcin in normal subjects. AB - To test whether the administration of sodium fluoride in vivo results in an increase in osteocalcin concentration, we administered sodium fluoride to seven healthy male subjects for a period of 3 weeks. Fasting calcium, phosphate, alkaline phosphatase, 25-hydroxyvitamin D, parathyroid hormone and osteocalcin were measured prior to, during and 6 weeks after fluoride administration. Plasma calcium, phosphate and alkaline phosphatase and serum 25-hydroxyvitamin D and parathyroid hormone concentrations did not alter. Serum osteocalcin concentrations increased following fluoride administration, and the mean osteocalcin concentration at 3 weeks was significantly higher than the pretreatment mean. Plasma urea and creatinine concentrations did not alter. Six weeks after the cessation of fluoride treatment, the mean serum osteocalcin concentration had returned to the pretreatment baseline. We conclude that fluoride administration in normal subjects over a short period increases serum osteocalcin concentration and probably stimulates osteoblastic activity. PMID- 3266961 TI - Visual rehabilitation of patients with advanced stages of glaucoma, optic atrophy, myopia or retinitis pigmentosa. AB - Ninety-six patients with advanced stages of glaucoma, optic atrophy, myopia or retinitis pigmentosa (RP) who could not manage with ordinary spectacles or simple magnifying aids were taken care of at the Low Vision Clinic for rehabilitation and followed for an average of 3.6 years (the glaucoma group) up to an average of 6.0 years (the optic atrophy group). They were given high power optical aids and subjected to educational training in the proper use of these aids for best utilization of residual vision. Many of them (for optic atrophy as high a percentage as 40.7) were taught to use extra macular retina by means of eccentric viewing technique. The mean age of the oldest group, the glaucoma patients, was 69.3 years. The three other groups were about 20 to 25 years younger, on an average. (Another 35 patients were seen for the first series of visits but could not be followed up, the main reasons being death (13 patients) and moving out of the area (9 patients). The mean power of the aids (mainly telescopes) used for distance vision was 2.1 x (RP)-5.3 x (optic atrophy). Increased near addition and hyperocular lenses were the main aids for reading and near vision, the mean power being 17.0 dioptres (glaucoma)-23.5 dioptres (RP)(4.3 x -5.9 x). Aids were also provided for intermediate distance and for "spot use". The mean number of series of visits was 3.1 (myopia)-3.5 (glaucoma) and the average number of 1 h training sessions 2.2 (glaucoma)-2.5 (optic atrophy, RP) per series of visits. With aids and educational training, the mean visual acuity improved on the first series of visits from 0.31 to 0.60 for the glaucoma group, from 0.19 to 0.70 for the optic atrophy group, from 0.12 to 0.68 for the myopes and from 0.35 to 0.52 for the RP group. After the last series of visits acuity was still as good as 0.51, 0.61, 0.73 and 0.45, respectively. The number of individuals able to read newspaper text increased from 16.1% to 100.0% for the glaucoma patients, from 14.8% to 100.0% for the optic atrophy patients, from 75.0% to 100.0% for the myopes, and from 50.0% to 95.5% for the RP patients. The results show clearly that the methods used for rehabilitation of patients with glaucoma, optic atrophy, myopia or RP through optical aids and sessions of educational training are very successful, with substantial improvement of life quality. PMID- 3266962 TI - Effect of levamisole on T cell in minimal change nephrotic syndrome. PMID- 3266963 TI - Sociodemographic correlates of suicidal ideation and reported attempts--a brief report on a community survey. PMID- 3266964 TI - Gallium-transferrin as a macromolecular tracer of vascular permeability. AB - Labeling of plasma transferrin with gallium was investigated to determine whether the gallium-transferrin complex could be effectively used as a macromolecular tracer in studies of capillary permeability using Positron Emission Tomography (PET). Three gallium-plasma preparations were tested and 2 h biodistribution studies were performed in rats. The three preparations gave similar blood clearance and tissue distribution data, but the methods used for evaluating gallium-transferrin binding were found to be suboptimal. Gallium clearance from blood was biexpoential with both components faster than that of 125I-albumin. Gallium distribution spaces in all tissues including intracerebral Walker-256 tumors were larger than those of albumin. These results indicate a relative instability of the gallium-transferrin complex in vivo, which appears to preclude its use as an acceptable radiolabeled protein for vascular permeability studies using PET. PMID- 3266965 TI - Rotavirus shown to be the main cause of acute childhood diarrhoea in a New Delhi hospital with a high prevalence in winter. PMID- 3266966 TI - Incidence of idiopathic vitamin K deficiency in infants: a national, hospital based, survey in Thailand, 1983. PMID- 3266968 TI - Chlamydia trachomatis infection in pregnant women. PMID- 3266969 TI - [Tuberculosis in uremic patients]. PMID- 3266967 TI - Acute lymphoblastic leukemia with expression of myeloid antigens. PMID- 3266970 TI - [Resistance of gram negative bacteria to new generation cephalosporins and the role of beta-lactamases in this type of resistance]. AB - In this study, by using the microbroth dilution method, in vitro susceptibilities of gram negative bacteria to new generation cephalosporins were examined, and among these, 40 bacteria which showed resistance against at least two antibiotics were tested for beta-lactamase production. Beta-lactamase production was positive in all of them. However, this type of resistance could not be transferred to susceptible recipients by conjugation experiments. Our results suggest that the resistance to beta-lactam antibiotics in these strains are related with chromosomally mediated beta-lactamases. PMID- 3266971 TI - [Susceptibility of gram negative bacteria to TMP-SMX and ofloxacin]. AB - In this study we evaluated the susceptibility of 127 gram negative bacteria isolated from urine cultures, to TMP-SMX and Ofloxacin in vitro by disk diffusion technique. While 91 percent of bacteria were sensitive to Ofloxacin, only 50 percent were sensitive to TMP-SMX. This resistance to TMP-SMX is compared with similar results of other studies. PMID- 3266972 TI - [Diagnosis of duodenogastric reflux in patients with duodenal peptic ulcer combined with chronic opisthorchiasis]. PMID- 3266974 TI - Two cases of haematogenous Candida endophthalmitis. PMID- 3266973 TI - [Effect of an Opisthorchis infestation on the clinical course of typhoid and its outcome. 2. The effect of an Opisthorchis infestation on changes in lymphocyte blast transformation in typhoid infection]. PMID- 3266975 TI - [Use of interleukin 2-activated lymphocytes (LAK cells) in adoptive immunotherapy of neoplasms]. PMID- 3266976 TI - [Oral manifestations in Langerhans' histiocytosis: report of 4 cases]. PMID- 3266977 TI - [Hematologic considerations in the dental management of the pregnant woman]. PMID- 3266978 TI - Do increased catecholamines and plasma methionine enkephalin in cirrhosis promote bleeding oesophageal varices? AB - Increased sympathetic tone and adrenal medullary activity in hepatic cirrhosis may promote portal hypertension. We suggest that they may be imperfect homeostatic mechanisms attempting to maintain systemic arterial pressure in response to chronic vasodilatation and that small, endogenous opioid peptides may play a part in this vasodilatation. As initial investigation of this hypothesis, we measured noradrenaline (an indicator of sympathetic tone), adrenaline and methionine enkephalin in the plasma of patients with cirrhosis with oesophageal varices which had or had not bled previously, patients with cirrhosis without varices, patients with acute liver disease and controls. In patients with cirrhosis, noradrenaline, adrenaline and methionine enkephalin were all greatest in those with oesophageal varices which had previously bled. In this group, noradrenaline correlated strongly with the widely used prognostic guide, Pugh's modification of Child's classification. In patients with acute liver disease, methionine enkephalin and adrenaline were increased six- and four-fold respectively. However, noradrenaline was normal, suggesting that increased sympathetic tone in cirrhosis may develop gradually. The use of opioid antagonists may enable determination of whether elevated plasma opioid peptides in cirrhosis stimulate the increase in sympathetic tone and plasma adrenaline, and promote bleeding oesophageal varices. PMID- 3266979 TI - [Malignant gastric leiomyoblastoma. The cause of subclinical digestive hemorrhage]. PMID- 3266980 TI - Polyclonal B-cell activation in human malaria: relevance to the development of anti-sporozoite specific immune response and of immunopathology in individuals from endemic areas (Rondonia State--Brazil). PMID- 3266981 TI - Adrenergic innervation of aortic patch-grafts in rats. AB - The regeneration of vascular adrenergic nerves was studied using the glyoxylic acid-induced fluorescence method for the specific demonstration of adrenergic nerves in syngeneic patch-grafts of the right atrium of the heart, vena cava and glutaraldehyde-treated vena cava transplanted into the abdominal aorta of the rat. Glutaraldehyde-treated segments of the supradiaphragmatic inferior vena cava were transplanted into the abdominal aorta of rats as well. At the end of the observation period of 24 weeks limited, patchy and defective innervation was observed in the syngeneic vena cava and atrial patches. No adrenergic nerves were found in the glutaraldehyde-treated vein patch-grafts or vein grafts. Owing to the very poor innervation of atrial and venous patch-grafts the results are not entirely in agreement with the target organ concept of adrenergic nerve regeneration. In this study the suture line around the patch graft probably hampers regeneration of vascular adrenergic nerves in the patches. PMID- 3266982 TI - Parameters of production and partial characterization of feline interleukin 2. AB - The conditions for the production of feline interleukin 2 (IL-2) from peripheral blood leukocytes (PBL) and splenocytes by concanavalin A (Con A) stimulation are described. Feline IL-2 was quantitated by measuring DNA synthesis in the murine IL-2-dependent cell line, CTLL-20. In addition, feline IL-2 was generated for the maintenance of long-term cultures of Con A-stimulated feline PBL and for biochemical characterization. Finally, IL-2 production was evaluated from the PBL of feline leukemia virus (FeLV)-infected cats. Con A at 9.6 micrograms/ml produced a plateau of peak IL-2 activity from 24 to 48 h following stimulation. The tumor promoter, phorbol myristic acetate, stimulated feline IL-2 production and enhanced Con A-stimulated feline IL-2 production. Fetal calf serum (FCS) was not required for IL-2 production; however, FCS at 5% (v/v) allowed for maximal Con A-stimulated IL-2 production. Feline IL-2 generated from Con A-stimulated splenocytes migrated with an apparent molecular size of 13.7 to 23 kD by gel filtration chromatography and supported the proliferation of Con A-activated feline PBL at a final concentration of 0.3 to 0.9 units/ml. PMID- 3266984 TI - The association of health with stressful life changes, social supports, and coping. AB - Cross-sectional associations of social stressors, social supports, and coping strategies with health status were explored in a self-selected sample of 157 white adults. Using a mailed questionnaire, stressful life changes were assessed by a 40-item version of the Social Readjustment Rating Scale, social supports were measured by a 13-item index, and health status was assessed by the 63-item Duke-UNC Health Profile (DUHP). Responses to a recent stressful event were categorized by method of coping and by focus of coping. In a multivariate analysis controlling for the effects of age, gender, and education level, higher 12 month life change score was related to lower composite DUHP score. The use of active-cognitive coping was directly associated and the use of avoidance-coping was inversely associated with health status. When interaction terms were included in the multivariate analysis, avoidance-coping potentiated the adverse health effect of stressors and weak social supports potentiated the harmful effect of avoidance-coping on health. The findings suggest that the propensity to engage in avoidant behavior in response to a stressful experience is associated with health impairment, particularly when social supports are weak. PMID- 3266983 TI - The effects of human interferon-alpha upon in vitro canine immune responses. AB - The effects of varying amounts (100.0-0.01 units/ml) of human interferon (IFN) alpha upon in vitro canine immune responses were studied. Exogenous heterologous species IFN-alpha suppressed B-cell differentiation in a dose-dependent fashion and enhanced interleukin-2 production (P less than 0.05) by activated T lymphocytes. Interferon enhanced natural killer (NK) cytotoxicity when tested against NK-resistant target cells (less than 0.05). One hundred units IFN/ml increased interleukin-1 production by canine monocytes, but this effect was not statistically significant. Exogenous IFN had no discernible effect upon lectin induced lymphocyte blastogenesis. The results of this study demonstrate that human IFN-alpha does affect various canine lymphocyte functions and these effects depend upon the in vitro assay system employed. PMID- 3266985 TI - [New orofacial manifestations during human immunodeficiency virus infection]. PMID- 3266986 TI - Treatment of low vision in the progressive cone dystrophies. AB - Twenty-three patients suffering from the progressive cone dystrophies (PCD) were evaluated retrospectively, after they had undergone treatment for low vision. All patients were able to read 1 M or smaller print with magnification, despite poor central acuity. Eighteen (78%) patients achieved their primary rehabilitation goal, and 86% of the low vision devices prescribed were used at follow-up. Photosensitivity was reported by a large number of patients. Seven patients indicated that alleviating this problem was their primary rehabilitation goal. Eight (35%) found sun filters to be helpful. Our successful experience with patients with these disorders suggests that examination for, and trial of, low vision devices is warranted. PMID- 3266988 TI - Rapid isoelectric focusing of plasmid-mediated beta-lactamases with Pharmacia PhastSystem. AB - A modified isoelectric focusing method for rapid semiquantitative identification of plasmid-mediated beta-lactamases by use of the Pharmacia PhastSystem (Uppsala, Sweden) is described. Sonication of bacterial colonies collected directly from growth plates decreased the time required for the procedure. With sonic extracts of known beta-lactamase-producing strains used as controls, the assay could be completed in less than 2 h. PMID- 3266987 TI - Bactericidal activity of oxacillin against beta-lactamase-hyperproducing Staphylococcus aureus. AB - The bactericidal activity of oxacillin against beta-lactamase-hyperproducing strains of Staphylococcus aureus for which the MIC by MicroScan was 1 or 2 micrograms/ml after incubation for 24 h was evaluated by MBC studies and kill kinetics methods. MBC and kill kinetics tests were both performed using Mueller Hinton broth (MHB), with and without 2% NaCl supplementation, and incubation at 30 and 35 degrees C. When MBC testing was performed with salt-supplemented MHB, the oxacillin MBC/MIC ratio was greater than 8 for 17 and 16 of 17 S. aureus isolates at 30 and 35 degrees C, respectively. With unsupplemented MHB, the MBC/MIC ratio was greater than 8 for nine and six strains at 30 and 35 degrees C, respectively. Five representative strains were selected for kill kinetics studies under the four different test conditions. Oxacillin appeared more bactericidal by the kill kinetics method than by MBC testing. Moreover, salt supplementation did not affect the results of kill kinetics studies as dramatically as it did the MBC results. Thus, bactericidal testing results are markedly influenced by the technique employed, and further in vivo studies are necessary to fully evaluate the efficiency of oxacillin against beta-lactamase-hyperproducing strains of S. aureus. PMID- 3266989 TI - Follow-up cell-mediated immune functions in "professional" blood donors. PMID- 3266990 TI - Inhibitory effect of interleukin-1 on the in vitro PHA-stimulated lymphocytes of some blood donors. PMID- 3266991 TI - Anti-interleukin-2 receptor monoclonal antibody therapy induces anti-idiotypic antibodies in mice that block both in vitro and in vivo activity. AB - Monoclonal antibodies (Mab) targeting certain T cell-surface proteins including the interleukin-2 (IL2) receptor molecule exert powerful immunosuppressive effects. A potential limiting factor to Mab therapy is the formation of neutralizing anti-idiotypic antibodies (Anti-Id). In this study, we demonstrate that an anti-IL2 receptor Mab, M7/20, when administered at doses which are immunosuppressive in vivo rapidly elicits an anti-idiotypic (anti-Id) antibody response. The induced antibodies are capable of blocking M7/20 binding to its target, the IL2 receptor, in vitro. Such anti-Id when given in concert with M7/20 block the expected in vivo inhibitory effects in delayed type hypersensitivity. Thus, mice respond to therapeutic doses of Mab therapy with the formation of neutralizing anti-Id. As this response is similar to that observed in humans given xenogeneic Mab, this model may be useful to further our understanding of this form of therapy. PMID- 3266992 TI - T-cell functional defects in rheumatoid arthritis: intrinsic or extrinsic? AB - This study investigated two mechanisms which may underlie abnormal T-cell function [lymphocyte proliferation and interleukin-2 (IL-2) production] in rheumatoid arthritis (RA). These were: (a) a possible lack of the IL-2-producing CD4+2H4+ lymphocytes and (b) the possible inhibitory role of monocytes and neutrophils. Numbers of CD4+2H4+ cells did not differ between normal controls and patients with RA, although IL-2 produced by the peripheral blood mononuclear cells (PBMC) of the same individuals was markedly reduced in the patient group (P less than 0.001). Many rheumatoid peripheral blood mononuclear cell preparations, but very few control, were contaminated with neutrophils (P less than 0.001). This was more marked in patients with active RA than in those with inactive disease (P less than 0.001). Numbers of monocytes were similar in all groups. Monocyte depletion, or addition of indomethacin and/or catalase in PBMC, caused a significantly greater increase of responses in RA patients than in controls. This effect was significantly higher in patients with active disease than in the inactive group. These findings suggest that activated monocytes and neutrophils found in the rheumatoid PBMC preparations exert inhibitory effects mediated, in part, by the production of prostaglandins and reactive oxygen intermediates. Monocyte depletion and partial reconstitution resulted in significant increase of lymphocyte proliferation and IL-2 production in both controls and patients. None of the manipulations performed succeeded in normalizing the deficient rheumatoid T-cell responses. These data support the hypothesis that non-lymphoid cell populations play an important role in the T-cell dysfunction characteristic of RA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3266993 TI - Serum interleukin-2-receptor in rheumatoid arthritis: a prognostic indicator of disease activity? AB - Interleukin-2 (IL-2) is an important growth factor for T lymphocytes. Its effects are mediated by cell surface receptors (IL-2 R) expressed on activated T cells. Receptor protein can be shed from cell membranes and the soluble form (sIL-2 R) is detectable by enzyme linked immunosorbent assay (ELISA). We have studied serial levels of sIL-2 R in the sera of patients with rheumatoid arthritis (RA). In 13 patients with active disease, the mean serum level of sIL-2 R was raised compared to age-matched healthy controls. In 48 samples taken at different times from 13 patients, serum sIL-2 R correlated significantly with Ritchie joint index, duration of early morning stiffness, patient pain score, physician's assessment, erythrocyte sedimentation rate (ESR) and platelet count. In individual patients, serial sIL-2 R serum levels fell with treatment preceding clinical improvement. In four patients where serum sIL-2 R levels fell and clinical improvement occurred, subsequent spontaneous increases of serum sIL-2 R level preceded increased clinical disease activity by up to 2 weeks. Serum sIL-2 R level in RA probably reflects activation of underlying immunopathogenic mechanisms and appears to be an excellent monitor of clinical disease activity. More importantly, a rising level may also predict exacerbation of disease activity. PMID- 3266995 TI - Clinical implications of the presence of anti-Ro (SSA) antibodies in patients with rheumatoid arthritis. AB - The clinical and serologic findings in 25 patients with rheumatoid arthritis (RA) of more than 5 years' duration, who had antibodies to Ro(SSA) cellular antigen, were analyzed and compared with those in 50 anti-Ro(SSA) negative RA patients with similar disease duration. Ninety-six percent of the anti-Ro(SSA) positive patients were female, compared to 74% in the negative group. The majority of antibody positive patients had symmetric erosive synovitis, similar to that observed in the negative group. Extra-articular manifestations were similar in both groups, except for features of Sjogren's syndrome (keratoconjunctivitis sicca and positive labial salivary gland biopsy), which were significantly more common in patients with anti-Ro(SSA) antibodies. Anemia of chronic disease was also more common in these patients, as were rheumatoid factor (RF) and antinuclear antibodies (ANAs). No patient in either group had antibodies to ds DNA or Sm and none developed clinical features suggestive of systemic lupus erythematosus (SLE). D-penicillamine, given in the majority of patients in both groups, produced adverse reactions in 72% of the anti-Ro(SSA) positive patients, but only in 27% of the negative ones. Thus, anti-Ro(SSA) antibodies seem to characterize a distinct group of RA patients who are almost exclusively female, express more activated B-cell function, have a high prevalence of Sjogren's features and commonly develop side effects to D-penicillamine. PMID- 3266994 TI - Synovial fluid concentrations of interleukin-1 beta and proteoglycans are inversely related. AB - Interleukin-1 beta (IL-1 beta) and proteoglycans have been quantified by radioimmunoassay (IL-1 beta) and enzyme linked immunosorbent assay (proteoglycans) in synovial fluids and sera from patients with rheumatoid arthritis (RA) and reactive arthritis. All fluids were also tested for their ability to influence proteoglycan metabolism in a cartilage explant culture system. Synovial fluid IL-1 beta concentrations were inversely related to proteoglycan concentrations in samples from both RA and reactive arthritis patients (P less than 0.002 for all patients). There was no statistically significant relation between immunoreactive IL-1 beta concentration and proteoglycan synthesis or degradation in explants cultured in synovial fluid containing medium. Synovial fluid IL-1 beta concentrations were not related to erythrocyte sedimentation rate or joint total leukocyte count. IL-1 beta was not detectable (limit 250 pg/ml) in any unextracted sera. Although it appears likely that IL-1 beta is involved in the inflammatory and degenerative processes in joint disease, our findings indicate that there is no simple positive relationship between immunoreactive levels of this cytokine in synovial fluid and liberation of proteoglycans from articular cartilage as reflected in synovial fluid proteoglycan concentration. PMID- 3266996 TI - Enhancement of chemically induced bladder carcinoma by cyclosporin A. AB - The effects of cyclosporin A (CsA) on the induction of bladder carcinoma were investigated in Wistar rats using N-butyl-N (4 hydroxybutyl) nitrosamine (BBN) as a known initiator of carcinogenesis. Rats treated with 0.05% BBN + 5 mg/kg per day CsA or 0.05% BBN + 12.5 mg/kg per day CsA developed a dose-dependent (two to fourfold) enhancement of bladder tumor expansion and infiltration as compared to those treated with 0.05% BBN alone. In control rats receiving CsA at doses of 5 mg/kg per day or 12.5 mg/kg per day, no bladder carcinoma occurred. All CsA treated groups, with or without 0.05% BBN, displayed slight or moderate medullary atrophy of the thymus. The results indicate that immunosuppression with CsA enhances the induction of bladder tumors by BBN. Furthermore, the immunosurveillance theory that effective expression of the immune response may be important in the control of tumor development was confirmed in the carcinogenesis of epithelial cell tumors. PMID- 3266998 TI - The prevalence of neuropsychiatric disorders in a nursing home population. AB - The prevalence of neuropsychiatric disorders and other medical illnesses was investigated in 65 nursing home residents. The authors found neuropsychiatric disorders to be present in 94% of the sample. The neuropathologic causes of these syndromes were found to be more diverse than in previous studies. The most frequent causes were degenerative, vascular, and toxic. The most common psychiatric syndromes that resulted from these neuropathologic disorders were dementia syndrome (72%), organic personality syndrome (14%), and organic psychotic disorders (12%). The most common behavioral problems, agitation and aggression, most likely reflected the high prevalence of frontal lobe damage and affected 48% of the sample. Other non-neuropsychiatric medical problems were significantly less common. While only 4% of the sample had no neuropsychiatric diagnosis, 39% had no other non-neuropsychiatric diagnosis. These results suggest that the nursing home is not used as a referral source for chronic medical conditions in general but almost exclusively for the care of chronic neuropsychiatric disorders. PMID- 3266997 TI - The nature of psychotic symptoms in senile dementia of the Alzheimer type. AB - The Alzheimer Disease Research Center at Washington University's medical school has gathered a large sample of subjects with senile dementia of the Alzheimer type (SDAT) who are free of other potentially complicating medical, neurologic and psychiatric disorders. Using this homogeneous population, we have characterized psychotic symptoms associated with SDAT. Three groups of symptoms occur commonly: paranoid delusions, misidentification syndromes, and hallucinations. The nature and frequency of these syndromes are discussed. PMID- 3266999 TI - Dementia: the crisis of our times. PMID- 3267000 TI - Acute renal failure associated with cardiac surgery. AB - We present the incidence, management and outcome of acute renal failure (ARF) in children who underwent cardiac surgery. Fourteen (9%) from a total of 156 children developed ARF in our hospital in a 3-year period. Patients were aged 2 days to 15 years. Prerenal failure was present in 6 and renal type in the remaining 8 children. Peritoneal dialysis treatment was utilized in 58% of patients. Neurologic and respiratory complications were present. Mortality rate was 58% and related to underlying pathology and to complications in other organs. The management of these patients must be by competent personnel preferably trained in pediatrics. PMID- 3267001 TI - [Effects of radix Rehmanniae and processed radix Rehmanniae on some immune functions in mice]. PMID- 3267002 TI - Some pharmacokinetic data on miocamycin. I: Serum, urinary and prostatic levels. AB - The pharmacokinetics of miocamycin were studied in ten healthy male volunteers after three different administrations: the first group received 600 mg in a single oral dose; the second received 1200 mg divided into two administrations of 600 mg, each one every 12 h; the third received 1200 mg in a single oral dose. Prostatic levels of miocamycin were recorded after the administration of 1200 mg, divided into two administrations of 600 mg every 12 h. The pharmacokinetic analysis was carried out by applying a single-compartment kinetic model with zero order absorption. The apparent duration of absorption (T) was about 0.55 h for all subjects. The area under the curve was 7.5767 +/- 0.2511 mg/h/l in the first group; 6.7333 +/- 0.6058 mg/h/l in the second group; and 18.6825 +/- 15.1555 mg/h/l in the third. The prostatic levels were five times higher than those in the serum at the same time. PMID- 3267003 TI - Serum lipids and apolipoproteins in relation to glycaemic control and diabetic nephropathy in long-term survivors of diabetes: results of the Erfurt Study. AB - Follow-up data of all 208 long-term diabetics (duration of the disease at least 20 years) living in the closed area of the Erfurt district in 1970 had demonstrated the importance of lipoprotein pattern for longevity. Now the dependence of lipoprotein levels on both the diabetes-related conditions nephropathy and glycaemic control has been examined in 47 of them, still alive in 1985 that means 35 or more years after the onset of diabetes. Glycaemic control was assessed by measuring the glycosylated haemoglobin (n = 44). Diabetic nephropathy was assumed in case of persistent proteinuria. Poor glycaemic control (n = 16) was associated with increased levels of atherogenic lipoproteins as reflected by higher concentrations of total cholesterol, LDL cholesterol, apolipoprotein B, and triglycerides, as well as a changed HDL composition indicated by a decreased HDL cholesterol/apolipoprotein A--I ratio. Higher ratios of total cholesterol to HDL cholesterol and apolipoprotein B to apolipoprotein A- I point to an increased risk of developing atherosclerotic diseases in poorly controlled diabetics. 86% of the well controlled long-term diabetics had non pathological values of LDL cholesterol, triglycerides, apolipoprotein B, HDL cholesterol, and apolipoprotein A--I but only 31% of the poorly controlled patients did so. Diabetic nephropathy in the absence of chronic renal failure (n = 10) was characterized by higher values of LDL cholesterol, triglycerides, total cholesterol/HDL cholesterol, and apolipoprotein B/apolipoprotein A--I. 80% of the subjects with a pathological lipoprotein pattern were proteinuric or in poor glycaemic control or both. Therefore, it is concluded that prevention of these two conditions might help to delay atherosclerosis via its beneficial influence on lipoprotein metabolism. PMID- 3267004 TI - Effects of ovariectomy and 17 beta-estradiol on bone GLA protein in growing rats: an indirect evidence for estrogen receptors in bone cells. AB - Estrogen deficiency after ovariectomy in the rat is followed by an increase of bone turnover and bone loss. Estrogens are thought to modulate the sensitivity of skeleton to Parathyroid Hormone; according to the recently reported evidence of estrogen receptors on osteoblasts, however, a direct effect on bone cells should not be ruled out. We studied the behaviour of Bone Gla Protein (Osteocalcin), a reliable marker of osteoblast function, in growing rats after ovariectomy and treatment with 17 beta-estradiol. Results indicate that ovariectomy stimulates, as expected, bone turnover, and that estrogen induces a further increase of osteoblast activity revealed by the rise of Bone Gla Protein plasma levels. This data may have clinical implications in humans, where estrogens are currently suggested for prevention and therapy of post menopausal osteoporosis. PMID- 3267006 TI - Factors associated with presence of decubitus ulcers at admission to nursing homes. PMID- 3267005 TI - Prevention of cation transport in the frog tongue epithelium by local anesthetics. PMID- 3267007 TI - Antigen processing. PMID- 3267008 TI - Alpha-1 antitrypsin and serum albumin levels in tear fluid of healthy subjects and in persons with conjunctival diseases. PMID- 3267009 TI - Muscarinic cholinergic binding sites on rat lymphocytes. AB - Receptors for neurotransmitters in blood cells could serve as useful markers for the same receptors in solid tissues. Muscarinic receptors have been identified in human, rat and mouse lymphocytes by binding of [3H]quinuclidinyl benzilate (3H QNB); however, the biochemical and pharmacological characterization of such binding sites has not been complete. Spleen lymphocytes were isolated on a histopaque gradient and incubated in Hank's buffer with 3H-QNB. Binding of 3H-QNB was linear with increasing protein concentrations and was saturable. Binding constants were Bmax = 111 +/- 10.5 fmol/10(6) cells, and Kd = 29.7 +/- 3.9 nM (n = 7). An extensive pharmacological analysis of these binding sites indicated that several cholinergic muscarinic drugs were capable of inhibiting 3H-QNB binding. Muscarinic antagonists were more potent than agonists, and lipophilic drugs were more potent than hydrophilic drugs. Several non-cholinergic drugs were also capable of inhibiting 3H-QNB binding; however, they did so also in brain membranes, while a third group of non-cholinergic drugs and neurotransmitters were inactive. Similar results were also obtained in circulating lymphocytes and in lymphocyte membranes. These results suggest that lymphocytes possess muscarinic receptors which share several, although not all, characteristics of the same receptors in brain and other tissues. Measurement of these binding sites could be useful to monitor the status of muscarinic receptors in solid tissues. PMID- 3267010 TI - Elucidation of cellular targets responsible for tetrachlorodibenzo-p-dioxin (TCDD)-induced suppression of antibody responses: I. The role of the B lymphocyte. AB - The objective of these studies was to identify the primary cellular target(s) responsible for TCDD (tetrachlorodibenzo-p-dioxin)-induced suppression of antibody production. Responses to T-independent and T-dependent antigens (administered in vivo or directly to splenic culture) were suppressed in a dose related fashion in female B6C3F1 mice dosed for 5 consecutive days with 0.1, 1.0 and 10.0 micrograms/kg of 2,3,7,8-TCDD. When nonadherent (B and T) and adherent (macrophage) cells from vehicle- and TCDD-treated mice were combined in various combinations and immunized with either DNP-Ficoll (T-independent) or sRBCs (T dependent), it was demonstrated that nonadherent cells, but not adherent cells, were functionally affected by TCDD. Similarly, as various combinations of B + macrophage and T + macrophage populations were immunized with sRBCs, the B cell was shown to be the primary target. Using LPS as the stimulus, an inhibition of the antibody response with no effect on the mitogenic response further indicated that the primary target of the TCDD-induced suppression of IgM antibody production is the B lymphocyte at the level of cell differentiation. PMID- 3267011 TI - In vivo depression of lymphocyte traffic in sheep by VIP and HIV (AIDS)-related peptides. AB - Core pentapeptides and an octapeptide (Peptide T) computer deduced from amino acid sequences from vasoactive intestinal peptide (VIP) and the 120 gp external envelope of the HIV (AIDS) virus and synthesized have been reported to have important in vitro and in vivo activity including inhibition of HIV binding to CD4 surface antigens of brain cells and lymphocytes and limitation of HIV infectivity. Two of these core pentapeptides, peptide TTNYT (Peptide T [4-8]) and peptide TDNYT (VIP [7-11]), are reported here, on acute infusion into cannulated afferent popliteal lymphatics of sheep, to produce prompt and marked depressions in the output of both small recirculating and blast lymphocytes into popliteal lymph node efferent lymph. As with a prior VIP infusion study, there appeared to be a selective effect on T4 (CD4) lymphocytes, with a marked predominance of T4 (CD4) lymphocytes in the lymphocyte depleted efferent lymph. PMID- 3267012 TI - Human hybridoma suppressor factor acts selectively on CD4+ cells. AB - A human thymus cell hybridoma secretes an immunosuppressive lymphokine, referred to as hybridoma suppressor factor (HSF). This factor suppresses polyclonal immunoglobulin (Ig) production as well as Interleukin-2 (IL-2) production in pokeweed mitogen (PWM)-stimulated peripheral blood mononuclear cells (PBMC). Similar suppression of Ig and IL-2 production was observed in reconstituted cultures of CD4+ cells and non-T cells. Here we analysed, further, the mechanism of HSF-mediated suppression of Ig and IL-2 production. We demonstrated that HSF inhibited PWM-induced IL-2 production by CD4+ cells but not by CD8+ cells and its suppressive activity on Ig production was totally abrogated by preabsorption with CD4+ cells, but not by CD8+ cells. These results indicate a subset specific action of HSF. PMID- 3267013 TI - Granulopoiesis in tadpoles of Rana esculenta. Survey of the organs involved. AB - The topography and nature of granulopoietic tissues appearing during the larval period of Rana esculenta have been investigated using light and electron microscopy. The formation of eosinophils and heterophils occurred in the interstices of the pronephros and opisthonephros, in the mesenchymal sheath surrounding the pronephric duct, as well as in the mesentery and mesenchymal coat of the bile duct and hepatic ducts. Developing basophils were very rare, being detectable only in the stroma of the trunk kidneys. The pronephric interstices additionally contained differentiating lymphocytes, the opisthonephric interstices differentiating lymphocytes and erythrocytes. In contrast, the mesenchymal sheath of the pronephric duct as well as the mesentery and the mesenchymatous coat of the bile duct and hepatic ducts were solely granulopoietic. PMID- 3267014 TI - Variation in thin filament size in the skeletal muscle of the frog. AB - The sartorius muscle of Rana esculenta was fixed and dehydrated by different methods and cross-sections of sarcomeres of different lengths were examined by electron microscopy. The area within the outlines of the thin filaments in negatives was measured using a high-resolution television system and a graphics tablet or by using a microdensitometer and computer processing the images with a density threshold above the background level. In all specimens the area of the thin filaments in the I-bands was found to be larger than in the S-zones of the A bands where the thick and thin filaments interpenetrate. The difference was statistically significant and independent of the length of the sarcomere. The results are in agreement with previous observations in glycerol-extracted fibres. It is suggested that the change in size of the thin filaments might be accounted for by some interaction with the thick filaments. PMID- 3267015 TI - The role of HMG CoA reductase and dolichol synthesis in the control of 3T6 cell proliferation: effects of cell crowding, serum depletion and addition of epidermal growth factor. AB - The proliferation of 3T6 cells was substantially decreased when the monolayer cultures were allowed to reach confluency. This growth inhibition (so-called density-dependent inhibition) was of the same magnitude as that following serum depletion in non-confluent cultures. Each type of growth inhibition was correlated to a depression of the activity of 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG CoA) reductase, an enzyme that regulates the biosynthesis of cholesterol and isoprenoid derivatives (e.g. dolichol) by catalysing the reduction of HMG CoA (which is derived from acetyl-CoA) into mevalonate. However, the depression of enzyme activity was more substantial in cells exposed to cell crowding than that in serum-depleted cells (87 and 48%, respectively). On the other hand, there was a 60-65% inhibition of the incorporation of mevalonate into dolichol due to serum deprivation, while it remained at normal level in confluent cultures, which implies that the inhibitory effects on dolichol synthesis due to these two experimental conditions were approximately equipotent. Addition of epidermal growth factor (EGF) to the cell cultures, whose proliferation was inhibited due to serum depletion, restored DNA synthesis completely, and these effects were related to a normalization of the activity of HMG CoA reductase and of the incorporation of mevalonate into dolichol. In contrast, in confluent cells addition of EGF only caused a slight increase in DNA synthesis and activity of HMG CoA reductase, and there was no significant increase in the incorporation of mevalonate into dolichol either.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267016 TI - DNase I nick translation in situ on meiotic chromosomes of the mouse, Mus musculus. AB - DNase-I-sensitive sites have been located on the meiotic chromosomes of the mouse, Mus musculus, by the in situ DNase I nick-translation method. We find that: (1) of all the cell types studied, pachytene nuclei are the most sensitive to DNase I; (2) in diplotene the nicks occur preferentially in the vicinity of chiasmata; (3) the sex chromosomes are also sensitive to the enzyme despite their transcriptional quiescence; and (4) in the sex bivalent the nicks are primarily observed in the putative region of recombination. We conclude that, in addition to discriminating between the transcriptionally active and inactive states of chromatin, DNase I identifies recombination-specific chromatin changes in meiotic prophase. PMID- 3267017 TI - Initiation of the cortical reaction in hamster and sheep oocytes in response to inositol trisphosphate. AB - Microinjection of inositol 1,4,5-triphosphate into sheep and hamster oocytes induces secretion of cortical granules in a dose-dependent manner. In the sheep, this effect is strongly pH-dependent with minimal exocytosis taking place at pH 6.8 but a full cortical reaction occurring at pH8.0. Exocytosis in the hamster is also affected by the pH of the external medium but to a lesser extent. Injection of GTP gamma S also induces exocytosis in both species but is more effective in the hamster. It is suggested that inositol metabolism stimulated by sperm-egg interaction with a GTP-binding protein may be part of the mechanism leading to cortical granule exocytosis and that this may be modulated by the external pH. PMID- 3267018 TI - Studies on some iridium(III) complexes with Schiff bases derived from amino carboxylic acids. AB - The reactions of iridium(III) chloride with different Schiff bases gave complexes of types [Ir(SB)3], [Ir(SB')Cl(H2O)2], [Ir(SB'')Cl2]n, [Ir(SB'' ')Cl(H2O)]n (SBH = Schiff bases derived from anthranilic acid and benzaldehyde, acetophenone, vanillin, cinnamaldehyde or m-hydroxyacetophenone; SB'H2 = Schiff bases derived from anthranilic acid and salicylaldehyde or o-hydroxyacetophenone; SB''H = Schiff bases derived from p-aminobenzoic acid and benzaldehyde, acetophenone, vanillin, cinnamaldehyde, or m-hydroxyacetophenone; SB'' 'H2 = Schiff bases derived from p-aminobenzoic acid and salicylaldehyde or o-hydroxyacetophenone). These complexes have been characterized on the basis of elemental analyses, conductance, magnetic moment, and spectral (electronic, i.r., and 1H n.m.r.) data. The electronic spectra reveals octahedral geometry for these complexes except for [Ir(SB'')Cl2]n, which is trigonal bipyramidal. The thermal behavior of these complexes has also been studied by TG, DTG, and DSC techniques. The different kinetic parameters, viz., order of reaction, activation of energy, and heat of reaction were calculated. The antifungal and antiviral activities of the complexes with Schiff bases derived from anthranilic acid have also been investigated. PMID- 3267019 TI - Fura-2 calcium transients in frog skeletal muscle fibres. AB - 1. Intact single twitch fibres from frog muscle were mounted at long sarcomere spacing (3.5-4.2 microns) on an optical bench apparatus for the measurement of absorbance and fluorescence signals following the myoplasmic injection of either or both of the Ca2+ indicator dyes Fura-2 and Antipyrylazo III. Dye-related signals were measured at 16-17 degrees C in fibres at rest and stimulated electrically to give a single action potential or brief train of action potentials. 2. The apparent diffusion constant of Fura-2 in myoplasm, Dapp, was estimated from Fura-2 fluorescence measured as a function of time and distance from the site of dye injection. On average (N = 7), Dapp was 0.36 x 10(-6) cm2 s 1, a value nearly 3-fold smaller than expected if all the Fura-2 was freely dissolved in the myoplasmic solution. The small value of Dapp is explained if approximately 60-65% of the Fura-2 molecules were bound to relatively immobile sites in myoplasm. 3. In resting fibres the fraction of Fura-2 in the Ca2+-bound form was estimated to be small, on average (N = 11) 0.06 of total dye. However, because of the large fraction of Fura-2 not freely dissolved in myoplasm, and the indirect method employed for estimating Ca2+-bound dye, calibration of the resting level of myoplasmic free Ca2+ ([Ca2+]) from the fraction of Ca2+-bound dye was not considered reliable. 4. In response to a single action potential, large changes in Fura-2 fluorescence (delta F) and absorbance (delta A) were detected, which had identical time courses. As expected, the directions of these transients corresponded to an increase in Ca2+-dye complex. For wavelengths, lambda, between 380 and 460 nm, peak delta A(lambda) was closely similar to the Ca2+-dye difference spectrum for Fura-2 determined in in vitro calibrations. Beer's law was used to calibrate the concentration of Ca2+-dye complex formed during activity (delta[CaFura-2]) from the delta A(lambda) signal. Peak delta[CaFura-2] was found to vary between 0.01 and 0.4 mM, depending on the total concentration of injected Fura-2 ([Fura-2T]), which ranged as high as 0.9 mM. 5. In fibres in which peak delta[CaFura-2] was less than 0.06 mM, delta[CaFura-2] had a limiting minimal half-width of 50-60 ms. However, as peak delta[CaFura-2] increased (up to 0.3-0.4 mM), delta[CaFura-2] half-width became markedly prolonged (up to 150-200 ms), indicative of a strong buffering action of large concentrations of Fura-2 on the underlying [Ca2+] transient (delta[Ca2+]).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267020 TI - Circulatory effects of a depilatory dose of mouse epidermal growth factor in sheep. AB - 1. Haemodynamic parameters and tissue blood flow rates were measured in two groups of five sheep infused I.V. for 24 h with either saline or 128.6 micrograms mouse epidermal growth factor (mEGF) kg-1 body weight. Measurements were made preinfusion and at +3, +12, +24, +27 and +48 h. We wished to assess relationships between blood flow rates and known functional changes in various organs during EGF treatment, especially any relationship between skin blood flow rate and the known depilatory effects of the protein in sheep. 2. Cardiac output increased and total peripheral resistance and mean arterial pressure decreased during and after infusion in the mEGF-treated group relative to the control group. 3. The greatest increase in blood flow rates occurred in woolled skin (+500%) during mEGF infusion, a result which in itself may have been disparate with the known depilatory effects of EGF. The mucosas of the alimentary tract (except abomasum) and the submaxillary and sublingual salivary glands also showed vasodilatation. 4. There were short-term increases in pituitary and adrenal gland blood flow that may have been associated with the corticotrophin-releasing factor properties of EGF. Flow in the thyroids showed the greatest increase post-infusion when thyroid hormone metabolism may have been reverting to normal. Blood flow rates decreased in the pancreas and perirenal fat. 5. Our general conclusion was that mEGF had specific vasodilator effects in the skin, the thyroid, submaxillary and sublingual glands and the mucosas of most of the alimentary tract. PMID- 3267021 TI - Corticotrophin-releasing factor, vasopressin and pro-opiomelanocortin mRNA responses to stress and opiates in the rat. AB - 1. Rats underwent either: (1) acute or chronic morphine or naloxone administration; (2) simple morphine withdrawal or naloxone-precipitated withdrawal in morphine-dependent animals; or (3) stress from I.P. administration of hypertonic saline. 2. Quantitative in situ hybridization histochemistry was performed using synthetic oligonucleotide probes for corticotrophin-releasing factor (CRF), vasopressin, pro-opiomelanocortin (POMC), dynorphin, enkephalin and oxytocin mRNAs. The paraventricular and supraoptic nuclei were examined in all studies and the arcuate nucleus and pituitary gland in the acute withdrawal study. 3. Neither acute nor chronic morphine administration altered either (a) hypothalamic parvocellular or magnocellular CRF mRNA, or (b) anterior pituitary or pars intermedia POMC mRNA. 4. Naloxone-precipitated morphine withdrawal resulted in a marked increase in parvocellular (but not magnocellular) CRF mRNA within 4 h and levels remained elevated through 24 h. There was no change in arcuate nucleus or pars intermedia POMC mRNA, but in the anterior pituitary there was a delayed increase, significant at 24 h. 5. Simple morphine withdrawal without the use of naloxone did not result in any change in CRF mRNA but there were increases in magnocellular vasopressin and dynorphin mRNA, presumably related to decreased water intake. 6. Intraperitoneal hypertonic saline stress also resulted in a marked accumulation of both parvocellular CRF and vasopressin mRNA without any concomitant change in magnocellular vasopressin mRNA. Increased translation of CRF mRNA was also evidenced by increased immunoreactive CRF detected by immunocytochemistry. PMID- 3267022 TI - Cross-bridge behaviour in skinned smooth muscle of the guinea-pig taenia coli at altered ionic strength. AB - 1. The effects of varied levels (25-300 mM) of ionic strength on mechanical properties and ATP hydrolysis rate of chemically skinned guinea-pig taenia coli fibres were investigated. 2. The tension development following activation by calcium (pCa 4.8), and relaxation following removal of calcium (pCa 9), were slower in 25 mM compared to 150 mM ionic strength. In fibres activated by thiophosphorylation of myosin light chains, by exposure to ATP-gamma-S, the tension development was rapid and independent of ionic strength. 3. The maximal shortening velocity (Vmax) was obtained from force-velocity relations determined by the quick-release method. The rate of ATP hydrolysis (JATP) was determined by measurement of pyruvate released from phosphoenolpyruvate (PEP). In order to obtain maximal Vmax and JATP at a Mg-ATP concentration of 1 mM, an ATP regenerating system was required. In thiophosphorylated fibres 2 mM phosphocreatine (PCr) or 3.2 mM-PEP were adequate for maximal Vmax and JATP respectively. In calcium-activated fibres 5 mM-PCr was required for maximal Vmax. 4. The isometric force of thiophosphorylated fibres showed a biphasic dependence on ionic strength with a maximum at 90 mM. Vmax was essentially unchanged between 50 and 200 mM ionic strength. At 25 mM ionic strength, isometric force and Vmax were decreased by, respectively, about 15 and 25%. At 250 mM ionic strength, isometric force and Vmax were decreased by, respectively, 47 and 33%. 5. Vmax decreased with decreasing [Mg-ATP]. At [Mg-ATP] less than 0.1 mM there was no difference in Vmax between 35 and 150 mM ionic strength. At 250 mM ionic strength Vmax was lower than that at 150 mM at all [Mg-ATP]. 6. JATP during contraction in thiophosphorylated fibres at 35, 150 and 250 mM ionic strength was respectively, 0.62, 0.98 and 0.93 mumol g-1 min-1. The energetic tension cost (JATP/force) increased with ionic strength. 7. The force response to a quick stretch was investigated in the relaxed, contracted and rigor states at 25, 150 and 250 mM ionic strength. Stiffness in the relaxed state increased with speed of stretch and was higher the lower the ionic strength. In the contracted and rigor states, stiffness was also affected by ionic strength, but the relative effect in the contracted state was small.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267023 TI - Inositol trisphosphate-induced membrane potential oscillations in Xenopus oocytes. AB - 1. The role of inositol 1,4,5-trisphosphate (Ins1,4,5P3) in controlling the membrane potential oscillations induced by acetylcholine in Xenopus oocytes was investigated by studying the effect of injecting Ins1,4,5P3. 2. Perfusing Xenopus oocytes with low concentrations of acetylcholine (less than or equal to 1 x 10( 7) M) induced regular oscillations in membrane potential. The frequency of these oscillations accelerated as the concentration of acetylcholine was increased. 3. Ionophoretic application of low doses of Ins1,4,5P3 stimulated membrane depolarization in the form of an initial brief spike which was followed by a burst of oscillations when the amount of Ins1,4,5P3 injected was increased. 4. When low doses of Ins1,4,5P3 were injected at 30 s intervals, there was rapid desensitization of the early response which recovered if the interval between injections was extended to 2 min or longer. 5. In comparison to the vegetal pole, the animal pole was much more sensitive to Ins1,4,5P3. This localization of Ins1,4,5P3 sensitivity in the animal pole may contribute to the electrical field which surrounds Xenopus oocytes. 6. A model is presented to explain these oscillations based on the phenomenon of calcium-induced calcium release. It is proposed that Ins1,4,5P3 releases calcium from an Ins1,4,5P3-sensitive pool which is then periodically taken up and released by an Ins1,4,5P3-insensitive pool. It is the overloading of this Ins1,4,5P3-insensitive pool which may provide the trigger to spontaneously release calcium back into the cytoplasm. PMID- 3267026 TI - Production of human B cell hybridomas with interleukin 2 receptors selected by a new selective medium, HAT-neo. PMID- 3267024 TI - Double-hyperbolic force-velocity relation in frog muscle fibres. AB - 1. The relationship between force and velocity of shortening was studied at 2.10 micron sarcomere length during fused tetani (1-3 degrees C) in single fibres isolated from the anterior tibialis muscle of Rana temporaria. The speed of shortening was recorded from the whole fibre and, in some experiments, simultaneously from a short (ca. 0.6 mm) segment, while the preparation was released to shorten isotonically at selected force levels ('load-clamp' recording). The segment was defined by opaque markers of hair that were placed on the fibre surface. The distance between the markers was recorded by means of a photo-electric detector system. 2. The force-velocity relation had two distinct regions, each one exhibiting an upwards concave shape, that were located within the ranges 0-78 and 78-100% of the measured isometric force (P0), respectively. The two portions of the force-velocity relation could be fitted well by hyperbolic functions or by single-exponential functions. The curvature was more pronounced in the high-force region than at low-intermediate loads. The transition between the two portions of the force-velocity relation (the 'break point' of the force-velocity curve) occurred at 78.4 +/- 0.4% of P0 (mean +/- S.E. of mean, n = 12) corresponding to 10.9 +/- 0.4% of maximum velocity of shortening (Vmax). The general shape of the force-velocity curve, and the appearance of a break point near 78% of P0, was the same when measurements were made from the whole fibre and from a short segment along the same fibre. 3. The 'negative' branch of the force-velocity relation was delineated for loads ranging from P0 to 1.6-1.8 P0 in five experiments. The negative branch formed a smooth continuation of the force-velocity relation recorded between 0.78 P0 and P0. The force-velocity relation was nearly flat between 0.90 P0 and 1.20 P0, the difference in speed of shortening or elongation being 1.8 +/- 0.3% (mean +/- S.E. of mean, n = 5) of Vmax over this range. 4. An increase in sarcomere length from 1.85 to 2.60 micron did not affect Vmax but caused a steady decrease in curvature of the force-velocity relation, both at low-intermediate loads and in the high force range. Similar changes in shape of the force-velocity relation were produced by osmotic compression of the fibre in a Ringer solution made hypertonic by addition of 98 mM-sucrose.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267027 TI - [Bullous degeneration of the cornea as a complication of cataract extraction]. PMID- 3267025 TI - Stimulation of breathing movements by L-5-hydroxytryptophan in fetal sheep during normoxia and hypoxia. AB - 1. In fetal lambs in late gestation, systemic infusion of L-5-hydroxytryptophan (L-5-HTP) during normoxia greatly increases the incidence of fetal breathing movements (FBM) and high-voltage electrocortical activity (HV ECoG). It also induces FBM during HV ECoG and increases blood pressure. To investigate its mechanism of action, L-5-HTP was administered in conjunction with the 5-hydroxy tryptamine (5-HT) antagonists ketanserin or cyproheptadine. L-5-HTP was also infused with or without the antagonists during hypoxia, to test whether it would overcome the inhibition of FBM by hypoxia. 2. When L-5-HTP was given in normoxia, cyproheptadine blocked and ketanserin reduced the increase in blood pressure, both drugs blocked the stimulation of FBM, but neither drug prevented the induction of prolonged episodes of HV ECoG. 3. In hypoxia, L-5-HTP similarly stimulated FBM. This effect was also blocked by cyproheptadine and was delayed by ketanserin. 4. The antagonism of the effects of L-5-HTP on blood pressure and the incidence of FBM in normoxia and hypoxia is consistent with the action of L-5-HTP via 5-HT receptors. At present there is no clear explanation of the mechanism by which L-5-HTP induces HV ECoG. PMID- 3267029 TI - CD4+ T cell subsets in experimental cutaneous leishmaniasis. PMID- 3267028 TI - Pharmacologic effects of lactones isolated from Pulsatilla alpina subsp. apiifolia. AB - Two lactone compounds, protoanemonin and anemonin, were determined in the flowering aerial parts of P. alpina subsp. apiifolia. Anemonin is the primary compound responsible for the antipyretic activity and both anemonin and protoanemonin participate in the sedating effect. PMID- 3267030 TI - Development of chagasic autoimmune myocarditis associated with anti-idiotype reaction. PMID- 3267031 TI - In vivo leishmanicidal mechanisms in tegumentary leishmaniasis. Ultra-structural observations. PMID- 3267032 TI - Frequency of Leishmania-reactive T cells in lesions of American mucocutaneous leishmaniasis (AMCL) patients. Its relevance in the process of healing or aggravation of the disease. PMID- 3267033 TI - B cell dependent T lymphocyte responses in leishmaniasis. AB - The activation of B cell dependent T cells during Leishmania infection cannot be considered a trivial event, because their removal profoundly alters the course and outcome of infection within genetically susceptible and resistant mouse strains. The demonstration that idiotype recognizing T cells also appear within human populations sensitized to leishmanial antigens as a result of asymptomatic or subclinical infections supports a role for these cells in immunity. These cells are not demonstrable in patients with active visceral disease, so that their role in promoting specific unresponsiveness has not been extended to humans. Whether B cell dependent, idiotype specific T cells represent a functionally distinct T lymphocyte subset with unique regulatory activities remains to be determined. PMID- 3267034 TI - Serum-mediated immunosuppression in American visceral leishmaniasis. PMID- 3267035 TI - Protective T cell responses in BALB/c mice infected with Leishmania donovani. PMID- 3267036 TI - [Immunologic studies on lymphocyte subpopulation, T-cell subset, natural killer cell and immunoglobulin G subclass in inflammatory periapical lesions]. PMID- 3267037 TI - Effect of reduced glutathione (GSH) on dopamine (DA) and gamma-aminobutyric acid (GABA) concentration in the mouse brain following intoxication with 1-methyl-4 phenyl-1,2,3,6-tetrahydropyridine (MPTP). PMID- 3267038 TI - [Epidemiological survey of a group of drug addicts]. PMID- 3267039 TI - [Subpopulations of peripheral blood leukocytes in generalized simple psoriasis]. PMID- 3267040 TI - Temporal summation in the achromat. AB - We investigated temporal summation of the rods in a complete achromat, who lacks cone vision. Critical duration (tc) was estimated both at the achromat's preferred area of fixation and at an area 12 deg laterally in the nasal visual field. Comparable tc determinations were made in a normal trichromat. At background luminances of 0.0 and 0.6 scot. td, where the rods mediate detection, the values of tc were similar for the achromat and the normal. At a luminance of 813 scot. tds, however, where the middle-wavelength sensitive cones mediate detection in the trichromat, the tc for the achromat was much longer than that for the trichromat. PMID- 3267041 TI - [Clinical picture of acute pancreatitis]. PMID- 3267042 TI - Thymus-independent type 2 responses in lymph nodes. PMID- 3267044 TI - Immunohistochemical study on cultured FDC-C enriched lymphoid cell populations. PMID- 3267043 TI - IgG subclass distribution in juvenile human tonsil: IgG3 and IgG4 results of specific antibody production using synthetic peptides. AB - A decapeptide with a sequence corresponding to a part of the hinge region of human IgG3 was used to prepare a mouse monoclonal antibody (Mab 330-2.2). The Mab recognized IgG3 in ELISA only when the IgG3 was denatured by mild heat. Mab specificity in immunohistochemistry was calibrated with a number of reference Mabs obtained through a WHO/IUIS collaborative study. Finally, Mab 330-2.2 was used in conjunction with a set of other isotype specific Mabs to study the (sub)class distribution of cytoplasmic Ig containing cells in palatine tonsil. IgG3 within the IgG class was strongly over-represented in our tonsil material if compared to the representation of IgG3 in serum. PMID- 3267045 TI - FDC-iccosome mediated antigen delivery to germinal center B cells, antigen processing and presentation to T cells. PMID- 3267046 TI - Is the survival of memory B cells dependent on the persistence of antigen? PMID- 3267047 TI - Memory B cells but not virgin B cells are activated in germinal centers. PMID- 3267048 TI - A subpopulation of germinal center B cells differentiate directly into antibody forming cells upon secondary immunization. AB - In the present study we sought to test the hypothesis that GC B cells may be stimulated to differentiate into AFCs during the induction of the secondary antibody response. To test this we gave HRP immune mice a booster immunization and looked for AFCs in the GCs making anti-HRP specific antibody. Within 3 days cells in the GCs were making anti-HRP. Most of the cells were just starting to make immunoglobulin in the rough endoplasmic reticulum but some were nearly mature plasma cells like those in the medullary cords. Furthermore, we isolated GC B cells after a boost with OVA and tested their ability to differentiate directly into AFCs. Data obtained using an OVA specific RIA indicated that purified GC B cells would differentiate and produce specific antibody in the absence of added T cells or antigen. Examination of the cells after 5 days in culture indicated that many of them had differentiated into large plasma cells. These results obtained both in vivo and in vitro demonstrate that shortly after booster immunization GC B cells receive the appropriate antigen and T cell signals in vivo to differentiate and become AFCs. PMID- 3267050 TI - Thymic stromal elements defined by M.Abs: ontogeny, and modulation in vivo by immunosuppression. PMID- 3267049 TI - Surface IgD phenotype of rat germinal centre precursor cells. PMID- 3267051 TI - A low density fraction of bone marrow cells enriched in prothymocyte activity. PMID- 3267052 TI - Vascular thymus transplantation in rats: a new method to study thymocyte kinetics. PMID- 3267053 TI - M receptor and differentiation of T lymphocytes in the developing human thymus. PMID- 3267054 TI - Structural and cellular changes in the mouse thymus during pregnancy. PMID- 3267055 TI - Synovial T cells detect polymorphism of class II HLA antigens. PMID- 3267056 TI - Activated inflammatory T lymphocytes in rheumatoid synovitis--effect of cyclosporine A and anti-Tac. PMID- 3267058 TI - Interleukin-2 induced changes in mononuclear cell surface charge. PMID- 3267057 TI - Correlation of IL2 production and lymphoid tissue make-up in two inbred strains of rats. PMID- 3267059 TI - In vivo localization of B lymphocyte progenitor cells in mouse bone marrow. PMID- 3267060 TI - The expression of lymphocyte adhesion molecules on cultured high endothelial cells. PMID- 3267061 TI - Endocytic stripping of ligands from migrant lymphocytes in high endothelial venules (HEV): implications for immunomodulation vs viral pathogenesis. PMID- 3267063 TI - Migration patterns of dendritic cells in the mouse. PMID- 3267062 TI - T lymphocyte precursors migrate towards chemotactic peptides secreted by embryonic or juvenile thymus. PMID- 3267064 TI - Rat immunoglobulin genes have comparable patterns of JH rearrangement in normal peripheral B cells and in pre-B and cultured TdT+ cells from bone marrow. AB - Pre-B cells from normal rat bone marrow were isolated by first rosette-depleting granulocytes, T cells and stem cells with W3/13 mAb and mature B cells with anti Ig mAb, and then in some samples enriching by FACS-sorting HIS24+ cells. Presumptive precursors of these pre-B cells possessing terminal deoxy-nucleotidyl transferase were prepared by culture of normal marrow. The extent of rearrangement of kappa and heavy chain genes was estimated on both these types of cells and on mature peripheral B cells by measuring the disappearance of the germ line restriction fragments encoding J segments (other than JH1) relative to a non rearranging CK fragment. Pre-B cells and B cells showed similar degrees of rearrangement of their kappa genes, leaving roughly half in germ-line form; the TdT+-enriched cells showed approximately similar heavy chain rearrangement as the peripheral B cells. Some non-germ-line restriction fragments hybridising with JH in sufficient amount to register as discrete bands on Southern blots were found in common between these different cell populations taken from different individual donors. These may represent preferred D-JH or perhaps V-D-JH rearrangement arising repetitively in independent clones, or may be due to dominance by a few preferred clones. PMID- 3267065 TI - The identification of murine Peyer's patch T cell-derived factors which enhance IgA responses. PMID- 3267066 TI - Activated Fc alpha T cells in Crohn's disease are involved in regulation of IgA. AB - Activated peripheral T cells (APT) of patients with Crohn's disease (CD) have been analysed for the expression of IgA-Fc receptors and for competence of IgA regulation. It was found that within the subset of APT an increased number of cells express binding sites for IgA (IgA-Fc), that was not found in other diseases with elevated numbers of APT. Moreover the number of IgA-Fc receptor expressing T cells was found to be increased in the inflamed mucosa too. Cocultures with autologous B cells revealed that isolated IgA-Fc receptor bearing T cells of patients with CD suppress IgA secretion. These data support the hypothesis that APT are involved in the immunopathogenesis of CD. PMID- 3267067 TI - Chicken B lymphocyte differentiation: bursal microenvironment and differences in ontogeny between normal and SPF birds. PMID- 3267068 TI - Postnatal development of non-lymphoid and lymphoid cell populations in situ in diabetes-prone BB rats. PMID- 3267069 TI - Carrageenan induced changes in the immunomodulatory capacity of macrophages: an in vitro study. PMID- 3267070 TI - The involvement of T-cells in the stimulatory effect of a water-in-oil emulsion on the B-cell response. PMID- 3267071 TI - B lymphoma cells process and present their endogenous IG: implications for network theory. PMID- 3267072 TI - Accessory cell neoplasia as a result of the breakdown of immunological regulation? PMID- 3267073 TI - Memory B cells generated in T cell-dependent antibody responses colonise the splenic marginal zone. PMID- 3267074 TI - Surgery in the treatment of bleeding oesophageal varices--new appraisal? PMID- 3267075 TI - Mesocaval shunt for bleeding oesophageal varices. AB - A total of 43 patients underwent end to side mesocaval (25 patients) or interposition shunts (18 patients) for bleeding oesophageal varices in 1970-1985. Alcoholic cirrhosis was the aetiology in 30 patients. The operation was elective in 26 and urgent or as emergencies in 17 instances. Operative mortality in elective operations was 19%. In emergency operations the bleeding was controlled in all but one patient, but the mortality was 56%. In Child's group C the mortality was also high, about 50%. During the follow-up of 18 months to 16 years there were five episodes of gastrointestinal bleeding, two of which might have been variceal. Out of the 43 patients 22 survived at least 2 years. Most of the late deaths were caused by hepatic coma; no patient died of recurrent variceal bleeding. - The two types of shunt were equally effective in lowering portal venous pressure. Two venous leg ulcers occurred after an end to side shunt. During the period under study the end to side mesocaval shunt was abandoned and from 1980 only interposition shunts have been performed in our clinic. PMID- 3267076 TI - Reference values for analytes of 24-h urine collections known to be complete. AB - One hundred and twenty two 24-h urine collections were obtained from a representative sample of men and women in the general population aged 25-44 years. The collections were verified for their completeness by urine recovery of oral doses of para-amino benzoic acid. Means (with 0.95 reference intervals) for both sexes for 24-h urinary output were determined for nitrogen, urea, creatinine, urate, ammonia, sodium, potassium, volume, and pH. Within person variation in nitrogen, urea, creatinine, ammonia, sodium and potassium was estimated for a consecutive 28-day series of 24-h urine collections for eight individuals. Within person variation was greatest for sodium and least for creatinine. These differences when compared with the between person variation in the analytes studied have implications for the precision with which a result from a single specimen can be used to place an individual within a distribution of values for epidemiological purposes. In clinical biochemistry, the population results reported here should be appropriate as a reference base for comparison with individual patient results. PMID- 3267077 TI - A comparison of the conventional and the rosette method of determination of interleukin 1 (IL-1) activity. The advantages of the rosette method. AB - In this report we compare the conventional method of determination of IL-1 activity with a new rosette assay. Determination of IL-1 activity in the rosette assay is well correlated with the conventional method and equally sensitive. However, the rosette method is able to dissect the activity of IL-1 from IL-2 and to determine the immunotropic, optimal dose of IL-1 more accurately. PMID- 3267078 TI - Secretion of interleukin 1 (IL-1) by peritoneal macrophages upon contact with syngeneic T cells is Ia-restricted and antigen-independent process. AB - We deliver an evidence that secretion of interleukin 1 by macrophages upon contact with T cells is an Ia-restricted and antigen-independent event. Antigen specific T cell lines or quiescent thymocytes induce comparable quantities of IL 1 from Ia-compatible macrophages. Addition of antigen together with antigen specific T cells does not increase production of IL-1. Con A-activated thymocyte derived blasts induce less IL-1 than unstimulated thymocytes. Peritoneal B cells do not secrete IL-1 although they present GAT effeciently to GAT-specific T cell clones. Lastly, the production of IL-1 can be inhibited by a treatment of macrophages with monoclonal antibodies against Ia but not H-2D antigens. The results indicate that the release of IL-1 is solely a result of an interaction between Ia molecules on macrophages and the receptor for Ia on interacting T cells. This process does not require antigen/lectin bridge between the interacting cells. PMID- 3267079 TI - Relative and absolute numbers of T lymphocyte subpopulations and NK cells in male population in relation to age. AB - Using BMA monoclonal antibodies and fluorescent microscope, percentages and absolute numbers of lymphocytes, T cell subsets and NK cells were enumerated in peripheral blood from 126 healthy men. Although absolute numbers of total lymphocytes did not differ according to age, the numbers and percentage of natural killer (NK) cells showed positive interrelationship with age. The percentage but not absolute numbers of cells reacting with BMA 030 (CD3) and BMA 040 (CD4) antibodies were significantly increased only in groups aged of 20-29 yrs and 30-39 yrs. The percentage and number helper/inducer T cells (CD4) were comparable in the four groups of subjects. These results indicate that peripheral lymphocyte populations and T cell subsets and NK cells remarkably vary in healthy men over a wide range of ages. PMID- 3267081 TI - The new biology. PMID- 3267080 TI - Cross-reaction of 791T/36 monoclonal antibody with immunological activated human peripheral blood mononuclear cells. AB - Monoclonal antibody 791T/36, directed against surface antigen on the human osteosarcoma cell line (791T), and cross-reacting with surface antigen p72 expressed on activated (PHA, MLR) human peripheral blood mononuclear cells (PBM), was used in analysis of p72 antigen in vitro. Using FACS-IV system and fluorescence microscope, it was shown that expression of p72 antigen on PBM cells is dependent on phytohaemagglutinin (PHA) stimulation, and alloantigens in mixed lymphocyte reaction (MLR). The increase of p72 expression is always connected with lymphocytes proliferation activity (FACS-IV analysis and 3H-Thymidine incorporation assay). The expression of p72 is not significantly dependent on cell size, and stage of the cell in the cell cycle. A suggestion, that p72 is a one of so-called "proliferation antigens" is discussed. Present study emphasizes a problem of cross-reactivity in the context of possible errors in diagnosis and therapy, when a monoclonal antibody cross-reacts with cells other than intendent target cells. PMID- 3267082 TI - Early and late results of re-operation for coronary artery disease: a 13-year experience. AB - A second coronary artery bypass grafting procedure was performed for recurrent angina in 119 patients between 1970 and mid-1983. Angiographic findings were assessed and computerized using the Brandt myocardial scoring system. The myocardial score was similar prior to the first and second operations. Graft failure was the most common indication for re-operation, either alone (48%) or in combination with progression of coronary artery disease (29%) or incomplete revascularization (10%). Progression of coronary artery disease alone was an indication in 9% and previous incomplete revascularization alone in 4%. The completeness of revascularization at the end of operation was analysed using a new index, the myocardial score/graft coverage rate. This showed that revascularization was less complete at the second operation than at the first (P less than 0.0001). The hospital mortality at re-operation was 2.5% and the peri operative myocardial infarction rate was 9.2%. The follow-up period was 54 months (range 10-160 months). Actuarial survival was 94% at 5 years and 74% at 10 years. The average onset of recurrent angina was earlier after the second operation than after the first (P = 0.001). Using a cumulative actuarial curve, survival at 8 years was 85%, a further 6% of patients had undergone a third or fourth operation, and a further 25% were in NYHA Classes III or IV. Therefore 54% achieved a good or excellent result. It was concluded that re-operation is a worthwhile procedure. PMID- 3267083 TI - Superoxide dismutase activity in thymus cell suspension: effects of methionine enkephalin and morphine. AB - Superoxide dismutase activity of rat thymus-derived cells was studied by the inhibition of L-adrenaline auto-oxidation oxidation in vitro. The incubation of cells in the presence of methionine-enkephalin (Met-Enk) or morphine (2-20.10(-7) M and 2-8.10(-6) M, respectively) was performed in Krebs-bicarbonate buffer at 37 degrees C for 180 min. After a lag period of 30 to 60 min of incubation, both Met Enk and morphine decreased the inhibitory activity of cell suspension on the adrenaline autooxidation. Naloxone blocked the effects of opioids in near equimolar concentrations. The observations suggest the interaction of opioids on superoxide anion production of T cell lymphocytes. PMID- 3267084 TI - Influence of ultrasound on the electroretinogram and ultrastructure of the frog retina. AB - Electroretinography and electron microscopy were used to analyze frog retinas exposed to ultrasound. Toxic doses of ultrasound reduce the ERG b-wave amplitude and induce irreversible destructive changes in cells of all retinal layers. Therapeutic doses of ultrasound increased the b-deflection amplitude and led to slight mitochondrial edema and a decrease in the osmiophilicity of rods and cones. These studies support the view that therapeutic ultrasound doses increase the activity of photoreceptor cells. PMID- 3267085 TI - Treatment of murine lupus with monoclonal antibody to L3T4. I. Effects on the distribution and function of lymphocyte subsets and on the histopathology of autoimmune disease. AB - Monoclonal antibodies (MoAb) to L3T4 have been used successfully to suppress autoimmunity in murine models for several human autoimmune diseases. To clarify the immunologic and clinical consequences of treatment with anti-L3T4, we examined the effects of chronic administration of anti-L3T4 on the composition of lymphoid organs, the function of lymphocytes, and the histopathology of autoimmune disease in lupus-prone NZB/NZW F1 (B/W) mice. Weekly treatment with anti-L3T4 (2 mg/mouse) from age 5 to 8 months depleted L3T4+ cells from the spleen and lymph nodes, and prevented the development of splenomegaly and lymphadenopathy. The MoAb bound to target cells in the thymus and modulated their expression of the L3T4 antigen but, in contrast to its effect in extrathymic sites, anti-L3T4 did not deplete the target population from the thymus. In fact, after 3 months of therapy, mice that had been treated with anti-L3T4 had much larger thymuses than control mice that had been treated with saline, suggesting that treatment with anti-L3T4 prevented the thymic atrophy that occurs spontaneously in murine lupus. Despite depleting L3T4+ cells from the spleen, treatment with anti-L3T4 did not diminish the response of splenic lymphocytes to T and B cell mitogens, and it augmented splenic natural killer (NK) cell activity. Finally, treatment with anti-L3T4 decreased the diverse histopathologic manifestations of murine lupus. It dramatically reduced glomerular immunoglobulin and complement deposition and diminished lymphocytic infiltration and vasculitis in the kidneys. Treatment also reduced extrarenal immunopathology, including focal hepatitis and salivary gland infiltration. These observations have implications regarding the use of CD4 MoAb in people with autoimmune diseases. PMID- 3267086 TI - Non-MHC-restricted, tissue-specific T cells recognizing autologous oligodendrocytes in the normal SJL/J mouse. AB - The oligodendrocyte (OD), a glial cell that produces myelin in the central nervous system (CNS), represents a possible target for autoreactive T cells in autoimmune demyelinating processes. To analyze OD/T lymphocyte interactions, we sensitized in vitro SJL/J mouse spleen cells (SC) over Lewis rat OD cultures and maintained them as long-term T-cell lines in interleukin-2 (IL-2)-containing medium. The proliferative response of these lines could be elicited by syngeneic OD as well as by Lewis rat OD, but appeared to be tissue-specific since SC failed to trigger their proliferation. A T-cell clone of the CD3+, CD8+, CD4- phenotype was obtained from these lines. This clone could mount an IL-2-dependent, tissue specific, non-major histocompatibility complex (MHC)-restricted proliferative response to OD from rat, guinea pig and various strains of mice (including syngeneic OD), but not to SC, whether resting or activated, nor to astrocytes, kidney cells or Langerhans islets. Thus, we showed that SC from normal unimmunized SJL/J mice include a so far undescribed anti-OD autoreactive T-cell population which can be grown in vitro and develop tissue-specific, non-MHC restricted proliferative responses. PMID- 3267087 TI - Decubitus ulcers on admission to nursing homes: prevalence and residents' characteristics. PMID- 3267088 TI - [The use of analgesics-antipyretics in dentistry]. PMID- 3267089 TI - [Selected indicators of immunity in patients with chronic osteomyelitis]. PMID- 3267091 TI - [Ungual pathology in histiocytosis x]. PMID- 3267090 TI - Susceptibility to lipid peroxidation and accumulation of fluorescent products with age is greater in T-cells than B-cells. AB - The age-related loss of immune function, which is primarily due to loss of T lymphocyte function, is also associated with accumulation in spleen lymphocytes of autofluorescent products indicative of peroxidation damage. In this study, we examined T-cell membranes for age-related changes which could be related to lipid peroxidation. Using fluorescence spectroscopy of CHCl3:CH3OH membrane extracts, we observed that old T-cells have a 2-fold greater accumulation of fluorescent products than old B-cells and that young T-cells, when exposed to free radicals in an in vitro system, accumulate significantly more fluorescent products over time than young B-cells. We used fluorescence polarization to show that young T cell membranes are more fluid than young B-cell membranes. However, T-cell membrane fluidity decreases with age, whereas B-cell membrane fluidity does not change; in old mice, T-cell membranes are significantly less fluid than old B cell membranes. Using two-dimensional electrophoresis, we showed that membrane extracts of old T-cells contain many more proteins than extracts of young T cells. Our results indicate that age-related changes occur in T-cell membranes which could be due to their increased susceptibility to lipid peroxidation and these changes may contribute to the age-related decline in immune function. PMID- 3267092 TI - [The study of tooth-development age of Thai children in Bangkok]. PMID- 3267093 TI - [Marginal periodontitis and immune system. II. Analysis of peripheral lymphocytes in young adults with severe periodontitis]. PMID- 3267094 TI - Measurement of myoglobin diffusivity in the myoplasm of frog skeletal muscle fibres. AB - 1. Experiments were carried out on intact, single skeletal muscle fibres from frog in order to estimate the apparent diffusion constant of myoglobin (denoted DAPP) in the myoplasm of living muscle cells. An optical technique was employed to measure myoglobin concentration along the fibre axis following injection of metmyoglobin (denoted metMb) at a point source. The concentration profiles were fitted by the one-dimensional diffusion equation to give estimates of DAPP. The method relied on the fact that myoglobin is normally absent from these frog fibres, thus permitting resolution of the myoglobin-related absorbance above the intrinsic absorbance of the fibre. 2. One complication in the method was that metMb became significantly reduced to oxymyoglobin (denoted MbO2) during the elapsed time before measurement of the concentration profile. The rate of reduction was evaluated by fitting myoglobin-related absorbance spectra, measured at different times following injection of metMb, with in vitro absorbance spectra of metMb and MbO2. Results from four experiments indicated that reduction could be described by a first-order, irreversible reaction having an average rate constant of 0.0164 min-1 (22 degrees C). The effect of reduction on the fitting of DAPP was taken into account. 3. DAPP was determined under three fibre conditions: (1) long sarcomere spacing (3.6-3.8 microns) at 16 degrees C, (2) long sarcomere spacing at 22 degrees C, and (3) normal sarcomere spacing (2.4-2.7 microns) at 22 degrees C. The average values for DAPP under these conditions were: (1) 0.12 (n = 5); (2) 0.17 (n = 5); and (3) 0.15 (n = 7) x 10(-6) cm2 s-1. The average value at 22 degrees C, 0.16 x 10(-6) cm2 s-1, is about 4 times smaller than values for myoglobin diffusivity at 20 degrees C commonly assumed in models of facilitated transport of oxygen by myoglobin. 4. In order to test the possibility that the unexpectedly low value of DAPP found in intact fibres might be due to the binding of myoglobin to relatively immobile sites in myoplasm, experiments were carried out in a cut-fibre preparation using a technique described by Maylie, Irving, Sizto & Chandler (1987 b) for determining the diffusion constants and degree of myoplasmic binding of absorbance dyes. Values for DAPP and the factor (denoted 1 + beta) by which the total myoglobin concentration exceeded the free myoglobin concentration were obtained by fitting the absorbance data by solutions of the one-dimensional diffusion equation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267095 TI - Inducing effect of periodontopathic bacteria on interleukin-1 production by mouse peritoneal macrophages. PMID- 3267096 TI - [Activity of serum regulators of the growth of granulocyte-macrophage (GM) colonies in acute lymphoblastic leukemia (ALL) in children]. PMID- 3267097 TI - [Seroepidemiology of tetanus and diphtheria: survey of the Latium Region]. PMID- 3267098 TI - [A new perspective in the field of vaccination]. PMID- 3267099 TI - [Pneumocystis carinii pneumonia; diagnostic and therapeutic difficulties]. PMID- 3267100 TI - [Production of monoclonal antibodies and their use]. PMID- 3267101 TI - Factors influencing the cellular response in bronchoalveolar lavage and peripheral blood of patients with pulmonary tuberculosis. AB - Subsegmental bronchoalveolar lavage was performed in 30 patients with active pulmonary tuberculosis and six control subjects. Total leucocyte count, absolute lymphocyte count, count of polymorphonuclear leucocytes, T and B lymphocytes were determined in peripheral venous blood. These parameters and macrophage counts were also determined in bronchoalveolar lavage fluid. Variations in the cellular responses were correlated with patients' age, sex, nutritional status and duration of symptoms as well as radiological severity of disease. Patients of both sexes (seven female) showed similar responses. Decreased cell counts in peripheral blood were observed in patients aged 31 to 40 years. Well-nourished patients (n = 19) had higher counts of lymphocytes in peripheral blood and polymorphonuclear leucocytes in bronchoalveolar lavage fluid. The duration of symptoms had a significant influence on cellular responses. In blood, lymphocyte counts were increased in those with symptoms of shorter duration but reduced in those symptomatic for more than 6 months. In bronchoalveolar lavage fluid also all cellular elements were increased in those symptomatic for less than 6 months but a decline followed in those with symptoms for longer duration. Patients with minimal disease radiologically showed higher total leucocyte counts in blood, whereas those with moderately advanced lesions had elevated absolute lymphocyte counts. T cell lymphopenia was observed in blood of patients with far advanced disease. The inflammatory response in bronchoalveolar lavage fluid, however, increased in parallel with the severity of disease. Patients with far advanced lesions showed marked inflammation irrespective of duration of symptoms. Thus, the pattern of inflammation in bronchoalveolar lavage fluid was not similar to that in peripheral blood, particularly in patients with far advanced lesions. PMID- 3267102 TI - Increased fibroblast colony stimulating activity (F-CSA) in serum of myeloproliferative disorders. AB - Sera of patients with primary myelofibrosis (PMF), primary thrombocythemia (PT), polycythaemia vera (PV) and chronic myeloid leukemia (CML) contained a significantly increased F-CSA (or F-CSAs) compared to those of normal subjects and patients with secondary thrombocytosis (ST). This F-CSA was heat sensitive and had the capacity to promote both proliferation and maturation of normal marrow fibroblast colony-forming cells (CFU-F). This F-CSA seemed to be different from human platelet derived growth factor (PDGF), tumor necrosis factor (TNF) and fibroblast growth factor (FGF) from bovine brain. This F-CSA might be of importance in the pathogenesis of bone marrow fibrosis in myeloproliferative disorders. PMID- 3267104 TI - Epidemiology and socio-economic aspects of osteoporosis in Finland. AB - The public health problem of osteoporosis is assessed epidemiologically and economically. Osteoporosis is mainly a problem of old people. Ageing of the population will increase the number of osteoporotic fracture patients and the need of hospital and other services. It is possible to prevent osteoporosis and the goal of health planning activities should thus be directed more to the prevention of osteoporosis. PMID- 3267103 TI - Response of bovine intestinal leukocytes to recombinant bovine interleukin-2. AB - The effects of recombinant bovine interleukin-2 (rBoIL-2) on unstimulated leukocytes isolated from the small intestine of normal adult cows were examined in vitro. While intraepithelial leukocytes (IEL) were shown to be poorly responsive, leukocytes isolated from the lamina propria (LPL) and Peyer's patches (PPL) of the same animals responded to rBoIL-2 in the absence of exogenous stimuli. Although the effect of rBoIL-2 on all three cell populations was dose dependent, stimulation was observed at low doses (less than or equal to 10 mu/ml) of rBoIL-2 only when 2-mercaptoethanol (2-ME) or additional mitogenic signals (ie. ConA) were provided. However, higher doses of rBoIL-2 stimulated the proliferation of IEL (greater than or equal to 100 mu/ml), LPL and PPL (greater than or equal to 20 mu/ml) even in the absence of 2-ME or exogenous lectins. The proliferative effects of rBoIL-2 were detected within 2 days of culture and peaked after 5 days. Adherent cell (AC) depletion of PPL resulted in a marked reduction of IL-2-induced proliferation which could be restored by adding back AC (7%) or supplementing the cultures with 2-ME (50 microM). Furthermore, addition of 2-ME not only substituted for AC, but highly augmented the proliferative response to rBoIL-2. Nylon wool fractionation of PPL revealed that both T-cell enriched (nylon wool non-adherent) and T-cell-depleted (nylon wool-adherent) populations were responsive to rBoIL-2 in the presence of AC and/or 2 ME.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267105 TI - Is lactose malabsorption a risk factor in fractures of the elderly? AB - The prevalence of lactose malabsorption (LM) was determined by lactose tolerance tests in 18 women with spinal fragility fractures and 28 women with hip fractures and compared with 35 female controls of the same ethnic background. The association of LM with bone density in the spine, bone mineral density in the distal radius and histomorphometric values of iliac crest biopsies was also evaluated. The prevalence of LM did not differ between the fracture groups and the control subjects. Patients with LM did not differ from those with normal lactose tolerance with regard to bone densitometry or histomorphometric findings in iliac crest biopsies. These results suggest that in Finland LM is not a risk factor for osteopenic fractures in the elderly. PMID- 3267106 TI - Values of noninvasive techniques in predicting bone histology. AB - These studies investigate the predictive value of the newer, noninvasive techniques (i.e. CT scans, measurement of bone mineral density by photon absorptiometry, and recent serum biochemical tests such as bone Gla-protein and specific bone alkaline phosphatase) by comparing these results to those of histomorphometry after bone biopsy. Results reveal interesting correlations and lack of correlations between bone parameters and biochemical measurements and indicate that bone biopsies along with newer noninvasive techniques represent the optimal approach to patients with metabolic bone diseases. PMID- 3267107 TI - Production of IL-1-mimicking anti-idiotypic antibodies in rabbits in response to IL-1 immunization. AB - This report describes the characterization of immunoglobulins with interleukin-1 (IL-1)-like activity from the serum of rabbits immunized with partially purified mouse IL-1. Early after immunization, immune sera were found to contain anti-IL-1 antibodies (idiotypes) that inhibited IL-1 bioactivity (augmented-proliferation of PHA-stimulated thymocytes). Later, anti-idiotypic antibodies appeared that mimicked IL-1 activity. These IL-1-like antibodies were affinity purified either on an anti-IL-1-enriched Ig-Sepharose 4B column from an early bleed or sequentially on anti-Ig and Protein A immunoadsorbent columns. By ELISA anti idiotypic antibodies specifically bound to rabbit anti-IL-1 antibodies. Functionally, IL-1 mimicking antibodies were reproducibly effective in augmenting the in vitro proliferation of PHA-stimulated thymocytes or Con A-stimulated D10 cells. On the other hand, they did not support proliferation of the IL-2 dependent CTLL-2 cells. The ability of IL-1-mimicking antibodies to enhance thymocyte proliferation could be blocked by functional site related anti-IL-1 antibodies. By Western blot, 125I-labeled IL-1 and IL-1-mimicking antibodies bound to a similar 23 Kd mol. wt protein material recovered from the lysate of thymocytes stimulated with PHA for 48 h. That the observed bioactivity could be attributed to antibody molecules and not to contaminant IL-1 was ascertained by several methods, namely (1) SDS-PAGE analysis of 125I-labeled material and (2) resistance to loss of bioactivity by lyophilization. Furthermore, as neither Ig anti-Ig nor BSA-anti-BSA complexes mimicked IL-1-augmented thymocyte proliferation, a non-specific effect due to immune complexes could be excluded. The occurrence of antibodies mimicking several of the IL-1 functions induced following IL-1 immunization suggests a potential role for the idiotypic network in modulating cytokine activities and a possible link between regulation of the immune system by cytokines and immunoglobulin idiotypes. PMID- 3267108 TI - Idiotypic spreading promotes the production of pathogenic autoantibodies. AB - We propose that a major immunoregulatory abnormality in murine and human autoantibody-mediated disease is idiotypic spreading. By this mechanism, B cells with the genetic information to produce immunoglobulin (Ig) bearing certain public idiotypes (Ids) are selectively upregulated, probably by Id-recognizing helper T cells. The model in which we are testing the hypothesis is systemic lupus erythematosus (SLE) in humans and NZB/NZW F1 (BW) female mice. Recent experiments have shown that the number of public Ids expressed on the Ig of nephritic BW mice is quite restricted. IdX is the dominant Id on serum Ig; IdGN1 and IdGN2 are also common. All three Ids were initially derived from spontaneous antibodies to DNA. Together the three are present on 85% of the total Ig repertoire. Such restriction suggests idiotypic spreading. In glomerular Ig deposits from nephritic BW mice, IdGN1 and IdGN2 are found on 45% of the total Ig: IdX is present in minute amounts. Furthermore, suppression of IdGNs by administration of anti-IdGN1 to BW mice resulted in significant delay in the onset of nephritis, but the IdGNs escaped from control and eventually caused a fatal nephritis. Finally, studies of glomerular Ig deposits in renal biopsies of patients with SLE have shown that IdGN2 dominates such Ig, being present in 76% of renal biopsies from SLE patients and in 6% from patients with non-lupus immune nephritis. Therefore, we have concluded that IdGN1 and IdGN2 are markers of nephritogenic subsets of autoantibodies and are probably the products of idiotypic spreading most likely to cause disease. Finally, after a review of recent experiments suggesting the dominance of autoreactive, Mossman Type 2 T helper cells in nephritic BW mice, it is hypothesized that autoreactive, IdGN recognizing helper T cells may be central to the sustained upregulation of pathogenic autoantibodies in murine and human SLE. PMID- 3267109 TI - Anti-acetylcholine receptor antibody related idiotypes in myasthenia gravis. AB - Anti-acetylcholine receptor antibody associated idiotypes were defined by six murine monoclonal antibodies raised against purified receptor antibodies. Four of the monoclonal antibodies bound to idiotopes located within or close to the antigen binding site of the anti-receptor antibodies; the other two monoclonal antibodies were directed against framework determinants. These monoclonal antibodies recognized idiotopes present on immunoglobulins in 14-60% of patients presenting myasthenia gravis, indicating substantial idiotype sharing. These idiotopes were also found in patients with no detectable anti-receptor antibody activity in their serum. In all patients studied, the pattern of idiotypes fluctuated considerably during the course of the disease regardless of clinical symptoms. This suggests continuous modulation of the autoimmune process in myasthenia gravis. PMID- 3267110 TI - Antibodies from patients and mice with autoimmune diseases react with recombinant hnRNP core protein A1. AB - Sera from autoimmune patients and normal volunteers were tested for antibodies to the A1 core protein of heteronuclear ribonucleoprotein (hnRNP) particles by ELISA and Western blot assays. The A1 protein used in these studies was produced by recombinant DNA technology. Thirty-seven per cent of patients with systemic lupus erythematosus produced anti-A1 antibodies, compared to 7% of normal controls. Several strains of autoimmune mice were also analysed. They spontaneously made high-titered responses to A1. Normal strains showed very low anti-A1 response unless they were specifically immunized with the antigen. Following immunization, normal mice also made high-titered responses to the A1 protein. These studies demonstrated that the A1 protein itself is an autoantigenic component of hnRNP particles. Our studies uncovered no evidence of linkage between the production of anti-A1 and of anti-DNA antibodies. PMID- 3267111 TI - [Preliminary studies on the monoclonal antibody-ricin conjugates]. PMID- 3267112 TI - [Lymphomatoid papulosis: a report of two cases]. PMID- 3267113 TI - Muscle and bone in paraplegic patients, and the effect of functional electrical stimulation. AB - 1. Four paraplegic men volunteered for an exercise programme in which their paralysed quadriceps muscles were stimulated by means of computer-regulated electrical impulses applied through external electrodes. The first exercise regimen consisted of leg raising against a graded load, and during the second regimen exercise took the form of cycling on a modified bicycle ergometer. Each subject exercised five times weekly for 10 weeks during the first regimen and 32 weeks during the second regimen. 2. Whole-body protein turnover determined by L [1-13C]leucine during feeding remained constant during both exercise regimens, when expressed either in terms of body weight or fat-free mass derived from measurements of total body potassium. 3. Quadriceps muscle protein synthetic rate increased during the study, from 0.0712 to 0.0985%/h (P less than 0.05), as did quadriceps muscle area assessed by computed tomography. 4. Bone mineral content for lumbar vertebrae was normal in all four patients, but for the femoral mid shaft bone mineral content averaged only 66% of normal for three of the patients. Trabecular bone density in the distal tibia ranged from normal to 2% of normal for the men with the shortest and longest periods of disability, respectively. No changes in bone mineral content or bone density occurred during the exercise period. PMID- 3267114 TI - Inositol trisphosphate and calcium signaling. PMID- 3267117 TI - [Growth and functions of mouse submandibular gland epithelial cells in culture and in their chemically-transformed counterparts]. PMID- 3267116 TI - [Uterine atonia and hemorrhage from the inferior epigastric artery after cesarean section]. PMID- 3267118 TI - [Immunogenetic analysis of autoantibody production induced by a B cell differentiation factor, B151-TRF2]. PMID- 3267115 TI - Agonist-induced calcium oscillations in depolarized fibroblasts and their manipulation by photoreleased Ins(1,4,5)P3, Ca++, and Ca++ buffer. PMID- 3267119 TI - [Proliferation and expression of the differentiated phenotype of cultured chondrocytes from rabbit craniofacial complex]. PMID- 3267120 TI - [Prevalence of hypertension in 18-year-old males in the city of Buenos Aires. Evaluation of a detection method following previous screening by nurses]. PMID- 3267121 TI - Evaluation of Langerhans cells and T cell subsets in oral lichen planus, in comparison with oral leukoplakia. PMID- 3267122 TI - [Interleukin-1 preparation (Il-1) and practical possibilities for its use]. PMID- 3267123 TI - Current and future aspects of cancer diagnosis with PET. PMID- 3267124 TI - Dementia syndrome and the onset of mind. PMID- 3267126 TI - [Prevalence of hepatitis B virus infection in dentists of District I of the province of Buenos Aires]. AB - Two samples were analyzed; first survey carried out by 250 odontologists chosen out of total number of 1,500 dentists belonging to District I Province of Buenos Aires; the other, by 31 students out of the 180 who attended the last course at the School of Odontology in the National University of La Plata. Through the determination of anti-HBc by enzyme-immuno test, a prevalence of infection due to HBV of 9.6% was found in the odontologists' sample. The prevalence is meaningfully higher than of the general population (5.8), therefore it is demonstrated for the first time in our medium that these professionals constitute a high-risk population. The prevalence found by the students (6.4) was not meaningfully different from that of the general population. The prevalence of an i-HBc found in each of the services taken into account was directly proportional to the number of patients daily assisted. The prevention and sterilization measures for HBV were proved to be unsuitable. No association between a certain HLA pattern and the different serological images, was found. PMID- 3267125 TI - Clinical experience of K18 (IgG-melphalan) for five cases of refractory multiple myeloma. PMID- 3267127 TI - Characterization and biogenesis of 5'-methylthioxylofuranosyl adenine, a new natural analog of 5'-methylthioadenosine. PMID- 3267129 TI - Directional release of lymphokines from T cells. PMID- 3267128 TI - Two phases of ornithine decarboxylase activation during lymphocyte mitogenesis. PMID- 3267130 TI - T-cell vaccination. PMID- 3267131 TI - Expression of TCR types on gut intraepithelial lymphocytes. PMID- 3267132 TI - B cells at the molecular level. PMID- 3267133 TI - Unexpected mAb reactivities in lymphoid neoplasia. PMID- 3267134 TI - Immunotherapy of cancer using IL-2. PMID- 3267135 TI - Limiting HIV infectivity with peptides. PMID- 3267136 TI - Epidermal growth factor (EGF) influences DNA synthesis in human fetal kidneys maturing in serum-free organ culture. AB - Human fetal kidney explants (13-17 weeks of gestation) were maintained in serum free organ culture. The influence of epidermal growth factor (EGF) was determined after 2 and 5 days by evaluating DNA and protein synthesis as well as the activities of five brush border hydrolases. During the studied period the overall morphology was preserved and the analysed parameters remained constant. Only DNA synthesis decreased after 2 days. The addition of EGF to the medium did not change any of the cell activities, except DNA synthesis. In fact, the incorporation of [3H]thymidine was significantly stimulated by 105% in 5-day explants cultured in the presence of the growth factor. These results indicate that EGF directly influences proliferation but not maturation of brush border enzymes in fetal human kidneys in culture. PMID- 3267137 TI - Membrane expression of IgG but not maturation to secretion requires DNA replication. AB - In this work we have addressed two questions. Does switch recombination occur before membrane expression or only concomitantly with induction to high rate synthesis and secretion of IgG? Does interleukin-4 induce switch to IgG1 or maturation of already switched cells? To answer these questions we used the DNA synthesis inhibitor hydroxyurea (HU) to analyze the requirements for DNA replication in the induction of membrane expression or high rate secretion of all IgG subclasses by cultures of mouse spleen cells stimulated by lipopolysaccharide (LPS) and supplemented with IL-4, the absolute numbers of cells bearing membrane bound IgG was always decreased by HU, indicating that immunoglobulin class switching requires DNA replication. IL-4 did not augment the numbers of cells expressing any IgG isotype. In contrast, the number of high rate secretors of all IgG isotypes was not affected by HU, except in the case of IgG3 and IgG2b shortly after stimulation. Addition of IL-4 resulted in an increased number of secretory cells, and also this effect was resistant to HU. Thus, for any isotype, treatment with HU or IL-4 increased the frequency of secretory cells relative to the surface positive population. This data indicates that: 1) IL-4 is a broad range, non isotype-specific maturation factor for LPS-activated B cells; 2) induction to high rate secretion has a negative effect on proliferation; and 3) immunoglobulin class switch, but not induction to secretion of any immunoglobulin isotype, requires DNA replication, suggesting that switch recombination had to occur before expression of IgG in the membrane-bound form. PMID- 3267138 TI - Alpha-amylase structure and activity. AB - Two computerized methods of predicting protein secondary structure from amino acid sequences are evaluated by using them on the alpha-amylase of Aspergillus oryzae, for which the three-dimensional structure has been determined. The methods are then used, with amino acid alignments, to predict the structures of other alpha-amylases. It is found that all alpha-amylases of known amino acid sequence have the same basic structure, a barrel of eight parallel stretches of extended chain surrounded by eight helices. Strong similarities are found in those areas of the proteins believed to bind an essential calcium ion and at that part of the active site that catalyzes bond hydrolysis in the substrates. The active site, as a whole, is formed mainly of amino acids situated on loops joining extended chain to the adjacent helix. Variations in the length and amino acid sequence of these loops, from one alpha-amylase to another, provide the differences in binding the substrates believed to account for the known variations in action pattern of alpha-amylases of different biological origins. PMID- 3267139 TI - Development of a bifunctional crosslinking agent with potential for the preparation of immunotoxins. AB - A new protein crosslinking agent, 2,3-dibromopropionyl-N-hydroxysuccinimide ester, has been synthesized and characterized. The potential use of this compound as a temperature-controllable heterobifunctional crosslinking agent has been investigated using model systems and its reactivity compared with that of chlorambucil-N-hydroxysuccinimide ester. The coupling of 14C-labeled phenylethylamine to lysozyme has been used to illustrate the feasibility of the use of this crosslinking agent for the synthesis of immunotoxins. PMID- 3267140 TI - Metabolic activation of human polymorphonuclear leukocytes by opsonized Haemophilus influenzae type b. PMID- 3267141 TI - Dementia praecox revisited. Age disorientation, mental status, and ventricular enlargement. AB - Thirty-nine patients with DSM-III diagnoses of schizophrenia were examined for age disorientation, an inability to produce one's correct chronological age upon request. Six patients were age-disoriented and demented (as defined by Mini Mental State evaluation), while two patients had delusions concerning their age, but were not demented. Age-disoriented, demented patients had very large cerebral ventricles and very low Mini-Mental State scores. This group differed on the cognitive and neuroanatomic variables from other demented, but not age disoriented, patients, as well as from non-demented patients who were age oriented. The age-disoriented patients appeared to be at an extreme end of the dementia spectrum in schizophrenia. PMID- 3267142 TI - Prevalence of familiality, obstetric complications, and structural brain damage in schizophrenic patients. AB - Schizophrenic in-patients with and without a family history were identified prospectively. The two groups did not differ with respect to clinical variables, ventricular enlargement, prevalence of cortical sulcal widening, or a history of obstetric complications, even when a variety of definitions of familiality were used. PMID- 3267143 TI - Choice of comparison group and findings of computerised tomography in schizophrenia. AB - The literature indicates that whether or not schizophrenic patients are reported to have significant lateral ventricular enlargement depends on control, and not schizophrenic-group values. This discrepancy does not result from differences in age, the ratio of males to females, the number of control subjects used in each study, or whether control groups are comprised of normal subjects or medical patients. However, medical-patient controls tend to have smaller ventricles than do normal individuals. Thus, we assessed lateral- and third-ventricle size and the degree of cortical atrophy in 30 normal volunteers, 30 medical patients, and 30 chronic schizophrenic patients. The use of a medical control group seemed to result in underestimates of ventricle and sulcal size in the normal population and, therefore, overestimates of these values in schizophrenic groups. PMID- 3267144 TI - [Clinical aspects, incidence and prognostic significance of early post-infarction angina]. PMID- 3267145 TI - Genetic transformation in Haemophilus influenzae: physical and biological properties of three DNA constructs carrying nov gene. PMID- 3267146 TI - Study of serum IgE, T and B lymphocytes in bronchial asthma. PMID- 3267147 TI - Imaging pattern of previously in vitro sensitized and interleukin-2 expanded autologous lymphocytes in human cancer. AB - In vivo patterns of lymphocytes sensitized against autologous tumor (in vitro) were studied in seven patients with metastatic cancer as a potential candidate for an alternative method of radioimmunodetection and adoptive immunocytotherapy. Peripheral blood lymphocytes (PBL) were either activated in Interleukin-2 (IL-2) [lymphokine activated killer (LAK) cells] or sensitized against autologous tumor cells by in vitro co-culture (IVC) and expanded in IL-2 (educated cells); both were then labelled with 111In. Labelled autologous cells (1 x 10(7)-5 x 10(8)) were administered to patients and biodistribution studied by imaging under a gamma camera at various time intervals. In 4/7 cases, imaging with the educated cells showed concentrations of radioactivity at sites that correlated positively with clinically detectable metastatic tumor. By contrast, only one instance of positive uptake was seen with the LAK cells. Other than slight fever in three cases, infusions of labelled PBL were well tolerated. Educated lymphocytes were cytotoxic against autologous tumor cells and the cytotoxic reactivities of the educated cells were maintained in continuous culture in IL-2 for 4-6 weeks. Evidence of accumulation of radiolabelled educated autologous cells at a significantly higher frequency than that of the LAK cells suggests that in vitro expanded educated PBL might be better candidates for radioimmunodetection of human cancer, and continuous cultures of such educated autologous PBL might be sources for repeated administration of these effector cells. PMID- 3267148 TI - Remodeling of mouse thymocyte nuclei depends on the time of their transfer into activated, homologous oocytes. AB - The potential of parthenogenetically activated mouse oocytes to remodel somatic cell nuclei was studied by ultrastructural means using oocyte-thymocyte hybrids. Complete nuclear remodeling, initiated by nuclear envelope breakdown and chromosome condensation (which is followed by formation of pronucleus-like nucleus) is possible only during a short time gap between metaphase II and telophase of meiotic division. Maturation-promoting factor activity is high during this period. The thymocyte nucleus can follow the sequence of morphological changes only in concert with the development of the native nucleus and only after exposure of the chromatin to the ooplasm. If hybridization is effected with pronucleate oocytes, the thymocyte nucleus retains its interphase character but shows particular modifications in nucleolar morphology (identical to changes observed during reactivation of the nucleolus in stimulated lymphocyte) and in the activity of the nuclear envelope (blebbing). Thus the nucleus not exposed to maturation-promoting factor activity may be influenced by a 'programme' specific for oocyte (blebbing) and by a programme inherent in the introduced somatic cell nucleus. PMID- 3267149 TI - A prevalence study of symptoms associated with TM disorders. PMID- 3267150 TI - Alpha-1-antitrypsin (Pi) types in multiple sclerosis and lack of interaction with immunoglobulin (Gm) markers. AB - Susceptibility to multiple sclerosis is thought to involve several genetic loci apart from the HLA region on chromosome 6. No Pi allotype nor phenotype was associated with the disease in 125 unrelated patients from the Grampian region of northeast Scotland. Despite a previously reported Gm-HLA association in this population there was no apparent interaction between Pi alleles and Gm type which influenced disease susceptibility. PMID- 3267151 TI - The expression of murine alloantigens on blood lymphocytes. AB - Single- and two-colour immunofluorescence was used to analyse and compare the expression of 12 antigens on the surface of Ig- mouse blood lymphocytes (BL) and Ig- lymph node (LN) cells. Studies in different strains of mice showed that: (i) there were fewer Thy-1+, Ly 1+, L3T4+ cells in BL compared to LN; (ii) Ly 2+ BL showed a unique fluorescence profile with a temporal variation in antigen density not evident in LN; (iii) Thy-1- Ly 1- cells were more common in BL than LN; (iv) L3T4 and Ly 2 were present on mutually exclusive subpopulations in BL; (v) Ly 6A, (Ly 6.2), Ly 6C (Ly 28.2) Ly 28.6C and Ly 12.1 antigenic determinants were expressed on the same proportion of BL and LN cells and to the same level; (vi) Ly 24 (Pgp-1) was the only alloantigen examined where the number of positive cells was increased in BL (65%) compared to LN (40%); (vii) Ly 5 and Ly 15 (LFA 1) showed significant differences in antigen density distribution between BL and LN; (viii) Ly 21.2 was similar to Ly 15.2 expression; (ix) 20% of Ig-LN cells were Ia+, but Ia was absent from Ig-BL. Thus, BL differ in antigen distribution and density from lymphocytes in LN and other tissues and should be considered as a unique population of lymphocytes. PMID- 3267152 TI - Maintained changes in motoneuronal excitability by short-lasting synaptic inputs in the decerebrate cat. AB - 1. During investigation of the tonic stretch reflex in the unanaesthetized decerebrate cat we observed that a short train of impulses in Ia afferents from the soleus muscle (or its synergists) may cause a prolonged activity in the soleus muscle as judged by EMG and tension recordings. This excitability increase, which outlasted the stimulus train, could stay virtually constant during long periods (even minutes), but could be terminated at any time by a train of impulses in, for example, the peroneal nerve. 2. Gradation of the strength of stimulation and the duration of the train of impulses show that the amount of maintained excitability increase depends-within some limits-on the total amount of Ia impulses. 3. In paralysed preparations a short train of impulses in Ia afferents from any part of the triceps surae, caused a maintained increase of the efferent activity in the nerves to triceps surae and a maintained increase of the triceps surae monosynaptic test reflex. These experiments demonstrate the existence of a central mechanism (in the spinal cord and/or the brain stem), which is responsible for the maintained excitability increase seen in motoneurones to the homonymous and synergic muscles. 4. In acute spinal preparations it was not possible to demonstrate any long-lasting excitability increase by a train of Ia impulses. Following intravenous administration of the serotonin precursor 5-hydroxytryptophan, mimicking the tonic activity of these pathways in the decerebrate state, it was again possible to elicit the long lasting excitability increase by a train of impulses in Ia afferents. A subsequent I.V. injection of methysergide (a serotonin receptor blocker) abolished the long-lasting excitability increase. This set of experiments demonstrates that the basic mechanism responsible for the maintained excitability increase is located at segmental level, and involves serotonergic systems. 5. It was demonstrated that activation of several ipsilateral and crossed reflex pathways by trains of impulses in cutaneous or high-threshold muscle afferents could trigger a maintained excitability increase of those motoneurone pools which were activated by the stimulation. Trains of stimuli to facilitatory regions in the brain stem could also cause a long-lasting excitability increase of motoneurones. Furthermore, activation of all reflex pathways which mediate postsynaptic inhibition to a motor nucleus (including recurrent inhibition via Renshaw cells) could terminate the prolonged excitability increase of that particular motor nucleus.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267153 TI - Bistability of alpha-motoneurones in the decerebrate cat and in the acute spinal cat after intravenous 5-hydroxytryptophan. AB - 1. In the preceding paper (Crone, Hultborn, Kiehn, Mazieres & Wigstrom, 1988) it was shown that a short-lasting synaptic excitation ('on' stimulus) of extensor motoneurones (primarily triceps surae) in the decerebrate cat often resulted in a maintained excitability increase, which could be reset by a short-lasting inhibitory stimulus train ('off' stimulus). In the present experiments intracellular recording from triceps surae motoneurones and the electroneurogram (ENG activity) from triceps surae nerve branches were performed in parallel. 2. Sustained firing of individual triceps surae motoneurones was most often recorded in parallel with the maintained ENG activity following a synaptic 'on' stimulus. When the motoneurone was silenced, by a hyperpolarizing current through the microelectrode, there was no sign of on-going synaptic excitation during the maintained ENG activity following an 'on' stimulus. It was therefore suggested that voltage-dependent intrinsic properties of the motoneurones themselves could be responsible for the maintained firing. 3. In confirmation of this hypothesis it was found that short-lasting depolarizing current pulses through the recording microelectrode could trigger a self-sustained firing in the motoneurone provided that the bias current (i.e. the holding potential) was kept within certain limits. Hyperpolarizing current pulses terminated the firing. When the spike generating mechanism was inactivated (by long-lasting excessive depolarization) similar depolarizing and hyperpolarizing current pulses could initiate and terminate plateau potentials in the motoneurones. By grading the depolarizing current pulses it was found that the plateau potentials were of all-or-none character, typically around 10 mV in amplitude. The two levels of excitability which can be triggered by short-lasting excitation and inhibition of the motoneurones is referred to as 'bistable' behaviour of the motoneurones. 4. After an acute spinal transection, in the unanaesthetized cat, the bistable behaviour of the motoneurones disappeared. However, it reappears following intravenous injection of the serotonin precursor 5-hydroxytryptophan (50-120 mg/kg). 5. Individual triceps surae motor units were recorded by selective EMG electrodes during tonic stretch reflexes in the decerebrate preparations. Based on an analysis of their firing pattern during lengthening and shortening (or vibration) of the muscle it is suggested that plateau potentials in motoneurones are recruited during the tonic stretch reflex. Furthermore, it is argued that a quantitatively important part of the depolarization of motoneurones during the tonic stretch reflex indeed originates from these plateau potentials.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267154 TI - Quantitative comparisons of hydraulic permeability and endothelial intercellular cleft dimensions in single frog capillaries. AB - 1. We have investigated the ultrastructure of the intercellular clefts of the walls of single capillaries and venules of the frog mesentery in which the hydraulic permeability (Lp) and the reflection coefficient of the vessel walls to serum albumin (sigma BSA) had been measured using the micro-occlusion technique of Michel (1980). Our aim was to investigate whether the dimensions of the clefts were sufficient to accommodate the pathways through the vessel walls necessary to account for the measured permeability. 2. Lp was measured in seventeen individually perfused vessels. The walls of fourteen of these were relatively impermeable to macromolecules with a sigma to albumin greater than 0.66 (mean value 0.83, S.E.M. +/- 0.04). The Lp of these fourteen vessels ranged from 1.8 x 10(-7) to 12.5 x 10(-7) cm s-1 cmH2O-1 and had a mean value of 5.9 (S.E.M. +/- 0.85) x 10(-7) cm s-1 cmH2O-1. 3. Cleft dimensions estimated from electron micrographs of 642 transversely sectioned endothelial cell junctions from the same seventeen vessels gave a value for the mean cleft width (W) of 0.0220 micron (S.E.M. +/- 0.0064 micron). The mean depth of the clefts from luminal to abluminal surface of the endothelium (delta x) was 0.395 micron (S.E.M. +/- 0.091 micron) with a range of 0.104-1.70 micron. The cleft length per unit area of cell wall (L), calculated using the formulation of Bundgaard & Frokjaer-Jensen (1982), was 2064 (S.E.M. +/- 112) cm cm-2. Measurements were also made of cleft dimensions from longitudinally sectioned junctions from five of the seventeen vessels. 4. The fraction of the surface area of capillary wall occupied by the clefts (Ap = LW) had a mean value of 0.0048 (+/- 0.00014) for all seventeen vessels with a range of 0.0030-0.0074 when estimated from transverse sections. There was no correlation between the variation of Lp between different vessels and the variations of Ap. 5. Data from the fourteen vessels when sigma BSA was greater than 0.66 revealed a correlation between values of Lp and the reciprocal of delta x (r = 0.6675, P less than 0.01). No correlation was found between Lp and the mean thickness of the endothelial cells in the vicinity of the clefts. This is strong evidence for the intercellular cleft being the principal pathway for fluid movements. Variation in cleft depth appears to be a factor determining variation in permeability between different capillaries.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267155 TI - The voltage-dependent block of ATP-sensitive potassium channels of frog skeletal muscle by caesium and barium ions. AB - 1. Patch clamp techniques were used to study the action of external Cs+ and Ba2+ on adenosine 5'-triphosphate (ATP)-dependent K+ channels in sarcolemmal vesicles from frog skeletal muscle. Both ions block channels in a voltage-dependent fashion, block increasing with hyperpolarization. 2. The Cs+ block is flickery, mean unitary current being reduced and open-level noise increased. The concentration dependence is consistent with 1:1 binding, with a dissociation constant (Kd) of 4.1 mM at -62 mV. The Kd increases e-fold for a 20 mV depolarization. 3. The kinetics of Cs+ block were analysed by amplitude distribution analysis, and by measurement of the excess open-level variance. Both methods gave similar rate constants for blocking and unblocking; about 20 mM-1 ms 1 and 75 ms-1 at -62 mV. 4. All the voltage dependence of the Cs+ block appears to lie in the blocking reaction; unblocking is independent of voltage. 5. Ba2+ blocks with slower kinetics, so that blocking events can be resolved in single channel records. Ba2+ reduces mean open time and causes long closings. 6. The blocking rate constant for Ba2+ was measured from the open times. It was about 1.7 mM-1 ms-1 at -62 mV and increased e-fold for a 40 mV hyperpolarization. The unblocking rate, measured from closed times, yielded a Kd of about 0.1 mM at -62 mV, in agreement with that measured from the reduction in open-state probability. 7. Our results suggest that Cs+ and Ba2+ block at sites within the channel, and provide evidence that the channel is a multi-ion pore. PMID- 3267156 TI - Ionic basis of receptor potential of frog taste cells induced by acid stimuli. AB - 1. The ionic mechanism underlying the receptor potential in frog taste cells induced by acid stimuli was studied with single microelectrodes by replacing superficial and interstitial fluids of the tongue with modified saline solutions. 2. The removal of Na+, Ca2+ and Cl- from the normal interstitial fluid did not affect the receptor potential induced by acid stimuli. Interstitial 100 mM-K+ saline did not affect the acid response. 3. The receptor potential was reduced greatly when Ca2+ was removed from the superficial saline, but was increased when the Ca2+ concentration was elevated. The removal of superficial Cl- did not affect the receptor potential. The receptor potential elicited by superficial Ca2+-free saline was partly due to Na+. Li+, K+, NH4+ or choline + substituted for Na+ in producing the receptor potential. The amiloride-sensitive Na+ channel on the receptor membrane did not contribute to the receptor potential. With pure water adaptation of the tongue surface, the mean magnitude of the acid response was 35% of the control. 4. The receptor potential was unaffected by superficial tetrodotoxin (TTX) but was blocked by superficial Ca2+ antagonists such as Co2+ and Cd2+. Sr2+ substituted for Ca2+ in generating the receptor potential. 5. The receptor potentials observed under various concentrations of superficial Ca2+ became smaller when Na+ was present in the superficial fluid, indicating a competition between Ca2+ and Na+. 6. It is concluded that a large portion of the receptor potential induced by acid stimuli is produced by cations passing through a tastant-gated Ca2+ channel on the taste receptor membrane. Both divalent (Ca2+, Sr2+) and monovalent (Na+, Li+, K+, NH4+, choline+) cations can pass through the Ca2+ channel. The other mechanism responsible for the remaining part of the receptor potential is discussed. PMID- 3267158 TI - Gardnerella vaginalis: diagnosis and management. PMID- 3267157 TI - Rayleigh match in congenital stationary night blindness. AB - Rayleigh matches performed by 13 patients with Schubert-Bornschein type congenital stationary night blindness with normal color vision, revealed that they use consistently slightly more red light primary in order to achieve a brighter yellow match than a control group with normal color vision and visual acuity. The matching differences between the two groups were statistically significant. PMID- 3267159 TI - Cell-mediated immunity in patients with sickle cell anaemia. AB - Homozygous sickle cell disease patients have an increased risk of developing severe infections, probably because of impaired immunity. Cellular immunity was studied in thirty-two patients with S homozygous haemoglobin (SS) and compared to 32 A homozygous haemoglobin (AA) healthy subjects. A leukocytosis was observed but with a significant diminution of T4 and T8 proportions in sickle cell patients. B lymphocytes, concanavalin A, phytohaemagglutinin, and phorbol myristate acetate-induced lymphocyte proliferation were not different between the two groups except for enhanced pokeweed mitogen stimulation in SS patients. In contrast, addition of autologous sera to mitogen-induced cultures resulted in a potentiation of lymphocyte proliferation significantly greater in patients with S homozygous haemoglobin when compared to subjects with A homozygous haemoglobin. This highly amplified mitogen-induced response of lymphocytes by SS autologous sera, when compared to AA autologous sera, was not observed when these sera were added to lymphocytes obtained from an allogenic healthy individual. In vivo interleukin 2 production and natural killer activity were not different between SS and AA individuals. We conclude that there are functional abnormalities of cell-mediated immunity in patients with sickle cell anaemia and the SS lymphocyte activation by autologous sera was probably due to infectious and drepanocytic antigenic determinants contained in SS serum. PMID- 3267160 TI - Thymic T-cell lymphoma with the CD8+ (OX-8), CD4+ (W3/25) phenotype, induced in F344/NCr rats by nitroso-2-hydroxypropylurea. AB - Thymic T-cell lymphomas were induced by administration of nitroso-2 hydroxypropylurea (NHPU) at a dose of 1.6 mg by gavage twice weekly for each of 20 weeks in F344/NCr rats. Lymphomas began to appear 5-10 weeks after the first intubation. Primary and transplantable tumors were subjected to morphological, histogenetic and immunological characterization. Lymphomas composed of medium sized lymphocytes (prolymphocytes) arose within individual thymic lobules, often in atrophic thymic lobes and metastasized slowly to the T-cell zones of the splenic white pulp. The tissue fixative was important for tumor morphology and classification, with Bouin's fluid markedly superior to formalin. Transplantable tumors were similar morphologically except for one lymphoblastic lymphoma, but all transplants metastasized quickly to spleen, liver, thymus, and other tissues. Fluorescence-activated cell sorter (FACS) analysis of primary and transplantable lymphomas revealed cells of the T-cell lineage, with tumor cells expressing both OX-8 (CD8) and W3/25 (CD4) antigens. Immunoperoxidase studies of spleen showed infiltration of OX-8+ tumor cells first into T-cell dependent areas of the splenic white pulp. PMID- 3267161 TI - Changes of biophysical characteristics of rat thymocytes with age. PMID- 3267162 TI - Effect of ethanol and acetaldehyde on the enzymatic activity of human pancreatic juice in vitro. I. Inhibition of alpha-amylase and lipase activity. PMID- 3267163 TI - [Politico-administrative distribution of nutritional status according to a height census of 1st grade school children in Panama]. AB - Height is the anthropometric measurement that best summarizes the effects of socioeconomic factors on the health and nutritional status of a given community. For the purpose of identifying the lowest disaggregation level, the political administrative areas with the highest malnutrition prevalences, a height census that included 58,000 children who attended the 3,000 schools of the country was carried out. The Republic of Panama is politically-administratively divided into 9 provinces, 65 districts, one Indian community and 505 "corregimientos." The results obtained showed marked differences in height retardation among provinces, among districts and among "corregimientos." In the latter, retardation in first grade children varies from 0 to 95%. Important differences were also observed within a same district among "corregimientos", as is the case with the District of Nata, which vary from 4 to 40%. The height census permitted the identification and quantification of nutritional damage in 28 districts and 204 priority "corregimientos", where it is expected, resources from the public sector will be assigned in order to substantially reduce the prevailing poverty, as well as the food and nutrition problems. PMID- 3267164 TI - How do cytotoxic T lymphocytes avoid self-lysis? PMID- 3267165 TI - Lymphokine-activated killer cell activity. PMID- 3267166 TI - Lack of tolerance to a soluble MHC class I antigen. PMID- 3267167 TI - The bimolecular structure of the interleukin 2 receptor. PMID- 3267168 TI - Koch's postulates and the molecular biology of T-cell function. PMID- 3267169 TI - MHC class II molecular structure--permitted pairs? PMID- 3267170 TI - Perforin--a primary or auxiliary lytic mechanism? PMID- 3267171 TI - Colony-stimulating factors in vivo and in vitro. PMID- 3267172 TI - T-cell activation in health and disease. PMID- 3267173 TI - Interleukin 1 and T-cell activation. PMID- 3267174 TI - How important is the L3T4 antigen to L3T4+ cell function in vivo? PMID- 3267175 TI - Exploiting the immune system's own strategies for immunotherapy. PMID- 3267176 TI - [Our experience with the picosecond neodymium-YAG laser after cataract surgery]. PMID- 3267178 TI - Evolution of cutaneous lymphoid hyperplasia to cutaneous T-cell lymphoma. PMID- 3267177 TI - Characterization of human corticotrophin-releasing hormone and pro opiomelanocortin-related peptides in a thymic carcinoid tumour responsible for Cushing's syndrome. AB - Severe Cushing's syndrome developed in a man of 35 years. Plasma ACTH and lipotrophin hormone levels were supranormal, and dexamethasone failed to stop their production. An ACTH-producing thymic carcinoid tumour was found to be responsible for the Cushing's syndrome. The tumour tissue contained pro opiomelanocortin (POMC)-mRNA and POMC-related peptides. In addition, human corticotrophin-releasing hormone (h-CRH) (0.25 ng/mg wet tissue) was identified in the tumour extract. Among a series of extracts from two normal and three tumoral (Nelson's syndrome) pituitary glands, six non-pituitary POMC-producing tumours and five normal thymuses examined, only the extract from the thymic tumour of our patient contained h-CRH. The molecule isolated had the same properties as synthetic h-CRH (dilution, Sephadex G 50 chromatography). Circulating h-CRH levels, however, were normal. The possible involvement of such ectopic CRH production in the aetiology of Cushing's syndrome remains uncertain. PMID- 3267179 TI - UVC irradiation of human epidermal Langerhans cells decreases the alloactivating and antigen presenting capacity. PMID- 3267180 TI - Anticardiolipin and antinuclear antibodies in discoid lupus erythematosus--their clinical significance. PMID- 3267181 TI - [Immunological study of colostrum]. AB - Breast milk has many advantages over cow's milk in feeding of infants. Breast-fed newborns usually have much less chance of infections than do bottle-fed ones. In this communication, the cellular and humoral immunocompetent components in the colostra of 80 mothers were studied. The results showed: 1) Colostrum contained a large number of viable leukocytes as blood, but the vast majority was monocyte/macrophage (63.76%); 2) T and B lymphocytes were present in the colostrum, the number of T cell was much less than that of the blood; 3) The colostral mononuclear cells (MNC) had lymphoproliferative responses to mitogens and the mitogenic capability decreased gradually postpartum; 4) The colostral MNC were able to produce interleukin 2, and 5) Immunoglobulins G, A and M and C3 and C4 were present in small amount in the colostrum, however, the concentration of IgA was nearly half of that of the blood. In conclusion, colostrum contains a lot of cellular and humoral immunocompetent components which will confer newborns with passive immunity to various microorganisms. PMID- 3267182 TI - [Epidemiological cross section study of partially edentulous patients]. PMID- 3267183 TI - [Trichomonas vaginalis, epithelial cells, spermatozoa, and immunologic reactions. How and why an infection persists unchanged despite knowing an adequate drug therapy]. PMID- 3267184 TI - [Relationship between mast cells and mouse trigeminal ganglion]. PMID- 3267185 TI - Recent trends in the incidence and epidemiology of Kala-azar in Madras city. PMID- 3267186 TI - Psychosomatic symptoms, social support and self worth among the elderly in Hong Kong. AB - A prospective study to test the relationship between social support and health outcomes among the 1000 elderly Chinese subjects aged 70+ is being carried out in a Hong Kong New Town. This paper reports on the study factors related to psychosomatic complaints based on the first phase cross sectional data. Logistic regression analysis shows that being female, living in institutions, having a low level of social support and a low level of self worth independently increased the risk of developing a high level of psychosomatic symptoms. The relative risks for these factors range from 1.4 to 1.9 and all were significantly different from unity. PMID- 3267187 TI - [Mitral valve prolapse: two-dimensional echocardiographic screening in apparently healthy students]. AB - To elucidate the clinical features of mitral valve prolapse in apparently healthy young population, two-dimensional echocardiography was performed in the students (18-22 years) without documented organic heart diseases. Focusing on the systolic dislocation and configuration of the anterior mitral leaflet, a following two dimensional echocardiographic criterion for grading prolapse was used: Grade I: subjects only with slight slip of the tip of the anterior mitral leaflet (AML) toward the left atrium, Grade II: those with considerable slip of the AML but keeping a normal convex shape in the leaflet body toward the left atrium, and Grade III: those with severe slip of the AML with its ballooning toward the left atrium. Among 2016 students examined, 1507 subjects (74.8%) were judged to be normal, 343 (17.0%) to be Grade I, 141 (7.0%) to be Grade II, and 25 (1.2%) to be Grade III. Of the 25 subjects in Grade III, 20 subjects underwent further examination including a questionnaire about the subjective complaints, physical examination, electrocardiograms at rest and during exercise, Doppler echocardiography and postural tests. Concerning the subjective symptoms, eight subjects had some complaints including chest pain, shortness of breath, dizziness, palpitation, fatigability and synocope, and four of the eight had more than three complaints. Mid-systolic click and a late systolic murmur were audible in four and funnel chest was observed in one. No specific findings were found by electrocardiograms. Mild mitral and tricuspid regurgitations were observed by Doppler echocardiography in four and nine subjects, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267188 TI - Time-resolved X-ray diffraction studies on the effect of slow length changes on tetanized frog skeletal muscle. AB - 1. The mechanism of the enhancement and the deficit of isometric force by slow length changes in frog skeletal muscle was studied with the time-resolved X-ray diffraction technique, using intense X-rays of synchrotron radiation. 2. When a tetanized muscle was slowly stretched by 4% from sarcomere lengths 2.3-2.4 microns, the force rose to a peak during stretch and then decreased to a steady level 10-15% higher than that immediately before stretch. 3. The intensity of the 1,1 equatorial reflection decreased nearly linearly during stretch and then again increased after the completion of stretch, reaching a steady level 12 +/- 5% (mean +/- S.D., n = 11) lower than that immediately before stretch. The above 1,1 intensity change was roughly a mirror image of the force change. 4. The intensity of the 1,0 equatorial reflection showed no marked changes in response to a slow stretch, except for an initial transient increase observed occasionally. 5. If a tetanized muscle was slowly released by 4% from sarcomere lengths 2.3-2.4 microns, the steady force attained after the completion of release was lower than that immediately before release. 6. The 1,1 intensity increased slightly during release, while the 1,0 intensity did not change significantly. 7. The half-width of both the 1,0 and the 1,1 reflections did not change appreciably in response to slow length changes. 8. Slow length changes always produced changes in the spacing between the reflections as expected from the constant-volume behaviour of the myofilament lattice. 9. These results indicate that a slow stretch produces disordering of the myofilament lattice in such a way that the thin filaments are displaced from trigonal positions in the thick filament lattice. The resulting increase in the overall repulsion forces between the filaments may lead to the enhanced isometric force after stretch. PMID- 3267189 TI - Phosphorus nuclear magnetic resonance studies on the effect of duration of contraction in bull-frog skeletal muscles. AB - 1. Contraction and recovery of bull-frog skeletal muscles were studied using 31P nuclear magnetic resonance (NMR), with a time resolution of 16 s, at 4 degrees C. The muscles were stimulated tetanically for various periods (0.2-10 s) at a sarcomere length of 2.4 microns. Changes in the concentrations of inorganic phosphate (Pi), phosphocreatine (PCr) and other metabolites were studied for repeated cycles of contraction and recovery. 2. In resting muscles, bathed in a solution gassed with 95% O2 and 5% CO2, the concentration of Pi was 1.15 +/- 0.21 mmol kg-1 wet weight (mean +/- one S.D., n = 12), that of ATP was 3.32 +/- 0.15 mmol kg-1 (mean +/- one S.D., n = 12) and that of sugar phosphates was less than 0.5 mmol kg-1. The intracellular pH (pHi) was 7.22 +/- 0.01 (mean +/- one S.D., n = 12). These results are averages for fibres which probably have different values. 3. On stimulating the muscles pHi shifted in the alkaline direction and subsequently recovered. The extent of the alkaline shift was linearly related to the contraction duration (0.2-10 s) with a rate of 0.01 pH unit s-1. 4. The increase in Pi with stimulus duration was biphasic, consisting of an early burst, 0.38 +/- 0.10 mmol kg-1 (+/- 1 S.D., n = 5), complete within about 0.2-0.5 s, followed by a slower steady-state increase. The steady-state rate of Pi increase was 0.33 +/- 0.02 mmol kg-1 s-1 (+/- 1 S.D., n = 5) in agreement with the results of previous studies involving chemical analyses. 5. The time course of Pi recovery was well described by a single exponential. Intensities of ATP, sugar phosphates and the peaks in the phosphodiester region did not change during a 2 s tetanus. 6. The amount of PCr hydrolysed (-delta PCr), associated with contractions of various durations, coincided well with Pi increase (delta Pi). This was found during the whole recovery period except for the initial few minutes following relaxation when -delta PCr was significantly smaller than delta Pi. The difference was 0.35 +/- 0.03 mmol kg-1 (mean +/- 1 S.D., n = 3) immediately after a 2 s tetanus. 7. In contractions of 2 s or longer, the extent of the temporal separation between delta Pi and -delta PCr was almost the same, but in contractions of less than 2 s it was significantly reduced.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267190 TI - Implementation of a microcomputer-based opportunistic health maintenance programme in a general practice teaching clinic. AB - The general practice teaching clinic at the Chinese University of Hong Kong uses a microcomputerbased medical record system. To implement a uniform and up-to-date health maintenance programme, a set of protocols has been written for a list of health maintenance items, and the computer has been programmed to identify the items which should be carried out at each patient encounter. Over a period of 16 months, after the start of this programme, 99% of the 1120 clinic patients had a minimum of two items performed. Of a selected sample of 203 patients 119 attended the clinic more than once in the same period and 47% of these patients had all of the health maintenance items recommended for their age and sex group completed. Abnormal screening results led to action by the general practice team. The process of implementing a health maintenance programme has helped the team to discuss current recommendations and to agree on standards. The programme has also helped with undergraduate teaching. The automated opportunistic health maintenance programme is a practical tool for improving patient care. PMID- 3267191 TI - Diabetes mellitus: attitudes, knowledge and glycaemic control in a cross sectional population. AB - A questionnaire to households in Oxfordshire identified 431 diabetic patients living in the area and 272 of them completed a questionnaire about their attitudes to and knowledge of diabetes, and were subsequently interviewed. Most did not regard diabetes as a serious disease and had little knowledge of possible complications. Patients found dietary compliance the most difficult part of their treatment. Among non-insulin treated patients there was a significant association between difficulty with diet and body mass index and glycosylated haemoglobin values. The results suggest that there is a need for more effective advice on diet and for better education of patients about the nature of diabetes and its complications. PMID- 3267192 TI - Erosive pustular dermatosis of the scalp following zoster ophthalmicus. PMID- 3267193 TI - Effects of some different pulse parameters on the perception of intravaginal and intra-anal electrical stimulation. PMID- 3267195 TI - Long-term implantation of platinum electrodes: effects on electrode material and nerve tissue. PMID- 3267194 TI - Miniaturised device for long-term intravaginal electrical stimulation for the treatment of urinary incontinence. PMID- 3267197 TI - [Why do physicians continue to smoke?]. PMID- 3267196 TI - Spontaneous subcutaneous and mediastinal emphysema--a complication of lung function tests in Pneumocystis carinii pneumonia. AB - A case is described of subcutaneous and mediastinal emphysema developing as a complication of lung function tests in an immunocompromised patient with presumed Pneumocystis carinii pneumonia. PMID- 3267199 TI - AIDS in Africa--clinicopathological aspects. PMID- 3267198 TI - [Adjuvant therapy for support of an endodontic therapy. 1: Experimental bases]. PMID- 3267200 TI - Generation of the e-wave of the electroretinogram in the frog retina. AB - The e-wave and a delayed-OFF increase in extracellular K+ concentration are both maximum in the distal half of the inner plexiform layer. These responses also have similar latency, time-course, intensity-dependence, surround properties, and sensitivity to tetrodotoxin. Current source-density analysis of the e-wave reveals a current sink through the proximal retina, a source at the retinal surface, and, in some cases, a weaker source in the mid-retina. These results suggest a model for e-wave generation: delayed-OFF activity in proximal neurons releases K+, which enters Muller cells in the inner plexiform layer; a current exists Muller cells primarily via their endfeet, and the return flow through extracellular space produces the e-wave. PMID- 3267201 TI - Columnar organization of the optic tectum in the frog. AB - Cobaltous lysine complex was used to label tectal cells. Cobalt soaked into a piece of filter paper and placed onto the surface of the tectum labelled neurons in the whole thickness of the tectum below the filter paper. The labelled area was sharply demarcated from the unlabelled tectal tissue. Focal cobalt injections into different tectal layers labelled small groups of cells and the cobalt-filled structures were perpendicularly oriented to the surface of the tectum. Efferent axons could be followed into layer 7, but other lateral connections were very sparse. These results support the hypothesis that the tectum has columnar organization similar to that of the mammalian neocortex. PMID- 3267202 TI - Synaptic organization of retinotectal connections of the frog application of pulse triggered averaging. AB - Pulse-triggered averaging technique was applied to retinotectal connections of the frog. An extracellular single unit was first isolated from the terminals of retinal fibers, and then intracellular responses were recorded from a tectal neuron in the vicinity of the extracellular recording electrode. Intracellular potentials in response to a moving stimulus were averaged by triggering with the isolated presynaptic impulses. The results show that "on-off" retinal fibers monosynaptically excite E-E type (EPSP at "on" and "off" of light) and EI-EI type (EPSP-IPSP at "on" and "off" of light). One of the E-E type neurons was identified as a large ganglionic neuron in layer 8. PMID- 3267203 TI - Fine structure of the primary afferent vestibulocochlear terminals in the frog. AB - The synaptology of the primary afferent vestibulocochlear fibers of the frog's nucleus vestibularis lateralis (NVL), nucleus cochlearis dorsalis (NCD) and nucleus saccularis (NS) was studied with the aid of cobalt labeling technique. On the basis of their sizes and morphological characters, two types of boutons could be distinguished. The type one large boutons making only axosomatic contacts were found in the NVL and NS. The form of contact in these boutons was mainly attachment plaque without vesicle accumulation in the contact zone. The second type of bouton having a smaller diameter and spheric vesicles, were engaged both in axosomatic and axodendritic synapses in all three nuclei studied. There was about the same number of axosomatic and axodendritic boutons in the NCD and NS; while the numerical distribution of type one and type two axosomatic boutons was similar in the NVL and NS. On the basis of our results it is suggested that the NS may be a transitory form between the NVL and NCD. PMID- 3267204 TI - Responses of auditory brainstem neurons in the grassfrog to clicks. AB - Single unit recordings were made in the dorsal medullary nucleus and in the torus semicircularis of the immobilized grassfrog. The natural calls have a periodic pulsatile structure. To investigate the coding of pulse repetition rate periodic click trains with varying pulse repetition rate and an ensemble of clicks distributed randomly in time were used as stimuli. In the dorsal medullary nucleus strong time-locking to clicks was found. Most units showed an activation followed by suppression response. Some units showed a preference for pulse repetition rates matching their low-frequency sensitivity. In the torus semicircularis part of the units showed responses similar to dorsal medullary nucleus units. Other response types were activation irrespective of pulse repetition rate, and suppression followed by activation. The responses to the two stimulus ensembles were more compatible in the dorsal medullary nucleus than in the torus semicircularis. PMID- 3267205 TI - [Studies on the antipyretic and analgesic actions of actinodaphnine]. PMID- 3267206 TI - The control of cytosolic Ca2+ concentration: studies of high affinity Ca2+ transport in permeabilized acini of rat submandibular glands. AB - Active Ca2+ transport was studied in acini that had been permeabilized by incubation in buffer nominally free of Ca2+ in order to avoid any contribution to measured Ca2+ uptake by elements of the plasma membrane. In most experiments, ruthenium red was used to inhibit mitochondrial Ca2+ uptake. Non-mitochondrial Ca2+ transport was greatest at pH 7.0-7.5 and required Mg2+-ATP at concentrations typical of the cytosol (K0.5 = 1.36 +/- 0.53 mM). Other substrates were much less effective than ATP. Ca2+ uptake was stimulated by Ca2+ at concentrations near those measured in intact cells (K0.5 = 0.43 +/- 0.17 microM). Hill coefficients at subsaturating concentrations of Ca2+ (1.08 +/- 0.27) and Mg2+-ATP (0.81 +/- 0.22) indicated that cooperative interactions are not characteristic of the major cationic regulators of Ca2+ transporting activity. Na+ did not release Ca2+ from acinar mitochondria, but consistently reduced non-mitochondrial Ca2+ uptake by about 20% as compared to uptake in the presence of an equimolar K+ concentration. The properties of non-mitochondrial Ca2+ uptake in permeabilized acini are similar to those of high affinity Ca2+ uptake which, in broken cell preparations, has been found distributed in parallel with elements of the endoplasmic reticulum. The Ca2+-sequestering properties of a non-mitochondrial organelle in permeabilized submandibular gland acini are those expected of a principal regulator of cytosolic Ca2+ and could account for the ionized Ca2+ concentration measured in resting salivary acinar cells. PMID- 3267207 TI - Identification of a new class of steroid hormone receptors. AB - The gonads and adrenal glands produce steroids classified into five major groups which include the oestrogens, progestins, androgens, glucocorticoids and mineralocorticoids. Gonadal steroids control the differentiation and growth of the reproductive system, induce and maintain sexual characteristics and modulate reproductive behaviour. Adrenal steroids also influence differentiation as well as being metabolic regulators. The effects of each steroid depend primarily on its specific receptors, the nature of which could therefore provide a basis for classification of steroid hormone action. The successful cloning, sequencing and expression of the human glucocorticoid (hGR) (ref. 1), oestrogen (hER), progesterone (hPR), and mineralocorticoid (hMR) receptors, complementary DNA, plus homologues from various species, provides the first opportunity to study receptor structure and its influence on gene expression. Sequence comparison and mutational analysis show structural features common to all groups of steroid hormone receptors. The receptors share a highly conserved cysteine-rich region which functions as the DNA-binding domain. This common segment allows the genome to be scanned for related gene products: hMR cDNA for example, was isolated using an hGR hybridization probe. In this study, using the DNA-binding domain of the human oestrogen receptor cDNA as a hybridization probe, we have isolated two cDNA clones encoding polypeptides with structural features suggestive of cryptic steroid hormone receptors which could participate in a new hormone response system. PMID- 3267208 TI - Sequence of a cloned cDNA encoding human ribosomal protein S11. PMID- 3267209 TI - Erythroid differentiation factor is encoded by the same mRNA as that of the inhibin beta A chain. AB - We have isolated a protein that exhibits a potent differentiation-inducing activity toward mouse Friend erythroleukemia (MEL) cells and human K-562 cells. The protein, designated erythroid differentiation factor (EDF), was found in the culture fluid of human THP-1 cells that had been treated with phorbol 12 myristate 13-acetate. EDF is a homodimer with a Mr of 25,000; the Mr of the monomer is 15,500. cDNA clones encoding the Mr 15,500 subunit of EDF from THP-1 libraries were isolated and sequenced. Surprisingly, the sequence of EDF mRNA is identical to that for the beta A subunit of inhibin, a gonadal protein that suppresses the secretion of pituitary follicle-stimulating hormone. Southern blot analysis indicates that only one gene for EDF/inhibin beta A exists in the human genome. When the EDF subunit cDNA was linked to a simian virus 40 expression vector containing the dihydrofolate reductase gene and transfected into Chinese hamster ovary dihydrofolate reductase negative cells, the transformants began to secrete EDF, demonstrating that the cDNA actually encoded the EDF subunit. PMID- 3267211 TI - Identification and chromosomal mapping of a duplicated X-specific human sequence. PMID- 3267210 TI - Human P450PCN1: sequence, chromosome localization, and direct evidence through cDNA expression that P450PCN1 is nifedipine oxidase. AB - P450PCN protein levels and nifedipine oxidase activities were quantitated in 12 human livers and were shown to be highly correlated. Antibody against rat P450PCN1 completely inhibited all nifedipine oxidase activity in three human liver samples. These results suggest that a human P450 related to rat P450PCN1 is the major form of P450 catalyzing nifedipine oxidation. The cDNA for a human P450, designated phPCN1, was isolated from a human liver lambda gt11 cDNA library, and sequenced completely. The deduced amino acid sequence is 77% similar to rat P450PCN1. By use of the adenovirus- and SV40-based expression vecotr p91023(B), the phP450PCN1 cDNA was expressed in COS cells and had high nifedipine oxidase activity, providing conclusive evidence that this P450 is the primary enzyme associated with metabolism and inactivation of this important drug. Using somatic cell hybrids, the P450PCN gene was localized to human chromosome 7. PMID- 3267212 TI - The ETS genes on chromosome 21 are distal to the breakpoint of the acute myelogenous leukemia translocation (8;21). AB - The definition of the genetic linkage map of human chromosomes may be helpful in the analysis of cancer-specific chromosome abnormalities. In the translocation (8;21)(q22;q22), a nonrandom cytogenetic abnormality of acute myelogenous leukemia (AML), we previously observed the transposition of the ETS2 gene located at the 21q22 region from chromosome 21 to chromosome 8. However, no ETS2 rearrangements were detected in the DNA of t(8;21)-positive AML cells. Genetic linkage analysis has allowed us to locate the ETS2 gene relative to other loci and to establish that the breakpoint is at an approximate genetic distance of 17 cM from ETS2. When the information from the linkage map is combined with that from molecular studies, it is apparent that (a) the t(8;21) breakpoint does not affect the ETS2 gene structure or the structure of the other four loci proximal to ETS2: D21S55, D21S57, D21S17, and ERG, and ETS-related gene; and (b) the actual DNA sequence involved in the t(8;21) must reside in a 3-cM genetic region between the D21S58 and the D21S55/D21S57 loci, and remains to be identified. PMID- 3267213 TI - Linear order of the four BCR-related loci in 22q11. AB - It has recently been shown the a probe for the 3' end of the BCR gene recognizes a family of four BCR-like genes that map to 22q11. Using a panel of somatic cell hybrids with rearrangement of chromosome 22, we have determined their order within 22q11: BCR-2, BCR4, BCR1, BCR-3, with BCR-2 the most centromere proximal. All of the BCR-like genes map proximal to the 22q11-q12 breakpoint of a t(11;22) in a Ewing sarcoma. PMID- 3267214 TI - Nucleotide sequence from bacteriophage phi 80 with high homology to the major coat protein gene of lambda. PMID- 3267215 TI - Direct sequencing of enzymatically amplified human genomic DNA. AB - The polymerase chain reaction is a recently described technique that uses flanking oligonucleotide primers and repeated cycles of enzymatic primer extension to amplify a short segment of DNA by greater than 100,000-fold. By use of sequencing primers located internal to the amplification primers, direct genomic sequence was obtained from enzymatically amplified DNA by using the dideoxynucleotide chain-termination method. The method is relatively simple and offers significant advantages in identifying mutations in genes for which the normal sequence is known. Heterozygous and homozygous mutations in the human beta and gamma-globin loci were unambiguously identified in 3 days with less than 1 microgram of genomic DNA. PMID- 3267216 TI - Locations and contexts of sequences that hybridize to poly(dG-dT).(dC-dA) in mammalian ribosomal DNAs and two X-linked genes. AB - Sequences located several kilobases both 5' and 3' of the stably transcribed portion of several genes hybridize to radio-labeled pure fragments of the alternating sequence poly (dG-dT) (dC-dA) ["poly(GT)"]. The genes include the ribosomal DNA of mouse, rat, and human, and also human glucose-6-phosphate dehydrogenase (G6PD) and mouse hypoxanthine-guanine phosphoribosyl transferase (HPRT). HPRT has additional hybridizing sequences in introns. Fragments that include the hybridizing sequences and up to 300 bp of adjoining DNA show perfect runs of poly(GT) (greater than 30bp) in all but the human 5' region of rDNA, which shows a somewhat different alternating purine:pyrimidine sequence, poly(GTAT) (36bp). Within 150 bp of these sequences in various instances are found a number of other sequences reported to affect DNA conformation in model systems. Most marked is an enhancement of sequences matching at least 67% to the consensus binding sequence for topoisomerase II. Two to ten-fold less of such sequences were found in other sequenced portions of the nontranscribed spacer or in the transcribed portion of rDNA. The conservation of the locations of tracts of alternating purine:pyrimidine between evolutionarily diverse species is consistent with a possible functional role for these sequences. PMID- 3267217 TI - Haloperidol binding to monoclonal antibodies. Hypervariable region amino acid sequence determination. AB - The primary sequences of five monoclonal antibodies (mAbs A-E) which bind with various affinities (Kd = 4-810 nM) to the D-2 dopaminergic antagonist, haloperidol, have been determined. Immunoglobulin light and heavy chain mRNA was isolated and gene sequence determined by primer extension in the presence of dideoxynucleotides. The pattern of insertions and deletions found within the hypervariable regions produce loops which differ in length from one antibody to another, and are directly responsible for establishing the gross architecture of the combining site. Two of the anti-haloperidol mAbs have long hypervariable loops which form a pocket-shaped combining site. Three other mAbs have deletions of 3 or 4 amino acids in the third heavy chain complementarity producing region which result in a groove-like combining site as determined by computer based molecular modeling. A discussion of the probable mechanism by which the given sequences were generated from various gene segments is also presented. PMID- 3267218 TI - Influenza B virus evolution: co-circulating lineages and comparison of evolutionary pattern with those of influenza A and C viruses. AB - Sequence analyses and comparison of the genes coding for the nonstructural (NS) and hemagglutinin (HA) proteins of different influenza B viruses isolated between 1940 and 1987 reveal that the number of substitutions is not always proportional to the time between isolates. Examination of 14 influenza B virus NS gene and 10 HA gene sequences by the maximum parsimony method suggested that--as with influenza C viruses--there are multiple evolutionary lineages which can coexist for considerable periods of time. Comparison of the sequence divergence among genes of viruses belonging to type A, B, and C virus suggests that, in man, influenza B viruses evolve slower than A viruses and faster than C viruses. We propose an evolutionary model for influenza B viruses that is intermediate between the pattern for human influenza A viruses and that for influenza C viruses. PMID- 3267220 TI - Genomic and cDNA cloning of the human C1 inhibitor. Intron-exon junctions and comparison with other serpins. AB - Amino acid sequencing of trypsin fragments of C1 inhibitor gave regions of low codon degeneracy that were used for oligonucleotide probes. Human liver cDNA libraries gave clones containing most of the protein sequence, showing that the inhibitory domain belongs to the 'serpin' class of protein inhibitors. Fragments of these cDNA clones were used to probe human genomic cosmid libraries. The genomic sequence was found to be about 17 X 10(3) base pairs, with a coding sequence of approximately 1800 base pairs containing introns at amino acid positions--6, 162, 207, 275, 321, 395, and one in the 5' non-coding region. There is very little similarity of intron position amongst the serpin genes. All but one of the intron positions in the C1 inhibitor structural gene correspond to surface residues if C1 inhibitor is considered to have a structure similar to the cleaved form of alpha 1-antiproteinase. The serine and threonine residues in the N-terminal 100 amino acids of the sequence thought to carry complex carbohydrates are found in a single exon. PMID- 3267221 TI - Nucleotide sequence of cDNA and predicted amino acid sequence of rat liver uricase. AB - A cDNA clone for rat liver uricase (EC 1.7.3.3), which is localized in the core of peroxisomes, was isolated from a rat liver cDNA library in lambda gt11. The clone, referred to as lambda rURC-1, induced formation of a fusion protein (molecular mass 140 kDa) in the presence of isopropyl beta-D-thiogalactoside. Immunoglobulin G reactive with the fusion protein recognized only a protein with molecular mass of 33 kDa, corresponding to the molecular mass of uricase. The nucleotide sequence of the isolated cDNA was determined and the amino acid sequence was predicted. An open reading frame was identified and found to encode a polypeptide of 280 amino acids with a molecular mass of 32226 Da. The cDNA contained 14 base pairs of 5'-untranslated sequence and 192 base pairs of 3' untranslated sequence. The sequences of four internal peptide fragments, determined by Edman degradation, were identical to parts of the sequence predicted from the cDNA. The complete amino acid sequence predicted for rat liver uricase was compared with that of soybean nodulin uricase and nine highly homologous regions of the two enzymes were found. PMID- 3267219 TI - Identification of mutant monoclonal antibodies with increased antigen binding. AB - Sib selection and an ELISA have been used to isolate hybridoma subclones producing mutant antibodies that bind antigen better than the parental monoclonal antibody. Such mutants arise spontaneously in culture at frequencies of 2.5-5 X 10(-5). The sequences of the heavy and light chain variable regions of the mutant antibodies are identical to that of the parent and the Ka values of the mutants and the parent are the same. The increase in binding is associated with abnormalities of the constant region polypeptide and probably reflect changes in avidity of these antibodies. PMID- 3267222 TI - Cloning and sequence of beta tubulin cDNA from Giardia lamblia. PMID- 3267223 TI - The N terminus of laminin A chain is homologous to the B chains. AB - A major proteolytic fragment (E1/E1-4) of the basement membrane protein laminin, comprising the three short arms with some terminal globules missing, was isolated by elastase digestion, and partial protein sequence data were determined for several tryptic peptides. Sequences which corresponded to A-chain structures were used to synthesize oligonucleotides for the construction and screening of a primer-extended cDNA library from mouse PYS-2 cells. A clone of 1.1 kb was obtained and shown by sequencing to correspond to the 5' end of the 10-kb mRNA of the A chain of laminin. The clone contains 77 nucleotides of 5' untranslated sequence and a region coding for 334 amino acids, including a presumptive signal peptide of 24 amino acids. The sequence is 30% homologous to the corresponding N terminal part of the B1 chain of laminin, suggesting the same structure for both domains. The data present further evidence for a recent structural model which postulates that each of the three laminin polypeptide chains forms a distinct short arm. PMID- 3267224 TI - The complete nucleotide sequence of the gene coding for the human aldolase C. PMID- 3267225 TI - Nonsense mutation causing steroid 21-hydroxylase deficiency. AB - We determined the sequence of a mutant CYP21B gene isolated from a patient with the severe, "salt-wasting" form of congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency. Codon 318 in this gene is changed from CAG, encoding glutamine, to TAG, a nonsense codon. This is predicted to result in a completely nonfunctional enzyme due to premature termination of translation. In addition, when the cloned mutant gene was transfected into mouse Y1 adrenal cells, the resulting mRNA levels were decreased compared with transfected normal CYP21B genes. This mutation was carried by 3 of 20 unrelated patients with 21 hydroxylase deficiency alleles as determined by hybridization with a specific oligonucleotide probe. This mutation is also seen in the normal CYP21A pseudogene, so that its presence in the abnormal CYP21B gene may be the result of a gene conversion event. PMID- 3267227 TI - Evidence for gene conversion between the phosphoglycerate kinase genes of Trypanosoma brucei. AB - Trypanosoma brucei contains a tandem array of three genes for phosphoglycerate kinase (PGKase), genes A, B and C, each coding for a different protein. We have compared allelic variants of this gene array and find evidence for gene conversion between the three genes. Near the 3' end, the different alleles and gene B contain a variable sequence that is similar to the corresponding sequence in either gene A or gene C. This sequence is flanked by glycine triplets that are conserved in all PGKases from bacteria to mammals. The triplets are encoded by (GGT)n, resulting in sequences that resemble the recombination-promoting chi sites of Escherichia coli. Upstream of the variable sequence, there is an area of 800 base-pairs in which genes A, B and C are highly homologous; in all three genes this region ends with a sharp boundary at which gene B again shows segmental homology with both genes A and C. These results suggest that repeated gene conversion events partially erase the differences between genes A, B and C that arise in evolution and suggest that chi-like sequences may act as recombinational hotspots in protozoa such as T. brucei. PMID- 3267228 TI - The nucleotide sequence of bacteriophage T5 DNA at the region between early and late genes. PMID- 3267226 TI - Genes expressed in the brain define three distinct neuronal nicotinic acetylcholine receptors. AB - Four genes encode the related protein subunits that assemble to form the nicotinic acetylcholine receptor (nAChR) at the motor endplate of vertebrates. We have isolated from the chicken genome four additional members of the same gene family whose protein products, termed alpha 2, alpha 3, alpha 4 and n alpha (non alpha) probably define three distinct neuronal nAChR subtypes. The neuronal nAChR genes have identical structures consisting of six protein-coding exons and specify proteins that are best aligned with the chicken endplate alpha subunit, whose gene we have also characterized. mRNA transcripts encoding alpha 4 and n alpha are abundant in embryonic and in adult avian brain, whereas alpha 2 and alpha 3 transcripts are much scarcer. The same set of neuronal genes probably exists in all vertebrates since their counterparts have also been identified in the rat genome. PMID- 3267230 TI - Molecular cloning and sequencing of coho salmon growth hormone cDNA. AB - A cDNA library was constructed using mRNA isolated from coho salmon pituitaries. By employing rainbow trout growth hormone cDNA as a probe, the coho salmon cDNA was isolated and the complete nucleotide (nt) sequence determined. The coding region contains 630 nt while the 5'- and 3'-untranslated regions are 64 and 489 nt in length, respectively. Comparison of the noncoding regions of coho and chum salmon cDNAs reveal identity at the 5' end but significant variation in the 3' end. Chum salmon and rainbow trout have identical amino acid (aa) sequences, but coho salmon growth hormone has a sequence that differs by 6 of the 188 predicted aa. Since salmonids are tetraploid, this difference may be the result of either divergence of the same growth hormone locus or of variation between different loci. Comparisons of the cDNA restriction maps of these three fish species suggest the former possibility. PMID- 3267229 TI - A survey of the alpha-tubulin gene family in chicken: unexpected sequence heterogeneity in the polypeptides encoded by five expressed genes. AB - To characterize the alpha-tubulin gene family in chicken, we have isolated five chicken alpha-tubulin genes and determined the majority of the sequences of the encoded polypeptides. Three of these (c alpha 3, c alpha 5/6 and c alpha 8) encode novel, expressed alpha-tubulins that have not previously been analyzed, whereas one gene segment is a pseudogene and another appears capable of encoding a functional subunit (although we were unable to document its expression in a survey of chicken tissues). Together with two additional expressed, functional alpha-tubulins reported earlier, we conclude that the chicken alpha-tubulin family is comprised of at least five functional genes whose polypeptide products are substantially more heterogeneous than found in preceding analyses of vertebrate alpha-tubulins. Comparison of the amino acid sequences reveals that the five polypeptides are between 96 and 83% identical, with the extreme carboxy terminal residues representing a highly heterogeneous variable domain. Since some alpha-tubulins undergo cyclic post-translational removal and readdition of a carboxy-terminal tyrosine, the notable sequence divergence in this domain suggests that individual tubulins probably participate to different extents in this modification cycle. PMID- 3267231 TI - Sequence analysis of the hemagglutinin of B/Ann Arbor/1/86, an epidemiologically significant variant of influenza B virus. AB - Influenza B/Ann Arbor/1/86 is representative of antigenic variants responsible for the most important influenza epidemics during the 1985/1986 season. The nucleotide sequence of the hemagglutinin HA1 region and the deduced amino acid sequence are presented. Compared to the previous winter's vaccine strain B/USSR/100/83, B/AA/1/86 possesses 18 amino acid substitutions and 2 amino acid insertions, 50% of which are distributed within the vicinity of the reported single immunodominant antigenic site. PMID- 3267232 TI - Conservation of histone H2A/H2B intergene regions: a role for the H2B specific element in divergent transcription. AB - The organization and function of potential regulatory elements associated with the promoters of chicken H2A and H2B genes pairs have been examined. The intergene regions of six dispersed and divergently-transcribed H2A/H2B gene pairs contain several extremely well conserved and spaced blocks of sequence homology. Adjacent coding regions are on average 342 base-pairs apart. Respective TATA boxes are separated by 180 base-pairs and within this confined region there are four CCAAT boxes and a previously identified 13 base-pair H2B-specific element (H2B-box) which has homology to the octamer motif present in a number of gene promoter/enhancer elements. Transcription of H2A and H2B genes from wild-type and mutant constructs was measured in transient assays by transfection into HeLa cells, and in permanently transformed clonal cell lines. In vitro separation of the two genes at a unique intergenic site significantly decreased transcription of each gene. This suggested that the H2A/H2B gene pairs contained overlapping promoters. Deletion or point mutagenesis of the H2B-specific element decreased the levels of H2B and the H2A transcripts indicating that this sequence is a common regulatory element of both genes in the divergent-pair configeration. PMID- 3267233 TI - Nucleotide sequence analysis of the C.AKR Lyt-2a gene: structural polymorphism in alleles encoding the Lyt-2.1 T-cell surface alloantigen. AB - The Lyt-2a allele of the C.AKR strain of mice (genotype Lyt-2a, Lyt-3a) was cloned, and its complete nucleotide sequence as well as that of 2 kb of 5' flanking DNA was determined. The sequence was compared with the partial sequence of the Lyt-2a allele of DBA/2 (genotype Lyt-2a, Lyt-3b) and the nearly complete sequence of the B10.CAS2 Lyt-2b allele reported by Liaw and coworkers (1986). The coding regions of the two Lyt-2a alleles differ from each other by two nucleotide substitutions in the three exons over which they could be compared, resulting in two amino acid substitutions in the leader and transmembrane segments. The coding region of the C.AKR Lyt-2a allele differs from the Lyt-2b allele by two nucleotide substitutions in the extracellular V-like domain, one of which is silent and the second of which leads to substitution of valine for methionine at amino acid position 78 giving rise to the Lyt-2.1 allotypic specificity. The coding region of the DBA/2 Lyt-2a allele shares with C.AKR the allotypic substitution at position 78 and differs from Lyt-2b by three additional nucleotide substitutions in the coding regions, two of which lead to amino acid substitutions in the leader and transmembrane segments. It would therefore appear that the Lyt-2 alleles of the three strains analyzed are distinct, and the nomenclature Lyt-2a1 and Lyt-2a2 is suggested to distinguish the alleles of C.AKR and DBA/2, respectively. These alleles share a common difference from the Lyt-2b gene product at position 78, and since the amino acid substitutions which distinguish them from each other are in the leader and transmembrane segments, their mature Lyt-2 gene products appear antigenically identical. PMID- 3267234 TI - Structure of human clathrin light chains. Conservation of light chain polymorphism in three mammalian species. AB - Complementary DNAs (cDNA) encoding the brain and non-brain forms of the human clathrin light chains LCa and LCb have been isolated, sequenced, and compared with their homologues in cow and rat. The significant differences that distinguish LCa from LCb and the brain from non-brain forms show remarkable preservation in all three species. These features include the position and sequence of the brain-specific inserts, a totally conserved region of 22 residues near the amino terminus, the LCb-specific phosphorylation site, the heavy chain binding site, and a distinctive pattern of cysteine residues near the carboxyl terminus. Unorthodox sequences for translation initiation and polyadenylation are found for LCb contrasting with LCa which exhibits orthodox regulatory sequences. Small insertions in human LCa revealed a duplicated sequence of 13 residues that flank the 22-residue conserved region. Only the carboxyl-terminal copy of this sequence is present in LCb. All sequences are consistent with the heavy chain binding site comprising an alpha-helical central region of the light chains. The hydrophobic face of this helix, which is presumed to interact with the heavy chain, is highly conserved between LCa and LCb, whereas the hydrophilic face shows considerable divergence. To help define the carboxyl-terminal limit of the heavy chain binding region, the epitope recognized by the CVC.6 monoclonal antibody was localized to residues 192-208 of LCa with glutamic acid 198 being of most importance. The faithful preservation of clathrin light chain polymorphism in three mammalian species provides evidence supporting a functional diversification of the brain and non-brain forms of LCa and LCb. PMID- 3267235 TI - Human CD3-epsilon gene contains three miniexons and is transcribed from a non TATA promoter. AB - The antigen receptor of the T lymphocyte consists of two variable T-cell receptor chains (either TCR-alpha, TCR-beta or TCR-gamma, TCR-delta) noncovalently linked to four different invariant membrane proteins (CD3-gamma, CD3-delta, CD3-epsilon, and the CD3-zeta homodimer). The CD3 genes are expressed early in thymocyte development, preceding the rearrangement and expression of the T-cell receptor genes. Here we report the isolation and structural analysis of the human CD3 epsilon gene. The gene consisted of nine exons. Three exons, encoding the junction of leader peptide and mature protein, were extremely small (21, 15, and 18 base pairs, respectively). The murine gene contained only two such miniexons, the sequences of which were not homologous to those of the three human miniexons. But from comparisons of intron sequences the regions surrounding the human miniexons III and IV appeared to be closely related to those surrounding the murine miniexons III and IV. The most-3' miniexon in the human gene (IVa) had no murine counterpart and appeared not to duplicate any of the other miniexons. Sequence analysis of CD3-epsilon cDNA clones isolated from four independent libraries gave no evidence for alternative use of these miniexons. Like CD3 delta, the CD3-epsilon gene was transcribed from a weak, nontissue-specific, TATA less promoter. Pulsed-field electrophoresis showed that the human CD3-epsilon gene was separated from the CD3-gamma, CD3-delta gene pair by at least 30 kilobases, but by no more than 300 kilobases. PMID- 3267236 TI - The sequence of the reovirus serotype 3 L3 genome segment which encodes the major core protein lambda 1. AB - We present the sequence of reovirus serotype 3 (strain Dearing) genome segment L3 which encodes protein lambda 1, one of the two major components of the core shell. The genome segment is 3896 nucleotides long, with 5'- and 3'-noncoding regions of 13 and 181 nucleotides, respectively. Protein lambda 1 is 1233 amino acids long. It is a slightly acidic protein, with a predicted alpha-helix and beta-sheet content of 23.6 and 28.3%, respectively. Its rather low predicted alpha-helix contact is consistent with its being a structural protein. The 123 amino acid long region at its amino terminus is very hydrophilic and contains three alpha-helical regions, one being 26 amino acids long. Protein lambda 1 contains two functional motifs. The first is a nucleotide binding site -TKGKSSG- starting at residue 8, the other is a "zinc finger" motif centered around amino acid residue 194. This suggests that protein lambda 1 functions during the transcription of either dsRNA into plus strands or of plus strands into minus strands, or during both. It displays no significant sequence similarity to any protein sequence in the GenBank data base. PMID- 3267237 TI - Putative termination sites for rDNA transcription in rice. AB - A clone bearing a 9.8 kb insert DNA containing the rDNA unit was identified by screening an EcoR1 library of rice DNA in lambda Charon 4 phage with [32P]-rRNAs. The S1 nuclease mapping of the rDNA-precursor rRNA hybrids showed the presence of two transcription termini on the rDNA. They were mapped at positions 616 and 620 nucleotides downstream to the end of the 25S rRNA gene. The 18 nucleotide sequence, where the transcription terminates on the rDNA in rice and mice are homologous albeit in the reverse orientation. PMID- 3267238 TI - Cloning of a major repeat DNA sequence from Pyura stolonifera. AB - We have cloned a 147-bp Hind III fragment from a marine ascidian Pyura stolonifera. This sequence is arranged in tandem in arrays up to 20 kb in size and represents more than 5% of the total genomic DNA. The basic 147-bp unit was isolated from Hind III-digested genomic DNA and cloned into M13. Sequence analysis of seven clones revealed that the sequence is AT rich (75%) and can be separated from main band DNA by equilibrium density gradient centrifugation in the presence of the ligand dye Hoechst 33258. The sequence is highly conserved and is changed only by single base substitution mutations in the different clones. Use of this sequence as a probe demonstrated varying degrees of hybridization with DNA isolated from a wide range of other ascidians. Northern blot analysis revealed the presence of RNA hybridizing to the repeat in unfertilized eggs but transcription of this sequence was not evident in the adult organism. PMID- 3267239 TI - Mouse spleen derived cDNA clones containing per repeat sequence. PMID- 3267240 TI - Complete nucleotide sequence of the tycA gene coding the tyrocidine synthetase 1 from Bacillus brevis. PMID- 3267241 TI - cDNA cloning and primary structure determination of the peroxisomal trifunctional enzyme hydratase-dehydrogenase-epimerase from the yeast Candida tropicalis pK233. AB - We report the isolation and nucleotide (nt) sequence determination of a cDNA encoding the peroxisomal trifunctional beta-oxidation enzyme hydratase dehydrogenase-epimerase (HDE) from the yeast Candida tropicalis pK233. Poly(A)+RNA isolated from C. tropicalis cells grown in oleic acid medium was used to construct a cDNA library in lambda gt11. The library was screened with a polyclonal antiserum against HDE. A recombinant was confirmed to encode HDE by hybridization-selection translation and immunoprecipitation. The HDE cDNA (HDE) has a single open reading frame of 2718 nt, encoding a protein of 905 amino acids, not including the initiator methionine. The Mr of the protein is 99,350. A partial gene duplication is believed to have occurred in the evolution of the HDE gene. Codon utilization in the gene is not random, with 86.0% of the amino acids specified by 23 preferentially used codons, a situation similar to that found in genes encoding peroxisomal catalase and the various fatty acyl-CoA oxidases from C. tropicalis. The increase in HDE activity in C. tropicalis cells grown in oleic acid medium as opposed to glucose medium is due, at least in part, to increased HDE-specific mRNA levels. PMID- 3267242 TI - Metabolic and ventilatory responses during race pace at marathon. PMID- 3267243 TI - Evaluation of muscular load of m. biceps brachii in isometric contraction with the use of microvibration. PMID- 3267244 TI - Effects of jogging/running training on cardiorespiratory fitness, serum lipids, and body composition in healthy males. PMID- 3267245 TI - [The change in the electromyogram and the heart rate during static muscle work by wearing a pressure suit]. PMID- 3267246 TI - [Relationship between the force-velocity properties developed by consecutive muscular power and muscle fiber composition]. PMID- 3267247 TI - Time to peak force and force developing speed during fast maximal and submaximal isometric voluntary contractions. PMID- 3267248 TI - Comparison of HR-VO2 regression in mental and physical exertion. PMID- 3267249 TI - Physiological responses to various kinds of garments in cold, neutral, and warm conditions and their implications for physiological formation of physical characteristics in humans. PMID- 3267250 TI - Analyzing the food sciences from a viewpoint of food intake, eating behavior and their relationship. PMID- 3267251 TI - Studies on adaptation to protein deficiency. PMID- 3267253 TI - Influence of climate on human in living environment. PMID- 3267252 TI - Home automation and human factor. PMID- 3267254 TI - [Nomogram for predicting energy expenditure during treadmill walking]. PMID- 3267255 TI - [Effect of heavy exercise and forced running training on serum lipid peroxide]. PMID- 3267256 TI - [Cardiorespiratory responses during submaximal work by wearing the pressure suit]. PMID- 3267257 TI - Acute effects of marathon running on postmarathon maximal oxygen uptake. PMID- 3267258 TI - [Some ideas of new inner space development of physiological anthropology]. PMID- 3267259 TI - Nonionizing radiation protection. Second edition. PMID- 3267260 TI - Nonionizing radiation protection. Regulation and enforcement procedures. PMID- 3267261 TI - Nonionizing radiation protection. Optical radiation, with particular reference to lasers. PMID- 3267262 TI - [Prosthetic crown margins: clinical and esthetic evaluation. 1]. PMID- 3267263 TI - [Diastema closure in the upper arch]. PMID- 3267264 TI - [Preoperative radiographic study of root canals]. PMID- 3267265 TI - [Operative wall analysis of the maxillary molars]. PMID- 3267266 TI - [Lipoma of the oral cavity. Two clinical cases]. PMID- 3267267 TI - [AIDS: prevention is the only treatment]. PMID- 3267268 TI - ["Gingivamol" flexible mask. 4 clinical cases]. PMID- 3267269 TI - [Swiss Academy of Medical Sciences. Annual report 1988]. PMID- 3267270 TI - Outpatient surgery for prolapsed lumbar disc. AB - A selected series of 14 patients with lumbar disc prolapse causing sciatica have been operated successfully with outpatient (daycase) surgery. Postoperative pain has been much less than expected. This form of surgery has proved very acceptable to patients and to their family doctors. PMID- 3267271 TI - Extreme lateral lumbar disc herniation. AB - Extreme lateral lumbar disc herniation (ELLDH) occurring into and/or outside the intervertebral foramen was encountered in 95 cases amongst 1600 operations for herniated lumbar disc (6%): 43% occurred at L5-S1, 38% at L4-5, 18% at L3-4, and 1% at L2-3. The incidence amongst all herniations at one particular level was 6% at L5-S1, 4% at L4-5, and 18% at L3-4. The clinical presentation varied according to the level of extreme lateral disc herniation, but was not different from the presentation of a classical paramedian herniation occurring one level above. Forty-three patients were investigated with computed tomography (CT) only, 2 with myelography only, and 50 with both. CT always clearly demonstrated the pathology, but some cases are presented to illustrate the differential diagnosis. Myelography was normal in 13 cases; in 27 cases it showed a typical shortening and enlargement of the nerve root sheath which enters the affected intervertebral foramen. At operation, a total facetectomy was performed in 52 patients, a partial facetectomy in 34, and a lateral approach to the intervertebral foramen in 9. The lateral approaches, either paramuscular with retraction of the paraspinal muscles from the midline, or transmuscular by splitting of the paraspinal muscles, are described and illustrated in detail. PMID- 3267272 TI - Horse riding and head injury: admissions to a regional head injury unit. AB - A retrospective survey has been carried out of 59 patients who suffered head injury related to horse riding out of 7172 cases of head and spinal injury admitted to a regional head injury unit in the 5-year period 1980-85. Most (85%) were female, against the usual 80% male predominance of head injury, 56 were minor injuries and 3 severe, of whom 2 died. Skull fracture was present in 10 patients (17%) of whom at least 5 had been wearing headgear at impact, and scalp trauma was noted in 22 (37%) with a predominance of occipital injuries. All the severely injured cases had an occipital skull fracture. One fifth of the patients suffered additional significant injuries. While most patients (90%) made a good recovery, 2 remained moderately and one severely disabled. Horse riding posed a significant risk of head injury to the population of riders, mainly young women. This survey suggests that the wearing of amateur riding headgear does not adequately protect the rider from scalp and skull injury, particularly in the occipital region. PMID- 3267273 TI - Intradural free fragment of the lumbar region: report of two cases. AB - Two cases of intrathecal disc protrusion and a review of the literature is presented. The rarity of this complication, which might occur after an incomplete disc removal, is pointed out. These two cases confirmed that the L4-5 interspace is the one most commonly affected. PMID- 3267274 TI - Transpetrous spread of acoustic neuroma into the middle cranial fossa: report of two cases. AB - We report two patients with acoustic neuromas which spread upwards through the petrous temporal bone into the middle fossa as well as medially through the porus acousticus into the posterior fossa. There appear to be no previous reports of such transpetrous spread of an acoustic neuroma. PMID- 3267275 TI - Life expectancy curves. PMID- 3267276 TI - Clinical features and outcome in 1076 patients with ruptured intracranial saccular aneurysms: a prospective consecutive study. AB - In a well-defined area, The Kingdom of Denmark, 1076 patients with ruptured intracranial aneurysms were admitted to the six Danish neurosurgical departments in a prospective consecutive study in the 5-year period 1978-1983. Follow-up examinations were accomplished 3 months and 2 years after the admission. A total of 674 women and 402 men with a median age of 49 years were included in the study. The localisation of the ruptured aneurysms were: internal carotid artery 285, anterior communicating artery and horizontal part of anterior cerebral artery 383, middle cerebral artery 291, basilar and vertebral arteries 83 and peripheral or other localisation 34. A significantly better outcome was seen in cases with internal carotid aneurysms compared to other localisations. 670 patients underwent operation. A highly significantly better outcome was found in operated versus non-operated patients in comparable clinical conditions. The advantage of microneurosurgery was well documented. Patients with vasospasm had a significantly worse outcome. Within the first 2 weeks a daily rebleeding rate from 0.2% to 2.1% was observed, and patients who rebled had a significantly worse outcome compared to patients, who did not rebleed. The overall outcome at 2-year follow-up was: normal 27.5%, mild dementia 15.8%, severe dementia 9.9%, vegetative 1.3% and mortality 45.5%. PMID- 3267277 TI - The timing of aneurysm surgery. PMID- 3267278 TI - Clinical features and outcome in 48 patients with unruptured intracranial saccular aneurysms: a prospective consecutive study. AB - During a 5-year period (1978-1983) the clinical features and operative morbidity/mortality were registered prospectively for all patients in Denmark with an unruptured symptomatic (27 patients) or incidental (21 patients) intracranial saccular aneurysm. A follow-up examination was performed 2 years after diagnosis of the aneurysm. Thirty symptomatic aneurysms in 27 patients most frequently involved the visual pathways or ocular motility (66%). The median diagnostic delay for patients with impaired visual acuity was 7 months but only 14 days for patients with impaired ocular motility. The localisation of the 30 symptomatic and 23 incidental aneurysms were: internal carotid artery (73% approximately 35%), anterior communicating artery (3% approximately 26%) and middle cerebral artery (7% approximately 35%). The diameters of 73% of the symptomatic aneurysms were greater than 10 mm, while the diameter of 74% of the incidental aneurysms were below 10 mm. The total operative morbidity and mortality were 15% and 4%, respectively. The mortality rate in the follow-up period was 10-11% mainly due to fatal bleeding from unoccluded aneurysms. In 21 survivors, a normal mental status was found in 43% and mild dementia was found in another 43%. The impaired visual acuity was unchanged in 67% of patients, while the ocular motility had normalised in 75%. A normal daily functional capacity was enjoyed by 57% while 43% had a moderate reduction, mostly due to visual disturbances. PMID- 3267279 TI - A head injury polemic. PMID- 3267280 TI - Surgical treatment of syringomyelia with syringopleural shunting. AB - The clinical course of 21 patients who underwent syringopleural shunting for syringomyelia is summarised. All the patients were continuing to deteriorate at the time of the operation. Objective improvement was seen in nine patients following the procedure but three subsequently deteriorated. Contralateral syrinx symptoms have appeared in two patients. No change was seen in six patients who did not deteriorate later. Three were worse following the procedure. In syringomyelia with marked hydrocephalus, ventricular drainage by a valved shunt may be the preferred first procedure. Craniovertebral decompression is recommended for syringomyelia with hindbrain herniation without dense arachnoiditis. In appropriate cases syringopleural shunting may be performed in combination with craniovertebral decompression, and may be the procedure of choice in cases with marked hindbrain arachnoiditis. In cases with a sizeable syrinx who have subsequently deteriorated following craniovertebral decompression, syringopleural shunting may be considered the preferred second procedure. Syringopleural shunting is suggested in amenable cases of syringomyelia associated with spinal tumour, trauma or arachnoiditis. PMID- 3267281 TI - Cervical disc prolapse in the elderly: an easily overlooked, reversible cause of spinal cord compression. AB - It is important to distinguish cord compression due to cervical disc prolapse, which has a very favourable prognosis following surgery, from that due to cervical spondylosis. In the elderly the occurrence of cervical disc prolapse as a cause of spinal compression may be under-recognised because symptoms are too readily attributed to long standing degenerative changes on plain cervical X rays. The difficulty of making an accurate diagnosis is complicated further in the elderly by the prevalence of other diseases which may mask the symptoms of cord compression. We report our experience with 19 patients over 60 who underwent anterior cervical discectomy for myelopathy due to intervertebral disc prolapse. There was generally a short history of walking difficulty, but the presence of 'numb clumsy hands', perhaps due to selective posterior column impairment, was often a more disabling complaint. Neck pain and disturbances of micturition were unusual. The prognosis after disc excision can be excellent. In this series all the severely disabled patients returned to an independent existence. Overall 16/19 patients made an excellent or good recovery. PMID- 3267282 TI - Optic nerve gliomas in children: a reappraisal. AB - The Children's Tumour Registry in Manchester records details of children in the North West Region of England with gliomas of the anterior optic pathways. In the 30 years to 1983, the diagnosis of optic nerve glioma was confirmed in only 22 children out of a population of 1 million under the age of 15 years. This paper examines the presentation, investigation and management of these children in relation to the site of their tumour. The place of radiotherapy is considered, and with the widespread availability of new imaging techniques, fresh protocols are offered for the investigation and treatment of this rare tumour. PMID- 3267283 TI - Antimicrobial prophylaxis in neurosurgery. PMID- 3267284 TI - AIDS and the neurosurgeon. AB - AIDS is a fatal viral infection transmitted by body fluids, primarily blood, which is becoming more common in the U.K., and if the gloomiest predictions are true will affect millions in the next decade. Most, if not all, of these patients will at stage develop neurological manifestations: therefore the neurosurgeon will find it difficult to avoid close contact with the syndrome. As the presentation may mimic a number of neurological conditions, or patients with AIDS may suffer head injury, subarachnoid haemorrhage, or other common conditions, it is probably wise to assume all patients have AIDS and to modify operating technique and other procedures where blood may be spilt to minimise the risks of acquiring the infection. PMID- 3267285 TI - Multiple brain abscesses: treatment by a conservative approach--a case report. AB - A 57-year-old male with six brain abscesses was successfully treated with metronidazole and ampicillin under close CT-control. To exclude possible tuberculosis a cortical abscess was excised for culture and microscopy. Hydrocephalus which developed was drained and subsequently treated with a permanent ventriculo-peritoneal shunt. Within 42 weeks the remaining five abscesses all showed complete resolution on the CT-scan. PMID- 3267286 TI - The bacteriology and chemotherapy of acute pyogenic brain abscess. PMID- 3267287 TI - Neurovascular decompression for cranial rhizopathies. AB - For some cranial rhizopathies, such as hemifacial spasm and glossopharyngeal neuralgia, treatment has been unsatisfactory. Neurovascular decompression now offers a cure in almost 90% of these cases. In spite of the availability of alternative minor surgical procedures for trigeminal neuralgia, neurovascular decompression, being non-destructive, is a superior method of treatment. Vascular compression may also play a role in atypical facial pain and decompression may offer relief in this intractable condition. Vascular compression was not observed on exploration for nervus intermedius neuralgia, spasmodic torticollis and Meniere's disease. However, microsurgical techniques for selective section of nerves have been beneficial in Meniere's disease and nervus intermedius neuralgia. Neurovascular decompression is a relatively major procedure and is associated with a complication rate of 15%, deafness being most significant. Surgical expertise, a familiar operating team and possibly intraoperative monitoring facilities can reduce these complications. PMID- 3267288 TI - Changes of blood flow in oestrogen-induced hyperplastic anterior pituitary lobe following bromocriptine administration. AB - Anterior pituitary hyperplasia and histologically verified adenomas were induced by diethylstilboestrol (DES) containing implants in a total of 104 female F344 rats. Thirty rats were used as controls. Blood flow in the anterior pituitary (PBF) was measured using the hydrogen clearance method. PBF was progressively reduced to 25% by DES in 13 weeks but the total adenohypophysial blood flow (flow as measured per unit weight multiplied by weight of the gland) was raised by 75%. Bromocriptine (BC, 1 mg/kg intravenously) reduced PBF by a maximum of 27% in tumour-bearing rats. When bromocriptine (1 mg/kg/day subcutaneously) was given for 7 days before the measurements the hyperplastic effect of DES on the pituitary gland and the total blood flow through the pituitary were both reduced by 23%. Reduction of blood supply may be one of the reasons that bromocriptine is clinically useful. PMID- 3267289 TI - A transcavernous-transsellar approach to the basilar tip aneurysms. AB - A series of 11 patients with a basilar tip aneurysm were treated operatively. The aneurysm had ruptured in all cases and caused at least one haemorrhage prior to surgery. Four patients harboured large aneurysms, while in the rest of them the aneurysms were small in size. In all the 11 patients a modified pterional transcavernous-transsellar approach was used which considerably facilitated clipping and secured complete exclusion of all aneurysms, including the large ones. Eight patients made a complete recovery and resumed their original occupation. One is hemiparetic but capable of self care, one is hemiplegic, and one died after surgery. The purpose of this report is to present our modified surgical approach to basilar tip aneurysms, which provides good exposure of the entire region of the bifurcation of the basilar artery and adjacent blood vessels as far as the anterior inferior cerebellar arteries, and requires but minimal retraction of the brain. PMID- 3267290 TI - Management of difficult intracranial aneurysms by deep hypothermia and elective cardiac arrest using cardiopulmonary bypass. AB - Giant anterior circulation aneurysms and some basilar aneurysms can cause problems due to their size, the presence of clot in the aneurysm and the difficulty of applying a clip without kinking the perforating vessels. By utilising cardiopulmonary bypass via the femoro-femoral perforating vessels. By utilising cardiopulmonary bypass via the femoro-femoral route the patient can be cooled to below 20 degrees C allowing the circulation to be stopped for up to 3/4 hour. This will enable the neurosurgeon to unhurriedly dissect out the aneurysm without fear of rupture and where necessary open the aneurysm to remove clot and clip the aneurysm. By draining the circulating volume into the venous reservoir of the pump, a large aneurysm may collapse thus enabling it to be clipped more easily. It is, therefore, a useful technique for difficult aneurysms. We present here a series of 11 patients who underwent this procedure with excellent results in 7. All patients had aneurysms which would otherwise have been either inoperable or very risky to tackle. PMID- 3267291 TI - Motorcycling and head injury: admissions to a regional head injury unit. AB - In a 5-year period during which 7,178 patients with head injury were admitted to a regional head injury unit, 191 motorcyclists (2.7%) were admitted with head injuries of which 76% were classified as minor, 6% as moderate and 18% as severe (in coma). Two thirds of the patients were aged 20 years or less. Eighty-two riders (43%) had some form of facial or scalp trauma and 37 (19%) sustained skull fracture. Intracranial haematomas requiring surgical evacuation were detected in 3 of the minor head injuries (2%), 2 of the moderate injuries (17%) and 11 of the severely head injured patients (32%). Twenty-nine of the 34 severely injured patients were managed using artificial ventilation and intracranial pressure monitoring. The remaining patients died before these measures could be instituted. Overall mortality was 7%, but deaths were restricted to the severely head injured, among whom there were 13 fatalities. Head injuries associated with motorcycle riding include an unduly high proportion of severe cases and occur in a young population, often within a short time of starting to ride a motorcycle. Protective headgear was virtually always worn (94%); to reduce morbidity further, increased training and supervision during the first 6 months of motorcycle ownership should be emphasized. PMID- 3267292 TI - Partial posterior vertebrectomy for anterior thoracic cord compression. AB - Compression of the anterior aspect of the thoracic cord is a common neurosurgical emergency. Treatment is generally unrewarding. Decompression by the anterior and antero-lateral approach is difficult and time consuming, and decompressive laminectomy offers poor results. It is suggested that in selected cases the removal of a small part posterior of the vertebral body via a posterolateral approach is an appropriate alternative treatment. PMID- 3267293 TI - Metastatic carcinoid tumour of the CNS from two different primary sites. AB - Two cases of carcinoid tumour affecting the central nervous system through their metastases were treated surgically. The first case was carcinoid tumour of the lung with a single metastases in the right frontal lobe of the brain, while the second developed metastases of the sixth thoracic vertebra from a terminal ileum bowel primary causing spinal cord compression. Neither case developed carcinoid syndrome. The rarity of such metastases affecting the central nervous system is discussed together with a review of the literature. PMID- 3267294 TI - Xanthogranuloma of the choroid plexus of lateral ventricle, presenting with parosmia and parageusia. AB - Xanthogranulomas of the choroid plexus are usually asymptomatic. We present a short case report of a 60-year-old male whose symptoms of parosmia and parageusia have been relieved following surgical removal of a xanthogranuloma situated in the right lateral ventricle. Previous case reports and correlation of symptomatology and pathology are discussed. PMID- 3267295 TI - Risk of death in perspective. PMID- 3267296 TI - Perspectives in neuro-oncology. PMID- 3267297 TI - Status of extracranial-intracranial anastomoses for cerebral ischaemia 2 years after the international by-pass study. PMID- 3267298 TI - Post-ictal blood pressure in aneurysmal subarachnoid haemorrhage. AB - A prospective study in which the effect of the post-ictal systemic blood pressure levels on the outcome following surgically treated aneurysmal subarachnoid haemorrhage (SAH) in 325 patients is reported. No differentiation was made between pre-existing essential and prolonged reactive hypertension. A significant association was found between the trend for rising diastolic blood pressure levels and the tendency towards a poor outcome. There was a similar trend for rising systolic blood pressure levels which did not reach statistical significance. Patients with definite hypertension (blood pressure of 160/95 mmHg or greater) were 1.6 times as likely to have a poor outcome than were those with lower blood pressures. PMID- 3267299 TI - Cerebrospinal fluid production in subarachnoid haemorrhage. AB - Eight patients with subarachnoid and/or intraventricular haemorrhage underwent continuous extraventricular drainage and cerebrospinal fluid production was estimated by modified open drainage. The patients were in Hunt & Hess grades 2-5 on admission. Drainage was instituted within 24 h after the last bleeding episode in seven patients and the duration of drainage was 3-37 days. The median amount of CSF that was drained in 24 h was 210 ml. CSF production rate was 0.10-0.55 ml/min (median 0.28 ml/min) and there was a great variation within as well as between patients. Thus there was a trend towards a reduction in CSF production compared to reported normal values for CSF production. Three of six surviving patients required a shunt. The possible role of reduction in CSF production rate in the modification of intracranial hypertension and hydrocephalus after subarachnoid haemorrhage is discussed. PMID- 3267300 TI - Creatine kinase (CK-BB) determination in cerebrospinal fluid after acute experimental head injury. AB - Early changes of the activity of enzymes such as creatine kinase in the cerebrospinal fluid (CSF) or serum are often investigated after head injuries to assess the extent of brain damage and establish a reliable prognosis. The purpose of the present study was to determine levels of creatine kinase isoenzyme CK-BB in the CSF of rats after experimental head injuries. External head injuries of different severity were inflicted on rats, immediately after which CSF was collected for isoenzyme activity determination. It was found that the levels of CK-BB were significantly elevated immediately after the head injury and that the greater the degree of external cranial injury inflicted, the higher the isoenzyme activity was. The results seem to provide evidence that CK-BB activity is an early indicator of brain damage and that its level may reflect the extent of cerebral damage involved. PMID- 3267301 TI - The treatment of hemifacial spasm by sling retraction. AB - A new method of microvascular decompression of the facial nerve using sling retraction is described. This method may elucidate the way in which this microsurgical exploration in the posterior fossa relieves hemifacial spasm. PMID- 3267302 TI - The localisation of radiolabelled murine monoclonal antibody 81C6 and its Fab fragment in human glioma xenografts in athymic mice. AB - The localisation of the radioiodinated Fab fragment of monoclonal antibody (Mab) 81C6, reactive with a glioma-associated extracellular matrix antigen, was studied in athymic mice bearing subcutaneous and intracranial xenografts of D-54 MG glioma cells. In vitro 81C6 Fab showed a marked loss of immunoreactivity and affinity for antigen compared to intact Mab 81C6. In vivo, the plasma half-life of 81C6 Fab was 7.0 hours compared to 2.1 days for 81C6. 81C6 Fab levels in tumours peaked at 2.6-3.8% injected dose/g in 2-6 h; Mab 81C6 reached 33.9% dose/g at 48 h. Localisation indices and tumour:tissue ratios were superior for Mab 81C6. Estimated radiation doses to tumour and normal tissues were lower for 131I-81C6 Fab than 131I-81C6. To realise the theoretical benefits of fragments as localising agents, Fab fragments of higher immunoreactivity and affinity, or bivalent F(ab')2 fragments are required. PMID- 3267303 TI - In vivo localisation of radiolabelled monoclonal antibody in human gliomas. AB - F(ab')2-fragments of the anti-melanoma monoclonal antibody MeI-14 were labelled with 123I for external scanning and with 125I for tissue measurement of radioactivity and injected intravenously into patients scheduled for surgical resection of a glioma. The paired-label study was performed by injecting simultaneously 131I-labelled control (F(ab')2-fragments. The patients were scanned by computerised tomoscintigraphy. After surgery, the activities of 125I and 131I were counted in tumour and normal tissues. The results indicate that there was a low but definite uptake of the antibody in the tumour due to its specificity. The external detection was difficult because of accumulation of antibody fragments in the skull. PMID- 3267304 TI - Neoplastic meningitis from a pineal tumour treated by antibody-guided irradiation via the intrathecal route. AB - A monoclonal antibody (UJ181.4) was labelled with 131I and given intrathecally to a patient who was critically ill with neoplastic meningitis due to a disseminated pineoblastoma. The target antigen had first been demonstrated on tumour cells by immunocytological testing of cerebrospinal fluid (CSF). As a preparation for therapy, a test dose of 131I-UJ181.4 antibody was given simultaneously with a control antibody labelled with 125I. Good evidence of in vivo immunolocalization was obtained by external gamma counting and by analysis of the radiolabels on centrifuged CSF cells. Specificity ratios of between 10:1 and 20:1 were obtained by these methods. A single relatively small therapeutic dose of 131-I (870 MBq) given by the intrathecal route, resulted in a marked clinical improvement and sustained remission for 22 months. PMID- 3267305 TI - Epidermal growth factor binding in intracranial neoplasms: preliminary biochemical and clinicopathological findings. AB - The binding capacity for epidermal growth factor (EGF) was determined in 34 intracranial neoplasms (14 glioblastoma, seven low-grade gliomas, six meningiomas, and seven others) and four specimens of normal brain by using [I125]EGF. EGF binding and binding affinity of the sites in the tumour and brain samples were compared to placenta and rat liver. All specimens of normal brain were negative. Ten of 14 glioblastoma specimens contained EGF binding (level range 10-39,660 fmol/mg protein), however, ligand binding affinity was high in only three tumours. Only one of nine low-grade gliomas contained EGF binding activity. Five of six meningiomas contained EGF binding sites (level range 49-776 fmol/mg protein) and binding affinity was high in two. When present EGF binding activity was found in all cellular fractions except the cytosol. There were no clinical or histopathological features within major tumour groups that were predictive of either high or specific EGF binding activity. These preliminary studies have confirmed that EGF receptor-like activity is present in the particulate fractions of intracranial neoplasms of both mesenchymal and neuroctodermal origin. In a large proportion of these tumours the EGF binding affinity is low, suggesting either a less specific or truncated EGF binding site. PMID- 3267306 TI - Comparison of in vitro cloning assays for drug sensitivity testing of human brain tumours. AB - Three in vitro clonogenic assays were used to determine the sensitivity of an established human glioblastoma cell line (U251-MG) to five chemotherapeutic agents. The colony-forming efficiency of untreated culture was 0.695 +/- 0.170 in a monolayer assay with irradiated feeder cells, 0.018 +/- 0.006 in a low-O2 agar assay, and 0.049 +/- 0.021 in a two-layer agar system with nutrient-enriched medium (p less than 0.001). Comparison of the slope of the regression line for the dose-response curve and the interpolated ID90 for each drug showed that U251 MG was equally sensitive to aziridinylbenzoquinone and dianhydrogalactitol in all three assays. The sensitivity of this cell line to 1,3-bis-(2-chloroethyl)-1 nitrosourea (BCNU), cis-dichlorodiammineplatinum (II) (CDDP) and 9-hydroxy-2-N methylellipticine (HME), however, varied depending on the assay used. In no instance did U251-MG show greater sensitivity (lower ID90 or steeper slope) in the low-O2 agar assay than in the other assays. BCNU and CDDP were least active in the monolayer assay, whereas HME showed both the lowest ID90 and steepest slope using this technique. We conclude that different in vitro tumour clonogenic assays show different colony-forming efficiencies for the same cell line and may show different responses to certain drugs. Identification of accurate predictive models of drug sensitivity will require correlative in vivo and in vitro studies. PMID- 3267307 TI - Clinical and laboratory findings in patients with multiple meningiomas. AB - A series of eight patients with multiple meningiomas is presented. Up to 14 meningiomas were diagnosed in one patient. The clinical and laboratory findings suggest that multiple meningiomas do not constitute a disease entity of their own featuring disease-specific clinical or laboratory findings. In our series we find a female predominance with seven female and one male patient. The histological findings were mixed, even within the individual cases. There are no consistent patterns of steroid receptor levels or chromosomal aberrations in the more recent cases in which these parameters could be investigated. PMID- 3267308 TI - The pyruvate kinase isoenzyme shift in human gliomas: a potential marker in the treatment of gliomas. AB - In primary human brain tumours a shift occurs in the synthesis of isoenzymes of pyruvate kinase from the M towards the K-type. In astrocytomas, oligodendrogliomas and glioblastomas, which were localised in the cerebral hemispheres of adult patients over 20 years of age, the shift correlated well with histological grading and growth rate as observed in postoperative survival. Gliomas of adults, localised in midline structures, as well as childrens gliomas were characterised too by a strong shift from M towards the K type. However, in these tumours, less correlation with histological grading and growth rate was found. The isoenzyme shift can be rapidly demonstrated with an alanine inhibition test. The application of this assay may have a diagnostic value during operation for gliomas in grading of malignancy in adults as well as demarcation of the resection of gliomas in all age groups. The test can be performed within 10-15 min and can thus fit easily into a surgical procedure. A case report is presented for illustration. PMID- 3267309 TI - Cervical cord extradural haematoma with familial cutaneous haemangiomas. AB - This case report confirms the link between familial cutaneous haemangiomas and haemangiomas of the spinal extradural space. Haemorrhage from a cervical extradural haemangioma may cause a haematoma resulting in an anterior cord syndrome. Recovery is possible with early diagnosis and surgical decompression at the involved level. If the diagnosis is not made the patient may die from this extradural cervical compression. Diagnosis involves myelography with spinal angiography to confirm the site and extent of both haemangioma and extradural haematoma. PMID- 3267310 TI - A device for long-term monitoring of intracranial pressure. AB - A simple and inexpensive device is described for measurement of intracranial pressure over prolonged periods. PMID- 3267311 TI - Transsphenoidal chiasmopexy for long standing visual failure in the secondary empty sella syndrome. AB - The development of an empty sella syndrome is a well recognized complication in the treatment of pituitary tumours and usually presents with visual failure. Transsphenoidal chiasmopexy has been successful in reversing the visual loss when performed in the acute stage. A case, where a delay of 18 months in the surgery does not appear to have affected the outcome, is presented and the literature reviewed. PMID- 3267312 TI - Frequency of neurosurgical disorders in the U.K. PMID- 3267313 TI - Super-specialisation in neurosurgery. PMID- 3267314 TI - Reduction of rheumatoid periodontoid pannus following posterior occipito-cervical fusion visualised by magnetic resonance imaging. AB - Nine patients (four females and five males) with chronic rheumatoid arthritis (RA) and atlanto-axial (AA) instability subjected to occipito-cervical fusion were evaluated clinically and radiologically. All of them had soft tissue formation (pannus) around the odontoid peg. The age ranged from 50 to 79 years (mean: 66). The duration of the RA disease was 3-48 years (mean: 18.5). All patients were seropositive. Both conventional radiography and magnetic resonance imaging (MR) were performed pre- and postoperatively. All fusions except one were stable. One patient was re-fused after 2 months because of wire break. With regard to pain all patients had improved and eight were pain free. Six patients who experienced signs of myelopathy prior to the fusion had improved at follow up. MR revealed reduction of pannus in all nine cases. This was obvious in one patient within 6 weeks postoperatively. The MR findings of a reduction or even disappearance of pannus following posterior fusion should decrease the need for transoral surgery. PMID- 3267315 TI - Shotgun injuries of the spine: neurosurgical management of five cases. AB - The role of neurosurgical intervention in penetrating spinal injury has not been clearly established. Functional outcome has not been shown to be influenced by operation. In fact, neurosurgical intervention has been shown to potentially increase the risk of serious complications. This paper examines a unique subset of patients with penetrating spinal injury-those secondary to shotguns. An analysis of five such cases and a review of the limited literature on the subject suggests that neurosurgical intervention is of limited value in such injuries and that initial management should focus primarily upon non-neurological injuries. PMID- 3267316 TI - Role of a separate subcutaneous cerebro-spinal fluid reservoir in the management of hydrocephalus. AB - A retrospective survey has been carried out on 56 children with shunted hydrocephalus either with a primary idiopathic cause or as a result of a low spina bifida complex. In all 56 children, a separate reservoir has been inserted at some stage in the management of their hydrocephalus. There was no mortality. Morbidity was not increased from CSF infection or shunt blockage. There was less chance of the initial shunt blocking and there was a lesser incidence of visual and schooling handicap. Double cortical puncture did not result in an increased incidence of hemiplegia or epilepsy. We conclude that a separate reservoir greatly eases the management of these children and does not cause significant increased morbidity. PMID- 3267317 TI - Creatine kinase BB release into cerebrospinal fluid after lateral ventricle cannulation. AB - Creatine kinase (CK) and creatine kinase BB isoenzyme (CK-BB) activities were measured in ventricular CSF obtained by lateral ventricle cannulation in patients suspected of normal pressure hydrocephalus. Lateral ventricle cannulation resulted in highly and variably elevated CK and CK-BB levels. The results emphasise the interference of these CK and CK-BB elevations in studies on the prognostic value of CSF CK and CK-BB levels in head trauma patients with respect to outcome. PMID- 3267318 TI - Post-traumatic intraventricular haemorrhage: a reappraisal. AB - Ten patients are described in whom intraventricular bleeding occurred after blunt head injury. A mechanism is proposed to explain this phenomenon by drawing analogies with neonatal intraventricular haemorrhage and the pathological findings in strangulation. The outcome in the patients described seems more favourable than in those hitherto reported. PMID- 3267319 TI - Subdural haematoma associated with long term oral anticoagulation. AB - Twenty-two patients with subdural haematomas associated with long term oral anticoagulation have been reviewed. Clinical presentation was similar to other subdural haematomas, but patients were generally older and the clinical course was more rapid. The incidence of over-anticoagulation was 23% and there was no correlation between anticoagulant status and the extent of bleeding or prognosis. Mortality was 27%, a residual neurological deficit was present in 14% and 59% made a complete recovery. The results suggest that morbidity and mortality could be reduced by early diagnosis and treatment and any patient on oral anticoagulant therapy who develops a headache or confusion should have urgent neurological investigation, including a CT scan. The indications for long term anticoagulation, particularly in the elderly, should be critically reassessed. PMID- 3267320 TI - The influence of unruptured intracranial aneurysms on life expectancy in relation to their size at the time of detection and to age. AB - A theoretical evaluation of the lifetime probabilities of different outcomes in patients with unruptured intracranial aneurysms (UA) has been made using a life table method. The calculations were performed for aneurysm presenting ages from 20 to 70 years of age for men and women assuming an annual risk of aneurysm rupture of 1%, 2% and 3% and a rate of mortality after rupture of 50%. At 10, 20, 30, 40, 50 and 60 years after the diagnosis of an UA the probability of survival without bleeding is reduced below the expected probability of survival according to the life tables by the following percentages (assuming an annual risk of bleeding of 2%): 19%, 34%, 46%, 56%, 64% and 72%, respectively. A survey of the lifetime probabilities of four different outcomes for patients with an UA indicates a substantial reduction in life expectancy after the diagnosis of an UA. In most ages the surgical risks are more than balanced by the risks associated with an untreated unruptured aneurysm. PMID- 3267321 TI - Misleading clinical syndromes of CSF shunt malfunction. AB - CSF shunt malfunction is nowadays a common emergency. It may occasionally simulate some more sinister underlying central nervous system disease. We describe three examples where simple mechanical revision of a faulty shunt reversed bizarre and misleading neurological syndromes. PMID- 3267322 TI - Diaphragm paralysis from cervical disc lesions. AB - An opera singer, who "made her living with her diaphragm", developed a post traumatic unilateral radiculopathy due to cervical disc lesions, C3 to C6. During one year of severe neck and left arm pain she gradually lost the ability to sing difficult operatic passages which brought an end to her music career. Following a three level anterior cervical decompression and fusion, the neck and arm pain was immediately relieved. One week later her voice and singing ability returned to its full strength and power permitting her to resume her activities as a vocalist. The diagnosis of paresis of the left hemi-diaphragm as part of the cervical disc syndrome was implied by postoperative retrospective inference. PMID- 3267323 TI - Transphenoidal meningohydroencephalocoele. AB - A case of transsphenoidal meningohydroencephalocoele is presented. The clinical features and pathogenic factors are discussed briefly. An awareness of this condition should prevent attempted biopsy--which might otherwise prove disasterous. Air or contrast cisternography, with plain or computerised tomographic radiology, would seem to be the investigation of choice. PMID- 3267324 TI - Metastasis of parotid acinic cell carcinoma to an internal carotid aneurysm: a case report. AB - Tumours related to intracranial aneurysms are rare. The authors report the metastasis of a parotid acinic cell carcinoma which spread to an intracavernous carotid aneurysm in a 51-year-old female. The tumour and aneurysm were partially excised at craniotomy with relief of the patients presenting headache. PMID- 3267326 TI - Seizures and epilepsy. PMID- 3267325 TI - Diffuse cerebrospinal gliomatosis: clinical and radiological findings. AB - Diffuse cerebrospinal gliomatosis is extremely rare. We report the case of a 47 year-old man who presented with clinical features of intracranial hypertension. He developed ascending paraplegia and died. This latter clinical feature has not previously been reported. Clinical features and diagnostic difficulties are discussed. PMID- 3267327 TI - CT scanning in the management of intracranial abscess: a review of 100 cases. AB - One hundred cases of brain abscess presenting between 1974 and 1984 are reviewed. The overall mortality was 20%, 98 cases were actively treated with a peroperative mortality of 14%. The results are compared to Garfield's 1969 series, drawn from similar clinical material. Changes in presentation and outcome are described. A significant improvement in survival (p less than 0.001) has occurred following the introduction of computerised tomography (CT Scan) which permits the rapid diagnosis and accurate localisation of intracranial sepsis. As the basic therapeutic regime remains unchanged (burr hole aspiration and appropriate antibiotic treatment), other aspects of management have been examined, leading to the suggestion that CT Scanning has made a major contribution to the reduction in mortality. PMID- 3267329 TI - Craniovertebral anomalies: a study of 82 cases. AB - Eighty-two cases of craniovertebral anomalies have been analysed. Fifty of these were operated upon. Congenital atlanto-axial dislocation was the commonest anomaly encountered (56.1%). Multiple anomalies were frequently seen (48.8%). Common combinations were atlanto-axial dislocation with occipitalisation of atlas, basilar invagination with Arnold-Chiari malformation and basilar invagination with occipitalisation of atlas. There was a high incidence (50%) of neck deformity and/or a low hairline which provided a good clue to the diagnosis. Precipitating factors, paroxysmal symptoms and an acute onset were common in cases of atlanto-axial dislocation. Cranial nerve and cerebellar dysfunction were common in cases with multiple anomalies. Thirty-six (72%) patients improved following surgery, and three died. PMID- 3267328 TI - Antifibrinolytic therapy in patients with aneurysmal subarachnoid haemorrhage. AB - In a prospective consecutive non-randomised study including 1076 patients with ruptured intracranial aneurysms 205 patients received epsilon aminocraproic acid (EACA) and 871 did not. No significant differences between the two groups concerning clinical condition on admission, sex, age, localisation and size of the aneurysms were seen. No cases of rebleeding (RB) were observed within the first 4 days in the EACA treated patients, but within the first 48 hours, which is the optimal period recommended for operation of patients in good clinical condition, this difference of the rates of RB between EACA treated and not treated patients is not significant. A significantly lower rate of RB was observed in the EACA group within the first 2 weeks, but no significant differences in morbidity and mortality were found at the 2-year follow-up examination. PMID- 3267330 TI - Intraventricular haematoma: management of comatose patients with valve regulated external ventricular drainage. AB - Over a 2-year period, 22 consecutive comatose patients (Glasgow Coma Score of less than or equal to 8) with intraventricular haematomas were managed with prolonged external ventricular drainage via an external one-way valve regulated system. The mean duration of drainage was 12 days. The overall mortality was 23%. According to the Glasgow Outcome Scale, 36% had severe to moderate disability and 41% made good recovery. Mortality and morbidity were closely related to the type of intraventricular haematoma and patients' preoperative clinical state. Drainage related complications: infection, and ventricular catheter blockage requiring revision, were not observed as a result of this technique. Of the survivors, nine eventually required ventriculoperitoneal shunts. Sump and valve regulated external ventricular drainage is, therefore, a useful procedure in the management of patients with extensive intraventricular haematoma. PMID- 3267331 TI - The role of needle biopsy in the management of malignant spinal compression. AB - With the changing management of malignant spinal cord compression there has been a reduction in numbers of patients treated by conventional laminectomy. This has resulted in a move either to the use of radiotherapy or to the use of more major surgical procedures such as the transthoracic approach. In both of these situations a more logical approach to deciding on the treatment modality to be used can be achieved by determining the histology of the lesion by percutaneous needle biopsy. This paper describes the technique of needle biopsy and presents evidence that shows that a reliable and immediate diagnosis can be achieved by the use of smear histology. PMID- 3267332 TI - Complications due to prolonged ventricular fluid pressure recording. AB - All complications in a consecutive series of 648 patients subjected to prolonged recording of the ventricular fluid pressure (VFP) during 1982-1986 were registered and analysed. The procedure did not cause permanent symptoms or deficits in any case except for one haemorrhagic complication. Definite infections caused by the VFP recording were found in 4.3% of the 540 patients (83%) surviving their disease or lesion, and in 1.9% in non-survivors. These infections were almost exclusively registered in patients treated with prolonged drainage of hemorrhagic ventricular fluid, while definite infections in other patients were found in only 1.3%. Most infections were caused by Staphylococcus epidermidis and all infections could be treated successfully. Infection did not cause or contribute to the lethal outcome in any case. In 60% of the cases with infectious complications laboratory signs of ventriculitis occurred after a surgical revision of the ventriculostomy. The duration of VFP recording was of subordinate importance for the development of infection. In 13 patients (1.9%) during the studied period a reliable VFP recording was not obtained, a fact that points to the need for alternative methods in a minority of patients with elevated intracranial pressure. It is concluded that complications caused by VFP recording can be kept at an acceptably low frequency in patients without haemorrhagic cerebrospinal fluid demanding long-term drainage. PMID- 3267333 TI - Sincipital encephalocoeles: a review of clinical presentations and methods of surgical repair in Ibadan, Nigeria. AB - Between January 1972 and September 1987, 10 sincipital (fronto-ethmoidal) encephalocoeles were encountered at the neurosurgical unit of the University College Hospital, Ibadan, Nigeria. Seven of the eight patients whose clinical records were available for study were females. The age at presentation varied from 7 days to 5 years. All patients exhibited a mass at the root of the nose. An increase in the size of the lesion was noted, prior to surgery. Clinically, there was no hydrocephalus. Associated birth defects were minor. Five patients underwent intracranial repair. One patient's lesion was excised extracranially. In all these patients, a lump remained or recurred after surgery. Only one patient returned for a recommended second stage of repair at which the residual mass was completely excised. The default rate from follow-up was high. A combined intracranial and extracranial repair during the same hospital admission may offer the best chance for cure. PMID- 3267334 TI - Ventriculo-pleural shunting for adult hydrocephalus. AB - In order to evaluate the efficacy and safety of ventriculo-pleural shunting as an alternative to conventional atrial and peritoneal procedures, we have carried out a retrospective study of 88 pleural shunting procedures. There was a 7% complication rate related to the use of the pleural space as the shunt terminus. Complications at the pleural end included shunt obstruction (functional or structural), pleural effusion, pneumothorax, and other technical problems. There were no deaths associated with shunt dysfunction or other complications. Ventriculo-pleural shunting for hydrocephalus, when used with appropriate precautions and with careful patient selection is a viable alternative for the treatment of adult hydrocephalus. The complications that are unique to this procedure are pneumothorax and pleural effusion. They were encountered infrequently in this series. Ventriculo-pleural shunting may be indicated when other routes are not available. PMID- 3267335 TI - Carotid traumatic aneurysm treated by detachable balloon. AB - The authors report the case of a young man who developed a large infraclinoid carotid aneurysm following a blunt head injury and presented with epistaxis. The aneurysm was occluded by a detachable balloon resulting in a good recovery. PMID- 3267336 TI - Ependymoma of the fourth ventricle: an unusual presentation. AB - The authors describe the case history of a patient who suffered a subarachnoid haemorrhage originating from an ependymoma of the fourth ventricle. The unusual nature of this presentation is emphasised in their review of a series of 22 patients with ependymomas of the craniocervical junction. PMID- 3267337 TI - Comparative study of brain abscess by computed tomography and magnetic resonance imaging: report of two cases. AB - Two cases of cerebral abscess with different presentations are reported. The source of the abscess remained obscure in one case while in the other arose from infection of the right frontal sinus. While in one case a magnetic resonance image was obtained preoperatively, both cases underwent parallel monitoring in the postsurgery period by computed tomography and magnetic resonance imaging. The relative merits of these two imaging techniques in the diagnosis and monitoring of such lesions are discussed, and the literature is reviewed. PMID- 3267339 TI - Metastases. PMID- 3267338 TI - Primary cerebral T-cell lymphoma: a case report. AB - A case of a 16-year-old boy with a rapidly progressive primary cerebral pleormorphic lymphoma of the brain is reported. Immunostaining with a panel of antibodies confirmed the T-cell lineage of the tumour. This is apparently the first documented report of primary T-cell lymphoma of the central nervous system. PMID- 3267340 TI - Use of cefotaxime in brain abscess. PMID- 3267341 TI - Substance P neurons in the human hippocampus: an immunohistochemical analysis in the infant and adult. AB - An analysis of the distribution of substance P immunoreactive nerve cell bodies and fibres is given for infant and adult human hippocampus by using the peroxidase-antiperoxidase technique of Sternberger. The description covers the substance P distribution in the area dentata, the Ammon's horn, the subicular complex and the entorhinal cortex. Each region shows a specific pattern in its substance P immunoreactivity. In general, the hippocampal neurons occur in three major classes of interneurons: large (20-35 microns) horizontal bipolar or multipolar neurons in the alveus, in the deep part of the subicular complex, the entorhinal cortex, and in the white matter of the angular bundle; small (10-20 microns) and large (20-35 microns) vertically oriented bipolar or multipolar neurons in the stratum oriens, in the stratum pyramidale of the Ammon's horn, and in the deep part of the subicular complex and the entorhinal cortex; large (20-35 microns) multipolar neurons in the hilus. Substance P immunoreactive fibres are particularly abundant around pyramidal cells of the CA2 and CA3 subfields of the Ammon's horn and around granule cells of the area dentata. They are also detected in the fimbria and angular bundle. Comparative study of the infant and adult hippocampus reveals no variation in the area dentata and Ammon's horn except that substance P immunoreactive fibres are more abundant in the molecular layer of the area dentata in adults. In contrast, a far more extensive number of substance P immunoreactive cell bodies are detected in the deep layers of the subicular complex and the entorhinal cortex, as well as in the white matter of the angular bundle in infants aged between three and 12 months old. This rich substance P immunoreactive network raises questions concerning its function within the human hippocampus. PMID- 3267343 TI - Cholinergic innervation and topographical organization of muscarinic binding sites in rat brain: a comparative autoradiographic study. AB - Employing [3H]hemicholinium-3 ([3H]HC), [3H]pirenzepine([3H]PZ) and [3H]quinuclidinyl benzilate ([3H]QNB), autoradiographic binding studies were performed to identify and quantitate the localization of high-affinity choline carriers, M1-subtype of muscarinic binding sites and a mixed population of M1- and M2-subtypes of muscarinic binding sites, respectively, in 38 anatomically defined areas of rat brain. Labelling of adjacent brain sections with [3H]HC, [3H]PZ and [3H]QNB revealed different topographical binding patterns. [3H]HC binding, which is supposed to reflect cholinergic innervation, was dense in the nucleus accumbens, olfactory tubercle, caudate putamen, basolateral amygdaloid nucleus and the interpeduncular nucleus. Moderate but heterogeneous binding was found in thalamic, hypothalamic, hippocampal and cortical areas. Maximal [3H]PZ binding was observed in the nucleus accumbens, olfactory tubercle and in discrete substructures of the hippocampus, e.g. CA1 and dentate gyrus. Binding to other hippocampal and cortical areas was intermediate, whilst minor binding was found in thalamic, hypothalamic and brain stem areas. The binding of [3H]QNB was more evenly distributed over the brain as compared to that of [3H]PZ. [3H]QNB clearly exceeded the binding of [3H]PZ in the thalamus, hypothalamus and brain stem. A relationship was found between the topography patterns of the [3H]PZ and [3H]QNB binding sites. However, some brain areas showed preference for one of the two ligands, pointing to a distinct localization of M1- and M2-subtypes of muscarinic binding sites. Although M1 sites appeared to predominate in the basal ganglia, hippocampus and cortex, some heterogeneity was observed indicative of the minor occurrence of M2 sites within these structures. There was no relationship between the density of the presumed cholinergic innervation and the binding capacity of either of the muscarinic sites in the various brain areas. However, a relationship was found between M2-selectivity and [3H]HC binding, pointing to a possible presynaptic localization of the M2-sites. In addition, it is suggested that distinct cholinergic cell groups might project their fibres to brain areas containing particular subsets of postsynaptic muscarinic binding sites. PMID- 3267342 TI - Compromises between penetration of antisera and preservation of ultra structure in pre-embedding electron microscopic immunocytochemistry. AB - Light microscopic pre-embedding immunocytochemistry on free-floating brain sections is commonly performed with antisera to which a detergent is added. For instance, the trajectories and the terminals of axons of neurons labelled by anterograde neuroanatomical tracing with Phaseolus vulgaris-leucoagglutinin (PHA L) are commonly visualized by immunocytochemistry, using antisera to which 0.5 per cent Triton X-100 is added. In this material the ultrastructural details are very poorly preserved. Omitting the detergent from the antisera results in no or very superficial staining. To improve the quality of ultrastructural preservation while still obtaining sufficient penetration of the antisera, we subjected vibratome sections of rat brain containing PHA-L-labelled neuronal perikarya and processes to PHA-L-immunocytochemistry in the presence, at various concentrations, of the detergents Kodak Photo-Flo 200, Triton X-100, Saponin, Nonidet P-40 or sodium deoxycholate. As controls served incubations without detergents. The addition of 0.1 per cent Photo-Flo 200 to all the immunoreagents, together with a relatively long incubation time, results in a balanced compromise between the demands of preservation of the ultrastructure and penetration of the antisera. If the PHA-L-immunocytochemistry is preceded by a short treatment with 0.05-0.1 per cent Triton X-100, the penetration is further improved, although at the expense of ultrastructural detail. PMID- 3267344 TI - Laminin facilitates and guides fiber growth of transplanted neurons in adult brain. AB - Laminin has been shown in vitro to act as a surface adhesive molecule for neuronal process elongation. To test whether laminin has a similar role in the brain, we sequentially injected laminin and transplanted fetal neurons into various brain regions to determine if the fetal neurons would preferentially grow along a laminin injection tract. In the fetal brain, the raphe area of the rostral rhombencephalon is rich in serotonergic (5-HT) neurons; the rostral ventral mesencephalon is rich in dopamine (DA) neurons, while the lateral rhombencephalon is rich in norepinephrinergic (NE) neurons. These three areas were transplanted to the motor cortex, neostriatum or hippocampus of adult animals. The tract used for microinjection of cell suspension was then immediately filled with laminin in a suspension media or a laminin-collagen (type IV) mixture. In other animals, laminin or control solution was injected in a separate needle tract displaced 0.3-1 mm from the transplant injection tract. Straight and thick 5-HT, DA or NE immunoreactive (IR) fibers (stained with anti-5 HT or anti-tyrosine hydroxylase antiserum) were predominant within the laminin treated tracts, or were directed toward the laminin-treated parallel tracts when it was positioned less than 0.5 mm from the transplant site. The density of 5-HT , DA- and NE-IR fibers in the injection tracts in all three brain areas was much higher for laminin and laminin-collagen mixture than control media. Thin axonal fibers of fetal 5-HT and NE neurons were observed surrounding the laminin-treated tracts, but not around vehicle-injected tracts. In addition, a number of transplanted 5-HT, DA and NE neuronal cell bodies were seen within the laminin treated tracts, but not in vehicle-treated tracts. Finally, laminin injection to the hippocampus, motor cortex or neostriatum of the adult brain did not stimulate sprouting of undamaged adult 5-HT or NE fibers. These results suggest that purified laminin can facilitate and guide process outgrowth of 5-HT, DA and NE neurons during early developmental stage, but does not induce sprouting on these same fiber types in the adult brain. PMID- 3267345 TI - Expression of three (and a putative four) protein kinase C genes in brains of rat and rabbit. AB - Protein kinase C (PKC) is a phospholipid- and calcium-dependent enzyme found throughout the body, and especially abundantly in the brain. Isozymic forms of PKC, encoded by a family of PKC genes, are currently under intensive study. Sequence analysis of the cDNAs for three, and possibly four, PKCs has enabled the design of specific oligodeoxyribonucleotide probes. We labelled these probes with 35S and used them for in situ hybridization histochemical studies. Transcripts encoding PKC types beta, gamma, and a putative 'epsilon' were visualized throughout the rat central nervous system. They differed from one another in their distributions. PKC type alpha mRNA was found throughout the rabbit central nervous system, but seemed less abundant there than the other PKC transcripts detected in the rat. The distinct distributions of expression of the genes for the PKC isozyme suggest that each has specialized roles in the brain. PMID- 3267346 TI - Expression of phenylethanolamine N-methyltransferase (PNMT) and neuropeptide Y (NPY) in embryonic rat medulla oblongata grown in Oculo. AB - Expression and development of specific markers of the adrenergic phenotype were studied in central neurons grown in transplant system. Medulla oblongata from embryonic day 12.5 (E12.5) or E18 rat was grafted into the anterior chamber of the eye of adult rat hosts. After two months, grafts were examined for the presence of immunoreactivity (IR) and catalytic activity to the epinephrine synthesizing enzyme, phenylethanolamine N-methyltransferase (PNMT, E.C. 2.1.1.28), a specific adrenergic marker. In addition, grafts were examined for immunoreactivity to neuropeptide Y (NPY) and tyrosine hydroxylase (TH), the rate limiting enzyme in catecholamine synthesis. In E12.5 grafts, PNMT was expressed de novo, enzyme activity developed to levels similar to those in adult rat brainstem and PNMT-IR neurons were observed. TH-IR and NPY-IR neurons were also observed. In contrast, PNMT-IR was not observed in E18 grafts even though these already contained PNMT-IR neurons at the time of grafting. This was not due to poor growth of E18 grafts, in general, since TH-IR neurons were present and the protein content of the grafts was similar to that of E12.5 grafts. These studies suggest that adrenergic neurons survive well in oculo if they are transplanted prior to the age when neuroblasts have initially expressed the adrenergic phenotype, migrated to their final positions and elaborated processes. In addition, these studies establish a transplant system in which factors required for the development of central adrenergic neurons can be more easily studied than in situ. PMID- 3267347 TI - Calcitonin gene-related peptide (CGRP)-immunoreactive neurons in the human cervico-thoracic paravertebral ganglia. AB - The occurrence of CGRP-immunoreactive neurons in human paravertebral sympathetic ganglia was investigated and CGRP-immunoreactive perikarya correlated with the distribution of structures which were immunoreactive to other peptides and tyrosine hydroxylase, the key enzyme of catecholamine-synthesis. CGRP immunoreactive neurons were present in all investigated ganglia (superior cervical ganglion, stellate ganglion, thoracic ganglia IV and VII). Most of the CGRP-immunolabelled cell bodies contained also vasoactive intestinal polypeptide as well as somatostatin-immunoreactivity. Approximately 40 per cent of the CGRP immunoreactive neurons were weakly tyrosine hydroxylase-immunolabelled. CGRP immunoreactive cell bodies appear to be neither identical with the large population of neuropeptide Y-labelled perikarya nor with the large group of cell bodies which were surrounded by leuenkephalin-immunoreactive nerve fibres. Colocalization of CGRP- with vasoactive intestinal polypeptide- and somatostatin immunoreactivity in postganglionic sympathetic neurons substantiates the suggestion of sympathetic origin of respective peptidergic nerve fibres in sweat glands. PMID- 3267348 TI - Malignant tumors among Koreans-relative frequency study on 19,140 cases during 1978 to 1986. AB - A statistical analysis was made on 19,140 primary malignant tumors histopathologically diagnosed at Seoul National University Hospital during 9 year period from 1978 to 1986. The study was performed to understand the recent trend of the relative frequency of the primary malignant tumors among Koreans and to compare it with the previous studies using same hospital materials, twice presented in 1968 and 1978, respectively. Sex distribution of the cases was 10,025 (52.38%) males and 9,115 (47.62%) females. Among males the frequency rank was stomach (33.88%), lung and bronchus (8.73%), leukemia (7.02%), liver (4.79%) and oral cavity (4.70%). And among females it was uterine cervix (24.48%), stomach (20.45%), thyroid (7.87%), breast (6.48%) and leukemia (4.78%). The relative frequency of malignant tumors in this study was generally similar to the previous data published in 1978 at this department, except for the fact that stomach and lung cancers were more commonly seen in both sexes during this study period than the previous periods of years. PMID- 3267349 TI - Recent trends of syphilis prevalence in normal population in Korea-1986. AB - The 6,097 blood donors in Seoul area, the 1,883 pregnant women delivered at Severance Hospital and the 5,136 physical examinees were evaluated for VDRL reactivity. Also, the FTA-ABS and TPHA tests were performed on those who were VDRL-positive, and the 19S (IgM)-FTA test were done on the subjects who were reactive for the FTA-ABS and TPHA tests. All the subjects were over the age of 20 and the study period was conducted from January of 1986 through December of 1986. The results are summarized as follows: 1. VDRL-positive rates were 0.5% in the blood donors, 0.6% in the pregnant women and 0.8% in the physical examinees. 2. The quantitative test of VDRL resulted in low titer below 1:4 in 96% of VDRL positive pregnant women and physical examinees. 3. The 19S (IgM)-FTA test was reactive in 3 of 12 treated subjects (25%) and 4 of 10 untreated subjects (40%). From the results it is clear that the prevalence of syphilis is continually decreasing compared to the mid 1970's and the early 1980's. PMID- 3267350 TI - Cross-sectional illustration on major types of conjoined twins. AB - Conjoined twins show varying degree of conjoining in either facing or side-by side fashion. Cephalothoracopagus janiceps is a prototype of facing anomaly in which the two bodies demonstrated a cross symmetry to the midline, that is axial symmetry. Interfacial and intersternal lines crossed at a right angle and no abnormality of situs was associated. Dicephalus dipus dibrachius is a case of side-by-side union, in which the bodies facing nearly the same direction were symmetrical to the middle sagittal plane. Abnormal situs of one was always associated. Other types of conjoined twins as thoracopagus lie between the two extremes of facing and side-by-side union. The three dimensional architectures of the organs in each type would be explained using cross sectional figures of skull, thorax and pelvis. Although the facing twins share the internal organs without fusion, the organs in the side-by-side component are fused with modification of the situs. We postulate sixteen pairs of situs and four manners of division for the explanation of the midline organs and the presence of a dominant co-twin. The splenic locations in a given cardiopulmonary situs are evaluated for the appraisal and applicability of these hypotheses. PMID- 3267352 TI - Primary intimal fibroplasia of the renal artery. AB - Two cases of primary intimal fibroplasia of the renal artery with renovascular hypertension are described. Case 1 was 27 year old female who was incidentally found to have blood pressure of 210/130 mmHg on routine physical examination. Renal arteriogram revealed tubular narrowing of the mid protion of the left renal artery. Both patients showed lateralization in renin activity at the involved side renal vein. Case 2 was a 10 year old girl who was first noted to have a hypertension of 180/120mmHg after a sudden attack of seizure, vomiting and altered consciousness. Renal arteriogram showed concentric narrowing of the proximal half of the right renal artery. Histopathologic examination of the affected arterial segments from both cases showed essentially same findings, i,e., diffuse fibrous thickening of the intima occluding the lumen, focal fragmentation, duplication and disappearance of the internal elastic membranes. There were no deposit of lipid and inflammatory cells. The media and adventitia remained intact. The blood pressure of both patients became normal, after the surgery and the patients are in good health up to this time. PMID- 3267351 TI - Histiocytic medullary reticulosis: radiologic diagnosis of splenic infarction--a case report. AB - A case of histiocytic medullary reticulosis with splenic infaraction from a 23 year-old male is presented. Radiologic findings on selective spleen scintigraphy and abdominal CT are described. Selective spleen scintigraphy showed huge, multilobulated spleen with numerous photon-deficient areas in it and peripherally. Abdominal CT showed large peripheral band-like low density and infiltrative lesion in spleen with accompanying intraabdominal lymphadenopathy. Histoligical features were consistent with HMR in spleen and liver specimens. PMID- 3267353 TI - Congenital absence of ductus arteriosus--an autopsy case. AB - Isolated absence of the ductus arteriosus is extremely rare condition although the ductus arteriosus may be hypoplastic or aplastic in association with other aortic arch anomalies. Authors described a case of isolated agenesis of the ductus arteriosus documented by postmortem examination of a newborn infant who died of pneumonia following operation for a large omphalocele. The heart showed ventricular septal defect. However, no other cardiovascular anomalies were associated in this case. There were three vessels that were taking off from the aorta consisted of the right brachiocephalic artery, left common carotid-artery and left subclavian artery. The anteriorly located pulmonary artery was divided into the right and left pulmonary arteries. There was no connection of vessel between the pulmonary artery and the aorta. PMID- 3267354 TI - In vitro activities of eight antibiotics against methicillin-resistant S. aureus and S. epidermidis strains isolated in Korea. AB - Staphylococcus aureus and Staphylococcus epidermidis strains isolated at eight large medical centers in Korea were examined for methicillin resistance and resistance to eight other antibiotics; cefazolin, cefamandole, cefuroxime, cefoxitin, cefotaxime, moxalactam, penicillin G and vancomycin. Methicillin resistance was found in 296 of 1225 strains (24.2%) of S. aureus and 126 of 348 strains (36.2%) of S. epidermidis. Methicillinresistant strains were isolated from all sources with the frequency of isolation ranging from 11% to 60%. From pleural effusion, throat swab and blood, methicillin-resistant strains of S. aureus were more frequently isolated with statistical significance (Chi-squared test, 95% confidence). Almost all of Methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE) strains were multiply resistant to one or more tested eight antibiotics. However only 7(2.4%) of 296 MRSA strains and 2(1.6%) of 126 MRSE strains were resistant to vancomycin. Vancomycin was the most effective antibiotic against staphylococcal isolates as well as MRSA and MRSE. PMID- 3267355 TI - Tissue parasitic diseases in Korea. AB - Parasitic disease is still important subject in the field of infectious diseases in Korea considering it's number and morbidity. Recently there was conspicuous reduction of parasitic disease in terms of soil-transmitted nematodiasis, but parasitism affecting organs other than intestinal tract is still a considerable problem. This survey covers the parasitic diseases cross-sectioned at a pathology laboratory of a referral hospital, trying to elucidate the significance of its relative frequency and also to describe some histopathological changes made by different parasites. Entire pathological materials of parasitic diseases, that were referred, examined and confirmed at the Department of Pathology, Seoul National University Hospital from 1968 to 1987, were used for the study. There was a total of 594 cases of tissue parasitic diseases. This number accounted for 0.33 per cent of total accessions of surgical pathology. There occurred average 30 cases of tissue parasitic disease each year at this Hospital. Protozoal diseases were constituted of 15 cases of amebiasis, 7 cases of leishmaniasis (imported) and 5 cases of Pneumocystis carinii infections. Among helminthic infections cysticercosis was the most common (425 cases), and was followed by paragonimiasis (35 cases), sparganosis (31 cases), clonorchiasis (32 cases) and ascariasis (16 cases). In addition there were 4 cases of anisakiasis, 2 cases of fascioliasis, 2 cases of echinococcosis (imported) and a case of strongyloidiasis and a case of metagonimiasis respectively. It is emphasized that imported parasitic diseases such as leishmaniasis and hydatid disease become steadily found nowadays. Schistosomiasis is another possible imported disease, but not found in this series. And certain cestodiasis particularly cysticercosis and sparganosis should be the subjects of epidemiologic re-evaluation in view of steady occurrence of their morbidity. PMID- 3267356 TI - Malignant histiocytosis. Clinicopathologic review of 18 cases with immunohistochemical study. AB - We reviewed clinical and pathologic characteristics of 18 cases of malignant histiocytosis including 2 autopsy cases with special interest on their immunohistochemical characteristics. We report 3 cases of unusual immunohistochemical finding and postulate these cases may be a supportive evidence of the view that dendritic cells share common precursor with those of mononuclear phagocytic system. More accumulated cases in the future and careful analysis would be needed to answer the basic question about the origin of malignant histiocytosis. PMID- 3267357 TI - Prenatal diagnosis of a heterozygote of salt wasting congenital adrenal hyperplasia due to 21-hydroxylase deficiency by genetic linkage analysis. AB - For the purpose of prenatal diagnosis of CAH, genetic linkage analysis by HLA genotyping with lymphocytes and cultured amniotic cells were performed in a family at risk in which two consecutive children had been affected with SW CAH. In addition, the response of serum 17-OHP to intravenous ACTH was determined in obligate carrier parents, and 17-OHP concentration of amniotic fluid was also measured at 16 weeks of gestation. As might be expected, the baseline levels of 17-OHP in obligate parents were significantly higher than that of normal control. Although the post stimulation response of 17-OHP to ACTH in the mother (I-2) was significantly higher than that of normal control, the post stimulation levels of 17-OHP were in normal range in the father (I-1). The 17-OHP level (5.7 ng/ml) in the amniotic fluid showed intermediate value compared to Pang's report (normal less than 30 ng/ml, CAH greater than 12.0 ng/ml) suggesting heterozygote of the fetus. Genetic linkage analysis by HLA genotyping with cultured amniotic cells revealed heterozygote in their fetus (II-3) who has received one chromosome No,6 containing HLA haplotype A24, B40, Cw3 (normal allele for 21-OH) from the father and the other chromosome No,6 containing HLA haplotype A2, Bw62, Cw4 (mutant allele for 21-OH D) from the mother. In conclusion, attempts to detect heterozygote for 21-OH deficiency by ACTH stimulation test were partially successful and prenatal diagnosis of CAH by the hormone studies in ammiotic fluid requires reliable values in normal, heterozygotes and patients group, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267358 TI - Herpes zoster ophthalmicus and delayed contralateral hemiparesis. AB - Central nervous system is often involved by herpes zoster but it is very rarely seen that contralateral hemiparesis or hemiplegia developed after herpes zoster ophthalmicus. We report a case of herpes zoster ophthalmicus followed by the delayed contralateral hemiparesis. A 33-year-old man developed acute cerebral infarction and resultant right hemiparesis 44 days after herpes zoster ophthalmicus in the left side. Brain CT disclosed hypodense area in the left basal ganglia. Cerebral angiography revealed segmental narrowing of M1 portion of the right middle cerebral artery. PMID- 3267359 TI - A case of Stewart-Treves syndrome. AB - Several months after left radical mastectomy without irradiation therapy for breast cancer, a 74-year-old woman developed severe edema on the homolateral arm extending to the axilla. Ten years later, purplish to brownish blotch and nodules accompanied with heating sensation and pain appeared and increased in size gradually on the left forearm. The patient was treated by irradiation therapy under the clinical and histopathologic diagnosis of Stewart-Treves syndrome and almost all of the skin lesions and symptoms disappeared after irradiation of 6450 rads. PMID- 3267360 TI - Computerized quality control of radioimmunoassay in Korea. AB - Automated data processing and quality control of radioimmunoassays offer not only increased speed but also a more thorough and statistically rigorous analysis of results. An external quality assessment scheme for serum thyroxine, triiodothyronine and thyroid stimulating hormone (TSH) assays was performed in five nuclear medicine laboratories in Korea to compare with the assay performances of the World Health Organization Radioimmunoassay Program. The required radioimmunoassay kits were supplied through the International Atomic Energy Agency (IAEA). We have determined the weighted root mean squared error, and variance ratio as the indices of standard curve and also the average batch coefficient of variation (ABCV) as the parameters of response error relationship curve and precision profile. There was a good fit for the triiodothyronine assay, but 3 of 5 laboratories showed possible bad fit in the T4 and TSH assay systems. The ABCV was less than 5 percent for the T3 and T4 assay system, however for the TSH system, only 1 laboratory showed the ABCV value of less than 5 percent. We have also calculated the within batch variation (drift) and between laboratory variations. PMID- 3267361 TI - Congenital chloridorrhea in Korean infants. AB - The present paper describes two Korean male infants, 1. 16 year old and newly born neonate from two families who were diagnosed and managed for one of very rare inborn errors of metabolism, congenital chloridorrhea (Darrow-Gamble syndrome). The diagnosis was suggested by one of the authors (HRM) from the unusual combination of metabolic alkalosis with severe gastrointestinal disorder presenting with chronic, profuse watery diarrhea in the newborn period in the first patient; and the maternal polyhydramnios, the appearance of dilated fetal bowel loops on prenatal ultrasonography and profuse watery diarrhea beginning at birth without passage of meconium in the second patient. The diagnosis was confirmed in both patients by examination of the stool chloride concentration which revealed extremely high exceeding the sum of sodium and potassium concentrations. Serum electrolytes and arterial blood gas analyses revealed hyponatremia, hypokalemia and hypochloremia with elevated bicarbonate. With replacement of fluid and electrolyte deficit and adequate dietary supplements of potassium and chloride, both patients remained well although the character of the stools waxed and waned. This is the first reported case of congenital chloridorrhea in korean population. PMID- 3267362 TI - Refractoriness to platelet transfusion after single-donor consecutive platelet transfusions and its relationship to platelet antibodies. AB - In thirty patients with acute leukemia and severe aplastic anemia receiving random single donor platelet transfusions, the development of refractoriness by consecutive platelet transfusions with cytapheresis and its relationship to the appearance of anti-platelet antibodies were investigated. The median number of platelet transfusions inducing refractoriness was 13 times, and 20% of the patients remained unrefractory despite of the repeated multiple platelet transfusions up to 20 to 25 times. The results of anti-platelet antibody tasts by the enzyme-linked immunosorbent assay(ELISA) and immunofluorescent techniques(IFT) showed no statistically significant relationship with the refractoriness (p greater than 0.1). Although there was significant correlation between the results of ELISA and IFT, both tests were insufficient to find out refractoriness even with the use of pooled platelets from multiple donors as target cells. This study shows that 13 single donor platelet transfusions result in refractoriness, that both ELISA and IFT are insufficient to detect refractoriness despite of their significant correlation, and that other methods than these are needed in order to detect alloimmunization. PMID- 3267363 TI - Hepatic amyloidosis--two cases report. AB - Amyloidosis is classified according to the distribution pattern of amyloid deposition sites and associated diseases. Hepatic amyloidosis is not infrequent, although rarely causes clinical liver disease. We report two cases of amyloidosis diagnosed by liver biopsy. One presented with symptoms related almost to the liver disease, such as jaundice, hepatomegaly and indigestion. Echocardiogram revealed hypertrophic cardiomyopathy, suggesting cardiac involvement of the amyloidosis. The patient died of hepatic failure. The other case was found in a patient with an end stage renal disease. Features of congestive heart failure in this case may reflect cardiac involvement. The pattern of hepatic amyloid deposition in both of these cases was diffuse perisinusoidal. The predominant intralobular deposition suggests that these are amyloidosis of the secondary type. PMID- 3267365 TI - Multiple symmetric lipomatosis. AB - Multiple symmetric lipomatosis (MSL) is an extremely uncommon disorder. In the medical literatures about 200 cases have been reported. MSL is not associated with other generalized lipomatous disorders, nor are these patient to be necessarily obese. The cause of MSL is unknown. The disorder usually occurs in middle-aged males and there is frequently a history of alcoholism. Some instances of familial occurrence have been reported, but the majority of cases are sporadic. Two cases of MSL are presented. PMID- 3267364 TI - Cystic fibrosis--a case presented with recurrent bronchiolitis in infancy in a Korean male infant. AB - The aim of this case report is to draw the attention to the occurrence of cystic fibrosis (C.F.) in a Korean infant and thus increase the awareness for the diagnosis. The male infant was presented with a history of recurrent bronchiolitis manifested by severe cough, wheeze and dyspnea from three weeks of age, in whom the diagnosis of C.F. was clinically suspected and was confirmed by demonstration of two elevated sweat chloride levels (97 mEq/L and 99 mEq/L) in the patient. The diagnosis was delayed because the main manifestations of C.F. were the same as the main symptoms of common diseases such as cough, diarrhea and failure to thrive. C.F. is probably underdiagnosed in Korean population both because the diagnosis is not considered since the disease is thought to be uncommon or even not to occur and because diagnostic facilities including the quantitative iontophoresis sweat test are lacking. PMID- 3267366 TI - Solitary angiokeratoma developed in one area of lymphangioma circumscriptum. AB - We describe a boy who developed a dark brown colored nodule in an area of lymphangioma circumscriptum following repeated local injuries. The nodule showed the clinical and pathologic features of solitary angiokeratoma. It is possible that previous injuries predisposed the lesion to the development of solitary angiokeratoma. PMID- 3267367 TI - Intestinal pathology in human metagonimiasis with ultrastructural observations of parasites. AB - A human case of intestinal metagonimiasis that was incidentally found during the histological examination of a resected segment of jejunum was described. The small adults trematode of Metagonimus yokogawai were found free in jejunal lumen as well as impacted in intervillous spaces. Histologically intestinal lesions were massive lymphoplasmacytic and eosinophilic infiltration in stroma, erosion of neanby enterocytes, goblet cell depletion and occasional villous edema. Scanning electron microscopy revealed the worm of spatulate appearance with rake shaped tegumental spines. By transmission electron microscopy, the syncytial integument with dense discoidal bodies, basement membrane muscle cells and subtegumental cells were observed. Characteristic junctional complex was demonstrated between subtegumental and parenchymal cells as well as between parenchymal cells. PMID- 3267368 TI - A phase 2 study of surveillance in patients with metastatic renal cell carcinoma and assessment of response of such patients to therapy on progression. AB - Following preliminary studies suggesting that some patients with metastatic renal cell carcinoma had accelerated tumor growth after entry into chemotherapy studies, 73 patients with measurable metastatic disease referred to a tertiary referral center for consideration for experimental treatment protocol have been observed to attempt to establish the incidence of spontaneous regression. Initially, patients went off study if metastases showed greater than 25% increase in products of bidimensional measurement but with increasing confidence patients only went into therapy protocols with the development of symptomatic progression. In this selective series, on observation, three complete (histologically documented) and two partial unexplained "spontaneous" regressions were observed and a further four patients had prolonged stable disease for more than 12 months. On progression, 52 were entered into treatment protocols (BCG n = 19, Mitozantrone n = 12, and Welferon n = 21). A further two complete and five partial responses (14%) and four prolonged stable disease were observed confirming that the previously reported responses with these agents are not totally explicable on the basis of "spontaneous" response. PMID- 3267369 TI - Phase I study of recombinant human tumor necrosis factor-alpha in patients with advanced malignancies. AB - A clinical phase I trial with recombinant human tumor necrosis factor-alpha (rTNF alpha) was performed in 30 patients with advanced malignancies. The maximal tolerated dose (MTD) by 3 times weekly intramuscular (i.m.) application was 150 micrograms m-2. Main subjective toxicities including chills, fever, hypotension, fatigue, and anorexia were dose-related. In addition, transient changes in hematologic parameters and lipid metabolism were noted. Two out of 25 evaluated patients showed a minor tumor response after eight weeks of therapy. There was evidence for an improvement of in vivo immuneresponsiveness as revealed from positive delayed type hypersensitivity (DTH) skin tests of 3 out of 6 pretherapeutically anergic patients. We conclude from this phase I trial that rTNF-alpha can be safely administered at doses up to 150 micrograms m-2 i.m., 3 times weekly, without evidence of cumulative toxicity in long-term treatment. PMID- 3267370 TI - Regulatory hierarchies. PMID- 3267371 TI - Mathematical modeling for antibody therapy in the setting of antigenic modulation. AB - The in vivo efficacy of passive monoclonal antibody therapy is limited in certain systems by the process of antigenic modulation. We describe a compartmental model which addresses the kinetics of in vivo cell binding of murine monoclonal antibody T101, modulation of the T65 target antigen, serum levels of T101, and elimination of target cells. Observed data compare favorably to that predicted by the model. The model suggests that there is no rationale for administering T101 as a prolonged, continuous infusion for passive antibody therapy. PMID- 3267372 TI - Molecular neurobiology. Past, present, and future. PMID- 3267373 TI - Memory for pictures: does an age-related decline exist? AB - In the present experiments, the effects of varying detail on memory were examined. In Experiment 1, pictorial embellishment was varied by presenting old and young adults with normal photographs, high-contrast photographs, or line drawings, and testing their memory immediately and 4 weeks later. All of the subjects did best with the most elaborate pictures (normal photographs), and old subjects remembered as well as young at the immediate but not at the delayed interval. In Experiment 2, detail was varied by adding background to line drawings of a central object. Subjects of both ages profited from enhanced background detail, and there were no differences in memory as a function of age. Experiment 3 replicated Experiment 2, except that subjects studied the pictures under divided attention conditions. Again, subjects of both age recognized elaborate pictures best, and no significant age differences emerged. The studies suggest that old and young adults profit from visual embellishment and that memory for meaningful pictures remains relatively intact with age. PMID- 3267374 TI - Life satisfaction in old age: linking social psychology and history. AB - A life course perspective on aging assumes that adaptation is governed by factors beyond the immediate situation. Using longitudinal data on 79 women from the 1900 generation of the Berkeley Guidance Study, we examined how social and psychological factors interact over time in the course of successful aging, as expressed by life satisfaction. The consequences of adaptive resources in early adulthood vary in relation to social class. Intellectual skills in 1930 indirectly predict life satisfaction in old age for women from the working class, whereas emotional health is more influential in the life satisfaction of women with higher class origins. Social activity in old age makes a difference only in the lives of women from the working class. Finally, adaptation to old age is related to women's experiences with past stressful events. Middle-class women in 1930 showed gains attributable to Depression hardship (1930s), whereas the life satisfaction of women from the working class was diminished by such hardships. Several mechanisms are discussed that may link widely separated problem situations and life events across the life course. The analysis provides empirical support for the proposition that the influence of social change on life trajectories is contingent on what individuals bring to change situations. PMID- 3267375 TI - Age differences in the structure of the Philadelphia Geriatric Center Morale Scale. AB - In this research we examined age differences in the factorial structure of the Philadelphia Geriatric Center (PGC) Morale Scale. In particular, we viewed the covariance structure of the PGC Morale Scale items as a function of several parameter matrices. We analyzed the factorial invariance by testing hypotheses involving the equivalence constraints of one or more parameter matrices in the young-old (65-74) and the old-old (75 and over) populations. Data for this research came from the 1968 National Senior Citizens Survey. Analysis of covariance structures, or LISREL, was used to assess the factorial invariance of the PGC Morale Scale. Although there are some statistically significant age differences in the factorial structure, substantively they are less important. PMID- 3267376 TI - Locus of control in aging research: a case for multidimensional and domain specific assessment. AB - Do locus of control beliefs change in later life? Is locus of control related to aging-relevant outcomes involving intelligence and health? In past research on these topics, the use of unidimensional and generalized measures of locus of control has led to a set of inconsistent findings. Three studies were conducted to examine the usefulness of multidimensional and domain-specific measures of locus of control for examining age differences and correlates. College students and elderly adults were compared on Levenson's multidimensional and generalized (internal, chance, and powerful others) locus of control scales and two domain specific versions related to intelligence and health. As predicted, no age differences were found with generalized measures, but the elderly were more external on intelligence- and health-specific locus of control dimensions. Age differences were found most often on the chance and powerful others control dimensions, suggesting that the elderly acknowledge the importance of external sources of control and at the same time preserve their sense of internal control. In addition, the domain-specific scales were better predictors of behavioral outcomes within their respective domains for the elderly but not for the young. The findings suggest that multidimensional and domain-specific conceptions of control are advantageous for aging research. PMID- 3267377 TI - Age and the selectivity of visual information processing. AB - Two experiments were conducted to assess age differences in the selectivity of visual information processing. Selectivity was measured by the amount of interference caused by nontarget letters when subjects detected a target letter in a visual display. In both experiments, young and elderly groups participated in search and nonsearch conditions; in the search condition targets appeared anywhere in the display, whereas in the nonsearch condition targets were confined to the center position of the display. In the first experiment, subjects were assigned to either condition for two sessions of testing, and in the second experiment each subject participated in both conditions. In both experiments nontargets produced larger interference effects for old compared to young adults in the search condition but not in the nonsearch condition. The obtained pattern of age effects could not be explained by age-related reductions in parafoveal acuity. The findings indicate that the magnitude of divided-attention deficit increases with age, whereas focused-attention deficits are unaffected by aging. PMID- 3267378 TI - Functional decline in the early stages of Alzheimer's disease. AB - At present most reports of functional decline in patients with Alzheimer's Disease (AD) are anecdotal, and few studies have objectively documented the course of the disease. This is a report of a 2-year follow-up of 15 AD patients characterized by mild functional impairment, and 22 age-, sex-, and education matched control subjects. In a previous cross-sectional study of these 37 subjects and 16 AD patients with moderate functional impairment, we found that measures of memory and attention deficits accounted for much of the impairment observed in functional competence. The current longitudinal study found that these same initial assessments could be used to predict functional decline in the 15 mildly impaired patients. These patients were observed to decline to levels similar to those of the 16 moderate patients. In contrast, the control subjects exhibited little decline during the same period. These results both affirm that it is possible to diagnose AD in its mild form and demonstrate the validity of the initial diagnosis. PMID- 3267380 TI - Cognitive functioning of older people in relation to social and personality variables. AB - Age differences in performance on memory measures and in subjective ratings of memory adequacy were examined in the context of 12 social, personality, adjustment, and lifestyle measures. Participants were 285 men and women, aged 65 to 93, of middle- and working-class backgrounds. A series of multivariate and univariate analyses revealed that a large proportion of the age differences and virtually all of the social-class differences on memory measures could be accounted for by contextual variables, with education, intellectual activity, extroversion, neuroticism, and lie scores (on the Eysenck Personality Inventory) all accounting for more of the variance in memory performance than did age. Self rated memory adequacy was not correlated with performance, and although the expected finding of lower ratings by older participants was obtained with the working-class group, the opposite was true for the middle-class group. Implications of these results for understanding age differences in memory are discussed. PMID- 3267379 TI - Social support and adaptation to stress by the elderly. AB - The first of a two-phase project is reported that examined the prospective effects of stress and social support on the physical and mental health of the elderly. A sample of 50 elderly subjects was assessed at two points in time over a 6-month period. Results indicated that social support was a significant predictor of physical health status, whereas mental health was related to the Stress X Social Support interaction term. These latter results were consistent with the buffering hypothesis, in that high levels of social support served to reduce the negative impact of stress on mental health. Individuals who were in better mental health at the initial assessment experienced fewer stressful events and higher levels of social support over the subsequent 6-month period. The implications of these findings for research and theory regarding the relation between stress and social support are discussed. PMID- 3267381 TI - Relation of age at onset to duration of episode in unipolar depression. AB - The purpose of this study was to test the hypothesis that the duration of episodes of unipolar depression increases with age at onset. On the basis of elevated scores on a self-report depression measure, 2,020 persons were selected from a larger community sample to be interviewed and diagnosed using the Schedule for Affective Disorders and Schizophrenia-Research Diagnostic Criteria procedures. Of the 2,020 persons, 865 had a history of one or more episodes of unipolar depression. The potential effects of the following variables (singly and in interaction) on duration of episode were assessed by means of multiway frequency table analysis and chi-square: age at onset, sex of subject, interval since occurrence of the episode, and type of disorder (major vs. minor depressive disorder). The hypothesis that duration of episodes of depression increases with age at onset was not supported. Women were more likely to have multiple episodes, but did not have longer lasting episodes. PMID- 3267382 TI - Clinical tests of memory in dementia, depression, and healthy aging. AB - In Study 1, carefully screened elderly adults with primary degenerative dementia or major depression were compared to healthy aged control subjects on three tests of learning and memory: the Benton Visual Retention Test, Inglis Paired-Associate Learning Test, and the Fuld Object-Memory Evaluation (OME). The sharpest distinction in performance among the groups was observed on the OME, and discriminant equations based on this test correctly classified a high percentage (greater than or equal to 90%) of participants. Study 2 applied the classification rules derived in the first investigation to an unselected series of geropsychiatry inpatients referred for neuropsychological evaluation. There was agreement between memory test classification and general categories of clinical discharge diagnosis (organic vs. functional) for 21 of 25 patients, and with status at follow-up approximately 18 months later. Predictive value computations suggested that the OME is more accurate in confirming true dementia than in detecting dementia syndromes associated with functional disorders. PMID- 3267383 TI - Effects of structured social interaction with geriatric mentally retarded clients: an exploratory study. AB - In this study, using an observation-based inferred self-concept (social competency measure), I examined a structured program of client-staff interaction reinforcing self- and environmental awareness in institutionalized geriatric mentally retarded clients. Results indicate significant improvement over successive sessions. Subjects in structured interaction had a more positive self concept in the post-treatment period when compared either to pretreatment baseline or to a control group that had not been in structured interaction with staff. Results support the use of structured interaction--which serves as a reinforcer for improved functioning--to increase staff contact with clients. PMID- 3267385 TI - Friendships of older men and women: exchange patterns and satisfaction. AB - In this study we examined the relation between perceived equity of exchanges and friendship satisfaction for a sample of 110 older men and women. Respondents were interviewed concerning their relationship with their best friend and one other friend in their support network. Perceived equity was a significant predictor of friendship satisfaction only in the case of the other friend. In addition, results showed that men were involved in more equitable friendships than were women. Discussion focuses on the importance of equity consideration and gender differences in the friendships of older adults. PMID- 3267386 TI - Prospective/intentional and incidental everyday memory: effects of age and passage of time. AB - The effects of age and passage of time on incidental and prospective/intentional everyday memory were examined in this study. Seventy-nine volunteers, men and women between the ages of 23 and 93 years, were tested twice, and 33 of these volunteers were tested three times over an 18-month period. They were asked to recognize or to recall, either in writing or orally, experiences from a 3-day period in which they served as research subjects. Results demonstrated that incidental, but not prospective/intentional, memory appeared to be influenced by age and passage of time. Results imply that salience and context are important factors in aging memory performance, and that certain types of everyday retrospective reports may be reliable. PMID- 3267384 TI - Activity duration and adult age differences in memory for activity performance. AB - Young and elderly subjects performed a series of activities that varied in the duration of their performances (45 s, 90 s, and 180 s). Duration was found to have a negligible effect on the subsequent recall of the activities and on the magnitude of the age deficit in recall. Operationalization of the program for performing an activity seems essential for establishing a memory trace of that activity's performance, but the duration of performing that activity seems to yield no further enhancement of that trace. PMID- 3267387 TI - Daily well-being of older adults with friends and family. AB - Family members are the major source of physical and emotional support for older adults, yet researchers suggest that friendships have a stronger bearing on subjective well-being. In this research we sought an explanation for this inconsistency in older adults' immediate experiences with friends. Retired adults provided self-reports on their subjective states at random moments during a typical week. Analyses of these reports confirmed the prediction that older adults have more favorable experiences with their friends than with family members. The difference is partly attributable to the greater frequency of active leisure activities with friends, but is also due to unique qualities of interactions with friends that facilitate transcendence of mundane daily realities. We propose that friends provide an immediate situation of openness, reciprocity, and positive feedback that engenders enjoyment and subjectively meaningful exchanges. PMID- 3267388 TI - Adulthood age differences in causal attributions for cognitive, physical, and social performance. AB - Past research has revealed an unflattering pattern of attributions for the performance of the elderly. More specifically, poor performance by the elderly is attributed to internal and stable factors such as inability, whereas poor performance by the young is attributed to external and unstable factors such as bad luck. In the present study, 42 young (M age = 19.18 years) and 39 elderly (M age = 74.90 years) men and women made causal attributions for their own or for another person's hypothetical performance in the cognitive, physical, and social domains. When attributions for the same performance by young and elderly adults were compared, the results presented an unflattering view of the elderly, similar to the pattern in previous research. In contrast, when attributions for good versus poor performance by the elderly were compared, a more favorable picture emerged: The elderly were more likely to be given credit for their good performance than to be blamed for their poor performance. These findings give reason to question the pervasiveness of the negative view of the elderly that has been presented in previous studies. PMID- 3267389 TI - Adult age differences in the ability to cope with situations of high arousal in a precision sport. AB - Three field experiments are reported in which skilled miniature golf players varying in age were studied in three types of activities: training, minor competitions, and large competitions. Performance (i.e., number of shots) and arousal (heart rate and subjective ratings of anxiety) measures were registered in all types of activities. The major finding was that the level of performance of older adult players deteriorated in the large competitions, whereas groups of younger adult players, junior players, and youth players performed at the same level in all three events, although all of the groups exhibited a similar increase in arousal from training and minor competitions to large competitions. We suggest that older players may have a deficit in the ability to compensate for the negative effects of nonoptimal levels of arousal because of impairments in a variety of cognitive abilities critical to successful performance. PMID- 3267390 TI - Cross-sectional studies of personality in a national sample: 1. Development and validation of survey measures. AB - Short scales were developed to measure three broad dimensions of personality in the National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Followup Study. Items to measure neuroticism were selected rationally from the General Well-Being Schedule, and items to measure extraversion and openness to experience were selected by multiple regression from the NEO Personality Inventory. In a sample of 654 men and women from the Augmented Baltimore Longitudinal Study of Aging, all three short scales showed clear evidence of convergent and discriminant validity against full scales in self-reports, and against peer and spouse ratings. Because they were developed and validated on a sample with a comparable age range, the NHANES scales should be useful in examining age trends in these three personality dimensions in a national sample. PMID- 3267391 TI - Cross-sectional studies of personality in a national sample: 2. Stability in neuroticism, extraversion, and openness. AB - Data from the National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Followup Study were used to examine age differences in neuroticism, extraversion, and openness to experience. Cross-sectional analyses of data from 10,063 respondents showed that older subjects were slightly lower in neuroticism, extraversion, and openness; that age trends were not curvilinear; and that there were no differences in personality scores that might be attributable to a mild life crisis or transition. Comparison with data from 654 participants in the Augmented Baltimore Longitudinal Study of Aging (ABLSA) showed that the ABLSA sample was lower in extraversion and higher in openness than the national sample, although the differences were small in magnitude. Results were interpreted to mean that sampling and attrition in this longitudinal sample did not seriously bias results on these personality variables, and that cross-sectional findings from a large probability sample support the conclusion that personality is predominantly stable in adulthood. PMID- 3267392 TI - Reader and text variables as determinants of discourse memory in adulthood. AB - Young students, old students, and old nonstudents read and recalled short texts that were in either narrative or expository form. In addition, a set of six verbal ability measures thought to be related to discourse memory was obtained for all of the participants. Older subjects recalled less from the texts than younger subjects, and neither type of text nor student status modified the magnitude of the age differences. The set of verbal ability measures was adequately described by two principal components, one consisting of simple, speed related skills, and the other consisting of more complex skills. Each set of variables predicted a proportion of discourse memory variance, and accounted for some of the variance that would otherwise be attributed to age. The results suggest that age differences in some basic cognitive skills related to reading effectiveness might underlie age differences in memory for discourse. PMID- 3267393 TI - Stability and change in adult intelligence: 1. Analysis of longitudinal covariance structures. AB - We address two questions of central interest in adult intellectual development: the equivalence of psychometric tests' measurement properties at different ages, and the stability of individual differences in intelligence over time. We performed a series of longitudinal factor analyses using the LISREL program to model longitudinal data from Schaie's Seattle Longitudinal Study. The results indicate complete invariance in the loadings of five subtests of Thurstone's Primary Mental Abilities battery on a general intelligence factor. Individual differences in general intelligence were highly stable over 14-year epochs, with standardized factor correlations averaging about .9 between adjacent 7-year testing intervals. These results indicate that most individuals in this relatively select longitudinal sample maintained their relative ordering in intelligence. PMID- 3267394 TI - Reserve capacity of the elderly in aging-sensitive tests of fluid intelligence: replication and extension. AB - Fluid intelligence belongs to that cluster of intellectual abilities evincing aging loss. To examine further the range of intellectual reserve available to aging individuals and the question of replicability in a new cultural and laboratory setting, 204 healthy older adults (mean age = 72 years; range = 60-86) participated in a short-term longitudinal training study. For experimental subjects, 10 sessions consisted of cognitive training involving two subability tests (Figural Relations, Induction) of fluid intelligence. The pattern of outcomes replicates and expands on earlier studies. Older adults have the reserve to evince substantial increases in levels of performance in fluid intelligence tests. Transfer of training, however, is narrow in scope. Training also increases accuracy of performance and the ability to solve more difficult test items. Difficulty level was estimated in a separate study, with a comparable sample of N = 112 elderly adults. Future research is suggested to examine whether intellectual reserve extends to near-maximum levels of performance. PMID- 3267395 TI - Forgetting rates in modality memory for young, mid-life, and older women. AB - A mixed-modality (visual and auditory) continuous recognition task, followed immediately by a final recognition test, was administered to young (18-23 years), mid-life (38-50 years), and older (60-74 years) women. Subjects gave recognition responses for both the words and their presentation modality. Although older adults remembered less information about input mode than did the two younger groups, the age decrement was not the result of faster forgetting of such information by the elderly. When a ceiling effect at the initial lag was taken into account, forgetting rates for both words and input mode were comparable across the adult life span. PMID- 3267396 TI - Structure of subjective well-being among the elderly. AB - This article interprets subjective well-being within the framework of cognitive theories of emotion. A model consisting of three recurrent components of expressions of well-being--positive affect, negative affect, and cognition--was compared with two variations of models proposed by Liang. Drawing two random samples of persons with minimum age equal to 65 from the Myth and Reality of Aging in America Survey, lisrel analyses were undertaken on 17 items from the Affect Balance Scale and the Life Satisfaction Index Form A. All models provided an acceptable fit as indicated by ratios of chi-square to degrees of freedom. Implications are noted for the conceptualization and study of subjective well being. PMID- 3267397 TI - Influence of adult age on primary and secondary memory search. AB - We compared young and elderly adults on the ability to search lists of words stored in primary memory (PM) and in secondary memory (SM). The results of Experiment 1 indicated that age differences in search performance were greatest under SM conditions. Older adults, unlike the young, appeared biased toward responding that probe items were not members of the memory sets stored in SM. As a result of this apparent bias, older adults committed a large number of errors on trials in which the probe was a member of the memorized list (i.e., positive probe trials) yet few errors on trials in which the probe was not a member of the list (i.e., negative probe trials). In addition, the responses of older, but not younger, adults to negative probe trials were found to be more rapid than were those to positive probe trials. In Experiment 2 we examined this pattern of responding and concluded that age differences were involved in the ability to encode memory sets and transfer them from PM to SM as well as in the ability to retrieve information from SM prior to conducting a memory search. PMID- 3267398 TI - Environmentally induced analgesia: age-related decline in a neurally mediated, nonopioid system. AB - In order to examine the function of an endogenous system of pain inhibition during aging, rats (3, 14, and 24 months old) were exposed to 90 s of hind-paw shock. To investigate the pharmacology and anatomy involved in the production of hind-paw shock induced analgesia, the effects of naltrexone (7 mg/kg), scopolamine (5 mg/kg), and adrenalectomy were examined. Results revealed that there was an age-related reduction in the degree of analgesia produced by hind paw shock. Naltrexone and adrenalectomy did not alter the analgesia elicited by hind-paw shock. Scopolamine reduced the analgesia produced by hind-paw shock, and the effectiveness of scopolamine blockage declined with age. The results of a second experiment demonstrated that the effect of scopolamine was specific to the analgesia induced by hind-paw shock because scopolamine was ineffective in modifying the analgesia produced by a different stressor (cold water). These results suggest that the decline in hind-paw shock induced analgesia is the result of an alteration in the function of the cholinergic system. PMID- 3267399 TI - Specific exemplar retention and prototype abstraction in young and old adults. AB - The effects of age differences in retention of information about specific concept members on the ability to abstract central tendency information were examined. Young and older adults were presented with a series of visual patterns that were organized around a prototype. They were then presented with these same patterns plus a set of new patterns varying in prototype similarity in a recognition test. It was found that young adults retained more information about specific acquisition set exemplars, which resulted in slightly different recognition responses for new patterns. However, the recognition behavior of both young and older adults appeared to be governed by the same rules. It is suggested that the organization of conceptual information does not change with age, but the poorer retention of specific item information in older adults may result in a less complete representation. PMID- 3267400 TI - Memory complaint and memory performance in the depressed elderly. AB - Depressed and nondepressed elderly subjects recruited in the context of a large epidemiological study of health were compared on measures of self-reported memory disturbance and an objective index of memory performance (free recall). Three groups were studied including (a) subjects meeting Research Diagnostic Criteria (RDC) for major depression, (b) subjects with high levels of self-reported depressive symptoms who did not meet RDC for major depression, and (c) subjects with low levels of self-reported depressive symptoms. Subjects with high depression symptom levels reported significantly higher levels of memory complaint than did subjects with low symptom levels. However, there were no differences in self-reported memory disturbance as a function of depression diagnosis. Further, there were no significant differences between groups on the free-recall measure, either as a function of symptom level or diagnosis. It is argued that symptom severity rather than diagnosis of depression is important in determining impairment in depressed elderly people. PMID- 3267401 TI - Gender differences in satisfaction with grandparenting. AB - Grandmothers (n = 177) and grandfathers (n = 105) completed mail questionnaires covering demographic and family background, and grandparenting satisfaction and perceived responsibilities (disciplining, caretaking, helping, advising). Grandmothers' satisfaction scores significantly exceeded those of grandfathers, and different variables predicted men's and women's satisfaction scores. Discussion focuses on possible sources of these gender differences, and consequences of these differences for further research. PMID- 3267402 TI - As time goes by: change and stability in personality over fifty years. AB - Dimensions of personality, based on Q-sorted descriptions at seven points in time over a 50-year period and derived from a three-way component analysis, are described for a core sample of 118 subjects and two additional childhood samples of 99 and 108 subjects that partially overlap with the core sample. Stability and change in personality are described between adjacent periods and across a substantial segment of the life span from early childhood to late adulthood. These descriptions do not seem consistent with various explanations that personality develops either by stages or by steady gradual accumulation, or that it results from early effects. Instead, some aspects of personality shifted in level and correlational stability at particular intervals in time and according to sex of participants; other aspects were comparatively stable, irrespective of time interval and sex of participants. We suggest that the development of personality and achievement-based variables is not alike. Instead, personality development appears to be considerably more innovative and responsive-that is, more adaptive. PMID- 3267403 TI - Countercontrol treatment of sleep-maintenance insomnia in relation to age. AB - We administered countercontrol behavioral therapy for sleep-maintenance insomnia to 34 insomniacs--ranging in age from 35 to 78 years--in small groups. Twenty-two subjects received immediate and 12 received delayed treatment. Three self-report measures of sleep disruption were collected on daily sleep diaries at baseline, termination of treatment, 1-month follow-up, and 12-month follow-up. Although amount of time awake at night was correlated with age (r = .50), response to treatment was not. Even though older people experienced more time awake after sleep onset prior to treatment, they were able to profit from therapy as well as the younger insomniacs. Countercontrol therapy reduced the sleep complaint for the total group by about 30% at the end of treatment, with gradual improvement continuing through a 4-week follow-up. Nevertheless, it appears that sleep maintenance insomnia may be more difficult to treat than sleep-onset problems. PMID- 3267404 TI - Training the elderly on the ability factors of spatial orientation and inductive reasoning. AB - We examined the effects of cognitive training with elderly participants from the Seattle Longitudinal Study. Subjects were classified as having remained stable or having declined over the previous 14-year interval on each of two primary abilities, spatial orientation and inductive reasoning. Subjects who had declined on one of these abilities received training on that ability; subjects who had declined on both abilities or who had remained stable on both were randomly assigned to the spatial orientation or inductive reasoning training programs. Training outcomes were examined within an ability-measurement framework with empirically determined factorial structure. Significant training effects, at the level of the latent ability constructs, occurred for both spatial orientation and inductive reasoning. These effects were general, in that no significant interactions with decline status or gender were found. Thus, training interventions were effective both in remediating cognitive decline on the target abilities and in improving the performance of stable subjects. PMID- 3267405 TI - Cognitive and social functioning across adulthood: age or student status differences? AB - Younger adult students between 19 and 24 years of age (M = 21.3 years), older adult students between 61 and 76 years of age (M = 67.9 years), and older adult nonstudents between 62 and 76 years of age (M = 68.5 years) were assessed for health (self-ratings of physical and mental health), social functioning (self ratings of physical and mental activity, perceived role activity level, perceived roles, locus of control, and age-norm expectations), and cognitive functioning (Wechsler Adult Intelligence Scale-Revised vocabulary and block design, and paired associate memory). Age differences were observed in self-ratings of health, social roles, intellectual performance, and memory. No student status differences were observed. The results are discussed in terms of plasticity of intellectual function and characteristics of student status in later adulthood. PMID- 3267406 TI - Structure of perceptions of older adults: evidence for multiple stereotypes. AB - We examined the possibility that people hold multiple stereotypes of the elderly. Subjects were male and female university students. In the first phase of our study, stereotype content was sampled by asking subjects to describe the typical old person. In the second phase of the study, different subjects sorted traits from Phase 1 descriptions into one or more groups. Each group contained those traits that subjects felt could be found in one and the same older adult. Attitudes toward the stereotypes were also assessed. A distance matrix, based on the number of subjects who sorted each pair of traits into different groups, was analyzed by hierarchical cluster analysis. Evidence for multiple stereotypes was found both in the presence of contradictory traits given in Phase 1 descriptions and in the structure of the clusters. Different attitudes are identified for the cluster-defined stereotypes. PMID- 3267407 TI - Use of semantic context by patients with Alzheimer's disease. AB - In this study we used semantic-priming procedures to examine limitations in the use of semantic context by patients with Alzheimer's disease. We also tried to determine whether any such contextual effects were mediated solely through automatic processes or whether attentional processes were also involved. Three tasks were applied to examine the effect of semantic context on the performance of 18 normal elderly and 18 normal young subjects, and on 18 patients with Alzheimer's disease. When normal and demented subjects were asked to decide whether a given item was a member of a certain category, results showed that their response times were equally affected by the item's dominance in the category. The time that demented patients took to recognize a word was actually affected more by the semantic context provided by a priming sentence than was that of normal subjects. When asked to generate the final word of an incomplete sentence, demented subjects performed very poorly unless potential responses were highly constrained by sentence context. PMID- 3267408 TI - Word associations in old age: evidence for consistency in semantic encoding during adulthood. AB - Word associations of 80 young and 80 older adults were compared for 113 stimulus words. The proportion of paradigmatic responses varied with the grammatical class of the stimulus word and with the vocabulary level of the subject, but not with age. The same proportion of young and older adults gave the most common responses. Although older adults had a greater number of unique responses, this seems to reflect age differences in vocabulary level, as vocabulary but not age was a good predictor. Within-subject variability was also comparable across age, as on a retest young and older adults gave the same proportion of responses that were identical to those on the original test. Both age groups were more likely to repeat common than uncommon responses on the retest. This, together with analyses of response latency, suggests equivalent use of strategic processes across age. The results indicate that semantic structure and semantic encoding in adults are related to verbal ability, but not to age. PMID- 3267409 TI - Self-referent processing of age-specific material. AB - College students and elderly subjects made self- and other-descriptiveness judgments about trait adjectives that were age-specific descriptors. The young adults favored endorsement of traits that had been judged descriptive of young adults, compared to traits that had been judged descriptive of elderly adults. However, elderly adults endorsed an equivalent number of young and elderly traits. This indicates that content specificity with regard to age is more a characteristic of young adults than elderly people, with elderly adults being "schematic" for descriptors of both young and older people. Nonetheless, for the elderly subjects, the speed of self-reference decisions was slower for the young traits relative to the elderly traits, as if the young traits were somewhat less accessible. Although elderly adults recalled fewer adjectives overall than young adults, their pattern of recall was similar for self- versus other-referenced items. Thus, it seem unlikely that age differences in spontaneous self referencing account for the general age deficit in retention. PMID- 3267410 TI - Effects of a limited nap on night sleep in older subjects. AB - The night sleep of sixteen 50-60-year-old women, which had been preceded by either afternoon naps or no-nap control periods, was assessed by polygraphic and subjective measures. There were 2 nap and 2 non-nap nights. The naps were limited to a 1-hr opportunity. The measures of all subjects, good nappers (more than 20 min sleep on both nap occasions), and subjects with 50-min or more nap time, were separately analyzed. The null hypothesis of a nap effect could not be rejected. Within limits, naps may be recommended to offset the common night-time awakenings in older persons. PMID- 3267411 TI - How much and how fast: rapid processing of spoken language in later adulthood. AB - Speech processing involves rapid decoding and construction of meaning from a transitory acoustic signal. Because older adults have been found to be slower in performing many cognitive tasks, we hypothesized that they may have difficulty in immediate recall for speech of increasing input rate. Two experiments are reported in which both older and younger participants listened to and immediately recalled sentences that were systematically varied in speech rate and number of propositions. Although recall performance of the older adults showed a disproportionate decline when speech rate was increased, older adults, as well as the younger adults, were able to recall sentences of increasing propositional densities. We also found that the tendency to recall a greater proportion of main ideas than details (the levels effect) was enhanced by increased propositional density, and depressed by increased speech rate and increased age. These results are discussed in terms of an age-related change in the rate at which information can be processed in working memory. PMID- 3267412 TI - Age-related differences in the pleasantness of chemosensory stimuli. AB - Modest decrements in both taste threshold sensitivity and, more recently, suprathreshold sensitivity have been associated with the aging process. The present study was designed to investigate the existence of changes in preference for various concentrations of single tastes and of the same single tastes in more complex chemosensory mixtures. In this study, 300 participants from three different age groups (18-26, 32-45, over 65) rated for pleasantness four concentrations of sodium chloride, sucrose, and citric acid presented in both aqueous and beverage bases. Results showed significant effects of age, stimulus background, stimulus, concentration, and of several interactions, and they suggest that elderly subjects find salt and sugar pleasanter at higher concentrations than younger subjects do. PMID- 3267413 TI - Relation between aging and research productivity of academic psychologists. AB - Using a cross-sequential design involving four birth cohorts and five measurement periods, a curvilinear relation between aging and research productivity was found for more than 1,000 academic psychologists. Productivity typically began at a low rate in the 20s, increased to a peak around age 40, then decreased in the later years. Substantial individual differences were also observed. Those who began as high publishers remained more productive than the low or medium groups at each age level examined, and even at ages 55-64 they were more productive than the medium or low publishers were at their highest rate. Altogether, across cohorts and publishing levels, age accounted for 6.5% of the variance in publication rate from ages 25-34 to 55-64. PMID- 3267414 TI - Reasoning on social dilemmas varying in emotional saliency: an adult developmental perspective. AB - The purpose of this study was to provide age-comparative evidence of social cognitive reasoning in adulthood, as mediated by the emotional saliency of tasks tapping postformal reasoning. Specifically, the tasks focused on the ability to resolve discrepant accounts of the same event sequence. It was assumed that less mature thinking may be more evident in reasoning contexts in which emotional factors play a major role. A postformal coding scheme was used to assess levels of reasoning in an interpersonal context. Tasks were administered to 60 subjects- adolescents and young and middle-aged adults. Measures of formal operations, ego level, and verbal ability were also administered. An interaction was found between age and degree of emotional saliency of the task for reasoning level. Specifically, adolescents performed less well on tasks higher in degree of emotional saliency. In addition, developmental differences in postformal reasoning as a function of age and ego level were found. PMID- 3267415 TI - Effects of adult age and level of skill on the ability to cope with high-stress conditions in a precision sport. AB - Younger and older highly skilled and moderately skilled miniature golf players were studied in training and competition. All of the players showed an increase of heart rate and rated anxiety from training to competition. A performance decline in competition was observed for both older players and less accomplished players. Results from a cognitive task (incidental recall of shots) suggest that older players are less proficient in coping with the high-stress conditions in competition, due to an age-related decline in task-relevant cognitive abilities. PMID- 3267416 TI - Age and its effect on perceptions of psychopathology. AB - Fifty young (M age = 27.2 years) and 50 older (M age = 66.1 years) laywomen read descriptions of a healthy woman and women with four types of psychopathology. One half of each age group read descriptions of a younger woman, and one half read identical descriptions of an older woman. Participants rated both the severity of the problem and reasons for their judgments. No support was obtained for the hypothesis that psychopathological symptoms are viewed as part of the "normal" aging process. PMID- 3267417 TI - Accelerated speech in dysarthria after acquired brain injury: acoustic correlates. PMID- 3267418 TI - Language-impaired children's comprehension of active versus passive sentences. PMID- 3267419 TI - The maternal language environment of children with language delay. PMID- 3267420 TI - An adaptation of the Aphasia Screening Test for use with Panjabi speakers. PMID- 3267421 TI - [A case of primary ciliary dyskinesia simulating diffuse panbronchiolitis]. PMID- 3267422 TI - [Problems in treating chronic empyema with fistula]. PMID- 3267423 TI - [Two cases of mucoepidermoid carcinoma of the bronchus]. PMID- 3267424 TI - Importance of digital subtraction angiography in the imaging of locomotor tumors. AB - Digital subtraction angiography (DSA) performed with modern sophisticated equipment has been improved substantially in its ability to document also small vessels and pathologic vascularization patterns in tumorous conditions of the locomotor apparatus. Its domain is in imaging vascular patterns hidden by structural (mainly sclerotic) shadows in their vicinity. In 152 patients out of the total patient collective in the Bone Tumor Register in Prague having a bone tumor or a tumor-like condition, DSA proved to be a mild method of choice for the diagnostic imaging of vascular patterns of the lesions and/or combined diapeutic interventions and has not lost its raison d'etre in the era of CT and MRI. PMID- 3267425 TI - [Where is pharmacology going in the 21st century?]. PMID- 3267426 TI - Passive smoking and lung cancer: a short critique. PMID- 3267427 TI - [Cellular mechanisms of primary arterial hypertension]. PMID- 3267428 TI - [Target cells for angiotensin II and vasopressin: the "black boxes" reveal their secrets]. PMID- 3267429 TI - [Choroidal silence]. PMID- 3267430 TI - [Measurement of the equivalent luminance of glare in ophthalmology. II. Apparatus and personal results]. PMID- 3267431 TI - [Mycotic endophthalmitis: vital importance of an early diagnosis]. PMID- 3267432 TI - [Multiple serous detachments of the neuroepithelium after glaucoma surgery]. PMID- 3267433 TI - [Study of presbyopia in Zaire]. PMID- 3267434 TI - Keratotomy and high myopia. PMID- 3267435 TI - [The necessity for permanent angiographic control in studying the evolution of angiomatosis]. PMID- 3267437 TI - [Isolated and unilateral arteriovenous anastomosis of the retina with a 25-year follow-up]. PMID- 3267436 TI - [Association of the Wyburn-Mason and morning glory syndromes]. PMID- 3267438 TI - [Does a thrombocytopathy really exist in dominant exudative vitreoretinopathy?]. PMID- 3267439 TI - Retinal fluorescein leakage in a case of retinitis pigmentosa. PMID- 3267440 TI - Morning glory syndrome and basal encephalocele mimicking a pituitary adenoma. PMID- 3267442 TI - Evaluation of nongenotoxic and genotoxic factors modulating the frequency of micronucleated erythrocytes in the peripheral blood of mice. AB - The hematological micronucleus test is regarded as an indicator of the clastogenic effect of chemicals and acute cytogenetic damage. The test can be carried out in red blood cells of the bone marrow and of the spleen, as well as in peripheral erythrocytes. We have determined the precise background values of micronucleated red blood cells for the peripheral blood of BALB/c, DBA/2, and NMRI mice. Bleeding, phenylhydrazine-induced hemolysis, and splenectomy generated an increase of micronucleated erythrocytes in the peripheral blood of mice. Our data thus demonstrate that such factors should be taken into consideration when the micronucleus test is used for screening the genotoxic potential of chemicals. Furthermore, the micronucleus-inducing effect of cyclophosphamide was studied in normal and splenectomized mice and, in addition, a comparison of the sensitivity of the micronucleus test was carried out in peripheral blood and bone marrow after cyclophosphamide treatment. Our data demonstrate that the kinetics of micronucleus formation were similar in normal and in splenectomized mice in which the micronucleus levels had returned to normal. The comparison of micronucleus formation in bone marrow and peripheral blood after cyclophosphamide treatment revealed the generation of similar quantities of micronucleated red blood cells in both tissues. The physiological mechanisms of micronucleus formation and removal and the potential role of chemically induced spleen damage during this process are discussed; the usefulness of the peripheral micronucleus test as a simple, rapid, and animal-saving modification of the standard bone marrow test is evaluated. PMID- 3267441 TI - Toxicity and mutual interactions of cadmium and zinc ions in normal and carcinogen-transformed mouse cells. AB - The toxicity of chloride salts of physiological (zinc, manganese, nickel) and non physiological (cadmium) bivalent metal ions was studied in normal or carcinogen transformed mouse embryo fibroblast cells. The dose response curves for toxicity to both types of cells exhibited similar shapes. The transformed cells, however, were about twice as sensitive to zinc toxicity as normal cells. When normal and transformed cells were grown together and incubated for several hours with an appropriate concentration of zinc, the malignant cells were selectively killed. Cadmium was much more toxic than the three other metal ions in both types of cells. Its toxic effect was reversed by simultaneous addition of zinc at nontoxic concentrations. PMID- 3267443 TI - Pyrene acts as a cocarcinogen with the carcinogens benzo[a]pyrene, beta propiolactone and radiation in the induction of malignant transformation in cultured mouse fibroblasts; soybean extract containing the Bowman-Birk inhibitor acts as an anticarcinogen. AB - Pyrene was found to act as a cocarcinogen in the induction of transformation of cultured Balb/c3T3 cells by three different types of carcinogens: a direct acting chemical carcinogen, beta-propiolactone, a chemical carcinogen requiring metabolic activation, benzo[a]pyrene, and a physical carcinogen (60Co) gamma radiation. Since pyrene enhanced transformation in vitro by approximately the same amount for all the carcinogens tested, these results suggest that the carcinogenic action of pyrene is not related to carcinogen metabolism or uptake in vitro. An extract of soybeans containing the Bowman-Birk protease inhibitor was shown to reduce transformation induced by beta-propiolactone, benzo[a]pyrene and gamma-rays, both with and without the cocarcinogenic effect of pyrene, to background levels; the magnitude of the reduction in transformation by the protease inhibitor preparation was unrelated to the concentration of carcinogen. Neither the mechanism for the cocarcinogenic action of pyrene not the anticarcinogenic effect of the soybean extract is known, but several hypotheses are discussed. PMID- 3267444 TI - Impairment of human polymorphonuclear leukocyte chemotaxis by 2,5-hexanedione. AB - The effect of n-hexane metabolites on human polymorphonuclear leukocyte chemotaxis and luminol-dependent chemiluminescence was investigated. No effect was detected when 2-hexanol, 2-hexanone and gamma-valerolactone were used; 2,5 hexanedione at 75 micrograms/ml inhibited chemotaxis and a direct correlation between increasing the xenobiotic concentration and the degree of inhibition was found. Chemotactic peptide-induced chemiluminescence was not affected by 2,5 hexanedione. In order to clarify the phenomenon, plasma membrane fluidity was investigated by fluorescence polarization of the fluorescent probe trimethylammonium diphenylhexatriene. 2,5-hexanedione increased the membrane fluidity, while the other n-hexane metabolites did not change the degree of fluorescence polarization. Results suggest that the cellular functions modulated by membrane-cytoskeletal organization are affected by 2,5-hexanedione also at the low concentrations. PMID- 3267445 TI - Ellagic acid toxicity and interaction with benzo[a]pyrene and benzo[a]pyrene 7,8 dihydrodiol in human bronchial epithelial cells. AB - Ellagic acid, a plant phenol present in various foods consumed by humans, has been reported to have both anti-mutagenic and anti-carcinogenic potential. To evaluate the potential anti-carcinogenic property of ellagic acid, we tested its effects on the toxicity of benzo[a]pyrene and benzo[a]pyrene, 7,8-dihydrodiol and binding of benzo[a]pyrene to DNA in cultured human bronchial epithelial cells. The toxicity of ellagic acid itself for human bronchial epithelial cells was also determined. Using a colony-forming efficiency assay, it was found that a nontoxic concentration of ellagic acid (5 micrograms/ml) enhanced the toxicity of benzo[a]pyrene 7,8-dihydrodiol in human bronchial epithelial cells. In contrast, ellagic acid at concentrations of 1.5 and 3.0 micrograms/ml inhibited binding of benzo[a]pyrene metabolites to DNA in these cells. An explanation for the potentiating effect of ellagic acid on the toxicity of benzo[a]pyrene, 7,8 dihydrodiol will require further investigation into the possible mechanisms of interaction between these two compounds. PMID- 3267446 TI - Predicting carcinogenicity of petroleum distillation fractions using a modified Salmonella mutagenicity assay. AB - The Ames Salmonella/microsomal activation mutagenesis assay has been modified to improve sensitivity and reproducibility to complex mixtures derived from the refining and processing of petroleum. Oil samples were dissolved in cyclohexane and subsequently extracted with dimethyl sulfoxide to produce aqueous compatible solutions which readily interact with tester bacteria. Also, the liver homogenate (S-9) and NADP cofactor concentrations were increased and hamster rather than rat liver S-9 was used. The initial slope of the dose response curve relating mutagenicity (revertants per plate) to the dose of extract added was used as an index of mutagenic activity; this slope was obtained through a computerized curve fitting procedure. The modified assay was used to rank 18 oil samples for mutagenic activity; this ranking correlates highly (r = 0.92) with potency rankings of the same samples previously determined from dermal carcinogenicity bioassays. Sensitivity and reproducibility of the assay are sufficient to permit routine use for detecting potential carcinogenic activity of individual refinery streams and blends which contain components boiling above 500 degrees F. PMID- 3267447 TI - V79 Chinese hamster cells deacetylate trans-N-acetoxy-4-acetylaminostilbene and trans-N-hydroxy-4-acetylaminostilbene to mutagenic and cytotoxic metabolites. AB - The N-acetoxy and N-hydroxy derivatives of trans-4-acetylaminostilbene (AAS) were demonstrated to induce gene mutations at the hgprt locus and to be cytotoxic in V79 cells. These cells deacetylated AAS. Paraoxon inhibited the deacetylation of AAS by more than 99% and reduced the mutagenicity and cytotoxicity of N-hydroxy AAS and N-acetoxy-AAS to about one-tenth. Hence, deacetylated metabolites, formed by the target cells, were important for the observed biological effects. PMID- 3267448 TI - Induction of sister chromatid exchanges by benzidine in rat and human hepatoma cell lines and inhibition by indomethacin. AB - The genotoxic activity of benzidine was studied in two cell lines derived from rat (H4) and human (HepG2) hepatomas which have been shown to be capable of activating certain promutagens. The responses were compared to results in two lung-derived fibroblast lines (IMR-90 and V79) which appear to have little or no metabolizing capability. Benzidine was found to induce sister chromatid exchanges in the two liver-derived cell lines in a dose-dependent fashion but failed to induce sister chromatid exchanges in the fibroblast lines. Since one proposed pathway for benzidine activation involves prostaglandin-mediated metabolism, we tested the effect of pretreatment with indomethacin, an inhibitor of this metabolic pathway. Indomethacin was highly effective in inhibiting benzidine induced sister chromatid exchanges in both H4 and HepG2 cells. These results suggest that some DNA damage may occur in the livers of fast acetylating species such as the rat without prior N-acetylation and that some amount of DNA damage may occur in the livers of slow acetylating species, even when the liver is not the target organ for carcinogenesis. PMID- 3267449 TI - A rapid cell membrane permeability test using fluorescent dyes and flow cytometry. AB - A reliable and rapid test to detect cytotoxic chemicals which affect cell membranes is described. Fluorescein diacetate freely penetrates intact cells where it is hydrolyzed to its fluorochrome, fluorescein, which is retained in the cell due to its polarity. On the other hand, ethidium bromide is known to be excluded from the intact cell, staining only nucleic acids of membrane-damaged cells. The combination of both fluorochromes results in counter-staining: intact cells fluoresce green (cytoplasm) and membrane-damaged cells fluoresce red (nucleus and RNA). Rat thymocytes freshly isolated without enzyme treatment were incubated simultaneously with test substance and dye solution fluorescein diacetate and ethidium bromide. A two-parameter analysis was performed on a flow cytometer with an on-line computer. Concentration-dependent effects of various detergents and solvents were quantified by measuring the amount of dye retention, i.e., the decrease or increase in fluorescein--fluorescence (peak shift), and the decrease in dye exclusion (increase in ethidium bromide-staining) relative to the untreated control. The assay can be used for rapid monitoring of chemical insults to cell membranes which precede the decrease of the viability measured by pure dye exclusion techniques. PMID- 3267450 TI - Enhancement of aldehyde dehydrogenase activity in human and rat hepatocyte cultures by 3-methylcholanthrene. AB - Aldehyde dehydrogenase was measured in primary cultures of hepatocytes obtained with a two-step collagenase perfusion either from human hepatic tissue or from livers of Fisher rats. Basal enzyme activity declines gradually as a function of time in culture, but remains at all times higher when measured with propionaldehyde and NAD (P/NAD) than with benzaldehyde and NADP (B/NADP). Treatment of the cultures with 2 microM of 3-methylcholanthrene for four days significantly increased the B-NADP activity of human and rat hepatocytes (tenfold and eightfold respectively). In human hepatocytes 3-methylcholanthrene increases also the P/NAD activity, but to a lesser extent (twofold), compared to the B/NADP activity. Due to the significant enhancement of B/NADP activity in cultures of human and rat hepatocytes after application of 3-methylcholanthrene, the initial difference in the basal activity levels between the P/NAD and B/NADP forms diminishes or, in the case of human hepatocytes, is even inverted. These results show for the first time that aldehyde dehydrogenase activity is increased in cultured human hepatocytes. This biochemical property is preserved in human and rat hepatocyte cultures, despite the rather quick loss of the basal aldehyde dehydrogenase activity. PMID- 3267451 TI - Sex differences in the biotransformation of 2-acetylaminofluorene in cultured rat hepatocytes. AB - Sex-related differences in susceptibility to 2-acetylaminofluorene (2-AAF) hepatocarcinogenicity and in vivo biotransformation of 2-AAF have been observed. In order to determine the contribution of hepatocytes to these differences, 2-AAF biotransformation was investigated in monolayer cultures of hepatocytes freshly isolated from male and female F-344 rats. In cultured hepatocytes from both sexes, ring and N-hydroxylated, deacetylated and conjugated metabolites were formed. The half-life of 2-AAF was similar at concentrations of 5 x 10(-6) and 10(-5) M; however, at 10(-4) M a slower rate was observed in cultures from males. Although the total formation of aqueous metabolites was similar, the ratio of sulfate to glucuronide conjugates of 2-AAF formed by hepatocytes from male and female rats differed. Sulfate conjugates predominated in hepatocytes from male rats, whereas in females, glucuronides predominated. The demonstration of sex dependent variations in the rate of metabolism at a high concentration of 2-AAF and in conjugation provides evidence that in vivo differences are a function, at least in part, of the biotransformation characteristics of hepatocytes. PMID- 3267453 TI - The in vitro screening of methylated 4-oxypiperidine compounds for inhibition of protein synthesis in a rabbit reticulocyte cell-free translation system. AB - A variety of methylated 4-oxypiperidine derivatives were tested for their ability to inhibit protein synthesis in vitro. A direct correlation was found between the extent of methylation of these compounds and their inhibitory activity in a rabbit reticulocyte lysate cell-free translation system. PMID- 3267452 TI - Effect of lead acetate on Sertoli cell lactate production and protein synthesis in vitro. AB - The effects of lead acetate on protein synthesis and lactate production by cultures of rat Sertoli cells in vitro were studied. Sertoli cell cultures prepared from 20 day old Sprague-Dawley rats were exposed to 0.01, 0.05 and 0.10 mM lead acetate. Lactate production was significantly elevated by all concentrations of lead after 3, 6, 9 and 12 hours of exposure. Protein biosynthesis as measured by [3H]-leucine incorporation was significantly depressed by 0.05 and 0.10 mM lead acetate after 2 hours of exposure. These results support the hypothesis that lead acetate may inhibit spermatogenesis by a disturbance of the metabolic activities of the Sertoli cells. PMID- 3267455 TI - Postconfluency MDCK monolayers as an in vitro model of solid tumor chemosensitivity. AB - Shortly after reaching confluency, canine MDCK cells enter a prolonged state of basal growth with doubling times of 200-300 hours. These values are similar to those commonly exhibited by in vivo solid tumors at clinically relevant sizes. By comparison with rapidly growing sparse density cultures, the postconfluent monolayers displayed a pronounced resistance to deazauridine, deoxyspergualin, and 5-fluorouridine. Drug concentrations required for unit levels of effect increased from several fold to several orders of magnitude as cells entered high density basal growth. This high density chemoresistance was observed for both growth inhibition and cytotoxicity, but was much more pronounced with the former. Dose-response curves were biphasic, suggesting that growth inhibition and cytotoxicity may be mediated by different mechanisms of drug action. The pronounced chemoresistance of postconfluent MDCK monolayers is similar to that encountered with many clinical solid neoplasms. It suggests that postconfluency monolayers, like multicellular spheroids and cellular multilayers, may provide better in vitro models of solid tumor chemosensitivity than subconfluent monolayer and suspension cultures. PMID- 3267454 TI - Formation of reactive 1-nitropyrene metabolites by lung microsomes and isolated lung cells. AB - The metabolism and activation of 1-nitropyrene (1-NP) to reactive intermediates by lung microsomes and isolated lung cells was studied. Mutagenicity of 1-NP metabolites was assayed in Salmonella typhimurium TA98NR, a strain lacking a major component of nitroreductase activity. In the presence of NADPH, microsomes from rabbit, rat and hamster lung metabolized 1-NP to mutagenic products to a similar degree. Pretreatment with a mixture of polychlorinated biphenyls (PCB) decreased the formation of mutagenic metabolites by rabbit lung microsomes, but did not affect the production of mutagens by rat or hamster lung microsomes. 3H-1 NP was metabolized to covalently bound protein products at a rate of 82 and 10 pmol/mg by rabbit and hamster lung microsomes, respectively, whereas no binding was detected in rat lung microsomes. PCB-pretreatment increased covalent protein binding of 3H-1-NP in lung microsomes from hamster and rat, but decreased the binding in rabbit lung microsomes. High performance liquid chromatography analysis indicated that 3H-1-NP was readily converted to ring-hydroxylated products by rabbit and hamster lung microsomes; the rate was much lower with rat lung microsomes. 3H-1-NP was activated to metabolites that covalently bound to protein in isolated rabbit lung cells, with the following rates being observed: Clara cells greater than lung digest greater than type II cells. In contrast, covalent protein binding in cells isolated from rat lung was very low. 1-NP was not activated to products mutagenic for S. typhimurium TA 98NR when co-incubated with cells isolated either from rabbit or rat lung. PMID- 3267456 TI - Stimulation of cell growth and proliferation in NIH-3T3 cells by onion and garlic oils. AB - Onion and garlic oil were seen to shorten the cell-doubling time and stimulate the growth and proliferation of NIH-3T3 cells. Following treatment with either onion or garlic oil, an increase in the growth rate and almost a 2-fold increase in cell number over the control was observed within a 24-hour period. Phorbol myristate acetate when given simultaneously with either oil appeared to nullify both effects. Following exposure to low doses (less than 10 micrograms/ml) of either oil, an increase in cell survival, not seen with the oil control tricaprylin, was observed following a 5-day exposure period. At higher concentrations cell survival decreased proportionately in all cases. The appearance of multinucleated cells, which increased with dose and time, was also observed following treatment with both garlic and onion oil. PMID- 3267457 TI - Comparison of the Ames assay and the induction of sister chromatid exchanges: results with ten pharmaceuticals and five selected agents. AB - Seven antischistosomal drugs, two antimalarial drugs, and one antiamoebic drug were tested in all five Ames strains for induction of mutation, as well as for induction of cytotoxicity, inhibition of cellular progression, and the induction of sister chromatid exchanges in two cultured mammalian cell lines. We found that two agents shown to be negative in the Ames test were positive for sister chromatid exchange induction. Based on qualitative and quantitative evaluation, we find that all but three of the pharmaceuticals should be considered to be potential human carcinogens. PMID- 3267458 TI - Quantitative analysis of antiviral drug toxicity in proliferating cells. AB - The toxicity of most antiviral compounds was dependent on the type of cell used to assay toxicity. Ranking of compounds according to toxicity was, however, very similar (p less than 0.01) in the three different cell types used in this study. The difference in toxicity observed for 9-beta-D-arabinofuranosyladenine between Flow 5000 cells and CCRF-SB cells could not be accounted for by differences in the intracellular concentrations. On the other hand, the different toxicities observed for ribavirin and 2'-deoxy-5-trifluorothymidine between Flow 5000 cells and CCRF-SB cells may be caused by the culture conditions (as shown for one cell type, HeLa S3, grown either as monolayer or in suspension) rather than by cell specific differences. The growth-inhibitory effect of most antiviral compounds increased with treatment time, indicating an additive nature of toxicity. The ability of cells to recover from toxic treatment with drugs varied greatly from compound to compound (from undetectable regrowth to 140% growth compared to control cells). Coaddition of natural nucleosides could, at best, only partly protect cells from the toxic influences of antiviral nucleoside analogs. As a result of comparing antiviral effects and toxicity in vitro, the unselective compounds may be eliminated from further development at the screening level. PMID- 3267459 TI - Genotoxicity in the hepatocyte/DNA repair test and toxicity to liver mitochondria of 1-hydroxyanthraquinone and several dihydroxyanthraquinones. AB - 1-Hydroxyanthraquinone and dihydroxyanthraquinones (alizarin, quinizarin, anthrarufin and chrysazin) were examined for genotoxicity in the hepatocyte/DNA repair test and for effects on oxidative phosphorylation in isolated rat liver mitochondria. Of the anthraquinone compounds tested, 1-hydroxyanthraquinone and 1,8-dihydroxyanthraquinone (chrysazin) induced DNA repair synthesis in rat hepatocytes, indicating their genotoxic activity. Only 1,2-dihydroxyanthraquinone (alizarin) exerted an uncoupling and inhibitory effect on mitochondrial respiration. The possible relationships of the genotoxic potencies and the uncoupling activities of these anthraquinones to their chemical structures are discussed. PMID- 3267460 TI - Culture duration alters the glutathione content and sensitivity to ethacrynic acid of rat hepatocyte monolayer cultures. AB - Many of the differentiated functions of hepatocytes are lost in culture, yet addition of certain medium supplements can aid in the retention of differentiated character. Therefore, the effect of time in monolayer culture on rat hepatocyte glutathione (GSH) synthesis and sensitivity to the GSH detoxicated xenobiotic ethacrynic acid was examined in cultures with and without medium supplementation by transferrin and sodium selenite. GSH content was found to be about 12 nmol/micrograms DNA at 4 hr in culture and to approximately triple by 24 hr. Intracellular GSH levels continued to increase in transferrin/sodium selenite supplemented cultures, from 32 to 41.6 nmol/micrograms DNA, while GSH levels in unsupplemented cultures declined to 18 nmol/micrograms DNA. However, the rate of GSH synthesis after diethylmaleate depletion was found to decrease from 4.2 to 2.8 nmol/hr/micrograms DNA at 4 and 24 hr after inoculation, respectively. GSH repletion rate increased to 3.9 nmol/hr/micrograms DNA at 48 hr. The GSH accumulation rate after depletion in supplemented cultures did not vary significantly over the initial 48 hr. Incubation for 3 hr with 100 microM ethacrynic acid (EA) did not elicit an increase in LDH leakage in hepatocyte monolayers after 4 or 48 hr in culture or in cultures with supplemented medium at any time point tested. Cultures 24 hr in medium without transferrin/sodium selenite supplementation exhibited significant LDH leakage after 3 hr of EA treatment. Over the 3 hr EA treatment, intracellular GSH content was decreased in all cultures. Only in the 24 hr unsupplemented cultures did GSH depletion exceed the 90% level previously associated with depletion of the mitochondrial pool of GSH and EA toxicity in hepatocytes. The experiments show that during the redifferentiation of hepatocytes in culture, a transient period occurs when apparent GSH synthesis is depressed and enhanced sensitivity to GSH-detoxicated compounds is observed. This period of increased sensitivity is prevented or at least delayed by inclusion of supplemental transferrin and sodium selenite, suggesting that redifferentiation can be regulated by extracellular influences. PMID- 3267462 TI - Effect of beta-lactam antibiotics on a human myeloid cell line: investigation of potential in vivo correlates in the mouse. PMID- 3267461 TI - Effects of beta-lactam antibiotics on eukaryotic cells. AB - A symposium on effects of beta-lactam antibiotics on eukaryotic cells was held as part of the 9th International Congress of Infectious and Parasitic Diseases (Munich, Germany, July 1986). This symposium provided an opportunity to review recent work on the effect of beta-lactam structures on mammalian cells in culture and to speculate on possible clinical implications. This paper is a comment on the subject matter covered by the symposium papers which follow. PMID- 3267463 TI - [Occlusion in complete dentures. Lingualized occlusion set-up according to Earl Pound]. PMID- 3267464 TI - [Polyurethane polymers for impression casting]. PMID- 3267465 TI - [Etiology of M.F.P.D. syndrome]. PMID- 3267466 TI - [Equilibration of complete removable dentures according to A.G. Lauritzen]. PMID- 3267467 TI - [Esthetics of the false gingiva in removable dentures]. PMID- 3267468 TI - The use of displacement packs in periodontal therapy. PMID- 3267469 TI - Management of chronic sclerosing sialadenitis incident to second-stage implant surgery. PMID- 3267470 TI - A practical approach to the diagnosis of chronic orofacial pain, Part II: Neurogenous and psychogenic pain. PMID- 3267471 TI - Dry mouth and salivary gland hypofunction, Part II: Etiology and patient evaluation. PMID- 3267472 TI - Idiopathic gingival fibromatosis. PMID- 3267473 TI - The effectiveness of a powered toothbrush on plaque removal in periodontal patients. PMID- 3267474 TI - [Manometric findings on esophageal motility in patients with reflux esophagitis]. AB - The aim of the study was to investigate the incidence of the acid reflux and its relationship to the oesophageal motility and to clinic symptoms. Recording of oesophageal manometry under basal and stimulating conditions obtained from 30 patients GERD and 10 healthy controls were assessed. Manometric results were analyzed for the occurrence of failed primary peristalsis, for the occurrence of peristaltic dysfunctions or for hypotensive LES pressure. Motor abnormalities found in the body of the oesophagus during simulated oesophageal reflux were described. The AA. found that there is not a sure correlation between the occurrence of peristaltic dysfunctions and hypotensive LES such as was not possible to find a direct relationship between peristaltic disorders and oesophagitis degree or symptoms. PMID- 3267476 TI - [Tumor markers in colorectal neoplasm pathology: our experience of the diagnostic and prognostic importance of CEA antigen]. AB - It is well known that the presence of a tumour may be accompanied by production and release into the serum of a substantial number of protein and/or hormonal substances. Only relatively recently, however, have investigators begun to identify which of these supposed markers may actually be clinically useful. A picture is thus gradually emerging of a number of markers (in actual fact only very few) which are already clinically useful, as well as others which are clinically promising and numerous markers which require more thorough clinical evaluation. Prominent among those already in clinical use is undoubtedly CEA. Carcinoembryonic antigen (CEA) is a glycoprotein isolated for the first time by Gold and Friedman in 1965. Very recently, sensitive radioimmune and immuno enzymatic assays have made it possible to determine serum levels lower than 3 ng/ml. Though high plasma levels of CEA do not indicate the presence of a tumour with certainty, very high levels are, however, to some extent indicative of its existence. In view of the fact that CEA possesses neither the sensitivity nor the specificity to be able to diagnose the presence or otherwise of a tumour, its use is generally recommended when formulating a prognosis or for monitoring surgical and/or medical therapy (chemotherapy and radiotherapy) in asymptomatic patients. We therefore carried out tests in 357 patients on file as having undergone surgery for neoplasms of the colon-rectum-anus, monitored in our colostomy outpatients' department, which was started up in 1980. 188 of these patients had already been submitted to CEA assay prior to surgery. The data are analyzed in relation to the site, stage and grade of differentiation of the neoplasm, the supposed radicality of the operation and the period of follow-up in these patients. PMID- 3267475 TI - [A rare complication in the suppression of a porto-systemic shunt in disabling encephalopathy]. AB - The authors describe an uncommon complication in a case of side-to-side portacaval shunt which was suppressed due to disabling portal-systemic encephalopathy; the patient was treated by esophageal transection with esophagogastric devascularization and nonoperative secondary occlusion of the shunt by external elastic traction on a Silastic catheter surrounding the anastomosis: a stenosis of the caval vein under traction required another operation in order to close the shunt. PMID- 3267477 TI - [Endobronchial lipoma (presentation of a case)]. AB - The Authors report on a case of endobronchial lipoma in a patient operated on six years previously for a clear-cell tumour of the kidney and discuss the diagnostic and therapeutic problems posed by this disease, after stressing its extreme rarity. PMID- 3267479 TI - Preparing neurologists for the 21st century. PMID- 3267478 TI - [Acute gastric volvulus]. AB - Gastric volvulus is an uncommon condition in which a torsion of the stomach results in acute or chronic gastrointestinal symptoms. We report a case of an intrathoracic organo-axial gastric volvulus secondary to a hiatal hernia. The patient died after surgery. Even though it was a surgical emergency, the patient was admitted to a Medical Department because she was regularly examined by the Digestive Endoscopy Unit for a hiatal hernia. The Authors emphasize the contribution of endoscopy to the preoperative recognition of this condition. PMID- 3267480 TI - A prospective study of the predictive value of electroencephalographic abnormalities for epileptic loss of consciousness. AB - Patients referred to a neurology clinic with their first episode of loss of consciousness were studied prospectively in order to clarify the positive predictive value of an epileptic EEG for establishing an epileptic cause of the loss of consciousness. The clinical diagnosis was categorised as epileptic or non epileptic. The EEG was reported as epileptic or non-epileptic, but abnormal or normal, according to recognised criteria. Patients were followed for a period ranging from 1 to 18 months to assess the accuracy of the original diagnosis. A total of 38 patients were available for analysis. Thirteen patients had a clinical diagnosis of epilepsy and 25 patients had a non-epileptic diagnosis. Five patients with an epileptic history had an epileptic EEG and 2 patients with a non-epileptic history had an epileptic EEG. Non-epileptic EEG abnormalities were present in a further 4 patients with a non-epileptic history. Follow-up was achieved for 53% of patients and in none of these was the final diagnosis different from the initial one. The positive predictive value of an epileptic EEG for a diagnosis of epilepsy was 71%, and the negative predictive value of a normal EEG for a diagnosis of non-epilepsy was 74%. The positive predictive value for any abnormality in the EEG for a diagnosis of epilepsy was 45%, and the negative predictive value of an absence of any abnormality in the EEG for a diagnosis of non-epilepsy was 70%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267481 TI - Transition from alpha to theta pattern coma in fatal cerebral anoxia. AB - A transition of alpha to theta pattern coma is documented in a case of fatal cerebral anoxia after a cardiac arrest. The patient was a 35-year-old woman who suffered a cardiac arrest due to myocardial ischaemia and ventricular tachycardia. Altogether 6 EEGs showing progressive deterioration were performed during the 11 days of survival. There was histopathological evidence of extensive ischaemic damage involving cerebral and cerebellar cortex, basal ganglia and brainstem structures. Although closed chest cardiopulmonary resuscitation was begun with minimal delay after cardiac arrest, the outcome may reflect the increasingly documented failure of this type of resuscitation to provide adequate organ perfusion during cardiac arrest. PMID- 3267482 TI - Choreoathetosis and thalamic haemorrhage. AB - A case of choreoathetosis due to thalamic haemorrhage and responding to pimozide is described. The anatomical changes, the neurotransmitter abnormalities and the drug treatment of chorea are discussed. PMID- 3267484 TI - Dementia, gait disturbance, incontinence and hydrocephalus. AB - Normal pressure hydrocephalus is frequently emphasised as a cause of reversible dementia, but is seldom encountered. Over a 2 year period, 5 patients presented with cognitive decline, and gait disturbance, with or without incontinence. CT head examination revealed hydrocephalus. Although none had symptoms of raised intracranial pressure on initial presentation, there were clinical or CT signs of raised intracranial pressure in 4 of the 5. Underlying pathologies were meningeal lymphocytic lymphoma, idiopathic meningeal fibrosis, periaqueductal glioma, basilar aneurysm and basilar invagination. All patients responded to the insertion of a shunt. Over the same period, only 1 patient was shunted for idiopathic normal pressure hydrocephalus, without improvement. We challenge the concept of idiopathic normal pressure hydrocephalus as a cause of cognitive deterioration. PMID- 3267483 TI - Neurologists' use and interpretation of antiepileptic drug monitoring in the treatment of epilepsy. AB - Of the 150 local Ordinary Members of the Australian Association of Neurologists (AAN), 118 responded to a questionnaire on the use of AED level measurement in the management of epilepsy. AED level measurement is widely employed, but only phenytoin levels were accepted as being reliable by more than 90% of AAN members. Respondents questioned absolute reliance being placed on any of the other AED levels. PMID- 3267485 TI - Absence of antimyelin antibodies and serum demyelinating factors in most patients with chronic inflammatory demyelinating polyradiculoneuropathy. AB - Patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) often respond to plasma exchange. One explanation for this is that circulating factors, such as antibodies or toxic factors, are removed from the serum. We studied CIDP nerves and CIDP sera for the presence of antibodies to myelin, Schwann cells and galactocerebroside, using immunofluorescence and enzyme-linked immunosorbent assays. On 1 of 28 CIDP nerve biopsies there was evidence of an IgG antibody bound to myelin. One of 57 CIDP sera had evidence of an antimyelin antibody, compared with 12 of 68 Guillain-Barre syndrome sera. We failed to find evidence of antibodies to Schwann cells or galactocerebroside in CIDP. The serum from only 1 of 11 patients showed demyelinating activity after direct intraneural injection. Thus these techniques do not demonstrate the presence of humoral factors to the tested antigens in the majority of CIDP patients. However, more sensitive methods may demonstrate antibodies to these antigens. Alternatively, CIDP may be associated with antibodies or factors toxic to other antigens, or else the response to plasma exchange may not be due to removal of a humoral factor. PMID- 3267486 TI - A family with late onset autosomal dominant cerebellar degeneration. AB - A family is described in which 5 (4 female and 1 male) of 8 siblings from one marriage developed a late onset cerebellar degeneration. Four of the 5 affected persons presented separately to different neurologists. Because the original enquiries into family history were negative, and because of the exclusion of other recognised causes for the clinical picture, a diagnosis of idiopathic chronic cerebellar degeneration was made for the individual patients. All patients experienced their first symptoms between the ages of 48 and 55 years, with a gradual unremitting deterioration from the onset. Cerebellar atrophy was confirmed on CT head scan in all cases. Clinically, apart from the cerebellar ataxia, there were no consistent signs of degeneration of any other central or peripheral nervous system pathway. Geographical factors severely limited family contact, and consequently none of those afflicted was aware of similarly affected relatives. Hence, this particular family illustrates the great importance of obtaining a detailed, accurate family history and of assiduous follow-up of the entire family. Only after many years did it become obvious that multiple members of the family were affected by a similar neurological problem. PMID- 3267487 TI - Spinal subdural abscess. AB - Spinal subdural abscess is a rare condition that is clinically similar to spinal epidural abscess. A case of spinal subdural abscess is reported, and the characteristic clinical findings and specific myelographic features in this patient are noted. Urgent myelography and surgery are necessary to prevent the rapid deterioration that often occurs in this condition. PMID- 3267488 TI - Effects of topical capsaicin on normal skin and affected dermatomes in herpes zoster. AB - Hyperalgesia and allodynia, lasting for months or even years, occurs in the form of post-herpetic neuralgia in approximately 70% of adults previously infected with the varicella herpes zoster virus. The present study aimed at testing the analgesic desensitising actions and reversibility of repeated application of topical capsaicin on disordered polymodal nociceptors and peptidergic sensory fibres mediating warm and pain sensation. Cutaneous nociceptor desensitisation was measured using the Glasgow automated thermal threshold test (Medelec TTT). For normal subjects (n = 69) the mean forearm warm threshold was 0.15 +/- 0.07 degrees C and the cold threshold was 0.14 +/- 0.10 degrees C. A variable degree of partial desensitisation of herpes-affected skin was found in 15 patients with post-herpetic neuralgia before capsaicin treatment where the mean threshold elevation for warm detection was 1.19 degrees C and 0.7 degrees C for cold detection, compared with the corresponding normal skin. In preliminary studies of 15 patients with post-herpetic neuralgia, good pain relief averaging 30% or 77% occurred in the affected dermatome(s) after 3 to 4 weeks of 0.01% or 0.05% capsaicin cream respectively, applied 3-4 times daily. The warm thresholds, after chronic capsaicin treatment, increased between 0.1 and 7.60 degrees C, the average elevation being 3.69 degrees C. By contrast cold thresholds after capsaicin altered inconsistently and by only an average of 0.08 degrees C. The results suggest that elevation of the warm threshold may indicate the desensitisation achieved by capsaicin treatment of skin polymodal nociceptors. Cold detection, being dependent upon A-delta cold fibre function, is unaffected by capsaicin treatment. There was a poor correlation between pain relief and elevation of warm detection in response to capsaicin treatment. Generally, it was found that those patients with less initial desensitisation to warm detection as a consequence of post-herpetic neuralgia experienced better pain relief after capsaicin was applied. The method used permits determination of the minimum effective desensitising dose of capsaicin, enables patient compliance and progress to be monitored and should allow the prediction of patients likely to achieve the best response to treatment. PMID- 3267489 TI - Abnormalities of visual evoked responses in hyperprolactinaemia. AB - The relationship between the visual evoked response (VER) and chiasmal lesions remains unclear, although a few published studies have reported waveform distortions as the major abnormality. In this study of 10 female and 2 male patients we carried out a retrospective analysis of the latencies and waveforms of their full field and half field VERs to pattern reversal stimulus. CT scanning showed minimal suprasellar involvement in 3 patients. The VER in 2 of these 3 patients showed slight prolongation in latency and waveform distortions. In 4 of the remaining 9 patients with no suprasellar involvement, the VER showed waveform distortions but normal latencies. We conclude that waveform distortion of the VER is an early finding in patients with pituitary tumours, even in the absence of suprasellar extension. PMID- 3267490 TI - Somatosensory evoked potentials, electroencephalography and CT scans in the assessment of the neurological sequelae of decompression sickness. AB - Decompression sickness can lead to neurological complications. Recovery may be studied by somatosensory evoked potentials (SEPs), which are more sensitive than normal methods of neurological examination, and by electroencephalography (EEG). The combination of EEG and SEP may be useful in differentiating among spinal, brainstem and cortical pathology. PMID- 3267491 TI - The flight of colours test. Its value as an indicator of dysfunction of the visual pathways. AB - The flight of colours (FOC) test was compared with visual evoked potentials (VEPs) in 135 patients in a 2 year prospective study, to determine whether the FOC test is a sensitive and reliable alternative. We obtained an 80% overall agreement between the tests, confirming the levels of agreement reported by Rolak (87%) and Swart and Millac (92%). Abnormal VEPs, however, were more closely associated with cases of clinically definite multiple sclerosis (MS) while abnormal FOCs were more frequent in cases of non-demyelinating disease and cases without clinically evident optic nerve or other ocular disorder. We cannot explain this result by any demonstrated superiority of the FOC test over VEPs in non-demyelinating visual disturbances, whether clinically evident or not. Thus the study does not confirm the earlier expectation that the FOC test would be a reliable alternative to the study of VEPs in the differential diagnosis of MS. PMID- 3267492 TI - Scanning electron microscopy investigation of resin penetration of enamel lamellae. PMID- 3267493 TI - How quickly does diet make for change: a study of sulcus depth. PMID- 3267494 TI - The temporomandibular joint in function and dysfunction. PMID- 3267495 TI - Effects of zinc chloride mouthwash on plaque and zinc levels of surface enamel. PMID- 3267497 TI - Glass ionomer: a versatile adhesive dental cement? PMID- 3267496 TI - Evaluation of a floss-holding device compared to hand-held floss for interproximal plaque, gingivitis, and patient acceptance. PMID- 3267498 TI - [Breathing through the nose with correct positioning of the oral cavity as the basis for successful treatment of cheilognathopalatoschisis]. PMID- 3267499 TI - [Comparison of the closed and open method of treatment of fractures of the zygomatic complex]. PMID- 3267500 TI - [Precancerous conditions and carcinomas in patients on immunosuppressive therapy]. PMID- 3267501 TI - [Diagnosis and therapy of tumors of the parapharynx]. PMID- 3267502 TI - [Mucous island flaps on submucous pedicles]. PMID- 3267503 TI - [The importance of determining circulating immune complexes in the differential diagnosis of chronic parotitis and Sjogren's syndrome]. PMID- 3267504 TI - [Congenital giant pigmented nevi]. PMID- 3267505 TI - [Reconstruction of the soft tissue covering of the lower leg using free vascularized flaps in the treatment of posttraumatic osteomyelitis of the tibia]. PMID- 3267506 TI - [Giant angiolipoma of the neck in a 5-month-old child]. PMID- 3267507 TI - Glass ionomers expand services. PMID- 3267508 TI - Fund steers research to future. PMID- 3267509 TI - Skills for implant dentistry rely on an innovative spirit. PMID- 3267510 TI - Segmentation in leech development. AB - Segments in glossiphoniid leeches, such as Helobdella triserialis, are the products of sterotyped cell lineages that yield identifiable cells from first cleavage. Cell lines generating segmental tissues are separated from those generating prostomial tissues early in development. Segments arise from five bilateral pairs of longitudinal columns of primary blast cells that are generated by five bilateral pairs of embryonic stem cells called teloblasts. There are four ectodermal cell lines (N, O, P and Q) and one mesodermal cell line (M) on each side of the embryo. In normal development, each cell line generates a segmentally iterated set of identified definitive progeny comprising a mixture of cell types. In the M, O and P cell lines, each blast cell generates one segment's worth of definitive progeny (segmental complement). But the clones of blast cells in each of these three cell lines interdigitate longitudinally with cells of the adjacent clones from the same line, so that the clone of an individual m, o and p blast cell is distributed across more than one segment. Thus, there is no simple clonal basis for morphologically defined segments. In the N and Q cell lines, two blast cells are required to produce one segmental complement of definitive progeny; in each of these two cell lines, two classes of blast cells (nf and ns, qf and qs) are produced in exact alternation. Primary n and q blast cells are about the same size and are produced at the same rate as blast cells for the o and p bandlets, but the longitudinal extent of their clones is roughly half that of the o and p blast cells' clones.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267511 TI - Combined action of multiple antihypertensive mechanisms. Proceedings of an official satellite symposium of the 12th scientific meeting of the International Society of Hypertension. Nara, Japan, 26 May 1988. PMID- 3267512 TI - The effect of anabolic and antianabolic hormones on the histological and histochemical changes of alveolar process and periodontal ligament. PMID- 3267513 TI - The effect of irradiation on healing of mandibular fractures. PMID- 3267514 TI - Dental caries and some trace elements on human enamel and dentin. PMID- 3267515 TI - Development of a new cement. PMID- 3267516 TI - Radiographic evaluation of maxillary sinus by computed tomography. PMID- 3267517 TI - Scattered radiation from different implant materials during radiotherapy. PMID- 3267518 TI - Effect of cyclophosphamide, fluorouracil and their combination on dental caries in rats. PMID- 3267520 TI - Periodontal disease and AIDS. PMID- 3267519 TI - Two-year study of unilateral subperiosteal implant. PMID- 3267521 TI - AIDS not found worldwide. PMID- 3267522 TI - Ice may ease toothache. PMID- 3267523 TI - Clinical examination of patients with orofacial pain. PMID- 3267524 TI - Damage of the Hertwig's epithelial root sheath: effect upon root growth after autotransplantation of teeth in monkeys. PMID- 3267525 TI - Solubility and biocompatibility of calcium hydroxide-containing root canal sealers. PMID- 3267526 TI - C-shaped root canals in mandibular second molars in a Chinese population. PMID- 3267527 TI - Histological and bacteriological study of pulps extirpated after luxation injuries. PMID- 3267528 TI - Frequency of dental and traumatic events in the etiology of temporomandibular disorders. PMID- 3267529 TI - Root fractures: a case of dental non-intervention. PMID- 3267530 TI - Lubricants, irrigants and chelating agents: selection and use. PMID- 3267531 TI - Calcium hydroxide delivery systems. PMID- 3267532 TI - Apexification of a tooth with immature apices. PMID- 3267533 TI - Evaluating and communicating prognosis. PMID- 3267534 TI - Function regulator II treatment combined with LARS for a patient developing dysfunction while in treatment. PMID- 3267535 TI - Treatment of internal derangement of the temporomandibular joints following nasotracheal intubation. PMID- 3267536 TI - Cohabitation and marriage in the 1980s. AB - Using cohabitation and marriage histories collected in 1985 from 23-year-old women and men, this study investigates the process of union formation, considering transitions from single life into cohabitation and marriage. The outcomes of cohabitation are also considered--both the dissolution of unions and the transformation of cohabiting unions into marriage. These data indicate that large proportions of men and women experience cohabitation fairly early in the life course. At the same time, many cohabiting unions are dissolved fairly quickly and numerous others are soon transformed into marriages. Thus even though cohabitation will be experienced by many, most people will continue to spend substantially more time in marital unions than in cohabiting unions. PMID- 3267537 TI - The demographic context of recent change in the structure of American households. AB - This article examines recent changes in the structure of American households within the context of broad population changes. Decreases in married-couple households and increases in single-parent households are almost entirely due to the changing patterns of marriage, divorce, fertility, and child custody; headship rates for families have remained relatively stable. Increases in single person and other nonfamily households are due to increases in the size of the unmarried, childless population and to the aging of this population. Increasing propensities to live alone or with nonrelatives were observed between 1970 and 1980, but these behavioral changes have abated during the early 1980s. PMID- 3267538 TI - Historical changes in the household division of labor. AB - A number of studies published in the 1970s asserted that the amount of time women spend doing housework shows no historical decline. This article draws on evidence from time-budget surveys--three from the United States (1965, 1975, and 1985) and three from the United Kingdom (1961, 1974, and 1984)--to investigate the evolution of housework time for men and women over the last three decades. Clearly much other than housework has changed over this period. More women have paid jobs, more men are unemployed, and families have gotten smaller on average. Even having controlled for such sociodemographic changes, we conclude that in the two countries, women in the 1980s do substantially less housework than those in equivalent circumstances in the 1960s, and that men do a little more than they did (although still much less than women). These changes correspond closely to developments in four other countries (Canada, Holland, Denmark, and Norway) for which historical time-budget evidence is available. PMID- 3267540 TI - Household organization and the interregional variation of out-migration rates. AB - Regional out-migration rates may depend on localized conditions, but the range of possibilities for migration decision making in multiperson households includes processes in which the response to variations in localized conditions depends on household size. Analyses of migration rates for households indicate that larger households exhibit more extreme responses to variations in localized conditions and that this is an important source of variation in regional out-migration rates. PMID- 3267539 TI - Union patterns and children's living arrangements in Latin America. AB - This article analyzes how union patterns in Mexico and Colombia affect the lives of children. The proportion of children affected by a disruption by the age of 15 is estimated by using life table methods. The factors that contribute to a child's risk of experiencing a disruption are investigated by using proportional hazard models. Finally, the living arrangements of children by the mother's marital status, the urban status, and the mother's educational attainment are explored. The findings indicate that about one-fifth of Mexican children and one third of Colombian children spend some time with an unmarried mother by the age of 15. In addition, those who experience a disruption or are born outside of a union spend a considerable length of time in the single-parent state. Most children of an unmarried mother live in an extended-family household, often with a grandparent. PMID- 3267542 TI - Changing mortality patterns that led life expectancy in Japan to surpass Sweden's: 1972-1982. AB - Between 1972 and 1982, Japan caught up to and then surpassed Sweden as the country with the longest life expectancy. The contributions of different causes of death and age groups to life expectancy changes in males during this time period are examined in detail for these two countries. Even though cerebrovascular disease mortality rates remained lower in Sweden over the entire interval, the rapid gain made by Japan relative to Sweden for this cause of death was a prime factor in Japan's ending the period with a higher life expectancy. Important contributions to life expectancy improvement in Japan came from declining mortality rates in those aged 55 and older. PMID- 3267541 TI - Infant mortality and socioeconomic development: evidence from Malaysian household data. AB - Household data from Malaysia are used to assess the roles of a number of mortality correlates in explaining the inverse relationship between the infant mortality rate (IMR) and socioeconomic development. Increases in mothers' education and improvements in water and sanitation are the most important household-level changes that accompany regional and temporal development and contribute to the inverse relationship between the IMR and development. One concomitant of development--reduced reduced breastfeeding--has kept the relationship from being even stronger. Continued prevalence of extended breastfeeding in the poorer states of Peninsular Malaysia and a narrowing of educational and sanitation differentials helped close the IMR gap between the richer and the poorer states. PMID- 3267543 TI - The current differential in black and white life expectancy. AB - The 1980 National Center for Health Statistics life tables for the U.S. black and white populations reveal a difference in life expectancy of 7 years between black and white males and 6 years between black and white females. Using cause substituted life tables, we show that a number of causes of death contribute to the difference. The largest contributors are cardiovascular disease for both sexes and homicide and cancer for males. PMID- 3267544 TI - Migration distances: an international comparison. AB - Comparing the level or amount of migration within different countries has been a longstanding problem because the local administrative areas commonly used as the basis for measuring migration vary greatly in size and significance within and between countries. Distance moved is a critical aspect of most concepts of migration, and measuring it would facilitate cross-national comparisons. Apparently only the United States, Great Britain, and Sweden have measured migration distances for the country as a whole, and this information is used as the basis for comparative analysis of spatial mobility. PMID- 3267545 TI - What are the economic consequences of divorce? AB - Our analysis suggests that Weitzman's finding concerning the precipitous decline in the economic status of women following divorce is likely to be incorrect. Her findings not only imply improbably large changes in income but are also inconsistent with the information she reports on changes in income and in income per capita. Corrected estimates suggest a decline in economic status of about one third, rather than the widely cited 73 percent figure. It remains the case that the economic status of men and women diverge substantially in the years after divorce. That difference, however, is not nearly as dramatic as suggested by Weitzman's findings. PMID- 3267546 TI - [Pathologic anatomy of the teeth and the oral mucosa. 3]. PMID- 3267547 TI - [Adaptation of cemented and uncemented cast crowns]. PMID- 3267548 TI - [Cuneiform erosion: a common pathology of tooth crowns]. PMID- 3267549 TI - [Chemomechanical caries removal: the Caridex system]. PMID- 3267550 TI - ["Preclinical" exercise in endodontics with final clearing of the teeth]. PMID- 3267551 TI - [Endodontic statistics: analysis of 100 cases]. PMID- 3267552 TI - [Pathologic anatomy of the teeth and oral mucosa. 4]. PMID- 3267553 TI - [Periodontology and reconstructive dentistry. Operative technic]. PMID- 3267554 TI - [Pain-dysfunction syndrome of the TMJ. Clinical and statistical aspects]. PMID- 3267555 TI - [Ultrasound in endodontics. A proposed application]. PMID- 3267556 TI - [Possible contagion of the HTLV III virus and professional responsibility of the dentist]. PMID- 3267558 TI - [Neoplasms: odontoma, 6 clinical cases]. PMID- 3267557 TI - [Fosfomycin in ambulatory dental practice]. PMID- 3267559 TI - [Combined treatment of the impacted canine: the double arch technic]. PMID- 3267560 TI - [Interpretation of bite-wing radiographs in restorative dentistry]. PMID- 3267561 TI - [Clinical and microscopic study of a photopolymerizing composite]. PMID- 3267562 TI - [Osteoporosis of the jaws. Clinical and therapeutic considerations]. PMID- 3267563 TI - [Control of costs]. PMID- 3267564 TI - [The personal computer in the dental office. 2. Applications]. PMID- 3267565 TI - [Polishing and finishing of silver amalgam. 1]. PMID- 3267566 TI - [Rhinomanometry and orthodontics. Statistical analysis]. PMID- 3267567 TI - [Frenums: clinical aspects and surgical technic]. PMID- 3267568 TI - [Blood pressure screening]. PMID- 3267569 TI - Who's in charge here?! PMID- 3267570 TI - Child abuse--is dentistry doing its part to stop it? PMID- 3267571 TI - Office space-sharing and how it works. PMID- 3267572 TI - A computerless data base can monitor your practice. PMID- 3267573 TI - Staff incentive pay: yes or no in your practice? PMID- 3267574 TI - The pain doctors: the evolution of a pain practice. Interview by Drs John Herald and Michael P. Pecenka. PMID- 3267575 TI - How to approve your chances of getting a bank loan. PMID- 3267576 TI - Doctor's support. PMID- 3267577 TI - Inadequate analgesia. PMID- 3267578 TI - Medical problems with local analgesia. PMID- 3267579 TI - Intraligamentary injections. PMID- 3267580 TI - Aspiration during dental local anesthesia. PMID- 3267581 TI - Future possibilities with local anaesthesia. PMID- 3267582 TI - Management of the deep carious lesion. PMID- 3267583 TI - Paediatric oral medicine: 3. The teeth. PMID- 3267584 TI - Diagnosis and treatment of juvenile periodontitis. PMID- 3267585 TI - Management of a large pigmented lesion. PMID- 3267586 TI - Surgical/prosthetic problems of a large leaf fibroma. PMID- 3267587 TI - Partial dentures in the management of severe tooth wear. PMID- 3267589 TI - The sense of smell. PMID- 3267590 TI - Prosthetic and surgical care of the elderly radiotherapy patient: the GDP's role. PMID- 3267588 TI - Dental trauma: 1. General aspects of management, and trauma to the primary dentition. PMID- 3267591 TI - Neurilemmoma of the tongue. PMID- 3267592 TI - The dental care of the aged. PMID- 3267593 TI - Gerodontology: the problem? PMID- 3267594 TI - The role of anatomy in the initiation and spread of periodontal disease: 1. PMID- 3267595 TI - Paediatric oral medicine: 4. The gingiva. PMID- 3267596 TI - Slot retention: an alternative to pins in the large amalgam restoration. PMID- 3267597 TI - An integrated treatment approach to severe hypodontia. PMID- 3267598 TI - Dental soft polymers: plasticizer composite and leachability. PMID- 3267599 TI - Axial strengths of foil, all-ceramic and PFM molar crowns. PMID- 3267601 TI - Significance of filler content to properties of silicone impression materials. PMID- 3267600 TI - A comparison of denture base acrylic resins polymerised by microwave irradiation and by conventional water bath curing systems. PMID- 3267602 TI - Compressive strength comparison and crystal morphology of dental cements. PMID- 3267603 TI - Biophysical stress analysis of restored teeth: experimental strain measurement. PMID- 3267604 TI - Influence of tissue conditioners on the clinical deformation of maxillary complete dentures. PMID- 3267605 TI - [The problem of conscious sedation in dentistry from the judicial point of view]. PMID- 3267606 TI - [Judicial and medico-legal problems in the use of conscious sedation in dentistry]. PMID- 3267607 TI - [Doctrinal concepts and practice in the use of sedation machines in dentistry]. PMID- 3267608 TI - [General anesthesia in dentistry. Clinical indications and medico-legal implications]. PMID- 3267609 TI - [Shock in dentistry]. PMID- 3267611 TI - [Blood pressure and the incidence of hypertension in Cracow's elderly]. PMID- 3267610 TI - [Effect of cardiac glycosides on blood circulation and oxygen consumption of the stomach, intestines and pancreas]. PMID- 3267612 TI - [Disorders of cardiac rhythm and conduction in hypertension]. PMID- 3267613 TI - [Effect of kerosine hydrocarbons on the activity of microsomal monooxygenases in the rat liver]. PMID- 3267614 TI - [Evolution of the methods of general anesthesia in the surgical treatment of laryngeal cancer in the light of the data from the Otolaryngological Clinic, Cracow Medical Academy]. PMID- 3267615 TI - [Effect of hormonal dysfunction on the metabolism of high-energy phosphorus compounds in the myocardium]. PMID- 3267616 TI - Lymphatic vessels in the laryngeal mucosa--the glottis network. PMID- 3267617 TI - Variations of the sternocleidomastoid muscle in human fetuses. PMID- 3267618 TI - Descriptive and measurements study of the osseous labyrinth in adults. PMID- 3267619 TI - The cortical branches of the posterior cerebral artery in man. PMID- 3267621 TI - Estimation of fetal age on the basis of certain measurements and ossification of the sternum. PMID- 3267620 TI - Types of cortical branches of the posterior cerebral artery in man. PMID- 3267623 TI - Study of the composition of the liver during gestation in the rat. Influence of the hydrocortisone acetate. PMID- 3267624 TI - Correlation between Scharf-Bloom index and stromal modifications in the breast cancer. PMID- 3267622 TI - Typology of the renal pelvices in human fetuses. PMID- 3267625 TI - Ultrastructure of the adrenocortical cells in autotransplanted glands in rabbits. PMID- 3267626 TI - Morphological and molecular organization of the brain postsynaptic densities. PMID- 3267628 TI - Ultrastructure of the pineal gland in 3 months old pigs. PMID- 3267627 TI - The effect of estradiol on histological structure and ultrastructure of the pineal gland in sexually immature female pigs. PMID- 3267629 TI - The trigeminal ganglion in human embryos at stage 16th and 17th (6th week). Light microscopic study. PMID- 3267630 TI - Study of the carotid body in the cat with special reference to its innervation. I. Light microscopy. PMID- 3267631 TI - Sources of autonomic and afferent fibers to the uterine cervix in pig. PMID- 3267633 TI - Sources of the autonomic and afferent fibers to the clitoris in pig. PMID- 3267632 TI - Sources of the autonomic and afferent fibers to the horns and body of the uterus in pig. PMID- 3267634 TI - Lymphatic net in the mucosa of the trachea and infraglottic area. PMID- 3267635 TI - Changes in the lymphatic vessels network of the larynx caused by atrophy and hypertrophy of mucosa. PMID- 3267636 TI - [Preparation using Cool-Diamant burs of Prof. Buchs]. PMID- 3267638 TI - A simple and inexpensive external fixator. AB - A simple and inexpensive external fixator has been designed. It is constructed of galvanized iron pipe and mild steel bolts and nuts. It can easily be manufactured in a hospital workshop with a minimum of tools. PMID- 3267637 TI - Injuries in attempted suicide by jumping from a height. AB - This study was undertaken to investigate the pattern of injuries and the management of 28 patients who attempted suicide by jumping from a height. Most of the patients had serious psychiatric disorders. All but two of the patients sustained multiple injuries. The most common injury patterns were fractures of the spine and lower extremities. It was concluded that, in addition to urgent orthopaedic and surgical care, early psychiatric assessment and therapy with transfer to a psychiatric department as soon as possible facilitates the recovery and rehabilitation of these patients. PMID- 3267639 TI - Morbidity following isolated fractures of the sacrum. AB - There is little information in the orthopaedic literature on the long-term results following isolated fractures of the sacrum. The present study traced patients with these fractures, and attempted to identify the incidence of long term symptoms. The study revealed that isolated fractures of the sacrum are not always benign, and may result in chronic discomfort (sacrodynia) or persistent neurological symptoms. PMID- 3267640 TI - Fracture of the penis and the result of surgical management. AB - Twenty-nine patients with fracture of the penis were treated between January 1983 and January 1987. The mean age was 26 years (range 18-61 years) and 25 of them (86.2 per cent) were single. The first four patients were managed conservatively with bad results in three cases. Immediate exploration with repair of the tear of the tunica albuginea was carried out in 25 patients, who all had excellent results with retained potency and only mild pain during early intercourse that disappeared within the first 4 months. Urethral injury in association with fracture of the penis was not seen in this series. In view of the good results we recommend immediate surgical repair in cases of fracture of the penis. PMID- 3267641 TI - An analysis of civil aircrash statistics 1977-86 for the purposes of planning disaster exercises. AB - Details of 473 aircrashes throughout the world for the period 1977-1986 were obtained from the Civil Aviation Authority. 114 occurred on or near and 359 away from airfields. In 188 there were survivors and in 285 none. On or near airfields it was more common to have survivors, and away from airfields more common to have none, yet crashes with survivors were more common away from airfields. In ten years there were only 3 crashes with more than 50 seriously injured live casualties. Acted out disaster exercises with mock casualties should not have more than 50 injured casualties, of whom not more than 20 should have serious injuries (i.e. need admission to hospital). The problems of crashes with much larger casualty figures should be worked through in table-top exercises. PMID- 3267642 TI - 99mTc-SN-pyrophosphate scintigraphy following traumatic posterior dislocation of the hip. AB - Avascular necrosis of the head of the femur is a serious complication of traumatic dislocation of the hip joint; therefore 99mTc-SN-pyrophosphate scintigraphy was carried out 10 to 14 weeks (average 12 weeks) after the injury on 12 patients to determine whether it was possible to demonstrate reduced or no activity of the head of the femur before development of radiological avascular necrosis of the head of the femur. Increased activity was observed in 9 of 11 hips with fracture-dislocation of the head of the femur, acetabulum or both, and normal activity was demonstrated in the contralateral hip of all patients. During the follow-up period avascular necrosis of the head of the femur developed in four hips from 6 to 20 months after the accident. It is concluded that 99mTc-SN pyrophosphate scintigraphy 12 weeks after traumatic dislocation of the hip was unable to identify hips at risk of later development of avascular necrosis of the head of the femur. PMID- 3267643 TI - 'Whiplash injuries' of the neck: a retrospective study. AB - This is a retrospective study of 102 patients with whiplash injuries of the neck followed up at approximately 2 years. The results show that 67 patients were asymptomatic by this time and the remaining 35 patients still exhibited symptoms. Prognostic indicators were found to be age, occipital headaches, referred symptoms, interscapular pain, abnormal neurological signs, positive radiological findings and osteoarthritic changes of the cervical spine. Symptoms that persisted for more than 2 months indicated prolonged disability. PMID- 3267644 TI - Long-term follow-up of six patients with acute spinal injury following dural decompression. AB - We report six cases of spinal injury in which there was bony encroachment on the spinal cord. At the time of decompression the dura was noted to be tense and non pulsatile. This method of anterior decompression of burst fractures of the spine suggests that bony decompression of the spinal canal associated with durotomy released the spinal epidural veins which had become congested and had inhibited the free flow of CSF, and we believe also had decreased arteriolar inflow to the cord. Full neurological recovery occurred in three of the six neurologically impaired patients and partial recovery in the remaining three. We believe that a dural decompression may be of some use in preventing a 'compartment syndrome' of the spinal cord. Further animal studies are recommended before the procedure is used routinely. PMID- 3267646 TI - Isolated dislocation of the scaphoid. PMID- 3267645 TI - Ulnar artery aneurysms after injury mimicking acute infection in the hand. AB - Two cases of ulnar artery aneurysm, with concomitant ulnar nerve compression in the palm are presented. Both followed acute injury and presented with an increasingly painful, warm swelling within 2 weeks of injury. An initial diagnosis of infection was made by experienced clinicians in each case. Ulnar artery aneurysm may be wrongly diagnosed as acute infection. It is suggested that simple excision of the aneurysm and ligation of the ulnar artery is the treatment of choice. Angiography should be reserved for those cases where there is doubt about the diagnosis or adequacy of the collateral circulation. Ulnar nerve deficit may be a result of direct injury rather than a neuropraxia from compression by the aneurysm. PMID- 3267647 TI - Reliability of physical examination in penetrating chest injuries. AB - The decision to insert an intercostal drain in chest injury must occasionally be made without a chest radiograph. A prospective analysis of the reliability of physical examination in penetrating pleural injuries was undertaken. A total of 51 consecutive patients were examined before obtaining a chest radiograph. The presumptive diagnosis and decision to institute intercostal drainage were compared with the radiological diagnosis and the actual decision in each patient. A policy of selective drainage of large pleural collections was employed. The series consisted mainly of stab injuries in young men. Physical examination accurately diagnosed 13 of the 14 large pneumo- or haemothoraces. This reliability combined with the selective drainage policy showed that physical examination accurately predicted the need for tube thoracostomy with a sensitivity of 96 per cent and a specificity of 93 per cent. This study suggests that experienced clinicians should not hesitate to institute immediate life saving intercostal drainage when needed, before a chest radiograph is obtained. PMID- 3267648 TI - Fractures of the distal femur: the role of the Zickel supracondylar fixation device. AB - Supracondylar fractures of the femur are often difficult to manage, especially in the elderly whose osteoporotic bone renders internal fixation tenuous. The Zickel supracondylar device provides a dynamic, medullary fracture fixation secure enough to allow unsupported early mobilization even in the elderly. The device can be inserted through small incisions, minimizing surgical injury. Interlocking screws prevent shortening and rotation and allow its use even in comminuted fractures. In 16 patients with non-pathological fractures, follow-up was possible on 14. There were 7 excellent, 5 satisfactory and 2 unsatisfactory results. There were no failures. Follow-up ranged from 6 months to 2 years. The device also proved effective in four patients with pathological fractures, the closed insertion allowing the benefit of early radiotherapy. This small but varied series shows the value of the Zickel supracondylar device in this difficult fracture. PMID- 3267649 TI - The AO tubular external fixator in the treatment of open fractures and infected non-unions of the shaft of the femur. AB - A series of 14 cases of open fractures of the shaft of the femur and another group of 13 cases of infected non-union of the shaft of the femur are reported. They were treated with the AO tubular external fixator. The complications and results are assessed and it is concluded that the AO external fixator system has a valuable part to play in these difficult cases. PMID- 3267650 TI - Intertrochanteric fractures of the femur: a prospective study comparing the use of the Kuntscher-Y nail and a sliding hip screw. AB - This prospective randomized study has compared the use of the Kuntscher-Y nail and a sliding hip screw in the treatment of intertrochanteric fractures of the femur. For patients whose general health was good, the use of the sliding hip screw was associated with a significantly lower 1-year mortality rate. The use of the sliding screw also resulted in a higher proportion of 1-year survivors regaining their prefracture level of mobility. There was no difference in the rates of cutting-out of the two implants but use of the Kuntscher-Y nail was associated with a greater incidence of shortening. PMID- 3267651 TI - Clinical diagnosis of ruptures of the anterior cruciate ligament: a comparison between the Lachman test and the anterior drawer sign. AB - A comparative study of the diagnostic accuracy between the Lachman test and the anterior drawer test was performed by examining 144 knees with ruptured anterior cruciate ligaments. The diagnosis of anterior cruciate ligament rupture is often difficult to establish, especially in recent injuries with acute haemarthrosis. The diagnostic accuracy of the Lachman test in recent ruptures when the patient is examined without general anaesthetic is superior to that of the anterior drawer test, while in chronic cases with third-degree instability the two tests are equally reliable. PMID- 3267652 TI - Meniscal injuries associated with rupture of the anterior cruciate ligament: a retrospective study. AB - The purpose of this study was to demonstrate the extent of meniscal involvement when the anterior cruciate ligament is torn. Data from 189 cases operated on for lesions of the anterior cruciate ligament form the basis of this report. The patients chosen for this study were all athletes forming two main groups. In one group, 82 patients were operated on immediately after their initial injury and in the other group 107 patients came for treatment because of persistent symptoms. It was recorded in the case notes whether there were any articular cartilage changes found at operation. Meniscal involvement was noted in 24.4 per cent of the patients of the first group. In particular, the meniscus was found to be torn in 20.6 per cent of the so-called 'isolated' tears and in 27.1 per cent of the combined cruciate injuries. No articular cartilage changes were noted in this group. In the second group meniscal injuries were seen in 61.6 per cent of the cases. More specifically, the menisci were involved in 26.7 per cent of the knees with first-degree instability, in 57.5 per cent with second-degree, rising to 75 per cent in knees with third-degree instability. Articular cartilage changes were seen in 20 per cent, 67.5 per cent and 78.8 per cent respectively. There is ample evidence in our study of the progressive meniscal involvement and degeneration in the knee of the athletically active individual after an anterior cruciate ligament rupture. PMID- 3267653 TI - Internal stabilization after external fixation of fractures of the shaft of the tibia: sense or nonsense? AB - A series of 95 patients with fresh fractures of the shaft of the tibia, treated primarily with a Vidal-Adrey transfixation frame, was studied retrospectively. Only 20 fractures (21.0 per cent) attained clinical and radiological consolidation within 4 months after injury. Pseudoarthrosis was seen in 12 patients (12.9 per cent). The external fixator was attached for an average time of 25.0 weeks. Pin loosening was seen in seven patients (7.3 per cent), minor pin track infection in nine (9.4 per cent) and major pin track infection in three (3.1 per cent). In 31 patients (32.6 per cent) a second operative procedure was necessary to accelerate fracture healing. In 17 patients an autologous bone graft was carried out with the external fixator in place. Internal stabilization was performed after removal of the external fixator frame in 14 cases, at an average time of 9.4 months after injury. In difficult fractures we feel that change from external to internal fixation should be performed earlier; it makes early removal of the fixator pins possible and prevents the problems associated with prolonged use of fixator frames. The internal fixation, eventually combined with a transplantation of cancellous autografts, creates a mechanical and biological stimulus for bone consolidation. Functional recovery may also be improved because of a shorter healing time. PMID- 3267655 TI - Anatomy of the 'venous foot pump'. AB - The gross anatomy of the deep plantar veins has been examined in 14 cadaveric feet in order to assess their function as a 'venous foot pump'. The lateral plantar vein was found to be larger than the medial and is double in its proximal segment. Both plantar veins contain valves which face proximally and have a convoluted and intermuscular course. These features suggest that the deep plantar veins act as a pump that empties during contraction of the intrinsic foot muscles during the stance phase of gait. PMID- 3267654 TI - Peritalar dislocation: a follow-up report of 21 cases. AB - A total of 21 patients with peritalar dislocation, treated during the last 15 years in our hospital are reviewed. Of these, 18 had medial and 3 lateral dislocations. At follow-up, 10 patients with medial dislocation experienced either occasional pain due to the limitation of subtalar movements, or chronic pain due to severe osteoporosis of the hindfoot. All these patients with lateral dislocation had severe chronic pain, which was alleviated by subtalar arthrodesis in two of them. It is concluded that peritalar dislocation produces varying degrees of disability in the majority of patients with medial dislocation and serious disability in all patients with lateral dislocation. This is due to the severity of the soft tissue damage and the prolonged immobilization of the foot without bearing weight. It is essential to mobilize the foot as soon as possible after the injury. PMID- 3267656 TI - An unusual weightlifting injury. PMID- 3267657 TI - Irreducible dislocation of the subtalar joint: a report of two cases. AB - Two patients with irreducible lateral dislocation of the subtalar joint are reported. In both patients the injury was closed and associated with a lateral calcaneal fracture. Open reduction confirmed the tendon of tibialis posterior was located around the lateral aspect of the neck of the talus and prevented reduction. PMID- 3267658 TI - Acute bowel entrapment between two lumbar vertebrae. PMID- 3267659 TI - Fracture-dislocation of the first thoracic on the second thoracic vertebrae in a schoolboy. PMID- 3267660 TI - The use of Zickel supracondylar nails in the presence of a cemented hip prosthesis. AB - Zickel supracondylar nails are a useful method of treating fractures of the distal third of the femur. A case is reported to show their use is not precluded by the presence of a cemented hip prosthesis. PMID- 3267662 TI - [Orthodontics in orofacial region with help of function regulators]. PMID- 3267661 TI - Salter-Harris type III fracture of the proximal humeral physis. AB - Salter-Harris type III, IV and V injuries of the proximal humeral physis are rare. We report an undisplaced Salter-Harris type III injury of the humeral head physis in a 10-year-old girl. The fracture united with non-operative treatment. PMID- 3267663 TI - [Osteosynthesis in orthodontic surgery using screws and mini-plates]. PMID- 3267664 TI - [Time factors in functional treatment of skeletal Class II]. PMID- 3267665 TI - [A new method to stop fingersucking]. PMID- 3267666 TI - An in vitro study of factors contributing to the blandness of zinc oxide-eugenol preparations in vivo. PMID- 3267667 TI - Morphological and radiographic study of the apical foramen in distal roots of mandibular molars. Part I. The location of the apical foramen on various root aspects. PMID- 3267668 TI - Morphological and radiographic study of the apical foramen in distal roots of mandibular molars. Part II. The distance between the foramen and the root end. PMID- 3267669 TI - The root canal anatomy of mandibular incisors in a southern Chinese population. PMID- 3267670 TI - Central giant cell granuloma associated with a non-vital tooth: a case report. PMID- 3267671 TI - Prospects and challenges of educating deaf pupils in Nigeria: teachers' perceptions. AB - Structured interviews with 40 teachers of deaf primary school pupils and a matched control group of 40 other teachers examined their respective perceptions of the problems and prospects of educating deaf pupils in Nigeria. The greatest challenge identified by the teachers was society's weak acceptance of the legitimacy of deaf education and the greatest prospect was the high achievement motivation of deaf pupils. PMID- 3267672 TI - A positive approach to the treatment of aggressive brain injured clients. AB - A broad spectrum behavior therapy approach was used to treat physical aggression in five brain injured clients. The approach employed high density reinforcement, reinforcer sampling, environmental control, selection of appropriate responses, inconvenience review, self-control training and self-monitoring. All five clients showed significant decreases in aggression immediately after the implementation of the program. PMID- 3267673 TI - Modern technology in the rehabilitation process. AB - Modern technology gives a variety of new opportunities for severely disabled persons. It is time to start a serious discussion about how these new opportunities can be incorporated in rehabilitation theory and practice. In this article we show how modern technology may support independent life for the severely disabled. And we also discuss how modern technology can be used to change the environment. Removal and prevention of environmental barriers for participation is one main practical rehabilitation method. Modern technology therefore must also be evaluated by its environmental consequences. One important question is: How can modern technology open up more areas of normal participation for the disabled? The research approach is fieldwork, interviews with disabled persons, co-operation with organizations inventing and producing new products, as well as participation in social analysis and environmental change. Two conclusions to date are: (1) There is a wide gap between new technical possibilities and the real life situation of most people with severe disabilities; (2) Modern technology used as aids for people with severe disabilities has a rehabilitative effect only if it is supported by a sufficient social system for transport, security and care. PMID- 3267674 TI - Relative importance of after-effects, environment and socio-economic factors on the social integration of stroke victims. AB - This research is about the social integration of victims of a cerebrovascular accident. The objective is to evaluate the relative importance of physical after effects, socio-economic characteristics, social and environmental factors on the degree of social integration subsequently achieved. This is a longitudinal evaluation with three data collections from an initial sample of 129 persons from the Quebec City area, Canada. Individual functional autonomy increases significantly while in institution and during the six months following discharge. At the time of discharge, 72.9% return to a normal home. A regression analysis shows that the determining factors relating to homecoming are motor functions and autonomy, personal perception of health conditions, proximity of children and relatives, relatively low age, regular presence of another person in the home, and proximity of friends. An important decrease in the practice of many activities occurs six months after homecoming: paid work, housework, management of personal affairs, and leisure activities. Absence of serious motor and language after-effects, a high level of perceived health condition, accessible facilities, proximity of relatives, and the ownership of a car are the factors most strongly associated with continued practice of these activities. Social contacts are more frequent than for comparable populations as far as children and relatives are concerned, but they are less frequent with friends. Proximity is a key factor. A quarter of the sample experiences problems relating to psychological well-being. PMID- 3267675 TI - The concept of normalisation as a principle of educational theory and practice. AB - Throughout the world, it is increasingly recognised that efforts should be made to ensure that young children with mental handicap (mental retardation) receive their education in integrated settings. This article reviews the obstacles to be overcome in implementing this principle of "normalization", and what parents, professionals, and society and its institutions might be called upon to do if it is to be achieved in practice. It concludes by presenting ten guidelines for future development of policy and practice, based on reports and studies conducted in different parts of the world. The successful introduction of integrated provision in some places provides models for its wider implementation. It is also a source of encouragement for those who have yet to achieve this objective. PMID- 3267676 TI - An analysis of the survival rate of total-condylar total knee prostheses with posterior stability. AB - Survival rate tables are an adequate and relatively new means of evaluating prostheses of the knee. These tables may be used to make a clear distinction between success and failure. In a study of 160 prostheses followed-up over a period of 9 years, a Total-Condylar knee prosthesis with posterior stability has a 90% probability of surviving for the entire period, based on mechanical and radiological failures, and a 96% probability based on failures that required its removal. The probability of mechanical or radiological failure is 1% per annum. PMID- 3267677 TI - The personalized hip prosthesis. AB - The authors discuss the general concept, method of use and first clinical results obtained with a "personalized" femoral component of a hip arthroprosthesis based on the computer-graphic processing of measurements obtained from radiography and CT scan. This prosthesis is considered to be innovative as compared to traditional cementless prostheses. PMID- 3267678 TI - Isoelastic shoulder prostheses. Considerations on use and results. AB - The principles underlying the use of isoelastic shoulder prostheses are discussed and the results obtained in 8 patients are reported. Two operations were for pseudarthrosis of the humeral neck and 6 for osteolytic neoplasms. The results were assessed after an average follow-up of 4 years. Full movement was never recovered; there was partial recovery in 6 cases, and no significant recovery in 2. The extent of the surgical resection was determined by the type of lesion; in more conservative resections which allowed for the reconstruction of tendinous insertions, the functional results were better than in wide resections. The difficulty of recovering good movement was related to the limited possibilities of reconstructing the insertions of the external rotator muscles. PMID- 3267679 TI - Percutaneous lumbar nuclectomy according to the Onik method: indications, technique, first results. AB - The authors report their first experience with 20 cases of lumbar herniated disc treated by percutaneous nuclectomy according to the Onik method. The methods used for a precise preliminary assessment of the prolapse in order to establish correct indications are discussed. The technique of the operation is then described. The simplicity and relative absence of trauma in this type of surgery, associated with the patient's rapid recovery, drastically reduces hospitalization time, with consequent social and economic advantages. The clinical results at follow-up are sufficiently rewarding to suggest a wider use of this method, but it is essential to restrict it to the indications laid down, which are fully illustrated. The method is applicable only to contained hernias and is contra indicated in extruded hernias. PMID- 3267680 TI - Fractures of the humerus associated with paralysis of the radial nerve. AB - Forty-two cases of fracture of the humerus associated with paralysis of the radial nerve and treated over a period of 30 years were analysed. There was predilection for the mid-distal third, followed by the mid third and the supracondylar segment. Paralysis was complete in 39 cases and partial in 3. Treatment was conservative in 14 cases, early surgical in 18 (within 30 days), and late surgical in 10 (mean 4.7 months). The latter group involved cases where conservative treatment had not achieved recovery of neural function. Of the fractures treated conservatively, the diaphyseal fractures were slightly or moderately displaced, while supracondylar fractures were very displaced. Most of the fractures treated surgically were moderately or considerably displaced. Neurological recovery was satisfactory in 86% of the cases treated conservatively, in all those operated early, and in 50% of those operated late. The choice of treatment as between conservative or surgical must be on an individual basis, depending on the site and degree of displacement of the fracture, the extent of any exposure, and the degree of neurological deficit. PMID- 3267681 TI - Osteosynthesis of fractures of the upper end of the radius. AB - Osteosynthesis of fractures of the head of the radius is regarded with disfavour by many ortophaedic surgeons, who prefer excision of the fractured head. However, osteosynthesis is capable of producing excellent results, as long as the correct indications are observed and it is carried out with minimal trauma, and by simple, small methods of synthesis. The authors report 13 cases treated by this method. PMID- 3267682 TI - The locked Grosse-Kempf intramedullary nail in the treatment of diaphyseal and metaphyseal fractures of the femur and tibia. AB - The Gross-Kempf locked intramedullary nail widens the indications for the traditional Kuntscher nail in the treatment of diaphyseal and metaphyseal fractures of the lower limbs. The study includes 87 patients with a total of 93 closed fractures treated between 1981 and 1987. Osteosynthesis was carried out in 85 closed fractures and in 8 Grade 1 or 2 open fractures. Possible assemblies in relation to the level and type of fracture and the protocol for weightbearing are illustrated, with emphasis on the fact that dynamization of static assemblies is not always essential. The high percentage of positive results (86%) and the relatively small incidence of complications confirm the validity of this method. The only drawback is the fairly high dose of radiation absorbed by the surgeon during the operation. PMID- 3267683 TI - The Ilizarov apparatus in the treatment of congenital dysmetria of the leg. AB - The effectiveness of the treatment of congenital leg length discrepancy depends on careful evaluation and selection before embarking on a programme of treatment. Over the years several types of surgery have been used to correct leg length discrepancy, starting with Codivilla (1905), who performed osteotomy followed by gradual transcalcaneal traction. This was succeeded by external fixators of various kinds. Unknown to most of the Western world, the Russian surgeon Ilizarov devised in 1950 an external fixation device which because of its mechanical and biological features could be applied to many orthopaedic and traumatological conditions. Since 1983 we have used this for the treatment of congenital dysmetria of the lower limbs resulting in leg length discrepancy. PMID- 3267684 TI - Cystic degeneration of the lateral meniscus. Pathogenesis and diagnostic approach. AB - Twelve patients with cystic degeneration of the lateral meniscus were submitted to magnetic resonance and arthroscopy. This study showed that mixoid degeneration is produced initially within the meniscal substance and subsequently progresses towards and may rupture through the outer margin, so producing the clinically detectable cyst on the outer margin of the joint. In the light of the information obtained from magnetic resonance and subsequent surgical verification, existing hypotheses regarding the pathogenesis and evolution of the lesion have been re examined. PMID- 3267685 TI - Peri-pyramidal semilunar dislocation of the carpus. AB - Peri-pyramidal semilunar dislocation of the carpus is a very rare variety of perilunar dislocation. For this reason, the authors present a case of open peri pyramidal semilunar dislocation, discuss the aetiopathogenetic mechanism involved, and report the excellent result obtained with reduction and immobilisation in plaster for six weeks. PMID- 3267686 TI - The early diagnosis of idiopathic femoral osteonecrosis. AB - Idiopathic osteonecrosis of the femoral head presents many problems of diagnosis and treatment during the early stages of the disease due to the paucity of clinical manifestations and the absence of radiographic evidence. By the time that the radiographic and clinical evidence are sufficient for a reliable diagnosis, the disease is so advanced that treatment is a problem. Early diagnosis is therefore the key issue and, in this context, instrumental tests, CT scanning and the measurement of blood flow velocity play an ever-increasing role. In the early stages of the disease CT scanning shows characteristic changes in the socalled "asterisk sign" of Dihlmann, and this has proved useful not only in terms of diagnosis, but also in order to initiate early treatment of the disease. Although radioisotope methods with double tracer do not allow for direct visualisation of the circulation in the femoral head, they have proved to be extremely reliable in evaluating the perfusion index of the femoral heads by providing activity/time curves which are a reliable estimate of regional blood flow. PMID- 3267687 TI - Osteoid osteoma of the body of the first sacral vertebra. Case report. AB - A rare case of osteoid osteoma localised in the anterior aspect of the first sacral vertebra is described. Scintigraphy and CT scan are essential for a correct diagnosis in this condition. Because of the site of the lesion, surgery was performed by an anterior transperitoneal approach. PMID- 3267688 TI - A case of isolated paralysis of serratus anterior. AB - The authors present a case of isolated paralysis of the serratus anterior due to compression of the long thoracic nerve by a cervical rib. The clinical and diagnostic features are described. Removal of the vertical rib resulted in complete functional recovery of the muscle involved. PMID- 3267689 TI - Bifocal instability of the cervical spine. Case report. AB - The authors report a case of bifocal instability of the cervical spine (C2-C3) emphasizing the rarity of the lesion, particularly as the instability at C4-C5 became evident a few months after the first operation involving surgical reduction and stabilisation at C2-C3 with a metal loop. PMID- 3267690 TI - Perspectives on dental health, Part III: 1988 Hawaii State Department of Health- dental practice surgery. PMID- 3267692 TI - Resection of ameloblastoma and reconstruction of mandible: a case report. PMID- 3267691 TI - Incidence of root caries in older adults. PMID- 3267693 TI - Macrophage plasma membrane receptors: structure and function. Proceedings of a meeting. Oxford, March 1987. PMID- 3267694 TI - Dynamic changes in viscoelastic properties in cytotoxic T-lymphocyte-mediated killing. AB - The biophysical properties of cytotoxic T lymphocytes during the killing of their target cells was investigated by using a human cytotoxic T lymphocyte clone, F1, and the target cell, JY, for which it is specific. In single cytotoxic cell/target cell pairs after their conjugation there are changes in the viscoelastic properties of the target cell in association with the lethal hit delivery and post-binding cytolytic steps. On the basis of these changes in the target cell, the complex cytolytic event can be divided into stages: the viscoelastic coefficients exhibited an initial increase followed by a return to resting values; thereafter these coefficients decreased below control and then rose again prior to lysis. The eventual killing of the target cell involves bubbling and swelling of the nucleus, clustering of granules, damage to the cytoplasmic membrane, cell swelling, and lysis. The viscoelastic changes involved in target cell death suggest the loss of integrity of its cytoskeletal apparatus. PMID- 3267696 TI - Effects of synthetic polycations on leucine incorporation, lactate dehydrogenase release, and morphology of human umbilical vein endothelial cells. AB - Naturally occurring cationic proteins secreted by human granulocytes have pro inflammatory effects including induction of increased vascular permeability and oedema, which are likely to be mediated by damage to vascular endothelium. Synthetic cationic polyamino acids have been shown to exert similar inflammatory effects in vivo. We have therefore used a range of synthetic polycationic amino acids to investigate the characteristics required to cause endothelial cell damage, assessed by in vitro inhibition of leucine incorporation into macromolecules by human umbilical vein endothelial cells (HUVEC) in culture. Exposure of HUVEC to 20 nM-2 microM cationic polypeptides of similar Mr(av) (approximately 40,000) in the presence of 20% serum produced a dose-dependent inhibition of [3H]leucine incorporation by polymers of ornithine, arginine or lysine. Similar results were obtained using [3H]thymidine. Neutral or anionic polypeptides of similar Mr were without effect. The molar potency of polylysines increased over the range Mr 40,000-120,000, while polylysines of Mr(av) less than 25,000 had no effect. In the absence of serum, inhibition occurred more rapidly and at lower doses. Inhibition of leucine and thymidine incorporation was time dependent, e.g. exposure to 800 nM-polylysine, Mr(av) 90,000, led to progressively increasing inhibition that was complete after 24 h exposure, and was irreversible. The effects of polycations could not be blocked by pretreatment of the cells with polyanions. Precoating of the culture surface with polylysines had no effect on leucine incorporation by HUVEC or their subsequent response to polylysines in solution. Exposure to the peptide Arg-Gly-Asp-Ser inhibited incorporation by 30% but did not increase susceptibility to polylysine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267695 TI - Expression pattern of two related cystic fibrosis-associated calcium-binding proteins in normal and abnormal tissues. AB - This paper reports further study of the identity and function of a protein shown to be elevated in serum from cystic fibrosis (CF) patients and clinically normal heterozygotes. Monoclonal antibodies, specifically recognizing the tentatively named cystic fibrosis antigen (CFAg), were produced. Immunoaffinity purification of CFAg from several sources revealed two components: 11 x 10(3) and 14 x 10(3) Mr protein. cDNA clones corresponding to each protein have been isolated. Data base comparisons of the deduced amino acid sequences suggest that both genes encode related but distinct calcium-binding proteins. We propose the name calgranulin A and B, for the 11 x 10(3) and 14 x 10(3) Mr components, respectively. It is clear from the assignment of the calgranulin genes to chromosome 1 that neither is the product of the mutant CF gene, which maps to chromosome 7. We have used the monoclonal antibodies to study the tissue distribution of the two proteins in a wide-ranging immunohistological survey. Where possible the pattern of expression was confirmed by RNA blot analysis. Strong calgranulin expression in granulocytes was confirmed. In addition to myeloid cells, a restricted subset of normal stratified squamous epithelia were found to be calgranulin-positive. These included tongue, oesophagus and buccal cells, the last of which has been shown to have altered calmodulin activity in CF patients. Using indirect alkaline phosphatase staining, tissue sections of lung, pancreas and skin (normally considered sites where the CF defect is expressed) were not calgranulin-positive. However, by indirect immunofluorescence, nasal polyp sections showed weak patchy calgranulin expression in some epithelial cells, and stronger, higher frequency expression when such cells were briefly cultured.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267697 TI - The response of haemopoietic cells to growth factors: developmental implications of synergistic interactions. AB - Haemopoietic cell growth factors are normally assayed using unfractionated marrow cells (NBM). However, using this population it is difficult to distinguish between direct versus indirect effects, because of the low incidence of colony forming cells (CFC) and the presence of possible accessory cells (which may themselves be acted upon by the growth factors and stimulated to produce other growth stimulatory or inhibitory molecules that influence the development of the CFC). Furthermore, NBM contain the whole spectrum of multipotent and lineage restricted CFC and it is often difficult to determine precisely which populations are being stimulated to develop. This latter problem can be solved, in part, by using marrow from mice previously treated with 5-fluorouracil (5-FU): an agent that preferentially kills the more mature, actively cycling CFC but spares the proliferatively quiescent multipotent stem cells. Since the 5-FU-treated marrow also contains many possible accessory cells, however, it is again not clear whether or not the responses elicited by growth factors are due to direct or indirect effects upon the CFC. To circumvent this problem we have obtained a highly enriched population of multipotent stem cells (FACS-BM) that is free of accessory cells, and have compared the responses of these cells to NBM and to 5 FU-BM in the presence of a variety of growth factors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267698 TI - 'Blebbing' of the nuclear envelope of mouse zygotes, early embryos and hybrid cells. AB - In the mouse zygote and in two-cell stage embryos the inner leaflet of the nuclear envelope of pronuclei and that of blastomere and polar body II nuclei evaginate, forming multiple blebs within the perinuclear space, which contains a granular material. Blebbing exists only in oocytes activated by sperm in vivo or in vitro, or parthenogenetically by treatment with ethanol or puromycin. The germinal vesicle and an interphase nucleus formed after treatment of the oocyte at metaphase I by puromycin do not form blebs. Formation of blebs is specifically located in the cell cycle. The burst of the blebbing activity occurs during the first half of the cell cycle in one-cell embryos and in the earliest interphase period in the second cell cycle. Blebbing ceases from the beginning of the third cell cycle. The occurrence in the cytoplasm of 'double-layered' vesicles containing granular material resembling bleb contents and the disappearance of blebs from the nuclear envelope by the end of the cell cycle provide evidence that blebs represent a step in the transport of some material from the nucleus to the cytoplasm. Ethanolic phosphotungstic acid does not stain blebs, suggesting the absence of basic protein in their contents. Blebbing can be induced in somatic (thymocyte) and embryonic (blastomere of 8-cell stage embryo) nuclei following cell hybridization with activated oocytes. Their response to the oocyte cytoplasm by initiating blebbing depends on: (1) the position of the host cell in its cell cycle at the moment of hybridization, and (2) the time spent by the foreign nuclei in the host cytoplasm following cell fusion. If donor nuclei are introduced close to the time of activation, they start to produce blebs at the time corresponding to the initiation of blebbing by the female pronucleus in the first cell cycle. If foreign nuclei are introduced a few hours after activation they must be incubated in the host cytoplasm for some time before initiation of bleb formation, provided that the host pronucleus has initiated blebbing by that time. The existence of blebbing in nuclei formed only after oocyte activation, and the timing and the general occurrence of this event during the earliest cleavage stages of almost every mammalian embryo, suggest that this special nucleocytoplasmic transport plays a specific role at the beginning of development. PMID- 3267699 TI - Cell adhesion to hydroxyl groups of a monolayer film. AB - We have studied cells on chemically defined monomolecular films of the long-chain alcohol docosanol. Langmuir-Blodgett films of the alcohol were deposited on glass coverslips, previously made hydrophobic with octadecyl groups. This gives films in which the alcohol headgroups face outwards to the water. Molecular orientation and film integrity were shown by a fluorescence adsorption test. Cell contacts on the films were observed in media without proteins by interference reflection microscopy (IRM) and the mechanics of detachment were examined by hydrodynamic shearing in a flow chamber. Cell contact with docosanol was compared with that on an adjacent area of octadecyl glass without a monolayer. Dictyostelium amoebae settled and spread on both docosanol and octadecyl glass, but little or no locomotion was seen on docosanol. On octadecyl glass the amoebae moved actively, forming ultrathin cytoplasmic lamellae, which look dark under IRM, and left distinctive trails of membranous debris. Hydrodynamic shearing showed that the amoebae stuck strongly to both surfaces and could not be removed from either at the maximum attainable wall shear stress of 6Nm-2. Red blood cells also adhered to both surfaces and removal from both occurred between 1 and 3Nm-2. IRM and scanning electron microscopy (SEM) studies indicated that this force leads to a minimal measure of red cell adhesion, since removal often involved the breakage of cytoplasmic tethers. Our results show that alcoholic -OH groups, in a two dimensional array, provide a surface that is strongly adhesive for cells. No other method has made it possible to demonstrate cell adhesion purely to -OH groups, in a known orientation and density, and in the absence of any other functional groups on the interface. PMID- 3267700 TI - In vitro modulation of endothelial fenestrae: opposing effects of retinoic acid and transforming growth factor beta. AB - Cultured endothelial cells isolated from fenestrated capillaries express many properties characteristic of their in vivo differentiated phenotype, including the formation of a limited number of fenestrae. In this study, we have investigated whether physiological factors that control cell differentiation might regulate the surface density of fenestrae in capillary endothelial cells. We have found that treatment of the cultures with retinoic acid (10 microM) induces a more than threefold increase in the surface density of endothelial fenestrae, whereas transforming growth factor beta (TGF beta) (2 ng ml-1) causes a sevenfold decrease in the surface density of these structures. These results show that the expression of endothelial fenestrae is susceptible to bidirectional modulation by physiological signals, and suggest that retinoids and TGF beta may participate in the regulation of fenestral density of capillary endothelium in vivo. PMID- 3267701 TI - Orthodontic office design. Children's areas: an emerging trend. PMID- 3267702 TI - Clinical and instrumental functional analysis and treatment planning. Part 4. Instrumental analysis of mandibular casts using the mandibular position indicator. PMID- 3267704 TI - Computerized scheduling with a Grid-Loop System. PMID- 3267703 TI - Dr. Alex Jacobson on the challenges in orthodontic education today. Interview by Dr. Gottlieb. PMID- 3267705 TI - Buccal shield appliance for mandibular arch expansion. PMID- 3267706 TI - Practice building through effective chairside manner. PMID- 3267707 TI - Decline in children's caries reported. PMID- 3267708 TI - One dentist's finances. PMID- 3267709 TI - Differential diagnosis in dentistry. HIV associated gingivitis. PMID- 3267710 TI - [Perspectives in familial hypercholesterolemia: with particular reference to associated ischemic heart disease]. AB - Seventy heterozygous patients with familial hypercholesterolemia (FH), aged 3 to 91 years (37 men and 33 women), from 38 different families were studied to ascertain their clinical profiles including the pattern of distribution of total cholesterol (TC), Achilles tendon thickness (ATT), and a sex difference in age at the onset of ischemic heart disease (IHD). Eighteen family members who died of IHD were included in this study. The TC level was 332.2 +/- 95.0 mg/dl (mean +/- SD), and the ATT was 12.0 +/- 2.7 mm. IHD was observed in 20 men and 8 women, with an incidence in men 2.5 times higher than that in women. The mean age at the onset of IHD in men was in the sixth decade, one decade younger than in women. IHD was even observed in patients with TC levels of nearly 230 mg/dl. One of the 18 family members was considered a homozygote of the disease by autopsy findings. Twelve of the remaining members died suddenly, and another five had fatal myocardial infarction. We conclude that, (1) IHD is frequently associated with FH, even though TC levels are 230-300 mg/dl, (2) complications of IHD peak earlier in men (sixth decade) than in women (seventh decade) and (3) relatively large numbers of family members died suddenly, especially men. PMID- 3267711 TI - [Observations of dilated cardiomyopathy with marked clinical improvement]. AB - Although the prognosis of dilated cardiomyopathy (DCM) is poor, some patients occasionally follow favorable clinical courses and have significant improvement in cardiac function. To elucidate the mechanism of such improvement, we compared the clinical and pathological findings of 54 cases with DCM, including 12 cases with significant improvement (Dd less than 55 mm, %FS greater than 22%) during two years' follow-up (improved group), 26 without significant improvement (unimproved group), and 16 who died within two years (decreased group). Percent fractional shortening (%FS) in the deceased group was less than that in the unimproved group (12.4 +/- 3.9 vs 17.2 +/- 6.2, p less than 0.01). Pulmonary capillary pressure (PC) and % fibrosis in the deceased group were greater than those in the unimproved group [(22.7 +/- 9.5 vs 11.4 +/- 4.2 mmHg, p less than 0.001), (21.7 +/- 9.9 vs 13.4 +/- 3.6, p less than 0.01)], respectively. Although Dd, Ds, %FS, end-diastolic wall thickness (Thd), and PC in the improved group were not different from those in the unimproved group. End-systolic wall stress (WSes) in the improved group was greater than that in the unimproved group (376 +/- 73 vs 319 +/- 60 g/cm2, p less than 0.02), but % fibrosis was less in the improved group (7.6 +/- 3.4 vs 13.4 +/- 3.6, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267712 TI - [Left ventricular wall thickness in hypertrophic cardiomyopathy: comparisons of measurements by magnetic resonance imaging, cineangiography, and echocardiography]. AB - To evaluate the usefulness of magnetic resonance imaging (MRI) in measuring regional wall thickness of the left ventricle, 11 patients with hypertrophic cardiomyopathy (HCM) were imaged. The measurements were compared with those obtained by two-dimensional echocardiography (2D-echo) and cineangiography. Regional wall thickness was ascertained at six locations including the base, middle, and apex of the interventricular septum (IVS) and left ventricular posterior wall (LVPW) from the two selected transverse sections. All of these six locations were also measured for the IVS by biventriculography and for the LVPW by left ventriculography with the left anterior oblique view. Only the base was measured for both the IVS and LVPW using 2D-echo because of the difficulty in obtaining good images for the middle and apex of the left ventricle. The measurements by MRI correlated well with those obtained by 2D-echo and cineangiography in the majority of locations. At the base, where the wall thickness was measured by the three methods, the measurements of the IVS correlated well each other (r = 0.63 to 0.81). However, a good correlation was obtained only between 2D-echo and MRI for the LVPW r = 0.75. The correlation between MRI and cineangiography was generally good for the IVS at any levels (r = 0.76 to 0.87), but not for the LVPW. This was partially due to the narrow range of data for the LVPW as well as to the difficulty in determining the epicardial border in left ventriculograms. In conclusion, regional wall thickness can be correctly measured by MRI in any locations of the left ventricle even at the apex, where measurement is difficult by other methods. PMID- 3267713 TI - [Effect of hypertension on asymmetrical septal hypertrophy: an echocardiographic study]. AB - The effect of hypertension on asymmetrical septal hypertrophy was studied by echocardiography to differentiate idiopathic asymmetrical septal hypertrophy (ASH) from ASH with hypertension. One hundred eight patients with ASH proven by echocardiography were categorized in two groups; 53 patients with hypertension (greater than 160 systolic, greater than 95 diastolic) (hypertensive group: HT) and 55 patients with normal blood pressure (normotensive group: NT). Septal hypertrophy was classified as mid-portion (M-type), diffuse (D-type), and basal (B-type) hypertrophy by the long-axis view, and also diffuse (I-type), anterolateral (II-type), anteroseptal (III-type), and anterior septal (IV-type) by the short-axis view, respectively. Endomyocardial biopsy and left ventriculography were performed in 50 patients (18 hypertensives and 32 normotensives). In the hypertensive group, 45%, 30%, and 25% of cases had diffuse, basal and mid-portion hypertrophy, respectively. There was no case in the basal hypertrophy whose biopsy findings were compatible with hypertrophic cardiomyopathy. In the normotensive group, 78% and 22% of patients had midportion and diffuse hypertrophy, respectively, but none of them had the basal hypertrophy. Type IV was seen in only six patients in the normotensive group. PMID- 3267714 TI - [Left ventricular diastolic reserve during acute pressure loading in hypertrophic cardiomyopathy and dilated cardiomyopathy]. AB - To evaluate left ventricular diastolic reserve during acute pressure loading, changes in mitral flow velocity patterns before and after the elevation of blood pressure were analyzed by pulsed Doppler echocardiography in 11 cases of hypertrophic cardiomyopathy (HCM), nine cases of dilated cardiomyopathy (DCM), and 11 control subjects. Systolic blood pressure was elevated 25% above basal values by methoxamine infusion (0.01 mg/kg/min). Before and after methoxamine, left ventricular dimension and mitral flow velocity pattern were obtained by M mode and pulsed Doppler echocardiography, respectively. The peak velocity in the rapid filling and atrial contraction phases and time-velocity integrals were measured from the flow pattern. After methoxamine, left ventricular diastolic dimension was significantly increased in all groups, from 43.8 +/- 4.7 mm to 47.4 +/- 4.9 mm in the control subjects, from 43.7 +/- 6.3 mm to 47.2 +/- 6.0 mm in HCM, and from 57.9 +/- 6.4 mm to 60.6 +/- 5.9 mm in DCM. Left ventricular systolic dimension was significantly increased from 48.6 +/- 8.4 mm to 52.8 +/- 8.3 mm in DCM, but not in the control subjects or HCM. The peak velocity in the rapid filling phase was significantly increased from 60 +/- 16 cm/sec to 69 +/- 14 cm/sec in the control subjects and tended to be increased from 44 +/- 13 cm/sec to 52 +/- 12 cm/sec in HCM. The extent of this increase tended to be less in HCM. However, the peak velocity in the rapid filling phase tended to decrease in DCM. There were no consistent trends of changes in the peak velocity in the atrial contraction phase in any groups. The mitral velocity integral increased from 502 Hz-sec to 621 Hz-sec in the controls and from 525 Hz-sec to 613 Hz-sec in HCM, but it did not increase in DCM. These findings suggest that there is impaired diastolic reserve during acute pressure loading in HCM and DCM and that the diastolic disturbance might be reflected in the early diastolic phase, rather than in the late diastolic phase. PMID- 3267715 TI - [Clinical significance of electrocardiographic P-terminal force in V1 in patients with hypertrophic cardiomyopathy]. AB - The clinical usefulness of P-terminal force in lead V1 (P-TF) was evaluated in 49 patients with hypertrophic cardiomyopathy. These 49 patients were categorized as 17 with an abnormal P-wave (P-TF greater than or equal to 3.0 msec.mV: group A) and 32 with a normal P-wave (P-TF less than 3.0 msec.mV: group B). Systolic blood pressure response (delta SBP) during the treadmill exercise test was significantly less in the group A than in the group B (delta SBP: 36 +/- 22 mmHg, 58 +/- 26 mmHg, respectively). Left atrial dimension measured from the M-mode echocardiogram was 37.8 +/- 5.0 mm in the group A and 31.0 +/- 5.2 mm in the group B. These differences were statistically significant (p less than 0.05). Left ventricular end-diastolic pressure averaged 19.5 +/- 7.9 mmHg in the group A and 13.5 +/- 4.0 mmHg in the group B (p less than 0.05). When comparing the group A and B, negative dp/dt / positive dp/dt of the group A was significantly less (0.69 +/- 0.14, 0.90 +/- 0.18, respectively) and the time constant T of the group A was significantly prolonged (86 +/- 30 msec, 56 +/- 10 msec, respectively). According to classifications of hypertrophic cardiomyopathy, all patients with the obstructive type had an abnormal P-wave. On the contrary, the majority of patients with apical hypertrophy had a normal P-wave.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267716 TI - [A new method quantifying tricuspid regurgitant volume by two-dimensional color and continuous wave Doppler echocardiography]. AB - To determine appropriate surgical management of secondary tricuspid regurgitation (TR), we attempted to quantify TR volume by using two-dimensional color Doppler echocardiography (2-DD) and continuous wave Doppler echocardiography (CW). Thirty patients with TR associated with acquired valvular disease were selected for the study. 1. The new quantitative method: TR was observed from two right-angled cross-sections in 2-DD (one; the parasternal long-axis view of the right ventricular inflow tract, and another; the apical four-chamber view or short-axis view at the level of the aortic valve). The width of the regurgitant jet (a and b) was measured at the position just below the tricuspid valve, and the cross sectional area (S) of TR was calculated as an ellipse where the major and minor axes were a and b (pi/4.ab). The CW is recorded from the center of the regurgitant jet. The regurgitant volume of one unit area (Vp) was calculated by integrating a parabolic flow velocity signal during ejection phase (2/3.vt, where v = peak velocity, t = regurgitant time). Assuming that the fluid figure of TR flow is oval, the regurgitant volume per one beat (VTR) was calculated by the formula: 1/3.S.Vp = pi/18.abvt. 2. Thirty patients were classified into three groups according to VTR: Group 1, less than 10 cc (n = 12); Group 2, 10-20 cc (n = 12); and Group 3, greater than or equal to 20 cc (n = 6). Compared with pulsed Doppler echocardiography and right ventriculography, our classification was much more practical. Namely, in Group 1, the VTR decreased postoperatively with no surgical intervention for the tricuspid valve; in Group 2, 11 underwent tricuspid annuloplasty (TAP) while one received no surgical intervention, and all showed a decrease (less than 10 cc) in the VTR, in Group 3, five underwent TAP while one patient received tricuspid valve replacement (TVR), and three of the five showed 10-20 cc postoperative VTR. 3. There was a significant correlation between the preoperative VTR and tricuspid annular diameter (TAD) at end-diastole, right atrial mean pressure and right ventricular end-diastolic pressure. In three patients of Group 3 with the residual postoperative VTR of 10-20 cc, preoperative right ventricular systolic pressure and pulmonary capillary pressure were lower; and the preoperative systolic pressure gradient across the tricuspid valve was less than or equal to 20 mmHg and the TAD was greater than 50 mm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267717 TI - [Evaluation of secondary tricuspid regurgitation by intraoperative epicardial pulsed Doppler echocardiography]. AB - Since 1985, we have evaluated secondary tricuspid regurgitation associated with acquired mitral valve disease in patients undergoing open mitral surgery by intraoperative epicardial two-dimensional and pulsed Doppler echocardiography. We found intraoperative pulsed Doppler echocardiography to be a sensitive, safe technique allowing surgeons to evaluate the severity of tricuspid regurgitation intraoperatively, even in critically ill patients who cannot afford preoperative cardiac catheterization. To assess the severity of tricuspid regurgitation intraoperatively, the transducer was placed directly on the right atrium. The ultrasound beam was transmitted into the right atrium at right angles to the tricuspid valve orifice to record intraoperative four-chamber two-dimensional echocardiograms, which were used to detect the sites of eight sample volumes, one in the right ventricle and seven in the right atrium, for pulsed Doppler echocardiography. The pulsed Doppler signals were recorded in each sample volume before and after cardiac procedures. The pansystolic abnormal signals lasting from tricuspid valve closure to the subsequent opening and consisting of components moving away from the tricuspid valve were interpreted as tricuspid regurgitant flows. Without operative correction of the tricuspid valve, secondary tricuspid regurgitation can resolve following mitral valve surgery alone. However, to our knowledge, there are no published reports of objective findings of intraoperative changes of secondary tricuspid regurgitation. Here we present the unique intraoperative pulsed Doppler echocardiographic features of tricuspid regurgitation before and after cardiac procedures. A 30-year-old woman with preoperative diagnosis of aortic regurgitation, mitral stenosis and severe tricuspid regurgitation underwent aortic and mitral valve replacement. The intraoperative pulsed Doppler echocardiograms recorded after pericardiotomy and before cannulation of the heart showed tricuspid regurgitant flow signal in all of the seven sample volumes in the right atrium, which was interpreted as severe tricuspid regurgitation. After surgical procedures, no regurgitant flow from the tricuspid orifice to the right atrium was detected in the eight sample volumes. This suggested that preoperative secondary tricuspid regurgitation improves without operative procedures for the tricuspid valve. All intraoperative echocardiographic procedures were performed within 5 min, and no arrhythmias or other complications related to this technique were noted. Epicardial pulsed Doppler echocardiography is helpful in assessing tricuspid valve function of patients undergoing mitral valve surgery bef PMID- 3267718 TI - [Prognosis of primary pulmonary hypertension and its determinants]. AB - Most patients with primary pulmonary hypertension (PPH) die within two to four years of the onsets of their symptoms. However, several reports have described patients with PPH who have lived more than 10 years including a case with regression. We studied prognoses and the various determinants in 21 patients (7 men and 14 women; 18 deceased and three living) with PPH to elucidate its pathophysiology. Age at the onset of the disease varied from 12 to 73 years, with a mean of 29 years. All causes of death were of right heart failure, except for two cases of non-cardiac deaths. The prognoses were as follows: less than one year, two cases; 1-2 years, seven (one living); 2-3 years, five; 3-4 years, two; 4-5 years, one; more than six years, four (two living), with a mean of three years and five months. Pulmonary artery pressure decreased 10 years later (mean pressure, from 54 to 41 mmHg) in one patient, who lived for 13 years, followed by a non-cardiac death. Various clinical and pathological factors, including age at the onset of disease, sex, relationship to pregnancy, immunological abnormalities (4, positive; 17, negative), patent foramen ovale (five, patent; 16, not patent), PaO2, hemodynamic parameters, treatments, pathological subtypes (10, plexogenic pulmonary arteriopathy; two, pulmonary micro-thromboembolism; one, pulmonary veno occlusive disease) numbers of plexiform lesion/cm2 were examined for prognostic correlations. None of the above factors were found to correlate significantly with prognoses. The only significant correlation was between the cardiac index (r = 0.981, p less than 0.001, n = 6), and total pulmonary resistance (r = -0.894, p less than 0.02, n = 6) in patients with pregnancy-related PPH. There was variability in the state of progression, namely, from rapid progression to regression. Clinically as well as pathologically, PPH may consist of several subgroups. However, whether it is due to differences in etiology or reactions of the disease is not clear. The pregnancy-related cases may comprise a homogenous subgroup within PPH. PMID- 3267719 TI - Significance of systolic time intervals in predicting prognosis of primary pulmonary hypertension. AB - To elucidate the characteristics of left ventricular (LV) function and LV shape in primary pulmonary hypertension (PPH), systolic time intervals (STIs) and two dimensional echocardiograms in seven patients with PPH were studied and compared with those of 12 normal controls. Serial changes in STIs were also analyzed as to clinical outcomes. All patients were females and aged from 14 to 53 years. The follow-up period was 50 +/- 30 months, and five patients died of cardiac causes during the study period. The patients with PPH had a significantly prolonged pre ejection period (PEP) and PEP index. Left ventricular ejection time (LVET) and the LVET index in the PPH group, at the time of diagnosis, showed no statistical differences compared with those of the controls, but three patients with PPH showed a marked shortening of LVET. A significant decrease in the LVET/PEP ratio was observed in patients with PPH. Left ventricular end-diastolic dimension (EDD) and end-systolic dimension (ESD) were significantly less in patients with PPH than in the controls. No difference in percent fractional shortening of the left ventricle and the mean velocity of circumferential fiber shortening was observed. The degree of LVET shortening correlated with the decrease in EDD (r = 0.97). During follow-up, marked shortening of the LVET index, below approximately 350 msec, was observed immediately before death or clinical deterioration. From these results, we conclude that in PPH, (1) left ventricular function is impaired due to reduced volume of the left ventricle during diastole, reflecting a shortening of LVET and the LVET index, and (2) analysis of serial LVET indexes is useful for predicting the prognosis. PMID- 3267720 TI - [Diastolic right ventricular hemodynamics in right ventricular overloads assessed by pulsed Doppler echocardiography]. AB - To assess right ventricular (RV) filling dynamics, RV inflow velocity patterns of pulsed Doppler echocardiograms and jugular pulse tracings were analyzed in 59 patients with various types of RV overloads and in 20 normal subjects. The patients were classified as (1) RV volume overload group (RVVO) consisting of 25 patients with atrial septal defect (ASD) without pulmonary hypertension (PH), (2) RV pressure overload group consisting of 26 patients including 12 with primary pulmonary hypertension (PPH), eight with mitral stenosis, three with pulmonary stenosis and three with cor pulmonale, and (3) RV volume and pressure overload group consisting of eight patients with ASD and PH. The acceleration time (AT), deceleration time (DT) and the A/D ratio were measured from the RV inflow velocity patterns, and v-y interval and the y/H ratio were measured from jugular pulse tracings. The results were as follows: 1. AT was significantly prolonged in groups with pressure overload as well as pressure and volume overload compared with that of the normal controls. 2. DT was significantly prolonged in all overload groups compared with that of the normal controls except for PPH, and was particularly prolonged in the group with pressure overload. 3. The A/D ratio was significantly increased in all overload groups, particularly in the groups with pressure overload. 4. In patients with volume overloads, the v-y interval was longer and the y/H ratio was higher than in the normal controls. RVVO shifted to the right and superiorly. The reverse was true in the pressure overload group, and the high ratios were observed in the remainder. 5. In 12 patients with ASD evaluated pre- and postoperatively, AT, DT and the A/D ratio were restored to normal after surgery. These findings suggest that RV volume overload was characterized not only by increased inflow velocity during the rapid filling period, but prolongation of this period and compensatory increase of atrial inflow velocity. However, the pressure overload group had disturbed rapid filling and a decrease in end-diastolic RV compliance. The group with both pressure and volume overloads was between the two. In conclusion, the mode of RV filling in patients with RV overload showed various patterns depending on the type of overload. The RV inflow velocity pattern recorded by pulsed Doppler echocardiography is of use in discriminating these varieties. PMID- 3267722 TI - [Detection of late potentials on the signal averaged body surface ECG using X, Y, Z and anterior chest leads]. AB - We developed the system of high-frequency analysis of the signal-averaged body surface ECG to detect low amplitude signals in the terminal portion of the QRS. Thirty-five patients four or more weeks after transmural myocardial infarction (MI) and 30 normal volunteers were studied. All patients were in normal sinus rhythm and did not have bundle branch block. Body surface ECG recording using bipolar X, Y, and Z leads was performed in a shielded room. One lead served as the reference. The three-channel amplifier was a commercially-available ECG system. The common mode rejection ratio was 120 dB. The signal from each lead was amplified and passed through an analogue filter (NF FV 624) with a low-cut frequency of 100 Hz and a high-cut frequency of 300 Hz. Then AD conversion was performed with 12-bit accuracy, 1024 samples/sec. The filtered signals for the three leads were displayed separately for each channel and were combined into a vector magnitude, square root of X2+Y2+Z2. The percent ratio of the root mean square voltage in the last 40 msec of the QRS complex to that of the total filtered QRS (%RMS40) and the duration of the filtered QRS were automatically calculated. These parameters obtained from the three groups were compared. Signal averaged, non-filtered and filtered body surface ECGs were recorded using 25 (5 x 5 array) anterior chest unipolar leads in 20 normal volunteers and in patients with late potential. The departure index was calculated as the voltage differences between the mean value (M) in normal persons and the value in patients (Xi) with MI using the formula (Xi-M/SDi) at intervals every four msec. The departure maps, capable of identifying the location of the MI, were made from the departure index at four msec intervals; then the late potential (LP) area maps were superimposed on the departure maps. To determine the late potential, we used the filtered ECG of X, Y, and Z leads and quantitative values (%RMS 40) obtained from a vector magnitude incorporated in these three leads. Six MI patients, four anterior and two inferior, with the late potential had low amplitude signals at the end of the filtered QRS complex. The %RMS 40 was 6.8 +/- 2.9% (p less than 0.001) in MI patients with the late potential, 2.8 +/- 8.5% (p less than 0.01) in MI patients without the late potential, and 37 +/- 11% in normal subjects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3267723 TI - [Advances in intracoronary thrombolysis treatment]. AB - Based on the results of intracoronary thrombolysis in 30 patients with initial onset of anterior myocardial infarction, we concluded that: (1) left ventricular function and clinical features are markedly improved when reperfusion is accomplished within four hours after coronary artery occlusion; and (2) intracoronary thrombolysis therapy should be considered possible up to 10 hours after the onset of myocardial infarction to prevent expansion of infarct sizes and to preserve ventricular functions. Not infrequently, there is a significant stenosis at the site of initial occlusion after thrombolytic therapy, which results in an immediate reocclusion. Consequently, percutaneous transluminal coronary angioplasty (PTCA) is now widely performed after thrombolytic treatment to achieve more definite revascularization. Our early experiences showed that PTCA following thrombolytic treatment has an increased potential for reinfarction rather than added benefits for left ventricular functions. More recently, however, since our PTCA technique has been improved so as to achieve sufficient dilatation of the stenosed coronary artery, there has been less tendency to immediate reinfarction after the procedure for acute myocardial infarction. Whether PTCA should be added to thrombolytic therapy during the acute phase of myocardial infarction is controversial. The alternative is to wait until it can be performed on an elective basis. It is obvious that early revascularization is essential for preserving left ventricular functions after acute myocardial infarction. For this reason, thrombolytic agents such as tissue plasminogen activator and plasminogen proactivator, which can be administered intravenously, are being intensively sought using molecular biological techniques. The ideal thrombolytic agents should have more fibrin-specific properties with longer half lives than currently-available substances. However, so far none of these novel agents, have been studied in patients. PMID- 3267721 TI - [Left and right ventricular cardiac outputs in early neonatal periods examined using Doppler echocardiography]. AB - To evaluate early neonatal circulatory adaptation, left and right ventricular cardiac outputs were examined in 10 normal neonates using Doppler echocardiography. Serial examinations were performed until ductal closure was confirmed. Two-dimensional echocardiography and Doppler echocardiography were used to evaluate structures of the heart and great vessels and flow within them. Then, the diameters of the ascending aorta (dAo) and pulmonary artery (dPA) were measured using M-mode echocardiography. The flow velocity patterns of the ascending aorta and pulmonary artery were recorded, measuring mean aortic (VAo) and pulmonary artery velocities (VPA). Left (LVCO) and right ventricular cardiac outputs (RVCO) were calculated as follows: LVCO = (dAo)2/4 x pi x VAo x 60, RVCO = (dPA)2/4 x pi x VPA x 60. 1. Patency of the ductus arteriosus was confirmed by the shunt through it in all neonates initially examined. The initial velocity pattern of the ductal shunts was bidirectional (9/10) or continuous left-to-right (1/10). The flow velocity pattern changed to continuous left-to-right in most neonates, and spontaneous closure of the ductus was confirmed at the age of 13 to 64.5 (mean 31.4) hrs. 2. Left-to-right shunt through the stretched foramen ovale was noted in six neonates temporarily. 3. As for the arterial diameter, dAo did not change, but dPA decreased at the time of spontaneous closure of the ductus. 4. Concerning mean aortic velocity, VAo increased when a continuous ductal left to-right shunt was initially suspected, while VPA increased when spontaneous closure of the ductus was confirmed. 5. For cardiac output, LVCO (ml/min) changed from 618.4----718.3----562.7, while RVCO showed no change (576.1----546.5--- 557.8) according to a ductal flow change from bidirectional to continuous left-to right and finally to no shunt. The LVCO/RVCO ratio increased with increasing age and (in 7/9) the maximal rate was noted when the continuous left-to-right ductal shunt was confirmed. The increased LVCO contributed to the increased LVCO/RVCO ratio. Using this method, serial evaluations of two ventricular cardiac outputs could be made. PMID- 3267724 TI - [Evaluation of therapeutic interventions of sustained monomorphic ventricular tachycardia guided by an electrophysiologic study: a case report]. AB - Therapeutic evaluation of sustained monomorphic ventricular tachycardia (VT) using electrophysiologic study (EPS) is presented in a case of refractory VT. A 54-year-old man with a history of recurring syncope underwent coronary angiography which revealed total occlusion of the posterior descending branch of the right coronary artery. Left ventriculography showed a left ventricular aneurysm at the cardiac apex. Ejection fraction of the left ventricle was 36%. He had four VTs of different QRS morphologies in 12 lead electrocardiograms. According to our programmed ventricular stimulations, single or double, and rarely triple, extra stimuli were administered after eight basic stimuli at two basic cycle lengths. Rapid ventricular pacing, up to 210 bpm, was then added. The stimuli were delivered to two different sites in the right ventricle and to at least one site in the left ventricle. When the entire protocol could not induce VT, isoproterenol was given intravenously, and the same protocol was repeated. No drug could prevent VT attacks, even after the surgical resection of two VT foci, VT was still inducible. Postoperative drug therapy could not prevent VT induction in EPS. However, changes in the mode required for VT induction were observed. Among 47 patients with sustained monomorphic VT treated in our hospital, 24 had EPS to evaluate the efficacies of therapeutic interventions, such as drugs and surgery. In 14 patients, no VT was induced by the entire VT induction protocol. Among the remaining 10 patients, four showed changes in the VT induction mode, but VT recurred in their clinical courses even after their treatments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267725 TI - [Dissecting aortic aneurysm of DeBakey type II diagnosed by color Doppler flow imaging and treated by a Bentall surgical procedure: a case report]. AB - A 33-year-old man with known annuloaortic ectasia was admitted to the hospital because of chest pain. A dissecting aortic aneurysm was strongly suspected, but angiography was not performed because of his history of allergic reaction to iodine contrast material. Two-dimensional echocardiography demonstrated a markedly dilated basal aorta. The aortic wall immediately above the right sinus of Valsalva appeared to divide the aortic lumen into anterior and posterior channels. A defect in the intimal flap with a diameter of two cm was also detected six cm above the aortic ring. Color Doppler flow mapping showed blood flow passing through a probable entrance tear from the true lumen into the false lumen. Reentry could not be detected by Doppler imaging. All major aortic tributaries were presumed patent and supplied via the true lumen. The patient underwent successful emergency Bentall surgical procedure and recovered. It is emphasized that in some cases of DeBakey type I or II aortic dissection, color Doppler flow imaging is helpful for determining indications for emergency surgery. PMID- 3267726 TI - [Van der Hoeve's syndrome with Ebstein's anomaly, and prolapse of the mitral and aortic valves: a case report]. AB - A hitherto unrecognized case of van der Hoeve's syndrome complicated by Ebstein's anomaly, and prolapse of the mitral and aortic valves was reported. A 46-year-old woman presented with blue sclera, osteogenesis imperfecta and a hearing loss, which are typical symptoms of this syndrome. The electrocardiogram showed a type B WPW syndrome. The phonocardiogram showed a loud and widely split first heart sound, an accentuated protodiastolic extrasound, a decrescendo regurgitant systolic murmur, and a presystolic murmur. The x descent of the jugular phlebogram was obliterated by a markedly increased c wave. Based on M-mode and two-dimensional echocardiograms, 1) the interventricular septal motion was paradoxical and the closure of the tricuspid valve was delayed, 2) the septal tricuspid leaflet was displaced toward the apex from its normal annular insertion on the apical four-chamber view, 3) the three leaflets of the tricuspid valve were abnormally elongated, 4) the anterior mitral leaflet and the non-coronary cusp of the aortic valve were elongated and prolapsed. Doppler echocardiography detected severe tricuspid and mild mitral regurgitations. We suggest that the development of Ebstein's anomaly is possibly related to that of osteogenesis imperfecta genetically and that not only Ebstein's anomaly but a connective tissue disorder contributes to the elongated and prolapsed leaflets. PMID- 3267727 TI - [Comparisons of images simultaneously documented by digital subtraction coronary arteriography and cine coronary arteriography]. AB - Using an angiography apparatus capable of simultaneously processing digital subtraction angiograms and cine angiograms, the diagnostic capabilities of both methods for the coronary arteries (DSCAG and Cine-CAG) were compared. 1. Twenty stenotic lesions of the coronary arteries of 11 patients were evaluated using both modalities. The severity of stenosis using DSCAG with a 512 x 512 x 8 bit matrix was semiautomatically measured on the cathode ray tube (CRT) based on enlarged images on the screen of a Vanguard cine projector which were of the same size as those of or 10 times larger than images of Cine-CAG. The negative and positive hard copies of DSCAG images were also compared with those of Cine-CAG. The correlation coefficients of the severity of stenosis by DSCAG and Cine-CAG were as follows: (1) the same size DSCAG images on CRT to Cine-CAG, 0.95, (2) 10 times enlarged DSCAG images on CRT to Cine-CAG, 0.96, and (3) the same size DSCAG images on negative and positive hard copies to Cine-CAG, 0.97. The semiautomatically measured values of 10 times enlarged DSCAG images on CRT and the manually measured values of the same size negative and positive DSCAG images in hard copy closely correlated with the values measured using Cine-CAG. 2. When the liver was superimposed in the long-axis projection, the diagnostic capabilities of DSCAG and Cine-CAG were compared. The materials included 10 left coronary arteriograms and 11 right coronary arteriograms. Diagnostically, DSCAG was more useful than Cine-CAG in the long-axis projection. PMID- 3267728 TI - [Analysis of digital subtraction angiography for estimating flow reserve in critical coronary artery stenosis]. AB - To assess the accuracy of digital subtraction angiography in evaluating coronary flow reserve in cases with critical coronary artery stenosis, time-density curves were obtained from digital subtraction coronary angiograms in the myocardial region of interest. Time to peak contrast (TPC) and time constant of the washout exponential curve (T) were measured in 14 patients with stable effort angina pectoris and critical one vessel lesion before and after percutaneous transluminal coronary angioplasty (PTCA). All patients had normal left ventricular ejection fraction (59 +/- 7%) and 201T1 myocardial images at rest. The values of TPC and T were significantly shortened from 5.4 +/- 1.3 to 4.5 +/- 1.0 sec (p less than 0.02) and from 10.9 +/- 3.8 to 5.3 +/- 1.3 sec (p less than 0.001) after PTCA, respectively. However, in 9 patients TPC values were approximately the same before and after PTCA. In five experimental dogs with critical circumflex coronary artery stenosis, coronary flow (CF; Doppler flowmeter) and systolic thickening of the posterior wall (by sonomicrometry) at rest did not differ from those of the controls. However, contrast media-induced reactive hyperemia was markedly attenuated, accompanied by a significant increase in T (7.7 +/- 4.5 vs 15.8 +/- 10.9 sec, p less than 0.01) and totally unchanged TPC (both 6.8 sec). With simultaneous tracings of CF and time-density curves, TPC and washout phases corresponded with contrast-induced transient CF reduction and hyperemic phases, respectively. We concluded that T may be more sensitive for estimating CF maintained nearly normal, e.g., in patients with stable effort angina pectoris having normal left ventricular wall motion at rest. PMID- 3267729 TI - [The significance of early coronary reperfusion in patients with acute myocardial infarction assessed by regional wall motion]. AB - Left ventricular ejection fraction, regional wall motion, hospital mortality rate, and reocclusion rate of the infarct-related coronary artery after thrombolytic therapy were examined in 164 consecutive patients who were admitted within 12 hours of the onsets of their symptoms of acute myocardial infarction. The patients were divided into three groups based on the findings of initial coronary angiography before and after administration of urokinase: (1) stenosed (the infarct-related coronary blood flow was visualized at initial angiography) (n = 41); (2) successfully thrombolysed (n = 82); and (3) unsuccessful (n = 41). The patients in each group were also subdivided into three subgroups based on the recanalized time (hours): within three, three to six hours and six hours or longer. The hospital mortality rates were 4.9% (two of the 41 patients) in the stenosed; 8.5% (seven of the 82 patients) in the thrombolysed; 29.3% (12 of the 41 patients) in the unsuccessful group, and 12.8% (21 of the 164 patients) overall, respectively. There were significant differences among these three groups. The incidence of pump failure as a cause of death in the acute stage was significantly low in the stenosed (two of the 41 patients) and in the thrombolysed (3 of the 82 patients) groups compared to the unsuccessful group (eight of the 41 patients). The rates of rethrombosis one month after thrombolytic treatment were 3% in the stenosed and 4% in the thrombolysed groups. On the contrary, visualization of coronary blood flow at the chronic stage (approximately one month later) was confirmed in 19% of the patients in the unsuccessful group. Left ventricular ejection fraction one month after thrombolytic therapy in the subgroup with the recanalized coronary arteries within three hours was significantly higher than that of the unsuccessful group, but, after three hours of procedure, no significant difference of left ventricular ejection fraction was present among three groups. Regional wall motion in patients with the recanalized coronary artery within 12 hours was better than that of the unsuccessful group. The area of improved wall motion was wide in patients with early recanalization in the stenosed and thrombolysed groups. Thus, early recanalization within three hours is mandatory for reducing mortality and for improving ejection fraction and wall motion. PMID- 3267730 TI - [Dipyridamole-loading scintigraphy in patients with subendocardial infarction using single photon emission computed tomography]. AB - To detect myocardial lesions in patients with subendocardial (nontransmural) infarction, myocardial perfusion images of thallium-201 (T1-201), using single photon emission computed tomography, were obtained in 17 patients during and three hours after coronary vasodilatation induced by the administration of dipyridamole. Controls consisted of 28 patients with transmural infarction and 11 with angina pectoris. Dipyridamole was infused intravenously at a rate of 0.142 mg/kg per min for four min, and the washout rate of T1-201 was calculated by the segmental ROI method. The results were as follows: 1. Many patients with nontransmural infarction exhibited various T1-201 myocardial perfusion images. 2. The prevalence of redistribution among patients with nontransmural infarction was 88.2% (15 of 17), and its reverse redistribution was 64.7% (11 of 17). Every subject exhibited a number of abnormal T1-201 myocardial perfusion images. 3. In patients with nontransmural infarction the occurrence of reverse redistribution images was significantly higher (64.7%) compared to those with transmural infarction (10.7%), and the occurrence of redistribution images was significantly higher (88.2%) compared to those with angina pectoris (45.5%). 4. The abnormal perfusion images most frequently present in the areas corresponding to the sites of ST-T changes on ECG were reverse redistribution (26.7%), redistribution (17.3%), and fixed defect (6.7%) in order. 5. The phenomenon of reverse distribution images was found irrespective of stenotic coronary artery lesions on selective coronary angiography. Most areas corresponding to the sites of reverse redistribution showed ST-T changes on ECG and high washout rates of T1-201. In conclusion, these findings suggest reflections of uneven coronary blood flow and the mixed normal and scarred myocardium in patients with nontransmural infarction. PMID- 3267731 TI - [Quantitation of the severity of coronary artery disease using thallium-201 tomographic scores]. AB - To evaluate coronary artery disease, a new quantitative thallium-201 (201T1) tomographic scintigraphic score (TSS: modified Massie's score) using oxygen consumption (METS) was developed and compared with coronary angiographic score (CAG-S) in 27 patients (eight patients with normal coronary angiograms, and five, eight and six patients with one, two and three vessel disease, respectively) without previous myocardial infarction. All patients received both coronary angiography and the treadmill exercise test using 201T1-myocardial single photon emission computed tomography (SPECT) within two weeks. The redistribution area (RA) and washout rate area (WA) were derived from the circumferential profile analysis using apical (A), midventricular (M) and basal (B) short-axis images. To obtain TSS values, the sum of these values was divided both by percentage of the age-predicted maximal heart rate (%PMHR) and the METS value as follows: TSS = [RA (A, M, B) + WA (A, M, B)]/(%PMHR x METS). The results were as follows: 1. TSS values were 6.4 +- 1.6, 9.4 +/- 2.2, 24.2 +/- 12.0 and 30.6 +/- 5.0 (mean +/- SD) in normal, one, two and three vessel disease groups, respectively. Significant differences were found among each group except between two and three vessel disease groups. 2. The detectability of significant coronary artery disease was 89% (17/19) except in two patients with one vessel disease. 3. A high correlation coefficient was found between TSS (X) and CAG-S (Y), i.e., Y = 0.8X - 3.5 (r = 0.944, p less than 0.001). It was concluded that the tomographic scintigraphic score (TSS) is useful not only for detecting, multivessel disease but also for totally-evaluating its severity, extent and influence on collateral supply, and could be used for analyzing prognosis and the selection of therapeutic interventions. PMID- 3267732 TI - [Detection of left ventricular thrombi after acute myocardial infarction using Ga 67-DFO-DAS-fibrinogen]. AB - Ga-67-DFO-DAS-fibrinogen (Ga-fbg) scintigraphy, a new radiopharmaceutical method, was performed for detecting intraventricular thrombi following acute myocardial infarction in five patients. The thrombi in four of them were detected by two dimensional echocardiography (2DE) and that in the fifth patient was suspected during magnetic resonance imaging. Imaging of the heart was performed using a scinticamera with a medium energy collimator and multiple views (anterior, LAO 30 degrees, LAO 45 degrees, and lateral) three and four days after the intravenous administration of Ga-fbg. By Ga-fbg scintigraphy, intraventricular thrombi were detected in four patients. The size of the thrombi visualized by Ga-fbg appeared larger than those by 2DE. In one patient examined again after anticoagulant therapy, a thrombus was missed by 2-DE, but it was detected by Ga-fbg, though the radioactivity of the thrombus decreased. We concluded that Ga-fbg scintigraphy is a very simple method and sufficiently useful for detecting active left ventricular thrombi and for monitoring the effect of anticoagulant therapy. It could be more sensitive than 2DE for determining the extent of an active intraventricular thrombus. PMID- 3267734 TI - [Accuracy of the Master's exercise test in detecting significant coronary artery disease]. AB - To assess the significance and accuracy of noninvasive tests in detecting significant coronary artery disease (CAD; greater than 50% stenosis), the Master's exercise test, treadmill exercise test and dipyridamole-loading myocardial perfusion scintigraphy were performed and their results were compared with coronary angiographic findings in 60 patients with angina but without myocardial infarction. Among these, 27 patients had significant CAD. The Master's test performed in outpatient clinics had an 85% sensitivity and a 76% specificity in detecting significant CAD, when the degree of ST depression was equal to or exceeded 1 mm. The sensitivity further improved to 96% by adding chest pain to the criteria; then all patients with multivessel disease or critical ischemia were identified by the Master's test. Treadmill tests performed after admission had a 78% sensitivity and a 67% specificity. When the severity of ischemia was judged either by exercise capacity or the degree of ST depression or the coronary T wave, the treadmill test was superior to the Master's test. Although patients without significant CAD had longer exercise capacity and the higher maximum heart rate in the treadmill test than did those in the Master's test, these trends were similar but less marked in patients with significant CAD. Dipyridamole-loading myocardial perfusion scintigraphy showed an excellent sensitivity and specificity; 96% and 94%, respectively, in detecting significant CAD. It was particularly useful in distinguishing false positive exercise results due to left ventricular hypertrophy and coronary spasm and that in women, from true positive results. In conclusion, the Master's test is a simple and useful method for screening CAD in community hospitals and in outpatient clinics. PMID- 3267733 TI - Sequence of mechanical and electrical changes during myocardial ischemia: assessment by an ambulatory left ventricular function monitor. AB - To investigate the relationship between left ventricular function and electrical changes during myocardial ischemia, ambulatory left ventricular function monitoring and ECG recording were made during the ergometer exercise test in 14 patients with coronary artery disease. An ambulatory ventricular function monitor consists of a small cadmium telluride (CdTe) radionuclide probe (250 g) affixed to the patient's chest wall, a preamplifer (10 g), and a portable data acquisition unit (600 g). Left ventricular time-activity curves were recorded continuously using this monitor, and the end-systolic count (volume), end diastolic count (volume) and ejection fraction were calculated after background subtraction. Twenty-eight exercise tests were performed in the supine and upright positions. In 15 tests, left ventricular dysfunction, i.e., an increase in the end-systolic count (greater than or equal to 10%) and a decrease in ejection fraction (greater than or equal to 5%), and ST depression (greater than or equal to 0.1 mV) were observed. In these 15 tests, exercise duration was 362 +/- 27 sec. Left ventricular dysfunction occurred earlier than ST depression and the time difference was 97 +/- 19 sec. Left ventricular function recovered 33 +/- 8.5 sec after discontinuation of exercise, while ST depression continued for the additional 85 +/- 18.5 sec after recovery of left ventricular function. In conclusion, 1) left ventricular dysfunction occurs earlier than electrical changes during exercise-induced ischemia; 2) left ventricular dysfunction improves earlier than electrical changes after exercise; and 3) the same temporal sequence exists in the restoration from myocardial ischemia. PMID- 3267735 TI - [Effects of bathing on cardiac function in patients with myocardial infarction: hemodynamic and Doppler echocardiographic studies]. AB - Hemodynamic changes during bathing in patients with myocardial infarction were studied using a Swan-Ganz catheter and Doppler echocardiography. The subjects consisted of 14 patients with myocardial infarction (mean age 55.6 years), including the six extensive ones of the anterior wall, five of the anteroseptal wall, two of the inferior wall, and one of the inferoposterior wall. Bathing was by means of 42 degrees C tap water for five min in the supine position in a Hubbard tank. Pulsed wave Doppler was used to analyze left and right ventricular inflow velocity patterns, and continuous wave Doppler was employed to measure right ventricular outflow velocity. Blood pressure, pulmonary arterial pressure, pulmonary arterial wedge pressure and right atrial pressure increased significantly during bathing. After bathing, these parameters decreased and remained lower than the baseline levels before bathing. Heart rate and the cardiac index increased significantly during bathing, but decreased after bathing. The systemic vascular resistance index and pulmonary vascular resistance index decreased significantly during bathing, but increased after bathing. The A/R ratio at the left and right ventricular inflow tracts increased during bathing, and right ventricular outflow velocity increased significantly. However, when the subjects were categorized into two groups, i.e., those whose pulmonary arterial pressure consistently increased to the higher level than the average during bathing and those who did not show any increase, the A/R ratio at the inflow tract of the left ventricle increased significantly during bathing in the former group, but there was no significant change in the latter group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267736 TI - [Coronary artery tone assessed by the administration of ergonovine maleate and nitrates]. AB - Angiographic changes caused by administering ergonovine maleate (EM) and nitrates were quantitated in 136 patients without significant coronary artery disease. Percent coronary artery (CA) narrowing was calculated in 67 patients with a negative EM test (Group A) and 69 patients with a positive EM test (Group B) as follows: (Formula; see text) In both groups, coronary artery narrowing before and after EM did not differ among the proximal, middle or distal segments of each coronary artery. The measurements of the right coronary artery were greater than those of the left anterior descending artery (p less than 0.01 after EM, p less than 0.05 before EM), and those of the left main trunk were markedly less than those of the other coronary arteries (p less than 0.01). In both groups, coronary narrowing after EM administration was greater than before administration (p less than 0.01). Initial coronary narrowing in Group B was also greater than in Group A (p less than 0.01), similar to the responses for EM. In 19 patients with coronary artery spasm provoked by EM coronary artery narrowing before and after EM was 37 +/- 12% and 69 +/- 23% for coronary arteries with spasm, and 30 +/- 13% and 42 +/- 16% for those without spasm. Not only after, but also before EM administration, coronary narrowing was greater in the arteries with spasm than in those without spasm (p less than 0.01). Furthermore, the arteries without spasm showed greater sensitivity to EM and nitrates than did the arteries of the control patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3267737 TI - [Emergency percutaneous transluminal coronary angioplasty for acute myocardial infarction]. AB - Coronary angioplasty combined with thrombolytic therapy using urokinase (UK-PTCA) was attempted for acute myocardial infarction from September 1983 to December 1985, and without thrombolytic therapy (direct PTCA), thereafter. For UK-PTCA, the lesion was severely stenosed in 13, subtotally occluded in two and totally occluded in 21, and 29 lesions (81%) were successfully dilated. For direct PTCA, the lesion was stenosed in five, subtotally occluded in two and totally occluded in 14, and 19 lesions (90%) were dilated. Only one lesion in UK-PTCA had restenosis during hospitalization, but it was successfully redilated. Follow-up angiography was performed for 26 among 29 UK-PTCA cases and showed patency (diameter stenosis less than 50%) in 13, restenosis (less than 50%) in 12 and occlusion in one. Ten among 12 restenosed lesions were redilated and they were all patent at subsequent angiography. In 15 of 19 dilated lesions with direct PTCA, the lesion was patent in 10, and restenosed in five. Four of them were redilated and remained patent at subsequent angiography. Major complications occurred only in the UK-PTCA group before the judicious use of intra-aortic balloon pumping for hemodynamic instability. These included two deaths due to cardiogenic shock, one coronary dissection, and one sudden reocclusion, possibly due to thrombus formation. PTCA is applicable with or without thrombolytic therapy for acute myocardial infarction with high primary success rate and maintain coronary flow thereafter. PMID- 3267738 TI - A car with flat tyres? PMID- 3267740 TI - The practice library. PMID- 3267739 TI - The future of community and residential care. PMID- 3267742 TI - Psychological distress: outcome and consultation rates in one general practice. AB - This paper reports a one-year follow-up of random samples of 90 male and 96 female patients attending one general practitioner. There was no statistically significant difference between men and women in the total score on the 28-item general health questionnaire or any of the subscores. However, the diagnostic labels applied to the two sexes were strikingly different as was the prescribing of psychotropic drugs. Outcome of psychological distress was assessed in terms of change in total general health questionnaire score. Two thirds of the patients (65%) showed normal scores at the beginning and end of the follow-up period, 19% changed from abnormal to normal and 8% changed from normal to abnormal. The remaining 9% had persistently high scores though less than half had been given a psychiatric diagnosis. They had very high consultation rates persisting over several years and three-quarters were known to have chronic physical illness. It seems possible that some patients with persistently high consultation rates who present with chronic, mainly somatic, symptoms may be or may become psychologically distressed to a significant degree and that this psychological distress goes unrecognized in the presence of physical disease. PMID- 3267741 TI - Group therapy in a general practice setting for frequent attenders: a controlled study of mothers with pre-school children. AB - The frequent attendance of women suffering from anxiety and depression is a common problem in general practice and the problems are often externalized through the women's children. A small controlled study was carried out in a general practice surgery to see whether demand for medical attention by mothers of pre-school children would decrease after they attended a discussion group. Twenty women who fulfilled the study criteria of more than double the national average consultation rate for their age group and of having at least one pre school child, were sequentially allocated to a treatment or control group. The group therapy was held over two terms of 10 sessions, each of 90 minutes, and was led by a psychologist and a general practitioner. Consultation rates (including surgery visits, house calls and prescription requests) were recorded for five consecutive six-month periods before and after the intervention. At follow-up six months after the end of the treatment a significant reduction in consultation rate had been achieved and maintained by the treated group compared with the controls (P<0.01). This study shows the value of attending to the cause of frequent consultation as well as to the complaints presented. PMID- 3267743 TI - Analysis of a general practitioner's work in a private nursing home for the elderly. AB - A quantitative analysis was made over a fouryear period (1984-87) of the work and time involved for one rural general practitioner in caring for 42 elderly patients living in a private nursing home. The results were compared with those for the rest of the practice. The study showed that the consultation rate for nursing home patients was 50% higher than the rate for the remaining practice patients aged 65 years or over, and more than twice that for the whole practice. The prescribing rate in the nursing home was twice that of the 65+ years group and six times the rate for the whole practice. The hospital referral rate for nursing home patients was twice that of the 65-74 years group, and four times that for the whole practice. The time involved per year in looking after each nursing home patient was nearly twice that for the remaining practice patients aged 65-74 years, and three times that for practice patients aged under 65 years. From this study it would appear that concentrations of elderly patients in nursing homes in areas served by only a few general practitioners can cause considerable increases in workload. This could present problems in the organization of suitable care. PMID- 3267744 TI - Some clinical aspects of Crohn's disease in Northern Ireland: an aid to earlier diagnosis? AB - A retrospective epidemiological study of Crohn's disease in Northern Ireland between 1966 and 1981 has been carried out. Using strict diagnostic criteria 440 cases were identified and aspects of the clinical presentation of the disease at initial diagnosis were examined. This paper describes the clinical pattern of the major symptoms of the disease and highlights the delay in diagnosis. One-third of cases (32.7%) were not diagnosed until more than a year after the onset of symptoms and 7.5% of cases were not diagnosed for more than five years. Colicky abdominal pain, one of the classical diagnostic symptoms of Crohn's disease was not present at initial diagnosis in 28.6% of cases nor were altered bowel habits found in 24.5% of cases. Only 17.7% of cases had an abdominal mass, just over half had an elevated erythrocyte sedimentation rate or lowered haemoglobin level and only 39.8% had rectal bleeding.Increased awareness by general practitioners of the delay in diagnosis of Crohn's disease may lead to earlier investigation and diagnosis of the condition which in this community occurs with an incidence of 2.34 new cases per 100 000 of the population per year. PMID- 3267745 TI - Pure tone audiometry: comparison of general practice and hospital services. AB - Pure tone audiometry was obtained for both ears of 32 children by a general practitioner using a simple audiometer in his surgery, and by audiometricians in a hospital department on the same day. Comparing the worst hearing threshold at any of the three tested frequencies, the general practitioner did not find any ears to hear more than 10 dB better than the hospital (no false negatives). However, there were six false positives (9%) where the general practitioner identified an apparent hearing loss of greater than 15 dB. It is concluded that pure tone audiometry could be carried out accurately in the practice. PMID- 3267746 TI - Why family doctors should not advertise. AB - Medical care is a form of production of values, but not of commodities. This article argues that advertising as it is normally understood is not appropriate to general practitioner care. Acceptance of advertising by the medical profession would assist in the commercialization of a currently non-commercial relationship between doctors and patients. We should refuse to take this step and accept our responsibility to devise better futures than the market has so far been able to provide. PMID- 3267747 TI - Dispensing by the community pharmacist: an unstoppable decline? AB - After posing the question ;Is your chemist really necessary?' this article demonstrates that the original role of the retail chemist - the preparation and safe dispensing of medicines - has become eroded. Furthermore, it is shown that the proposed new community roles are currently being carried out by other members of the primary care team. Finally, it is argued that the retail pharmacist may not give value for money and that doctor dispensing is a less expensive and safer alternative. PMID- 3267748 TI - Outcome and duration of telephone consultations in a general practice. PMID- 3267749 TI - Pharmacies in health centres. PMID- 3267751 TI - Coronary heart disease prevention. PMID- 3267750 TI - Triglyceride screening in the surgery. PMID- 3267752 TI - Transfer of medical records. PMID- 3267753 TI - Medical knowledge: a 'clinical drift'. PMID- 3267754 TI - HIV prevalence screening of pregnant women. PMID- 3267755 TI - Provision of injecting equipment to drug users. PMID- 3267756 TI - [Visual function and the preparation for employment of persons with congenital glaucoma. V. Preparation for working employment]. PMID- 3267758 TI - [The role of bilateral simultaneous elongation of the rectus medialis muscle in the treatment of convergent strabismus]. PMID- 3267757 TI - [Treatment of chorioretinal degeneration]. PMID- 3267759 TI - [Intrascleral iridencleisis in the treatment of congenital glaucoma in children]. PMID- 3267760 TI - [Phacolytic glaucoma as a complication of highly developed cataract]. PMID- 3267761 TI - [Isolated hemorrhages in the macula lutea as a precursory sign of endocarditis]. PMID- 3267762 TI - [Senile macular degeneration]. PMID- 3267764 TI - [Primary neoplasms of the orbit]. PMID- 3267763 TI - [Fluorescein angiography of the anterior segment of the eye]. PMID- 3267765 TI - Kinetics of histone gene expression during early development of Xenopus laevis. AB - Using literature data for transcriptional and translational rate constants, gene copy numbers, DNA concentrations, and stability constants, we have calculated the expected concentrations of histones and histone mRNA during embryogenesis of Xenopus laevis. The results led us to conclude that: (i) for X. laevis the gene copy number of the histone genes is too low to ensure the synthesis of sufficient histones during very early development, inheritance from the oocyte of either histone protein or histone mRNA (but not necessarily both) is necessary; (ii) from the known storage of histones in the oocyte and the rates of histone synthesis determined by Adamson & Woodland (1977), there would be sufficient histones to structure the newly synthesized DNA up to gastrulation but not thereafter (these empirical rates of histone synthesis may be underestimates); (iii) on the other hand, the amount of H3 mRNA recently observed during early embryogenesis (Koster, 1987, Koster et al., 1988) could direct a higher and sufficient synthesis of H3 protein, also after gastrulation. We present a quantitative model that accounts both for the observed H3 mRNA concentration as a function of time during embryogenesis and for the synthesis of sufficient histones to structure the DNA throughout early embryogenesis. The model suggests that X. laevis exhibits a major (i.e. some 14-fold) reduction in transcription of histone genes approximately 11 hours after fertilization. This reduction could be due to a decrease in the number of transcribed histone genes, a decreased rate constant of transcription with continued transcription of all the histone genes, and/or a reduction in the time during the cell cycle in which histone mRNA synthesis takes place. Alternatively, the histone mRNA stability might decrease approximately 16-fold 11 hours after fertilization. PMID- 3267766 TI - Ill-conditioning associated with the "end-point" method for the determination of kinetic parameters describing irreversible enzyme inactivation by an unstable inhibitor. AB - Study of the complete time-course of irreversible enzyme inhibition by an unstable inhibitor yields more information than can be obtained by recording data only at the end point of reaction. Time-course analysis of co-operative irreversible enzyme inhibition by an unstable inhibitor has been shown to be considerably less susceptible to ill-conditioning than the "end-point" method for the determination of kinetic parameters describing inactivation. As a result, mechanisms that cannot be distinguished by the "end-point" method are readily differentiated by time-course analysis without the need to isolate intermediate species. PMID- 3267767 TI - Metabolic control theory: a structural approach. AB - In the general framework of metabolic control theory, we describe a method of mathematical modelling that provides a way of analysing the sensitivity of a metabolic system to perturbations of the environment or of the internal state of this system. The method can be applied to any metabolic system, involving for instance conservation relationships, non-specific external parameters, etc., and leads in particular to a characterization of the control matrices and to a generalization of the summation and connectivity theorems. In this paper, we emphasize the structural characterizations and properties of the systems which depend only on the structure of the metabolic network, and not on the reaction kinetics. The advantage of this approach lies of course in the fact that the structure of the metabolic network is an invariant of the system which depends neither on the environment nor on the internal state of this system. The aim of this paper is to show the efficiency of such a structural approach. PMID- 3267768 TI - On the time dependent diffusion of macromolecules through transient open junctions and their subendothelial spread. 2. Long time model for interaction between leakage sites. AB - In Part 1 of this study (Weinbaum et al., 1988) a short time model has been proposed to describe the initial time dependent leakage of macromolecules at short distances (5 microns or less) from the exit of a transient open junction which the authors have hypothesized as a characteristic feature of endothelial cells in the process of turnover (Weinbaum et al., 1985). This open junction pathway has also been proposed (Weinbaum et al., 1988) to be the primary ultrastructural correlate of the 20 nm diameter large pore suggested by Renkin et al. (1977) using the predictions of cylindrical pore theory. The short time model in (Weinbaum et al., 1988), however, has major limitations in that it neglects the interaction between leakage sites, macromolecular entry through other pathways, the finite thickness of the vessel wall and the curvature of the cell perimeter. The longer time model developed herein will attempt to describe each of these features and also present an improved model and analytic solution for the steady state flux and uptake. In the previous steady state model developed by Weinbaum et al. (1985) the effect of the resistance of the transient open junctions and the non-isotropic diffusion in the underlying tissue due to the internal elastic lamina (IEL) were both neglected. New solutions are first presented which describe the effect of these important model refinements on the steady state macromolecular permeability of the major arteries. Time dependent solutions are then presented to predict the transient longer time labeling following the introduction of tracer macromolecules of varying size. These solutions and the corresponding short time solutions in Weinbaum et al. (1988) are the first solutions to our knowledge to describe the difficult time-dependent boundary value problem to determine how the channel exit concentration and flux at a leaky junction vary with time. This is accomplished by casting the boundary value problem in the form of an integral equation for the unknown flux at the cleft exit and then solving this problem using a specially designed numerical technique. The theoretical predictions are used to interpret the behavior of the localized leaks to HRP and albumin that have been reported in Stemerman et al. (1986) and our own recent experiments (Lin et al., 1988). PMID- 3267769 TI - Percolation thresholds in square-lattice Kauffman model. AB - In Kauffman's random Boolean network model for genetics, each gene is either on or off, depending in a fixed random way on whether K neighbor genes are on or off. Our computer simulation puts these genes on the sites of a square lattice and asks if the "off" genes, the "on" genes, the "oscillating" genes and the non oscillating "stable" genes are percolating, i.e. form one connected network of neighboring sites. The percolation thresholds for stable and for oscillating genes are found to coincide numerically with the transition to chaos at p = 0.29. Up to one million sweeps through the lattice were made to find that agreement. PMID- 3267770 TI - Experiences of a woman who intended to relinquish her infant for adoption. AB - A woman with an unplanned pregnancy who intended to relinquish her infant after birth was studied from her third trimester of pregnancy through one month postdelivery. The woman was formally interviewed three times during this period and information was collected from her medical records. The Janis-Mann model of decision-making and Blair and Salerno's maternity career timetable provided the framework for this study. Data were analyzed using qualitative methods. Findings indicate that the woman progressed quickly through the stages of decision-making, and that there was a lack of assumption of the maternal role with efforts to remain detached from the infant. PMID- 3267771 TI - Coping behaviors of hospitalized preschool children. AB - This study examined the coping behaviors of 208 hospitalized preschoolers during high stress and low stress events. The children were observed during 722 events and their behaviors were recorded on the Children's Coping Strategies Checklist (CCSC). The group included acutely and chronically ill children. While the preschoolers used more coping behaviors in low-stress events than they did in high-stress events, there were very few differences between the number of coping behaviors used by chronically ill and acutely ill children. The tendency to use fewer coping behaviors in high-stress events was more marked in the acutely ill children. There were larger differences in the specific coping behaviors used in high-stress and low-stress events. The types of coping behaviors used most frequently were Information Seeking (watching and visual examination) and Direct Action (tension reducing involving self, control by active participation, and control by preventing or delaying an event). The children used very few Independence/Growth and Intrapsychic coping behaviors. The research and clinical implications of the findings are discussed. PMID- 3267772 TI - Seven caring functions of black grandmothers in adolescent mothering. AB - Exploration of the involvement of Black grandmothers (N = 12) in the primary infant care activities of young adolescent mothers is the focus of this descriptive study. Seven categories of "grandmother caring functions" are identified from an analysis of interview data: managing, caretaking, coaching, assessing, nurturing, assigning, and patrolling. The importance of the grandmother in the functioning of the low-income extended Black family and the maternal role process of the adolescent mother is discussed. PMID- 3267773 TI - Solubilization and partial purification of S-adenosyl-L-homocysteine binding proteins from the rat brain. AB - Rat brain proteins presenting high-affinity binding of S-adenosyl-L-homocysteine were solubilized and purified. Extraction of binding protein was carried out in the presence of Triton X-100 and 1 M NaCl; this solubilized fraction exhibits similar kinetic properties than the membrane proteins. Purification was performed using affinity chromatography on S-adenosyl-L-homocysteine carboxyhexyl Sepharose 48 conjugate. The analysis of the affinity gel eluate by SDS-PAGE showed high purification ratios for two proteins exhibiting 54 and 68 kDa. Three activity peaks were separated when solubilized membrane proteins were submitted to isoelectric focusing; the activity peaks corresponded to proteins of pH1 6.0, 6.5, and 7.2. SDS-PAGE separation of proteins contained in each peak showed protein aggregation; a 54-kDa subunit was present in each aggregate. Solubilized membrane proteins were labeled by photoaffinity labeling with tritiated S adenosyl-L-homocysteine; the 54- and 68-kDa proteins were found among the specifically labeled proteins. Finally, according to the previous data from the literature, the purified S-adenosyl-L-homocysteine binding proteins do not seem to be the same as adenosine receptors or phosphatidylethanolamine-N methyltransferase. PMID- 3267774 TI - [Reaction of the periodontal tissues to orthodontic movement]. PMID- 3267775 TI - [The role of orthodontics in the treatment of dysfunction]. PMID- 3267776 TI - [Lingual bracket orthodontics: another approach]. PMID- 3267777 TI - [Agenesis]. PMID- 3267778 TI - [Orthodontics and speech therapy: apropos of rehabilitation]. PMID- 3267779 TI - [The transposed canine: classification and therapeutic approach]. PMID- 3267780 TI - [How to avoid recurrence]. PMID- 3267781 TI - [The orientation of the head in the cephalostat during the recording of cephalographs of the face (posterior-anterior axis)]. PMID- 3267782 TI - [The use of automated technics and computers in orthodontics]. PMID- 3267783 TI - [Cleft palate and x-ray computed tomography: a multi-dimensional study in children and young adults]. PMID- 3267784 TI - [The normal values of a series of craniofacial parameters during a longitudinal study of growth in monkeys]. PMID- 3267785 TI - [The soft tissue profile and the choice of extractions]. PMID- 3267787 TI - [An example of typological analysis and its practical application in orthodontics]. PMID- 3267786 TI - [Mouth breathing and facial growth: the evidence of twins]. PMID- 3267788 TI - [The mechanical structure of the calvaria (the cranial vault)]. PMID- 3267789 TI - [The aging facial profile in vestibular orientation. Discriminant functions and vertical limits]. PMID- 3267790 TI - [The maxillary canine: its diverse inclinations. Use of the straight wire]. PMID- 3267791 TI - [Presentation of the discussion question: contribution to the choice of orthodontic wire]. PMID- 3267792 TI - [Load/flexion relations and activation/displacement relations in the understanding of orthodontic mechanisms]. PMID- 3267793 TI - [Dental cements. Comparative "in vitro" study of film thickness. Effect of types of cement and trade marks]. PMID- 3267794 TI - [Histological evaluation of the efficiency of manual or ultrasonic instrumentation in upper molars (curved or twisted wide and narrow canals)]. PMID- 3267795 TI - [Sealapex, C.R.C.S., Fill Canal and N-Rickert, study of biocompatibility in subcutaneous connective tissue of rats]. PMID- 3267796 TI - [Three years of dental care in Tyrol]. PMID- 3267797 TI - [Older patient--success of modern analysis (Part 2)]. PMID- 3267798 TI - [Activity of NADH dependent methemoglobin reductase in erythrocytes of infants]. PMID- 3267799 TI - [Liver diseases in children during treatment of acute leukemia and non-hodgkin's lymphoma]. PMID- 3267800 TI - [The effect of rehabilitation on lung ventilation parameters in children with idiopathic scoliosis]. PMID- 3267801 TI - [Congenital deficiency of NADH dependent methemoglobin reductase in erythrocytes of two children with methemoglobinemia]. PMID- 3267802 TI - [Methemoglobinemia in an infant due to the transient deficiency of NADH-dependent methemoglobin reductase in erythrocytes]. PMID- 3267803 TI - [Severe bone changes in acute lymphoblastic leukemia of children]. PMID- 3267804 TI - [Ovarian recurrence after the completion of therapy in two girls with acute lymphoblastic leukemia]. PMID- 3267805 TI - [Congenital heart defect as a dominant symptom of Fanconi's syndrome]. PMID- 3267806 TI - [Special aids in preventive periodontics. Indications and use, information- instruction, motivation, remotivation, recall, timing]. PMID- 3267807 TI - [Comparative studies of general anesthesia of sheep with ketamine and etomidate]. AB - The studies were carried out on 48 sheep, 2-6 years old, weighing 33-67 kg. The animals were divided into two groups, 24 sheep each. From these 24, 16 sheep were tested for the plasma electrolytes contents, and 8 were tested for the acid-base balance and the oxygenation level of the arterial blood. Sheep from the first group were given xylasine in the dose of 0.1-10.3 mg/kg od body weight and etomidate (1 mg/kg of body weight). Sheep from the second group were given diazepam in the dose of 0.5 mg/kg of body weight and ketamine (20 mg/kg of body weight). In the first group the surgically effective anaesthesia lasting 15-20 minutes was obtained. During the anaesthesia a respiratory depression together with the decrease of oxygen saturation of the blood was observed. Also, a respiratory insufficiency leading to a respiratory acidosis, hypokalemia, hypocalcemia, hypomagnesemia and hypochloremia of plasma were observed. In the second group of sheep treated with ketamine and diazepam the increased pulse rate, respiratory insufficiency, hypokalemia, hypocalcemia and hypophosphatemia were observed. It has been said that respiratory and blood oxygenation disorders are the result of the forced long lasting position on one side. After treating with diazepam and ketamine bigger changes were observed. Usually all these changes and disorders recessed at the end of the experiment. PMID- 3267808 TI - The roots of the splanchnic nerves of the rabbit. AB - The aim of this study was to skeletonize the roots of the greater splanchnic nerve, lesser splanchnic nerve and lumbar splanchnic nerves as well as to investigate their participation in the structure of the celiac plexus in the rabbit. PMID- 3267809 TI - [Superoxide dismutase, catalase and glutathione peroxidase activities in mice with natural lymphocytic leukemia]. AB - In the mice of the high leukemic strain, sick with natural lymphatic leukemia, the following parameters were determined on the 0 day, after 90, 180 and 270 days of observation: activity of the superoxide dismutase (SOD-EC1.15.1.1), glutathione peroxidase (GSH-px-EC1.11.1.9) in the blood and catalase activity in erythrocytes. It was observed that the activity of all three enzymes during the development of the leukemic process decreased. This phenomenon indicates the disturbance of the protective role of these enzymes against free radicals in leucogenesis in mice. PMID- 3267810 TI - [Levels of copper and its antagonists in mice with natural lymphocytic leukemia]. AB - In the mice of high leukemic strain, sick with natural lymphatic leukemia, levels of copper, zinc and cadmium in blood and inner organs were determined by the method of atomic absorption spectrophotometry. Mice were killed on the 0 day (when 10 weeks old) and after 90, 180 and 270 days of observation. In plasma the level of ceruloplasmin (EC1.12.3.1) was determined. It has been proved that in mice with lymphatic leukemia the levels of copper, zinc and cadmium are higher than in control animals. It was also found out that there is some disturbance in the natural antagonism between these metals. The activity of ceruloplasmin in the course of leukemia was determined. We have also tried to interpret the role of heavy metals in leukemogenesis in mice. PMID- 3267811 TI - [Effect of copper and selenium on the histopathologic picture of the internal organs and the accumulation of these metals in hens]. AB - The hens were given per os every second day for the period of 6 weeks selenium in the amount of 0.2 mg/l water (group I), 1.4 mg (group II), copper in amount of 1000 mg/kg feed (group III) and both metals jointly (group IV)--0.2 mg Se and 1000 mg Cu and group V--1.4 mg Se and 1000 mg Cu. Histopathological studies on hens organs and accumulation of metals in tissue were carried out. It was found that selenium in the amount of 1.4 mg/l water causes insignificant oedema of liver and kidneys, whereas copper (group III) shows clear hepato- and nephropathic effect. Selenium administered jointly with copper (group V) acts protectively in parenchymatous organs against the toxic effect of copper alone. PMID- 3267812 TI - Immunological properties of selected strains of Trichophyton genus. AB - The investigations demonstrated that the strains under study, either virulent or in the form of inactivated vaccines, induced a delayed type allergy. The response depended upon the affiliation to a determined species and individual properties of a strain. The strain T. mentagrophytes 1 displayed the highest biological activity, since it was a good inducer of allergy and a manufacturer of active trichophytin in tests performed both in vivo and in vitro. PMID- 3267813 TI - [Radiologic evaluation of the position of the heart and its valves in American mink Mustela vison (Brisson, 1756)]. AB - Resorting to anatomical and radiological methods we have examined the position of the heart and the projection of the heart valves. The costotopy and the ortodiagram of the heart was analyzed. Special attention was paid to the difference between the position of the heart in female and male minks. We have found that in the majority of minks the heart is enclosed between 5 and 8 rib; it is situated with is greater part on the left side of the chest, especially in females. PMID- 3267814 TI - [Skeletotopy of the kidneys of American mink Mustela vison (Brisson, 1756)]. AB - A radiological and anatomical analysis of the position of 120 kidneys of 60 minks of both sexes in relation to the vertebral column was carried out. It was found that they are situated at the height of Th13 to L5, the right kidney is situated more cranially than the left one and most often across the fourteenth rib (female 51.5%, male 59.3%). PMID- 3267815 TI - [Analysis of the effects of oxytocin, vasopressin, angiotensin, serotonin and histamine on the blood flow in the reproductive organs of swine the during estrous cycle]. AB - We have measured the magnitude of flow in the uterine artery (ua) and in ovarian artery (oa) in the isolated reproductive organs of pig (100-130 kg/per head) perfused with their own blood or Krebs-Henseleit's solution. The pressure was kept on the constant level 100 mm Hg. Were administered intraarterially Oxytocin (O), vasopressin (W), histamine (H), serotonin (5-HT) and hypertensin (A). Their possible influence on the processes of regulation of blood flow in the porcine reproductive organs during oestrus cycle was analysed. It was stated that O produced a decrease of blood flow (bf) in the periovulatory period (1-2 and 16-18 day of cycle). On the other hand doses many times bigger did not cause significant changes in ua in the luteal phase and in oa in all phases of the cycle. Action of O is connected with its pressing action on the uterine vessels, contracted by the smooth muscular coat of this organ. Limiting bf action of W and A is mainly connected with their direct vasoconstructive effect. Our results indicated that in physiological conditions during oestrous cycle O, W and A did not evoke significant changes in the regulation of blood flow in the porcine reproductive organs. High sensitivity of the investigated vessels on 5-HT in the luteal phase and lower sensitivity in the periovulatory phase could indicate serotonin's influence on the regulating changes of blood flow during oestrous cycle. Vessels of both investigated areas were very sensitive to H. Especially high sensitivity of oa vessels on H is correlated with an increase of sensitivity of the vessels on 5-HT and catecholamines in the luteal phase. It seem that H has significant importance as a factor antagonising influence of 5-HT and catecholamines in the luteal phase of cycle in the pig. Sensitivity of oa vessels on the investigated drugs was lower in all phases of the cycle studied than sensitivity of ua vessels, the only exception was when H was used. We observed similar reaction on used drugs, both in experiments with perfusion with the blood and with the Krebs-Henseleit's solution. It may suggest that vessels reaction depends upon the functional state of the organ and it is not directly connected with the hormones present in the blood. PMID- 3267816 TI - Neuronal migration abnormalities can still be diagnosed by computed tomography! AB - Magnetic resonance imaging is presently the best modality for evaluating gray/white matter anatomy. However, this modality is expensive and not yet readily available in all countries. Most neuronal migration abnormalities can be accurately diagnosed by computed tomography (CT) provided excellent scanning technique is used. Abnormalities of neuronal migration were identified with CT brain scans in 68 children and were categorized as focal heterotopias (11 patients), multifocal heterotopias (19 patients) of diffuse migration disorders (38 patients). The principal indications for imaging were correlated to the radiological features. Neuropathological confirmation of the migration abnormality was obtained in 8 patients. An increased awareness by both clinicians and radiologists together with optimal CT technique are essential for the accurate diagnosis of migration disorders in children. PMID- 3267817 TI - Development of the human motor trigeminal nucleus. AB - The morphometric features of the motor trigeminal nucleus of the developing human brain were examined using complete serial celloidin sections of 13 brains, including 10 fetal brains. Our results suggest that the developmental processes of the motor trigeminal nucleus should be divided into four stages as follows: (1) primary stage, characterized by the early neuronal differentiation; (2) secondary or preparatory stage; (3) tertiary stage, characterized by massive neuronal death, and (4) postnatal stage, characterized by the maturation of neuropils. There were differences between the neuronal death observed in human and animal brains. Possible implications of these observations for the development of the nervous system are discussed. PMID- 3267818 TI - Heterogeneity of nemaline myopathy. A follow-up study of 13 cases. AB - The marked heterogeneity of nemaline myopathy is again shown in the present series of 13 patients. Most children have a long-standing, mild, and slowly progressing proximal myopathy. Two brothers with extreme weakness died during the neonatal period of respiratory failure representing the X-linked variant. One adult with proximal weakness was also diagnosed as having nemaline myopathy. An unusual course was observed in 2 infants who initially had moderate weakness but subsequently developed severe generalized weakness including respiratory muscles. This led to irreversible respiratory failure requiring continuous ventilatory support for as long as 9 and 15 years, respectively. Although uncommon, the possibility of an imminent respiratory failure in initially weak infants should also be taken into account within the clinical spectrum of nemaline myopathy. PMID- 3267819 TI - Radiation exposure to the ocular lens during CT scanning. AB - Measurements of radiation exposure during routine CT scanning were found to average 4.2 R at the level of the ocular lens. This data was combined with CT scanning rate data from a sample of 100 patients followed in the myelomeningocele clinic. The number of scans averaged 7.75/patient with a range of 0-34 scans. Cumulative radiation exposure to date ranged from 0 to 143 R. Radiation dosage nomenclature and acceptable limits are discussed and recommendations for reduction of dosage are presented. PMID- 3267820 TI - Patient data system for monitoring shunts. AB - Rapidly locating accurate data on a patient's shunt system is often extremely difficult. We have developed a simple system to fill a perceived need for recording current data on a patients shunt. This system employs an easily updated record in the patient's hospital or clinic chart as well as a wallet-sized data card for the patient or his family to carry. The data in the chart include the configuration of the patient's current shunt system and a graphic record of previous shunt problems. The small patient data card describes the age of the shunt system and its current configuration. We have found that this system provides assistance in the routine follow-up of patients with shunts and plays an extremely necessary role in the emergency evaluation of these patients, particularly when an emergency evaluation is undertaken in facilities distant from the location of regular treatment. PMID- 3267821 TI - An unusual syndrome of pediatric brainstem trauma. AB - We report 2 cases of children who developed a delayed hemiparesis following minor closed head injury with no alteration in consciousness and normal CT studies. MRI showed focal lesions in the ventral pons contralateral to the hemiparesis. Both patients recovered to near normal neurologic function within several days of injury. We postulate a mechanism of injury based on focal contusion of perforating brainstem arteries resulting in the delayed onset of vasospasm. PMID- 3267822 TI - The dream of unity of psyche and body: has it passed us by? Interview with Professor Thure von Uexkuell. Interview by Juergen-Peter Stroessel. PMID- 3267823 TI - Clinical process studies on anxiety and aggressiveness affects in the inpatient therapy of anorexia nervosa. AB - Under the assumption of affect defense (alexithymia), 20 anorexia nervosa patients being treated in the University Hospital of Hamburg-Eppendorf were examined with respect to their affects of anxiety and aggressivity by employing speech samples (three times a week)--according to Gottschalk-Gleser--and questionnaires (ANIS) during hospitalization and compared to 10 control patients from somatic clinics (orthopedics, surgery, gynecology). Particular attention was given to emotional responses toward events during the inpatient period. The most important result found was the distinct affectivity in the anorexia patients, which was partly stronger than that of the somatic control patients, so that judging from our anorexia nervosa sample the hypothesis of alexithymia will have to be renewed and requires a more differentiated discussion. PMID- 3267824 TI - Our varying ability to predict the outcomes of psychotherapy. AB - The general inability to make clinical predictions of psychotherapeutic change, which has been suggested by previous research, is questioned in this study. It is argued and empirically demonstrated in a sample of 8 experienced psychologists and 8 psychology students that there are reliable individual differences in the ability to make accurate predictions. Above-chance accuracy is significantly frequent in the former group of judges (and nonexistent in the latter group), and performance also appears to be influenced by the conditions of the prediction task. PMID- 3267826 TI - Experiences in the psychotherapy of rheumatoid arthritis. AB - According to the relevant literature, psychological factors may play an important role in the onset and clinical course of rheumatoid arthritis. This is the first study reported in which the treatment of rheumatoid arthritis is based on such factors. Twenty-seven arthritics were treated psychotherapeutically and a close connection was seen between the course of the psychotherapy and the development of the somatic disease. PMID- 3267825 TI - Comprehensive assessment of change in patients treated with short-term dynamic psychotherapy: an overview. A 2-year follow-up study of 34 cases. AB - Change was assessed in 34 patients at the end of short-term dynamic psychotherapy (STDP), and at 2 follow-ups (1 year and 2 years subsequent to treatment). The assessment was made from different perspectives and according to multiple criteria and methods of measurement. The results indicate that, when a particular form of STDP is selected according to each patient's ego resources, motivation for therapy, and motivation for change, approximately 90% of the patients will attain substantial symptom relief. The majority of the patients in this study also gave evidence of positive change in adaptive functioning, while one-third attained some dynamic/structural change as well. Clinically rated improvement was confirmed by changes in the patients' self-reported distress level (SCL-90), and from psychological test findings (MMPI). Improvement observed at the end of therapy was sustained throughout the 2-year follow-up period. PMID- 3267827 TI - Alexithymia: subscales and relationship to depression. AB - The purpose of this study was to determine the extent to which Toronto Alexithymia Scale (TAS) scores and derived subscale scores changed in a sample of newly abstinent alcoholic inpatients. Subjects completed the TAS and the Beck Depression Inventory (BDI) on the date of their application for care (Time 1) and at the end of their 3rd week in treatment (Time 2). Patients' mean BDI scores dropped significantly from Time 1 to Time 2; however, the expected concomitant drop in mean TAS scores did not occur. TAS subscales analysis suggests that the subscale associated with the ability to identify one's feelings and to distinguish them from bodily sensations may capture the alexithymia construct better by itself than when combined with the second 2 subscales, daydreaming and external thinking, to create the total TAS score. PMID- 3267828 TI - [Rediscovered: high labial bow]. PMID- 3267829 TI - [Problem of color analysis and its communication]. PMID- 3267831 TI - [Who is becoming the dental technician for orthodontics?]. PMID- 3267830 TI - [Ceramic inlay (I)]. PMID- 3267832 TI - [Laboratory prepared posterior composites--an esthetic alternative]. PMID- 3267833 TI - [Ceramic inlay (II)]. PMID- 3267834 TI - [Metallurgical aspects of polychrome lamination]. PMID- 3267835 TI - [Apropos dental technicians]. PMID- 3267836 TI - [The way to the master title in dental technical handwork--practical examination]. PMID- 3267838 TI - [Periapical tissue and its repair potential]. PMID- 3267837 TI - [Comparative S.E.M. study of the efficacy of the Piezon Endo system of canal preparation with a manual method]. PMID- 3267839 TI - [Ultrasonic retrieval of a broken instrument: apropos of a case]. PMID- 3267840 TI - [Tomodensitometry: possible role in endodontic surgery]. PMID- 3267841 TI - [Etiology of gingival swelling]. PMID- 3267842 TI - [Pathological root resorptions and their treatments]. PMID- 3267843 TI - [Calcium hydroxide in endodontic treatment of large periapical lesions]. PMID- 3267844 TI - [Initial penetration technic for simultaneous progressive enlargement. 2. Comparative scanning electron microscopy study of root surfaces after classic instrumentation and progressive enlargement]. PMID- 3267845 TI - [Treatment of an endo-periodontal lesion]. PMID- 3267846 TI - [Case of Doctor S. Yguel-Henry. A dental fistula]. PMID- 3267847 TI - [Combined lateral and thermomechanical condensation: clinical role]. PMID- 3267848 TI - [Direct quantification of marginal gap (double embedding technic): application to manual lateral condensation]. PMID- 3267849 TI - [Respiratory diseases ... danger!]. PMID- 3267850 TI - [Surface coloring for built ceramic]. PMID- 3267851 TI - [A look at the "one bake" method of Asami Tanaka]. PMID- 3267852 TI - [Biomate-C (R*) for ceramo-metal frameworks]. PMID- 3267854 TI - [Consumer participation in health programs]. PMID- 3267853 TI - [Perception of light and color]. PMID- 3267855 TI - ["Operation Impact" against malaria in the State of Para, Brazil]. PMID- 3267856 TI - [The use of curtains soaked with deltamethrin in malaria control in mining areas in the Federal Territory of Amapa, Brazil. Preliminary report--1986]. PMID- 3267857 TI - [Predatory activity of Astronotus ocellatus (Cichlidae) on Biomphalaria glabrata (Planorbidae)]. PMID- 3267858 TI - [Detection of leptospirosis in rats in the city of Recife, Pernambuco, 1983 1985]. PMID- 3267859 TI - [Dispersion of cases of malaria in Brazil]. PMID- 3267860 TI - [Federation Dentaire Internationale. Analysis of methods for identification of groups and individuals at high risk for caries]. PMID- 3267861 TI - [Enthesitis and enthesiopathy]. PMID- 3267862 TI - [Bilateral dissecting osteochondrosis of the hip joint (case report)]. PMID- 3267863 TI - [The HLA-DR antigen locus in patients with rheumatoid arthritis]. PMID- 3267864 TI - [Survey of rheumatic diseases in an urban population]. PMID- 3267865 TI - [Changes in the hands and late complications in diabetes]. PMID- 3267866 TI - [Renal complications in uric arthritis]. PMID- 3267868 TI - [Present possibilities and value of surgical treatment of the hip joint in juvenile rheumatoid arthritis]. PMID- 3267867 TI - [The importance of the ecological triad in the development of rheumatic fever]. PMID- 3267869 TI - [Manifestations and care of acute shoulder pain in seashore tourists]. PMID- 3267870 TI - [Climate and meteorological factors in Crikvenica]. PMID- 3267871 TI - [Rheumatic diseases in Zimbabwe]. PMID- 3267872 TI - [Diagnostic and therapeutic problems in patients with temporal arteritis and rheumatic polymyalgia]. PMID- 3267873 TI - [Pachydermoperiostosis--4 case reports]. PMID- 3267874 TI - [Renal transplantation from a related living donor: effect of donor specific blood transfusion]. PMID- 3267875 TI - [Rupture of the left ventricular free wall: a predictable complication of myocardial infarction?]. PMID- 3267877 TI - [Neoplasms of the pancreas and biliary tract: use of cytology in diagnosis]. PMID- 3267876 TI - [Sclerotherapy of esophageal varices: a prospective study]. PMID- 3267878 TI - [Clinical course of rheumatoid arthritis. A 10-year retrospective study]. PMID- 3267879 TI - [Intensive care units: indications for admission and mortality]. PMID- 3267880 TI - [Results of elective surgery of duodenal ulcer]. PMID- 3267881 TI - [Tachycardia with wide QRS complex: differential diagnosis]. PMID- 3267882 TI - [A patient with hypercalcemia: co-existence of multiple myeloma and parathyroid adenoma]. PMID- 3267883 TI - [Cryptococcosis in renal transplantation. A report of 4 cases]. PMID- 3267884 TI - [Leptospirosis. Zoonosis without transcendence in Chile?]. PMID- 3267886 TI - [The Edinburgh Declaration]. PMID- 3267885 TI - [The problem-oriented medical record. Bases for its use with critically ill patients]. PMID- 3267887 TI - [The need for physicians in Chile: a note of caution]. PMID- 3267889 TI - [Patients with gastric cancer: analysis of DNA ploidy patterns]. PMID- 3267888 TI - [Cerebrovascular disorders in Chile between 1952 and 1984: the evolution in mortality]. PMID- 3267890 TI - [Differences in hematologic variables according to ABO blood group]. PMID- 3267891 TI - [Exposure to solvents: detection of subtle neurotoxic effects in young workers]. PMID- 3267892 TI - [Patients with alcoholic psychoses: evaluation of the presence of psycho-organic impairment]. PMID- 3267893 TI - [Circulating immune complexes in infective endocarditis]. PMID- 3267894 TI - [Campylobacter jejuni and Campylobacter coli: epidemiologic markers of isolated strains in Santiago, Chile]. PMID- 3267895 TI - [Biliary composition and bile acid metabolism in young men and women]. PMID- 3267896 TI - [Pharmacokinetic study of subcutaneous disulfiram implants]. PMID- 3267897 TI - [Severe hypercalcemia: response to treatment]. PMID- 3267898 TI - [Right ventricular infarction: clinical and angiographic aspects]. PMID- 3267899 TI - [Chronic hemodialysis: experience of the 1st 15 years at university hospital]. PMID- 3267900 TI - [Chronic renal insufficiency: hemodialysis and nutritional treatment based on a urea kinetic model]. PMID- 3267901 TI - [Chronic active hepatitis induced by nitrofurantoin]. PMID- 3267902 TI - [Diffuse cavernous hemangioma of the rectum]. PMID- 3267903 TI - [Fascioliasis hepatica causing bile duct obstruction]. PMID- 3267905 TI - [The progress of pharmacology and the therapeutic revolution]. PMID- 3267906 TI - [Primary health care: the cost of delivery of health care at a rural outpatient clinic]. PMID- 3267904 TI - [The medical society and national medicine]. PMID- 3267907 TI - [Prognostic value of left ventricular indices in chronic aortic insufficiency]. PMID- 3267908 TI - [Physician-patient relations: comparative study of 2 internal medicine services]. PMID- 3267909 TI - [Electric and motor activity at the level of the small intestine in the dog: contractions without spikes and spikes without contractions]. PMID- 3267910 TI - [Fetal alcohol syndrome: prevalence in 4 special education schools in Chile]. PMID- 3267911 TI - [Acute viral hepatitis: etiology in the southern area of Chile]. PMID- 3267912 TI - [Myocardial infarction in patients older than 65 years of age]. PMID- 3267913 TI - [Primary gastric lymphoma: clinical and histologic aspects in 41 cases]. PMID- 3267914 TI - [Tumors and pseudotumoral lesions of the large intestine: frequency, distribution and histologic types]. PMID- 3267915 TI - [Cytodiagnosis of solid abdominal masses: cytologic study by percutaneous puncture with a fine-needle guided by echography, computed tomography or radioscopy]. PMID- 3267916 TI - [Spontaneous esophageal rupture: a report of 2 cases and a review of the literature]. PMID- 3267917 TI - [Adenolipoma of the breast. A clinical case]. PMID- 3267918 TI - [Lipoma of the mediastinum. A clinical case]. PMID- 3267919 TI - [Internal medicine in the structure of a general hospital]. PMID- 3267920 TI - [Cleft lip and cleft palate in Santiago de Chile: epidemiologic study]. PMID- 3267921 TI - [The School of Public Health of the University of Chile: recognition of the World Health Organization]. PMID- 3267922 TI - [Beta glucuronidase activity in Salmonella typhi and paratyphi]. PMID- 3267923 TI - [Cystic fibrosis: an emerging disease]. PMID- 3267924 TI - [Genetic characterization of the hospital population of Santiago]. PMID- 3267925 TI - [Crystallization of cholesterol in the gallbladder bile]. PMID- 3267926 TI - [Kallikrein excretion in patients with nephritic and nephrotic syndromes]. PMID- 3267927 TI - [Influence of maternal thyroid pathology on pregnancy]. PMID- 3267928 TI - [Surgical treatment of active infective endocarditis]. PMID- 3267929 TI - [Depression in cerebrovascular disorders: a prospective study and the effect of maprotiline therapy]. PMID- 3267930 TI - [Cerebral ischemia in young adults: experience with 55 cases]. PMID- 3267932 TI - [Retroperitoneal tumors: cytologic diagnosis by fine-needle puncture]. PMID- 3267931 TI - [The dying patient: use of intravenous fluids and management of fever]. PMID- 3267933 TI - [The bundle of His: non-invasive recording of its activity]. PMID- 3267934 TI - [Paraquat poisoning]. PMID- 3267935 TI - [Malignant angioendotheliomatosis: a clinical case]. PMID- 3267936 TI - [Kikuchi's necrotizing lymphadenitis: histopathology of 2 cases]. PMID- 3267938 TI - [The significance of disease]. PMID- 3267937 TI - [Tuberous sclerosis with probable bilateral renal angiolipoma]. PMID- 3267939 TI - [Typhoid fever in Santiago: the role of food handlers at elementary schools]. PMID- 3267941 TI - [The Revista Medica de Chile 100 years ago]. PMID- 3267940 TI - [Demand and professional resources in clinical laboratories]. PMID- 3267942 TI - [Expanding lesion of the right retromandibular region]. PMID- 3267943 TI - [A case of erythema multiforme with only oro-genital manifestations]. PMID- 3267945 TI - [MPDS syndrome]. PMID- 3267944 TI - [Oro-dental manifestations of Ellis-Van Creveld syndrome]. PMID- 3267946 TI - [The importance of ophthalmic changes in TMJ dysfunction syndrome]. PMID- 3267947 TI - [Tooth impaction. Apropos of a clinical case of bilateral impacted mandibular canines]. PMID- 3267948 TI - The challenge to dentistry of chronic pain. PMID- 3267949 TI - [Hypohydrotic ectodermal dysplasia syndrome]. PMID- 3267950 TI - [Composite resins for dental restoration available in Portugal]. PMID- 3267951 TI - [Bleaching of endodontically treated teeth]. PMID- 3267952 TI - [Esthetic rehabilitation as a multidisciplinary part of current dental medicine]. PMID- 3267953 TI - [Past, present and future]. PMID- 3267954 TI - [Central giant cell granuloma. (Apropos of a clinical case)]. PMID- 3267955 TI - [Heat treatment of dental amalgam alloys--Amalstoma C]. PMID- 3267956 TI - [Lemurine apophysis]. PMID- 3267957 TI - A survey of materials used by dental practitioners in South Africa. PMID- 3267958 TI - Watersorption and polymerization shrinkage of restorative resins. PMID- 3267959 TI - The use of the temporalis muscle flap in reconstruction of the maxilla. PMID- 3267960 TI - Development of a computerized patient care system at Medunsa. PMID- 3267961 TI - The effect of storage temperature on fogging of two types of intra-oral dental X ray film. PMID- 3267962 TI - The maxillary labial frenum and frenoplasty: a review and case report. PMID- 3267963 TI - A survey of the prosthetic techniques used by University of Stellenbosch graduates 1976-1985. PMID- 3267964 TI - Non-inbred Sprague-Dawley germfree rats as a model for oral candidiasis. PMID- 3267965 TI - General practitioner's radiology casebook IV. Tooth disease in a pregnant woman. PMID- 3267966 TI - General practitioner's radiology casebook V. Complications of a jaw injury. PMID- 3267967 TI - Stress and the dental practitioner. PMID- 3267968 TI - A chance-corrected measurement of agreement in the Community Periodontal Index of Treatment Needs (CPITN). PMID- 3267969 TI - The effect of 0.05% NaF, 0.4% SnF2 and conventional oral hygiene methods on plaque formation in the orthodontic patient. PMID- 3267971 TI - A survey of dental radiological protection in general practice in the Republic of South Africa--Part II: The hazard to the operator, staff and persons in the environs. PMID- 3267970 TI - General practitioner's radiology casebook VI. Maxillary sinus foreign body. PMID- 3267972 TI - Sucrose consumption and dental caries in twelve-year-old children of all ethnic groups residing in Cape Town. PMID- 3267973 TI - Mercury in dentistry. PMID- 3267974 TI - Designing school dental health programmes in South Africa. PMID- 3267975 TI - [Electronic blood pressure apparatus as a substitute for the standard sphygmomanometer]. PMID- 3267976 TI - General practitioner's radiology casebook III. Maxillofacial bone fractures. PMID- 3267977 TI - AIDS and the dental assistant. PMID- 3267979 TI - AIDS reference service offered. PMID- 3267978 TI - President Reagan responds to AIDS commission report. PMID- 3267980 TI - Lyme disease--the great imitator. PMID- 3267981 TI - [Some aspects and thoughts on issues and carrying out treatment of marginal periodontitis. II. Treatment planning]. PMID- 3267982 TI - [Results of a 3-year Elmex program during orthodontic treatment with fixed appliances]. PMID- 3267983 TI - [Form changes of temporomandibular joint and its clinical significance]. PMID- 3267986 TI - [Infections and abscesses in dental practice. I. Causes, dry socket, central bone marrow abscess]. PMID- 3267984 TI - [Preventive resin filling with Ful Fil--pit and fissure sealants with Prisma shield]. PMID- 3267985 TI - [Tisaduo, new construction of a double pin]. PMID- 3267987 TI - [Tooth root tip amputation and oral surgical interference in dental practice]. PMID- 3267988 TI - [Clinical function analysis]. PMID- 3267989 TI - [The Centrograph, jaw relation record of Kolndorffer as universal aid in bite registration]. PMID- 3267990 TI - [After-registration of a re-mounted complete denture]. PMID- 3267991 TI - [Conservative therapy of apical process]. PMID- 3267992 TI - [Cost comparison of endodontic implant systems. 2. How are various implant systems judged?]. PMID- 3267993 TI - [Fissure seals and fissure fillings (extended seals). Evaluation after 2 years]. PMID- 3267994 TI - [Anterior tooth loss in adolescents--causes and therapy possibilities]. PMID- 3267995 TI - [Clinical evaluation of posterior composites after 24 months]. PMID- 3267996 TI - [Masticatory dysfunction--an interdisciplinary approach]. PMID- 3267997 TI - [Oral rehabilitation of patients after radical surgery in mandibular region]. PMID- 3267998 TI - [Controlled apex position determination for transdental fixation and tooth root resection]. PMID- 3267999 TI - [Some aspects and thoughts on issues and carrying out treatment of marginal periodontitis. 1. Test findings]. PMID- 3268000 TI - [Are advertising claims of toothbrushes with synthetic bristles justified?]. PMID- 3268001 TI - [Epidemiological investigation of influence of systemic non-steroid anti rheumatics on the periodontium]. PMID- 3268002 TI - [Non-precious alloys for metal-ceramics]. PMID- 3268003 TI - [Patient risks from panoramic X-rays]. PMID- 3268005 TI - [What causes tax reform?]. PMID- 3268004 TI - [Dentist investments (I). More foresight in the establishment]. PMID- 3268006 TI - [Transdental fixation with the Tisa-pin system]. PMID- 3268007 TI - [Dentist investments (II). Dentist delays procuring supplies]. PMID- 3268009 TI - [Scanning electron microscopic investigation of upper surface structure of wedge shaped defects]. PMID- 3268008 TI - [Psyche of the child patient is for the most part alone in orthodontic treatment]. PMID- 3268010 TI - [Acupuncture in dentistry]. PMID- 3268011 TI - [Test of corrosion stability of parapulpal pins--an in vitro study]. PMID- 3268012 TI - [Working with elderly patients in daily practice]. PMID- 3268013 TI - [Caridex--first clinical experimental report of a caries removal system]. PMID- 3268014 TI - [Local antibiotic therapy with sulmycin implant--results of a pilot study]. PMID- 3268015 TI - [Precision of dental models prepared by cut model method]. PMID- 3268016 TI - [Review of a case of Pierre-Marie-Sainton syndrome]. PMID- 3268017 TI - [Cooperation between pediatrician and dentist--wish and reality]. PMID- 3268018 TI - [Combination preparations of botanical extracts as adjuvants in oral mucosal defense]. PMID- 3268019 TI - [Does music during dental treatment have an influence on heart and circulation parameters?]. PMID- 3268020 TI - [Dynamics of bone and implantology]. PMID- 3268021 TI - [Modern aspects of periodontology and endodontics]. PMID- 3268022 TI - [Recent clinical experiences with Ultracain preparations versus different lidocains]. PMID- 3268023 TI - [Cephalometric analysis of patients wearing full dentures]. PMID- 3268025 TI - [In vivo plaque formation on conventional denture material in humans--an experimental long-term study]. PMID- 3268024 TI - [Effects of calcium phosphate lactate in sweet bread spreads on experimental caries in Wistar rats]. PMID- 3268026 TI - [Sarcomatoid carcinoma of the larynx]. AB - In this paper the clinical and pathological aspects of a case of sarcomatoid carcinoma (spindle cell squamous carcinoma) of the larynx are reported. The diagnosis is confirmed by immunohistochemical analysis. PMID- 3268027 TI - [Congenital malformations of the stapes area]. PMID- 3268028 TI - Medico-legal in ORL. PMID- 3268029 TI - [Nasal provocation using histamine. A comparison of threshold determination using 3 methods of rhinomanometry]. AB - Three methods of rhinomanometry were compared with each other with respect to their ability to determine the histamine threshold (histamine concentration for a 100% increase of the initial total nasal resistance): the active anterior rhinomanometry (AAR), the active posterior rhinomanometry (APR) and the passive anterior rhinomanometry (PAR). Nasal challenge and consecutive measurement by the three methods of rhinomanometry were conducted in a group of 11 volunteers. The three methods gave significantly different histamine concentration thresholds (p = 0.002). Unilateral histamine thresholds as available from AAR and PAR (at a flow of 250 cm3/sec) did not differ significantly (p = 0.299). For AAR and APR, histamine thresholds were assessed at 5 different pressure values as well as at 5 different flow values. The thresholds did not appear to be significantly different at any one of those pressure gradients (p = 0.690) or flow values (p = 0.357). PMID- 3268030 TI - Cochleostomy. Long term results. AB - The original technique of the operation of cochleostomy is described. It should be considered as conservative operation, since it produces an "ostomy" of the cochlear promontory bone, joining the spiral ligament and mucosa of middle ear, without opening of the Cochlea. There is no risk of iatrogenic anacusis. The follow up of 178 cases with more than 10 years after surgery is described. The results are significantly better than endolymphatic sac surgery. PMID- 3268031 TI - Transplants and implants for major ear anomalies. AB - To accomplish two objectives, morphological and functional improvements, in plastic operation of major ear anomalies, the authors presented a surgical method utilizing exclusively auto materials and several pedicles of skin, fascia and periostium. A partially implantable middle ear implantable hearing aid (Partial MEI) is also an indication to those anomalies. Incidentally, we implanted the first Partial-MEI to a patient with unilateral atresia-microtia. The case was presented and demonstrated Partial-MEI implantation as one of the approaches for major ear anomalies to improve hearing. PMID- 3268032 TI - [Experiences with endonasal ethmoidectomy]. AB - The surgical technique of intranasal ethmoidectomy is described just as the utility of it, thinking of the pathogenesis of ethmoid, maxillary and frontal sinusitis. Besides, a group of 60 patients is studied. All patients underwent an intranasal ethmoidectomy. Symptoms, diagnosis, surgical indications and postoperative results are discussed. PMID- 3268033 TI - [A method of assaying thiorphan in aqueous solutions. Application to the stability control of galenic preparations]. PMID- 3268034 TI - [1H, 3H-quinazolinediones-2,4: synthesis, physicochemical characteristics and study of the denaturation inhibition of bovine serum albumin]. PMID- 3268035 TI - [Effects of various extracts of Dittrichia viscosa (L.) W. Greuter on experimental gastric ulcer]. PMID- 3268036 TI - [Pharmacodynamic study of phenyl-2 isopropyl allophanate (SCS 289)]. PMID- 3268037 TI - Cloning and chromosomal mapping of human cytochrome b5 reductase (DIA1). AB - We have isolated a cDNA clone that codes for human cytochrome b5 reductase. The cDNA was used to analyse, by Southern-blot hybridization, DNA isolated from a panel of 11 independent human-rodent somatic cell hybrids. The results indicate that cytochrome b5 reductase is encoded by a single gene located on human chromosome 22. PMID- 3268038 TI - Linkage between the expressed hypervariable gene locus PUM and the gene coding for the Duffy blood group FY. AB - Linkage is reported between the expressed hypervariable gene locus PUM and the gene coding for the Duffy blood group FY, with a maximum lod score of 4 at theta = 0. Linkage can be excluded between PUM and PEPC at a distance of 10 cM. PMID- 3268039 TI - Close linkage of PUM and SPTA within chromosome band 1q21. AB - Nine families were examined for linkage on chromosome 1 between the hypervariable gene PUM and the alpha-spectrin (SPTA) gene using DNA probes. Close linkage was found with a maximum lod score of 5.98 at theta = 0.05. Hybridization to DNA from somatic cell hybrids made from a parent line carrying a balanced X:1 translocation showed both genes to lie proximal to the breakpoint at 1q23. DNA hybridization to cell lines carrying deletions of 1q21-25 showed the presence of two polymorphic alleles for both loci. These results, combined with existing in situ hybridization data, suggest PUM and SPTA both lie within 1q21. Linkage analysis between PUM and the Duffy blood group (FY) gave a maximum lod of 2.15 at theta = 0.15. These data combined with data from another laboratory give a maximum lod of 5.21 for linkage between PUM and FY at theta = 0.10. PMID- 3268041 TI - The analysis of close linkage in large families. AB - In large families, if two closely linked loci both have rare alleles and several distant members are ascertained through one having rare alleles at both loci, simple estimates of their recombination fraction are possible. This information is free from errors due to both reduced penetrance and erratic paternity. Simple estimates based on counting will often have high efficiency and limited bias. Some problems of linkage analysis between loci with codominant expression in complete three generation families are also considered. The omission of individuals of uncertain genotype at the test locus will be more efficient than their inclusion. PMID- 3268040 TI - Confirmation of the relationship of HLA (chromosome 6) genes to depression and manic depression. II. The Ontario follow-up and analysis of 117 kindreds. AB - HLA typing was conducted on 577 family members of 86 families having at least two first-degree family members with a lifetime history of major depression or bipolar disorder. The results were combined with a follow-up study of 10 Newfoundland kindreds and with the data obtained from our previous studies, giving a total cohort of 117 families of diverse ethnic and geographic origin. There was increased sharing of HLA haplotypes, as compared with random expectation, over all possible pairwise comparisons both in the follow-up studies (P less than 0.025) and in the total data (P less than 0.01). The increase in HLA haplotype sharing over random expectation was greater if comparisons within heavily loaded sibships (by prior convention, sibships with three or more affected siblings) were omitted from the analysis (P less than 0.002). There was also non-random transmission of HLA haplotypes in 50 families selected for a low load, unaffected parent (P less than 0.005). Thus, we conclude that genes in the HLA region of chromosome 6 constitute one of the elements in the multifactorial etiology of affective disorder. This conclusion does not depend on any assumption concerning genetic heterogeneity or epistasis or on specific modes of transmission, penetrance values or linkage distances. In addition, the data suggest that chromosome 6 region genes may have a different effect in unipolar and bipolar illness. PMID- 3268042 TI - Multipoint mapping and the emperor's clothes. AB - On the hypothesis of no interference, pedigree probabilities for segregating loci considered simultaneously factor into pairwise probabilities, and multipoint mapping reduces to multiple pairwise mapping. Under these conditions, use of a computer program such as linkage or mapmaker entails no gain but substantial loss (measured as map distortion, wasted data, concealed evidence, redundant calculation and exaggerated multiple recombination) by comparison with maps based on lod scores. This is illustrated by the current maps of chromosomes 1 and 2. PMID- 3268043 TI - A cytogenetic study of 47,XXY males of known origin and their parents. AB - A number of patients with both sex chromosome aneuploidy and the fragile X syndrome have been reported and this has led to the hypothesis that females heterozygous for the fragile X mutation have an increased rate of meiotic nondisjunction. Furthermore the suggestion has frequently been made that a predisposition to meiotic nondisjunction is associated with an increase in mitotic nondisjunction. We have tested these two hypotheses by examining the chromosomes of a series of 47,XXY males and their parents. In the majority the parental origin of the additional sex chromosome was known. The cells were cultured under conditions suitable for demonstrating the fragile X and 100 cells were scored 'blind' from the patients and both parents. No fragile X individual was seen and there was no difference in the proportion of aneuploid cells between the parents in whom the nondisjunction event occurred and the control parents. Therefore, our results lend no support to the suggestions that the fragile X is associated with an increase in sex chromosome aneuploidy or that individuals in whom meiotic nondisjunction occurs have an increased level of mitotic nondisjunction. PMID- 3268044 TI - Effects of environmental changes on the phenotypic expression of human polygenic traits. AB - The very large increase in adult stature during the last century is well documented for many countries and this phenomenon has been associated with the rapid improvement of environmental conditions. In the case of Italy, data relative to its regions and drawn from the military records of the last century showed a rapid normalization (i.e. elimination of both negative skewness and hyperkurtosis) of the distribution (1874-1938), followed by acceleration of the average increase (1938-57), which is now approaching a plateau (1957-64). Two different interactions between genotype and environment are hypothesized: the curve normalization is interpreted as being due to the elimination of extremely unfavourable conditions which inhibit growth, while the rapid stature increase is possibly due to the achievement of an environmental threshold, such as to permit a complete expression of the genetic potential. In fact, under the multifactorial model, a perfectly normal distribution is expected, unless there is differential selection before age 18. PMID- 3268045 TI - Evidence on incest based on homozygosity. The use of multiple hypervariable probes for the probable detection or exclusion of incest. AB - An opinion is sometimes requested on the future health of a child who is up for adoption when parental incest is a realistic possibility and it is impossible or inexpedient to acquire blood from both parents. In such circumstances evidence of incest may be obtained by an analysis of blood from the child alone. PMID- 3268046 TI - [Analysis of amino acids in hydatid fluid by HPLC]. PMID- 3268047 TI - [Purification of hydatid fluid from sheep]. PMID- 3268048 TI - [Physical chemical characteristics of fraction 5 of hydatid fluid]. PMID- 3268049 TI - [Production of anti-hydatid monoclonal antibodies]. PMID- 3268050 TI - [Description and life cycle of Paramphistomum microbothrium Fischoeder, 1901, (Trematoda, Paramphistomidae) in Algeria]. PMID- 3268051 TI - [Relationship between the pathogenicity and the toxigenicity of Vibrio cholerae 01 and Vibrio cholerae not 01]. PMID- 3268052 TI - [Trematodes of Bulinus truncatus (Mollusca, Planorbidae) in Algeria]. PMID- 3268053 TI - [Pitfalls in the diagnosis of monoclonal immunoglobulins]. PMID- 3268054 TI - [Production of monoclonal antibodies against a strain of rabies virus]. PMID- 3268055 TI - [Role of neuraminidase in the pathogenicity of Vibrio cholera 01 and Vibrio cholerae not 01]. PMID- 3268056 TI - [The battle against tuberculosis in Algeria. Means and results]. PMID- 3268057 TI - [A crossed pharmacokinetic assay of two presentations of HRZ: one with combined components and one with isolated components H+R+Z]. PMID- 3268058 TI - [Campylobacter: pediatric experience in Oran]. PMID- 3268060 TI - [Mass survey for colorectal cancer]. PMID- 3268059 TI - [A new zymodeme of Leishmania tropica, agent of Aleppo boil (Syria)]. PMID- 3268061 TI - A new surgical approach to vasodilating therapy in peripheral occlusive vascular disease. PMID- 3268062 TI - A correlative study of axonal and perineurial regenerations after crush nerve injury in rat sciatic nerve. PMID- 3268063 TI - [Surgery for acquired valve disease (I): Past and present of rheumatic heart disease]. PMID- 3268064 TI - [Clinical study of non-epithelial malignant tumor of the stomach]. PMID- 3268065 TI - [The treatment of irradiation injuries of the colon and rectum]. PMID- 3268067 TI - [Angiographically occult AVM: report on two cases]. PMID- 3268066 TI - Tricuspid endocarditis complicating transvenous permanent pacemaker implantation. PMID- 3268068 TI - [Hyperbilirubinemia due to hepatic failure following open-heart surgery]. PMID- 3268069 TI - [Intussusception of the small intestine caused by villous adenoma: a case report]. PMID- 3268070 TI - Evaluation of some immunologic indices in children with HBV-mediated membranous glomerulonephritis. AB - Evaluation of the selected parameters of the immune system in MGN children has revealed some correlation between clinical advancement of the disease and the presence of the immune complexes in the serum. The results obtained point to the predominance of the suppressive reaction. PMID- 3268071 TI - The formation of soluble heat IgG aggregates for immunological studies. AB - The structural alteration associated with the aggregation of heated immunoglobulin molecules and the triggering of their effector reactivity was studied using soluble aggregate derivatives. Large but still soluble aggregate species were obtained by the formation of complexes of heated immunoglobulin molecules with azo dyes - Congo Red or Trypan Blue. Exposed peptide fragments in the area rearranged on heating were identified by short-lasting proteolysis. The altered area was in this way localized in the Fab portion of the heavy chain. The heavy chain fragment bordered by disulphides which stabilize the domains V and CH1 was indicated as a most probable peptide portion forming the link between the aggregating molecules. The obtained dye-aggregate species retain their effector activity. The effect of structural alterations in the Fab fragment on the Fc remains unclear. PMID- 3268072 TI - Removal of surface adherent Staphylococcus aureus in the determination of phagocytosis and intracellular killing by the use of lysostaphin. AB - Use of lysostaphin to remove non-phagocytized, granulocyte-adherent bacteria allows more precise calculation of the percentage of the ingested as well as killed bacteria in the process of phagocytosis. PMID- 3268073 TI - Participation of polypeptide proteinase inhibitors in proliferation of fibroblasts. AB - The polypeptide proteinase inhibitors (PI) isolated from Cucurbitaceae plants, bovine pancreas, lima bean kale seeds and some other sources were assayed in mouse, rat and human cell cultures for possible mitogenic effects. PI stimulated the proliferation of the spare cultures of Balb/c 3T3 and NRK-49F fibroblasts pretreated with trypsin. PI had no effect on [3H]thymidine incorporation by the monolayer cultures of the mouse or rat cells. Also certain human cell lines were unresponsive to PI. The results suggest that PI have growth factor-like activities which are cell and/or species specific. PMID- 3268074 TI - [Influence of proximal gastric vagotomy on the esophageal high pressure zone in dogs]. AB - The influence of parietal cell vagotomy (PCV) on esophagogastric high pressure zone (HPZ) (pressure and length) was studied in 30 dogs. The animals were divided in 3 groups: group 1, 10 dogs submitted to PCV with gastric denervation until the esophagogastric junction; group 2, 10 dogs submitted to PCV with gastric denervation into esophagogastric junction and 3 cm above this; group 3 (control), 10 dogs submitted to laparotomy only. In the postoperative period (immediate and later) it wasn't observed any alteration of pressure and length of esophagogastric HPZ in three studied groups. PMID- 3268075 TI - Immediate effects of the endoscopic sphincterotomy on the motility of the sphincter of Oddi. AB - An endoscopic manometric technique was used to determine the CBD-duodenum junction pressure profile before and immediately after endoscopic sphincterotomy in 13 patients with common bile duct stones. Premedication (meperidine, atropine, and diazepam) was given to all patients and endoscopic retrograde cholangiopancreatography was performed before endoscopic sphincterotomy. In the patients with intact papilla the features of the sphincter of Oddi motility were similar to those previously described for patients not given premedication or submitted to cholangiography before endoscopic sphincterotomy. Endoscopic sphincterotomy which was successful for immediate stone removal in 9 of 13 patients caused an immediate reduction of sphincter of Oddi motility in all patients, but abolished it in only 2 of them. The present results show that successful common bile duct stone extraction by means of endoscopic sphincterotomy can be accomplished without total abolition of sphincter of Oddi motility. PMID- 3268076 TI - Obstructive jaundice caused by blastomycosis of the lymph nodes around the common bile duct. AB - A case of obstructive jaundice due to granulomatous blastomycosis is presented. The patient had complained of abdominal pain in the right hypochondrium and jaundice. During hospitalization, the laboratory tests showed evidence of obstructive jaundice and complementary tests a distended gallbladder, dilatation of the intra and extrahepatic bile ducts with enlarged lymph nodes of the hepatic hilus. During the operation a cholestatic liver, distended gallbladder and enlarged lymph nodes around the common bile duct were found. Histopathology of the lymph nodes revealed South American blastomycosis. The medical management consisted of amphotericin B. At present the patient is alive and well. PMID- 3268079 TI - Molecular biology of endocrinology. PMID- 3268077 TI - Bowen's disease: a rare condition in an unusual extension. AB - The detection of Bowen's disease, a very rare condition in an unusual extension- literally covering the anogenital area--and the successful more conservative way of handling the lesions, through surgical separate steps, prompted the authors to review the literature and to report the case. PMID- 3268078 TI - [Clinical conference at the Brazilian Institute for Studies and Research in Gastroenterology]. PMID- 3268080 TI - [Configuration factors between a cylindrical element as a model of the human body and a rectangular plane]. PMID- 3268081 TI - Effect of work load durations in progressive exercise relationships between lactate and anaerobic thresholds. PMID- 3268082 TI - [Ventilatory response to hypercapnia at rest in the summer and winter]. PMID- 3268084 TI - [Optimum listening level of music]. PMID- 3268083 TI - Prediction of pulmonary residual volume from anthropometric measurements in Caucasian male adults. PMID- 3268085 TI - [A comparison of maximal oxygen debt determined by Dimri's extrapolation and actual methods]. PMID- 3268086 TI - [Effects of sports habituation on physique and physical fitness of the elderly- in a case of gate ball players]. PMID- 3268087 TI - [Inverted intraoral osteotomy of the mandibular ramus for correction of prognathism]. PMID- 3268088 TI - [56 fused teeth in the primary dentition: one year prospective study]. PMID- 3268089 TI - [Epidermoid carcinoma of the cervix with metastases to the mandibular body. Report of a case]. PMID- 3268091 TI - Marking patients' skin for radiotherapy treatment field alignment. AB - From the survey and research, it appears that sterile or non-sterile waterproof Indian ink used for tattooing patients produces few reported side effects and problems considering the number of patients tattooed. Marker pens also seem to be entirely suitable for patients and for radiotherapy centre requirements. PMID- 3268090 TI - [Osseous periodontal lesions associated with proximal restorative defects using different restorative methods, prevalence and risk]. PMID- 3268092 TI - Radiographic experiences with the double-balloon mitral valvotomy. PMID- 3268093 TI - An obstetric surprise. PMID- 3268095 TI - A lateral oblique radiographic projection for use in dacrocystography. PMID- 3268094 TI - Training of radiographers in Chile. PMID- 3268096 TI - Male breast cancer--a case study. PMID- 3268097 TI - Dysbaric osteonecrosis (caisson disease). PMID- 3268098 TI - New angles on the radiographic examination of the hand--I. PMID- 3268100 TI - [Preparation of autologous fibrin adhesive]. PMID- 3268101 TI - [In vitro test of human fibrin adhesive]. PMID- 3268099 TI - [Synthetic adhesives: errors to avoid in application]. PMID- 3268102 TI - [5 clinical cases treated with autologous fibrin adhesive]. PMID- 3268103 TI - Studies on fermented corn flour poisoning in rural areas of China. I. Epidemiology, Clinical Manifestations, and Pathology. AB - An outbreak of a new type of fatal food poisoning has been reported in different parts of the People's Republic of China. Liver, kidney, heart, and brain were the main target organs, and the overall fatality of intoxicated individuals was 38.2%. Evidence obtained from epidemiological studies and animal tests indicates that the food poisoning was caused by the consumption of homemade fermented corn flour products. PMID- 3268104 TI - Inflammatory potential of grain dust. AB - A comparative analysis of toxicity and inflammatory potential of spring wheat, oat, corn, and flax seed was performed. The extracts were examined by quantification of gram-negative bacterial endotoxin and protein contents, chemotaxis for purified human polymorphonuclear leukocytes, and several alveolar macrophage functions including phagocytosis, release of lactate dehydrogenase, macromolecular synthesis (protein and RNA), and interleukin-1 production. The results suggested that the extracts of all four grain dusts inhibited protein synthesis and decreased phagocytosis of alveolar macrophages at 7.5-25 mg/ml. Protein synthesis was inhibited to 40.2% of control and phagocytosis to 47.9% of control. Interleukin-1 production was stimulated, as indicated by a stimulation index range from 3.8-fold to 14.3-fold over controls. The activity of these grain dust extracts did not correlate with the endotoxin content of the samples. The data demonstrate that the extracts of all four dusts produced ill effects in rat alveolar macrophages in vitro and suggested a potential hazard to agricultural workers exposed to grain dust. PMID- 3268106 TI - Chemical industry: toward harmony with the environment. AB - From the very moment that the chemical industry became aware of the necessity of acting more eco-compatibly--in part by its own experience and judgment and in part admittedly under the influence of concerned authorities and citizens--the endeavour for environmental protection received decisive momentum. Today, impressive improvements have been realized in many fields and in many places. The technical possibilities for further achievement in this domain are unlimited. This statement is valid for products as well as for production processes. However, the consumer must also play his role in this exercise. His consumption attitude must be eco-conscious as well; progress will not be possible unless he is willing to pay more for eco-compatible products, manufactured by eco compatible processes. In an area where so many are committed to acting responsibly, wise and well-weighed governmental influence is indispensable. PMID- 3268105 TI - An epidemiological study on farmer's lung among hay grinders in Dafeng County. AB - This article reports on an epidemiological survey of the presence of farmer's lung among 1054 farmers who grind moldy hay. The prevalence was 8.3-11.4%. The main pathogen was Thermoactinomyces vulgaris. The factors which influenced farmer's lung were the moldy state of the hay and the dust concentration. The epidemiological features of farmer's lung are analyzed and discussed and certain preventive measures are suggested. PMID- 3268107 TI - Natural inhalation exposure to coal smoke and wood smoke induces lung cancer in mice and rats. AB - In an rural area with a high mortality rate of lung cancer in humans, mice and rats were placed in an environment in which they inhaled coal smoke and wood smoke in indoor air for 15 to 19 months. The incidences of lung cancer in mice in the control group, wood group, and coal group were 17.0% (29/171), 45.8% (81/177), and 89.5% (188/210), respectively: in rats the incidences were 0.9% (1/110), 0 (0/110), and 67.2% (84/125), respectively. In addition, the pollutants in the air were analyzed. The results indicate that coal smoke is a highly significant risk factor for lung cancer in humans in Xuan Wei County of Yun Nan Province in China. PMID- 3268108 TI - Human exposure to carbon monoxide and inhalable particulate in Beijing, China. AB - Twenty nonsmoking volunteers were selected from the staff members of the Institute of Health according to their housing conditions. Carbon monoxide (CO) and particulate matter in the outdoor and indoor air and personal exposure were monitored simultaneously for 1 week in summer and 1 week in winter. At the same time some public areas, such as workplaces and shopping and traffic areas, were also monitored. The average outdoor concentration for CO was 1.5 ppm in summer and 3.9 ppm in winter; indoors it averaged 2.8 ppm in summer and 20.1 ppm in winter. Personal exposure fluctuated between these values. The level of COHb averaged 0.2% in summer and 1.9% in winter. The level of inhalable particles was higher in winter than in summer, but the difference was not as marked as that for CO. The activity diary showed that the time spent at home was around 66% and that total indoor (home and workplace) time was over 90%. This indicates the importance of studying indoor pollution and personal exposure. PMID- 3268109 TI - Target and nontarget actions of phenthoate and carbofuran: brain acetylcholinesterase, kidney iodide peroxidase, and blood thyroxine profiles in Channa punctatus. AB - Phenthoate- and carbofuran-containing insecticides are widely used by Indian farmers, thus endangering fish by exposing them to the hazards of a chronic low dose of these xenobiotics. Channa punctatus, cultivated under paddy-cum-fish culture programs, was treated with 176 ppb phenthoate, 333 ppb carbofuran, or a mixture of 88 ppb phenthoate plus 250 ppb carbofuran for 15 days. The rate of mortality was 10% in all treatments. These xenobiotics caused significant inhibition of brain acetylcholinesterase concomitant with low kidney iodide peroxidase activity and depressed blood thyroxine levels. It is surmised that phenthoate and carbofuran compounds are capable of significantly influencing the hormonal status of fish which is mediated via their target action on the nervous system. PMID- 3268110 TI - Lead exposure in pregnant women and their newborns in the city of Sao Paulo, Brazil. AB - Blood lead concentrations of a group of mothers and their newborns were studied. The results showed a correlation between maternal and newborn levels. It is suggested that biochemical alterations may be present in some of the mothers and in a smaller proportion of the newborns. In addition, a comparison of the lead levels in blood with those in the environment was made. PMID- 3268111 TI - Investigations on methyl mercury contamination of fishes in the Second Songhua River. AB - Fishes in the middle reaches of the Second Songhua River in Jilin Province were heavily contaminated by methyl mercury, the average content of 61 fish samples being 0.42 mg/kg. The upper and lower reaches were less contaminated and the averages were 0.12 mg/kg (53 samples) and 0.08 mg/kg (20 samples), respectively. The average methyl mercury content of fishes (20 samples) collected from a nearby "nonpolluted" water reservoir was 0.03 mg/kg. In a total of 134 fish samples collected from the Second Songhua River, 41% of the samples had a methyl mercury content exceeding the National Tolerance Limit of 0.2 mg/kg. PMID- 3268112 TI - Analysis of organic and inorganic components of inhalable particles in the atmosphere. AB - Samples of total suspended particulate matter and inhalable particles were collected from the atmosphere in Beijing, Shanghai, Wuhan, Taiyuan, and Zibo. The size distribution of particles, the variations in their concentrations during different seasons, and the concentrations of 10 kinds of inorganic elements and polycyclic aromatic hydrocarbons were also obtained. This information provided a scientific basis for studying the effects of particle pollution on human health, for formulating health standards, and for taking preventive measures. PMID- 3268113 TI - Pulmonary function study of retired cotton textile workers and the relationship to cigarette smoking. AB - A group of 173 retired cotton textile workers from one cotton mill in Shanghai was surveyed. A modified British Medical Research Council (BMRC) questionnaire was administered, and lung function tests were performed using an LR-80 flow volume machine made in China. All workers had worked in the preparatory and spinning departments for more than 25 years. A group of 373 healthy age-matched individuals with similar social, economic, and educational backgrounds but with no history of dust or any toxic agent exposure was selected as the control group. Pulmonary function parameters from the forced expiratory effort were recorded. Prediction equations were derived from 157 controls who had never smoked and had no history of respiratory or cardiovascular disorders. The ratios of observed to predicted values in the male and female cotton textile workers and controls were examined using two-way analysis of variance and Student's t test. There was no significant difference between the cotton textile workers and the controls in lung function parameters, whereas cigarette smoking had a distinct impact on all the parameters except forced vital capacity. The effects of cotton dust exposure and cigarette smoking appeared to be additive. It is suggested that the effect of cigarette smoking on the respiratory tract may be located mainly in the small airways. PMID- 3268114 TI - Reproducibility of low-dose extrapolation procedure: comparison of estimates obtained using different rodent species and strains. AB - Carcinogenic risk assessment based on low-dose extrapolation of dose-response relationships is characterized by a significant level of uncertainty. The aim of this study was to investigate the reproducibility of risk estimates carried out using different animal species and strains. The Weibull and multistage mathematical modes, as well as the "linearized multistage" model (EPA "conservative" procedure), have been used for dose-response relationship fitting. Whenever necessary, the Michaelis-Menten function was introduced in the models to account for a possible metabolic process. The analysis was directed to dietary sodium saccharin and vinyl chloride inhalation carcinogenicity (nine total dose response relationships). Data from different strains, species, and researchers were available for these substances. The general pattern of two sodium saccharin curves was an upward curve in both cases with a high consistency among parameters and risk estimates (the latter ranging within a factor 3). For vinyl chloride the trend was clearly downward for six carcinogenic dose-response relationships from different species; low-dose risk estimates, based on the upper confidence limits of the linear component, range within a factor 3. The study has indicated the reproducibility of the low-dose extrapolation process using different strains and species. PMID- 3268115 TI - Dose-response relationships in rodents of promoter carcinogens: a tentative interpretation of some downward trends. AB - This study analyzes a set of dose-response curves relative to promoter carcinogens administered to experimental animals with or without initiator pretreatment. In the case of initiator plus promoter treatment, as well as for low experimental doses, the experimental data and their mathematical fitting indicate a downward shape of the dose-response curves as a general feature. In this study, the following hypothesis, according to the two-stage carcinogenic action of initiator plus promoter treatment, is presented to interpret this downward shape: (i) an initiating action, involving a subset of available "targets" (the number of "initiated" targets is assumed to depend on initiating treatment level), and (ii) a subsequent dose-dependent promoting process, mainly involving the initiated targets. This process reaches a saturation level when all the initiated targets have been promoted. This kind of process may be quantitatively described by a saturated exponential model: P(d) = K(1 - exp(-K0 + K1d)] which fits the experimental data fairly well. No indication supporting the hypothesis of a threshold for the chemicals examined resulted from the analysis. In the specific case of sodium saccharin, experimental dose-response relationships were available with or without initiator pretreatment (BBN and MNU). While in the first case the shape of the dose-response curve is downward, in the second case, it is upward and significantly different. PMID- 3268116 TI - Prediction of environmental fate and effects of heteroatomic polycyclic aromatics by QSARs: the position of n-octanol/water partition coefficients. AB - The HPLC and TLC retention, n-octanol/water partition coefficients (log Kow), bioconcentration factors, and acute toxicity data of 29 heteroatomic polycyclic aromatic hydrocarbons and 7 parent polycyclic aromatics were determined experimentally. For the same set of compounds, molecular weights, fragmental log Kow values, and molecular connectivities were calculated. Quantitation of the mathematical relationships between the variables was used to validate the predictive potential of various parameters. The importance of log Kow in predictive studies is highlighted. It is concluded that the internal concentration of a pollutant in the organism should be used as a parameter in future QSAR work. PMID- 3268117 TI - Prediction of the environmental hazard of organic pollutants in an effluent from a pesticide-producing plant. AB - A prediction of the environmental hazard of 59 organic pollutants (e.g., pesticides, solvents, phenolics, and detergents) in the effluent from a pesticide producing plant has been performed. Data on chemical fate (degradation, hydrolysis, volatilization, and bioaccumulation) and toxic effects have been obtained in a literature search and stored in a databank. The hazard has been evaluated on the basis of persistence, toxicity, and tendency to bioaccumulate. The predicted hazard, which indicates which pesticides are the most hazardous, is presented and visualized in plots of data from the databank on discharged amounts, persistence (in terms of half-lives), toxic effect concentrations related to the concentrations detected in the wastewater, and bioaccumulation factors (BCF). PMID- 3268118 TI - Abstracts of papers presented at the International Meeting on the Toxicity of Drugs and Other Chemicals. July 29-August 2, 1986, Beijing, China. PMID- 3268119 TI - The chemical industry: challenges and opportunities through the year 2000. AB - Three major areas are discussed regarding future challenges and opportunities for the chemical industry: (1) product qualities, (2) the waste situation, and (3) monitoring needs in industry and the environment. It is stressed that there remains much to be done with respect to improving safety testing and assessment of chemicals and that our knowledge of the environmental behavior of existing chemicals is dismal. The currently rather unsatisfactory information transfer situation is highlighted. Regarding waste production, in principle, the chemical industry must develop and operate closed systems to the extent that is technically feasible. In the area of monitoring, a new generation of "key indicators" must be developed. These indicators will be symptom oriented and capable of reacting to and indicating the presence of biologically active agents of unknown nature or variety. They can thus detect unexpected changes in the environment and allow assessment of the biological relevance of emissions and effluents of unknown chemical compositions. Regarding exposure changes, a new analytical approach is suggested in the form of "Exposure-Trend-Analysis Systems" (ETAS), which optimize the detection of unexpected concentration trends in environmental matrices without focusing on preselected chemicals. It is suggested that the chemical industry can meet all reasonable demands for improving its performance in protecting the environment, provided that governments and the industry itself cooperate on an international level--beyond the European Common Market. PMID- 3268120 TI - Extensive atrazine pollution of drinking water in the Lombardia region and related public health aspects. AB - Introduced in 1957, atrazine is a herbicide used worldwide, mainly in corn cultivation areas for weed control. It is only slightly volatile, is highly soluble in water, and is moderately persistent in topsoil, where it is strongly absorbed to organic carbon. Because of these properties, atrazine can leach to ground water and persist for a long time. This work presents the results obtained so far from an investigation initiated because of an emergency situation in the Lombardia Region of Italy caused by the occurrence of levels of atrazine in drinking water exceeding those established by the European Economic Community and Italian regulations. Water samples from almost 3000 wells were analyzed in different laboratories of the Lombardia Region. Atrazine contamination occurred in a significant number of the wells examined. Examination of the analytical data overall leads to the conclusion that the agricultural use of atrazine in the Lombardia Region is a serious source of ground water contamination. In some areas other factors may be responsible for the contamination of ground water (for instance, industrial activities and/or uncontrolled waste discharges). Geological and hydrological characteristics may play an important role in ground water contamination. Purification systems containing active charcoal seem to be highly efficient in removing atrazine from contaminated water. PMID- 3268121 TI - Blood lead levels in children living in three communities, at different risks of lead pollution. AB - We carried out a survey on blood lead levels in children living in three different communities in Umbria, Italy: Corciano, a small community (12,500 inhabitants), free of lead-using factories and with light traffic; Perugia, a medium-sized city (146,500 inhabitants); Deruta, a small community (7500 inhabitants) whose economy is based mainly on the production of artistic pottery, mostly in small home-operated factories. The study sample was made up of 539 children (275 boys and 264 girls); 156 of them attended nursery school (aged 3-6) and 383 primary school (aged 6-11). The mean blood lead level was significantly higher in Deruta than in Corciano (9.7 vs 8.3 micrograms/dl); Deruta children whose parents were occupationally exposed to lead had significantly higher blood lead levels than children of lead-unexposed parents (10.7 vs 9.0 micrograms/dl). The mean blood lead level was higher in Perugia than in Corciano children. On the average boys had higher blood lead levels than girls in all of the groups. We conclude that blood lead levels were low in the groups of children studied. Nevertheless children of ceramic workers and children living in a medium-sized city had greater lead absorption than children living in the control area. PMID- 3268123 TI - Aspects of poisoning with traditional medicines in southern Africa. AB - During 1981-1985, 1306 patients were admitted to Ga-Rankuwa Hospital due to acute poisoning. The major causes were paraffin (59.0%) and traditional medicines (15.8%). The mortality from paraffin was low (2.1%), but poisoning from traditional medicine resulted in a high mortality (15.2%) and accounted for 51.7% of all deaths. The traditional healer was the main source (83.4%), of traditional medicines, while 11.6% was bought from African medicine shops. The rest was acquired from other sources. In 82.5% of cases traditional medicines were taken orally, and in 10.5% of cases they were administered as an enema. Poisoning by traditional medicines was always accidental and probably due to overdosage. Vomiting, diarrhea, and abdominal pain were the most frequently encountered symptoms while the lungs, liver, and central nervous system were commonly affected. Treatment consisted of ventilation, intravenous fluids, and other palliative measures. A great deal of secrecy still surrounds traditional medicine, hampering rational therapy. Questioning of patients and interviews with traditional healers facilitated the identification of a number of major etiological agents. This elucidated the problem and should promote effective treatment. PMID- 3268125 TI - Enough British neurosurgeons? PMID- 3268124 TI - Joint Toxicology Network at the Latin American Regional Level. AB - The Environmental Health Program of the Pan American Health Organization has established goals to be able to comply with the resolutions of the Board of Directors and the Executive Committee. As an integral part of the Environmental Health Program, the Pan American Center for Human Ecology and Health (ECO) must contribute to the achievement of these goals. Generally speaking, there is a scarcity of toxicology professionals in the Region of the Americas. In order to ameliorate this situation, it is suggested that activities in the areas of training professionals, conducting research, dissemination of information, and publishing of educational materials be undertaken. It is proposed that the "Joint Toxicology Network at the Regional Level" be created. The objectives of such a network would be the promotion and encouragement of activities in the area of toxicology; assistance to countries in identifying their needs; encouragement of information exchange, publication and training in toxicology; and support of the Toxicology Information Centers. In order to achieve the Network objectives, it is suggested that activities be undertaken by the national groups belonging to the network. PMID- 3268122 TI - Chromosomal aberrations and sister chromatid exchanges in workers exposed to lead. AB - The frequencies of chromosomal aberration (CA) and sister chromatid exchange (SCE) in the peripheral blood lymphocytes of 21 lead-exposed workers from a battery factory were studied, and their blood lead (Pb-B) levels were determined. The results demonstrated that when the mean Pb-B level reached 50 micrograms/dl, the CA percentage increased significantly compared with that of the nonexposed controls. The CA percentage increased as the mean Pb-B level increased, showing a dose-effect relationship. When the mean Pb-B level was as high as 80 micrograms/dl, the rate of SCE in the lymphocyte was also increased significantly, but no correlation was observed between these two parameters. On the basis of such results, lead should be considered an agent harmful to the human chromosome. PMID- 3268126 TI - The place of thalamotomy in the treatment of parkinsonism. AB - L-Dopa therapy, like thalamotomy, is capable of suppressing some of the symptoms of Parkinsonism but is not a cure. The side effects of L-Dopa therapy can prove as incapacitating as the original symptoms of Parkinsonism. There remains a place for thalamotomy in the treatment of selected cases where symptoms are mainly localised, particularly to the non-dominant limbs, and it has also shown itself to be effective in suppressing dyskinetic movements due to L-Dopa. PMID- 3268127 TI - Familial subependymomas. AB - A family of eleven siblings is presented, five of whom developed a brain tumour. Three siblings had a subependymoma, one had an ependymoma and in one case the tumour was unverified histologically. The significance of familial brain tumours is discussed. PMID- 3268128 TI - Age as a prognostic factor after intracranial aneurysm rupture. AB - 1,076 patients with ruptured aneurysms admitted to neurosurgical units in Denmark over a period of 5 years were followed up for 2 years. The outcome as regards survival and normality of mental state was assessed in relation to age, clinical grade, and whether or not surgery was performed. For all ages and grades operated patients did better than those not operated on. Age seemed to have no bearing on outcome except for operated on good condition patients (grades 1-3) under the age of 40 years, who were significantly more likely to have a normal mental outcome than other groups. PMID- 3268129 TI - Experience with 'open evacuation of pus' in the treatment of intracerebral abscess. AB - Twenty-seven of 29 consecutive patients with brain abscess were treated by 'open evacuation of pus'. This technique involves wide exposure of the brain so that the abscess capsule may be incised and cleared of pus under direct vision. The empty capsule is left in situ after antibiotic irrigation and the wound is closed without drainage. Of the 27 patients, one died (3.7%), two were partly disabled and 24 (88.9%) were left with no neurological disability caused by the abscess. In only one case was a further operation required to remove pus which had reformed after an adequate primary clearance. There were no cases of wound sepsis or of late recurrence of the abscess. The author believes that 'open evacuation of pus' is the most satisfactory surgical technique for an intracerebral abscess. PMID- 3268130 TI - The outcome of unilateral occipital lobectomy in 12 foetal lambs in about the 100th day of gestation: a preliminary report. AB - In this study occipital lobectomies were carried out on 12 foetal lambs on about the 100th day of gestation. Three lambs were born alive and had computed tomographic (CT) scans performed on the 13th or 18th day of life. One lamb was found to have hydrocephalus due to ventriculitis. All three lambs had low attenuation areas on their CT scans suggesting that scarring rather than regeneration of the cerebral tissues had taken place. There was no evidence that accelerated bone healing of the skull had occurred. It is speculated that the lack of regeneration cerebral tissues and poor bone healing may have been due to the procedure being performed at a comparatively late stage of gestation. PMID- 3268131 TI - Vasoactive neurochemicals identified in omentum: a preliminary report. AB - There has been increasing interest in biologic, immunologic, and chemical activity originating from omental tissue. Since clinical improvement has been observed in some patients very shortly after surgically transposing their omentum to the spinal cord or brain, the question arose as to whether neurochemicals might be present in omental tissue; a possible explanation for some of these neurological changes. This paper reports the presence of vasoactive neurochemicals in canine omental tissue. It remains unclear, however, whether the omentum produces or simply concentrates these and other neurochemicals. PMID- 3268133 TI - Diagnosis of chronic subdural haematoma: the advantages of MR imaging compared with the CT-scan. AB - Two cases of chronic subdural haematoma are reported. Both highlight the difficulties associated with the diagnosis of such collections in the isodense phase on Computed Tomography. Magnetic Resonance Imaging proved its higher discriminating power by delineating the haematomas in both cases. The respective values of these two imaging techniques are discussed with a review of the current literature. PMID- 3268132 TI - Experimental cerebral and plasma pharmacokinetic studies of TCNU: implications for brain tumour chemotherapy. AB - This study of the pharmacokinetics of TCNU, a new nitrosourea, in the rodent has shown that TCNU concentrations in the plasma (ng/ml) and brain (ng/g) are equivalent from 15 min to 4 hours after drug administration. The absolute levels of TCNU obtained with a dose of 100 mg TCNU/kg bodyweight were at most time points, three to four times those obtained with dosage of 25 mg TCNU/kg. The profile of rodent plasma TCNU levels following drug administration is similar to that recorded in humans, with peak TCNU concentrations occurring around 45 min. Since TCNU crosses an intact blood brain barrier (BBB), and clinical Phase I trials have shown it to possess potent antitumour properties. It may be a useful agent in the management of primary and secondary cerebral neoplasia. PMID- 3268134 TI - Danger of lumbar puncture in spinal cord compression. AB - Rapid deterioration in the symptoms and signs of spinal cord compression following lumbar puncture is an unusual complication which must be thought of before undertaking this procedure as part of myelography. PMID- 3268135 TI - Subdural haematoma caused by metastatic dural carcinomatosis. AB - A case of subdural haematoma caused by metastatic dural carcinomatosis is reported. The condition is a rare but distinct entity. It is usually due to vascular obstruction of the dural vessels by tumour cells. If diagnosed early, patients may benefit from neurological surgery. PMID- 3268136 TI - Neuroradiological measurements. PMID- 3268137 TI - The aetiology of cervical spondylotic myelopathy. PMID- 3268138 TI - Dexamethasone and the serious head injury. PMID- 3268139 TI - Subtemporal decompression: radiological observations and current surgical experience. AB - Subtemporal decompression, although seldom used today for the management of hydrocephalus, pseudotumour cerebri, or premature closure of cranial sutures, is still used in many centres to alleviate intracranial hypertension caused by tumour, trauma, or severe intracranial haemorrhage. The charts of 50 patients undergoing subtemporal decompression for either severe head trauma or severe intracranial haemorrhage were reviewed. Preoperative and postoperative computed axial tomographic scans were available in 15 patients for analysis of the effects of decompression on the underlying temporal lobe. Calculation of the additional space provided by subtemporal decompression ranged from 26 to 33 cm3. PMID- 3268140 TI - Correction factors for gravimetric measurement of peritumoural oedema in man. AB - The water content of samples of normal and oedematous brain in lobectomy specimens from 16 patients with cerebral tumours has been measured by gravimetry and by wet and dry weighing. Uncorrected gravimetry underestimated the water content of oedematous peritumoural cortex by a mean of 1.17%, and of oedematous peritumoural white matter by a mean of 2.52%. Gravimetric correction equations calculated theoretically and from an animal model of serum infusion white matter oedema overestimate peritumoural white matter oedema in man, and empirical gravimetric error correction factors for oedematous peritumoural human white matter and cortex have therefore been derived. These enable gravimetry to be used to accurately determine peritumoural oedema in man. PMID- 3268141 TI - Pre-existing arterial hypertension in subarachnoid haemorrhage: an unfavourable prognostic factor. AB - In the Danish Aneurysm Study 1,076 patients were admitted with an aneurysmal subarachnoid haemorrhage in the 5-year period 1978-83. Pre-existing arterial hypertension, defined by the necessity for antihypertensive treatment at the time of admission was identified in 155 patients (15%). Nine hundred and two (85%) were normotensive. Nineteen patients were excluded because of inadequate information. Comparisons between the hypertensive and normotensive groups of patients showed no significant differences in sex-distribution, onset and course of the initial insult, results of primary CT-scan, location, size and numbers of aneurysms, number of rebleedings, and also in neurological symptoms, mental status, accommodation and occupation at a 2-year follow-up examination. The hypertensive group differed significantly in the following variables from the normotensive group. The median age was 8 years older (55 and 47 years of age respectively); a fewer number of patients fell into Hunt grade I-II on admission (34% and 43% respectively); an increased frequency of extracranial (23% and 13% respectively) and intracranial (35% and 18%, respectively) atherosclerosis was seen on angiography; a fewer number of patients underwent operation (48% and 66%, respectively); and at the 2-year follow-up examination an increased rate of overall mortality was evident (59% and 42%, respectively). There was an increased rate of mortality in patients in Hunt grade I-II on admission (52% and 22%, respectively) and an increased rate of mortality in patients who rebled (100% and 75%, respectively). Pre-existing arterial hypertension is an unfavourable prognostic factor after an aneurysmal subarachnoid haemorrhage. PMID- 3268142 TI - Choline acetyltransferase activity in omental tissue. AB - Choline acetyltransferase (ChAT), the enzyme responsible for the formation of ACh from choline and acetyl-coenzyme A, is a marker of cholinergic function and is significantly depressed in the brains of Alzheimer patients. It has been shown that omental tissue contains several neuroactive substances and causes revascularization when placed upon the brain of stroke patients. In this study, it was demonstrated that omental tissue exhibits specific ChAT activity. This activity was choline-dependent, inhibited by N-ethylmaleimide (a known ChAT inhibitor), and was characterized by kinetic parameters consistent with values for the neuronal enzyme. It is suggested that omental placement to the brain together with oral choline administration might prove to be useful for increasing ACh synthesis in Alzheimer's disease. PMID- 3268143 TI - Factors affecting cerebrospinal fluid flow in a shunt. AB - Nineteen hydrocephalic patients were studied to determine factors affecting cerebrospinal fluid (CSF) flow through shunts. This study was based on our previously reported method by which fluctuations in CSF flow through a shunt of from 0.01 ml min-1 to 1.93 ml min-1 were identified, each having its own rhythmic pattern. While CSF flow in a supine position was less than 0.01 ml min-1, head elevation to 60 degrees led to increases in CSF flow from 0.12 ml min-1 to 0.17 ml min-1. Sudden respiratory changes such as coughing also affected CSF flow. CSF flows were higher than average between 10 pm and 7 am, and changes in CSF flow were related to slight increases in ICP during REM sleep. There is no relationship between CSF flow in a shunt and daily fluid intake which varied from 27 ml kg-1 to 103 ml kg-1, and no significant changes in CSF flow resulting from rapid intravenous injection of Glycerol and Ringer's solution. PMID- 3268144 TI - CSF-dynamics in syringomyelia: intracranial pressure and resistance to outflow. AB - The several theories on the pathogenesis of syringomyelia have not resulted in the satisfactory selection of those patients who can be treated by CSF diversion. In the present paper three types of syringomyelia are described by case studies. The classification is made by investigation of CSF-dynamics, a measurement of CSF pressure and resistance to outflow of CSF. It is proposed that in a subgroup of patients with syringomyelia the cause is defective CSF resorption and that this group may be selected out and treated accordingly. PMID- 3268145 TI - Syringomyelia of the thoracic spinal cord associated with spinal meningiomas. AB - Syringomyelia is known to occur secondary to compression of the spinal cord. We report the case of a female patient who underwent removal of a spinal meningioma. She re-presented 30 years later with multiple meningiomas causing cord compression. After a 4 year interval she was found to have developed a syrinx proximal to the site of compression. Comparison with previous case reports suggest that the causation of syringomyelia is multi-factorial. PMID- 3268146 TI - Spontaneous massive haemorrhage into acoustic neuroma during anticoagulation therapy. AB - We report the case of a 58-year old man who bled into an undiagnosed acoustic neuroma while on long-term anticoagulation therapy which was commenced following aortic valve replacement. The patient presented with multiple cranial nerve paralysis of sudden onset. The tumour was subtotally removed but died 5 days postoperatively from recurrent haemorrhage into the tumour bed. PMID- 3268147 TI - Asymmetrical hydrocephalus following evacuation of a subdural haematoma. AB - A case of asymmetrical hydrocephalus complicating the surgical evacuation of a subdural haematoma is reported. PMID- 3268148 TI - Primary cerebral lymphoma presenting as steroid-responsive chiasmal syndrome. AB - A case of multiple primary cerebral lymphoma presenting with bitemporal hemianopsia due to a large suprasellar lesion is described; the visual symptoms improved after corticosteroid treatment. Involvement of the optic pathways is very unusual in primary central nervous system lymphomas; the visual symptoms can be due to lymphomatous uveitis or to infiltration of the optic nerves by leptomeningeal lymphoma, whereas bitemporal hemianopsia due to chiasmal compression has not been reported as first symptom of a cerebral lymphoma. The CT finding of multiple hyperdense well-enhanced lesions and their symmetrical distribution in the basal ganglia and frontal horns suggest the diagnosis of lymphoma. Improvement of neurological deficits during corticosteroid treatment is another feature typical of cerebral lymphomas. PMID- 3268149 TI - Cerebral gumma. AB - A patient presented with symptoms from a tumour in the frontal region. Syphilis had been treated 15 years earlier but the serological tests were inconclusive on this admission. The CT-scan showed oedema surrounding a contrast enhancing tumour. Angiography showed displaced but otherwise normal vessels. Histologically the lesion proved to be a gumma. PMID- 3268150 TI - Neurosurgical bacterial infections. PMID- 3268151 TI - Cerebral abscess. PMID- 3268152 TI - Alveolar soft part sarcoma of the pituitary gland with secondary involvement of the right cerebral ventricle. AB - An alveolar soft part sarcoma localised in the pituitary gland extended into the suprasellar region. Three years after surgical removal there was a recurrency in the occipital horn of the right cerebral ventricle. This type of tumour predominantly occurs in the limbs and has never been reported in the pituitary region. PMID- 3268153 TI - Epidermoid cyst of the fourth ventricle. AB - The case of a 52-year-old patient with a fourth ventricle epidermoid is reported. The initial presentation included long-standing headaches, progressive anomalies of gait and slight impairment of mentation. CT showed a hypodense mass enhancing peripherally after contrast infusion. Brain auditory evoked responses (BAER) showed asymmetric increased latencies. At operation, total removal of an extensive fourth ventricle epidermoid was achieved. A delayed meningitis occurred postoperatively. Physical examination was normal at the 2 year follow-up and BAER were improved. The etiological and clinical features of fourth ventricular epidermoids are briefly reviewed. The diagnostic value of CT is emphasised but the possibility of CT-dense epidermoid cysts deserves a special mention. Total removal of the neoplasm is the theoretical aim of operative treatment, but this purpose may be harmful when the ventricular floor is involved by the capsule. PMID- 3268155 TI - Intracranial hypertension: an unusual case due to sinus obstruction by fibrosarcoma. AB - A case of a skull fibrosarcoma compressing the right lateral sinus is presented as a rare cause of intracranial hypertension. PMID- 3268154 TI - Lumbar disc herniation causing focal expansion of the spinal canal. AB - A case of disc prolapse expanding the lumbar spinal canal by eroding the dorsal aspect of the body of L4 vertebra is reported. Despite no previous reports this condition is not considered to be extremely rare. PMID- 3268156 TI - Head measurements. PMID- 3268157 TI - Postoperative intracerebral haemorrhage. PMID- 3268158 TI - Management of intraventricular haemorrhage in patients with haemorrhagic cerebrovascular diseases. AB - The authors propose a four-grade classification for intraventricular haemorrhage (IVH) caused by haemorrhagic cerebrovascular diseases. Grading is based on the distribution and volume of the haematoma in the ventricular system as revealed by computed tomography (CT). In Grade I IVH, CT shows no haematoma in the ventricular system, but the cerebrospinal fluid contains some fresh blood; Grade II IVH fills a circumscribed portion of one or both lateral ventricles. This grade is divided into two: Grade IIa having a haematoma volume of, or less than 20 ml in the ventricular system and Grade IIb of more than 21 ml; Grade III IVH fills the entire length of one lateral ventricle and none, or circumscribed portion, of the other lateral ventricle; and Grade IV IVH entirely fills both lateral ventricles. This grading scale correlated with the mortality and morbidity of the IVH patients. Its application will assist in the selection of continuous ventricular drainage or direct evacuation of intraventricular haematoma as the management method. PMID- 3268160 TI - Recurrent aneurysmal subarachnoid haemorrhage: incidence, timing and effects. A re-appraisal in a surgical series. AB - A series of 510 patients with proven aneurysmal subarachnoid haemorrhage (SAH) is reported. The incidence of recurrent haemorrhage during the period awaiting surgery was 13.7%. There was no significant difference in incidence between good and poor grade patients. Following rebleeding there was an immediate mortality of 34% in good grade patients and 52% in poor grade patients. In the long term only 44.4% of good grade and 8% of poor grade patients made a good recovery following a second bleed as compared to 70.6% and 52.8% respectively for those who did not rehaemorrhage. PMID- 3268159 TI - The natural history of subarachnoid haemorrhage with negative angiography: a prospective study and 3-year follow-up. AB - One hundred and forty-eight patients with negative cerebral angiography after subarachnoid haemorrhage are reported. Good grade, normotension and normal CT are associated with a favourable outcome. In 89 patients with negative four-vessel angiography the overall annual risks of rebleeding and fatal rebleeding were 1.5% and 0.4% respectively. In 52 patients undergoing appropriate limited angiography corresponding risks were 2.5% and 1.9%. No fatal rebleeds occurred after 6 months. Initial CT scanning in 104 patients was abnormal in 34. Of these, 14 had SAH alone, in whom no episodes of rebleeding occurred, although SAH on CT was associated with an increased chance of a poor outcome. Twenty had other abnormalities, three of whom rebled, two (both with ICH on CT) being fatal. The annual risks of rebleeding and fatal rebleeding in patients with these CT abnormalities were 5.0% and 3.33% respectively. Fifty-two patients were hypertensive, of whom six rebled, four fatally. Two of the 89 normotensive patients rebled, neither fatally. PMID- 3268161 TI - Aneurysmal subarachnoid haemorrhage: overall outcome and incidence of early recurrent haemorrhage despite a policy of acute stage operation. AB - A series of 480 patients who were alive upon admission following an aneurysmal subarachnoid haemorrhage (SAH) is reported. These patients represented 40% of the total Swedish incidence during a 3-year period. The three neurosurgical referral centres covering this population had a similar policy of early diagnosis and acute state surgery in all patients considered of having a potential to survive without permanent disabling cerebral malfunction. At 2-year follow up 45% showed a good neurological recovery, the morbidity was 25% and the mortality was 30%. Some more lives might have been saved with an improved ultra-early referral system since there were 21 initially good-to-fair risk patients (4% of the total SAH population) who rebled fatally before surgery and within 48 h. For comparison, in the Kingdom of Denmark, with a general policy of delayed operation, out of 1076 patients who were alive upon admission, 27.5% made a good recovery, while the morbidity was 27%, and the mortality was 45.5%. PMID- 3268163 TI - Head injury rehabilitation: 4 years' experience in Edinburgh. AB - A survey was done of all cases of head injury admitted to a neurorehabilitation unit which, while mainly servicing the regional acute head injury unit, receives patients from throughout Scotland. During the 4 calendar years 1983-1986, 183 new cases of head injury were treated. The patients were predominantly young adult males the great majority of whom had suffered severe head injuries. Most were directly transferred from neurosurgical units within 6 months of injury. The length of stay in the unit varied from less than 1 month for half of the patients to as long as 10 months. Eighty-four per cent of patients were discharged home. The limitations and constraints upon the service are described and the need for a rational approach to the development of head injury rehabilitation facilities in the United Kingdom are discussed. PMID- 3268162 TI - Spinal cord compression: delay in the diagnosis and referral of a common neurosurgical emergency. AB - In 76 consecutive patients with spinal cord compression the process of diagnosis and referral was investigated. This investigation was carried out at the time of admission to the neurosurgical unit when it was possible to obtain fresh information about each patient's pre-admission management. All the patients had been referred from District General Hospitals and 71 had previously consulted their general practitioners. Sixty-two per cent took over a week from the time they first saw their own doctor to reach the referring hospital, after reaching hospital 47% of patients waited a week or more before they were referred to a neurosurgeon. During the process of referral, the proportion of patients able to walk unaided and control their sphincters fell from 68% to 10% while the proportion with complete cord lesions rose from 1.5% to 28%. In 48% of cases there had been delays in diagnosis and referral which appeared avoidable. The reasons for these delays and their effect on the eventual outcome are assessed. PMID- 3268164 TI - Trigeminal schwannomas: has the 'new technology' made any difference? AB - Computerised axial tomography (CT) and magnetic resonance imaging (MRI) should make detection of small trigeminal Schwannomas easier. Review of histories of five patients with trigeminal Schwannomas suggests that CT (and in one patient MRI) does not appear to lead to earlier detection of these tumours. Despite the availability of CT, three patients presented with large Schwannomas. A high index of clinical suspicion remains crucial to the diagnosis. Recent advances in diagnostic radiology have, however, considerably facilitated the logical planning of the operative approach. In that respect, it may be anticipated that the prognosis for these rare tumors will be improved. PMID- 3268165 TI - Cerebral medullary venous malformations. Report of four cases and review of the literature. AB - Each type of cerebral vascular malformation has its own unique clinical, radiological and pathological features, and a different pattern of natural evolution. With greater awareness and advances in neuroimaging, there is increasing recognition of Cerebral Medullary Venous Malformations (MVM), angiographically characterised by an 'Umbrella' or 'Caput Medusae' appearance. The clinical and radiological features of four patients with angiographically demonstrable features of cerebral medullary venous malformations, seen in our departments are presented to illustrate the features of cerebral MVMs. Three patients have been managed conservatively and one has been treated with stereotactic radiosurgery. The literature on cerebral MVMs has been reviewed and presented in this paper. It appears that most are benign and even in those cases where there has been a haemorrhage the outcome seems to be much better than with arteriovenous malformations. The rationale behind radiosurgical treatment is discussed. Before embarking upon any form of interventional therapy the natural course of these lesions should be considered. PMID- 3268166 TI - Modified hemispherectomy for epilepsy: early results in 10 cases. AB - Early outcome results for 10 cases of modified hemispherectomy are presented. All patients had a history of infantile hemiplegia and intractable epilepsy. Pre- and postoperative measures for seizures and motor and cognitive and behavioural functioning are described. Early results are encouraging with no mortality and a low rate of complications. There was a complete cessation of seizures in seven patients and a considerable reduction in seizure frequency in two. Motor functioning was largely unaffected. Behaviour problems tended to improve at the cessation of seizures. IQ scores did not deteriorate as a consequence of operation and some patients showed considerable gains in IQ with the passage of time. Details of cognitive functioning are described. PMID- 3268168 TI - Third ventricular tuberculoma: a case report. AB - Tuberculomas of the brain can now be diagnosed readily with computerised axial tomography. A rare, biopsy proven case of a third ventricular tuberculoma is presented. Typical CT scan findings are discussed and management with drugs and minimal surgical intervention when necessary is stressed. PMID- 3268167 TI - Tuberculous spondylitis in adults: diagnosis and treatment. AB - A retrospective study of 23 patients with spinal tuberculosis (TB) was conducted, with special attention to the diagnosis and method of treatment. Computerised tomography (CT) was found to be the diagnostic radiological modality of choice. Triple therapy with the new anti-tuberculous drugs and posterior or posteriolateral decompression succeeded in decompressing the cord and eliminating the tuberculous lesion in all cases. The outcome was comparable to series where anterior decompression was adopted. None of the patients required spinal fusion. Erythrocyte sedimentation rate was the most consistent blood test in suggesting the diagnosis and was the best tool for evaluating a patient's response to treatment. The average hospital stay was only 17 days, which speaks favourably for the surgical management of tuberculous spondylitis. PMID- 3268169 TI - Meningo-angiomatosis: a case report. AB - We report a case of Meningo-angiomatosis, a rare hamartomatous lesion of the cerebral cortex. The main clinical and pathological features of this entity are discussed. PMID- 3268171 TI - The frequency distribution of cardiovascular diseases in 13 hospital admitted patients in Korea. Korean Society of Circulation. AB - The frequency distribution of cardiovascular disease are changing recently due to the development of living environment. Unfortunately there are few epidemiological studies of cardiovascular diseases in general population, we tried to estimate the recent trend of cardiovascular diseases studying hospitalized patients in nationwide 13 large hospitals during a year of 1985. The hypertensive disease (24.1%) was the most common cardiovascular disease and the next were cerebrovascular disease (15.8%), arrhythmias (12.2%), ischemic heart disease (9.7%), congenital heart disease (9.1%), and rheumatic heart disease (5.4%) in order. This results showed that hypertensive disease and cerebrovascular disease are still the major cardiovascular disease and ischemic heart disease and arrhythmias are increased. But chronic rheumatic heart disease is declined compared with previous studies in hospitalized patients. PMID- 3268172 TI - Assessment of anterior shoulder instability by CT arthrography. AB - Computed tomography (CT) immediately after double-contrast shoulder arthrography was taken in twenty-two young male patients with anterior shoulder instability including recurrent dislocation and subluxation. This recently developed technique called CT arthrography can provide significant information about patients with glenohumeral instability which is difficult to obtain by conventional arthrography. Information about glenoid labrum pathology is useful for proper management of the shoulder with instability. Lesions identified in this study include anterior labral defects (attenuation, tear, displacement), anterior capsular distension and/or detachment, Hill-Sachs lesion, anterior glenoid rim compression fracture, and fracture of scapula. This article describes the method used in CT arthrography of the glenohumeral joint, reviews the normal cross-sectional anatomy, and emphasizes the importance of the application of CT arthrography in the shoulder disorder with instability. CT arthrography of the glenohumeral joint is easy to perform, is accurate, and has lower radiation dose than arthrotomography. PMID- 3268170 TI - Histaminergic cells in the choroid plexus of rat. AB - The choroid plexus of the rat was examined immunocytochemically using both an antibody directed towards a histamine thyroglobulin conjugate as well as to histidine decarboxylase. Histamine- as well as histidine decarboxylase immunoreactive cells were found within or in the vicinity of the plexus epithelium, with processes extending to the neighbouring epithelial cells or surrounding tissue, suggesting a specific function for histamine on the choroid plexus. PMID- 3268174 TI - A case of congenital factor V deficiency. AB - A case of Factor V deficiency, the first case in Korea, is reported in a 9-year old boy whose plasma concentration of Factor V was 6%. He complained of easy bruisability, prolonged bleeding from the mouth after minor trauma and hemarthrosis and flexion contracture of the right knee. His parents are heterozygous (maternal Factor V concentration 52%, paternal 40%). PMID- 3268173 TI - Intracranial granulocytic sarcoma (chloroma) in a nonleukemic patient. AB - Chloroma is a granulocytic sarcoma with it's characteristic greenish color. Recently there is an increased number of cases that are apparently aleukemic when the tumor mass is first presented. Recently we experienced a case of granulocytic sarcoma with characteristic green color (chloroma), which showed no evidence of leukemia in the bone marrow and peripheral blood. This patient presented headache, and was diagnosed brain tumor on computed tomography. A left parietal cranietomy was done to remove a large central dome-like mass, 8 cm, involving the dura with a slightly dusky greenish solid appearance. Compact nests of moderately mature granulocytes and immature cells comprised the tumor. Histochemical and electron microscopic studies confirmed these tumor cells as myeloid cells in varying stages of maturation. Several days after the operation, left cervical lymph nodes became palpated, and the biopsied lymph nodes revealed same neoplastic cells seen in the skull. However, bone marrow aspiration, biopsy and peripheral blood smears did not show any evidence of leukemia. PMID- 3268175 TI - Prostatic malacoplakia. An ultrastructural and immunohistochemical study. AB - A case of malacoplakia of the prostatic gland associated with prostatic nodular hyperplasia from a 69 years old man was presented, and its light and electron microscopic and immunohistochemical features were discussed along with its pathogenesis. This lesion was incidentally found in a transurethral prostatectomy specimen, and consisted of large number of epithelioid cells in which were typical cytoplasmic inclusions known as Michaelis-Gutmann bodies. Ultrastructurally, these inclusions showed a dense, central calcified bodies of various developmental stages. Immunohistochemical study using antilysosomal antibody revealed no lysosomal activity. Based on these findings, we could suspect that main problem for this development of malacoplakia is altered intracellular digestion process of foreign biologic materials. PMID- 3268176 TI - Liver cell adenoma in a neonate--report of an autopsy case. AB - A case of liver cell adenoma that was incidentally found at postmortem examination of a neonate who died of E. coli sepsis is described. The adenoma was a sharply demarcated, not encapsulated mass located subcapsularly in the right lobe, and was pale tan to light yellowish round nodule of 0.9 cm in diameter. Microscopically, the tumor was composed of sheets and cords of uniform and slightly enlarged hepatocytes separated by dilated sinusoids. There were no portal zones or central veins to suggest the normal lobular architecture. The nuclei were bland and the cytoplasm varied from clear to acidophilic, containing lipid vacuoles. Ultrastructural examination showed that the hepatocytes of the tumor had highly differentiated organelles, reminiscent of normal hepatocytes. PMID- 3268177 TI - Infantile hemangioendothelioma of the liver--a case report. AB - A case of type 1 infantile hemangioendothelioma of the liver in a 3 month old male infant who had an abdominal mass incidentally noted at 40 days of age, is described. Grossly, the tumor showed a well circumscribed, pinkish gray and gelatinous mass with areas of central necrosis, multifocal thrombi and hemorrhages, and small cysts. Microscopically, the lesion consisted of numerous vascular channels of various size lined by a single layer of flat or plump endothelial cells. Areas of infarction, thrombosis and calcification, and formation of cavernous hemangiomatous foci were also noted in the lesion. Ultrastructurally, the cells had the characteristics of endothelium, including basal lamina, pinocytic vesicles, and Weibel-Palade bodies. Factor VIII associated antigen was demonstrated in the tumor cells. PMID- 3268178 TI - A study on the effect of garlic to the heavy metal poisoning of rat. AB - When garlic (Allium sativum) was administered to rat per os simultaneously with cadmium, methylmercury and phenylmercury to detect the protective effect against the heavy metal poisoning, accumulation of heavy metals in liver, kidneys, bone and testes were decreased, and histopathological damages and the inhibition of serum alkaline phosphatase activities by heavy metals were reduced. Such effect of garlic was not shown in the 1.7% garlic treated group and most remarkable in the 6.7% garlic treated group. The protective effect of garlic was superior to those of 2,3 dimercapto-1-propanol (BAL) and D-penicillamine (PEN), and nearly similar to those of 2,3-dimercaptosuccinic acid (DMSA) and N-acetyl-DL penicillamine (APEN), the current remedies, while garlic was not effective as a curative agent for heavy metal poisoning. The excretion of cadmium was enhanced, more through feces than urine by garlic but the effect to the urinary excretion of cadmium was not significant comparing with DMSA or APEN when cadmium was ip injected in the first 3 days during the 12 days of oral administration of DMSA, APEN or garlic. PMID- 3268179 TI - Intraspinal narcotic anesthesia in open heart surgery. AB - Intraspinal narcotic anesthesia was performed in 180 open heart surgery patients. 0.1 mg/Kg of morphine or 1.5 mg/Kg of meperidine was administered as the primary anesthetic in the subarachnoid space using the barbotage technique. Of the 180 patients scheduled for open heart surgery, morphine was administered to 95 patients, meperidine to 55 and a mixture of morphine and meperidine to 30 patients. From a clinical point of view, there were no significant cardiovascular problems, however, respiratory depression seemed to be most serious after morphine administration. Mild complications such as pruritus (11.1%), voiding difficulty (10.6%), intraoperative awareness (4.4%) and spinal headache were observed, however these were mild, not major clinical problems and were acceptable. Postoperative analgesic effect and respiratory controllability were excellent. PMID- 3268181 TI - An evaluation of frozen section biopsy in 4434 cases. AB - Frozen section diagnosis is a highly useful method of diagnosis. There were 4434 frozen sections, 24 false positive diagnosis, 65 false negative diagnosis and 30 deferred diagnosis. This method achieves the highest accuracy when there is a cooperation between experienced surgeon and reliable and careful pathologist. It is wise to defer the diagnosis of consult to other pathologist in difficult situation. PMID- 3268180 TI - Malignant lymphomas in Korea. AB - A retrospective histological study of 540 malignant lymphomas diagnosed at the Department of Pathology of the Seoul National University from 1976 through 1986 is presented. Malignant lymphoma is the 10th most common malignant tumor in Korea, comprising 3.07% of all malignancy during period of study. Among malignant lymphomas non-Hodgkin's lymphoma accounted for 82% and accordingly the Hodgkin's disease was for 18%. The most common type of non-Hodgkin's lymphoma was diffuse histiocytic lymphoma of Rappaport. Follicular lymphoma was very rare, comprising only 2.3%. T-cell lymphoma accounted for 9.6% of non-Hodgkin's lymphomas, the most frequent type being lymphoblastic lymphoma. Immunoblastic sarcoma and mycosis fungoides were occasionally seen but there was no case of pleomorphic adult T-cell lymphoma. Among Hodgkin's diseases, mixed cellularity type was the most common type, and nodular sclerosis type was relatively rare. PMID- 3268182 TI - The effect of verapamil on cysteamine-induced duodenal ulcer in the rat. AB - To determine the effect of verapamil on experimental duodenal ulcer, pathologic assessment and secretory study were performed in the rats with ulcerogenic dose of cysteamine. The cysteamine increased gastric acid secretion and produced double duodenal ulcers at the proximal protion of the duodenum. Intramuscular injection of verapamil, 3 hours later, produced a significant decreased in gastric acid secretion which lasted at least 4 hours (cysteamine vs. cysteamine+ verapamil; 63.5 +/- 18.4 muEq vs. 25.5 +/- 9.0 muEq during the 1st hour after verapamil administration, 83.1 +/- 24.2 muEq vs. 27.8 +/- 12.3 muEq during the 2nd hour, 110.9 +/- 14.4 muEq vs. 38.5 +/- 25.9 muEq during the 3rd hour, 116.4 +/- 12.1 muEq vs. 40.7 +/- 29.6 muEq during the 4th hour, p less than 0.001). However, cysteamine-induced duodenal ulcers were not alleviated by two doses of intramuscular verapamil administration (4 mg/kg x 2). It is presumed that suppression of gastric acid secretion may not be sufficient to reduce cysteamine induced duodenal ulcer formation or that verapamil itself may have aggresive effects against duodenum. To illucidate the exact role of verapamil in cysteamine induced duodenal ulcer, further studies would be needed. PMID- 3268183 TI - A case of leukemia-associated arthritis--identification of leukemic cells in synovial fluid by light microscopy. AB - One case of arthritis complicating leukemia is described in which leukemic cells were identified in synovial fluid by light microscopy. Although arthritis is a well-known manifestation of leukemia with an incidence of 13.5%, the pathogenesis often is unclear, and the direct demonstration of leukemic cells in synovial fluid has been very uncommon. A 16 year-old male patient was admitted due to left elbow joint pain and swelling. Synovial fluid examination revealed blast cells and this finding has directed to a final diagnosis of acute lymphoblastic leukemia. PMID- 3268184 TI - Lichen planus specific antigen and antibodies--in a patient with generalized lichen planus. AB - A 43-year-old man with generalized lichen planus demonstrated serum antibodies against autologous lesional skin. Indirect immunofluorescence using serum and papular lesional skin revealed a lichen planus specific antigen found only in the granular layer. The specific tissue antigen was not detected in normal skin from this patient, in normal skin from patients with skin disorders other than lichen planus or in skin from normal control persons. When titers of the serum antibodies against lichen planus antigen were examined before and after a successful therapy a positive correlation of the titer could be found in this patient. PMID- 3268185 TI - Syringomatous adenoma of nipple--a case report. AB - A syringomatous adenoma of the nipple is a benign locally infiltrating neoplasm histologically similar to the syringoma of the skin. Morphologically similar lesions have been described as adenoma of the nipple or florid papillomatosis. Patient was a 33 year old woman who was admitted with a history of bloody nipple discharge from her right breast. With a clinical impression of Paget's disease explorative mastectomy was performed. Microscopically typical tubular and duct like structures with syringomatoid features were present throughout the stroma of the nipple. PMID- 3268186 TI - Age differences in target identification as a function of retinal location and noise level: examination of the useful field of view. AB - Foveal and peripheral target detection were compared in young adults (M age = 22 years) and older adults (M age = 66 years) who were optically corrected for the viewing distance. In a two-alternative, forced-choice task, target letters were presented at 0 degree to 10.5 degrees from fixation. Targets were presented alone, flanked on each side by one noise element (i.e., nontarget letter), or embedded in a horizontal row of 19 noise elements. An Age X Noise Level X Location interaction was obtained, wherein age differences were largest for peripheral targets presented in noise. Slope analyses of latency data showed that the performance of young adults in the high-noise condition was most similar to that of older adults in the low-noise condition. At the functional level, results indicated that aging is associated with a restricted useful field of view. In addition, the data suggest that age differences in search can be described by a model in which older adults take smaller perceptual samples from the visual scene and scan these samples more slowly than do the young adults. PMID- 3268187 TI - Measuring the social climate of congregate residences for older people: Sheltered Care Environment Scale. AB - We developed the Sheltered Care Environment Scale (SCES) to provide researchers and practitioners with a practical means of assessing the social climate in congregate residential settings for the elderly. The SCES, a 63-item yes/no questionnaire that can be completed by residents and staff members of a facility, taps their perceptions of seven dimensions of the social environment. These dimensions concern the quality of relationships, the personal growth orientation present in the facility, and maintenance and change of the social system. The SCES discriminates among settings, has moderate to high internal consistency and split-half reliability, and is sensitive to environmental change against a backdrop of relative stability over time. The SCES reflects actual, agreed-on qualities of a setting and is relatively unaffected by characteristics of the respondent. Normative data are available from a national sample of 244 facilities representing the variety of residential settings available to the elderly. PMID- 3268188 TI - Age and health care beliefs: self-efficacy as a mediator of low desire for control. AB - The relation between individuals' age, desire for control, information, and perceived self-efficacy was examined using a cross-sectional comparison of 116 noninstitutionalized adults, ages 20 to 99. We found that individuals over 60 years of age desired less health-related control than did younger adults, and preferred that health professionals make decisions for them. Differences in desire for health-related information were in the same direction but were not significant. Older adults also desired less control in general day-to-day living. Perceived self-efficacy was also lower for individuals over 60 years of age. Results suggested that perceived self-efficacy mediated the age differences in health-related desire for control. Mediation of general desire for control, however, was not strong. Cohort and developmental explanations are provided for these findings. It is suggested that those individuals most at risk for chronic illnesses and hospitalization are also those who are most likely to fail to take an active role in their health care. PMID- 3268191 TI - Inferences about age impairments in inferential reasoning. AB - Two experiments are reported in which specially constructed series completion tests were administered to samples of young and older adults to determine why increased age is associated with poorer performance on measures of inductive reasoning. The results indicated that young and older adults did not differ significantly in the effectiveness of processes concerned with determining simple relations, but that older adults were impaired when the relations are complex or when different problems involve alternative organizational patterns. We conclude that the poorer performance of older adults relative to young adults on tasks of this type may be due to inadequate (e.g., overly simplistic or temporally instable) relational structures for the integration of problem elements. PMID- 3268189 TI - Life satisfaction and age concentration of the local area. AB - Data from a community sample of persons 60 years old and older were analyzed to determine if the concentration of older persons in the local area (operationally defined as census tracts) was related to the respondent's life satisfaction after controlling for the known effects of physical health, socio-economic status, social participation, and other microlevel variables. Results showed that the effect of age concentration is negative, but that this effect differs according to the frequency with which a respondent visits a close friend who lives outside the neighborhood and the number of voluntary associations to which the respondent belongs. The more frequently respondents visited outside the neighborhood, the greater the negative effect of age concentration. On the other hand, the more voluntary association memberships respondents had, the smaller the negative effect of age concentration. PMID- 3268190 TI - Old-age deficits in the sense of smell as gauged by thresholds, magnitude matching, and odor identification. AB - Twenty elderly subjects (70-90 years old) and 20 young control subjects (18-24 years old) underwent three kinds of olfactory testing: absolute thresholds to three odorants (d-limonene, iso-amyl butyrate, benzaldehyde), magnitude matching of these odorants to salt tastes, and odor identification of 30 common substances. For all three odorants elderly subjects' mean threshold significantly exceeded that of the young by about ninefold for d-limonene, about threefold for benzaldehyde, and about twofold for iso-amyl butyrate. These threshold differences predict approximate concentration differences necessary to arouse the same estimated odor strength above the threshold for the elderly and the young. Young subjects also scored better than the elderly in odor identification, even when subjects were given four alternatives from which to select the correct label. Unimpaired olfactory functioning is uncommon in the elderly; correlational tests show that as a group the young have better olfactory ability and show more interindividual uniformity. PMID- 3268192 TI - Radial localization in the aged. AB - Elderly subjects were 41% less accurate than young subjects in localizing a point in the frontal plane. The decline could be ascribed neither to an age difference in image formation or skill acquisition nor to a difference in motivational level or trace retention. Evidently the "ambient" or "transient" visual system is compromised at an elementary level. Reasons why this deficit may not be compounded at more complex levels of spatial processing are suggested. PMID- 3268193 TI - Effects of age stereotyping in a simulated interview. AB - The effects of age stereotyping on subjects' ratings of interviewee potential were investigated using a simulated auditory interview. Male and female participants (N = 156) listened to a 12-min interview of a supervisory candidate applying for a temporary position in industry and then rated the interviewee's qualifications for the supervisory position. Participants gave higher overall interview ratings to a younger interviewee even though he had the same qualifications as an older interviewee. Ratings given to the older interviewee, however, were not significantly different from those given to an interviewee whose age was not designated. The findings are discussed in terms of the influence of both positive and negative age stereotypes on ratings of applicant potential. PMID- 3268194 TI - Affect, personality, and facial expressive characteristics of older people. AB - This study explored the relationship between emotion-based personality traits and expressive patterns in older subjects. Specifically, the study sought to demonstrate (a) that individuals have emotion expression biases, as revealed by structural and dynamic properties of the face, and (b) that there is a link between facial characteristics (as indexed by the judgments of trained and naive raters) and personality traits. An encoding/decoding paradigm was used; 30 adult, naive judges rated five emotion-pose photographs for each of 14 older subjects who had also completed a personality trait measure. Results indicated that individuals vary in their ability to accurately encode emotion states and that these patterns are linked to personality traits in an affect-specific way. The results are discussed within the framework of Darwinian theory and Plutchik's model of personality. PMID- 3268195 TI - Age differences in the speed and capacity of information processing: 1. A dual task approach. AB - Sixty subjects, spanning the age range from 20 to 65, performed a series of tasks designed to evaluate the effects of aging on the speed and capacity of the human information-processing system. A tracking task was performed alone and concurrently with different versions of a Sternberg memory search task that varied the degree of resource competition with the tracking task. A dichotic listening task, a tracking-task measure of perceptual-motor speed, and a complex transcription task were also performed. The data revealed a monotonic decrease in processing speed with age but no difference in time-sharing abilities between age groups. The latter conclusion was supported by a factor analysis of the test scores, which revealed that scores on the factor defining time-sharing did not differ with age. PMID- 3268196 TI - Patterns of memory loss in three elderly samples. AB - Three groups of people ranging in age from 64 to 88 years performed tasks of word generation, paired-associate recall, and free and cued recall. The groups differed in socioeconomic status, verbal intelligence, and apparent levels of daily activity. A fourth group, consisting of young undergraduates, was also tested. Results showed that whereas there were age-related differences in some tests, these age differences were strongly modulated by characteristics of the participants and characteristics of the tasks. The findings are discussed in a contextualist framework. PMID- 3268197 TI - Successful aging: a theme for international psychology. AB - Results of a 13-nation international survey on human values and well-being over the adult life span were reported. Four age groups (under 25, 25-34, 35-49, and over 50 years of age) were compared on four indices: satisfaction with job relations, satisfaction with human relations, satisfaction with material needs, and religiosity. The research involved Australia, Brazil, Canada, France, India, Italy, Japan, Korea, the Philippines, Singapore, the United Kingdom, the United States, and West Germany. Persons over 50 years of age obtained high scores on satisfaction with human relations, satisfaction with material needs, and religiosity, whereas those under 25 scored low on these scales. Thirty-five to 49 year-olds scored highest on satisfaction with job relations. With some exceptions, these trends are relatively consistent across nations. We conclude that the oldest group shows most contentment, satisfaction, and stability in response to the questions. PMID- 3268198 TI - Relieving feelings of strain among women with elderly mothers. AB - I hypothesized that feelings of strain experienced by an adult daughter are likely to interfere with the nature of her relationship with her aging mother and to have a potentially deleterious effect on the mother. To test this proposition, I devised a study that examined the impact of two brief interventions on 37 middle-aged women and 24 of their elderly mothers: (a) a cognitive-behavioral presentation designed to reduce the daughter's unrealistic feelings of responsibility and (b) a supportive-educational presentation designed to increase the daughter's awareness of her mother's needs. I found that the first procedure was more effective than the second in reducing the daughter's burden, improving the mother-daughter relationship, and decreasing the loneliness experienced by the elderly mother. PMID- 3268199 TI - Selective reminding procedure in depression and dementia. AB - Patients with mild dementia of the Alzheimer's type (DAT), patients with major depression, and normal elderly control subjects were administered a verbal learning task using the selective reminding procedure. Depressed patients were impaired on total recall and the proportion of items retained from one trial to the next without reminding and did not benefit from imagery in retaining items over consecutive trials. The DAT patients were impaired on all measures derived from the test, including storage and recognition memory. With the exception of the ability to benefit from imagery, all of the measures distinguished depressed and mild DAT patients. These findings are consistent with deficient encoding in DAT and performance deficits as a function of effortful cognitive processing in depression. PMID- 3268200 TI - Activity, event transactions, and quality of life in older adults. AB - A multidimensional assessment of activity and subjective well-being based on a cognitive model of event causation was tested in a sample of 60 older adults. Activity was conceptualized as involving the occurrence of an event, the presence or absence of a response to that event, and the hedonic tone of the outcome of that transaction. Events were categorized as to whether the environment or the individual initiated them: demands or desires, respectively. Well-being was conceptualized as having two independent components, positive and negative, assessed by positive and negative mood scales and general well-being and quality of-life scales. Analyses showed that older adults who were responsive to events reported more positive well-being, but high responding was also associated with negative aspects of well-being. Demands interacted with desire responding and outcome; affective outcomes of desired actions were significantly influenced by the occurrence of demand events. Results are interpreted in an expanded model of activity theory. PMID- 3268202 TI - Declines in divergent thinking with age: cross-sectional, longitudinal, and cross sequential analyses. AB - Six measures of divergent thinking were administered to 825 men ranging in age from 17 to 101 over the period from 1959 to 1972; repeat administrations were given to a subset of 278 men after a 6-year interval. Cross-sectional analyses showed curvilinear trends, with an increase in scores for men under 40 and a decline thereafter. Repeated measures analyses on subjects initially aged 33 to 74 generally replicated this finding, whereas cross-sequential analyses suggested a decline for all cohorts tested at a later time. Additional analyses suggested that not all of the decline could be attributed to reduced speed of response production. These longitudinal findings confirm earlier cross-sectional reports of decline in divergent thinking abilities with age. PMID- 3268201 TI - Social networks as assets and liabilities in recovery from stroke by geriatric patients. AB - Interactions in the social networks of 48 elderly stroke patients were examined as factors influencing outcomes after hospital discharge. Structured interviews assessed the frequency of perceived positive and negative interactions, as well as patients' behavioral independence, time use, personal adjustment, and cognitive functioning. Negative interactions occurred less frequently than positive ones. After controlling for status at hospital discharge, negative and positive interactions differentially explained variance in morale, psychiatric symptoms, and cognitive functioning. Although negative interactions were associated with poorer morale and greater psychiatric symptoms, positive interactions were associated with less mental confusion. Patients' reporting and not reporting negative interactions did not differ significantly on a variety of social and demographic variables previously shown to predict social interactions and well-being. Findings indicate that social interactions may both impede and facilitate rehabilitation for older adults and have implications for both theories of social support and the design of therapeutic interventions. PMID- 3268203 TI - Locus of control and patient role adjustment of the elderly in acute-care hospitals. AB - Felton and Kahana's (1974) conclusion that patients with external locus of control beliefs were better adjusted in institutions was reexamined in a high constraint acute-care hospital. Subjects were 105 patients aged 60-93. The Multidimensional Health Locus of Control (MHLC) scales were used to measure of locus of control, and eight staff-rating items measured hospital adjustment. Also, the Loss of Independence subscale of the Hospital Stress Rating Scale was used to indicate perceived institutional constraint. The three MHLC scales correlated weakly (p less than .05) with adjustment (Internality, -.24; Externality-Powerful Others, .22; Externality-Chance, -.22), and each contributed significantly in multiple regression (R = .48). Those patients who perceived greater constraint were more poorly adjusted (r = -.24). Those with stronger beliefs that powerful others control health outcomes perceived less constraint in the hospital situation (r = -.19), whereas those with stronger internal control beliefs perceived greater constraint (r = .29). Beliefs in chance were unrelated. Findings are related to concepts of primary and secondary control. PMID- 3268204 TI - Everyday problem solving in adulthood and old age. AB - We examined everyday problem solving in adulthood and compared it with traditional measures of cognitive abilities. In the first phase of the research, we describe the construction of an inventory to assess problem solving in situations that adults might encounter in everyday life and examine raters' judgments of effective responses to the problems. In the second phase, adults (N = 126) between the ages of 20 and 78 were administered the inventory and tests of verbal and abstract problem-solving abilities. Results indicated modest but significant positive correlations between performance on the inventory and traditional ability tests. The examination of age differences revealed that performance on the Everyday Problem-Solving Inventory and verbal ability test increased with age, whereas performance on a traditional problem-solving test declined after middle age. In addition, education was unrelated to everyday problem solving, highly related to verbal ability, and moderately related to traditional problem solving. Results are discussed in relation to pluralistic conceptions of intelligence and theories of adult intellectual development. PMID- 3268205 TI - Age differences in coping with chronic illness. AB - We examined the correlation between age and six coping strategies in a sample of 151 middle-aged and older chronically ill adults. Coping strategies included cognitive restructuring, emotional expression, wish fulfilling fantasy, self blame, information seeking, and threat minimization. Older adults were less likely to use emotional expression or information seeking than were middle-aged adults in their efforts to cope with the illness. These strategies were related to age even when numerous illness characteristics (e.g., physical limitations) were used as control variables. Interaction effects showed that older adults who perceived their illnesses as highly serious were less likely than were others to cope by seeking information, reconstruing their illness as having positive aspects, or engaging in wishfulfilling fantasies, and more likely to cope by simply minimizing the illness's threat. Consideration of related research studies suggests that the age differences in emotional expression may be due to age related shifts in the types of stresses experienced, whereas the age differences in information seeking may be more strongly linked to cohort phenomena. PMID- 3268206 TI - Age differences in stress and coping processes. AB - The dramatic increase in the numbers of people who are living into old age has been accompanied by a growing interest among psychologists and health care professionals in their sources of stress and how they cope with them. Despite this interest, little is known about normative stress and coping patterns and the ways in which these patterns differ in older and younger people. This study, which draws on stress and coping theory, compares younger and older community dwelling adults in daily hassles and eight kinds of coping. Two interpretations of age differences are evaluated: a developmental interpretation, which says that there are inherent, stage-related changes in the ways people cope as they age, and a contextual interpretation, which says that age differences in coping result from changes in what people must cope with. The findings indicate that there are clear age differences in hassles and coping. Overall, the findings tend to support the developmental interpretation, although the contextual interpretation also applies. PMID- 3268207 TI - Chronic financial strain, social support, and depressive symptoms among older adults. AB - The purpose of this study is twofold: one, to determine whether chronic financial strain is related to depressive symptoms among a random community sample of older adults, and two, to assess whether social support counterbalances or buffers the deleterious effects of financial strain. The findings suggest that elderly people suffering from financial strain are more likely to be depressed than are older adults with fewer financial problems. In addition, the data support the stress buffering hypothesis, that is, that older people who have more informational support and who provide support to others, more often report fewer symptoms of depression as a result of financial strain than do elderly respondents who have less informational support and who do not provide support to others. Tangible and emotional support are found to be less effective coping resources when financial strain is present. PMID- 3268208 TI - Emotion communication skills in young, middle-aged, and older women. AB - We assessed the effectiveness of an emotion induction procedure for the study of emotional communication in adults; we also gathered preliminary age-comparative data on the expressive and receptive capacities of a sample of adult women. Young, middle-aged, and older women (encoders) related emotional experiences following mood induction and then assessed the intensity of their affective experiences. Videotapes of these sessions (facial expressions only) were shown to young, middle-aged, and older female judges (decoders), who rated the encoders for emotional intensity as well as for type of affect being communicated. Validity and reliability issues with respect to the procedure's usefulness are discussed. Decoding accuracy was found to vary with age congruence between encoder and decoder, suggesting a decoding advantage accruing through social contact with like-aged peers. Older decoders did most poorly, but a differential warm-up effect was evident, suggesting that the performance of older subjects might be enhanced with practice. There were also trends suggesting that the affective expressions of older subjects may be harder to decode owing to age related structural changes in the face. Results are discussed in the context of theoretical models of affective development. PMID- 3268209 TI - Imagery mnemonic training in a patient with primary degenerative dementia. AB - A visual-imagery mnemonic was used as a memory training aid for a 66-year-old patient with primary degenerative dementia. Length of retention time was used as the primary outcome measure. The application of the mnemonic procedure extended the length of retention time for name-face recall from baseline. Performance gains were sustained at one month. PMID- 3268210 TI - Adult age differences in the speed and capacity of information processing: 2. An electrophysiological approach. AB - A total of 60 subjects performed different variants of the Sternberg memory search task in an experiment designed to evaluate aging differences in the speed of the human information-processing system. The present study examined the nature of the age-related slowing using convergent methodologies of Sternberg's additive factors logic, the speed-accuracy trade-off, and the P300 component of the event related brain potential. These methodologies revealed that a substantial component of slowing was manifest in perceptual encoding, response criterion adjustment, and response execution, with a lesser component related to memory search speed. PMID- 3268211 TI - An Orientation questionnaire. AB - We describe the development of an Orientation Questionnaire (OQ), a standardized measure of the impairment of an older person's ability to communicate orientation information. Starting with a pool of selected items, we made a series of revisions that resulted in a 17-item questionnaire with a score range from 0 through 40 points. In additional studies we determined that OQ scores evidence adequate reliability (test-retest r = .969) and adequate validity (r with nurse ratings = .798 and .793; r with behavioral assessment = .807). The OQ scores discriminated groups on the basis of environmental structure (community vs. nursing home vs. neuropsychiatric hospital) and psychiatric diagnosis (organic vs. schizophrenic vs. no diagnosis). Tentative classification data are presented, and uses of the OQ are discussed. PMID- 3268212 TI - Life satisfaction and identity structure in late middle-aged men and women. AB - A total of 32 retirement-age subjects (17 men and 15 women) provided information about their lives by rating each of their identities in terms of a list of self generated features. They also rank-ordered their currently enacted identities in terms of time spent in each and completed a life-satisfaction questionnaire. The Identities X Features matrices were analyzed by algorithms that generated a hierarchical model of identity structure for each subject based on feature ratings. The hierarchical levels of identities were combined with time-spent rankings to obtain an index of personal style, a measure that reflected the unique organization of identities for each subject. Personal style indices were then correlated with life-satisfaction scores. Results confirmed the prediction that life satisfaction in this age group is a function of the amount of time spent in identities that give expression to multiple aspects of the self. PMID- 3268213 TI - Interventions with care givers of dementia patients: comparison of two approaches. AB - We compared the effect of two approaches, family counseling and support groups, for relieving the stress and burden experienced by care givers of dementia patients. Both treatments are designed to implement features of a stress management model that have been identified in prior research with this population: providing information about the patient's disease and its effects on behavior, teaching behavioral problem solving for managing difficult behavior, and identifying potential support for care givers. Subjects were primary care givers of dementia patients living in the community; they included husbands, wives, daughters, and other relatives. Although subjects in the treatment groups made significant gains over time, they did not differ from wait-list subjects who showed similar improvements. One-year follow-up interviews indicated that gains made during the treatment period were maintained. PMID- 3268214 TI - Effects of cognitive training on primary mental ability structure. AB - We report results of the first empirical test, as far as we know, of the assumption of structural invariance of latent constructs from pretest to posttest in cognitive training research on the elderly. In all, 401 participants in the Seattle Longitudinal Study, over 62 years old, received a 5-hr test battery at pre- and posttest that included 16 ability tests, marking the five primary abilities of Spatial Orientation, Inductive Reasoning, Numerical Ability, Verbal Ability, and Perceptual Speed. A total of 229 of our subjects received 5 hr of individual training on either Spatial Orientation or Inductive Reasoning. Restricted factor analysis with the LISREL algorithm tested the hypothesis of measurement equivalence across test occasions, separately for the control subjects and for each of the training groups. When ability-specific cognitive training intervenes, no structural change is observed for abilities not subject to intervention. However, slight shifts occurred in the optimal regression weights for the different markers for the training target abilities. PMID- 3268215 TI - Adult age differences in the perception and learning of artistic style categories. AB - Adult age differences in conceptual behavior were studied using informationally complex stimuli from real-world categories: paintings by two impressionist artists. In Experiment 1 we examined perceptions of category structure by having subjects sort paintings according to style similarity. Young adults were observed to depend more on abstract information in making style judgments, whereas older adults relied more on similarity in content. This resulted in different category structures between age groups, but similarity judgments in both groups appeared to correspond to actual style differences between the two artists. In Experiment 2, learning efficiency was shown to increase with a painting's category centrality, but older adults had particular trouble learning noncentral items. At transfer, both age groups were able to use abstracted central tendency information to categorize new paintings, although young adults appeared to have better access to information about specific category exemplars from acquisition. The results are generally consistent with those from studies using simpler artificial stimuli. PMID- 3268217 TI - An investigation of age-related factors in the age-job-satisfaction relationship. AB - Most researchers have found a positive linear relation between age and job satisfaction. We attempted to account for this relationship by measuring variables that had been proposed to be causal factors. Subjects were 496 city and county managers working in Florida. Potential explanatory variables were (a) job congruence (the difference between what managers prefer and what they perceive they have in a job), (b) internal-external locus of control, and (c) related demographics-age, salary, organizational tenure, position tenure, and organizational level. Multiple regression analyses found that job congruence and work locus of control accounted for almost all of the variance in the age satisfaction relationship. This study supports the job change hypothesis, which proposes tha older workers get more of what they want out of work. PMID- 3268216 TI - Adult age differences in integrative spatial ability. AB - Young and older adults were contrasted in three experiments that involved manipulation of the number of required spatial integration operations (Experiments 1 and 2) and manipulation of the amount of information per operation (Experiment 3). Older adults performed at lower levels of accuracy than did young adults in each experiment. However, the magnitude of the age differences tended to increase with each successive integration operation but was constant across different quantities of relevant information. I interpreted these results as suggesting that one factor responsible for age differences in tests of spatial ability is an age-related reduction in the efficiency of executing operations responsible for the accurate and stable representation of spatial information. PMID- 3268218 TI - Effects of control beliefs and attributions on memory self-assessments and performance. AB - Individual differences in memory performance among elderly adults be due, in part to variability in personality and metamemory variables. We examined whether control beliefs, attributions, and depression were related to memory self assessments, performance, and change in these variables across two trials. Participants were 47 elderly adults (M age = 69.72 years). Results of multiple regression analyses were consistent with predictions. Those individuals with stronger internal control beliefs made higher self-assessments at the first trial. Those who made higher assessments and those younger in age had higher performance at the first trial. Those with higher performance at the first trial and those who attributed this performance to internal, stable, and global causes were less likely to show decrements in self-assessments and performance across trials. Implications of the findings for enhancing memory performance are discussed. PMID- 3268219 TI - Process and strategy in memory for speech among younger and older adults. AB - Younger and older adults listened to and immediately recalled short passages of speech that varied in the rate of presentation and in the degree of linguistic and prosodic curing. Although older adults showed a differential decrease in recall performance as a function of increasing speech rate, age differences in recall were reduced by the presence of linguistic and prosodic cues. Under conditions of optimum linguistic redundancy, older adults were also found to add more words and to make more meaning-producing reconstructions in recall. Differences in overall performance are accounted for in terms of age-related changes in working memory processing and strategy utilization. PMID- 3268220 TI - Aging and memory for words and action events: effects of item repetition and list length. AB - We were concerned with the effects of item repetition, list length, and class of item on free recall in elderly as compared with young adults. In Experiment 1, samples of young and elderly adults recalled a list of 27 words and a list of 27 action events (minitasks performed by the subjects). Some items were presented once and some twice. Although the younger subjects showed better recall on both types of lists, the older sample benefited from item repetition as much as did the younger sample. This finding was replicated in Experiment 2. A second finding in Experiment 2 was a significant aging effect in the recall of long but not of short lists of both words and action events. The absence of an Age X Repetition Effect interaction was ascribed to the strength nature of the repetition manipulation. The age effects in the recall of the long lists were attributed to possible deficits in retrieval proficiency. PMID- 3268221 TI - Age, ego level, and the life-span development of coping and defense processes. AB - Developmental variation in coping and defense strategy use was examined in a sample of 100 male and female participants ranging in age from 10 to 77 years. Each participant was administered Loevinger's ego development task, the Ways of Coping measure, and the Defense Mechanism Inventory. In addition, a brief narrative of a stressful experience was assessed for the developmental level of the response and for its content. The results suggest that, in addition to age, the developmental measures of ego level and source of stress predict the use of particular coping and defense strategies. In keeping with other research, sex differences in coping and defense strategies were also found. These findings are discussed in light of the need for tasks that are able to assess both developmental and individual differences in the maturity of coping and defense strategy use. PMID- 3268222 TI - Ocular fixation control as a function of age and exposure duration. AB - In previous work we reported that fixation stability did not deteriorate in older adults over relatively long viewing durations. In the present study we reanalyzed the data to examine potential aging effects on fixational control for viewing durations typically used in psychological experimentation. Monocular eye movements were recorded in 12 older and 12 younger observers using a dual Purkinje image technique, while observers fixated a stationary target. The two dimensional scatter of eye positions was measured during nine viewing durations ranging from 100 ms to 12.8 s. Fixational control of the two groups was comparable at all of the viewing durations. Both younger and older observers were able to maintain fixation within an area several times smaller than the size of the fovea. Implications for aging studies that use briefly presented visual stimuli are discussed. PMID- 3268223 TI - An experimental inquiry into transference roles and age. AB - In this psychotherapy analogue investigation, the effects of client age and therapist age on transference-like projections onto therapists were examined. Young (25-35) and older (60-70) pseudoclients compared paraprofessional therapists to significant figures in their own lives after a dyadic "helping" interview. The results provide empirical support for the phenomenon of reverse transference in therapy with older patients. Older clients were more inclined than young clients to view therapists, particularly younger therapists, as similar to their children. Young clients more willingly attributed parental qualities to older therapists. Both old and young clients may see therapists more as peers or friends than as family members. PMID- 3268224 TI - Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers. AB - A stress and coping model was used to study predictors of individual differences in caregiver adaptation. A total of 54 family caregivers of elderly dementia patients completed interviews and questionnaires assessing the severity of patient impairment and caregiving stressors; caregiver appraisals, coping responses, and social support and activity; and caregiver outcomes, including depression, life satisfaction, and self-rated health. Correlational and regression analyses supported the utility of the stress and coping model. Appraisal, coping responses, and social support and activity were significant predictors of caregiver outcome, even when severity of caregiving stressors was statistically controlled. The importance of a multidimensional approach to assessing caregiver outcomes was supported by regression analyses indicating that each caregiver outcome was predicted by different patterns of stressors, appraisal, coping, and social support and activity. Results are discussed in terms of a stress and coping model of caregiving, and clinical implications for work with caregiving families. PMID- 3268225 TI - Metamemory in older adults: the role of monitoring in serial recall. AB - Older and younger adults were asked to think aloud while studying sets of pictures matched in difficulty for immediate serial recall. When instructed only to remember, young adults tended to study longer, rehearse more, and recall better than did older adults on the most difficult lists. Young adults were also much more likely to spontaneously test themselves during study in the most difficult condition. Older adult groups instructed either to study longer or to self-test, both showed improved recall. Only the older adults who had been instructed to self-monitor, however, recalled better on tests of short-term maintenance and generalization; overt rehearsal data showed that these older adults continued to test themselves. Metamemory deficits may be present with older adults when a strategy, like self-testing, is needed to generate metamemorial knowledge. Strategies such as self-testing can be easily taught, however, and they hold promise of being useful across situations. PMID- 3268226 TI - Acquisition of word-processing skills by younger, middle-age, and older adults. AB - A total of 45 subjects in three age groups (younger, middle-age, older) were trained to word process on microcomputers using a commercial training program and an experimenter-designed test and evaluation protocol. Although all of the subjects mastered the essentials of word processing, the older group took significantly longer to complete the training and evaluation procedures and performed more poorly on a review examination that tested their knowledge of the word-processing commands and techniques. The results are discussed in relation to requirements for trainer assistance, motivational factors, and the need to design training protocols that meet the needs of older adults. PMID- 3268227 TI - Life stress, social support, and self-esteem in an elderly population. AB - Findings in previous studies of the stress-buffering properties of social support have been erratic. This study suggests that at least part of the reason for those inconclusive findings may be that researchers are using oversimplified models of the stress process and limited statistical approaches to assess the effects. The findings in this study indicate that social support (a) helps to reduce the deleterious effects of stress on emotional disorder primarily by bolstering the self-esteem of older adults and (b) affects psychological well-being only indirectly through self-esteem. Two distinct approaches to the statistical estimation of stress-buffering effects are also examined. PMID- 3268228 TI - The role of representations in age differences in analogical reasoning. AB - Age-related declines in the efficiency of a number of cognitive tasks have been postulated to be attributable to decreases with age in the quality of internal representations used to mediate performance on those tasks. This proposal was investigated in a geometric analogies task by manipulating variables (i.e., the number of elements per term and the temporal delay between presentation of pairs of terms) assumed to affect the quality or stability of internal representations. As expected, the performance of older adults was impaired more than that of young adults by these manipulations. Further analyses revealed that these representational deficits may be due to a reduction of approximately 40% in the quantity of some type of processing resource between, approximately, 20 and 70 years of age. PMID- 3268229 TI - Neuropsychological problem-solving skills in the elderly. AB - This article describes the performance of a representative sample of 110 participants aged from 65 to 75 years. Participants completed the Trail-Making Test, Tactual Performance Test, and Booklet Category Test. Results confirmed that previously established cutoff scores used to determine impairment are not appropriate for this age group. Significant sex differences were found for the Tactual Performance Test and Booklet Category Test. Mean scores presented in this article provide useful normative standards for the three aforementioned tasks when given to patients aged from 65 to 75 years. PMID- 3268230 TI - Stress processes and the misuse of drugs in older adults. AB - There is increasing concern about the misuse of drugs among the elderly. We assessed misuse, including drug usage, drug interactions across pharmacologic classes, and multiple drugs in the same pharmacologic class, in a community sample of 65 to 74-year-olds, and evaluated its relation to stress and coping processes and psychological and somatic health. Assessments were made repeatedly over a 6-month period. Results indicated that misuse was multidimensional and widespread. Misusers did not differ from nonmisusers on antecedent psychosocial variables, nor did they report more hassles or cope differently than nonmisusers. However, misusers and nonmisusers differed on their subjective experience of stressful encounters; misusers experienced their hassles as more intense, and they experienced more threat emotions and more dissatisfaction with their coping than did nonmisusers. Misuse was also associated with long-term psychological satisfaction, psychological symptoms, and somatic health. PMID- 3268231 TI - Chronic strain, locus of control, and distress in older adults. AB - In this study, I examined whether locus of control beliefs buffer or mediate the impact of chronic financial strain on psychological well-being. Data are from a longitudinal survey of a random community sample of older adults. Findings suggest that elderly people with internal locus of control beliefs are less likely to suffer from the deleterious effects of chronic financial strain than are older adults with external locus of control orientations. PMID- 3268232 TI - Mental health differences among retirees and workers: findings from the Normative Aging Study. AB - Researchers during the past decade have found little effect of retirement on physical health. However, retirement entails a number of losses, and its effect on mental health, as measured by the prevalence of psychological symptoms, is unclear. We examined psychological symptoms in a sample of 1,513 older men, participants in the Normative Aging Study, using the SCL-90-R (Derogatis, 1983). Analyses of variance indicated that retirees reported more psychological symptoms than did workers, even after controlling for physical health status. Exploratory analyses examining the circumstances of retirement found no effects for length of retirement or part-time employment, but did find effects for the timing of retirement. Both early and late retirees reported more psychological symptoms. Late workers (aged 66 and older) reported the fewest symptoms. Reasons for these findings are discussed. PMID- 3268233 TI - Further observational data on the behavioral and social world of institutions for the aged. AB - This study is an extension of previous observational work on the social ecology of dependence and independence in the institutionalized elderly. Observations of everyday, naturally occurring interactions between elderly residents of two different long-term institutions and their social partners were extended such that, aside from the identification of type of behavior, the dyadic form and continuity of each behavior was specified. The following were among the major results: (a) Previously found interaction patterns between elderly residents and their social partners, replicated in both a nursing home and a home for the chronically ill, supported the notion of discrepant social ecologies for dependent versus independent behaviors of residents: (b) specification of each behavioral act as to its dyadic form underscored the fact that the interactions were controlled largely by social partners and not by the elderly residents; (c) coding continuity or discontinuity of behavior suggested that independent behaviors were maintained by chaining; and (d) elderly residents in the home for the chronically ill evinced, as expected, more dependence-related behaviors. PMID- 3268234 TI - Age and forgetting rate with pictorial stimuli. AB - The rate of forgetting standardized line drawings of common objects was assessed in groups of young (M age = 22 years) and older (M age = 70.5 years) subjects. The two groups forgot equal quantities of pictorial stimuli over successive intervals of 10 min, 2 hr, and 48 hr, after being matched for original learning. In contrast, the older subjects showed the expected age decrement in reproduction of geometric designs from memory. These findings indicate that aging does not affect retention of pictures when differences in learning and retrieval abilities are controlled. PMID- 3268235 TI - Achievement motivation, achieving styles, and morale in the elderly. AB - This research extends the literature on variables predictive of morale from the often-researched demographic, physical, and social factors to the psychological variables of achievement motivation and achieving styles. A sample of 115 older adults completed the Work and Family Orientation Questionnaire, the L-BLA Achieving Styles Inventory, and the PGC (Philadelphia Geriatric Center) Morale Scale. Regression analysis indicated that five variables were predictive of morale: (a) direct achieving style, (b) instrumental achieving style, (c) health, (d) social participation, and (e) age. The instrumental achieving style and age were inversely related to morale, although the direct and instrumental achieving styles were the two best predictors of morale. PMID- 3268236 TI - Old is old is old? AB - We examined potential differences between two matched subgroups of elderly men: young-old (65-74 years of age; n = 53) and old-old (75 years of age and older; n = 56). Subjects were fairly healthy men from community agencies, who were interviewed and tested on a number of characteristics involving personality, mood, attitudes, and behaviors. Although t tests and correlations indicated some differences between the groups, the overall findings underlined their similarity on the vast majority of variables scrutinized. The crucial base for enhancing understanding in gerontology should not only focus on the age-advancing senescent person but on the whole individual. PMID- 3268238 TI - The role of theories of cognitive aging: comment on Salthouse. AB - Cognitive models of aging ought, minimally, to simulate age effects for a broad range of tasks, and their underlying assumptions ought to be constrained by existing data on cognitive mechanisms. Salthouse's model (and other parallel distributed-processing network models) meets the first criterion better than it meets the second. Another weakness is in its inability to account for goal directed behavior. Thus, models like that of Salthouse seem best suited to the description of automatic information processes such as recognition. I conclude that such models are best evaluated in competition with standard symbolic processing models. I introduce simulation of chess position recall by older and younger chess players and compare it with Salthouse's model. PMID- 3268237 TI - Different patterns of cognitive slowing produced by Alzheimer's disease and normal aging. AB - Aging has previously been shown to produce a generalized proportional slowing of all cognitive operations. In contrast, the present results suggested that Alzheimer's disease produces a disproportionate reduction in the speed with which patients carry out one or more mental operations. The tasks that demented patients found particularly difficult involved either a self-directed search of their lexicon or the use of familiarity information. PMID- 3268239 TI - Application of operant procedures in a group of institutionalized aggressive geriatric patients. AB - This study used positive reinforcement schedules versus no reinforcement on a group of 6 highly aggressive, institutionalized elderly patients. Dependent measures included confirmed incidents of physical and verbal aggressive behavior monitored across an ABAB design with a 4-month phase-out period. Results indicated that aggressive behavior can be significantly decreased in a group setting and subsequently generalized to ward behavior. Ancillary aspects of the study included the role of tangible and back-up reinforcers and staff attitude and behavior. Implications for future research are discussed. PMID- 3268240 TI - Investigation of student status, background variables, and feasibility of standard tasks in cognitive aging research. AB - Data are reported on a variety of cognitive tasks from 62 college students and 362 nonstudent adults between 20 and 79 years of age. The goals of the project were as follows: (a) to investigate the validity of the practices of using college students and adults over age 65 in studies of cognitive aging, (b) to examine the influence of a variety of background variables on age trends in cognitive performance, and (c) to initiate the development of standard tasks to assist in the description of subject samples in cognitive aging research. The age trends in cognitive performance were relatively independent of an assortment of background variables, but because college students were atypical of their age group in several performance measures they may be suspect as the young-adult control subjects in investigations involving these types of measures. Adults over the age of about 65 appear to exhibit accelerated slowing of speeded performance, but in other respects perform about as one would expect on the basis of the age trends observed between the ages of 20 and 65. PMID- 3268241 TI - Effect of respite care on dementia and nondementia patients and their caregivers. AB - The impact of a respite program on the cognitive and physical functioning of dementia and nondementia patients, and on the burden perceived by their caregivers, was assessed in a pretest-posttest design. A total of 55 caregivers were interviewed twice, 5 weeks apart. In the respite group, the caregiver's patient experienced a 2-week respite stay in a nursing home during the 5-week interval, whereas in the waiting-list comparison group, the patient experienced ongoing in-home care during the interval. We hypothesized that patient diagnosis (dementia vs. nondementia) would interact with respite exposure, with nondementia patients showing more improvement from respite than dementia patients. Regardless of diagnosis, however, positive effects from respite exposure were found for caregiver reports of the patient's memory and behavior. PMID- 3268242 TI - EAS temperaments during the last half of the life span: twins reared apart and twins reared together. AB - In this first behavioral genetic study of personality in the last half of the life span, results are reported using the powerful adoption/twin design that compares identical and fraternal twins reared apart and identical and fraternal twins reared together. Traits studied were the EAS temperaments (emotionality, activity level, and sociability), traits that show substantial genetic influence in childhood. It was hypothesized that the EAS traits would also show significant genetic influence later in life and that most of the environmental variation would be nonshared--that is, twins reared together would show no greater resemblance for the EAS traits than twins reared apart. Both hypotheses are supported. PMID- 3268243 TI - Classically conditioned cardiac responses in "old" and "young" Fischer 344 rats. AB - Male and female Fischer 344 rats, 12 or 26-28 months of age, received two sessions of Pavlovian heart rate conditioning, and were compared with same-sex and same-age controls receiving unpaired presentations of the tone conditional stimulus (CS) and the shock unconditional stimulus (US). Older rats of both sexes demonstrated slower acquisition of the heart rate (HR) conditioned response (CR), and smaller magnitude changes than did the younger animals. Control experiments in 6-, 12-, 24-, and 30-month-old animals indicated that these differences were not due to an impaired sensitivity to the CS or US in the older animals. Results are discussed in terms of their implications for use of this animal model in investigations of age-related deficits in associative learning. PMID- 3268244 TI - Aging, attention, and intelligence. AB - The aims of this study were (a) to find out if attentional ability factors that are separate from the well-established ability factors (e.g., fluid intelligence, crystallized intelligence, and short-term acquisition and retrieval function) can be identified, and (b) to establish, through the use of part correlations, whether attentional abilities play a role in the changes in fluid and crystallized intelligence that occur with increasing age. A battery of 36 tests (19 psychometric tests and 17 measures of attentional processes) were given to 100 people. 20 of whom were in each age decade between 20 and 70. Results indicated that three attentional factors--Search, Concentration, and Attentional Flexibility--exist at the primary-ability level and that all three define fluid intelligence at the second-order level. Results also indicate that the decline in fluid intelligence with increasing age disappears if attentional factors are parted-out. Similarly, the increase in crystallized intelligence with increasing age becomes even greater if one controls for attentional processes. I conclude that changes in attentional processes play an important part in changes in human intelligence with age. PMID- 3268245 TI - Sustained attention in adulthood: a unique, large-sample, longitudinal and multicohort analysis using the Mackworth Clock-Test. AB - A cross-sectional sample of men (n = 177) tested in 1962-1964, and men (n = 188) and women (n = 113) tested in 1980-1984, and a longitudinal sample (n = 53) of men tested in 1962-1964 and 1980-1984, were used to investigate age differences and 18-year age changes on a 62-min sensory vigilance task that made virtually no demand on memory, the Mackworth Clock-Test. Age differences and changes in the vigilance decrement were also examined. No age differences or changes were obtained for detection accuracy. Target response time showed significant age related 18-year longitudinal changes and one significant cross-sectional age difference; the overall age effect was of a U-shaped function with a minimum at middle age. Age differences and changes were obtained in a measure of arousal: skin potential response latency; the overall age effect was also consistent with a U-shaped function. There was little consistent evidence of a differential effect of age on the vigilance decrement. Outcomes contradictory to Surwillo and Quilter (1964) and Quilter, Giambra, and Benson (1983) are reconciled through additional statistical analyses. PMID- 3268246 TI - Age-related differences in lexical access, spreading activation, and simple pronunciation. AB - An experiment was conducted to address age-related differences in lexical access, spreading activation, and pronunciation. Both young and older adults participated in a delayed pronunciation task to trace the time course of lexical access and a semantic priming task to trace the time course of spreading activation. In the delayed pronunciation task, subjects were presented a word and then, after varying delays, were presented a cue to pronounce the word aloud. Older adults benefited considerably more from the preexposure to the word than did the younger adults, suggesting an age-related difference in lexical access time. In the semantic priming pronunciation task, semantic relatedness (related vs. neutral), strength of the relationship (high vs. low), and prime-target stimulus onset asynchrony (200 ms, 350 ms, 500 ms, 650 ms, and 800 ms) were factorially crossed with age to investigate age-related differences in the buildup of semantic activation across time. The results from this task indicated that the activation pattern of the older adults closely mimicked that of the younger adults. Finally, the results of both tasks indicated that older adults were slower at both their onset to pronounce and their actual production durations (i.e., from onset to offset) in the pronunciation task. The results were interpreted as suggesting that input and output processes are slowed with age, but that the basic retrieval mechanism of spreading activation is spared by age. PMID- 3268248 TI - Young and older adults' use of context in spatial memory. AB - We evaluated the hypothesis that older adults remember spatial information less well than younger adults because they use contextual information less effectively. Young and older adults studied schematic town maps on which structures were presented either simultaneously or successively and on which a network of streets was either present or absent. However, age did not interact with either contextual variable. Thus, we conclude that age differences in spatial memory do not arise from differences in the use of context. PMID- 3268247 TI - Forgetting of pictures over a long retention interval in young and older adults. AB - Young and older adults were presented with pictures for study. Their recognition of the information was tested at five retention intervals: immediately, and 48 hr, 1 week, 2 weeks, and 4 weeks later. The main finding of interest was that picture recognition did not show an age-related decline until the 1-week retention interval. PMID- 3268250 TI - Stability and change in adult intelligence: 2. Simultaneous analysis of longitudinal means and covariance structures. AB - We analyzed data on psychometric intelligence from the Seattle Longitudinal Study, simultaneously estimating longitudinal factors, their covariance structure, and their mean levels. Data on five Thurstone Primary Mental Abilities subtests were available for 412 adults, ages 22-70 at first test, who were tested three times at 7-year intervals. A previous longitudinal factor analysis had shown high stability of individual differences (covariance stability) in general intelligence for three adult age groups. We extended that model to estimate factor means. All three age groups showed high levels of covariance stability, but differed sharply in their mean profiles. The young group showed increasing levels of general intelligence, the middle-aged group had stable levels of intelligence, and the old group showed salient, approximately linear, decline. The patterns of stability in middle-age, followed by mean decline and high covariance stability in old age, suggest a normative developmental transition from a stability pattern to a decline pattern of general intelligence, with the inflection point occurring somewhere around age 60. PMID- 3268249 TI - Urinary incontinence and psychological distress among older adults. AB - We examined the relationship between urinary incontinence and psychological distress in a sample of community-dwelling older adults. The data are from a probability sample of Washtenaw County, Michigan residents ages 60 years and older, who were interviewed in 1983 and 1984. A total of 747 women and 541 men were included in the analyses. Experiencing urinary incontinence, particularly in a severe form, was weakly related to depression, negative affect, and low life satisfaction. These relationships are partly explained by the fact that incontinent respondents are less healthy than are continent respondents. PMID- 3268251 TI - A longitudinal study of the psychosocial impact of stroke on primary support persons. AB - We investigated longitudinally the effects of a stroke on the social support systems and well-being of the patient's primary support person, both acutely and as the condition stabilized. Individuals who had suffered a first stroke and a primary support person participated in two waves of data collection, carried out in 6-month intervals beginning 7 weeks after the stroke. Our data show that the prevalence of depressive symptoms is from 2 1/2 to 3 1/2 times higher than rates found among representative samples of middle-aged and elderly populations. Mean level of depression did not change over time, although level of optimism declined significantly. Multiple regression analyses showed that levels of depression and perceived burden in support persons are highly related to aspects of the stroke such as its severity, and that demographic variables such as age and income play a relatively minor role in attenuating these relations in the acute adjustment phase. However, from 7 to 9 months after the stroke, well-established demographic variables such as health, income, and age were significant predictors of depression. Individuals who were older and who had good health and higher incomes were least depressed. PMID- 3268252 TI - Assessing remote memory with an improved public events questionnaire. AB - In the present research, public events recall and recognition tests were developed that appear to be psychometrically stronger than those used in the past. Following test construction, these tests were administered to older and middle-aged participants in order to examine the effects of chronological age and historical time period on memory for remote news events. Results indicated that middle-aged participants generally exhibited a better memory for news events than did older participants for the time periods that both age groups lived through. Across the life span, a common pattern was observed. Specifically, there was an increase in memory for events until the teenage years and fairly constant performance thereafter for both age groups. From these findings, we can clearly argue against a loss theory of remote memory. Some gender differences were observed on the recall and recognition tasks, but they were not as global or as frequent as Botwinick and Storandt (1980) suggested. The clinical potential of the remote memory tests is briefly considered. PMID- 3268253 TI - Aging and the restructuring of precued movements. AB - A precue paradigm was used to examine the time it takes to restructure a planned motor response. Two groups of subjects, a young group and an elderly group, performed an aiming task in which 75% of the trials involved no change of movement parameters. On remaining trials, subjects had to change one or more of the movement parameters. Elderly subjects had slower reaction times (RTs), movement times, and made more errors in both conditions. Elderly subjects had proportionally longer RTs overall, independent of restructuring a movement plan. Preparation of arm and direction also exhibited a proportional increase in RT. However, differential aging effects were found for preparation of extent. Elderly subjects were slower preparing short movements compared with long movements, whereas young subjects showed the opposite trend. These results suggest that with advancing age, operations concerned with movement-plan restructuring for arm and direction undergo change in processing rate, whereas operations for extent undergo more extensive alteration. PMID- 3268254 TI - Utilization of path-analytic procedures to investigate the role of processing resources in cognitive aging. AB - Data from two batteries of tests administered to 129 and 233 adults, ranging from 20 to 79 years of age, were analyzed to explore the viability of models postulating that age differences in the quantity or efficiency of processing resources are responsible for many of the age differences observed in cognitive functioning. Path-analysis procedures were used to estimate the direct and indirect, or resource-mediated, effects of age on cognitive performance. Results, with simple speed and memory measures serving as the indexes of processing resources, indicated that there was little support for a strong resource model, and evidence derived from a weak resource model suggested that resource-mediated contributions to age differences are small, relative to those not mediated by processing resources. PMID- 3268255 TI - Adult age differences in the effects of sentence context and stimulus degradation during visual word recognition. AB - I investigated adult age differences in the efficiency of feature-extraction processes during visual word recognition. Participants were 24 young adults (M age = 21.0 years) and 24 older adults (M age = 66.5 years). On each trial, subjects made a word/nonword discrimination (i.e., lexical decision) regarding a target letter-string that was presented as the final item of a sentence context. The target was presented either intact or degraded visually (by the presence of asterisks between adjacent letters). Age differences in lexical decisions speed were greater for degraded targets than for intact targets, suggesting an age related slowing in the extraction of feature-level information. For degraded word targets, however, the amount of performance benefit provided by the sentence context was greater for older adults than for young adults. It thus appears that an age-related deficiency at an early stage of word recognition is accompanied by an increased contribution from semantic context. PMID- 3268257 TI - Memorability functions as an indicator of qualitative age differences in text recall. AB - An analysis in which the probability of text unit recall for older adults [p(Re/O)] is plotted as a function of this probability for the young [p(Re/Y)] is considered as one way to assess whether there are qualitative differences in text recall for young and old. The application of this relative memorability analysis to previously reported data dealing with the immediate recall of spoken sentences (Stine, Wingfield, & Poon, 1986) revealed that although older adults show qualitative recall similar to younger adults when informational density is low, they show less discrimination among text elements when informational density is increased. PMID- 3268256 TI - Changes in naming ability with age. AB - We administered to 80 optimally healthy subjects, 30-80 years old, the Boston Naming Test, a test of confrontation naming. Results indicated that naming ability remains fairly stable across the adult life span until individuals are in their 70s, at which point there is a significant decline in performance (p less than or equal to .0001). Semantic errors (i.e., circumlocutions, semantically related associates, and nominalizations) and perceptual errors increase with age. Lexical errors (i.e., phonologically related real words and phonologically related nonwords) do not increase with age. Results of multiple regressions that included other neuropsychological variables indicate that estimated IQ, but not new learning ability, predicts a subject's naming score. PMID- 3268258 TI - Subjective well-being evaluations among older black Americans. AB - The causal relations among social status and resource, health, and stress factors, and a single-item measure of subjective well-being (i.e., happiness) were examined among a national sample of 581 Black adults aged 55 years and over. Results indicated that although social status and resource factors had a limited impact on happiness ratings, these measures were important in predicting intermediate factors related to health status and satisfaction and stress. Happiness was directly influenced by stress and reported satisfaction with health, whereas the effect of health disability was mediated by stress and health satisfaction. The findings suggest that certain groups of older Blacks (i.e., relatively younger, widowed, and separated) may be at specific risk for diminished well-being. However, adverse health and life conditions, which are determined by status and resources, represent circumstances that further jeopardize the well-being of older Black adults. PMID- 3268259 TI - Remarriage as a coping response for widowhood. AB - Consideration and use of remarriage as a response to cope with the death of a husband was examined in 39 women who had been widowed and had subsequently remarried, 192 widows who had considered remarriage but had not yet remarried, and 420 widows who had not considered remarriage. Controlling for age, we found that women who had remarried reported fewer current concerns than did the other two groups. Furthermore, we found that women who retrospectively recalled the most concerns immediately after the death of the spouse were the ones who eventually remarried. The remarried group believed that they were experiencing significantly fewer concerns now than they had after the spouse's death; the women who had not considered remarriage believed that they were experiencing the same number of concerns now as before; and those women who had considered remarriage believed that they were experiencing significantly more concerns. Implications for remarriage as a coping mechanism for widowhood and the relation of age to remarriage decisions are discussed. PMID- 3268260 TI - The relation between locus of control and coping in two contexts: age as a moderator variable. AB - We examined the relation between locus of control and coping as moderated by age and context. A total of 96 adolescents, young adults, middle-aged adults, and older adults were administered Lazarus's Ways of Coping questionnaire, a situation-specific controllability measure, a defensive coping questionnaire, and Levenson's Internality, Powerfulness of Others, and Chance global locus of control scales for challenging and threatening contexts. Age moderated the relation between locus of control and coping. Internality was positively related to escape-avoidance, hostile reaction, and self-blame for younger individuals and negatively related for older adults. A belief in powerfulness of others was positively related to planful problem-solving and self-controlling in older adults and negatively related for younger individuals. Finally, a belief in chance was positively related to distancing and self-controlling for older adults and negatively related for younger individuals. The implication that dimensions of control vary with age is discussed. PMID- 3268261 TI - Dual-task performance as a function of adult age and task complexity. AB - A dual-task procedure was used to examine capacity demands of letter-matching in younger and older adults. Older subjects generally were slower on both tasks than were younger adults, but this difference was especially pronounced for the late stages of category matching, suggesting that retrieval and comparison of category information is particularly demanding for older adults. PMID- 3268262 TI - Classical conditioning of the eyeblink response in the delay paradigm in adults aged 18-83 years. AB - To determine if age differences in classical conditioning of the eyelid response begin to appear in middle age in humans as they do in animals, adult subjects aged 18-83 years were trained in the delay conditioning paradigm. Large age effects occurred. Statistically significant differences first appeared in the decade of the 40s. Within-age-group variability was large. To reduce variability, subjects were classified by the magnitude of their unconditioned response (UR). Regardless of age, subjects with low amplitude URs conditioned poorly. In the normal UR amplitude group, the correlation between age and total percentage conditioned responses (CRs) was -.58. Eyeblink rate and voluntary responding did not account for age differences in conditioning, and it was unlikely that hearing acuity or corneal sensitivity caused the differences. Parallels between human and animal eyelid conditioning are considered, and it is suggested that age changes in the cerebellum may affect conditioning in aging mammals, including humans. PMID- 3268264 TI - Attitudes toward older and younger adults: a meta-analysis. AB - Attitudes toward the elderly have been examined in a number of empirical studies, yet the question of whether the elderly are viewed more negatively than younger persons has not been resolved. A meta-analysis of the literature was conducted to examine this question; results demonstrated that attitudes toward the elderly are more negative than attitudes toward younger people. However, smaller differences between the evaluations of elderly and younger targets were found when (a) the study used measures of personality traits (compared with measures of competence), (b) there were a larger number of dependent measures included in the effect size, (c) specific information was provided about the target person (compared with when a general target such as old person was used), and (d) a between-subjects design (compared with a within-subjects design) was used. These results support Lutsky's (1981) conclusion that age, in and of itself, seems to be less important in determining attitudes toward the elderly than other types of information. The methodological limitations within the literature and a need to consider multiple components of attitudes toward older individuals are discussed. PMID- 3268263 TI - Hopelessness as a measure of suicidal intent in the depressed elderly. AB - Suicidal ideation in the elderly has been related to depression, changes in health, and anticipation of a limited future. The present study examined the Hopelessness Scale (HS) and its relation to these factors in a depressed geriatric population. A total of 120 elderly outpatients, who had applied to receive psychotherapy for depression, completed the HS, Beck Depression Inventory (BDI), health ratings, and the Schedule for Affective Disorder and Schizophrenia (SADS) at intake. The HS was found to be internally consistent, and a principal components analysis revealed three distinct factors that were related to hope, feelings of giving up, and future planning. The HS, BDI, and health ratings were predictive of suicidal ideation as measured by specific items in the SADS. The relation among suicidal ideation hopelessness, depression, and health perceptions for the depressed aged are discussed. PMID- 3268265 TI - Symptoms of psychological distress among caregivers of dementia patients. AB - Nine subscales of the Brief Symptom Inventory (BSI) were examined for caregivers of dementia patients. Caregivers (N = 184) were divided into groups on the basis of age (less than or equal to 59 and 60+ ) and gender. Their scores were compared with age-matched norms. All of the caregiving groups were significantly elevated on the Hostility subscale. Both younger and older women scored higher than the norms on the Anxiety subscale, and the older women were significantly elevated on three other subscales as well. The Anxiety and Hostility subscales of the BSI were most strongly correlated with the Burden Interview, a measure of the demands imposed by caregiving activities. This relation between burden and symptomatology highlights the stressful nature of caregiving. PMID- 3268266 TI - Cognitive monitoring and strategy choice in younger and older adults. AB - Younger (24- to 39-year-old) and older (60- to 88-year-old) adults learned a list of vocabulary words; one half of the words were studied using a generally more powerful strategy (mnemonic keyword method), and one half mediated with a less powerful approach (generating semantic contexts). Before using these strategies as part of the experiment, neither younger nor older adults judged that the keyword method was more effective and neither group preferred one strategy over the other. After using the strategies and taking a test of strategically studied unfamiliar vocabulary words, the younger subjects reported accurately the relative effectiveness of the two strategies and selected the one that had worked better for them to apply to a subsequent list of vocabulary items. The older participants were not as aware of the differential potency of the strategies and did not rely as much as did the younger subjects on knowledge of strategy utility in making strategy choices. In short, metacognitive awareness of strategy effects produced by monitoring and use of metacognitive awareness in regulating strategy choice were more pronounced in the younger compared with the older sample in this study. PMID- 3268267 TI - Treatment of sleep-maintenance insomnia in older adults: sleep period reduction, sleep education, and modified stimulus control. AB - We evaluated a behavioral treatment package consisting of sleep period restriction, sleep education, and modified stimulus control in the treatment of sleep-maintenance insomnia in older adults. A multiple baseline design was used with 4 chronic insomniac subjects, ages 59, 65, 65, and 72. Sleep diaries and an objective behavioral measure of sleep were used to monitor improvement. Results revealed clinically significant reductions in time awake after sleep onset in 3 subjects, coincident with the initiation of treatment. These improvements were maintained at 2- and 6-month follow-ups. The 4th subject showed little improvement; however, a polysomnogram conducted on this subject at the end of the study revealed a fragmented sleep pattern secondary to periodic movements of sleep (nocturnal myoclonus). These encouraging but preliminary results call for further controlled evaluations of the efficacy of this behavioral treatment package for sleep-maintenance insomnia. The importance of conducting polysomnographic studies on elderly insomniacs is discussed. PMID- 3268268 TI - Interviewing older adults: validity of self-reports of satisfaction. AB - Respondents in a personal interview study were asked to evaluate several domains of their lives using several different response scales that included both verbal and pictorial response alternatives. Structural equation models were specified to permit estimation of the validity of these survey measures. Across all of the items, the concept factors explain an average of about one half of the total variance, method factors explain about one tenth of the variance, and the remaining one third or so of the variance is unique to each item. Comparisons of the validity of reports by respondents of different ages indicate that method factors explain almost twice as much of the variance in the responses of older respondents as in those of younger respondents. PMID- 3268269 TI - Long-term memory loss in senescent rats: neuropsychological analysis of interference and context effects. AB - Four experiments are reported in which normal, senescent (25-27 months) and young adult (6 months) rats were tested for recall of a passive avoidance response 1 hr or several weeks after conditioning. There were no age differences at the 1-hr test, but a decrement was observed in old rats tested under standard conditions after long delays. The age-related impairment was exaggerated when additional approach training was administered in an identical apparatus between avoidance conditioning and testing. When the approach training was administered in an apparatus that contrasted markedly from the original, no age differences were observed. It was concluded that increased susceptibility to interference and contextual factors contributed to rapid forgetting in old rats, a pattern very similar to that observed previously in young adult rats with selective lesions to the hippocampus. PMID- 3268270 TI - Effects of aerobic exercise training, age, and physical fitness on memory-search performance. AB - We investigated the effects of exercise training on memory performance. One group of 13 men (M = 42.92 years of age) participated in supervised aerobic exercise (jogging) three times a week for 12 weeks. A second group of 15 men (M = 43.67 years of age) performed anaerobic exercise (strength training) for the same period of time. Subjects' reaction time (RT) performance in a memory-search task was assessed both before (Time 1) and after (Time 2) the 12 weeks of exercise training. Results indicated that there was no significant change in memory-search performance over time as a function of exercise training. Analyses of the Time 2 RTs demonstrated that aspects of memory-search performance were related significantly both to subjects' initial (Time 1) level of fitness and to age, but not to the amount of change in fitness associated with aerobic exercise training over this 12-week duration in this age group. PMID- 3268271 TI - Relation of life goals at age 70 to activity participation and health and psychological well-being among Terman's gifted men and women. AB - In this study I investigated the relation of life goals to activity participation and health and psychological well-being for men and women in Terman's Study of the Gifted. The subjects were between the ages of 65 and 75 years (M = 70.2 years) when they responded to a mail-out survey in 1982. The study included three goals scales-Autonomy, Involvement, and Achievement Motivation-as well as measures of activity participation and health and psychological well-being. Multiple regression analyses in which the three goals scales were used to predict health and psychological well-being were both significant. Path analyses demonstrated both a direct and an indirect contribution, through activity participation, of life goals to health and well-being. In most cases, the indirect effect of life goals on health and well-being accounted for more than one half of the total effect. Implications of the results for life satisfaction in aging are discussed. PMID- 3268272 TI - Effects of thematic information on script memory in young and old adults. AB - In two experiments, we evaluated the hypothesis that older adults' poorer memory for prose is due to an inability to integrate thematic information with text material. Subjects read scripts either preceded by a thematic background or no theme. In Experiment 1, memory was tested either immediately or after 24 hr delay. Younger adults (aged 20-36) recalled more and were more accurate in recognition than were older adults (aged 57-87). Both younger and older subjects were affected by thematic information in delayed, but not in immediate recall. In Experiment 2, we presented a shorter narrative and memory was tested only after 24 hr. Younger subjects recalled more than older ones, but their recognition scores did not differ from those of the older adults. As in Experiment 1, there was no interaction of age with thematic information. The results of these studies suggest that older adults are as likely to integrate thematic information in remembering as younger ones. PMID- 3268273 TI - Effects of age, tenure, training, and job complexity on technical performance. AB - Effects on performance of age, tenure, training level, and job complexity were investigated in a cross-sectional study using a sample of 1,308 service engineers employed by a multinational office equipment company. Two measures of job performance were derived from production record data, one relating to the quality of servicing and the other to the speed with which services were completed. Scores for each performance measure were analyzed by analysis of variance. For the quality of servicing measure, a significant main effect of age and a significant Age X Training interaction were obtained, and the relation between age and job performance took the form of an inverted U. For the speed of servicing measure, the main effects of age, tenure, training level, and job complexity were significant and there were no significant interactions. However, for both performance measures, age accounted for only a very small proportion of the variance. We discuss these results with reference to the existing literature on age and technical job performance, and conclude that training, especially if it is recent, may moderate adverse effects of age on job performance. PMID- 3268274 TI - Effect of instructional set on responses to the Geriatric Depression Scale. AB - A community sample of elderly subjects (M age = 74 years) was randomly assigned to four variations in reference group instructions on the Geriatric Depression Scale (GDS). In one condition, subjects received no instructions as to reference group, which is the standard instructional format of the test. In the other three conditions, subjects were asked to compare themselves with one of three reference groups: age group peers, adults in general, or themselves at a younger age. Results indicated that the GDS is robust with respect to variation in reference group instruction. PMID- 3268275 TI - The influence of age on consistent and varied semantic-category search performance. AB - Three experiments examined age-related consistent mapping (CM) and varied mapping (VM) practice effects. In separate experiments, young (age, 19-22), middle-aged (37-50), and older (64-88) adults' performance was examined using semantic category and letter-based search paradigms. After extensive practice, major age differences occurred in CM search. Young and middle-aged subjects showed near zero comparison slopes, large reductions in mean reaction times, and substantial reductions in response variability. Although older adults' reaction time decreased with CM practice, the reduction in reaction time, comparison slope, and response variability was small compared with the other groups. In VM search, older subjects were slower than the other age groups, but all groups exhibited similar linear set-size functions, search termination, and comparison-load effects. We concluded that age-associated declines in cognitive performance may be due in large part to the degree with which older adults can acquire or use automatic processes to perform tasks. PMID- 3268276 TI - A three-year follow-up of older adult participants in a memory-skills training program. AB - This study examined the long-term effects of participation in a self-taught memory training program. In all, 27 memory training and 13 nontraining participants were assessed at approximately 3-year follow-ups. Assessment of these groups prior to the introduction of training had revealed nonsignificant differences in memory performance but marked differences in level of memory complaints, with training participants evidencing higher levels of complaints. The current assessment again demonstrated overall nonsignificant differences in memory performance but significant differences in memory complaints between the two groups. More specifically, the training group evidenced significant decreases in memory performance over the 3-year interval, but no significant changes in memory complaints were observed for either group. Thus, memory training appeared to have little long-term effect on memory functioning. Future research should explore long-term maintenance strategies in memory training with older adults. PMID- 3268277 TI - Do clever old people have earlier and richer first memories? AB - In a study of 377 people, from 54 to 83 years old, it was shown that the age of earliest memories was unrelated to current age but was related to intelligence. People with high IQ test scores remembered first and second memories at an earlier age than did those with lower IQ test scores. Intervals between first and second memories were briefer for those with high scores. The content of early memories was unrelated to age or intelligence. PMID- 3268278 TI - Absence of age-related proneness to short-term retroactive interference in the absence of rehearsal. AB - Age differences in short-term retroactive interference, unconfounded with age differences in rehearsal in the retention interval of the Brown-Peterson Task, were not found in a cross-sectional study of adults 18-32 and 64-78 years of age. Degree of retroactive interference was manipulated conjointly with distractor interval length (0-15 s). Individual memory span was assessed and used as the list length in order to achieve stimulus equivalence of memory loads across individuals and age groups. An attention-demanding matching task that adjusted itself in difficulty to the individual's attentional capacity was used as the distractor activity. Covert rehearsal during the retention interval was inferred using several measures, including a comparison of distractor task performance in the presence and in the absence of a memory load, and rehearsers were excluded from the primary analyses. We conclude that there is no interference proneness with increasing age in the present study. PMID- 3268279 TI - Supportive relationships in later life. AB - We adopted a multidimensional approach to the study of the social support convoys of older adults. We distinguished between age and gender differences in four specific dimensions of the social support convoy: (a) existence versus functioning of relationships in the convoy, (b) kinds of relationships (i.e., those with children, siblings, and friends), (c) types of social support (i.e., emotional support, respect, and health support), and (d) receipt versus provision of support. Using a national survey of 718 adults, multivariate and univariate analyses of variance were performed to determine age and gender differences in these four dimensions of social support. The multidimensional approach was useful in pinpointing those aspects of the social support convoy affected by aging. We anticipated that the social support convoy would be devastated by aging. Instead, we found that older people received less support (i.e., emotional and health support) in the absence of sibling relationships. Otherwise, the effects of aging had more to do with what the older person contributed to the convoy than with what he or she received. Women had better social support resources than men, particularly within their friendships. We found no evidence, however, that women's social support advantage counterbalanced the effects of aging on the convoy. PMID- 3268280 TI - Adult age differences in implicit and explicit memory: time course and encoding effects. AB - Young and older adults were tested at three delays on word-stem completion or cued recall following semantic or structural word judgments. Identical three letter stems were present at retrieval for both implicit (completion) and explicit (cued recall) tasks; only the intention to recall list words differed. The young adults outperformed the older adults on both implicit and explicit tasks at all test delays. Under some conditions, the older but not the young adults performed more poorly on cued recall than on stem completion, suggesting a possible failure to use implicitly available information to support explicit remembering. These results suggest that some forms of implicit memory decline with normal aging. PMID- 3268281 TI - Organization of depressive symptoms in the elderly population: hierarchical patterns and Guttman scales. AB - Survey data from the US-UK Cross-National Geriatric Community Study was examined for hierarchical patterns in the organization of depressive symptomatology in the elderly population. A pattern similar to that previously found in a younger sample (Sturt, 1981) was evident. Low prevalence symptoms were associated with increased numbers of other symptoms. The poor fit of high-frequency somatic symptoms in this hierarchy was explained by their low specificity for depression in an elderly population. Derived Guttman scales of somatic and affective symptoms suggested, nonetheless, that such low-specificity symptoms may be clinically significant in the ontogeny of depression. PMID- 3268283 TI - Continuity in intellectual functioning: the role of self-reported health. AB - Surviving members of the Berkeley Older Generation Study were interviewed and tested with the Wechsler Adult Intelligence Scale in 1969-1970 and again in 1983 1984, when subjects' ages ranged from 73 to 93. Health was assessed by self reports at both measurement periods. Although many individuals showed some decline in intellectual functioning, substantial individual differences were apparent at all age levels. More than one half of the subjects showed no reliable change, and a minority showed a reliable increase in verbal scores. The role of self-reported health has increasing importance in the maintenance of intellectual functioning in advanced old age. PMID- 3268282 TI - Structural integration of the Affect Balance Scale and the Life Satisfaction Index A: race, sex, and age differences. AB - In this research we examined race, sex, and age differences in the factorial structure of Liang's (1985) model of subjective well-being that integrates the Affect Balance Scale and the Life Satisfaction Index A. In particular, we viewed the covariance structure of the items as a function of several parameter matrices. We analyzed the factorial invariance by testing hypotheses involving the equivalence constraints of one or more parameter matrices with regard to the following: White and Black subsamples, men and women, and the young-old and the old-old. Data for the research came from the 1974 Harris National Council on Aging Survey, Myths and Reality of Aging in America. Analysis of covariance structures, or LISREL, was used to assess the factorial invariance. Replicated race differences were found in the factorial structure, but sex and age differences were not found. Consistent race differences were found for the second order factor loadings for negative affect. PMID- 3268284 TI - Evaluation of a mutual help network for the elderly residents of planned housing. AB - We set up a mutual help network among the elderly residents of a government subsidized apartment building and evaluated its impact on their social ties, social support satisfaction, and depression. A quasi-experimental design was used, with the residents of a similar building located in the same neighborhood serving as the control group. A total of 230 individual services were exchanged, and 28 group activities were organized during the study period. There was almost no difference between experimental and control groups with respect to the change over the study period in the number of social ties with other residents of the building. Support satisfaction decreased in both groups, but the decrease was larger in the experimental group. The control group had a slight decrease in the frequency of their depressive symptoms, whereas the experimental group had a moderate increase. More research is needed on the ability of social support interventions to produce beneficial effects on mental health among individuals who are not experiencing a particular life stress. PMID- 3268285 TI - Genotype-environment interaction in personality development: identical twins reared apart. AB - The focus of this study is to identify specific genotype-environment (GE) interactions as they contribute to individual differences in personality in later life. In behavioral genetics, GE interaction refers to the possibility that individuals of different genotypes may respond differently to specific environments. A sample of 99 pairs of identical twins reared apart, whose average age is 59 years, has been studied as part of the Swedish Adoption/Twin Study of Aging (SATSA). Hierarchical multiple regression was used to detect interactions between personality and environmental measures after the main effects of genotype and environment were removed. Analyses yield evidence for 11 significant interactions that provide the first evidence for GE interaction in human development using specific environmental measures. Thus, in addition to the main effect contributions of heredity and environment, GE interactions contribute to individual differences in personality as measured in the second half of the life course. PMID- 3268286 TI - Age, variability, and speed: between-subjects diversity. AB - Two independent data sets were selected to examine the interrelations among reaction time (RT), between-subject variability or diversity (SD), and age. In both data sets, a strong correlation between RT and SD was obtained. This strong correlation was not affected when age was controlled in a partial correlation analysis. On the other hand, a weaker but significant correlation was obtained between age and SD. This correlation was eliminated when RT was controlled in a partial correlation analysis. Our analyses of the two data sets also indicated that the relation between RT and SD is identical for both young and elderly groups. Thus, the greater diversity often observed in performances of older groups is a direct consequence of slowing, rather than an independent effect of advancing age. PMID- 3268287 TI - Effects of ozone and nitrogen dioxide on human lung proteinase inhibitors. AB - Based on available knowledge, this study shows that alpha-1-proteinase inhibitor (alpha 1-PI) plays an important role in protecting lung elastin from elastolytic proteinases, particularly human neutrophil elastase (HNE). Studies previous to this one showed that alpha 1-PI was very susceptible to inactivation by oxidants. We sought to use this oxidant sensitivity as an in vivo marker for ozone (O3) and nitrogen dioxide (NO2) exposure. The mechanism of alpha 1-PI inactivation by O3 and NO2 was examined to provide insight concerning the pathogenesis of oxidant mediated lung damage. Attention also was focused on the bronchial leukocyte proteinase inhibitor (BLPI), which inhibits HNE in the bronchial secretions. Careful examination of blood plasma samples from individuals exposed to 0.5 ppm O3 for four hours on two consecutive days failed to detect any inactivation of alpha 1-PI. This result showed that blood alpha 1-PI was not a satisfactory marker for O3 exposure, but, more importantly, demonstrated that inhaling O3 for short periods does not grossly inactivate this important protein. Studies on BLPI showed that it is a significant inhibitor of HNE and probably plays a more important role in protecting the lung than previously thought. BLPI, like alpha 1 PI, was found to be inactivated by oxidants, including O3 and NO2. The mechanism of O3 inactivation of leukocyte proteinase inhibitors was studied using alpha 1 PI, alpha-1-antichymotrypsin (alpha 1-Achy), BLPI, and Eglin C. While all these inhibitors differed in structure, the concentrations of O3 required for inactivation were essentially the same, except for alpha 1-Achy, which only lost half of its inhibitory activity. It would seem from these results that O3 can damage proteins via the oxidation of any of the following: tryptophan (Trp), methionine (Met), tyrosine (Tyr), or histidine (His) residues. Interestingly, Eglin C, which does not have oxidizable amino acids in its inhibitory active site, was inactivated by the same amount of O3 as BLPI, BLPI was easily inactivated by a methionine-specific oxidant, suggesting an important role for methionine in this inhibitor. In vitro exposure of alpha 1-PI and BLPI to 800 moles of NO2 per mole of inhibitor resulted in 35% and 50% losses of HNE inhibitory activity, respectively. Tryptophan was destroyed by NO2 and studies are in progress to examine effects on other amino acids. PMID- 3268288 TI - Disposition and metabolism of free and particle-associated nitropyrenes after inhalation. AB - The objective of this project was to determine the biological fate of 1 nitropyrene (NP) aerosols in rats. The results from these studies indicate that, over the range of aerosol concentrations tested, pathways for excretion of 14C-NP equivalents in urine and feces were independent of the exposure concentration of NP, either in its pure form or associated with diesel exhaust particles. In all cases, fecal excretion was the major route of elimination of 14C-NP equivalents, with about 2 times more excreted by this route than by urine. Fractional respiratory tract deposition of 14C-NP did not appear to be dependent on exposure concentration. In most cases, half-times for elimination of 14C in urine and feces were about 15 to 20 hours. In all exposures, 14C was widely distributed in the tissues examined. Analysis of the tissues for NP and metabolites indicated that within 1 hour after exposure greater than 90% of the 14C was associated with NP metabolites. Lungs of rats exposed to 14C-NP coated on diesel exhaust particles contained nearly 5 times more 14C than lungs from rats exposed to pure aerosols of 14C-NP (148 vs 29 pmole g lung) within 1 hour after exposure. This difference was increased to 80-fold at 94 hours after exposure (80 vs 1 pmole g lung). Long-term clearance half-times of 14C from various tissues were similar, with values of about 30 to 50 hours measured. Pre-exposure to diesel exhaust prior to exposure to NP may result in increased retention of a small fraction of the NP. Equilibrium organ concentrations predicted for tissues following continuous exposure to NP suggest that both low inhaled concentrations of NP and association of NP with insoluble diesel particles can result in an increased retention of NP in the lungs above what might be predicted using data obtained from animal studies using high concentrations of pure NP. The liver and kidneys are among the other organs predicted to contain the highest amounts of NP. PMID- 3268289 TI - Transport of macromolecules and particles at target sites for deposition of air pollutants. AB - This study analyzed rats' nasal, tracheal and bronchoalveolar epithelial permeability to macromolecules after they were exposed, in 2- or 4-hour periods of rest or exercise, to ozone (O3) (0.6, 0.8 or 2 ppm), nitrogen dioxide (NO2) (2.5, 6 or 12 ppm) or formaldehyde (10 ppm). Exercise was performed on a treadmill operated at a speed that led to a 2-fold increase in oxygen consumption. Histopathologic and electron microscopic cytochemical and autoradiographic studies were performed to identify the structural aspects of mucosal response. In rats not exposed to pollutants, the quantity of macromolecular tracers (99mTc-DTPA, 125I-BSA) in blood sampled 6, 7, 8, 9 and 10 minutes after a slow 5-minute instillation of comparable quantities of tracer molecules in the lumen of each zone, was lowest in nasal, highest in tracheal, and intermediate in the bronchoalveolar region. Exposure of resting rats to O3 did not affect nasal permeability, but tracheal and bronchoalveolar permeabilities increased by 2-fold 1 hour after the exposure. In rats exposed at rest to O3, tracheal permeability was no longer elevated 24 hours after exposure, but bronchoalveolar permeability remained elevated at 24 hours after exposure and was normal at 48 hours. Exposure during exercise increased the effect of O3 in the trachea and in the bronchoalveolar zone. However, exercise also prolonged the duration of the O3 effect on the tracheal zone from 1 hour to 24 hours and, in the bronchoalveolar zone, from 24 hours to 48 hours. Histologically, focal inflammatory lesions in the alveolar zone were maximal at 48 hours after a 4-hour resting exposure to O3. After exposure during exercise, the area of lung involved by lesions increased 4- to 7-fold above the lesion-bearing area in rats exposed while resting. By electron microscopy, horseradish peroxidase (HRP) was localized in epithelial intercellular spaces, but not in the apical tight junctions, of tracheal epithelial cells from O3-exposed rats; no HRP was found in intercellular spaces in controls. The number of HRP-containing endocytic vesicles in tracheal epithelial cells was 2-fold greater in rats exposed to O3 than in control rats. This 2-fold increase in vesicles presumed to be transporting HRP matches the 2 fold increase in transfer of DTPA from the tracheal lumen to the blood. Electron microscopic autoradiography revealed 125I-BSA accumulation in subepithelial connective tissue, and electron microscopic cytochemistry identified accumulation of HRP not only between cells but also at the basal lamina.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3268290 TI - O2-dependent nitrogenase switch-off in Rhodobacter capsulatus E1F1. AB - Nitrogenase of Rhodobacter capsulatus E1F1 (formerly known as Rhodopseudomonas capsulata E1F1) was partially resistant to O2 inactivation in vivo. This inactivation was reversed by restoring anaerobic conditions, was independent from de novo protein synthesis and its extent was decreased upon preincubation of the cells with dioxygen at low pressures and also in the presence of H2. Illuminated cells exhibited a low rate of O2 uptake which was enhanced in the presence of H2, particularly in cells preincubated with O2. These results indicate that R. capsulatus E1F1 can develop for nitrogenase a protective system against dioxygen which, at least, consists of an uptake hydrogenase and an inducible electron transport system linked to a respiratory chain. PMID- 3268291 TI - [Evolution of several enzyme activities of Aureobasidium pullulans during the transition from yeast to mycelium induced by ethanol]. AB - Some key enzyme activities from the energy metabolism of A. pullulans have been studied during the ethanol-induced yeast-to-mycelium transition. Both the mycelial and yeast-like forms showed greater glucose-6-phosphate dehydrogenase activity than phosphofructokinase. During the morphological transition, the most outstanding variations occurred in large cells (3 days), especially for citrate synthase, malate dehydrogenase and isocitrate lyase activities. However, similar variations were detected in cultures without glucose or ethanol, which showed no morphological transition. Therefore, the observed changes in the enzymatic activities may be attributed to the absence of glucose. As this is not sufficient to induce the morphological transition, we conclude that there is no evidence of a clear-cut relationship between morphology and the activity of the enzymes studied. PMID- 3268292 TI - Relationships between physico-chemical parameters and microbial groups in Manchego and Burgos cheeses studied by principal component analysis. AB - Principal component analysis was used to examine the correlations between two sets of variables, one representing physicochemical characteristics (pH, aw and NaCl, moisture and fat content) of Manchego (36 samples) and Burgos (36 samples) cheeses, and the other representing counts of several microbial groups (mesophiles, psychrotrophs, lactic acid bacteria, coliforms, enterococci, staphylococci and molds and yeasts). Thermonuclease content was also included. In addition to the expected relationships (NaCl content, moisture, aw, etc.), significant correlations between some compositional characteristics and levels of certain microorganisms were found. These correlations were dependent on the type of cheese. Thermonuclease content was positively related to enterococci and ripening (only in Manchego cheese). In contrast to former observations, no relationships were observed between coliforms and enterococci counts. PMID- 3268293 TI - Development of precipiting antibodies in rabbits inoculated with Streptococcus pneumoniae by crossed immunoelectrophoresis. AB - The antibody response of rabbits immunized with a strain of Streptococcus pneumoniae serotype 1 was studied by crossed immunoelectrophoresis. Sera taken every 4 weeks up to eight months post inoculation were tested in order to observe the development of precipiting antibodies, a complete response being encountered on week ten. PMID- 3268294 TI - [Isolation of imazalil and prochloraz resistant Penicillium variable strains from a commercial citrus warehouse]. AB - "In vitro" sensitivity of two strains of Penicillium variabile to different concentrations of Imazalil and Prochloraz has been studied. Both strains were isolated from a citrus packing-house in which Imazalil was used. These strains were resistant to both compounds showing a ED50 higher than 100 ppm. PMID- 3268295 TI - [Taxonomic study of epiphyte lactic bacteria in grapes in Galicia]. AB - A taxonomic analysis of the malolactic microflora present in nine grape samples from different zones of Galicia, was carried out. Nineteen strains were isolated and identified as Lactobacillus plantarum (42%), L. brevis (10.6%), L. casei (5.25%), L. hilgardii (5.25%), Streptococcus cremoris (5.25%), Leuconostoc lactis (5.25%), L. oenos (10.6%), and Pediococcus acidilactici (15.8%). PMID- 3268296 TI - Epidemiology of Yersiniae in Barcelona, Spain. AB - Between April 1980 to December 1984 we undertook a study on the epidemiology of pathogenic Yersinia. Stool specimens from 5.199 patients with acute gastroenteritis were studied and Y. enterocolitica biotype 4 serotype 3 was isolated in 42 cases (0.8%). The serological response was studied in 21 of these patients. Faecal specimens from 784 non-laboratory animals were also studied. The only pathogenic isolates from these animals were seven strains of Y. enterocolitica biotype 4 serotype 3 from six pigs and one dog and one strain of Y. pseudotuberculosis from a pig. The search of pathogenic Yersinia in 424 samples form row foods allowed the isolation of eight strains of Y. enterocolitica serotype 3 and one strain of Y. pseudotuberculosis from pig's tongue. PMID- 3268297 TI - [Induction of cellulases and xylanases in Aureobasidium pullulans]. AB - The specificity or induction of wood-degrading enzymes using series of mono, di or polysaccharides as carbon source for the yeasts Geotrichum candidum and Trychosporon penicillatum and the yeast-like organism Aureobadidium pullulans were studied. The strain A. pullulans was the only one that when xylan or "steam exploded wood" were used as carbon source all the enzymes tested were found. This strain was unable to grow on carboxymethyl or Avicel cellulose. D-xylose was the nutritional inducer of beta-xylosidase and beta-xylanase but D-glucuronic acid induced CMCase activity and beta-glucosidase was produced with every carbon source. The 1,4 beta-xylobiose was not an inducer of beta-xylanase but with the structural 1,2-beta- and 1,3-beta-xylobiose isomers high levels of this enzyme were obtained. PMID- 3268298 TI - [Morphologic and functional aspects of keratinocytes and melanocytes cultivated in vitro]. PMID- 3268299 TI - [Viability assay of cryopreserved bone marrow cells before autologous transplant]. PMID- 3268300 TI - Noradrenergic innervation of the lingual papillae in certain rodents pre-treated with adriblastin. II. A comparative study on circumvallate and foliate papillae. PMID- 3268301 TI - [The condition of steroid hormone receptors in rats, after acute treatment with tamoxifen]. PMID- 3268302 TI - Detection of DNA damage "in vitro" by a topoisomerase II inhibitor with a low shear viscometer. PMID- 3268303 TI - [Erythrocyte lability in neoplastic diseases studied using in vitro-induced formation of Ehrlich-Heinz bodies]. PMID- 3268305 TI - [Ophthalmological symptoms of Basedow's disease]. PMID- 3268304 TI - [Surgery of the orbit in endocrine exophthalmos. Preliminary results of a new approach to orbital decompression in Basedow orbital diseases]. PMID- 3268306 TI - [Endocrine ophthalmopathies. Radiological aspects]. PMID- 3268307 TI - [The medical treatment of endocrine exophthalmos]. PMID- 3268308 TI - [Cyclosporin treatment of Basedow's ophthalmopathy]. PMID- 3268309 TI - [Medical ocular treatment]. PMID- 3268310 TI - [A plea for kinetic perimetry]. PMID- 3268311 TI - The meaning of simultaneous PERG-VER in the early diagnosis of glaucoma: a statistical evaluation. PMID- 3268312 TI - Visual field testing of driving license applicants. PMID- 3268313 TI - Sclerosing lipogranuloma of the orbit. PMID- 3268314 TI - Amiodarone and optic neuropathy. PMID- 3268316 TI - Optic nerve infiltration in leukemia. PMID- 3268315 TI - Histopathological findings after intravitreal silicone injection in a case of retinal detachment with proliferative vitreoretinopathy. PMID- 3268317 TI - Community periodontal index of treatment needs. PMID- 3268318 TI - Microcomputer survey of Ontario health unit dental divisions. PMID- 3268319 TI - The public's awareness, utilization, and satisfaction levels with dental public health programs in North York: 1981-1987. PMID- 3268320 TI - Attracting dental graduates to rural locations: evaluation of the Saskatchewan initiative. PMID- 3268321 TI - Dental health promotion for seniors: the Toronto experience. PMID- 3268322 TI - AIDS not found worldwide. PMID- 3268323 TI - Processing relational and item-specific information: effects of aging and division of attention. PMID- 3268324 TI - The use of scattergrams for the representation and analysis of lateralized interference effects in neuropsychology. PMID- 3268325 TI - Mental rotation and the identification of disoriented objects. PMID- 3268327 TI - Typicality, familiarity and the recognition of male and female faces. PMID- 3268326 TI - The visible persistence of illusory contours. PMID- 3268328 TI - Conceptual masking in brief visual displays. PMID- 3268329 TI - Perceptual information and response strategies: a comment on Briand and Klein. PMID- 3268330 TI - Morphological changes during surgical-orthodontic treatment including total combined osteotomies of the maxilla and mandible. PMID- 3268331 TI - Assessment of periodontal treatment needs in Japan Maritime Self Defense Force by CPITN. PMID- 3268332 TI - An experimental study of dentinogenesis in autografted dental pulp in rats. PMID- 3268333 TI - Pregnancy and multiple sclerosis. An Australian perspective. AB - The effect of pregnancy on the relapse rate of multiple sclerosis (MS) has been investigated. Obstetric and relapse histories of 52 women from New South Wales with clinically definite MS were obtained by telephone interview. These women had 101 pregnancies of which 85 were at risk of an MS relapse. No increased risk of relapse during the pregnancy period was demonstrated. The relapse that did occur during the pregnancy period were clustered in the last trimester of pregnancy and first 3 months post partum. PMID- 3268334 TI - Oxcarbazepine: preliminary clinical and pharmacokinetic studies on a new anticonvulsant. AB - Oxcarbazepine is a new anticonvulsant, currently undergoing clinical trials. Its spectrum of antiepileptic action, and its chemical structure, resemble those of carbamazepine, though the 2 drugs have no pharmacologically active metabolites in common. In a study of 7 adults with poorly controlled partial epilepsy, progressive substitution of oxcarbazepine for carbamazepine left seizure control unaltered in 4 and improved in 3, whilst 5 became more alert and one was rendered ataxic. Three subjects became hyponatraemic. There were no other adverse effects. Plasma levels of the drug and its pharmacologically active 10-hydroxy derivative were measured sequentially over 4 days after a single drug dose at the outset of therapy in 5 subjects. Calculated pharmacokinetic parameter values for the drug, assuming complete oral bioavailability, were: absorption lag time 2.07 +/- 1.61 h: absorption rate constant 8.328 +/- 8.941 h-1: apparent volume of distribution 3.937 +/- 2.222 L kg-1: oral clearance 2.898 +/- 1.439 L kg-1: elimination rate constant 0.609 +/- 0.261 h-1 (half-life 1.26 +/- 0.37 h), while the metabolite had a formation rate constant of 0.593 +/- 0.233 h-1, and an elimination rate constant of 0.082 +/- 0.014 h-1 (half-life 8.74 +/- 1.79 h). Even with a single dose, peak plasma metabolite levels were substantially higher than those of the parent drug. Oxcarbazepine appears to be a promising alternative to carbamazepine as an anticonvulsant, although in view of its rapid elimination it probably serves mainly as a prodrug for its 10-hydroxy metabolite. PMID- 3268335 TI - Pseudo-multiple sclerosis: a clinico-epidemiological study. AB - Despite the advance represented by nuclear magnetic resonance imaging, the diagnosis of multiple sclerosis (MS) remains clinical. It has been our impression that a diagnosis of MS reduces further critical neurological thought and assumes an air of certainty after a number of visits in the absence of any new evidence for the diagnosis. One of us (E.G.S-W.), as part of a nationwide epidemiological study, reviewed 387 patients in Western Australia who had been diagnosed as having MS. Three diagnostic sub-groups were identified: group A--318 patients considered to have MS, group B--32 patients with an alternative chronic neurological disorder, and group C--35 patients not considered to have a neurological illness. Patients in group C were predominantly females (89%) and nurses (34%) with an earlier age of onset of symptoms (mean 28 years, range 12-46 years). Frequent clinical features included monocular diplopia, tunnel vision, 'give-way' weakness and hemisensory loss of all modalities of sensation. The major clinical features of patients in group B, which were atypical for MS, included onset of non-remitting, progressive disease before age 35 years, localised disease, and normal optic nerves and eye movements. The results of this study serve to promote critical analysis of the accuracy of diagnosis of MS in individual cases. PMID- 3268336 TI - Glossopharyngeal neuralgia. AB - Nine cases of glossopharyngeal neuralgia have been seen in the last 5 years and are reported. They fall into 2 groups, namely otitic and oropharyngeal, according to the initial location of pain. The condition is probably more common than is recognised, largely because there are diagnostic difficulties with the otitic form where the pain radiates widely into the distribution of the trigeminal nerve and also into upper cervical dermatomes. The pain is more variable than that seen in trigeminal neuralgia but usually responds initially to carbamazepine. The results from surgical section of the ninth and the upper rootlets of the tenth nerve have been good. The clues to the diagnosis are the initial site of the pain in the oropharynx and in or around the ear, the characteristics of the pain and its triggering factors, and a response to carbamazepine. PMID- 3268337 TI - Pathological changes in the vagus nerve in diabetes and chronic alcoholism. AB - Morphometric studies have been performed on the vagus nerve removed at autopsy from control subjects and from patients with diabetes and chronic alcoholism. In all diabetic and chronic alcoholic subjects there was significant reduction in the density of myelinated fibres at the most distal level of the nerve. Degenerative changes in the nerve are consistent with the findings of abnormal vagal function in diabetics and chronic alcoholics. PMID- 3268338 TI - Non-invasive tests of neurovascular function. AB - This paper describes the value of non-invasive neurovascular function tests in the clinical setting. Painful transcutaneous electrical nerve stimulation (TENS) of the dorsum of the foot evoked axon reflex vasodilatation, measured by laser Doppler flowmetry. In addition, acetylcholine and sodium nitrite (NaNO2) were iontophoresed to cause vasodilatation by endothelium-dependent and -independent mechanisms, respectively. Compared with healthy volunteers, diabetic patients with clinically diagnosed neuropathy showed reduced electrical axon reflex flare responses. These responses in one additional subject were absent in a region of denervated skin. Acetylcholine responses, but not NaNO2 responses, were also depressed in patients with diabetic neuropathy. Such reduced cutaneous nocifensor functions may contribute to some symptoms and complications of diabetes mellitus. PMID- 3268339 TI - Diabetic focal myelopathy. AB - The existence of myelopathy as a complication of diabetes is debatable and, in the few reported cases, spinal involvement has been diffuse. We describe 2 cases of focal myelopathy. Two insulin-dependent, middle-aged men with adult-onset diabetes presented with gradually ascending lower limb pain and numbness without sphincteric symptoms. Examination showed mixed upper and lower motor signs in the lower limbs, with a severe impairment of cutaneous sensation below a sharply demarcated band at the T9-10 level with relative preservation of posterior column function. Myelography was normal. CSF showed mild elevation of protein and in one case showed 23 x 10(6) white cells/L. Nerve conduction studies showed a co existing, mild sensorimotor neuropathy. There was no evidence of truncal radiculopathy on paraspinal EMG. Extensive investigation for other causes of myelopathy was negative. PMID- 3268340 TI - Hereditary motor neuron disease. AB - Nine cases of motor neuron disease (amyotrophic lateral sclerosis) in one family over 3 generations are presented. In 2 instances the disease was transmitted from parent to child. Several of the patients were first cousins. There was no skipping of a generation. The positive family history had been overlooked by several neurologists, although they had enquired for it. Familial motor neuron disease accounts for at least 10% of cases of this disorder. PMID- 3268341 TI - Visual evoked responses in diabetes. AB - In view of the conflicting evidence concerning prolongation of the VERs in diabetes, pattern reversal VERs were performed on 60 diabetic inpatients. Only in one patient was the VER unequivocally delayed without some other explanation and in 2 other patients it was prolonged in association with proliferative retinopathy. In the latter instance the latency may have been increased by involvement of the maculo-papillary fibres of the optic nerve which may occur during their passage through the retina. Otherwise the study does not strongly support the concept of optic neuropathy or central encephalopathy of the visual system in diabetes, at least as far as can be demonstrated by visual evoked cortical responses to pattern reversal stimuli. PMID- 3268342 TI - Electroencephalographic abnormalities in patients with normal contrast computerised axial tomography brain scans. AB - The present investigation shows how, in certain circumstances, electroencephalography is capable of detecting the presence of cerebral dysfunction when CT head scanning fails to reveal that any abnormality is present. PMID- 3268343 TI - Herpes zoster arteritis. Clinical and angiographic features. AB - Herpes zoster ophthalmicus is a common condition, and has now been widely recognised as associated with the delayed onset of neurological events, associated with angiographic evidence of arteritis. The time lag between the zoster and subsequent neurological symptoms, along with the age of the patients, often leads to a missed diagnosis. As more cases are recognised, the pathogenic mechanisms will be better characterised and treatment may become more effective. PMID- 3268344 TI - Listeria rhomboencephalitis. AB - Listeria rhomboencephalitis is a rare form of listeriosis which is frequently not diagnosed before death. We here describe an instance in an apparently healthy immunocompetent lady which responded to appropriate therapy. Treatment with intravenous ampicillin with or without an aminoglycoside antibiotic should be instituted early if the patient is to survive. PMID- 3268345 TI - Neurological sequelae of lightning stroke. AB - Two cases of patients struck by lightning are described. One instance occurred while the victim was using the telephone; the other victim received a direct lightning strike to the head. Both patients had acoustic shock injuries and one developed a cerebral infarct. The mechanisms of these injuries are discussed and the relevant literature is reviewed. PMID- 3268346 TI - The effects of capsaicin denervation on leucocyte and complement components of the inflammatory response. AB - Primary afferent unmyelinated nerves containing substance P modulate the inflammatory response to injury through a process known as neurogenic inflammation. Rats treated as neonates with capsaicin, to destroy these nerves permanently, have a reduced capacity to mount an inflammatory response as measured by swelling or plasma extravasation. In this study we examined some aspects of the immunological response to injury in capsaicin-treated rats. One question addressed was whether changes in the inflammatory response are due to abnormal innervation or to a direct toxic effect of capsaicin. It was observed that the histological appearance of thymus, splenic white pulp and popliteal lymph nodes was unaltered in capsaicin-treated rats. However, there was an increase in leucocyte number in splenic red pulp. There was also an increase in the white cell numbers in the peripheral circulation (7 +/- 1 X 10(6)/mL for normal rats and 14 +/- 2 X 10(6)/mL in capsaicin-treated rats, p less than 0.001, Student's t-test). This affected all white cell subgroups. Complement levels in capsaicin-treated rats were not different from normals and both groups showed a similar depletion 6 days following antigenic stimulation with sheep red cells. These data support the view that the reduced cellular response to injury in the capsaicin-treated rat is secondary to the effect of the chemical on afferent nerves and not to a primary toxic effect on cells of the inflammatory response. PMID- 3268347 TI - Unreported symptomatic and asymptomatic ischaemic heart disease in patients presenting with TIA or minor stroke detected by the London School of Hygiene Cardiovascular Questionnaire and Minnesota coding of a routine ECG. AB - In a prospective study of 87 patients with TIA or minor stroke (48 men and 39 women, average age 65 years) a history of ischaemic heart disease (IHD) was present in 30 (angina in 25 and myocardial infarction (MI) in 19, 14 having both). The London School of Hygiene Questionnaire did not confirm the diagnosis of IHD in 7 patients, but did detect a further 5 patients with angina and/or MI. The Minnesota coding of the ECG revealed 5 patients with asymptomatic suspect IHD and 15 with probable IHD (a total of 23%). Cardiomegaly (cardiothoracic ratio greater than 0.5) was present in 28 patients, 9 with a history of MI and 8 with a history of angina. These findings indicate that IHD is common in patients with cerebral vascular disease. As both probable IHD on Minnesota coding of the ECG and the presence of cardiomegaly are highly predictive of a poorer outcome, the findings add further weight to the argument that, amongst patients with minor cerebral ischaemia, a sub-group at high risk of death due to IHD can be detected by using simple methods rather than by performing routine coronary angiography on all patients as has been suggested in recent times. PMID- 3268349 TI - Lacunar infarction: a 12 month study. AB - Identification of lacunar infarction as a cause of stroke is important, as investigation, treatment and outcome differ from those in the other stroke categories. In this study of 121 acute strokes admitted over a period of 12 months, 28 patients (23%) were found to have lacunar infarction and 93% of patients with lacunes had either a past history of hypertension or echocardiographic evidence of left ventricular hypertrophy. The degree of left ventricular hypertrophy tended to be moderate to severe with an average left ventricular mass on echocardiography of 120 g/m2. Pure motor hemiparesis was the commonest clinical presentation and lacunar infarction overall has a low mortality. PMID- 3268348 TI - Protein metabolism in Duchenne muscular dystrophy, monoclonal and mixed skeletal muscle cultures. AB - Previous studies have suggested that accelerated protein degradation or a reduced rate of protein synthesis is the process responsible for muscle wasting in Duchenne dystrophy. Skeletal muscle biopsies were obtained from 4 Duchenne dystrophy and 6 normal male orthopaedic control patients. Muscle cultures were established from dissociated single cells and protein metabolism was studied in mixed, confluent, post-fusion cultures. The rate of total protein synthesis was significantly greater in Duchenne cultures, while the degradation rate of long half-life protein was not significantly different in Duchenne dystrophy and control cultures. Monoclonal cultures from 1 Duchenne and 1 control biopsy demonstrated considerable variation in protein synthesis and degradation rates and creatine kinase activity between clones from each biopsy. This suggests that individual myoblasts differ significantly in growth and myogenic potential. PMID- 3268350 TI - A case-control study of cerebrovascular disease in Western Australia. AB - One hundred and twenty-nine patients notified to the Perth Community Stroke Study in whom the final diagnosis was cerebrovascular disease were matched with controls of the same sex and 5-year age group drawn from the records of the usual general practitioner of each index case. The control subjects were interviewed and examined briefly at home, following the same protocol as that used for assessment of cases. The significant risk factors for cerebrovascular disease to emerge in the case-control comparison were previous stroke (estimated relative risk 6.6), signs of peripheral vascular disease (3.6) and current smoking (2.6). Being married (0.6) and history of migraine (0.4) were significant protective factors. There was no association between a history of hypertension and cerebrovascular disease in this series. PMID- 3268351 TI - The Perth Community Stroke Study: attack rates for stroke and TIA in Western Australia. AB - A community-based register of cases of acute cerebrovascular disease in a representative segment of the city of Perth, Western Australia, has been developed. Stroke attack rates, pathological diagnoses and site of care of the cases, as revealed by the register, are analysed. PMID- 3268352 TI - Paramedian thalamic and midbrain infarction: the 'mesencephalothalamic syndrome'. AB - Paramedian infarction in the region of the thalamus and upper midbrain may produce a wide range of neuro-ophthalmological, behavioural and motor abnormalities. The paramedian arteries arise from the first part of the posterior cerebral artery, also known as the basilar communicating artery. The particular arterial topography and its anatomical variation may result in unusual combinations of clinical signs, and infarction may be bilateral in some cases. Diagnosis is often aided by CT scanning and magnetic resonance imaging. Both atherosclerotic occlusion and embolism are thought to be responsible for these particular syndromes. We describe 3 cases that illustrate some of the various clinical features and underlying anatomical vascular arrangements which may be seen in this condition. Thalamic dementia was present in one case with evidence of bilateral thalamic infarction. A complex ophthalmoplegia and hemiparesis were seen in another case, and the third case had a combination of thalamic dementia and ophthalmoplegia. PMID- 3268354 TI - Lipids in cerebrovascular disease: is there an association? AB - A study of 22 patients with a history or either transient ischaemic attacks or of one or more cerebrovascular accidents failed to show any relationship between circulating lipids and cerebrovascular disease. PMID- 3268353 TI - Spinal arteriovenous malformations: some diagnostic difficulties with illustrative cases. AB - Spinal arteriovenous malformations commonly present with progressive or step-like cord and conus dysfunction. Diagnosis is achieved by demonstrating abnormal vessels on the cord by means of high-quality myelography followed by selective spinal angiography. Diagnostic difficulties arise where screening myelography is equivocal or where angiography is negative in patients with suggestive myelographic findings. Negative investigation may not exclude a spinal arteriovenous malformation in patients with very suggestive clinical presentations. Occasionally reinvestigation after a period of follow-up or surgical exploration, even in the absence of a definite diagnosis, may be indicated. PMID- 3268355 TI - Scalp and intracerebral P300 in surgery for temporal lobe epilepsy. AB - We have studied the scalp and intracerebral recordings of 12 patients with intractable temporal lobe epilepsy. The intracerebral P300 provides useful diagnostic information regarding the epileptogenicity of a temporal lobe. The scalp P300, by nature of its bilateral scalp distribution, is unable to be used diagnostically in assessing candidates for possible anterior temporal lobectomy. PMID- 3268356 TI - [Grinding, that great unknown]. PMID- 3268357 TI - Caries in Israel--present and future. PMID- 3268359 TI - Forecasting of dental manpower in Israel. PMID- 3268358 TI - Two different techniques of forced eruption as an aid in the treatment of severely damaged teeth. PMID- 3268360 TI - [Clear cell odontogenic tumor. Case report]. PMID- 3268361 TI - [Clear cell tumors of the oral cavity. Immunohistochemistry--differential diagnosis]. PMID- 3268362 TI - [Diagnostic problems in nodular fasciitis of the face and neck]. PMID- 3268363 TI - [Multiple occurrence of odontogenic keratocysts. Case report]. PMID- 3268364 TI - [Subtotal nose reconstruction after malignoma removal. Interior mucosal flap and external labio-nasal flap]. PMID- 3268365 TI - [Arterial supply of two fat-pads: Bichat's fat-pad--pararenal adipose capsule]. PMID- 3268366 TI - [Aspects of the in vitro behavior of cells from squamous cell carcinomas of the oral cavity]. PMID- 3268367 TI - [Histological findings in human lyophilized homologous cartilage grafts]. PMID- 3268368 TI - [Intracavity brachytherapy in the sphenoid and jaw bones, the oral cavity and the pharyngeal area. Evaluation of reload technic, radiation planning and results]. PMID- 3268369 TI - [In vitro studies of the effect of laser beams (488nm) on human immunocompetent cells]. PMID- 3268370 TI - [Absorbable osteosynthesis materials for immobilization of mandibular fractures. Animal experimental study]. PMID- 3268371 TI - [Comparative study of 2 preventive filling methods in pedodontics]. PMID- 3268373 TI - [Hemostatic drugs]. PMID- 3268372 TI - [The practice of oral surgery from a periodontal and preprosthetic perspective]. PMID- 3268374 TI - [Hand instruments in oral surgery]. PMID- 3268375 TI - [Exfoliative cytology and biopsy in current dental practice]. PMID- 3268377 TI - [Radiolucent images of the mandibular symphysis]. PMID- 3268376 TI - [Benign proliferations of the oral mucosa]. PMID- 3268378 TI - [Social protection and dental care in Great Britain]. PMID- 3268379 TI - [Implications of restorative dentistry on periodontal health]. PMID- 3268380 TI - [The effect of a Salicylate gel on removable resin denture tolerance. Study of 100 clinical cases]. PMID- 3268381 TI - [Training of "Afghans Doctors" at "Medical Training for Afghans (Peshawar Pakistan)]. PMID- 3268382 TI - [Non-steroidal anti-inflammatories in dentistry. Advantages and prescription risks]. PMID- 3268383 TI - [Management of the suspicion of oral candidiasis]. PMID- 3268384 TI - [Tooth grafts]. PMID- 3268385 TI - [Anatomical imperatives in endosseous implantology]. PMID- 3268386 TI - [The role of the dentist in diagnosis of malignant conditions of the oral cavity]. PMID- 3268387 TI - [Exfoliative cytology and biopsy in current dental practice]. PMID- 3268388 TI - [Frena]. PMID- 3268389 TI - [Apropos of a case of myofacial pain dysfunction syndrome]. PMID- 3268390 TI - [Hygiene in the dental office: the card]. PMID- 3268391 TI - [Health insurance in F.R.G. A structural reform in view]. PMID- 3268392 TI - [Combination of periodontal technics in surgical treatment of apical lesions]. PMID- 3268393 TI - [Social protection and dental care in Italy]. PMID- 3268394 TI - [Spatial visualization of models in complete dentures]. PMID- 3268395 TI - [Spatial visualization of models in complete dentures]. PMID- 3268396 TI - [How to treat vertical dimension insufficiency in the natural dentition]. PMID- 3268397 TI - [Hematemesis in cirrhotic patients: diagnostic-therapeutic progress and new criteria for assessing the surgical risk]. PMID- 3268399 TI - [Pre- and postoperative management in experimental surgery: our experience]. PMID- 3268398 TI - [Early gastric cancer: our experience in the last 10 years]. PMID- 3268400 TI - [Rupture of the ascending aorta during reintervention via a median longitudinal sternotomy]. PMID- 3268401 TI - [Aorto-iliac disease associated with horseshoe kidney: consideration of a successfully-treated case]. PMID- 3268402 TI - Mullerian inhibiting substance production and testicular migration and descent in the pouch young of a marsupial. AB - The ontogeny of Mullerian inhibiting substance (MIS) production by the developing testis of an Australian marsupial, the tammar wallaby (Macropus eugenii), was determined during pouch life using an organ-culture bioassay of mouse fetal urogenital ridge. This information was related to the morphological events during testicular migration and descent. MIS biological activity was found in testes (but not ovaries or liver) of pouch young from 2 to 85 days of age. MIS production had commenced by day 2, which is within a day of the first gross morphological signs of testicular differentiation. Mullerian duct regression occurred between 10 and 30 days, which partly coincided with testicular migration to the inguinal region and enlargement of the gubernacular bulb (15 to 30 days). These observations are consistent with the hypothesis that MIS may be involved in testicular transabdominal migration. The epididymis commenced development and growth only after the testis had descended through the inguinal ring. This provides no support for the suggestion that the epididymis is involved in testicular descent into the scrotum. The basic sequence of events in post testicular sexual differentiation in the wallaby is sufficiently similar to that seen in eutherian mammals to make it an excellent experimental model for future studies of testicular differentiation, migration and descent. PMID- 3268403 TI - Development of functional innervation in the second and third order auditory nuclei of the chick. AB - The neurones that constitute the auditory nuclei of the brainstem in the chick (nuclei magnocellularis, NM, and laminaris, NL) are generated between days 2 and 4 of incubation. These neurones migrate towards the dorsal surface of the brainstem over the next few days and reach their final destination at about day 9 of incubation. We have examined the development of functional connections between the auditory nerve and neurones in NM and between neurones in NM and NL in embryos from stage 34 (day 8 of incubation) using electrophysiological techniques and electron and light microscopy. The earliest extracellular recordings of electrically evoked field and spike potentials were made in NM with stimulation of the ipsilateral auditory nerve and in NL with stimulation of the ipsilateral NM at stage 35 (day 9). No activity could be recorded in NL with stimulation of the auditory nerve at this stage. By stage 37 (day 11), direct stimulation of the contralateral NM evoked responses in NL and by stage 38 (day 12) stimulation of the auditory nerves evoked stable field potentials in NL. These potentials changed polarity as the electrode penetrated NL in a direction that was perpendicular to the laminar arrangement of neurone somas and parallel to the dendritic axes of these neurones. In 18 of 26 analyses of current-source density in NL of 12 preparations between stages 38 and 40 there was a sink of current associated with synaptic activity at levels both above and below the source of current (cell somas) following stimulation of the ipsilateral auditory nerve. In the remaining analyses, and in all 15 analyses from preparations older than stage 40, stimulation of the ipsilateral input evoked only a single sink of current above the level of the cell somas. In all preparations from embryos at stage 38 and older, stimulation of the contralateral auditory nerve was associated with a single sink of current below the level of the cell somas. The axon projections to the ipsilateral NL from neurones in NM were examined using HRP labelling between stages 38 and 40. The presence of terminal fields of single axons in both the dorsal and ventral dendritic regions of the ipsilateral NL at these ages was confirmed. Furthermore, dense vesicles within synaptic terminals in both the dorsal and ventral dendritic fields could be identified in preparations at stage 36 following injection of HRP into NL and stimulation of the ipsilateral NM.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3268404 TI - Early innervation of the metanephric kidney. AB - During kidney differentiation, the nephrogenic mesenchyme converts into renal tubules and the ureter bud branches to form the collecting system. Here we show that in the early undifferentiated kidney rudiment there is a third cell type present. In whole-mount preparations of cultured undifferentiated metanephric kidneys, neurones can be detected by immunohistochemical means with antibodies against the neurofilament triplet, 13AA8, and against neuronal cell surface gangliosides, Q211. Clusters of neuronal cell bodies can be seen in the mesenchyme close to the ureter bud. The terminal endings of neurites are found around the mesenchymal condensates that later become kidney tubules. A similar distribution of neurites can be revealed in tissue sections of kidney grafts growing in the chicken chorioallantoic membranes. In primary cultures of the ureter bud cells, neurones are constantly present. In another report, we have shown that, in experimental conditions, neurones are involved in regulation of kidney morphogenesis. The present results raise the possibility that neurones of the metanephric kidney may have this function in vivo as well. PMID- 3268405 TI - Pioneer neurones use basal lamina as a substratum for outgrowth in the embryonic grasshopper limb. AB - During axonogenesis, contacts made by the growth cone with its substratum are important in guiding the direction of neurone outgrowth. This study examines the contacts made by the growth cones of pioneer neurones in the embryonic grasshopper limb. Individual pioneer neurones at different stages of development were injected with horseradish peroxidase and the contacts made by the filopodia at the tip of their growth cones were examined by electron microscopy. Filopodia made few contacts with mesodermal cells, some contacts with ectodermal cells and very frequent contacts with basal lamina underlying the ectoderm. Components of the basal lamina may therefore play a role in guiding pioneer axon outgrowth. PMID- 3268406 TI - Mesoderm induction in Xenopus laevis: responding cells must be in contact for mesoderm formation but suppression of epidermal differentiation can occur in single cells. AB - When Xenopus embryos are cultured in calcium- and magnesium-free medium (CMFM), the blastomeres lose adhesion but continue dividing to form a loose heap of cells. If divalent cations are restored at the early gastrula stage the cells re adhere and eventually form muscle (a mesodermal cell type) as well as epidermis. If, however, the cells are dispersed during culture in CMFM, muscle does not form following reaggregation although epidermis does. This suggests that culturing blastomeres in a heap allows the transmission of mesoderm-induction signals from cell to cell while dispersion effectively dilutes the signal. In this paper, we have attempted to substitute for cell proximity by culturing dispersed blastomeres in XTC mesoderm-inducing factor (MIF). We find that dispersed cells do not respond to XTC-MIF by forming mesodermal cell types after reaggregation, but the factor does inhibit epidermal differentiation. One interpretation of this observation is that an early stage in mesoderm induction is the suppression of epidermal differentiation and that formation of mesoderm may require contact mediated signals that are produced in response to XTC-MIF. We have gone on to study the suppression of epidermal differentiation in more detail. We find that this is a dose-dependent phenomenon that can occur in single cells in the absence of cell division. Animal pole blastomeres become more difficult to divert from epidermal differentiation at later stages of development and by stage 12 they are 'determined' to this fate. Fibroblast growth factor (FGF) also suppresses epidermal differentiation in isolated animal pole blastomeres and transforming growth factor-beta 1 acts synergistically with FGF in doing so. PMID- 3268407 TI - Implants of quail thymic epithelium generate permanent tolerance in embryonically constructed quail/chick chimeras. AB - In situ implantation of a quail wing bud into a chick embryo at 4 days of incubation (E4) regularly results in the normal development of the implant followed by its acute rejection starting within two weeks post-hatching. If the epithelial thymic rudiments of the quail donor are implanted into the branchial arch area of the chick recipient after partial removal of its own thymic primordia, a chimeric thymus develops in the chick host and this induces tolerance to the quail wing by the chick recipient. The species identity of cells in chimeric thymuses was mapped using Feulgen-Rossenbeck' staining and immunolabelling with monoclonal antibodies directed against quail or chick B-L antigens. Certain lobes contained only chick cells both at the stromal and hemopoietic cell levels. Others had a quail epithelial stroma containing host hemopoietically derived cells. Only chimeras in which at least one third of the thymic lobes were chimeric showed permanent tolerance to the grafted wing. Since the two species exhibit distinct developmental rates, we decided to study the kinetics of thymic involution after birth. Although the changes in thymus weight and histological structure are fundamentally similar in quail and chick, those in the quail start about 7-8 weeks earlier. In the chimeric thymuses, the lobes whose epithelial cells were quail involuted at the rate of control quail showing no influence of the hemopoietic thymic compartment in this process. Tolerance induced by the thymic epithelium during embryogenesis and in early postnatal life was maintained after a profound involution of the quail thymic graft had occurred. PMID- 3268408 TI - Evidence for dedifferentiation and metaplasia in amphibian limb regeneration from inheritance of DNA methylation. AB - Amphibian limb regeneration is a process in which it has been suggested that cells of one differentiated type may dedifferentiate and give rise to cells of another type in the regenerate. We have used two tissue-specific hypomethylations in the newt cardioskeletal myosin heavy chain gene as lineage markers to follow the fate of cells during limb regeneration. Analysis of genomic DNA from different muscle cell populations allowed the assignment of one marker to the muscle (Hypo A) lineage and the other, more tentatively, to the 'connective tissue' (Hypo B) component of muscle. The contribution to regenerated limb cartilage and limb blastemal tissue by cells carrying these markers was estimated by quantitative analysis of Southern blot hybridizations using DNA from regenerate tissues. The results are consistent with a contribution of cells from both muscle and connective tissue lineages to cartilage in regenerated limbs. In addition, removal of the humerus at the time of amputation (eliminating any contribution from pre-existing cartilage), has provided evidence for an increased representation of cells carrying the connective tissue marker in regenerate cartilage but did not affect the representation of cells carrying the muscle cell marker. PMID- 3268409 TI - XY follicle cells in ovaries of XX----XY female mouse chimaeras. AB - Oocytes with adhering follicle cells were sampled from ovaries obtained from 11 GPI-1A----GPI-1B chimaeras, comprising 10 females and 1 hermaphrodite. GPI analysis of individual oocytes revealed a marked bias towards the GPI-1B component in the germ line of this chimaeric combination. GPI-1B XY oocytes were identified in the ovary from the hermaphrodite, the bias towards the GPI-1B germ line perhaps helping to counterbalance the normally severe selection against XY oocytes. GPI analysis of follicle cells revealed a much more balanced contribution of the two components to this ovarian cell type. Importantly, GPI-1A follicle cells were identified in more than half the follicles from an XX----XY female in which the GPI-1A component was XY, supporting an earlier conclusion of Ford et al. (1974) that XY cells can contribute to the follicles of XX----XY female mice. It is suggested that XY cells can be recruited to form follicle cells in XX----XY chimaeras when there is a developmental mismatch between the two components, such that an ovary-determining signal produced by the XX component pre-empts the testis-determining action of the Y. PMID- 3268410 TI - Experimental manipulation of sexual differentiation in wallaby pouch young treated with exogenous steroids. AB - We have investigated the effects of androgen or oestrogen treatment of female or male tammar wallabies from the day of birth, when the gonads are histologically undifferentiated, to day 25 of pouch life, when the gonads and the Wolffian and Mullerian ducts have differentiated and the testes have migrated through the inguinal canal. Female tammars treated with testosterone propionate (24-50 mg kg 1 day-1) orally for 25 days had enlarged Wolffian and Mullerian ducts. Mammary and pouch development, however, was indistinguishable from that of control females. The treatment had no apparent effect on ovarian development, or on ovarian position in the abdomen. The phallus of males and females was similar in size, and neither experimental treatment had a significant effect on its size at day 25. Male tammars treated with oestradiol benzoate (1.2-2.5 mg kg-1 day-1) orally for 25 days had gross hypertrophy of the urogenital sinus. Testicular morphology was abnormal; many of the germ cells appeared necrotic, the seminiferous tubules were of reduced diameter, and there were few Leydig cells and increased amounts of fibrous tissue between the tubules. The cortex of these gonads contained some areas which had an ovarian appearance, lacking tubules and containing numerous germ cells. The Mullerian ducts of control males had regressed, but this was prevented by oestrogen treatment, suggesting an inhibition of either Mullerian Inhibiting Substance (MIS) production or its action. Normal testicular migration was inhibited in treated males; the testes remained high in the abdomen, similar in position to the ovaries of control females, whilst control males all had testes in the inguinal region. The gubernaculum and processus vaginalis of control males extended into the scrotum, but in treated males they terminated outside it. Oestrogen treatment had no effect on the size of the scrotum and did not induce mammary or pouch development. These experiments show that marsupials, like eutherians, have a dual hormonal control of Wolffian and Mullerian development. By contrast, the initial development of the mammary glands, pouch, gubernaculum and scrotum does not appear to be under hormonal control and is therefore likely to be autonomous and dependent on genotype. PMID- 3268411 TI - Retinoic acid proximalizes level-specific properties responsible for intercalary regeneration in axolotl limbs. AB - The objective of this study was to determine whether retinoic acid (RA) coordinately proximalizes positional memory and the cellular recognition system that detects pattern discontinuity in regenerating amphibian limbs. The strategy was to test the capacity of RA-treated blastemas to evoke intercalary regeneration when grafted to an amputation level proximal to their level of origin. Control wrist and ankle, or elbow and knee blastemas treated with the retinoid solvent, dimethylsulphoxide, evoked intercalary regeneration as effectively as untreated blastemas, when grafted to the midstylopodial amputation surface of host limbs. RA-treated wrist and ankle or elbow and knee blastemas were proximalized and formed complete limbs that were at an angle to, or continuous with, the midstylopodium of the host limb. No intercalary regeneration, from either graft or host, was observed in these cases. The results indicate that the cellular mechanism that recognizes disparities between non neighbouring cells and initiates intercalary regeneration is coordinately proximalized with positional memory. Thus the recognition mechanism and positional memory are directly related. Intercalary regeneration and corrective displacement (affinophoresis), both of which restore a pattern of normal cell neighbours by different means in regenerating axolotl limbs, appear to use the same mechanism to recognize pattern discontinuity. PMID- 3268413 TI - Effect of Dycal on dentin permeability. PMID- 3268412 TI - Pulpal response to topical application of citric acid to root dentin. PMID- 3268414 TI - Root form and canal anatomy of mandibular first molars in a southern Chinese population. PMID- 3268416 TI - Effect of concentrated hydrogen peroxide solution on the surface morphology of cut human dentin. PMID- 3268415 TI - Incidence of external root resorption and esthetic results in 58 bleached pulpless teeth. PMID- 3268417 TI - An enzyme histochemical study of the influence of formocresol and calcium hydroxide on the dental pulp. PMID- 3268418 TI - Painful dysesthesia of the inferior alveolar nerve following use of a paraformaldehyde-containing root canal sealer. PMID- 3268419 TI - [Fine-needle biopsy in the early diagnosis of thyroid neoplasms]. AB - Among the patients directed to the Department of Endocrinology of the Institute of Internal Medicine for diagnostic examinations of the thyroid, 726 (647 women and 79 men, of age between 16 and 79 years) were qualified to surgery after scintigraphic detection of cold nodules. From this group, 474 patients had thin needle biopsy specimens taken for cytologic examination. The results of the latter examinations have been compared with those of histologic examination performed on the tissue removed during surgery. The occurrence of a malignant tumor (in 99.1%--thyroid cancer) was found in 108 patients (22.8%) from the group having thin-needle biopsy performed. Comparison of the results of cytologic examination with those of postoperative histologic examination demonstrated low sensitivity of biopsy examination (50.0%), as opposed to high specificity (96.2%) and high accuracy (85, 3%). Analysis of the false-negative results (54/108) revealed that the main causes of errors are difficulties in differentiation of adenoma from follicular carcinoma. Widening of the indications to surgery by a group of patients with adenoma will increase sensitivity to 84.8% and will require including into the operated group of about 50% of patients with scintigraphically diagnosed cold nodules: The introduction of the new term: "urgent strumectomy", has been proposed; also a diagnostic algorithm, useful for early diagnosis of malignant tumors of the thyroid, has been discussed. PMID- 3268420 TI - [Scintigraphically detected "hot" thyroid nodules in the specimens from patients of the Thyroid Disease Clinic in Gda'nsk--clinico- histopathological analysis]. AB - A group of 153 patients with scintigraphically detected autonomic "hot" nodules of the thyroid has been subjected to clinical and histopathological analysis. Substantial part of these patients (30.1%) had hyperthyroidism, partly (in 19.9% of cases) in the form of the thyrocardiac syndrome. A most frequent histopathological lesion found within "hot" nodules was follicular adenoma. The occurrence of malignancy in the form of highly differentiated thyroid carcinoma was observed in 2.6% of cases. The incidence of thyroid carcinoma within "hot" nodules was in our material only two and half times smaller than in a previously analyzed group of patients with "cold" nodules of the thyroid. PMID- 3268421 TI - [Incidence of simple goiter among the population of the Goldap community]. AB - The possibility of the occurrence of goiter endemia++ among the inhabitants of Goldap community in the Suwalki voivodeship has been investigated. The investigations embraced 2488 persons, i.e. 21% of the population of the studied community. The occurrence of goiter was revealed in 38% of the investigated persons, and this observation lead to the conclusion that goiter is endemic among the population of the Goldap community. Such features as high incidence of thyroid enlargement of low degree (OB and I), higher incidence of goiter in women than in men, absence of cases with hypothyroidism, and low incidence of nodular goiter, characterize the observed endemia++ as mild. PMID- 3268423 TI - Histochemical demonstration of a rhodopsin-like substance in the eye of the arrow worm, Spadella schizoptera (Chaetognatha). AB - The presumed photoreceptive region of the arrow-worms of the species Sagitta crassa and Spadella schizoptera consists of perforated lamellae which are unique as the photoreceptive structure. The existence of a visual pigment in this region was demonstrated by a histofluorescent technique using Spadella schizoptera, whose presumed photoreceptive region was much larger than in Sagitta crassa. A specific fluorescence, indicative of the presence of retinal-based proteins, appeared only in the perforated lamellar region. The result suggests that the perforated lamellae contain a rhodopsin-like substance and could be the primary photoreceptive site. PMID- 3268422 TI - [Isotope, biochemical and roentgenological studies in the diagnosis and evaluation of the treatment of osteoporosis of endocrine etiology]. PMID- 3268424 TI - Anticonvulsant effects of avermectin in DBA/2 mice and rat. AB - The anticonvulsant activity of avermectin B (AVM) was studied after systemic administration in DBA/2 mice (seizures induced by sound) and rats (seizures induced by pentylenetetrazol, cephazolin and maximal electroshock test). Protection against sound-induced seizures was given after intraperitoneal administration of AVM (30 and 50 mg/kg). Cephazolin-induced seizures in rats were attenuated by intraperitoneal administration of AVM (10 and 20 mg/kg). AVM increased the antipentylenetetrazol activity of diazepam. No significant protection against the tonic component in the electroshock test was observed. Behavioural effects of AVM included signs of sedation in both mice and rats. In all, these results indicate that, besides its specific anthelmintic effects, AVM possesses anticonvulsant properties, the mechanism(s) of which still remain to be elucidated. PMID- 3268425 TI - Behavioural and ecomorphological responses of the neotropical pacu Piaractus mesopotamicus (Teleostei, Serrasalmidae) to oxygen-deficient waters. AB - The serrasalmid Piaractus mesopotamicus is an obligate gill-breather encountered in the floodplains of the Parana-Paraguay River system, even when the O2 concentrations there are below 0.5 mg 1(-1). Similar conditions occur in fish ponds where this species is cultured. Locomotory activity is affected by both O2 concentration and surface access. Activity increases with hypoxia if fish have surface access, but decreases if surface access is denied by floating macrophytes. Below 0.4 mg 1(-1), larvae as well as larger fish are capable of utilizing the oxygen-rich surface layer of the water for respiration, in order to survive periods of habitat-induced hypoxia. This so-called aquatic surface respiration (ASR) entails an increase in locomotory activity and an ecomorphosis, involving the formation of a dermal extension on the lower jaw in larger fish, that apparently has a hydrodynamic funciton of using the surface layer for gill respiration. Although larvae display ASR, no ecomorphological adaptations were found. When the water is aerated, the extended lip of the larger fish regresses to its original size. Below a macrophyte cover fish are not able to survive O2 depletion. Histological examinations show that the extension is formed by edematous processes in the stratum spongiosum. Ventilation frequency increases with falling O2 and decreases during ASR, thus demonstrating a better O2 supply at the surface layer of the water. PMID- 3268426 TI - Alkaloid venom of European ants in the genus Monomorium. Site of synthesis, identification and quantification. AB - The venom of the European Ant Monomorium is composed of five alkaloids: three 2.5 transdialkylpyrrolidines and two 2.5 transdialkylpyrrolines. The venom is synthesized by a glandular complex composed of a biramous external filamentous gland, and a single internal gland invaginated into the reservoir. External glands and the proximal two-thirds of the internal gland are composed of glandular units, with one glandular cell and one associated duct cell. Glandular cells contain numerous giant mitochondria, a well-developed smooth endoplasmic reticulum and enigmatic rod-shaped structures. The secretory product is electron lucent. The distal third of the internal gland is composed of 38-48 large secretory cells issuing directly into the reservoir. Their secretory product presents the same characteristics as the venom accumulated in the reservoir (opacity, affinity to stains and osmium). PMID- 3268428 TI - Morphometric and stereological analysis of rat testis and epididymis in an early phase of saturnism. AB - Adult male Wistar rats were poisoned by ad libitum ingestion of lead acetate at concentrations of 0.5 g/l and 1.0 g/l in drinking water, for 90 days. Blood lead exhibited a significant increase in both treated groups. A decrease in haematocrit and haemoglobin, together with a rise in glucose levels, confirmed lead intoxication. No signs of lesion were detected upon histological examination of testes, caput and cauda epididymidis. In this early phase of intoxication, no alteration occurred in the seminiferous tubule diameter, in the germinal epithelium height, nor in the rate of spermatogenesis and the production of spermatozoa. The caput epididymidis also showed no structural change. In the cauda epididymidis, however, an increase in ductal diameter, and a decrease in epithelial height, were observed. The concentration of spermatozoa stored in the caudal region of the epididymis exhibited a significant increase in lead-treated animals. The results, which reveal an early involvement of cauda epididymidis in lead intoxication, are discussed in terms of a disturbance in the neuroendocrine mechanism controlling the multiple epididymal functions. PMID- 3268430 TI - Difference in tactile property of palatine mucosa and lingual dorsal mucosa which are opposite planes in the oral cavity. PMID- 3268429 TI - Stressful crowding during pregnancy advances onset of offspring adrenocortical rhythm. AB - Stress by crowding and disturbance during the final third of pregnancy in mice advanced the onset of the diurnal plasma corticosterone rhythm in the male offspring from day 25 to day 18. Treated pups showed this altered development whether fostered to treated or to control dams, but it was not apparent in control pups raised by treated dams. Graded adrenocortical responses to increasingly stressful stimuli were not affected by stress during gestation. PMID- 3268427 TI - Relationships between swimming speed, oxygen consumption, plasma catecholamines and heart performance in rainbow trout (S. gairdneri R.). AB - Rainbow trout swimming at controlled speeds in a tunnel respirometer have been used to measure oxygen consumption and plasma catecholamine levels, and systolic pressure/frequency relationships. Catecholamine (CA) levels evaluated in trout plasma at low swimming speed [0.5 bodylengths/second (bl/s)] were: adrenaline (A) 1.77 +/- 0.22 nM; noradrenaline (NA) 3.94 +/- 0.83 nM; dopamine (DA) 2.40 +/- 0.36 nM. No significant increase was observed during moderate exercise (1.5 bl/s): A 1.60 +/- 0.20 nM; NA 5.76 +/- 1.07 nM; DA 2.31 +/- 0.80 nM, or stronger exercise (2.0 and 2.5 bl/s-1): A 2.10 +/- 0.21 nM; NA 5.90 +/- 0.90 nM; DA 2.21 +/- 0.40 nM. A correlation was found between heart rate at these swimming speeds, and its position on the systolic pressure frequency curve of isolated hearts, which suggests that the heart functions at maximum systolic pressure at low (0.5 bl/s-1) swimming speeds and that this pressure decreases during exercise as cardiac frequency rises. PMID- 3268431 TI - Studies on addition-type silicone impression materials. Part III. Setting and mechanical properties. PMID- 3268432 TI - [Test of GP solvent for mutagenicity]. PMID- 3268433 TI - [Blood reflux into cartridge in dental anesthesia (I)]. PMID- 3268434 TI - [Functional responses of rat submandibular explant under the favorable culture conditions in serum-free media]. PMID- 3268435 TI - [Effects of GaAlAs laser diode in treatment of hypersensitive dentine]. PMID- 3268437 TI - Follow-up study of unilateral nephrectomized patients. Preliminary report: long term effects of unilateral nephrectomy. PMID- 3268436 TI - [A case of foreign body giant cell granuloma]. PMID- 3268438 TI - [Closure of clefts of the hard palate using prostheses anchored with precision attachments]. PMID- 3268439 TI - [The waterworks at Vilmany are 50 years old, water has favourable fluoride effect]. PMID- 3268441 TI - [Clinico-anatomical implications of conduction anesthesia in the maxilla]. PMID- 3268440 TI - [3 years' results of the WHO xylitol caries-preventing program in Hungarian children's homes. VI. Changes in the carbohydrate-protein ratio in dental plaque]. PMID- 3268442 TI - [Oral biological modeling of dental caries in rats. 5. Effect of a desalivation procedure on the progression of dental caries]. PMID- 3268444 TI - [Thermo-analytic study of hard tissues in selenium-consuming experimental animals]. PMID- 3268443 TI - [Conditions of the routine use of chlorhexidine preparations in periodontics and oral surgery]. PMID- 3268445 TI - [Analysis of 3 cases of hypercementosis]. PMID- 3268446 TI - [Clinical and pathological features of mixed odontogenic tumors (ameloblastic fibroma and ameloblastic fibro-odontoma)]. PMID- 3268447 TI - [Transposition of the cuspids]. PMID- 3268448 TI - [Current experience with the use of cryotherapy in dentistry]. PMID- 3268449 TI - [Pathogenesis and treatment of juvenile periodontitis]. PMID- 3268450 TI - [Two-phase surgical correction of micrognathism caused by rheumatoid arthritis]. PMID- 3268452 TI - [Longitudinal study and orthodontic treatment of a pair of twins]. PMID- 3268451 TI - [Possibilities of the use of lasers in oral surgery]. PMID- 3268453 TI - [Simultaneous orthodontic and prosthodontic treatment of adults]. PMID- 3268454 TI - [Correlations of caries susceptibility of the deciduous and permanent dentition]. PMID- 3268455 TI - [Direct measurement of blood flow in the sublingual salivary gland of the rat]. PMID- 3268456 TI - [Surgical correction of middle-face deformities]. PMID- 3268457 TI - [Simultaneous direct flow and 86Rb-based measurements in the determination of sublingual blood flow in rats]. PMID- 3268459 TI - A note on Anopheles dirus Peyton and Harrison, 1979 [An. balabacensis (sensu lato) Baisas, 1936] in India. PMID- 3268458 TI - [Microbiological study of the root canal content in teeth with periapical granuloma]. PMID- 3268461 TI - [The personal computer in the dental office. 1. Hardware and software]. PMID- 3268460 TI - Vertical distribution of Anopheles stephensi larvae in Calcutta. PMID- 3268462 TI - [Germectomy of lower third molars. Indications and contraindications]. PMID- 3268463 TI - [Postoperative pain complications in endodontic treatment]. PMID- 3268464 TI - [SEM morphostructural findings in a case of compound odontoma]. PMID- 3268465 TI - [Marginal gaps in gold partial crowns. In vivo evaluation before and after cementation]. PMID- 3268466 TI - [Gingival epuli. Anatomico-clinical aspects. 1. Histological analysis]. PMID- 3268467 TI - [Alcoholization of the mental nerve. Treatment technic]. PMID- 3268468 TI - [Surgical technic in the anterior sector]. PMID- 3268469 TI - [Autotransplantation of the periosteal free gingival flap]. PMID- 3268470 TI - [Psychology of the aging patient]. PMID- 3268471 TI - [Cash flow and balancing]. PMID- 3268474 TI - [Comparative study of temperature increase from halogen lamps]. PMID- 3268473 TI - [Traction resistance of cemented fabricated prosthesis]. PMID- 3268472 TI - [Conscious sedation in pedodontics. 1]. PMID- 3268475 TI - [Gitter: a new dental implant. Experimental research]. PMID- 3268476 TI - [Gingival epulis. Anatomoclinical aspects. 2. Immunohistochemical study]. PMID- 3268477 TI - Five-year study of two light-cured posterior composite resins. PMID- 3268478 TI - Polishing porcelain veneers: an SEM and specular reflectance analysis. PMID- 3268479 TI - Interface gap at amalgam margins. PMID- 3268480 TI - Characterization of glass ionomer filling materials. PMID- 3268481 TI - Creep and recovery of composites for use in posterior teeth during static and dynamic compression. PMID- 3268482 TI - In vitro color changes of posterior composites. PMID- 3268483 TI - Creep of resin veneer materials. PMID- 3268484 TI - Tensile fatigue of resin cements to etched metal and enamel. PMID- 3268486 TI - Craniofacial trauma. PMID- 3268485 TI - Desquamative gingivitis treated with occlusive steroid therapy: a pilot study. PMID- 3268487 TI - Concepts and classification of craniofacial trauma: biomechanical principles. PMID- 3268489 TI - Bone grafting techniques in craniofacial trauma. PMID- 3268490 TI - The extended access approach for treatment of maxillary fractures. PMID- 3268488 TI - Multidimensional imaging in maxillofacial surgery. PMID- 3268491 TI - Stable internal fixation of midfacial fractures. PMID- 3268492 TI - Management of frontal sinus fractures. PMID- 3268493 TI - Ocular injuries in craniofacial trauma. PMID- 3268494 TI - Orbital fractures. PMID- 3268495 TI - Posttraumatic telecanthus. PMID- 3268496 TI - Simplified treatment of malar complex fractures. PMID- 3268497 TI - Emergency neonatal care. PMID- 3268498 TI - Neurosurgical emergencies. PMID- 3268499 TI - Cold and heat injury. PMID- 3268500 TI - Neonatal shock. PMID- 3268501 TI - Management of neonatal emergencies in the community. PMID- 3268502 TI - Counselling the parents and relations of critically ill neonates. PMID- 3268503 TI - Delivery room care of an asphyxiated newborn infant. PMID- 3268506 TI - Ventilatory therapy. PMID- 3268504 TI - Respiratory distress in the newborn. PMID- 3268505 TI - Apnea in preterms. PMID- 3268507 TI - The bleeding neonate: a diagnostic and therapeutic approach. PMID- 3268508 TI - Exchange transfusion. PMID- 3268509 TI - Neonatal convulsions. PMID- 3268510 TI - Neonatal hypoglycemia: diagnosis and management. PMID- 3268511 TI - Neonatal tetanus--preventive, diagnostic and therapeutic approach. PMID- 3268512 TI - Acute renal failure. PMID- 3268513 TI - Neonatal cardiac emergencies. PMID- 3268514 TI - Hypertensive emergency. PMID- 3268515 TI - Neonatal necrotizing enterocolitis. PMID- 3268516 TI - Intestinal obstruction in the newborn--diagnostic approach and principles of management. PMID- 3268517 TI - Rapidly progressive (crescentric) glomerulonephritis in erythema nodosum leprosum: case report. AB - A middle aged man (48 years) with short duration of illness (7 days) was admitted in the state of acute renal failure with erythema nodosum leprosum. He had repeated episodes of erythema nodosum leprosum in the past. His blood pressure was normal (150/80 mmHg). During his hospital stay he was in the state of progressive anaemia (Hb = 8.8 g/dl to 7.2 g/dl), oliguria (urine out-put = 250 350 ml/day), azotaemia (blood urea = 198 mg/dl to 218 mg/dl) and impaired renal function tests with fatal outcome. Kidneys were smooth, congested and weighing 150 g each with histological features of rapidly progressive (crescentric) glomerulonephritis, a result of immune complex deposition from recurrent erythema nodosum leprosum episodes. PMID- 3268518 TI - [Control of the contacts: its interference on the epidemiological status of Hansen's disease]. AB - The control situation of hanseniasis patients' contacts needs a deeper study which would show the reality in the public health centers and their consequence over the whole country. The increasing of the prevalence rate of the disease added to the bad social-economic conditions of the patients and contacts gave us subsidies to important studies to understand the present epidemiological picture. This research had the purpose of diagnosing the control situation of hanseniasis patients' contacts in a public health center which had, at the moment of this research (1983) 160 hanseniasis patients (incidence of 1.2/1000) and 757 contacts registered in a Subprogram of Hansen's Disease Control. PMID- 3268521 TI - [International agencies and the control of Hansen's disease in Brazil]. AB - Main modes of international participation in hanseniasis control in Brazil, both public and private, are briefly described: public modes are established country to country or through Pan-american Health Organization; the others are essentially identified as "voluntary organizations". A descriptive assessment of this experience in Brazil follows. Considering our vast territory and a huge accumulated social debt, possible cooperative work is explored, adopting clear criteria (establishing priorities, planning and participative management), viewing basic actions as public attribuitions complemented by internacional organisms when necessary. PMID- 3268519 TI - [Human resources in Hansen's disease]. AB - In the control of endemic leprosy in Brazil, a qualitative and quantitative lack of human resources was felt as one of its most serious difficulties. Consequently, a systematical review on the practices of Human Resources on Leprosy was carried out, covering the period between 1940 and 1980. An interesting paradox was then observed: sectorial authorities always recognized that courses and training are an important tool in order to improve the conditions for operating the leprosy control but when they are put in practice, they result transitory and ineffective. The maintenance of this fact, associated to low salaries and inadequate working conditions indicated the necessity of formulating and implanting a policy for the development of Human Resources in leprosy at a nationwide level. The experience consisted of setting up a sheme of encouragement and support to State Health Departments for training at local level; at regional level, extension courses were organized by the Nacional Departament, in Amazonia, Mid-west, South, Northeast and Southeast. The strengthening and/or development of a referral system at state level were reached through the national specialization course of Sanitary Dermatology; international qualifications were obtained, as a complement, by joint action with Pan-American Organization of health. Results, details, characteristics and strategies of this process are presented and discussed by discursive and tabular forms. PMID- 3268520 TI - [New criteria for the characterization of facies leprosa]. AB - Facies leprosa was characterized by a combination of nasal change and resorption of nasal bone, anterior nasal spine, supra-incisive alveolar region and anterior alveolar process of the maxilae, associated with the loss of upper incisors teeth, according to the criteria of radiographic interpretation. PMID- 3268522 TI - [Characterization of the teaching in Hansen's disease in the undergraduate nursing education in the State of Sao Paulo]. AB - The study describes the situation of the hanseniasis teaching in the undergraduated nursing courses. In the analysis based on data taken from five schools of the state of Sao Paulo, Brazil, a heterogeneity of procedures became evident in the disease teaching, related to the schedule used, to the local of practical training activities, as well as to specific subjects on hanseniasis. PMID- 3268523 TI - [Orthodontic caries]. PMID- 3268524 TI - [Systematic transfer of instruments]. PMID- 3268525 TI - [The scanner view of the facial mass. Applications in implantology]. PMID- 3268526 TI - [Skeletal reconstruction using a scanner. Use of the Scanlam cutting system]. PMID- 3268527 TI - [Dentin sensitivity]. PMID- 3268529 TI - [Handling materials]. PMID- 3268528 TI - [Oral operations under general anesthesia]. PMID- 3268530 TI - [Comparative study of 2 nongamma 2 amalgams of similar copper content]. PMID- 3268531 TI - [New techniques of loco-regional anesthesia. What are they worth?]. PMID- 3268532 TI - [Neuro-musculo-articular rehabilitation of the totally edentulous]. PMID- 3268533 TI - [If the year 2000 were a fable]. PMID- 3268534 TI - [Marketing for the dentist: myth or reality?]. PMID- 3268535 TI - [Individual protection of the dentist and his staff]. PMID- 3268536 TI - [The pregnant woman]. PMID- 3268538 TI - [From assistant to collaborator, or memories of an old timer]. PMID- 3268539 TI - [Deciduous teeth: anatomic, histologic and physiologic aspects, therapeutic implications]. PMID- 3268537 TI - [A-Gram, antibiotic for current dental practice. Results of an open study of 74 ambulatory patients]. PMID- 3268540 TI - [Radiographic evaluation of permanent tooth eruption]. PMID- 3268541 TI - [Prevention in pedodontics]. PMID- 3268542 TI - [Pulpotomy in deciduous teeth]. PMID- 3268543 TI - [Injuries to deciduous teeth: clinical approach]. PMID- 3268544 TI - [Replacement of deciduous teeth: on esthetic and functional solution]. PMID- 3268545 TI - Photo-pattern analysis and computation in the evaluation of the cytotoxicity of dental materials in vitro. PMID- 3268546 TI - Quantitative enzyme cytochemistry in the in vitro biocompatibility testing of dental materials. PMID- 3268547 TI - Quantitative enzyme spectroscopy in the assessment of cell damage in vitro. PMID- 3268548 TI - Cytotoxic effects of pH, fluoride and zinc. PMID- 3268549 TI - In vitro studies on the local pharmacodynamics, pharmacology and toxicology of eugenol and zinc oxide-eugenol. PMID- 3268550 TI - Mechanisms and kinetics of metal release from dental alloys. PMID- 3268551 TI - Consideration of dentine permeability in cytotoxicity testing. PMID- 3268552 TI - Antibacterial properties of endodontic materials. PMID- 3268553 TI - The testing of endodontic materials in vitro. PMID- 3268554 TI - International conference: In Vitro Assessment of the Biocompatibility of Dental Materials. 21-22 September 1987. Birmingham University, UK. PMID- 3268555 TI - In vitro assessment of the biocompatibility of dental materials--the millipore filter method. PMID- 3268556 TI - The radiochromium release method for evaluation of cytotoxicity in vitro. PMID- 3268557 TI - The model cavity method incorporating dentine. PMID- 3268558 TI - Methods of assessment in vitro of restorative material cytotoxicity using an intact human dentine diffusion step. PMID- 3268560 TI - Case history. Angle Class II malocclusion. PMID- 3268559 TI - Case history. Angle Class II malocclusion. PMID- 3268561 TI - Pink teeth of the dead: 1. A clinical and histological description. PMID- 3268562 TI - Gender and ethnic differences of the radiographic image of the frontal region. PMID- 3268563 TI - Age determination in a living individual--a case report. PMID- 3268564 TI - The dentist and patient--a legal review. PMID- 3268565 TI - Condylar movement recordings for analyzing TMJ derangements. PMID- 3268566 TI - Doppler auscultation: an aid in temporomandibular joint diagnosis. PMID- 3268567 TI - Tenderness and acupuncture points in the masseter muscle: a correlation study. PMID- 3268568 TI - Comparison of internal derangements with condyle-fossa relationships, horizontal and vertical overlap, and Angle Class. PMID- 3268570 TI - Internal derangements: a comment on the need for diagnostic homogeneity. PMID- 3268569 TI - Possibilities and limits in identifying the TMJ articular meniscus with the CT Scanner: a comparative anatomoradiological study. PMID- 3268571 TI - Muscle physiology relevant in craniomandibular disorders. PMID- 3268572 TI - [Duplication in radiology]. PMID- 3268573 TI - [Dental health education program for 5th year students]. PMID- 3268574 TI - [The occlusal plane in complete dentures]. PMID- 3268575 TI - [Osseointegrated implants: clinical results of a Louvain study]. PMID- 3268576 TI - [Computerization: factors in choice]. PMID- 3268577 TI - Women in dentistry. PMID- 3268579 TI - [Hypnodontics]. PMID- 3268578 TI - [The in vitro effect of different fluoride preparations on Dicor porcelain]. PMID- 3268580 TI - AIDS risk from needle sticks said to be low. PMID- 3268581 TI - Saliva substance may inhibit deadly AIDS virus infectivity. PMID- 3268582 TI - [Relative abrasion of dentifrices--a dentifrice for each]. PMID- 3268583 TI - Class II, division II treatment utilizing the ten-two directional force system: a case report. PMID- 3268584 TI - Class II, division I, bimaxillary protrusion: a case report. PMID- 3268586 TI - Facial esthetics and the Tweed technique. PMID- 3268585 TI - Anchorage loss: a comparative analysis. PMID- 3268587 TI - Practice disposition at retirement. PMID- 3268588 TI - A look at soft tissue modifications. PMID- 3268589 TI - Class II, non-extraction treatment: a case report. PMID- 3268590 TI - Marking mosquito larvae for mark-release-recapture studies on adults. PMID- 3268591 TI - Day-time resting hubitats of culicine mosquitoes and their preponderance in Bastar district, Madhya Pradesh, India. PMID- 3268592 TI - Prevalence of winter forms of Anopheles annularis V. d. Wulp (Diptera:Culicidae) in Keonjhar district of Orissa. PMID- 3268593 TI - Clinical evaluation of purified chick embryo cell antirabies vaccine for post exposure treatment. PMID- 3268594 TI - An epidemiological study of measles epidemic in district Bhilwara, Rajasthan. PMID- 3268595 TI - Prevalence of intestinal parasites in a rural area of Rajasthan. PMID- 3268596 TI - Sero-epidemiological survey of measles in a tribal district of Himachal Pradesh. PMID- 3268597 TI - Immunodiagnosis of Kala-azar by ELISA using intact promastigote. PMID- 3268599 TI - Serologic evidence of yersiniosis in Ranchi. PMID- 3268598 TI - Immune profile of children with lower respiratory tract infection in relation to nutritional status. PMID- 3268600 TI - Validity of indirect haemagglutination test in diagnosis of malaria. PMID- 3268601 TI - Comparative evaluation of latex agglutination (LAT) and coagglutination (COAG) tests for rapid diagnosis of typhoid fever. PMID- 3268602 TI - Comparisons of sleep-wake habits of morning and evening types in Japanese worker sample. PMID- 3268603 TI - Decrease of households in a rural community of Japan in relation to demographic and occupational change. PMID- 3268604 TI - Cardiovascular effect of simultaneous static contractions of the digit flexors and the quadriceps. PMID- 3268606 TI - Proceedings of the twenty-second annual conference of the Human Ergology Society. Yokohama, June 17-19, 1987. Abstracts. PMID- 3268605 TI - Orthostatic tilt responses of young men and women in relation to physical characteristics. PMID- 3268607 TI - Body constitution and muscle strength of becak drivers in Bandung City, Indonesia. PMID- 3268608 TI - Epididymal white adipose tissue after cold stress in rats. I. Nonmitochondrial changes. AB - Epididymal adipose tissue in the rat is generally considered to be "pure" white adipose tissue (WAT) with a characteristic structure and function. Previous studies in cats have, however, indicated that adipose tissue with the morphological appearance of WAT could be converted into a tissue with the morphological appearance of brown adipose tissue (BAT) by intermittent cold stress. The present electron microscopic and morphometric study describes the effect of intermittent cold stress on the epididymal WAT of young rats. The tissue volume decreased markedly as did the lipid content. The mitochondrial volume increased dramatically. The extracellular matrix was vastly reduced as was the thickness of the plasma membrane, and the number of gap junctions between adipocytes increased markedly. Indications of neoinnervation and neovascularization were observed. A great abundance of preadipocytes indicated proliferative activity of the endothelium. The low amount of lipid droplets and a relative abundance of smooth and rough endoplasmic reticulum. Golgi apparatus, and lysosomes in the epididymal WAT of cold-stressed rats gave the cells the morphological appearance of young adipocytes or preadipocytes whereas the hypertrophic and hyperplastic mitochondria, the relative paucity of ribosomes on lipid droplet membranes, and the increased innervation and vascularization gave the cells the morphological characteristics of brown adipose tissue. PMID- 3268609 TI - An ultrastructural study of the effects of gossypol on the endometrium of the female rat. AB - Abnormal desmosomes were found in the endometrial epithelial cells of rats treated orally with gossypol acetic acid at a dose of 60 mg/kg/day for 30 days. Desmosomes in the endometrium of rats treated at 40 mg/kg/day were similar to those of controls. Abnormalities included an increase in desmosome number with prominent filamentous interconnections, asymmetry, disorganization of tonofilaments, missing tonofilaments, missing desmosomal plaques that did not appear to line up with those of the adjacent cell. It is thought that the antifertility actions of gossypol may be due to a disturbance of desmosome formation. This would cause a disruption of endometrial cell adhesion as well as an alteration in the microenvironment within cytoplasmic domains. These changes could lead to an endometrial environment unfavorable to fetal development. PMID- 3268610 TI - The ciliary necklace--a transmission electron microscopic study using tannic acid containing fixation. AB - Human respiratory cilia, including those in seven cases of immotile cilia syndrome, were examined by transmission electron microscopy after tannic acid containing fixation. This fixation method is useful for ultrastructural observation of unit membranes and of the dynein arms and protofilaments of cilia. In addition, intramembrane particles and electron-dense strands were also demonstrated in the neck of the cilia. These structures may correspond to the ciliary necklace, which has been demonstrated by the freeze-etch technique. In high-magnification electron micrographs, the intramembrane particles were 10 nm in diameter and the necklace spacing was about 30 nm in human respiratory cilia. Prior to this study, no reports on ultrastructural abnormalities of the ciliary necklace in humans had appeared, probably because of technical problems with tissue preparation. Therefore tannic acid-containing fixation appears to be useful for ultrastructural observation of the ciliary necklace. PMID- 3268611 TI - Effects of pressure on vesicle size, density, and distribution in the canine carotid arterial endothelium. AB - The purpose of the present experiment was to study the effects of internal hydrostatic pressure on vesicle size, density, and distribution in the canine carotid arterial endothelium by transmission electron microscopy. The pressures applied in this study were 0 (control), 40, 60, 80, 100, and 150 mm Hg. The results of transmission electron microscopy and computer analysis on the plasmalemmal vesicles of aortic endothelium showed that luminal, abluminal, and junctional vesicles all increased their diameter as the pressure was raised from 0 mm Hg, reaching a maximum at 80 mm Hg, and then decreased in size with further increases in pressure to 150 mm Hg. There was a significant difference in diameter among vesicles in different regions of the endothelium, with the diameter of luminal vesicles larger than those of abluminal and junctional vesicles. The densities of vesicles showed very little change from 0 to 80 mm Hg; but they increased markedly as the pressure was further raised from 80 to 150 mm Hg. These results indicate that pressure is an important mechanical factor governing the size and density of plasmalemmal vesicles in aortic endothelium. PMID- 3268613 TI - Eosinophilic granuloma of bone: a case report. PMID- 3268612 TI - Relationships between diet and decay levels in pre-school children. PMID- 3268614 TI - An update on antibiotic prophylaxis in infective endocarditis. PMID- 3268616 TI - The oral and dental manifestations of bulimia nervosa compared with those of anorexia nervosa. PMID- 3268615 TI - Changes in patterns of dental treatment provided for children in Ireland between 1963 and 1983. PMID- 3268617 TI - Tubular occlusion--treatment of hypersensitive dentin. PMID- 3268618 TI - Geriatric dentistry in the undergraduate curriculum. PMID- 3268619 TI - Direct reimbursement: an economic analysis. PMID- 3268620 TI - Management of primary molar ankylosis: report of a case. PMID- 3268621 TI - A clinico-pathologic presentation. PMID- 3268623 TI - Orthodontic techniques useful in general practice. PMID- 3268622 TI - Use of pit and fissure sealants among Massachusetts dentists. PMID- 3268624 TI - Behavior management in pediatric dentistry. PMID- 3268625 TI - Flow of various brands of Gutta-percha cones under in vitro thermomechanical compaction. PMID- 3268626 TI - Alteration of the manipulative properties of plain gut suture material by hydration. PMID- 3268627 TI - Effects of calcium hydroxide and sodium hypochlorite on the dissolution of necrotic porcine muscle tissue. PMID- 3268628 TI - Apical extrusion of thermoplasticized Gutta-percha used as a root canal filling. PMID- 3268629 TI - Mechanical properties of endodontic broaches and effects of bead sterilization. PMID- 3268630 TI - A comparison of endodontic file quality and file dimensions. PMID- 3268632 TI - Periapical actinomycosis involving Actinomyces israelii. PMID- 3268631 TI - Endodontic therapy of an unusual maxillary second molar. PMID- 3268633 TI - Custom acrylic retainer for endodontic isolation. PMID- 3268634 TI - Root formation in molar teeth of the CD-1 mouse. PMID- 3268635 TI - Ultrasonic endodontic sealer placement. PMID- 3268636 TI - Antimicrobial and toxic effect in vitro of a bisdequalinium acetate solution for endodontic use. PMID- 3268637 TI - Influence of a barrier technique on electric pulp testing. PMID- 3268639 TI - ADA Washington Memorandum: AIDS and infection control. PMID- 3268638 TI - Maxillary second molar with three buccal roots. PMID- 3268640 TI - Periodontal disease and AIDS. PMID- 3268641 TI - Central nervous system disease: a dental diagnosis? PMID- 3268642 TI - Peer review. PMID- 3268643 TI - An assessment of two dental health education programmes for school children in the Lothian region of Scotland. PMID- 3268644 TI - The use of overdentures in patients with dentinogenesis imperfecta. PMID- 3268645 TI - A neonatal tooth in a cleft palate baby: a complicating feature in neonatal orthopaedics--a case report. PMID- 3268646 TI - Early diagnosis of localized juvenile periodontitis--a case report. PMID- 3268647 TI - Eosinophilic granuloma affecting the palatal gingiva--a case report. PMID- 3268648 TI - Cerebral gigantism (Sotos syndrome)--two case reports. PMID- 3268649 TI - The effect of balanced and unbalanced extraction of primary molars on the relationship of incisor centre lines--a pilot study. PMID- 3268650 TI - Consultants' advice and professional responsibility: an ethical analysis. PMID- 3268651 TI - Stress: its relationship to legal vulnerability and its management. PMID- 3268653 TI - Teaching health law in schools of dental medicine. American Society of Law and Medicine. PMID- 3268652 TI - Legal implications of infectious disease in the dental office. PMID- 3268654 TI - Subacute bacterial endocarditis: current perspectives. Interview by George M. Rakes, Mark J. Panneton, Curtis G. Kuster, and Wayne A. Labart. PMID- 3268655 TI - Narcotic sedation: an evaluation of cardiopulmonary parameters and behavior modification in pediatric dental patients. PMID- 3268656 TI - Effect of anti-neoplastic therapy on dental maturity and tooth development. PMID- 3268657 TI - A correlation study of sweet preference and caries severity. PMID- 3268658 TI - Viscosity changes of APF gels under shearing effects. PMID- 3268659 TI - Preventive and interceptive orthodontics in the mixed dentition with the myofunctional eruption guidance appliance: correction of overbite and overjet. PMID- 3268660 TI - [Reciprocal exchange between pulpal and periodontal pathologies]. PMID- 3268661 TI - [Inflammation pathways from the pulp to the periodontium]. PMID- 3268662 TI - [Histological aspects of pulpal lesions of periodontal origin]. PMID- 3268663 TI - [Differential diagnosis of endo-periodontal lesions]. PMID- 3268664 TI - [Operative chronology in treatment of endo-periodontal lesions of inflammatory origin]. PMID- 3268665 TI - [Surgical approach to endo-periodontal lesions]. PMID- 3268666 TI - [Dentin hypersensitivity]. PMID- 3268667 TI - [Periodontal and endodontic implications of dental trauma]. PMID- 3268668 TI - [Dental root resorption]. PMID- 3268669 TI - Biological and genetical aspects of early onset periodontitis. PMID- 3268670 TI - [Electromyographic study of mastication in bruxers]. PMID- 3268671 TI - [Recovering of periodontal recessions with gingival grafts. (2). With demineralization of the root surface with citric acid]. PMID- 3268672 TI - [Action of fibronectin on the clinical attachment level one year after periodontal surgery in man]. PMID- 3268673 TI - [The role of microscopic examination of bacterial plaque in periodontics]. PMID- 3268674 TI - [The double flap: a useful surgical technic]. PMID- 3268675 TI - [Functional disorders of the masticatory apparatus]. PMID- 3268676 TI - The mandibular staple bone plate: a review of 20 years. PMID- 3268678 TI - The new lottery--malpractice litigation. An analysis. PMID- 3268677 TI - Some effects of drug usage on prosthodontic treatment for the elderly. PMID- 3268679 TI - Levels of computer usage in the dental office. PMID- 3268680 TI - The bad news bugs in the microbial zoo. PMID- 3268681 TI - Maintenance of dental implants. PMID- 3268682 TI - The use of the semi-lunar flap to cover gingival recession. PMID- 3268683 TI - Reconstruction for vertical bone defects by beta-tricalcium phosphate application. A three-year period observation. PMID- 3268684 TI - Multicrystalline aluminum oxide tooth implants in rhesus monkeys. PMID- 3268685 TI - Biological engineering and implantology. PMID- 3268686 TI - Prevention of alveolar bone loss postextraction with HTR polymer grafting material. PMID- 3268688 TI - The elevation of dental implantology to the height of incompetence. PMID- 3268687 TI - Versatility of the subperiosteal implant utilizing CAD-CAM multiplanar diagnostic imaging. PMID- 3268689 TI - Stress transfer at the implant interface. PMID- 3268690 TI - Implant surface characteristics and tissue interaction. PMID- 3268691 TI - Connective tissue-dental implant interface. PMID- 3268692 TI - The epithelium dental implant interface. PMID- 3268693 TI - A report from the East. PMID- 3268694 TI - The importance of design and analysis in clinical trials. PMID- 3268695 TI - Bioactive surface coatings: cause for encouragement and caution. PMID- 3268696 TI - An instructional module concerning oral implantology: 1. Preliminary design and field testing. PMID- 3268697 TI - Eight year analysis of alumina dental root implants in human subjects. PMID- 3268698 TI - [The flow of a new diagnostic laboratory information system]. PMID- 3268700 TI - [An overview on the medical databases of the future]. PMID- 3268699 TI - [A far-reaching clinical laboratory information system--the present status and future]. PMID- 3268701 TI - [Expectations of the clinical laboratory information system]. PMID- 3268702 TI - [An ideal form of the clinical laboratory information system]. PMID- 3268703 TI - [Sequential display of the patterns showing the results of clinical tests]. PMID- 3268704 TI - [A display of deviations in test data]. PMID- 3268705 TI - [A system for physiopathologic study of the results of blood gas analysis using a vector display]. PMID- 3268706 TI - [A unified management system for clinical laboratory information]. PMID- 3268707 TI - [Re-evaluation of normal values using databases]. PMID- 3268708 TI - [A laboratory information management system using memory cards]. PMID- 3268709 TI - [Surgical anatomy of the rectal and anal blood vessels]. PMID- 3268710 TI - [The surgical anatomy of the rectal and anal blood vessels]. AB - The authors examined 40 rectum specimens by angiography, preparation and staining methods to show the exact arterial vessel supply of the rectum and tried to find out whether a reason could be found for the relatively high rate of suture leaks after low resection of the rectum or not. The insertion of the levator muscle is a sort of vessel divide: caudal to the levator muscle the inferior rectal artery is the main supplying vessel, cranially the superior rectal artery. Here a vessel deficient-area always remains in the dorso-caudal sector of the rectal ampulla which cannot be compensated by another rectum-supplying vessel. The middle rectal artery supplies the rectum accessorily. The results are able to explain why the suture leaks are constantly observed in the dorso-caudal ampulla after profound anterior resection of the rectum. Furthermore the results account for the good healing tendency of coloanal anastomoses: the inferior rectal artery amply supplies the anal canal; there is not the same vessel-deficient area as found cranial to the levator muscle. PMID- 3268711 TI - [The incomplete esophagoplasty]. AB - When esophageal reconstruction has to be repeated the most usual reason is the inadequate length of the transplant. This is mainly due to unfavorable vascular architecture, necrosis of the proximal end, and tactical or technical errors in selection and placement of the transplant and the evaluation of vascular supply and length. Mobilization of the transplant is a relatively low-risk method used in esophageal reconstruction. In some cases remobilization can be combined with transfer of the transplant from the subcutaneous channel to the retrosternal space. The indications for repeat esophageal reconstruction with new transplant material are necrosis or malignant degeneration of the transplant and failure of attempts to reuse the initial transplant. PMID- 3268712 TI - [Does measuring axillo-rectal temperature difference help in the diagnosis of acute appendicitis?]. AB - The value of the axillorectal temperature difference in the diagnosis of acute appendicitis was estimated with the aid of statistical methods. The axillorectal temperature difference turned out to be of very low discriminant ability between acute appendicitis and non-acute conditions. PMID- 3268713 TI - [When are current methods of chemotherapy of gastrointestinal tumors of reliable value?]. PMID- 3268714 TI - Genetics in the medical laboratory. PMID- 3268715 TI - Effect of beta-propiolactone on some routine haematological tests. PMID- 3268716 TI - Brucella antibodies in Sudanese blood donors. PMID- 3268717 TI - A review of clinical cytogenetic services in Great Britain. PMID- 3268718 TI - Relationship between sperm concentration and the rate of fertilization in vitro of golden hamster eggs. PMID- 3268719 TI - Plasma membrane changes during epididymal transit in the guinea pig spermatozoa. PMID- 3268720 TI - [Antimicrobial activity of mycotoxins]. PMID- 3268721 TI - [The growth of petroleum-oxidizing microorganisms of the genus Mycobacterium on multicomponent substrates]. PMID- 3268722 TI - [The phytopathogenic properties of bacteria isolated from urologic patients]. PMID- 3268723 TI - [Extracellular sorbitol dehydrogenase activity of fungal species in the genus Fusarium Lk.: Fr]. PMID- 3268724 TI - [Effect of physical and chemical factors on the iridovirus of the mosquito Aedes cantans]. PMID- 3268725 TI - [The antimicrobial substances of salvin and the properties of its main active component]. PMID- 3268726 TI - [The antimicrobial activity of nitrogen-containing terpene derivatives]. PMID- 3268727 TI - [Restriction analysis of plasmid pSG1912]. PMID- 3268728 TI - [Micromycetes developing on sausage products during storage]. PMID- 3268729 TI - [Infrared spectra of the fractions and antimicrobial substances of the preparation salvin]. PMID- 3268730 TI - [A method for determining the antimicrobial activity of a 1% arenarin eye ointment]. PMID- 3268731 TI - [Value of electroencephalographic studies for the evaluation of the neurotoxic effect of metallic mercury]. AB - The results of 373 EEG investigations were analysed. They were obtained in a period of 4 years in 222 workers with occupational exposure to metallic mercury in the synthesis of acetaldehyde and salt electrolysis. Abnormal or borderline abnormal results were found in 13% of them. Results were compared in groups differing in age, duration of occupation, working post and Hg excretion with urine. Significantly greater frequency of increased Hg absorption was found in the group with abnormal records. The authors stressed the following morphological features of EEG in those exposed to Hg: tendency for seizure activity, loss of ability of following of rhythmic flashes, unchanged frequency of background activity despite increasing degree of other abnormalities, absence of low-voltage tracings, persistence of abnormalities in the records after loss of contact with mercury. PMID- 3268732 TI - [Visual evoked potentials and the time of motor reaction to visual stimuli in chronic metallic mercury poisoning]. AB - In a group of 10 patients with diagnosed occupational chronic poisoning with metallic mercury a correlation was sought between the parameters of the visual evoked potentials and the results of the psychological test evaluating the rapidity of motor response to the visual stimuli. The analysis suggest a cerebral dysfunction of the visual neurons and reduced rate of visual information transformation to the motor effector at the level of the cortical association centre. PMID- 3268733 TI - [Electroencephalographic changes in reversible ischemic cerebral infarction]. AB - In 246 patients with reversible ischaemic neurological deficit eeg investigations were carried out. The eeg curves were compared with the clinical symptoms, with reference to the region of vascularisation, intensity of neurological signs, and time of regression of the clinical symptoms. The obtained results demonstrated, that in 246 EEG records made during acute phase of the disease 110 were normal, and from 136 abnormal records the majority (85 curves) showed only small changes. We have noticed that eeg records with no or small changes we met in patients whose clinical symptoms disappeared during 10 days from the beginning of the disease, where with the neurological syndrome lasting for a longer period, the number of the records with more severe changes was considerably larger. In our opinion, an eeg record showing no, or slight degree of pathology may suggest a reversible character of the ischaemic stroke. PMID- 3268734 TI - [Postmortem study of the cerebral vascular system by the method of vascular casts in patients with ischemic cerebral infarction]. AB - The method of vascular casts was used for investigation of the cerebral vessels in subjects with atherosclerosis. The studied material comprised 35 brains taken from patients aged 70-85 years who died after strokes and 5 brains of patients aged 21-30 years who died after traffic accidents as a control group. It was found that small vessels in the atherosclerotic brains were tortuous and had numerous narrowings, they appeared elongated, and their course differed from that in young subjects. The casting method provided oval-shaped impressions of endothelial cell nuclei which could not have been visualized so clearly with the previously used histological methods. PMID- 3268735 TI - [Oculomotor nerve paralysis in intracranial aneurysm]. AB - The authors analysed the data in 257 cases treated surgically for intracranial aneurysms. In 8 of these cases evidence of damage to the oculomotor nerve was found, as a result of aneurysms of the posterior communicating artery or the internal carotid near the site where the posterior communicating artery branches off. Six patients had oculomotor nerve paralysis and two had only partial involvement of the nerve. In 4 cases the aneurysm was not ruptured but manifested itself as headache followed by oculomotor damage. The authors stress the necessity of carrying out arteriography in each not clear case of oculomotor damage. PMID- 3268736 TI - [Neurosurgical treatment of developmental defects of the nervous system (ddns) in infants]. AB - In a survey of 151 children treated surgically in the earliest period of life the author discusses the complex pathomechanism of damage to the nervous tissues in various age groups indicating important elements in the surgical management which may prevent secondary changes impairing human development in further life periods. In the follow-up 89.4% of children the previously inhibited development was resumed, at the level determined by the preserved nervous structure. PMID- 3268737 TI - [Effect of dehydrobenzperidol (DHB) on cortical and thalamic somatosensory evoked potentials in patients with muscle dystonia]. AB - Investigations of somatosensory evoked potentials in patients with muscular dystonia meet with difficulties due to abnormal muscle tone and dyskinesia producing myogenic artifacts deforming potentials recorded after their evoking. For obtaining better conditions for recording of somatosensory evoked potentials single dose of DHB was used. Somatosensory evoked potentials were recorded before and after operations and during stereotactic thalamotomy of the complex of the VL nucleus in the thalamus. The authors report the results of investigations in the above mentioned three periods of treatment in hospital. The results suggest the hypothesis that DHB affects the cerebellofugal transmission organizing the proper muscle tone. PMID- 3268738 TI - [Brain abscesses of unknown etiology]. AB - On the basis of literature data and own material of 18 cases of cerebral abscesses of unknown origin the authors discuss their incidence, most frequent locations, diagnostic difficulties and results of surgical treatment in relation to remaining groups of cerebral abscesses of known aetiology. PMID- 3268739 TI - [Possibility of using neuropsychological diagnosis in present-day medicine]. PMID- 3268741 TI - Subject: Class 2 resin, update. PMID- 3268740 TI - [Coexistence of several arteriovenous fistulas in the pia mater. Case report]. AB - A patient is reported with a history of subarachnoid haemorrhage and coexistent intracerebral and subdural haematomas. The source of haemorrhage were two pial arteriovenous fistulae supplied by the frontopolar artery. They coexisted with a meningeal arteriovenous fistula supplied by the anterior meningeal branch of the ophthalmic artery. PMID- 3268743 TI - The earlier the colonization by mutans streptococci, the higher the caries prevalence at 4 years of age. PMID- 3268742 TI - Associations between microbial species in subgingival plaque samples. PMID- 3268744 TI - Phospholipase A2: a possible virulence factor of Capnocytophaga ochracea. PMID- 3268745 TI - Fatty acids and sugars in lipoplysaccharides from Bacteroides intermedius. Bacteroides gingivalis and Bacteroides loescheii. PMID- 3268746 TI - Enumeration of cultivable black-pigmented Bacteroides species in human subgingival dental plaque and fecal samples. PMID- 3268747 TI - Activity of metronidazole and its hydroxy metabolite against clinical isolates of Actinobacillus actinomycetemcomitans. PMID- 3268748 TI - In vitro susceptibility of Candida species to lysozyme. PMID- 3268749 TI - Differentiation between Bacteroides gingivalis, Bacteroides endodontalis and Bacteroides asaccharolyticus by means of HPLC analysis of non-derivatized free metabolic acids. PMID- 3268750 TI - Predominant cultivable microflora of plaque on removable dentures in patients with denture-induced stomatitis. PMID- 3268751 TI - Yeasts, enteric rods and pseudomonads in the subgingival flora of severe adult periodontitis. PMID- 3268752 TI - Cell surface mutants of Streptococcus sanguis with altered adherence properties. PMID- 3268753 TI - Importance of infection level of mutans streptococci for recolonization of teeth after chlorhexidine treatment. PMID- 3268754 TI - Isolation and characterization of plasmid DNA from Bacteroides strains isolated from the human oral cavity. PMID- 3268755 TI - The occurrence of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, Bacteroides intermedius and spirochaetes in the subgingival microflora of adolescents and their relationship with the amount of supragingival plaque and gingivitis. PMID- 3268756 TI - Intra-oral distribution of black-pigmented Bacteroides species in periodontitis patients. PMID- 3268757 TI - Achromopeptidase for rapid lysis of oral anaerobic gram-positive rods. PMID- 3268758 TI - Penicillin-induced lysis in fluoride-resistant mutants of Streptococcus mutans. PMID- 3268759 TI - Acute phase proteins in patients with chronic periapical granuloma before and after surgical treatment. PMID- 3268760 TI - [International conference "Feral rabies: results and prospects of oral vaccination in Europe". (Sirmione and Trento, 19-21 October 1987). Proceedings]. PMID- 3268761 TI - Rabies in Ireland: a precarious freedom. AB - The prolonged freedom from rabies enjoyed by Ireland is based on both its island location and the rigid enforcement of national legislation. The yachting tourist and the increased level of shipping activity in ports and harbours are a major threat of disease introduction. Mass media publicity and public awareness are the main safeguards necessary to protect the freedom of our island. PMID- 3268762 TI - Animal rabies in Poland: epidemiological situation and methods of control. AB - The epidemiological situation and methods of control of animal rabies in Poland are presented. Registered data on rabies cases for the period from 1948 up to 1986 are discussed. Two species of animals, namely dogs and foxes, have played the major role in the epidemics of rabies. The undertaken measures have proved satisfactory to control rabies due to dogs as a vector but were found inadequate to control wild-life rabies. Since 1967 the fox has been the main vector of the epizootics of rabies. PMID- 3268763 TI - [Rabies in Hungary]. AB - The rabies in Hungary between 1954 and 1967 was sporadic, and only later it became an epidemic disease (800-1,300 cases per year). More than 90% of the cases was diagnosed in foxes. Rabies occurs at different frequencies all over the country. Defense has been based on annual vaccination of dogs against rabies and on decrease of the fox populations with hunting, poisoning and gasification of burrows. Nowadays we have considered to initiate oral vaccination of foxes and at the same time to avoid poisoning because of its environmental effects, and gasification because of its low effectiveness. PMID- 3268764 TI - Present status of bat-rabies in Europe. AB - Since 1985 there has been an increase of bat rabies in Europe, especially in Denmark, the Federal Republic of Germany and the Netherlands. The present knowledge on the epidemiology, diagnosis and prophylaxis of the disease is summarized. PMID- 3268765 TI - The rabies situation in The Netherlands. AB - From time to time the Netherlands are confronted with sylvatic rabies. The last time was in December 1986. The distribution of sylvatic rabies is restricted to certain areas: mainly the northeast and the south. Rabies is considered not to be endemic in the Netherlands. Oral vaccination is at the moment not under discussion. Since August 1986 examination on bat rabies has started. In 1987 81 out of 1150 bats were found to be positive. The epidemiology of this type of rabies is still unclear. PMID- 3268766 TI - [Health ethology of the fox and antirabies vaccine in the Italian experience]. AB - In order to contribute to the planning of antirabies oral vaccination of foxes a series of ethological and ecological investigations have been carried out. The results obtained are briefly summarized and discussed together with experimental data on antirabies immunization of dogs and foxes with different vaccines. PMID- 3268767 TI - [Experience with antirabies vaccination of foxes using the oral route coordinated among several European countries and perspectives on the use of recombinant vaccinia-rabies virus]. AB - Campaigns of fox vaccination against rabies were carried out in Belgium, grand duchy of Luxembourg and France in September 1986, June and September 1987. The SAD B19 attenuated strain of rabies virus, contained in baits (Tubingen baits) was used as vaccine. Baits were distributed at a range density of 11 to 15 baits per km2. First results are very encouraging. A recombinant vaccinia virus harbouring the rabies virus glycoprotein gene has been developed. This recombinant virus can be given to the fox by the oral route and protects it against rabies virus challenge; it is also innocuous for the fox and other non target European species. A first trial of fox vaccination against rabies using this recombinant vaccinia-rabies virus has been carried out in Belgium, on a military domain, in October 1987. PMID- 3268768 TI - [The Italian experience in the control of rabies. I. Procedural methods]. AB - Oral vaccination of foxes associated with their control has been shown to be a rapid and safe method to extinguish enzootic foci of sylvatic rabies and to prevent the entry and spreading of this zoonosis in free zones of Italy. Domestic animals vaccination with live modified vaccines in zones with sylvatic rabies has proved to be highly effective in limiting the cases, recorded only in non vaccinated animals. PMID- 3268769 TI - [The Italian experience in the control of rabies. II. Laboratory research]. AB - Diagnoses of rabies have been performed at the Zooprophylactic Institutes of Brescia and Padua since 1977, 5,765 foxes have been examined and 1,805 (31.30%) resulted positive. The same Institutes have performed also the laboratory tests in order to control the presence of Tetracycline, the serum conversion and the presence of wild or attenuated viruses in the nervous tissue of foxes and other wild animals in occasion of the oral vaccination campaigns of foxes. PMID- 3268770 TI - [Oral vaccination in the control of feral rabies]. AB - The authors briefly report the results of laboratory and epidemiological investigations on living modified and inactivated antirabies vaccines, started in 1975 and carried out in collaboration with public health authorities and scientific institutions. The antirabies oral vaccination of foxes, using a live and modified vaccine (SADB19 Tub.) began in Brescia province (Val Camonica) in 1984 and was extended in 1985 to Bolzano and Trento provinces. Since July 1986 no more cases of rabies have been observed in Italy. The problems related to the distribution in the territory of live and modified antirabies vaccines, the immunological value of inactivated vaccines, the connections between sylvatic rabies and bat rabies (or pseudorabies), are discussed. PMID- 3268771 TI - [The Italian experience in the control of rabies. III. Laboratory studies on SADB19 Tu vaccine used in the fox vaccination campaign]. AB - Results of laboratory investigations on the SADB19 Tu vaccine used for oral vaccination of fox show: 1) the need to check the vaccine efficacy before its application in the field; 2) the importance of monoclonal antibodies to distinguish sylvatic from vaccinal virus strains in the diagnosis of rabies during the vaccination campaigns; 3) the relevance of a careful evaluation of the epidemiological risk encountered when releasing baits containing activated vaccine. PMID- 3268772 TI - [The rhabdovirus program at the Istituto Pasteur--Fondazione Cenci Bolognetti]. AB - Studies carried out under the research program on Rhabdovirus sponsored by the Istituto Pasteur--Fondazione Cenci Bolognetti are reviewed. The program was mainly focused to investigate biologically relevant characteristics of this virus and to evaluate epidemiological and prophylactic aspects involved in sylvatic rabies control measures. PMID- 3268773 TI - Rabies epidemiology, natural barriers and fox vaccination. AB - Rabies in Central Europe is maintained and spread by red foxes (Vulpes vulpes). The epidemiology is explained by a variety of parameters of the main host. Certain natural and artificial topographic features may function as barriers to the spread of the virus within fox populations. Taking into account epidemiological barriers greatly facilitated the strategic application of oral immunization of foxes for freeing Switzerland from rabies. PMID- 3268774 TI - [Practical implementation of oral vaccination of foxes in canton Tessin]. AB - The oral fox vaccination campaigns in 1984/85 in canton Tessin in Switzerland are described in detail. An area of 197 km2 was treated 4 times with 2260 baits in order to prevent the invasion of a rabies epizootic from abroad. A comparison is made to the rest of Switzerland, where from 1978 to 1986 a total of 545,399 baits were distributed. An evaluation of the campaigns in 10 cantons revealed that the total costs varied between 2.17 Sfr (1.54 $) and 5.84 Sfr (4.16 $) per bait. PMID- 3268775 TI - [Prevention of feral rabies in the province of Rome]. AB - This summary briefly describes the work carried out in recent years by the staff of the Province of Rome for prevention of sylvatic rabies. PMID- 3268776 TI - [Proposal for changing the ministerial instructions for antirabies prophylaxis in the light of the experience of the Centro Antirabbico di Roma]. AB - Records of clinical assistance and of post-exposure antirabies prophylaxis from 4820 outpatients who attended the Antirabies Center of Rome following animal bites in 1986 were analysed. We observed a high proportion of people submitted to active immunization (44% received at least one shot of HDCV vaccine) in spite of the fact that rabies is absent from Central Italy since many decades in both wild and domestic animals. These considerations suggest the opportunity of a major revision of the official recommendations for rabies prevention, and we feel that different policies should be adopted in rabies enzootic areas (such as Northern Italy) compared to those where the risk is only potential. Immunization should be avoided after bites by rodents; passive immunization should be added to the vaccine after bites by wild animals in enzootic areas, while bites by cats and dogs, even uncaptured, will not be necessarily followed by vaccination in non enzootic areas. PMID- 3268777 TI - [Rabies in Austria 1966-1986]. AB - The epidemiology of rabies in Central Europe with particular reference to Austria is described. Fox represents the vector of the infection while other animals are involved in the epidemiological picture only incidentally. Oral immunization of foxes has been successfully achieved. PMID- 3268778 TI - [Campaign against fox rabies in Belgium: 1st campaign for the vaccination of foxes by the oral route]. AB - The procedures followed in the first antirabies campaign carried out in Belgium with oral vaccination of foxes are described. Although the evaluation of the results is planned after the third campaign, preliminary data show a decrease in the expected number of cases in the vaccine treated zone. PMID- 3268779 TI - Adventurism and dentistry. PMID- 3268780 TI - Dietary fluoride supplements for New Mexico's children--the role of the dentist. PMID- 3268781 TI - Assessment of natural fluoride levels in well water with significant dental implications. PMID- 3268782 TI - Oral manifestations of Sjogren's syndrome. PMID- 3268783 TI - Allergic reaction to prophy paste: report of a case. PMID- 3268784 TI - Your monthly trend indicators: measures to improve your practice performance. PMID- 3268785 TI - The effect of surface morphology on the shear bond strength of glass ionomer to resin. PMID- 3268786 TI - Efficacy of visible-light generators with changes in voltage. PMID- 3268787 TI - Mercury leakage during amalgam trituration. PMID- 3268788 TI - Changes in properties of glass-ionomer luting cements with time. PMID- 3268789 TI - Preserving the integrity of a casting with direct gold. PMID- 3268790 TI - The long-term effects of daily rinsing with stannous fluoride or sodium fluoride on bacteria in dental plaque. PMID- 3268791 TI - Dietary sources of fluoride for infants and children in Hong Kong. PMID- 3268792 TI - Effect of smokeless tobacco on plasma lipoproteins in adolescents. PMID- 3268793 TI - Longitudinal changes in the width of attached gingiva in children. PMID- 3268794 TI - Neoplastic diseases in a pediatric population: a survey of the incidence of oral complications. PMID- 3268795 TI - Nonlinear dose-response characteristics of alphaprodine sedation in preschool children. PMID- 3268796 TI - Infant commissural burn management with reverse pull headgear. PMID- 3268797 TI - Dental eruption in low birth-weight prematurely born children: a controlled study. PMID- 3268798 TI - Fluoride supplement-induced dental fluorosis: case reports. PMID- 3268799 TI - Complications occurring resultant to dens invaginatus: case report. PMID- 3268800 TI - Time dependence of enamel fluoride acquisition for APF gels. I. In vitro study. PMID- 3268801 TI - Time dependence of enamel fluoride acquisition from APF gels. II. In vivo study. PMID- 3268802 TI - An evaluation of pulpal therapy in primary incisors. PMID- 3268803 TI - Fluoride in toothpastes for children: suggestion for change. PMID- 3268804 TI - Fluoride content of infant formulas: soy-based formulas as a potential factor in dental fluorosis. PMID- 3268805 TI - Radiographic assessment of the alveolar bone in children and adolescents. PMID- 3268806 TI - Evaluation of stress-relief methods on cobalt-chromium orthodontic wires. PMID- 3268807 TI - The extent of trauma and postextraction pain in children. PMID- 3268808 TI - A determination of the sensitivity of the dental pulp of primary maxillary anterior teeth to electrical stimuli in children with unilateral and bilateral clefts. PMID- 3268809 TI - Complete overlay dentures for the pediatric patient: case reports. PMID- 3268810 TI - Unusual foreign body presenting as a palatal tumor: case report. PMID- 3268811 TI - The year 2000 health objectives for the nation. PMID- 3268812 TI - [Pathologic brain cavity after idiopathic intracerebral hematoma treated conservatively and surgically]. PMID- 3268813 TI - [Computerized tomography of tumors of the maxillary sinuses]. PMID- 3268814 TI - [Studies of the ingrowth of gentamicin-septopal beads into bone with inflammatory changes]. PMID- 3268815 TI - [Usefulness of scintigraphy of the parasternal lymph nodes using 99mTc-NANOCOLL for planning supplementary radiotherapy in patients with breast cancer]. PMID- 3268816 TI - [Radiocinematographic evaluation of esophageal speech after myotomy of the pharyngoesophageal sphincter]. PMID- 3268817 TI - [Radiocinematographic studies of the effect of myotomy of the pharyngoesophageal sphincter on the development and function of the neophonation apparatus]. PMID- 3268818 TI - [Analysis of the causes of errors in the interpretation of intraoperative cholangiography]. PMID- 3268819 TI - [Effect of prazosin on serum lipids, lipoproteins and apo-lipoproteins in patients with hypertension]. PMID- 3268820 TI - [Specificity of drug therapy of hypertension in patients with diabetes mellitus]. PMID- 3268821 TI - [Pharmacokinetics of anti-arrhythmia drugs in pregnancy]. PMID- 3268822 TI - [Use of calcium channel blockers in gastroenterology]. PMID- 3268823 TI - [New beta-lactam antibiotics: penems and monobactams]. PMID- 3268824 TI - [A new technological application in functional complete dentures: the micro wave]. PMID- 3268825 TI - The prevalence of dental caries, fluorosis, and dental attitudes among primary schoolchildren in Omdurman--Sudan. PMID- 3268826 TI - Generalized oral and cutaneous hyperpigmentation in Addison's disease. PMID- 3268827 TI - A survey of student and professional attitudes in a dental school in Maharashtra, India. PMID- 3268828 TI - [Monoalveolyse in African people in Senegal. (Apropos of 20 cases)]. PMID- 3268829 TI - Cephalometric measurement of overjet values in Nigerians. PMID- 3268830 TI - [Experimental testing of the hydrogel dressing Geliperm]. AB - The dressing materials used in the local treatment for dressing large defects of skin, subcutaneous and muscular tissues do not have the optimum protective and therapeutic properties. We carry out experiments tending to achieve new kinds of dressing impermeable for microorganisms, free from toxic, allergic, action and acridity and not evoking pathological tissue reaction in a long-lasting contact with the wound. What is more, the new dressing should hasten the cicatrization process of a wound and enable its control as well as soothe the pain if it is possible. Some of these properties were achieved by the usage of cross-linked hydrophilic polymers with high ability of water absorption, creating elastic gels in its presence. The dressing of this type called Geliperm was produced by Geistlich Sons Ltd. and BYK Goldbin-Konstanz firms. The methods of evaluation of hydrogel dressing materials comprising a preliminary, standard and qualifying evaluation were worked out in the Department of Experimental Surgery and Biomaterials Research Medical Academy of Wroclaw. According to the worked out scheme of experiments the Geliperm dressing was evaluated. We have discovered on the basis of the carried out experiments that the new generation of gel dressing has, to a large extent, the properties of the so called "ideal dressing". PMID- 3268831 TI - [Local treatment of burn injuries and traumatic wounds with a hydrogel Geliperm dressing]. AB - Hydrogel Geliperm dressings of BYK Goldbin - Konstanz and Geistlich Sons Ldt. firms were used in patients in case of skin burns and some traumatic wounds. During a four-year observation it was discovered that those materials are safe for the patient, their removing is painless and their are fully useful in the treatment of burns and traumatic wounds in surgical departments and in the ambulatory treatment. Geliperm does not have allergic action. Because of its physicochemical and biological properties Geliperm may have also usage for example in the treatment of leg ulcerations, of bed-sores and of radiation skin defect. PMID- 3268832 TI - [Vascular prosthesis made of polyester threads for microsurgery]. AB - The results of experimental and medical application of worked out by the authors synthetic microvascular prosthesis with the internal diameter from 1 to 3 mm. The prostheses were implanted to the abdominal aorta and to the tail vein of rats and also to femoral and carotid arteries of cats for a period of 1 till 15 months. The angiographic and morphologic experiments of blood flow were carried out. The patency of the microprosthesis in the experiments was to 92.7%. The micro-implant adaptation was characterized by complete tissue isolation of a synthetic skeleton with formation of thin and even internal membrane covered with endothelium layer. In fact the possibility of arterial and venous prostheses having a 1-2 mm diameter with synthetic substitutional textile products creates new possibilities for the further development of the microvascular surgery. The microvascular prosthesis was applied to 10 patients in plastic surgery of small circumferential arteries of limbs achieving positive results. PMID- 3268833 TI - [Operative dentistry using metallic ions. The reversible nature of the incipient caries process]. PMID- 3268834 TI - [Demineralization and remineralization of carious lesions, basic concepts and experimental methodology]. PMID- 3268835 TI - [Primer Simposio Internacional sobre Cariologia. Febrero de 1987. Mexico]. PMID- 3268836 TI - [Physiology of the carious lesion. Factors which affect demineralization and remineralization]. PMID- 3268837 TI - [Dental caries in Latin America, present and future]. PMID- 3268838 TI - [The impact of dental research on health promotion and the advancement of science in general]. PMID- 3268839 TI - [In vitro effect of some mouthrinses in Streptococcus salivarius]. PMID- 3268840 TI - [Oral ecology]. PMID- 3268841 TI - [Comparative study of 20 domestic and foreign dental amalgams]. PMID- 3268842 TI - [Procedures for placement in the upper jaw of a subperiosteal implant made in Mexico]. PMID- 3268843 TI - [Extracapsular disturbances of the temporomandibular joint]. PMID- 3268844 TI - [Rheumatoid arthritis]. PMID- 3268845 TI - [Plane tomography of a paradental cyst]. PMID- 3268846 TI - [Evaluation of operational level of fluoridation of water]. PMID- 3268847 TI - [Effect of cooling on the quality of diamond turbine grinders at work in amalgam]. PMID- 3268848 TI - [Examination of employees of Lachema Kaznejov Plant]. PMID- 3268849 TI - [Caries of deciduous teeth in Bratislava preschool children]. PMID- 3268850 TI - [The relation of the fear of dentistry to some traits of personality]. PMID- 3268851 TI - [Results of an investigation of secondary caries. Part I]. PMID- 3268852 TI - [Causes of extractions of permanent teeth in a health community dental center. 1]. PMID- 3268853 TI - [Spontaneous repair after partial resection of the right half of the mandible on account of a chondrosarcoma]. PMID- 3268854 TI - [Dens in dente]. PMID- 3268855 TI - [Protection and safety when using visible light curing units]. PMID- 3268856 TI - [Application of the Sof-Lex pop-on systems during adjustment of the composite filling Silar]. PMID- 3268857 TI - [Extraction of teeth in undiagnosed fractures of the mandible--expert opinion]. PMID- 3268858 TI - [Comparative study of the electric measurements of the length of root canals by means of direct current]. PMID- 3268859 TI - [Importance of aesthetic aspects of the face in the therapeutic plan]. PMID- 3268860 TI - Legal tests for diagnosis and treatment. PMID- 3268861 TI - MPs to fight on against charges. PMID- 3268863 TI - Micros in the surgery. PMID- 3268862 TI - Retirement before 70. PMID- 3268864 TI - DEB fees for veneers. PMID- 3268866 TI - Pensions again. PMID- 3268865 TI - A tale of two videos. PMID- 3268867 TI - [Human rights and psychiatric patients in Japan: psychiatry and ideology]. PMID- 3268868 TI - [Ethical and political problems in law and psychiatry: an international view point]. PMID- 3268869 TI - [Revision of the Mental Hygienic Laws: with special reference to the protection of the rights of the mentally ill]. PMID- 3268870 TI - [International agreement and the responsibility of each nation to uphold the rights of patients]. PMID- 3268871 TI - [For the benefit of psychiatric patients]. PMID- 3268872 TI - [Guardians: legal guardians and persons in charge of patients. The Japanese family system and psychiatry]. PMID- 3268873 TI - [Selection of guardians and trustees for the mentally incompetent]. PMID- 3268875 TI - [Psychiatric security hospitals]. PMID- 3268874 TI - [Prediction of the development of dangerous behaviors: facts and fancy]. PMID- 3268876 TI - [Treatment of dangerous patients--experiences in The Netherlands]. PMID- 3268877 TI - [Revision of the mental health laws]. PMID- 3268878 TI - [Revision of the mental health laws]. PMID- 3268879 TI - [A proposal for the revision of the Japanese mental health laws]. PMID- 3268880 TI - [Revision of the Mental Health Law in Australia]. PMID- 3268881 TI - [Characteristics of the Japanese mental health laws: a comparative study]. PMID- 3268882 TI - [The course of bipolar disorder, effectiveness of drug therapy and the status of the central nervous system studied by computerized tomography]. PMID- 3268883 TI - [Computerized tomography in the evaluation of the central nervous system of patients with bipolar disorder]. PMID- 3268884 TI - [Heart rate reactivity to stimuli in patients with endogenous depression. II. The orthostatic test]. PMID- 3268886 TI - [Effect of diazepam on cognitive and psychomotor functions in patients with neuroses in relation to various anxiety levels]. PMID- 3268885 TI - [Diagnosis of functional psychoses using the VRDC system. Preliminary report]. PMID- 3268887 TI - [Mental disorders among active service military personnel hospitalized at the Psychiatric Clinic, Medical Academy, in Wroclaw]. PMID- 3268888 TI - [Projection aggression among patients and personnel of a psychiatric hospital]. PMID- 3268889 TI - [Treatment of families with alcohol dependence in Poland]. PMID- 3268890 TI - [Evaluation of the diagnostic usefulness of inventory scales of the symptoms of alcohol dependence]. PMID- 3268891 TI - Acute upper gastrointestinal haemorrhage in patients aged 80 years or more. AB - We report a series of 103 admissions of patients aged 80 years or more with acute upper gastrointestinal haemorrhage to one hospital over a four-year period. A cause was eventually found during 81.5 per cent of admissions and of these, 57 per cent had bled from chronic peptic ulcers. After 64 per cent of admissions, the patient received a blood transfusion and in 25 per cent, the blood transfusion exceeded 5 units. Nine patients had surgery for peptic ulcer during admission but no operations were performed in patients with other causes of upper gastrointestinal haemorrhage. Patients with peptic ulcer, when compared to patients with other causes for haemorrhage, were more likely to have symptoms of upper gastrointestinal disease before presentation. They were also more likely to continue to bleed, to bleed again, to require surgery, and to die as a consequence of haemorrhage. Eighteen admissions (17.5 per cent) ended with death but in only 11 (10.5 per cent) did the patient die directly because of haemorrhage. Nine of these bled from a peptic ulcer, one from oesophageal varices and one from an unknown cause. Patients who died from haemorrhage, when compared to all others, were more likely to have bled from a peptic ulcer and to have significant co-existing disease, to have ingested non-steroidal antiinflammatory drugs or aspirin before admission, to have raised blood urea level and low systolic blood pressure at admission and to have required blood transfusion of more than 5 units. Our study has shown that upper gastrointestinal haemorrhage secondary to peptic ulceration is a serious and often fatal condition in the elderly. Identification and effective monitoring of those at particular risk of death may be essential if mortality is to be reduced. PMID- 3268892 TI - Aluminium encephalopathy: clinical and immunological features. AB - Aluminium encephalopathy is a specific syndrome occurring in dialysis patients and linked to high aluminium levels in dialysis water. We present the features of 38 cases seen in a single dialysis and transplantation unit. Serum immunoglobulin levels and the prevalence of histocompatibility antigens are discussed. The syndrome in its complete form is specific and easily recognizable. Careful attention to premonitory symptoms may lead to earlier diagnosis. PMID- 3268893 TI - Outcome of orthotopic liver transplantation in the aetiological and clinical variants of acute liver failure. AB - Thirty-three patients with acute liver failure underwent orthotopic liver transplantation, including 16 with fulminant hepatic failure, 15 with late-onset hepatic failure and two with severe acute liver failure (coagulopathy without encephalopathy). Twenty-three (70 per cent) survived to leave hospital and 21 of these are currently alive and well. Outcome correlated with the serum bilirubin level before transplantation (p less than 0.05) but no correlation was found with the variant of acute liver failure, grade of encephalopathy, cerebral oedema, serum creatinine, white cell count, prothrombin time or platelet count at the time of transplantation. Severe coagulation factor deficiencies did not constitute a clinical problem. One patient developed a neurological deficit secondary to cerebral oedema, but otherwise the morbidity reflected that observed in the general population after transplantation. Careful monitoring of intracranial pressure and surveillance (with early aggressive therapy) for bacterial and fungal infections is very important in achieving a successful outcome after transplantation. PMID- 3268894 TI - Clinical experience with aminohydroxypropylidene bisphosphonate (APD) in the management of cancer-associated hypercalcaemia. AB - Fifty-five patients with symptoms caused by hypercalcaemia associated with cancer were treated with varying regimens of intravenously-administered aminohydroxypropylidene bisphosphonate after initial rehydration. Of 48 patients where adequate data were available, 32 (66 per cent) were rendered normocalcaemic and 16 (33 per cent) remained mildly hypercalcaemic. In these cases, failure to restore normocalcaemia was attributable to elevated renal tubular reabsorption of calcium in nine (18 per cent) and to inadequate suppression of bone resorption in seven (14 per cent). There was no significant difference in response and duration of effect (median 20 days) between single doses of 15, 25 and 45 mg, or when the 45 mg dose was administered over three, six or 24 h. These single dose regimens were similar in terms of effect on calcium levels and duration of action, to multiple daily doses of 15 mg for a mean of six days. While the effect of 5 mg dose was not significantly different from the higher doses, suppression of serum calcium levels was less marked and the effect on duration of action significantly shorter than with the 45 mg dose. In seven cases, treatment with a second course was less effective even with higher doses because suppression of bone resorption was poorer. These data indicate that there is little difference between the therapeutic effects of multiple 15 mg and single 15-45 mg intravenous infusions of aminohydroxypropylidene bisphosphonate in hypercalcaemia associated with cancer. A single intravenous infusion of a moderate dose (for example 15-30 mg) would be a convenient and effective way of treating most patients. PMID- 3268895 TI - Microleakage of posterior composite resins using glass ionomer cement bases. PMID- 3268896 TI - Conservative resin restoration of endodontically treated teeth. PMID- 3268897 TI - Evaluation of a chemomechanical method of caries removal in root surface lesions. PMID- 3268898 TI - Clinical evaluation of gingival inflammation following use of buffered aspirin and buffer-only oral rinses. Preliminary results. PMID- 3268899 TI - Unlocking maxillary third molars to restore occlusal function. PMID- 3268900 TI - Anterior crossbite correction in the primary dentition using fixed inclined planes. II. Further examples and discussion. PMID- 3268901 TI - Placement of overdenture attachments using a visible light cured resin. PMID- 3268902 TI - [Determination of serum bilirubin fractions using gel-filtration]. AB - Serum bilirubin has been fractionated by means of a gel-filtration technique, on Bio-Gel P-10 columns and with caffeine solution as eluent. When sera containing high concentration of direct-reacting bilirubin were applied to the column, a bilirubin fraction was eluted with the protein. This bilirubin fraction is not set free from protein in the presence of urea, guanidine and sodium dodecyl sulfate; moreover it exhibits peculiar behaviour in the direct and indirect diazo reaction and in enzymatic oxidation by bilirubin-oxidase as well. On the basis of these data, such bilirubin fraction has been identified with the previously described delta-bilirubin. A method for the quantitative measurement of delta bilirubin, based on gel-filtration separation followed by diazo-reaction, has been worked out. Results by this method satisfactorily compared with the Kodak Ektachem method. PMID- 3268903 TI - [Morphologic aspect of lymph nodes and its correlation to clinical stage and survival in 11 cases of chronic lymphatic leukemia]. AB - The morphologic lymphonode features have been reviewed in 11 cases of chronic lymphocytic leukemia and correlated to the clinical staging and survival. It is observed that 3/4 of cases with focal immaturity in the lymphonodes presented a more advanced clinical staging and shorter survival. PMID- 3268904 TI - [Results and observations on the research of circulating immunocomplexes in subjects with suspected autoimmune pathology]. AB - The authors have investigated the level of circulating immune complexes (CIC) in 409 patients (some hospitalized) suffering from disease in which the presence of CIC had been suspected. The 10% (forty-one) was positive, and clinical manifestations related have shown, in the majority of patients, a close relation with diseases in which there was, or it was possible to presume, an immunological pathogenic mechanism. Besides the authors examine a case with close association between high level of CIC and leptospirosis. PMID- 3268905 TI - [Technics for identifying Cryptosporidium spp. in feces: synthetic review and personal experience on anti-HIV seropositive, AIDS-related complex and AIDS subjects]. AB - The authors describe the most common techniques used for the detection of Cryptosporidium spp. in the faeces. Coproparasitological investigations have been carried out on 216 patients anti-HIV seropositives, 192 of them with no symptoms, 5 with ARC and 19 with AIDS. The techniques that have been used are: the FPC concentration, the colouring of Henriksen and Pohlenz and modified Koster, the indirect immunofluorescent assay with monoclonal antibodies. Oocystis of Cryptosporidium spp. have been recovered in three patients, two ARC and one AIDS. On the ground of the authors' experiences the used techniques must be considered particularly suitable for the diagnosis of cryptosporidiosis. PMID- 3268906 TI - [Determination of specific IgM using column chromatography in immunologic diagnosis of toxoplasmosis]. AB - The usefulness of detecting specific IgM antibodies in the immunodiagnosis of toxoplasmosis is fraught with false positive and false negative results. For instance false positivity can be obtained when rheumatoid factor is present in the serum while false negativity can occur because competing levels of IgG antibodies. We report the results obtained by the use of a simplified chromatographic method, commercially available in kits, for the separation of IgM from IgG in the immunodiagnosis of toxoplasmosis. The 1564 sera tested by indirect immunofluorescent technique (IFA) showed that 119 (7.6%) were positive if the whole serum was tested and only 7 (0.4%) after the chromatographic separation. This suggests that the use of this method can notably reduce the number of false results in sera with high IFA titer of IgM to toxoplasma. PMID- 3268907 TI - [Comparison, using RAST-inhibition, of the allergenic potency of Dermatophagoides pteronyssinus extracts obtained from: whole mite culture, fraction of enriched mite culture, fraction of feces enriched culture, purified mite bodies, commercial extracts]. AB - The RAST-inhibition potency has been obtained from five extracts prepared by: whole mite culture, mites-enriched culture, faeces-enriched culture, purified mite bodies, commercial extract. The present study demonstrates that extracts of: a) purified bodies, and b) faeces-enriched culture are both potent preparations in RAST-inhibition. PMID- 3268908 TI - Method for the determination of urinary porphyrins. PMID- 3268909 TI - [A case of erythema nodosum in tularemia]. AB - Since 1980 some epidemics of tularemia occurred, involving large areas of Tuscany (Italy). Among the different clinical features described in the classic form of tularemia, erythema nodosum never has been reported. One case of erythema nodosum, the first reported in course of tularemia, is described. The correct diagnosis is based on careful question about exposure to mammals and ticks. The importance of early treatment is stressed. PMID- 3268910 TI - [Lipid parameters in a homogeneous population sample in relation to age and sex]. AB - The authors have examined the total cholesterol, the HDL cholesterol, the LDL cholesterol, triglycerides, and the HDL cholesterol/total cholesterol ratio on 313 men and 305 women divided into groups in relation with age (40 years, 40-60 years, 60 years). Significant differences have emerged comparing these different subgroups as regards the considered parameters. About examined population, we have observed higher value of all principal seric lipids than national media. Implications of these data in the evaluation of cardiovascular disease are discussed. PMID- 3268911 TI - [Application to an automatic system of a direct method for determining atypical variants of cholinesterase using succinyldithiocholine as substrate]. AB - The determination of human serum cholinesterase (EC 3.1.1.8) is frequently requested to detect patients with atypical forms of the enzyme which reacts abnormally with succinylcholine (suxamethonium), employed as a neuromuscular blocking agent. Usually, for biochemical identification of succinylcholine sensitive individuals the standard reaction is run with and without the inhibitors, notably dibucaine. A new test for direct determination of succinylcholine sensitive individuals which use a substrate analogue of succinylcholine was applied to a automated instrument. The linearity, precision, recovery, interference and correlation of the method have been evaluated. We have estimated the reference intervals for a population of 364 healthy subjects subdivided for sex, three atypical homozygotes and two atypical heterozygotes. On the basis of analytical performance we can conclude that this test may offer a further parameter for preoperative screening of individuals with an abnormal response to the muscle relaxant succinylcholine, thus avoiding the determination of genotype by measurement of dibucaine number. PMID- 3268912 TI - [Evaluation of interferences in electronic platelet count]. AB - A platelets count was performed on 100 subjects using both the electronic counter and a manual method; the results obtained concerning healthy subjects are overlapping. In subjects with structural alterations regarding platelets and red blood cells, the electronic counter method has overestimated the number, yet making note of it. PMID- 3268913 TI - [In vitro evaluation of the antibiotic effect of imipenen on bacterial strains isolated mostly from compromised patients]. AB - The antibacterial activity in vitro of Imipenem (N-formimidoyl-thienamycin) was studied on 237 recently-isolated nosocomial bacterial strains and compared with Aztreonam, Cefotaxime, Ceftazidime, Ceftriaxone, Piperacillin, Amikacin and Netilmicin through the determination of susceptibility by the Kirby-Bauer method. Taking into account that 65% bacterial strains, out of the examined ones, came from antibiotic high-pressure departments (45% from bone-marrow transplanted patients in the Hematological Department and 20% from Intensive Care Unit patients), the results obtained in vitro show an activity of Imipenem on Gram negative bacteria as much as a 92.7% susceptibility and a 75.7% on Gram-positive bacteria; when compared with the activity of the other antibiotics, Imipenem shows a really excellent activity. PMID- 3268914 TI - [Statistic relation between seropositivity to Toxoplasma gondii and several risk factors in a sample of pregnant women]. AB - We analysed, in the period 1984-1986, the serum of 1733 pregnant women. The relation between the positivities and some probable factors of risk, alimentary habits and touch with tame animals has had valued by statistical method. The analysis shows no increase of risk in the group used to eat underdone meats compared with the group in touch tame animals. PMID- 3268915 TI - [Procedure for identifying atypical variants of pseudocholinesterase for the prevention of prolonged apnea induced by succinylcholine]. AB - The simple Sclavo test based on succinyldicholine hydrolysis and on the following reaction with 5,5'-dithio-bis-2-nitrobenzoic acid for detection of the atypical patterns of serum cholinesterase has been investigated. A yellow staining appears but in presence of the atypical forms of the enzyme. Analysis of 4055 serum samples by the 430 Selective Analyzer Sclavo allowed the identification of one atypical homozygous patient. Prolonged apnoea induced by use of succinyldicholine as a neuromuscular blocking agent during anaesthesia may be avoided by use of this test. PMID- 3268916 TI - [An interesting case of monoclonal component]. AB - The authors present an interesting case of monoclonal component concerning a 61 years old patient, incorrectly identifiable with the IFE technique only. Moreover they describe the analytic methodology used to identify the monoclonal component which resulted to be secreted in three different ways of polymerization. PMID- 3268917 TI - [Urine bacterial flora and chemoantibiotic resistance: observations on ambulatory patients and hospitalized patients at the local health district No. 11 of Fabriano (Ancona)]. AB - This paper reports the results of a study carried out on 4614 samples of urine from inpatients and outpatients according to the sex. The positive monomicrobic urine specimens were examined and isolated strains were tested against various antimicrobial drugs. Our findings showed that 43.1% of urine specimens examined from inpatients and 38.4% from outpatients proved to be positive. Among the bacterial species more frequently isolated, significant differences among Enterobacter spp. in males and coagulase-negative Staphylococcus spp. in females from general practice, and Pseudomonas spp. in females from the hospital were observed. Statistical analysis reveals that: a) no significant differences were found in antibiotic-resistance among Escherichia coli, Proteus rettgeri, Streptococcus faecalis, Enterobacter spp. and Pseudomonas spp., isolated from inpatients and outpatients as regards males and females; b) Klebsiella spp., Proteus rettgeri and coagulase-negative Staphylococcus strains isolated from females inpatients are more chemo-resistant than those from females outpatients. PMID- 3268918 TI - [Sex determination in hair roots without sheath: proposal of a method for preparation of specimens]. AB - Japanese authors have described a procedure for the sex determination of human hair roots without epithelial sheath, paraffin embedded and fluorescent stained for cortical cell nuclei Y or X sex chromatins. This method however is not sufficiently practical for forensic science purposes: it is difficult and not guaranteed to obtain suitable longitudinal hair sections with possible loss of evidence particularly serious when the questioned hair is only one. The authors, researching Y-bodies with Quinacrine, present an alternative technique of preparation of specimens without embedding which is simple and quick, reproducible and satisfying in results and that avoids loss of material. PMID- 3268919 TI - Lymphocyte subsets in peripheral blood of cigarette smokers. PMID- 3268920 TI - Relation between fasting C-peptide and other clinical and metabolic variables in non-insulin-dependent diabetes mellitus. PMID- 3268921 TI - [Semiautomatic procedure for determining urine iron in subjects treated with deferoxamine B]. AB - A semiautomatic method for the determination of urine iron during treatment with deferoxamine B has been evaluated: samples were diluted 1:10 with a TCA 10% and thioglycolic acid 1.1% solution and processed after centrifugation by the aca III discrete clinical analyzer Du Pont. In this way an overestimation of values depending on the turbidity caused by proteins is avoided and the bad smell is limited thanks to the very low concentration of the thioglycolic acid solution. A good correlation with the atomic absorption spectrophotometry, specially for values less than or equal to 20 mg/l, was observed examining urine samples of 150 patients treated with deferoxamine B. PMID- 3268922 TI - [Comparison between 2 separation methods of IgM and IgG in serologic diagnosis]. AB - The concentrations of the IgG and IgM fractions have been determined on thirty whole sera and after treatment with protein A, or after chromatographic separation. The analysis of the differences has been effected with Student's t test. No statistically significant differences have been noted between the two methods of separation as far as IgM fraction is concerned, but, on the contrary, significant differences are present for the separation of IgG fraction. PMID- 3268923 TI - [Circadian rhythm of human lymphocyte subpopulations]. AB - Circadian rhythm of lymphocyte subsets was investigated in four healthy subjects, males, aged 35-58 years old. After a period of ambiental synchronization, venous blood samples were taken during a span of a day at 0.00 a.m., 4.00 a.m., 8.00 a.m., noon, 4.00 p.m. and 8.00 p.m. Lymphocyte subsets (OKT3, OKT4, OKT8, OKB7, OKJa1) were determined by monoclonal antibodies method, and serum level of cortisol by radioimmunoassay method. The OKT4/OKT8 ratio was also calculated. Data were analyzed by chronograms (mean +/- 1SD) and by cosinor method. Results show a significant circadian rhythm for each lymphocyte subset and for serum cortisol levels. The lowest levels of all circulating subsets were seen between noon and 4.00 p.m. and the highest levels around midnight, inversely related with the circadian rhythm of serum cortisol. The OKT4/OKT8 ratio, on the contrary, was relatively constant during the day, without a significant circadian rhythm. These observations have laboratoristic, clinical, and therapeutic implications and should be considered in the course of immunological studies. PMID- 3268924 TI - [Automatic tracing of conversion scales from conventional units to the SI system of units]. AB - American medical journals, as the Journal of the American Medical Association (JAMA), and the American Journal of Clinical Pathology (AJCP), the Journal of the American Society of Clinical Pathologists (ASCP), are shifting to selected SI (Systeme International d'Unites) units for reporting measurements. Further discussion by the AMA, the ASCP and other organizations is required before consensus in the US medical community can be reached as to the extent of and time frame for conversion to SI for reporting clinical laboratory measurements: however this decision will certainly greatly speed up the process of conversion in European countries too. Transition to SI units will require the use of different reference ranges, and there will be a potential for serious misinterpretation of laboratory data unless well-planned educational programs are instituted before the change. A simple program written in Microsoft Basic for automatically tracing on one's personal computer (PC) monitor a dual scale, in the conventional and in the SI system of units, is presented here. The program may be easily implemented and run on every PC operating under MS-DOS, equipped with a CGA or an AT&T6300 graphic card: through the operating system the scales may also be printed on a dot-matrix graphic printer. We believe that this, and other tools of this kind, will be useful in the thorough educational process of those reading the reports, and will be an important factor in the success of conversion to SI reporting. PMID- 3268925 TI - [Evaluation of the specific immune response after anti-rubella vaccination]. AB - A selective rubella immunization program was carried out in the Siena (Italy) area since 1984. 912 schoolgirls aged 10 to 18 were screened for rubella antibodies. Seropositivity rates, increasing with age, appeared quite heterogenous among subjects living in different villages. Seronegative girls were partly voluntarily immunized with RA 27/3 live attenuated rubella vaccine. Serological and clinical controls performed on 238 subjects one month after immunization showed a 99.6% vaccine-induced seroconversion rate and mild post vaccinal reactions in 26% of vaccinees. Serological control performed, on 172 subjects, at 8-12 days after vaccination revealed that in most cases vaccine induced haemagglutination-inhibiting antibodies are not detectable at the time. The results are discussed in relation to a forthcoming introduction of compulsory rubella vaccination in our Country. PMID- 3268926 TI - [Securing of precious metal precision attachment to non-precious metal alloys]. PMID- 3268928 TI - [Ceramic inlay (III)]. PMID- 3268927 TI - [New materials and methods for clinically and esthetically acceptable restorations]. PMID- 3268929 TI - [Child's prosthesis in orthodontics]. PMID- 3268930 TI - [Ceramic-metal crowns]. PMID- 3268931 TI - [Rational model preparation with model-split-system (I)]. PMID- 3268932 TI - [Relaxation splint]. PMID- 3268934 TI - [Contamination of the atmosphere]. PMID- 3268933 TI - [Biological simulator]. PMID- 3268935 TI - [The sunrise]. PMID- 3268936 TI - [Cell-mediated immune response in patients with fungal infections of the mouth in prosthetic stomatopathies]. PMID- 3268937 TI - [Relationship between the occurrence of malocclusion and presence of signs of stomatognathic system dysfunction in secondary school students]. PMID- 3268938 TI - [Basal cell carcinoma among the cases of Dermatology Clinic I of the Silesian Medical Academy in Katowice]. AB - The authors present their own experiences in the treatment of 24 patients with the nevoid basal-cell carcinoma syndrome. All the patients underwent surgical treatment, in 12 of them some of the tumours were treated with X-rays. Two patients were found to have 32 and 26 nevoid basal-cell carcinoma respectively. In none of the 24 patients recurrence was noted. However in many of them the new foci of carcinoma required systemic treatment. PMID- 3268939 TI - [Urticaria in atopic dermatitis]. AB - During examinations of 479 patients referred for atopic dermatitis and 520 with urticaria it was found that in the first group coexistence of these diseases was frequently occurring, and in the second group it was rare. Food allergens caused slightly more frequently episodes of urticaria than exacerbations of atopic dermatitis. Coexistence of urticaria with atopic dermatitis was particularly frequent in patients: a) with a high IgE titre, b) with a history of allergy in the families of both parents, c) in patients with respiratory allergy associated with skin lesions. PMID- 3268940 TI - [Effect of ovalbumin lysozyme on healing of standard skin wounds in guinea pigs]. AB - External application of ovalbumin Lysozyme in normal saline in enzyme concentration 1 mg/ml shortened evidently the time of healing of standard skin wounds in guinea pigs (p less than 0.00001) as compared to control groups. The inflammatory reaction around the wound was reduced also. No manifestations of allergy to ovalbumin lysozyme were noted. This favourable effect of lysozyme on wound healing seems to be related to the cationic influence of lysozyme on cell membranes of keratinocytes and on change of wound pH. PMID- 3268941 TI - [Aerobic and anaerobic bacterial flora of crural ulcers]. AB - In a group of 600 patients treated in the Metropolitan Dermatological Hospital in Warsaw bacteriological examination were carried out of swabs from the untreated crural ulcers. In 95% of these cultures growth of pathological aerobic organisms was obtained. Coagulase-positive staphylococci (St. aureus) and Gram-negative bacteria (Pseudomonas aeruginosa, Proteus vulgaris, Enterobacter sp and E. coli) prevailed. In 27% of cases the cultured strains were resistant to the generally available antibiotics. In the second group in 70 patients no growth of anaerobes exclusively was noted. Pathological aerobes and anaerobes in the same case were found in 45% of cultures. In the remaining ones pathogenic aerobes were present with a similar frequency as in the preceding group. Of the anaerobes the most frequently cultured species were Gram-negative bacteria such as Bacteroides melaninogenicus, Bacteroides sp, and Bacteroides fragilis. Among pathogenic anerobic cocci Peptostreptococcus and Peptococcus were most frequent. In 2 cases spore-forming anaerobic bacteria (Clostridium perfringens) were obtained. Forty eight percent of anaerobes were resistant to the commonly used antibiotics. PMID- 3268942 TI - [Analysis of the incidence of sexually transmitted diseases in 1987]. AB - In 1987 the number of cases of early symptomatic syphilis increased by 1.5% to 1211 cases (3.2 per 100 thousand). Early asymptomatic syphilis was diagnosed in 2.5 per 100 thousand of the population, that is 5% less than in the preceding year. In all, 2136 cases of early syphilis were recorded, that is 1% less than in the preceding year, and the incidence was 5.7 per 100 thousand. The incidence of gonorrhoea decreased by 23% to 7665 cases, that is 20.3 per 100 thousand, the lo west incidence after World War II. The male/female sex ratio was 3.4:1. The incidence of non-gonococcal urethritis was 16% lower in men, that is 26.6 per 100 thousand of men. The ratio of NGU to gonorrhoea was 82:100. Anti-HIV antibodies were detected in 1987 in another 32 Polish citizens (since 1985 they were found in 52 Polish citizens) and 7 foreigners, 3 of whom left Poland. Homosexual and bisexual males prevailed (23), 14 were haemophiliacs, 9 were women (5 prostitutes). Two new cases of AIDS were found (three in all), all three patients died. PMID- 3268943 TI - Malpractice. PMID- 3268944 TI - Game plan. PMID- 3268945 TI - Nitrous oxide. PMID- 3268946 TI - [Prevalence and severity of gingival disease in mentally retarded children in 5 children's homes in Havana]. PMID- 3268947 TI - [Radiology of bone grafts]. PMID- 3268948 TI - [Case reports. Tooth replantation]. PMID- 3268949 TI - [Time spent on different operative and endodontic procedures by students at the Conservative Dental Clinic at the Havana Dental School]. PMID- 3268950 TI - [Carrier clips for linear radiation sources]. PMID- 3268951 TI - [Influence of oxidation on the ceramometal bond]. PMID- 3268952 TI - [Recurrent aphthous stomatitis and its possible relation to Giardia lamblia parasitism. Preliminary study]. PMID- 3268953 TI - [Factors causing fear in dental care]. PMID- 3268954 TI - [The use of masks in planning and prediction in craniofacial surgery]. PMID- 3268955 TI - [Rates of edentulousness in ages 18, 35 to 44, and 65 years and older in the population of Cienfuegos and Moron]. PMID- 3268956 TI - [Local peculiarities in the diameter of lymph channels in the lingual mucosa by age]. PMID- 3268957 TI - [Statistical study of embryonal cysts of the neck]. PMID- 3268958 TI - [Surgical morbidity of the salivary glands. Study of 210 patients]. PMID- 3268959 TI - [Malignant lesions of the facial skin. Statistical study]. PMID- 3268960 TI - [Bacteriological study of clinical cervicofacial infections]. PMID- 3268961 TI - [Treatment of simple anterior crossbite in pediatric dentistry]. PMID- 3268962 TI - [Most frequent causes of tooth mortality in a group of Boyeros patients]. PMID- 3268963 TI - [Project for the function of a service or area of dentobacterial plaque control]. PMID- 3268964 TI - [Effectiveness of a 3% chlorhexidine acetate toothpaste in prevention and treatment of periodontal disease]. PMID- 3268965 TI - [Incidence of cancer of the lip]. PMID- 3268966 TI - [Periodontal trauma and its correlation with vertical bone loss and root exposure]. PMID- 3268967 TI - [Analysis of the pH of anesthetic solutions commonly used in Spain]. PMID- 3268968 TI - [A case of eosinophilic granuloma and its development to Hand-Schuller-Christian syndrome]. PMID- 3268969 TI - [Jaw cysts. Analysis of treatment]. PMID- 3268970 TI - [Oral health. Socio-professional criteria for improvement in the autonomous Euskadi community]. PMID- 3268971 TI - [The importance of integral and sequential treatment of patients with cleft lip and palate]. PMID- 3268972 TI - [Apropos...dental occlusion and mandibular condyle function]. PMID- 3268973 TI - [Federation Dentaire Internationale. Analysis and methods for identification of groups and individuals at high risk for caries. Summary and recommendations for future investigations]. PMID- 3268974 TI - [Federation Dentaire Internationale. The impact of changing disease trends on dental education and practice]. PMID- 3268975 TI - [Federation Dentaire Internationale. Guide for use of cements in fixed restorations]. PMID- 3268976 TI - [Federation Dentaire Internationale. Harmlessness of dental amalgam]. PMID- 3268977 TI - [Federation Dentaire Internationale. Recommendations for dental mercury hygiene]. PMID- 3268978 TI - [Federation Dentaire Internationale. Recommendations for a list of disposable instruments and materials to be used in emergency dental treatment during mobile missions]. PMID- 3268979 TI - [Rationale for endodontic retreatment]. PMID- 3268980 TI - [Principal causes of endodontic failure]. PMID- 3268981 TI - [Cleaning and shaping during endodontic retreatment: a standardized approach]. PMID- 3268982 TI - [Compaction of warm gutta percha during endodontic retreatment]. PMID- 3268983 TI - [When can the final prosthetic restorations be done after endodontic retreatment?]. PMID- 3268984 TI - [Endodontic failures. Rationale and applications in surgical retreatment]. PMID- 3268985 TI - [The new alloys. Introductory memorandum]. PMID- 3268987 TI - [Know how to translate: "resiliency" does not mean ductility (resilience)]. PMID- 3268986 TI - [Reconditioning of brackets]. PMID- 3268988 TI - [Beyond mechanics, and a certain spiritual state]. PMID- 3268989 TI - [Bibliodent: how it can help you]. PMID- 3268990 TI - [The automated appointment]. PMID- 3268991 TI - [Orthodontic movement of a tooth without its apex]. PMID- 3268992 TI - [Orthodontic use of alloys called "shape memory"]. PMID- 3268993 TI - [Criteria for choice of an orthodontic wire]. PMID- 3268994 TI - [Shape memory and associated phenomena]. PMID- 3268995 TI - [Magnets and magnetic fields in orthodontics]. PMID- 3268996 TI - [Cranio-facial biodynamics]. PMID- 3268997 TI - [Incisal edge to edge and prognosis of treatment of Angle Class III malocclusions]. PMID- 3268998 TI - [Corrosion of metal alloys used in prosthodontics]. PMID- 3268999 TI - [Preparation of an orthognathic surgery case]. PMID- 3269000 TI - [Implants in oral rehabilitation]. PMID- 3269001 TI - [Hyperplastic lesions of the oral mucosa. Apropos of a clinical case of epulide granulomatosa of unusual size]. PMID- 3269002 TI - [Some considerations on ergonomics and dentistry]. PMID- 3269003 TI - [The attitude of the child in pediatric dental practice. The doctor-patient relationship in pediatric dental practice]. PMID- 3269004 TI - [Mortality of asthma]. PMID- 3269005 TI - [Prothrombotic status: myth or reality]. PMID- 3269006 TI - [Thyroid carcinoma: an attempt at classifying and staging according to a modified TNM system. Analysis of 459 surgically treated cases]. PMID- 3269007 TI - [Surgical treatment of multiple symmetrical lipomatosis (Madelung's disease)]. PMID- 3269008 TI - [Morphologic and ultrastructural aspects of the lamina propria of the human uterine tubes]. PMID- 3269009 TI - [Morphofunctional study of the fibromuscular architecture of the ampullar portion of the human ductus deferens]. PMID- 3269010 TI - [Umbilical vein thrombosis]. PMID- 3269011 TI - [Effect of Rosa rubiginosa oil on the healing of open wounds]. PMID- 3269012 TI - [Epidemiology of dental caries and periodontal disease in Guatemala]. PMID- 3269013 TI - [Epidemiology of disease and clinical disorders of the mouth in Guatemalan students. 2. Results from the Guatemala district]. PMID- 3269014 TI - Communicating for top performance: the job description - Part I. PMID- 3269015 TI - Accreditation of dental technology education programs: the NADL role. Part I. PMID- 3269016 TI - Tetanus--reviewing a persistent problem. PMID- 3269018 TI - Saliva inhibits HIV infectivity. PMID- 3269017 TI - Laboratory owner's self-appraisal. PMID- 3269019 TI - Communicating for top performance: the job description--Part II. PMID- 3269020 TI - Information and assistance. PMID- 3269021 TI - OSHA hazard communication standard. Part I. PMID- 3269023 TI - Cell physiology of blood. PMID- 3269022 TI - What every dentist should know before signing a contract with a dental benefit organization. PMID- 3269024 TI - Measurement of membrane potential responses elicited from blood cells: effect of the dye/cell ratio and the presence of an intracellular calcium probe. PMID- 3269025 TI - The dynamics and relationship of K+ efflux and Ca++ influx in B lymphocytes after antigen-receptor cross-linking. PMID- 3269026 TI - The events leading to secretory granule fusion. PMID- 3269027 TI - Examination, diagnosis and treatment planning for patients with periodontal diseases. PMID- 3269028 TI - Standardized quality oral hygiene instruction for the mechanical removal of bacteria and their products. PMID- 3269029 TI - AIDS in Texas Symposium to be held Oct. 22-23. PMID- 3269030 TI - UT School of Public Health receives $3 million grant for AIDS education. PMID- 3269031 TI - Periodontics--on the verge of a new era. PMID- 3269032 TI - Occlusal therapy and its role in the etiology and treatment of periodontal diseases. PMID- 3269033 TI - Re-evaluation of the periodontal patient. PMID- 3269034 TI - Referring a patient. PMID- 3269035 TI - Periodontal surgery--resection, regeneration and reconstruction of osseous tissue. PMID- 3269036 TI - Periodontal surgery--mucogingival aspects. PMID- 3269037 TI - Maintenance care for patients with periodontal diseases: a conclusion. PMID- 3269038 TI - PAID DENTAL update. PMID- 3269039 TI - Low occupational risk of AIDS. PMID- 3269040 TI - Regulation of breathing. PMID- 3269041 TI - Inspiratory response to occlusion of arteries in the ventral surface of the medulla in anesthetized cats. AB - By the occlusion of arteries in the ventral surface of the medulla, the blood supply to the central chemoreceptor for respiration was examined in anesthetized, paralyzed and peripheral chemodenervated cats. Phrenic nerve activities (P.N.A.), as an index of the respiratory center output, increased with an injection (3 ml/min, 10 sec) of hypercapnic blood (PCO2 = 104.5 mmHg) into the vertebral artery (VA injection response). The VA injection responses during occlusion of arteries in the ventral surface of the medulla were classified into three groups: 1) The response disappeared by the bilateral occlusion of the anterior inferior cerebellar arteries (AICA) in 8 out of 29 cats. 2) The response disappeared by the occlusion of both AICA and the posterior inferior cerebellar arteries (PICA) in 9 cats. 3) The response did not disappear in spite of the additional occlusion of several branches from the basilar artery in 11 cats, although the response had diminished. These different results may be due to the complexity of the central chemosensitive structure or of the central vascular system. However, among arteries the AICA blood flow seemed to be most preferentially related to the VA injection response. Thus, at least a part of the central chemosensitive structure may be located in the area perfused by the AICA. PMID- 3269042 TI - Effect of external cues for pedal pacing on breathing pattern during cycle exercise. AB - Fourteen subjects performed cycle exercise at work loads of 0 and 1 kp, each for 3 min, during which the pedal rate was kept constant by various external cues. Six cues were used in order: no cue (N1), a speedometer dial (S), a flashing light (F), a verbal command (V), a metronome sound (M) and no cue, again (N2). An attempt was to study the effect of these cues on breathing pattern in a lower tidel volume (VT) range during exercise, actually VT increasing to 2 times the resting levels. In N1 and N2, exercise was performed at preferred pedal rates, which were 40 +/- 4 (mean +/- S.E.)rpm and 52 +/- 2 rpm, respectively. Pedaling to other four cues was kept at 50 rpm. Ventilatory responses during exercise were similar in all conditions of cue except N1. Increases in respiratory frequency (f) during exercise were similar in S but greater in F at 0-kp load and in V and M at 1-kp load, compared with N2. The greater increases in f in F, V and M were due to greater shortening in inspiratory (T1) and expiratory (TE) durations. In any conditions of cue, T1 and TE decreased with increasing VT in response to exercise. The present study indicates that (1) breathing pattern during rhythmic exercise is affected by external rhythmic stimuli like F, V and M, and (2) there is no such a VT range that TI and TE remain constant in the VT-TI and VT-TE relations during exercise. cycle exercise: rhythmic cue during exercise; breathing pattern. PMID- 3269043 TI - Medullary inspiratory neurons with stable respiratory rhythm and little correlation to phrenic high-frequency oscillation. AB - Respiratory neurons with a highly stable rhythm have been proposed to be involved in the central neural mechanism responsible for the respiratory rhythmogenesis. In the present study it was examined whether the stably discharging inspiratory neurons are related to the high-frequency oscillation (HFO) in the phrenic nerve activity. Experiments were performed on 27 vagotomized rabbits anesthetized with diethyl ether, immobilized with gallamine triethiodide, and ventilated artificially. Spike-triggered averaging was used to evaluate the degree of the correlation between inspiratory unit spikes and the phrenic HFO. Twenty out of the 35 inspiratory units examined were related to HFO and were located in the medullary reticular formation (n = 19; n, number of units) and in the vicinity of the nucleus tractus solitarius (n = 1). The correlation to HFO decreased after the intravenous injection of thiamylal. The inspiratory units with little correlation to HFO were located in the reticular formation of the pons (n = 3) and medulla (n = 12). The inspiratory neurons with a stable respiratory rhythm (n = 4) had little correlation to HFO and located in the lateral region of the medullary reticular formation. These results suggest that the central neural mechanisms responsible for phrenic HFO are not directly related to the respiratory rhythmogenesis. PMID- 3269044 TI - The origin of the initial abrupt increase in ventilation at the onset of muscular exercise (phase 1) in man. AB - Ventilation and cardiac output in response to four different exercises, namely, volitional pedalling using a bicycle ergometer with a very mild (7 Watt) load, passive pedalling, electrically-induced isometric twitches of one leg, and voluntary twitches simulating the previous electrical twitches, were measured simultaneously during the transient phase from rest. Cardiac output was determined by automated impedance cardiography. A sudden increase in ventilation was observed immediately after the onset of the volitional and passive pedalling whereas cardiac output increased only gradually. Only a slight difference was observed between the cardio-ventilatory responses to volitional and passive exercises. Neither ventilation nor cardiac output changed significantly in response to volitional and electrical twitches of one leg. Conclusions were then drawn that the cardio-dynamic process could be ruled out as the origin of the initial ventilatory response, and instead, other neurogenic mechanisms mediated either centrally or peripherally, should be considered. PMID- 3269045 TI - Effects of prolonged physical training on ventilatory response to hypercapnia. AB - In order to determine whether or not resting ventilatory response to hypercapnia is changed by physical training, we studied the effect of long-term physical training on the slope of ventilatory response to CO2 at rest. The subjects were 9 untrained freshmen ranging in age from 18 to 20 years. Five out of nine subjects belonged to the badminton team after entering university in April 1980, and participated in their team's training for about 3 hr per day, 3 times a week year round for about 4 years until March 1984. Maximum oxygen uptake (VO2max), maximum pulmonary ventilation (VEmax) and maximum heart rate (HR max) were determined during maximal treadmill exercise before and after training. The slope (S) of ventilatory response to carbon dioxide at rest was measured by Read's rebreathing method. VO2max increased after training in the trained subjects and mean values of VO2max which were measured in 1982, 1983, and 1984, were statistically higher than that of 1980. Similar tendency was observed in VEmax and VO2max/W. Average values and standard deviations of S before training were 1.91 +/- 0.52 liter/min/torr and were decreased gradually with increasing training period; the differences in the S value before (1980) and after training, i.e., 1982, 1983, and 1984, were all significant. Such difference could still be seen after S was recalculated as SN by using normalized ventilation for 70 kg body weight, while there were no significant differences in the S and SN between baseline and repeated studies in the untrained group. In addition, CO2 responsiveness was found to correlate negatively with maximum oxygen uptake in 4 out of the 5 trained subjects. These results suggest that in normal subjects, long-term physical training, as in the present study, decreases CO2 responsiveness at rest. PMID- 3269046 TI - Home sleep monitor for detecting apnea episodes by nasal flow and tracheal sound recordings. AB - We have developed a portable home sleep monitoring system using nasal airflow (NA), tracheal sound recordings (TSR), and electrocardiogram (ECG). NA was recorded by two thermisters. TSR was recorded by a microphone attached to the skin overlying the cervical trachea. Three kinds of signals were recorded with a cassette recorder. Thirty-seven outpatients who had sleep complaints were monitored during sleep at home using this recorder. Attachment of the pickups was performed by the patients themselves. Recordings were played back and analyzed by a personal computer to evaluate apnea episodes from TSR and R-R intervals beat by beat. This home monitoring system had labor-saving and cost-saving benefits and seemed to be a satisfactory technique for screening. PMID- 3269047 TI - Effect of sleep position on obstructive sleep apnea. AB - In order to examine the effect of sleep position on sleep apnea episodes, seven male patients diagnosed as having obstructive sleep apnea syndrome without any organic complication of the upper airway were studied while lying in a supine or lateral position during an all-night polysomnographic study. Apnea index, apnea time/total sleep time (%) and the number of episodes per hour in which oxyhemoglobin saturation dropped below 85% decreased significantly from 51.0 +/- 8.6 (mean +/- S.D.) events/hr, 40.4 +/- 5.8% and 36.2 +/- 9.8 episodes/hr during sleep in supine position to 27.6 +/- 9.1 events/hr, 19.4 +/- 6.0% and 12.9 +/- 5.3 episodes/hr during sleep in lateral position, respectively. Lowest oxyhemoglobin saturation increased significantly from 70.7 +/- 2.6% to 78.0 +/- 2.4%. Thus, sleep in the lateral position may be a simple treatment before essential treatment for patients with obstructive sleep apnea syndrome. PMID- 3269048 TI - Abnormal breathing patterns in patients with mitral stenosis: a possible compensatory role. AB - The breathing patterns of 37 patients with mitral stenosis were investigated in standing position by Konno-Mead analysis. Hemodynamic parameters were measured by cardiac catheterization, pulmonary function variables by pulmonary function testings and distribution of pulmonary perfusion by Tc-99m-MAA scintigraphy. Seventeen patients displayed rib cage dominant breathing patterns, and 6 patients displayed paradoxical breathing patterns, whereas 14 patients displayed normal breathing patterns. None of these patients exhibited an abdomen dominant breathing pattern. The patients with abnormal breathing patterns (rib cage dominant or paradoxical) displayed significantly higher values of pulmonary arterial pressure (p less than 0.01), capillary wedge pressure (p less than 0.01), total pulmonary vascular resistance (p less than 0.01) and mitral valve gradient (p less than 0.05) as well as smaller mitral valve area (p less than 0.05) and lower values of both in PaO2 (p less than 0.05) and diffusing capacity (p less than 0.05) than patients with normal breathing patterns. Abnormal distribution of pulmonary perfusion with hyperperfusion in the upper zone of the lung were found to be associated with the abnormal breathing patterns. Since rib cage dominant and paradoxical breathing patterns are known to increase ventilation in the upper zone of the lung, these abnormal breathing patterns may represent a compensatory mechanism serving to match ventilation and perfusion. PMID- 3269049 TI - Effect of aminophylline on ventilatory response to hypercapnea in patients with asthma. AB - The nature of ventilatory response to CO2 in patients with airway obstruction is controversial. Although the bronchodilating effect of aminophylline has been well documented, its effect on direct stimulation of breathing has not been systematically evaluated. Therefore, the effect of intravenous aminophylline on ventilatory response to CO2 of patients with asthma was studied by comparing with that of the healthy subjects. Ventilation (VE) at rest was not significantly different between in asthmatics and healthy subjects, and mouth occlusion pressures (P0.1) at rest was significantly higher in asthmatics than in healthy group (p less than 0.05). P0.1 after aminophylline increased significantly (p less than 0.05) compared to control value in asthmatics. Changes in VE and P0.1 relatively correlated well in both groups before and after aminophylline (r = 0.58). Ventilatory response to CO2 (VE/PA CO2) and P0.1 response to CO2 (P0.1/PACO2) in asthmatics were slightly increased, but not significantly different from those in the healthy group before and after aminophylline. These findings suggest that aminophylline might be effective in enhancing ventilatory response to CO2 in asthmatics than in healthy subjects, because of its bronchodilating effect and stimulation to the respiratory neurons. PMID- 3269050 TI - Mouth occlusion pressure as a useful indicator for weaning from mechanical ventilation. AB - We studied the usefulness of the neuromuscular inspiratory drive (P0.1) and P0.1 normalized by ventilation (sP0.1) as indicators for weaning from mechanical ventilation. The patients were classified into two groups on the basis of outcome: a successful group who could have weaning and an unsuccessful group who could not be free from mechanical ventilation. The unsuccessful group showed significantly greater P0.1 (6.35 +/- 2.95 cmH2O) than successful group (2.81 +/- 1.21 cmH2O). The patients who failed in weaning also showed an increase in sP0.1 which would mean an increase in respiratory impedance. These results suggest that P0.1 and sP0.1 might be useful to follow the time course during weaning from mechanical ventilation. PMID- 3269051 TI - Relationships among panic-fear personality, aging, and ventilatory activity. AB - We have studied 204 healthy male subjects ranging in age from 20 to 59 years. They were divided into four 10-year age groups. Each age group was further divided into 2 subgroups with high and low Panic-Fear scores. The ventilatory activities of all the groups were compared. In the younger generation (20-39 years), the low PF group revealed a higher slope in CO2 response curve than the high PF group (p less than 0.05). This result was considered to be related to the difference in CO2 production between the two groups. In the older age groups, however, the high PF subjects exhibited a tendency to increase the CO2 response slope with increasing ages. This contradictory result was thought to be due to the age dependent change in biogenic amine activity. PMID- 3269052 TI - Electrophysiological properties of respiratory laryngeal motoneurons and effects of thiopental. AB - Transmembrane potentials of the respiratory laryngeal motoneurons were recorded in decerebrate, vagotomized and paralyzed cats. Twenty inspiratory and thirteen postinspiratory neurons were identified. Periodic membrane potential (MP) fluctuations as well as patterns of postsynaptic potentials (PSPs) were characterized in each type of neurons by measuring the input resistance and injecting Cl- to reverse inhibitory PSPs. On the basis of PSP patterns, two subtypes of inspiratory neurons could be distinguished. Thiopental (2-3 mg/kg, i.v.) produced depolarization together with reduction of firing in most laryngeal neurons. Excitatory and inhibitory PSPs were both depressed and MP fluctuations became smaller in each phase of the respiratory cycle. Elevation of the firing threshold and separation of IS-SD spikes often occurred after thiopental. These results suggest that thiopental depresses the laryngeal motoneuron through inhibition of synaptic transmission and of spike generation. PMID- 3269053 TI - Stereotyped phrenic response to laryngeal afferent volleys: the mechanism and anesthetic sensitivity. AB - The stereotyped reflex changes in phrenic discharge, produced by train(s) of electrical shocks to myelinated afferents in the internal branch of the superior laryngeal nerve (SLN), were studied in vagotomized cats and rabbits, mechanically ventilated with the mixture of oxygen and nitrous oxide. Single weak shocks caused a short latency (4-5 msec) phrenic response, an excitation followed by a slight inhibition for 10 msec, which was repeatable at a rate of 200 Hz or more. Repeated weak shocks at a rate higher than 100 Hz or single stronger shocks caused a powerful inhibition with a limited duration (25-30 msec) of both the central inspiratory activity (CIA) and short latency response. This stereotyped inhibition, which was followed by a rebound excitation, could occur every 30-50 msec with some reduction and was apparently associated with a decreased slope of integrated phrenicogram. During inhalation of halothane (0.5-1.5%), the short latency phrenic response was reduced, while the stereotyped inhibition and the reduction of phrenic augmentation were markedly enhanced when the CIA was slightly depressed by halothane inhalation. Therefore, the stereotyped inhibition produced by myelinated laryngeal afferents. PMID- 3269054 TI - Responses to severe hypoxia of phrenic and recurrent laryngeal nerve activity in vagotomized cats. AB - We investigated changes in activities of phrenic nerve (PN) and the recurrent laryngeal nerve (RLN) during progressive hypoxia produced by administration of a mixture of 5% O2 in N2 and a mixture of 5% O2 in N2O in 8 vagotomized, paralyzed, and artificially ventilated cats anesthetized with halothane. During progressive hypoxia produced by administration of 5% O2 in N2, both PN and RLN activities initially increased and then decreased at approximately the same rate. The relationship between PN and RLN activities during the respiratory stimulation and the relationship between PN and RLN activities during the depression due to hypoxia were both linear and were represented by the same linear regression line. The responses of PN and RLN activities to progressive hypoxia produced by administration of 5% O2 in N2O were basically similar to those observed during administration of 5% O2 in N2 although a concomitant increase in depth of anesthesia with N2O enhanced the occurrence of hypoxic respiratory depression. These results suggest that the respiratory modulation of recurrent laryngeal motoneuron activity is closely related to that of phrenic motoneuron activity and that both motoneurons share similar control mechanisms. Neither severe hypoxia nor addition of N2O to a halothane-anesthetized cat seems to affect the close linear relationship between PN and RLN activities. PMID- 3269055 TI - Effects of high-frequency inflation (HFI) on expiratory activity. AB - It has been reported that triangular-shaped positive pressure pulses applied to the airway (high-frequency inflation, HFI) stimulates pulmonary stretch receptors and prolongs expiratory duration. In the present experiment, changes in the integrated curve of expiratory activity induced by HFI were investigated. Duration until the onset of the expiratory activity (E1 stage) was unchanged. In the E2 stage, the initial ascending slope became steeper and higher peaks were reached during HFI stimulation. The period from the onset of the slope to the peak, previously designated the stage of active expiration (Ea stage), showed no consistent change in duration and remained unchanged on average. The period after the peak until the onset of the following inspiratory activity was consistently prolonged. This period was designated the declining stage of expiration (Ed stage). PMID- 3269056 TI - Effect of vagus nerve cooling on hypercapnic and hypoxic ventilatory responses in anesthetized dogs. AB - We studied ventilatory responses under hypercapnic and hypoxic conditions in 18 lightly anesthetized dogs, using a vagus nerve cooling technique. One side of the cervical vagosympathetic trunks of dogs were previously severed, and a copper cooling probe was attached to the other side. When the cervical nerve was cooled below 7 degrees C, Hering-Breuer inflation reflex ceased. We found that when the vagus nerve was not cooled or cooled up to 7 degrees C, the respiratory frequency increased significantly in relation to hypercapnic gas inhalation. However, the increment of respiratory frequency was reduced by bilateral cervical vagotomy. On the other hand, the respiratory frequency in response to hypoxia increased significantly, even when bilateral vagotomy was done. The increment of the tidal volume in response to hypercapnic gas inhalation was reduced by the Hering-Breuer inflation reflex. We found that the effect of the vagus nerve on respiratory regulation was different between hypercapnic and hypoxic gas inhalation. PMID- 3269057 TI - Arterial H+ as a determinant for interindividual variability of respiratory chemosensitivity to hypoxia in man. AB - Ventilatory response to normocapnic progressive hypoxia (A/BSA) was measured in 76 healthy males to examine how arterial blood gases and acid base status are involved in interindividual variability of hypoxic chemosensitivity. A/BSA and HCO3- were significantly higher in Group 1 (26 subjects, mean age = 15.8 +/- S.D. 0.9 years) than those in Group III (26 subjects, mean age = 46 +/- 7.1 years). A/BSA and HCO3- in Group II (24 subjects, mean age = 29.8 +/- 6 years) were in the middle of Groups I and III. Arterial blood gases and H+ were similar among the 3 groups. Arterial H+ correlated inversely with A/BSA (subjects with lower arterial H+ on air had higher hypoxic response) in Group I, while the correlation was positive (subjects with higher H+ on air had higher hypoxic response) in Group III. The correlation was not seen in Group II. PaCO2 and H+ correlated positively in the 3 groups. Intrasubject stability was equivalent among H+, PaCO2, and HCO3- (mean coefficients of variation = 1.81, 1.83, and 1.65, respectively), but smaller than that in PaO2 (3.28%). These results indicate that interindividual variability in hypoxic ventilatory response is related to arterial H+ in adolescent and middle age groups but the relation is opposite between the 2 groups. PMID- 3269058 TI - [Mercury contamination in Transvaal dental practices]. PMID- 3269059 TI - Malignant hyperthermia and the dental practitioner. PMID- 3269060 TI - Dentistry's negative image--a self-fulfilling prophecy. PMID- 3269061 TI - General practitioner's radiology casebook VII. Mandibular fibrous dysplasia. PMID- 3269062 TI - Patterns of variability in the South African Negro dentition. PMID- 3269063 TI - Pathological conditions detected on panoramic radiographs of two Johannesburg populations. PMID- 3269064 TI - General practitioner's radiology casebook VIII. Oral squamous cell carcinoma. PMID- 3269065 TI - Hypnosis in dental practice: from awkward add-on to smooth integration. PMID- 3269066 TI - Oral manifestations of nutritional anaemias: a case report. PMID- 3269067 TI - Enamel fluoride distribution in human maxillary permanent first molars. PMID- 3269068 TI - General practitioner's radiology casebook IX. Odontome. PMID- 3269070 TI - Safety of dental amalgam. PMID- 3269069 TI - Recommendations: dental mercury hygiene. PMID- 3269071 TI - Resorption of the mandibular residual ridge related to the gonial angle: a radiological assessment. PMID- 3269072 TI - Determination of the gamma-2 phase in a South African dispersed phase amalgam alloy. PMID- 3269073 TI - General practitioner's radiology casebook X. Fibrous dysplasia of the maxilla and zygoma. PMID- 3269074 TI - Behavioural characteristics in relation to oral health status of patients seeking dental care in Transkei. PMID- 3269075 TI - The training of dental manpower in South Africa. PMID- 3269076 TI - The Dental Association of South Africa. Committee on Preventive Dentistry. A health education package for dentistry. PMID- 3269077 TI - [The Dental Association of South Africa. Committee on Preventive Dentistry. Comparison of methods of infectious endocarditis prevention]. PMID- 3269078 TI - General practitioner's radiology casebook XII. Maxillary sinus carcinoma. PMID- 3269079 TI - [Biophotometric bases of use of laser beams in conservative and surgical stomatology]. PMID- 3269080 TI - [Stomatological components of an integrated program for prevention of non communicable chronic diseases]. PMID- 3269081 TI - Present and future means of caries control. PMID- 3269082 TI - [Clinical longitudinal studies on the influence of therapy with fixed bridges on oral hygiene and marginal periodontium]. PMID- 3269083 TI - [Determination of need for orthodontic treatment from social-hygienic aspect]. PMID- 3269084 TI - [Properties and clinical application of dental implants of Bionit aluminium oxide ceramic]. PMID- 3269085 TI - [Cariogenic significance of acidity characteristics of Streptococcus mutans]. PMID- 3269086 TI - [Social milieu and the employment of dental manpower systems]. PMID- 3269087 TI - [Care programme for the adult population in Karl-Marx-Stadt to the year 2000. Sample of regions with effective prevention over a long-term period]. PMID- 3269088 TI - [Microbiological-histological controlled treatment study for evaluation of efficacy of one step and stepwise excavation of deep carious lesions]. PMID- 3269089 TI - [Dynamics of caries increment of children age 6 to 14 in the district of Rostock]. PMID- 3269090 TI - [Verification of microorganisms in dentin of filled teeth by comparison of light, transmission electron and scanning electron microscopy]. PMID- 3269091 TI - [Caries limiting effectiveness of newly developed fluoride-containing gels after 3 years clinical use in preschool years]. PMID- 3269092 TI - Restorative problems: some periodontic and orthodontic solutions. PMID- 3269093 TI - Dental malpractice suits rise sharply. PMID- 3269094 TI - Oh, those icy fingers! PMID- 3269095 TI - House bill authorizes AIDS training, residences. PMID- 3269096 TI - New AIDS journals available. PMID- 3269097 TI - AIDS policy uncertain. PMID- 3269098 TI - Global fallout distribution in fireplace ashes. PMID- 3269099 TI - Recovery of ethanol-induced impairments in receptor-mediated endocytosis of asialoorosomucoid in isolated rat hepatocytes. PMID- 3269100 TI - The significance of fibrotic tight strictures of the ileum in Crohn's disease. PMID- 3269101 TI - Catheter ablation of ventricular tachycardia. PMID- 3269102 TI - The declining applicant pool. PMID- 3269103 TI - Roseto, Pennsylvania 25 years later--highlights of a medical and sociological survey. PMID- 3269104 TI - The Gordon Wilson lecture. Mutations in type I procollagen genes. An explanation for brittle bones and a paradigm for other diseases of connective tissue. PMID- 3269106 TI - Attitudes toward microcomputers in dentistry. PMID- 3269105 TI - On the pathogenesis of angina pectoris and its silence. AB - Recent interest in silent angina deals in a sense with a double unknown since the pathogenesis of angina pectoris remains unexplained. In this report, we present evidence from two human postmortem studies and from experiments conducted in eleven awake dogs which supports a hypothesis that angina pectoris may be mediated by an intracardiac chemoreceptor receiving its primary blood supply from the proximal coronary circulation. The clinical events and the postmortem findings in both human subjects supported the hypothesis. The somatic responses observed in the awake dogs resembled those of humans with angina pectoris. Because the cardiogenic hypertensive chemoreflex in dogs is maximally elicited by serotonin normally carried by the platelets and released during their aggregation, angina pectoris as well as numerous other clinical events observed during acute myocardial ischemic episodes could be similarly explained as consequences of the activation of a coronary chemoreceptor in man. Thus, at least some and possibly most examples of angina pectoris may be mediated via the coronary chemoreceptor and vagal afferents to the brain, and injury or destruction of this chemoreceptor could interdict the perception of anginal pain. PMID- 3269107 TI - The effects of sodium chloride on the reduction of the gag reflex. PMID- 3269108 TI - [Endoscopy and complementary procedures in children. Second international symposium of the Pediatric Surgery Clinic of the University of Munster. 5-7 November 1987. Proceedings]. PMID- 3269109 TI - Bronchoscopy performed by the anaesthesiologist in children with severe airway problems. PMID- 3269110 TI - Neonatal bronchoscopy. PMID- 3269111 TI - The role of developmental disorders in chronic recurrent respiratory diseases in infants. PMID- 3269112 TI - [Laryngo-tracheo- and bronchial diagnosis and therapy in pediatric surgery]. PMID- 3269113 TI - [Value of bronchial lavage and broncho-alveolar lavage in bronchial asthma in childhood]. PMID- 3269114 TI - [Types and significance of tracheal stenoses]. PMID- 3269115 TI - [The status of surgical and endoscopic treatment procedures in treatment of portal hypertension in children]. PMID- 3269116 TI - [Bronchoscopic local treatment of pediatric bronchial lymph node tuberculosis with lymph node invasion]. PMID- 3269117 TI - [Changes in the tracheobronchial tree of children with esophageal atresia]. PMID- 3269118 TI - [Indications for bronchologic study in children and adolescents]. PMID- 3269119 TI - [Extraction without forceps of tracheo-bronchial foreign bodies in children]. PMID- 3269120 TI - [Thoracoscopy in children]. PMID- 3269121 TI - [Intraoperative endoscopy in children]. PMID- 3269122 TI - [5 years' experience with endoscopic studies in children--value in diagnostic assessment]. PMID- 3269123 TI - [Endoscopic percutaneous placement of a bouginage guide for dilatation treatment of the esophagus following 3d degree chemical burn]. PMID- 3269124 TI - Endoscopic treatment of oesophageal stenosis in children. PMID- 3269125 TI - Evaluation of motility disorders in caustic oesophagitis. PMID- 3269126 TI - Endoluminar sclerotherapy (ES) of oesophageal varices: technique and preliminary results. PMID- 3269127 TI - Campylobacter pylori in children: endoscopic and histopathologic investigations. PMID- 3269128 TI - [ERCP in children]. PMID- 3269129 TI - [ERCP and associated methods in children--cases from a personal patient sample]. PMID- 3269130 TI - Non-hereditary relapsing pancreatitis and malformation of the spine in an eleven year-old girl. PMID- 3269131 TI - Paediatric colonoscopy--an experience of 102 cases. PMID- 3269132 TI - Endoscopic criteria of Crohn's disease in childhood and adolescence. PMID- 3269133 TI - Congenital strictures of anterior urethra in childhood. PMID- 3269134 TI - Urethroscopy and uroflowmetry in the postoperative follow-up of hypospadias. PMID- 3269135 TI - Operative nephroureteroscopy in childhood--indications and techniques. PMID- 3269136 TI - Arthroscopy of the injured knee in children. PMID- 3269137 TI - [Arthroscopy in children--an outmoded diagnostic procedure?]. PMID- 3269138 TI - [Bronchoscopy in childhood--implications for anesthesia]. PMID- 3269139 TI - [Anesthesia problems in pediatric bronchoscopy]. PMID- 3269140 TI - [Early treatment of Class III malocclusion using chin-cups, functional appliances and protractors]. PMID- 3269141 TI - [What's new in ... periodontics]. PMID- 3269142 TI - [Periodontal treatment to cover local and generalized gingival retraction. Subpediculated connective tissue graft (report of 2 clinical cases)]. PMID- 3269143 TI - [Induced regression of established buccal carcinomas and suppression of dysplastic changes in the oral mucosa using oxygen radical generating systems: an objective study of glucose oxidase, horseradish peroxidase and hyperbaric oxygen]. PMID- 3269144 TI - [Ultrastructural study of skeletal muscle in the acromegalic patient]. PMID- 3269145 TI - [Microbiological composition of dental plaque from different areas of the mouth. 1. Preliminary results]. PMID- 3269146 TI - [Prevalence of hepatitis B in the Dental School Central University of Venezuela]. PMID- 3269147 TI - [The influence of mycoplasmas in periodontal disease]. PMID- 3269148 TI - [Effectiveness of 2 resins used as sealants]. PMID- 3269149 TI - [Resins in posterior teeth: clinical study]. PMID- 3269150 TI - [Effects of polishing of amalgam restorations. 2-year report of a clinical study]. PMID- 3269151 TI - [Progressive drawing of permanent human teeth]. PMID- 3269152 TI - [Planning in removable partial dentures]. PMID- 3269153 TI - [Notes on dental psychology, or the interdisciplinarity of psychology and dentistry]. PMID- 3269155 TI - [Candidiasis, the most frequent mycosis in dentistry]. PMID- 3269154 TI - [General anesthesia. A new dental school program in odontopediatric care]. PMID- 3269156 TI - [Early diagnosis of a cemento-ossifying central fibroma]. PMID- 3269157 TI - [Research as the center of a service teaching program: a concrete experience. (Zuata UCV program, Maraven, M.S.A.S.)]. PMID- 3269158 TI - [Teaching of epidemiology in the U.C.V. Dental School]. PMID- 3269159 TI - [The politics of health in the Venezuelan state]. PMID- 3269160 TI - [Notes on the production of services in Latin America]. PMID- 3269161 TI - [Extramural programs ... service-teaching 23 years]. PMID- 3269162 TI - [A mathematical model for a life expectancy table for permanent teeth]. PMID- 3269163 TI - [Dentistry and the total national educational process]. PMID- 3269164 TI - [Methodological criteria for professional dental education in Venezuela and Cuba]. PMID- 3269165 TI - [Oral health and the politics of prevention in Venezuela]. PMID- 3269166 TI - [Some reflections on community participation]. PMID- 3269167 TI - [Dentition and depression]. PMID- 3269168 TI - A reassessment of pregnancy staging. AB - A system of staging pregnancy that is directly related to normal development is proposed to replace the currently used 'trimester' system. If accepted, this concept of staging could be applied across species without the likelihood of a grossly incorrect assessment of the stage of development. In contrast to this, the division of a pregnancy into trimesters is based upon an accident of mathematics and bears no relationship to human development. The proposal is to divide pregnancy into three stages, termed 'horizons'. First is the 'embryonic horizon' from fertilisation until the end of the 8th week from fertilisation, i.e., 10 weeks from the first day of the last menstrual period (LMP). The 'early fetal horizon' extends from the end of the embryonic phase to the 25th week of gestation (i.e., 25 weeks from the first day of the LMP). This horizon is divided into the 'primitive phase' (up to the 15th week of gestation) and the 'transitional phase' (from the 15th to the 25th week of gestation). The 'late fetal horizon' extends from 25 weeks to beyond term and is divided into the 'premature phase' (from 25 weeks to 36 weeks of gestation), the 'mature phase' (36 weeks to term) and the 'post-mature phase' which extends from term to about 45 weeks of gestation. The importance of this phase is the fact that perinatal morbidity and mortality is proportional to the length of time the gestation continues beyond maturity. It must be stressed that the terms 'horizon' and 'phase' are intentionally imprecise. This is to emphasise that human development is a continuum and not a series of steps. PMID- 3269169 TI - [Esthetics and periodontology]. PMID- 3269170 TI - [Esthetic restoration of the incisal-canine sector: the role of forced eruption]. PMID- 3269171 TI - [Effect of prostaglandin E1 or E2 on wound healing of the rat gingiva. Ultrastructural study]. PMID- 3269172 TI - [Morphological study of occlusal fissures in lower primary molars--enamel thickness, depth, and angle]. PMID- 3269173 TI - [A study of palpation to determine premature tooth contact during tooth tapping. Part 3. Relationship between tooth displacement and ability to distinguish by palpation]. PMID- 3269174 TI - [Basic investigation using K6 diagnostic system. Part I. Monitoring three dimensional accuracy]. PMID- 3269175 TI - [A case of multiple supernumerary impacted teeth in the upper primary incisor region and long-term follow-up observation]. PMID- 3269176 TI - [Distribution of fluoride concentration in the thigh-bone of the rat]. PMID- 3269177 TI - [A case of resorption of mandible after augmentation mentoplasty with an alloplastic implant]. PMID- 3269178 TI - [Studies of articulation and accompanying tongue and mandibular movements before and after surgical correction of mandibular prognathism. Part 2. Tongue and mandibular movements during speech]. PMID- 3269179 TI - [A study of temporary filling materials--especially the effects on the soft tissue and the solubility of temporary filling materials]. PMID- 3269181 TI - [Histopathological changes of the periodontal tissues caused by impact forces]. PMID- 3269180 TI - [Studies on anaerobic bacteria from the root canals of patients with apical periodontitis, especially emphasizing the relations between clinical symptoms and the occurrence of bacteria]. PMID- 3269182 TI - [Porcelain-fused-to-palladium base dental alloys. Development and properties]. PMID- 3269183 TI - [Basic investigation using K6 diagnostic system. Part II. Changes in monitoring accuracy caused by varying magnet inclinations]. PMID- 3269184 TI - [A study on slight displacement of the mandible--influenced by supporting point location and occlusal forces]. PMID- 3269185 TI - [Properties of light-cured crown and bridge veneering resins]. PMID- 3269186 TI - [Comparison of hand instrument, ultrasonic and canal finder system for root canal cleaning and shaping]. PMID- 3269187 TI - [Electrochemical corrosion behavior of Ag-Pd alloys by heat treatment]. PMID- 3269188 TI - [A case of rapidly progressive periodontitis with craniomandibular disorder]. PMID- 3269189 TI - [Two cases of adenomatoid odontogenic tumor difficult to diagnose clinically]. PMID- 3269190 TI - [In vitro experiments with respect to the invasiveness of Propionibacterium acnes into human teeth]. PMID- 3269191 TI - [Effectiveness of ovariectomy on mineralization of bone and incisor teeth in rats]. PMID- 3269192 TI - [Three-dimensional analysis by simultaneous tomography of the bony space of the temporomandibular joint]. PMID- 3269193 TI - [Quantitative studies of blood flow kinetics of skin after irradiation with Nd YAG laser]. PMID- 3269194 TI - [Evidence of generation changes in face size of Indian families]. PMID- 3269196 TI - [Quantitative analysis of the image layer in the anterior region of rotational panoramic radiography]. PMID- 3269195 TI - [Errors in three dimensional measurements of dental casts using the Pindex system]. PMID- 3269197 TI - [Localization of Streptococcus intermedius in the sound teeth and gingival sulci]. PMID- 3269198 TI - [The effect of experimental mandibular separation on the mandibular condyle in growing rats]. PMID- 3269199 TI - [Histological, immunohistochemical and ultrastructural studies of the histiocytes in the lymphocytic follicles of mouse and rat cervical lymph nodes exposed to antigen]. PMID- 3269200 TI - [A clinical study on the light-cured direct relining material for denture base]. PMID- 3269201 TI - [Good results from early orthodontic treatment in two cases of laterally shifted mandible causing masticatory muscle pain in juvenile patients]. PMID- 3269202 TI - [A histological study of the effects of laser irradiation by "soft laser 632" on the oral mucosa, dorsal skin, knee joint, temporomandibular joint of rats and the dental pulp of humans]. PMID- 3269203 TI - [A case of specific prosthesis in a bilateral maxillectomy patient]. PMID- 3269204 TI - [Analysis of toys: 1. Lead, cadmium and barium migration. 2. Migration of coloring agents in artificial saliva]. PMID- 3269205 TI - [Epidemiological and trauma profile of Algerian pedestrian victims of traffic accidents]. PMID- 3269206 TI - [Early neonatal mortality in Belgium 1981. Analysis according to birth weight, mother's health status and father's social occupational group]. PMID- 3269207 TI - [Information on the composition of chemical preparations for sale on the Belgian market]. PMID- 3269208 TI - Homograft skin banking--current practices and future trends. AB - Homograft skin remains a very successful technique for covering major burns. This paper reviews current techniques of harvesting, microbiological testing, freezing and thawing of the skin, that lead to its optimal use. Recent advances, especially the use of homograft skin in combination with split skin and skin cultures, will add to the effectiveness of homograft skin application. PMID- 3269209 TI - Blepharospasm--patient's perspective. AB - It is difficult to determine which age group is hardest hit by BEB-Meige's: 30 to 45 years (lowest number although increasing), 45 to 60 years (largest group), or 60 to 75 years (second largest group). Each group feels it is hardest hit for different reasons. PMID- 3269210 TI - A method for evaluating systems of epidemiological surveillance. AB - Epidemiological surveillance is the systematic collection, analysis and dissemination of health data for the planning, implementation and evaluation of public health programmes. Established surveillance systems should be regularly reviewed on the basis of explicit criteria of usefulness, cost and quality; systems should be modified as a result of such review. Attributes of quality include: (i) sensitivity, (ii) specificity, (iii) representativeness, (iv) timeliness, (v) simplicity, (vi) flexibility and (vii) acceptability. To date, evaluation of surveillance systems has been limited in scope and content. The evaluation method proposed in this article offers an organized approach to the evaluation of epidemiological surveillance systems. The usefulness of a surveillance system is measured by whether it leads to prevention or control or a better understanding of adverse health events. The measure can be qualitative, in terms of the subjective views of those using the system, or quantitative in terms of the impact of surveillance data on policies, interventions or the occurrence of a health event. The cost of a system includes indirect as well as direct costs, and should be measured in relation to the benefits obtained, such as reduction of medical-care expenses and of time lost from work. All elements of the system should be included in the cost: data collection, analysis and dissemination. The sensitivity of a surveillance system is its ability to detect health events (completeness of reporting). Its specificity is inversely proportional to the number of false positives it reports. Reports of a disease that do not meet the case definition are false positives, and may result in resources being wasted in investigating them.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3269211 TI - Experience with the Exeter total hip replacement since 1970. AB - The satisfactory long-term radiographic appearances with the use of the collarless, smooth, polished, tapered stem encourage its continued use. With the same stem geometry shortly to become available with interchangeable heads, the capacity for the surgeon to change the bearings when polythene wear starts to become marked should address what certainly will emerge as one of the major long term problems of total hip arthroplasty. PMID- 3269212 TI - Determination of sulfobromophthalein excretion in rabbits. AB - The excretion of sulfobromophthalein (BSP) is determined by hepatic uptake (storage capacity) and secretion (transport maximum). We calculated the BSP excretion data in six rabbits by measuring the rate of rise of BSP at various infusion rates. The relative storage capacity was determined to be 0.34 +/- 0.13 mg.mg-1.dl-1.kg-1. The transport maximum was calculated to be 0.91 +/- 0.12 mg.min-1.kg-1. These results compare closely with previously reported results using more direct measurements that require anesthesia and surgical cannulation of the biliary tree. Repeated studies were easily performed. Our method provides a reliable and simple technique to study the effects of various conditions or substances on BSP excretion in conscious, unanesthetized rabbits. PMID- 3269213 TI - Penile gangrene: a separate entity from Fournier's syndrome? PMID- 3269214 TI - Anorexia nervosa and motherhood: reproduction pattern and mothering behavior of 50 women. AB - A follow-up carried out on an average 12.5 years after hospital contact of 151 patients with a former diagnosis of anorexia nervosa (AN), aimed at reproduction outcome. None of the 11 males had children. Fifty of the 140 women had given birth to a total of 86 children, which is approximately one third of the expected fertility. Involuntary childlessness was of the same size as found in the background population. The rate of prematurity among the offspring was twice the expected and perinatal lethality six times the expected. Mentally the mothers did well, both during pregnancy and the post partum period. They breast-fed their children for the same mean time as did other women, and the development of the children did not differ from that found in a background population. More women in the group of mothers than in the group of non-mothers had better scores of all round functioning at follow-up. PMID- 3269215 TI - Smoking, nonsteroidal anti-inflammatory drugs, and acetaminophen in gastric ulcer. A study of associations and of the effects of previous diagnosis on exposure patterns. AB - A study was conducted in Sydney, Australia to investigate whether the use of some nonaspirin nonsteroidal anti-inflammatory (anti-arthritic) drugs was associated with gastric ulcer in patients who had had neither a gastric nor a duodenal ulcer diagnosed previously (i.e., in new cases of peptic ulcer), and whether the use of anti-arthritic drugs, aspirin, acetaminophen, and cigarettes was influenced by the diagnosis of a peptic ulcer--either gastric or duodenal. Bleeding of gastric ulcer in new cases was studied in relation to smoking, use of aspirin or anti arthritic drugs, and age. The 417 patients in the study lived in Sydney and were interviewed between 1982 and 1985 after diagnosis of a gastric ulcer; 192 patients had had a gastric or duodenal ulcer diagnosed previously (i.e., were recurrent cases of peptic ulcer), and the remaining 225 patients were new cases to whom 411 community controls were matched on sex, age, and prestige of area of residence. In new cases, odds ratios of gastric ulcer were 5.0 for daily aspirin use and 2.3 to 5.4 for daily anti-arthritic drug use. Fewer recurrent cases than new cases had used aspirin daily (odds ratio (OR) = 0.5) or anti-arthritic drugs daily (OR = 0.5), and more recurrent than new cases had used acetaminophen daily (OR = 2.5). Among new cases, bleeding of gastric ulcer was less common in smokers (OR = 0.6), and more common in daily users of aspirin (OR = 2.1) and, to a lesser extent, in daily users of anti-arthritic drugs (OR = 1.5), and in patients aged 60 or more years (OR = 2.3) independent of usage of the above drugs. It is concluded that 1) the use of anti-arthritic drugs increases gastric ulcer risk; 2) diagnosis of a gastric or duodenal ulcer causes a decrease in the use of aspirin and anti-arthritic drugs and an increase in acetaminophen use, but does not change smoking habits; 3) aspirin use or advancing age may add to the risk of bleeding ulcer although the role of anti-arthritic drugs is less clear. PMID- 3269216 TI - HLA-B27-associated arthropathy in childhood: long-term clinical and diagnostic outcome. AB - We conducted HLA-B27 tissue typing assessments on 430 consecutive children whose main symptom at presentation to our clinic was arthritis/arthralgia. Eighty-five of them (20%) had the B27 antigen. Thirty-six of these children were reexamined after a mean followup period of 8.9 years. Although most had definable rheumatic diseases, only 2 met the New York criteria for ankylosing spondylitis (AS). Children with HLA-B27 and arthritis/arthralgia, although at increased risk of developing AS, have diverse diagnostic and clinical outcomes. The AS criteria used to diagnose the disease in adults may not be appropriate for use in children. PMID- 3269217 TI - Special report--request for comment. Guidelines for authors submitting reports of computer programs and a call for comments. PMID- 3269218 TI - The stability of health status in rheumatoid arthritis: a five-year study of patients with established disease. AB - We employed a health status measure to describe the outcomes of rheumatoid arthritis patients over five years. Of the 410 rheumatoid arthritis patients who were originally administered the Arthritis Impact Measurement Scales (AIMS), 299 completed a follow-up five years later. Data were analyzed using nine health status scales, three components of health status, and an overall arthritis impact item. Results for survivors indicated that there were no clinically important deteriorations in any of these measures. In fact, small improvements on most measures were found. The health status changes were similar for patients originally in a clinical trial and for those receiving routine specialty care. Age was found to positively relate to improvements in psychological status and overall arthritis impact, but we were unable to demonstrate any consistent effects of sex, marital status, education, or disease duration. Our results contrast with other studies that have noted major declines over time in the health status of patients with rheumatoid arthritis. Furthermore, level of education was not a major determinant of morbidity in this group. These results suggest that health status in certain patients with rheumatoid arthritis is more stable than previously thought. This has implications for both clinical practice and clinical research in rheumatology. PMID- 3269219 TI - Replacement of the transverse aortic arch during emergency operations for type A acute aortic dissection. Report of 26 cases. AB - In type A aortic dissection, the intimal disruption is located on or extends to the transverse arch in about 20% of patients. Replacement of the arch may then be necessary to avoid leaving an unresected, acutely dissected aorta and to prevent bleeding, progression of aneurysm, rupture, and ultimately reoperation or death. From 1970 to September 1987, 119 patients were operated on for type A acute dissection. Starting in January 1977, gelatin-resorcin-formaldehyde biologic glue was used in 91 patients to reinforce the dissected tissues at the suture sites. Among these 119 patients, 26 (ages 32 to 76 years) underwent replacement of the transverse aortic arch in addition to replacement of the ascending aorta. In 20 patients cerebral protection was achieved by profound hypothermia (16 degrees to 20 degrees C) associated with circulatory arrest (15 to 40 minutes, mean 27 minutes) during the distal anastomosis. In six patients the carotid arteries were selectively perfused with cold blood (6 degrees C) during moderate core hypothermia (28 degrees C) while cardiopulmonary bypass was discontinued (19 to 34 minutes, mean 25 minutes) to allow the prosthesis to be sutured without the distal aorta being cross-clamped. Moderate hypothermia avoided the long rewarming time necessitated by profound hypothermia. The hospital mortality rate was 34% (9/26). Two of the 20 patients subjected to profound hypothermia and circulatory arrest died during the operation and seven patients died of postoperative complications. No deaths or major complication were observed in the other six patients. Follow-up of the 17 survivors ranges from 3 to 90 months (mean 39). One patient died 6 months after the operation of cerebral hemorrhage. One patient is disabled by neurologic sequelae. Fifteen patients are in good clinical condition (New York Heart Association class I or II). Postoperative aortograms in 12 patients, and computed tomographic scans in all, have shown a stable repair of the transverse arch in all survivors but a persisting dissection of the descending aorta in 11 (70%). Growing experience and improving results in emergency operations for type A aortic dissection have led us to extend the replacement of the aorta to the transverse arch whenever necessary. The gelatin resorcin-formaldehyde glue has proved to be an efficient adjunct. The best cerebral protection was obtained in our experience by carotid perfusion with cold blood during circulatory arrest at moderate core hypothermia. PMID- 3269220 TI - Relief of sciatic radicular pain by sciatic nerve block. PMID- 3269221 TI - Students rank characteristics of the clinical teacher. PMID- 3269222 TI - Prospective study of asthma in relation to smoking habits among 14,729 adults. AB - The prevalence and incidence of asthma in relation to cigarette smoking habits was studied in a population of 14,729 Finnish adult men and women who participated in a postal health survey in 1975. Of those invited to participate in a new survey in 1981, 89.7% replied. Asthma was diagnosed on the basis of self reporting of asthma diagnosed by a physician and by record linkage to a national register of hospital admissions to all general and tuberculosis hospitals during 1972 and 1983. The prevalence of diagnosed asthma in 1975 was significantly higher among male smokers than among male non-smokers (relative risk (RR) = 1.73); no significant difference was observed for women (RR = 1.33). People with asthma were slightly but not significantly more likely to stop smoking during the six year follow up period (RR = 1.23). The incidence of asthma among those who had neither reported asthma in 1975 nor been admitted to hospital for asthma before the 1975 questionnaire study was not significantly higher among smokers than among non-smokers during follow up. Although possible mechanisms exist to explain how smoking could have a role in the aetiology of asthma, this study suggests that smoking is not a strong risk factor for asthma. PMID- 3269223 TI - Families' perceptions of burden of care for chronic mentally ill relatives. AB - Eighty-six family caregivers participated in small group interviews about their experience of burden in caring for mentally ill relatives. Families experienced profound burdens as a result of their interactions with the mental health care system, particularly in negotiating crisis situations; acting as patient advocates and case managers; obtaining adequate community resources, continuity of care, and information; dealing with legal barriers; and communicating with mental health professionals. Recommended methods of reducing family burden and improving the care of the mentally ill who reside in the community are family education, inclusion of the family in treatment decisions, changes in current mental health laws, redirection in professional training, and development of mobile crisis teams. PMID- 3269224 TI - The true function of the thymus. PMID- 3269226 TI - [The memorandum for asking continuously the essence of labour science]. PMID- 3269225 TI - [Effects of running approach distance on maximal anaerobic power by Margaria Kalamen test]. PMID- 3269227 TI - A preliminary study of walking bias phenomenon which is related to ring wandering. PMID- 3269228 TI - The radiographer's role in an early detection programme for breast cancer. PMID- 3269229 TI - Monitoring the dose to patients undergoing common x-ray examinations. PMID- 3269230 TI - Magnetic resonance imaging (MRI) of the orbit. PMID- 3269231 TI - CT scanning in congenital dislocation of the paediatric hip. PMID- 3269232 TI - New angles on the radiographic examination of the hand--III. PMID- 3269233 TI - Arcuate line integrity: an important sign in sacral metastatic disease. PMID- 3269235 TI - Time course of contact hypersensitivity to DNFB and histologic findings in mice. AB - This experiment pursued the time course of contact hypersensitivity to 2,4 dinitro-1-fluorobenzene (DNFB) and histologic changes of the cutaneous reaction in mice. The contact hypersensitivity reached a maximum 4 days after sensitization (96.9 +/- 6.7% vs. 22.7 +/- 1.3% in control) and persisted for 3 weeks. The cutaneous hypersensitivity reaction showed peak reactivity at 24 hr after challenge (96.2 +/- 4.7% vs. 11.5 +/- 1.7% in control), and persisted up to 96 hr (13.2 +/- 2.1%). Prime histologic changes observed in this experiment were the exocytosis of lymphoid cells and epidermal thickening which appeared at 20 hr after challenge. Edema, vasodilatation and increased mast cells were observed within the dermis at 4-8 hr. However, edema and vasodilatation disappeared gradually, but numbers of mast cell increased up to 96 hr. The dermal infiltrates were maximum at the 28-72 hr after challenge. PMID- 3269240 TI - Myocutaneous flaps in general surgery. AB - In recent developments in the repair of large surgical defects where simple flap rotation may have been previously employed, myocutaneous flaps are being used because of functional advantages and to decrease the number of reconstructive procedures. The authors have employed myocutaneous flaps in 40 cases from January 1980 until April 1985 at Presbyterian Medical Center in Chonju. The primary disease was malignant in 31 cases and benign in 9 cases. Seven types of flaps were employed: The pectoralis major myocutaneous flap (20 cases); the trapezius myocutaneous flap (12 cases); the latissimus dorsi flap (2 cases); an osteomyocutaneous flap employing the sternocleidomastoid and clavicle (1 case); the gracilis myocutaneous flap (3 cases); the gluteus maximums myocutaneous flap (1 case); and a tensor fascia lata flap in one case. In more than 75% the skin island survived and an eventually successful result was obtained in 35 cases (87.5%). PMID- 3269241 TI - Renal arterial embolization with absolute ethanol. AB - Twenty separate infarction procedures with absolute ethanol were performed on eighteen renal tumors in seventeen patients at Department of Radiology, Seoul National University Hospital since 1982. Fifteen were hypernephroma cases and two were angiomyolipoma cases. The indications for renal infarction were the preoperative interruption of renal arterial flow in eight cases of hypernephroma, and primary therapy or palliation of symptoms in seven cases of hypernephroma and two cases of angiomyolipoma. Average 15ml of absolute ethanol was injected for renal arterial embolization at a rate of 1-2 ml/sec via balloon occlusion catheter or superselective administration technique. Though the long-term beneficial effect on survival was not confirmed, transcatheter embolization with absolute ethanol was suggested to be used as indispensible treatment in preoperative and inoperable or symptomatic cases of renal tumor. PMID- 3269242 TI - The nationwide epidemiological study of mental disorders in korea. AB - The lifetime prevalences of DSM-III mental disorders using Korean version of DIS III are presented. They were studied in 5,100 adults (aged 18 to 65) in household selected by two stage cluster sampling. Comparisons were made between regions, sex and age groups. International comparison with Epidemiologic Catchment Area program was also made. PMID- 3269243 TI - Antimicrobial susceptibility of bacteria isolated in 1985--with special reference to prevalence of methicillin-resistant staphylococcus aureus and activities of cefazolin, cefotaxime and piperacillin. AB - Antimicrobial susceptibility of nine species and one group of bacteria isolated from patients at the hospitals of Seoul National University, Severance, Hanyang University, and Kyungpuk University were tested by agar dilution method. S. aureus was most susceptible to cefazolin, methicillin and cotrimoxazole, and enterococci to ampicillin. Isolates of Enterobacteriaceae were most frequently susceptible to aminoglycosides and cefotaxime. Cefazolin susceptibility was markedly different from species to species. Aminoglycosides and piperacillin were more active than others against P. aeruginosa, and amikachin against A. anitratus. A large proportion of strains of several different species were conditionally susceptible to either tetracycline, ampicillin, cefazolin or cotrimoxazole suggesting the usefulness of these drugs for treatment of urinary tract infection. Activity of cefotaxime was highest against E. coli, and K. pneumoniae, while lowest against A. anitratus and P. aeruginosa. Decrease in the proportion of susceptible isolate was noted in E. coli and K. pneumoniae to cefazolin, K. pneumoniae, E. cloacae and S. marcescens to cotrimoxazole, and P. aeruginosa to tobramycin and gentamicin. PMID- 3269244 TI - Magnetic resonance imaging in neurologic diseases--comparison with computed tomography. AB - Magnetic resonance (MR) and computed tomography (CT) imagings were compared in 121 patients with various neurologic diseases. MR was performed with either 0.15 Tesla resistive or 2.0 Tesla superconducting systems developed by Korea Advanced Institute of Science and Technology (KAIST), using multi-slice spin echo technique with a variety of pulse sequences reflecting proton density, T1 and T2 relaxation times. MR was more advantageous in the detection of the lesions, accurate depiction of the lesion extents, and/or demonstration of anatomic details in sagittal or coronal plane in 36 of the 121 patients. These included white matter diseases, cervical cord tumors, syringomyelia, brain stem tumors, foramen magnum tumor, acute cerebellar infarction, Chiari malformation, isodense subacute subdural hematomas, cavernous hemangioma, A-V malformation with hemorrhage and some unknown pathologies. Even though 2.0T superconducting system showed greater capability of demonstrating the anatomic details and contrast discrimination between normal and abnormal tissues, the ability of MR to separate the tumor from the edema and to differentiate among different pathologic entities remained to be further evaluated. CT was superior to MR in 13 patients with acute intracranial hematomas, small calcific lesions, inflammatory granulomas or meningiomas. CT takes less time and may be preferable in very young or elderly patients. Both MR and CT gave equivalent information in the remaining patients. MR proved to complement CT in the evaluation of many disease entities and may actually supplant CT in some. PMID- 3269245 TI - Relationship between the result of preoperative pulmonary function test and postoperative pulmonary complications. AB - Good preoperative screening and evaluation of patients undergoing surgery is necessary because it serves to identify the individual who is at risk of increased intra-operative and postoperative morbidity and mortality. The retrospective study was done in an attempt to determine if abnormalities in preoperative pulmonary function, detected by routine pulmonary function tests, would predict which patients would suffer from pulmonary complications following surgery. Pulmonary complications in the postoperative period included fever, atelectasis and respiratory failure. The overall incidence of pulmonary complications from our 78 patients undergoing surgery was 37 percent based on clinical criteria. This incidence was high in patients with FEV1 less than 1.0 L/sec, MVV less than 40% of predicted value and PCO2 more than 45 mmHg. PMID- 3269246 TI - Menkes disease--an autopsy case with metal analysis of hair. AB - We report the first case of Menkes' disease in Korea, occurring in a 1 1/2 year old boy with characteristic clinical, arteriographic and pathologic features. Postmortem examination revealed widespread neuronal destruction and abnormally tortuous and elongated large arteries including cerebral, visceral and limb vessels. Microscopically, many of the hairs formed were twisted (pili torti), of varying caliber (monilethrix), and fractured (trichorrhexis nodosa). In the radioactivated analysis of scalp hair, copper elements was not found. The abnormal vessels were characterized by fragmentation and disruption of the internal elastic lamina with intimal proliferation. The neuronal destruction was widespread in the cerebral gray matter and in the cerebellum, and there was associated gliosis. The changes in the cerebellum were particularly severe, with neuronal loss in the internal granular cell layer. Many Purkinje cells were lost, and the remainder showed unusual dendritic sprouts from the cell body and grotesque proliferation of dendritic tree. In other organs, mild chronic peribronchitis, and scattered foci of immature glomeruli in renal cortex were noted. PMID- 3269247 TI - Postural relief of food impaction in a patient with stenosed esophagus--a case report. AB - A patient with past history of esophageal stenosis complained of sudden dysphagia in the erect position which was relieved transiently in the supine position. Initial esophagoscopy failed to detect any mass in the lumen. Esophagogram revealed shifting foreign body from lower stenotic site to upper dilated area with postural change from the erect to the supine position. A French bean was detected and removed during the second esophagoscopy. PMID- 3269248 TI - Adriamycin custom-tailored immunoconjugates in the treatment of human malignancies. AB - Twenty-three patients with disseminated refractory malignancies each received a tailored combination of adriamycin-conjugated murine monoclonal antibodies. Tumors were typed using a panel of antibodies. Cocktails of up to six antibodies were selected based on binding greater than 80% of the malignant cells as tested by immunoperoxidase and flow cytometry. These monoclonal antibodies were then conjugated to Adriamycin and administered intravenously. Seventeen of 23 patients had reactions to the administration of immunoconjugates, but these were tolerable in all but two patients. Fever, chills, pruritus, and skin rash were by far the most common transitory reactions. All were well controlled with premedication. In several patients there was limited antigenic drift among various biopsies within the same patient over time. This observation confirms the necessity for the use of a cocktail of antibodies if one wishes to cover all tumor cells. Preliminary serologic evidence suggests that the development of an IgM antibody, which is specific against the mouse monoclonal antibody, has the specificity and sensitivity to predict clinical reactions. Selected patients were re-treated. One patient with chronic lymphocytic leukemia had re-treatment on three occasions and demonstrated regression of peripheral lymph nodes. Two patients with breast carcinoma had definite improvement in ulcerating skin lesions and two patients with tongue carcinoma had shrinkage of their lesions. In the course of the study free Adriamycin released from the monoclonal antibodies was discovered to be a limiting factor in the amount of antibody that could be administered. Up to 1 g of Adriamycin and up to 5 g of monoclonal antibody were administered. The limiting factor appeared to be a variable dissociation of active Adriamycin from the antibody that unpredictably caused hemopoietic depression. This study demonstrates the feasibility and reviews technical considerations in preparing immunoconjugate cocktails for patients with refractory malignancies. The major technical hurdle appears to be the selection of an effective conjugation method that can be used to optimally bind Adriamycin to monoclonal antibodies for targeted cancer therapy. PMID- 3269249 TI - Continuous cell lines as substrates for biologicals: report of a joint meeting of WHO, IABS (cell Culture Committee Subsection), and ESACT. PMID- 3269250 TI - Fundamentally flawed? PMID- 3269251 TI - Toxicities associated with monoclonal antibody infusions in cancer patients. AB - The toxicity during and following 291 infusions of 19 murine and three human monoclonal antibodies (MoAB) in 177 cancer patients with 10 different malignancies was assessed. Doses ranged from 0.5 to 500 mg administered over 0.25 to 24 hours. Various reactions in varying degrees were observed in 45 (28%) patients during their first MoAb infusion. Nine additional patients experienced toxicity following a subsequent antibody infusion. Antibodies that reacted with circulating cells were associated with toxicity in 20 of 28 (71%) of the first infusions, compared to 24 of 127 (19%) for patients receiving antibodies that did not react with circulating cells. Fevers, rigors, chills, and diaphoresis were observed in 10% to 12% of the patients and were associated with binding to circulating cells. Presumed hypersensitivity reactions, including urticaria, pruritus, bronchospasm, and anaphylaxis occurred in 20 patients (11%). There were five episodes of bronchospasm and a single episode of anaphylaxis. Liver transaminases were elevated in 14%. There was no correlation between dose or infusion rate and toxicity. Murine monoclonal antibodies that are not conjugated to cytotoxic agents can be given with an acceptable frequency of side effects and serious allergic reactions. There is a small risk of anaphylaxis, and one should avoid rapid infusion of high antibody doses in the presence of circulating target cells and/or circulating free antigen. PMID- 3269252 TI - Report of two cases of acute myelogenous leukemia immunized with autologous leukemia-derived hybrid cells. AB - Reports that immunizations with leukemia-derived hybrid cells prolonged the survival of leukemic mice led us to attempt an analogous approach in two adult patients with acute myeloid leukemia (AML). Hybrid cells were prepared from the pretreatment marrows of the newly-diagnosed patients with D98OR cells, in the first case, and with KR12 cells, in the second case. (D98OR and KR12 cells are human cell-lines.) Hybrids formed with KR12 cells expressed HLA antigens of both parental sources and some of the clonal isolates expressed myeloid-associated determinants. The immunizations were performed during the first complete clinical remission; the patients were demonstrably immunocompetent. Positive delayed type hypersensitivity responses to both (X-irradiated) hybrid cells and to (X irradiated) autologous pretreatment marrow were observed following the immunizations. Mixed lymphocyte reactions toward autologous marrow were positive in one of the patients. In both, relapse occurred approximately two months after the first immunization and eight months after first diagnosis. The first patient remained in complete remission for two and one-half years following reinduction chemotherapy; reinduction chemotherapy was unsuccessful in the second patient. PMID- 3269253 TI - Neurotoxicity of prenatal carbon monoxide exposure. AB - Despite the very wide recognition that carbon monoxide (CO) is a significant neurotoxicant, the level at which subtle effects occur, and the existence of sensitive periods in development for such toxicity, has been undetermined. In terms of risk to the fetus, a potentially susceptible sub-population, there is concern, first, that the level of exposure at which neurotoxicity occurs may be different from the adult, and second, that the site of toxic action and subsequent neurotoxic effects of CO may be different in the immature and mature brain. The investigator studied the susceptibility of the developing brain to moderate levels of CO maintained chronically through the period of neuronal proliferation, and into the period of synapse formation. Carbon monoxide may be thought of as both a prototypical hypoxic agent, and a significant public health hazard in its own right. Carbon monoxide is a ubiquitous toxic agent that accounts for large numbers of deaths and significant morbidity in human populations. Subtle neurotoxic effects of this agent may be even more common, but they may go largely undetected, or fail to be associated with CO exposure. We have shown that prenatal CO exposure at moderate levels can produce significant neurotoxic effects in rats. The data obtained from the cerebellum and neostriatum, in particular, suggest that chronic, moderate perinatal CO exposure may disrupt neuronal proliferation and, perhaps, may disrupt certain markers for neurochemical transmission. PMID- 3269254 TI - Effects of nitrogen dioxide on alveolar epithelial barrier properties. AB - This study analyzed the effects of nitrogen dioxide (NO2) on alveolar epithelial permeability and transport properties. Primary cultured monolayers of rat Type II pneumocytes, cultured on both nonporous and porous surfaces, were used as models of isolated alveolar epithelium for in vitro exposure to nitrogen dioxide. The effects of nitrogen dioxide exposure for monolayers cultured on nonporous substrata were monitored by observing the changes in the net volume of fluid under the monolayer; for cells cultured on porous substrata, alterations in tissue bioelectric properties were noted. As a first step, primary cultured monolayers of rat Type II pneumocytes plated on nonporous plastic Petri dishes were used to investigate the effects of nitrogen dioxide on alveolar epithelial barrier properties. Such monolayers form fluid filled domes that are thought to result from active solute transport from medium to substratum, with water following passively. We used dome formation as a transport marker. Five-day-old cultures were directly exposed to 30 ppm NO2 in 5 percent CO2 in air at 25 degrees C, by cyclically tilting culture plates from side to side, so that both halves of the monolayer were exposed during each cycle. Exposures consisted of 10 cycles of four minutes each (two minutes per side), for a cell exposure time of 20 minutes. Control plates were simultaneously exposed to 5 percent CO2 in air under identical conditions. One day after the exposure, nitrogen dioxide-exposed monolayers exhibited significant decreases in dome density and individual dome volume, compared to the controls. By 48 hours post-exposure, differences between nitrogen dioxide-exposed and control monolayers were less, but remained significant. These results showed that short-term sublethal exposures to nitrogen dioxide produce a decrease in dome formation in Type II alveolar epithelial cell monolayers. This finding is most likely due to a decrease in the active transepithelial sodium transport rate, or an increase in the permeability of cell membranes or tight junctions, or both. Addition of vitamin E-containing liposomes to the culture media 24 hours pre-exposure did not affect the nitrogen dioxide induced decrease in dome formation, indicating that under these circumstances no protective effect was provided by the antioxidant.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3269255 TI - The effects of ozone and nitrogen dioxide on lung function in healthy and asthmatic adolescents. AB - The aim of this project was to investigate whether or not well characterized groups of healthy adolescents and adolescents with asthma differed in their sensitivity to ozone and nitrogen dioxide at near ambient concentrations of these pollutants. The project was divided into three phases. In each phase, ten healthy and ten asthmatic adolescents were exposed via a mouthpiece to three different atmospheres (filtered air, ozone, and nitrogen dioxide, at either 0.12 or 0.18 ppm) on separate days at least one week apart. During Phase I, subjects at rest inhaled the test atmospheres at 0.12 ppm for two 30-minute periods. The following pulmonary functional values were measured before, during, and after exposure: peak flow, total respiratory resistance, thoracic gas volume at functional residual capacity, maximal flow at 50 and 75 percent of expired vital capacity (performed with both room air and a helium-oxygen mixture), and forced expiratory volume in one second. Pulmonary function was not consistently altered in either the asthmatic or the healthy nonasthmatic adolescents as a result of the exposures. As a result, the study was repeated with the addition of ten minutes of exercise to the 30-minute rest exposure period (Phase II). In Phase II, small but significant increases in total respiratory resistance to all test atmospheres were seen after exposure at 0.12 ppm during exercise in both healthy and asthmatic adolescents. However, the increase in resistance between the groups of subjects was not statistically different. On the basis of these results, Phase III was conducted at higher concentrations of the pollutants (0.18 ppm). In Phase III, statistically significant changes were seen in average total respiratory resistance values in both healthy and asthmatic adolescents exposed to 0.18 ppm ozone while exercising. Again, the difference between the groups was not significant. Small decreases in average forced expiratory volume were found in healthy subjects exposed to ozone and filtered air. After exposure to nitrogen dioxide there was a 3 percent decrease in the forced expiratory volume in one second in asthmatic subjects. This change was not significant. It is concluded that there were no differences in pulmonary function responses between asymptomatic, allergic asthmatic adolescents and healthy adolescents exposed to either ozone or nitrogen dioxide under the conditions of these studies. However, an increase in total respiratory resistance was observed in both asthmatic and healthy adolescent subjects after their exercise exposure to 0.18 ppm ozone.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3269256 TI - Studies on the metabolism and biological effects of nitropyrene and related nitro polycyclic aromatic compounds in diploid human fibroblasts. AB - Nitro derivatives of polycyclic aromatic hydrocarbons are produced primarily as the result of incomplete combustion. Nitropyrenes have been identified as primary mutagenic compounds of diesel emission particulate and are tumorigenic in laboratory animals. Since nitropyrenes do not react directly with DNA, their effects presumably are mediated through cellular conversion of the parent compounds into reactive species. For example, 1-nitropyrene (1-NP) is activated by enzymatic reduction to 1-nitrosopyrene (1-NOP), followed by reduction to the hydroxylamine, which undergoes decomposition to yield a nitrenium ion, that reacts with DNA. The cytotoxic effects of 1-nitropyrene and 1-nitrosopyrene were compared in fibroblasts from normal persons, from excision-repair-deficient xeroderma pigmentosum (XP) patients, and from a patient with an inherited predisposition to malignant melanoma of the skin (hereditary cutaneous malignant melanoma [HCMM]). HCMM cells are more sensitive than normal cells to the cytotoxic and mutagenic effects of 4-nitroquinoline-1-oxide, and they form more DNA adducts per concentration of this agent than do normal cells. However, the HCMM cells exhibit the same sensitivity as normal cells to 4 hydroxyaminoquinoline-1-oxide, which suggests they are more capable than normal cells of metabolizing the parent compound into a more reactive form. On the basis of concentration, 1-NOP was much more cytotoxic than 1-NP. With both compounds, the normal cells exhibited a shoulder on their survival curves that was lacking for the XP cells. The dose of 1-NP giving 37% survival was 46 microM for a series of four normal cell lines, 22 microM for the HCMM cell line tested, and 12 microM for the XP cell line. The slope of the 1-nitropyrene survival curve for XP cells was 2.5 times steeper than the slope of the curve of the normal cells; the slope of the 1-NP survival curve for the HCMM cells was intermediate between the XP cells and the normal fibroblasts. The slope of the 1-nitrosopyrene survival curve for XP cells was also 2.5 times steeper than that for the normal cells, but the HCMM cells showed a normal response. If the resistance of normal cells to the cytotoxic effect of these compounds reflects their ability to remove potentially cytotoxic adducts from their DNA before these lesions cause cell death, normal cells should require a higher initial number of DNA adducts than XP cells do to cause a particular degree of cell killing.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3269257 TI - Respiratory infections in coal miners exposed to nitrogen oxides. AB - Coal miners working underground may be exposed chronically to low levels of nitric oxide and nitrogen dioxide from diesel engine emissions and from the use of explosives for blasting. The aims of this study were to establish whether long term exposures to low concentrations of these gases at nine British coal mines had been associated with increased susceptibility to respiratory infections and, if so, to estimate the relative risks for different levels of exposure. The nine mines concerned had been involved, since 1954, in a prospective epidemiological study of coal miners' health. Median levels of nitrogen oxides in 4,933 pairs of full-shift samples, taken at the mines during the years 1976 through 1982 were 0.2 ppm nitric oxide and 0.03 ppm nitrogen dioxide; 10 percent of the concentrations exceeded 1.1 ppm nitric oxide and 0.08 ppm nitrogen dioxide. Multiple regression estimates of concentrations associated with different underground locations, types of work, and mining conditions at each mine were combined with detailed records of miners' attendance at work at similar locations in earlier years. These retrospective estimates of individuals' underground exposures to nitrogen oxides referred to between five- and 16-year periods of exposure. Also available for study were records of the men's exposures to respirable mine dusts and information from five-yearly medical surveys about their smoking habits, respiratory symptoms, and questionnaire-elicited reports of sickness absences attributed, among other things, to respiratory infections. The reliability of the latter reports was examined in a sample of 471 of the men by comparing the answers to the questionnaire with physicians' diagnoses on certified sickness absence records. Miners' references to bronchitis, influenza, or colds as the cause of prolonged sickness absence during the three years preceding the surveys did, in general, reflect real spells of absence from work, lasting at least seven days, that had been diagnosed by doctors as due to respiratory infections. But only about 20 percent of the men whose colliery records indicated that there had been such an absence acknowledged them in the survey as due to a "chest illness". Most of the under-reporting was of absence certified as due to influenza, colds, or "upper respiratory tract infection", and this under-reporting was not related to the men's ages or smoking habits. The main analyses referred to 5,408 reports of colds, influenza, or bronchitis at a total of 40,071 interviews involving nearly 20,000 miners.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3269258 TI - Factors affecting possible carcinogenicity of inhaled nitropyrene aerosols. AB - Nitroaromatics in general, and 1-nitropyrene in particular, are potent bacterial mutagens and animal carcinogens. Their importance as possible human carcinogens is difficult to assess because they are usually found in the environment as the products of combustion processes, and so they usually exist with many other compounds associated with airborne particles. The experiments reported here were carried out to determine if the inhalation of particle-associated 1-nitropyrene, or the concomitant exposure to an irritant gas, would alter the tissue distribution of 1-nitropyrene or its metabolites, compared to their distribution after inhalation of pure 1-nitropyrene. These experiments were intended to yield insights into the mechanisms involved in the potential carcinogenicity of particle-associated nitroaromatics as inhaled in the environment from automotive emissions and other sources. Groups of Fischer 344 rats inhaled pure 14C-1 nitropyrene aerosols, with and without coexposure to 5 parts per million sulfur dioxide, or 14C-1-nitropyrene adsorbed onto gallium oxide particles, with and without coexposure to sulfur dioxide, for four weeks. Lung retention of 14C-1 nitropyrene was not prolonged by its association with gallium oxide particles or by coexposure to sulfur dioxide. There was a marked inflammatory and fibrogenic response to the gallium oxide particles. Another set of experiments was carried out in which rats were exposed to 14C-1-nitropyrene either as pure aerosol or adsorbed onto carbon black particles. The amount of 14C in the lung that was bound to carbon black particles steadily decreased with time after exposure, compared to total lung 14C, indicating removal of 14C from the particles. Thirty minutes after exposure, the amount of 14C covalently bound to lung macromolecules, expressed as a percentage of calculated deposited radioactivity, was twofold greater for 1-nitropyrene adsorbed onto carbon black than for 1 nitropyrene alone. The amount of covalently bound 14C increased with time after exposure to 14C-1-nitropyrene adsorbed onto carbon black, reaching a level of approximately 1 percent of deposited radioactivity, 10-fold greater than that seen with pure 14C-1-nitropyrene seven to 30 days after exposure. The level of covalently bound 14C declined steadily after exposure to pure 14C-1-nitropyrene. Carbon black particles associated with adsorbed 1-nitropyrene offer the potential of studying DNA adduct formation in the lung, because DNA modification might be greater after inhalation of 1-nitropyrene adsorbed onto carbon black than after inhalation of pure 1-nitropyrene or 1-nitropyrene associated with metal oxides, such as gallium oxide.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3269259 TI - Maximal aerobic capacity at several ambient concentrations of carbon monoxide at several altitudes. AB - In order to assess the combined effects of altitude and acute carbon monoxide exposure, 11 male and 12 female subjects, nonsmokers in good health, were given incremental (two minutes at each workload) maximal aerobic capacity tests at four levels of ambient carbon monoxide (0, 50, 100, and 150 parts per million) at four altitudes (55, 1,524, 2,134, and 3,048 m). Five male and four female subjects completed all 16 experiments. The remaining subjects completed either eight or 12 experiments; at least eight male and eight female subjects were tested at each combination of carbon monoxide and altitude. Test conditions were double-blind. Subjects initially were screened with a medical history questionnaire, a 12-lead electrocardiogram, pulmonary function tests, anthropometric and body fat measurements, blood volume determinations, and a maximal aerobic capacity test. Each subject, after attaining the required altitude and ambient carbon monoxide level, performed the maximal aerobic capacity test (maximum VO2) meeting required conditions to assure that a maximal level was attained. Blood samples were drawn prior to the aerobic capacity test; at workloads of 50 watts, 100 watts, 150 watts, and maximum; at the fifth minute of recovery; and prior to repressurization to sea level. Blood was analyzed for hemoglobin, hematocrit, plasma proteins, lactates, and carboxyhemoglobin. Carbon-monoxide carboxyhemoglobin uptake rates were derived from the submaximal workloads. Maximum VO2 was similar at 55 m and 1,524 m, and decreased from the 55-m value by 4 percent at 2,134 m and by 8 percent at 3,048 m. Despite increases in carboxyhemoglobin, no additional significant decreases in maximal aerobic capacity were observed. With increasing carbon monoxide, a decrease in maximum VO2 independent of altitude was observed. Carboxyhemoglobin concentrations at maximum VO2 were highest at 55 m and lowest at 3,048 m. Carboxyhemoglobin concentrations were lower in female subjects than in male subjects. Immediately prior to and at maximal workloads, carbon monoxide shifted into extravascular spaces and returned to the vascular space within five minutes after exercise stopped. We demonstrated that altitude hypoxia and carbon monoxide hypoxia act independently on the parameters of the maximal aerobic capacity test. We also demonstrated a decrease in the carbon monoxide concentration to carboxyhemoglobin as altitude increased, which can be attributed to the decrease in driving pressure of carbon monoxide at altitude. PMID- 3269260 TI - Postnatal changes in blood spot 17-hydroxyprogesterone level in healthy preterm and full-term neonates. AB - Blood spot 17OH-P concentrations were determined in 14 healthy premature (mean birthweight 1439 g, mean gestational age 30 weeks) and full-term newborn infants (mean birthweight 3532 g, mean gestational age 39.2 weeks) during the first five weeks of life to provide reference data for infants with various gestational and postnatal ages. It was demonstrated that with advancing age there was an abrupt fall in 17OH-P from 296.2 +/- 84.1 nmol/l on the first day to 101.2 +/- 19.5 nmol/l on the 7th day (p less than 0.001) and 75.7 +/- 8.7 nmol/l (p less than 0.05) on the 14th day in premature infants. In full-term neonates its initial value is much lower (90.1 +/- 12.5 nmol/l) and its fall during the first week is much less pronounced (51.5 +/- 6.5 nmol/l, p less than 0.01). Comparing the postnatal changes in 17OH-P in the two groups it proved to be significantly higher in premature than in full-term infants at all ages except for the 4th week. When blood spot 17OH-P values were studied as a function of gestational age at the age of 5 days a significant inverse relationship was found between the two parameters. It is assumed that in addition to placental 17OH-P production and perinatal stress, renal salt wasting may also account for the long lasting elevation of 17OH-P plasma level seen in premature infants. PMID- 3269261 TI - Effect of quality of feeding on serum lipoprotein levels in premature infants. AB - The effect of the quality of feeding on serum lipoprotein levels was studied in 30 premature infants (mean gestational age 31.7 +/- 2.0 weeks, birth weight 1568 +/- 238 g). The neonates were classified into three groups fed with breast milk and two different formulae with low and high lipid contents. No significant differences in the serum triglyceride, total cholesterol, VLDL-, LDL-, and HDL cholesterol values were found after six week's feeding of various lipid and protein intake. PMID- 3269262 TI - Type of feeding does not influence thyroid hormone levels in premature infants. AB - Thirty premature neonates (mean gestational age 31.8 +/- 3.90 weeks; mean birth weight 1569 +/- 236 g) were divided into three groups receiving breast milk, Robolact and Pre-Aptamil formula feeding. The infants with and without neonatal idiopathic respiratory distress syndrome (IRDS) were separately evaluated. No effect of the type of feeding and of a previously experienced IRDS on the blood T3-, T4-, and THS-levels could be demonstrated at the age of 6 weeks. PMID- 3269263 TI - Normal lipid values (cholesterol, triglycerides and HDL-cholesterol) for children in a rural area of Hungary. A screening program. AB - Screening for serum total cholesterol (Ch), triglyceride (Tg) and HDL-Ch levels was performed in 3 Hungarian rural areas among 3-14-year-old children, divided into three groups: 3-6, 6-10 and 10-14-year-old, respectively. The mean levels as well as the 85, 90 and 95 percentile values of the investigated lipids are given. The serum HDL-Ch levels were very low in all three groups: 0.96 mmol/l in group I. (3-6 years), 0.99 mmol/l in group II. (6-10 years) and 1.04 mmol/l in the group III. (10-14 years). We did not found any correlation between the age and lipid parameters of the children. Significant positive correlation was detected between the serum Ch and HDL-Ch levels, and a significant negative correlation was observed between the serum Tg and HDL-Ch concentrations. Our data represent the normal lipid values (Ch, Tg, HDL-cholesterol) for 3-14-year-old children, living in rural area. PMID- 3269264 TI - Fibronectin on the bronchoalveolar surface in children with recurrent obstructive bronchitis. AB - Fibronectin is normally present in the lower respiratory tract. Significantly increased levels of it were detected in the lavage fluid in patients with interstitial lung diseases. Because this molecule appears to mediate a number of components of the inflammatory process, we evaluated the status of fibronectin in plasma and bronchoalveolar lavage in patients with recurrent obstructive bronchitis when signs of severe chronic mucosal inflammation were observed bronchoscopically. There was no considerable difference in plasma concentrations of fibronectin obtained from healthy children and patients. A comparison of lavage fibronectin/albumin ratios with plasma fibronectin/albumin ratios suggested significant local production, especially when the lavage and plasma ratios were measured in the same patients. Phagocytic activity of alveolar macrophages and blood granulocytes from the same patients was enhanced at both concentrations of fibronectin used. This concentrations referred to values quantified in the lavage fluid. The metabolism of fibronectin seems to be an important factor in tracing the inflammation process not only in adults with chronic interstitial lung diseases, but also in children with recurrent obstructive bronchitis. PMID- 3269265 TI - Effect of experimental airway inflammation on bronchial hyper-responsiveness induced by Broncho-Vaxom in dogs. AB - We studied correlation between airway hyper-responsiveness induced by local exposure to a macrophage inductor Broncho-Vaxom and the development of airway inflammation in dogs. To detect airway inflammation, bronchoalveolar lavage and biopsy of airway mucosa were performed. The airway responsiveness was registered by capnograph measuring gas-exchange disturbances during obstructive reactions provocated by inhalation of various concentrations of acetylcholine aerosol. Broncho-Vaxom generated a protracted airway inflammation characterized by a slight and reversible increase in the number of neutrophils at 24 h after induction, and by a long-lasting influx of macrophages peaked about at the second week. The number of macrophages turned to initial levels 3 weeks later. Macrophages migrating to the bronchoalveolar surface were activated because peroxidase positivity and bearing C3b receptors of these cells increased gradually during the inflammatory process. Airway responsiveness measured at 3, 6 and 24 h after induction did not differ significantly from baseline values, but hyper-responsiveness was developed at 96 h using 0.5 and 1.0% acetylcholine aerosol (p less than 0.01 and p less than 0.001) during the non-purulent, macrophage-mediated inflammation. This situation modelled by Broncho-Vaxom induction is very similar to those observed in children with recurrent obstructive bronchitis. The results suggest that a macrophage-mediated inflammation caused by antigens, infections or pollutants may generate a long lasting airway hyper-responsiveness. PMID- 3269266 TI - Lymphocyte subpopulations in the peripheral blood of children with coeliac disease. AB - Circulating lymphocytes were enumerated in 28 children with coeliac disease and in 13 healthy controls by immunofluorescent staining using monoclonal antibodies for T surface phenotypic markers and polyvalent antisera for surface immunoglobulins (B cells). Proportion of peripheral T and B cells and the ratio of helper and suppressor T cells were not significantly different in coeliac children from those in controls. Authors conclude on the basis of the results that a significant impairment of circulating pool of lymphocytes in coeliac disease is improbable. PMID- 3269267 TI - Serum complement C2 levels in patients suffering from cystic fibrosis (CF). AB - Serum C2 complement levels were measured in 17 children suffering from CF, 17 with obstructive bronchitis, and 7 control children. No correlation was found between the C2 level and the clinical stage in Shwachman score, the HLA B7 or B18 antigens and the ventilation functional parameters. The mean serum C2 complement level did not differ in the three investigated groups, but in 5 of the 17 CF patients the serum C2 was diminished according to the possibility of C2 complement heterozygosity. The CF patients with diminished C2 complement levels exhibited HLA B7, B12 or B35 antigens. The serum C2 complement levels were significantly higher in the HLA B18 antigen-carrier CF homozygotes. PMID- 3269268 TI - A family study of cases with unidentified multiple congenital abnormality. AB - A family study was conducted in 1384 index patients affected by unidentified MCAs, which represented a 50.6% sample of the population-based material of the Hungarian Congenital Malformation Registry, 1973-1980. 39 cases due to misdiagnosis, and 32 cases due to a recently achieved nosological diagnosis were excluded. Furthermore, for 109 index patients no new home address was available and 166 families refused to cooperate or they were not able to give a complex dataset. Finally, affected first degree relatives of 1038 index patients were evaluated on the basis of medical documentation. 5.1% of fathers and 4.2% of mothers were affected and more than half of them were affected by one component congenital anomaly of index patients. The sib-occurrence of congenital anomalies and of multiple congenital abnormalities was 11.0% and 3.5%, respectively. The specific sib-occurrence (i.e. fully of half-concordant congenital anomalies in sibs) was 5.5%. Furthermore, there is an increased risk for fetal death in previous and subsequent pregnancies of index patients' mothers. By the help of the family study multiple congenital abnormality entities were identified in 78% of sib-occurrence of unidentified multiple congenital abnormalities. Some previously delineated congenital anomaly syndromes were recognized and six probably new syndromes or associations were delineated. PMID- 3269269 TI - Oxcarbazepine (GP 47 680) in the treatment of intractable seizures. AB - A single blind, within-patient clinical study was carried out on sixteen profoundly mentally retarded in-patients. Five of them had primary generalized, four had partial, six secondary generalized and one had mixed epileptic seizures. With the exception of two patients, all had for months or years been on CBZ combined with other anticonvulsive drugs. Eleven cases had received diphenylhydantoin, eight valproate, six had been given phenobarbital and five nitrazepam. Without changing other anticonvulsive therapy, CBZ was replaced by ox CBZ up to a dosage of 30 mg/kg b.w. in two or three daily doses. The anticonvulsive efficacy of ox-CBZ was considered better than that of CBZ in eight patients. In three cases, CBZ was preferred and in the remaining five no preference could be stated. A desirable psychotropic effect was found in three patients on ox-CBZ. Unwanted side effects occurred in seven patients. Two of them had their first episode of status epilepticus during the trial. Two out of sixteen patients had to discontinue the therapy. One of them experienced several episodes of status epilepticus, and the other patient lost appetite and had to be fed by tube. No signs of hepatitis occurred in any patient. Three patients are still on ox-CBZ, three and a half years from the start of the trial. PMID- 3269270 TI - The joint influence of diet and increased physical activity in obese children. AB - The authors performed a three week treatment and examination of 20 children with obesity of non-endocrine origin, and they compared the examination results with those of healthy children. The treatment of the obese children consisted of a diet and an individually determined training programme. In the course of the examinations it was established that the weight of the obese children decreased, their physical working capacity increased, their glucose and fat metabolism showed a tendency to improve. On the basis of all their findings authors wish to stress the importance of the primary and secondary prevention of cardio-vascular diseases as early as in childhood. PMID- 3269271 TI - Steroid metabolism in obese children. I. The relationship between body composition and adrenal function. AB - The relationship between anthropometric data and urinary excretion of steroids measured by gas chromatography was examined in 31 obese and 25 normal weight children. The children were assorted to eight groups according to their pubertal index (Tanner), gender and weight. There was a trend for higher daily excretion in obese children than in non-obese ones; the differences were greatly reduced when the excretion rate was calculated for body weight. Correlation was sought between the body weight at one hand and the excretion of certain steroid groups like C21O5 corticoid metabolites and compounds representing the androgen line, androsterone (A) plus ethiocholanolone (E) and dehydroepiandrosterone (DHA), at the other hand. While in normal children these parameters were intercorrelated, no correlation could be shown in obese children. In them, no differences in the correlation coefficients were found whether the steroid excretion rates were compared with body weight, body surface or body mass index (BMI). A relationship between the weight related to ideal weight and the excretion of cortisol metabolites was demonstrated in both sexes; for androgen excretion only in boys already in puberty. For all nine steroid compounds determined in this study, there was a stronger correlation between the excretion rate and the anthropometric findings in the prepubertal groups than in children with signs of puberty. The changes demonstrated in this study point to certain alterations of the adrenal function of obese children but no marked disturbances in their steroid metabolism can be expected. PMID- 3269273 TI - Proceedings of the 1988 congress and scientific meeting of the Chinese Medical Association. Abstracts. PMID- 3269272 TI - Steroid metabolism in obese children II. Steroid excretion of obese and normal weight children. AB - Comparative studies on adrenal function have been performed in 56 children, 31 obese and 25 of normal weight. Their body weight fell within the range between 80 and 215% of the ideal weight (100%). Nine steroids resp. steroid groups were measured by gas chromatography. The participants were grouped by degree of fatness, sex and presence of absence of puberty (Tanner I or higher than I). The urinary steroid excretion rate was corrected for weight. Altered steroid metabolism was found in obese children as compared with the normal groups: not only the excretion of cortisol metabolites was increased but also that of androgen metabolites and pregnenediol, metabolite of pregnanolone. There is a trend for increased excretion of all steroid groups, in certain cases this attains the level of statistical significance. Wide variability was observed in the steroid excretion of obese children, in about one third of them there was hypersecretion of some components of the steroid spectrum. This phenomenon was more frequently encountered in boys. Extension of the normal range of steroid excretion rates of obese children seems to be justified. PMID- 3269274 TI - [Results of trabeculoretraction (apropos of 90 personal cases)]. PMID- 3269275 TI - [Medium-term results of radial keratotomies and discussion]. PMID- 3269276 TI - [Refraction after radial keratotomy: apropos of 250 cases]. PMID- 3269277 TI - [Presentation of a surgical technic: phacoemulsification of the capsular bag after circular linear capsulotomy and implantation in the bag: rigid implant, soft implant]. PMID- 3269278 TI - [Presentation of an instrument to measure lens opacity: the opacity lensmeter 701]. PMID- 3269279 TI - [Inhibition scotoma in binocular vision in convergent strabismus]. PMID- 3269280 TI - [Weakening of the internal rectus muscle by a peripheral triple action]. PMID- 3269281 TI - [Ischemia of the anterior segment after surgery of strabismus: apropos of a case]. PMID- 3269282 TI - [A privileged observation of bilateral retinoblastoma ... 35 years after]. PMID- 3269283 TI - [Pseudotumor of pigment epithelium disclosing serpiginous choroiditis]. PMID- 3269284 TI - [Bacterial endocarditis in acute anterior uveitis]. PMID- 3269285 TI - [Wolfram's syndrome: apropos of a case]. PMID- 3269286 TI - [Severe contusions of the eye. Epidemiologic and lesional aspects. Apropos of 130 cases]. PMID- 3269287 TI - [Atonic ectropion of the upper eyelid]. PMID- 3269288 TI - [A case of bilateralized stunning retrobulbar optic neuritis in multiple sclerosis]. PMID- 3269289 TI - [Ectopic parathyroid adenoma disclosed by cortical blindness and hypercalcemic encephalopathy]. PMID- 3269290 TI - [Influence of Healon on the endothelial morphometry of penetrating keratoplasties]. PMID- 3269291 TI - [Electronic and digital imaging in ophthalmology. Analysis and prospects of future development]. PMID- 3269292 TI - [Analysis of the visual fields in 300 patients with glaucoma collected by an ophthalmologic monitor]. PMID- 3269293 TI - [New systems of cleaning contact lenses and the security of the wearer]. PMID- 3269294 TI - [Ocular manifestations of holoprosencephaly. Apropos of a case]. PMID- 3269295 TI - [Current evaluation of the treatment of retinal detachment by cryocoagulation and gas tamponade without scleral buckling]. PMID- 3269296 TI - [Intraocular injection of SF6 in surgery of retinal detachment]. PMID- 3269297 TI - [Complications of intravitreous injections of perfluorocarbons-gas in the treatment of retinal detachment]. PMID- 3269298 TI - [Retinal detachment in pseudophakia. Analysis of surgical results]. PMID- 3269299 TI - [Sympathetic ophthalmia. Long-term course]. PMID- 3269300 TI - [Retroequatorial myopexy of the internal rectus muscle in variable-angle esotropia]. PMID- 3269301 TI - [Postoperative bacterial endophthalmia. Prognostic factors]. PMID- 3269302 TI - [Ocular complications of keratosis lichenoide striata]. PMID- 3269303 TI - [Exophthalmos in children: contribution of the scanner and MRI in diagnosing spontaneous hematoma]. PMID- 3269304 TI - Chest pain after cardiac surgery. PMID- 3269305 TI - Coarctation of the aorta. PMID- 3269306 TI - Precise measurement of fluid administration in hemodynamic monitoring. PMID- 3269307 TI - The postoperative liver transplant patient. PMID- 3269308 TI - Establishing a nutrition committee in an MICU. PMID- 3269309 TI - The spouse's response to coronary artery bypass graft surgery. PMID- 3269310 TI - Periventricular-intraventricular hemorrhage: nursing implications. PMID- 3269311 TI - Metamorphosis of a critical care nurse: the first year. PMID- 3269312 TI - Methemoglobinemia. PMID- 3269314 TI - Troubleshooting thermodilution pulmonary artery catheters. PMID- 3269313 TI - Caring for patients with implantable cardioverter defibrillators. PMID- 3269315 TI - The effective cough. Forefronts of pulmonary care. PMID- 3269316 TI - Product evaluation in critical care. PMID- 3269317 TI - Complications of Haemophilus influenzae. PMID- 3269318 TI - Implementing the educational standards for critical care nursing: Part IV. The evaluation standards. PMID- 3269319 TI - Esophageal perforation: a nursing diagnosis approach. PMID- 3269320 TI - Acute pancreatitis: a gastrointestinal emergency. PMID- 3269321 TI - Lown-Ganong-Levine syndrome. PMID- 3269322 TI - Discharge planning: a critical care responsibility. PMID- 3269323 TI - Emergency stabilization in transport of critically ill neonate. PMID- 3269324 TI - Liver transplantation: postoperative ICU care. PMID- 3269325 TI - Visiting in the ICU: time for a change. PMID- 3269326 TI - Single-lung allograft: a nursing perspective. PMID- 3269327 TI - Critical care visitation: an ethical dilemma. PMID- 3269328 TI - Therapeutic intervention scoring. PMID- 3269329 TI - Endotracheal administration of medications. PMID- 3269330 TI - Ventricular tachycardia. PMID- 3269331 TI - Inferior-wall myocardial infarction. PMID- 3269332 TI - The elements of permanent cardiac pacing. PMID- 3269333 TI - Understanding mechanical ventilation. PMID- 3269334 TI - Cardiac arrhythmias: diagnosis and treatment. PMID- 3269335 TI - Critical care orientation using self-learning modules. PMID- 3269336 TI - Digoxin immune Fab ovine. PMID- 3269337 TI - Pulse oximetry: a nursing care plan. PMID- 3269338 TI - Acute pulmonary edema following use of naloxone: a case study. PMID- 3269339 TI - Critical nurse as home health care consultant. PMID- 3269340 TI - Post-treatment benefits to high school students from participation in a fluoride mouth-rinsing program for 11 years. PMID- 3269341 TI - Experimental study on a photometer attached to a dental handpiece. PMID- 3269342 TI - A design of dental practice checker for dental examination. PMID- 3269343 TI - Isolation and some properties of aeration-persistant mutants of Streptococcus mutans strain HS 6. PMID- 3269344 TI - A morphological study on the mandibular symphysis of the cleft lip and palate patients with anterior crossbite. PMID- 3269345 TI - [Statistical analysis of new out-patients in the Department of Medicine, Fukuoka Dental College Hospital -IX: From January 1 to December 31, 1986]. PMID- 3269346 TI - [Transparent X-ray protective barrier for fluoroscopy]. PMID- 3269347 TI - [The course of the mandibular canal at the mental foramen region. Part 1. Radiographic survey from the tooth axis]. PMID- 3269348 TI - [Study of neurogenic inflammation (I)]. PMID- 3269349 TI - [Accessory parotid gland in man (II)]. PMID- 3269350 TI - [The clinical observation of gallium alloy as a new dental restorative material for primary teeth]. PMID- 3269351 TI - [A case of multi-lingual bracket orthodontic treatment]. PMID- 3269352 TI - [Electron microscopic study of cysts developing in the soft tissue of the oral region. Part 2. A case of mucous cyst]. PMID- 3269353 TI - [Personal identification of an unknown skeleton by dental examination]. PMID- 3269354 TI - [Seven interesting panoramic radiographs obtained in students' practice]. PMID- 3269355 TI - [Epidemiological immunological studies on leprosy in Okinawa. V. Statistical observation of outpatients]. PMID- 3269356 TI - [A case of type 1 lepra reaction accompanied by secondary diabetes mellitus and hypothyroidism]. PMID- 3269357 TI - Immune system and cancer. PMID- 3269358 TI - Thymic stroma-derived T cell growth factor: its role in the growth of immature thymocytes and T cell repertoire selection. AB - A newly established thymic stromal cell clone, MRL104.8a exhibited capacities to express Ia antigens and to support the growth of antigen-specific, interleukin-2 (IL-2)-dependent helper T cell (Th) clones without requirement of antigen and exogenous IL-2. Such growth was substituted by a factor produced into cultures by the MRL104.8a clone. This substance designated as thymic stroma-derived T cell growth factor (TSTGF) was demonstrated to be the protein that has an apparent molecular weight of about 25,000 and a pI of 6.0 and to be distinct from the previously described interleukins and cytokines. While the capacity of TSTGF to promote T cell proliferation was initially found by using various Th clones, further studies have demonstrated its capability of supporting the growth of immature (L3T4- Lyt-2-) thymocytes. TSTGF alone failed to function for the proliferation of double-negative thymocytes, whereas this novel growth factor was capable of inducing the proliferation of immature thymocytes by synergy with IL 1. Such growth promotion was further enhanced by the addition of IL-2 or IL-4 to cultures. The data were also presented that TSTGF could contribute to the clonal elimination in the thymus. The growth of a Th clone, 9-16, was supported on the TSTGF-producing and Ia-expressing MRL104.8a monolayer in the absence of the antigen against which this Th clone is directed. In contrast, the presence of the relevant antigen in the MRL104.8a culture elicited the lethal growth-inhibition of Th clone cells. Taken collectively, the results provide strong support for the proposition that TSTGF may play an essential role in the intrathymic T cell development in the context of T cell growth promotion and T cell repertoire selection. PMID- 3269359 TI - The molecular basis of antigen presentation. AB - We have used a multifactorial approach to investigate the relationship between the structure of class II major histocompatibility complex (MHC)-encoded cell surface molecules (Ia) and the recognition of Ia-bound peptide antigens by clonally distributed alpha beta heterodimeric T cell receptors (TCR). Four distinct parameters of Ia structure-function--1) control of Ia assembly and transport to the surface membrane; 2) serological reactivity with panels of monoclonal antibodies; 3) ability to present peptide antigens to T cells for functional activation; and 4) differential peptide binding independent of the TCR -have been measured. This has allowed assignment of allelically polymorphic subregions or individual residues to locations in a model class II molecular structure and attribution to these subregions and residues of specific functions such as control of alpha beta chain interaction and protein folding, antigenic peptide binding, or TCR binding. The results of these analyses have provided an internally consistent picture of the class II molecule that fits well with a hypothetical model for Ia derived by analogy from the recently solved HLA class I crystal structure. They have also given us the first clear definition of specific peptide binding residues within the general peptide binding region of Ia and have revealed an unexpected asymmetry in the structure-function relationships of the putative alpha and beta chain helical regions. Overall, the results of these studies indicate the critical importance of multi-parameter analysis in creating useful molecular models using non-chemical techniques. They also suggest that hypotheses about TCR-Ia interaction may have to take into account a significant asymmetry in the function of the two major polymorphic regions of histocompatibility molecules. PMID- 3269360 TI - Induction of tumor-specific in vivo protective immunity by immunization with tumor antigen-pulsed antigen-presenting cells. AB - The present study investigates the role of antigen-presenting cells (APC) in inducing tumor-specific in vivo protective immunity. Thy-1+ cell-depleted, Mac-1+ cell-enriched fraction of normal BALB/c spleen cells were used as a source of APC. These APC were cultured in vitro with the membrane fraction isolated from Rous sarcoma virus-induced CSA1M fibrosarcoma derived from BALB/c strain. The administration of such APC into naive BALB/c mice generated the capacity of these animals to reject the subsequently challenged viable CSA1M tumor cells. The induction of anti-CSA1M in vivo protective immunity required three consecutive immunizations with more than 10(5) APC which had been pulsed in vitro with 200 micrograms protein component of CSA1M membrane fraction. This immunity was tumor specific, since the inoculation of CSA1M or Meth A fibrosarcoma membrane component-pulsed APC resulted in the selective immunity against the challenge with homologous types of tumor cells. The CSA1M-specific in vivo protective immunity was also induced by injecting APC pulsed with solubilized CSA1M membrane components. Moreover, it was demonstrated that the efficiency for inducing anti CSA1M immunity was much higher in the utilization of tumor antigen-pulsed APC than in the immunization with tumor antigens emulsified in complete Freund's adjuvant. These results indicate the crucial role of APC in generating tumor rejection immunity in vivo, and this model presents a novel approach to induce tumor-specific immunity without utilizing tumor cells themselves. PMID- 3269361 TI - Regulation of cytokine gene expression: gene activation in type I IFN and IL-2 systems. AB - Cytokines represent essential soluble mediators in cell-to-cell communication and they are known to play crucial roles in many biological processes, including viral infection, inflammation and immunity. We have been focusing on two cytokine systems, the interferon (IFN) and interleukin 2 (IL-2) systems each of which respectively plays a key role in viral infections and the immune response. In both cases, expression of those cytokines and, in the case of IL-2 system, the receptor is tightly regulated at the transcriptional level. Recent studies in our laboratory as well as others have uncovered the mechanism(s) operating in the regulation of those genes and have provided further insights on how the two cytokine systems operate and what is the biological significance of gene regulation in these systems. Here, we summarize the current understanding of the IFN system and IL-2 system in the context of host defense against viral infections and T cell neoplasms, respectively. PMID- 3269362 TI - Cytotoxic T cell clones against human autologous cancers: analysis of target antigen and the mechanism of specific target cell destruction. AB - The human autologous pair of a cytotoxic T cell clone and tumor line could be very useful for the investigation of the specific destruction of autologous tumor cells by cytotoxic T lymphocytes (CTL), including analysis for tumor-specific antigen possibly of the rejection type, clonotypic T cell antigen receptors and biochemical characteristics of the cytotoxic molecules produced from CTL. We established such a pair of autologous specific CTL clone TcHMC-1 and target clone HMC-1-8 that were derived from the metastatic pleural effusion of a patient with mammary carcinoma. TcHMC-1 showed more than 60% specific cytotoxicity against HMC 1-8, and it was confirmed, using cold target inhibition assays, that this clone did not demonstrate nonspecific cytotoxicity against a allogeneic targets as well as the natural killer (NK) cell activity. We also confirmed the in vivo action of TcHMC-1 against HMC-1-8 cells by the Winn assay in nude mice. Using anti-CD3, 4, and 8 as well as anti-class I monoclonal antibodies (mAbs), it was demonstrated that T cell antigen receptor molecule complexes Ti/T3 on TcHMC-1 and corresponding specific tumor antigens on HMC-1-8 are involved in the cytotoxicity under the restriction of major histocompatibility complex (MHC) class I products. We developed mAb 3A2 reacting with the specific antigens on HMC-1-8 that could play an important role in this autologous pair. This mAb inhibited selectively the cytotoxic action of TcHMC-1 against HMC-1-8, and identified a molecule with approximately 92 kd m.w. 3A2-defined antigen was highly expressed on autologous primary breast carcinoma tissue, but not on normal mammary gland in the same patient. Moreover, this antigen can be detected on approximately 50% of human allogeneic breast carcinomas, but not on other neoplastic cells except for 1 out of 10 prostatic carcinomas. It was also suggested that 3A2-defined antigen is not murine mammary tumor virus-related antigen. PMID- 3269363 TI - Targeting of cytotoxic cells against tumors with heterocrosslinked, bispecific antibodies. AB - Cytotoxic cells express specific receptors on their surfaces by which they distinguish altered or foreign cells from normal autologous cells. Recently, a method has been developed by which the natural recognition system of cytotoxic cells can be artificially manipulated, giving rise to cytotoxic cells of any desired specificity, including specificity against tumor and virally infected cells. The method for retargeting cytotoxic cells employs heterocrosslinked antibodies, in which one antibody is directed against the cytotoxic cell receptor (CCR) involved in lysis, while the second antibody is directed against a target cell structure, for example a tumor or viral antigen. By linking the CCR directly to the target cell, the heterocrosslinked antibodies promote the formation of effector: target conjugates and signal the cytotoxic cell to deliver a lethal hit. T cells can be targeted by heteroconjugates containing antibodies against components of the T cell receptor complex, e.g., Ti or CD3, while several types of antibody-dependent cellular cytotoxicity (ADCC) effector cells, including K/NK cells, macrophages, and neutrophils, are targeted using heteroconjugates containing antibodies against Fc gamma receptors. In peripheral blood from normal donors at least six types of targetable activities have been identified in vitro. In Winn type tumor neutralization assays in nude mice, targeted T and K cells can prevent the establishment of subcutaneous tumor at low effector: tumor ratios. Moreover, targeted human peripheral blood T cells cause the eradication of established intraperitoneal human ovarian carcinoma in nude mouse models. Targeted cytotoxic cells therefore hold great promise as a novel form of cancer immunotherapy in humans. PMID- 3269364 TI - Gene probes for the detection of aerolysin in Aeromonas spp. PMID- 3269365 TI - Proceedings of the Second Aeromonas/Plesiomonas Workshop. Miami Beach, Florida, USA, 7 May 1988. PMID- 3269366 TI - [High-strength ceramic crown--Cerestore, Dicor, Vita Pt. crown]. PMID- 3269367 TI - [Malignant fibrous histiocytoma in maxilla--report of a case and review of literature]. PMID- 3269368 TI - [Scanning electron microscopic study of dispersal amalgams]. PMID- 3269369 TI - [Marginal leakage of resin bonded restorations with thermal change]. PMID- 3269370 TI - [Heavy metals concentrations in the air of the dental laboratories, in the blood and urine of dental laboratory technicians]. PMID- 3269371 TI - [Access preparation, anatomy, and canal length measurement]. PMID- 3269372 TI - [Effect of conservative treatment of temporomandibular disorders]. PMID- 3269373 TI - [The immunohistochemical study on the distribution of S-100 positive cells in salivary gland]. PMID- 3269374 TI - [A survey of dental disease and delivery system in the Island of Chonnam]. PMID- 3269375 TI - [Clinical studies on oral infections in the oral cavity and maxillofacial regions]. PMID- 3269376 TI - [A study of dental caries process with radiographic and histologic methods]. PMID- 3269377 TI - A clinical evaluation of 60 intentionally replanted teeth. PMID- 3269378 TI - [Early orthopedic appliance use in cleft lip and palate]. PMID- 3269379 TI - [Pit and fissure sealants]. PMID- 3269380 TI - [A study on temporomandibular joint dysfunction with computed tomogram (1). Standardization of interpretation of normal T.M.J]. PMID- 3269381 TI - [A longitudinal study of Korean children's growth pattern according to Gonial angle using cephalometric radiography]. PMID- 3269382 TI - A new concept for orthodontic therapy; pulsed electromagnetic fields to modify cell behavior in bone growth. PMID- 3269383 TI - [A clinical study on myxomas of jaw bones]. PMID- 3269384 TI - [Developmental changes in guanine aminohydrolase in rat calvaria]. PMID- 3269385 TI - A survey of the statistical techniques reported in dental journals. PMID- 3269386 TI - Binding-protein-dependent glucose transport by Agrobacterium radiobacter grown in glucose-limited continuous culture. AB - Agrobacterium radiobacter NCIB 11883 was grown in glucose-limited continuous culture at low dilution rate. Whole cells transported glucose using an energy dependent mechanism which exhibited an accumulation ratio greater than 2000. Three major periplasmic proteins were purified and their potential role as glucose-binding proteins (GBP) were investigated using equilibrium dialysis. Two of these, GBP1 (Mr 36,500) and GBP2 (Mr 33,500), bound D-glucose with high affinity (KD 0.23 and 0.07 microM respectively), whereas the third protein (Mr 30,500) showed no binding ability. Competition experiments using various analogues showed that those which differed from glucose at C-6 (e.g. 6-chloro-6 deoxy-D-glucose and 6-deoxy-D-glucose) variably decreased the binding of glucose to both GBP1 and GBP2, whereas those which differed at C-4 (e.g. D-galactose) were only effective with GBP1. The rate of glucose uptake and the concentration of the glucose-binding proteins increased in parallel during prolonged growth under glucose-limitation due to the emergence of new strains in which GBP1 (e.g. strain AR18) or GBP2 (e.g. strain AR9), but not both, was hyperproduced and accounted for at least 27% of the total cell protein. It is concluded that A. radiobacter synthesizes two distinct periplasmic binding proteins which are involved in glucose transport, and that these proteins are maximally derepressed during growth under glucose limitation. PMID- 3269387 TI - The relationship between glucose transport and the production of succinoglucan exopolysaccharide by Agrobacterium radiobacter. AB - Agrobacterium radiobacter NCIB 11883 was grown in ammonia-limited continuous culture at low dilution rate with glucose as the carbon source. Under these conditions the organism produced an extracellular succinoglucan polysaccharide and transported glucose using the same periplasmic glucose-binding proteins (GBP1 and GBP2) as during glucose-limited growth. Transition from glucose- to ammonia limited growth was accompanied by a very rapid decrease in glucose uptake capacity, whereas the glucose-binding proteins were diluted out much more slowly (t1/2 approximately 1 h and 14 h respectively). Although the rate of glucose uptake and the concentrations of GBP1 and GBP2 were much lower during ammonia limitation, the activities of enzymes involved in the early stages of glucose metabolism and in the production of succinoglucan precursors were essentially unchanged. Glucose transport was also investigated in two new strains of A. radiobacter which had been isolated following prolonged growth under glucose limitation. Glucose uptake by strain AR18 was significantly less repressed during ammonia limitation compared with either the original parent strain or strain AR9, and this was reflected both in its relatively high concentration of GBP1 and in its significantly higher rate of succinoglucan synthesis. Flux control analysis using 6-chloro-6-deoxy-D-glucose as an inhibitor of glucose transport showed that the latter was a major kinetic control point for succinoglucan production. It is concluded that glucose uptake by A. radiobacter, particularly via the GBP1 dependent system, is only moderately repressed during ammonia-limited growth and that the organism avoids the potentially deleterious effects of accumulating excess glucose by converting the surplus into succinoglucan. PMID- 3269388 TI - Restriction endonucleases in Clostridium pasteurianum ATCC 6013 and C. thermohydrosulfuricum DSM 568. AB - A small collection of clostridia was surveyed for type II restriction endonucleases. Enzymes were detected in two organisms. Clostridium pasteurianum ATCC 6013 contains an isoschizomer of ThaI (FnuDII) [5'-CGCG-3'] and preliminary evidence suggests that cleavage generates blunt-ended fragments. Clostridium thermohydrosulfuricum DSM 568 contains an isoschizomer of MboI (Sau3A) [5'-GATC 3'] that is inactive on dam methylated substrates. The DNA of this latter organism shows dam methylation. PMID- 3269389 TI - The metabolism of aromatic ring fission products by Bacillus stearothermophilus strain IC3. AB - Bacillus stearothermophilus IC3 degraded the meta cleavage product of catechol, 2 hydroxymuconic semialdehyde, to pyruvate and acetaldehyde via the 4 oxalocrotonate pathway. The pathway was identical to those previously delineated in several mesophilic organisms. However, all the enzymes showed activity at 55 degrees C and other properties (substrate specificities and effects of metal ions) also differed from those displayed by the mesophilic enzymes. All enzymes of this meta cleavage pathway, except the 2-hydroxy-6-oxohepta-2,4-dienoate hydrolase and 4-hydroxy-2-oxovalerate aldolase activities, were induced by growth on phenol. PMID- 3269390 TI - Effects of validamycin A on the morphology, growth and sporulation of Rhizoctonia cerealis, Fusarium culmorum and other fungi. AB - All Basidiomycotina screened were sensitive to validamycin A, whereas most Ascomycotina and all Mucorales and Oomycetes were insensitive. Studies with Rhizoctonia cerealis and Fusarium culmorum showed that, in semi-solid culture, the antibiotic caused a decrease in colony radial growth rate and that this was associated with a decrease in mean hyphal extension rate and an increase in hyphal branching. However, the antibiotic did not alter the morphology of R. cerealis grown in liquid culture (shaken or stationary). Validamycin A caused a reduction in the number and viability of conidia produced by F. culmorum. PMID- 3269391 TI - The alternative respiratory pathway of the yeast Candida parapsilosis: oxidation of exogenous NAD(P)H. AB - The yeast Candida parapsilosis possesses two routes of electron transfer from exogenous NAD(P)H to oxygen. Electrons are transferred either to the classical cytochrome pathway at the level of ubiquinone through an NAD(P)H dehydrogenase, or to an alternative pathway at the level of cytochrome c through another NAD(P)H dehydrogenase which is insensitive to antimycin A. Analyses of mitoplasts obtained by digitonin/osmotic shock treatment of mitochondria purified on a sucrose gradient indicated that the NADH and NADPH dehydrogenases serving the alternative route were located on the mitochondrial inner membrane. The dehydrogenases could be differentiated by their pH optima and their sensitivity to amytal, butanedione and mersalyl. No transhydrogenase activity occurred between the dehydrogenases, although NADH oxidation was inhibited by NADP+ and butanedione. Studies of the effect of NADP+ on NADH oxidation showed that the NADH:ubiquinone oxidoreductase had Michaelis-Menten kinetics and was inhibited by NADP+, whereas the alternative NADH dehydrogenase had allosteric properties (NADH is a negative effector and is displaced from its regulatory site by NAD+ or NADP+). PMID- 3269392 TI - Valine dehydrogenase from Streptomyces fradiae: purification and properties. AB - Valine dehydrogenase (VDH) was purified to homogeneity from cell-free extract of Streptomyces fradiae, which produces tylosin. The enzyme was purified 1508-fold in a 17.7% yield using a combination of hydrophobic chromatography and ion exchange fast protein liquid chromatography. The Mr of the native enzyme was determined to be 218,000 and 215,000, by equilibrium ultracentrifugation and size exclusion high-performance liquid chromatography, respectively. The enzyme is composed of 12 subunits of Mr 18,000. Using analytical isoelectric focusing the isoelectric point of VDH was found to be 4.7. Oxidative deamination of L-valine was optimal at pH 10.6. Reductive amination of 2-oxoisovalerate was optimal at pH 8.8. The Michaelis constants (Km) were 1 mM for L-valine and 0.029 mM for NAD+. Km values for reductive amination were 0.80 mM for 2-oxoisovalerate, 0.050 mM for NADH and 22 mM for NH4+. PMID- 3269393 TI - Regulation of autotrophic metabolism in Pseudomonas oxalaticus OX1 wild-type and an isocitrate-lyase-deficient mutant. AB - In Pseudomonas oxalaticus the activity and synthesis of the Calvin cycle enzyme ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO) are regulated by inactivation and endproduct repression, respectively. Phosphoenolpyruvate (PEP) has been suggested to function as a signal molecule for the latter control system. During growth of the organism in carbon-source-limited continuous cultures with various ratios of acetate and formate in the feed, the RuBisCO levels varied considerably, but no correlation was observed with the intracellular concentrations of PEP. To study whether the repression exerted by acetate utilization was dependent on the synthesis of glycolytic intermediates from this compound, an acetate-negative mutant defective in isocitrate lyase was isolated and characterized. Clear evidence was obtained that in this mutant acetate is as effective in repressing RuBisCO synthesis as in the wild-type. It therefore appears more likely that acetyl-CoA or a closely related metabolite functions as a signal molecule in the regulation of RuBisCO synthesis. PMID- 3269394 TI - Cloning and nucleotide sequence of senN, a novel 'Bacillus natto' (B. subtilis) gene that regulates expression of extracellular protein genes. AB - A new 'Bacillus natto' gene, senN, that regulates the expression of several extracellular proteins in B. subtilis has been cloned and sequenced. senN codes for a small, highly basic protein with an amino acid sequence different from the products coded by the regulatory genes sacQ, sacV, prtR and hpr. SenN stimulates gene expression at the transcriptional level. A putative homologous locus has been detected in the B. subtilis chromosome by Southern blotting. PMID- 3269396 TI - Third party payments. PMID- 3269395 TI - An overview for dentistry. PMID- 3269397 TI - Porcelain inlays and onlays. PMID- 3269398 TI - Needed service provided. PMID- 3269399 TI - Identity sought. PMID- 3269400 TI - The safe dentist. PMID- 3269401 TI - A sibling case of congenital gingival fibromatosis: treatment and postoperative evaluation. PMID- 3269402 TI - A clinical evaluation of a simplified gothic arch tracing method. PMID- 3269404 TI - Measurement of water solubility of resin components by means of high performance liquid chromatography. PMID- 3269403 TI - Denture base filling materials mixed with tannin-fluoride preparation. Part 1. Mixing ratio to the autopolymerizing resin. PMID- 3269405 TI - Effect of resin components on the growth of Streptococcus mutans. PMID- 3269406 TI - Symmetry analysis of the human face based on Moire topography. PMID- 3269407 TI - Rebuilding of missing walls with composite resin prior to endodontic treatment- report of cases. PMID- 3269408 TI - Pattern of initial displacements of maxillary complex from maxillary protraction forces applied in various directions. PMID- 3269409 TI - Three dimensional shape measurement of teeth by means of high precision laser displacement meter. PMID- 3269410 TI - An HRP study of the central localization of the rabbit stylopharyngeal motoneurons and the peripheral courses of their axons. PMID- 3269411 TI - A personal computer-based on-line biosignal processing in clinical orthodontics. PMID- 3269412 TI - Survey on periodontal health in a group of industrial employees using the Community Periodontal Index of Treatment Needs. PMID- 3269413 TI - [Calcium kinetics in sarcoplasmic reticulum of canine masseter muscle. Comparison of temperature dependence in masseter muscle, femoral muscle and heart muscle]. PMID- 3269414 TI - [The effects of antineoplastic agent (Adriamycin) on Ga-67 uptake in cultured tumor cells]. PMID- 3269415 TI - [Characteristics of tooth root distribution during impact on the teeth]. PMID- 3269416 TI - [The mobility of healthy teeth as measured with the impact hammer method]. PMID- 3269417 TI - [Influence of tube voltage on image quality in dental xeroradiography]. PMID- 3269418 TI - [The influence of water sorption on the mechanical characteristics of posterior composite resins]. PMID- 3269419 TI - [Fundamental studies of adhesion mechanisms of cultured cells to glass-ceramics]. PMID- 3269420 TI - [Investigation of X-ray apparatus in dental clinics in Yokosuka and Suntoh areas]. PMID- 3269421 TI - [Pharmacological analysis on the role of endogenous vasoactive substances in regulating mechanism of microcirculatory dynamics in oral region. Effect of vasoactive substances on pulpal blood flow]. PMID- 3269422 TI - [Pharmacological analysis on the role of endogenous vasoactive substances in regulating mechanism of microcirculatory dynamics in oral region. Effect of bradykinin on isolated canine lingual arteries]. PMID- 3269423 TI - [Factors regulating the size of triton shells from erythrocytes in isotonic media]. PMID- 3269424 TI - [Distribution of mast cells in the rat submandibular gland]. PMID- 3269425 TI - [A morphological study on the reaction of the pulpal vasculature following experimentally induced acute pulpitis in dogs]. PMID- 3269426 TI - [Fundamental studies of adhesion mechanisms of cultured cells to biomaterials]. PMID- 3269427 TI - [67Ga uptake in mouse leukemia cell]. PMID- 3269428 TI - [The venous distribution in the human maxilla using the corrosion resin cast method]. PMID- 3269429 TI - [Simultaneous analysis on tapping of the mandible by various parameters]. PMID- 3269430 TI - [Radiographic technique with low exposure using computed panoramic tomography]. PMID- 3269431 TI - [Biochemical study of biomaterials. Characterization of human periodontal ligament fibroblast-like cells]. PMID- 3269432 TI - [Biochemical study of biomaterials. Cell response in relation to mechanical stress]. PMID- 3269433 TI - [The ultrastructure of venous valves in the human fetus tongue]. PMID- 3269434 TI - [The vibration transfer characteristic of dry human skull]. PMID- 3269435 TI - [Intravenous sedation for dentistry. Application of intravenous sedation with flunitrazepam to oral surgery for outpatients]. PMID- 3269436 TI - [A case of speech restoration with speech aid following resection of soft palate tumor]. PMID- 3269437 TI - [Two cases of sequela caused by dental implant]. PMID- 3269438 TI - [Effect of halothane on isolated canine mesenteric artery and vein. On the hypotensive effect of halothane during general anesthesia]. PMID- 3269439 TI - [Immunohistochemical studies of epidermal growth factor and nerve growth factor in submandibular glands of mice during period of pregnancy and lactation]. PMID- 3269440 TI - [A three-dimensional observation on arteriovenous anastomoses in dog tongue using corrosive resin cast]. PMID- 3269441 TI - [Effects of testosterone and Estradiol-17 beta on submandibular saliva of rat]. PMID- 3269443 TI - [Potential use of neutron radiography in oral region]. PMID- 3269442 TI - [Fundamental study on the healing of bone injuries with bone scintigraphy and xeroradiography]. PMID- 3269444 TI - [Intra-oral environment of SIgA and clinical examination in the case of disease]. PMID- 3269445 TI - [A case of missing primary and succedaneous incisor tooth of three brothers]. PMID- 3269447 TI - [The factor to relation of measure tooth mobility by hammer microphone method]. PMID- 3269446 TI - [Chemical structure and immunobiological activities of peptidoglycan isolated from Bacteroides gingivalis]. PMID- 3269448 TI - [Experimental studies on the mechanical enlargement of root canal. Part 1: Effects of debridement in the root canals following instrumentation. Part 2: The relationship between mechanical destruction of apical constriction and healing of the periapical tissue]. PMID- 3269449 TI - [Application of dental xeroradiography for periodontal region. Influence of development electrode voltage on edge contrast quality]. PMID- 3269450 TI - [Functional changes in the dorsal motor nucleus of the vagus nerve caused by trigeminal irritation]. PMID- 3269451 TI - [Molecular weight and dental material properties of denture base PMMA resin prepared by the microwave curing method]. PMID- 3269452 TI - [Search according to CRP and ESR in oral disease]. PMID- 3269453 TI - [Identification of corpses in an aircraft accident verified by means of statistical management]. PMID- 3269454 TI - [Three-year clinical results of posterior composite resins--with special reference to the marginal degradation of restorations]. PMID- 3269455 TI - [A standardized setting apparatus for MKG measurement and its clinical application]. PMID- 3269456 TI - [The pathway of 67Ga uptake into cultured tumor cells]. PMID- 3269457 TI - [Biochemical study on development of human tooth germ. Preparation of monoclonal antibodies against human periodontal ligament fibroblast-like cells]. PMID- 3269458 TI - [Pharmacological study of the mechanism of the contractile effect of bradykinin on isolated canine lingual artery]. PMID- 3269459 TI - [The relationship between Ga-67 uptake and transferrin receptors in tumor cells]. PMID- 3269460 TI - [Biochemical study on cell differentiation in hard tissue. Preparation of a monoclonal antibody against rat osteoblasts]. PMID- 3269461 TI - [Modal analysis of dry human skull]. PMID- 3269462 TI - [Vibration transmission characteristics and dynamics of teeth and periodontal tissues]. PMID- 3269464 TI - Introduction to paid dental. PMID- 3269463 TI - [Changes of vascular architecture during shedding of dog deciduous teeth]. PMID- 3269465 TI - Attracting new patients using direct mail. PMID- 3269466 TI - Internal marketing: can it build a practice? PMID- 3269467 TI - Issues of hiring and firing. PMID- 3269468 TI - Computers in dentistry. PMID- 3269469 TI - Dental insurance and internal marketing. PMID- 3269470 TI - Dental public relations. PMID- 3269471 TI - Conservative esthetic posterior restorations. PMID- 3269472 TI - Resolving patient objections. PMID- 3269473 TI - Expressly for the staff. Ways the staff can improve cash flow. Part 3: The role of the staff in inventory control and bill paying. PMID- 3269474 TI - It shouldn't have happened, but it did. PMID- 3269475 TI - Creating a patient relations team. PMID- 3269476 TI - Motivating auxiliary staff. PMID- 3269477 TI - Yellow pages advertising attracts new patients. PMID- 3269478 TI - [Postrestorative problems of hypersensitive dentin]. PMID- 3269479 TI - [Extirpation of the submandibular gland as treatment for sialolithiasis and/or chronic sialoadenitis. A review of 68 cases]. PMID- 3269480 TI - [Mouthrinses. Plaque prevention by means of chlorhexidine and surfactants]. PMID- 3269481 TI - [Diagnosis and management of pain in dental practice]. PMID- 3269482 TI - [Guidelines for individual application of fluoride]. PMID- 3269483 TI - [Caries prevalence related to social factors in ten-year-old children]. PMID- 3269484 TI - [Five years of experience with postgraduate courses in clinical periodontology]. PMID- 3269486 TI - [Principles and guidelines for occlusal therapy in high risk groups]. PMID- 3269485 TI - [Comparative study of immediate versus complete dentures]. PMID- 3269487 TI - [Treatment of free-situations with Linkow blades and fixed bridges]. PMID- 3269488 TI - [Oral manifestations in Cowden's syndrome]. PMID- 3269489 TI - [Etiology and pathogenesis of odontogenic cysts and tumors]. PMID- 3269490 TI - [Treatment of odontogenic cysts, a new method]. PMID- 3269491 TI - [Histopathology of odontogenic tumors]. PMID- 3269492 TI - [Odontomas, clinical and radiological aspects]. PMID- 3269493 TI - [Ameloblastoma of the jaw]. PMID- 3269494 TI - [Identification of persons not dentally fit: a survey among adult, national health-insured residents of The Netherlands]. PMID- 3269495 TI - [A comparative study of immediate versus complete dentures: evaluation by the patient]. PMID- 3269497 TI - [The pregnant patient in the dental practice]. PMID- 3269496 TI - [Drug prescription in dental practice]. PMID- 3269498 TI - [Diagnostic criteria for root surface lesions]. PMID- 3269499 TI - [Frequency of prescribing bitewing radiographs. A survey among Dutch dentists]. PMID- 3269500 TI - [Periodontal knowledge, attitude and behavior of Dutch adolescents]. PMID- 3269501 TI - [Evaluation of dental treatment before graduating]. PMID- 3269502 TI - [Dental care in the supplementary national health insurance: an assessment]. PMID- 3269503 TI - Fluctuations in intra-ocular pressure with sleep: I. Time course of IOP increase after the onset of sleep. AB - Ten normal subjects slept over a series of four nights for time periods of 30 minutes, 1, 2 and 4 hours. Intra-ocular pressure (IOP) measurements were made using a non-contact tonometer before and after sleep. The subjects showed a significant increase in IOP of 3.45 mm Hg after 30 minutes of sleep and a further IOP increase thereafter to 6.41 mm Hg above baseline. Such increases in IOP after sleep in normal subjects suggest that glaucoma patients and those suspected of having glaucoma should be monitored overnight to assess their IOP control mechanisms. PMID- 3269504 TI - Fluctuations in intra-ocular pressure with sleep: II. Time course of IOP decrease after waking from sleep. AB - Intra-ocular pressure (IOP) was measured immediately after normal subjects were woken from at least 5 hours sleep. Measurements were made at approximately 15 s intervals, for about 20 minutes. The IOP of all 14 subjects was elevated after sleep and returned to baseline levels with a time course which was approximately exponential; the longest time constant of return of IOP to baseline was 1056.9 s, and the shortest 133.5 s. Mean time constant of recovery was 404.8 s. The decrease in IOP may be related to melatonin levels which increase during sleep and decrease in the light, or be related to accommodation and eye movements which may act to 'pump' aqueous from the eye. PMID- 3269505 TI - Dehydration of hydrogen contact lenses in vitro and in vivo. AB - An attempt was made to derive a model for predicting the extent of hydrogel lens dehydration in vivo (delta Wv) by using a contact lens refractometer to (1) measure the water content (W) of eight lenses ranging from 36.5 to 85.8% water before and after 90 min lens wear by six subjects; and (2) measure the rate of dehydration of the same lenses in vitro (delta Wt), in a controlled, randomized, double-masked experiment. A significant correlation was demonstrated between W and the rate of change of delta Wt (the dehydration rate, D), whereby lenses of higher water content dehydrate at a slower rate. No correlation was found between W and delta Wv or between D and delta Wv, thus precluding the development of a predictive model. Possible reasons for this failure, and directions for further research, are discussed. PMID- 3269506 TI - Are colour vision standards justified for the transport industry? AB - Colour vision standards are imposed in the road, rail, maritime and aviation industries and are often subject to vigorous opposition by those excluded by the standard. With greater emphasis in recent years on equality of opportunity, it is important that standards of personal fitness, such as colour vision standards, be subject to critical scrutiny. Such appraisal should be able to demonstrate that the community benefit arising from the application of the standard is sufficient to justify the personal and other costs of retaining the standard. This paper reviews the evidence relating to colour vision standards in the transport industries and concludes that a strong case can be made for their retention in public transport. PMID- 3269507 TI - Laboratory evaluation of blended lenticular aphakic lenses. AB - Six types of blended lenticular aspheric lenses for the correction of aphakia were assessed with respect to mass, spectacle magnification, off-axis power errors, peripheral distortion, visual field size and cosmetic appearance. Relative to spherical surfaced lenses, these lenses showed considerably reduced mass, reduced peripheral distortion, increased visual field size and improved cosmetic appearance. All but one type showed considerably reduced off-axis power errors, but none of the lenses showed much reduction in spectacle magnification. In general, the manufacturers' claims made in favour of the blended lenticular lenses were supported. PMID- 3269508 TI - The spherical aberration of intra-ocular lenses. AB - Seidel aberration theory shows that the spherical aberration of a spherically surfaced intra-ocular lens cannot be made zero but only minimized and that the optimum shape is independent of the aberration of the rest of the eye (i.e. the cornea). The optimum shape of an intra-ocular lens correcting for spherical aberration is almost plano-convex with the more curved surface facing the cornea. The resulting total Seidel spherical aberration of the whole eye cannot be made zero unless the cornea has an asphericity much higher than the population mean. PMID- 3269509 TI - Clinical experience with preferential looking acuity tests in infants and young children. AB - Early preferential looking methods for the assessment of infant visual acuity relied upon formal psychophysical procedures that were lengthy and only easily applicable to laboratory studies. Two clinically appropriate techniques evaluated in this study both maintain a forced-choice testing protocol and are administered by a single examiner. One method employs a specially constructed optical projection system to present gratings in a dark-room. The second method relies upon a commercially available acuity card test, used with good room lighting. Paediatric clinical patients and normal infants and young children were examined using both techniques. Findings demonstrate that suitably adapted preferential looking methods can provide rapid and valid estimates of visual acuity in infants and young children. The tests appear sufficiently robust to be appropriate for routine clinical use. PMID- 3269510 TI - Referrals and notifications by British optometrists. AB - 1031 British optometrists completed a questionnaire to give information on their rates of referral and notification to the medical profession. Data were collected in relation to the conditions concerned, the age and sex of the patient, and the spectacle correction. Major causes of referral were cataract, glaucoma, fundus changes, headaches/migraine/eye pain and lowered visual acuity; 6.5% of all patients seen were referred to their general medical practitioner notified, and of this group it was estimated that 25-30% could have managed with reading glasses which comprised spherical lenses of equal power. If such glasses could be self-selected, without reference to a medical practitioner or optometrist, a significant number of people would not benefit from the health screening aspects of the eye examination. PMID- 3269511 TI - Dual-mode behaviour in the human accommodation system. AB - The human accommodation system was investigated using a dynamic infra-red optometer to determine whether its feedback control process exhibited dual-mode behaviour. Ramp changes of target accommodative demand presented monocularly at various velocities (0.5-0.6 D s-1) with a fixed 2 D amplitude elicited two modes of behaviour. Smooth ramp movements were observed for low-velocity stimuli, whereas step responses predominated for high-velocity stimuli. At intermediate velocities, combined step-ramp responses were more prevalent. The characteristic of these step-ramp responses showed two important properties that suggest a pre programming mechanism. The amplitude of the step portion of a step-ramp response approximated the value of the ramp stimulus at the time corresponding to the end of the step movement. Also, the initial step amplitude increased with increasing target ramp velocity. It appears that the amplitude of the preprogrammed accommodative movement was based on an estimate of the expected ramp target position at the end of the response. These findings are consistent with a recent unifying theory of oculomotor control in which the various oculomotor subsystems (versional and vergence eye movements and accommodation) each has fast and slow components. The fast component exhibits preprogramming, while the slow component shows continuous feedback control. PMID- 3269512 TI - Responses of myopes to volitional control training of accommodation. AB - Twelve young, low myopes were trained to control volitionally their accommodation responses and to achieve clear focus on visual targets moved progressively outward in optical distance. The trainees participated in from 15 to 40 daily training sessions (mean = 28 sessions). All demonstrated volitional control with varying degrees of control authority. Though three of the trainees were unsuccessful, the group achieved a statistically reliable extension of their far points. Post-training optometric examinations were reliably improved over pre training examinations, but did not appear to be commensurate with the large gains in far-point extension. It was hypothesized that the learned skill may have been 'instrument-specific', i.e. it might not fully generalize to significantly improved post-training binocular performance unless it were accompanied by clinical assistance to transfer the training. PMID- 3269513 TI - Visual search with non-foveal vision. AB - Experiments have been carried out to determine free visual search capabilities when an observer uses only peripheral vision. Foveal vision was eliminated by simulating a full foveal scotoma by means of a stabilized retinal image. Observers were asked to search an unstructured field for a single static target. Results from these experiments established that foveal vision plays a more significant role than is generally assumed in even the most basic of search tasks where the primary mechanism for target acquisition is assumed to be detection only. Results are discussed in terms of the visual lobes for the targets of search. PMID- 3269514 TI - Correlations between ocular optical components, height and head circumference. AB - Correlations between the ocular optical components, height and head circumference were investigated in 144 subjects. Refraction had a higher correlation with axial length than with corneal curvature. On the other hand, height and head circumference had a higher correlation with corneal curvature than with axial length. These results express the dependence of refraction on the axial length and suggest a similarity between corneal and skeletal growth, compared with the relatively independent elongation of the eye. Refraction correlated significantly with head circumference but not with height, relations which may be explained by considering some of the optical components that determine refraction, rather than treating refraction as a single factor. PMID- 3269515 TI - Disparity-induced accommodation in late-onset myopia. AB - The effect of disparity-vergence on the accommodation response (AR) was measured in 10 late-onset myopes (LOMs) and 10 emmetropic subjects during the course of a 10 minute near-vision task (working distance 33 cm). Disparity was induced by the introduction of 3 and 6 delta base-out prisms placed before the right eye, and the resulting AR for the left eye was measured at 1 min intervals using an objective infra-red optometer. LOMs showed a significant increase in AR with increasing disparity whereas emmetropes showed no significant difference in AR for all disparity conditions. The implications of these findings are discussed with reference to the aetiology of late-onset myopia. PMID- 3269516 TI - A capstan toric surface can occur in two distinct forms descriptively termed pulley and capstan forms. PMID- 3269517 TI - Correction of combined anterior and posterior crossbites in the primary dentition with fixed appliances: case report. PMID- 3269518 TI - A laboratory fabricated fixed appliance for extruding anterior teeth with subgingival fractures. PMID- 3269519 TI - Enamel fluoride uptake from a new APF foam. PMID- 3269520 TI - A descriptive study of 201 uncombined alphaprodine HCl conscious sedations in pediatric dental patients (1982-1985). PMID- 3269521 TI - Nickel sensitivity in pediatric dental patients. PMID- 3269522 TI - Failure of eruption associated with anomalies of the dentition in siblings. PMID- 3269523 TI - Intra-alveolar fracture of a developing permanent incisor. PMID- 3269525 TI - Occupational exposure to AIDS. PMID- 3269524 TI - Dental development in hemifacial microsomia. I. Eruption and agenesis. PMID- 3269526 TI - The durability of primary molar restorations: I. Observations and predictions of success of amalgams. PMID- 3269527 TI - The durability of primary molar restorations: II. Observations and predictions of success of stainless steel crowns. PMID- 3269528 TI - The durability of primary molar restorations: III. Costs associated with placement and replacement. PMID- 3269529 TI - Joint meeting of the Hungarian and Polish Pharmacological Societies on actual problems of neuro-psychopharmacology. Budapest, October 1-3, 1987. Proceedings. PMID- 3269530 TI - The melatonin generating system in the rat retina and pineal gland: effect of single and repeated electroconvulsive shock (ECS). AB - N-Acetyltransferase (NAT), a rate-limiting enzyme in the melatonin synthesis which converts serotonin to N-acetylserotonin, shows a distinct circadian rhythm in the rat pineal gland and retina, with low activities during the light phase and peak activities during the dark phase. Hydroxyindole-O-methyltransferase (HIOMT), an enzyme which methylates N-acetylserotonin to melatonin, did not show any significant diurnal variations in both analyzed tissues. Isoproterenol, a selective beta-adrenoceptor agonist, when administered during morning hours of the light phase, markedly increased NAT activity in the pineal gland, but not in the retina. Electroconvulsive shock (ECS), especially when applied repeatedly (ECS x 10, once daily) significantly increased NAT activity in the retina and tended to decrease the enzyme activity in the pineal gland in isoproterenol treated rats. ECS x 10 slightly increased and decreased the nocturnally stimulated NAT activity in the rat retina and pineal gland, respectively. PMID- 3269531 TI - Syntactic analysis of the experimental epileptic EEG. AB - A new assay of afterdischarge pattern evaluation is presented, using computerized automatic analysis where procedure of data reduction, known as syntactic analysis, was involved. Effects of phenobarbital and diazepam on afterdischarge pattern were also studied. Adopting Kalman filters technique and Markov chain midel a multi-channel analysis was performed. Significant differences between effects of two tested drugs on seizure activity propagation were found. PMID- 3269532 TI - Effect of fluphenazine on the footshock-induced opioid analgesia and leu enkephalin concentration in the rat brain. AB - The effect of post-shock injection of 5 mg/kg fluphenazine on stress-induced analgesia (tail immersion test) and leu-enkephalin content in discrete brain areas (radioimmunoassay) was studied in male Wistar rats. The stress-induced analgesia, which was naloxone-reversible, was attenuated and shortened by fluphenazine, the drug also antagonized the stress-induced fall in hypothalamic leu-enkephalin content. Fluphenazine alone depressed the leu-enkephalin content in the medulla oblongata, and this effect was less marked in rats subjected to footshock. PMID- 3269533 TI - Leu-enkephalin content in rat brain during prolonged treatment with imipramine or amitriptyline. AB - The influence of imipramine (IMI) or amitriptyline (AMI) on the level of immunoreactive leu-enkephalin (ir-LENK) in the striatum and hypothalamus was studied in rats. Each drug was given by drinking water once or over periods of 1, 3, 4 and 6 months. The ir-LENK in brain perfusates was measured after 3 or 9 month treatment with IMI. The results obtained indicate that during prolonged administration of IMI the central enkephalinergic system is dynamically changed. We have observed that chronic (but not acute) administration of IMI induced different effects on LENK level in the examined structures than changes caused by treatment with AMI. PMID- 3269534 TI - The effect of various MAO-B inhibitors on rabbit arterial strip response to tyramine. AB - Studies on the response to tyramine of the rabbit pulmonal artery strip have revealed that several specific MAO-B inhibitors (TZ-650, J-580, AGN-1135, U-1424 MDL-72165 and Ro 16-6491) potentiated the responses in a dose-dependent manner, similarly as a semi-selective MAO-B inhibitor pargyline and a nonselective MAO inhibitor tranylcypromine did. Only (-)deprenyl inhibited the response. Thus the inhibition of noradrenaline-releasing effect of tyramine, a property favorable from the point of view of safety in clinical practice, is a specific feature of ( )deprenyl and not a more general characteristics of MAO-B inhibitors. PMID- 3269535 TI - Presynaptic modulation by endogenous ouabain-like substances of noradrenaline release from blood vessels. AB - The effect of an endogenous ouabain-like compound (OCL) and of ouabain was studied on [3H]noradrenaline release and on the tension of rabbit pulmonary arterial strip. Similarly to ouabain, the OLC enhanced release of [3H] NA in resting and in stimulated condition. Moreover, in the presence of OLC and ouabain, the tension of the rabbit artery increased gradually and the contraction evoked by electrical stimulation was potentiated. It is suggested that this mechanism might be involved in the physiological regulation of blood pressure or in the genesis of hypertension. PMID- 3269536 TI - Temporal-lobe abnormalities in thanatophoric dysplasia. AB - We identified distinctive and characteristic abnormalities in the hippocampal formations of 4 individuals with thanatophoric dysplasia (TD), one of whom was a fetus of 19 weeks gestational age. Primitive medial fissures in this subject could be identified, but development of the dentate gyrus and organization of the pyramidal layer in the hippocampal formation were abnormal. We infer that temporal-lobe dysmorphogenesis in TD begins between 11.5 weeks gestational age, when hippocampal and fimbriodentate fissure formation takes place, and 13.5 weeks gestational age, when differential proliferation and migration of the cells that form the pyramidal layer and the dentate gyrus takes place. Any etiology proposed for TD must not only account for disordered endochondral and endomembranous bone formation but also explain the origins of early temporal-lobe dysplasia. PMID- 3269537 TI - Neonatal cerebral venous thrombosis. AB - Five cases of neonatal cerebral venous thrombosis (NCVT) diagnosed by magnetic resonance imaging (MRI) are presented in this report. MRI was specific for the anatomic diagnosis, demonstrating involvement of the superior sagittal sinus in 3 infants or deep venous system in the remaining 2. Four cases were associated with perinatal hypoxia or cranial trauma. Three of these children show significant developmental delays. The increased use of MRI may add significant information on the association of cerebral venous thrombosis with the common systemic illnesses of newborns. PMID- 3269538 TI - Symptomatic Chiari I malformation in childhood: a report of 7 cases. AB - The Chiari I malformation, once thought to be a disorder of clinical importance only in the teen years and beyond, is now recognized as being significant in the pediatric population as well. We have reviewed 7 cases of Chiari I malformation in children less than 12 years of age. Hydrosyringomyelia was often, but not invariably, an accompanying feature, and this in turn was associated with scoliosis and motor weakness. All patients had posterior fossa and cervical decompression with dural grafting procedures, as well as various types of syringosubarachnoid shunts placed. Intraoperative ultrasound was found to be a valuable surgical adjunct. Symptoms and signs were improved or stabilized in all patients. We feel that this disorder is now more commonly reported in young children because of the increased availability of noninvasive neuroimaging techniques, especially magnetic resonance imaging. Questions are raised as to the actual incidence of undiscovered cases of this disorder in children with commonly seen conditions such as scoliosis. PMID- 3269539 TI - Planning ventriculoperitoneal shunts in infants and small children. AB - A neurosurgeon planning a ventriculoperitoneal shunt in an infant or child must consider the question of how long a shunt to use in order to compensate for linear growth. Ideally, the system should be just long enough to accommodate the child's further development without being any longer than necessary. To approach the problem systematically, we used established criteria for prediction of growth to determining the catheter length required in adulthood. Our aim was to devise a simple 'rule of thumb' method for determining the catheter length necessary for maximal survival of a functioning shunt system. PMID- 3269540 TI - Relationship between intracranial and sagittal sinus pressure in normal and hydrocephalic dogs. AB - The relationship between intracranial and sagittal sinus pressure in normal and kaolin-induced hydrocephalic greyhounds was examined. In normal dogs there was an average 14 mm Hg pressure difference between the ventricles and the sagittal sinus. Elevations of intraventricular pressure were accompanied by small but consistent elevations in sagittal sinus pressure. In hydrocephalic dogs the average pressure differential was only 2 mm Hg. Also elevations of intraventricular pressure were accompanied by greater elevations in sagittal sinus pressures than those seen in normal dogs. The volume-buffering capacity of the sagittal sinus was decreased, and sinography revealed filling of unusual venous collaterals in hydrocephalic dogs--both suggesting an increased resistance to outflow in the sagittal sinus. PMID- 3269541 TI - The Neuro Image Quiz. Macrocephaly. PMID- 3269542 TI - Posterior fossa mass and hydrocephalus in a 7-month-old boy. PMID- 3269543 TI - A technique for removal of an adherent ventricular catheter. AB - A method of freeing the attachment of the intraventricular catheter to the ventricular ependyma or chorioid plexus is described. A metal ventricular cannula is inserted into the lumen of the ventricular catheter and a cutting current from a unipolar diathermy is applied to the distal end. The cutting effect at the interventricular end of the metal cannula effectively lyses the adhesions and permits safe removal of the ventricular catheter without subsequent bleeding. PMID- 3269544 TI - Canadian dental hygienist study. Part I: Demographic and educational profile highlights. PMID- 3269546 TI - Obesity: a case for prevention. PMID- 3269545 TI - Canadian Fund for Dental Education (C.F.D.E.). PMID- 3269547 TI - Teeth make their "mark" in forensic odontology. PMID- 3269548 TI - Ridge maintenance by root submergence. PMID- 3269549 TI - Idiopathic focal gingival fibromatosis: a case report. PMID- 3269550 TI - Clinical incident associated with Nobelpharma(R) fixture mounts. PMID- 3269552 TI - Gingival attachment on carious roots. PMID- 3269551 TI - Periodontosis case report: 20-year follow-up with laboratory findings. PMID- 3269553 TI - 12-year follow-up study of the Hamburg short psychotherapy experiment: an overview. AB - In 1971/72 eighty-seven psychoneurotic and psychosomatic patients of the Psychosomatic Outpatient Department at the University Clinic of Hamburg-Eppendorf attained an indication for short-term psychotherapy. Nineteen patients did not accept our offer despite a sufficient prognosis; they form the nontreated control group. The remaining 68 patients were assigned at random to a psychodynamic conflict-centered (n = 34) or to a client-centered therapy (n = 34), each with a maximum of 30 sessions. In spite of this long interval of 12 years we gained information about 82.5% of our patients. The follow-up program consisted of a multidimensional approach to describe the posttreatment development of our patients: psychological tests, self-rating by the patient and assessments by the follow-up interviewer and independent ratings of experts. The efficacy of short psychotherapy is seen in the test scale 'extraversion' for both treatment groups, for 'depression' only for the client-centered therapy; for the psychodynamic therapy there is a tendency for late changes. The clinical ratings show no significant differences between the treatment and the control groups. Sex combination in the therapeutic dyads (i.e. same sex vs. opposite sex) is important for patients' posttherapeutic development. PMID- 3269554 TI - Attempted suicide in psychiatric outpatients with concurrent physical illness. AB - Fifty outpatients with concurrent psychiatric and physical illness who were referred following a suicidal attempt to the Outpatient Psychiatric Department, University of Athens, during a period of 3 years (1979-1981) were compared with a random sample of 85 psychiatric outpatients without concurrent physical illness who had attempted suicide at the same time period. Attempters suffering from both mental and physical illness were more often of an older age, married, pensioners or housewifes, were living with their own family, were suffering from organic psychotic condition or major affective disorder (depressive type) and more frequently used violent methods for attempting suicide. Among attempters the commonest physical illnesses were neurological diseases (40%), cardiovascular diseases (26%) and cancer (10%). PMID- 3269555 TI - Patterns of depression in medical patients and their relationship with causal attributions for illness. AB - The present study investigated the factor structure of the Beck Depression Inventory (BDI), and causal attributions for the development of illness in a sample of 102 inpatients of a thoracic surgery department, with the main objective of examining the power of causal attributions and functional support in predicting different factors derived from the BDI. The results revealed that the BDI clusters into affective/motivational, somatic/vegetative, self-blame and self punitiveness dimensions. Causal attributions for the development of illness were represented by family conflicts, environmental adversity, finance/health problems, bad luck, and four self-related clusters. Examination of the predictors of the BDI dimensions showed that causal attributions to uncontrollable, unmodifiable variables were predictors for the affective/motivational dimension, whereas illness severity and greater age were related to the somatic/vegetative symptomatology. The results supported the recommendations for the exclusion of such symptoms in assessing depression severity among medical patients. PMID- 3269556 TI - Cardiovascular reactivity, hostility, and family history of hypertension. AB - This study was conducted to evaluate the relations between cardiovascular reactivity and two types of hostility, namely, overt expression of hostility in contrast to the covert experience of hostility. Diastolic blood pressure reactivity was associated with not overtly expressing hostility. For persons with a parental history of hypertension, systolic blood pressure (SBP) reactivity was associated with low scores on the covert hostility measure of irritability, while for persons without a parental history of hypertension, SBP reactivity was associated with high scores for irritability. The results are discussed in light of research in the area of cardiovascular reactivity and stress-related cardiovascular disease. PMID- 3269557 TI - Dynamic factors affecting lesion initiation and progression in human dental enamel. Part I. The dynamic nature of enamel caries. PMID- 3269558 TI - The need for early infant and toddler dental care: a pictorial argument. PMID- 3269559 TI - Characteristic abrasion of permanent incisors in Jordanians caused by a bad eating habit. PMID- 3269560 TI - Odd gums: the prevalence of common gingival and alveolar lesions in 23,616 white Americans over 35 years of age. PMID- 3269561 TI - Dynamic factors affecting lesion initiation and progression in human dental enamel. II. Surface morphology of sound enamel and carieslike lesions of enamel. PMID- 3269562 TI - Veneering serviceable restorations. PMID- 3269563 TI - The use of apically positioned flaps in association with overdenture abutments. PMID- 3269564 TI - Use of implants in restorative therapy in patients with reduced periodontal tissue support. PMID- 3269565 TI - Erythema migrans of the oral mucosa. Report of two cases. PMID- 3269566 TI - Biocompatibility of an enamel and dentin adhesive under different conditions of application. PMID- 3269567 TI - Effect of storage time and ambient humidity on accuracy of dental elastomeric impression materials. PMID- 3269568 TI - The toxicity of amalgam: a preliminary report. PMID- 3269569 TI - The adaptation of a visible light cured calcium hydroxide liner to dentin. PMID- 3269570 TI - Effects of sodium fluoride and stannous fluoride solutions on caries-like lesion formation around adhesive orthodontic brackets: an in vitro study. PMID- 3269571 TI - Use of combined periodontal and restorative procedures in the comprehensive esthetic treatment of anterior teeth. Report of a case. PMID- 3269572 TI - Clinical significance of the supplementary innervation of the mandibular teeth: a dissection study of the transverse cervical (cutaneous colli) nerve. PMID- 3269573 TI - A scanning electron microscope study of the end rounding of bristles in eight toothbrush types. PMID- 3269574 TI - The influence of different base materials on marginal adaptation and wear of conventional Class II composite resin restorations. PMID- 3269575 TI - Functional and esthetic oral rehabilitation of an oboe player by transdental fixation: report of a case. PMID- 3269576 TI - A technique for esthetic treatment of maxillary anterior infrabony lesions. PMID- 3269577 TI - Causes of failure following oral rehabilitation: biological versus technical factors. PMID- 3269578 TI - Facial palsy: a complication of sagittal ramus osteotomy (Obwegeser-Dal Pont technique). Report of a case. PMID- 3269579 TI - Aspirin, buffered aspirin, and effervescent buffer rinses in reducing gingival inflammation in patients with gingivitis and early periodontitis. PMID- 3269580 TI - Uprighting of ectopically erupting molars in children. PMID- 3269581 TI - Lingual nerve damage: causative factors and management. PMID- 3269582 TI - Simulating irregular enamel surface texture in composite resin restorations. PMID- 3269583 TI - A caries-free pattern of response by oral tissues to coverage by a mucosa-borne removable partial denture. PMID- 3269584 TI - The use of composite resin for creating anterior guidance during occlusal therapy. PMID- 3269585 TI - Extramarginal enamel marker used to facilitate finishing of composite resin restoration margins. PMID- 3269586 TI - A quantifying grid for the Cavidrill training aid. PMID- 3269587 TI - Surface energy of chemomechanically prepared dentin. PMID- 3269588 TI - Rubber dam--an essential safeguard. PMID- 3269589 TI - The loose self-threading pin: treatment alternatives. PMID- 3269590 TI - Clinical guide for removing caries using a caries-detecting solution. PMID- 3269591 TI - A comparison of articulator settings obtained using a computerized pantograph with settings obtained using a lateral check bite recording. PMID- 3269592 TI - Post-endodontic obturation pain: a comparative evaluation. PMID- 3269593 TI - Dens evaginatus: report of a case. PMID- 3269594 TI - An SEM study of the effects of air-polishing on fissure surfaces. PMID- 3269595 TI - Operative procedures prior to reconstructive therapy. PMID- 3269596 TI - Tooth color modification and porcelain veneers. PMID- 3269597 TI - Reconstructive mucogingival surgery: the management of amalgam tattoo. PMID- 3269598 TI - Partial edentulism treated with cast framework removable partial dentures. PMID- 3269599 TI - Overdentures for the general dental practitioner. PMID- 3269600 TI - The transitional complete denture. PMID- 3269601 TI - Retrieval of silver points: report of a case. PMID- 3269602 TI - Radiopacity and color of elastomeric impression materials. PMID- 3269603 TI - Sealants in a school-based preventive program: a six-month evaluation. PMID- 3269604 TI - Aseptic dental alginate impressions. PMID- 3269605 TI - Successful intentional reimplantation of mandibular molars. PMID- 3269606 TI - A method for bleaching discolored vital teeth. PMID- 3269607 TI - Measurement of sealant volume in vivo using image-processing technology. PMID- 3269608 TI - Softening of composite resin by moisture and cements. PMID- 3269609 TI - "Future radiology" vs. traditional methods. PMID- 3269610 TI - The bifunctional posterior restoration. PMID- 3269611 TI - [Analysis of binding times of dental plaster]. PMID- 3269612 TI - [Minigraph, its structure and applications]. PMID- 3269613 TI - [Comparative studies on resistance to corrosion of alloys based on nickel (Ni Cr)]. PMID- 3269614 TI - 2000. PMID- 3269615 TI - First impressions. PMID- 3269616 TI - OSHA inspection. PMID- 3269617 TI - Pressure point. PMID- 3269618 TI - [Restoration of pulpless teeth with corono-radicular amalgam]. PMID- 3269619 TI - [Arterial pressure in dental practice]. PMID- 3269621 TI - [Use of laser rays in the medico-dental field]. PMID- 3269620 TI - [Mechanical agents for control of bacterial plaque used by occupational categories in the city of Aracatuba--toothbrushes]. PMID- 3269622 TI - [Some effects of puberty, the menstrual cycle, pregnancy and menopause on the oral cavity]. PMID- 3269623 TI - [Radiography of residual pathology in the edentulous]. PMID- 3269624 TI - [3 mandibular incisors]. PMID- 3269625 TI - [Analysis of a France -- U.S.A. bibliographic study of the 1975-1985 decade]. PMID- 3269626 TI - [The role of the orthodontist in surgical-orthodontic treatment. 1. Segmental osteotomies]. PMID- 3269627 TI - [A case of atypical traumatic monoalveolysis]. PMID- 3269628 TI - [Electrogenesis mechanisms of slow excitatory and inhibitory postsynaptic potentials in hamster submandibular ganglion cells]. PMID- 3269629 TI - [Judging of antero-posterior mandibular position by gripping the temporal muscle region]. PMID- 3269630 TI - [Experimental studies on the healing process of full-thickness mucosal autograft in the mouth]. PMID- 3269631 TI - [Colonization mechanism of Bacteroides intermedius]. PMID- 3269632 TI - [Alterations in the length of lateral segments during the transitional period between deciduous and permanent dentition]. PMID- 3269633 TI - [Decoding and color imaging of X-ray CT data with a personal computer]. PMID- 3269634 TI - [Electron microscope studies of changes of ameloblasts after administration of various kinds of drug]. PMID- 3269636 TI - [Effects of sodium fluoride on the glycolytic metabolism and fluoride adaptation of Actinomyces viscosus Frank 1 in short and long-term continuous culture]. PMID- 3269635 TI - [An experimental study on marginal seal of dental cements used in crowns and bridges]. PMID- 3269637 TI - [Fluoride distribution and chemical reaction to fluorides in human permanent cementum]. PMID- 3269638 TI - [Experimental studies on the lateral force exertion mechanism in the final phase of chewing stroke]. PMID- 3269639 TI - [An experimental study on regeneration of the periodontal ligament of rat incisor in vivo and in vitro]. PMID- 3269640 TI - [Immunohistochemical study on regeneration of the rat submandibular gland]. PMID- 3269641 TI - [Dental caries prevalence in infants under a dental health care program]. PMID- 3269642 TI - [An experimental study on permeability, cell coupling and intercellular junctions in acinar cells during secretion. Morphological changes of tight and gap junctions in rat submandibular gland]. PMID- 3269643 TI - [Development of junctional epithelium of the rat molar. A study using immunohistochemistry and electron microscope]. PMID- 3269645 TI - [Histopathological studies of periodontal tissue reactions using hard-setting materials for furcation perforation treatment in dogs]. PMID- 3269644 TI - [The role of 5-hydroxytryptamine (5-HT) on biosynthesis of sialic acid and secretory function in rat submandibular gland]. PMID- 3269646 TI - [Translucent crystallized mica castable ceramics]. PMID- 3269647 TI - [Growth and development of the dental arch, alveolar ridge and palate in the lateral segment from the late period of mixed dentition to the early period of permanent dentition]. PMID- 3269648 TI - [Changes in oral functions before and after surgical-orthodontic treatment by means of video]. PMID- 3269649 TI - [The reappearance of mandibular movement]. PMID- 3269650 TI - [Oral colonization of Bacteroides gingivalis and effects of the antibody on plaque-susceptible rats]. PMID- 3269651 TI - [An experimental study on dentinogenesis in rat incisor pulp tissue]. PMID- 3269652 TI - [Redundant shadows in panoramic tomography. Estimating the imaging positions of the objects by mathematical analysis]. PMID- 3269653 TI - [Reduction of redundant shadows using the new panoramic tomograph "PM 2002 CC"]. PMID- 3269654 TI - [Electron microscopy and electron immunohistochemistry of enamel protein]. PMID- 3269655 TI - [A scanning electron microscopic study on secondary dentin in deciduous teeth]. PMID- 3269656 TI - [The effect of dressings on healing of experimental wounds in the oral mucosa. Especially the effect of collagen wound dressings]. PMID- 3269657 TI - [The fine structure of microcanals in deciduous coronal dentin]. PMID- 3269658 TI - [Physiological characteristics of tissues surrounding an osseointegrated implant and the present clinical situation in Tokyo Dental College]. PMID- 3269659 TI - [The chronic form of Reiter's syndrome]. PMID- 3269660 TI - [Etiologic factors in premature labor in pregnant women with insulin-dependent diabetes]. PMID- 3269661 TI - [Medullary carcinoma of the thyroid gland]. PMID- 3269662 TI - [Neutrophil values in neonatal sepsis]. PMID- 3269663 TI - [The importance of a battery of tests in the etiologic diagnosis of allergic contact dermatitis]. PMID- 3269664 TI - [The medico-legal significance of natural death in the geriatric population]. PMID- 3269665 TI - [Cholesteatoma of the tympanic cavity caused by osteoma of the mastoid process]. PMID- 3269666 TI - [Multiple adenomatous polyposis of the colon with malignant changes]. PMID- 3269667 TI - [A bleeding ulcer in Meckel's diverticulum diagnosed preoperatively]. PMID- 3269668 TI - [Social support and health]. PMID- 3269669 TI - [Changes in the eye in diabetes]. PMID- 3269670 TI - [The Y-type drainage implant in surgery in neovascular glaucoma]. PMID- 3269671 TI - [Surgical treatment of the sequelae of proliferative diabetic retinopathy in the posterior segment of the eye]. PMID- 3269672 TI - Assessment of functional low-density lipoprotein receptor activity on lymphocytes of normal subjects and patients with familial hypercholesterolemia. AB - In FH, abnormalities of the gene encoding the receptor for LDL lead to hypercholesterolemia and premature atherosclerosis. A method to identify LDL receptor defects using peripheral blood lymphocytes has been developed. When endogenous synthesis of cholesterol was blocked, proliferation of mitogen stimulated normal human lymphocytes was markedly inhibited unless an exogenous source of sterol was supplied. When exogenous sterol was provided as a plasma lipoprotein, LDL receptor-mediated interaction with apolipoprotein-B or -E was essential for the provision of cholesterol to normal human lymphocytes. Thus, functional LDL receptors were necessary to permit proliferation of normal lymphocytes in these cultures. Lymphocytes from patients heterozygous for abnormalities in the LDL receptor gene can be distinguished from normal lymphocytes by their diminished functional LDL receptor activity. Of interest, following treatment with plasma cholesterol-lowering agents, functional lymphocyte LDL receptor activity normalized in some but not all patients with heterozygous FH, whereas plasma LDL cholesterol levels decreased in all patients. These results suggest that therapy with plasma cholesterol-lowering agents can lead to increased expression of LDL receptors by lymphocytes in the majority of patients with heterozygous FH. The failure of some heterozygous FH patients to increase functional LDL receptor activity after prolonged therapy indicates that there is heterogeneity in these patients despite a similar capacity of the therapy to decrease plasma LDL cholesterol. Variability in the expression of the normal LDL receptor gene in individual T lymphocytes may account for some of these findings. PMID- 3269673 TI - Glucocorticoid-induced DNA fragmentation in acute lymphoblastic leukemia cells. PMID- 3269674 TI - Thrombin is an important mediator of cyclic coronary blood flow variations due to platelet aggregation in stenosed canine coronary arteries. PMID- 3269676 TI - Improving health service performance by modifying medical practices. PMID- 3269675 TI - Expression of a metallothionein-vasopressin fusion gene in transgenic mice produces hypervasopressinemia and manifestations of nephrogenic diabetes insipidus. PMID- 3269677 TI - An effective new prognostic staging system for AIDS. PMID- 3269678 TI - Primary biliary cirrhosis (PBC): is effective therapy now at hand? PMID- 3269679 TI - Effects of inspiratory loading on 31phosphorus magnetic resonance spectroscopy of the inspiratory intercostal muscles in normal humans. PMID- 3269680 TI - Cloning and expression of the chicken ovary aromatase P-450: expression of mRNA in tissues of the Sebright and Leghorn chicken. PMID- 3269681 TI - Conversion of medullipin I by the liver. PMID- 3269682 TI - Electrophysiologic effects of aspirin on myocardium: interaction with catecholamine. PMID- 3269683 TI - Prehypertensive Dahl S rats show no rise in glomerular filtration rate after an amino acid infusion. AB - When one administers a protein or amino acid load, both GFR and renal blood flow increase about 40% in normal humans as well as in dogs and rats. The protein load causes vasodilation in both the afferent and the efferent arterioles. In these prehypertensive Dahl S rats, it is likely that there is already some vasodilation of the afferent and efferent arterioles and possibly some mesangial relaxation, in order to bring the GFR to normal levels in the face of some intrinsic abnormality in glomerular filtration. Since these arterioles are already dilated, there can be little further dilation in response to the amino acid load and hence no further increase in GFR. It is possible that this limited capacity for further vasodilation could serve as a predictor of future hypertension. PMID- 3269684 TI - Histidyl-proline diketopiperazine causes satiety by antagonism of norepinephrine metabolism in the hypothalamic paraventricular nucleus. PMID- 3269685 TI - The effect of phospholipid (lysophosphatidylcholine) on arterial relaxation in vitro and in situ. PMID- 3269686 TI - Strengthening the links between research and management. PMID- 3269687 TI - Betel-nut chewing and pregnancy. PMID- 3269688 TI - An analysis of gastrointestinal malignancies in Papua New Guinea: a 27-year study (1958-1984). PMID- 3269689 TI - Knowledge and attitudes related to oral health of children attending community schools in Port Moresby. PMID- 3269690 TI - Inaccuracies in the reporting of genealogies in a highlands community in Papua New Guinea. PMID- 3269692 TI - Wife-beating in Papua New Guinea--is it a problem? PMID- 3269691 TI - Infertility amongst Asaro Valley women. PMID- 3269693 TI - Who attends antenatal clinics in the National Capital District? An analysis of clinic records. PMID- 3269694 TI - Trends in the nationalization and qualifications of Papua New Guinea's provincial assistant secretaries for health. PMID- 3269695 TI - Dysfunctional uterine bleeding: when an 'abortion' is not an abortion. PMID- 3269696 TI - Modern operative concepts in treatment of strictures of posterior urethra, of urethrocutaneous and urethrorectal fistulas. PMID- 3269697 TI - Controlled breeding in the Asiatic buffalo (Bubalus bubalis). AB - Recent developments in exogenous hormone therapy to control and facilitate breeding in domestic buffalo cows (B. bubalis) are reviewed. Oestrus in domestic animals was synchronized satisfactorily during the normal breeding season by both of the standard treatments with prostaglandins or progestagens initially developed for use in Bos taurus cattle. Anoestrous cyclic cows treated with prostaglandin showed synchronized oestrus and conception rates similar to those recorded in normal cyclic animals, though the responses may have depended to some extent on increased intensity of observation of oestrus. Seasonally acyclic animals treated with progestagens and pregnant mare serum gonadotrophin also showed synchronized oestrus and conception rates equivalent to those recorded in cyclic animals, but these observations did not include prepubertal heifers or cows in the early stages of post-partum anoestrus. Controlled breeding did not overcome a general problem of low conception rates at spontaneous oestrus. Further investigations of controlled breeding should incorporate other management strategies, such as better feeding and reduced heat stress, which are known also to improve buffalo reproduction. PMID- 3269698 TI - Ovulation in the merino ewe in the breeding and anoestrous seasons. AB - The pattern of ovulation of Merino ewes was studied by repeated laparoscopy each 14 days in the anoestrous (n = 97) and breeding (n = 87) seasons. In the anoestrous season the proportion of ewes ovulating did not decrease below 11%, 42% of ewes never ovulated and the remainder fluctuated between the two states. On 20 occasions a clear anovulatory period was interrupted by an isolated spontaneous ovulation. In the breeding season the overall mean proportion of ewes with corpora lutea or albicantia at laparoscopy was 87%, 54% of ewes ovulated regularly throughout while in another 31% absence of corpora lutea or albicantia coincided with the follicular phase of an oestrous cycle as evidenced by an appropriately aged corpora lutea at the next laparoscopy. Of the remaining 15% of the flock 3% had anovulatory periods greater than 14 days while the remainder experienced irregular ovulatory cycles--the majority due to short periods of anovulation but some ewes retained corpora lutea for longer than 14 days while others ovulated twice between successive laparoscopies. PMID- 3269699 TI - Potential for fecundin to influence the reproductive performance of merino ewes in Western Australia. AB - Four experiments were conducted at different locations in Western Australia to evaluate the effectiveness of immunizing young (maiden, 1 1/2 year old) and adult Merino ewes with Fecundin to improve their reproductive performances. The ovulation rates of immunized maiden ewes was increased (0.06-0.30) above that of untreated ewes in both experiments 1 and 2. However, there were no significant improvements in the marking percentages for the immunized ewes with the differences between the untreated and immunized ewes ranging from -16.4 to 5.8%. In comparison with untreated ewes immunization 6 and 2 weeks before the start of joining depressed ewe fertility by 26.1% whereas immunization 8 and 4 weeks before the start of joining did not significantly affect fertility. The availability of oat grain ad libitum prior to parturition and during early lactation did not improve the survival of lambs born to immunized ewes. In experiments 3 and 4 immunization of adult Merino ewes increased their ovulation rates (0.41-0.63) above untreated controls and tended to increase the proportion of pregnant ewes which had multiple pregnancies (from -2.3 to 34.2%). The responses at the end of lambing were variable (from -19.8 to 37.5% lambs marked) with high lamb mortalities occurring in some experiments. There was no adverse effect on the reproductive performances following consecutive annual immunizations over 3 years and the absence of treatment for 1 year did not prevent a response in the following year. PMID- 3269700 TI - Reproductive behaviour in survival: a comparison between wild and domestic sheep. AB - The recorded behaviour of wild species of Ovis at the beginning of the breeding season supports the proposal that mating is synchronized by the 'ram effect', a phenomenon already described in domestic sheep. Animals separate into exclusive male flocks, and flocks of females and young animals for most of the year. They reunite just before the rutting season. At lambing there appear to be behavioural mechanisms that ensure that ewes lamb in close proximity to one another. It is hypothesized that these behavioural characteristics of wild sheep help protect the newborn and that much of the reproductive and maternal behaviour of domestic sheep may be traced to comparable behaviour in wild species. PMID- 3269701 TI - Onset of psoriasis coincident with tetracycline therapy. PMID- 3269702 TI - Spectacle frame dermatitis due to paraphenylenediamine. PMID- 3269703 TI - PUVA therapy of chronic actinic dermatitis. PMID- 3269704 TI - But can you prove it? PMID- 3269705 TI - Australian Dermatopathology Society. Multiple indurated skin nodules. PMID- 3269706 TI - How many dermatologists? 1973 revisited. PMID- 3269707 TI - Panniculitis: problems with diagnosis. PMID- 3269708 TI - Trichothiodystrophy--biochemical and clinical studies. PMID- 3269709 TI - Polyurethane implants: a 6-year review of 416 patients. AB - The author reviews 6 years of experience and 416 patients in whom polyurethane implants were used for augmentation and reconstruction of the breast. As with many other plastic surgeons, early use was confined to "salvage cases." Owing to the impressive results, use was extended to routine augmentation. Polyurethane implants are now used exclusively for aesthetic breast surgery. Results are evaluated for replacement of gel capsules and simple and radical mastectomy reconstruction. Gel capsules (Baker stages III to IV), in which prostheses were removed and replaced with polyurethane-covered implants, improved in 29 of 32 patients (87 percent). For reconstruction, placement of polyurethane implants in unscarred situations gives far superior results than following repeated procedures. The incidence of infection is no higher than with gel implants. Removal without capsulectomy was not a problem in most instances. However, on two recent occasions capsulectomy was extremely difficult. PMID- 3269710 TI - Advice versus extended treatment for alcoholism. PMID- 3269711 TI - Prevention of accidental extubation in newborns. AB - Maintaining endotracheal intubation is critical to treating respiratory failure in newborns. To reduce accidental extubations in our neonatal intensive care unit, a prospective comparison of rates of extubation was made between two taping methods and whether or not a head restraint was used. One tape method was significantly better at preventing accidental extubations. Head restraint was not a benefit when used prospectively. Factors that preceded or were associated with accidental extubation included the time intubated, infant agitation, endotracheal tube suctioning, the infant turning its head, chest physiotherapy, loose tape, too short a tube between lip and adapter, weighing, and endotracheal tube taping. This information and the study design are valuable in developing strategies to minimize accidental endotracheal extubation and the subsequent risks of airway injury and subglottic stenosis in sick newborns. PMID- 3269712 TI - Impacted Sengstaken Blakemore tube. PMID- 3269713 TI - Malignant lymphoma presenting as initial symptom in the uterus. Case report. PMID- 3269714 TI - A simple method for determination of plasma thiocyanate. AB - We describe a method for the determination of thiocyanate in plasma from blood collected under field conditions in heparinised glass capillary tubes. After deproteinisation of plasma with perchloric acid, thiocyanate is directly determined colorimetrically by the Konig reaction with sodium hypochlorite as the chlorinating reagent and barbituric acid as the coupling agent. This simple method cannot be applied to urine as the latter contains interfering compounds. PMID- 3269715 TI - Comparison of latex and haemolysin tests for determination of anti-streptolysin O (ASO) antibodies. AB - A latex agglutination test was compared with the micro-titration haemolysin inhibition method for the detection of anti-streptolysin O (ASO) antibodies in 428 serum samples. After slight modification of the latex method to produce maximal agglutination good agreement was shown between the results obtained by the two methods. The latex test had a sensitivity of 83.6%, a specificity of 93.3%, a predictive positive value of 86.5% and a predictive negative value of 91.6%. It was convenient, required less labour than the haemolysin test, and permitted economic testing of small numbers of sera. PMID- 3269716 TI - Effect of oxidant gases on membrane fluidity and function in pulmonary endothelial cells. PMID- 3269717 TI - Human parasitology, an integral medical science. PMID- 3269719 TI - [3 cases of furunculoid myiasis caused by Dermatobia hominis larvae]. PMID- 3269718 TI - [Immunodiagnosis of onchocerciasis]. PMID- 3269720 TI - [Chronic Chagas cardiopathy in Chile. Frequency of abnormal electrocardiograms in 13,515 inhabitants of rural and periurban areas of endemic Chagas disease, with positive or negative serology]. PMID- 3269721 TI - [Cryptosporidiosis in children under 2 years of age. Efficacy of 2 technics used for laboratory diagnosis]. PMID- 3269723 TI - [Intestinal infections by protozoa and helminths in predominantly ambulatory patients seen at 16 institutions of the Northern Metropolitan Health Service, Chile, 1985-1987]. PMID- 3269722 TI - [Nutritional status in children under 6 years of age and its association with malaria and parasitic intestinal diseases in Cordoba, Buenaventura, Colombia]. PMID- 3269724 TI - [Induced resistance in human volunteers to increasing doses of Loxosceles laeta spider venom]. PMID- 3269725 TI - The Edinburgh declaration. PMID- 3269726 TI - [Anisakid nematodes in autochthonous fishes of the Valdivia river basin, Chile]. PMID- 3269727 TI - [Intestinal protozoa and helminths: frequency of infection, nutritional status and digestive manifestations in children at boarding houses and a day care center in Santiago, Chile . 1988]. PMID- 3269728 TI - [Infection by Diphyllobothrium pacificum, probably acquired in the South of Chile, in a 3-year-old child]. PMID- 3269729 TI - [Evaluation of the effectiveness of albendazole in the treatment of human strongyloidiasis]. PMID- 3269730 TI - [Epidemiology of bovine and porcine cysticercosis in Chile. Tendencies of the prevalence rates, in animals slaughtered in abattoirs of the country. 1977-1986]. PMID- 3269731 TI - [Epidemiology of animal fascioliasis in Chile. Tendencies of infection rates, by regions, in 5 species of mammals for consumption slaughtered in abattoirs of the country. 1977-1986]. PMID- 3269732 TI - [Braunina cordiformis Wolf, 1903 (Digenea: Brauninidae) in a Chilean dolphin Cephalorhynchus eutropia Gray, 1846 (Cetacea: Odontoceti)]. PMID- 3269733 TI - [Parasitism by Pleistophora sp. in coho salmon (Oncorhynchus kisutch) in Chile]. PMID- 3269734 TI - [Experimental infection in AxC rats with increasing inoculation doses of Trichinella spiralis larvae and distribution of the resulting larvae in various muscular groups]. PMID- 3269736 TI - New angles on the radiographic examination of the hand--II. PMID- 3269735 TI - 'Hunt the thimble': a study of the radiology of ingested foreign bodies. PMID- 3269737 TI - Economic aspects of computed tomography service. PMID- 3269739 TI - Manual or automatic exposure controller imaging in mammography. PMID- 3269738 TI - The selection of films and intensifying screens for use as a two-dimensional detector in a computed tomography system. PMID- 3269740 TI - Provision and management of a mobile routine radiographic service to the community. PMID- 3269741 TI - [Necessary knowledge of molar form for restoration]. PMID- 3269743 TI - [Treatment of cardiorespiratory emergencies]. PMID- 3269742 TI - [Malocclusion involving the joint]. PMID- 3269744 TI - [Changes in periodontal tissues in aging]. PMID- 3269745 TI - [Test of 4 osseointegrated implants]. PMID- 3269746 TI - [Physiopathology of aging bone]. PMID- 3269747 TI - [Distalization of molars using magnetic forces]. PMID- 3269748 TI - [Tweed treatment and the biretrusive profile]. PMID- 3269749 TI - [Schilder technic]. PMID- 3269750 TI - [Place the front teeth where they grew]. PMID- 3269751 TI - [The upper arch: the position of each tooth]. PMID- 3269752 TI - [Lower arch: how to place each tooth]. PMID- 3269753 TI - [Postero-lateral: esthetic and functional selection]. PMID- 3269754 TI - [Harmonization of the teeth in the context of expression]. PMID- 3269756 TI - [The plate assists in carrying out diverse functions]. PMID- 3269755 TI - [Analysis of a case of cleido-cranial dysostosis]. PMID- 3269757 TI - [Characterization in placement of anterior teeth]. PMID- 3269758 TI - [Esthetics and anatomical conditions]. PMID- 3269759 TI - [Occlusal pathology and TMJ]. PMID- 3269760 TI - Canine periodontal disease. PMID- 3269761 TI - Correction of a base--narrow mandibular canine teeth. PMID- 3269762 TI - Correction of rostrally-displaced maxillary canines. PMID- 3269763 TI - Case report: chronic recurrent halitosis. PMID- 3269765 TI - Case report: locating a migrating canine tooth with X-ray. PMID- 3269764 TI - Case report: control of stomatitis by use of an astringent obtundent. PMID- 3269766 TI - The Ultrafil Technique. PMID- 3269767 TI - Crowns and restorations. PMID- 3269768 TI - The diagnosis and treatment of oronasal fistulas in three cats. PMID- 3269769 TI - Inappropriate crown amputation. PMID- 3269770 TI - Extraction, pulpectomy, pulpotomy, or blunting of macaque canine teeth. PMID- 3269771 TI - Some new thoughts on feline stomatitis/gingivitis complex. PMID- 3269772 TI - "Orthodontics: a starting point". PMID- 3269773 TI - Canine periodontal disease--clinical examination and diagnosis. PMID- 3269774 TI - Restorative materials--plastics. PMID- 3269775 TI - The use of bleach and hydrogen peroxide in endodontics irrigation. PMID- 3269776 TI - Mandibular osteomyelitis caused by Coccidiodes immitis. PMID- 3269778 TI - Orthodontic tooth movement of canine teeth. PMID- 3269777 TI - Fractured maxillary first molars in two dogs. PMID- 3269779 TI - Approach to feline oral disease. PMID- 3269780 TI - Maxillectomy in a nine-year-old cat. PMID- 3269781 TI - The procedure for complete dental prophylaxis. PMID- 3269783 TI - Nomenclature systems. PMID- 3269782 TI - To whom it may concern: brachygnathism. PMID- 3269784 TI - The Oklahoma Canine Oral Health Index. PMID- 3269785 TI - Amalgam. PMID- 3269786 TI - The chloropercha dip technique. PMID- 3269787 TI - Use of the McSpadden compactor for root canal obturation in dogs and macaques. PMID- 3269788 TI - Osteoblastoma of the mandible--a case report. PMID- 3269789 TI - The percentage reliability of Angle ANB. PMID- 3269790 TI - Submucous cleft palate anomaly in India--a hospital based study. PMID- 3269791 TI - Orthodontic management of maxillary, bilaterally and palatally impacted canines- a case report. PMID- 3269792 TI - Multiple supernumerary teeth--a short case report. PMID- 3269793 TI - Central haemangioma of the maxilla--a rare entity. PMID- 3269794 TI - Emergency method of splinting teeth. PMID- 3269795 TI - The structure of the mycelial wall of Agaricus bisporus. AB - The chemical composition of fractions extracted from the mycelial walls of Agaricus bisporus was studied. Attempts were made to locate these materials "in situ" by comparing electron micrographs of shadowed and sectioned cell walls. There are at least two chemically distinct species of carbohydrate polymers: one yielding mainly glucose with lower amounts of mannose, galactose and xylose and amino acids, and the other yielding chiefly N-acetylglucosamine with some glucose and amino acids. It was shown that none of these polymers constituted a completely physically distinct layer, but there do seem to be two regions at the outer and inner surfaces with apparently different properties. Materials which react with MnO4K to produce an electron-dense material are located throughout the wall, but tend to be concentrated in the outer and inner regions. It was shown that fibers constitute one important fraction of the original wall material. PMID- 3269796 TI - [Isolation of a cellulase hyperproducer Trichoderma pseudokoningii mutant]. AB - The present study describes the production of cellulases by a native strain of Trichoderma pseudokoningii in the presence and absence of a catabolic repressor. We report a plate assay for selecting fungal mutants capable of synthesizing the cellulase enzymes under conditions of catabolite repression. This method was used for the selection of catabolite repression-resistant mutants. One mutant, B-1, secreted 3.3 times the extracellular protein and 3 times the endoglucanase and filter paper activity in submerged cultures when compared with the wild type strain. The cellobiase activity remained at similar levels in both strains. Although this mutant was isolated as i cellulase producer in the presence of 500 mM glycerol on agar plates, in liquid medium containing the repressor B-1 it exhibits only partial derepression of the cellulase complex. PMID- 3269798 TI - Mandatory continuing education rules developed. PMID- 3269797 TI - Contract analysis aids decision making. PMID- 3269799 TI - Infectious waste disposal guidelines clarified. PMID- 3269800 TI - Decline in children's caries reported. PMID- 3269801 TI - [The robot articulator: a new dental instrument. 1. Applications and principles]. PMID- 3269802 TI - [Kinesiologic analysis of the T.M.J. 1. Establishment of an equation system governing the system]. PMID- 3269803 TI - [Functional morphology of maxillary incisors. Preliminary statistical study]. PMID- 3269805 TI - [Statistical occlusion]. PMID- 3269804 TI - [Hinge axis and registration of condylar movements in removable denture]. PMID- 3269806 TI - [Biomechanical analysis of the T.M.J. 2. Establishment of a simulation model and application to the study of the mean center of rotation]. PMID- 3269807 TI - [Indications for surgical treatment]. PMID- 3269808 TI - [Alarming notes on AIDS from around the world]. PMID- 3269809 TI - [Model for design and construction of a dental office. 1]. PMID- 3269810 TI - [Manual canal preparation. Comparison of 2 technics]. PMID- 3269811 TI - [Tumors of the mouth. What is the future of prevention?]. PMID- 3269812 TI - [Grossman's cement (Mynol) in canal obturation]. PMID- 3269813 TI - [Principles of geriatric pharmacology. 2. Drug interactions and side effects]. PMID- 3269814 TI - [Pathology of the oral cavity in cases of HIV infection]. PMID- 3269815 TI - [Oral implantology: historico-scientific report. 1]. PMID- 3269816 TI - [Evaluation of the efficiency of the giromatic in canal enlargement]. PMID- 3269817 TI - [Choanal atresia and dento-maxillo-facial dysmorphism]. PMID- 3269818 TI - [Consent in implantology. Medico-legal principles]. PMID- 3269819 TI - [Tooth impaction. Clinico-statistical report]. PMID- 3269820 TI - [Model for design and construction of a dental office. 2]. PMID- 3269821 TI - [Comparative evaluation of a new hybrid composite]. PMID- 3269822 TI - [Antiplaque agents in periodontal disease. Antiseptics]. PMID- 3269823 TI - [Nasolabial cysts, a rare disease. Clinical case]. PMID- 3269824 TI - [Atracurium besylate in pediatric oral surgery]. PMID- 3269825 TI - [Technic and administration routes of drugs]. PMID- 3269827 TI - Osteointegrated dento-alveolar replacement system (Flexiroot). PMID- 3269826 TI - [Digital pulsography and the "Dental Fear Scale" in preoperative evaluation of the ambulatory dental patient]. PMID- 3269829 TI - The Cebus monkey in biomedical research. PMID- 3269828 TI - Behavior of periimplant tissue in situ and the new tissue that surrounds endosteal titanium screws. PMID- 3269830 TI - Implantology as a dental specialty: a moral and an educational focus. PMID- 3269831 TI - Tantalum pin implants in humans: a study employing optical and electron microscopy. PMID- 3269832 TI - Alveolar ridge augmentation utilizing collagen wound dressing. PMID- 3269833 TI - Comparison of two-dimensional and three-dimensional finite element analysis of a blade implant. PMID- 3269835 TI - Supplemental treatment for a rejected tooth transplant - second immediate homogenous transplant. PMID- 3269834 TI - Further clinical applications of bioresorbable PLA 37.5 GA 25 and PLA 50 polymers for limited bone augmentation and bone replacement. PMID- 3269836 TI - The significance of "fibro-osseous integration" and "osseointegration" in endosseous dental implants. PMID- 3269837 TI - Maxillary sinus augmentation for endosteal implants: organized alternative treatment plans. PMID- 3269838 TI - Accurate vertical measurement of available bone in the posterior mandible. PMID- 3269839 TI - Classification of partially edentulous arches for implant dentistry. PMID- 3269840 TI - [Running use and the decrease of effect of a disinfectant for dental instruments]. PMID- 3269841 TI - [Maximal flow rate of whole saliva in response to citric acid in humans]. PMID- 3269842 TI - [A report of two cases with Class II, division 2 malocclusion]. PMID- 3269843 TI - Psychological changes in exercising COPD patients. AB - The effects of regular aerobic exercise on state-trait anxiety (Spielberger) and Depression (Zung) were assessed for nine men and six women, 46-71 years of age, with chronic obstructive pulmonary disease (COPD). Treatment subjects (N = 9) were evaluated prior to and following 14 and 28 weeks of exercise. Control subjects (N = 6) were evaluated at the same times but did not participate in the initial 14 weeks of exercise. The exercise regime consisted of stretching before and after 30 minutes of walking at about 50% of maximal oxygen uptake. Analyses showed the exercise intervention to have little impact on state-trait anxiety or depression scores. Anecdotal remarks and perceptions of the subjects suggest that further investigation of the relationship between exercise and psychological status of COPC patients is justified. PMID- 3269844 TI - Self-assessment of selected interpersonal abilities in hard of hearing and deaf adolescents. AB - An understanding of the ability of persons with hearing impairments to interact socially needs to consider the impact of their disabilities on communication with non-disabled persons. This study examined the responses of 197 hard of hearing and deaf adolescents and a control group of 53 non-disabled young people between 14 and 18 years of age to statements in a questionnaire designed to elecit how they might behave in different contexts, with additional, independent assessment of the subjects by teachers and other educational staff. Results suggest that biological differences alone do not account for differences in self-conception found between those with hearing disabilities and those without, nor between different subgroups of those with hearing disabilities. Other cognitive, emotional, motivational and social factors also play a part. This opens up the possibility of developing new rehabilitation and training programmes to help young people with hearing disabilities acquire more positive self-assessments. PMID- 3269845 TI - Use and usefulness of lower limb prostheses. AB - This article concerns a study of the use and usefulness of lower limb prostheses. The method used is discussed: the combining of quantitative data gathered via structured questions with qualitative data about the experiences, wishes and opinions of the people most involved. Some of the results regarding the users, the use and usefulness of prostheses and the wishes of the users are mentioned. Recommendations based on the results are also mentioned. PMID- 3269846 TI - Mentally retarded adolescents: evaluation of communication strategies in different settings. AB - The present project aims to evaluate communication strategies used by mentally retarded adolescents in different types of verbal interaction. The study was carried out on 17 subjects and notably shows that their language content is mostly informative and that the control of conversation varies according to the interlocutor's status. Moreover, the global developmental age of the subjects appears to be a significant factor in the use of communication strategies. This could have pedagogical implications. PMID- 3269847 TI - [The quality of aid relationship in the dental office vs. the emotional needs of the patient]. PMID- 3269848 TI - The mercury scare. PMID- 3269849 TI - [Realization of the Hanau Quint]. PMID- 3269850 TI - [A case report of anterior open bite with anterior crowding]. PMID- 3269851 TI - [Birooted bilateral maxillary primary canines; case reports]. PMID- 3269852 TI - [Mechanical and photoelastic study on the amount of retention and the stress distribution of pin retained restoration]. PMID- 3269853 TI - [Case studies on the simultaneous two jaw surgery for surgical correction]. PMID- 3269854 TI - [A case report of successful alignment of dilacerated maxillary central incisor]. PMID- 3269855 TI - [Straight wire appliance]. PMID- 3269857 TI - [A clinical study on the O-P anchor attachment overlay denture]. PMID- 3269856 TI - [The morphologic study on the residual alveolar ridge according to loss of teeth]. PMID- 3269859 TI - [ENAP (Excisional New Attachment Procedure)]. PMID- 3269858 TI - Hyperbaric oxygenation after microvascular transfer of free osteocutaneous groin flap: a preliminary study. PMID- 3269860 TI - [Furcation involvement]. PMID- 3269861 TI - [Maintenance care for treated periodontitis patients]. PMID- 3269862 TI - [Marsupialization in cyst management]. PMID- 3269863 TI - [Marginal leakage test on "glass ionomer" composite resin]. PMID- 3269865 TI - [A clinical study on the osteomyelitis of the jaws]. PMID- 3269866 TI - [Cosmetic concepts in orthodontics]. PMID- 3269864 TI - [Scanning electron microscopic study of the white rat periodontium]. PMID- 3269867 TI - [Esthetic mouth preparation for ceramo-metal restoration]. PMID- 3269868 TI - [The horizontal plane for dental panoramic radiography]. PMID- 3269869 TI - [The computed tomography and plain radiography in the diagnosis of paranasal sinus disease (except the maxillary sinus)]. PMID- 3269871 TI - [Esthetic consideration of PFM crown]. PMID- 3269870 TI - [A case report of Angle's Class III malocclusion]. PMID- 3269872 TI - [Application of collagen matrix (Osteovit) for correction of defects on maxillofacial region]. PMID- 3269873 TI - [Fracture of the condyle head]. PMID- 3269874 TI - [A clinical study of unusual malignant oral neoplasms]. PMID- 3269875 TI - [The effect of morphine sulfate on blood pressure and heart rates during halothane anesthesia]. PMID- 3269876 TI - [A histologic study on the effect of laser irradiation on the tooth movement by heavy force]. PMID- 3269877 TI - [Modern amalgam cavity]. PMID- 3269878 TI - [Composite resin. Modern cavity form]. PMID- 3269880 TI - [Modern cavity form glass ionomer cement]. PMID- 3269879 TI - [Gold inlay. Gold onlay]. PMID- 3269881 TI - [Study on the fracture of the condyle head]. PMID- 3269882 TI - [Variation of blood pressure and pulse rate on the surgical extraction of the lower wisdom tooth]. PMID- 3269883 TI - [Stainless steel crown]. PMID- 3269884 TI - [Dental caries prevalence of primary school children in Chungju (VI)]. PMID- 3269885 TI - [A case report of excessive bleeding after tooth extraction of periapical granuloma in a patient with idiopathic thrombocytopenic purpura]. PMID- 3269886 TI - The short comings of capitation. PMID- 3269887 TI - The manpower crisis. PMID- 3269888 TI - Tongue thrusting: a continuing problem. PMID- 3269890 TI - The value of orthodontic records. PMID- 3269889 TI - Endodontic reimplantation: a case report. PMID- 3269891 TI - HIV-related ulcerative gingivitis and periodontitis. PMID- 3269892 TI - The risk with capitation. PMID- 3269894 TI - ODA teaches 700 youngsters how to brush and floss. PMID- 3269893 TI - Orthodontic treatment: the adult patient. PMID- 3269895 TI - Study on the mandibular joint of the fetal mouse. PMID- 3269896 TI - Distribution of capillaries in the condylar cartilage of the fetal mouse. PMID- 3269897 TI - Reevaluation of bonding system for intermaxillary fixation. PMID- 3269898 TI - [The first texts of European dentistry: harmonization]. PMID- 3269899 TI - [Descriptive study of the distribution of lymphocytes and plasmacytes in healthy human dental pulp]. PMID- 3269900 TI - [Simulation for understanding and demonstration of the vestibular object rule in radiography (Clarke's rule)]. PMID- 3269901 TI - [Curing lights - status]. PMID- 3269902 TI - [Development changes of myofibrillar protein composition in rat masseter muscle]. PMID- 3269903 TI - [Biochemical studies on the non-collagenous proteins from bovine periodontal ligament. Is 68K protein considered as a link protein for HA and ALPase?]. PMID- 3269904 TI - [Investigation on X-ray irradiation reduction for pediatric patients in oral radiography. Development of new thyroid shield protector in pediatric intraoral radiography]. PMID- 3269905 TI - [Biochemical study of human periodontal ligament fibroblasts. Cellular responses by a mechanical stress]. PMID- 3269906 TI - [Isolation and identification of bacteria lytic against Streptococcus sanguis from dental plaque of young children]. PMID- 3269907 TI - [Measuring cast equipment]. PMID- 3269908 TI - [Relationship between the post-treatment relapse and the posterior discrepancy in Class III malocclusion]. PMID- 3269909 TI - [Fluctuation of electrolytes in the blood of orally diseased patients]. PMID- 3269910 TI - Annual report on findings of infectious agents in Japan 1987. PMID- 3269911 TI - Diagnostic and surgical arthroscopy of the temporomandibular joint. Historical perspective & preliminary results. PMID- 3269912 TI - Infectious waste management legislation. PMID- 3269913 TI - Legal comments. House bills nos. 1151 & 1044. PMID- 3269914 TI - How to develop and monitor a marketing campaign for your practice. PMID- 3269915 TI - Employee dismissal: steps to avoid litigation. PMID- 3269916 TI - CT scans in dentistry. PMID- 3269917 TI - Comparison of AIDS cases reported in Missouri, 1982 to August 19, 1988. PMID- 3269919 TI - Ensuring 'clean' donated blood. PMID- 3269918 TI - Letters: another way to win patients and enhance your professional practice image. PMID- 3269920 TI - A bigger threat than caries. PMID- 3269921 TI - Practical guide to microscopy. PMID- 3269922 TI - Attacks on the mouth's self-cleaning system. PMID- 3269923 TI - A substitute for bone. PMID- 3269924 TI - Research breakthroughs at world congress. PMID- 3269925 TI - Laying the groundwork of a dental service. PMID- 3269926 TI - African AIDS pattern is not peculiar. PMID- 3269927 TI - AIDS quarantining 'is too risky'. PMID- 3269928 TI - AIDS deaths in Emirates topped 20 last year. PMID- 3269929 TI - New measures strengthen GCC bid to control AIDS spread. PMID- 3269930 TI - Case presentation: bulimia nervosa. PMID- 3269931 TI - [Pulp pathology of deciduous molars and ectopic eruption of premolars. Longitudinal clinical study]. PMID- 3269932 TI - [Segmentation of the upper jaw in orthognathic surgery]. PMID- 3269933 TI - [File on documentation of orthodontic clinical cases. 1]. PMID- 3269934 TI - [Clinico-diagnostic evaluation of face form]. PMID- 3269935 TI - [Development of 3rd molar impaction and its prevention]. PMID- 3269936 TI - [Relapse and retention. 2]. PMID- 3269938 TI - [Extraoral traction with face-bow: evaluation of the action of the intraoral arch]. PMID- 3269937 TI - [Individualized treatment of an atypical Class II, division 1 case with dental reimplantation]. PMID- 3269939 TI - Conceptual errors in combat casualty care training. PMID- 3269940 TI - [Central hemangioma of the mandible]. PMID- 3269941 TI - [Secondary retention in the deciduous dentition]. PMID- 3269942 TI - [Factors affecting the use of mouth protectors during field hockey]. PMID- 3269943 TI - [Dental care in Utrecht. The Netherlands]. PMID- 3269944 TI - [Non-verbal behavior: its function and meaning]. PMID- 3269945 TI - [Splints for the management of temporomandibular disorders]. PMID- 3269947 TI - [An alternative method to measure denture satisfaction]. PMID- 3269946 TI - [Patient exposure from intraoral dental radiographic examination]. PMID- 3269948 TI - [Immediate and delayed effects of a dental health education film on periodontal knowledge, attitudes and reported behavior of Dutch adolescents]. PMID- 3269949 TI - [Antibacterial agents in periodontal therapy]. PMID- 3269950 TI - [Non-verbal behavior: its function and meaning. Part 2]. PMID- 3269951 TI - [Maxillary odontogenic sinusitis]. PMID- 3269952 TI - [Histometric analysis of the Ellegaard-model in beagle dogs]. PMID- 3269953 TI - [Dental hygienists in the orthodontic office]. PMID- 3269954 TI - [Dental anxiety in The Netherlands]. PMID- 3269955 TI - [Quantification of initial carious lesions]. PMID- 3269956 TI - [High caries risk patients: selection on the basis of salivary S. mutans and lactobacilli counts]. PMID- 3269957 TI - [Dental caries in 15-year-old children in Tiel and Culemborg]. PMID- 3269958 TI - [The dental health in the south east of Friesland. An epidemiological evaluation of a dental health education project]. PMID- 3269959 TI - [Properties of amalgams]. PMID- 3269960 TI - [Cavity preparations: extension restricted]. PMID- 3269961 TI - [Toxicity of dental amalgam]. PMID- 3269962 TI - [Amalgam toxicity revisited]. PMID- 3269963 TI - [Non-verbal behavior: its function and meaning. Part 3]. PMID- 3269964 TI - [The relationship between the amount of occlusal support and the (dys)function of the masticatory system]. PMID- 3269965 TI - [Characteristics of anxious dental patients. Results of a nationwide survey]. PMID- 3269966 TI - [Selection of acrylics used for dentures]. PMID- 3269967 TI - Getting the best out of the bank. PMID- 3269968 TI - Class 3 malocclusions. PMID- 3269969 TI - Patterns of change in orthodontics. PMID- 3269970 TI - Orthodontic case report. PMID- 3269971 TI - Partnership vs. cost-sharing. PMID- 3269972 TI - The roots of stress. PMID- 3269973 TI - The five minute TMJ screening exam. A simple, time-efficient method. PMID- 3269974 TI - Diffusion hypoxia--when it follows nitrous oxide conscious sedation. PMID- 3269976 TI - Subject: update, environmental surface disinfection. PMID- 3269975 TI - Oral premedication. Its use in dentistry. PMID- 3269977 TI - Beware the spoken word. The often forgotten dangers. PMID- 3269978 TI - News you can use. PMID- 3269979 TI - A safer dental environment. PMID- 3269981 TI - The laminates and veneers. PMID- 3269980 TI - Posterior composite resins. PMID- 3269982 TI - Subject: tooth preparation, tunnel prep. PMID- 3269983 TI - The adverse effect of electrosurgery on the alveolar bone. PMID- 3269984 TI - Health care crisis. PMID- 3269986 TI - Subject: tooth preparation, tunnel prep. PMID- 3269985 TI - Internal derangements of the temporomandibular joint. When to operate? PMID- 3269987 TI - Noisy joints. Non-surgical management. PMID- 3269988 TI - Mercury and dentistry. The controversy continues. PMID- 3269989 TI - Clinical pathological conference. PMID- 3269990 TI - Discipline proceedings. A serious risk. PMID- 3269991 TI - Coming to grips with the third party. PMID- 3269992 TI - Generation and degradation of the complement fragment C5a in human serum by Bacteroides gingivalis. PMID- 3269993 TI - Colonization of osseointegrated titanium implants in edentulous patients. Early results. PMID- 3269994 TI - Saliva increases serum IgG retention on Streptococcus mutans. PMID- 3269995 TI - Ultrastructure of the cell envelope of Bacteroides forsythus strain ATCC 43037T. PMID- 3269996 TI - The effect of the occlusal splint on the biomechanics of the cranium, cervical spine, mandible and the hyoid region. PMID- 3269997 TI - Practical applications of the PA cephalometric headfilm. PMID- 3269998 TI - A technique for gnathological study models. PMID- 3269999 TI - Class II division 1 history of TMJ trauma--maxilla and mandible orthognathic surgery. PMID- 3270000 TI - Class I, TMJ dysfunction--orthodontics and restorative dentistry. PMID- 3270002 TI - [Non licensed dentists and "half-educated bandits". A visit to China]. PMID- 3270001 TI - [Recurrent herpes labialis]. PMID- 3270004 TI - [Biopsy in dental practice, when and how?]. PMID- 3270003 TI - [Organ regeneration--is there an interest in the field of odontology?]. PMID- 3270005 TI - [Bone loss among 14-year old students in Oslo and Oppegard--measured with the use of bite-wing radiographs]. PMID- 3270006 TI - [Mercury contamination in the dental clinic]. PMID- 3270007 TI - [Effectiveness and productivity of the dental health care system]. PMID- 3270008 TI - [Points of view regarding the frequency of examination and treatment for children and young adults]. PMID- 3270009 TI - [Disinfection of alginate impressions: the effect on the surface layer of the plaster models]. PMID- 3270010 TI - [Dental health habits and some contributing variables among 40- and 55-year old adults in Skien]. PMID- 3270011 TI - [Experience obtained by requiring dental hygiene students to work for the Public Dental Health Care System from 1979-87]. PMID- 3270012 TI - [AIDS information. The prison project]. PMID- 3270013 TI - [AIDS info. The challenge]. PMID- 3270014 TI - [AIDS-watch in Europe]. PMID- 3270015 TI - [AIDS info. Youth, knowledge and condoms]. PMID- 3270016 TI - [Using clean needles; an important weapon in fighting HIV]. PMID- 3270017 TI - [Cranio-mandibular pathosis in a group of patients at a university clinic]. PMID- 3270019 TI - [The likeliness of contracting HIV]. PMID- 3270018 TI - [Geriatric dentistry]. PMID- 3270020 TI - [What happens to the dentist who is HIV-positive?]. PMID- 3270021 TI - [Root canal obturations and periapical conditions in a group of Norwegian adults]. PMID- 3270022 TI - [General treatment methodologies in endodontic therapy]. PMID- 3270023 TI - [Mechanical instrumentation of root canals]. PMID- 3270024 TI - [The follow-up of root resections]. PMID- 3270025 TI - [The use of antibiotics in the treatment of periodontal disease]. PMID- 3270026 TI - [The method for collection of data on dental health among adults in Skien]. PMID- 3270027 TI - [Snuff use in Norway]. PMID- 3270028 TI - [Is the use of smokeless tobacco "worth" it? Physiologic effects]. PMID- 3270029 TI - [Cancer risk with the use of smokeless tobacco (snuff and chewable tobacco)]. PMID- 3270030 TI - [Snuff--clinical tissue changes and the cancer risk]. PMID- 3270031 TI - [Laboratory testing associated with oral medical diagnosis in dental practice]. PMID- 3270032 TI - [Dental health and dental health care habits among a group of 5-year olds]. PMID- 3270033 TI - Cavity design and placement techniques for Class 2 composites. PMID- 3270034 TI - Use of a two-stage composite resin fill to reduce microleakage below the cementoenamel junction. PMID- 3270035 TI - Contraction gap under composite resin restorations: effect of hygroscopic expansion and thermal stress. PMID- 3270036 TI - Direct gold as a practice builder. PMID- 3270037 TI - Microleakage of Ketac-Silver in the tunnel preparation. PMID- 3270038 TI - Fracture strength of premolars with Class 2 silver amalgam restorations. PMID- 3270039 TI - Longevity of complex amalgam restorations. PMID- 3270040 TI - Effect of fluoride from dental materials on acid demineralization of enamel. PMID- 3270041 TI - Postoperative sensitivity associated with posterior composite and amalgam restorations. PMID- 3270042 TI - The future of restorative dentistry. PMID- 3270043 TI - Early observations and three-year clinical evaluation of four amalgam alloys. PMID- 3270044 TI - A three-dimensional finite element model. PMID- 3270045 TI - Seating of cast gold inlays and onlays with and without gingival margin bevels. PMID- 3270046 TI - Periodontal considerations of operative dentistry. PMID- 3270047 TI - Benign ependymomas of the posterior fossa in childhood. AB - A series of 22 infants and children with posterior fossa benign ependymomas treated surgically during the past 12 years is presented. All patients were operated on with posterior fossa craniotomy: visible total resection in 10, subtotal resection in 9, partial resection in 2 and biopsy only in 1. One patient (4.5%) died shortly after surgery. Only 5 patients had documented infiltration of the floor of the fourth ventricle. Postoperative radiotherapy was administered with variable radiation fields and doses. Two out of six patients who had total resection and postoperative radiation therapy did not show recurrence during at least 26 months follow-up period. However, patients with incomplete tumor resection almost invariably developed recurrence. An attempt should be made to remove posterior fossa ependymomas totally at the initial craniotomy. The risk periods for recurrence were between 1 and 2 years after subtotal resection and between 2 and 3 years after total resection. In our experience, gross recurrent tumors appear to be resistant to chemotherapy, and a combination of surgery and radiation therapy does not necessarily prevent recurrence. Newer agents or protocols of adjuvant chemotherapy are needed to explore. PMID- 3270048 TI - Hyperbaric oxygen in the treatment of elevated intracranial pressure after head injury. AB - This study is the first to evaluate the effect of hyperbaric oxygen (HBO) on elevated intracranial pressure (ICP) after severe head injury during documented controlled ventilation, hypocapnea, and minute-by-minute ICP data collection. We studied the effect of HBO at 2 atmospheres absolute (ATA) with 100% O2, on ICP in 2 patients, aged 5 and 21 years. Each patient had diffuse cerebral swelling after blunt trauma and after a gun shot wound, respectively. Both required controlled hyperventilation, osmotic diuretics and ICP monitoring. ICP, mean arterial blood pressure, pulse and atmospheric pressure were recorded at 1-min intervals during 1-hour treatments and for 15 min before and after HBO therapy. Controlled hyperventilation was continued during HBO therapy and PCO; was measured at intervals. Each patient underwent 4 treatments. Data was divided into 5 phases, all at 100% O2; (1) prior to therapy; (2) during pressurization from 1 to 2 ATA; (3) at 2 ATA; (4) during depressurization from 2 to 1 ATA, and (5) after HBO therapy. During pressurization the mean ICP dropped from 13 to 8 Torr, rising to 14 Torr during HBO therapy at 2 ATA, and to 16 Torr during depressurization to 1 atmosphere, then returning to 12 Torr after HBO therapy. We conclude from this preliminary work that HBO may lower ICP in head-injured patients with diffuse cerebral swelling during the first 15 min, or pressurization phase, of therapy. However, rebound elevations in ICP may occur during or after treatment. No lasting effects of treatment were seen after concluding therapy. The effect of HBO on elevated ICP has not yet been clarified, but deserves further careful study in those patients with severe enough injury to require ICP monitoring. PMID- 3270049 TI - Pediatric cerebral abscess. AB - Fifty-four consecutive cases of children with cerebral abscess from 1958 to 1987 are reviewed. Their average age was 6.6 years, ranging from 3 days to 19 years. A wide range of organisms and underlying diseases was encountered. The predominant mode of surgical therapy was craniotomy with resection of the abscess. Aspiration and craniotomy with drainage-evacuation were also employed in our series. No underlying disease was found in 10 (19%) of the children. Cyanotic heart disease (CHD) was present in 13 (24%) of the children. Four children had dental abscesses and 1 had otitis media. Seven (13%) children had abscesses secondary to hydrocephalus/shunt infections. Sinusitis and otitis accounted for 5 cases (9%). Four children (7%) had tuberculomas. One abscess was associated with a nasal dermal sinus and one was congenital. Fourteen (26%) patients had negative cultures. Fourteen (26%) abscesses contained streptococci of various types. Staphylococci were found in only 5 (9%) of the abscesses. The congenital abscess was caused by salmonella. Two abscesses (7%) were fungal. Both of these patients died. Six children (11%) were treated without surgical intervention. Three of them died. Forty-eight children had surgical intervention; 12 underwent aspiration, 14 underwent open evacuation of the abscess, and 22 had abscesses resected. Mortality in the aspiration group was twice that of the evacuation or resection group (17, 7 and 9%), respectively). The factor which correlated best with mortality was the patient's clinical status on admission. The advent of CT scan at our facility improved mortality by facilitating accurate diagnosis and surgical intervention. Overall mortality rates decreased from 31 to 5.7% and surgical mortality fell from 21 to 2.9%. PMID- 3270050 TI - Gait analysis of cerebral palsy children before and after rhizotomy. AB - Over the past decade, selective posterior rhizotomy has been used successfully to reduce spasticity in patients with cerebral palsy. Although clinical evaluation of these patients revealed functional improvement following surgery, more objective analysis of the outcome of this surgery was sought. Kinematic gait analysis of 14 patients with spastic cerebral palsy was performed before and after selective posterior rhizotomy. Measurements of stride length, thigh range of motion, knee range of motion, average speed of walking, and cadence were made. Statistically significant increases in stride length, thigh range and knee range were found. Average speed was increased and cadence was virtually unchanged. These results corroborate clinical findings of improvement in gait of spastic patients with cerebral palsy following selective posterior rhizotomy. PMID- 3270051 TI - Fetal neuropathology of proliferative vasculopathy and hydranencephaly hydrocephaly with multiple limb pterygia. AB - We describe the third family in which fetuses have very narrow cerebral cortical mantles, enlarged ventricles, a peculiar proliferation of cerebral cortical arteries, and hypoplasia of muscle. We describe the youngest fetus yet reported. Previously this condition was interpreted as destructive, perhaps due to infection. We believe it is a primary failure of neuroectodermal cells to form in the ventricular zone with too few resulting cells in cerebral cortex and that the abnormal vascular proliferation is part of the malformation. The involvement of both sexes suggests autosomal recessive inheritance. PMID- 3270052 TI - Dementia, rigidity and seizures in an adolescent boy. PMID- 3270053 TI - Spinal cord injury in I-cell disease. AB - I-cell disease (ICD), mucolipidosis II, is an autosomal recessive syndrome resulting from defective phosphorylation of acid hydrolases. The diagnosis is made in early childhood and in most cases death occurs by age 5 as a result of cardiorespiratory complications. Pathologic changes are limited to mesenchymal tissues. We treated two children with ICD who developed atlantoaxial dislocation and myelopathy following minor injuries. The first child developed cardiovascular instability with manipulation of the C1 ring at operation, necessitating removal of the arch of C1 and fusion from occiput to C2. The second child was quadriplegic following anatomic reduction of the C1-C2 dislocation at operation during which somatosensory evoked potentials (SSEPs) showed no deleterious change. The atlantoaxial joint is unstable in ICD due to an incompetent transverse ligament infiltrated by storage cells. A cartilaginous, rather than calcified, odontoid process may contribute to the instability. The intraoperative neural injury occurred during attempts to effect anatomical reduction of the chronically dislocated C1-C2 joints and could have resulted from inadvertent trauma to the vertebral arteries and subsequent infarction of the cord. The lack of change in the intraoperative SSEPs was probably due to relative sparing of the posterior columns during the cord injury. We recommend that children with ICD and atlantoaxial instability undergo closed reduction of any existing malalignment followed by posterior C1-C2 fusion as long as the operative risk is not prohibitive. If preoperative closed reduction is not readily feasible and the cord is severely compromised, the C1 arch should be removed and the occiput fused to C2. Forceful attempts at anatomical reduction of the chronically dislocated C1 C2 segments should be avoided. PMID- 3270054 TI - Postradiation meningioma in a child. AB - Tumors caused by radiation treatment are not unknown. They may be benign or malignant. Among these, postradiation meningiomas (PRM) are considered to be a distinct entity. A case of a child who developed a PRM is presented. She received radiation therapy for a presumed thalamic glioma 11 years earlier. An unusual and interesting aspect of this tumor was its attachment to the membrane of the old subdural hematoma, following a shunting procedure. There was no dural attachment. The pathology of PRMs and meningiomas in children are discussed in light of our recent experience. PMID- 3270055 TI - [Concepts on pathological occlusion]. PMID- 3270056 TI - [A comparative study of cephalometric patterns in centric relation and dental occlusion. CIERO]. PMID- 3270057 TI - [Analgesia of the TMJ and peripheral musculature. The Ryodoraku acupuncture method]. PMID- 3270058 TI - [Orthopedic imbalance and its repercussions on the stomatognathic system. Grupo de estudios Cuauhtemoc]. PMID- 3270059 TI - [Control of caries and the pit and fissure system]. PMID- 3270060 TI - [The oral health process in Tlaxcaltecas students]. PMID- 3270061 TI - [Prevalence of dental caries by high, average and low risk]. PMID- 3270062 TI - [Nutrition in healthy gestation and lactation]. PMID- 3270063 TI - [Classification of fractures of articular processes of the lower jaw]. PMID- 3270064 TI - [Prevention of acute conditions during ambulatory treatment in dental surgery]. PMID- 3270065 TI - [Repeated fracture of the lower jaw--the object of an expert opinion]. PMID- 3270066 TI - [Multiple injuries--the subject of expert opinion]. PMID- 3270067 TI - [Facial growth asymmetry after fracture of the articular process of the lower jaw. A new unit in the traumatology of the facial skeleton in children]. PMID- 3270069 TI - [Model technique in fixed prosthetics. Part II. Stability of model portions]. PMID- 3270068 TI - [Incidence of orthopedic abnormalities of the jaws in the Martin district]. PMID- 3270070 TI - ESPE: Quality is the keynote. PMID- 3270071 TI - Self employment. PMID- 3270072 TI - Experiences in clinical periodontal practice. PMID- 3270073 TI - Experiences of practicing in the North. PMID- 3270074 TI - Recommendations for infection control procedures. Canadian Dental Association. PMID- 3270075 TI - Guidelines for the control of radiation in the dental office. Canadian Dental Association. PMID- 3270076 TI - The first interview; look and listen. PMID- 3270077 TI - Hepatitis B, immunization, and pregnancy. PMID- 3270078 TI - Gingival and systemic manifestations of chronic liver disease: pre- & post-liver transplant. PMID- 3270079 TI - Osseous grafting: olecranon as an alternative source. PMID- 3270080 TI - A comparative study of free gingival and subepithelial connective tissue grafts. PMID- 3270081 TI - Jejunal mucosal architecture and fat absorption in male homosexuals infected with human immunodeficiency virus. AB - Diarrhoea and weight loss are common features of human immunodeficiency virus (HIV) disease. The mechanism of diarrhoea occurring in the absence of known enteropathogens is currently unknown. We have measured fat absorption, using the 14C triolein breath test, and quantitatively assessed jejunal villous architecture in 20 male homosexuals at various clinical stages of HIV disease. Enteropathogens were not detected in any subject at the time of jejunal biopsy in stool or jejunal mucosa. Partial villous atrophy was the sole histological abnormality and was detected at any clinical stage of HIV disease. The 14C triolein breath test quantitatively correlated with the degree of jejunal villous atrophy. In addition subjective presence of diarrhoea was related to the detection of fat malabsorption. Thus diarrhoeal disease in HIV infected patients in the absence of enteropathogens may be due to jejunal enteropathy and may be present at early clinical stages of HIV disease. PMID- 3270082 TI - Panic anxiety and hyperventilation in patients with chest pain: a controlled study. AB - We studied the relation between mood disorder and hyperventilation (hypocapnia) before and during exercise treadmill testing in 113 chest pain patients attending a cardiac clinic and 30 healthy controls. In most patients end-tidal PCO2 (PCO2) rose in the normal way on exercise but in a subset of 24 (21 per cent) there was no rise: these patients with initial hyperventilation had significantly higher anxiety scores than those with a normal exercise-induced rise in PCO2. Two of the 24 had ischaemic heart disease and 10 (42 per cent) complained of recent panic anxiety compared with 12 (13 per cent) of the 89 with normal rise in PCO2 (p less than 0.05). Rates of psychiatric morbidity were similar in patients with 'typical' and 'atypical' chest pain. Resting hypocapnia occurred more often in patients with panic anxiety than in either anxious or non-anxious patients without panic. Panic patients also reported more symptoms of breathlessness and hyperventilation-related complaints than those without panic. Our findings confirm the important association between panic and hyperventilation in patients with chest pain. Furthermore, patients with exercise-induced hyperventilation are more likely to have a psychiatric than a cardiac disorder. Early detection and treatment of these patients may reduce the potential morbidity associated with unnecessary invasive investigations. PMID- 3270083 TI - Pneumococcal bacteraemia in adults in a low socio-economic urban population. AB - Between January 1984 and December 1985, 183 adult patients, subsequently shown to have pneumococcal bacteraemia, were admitted. Of these infections, nine were caused by penicillin-resistant strains, and three of these were resistant to other antibiotics. The organisms from 150 patients were serotyped/grouped. The primary site of infection was lung in 90 per cent of patients. Among the patients with pneumonia, those with serovar 3 strains accounted for most intensive care unit admissions, most cases requiring inotropic drugs, and mechanical ventilation and had the highest complication rate and mortality. Findings which predicted the need for intensive care included higher age, elevated concentrations of serum urea, creatinine, and phosphate and lower levels of total serum protein, albumin and calcium. Twenty-four patients died of whom 23 had pneumonia. The case fatality rate among all of the patients admitted to the intensive care unit was 60 per cent and among those not admitted to the unit, 9.2 per cent. Of the patients who died, 41.7 per cent did so within the first five days of admission. The prophylactic use of polyvalent pneumococcal vaccine in industrial workers from low socio-economic groups should be carefully considered. PMID- 3270084 TI - Prospective rheumatological study of muscle and joint symptoms during Trichinella nelsoni infection. AB - One hundred and fifty patients were assessed during an outbreak of Trichinella infection in Northern Italy. The aetiological agent was proved to be T. nelsoni. A detailed prospective rheumatological study was carried out. Myalgia was observed in 88 per cent, muscle weakness in 60 per cent, myositis in 62 per cent and arthralgia in 20 per cent of the patients. The arthralgia score was strictly related to myalgias-myositis. The degree of myositis correlated with the degree of hypereosinophilia. Muscle damage in tissue samples was often observed in areas where eosinophils were the major cell population infiltrating the tissue. No relationship was seen between IgG antibody titers against Trichinella or IgE levels and clinical manifestations. Steroids, thiabendazole or mebendazole were not administered. We observed no CNS or heart involvement nor did we see vasculitis. After six months 18 patients, with the highest degree of myositis and hypereosinophilia had all improved. None showed abnormalities in laboratory tests and only four were still complaining of muscle aches. T. nelsoni-related infection appears to induce musculoskeletal symptoms in the majority of patients, but the long term course and prognosis is favourable. PMID- 3270085 TI - Hypertension and renal dysfunction in bone marrow transplant recipients. AB - The incidence of acute renal failure, hypertension and electrolyte disorders in 64 bone marrow transplant recipients randomized to receive either cyclosporin or cyclophosphamide was investigated. Sixty-four per cent of patients developed acute renal failure, 75 per cent hypertension, and 88 per cent significant hypomagnesemia. The incidence of diastolic hypertension and hypomagnesemia was greater in the patents treated with cyclosporin. Hypomagnesemia was due to magnesium wasting by the kidney. Both groups received similar cumulative doses of aminoglycoside antibiotics. Significant proteinuria developed in all but one patient and nephrotic-range proteinuria was noted in 21 per cent. The cause of the proteinuria is unclear; no obvious morphologic changes were seen at autopsy in patients who exhibited nephrotic-range proteinuria. The abnormalities of renal function were shown to be transient in patients who were observed for periods ranging from one to three years. It is concluded that hypertension, renal failure and hypomagnesemia are common in the setting of bone marrow transplantation. Whereas cyclosporin probably aggravates the severity of these disorders, it is likely that other factors (e.g., aminoglycoside antibiotics) play a major role as shown by the high incidence of renal and electrolyte disorders in patients treated with cyclophosphamide alone. PMID- 3270087 TI - Experiences to cherish for a lifetime. PMID- 3270086 TI - Growth hormone, body composition and somatomedin C after treatment of acromegaly. AB - Acromegaly is associated with abnormal indices of body composition (as determined by exchangeable sodium, exchangeable potassium and total body water estimations) which may be corrected by treatment. We related these indices of body composition to the attained growth hormone levels (mean of five daytime values) in 42 treated acromegalics. Somatomedin C was measured in 30 subjects. The mean duration of treatment was 7.7 years (range 1-26). Exchangeable sodium, potassium and total body water were significantly lowered by treatment. After treatment of acromegaly subjects whose growth hormone level was below 5 mU/l achieved normal body composition more often than those with higher levels. Growth hormone concentration of below 5 mU/l after treatment should be regarded as more appropriate index of control of acromegaly than the higher levels previously recommended. PMID- 3270088 TI - Top secret. PMID- 3270089 TI - X-rays ... benefits and hazards. PMID- 3270090 TI - Risk takers. PMID- 3270091 TI - High tech. PMID- 3270092 TI - The management of severe dental erosion using posterior occlusal porcelain veneers and an anterior overdenture. PMID- 3270093 TI - Approximal surface finishes on amalgam restorations. PMID- 3270094 TI - Endodontics and the elderly patient. PMID- 3270095 TI - Direct hybrid composite inlays. PMID- 3270096 TI - In vitro temperature rises produced by five polymerising light sources. PMID- 3270097 TI - Restorative problems following failure of implants. PMID- 3270098 TI - Porcelain veneers--a four-year follow-up. PMID- 3270099 TI - [Quantification of the acute toxicity of antiseptic endodontic solutions with a hemolysis screening test]. PMID- 3270100 TI - [Effectiveness of rapid sterilization equipment used in endodontics]. PMID- 3270101 TI - [Corrosion and biocompatibility of intraosseous endodontic vitallium implants in humans: report of 2 cases using scanning electron microscopy, electronic microprobe, and routine histological procedures]. PMID- 3270102 TI - [Patient selection for prosthetic treatment over osseointegrated implants]. PMID- 3270103 TI - [Analysis of causes of exodontia in patients with impacted lower wisdom teeth and their relation to occlusion]. PMID- 3270104 TI - [Clinical and radiographic study of 255 cases of apical periodontitis]. PMID- 3270105 TI - [Harmlessness of dental amalgam]. PMID- 3270106 TI - [Recommendations for dental mercury hygiene]. PMID- 3270107 TI - [Effects of processing temperature variations on radiographic contrast and density]. PMID- 3270108 TI - [Prevalence of occlusal caries according to degree of eruption in first permanent molars]. PMID- 3270109 TI - [The anatomical basis for intraoral anesthesia of the maxillary nerve]. PMID- 3270110 TI - [Variations in the depth of the human mandibular fossa in the total absence of permanent teeth]. PMID- 3270111 TI - [Idiopathic gingival fibromatosis. Report of a case]. PMID- 3270112 TI - The effect of roentgen radiation on the capillary sprouts and superficial loops of granulation tissue. I. Quantitative study of the vascular volume. PMID- 3270113 TI - [Effect of guarana and Stevia Rebaudiana Bertoni (leaves) extracts, and stevioside, on the fermentation and synthesis of extracellular insoluble polysaccharides of dental plaque]. PMID- 3270114 TI - [Development and trends in all ceramic restorations from 1971 to 1987]. PMID- 3270115 TI - [Dentistry and AIDS]. PMID- 3270116 TI - [Radiation treatment in advanced cancer of the lung]. AB - This is an attempt to evaluate the results of the radiotherapeutic treatment in patients with advanced lung cancer. The results of a series of 200 patients with lung cancer no oat cell. Average age: 59 years, ranging from 39 to 78, with male frank predominance (174/200). The histologic diagnosis was obtained in 159/200 (79.5%) of the patients of which, 52.8% were epidermoid carcinomas. The series was classified in three staging according to the American Joint Committee for Cancer Staging and End Results Reporting (AJC); the results was: 172/100 (86%) E III and 28/200 (14%) E I and II. The main objective of this work was the anlysis of E III which was subdivided into E III M0 and E III M1 for its study according to the absence or presence of metastasis when making the diagnosis. Besides, the patients were classified according to their clinical state at the beginning of treatment (performance status) following the Zubrod's scales. The statistics analysis shows the prognostic relevance of this parameter. The results of the two plans of irradiation treatment were analysed: continuous cycle (60 Gy in 6 weeks) and split course (2 cycles of 30 Gy in two weeks with three weeks of rest in between). There were not statisticaly significant difference either in the clinical or in the radiological response in both groups. Both groups were correlated under the following parameters: a) Performance Status, b) immediate response to treatment, c) quality of life after radiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3270117 TI - [In vitro development of the female gonads of chick embryos]. AB - Having studied the functioning left ovary and the atrophic right ovary of the chicken during its in ovo embryogeny, we decided to study its development in vitro. For that purpose the explants of left and right ovaries of 7 at 19 days of in ovo development were cultured in Eagle medium, supplemented by bovine fetal serum and lated processed for structural and ultrastructural studies. At every ages the left ovary showed a cortex and a medulla while the right ovary had no cortex. Epithelial cells were observed in the cortex, encircling ovocytes having typical Balbiani's bodies formed by mitochondria, Golgi aparatus and centriole. Some nuclei were in the meiotic prophase. The right ovary and the medulla of the left ovary failed to show the lacunar aspect characteristic in the ovo study. Conversely, cell cords were found, formed by epithelial cells and ovocytes which being very close to each other, gave the cord a compact aspect. Among the cords, groups of interstitial cells could be seen, which were more frequent in the cultures of older ova and in both ovaries. The left and the right ovaries, therefore, developed according to the genetic pattern. Notwithstanding, the left ovary medulla and the right ovary would be modulated by extragonadal factors which would be inactive when the gonads are not in their natural environment. PMID- 3270118 TI - [Structural and histochemical characterization of a struma ovarii]. AB - We have studied the thyroid tissue present in a cystic ovarian teratoma with the purpose of characterizing its structural and histochemical components. The methods of hematoxilyn and eosin, PAS, PAS/sialidase, Alcian blue at pH 2.5 and 1.0, were used, as well as, blocking reactions, Cason's thrichromic, and toluidine blue at pH 3.8. In the tissue we observed zones with follicles of normal appearance that varied considerably in size. The epithelium was constituted by cuboid cells surrounding a colloid substance of uniform aspect, that was strongly acidophilic, PAS positive and with variable reactivity with toluidine blue and weakly alcianophilic. With the thrichrome method, the different follicles stained in different tones. Parafollicular clear cells, bigger and less basophilic than follicular ones, with a nucleus having a lax chromatin, were identified. Cystic follicles were observed in whose cavities were conspicuous histyocytes surrounding rests of colloid substance, with metachromatic and PAS positive granules in their cytoplasm. Some groups of follicles were rudimentary, scarcely differentiated, and mostly without colloid. Others, with a greater degree of differentiation, showed diminutes follicles with intensely basophilic and PAS positive colloid. Beasides, follicular groups with excessive content of colloid appeared very distended and lined by a flat epithelium. According to the characteristics analyzed it may be concluded that: 1) it is a highly differentiated monoblastic teratoma, in which it appears non encapsulated thyroid tissue; 2) the tumor resembles in different areas, either normal thyroid tissue, thyroid adenoma of the macrofollicular type, fetal or microfollicular and solid or embryonary adenoma, and follicles with the pattern of "thyroiditis". PMID- 3270119 TI - [Caroli's disease: congenital cystic and segmentary dilatation of the intrahepatic bile ducts]. AB - Congenital cystic segmentary dilatation of the intrahepatic biliary ducts is a rare disease. Although several cases has been described in medical literature, its occurrence such as it was originally referred is exceptional. Some cases coexist with congenital hepatic fibrosis and portal hypertension. A characteristic phenomenon is the formation of stones and canalicular infection. In this article, three cases of Caroli disease (females, 57, 53 and 58 years old) are described. Case n 1 was a complex malformation including: a) cystic and segmentary dilatations of the intrahepatic biliar ducts; b) intra and extrahepatic lithiasis and recurrent infections; c) fusion of the choledocus and gallbladder in a common sac; d) hepatic cavernosus hemangioma and a supernumerarious lobe. Case n 2 showed: a) cystic and segmentary dilatation of the intrahepatic biliar ducts; b) portal fibrosis; c) polycystic kidneys; d) portal hypertension. Case n 3 showed: a) cystic and segmentary dilatation of the intrahepatic biliar ducts; b) portal fibrosis; c) polycystic kidneys and spleen; d) portal hypertension. Prognostic of this patients is variable and depends on the recurrent infections and the coexistence of other malformations which are frequently severe. Surgery is the only treatment for the disease although there are no definite conclusions concerning the long-term results. PMID- 3270120 TI - [Ventricular septal defect after acute myocardial infarction]. AB - We report six patients from our Intensive Care Unit with ventricular septal rupture (VSR) post acute myocardial infarction. There were 3 males and 3 females, mean age 57.8. None of them had prior myocardial infarction. Four patients had recent onset angina and 2 had not previous angina. Inferior wall myocardial infarction was two-fold times more frequent than anterior wall infarction. Three patients had right ventricular infarction. Early severe heart failure was present in 85% of patients, being sudden in onset in 3. In 2 patients surgical closure of VSR was performed, being it successful in 1 with good long-term survival. In conclusion, VSR is a serious complication of acute myocardial infarction. Accuracy in diagnosis and solid therapeutic measures are required. PMID- 3270121 TI - [Pyogenic hepatic abscess]. AB - Ten patients, 6 men and 4 women, with a mean age of 53 years, having pyogenic liver abscess, were studied to review the principal features of the clinical and bacteriological diagnosis. In 9 cases the abscess was located in the right hepatic lobe. Bacteriological diagnosis was made in 6 cases: the etiology was nonmicrobian in 3 and two microorganisms were found in the other 3 cases. The isolated pathogens were: Escherichia coli (3 cases), Staphylococcus sp (3 cases), Enterobacter agglomerans (1 case), Citrobacter sp (1 case), Streptococcus sp (1 case). The basic clinical pattern included fever in 9 patients, pain in upper right side of the abdomen in 8, jaundice in 5 and respiratory symptoms in 5. In 2 cases the diagnosis was confirmed by ultrasonography, in 2 by scintigraphy and in 3 both methods were used. Surgical drainage was practiced in 7 patients, with favorable course in 6. Three patients were not operated; 2 died and the third was cured with medical treatment. The importance of the clinical suspicion even with few data is pointed out, specially prolonged fever with painful syndrome in upper right side of the abdomen. The aid of the diagnosis imaging is valuable for verification. The precise bacteriological diagnosis by culture of the material obtained in surgery or by percutaneous drainage of the abscess allows the selection of the most suitable antibiotic therapy. PMID- 3270122 TI - [The management of acute diarrhea in adults]. PMID- 3270123 TI - [Fever, malnutrition, asthenia of subacute development]. PMID- 3270124 TI - [Corrosion of amalgam restorations. "In vivo" behavior in anodic polarization technic]. PMID- 3270125 TI - [Articulator registration and programming in complete dentures]. PMID- 3270126 TI - [TMJ ankylosis. Surgical treatment with insertion of a free muscle graft]. PMID- 3270127 TI - [Seminar on composite resins in posterior teeth]. PMID- 3270128 TI - [Variations in the SNA angle]. PMID- 3270129 TI - [Orofacial emergencies in first aid]. PMID- 3270130 TI - [Trigger points and craniofacial pain]. PMID- 3270131 TI - [Voids in endodontic obturations. Comparative study of rat subcutaneous connective tissue response to implantation of polyethylene tubes and dentin, partially filled with endomethasone and gutta percha cones]. PMID- 3270132 TI - [Marginal leakage of cavity sealers and amalgams]. PMID- 3270133 TI - [Candida--infections--biology and pathology]. PMID- 3270134 TI - [New directives in the use of CPR]. PMID- 3270135 TI - [The weed for chemical and hematological laboratory analysis in dental practice]. PMID- 3270136 TI - [The role of the dental practitioners in encouragement/aiding their patients in curtailing smoking]. PMID- 3270137 TI - [The presence of mercury in the urine of dentists in the southwestern portion of Finland]. PMID- 3270138 TI - [What is new in diagnosing periodontal disease?]. PMID- 3270139 TI - [Does patient oral health care education improve dental health care?]. PMID- 3270140 TI - [Factors which influence the choice of pain medication]. PMID- 3270141 TI - [Does the presence of calculus always cause periodontal disease?]. PMID- 3270142 TI - [The teaching of occlusal physiology in dental schools in the nordic countries]. PMID- 3270143 TI - [Working hygiene for dentists. Mercury as a risk factor in dental practice (Part 3)]. PMID- 3270144 TI - [When periodontal treatment fails--is the failure due to lack of home care instruction?]. PMID- 3270145 TI - [Indications for gold restorations. Gold foil]. PMID- 3270146 TI - [Special diets and the influence on children's teeth]. PMID- 3270147 TI - [Recommendations with regard to the use of different types of oral prophylaxis among different age groups]. PMID- 3270148 TI - [Does increased awareness with regard to dental health among the public improve the dental health?]. PMID- 3270149 TI - [Is the pacifier necessary?]. PMID- 3270150 TI - [The use of scanning electron microscopy in the study of the oral mucosa]. PMID- 3270151 TI - [Smokeless tobacco--a new challenge to health maintenance]. PMID- 3270152 TI - [The effects of smokeless tobacco on oral health]. PMID- 3270153 TI - [The chain of asepsis in the orthodontic office]. PMID- 3270154 TI - [Colors in the orthodontic office]. PMID- 3270156 TI - [Choice and management of documents. Legal aspects and role of the computer]. PMID- 3270155 TI - [The orthodontic environment]. PMID- 3270157 TI - [Which computer, for which orthodontist?]. PMID- 3270158 TI - [Masses of the lateral neck. Apropos of a case of swelling in the right submaxillary region]. PMID- 3270159 TI - [Drug induced oral lesions]. PMID- 3270160 TI - [Semiology of the salivary glands]. PMID- 3270161 TI - [Biomaterials in oral surgery]. PMID- 3270162 TI - Discipline: what it is and how to do it. PMID- 3270163 TI - Newsletters spread the news of progressive laboratories. PMID- 3270164 TI - Mandated health benefits legislation. PMID- 3270165 TI - Can you afford to second guess the IRS? PMID- 3270166 TI - Infection control hotline. PMID- 3270167 TI - Predicatibility of the chalk carving manual dexterity test to laboratory performance. PMID- 3270168 TI - Developing the laboratory's pricing policy and fee structure. PMID- 3270170 TI - Incorporating an orthodontic department into your laboratory. PMID- 3270169 TI - A precision removable bridge. PMID- 3270171 TI - Quality circles: what are they? What do they do? Who needs them? PMID- 3270172 TI - Insights into education--an interview with dental technology students and graduates. PMID- 3270173 TI - A new pathophysiology and classification of TMJ dysfunction. PMID- 3270174 TI - Tricyclic antidepressants and the treatment of facial pain. PMID- 3270175 TI - [Changes in hard- and soft-tissue profiles associated with simultaneous movement of entire maxilla and mandible for mandibular prognathism]. PMID- 3270176 TI - [Immunosuppressive factors in the blood of patients with acute viral hepatitis B. I. General characteristics of inhibitory activity]. PMID- 3270177 TI - [Risk factors for acute viral encephalitis in childhood and adolescence]. PMID- 3270178 TI - [Adrenaline, noradrenaline and vanilmandelic acid in the urine in diabetics]. PMID- 3270179 TI - [The importance of using objective adaptometry in ophthalmology]. PMID- 3270180 TI - [Combined deficiency of factor VII and X in a patient with multiple myeloma and amyloidosis]. PMID- 3270181 TI - [A pneumonic type of tuberculosis in a 15-year-old girl]. PMID- 3270182 TI - [Computerized tomography in the diagnosis of pathologic processes in the middle ear]. PMID- 3270183 TI - [Computer tomography in the diagnosis of pathologic processes in the paranasal sinuses]. PMID- 3270184 TI - [Clinical and laboratory characteristics of congenital hypothyroidism in neonates detected in a screening program]. PMID- 3270185 TI - [Dyslipidemia in primary biliary cirrhosis]. PMID- 3270187 TI - [The status of the visual field in relation to the size of the pulse blood volume in intraocular vessels in glaucoma without increased intraocular pressure]. PMID- 3270186 TI - [Epidemiology of AIDS in Belgrade]. PMID- 3270188 TI - [Hairy cell leukemia]. PMID- 3270189 TI - [Sickle cell anemia and asplenia]. PMID- 3270190 TI - [Diagnostic value of magnetic and nuclear magnetic resonance in gynecology and obstetrics]. PMID- 3270191 TI - [Physical stress tests in cardiology]. PMID- 3270192 TI - [Specifics of ECG findings in physical stress tests in patients who survived myocardial infarcts]. PMID- 3270193 TI - [Holter monitoring in the evaluation of myocardial ischemia]. PMID- 3270194 TI - [Somatic diseases in suicides with a somatic appeal]. PMID- 3270195 TI - [Conductive deafness in children in the region of Kraljevo]. PMID- 3270196 TI - [Causes of conductive deafness in children with an intact tympanic membrane in the region of Kraljevo]. PMID- 3270197 TI - [Use of various surgical interventions in rectal tumors]. PMID- 3270198 TI - [Calcification of the globus pallidus]. PMID- 3270199 TI - [Efficacy of Stimovul for ovulation induction in infertile women]. PMID- 3270201 TI - [Legal medicine. Expert activity of the physician in general practice]. PMID- 3270200 TI - [Differential diagnosis of lesions of the median nerve]. PMID- 3270202 TI - [Legal medicine. Medical expert ethics]. PMID- 3270203 TI - [The importance of medical documentation in legal medicine expertise]. PMID- 3270204 TI - [Medico-legal autopsy of people killed in traffic accidents]. PMID- 3270205 TI - Questions on relative analgesia. PMID- 3270206 TI - The relationship of relative analgesia and intravenous sedation. PMID- 3270207 TI - The use of nalbuphine (Nubain) for analgesia in combination with methohexitone sodium. PMID- 3270208 TI - Plant life in cold climates. AB - Structural and functional features of plants from cold regions such as high mountain and tundra environments are characterized. Cold climates are not necessarily cold for plants at all times and influences of plant-growth form on canopy climate are substantial. Extreme low temperatures can cause temporal cessation of metabolic processes or partial tissue losses, but rarely represent an existential problem for plants native to cold regions. Low temperatures induce drastic changes in plant physiognomy and leaf anatomy, but dry matter allocation to the different plant compartments does not show a uniform trend. This suggests that generalizations of optimization and adaptation theories are not appropriate in this respect and that the functional importance of carbohydrate budgets is commonly over-estimated. Inconsistent with widespread beliefs, photosynthetic capacity in plants from cold regions is not essentially different from that in temperate regions, when comparable life forms are considered. Prevailing leaf temperatures exert minor limitations to seasonal photosynthetic carbon gain. Low temperatures come into play primarily in two ways: indirectly, via the length of the growing season and perhaps mineral nutrient availability, and directly, through influences on the growth process per se. Inherited slow or temporally restricted growth resembles an evolutionary response to long-term expectations of low resource availability. Within these genetic constraints the mitotic rate seems to be an essential point of action where low temperature determines the growth of an individual under respective local climates. Evidence is provided to support this view of an overruling significance of developmental processes in plant performance under cold conditions. PMID- 3270209 TI - Temperature and the distribution of plant species. AB - An understanding of the mechanisms by which temperature influences the distribution of species and vegetation has been attempted by modelling population growth and establishing those stages of the plant life cycle which, when diminished by extremes of temperature, for example, may have the greatest impact on plant survival. This analysis suggests that the heat sum of the growing season, measured as day-degrees, controls the distribution of annual vegetation. For perennial vegetation both the heat sum of the growing season and the annual, absolute minimum temperature are critical. Climatic correlations and experimental analyses indicate that, in northern Europe, the northern latitudinal and upper altitudinal limits of lowland and southern vegetation are directly controlled by climate. In contrast, the southern and lower altitudinal limits of upland and northern vegetation are likely to be controlled by temperature-sensitive competition with southern or lowland species. Many of the temperature-sensitive processes of plant growth and development, such as the non-linearity of extension growth and variations in the threshold temperatures of processes, may increase the realized heat sum at a particular geographical location. However, in more northerly climates, photoperiodic control is crucial in avoiding precocious development in the highly variable climatic conditions of early spring. PMID- 3270210 TI - Temperature as a determinant of plant productivity. AB - Quite small variations in temperature such as those that exist between the north and south of Britain, or on a local scale between north and south aspects of a hill, may cause large variations in plant productivity. An attempt is made to assess the effect of a 1 degree C increase in the mean temperature of the growing season by using published data from various sources. The conclusion reached is that a 1 degree C increase in a north temperate climate may be expected to increase plant productivity by about 10%, providing that other factors like water or nutrients do not become limiting. But, for annual crops, a negative effect of temperature has sometimes been observed. This may be because temperature speeds up the development of the crop and thus reduces the duration of photosynthesis. In the natural environment variations in solar radiation and wind speed may often exert an effect on growth because they influence the energy balance, altering the temperature of meristems and other plant tissues in subtle ways which have a significant impact on the pattern of carbon utilization. A more precise understanding of the relationship between growth and weather variables is unlikely to be achieved unless models are developed which enable integration of component processes of growth with what is known about the spatial and temporal variation in the weather variables. PMID- 3270211 TI - [Is the water filtration from dental units sufficiently effective? The clearing effectivity of four commercially available filters]. PMID- 3270212 TI - [The incidence of dental decay among immigrant children in Copenhagen]. PMID- 3270213 TI - [The knowledge, attitude and methods employed to maintain dental health among immigrants]. PMID- 3270214 TI - [Cyclic nucleotides in salivary glands and their secretions]. PMID- 3270215 TI - [Microcomputers used in administration in the private dental practice]. PMID- 3270216 TI - [Community dentistry and computerization]. PMID- 3270217 TI - [Dental image processing--a diagnostic aid]. PMID- 3270218 TI - [Diagnosis and treatment planning in orthodontic therapy by the use of digital cephalometry]. PMID- 3270220 TI - [Chinese-Danish cooperation in the field of dentistry]. PMID- 3270219 TI - [Properties of calcium hydroxide cements]. PMID- 3270221 TI - [Being a dentist in China]. PMID- 3270222 TI - [Experience from an advanced course in acupuncture in China]. PMID- 3270223 TI - [A dental practitioner in India]. PMID- 3270224 TI - [Dental equipment for developing countries]. PMID- 3270225 TI - [Small plate osteosynthesis in the treatment of mandibular fracture]. PMID- 3270226 TI - [The effect of a preventive dental care program among chocolate factory workers]. PMID- 3270227 TI - [The evaluation process of a preventive dental care program for chocolate factory workers]. PMID- 3270228 TI - [The importance of a routine radiographic examination]. PMID- 3270229 TI - [Enactment of law and ethics in relationship to AIDS and HIV infection]. PMID- 3270230 TI - [Oath associated with graduation--oath as a dentist?]. PMID- 3270231 TI - [Dental care for certain groups of adults]. PMID- 3270232 TI - [Dental students as volunteers in Sri Lanka]. PMID- 3270233 TI - Infection control in Danish dental offices. PMID- 3270234 TI - [Do the autoclaves in dental offices render adequate sterilization?]. PMID- 3270235 TI - [Recesses of the sphenoid sinus depicted on panoramic radiographs: a case presentation]. PMID- 3270236 TI - [Local gold-pigmentation in gingiva]. PMID- 3270237 TI - [Dental health in children with cerebral palsy, estimated from information gained from the Danish Health Service Recording System]. PMID- 3270238 TI - [Laser light and its use]. PMID- 3270239 TI - [Complaints from patients regarding dental treatments 1983-1987: an evaluation on the function of committees set up to investigate and render judgement on the complaints]. PMID- 3270240 TI - [The knowledge and understanding of commonly used statistical terms among Danish dentists and dental students]. PMID- 3270241 TI - [Microflora in cases of periodontal diseases]. PMID- 3270242 TI - [Virulence factors in bacteria associated with periodontal disease]. PMID- 3270243 TI - [Antibiotic treatment in cases of marginal periodontitis?]. PMID- 3270245 TI - [AIDS is everyone's problem]. PMID- 3270244 TI - [Artifacts in dental radiographs caused by fixation solution]. PMID- 3270247 TI - [States of disease caused by the formation of plaque]. PMID- 3270246 TI - [Perimolysis caused by ritual vomiting in a patient with schizophrenia]. PMID- 3270248 TI - [Health, society and planning]. PMID- 3270249 TI - [School for dental assistants and hygienists]. PMID- 3270250 TI - [Evaluation of treatment following conservative physiologic occlusal rehabilitation--a 3-year follow-up study of 44 patients]. PMID- 3270251 TI - [Opinions regarding fear, pain and pre-medication in dental practice]. PMID- 3270252 TI - [Rhinolith--its occurrence and dental implications]. PMID- 3270253 TI - [Statistical evaluation of dental treatments rendered to the adult population (20 80 year) in Kalmar 1984-1986]. PMID- 3270254 TI - [How should we treat the unerupted third molar? Do we perform the correct treatment for each patient]. PMID- 3270255 TI - [Dental health among adults in the region of Gavleborg--patients with complete dentures]. PMID- 3270256 TI - [Dental health care in Finland]. PMID- 3270257 TI - [Fear among children and young adults]. PMID- 3270258 TI - [Oral manifestations associated with Sjogren syndrome--clinic, diagnosis and treatment]. PMID- 3270260 TI - [The active patient - patients psychological reactions to complete dentures]. PMID- 3270259 TI - [Central hemangioma--diagnosis and treatment of an acute case]. PMID- 3270261 TI - [Oral complications due to radiation of the head and neck regions]. PMID- 3270262 TI - [Radiographic evaluation of vertical bone loss]. PMID- 3270263 TI - [Written procedure information for patients undergoing surgical procedures]. PMID- 3270264 TI - [Premedication and sedation of geriatric patients undergoing dental treatments in hospital environment]. PMID- 3270265 TI - [Use of protective gloves for the purpose of infection control among dentists in the county of Malmohus]. PMID- 3270267 TI - [The role of the hygienists in dental health care and working conditions]. PMID- 3270266 TI - [Measurements related to the amount of mercury in blood and urine in patients exhibiting side effects suspected originating from dental filling materials]. PMID- 3270268 TI - [A comparison between smoking and applied forces to the dentition demonstrated that smoking is damaging to periodontal health]. PMID- 3270269 TI - [Desquamative gingivitis]. PMID- 3270270 TI - [Chromatographic and immunoelectrophoretic characteristics of a labelled bacterial antigen]. PMID- 3270271 TI - [The occlusal doctrine, the selection of gnathological equipment and sharing of tasks in the prosthodontics]. PMID- 3270272 TI - [Electrognathographics in stomatology]. PMID- 3270273 TI - [Record and measurement of Bennett movement]. PMID- 3270274 TI - [Oral health in SFR Yugoslavia]. PMID- 3270276 TI - [Microscopy methods in diagnosis of periodontal disease]. PMID- 3270275 TI - [Valuation of influence of orthodontic treatment on oral health]. PMID- 3270277 TI - [Tooth mobility using small loads]. PMID- 3270278 TI - [Differential diagnosis between pulpal and periodontal lesions]. PMID- 3270279 TI - [The difference between native and immigrant inhabitants of Ljubljana in periodontal treatment needs]. PMID- 3270280 TI - [Condition of teeth and periodontal tissue in patients who had suffered a heart attack]. PMID- 3270281 TI - [Root cementum permeability]. PMID- 3270282 TI - [The radiographic analysis of prevalence of overhanging fillings and crowns and the effect of periodontal tissues]. PMID- 3270283 TI - [Hygienic phase of the treatment of periodontal disease]. PMID- 3270284 TI - [Bioadhesive polymeric films for the application onto the oral mucosa]. PMID- 3270285 TI - [Inhibitors of cysteine proteinase in the inflamed gingivae]. PMID- 3270286 TI - [Clinical and organizational evaluation of endodontic therapy in triage clinics health center Novo Mesto]. PMID- 3270287 TI - [The effectiveness of the dispensary work--the state of teeth of the five form pupils in the school years 1986/87 and 1984/85 at primary school in Sevnica]. PMID- 3270288 TI - [Prevention of viral infections in dentistry]. PMID- 3270289 TI - [New radiologic imaging methods in maxillofacial surgery]. PMID- 3270290 TI - [Hematology and the transfusion service. A collection of guidelines, methodologic instructions, technical standards, methodologic lists and research methods]. PMID- 3270291 TI - [The QRS amplitude in the electrocardiogram is modified by pericardial fluid and its content of sodium chloride]. PMID- 3270292 TI - Endothelial role in alpha-adrenergic induced vasoconstriction in rat thoracic aorta. PMID- 3270293 TI - [Epidemiology of gastrointestinal nematodes of goats infected under natural conditions in arid zones of Venezuela]. PMID- 3270294 TI - [Anthropometric variables and their discriminatory potential in group of individuals stratified by sex and age]. PMID- 3270295 TI - [Optimization of mercury determination in the muscular tissue of fishes by atomic absorption]. PMID- 3270296 TI - [Seminal parameters and fertilizing capacity of human spermatozoa]. PMID- 3270297 TI - [Preparation and characterization of prodrugs of the potential schistosomicid praziquantel]. PMID- 3270298 TI - The effect of tunicamycin on acid phosphatase from the Leishmania cell surface. PMID- 3270299 TI - [Hepatic fibrosis and progesterone]. AB - To study the progesterone (Prog.) action on the hepatic fibrosis, we produced fibrosis on 55 New Zealand male rabbits, by oral ingestion of carbon tetrachloride (Cl4C) and ethanol. They developed it in six months. All the animals received the toxic. A group of these animals also received the Prog since the onset (0.66 mg/3 times a week, IM) and the rest received it 180 days after the beginning of the experiment. We could see in the biopsies of the animals who received Prog since the beginning or after 180 days: protection of the hepatocytes, no vacuolization of the cell, no inflammatory infiltrate, no fat metamorphosis, very thin fibrous hands. If one of these alterations had appeared with the toxic, the Prog action would have diminished it gradually until its disappearance. Between the groups who received only toxic and the groups that received th Prog (at the beginning or deferred), the laboratory results showed a high significative difference (p less than o.01) especially in the transferases (ASAT-ALAT) in the 60-180 days period. The Prog in the fibroblasts culture and in the treatment of desmoid tumours, on operative adhesions, destroy the fibroblasts and for this action diminished the volume of the tumour and the adhesions. Perhaps the incomplete resolution of the cirrhosis (though the hands of fibrosis diminished considerably) could be explained by the activity of another kind of fibroblast (the myofibroblast), which provokes the retraction of cirrhotic hepatic tissue. PMID- 3270300 TI - [Value of the endoscopic sphinctero-papillotomy by surgical radiocholangiodebitometry]. AB - First results of a prospective study about behavior evaluation of endoscopic sphincterotomy of the ampulla of Vater (EPE) through a serial surgical debitometric (RCDM) assessment are analyzed. Five patients submitted to an EPE looking for a biliary tract decompression because of clinical reasons, prior their surgical cholecystectomy, are comparatively evaluated by serial RCDM with regard to 24 patients receiving a broad transduodenal sphincteroplasty (EPTD). Normal debitometric values (N greater than or equal to 13 cc/min.) were obtained from a sample of 673 surgically explored patients. Debitometric behavior of EPE were comparable in all cases and over our standard (mean = 18.6 +/- 2.3 cc/min.); they showed no differences to surgical EPTD patients (x = 18.3 +/- 2.0 cc/min.). Despite uniform results in the EPE group, a more extensive sample is necessary for definitive conclusions; serial surgical RCDM in patients who received EPE, in spite of limited indications, seems to be a valuable method to analyze early functional events after the procedure. PMID- 3270301 TI - [Pathogenic aspects of duodenal ulcers by cysteamine. Role of the Brunner glands]. AB - In Wistar rats, the acid factor, the peripheral dopaminergic mechanism and the role of Brunner gland (BG), in the prevention of the Cysteamine duodenal ulcer (CDU) were studied. It was found that Bromocriptine; a peripheral dopaminergic neuronal receptor agonist (DA2), produced prevention of the CDU and blocked of PAS depletion of the BG; in contrast, SCH23390, a peripheral dopaminergic vascular receptor antagonist (DA1), and SAMe, a peripheral and central antidopaminergic; induced aggravation of CDU and total depletion of the BG. In conclusion, the HCl factor, a peripheral dopaminergic mechanism and impaired Brunners gland secretion of PAS mucus, in the pathogenesis of the CDU was postulated. PMID- 3270302 TI - [Carcinoid tumor of the rectum: report of a case with histochemical and ultrastructural study]. AB - A case of rectal carcinoid tumor in a 54 year old female patient is reported. An endoscopic resection of an elevated high rectal lesion was done after performed a well established radiologic and endoscopic diagnosis. The tumor was localized in the submucosa of the rectum. Microscopically, neoplastic cells were mainly arranged in nests and trabecular structures within thin fibrous stroma. Mitotic figures and pleomorphism cellular were uncommon. Histochemically the argyrophil stain of Grimelius were positive but the Masson-Fontana silver stain were negative. At the ultrastructural level neurosecretory granules were found in the cytoplasma, varied in shape and size, and 150-400 nm in longest axis. PMID- 3270304 TI - First International Capri Conference on Brain and Female Reproductive Function: Basic and Clinical Aspects. Abstracts. Capri (Italy), May 25th-30th, 1987. PMID- 3270303 TI - [Stress and psychism in chronic peptic ulcer]. PMID- 3270305 TI - Heidelberg International Symposium on New Aspects in Female Contraception: Update and Trends. Abstracts. Heidelberg (West Germany), June 13th-16th, 1987. PMID- 3270306 TI - Pain and reproduction. Modena, September 20-22, 1987. Satellite symposium of the third meeting of the International Headache Society. PMID- 3270307 TI - Development of sheep embryos in vitro in a medium supplemented with different serum fractions. AB - Sheep embryos will generally develop into expanded blastocysts in vitro only in culture media supplemented with serum or serum components. In order to better understand how serum supports embryo development, a batch of ovine serum was fractionated by (a) ultrafiltration into two components containing substances with molecular weights greater and less than 10 Kd (kilodaltons), and (b) gel filtration into protein fractions 1, 2 and 3, containing groups of proteins with mean molecular weights of about 500, 150 and 65 Kd, respectively. The principal protein in fraction 3 was albumin. Day 6 sheep morulae were cultured in vitro for 48 hours in a bicarbonate-buffered salt solution supplemented with various concentrations of ovine serum or of these components or protein fractions of serum. Morulae could develop to fully expanded blastocysts in medium supplemented with whole serum or with the greater than 10 Kd component or protein fraction 3 only, but could not develop in medium supplemented with the less than 10 Kd component only or with the less than 10 Kd component and protein fractions 1 or 2. However, the proportion of embryos that developed fully in medium supplemented with the greater than 10 Kd component or protein fraction 3 was increased by adding the less than 10 Kd component of serum to the medium. The addition of protein fraction 2 decreased the proportion of embryos that developed to expanded blastocysts in medium containing protein fraction 3 and the less than 10 Kd component, but not in medium containing whole serum. Since the compositions of different sera may vary markedly, these results suggest (a) reasons why different sera vary in their ability to support embryo development in vitro, and (b) factors which may influence development of the sheep embryo in the uterus, where plasma proteins comprise nearly all the protein in the fluid bathing the embryo. PMID- 3270308 TI - Cellularity of organs in mature rams of different breeds. AB - The relative importance of cell number and cell size in determining the mass of 16 organs and tissues in mature rams of six different breeds was studied through estimation of organ deoxyribonucleic acid (DNA) content. The mean fleece-free empty body weight (FFEBW) ranged from 54.6 +/- 0.3 kg for Camden Park Merinos to 76.7 +/- 1.6 kg for Strong Wool Merinos. For all organs, mass increased with FFEBW, but the relationship was significant across all sheep for only eight organs (blood, kidney, liver, abomasum, vastus lateralis muscle, skin, perirenal fat and triceps muscle). There were significant differences between breeds in the mass of 11 organs. With four (heart, rumen reticulum, small intestine and testicular fat) this difference was independent of breed differences in FFEBW, whereas with another four (kidney, abomasum, vastus lateralis muscle and skin), it was closely related to FFEBW. Breed differences in the mass of the remaining three organs (blood, liver and perirenal fat) were partly related to FFEBW and partly breed specific. Blood mass increased with FFEBW across all animals, but, within a breed, it declined as FFEBW increased. The increase in the mass of perirenal fat with FFEBW was significantly greater within a breed than between breeds. Cell number increased significantly with the mass of all organs except blood and brain. There were between-breed differences in the number of cells in seven organs (liver, heart, rumen reticulum, abomasum, small intestine, vastus lateralis muscle and skin), which, except for heart, were attributable to between breed differences in organ mass. With heart, the increase in cell number with organ mass within a breed was greater than across all breeds. Cell size was significantly related to organ mass only with vastus lateralis muscle, spleen, perirenal fat and liver. The relationship for vastus lateralis muscle and spleen was negative, indicating that cells were smaller in larger organs. There were differences between breeds in cell size for heart, vastus lateralis and triceps muscles. These differences for heart and triceps muscle were breed specific, whereas for vastus lateralis muscle it was attributed to breed differences in organ weight. There was a 30-fold range in mean cell size across organs, with adipose tissue having the largest cells, muscle tissue intermediate and visceral tissues the smallest. In general, organ mass is positively related to FFEBW. Cell number, not cell size, is largely responsible for differences in organ mass between mature sheep of different breeds. PMID- 3270309 TI - Post-heparin triacylglycerol lipases in ovine plasma. AB - Lipoprotein lipase and hepatic lipase have been shown to be present in the post heparin plasma of sheep. Intravenous injection of heparin into sheep produced a rapid increase in the free fatty acid concentration and lipolytic enzyme activity of the plasma, both peaking within 5-15 min and then falling to pre-heparin levels within 30-60 min. Lipolytic activity was not detected in plasma before heparin treatment. Two distinct lipolytic activities were separated from the plasma by chromatography on heparin-Sepharose 6B. Lipoprotein lipase was identified on the basis that the lipolytic activity was dependent upon the addition of plasma, inhibited by 1M NaCl, and inhibited by a specific antiserum against lipoprotein lipase. The second lipolytic activity of plasma was identified as hepatic lipase, as it was not dependent upon plasma for activity, nor was it inhibited by 1M NaCl or antiserum against lipoprotein lipase. Its properties were identical to the lipase extracted from the liver of sheep. Lipoprotein-lipase activity, but not hepatic-lipase activity, was dependent upon the nutritional state of the sheep at the time of heparin injection. However, hepatic lipase comprised a significant proportion of the total lipolytic activity. PMID- 3270310 TI - Gene mapping in marsupials and monotremes, V. Synteny between hypoxanthine phosphoribosyltransferase and phosphoglycerate kinase in the platypus. AB - In order to extend comparative mapping studies to the monotreme mammals (subclass Prototheria), somatic-cell hybrids were obtained between Chinese-hamster cells deficient in hypoxanthine phosphoribosyltransferase (HPRT) and platypus fibroblasts. The characteristics of these hybrids closely resemble those of metatherian x eutherian hybrids, in that they are recovered at low frequency and they rapidly segregate and fragment platypus chromosomes. Biochemical and cytological studies of the hybrids, their subclones and HPRT-deficient revertants indicate that phosphoglycerate kinase is syntenic with HPRT in the platypus (as it is in other mammals); however, the studies do not permit chromosomal assignment of the syntenic group. The implications of the chromosomal location of this ancient synteny group for the evolution of the mammalian X chromosome are discussed. PMID- 3270311 TI - Polymorphic inversion and esterase loci complex on chromosome 2 of Drosophila buzzatii. II. Spatial variation. AB - The potential influence of linked inversions on allele frequency variation at the Est-1 and Est-2 loci among Australian populations of D. buzzatii was determined by statistical analyses allele and inversion gametic frequencies. Most of the significant spatial and climatic associations found for all Est-1 allele frequencies, and for one allele only of Est-2 (Est-2c+), were accounted for by their linkage disequilibria with the inversions, which covaried with environmental variables. Consistent with this result, the spatial and climatic associations for conditional Est-1 and Est-2 allele frequencies tended to be different from those for the respective unadjusted allele frequencies. In one important respect, the results for Est-1 and Est-2 were not altered by inversions. For both unadjusted and conditional Est-1 allele frequencies, few climatic associations remain after correcting for geographic location, whereas for both unadjusted and conditional Est-2 allele frequencies, climatic associations remain after correcting for geographic location. Thus, apparent selection affecting allele frequencies at the Est-2 locus is not accounted for by linked inversions. PMID- 3270312 TI - Metabolism of sulfur-containing amino acids by pregnant merino ewes. AB - The availability and utilization of cystine and methionine were measured in single-bearing Merino ewes on three occasions, approximately 90, 110 and 130 days after mating, and the effects on these traits of sulfur amino acids (SAA) infused into the abomasum were also measured. Two levels of SAA were infused containing 0.5 or 1.0 g day-1 organic sulfur with DL-methionine contributing two-thirds and L-cystine one-third of the supplementary sulfur. The quantity of the diet offered was increased at each occasion so as to maintain maternal liveweight. The rates of irreversible loss of both cystine and methionine from plasma increased as pregnancy advanced, but the ratios between the rates of irreversible loss and intake of digestible organic matter (DOMI) did not vary with stage of pregnancy. The average daily rates of irreversible loss of cystine and methionine by the ewes consuming the diet alone were 13.6 and 119 mmol kg-1 DOMI respectively. The average rates of irreversible loss of methionine (Im, mmol h-1) and of cystine (Ic, mmol h-1) were both linearly (P less than 0.05) related to the rate of infusion of organic sulfur into the abomasum (s, g day-1): Im = 2.44 (+/- 0.33) s + 1.28 (+/- 0.13); and Ic = 0.16 (+/- 0.02) s + 0.30 (+/- 0.01). Five per cent of the rate of irreversible loss of cystine arose from trans-sulfuration of methionine by ewes consuming the ration only, but greater percentages (14 and 22%) were observed when the ration was supplemented with SAA (P less than 0.05). These transfer quotients were not influenced by stage of pregnancy. The stage of pregnancy did not influence the concentration of cystine or methionine in the plasma, but the abomasal infusions of SAA significantly increased the concentration of both SAA. The ewes consuming the basal diet were in positive balance for both nitrogen and sulfur. The retention of nitrogen did not vary with stage of pregnancy (average (s.e.), 5.8 (0.9) g day-1), but that of sulfur increased from 0.6 to 1.0 and 1.3 g day-1 in periods 1, 2 and 3, respectively (P less than 0.05). The retentions of nitrogen (N, g day-1) and of sulfur (S, g day 1) were linearly and significantly related to the rate of infusion of organic sulfur into the abomasum (s, g day-1): N = 2.7 (+/- 0.7)s + 4.4 (+/- 0.3); and S = 0.49 (+/- 0.03)s + 0.72 (+/- 0.01).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3270313 TI - Effects of intradermally injected and topically applied mouse epidermal growth factor on wool growth, skin and wool follicles of merino sheep. AB - Twice daily intradermal (ID) injections of mouse epidermal growth factor (mEGF) in sterile saline for 1-4 days into delineated areas of skin of Merino sheep produced dose-dependent changes in wool follicles and fibres, ranging from slight reduction in follicle bulb size and transient disturbance of cuticle formation on some fibres to the induction of catagen of follicles and shedding of fibres with distorted, tapered ends. Regeneration of follicles commenced by day 7. By contrast, ID injections of saline did not affect follicle activity. The epidermis became thicker and more parakeratotic after multiple injections of mEGF than after injection of saline, but was almost normal again by day 14. Persistent small increases in sebaceous gland size, additional to those induced by ID injections of saline, and delayed small increases in sweat gland size also occurred after multiple injections of mEGF. Daily topical applications of mEGF in 50% (v/v) aqueous propylene glycol 5 days each week for 4 weeks did not affect wool growth or the follicles and other skin components. The only effect observed, due to application of the aqueous propylene glycol, was an increase in the number of layers of cornified cells in the stratum corneum of the epidermis, with the cells arranged in clearly discernible stacks. The effects produced by ID injections of mEGF indicate that mEGF acts directly on the pilosebaceous and epidermal components of skin. PMID- 3270314 TI - Intra-operative testing for completeness of vagotomy. PMID- 3270315 TI - Proximal gastric vagotomy for duodenal ulcer disease--whither to now or to wither now? PMID- 3270316 TI - Primary adrenal tumours--a ten-year experience. AB - The experience of 31 patients with primary adrenal tumours seen in one teaching hospital over a 10-year period is reviewed. There were 10 patients who had benign cortical adenomas; 11 had adrenal cortical carcinomas, and 10 had phaeochromocytomas, one of which was malignant. During the review period, a primary adrenal mass was discovered in 5% of 2951 autopsies performed in the study institution. The diagnosis and management of these uncommon tumours is reviewed. PMID- 3270317 TI - The management of injuries--a review of deaths in hospital. AB - A prospective review was undertaken of the management of 111 consecutive patients who died in hospital after admission for treatment of injuries. A standard set of data relating to each patient was reviewed by each member of a trauma death audit committee and then by the whole committee. Autopsy reports were available on all patients. Conclusions were drawn concerning defective aspects of patient management and possible avoidance of each death. Injury severity was assessed using the Trauma Score (TS) and Injury Severity Score (ISS). The possibly avoidable death (PAD) rate was 17%. The most common defects in management were related to inadequate fluid resuscitation and delays in definitive management. The greatest contributions to the PAD rate were from inadequate fluid resuscitation, delays and inadequate perception of the severity of injuries or significance of clinical deterioration. Increasing age was related to a higher frequency of PAD. PAD rate in the presence of severe head injury was 8%, but was 63% in the absence of a severe head injury. It is concluded that review of all trauma deaths is an achievable, beneficial and essential part of a hospital-based integrated trauma service. TS and ISS are not sufficiently sensitive to justify their use in selecting deaths for review. Improved blood volume replacement, earlier and more direct management and supervision by senior specialist staff, and elimination of causes of delay in patient management should all decrease the death rate from injuries particularly in patients without severe head injury. PMID- 3270318 TI - A direct patient approach for pre-operative autologous blood donation and transfusion. AB - A patient-motivated pre-operative autologous blood transfusion service is described. The programme is organized and staffed by members of the Transfusion Service. In this programme patients who are enrolled for preoperative autologous blood collection are selected from elective surgical waiting lists without a formal referral from the surgeon. Since starting the scheme the average number of units donated per month has increased from 8 to 33 and complications have been minor. The system has proved to be practical and cost-effective, and it has a definite place as part of an overall approach to the prevention of transfusion related complications. PMID- 3270319 TI - Clinical spectrum of primary empty sella turcica. AB - Over recent years empty sella turcica has become more frequently diagnosed with high resolution computerized tomography and the associated clinical abnormalities have been better described. In this article the spectrum of clinical presentation is based on a review of 26 cases with six illustrative case reports. Recommendations for management and further assessment are presented. It is important for clinicians to be aware of the varying presentations of this syndrome, since it should not be considered simply as an incidental finding. A patient diagnosed with empty sella syndrome requires clinical and endocrine evaluation, and appropriate follow-up as determined by initial test results. PMID- 3270320 TI - Infection in branchial cysts. AB - A series of 26 branchial cysts is reported. Seventeen patients presented with no history of infection, three with mild infection and six patients were referred with chronic or recurrent infection. The diagnosis of branchial cyst was confirmed histologically in each. Infection did not appear to be an important feature in the presentation of the 17 larger, visible cysts in the lateral neck diagnosed pre-operatively. Overt infection may have been prevented by antibiotics and aspiration of the cyst in three of these patients who had rapidly enlarging, uncomfortable, tense cysts. It is emphasized that a branchial cyst should be considered in explanation of any collar stud abscess or inflammatory mass in the lateral neck. PMID- 3270321 TI - Appendicitis in the first three years of life. AB - Appendicitis is the first 3 years of life is uncommon and most cases are perforated at laparotomy. Case records at the Adelaide Children's Hospital were reviewed over a 12-year period. The findings were that acute appendicitis in this age group is commonly associated with respiratory symptoms and diarrhoea, the appendix was gangrenous or perforated in 92% of cases, and there was a significant delay in diagnosis. It is concluded that full evaluation of any child of this age with fever, vomiting, abdominal pain and tenderness is mandatory, and should include rectal examination, abdominal radiographs, differential white cell count and urinary examination. Examination under sedation may be necessary. PMID- 3270322 TI - Weight loss in patients with head and neck cancer: malnutrition or tumour effect? AB - Isotopic infusions, hormone assays and calorimetry have been used to test the hypothesis that weight loss in head and neck cancer (HNC) patients is not due to pure malnutrition, but that a large component of the weight loss in these patients is a consequence of the metabolic effects induced by the tumour on the host. Twelve patients with advanced HNC were compared with eight depleted patients (DEP) who did not have cancer. Both groups had lost more than 10% of well body weight. Neither patient group had an elevated rate of energy expenditure as determined by calorimetry. Both glucose production and plasma glucose clearance were not significantly different between the two groups. The percentage of glucose production undergoing recycling to lactate was elevated in the HNC patients compared with the DEP patients. In addition, the percentage of glucose undergoing oxidation to CO2 was significantly lower in the HNC patients compared with the corresponding DEP value. The HNC patients were significantly more catabolic than the DEP patients and their serum cortisol concentration was also significantly elevated. Although the basal plasma insulin concentrations were similar in the two groups, the response to glucose infusion was markedly less in the HNC patients. It is concluded that patients with advanced HNC are metabolically different from starving patients, although both may lose a similar amount of weight. In particular, the adaptive response of protein conservation seen in simple starvation does not occur in the HNC patient. PMID- 3270323 TI - Median nerve compression in the palm of the hand by an anomalously enlarged ulnar artery. AB - Median nerve compression in the carpal tunnel by a thrombosed persistent median artery and a large aberrant artery substituting for the radial artery has been described but there have been no reports of median nerve compression in the palm of the hand by an anomalously enlarged ulnar artery. A 46 year old man is described who presented with clinical and electrophysiological features consistent with a median neuropathy at the wrist but surgical exploration revealed median nerve compression in the palm of the hand by an anomalously enlarged palmar branch of the ulnar artery. This case highlights another treatable cause of median nerve compression and illustrates that symptoms suggestive of carpal tunnel syndrome may be produced by median nerve compression in the palm of the hand. PMID- 3270324 TI - Primary iliac-appendiceal fistula. AB - Primary aorto-appendiceal fistula has been reported only once previously. A further case is presented in which bleeding, per rectum, occurred in association with rupture of an aorto-iliac aneurysm adherent to an acutely inflamed appendix. Postoperatively the patient had several complications including permanent asymmetrical L1 paraplegia and delayed presentation of an intramedullary abscess of the femur which grew Bacteroides fragilis organisms. These complications highlight the high morbidity associated with aortocolic fistulae. PMID- 3270325 TI - Colonoscopic diagnosis of an aorto-appendiceal fistula. AB - A case of an aorto-appendicular, aorto-enteric fistula diagnosed by colonoscopy after presentation with colonic haemorrhage is reported. The role of colonoscopy in such patients is discussed and reported experience is reviewed. PMID- 3270326 TI - Blepharophimosis, ptosis, epicanthus inversus syndrome (BPES syndrome) PMID- 3270327 TI - Acquired ocular motor apraxia due to bilateral frontoparietal infarcts. AB - A case of acquired ocular motor apraxia in a 78-year-old man is reported. Disordered saccades and pursuit movements in the horizontal and vertical planes were recorded electro-oculographically. Magnetic resonance imaging showed bilateral border-zone infarcts, involving the frontal lobes and the superior part of the inferior parietal lobules. PMID- 3270328 TI - Suspiciousness induced by four-hour intravenous infusions of cocaine. Preliminary findings. AB - Cocaine hydrochloride was administered to experienced users as an intravenous (IV) loading dose of 40 to 80 mg, followed by four-hour continuous IV infusions of either cocaine or placebo. Rates of cocaine infusion were individualized to maintain steady-state cocaine concentrations for the duration of the infusion. During the infusions, subjects rated themselves on questions that assessed their suspiciousness and paranoia, and nurse-observers took descriptive notes on the subjects' behavior; these notes were later scored on a scale for guarded, suspicious, and paranoid behavior. Nurses observed and rated moderately suspicious behavior when cocaine IV bolus loading doses were followed by cocaine infusions, but not when loading doses were followed by saline solution infusions; subjects did not rate themselves as suspicious during any of the study conditions. Suspiciousness during low-dose cocaine infusions significantly correlated with the amount of cocaine previously administered to the subjects. Suspiciousness during infusions was not related to plasma cocaine concentrations, preadmission drug use, or psychiatric symptoms and history. Cocaine infusions may be a useful tool to pursue the biology of stimulant psychoses. PMID- 3270329 TI - Failure of preenucleation radiation to decrease uveal melanoma mortality. AB - We analyzed uveal melanoma metastases in a group of 41 patients who received 20 Gy of preenucleation radiation in a Northern California Oncology Group preliminary phase I/II study, and compared their survival rates with a retrospective control group of 31 patients with characteristics matching the entrance criteria but treated with enucleation alone. Using the Cox proportional hazards model, we found that increased tumor diameter, mixed or epithelioid cell type, and radiation adversely affected survival. In vivo studies of cell cycling indicated that 20 Gy of preenucleation radiation appeared to diminish the reproductive integrity of the tumor cells. It is most likely that the failure of preenucleation irradiation to prolong patient survival was because of micrometastases that occurred before treatment. PMID- 3270330 TI - Influence of endogenous prostaglandins on secretin-mediated inhibition of gastric acid secretion in dogs. AB - The influence of endogenous prostaglandins on secretin-mediated inhibition of gastric acid secretion was examined in 6 mongrel dogs with Thomas gastric and Herrera pancreatic cannulas. The dogs were given intravenous pentagastrin (1 microgram/kg.h) during the 180-min experiment, and graded doses of secretin (0.3 1.5 micrograms/kg.h) (1-5 CU/kg.h) were infused intravenously between 60 and 120 min. In alternate, otherwise identical experiments, a prostaglandin synthesis inhibitor, either indomethacin or meclofenamate, was also administered throughout the experiment. Increasing doses of secretin led to increasing inhibition of gastric acid output with the maximum inhibition at 1 microgram/kg.h (3.3 CU/kg.h) of secretin. Both indomethacin and meclofenamate abolished the inhibitory effects of secretin on gastric acid secretion. The inhibitors of prostaglandin generation had no effect on the serotonin system. We concluded that secretin mediates its inhibitory action on gastric acid secretion, at least in part, through endogenous prostaglandins. PMID- 3270331 TI - Alternate and simultaneous binaural bithermal caloric testing: a comparison. AB - This study compares the results from simultaneous binaural bithermal and alternate binaural bithermal caloric testing of 652 patients with dizziness. Also compared are the abilities of these tests to distinguish between a population of healthy asymptomatic subjects and our patient population. Caloric testing used a closed-loop irrigation system. Eye movements were monitored with electro oculography. The agreement between the results from the two tests was low. Also, while the simultaneous test was more sensitive, the alternate test was more specific. Using receiver-operator characteristic methodology, it was found that the ability of the alternate test to distinguish between a healthy population and a patient population was superior to that of the simultaneous test. There was no improvement in the ability to distinguish between a healthy population and a patient population when the results from the two tests were combined as compared to using the alternate caloric test alone. PMID- 3270332 TI - Sublingual nifedipine in acute severe hypertension. AB - Sublingual nifedipine was used for the treatment of acute severe hypertension in 12 children with renal disease. An average dose of 0.24 mg/kg was safe and proved effective on most occasions within 30 minutes with a median duration of action of three hours. There were no major adverse effects. PMID- 3270333 TI - Border hopping as a consequence of premarital HIV screening: the Kenosha diamond. PMID- 3270334 TI - In-hospital cardiopulmonary resuscitation. AB - A retrospective review of 399 cardiopulmonary resuscitation (CPR) efforts in 329 veterans was performed to evaluate the observation that few geriatric patients were discharged alive after they underwent CPR. Cardiopulmonary resuscitation efforts with witnessed arrests were more frequently successful than efforts with unwitnessed arrests (47.7% vs 29.9%) and resulted in live discharge more often than efforts with unwitnessed arrests. Cardiopulmonary resuscitation efforts that resulted in a live discharge were more brief and involved a lower mean number of medication doses. Of the 77 CPR efforts in patients 70 years of age or older who had arrests, 24 (31%) were successful, and in 22 (92%), patients were alive after 24 hours. None lived to discharge. There were 322 CPR efforts in the younger cohort; 137 (43%) were successful, in 124 (91%) of these 137 efforts, patients were alive after 24 hours, and in 22 (16%), patients were discharged alive. Older patients were significantly less likely to live to discharge both at the time of arrest and 24 hours after successful resuscitation. When a multivariate analysis was used, the presence of sepsis, cancer, increased age, increased number of medication doses administered, and absence of witness were all "predictive" of poor outcome. Cardiopulmonary resuscitation should be administered only to those who have the greatest potential benefit from this emotionally and physically traumatic procedure. PMID- 3270335 TI - Serum levels of gastrin in patients with colorectal neoplasia. AB - Serum concentration of gastrin determined by radioimmunoassay in 90 consecutive patients who underwent colonoscopy, and serum levels of gastrin in patients with colorectal neoplasia and controls were compared. Based on clinical history, findings of colonoscopy, and pathologic examinations of biopsies, 80 patients were considered eligible for the study. Serum levels of gastrin in 36 controls were 54.1 +/- 13.1 pg/ml and did not differ from serum levels of gastrin in 44 patients with colorectal neoplasia. There was also no significant difference in serum levels of gastrin among 28 patients with adenomas and 16 patients with carcinoma. The present study disclosed that carcinogenesis of the colon and rectum was not associated with hypergastrinemia. PMID- 3270336 TI - Effects of iodinated glycerol on thyroid function studies in elderly nursing home residents. AB - Iodinated glycerol is used as a mucolytic expectorant in the treatment of respiratory disorders. Iodine can inhibit the biosynthesis of thyroid hormone and induce hypothyroidism, particularly in patients with a history of thyroid disease. Such effects have not been reported in individuals without known thyroid disease who are being treated with organically bound iodine in the form of iodinated glycerol. In the course of a thyroid screening program for nursing home residents, eight subjects were identified who were being treated with iodinated glycerol. Five of these were found to have thyrotropin elevations; one showed a low serum thyroxine level and a decreased free thyroxine index. None of these residents had a history of thyroid disease. Abnormalities of thyroid function improved or resolved after discontinuation of therapy. Elderly nursing home residents without known thyroid disease are at risk of thyroid suppression when given iodinated glycerol. PMID- 3270338 TI - Why model strokes? PMID- 3270337 TI - Neutrophil storage pool depletion in neonates with sepsis and neutropenia. PMID- 3270339 TI - [Immediate results of surgical and combined treatment of patients over 60 years of age with cancer of the uterine body]. AB - The paper discusses the results of long-term investigations of application of surgery for endometrial carcinoma in patients aged 60-84 years. Intraoperative lethality was 0.2% [corrected], postoperative--0.8%. Surgical treatment proved safe. Suggestions were made to use it in a wider range of indications in older patients. Its application, however, requires careful preoperative preparation, adequate extent of tumor excision, fine surgical technique and effective postoperative intensive care. PMID- 3270340 TI - Potential hazard of Hudson-type [corrected] facemask. PMID- 3270341 TI - Who may drive? Who may not? Who shall decide? PMID- 3270342 TI - The incidence and clinical pattern of deep vein thrombosis in the Chinese in Hong Kong. PMID- 3270343 TI - Making claims: guest editorial. PMID- 3270345 TI - [Current concepts on combined compound odontoma]. PMID- 3270344 TI - L-2-oxothiazolidine-4-carboxylate protects cultured endothelial cells against hyperoxia-induced injury. AB - When bovine pulmonary artery endothelial monolayers were exposed to hyperoxia (95% O2 and 5% Co2), they responded by selectively elevating the intracellular concentration of glutathione without affecting the activities of glutathione peroxidase or glutathione reductase, L-2-Oxothiazolidine-4-carboxylate, an intracellular cysteine-delivering agent, further enhanced the intracellular concentration of glutathione in oxygen-exposed endothelial cells and protected them from the lethal effect of hyperoxia. In contrast, buthionine sulfoximine, a potent inhibitor of gamma-glutamylcysteine synthetase, reduced the glutathione concentration and rendered the cells more sensitive to the toxic effect of oxygen. Both L-2-oxothiazolidine-4-carboxylate and buthionine sulfoximine had no effect on the activities of glutathione peroxidase or glutathione reductase. Our results suggest that L-2-oxothiazolidine-4-carboxylate may have the potential of preventing oxygen toxicity. PMID- 3270346 TI - [Rhinocerebral mucormycosis (cigomycosis or ficomycosis) in a diabetic patient. Report of a case]. PMID- 3270347 TI - [White lesions of the oral mucosa. Epidemiological study of 5868 patients in the University of Bajio Diagnostic Clinic]. PMID- 3270348 TI - [Relationship between habitual consumption of chile (capsicum annum) and the presence of submucous fibrosis]. PMID- 3270349 TI - [Premedication in dentistry]. PMID- 3270350 TI - [Functional, involutional and pathological oral changes with age. 1. Dental aspects]. PMID- 3270351 TI - [Orthognathic surgery in periodontally compromised patients]. PMID- 3270352 TI - [Oligodontia. Management of a case]. PMID- 3270353 TI - Chloride effect on a neutral-carrier-based pH-sensitive microelectrode and its intracellular application. PMID- 3270354 TI - Studies on the toxicity of pyrolytic products of polychlorotrifluoroethylene. PMID- 3270355 TI - Synonymous codon usage and cost of genetic information. PMID- 3270356 TI - Biomechanical analysis on posterior spinal instrumentions for spinal deformities- a comparative study. PMID- 3270357 TI - Subclassification of atypical psychosis. PMID- 3270358 TI - Asymptomatic ischemic cerebral lesions--MRI study on a high risk group. PMID- 3270359 TI - Dopamine-immunoreactive neurons in the blowfly visual system: light and electron microscopic immunocytochemistry. AB - Dopamine-immunoreactive (DA-IR) neurons were mapped in detail in the visual system of the blowfly, Calliphora erythrocephala. Three types of DA-IR neurons could be identified in the optic lobes. One type constitutes a population of several thousand columnar small field amacrine neurons in the second neuropil region, the medulla. The other two types are large field projection neurons innervating the next, more central, synaptic region comprising the lobula and the lobula plate, as well as centres of the midbrain. Their cell bodies are located latero-ventrally in the brain. No DA-IR neurons were seen in the most peripheral visual synaptic neuropil, the lamina. The two types of projection neurons form overlapping wide field arborizations in the lobula and lobula plate and cannot be distinguished from each other in this region. Their central connections are different, however. One type of projection neuron, BOD1, consists of two neurons that bilaterally connect the optic lobes and neuropil on each side of the oesophageal foramen in the posterior protocerebrum. The other type, BOD2, also consists of two bilateral neurons similar to BOD1, but with their central processes posteriorly in the lateral protocerebrum. The amacrine DA-IR neurons form lateral processes in three layers of the medulla synaptic neuropil. These neurons were also investigated by means of electron microscopical immunocytochemistry. They contain predominantly clear vesicles, but a few dense core vesicles could be resolved. The synaptic connections of the DA-IR amacrines suggest that they form centrifugal feedback circuits between the inner and the outer portion of the medulla. The present results indicate that dopamine may be a neurotransmitter in functionally different classes of neurons of the blowfly visual system: amacrines and projection neurons. PMID- 3270360 TI - Distribution of degeneration of cholinergic neurons in the septum following axotomy in different portions of the fimbria-fornix: a correlation between degree of cell loss and proximity of neuronal somata to the lesion. AB - The degree of cell loss of immunohistochemically stained cholinergic neurons was quantitatively compared in equivalent regions of the septum in three groups of animals with lesions transecting their axons at different levels in the fimbria fornix (FF). Locations of different septal regions and of FF lesions were defined according to their distances from fixed anatomical reference points. Individual animals all exhibited a gradient of cholinergic cell loss, such that the severity of cell loss diminished progressively in the rostral and ventral directions as the distance from the lesion increased beyond a certain point. Comparison of animals with FF lesions in different locations showed that this gradient of cell loss shifts in the caudo-rostral and dorso-ventral directions within the septal complex in direct relation to the proximity of the axotomizing FF lesion. These findings suggest that among septal cholinergic neurons there is a fixed spatial relationship between the distance of neuronal somata from an axotomizing FF lesion and the likelihood of neuronal loss in response to axotomy. This relationship could not be defined precisely using the material studied, but simple geometrical calculations showed that within 2500 microns of the lesion cell loss is always pronounced (less than 30 per cent detectable cells vs controls) and beyond 4000 microns cell loss is generally not severe (greater than 80 per cent detectable cells). Between these two distances cell loss diminishes in a gradiated manner. Thus, relatively small differences (1 mm) in the location of FF lesions can lead to marked differences in the severity of degeneration observed in certain equivalent regions of the septum. The findings have implications both for attempts to understand the causes underlying retrograde neuronal degeneration and for studies investigating means of preventing retrograde degeneration of cholinergic septal neurons. PMID- 3270362 TI - Dentistry and physical anthropology. A personal view. PMID- 3270361 TI - Immunoreactive corticotropin releasing factor in adult and developing rat cerebellum: its presence in climbing and mossy fibres. AB - Corticotropin Releasing Factor (CRF) immunoreactivity was localized within the rat central nervous system with immunocytochemical methods, using a highly specific anti-serum to rat-CRF. In adult rats abundant CRF immunoreactivity (CRF ir) was found in perikarya of the inferior olivary nucleus, in climbing fibres in the molecular layer, and mossy fibres in the granular layer of the cerebellum and in the cerebellar nuclei. CRF-ir climbing fibres were found in a longitudinal zonal pattern throughout the molecular layer. In developing cerebellum only a few CRF-positive fibres were seen on postnatal day 8. From day 8 onwards a gradual increase in CRF-ir was found in both the molecular and granular layer with formation of CRF-positive nests around Purkinje cellbodies starting at day 12. Subsequent outgrowth into the molecular layer could be followed, leading to an adult level of CRF-ir in the cerebellum at approximately day 22 postnatally. CRF ir in mossy fibres has as adult appearance from approximately day 18. The temporal and morphological changes of CRF-ir in fibres in the cerebellum of immature rats followed closely the morphological development of climbing and mossy fibres. The present findings indicate that CRF (or related substances) are already present in both climbing and mossy fibres during their outgrowth into the cerebellum. PMID- 3270364 TI - Orthodontic treatment in primary dentition. PMID- 3270363 TI - Dentition and occlusion in prematurely born children. PMID- 3270365 TI - Multistrand wire splint application following orthodontic realignment of migrated teeth. PMID- 3270366 TI - Measurement of maxillary central incisor inclination. PMID- 3270367 TI - Considerations on palatal repair in unilateral cleft lip and palate (UCLP). PMID- 3270368 TI - A comparison of physical properties of lips among white and black adults. PMID- 3270369 TI - Calcified mass in the submandibular region. PMID- 3270370 TI - Inter- and intra-examiner variability in interpretation of early periodontal disease by radiographs. PMID- 3270371 TI - Diet and caries in 4 to 8-year old children on a Kibbutz. PMID- 3270372 TI - Caries prevalence among 2nd and 7th grade Jerusalem schoolchildren. PMID- 3270373 TI - Effect of multiple applications of Bitupal on squamous stratified epithelium in rats. PMID- 3270374 TI - The dental student and his teacher--model or anti-model. PMID- 3270375 TI - Cryosurgical destruction of gingival epithelium in the rat: establishment of a minimal cryodose. PMID- 3270376 TI - Experimental evaluation of biodegradable ceramics as a substitute for bone grafting. PMID- 3270377 TI - Four-year follow-up of occlusal amalgam restorations in extended vs. nonextended cavity preparation. PMID- 3270378 TI - Restore Class V lesions with glass ionomer/composite resin. PMID- 3270379 TI - Are rubber gloves AIDS protection guarantee? PMID- 3270380 TI - Latest research adds to validity of non-reduction for Cerinate veneers. PMID- 3270381 TI - Etched porcelain placement technique is simplified and easier than before. PMID- 3270382 TI - [Therapeutic guidelines of the Argentinian Athenaeum of Dentistry in the treatment of malocclusion]. PMID- 3270383 TI - [Surgical preparation of root canals]. PMID- 3270384 TI - [Toward an integrated and multidisciplinary dentistry]. PMID- 3270385 TI - [Hemorrhagic bone cysts]. PMID- 3270386 TI - [Primary care in dentistry]. PMID- 3270387 TI - [Interproximal stripping: a new technic for obtaining space in skeletal-tooth discrepancy]. PMID- 3270388 TI - [An experimental radiographic method applied to root fractures]. PMID- 3270389 TI - [Decontamination, disinfection and sterilization in dentistry]. PMID- 3270390 TI - [Incidence of retained teeth]. PMID- 3270391 TI - [The inflammatory periodontal lesion]. PMID- 3270392 TI - [Cephalometry of the Cuban population. 1. Soft tissue profile: some measuring lines]. PMID- 3270393 TI - [Upper canines retained in the palatal bone: therapeutic management]. PMID- 3270394 TI - [Treatment of root fractures]. PMID- 3270395 TI - [Interceptive orthodontics using the Tridimensional Space Maintainer]. PMID- 3270396 TI - [Cephalometric evaluation of adenoidal hypertrophy]. PMID- 3270398 TI - [A standard computer system for management of production]. PMID- 3270397 TI - [A computerized weighing system for the pharmaceutical industry: philosophy, realization and validation]. PMID- 3270400 TI - [The use of flavor profile analysis for optimization of gustatory characteristics in formulated foods]. PMID- 3270399 TI - [Strategic profile of a firm operating in the pharmaceutical field]. PMID- 3270401 TI - [New frontiers in the production of flavoring agents]. PMID- 3270402 TI - Multivariate methods and ECG analysis. PMID- 3270403 TI - Manifestations of drug reactions. Urticaria and cutaneous necrotizing venulitis. PMID- 3270404 TI - [The influence of fluoridated water consumption on Enolase activity level in the saliva of caries-resistant and caries-susceptible individuals]. PMID- 3270406 TI - [The level of health education according to the age of persons under examination and the kind of agglomeration inhabited by them]. PMID- 3270405 TI - [Extirpation of pulp with anesthesia with immediate filling of root canal by endomethasone paste and zinc oxide with eugenol]. PMID- 3270407 TI - [Estimation of the fillings made of composite materials: Isofill, Isopast and Evicrol]. PMID- 3270408 TI - [Clinical and mycological examination of oral mucosa of workers employed in plastics works "ERG" in Krywald]. PMID- 3270409 TI - [Differentiation of dermal fistulas within face and neck]. PMID- 3270410 TI - [Chondrosarcoma of mandible as a result of malignant transformation of chondroma and osteoma]. PMID- 3270411 TI - [Malocclusion among children with florid caries]. PMID- 3270412 TI - [Oral cavity in ectodermal defect--incontinentia pigmenti Franceschetti Jadassohn]. PMID- 3270413 TI - [Diagnostic value of radiological images of facial skeleton performed by means of the "Louisette" method]. PMID- 3270414 TI - [Periodontal disease frequency in population of Wroclaw]. PMID- 3270415 TI - [Cu content in teeth of children living in the areas contaminated by Zn, Cd and Pb]. PMID- 3270416 TI - [Selected problems of dental caries in men of military age]. PMID- 3270417 TI - [Extirpation of pulp with immediate filling of root canal with AH26 paste, Reogan and Grossman's cement]. PMID- 3270418 TI - [The influence of smoking on thiosulphate sulphurtransferase (rhodanese) activity in mixed saliva]. PMID- 3270419 TI - [Estimation of the selected functions of white blood cells in ondogenic inflammatory processes within facial skeleton]. PMID- 3270420 TI - [Patient treatment with primary and secondary cleft palate--the open question]. PMID- 3270421 TI - [AIDS]. PMID- 3270422 TI - [The influence of interdental space cleaning on periodontal condition]. PMID- 3270423 TI - [Periodontal condition in schoolchildren in two years' examinations]. PMID- 3270424 TI - [Oral hygiene and periodontal condition in secondary schoolchildren from the town of Leszno]. PMID- 3270425 TI - [Examination of Zn, Cd and Pb content in hard tissues of primary teeth in children from environments of various concentration of these metals in the atmospheric air]. PMID- 3270426 TI - [Estimation of polyamide silk efficiency of home production for cleaning contact surfaces of teeth]. PMID- 3270427 TI - [Knowledge of caries prophylaxis gathered from questionnaire answers of the young from Szczecin schools beyond primary schools]. PMID- 3270428 TI - [Organization principles of the sick's treatment with faciomaxillary and occlusal abnormalities]. PMID- 3270429 TI - [Application of complex grafts of autogenic bone marrow and allogenic lyophilized bone in fracture and mandible defect delayed healing treatment]. PMID- 3270430 TI - [Facial skeleton--the subject of anthropologists' and doctors' studies]. PMID- 3270431 TI - [Two cases of multiple cysts]. PMID- 3270432 TI - [Occlusal-dental disorders as a result of premature loss of milk molar teeth]. PMID- 3270433 TI - [Regeneration of fractured mandibular condylar process after functional treatment]. PMID- 3270434 TI - [The colostomized patient: a study on his self-image and on his surgeon's image]. PMID- 3270435 TI - [Cancer of the stomach in the elderly patient. Treatment problems]. PMID- 3270436 TI - [Treatment of acute pancreatitis: our experience]. PMID- 3270438 TI - The management of severe bone loss associated with localised periodontal disease- a case report. PMID- 3270437 TI - [Post-infarct aneurysm of the left ventricle with intact coronary vessels]. PMID- 3270439 TI - Salvaging scrap time. PMID- 3270440 TI - A brighter outlook. PMID- 3270441 TI - Will the claim pass review? PMID- 3270442 TI - The future of dental advertising. PMID- 3270443 TI - 1985 survey shows more advertising dentists in higher income brackets. PMID- 3270444 TI - A tale of small claims court. PMID- 3270445 TI - Harlequin colour in the Great Dane dog. AB - Breeding data from Eire and Great Britain confirm the hypothesis of Sponenberg (1985) that the harlequin colour of the Great Dane breed of dog is due the combined action of a dominant gene H with the merle gene M in the genotype H+M+. The typical bluish coloration induced by M is modified to white by the action of H. The H gene is a prenatal lethal when homozygous HH and this study offers clear indication that the heterozygous H+ interacts with M to reduce the viability of white merle homozygotes H+MM. PMID- 3270446 TI - A cytogenetic description of a new species of the Anopheles culicifacies complex. AB - Cytogenetic observations on an extensive material of the Anopheles culicifacies complex from the Thenpennai river area, Tamil Nadu, South India show that the populations are made up of four cytologically distinct species. Three of these, labeled A, B and C have already been described. A fourth one, monomorphic for the inversion arrangement +a +b in the X chromosome and il + hl in the second chromosome, is designated as D, another morphologically indistinguishable sibling species. Each sibling species is characterized by a species-specific type of Y chromosome. Both of these criteria, inversions and Y-chromosomes can be used to distinguish these important malaria vectors. PMID- 3270447 TI - [Bone biocompatibility of a vegetable fiber based alveolar dressing]. PMID- 3270448 TI - [The deciduous tooth, an experimental model for the study of biomaterials]. PMID- 3270449 TI - [The reaction of stannous fluoride solution with biologic apatites. The case of carious dentin]. PMID- 3270450 TI - [In vivo study of the corrosion potential of 2 dental amalgams]. PMID- 3270451 TI - [Waxes and thermoplastic mixtures]. PMID- 3270452 TI - Stem cells. Proceedings of the British Society for Cell Biology-the Company of Biologists Limited symposium. Bristol, April 1988. PMID- 3270453 TI - Differentiation of fibroblast stem cells. AB - Primary human skin fibroblasts derived from the abdomen of 45 female donors of the four age groups 1-20, 20-40, 40-60, and 60-80 years were studied in primary explant, in primary low-density mass cultures, and in primary clonal populations in vitro. As a function of the age of the donor, primary mitotic and postmitotic fibroblasts in the three primary cell systems analysed represent heterogeneous populations with reproducible changes in the proportions of the mitotic fibroblasts MF I, MF II, MF III, and postmitotic fibroblasts PMF IV, PMF V, PMF VI, and PMF VII. These findings make it very likely that equivalent cell types exist in the connective tissue of skin in vivo, and that these cells undergo reproducible changes in the proportions of the mitotic and postmitotic counterparts in vivo as a function of the age of the donor. Secondary mitotic human skin fibroblast populations of the cell line HH-8 in vitro underwent 53.6 +/- 6.0 cumulative population doublings (CPD) in 302 +/- 27 days. If appropriate methods are applied, mitotic fibroblasts differentiate spontaneously into postmitotic fibroblasts which are kept in stationary cultures for up to 305 +/- 41 additional days. As a function of the CPD level and of the duration of stationary culture, secondary mitotic and postmitotic fibroblast populations are heterogeneous populations with reproducible changes in the proportions of mitotic fibroblasts MF I, MF II, and MF III, and postmitotic fibroblasts PMF IV, PMF V, PMF VI, and PMF VII. The seven secondary fibroblast cell types show differentiation-dependent and cell-type specific patterns of [35S]methionine polypeptides in total soluble cytoplasmic and nuclear proteins, in secreted proteins, and in membrane bound proteins. These findings make it very likely that the morphologically recognizable primary and secondary fibroblasts differentiate spontaneously along a seven stage terminal cell lineage MF I - MF II - MF III - PMF IV - PMF V - PMF VI - PMF VII in three compartments of the fibroblasts stem cell system. PMID- 3270454 TI - Molecular events associated with the action of haemopoietic growth factors. AB - Haemopoietic growth factors stimulate a number of consensus biochemical and molecular events regardless of the specificity detailed by unique ligand and receptor structures. Analysis of three distinct colony stimulating factors, CSFs (IL-3, G-CSF, GM-CSF) and the lymphocytotropic growth factor IL-2 reveal remarkable similar distal subcellular biochemical signals although initial membrane 'signal transduction' may differ significantly. Both early progenitor cell growth factors, such as IL-3, and late acting factors such as CSF-1, stimulate tyrosine and serine-threonine substrate phosphorylations. One substrate (p68) is phosphorylated by many CSF stimulants, including IL-2, suggesting a highly conserved role in many unique receptor(s) signal transduction processes. The proliferative CSFs and IL-2 also stimulate the expression of many of the same genes including proto-oncogenes, ornithine decarboxylase and members of the ancient family of stress response genes. Although initial membrane events may differ among the respective proliferative stimulants, biochemical and molecular convergence on highly conserved cellular substrates and the programme of gene expression is seen. PMID- 3270455 TI - A steep decline of death in a shigellosis epidemic in Bangladesh by a community- participated intervention. AB - The outcome of an intervention of a shigellosis epidemic during April-July 1985 at Dimla, northern Bangladesh is reported. People of the epidemic-affected community operated a makeshift hospital to provide early indoor treatment for 1,708 patients of blood dysentery, based on empirically selected antibiotic(s), oral rehydration of the patients and giving them high-protein diets. They raised funds and received technical and logistic assistance from the physicians and officials of the local government health centre and of the International Centre for Diarrhoeal Disease Research, Bangladesh. In comparison with the number of deaths recorded before intervention, there was a 187-fold reduction of case fatality ratio from 11.2 to 0.06% (p less than 0.0001). Probable causes for this precipitious decline of mortality are discussed. It is concluded that such a community action in the intervention of a rural shigellosis epidemic in a developing country may avert death almost totally. PMID- 3270456 TI - Enteropathogenicity of plesiomonas shigelloides by oral inoculation in adult conditioned rabbits. AB - To study presumptive diarrhoeagenic and invasive properties of Plesiomonas shigelloides, adult conditioned rabbits (n = 75) were fed 10(10) CFU of 3 isolates (2 from diarrhoea patients and one from river water) of the organism, and one isolate of Shigella sonnei (from a dysentery patient as positive control) or brain-heart infusion broth (as negative control). Each rabbit received in succession i.v. cimetidine (50 mg/kg body weight), two 15 ml oral doses of 5% NaHCO3 at 15 and 30 minutes respectively, prompt bacterial or sham inoculum followed 30 minutes by 2 ml of i.p. tincture of opium. Rabbits fed with P. shigelloides did not die or develop diarrhoea, but in a majority of them, histopathological examinations of the intestine revealed mild acute inflammation of the mucosa, mainly in the ileum. There was no serum antibody response by indirect haemagglutination against the lipopolysaccharide of the homologous strains of P. shigelloides. The culture filtrates of the organism also did not show any cytotoxic morphological changes on CHO and Y1 adrenal cell cultures. By contrast, rabbits fed with S. sonnei developed clinical diarrhoea, small to widespread severe acute inflammation of the gut mucosa, and all died on day 7. It may be concluded that P. shigelloides are able to provoke a mild inflammatory lesions of the gut mucosa in this rabbit model; but there is little prospect of using this model to assess easily the virulence of the organism. PMID- 3270457 TI - [Adenomatoid odontogenic tumor. (Adenoameloblastoma. Adenomatoid ameloblastic tumor. Adenomatoid ameloblastoma. Pleomorphic adenomatoid tumor)]. PMID- 3270458 TI - [Elements which make up a better extraction]. PMID- 3270459 TI - [Endodontic openings]. PMID- 3270460 TI - [Abscesses]. PMID- 3270461 TI - [Introduction to evaluation of postgraduate courses]. AB - A broad approach to evaluation, from different points of view is done. Goals, contents, methods and evaluation of a teaching activity are listed and treated. Characteristics of evaluation in each domain of knowledge are briefly explained. Opportunities of evaluation in different steps of a teaching sequence are pointed out. Several techniques of evaluation are listed and described. A positive attitude towards changes and improvements in evaluation of post-graduate courses is strongly encouraged. PMID- 3270462 TI - [Prevention in orthodontics]. PMID- 3270463 TI - [Eruption of deciduous teeth. General symptoms]. PMID- 3270464 TI - [Paper points in endodontics. Absorption speed of some types of paper points used in endodontics]. PMID- 3270465 TI - [Gamagraphy of the TMJ. Comparative study with radiographic examination in pain dysfunction syndrome]. PMID- 3270466 TI - [Failures in oral implantology]. PMID- 3270467 TI - [Plasmacytoma]. PMID- 3270468 TI - [Radiation caries. A therapeutic option]. PMID- 3270469 TI - [Osteosarcoma of the mandible with a "sun ray" reaction]. PMID- 3270470 TI - [Ankylosis of permanent teeth]. PMID- 3270471 TI - [Eruption of deciduous teeth. Possible local and general manifestations]. PMID- 3270472 TI - [Glass ionomer cement. Classification, indications, properties and methods of use]. PMID- 3270473 TI - [Audition among dental health care personnel]. PMID- 3270474 TI - [Exposure to mercury among dental health care personnel in and around Stockholm]. PMID- 3270475 TI - Prevalence of torus palatinus and torus mandibularis in five Asian populations. PMID- 3270476 TI - Correlation between viscosity and sialic acid content of whole human saliva. PMID- 3270477 TI - Decrease in cleft lip and palate by vitamin B12 in CL/FR mice. PMID- 3270478 TI - Antimicrobial effects of root canal filling materials. PMID- 3270479 TI - The thickness of enamel in the mandibular primary teeth--the difference of diameter between labial (buccal) and lingual enamel. PMID- 3270480 TI - Regularity in the development of cleft lip and/or palate patterns. PMID- 3270481 TI - Quantitative studies on the effect of Nd:YAG laser irradiation. PMID- 3270482 TI - Magnetometric detector of tongue movements during articulation of Japanese sound in normal Japanese and Progenia. PMID- 3270483 TI - A new ND:YAG laser handpiece and its clinical applications. PMID- 3270484 TI - [Congenital tuberous sclerosis: a case with pulmonary involvement]. PMID- 3270485 TI - [Pulmonary tuberculosis: epidemiological evaluation]. PMID- 3270486 TI - [Usefulness of the circulating eosinophil count test in the diagnosis of allergic bronchial asthma]. PMID- 3270487 TI - [Bilateral traumatic chylothorax]. PMID- 3270488 TI - [Concerning primary tuberculosis]. PMID- 3270489 TI - [Correlations between the positivity of the skin test for different respiratory allergens, IgE fluoro-allergo-sorbent test and Phadezym RAST]. PMID- 3270490 TI - [Prognostic value of aspecific and specific bronchial provocation tests in patients with allergic rhinitis]. PMID- 3270491 TI - [Treatment of aortic stenosis in the aged without the use of catheterization]. PMID- 3270492 TI - [Pollinosis caused by olive trees in the Province of Salentina]. PMID- 3270493 TI - [Case contribution to the knowledge of Marfan's syndrome: description of a clinical case]. PMID- 3270494 TI - [Diffuse interstitial pulmonary fibrosis in tobacco-industry workers]. PMID- 3270495 TI - [A transversal epidemiological study of factors associated with risk of respiratory diseases in a school-age population of Southern Italy]. PMID- 3270496 TI - [Left ventricle-right atrium intracardiac shunt following replacement of mitral valve prosthesis]. PMID- 3270497 TI - [Spontaneous pneumothorax in chronic bronchopneumopathies]. PMID- 3270499 TI - Changes in milk composition during lactation in the potoroo, Potorous tridactylus (Marsupialia: Potoroinae). AB - Milk samples from captive potoroos were analysed for composition during weeks 3 25 of the lactation period. During pouch residence, up to week 16, carbohydrate levels were high, ranging from 9 g 100 ml-1 at week 5 to 15 g 100 ml-1 at week 15; fat levels were consistently low, at around 2 g 100 ml-1; protein levels gradually increased from 5 g 100 ml-1 before week 10 to 12 g 100 ml-1 at week 16. Growth rates during this period increased exponentially, from 1 g week-1 at week 3 to 40 g week-1 at week 16. Thereafter, as the young left the pouch, marked changes were seen in carbohydrate and fat levels: by week 25, carbohydrate levels had fallen to 2 g 100 ml-1, and fat levels had risen to 26 g 100 ml-1. Protein levels increased moderately, reaching 15 g 100 ml-1 by week 25. Growth rates further increased during this period, to reach 60 g week-1 by week 25. Thus, trends in milk composition previously observed in Macropus species were observed also in the potoroo, suggesting a consistent pattern across the macropodid family. Carbohydrate levels in potoroo milk tend to be higher than in other macropodids, but total milk intake is as important as composition in determining growth rates. PMID- 3270498 TI - Short-term effects of exogenous growth hormone: effects on milk production and utilization of nutrients in muscle and mammary tissues of lactating ewes. AB - Exogenous bovine growth hormone at a dose of 0.1 mg kg-1 liveweight increased yields of milk and milk constituents and milk fat content when injected over 5 days into ewes in mid-lactation. These changes in milk production were associated with changes in the supply to, and utilization of, nutrients by leg muscle and mammary tissues. Arterial concentrations of glucose and non-esterified fatty acids increased significantly, concentrations of lactate and 3-hydroxybutyrate tended to increase, and concentrations of triglycerides associated with very low density lipoproteins decreased significantly. Growth hormone increased mammary uptake of non-esterified fatty acids, decreased mammary uptake of very low density lipoproteins and tended to reduce the release of lactate from leg muscle. Oxidation of non-esterified fatty acids in the whole body and mammary tissue was increased by growth hormone and there was a tendency for reduction of glucose oxidation in mammary tissues. During injection of growth hormone, blood flow to leg muscle and mammary tissues increased as did the calculated ratio of blood flow; milk yield. These changes in blood flow, together with changes in arterial concentrations and tissue utilizations of key metabolites, were sufficient to account for the synthesis of extra milk and milk constituents. PMID- 3270500 TI - Are megabats flying primates? Contrary evidence from a mitochondrial DNA sequence. PMID- 3270501 TI - Oestrogen sulfotransferase: isolation of a high specific activity species from bovine placenta. AB - During the course of a study of the control of expression of steroid-binding proteins in human mammary cancer oestrogen sulfotransferase was isolated from bovine placenta. By a combination of salt precipitation and ion-exchange and gel permeation chromatography two forms of the enzyme were isolated. The forms, which apparently differ only in charge, have specific activities 100-300 times greater than has previously been reported for the enzyme. Partial peptide sequences of these enzymes are presented. PMID- 3270502 TI - Development of sheep embryos in vitro in a medium supplemented with different batches of serum albumin. AB - Variability in different lots of commercial serum albumin affects mammalian embryo development in culture. The composition of commercial preparations of ovine, bovine and defatted bovine serum albumin and a fraction of ovine serum containing proteins with a mean molecular weight of 65 kDa (fraction 3) was examined by polyacrylamide gel electrophoresis. All preparations were heavily contaminated with serum proteins other than albumin. Day-6 sheep morulae were cultured for 48 h in a basal bicarbonate-buffered salt solution supplemented with the commercial preparations of ovine, bovine or defatted bovine serum albumin. These three albumin preparations differed in their abilities to support the development of morulae into expanded blastocysts, but these differences disappeared when the basal medium was also supplemented with a component of ovine serum containing substances with molecular weights of less than 10 kDa. In the latter case, the three commercial albumin preparations and fraction 3 of ovine serum all supported full development in about 40-60% of morulae. PMID- 3270503 TI - Control of ram sperm adenylate cyclase by divalent cations. AB - The adenylate cyclase activity of ram sperm increased on freeze-thawing and the enzyme was stable at 0 degrees C. Its activity was stimulated by Mn2+, Zn2+, Co2+, Mg2+ and Ca2+ in descending order of activity. The enzyme was insensitive to fluoride when Mn2+ concentration was in excess. Mn2+-stimulated enzyme activity was decreased by the simultaneous addition of Co2+, or Cd2+, or Ni2+, and particularly Cu2+. Sulfhydryl compounds (viz. dithiothreitol, glutathione, dithiocarbamate, 2-mercaptoethanol, ergothioneine and cysteine) and chelating agents (viz. D-penicillamine and 8-hydroxyquinoline) were effective, to varying degrees, in overcoming the inhibition by Cu2+. Ca2+ augmented the stimulatory effect of Mg2+, Co2+, Zn2+ and Mn2+ on enzyme activity. PMID- 3270504 TI - Structure-activity studies of melatonin analogues in prepubertal male rats. AB - Comparison has been made between the activity of the pineal hormone melatonin, and several analogues and metabolites in inhibiting sexual development in a protein-restricted prepubertal rat model. Eleven melatonin analogues or metabolites were tested with the aim of evaluating the model as a test of the hypothesis that melatonin acts as a prohormone and that the ring schism metabolites (kynurenamines) mediate many of the effects attributable to melatonin. Although the hypothesis could not be confirmed, modification of the melatonin structure by lengthening the acrylamide side chain or by replacing the 5 methoxy function with fluorine resulted in loss of biological potency. Modification of the melatonin structure to block the two known points of metabolism resulted in no significant alteration in biological activity. Thus 6 chloromelatonin (blocking 6-hydroxylation) and 2,3-dihydromelatonin (blocking oxidative cleavage of the C2-C3 bond) and 6-chloro-2,3-dihydromelatonin remained biologically active. The metabolic products of brain indoleamine-2,3-dioxygenase, N-acetyl-N2-formyl-5-methoxy kynurenamine (aFoMK) and N-acetyl-5-methoxy kynurenamine (aMK), paradoxically were also biologically active. PMID- 3270505 TI - Committee to be named to advise government about fetal tissue transplantation experiments. PMID- 3270506 TI - Spontaneous retraction of indwelling catheters: previously unreported complications. AB - The development of totally implantable reservoir central venous access systems has been an important advance in patients requiring long-term central venous access. With lower rates of infection and thrombosis than those with external catheters, they have potential for greater longevity and patient acceptance. Complications such as subcutaneous prosthetic infection, infusate extravasation, and difficulty in locating and puncturing the port have been reported. We present two cases of catheter migration and withdrawal from the subclavian vein. This presumably occurred from the action of the underlying pectoralis muscle on the reservoir, as well as a "jetting effect" during flushing. We make suggestions for prevention of similar problems in the future. PMID- 3270507 TI - Ultraviolet-induced dimerization of non-adjacent pyrimidines. A potential mechanism for the targeted -1 frameshift mutation. AB - The DNA photoproduct responsible for the ultraviolet (u.v.)-induced targeted -1 frameshift mutation is unknown. Based on mutagenesis studies by others, we surmised that this lesion might be found in high abundance in single-stranded DNA. u.v. irradiation of the single-stranded alternating copolymer poly[d(G-T)] yielded a photoproduct that was characterized in detail. It consists of a thymine thymine cyclobutane dimer of predominantly cis-syn configuration occurring between non-adjacent thymidyl residues on the same strand. Its formation is strongly inhibited in double-stranded DNA. A similar u.v. photoproduct was obtained in higher yield from the polypyrimidine alternating copolymer poly[d(C T)] under conditions in which it is single-stranded. It is proposed that replication across the unrepaired photoproduct: (formula; see text) is the cause of the targeted u.v.-induced -1 frameshift mutation. PMID- 3270508 TI - Hydroxyurea and etoposide: in vitro synergy and phase I clinical trial. AB - L1210 murine leukemia cells were treated with hydroxyurea (10-200 microM) for 24 hours and/or etoposide (0.17-3.4 microM) for 2 hours. Combination treatments used a fixed molar hydroxyurea:etoposide ratio of 58.9:1, and drug-drug interactions were quantitated according to the median effect principle. Hydroxyurea and etoposide were antagonistic at low doses at which the survival fraction was greater than 0.5 and synergistic at higher doses at which the survival fraction was less than 0.25. In a phase I clinical trial, 19 patients were treated with the two drugs at one of three dose levels. The dose-limiting toxic effect was myelosuppression. Doses of 100 mg of etoposide/m2 per day by continuous infusion and 500 mg of hydroxyurea orally every 4 hours, both for 3 days, are recommended for phase II trials. PMID- 3270509 TI - Dialysis amyloid presenting as acute arthritis. PMID- 3270510 TI - The stability of coexisting psychiatric syndromes in alcoholic men after one year. AB - Alcoholic men (N = 241) were administered a criterion-referenced, structured, DSM III compatible, diagnostic interview while hospitalized and again 1 year later as outpatients. This interview independently evaluates the lifetime prevalence of 15 major psychiatric disorders. In addition to alcoholism, the most frequently occurring coexisting disorders were depression, antisocial personality and drug abuse. After 1 year, the number of positive syndromes declined slightly (chi = 2.0 to 1.8). However, the absolute and relative number of additional psychiatric syndromes remained stable over 1 year for the entire sample. Across individuals, the overall rates of agreement for the 15 syndromes ranged from a high of 100% to a low of 85%. Similarly, the agreement for the current and lifetime diagnoses ranged from 86 to 99%. These data indicate that a substantial portion of male alcoholics experience symptoms that are common to other psychiatric disorders. They also suggest that the endorsement of multiple psychiatric symptoms is not due simply to the acute emotional and physical distress that often accompanies a recent hospitalization for alcoholism treatment. Instead, for many male alcoholics, the symptom patterns appear to reflect additional psychiatric disorders that are stable over time and a potential target of treatment. PMID- 3270511 TI - Home ambulatory blood pressure readings do not differ from clinic readings taken at the same time of day. AB - In most hypertensives clinic blood pressure (BP) is variably higher than home BP, but the underlying mechanisms are uncertain. We investigated whether the 24-hour ambulatory home BP profile as well as the office-home BP discrepancy could vary with the time of day of application of the recording system (from 08.00 h to 19.00 h) in 135 untreated hypertensives who underwent non-invasive home BP monitoring (ICR 5200). Neither systolic nor diastolic 24-hour home BP (average of daily readings, area-under-the-curve) varied significantly with the time of day of application of the system. Clinic BP was about 12% higher than 24-hour home BP in the whole population, mean values being 161.4/102.9 mmHg (office BP) vs 141.2/90.8 mmHg (average 24-hour home readings), as well as in each of the subcohorts based on the time of day of application of the system (all P less than 0.01). However, in none of the subcohorts were there any statistically significant differences between clinic BP and home BP readings taken at the same time of day as the clinic readings. No correlation was found between clinic heart rate and clinic-home discrepancy. We conclude that in essential hypertension 24 hr non-invasive ambulatory BP monitoring can begin indifferently from 08.00 h to 19.00 h with no expected influence of time of application on results and that clinic BP is not dissimilar from home BP at the same time of day. PMID- 3270512 TI - Healthy nutrition. Preventing nutrition-related diseases in Europe. PMID- 3270513 TI - Experimental study of proteinuria caused by chronic exposure to mercury. AB - Proteinuria induced by chronic exposure to mercury and the relationship between urinary mercury and kidney damage were explored in rats using ultrafiltration concentration, gel chromatography, and transmission electron microscopy. The results showed that the primary site of damage was the proximal renal tubule and that the glomerulus was eventually involved. Of the tubular cell ultrastructures, the lysosome was the most sensitive to mercury, and there was a close relation between the excretion of urinary mercury and the mercury detoxication mechanism of the kidney. Many deposits were found in the endothelia and mesangia of the glomeruli. The results of the study showed that urinary mercury consisted of three components, that filtration through the glomeruli was an important source of urinary mercury, and that the mercury excreted from the renal tubules reflected the mercury-loading status of the kidney. PMID- 3270514 TI - Pulmonary injury in laboratory animals induced by Huai-Nan coal mine respirable dust. AB - The BAL technique was used to assess the pulmonary injury of coal dust and rock dust in Huai-Nan coal mine in Anhui Province. Dust suspended in saline and dust free supernatant were instilled intratracheally to Wistar rats and Syrian hamsters. Saline was used in treating controls. The animals were sacrificed 24 h after treatment, their lungs were lavaged, and pulmonary damage was evaluated by cellular and biochemical assays of lavage fluid. Pulmonary injury was expressed by the cell toxicity index (CTI). CTI is the product of the number of times of meaningful parameters for treated groups compared to controls (LDH, acid phosphatase, and polymorphonuclear neutrophils in this case). The CTI values were found to be 5.19, 2.28, and 5.15 for rock dust, coal dust, and Shanghai suspended particulates, respectively. The toxicity of rock dust is higher than that of coal dust, but is similar to that of Shanghai suspended particulates. The cell toxicity of dust suspension solution is higher than that of dust-free supernatant. CTI can be used as an indicator of the relative toxicity of respirable dusts in in vivo studies. PMID- 3270515 TI - Correlation between lung cancer prevalence and activities of aryl hydrocarbon hydroxylase and glutathione S-transferase in human lung tissues. AB - The activities of aryl hydrocarbon hydroxylase (AHH) and glutathione s transferase (GST) were measured in the lung tissues of lung cancer patients and patients without lung cancer. The results indicate that after controlling for age, sex, smoking, living conditions, occupational exposure, and medication history, the ratio of AHH to GST (AHH/GST) in the lung tissues of cancer patients was significantly higher than that in noncancer patients. This difference might suggest a genetic difference in benzo[a]pyrene (BP) activations between the two groups of patients, but whether there is a casual relation between AHH/GST and lung cancer is still a question. AHH/GST was high in patients who smoked. It is conceivable that smoking might increase the rate of BP activation. There was a positive correlation between AHH activity and the amount the lung cancer patients smoked, but the AHH activity was not affected by smoking in noncancer patients. The AHH activity of lung cancer patients seems more sensitive to induction by polycyclic aromatic hydrocarbons than that of noncancer patients. However, this suggestion should be further verified. PMID- 3270516 TI - Cardiotoxicity of the lipophilic compound aluminum acetylacetonate in rabbits. AB - Aluminum acetylacetonate was administered to New Zealand white rabbits as liposome preparations and was found to distribute approximately 1:1 between water and phosphatidylcholine dipalmitoyl vesicles. Biochemical monitoring proved that after 2 weeks of daily injection of 40 micrograms of Al(III) in the above form, the animals developed significant signs of cardiac suffering, evidenced by variations in lactic dehydrogenase and creatinine phospokinase. Histopathologic investigation revealed that aluminum acetylacetonate caused unambiguous myocardial infarcts, characterized by myocardial contraction bands. In contrast, injection of Al(III) as a simple salt (lactate, 20 mg/day for 3 weeks) gave a less severe myocardiopathy, certainly not infarctual. Aluminum acetylacetonate given to rabbits appears to be, to our knowledge, the only chemical tool able to mimic spontaneous infarction situations in humans. PMID- 3270517 TI - Identification and description of low-molecular weight chemicals inducing hypersensitivity in man. AB - The purpose of this study is to compose a list of allergenic chemicals. Each chemical is described in a monograph. The objective of such a monograph program is to collect from the international scientific literature available relevant experimental, chemical, and epidemiological data on chemicals to which humans are known to be exposed and sensitized. A list of 721 chemicals, with related synonyms and trade names, that induce allergic responses and hypersensitivities was prepared. The chemicals were selected on the basis of evidence of human exposure and sensitization. Each monograph contains several data considered relevant to the evaluation of the sensitizing hazards of chemical substances. The data are divided in three sections: chemical identity, sensitizing power, and occurrence. All the data contained in the monographs along with the references and the synonyms are stored in a database application computer program. Preliminary results of 308 of 721 monographs analyzed are reported. PMID- 3270518 TI - Pesticide residue control in the years 1980-1982. AB - Data on pesticide residue on vegetables, fruits, cereals, and other foods of vegetable or animal origin determined by Provincial Laboratories during the years 1980-1982 are presented and compared with levels permitted by Italian legislation. An analysis of the results obtained from about 3000 samples shows that a high percentage of samples did not contain detectable pesticide residues or had residue levels below the maximum allowed by Italian law: 98% of the vegetables, 94.6% of the fruit, and 97.5% of the cereals (fumigants not considered here). On fruit, some residues exceeding the permissible levels for postharvest compounds, i.e., ethoxyquin, ethylenebisdithiocarbamate (EBDC), and benzimidazolmethylcarbamate (BMC), were found in apples and pears. Residue levels of some organochlorinated compounds slightly exceeding the legal limit were observed in some food samples of animal origin (mainly cow's milk). Comparing the present results with those of previous studies indicates that there has been a general decline in the residue levels of aldrin/dieldrin in milk and milk products. PMID- 3270519 TI - Accumulation of organic air constituents by plant surfaces. Spruce needles for monitoring airborne chlorinated hydrocarbons. AB - The needles of the spruce (Picea abies) were used to monitor ambient air for organic trace substances. Analyses of spruce needles in an industrialized area demonstrated that the concentrations of these substances were much higher than those in a nonindustrialized area. PMID- 3270520 TI - The use of isolated rat hepatocyte in prescreening of hepatotoxicants: observation on toxic effects of 14 compounds. AB - Fourteen compounds, differing in structure, mechanism of action, and primary target organs, were tested for cytotoxic responses in isolated hepatocyte suspensions prepared by a nonperfusion method from male Sprague-Dawley rats. The trypan blue exclusion test, measurement of enzyme activities in supernatants, and enzyme histochemistry were taken as indexes of cytotoxicity. All 14 compounds inhibited enzyme activities in hepatocytes. However, the activities of GOT and LDH in supernatants increased after exposure to the three haloalkanes, but decreased after exposure to the other chemicals (Na2CrO4, etc.). The number of dyed cells increased after exposure to six haloalkanes and the order of their relative toxicities in vitro was roughly in concordance with that of their in vivo hepatoxicities. These results indicate that isolated hepatocytes are useful for prescreening of potential hepatotoxicants; the so-called "enzyme leakage" should be replaced by "enzyme in supernatant" to reflect toxicities of different kinds of compounds; enzyme histochemistry is also a sensitive index in toxicological tests with isolated rat hepatocytes. PMID- 3270521 TI - Studies on the tolerance limit of fluoride in food in China. AB - To estimate the appropriate tolerance limit of fluoride in food in China, fluoride-related endemic diseases, background levels of fluoride in foods, and daily total intake of fluoride per capita were studied in addition to the subchronic toxicity test of fluoride in rats. In the general population, the daily total intake of fluoride from food, water, and air is 1.45-3.15 mg per capita. On the basis of these results and other information, it is suggested that the ADI of fluoride in the Chinese population should be 3.5 mg per capita, or 0.058 mg/kg body wt, and the tolerance limit of fluoride should be 1.0 ppm in rice, wheat flour, vegetables, and freshwater fish. PMID- 3270522 TI - An investigation of the effects of cadmium exposure on human health. AB - An epidemiological survey of the effects of cadmium (Cd) exposure on the population living near Cd industries, carried out in five provinces of China, revealed that the critical value of urinary Cd excretion was 15 micrograms/liter. Both the average amount of Cd excreted and the incidence of low-molecular-weight protein in urine were positively correlated with the total intake of Cd. The incidence of low-molecular-weight protein excreted in urine was elevated significantly in the exposed group, with a total Cd intake of 133 micrograms per capita per day. It is suggested that the acceptable daily intake (ADI) of Cd be 100 micrograms per capita or 1.67 micrograms/kg body wt. PMID- 3270523 TI - A bacteriological and helminthological investigation of a sewage-irrigated area in a Beijing suburb. AB - The municipal sewage and raw sludge removed from a sewage treatment plant were the main sources of pollution by pathogenic bacteria and helminthic eggs in land utilization. The level of pollution in the sewage-irrigated areas was as high as that in the areas using fresh night soil. The survival time of Salmonella and Ascaris ova in soil irrigated with sewage was relatively long. The soil had a definite natural capacity for purifying pathogenic bacteria. Because of the different ways of watering, the number of Salmonella detected on vegetables irrigated with sewage was higher than that on vegetables manured with night soil, whereas the reverse held for the number of Ascaris ova. The differences in latent Salmonella infection and the geometric mean titer of serum agglutination for typhoid between the vegetable growers living in the sewage-irrigated area and those living in fresh night soil areas were not remarkable. The prevalence of soil-transmitted ascaridiasis among vegetable growers in sewage-irrigated areas was slightly lower than that among growers in fecal-contaminated areas. When the number of fecal coliforms in sewage was no greater than 10(4)/liter and no less than 85% of Ascaris ova could be removed by sewage treatment, the number of Salmonella and Ascaris ova detected decreased noticeably. PMID- 3270524 TI - 3-D graphics modelling of the tRNA-like 3'-end of turnip yellow mosaic virus RNA: structural and functional implications. AB - The tRNA-like structure of the aminoacylatable 3'-end of turnip yellow mosaic virus (TYMV) RNA was submitted to 3-D graphics modelling. A model of this structure has been inferred previously from both biochemical results and sequence comparisons which presents a new RNA folding feature, the "pseudoknot". It has been verified that this structure can be constructed without compromising accepted RNA stereochemical rules, namely base stacking and preferential 3'-endo sugar pucker. The model has aided interpretation of previous structural mapping experiments using chemical and enzymatic probes, and new accessibilities of residues could be predicted and tested. Pseudoknots have been considered as potential splice sites because they form antiparallel helical segments in a single RNA molecule. We have examined this possibility with the constructed 3-D model and could verify the hypothesis on a structural basis. The model presents a striking similarity with canonical tRNA and allows a valuable comparison between the protection patterns of yeast tRNA(Val) and tRNA-like viral RNA by cognate yeast valyl-tRNA synthetase against structural probes. PMID- 3270525 TI - A stereochemical model of the transpeptidation complex. AB - Molecular models are proposed to describe the relative arrangement of aminoacyl and peptidyl tRNAs when bound to their respective A and P sites on the ribosome. The crystallographically determined structures of tRNAasp and tRNAphe have served as the models for these bound structures, while the imposed steric constraints for the model complexes were based on the results of published experimental data. The constructed models satisfy the stereochemical requirements needed for codon anticodon interaction and for peptide bond formation. In this paper, the results of the complex containing tRNAphe as the A and P site bound transfer RNAs, is compared to a similarly constructed model which uses tRNAasp as the ribosome bound transfer RNAs. The models have the following three major features: 1) the aminoacyl and peptidyl transfer RNAs assume an angle of approximately 45 degrees relative to each other; 2) in providing the proper stereochemistry for peptide bond condensation, a significant kink must be present in the messenger RNA between the A site and P site codons; and 3) a comparison of the two model complexes indicates that structural variations between the tRNAs or any allosteric transitions of the transfer RNAs associated with codon-anticodon recognition may be accommodated in the model by way of freedom of rotation about the phosphate backbone bonds in the mRNA between consecutive codons. PMID- 3270526 TI - The conformation of the d(ACCCGGGT) duplex in aqueous solution. AB - The nonexchangeable base and sugar protons of the octanucleotide d(ACCCGGGT)2 have been assigned using two dimensional homonuclear Hartmann-Hahn relayed spectroscopy (HOHAHA), double quantum filtered homonuclear correlation spectroscopy (DQFCOSY) and nuclear Overhauser spectroscopy (NOESY) in D2O at 12 degrees C. The observed NOE's between the base protons and their own H2' protons and between the base protons and the H2' protons of the 5' adjacent nucleotide and the observed coupling constants between the deoxyribose 1' and 2',2'' protons indicate that this duplex assumes a right-handed B-type helix conformation in solution. PMID- 3270527 TI - NMR studies of backbone-alkylated DNA: duplex stability, absolute stereochemistry, and chemical shift anomalies of prototypal isopropyl phosphotriester modified octanucleotides, (Rp,Rp)- and (Sp,Sp)-(d [GGA(iPr)ATTCC])2 and -(d-[GGAA(iPr)TTCC])2. AB - The DNA octamer (d-[GGAATTCC])2 and four alkylated analogues, (Rp)-(d [GGA(iPr)ATTCC])2, (Sp)-(d-[GGA(iPr)ATTCC])2, (Rp)-(d-[GGAA(iPr)TTCC])2, and (Sp) (d-[GGAA(iPr)TTCC])2 have been examined using 1H and 31PNMR spectroscopies. Duplex stability, as monitored by both NMR and optical measurements, is shown to be a function of both site and stereochemistry of the phosphotriester moiety. Chemical shift changes relative to the native octamer indicate that there are long-range perturbations in the isopropylated molecules. 1HNMR is shown to be a general means by which stereochemistry at phosphorous can be determined. PMID- 3270528 TI - Structural and conformational studies on deoxyguanosyl-3',5'-deoxyadenosine monophosphate and its ethyl phosphotriester analogs--left-handed dimers. AB - The mode of base-base stacking, the handedness and the sugar(dGpA)phosphate backbone conformation of deoxyguanosyl 3'-5' deoxyadenosine and its diastereomeric ethyl phosphotriester analogs were studied by 1H NMR, UV and CD spectroscopy. The results indicate the three dimers are left-handed, while the sugar phosphate backbone is comprised predominantly of C2-endo,gg(C4-C5) and g'g (C5-O) conformers. The two bases are extensively stacked and interact about 90 degrees along the dyad axes. The extent of base overlap in dGpA is slightly greater than in either ethyl phosphotriester analog. The absolute configurations of the two ethyl phosphotriester diastereoisomers of dGpA can be assigned by one dimensional and two-dimensional 1H NMR nuclear Overhauser enhancement experiments. PMID- 3270529 TI - Crystal and molecular structure of the sodium salt of the dinucleotide duplex d(CpG). AB - The crystal and molecular structure of the sodium salt of deoxycytidylyl-(3H-5H) deoxyguanosine has been determined from X-ray diffraction data. The crystal, obtained from an aqueous gamma-butyrolactone solution at pH = 5.3 are orthorhombic, P212121, a = 10.640(2), b = 11.184(2) and c = 44.618(4)A. The structure was refined to an R = 0.041. The d(CpG) structure is similar to the ammonium salt solved by Cruse et al.(1). Both structures form a parallel self base paired mini-double helix. In d(CpG).Na+ one of the two paired cytosines is protonated on N(3). The cytosines form 3 hydrogen bonds while the guanines form only 2. The Na+ ion is coordinated with five groups: two water molecules, O(6) of guanine A, N(7) of guanine B and 0(5') of cytosine B, forming a square pyramid. The hydration shell around the mini-helix is analysed and compared with that of the ammonium salt, d(CpG).Na+ is the second d(CpG) oligonucleotide found with a self base pairing arrangement despite of the fact that the crystallization conditions and counterion were different in both cases. The hypothesis that self base pairing is not only a crystallization artifact but may play a role under physiological conditions as a source of transversion mutations is discussed. PMID- 3270530 TI - A preliminary structure for the DNA binding protein from bacteriophage IKe. AB - A modelling procedure has been utilized to obtain a preliminary three-dimensional structural model for the bacteriophage IKe DNA binding protein (IKe-DBP) based on the known high resolution X-ray diffraction structure of a functionally related protein (G5BP) from bacteriophage fd. The degree of structural homology observed is much higher than the 44% primary sequence identity between these proteins would indicate. These studies suggest IKe-DBP, like G5BP, is composed of a central three-stranded beta sheet from which protrude three extended beta loops. Furthermore, the IKe-DBP structural model can easily form, without conformational rearrangements, the compact dimer unit that is the functionally active species of G5BP. Structural comparisons show residues conserved in the primary sequence of both proteins tend to cluster in two regions. The first being essential for the maintenance of dimer association. The second about the two DNA binding channels which cross the face of each dimer. Based upon an earlier characterized G5BP-DNA complex, a model for DNA complexation to IKe-DBP is also presented. PMID- 3270531 TI - Distribution of charges in Bacillus intermedius 7P ribonuclease determines the number of cooperatively melting regions of the globule. AB - A correlation between the distribution of charged side groups in the globule of Bacillus intermedius 7P ribonuclease (binase) and the process of heat denaturation was studied at different pH values in order to estimate a relation between charge distribution in globular proteins and the character of cooperative thermodynamic transitions. As was shown by comparing the results of scanning microcalorimetric analysis of heat denaturation with the three-dimensional structure of binase, at optimal pH the molecule exists as a single cooperative system stabilized by hydrogen bonds, Van der Waals' contacts, and electrostatic interactions like salt bridges. At pH lower than 4.0 (below the physiological optimum) the cooperativity type of the system was found to change due to a reversible cooperative transition in the ternary structure of the protein globule. It has been concluded that the molecular architecture and the arrangement of atoms do not change considerably in different environments; thus the thermodynamic properties of the globule vary due to the alteration of charge distribution and the consequent changes in the size and number of cooperative regions of the globule. Thus, structural and energetic domains may be non coincident in proteins. PMID- 3270532 TI - Structural forms and transitions for the complex of mercury(II) with poly(dG-dC). AB - Infrared spectroscopy was used to study hydrated double-helical poly(dG-dC) complexed with varying amounts of mercury(II). For one Hg(II) per ten nucleotide residues (r = 0.1), the B structure was stabilized and the B* structure was absent at high hydration. The Z structure did not form as hydration was reduced. For r = 0.2, the B and Z structures coexisted at high hydration and the transition to total Z structure was broad as hydration was reduced. Hg(II) was bound exclusively to the guanine residues probably at N3 or N7 for r less than or equal to 0.25. The cytosine residue did not protonate (at N3) as Hg(II) was bound to guanine. The addition of NaCl together with Hg(II) reduced the binding of Hg(II), stabilized the B structure at the highest hydration and caused a sharp transition between the B and Z structures as hydration was lowered. Hydration with D2O stabilized the Z structure for poly(dG-dC) complexed with HgCl2. PMID- 3270533 TI - Energetics of left and right handed models of DNA. AB - It has been shown by model building studies that various right handed and left handed models are compatible with X-ray data of B-DNA and C-DNA. These models are also found to be in good agreement with infrared dichroism data. Detailed potential energy calculations have now been carried out for these models, viz., right and left handed B-DNA and right and left handed C-DNA. It is found that base sugar stacking and interactions involving the phosphate groups are the dominant forces for stabilizing a particular structure. For some sequences, viz., A-A, T-A and C-A, left handed stacking is quite favourable in both B and C structures. But intranucleotide interactions make the left B-DNA unfavourable while the left C-DNA structure is more stable, for all the sequences, than the right C-DNA structure, proposed from fibre data. For the hexanucleoside pentaphosphate fragments the same trend is observed, with the right handed B-DNA being the most stable of the four models studied. However, the left C-DNA structure is only marginally higher in energy, particularly if the shielding effect of the counter ions, on the phosphate group is taken into consideration. PMID- 3270535 TI - Conserved putative signals in 3' intron junctions in rodents. AB - Several 3' splice signals are known todate. At the 3' splice site an AG doublet is frequently found. Just upstream of the splice site there is a string of 6-11 pyrimidines. More recently it has been found that one of the stages in the splicing process involves formation of a lariat, in which the 5' end of the intron forms a 2'-5' branch with an A residue located 18-37 nucleotides upstream of the 3' splice site. The branching-point consensus is weakly defined and consists of the sequence YNYTRAY, where Y is a pyrimidine, R a purine and N any base. The A in the sixth position is the one with which branching occurs. Here we present the results of extensive searches for additional putative signals around the branching-point consensus and the 3' splice site in rodent nuclear precursor mRNAs. The signals obtained for the over 370 rodent introns are compared with those found in a larger eukaryotic sample containing over 900 nuclear pre-mRNA introns. Of particular interest are GGGA and CCCA. In both analyses GGGA occurs about 60 nucleotides upstream and CCCA is found 3-40 nucleotides downstream from the 3' splice site. A model explaining some of the putative signals discussed here is also proposed. This model involves formation of alternate stem-loop structures around the branching point and 3' splice site. Such signals and structures can possibly aid in protein or nucleoprotein branching point and splice site recognition. PMID- 3270534 TI - Structural requirements for a primitive adaptor molecule. AB - Adaptor properties of linear hairpin helices have been examined. The analysis suggests that neither right nor left handed hairpin helices can simultaneously read a comma free messenger and align aminoacyl residues for peptide condensation. Comparison of these studies with the model of the present day peptidyl transfer intermediate suggests that the "L" shaped folding of the present day tRNAs may be a prerequisite for adaptor function. Therefore, the three-dimensional organization of the ancestral adaptor molecule must have had structural features similar to its present day counterpart. PMID- 3270536 TI - Differential DNase I sensitivity of the two complementary nucleosomal DNA strands in cycloheximide-treated Ehrlich ascites tumor cells. AB - The accessibility of the two complementary DNA strands in newly replicated chromatin of Ehrlich ascites tumor (EAT) cells grown under conditions of cycloheximide-inhibited protein synthesis was studied by analysis of the DNase I digestion of isolated nuclei. Bulk DNA was labeled with 14C-thymidine and the newly synthesized strands - with bromodeoxyuridine and 3H-thymidine. The DNase I digests were fractionated in two successive CsCl density gradient centrifugations to obtain a dense fraction containing 15-20% newly replicated DNA. Analysis of the distribution of 14C-labeled parental DNA fragments complementary to the 3H nascent strand has shown that the 14C-labeled fragments prevail in the region of 30-50 nucleotides. Simulation experiments using the rate constants for DNase I attack show that this result may be explained by an enhanced accessibility at the nucleosomal 5'-end region of the parental strands, where the H2a-H2b dimer interacts with DNA. This asymmetry seems to be induced by interactions in the chromatin. PMID- 3270537 TI - A computer modelling approach to study the mode of binding of L-lyxoflavin-5' monophosphate to flavodoxin. AB - The mode of binding of L-lyxoflavin-5'-monophosphate has been studied by a computer modelling method. Energetically preferred conformers of L-lyxoflavin-5' monophosphate have been obtained using empirical potential energy functions. These minimum energy conformers were used to study the mode of their binding to flavodoxin. The study indicates that L-lyxoflavin-5'-monophosphate can also have coenzymatic activity similar to flavin mononucleotide. But its lower activity compared to flavin mononucleotide is due to the lower conformer population that initiates the binding process. It is also concluded from this study that the inability of L-lyxoflavin to promote growth in some cases is at the phosphorylation level and not at the coenzyme level. PMID- 3270538 TI - The space structure of a conformationally labile oligopeptide in solution: angiotensin. AB - The paper describes a new approach to the problem of space structure description for conformationally labile molecules existing in solution as a set of different conformers in dynamic equilibrium. In such a case the "average" model derived exclusively from physico-chemical data represents a virtual structure devoid of physical sense. The proposed approach involves the selection of statistical weights wi for molecular conformers in solution by combined use of spectroscopic data and energy calculations (including the Monte-Carlo technique). Consequently, it appears possible to confine the entire region of all wi values only by those points (wi) that provide a reasonable agreement between the results of calculations and the experimental data. The approach was put to trial by using the linear octapeptide angiotensin, a well-known bioregulator with a wide spectrum of action. The 1H NMR and fluorescence spectroscopy were used as a source of experimental evidence concerning the space structure of the peptide in aqueous solution. The spin-lattice relaxation rates induced by the spin label allowed to estimate simultaneously several parameters characterizing the distance between the spin label and different functional groups in the angiotensin molecule. At least 5 types of angiotensin conformers were shown to be "indispensable" to achieve a good agreement between the results of energy calculations and 1H NMR spectroscopy data obtained in solution. The statistical weight estimates for angiotensin conformers permit to predict, with a high degree of accuracy, the value of singlet-singlet energy transfer between the Phe and Tyr aromatic chromophores of the molecule in aqueous solution. The proposed approach to the description of conformationally labile molecules can be actually regarded as stepwise refinement of statistical weight limits for sets of low-energy conformers in solution upon accumulation of new experimental evidence. The same appears to apply to conformationally labile molecules of non-peptide nature. PMID- 3270539 TI - Nucleic acid model building: the multiple backbone solutions associated with a given base morphology. AB - A constrained model building procedure is used to generate nucleic acid structures of the familiar A-, B-, and Z-DNA duplexes. Attention is focused upon the multiple structural solutions associated with the arrangements of nucleic acid base pairs rather than the optimum sugar-phosphate structure. The glycosyl (chi) and sugar torsions (both the ring puckering and the exocyclic C5'-C4' (psi) torsion) are treated as independent variables and the resulting O3'...O5' distances are used as closure determinants. When such distances conform to the known geometry of phosphate chemical bonding, an intervening phosphorus atom with correct C-O-P valence angles can be located. Four sequential torsion angles- phi', omega', omega and phi--about the C3'-O3'-P-O5'-C5' bonds are then obtained as dependent variables. The resulting structures are categorized in terms of conformation, ranked in potential energy, and analyzed for torsional correlations. The numerical results are quite interesting with implications regarding nucleic acid models constructed to fit less than ideal experimental data. The multiple solutions to the problem are useful for comprehending the conformational complexities of the local sugar-phosphate backbone and for understanding the transitions between different helical forms. According to these studies, unique characterization of a nucleic acid duplex involves more than the determination of its base pair morphology, its sugar puckering preferences, or its groove binding features. PMID- 3270540 TI - An NMR study of the polymorphous behavior of the mismatched DNA octamer d(m5C-G m5C-G-T-G-m5C-G) in solution. The B, Z, and hairpin forms. AB - The polymorphism exhibited by the mismatched octamer d(m5C-G-m5C-G-T-G-m5C-G), as a function of the temperature, DNA concentration and ionic strength, was investigated by means of NMR spectroscopy. It is shown that this partly self complementary DNA fragment, under conditions of low DNA concentration (0.4 mM) and low ionic strength, exclusively prefers to adopt a monomeric hairpin form, which consists of a stem of three Watson-Crick-type base pairs and a loop of only two residues. This in striking contrast with earlier intimations in literature, which postulated that in oligonucleotides loop formations containing only two residues are sterically impossible. Moreover, the hairpin form displays an unusual stability in comparison with previously reported hairpins. A Tm of 332 K and a delta H degree of -130 kJ.mol-1 were calculated for the hairpin to random coil transition. At high DNA concentration (8 mM) and/or upon the addition of sodium chloride the hairpin form occurs in slow exchange with a B-DNA dimer structure (approximately 20% at 270 K, no added salt), which comprises two central GxT-mismatched base pairs with the bases as major tautomers. At higher ionic strength (greater than 100 mM NaCl), or upon the addition of methanol, a third species appears, which is in slow exchange with both the B dimer and the hairpin form. This third species could be identified with a Z DNA form, comprising two GxT mismatches with the bases as major tautomers, with the guanine bases syn and the cytosine and thymine bases anti. PMID- 3270541 TI - Conformational and model-building studies of the hairpin form of the mismatched DNA octamer d(m5C-G-m5C-G-T-G-m5C-G). AB - The hairpin form of the mismatched octamer d(m5C-G-m5C-G-T-G-m5C-G) was studied by means of NMR spectroscopy. In a companion study it is shown that the hairpin form of this DNA fragment consists of a structure with a stem of three Watson Crick-type base pairs and a loop consisting of only two nucleotides. The non exchangeable proton resonances were assigned by means of two-dimensional correlation spectroscopy and two-dimensional nuclear Overhauser effect spectroscopy. Proton-proton coupling constants were used for the conformational analysis of the deoxyribose ring and for some of the backbone torsion angles. From the two-dimensional NMR spectra and the coupling-constant analysis it is concluded that: (i) the stem of the hairpin exhibits B-DNA characteristics; (ii) the sugar rings are not conformationally pure, but display a certain amount of conformational flexibility; (iii) the stacking interaction in the stem of the hairpin is elongated from the 3'-side in a more or less regular fashion with the two loop nucleotides; (iv) at the 5'-side of the stem a stacking discontinuity occurs between the stem and the loop; (v) at the 5'-side of the stem the loop is closed by means of a sharp backbone turn which involves unusual gamma' and beta+ torsion angles in residue dG(6). The NMR results led to the construction of a hairpin-loop model which was energy-minimized by means of a molecular-mechanics program. The results clearly show that a DNA hairpin-loop structure in which the loop consists of only two nucleotides bridging the minor groove in a straightforward fashion, (i) causes no undue steric strain, and (ii) involves well-known conformational principles throughout the course of the backbone. The hairpin form of the title compound is compared with the hairpin form of d(A-T-C-C T-A-T4-T-A-G-G-A-T), in which the central -T4- part forms a loop of four nucleotides. Both models display similarities as far as stacking interactions are concerned. PMID- 3270542 TI - The structure of poly(dA).poly(dT) as revealed by an X-ray fibre diffraction. AB - X-ray diffraction in fibres revealed that the calcium salt of poly(dA).poly(dT) is a 10-fold double helix with a pitch of 3.23 nm. The opposite sugar-phosphate chains in the refined model are characterized by a complete conformational equivalence and contain sugars in a conformation close to C2'-endo. As a result a new model of the sodium salt of poly(dA).poly(dT) has been constructed, which is different from the Heteronomous DNA proposed earlier (S. Arnott et al., Nucl. Acids Res. 11, 4141 (1983)). The new model of Na-poly(dA).poly(dT) has conformationally similar opposite chains; it is a structure of the B-type, rather like that of Ca-poly(dA).poly(dT). PMID- 3270543 TI - The cell surface in development and cancer. PMID- 3270544 TI - The molecular biology of cell determination and cell differentiation. PMID- 3270545 TI - The effect of rifampicin on the development of the Streptomyces bacteriophage phi C31. AB - The production of phi C31 progeny virus was inhibited by rifampicin when it was added at any time before 20 minutes after induction of the thermoinducible lysogen Streptomyces coelicolor 01. The inhibition was gradually lost as the antibiotic was being added later on until the end of the latent period, which lasts about 45 minutes. This effect was not due to resistance of transcription to rifampicin but to accumulation of intracellular virions from around 20 minutes postinduction. When a rifampicin-resistant lysogen was induced in the presence of the antibiotic, no inhibition of RNA synthesis was detected, although a smaller population of progeny than in control cultures without rifampicin was obtained. Two possible explanations of this fact are discussed. PMID- 3270546 TI - Characterization of an hospital disseminated plasmid encoding resistance to gentamicin and other antimicrobial agents. AB - A preliminary report has shown the existence of an endemic R plasmid in the University Hospital of Zaragoza. The results presented in this paper demonstrate the dissemination of a new 73 kilobases plasmid into multiple strains and species of gram-negative bacilli. This transferable plasmid belongs to Incompatibility group P and mediates resistance to ampicillin, tetracycline, gentamicin, kanamycin, streptomycin, chloramphenicol and sulfamethoxazole, synthesizing the aminoglycoside-modifying enzymes 3-acetyltransferase, 3'phosphotransferase, and 3"nucleotidyltransferase, and a TEM-1 beta-lactamase. These results and the previous findings show that a family of gentamicin-resistance plasmids exists among the gram-negative bacteria in the University Hospital. Resistance to gentamicin in all these plasmids is associated with the formation of 3-N acetyltransferases. PMID- 3270547 TI - trans-dichlorobis(di-n-propyl sulfoxide)platinum(II). AB - [PtCl2(C6H14OS)2], Mr = 534.48, monoclinic, P2(1)/c, a = 9.092 (2), b = 5.696 (2), c = 19.749 (7) A, beta = 110.63 (3) degrees, V = 957.2 (6) A3, Z = 2, D chi = 1.854 Mg m-3, lambda(Mo K alpha) = 0.71069 A, mu(Mo K alpha) = 7.894 mm-1, F(000) = 520, room temperature, R = 0.047 for 1842 unique observed reflections. The Pt atom is located on a center of symmetry. Pt has trans square-planar coordination and the sulfoxide ligands are bonded through their S atoms. The Pt Cl bond distances are 2.292 (3) A. The Pt-S bond lengths [2.292 (2) A] are significantly longer than the corresponding distances in the cis isomer. The packing consists of layers of molecules parallel to the ab plane. PMID- 3270548 TI - The structure of stiripentol: 4,4 dimethyl- 1-(3,4-methylenedioxyphenyl)-1-penten 3-ol-a novel antiepileptic drug. AB - C14H18O3, Mr = 234.29, monoclinic, P2(1)/a, a = 14.550 (8), b = 6.133 (4), c = 15.703 (7) A, beta = 116.1 (4) degree, V = 1254.4 (5) A3, Z = 4, Dm = 1.24 (4), Dx = 1.239 g cm-3, lambda (Cu K alpha) = 1.54184 A, mu = 6.15 cm-1, F(000) = 504, room temperature, R = 0.065 for 2426 observed reflections. The five-membered ring A has an envelope conformation, the apical atom C(7)* being out of the plane. The conformation of the side chain attached to C(1)* is almost fully extended. The molecules are packed in a head-to-tail fashion as hydrogen-bonded dimers: O(3)...O(4)* [1-x, y, 1-z] = 3.124 (8), HO(3)...O(4)* = 2.19 (9) A, O(3) HO(8)...O(4)* V 160.2 (6) degree. PMID- 3270549 TI - The structure of (1,2-benzisoxazol-3-yl)methanesulfonamide: a novel antiepileptic drug. AB - C8H8N2O3S, Mr = 212.54, monoclinic, P2(1)/a, a = 7.347 (9), b = 13.237 (4), c = 10.128 (8) A, beta = 108.916 (6) degree, V = 931.9 (1) A3, Z = 4, Dm = 1.52 (4), Dx = 1.514 g cm-3, lambda (Cu K alpha) = 1.54184 A, mu = 28.35 cm-1, F(000) = 440, room temperature, R = 0.040 for 1864 observed reflections. The sulfonamide N forms intermolecular hydrogen bonds with the benzisoxazole ring N and also with the O on the sulfonamide group. Centrosymmetrically related benzisoxazole ring pairs are pi bonded with a high degree of overlap. PMID- 3270550 TI - 1-Ethynyl-4-hydroperoxy-1,2,3,4-tetrahydro-1-naphthol. AB - C12H12O3, Mr = 204.2, monoclinic, P2(1)/c, a = 11.815 (2), b = 7.673 (2), c = 12.580 (3) A, beta = 115.06 (2) degree, V = 1033.1 (9) A3, Z = 4, Dx = 1.313 g cm 3, lambda (Cu K alpha) = 1.54184 A, mu = 7.34 cm-1, F(000) = 432, T = 299 K, R = 0.065 for 1420 observations (of 2131 unique data). The stereochemistry of the hydroxyl and hydroperoxyl groups is cis. The hydroperoxyl O-O bond distance is 1.476 (2) A. The hydrogen-bonding pattern consists of two intermolecular interactions: a hydroperoxyl donor to the hydroxyl group, with an O...O distance of 2.818 (2) A and an O-H...O angle of 168 (2) degree, and a hydroxyl donor to O(3) of the hydroperoxyl group, with a distance and angle of 2.670 (2) A and 170 (2) degree, respectively. PMID- 3270551 TI - [N,N-bis(2-hydroxyethyl)dithiocarbamato-S,S']dichlorogold( II). AB - [Au(C5H10NO2S2)Cl2], Mr = 448.1, space group P212121 (No. 19), a = 7.446 (2), b = 11.434 (4), c = 13.110 (3) A, V = 1116.2 (5) A3, Z = 4, Dm = 2.74 (5), Dx = 2.67 g cm 3, graphite-monochromatized Mo Ka radiation, lambda = 0.71069 A, mu = 144.0 cm-1, F(000) = 832.2, T = 298 K, R = 0.0432, wR = 0.0397 for 1974 unique reflections and 118 parameters. The gold atom is in a roughly squareplanar environment, distorted as a result of the small bite distance of the chelating dithiocarbamate ligand. Molecules pack in the crystal lattice such that there are linear...S...Au...S... chains parallel to the a axis. PMID- 3270552 TI - Structure of an antitumour drug: 9-hydroxy-2,5,11-trimethyl-6H-pyridol[4,3-b] carbazolium acetate (9-hydroxy-2-methylellipticinium acetate; Celiptium) dihydrate. AB - C18H17N2O. C2H3O2. 2H3O, Mr = 336.2, monoclinic, C2/c, alpha = 21.789 (2), b = 12.853 (1), c = 14.004 (2) A, beta = 114.80 (1) degree, V = 3560.2 A3, Z = 8, Dm = 1.24, Dx = 1.255 Mg m3, lambda (Cu K alpha) = 1.54178 A, mu = 0.754 mm-1, F(000) = 1584, T = 298 K, R = 0.052 for 2236 observed reflections. Antitumor drug. The crystal structure involves the packing of resonant rings held together by a network of hydrogen bonds involving hydroxyl groups, acetate ions and water molecules. The main feature is the two stacking patterns found together in the crystal structure; this feature appears to differ from other derivatives. PMID- 3270553 TI - Nucleic acid intercalating drug. The structure of 9-hydroxy-2,5,11- tetramethylpyrido[4,3-b]carbazolium (9-hydroxy-2,6- dimethylellipticinium) chloride monohydrate. AB - C19H19N2O.Cl. H2O, Mr = 344.6, triclinic, P1, alpha = 12.980 (1), b = 9.454 (2), c = 7.148 (1) A, alpha = 75.23 (2), beta = 99.73 (3), gamma = 91.83 (2) degree, V = 835.9 A3, Z = 2, Dm = 1.35 (2), Dx = 1.369 Mg m-3, lambda (Cu Ka) = 1.54178 A, mu = 2.11 mm-1, F(000) = 364, T 298 k, R 0.059 for 2767 observed reflections. Antitumour drug that displays one of the highest DNA affinities (4 x 10(6) M 1) among ellipticine derivatives. The structure analysis confirms the intercalation hypothesis. There is stacking of centrosymmetrically related parallel molecules along c, alternately spaced by 3.43 and 3.48 A. The crystal structure confirms the desolvation effect of the sixth nitrogen position. PMID- 3270554 TI - Structure of adenosine-5'-mononicotinate (AMN) trihydrate: an analog of NAD for testing intramolecular stacking. AB - C16H16N6O5.3H2O, Mr = 426.4, monoclinic, P21, a = 9.535 (2), b = 13.932 (2), c = 7.138 (2) A, beta = 93.13 (2) degrees, V = 946.85 A3, Z = 2, Dx = 1.495 g cm-3, lambda (Cu K alpha) = 1.5418 A, mu = 9.93 cm-1, F(000) = 428, T = 294 K, R = 0.045 and wR = 0.059 for 1460 observed reflections [I greater than 3 sigma (I)]. The AMN molecules, unlike NAD or other model structures of NAD, are not charged and exhibit intra- as well as intermolecular stacking of pyridine ring over adenine ring. There is extensive hydrogen bonding in the crystal involving the pyridine and adenine rings and the three water molecules. Rather surprisingly, the ester carbonyl O atom is not involved in the hydrogen bonding. PMID- 3270555 TI - A DNA-intercalating compound derived from 7H-pyridocarbazole: the structure of 10 methoxy-2-methyl-7H-pyrido[4,3-c]carbazolium iodide. AB - C17H15N2O+.I-, Mr = 390.22, monoclinic, P21/c, a = 10.017 (2), b = 8.123 (5), c = 19.074 (4) A, beta = 95.86 (2) degrees, V = 1544 (2) A3, Z = 4, D chi = 1.67 g cm 3, mu = 2.10 cm-1, lambda (Mo K alpha) = 0.7107 A, F(000) = 768, R = 0.04 for 1236 unique reflections measured at 295 K. Dimensions of the ring system are similar to those found in 6H-pyridocarbazole analogues (ellipticine derivatives). The iodine ion and pyridocarbazolium system are linked by a hydrogen bond. The planar 7H-pyridocarbazole cations form stacks approximately parallel to b. Interactions between stacks occur by weak van der Waals forces. PMID- 3270556 TI - [Structure of a psoralen-thymine photoproduct: model for the interaction with DNA on the pyrone ring of psoralen]. AB - Photoadduct 4-ethoxypsoralen-thymine (4a-methyl-11,1-epoxyethanofuro [3'',2'',:6',7']chromeno-[2',3':1,2]cyclobutal[4,3-d]pyrimid in e-2,4, 5-trione), C18-H14N2O6, Mr = 354.1, monoclinic, P21/c, a = 9.021 (3), b = 11.504 (1), c = 16.397 (3) A, beta = 110.45 (1) degrees, V = 1594.4 A 3, Z = 4, Dm = 1.46, D chi = 1.475 Mg m-3, lambda (Mo K alpha) = 0.71069 A, mu = 0.072 mm-1, F(000) = 736, T = 298 K, R = 0.032 for 1442 observed reflections. This original structure of an intramolecular photoproduct obtained photochemically gives structural information about the cycloaddition of the thymine base on the pyrone ring of the psoralen. The crystal structure displays deformations of the planes of the two rings which form a dihedral angle of 40.5 degrees and a cis-anti conformation relative to the cyclobutane bridging component. PMID- 3270557 TI - Effect of cavity varnishes on microleakage of amalgam restorations. PMID- 3270558 TI - Effect of air-powder abrasive spray on glass ionomers. PMID- 3270559 TI - Effect of pH levels in swimming pools on enamel of human teeth. PMID- 3270560 TI - Inhibition of artificial caries lesion formation by APF and neutral NaF office gels. PMID- 3270561 TI - Mouthrinses as adjuncts for plaque and gingivitis management. A status report for the American Journal of Dentistry. PMID- 3270562 TI - Attractive benefits attract employees. PMID- 3270563 TI - Success rate in endodontic therapy--a retrospective study. Part II. AB - An evaluation of the success and failure in endodontic therapy performed by undergraduate students over a seven year period was made. The success rate was found to be 90.6%. Age and sex had no significant determination on the outcome of treatment. Further observations on other factors that might influence the prognosis of endodontic therapy were made and discussed in this paper. PMID- 3270564 TI - Dental office screening for hypertension. AB - Myocardial infarction and cerebrovascular accidents kill more people than all other causes of death combined, and hypertension is the single most important risk factor involved. From studies it is known that about 7% to 10% of adult dental patients will suffer previously unsuspected hypertension and which can be detected as a result of blood pressure screening programmes. Dentists can provide this valuable service in regard to total health care of their patients. Also by having base-line records of blood pressure for their patients and by maintaining competence in blood pressure measurement, a dentist is much better prepared to accurately assess and manage cases of collapse which may occur at any time. PMID- 3270565 TI - Enamel defects in 11-12 year-old subjects in a fluoridated area. AB - Enamel defects were studied in a group of 11-12 year-old children in a fluoridated area using the DDE index. The mouth prevalence of this condition was 72.5 per cent with a tooth prevalence of 40.4 per cent. Enamel opacities accounted for 96.5 per cent of the total condition of which the diffuse patchy type predominates. The defects on the affected posterior teeth occurred most commonly on both the buccal and lingual/palatal surfaces, with most defects being located in the incisal one-half, gingival one-half and occlusal simultaneously. In the affected incisors, the highest proportion of defects affected the buccal surface only, with the most frequent location being the incisal one-half and gingival one-half simultaneously. In 20.9 per cent of the affected subjects, there was a 100 per cent tooth involvement. PMID- 3270566 TI - Secondary oral tuberculous ulcerations. PMID- 3270567 TI - Congenital epulis of the newborn. AB - A typical case of congenital epulis of the newborn is presented. Differential diagnosis from the granular cell tumor is discussed. PMID- 3270568 TI - Success rate in endodontic therapy--a retrospective study. Part I. AB - A survey was undertaken to review the success rate of endodontic treatment carried out by the undergraduates of the Dental Faculty, University of Singapore over a seven year period. A recall system resulted in a total of 385 cases which were successfully recalled and reviewed. The survey comprised of two parts:--A) history-taking from the endodontic record charts and B) clinical and radiographic evaluation of the cases. The cases in the survey had a minimum 2-year recall period. The success rate obtained was 90.6% which compared favourably with other studies. Root canals that were underfilled and root-fillings showing satisfactory apical compression were found to be more successful, the results being statistically significant (P less than 0.05). Endodontic therapy in non-vital teeth and a recall period of at least 2 years were also associated with a higher success rate. This paper discusses the overall success rate of endodontic therapy and the success and failure rate in relation to age and sex. The success rate in relation to other factors such as level of root-filling, apical compression and period of recall will be reported in a separate part of this paper. PMID- 3270569 TI - The gingival marginal discrepancies of posterior composite restorations. AB - The purpose of this study is to assess the gingival marginal discrepancies of various types of composite restoratives using contoured matrix bands. The result of this study demonstrated that despite the great care taken during insertion and adaptation of the various composite restoratives, and inspite of bevelling of all cavosurface enamel margins, gingival deficiencies and/or excesses do still occur. PMID- 3270570 TI - Treatment of discoloured anterior teeth using a simple veneering technique. AB - Discoloration of anterior teeth presents the restorative dentist with a complex aesthetic problem. Various methods are available for the management of discoloured anterior teeth. A simple one visit veneering technique using new improved composite resin materials and opaquing agents is described. Even though the technique provides interim treatment only, it has its advantages and definite clinical applications. The aesthetic result obtained is dramatic as the various shades available allow mixing and characterisation and even patient approval before polymerizing using a light curing system. The development of opaquing agents has allowed even the most severely discoloured anterior teeth to be adequately masked so that the underlying discoloration will not show through the translucent composite resin veneers. PMID- 3270571 TI - Quantitative analysis of areca catechu (betel) nut flavanols (tannins) in relation to oral submucous fibrosis. AB - The processed areca catechu (betel) nuts are popularly chewed in the Indian sub continent. The significance of areca flavanol (tannin) in relation to oral submucous fibrosis and oral carcinogenesis has been reviewed. The quantitative analysis of ten different commercial nut samples from Bombay, India showed wide variations and a higher than average content of flavanols. These variations reflect their appeal and also influence the predisposition of these diseases. The incidence of oral submucous fibrosis and the nut flavanol contents from Bombay and Kerala were taken for comparisons. PMID- 3270572 TI - Morphological evidence of innervation of taste buds of rat fungiform papillae after acute X-ray irradiation. AB - An acute dose of 2000 Roentgens (R) of x-ray was delivered to the head and neck area of Sprague-Dawley rats. Groups of rats were sacrificed at 0, 3, 7, 14, 21 and 30 days after x-ray irradiation. Both general nerve staining and localization of cholinergic nerves by special staining of fungiform papillae were performed. No apparent change in number and distribution of nerve fibres were observed light microscopically within the fungiform papillae containing normal, degenerating and regenerating taste buds. Similarly, cholinesterase activity was present in all control and experimental groups. These preliminary findings do not support the theory that taste bud degeneration is due to x-ray irradiation causing damage to related nerve fibres. A theoretical model of taste bud degeneration after acute x ray irradiation is proposed. PMID- 3270574 TI - [Importance of intermediate panoramic radiography in orthodontic treatment]. AB - The authors justify the importance of the panoramic radiographs taken in the intermediary phases of the orthodontic treatment presenting a clinical case of a late developing supranumerary pre-molar. PMID- 3270575 TI - [The effects of visual and auditory stimulation on arterial pressure and urinary sodium excretion in rats]. AB - Countless sistemic alterations are broken out by stimuli originated by environmental, nutritional and hormonal conditions that are disadvantageous. In order to verify the effects of these stimuli on the arterial pressure and the urinary excretion of sodium, a group of 100 animals were submitted to illumination for 24 hours, auditive stimulation, dehydration and injection of adrenaline. The results show that constant illumination provokes and increase of arterial pressure (p less than 0.01), that is installed in the first 24 hours and its kept until the end of the experiment. The phasic auditive stimulation encourages an increase of arterial pressure (p less than 0.01) and its consistent to every stimulation. The arterial pressure amount in the introduction of prolonged auditive stimulation (p less than 0.01) but decreases in function of the time of the application of the stimulus. The application of illumination followed by injection of adrenaline, and illumination followed by dehydration not changing the response obtained us an isolated luminous stimulus. The urinary sodium excretion, was increased (p less than 0.01). Based on the results we arrived to the following conclusions: 1) The application of constant illumination and auditive stimulation provoke an increase of arterial pressure; 2) The pressuring responses to the phasic and continuous auditive stimulations are different; 3) There is an increase in the urinary sodium excretion. PMID- 3270573 TI - Residual cyst: an incidental finding during alveolectomy. AB - A case of a residual cyst with hyaline bodies from the 26 region discovered fortuitously during alveolectomy is described. The importance of preliminary radiographic evaluation is emphasised. Differential diagnosis from the unicystic ameloblastoma is discussed. PMID- 3270576 TI - [Influence of pre- and post-operative treatment with saline glucose solution on oral surgery wound healing. Histological study in rats]. AB - The liquids are essential nutrients to normal organic function. The corporal growing and development, and the tissue neoformation are affected by the hydrosaline unbalanced. In 100 albinus rats submitted to 24 hours of hydroprivation in the pre and post-operative periods was studied the effect of the saline/glucose treatment on the wound healing. With five groups of 20 animals was shaped: GI - Control, and GII.1 - Saline/glucose pre-operative treatment, and GIII.1 - Saline/glucose post-operative treatment, and GII.2 - water pre-operative treatment, and G-III.2 - water post-operative treatment. In 1, 3, 9, 15 and 21 post-exodontic days the histological analyses of wound healing was did. The results show that the saline/glucose treatment to promove amount in the bone tissue and the osteoblastic activity, with better recuperation of the unbalanced hydrosaline effect. The conclusion is that: 1) the saline/glucose solution aid the tissue neoformation and the wound healing; 2) this effect is consistent in the pre and post-operative periods. PMID- 3270577 TI - Morbidity, injuries and sick absence in fishermen and seafarers--a prospective study. AB - In the period 1986-1988 a prospective study comprising 30 crew members of deep sea factory-trawlers (altogether 2468 fishermen) and 85 of the merchant navy vessels (total 2906 seafarers). At least one chronic ailment or a deviation from the norm was found in 32.5% of fishermen and in 45.4% of seafarers. On the average the seafarers were older than their counterparts fishermen by 2 years and 2 month. Traumas, fractures, wounds and injuries were the most often, the prevailing reason for the sick absence (619 days sick absence per 1000 fishermen and 1075 days sick absence per 1000 seamen annually). The most frequent in fishermen were: acute infections of the respiratory tract, skin diseases, diseases of the oral cavity and teeth, diseases of the articulations. The diseases of a highest prevalence in seafarers were: acute infections of the respiratory tract, diseases of the oral cavity and teeth, skin diseases, gastritis and duodenitis. There were noted 27 serious ailments and 9 accidents requiring repatriations on shore and home in fishermen and 18 such diseases and 21 accidents in seafarers. PMID- 3270578 TI - Problems of medical care on passenger ship (on the basis of the author's own practice). AB - On the basis of his practice the author presents the problems and various conditions of medical care on passenger ship. The subject of the present analysis are the reasons of the morbidity, a special attention is paid to the prevalence of the diseases affecting respiratory tract, skin, and traumas and accidents- being responsible for 70% of morbid cases. A particular stress was put upon the differences of the characteristic of morbidity in the passengers and crew and to all the states requiring intensive treatment or evacuation. There are reviewed the conditions of the medical services rendered on land and on sea in the Caribbean region as well as economical aspects of medical practice on passenger ships. PMID- 3270579 TI - Evaluation of psychical state of the engine room crew members of a long period of service at sea. AB - The work was made to find the traits of personality in the engine room crew members of a long occupational experience, which alleviate or aggravate their process of adaptation to the conditions of work at sea. The goal of investigation was to answer the question whether and if so then to what extent neurotic and psychopathic disturbances are negatively select in the scope of their occupational adaptation. 270 seafarers were subjected to examinations performed by means of the following tests: MMPI, Behaviour Examination Patterns, Social Readjustment Rating Scale, Scale of Psychical Load with work. The research resulted in conclusions: neurotic disturbances do not select negatively members of the engine room crew as to their occupational adaptation. Neurotic disturbances are getting more intense with the age and the employment period. In spite of this the seafarers affected are objectively regarded good workers. Disturbances of behaviour and personality reveal decreasing tendency with the age and the length of service, most probably it is the mechanism of natural selection that should be accounted for. In this group 6.5% of persons show tendency to fall in alcohol dependency. Seamen aged 40-50 years constitute a group that such deviated types are most frequent, therefore they should be given a special medical attendance. PMID- 3270580 TI - Evaluation of the pathological changes progress in people of long-term exposure to asbestos dust during 5-year observation. AB - In order to evaluate the dynamics of the pathological changes in the respiratory system of the workers exposed to asbestos dust in the industrial plants of Gdank Sopot-Gdynia, after the first series of examinations in 1981/82 the tests were repeated in 1986/87 comprising 340 persons i.e. 85.4% of previously examined. Minimal employment period was 10 years. After 5 years the state of health of the subjects got worse. The number of the chronic nonspecific lung diseases and the rate of ventilatory disorders increased. The number of the people with irregular small opacities present in the radiological picture of the lungs also got higher. After the period of 5 years more than a doubled increase of asbestosis was found. These changes were much more often in women. The author suggests that the exposure to asbestos longer than 10 years induces changes in the respiratory system of a progress that in the group observed proved to be distinct and quite rapid. PMID- 3270581 TI - Impact of the working environment upon the state of health of the dockers handling dusty materials (with a special regard to respiratory and circulatory system). AB - The present report addresses the question of whether, and if so then in what extent the dust present at the loading works of bulk cargo affect the respiratory system of dockers. The values of the air dustiness change within a wide range according to the worksite, type of the dust material, dust dispersion degree, loading techniques employed, climatic conditions and others. 766 dockers exposed to dusty materials were examined. A subjective examination was conducted--by means of the questionaire aimed at chronic bronchitis and physical, laryngological, RTG, spirometric, gasometric and ECG examinations. The increase in the incidence of chronic bronchitis correlated with age, period of employment, type of dusty material and smoking habit was observed. The main reason for the high morbidity rate for chronic bronchitis in the workers handling dusty cargo in ports is combined effect of smoking and occupational factors. PMID- 3270582 TI - To the problem of toxoplasmosis in Vietnam. AB - The number of 259 human seria was examined for Toxoplasma gondii antibodies in 1984. Under survey were 140 persons from Duyen Thai village situated in a suburban agricultural area of Hanoi, and 119 persons from the villages of Mai Chau district in a mountainous valley near Laos border. A microreaction of complement fixation had shown higher titres in Mai Chau (24.3%) in comparison with 15.7% in Duyen Thai, using 1:16 and higher titres as significant reaction. Age distribution of antibodies revealed early infection in the childhood, as 50% of children had significant reactions in Mai Chau and 27.6% in Duyen Thai. Lately the level of antibodies was decreasing to a minimum (8%) in Duyen Thai in the age group of 30-49 years. PMID- 3270583 TI - Peculiarities of Mekong schistosomiasis with particular attention to the People's Democratic Republic of Laos. AB - The authors examined 10 children with clinical symptoms suggestive of intestinal or hepatolienal schistosomiasis. All the children were from the endemic focus in Laos. We found eggs of schistosomes that were smaller and rounder (60.95 X 51.55 microns) than those from a southern Chinese strain of S. japonicum (62.64 X 73.49 microns). There were no Oncomelania species found among the snails in this endemic area. These observations confirm those reports in the literature that assert a new species for S. mekongi based upon epidemiological, biological and morphological characteristics. PMID- 3270584 TI - Preliminary reports on hyperbaric oxygen therapy in multiple sclerosis. AB - Preliminary clinical examinations comprised 16 patients suffering from multiple sclerosis, the mean duration of the disease 9.33 years, of the manifestations at different stages of the development--evaluated on the basis of Kurtzke scale. The patients were subjected exclusively to the treatment with oxygen hyperbary--all in all 25-30 exposures, with the intervals of 24 hours, under the O2 pressure of 2 ata. The qualification for the purposes of treatment and the classification of the symptoms present were carried out according to Fisher, the results obtained were evaluated in conformity with standard version of the Disability Status Scale of Kurtzke. Apart from the routine clinical and laboratory tests the programme of the examinations included also a quantitative determination of immunoglobulins level, complement activity as well as the determination of T and B lymphocytes. An eminent change for the better was found in 14 afflicted persons, in one patient after 15 exposures a worsening was observed and the treatment was arrested. As to the immunological parameters investigated, a general decrease of IgG, IgM, IgA in serum, increase of the complement fraction and its 50% hemolysis determined activity were observed, whereas quantitatively investigated T and B lymphocytes did not show any typical changes. The authors discuss the results. PMID- 3270585 TI - Investigations into the effect on rats of volatile organic compounds released from the set of building and finishing materials. AB - White, male Wistar rats were exposed continuously in chamber during 3 months on volatile organic compounds emitted from set of building and finishing materials used in living areas on ship. The air contamination was checked. The following tests for determination of combined toxic effects were performed: functional activity, the body and organ weights, basic hematological determinations, serum enzyme activity (GOT, GPT, AP, LAP, LDH), serum concentrations of protein, urea, creatinine, bilirubin, lipids, cholesterol, triglycerides, and in the liver mitochondria Mg+2(-)-ATPase, concentration of cholesterol, phospholipids, and liver function after loading with benzoate. After 3 months of the exposure we observed changes in AP and LDH activities, and decrease of the concentration of serum triglycerides. PMID- 3270586 TI - Ergonomic analysis of the working post of gutter in the fish processing plant and the dependency between subjective evaluation of the work fatigue and the body posture assumed while working. AB - The main goal of the present paper was an ergonomic analysis of the working post of the gutters employed in the Fish Processing Plant in Gdansk and to find the relation between the ailments manifest in the musculo-skeletal system, the degree of the weariness with the work and the body posture assumed during the operations after the first and the sixth hour of the work. The material investigated comprised 20 gutters aged 30-49 years, their employment period on given working post ranging from 11 to 16 years. On the basis of the observation and time analysis of each operation an ergonomic analysis of their working posts was accomplished. Apart from this the subjects were submitted to a questionaire concerning subjective evaluation of the factors affecting fatigue as well as the degree of several body parts load. Shutter method was employed in the cinematographic analysis of the simple flat images. When the contours of a woman were drawn in schemes the following angles could be plotted: angles of the forward inclination of the trunk and the head, angle of the left hand. The pictures were taken in two series: after the first and the sixth hour of the work. On the basis of these investigations no statistically significant differences in the angle of the forward inclination of the trunk and the head after the first and the sixth hour of work were revealed. It indicate the other reasons than a body posture as decisive in the origin of the fatigue with work.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3270587 TI - Some remarks concerning methodological problems of medicine. AB - The present paper deals with methodological problems in medicine as science- against other practical sciences especially pedagogics. The authors try to define the specificity of medicine, which relies on dissimilarity of the methodological directives directing the research practice of medicine. In the authors' belief this type of reflection is an essential, complementary element in the individual's knowledge of medicine making the medical research practice a more rational process. PMID- 3270589 TI - Infection control: it can't hurt and it always helps. PMID- 3270588 TI - Cultural factors and symptoms of schizophrenia, a comparative study in Malta and Poland. AB - The examinations comprised 120 cases of schizophrenia in Poland and 80 cases on Malta. Clinical analysis showed differences in symptomatology of the disease, delusions and hallucinations content, in methods of the treatment applied and in the prognosis--as a result of pathoplastic effect of cultural-racial and sociodemographic factors. In comparison with Polish patients Maltese schizophrenics showed a less diversified psychotic symptomatology. PMID- 3270590 TI - [Factors influencing fluorine absorption and excretion in people and animals]. AB - Factors that make fluorine absorption and excretion easy or difficult from organisms of people and animals have been analysed. Fluorine is easily absorbed in presence of alimentary fat from soluble dust, from water environment, especially from an acid one. Compounds of calcium, magnesium, aluminium, microelements and various high protein diet make fluorine absorption difficult. Compounds that easily absorb fluorine, namely compounds of calcium, magnesium, aluminium, boron, phosphorus and vitamin C as well as climatic conditions (increasing perspiration) make fluorine excretion from organisms easy. Fluorine excretion is made difficult in the period of intensified mineralization and lactation processes. The age of the person is also important. PMID- 3270591 TI - [Sterinole and cetylpirydine chloride influence on non-sporulated anaerobic bacteria of oral cavity]. AB - Sensibility (MBC--Minimal Bactericidal Concentration) of 97 strains of non sporulated anaerobic bacteria separated from clinical material from oral cavity to Sterinole (Polfa) and cetylpirydine chloride has been examined. Experiments have been carried out by means of suspension method adapted appropriately to the tests on non-sporulated anaerobes. 72 hours' cultures of strains containing 10(9) of live bacterial cells in 1 ml have been used as inoculum. MBC readings have been performed after 7 days' incubation at temperature of (37 degrees C) 310 degrees K. From the total number of 97 strains under examinations 34 strains were sensible to low concentration of Sterinole equal to 7.8 to 15.5 micrograms/ml. Further 19 strains exacted MBC within 15.6 to 31.1 micrograms/ml and further 40 strains perished in the antiseptic concentration of 31.2 to 62.4 micrograms/ml. The remaining 4 strains exacted concentration of 62.5 to 125 micrograms/ml to be perished. Among 97 strains 29 strains were perishing in low concentrations of cetylpirydine chloride equal to 7.8 to 15.5 micrograms/ml. Successive 25 strains were damaging by the antiseptic concentration equal to 15.6 to 31.1 micrograms/ml. Further 28 strains exacted utilization of concentration equal to 31.2 to 62.4 micrograms/ml while in case of the remaining 15 strains MBC values achieved the level of 62.5 to 125 micrograms/ml. Strains from Leptotrichia buccalis and then Gram--positive anaerobic bacteria were the most sensitive ones both to Sterinole and cetylpirydine chloride while Gram--negative anaerobic bacteria and anaerobic micrococcus were less sensitive. PMID- 3270592 TI - [Mycotic infection in various diseases of oral cavity and cytologic examinations' usefulness for early detection of them]. AB - Basing on observations of a group of patients treated in Oral Mucosa Diseases and Industrial Dentistry Department analysis of some cases with clinical symptoms of oral cavity mycosis, without any clinical symptoms but with subjective complaints pointing out the possibility of mycotic infection existence and with other diseases of oral mucosa from the point of view of additional mycotic infections has been performed. Clinical examinations, cytological and microbiological examinations have been carried out. Cytological examination has been proved useful for quick determination of oral cavity mycotic infections that has been confirmed by microbiological examinations. Early detection of the infection was precipitating the treatment procedure and improving the disease prognosis. PMID- 3270593 TI - [Attempt of conservative treatment efficiency evaluation of inhabitants of Wroclaw]. AB - 2979 inhabitants of Wroclaw aged from 18-80 years, in this 1581 women and 1398 men, have been examined stomatologically. Clinical material has been collected and analysed, average values of D, M, F in women and men in 5 age groups have been calculated. Indicators D/DMF, M/DMF and M/DMF as well as percentage of people under examination with toothlessness and frequency they take advantage of stomatological care have been calculated. The results point out higher D/DMF medicinal demand in men than in women. Along with the age of persons under examination percentage of extracted teeth in the DMF, M/DMF values increases and the proportion of effective healing to the demand F/DMF decreases. Over 80% of persons under examination take occasionally advantage of stomatological care without pain symptoms. PMID- 3270594 TI - [Radiological estimation of interradicular space of primary molar teeth]. AB - Radiological estimation of interradicular space of primary molar teeth has been performed. Radiograms taken from the department's archives on which primary molar teeth without dental caries were visible have been used for the purposes of the examinations. Roentgenograms had been made for exposition conditions required for endodontic therapy needs. Periodontium, lamina dura of the alveolus, bone texture of the interradicular space and disposition of permanent tooth buds have been estimated according to the radiograms. From the examination results it followed that proper estimation of interradicular space of primary molar teeth according to radiograms made for endodontic therapy needs is not possible. Radiological image of interradicular space of primary molar teeth in various both with reference to bone structure and disposition of permanent tooth buds. In most cases the interradicular space of primary molar teeth demonstrates thin bone structure on radiograms that should be considered to be physiological state when the continuity of lamina dura of the alveolus is preserved. PMID- 3270595 TI - [Clinical training of students of stomatology and its estimation in the light of the patients' opinions]. AB - Estimation of the students' work from the IVth and Vth year of stomatology has been performed basing on the inquiry opinions of the patients. The opinions concerned in the first place the period of time they should wait for treatment and their frame of mind before the stomatological operation. Most of the patients applied regularly to the students to treat their teeth. High percentage of the people waiting for the visit were good-tempered or a little upset persons. The predominant majority of the patients were very satisfied with the help given to them by the students of stomatology. PMID- 3270596 TI - [Estimation of distant results of the repeated endodontic treatment of teeth]. AB - An attempt of treatment of 78 teeth with root canals filled incorrectly has been undertaken. The treatment has been correctly brought to completion in case of 67 teeth (84%). After 3 to 36 months no clinical pathological symptoms was found during follow-up examinations and total bone reconstruction was found by radiological examinations in 53.7% of cases. In the other cases pathological changes were decreasing. Root apex resorption took place in one case. PMID- 3270597 TI - [Vascularization of skin-muscle flap from greater pectoral muscle]. AB - The results of studies on vascularization of skin-muscle flap from greater pectoral muscle have been presented. Flaps taken from human dead bodies were injected by Micropaguae preparation and then the range of vascularization of greater pectoral muscle by thoracoacromial artery and its branches was estimated on roentgenograms. It has been found that t.p.b. pectoral branch is characterized by small variation of the run that enables safety utilization of the flap in clinical practice. PMID- 3270598 TI - [Anthropometric examinations of the sick with congenital inborn facial-maxillary occlusal defects]. AB - The authors describe rules, usefulness and advantages from carrying out anthropometric examinations in the sick with facial-maxillary-occlusal defects in the paper. They present a card especially elaborated for these examinations and used in case of each sick. PMID- 3270599 TI - [Treatment of open bite connected with tongue overgrowth by means of surgical orthodontic method]. AB - A case of 17 years old female patient with the open bite connected with dimension enlargement and changed function of the tongue has been described. After the operation of the tongue by means of Reinwald method an active upper base with barrier and rubber traction between paracentral upper and lower incisors have been applied. The open bite was eliminated within one year the speech and appearance of the patient improved at the same time. PMID- 3270600 TI - [Staphylococcuses and their drug-resistance in inflammations of submandibular lymph nodes in children]. AB - Analysis of bacteriological examination results in 46 children with submandibular lymph nodes inflammation has been presented in the paper. The examinations have been carried out from the point of view of observation of bacterial flora variation and its drug--resistance. The analysis of examination results has revealed existence of strains such as: S. aureus, S. albus, S. epidermidis. The attention has been called to the necessity of bacterial flora examinations considering substantial changes in the frequency of particular strains occurrence and their drug resistance. PMID- 3270601 TI - [The influence of long-term utilization of some herbicides on oral cavity tissues of white rats]. AB - Three mixtures of herbicides have been administered to white rats of Wistar strain by means of stomach tube. After 9 months of studies laboratory examinations were carried out in these animals namely analysis of urine, peripheral blood, bone marrow smears and segments of parotid glands and cheek's mucous membrane were uptaken to histopathological examinations. Morphological changes whose intensification didn't depend on the dose and type of preparation have been found in the glands. These changes were of non-specific character- similar changes were also present in the glands in rats in the course of poisoning by other toxic agents. Vacuolar changes whose intensification was increasing with the exposure time have been observed in the cells of mucous membrane epithelium. PMID- 3270602 TI - [Potassium content analysis in healthy teeth in people of various ages]. AB - Potassium level in permanent teeth has been designated by X-ray fluorescence and some relationships of the content of this element between individual groups of teeth according to the age and sex have been proved. Average K level in molar teeth of men and women was 272.1 +/- 50 (M-SE) ppm, in premolar teeth--297.6 +/- 7.1 ppm, in cuspid teeth--287.0 +/- 7.5 ppm and in incisive teeth--324.7 +/- 12.3 ppm. Irrespective of the age potassium level in permanent teeth in men and women doesn't essentially differ. In the remaining groups of teeth but molar teeth potassium level essentially increases with the age. The greatest growth of potassium with the age has been observed in incisive teeth. PMID- 3270603 TI - [Biocybernetic approach to the thermometric methods of blood supply measurements of periodontal tissues]. AB - Specific biocybernetic approach to the problem of the blood supply determination of paradontium tissues by means of thermometric methods has been presented in the paper. The compartment models of the measuring procedure have been given. Dilutodynamic methology and classification has been applied. Such an approach enables to select appropriate biophysical parameters describing the state of blood supply of paradontium tissues and optimal design of transducers and measuring methods. PMID- 3270604 TI - [Proper magnitude of the mouth slit and lower lip in men of the age of 51-70 years]. AB - The magnitude of the mouth slit and lower lip in men of the age of 51-70 years has been determined in to order to assign the ground for the estimation of the result of lower lip reconstruction. PMID- 3270605 TI - [Electromyographic estimation of functional state of the mouth slit's muscles after the lip reconstruction by means of various methods]. AB - The authors present the results of functional state examination of the orbicular muscle of the mouth in 28 patients operated by means of Abbe's and Karapandzicz's method because of vermilion border's carcinoma. It has been found that no features of neurogenic damage of the muscle were present in the group of patients operated by means of Karapandzicz's method and the return to its proper function was more frequent. It points out that Karapandzicz's method is less invasive in comparison with Abbe's method. PMID- 3270606 TI - [Participation of temporomandibular joints in rheumatoid disease in persons of developmental age]. AB - From the midst of 97 patients of developmental age with verified rheumatoid disease treated in the health resort in Cieplice-Zdroj in 21 patients, i.e. 21.6% of the total number of the patients under examinations joints coming within this process have been found. The authors explain causes of some symptoms in the aspect of musculo-articular system of masticatory organ existing in these persons. They also verify criteria accepted for estimation of the damage degree of the stomatognathic system. PMID- 3270607 TI - [Specific modification of Weber's splint]. AB - The author has presented his own modification of Weber's splint. He has described its construction, he has given indications and contraindications for its utilization and he has emphasized its advantages and shortcomings. PMID- 3270608 TI - [Analysis of odontogenic perimaxillary inflammation processes]. AB - Basing on retrospective analysis of 542 case histories the causes producing purulent perimaxillary inflammation processes most frequently have been presented taking causal teeth, their treatment method and the state of periapical tissues into consideration. From the analysis of the material it follows that never treated teeth with gangrenous pulp (46.3%) are the most frequent cause of perimaxillary abscess while the teeth treated endodontically were the cause of these pathologic states in 24.3% of the cases. The specific observations prove the results obtained by other authors, namely that the teeth treated endodontically without periapical inflammatory changes are rarely the cause of perimaxillary purulent processes. PMID- 3270609 TI - [Clinical estimation of usefulness of cervin preparation in treatment of necks of teeth hypersensitivity]. AB - Basing on clinical experiments the efficiency of Cervin preparation in treatment of necks of teeth hypersensitivity has been estimated. The experiments have been carried out in 52 patients for 171 teeth with denuded and hypersensitive tooth necks. Basing on the results obtained it has been found that the preparation gave satisfactory results in the form of regression or decrease of ailments and it can be used for neutralization of tooth necks in course of parodontopathy. PMID- 3270610 TI - [Rare case of supernumerary teeth]. AB - A case of supernumerary teeth existence in maxilla and mandible in 21-years' old female patient has been described. The possibility of utilization one of them situated in the dental arch as an abutement for prosthetic crown has been considered. PMID- 3270611 TI - [Teeth squeezing into pterygomandibular space in course of their extraction]. AB - The authors demonstrating two cases of pushing through lower wisdom teeth into pterygomandibular space in course of their extraction state that this complication of teeth extraction is the fault in medical art. They describe symptoms of inflammatory complications and surgical management that has been applied in these cases. PMID- 3270612 TI - [Cranioscopy and injuries of orbital cavities]. AB - Craniometric methods for measurement of orbital cavity as a three-dimensional form have been discussed. The authors notice their deficiency and lack of possibility of their practical utilization. It has been stated that works at a new measurement technique whose results would apply in the teaching hospital should be undertaken in the presence of repeatedly existed injuries of the middle and upper storey of facial skeleton. PMID- 3270613 TI - [Mandible magnitude in Crouzon syndrome]. AB - The authors describe Crouzon syndrome in 5 patients aged 9, 10, 13, 40 and 43 years. Typical image of Crouzon syndrome has been found in the woman and three children and its abortive form--in the man. The authors present their own studies on branch height, length of the body of the mandible and the angle value of the mandible according to the Costaras-Volarich and Pruzancky method in their paper. The ratio of the branch to the body is 1:1 in all patients under examination and it is not equal to the normal ratio of 2:3. The angle of the mandible is also greater than the normal value. The authors put forward a hypothesis that pseudomesioclusion in the sick with Crouzon syndrome can be conditioned not only by maxilla dysplasia but also by excessive height of the branch and increased angle value of the mandible basing on their own observations. This hypothesis, however, exact further radiocephalometric studies and close cooperation of obstetricians, paediatricians and orthodontists. PMID- 3270614 TI - [Examination of CPITN indicator usefulness in specialist periodontal care]. AB - Usefulness of CPITN indicator in specialistic parodontological care in 70 patients aged between 15-59 years has been estimated. One specialist was denoting the CPITN indicator on a special card and sending these patients to 1 out of 4 parodontologists in order to determine therapeutic management in a traditional way without knowing the value of CPITN. Comparing therapeutic needs based on CPITN value and on specialistic clinical examination it has been found that in 55.7% there existed a difference in parodontological needs and in 24.3% cases CPITN indicator determined therapeutic needs more precisely. It has resulted from utilization of diagnostic tool--WHO 621 tube. In 37.1% of the cases there existed inconsistency in determining therapeutic needs by both methods. It has resulted from the differences of both programs' assumptions. Although the CPITN system is intended for determination of parodontological needs of a certain community it can also be applied in specialistic parodontological care. PMID- 3270615 TI - [Indicator of periodontal therapeutic needs (CPITN) in adults aged between 35-44 years in Szczecin province]. AB - The authors have studied parodontological therapeutic needs utilizing the indicator of needs (CPITN) in 122 adults (35-44 years old) living in a small city of Lobez and adjacent villages in Szczecin province. From the results obtained it follows that the greatest percentage of parodontological therapeutic needs referred to the third category of these needs (82.8%). The average number of sextances with dental deposits falling to 1 person was 2.3 and with gingival pockets of 6 mm or deeper--2.1. No person with healthy parodontium has been found. Significantly greater parodontological therapeutic needs have been found in men than in women. PMID- 3270616 TI - [Indicator of periodontal therapeutic needs (CPITN) in adults aged between 35-44 years from three population groups in Cracow province]. AB - Parodontological therapeutic needs in 180 persons aged between 35-44 years among inhabitants of Cracow, Wieliczka and villages of Cracow province have been determined. Among women and men under examination the following needs have predominated: the necessity of dental deposits removal and curretage of pathological gingival pockets (75.56--77.78%). In 39 persons (21.68%) there was a need of complex treatment. PMID- 3270617 TI - Incidence of carious lesions around Class V composite resin restorations. PMID- 3270618 TI - Morphologic characteristics of lower third molar as related to successful endodontic therapy. PMID- 3270620 TI - Anatomic measurements of teeth in two different racial groups from the Middle East. PMID- 3270619 TI - The apical seal by McSpadden obturation technique with and without sealer versus lateral and vertical condensation techniques. PMID- 3270621 TI - Reconstruction of the Auriculum. PMID- 3270622 TI - Classification of congenital deformities of the auricle. PMID- 3270623 TI - External ear reconstruction. PMID- 3270624 TI - Reconstructive surgery of the auricle. PMID- 3270626 TI - Useful tricks in ear reconstruction. PMID- 3270625 TI - Reconstruction of the auricle: an animal experimental and clinical study. PMID- 3270627 TI - Earlobe reconstruction using island flap with postauricular blood vessels. PMID- 3270628 TI - Reconstruction of the auricle with preserved homologous rib cartilage. PMID- 3270629 TI - Special problems and variations in otoplasty techniques. PMID- 3270630 TI - Porecon implant and fan flap: a concept for reconstruction of the auricle. PMID- 3270631 TI - Surface preparation. PMID- 3270632 TI - Indications and contraindications for different types of implant therapy. PMID- 3270633 TI - Tooth replacement by oral endoprostheses: clinical aspects. PMID- 3270635 TI - Surgical considerations in implant dentistry. PMID- 3270634 TI - Implants for partial edentulism. PMID- 3270636 TI - Current implant usage. PMID- 3270637 TI - Implants for edentulous patients. PMID- 3270638 TI - Don't alter existing dental treatment prior to peer review. PMID- 3270639 TI - Tools--finishing Crozat cases. PMID- 3270640 TI - Case report. Angle class III malocclusion. PMID- 3270641 TI - Case report. Angle class I malocclusion and missing incisor. PMID- 3270642 TI - Surgical elevation of impacted mandibular second molars. PMID- 3270643 TI - [Gigantic giant cell fibroma in Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University]. AB - An unusual case of gigantic giant cell fibroma was reported and included in the series of 3 cases seen at Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, during the past 14 and a half years since this particular lesion was first described in 1974. These 3 cases, representing 0.5% of all fibrous lesions, were presented and discussed according to their distribution, location, sex, incidence, clinical and histologic appearance in reference to the literature. This article also discussed the importance of biopsy and recommended that it should be routinely done to obtain a definite diagnosis of the lesion. PMID- 3270644 TI - [Antibacterial effects of CMCP, Cresophene, and formocresol as root canal medications]. AB - This clinical and laboratory study was to compare the antimicrobial effects of camphorated monoparachlorophenol, Cresophene and formocresol. Root canals of anterior teeth with 3-5 mm. rarefied area were instrumented and irrigated until they were ready to be filled. The patients returned every 7 days. Intracanal medicaments were changed until negative culture was obtained. The number of visits was recorded. The comparative effectiveness of the three medicaments were analysed. Results showed no statistical differences of the three medicaments (p greater than 0.1). The antimicrobial activity against bacteria from positive root canal culture of these three antiseptics were assayed by disc diffusion method. The inhibition zone of camphorated mono-parachlorophenol and Cresophene were nearly the same size, but that of formocresol had greater diameter. Using Gram's staining procedure, the majority of bacteria obtained from root canals was identified as gram positive cocci (94.74%). PMID- 3270645 TI - [Incidence of impacted wisdom teeth and complication in Thai community]. AB - A prospective study of mandibular third molar wisdom teeth including the type, age groups, presurgical and post surgical problem of the 175 Thai patients (184 teeth) was analysed. The patients were male 54.86% female 45.17%. The youngest patient was 16 years old and the oldest patient was 56 years old. The age group 16-24 years was found largest (48.57%). The mesioangular impaction was found 62.5%, vertical impaction 18.47, horizontal impaction 17.39% disto-angular impaction 1.09%, buccolingual impaction 0.54% respectively. The presurgical symptoms were pain, headache, joint pain, mastoid pain, infection, food impaction and orthodontic need. The postsurgical complication rate overall 6.86% that include dry socket 2.86%, bleeding 2.29% and infection 1.14%, dysesthesia 0.57%. PMID- 3270646 TI - [Mercury levels in urine and head hair of dental personnel]. AB - As dentists and their assistants are usually exposed to mercury in their clinical practices. The objective was to investigate the mercury level in these dental personnel. Urine and head hair samples were collected from 201 dental personnel and 57 unexposed controls for mercury analysis. The mercury content was analyzed by using cold vapour atomic absorption spectrophotometry. The results showed that mercury levels in the urine and head hair of dental personnel were significantly higher than in the controls (P less than 0.01). The urine mercury concentration of the unexposed controls ranged from 0.1-10.0 micrograms/l (means = 2.6 +/- 0.29 micrograms/l). The highest urine mercury level was found in the group of dental assistant (means = 17.1 +/- 2.44 micrograms/l). The mean urine mercury levels found in dentists, dental students and dental technicians were 10.1 +/- 1.42, 11.1 +/- 1.69 and 3.2 +/- 0.69 micrograms/l respectively. The amounts of urine mercury from dental assistants, dentists and dental students were 81.0%, 38.2% and 43.5% higher than the threshold limit value respectively. The mean head hair mercury concentration of unexposed controls ranged from 0.3-12.2 micrograms/g (means = 2.8 +/- 0.36 micrograms/g). The highest head hair mercury concentration was found in the group of dental assistant and 6th year dental students (means = 10.1 +/- 0.84 and 10.5 +/- 3.2 micrograms/g). The mean head hair mercury levels found in dental assistants, dentists, dental students and dental technicians were 10.1 +/- 0.84, 7.5 +/- 1.2, 6.5 +/- 1.54 and 2.8 +/- 0.53 micrograms/g respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3270647 TI - [Viral hepatitis B infection. Transmission and prevention for dentists]. AB - Hepatitis B infection is the most important infectious occupational hazard in the dental profession. Hepatitis B virus (HBV) is its etiology and can be transmitted by blood. Dentists were in a high risk of contracting this disease due to the procedures and instruments of dental treatment 1% of dentists were found to be carriers of HBs Ag whereas 13.6% demonstrated the presence of anti-HBs. In intraorally, the greatest concentration of hepatitis B infection was at the gingival sulcus. The role of saliva in transmission was not documented. Vaccination and practical infection control in the operatory could prevent transmission of infection from the patients to dentists or to the other patients. PMID- 3270648 TI - [Craniofacial norm for Thai in combined orthodontic surgical procedure]. AB - Combined Orthodontic and Surgical procedures are widely used in correcting Dentofacial deformities. Lateral cephalogram are a must in diagnosis procedure to fascilitate in localizing the problems leading to in accurate treatment planning. Recent studies show that there are different facial morphology among people around the world. This study was conducted to study 100 of Thai facial profiles to use an aid in diagnosis and treatment planning in Orthognathic surgery patients. Results of this study showed that not only facial morphology of thai people are differ from those of Caucasians but also thai females and males are differ in facial forms. PMID- 3270649 TI - [Dentinal dysplasia type I]. AB - Dentinal dysplasia is one of the rarest hereditary disturbances of dentin formation characterized by the teeth present with short blunt roots, considerably reduced or obliterated pulp spaces, periapical abscess or cysts without an obvious causative factor, and spontaneous exfoliated. These features were observed on a patient referred for prosthodontic assessment, and an investigation of other members of the family revealed that the father and two siblings were also affected. The report described the clinical, radiographic, histologic and scanning electron microscopic features and discussed the features which separated from dentinogenesis imperfecta. PMID- 3270650 TI - [Successful endodontic treatment of dens in dente]. AB - The dens in dente is a developmental variation which is thought to arise as a result of an invagination in the surface of a tooth crown before calcification has occurred. This report is a case which documents the successful non surgical endodontic treatment permanent tooth with dens in dente by periodical dressing the intracanal space with calcium hydroxide for a year and follow up after permanent filling-for one and a half years. After a sign of repair around the periapical area had occurred, the canal was filled with warm gutta percha technique. The importance of early and corrected diagnosis, the possible significance of even a small and noncarious dens in dente, and the treatment of anomaly were emphasized. PMID- 3270651 TI - Oro-facial manifestations of HIV infections. AB - Oral manifestations in HIV infected individuals are common and may occur as mycotic, bacterial or viral infections neoplasms or manifestations of unknown etiology. Some of the oral manifestations may be of importance in early diagnosis of HIV infection. In particular, oral candidiasis occurring as pseudomembranous, erythematous and hyperplastic types should be considered. Oral hairy leukoplakia, pathognomonic for an HIV infection, has been considered to represent a probable diagnostic marker for the development of AIDS. HIV gingivitis and periodontitis are of particular significance. Early and correct diagnosis of HIV-associated manifestations are of importance to the patient as well as to the dentist who should take adequate protection measures. PMID- 3270652 TI - [Glycosaminoglycans of gingival epithelium and connective tissue during experimental periodontitis in dogs]. AB - The purpose of this study was to investigate the changes in concentration of glycosaminoglycans (CAGs) and to investigate the incorporation of 3H-glucosamine into GAGs in vitro in the epithelium and sub-epithelium connective tissue separated from the gingiva during a period of experimental periodontitis. Periodontitis was induced by placement of a silk ligature below the gingival margin in dog molars. The GAGs extracted from gingival samples obtained 0, 7, 21, 60 and 90 days before and after the ligature placement were separated by cellulose acetate membrane electrophoresis for both qualitative and quantitative analysis. Hyaluronic acid content of the epithelium was decreased significantly at the acute phase of inflammation. In the connective tissue, the amounts of dermatan sulfate and hyaluronic acid were higher, but chondroitin sulfate and heparan sulfate levels lower than in the control. The incorporation of 3H glucosamine into GAGs in the epithelium was greater than that in connective tissue at the acute phase. The greatest incorporation of 3H-glucosamine was found in chondroitin sulfate at the acute phase, and did not return to the basal level at the chronic phase. These findings suggest that the biochemical response of GAGs in the epithelium to inflammation might be different from that in connective tissue. PMID- 3270653 TI - The reaction of peri-implant tissues to titanium alloy and apatite-coated implants during the healing phase. AB - Oral implantation has been a controversial dental therapeutic procedure. Many implant materials and designs are presently in progress of study to evaluate the long term response of peri-implant tissues, together with anticipated loading considerations. The purpose of this examination was to make clear whether a fibrous layer would form between bone and Titanium alloy and apatite-coated Titanium implants under stressed and unstressed conditions, during the healing phase after implantation. The in vivo evaluation of 10 implants were made on two dogs. The upper 2nd and 3rd and lower 3rd and 4th premolar teeth were extracted and the sockets allowed to heal for 3 months. The implants in the unstressed condition were completely submerged, and in the stressed condition they were left with their top 2 mm above the surface of the bone, so that after suturing the top of the implant was exposed to the oral environment. After the postoperative healing phase of 3 months, the animals were killed and the specimens were prepared for histological, SEM examinations and EDX analysis of the interface zone between bone and the implants. Histological examination showed a direct contact between the apatite-coated implant and new bone, so that the implant became anchored to bone without an intervening soft tissue layer and a similar result was obtained between the Titanium implant and bone in the unstressed condition. However the high magnification electron micrographs showed a thin connective tissue between the bead-blasted surface of the Titanium implant and bone, and this peri-implant tissue could be detached from the implant. In the stressed condition, a thin layer of fibrous tissue was interposed between the Titanium implant and bone. The high magnification electromicroscopical views of the interface zone between the bone and these implants showed coarse fiber bundles developed perpendicular to the Titanium surface and their terminal ends were confluent with the rugged Titanium surface presumably as a result of micro movement during the 3 months healing phase. In this study, an adequate space for a development of fibro-anchorage was about 20-200 microns in width. If occlusal stresses were within permissible range in healing period, the relative motion of the implant and bone was then optimal for the formation of a fibro-anchorage. It could be suggested that an ideal stress transfer from the Titanium implant to bone might be achieved by this fibro-anchorage. PMID- 3270654 TI - [Effects of sex hormones on human PMN migration]. AB - It is believed that gingivitis at puberty is exaggerated by alterations of the hormonal balance. We have suggested that estradiol promotes the gingivitis at puberty while progesterone reduces it (J. Hiroshima Univ. Dent. Soc. 19: 1987). But the mechanisms of these hormones which influence gingival inflammation are not known yet. Therefore, we hypothesized that one of the possible mechanisms of sex hormones on gingival inflammation is through their action on polymorphonuclear leucocytes (PMNs) function because PMNs play an important role in periodontal disease. The purpose of this study was to investigate the effect of sex hormones on PMNs function, especially their migration in vitro. PMNs and plasma were obtained from heparinized peripheral blood of 23 healthy adults. PMNs were preincubated at 37 degrees C for 15 minutes with progesterone or 17 beta estradiol at designated concentrations. After preincubation, PMNs migration was measured using 48-well chemotaxis micro-chamber with N-formyl-methionyl-leucyl phenylalanine (FMLP) as chemoattractant. The levels of estradiol and progesterone in the plasma were determined using Direct Radioimmunoassay Kits and the correlation between sex hormone levels and PMNs migration was investigated. PMNs migration to 10(-6) M FMLP was enhanced significantly by progesterone at the concentrations of 200 ng/ml while it was reduced by estradiol at 0.4 ng/ml and 2.0 ng/ml. Random migration of PMNs was enhanced significantly by progesterone at 20 ng/ml while it was reduced by estradiol at 0.4 ng/ml. Significant positive correlation was found between progesterone level in plasma and the PMNs migration in vitro. Estradiol level in plasma did not have any correlation with the PMNs migration in vitro.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3270655 TI - [Marginal periodontitis and the immune system. III. Differences in peripheral blood lymphocyte subsets before and after treatment in adult periodontitis patients]. AB - The lymphocyte subsets in the peripheral blood of 8 individuals, aged 25 to 57 yr, with moderate to advanced adult periodontitis were analyzed before and after treatment by means of flow cytometry, and then compared with the findings in 20 normal adults (aged 30 to 45 yr). The results were as follows: the percentage of OKT-8+ (CD 8) in the patients (20.25 +/- 7.15%) was lower than that in normal individuals (31.50 +/- 6.03%, P less than 0.01) while the OKT-4/OKT-8 ratio (2.34 +/- 1.18) was higher than the corresponding ratio in the controls (1.23 +/- 0.37); however, there was no significant difference in the percentages of OKT-3+ (CD 3), OKT-4+ (CD 4) and Leu-12+ (CD 19) between patients and normal subjects. The percentages of OKT-3+, OKT-4+, OKT-8+, Leu-12+ and OKT-4/OKT-8 after the periodontal therapy did not show a significant difference compared with the data obtained before treatment. These results indicate that the decrease in suppressor/cytotoxic T-cell population may be a kind of pathological disposition of the initiation and/or course of adult periodontitis. PMID- 3270656 TI - [Biochemical characterization of phenytoin-induced hyperplastic human gingival fibroblasts. Non-collagenous proteins biosynthesis]. AB - Phenytoin (PHT), administered as an anticonvulsant, has a side effect gingiva overgrowth in approximately 50% of patients. The present study was attempted to explore the biochemical mechanism on non-collagenous protein biosynthesis as affected by PHT. Responder cells (RES A3, RES C2) of a patient with gingival overgrowth were obtained by the method of Kawase et al. Normal human gingival fibroblasts (Gin-1), purchased from ATCC, were also used. All cells were inoculated at 1 x 10(4) cells/cm2 (12 multi-well plate or 60 mm tissue culture dish), and then cultured for 4, 8 and 12 days with or without PHT (5 micrograms/ml). Prior to harvesting at the indicated times, cells were incubated with 14C-amino acids (1.25 microCi/ml) for 24 hours. The 14C-labeled proteins were isolated from the cell layers including extracellular matrix, following Kurkinen et al. with a minor change. Each 14C-labeled fraction was dissolved in 3 ml of Aquasol-2 and the radioactivity by a liquid scintillation counter. The DNA content of cell layers affected by PHT was increased on Gin-1, RES A3 and RES C2 at the post-confluence, resulting also in an increase in cell number. Two morphologically different phenotypes of responder cells were observed, differing in nuclear and cell sizes. At 12 days culture, RES A3, were stimulated by PHT, showed increased synthesis of both total extractable proteins (EP) and binding proteins (BP) labeled with 14C-amino acids. Therefore, at least two distinct phenotypic responder cells are present in the PHT-induced overgrowth gingiva, alter the synthesis of non-collagenous proteins. PMID- 3270657 TI - [The effect of water rinsing in removal of endotoxin from exposed root]. AB - Previous studies have revealed that periodontally involved exposed roots show evidence of biologic toxicity possibly due to endotoxin from subgingival micro organisms. Eleven periodontally involved teeth and five periodontally healthy teeth comprised the material. The teeth were rinsed in ultrasonic cleaner containing pyrogen-free water for one hour. The samples were taken from the solution after 1, 5, or 60 minutes. With the aim of removing residual endotoxin on the roots not eliminated by rinsing, each tooth was subjected to extraction of endotoxin with 45% phenol in water for 90 minutes at 65 degrees C. After extraction of endotoxin, the root surface of the involved teeth was further planned with a hand scaler. Endotoxin was extracted from the particles removed from the root surfaces. All samples were tested for endotoxin by limulus amoebocyte lysate assay. The amount of endotoxin from involved teeth was 4,500 +/ 2,000 ng per tooth and from healthy teeth it was 370 +/- 120 ng per tooth. The amount of residual endotoxin on roots from involved teeth was 32 +/- 20 ng per tooth and from healthy teeth it was 1.2 +/- 1.1 ng per tooth. The amount of endotoxin collected from particles removed from previously rinsed involved root surfaces was 1.5 ng per tooth. The rate of removal of endotoxin by water rinsing of a tooth was 64 +/- 25% in 1 minute, 85 +/- 16% in 5 minutes, 99 +/- 0.6% in 60 minutes. PMID- 3270658 TI - [Introduction of a method of promoting periodontal disease awareness]. AB - In periodontal diseases, due to lack of subjective symptoms, disease awareness and professional consultations are often dismissed even by subjects with already established periodontal lesions. The purpose of this study was to gain data concerning the relationship between bleeding induced by interdental stimulating and some of the clinical indices used in routine periodontal examinations in order to consider if wooden interdental cleaners, which are available to patients themselves, could be used as a means of arousing disease awareness. Furthermore, the buccolingual insertion of interdental cleaners was confirmed together with reconsiderations on its role as a means of proximal plaque control. 180 interdental sites of 30 new out-patients suspected of gingivitis or periodontitis consisted the material. As comparative indices to interdental stimulating, Bleeding on Probing (BOP), Probing Depth (PD), Gingival Index (GI) and Gingival Crevicular Fluid (GCF) measurement were selected. The interdental cleaning efficiency was reconsidered by assessment of interproximal plaque removal. As a result, bleeding was induced both by interdental stimulating and probing in 106 of the 180 experimental sites and was the majority. In relation to PD, concerning pockets less than 1.5 mm, bleeding was not induced by interdental stimulating. 58.8% of 3 mm pockets and all of the pockets deeper than 5 mm bled on interdental stimulating. Concerning the relationship with the GI, no site evaluated GI. 0 bled on interdental stimulating. 12.9% of sites evaluates GI. 1, 73.3% of sites evaluated GI. 2, and all of the sites evaluated GI. 3 bled on interdental stimulating. 39.0% of sites with GCF measurement of 0-21, 51.9% of sites with GCF measurement of 21-40 and 96.8% of sites with GCF measurement of over 81 showed bleeding on interdental stimulating.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3270659 TI - [Epidemiological study of periodontal disease. Mass examination in university students with CPITN]. AB - The purpose of this study was to investigate the prevalence and treatment needs of periodontal disease in the 1,150 university students (male: 726, female: 424) by using simplified Community Periodontal Index of Treatment Needs (CPITN-S). The results were as follows: 1. Approximately 85% of all the subjects have something wrong in periodontal tissue. If examined in detail; 1) Code 4: a group (1.6%) who had a deep pocket more than 6 mm. 2) Code 3: a group (20.1%) who had a shallow pocket 4 to 5 mm. 3) Code 2: a group (55.9%) who had supra- or subgingival calculus. 4) Code 1: a group (7.5%) who had bleeding on probing only. 2. As for treatment needs (TN), approximately 78% of the subjects need to receive professional prophylaxis and more complex treatment including periodontal surgery (TN 2-3). 3. Average time required to examine one subject was about one minute, so we could cut down the measuring time. From this point, we have understood that simplified CPITN was greatly effective to curtail the time for the primary screening of periodontal disease in the young age group. PMID- 3270660 TI - [Behavioral dental science. Part VIII. The dentist's rating and adolescents' perceptions of oral health]. AB - The purpose of this study was twofold. The first objective was to measure the periodontal status and perceptions of oral health in adolescents. The second objective was to determine the effects that a program of dental health education would have on their periodontal status and perceptions of oral health. The dental health education with a 90-minute lecture had been given to eleventh-grade students (352) in the previous year. The dental health education program was not carried out in tenth-grade students (442) yet. The oral examination was performed by a dentist for both grades. The examination time was about ten seconds per person. The students' periodontal status was scored as "excellent (+2)," "good (+1)," "questionable (0)," "poor (-1)," or "very poor (-2)" according to the criteria of an Oral Rating Index (ORI) System proposed by the present authors. The level of students' perceptions was assessed by the cognition score of our dental health test (10 items concerning dental attitudes and behavior). Main results were as follows: 1. Only 6% of the 10-th grade students were judged as having "excellent (+2)" oral health. Thirty-six percent were "very poor (-2)" or "poor (-1)" periodontal status. 2. The mean cognition score and the mean ORI score of the 11-th grade students were significantly greater for each sex group than those of the 10-th grade students. 3. The cognition score showed a clear relationship to the ORI score in each grade and in all. The behavioral component of the cognition score was more closely related to the ORI score. These findings suggest that the dental health education contributes to the improvement of periodontal status as well as that of perceptions. Furthermore, the ORI may be utilized for a screening system to evaluate adolescents' periodontal status quickly and effectively. PMID- 3270662 TI - [Development of breath detector for halitosis (1). Theory and method]. AB - A Breath Detector was developed and its clinical application was investigated. It is very difficult to judge how one's own breath smells. The sense of smell is the most unreliable of the senses and has still not been scientifically clarified. Everyone who tried to accurately express the strength and the character of some smell will be puzzled to see the difficulty of expression. A smell on one's breath is actually impossible to expressed on the same scale as for weight or length. On a laboratory basis, it is certainly possible to clarify the concentration and the mass of some odor by using graphic or numerical values with Gas chromatography. However such measuring methods at laboratories are not available in our daily clinical life when it is required to check easily, anytime and anywhere. In consideration of the above, We believe that this Breath Detector with a built-in small special gas sensor will act a substitute for an analyzer, and that the device can express how strong the smell on one's breath is. Therefore we recommend Breath Detector as a product many patients have been waiting for. PMID- 3270661 TI - [Blood reflux into cartridge in dental anesthesia. Detection of total protein and human hemoglobin in residual anesthetic solution]. AB - The present study was designed to elucidate the blood reflux into cartridge under infiltration anesthesia. When imitation examination was carried out using pontamine blue dye solution in 7 kinds of syringes for the use of cartridge, dye reflux was observed in all of them. Compared 4 kinds of cartridges on the market, dye reflux was observed in all except one. The amounts of protein in residual anesthetic solution of cartridges after infiltration anesthesia were quantitatively measured by dye binding method. Human hemoglobin was also measured by enzyme immunoassay (EIA). The detection rates of protein and human hemoglobin were 26.2% (85/324) and 24.2% (24/99), respectively. From these facts that blood reflux cannot be avoided in the cartridge system, it is necessary to prohibit the reuse of residual anesthetic solution of cartridge as quickly as possible to avert the risk of cross infection of HB and AIDS virus. PMID- 3270663 TI - [Development of breath detector for halitosis (2). Clinical evaluation]. AB - A breath detector was developed and its clinical application was investigated. 20 patients that included self-halitosis patients and periodontally diseased patients with halitosis were the subjects of this investigation. Measuring by breath detector was tried third time and most high score was taken for one's smell revel. The same time mouth air was analyzed by gas chromatograph. The amount of volatile sulphur compounds in mouth air was made a comparison between the two methods. The intensity of halitosis by olfactory panel were divided into four groups, (-) good, (+/-) slight, (+) warn, (++) severe. And we investigated that breath detector's judgement and olfactory panel were in agreement or not. A breath detector was very sensitive for volatile sulphur compounds as well as gas chromatograph. It was therefore concluded that breath detector seemed to be potentially useful in clinical objective evaluation of halitosis and periodontal diagnosis. PMID- 3270664 TI - [Topical application of the controlled release strips containing ofloxacin (PT 01) in periodontal therapy]. AB - The association of periodontopathic bacteria in the subgingival plaque with human periodontal disease has been well established. However, past attempts at reducing the level of pathogenic bacteria by using antibiotics as well as other antibacterial substance, so far, have not been fully successful. In this study, the effect of topical application of ofloxacin (OFLX), a synthetic antibiotic, was evaluated in relation to the clinical parameters. For this purpose, the new developed controlled release strips containing OFLX (PT-01), in which there were structurally immediate- and sustained-releasing portions, were used. 147 adult patients suffering from moderate to severe periodontitis were selected for this study. The patients had received no periodontal treatment previously and had taken no antibiotics within the preceding 6 months. Three different sites with a deep probing pocket depth (greater than or equal to 5 mm) were randomly selected in each patient, and were divided into three groups, i.e., PT-01 applied site (T), placebo-applied site (P) and control site (C). Periodontal treatments consisted of oral hygiene instruction and supragingival scaling on day 0 and 7, and subgingival scaling and root planing on day 14. PT-01 was applied in the periodontal pocket weekly on day 0 to 35, and clinical parameters on each site were recorded weekly. The results showed that, during first 14 days, significant reduction in the percentage of the sites which showed bleeding on probing, pus discharge or mobility of the tooth was observed in the PT-01 applied site. However in placebo and/or control group, no significant change in any parameters was observed in this period. While, after subgingival scaling and root planing, significant improvement was found at all sites in every clinical parameter. Especially, PT-01 applied sites showed significant improvement in the gingival index and bleeding on probing, compared to placebo-applied or control sites. These results suggest that weekly insertion of PT-01 in the periodontal pocket along with the subgingival scaling and root planing could have significant effect on the improvements in the gingival inflammation. Taken together, weekly application of PT-01 might have ameliorating effect as adjuncts of mechanical subgingival plaque control in the periodontal treatment. PMID- 3270665 TI - [Microbiological evaluation of topical application of the controlled release strips containing ofloxacin (PT-01) in the human periodontal pocket]. AB - The recognition that destructive periodontal diseases may be caused by specific microorganisms has led to an increased interest and usage of antimicrobial agents in periodontal therapy. In this study, the effect of topical application of ofloxacin (OFLX), a synthetic antibiotic, was microbiologically evaluated. The new developed controlled release strips containing OFLX (PT-01), in which there were structurally immediate- and sustained-releasing portions, were applied to the periodontal pockets of 27 adult subjects with periodontitis. Three different sites with a deep probing pocket depth (greater than or equal to 5 mm) were randomly selected in each patient, and were divided into three groups, i.e., PT 01 applied site (T), placebo-applied site (P) and control site (C). Periodontal treatments consisted of oral hygiene instruction and supragingival scaling on day 0 and 7, and subgingival scaling and root planing on day 14. PT-01 was weekly applied on day 0 to 35, and the subgingival plaque samples from each site were collected on day 0, 14, 21 and 42. The dynamics of subgingival microflora was investigated by dark field microscopy for determination of the %s of spirochetes, motile rods and coccoid cells, and anaerobic and aerobic cultivations for the determinations of the total number of subgingival bacteria, black-pigmented Bacteroides (BPB), Fusobacterium species and Actinobacillus actinomycetemcomitans. The results showed that the significant reduction of %s of spirochetes and motile rods and significant increase of % coccoid cells were found in only PT-01 applied sites during first 14 days. In this period, the total number of cultivable bacteria, BPB and Fusobacterium species were also significantly reduced in T sites. While, after subgingival scaling and root planing were performed, significant changes in the proportions and numbers of the subgingival microflora were found in all sites. Especially, PT-01 applied site showed significant improvement in the %s of spirochetes and motile rods as well as the total number of the bacteria. Moreover, the further microbiological determinations of the each isolate revealed that no detectable amounts of A. actinomycetemcomitans could be found from any samples in this study. These results suggested that weekly application of PT-01 in the periodontal pocket could have significant effects on the qualitative and quantitative improvements in the subgingival microflora. It was also suggested that the application of PT 01 might have ameliorating effect as adjuncts of mechanical subgingival plaque control in the periodontal treatment. PMID- 3270666 TI - [Periodontal surgical approach to the vertical fracture of the root. The application of composite resin to the fractured root surface]. AB - For a patient who had a deep periodontal pocket without an attached gingiva on labial central area of left upper canine, a free gingival graft from the palate was done. After that, a flap was reflected and the cause of the lesion was determined. It became clear that there was a vertical fracture of the root and a composite resin (Clearfil-SC) was used to fill the fractured area. It has been 2 1/2 years since the therapy and the prognosis is good. PMID- 3270667 TI - [Morphological relationship between maxillary sinus and skeletal facial type]. AB - The purpose of this study was to investigate the variation of the morphology of maxillary sinus in relation to the skeletal facial type. The materials consisted of lateral cephalometric roentgenograms of 100 adult Japanese females. Nine features representing the form of maxillary sinus were selected and the principal component analysis was carried out to determine the characteristics of sinus morphology. The following results were obtained. The form of maxillary sinus seems to mainly influence (or be influenced by) the antero-posterior facial symptom rather than the vertical facial symptom. A case which had a large SNA angle presented a tendency to have a maxillary sinus with a larger antero inferior portion and more upright anterior wall. The results indicate that the occlusal function may relate to the formation of the maxillary sinus. PMID- 3270668 TI - [A cephalometric study on the similarity of craniofacial morphology between children and their parents]. AB - This study was performed to estimate genetic influences on craniofacial form and to obtain a method of analysing the characteristics in a child as well as the individual growth prediction in each child. Posteroanterior and lateral cephalographs were used to estimate the morphological similarities of craniofacial form between 150 children and their parents. Subjects consisted of 38 boys and 112 girls who were estimated to mature according to the bone maturity index (B.M.I.) on the hand radiographs and who were older than 13 years chosen from among 3,500 orthodontic patients registered at the University Hospital associated with the Faculty of Dentistry, Kyushu University. The correlation analysis in family, estimation of the sexual linkage, the multi-regression analysis and estimation of the heritability of craniofacial characters were computed. The differences in correlations were also tested between prepuberty and postpuberty craniofacial forms in another 100 children with orthodontic treatment. The results are as follows: 1. The craniofacial form of children was highly correlated with that of their parents. 2. The genetic effects of determining the craniofacial form of offspring by the father were equivalent to those by the mother, but daughters were more affected by parents than were sons. 3. The proportions of multi-regression functions ranged from 3.7 to 34.0 percent. These values are too low to predict the growth of a child. 4. The calculated heritabilities on craniofacial form were from 0.286 to 0.962, with the majority being more than 0.600. 5. The coefficients of correlation between the children and their parents increased with growth, regardless of their orthodontic treatment. PMID- 3270669 TI - [Post-treatment changes of skeletal Class III morphology operated by orthognathic two-jaw surgery]. AB - The purpose of this study was to investigate the dentofacial changes following orthognathic Two-jaw surgery in skeletal Class III patients. The materials consisted of cephalometric head films of 20 patients who had simultaneously undergone Le Fort I osteotomy and mandibular ramus osteotomy. All cases received the pre- and post-operative orthodontic treatment and had the observation periods over than one year after postoperative orthodontic treatment. The cephalometric radiographs were taken at following five stages: 1. Before preoperative orthodontic treatment, 2. Immediately before surgery, 3. After intermaxillary fixation, 4. After postoperative orthodontic treatment, and 5. Posttreatment observation period. The results were as follows: 1. The anteroposterior skeletal relapse was minimum after surgery. 2. The surgical manner of the maxillary vertical displacement did not effect the stability of the upper facial height after surgery. The lower facial height tended to decrease slightly during postoperative orthodontic treatment. 3. The upper and lower incisors showed lingual tipping during intermaxillary fixation, but the upper incisors tipped labially during retention period. In conclusions, Two-jaw surgery was considered to be quite effective for the correction of skeletal Class III malocclusions especially with the maxillary deficiency. PMID- 3270670 TI - [The effects of dexamethasone and expansion stress on the osteoblasts in mouse calvarial suture in vitro, with special reference to incorporation of 3H thymidine and 3H-proline]. AB - Behavior of sutures in response to expansion stress are thought to be in parallel with the response of bone to orthodontic tooth movement. To investigate this relation between psychologic stress and osteoblasts during orthodontic tooth movement, the effects of expansion stress and 10(-7) M dexamethasone on sutural osteoblasts of mouse calvaria were examined in vitro. The model consists of a tensile force applied to the mouse sagittal suture. Expansion stress induced the formation of osteoid in the sutural areas, and incorporation of 3H-thymidine and 3H-proline in sutural osteoblasts were found to be stimulated by expansion stress. Furthermore, labelling index of 3H-thymidine in the osteoblasts was also found to be stimulated. On the other hand, dexamethasone inhibited the incorporation, labelling index and matrix formation. Moreover, these induced stimulations in expansion stress were inhibited by 10(-7) M dexamethasone treatment. As described above, dexamethasone, which is a synthetic glucocorticoid, inhibited the incorporation of 3H-thymidine and 3H-proline, the labelling index of 3H-thymidine, and the matrix formation in sutural osteoblasts that were stimulated by expansion stress. Therefore, also during orthodontic tooth movement, increased secretion of glucocorticoid that is stimulated by psychologic stress may inhibit the proliferation, cell differentiation, and matrix formation of osteoblasts in periodontal ligaments. PMID- 3270671 TI - [Correlations between masticatory performance in chewing gum method and occlusion as well as dento-facial morphology]. AB - In order to examine the characteristics of the chewing gum masticatory test, the amount of sugar elution, the chewing time and the amount of sugar elution per second were measured in 109 young adults (93 males and 16 females), after 70 strokes of mastication. Their sex differences, differences among various occlusions, correlations with occlusal areas of the buccal teeth and correlations with roentgen cephalometrics were analyzed. 1. There was no sex difference in the amount of sugar elution. However, chewing time was shorter and the amount of sugar elution per second was higher in males than in females. 2. Compared with the normal occlusion group, the amount of sugar elution was significantly lower in the crowding and anterior cross bite groups (Inoue's classification), and in the Class III malocclusion group (Angle's classification) in males. The amount of sugar elution per second was also significantly lower in the crowding and anterior cross bite groups. However, significant differences could not be found for chewing time. 3. The amount of sugar elution per second was significantly correlated with occlusal areas in males and total samples. 4. The amount of sugar elution was significantly correlated with less than ANB and less than L 1 to MP in males, with less than L 1 to MP in total samples. The chewing time was significantly correlated with S-N, N-Me, N-ANS, S'-Ptm' in females. The amount of sugar elution per second was significantly correlated with less than SNA and less than L 1 to MP in males, and with A'-Ptm', Cd-Go, Go-Pog', Cd-Gn, less than SNA, less than L 1 to MP, less than MP-SN and gonial angle in total samples. 5. It is concluded that the chewing gum masticatory test is highly correlated with occlusion and dento-facial morphology. In particular, amount of sugar elution per second was thought to be a useful measure for masticatory performance in clinical orthodontics. PMID- 3270672 TI - [Three-dimensional analysis of maxillary alveolar process in bilateral cleft lip and palate patients]. AB - The collapsed maxillary alveolar arch in bilateral cleft lip and palate (BCLP) patients was quantitatively evaluated by three dimensional analysis. Materials were consisted of alveolar models taken from 15 Japanese boys (11 years old) with BCLP. The findings obtained were as follows: 1. Examination of the alveolar displacement in individual BCLP patients disclosed a marked tendency of inward and upward displacement of the lateral segments. On the other hand, premaxilla showed an upward displacement in the vertical dimension with a great deal of variation in the amount and direction of horizontal displacement. 2. Concerning the average amount of horizontal displacement, the premaxilla showed relatively little, but the lateral segment, especially the left one, showed a considerably large amount. In the vertical dimension, both the premaxilla and lateral segment were displaced markedly upward. 3. Patterns of collapsed alveolar arch in BCLP patients were classified according to the amount of horizontal displacement of the premaxilla into the following 4 types; type A (larger displacement towards the inside), type B (moderate or smaller displacement towards the inside), type C (moderate or smaller displacement towards the outside) and type D (larger displacement towards the outside). The order of prevalence of these 4 types was B,C,A,D in order. On the other hand, in the vertical dimension, the direction of displacement of the premaxilla was upward in all patients. 4. The anterior edge of the lateral segments showed the largest amount of displacement both in the horizontal and vertical dimensions. In a comparison of these results with those of Unilateral Cleft Lip and Palate (UCLP), the total amount of horizontal displacement of the maxillary alveolar process was larger in UCLP, while the vertical one was larger in BCLP. A remarkable difference between BCLP and UCLP was found in the displacement of the anterior region due to the premaxilla in BCLP. PMID- 3270673 TI - [Stress distribution in mandible induced by occlusal force in different horizontal mandibular positions]. AB - The objective of this study was to investigate the stress distribution in the mandible induced by occlusal forces in a various different horizontal mandibular positions identified as neutroclusion, distoclusion, mesioclusion, and laterally shifted occlusion. A three dimensional Finite Element Method (3D-FEM) was applied to an artificial model of a simulated mandible constructed as a homogeneous, isotropic and elastic body. This model was divided into 480 elements with 785 nodes. The right and left heads of the mandibular condyles and the occlusal surfaces of the posterior teeth of the model were restrained. These restraints acted against the loading of the masticatory forces which consisted of a pair of masseter, temporal, and also the lateral and medial pterygoid muscles. The stress distributions analyzed by 3D-FEM were graphically demonstrated on a three dimensional display system. The data obtained were summarized as follows: I. Neutroclusion (1) Tensile stress appeared along the anterior border of the ramus, and compressive stress appeared along the angular portion of the ramus. (2) Compressive and tensile stress appeared on the external and the internal surfaces of the anterior portion of the mandibular body. II. Distoclusion and mesioclusion (1) As the position of the mandible was moved distally, the absolute values of the stress tended to increase on the same areas which is the external and the internal surfaces of the anterior portion of the mandibular body. (2) Compressive stress which appeared on the occlusal surfaces of the posterior teeth was very great in distoclusion. At the same time, the stress that appeared on the heads of the mandibular condyle was also great in mesioclusion. III. Right laterally shifted occlusion (1) Tensile stress appeared along the left sides of both of the left and right rami, and compressive stress appeared along the right side of both of the left and right rami. (2) A great amount of stress appeared on the left occlusal surfaces of the posterior teeth and on the left portion of the mandibular body. From these results, it was determined probably that the mandibular morphogenesis was influenced by a series of stress factors which were induced by the forces of the masticatory muscles. PMID- 3270674 TI - [Dental arch form achieved by orthodontic treatment]. AB - The objective of this study was to compare the dental arch forms of a control group with normal occlusion to the finished dental arch forms achieved by orthodontic treatment. The data consisted of 185 Japanese males and 275 Japanese females. These sex groups were divided into three groups, i.e., a group treated by extraction of the four first premolars, a group treated by non-extraction method and a control group consisting of individuals with normal occlusion. Findings were as follows: 1. The position of each tooth showed a normal distribution, with a small range of variation in all groups. 2. There were no significant differences in the range of tooth distribution among the three groups in each sex. However, the measurement of the male values were larger than those for the females. 3. In comparison with the other two groups, the transversed width between the same number of teeth of the extraction group had a larger width in the anterior teeth segment and a smaller width in the posterior teeth segment. The non-extraction group had a larger width in all of the teeth segment except for the second molars, than for control group. There were significant differences in all of the teeth between the males and the females. 4. As a result of a qualitative and a quantitative examinations, it was determined that the dental arch forms were almost the same among the three groups for each sex. The dental arch became progressively longer in the following successive order for the extraction group, the control group and the non-extraction group. 5. Except for the intercanine width, the dental arch forms of the Japanese group were wider and longer than that of the Caucasian North American group. In spite of the variation of the genetic background in respect to the differences of the ethnic background and sex, it was confirmed that there were no noticeable differences in the dental arch forms between the orthodontically treated groups and the non-treated group with normal occlusion. PMID- 3270675 TI - Relationship between the development of skeletal mesio-occlusion and posterior tooth-to-denture base discrepancy--its significance in the orthodontic reconstruction of skeletal Class III malocclusion. AB - The purpose of this paper is to explain the relationship between the development of Skeletal Class III malocclusion and the posterior discrepancy. Four cases which had severe Skeletal Class III malocclusion and had experienced unsuccessful orthodontic correction are presented to evaluate the causative factors of Skeletal Class III malocclusion. The forward displacement of the mandible was associated with inferiorely positioned maxillary molars and/or superiorly positioned mandibular molars caused by the "squeezing out" effect of posterior discrepancy, which provides a less steep maxillary occlusal plane in the denture frame. Perhaps continuous forward displacement of the mandible induces vertical condylar elongation which establishes the characteristics of Skeletal Class III malocclusion. A new approach to the orthodontic treatment of skeletal Class III malocclusion was achieved by the control of the occlusal plane with four second molars extraction in order to eliminate the posterior discrepancy. PMID- 3270676 TI - [An easily and immediately releasable intermaxillary fixation appliance for use after the correction of surgical orthognathic cases of jaw deformity or fracture]. AB - In oral surgery, intermaxillary fixation is routinely applied after surgery in cases of surgical orthognathic correction of jaw deformity or fractures. Intermaxillary fixation requires two conflicting factors: Stiff fixation and quick release in an emergency, as in nausea and vomiting. Conventional methods of intermaxillary fixation require multiple stiff ligation after an operation, but in an emergency these ligations can not be cut quickly to free the airway. We have developed a new fixation method placing a third wire (locking bow) above the upper splint or below the lower splint. The locking bow is hooked onto the splint on the unoperated side and firmly ligated to the splint on the jaw being operated upon. The ligatures can be quickly and easily released by pulling out the locking bow. This can be done by the patient himself or another person. This article describes the principles and clinical application of the method. We have found it to be useful in clinical practice. PMID- 3270677 TI - Responses of nerve fibers to pulpal inflammation and periapical lesions in rat molars demonstrated by calcitonin gene-related peptide immunocytochemistry. PMID- 3270678 TI - Release of calcium and hydroxyl ions from set endodontic sealers containing calcium hydroxide. PMID- 3270679 TI - Resorption after physiological and rigid splinting of replanted permanent incisors in monkeys. PMID- 3270680 TI - A morphological study of dentinal nerve endings. PMID- 3270681 TI - Endodontic retreatment--case selection and technique. Part 2: Treatment planning for retreatment. PMID- 3270682 TI - Ultraspeed versus Ektaspeed X-ray film: endodontists' perceptions. PMID- 3270683 TI - Treatment of iatrogenic root perforations with associated osseous lesions. PMID- 3270684 TI - The vehicle of toothpaste in the control of plaque and calculus. PMID- 3270685 TI - Gingival and microbiological changes in the primary dentition in the total absence of oral hygiene. PMID- 3270686 TI - Efficacy of Caridex in children and adults. PMID- 3270687 TI - Status of occlusal surfaces and condition of smooth surfaces of the first permanent molars in groups of Finnish and Russian children. PMID- 3270688 TI - Preventive and interceptive orthodontics in the mixed dentition with the myofunctional eruption guidance appliance: correction of crowding, spacing, rotations, cross-bites, and TMJ. PMID- 3270689 TI - The pedodontist's tool box: Part 1. An introduction to NLP. PMID- 3270690 TI - Systemic influences on the bone response to dental and orthopedic implants. PMID- 3270691 TI - Titanium and calcium phosphate ceramic dental implants, surfaces, coatings and interfaces. PMID- 3270692 TI - An instructional module concerning oral implantology: II. Development and implementation. AB - This paper represents the second of a series of papers documenting the design/development process of an individualized instructional module concerning oral implantology. This module was specifically designed for predoctoral dental students. The first paper discussed the rationale for the module and the initial field testing of the preliminary module. This paper examines the design and development of the oral implantology instructional module given to second and third year predoctoral dental students at the Medical College of Georgia School of Dentistry.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3270693 TI - Investigation of tissue/implant interactions during the first two hours of implantation. AB - The objective of this study was to determine whether detectable differences exist in the initial process of tissue incorporation of implant materials of different original surface energies. Our earlier work focused on materials implanted for days to months; the experiments reported here addressed the initial 2 hours of implantation. Surface-treated metal implants were placed in the fascial plane in the back of New Zealand white rabbits for 5 minutes to 2 hours. Prior to implantation, the metal plates were characterized by infrared spectroscopy, ellipsometry, and contact potential methods; the same analytical techniques, as well as scanning electron microscopy and contact angle measurements were applied to the explanted samples. No significant cellular adhesion was observed within the first 2 hours of implantation. Films rich in lipids and proteins were detected on the implants, however, within 5 minutes. There is good evidence for specific film differentiation as a function of differing initial substratum surface energies. PMID- 3270694 TI - The button implant--personal technique. PMID- 3270695 TI - Utilization of the PS bar system for subperiosteal implants. PMID- 3270696 TI - Principles of antimicrobial prophylaxis during surgical placement of implant prostheses. PMID- 3270697 TI - Finite element stress analysis of root-form implants. PMID- 3270698 TI - [Spreading of malignant tumor cells in human mandible. Histopathological study of autopsy cases]. PMID- 3270699 TI - [Epidemiological studies on caries activity test by KKY-agar--Streptococcus mutans selective medium]. PMID- 3270701 TI - [Determination of premature contact tooth using amplitude level of time domain wave forms]. PMID- 3270700 TI - [Pharmacological analysis of pulpal microcirculatory hemodynamics]. PMID- 3270702 TI - [Gene frequencies of blood polymorphisms in the Japanese population of the Izena Island]. PMID- 3270703 TI - [A case of two impacted paramolar in lower right molar dentition]. PMID- 3270704 TI - [Psoriasis and the HLA complex]. PMID- 3270705 TI - [Alcoholism and traffic accident injuries]. PMID- 3270706 TI - [Theory and practice in focal problems from the aspect of the dentist]. PMID- 3270707 TI - [Therapy of stage IV ischemia due to chronic arterial obliteration]. PMID- 3270708 TI - [Clinical and laboratory problems in the diagnosis of AIDS (case report)]. PMID- 3270709 TI - [Variations in the clinical picture in patients with trichinosis]. PMID- 3270710 TI - [Case report of a horseshoe kidney]. PMID- 3270711 TI - [Clinico-laboratory diagnosis of AIDS]. PMID- 3270712 TI - [Correlation of clinico-neurologic and thermographic findings in the lumbo-sacral radicular syndrome]. PMID- 3270713 TI - [The effect of immunologic and bacteriologic factors on the surgical outcome in palatoschisis]. PMID- 3270714 TI - [Mycobacteriosis of the lymph nodes caused by Mycobacterium fortuitum]. PMID- 3270715 TI - [Serum immunoglobulins in patients with psoriasis]. PMID- 3270716 TI - [Complications of diabetes]. PMID- 3270717 TI - [The importance of systematic examinations in women for the detection of breast cancer]. PMID- 3270718 TI - [Acute cholecystitis in childhood]. PMID- 3270719 TI - [Anthropometric characteristics of preschool children from the region of Stari Grad in Sarajevo]. PMID- 3270720 TI - [Case reports on 2 patients with acromegaly]. PMID- 3270721 TI - [Arterial hypertension and coronary disease in old age]. PMID- 3270723 TI - [The prevalence of diabetes mellitus in the northeastern region of Bosnia]. PMID- 3270722 TI - [Clinical observations of hoarseness in adolescence]. PMID- 3270724 TI - [Aspects of treatment of varicosities of the lower extremities]. PMID- 3270725 TI - [The results of a 1-year study of morbidity in myocardial infarct in the region of Listica]. PMID- 3270726 TI - [Possibilities of Doppler echocardiography--will the results of heart catheterization and angiography remain as the "gold standards" in cardiology. I]. PMID- 3270727 TI - [Adolescents from alcoholic families and antisocial behavior]. PMID- 3270729 TI - [Multiple myeloma]. PMID- 3270728 TI - [Primary pulmonary hypertension]. PMID- 3270730 TI - [The effect of "Sockovac" thermo-mineral water from Grancanica on models of inflammation and models of the digestive and urogenital systems]. PMID- 3270731 TI - [Interventional cardiac catheterization]. PMID- 3270732 TI - [The incidence of Mycoplasma in women with inflammatory changes in the genital organs]. PMID- 3270733 TI - [The incidence of congenital anomalies of the oral cavity in neonates in the Banja Luka region]. PMID- 3270734 TI - [Strategies in the campaign against mortality in Duchenne's myopathy from the aspect of modern cardiology]. PMID- 3270735 TI - [The appearance of insulin antibodies in diabetics]. PMID- 3270736 TI - [Why sympathetic ophthalmia?]. PMID- 3270737 TI - [Ladd's bridle as a cause of vomiting in the neonatal period (case report)]. PMID- 3270738 TI - [The role of ECG changes in mortality in a Croatian population]. PMID- 3270739 TI - [Histologic changes in an autologous venous bypass]. PMID- 3270740 TI - [The effect of exogenous melatonin on the acinar and mast cells of the pancreas]. PMID- 3270741 TI - [Serum immunoglobulins in patients with psoriasis]. PMID- 3270742 TI - [Evaluation of the effect of ofloxacin, a new chemotherapeutic agent]. PMID- 3270743 TI - [Post-traumatic leptomeningeal cysts of the scalp in children]. PMID- 3270744 TI - [Socio-medical aspects of tattooing and motivations for its removal]. PMID- 3270745 TI - [Injuries of the peripheral blood vessels]. PMID- 3270746 TI - [Successful defibrillation in emergency medical care]. PMID- 3270747 TI - [AIDS in children: clinical, immunologic and epidemiologic characteristics]. PMID- 3270748 TI - [Coombs-positive hemolytic anemia with a commentary on our cases]. PMID- 3270749 TI - [The types and causal genesis of urolithiasis in the Sarajevo region]. PMID- 3270750 TI - [Spontaneous subcortical (lobar) intracerebral hematoma]. PMID- 3270751 TI - [An aggressive surgical approach in comatose patients. Analysis of data from a newly created neurotraumatology department]. PMID- 3270753 TI - [Diabetes mellitus and pulmonary tuberculosis]. PMID- 3270752 TI - [Antireflux ureterocystoneostomy with emphasis on a single simultaneous bilateral operation]. PMID- 3270754 TI - [Emergency conditions in ophthalmology]. PMID- 3270755 TI - [Epidural hematoma in the posterior cranial fossa]. PMID- 3270756 TI - [The organization and importance of occupational rehabilitation at the level of a health center]. PMID- 3270757 TI - [Langerhans cells--antigen-presenting cells of the epidermis]. PMID- 3270758 TI - [Finger injuries caused by rings]. PMID- 3270759 TI - [Myelodysplastic syndromes]. PMID- 3270760 TI - [Incidence of congenital anomalies of the locomotor system in neonates in the Banja Luka region]. PMID- 3270761 TI - [Serum calcium, phosphorus and alkaline phosphatase as indicators in the therapy of renal osteodystrophy]. PMID- 3270762 TI - [Personal experience with the Sarmiento method in the treatment of diaphyseal fractures of the lower leg]. PMID- 3270763 TI - [Epidemiologic analysis of malignant neoplasms in Bosnia-Herzegovina based on data gathered from the registry of malignant diseases]. PMID- 3270764 TI - [Immunologic characteristics of neonates and premature infants]. PMID- 3270765 TI - [Noncritical use of drugs in childhood]. PMID- 3270767 TI - [Dermatomycoses in Yugoslavia and the widespread use of the antifungicide Ecalin]. PMID- 3270766 TI - [The frequency of manifestations of dysplastic changes and gastric carcinomas in various "precancerous conditions"]. PMID- 3270768 TI - [Mesenteric thrombosis as a problem in the differential diagnosis of diarrheal diseases in geriatrics]. PMID- 3270769 TI - [Brain abscess]. PMID- 3270770 TI - [Malignant tumors of the colon and rectum]. PMID- 3270771 TI - [Surgical treatment of lesions of the cervical disks using a frontal approach without intervertebral fusion]. PMID- 3270772 TI - [Experience with the IUD in the territory of Korcula]. PMID- 3270773 TI - [Ventilation-perfusion imbalance and its effect on the onset of partial respiratory insufficiency in chronic nonspecific obstructive lung disease]. PMID- 3270774 TI - [Long-term results in artificial heart valve replacement surgery]. PMID- 3270775 TI - [The importance of early detection of congenital anomalies of the urologic tract in neonates and infants]. PMID- 3270776 TI - [Craniocerebral injuries in relation to general skiing injuries]. PMID- 3270777 TI - [Hypoplasia of the portal vein and chronic splenic tumor caused by retroperitoneal fibromyxoma]. PMID- 3270779 TI - [Transference in psychosomatic patients in analytical psychotherapy]. PMID- 3270778 TI - [Arterial embolisms of the extremities]. PMID- 3270780 TI - [Organophosphate poisoning--the necessity of rapid atropine administration in emergency medical care (case report)]. PMID- 3270781 TI - AIDS is spreading. PMID- 3270782 TI - FDA implements plan to shorten AIDS research. PMID- 3270783 TI - AIDS not found worldwide. PMID- 3270784 TI - Minority recruitment and retention at Fairleigh Dickinson University School of Dentistry. PMID- 3270786 TI - Symposium. New Developments in the diagnosis and treatment of systemic fungal infections. Utrecht, December 9, 1987. PMID- 3270785 TI - Application of serological tests in the diagnosis of invasive candidiasis. PMID- 3270787 TI - Risk of HIV infection in dentistry. PMID- 3270788 TI - Factors contributing to current EFDA inactivity. PMID- 3270789 TI - Part 1. Risk management and people. Patient selection. PMID- 3270790 TI - Peer review can prevent a lawsuit. PMID- 3270791 TI - Part 2. Records require maintenance. PMID- 3270792 TI - Informed consent. A professional obligation. PMID- 3270793 TI - Professional liability insurance review. PMID- 3270794 TI - Multistate AIDS education network formed. PMID- 3270795 TI - Immunization program among primary school pupils (experience in Paya Bakung village, North Aceh). PMID- 3270796 TI - Spiramycin and erythromycin in the treatment of acute tonsillopharyngitis in children. PMID- 3270797 TI - A study comparing rooming-in with separate nursing. PMID- 3270799 TI - Cardio-respiratory adaptation of the preterm infant at birth. PMID- 3270798 TI - Rooming-in for babies born by caesarean section in Dr. Cipto Mangunkusumo General Hospital Jakarta. PMID- 3270800 TI - Neonatal mortality in Yogyakarta rural areas. PMID- 3270801 TI - Description of renal biopsy in frequently relapsing and corticosteroid non responsive nephrotic syndrome in childhood. PMID- 3270802 TI - Colloid oncotic pressure in children with nephrotic syndrome. PMID- 3270803 TI - Hypovolemic shock complicating nephrotic syndrome in a child. PMID- 3270804 TI - Recent advances in the management of end-stage renal disease (ESRD) in children. PMID- 3270805 TI - [Effect of biguanide derivatives (phenformin) on glucose tolerance in "borderline" and asymptomatic ("chemical") diabetes mellitus. Results of a 5-year prospective study]. PMID- 3270806 TI - [Prognostic value of the rosette formation test in patients with surgically treated stomach cancer]. PMID- 3270807 TI - [Effect of aminophylline on ventricular rate in patients with stabilized atrial fibrillation]. PMID- 3270808 TI - [Evaluation of motor activity of the gallbladder in obese and lean women]. PMID- 3270809 TI - [Echocardiographic evaluation of various indicators of left ventricular function in patients with hypertension during a chronic dialysis program]. PMID- 3270810 TI - [IGA nephropathy]. PMID- 3270811 TI - [Effect of long-term administration of 25-hydroxycholecalciferol on the regeneration of compact and spongy bone tissue in dogs receiving prednisone]. PMID- 3270812 TI - [Correlation of serum lactate dehydrogenase activity with bone marrow proliferation in patients with acute myeloblastic leukemia]. PMID- 3270813 TI - [Evaluation of the effect of mazindol on the motor function of the stomach in obese persons]. PMID- 3270814 TI - [A case of disseminated histoplasmosis]. PMID- 3270815 TI - [Progress in endocrinology]. PMID- 3270816 TI - [Analysis of circulating immune complexes with reference to DNA complexes in patients on hemodialysis and in those with chronic renal failure]. PMID- 3270817 TI - [Lymphoma of the gastrointestinal tract]. PMID- 3270819 TI - [Preprosthetic and esthetic periodontics: apropos of a case]. PMID- 3270820 TI - [Efficiency of a complex stomatological care at preschool age. Part II. Condition of dental health]. PMID- 3270818 TI - [3 cases of conservatively treated aortic dissecting aneurysm in patients with arterial hypertension. Results of a long-term ambulatory observation]. PMID- 3270821 TI - [Modified face mask according to Delair]. PMID- 3270822 TI - [Gunshot wounds of face and jaws and their consequences]. PMID- 3270823 TI - [New types of diamond grindstones made in Chirana Concern, Nove Mesto na Morave. Part I. Unified international classification of stomatological rotation tools]. PMID- 3270824 TI - [Clinical experience with extraoral surgery preparative parallelometer]. PMID- 3270825 TI - The value of an improved scoring system (CGHQ) for the General Health Questionnaire in a representative community sample. AB - The value of a new method of scoring the General Health Questionnaire (CGHQ) has been assessed in a representative sample of 6317 British community residents aged 18+. The CGHQ, which takes account of the chronicity of psychiatric symptoms, is found to be superior to the conventional scoring method in yielding a wider range of scores, a more normal distribution and in its close association to a well validated measure of neurotic illness. On the other hand, the conventional GHQ and the CGHQ score appear equally sensitive to a number of socio-demographic variables, including social class, marital status and employment. An important finding is that the two methods identify different individuals as cases. Compared with the GHQ, the CGHQ identifies a higher proportion of the middle-aged. The implications of these findings with respect to the optimal method of scoring the GHQ are discussed. PMID- 3270826 TI - Scoring nonresponse on the Mini-Mental State Examination. AB - Alternative procedures for coding nonresponse on the Mini-Mental State Examination as error or as correct) results in different classification of 13% of a random sample of 1931 subjects aged 60 and over. Comparison of responders' and nonresponders' ability to perform activities of daily living, and examination of the relative difficulty level of omitted items indicates that, in epidemiological surveys, scoring nonresponse as error is more likely to be correct. PMID- 3270827 TI - Cerebral blood flow and metabolism of oxygen and glucose in young autistic adults. AB - Regional cerebral blood flow, oxygen consumption and glucose consumption were measured by positron emission tomography in six young autistic men. No significant differences were found between patients and normal controls for any of the physiological variables. The results do not substantiate the previous finding of glucose hypermetabolism in autism; the likely reasons for the variance in findings are discussed. PMID- 3270828 TI - Tribulin in post-traumatic stress disorder. AB - Tribulin (endogenous monoamine oxidase inhibitor/benzodiazepine receptor binding inhibitor) output was measured in the urine of 18 patients with post-traumatic stress disorder (PTSD) and 13 controls. The level of the two inhibitory activities was highly significantly correlated in the group as a whole. There was no difference between output of either inhibitor in patients and controls. However, when the PTSD group was subdivided according to various psychometric ratings, a pattern of output did emerge. Levels of both inhibitory activities were higher in agitated compared with non-agitated subjects, and lower in extroverts compared with introverts. This finding supports the view that tribulin output is raised in conditions of greater arousal. PMID- 3270829 TI - Spatiotemporal memory and rate of forgetting in acute schizophrenics. AB - Some schizophrenics show anomalies in the frontal and temporal lobes. It is uncertain whether the cognitive deficits shown by Type I schizophrenics are caused directly by such anomalies, or by a deficit in the exertion of attentional effort. In this study, 16 acute schizophrenics, who broadly fitted the Type I characterization and their controls were given a battery of cognitive tests. The patients were impaired on effort-demanding tasks such as the Wisconsin Card Sorting Test, a verbal fluency test and the WAIS, which are susceptible in varying degrees to frontal, temporal and parietal lobe lesions. Patients were not disproportionately impaired, however, on a test of temporal memory and another of spatial memory, an impairment pattern that selectively reflects frontal and medial temporal lobe lesions respectively, nor were they impaired on a rate of forgetting task sensitive to medial temporal lobe lesions. These tasks were chosen not only because performance on them is selectively sensitive to frontotemporal lobe lesions, but also because it seems to depend on exerting minimum amounts of attentional effort. It is tentatively concluded that the cognitive deficits shown by Type I schizophrenics are caused by a problem in exerting attentional effort of unknown origin. PMID- 3270830 TI - Food craving, mood and the menstrual cycle. AB - Seventy-six women, with a mean age of 35.7 years, who reported premenstrual craving for sweet foods in a retrospective questionnaire, were assessed prospectively with a pre- and post-menstrual eating questionnaire and daily ratings of craving, mood, irritability and breast tenderness over two menstrual cycles. In 72% of these women a perimenstrual pattern of food craving was confirmed. In 13% this craving was confined to the menstrual phase. There was no consistent association between food craving and mood change, either in timing or severity. Women with more severe mood change did not report more severe craving. There was also no association between food craving and cyclical breast tenderness. Perimenstrual food craving, therefore, appears to be a cyclical phenomenon in its own right, of uncertain aetiology and worthy of further study. PMID- 3270831 TI - Gender, family environment and schizophrenia. AB - This study examined the relationship between patient's gender and family environment, and the consequences of this for the course of treatment of schizophrenia. Data for 160 DSM-III schizophrenics and a family member were obtained regarding attitudes towards treatment, tolerance of symptomatic deviance, and one-year rehospitalization and lengths of hospital stay. Findings suggest that ill sons may be sent to hospital more often and remain in hospital longer than ill daughters, in part due to social norms and expectations of parents associated with gender. PMID- 3270832 TI - Drug response patterns as a basis of nosology for the mood-incongruent psychoses (the schizophrenias). AB - Interaction of therapeutic drugs with a series of different biopathological substrates of psychosis might be expected to generate a series of different response patterns. Herein the authors suggest that multi-modal response patterns following lithium and neuroleptic treatment of psychotic patients may aid in resolving the heterogeneity of psychotic disorders and lead to a new nosology of the psychoses. PMID- 3270833 TI - Symptom complaints, psychiatric disorder and abnormal illness behaviour in patients with upper abdominal pain. AB - Seventy patients presenting to the gastroenterologist with upper abdominal pain were examined by a psychiatrist to establish the presence of psychiatric disorder, illness behaviour and to record in detail their symptom pattern. The 37 patients who had no organic cause for their abdominal complaints were subdivided into those with and without psychiatric disorder. The former (21 patients) demonstrated more illness behaviour, they complained of more abdominal symptoms and their pain was both more severe and more persistent than in the patients with organic disease and those with non-organic illness who did not have psychiatric disorder. The latter group reported no symptoms of 'psychoneurosis' and should probably be regarded as a separate group if the aetiology of functional abdominal pain is to be clarified. Those with non-organic abdominal complaints who had psychiatric illness could be distinguished by the presence of three symptoms, namely depression, anxiety and fatigue. Detection and treatment of their psychiatric disorder might lead to a decrease in their symptomatic complaints and illness behaviour. PMID- 3270834 TI - Emotion recognition in autism: coordinating faces and voices. AB - Autistic and non-autistic mentally retarded adolescents and young adults were individually matched for age and verbal ability and were given tasks in which they chose photographs of faces for emotionally expressive voices, and photographs of non-emotional things or events to accompany recorded sounds. The results were that relative to control subjects, autistic individuals performed less well on the emotion tasks than on the non-emotion tasks. The findings suggest that autistic individuals have a disability in recognizing bodily expressions of emotion, and that there is a degree of task-specificity to this impairment. PMID- 3270835 TI - Depression in torticollis: a controlled study. AB - Eighty-five patients with idiopathic, persistent spasmodic torticollis were compared to a control group of 49 patients with cervical spondylosis to assess (1) the prevalence of psychiatric disorder prior to and following the onset of their physical complaint, and (2) to establish the effect of torticollis on self reports of depression on the Beck Depression Inventory, and self-rated hopelessness on the Hopelessness Scale. The prevalence of psychiatric disorder in the two groups did not differ. The torticollis patients had significantly higher mean scores on the Beck Depression Inventory, but did not differ from the control group in terms of hopelessness. Self-referent negative cognitions such as self blame, self-accusation, self-punitive thoughts, and negative body-image emerged as the prominent component of depression in torticollis, which has implications for the management of depression in torticollis. PMID- 3270836 TI - Depression and anxiety in unemployed men. AB - Psychiatric status and psychosocial variables were assessed in a group of 80 unemployed men. Symptoms of depression and anxiety were assessed using the Present State Examination and 'caseness' rated according to the Bedford College criteria. Among men who were normal at the time of job loss, 14% developed a 'case' disorder and a further 17% a 'borderline case' disorder over the first 6 months of unemployment. These rates are similar to those found in studies concerned with a wider range of severe life events. An increased risk of onset was associated with three factors: lack of an intimate relationship with a wife or girlfriend, trait shyness, and pre-existing economic difficulties. PMID- 3270837 TI - Mortality in eating disorders. AB - Crude mortality rates and mortality rates standardized against a British reference population have been calculated for a group of 460 consecutive patients with eating disorders seen between 1971 and 1981 in a tertiary referral centre for eating disorders. Crude mortality rates were 3.3% and 3.1% in the anorexia nervosa and bulimia nervosa groups respectively. Standardized rates demonstrated a six-fold increase in mortality in the anorexia nervosa group. The most common cause of death in this group was found to be suicide, with the risk of death remaining high for at least eight years after initial assessment. Specific associations of increased mortality were: being in the lowest weight group at the time of presentation, and having recurrent hospital admissions for eating problems. PMID- 3270838 TI - A community study of minor psychiatric morbidity in Taiwan. AB - A community study of minor psychiatric morbidity (MPM) was carried out on three population samples aged 15 and above randomly selected from rural (Yenpu), suburban (Chishan), and urban (Kaohsiung) communities (N = 350 for each) in Taiwan. A two-stage case finding strategy was applied with a newly developed and validated screening questionnaire (CHQ), and a modified Chinese version of the Clinical Interview Schedule (CIS-CV). The total response rate was 99.4% and there was no time lag between the CHQ screening and the second stage clinical interview conducted by a psychiatrist. The weighted validity of the CHQ was found to be acceptable (sensitivity 69.6%, specificity 94.8%, misclassification rate 11.4%). The overall weighted prevalence rate was 18.0% for men and 33.3% for women. Both the CIS and the CHQ data are used as the morbidity indices to investigate the sociodemographic risk factors of MPM. A higher risk of MPM, which occupied 92% of the total morbidity, was found to be associated with women aged 35 and above, the unemployed men, and the lower socioeconomic status after linear modelling. PMID- 3270839 TI - A comparative study of the psychiatric practice of a tantrik healer and a hospital out-patient clinic in the Kathmandu Valley. AB - This paper summarizes the information gathered from healer and hospital patients consulting for mental illness in the Kathmandu Valley. While the tantrik healer appeared to be emulating the hospital in the speed and impersonality with which patients were processed, healer patients appeared to enjoy a greater degree of family support than did hospital patients. PMID- 3270840 TI - Marriage, motherhood and psychiatric morbidity in New Zealand. AB - The prevalence of psychiatric disorder, as assessed by both the GHQ-28 and the short PSE, is described for a random community sample of New Zealand women. In contrast to previous studies, married and widowed women and mothers showed lower rates than the never married and childless women. A plausible explanation is provided by available analysis of New Zealand gender roles. Such an explanation would reconfirm the importance of socio-cultural factors in community psychiatric disorder. PMID- 3270841 TI - The sporadic v. familial classification given aetiological heterogeneity: II. Power analyses. AB - This paper examines the power of the sporadic v. familial method as applied to schizophrenia and major depression. The model used assumes aetiological heterogeneity with a subpopulation of cases due to a 'major' environmental event and the remainder resulting from a generalized single major locus. The findings suggest that, for sample sizes to which it is commonly applied, the sporadic v. familial classification has low power to detect aetiological heterogeneity. When applied to nuclear families, substantial power requires at a minimum 100-150 proband families. If the proportion of environmental cases in the population is low, or the 'test' for environmental aetiology in probands does not have high sensitivity and specificity, the required sample sizes are considerably larger. Adding monozygotic twins increases the power of the method, but including second degree relatives does not. The optimal approach to the sporadic v. familial method will differ as a function of the frequency of the disorder and the relative effort and expense of examining probands versus family members. Other methods should be considered for discriminating genetic and environmental forms of illness. PMID- 3270842 TI - [High molecular weight kininogen and its abnormality]. PMID- 3270843 TI - [Molecular genetics of human color vision]. PMID- 3270844 TI - [Chronic granulomatous disease]. PMID- 3270845 TI - [Inborn errors of metabolism]. PMID- 3270846 TI - [Biochemistry of inherited metabolic diseases--qualitative and quantitative abnormalities of proteins]. PMID- 3270847 TI - [Heterogenous phenotypes associated with molecular abnormalities in inherited metabolic disorders]. PMID- 3270848 TI - [Molecular biology of the human gene]. PMID- 3270850 TI - [Chromosome mapping of metabolic disorder]. PMID- 3270849 TI - [Diagnosis and screening of inborn errors of metabolism]. PMID- 3270851 TI - [Treatment and preventive care on inborn errors of metabolism]. PMID- 3270852 TI - [Gene therapy and animal model for inborn errors of metabolism]. PMID- 3270853 TI - [Malignant hyperphenylalaninemia--tetrahydrobiopterin (BH4) deficiency]. PMID- 3270854 TI - [Carbamyl phosphate synthetase I deficiency]. PMID- 3270855 TI - [Citrullinemia]. PMID- 3270856 TI - [Argininosuccinic aciduria]. PMID- 3270857 TI - [Molecular genetics of gyrate atrophy]. PMID- 3270858 TI - [Prolidase deficiency]. PMID- 3270859 TI - [Hyperglycinemias]. PMID- 3270860 TI - [Hypertyrosinemia]. PMID- 3270861 TI - [Organic acidemias and disorders of branched chain amino acids: overview]. PMID- 3270863 TI - [Medium chain acyl-CoA dehydrogenase deficiency]. PMID- 3270862 TI - [Isovaleric acidemia]. PMID- 3270864 TI - [Short chain and long chain acyl-CoA dehydrogenase deficiencies]. PMID- 3270865 TI - [Glutaric acidemia type II]. PMID- 3270866 TI - [Propionic acidemia]. PMID- 3270867 TI - [Maple syrup urine disease]. PMID- 3270868 TI - [beta-Ketothiolase deficiency]. PMID- 3270869 TI - [Methylcrotonyl-CoA carboxylase deficiency]. PMID- 3270870 TI - [Inborn errors of nucleic acid metabolism]. PMID- 3270871 TI - [Hypoxanthine guanine phosphoribosyl transferase deficiency; Lesch-Nyhan syndrome]. PMID- 3270872 TI - [Abnormalities of adenosine deaminase]. PMID- 3270873 TI - [Disorders of DNA repair--xeroderma pigmentosum, and other hereditary diseases with abnormal DNA repair]. PMID- 3270874 TI - [Disorders in carbohydrate metabolism]. PMID- 3270875 TI - [Glycogenosis (molecular mechanism of muscle glycogenosis)]. PMID- 3270876 TI - [Glucose-6-phosphate dehydrogenase deficiencies]. PMID- 3270877 TI - [Galactosemia]. PMID- 3270878 TI - [Aldolase deficiency]. PMID- 3270879 TI - [Congenital lactic acidemia]. PMID- 3270881 TI - [Molecular aspects of phosphoglycerate kinase abnormalities]. PMID- 3270880 TI - [Genetic defect of pyruvate dehydrogenase]. PMID- 3270882 TI - [Pyruvate kinase deficiency]. PMID- 3270883 TI - [Review of mucolipidoses]. PMID- 3270884 TI - [Molecular basis of fucosidosis and mannosidosis]. PMID- 3270885 TI - [Sialidosis]. PMID- 3270886 TI - [Inborn errors of lysosome protease]. PMID- 3270887 TI - [Galactosylceramidase deficiency--Krabbe's disease]. PMID- 3270888 TI - [Niemann-Pick disease]. PMID- 3270889 TI - [Multiple sulfatase deficiency]. PMID- 3270890 TI - [Sphingolipid activator protein deficiency]. PMID- 3270891 TI - [Congenital abnormalities of plasma lipoprotein metabolism]. PMID- 3270892 TI - [LDL receptor abnormality]. PMID- 3270893 TI - [Hypertriglyceridemia in a deficiency of lipoprotein lipase and hepatic lipase]. PMID- 3270894 TI - [Familial lecithin cholesterol acyltransferase deficiency]. PMID- 3270895 TI - [Collagen metabolic disorders--Ehlers-Danlos syndrome and osteogenesis imperfecta]. PMID- 3270896 TI - [Proteoglycan genetic disorder]. PMID- 3270897 TI - [Inborn errors of intracellular organelles]. PMID- 3270898 TI - [Peroxisome disorders]. PMID- 3270899 TI - [Adrenoleukodystrophy]. PMID- 3270900 TI - [Cystinosis and Salla disease]. PMID- 3270901 TI - [Hyperornithinemia, hyperammonemia and homocitrullinuria due to a defect of mitochondrial membrane transport]. PMID- 3270902 TI - [Hereditary abnormalities of NADH-cytochrome b5 reductase]. PMID- 3270903 TI - [Genetic endocrine disorders]. PMID- 3270904 TI - [Insulin resistant diabetes]. PMID- 3270905 TI - [Glucocorticoid resistance syndrome]. PMID- 3270906 TI - [Syndromes of thyroid hormone resistance--Refetoff syndromes]. PMID- 3270907 TI - [Steroid 21-hydroxylase deficiency--congenital adrenal hyperplasia]. PMID- 3270908 TI - [Disorder of thyroid hormone synthesis]. PMID- 3270909 TI - [Male pseudohermaphroditism]. PMID- 3270910 TI - [Genetic abnormalities of serum protein]. PMID- 3270911 TI - [Human serum albumin variants]. PMID- 3270912 TI - [Analbuminemia]. PMID- 3270913 TI - [Alpha 1-antitrypsin deficiency]. PMID- 3270914 TI - [Familial amyloidosis]. PMID- 3270915 TI - [Dysfibrinogenemia and dysprothrombinemia]. PMID- 3270916 TI - [Protein and gene structures of the contact factors and their abnormalities]. PMID- 3270917 TI - [Molecular and genetic basis of deficiency and molecular abnormality of coagulation factor XIII]. PMID- 3270918 TI - [Congenital abnormality of plasminogen]. PMID- 3270919 TI - [Congenital deficiency of alpha 2-plasmin inhibitor]. PMID- 3270920 TI - [State of periodontium in patients using partial removable dentures]. AB - The authors have examined 63 patients whom 86 partial removable dentures: functionally unstable dentures and supported ones in all have been made. The state of paradontium basing on G-I gingival index and Pl-I plaque index has been estimated. It has been found that the state of paradontium in the group of supported dentures irrespective of the utilization life was better than in the group of functionally unstable dentures. PMID- 3270921 TI - [Prosthetic treatment of a patient with complicated functional inferior prognathism]. AB - The authors present their own case of prosthetic treatment of a patient with functional inferior prognathism complicated by deviation and supraocclusion. Two stages treatment has been applied with utilization of overlaid splint-dentures and isometric and active exercises. Esthetic crowns on which desired canine teeth conduction has been obtained and frame dentures introduced in the new conditions of occlusion have been performed as the final treatment. Proper function of mastication has been restored and improvement of the appearance has been obtained that has considerably improved the frame of mind of the patient. PMID- 3270922 TI - [Analysis of electric cell power in oral cavity]. PMID- 3270923 TI - [Selected cases of prosthetic treatment in patients with lowered height of the occlusion]. AB - In the paper three selected cases that illustrate comprehensive prosthetic treatment in which modern methods and prosthetic materials have been used non conventional composed bridges with partial crowns on abutment teeth sealed with composites in patients with deep bite are reported. For facing the crowns and bridges such materials as Izosit, porcelain, acryl-derived material--Colorstat which is superior to acrylate considering its physicochemical properties have been used. For the reconstruction of the patients, own teeth Izofil adhesive material has been used for capping the teeth partly or totally establishing a new occlusal situation in anterior and lateral segments. PMID- 3270924 TI - [Individual protective crown]. AB - Protection of the worked out live teeth's crowns by covering them with protective crowns should be routine procedure when performing, stable prosthetic restoration. Carrying out of individual protective crown by the "intermediate" method, i.e. basing on plaster cast, is preceded by grinding operation in the mouth of the patient. Protective crown is made of quick-polymerizable acryl introduced into alginate impression and pressed against plaster cast prepared previously. Mechanically worked out crown is precise, esthetic and durable. The method of carrying out is simple, effective and safe for the patient in comparison with the methods used til now because there is no contact of the quick polymerizable plastics with the tissues of polished teeth and with parodontium. PMID- 3270925 TI - Porcelain fused to tooth--the state of the art. PMID- 3270926 TI - [Ifedipine induced gingival hyperplasia. Review and clinical cases]. PMID- 3270927 TI - [Bruxism]. PMID- 3270928 TI - [Parotid tumors. Diagnostic value of sialographic symptomatology. Study of 15 patients]. PMID- 3270929 TI - [Comparative study of 2 methods of treatment of dentin hypersensitivity]. PMID- 3270930 TI - [The epidemiological profile of patients hospitalized in a first-aid clinic in the city of Sao Paulo]. PMID- 3270931 TI - [The person with arterial hypertension under ambulatory treatment. II. A study of the problems, difficulties and changes in the disease and in its treatment]. PMID- 3270932 TI - [Nursing care for the individual with a neurological disease]. PMID- 3270933 TI - [Gastric intubation of the newborn infant]. PMID- 3270934 TI - [Basic human needs--an identification of the need for continuing education based on a content analysis of nursing records]. PMID- 3270935 TI - [The characteristics and aspirations of the current student graduating in nursing: a comparison between 2 teaching institutions]. PMID- 3270936 TI - [The guidance given to the pregnant woman during prenatal care: the performance of nursing professionals]. PMID- 3270937 TI - [The estimation of arterial pressure in children 1 to 6 years of age with special reference to the cuff width]. PMID- 3270938 TI - Purification and characterization of intracellular dextranase of Bacteroides oralis Ig4a. AB - Multiple forms of dextranase were detected in both intra- and extracellular fractions of Bacteroides oralis Ig4a. The molecular weights of these enzymes varied from 52,000 to 260,000 by sodium dodecyl sulfate-polyacrylamide-blue dextran gel electrophoresis. The intracellular dextranases were fractionated by chromatography and gel filtration steps, and the dextranases IV and V were obtained. The former was only partially pure. The molecular weights of the dextranases IV and V were estimated to be 120,000 and 105,000, respectively, by SDS-PAGE. The dextranase V was further characterized and it was revealed that the pH- and temperature optima were 5.0, and 55 degrees C, respectively. The Km value was 6.7 x 10(-2) mM for dextran T-70. The enzyme did not exhibit any metal ion requirements, but was inhibited by CoCl2 and HgCl2; lysine and alanine contents were especially high; it hydrolyzed the alpha-1,6-glucan by an exo-type mechanism, and was inactive toward glucans containing alpha-1,3-, alpha-1,4-, and beta-1,4-linkages. PMID- 3270939 TI - [Ultrastructural investigation of a mechanism of physiologic root resorption of deciduous teeth (Part 1)]. PMID- 3270940 TI - [Identification of acetylcholine, histamine and serotonin receptors in the porcine dental pulp]. PMID- 3270941 TI - [Bone morphometric studies on healing of extraction wounds in rats]. PMID- 3270942 TI - [Determination of vertical dimension by phonetics in a case of mandibular prognathism with overclosure]. PMID- 3270943 TI - [Scanning electron microscopic study of the developing roots in rat molars]. PMID- 3270944 TI - [Changes in three-dimensional ultrastructure of surface matrix of the cortical bone associated with aging]. PMID- 3270945 TI - Three-dimensional ultrastructure of the Golgi region of the formative chondrocyte in newborn rat mandibular condyle. AB - The three dimensional ultrastructure of Golgi region of formative chondrocytes from newborn rat mandibular condyle was examined by means of the method based on dilute osmium maceration with a high-resolution scanning electron microscope. The large area of formative chondrocytes was occupied by the cytoplasmic organelles related to matrix-synthesis such as Golgi apparatus, rough endoplasmic reticulum (RER) and mitochondria. The Golgi region of formative chondrocytes was composed of the limiting membranous structures such as some groups of the stacks of Golgi cisterns, vesicles, vacuoles, secretory granules, reticular constituents and small tabular or tubular RER. The Golgi cisterns were composed of both small tabular parts and rod-like parts arising from tabular parts. Small tabular parts were furthermore subdivided into three types of many, few and no penetrated ones. Reticular constituents were made up of limiting membrane visible as smooth image by scanning electron microscopy, therefore, are assumed to be one part of the GERL (Golgi apparatus-endoplasmic reticulum-lysosome). PMID- 3270946 TI - [Response of neurons in the trigeminal subnucleus caudalis and the bulbar lateral reticular formation to electrical stimulation of the masseter muscle]. PMID- 3270947 TI - [A case of local anesthetic intoxication results from intra-arterial lidocaine administration at cannulation of superficial temporal artery]. PMID- 3270948 TI - [Laser therapy and mechanism of cervical hypersensitive dentin]. PMID- 3270949 TI - [Biomaterials in oral surgery. 3. Standardized bioceramic cones for retrograde obturation after apicectomy]. PMID- 3270950 TI - [Mandibular fracture: use of miniplates]. PMID- 3270951 TI - [Why patients left orthodontic-dentofacial orthopedic treatment]. PMID- 3270952 TI - [Dental amalgam: the influence of immediate polishing on surface hardness, surface rugosity and emission of residual mercury--in vitro study]. PMID- 3270953 TI - [Chronic infection of an upper lateral incisor with sulcus involvement, successfully treated with combined endo-periodontal therapy]. PMID- 3270954 TI - Biocompatibility of cobalt-chromium alloys. "In vitro" and "in vivo" studies. PMID- 3270955 TI - Vertical variation in skeletal open bite: a classification for surgical planning. PMID- 3270956 TI - General practitioner's radiology casebook XV. Odontogenic keratocyst. PMID- 3270957 TI - KRAX is important operational determinant of tissue response. KRAX as parameter for classification. PMID- 3270958 TI - Protective effect of adenosine against hypoxic damage. Synaptic depression and adenosine. PMID- 3270959 TI - Means of clarifying mechanisms of desensitization. Energetics of conformational changes in receptors. PMID- 3270960 TI - Effect of low LDL not due to role in cholesterol metabolism. Support for 'hormone like' action of LDL. PMID- 3270962 TI - This and that: neither epinephrine nor adrenaline. PMID- 3270961 TI - New cardiotonics may act via adenosine receptors. Mechanisms of action of the new cardiotonic drugs. PMID- 3270964 TI - L-arginine is endogenous source of NO. PMID- 3270963 TI - Neurochemical interactions of cocaine with dopaminergic systems. PMID- 3270965 TI - Activated platelets, asthma and vascular injury. Pathophysiology of platelets. PMID- 3270966 TI - Understanding receptor kinetics has some way to go. Nicotinic receptors and the elusive beta. PMID- 3270967 TI - It may be interpretation, not experiment that is wrong. Interpreting non competitive inhibition. PMID- 3270968 TI - The acceptable face of international competition. Stereophobia: an economic afterthought. PMID- 3270969 TI - Autologous bone marrow transplantation in hematology. PMID- 3270970 TI - Prothrombin time standardization. PMID- 3270971 TI - The clinical heterogeneity of Macleod's (Swyer-James') syndrome. PMID- 3270972 TI - Diagnosis of primary hyperparathyroidism in a patient with acute renal insufficiency: the usefulness of scintigraphy. PMID- 3270973 TI - Drugs recently released in Belgium. Torasemide, nalbuphine, imipenem-cilastatin. PMID- 3270974 TI - Tissue changes in the rabbit periodontal ligament during orthodontic tooth movement. AB - In this (semi) quantitative animal study the reaction of the periodontal ligament (PDL) to experimental tooth movement is described. To this end, rabbit first incisors were moved sideways with helical torsion springs for periods varying from 3-24 hours. The initial force of the springs was 50 gf. The histomorphology of the PDL was studied in 5 microns thick plastic sections. Comparison with control animals and animals wearing passive springs showed that tooth movement leads to an increased trauma in the PDL within only a few hours. This trauma is characterized by hyalinization, tears and ruptures in the fibres and blood vessels, and by the presence of extravascular erythrocytes and pyknosis. Tissue damage significantly increased with time. After 24 hours of tooth movement, the PDL fibers are compressed or stretched in 68% of the sections and the blood vessels in the PDL are compressed or stretched in 62% of the sections. Even in the controls, more than 15% of the sections displayed slightly stretched or compressed fibers, and about 10% showed slightly compressed or stretched blood vessels. This indicates that some damage is regularly present in a normally functioning PDL. Increases in the percentage of sections with blood vessel compression are found in all groups wearing passive springs, especially after 6 hours. A high concordancy in compression and tension patterns of blood vessels and fibers is present in 83% of the sections. Pyknotic cells are practically confined to areas with compressed PDL fibers in rabbits wearing active springs. Extravascular erythrocytes were found in sections with all types of fiber patterns. A significant majority of extravascular erythrocytes, however, was found in areas with compressed fibers. PMID- 3270975 TI - Scanning electron microscopy substantiates histology in showing the inadequacy of the existing theories on the development of the proximal coronary arteries and their connections with the arterial trunks. AB - Development of proximal coronary arterial segments and coronary arterial orifices was studied by scanning electron microscopy in 20 rat embryos and by light microscopy in serial sections of 20 human and another 18 rat embryos. Neither by scanning electron microscopy nor by light microscopy did we observe more than two coronary arterial orifices. These coronary orifices were always situated in the sinuses of the aorta that faced the pulmonary artery. In the human embryos the coronary orifices emerged between 37-39 days of gestation (16-19 mm crown-rump length, Streeter horizon XVIII-XIX) and were invariably present beyond 39 days (19 mm crown-rump length, Streeter horizon XIX). In rat embryos, the coronary orifices emerged in both scanning electron microscopy and light microscopy at 15 17 days of gestation (13-17 mm crown-rump length) and were invariably present beyond 17 days (17 mm crown-rump length). In both human and rat embryos, either by scanning electron microscopy and light microscopy, the left coronary orifice was observed significantly earlier. In all the investigated embryos, human as well as rat, septation at arterial orifice level was complete, including the earliest stages studied. Light microscopy showed that at the emerging stages of the coronary orifices, the proximal epicardial segments of the left and right coronary arteries could already be identified in a peritruncal ring of epicardial vasculature, before the coronary orifice was observed. This was the case in human as well as in rat embryos. Thus, a coronary orifice was never seen in the absence of a proximal coronary artery. The present theories on development of the proximal coronary arteries and coronary orifices do not offer an adequate explanation for either these data or the known possible congenital abnormalities of the coronary arteries. Our study supports dual proximal coronary arterial development. These two proximal coronary arteries develop out of a peritruncal ring of vascular structures on to the aorta. The process by which the coronary orifices actually develop remains to be explained. PMID- 3270976 TI - Single coronary artery with transeptal anterior interventricular artery: a rare anatomical feature. AB - A case of a single coronary artery is described in a 50-year-old male, who died of asphyxia. The artery originated in the right aortic sinus and from it another artery emerged which crossed the crista supraventricularis and the interventricular septum and returned to occupy a subepicardial position in the lower half of the anterior interventricular sulcus. This partially intramyocardial artery was considered as the anterior interventricular artery. A literature survey showed only five cases with similar characteristics. The importance of this anomaly derives from the risk of damage occurring to the intramyocardial artery during a manipulation of the infundibulum of the right ventricle in a cardiac surgery or from problems of perfusion during coronary bypass procedures. PMID- 3270977 TI - Heterogeneity of the histological features along the course of the facial vein of the desert camel (Camelus dromedarius): relevance to brain cooling. AB - Sections from different parts along the facial vein of the camel (Camelus dromedarius) were examined by light microscopy. The results demonstrated heterogeneity among the various segments. Particular attention was paid to a specific area in the buccal region which was previously shown by physiological experiments to have a temperature-dependent myogenic tone. The morphology of that area showed highly thickened media with prominent bands of circularly disposed smooth muscles infiltrating both the intima and the adventitia. The morphology described in this study correlates well with the function and gives further credence to the proposed role of the facial vein in cranial thermoregulation particularly under heat stress. PMID- 3270978 TI - A reappraisal of the anatomy of the levator ani muscle in man. AB - A study of the attachments of the musculotendinous fibres of the levator ani muscle shows that it is made of two portions: a thick anterior portion which is mostly fleshy and a thin posterior portion which is mostly aponeurotic. The anterior portion consists of two layers: a superficial perineal layer and a deep pelvic layer. Both layers have a common origin from the back of the body of the pubic bone and the anterior part of the tendinous arch. In addition both layers make a U-shaped loop around the recto-anal junction. The posterior fibres of the deep pelvic layer received nerve supply only from the third and fourth sacral nerves. The rest of the muscle was supplied from the sacral nerves as well as the perineal branches of the pudendal nerve. The role of the anterior fibres in reinforcing the sphincters of the anal canal and fixation of the pelvic viscera is stressed. The close anatomical relation between the posterior portion of the muscle and the obturator internus suggests that the latter may play a role in supporting the weak posterior portion of the levator ani, especially during straining positions associated with lateral rotation at both hips. PMID- 3270979 TI - Morphometric and histological studies on the adrenal glands of the camel Camelus dromedarius. AB - The adrenal gland of the camel consists of an outer cortex and an inner medulla. The general disposition of the cortex and medulla, however, differs occasionally from that of other mammals. Extensions of medulla could reach as far as the periphery of the cortex. Islet of medullary tissue may be found in sections of the cortex and cortical tissue consisting of all zones of the cortex may occur around arteries or nerves in the medulla. The medulla may be separated from the cortex by connective tissue especially in old camels. The arrangement of noradrenaline-secreting cells is different from that in other ruminants; they are found in groups scattered between the adrenaline-secreting cells. Bundles of smooth muscle occur in venules at the corticomedullary interface. Accessory adrenal glands are found embedded in the renal fat. They are similar in structure to the adrenal gland. The adrenal cortex forms 74% of the volume of the gland and the ratio of the cortex to medulla is 4:1. The zona glomerulosa, fasciculata and reticularis constitute about 13%, 53%, and 29% by volume of the cortex, respectively. PMID- 3270980 TI - The vasculature of the rat embryo: an electron microscope study. AB - The ultrastructure of portions of the arterial and venous systems of the 11.5 day old Wistar rat embryos has been studied by scanning and transmission electron microscopy. The vessels at this stage of development are in the form of capillaries, and the arterial and venous types can be distinguished by the morphology of the endothelial cells by SEM. The endothelial cells of the arterial vessels gave prominent nuclear bulges and numerous microvilli apart from their spindle shape, whilst those of the veins appear flattened, are polygonal in shape, and have few microvilli. Transmission electron microscopy shows that the endothelial cells of the arteries and veins are identical in structure. The ultrastructure of these cells resembles that of endothelial cells at later stages of development including the adult type in that mature forms of cytoplasmic organelles are obtained. In studies on the intercellular junctions and fenestrations with lanthanum nitrate, the impression is formed that the vessels at this stage are impermeable to small molecular size particles, compared with adult capillaries. This suggests that cytoplasmic vesicles must play a major role in the transport of macromolecules in the 11.5 day embryonic vessels. PMID- 3270981 TI - Biocompatibility of dental materials. PMID- 3270982 TI - Glass ionomer cements. PMID- 3270983 TI - Liners and bases--current concepts and materials. PMID- 3270984 TI - Contemporary ceramic restorations: a comparative evaluation. PMID- 3270985 TI - Development of the Tort system, with special emphasis on experiences in Colorado. PMID- 3270986 TI - Tort reform is needed. PMID- 3270987 TI - Prevention, defense, and expert witnesses: schemes for defense. PMID- 3270988 TI - Murder, manslaughter, death, and criminal responsibility: some distinctions. PMID- 3270989 TI - In defense of Dr. Protopappas: the anesthesiologist's concerns related to the practice of sedation and local and general anesthesia. PMID- 3270990 TI - Use of "smart technology" in dentistry and medicine. PMID- 3270991 TI - Reflex bronchospasm-induced acute massive pulmonary collapse. AB - Acute massive pulmonary collapse following reflex bronchospasm is described in a patient undergoing general anesthesia. The authors suggest that a chest radiograph should be taken as routine procedure after the onset of airway constriction during anesthesia. PMID- 3270992 TI - Femoral false aneurysms: a recommendation for the method of repair. AB - False aneurysm formation is a major complication of vascular surgery. The most frequent site of anastomotic false aneurysm formation is the femoral artery. Between January 1974 and June 1986, 26 patients with 42 femoral false aneurysms were treated at the Princess Alexandra Hospital. Aneurysms developed following Dacron arterial grafting (29 aneurysms), saphenous vein grafting (10 aneurysms), umbilical vein grafting (one aneurysm) and femoral embolectomy (two aneurysms). Arterial wall failure (with intact suture and graft) was the most frequent operative finding. Ten recurrent aneurysms developed. There was a significantly greater number of recurrences when resuture or patch repair was employed than when an interposition graft was used as a repair. The development of a femoral anastomotic false aneurysm should be viewed as a total failure of that anastomosis and repair should be by replacement with an interposition graft rather than repair of the failed anastomosis by suture or patch. PMID- 3270993 TI - Radionuclide measurements of diastolic function for assessing early left ventricular abnormalities in the hypertensive patient. AB - Three measurements of diastolic filling were compared in 29 patients with essential hypertension and 27 age matched normotensive controls. Systolic function was normal in all but one of the patients. The mean (1SD) first one third filling fraction (a measurement of early diastolic filling) was significantly lower in the hypertensive groups (0.27 (0.24] than in the control group (0.45 (0.16)). The hypertensive group was subdivided into those with electrocardiographic abnormalities and those without. In the subgroup with a normal electrocardiogram the mean (1SD) first one third filling fraction measurement (0.28 (0.16)) was significantly lower than in the control group. In the subgroup with an abnormal electrocardiogram, the first one third filling fraction was even lower (0.24 (0.9)). In addition, the time to peak filling rate (213 (56) ms) was significantly longer in the subgroup with the abnormal electrocardiogram than in the control group (164 (45) ms). However, the interobserver reproducibility of the time to peak filling measurement was poor. The peak filling rate was low in the subgroup with an abnormal electrocardiogram, but not significantly different from the normal controls. The discriminatory value of the three diastolic measurements did not improve with exercise. These results showed an early diastolic filling abnormality in essential hypertension that did not appear to be caused by disease of the large coronary vessels as it was present in patients with normal wall motion and a normal exercise electrocardiogram. The occurrence of diastolic abnormalities when systolic function is still normal may mark an early stage in the development of hypertensive heart failure, at a time when the process is still potentially reversible. PMID- 3270994 TI - Regeneration of autotransplanted lymph node fragments. AB - In normal young minipigs thin slices of autologous mesenteric or superficial inguinal lymph nodes were implanted either in the greater omentum or subcutaneously in the groin region. The regeneration was studied histologically and connections between the afferent lymphatics and the regenerated tissue were checked. In the greater omentum, no regenerated lymph node tissue was found. In the inguinal region, lymphoid tissue with all the typical lymph node compartments was identified following antigenic stimulation in the draining area. Sinuses, germinal centres with a lymphatic corona, and a paracortex with typical high endothelial venules were seen. There was evidence of afferent lymphatics, e.g., macroscopically visible lymphatics, the occurrence of a subcutaneously injected dye, the effect of antigenic stimulation and a normal lymph node structure. Avascular transplants of autologous lymph node fragments regenerate subcutaneously, possibly providing a future technique for treating lymphoedema after radical excision or irradiation of lymph nodes. PMID- 3270995 TI - Treatment of vitiligo with khellin and ultraviolet A. AB - Twenty-eight patients with vitiligo were treated with a new photochemotherapeutic regimen using khellin, a furanochromone, as photosensitizer, together with ultraviolet A (UVA) irradiation. Twenty-five patients received khellin orally and three patients were treated with topical khellin. Treatments were given three times weekly. As opposed to psoralens, khellin did not induce skin phototoxicity with UVA but it induced repigmentation similar to psoralens. The treatment success strongly depended on the number of treatments. More than 70% repigmentation was achieved in 41% of the patients who had received 100 to 200 treatments. This success rate is comparable to the rate obtained with psoralens. Seven patients experienced a mild elevation of liver transaminases within the early treatment phase and their treatments were discontinued. No long-term internal organ or skin toxicity was observed. The major advantage of khellin is that it does not lead to phototoxic skin erythema and thus can be considered safe for home treatment. Because of its photochemistry it may be considered less hazardous than psoralens regarding mutagenicity and carcinogenicity. PMID- 3270996 TI - Topical application of cyclosporine on guinea pig allergic contact dermatitis. AB - Topical cyclosporine applied to the test site substantially inhibited the elicitation reaction of contact sensitivity in the guinea pigs previously sensitized with 2,4-dinitrochlorobenzene (DNCB). This suppressive effect of the drug was short lived and reversible. Cyclosporine was not effective when given six hours or later after antigenic challenge to the test site. Cyclosporine had no effect on the toxic contact reaction in normal animals either to croton oil or to DNCB in high concentration. Cyclosporine applied topically to the challenge site also resulted in a reduction of retest and flare-up reactions of contact sensitivity to DNCB, but did not affect the production of generalized rash in the same animals. These results indicate that in the future local topical application of cyclosporine may make treatment of human cutaneous immune-mediated disorders a possibility without serious side effects. PMID- 3270997 TI - Expression of MHC class II antigens and immunoglobulins in immunized pig foetuses. AB - Pig foetal spleen, liver and thymus cells were examined by using polyclonal antibody to pig immunoglobulins and monoclonal antibody reacting with a light chain determinant of pig MHC class II antigens. Pig foetuses were immunized with flagellin on the 72nd day of prenatal life. On the 14th day following antigen administration, large numbers of class II antigen-bearing cells and Ig-containing cells were demonstrated in the spleen using the immunofluorescence technique. Topographical localization of these cells in cryostat sections was very similar. PMID- 3270998 TI - Prevalence of essential tremor in the Parsi community of Bombay, India. AB - A door-to-door survey for neurologic diseases was conducted in a community of 14,010 people (Parsis living in colonies in Bombay, India). Neurologists used defined diagnostic criteria to evaluate persons with positive results on the screening survey. Two hundred thirty-three people (104 men; 129 women) were identified as having essential tremor. The overall prevalence ratio was 1663.1 [corrected] per 100,000 population. Age-specific prevalence ratios increased with age. Age-adjusted prevalence ratios were similar for men and women. To the best of our knowledge, this is the first community-based survey for essential tremor in Asia. PMID- 3270999 TI - Subtemporal-infratemporal and basal subfrontal approach to extensive cranial base tumours. AB - A subtemporal-infratemporal and basal subfrontal approach for the removal of extensive, predominantly extradural cranial base neoplasms is described. This approach was used successfully in six of our patients. The advantages of this approach are extensive exposure of the anterior and mid-cranial base as well as the clivus, direct exposure and management of the ipsilateral petrous and cavernous internal carotid artery (ICA), and access to extracranial vessels for microvascular flap transfer. Disadvantages include prolonged operative time and less control of the contralateral petrous ICA. Six patients with extensive cranial base neoplasms had operations using this technique without any mortality or major permanent morbidity. The value of this approach to patients in terms of control or cure of extensive cranial base tumours has to be proven by long term follow-up. PMID- 3271000 TI - Congenital "giant" nevus. PMID- 3271001 TI - Buspirone hydrochloride in the treatment of transvestic fetishism. AB - The author presents a case report of a 46-year-old man with generalized anxiety disorder and transvestic fetishism who responded to treatment with buspirone. The patient stopped cross-dressing while taking buspirone, but alprazolam had no effect on the frequency of cross-dressing. The author discusses the implications of using buspirone in the treatment of both inhibited sexual desire and transvestic fetishism. PMID- 3271002 TI - Effect of body posture on radionuclide measurements of gastric emptying. AB - The purpose of this investigation was to compare the effect of body posture on gastric emptying measurements of radiolabeled meals. Eight healthy male subjects were studied on four separate days. During each study subjects were fed a standardized meal of beef stew labeled with technetium-99m sulfur colloid, and orange juice. Measurements of solid-phase gastric emptying rates were obtained by a gamma camera. Subjects were studied in the lying, sitting, standing, or combined sitting-standing postures. The results demonstrated that the lying position significantly slowed gastric emptying compared to all other positions. Conversely, a decrease in emptying times of 51% and 35% occurred in the combined sitting-standing position compared to the lying and sitting position. These results support a marked effect of body posture on the radionuclide measurement of gastric emptying. PMID- 3271003 TI - Cesium-137 in soils from Chernobyl fallout. PMID- 3271004 TI - Diagnostic value of electroencephalography and brainstem auditory evoked potentials in dizziness. AB - Electroencephalogram (EEG) and brainstem auditory evoked potentials (BAEP) were recorded from 142 dizzy patients. The results were compared with those obtained by other neurological examinations of the same patients. Thirty-three percent (N = 44) of the patients had an abnormal EEG: 21% (28) showed focal abnormality, 12% (16) irritative features, and 10% (13) generalized disturbance. There were no differences in the distribution of abnormal EEGs in different diagnostic categories of dizziness, but irritative findings were not found in the cases of peripheral vestibular or psychogenic disturbances. EEG findings in 3 patients suggested temporal epilepsy, correlating with the clinical picture. BAEPs were abnormal in 18% (N = 21) of the recordings. There were 3 cases of MS and 5 ischaemic lesions in the vertebro-basilar region. Twelve of the 13 other patients with abnormal BAEP showed evidence of CNS pathology with other methods. EEG abnormalities were mostly non-specific; however, the irritative findings suggested cerebral pathology, such as epilepsy. An abnormal BAEP offers reliable evidence for brainstem lesion and is thus a useful examination in dizziness. PMID- 3271005 TI - Trapezoidal osteotomy of the distal radius for unacceptable articular angulation after Colles' fracture. AB - Loss of radial palmar tilt in malunion of Colles' fractures alters wrist biomechanics, abnormally loading the tenuous dorsal ligament complex. This can result in midcarpal instability with synovitis, pain, weakness, and possible articular degeneration. An osteotomy to correct radius alignment using a trapezoidal corticocancellous bone graft has been devised. The graft is harvested from the dorsal radius adjacent to the osteotomy and malunion site. When turned 90 degrees, a properly designed trapezoidal graft restores radial length, inclination, and palmar tilt in one step. Functional results in 15 patients at 46 months (range, 18 to 116) were comparable with a series using iliac crest graft and plate- and-screw fixation. This simple technique avoids disruption of the extensor retinaculum and reoperation for hardware removal as Kirschner-wire fixation proved adequate. PMID- 3271006 TI - Idiopathic hypoparathyroidism and paroxysmal dystonic choreoathetosis. PMID- 3271007 TI - A novel biologically active selenoorganic compound. VIII. Biotransformation of ebselen. AB - 1. The metabolism of ebselen, a Se-containing heterocyclic compound, in rats, pigs and human volunteers has been investigated. 2. Unchanged ebselen is not present in urine, plasma or bile. All metabolites of ebselen have in common that the isoselenazolone ring is opened. 3. Both in pigs and human, the dominant metabolite in plasma and urine is a Se-glucuronide. This is the major metabolite in rats as well but, additionally, some selenomethyl-derivatives of ebselen can be detected. PMID- 3271008 TI - An outbreak of a disease in farmed fallow deer (Dama dama L) resembling bovine virus diarrhea/mucosal disease. PMID- 3271010 TI - Research on oral diseases and its impact on dental education and practice. PMID- 3271009 TI - Disinfection methods in general practice and health authority clinics: a telephone survey. AB - Concern about the epidemic of the acquired immune deficiency syndrome led to discussions in one health district about the dangers of cross-infection from instruments in general practice and health authority clinics. In order to establish what current disinfection practices were in use a telephone survey was adopted as a quick and easy method of data collection. Information was collected on who was responsible for disinfection as well as details of how each instrument was disinfected. Results from 69 general practices and 21 health authority clinice in one health district are reported.Some form of sterilizer was used in 63 general practices. These included water boilers (49%), dry heat sterilizers (41%), autoclaves (5%) and pressure cookers (5%). Sixty one practices were using metal vaginal specula and of these 29 were disinfecting by boiling, three were using pressure cookers, 18 dry heat, seven chemical methods, three autoclaves and one the central sterile department of the local hospital. Of those who were boiling after simple washing, three practices boiled for five to 10 minutes and reused instruments during the same clinic. Of the 29 using simple boiling 20 (69%) were boiling for less than 20 minutes.The study highlights the fact that no formal advice has been given on disinfection practice by the DHSS, the health authorities or the family practitioner committees. The need to set up local guidelines and develop practical steps for their introduction are discussed. PMID- 3271011 TI - Future Prospects for the Control of Periodontal Disease. Proceedings of the Sunstar Portside Symposium. November 14-15, 1986. Kobe, Japan. PMID- 3271012 TI - The role of toothbrushing in the prevention and treatment of periodontal disease: personal experience of both clinical and experimental observation for more than thirty years. PMID- 3271013 TI - Light and electron microscopic studies of experimentally-induced pathologic changes in the rat periodontal tissue. PMID- 3271014 TI - Chemotaxis of cells isolated from periodontal tissues to different biological response modifiers. PMID- 3271015 TI - Regeneration of periodontal tissues. PMID- 3271016 TI - Collagen remodeling in wound healing by gingival fibroblasts in vitro. PMID- 3271017 TI - Alkaline phosphatase of human periodontal ligament fibroblast-like cells. PMID- 3271018 TI - Monoclonal antibodies against gingival components. PMID- 3271019 TI - The origin of periodontal infections. PMID- 3271020 TI - The role of Bacteroides gingivalis in periodontal disease. PMID- 3271022 TI - The role of spirochetes in periodontal disease. PMID- 3271021 TI - Actinobacillus actinomycetemcomitans in the pathogenesis of human periodontal disease. PMID- 3271023 TI - Characterization and immunobiologic activities of lipopolysaccharides from periodontal bacteria. PMID- 3271024 TI - Major antigens of human oral spirochetes associated with periodontal disease. PMID- 3271025 TI - The modulation of polymorphonuclear leukocyte function by Bacteroides gingivalis. PMID- 3271026 TI - Immunoregulatory aspects of periodontal disease. PMID- 3271027 TI - Diversity of IgG antibody responses in the patients with various types of periodontitis. PMID- 3271028 TI - Serum immunoglobulin G antibody to periodontal bacteria. PMID- 3271029 TI - Neutrophil defects and host-parasite interactions in the pathogenesis of localized juvenile periodontitis. PMID- 3271030 TI - Neutrophil functions in patients with severe periodontal disease. PMID- 3271031 TI - The function of gingival lymphocytes on the establishment of human periodontitis. PMID- 3271032 TI - Inductive effect of human recombinant IL-1 on differentiation of a macrophage like tumor cell line. PMID- 3271033 TI - Physiological considerations for periodontal health care. PMID- 3271034 TI - Monitoring of subgingival Bacteroides gingivalis and Actinobacillus actinomycetemcomitans in the management of advanced periodontitis. PMID- 3271035 TI - Clinical application of tissue reflectance spectrophotometry to periodontal disease. PMID- 3271036 TI - Prevalence of juvenile periodontitis among students at Nagasaki University. PMID- 3271037 TI - The concentration of salivary steroid hormones and the prevalence of gingivitis at puberty. PMID- 3271038 TI - Periodontal treatment by local drug delivery using resorbable base material. PMID- 3271040 TI - [Osteointegration: surgical principles]. PMID- 3271039 TI - [Radiodiagnosis and treatment plan with osseointegrated implants]. PMID- 3271041 TI - Ordered water structure in an A-DNA octamer at 1.7 A resolution. AB - The crystal structure of the deoxyoctamer d(G-G-Br U-A-BrU-A-C-C) was refined to a resolution of 1.7 A using combined diffractometer and synchrotron data. The analysis was carried out independently in two laboratories using different procedures. Although the final results are identical the comparison of the two approaches highlights potential problems in the refinement of oligonucleotides when only limited data are available. As part of the analysis the positions of 84 solvent molecules in the asymmetric unit were established. The DNA molecule is highly solvated, particularly the phosphate-sugar back-bone and the functional groups of the bases. The major groove contains, in the central BrU-A-BrU-A region, a ribbon of water molecules forming closed pentagons with shared edges. These water molecules are linked to the base O and N atoms and to the solvent chains connecting the O-1 phosphate oxygen atoms on each strand. The minor groove is also extensively hydrated with a continuous network in the central region and other networks at each end. The pattern of hydration is briefly compared with that observed in the structure of a B-dodecamer. PMID- 3271042 TI - Structure of a Z-DNA with two different backbone chain conformations. Stabilization of the decadeoxyoligonucleotide d(CGTACGTACG) by [Co(NH3)6]3+ binding to the guanine. AB - The complex between cobalt hexammine and decadeoxyoligomer d(CGTACGTACG) crystallizes into the space group P65 with unit cell constants a = b = 17.93A, and c = 43.41A. The molecules have the helix axis coincident with the crystal c axis. The decamers stack on top of each other and form a quasi-continuous helix. The structure is disordered. The asymmetric unit is a dimer (pPyr-pPur)2 with each base pair 60% of the time a C-G and 40% of the time a T-A. Restrainted least squares refinement led to an R-factor of 25.5% for 506 observed reflections above the two-sigma level. The structure was found to have one strand in the ZI conformation and the other in the ZII-conformation. The cobalt hexammine binds to two ZII-chains of symmetrically related molecules. On one ZII chain, two ammonia molecules of the cobalt hexammine bind to the N7 nitrogen and 06 oxygen atoms of the guanine bases and a third ammonia to the phosphate anionic oxygen atom of the preceding pyrimidine base, resulting in an "external" binding mode. On the other ZII chain, one ammonia molecule of the cobalt hexammine binds only to the anionic oxygens of the phosphate group of the guanine bases, leading to an "internal" binding mode. Thus, the basis of the stabilization of Z-DNA by [Co(NH3)6]3+ is its binding to only guanine nucleotides. It is surmised that statistical disordering of deoxyoligonucleotide structures which take a Z conformation, depends on the length of the oligomer. That is to say, octamers and decamers (which cannot use an integral number of molecules for a 12 base pair repeat) form disordered structures whereas tetramers and hexamers form well ordered structures. PMID- 3271043 TI - Structures of homopurine-homopyrimidine tract in superhelical DNA. AB - For homopurine-homopyrimidine tracts in superhelical DNA, we propose a structure involving Watson-Crick and Hoogsteen paired triple helixes, hairpin loops and unstructured domains. Topologically, the whole structure is equivalent to an open region. The proposed structure is consistent with available S1 cleavage, pH and alkylation data and energetics under superhelical stress; this new structure is a much more probable candidate than the one proposed by us recently (V.I. Lyamichev, S.M. Mirkin & M.D. Frank-Kamenetskii, J. Biomole. Str. Dyns 3, 327 338, 1985). PMID- 3271045 TI - The kinetics of DNA helix-coil subtransitions. AB - The kinetic analysis of individual helix-coil subtransitions were performed by comparing melting and renaturation profiles obtained at different temperature change rates. The duration of the three transition stages and its dependence on temperature and ionic strength were determined for a T7 phage DNA fragment. The obtained temperature dependence of the melting time for a stretch flanked by melted regions is in quantitative agreement with that predicted by the theory of slow processes (V.V. Anshelevich, A.V. Vologodskii, A.V. Lukashin, M.D. Frank Kamenetskii, Biopolymers 23, 39 (1984)). The reasons are discussed for the increasing relaxation time of this stretch in the middle of its transition with decreasing ionic strength. The zipping kinetics of a melted region under essentially nonequilibrium conditions was examined for T7 fragment and pAO3 DNAs. The obtained temperature dependence of the zipping time is in quantitative agreement with calculations based on the theory of slow processes. The renaturation times of stretches flanked by helical regions proved fairly small even at a low ionic strength. These times are several orders of magnitude smaller than the renaturation times of the same stretches with one helical boundary. A formal application of the theory of slow processes failed to account for the small renaturation times of stretches that are zipped from both ends. This is probably due to the non-allowance for the changing entropy of the loop linking two helix-coil boundaries migrating towards each other. Slow processes have been revealed in the intramolecular melting of Col E1 DNA at a high ionic strength. The reason for the long relaxation time of one subtransition is the large size of the loop that separates the melting stretch from the helical part of the molecule. This result can be accounted for by the theory of slow processes. PMID- 3271044 TI - Interpretation of DNA vibration modes: I--The guanosine and cytidine residues involved in poly(dG-dC).poly(dG-dC) and d(CG)3.d(CG)3. AB - A normal coordinate analysis has been carried out on guanosine and cytidine residues appearing in oligo and polynucleotides by using a simplified valence force field that allows the vibrational spectra of 5'-dGMP and 2'-deoxycytidine molecules to be reproduced. The role of both C2'-endo and C3'-endo conformations on sugar pucker, as well as that of glycosidic torsion angle (X), on several characteristic vibration modes of these residues have been studied. The present calculations based on a non-redundant set of internal coordinates preserving the harmonic approximation of the potential field, allows us to explain quite satisfactorily the modifications of the vibrational spectra in the 1550-1250 cm-1 and 785-500 cm-1 regions, when the right----left-handed conformational transition occurs. PMID- 3271046 TI - Contextual constraints on codon pair usage: structural and biological implications. AB - Complementary DNA sequence data of 278 protein coding genes from prokaryotic systems have been analysed at the level of near neighbour codon pairs. Our analysis points out that constraints exist even at the level of near neighbour codon pairs. These constraints are in addition to those which arise due to relative levels of tRNA. Codon pairs, which in the data base have different occurrence values from their expected values, neither have common secondary structure nor do have better stabilization due to high base stacking. Our study points out that there are strong interaction between constituent codons in these codon pairs. These strongly interacting codon pairs, we suggest, are involved in the formation of three dimensional structural elements of cDNA/mRNA and interact with ribosome and thus modulate translation. PMID- 3271047 TI - Simulation of interactions between nucleic acid bases by refined atom-atom potential functions. AB - Energy of interaction between nitrogen bases of nucleic acid has been calculated as a function of parameters determining the mutual position of two bases. Refined atom-atom potential functions are suggested. These functions contain terms proportional to the first (electrostatics), sixth (or tenth for the atoms forming a hydrogen bond) and twelfth (repulsion of all atoms) powers of interatomic distance. Calculations have shown that there are two groups of minima of the base interaction energy. The minima of the first group correspond to coplanar arrangement of the base pairs and hydrogen bond formation. The minima of the second group correspond to the position of bases one above the other in almost parallel planes. There are 28 energy minima corresponding to the formation of coplanar pairs with two (three for the G:C pair) almost linear N-H . . . O and (or) N-H . . . N hydrogen bonds. The position of nitrogen bases paired by two such H-bonds in any crystal of nucleic acid component in polynucleotide complexes and in tRNA is close to the position in one of these minima. Besides, for each pair there are energy minima corresponding to the formation of a single N-H . . . O or N-H . . . N and one C-H . . . O or C-H . . . N hydrogen bond. The form of potential surface in the vicinity of minima has been characterized. The results of calculations agree with the experimental data and with more rigorous calculations based on quantum-mechanical approach. PMID- 3271048 TI - 13C-NMR of ribosyl ApApA, ApApG and ApUpG. AB - The chemical shifts as well as the 13C-31P coupling constants of the carbon-13 nuclei in single-stranded ApApA, ApApG, and ApUpG are sensitive to sequence and temperature. ApApA and ApApG have similar properties with large shielding (up to 1.7 ppm) of many of the base carbons upon decreasing the temperature from 70 degrees C to 11 degrees C; the base carbons have smaller shielding changes in ApUpG. Large shielding and deshielding effects are observed for the 1', 3', 4' and 5'-carbons over this temperature range. Analysis of the 13C-31P couplings measured at the 4' ribose carbons show that the population of the anti rotamer about O5'-C5' varies from 98 to 75%, and is higher in ApApA and ApApG than in ApUpG. The CCOP coupling data at 2' and 4' is consistent with a blend of the antiperiplanar/-synclinal nonclassical rotamers about the C3'-O3' bond, varying from 89/11% in ApApG to 55/45% in ApUpG. The coupling and chemical shift data support the thesis that ApUpG is stacked much less than the other two molecules. The stacked forms of all three trinucleotides is most easily interpreted by a standard A-RNA model. It is not necessary to invoke the "bulged base" hypothesis [Lee, C.-H. and Tinoco, Jr., I. (1981) Biophysical Chemistry 1, 283-294; Lankhorst, P.P., Wille, G., van Boom., J.H., Altona, C., and Haasnoot, C.A.G. (1983) Nucleic Acids Research 11, 2839-2856] to explain the contrast in 13C spectroscopic properties of ApUpG in comparison to ApApG and ApApA. PMID- 3271049 TI - Aliphatic amino acid side chains associate with the "face" of the adenine ring. AB - We have synthesized the free amino acid adenylate anhydrides of phenylalanine, leucine, isoleucine and valine. These activated compounds are very labile at high pH, but at low pH they become more stable. Proton NMR spectra of these adenylates show that in every case, the hydrophobic side chains, even in these small molecules at low pH and low concentration, are associated with the "face" of the adenine ring. Although aromatic rings are known to associate with adenine in this fashion, to our knowledge this is the first report of an intercalative-type interaction of aliphatic side chains with nucleic acid bases. Since adenine is the most hydrophobic base, these interactions are of a hydrophobic character, and occur in spite of the fact that the adenine ring is protonated. These results may have implications regarding recognition processes in DNA-protein and RNA-protein interactions. PMID- 3271050 TI - Fluorescence studies on the coat protein of alfalfa mosaic virus. AB - The intrinsic luminescence of different forms of the alfalfa mosaic virus (AMV) strain 425 coat protein has been studied, both statically and time resolved. It was found that the emission of the protein (Mr 24,250), which contains two tryptophans at positions 54 and 190 and four tyrosines, is completely dominated by tryptophan fluorescence. The high fluorescence quantum yield indicates that both tryptophans are emitting. Surprisingly, the fluorescence decay is found to be strictly exponential, with a lifetime of 5.1 nsec. Similar results were obtained for various other forms of the protein, i.e. the 30-S polymer, the mildly trypsinized forms of the protein lacking the N-terminal part and the protein assembled into viral particles. Virus particles and proteins of stains S and VRU gave similar results, as well as the VRU protein polymerised into tubular structures. The fluorescence decay is also monoexponential in the presence of various concentrations of the quenching molecules acrylamide and potassium iodide. Stern-Volmer plots were linear and yield for the coat protein dimer with acrylamide a quenching constant of 4.5* 10(8) M-1 sec-1. This indicates that the tryptophans are moderately accessible for acrylamide. For the 30-S polymer a somewhat smaller value was found, whereas in the viral Top a particles the accessibility of the tryptophans is still further reduced. From the decay of the polarisation anisotropy of the fluorescence of the coat protein dimer the rotational correlation time was obtained as 35 nsec. Since this roughly equals the expected rotational correlation time of the dimer as a whole, it suggests that the tryptophans are contained rigidly in the dimer. The results show that in the excited state of the protein the two tryptophans are strongly coupled and suggest that the trp-trp distance is smaller than 10 A. Because the coat protein occurs as a dimer, the coupling can be inter- or intramolecular. The implications for the viral structure are discussed. PMID- 3271051 TI - Intravenous oxygenation with lactated Ringer's solution. AB - This experimental work was performed on 4 rabbits to demonstrate that administrations of oxygenated Ringer's lactate through the central venous infusion could be used as a means of oxygenation. The oxygen tensions of Ringer's lactate were determined upon changing the amount of oxygen being bubbled and the solutions with the mean PO2 and pH of 575.5 mmHg and 6.34 were used in this study. We did not use the solutions having the values below 416.6 mmHg PO2 and pH 6.08. After the infusion of the oxygenated solution through central vein, PaO2 values throughout the 1 hour experimental procedure were significantly increased above the control value. Other parameters such as pH, PaCOs, HCO3-, BE, O2 saturation did not show any statistically significant changes. Some degree of oxygenation could be obtained by infusing the oxygenated Ringer's solution. This suggested that oxygenation by infusion through the central venous line could used clinically in the treatment of some forms of hypoxia with hypovolemia. PMID- 3271052 TI - A case of aneurysm of the vein of Galen. AB - Aneurysm of the vein of Galen is a very rare disease. The authors present a case of secondary aneurysm of the vein of Galen which was confirmed by characteristic clinical symptoms, brain CT and angiographic findings. The patient was a 14-year old right handed girl with intermittent headache, nausea, vomiting, dysphasia and gait disturbance. Neurologic examination revealed dysarthria, nasal voice, blurring of both margins of optic discs, truncal ataxia and dysdiadochokinesia. Sensory function was normal but right hemiparesis was seen. Roentgenogram of the skull revealed diffuse thinning of the calvarium, widening of sella turcica and erosion of clinoid processes. Computed tomogram of the brain showed dilatation of all ventricles and round hyperdense mass behind the third ventricle in the midline. The lesion was enhanced markedly and homogeneously. Left and right internal carotid angiograms showed arteriovenousmal-formation with drainage to the aneurysm of the vein of Galen. PMID- 3271053 TI - Disseminated neonatal herpes simplex virus infection with necrotizing encephalitis--an autopsy case. AB - An autopsy case of disseminated HSV type 2 infection occurring in a neonate at 32 weeks' gestation, delivered by cesarean section after premature rupture of membrane of 7 days duration, is presented. Herpes simplex virus type 2 was isolated from the vesicular skin lesion. The mother and patient had specific antibody to type 2 herpes simplex virus. Patient's parents had denied any herpetic orolabial or genital lesion during or before this pregnancy. Cultures from the cervical and vaginal swabs of the mother were negative for HSV. Postmortem examination showed hepatic necrosis, skin vesicle, devastating necrotizing inflammation of the brain, chorioretinitis and interstitial pneumonitis. PMID- 3271054 TI - Intestinal Behcet's disease in a child--a case report. AB - Behcet disease is relatively rare in pediatric age group. And the bowel involvement is seen in only a small portion of Behcet disease. However, once the bowel is involved it is potentially life threatening event. We report a 15 year old boy with intestinal Behcet's disease who had a history of recurrent oral and genital ulcers for several years. He underwent right hemicolectomy under the impression of intestinal tumor. Pathologically the lesion was a large sharply delineated ulcer in the cecum. The ulcer was round and deep with elevating margin, and was associated with thickening of affected intestinal wall. Microscopically, the ulcer base consisted of granulation tissue with fissurings and underminings. Characteristic phlebitis and occlusive arterial lesion were seen in intestinal wall. The inflammatory lesion was most pronounced around the ulcer but could be recognizable throughout the resected specimen. PMID- 3271055 TI - Crohn's disease--a case report. AB - A case of rather typical Crohn's disease in a 10 year old girl is described. She had suffered from intractable abdominal pain, diarrhea and fever for 1 year. Eventual right hemicolectomy revealed diffuse involvement of terminal ileum, cecum and ascending colon by confluent ulcerations and transmural inflammation. Histologically there were numerous well developed non-caseating granulomas scattered transmurally and in regional lymph nodes. Deep penetrating ulcerations were characteristic. Acid fast staining failed to demonstrate any organism. The rarity of Crohn's disease in Korea and this occurrence in pediatric age prompted this report. PMID- 3271056 TI - Intramural sparganosis manifested as intestinal obstruction--a case report. AB - A case of intramural sparganosis of jejunum presenting as intestinal obstruction is described. Resected intestine from a 48 year old man with acute abdomen revealed a degenerated sparganum in the submucosa with typical tissue reaction and extensive edema. The tissue reaction was basically granulomatous, consisting of layers of inner palisading histiocytes and outer mononuclear cell infiltration. Many calcospherules were prominent within the degenerated worm. Eosinophil infiltration was scanty. PMID- 3271058 TI - The cellular basis of morphogenesis. PMID- 3271057 TI - A combined regimen of etretinate and UVB modulate T6+ and HLA-DR+ epidermal cells. AB - Using anti-T6 and anti-HLA-DR monoclonal antibodies, this study was designed to attain what would do to epidermal Langerhans cell (LC) markers in psoriatic patients when two remedies, etretinate and UVB, having controversial effects on LC were put to use simultaneously. In normal and psoriatic subjects, HLA-DR+ LC was approximately 80% of T6+ LC and a single dose of UVB equivalent to minimal erythema dose (MED), reduced LC membrane markers to approximately 30% of non irradiated control. The recovery of LC membrane markers, after a single dose of UVB exposure were significantly faster in the group of etretinate treated psoriatic subject than only UVB irradiated psoriatic control. Taken together, seemed to exert prompt recovery of normalization of the number of LC from the depletion following the UVB. PMID- 3271059 TI - Manipulation of mammalian development. PMID- 3271060 TI - [DNA-DNA homology and phenotypic characterization of environmental strains of Vibrio parahaemolyticus and Vibrio pelagius]. AB - A taxonomic study by means of DNA homology and the most recent phenetic criteria has been carried out in 11 environmental strains of Vibrio parahaemolyticus and 4 of Vibrio pelagius, previously ascribed to the respective phenons in a numerical taxonomy study. The strains of V. parahaemolyticus showed genetic homogeneity, a guanine plus cytosine content (G + C) of 46% and 61% homology with V. parahaemolyticus type strain ATTC 17802. They exhibited phenetic atypicalities but could be ascribed to the species V. parahaemolyticus. The strains of V. pelagius behaved similarly in regard to the phenotype, but were genetically heterogeneous; they showed a % G + C of 44-46 and were assigned to V. splendidus V. pelagius homology group. PMID- 3271062 TI - Self-regulation of the Earth as a living organism. PMID- 3271061 TI - Potassium ion accumulation in cells of different halobacteria. AB - Halobacteria live in extremely hypersaline environments accumulating K+ as compatible solute. We have studied the accumulation of intracellular potassium in recently isolated halobacteria with relatively moderate salt response, and compared it with the classical halobacteria with very extreme salt response. Significant differences have been found, the more moderate group having lower intracellular K+ concentrations. Some experiments have been carried out concerning the energy dependence of this K+ accumulation, which indicate that the moderate group seems to be less dependent on metabolic energy. The results are consistent with existence of different degrees of halophilia among halobacteria, probably corresponding to adaptation to different habitats. PMID- 3271063 TI - Transfection of MDCK cells with influenza virus ribonucleoprotein complexes. AB - Influenza virus ribonucleoprotein complexes isolated from MDCK-infected cells have been used to optimize transfection conditions of MDCK cells. Ribonucleoprotein complex-mediated infection was strictly dependent on pretreatment of the cell cultures, resistant to mild NP40 treatment and sensitive to RNase treatment. Under optimal conditions, up to 10(4) plaque forming units per microgram of viral RNA could be obtained. PMID- 3271064 TI - Characterization of an Aeromonas hydrophila strain isolated on a septicemic out break in a fish-farm of Spain. AB - An Aeromonas hydrophila strain (AH-3) was isolated from a septicemic out-break on a gold-fish farm near Barcelona (Spain). On the bases of their virulence and surface characteristics was classified as moderate to weakly virulent. PMID- 3271065 TI - The annual cycle of zooplankton-associated Vibrio cholerae and related vibrios in Albufera lake and its coastal surrounding waters (Valencia, Spain). AB - Most probable numbers of zooplankton-associated Vibrio spp. and V. cholerae were determined in Albufera lake, Spain, and in its coastal receiving waters throughout a year. Highest counts of 10(5) bacterial cells/g of plankton were associated to high temperatures and were also related to the kind of water. All isolates were non-01 serovars, and most belonged to Heiberg groups I and II. PMID- 3271066 TI - Structure of antischistosome compounds. IV. (3-Bromopropyl)triphenylphosphonium bromide. AB - C21H21BrP+.Br-, Mr = 464.2, monoclinic, P2(1)/c, a = 11.165(2), b = 10.160(2), c = 17.614(3)A, beta = 104.99(1) degree, V = 1930.08 A3, Z = 4, Dx = 1.597 g cm-3, graphite-monochromatized Cu K alpha radiation, lambda = 1.5418 A, mu = 61.6 cm-1, F(000) = 928, T = 292 K. Final R = 0.052 for 3255 observed reflections with I greater than 3 omega (I). Structure solved by direct methods. The bromopropyl moiety is in an extended conformation with the gauche+ C-C-C-Br torsion angle orienting the C-Br vector in a direction similar to the direction of the N-Br vector observed in the (2-aminoethyl)triphenylphosphonium bromide hydrobromide structure and the cyano vector in the (3-cyano-propyl)triphenylphosphonium bromide structure. PMID- 3271067 TI - Structural investigation of (1-methylimidazole)-2,3,7,8,12,13,17,18 octaethylporphinatozinc( II). AB - [Zn(C36H44N4)(C4H6N2)], [Zn(OEP)-(1-MeIm)], Mr = 680.26, monoclinic, P2(1)/n, Z = 4, F(000) = 1448, a = 14.099 (3), b = 17.762 (2), c = 14.475 (2) A, beta = 95.48 (1) degrees, V = 3608.4 A3, T = 294 +/- 1 K. The calculated and observed densities are 1.25 and 1.26 g cm-3. 5700 observed reflections (measured with Mo K alpha radiation, lambda = 0.71073 A) were used to refine the structure to a final R1 = 0.072 and wR = 0.098. The complex crystallizes isomorphously with [Co(OEP)(1 MeIm)] and similarities and differences in side-chain disorder and core conformations are described. The average Zn-Np bond distance is 2.068 (7) A and the axial Zn-N(Im) distance is 2.106 (4) A. The zinc(II) atom is displaced 0.42 (1) A from the porphyrin mean plane. The 1-methyl-imidazole ligand plane makes a dihedral angle of 10.5 degrees with a Zn-Np vector. This orientation of the 1 methylimidazole ligand corresponds well with that of previously determined imidazole metalloporphyrin structures and further indicates that the preferred orientation of imidazole ligands is essentially insensitive to the dn configuration of the metal ion of the metalloporphyrin. PMID- 3271068 TI - (Z,Z)-1,1'-(1,6-hexanediyl)bis(2-phenyldiazene) 2,2'-dioxide: a bis(azoxy) compound. AB - C18H22N4O2, Mr = 326.40, orthorhombic, Pbca, a = 19.475 (10), b = 10.435 (20), c = 8.762 (20) A, V = 1780.6 A3, Z = 4, Dx = 1.22 g cm-3, lambda(Mo K alpha) = 0.7107 A, mu = 0.76 cm-1, F(000) = 696, room temperature, 1564 reflections averaged from two octants, R = 0.044, wR = 0.050 for 669 observed reflections with I greater than sigma(I). The molecule has inversion symmetry and is nearly planar. The azoxy group is trans-substituted. Molecular packing is in herringbone type layers. PMID- 3271069 TI - Structure of 8-methyl-8-azabicyclo[3.2.1]oct-3-yl 3,5-dichlorobenzoate methylsulfate monohydrate (MDL 72222), an antagonist at neuronal 5-HT receptors. AB - C15H18Cl2NO2+.CH3SO3-.H2O, Mr = 428.33, triclinic, P1, a = 7.457 (2), b = 8.389 (1), c = 15.916 (3) A, alpha = 79.59 (1), beta = 85.63 (2), gamma = 87.16 (2) degrees, V = 975.8 (2) A3, Z = 2, Dx = 1.46 g cm-3, lambda (Cu K alpha) = 1.54178 A, mu = 42.32 cm-1, F(000) = 448, room temperature, R = 0.041 for 2419 independent observed reflections. The cation can be described in terms of the tropane group and an approximately planar dichlorobenzoate group. This conformation is compared with those of some structurally related anticholinergic agents. PMID- 3271070 TI - Structure of 3-isoadenosine. AB - 3-beta-D-Ribofuranosyladenine, C10H13N5O4, Mr = 267.25, orthorhombic, P2(1)2(1)2(1), a = 13.470 (4), b = 16.054 (6), c = 5.141 (2) A, V = 1111.8 (7) A3, Z = 4, Dx = 1.596 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 1.18 cm-1, F(000) = 560, T = 298 K, R = 0.043, wR = 0.042 for 1136 reflections. The tautomeric form present in the crystal is 6-NH2. The adenine moiety is nearly planar and the torsional angle of the glycosidic linkage O(4')-C(1')-N(3)-C(4) is -161.5 degrees. All N and O atoms except N(3) and O(4') participate in a three dimensional hydrogen-bonding system. PMID- 3271072 TI - Structure of 6-dodecyl-2-methoxy-1,4-benzoquinone, a new synthetic contact allergen. AB - C19H30O3, Mr = 306.45, triclinic, P-1, a = 5.453 (1), b = 5.608 (1), c = 30.129 (2) A, alpha = 85.85 (1), beta = 88.66 (1), gamma = 83.02 (1) degree, V = 912.0 (1) A3, Z = 2, Dx = 1.116 Mg m-3, Cu K alpha radiation, lambda = 1.5418 A, mu = 0.548 mm-1, F(000) = 336, T = 296 K, R is 0.040 for 2489 observed unique reflections. The aliphatic side chain is slightly rotated from the quinone ring. The angle between the quinone-ring plane and the mean dodecyl-chain plane is 20.8 (2) degrees. The average Csp3-Csp3 bond lengths and corresponding angles of the side chain are 1.515 (5) A and 113.8 (3) degrees. The average dimensions of the quinone ring are C-C 1.477 (4), C = C 1.337 (4), C = O 1.222 (3) A, C-C-C 118.9 (3), C = C-C 120.6 (3), O = C-C 120.6 (3)degrees. Neighbouring molecules form dimers by C-H...O interactions across centres of symmetry [C(3)...O(3) 3.413 (2) A]. The dimers are linked together via methyl H and carbonyl O along [100] [C(19)...O(3) 3.338 (3) A]; O(3) is a bifurcated acceptor. PMID- 3271071 TI - Structures of chloro(glycinato)(1,10-phenanthroline)copper(II) monohydrate (I) and aqua(1,10-phenanthroline)(L-phenylalaninato)copper(II) nitrate monohydrate (II). AB - (I) [CuCl(C2H4NO2)(C12H8N2)].H2O, Mr = 371.28, orthorhombic, P2(1)2(1)2(1), a = 6.795 (3), b = 12.496 (4), c = 17.273 (5) A, V = 1467 (1) A3, Dx = 1.680 Mg m-3, Z = 4, F(000) = 756, lambda(Mo K alpha) = 0.71069 A, mu(Mo K alpha) = 1.742mm-1. Room temperature. Final R = 0.046 for 1302 unique observed reflections. (II) [Cu(C9H10NO2)(C12H8N2)(H2O)]NO3.-H2O, Mr = 505.98, monoclinic, P2(1), a = 5.782 (2), b = 20.700 (6), c = 9.355 (3) A, beta = 97.58 (2)degrees, V = 1110 (1) A3, Dx = 1.514 Mg m-3, Z = 2, F(000) = 522, lambda(Mo K alpha) = 0.71069 A, mu(Mo K alpha) = 1.076 mm-1. Room temperature. Final R = 0.069 for 1929 unique observed reflections. The Cu ion displays distorted square-pyramidal coordination in both (I) and (II), with the chlorine atom (I) or the water molecule (II) in the apical position. The Cu-N bond lengths alter according to the electronegative character of the trans atom. The conformations of the five-membered chelate rings appear to depend on H bonding and van der Waals interactions. PMID- 3271073 TI - Structural comparison of 1-bromo- and 1-fluoroestradiol with D-estradiol. AB - 1-Bromoestra-1,3,5(10)-trien-3,17 beta-diol, C18H23BrO2, Mr = 351.3, orthorhombic, P2(1)2(1)2(1), a = 9.3864 (12), b = 12.927 (2), c = 12.948 (2) A, V = 1571.1 (4) A3, Z = 4, Dx = 1.484 Mg m-3, lambda(Mo K alpha) = 0.71069 A, mu = 259 mm-1, F(000) = 728, T = 298 K, R = 0.0514 for 2083 observed reflections. 1 Fluoroestra-1,3,5(10)-trien-3,17 beta-diol.0.5H2O, C18-H23FO2.0.5H2O, Mr = 299.4, orthorhombic, P2(1)2(1)2, a = 12.046 (4), b = 19.358 (5), c = 6.656 (2) A, V = 1552.1 (7) A3, Z = 4, Dx = 1.28 Mg m-3, lambda(Mo K alpha) = 0.71069 A, mu = 86 mm-1, F(000) = 644, T = 293 K, R = 0.0776 for 2781 observed reflections. Except for the carbon-halogen bond, bond angles and bond lengths of 1-bromoestradiol are within 7 e.s.d.'s of estradiol. Bond angles and bond lengths of 1-fluoroestradiol are within 11 and 7 e.s.d.'s of estradiol, respectively. The molecular conformations are nearly identical to that of estradiol. Like estradiol, 1 fluoroestradiol is present as a hemihydrate and extensive hydrogen bonding is observed. 1-Bromoestradiol is not hydrated and hydrogen bonding is limited to hydroxyl groups along the c axis. PMID- 3271074 TI - Structure of 3'-azido-3'-deoxythymidine, AZT. AB - C10H13N5O4, Mr = 267.2, monoclinic, P2(1), a = 5.716 (3), b = 11.998 (8), c = 17.658 (10) A, beta = 94.26 (4) degrees, V = 1208 A3, Z = 4, D chi = 1.47 g cm-3, lambda (Mo K alpha) = 0.71069 A, mu = 7.5 cm-1, F(000) = 560, T = 293 K. R = 0.060 for 2138 unique observed [F greater than 4 sigma (F)] reflections. The N glycosidic torsion angles chi have values -125.9 (5) and -172.0 (5) degrees, in the anti range. (Molecule-A values are given first throughout.) The sugar puckers are 2(3)T (C3'-exo/C2'-endo), with P = 171 (1) degrees and psi m = 14 (1) degrees, and 4(3)T (C4'-endo/C3'-exo), with P = 213 (1) degrees and psi m = 11 (1) degrees. The C4-C5 conformations, with gamma = 49.7 (5) and 173.7 (5) degrees, are + sc (gauche-gauche) and ap (gauche-trans). The conformational parameters used follow the guidelines of the IUPAC-IUB Joint Commission on Biochemical Nomenclature [Pure Appl. Chem. (1983), 55, 1273-1280]. The molecules in the asymmetric unit form a hydrogen-bonded, base-paired dimer. The bonding is as follows: N3A-0.973 A-H3A... 1.790 A...O2B, N3A...O2B 2.747 (8) A, angle at H3A 167 degrees and N3B-0.992 A-H3B...1.916 A...O2A, N3B...O2A 2.894 (8) A, angle at H3B 168 degrees. The propeller twist between the bases is 5 degrees [Wilson & Tollin (1987). Nucleosides Nucleotides, 6, 643-653]. PMID- 3271075 TI - The structure of Te(OH)6.Na3P3O9.K3P3O9. AB - The structure of this compound, originally described in space group C2/c [Averbuch-Pouchot & Durif (1987). Acta Cryst. C43, 1653-1655] is properly described as rhombohedral, space group R3c, with a = 12.355 (4) A, a = 51.01 (2) degrees, Z = 2. (Hexagonal cell: a = 10.640 (4), c = 32.16 (2) A, Z = 6). Revised coordinates are given. PMID- 3271076 TI - (3,6-Dimethyl-3,6-diazaoctan-1,8-dithiolato-S1,N3,N6,S8)oxotechnetium(V) pertechnetate. AB - [TcO(C8H18N2S2)]TcO4, Mr = 484.2, monoclinic, P2(1)/c, a = 7.447 (2), b = 16.952 (8), c = 12.236 (3) A, beta = 99.63 (2) degrees, V = 1523 (1) A3, Z = 4, D chi = 2.112, Dm = 2.09 (1) Mg m-3, lambda(Mo K alpha) = 0.71069 A, mu = 2.06 mm-1, F(000) = 952, T = 295 (1) K, final R = 0.071 for 2496 significant reflections and 173 parameters. The Tc atom is bound to the oxo group and the N and S atoms of the complex ligand in a rough square pyramid. The Tc atom lies 0.770 (3) A out of the S,N,N',S' plane. This plane is significantly distorted such that N and N' lie nearly 0.25 A out of the plane on opposite sides. The Tc-S bonds [2.238 (3), 2.266 (3) A] are short but other bond lengths and angles are normal. PMID- 3271078 TI - Structures of acetylcholine picrate and methoxycarbonylcholine picrate hemihydrate. AB - Acetylcholine picrate, C7H16NO2+.C6H2N3-O7-, Mr = 374.3, orthorhombic, Pbca, at 105 K: a = 18.799 (4), b = 7.726 (2), c = 22.878 (4) A, V = 3323 (2) A3, Z = 8, Dm(295 K, flotation) = 1.44, D chi(105 K) = 1.496 Mg m-3, mu(Mo K alpha) = 0.120 mm-1, F(000) = 1568, m.p. (hot-stage microscope) 381-382 K, R = 0.048 for 1049 observed [I greater than or equal to 3.0 sigma(I)] reflections. Methoxycarbonylcholine picrate hemihydrate, C7H16NO3+.C6H2N3O7-.1/2H2O, Mr = 399.3, monoclinic, P2/n, at 105 K: a = 11.337 (16), b = 7.279 (2), c = 21.424 (13) A, beta = 103.01 (7) degrees, V = 1723 (4) A3, Z = 4, Dm(295 K, flotation) = 1.49, D chi(105 K) = 1.539 Mg m-3, mu(Mo K alpha) = 0.126 mm-1, F(000) = 836, m.p. (hot-stage microscope) 391-391.5 K, R = 0.033 for 6359 observed [I greater than or equal to 3.0 sigma(I)] reflections. The acetylcholine ion as well as the methoxycarbonylcholine ion have as first neighbours a great number of oxygen atoms. Contacts to the quaternary ammonium group do not seem to be more important than contacts to the acetyl or methoxy-carbonyl moieties. No direct contacts between aromatic rings and quaternary ammonium groups are found. PMID- 3271077 TI - Structure of cis-Pt(asb)2Cl2, a platinum(II) complex with a styrylbenzothiazole ligand. AB - cis-Bis[2-(2-acetoxystyryl)benzothiazole]dichloroplatinum(II), [PtCl2(C17H13NO2S)2], Mr = 856.7, triclinic, P1, a = 12.145 (6), b = 12.859 (4), c = 11.021 (5) A, alpha = 105.88 (3), beta = 90.64 (4), gamma = 87.64 (4) degrees, V = 1654 (2) A3, Z = 2, D chi = 1.72 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 46.1 cm-1, F(000) = 840, T = 296 K, final R = 0.029 for 6121 unique observed reflections. The [PtCl2(asb)2] complex has square-planar geometry about the Pt, with the asb coordinated to the Pt through the N of the thiazole ring. The average Pt-N and Pt-Cl bond distances are 2.035 (1) and 2.287 (5) A. The ligand is non-planar with an average dihedral angle of 36 (3) degrees between the benzothiazole and the benzene rings. The dihedral angles between the platinum coordination plane and the benzothiazole and benzene rings are 78 (4) and 69 (7) degrees respectively. The acetoxybenzene rings in the two ligands have different orientations with respect to the olefin C atoms. PMID- 3271079 TI - Conformation of methylated amino acids: structure of 3,4-dimethoxy-alpha-methyl DL-phenylalanine sesquihydrate. AB - C12H17NO4.1.5H2O, Mr = 266.3, triclinic, P1, a = 5.872 (1), b = 11.437 (2), c = 20.434 (1) A, alpha = 95.74 (1), beta = 96.91 (1), gamma = 89.18 (1) degrees, V = 1355.5 A3, Z = 4, Dm = 1.29, D chi = 1.305 g cm-3, lambda(Cu K alpha) = 1.5418 A, mu = 8.3 cm-1, F(000) = 572, T = 294 K, R = 0.038 for 4006 reflections, I greater than or equal to 3 sigma(I). Both the molecules A and B in the asymmetric unit exist as zwitterions. With respect to the D enantiomer, the torsion angles psi 1 and psi 2 are +47.2 and -134.4 degrees in molecule A and +33.3 and -147.5 degrees in molecule B respectively. The torsion angles of the alpha-methyl group, NH3+ and COO- groups with respect to Cv are in molecules A and B respectively +67.2, +66.8, -174.3, -175.6, and -59.2 and -59.5 degrees. The hydrogen-bonding environment of water OW1 is trigonal nonplanar; OW2 is trigonal planar and OW3 is tetrahedral. The crystal structure is stabilized by a number of hydrogen bonds involving the amino and carboxylate groups of both molecules A and B and the water molecules. PMID- 3271080 TI - Structure and conformation of a nucleoside analog 5-nitro-1-beta-D arabinofuranosyluracil. AB - C9H11N3O8, Mr = 271, orthorhombic, P2(1)2(1)2(1), a = 9.241 (2), b = 20.518 (4), c = 6.187 (1) A, V = 1173.1 A3, Z = 4, D chi = 1.29 g cm-3, Mo K alpha, lambda = 0.7107 A, mu = 1.57 cm-1, F(000) = 600, T = 288 K, final R = 0.051 for 1078 observed reflections. Conformational features of the nucleoside include a glycosidic bond conformation in the anti range, a ribose moiety in the C(2')-endo (2E) form and the C(5')-(5') bond gauche to both C(4')-O(4') and C(4')-C(3'). PMID- 3271081 TI - Structure of antischistosome compounds. III. (3-Cyanopropyl)triphenylphosphonium bromide. AB - C22H21NP+.Br-, Mr = 410.3, monoclinic, P2(1)/c, a = 11.284 (1), b = 10.236 (1), c = 17.392 (2) A, beta = 105.33 (45) degrees, V = 1937.37 A3, Z = 4, D chi = 1.407 g cm-3, graphite-monochromatized Cu K alpha radiation, lambda = 1.5418 A, mu = 37.1 cm-1, F(000) = 840, T = 292 K. Final R = 0.044 for 3335 observed reflections. Structure solved by direct methods. The cyanopropyl moiety is in an extended conformation. However, the C-C-C-C torsion angle in this group is gauche+, which points the cyano group in a direction similar to the direction of the N-Br1 vector observed in the (2-aminoethyl)triphenylphosphonium bromide hydrobromide structure and the C-Br vector in the (3 bromopropyl)triphenylphosphonium bromide structure. This suggests a basis for the biological activities of these three compounds. PMID- 3271082 TI - Structure of 4-methylumbelliferyl-beta-D-glucopyranoside. AB - C16H17O8.1.5H2O, Mr = 364.33, monoclinic, C2, a = 14.314 (3), b = 6.851 (1), c = 18.178 (5) A, beta = 100.90 (2) degrees, V = 1750.46 A3, Z = 4, D chi = 1.382 Mg m-3, lambda(Mo K alpha) = 0.71069 A, mu = 0.933 mm(-1), F(000) = 768, T = 294 K, R = 0.078 for all 2160 reflections. The structure is characterized by the close stacking along the b axis of the planar 4-methylumbelliferyl ring system which is nearly perpendicular to b and the extensive hydrogen bonding scheme in which all hydroxyl groups are within 2.95 A of at least two other O atoms. PMID- 3271083 TI - Structure of 5-methyl-2'-deoxycytidine. AB - C10H15N3O4, Mr = 241.2, orthorhombic, P2(1)2(1)2(1), a = 10.454 (1), b = 11.922 (1), c = 9.057 (1) A, V = 1128.9 (1) A3, Z = 4, D chi = 1.419 Mg m-3, Cu K alpha radiation, lambda = 1.54178 A, mu = 0.95 mm-1, F(000) = 512, room temperature, R = 0.029 for 1186 observed reflections. The molecule has a typical C(2')-endo (2E) furanose ring associated with an anti base. The methyl substituent at C(5) causes a decrease of 2.6 degrees in the endocyclic bond angle at C(5). The ring oxygen O(4') is involved in an intermolecular hydrogen bond. PMID- 3271084 TI - N-benzyloxycarbonyl-L-aminosuccinyl-L-phenylalaninamide (Z-L-Asu-L-Phe-NH2). AB - C21H21N3O5, Mr = 395.42, orthorhombic, P2(1)2(1)2(1), a = 5.935 (2), b = 13.037 (1), c = 25.992 (2) A, V = 2011 (1) A3, Z = 4, D chi = 1.31 Mg m-3, lambda(Cu K alpha) = 1.5418 A, mu = 0.74 mm-1, F(000) = 832, room temperature, final R = 0.046 for 1343 observed reflections. The title compound adopts a type II' beta turn conformation in the solid state, stabilized by a 4----1 intramolecular hydrogen bond between the CO of the protecting benzyloxycarbonyl group and the NH2 of the terminal amide group. These results indicate that the beta-turn conformation, already found in the solid state for peptides embodying the sequence Asu-Gly or Asu-Ala, is highly preferred, even when the residue next to the aminosuccinyl moiety has a bulkier side chain. In the crystal, rows of hydrogen-bonded molecules are held together by van der Waals forces between hydrophobic phenyl groups. PMID- 3271085 TI - Polymorph IV of 4-amino-N-2-pyridinylbenzenesulfonamide (sulfapyridine). AB - C11H11N3O2S, Mr = 249.3, monoclinic, P2(1)/c, a = 13.56 (4), b = 6.48 (1), c = 14.12 (3) A, beta = 113.7 (1) degrees, V = 1136.4 (44) A3, Z = 4, D chi = 1.457 g cm-3, lambda(Mo K alpha) = 0.70926 A, mu = 2.29 cm-1, F(000) = 520, T = 291 K, final R = 0.085 for 1287 independent observed reflections. Sulfapyridine is a sulfonamide drug with antibacterial, antithyroid and antidiabetic properties. The molecule exhibits the same conformation as in all except one of the polymorphs previously studied, despite a hydrogen-bonded packing mode which differs from that observed in the three earlier reported polymorphs. Form IV exhibits three hydrogen bonds of the type N...N = 2.91 (1) A and N...O = 3.007 (7) and 3.076 (7) A. PMID- 3271086 TI - [Crystalline structure of L-glycyl-L-leucyl-L-phenylalanine hemihydrate]. AB - C17H25N3O4.1/2H2O, Mr = 344.4, monoclinic, B2, a = 18.299 (6), b = 18.781 (6), c = 5.917 (3) A, gamma = 110.65 (3) degrees, V = 1902.9 (10) A3, Z = 4, Cu K alpha, lambda = 1.54178 A, mu = 0.73 mm-1, F(000) = 740, D chi = 1.202 Mg m-3, room temperature, final R = 0.048 and wR = 0.048 for all (1470) reflections. The molecules are stacked in layers along the alpha axis. There are five intermolecular hydrogen bonds. PMID- 3271087 TI - [Crystalline structure of L-leucyl-L-leucyl-L-tyrosine chlorhydrate]. AB - C21H34N3O5+.Cl-, Mr = 444.0, orthorhombic, P2(1)2(1)2(1), a = 26.074 (5), b = 17.591 (4), c = 5.224 (2) A, V = 2396.1 (10) A3, Z = 4, Cu K alpha, lambda = 1.5418 A, mu = 1.71 mm-1, F(000) = 952, D chi = 1.231 Mg m-3, room temperature, final R = 0.080 and wR = 0.070 for 2439 reflections [(sin theta)/lambda greater than 0.03 A-1]. The peptide groups are planar; torsion angles (-101 and -88 degrees) indicate a roughly helical structure. The peptide bonds have a trans conformation. The crystal structure is stabilized by a network of hydrogen bonds. PMID- 3271088 TI - The structure and absolute configuration of acetomycin. AB - C10H14O5, Mr = 214.22, orthorhombic, P2(1)2(1)2(1), a = 14.1084 (6), b = 10.6443 (3), c = 7.1970 (1) A, V = 1080.80 (6) A3, Z = 4, D chi = 1.317 Mg m-3, Cu K alpha, lambda = 1.5418 A, mu = 0.8571 mm-1, F(000) = 456, T = 293 K, R = 0.052 for 816 observed [3 sigma (I)] Friedel pairs. The determined absolute configuration may be described as 3S, 4R, 5R, the five-membered ring having an envelope conformation, with the bulky substituents at cis positions. The bond lengths and angles are in agreement with those of the bromoacetoxy derivative. PMID- 3271089 TI - Structure of bis(methanol)(meso-tetraphenylporphinato)manganese(III) hexachloroantimonate bis(tetrachloroethane) solvate. AB - [Mn(C44H30N4)(CH3OH)2] [SbCl6].2C2H2Cl4, Mr = 1401.93, triclinic, P1, a = 11.104 (3), b = 12.086 (6), c = 12.619 (4) A, alpha = 115.33 (3), beta = 104.75 (2), gamma = 91.75 (3) degrees, V = 1461.3 A3, Z = 1, Dm = 1.58, D chi = 1.59 Mg m-3, lambda(Mo K alpha) = 0.71073 A, mu = 1.359 mm-1, F(000) = 698, T = 293 K, R = 0.079 for 4822 unique observed reflections. The manganese ion is coordinated to two methanol oxygens, Mn--O = 2.283 (5) A, and four porphinato nitrogen atoms, average Mn--N = 2.002 (5) A. PMID- 3271090 TI - Structure of C32H34N2O5S2: corrigendum. AB - The structure of this compound [Olszak, Stepien, Wajsman, Grabowski, Glinka & Lecocq (1987). Acta Cryst. C43, 2169-2171], which contains a 13-membered heterocyclic ring, was described as triclinic, space group P1, with a = 12.756 (3), b = 9.950 (3), c = 13.566 (3) A, alpha = 90.49 (1), beta = 118.04 (1), gamma = 90.04 (1) degrees, Z = 2. It should be described as monoclinic, space group C2/c, with a' = 23.947 (6), b' = 12.756 (3), c' = 9.950 (3) A, beta' = 90.57 (3) degrees, Z = 4. The C2/c coordinates are given. The molecule lies on an exact, rather than an approximate, twofold axis. PMID- 3271091 TI - Structure of 3-O-acetylgibberellin A3. AB - C21H24O7, Mr = 388.4, orthorhombic, P2(1)2(1)2(1), a = 13.279 (10), b = 15.615 (10), c = 9.427 (8) A, V = 1954.7 A3, Z = 4, D chi = 1.319 g cm-3, lambda(Mo K alpha) = 0.71069 A, mu = 1.0 cm-1, F(000) = 824, T = 293 K, R = 0.049 for 1805 observed reflections. The gibberellane skeleton shows the conformational variety characteristic of many other gibberellin derivatives. Ring A is in a sofa conformation while the five-membered ring B assumes an intermediate conformation between an envelope and a half-chair. The lactone ring is in an ideal envelope conformation and shows a marked difference in its two C-O distances. Each molecule is hydrogen bonded to two others to form continuous spiral chains along the c axis. PMID- 3271092 TI - Structure of salicylaldehyde thiosemicarbazone. AB - C8H9N3OS, monoclinic, C2/c, a = 14.206 (3), b = 14.244 (4), c = 10.457 (4) A, beta = 116.18(2) degrees, V = 1898.9 (8) A3, Z = 8, Dm = 1.387, D chi = 1.366 g cm-3, lambda(Mo K alpha) = 0.71069 A, mu = 2.90 cm-1, F(000) = 816.0, T = 298 K, final R = 0.0429 for 1322 observed reflections. The S and hydrazinic N atoms lie trans. The lowering of antibacterial activity compared to that of 4 phenylthiosemicarbazide may be correlated with the decrease in negative charge on the hydrazinic N atom. The crystal structure is stabilized by hydrogen bonding, stacking interactions and van der Waals forces. PMID- 3271093 TI - Structure of a 3 alpha-(D-methylglycoside) of 7,8 beta-epoxysinogenin--a cardioactive steroid. AB - C30H42O10, Mr = 562.66, orthorhombic, P2(1)2(1)2(1), a = 10.125 (1), b = 15.632 (2), c = 36.115 (4) A, V = 5716 (1) A3, Z = 8, Dm = 1.312 (2) (flotation), D chi = 1.308 g cm-3, Cu K alpha(lambda = 1.5418 A), mu = 7.18 cm-1, F(000) = 2416, T = 295 K. Final R(F) = 0.07 for 3348 significant reflections with I greater than or equal to 2.5 sigma(I). The A, B, C, D rings of the aglycone ring are found to be in cis-trans-cis fashion forming a buckled structure. The lactone is in C17 beta conformation. The molecules are stabilized by intermolecular hydrogen bonds. The longest direction of the steroid molecule is nearly parallel to the a axis. The conformational features exhibited by the molecule support proposals on activity. PMID- 3271094 TI - Two polymorphs of 2-bis[(2-hydroxyphenylmethylene)amino]methylphenol. AB - C21H18N2O3, Mr = 346.4, monoclinic, C2/c, a = 17.230 (3), b = 12.322 (2), c = 19.675 (3) A, beta = 121.265 (12) degrees, V = 3571 (2) A3, Z = 8, D chi = 1.289 g cm-3, lambda(Cu K alpha) = 1.54184 A, mu = 6.70 cm-1, F(000) = 1456, T = 296 K, R = 0.039 for 3209 observations (of 3691 unique data); triclinic, P1, a = 7.678 (2), b = 10.822 (2), c = 12.539 (2) A, alpha = 63.34 (2); beta = 74.92 (2); gamma = 84.04 (2) degrees, V = 899.1 (4) A3, Z = 2, D chi = 1.279 g cm-3, lambda(Cu K alpha) = 1.54184 A, mu = 6.65 cm-1, F(000) = 364, T = 299 K, R = 0.036 for 3095 observations (of 3399 unique data). Distances and angles are quite similar in the two structures. There are two strong intramolecular hydrogen bonds between a phenolic oxygen and an imino nitrogen in each structure. The intermolecular hydrogen bonds between two phenolic oxygens are closer in the monoclinic crystal than in the triclinic. This closer packing produces the higher melting point for the monoclinic polymorph. PMID- 3271095 TI - 1-Methoxy-3-(2-nitro-1-imidazolyl)-2-propanol (misonidazole). AB - C7H11N3O4, Mr = 201, monoclinic, P2(1)/c, a = 6.997 (1), b = 7.862 (1), c = 17.024 (3) A, beta = 97.06 (2) degrees, U = 929.4 (5) A3, Z = 4, D chi = 1.44 Mg m-3, lambda(Cu K alpha) = 1.5418 A, mu = 0.916 mm-1, F(000) = 424, ambient temperature, R = 0.049 for 1324 unique reflections. All bond lengths and angles have normal values and the planes of the nitro group and imidazole ring form a dihedral angle of 7.9 (1) degrees. PMID- 3271096 TI - Structure of a styrylbenzothiazole platinum(II) complex: [NEt4][PtBr3(asb)]. AB - Tetraethylammonium tribromo[2-(2- acetoxystyryl)benzothiazole]platinate(II), [(C2H5)4N]-[PtBr3(C17H13NO2S)], Mr = 860.4 monoclinic, P21/c, a = 11.230 (9), b = 19.333 (4), c = 13.685 (6) A, beta = 101.06 (4) degrees, V = 2916 (4) A3, Z = 4, D chi = 1.96 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 90.3 cm-1, F(000) = 1648, T = 296 K, final R = 0.047 for 3384 unique observed reflections. The [PtBr3(asb)]- unit has square-planar geometry about the Pt, with the asb coordinated to the Pt through the N of the thiazole ring and a Pt-N bond distance of 2.010 (8) A. The average Pt-Br distance is 2.426 (7) A. The ligand is non planar with a dihedral angle of 22.4 (7) degrees between the benzothiazole and the acetoxybenzene rings. The dihedral angles between the platinum coordination plane and the benzothiazole and benzene rings are 85.7 (1) and 71.3 (3) degrees respectively. PMID- 3271097 TI - Structure of a peptide surrogate, tert-butoxycarbonylalanyl-psi(CH2S) phenylalanine [Boc-Ala-psi(CH2S)-Phe-OH]. AB - C17H25NO4S, Mr = 339.5, monoclonic, C2 a = 24.927 (8), b = 5.252 (4), c = 16.867 (7) A, beta = 122.70 (1) degree, V = 1858.2 (9) A3, Z = 4, D chi = 1.21 g cm-3, lambda(Mo K alpha) = 0.71069 A, mu = 1.83 cm-1, F(000) = 728, T = 295 K. The final R value for 1466 independent observed reflections is 0.075. The thiomethylene dipeptide analogue possesses a C alpha i...C alpha i+1 distance somewhat smaller than in the extended amide counterpart due to a partially folded structure, especially in the C-terminal region. Pairs of molecules are held together by O-H...O = C (carboxylic acid) hydrogen bonds. PMID- 3271098 TI - Anonamine, C19H27NO7, neosenkirkine, C19H27NO6, and hydroxysenkirkine, C19H27NO7.CH3OH. Macrocyclic secopyrrolizidine alkaloids from Senecio anonymus Wood. AB - lambda(Mo K alpha) = 0.71069 A, T = 298 K. Anonamine (I) (12,21-dihydroxy-4 methyl-4,8-secosenecionan-8,11,16-trione): C19H27NO7, Mr = 381.2, monoclinic, C2, a = 24.247 (7), b = 8.766 (2), c = 9.072 (1) A, beta = 99.21 (2) degrees, U = 1903.3 (8) A3, Z = 4, Dm = 1.32 (1), D chi = 1.330 g cm-3, mu(Mo K alpha) = 1.09 cm-1, F(000) = 816. Neosenkirkine (II) (12-hydroxy-4-methyl-4,8-secosenecionan 8,11,16-trione): C19H27NO6, Mr = 365.2, monoclinic, C2, a = 24.45 (1), b = 8.781 (2), c = 9.029 (2) A, beta = 98.99 (3) degrees, U = 1915 (1) A3, Z = 4, Dm = 1.27 (1), D chi = 1.267 g cm-3, mu(Mo K alpha) = 1.01 cm-1, F(000) = 784. Hydroxysenkirkine (III) [12,18-dihydroxy-4-methyl-4,8-secosenecionan-8, 11,16 trione-methanol (1/1)]: C19H27NO7.CH3OH, Mr = 413.2, orthorhombic, P2(1)2(1)2(1), a = 9.052 (3), b = 13.150 (4), c = 17.404 (8) A, U = 2071 (1) A3, Z = 4, Dm = 1.33 (1), D chi = 1.325 g cm-3, mu(Mo K alpha) = 1.10 cm-1, F(000) = 888. Full matrix least squares refinement converged at R values of 0.042, 0.043 and 0.051 for 3163, 2894 and 2896 reflections for (I), (II), (III), respectively. All three crystals exhibit hydrogen bonds, including intramolecular O11...HO12 and intermolecular O8...HO12. In addition, intermolecular hydrogen bonds appear in (I) between O21...HO21' and in (III) between O8...HOCH3. The observed N...C8 distances across the eight-membered otonecine rings were 2.200, 2.245 and 1.712 A in (I), (II) and (III) respectively. PMID- 3271099 TI - Redetermination of the crystal and molecular structure of the antimalarial chloroquine bis(dihydrogenphosphate) dihydrate. AB - N4-(7-Chloro-4-quinolinyl)-N',N'-diethyl-1,4-pentanediamine bis(dihydrogenphosphate) dihydrate, C18H28ClN2+(3).2H2PO-4-2H2O, Mr = 551.8, monoclinic, P2(1)/c, a = 9.830 (2), b = 16.879 (3), c = 15.783 (4) A, beta = 105.51 (2) degrees, V = 2523.2 A3, Z = 4, Dx = 1.452 g cm-3, Mo K alpha, lambda = 0.71073 A, mu = 2.78 cm-1, F(000) = 1168, room temperature, final R = 5.5% for 2431 reflections with [F0] greater than 3 sigma. The chloroquine molecule is a dication with a hydrogen atom from each of the phosphate moieties residing on the quinoline and the terminal chain nitrogen atoms. Neighboring phosphate chains are bridged by chloroquine molecules via hydrogen bonding. Each hydrogen atom on each nitrogen atom, on each phosphate oxygen atom, and in each water molecule participates in hydrogen bonding. The helical manner in which the side chains of the chloroquine molecules wrap around phosphate chains and the stacking interval of the quinoline rings between the phosphate groups may be indicative of the interaction of chloroquine molecules with cellular constituents important to antimalarial action. PMID- 3271100 TI - 9-Amino-1,2,3,4-tetrahydroacridine hydrochloride monohydrate (THA.HCl). AB - C13H15N2+.Cl-.H2O, Mr = 252.74, monoclinic, P2(1)/c, a = 8.776(2), b = 8.514(1), c = 18.046 (4) A, beta = 107.09 (2) degrees, V = 1288.8 (5) A3, Z = 4, D chi = 1.302 Mg m-3, lambda (Cu K alpha) = 1.5418 A, mu = 0.238 mm-1, F(000) = 536, T = 293 K, final R = 0.042 for 2080 observed data. Atoms C2 and C3 of the reduced ring are disordered. The crystal structure has an extensive network of hydrogen bonds in which the water molecule donates its H atoms to two Cl ions and accepts the H atom from the protonated ring N atom. The amino group also donates its H atoms in hydrogen bonding to two Cl ions. PMID- 3271101 TI - Structure of chlorobis(dicyclohexylphenylphosphine)gold(I). AB - [AuCl[C6H11)2(C6H5)P]2], Mr = 781.2, monoclinic, P2(1), a = 11.117 (4), b = 13.606 (5), c = 12.284 (4) A, beta = 109.59 (3) degrees, V = 1753 (2) A3, Z = 2, D chi = 1.48 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 43.8 cm-1, F(000) = 792, T = 296 K, final R = 0.024 for 3239 unique observed reflections. The formation of complexes of the type LnAuX, where L is a phosphine, and X is halide or pseudohalide, shows considerable dependence on the nature of the phosphine. When L = Ph3P, three- and four-coordinated complexes are very easily prepared. However, for L = Cy3P, only linearly coordinated complexes could be isolated. The geometry of the title complex, with L = CyPhP, is best described as distorted trigonal planar. The P-Au-P angle is 158.24 (5) degrees while the P-Au-Cl angles are 92.63 (6) and 108.71 (6) degrees. Au-P distances are 2.300 (1) and 2.324 (1) A while Au-Cl is 2.744 (2) A. PMID- 3271102 TI - Cryocrystallography of biological macromolecules: a generally applicable method. AB - Methods have been developed that allow facile X-ray data collection for biological macromolecules at cryogenic (near liquid N2) temperatures. The crystals are first transferred from their mother liquor to a hydrocarbon environment, then mounted with a standard glass fiber (no capillary), and flash cooled in situ with a cold nitrogen stream on the diffraction apparatus. This approach prevents freezing of the solvent in the crystals, so that they maintain their crystallographic integrity. Significant improvement of resolution can result from the cryogenic data collection, and radiation damage in the cooled crystals is greatly reduced, or eliminated, for the duration of data collection. PMID- 3271103 TI - Structure of native porcine pancreatic elastase at 1.65 A resolutions. AB - The structure of native porcine pancreatic elastase in 70% methanol has been refined using film data to 1.65 A resolution, R = 0.169. A total of 134 molecules of water (but no methanol) has been refined. This structure, because of its native state and modestly high resolution, serves as the basis for comparison with other elastase structures complexed with natural or synthetic ligands. Internal structured water occupies distinct regions. Two regions (IW1 and IW7) suggest a mechanism for equalizing 'hydrostatic pressure' related to ligand binding and release. A third region (IW4) forms part of a hydrogen-bonding network linking the catalytic Ser 195 O gamma with a remote (13.4 A) surface of the enzyme. A comparison with the structures of all known serine proteases reveals that a linkage of Ser O gamma to remote surface is conserved in all cases, suggesting that the accepted catalytic mechanism of serine proteases needs to be re-evaluated. One possible mechanism for base catalysis of Ser O gamma H proton extraction is presented. PMID- 3271104 TI - More space-group changes. AB - Revised structures are reported for 19 crystalline compounds, based on space groups of higher symmetry than originally reported. In four cases the Laue symmetry is changed, one from 1 to 2/m and three from 2/m to mmm; in the remaining fifteen a center of symmetry has been added. For eight of these latter compounds we have obtained F values and carried out least-squares refinements in the centrosymmetric space groups, with more satisfactory results than originally reported. PMID- 3271105 TI - Synchrotron X-ray data collection and restrained least-squares refinement of the crystal structure of proteinase K at 1.5 A resolution. AB - The structure of the serine endopeptidase proteinase K (279 amino acid residues; 28,790 daltons) has been refined by restrained least-squares methods to a conventional R value of 16.7% employing synchrotron film data of 30,812 reflections greater than 3 sigma in the 5.0 to 1.5 A resolution range. During refinement, the molecular structure was restrained to known stereochemistry, with root-mean-square (r.m.s.) deviation of 0.015 A from ideal bond lengths. The average atomic temperature factor, B, is 11.1 A2 for all atoms. The final model comprises 2020 protein atoms and 174 solvent molecules (which were given unit occupancies). Four corrections to the amino acid sequence were made, which were confirmed later by sequence analysis of the proteinase K gene: a deletion of one glycine in position 80; a change of sequence in position 207-208 and insertions of the dipeptide 210-211 and of residue 270. The r.m.s. deviation in the alpha-C atomic positions between the final refined model and the initial model built on the basis of a 3.3 A mini-map is 1.72 A for 227 out of 266 residues, which were originally traced in the mini-map without sequence information. The positions of the remaining 39 residues deviate by more than 8 A from the original ones and are located in regions where extensive revision of the structural model was necessary. PMID- 3271106 TI - The use of pseudosymmetry in the rotation function of gamma IVa-crystallin. AB - Bovine lens gamma IVa-crystallin crystallizes in space group C222(1) with cell dimensions a = 35.1, b = 46.2, c = 186.2 A, and contains one molecule in the asymmetric unit. The structure was determined at 3.0 A resolution using cross rotation functions and R-factor searches with the bovine lens protein gamma II crystallin as the model structure. The rotation function appears to be very sensitive to the resolution range and type of coefficient employed; the use of normalized structure-factor amplitudes gave the best results. The potential problem of a pseudo solution due to an internal pseudo-twofold axis was put to advantage by aligning this axis parallel to z. The results of the R-factor search were well defined. The molecular replacement solution was improved by rigid-body least-squares refinement, initially of the whole molecule, then for the two domains. The R factor at this stage was 39.4% at 2.3-10.0 A. The gamma IVa structure has an even higher internal symmetry than gamma II, since the two domains are related by a rotation around the pseudo-twofold axis of 178.7 degrees as compared with 176.2 degrees for gamma II. PMID- 3271107 TI - Screened precession method for area detectors. AB - A method is presented in which the features of a Buerger-type mechanical precession camera can be simulated using an electronic area detector and a three circle automated goniostat. The resulting display as viewed on a video monitor is very much like a conventional precession photograph. The detector is stationary which causes a distortion that is negligible for precession angles less than 10 degrees. The virtue of this new method is that a precession image may be collected very fast and the intensities of the reflections when displayed are already digitized. The usefulness of these features is presented through two familiar tasks: the determination of a new protein crystal space group and the evaluation of a heavy-atom derivative. PMID- 3271108 TI - A model for the hydrogen-bond-length probability distributions in the crystal structures of small-molecule components of the nucleic acids. AB - The probability distributions of the N-H...O = C and O-H...O = C hydrogen-bond lengths observed in the crystal structures of the purines, pyrimidines, nucleosides and nucleotides have been fitted to a one-dimensional hydrogen-bond potential-energy function. In order to obtain a quantitative correspondence between the experimental and theoretical distributions, it is necessary to include with the usual hydrogen-bond-type potential-energy function, an effective crystal-packing force and two thermodynamical parameters of the crystal lattice, the Debye temperature and the Gruneisen constant. PMID- 3271109 TI - Thermal vibrations and electrostatic properties of parabanic acid at 123 and 298 K. AB - The crystal structure of parabanic acid (1H,3H-imidazoletrione, C3H2N2O3, Mr = 114.1) at 123 K [monoclinic, P2(1)/n, Z = 4, a = 10.704 (2), b = 8.187 (2), c = 4.969 (1) A, beta = 92.32 (1)o] has been determined by neutron and X-ray diffraction. Neutron reflections [1658, (sin theta)/lambda less than or equal to 0.78 A-1, lambda = 1.0470 (1) A, mu = 0.75 cm-1] in full-matrix least-squares refinement (wR = 0.055) gave nuclear parameters with bond lengths having estimated standard deviations (e.s.d.'s) of 0.001 A. X-ray reflections [3150 with magnitude of F magnitude of greater than or equal to 3 sigma and (sin theta)/lambda less than or equal to 1.3 A-1, Mo Ka, lambda = 0.7093 (1) A, mu = 1.708 cm-1] were used in full-matrix least-squares refinement (R = 0.022) assuming Stewart's rigid pseudoatom model, so as to determine the charge-density distribution. Sharp features near the O nuclei in the residual electron density map noted by Craven & McMullan (CM) [Acta Cryst. (1979), B35, 934-945] in their 298 K study were absent at 123 K. New refinements using CM's 298 K data give significant third-order thermal parameters for O atoms due to anharmonic molecular stretching, with good agreement between probability density functions, (p.d.f.'s) from X-ray and neutron diffraction. When deconvoluted from the thermal vibrations in the crystal, deformation charge densities derived at 298 and 123 K are in satisfactory agreement and conform closely to the 2 mm symmetry of the isolated molecule. The molecular dipole moment is 2.3 (3) D [7.7 (10) x 10(-30) C m]. A map of molecular electrostatic potential indicates that the carbonyl O atoms in parabanic acid are weakly electronegative. This is confirmed by calculation of the electrostatic energy of interaction for the two distinct H bonded pairs of molecules isolated from the crystal. Energy values are weakly attractive [-7 (3) and 5 (2) kJ mol-1]. Similar calculations are less reliable for pairs of molecules forming intermolecular C....O distances as short as 2.75 A. However, depending on the model, energy values are repulsive or negligibly small. Thus the high stability of parabanic acid crystals (m.p. 516 K with decomposition) cannot be explained. PMID- 3271110 TI - Structure and molecular orbital study of ergoline derivatives. 1-(6-Methyl-8 beta ergolinylmethyl)imidazolidine-2,4-dione (I) and 2-(10-methoxy-1,6-dimethyl-8 beta ergolinyl)ethyl 3,5-dimethyl-1H-2-pyrrolecarboxylate toluene hemisolvate (II) and comparison with nicergoline (III). AB - (I): C19H22N4O2 (Registry No. 95688-34-9), m.p. greater than 573 K, Mr = 338.4, orthorhombic, P2(1)2(1)2(1), a = 8.392 (2), b = 13.004 (2), c = 15.676 (5) A, V = 1710.7 (7) A3, Z = 4, Dx = 1.31 Mg m-3, Mo Ka radiation, lambda = 0.71069 A, mu = 0.08 mm-1, F(000) = 720, T = 293 K, final R = 0.051 for 990 independent reflexions. (II): C26H33N3O3.1/2C7H8 (Registry No. 54370-23-9), m.p. 427-429 K, Mr = 481.64, monoclinic, P2(1), a = 11.595 (4), b = 14.274 (2), c = 16.103 (4) A, beta = 100.19 (3) degrees, V = 2623 (1) A3, Z = 4, Dx = 1.22 Mg m-3, Mo Ka radiation, lambda = 0.71069 A, mu = 0.07 mm-1, F(000) = 1036, T = 293 K, final R = 0.064 for 2738 independent reflexions. Two independent molecules constitute the asymmetric unit, together with a toluene molecule. Parallel investigations of the title compounds by single-crystal X-ray analysis and theoretical calculations have converged in showing an extended configuration of the side chain attached at the C8 atom of the ergoline nucleus. PMID- 3271111 TI - Exact random-walk models in crystallographic statistics. IV. P.d.f.'s of [E] allowing for atoms in special positions. AB - The effect of scatterers, located in variable special positions, on the probability density function of the magnitude of the normalized structure factor has been investigated. Exact characteristic functions have been obtained for all the statistically different variable special positions in triclinic, monoclinic and ortho-rhombic space groups except in Fdd2 and in the space groups based on the point group 222, and the probability density functions have been evaluated from their Fourier or Fourier-Bessel series expansions. It is seen that the effect of heavy scatterers, located in the special positions investigated, is very marked and should be accounted for in cases of space-group ambiguities. PMID- 3271112 TI - Direct methods: the identification of space-group-specific inconsistent three phase structure invariants. AB - Certain space groups often permit the generation of pairs of triple relationships involving the same three parent reflections in different symmetry forms, giving rise to two equally probable invariant estimates which, because of the space group symmetry, must disagree by an a priori known phase shift. The 230 space groups have been examined to identify those which permit inconsistent triples, and the complete list which describes the forms of the pair of triples and their phase inconsistency is given. PMID- 3271113 TI - Direct methods: the identification of conditions which simplify the generation of inconsistent quadrupoles. AB - An algorithm is implemented to determine the form and phase shift for inconsistent type II quadrupoles for any space group having glide or screw-axis translations which are not a consequence of lattice centering. Cumulatively there are only six different Miller index restrictions and nine different phase shift forms common to all space groups of orthorhombic or lower symmetry. A similar analysis has been performed for a newly discovered type III class of quadrupoles. The configuration of the phase connections among the four triples of the type III quadrupole is different from the common configuration previously described for both normal (type I) and inconsistent (type II) quadrupoles. A knowledge of these constraint conditions for type II and III quadrupoles greatly simplifies a procedure for generating these relationships. PMID- 3271114 TI - A priori estimation of scale and overall anisotropic temperature factors from the Patterson origin peak. AB - An idea due to D. Rogers [Computing Methods in Crystallography (1965), edited by J. S. Rollett, pp. 117-148. Oxford: pergamon Press] has been developed and implemented. The method is an advantageous alternative to Wilson plot or K-curve scaling of intensity data. On the relative experimental scale the structure factor can be written in matrix notation as F(h) = kappa -1 sigma j fj(h) exp (2 pi ih tau xj) exp (-h tau bjh); and the squared structure-factor magnitude can be written as magnitude of F(h)2 = kappa -2 exp (-2h tau bh) [sigma j fj2+ 2 sigma j sigma k greater than jfjfk exp [2 pi ih tau (xj-xk)]], if a a common, or average, anisotropic temperature factor is factored out of the atomic summations. The fj2 summation corresponds to the Patterson origin peak, and the fjfk double summation to the off-origin Patterson peaks. A tovariate Gaussian density function, P(u) Pmin = Po exp (-u tau pu), is fitted by least squares to the origin peak from a Patterson synthesis with coefficients magnitude of F2 meas/sigma jf2j. Fourier inversion of the fitted Gaussian gives the scale and thermal parameters, k2 = (detp)1/2/(pi 3/2 Vcell Po) and b = (pi 2/2)p-1. The fit of the parameter Pmin is constrained by the condition that Pmin = -F(000)2/(k2Vcell sigma j Zj2), and thus only po and the six coefficients pij (i less than j = 1,2,3) are independent parameters. PMID- 3271115 TI - Biaxial tensors for anomalous scattering of X-rays in selenolanthionine. AB - X-ray pleochroism is observed near the Se K absorption edge in a monoclinic crystal of selenolanthionine monohydrate using linearly polarized synchrotron radiation and is explained by a simple molecular-orbital model. The complex anomalous-scattering tensor of selenium, measured by diffraction in a tetraronal crystal of the anhydrous compound, exhibits anisotropy nearly 6 for f' and 7 for f", the most yet found for a K edge. The crystal structure was determined for D-( )-selenolanthionine, space group P4(3)2(1)2, a = 6.651 (2), c = 21.758 (5) A, Z = 4, R = 0.027 for 304 unique reflections. PMID- 3271116 TI - Validity domain of the weak-phase-object approximation for electron diffraction of thin protein crystals. AB - The domain of validity of the weak-phase-object (WPO) approximation is evaluated for high-energy electrons (100 keV, 500 keV and 1 MeV) scattered by crystalline biological macromolecules. Cytochrome b5 is used as an example in which calculated dynamical diffraction intensities are used to simulate observed diffraction intensities which are then compared with intensities calculated by the weak-phase-object approximation. Three criteria of validity are used, namely the crystallographic residual (R value), the interpretability of difference Patterson maps, and the results of phasing by the heavy-atom isomorphous replacement method. The present calculations indicate that the error associated with the WPO approximation is quite acceptable up to a specimen thickness of 200 A for 100 keV electrons, which is two to four times the thickness limit for crystalline organic structures with much smaller unit-cell dimensions. An equally acceptable thickness limit at 500 keV and 1MeV is about 300-350 A. PMID- 3271117 TI - Peripheral ossifying fibroma/ossifying fibrous epulis. AB - This is a case report of a reactive lesion which occurs only in the gingiva. This lesion is of a long duration causing erosion of the superficial bone. Histologically it is similar to other epulides of the gingiva but in addition contains ossified tissue. The lesion's confusing terminology is being discussed in view of its understanding to an American-trained or a British-trained surgeon. A review of literature showed a recurrence rate of 7-20% thus making it mandatory for a close follow-up of the patient. PMID- 3271118 TI - The role of bacterial surface components in periodontal destruction. AB - This paper reports the activity associated with capsule-derived material and lipopolysaccharide extracted from Actinobacillus actinomycetemcomitans on connective tissue cells. The ability of lipopolysaccharide (LPS) to initiate inflammatory and destructive processes in the pathogenesis of periodontal disease was compared to that of capsular material (CM). The biological activities investigated were cytotoxicity to fibroblasts, stimulation of in-vitro bone resorption and Interleukin 1-like activities. PMID- 3271119 TI - Fate of betel nut chemical constituents following nut treatment prior to chewing and its relation to oral precancerous & cancerous lesion. AB - Areca (betel) nuts are popularly used as chewing agents. The nuts are chewed as such or processed by roasting, sundrying, soaking or boiling prior to chewing. Various agents such as slaked lime, tobacco, betel leaves are often incorporated into the chew. The habits of betel chewing are closely associated with oral cancer and precancerous lesions. The literature is repleted with numerous works on carcinogenicity of areca nut. It was demonstrated that the incorporation of lime and tobacco to the nut increase the incidence of mucosal changes. Chewers of soaked or boiled nuts demonstrated lower incidence of mucosal changes than those chewers of raw, sundried or roasted nuts. Estimation of the active chemical constituents in the nuts namely arecoline and polyphenols following nut treatments by sundrying, roasting, soaking and boiling, revealed reduction in these chemical contents. Marked reductions were observed when the nuts were subjected to soaking and boiling. These reductions may explain for the different in the incidence of the mucosal changes among users of different processed nut varieties. PMID- 3271120 TI - The dental health of factory workers in Pasir Gudang, Johor (Malaysia). AB - A study on the oral health status of 198 factory workers (in Antara Steel, Pasir Gudang, Johor) was carried out in November 1986. The subjects were predominantly male (94%) and Malay (91%) with an average age of 27.4 years. The prevalence of caries was 87.4% with a mean DMFT of 7.1 + 5.4. There were 3 subjects with full upper, lower dentures and 16 subjects with partial dentures. Two subjects examined needed dentures but were not wearing them. Thirty five (17.7%) of those examined needed urgent extractions, and 8 needed emergency treatment for fillings. Enamel opacities were found in 141 subjects (75.6%) but only 9 were aware of these defects. Dental health was very poor with 72% examined needing scaling. Seventeen (9%) had gross supra and subgingival calculus. There was a total of 107 (54%) smokers and heavy nicotine stains were found in 41 (20.7%), of the population examined. Examination of soft tissues showed 111 (56%) subjects with recurrent aphthous ulcers whilst 15 (7.6%) suffered from herpes labialis. Five subjects (2.5%) suffered from denture stomatitis whilst the prevalence of other soft tissue lesions was very low. PMID- 3271121 TI - Histological variation of the lining epithelium of the calcifying odontogenic cyst. A light microscopic study. AB - The lining epithelium of thirty cases of calcifying odontogenic cysts (COC) was studied light microscopically. Results show two distinct types: 1. the classical highly-differentiated lining epithelium characterised by a basal layer of columnar cells with nuclear polarisation supporting suprabasally several layers of stellate reticulum-like cells and containing variable amount of ghost cells present in all the cases and a necessary criteria for the diagnosis of COC; 2. the undifferentiated lining epithelium which is of 2-3 cells to 5-8 cells thick, non-, para- or orthokeratinised and resembled reduced enamel epithelium. This is seen in some cases in some parts of the cystic lining. Variations within the highly-differentiated epithelium include spindle-cell change, epithelial pearl formation and ghost cell dominant type. In the present series, ten cases were associated with odontome formation, three with melanin pigment and one with clear cells. The study supports the concept that COC are lesions of odontogenic origin that may arise as primary lesions from the remains of the dental epithelium or secondarily from the lining epithelium of pre-existing lesions. PMID- 3271122 TI - Tuberculous osteomyelitis of the mandible. AB - A case of tuberculous osteomyelitis of the mandible in a three and a half year old boy is presented. Multiple swellings developed and eventually ruptured leaving discharging sinuses and formed puckered scars. The management and mode of spread are discussed. PMID- 3271123 TI - Interocclusal records--a review of three common recording materials. AB - In restorative and prosthetic dental treatment, casts which duplicate the patient's dentition are frequently mounted in an articulator which simulates jaw movements. In order to relate the mandibular cast to the maxillary cast, records are made in the mouth utilising suitable materials. Three common recording materials will be discussed. PMID- 3271124 TI - Oral lichenoid drug reaction. AB - This is a case report of an oral lichenoid drug reaction of the buccal sulci in a female diabetic patient who was on an anti-hypertensive drug, alpha-methyldopa (Aldomet) and an oral hypoglycaemic drug, chlorpropamide (Diabinese). The clinical features, histological findings and management are presented. PMID- 3271125 TI - Artifacts in oral biopsy specimens: a case report. AB - Artifacts in oral surgical specimens could be ascribed to tissue alteration before, during or after biopsy procedures. A case of mandibular ameloblastoma presenting with a series of vacuoles in the subgingival tissue is described. The differential diagnosis and significance of these artifacts are discussed. PMID- 3271126 TI - The occurrence of oral-mucosal lesions among employees of a steelmill--a preliminary study. AB - A study has been conducted on 198 employees of a steel-mill industry. These participants were examined for mucosal lesions in the oral cavity and including the commissures and vermillion borders of the lips. The prevalences of 16 types of lesions are reported. PMID- 3271127 TI - A 5-year longitudinal study of caries development in first permanent molars in children. AB - The present study analysed the development of caries in 653 first permanent molars annually over a period of 5 years in children who were 7 years-old at baseline. The cumulative caries experience increased from 6.0% at baseline to 35.2% at the end of the study period. There were no appreciable differences in the annual incremental rate of caries experience among males and females. At baseline, the Malays and Indians have the highest and lowest caries experience respectively. At 12 years of age, the Chinese have the highest caries experience whilst the data for the Malays and Indians were comparable. The highest cumulative percentage increase in caries experience for the Malays, Chinese and Indians were between the ages of 7 to 8, 9 to 10 and 8 to 9 respectively while the average annual caries increment were 4.5%, 7.3% and 5.0% respectively. PMID- 3271128 TI - [The light and electron microscopic investigation of the structure and function of thyroid perifollicular cells]. PMID- 3271129 TI - [Treatment of internal resorption with Sealapex: a case report]. PMID- 3271131 TI - [Evaluation of previously made root canal treatments]. PMID- 3271130 TI - [Complex odontoma in mandible (a case report)]. PMID- 3271132 TI - [Investigation of the short-term healing of connective tissue autografts]. PMID- 3271133 TI - [Transillumination in dentistry]. PMID- 3271134 TI - [A prosthodontic problem: acromegaly]. PMID- 3271135 TI - [The effects of chlorzoxazone on postoperative trismus following lower third molar surgery]. PMID- 3271136 TI - [Frequency of endodontic treatment]. PMID- 3271137 TI - [Periodic evaluations of the treatment effect of glycerol injections into peripheral nerves in trigeminal neuralgia]. PMID- 3271138 TI - [Causes of smoking among university students]. PMID- 3271139 TI - [Evaluation of some properties of pour-type resins processed by injection technique and polymerized at room temperature]. PMID- 3271140 TI - [Evaluation of the indentation resistance of some veneering materials]. PMID- 3271141 TI - [An analysis of 201 mandibular fracture cases]. PMID- 3271142 TI - [A clinical investigation of patients with temporomandibular joint dysfunction syndrome]. PMID- 3271143 TI - [Prevention of microleakage at gingival margins in cervical resin restorations]. PMID- 3271144 TI - [An unusual case of phenytoin hyperplasia]. PMID- 3271145 TI - [Clinical investigation on radicular cysts]. PMID- 3271146 TI - [The formation techniques of laminate veneers]. PMID- 3271147 TI - [Marginal leakage of Class V composite resin restorations using a combination of conventional and microfilled resins]. PMID- 3271148 TI - [Side effects of chemical denture cleansers on denture metals]. PMID- 3271149 TI - [A cephalometric comparison of orthopedic (Activator) headgear and orthodontic (Edgewise) treatments in Class II, 1 malocclusions]. PMID- 3271150 TI - [Evaluation of the level of residual monomer in acrylic denture base materials having different polymerization properties]. PMID- 3271151 TI - [Antibacterial effectiveness of camphorated parachlorophenol]. PMID- 3271152 TI - [Investigation of the fatigue behavior of direct retainer metals]. PMID- 3271153 TI - [The effect of different finishing procedures on the surface of porcelain]. PMID- 3271154 TI - [Comparative evaluation of methods of determining the vertical dimension of occlusion in edentulous patients by cephalometric means]. PMID- 3271155 TI - [Role of calcium ions on prilocaine effects in isolated ileum]. PMID- 3271156 TI - [Indirect measurements of pH values of different dental cements]. PMID- 3271157 TI - [Relationship between gingival hyperplasia and transfer of phenytoin to saliva and serum]. PMID- 3271158 TI - [Adaptation of low-temperature injection gutta-percha to the root canal walls. A SEM study]. PMID- 3271159 TI - [Elimination of the smear layer from the cavity walls by means of a dilute organic acid: SEM study]. PMID- 3271160 TI - Reconstruction of midfacial posterior displacements in Le Fort fractures. PMID- 3271161 TI - [Dental caries after radiotherapy: a case report]. PMID- 3271162 TI - [Mucous retention cyst (case report)]. PMID- 3271163 TI - [Role of periodontal membrane in the eruption of a tooth]. PMID- 3271164 TI - [Complications of radiotherapy and protection methods]. PMID- 3271166 TI - [Computer applications in dentistry]. PMID- 3271167 TI - Linking dentists to the DEB by computer. PMID- 3271165 TI - [Prevalence of the utilization of fissure sealants]. PMID- 3271168 TI - Perspective. Update on oral and maxillofacial surgery. PMID- 3271170 TI - Future bright for dentistry: Loyola dean. PMID- 3271169 TI - Hospital dentistry expanding its role. PMID- 3271171 TI - Loyola dentists serve the poor at St. Basil's Health Service. PMID- 3271172 TI - Health professionals strive to protect children from abuse. PMID- 3271173 TI - Chairside cheerleading! PMID- 3271174 TI - Not a laughing matter. Part III. PMID- 3271175 TI - Focus on: high-tech dentistry. PMID- 3271176 TI - Infection control notes. Surface disinfection: cleaning up the confusion. PMID- 3271177 TI - Teeth bleaching ... a vital technique for you to know. PMID- 3271178 TI - Time is on your side. PMID- 3271179 TI - Blood pressure, salt appetite and mortality of genetically hypertensive and normotensive rats maintained on high and low salt diets from weaning. AB - 1. Blood pressure, bodyweight, saline preference and mortality rate were examined in spontaneously hypertensive rats (SHR) of the Okamoto strain and normotensive control Wistar-Kyoto (WKY) rats maintained on low (0.1% NaCl w/w), control (0.8% w/w) and high (3% w/w) salt diets from weaning until 6 months of age. 2. The growth rate of SHR on high salt diet was not significantly different from that on control diet but SHR maintained on a low salt diet exhibited a markedly reduced growth rate. While the growth rate of WKY on low salt diet was not significantly different from that on control diet, the bodyweights of WKY on high salt diet were significantly greater than those of animals on control diet. 3. While low salt diet markedly attenuated the development of hypertension in the SHR, high salt diet significantly exacerbated the blood pressure of this strain. Neither high nor low salt diet altered the blood pressure of WKY. 4. SHR on high and low salt diets had an increased mortality rate compared with SHR on control salt diet but these differences were of slight statistical significance. Conversely, WKY on all three diets exhibited similar mortalities over the 6-month observation period. There were no significant differences in mortalities between SHR and WKY on any diet. 5. The preference for 0.9% saline, when offered as a choice with water, was not significantly different between SHR on the different diets. WKY on high salt diet, however, exhibited a significantly reduced preference for saline over the 10-day test period compared with animals on control or low salt diet. 6. Thus dietary salt modulates the hypertension of SHR but not the blood pressure of WKY. SHR would appear to require more dietary sodium for normal growth and perhaps full expression of its hypertension. The higher and lower blood pressures of the SHR on high and low salt diet, respectively, were associated with increased mortality, which was a trend not seen in the WKY. PMID- 3271180 TI - Relationship between the dose-response effects of diazepam and clobazam on electroencephalographic parameters and on kindled amygdaloid seizure activity in rats. AB - 1. The possibility that the anticonvulsant activity of the benzodiazepines, diazepam and clobazam, is related to changes in EEG parameters, particularly beta activity, was investigated in amygdaloid kindled rats. 2. The effects of diazepam (1, 2, 4, 8 and 16 mumols/kg), administered intraperitoneally (i.p.), clobazam (1, 2, 4, 8, 16 and 32 mumols/kg, i.p.) or vehicle (dimethyl sulfoxide) on the cortical EEG of amygdaloid kindled rats were quantitated for 15 min using computerized period amplitude analysis. Immediately afterwards, the amygdala was stimulated and the after-discharge duration (AD) and the seizures stage (SS) were determined. 3. The equivalent percentage time (EPT) of the diazepam-treated group was decreased in the theta band (4-8 Hz) and increased in the alpha (8-12 Hz) and first six beta (12-36 Hz) bands. The mean peak amplitude (MPA) was increased in the alpha (8-12 Hz) and all seven beta bands (12-40 Hz). Clobazam increased the EPT and MPA in the alpha (8-12 Hz) and all seven beta (12-40 Hz) bands. The MPA was also increased by clobazam in the theta (4-8 Hz) band. 4. Diazepam reduced both the AD and SS of the kindled seizures at doses of 4, 8 and 16 mumols/kg, whereas clobazam was anticonvulsant at doses of 16 and 32 mumols/kg. The reduction in both AD and SS correlated with increases in the EPT and MPA in the first beta (12-16 Hz) band in the diazepam-treated group and in the first four beta (12-28 Hz) bands in the clobazam-treated group. PMID- 3271181 TI - Involvement of hypothalamic adrenaline in the clonidine withdrawal syndrome in normotensive and spontaneously hypertensive rats. AB - 1. The concentrations of adrenaline and other catecholamines (noradrenaline and its major metabolite DHPG, dopamine and its major metabolite DOPAC) were measured in the hypothalamus and medulla oblongata of normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) which had received a continuous subcutaneous infusion of clonidine (10 micrograms/kg per h) for 10 days, and also in WKY and SHR rats which were killed 15-18 h after the cessation of the 10-day infusion. 2. The concentrations of adrenaline in the hypothalamus and medulla oblongata/pons of the clonidine treated WKY and SHR rats were not different from their respective controls. However, the adrenaline concentrations in the hypothalamus (but not the medulla oblongata) were significantly decreased in the post-infusion WKY and SHR. 3. These results suggest that hypothalamic adrenergic mechanisms may have a common involvement in the post-clonidine infusion syndromes displayed by the WKY and SHR strains. PMID- 3271182 TI - Effect of potassium loading on bone sodium and total exchangeable sodium in sheep. AB - 1. The effect of potassium (K) loading for 10 days on bone sodium (Na) and total exchangeable Na in sheep was examined. 2. There were no significant changes in Na space or exchangeable Na after K loading. 3. Bone Na concentration decreased by approximately 20% after K loading. 4. The degree of mobilization of Na from both the non-exchangeable and exchangeable pools in bone is sufficient to account to a large degree for the observed increase in extracellular fluid volume and the net negative sodium balance which is observed during K loading. PMID- 3271183 TI - Catecholamine concentrations during exposure of resting man to the heat of a standard sweat test. AB - 1. Normal subjects were heated for 45 min with a heat cradle under the conditions used to investigate sweating clinically. 2. Skin temperatures on the chest and in the external auditory meatus rose but concentrations of noradrenaline and adrenaline decreased during heating. 3. There was no change in adrenoceptor affinity or number as a result of the heat exposure. 4. There was little change in blood pressure and heart rate and no dysrhythmias were observed with an electrocardiogram. 5. It is concluded that heating with a heat cradle is generally not stressful and that there is a reduction in sympathetic nervous activity involving noradrenergic or adrenergic transmission during the procedure. PMID- 3271184 TI - Long-lasting depolarization of the central terminals of cutaneous afferents in L7 segment evoked by volleys ascending from the sacral cord in the cat. AB - 1. In 72% of non-anaesthetized spinal cats, single volleys ascending from the sacral cord evoke long-lasting primary afferent depolarization in L7 segment. It occurs in the central terminals of cutaneous but not in Ia muscle afferents. 2. Volleys descending to L7 segment evoke only short-lasting presynaptic depolarization. 3. It is concluded that presynaptic inhibition in L7 segment produced by ascending volleys is more effective than that evoked by descending volleys. PMID- 3271185 TI - Effect of oestradiol replacement on swim-induced antinociception in ovariectomized mice. AB - 1. A 30 s swim in water at 30 degrees C reduced the number of abdominal constrictions produced in female mice by intraperitoneally administered acetic acid and this antinociceptive effect was antagonized by naloxone. 2. Oophorectomy abolished the development of antinociceptive activity in response to swim. 3. The development of antinociceptive activity and naloxone antagonism were restored in oophorectomized mice maintained on daily oestradiol injection. 4. The present study indicates that the increase in abdominal constriction response to acetic acid in oophorectomized mice was due to the removal of the source of female sex hormone. PMID- 3271186 TI - Amiodarone drug interactions: potential beneficial and adverse effects. AB - The loading dose and maintenance of so called "resistant" cases by amiodarone oral intake is explained. In cases resistant to amiodarone alone, the combination of this drug is attempted with Class I antiarrhythmic agents. However, this association could interact with these drugs because amiodarone appears to have a definite action on the kinetics of several cardiovascular drugs. The association of amiodarone with a very low dosage of beta-blocking agents preventing interactions also looks promising. These remarks are provided in addition to classical limitations of the association of amiodarone because of pronounced interactions with other nonantiarrhythmic drugs such as warfarin or digitalis, which also should have dosage reduced to prevent side effects. PMID- 3271187 TI - Long-term results of amiodarone therapy. AB - In order to assess the long-term efficacy of amiodarone, we followed 187 survivors of cardiac arrest and 316 patients with nonsustained or sustained ventricular tachycardia and compared the results of amiodarone therapy with the results of conventional therapy. All patients treated with amiodarone had failed to respond to one or more conventional agents. For survivors of cardiac arrest, survival of patients treated with amiodarone was equal to survival of patients treated with conventional agents. For patients with ventricular tachycardia, two year survival was 91% in the conventional therapy group and 68% in the amiodarone group but incidence of sudden death was similar, probably reflecting increased non-sudden death due to advanced age and left ventricular dysfunction in the amiodarone-treated group. Side effects led to the discontinuation of amiodarone in approximately 25% of patients over a mean follow-up of 28 months. In a subgroup of patients who had demonstrated a proarrhythmic effect to Class I antiarrhythmic agents, amiodarone proved safe and effective. Amiodarone was well tolerated and effective therapy for atrial fibrillation in 59% of patients who had failed to respond to conventional agents. Thus, amiodarone is a useful option for patients with arrhythmias unresponsive to standard antiarrhythmic agents. PMID- 3271188 TI - Case history roundtable discussion. Ventricular tachycardia. PMID- 3271189 TI - Sudden cardiac death: definition and management of high-risk patients. An international symposium. Anaheim, California, November 15, 1987. Proceedings. PMID- 3271190 TI - Nonpharmacologic therapy of ventricular tachycardia. AB - Nonpharmacologic therapies for patients with sustained ventricular tachycardia have been necessitated by the low frequency of drug-responsive patients. These nonpharmacologic therapies include antitachycardia pacemakers, low-energy cardioverters, defibrillators, surgery and, for the present, catheter ablation. Antitachycardia pacing alone should never be used because of the known incidence of acceleration of ventricular tachycardia to ventricular fibrillation. Thus, all electrical devices must include a back-up defibrillator at the very least. The current automatic implantable cardioverter-defibrillator, which has been implanted in over 1000 patients, has been shown to prevent sudden death. Surgery has offered the only method to cure the arrhythmia by removing the arrhythmogenic substrate. Improved surgical techniques with electrophysiologic guidance have an acceptable mortality and a clinical success rate in 80-90% range. Catheter ablation, which is an experimental procedure at this time, offers the promise of a nonsurgical technique to extirpate the ventricular tachycardia substrate. PMID- 3271191 TI - Noninvasive assessment and management of the patient at high risk of sudden cardiac death. AB - Evaluation of the patient who may be at high risk of sudden death includes consideration of symptoms, exercise testing, ambulatory electrocardiographic monitoring, and programmed electrical stimulation. The optimal approach to patients with potentially life-threatening ventricular arrhythmia is controversial. Programmed electrical stimulation may be the only useful method of assessment when there is marked biological variability of arrhythmia or when there is insufficient spontaneous or exercise-induced arrhythmia. Ambulatory electrocardiographic monitoring may document the arrhythmia/event, but more often relies upon the identification of a warning or marker arrhythmia. Current prognostic classifications grade the frequency of ventricular ectopy and presence of repetitive forms. Differentiation of pathogenetic and associated or marker arrhythmia as well as consideration of the type and stage of cardiac disease and the potential role of the autonomic nervous system may improve our ability to stratify risk for subsequent events and sudden death. Effective treatment aims to prevent recurrence and to improve mortality. The current approach relies on the abolition of marker arrhythmias or on their reduction by statistically determined amounts. In postmyocardial infarction patients, the efficacy of such therapy has not been determined. Large prospective, randomized studies in well characterized patients are required. The majority of patients with hypertrophic cardiomyopathy die suddenly. In the adult the finding of nonsustained ventricular tachycardia on electrocardiographic monitoring is a sensitive and specific marker of high risk and treatment of such patients with low-dose amiodarone is associated with improved survival. Characterization of patients with dilated cardiomyopathy has failed to identify a treatable pathogenetic feature of poor prognosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3271192 TI - Arrhythmias in heart failure--the role of amiodarone. AB - An in-hospital diagnosis of heart failure due to left ventricular dysfunction carries a very poor prognosis, which has been reported to be as high as 50% per annum. In many cases death has been sudden and unexpected and not strictly related to a refractory heart failure. In association with this, it has become more widely appreciated that ventricular tachyarrhythmias, often asymptomatic, are frequent in patients with left ventricular dysfunction, and in some studies, the frequency of ventricular arrhythmias has been the most powerful predictor of mortality. Several other variables have been reported as being predictors of a poor prognosis, including electrolyte abnormalities, poor left ventricular function, high plasma norepinephrine, and low blood pressure. In a prospective follow-up series of 152 patients with heart failure secondary to left ventricular dysfunction, we found that ventricular arrhythmias were the strongest predictor of subsequent mortality, while treatment with amiodarone was associated with longer survival. High plasma renin and norepinephrine concentrations were also associated with a poor prognosis and both were directly correlated with the frequency of ventricular arrhythmias. In previous double-blind studies we have demonstrated a reduction in ventricular arrhythmias with both captopril and enalapril, and this has been associated with a reduction in plasma norepinephrine and an increase in serum and total body potassium. Nonetheless, arrhythmias in these patients were by no means abolished despite correction of these neuroendocrine and electrolyte abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3271194 TI - Definition of patients at high risk of sudden arrhythmic cardiac death. AB - Prevention of sudden arrhythmic cardiac death must be preceded by identification of the high-risk patient to whom appropriate therapy can be given. The most common disease state associated with sudden cardiac death is coronary artery disease. Factors which identify a high-risk subset include: left ventricular dysfunction; frequent and complex arrhythmias on Holter monitoring; abnormal signal-averaged electrocardiograms; angina, ST depression, and exertional hypotension or ventricular arrthythmias on exercise testing; inducible sustained arrhythmias at electrophysiologic testing, or a combination of these factors. Other conditions which are known to be associated with sudden death include: dilated or congestive cardiomyopathy, hypertrophic cardiomyopathy, mitral valve prolapse, valvular heart disease, Wolff-Parkinson-White syndrome, myocarditis, congenital heart disease, electrolyte abnormalities, long QT syndromes, proarrhythmic effects of drugs, and less common conditions such as myocardial tumors and pulmonary hypertension. If the primary abnormality responsible for the tendency toward arrhythmias cannot be corrected, appropriate therapy should be administered to attempt to reduce the patient's risk of sudden arrhythmic cardiac death. PMID- 3271193 TI - Long-term efficacy, safety and survival of patients with potentially lethal ventricular arrhythmias treated with low-dose amiodarone. AB - The effect of low-dose amiodarone was prospectively evaluated in 110 patients with potentially lethal ventricular arrhythmias and structural heart disease. The patient population had frequent and high-grade ventricular premature complexes (VPCs) (greater than or equal to 39/h) (multifocal, couplets, nonsustained ventricular tachycardia) refractory to conventional antiarrhythmic drugs. All patients had structural heart disease (coronary artery disease in 61%) and also a decreased left ventricular ejection fraction (LVEF) (43 +/- 16%). Patients were treated with low-dose amiodarone (maintenance dose of 275 +/- 102 mg/day.) During follow-up over a period of 15 +/- 11.5 months, 24 patients died of cardiac cause and, of these, 13 died of sudden death. Ventricular arrhythmia suppression at 1, 2, 3, and 4 years was 69%, 80%, 78%, 92% for VPCs, respectively; 96%, 90%, 92%, and 98% for couplets, respectively, and 57%, 57%, 97%, and 91% for nonsustained VTs (NVTs), respectively. Intolerable, reversible side effects requiring withdrawal were encountered in 24 patients (22%) (neurologic 10%, gastrointestinal 6.5%, skin 3.7%, proarrhythmic 0.9%, and cardiac 0.9%). Except for keratopathy (less than or equal to grade II) seen in all patients, the tolerable side effects were transient with dose adjustment. The study population was divided into two groups according to LVEF: Group A (LVEF greater than or equal to 40%, mean 54.4 +/- 9.7) and Group B (LVEF less than 40% mean, 27.7 +/- 7.2). The patients were further classified into responders (suppression of at least 70% of VPCs, 90% of couplets, and 100% of NVTs) and nonresponders. The difference in survival between responders and nonresponders in groups A and B was not statistically significant. Cumulative survival at 1, 2, 3, and 4 years was 90%, 85%, 85%, and 85%, respectively. In conclusion, low-dose amiodarone treatment: 1) Is effective in controlling VPCs and its complex forms and maintains long-term arrhythmia suppression. 2) The side effect profile compares favorably with conventional antiarrhythmics; severe side effects associated with high dosages (pulmonary, hepatic, neurologic, etc.) were rare or absent. 3) Amiodarone improves survival of patients with potentially lethal ventricular arrhythmias. PMID- 3271195 TI - Correlation between subgingival bacterial proportions at individual sites in untreated moderate-advanced periodontal disease: single sampling versus multiple sampling. PMID- 3271196 TI - The effect of wearing surgical gloves on preclinical operative technique. PMID- 3271197 TI - Diagnostic imaging of the temporomandibular joint. PMID- 3271198 TI - Effectiveness of a prebrushing mouthrinse under single-trial and home-use conditions. PMID- 3271199 TI - A toothbrush handle for the use of the Meswak oral hygiene aid. PMID- 3271200 TI - Good help is hard to find. PMID- 3271202 TI - AIDS hotline for teens. PMID- 3271201 TI - The premier investment: home or office. Part 2. PMID- 3271203 TI - AIDS is spreading. PMID- 3271204 TI - Pit and fissure sealants. PMID- 3271206 TI - Implants--everything old is new again. PMID- 3271205 TI - Adult orthodontics. Unmasking the myths. PMID- 3271207 TI - HVE tips: maximizing high-velocity suction. PMID- 3271208 TI - AIDS hotline for teens. PMID- 3271209 TI - Removing patient fears: what the dental assistant can do. PMID- 3271210 TI - [The Caridex system: effect on wettability of hard tissues--preliminary results]. PMID- 3271211 TI - [Free gingival grafts. Simplified technic]. PMID- 3271212 TI - [Evaluation of a glass-ionomer cement after removal of orthodontic brackets]. PMID- 3271213 TI - [Clinical-statistical survey: dental care in Campania]. PMID- 3271215 TI - Taking your own advice. PMID- 3271214 TI - [Coxsackiosis of the oral cavity. Description of a clinical case]. PMID- 3271216 TI - Selecting the right restorative materials for your practice: an interview with Dr. Ralph Phillips. Interview by Mark Saxen. PMID- 3271217 TI - Marketing for fearful dental patients. PMID- 3271219 TI - Buying a dental practice--what to consider. PMID- 3271218 TI - 13 fatal errors dentists make. PMID- 3271220 TI - Putting nutrition into your practice. PMID- 3271221 TI - The $1,000 lease-hold dental office. PMID- 3271222 TI - The cephalosporins. PMID- 3271223 TI - New treatment for gum disease in AIDS patients. PMID- 3271225 TI - Insights on finding a computer for the growing dental practice. PMID- 3271224 TI - Dental caries of Vietnamese Boat People in Philippine First Asylum Centre, Palawan. PMID- 3271227 TI - A glimpse of dentistry in Turkey. PMID- 3271226 TI - Tales from the African bush. PMID- 3271228 TI - Rigid philosophy and style threatened the existence of his dental practice. PMID- 3271229 TI - Late diagnosis of congenital dislocation of the hip in the newborn. PMID- 3271230 TI - The abilities of myelinated and non-myelinated aortic fibers on the brain ischemia-mediated reflex bradycardia in the rabbit. PMID- 3271231 TI - [Physical disabilities in Hansen's disease at the time of diagnosis. I. Disability evaluation]. AB - The evaluation of the physical disabilities at the moment of the hanseniasis diagnosis was carried out through the clinical and epidemiological forms of the 8,915 cases recorded in the State of Sao Paulo, Brazil, from 1981 to 1983. The records of the physical disabilities were studied by three different methods: the disabilities at their highest grade, the disabilities' grade index achieved from the arithmetic mean of the added values of the different disability grades, and the absolute disabilities frequency. The study suggested that the maximum grade was the best evaluation method of the physical disabilities at the moment of the diagnosis, being an important indicator for the evaluation of prevention efforts and of the hanseniasis control. PMID- 3271232 TI - [Physical disabilities in Hansen's disease at the time of diagnosis. II. Indicators for evaluating a Hansen's disease control program]. AB - The evaluation of physical disabilities caused by hanseniasis at the moment of the diagnosis, was carried out through the clinical and epidemiological forms of the 8,915 cases recorded in the State of Sao Paulo, Brazil, from 1981 to 1983. The resulting data showed that the disabilities' evaluation at the moment of the diagnosis is an important index for the hanseniasis control programme specially when related to other variable elements involved in the diagnosis of the hanseniasis situation. PMID- 3271233 TI - [New normative instructions in a Hansen's disease control program]. PMID- 3271234 TI - [Hansen's disease in the State of Sao Paulo: diagnosis and a preliminary proposal for its control]. PMID- 3271236 TI - [Epidemiologic survey in the Vila Nova slum in the municipality of Duque de Caxias-RJ (July/1988)]. AB - Due to the high endemicity of Hansens Disease in the "Duque de Caxias Municipality", Rio de Janeiro State, Brazil, an Epidemiological Survey of "Vila Nova" slum was planed. The goal was to verify the prevalence of skin diseases of sanitary concern and, also, to analise the socio-economical conditions of the population, especially those related with environment sanitation. 45% dwellings were visited and 86% of the population (1903 persons) screened by dermoneurological examination performed by auxiliary personnel. Tables show frequency of skin disease that received treatment on domiciliary basis. 19 cases were suspicious of Hansen's Disease. The social profile was assessed through the study of several parameters of the population: --economical, sanitation, personal and home hygiene. PMID- 3271235 TI - [Temporal tendency in the detection of Hansen's disease in the municipality of Maringa-PR, 1977/1986]. AB - This study was dedicated to the analysis the behaviour of the Hansen's, disease in Maringa, State of Parana. Three hundred and forty eight clinical-epidemic cards were studied in patients who had Hansen's disease in the periods from 1977 to 1986. It was verified that the clinical forms Virchowian + Borderline had the highest percentual and prevailed in the age limit where people are economically active, concluding the same of a previous study which was performed by Belda & Lombardi and by Asseis et al. Tables and Figuras of the disease distribution are presented according to sex, origins, year of the detection, clinical form, age when it was diagnosed (the disease), time when symptoms appeared until the diagnosis with short comments, and its importance to the epidemic valuation of Hansen's disease in this city. PMID- 3271237 TI - [Definition of guidelines for dermatologic health hospitals (report of the working group constituted by resolution SS no. 27 of February 19, 1988]. PMID- 3271238 TI - [Surgical treatment of arrhythmia]. PMID- 3271239 TI - Cardiac transplantation in the Eurotransplant sphere--critical issues. PMID- 3271241 TI - Matching pulmonary resection to patient function. PMID- 3271242 TI - Perspectives of cardio-thoracic surgeons and societies: commemoration panel discussion. PMID- 3271240 TI - Transhiatal esophagectomy for benign and malignant disease. PMID- 3271243 TI - [Surgical treatment of ischemic heart disease]. PMID- 3271245 TI - [The role of surgery in multimodal treatment of lung cancer]. PMID- 3271244 TI - [Progress and improvement in surgery of aortic aneurysm of the thoracic aorta]. PMID- 3271246 TI - [Diagnosis and treatment of benign esophageal diseases]. PMID- 3271247 TI - [Current status and problems related to cardiac surgery in newborn and young infants]. PMID- 3271248 TI - [Characteristics and treatment of mediastinal cancer]. PMID- 3271249 TI - [Reconstructive surgery in acquired mitral valve diseases]. PMID- 3271250 TI - [Reconstructive surgery in respiratory tract diseases]. PMID- 3271251 TI - [Excision and reconstruction in Im esophageal cancer]. PMID- 3271252 TI - [Re-evaluation and re-examination of the currently available anti-bacterial agents]. PMID- 3271254 TI - [Chemotherapy of infection in compromised hosts]. PMID- 3271253 TI - [Progress in anti-microbial agents]. PMID- 3271255 TI - [Chemotherapy of refractory infections--selection and application of anti microbial agents]. PMID- 3271256 TI - [Chemotherapy of specific infections]. PMID- 3271257 TI - [Hospital infection and anti-bacterial agents--the role of anti-bacterial agents, refractoriness of hospital infections, and the need for regulation of antibiotic use for the prevention of cross infections]. PMID- 3271258 TI - [Energy expenditure for the consumption of mineral components from the environment by microorganisms]. PMID- 3271259 TI - [Various regularities in the growth of yeast cultures in media, containing carbohydrates and alcohols]. PMID- 3271260 TI - [Sensitivity to remantadine and other drugs of influenza A viruses isolated in 1982-1983]. PMID- 3271261 TI - [Antimicrobial properties of "Naftusia" mineral water]. PMID- 3271262 TI - [A diffusion chamber for growing microorganisms in vivo]. PMID- 3271263 TI - [Assessment of the precision of sanitary-microbiologic methods of water analysis]. PMID- 3271264 TI - [Study of the effect of dimexide on the ultrastructure of Staphylococcus aureus]. PMID- 3271265 TI - [The effect of mating conditions on the effectiveness of transmitting RP4 plasmids in Pseudomonas mallei]. PMID- 3271266 TI - [Immunologic criteria of the pathogenicity of epidermal staphylococcus]. PMID- 3271267 TI - [A study of populations of Vibrio cholerae by virulence]. PMID- 3271268 TI - [Detection of virulence factors in pathogenic Escherichia isolated from the environment]. PMID- 3271270 TI - [Features of the growth of a culture and ultrastructure of Staphylococcus aureus 209 P cells under the effect of novoimanine]. PMID- 3271269 TI - [Regularities of growth of ethanol-assimilating yeast Candida krusei in limited concentrations of nitrogen and phosphorus]. PMID- 3271271 TI - [The effect of novoimanine on the course of experimental staphylococcal sepsis]. PMID- 3271272 TI - [Comparison of the specificity and sensitivity of the passive hemagglutination reaction and other methods of indicating antibodies to adenoviruses]. PMID- 3271273 TI - [A modified method of determining the sensitivity of bacteria to furazolidone]. PMID- 3271274 TI - [Occurrence of anti-adrenal antibodies in Addison's disease in relation to the results of computerized tomography of the adrenal glands]. PMID- 3271275 TI - [Attempts at limiting necrotic areas in acute myocardial infarction by intravenous infusion of dipyridamole]. PMID- 3271276 TI - [Monocytes in Hodgkin's disease. II. Various metabolic functions and enzymatic activity of the monocytes in patients with advanced stages of Hodgkin's disease]. PMID- 3271277 TI - [The role of platelet-derived growth factor in the pathogenesis of various diseases. I. The role of platelet-derived growth factor in the inflammatory processes and arteriosclerosis]. PMID- 3271279 TI - [Clinical variability of hepatic clearance of antipyrine and Tc-99m-HIDA in healthy persons and in those with liver diseases. II. Effect of propranolol]. PMID- 3271278 TI - [Diurnal variability of hepatic clearance of antipyrine and Tc-99m-HIDA in healthy persons and in those with liver diseases. I]. PMID- 3271280 TI - [Post-fructose increase in the blood level of lactic acid in various pathologic conditions]. PMID- 3271281 TI - [Selected biochemical components of plasma and blood viscosity in patients with arteriosclerosis]. PMID- 3271282 TI - [Evaluation of the results of chronic hemodialysis therapy in Gda'nsk during the 15-year period 1969-1983. II. Technical, vascular and clinical complications and the causes of death]. PMID- 3271283 TI - [Effect of carbidopa-levodopa on growth hormone secretion and absolute eosinophil count in healthy persons and those with allergic diseases]. PMID- 3271284 TI - [Hemolytic crisis complicated by acute renal failure in a heterozygous woman with GPD deficiency caused by hypersensitivity to Hoya carnosa]. PMID- 3271285 TI - [Subcutaneous administration of deferoxamine in a patient with panmyelopathy and post-transfusion hemosiderosis]. PMID- 3271286 TI - [Immunomodulating effect of blood transfusion]. PMID- 3271287 TI - [Evaluation of the results of chronic hemodialysis therapy in Gda'nsk during the 15-year period 1969-1983. I. Patients' qualifications, arteriovenous fistula, general data and methods of hemodialysis therapy]. PMID- 3271288 TI - [Chemotactic activity of serum neutrophils during aspirin-induced bronchial spasm]. PMID- 3271290 TI - [Acetylation phenotype in diabetes mellitus]. PMID- 3271289 TI - [Arterial hypertension in acromegaly]. PMID- 3271291 TI - [Various elements of behavior patterns in obesity]. PMID- 3271292 TI - [Evaluation of systemic magnesium reserves in patients with calcium-induced kidney calculi]. PMID- 3271293 TI - [Indicators of blood viscosity in women during menopause]. PMID- 3271294 TI - [Correlation of glycosylated serum protein and glycosylated hemoglobin in patients with diabetes mellitus type 2 at various stages of metabolic compensation]. PMID- 3271295 TI - [Effect of verapamil on blood viscosity in ischemic heart disease]. PMID- 3271296 TI - [Thyroid function in patients with transplanted kidney treated with cyclosporin A or azathioprine with prednisone c]. PMID- 3271297 TI - [The renin-angiotensin-aldosterone system in familial diabetes insipidus of central origin]. PMID- 3271298 TI - [Studies of the mechanism of arterial hypotension induced by water immersion in healthy persons and in patients with diabetes mellitus]. PMID- 3271300 TI - [Disorders of the respiratory function in patients with chronic renal failure treated by hemodialysis. I. Evaluation of the functional state of the respiratory system]. PMID- 3271299 TI - [Occult blood test and fibrosigmoidoscopy in the diagnosis of neoplasms of the distal segment of the large intestine]. PMID- 3271301 TI - [Disorders of the respiratory function in patients with chronic renal failure treated by hemodialysis. II. Evaluation of pulmonary gas exchange and hemodialysis-related leukopenia]. PMID- 3271302 TI - [Plasma chemotactic activity stimulating the adhesiveness and inducing the aggregation of neutrophils in patients with acute pancreatitis]. PMID- 3271303 TI - [Apical hypertrophic cardiomyopathy--clinical, electrocardiographic, echocardiographic and hemodynamic evaluation]. PMID- 3271304 TI - [Cellular immunity and the results of 2-year immunosuppressive treatment combined with the administration of dipyridamole and indomethacin in patients with chronic glomerulonephritis]. PMID- 3271305 TI - [Anaplastic carcinoma of the thyroid gland with the clinical course suggesting subacute thyroiditis--personal observations]. PMID- 3271306 TI - [Evaluation of the liver condition in patients with congenital deficiency of plasma coagulation factors]. PMID- 3271307 TI - [Blood serotonin level and selected aromatic amino acids in the serum, liver tissue and brain of deceased persons with encephalopathy and hepatic coma in viral hepatitis and liver cirrhosis]. PMID- 3271308 TI - [Changes in the activity of the renin-angiotensin-aldosterone system and serum vasopressin (AVP) level during acute rejection of transplanted kidney]. PMID- 3271309 TI - [Effect of adrenergic stimulation on lipolysis in obese and lean women in the in vitro conditions]. PMID- 3271310 TI - [Markers of infection with hepatitis B virus in alcoholics]. PMID- 3271311 TI - [Cellular cytotoxicity in the studies of immunosuppressive activity of drugs]. PMID- 3271314 TI - The three processes that make bone. PMID- 3271313 TI - Technology assessment in biomedical research: dialysis and transplantation as cases in point. PMID- 3271315 TI - Studies on the HLA association to insulin-dependent diabetes mellitus (IDDM). PMID- 3271312 TI - [Cryptococcosis in patients with transplanted kidney treated with steroids and azathioprine]. PMID- 3271316 TI - [Study of arterial vascularization of the pancreas taken for transplantation]. PMID- 3271317 TI - [Changes in class II (HLA-D) antigen expression on T-lymphocytes in the recipients of allogeneic kidney transplants]. PMID- 3271318 TI - [Acute ethylene glycol poisoning--205 cases treated at the Acute Poison Control Center]. PMID- 3271319 TI - [Hemorrhage from the upper segment of the digestive tract in patients after kidney transplantation]. PMID- 3271321 TI - [Effect of sulindac on proteinuria and kidney function in patients with nephrotic syndrome]. PMID- 3271320 TI - [Blood platelet function in patients with chronic renal failure]. PMID- 3271322 TI - Correlations of homeostatic tubular functions with various renal structural lesions and clinical types of functionally-compensated glomerulonephritis. PMID- 3271324 TI - Isolated proteinuria. PMID- 3271323 TI - Pathogenesis of hypertension in IgA nephropathy. PMID- 3271325 TI - [Acquired immunodeficiency syndrome (AIDS) and kidney diseases]. PMID- 3271326 TI - [Decompensation syndrome and the changes in plasma osmolarity]. PMID- 3271327 TI - [Expression of HLA-D antigens, FcIgG and C3 receptors on peripheral blood monocytes in patients with chronic glomerulonephritis]. PMID- 3271328 TI - [Superoxide dismutase activity in erythrocytes and malondialdehyde levels in the erythrocytes and plasma at different periods of renal failure]. PMID- 3271331 TI - [Recombinant human erythropoietin (r-Hu-EPO) in the treatment of nephrogenic anemia]. PMID- 3271330 TI - [Late results of the immunosuppressive treatment of steroid-resistant nephrotic syndrome in children]. PMID- 3271329 TI - [Results of 2-week and 3-month antibacterial therapy of infections of the upper and lower segments of the urinary tract]. PMID- 3271332 TI - [Pathophysiological and clinical aspects of blood-biological material interactions in hemodialysis therapy]. PMID- 3271333 TI - Ancrod in glomerulonephritis. PMID- 3271334 TI - Are tuberculous patients at a great risk from hypercalcemia? AB - The risk of tuberculous patients to develop hypercalcemia was investigated in 33 patients aged 19 to 80. Twenty-two of the 33 received no vitamin D supplements. Before antituberculous chemotherapy serum calcium corrected for albumin and urinary calcium levels were normal, serum 25-hydroxyvitamin D (25(OH)D) levels were low, but serum 1,25(OH)2D levels, oral calcium load test and intestinal 47Ca absorption were normal. After 17 to 34 days of chemotherapy serum calcium corrected for albumin and 1,25(OH)2D levels were lower without change in serum D binding protein. In 11 patients 25(OH)D, 50 micrograms/day, was given orally for two months. 25(OH)D given three days before chemotherapy in five patients induced an increase of levels of 1,25(OH)2D which was greater than in 10 control patients with similar serum levels of 25(OH)D. When chemotherapy was added to 25(OH)D, the five patients showed high normal 1,25(OH)2D levels. The last six patients received 25(OH)D together with or after starting chemotherapy. None of the 33 patients developed hypercalcemia, even when supplemented with 25(OH)D for two months. It appears that hypercalcemia is uncommon in tuberculosis. PMID- 3271335 TI - Community-acquired bacteraemia; a prospective survey of 239 cases. AB - Over a one-year period 239 patients with community-acquired bacteraemia were studied prospectively to evaluate their clinical profile, course and outcome. Gram-negative organisms accounted for 108 (45 per cent) episodes of bacteraemia, Gram-positive 121 (51 per cent) and polymicrobial 10 (4 per cent). The organisms isolated most commonly were E. coli (28.9 per cent), Klebsiella spp. (7.5 per cent), S. pneumoniae (21.3 per cent), S. aureus (12.1 per cent) and haemolytic streptococci (4.6 per cent). The overall mortality was 29.2 per cent and most deaths were caused by bacteraemia or related complications. This condition therefore still has a high mortality despite modern antimicrobial drugs and intensive care. The most important factor in reducing mortality is early recognition and administration of appropriate antimicrobial drugs. PMID- 3271336 TI - Development and assessment of a computerized index of clinical disease activity in systemic lupus erythematosus. Members of the British Isles Lupus Assessment Group (BILAG). AB - Five centres in Great Britain and the Republic of Ireland have collaborated to produce a computerized index of clinical disease activity in systemic lupus erythematosus, based on the principle of the physician's intention to treat. The index assesses separately eight organ-based systems. The index has proved quick and easy to use despite a comprehensive database and compares favourably with two other indices of disease activity. It has great potential for use in multicentre studies of disease outcome and new therapies in systemic lupus erythematosus. PMID- 3271338 TI - [The history and prospects of studying calcium ions and cell functions]. PMID- 3271337 TI - Clinical features and therapy of acute thallium poisoning. AB - Severe acute thallium poisoning in a young man is described. He presented with transient loss of consciousness and paraesthesiae of finger tips and lips, with a blood thallium concentration of 5750 micrograms/l (levels above 200 micrograms/l are toxic). He rapidly lost limb sensation and power and later required temporary mechanical ventilation and nasogastric feeding. The neurological sequelae one year afterwards are a flaccid paraparesis, cerebellar ataxia and mental impairment. Immediate cardiovascular complications included hypertension, sinus tachycardia, ECG abnormalities and an episode of ventricular fibrillation. We were able to assess the relative merits of different methods advocated for enhancing thallium excretion. Oral Prussian blue, forced diuresis and haemodialysis were found to be the most effective: 2000 mg of thallium were eliminated over 20 days, 820 mg over 46 days and 225 mg over 25 days respectively by these methods. Haemofiltration was ineffective. Diethyldithiocarbamate, a chelating agent, brought about a rise in serum thallium concentration accompanied by clinical deterioration and its use should be abandoned. PMID- 3271339 TI - [Intracellular Ca2+ mobilization in cardiac muscle]. PMID- 3271340 TI - [Roles and mechanisms of IP3 and IP4 in calcium mobilization]. PMID- 3271341 TI - [Na(+)-Ca2+ exchange]. PMID- 3271342 TI - [EF-hand proteins; an intracellular calcium sensor]. PMID- 3271343 TI - [Vitamin D-dependent Ca2(+)-binding protein]. PMID- 3271344 TI - [gamma-Carboxyglutamic acid-containing proteins of bone]. PMID- 3271346 TI - [Microcalorimetric studies on Ca2+ binding by the Ca2+ binding proteins]. PMID- 3271345 TI - [Structure of Ca2(+)-binding proteins--X-ray and NMR]. PMID- 3271347 TI - [Calcium regulation of muscle contraction and three troponin components]. PMID- 3271348 TI - [Comparative biochemistry and molecular evolution of troponin]. PMID- 3271349 TI - [The regulation of polymerization and depolymerization of action of Ca2+]. PMID- 3271350 TI - [Ca2+ binding to calmodulin--conformational change and expression of function]. PMID- 3271351 TI - [Molecular evolution of calmodulin]. PMID- 3271352 TI - [Calmodulin-binding protein; recent biological aspects of calspectin (fodrin or nonerythroid spectrin)]. PMID- 3271353 TI - [Protein kinase C--multiplicity and distribution]. PMID- 3271354 TI - [Intracellular calcium signaling and selective inhibitors]. PMID- 3271355 TI - [Regulation of platelet functions]. PMID- 3271356 TI - [Functional domains of vitamin K-dependent blood coagulation factors]. PMID- 3271357 TI - [Temporal and spatial changes in intracellular Ca2+ upon fertilization and during cell division]. PMID- 3271358 TI - [Calcium metabolism and bone formation]. PMID- 3271359 TI - American cutaneous leishmaniasis: presentation and problems of patient management. PMID- 3271360 TI - [Adrenal gland involvement associated with paracoccidioidomycosis]. PMID- 3271361 TI - An outbreak of cutaneous leishmaniasis. PMID- 3271362 TI - [Relation of the brachial perimeter and some indicators of intrauterine growth]. PMID- 3271364 TI - [Echocardiographic diagnosis of intracardiac tumors]. PMID- 3271363 TI - [The spread of H. influenzae type B in familial contacts of children with with systemic infection by this agent]. PMID- 3271365 TI - [Metabolic alkalosis in cystic fibrosis of the pancreas]. PMID- 3271366 TI - [Gastric perforation in newborn infants]. PMID- 3271368 TI - [Cerebral infarction in full-term newborn infants with convulsions]. PMID- 3271367 TI - [Total virilism in a female patient: an unusual form of presentation of congenital adrenal hyperplasia]. PMID- 3271370 TI - [Menstruation disorders in adolescence]. PMID- 3271369 TI - [Hyperthyroidism]. PMID- 3271371 TI - [Disorders in sex differentiation]. PMID- 3271373 TI - [Prenatal diagnosis of chromosome abnormalities and other abnormalities in the amniotic fluid]. PMID- 3271372 TI - [Chromosomal diseases]. PMID- 3271374 TI - [Genetic counseling in habitual abortion]. PMID- 3271375 TI - [Inborn errors of metabolism]. PMID- 3271376 TI - [Teratogens]. PMID- 3271379 TI - Effect of vitamin C administration on serum and egg-yolk cholesterol level of the chicken. AB - Ascorbic acid (vitamin C) was given to 144-days-old layer chickens mixed with their ration at three concentrations: 30, 60 and 90 p.p.m. for 6 months. Cholesterol levels in blood serum (CS) and egg yolk (CE) were measured every 6 weeks (four periods); there was a marked decrease in CS in most treated birds, especially those receiving the highest concentration of vitamin C. There was also a slight decrease in CE in most treated birds. Thyroidal weight showed a significant increase in most treated groups, especially those receiving the highest concentration of vitamin C. PMID- 3271377 TI - [Polychemotherapy of leprosy in the Central African Republic, 1987]. AB - The Central African Republic, which once had the highest Hansen disease prevalence rate in the Central African States, had exemplary results in the control carried out on the basis of sulfonic monotherapy since 1958. In 1983, a cluster sample survey in Upper-Sangha seemed to show that the prevalence of the disease was underestimated. It then became necessary to adopt a new national strategy whose objective would be to reduce the prevalence of leprosy in the country by 50% within five years. For this, a "National Programme for the Control of Leprosy in C.A.R." has been developed; in part it foresees the setting up of polychemotherapy for patients. These treatment protocols should insure healing of paucibacillary forms within six months and of multibacillary forms within twenty four months. The new strategy of screening and decentralized treatment required retraining personnel and combining health education at individual and collective levels. The preliminary results of a national survey for the evaluation of the prevalence of leprosy are presented. PMID- 3271380 TI - Dietary regulation of ornithine transcarbamylase mRNA in liver and small intestine. AB - In the rat, changes in dietary protein intake give rise to changes in the levels of ornithine transcarbamylase (OTC) in liver and small intestine--an increase in liver and decrease in small intestine. The changes in enzyme level are accompanied by similar changes in levels of specific mRNA. Thus in liver, there is an increase in the level of specific mRNA when protein intake is increased, whereas in small intestine there is a small decrease. Comparison of changes in specific mRNA with total poly-A-containing RNA showed that the change in OTC mRNA in liver paralleled the change in total RNA levels. In contrast, in small intestine the small decrease in OTC mRNA levels when protein intake was increased was in the face of an increase in the level of total mRNA. Whereas the level of OTC is 20-fold higher in liver than in small intestine, the mRNA level for the enzyme differs by only 2.5-fold. PMID- 3271378 TI - [Polychemotherapy of leprosy in a rural area]. PMID- 3271381 TI - Effect of anti-oestradiol-17B antibodies on the reproductive response of ewes superovulated with PMSG. AB - A field experiment was conducted to examine the effect of anti-oestradiol-17B antibody titre on the oestrous and ovulatory responses of ewes to low (600 i.u.) or high (1200 i.u.) doses of pregnant mare's serum gonadotrophin (PMSG). Merino ewes were treated with intravaginal sponges and were subsequently used as vehicle treated controls or were immunized to produce reciprocal anti-oestradiol-17B antibody titres less than 1000 or greater than 1000. Ewes were then treated with PMSG and the incidence of oestrus and ovulation, ovulation rate, and yield of embryos recorded. Treatment of immune ewes with 1200 i.u. PMSG resulted in both a higher proportion of ewes ovulating and a higher ovulation rate than in immune ewes treated with 600 i.u. (86% v. 67% and 13.4 v. 6.0 respectively). As anti oestradiol-17B titres increased there was a reduction in the proportion of ewes exhibiting oestrus. The proportion of ewes ovulating decreased as antibody increased in ewes treated with 600 i.u. PMSG but not in those treated with 1200 i.u., suggesting an increased positive feedback of oestradiol with high PMSG doses. Fertilization rates were highest at the lower PMSG dose (68% v. 42%) and increased with increasing titre. Overall, there was no increase in ovulation rate or in yield of embryos over control values from either low (less than 1000) or high (greater than 1000) antibody titres. PMID- 3271382 TI - Milk composition in the northern brown bandicoot, Isoodon macrourus (Peramelidae, Marsupialia). AB - Milk samples were obtained at regular intervals throughout lactation from northern brown bandicoots, Isoodon macrourus, in captivity. Total concentration of milk solids was initially 7% (w/w) and increased linearly to 45% (w/w) by 55 days. Carbohydrate, lipid and protein concentrations increased from about 2% (w/w) to about 7-8% (w/w) at 30 days. Thereafter they diverged, with lipid increasing to between 25-30% (w/w) at 56 days, protein reaching maximal values of 10-15% (w/w) at just over 40 days and carbohydrate gradually declining to about 5% (w/w) at 56 days before a rapid fall to 1-2% (w/w) at the completion of lactation. The milk of the bandicoot exhibits a similar pattern of change during the course of lactation to that shown by other marsupials. PMID- 3271384 TI - Complete nucleotide sequence of the bovine beta-casein gene. AB - The beta-casein gene is a member of a small gene family encoding the calcium sensitive caseins, which are specifically synthesized and secreted by the mammary gland during lactation in response to both peptide and steroid hormones. The caseins are involved in the transport of calcium phosphate in milk, which is important for bone development in the infant mammal. We report here the organization and complete DNA sequence of the 8.5 kb long bovine beta-casein gene. Comparison with the rat beta-casein gene reveals that the exons of both genes correspond exactly. The 5' flanking sequences of all Ca-sensitive casein genes are conserved within the proximal 200 bp and contain several elements that probably function as cis-acting regulatory elements, including an octamer-like motif, and SV40-type core enhancer and a sequence that appears to be common to all lactoprotein genes. The latter sequence is flanked on either side by 12 bp direct repeats. These direct repeats are themselves each part of sequences that display two-fold symmetry. The first 30 nucleotides of the 3' flanking regions in the bovine and rat beta-caseins are well conserved, indicating that they are likely to be involved in the mechanism of 3' end processing of the primary transcript. PMID- 3271385 TI - The fate of tritiated rm-epidermal growth factor in the sheep: validation of the labelling procedure and rate of tissue clearance. AB - Plasmid-derived recombinant mouse epidermal growth factor, rm-EGF, was purified by ion pair reversed phase high performance liquid chromatography. The product peak (termed rm-alpha-EGF) was characterized by physicochemical techniques including fast atom bombardment mass spectrometry, high field proton magnetic resonance and amino acid sequencing (amino acid arrangement and composition). The rm-alpha-EGF was tritiated, labile tritium removed by lyophilization, and the product purified and characterized as for the parent compound to yield a compound identical to rm-alpha-EGF except for the isotopic hydrogen substitution. Label stability was validated by lyophilization of samples, especially urine. The tritiated rm-alpha-EGF was used to determine the excretion rate and tissue distribution pattern in the sheep. It was administered by intravenous infusion for 24 h at a dose rate of 120 micrograms kg-1 live weight. Blood, urine and faeces were collected at frequent intervals from all sheep up to slaughter. Sheep were slaughtered at 24 h (3 sheep), 48 h (3 sheep), and 192 h (1 sheep) from the start of infusion and samples of all tissues and organs collected. Samples were assayed by liquid scintillation counting, directly for liquids, and after combustion to tritiated water for solids. For residue studies all solid samples were lyophilized to constant weight before combustion, and volatile tritium determined from the lyophilisate. Urinary excretion was extensive and rapid. From the start of the infusion 30.1% of the administered tritium was recovered at 24 h, 40.4% at 48 h and 55.1% at 192 h. Comparison of RIA and tritium (3H) in plasma and urine samples indicated that the EGF had undergone considerable metabolism. Faecal excretion of EGF was also significant, being 1.5% at 24 h, 2.1% at 48 h and 10.0% at 192 h after the start of the infusion. Of the EGF not excreted at the time of slaughter, 41.9% (24 h), 36.8% (48 h) and 22.1% (192 h) was present in eight locations: muscle, intestine, gut content, skin, blood, liver, kidney, and lung. Tritium in fat (omental, perinephric, subcutaneous) was negligible, and no 3H was detected in the plucked fleece 192 h after the start of the infusion. Volatile metabolic products (H2O, CH4, NH3) excreted via the lung were not measured. The overall recoveries of 97.4% (24 h), 100.5% (48 h), and 97.8% (192 h) confirm that the label was in stable positions. This result thus validates the labelling procedure and the use of a generally labelled compound, and confirms the efficacy of the sampling procedure.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3271383 TI - Oestrogen sulfotransferase: molecular cloning and sequencing of cDNA for the bovine placental enzyme. AB - The female sex hormone, oestrogen, plays a central role in breast cell proliferation in both the normal and malignant state. It controls transcription from several genes, including that for the progesterone receptor, and in endometrial tissue, via this receptor, it controls the gene for the enzyme oestrogen sulfotransferase. This enzyme may control the level of the oestrogen receptor by sulfurylating free oestradiol. To study the mode of transcriptional control exercised by oestrogen, bovine oestrogen sulfotransferase cDNA has been cloned and the nucleotide sequence determined. The message, of which 1812 bases have been sequenced, contains an open reading frame of 885 bases which encode a protein of 295 amino acids and a maximum apparent molecular weight of 34,600. The deduced protein sequence is supported by existing peptide sequence data and appears to contain a steroid-binding region. Some physico-chemical characteristics of the enzyme appear to differ markedly from those previously reported. PMID- 3271386 TI - Statement regarding: Effects of scopolamine hydrobromide on the development of the chick and rabbit embryo. PMID- 3271387 TI - Is there an accessory sphincter of the cervical oesophagus? PMID- 3271388 TI - Malignant hyperthermia revisited. PMID- 3271389 TI - Airborne endotoxin associated with industrial-scale production of protein products in gram-negative bacteria. AB - Human and animal proteins of therapeutic value can be produced in E. coli, a gram negative bacteria. Endotoxin, a cellular component, is reported to have clinically significant health effects. Operations--including culturing the microbe, separating solids by centrifugation, and mixing/homogenizing--had associated endotoxin levels ranging from 0.07 ng/m3 to 12.8 ng/m3. Utilizing a 10 fold safety factor under the threshold where clinically significant changes can be detected, an action level of 30 mg/m3 for large scale operations involving the use of E. coli was established. Operations conducted without engineering controls had maximum airborne endotoxin levels of 1812 ng/m3. PMID- 3271390 TI - Digoxin induced Q-T prolongation. PMID- 3271391 TI - "Inadequate Flow After Internal Mammary-Coronary Artery Anastomoses". PMID- 3271393 TI - [3 methods of canal obturation]. PMID- 3271392 TI - Studies of blood pressure and prevalence of hypertension in schoolchildren in Jakarta. PMID- 3271394 TI - [Orthograde and retrograde retreatment of surgical failures]. PMID- 3271395 TI - [Retrospective analysis of 1200 apices]. PMID- 3271396 TI - [Anatomic-operative considerations with special reference to the apical third]. PMID- 3271397 TI - [A new experimental approach to evaluate the use of warm gutta percha in canal obturation]. PMID- 3271398 TI - [Comparative in vitro evaluation of amalgams with and without zinc in surgical endodontics]. PMID- 3271399 TI - [Comparison of root canal cleaning with manual or ultrasonic methods]. PMID- 3271400 TI - [Electronic measurement of root canal length: is it accurate?]. PMID- 3271401 TI - [Histological changes in dental pulp of teeth with periodontal lesions]. PMID- 3271402 TI - [Comparative clinical study in methods of measuring the length of root canals in endodontic treatment]. PMID- 3271403 TI - [Endo-periodontal lesions]. PMID- 3271404 TI - [Prevention of lipothymia in dental patients]. PMID- 3271407 TI - Glass ionomers. PMID- 3271405 TI - [Conscious sedation with nitrous oxide in minor oral surgery patients: one year's experience]. PMID- 3271409 TI - Essential oils. PMID- 3271408 TI - Bleaching vital teeth in canines. PMID- 3271406 TI - [Ultrasound in pedodontic endodontics]. PMID- 3271410 TI - Surgical removal of an odontoma in a dog. PMID- 3271411 TI - The flexibility of the nucleic acids: (III). The interaction of an aliphatic diamine, putrescine, with flexible B-DNA. AB - A theoretical modelling of the interaction of putrescine (H3+N-(CH2)4-(+NH3) with DNA is carried out, introducing two new features which make the simulation of this interaction considerably more realistic. Firstly, the DNA to which putrescine is bound is fully flexible and thus able to respond to the distorting influence of the ligand. Secondly, the effect of changing the ratio of DNA base pairs per bound ligand is explicitly modelled. In this way, we have been able to confirm the experimentally known preference of putrescine binding with AT base pairs in B-DNA, but we also show, through the new features introduced, that the nature of the binding site of the ligand and the resulting impact on DNA conformation is strongly modified by the ligand binding density. PMID- 3271412 TI - DNA models for A, B, C and D conformations related to fiber X-ray, infrared and NMR measurements. AB - A conformational analysis of the A, B, C and D DNA forms was made in order to establish molecular models presenting a good agreement with experimental data obtained from fiber X-ray, infrared linear dichroism and 31P NMR. The proposed models have been refined and do present good stereochemistry and optimized H-bond distances between bases associated with the Watson-Crick pairing. The DNA conformations proposed are a left handed double helix for the C form and right handed helices for A, B and D. Relations to conformational transitions between these forms are discussed. PMID- 3271414 TI - On the compact form of linear duplex DNA: globular states of the uniform elastic (persistent) macromolecule. AB - A theory of collapse of DNA considered as unifilar homopolymer is suggested. The collapse is interpreted as the coil-globule transition. Three reasons of the collapse such as the confinement in a microcavity, the influence of poor low molecular-weight solvent and the influence of polymeric solvent were studied. The results are summed up by the stage diagrams in variables: DNA length versus the characteristics of the compaction factor (the cavity volume, the energy of attraction of DNA segments in poor low-molecular-weight solvent and the concentration of polymer added). It is shown that a sufficiently long DNA forms the spherical compact particle while the relatively short DNA forms the toroidal one. More delicate features of the tertiary structure are determined by the relative role of the bending stiffness and steric repulsions in preventing further collapse. As the compaction occurs in polymeric solvent almost all added polymer is forced out from the globule. Thus, the internal structure of the compact DNA particle in polymeric solvent is similar to that in the model of microcavity. PMID- 3271413 TI - Theory of the anomalous resonant absorption of DNA at microwave frequencies. AB - Aqueous solutions of oligopolymer DNA have been observed by Edwards, Davis, Swicord & Saffer to show structured absorption of microwave energy in the region of several gigahertz characteristic of an ordered series of compressional normal mode vibrations propagating on the polymer chain. Hydrodynamic coupling of such vibrations to the surrounding solvent would preclude the existence of sharp resonances. The inclusion of electromagnetic interactions with surrounding counter ions yields a richer space of possibilities for complex behavior of the combined system. A well defined resonant absorption peak appears when the molecular motion and the nearby solvent motion are even slightly decoupled. The microwave electric fields in the vicinity of the molecule provide a mechanism for such a decoupling not present for the case of electrically neutral solvent. PMID- 3271415 TI - Infrared spectral studies of the non regularly alternating purine-pyrimidine hexamers d(m5CGGCM5CG), d(CBr8GGCCBr8G) and d(CGCGGC). AB - The oligonucleotides d(m5CGGCm5CG), d(CBr8GGCCBr8G) and d(CGCGGC) have been prepared and studied by infrared spectroscopy. The three sequences contain two GC pairs which are out of purine-pyrimidine alternation with the rest of the sequence. From the IR data of the d(m5CGGCm5CG) hexamer, it is shown that all of the dG residues adopt a syn conformation. The marker IR bands for the C3' endo syn conformation are at 1410, 1354, 1320 and 925 cm-1 whereas those for the C2' endo anti conformation at 1420, 1374 and 890 cm-1 are clearly absent. This result implies that the two adjacent guanines of the d(m5CGGCm5CG) sequence are in syn conformation. It is suggested that duplex formation occurs in d(CGCGGC) films and that all of the guanines are in syn conformation. In contrast, the central non brominated guanine of the d(CBr8GGCCBr8G) hexamer is found in anti conformation, as expected in a Z type structure of the non-alternating region. PMID- 3271416 TI - Binding stoichiometry of the gene 32 protein of phage T4 in the complex with single stranded DNA deduced from boundary sedimentation. AB - Short 145 base DNA fragments in complex with the helix destabilizing protein of bacteriophage T4, GP32, have been studied with boundary sedimentation. The sedimentation coefficient was determined as a function of concentration, protein nucleic acid ratio, temperature and salt concentration. It can be concluded that the measured values reflect the properties of the saturated DNA-GP32 complex. A combination of the earlier obtained translational diffusion coefficient of the complex with the sedimentation coefficient yields its anhydrous molecular weight (Mw = 5.4.10(5) D), which corresponds to a size of the binding site of 10 nucleotides per protein. This procedure is not sensitive to the presence of non binding protein molecules and to the assumed protein concentration, and therefore, it seems more reliable than a determination from titration experiments. Similar sedimentation measurements were performed with tRNA complexes containing 76 nucleotides. The translational diffusion coefficient can be calculated from the measured rotational diffusion coefficient and assuming the same hydrodynamic diameter for this complex as obtained for the 145 b DNA complex. The molecular weight derived from the data then also leads to a binding site size of about 10 nucleotides. This suggests that also the short tRNA-complex forms an open, strongly solvated structure, as was proposed for the 145 b DNA GP32 complex. PMID- 3271417 TI - 31P NMR studies of the binding of the oligonucleotide (Ap)3A to an oligodeoxythymidylate covalently linked to an acridine derivative. AB - 31P NMR was used to study the specific interaction of an oligodeoxynucleotide containing four thymines and covalently attached to an acridine derivative through its 3'-phosphate [(Tp)4(CH2)5Acr] with a complementary oligoribonucleotide (Ap)3A. 31P-1H and 1H-1H chemical shift correlation spectroscopies were jointly used to provide the assignment of the phosphorus resonances. A downfield shift of two phosphorus resonances of (Tp)4(CH2)5Acr and of two phosphorus resonances of (Ap)3A was observed upon complex formation. The assignment of the phosphorus resonances which are downfield shifted allowed us to propose a model involving an equilibrium between several 1:1 complexes where the acridine ring is intercalated between different A.T base pairs. PMID- 3271418 TI - Conformation and configuration at the central amine nitrogen of a nucleotide adduct of the carcinogen 2-(acetylamino)fluorene as studied by 13C and 15N NMR spectroscopy. AB - The conformation and configuration at the central nitrogen of the adduct 8-(N fluoren-2-ylamino)-2'-deoxyguanosine 5'-monophosphate has been investigated by high-field 13C and 15N NMR spectroscopy. One-bond nitrogen-hydrogen coupling constants and 13C chemical shifts for the adduct as well as for the model compounds diphenylamine, 4-nitrodiphenylamine and 2-aminofluorene have been measured in nonaqueous solutions. The data indicate a near planar configuration at the amine nitrogen that links the guanine and fluorene rings of the adduct. The orientations about the guanyl-nitrogen and fluorenyl-nitrogen bonds place the two ring systems in either perpendicular (Type A) or helical (Type B) conformations. It is suggested, based on structural similarities to diarylamines, that the G-N-C bond angle of the adduct is greater than 120 degrees in order to reduce unfavorable steric interactions between the two ring systems. Space filling molecular models of the adduct in duplex DNA show that the aminofluorene moiety can be oriented into both Type A and Type B conformations within the major groove. The configuration at nitrogen of diphenylamine, 4-nitrodiphenylamine and 2-aminofluorene has also been examined. PMID- 3271419 TI - 1H NMR study of self-association and restricted internal rotation of the C8 substituted deoxyguanosine 5'-monophosphate adduct of the carcinogen 2 (acetylamino)fluorene. AB - The high-field 1H NMR spectra of a nucleotide-carcinogen adduct formed from 2 (acetylamino)fluorene (8-(N-fluoren-2-ylacetamido)-2'-deoxyguanosine 5' monophosphate) have been examined in aqueous solution as a function of concentration at high and low temperatures. An anomalous concentration dependence of NMR spectra was observed at concentration levels over 1 mM. These spectral characteristics have been analyzed in terms of changes in self-association and in the interconversions between torsional diastereomers associated with the central nitrogen. Association constants have been computed. Stacking interactions, which involve both the fluorene and guanine rings, are strong, cooperative and highly temperature-dependent. Deacetylation alters the mode of stacking. Several effects of solvent and aggregation on the conformation at the central nitrogen are discussed. PMID- 3271421 TI - The flexibility of the nucleic acids: (I). "SIR", a novel approach to the variation of polymer geometry in constrained systems. AB - A novel and powerful methodology is developed which allows the alteration of molecular structures subjected to constraints and its application to polynucleotides with mononucleotide repeat symmetry, including the treatment of the flexible sugar rings is described. In contrast to procedures proposed by other authors, the constraints are formulated as differential equations which are linear with respect to the differentials of the geometrical variables. These equations can be solved easily by stepwise numerical integration involving sucessive infinitesimal rotations (SIR). Moreover, these equations define a set of independent curvilinear coordinates which can be used directly as the parameters of the energy functional in an energy minimisation procedure. This methodology allows the scanning of the full configurational space of a complex macromolecule, with direct access to the helicoidal variables in the case of periodic systems. Through this approach many problems involving biomacromolecular conformation, which would otherwise be intractable, may be studied with considerable ease. PMID- 3271420 TI - Conformations of complexes derived from the interactions of two stereoisomeric bay-region 5-methylchrysene diol epoxides with DNA. AB - The reaction mechanisms of two isomeric bay-region diol epoxides of 5 methylchrysene (trans-1,2-dihydroxy-anti-3,4-epoxy-1,2,3,4-tetrahydro-5 methylchrysene (DE-I) and trans-7,8-dihydroxy-anti-9,10-epoxy-7,8,9,10-tetrahydro 5-methylchrysene (DE-II) with double-stranded DNA in aqueous solutions were studied utilizing kinetic flow dichroism and fluorescence techniques. As in the case of the previously studied benzo(a)pyrene-7,8-diol-9,10-oxide isomers (BaPDE), both DE-I and DE-II rapidly form intercalation-type complexes (association constants K = 2700 and 1500 M-1 respectively in a neutral 5mM phosphate solution). The physically bound diol epoxide molecules react on time scales of minutes to form predominantly tetraols; a greater fraction (6 +/- 1%) of DE-I than of DE-II (2-3%) molecules react with the DNA to form covalent products. The DE-II isomer is characterized by a greater reactivity than DE-I, and the rates of reaction are markedly accelerated in the presence of DNA in both cases. The linear dichroism spectra of the covalent adducts reveal that the conformations of both types of adducts are similar, with the long axes of the phenanthrenyl chromophores tilted, on the average, at angles of 38-52 degrees with respect to the average orientations of the transition moments (at 260 nm) of the DNA bases. The conformations of the covalently bound DE-I and DE-II molecules resemble those observed in the case of the highly tumorigenic (+) enantiomer of anti-BaPDE.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3271422 TI - The flexibility of the nucleic acids: (II). The calculation of internal energy and applications to mononucleotide repeat DNA. AB - Results concerning the flexibility of mononucleotide repeat DNA are presented using a novel methodology, denoted "SIR", to describe continuous changes in the structure of the nucleic acid. This methodology, combined with internal energy calculations and analytical energy gradients allows us to determine optimal conformations of poly(dG).poly(dC) and poly (dA).poly(dT) in both the A and B forms, taking into account the influence of the solvent medium and explicit counterions. Subsequently, several different types of distorsion of these optimal structures are investigated. It is shown that excellent correlation with experimental results concerning coupled changes in structural variables is obtained and several new correlations are also detected. PMID- 3271423 TI - Prediction of 3-D structure of the Cro protein from phage 434. AB - A comparative model building process has been utilized to predict the three dimensional structure of the bacteriophage 434 Cro protein. Amino acid sequence similarities between the 434 Cro protein and other bacteriophage repressor and Cro proteins have been used, in conjunction with secondary structure prediction and the known structures of other base sequence specific DNA binding proteins, to derive the model. From this model the interactions between the 434 Cro protein and its operator DNA have been deduced. These proposed interactions are consistent with the known properties of the bacteriophage 434 Cro protein. PMID- 3271424 TI - Modelling and refinement of the crystal structure of nucleoprotamine from Gibbula divaricata. AB - The molecular structure of nucleoprotamine from Gibbula divaricata and its packing in oriented fibers has been modelled both to fit the X-ray diffraction pattern and to avoid steric compression. The representative model consists of 51 poly (dinucleotide) B-DNA helices with 51 poly(hexapeptide) chains associated with the major grooves. The prevailing peptide conformation is beta. The four arginine residues present are hydrogen-bonded to DNA phosphates while neutral peptides protrude into the minor grooves of neighboring nucleoprotamine molecules which are packed 2.61 nm apart in a screw-disordered, quasi-hexagonal lattice. This model reconciles a number of earlier, apparently conflicting experimental results and explains the remarkable stability of nucleoprotamines. PMID- 3271425 TI - The binding of fd gene 5 protein to polydeoxynucleotides: evidence from CD measurements for two binding modes. AB - Circular dichroism measurements were used to study the binding of fd gene 5 protein to fd DNA, to six polydeoxynucleotides (poly[d(A)], poly[d(T)], poly[d(I)], poly[d(C)], poly[d(A-T)], and the random copolymer poly[d(A,T)]), and to three oligodeoxynucleotides (d(pA)20, d(pA)7, and d(pT)7). Titrations of these DNAs with fd gene 5 protein were generally done in a low ionic strength buffer (5 mM Tris-HCl, pH 7.0 or 7.8) to insure tight binding, needed to obtain stoichiometric endpoints. By monitoring the CD of the nucleic acids above 250 nm, where the protein has no significant intrinsic optical activity, we found that there were two modes of binding, with the number of nucleotides covered by a gene 5 protein monomer (n) being close to either 4 or 3. These stoichiometries depended upon which polymer was titrated as well as upon the protein concentration. Single endpoints at nucleotide/protein molar ratios close to 3 were found during titrations of poly[d(T)] and fd DNA (giving n = 3.1 and 2.8 +/- 0.2, respectively), while CD changes with two apparent endpoints at nucleotide/protein molar ratios close to 4 and approximately 3 were found during titrations of poly[d(A)], poly[d(I)], poly[d(A-T)], and poly[d(A,T)] (with the first endpoints giving n = 4.1 4.0, 4.0, and 4.1 +/- 0.3, respectively). Calculations showed that the CD changes we observed during these latter titrations were consistent with a switch between two non-interacting binding modes of n = 4 and n = 3. We found no evidence for an n = 5 binding mode. One implication of our results is that the Brayer and McPherson model for the helical gene 5 protein-DNA complex, which has 5 nucleotides bound per protein monomer (G. Brayer and A. McPherson, J. Biomol. Struct. and Dyn. 2, 495-510, 1984), cannot be correct for the detailed solution structure of the complex. We interpreted the CD changes above 250 nm upon binding of the gene 5 protein to single-stranded DNAs to be the result of a slight unstacking of the bases, along with a significant alteration of the CD contributions of the individual nucleotides in the case of A and/or T-containing DNAs. Interestingly, CD contributions attributed to nearest neighbor interactions in free poly[d(A-T)], poly[d(A,T)], poly[d(A)], and poly[d(T)] were partially maintained in the CD spectra of the protein-saturated polymers, so that neighboring nucleotides, when bound to the protein at 20 degrees C, appeared to interact with one another in much the same manner as in the free polymers at 50 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3271426 TI - A neutron scattering study of the ternary complex EF-Tu.GTP-valyl-tRNAVal1A. AB - The complex formation between elongation factor Tu (EF-Tu), GTP, and valyl tRNAVal1A has been investigated in a hepes buffer of "pH" 7.4 and 0.2 M ionic strength using the small-angle neutron scattering method at concentrations of D2O where EF-Tu (42% D2O) and tRNA (71% D2O) are successively matched by the solvents. The results indicate that EF-Tu undergoes a conformational change and contracts as a result of the complex formation, since the radius of gyration decreases by 15% from 2.82 to 2.39 nm. tRNAVal1A, on the other hand, seems to mainly retain its conformation within the complex, since the radii of gyration for the free (after correction for interparticular scattering) and complexed form are essentially the same, 2.38 and 2.47 nm, respectively. PMID- 3271430 TI - Computer analysis of R-looped DNA from electron micrographs. AB - The algorithms of the analysis of R-looped DNA molecules from electron micrographs are presented. We propose a two-dimensional R-loop distribution map with abscissa and ordinate axes corresponding to the positions of the left and right ends of the loop respectively. A transcription analysis of the hybrid plasmid pSCV1, which comprises heterologous genes from SV40 and pBR322, based on this map illustrates the program application. PMID- 3271429 TI - Intensity changes of base and backbone Raman modes in the B to Z transition of poly(dG-dm5C). AB - Raman spectroscopy was employed to investigate the temperature-induced B to Z transition of poly(dG-dm5C). The transition midpoint was about 37 degrees C for a solvent containing 20 mM Mg2+. A 10-fold change in Mg2+ concentration altered the transition midpoint by at least 60 degrees C. Raman spectra of the B and Z forms of poly(dG-dm5C) exhibited characteristics similar to those observed with poly(dG dC). The 682 cm-1 guanine mode and 835 cm-1 backbone mode were present in the B conformation. In the Z form the intensities of these two bands decrease substantially and new peaks were observed at 621 cm-1, 805 and 819 cm-1. Several bands unique to poly(dG-dm5C) were also observed. Transition profiles of band intensity vs. temperature were determined for fourteen Raman bands. The curves of all of the base vibrations and one backbone mode had the same slope and midpoint. This indicates that conformational changes in the guanine and methycytosine bases occur concurrently. PMID- 3271427 TI - TGTG, G clustering and other signals near non-mammalian vertebrate mRNA 3' termini: some implications. AB - Analysis of non-mammalian vertebrate DNA sequences in the 500 nucleotides preceding and 200 nucleotides following mRNA 3' termini yields some distinct signals. In addition to the well known AATAAA sequence, TGTG recurs very frequently further downstream. GGGG, TGGG, GGAG and GAGG are frequent in this region too. It is suggested that unlike the AATAAA mRNA cleavage/processing signal, the other signals noted above are signals on the DNA, i.e. they are signals for mRNA termination. An asymmetric distribution of some complementary sequences, e.g. TGTG vs. CACA, GGGG vs. CCCC, on the same DNA strand is noted as well. A few other signals are also observed. PMID- 3271428 TI - Binding of non-intercalating antibiotics to B-DNA: a theoretical study taking into account nucleic acid flexibility. AB - A detailed theoretical study has been made for five antibiotics which all bind selectively to AT sequences in the minor groove of B-DNA: SN-18071, NSC-101327, distamycin-2, distamycin-3 and netropsin. The optimal complexes were found for systems in which the flexibility of DNA, as well as that of the antibiotics, was taken into account. Explicit, mobile counterions and a dielectric function modelling aqueous solution were also included. The binding geometries of the most strongly interacting antibiotics, distamycin-3 and netropsin, are compared in considerable detail and it is shown that notable differences exist between them. The results for netropsin are also discussed in the light of recent disagreements concerning its exact binding location within DNA. PMID- 3271431 TI - High-field 1H and 31P NMR studies on the binding of the anticancer agent mitoxantrone to d[CpGpApTpCpG]2. AB - A high-field 1H and 31P-NMR study of the oligomer d[CpGpApTpCpG]2 was carried out in H2O and water signal suppression was employed in all 1H NMR acquisitions. Particular attention was given to imino proton and 31P assignments. Two dimensional 31P-1H shift correlation contours were particularly useful in 31P assignments and confirming previous 1H assignments. Titrimetric addition of aliquots of the anticancer agent mitoxantrone resulted in selective and progressive chemical shifts with critical changes at stoichiometries of 1:1 and 2:1 drug to DNA ratios. The results indicate ultimate intercalative binding of the drug at both C.G. termini of the oligomer in accord with the previously determined C.G. preference and with non-nearest neighbor intercalation. PMID- 3271432 TI - A theoretical investigation of the sequence specificity in the binding of the antitumor drug anthramycin to DNA. AB - A theoretical study is presented concerning DNA-anthramycin adducts. By explicit energy minimisations using a semi-empirical energy formula and an advanced algorithm the structural properties and the energetics of this system are analysed. The results obtained demonstrate that the formation of a covalently bound adduct in which anthramycin is attached to the N2 site of a guanine within a DNA fragment is accompanied by a considerable change in the nucleic acid conformation as confirmed by recent experimental evidence. With the use of the "SIR" methodology for treating DNA flexibility the general features of this change are characterised. The sequence specificity of anthramycin binding is investigated and the important role of sequence dependent nucleic acid flexibility brought to light. This theoretical treatment thus provides new elements for the interpretation of the origins of ligand binding specificities. PMID- 3271433 TI - Protein structure and neutral theory of evolution. AB - The neutral theory of evolution is extended to the origin of protein molecules. Arguments are presented which suggest that the amino acid sequences of many globular proteins mainly represent "memorized" random sequences while biological evolution reduces to the "editing" these random sequences. Physical requirements for a functional globular protein are formulated and it is shown that many of these requirement do not involve strategical selection of amino acid sequences during biological evolution but are inherent also for typical random sequences. In particular, it is shown that random sequences of polar and amino acid residues can form alpha-helices and beta-strand with lengths and arrangement along the chain similar to those in real globular proteins. These alpha- and beta-regions in random sequences can form three-dimensional folding patterns also similar to those in proteins. The arguments are presented suggesting that even the tight packing of side groups inside protein core do not require very strong biological selection of amino acid sequences either. Thus many structural features of real proteins can exist also in random sequences and the biological selection is needed mainly for the creation of active site of protein and for their stability under physiological conditions. PMID- 3271434 TI - Hydrophobic interactions in the major groove can influence DNA local structure. AB - We have considered hydrophobic interactions among aliphatic hydrocarbon groups in A/T sequences. The slightly overwound sequences (T)n.(A)n yield structures with tightly stacked methyl groups along one side of the major groove. The sequence TTAA may yield a sharp bend by folding together the two pairs of stacked methyls on the opposite sides of the major groove. Thus the sequence can affect the formation of either a smooth bend or a sharp kink. These sequence dependent local conformations may be related to a number of biological results. PMID- 3271435 TI - Conformational studies of nucleic acids: III. Empirical multiple correlation functions for nucleic acid torsion angles. AB - There are seven significantly variable torsion angles in each monomer unit of a polynucleotide. Because of this, it is computationally infeasible to consider the energetics of all conformations available to a nucleic acid without the use of simplifications. In this paper, we develop functions suggested by and regression fit to crystallographic data which allow three of these torsion angles, alpha (O3'-P-O5'-C5'), delta (C5'-C4'-C3'-O3') and epsilon (C4'-C3'-O3'-P), to be calculated as dependent variables of those remaining. Using these functions, the seven independent torsions are reduced to four, a reduction in complexity sufficient to allow an examination of the global conformational energetics of a nucleic acid for the remaining independent torsion angles. These functions are the first to quantitatively relate a dependent nucleic acid torsion angle to several different independent angles. In all three cases the data are fit reasonably well, and in one case, alpha, the fit is exceptionally good, lending support for the suitability of the functions in conformational searches. In addition, an examination of the most significant terms in each of the correlation functions allows insight into the physical basis for the correlations. PMID- 3271437 TI - Crystal structure of a Z-DNA fragment containing thymine/2-aminoadenine base pairs. AB - The Z-DNA structure has been shown to form in two crystals made from self complementary DNA hexamers d(CGTDCG) and d(CDCGTG) which contain thymine/2 aminoadenine (TD) base pairs. The latter structure has been solved and refined to 1.3 A resolution and it shows only small conformational changes due to the introduction of the TD base pairs in comparison with the structure of d(CG)3. Spectroscopic studies with these compounds demonstrate that DNA molecules containing 2-aminoadenine residues form Z-DNA slightly more easily than do those containing adenine nucleotides, but not as readily as the parent sequence containing only guanine-cytosine base pairs. PMID- 3271436 TI - Ab-initio quantum mechanical calculations of NMR chemical shifts in nucleic acids constituents. III. Chemical shift variations due to base stacking. AB - Ab inito computations of the different contributions to chemical shift variations due to intra and interstrand stacking are reported for the GC, CG, AT and TA sequences of a B DNA helix. The results obtained for the non hydrogen atoms of the GC stacks show that the chemical shift variations are mainly due to the polarization contribution, the term which decreases slowly with the intermolecular distance. Because of the weaker polarity of adenine and thymine the geometric and polarization contributions are of closer absolute magnitude for the non hydrogen atoms of the intrastrand stacks but the polarization term is the determining contribution in the corresponding interstrand stacks. For the protons which undergo smaller shifts due to the polarization (or electric field effects) the role of the geometric contribution is more important and is even the leading one for the hydrogens of cytosine and thymine in the case of intrastrand stacking. The charge transfer plus exchange term has a non negligeable value for a limited number of cases corresponding to the shortest intermolecular interatomic distances. These results are discussed in relation with the qualitative differences observed between the proton and carbon spectra of dinucleotides and B-DNA duplexes. PMID- 3271438 TI - Structural features and hydration of d(C-G-C-G-A-A-T-T-A-G-C-G); a double helix containing two G.A mispairs. AB - Single crystal X-ray diffraction techniques have been used to characterise the molecular structure of the title compound to 2.5A resolution. The structure consists of ten standard Watson-Crick base pairs and two G.A mismatched base pairs. The purine-purine mismatches have guanine in the usual anti orientation with respect to the sugar and adenine in syn orientation. There are two hydrogen bonds formed between the mismatch bases, N-1 and O-6 of guanine with N-7 and N-6 of adenine respectively. The bulky purine-purine mismatches are accommodated with minor perturbation of the sugar-phosphate backbone. There is a slight improvement in base pair overlap at the mismatch sites. Details of the backbone conformation, base stacking interactions and hydration are presented and compared with those of the parent compound d(C-G-C-G-A-A-T-T-C-G-C-G). PMID- 3271440 TI - A new bithiazole derivative with intercalative properties. AB - In the course of studies related to new molecules with intercalative properties, we have been led to design and synthesize a bithiazole derivative, namely the 2 phenyl-6-[2'-(4'-(ethoxy-carbonyl)thiazolyl)]thiazolo[3,2- b][1,2,4]triazole (PETT). Its interaction with calf thymus DNA was studied using thermal denaturation and viscometry. Our results set in evidence that PETT acts as an intercalator, giving delta Tm, elongation and unwinding of DNA comparable to the values obtained for daunorubicin. The discrepancy between the data presented herein and those precedently obtained for bleomycin and bleomycin models provide evidence that these bithiazole derivatives interact differently with DNA. PMID- 3271442 TI - Interaction of the C14-OH group of adriamycin with DNA phosphate as spectroscopically evidenced. AB - Monitoring the band of the antisymmetric stretching vibration of the backbone PO 2 group in DNA-anthracycline complexes demonstrates an extraordinary wavenumber shift for the adriamycin complex compared to that of daunomycin. The structures of both anthracyclines, however, are very closely related and differ only by a surplus hydroxyl group of adriamycin in the C14 position. The wavenumber shift observed for the DNA-adriamycin complex is unequivocally attributed to an additional linkage of the C14-OH of adriamycin to the phosphate group of DNA. Thus, several of the hypothetical structural models for the DNA-adriamycin complex for which a hydrogen bond between the C14 hydroxyl of the drug and DNA phosphate was postulated (S. Neidle, Cancer Treatment Rep. 61, 928 (1977); G. J. Quigley et. al., Proc. Natl. Acad. Sci. USA 77, 7204 (1980)) get the first clear cut experimental evidence. PMID- 3271441 TI - Hydrogen bond equilibrium constants for the complexes of benzotriazole and some nucleoside derivatives. A near infrared study. AB - Approximate hydrogen bond association constants were determined by near infrared spectroscopy for pairs formed by benzotriazole and a number of nucleoside derivatives. The molecule of benzotriazole forms, in chloroform, hydrogen bonds with inosine, uridine and adenosine derivatives. The order of decreasing association constants for complexes formed by benzotriazole and uridine or inosine derivatives is the opposite of the one observed for pairs formed by adenosine and uridine or inosine derivatives. PMID- 3271439 TI - The condensation of chromatin and histone H1-depleted chromatin by spermine. AB - At low ionic strength, spermine induces aggregation of native and H1-depleted chromatin at spermine/phosphate (Sp/P) ratios of 0.15 and 0.3, respectively. Physico-chemical methods (electric dichroism, circular dichroism and thermal denaturation) show that spermine, at Sp/P less than 0.15, does not appreciably alter the conformation of native chromatin and interacts unspecifically with all parts of chromatin DNA (linker as well as regions slightly or tightly bound to histones). In chromatin, the role of spermine could be more important in the stabilization of higher-order structure than in the condensation of the 30 nm solenoid. The addition of spermine to H1-depleted chromatin revealed two important features: (i) spermine can partially mimic the role of histone H1 in the condensation of chromatin; (ii) the core histone octamer does not appear to play any role in the aggregation process by spermine as DNA and H1-depleted chromatin aggregate at the same Sp/P ratio. PMID- 3271443 TI - The effect of sequence heterogeneity on DNA melting kinetics. AB - We consider kinetics of the cooperative melting of DNA sections situated at the edge of the helix. Accurate calculations based on the real sequences of such sections demonstrate that their internal heterogeneity has a drastic effect on the melting kinetics. Allowance for the internal heterogeneity increases the relaxation time by several orders of magnitude as compared with a model based on the assumption of equal base-pair stability within a section. The relaxation times obtained are in good agreement with the experimental data of Suyama and Wada (A. Suyama and A. Wada, Biopolymers, 23, 409 (1984)). An analysis of the melting process revealed some simple sequence characteristics that determine its rate. An examination of the temperature dependence of the relaxation time led to a distinct interpretation of the apparent activation energies of the denaturation and renaturation. The relaxation time proved to reach its maximum near the equilibrium melting point of the section examined. PMID- 3271444 TI - Extension of Watson's model for the elongation cycle of protein biosynthesis. AB - The scheme for the elongation cycle of protein biosynthesis is proposed based on modern quantitative data on the interactions of mRNA and different functional forms of tRNA with 70S ribosomes and their 30S and 50S subunits. This scheme takes into account recently discovered third ribosomal (E) site with presumable exit function. The E site is introduced into 70S ribosome by its 50S subunit, the codon-anticodon interaction does not take place at the E site, and the affinity of tRNA for the E site is considerably lower than that for the P site. On the other hand, the P and A sites are located mainly on a 30S subunit, the codon anticodon interactions being realized on both these sites. An mRNA molecule is placed exclusively on a 30S subunit where it makes U-turn. The proposed scheme does not contradict to any data but includes all main postulates of the initial Watson's model (J. D. Watson, Bull. Soc. Chim. Biol. 46, 1399 (1964), and is considered as a natural extension of the later according to modern experimental data. PMID- 3271445 TI - Influence of lipid membranes on the conformational transitions of nucleic acids. AB - The conformational transitions of nucleic acids which were enclosed in reverse phase evaporation vesicles (REV) were studied by thermal denaturation with optical recording. Cloned fragments of double-stranded DNA containing 179 base pairs and 187 base pairs, respectively, and polyA.polyU were enclosed in REV with a yield up to every vesicle containing 50 nucleic acid molecules. With the 179 base pairs DNA enclosed in the vesicle from egg lecithin two well resolved helix coil transitions could be measured; one is very similar in the midpoint temperature Tm and halfwidth delta T1/2 to the transition of the free nucleic acid, and the other transition occurs stabilized at a 3.5 degrees C higher Tm value and with a broader delta T1/2, 2.7 degrees C instead of 0.6 degree C. Both transitions are from nucleic acids inside the vesicles. Varying the surface charge of the lipid membrane by adding the negatively charged phosphatidylserine or phosphatidylglycerol, an optimum in the yield of enclosure and a maximum in the increase in Tm (4.5 degrees C) and delta T1/2 (5.5 degrees C instead of 1.0 degrees C) was obtained at 20% phosphatidylserine or phosphatidylglycerol. In vesicles from pure negatively charged lipids no second population of nucleic acids was observed. Qualitatively, similar effects were observed with polyA.polyU. Stabilization and broadening of the second transition is higher for nucleic acids inside vesicles from lipids with unsaturated fatty acids, as dioleoyl-phosphatidylcholine, than with saturated fatty acids, dipalmitoyl phosphatidylcholine. Stabilization and broadening decrease with increasing ionic strength, whereas the relative contributions of both transitions to the total hypochromicity remain unchanged; the second transition coincides with the first at 90 mM Na+. From the experimental results it was concluded that the interaction of nucleic acids and lipid membranes is mainly of electrostatic nature. The nucleic acids exist inside the vesicles in two populations, one behaving like nucleic acid free in solution and one influenced by the contact with the membrane. All results are in accordance with a model in which the interaction between the nucleic acid and the membrane is in competition with the dipole dipole interaction inside the membrane surface. PMID- 3271446 TI - A theorem on Boussinesq solitons or why soliton formation sharpens resonant absorption and why this has nothing to do with real polymers. AB - Soliton formation has been proposed as an explanation for anomalously sharp resonances observed in DNA microwave absorption. We give an elementary, physical explanation of why line narrowing occurs for Boussinesq solitons. We consider real atoms bound by realistic chemical bonds and show that even under the assumption of the most favorable possible conditions, the soliton narrowing mechanism is a maximum correction of only a few percent. At each step of the argument, the simple calculations we show are either exact-in the sense of following the Boussinesq equation - or err on the side of emphasizing the soliton lifetime enhancement. Thus our results serve as an upper bound to any enhancement effects. PMID- 3271447 TI - Interactions of quinoxaline antibiotic and DNA: the molecular structure of a triostin A-d(GCGTACGC) complex. AB - The crystal structure of a DNA octamer d(GCGTACGC) complexed to an antitumor antibiotic, triostin A, has been solved and refined to 2.2 A resolution by x-ray diffraction analysis. The antibiotic molecule acts as a true bis intercalator surrounding the d(CpG) sequence at either end of the unwound right-handed DNA double helix. As previously observed in the structure of triostin A-d(CGTACG) complex (A.H.-J. Wang, et. al., Science, 225, 1115-1121 (1984)), the alanine amino acid residues of the drug molecule form sequence-specific hydrogen bonds to guanines in the minor groove. The two central A.T base pairs are in Hoogsteen configuration with adenine in the syn conformation. In addition, the two terminal G.C base pairs flanking the quinoxaline rings are also held together by Hoogsteen base pairing. This is the first observation in an oligonucleotide of. Hoogsteen G.C base pairs where the cytosine is protonated. The principal functional components of a bis-intercalative compound are discussed. PMID- 3271448 TI - Structure and conformation of the duplex consensus acceptor exon:intron junction d[(CpTpApCpApGpGpT). (ApCpCpTpGpTpApG)] deduced from high-field 1H-NMR of non exchangeable and imino protons. AB - The complementary consensus acceptor exon:intron junction d(ApCpCpTpGpTpApG) has been synthesized by a modified phosphotriester method. The non self-complementary octamer exists in the random coil form in aqueous buffer at 20 degrees C as evidenced by temperature variable 1H-NMR and NOE measurements. The non exchangeable proton assignments were secured using a combination of techniques including two-dimensional COSY, NOESY and 1H-1H-INADEQUATE. The octamer was annealed with the primary consensus sequence d(CpTpApCpApGpGpT). Confirmation of complete duplex formation was confirmed by detection and assignment of imino protons in D2O:H2O mixtures. Assignment of the non-exchangeable proton signals in the duplex consensus junction was then secured by a combination of two dimensional COSY correlations, NOESY and NOE experiments. Determination of individual vicinal coupling constants in the component deoxyribose moieties permitted deduction of the population of S conformations in this sequence. It is concluded that the consensus acceptor junction exists in solution in a conformation belonging to the B family, and that the bases are oriented anti. In addition the deoxyribose moieties in the 5' regions exist predominantly in the S form (2'endo-3'exo) whereas those residues on or adjacent to the junction on the primary strand show more N character (2'exo-3'endo). The contiguous bases A5-G6 (adjacent to the junction) and A15-G16 are stacked more closely than the other neighbor bases in this duplex sequence. These subtle structural and conformational differences in the exon:intron junction may serve as recognition signals for these critical sites in the genome. PMID- 3271450 TI - General acid-base catalysis in nucleobase amino proton exchange: cytidine. AB - A useful property of DMSO solvent has been exploited to reveal a new catalytic route for cytidine amino proton exchange, relevant to exchange in the macromolecular state, but hidden in aqueous solution. Additional exchange mechanisms in aqueous monomeric cytidine (and adenosine) are obscured by the formation of a fast-exchanging endocyclic-protonated intermediate, which dominates the kinetics. Endocyclic nucleobase protonation could be circumvented in the presence of buffer conjugate acid by the use of DMSO/water solvent, permitting the first unequivocal observation buffer acid-catalyzed exchange from the neutral, unprotonated nucleobase, i.e., general acid catalysis. Because buffer ionization is greatly reduced in DMSO through anion desolvation, nucleobase protonation is suppressed in the presence of buffer acid. Evidence is presented to describe this catalytic route as one involving hydrogen bond formation between the buffer acid and the endocyclic protonation site, C(N-3). Since this same configuration is found in Watson-Crick hydrogen bonding, experiments are presented to demonstrate faster cytidine amino proton exchange with the formation of the G-C base pair in DMSO. The importance of this mechanism in past aqueous monomer studies and in the interpretation of macromolecular (DNA) hydrogen exchange is discussed. PMID- 3271449 TI - Energy minimized structures of carcinogen-DNA adducts: 2-acetylaminofluorene and 2-aminofluorene. AB - Energy minimized structures of DNA modified by the aromatic amines 2 acetylaminofluorene (AAF) and 2-aminofluorene (AF), for which no experimental atomic resolution data exist, are presented. These have been computed with a new molecular mechanics program specifically designed to define distortions imposed by such adducts, and employing a rational strategy for searching the conformation space of a DNA molecule with covalently linked carcinogen. In alternating G-C sequences, the AAF adduct prefers to reside at the exterior of an undeformed Z helix. It can also induce base displacement with attendant denaturation and helix bending in sequences that disfavor the Z form, but undeformed B helices are excluded. The AF adduct, by contrast, prefers the major groove of an unperturbed B-helix, but can also induce carcinogen-base stacking in single stranded regions of the DNA, such as at the replication fork. The different biological properties of these two adducts may be related to their distinct PMID- 3271451 TI - A general approach to the optimization of the conformation of ring molecules with an application to valinomycin. AB - A general and efficient methodology is presented which allows molecules containing one or many rings of any size to be manipulated within energy minimization procedures. Variables describing the conformation of the molecules concerned are limited to dihedral and ring valence angles and the ring closure conditions are treated as equality constraints. An application is made to the ion transporter valinomycin and its complexes with K+ and Na+ which illustrates the possibilities of the approach and leads to results which allow a better understanding of the conformational mechanics of this important ionophore. PMID- 3271452 TI - Changes in conformation, stability and condensation of DNA by univalent and divalent cations in methanol-water mixtures. AB - Circular dichroism spectroscopy, absorption spectroscopy, measurements of Tm values, sedimentation analysis and electron microscopy were used to study properties of calf thymus DNA in methanol-water mixtures as a function of monovalent cation (Na+ or Cs+) concentration and also in the presence of divalent cations Ca2+, Mg2+, and Mn2+. In the absence of divalent cations only slight conformational changes occurred and no condensation and/or aggregation could be detected. The Tm values depend on the amount of methanol and on the nature and concentration of cations. In methanol-water mixtures higher thermal stability was observed in solutions containing Cs+ ions. Up to 40% (v/v) methanol the addition of divalent ions leads to DNA stabilization. At methanol concentration higher than 50% the presence of divalent cations causes DNA condensation and denaturation even at room temperature. The denaturation is reversible with respect to EDTA addition indicating that no separation of complementary strands occurred and the resulting form of DNA is probably similar to the P form. DNA destacking appears to be a direct consequence of stronger cation binding by the condensed DNA in methanol-water mixtures. PMID- 3271453 TI - The interactions of ruthenium hexaammine with Z-DNA: crystal structure of a Ru(NH3)6+3 salt of d(CGCGCG) at 1.2 A resolution. AB - A crystal of d(CGCGCG) in the Z-DNA lattice was soaked with ruthenium(III) hexaammine and its structure refined at 1.2 A resolution. Three unique metal complexes were found absorbed to each hexamer duplex. In addition, two symmetry related binding sites were located, yielding a total of five ruthenium complexes bound to each d(CGCGCG) duplex. One unique site and its symmetry related site are nearly identical to the binding site of cobalt(III) hexaammine on Z-DNA. At that position, the metal complex bridges the convex surfaces of two adjacent Z-DNA strands by hydrogen bonds to the N7 and O6 functional groups of the guanine bases. The remaining three ruthenium three ruthenium(III) hexaammine binding sites are not present in the cobalt(III) hexaammine Z-DNA structure. Of these, two are related by symmetry and span the gap between the convex outer surface of one Z-DNA strand and the helical groove crevice of a neighboring strand. The third ruthenium site has no symmetry mate and involves interactions with only the deep groove. In this interaction, the metal complex hydrogen bonds to both the phosphate backbone and to a set of primary shell water molecules that extend the hydrogen bonding potential of the deep groove crevice out to the surface of the molecule. Solution studies comparing the circular dichroism spectra of low salt poly(dG-dC).poly(dG-dC) samples in the presence of ruthenium(III) and cobalt(III) hexammine show that the ruthenium complex does stabilize Z-DNA in solution, but not as effectively as the cobalt analogue. This suggests that some of the interactions available for the larger ruthenium complex may not be important for stabilization of the left-handed DNA conformation. PMID- 3271454 TI - Relative stabilities and transitions of DNA conformations in 1:1 electrolytes: a theoretical study. AB - We use a recently developed formalism (1) to calculate the salt dependent part of the free energy determining DNA conformational stability in 1:1 electrolytes. The conformations studied are the A, B, C and alternating-B right-handed forms and the ZI, ZII left-handed forms of DNA. In the case of the B-ZI transition of d(G C).d(G-C) helices in NaCl solution, the free energy contribution considered suffices to describe the transition in a quantitative manner. The theory also predicts the occurrence of salt-induced B-A transitions which have been recently observed with poly[d(n2 A-T)] and poly[d(G-C)]. In other cases, additional terms in the free energy balance, particularly due to hydration effects, must be at least as important as salt effects in determining conformational stability and structural transitions in solution. If diffuse ionic cloud electrostatic effects alone would dominate in all cases, the relative helical stabilities at 0.2 M monovalent salt would decrease in the order C greater than B greater than A greater than ZII greater than ZI greater than alternating-B. At high salt concentrations (2.0 M-5.0 M), the order would be alternating-B greater than ZI greater than A greater than ZII greater than B greater than C. PMID- 3271455 TI - Relationship between curved DNA conformations and slow gel migration. AB - We propose some specific DNA conformations that explain, in terms of molecular conformations, the anomalous gel electrophoretic behavior of the sequences (VA4T4X), and (V2A3T3X2)i where V and X are either G or C. Previously (J. Biomole. Struct. Dyn. 4, 41, 1986) we considered hydrophobic interactions among aliphatic hydrocarbon groups in A/T sequences. In the sequences (T)n.(A)n, the T's are slightly bent to yield structures with tightly stacked methyl groups along one side of the major groove. By folding together the two pairs of stacked methyls on the opposite sides of the major groove. TTAA might yield a relatively sharp bend. On this basis, we show below that the sequences (VT4A4X)i might form a very tightly coiled super-helix whereas the sequences (VA4T4X)i form a broad super-helix of radius approximately 120 A for i = 25. The sequence (V2A3T3X2)i forms a slightly smaller radius super-helix. The time of passage through the gel has been taken to be inversely proportional to the smallest dimension of the molecule. Specifically we are taking the ratio of the apparent molecular weight to the actual molecular weight to be related to the moment of inertia I1 about the smallest principal axis of the molecular conformation. We find a good fit to the experimental gel mobility data of Hagerman (2) if we assume this ratio to be proportional to (I1)1/5. PMID- 3271456 TI - Why structured water causes sharp absorption by DNA at microwave frequencies. AB - Aqueous solutions of oligopolymer DNA have been observed by G.S. Edwards, C.C. Davis, M.L. Swicord and J.D. Saffer, Phys. Rev. Lett. 53, 1284 (1984) to show structured absorption of microwave energy in the region of several gigahertz, characteristic of an ordered series of compressional normal mode vibrations propagating on the polymer chain. Although hydrodynamic coupling of such vibrations to the surrounding solvent would preclude the existence of sharp resonances, the molecular nature of the solvent in the near neighborhood of the polymer and- paradoxically- the strong water/polymer interactions provide a means for effectively decoupling the polymer motion from the dissipation of the liquid. Recent measurements of DNA/water relaxation times allow estimating numerical values in a parameterization of the decoupling effect. The resulting predicted frequency dependence explains many of the smaller features of Edwards' experiment as well as the overall anomaly. A simple model gives a surprisingly complete account of the features of the data using only values determined from other experiments. PMID- 3271457 TI - Direct measurement of hydration-related dynamic changes in lysozyme using inelastic neutron scattering spectroscopy. AB - Inelastic neutron scattering spectroscopy is used to investigate dynamic changes in lysozyme powder at two different low D2O hydrations (0.07g D2O/g protein and 0.20 g D2O/g protein). In the higher hydration sample, the inelastic scattering between 0.8 and 4.0 cm-1 energy transfer is increased and the elastic scattering is decreased. The decreased elastic scattering suggests increased atomic amplitudes of motion and the increased 0.8 to 4.0 cm-1 scattering suggests increased motions in this frequency range. Comparison with normal mode models of lysozyme dynamics shows that the inelastic difference occurs in the frequency region predicted for the lowest frequency, largest amplitude, global modes of the molecular [M. Levitt, C. Sander and P.S. Stern, J. Mol. Biol. 181, 423 (1985). B. Brooks and M. Karplus, Proc. Natl. Acad. Sci (U.S.A) 82, 4995 (1985), R.E. Bruccoleri, M. Karplus and J.A. McCammon, Biopolymers 25 1767 (1986)]. Our results are consistent with a model in which an increased number of low frequency global modes are present in the higher hydrated sample. PMID- 3271458 TI - dC-dG alternating oligonucleotides: thermodynamic and kinetic aspects of the B-Z transformation. AB - The alternating cytosine-guanine oligodeoxyribonucleotides (dCdG)n, (dGdC)n, (dCdG)ndC (n = 3,4), (dGdC)7 and dG(dCdG)3 have been studied by UV and CD spectroscopy at different temperatures and NaCl concentrations. The analysis of the melting data, assuming an all-or-none model, reveals that in the B conformation the 5'G/C3' stacking interactions are enthalpically favoured with respect to the 5'C/G3' one. The CD investigation of the B-Z equilibrium shows that the Z-conformation is enthalpically stabilized, while the B-conformation is entropically favoured, in the range of NaCl concentration considered (1 to 5 M). The kinetic data for the B-Z transformation, obtained with a salt-jump technique for the hexamer (dCdG)3, support a mechanism by which the Watson-Crick hydrogen bonds are broken before the bases flip over separately and eventually stack, reforming the H-bonds, in the new helix. PMID- 3271459 TI - Interpretation of DNA vibration modes. II--The adenosine and thymidine residues involved in oligonucleotides and polynucleotides. AB - Normal coordinate analysis of the adenosine and thymidine residues involved in the right- and left-handed conformations of oligonucleotides and polynucleotides has been performed. The valence force field, employed in this work, allowed recently to reproduce the vibrational spectra of 2'-deoxythymidine and 2' deoxyadenosine. The calculated wavenumbers based on a non-redundant set of internal coordinates have been compared to the Raman and infrared peak positions arising from A, B, C, D and Z conformations, in the 1550-1250 cm-1 and 800-600 cm 1 spectral regions: i.e. characteristic of adenosine and thymidine residues. Moreover, a systematic study has been performed on the evolution of the vibrational wavenumbers as a function of the glycosidic angle (chi) and the sugar pucker conformation. PMID- 3271461 TI - The ionic strength dependence of the cooperativity factor for DNA melting. AB - The melting temperature for the d(AT)24.d(AT)24 stretch, located inside the DNA helix and terminally, have been determined in a wide range of ionic strength values (0.01 - 1 M Na+). The cooperativity factor was calculated from the shifts in the melting temperature of the stretch due to its different boundary conditions. With the sodium concentration decreasing from 1 M to 0.01 M the cooperativity factor dropped by three orders of magnitude, its change being less marked at high than at low ionic strength. PMID- 3271460 TI - Cooperative thermal denaturation of the assembly origin region of TMV RNA. AB - The assembly origin (AO) region of the tobacco mosaic virus RNA melts in an usually narrow (2.5 degrees C) temperature range. In an 0.01 M phosphate buffer the melting temperature of AO was found to be 41.5 degrees C. This value corresponds to the regions with the most stable secondary/tertiary structure of the whole TMV RNA molecule. It is assumed that the AO region has a specific tertiary structure, which is maintained by the long-range interactions as well as by interactions of the pseudoknot type. PMID- 3271463 TI - Crystallographic and molecular mechanics calculations on the anti-tumor drugs N [(2-dimethylamino)ethyl]-and N-[(2-dimethyl-amino)butyl]-9-aminoacridine-4 carboxamides and their dications: implications for models of DNA-binding. AB - The molecular structures of the N-(2-dimethylamino)ethyl and N-(2 dimethylamino)butyl derivatives of 9-aminoacridine-4-carboxamide, of current interest as potential anti-cancer agents have been determined by X-ray Crystallography. Both are in the free base form and have an intramolecular hydrogen bond between N10 of the acridine and the nitrogen atom of the carboxamide substituent. Molecular mechanics calculations have been used to explore the conformational flexibility of this substituent with respect to the chromophore in order to determine the low-energy conformers of both free base and protonated forms. These have revealed flexibility in the system with relatively low energy cost, especially in the physiological condition when the N10 atom is protonated and suggest that a previously published model for the interaction of these compounds with DNA, is energetically feasible. Implications for interactions with DNA have also been examined by computer modelling. PMID- 3271462 TI - Interactions of acridine orange with double stranded nucleic acids. Spectral and affinity studies. AB - Spectral properties of acridine orange (AO) alone or in complexes with natural and synthetic nucleic acids of various base composition have been studied in aqueous solutions by absorption and fluorescence spectroscopy. The dimerization constant and absorption spectra of the dye in monomeric and dimeric form were established; dimerization of AO resulted in quenching of its fluorescence. Complexes of the dye with synthetic nucleic acids differed in the degree of enhancement of fluorescence quantum yield, varying between 1.42 to 2.38 fold as compared to AO monomer; these differences, however, were not base-dependent. Affinity of the dye to natural and synthetic polymers was studied and analyzed using McGhee-von Hippel model of polymer-ligand interactions. Because the sterical requirement for intercalative binding assumes interaction of dye monomer, the correction for AO dimerization was made in all calculations. All studied DNAs (natural and synthetic ones, the latter being homopolymer pairs or alternating copolymers of A,T or G,C or I,C base composition) had similar intrinsic association constants (KI = 5 X 10(4) - 1 X 10(5), M-1) and binding site size (n = 2.0-2.4 b.p.). The exception was poly(dA).poly(dT), having KI = 1.2 X 10(4) and n = 19.3 b.p. The results of KI measurement for calf thymus DNA and AO in different sodium ion concentration were in good agreement with predictions of the counterion condensation theory. The intercalation of AO into DNA is discussed in view of recent theoretical models of DNA-ligand interactions. PMID- 3271464 TI - The complex of poly(dG).poly(dC) with arginine: stabilization of the B form and transition to multistranded structures. AB - We have studied by X-ray diffraction fibers of complexes of poly(dG).poly(dC) with N-alpha-acetyl-L-arginine ethylamide. Although these polynucleotides favour the A form of DNA, in this complex it is never found, thus confirming that arginine prevents the appearance of this form of DNA. At high relative humidity the B form is present. Upon dehydration two new structures appear. One of them is a triple helix, most likely formed by poly(dC+).poly(dG).poly(dC). The other structure found also has features which indicate a multistranded conformation. PMID- 3271466 TI - Proton NMR and NOE structural and dynamic studies of larger proteins and nucleic acids aided by isotope labels: T4 lysozyme. AB - This article reviews methods based on direct observation of proton NMR in macromolecules containing 13C or 15N labels. The resonances and Overhauser effects of protons attached to the labels can be edited or filtered from the remaining overlapping resonances. This leads to simplification of the spectra when labels are incorporated selectively. In 2D and related methods the label's chemical shift provides a second dimension which is useful for spectral differentiation and identification. The methods are useful for larger proteins and we describe our progress on studies of T4 lysozyme, mass 18.7 kD, in which we have already identified a large number of resonances. PMID- 3271465 TI - Circular dichroism of sanguinarine-DNA complexes: effect of base composition, pH and ionic strength. AB - The interaction of sanguinarine with various naturally occurring and synthetic deoxyribonucleic acids of different base composition and sequence has been studied from the measurement of circular dichroism spectroscopy in buffer of various ionic strengths and pH values where physico-chemical properties of DNA remain unchanged. Binding of sanguinarine to DNA causes a change in the circular dichroism spectrum of DNA itself by showing the increase of both positive and negative bands and appearance of a broad positive band with peak at 340 nm. All systems studied exhibit extrinsic positive band that is independent of DNA base composition and sequence. Calf thymus DNA-sanguinarine complexes in different salt concentrations show that, at saturation, the magnitude of molar ellipticity at 340 nm increases with decreasing sodium ions concentration. Sanguinarine-DNA complexes in buffer of various pH values also show that the molar ellipticity at 340 nm is greater in acidic pH and lower in alkaline pH. It is concluded that the alterations of secondary structure of DNA upon binding of sanguinarine is maximum in buffer of low ionic strength and acidic pH and the number of bound alkaloid molecules per base pair, at saturation, is more in G-C rich DNA than in A-T rich DNA. PMID- 3271467 TI - Sequence dependent conformation and local geometry of the conserved branch site sequence element d(TpApCpTpApApC), essential for yeast mRNA splicing, deduced from high resolution 1H-NMR. AB - The conserved sequence element and branch site splice signal d(TpApCpTpApApC) has been synthesized by a solid phase procedure. All the non-exchangeable protons have been assigned using a combination of one-dimensional and two-dimensional 1H NMR analytical procedures. On the basis of the low NOE intensities in the 1D-NOE and NOESY experiments, the heptamer exists in solution as a random coil. The deoxyribose rings towards the 5' terminus exist predominantly in the S form (2' endo-3'-exo) while residues on or adjacent to the 2' branch site in the eventual lariat structure [A(6) of TACTAAC] show more N-character (3'endo-2'-exo). In addition unique propeller twisting at contiguous AT base pairs in the consensus 5'-splice site occurs in the region in which there is partial complementarity with the branch splice signal TACTAAC. These subtle structural features, if carried over to the corresponding RNA, may have significance either as a recognition signals or for stereochemical reasons in the formation of the lariat intermediate in the maturation process of mRNA. PMID- 3271468 TI - Structure and conformation of the duplex consensus 5'-splice site d[(CpApGpGpTpApApGpT).(ApCpTpTpApCpCpTpG)] deduced from high field 1H-NMR of the non-exchangeable and imino protons. AB - The complementary consensus donor exon intron junction d(ApCpTpTpApCpCpTpG) has been synthesized by a solid phase procedure. The non-exchangeable proton assignments were obtained using one- and two-dimensional NMR techniques including NOE, COSY, NOESY and 1H-1H-INADEQUATE. The non self-complementary nonamer exists as a random coil form in aqueous buffer at 21 degrees C as evidenced by the temperature variable 1H-NMR and NOE measurements. The nonamer was annealed to the primary consensus donor junction d(CpApGpGpTpApApGpT) and confirmation of complete annealing was obtained by detection and assignment of base pair imino protons in D2O/H2O mixtures. Application of one- and two-dimensional NMR techniques permitted the complete assignment of all the non-exchangeable protons in the duplex nonamer. These data, together with determination of vicinal coupling constants in the individual deoxyribose moieties, permits the following conclusions on the structure and conformation of the consensus donor junction: (i) it exists in aqueous solution in a conformation that belongs to the B family (ii) the sugar-base orientations are anti (iii) the deoxyribose units exist predominantly in the S conformation (2'-endo-3'-exo) (iv) the contiguous A.T base pairs d[T(5)-A(6)-A(7)].d[T(12)-T(13)-A(14)], two positions removed downstream from the splice site (5'-CAG decreases GTAAGT-3'), are uniquely propeller twisted. The propeller twisting occurs in the region in which there is partial complementarity with the branch site splice signal TACTAAC. The cross-correlation rates were used to derive the interproton distances between adjacent AH2 protons of 4.00 A in the T(5)-A(6).T(13)-A(14) step and of 3.87 A in the A(6)-A(7).T(12) T(13) step. This structural and conformational feature if carried over into the primary RNA transcripts may serve as a recognition signal for this critical site in the genome. PMID- 3271471 TI - Z form of poly d(A-T).poly d(A-T) in solution studied by CD and UV spectroscopies. AB - Near UV CD spectra, UV absorption spectra and their first derivatives have been recorded on poly d(A-T).poly d(A-T) solutions in presence of high NaCl concentration and various amounts of NiCl2. Comparison of the results presented here with those obtained for poly d(G-C).poly d(G-C) and poly d(A-C).poly d(G-T) in comparable conditions, and the I.R. and Raman data on poly d(A-T).poly d(A-T), allows us to assign the new spectra to the Z conformation of poly d(A-T).poly d(A T) in solution. The mechanism by which nickel ions induce the B----Z interconversion in the presence of high NaCl concentration is discussed. PMID- 3271469 TI - The energetics of the B-Z transition in DNA. AB - The paper deals with the energetics of the transition to left-handed Z form in DNA with an arbitrary base sequence. There is a brief outline of the statistical mechanical model of the B-Z transition allowing for three possible states of each base pair. The parameters of the model can be determined by comparing the theory with experimental data for the B-Z transition in inserts with given sequences in circular DNA. The model contains six energy parameters, most of which have been determined before. In order to find the remaining parameters of the model and test its adequacy, a number of oligonucleotide sequences were synthesized and inserted into the pUC 19 plasmid. Two-dimensional gel electrophoresis was used to determine the superhelical density at which the inserts adopt the Z form. A statistical-mechanical treatment of these data yielded a complete set of six energy parameters for the B-Z transition. The theoretical assumption that the free energy of Z-form pairs does not depend on the type of adjacent pairs proved to be in agreement with the experimental data. PMID- 3271470 TI - On the use of chiral compounds for probing the DNA handedness: Z to B conversion in poly(dGm5dC) upon binding of Fe(phen)3(2+) and Ru(phen)3(2+). AB - In order to examine whether chiral metal complexes can be used to discriminate between right- and left-handed DNA conformational states we have studied the enantioselective interactions of Fe(phen)3(2+) and Ru(phen)3(2+) (phen = 1,10 phenanthroline) with poly(dGm5dC) under B- and Z-form conditions. With the inversion-labile Fe(phen)3(2+), enantioselectivity leads to shifts in the diastereomeric binding equilibria. This effect, known as the "Pfeiffer effect" (1 4), is monitored as slowly emerging circular dichroism of the solution, corresponding to a net excess of the favoured enantiomer. With Ru(phen)3(2+), which is stable to intramolecular inversion, the difference in DNA-binding strengths of the enantiomers results in an excess of the less favoured enantiomer in the bulk solution. This excess is detected in the dialysate of the DNA/metal complex solution. With both complexes we find that the delta-enantiomer is favoured when the polynucleotide adopts the B-form, as previously shown, but also when it initially adopts the Z-form conformational state. This observation, together with evidence from UV-circular dichroism and binding data, indicates that the binding of these metal complexes induces a Z- to B-form transition in Z form poly(dGm5dC). Consequently, neither of the studied chiral DNA-binders can easily be used to discriminate the DNA handedness. PMID- 3271474 TI - Structure of (dG)n.(dC)n under superhelical stress and acid pH. AB - We have recently shown that a (GA)n.(TC)n tract undergoes a sharp structural transition under superhelical stress (V.I. Lyamichev, S.M. Mirkin and M.D. Frank Kamenetskii, J. Biomol. Struct. Dyn. 2,327 (1985]. Unlike the well studied transitions to the cruciform and to the Z form, this novel transition was strongly pH-dependent. We have found the (dG)n.(dC)n insert to undergo a pH dependent structural transition similar to that of the (GA)n.(TC)n tract. These new data meet our earlier expectations and disagree with the data of D.E. Pulleyblank, D.B. Haniford and A.R. Morgan, Cell 42, 271 (1985). We conclude that a novel DNA structure (the H-form) is typical of homopurine-homopyrimidine mirror repeats (the H palindromes) under superhelical stress and/or acid pH. In the H form the homopyrimidine strand forms a hairpin while half of the homopurine strand interacts with the hairpin forming a triplex, the other half of the homopurine strand being unstructured (V.I. Lyamichev, S.M. Mirkin and M.D. Frank Kamenetskii, J. Biomol. Struct. Dyn. 2, 3, 667 (1986]. PMID- 3271472 TI - The crystal structure of d(CCCCGGGG): a new A-form variant with an extended backbone conformation. AB - The crystal structure of d(CCCCGGGG) has been determined at a resolution of 2.25 A. The oligomers crystallize as A-DNA duplexes occupying crystallographic two fold axes. The backbone conformation is, in general, similar to that observed in previously reported crystal structures of A-DNA fragments, except for the central linkage, where it adopts an extended structure resulting from all trans conformation at the P-O5'-C5'-C4' bonds. This type of conformation facilitates interstrand stacking between the guanines at the C-G site. The local helix twist at this step is very small (25 degrees) compared to an overall average of 33.5 degrees. The unique structure of the C-G base-pair step, namely the extended backbone and the distinct stacking geometry, may be an important feature in the recognition mechanism between double-stranded DNA molecules and restriction endonucleases such as Msp I, which cuts the sequence CCGG very specifically with a rate unaffected by neighboring base pairs. PMID- 3271473 TI - Sequence dependent conformations of oligomeric DNA's in aqueous solutions and in crystals. AB - In order to determine the sequence dependence of the conformation of deoxynucleotides, Raman spectra have been obtained for the following oligodeoxynucleotides in aqueous salt solutions and in crystals: d(CpG)(I), d(TGCGCGCA)(II), d(CACGCGTG)(III), d(CGTGCACG)(IV), d(CGCATGCG)(V), d(ACGCGCGT)(VI), d(CGCGTACGCG)(VII), d(CGCACGTGCG)(VIII) and d(CGTGCGCACG)(IX), d(GCTATAGC) (X), d(GCATATGC) (XI), d(GGTATACC) (XII) and d(GGATATCC) (XIII). The normal B type conformation is observed for all the oligomer DNA's at low salt (0.1-1.0 M NaCl) concentration in the temperature range of 0-25 degrees C. It was considered possible that all of the first nine oligomers could go into the Z form in aqueous high salt (5.0-6.0 M NaCl) solutions, and under these conditions the last four were considered candidates to go into the A form. The B-type conformation was found to exist in high salt solutions for (I), (IV), (V), (VI), (X), (XI) and (XIII); the Z or partial Z conformation appears in high salt solution for the oligomers, (II), (III), (VII), (VIII) and (IX); an A or partial A conformation appears in high salt solution for (XII). In the crystalline state, (IV), (VIII), (X), and (XI) stay in the B-form and all of the other oligomers adopt the complete Z-form except for (XII) which crystallizes in the A form. In both the crystal and in aqueous solutions, the identification of the conformation genus was made by means of Raman spectroscopy. In the crystal of (I), grown at pH7.0, guanosine is found to be in C3'-endo/syn conformation and cytidine in C2' endo/anti, which may be taken as the ideal building block of the typical Z conformation. At pH4, (I) crystallizes in a conformation similar to the B genus. A study of the thermally induced B to Z transition has been carried out for (II) and (III). Based on the analysis of Raman spectra of the alternating pyrimidine purine oligomers which might be expected to go into the Z form, the tendency for these oligonucleotides to adopt the Z form can be ranked as: d(CGCGCGCG) greater than (II) greater than (III) greater than (V) approximately (VI) greater than (IV) for octamers and (VII) greater than (VIII) greater than (IX) for the decamers. Similarly, those oligomers which might have a tendency to go into the A form could be ranked as (XII) greater than (XIII) approximately (X) greater than (XI). These data should provide help in formulating rules for predicting the sequence dependence of the B to A and B to Z transitions. Some possible rules are explored, but precautions should be taken. PMID- 3271476 TI - The role of structural water in the formation of nucleotide mispairs. AB - The results of NMR investigation of the double-helical nucleic acid fragments containing A.C, C.U, m6G.U and m6G.G mispairs can be explained on the assumption that the bases in such pairs being in usual tautomeric forms are linked via water bridges. A computer analysis of intermolecular interactions in the systems containing two bases and one or two water molecules shows that these pairs correspond to the energy minima. The formation of pairs with water bridges can be considered an intermediate step in mutagenesis caused by some spontaneous errors arising during nucleic acid biosynthesis as well in mutagenesis induced by alkylating agents. PMID- 3271475 TI - B-Z junctions in supercoiled pRW751 DNA contain unpaired bases or non-Watson Crick base pairs. AB - Structural distortions on the boundary between right-handed and left-handed DNA segments in negatively supercoiled plasmid pRW751 (a derivative of pBR322 containing (dC-dG)13 and (dC-dG)16 segments) were studied by means of osmium tetroxide, pyridine and glyoxal. These two probes react preferentially with single-stranded DNA, but only the latter requires non-paired bases for the reaction. Nuclease S1 and testing of the inhibition of BamHI cleavage (whose recognition sequences GGATCC lie on the "outer" boundaries between the (dC-dG)n and the pBR322 nucleotide sequence) were used to detect the site-specific chemical modification in pRW751. As a result of glyoxal treatment BamHI cleavage was strongly inhibited in topoisomeric samples whose superhelical density was sufficiently negative to stabilize the (dC-dG)n segments in the left-handed form. Osmium tetroxide, pyridine modification resulted in a similar inhibition of BamHI cleavage and in a formation of nuclease S1 sensitive sites. The results suggest that the "outer" B-Z junctions in pRW751 contain one or few non-paired bases or non-Watson-Crick base pairs. PMID- 3271478 TI - The influence of intercalator structure on DNA binding strength: the importance of side chain orientation. AB - A naphthothiophene intercalator with a cationic side chain linked to the ring through an ester group (1E) has been shown to bind to DNA almost an order of magnitude more strongly than a similar compound with the side chain linked to the ring through an amide group (1A) (W.D. Wilson, et al., Biophys. Chem. 24, 101-109 (1986]. X-ray crystallographic analysis of these two compounds indicates that both the ester and amide groups are essentially planar but that the amide is twisted approximately 30 degrees out of the aromatic plane of the naphthothiophene while the ester and ring system are co-planar. Proton NMR studies of the DNA complexes of these two compounds indicate that the naphthothiophene ring is intercalated in both 1A and 1E but that the protons of the ring system near the side chain interact with DNA base pairs at the binding site significantly better in 1E than in 1A. The protons next to the ester group on the side chain of 1E are also shifted upfield significantly more on addition of DNA than those of 1A. The large planar area of 1E, thus, allows greater stacking, complex geometry optimization, and dipolar interactions of the ester group with DNA base pairs at the binding site to account for the larger binding constant of this compound relative to 1A. PMID- 3271477 TI - Probes for double helical DNA sequence information: molecular mechanics study of a proposed model. AB - The biological activity of many molecules which bind to double helical DNA is related to the sequence specificity of their binding. The development of new substances of this type is challenging; a general solution to the problem does not exist. A new mechanism for small molecule-duplex DNA interaction termed intercalative displacement is proposed. The approach is promising for the design of new substances which will recognize sequence information on DNA. Molecular mechanics calculations in the absence of solvent and counterions predict that the proposed model is structurally and energetically closely related to the well known process of standard intercalation. The implications of these calculations for experimental studies are discussed. PMID- 3271479 TI - The thermodynamics of drug-DNA interactions: ethidium bromide and propidium iodide. AB - We report the first calorimetrically-derived characterization of the thermodynamics of ethidium bromide (EB) and propidium iodide (PI) binding to a series of nucleic acid host duplexes. Our spectroscopic and calorimetric measurements yield the following results: 1) At low salt (16mM Na+) and 25 degrees C. PI binds more strongly than EB to a given host duplex. The magnitude of this PI preference depends only marginally on base sequence, with AT base pairs showing a greater PI preference than GC base pairs. 2) The enhanced binding of PI relative to EB at low salt and 25 degrees C reflects a more favorable entropic driving force for PI binding. 3) The PI binding preference diminishes at higher salt concentrations (216mM). In other words, the binding preference is electrostatic in origin. 4) The salt dependence of the binding constants (delta lnKb/delta ln[Na+]) reveal that PI binds as a dication while EB binds as a monocation. 5) PI and EB both exhibit impressive enthalpy-entropy compensations when they bind to the deoxy homopolymers poly dA.poly dT and poly dA.poly dU. We have observed a similar enthalpy-entropy compensation for netropsin binding to the poly dA.poly dT homopolymer duplex. We therefore conclude that the compensation phenomenon is an intrinsic property of the host duplex rather than reflecting a property of the binding ligand. 6) When either PI or EB bind to the corresponding ribo homopolymer (poly rA.poy rU) we do not observe the enthalpy entropy compensation that characterizes the binding to the deoxy homopolymer. 7) EB and PI both bind more strongly to poly d(AT).poly d(AT) than to poly d(AU).poly d(AU). Specifically, the absence of the thymine methyl group in poly d(AU).poly d(AU) reduces the binding constant of both drugs by a factor of four. This reduction in binding is due to a less favorable entropy change. In this paper we present and discuss possible molecular origins for our observed thermodynamic and extra-thermodynamic data. In particular, we evoke solvent effects involving both the drugs and the host duplexes when we propose molecular interpretations which are consistent with our thermodynamic data. PMID- 3271480 TI - Conformations of duplex structures formed by oligodeoxynucleotides covalently linked to the intercalator 2-methoxy-6-chloro-9-aminoacridine. AB - A family of covalent complexes between oligonucleotides and derivatives of the intercalating agent 9-amino acridine has been synthesized (Asseline, U., Thuong, N.T. and Helene, C. (1983) C.R.Acad. Sci. (Paris) 297 (III), 369-372) and studied (Lancelot, G., Asseline, U., Thuong, N.T., and Helene, C. (1985) Biochemistry 24, 2521-2529; Lancelot, G., Asseline, U., Thuong, N.T., and Helene, C. (1985) J. Biomol. Str. Dyn. 3, 913-921) with a view to understand nucleic acid-nucleic acid recognition. In order to understand the nature of interactions between the intercalator and the oligonucleotides in such complexes and the sensitivity of such interactions to the polymorphic form of the DNA, we have carried out molecular mechanics simulations on duplex deoxyoligonucleotides d(A)6.d(T)6 (A and B forms) and d(TATC).d(GATA) (B form) covalently bound to 2-methoxy-6-chloro 9-aminoacridine through a pentamethylene linker chain. Structures in which the acridine derivative is end stacked (at the 3' and 5' ends) and in which the dye is intercalated between the terminal base pairs (at both the ends) and between second and third base pairs from the 3' end are all of reasonably low energy in both A and B forms of DNA. Our studies on 3' end complexes find that in the B form, intercalation of the dye between the second and third base pairs is preferred over the other two modes of binding, while in the A form, intercalation between the terminal base pairs is preferred. In the 5' end A and B form complexes, outside stacking and intercalation between the terminal base pairs are preferred, respectively. Our calculations suggest the possibility that the presence of the dye attached covalently to the DNA can induce conformational transitions in the DNA. For example, intercalation of the dye two base pairs from the end could induce an A----B transition. PMID- 3271481 TI - Phase diagrams for DNA crystallization systems. AB - Phase diagrams for several oligonucleotide duplex-spermine systems have been constructed. These diagrams characterize the duplex and spermine concentrations ranges in which crystalline precipitates are formed. All of them are wedge-like form. The slope of the upper branch of the diagram is determined by the oligonucleotide length. The position of the lower branch depends on both the nucleotide sequence and its length. The position of the lower branch depends on both the nucleotide sequence and its length. It has been shown that the addition to the system of MgCl2 and NaCl salts and MPD results in specific changes in the diagrams. A model for oligonucleotide duplex-spermine system has been suggested which explains the main characteristic features of the obtained phase diagrams. The experimental phase diagrams for the (pGpT)n (pApC)n-spermine system (n = 2,3,4) have been analyzed ion terms of this model and the values of the binding constants of spermine and Mg2+ ions binding to duplexes have been determined. It permitted to identify the complexes that precipitated in different regions of the phase diagrams under various conditions. The diagram obtained in the presence of a cobalt hexammine counterion is also considered. It has been shown that this phase diagram, in general, is similar to those obtained for the oligonucleotide duplex-spermine system. PMID- 3271482 TI - Base sequence effects in double helical DNA. I. Potential energy estimates of local base morphology. AB - A series of potential energy calculations have been carried out to estimate base sequence dependent structural differences in B-DNA. Attention has been focused on the simplest dimeric fragments that can be used to build long chains, computing the energy as a function of the orientation and displacement of the 16 possible base pair combinations within the double helix. Calculations have been performed, for simplicity, on free base pairs rather than complete nucleotide units. Conformational preferences and relative flexibilities are reported for various combinations of the roll, tilt, twist, lateral displacement, and propeller twist of individual residues. The predictions are compared with relevant experimental measures of conformation and flexibility, where available. The energy surfaces are found to fit into two distinct categories, some dimer duplexes preferring to bend in a symmetric fashion and others in a skewed manner. The effects of common chemical substitutions (uracil for thymine, 5-methyl cytosine for cytosine, and hypoxanthine for guanine) on the preferred arrangements of neighboring residues are also examined, and the interactions of the sugar-phosphate backbone are included in selected cases. As a first approximation, long range interactions between more distant neighbors, which may affect the local chain configuration, are ignored. A rotational isomeric state scheme is developed to describe the average configurations of individual dimers and is used to develop a static picture of overall double helical structure. The ability of the energetic scheme to account for documented examples of intrinsic B-DNA curvature is presented, and some new predictions of sequence directed chain bending are offered. PMID- 3271483 TI - A comparison of six DNA bending models. AB - The predictions of six DNA bending models were compared with experimental relative mobility data. The study showed that all the models are reasonably accurate in predicting bending in synthetic sequences and in a natural sequence. The least accurate of these models is the Calladine-Dickerson model. The most consistent model is the ApA Wedge, possibly because it distributes the bends into base-roll and base-tilt components. PMID- 3271484 TI - Agreement between single crystal X-ray and molecular mechanical sugar ring conformations. AB - We have calculated the deoxyribose sugar energy for a wide range of puckering parameters, (q, W), using different force fields. The intra-ring bond lengths, bond angles, and dihedral angles are calculated for every energy minimized structure and compared with 224 sugar ring structures available from DNA single crystal x-ray data. A modified Weiner's force field yields an excellent agreement with x-ray data. The calculated energy surface shows a variable amplitude repuckering path, with an average distortion of 0.42 A. Most of the experimental values of (q, W) fall within 1.0 Kcal/mol from the calculated minimum. PMID- 3271485 TI - Re-refinement of the B-dodecamer d(CGCGAATTCGCG) with a comparative analysis of the solvent in it and in the Z-hexamer d(5BrCG5BrCG5BrCG). AB - The effects of X-ray refinement algorithm on parameters characterising nucleic acid structure are analysed following the re-refinement of the B-dodecamer d(CGCGAATTCGCG). The main conclusions are the following. Mean deviations of main chain torsion angles between the two refinements average 12.6 degrees. Phase angle of pseudorotation for sugar puckers vary between 100 degrees and 180 degrees in the present refinement with amplitude of pucker around 30 degrees. On the other hand, the helical parameters have mean deviations less than 2 degrees. At most half of the assigned solvent positions are within 2 A in both refinements. In the second part of the work, plots of temperature factors (B's) versus occupancies (Q's) for solvent peaks have been analysed in the B-dodecamer and in the Z-hexamer d(5BrCG5BrCG5BrCG). Owing to the poor statistics, some of those conclusions should be regarded as tentative. Occupancy appears to depend on the number of contacts made by the solvent peak with the nucleic acid while temperature factor does not. Except when engaged in particular interaction sites, solvent molecules bound to phosphates have a tendency for high B's and variable Q's. Water molecules bound to polar atoms of the bases occupy various positions in the B-Q diagram. Particularly striking is the behavior of the water molecules belonging to the B-spine and to the Z-spine: the spread in occupancy of water molecules in the hydration spine of the Z-oligomer is larger than in the hydration spine of the B-oligomer. An opposite tendency is observed for the temperature factors. The first observation might reflect the special mobility of the water molecules building up the spine hydration in the Z-form where it continues without interruption from one hexamer to the next. In the B-form, on the contrary, the spine is restricted to the center part of the dodecamer. The second observation might reflect the sharpness of the local attractive potential in the Z-form and its broadness in the B-form. In both cases, dipole reorientations would occur, leading to a high local dielectric constant: in the Z form, through water molecules hopping from one site to another and, in the B form, because of rotational freedom. PMID- 3271486 TI - Conformational peculiarities of polynucleotides with a nonrandom base sequence according to the 1H----3H exchange rate in C8H groups of purinic residues. AB - We have determined the 1H----3H exchange rate constants between water and C8H groups of purinic residues of alternating polynucleotides poly(dA-dT).poly(dA dT), poly(dG-dC).poly(dG-dC) and poly(dA-dC).poly(dG-dT) as well as homopolynucleotides poly(dA).poly(dT) and poly(dG).poly(dC) in aqueous solutions with high-salt concentrations (3 M NaCl and 4-6 M CsF), in water-ethanol (60%) solution and in 0.15 M NaCl at 25 degrees C. The rate constants for adenine (kA) and guanine (kG) of polynucleotides were compared with corresponding constants for E. coli DNA. dGMP nd dAMP at the same conditions. The relation between exchange rates and conformations of polynucleotides permits the study of their conformational peculiarities in solution. Of three alternating polynucleotides examined in 0.15 M NaCl the exchange retardation was observed only for poly(dA dT).poly(dA-dT) as compared with that in B-DNA, which is in good agreement with the B-alternating "wrinkled" DNA model. The conformations of poly(dG-dC).poly(dG dC) and poly(dA-dC).poly(dG-dT), according to the exchange data obtained are within the B form. For homopolynucleotides in 0.15 M NaCl, the KA value for poly(dA).poly(dT) is nearly the same as kA for B-DNA, which indicates the similarity of their conformations, whereas the kG value for poly(dG).poly(dC) is 1.7-fold lower in comparison with the kG value in B-DNA. This seems to be connected with the existence of B = A conformation equilibrium for poly(dG).poly(dC) in solution. The increase of NaCl concentration to 3 M results in a B----Z transition in the case of poly(dG-dC).poly(dG-dC) and in the shift of B = A equilibrium towards the A-form in the case of poly(dG).poly(dC) as is evidenced by alterations of their KG values. Poly(dA-dT).poly(dA-dT) in 6 M CsF and poly(dA-dC).poly(dG-dT) in 4.3 M CsF maintain their inherent conformations in 0.15 M NaCl in spite of the fact that they are characterised by the "X-type" CD spectrum at these conditions. According to the exchange data the conformation of poly(dA).poly(dT) in 6 M CsF corresponds to the "heteronomous" DNA model or some other structure with lower accessibility of C8H groups of adenylic residues. PMID- 3271487 TI - Structural and dynamic properties of a bromouracil-adenine base pair in DNA studied by proton NMR. AB - We have synthesized and studied by proton NMR a duplex heptaoligonucleotide containing a 5-bromouracil (brU)-adenine base pair. This represents the first structural characterization of a B-form DNA containing brU. The brU.A base pair is Watson-Crick rather than Hoogsteen as seen for the monomers in the crystalline state. From analysis of the NOESY sepctra at very short mixing times evidence is presented that substitution of brU for T induces significant conformational changes from that of a normal B DNA. The helix twist between brU4.A11 and G3.C12 is ca. 15 degrees and for both brU4 and G3 the glycosyl torsion angles are significantly changed. The imino proton of the bru.A base pair shows a pH insensitive line with which shows that the pK of brU in this base pair is very much higher than that of the monomer. PMID- 3271488 TI - Approaching a complete classification of protein secondary structure. AB - A complete classification of types of the protein secondary structure is developed on the basis of computer analysis of the crystallographic structural data deposited in the protein Data Bank. The majority of amino acid residues fall into five conformation types. A conclusion is drawn that the number of sequence variants of torsion angles phi, psi in globular proteins is limited and is essentially less than the number of possible amino acid sequences for this chain length. Along with alpha-helix and beta-structure, the distribution analysis assigning every maximum of distribution of amino acid conformations on Ramachandran map to a certain type of the secondary structure exposed a third type of the secondary structure that was previously neglected. This type of the structure is extended left-handed helical conformation, designated as mobile (M-) conformation. A full set of M-conformation fragments that seems to play a major role in protein globule dynamics has been obtained, a small radius of correlation for the polypeptide chain in M-conformation is demonstrated. It explains a prevalence of short segments of mobile conformation revealed in globular proteins. For secondary structure types, the frequency of occurrence of amino acid residues has been computed. PMID- 3271490 TI - Long, chiral polypeptide 3(10)-helices at atomic resolution. AB - The crystal-state preferred conformation of the terminally blocked hepta- and octapeptides with the general formula -(Aib)n L-Leu-(Aib)2- (n = 4 and 5, respectively), determined by X-ray diffraction, was found to be a right-handed 3(10)-helix stabilized by five and six consecutive intramolecular NH...O = C H bonds of the C(10)-III type, respectively. The octapeptide structure represents the first observation at atomic resolution of a regular, chiral 3(10)-helix larger than two complete turns. In both cases the right handed screw sense of the helix is dictated by the presence of the single, internal L-residue. This study confirms the propensity of short peptides rich in Aib, the prototype of the amino acid residues dialkylated at the alpha carbon, to adopt a 3(10)-helical structure and is expected to help our understanding of the conformational preferences of the membrane-active, channel-forming, ion-transporting peptaibol antibiotics. PMID- 3271489 TI - Method of modeling protein structure by the two-dimensional nuclear magnetic resonance spectroscopy data; application to the proteinase inhibitor BUSI IIA from bull seminal plasma. AB - A new approach is suggested to model the spatial structure of protein molecules in solution based on combined use of the methods of theoretical conformational analysis and NMR spectroscopy data. At the first stage, special means are used to convert d connectivity information into the most probable values of dihedral angles. This allows search for possible spatial structures in the limited regions of the conformational space at further stages using the methods of the theoretical conformational analysis. The suggested approach was verified in reconstructing the spatial backbone structure of the fragment 17-57 of the proteinase inhibitor BUSI IIA from the bull seminal plasma. The structural model parameters are compared with the corresponding characteristics obtained from the X-ray analysis data for the homologic proteinase inhibitor from the Japanese quail ovomucoid. The suggested approach is shown to correctly reproduce both the general molecule topology and the conformations of individual amino acid residues. PMID- 3271491 TI - Turn of promotor DNA by cAMP receptor protein characterized by bead model simulation of rotational diffusion. AB - The rotation diffusion of DNA double helices and their complexes with the cAMP receptor protein (CRP) has been simulated by bead models, in order to derive information on their structure in solution by comparison with results obtained from dichroism decay measurements. Straight DNA double helices are simulated by linear, rigid strings of overlapping beads. The radius of the beads and the length of the string are increased simultaneously by the same increments from initial outer dimensions derived from crystallographic data to final values, which are fitted to experimental rotation time constants observed for short DNA fragments (less than 100 bp). The final values reflect the solvated structure with the same 'solvation layer' added in all three dimensions. The protein is simulated by overlapping beads, which are assembled to a structure very similar to that found by x-ray crystallography. Complexes of the protein with DNA are formed with the centres of palindromic DNA sites at the centre of the two helix turn-helix-motifs of the protein with some overlap of the two components. Simulation of the experimental data obtained for CRP complexes with specific DNA in the presence of cAMP requires strong bending of the double helices. According to our simulation the DNA is almost completely wrapped around the protein both in the complexes with a 62 bp fragment containing the standard CRP site and with a 80 bp fragment containing the second binding site of the lac operon. Simulations of the data obtained for a 203 bp fragment with both binding sites suggest that the two bound CRP proteins are in contact with each other and that the DNA is wrapped around the two protein dimers. A stereochemical model is suggested with a tetrahedral arrangement of the four protein subunits, which provides the advantage that two binding sites of the protein formed by two subunits each are located favorable for tight contacts to two binding sites on bent DNA, provided that the DNA sites are separated by an integer number of helix turns. In summary, the simulations demonstrate strong bending, which can be reflected by an arc radius in the range around 50 A. According to these data the overall bending angle of our longest DNA fragment is approximately 180 degrees, and thus the protruding ends are sufficiently close to each other such that RNA polymerase, for example, could contact both helical segments. PMID- 3271492 TI - Comparative study of the condensation of chicken erythrocyte and calf thymus chromatins by di- and multivalent cations. AB - The condensation of chicken erythrocyte (CE) and calf thymus (CT) chromatins upon addition of di- and multivalent cations has been studied using turbidity, precipitation and electric dichroism measurements. For all the cations investigated (Mg2+, Tb3+, Co(NH3)6(3+), spermidine Spd2+ and spermine Sp4+) condensation of CE chromatin occurred before the onset of aggregation, while aggregation of CT chromatin started before condensation with all cations except Mg2+ and Tb3+. Precipitation of CE chromatin required lower di- and multivalent cations concentrations than CT chromatin. The electric dichroism data for both chromatins, at low ionic strength in the absence of di- or multivalent cations, indicated that the nucleoprotein molecules were not totally decondensed but that a "precondensed" state was already present. A positive electric dichroism was observed for the most condensed chromatin fibers, in agreement with the "cross linker" models. Tb3+ led to less compact condensed particles as judged from the electric dichroism observations, but electron microscopy revealed that "30 nm fibers" were formed. Very little aggregation was produced by Tb3+. On the contrary, spermine produced very large networks of condensed molecules, but large spheroidal particles were also observed. The condensation of CE chromatin happened without changes of solution conductivity upon cation salt addition, regardless of the condensing cation, indicating a cooperative uptake of the ions during this process. PMID- 3271493 TI - Theoretical studies on alpha-helix--DNA interactions. AB - The interaction energies between (Ala)10 and alpha-helix fragment and different nucleotide sequences in right-handed B-form have been optimized using semi empirical potential energy functions. The energies are calculated for two different orientations of the alpha-helix, viz., when the alpha-helix axis taken in the N----C direction is (i) parallel and (ii) antiparallel to the 5'-3' ascending strand of DNA, proximal to it. When both the DNA molecule as well as the alpha-helix are treated as rigid molecules it is found that a polyalanine alpha-helix has slightly more favourable contacts when it is in the proximity of a four nucleotide sequence of 5'-(N-A-T-N)-3' type, where N is either a purine or a pyrimidine. However, when the two interacting molecules are allowed to undergo local structural variations then the interaction energy appears to be independent of the base sequence confirming the non-specific nature of these interactions. PMID- 3271494 TI - Solitons in DNA. AB - DNA is modeled as a homogeneous, cylindrical rod with nonlinear elasticity using the Ostrovskii-Sutin equation (OSE) with periodic boundary conditions. This equation predicts that longitudinal sound waves will be concentrated into packets called solitons. From a study of the damped OSE, we conclude that decay time is almost independent of the solitonic character of the solution. For the damped, driven OSE, on the other hand, we find that spectral features (such as absorption line widths and fine structure) are strongly influenced by the presence of anharmonicity. This effect is enhanced as the length of the DNA is increased. PMID- 3271495 TI - Length-dependent cruciform extrusion in d(GTAC)n sequences. AB - pBR322-derived plasmids have been constructed carrying d(GTAC)n.d(GTAC)n inserts of different lengths, in order to investigate the effect of insert size on cruciform extrusion and/or the B-Z transition. Plasmids with n ranging from 4 to 12 are hypersensitive to cleavage by the single-strand specific nucleases, S1 nuclease and Bal31 nuclease. Hypersensitive sites associated with the smaller alternating purine-pyrimidine tracts, however, coexist with the major pBR322 sites. Site-selective cleavage of these plasmids with the resolvase, T7 endonuclease I, demonstrates that all the inserts form cruciform structures when stably integrated into negatively supercoiled plasmids. An increase in the negative superhelical density of the DNA's induces cruciform formation within the insert region, resulting in a reduction in torsional stress consistent with the size of the insert. Moreover, as n decreases, the superhelical density required to stabilise the cruciform state increases. Therefore, the cruciform geometry is the favoured conformation of these d(GTAC)n.d(GTAC)n sequences under torsional stress. The stability of these cruciforms increases as n increases, with cruciformation occurring at lower superhelical densities and to the exclusion of the other pBR322 cruciforms. PMID- 3271496 TI - A general procedure for assigning the 31P spectra of drug-oligonucleotide complexes. AB - Taking advantage of the slow exchange at the NMR time scale occurring in drug oligonucleotides complexes the 31P signals in the bound forms are assigned by using 31P NMR two dimensional chemical exchange. This technique was applied to complexes between Actinomycin D and d[CpGpCpG] or d[m5CpGpm5CpG]. As compared to the labelled 17O, 18O this method proved to be a powerful and unique way to assign 31P in broad spectrum or with long oligonucleotides. PMID- 3271497 TI - Theoretical study of the sequence selectivity of isolexins, isohelical DNA groove binding ligands. Proposal for the GC minor groove specific compounds. AB - A theoretical study is presented of complex formation between DNA fragments of different base sequences and isolexins, "isohelical base reading polymers", formed of heteroaromatic pentagonal rings joined by appropriate linkers. Extensive computations are performed for the isolexin composed of the furan pyrrole-furan sequence. They involve charged ligands with propioamidinium groups at both ends as well as neutral molecules with terminal methyl, carbonyl and amino groups. Two different groups (C = O and NH) are used as linkers between the base reading moieties. The role of these elements on the binding preference of the ligands has been examined. The results show that the mere possibility of formation of hydrogen bonds between a ligand and the nucleic acid bases is not sufficient to ensure its binding specificity which is determined largely by the interplay of electrostatic factors. Thus the dicationic isolexins uniformly prefer AT sequences. For the neutral isolexins the nature of the groups forming the linkers is a major factor in defining the specificity, although these groups do not participate directly in the interaction with DNA. The C = O linkers favour binding to AT sequence while the N-H linkers permit preferential binding to the GAG sequence. Finally, for the first time in theoretical computations, a ligand is proposed which should bind preferentially to the minor groove of GC sequences: this ligand is a neutral isolexin composed of three furan rings linked by two N-H groups. This ligand is considered as an improvable prototype. Altogether the results presented open the path for the designing of minor groove ligands specific for any desirable DNA base sequence. PMID- 3271498 TI - 13C NMR assignments of the protonated carbons of [d(TAGCGCTA)]2 by two dimensional proton-detected heteronuclear correlation. AB - The resonances of the protonated carbons of [d(TAGCGCTA)]2 have been assigned by the two-dimensional proton-detected double-quantum heteronuclear correlation experiment [( 1H-13C]-DQCOSY). 13C-coupled and 13C-decoupled versions of the experiment were used. The assignment method is discussed in detail. The deoxyribose cross peaks segregate into five well-resolved regions, and the base cross peaks have distinct features that are helpful for assignments. The cross peaks from the 1H-13C pairs at the Cyd5, Ado2 and ThdCH3 base positions fall in separate regions of the spectrum from each other; they also are resolved from the closely spaced Ado8, Guo8, Cyd6 and Thd6. Additional parameters for distinction of the base signals are their differing J-coupling values and long-range coupling patterns. PMID- 3271499 TI - A systematic study of patterns of hydration in nucleic acids:(I) guanine and cytosine. AB - The hydration sites of guanine and cytosine are defined by examination of the crystal structures of bases, nucleosides, nucleotides, and three dinucleoside phosphate salts. The patterns of hydration for two guanine and cytosine containing oligonucleotides are then predicted. The relationship between these structural motifs and thermodynamic parameters is discussed. PMID- 3271500 TI - NaCl-induced chromatin condensation. Application of static light scattering at 90 degrees and stopped flow technique. AB - We have studied the NaCl-induced condensation of calf thymus chromatin by static light scattering of 90 degrees and shown that the increase in NaCl concentration up to 120-170 mM results in a large increase in scattering intensity of the total chromatin. Histones H1-depleted and trypsinized chromatin preparations do not reveal such a large increase in scattering intensity. The increase in the scattering intensity reflects the folding of the chromatin filaments, but not their aggregation. We have used this effect to monitor the kinetics of the chromatin condensation in response to a jump to higher NaCl concentrations by means of a stopped-flow technique. The results show that the condensation is a fast complex process consisting of at least two steps. The first step is only partially resolved by the stopped-flow apparatus. The second step has a time constant in the range of 20-50 ms, which does not depend on chromatin concentration. PMID- 3271502 TI - Polyamine-DNA interactions. Condensation of chromatin and naked DNA. AB - We have used flow linear dichroism (LD) and light scattering at 90 degrees to study the condensation of both DNA and calf thymus chromatin by polyamines, such as spermine, spermidine and its analogs designated by formula NH3+(CH2)iNH2+(CH2)jNH3+, where i = 2,3 and j = 2,3, putrescine, cadaverine and MgCl2. It has been found that the different polyamines affect DNA and chromatin in a similar way. The level of compaction of the chromatin fibers induced by spermine, spermidine and the triamines NH3+(CH2)3NH2+(CH2)3NH3+ and NH3+(CH2)3NH2+(CH2)2NH3+ and MgCl2 is found to be identical. The triamine NH3+(CH2)3NH2+(CH2)2NH3+ and the diamines studied condense neither chromatin nor DNA. This drastic difference in the action of the triamines indicates that not only the charge, but also the structure of the polycations might play essential roles in their interactions with DNA and chromatin. It is shown that a mixture of mono- and multivalent cations affect DNA and chromatin condensation competitively, but not synergistically, as claimed in a recent report by Sen and Crothers (Biochemistry 25, 1495-1503, 1986). We have also estimated the extent of negative charge neutralization produced by some of the polyamines on their binding to chromatin fibers. The stoichiometry of polyamine binding at which condensation of chromatin is completed is found to be two polyamine molecules per DNA turn. The extent of neutralization of the DNA phosphates by the histones in these compact fibers is estimated to be about 55%. The model of polyamine interaction with chromatin is discussed. PMID- 3271501 TI - Optical anisotropy of chromatin. Flow linear dichroism and electric dichroism studies. AB - The optical anisotropy of chromatin with different length of the linker DNA isolated from a variety of sources (Frend erythroleukemia cells, calf thymus, hen erythrocytes and sea urchin sperm) has been studied in a large range of mono- and bivalent cations concentrations by the use of flow linear dichroism (LD) and electric dichroism. We have found that all chromatins studied displayed negative LD values in the range of 0.25 mM EDTA - 2 mM NaCl and close positive values in the range of 2-100 mM NaCl. Mg2+ cations, in contrast to Na+ cations, induce optically isotropic chromatin fibers. All chromatin samples exhibit positive form effect amounting to 5-10% of LD amplitude observed at 260 nm. This form effect is determined by the anisotropic scattering of polarized light by single chromatin fibers. The conformational transition at 2 mM NaCl leads to the distortion of chromatin filament structure. The reversibility of this distortion depends on the length of the linker DNA - for chromatins with the linker DNA of 10-30 b.p. it is parially reversible, while for preparations with longer linker DNA it is irreversible. Relatively low electric field does not affect chromatin structure, while higher electric field (more than 7 kV/cm) distorts the structure of chromatin. Presented results explain the contradictory data obtained by electrooptical and hydrooptical methods. PMID- 3271504 TI - B-X transition in synthetic and natural (dA-dT)n.(dA-dT)n sequences. AB - AB-X transition of polyh(dA-dT).poly(dA-dT) was observed to occur in methanol water mixtures with methanol concentrations higher than 50% in the presence of a specific combination of monovalent and divalent cations. In the presence of Na+, divalent cations induce denaturation of poly(dA-dT).poly(dA-dT) accompanied by condensation and/or aggregation, and effect similar to that observed previously with random sequence DNA (Votavova, Kucerova, Felsberg and Sponar, J. Biomol. Struct. Dyn. 4,477-489, 1986). In the presence of Cs+ cations a B-X transition was induced by addition of Ca2+ or Mn2+ but not Mg2+ or Ni2+ ions. Circular dichroism and ultraviolet spectroscopy demonstrate that the X conformation is a double stranded form of poly(dA-dT).poly(dA-dT) belonging presumably to the B family which, however has an altered base stacking. The X conformation of poly(dA dT).poly(dA-dT) found in methanol-water mixtures is a condensed and/or aggregated form. In contrast, the X conformation characterized by similar CD spectra observed in high salt concentrations is not aggregated up to a concentration of 6 M CsF. In methanol-water mixtures (A+T)-rich bacterial DNA behaves essentially as a random sequence DNA revealing no detectable amount of the X form. On the other hand crab (Cancer pagurus) satellite and crab non-satellite DNAs containing varying amounts of (dA-dT)n.(dA-dT)n sequences were shown to undergo a B-X transition, at least partly, in both methanol-water mixtures and 6 M CsF solutions. PMID- 3271503 TI - A kinked model for the solution structure of DNA tridecamers with inserted adenosines: energy minimization and molecular dynamics. AB - Structural modelling techniques using energy minimization and molecular dynamics have been employed to generate kinked models for the solution structure of two DNA tridecamer sequences containing inserted adenosines: d(CGCAGAATTCGCG)2 and d(CGCAGAGCTCGCG)2. These models are consistent with NMR studies of these sequences in solution. The overall shapes of the two models are similar, consisting of three B-DNA sections: two outer segments on the same side of the central portion, with the additional adenosines acting as wedges to kink the structure. An alternative scheme for the hydrogen bond pairing at the kink site is suggested as a way for the additional adenosines to be stabilized in the duplex. PMID- 3271505 TI - Stabilization of the bio-membrane by small molecules: interaction of trehalose with the phospholipid bilayer. AB - Anhydrobiotic organisms undergo periods of acute dehydration during their life cycle. It is of interest to understand how the biomembrane remains intact through such stress. A disaccharide, trehalose, which is metabolised during anhydrobiosis is found to prevent disruption of model membrane systems. Molecular modelling techniques are used to investigate the possible mode of interaction of trehalose with a model monolayer. The objective is to maximise hydrogen bonding between the two systems. A phospholipid matrix consisting of 1,2-dimyristoyl-sn-glycero-3 phosphatidylcholine (DMPC) is chosen to represent the monolayer. The crystal structure of DMPC reveals that there are two distinct conformers designated as A and B. An expansion of the monolayer, coplanar with its surface, results in the trehalose molecule being accommodated in a pocket formed by four B conformers. One glucose ring of the sugar rests on the hydrophobic patch provided by the choline methyls of an A conformer. Five hydrogen bonds are formed involving the phosphate oxygens of three of the surrounding B conformers. The model will be discussed with reference to relevant experimental data on the interaction. PMID- 3271506 TI - Effect of excluded volume on topological properties of circular DNA. AB - We have performed computer simulations of closed polymer chains with allowance for the excluded volume effects within the framework of the free-joint model. The probability of knot formation, the linking probability of a pair of chains and the variance in the writhing number proved to be significantly affected by the excluded volume effects. This is true even for DNA with completely screened charges for which the b/d ratio (where b is the Kuhn statistical length and d is the diameter of the double helix) is as large as 50. Allowance for the electrostatic repulsion (change of the DNA effective diameter d) further increases the effects. The most dramatic dependence on d is found for the probability of knot formation. The data on the dependence of the variance of writhing, mean value of (WR)2, on d indicate that the DNA superhelix energy should be significantly ionic strength-dependent. Special calculations have shown that the free-joint model underestimates the mean value of (Wr)2 value by about 20% as compared with the wormlike model. PMID- 3271507 TI - Structure and stability of Z* DNA. AB - The structure and stability of the left handed Z* DNA aggregate was examined by spectroscopic methods and by electron microscopy. Poly(dGdC), upon heating in the presence of Mn++, forms a large aggregate which may be sedimented at 12,000 X g, with a circular dichroism spectrum characteristic of left handed DNA. Aggregation gives rise to turbidity changes at visible wavelengths, providing a convenient means of monitoring the transition in solution. The wavelength dependence of turbidity is consistent with the scattering behavior of a long thin rod. Electron microscopy shows that Z* DNA is a large fibrous structure of indeterminant length, with a uniform diameter of approximately 20 nm. The results obtained in solution and under the requisite conditions for electron microscopy are mutually consistent. Poly(dGdC) preparations with average lengths of 60, 240, 500, and 2000 base pairs all form Z* DNA. Poly(dGm5dC) forms Z* DNA in the presence of Mn++ without heating, but poly(dAdC)-poly(dGdT) and calf thymus DNA cannot be induced to the Z* form under any conditions tried. Kinetic studies, monitored by turbidity changes, provide evidence that the formation of Z* DNA proceeds by a nucleated condensation mechanism. Dissolution of the Z* aggregate results from the chelation of Mn++ or by the addition of the intercalator ethidium bromide. The allosteric conversion of Z* DNA to an intercalated, right handed form by ethidium is demonstrated by kinetic studies, equilibrium binding studies and circular dichroism spectroscopy. Electron microscopy provides a striking visualization of the dissolution of the Z* aggregate by ethidium. PMID- 3271508 TI - B-Z cooperativity and kinetics of poly(dG-m5dC) are controlled by an unfavorable B-Z interface energy. AB - Thermodynamic and kinetic properties of the B-Z transition of poly(dG-m5dC) were investigated using polynucleotide samples ranging in length from 11000 to 300 base pairs. Van't Hoff enthalpy values increase with increasing polymer length for the B-Z transition in 0.35 mM MgCl2, 50 mM NaCl, 5 mM TRIS, pH 8. Rates of the B to Z transition increase with increasing polymer length for a jump of 0 to 3 mM MgCl2 in 50 mM NaCl, 5 mM TRIS, pH 8. The activation energy of the B to Z transition equals 7.9 +/- 0.3 kcal/mol and is length independent. Thermodynamic and kinetic data were fit to a model that simulates distribution of B- and Z-form tracts at the midpoint of B-Z equilibrium as a function of polymer length. A cooperative length of 1000 +/- 200 base pairs is estimated for the B-Z transition. A direct relationship between rates of the B to Z transition and the square of the van't Hoff enthalpy values of the B-Z transition reflects a dependence of kinetics and cooperativity upon the energy of the nucleation event. Faster B to Z transition rates with increasing polymer length can be explained by a mechanism rate limited by nucleation within the polymer instead of the ends. PMID- 3271510 TI - CCAAT box revisited: bidirectionality, location and context. AB - The so-called CCAAT box is believed to be a major promoter element of higher eukaryotes though it is ill-defined being deduced from very limited sequence data. The comprehensive computer analysis of an unbiased set of 168 promoters presented here removes several of the persisting uncertainties. In particular, it delineates the region of preferential occurrence of the CCAAT element to -110 to 50 relative to the initiation site, suggests that integrity of this pentamer is essential, and confirms bidirectionality as a general property of this element. Within the above region the signal is found to occur in a specific sequence context which is an important supplement to its description. PMID- 3271511 TI - A simple qualitative representation of polypeptide chain folds: comparison of protein tertiary structures. AB - A new simple quantitative representation of three-dimensional structure of globular proteins is proposed which is useful for comparison of distantly related problems, computer sorting of large sets of conformations, and search of structurally similar domains in protein data base. The folding course of the polypeptide backbone is approximated by a set of successive vectors corresponding to the elements of regular secondary structure (e.g. alpha-helices, strands of beta-sheets) and non-regular segments. The parameters specifying the spatial organization of segments in this vector model are internal coordinates, namely, lengths of the vectors, planar and dihedral angles. Quantitative representation proposed allows to circumvent the problem of insertions/deletions and to avoid the stage of best superposition during protein comparison. An application was made to the comparison of three-dimensional structures of scorpion toxins Centruroides sculpturatus Ewing v-3, Buthus eupeus M9 and I5A, which have different chain lengths and low sequence similarity. PMID- 3271509 TI - Structural forms and transitions of poly(dG-dC) with Cd(II), Ag(I) and NaNO3. AB - Infrared spectroscopy was used to study the structures and transitions in hydrated gels of double-helical poly(dG-dC) complexed with the metal carcinogens Cd(II) and Ag(I). For one Cd(II) per ten nucleotides (r = 0.1), the B structure was stable at high and moderate hydrations with D2O and the B and Z structures coexisted at low hydrations. For poly(dG-dC) with Cd(II) at r = 0.2 to 0.35, the Z structure was stable at high hydrations (94% r.h. for r = 0.2). At a given value of hydration, H2O gave a higher content of Z structure than D2O. Cd(II) most likely binds to guanine residues at N7 in both the B and Z forms of poly(dG dC) but binding to guanine N3 can not be excluded. It is unlikely that Cd(II) binds to cytosine residues at the r values studied and the cytosine residues did not protonate at N3 as Cd(II) bound to guanine residues. Poly(dG-dC) with Ag(I) at r = 0.2 to 0.36, existed in a B-family structure which is different from the B family structure of the type I complex of Ag(I) and calf-thymus DNA. Poly(dG-dC) with Ag(I) did not assume the Z structure at lower hydrations even though NO3- was present in the sample. Ag(I) differs from other soft-metal acids which promote the Z structure. Ag(I) most likely binds to the guanine N7 or N3 and not to cytosine residues. Cytosine residues did not protonate at N3 as Ag(I) was bound to guanine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3271512 TI - Coenzyme reorientations in the active sites of aspartate aminotransferase isoenzymes studied by linear dichroism method. AB - Cytosolic and mitochondrial pig heart aspartate aminotransferases (cAspAT and mAspAT) and chicken heart cAspAT have been oriented in a compressed slab of polyacrylamide gel and their linear dichroism LD spectra have been recorded. The coenzyme's tilt angles in the active sites of chicken cAspAT and pig mAspAT and their quasisubstrate complexes imitating catalytic intermediates have been computed. The computations are based on reduced linear dichroism values (delta A/A), the known directions of the transition dipole moments in the coenzyme ring and atomic coordinates of the coenzyme obtained by X-ray crystallography. It has been found that formation of the enzyme complex with glutarate and protonation of the internal pyridoxal-lysine aldimine induce reorientations of the coenzyme. As a result of protonation, the coenzyme ring tilts by 27 degrees in cAspAT and 13 degrees in mAspAT. Formation of the external aldimine with 2-methylaspartate is accompanied by tilting of the coenzyme ring by 44 degrees in cAspAT and 39 degrees in mAspAT. For the quinonoid complex with erythro-3-hydroxyaspartate, the tilt angles were found to be 63 degrees in cAspAT and 53 degrees in mAspAT. It is inferred that the basic features of the active site dynamics are similar in the three AspAT's studied. The differences in the coenzyme tilt angles between cAspAT and mAspAT may be linked to catalytic and structural peculiarities of the isoenzymes. PMID- 3271513 TI - DNA sequence patterns in precisely positioned nucleosomes. AB - Several investigators have recognized the importance of non-periodic DNA sequence information in determining the translational position of precisely positioned nucleosomes. The purpose of this study is to determine the extent of such information, in addition to the character of periodic information present. This is accomplished by examining the half-nucleosome DNA sequences of a considerable number of precisely positioned nucleosomes, and determining the probability of occurrence of each dinucleotide type as a function of position from the nucleosome center to the terminus (positions 0 to 72). By the nature of this procedure, no assumptions of periodicity are made. The results show the importance of several DNA sequence periodicities including 6-7, 10, and 21 base pairs, in addition to significant nonperiodic information. The results demonstrate that each dinucleotide type is unique in terms of its positional preference in precisely positioned nucleosomes (for example AA not equal to TT). The probabilities of occurrence for the dinucleotide types can be used to predict the translational positions of a number of observed nucleosomes. PMID- 3271514 TI - Structural basis of stable bending in DNA containing An tracts. Different types of bending. AB - Structural determinants of DNA bending of different types have been studied by theoretical conformational analysis of duplexes. Their terminal parts were fixed either in an ordinary low-energy B-like conformation or in "anomalous" conformations with a narrowed minor groove typical of An tracts. The anomalous conformations had different negative tilt angles (up to about zero), different propeller twists and minor groove widths. Calculations have been performed for DNA fragments AnTm, TnAm, AnGCTm, AnCGTm, TmGCAn, TmCGAn which are the models of the junction of two anomalous structures on An and Tm tracts. On the AT step of the AnTm fragment the minor groove can be easily narrowed so that a whole unbent fragment of anomalous structure is formed on AnTm. According to our energy estimates, there should not be any reliable bending on AnTm. In contrast, in all other cases there was a pronounced roll-like bending into the major groove in the chemical symmetry region. Calculations of the junction between the anomalous and ordinary B-like structure for GnTm and CnAm have shown that there is an equilibrium bending with a tilt component towards the chain having the anomalous structure at the 5'-end. From our calculations it is impossible to determine precisely the direction of bending, though it can be suggested that the roll component of bending might be directed towards the major groove. The anomalous structure is the main reason of bending; alternations of pyrimidines and purines can modulate the value and the direction of equilibrium bending (only the value in the case of self-complementary fragments).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3271516 TI - Chemical probing of the B-Z transition in negatively supercoiled DNA. AB - An analysis of the B-to-Z transition as a function of supercoiling for a natural Z-DNA-forming sequence found in plasmid pBR322 is presented at nucleotide resolution. The analysis is based on reactivity to four chemical probes which exhibit hyperreactivity in the presence of Z-DNA: hydroxylamine, osmium tetroxide, diethyl pyrocarbonate and dimethyl sulfate. We find that the initial transition occurs largely within a 14 base pair region which is mostly alternating purines and pyrimidines. With increasing negative supercoiling. Z-DNA extends into flanking regions having less and less alternating character, first one direction and then in the other. Evidence of B-Z junctions is seen at four sites bracketing these three adjacent regions. One of these Z-forming regions contains the non-alternating sequence CTCCT, suggesting that such sequences can form Z-DNA without great difficulty if they are adjacent to alternating sequences. A plasmid containing three copies of a 61 base pair fragment bearing the entire Z-forming region shows equal reactivity of all three copies at any given superhelical density, implying that they compete equally and independently for the torsional strain energy which promotes the B-Z transition, and are unaffected by adjacent sequences more than 20-30 base pairs away. PMID- 3271515 TI - The duplex-hairpin conformational transition of d(CGCGCGATCGCGCG) and d(CGCGCGTACGCGCG): a thermodynamic and kinetic study. AB - We have studied the duplex-hairpin conformational transition in two perfectly palindromic sequences, d(CGCGCGATCGCGCG)(I) and d(CGCGCGTACGCGCG)(II), by means of UV-melting, electrophoretic and T-jump experiments. Both tetradecamers exhibit biphasic thermal profiles. The lower temperature transition is concentration dependent whereas the higher temperature transition is not. The former transition has been characterized by gel electrophoresis and shows two distinct bands, whose intensity depends on temperature. This behavior is due to the occurrence of a slow premelting interconversion between the duplex and hairpin forms in both tetradecamers. The kinetics of hairpin formation from the duplex is studied by T jump experiments. Relaxation spectra are well reproduced by a single relaxation time with rate constants characterized by a high temperature coefficient. In 10 mM NaCl, the duplex-hairpin conversion of I is characterized by an apparent activation energy of 96 +/- 6 kcal/mol, a value rather close to the expected denaturation enthalpy. In 1 mM NaCl a value slightly lower has been obtained. The rate of duplex-hairpin interconversion has been found to decrease as the salt concentration is raised. These data suggest that the transformation from the duplex to the hairpin form should imply a transition state with a simultaneous breaking of most base pairs, if not total strand separation. PMID- 3271517 TI - IR and UV studies on stability and conformations of short DNA duplexes containing a no-base residue: coexistence of B and Z conformations. AB - Tridecamers containing a central no-base residue (X) have been synthesized and hybridized to their complementary strands, so as to constitute duplexes consisting of two hexamers separated by central mismatched X-A or X-T pairs. The effect of the introduction of this deoxyribose derivative on duplex stability was investigated by measuring UV absorbance as a function of salt concentration and temperature. As expected, the duplexes containing the abnormal base pairs (X-T and X-A) are less stable when compared to the totally complementary duplexes (A-T and T-A). The X-T mismatched duplex shows the most unstable thermodynamical behaviour. The conformational changes of these duplexes were studied by IR spectroscopy in condensed phase as a function of water content. At high relative humidity, the IR spectra show that these tridecamers form B-type double stranded duplex structures. If the water content is decreased, only the duplexes m5CGm5CGCTXAGCTTC GCGCGAATCGAAG and, to a lesser degree, m5CGm5CGCTXAGCTTC GCGGCATTCGAAG undergo a partial B---Z transition involving the methylated hexamer, the conformation of the second segment remaining of the B type. These results show that only one apurinic residue leads to a flexible junction between B and Z forms in a short duplex containing 5-methyl-2'-deoxycytidines. PMID- 3271518 TI - On the occurrence of three-center hydrogen bonds in cyclodextrins in crystalline form and in aqueous solution: comparison of neutron diffraction and molecular dynamics results. AB - Three-center (bifurcated) hydrogen bonds may play a role by serving as an intermediate state between different dynamically changing hydrogen bonding patterns. Hydrogen bonding configurations can be studied experimentally by neutron diffraction and theoretically by computer simulation techniques. Here, both methods are used to analyse the occurrence of three-center hydrogen bonds in crystals of cyclodextrins. Almost all experimentally observed three-center hydrogen bonds in the crystal are reproduced in the molecular dynamics (MD) simulations, even as far as the detailed asymmetric geometry is concerned. On the basis of this result a MD simulation of cyclodextrin in aqueous solution is searched for the occurrence of three-center hydrogen bonds. Significant differences are found. In solution more different three-center hydrogen bonds per alpha-cyclodextrin molecule are observed than in the crystal but the population (existence as percent of the simulation period) of each three-center hydrogen bond is lower in solution than in crystal. These may indeed serve as intermediate states in the process of changing one hydrogen bonding pattern into another. PMID- 3271519 TI - UV photoelectron spectroscopy and ab initio characterization of valence orbital structures and conformations of neutral phosphate esters. AB - The HeI UV photoelectron spectrum of trimethyl phosphate (TMP) has been measured and interpreted with the aid of SCF molecular orbital calculations carried out with STO-3G, STO-3G* and 4-31G basis functions. The photoelectron spectrum of TMP is more accurately reproduced by results from 4-31G calculations than by results from STO-3G or STO-3G* calculations. However, all three basis sets yield results which predict the same assignment of the photoelectron spectrum. Results at the 4 31G level indicate that whether calculations are based on crystallographic bond angles and bond lengths or on STO-3G optimized geometries has little effect on the energetic ordering of the upper occupied orbitals. The energetic ordering of orbitals is also found to be only weakly dependent upon the torsional angle phi, describing rotation of ester groups about P-O bonds and upon the torsional angle psi, describing rotation of methyl groups about C-O bonds. For trimethyl phosphate, with C3 symmetry, the vertical ionization potentials of the upper occupied orbitals are 10.81 eV (8e), 11.4 eV (9a), 11.93 eV (7e), 12.6-12.9 eV (8a and 6e), 14.4 eV (7a) and 15.0-16.0 eV (5e and 6a). Calculations at the 4-31G level indicate that many of the highest occupied orbitals in neutral dimethyl phosphate and methyl phosphate have energies and electron distributions similar to orbitals in TMP. For TMP, a search for optimized values of phi and psi has been carried out at the STO-3G*level. In agreement with previous NMR studies and with classical potential calculations, the STO-3G* results indicate that both the gauche (phi = 53.1 degrees) and anticlinal (phi = 141.9 degrees) conformations are thermally accessible. Also in agreement with the classical potential calculations, the STO-3G* results predict that in the all gauche conformation energy is minimized when the methyl groups assume a staggered geometry (psi = 60 degrees to 80 degrees) and that an energy maximum occurs for an eclipsed geometry (phi = 0 degrees to 20 degrees). A study of the dependence of optimized values of O-P-O ester bond angles on the torsional angles, phi, was carried out at the STO 3G, STO-3G* and 4-31G levels. The results demonstrate that for C3 symmetry, the coupling of O-P-O angles to phi is influence by repulsive steric interactions. PMID- 3271521 TI - Inter-chain proline:proline contacts contribute to the stability of the triple helical conformation. AB - The triple helical conformation observed in the collagen group of proteins is related to the presence of large numbers of imino residues and is derived from the stereochemical properties of these residues. The triple helix is stabilized by increasing numbers of these residues. Hydrogen bonds are usually considered to be a major factor in the formation and stability of protein conformation, however, imino residues are not hydrogen bond donors. We have evaluated the role of these residues in stabilizing the triple helix by re-examining two X-ray based structures of the triple helical polypeptide (Pro-Pro-Gly)10 using molecular mechanics calculations. The two minimized structures are comparable in energy and have helical parameters close to the starting values for each starting structure. Our studies suggest that clusters of close van der Waals contacts between proline residues in adjacent chains contribute significantly to the stability of the triple helix. Preliminary NMR studies support this concept. We propose that non bonded interactions between proline residues may be a significant stabilizing force in the triple helix generated by (Pro-Pro-Gly)10. PMID- 3271522 TI - Different binding modes of spermine to A-T and G-C base pairs modulate the bending and stiffening of the DNA double helix. AB - The influence of base composition (and sequence) on the process of interaction between synthetic polynucleotides and spermine, has been investigated using ultraviolet (including second derivative) spectroscopy, and electric dichroism. Different binding modes of spermine to poly(dG-dC) as compared to A-T containing polynucleotides, were evidenced. An interaction with the N7 and O6 of guanine is probably partially involved in the former case while simple electrostatic interaction with the phosphate groups would dominate in the latter. In the intermediate binding range (spermine over DNA phosphate molar ratios Sp/P of the order of 0.1 to 0.2), the complexes with poly(dA).poly(dT) and those with poly(dA dT) displayed an important contribution of a permanent dipole moment to the orientation mechanism, as detected by the application of bipolar pulses in electric dichroism experiments. Just prior to precipitation (at Sp/P slightly larger than 0.3), these polynucleotides show electric dichroism and relaxation times characteristics corresponding to toroidal particles formation resulting from a bending of their chains. This implies asymmetric binding to phosphate sites on A-T containing polynucleotides. At low Sp/P ratios, spermine induced a stiffening of poly(dG-dC). No influence of spermine on the orientation mechanism of this polynucleotide was detected for Sp/P values ranging from zero to 0.35. The spermine-induced bending of A-T rich regions thus appears to be essential for DNA condensation into toroidal particles. PMID- 3271520 TI - A general procedure for generation of curved DNA molecules. AB - A general method for generation of base-pairs in a curved DNA structure, for any prescribed values of helical parameters--unit rise (h), unit twist (theta), wedge roll (theta R) and wedge tilt (theta T), propeller twist (theta p) and displacement (D) is described. Its application for generation of uniform as well curved structures is also illustrated with some representative examples. An interesting relationship is observed between helical twist (theta), base-pair parameters theta x, theta y and the wedge parameters theta R, theta T, which has important consequences for the description and estimation of DNA curvature. PMID- 3271523 TI - Site-specific chemical modification of B-Z junctions in supercoiled DNA as detected by nuclease S1 digestion, inhibition of restriction cleavage and nucleotide sequencing. AB - Structural distortions on the boundary between right-handed and left-handed segments in the superhelical plasmid pPK2 (a derivative of pUC19 containing (dC dG)n segments cloned into polylinker) were studied by means of chemical probes. Strong osmium tetroxide, pyridine (Os,py) modification of DNA at native superhelical density (sigma) was found in four thymines surrounding the (dC-dG)13 segment. These results correlated with restriction cleavage inhibition (due to modification): BamHI cleavage was strongly inhibited, unlike the neighbouring XbaI and SalI (weak or no inhibition). In the (dC-dG)8 segment considerably weaker modification of the B-Z junctions was observed, accompanied by weak inhibition of BamHI cleavage, while the neighbouring SmaI and KpnI were not affected. Os,py modification of DNA at native sigma was not detected by nuclease S1 cleavage at and (dC-dG)n segment. However, this enzyme recognized and cleaved at the B-Z junction, osmium modified at more negative sigma. The results obtained with the glyoxal and diethyl pyrocarbonate modification support the idea of very narrow B-Z junctions at native sigma. PMID- 3271524 TI - Selection of DNA binding sites by regulatory proteins. Functional specificity and pseudosite competition. AB - The frequency of base-pair occurrence in a set of recognition sequences for a particular DNA-binding protein is strongly related to the contributions to the binding free energy from the individual base pairs. Thus from the statistics of base-pair choice, it is possible to estimate the relative binding strengths of any base-pair sequences and to predict the effect of point mutations in specific sites. On the same basis, one can describe the binding properties of random DNA sequences and thereby the expected competitive effects from all the nonspecific DNA sites in the genome of a living cell. The statistical selection theory [Berg & von Hippel.J. Mol. Biol. 193 (1987) 723-750] describing these relations is extended and tested with computer simulations. The theory is shown to hold up well also in the case when base pairs contribute cooperatively to the binding interaction. The simulations also demonstrate the effects of the statistical small-sample uncertainty that appears due to the limited size of all sets of recognition sites identified. PMID- 3271525 TI - Electron microscopic and physico-chemical studies of DNA complexes with synthetic oligopeptides: binding specificity and DNA compact structures. AB - Binding to DNA of two synthetic peptides, Val-Thr-Thr-Val-Val-NH-NH-Dns and Thr Val-Thr-Lys-Val-Gly-Thr-Lsy-Val-Gly-Thr-Val-Val-NH-NH-Dns (where Dns is a residue of 5-dimethylaminonaphthalene-1-sulfonic acid), has been studied by circular dichroism, electron microscopy and fluorescence methods. It has been found that these two peptides can self-associate in aqueous solution as follows from the fact that concentration-dependent changes are observed in the UV absorbance and fluorescence spectra. The two peptides can bind to DNA both in self-associated and monomeric forms. The pentapeptide in the beta-associated form binds more strongly to poly(dG).poly(dC) than to poly[d(A-C)].poly[d(G-T)] and poly(dA).poly(dT) whereas the tridecapeptide exhibits an opposite order of preferences binding more strongly to poly[d(A-C)].poly[d(G-T)] and poly(dA).poly(dT) than to poly(dG).poly(dC). Binding is a cooperative process which is accompanied by the DNA compaction at peptide/DNA base pair ratios greater than 1. At the initial stage of the compaction process, the coalescence of DNA segments covered by bound peptide molecules leads to the formation of DNA loops stabilized by the interaction between peptide molecules bound to different DNA segments. Further increase in the peptide/DNA ratio leads to the formation of rod-like structures each consisting of two or more double-stranded DNA segments. The final stage of the compaction process involves folding of fibrillar macromolecular complexes into a globular structure containing only one DNA molecule. PMID- 3271526 TI - Statistical analysis of nucleotide runs in coding and noncoding DNA sequences. AB - A statistical analysis of the occurrence of particular nucleotide runs in DNA sequences of different species has been carried out. There are considerable differences of run distributions in DNA sequences of procaryotes, invertebrates and vertebrates. There is an abundance of short runs (1-2 nucleotides long) in the coding sequences and there is a deficiency of such runs in the noncoding regions. However, some interesting exceptions from this rule exist for the run distribution of adenine in procaryotes and for the arrangement of purine pyrimidine runs in eucaryotes. The similarity in the distributions of such runs in the coding and noncoding regions may be due to some structural features of the DNA molecule as a whole. Runs of guanine (or cytosine) of three to six nucleotides occur predominantly in noncoding DNA regions in eucaryotes, especially in vertebrates. PMID- 3271527 TI - Influence of a mechanical tension on the B-A and B-C conformational transitions in DNA fibres. AB - In the present fibre X-ray study we attempt to quantify the effect of a mechanical tension on the conformations, and transitions between the structural forms of DNA. A simple experimental device has been realized in order to apply precise mechanical forces on DNA fibres during X-ray exposure. It is shown that, as the applied tension is increased, the B----A transition can be prevented as well as with a decrease of the sodium salt content. A kind of distorted B form is then observed the helical parameters of which change with the relative humidity. On the contrary, the mechanical tension does not prevent the B----C transition; it only slows down the form change and improves the X-ray patterns up to a relative humidity of 0%. PMID- 3271530 TI - NMR studies of tris-intercalation: solution structure and interaction of d(CTTCGCGCGAAG) with an acridine trimer. AB - Tris-intercalation of an acridine trimer into the self-complementary dodecanucleotide d(CTTCGCGCGAAG) has been studied, in solution, by means of 1H and 31P nuclear magnetic resonance. In a first step all the non-exchangeable protons (except H5', H5"), the imino protons and seven of the eleven phosphorus have been assigned. The dodecanucleotide is shown to adopt a double helical B type structure. Most of the sugar puckers are in the O1'endo range, those of the internal guanosines being closer to C2'endo. Deviations from the canonical B structure are observed in the base stacking and the phosphodiester torsional angles at the 3T4C5G stretch. The addition of an acridine trimer to the base paired dodecanucleotide leads to the conclusion that the trimer, which is in slow exchange at the NMR time scale, tris-intercalates into the three C(3'-5')G sites of the central core, according to the excluded site model. This is evidenced by the large (1.4 ppm) upfield shift experienced by the imino protons of the three internal guanines and the shielding undergone by the acridine ring protons. Tris intercalation is also supported by the downfield shift experienced by 6 out of the 22 phosphorus. Two of them are shifted by nearly 2 ppm, a shift range reported for oligonucleotides complexed to actinomycin D; this suggests that the structure of the backbone of the dodecanucleotide is altered. PMID- 3271528 TI - New nomenclature for nucleic acid helix parameters Cambridge, UK, September 14, 1988. PMID- 3271529 TI - A rigorous basepair oriented description of DNA structures. AB - We propose new, rigorous definitions for (i) basepair fixed coordinate systems and (ii) the twist, tilt, and roll angles (called tau, t, rho) describing the relative orientation of adjacent basepairs and bases in a pair, in arbitrary DNA structures obtained from x-ray diffraction, 2D NMR, or energy calculations. In contrast to the corresponding angular parameters (tg, theta T, theta R) and coordinate systems introduced by Dickerson and co-workers and currently in use, our angular parameters and coordinate systems, together with a set of three displacement parameters, dx, dy, dz, provide a mathematically correct and general description of DNA conformations at the basepairs and/or base level. For instance, our description is applicable when the DNA structure considered is inherently curved, irregular, and/or does not possess dyad (or pseudodyad) axes. We develop a computationally convenient algorithm for rigorous DNA conformational analysis and apply it to some of the known crystal structures. We establish the connection to the currently used parameters and test the consistency and efficiency of our methodology by reconstructing the Dickerson B dodecamer using only the sequence and the set of parameters obtained from the atomic coordinates. The six parameter (tau, t, rho, dx, dy, dz) basepair level reconstruction is good but not perfect. Perfect reconstruction is obtained when one also considers each base in a basepair (consideration of propeller twist alone is not sufficient). The variation of the rigorous parameters proposed along the sequence is much larger, but their average values agree with fiber and solution data much better than in the case of the currently used set. The results of our analysis do not support Trifonov's AA.TT wedge model for DNA curvature but provide some evidence in favor of the Crothers junction-bend model. We point out some of the limitations of basepair level approaches when applied to DNA structure prediction and quantitative understanding of sequence-dependent variations in structure. PMID- 3271531 TI - Dynamics of drug-DNA interactions: a comparative temperature jump study of ellipticinium and 9-hydroxy ellipticinium. AB - The temperature-jump method has been used to compare the binding of 2-N methyl ellipticinium (NME) and 2-N methyl 9 hydroxy ellipticinium (NMHE) to three natural DNA's of different AT/GC composition. The relaxation signals, analyzed by the Pade-Laplace method, are characterized by two distinct relaxation times, tau 1 and tau 2, respectively in the 1-4 ms and 20-80 ms range. In the case of the NMHE/DNA interaction, the slower relaxation time tau 2 depends on the DNA composition, as follows: tau 2 (Micrococcus lysodeikticus) greater than tau 2 (Calf thymus) greater than tau 2 (Clostridium perfringens). Contrary to NMHE, NME which does not possess an OH group at the C-9 position, shows no relaxation time dependence upon DNA base composition. The observation of two relaxation times indicates that the binding equilibria are associated with at least two distinct drug/DNA complexes (probably arising from two distinct DNA binding sites). Three kinetic models, involving the formation of a weak intermediate ionic complex, are given to explain the binding reaction between these cationic drugs and the DNA. They allow the determination of the four rate constants associated with the two binding steps and lead to equilibrium association constants in agreement with those obtained from spectroscopic studies. The validity of the models is discussed and it is shown that the best kinetic scheme, for either NMHE or NME, could be that in which the ionic step is not a prerequiste to intercalation. The kinetic results show that the residence time of 9 hydroxy ellipticinium is markedly increased in GC rich DNA's and this could be related to the higher in vitro and in vivo cytotoxic properties of 9 hydroxy substituted ellipticines. PMID- 3271532 TI - Interaction of the antitumor antibiotic mitomycin C with Z-DNA. AB - Mitomycin C (MC), an antitumor antibiotic, alkylated Z-DNAs such as poly(dG dC)/Co(NH3)3+(6), poly(dG-m5dC)/Mg2+ and brominated poly(dG-dC) upon reductive activation. Computer-generated energy-minimized molecular models indicated that monofunctional alkylation of Z-DNA at the N2-position of guanine by MC did not distort Z-DNA geometry, but bifunctional alkylation, leading to interstrand crosslinks between two N2-positions of guanine was sterically unfavorable. The above three Z-DNA's were exposed both to monofunctionally and bifunctionally activated MC in separate experiments and the resulting covalent MC-polynucleotide complexes were examined for conformation and for covalent MC-adducts, by circular dichroism (CD) spectroscopy and HPLC analysis of nuclease digests, respectively. Monofunctionally activated MC alkylated all three polynucleotides in their Z forms, resulting in the same monofunctional N2-guanine adduct as that known to be formed with B-DNA. Upon bifunctional activation of MC, poly(dG-dC/Co(NH3)3+(6) reverted to the B-form and bifunctional (cross-link) adducts were detected, identical again with those formed with B-DNA. Poly(dG-m5dC), however, remained in the Z-form after the alkylation and only a monofunctional adduct could be detected. It was concluded that Z-DNA is subject to monofunctional alkylation by MC but cannot be cross-linked. The latter process occurs only when the Z-DNA is labile enough [as is in the case of poly(dG-dC)] to have some B-form in equilibrium at the site of the first formed monolinked adduct; the cross-linking then occurs at such local B-sites, pulling the overall B in equilibrium Z equilibrium irreversibly to the left. These results are in accord with the predictions from the above modeling. The irreversible "lock" by the MC cross-link on B-DNA may be exploited for probing Z-DNA intermediacy in various DNA functions. PMID- 3271533 TI - Experimental DNA-binding and computer modelling studies on an analogue of the anti-tumor drug amsacrine. AB - The DNA-binding properties of the anti-cancer drug amsacrine and a 9 aminoacridine analogue substituted at the 4 position with a 4 methanesulphonanilido-group, have been examined by means of unwinding, melting and equilibrium binding experiments. These find that the latter compound is at least as effective as a DNA-binder and intercalator as amsacrine itself. Molecular modelling and energetic calculations have confirmed this, and have produced plausible intercalation geometries. These show that there are subtle differences in the low-energy minor groove arrangements adopted by the substituents of the two drugs. Speculation is advanced that these differences may be relevant to the marked differences in cytotoxicity shown by the two compounds. PMID- 3271534 TI - Molecular structure, conformation and interactions of antitumor antibiotic cyanonaphthridinomycin, a covalent binder of DNA. AB - X-ray, NMR and molecular modeling studies on cyanonaphthridinomycin (C22H26N4O5), a DNA binding antibiotic, have been carried out to study the structure, conformation and interactions with DNA. The crystals belong to the space group P21 with the cell dimensions of a = 5.934(1)b = 20.684(4), c = 16.866(3)A, gamma = 90.9 degrees and Z = 4(two molecules/asymmetric unit). The structure was solved by direct methods and difference Fourier methods and refined to an R value of 0.087 for 4061 reflections. The conformation of the molecule is compared with that of naphthridinomycin. There are differences in the orientation of the methoxyl group and the saturated oxazole ring. 1 and 2D NMR studies have been carried out and the dihedral angles obtained from coupling constants have been compared with those obtained from the crystal structure. Molecular mechanics studies were carried out to obtain the energy minimized structure and its comparison with X-ray and NMR results. Molecular modelling studies were performed to propose models for drug-DNA interactions. Both partial intercalation and groove-binding models have been proposed. PMID- 3271535 TI - Poly(amino2dA-dT) isomerizes into the unusual X-DNA double helix at physiological conditions inducing Z-DNA in poly (dG-methyl5dC). AB - It is demonstrated that a two-state conformational isomerization is induced in the poly(amino2-dA-dT) duplex by submillimolar concentrations of divalent magnesium cations in low-salt aqueous solution. The isomerization is fast and has a low degree of cooperativity. The resulting conformer is the unusual X-DNA double helix originally observed with poly(dA-dT) at very high concentrations of CsF. Interestingly, the X form is induced in poly(amino2dA-dT) under the physiological conditions when poly(dG-methyl5dC) assumes Z-DNA. The same conditions of stabilization are presumably connected with the fact, observed in previous phosphorus NMR studies, that Z- and X-DNA have similar polydinucleotide backbone architectures. Results presented in this work permit to specify base pair exocyclic groups responsible for the radically different conformational variability of the synthetic DNA molecules containing alternating purine pyrimidine sequences of GC or AT base pairs. PMID- 3271536 TI - Crystal and molecular structure of the ammonium salt of the dinucleoside monophosphate d(CpG). AB - The crystal and molecular structure of the ammonium salt of deoxycytidylyl-(3' 5')-deoxyguanosine has been determined from 0.85 A resolution single crystal X ray diffraction data. The crystals obtained by acetone diffusion technique at -20 degrees C, are orthorhombic, P212121, a = 12.880(2), b = 17444(2) and c = 27.642(2) A. The structure was solved by high resolution Patterson and Fourier methods and refined to R = 0.136. There are two d(CpG) molecules in the asymmetric unit forming a mini left handed Z-DNA helix. This is in contrast to the earlier reported forms of d(CpG) where the molecules form self base paired duplexes. There are two ammonium ions in the asymmetric unit. The major groove NH+4 ion interacts with N7 of guanines through water bridges besides making H bonded interactions directly with the phosphate oxygen atoms. A second NH+4 ion is found in the minor groove interacting directly with the phosphate oxygen atoms. Symmetry related molecules pack in such a way that the cytosine base stacks on cytosine and guanine base on guanine. Our structure demonstrates that alternating d(CpG) sequences have the ability to adopt the left handed Z-DNA structure even at the dimer level i.e., in a sequence which is only two base pairs long. PMID- 3271537 TI - Stability and motion of a hairpin and the corresponding mismatched duplex: a theoretical exploration using molecular mechanics and normal mode analysis of 2D NMR results on d(GCCGCAGC). AB - The oligomer d(GCCGCAGC) can adopt two different conformations: i) a duplex with two mismatched A.C base pairs and ii) a hairpin with two C.G base pairs and a single stranded loop. We report molecular mechanics, normal mode analysis, and thermodynamic stability calculations for both structures. We show that the energy minimized structure and harmonic-dynamics results are in complete agreement with the observed NOE spectrum and imino proton exchange data. We conclude that the high stability of the hairpin structure over the duplex at low salt concentration is due to the higher vibrational entropy contribution to the system free energy by the single stranded loop and to the lack of minor groove phosphate/phosphate electrostatic repulsions that tend to destabilize the duplex. PMID- 3271538 TI - Sequence context of oligomer tracts in eukaryotic DNA: biological and conformational implications. AB - Recent studies of homooligomer tracts suggest different characteristics from random sequence DNA (dA).(dT) and (dG).(dC) tracts are frequent in upstream regions and in some cases have been shown to be essential for regulation. Here we examine homooligomer occurrences in non-coding and coding eukaryotic sequences, focusing on the context in which the homooligomers occur. This analysis of sequences in the junction areas yields distinct and consistent characteristics. In particular, the nucleotide interrupting a run is most frequently complementary to the run. The base next to it is most frequently identical to the one constituting the run. For A or T runs the least frequent nearest and next to nearest neighbors are G or C. For G or C tracts the least frequent are A or T. Complementary oligomers behave similarly. These and additional trends are strongest for run lengths greater than or equal to 3. The computations are carried out on the whole eukaryotic database of greater than 4 x 10(6) nucleotides, separately for coding and non-coding regions. These same trends are evident for both groups, but are somewhat stronger for the non-coding regions. The context in which the homooligomers occur may yield some clues to DNA conformation and its biological implications. PMID- 3271539 TI - Salt dependence of DNA structural stabilities in solution. Theoretical predictions versus experiments. AB - The predictions of currently available theories for treating DNA-diffuse ionic cloud free energy contributions to conformational stability have been tested against experimental data for salt induced B-Z and B-A transitions. The theories considered are (i) Manning's counterion condensation approach (CC), (ii) the idealized Poisson-Boltzmann approximation (PB), and (iii) the potentials of mean force (PMF) approach proposed by Soumpasis. As far as we can judge from comparison with the set of experimental data currently available, it is found that only the latter theory yields satisfactory quantitative results for the dependence of the B-Z and B-A relative stabilities on monovalent salt concentration. The correct application of the PB and CC theories does not yield very low salt Z-B transitions, in contradiction to earlier assertions. At low salt concentrations the PB theory is qualitatively correct in predicting that the B form is electrostatically more favorable than both the A and Z forms, whereas the CC theory is qualitatively wrong predicting that Z-DNA is more stable than both B and A DNA. PMID- 3271540 TI - Monte-Carlo simulation of DNA duplex hydration. B and B' conformations of poly(dA).poly(dT) have different hydration shells. AB - Monte-Carlo simulation of poly(dA).poly(dT) hydration by 30 water molecules per nucleotide pair has been performed. Two B-family conformations, both with a 36 degrees helical twist but with different minor groove widths, were considered. One conformation is Arnott's standard B form, the other one is specific for poly(dA).poly(dT) B' form with a narrowed minor groove. The mean energies and the mean numbers of water-water and water-DNA hydrogen bonds are close for the two conformations. Nevertheless, the hydration shell of the B' form differs drastically from that of the standard B form. The water arrangement in the minor groove of the B' form resembles the spine of hydration in the central part of Dickerson's dodecamer d(CGCGAATTCGCG). No such spine is formed in the hydration shell of the usual B form with a wider minor groove. In this conformation water bridges between adenine N3 or thymine O2 and oxygen of the sugar ring of the neighbouring nucleotide along the chain can be formed ("strings" in Dickerson's decamer d(CCAAGATTGG]. PMID- 3271541 TI - Intermolecular nuclear Overhauser effect and atomic pair potential approaches to wheat germ agglutinin-sugar binding. AB - The detailed binding mechanism of wheat germ agglutinin (WGA) with N acetylglucosamine (GlcNAc) was investigated using intermolecular 1H-1H nuclear Overhauser effect (NOE) and atomic pair potential (APP) calculations. Negative NOE was observed on the 1H spectrum of 1-O-methyl derivative of GlcNAc in a solution containing WGA, when the aromatic region of the WGA spectrum was irradiated. Analyses of the time dependence of NOE revealed that H2 and the N acetyl methyl protons of the sugar are in close proximity to the aromatic protons of WGA in the bound state. This was confirmed and further elucidated by the APP calculations. According to the calculation, the major binding force comes from a hydrogen-bonding between C3-OH of sugar and an acidic residue present in each of the two binding sites of WGA: Glu115 in site 1 and Asp29 in site 2. The binding is further assisted by the N-acetyl group which interacts with a few more polar amino acid residues in the binding sites. The optimized binding mode suggested by the APP calculations supports the NMR results in that H2 and a part of the N acetyl methyl protons are within 4.5 A distance from protons of both Tyr64 and Tyr73 in site 1 and of Tyr159 in site 2. PMID- 3271542 TI - High-field NMR and circular dichroism solvent-dependent conformational studies of the bradykinin C-terminal tetrapeptide Ser-Pro-Phe-Arg. AB - The conformational properties of the tetrapeptide Ser1-Pro2-Phe3-Arg4, the C terminal fragment of the nonapeptide hormone bradykinin, have been studied by circular dichroism and two-dimensional NMR techniques. Measurements of coupling constants, NH temperature dependence rates and nuclear Overhauser effects (performed with rotating frame nuclear Overhauser spectroscopy, ROESY) in H2O and CD3OH/D2O (80/20, v/v) reveal different conformations in the corresponding solvent. In aqueous solution the molecule exists in a random conformation or as an average of several conformations in rapid exchange. In CD3OH/D2O, however, the conformation is well-defined. The backbone of the peptide is extended, and the side-chains of Phe3 and Arg4 exhibit unusual rigidity for a peptide of this size. Evidently, the secondary structure is stabilized by a charge interaction between the guanidino group of Arg4 and the terminal carboxyl group, since experiments at various pH's show clearly that the definition of conformation decreases strongly upon protonation of the carboxyl function. A NH3+(Ser1)-COO-(Arg4) salt bridge, as well as any form of turn stabilized by hydrogen bonds can be ruled out with certainty. PMID- 3271543 TI - Structure of a potential cross-linking reagent: 2,2'-bis(methoxymethylene)-2,2' sulfonyldiacetonitrile (MMSBA). AB - The title compound (I) was prepared as a potential cross-linking reagent for nucleic acids and/or proteins. The compound is a stable, but reactive, crystalline solid which can be stored indefinitely upon adequate protection. The reagent reacts with amine nucleophiles - primary, secondary as well as heterocyclic - to afford bis-enamines. C8H8N2O4S, Mr = 228.23, monoclinic, C2/c, a = 18.031 (5), b = 9.372 (3), c = 13.455 (6) A, beta = 108.08 (5) degrees, V = 2161 (1) A3, Z = 8, Dx = 1.40 g cm-3, lambda(Mo K alpha) = 0.71069 A, mu = 2.81 cm1, F(000) = 944, T = 295 K. Final R = 0.041 for 1033 observed reflections. The bond distances in (I) are: S-O, 1.424 (3); S-C, 1.737 (4); C-CN, 1.417 (5); C=C, 1.342 (5); = C(H)-O, 1.295 (4); and C identical to N, 1.138 (5) A. The diagonal distance, alpha-alpha', between the two trans C atoms is 4.976 A. PMID- 3271544 TI - Structure and absolute configuration of (Z)-(+)-2-bromo-2-cycloundecenyl camphanate. AB - C21H31BrO4, Mr = 427.38, monoclinic, P2(1), a = 8.050 (1), b = 12.703 (3), c = 10.658 (1) A, beta = 102.56 (2) degrees, V = 1063.80 A3, Z = 2, Dx = 1.334 g cm 3, lambda(Cu K alpha) = 1.5418 A, mu = 28.09 cm-1, experimental temperature 296 K. F(000) = 448, R = 0.045 for 2015 unique reflections with I greater than or equal to sigma(I). The conformation of the 11-membered ring in this compound and its absolute configuration (1R) have been determined. PMID- 3271545 TI - 2-Aminopyridinium salicylate. AB - C5H7N2+.C7H5O3-, Mr = 232.2, orthorhombic, Pbca, a = 15.928(5), b = 11.830(5), c = 11.768(6) A, V = 2217(2) A3, Z = 8, Dm = 1.40, Dx = 1.391 g cm3, graphite monochromated CuK alpha, lambda = 1.54178 A, mu = 8.04 cm-1, F(000) = 976, T = 295 K, final R = 0.050 for 1116 reflections. Both six-membered rings are planar. The cations and anions are linked together in chains along the [001] direction by N-H...O hydrogen bonds. PMID- 3271546 TI - Structure of [Mg(HO3PCH(C6H5)2)2].8H2O, a layered phosphonate salt. AB - Bis(hydrogen diphenylmethylphosphonato)-magnesium octahydrate, [Mg(C13H12O3P)2].8H2O. Mr = 662.85, triclinic, P1, a = 6.1051 (15), b = 8.8308(14), c = 15.312(3) A, alpha = 78.514(13), beta = 83.993(11), gamma = 75.772(15) degrees, V = 782.8(3) A3, Z = 1, Dx = 1.41 g cm-3 (163 K), Mo K alpha, lambda = 0.71069 A, mu = 2.171 cm-1, F(000) = 350, T = 163 K, R = 0.0351 for 3749 reflections [F0 greater than or equal to 4 sigma(F0)]. The structure consists of alternating polar and nonpolar layers stacked along the crystallographic c axis. The polar layers contain Mg(H2O)26+ ions, water of hydration and the phosphonate O atoms, and the nonpolar layers contain the benzhydryl groups. Two-dimensional hydrogen-bonding networks link Mg(H2O)26+ and the water of hydration to the phosphonate O atoms. The shortest hydrogen bonds in the structure, 1.68(2) A, connect the P-OH H atom and the water of hydration. Slightly longer contacts [1.79(2), 1.85(2), 1.91(2), 1.92(2) A] connect the phosphonate O atoms (O1 and O3) to the H atoms of the Mg(H2O)26+ group. The coordination environment of the Mg atom is a very nearly regular octahedron of water O atoms. PMID- 3271547 TI - Acetyl benzyl disulfide. AB - S-Benzylthio thioacetate, C9H10OS2, Mr = 198.31, monoclinic, P2(1), a = 5.7112(5), b = 8.1912(5), c = 10.6486(8) A, beta = 92.230(8) degrees, V = 497.8(1) A3, Z = 2, Dm = 1.32(1), Dx = 1.323 Mg m-3, lambda(Mo K alpha) = 0.71073 A, mu = 0.47 mm-1, F(000) = 208, T = 299(1) K, RF = 0.024 for 812 reflections. In this molecule, the S-S [2.024(1) A] and S-C [1.802(3), 1.825(4) A] distances are typical and the C-S-S-C dihedral angle [-80.5(1) degree] lies at the lower end of the range reported for related compounds. The acetyl and disulfide groups are coplanar to within +/- 0.01 A. As a consequence, the molecule exhibits a short [3.078(2) A [intramolecular S...O contact. PMID- 3271548 TI - Structure of the radiation protection agent S-3-(3 methylaminopropylamino)propylphosphorothioic acid (WR 151,327). AB - C7H19N2O3PS.3H2O, Mr = 296.3, triclinic, P1, a = 6.859 (2), b = 7.077 (2), c = 16.326 (5) A, alpha = 96.64 (2), beta = 100.66 (2), gamma = 105.82 (2) degrees, V = 737.7 A3, Z = 2, D chi = 1.337 g cm-3, Mo K alpha, lambda = 0.71073 A, mu = 3.33 cm-1, F(000) = 320, room temperature, final R = 8.4% for 1614 reflections with /F0/ greater than 3 sigma. The overall conformation of the molecule is linear with a bend at the terminal N atom. The molecule is a double zwitterion with the two phosphate hydrogens residing on the two N atoms, and the three P-O bonds are of equal length at approximately 1.51 A. The S-P bond is unusually long at 2.13 A. Each H atom on each N atom and in each water molecule participates in hydrogen bonding. Within the crystalline lattice the molecule forms head-to-tail dimers. PMID- 3271549 TI - Structure of a modified cytosine: an antiviral nucleoside analog, homo-Ara-C. AB - Homo-Ara-C [5'-(hydroxymethyl)-5'-deoxy-1-beta-D-arabinofuranosyl-3H- cytosine], C10H16N3O5, Mr = 258.25, P2,2,2, a = 8.261 (2), b = 19.644 (4), c = 6.993 (6) A, V = 1134.8 A3, Z = 4, Dx = 1.511 g cm-3, lambda (Cu Ka) = 1.5418 A, mu = 10.5 cm 1, F(000) = 548, T = 288 K, final R = 0.053 for 1189 observed reflections. Conformational features of the nucleoside include a glycosidic bond conformation in the anti range, a ribose moiety in the 2E [C(2')-endo] form like 5'-N3-Ara-C, 5-NO2-Ara-U and Ara-C and a C(5')-C(6') bond that is gauche to C(4')-O(4') but trans to C(4')-C(3'). PMID- 3271550 TI - Structure of 6-(iodomethyl)-2-oxo-2-phenoxy-1,2-oxaphosphorinane. AB - C11H14IO3P, Mr = 352.11, monoclinic, P2(1)/n, a = 8.300 (3), b = 14.081 (2), c = 11.326 (4) A, beta = 104.32 (3) degrees, V = 1282.6 (13) A3, Z = 4, D chi = 1.823 Mg m-3, lambda(Mo K alpha) = 0.71073 A, mu = 25.8 cm-1, F(000) = 688, R = 0.035 for 2364 observed reflections. The six-membered ring O(1), P(2), C(3), C(4), C(5), C(6) is in a chair conformation with phenoxy and iodomethyl groups adopting axial and equatorial orientations, respectively. The bond distances and angles are unexceptional. PMID- 3271551 TI - Structure of 1 alpha,3 alpha-trimethylene-2',5-epoxyandrostane-3 beta, 17 beta diol 17-propionate methanol solvate (1/0.5). AB - C25H38O4.0.5CH4O, Mr = 418.6, monoclinic, P2(1), a = 19.8504 (20), b = 7.3909 (4), c = 15.7998 (18) A, beta = 93.09 (2) degrees, V = 2314.7 (8) A3, Z = 4, D chi = 1.201 Mg m-3, lambda(Cu K alpha) = 1.54184 A, mu = 0.604 mm-1, F(000) = 916, T = 295 K, R = 0.056 for 4946 unique observed reflections. The crystallographic asymmetric unit contains two steroid molecules and a molecule of methanol. All six-membered rings for both molecules have chair conformations. The D ring has a 13 beta-envelope conformation in molecule 1 and a 13 beta, 14 alpha half-chair conformation in molecule 2. The most significant differences between the crystallographically independent steroids are in the orientation of the H atoms of the C(3) hydroxyl groups and the conformations of the propionate side chains. When the crystallographically observed molecules are subjected to energy minimization their respective hydroxyl H-atom orientations are retained, but the D rings of both molecules refine to a common 13 beta,14 alpha-half-chair conformation and a significantly different orientation of the C(17) propionate side chain is generated. A comparison with other C(17)-ester-bearing steroids suggests that the energy minimization fails to simulate fully all intramolecular interactions. PMID- 3271552 TI - 3-Chloro-4-dimethylaminothioangelicin. AB - C13H10ClO2NS, Mr = 279.75, monoclinic, P2(1)/a, a = 14.490 (3), b = 22.598 (5), c = 7.336 (2) A, beta = 92.4 (1) degree, U = 2400 (1) A3, Z = 8, D chi = 1.548 g cm 3, lambda(Mo K alpha) = 0.71069 A, mu = 2.07 cm-1, F(000) = 1152, room temperature, R = 0.037 for 2423 independent reflections with I greater than or equal to 3 sigma(I). Each unit cell contains two independent molecules which differ mainly in the orientation of their N(CH3)2 groups. The two tricyclic moieties of each molecule are not coplanar, the pyran ring being tilted by 7.9 (1) degree with respect to the benzene ring in molecule 1 and by 8.7 (1) degree in molecule 2. There are weak interactions between the molecules involving the carboxylic O atoms and the H atoms of the phenyl moieties. PMID- 3271553 TI - New analysis of the neutron diffraction data for anhydrous orthophosphoric acid and the structure of H3PO4 molecules in crystals. AB - Two neutron data sets, which had been analyzed separately to determine the H-atom positions in H3PO4 crystals [Cole (1966). PhD Thesis, Univ. of Washington, Pullman, USA], have been re-analyzed in a joint refinement, fitting separate scale and extinction parameters for each data set, in order to obtain more precise positional and vibrational parameters. The new refinement gave R(F) = 0.036 for the combined 743 data. For the new results, and for six other H3PO4 molecules from four other, different crystal structures, thermal vibration analyses have been performed, and the molecular structures, thermal vibrations and hydrogen-bonding effects are compared. The rigid-body model is found to be better than the riding model for the PO4 groups. The P-OH bond lengths are markedly affected by hydrogen bonding, but seem to be independent of O = P-O-H conformation. These effects are interpreted in terms of the P-O partial double bond character. Crystal data (Cole, 1966): anhydrous orthophosphoric acid, H3PO4, Mr = 98.00, room temperature, P2(1)/c, a = 5.779(9), b = 4.826 (4), c = 11.606 (40) A, beta = 95.26 (18) degrees, V = 322.3 (20) A3, Z = 4, Dx = 2.019 mg mm-3, mu = 0.1687 mm-1 for neutrons with lambda = 1.450 A. PMID- 3271554 TI - Structural studies of analgesics and their interactions. XII. Structure and interactions of anti-inflammatory fenamates. A concerted crystallographic and theoretical conformational study. AB - A theoretical conformational analysis of fenamates, which are N-arylated derivatives of anthranilic acid or 2-aminonicotinic acid with different substituents on the aryl (phenyl) group, is reported. The analysis of these analgesics, which are believed to act through the inhibition of prostaglandin biosynthesis, was carried out using semi-empirical potential functions. The results and available crystallographic observations have been critically examined in terms of their relevance to drug action. Crystallographic studies of these drugs and their complexes have revealed that the fenamate molecules share a striking invariant feature, namely, the six-membered ring bearing the carboxyl group is coplanar with the carboxyl group and the bridging imino group, the coplanarity being stabilized by resonance interactions and an internal hydrogen bond between the imino and carboxyl groups. The results of the theoretical analysis provide a conformational rationale for the observed invariant coplanarity. The second six-membered ring, which provides hydrophobicity in a substantial part of the molecule, has limited conformational flexibility in meclofenamic, mefenamic and flufenamic acids. Comparison of the conformational energy maps of these acids shows that they could all assume the same conformation when bound to the relevant enzyme. The present study provides a structural explanation for the difference in the activity of niflumic acid, which can assume a conformation in which the whole molecule is nearly planar. The main role of the carboxyl group appears to be to provide a site for intermolecular interactions in addition to helping in stabilizing the invariant coplanar feature and providing hydrophilicity at one end of the molecule. The fenamates thus provide a good example of conformation-dependent molecular asymmetry. PMID- 3271555 TI - Static deformation densities for cytosine and adenine. AB - X-ray diffraction intensities for cytosine monohydrate have been measured at 97 K, to 2sin theta/lambda = 2.74 A-1, and used in a deformation refinement. Crystal data for cytosine monohydrate at 97 K: a = 7.728 (1), b = 9.817 (3), c = 7.520 (1), beta = 100.50 degrees, V = 560.94 A3, R = 0.0341 for 6456 unique reflections. The experimental static deformation density of cytosine compares very well with the corresponding theoretical 4-31G deformation density. Differences between theory and experiment occur at hydrogen-bonding sites. They are very similar to the corresponding differences between the theoretical deformation densities of formic acid monomer and cyclic dimer. The experimental static deformation density of 9-methyladenine was obtained in a deformation refinement against the low-temperature X-ray data of Craven & Benci [Acta Cryst. (1981), B37, 1584-1591]. It is similar to the maps presented by these authors. The comparison of the experimental deformation density of 9-methyladenine with the theoretical 4-31G deformation density of adenine shows qualitative agreement, which is improved when the 4-31G results are corrected for the absence of polarization functions in the basis set. Some of the remaining differences reflect the effects of substituting CH3 for H. The weak N...H hydrogen bonds have little influence on the deformation density in this structure. PMID- 3271556 TI - A model for vitamin B6--amino-acid-related metal complexes. Neutron diffraction study of aqua(N-salicylideneglycinato)copper(II) hemihydrate at 130 K. AB - A neutron diffraction study of aqua(N-salicylideneglycinato)copper(II) hemihydrate, [Cu(C9H7NO3)-(H2O)].0.5H2O, Mr = 267.7, a model for vitamin B6-amino acid-related metal complexes, has been carried out at 130 K. Least-squares refinement based on 3800 reflections [(sin theta/lambda)max = 0.786 A-1] converged at R(F2) = 4.5%. The crystal is monoclinic, space group C2/c, Z = 8 with cell parameters at 130 K: a = 17.030 (3), b = 6.665 (1), c = 17.469 (5) A, beta = 111.13 (1) degree, V = 1849.50 A3. The bond distances between non-H atoms have been determined with estimated standard deviations in the range 0.0008 0.0012 A; the corresponding values for distances involving H atoms are 0.0017 0.0020 A. The presence of a Cu11 ion does not significantly change the bond distances around the alpha-C atom from those observed in glycine or glycylglycine. There are, however, indications of differences in distance and direction relative to the pi system for the two alpha-C-H bonds. These bond vectors are inclined at angles of 30 and 71 degrees to the plane of the conjugated pi system. A planar conjugated pi-system is stabilized by chelation to the Cu ion. PMID- 3271557 TI - Low-temperature study of the A-DNA fragment d(GGGCGCCC). AB - The structure of the A-type duplex d(GGGCGCCC) was determined from data measured at 115 K to 2.0 A resolution. The space group, P4(3)2(1)2, is the same as for the 293 K structure; cell dimensions are a = 42.74 (4), c = 24.57 (1) A; R = 0.21 for 1694 observed reflections. The conformation and hydration are similar at the two temperatures. The average displacement parameters (B) for bases, sugars and phosphates all decrease by about 9 A2 relative to those found at 293 K. The individual values of B1/2 are linearly related to the distance from the molecular center of mass. PMID- 3271558 TI - Refinement of the structure of pseudoazurin from Alcaligenes faecalis S-6 at 1.55 A resolution. AB - The crystal structure of the redox protein pseudoazurin (123 amino acid residues; molecular weight 13,000 daltons) from Alcaligenes faecalis has been refined by fast Fourier restrained least-squares minimization. Cycles of rebuilding were carried out to escape from local minima. Individual isotropic temperature factor values were refined separately for all atoms. The R factor was reduced from 0.400 (for 2647 reflections in the 6.0-2.8 A resolution range) to 0.180 (for all 19,770 reflections in the 9.0-1.55 A resolution range) with a final estimated accuracy in atomic positions of 0.15 A. The final model comprises 917 protein atoms and 93 solvent molecules. The root-mean-square shift of the main-chain atoms between the final and the initial model is 0.94 A (maximum shift 1.8 A). Most of the larger shifts were the result of rebuilding on the graphics system. The average atomic temperature factor, B, is 23.0 A2 for all atoms. Side-chain atoms with high B values were omitted, and their positions checked from difference maps. The three carboxy-terminal residues were omitted from the final model as no single conformation could be assigned from the observed electron density. All other protein atoms were included. PMID- 3271559 TI - Solving DNA structures by MERLOT. AB - MERLOT, a molecular replacement computer package, has been successfully used for the determination of initial phases for five different oligonucleotide structures. Two of these, CCGG and CGCGCGTTTTCGCGCG, with 316 and 323 non-H atoms respectively in the asymmetric unit, have been solved ab initio using the MERLOT package. The rest are re-examinations of previously solved DNA oligomer structures, ioCCGG, CGCGAATTCGCG and CGCGAATTbrCGCG, with 160, 486 and 488 non-H atoms in the asymmetric unit respectively. Problems involved in applying the molecular-replacement technique to DNA structures, and their possible solutions, are discussed. PMID- 3271560 TI - Structures of the anticancer compounds N-(2-hydroxyethyl)-2-(3-nitro-1,2,4 triazol-1-yl)-acetamide (RB-6110) and 5-(1-aziridinyl)-3-nitro-1-(3-oxo-1-butyl) 1,2,4- triazole (RB-6162). AB - RB-6110: C6H9N5O4, Mr = 215.17, monoclinic, C2/c, a = 20.595 (3), b = 4.713 (1), c = 19.914 (4) A, beta = 110.69 (1) degree, V = 1808.3 A3, Z = 8, Dx = 1.588 Mg m 3, lambda(Cu K alpha) = 1.54178 A, mu = 0.838 mm-1, F(000) = 675, T = 298 K, final R = 0.042 for 1219 observed reflections with I greater than or equal to 1.5 sigma (I). RB-6162: C8H11N5O3, Mr = 225.21, monoclinic, P2(1)/c, a = 7.515 (1), b = 14.758 (2), c = 9.813 (1) A, beta = 108.49 (1) degree, V = 1032.1 A3, Z = 4, Dx = 1.450 Mg m-3, lambda(Cu K alpha) = 1.54178 A, mu = 0.927 mm-1, F(000) = 472, T = 298 K, final R = 0.042 for 1113 observed reflections with I greater than or equal to 1.5 sigma (I). RB-6110 and RB-6162 are 3-nitro-1,2,4-triazoles with potential application as anticancer agents. The nitro groups are in the plane of the aromatic triazole ring with dihedral angles of 1.2 (4) and 4.6 (4) degrees, respectively. The arizidine substituent of RB-6162 is almost perpendicular [dihedral angle 80.1 (4) degrees] to the triazole plane. Molecular-orbital calculations on RB-6162 have confirmed that this geometry is energetically favoured. The energy barrier to rotation about the triazole-aziridine bond has been determined as 51.5 (5) kJ mol-1 by the dynamic NMR method. PMID- 3271561 TI - [Periodontal disease]. PMID- 3271562 TI - [Methodology for cephalometric analysis as a base for sequential decisions]. PMID- 3271563 TI - [Linkow implants (blade-vent)]. PMID- 3271564 TI - [Antibiotics: update of forms and dosage]. PMID- 3271565 TI - [Biomechanical principles of Ricketts-Burstone sectional retraction]. PMID- 3271567 TI - [Oral hygiene and periodontal disease in a city with fluoridated water]. PMID- 3271566 TI - [Combined treatment with fixed and removable appliances]. PMID- 3271569 TI - [3 cases of space supervision]. PMID- 3271568 TI - [A palatinized lateral incisor. A reason for treatment?]. PMID- 3271570 TI - [Health conditions in the Republic of Argentina: strategies for change]. PMID- 3271571 TI - Lymphocytosis of large granular lymphocytes in splenectomized subjects. AB - Lymphocytosis of large granular lymphocytes (LGL) has been observed in 6 patients splenectomized for various pathological conditions. In all of them the LGL count was higher than 3.5 x 10(9)/l. No patient showed neutropenia nor suffered from rheumatoid arthritis. A surface markers heterogeneity was observed by immunophenotypic studies. A reversal of the CD4/CD8 ratio was observed in all patients, indicating that LGL are in the majority CD8+. Three patients showed the phenotype CD2+ CD3+ CD4- CD8+ indicating the T-lineage derivation of LGL; patient 6 showed a non-T non-B phenotype (CD2- CD3- CD4- CD8+/-). The percentage of lymphocytes presenting LGL-related markers (HNK-1, CD16, CD11b) was higher than that observed in normal subjects in 4 out of 5 examined patients. However, the percentage of cells bearing these markers was inferior to the LGL counts indicating that not all LGL express them. NK cytotoxic activity was similar to that of normal subjects in the three examined patients. Our data suggest that lymphocytosis of LGL in splenectomized subjects is a reactive process favoured by the asplenic state. PMID- 3271572 TI - [Immunosuppressive factors produced by a T cell line derived from acute lymphoblastic leukemia]. AB - The supernatant of CD8+ cells, isolated from a permanent lymphoblastoid cell clone established from a long term culture of a T cell acute lymphoblastic leukemia, contained two distinct molecules with suppressive activity on PHA1 induced PBMC proliferation. This clone does not produce TNF-alpha, TNF-beta, alpha-IFN, gamma-IFN, IL-1, IL-2 and has not natural killer activity. In the attempt to purify and biochemically characterize the lymphoblastic cell line derived T-cell SFs, a multi-step chromatographic separation has been used. Two different peaks of biologic activity have been separated by HPLC gel permeation in the range of 100-120 Kd and 75-85 Kd referred to as high molecular weight suppressor factor HMWSF, and low molecular weight suppressor factor LMWSF, respectively. These fractions were then concentrated, dialyzed and further purified by anion exchange HPLC. This chromatographic step allowed us to considerably purify the two SFs. The biologically active fractions derived from the previous chromatographic step were eventually subjected to hydrophobic interaction HPLC (HIC) for final purification. The highly purified material was characterized by polyacrylamide gel electrophoresis in sodium-dodecylsulfate (SDS PAGE): a single band corresponding to 115 Kd was observed for HMWSF, while LMWSF yielded a single band at 80 Kd. The isoelectric points (pI) of the different SFs was determined by flat-bed isoelectric-focusing: the HMWSF yielded a single band at pI 7.4, while a much lower pI was observed for LMWSF, 3.5-3.6. Studies on temperature lability indicated that both proteins are stable for 3-4 hours at room temperature (RT), 24-36 hours at +4 degrees C and 7-10 days at -80 degrees C. PMID- 3271573 TI - [A rapid decrease in the phosphatidylinositol cycle during neuroblastoma cell differentiation induced by retinoic acid]. AB - Inositol phospholipid turnover is part of a signal transduction mechanism which mobilize intracellular calcium and activate a calcium- and phospholipid-dependent protein kinase, protein kinase C. Phosphatidylinositol turnover has recently been implicated in the regulation of cell proliferation and transformation. Its role in differentiation has now been investigated using LAN-1 cells, a human neuroblastoma cell line which can be induced to differentiate along the neuronal pathway by RA. Treatment of LAN-1 cells with RA was followed by a rapid decrease of inositol phospholipid metabolism, as determined by isotopic methodology employing myo-[1,2-3H] inositol or [1(3)-3H] glycerol. Analysis of labelled phosphatidylinositol metabolites from prelabelled cells indicated a rapid decrease of inositol (1,4,5)trisphosphate and (1,2)diacylglycerol within 1 min. of induction of LAN-1 cell differentiation. These findings suggest that inositol phospholipid-derived metabolites (i.e. diacylglycerol and inositol trisphosphate) may be part of the mechanism by which certain RA signals are transduced, playing a key role in control of neuroblastoma cell differentiation. PMID- 3271575 TI - Laryngeal electromyography. PMID- 3271574 TI - Conventional and computed tomographic sialography in evaluating disorders of the parotid gland. PMID- 3271576 TI - Advances in evoked electromyography for the evaluation of facial nerve disorders. PMID- 3271577 TI - Portable hearing aid analysis and probe-microphone instrumentation. PMID- 3271578 TI - Instrumentation for objective assessments of vocal quality. PMID- 3271579 TI - Three dimensional imaging in otolaryngology. PMID- 3271580 TI - Biomechanical considerations in dental implant design. PMID- 3271582 TI - Medical risks associated with dental implants. PMID- 3271581 TI - Biocompatibility: the interaction of biomaterials and host response. PMID- 3271583 TI - The soft tissue interface in dental implantology. PMID- 3271584 TI - Prevalence and patterns of tooth loss in U.S. adult and senior populations. PMID- 3271585 TI - Periodontal considerations of implants and implant associated microbiota. PMID- 3271587 TI - Fibro-osteal and osteal integration. PMID- 3271586 TI - Bone tissue interface. PMID- 3271588 TI - Future directions in dental implant materials research. PMID- 3271589 TI - [Nuclear medicine diagnosis and treatment in pheochromocytoma and neuroblastoma]. AB - Localization procedures are required in catecholamine producing tumors following clinical and biochemical confirmation of phaeochromocytoma or neuroblastoma. Whereas computed tomography and ultrasound reflect morphological abnormalities, adrenomedullary scintigraphy with radiolabeled meta-iodobenzylguanidine depends on function. MIBG scintigraphy has the advantage of being able to detect intra- and extra-adrenal, uni- and bilateral or multilocular, benign and malignant phaeochromocytomas and neuroblastomas. Especially small lesions and tumor tissue in bone marrow in children with neuroblastoma can be visualized more easily. The same radiopharmaceutical agent radiolabeled with high doses of 131I may be used for treatment of phaeochromocytomas and neuroblastomas stage III and IV. In patients with malignant phaeochromocytomas this therapy may improve clinical symptoms and reduce tumor volume for months or even years, but probably this therapy is not curative. In children with neuroblastoma complete remission may be achieved by combining surgery, chemotherapy, and 131I-MIBG treatment. Therefore, this therapeutic modality should be included in the therapeutic strategy of stage III and IV neuroblastoma. PMID- 3271591 TI - Plasma concentration and urinary excretion of arginine vasopressin in children with moderately impaired renal function. AB - Plasma concentration and urinary excretion of arginine vasopressin (AVP) were measured in 20 children and adolescents with normal or moderately impaired renal function. Plasma AVP was higher in children with an inulin clearance less than 60 ml/min X 1.73 m2, whereas plasma osmolality did not differ in all children. Urinary excretion and urinary clearance of AVP (UCAVP) decreased in relation to impairment of renal function, and a strong negative correlation was found between plasma AVP and log UCAVP. Reduced urinary excretion of AVP may contribute to elevated plasma AVP in children with impaired renal function. PMID- 3271590 TI - Peritonitis in children undergoing dialysis. 10 years experience. AB - The clinical aspects of peritonitis were reviewed in 83 patients treated with continuous ambulatory or continuous cyclic peritoneal dialysis between May 1978 and April 1988. Peritonitis occurred in 50 patients whose mean duration of dialysis was 17.8 months, but not in 33 patients with a mean duration of dialysis of 10.4 months. The mean time from starting dialysis to the first episode of peritonitis was 7.1 months. The peritonitis rate was lower for continuous cyclic than for continuous ambulatory peritoneal dialysis (1 episode per 12.9 vs. 1 episode per 8.1 patient months, respectively). In 39% of the episodes, gram stain of the dialysate was positive. The dialysate leukocyte count was higher in gram negative than in gram-positive peritonitis. Seventy percent of the peritonitis episodes were gram positive, and Staphylococcus aureus was predominant. Only 1 of the 7 diapered infants had gram-negative organisms associated with peritonitis. Catheters were replaced in 48 cases, 26 because of infection. Sixty-nine percent of the patients were cured with antibiotic therapy alone. Although peritonitis was associated with a mortality rate of 1.2%, peritoneal dialysis remains the favored dialytic mode for children. PMID- 3271592 TI - Prognostic factors in the hemolytic-uremic syndrome. AB - During 1972-1986, 142 children with the hemolytic-uremic syndrome were treated. Most of them were infants (73%). The total mortality rate reached 25.4%. Computer analysis revealed the following risk factors of a fatal outcome: severe gastrointestinal symptoms during the prodromal period, coma, convulsions, malignant hypertension, persistence of prodromal symptoms over 7 days, hyperkalemia over 7 mmol/l, acidosis with bicarbonate level less than 15 mmol/l, a delay of over 5 days in starting dialysis, and transport to dialysis unit of over 100 km. The greatest risk of death existed during the first 3 weeks from onset. Among 142 children, 106 survived the acute phase. They were followed up from 2 to 16 years. Nine were lost to follow-up. Twelve children developed chronic renal failure. PMID- 3271593 TI - Association of congenital abnormalities of the kidney and urinary tract with those of other organ systems in 13,775 autopsies. AB - The occurrence of abnormalities of the kidney, urinary tract and other organ systems was reviewed in 13,775 autopsies. Forty-seven percent of 427 autopsies (60% of those under 18) with congenital abnormality of the kidney and urinary tract were found to have an associated abnormality other organ systems. Abnormalities of the cardiovascular (CV) system were most commonly associated with those of the kidney and urinary tract (25%), followed by the gastrointestinal (GI) tract (18%), central nervous system (10%), skeletal (9%), respiratory (8%), facial (7%), reproductive (5%), and chromosome and abdominal wall abnormalities (4% each). Renal and urinary tract abnormalities should be ruled out in any individual presenting with abnormalities of other organ systems, particularly the CV and GI systems and the CNS. PMID- 3271594 TI - Plasma and muscle carnitine in healthy and hemodialyzed children. AB - Total carnitine and its subfractions (free carnitine, short-chain and long-chain acylcarnitine) have been measured in plasma and muscle of healthy children of both sexes aged 0.1-18 years using a modified radiochemical-enzymatic assay. Up to the age of 9 years, no differences were apparent between boys and girls while in the range of 10-18 years the boys revealed increased and girls similar concentrations of free and total plasma carnitine compared to the younger children. Plasma concentrations of total and free carnitine revealed weak, but significant correlations with age in boys and girls, while muscle concentrations of total carnitine and its subfractions were not age dependent. No correlations were apparent between any of the plasma and muscle carnitine fractions. Plasma carnitine concentrations measured in hemodialyzed children showed a disturbed pattern of the fractions, whereas muscle concentrations were apparently normal in these patients. The present study provides reference values of free carnitine and the acylcarnitines in plasma and muscle of healthy children and emphasizes the necessity to use appropriate reference values for assessing carnitine metabolism in pediatric patients. PMID- 3271595 TI - Proteinuria and statural growth. AB - In order to assess the possible effects of proteinuria on statural growth, we studied 14 children with various glomerulopathies and proteinuria persistently above 30 mg/kg/day which were followed-up for 1.5-4.3 years. They had received only short-term steroid therapy or no steroids at all. During the follow-up, 3 patients lost 1-2.1 height standard deviation scores. These patients had proteinuria above 100 mg/kg/day with associated glycosuria, and they went into chronic renal failure. The other patients had minor variations of the growth curve. In our experience heavy proteinuria represents a risk factor for growth delay when it is associated with glycosuria and chronic renal failure. PMID- 3271596 TI - Prenatal diagnosis of severe urinary tract anomalies improves renal function and growth. AB - The clinical course of 14 children with bilateral renal disease diagnosed on prenatal ultrasound examination (prenatal group) was compared with a control group of 14 children who presented postnatally (postnatal group). The children in the prenatal group had earlier evaluation and treatment of their renal disease and fewer complications prior to diagnosis. Prenatally diagnosed children had a lower incidence of reduced renal function and better growth than matched controls. PMID- 3271598 TI - The new Periotest method. PMID- 3271597 TI - Calculus anuria in childhood. AB - The incidence of calculus anuria is relatively high in Iran. Eighteen children with this picture were studied in our departments between 1972 and 1984. The cause of anuria was bilateral obstruction by the calculi (14 cases), unilateral obstruction with a nonfunctioning kidney (3 cases) or aplasia on the other side (1 case). As demonstrated by our study, the cause of stone formation was a metabolic disorder in 50% of the children. This indicates that with anuria created by calculi formation, more consideration should be given to the possibility of metabolic disorders than has so far been the case. Further research should therefore be carried out in this respect, particularly in cases of the lower age range with indications of parental consanguinity, multiple and bilateral calculi, repeated calculi and repeated admissions, which were frequently observed by us. PMID- 3271599 TI - The assessment of periodontal disease activity. PMID- 3271601 TI - Some candid observations and reflections on the results of an in vitro test of the Siemens Periotest device. PMID- 3271600 TI - The effect of tooth mobility on probing depths. PMID- 3271602 TI - Use of a computer to include tooth mobility in comprehensive periodontal charting, diagnosis, and treatment planning. PMID- 3271603 TI - Cardiovascular responses to acute myocardial ischaemia in morphine-dependent rats. AB - 1. The cardiovascular responses to acute myocardial ischaemia were studied in opiate-dependent animals before and after 2 weeks morphine withdrawal. 2. Rats were treated with morphine sulphate in drinking water for 2, 3 or 5 weeks. The development of morphine tolerance and dependence was verified by the tail immersion test for analgesia and the naloxone-precipitated withdrawal syndrome, respectively. 3. Acute left coronary artery ligation induced a decrease in blood pressure, a slight increase in heart rate and ventricular tachycardia or fibrillation in anaesthetized naive rats. 4. Chronic morphine treatment did not alter the haemodynamic responses to coronary artery ligation. However, a significantly lowered incidence, and prolonged time of onset, of ventricular arrhythmias was found in 3 and 5 week morphine-treated rats. This phenomenon did not occur in animals receiving morphine for 2 weeks and in a 3 week morphine treated group which was subsequently withdrawn for 2 weeks. 5. It is suggested that the decreased occurrence of early ventricular arrhythmias resulting from acute myocardial ischaemia in chronic morphine-treated rats may be related to the degree of opiate tolerance and dependence. PMID- 3271604 TI - Distribution of cadmium in body organs and hepatic metallothionein content following chelation therapy. AB - 1. Calcium trisodium diethylene triamine penta-acetate (CaNa3DTPA), sodium 1,2 diaminocyclohexane tetra-acetate (Na2CDTA), triethylenetetramine hydrochloride (TETA.HCl) and sodium diethyldithiocarbamate (NaDDC) were investigated for their efficacy to mobilize cadmium (Cd) from various tissues and hepatic metallothionein (MT) in Cd-exposed rats. 2. All chelating agents reduced the hepatic Cd burden but did not elicit any influence on other tissues, except that TETA.HCl lowered pancreas Cd and NaDDC increased brain Cd. 3. Cadmium-induced hepatic MT was lowered upon treatment with CaNa3DTPA while it increased further following treatment with NaDDC. 4. The chelating agents, in split doses, are capable of reducing the hepatic burden of Cd and altering the hepatic MT level. 5. While all the chelating agents decreased Cu content of hepatic MT, only CaNa3DTPA decreased its Zn content and TETA.HCl mobilized MT-bound Cd. 6. The administration of chelating agents alone in normal animals showed that NaDDC induced greater hepatic MT synthesis and increased MT-bound Zn than other chelating agents. PMID- 3271605 TI - Comparative neuroanatomy of angiotensin II receptor localization in the mammalian hypothalamus. AB - 1. The distribution of angiotensin II (AII) receptor binding sites in the hypothalamus of rat, rabbit, sheep and human was determined by in vitro autoradiography using 125I-[Sar1,Ile8]-AII as radioligand. 2. High receptor binding levels were observed in the continuum of tissue comprising the anterior wall of the third ventricle, including the subfornical organ, the median pre optic nucleus and the organum vasculosum of the lamina terminalis. 3. High levels of binding sites were also found in the paraventricular and supra-optic nuclei, the median eminence and the arcuate nucleus. 4. These findings demonstrate sites in the hypothalamus of rat, rabbit, sheep and human where AII could exert its known actions on fluid and electrolyte balance, pituitary hormone release and cardiovascular function. PMID- 3271606 TI - Endothelium-derived relaxing factor released from cultured cells: differentiation from nitric oxide. AB - 1. Endothelium-derived relaxing factor (EDRF) is an extremely labile mediator thought to be identical to nitric oxide (NO). 2. A cascade superfusion technique was used to bioassay EDRF released from bovine aortic endothelial cells grown to confluence on microcarrier beads. 3. Bradykinin (1-100 nmol/l), infused through a 1 cm column of endothelial cells on microcarriers, released an EDRF-like substance that caused relaxations of de-endothelialized strips of rabbit aorta (precontracted with phenylephrine). These relaxations diminished on successive tissues in the cascade, when compared with those produced by glyceryl trinitrate as a stable standard. 4. Haemoglobin (1 mumol/l), infused directly over the bioassay tissues, abolished bradykinin-induced relaxations and these were restored within 5 min after removal of haemoglobin. The infusion did not affect the relaxations produced by glyceryl trinitrate in this system. 5. Methylene blue (20 mumol/l) inhibited bradykinin-induced relaxations when infused over the rabbit aortae, and reduced those relaxations produced by glyceryl trinitrate. The effects of bradykinin, but not glyceryl trinitrate, were partially restored after removing methylene blue. 6. These data are consistent with the known effects of these compounds on the activity of NO, and on EDRF in isolated blood vessels. 7. The activity of EDRF (released by bradykinin) was compared directly with NO on strips of guinea-pig trachea (de-epithelialized) interposed in cascade between two rabbit aortae; all strips were precontracted with histamine and phenylephrine. 8. A submaximal dose of NO that matched the relaxation produced by EDRF on the uppermost aorta, caused relaxation of the trachea, but EDRF had no effect on this tissue. In addition, the NO-induced relaxation of the lower aorta was greater than that produced by EDRF. 9. These data indicate that EDRF does not have identical biological activity to NO. EDRF could contain an NO moiety attached to a carrier molecule that is bound and stabilized in tracheal tissue. PMID- 3271607 TI - An unusual phosphatidylinositol turnover pathway in noradrenaline-perfused rat hearts. AB - 1. The phosphatidylinositol turnover pathway has been studied in noradrenaline perfused rat hearts using anion-exchange high performance liquid chromatography. 2. The active calcium-releasing compound inositol-(1,4,5)trisphosphate was detected together with its degradation products inositol-(1,4)bisphosphate and inositol monophosphate. All these products increased in response to noradrenaline stimulation. 3. At noradrenaline perfusion times from 5 s to 20 min there was no appearance of inositol-(1,3,4,5)tetrakisphosphate or its degradation products: inositol-(1,3,4)trisphosphate or inositol-(1,3) and (3,4)bisphosphates. 4. These data suggest the absence of the inositol-(1,4,5)trisphosphate phosphorylation/dephosphorylation pathway in heart. PMID- 3271608 TI - An appraisal of the effects of usual vs recent alcohol intake on blood pressure. AB - 1. In a population-based study of 343 men from two public utilities, 260 subjects reported drinking alcohol at least once a week. In these subjects a comparison was made of the relative effects on blood pressure of either their usual alcohol intake (assessed from a 7-day retrospective diary) or recent alcohol intake (alcohol consumed at the last drinking session in the 24 h prior to blood pressure measurement). 2. Both usual and recent alcohol intake showed similar correlations with level of blood pressure (BP). After adjustment of BP for the potential confounding influences of body mass index, age and smoking status, systolic and diastolic BP remained highest in those subjects with the highest reported levels of both usual and recent alcohol intake. 3. In regression analyses comprising only those subjects who reported drinking in the 24 h before BP measurement, a 3-4 fold greater effect of usual rather than recent intake on both systolic and diastolic BP was predicted from the b coefficients. Regression analysis also demonstrated that the relationship between usual alcohol intake and BP was independent of recent intake, while the relationship between recent intake and BP was no longer significant when usual alcohol intake was entered into the regression equation. 4. These observations suggest that consistent regular drinking is a more important determinant of the alcohol/BP relationship than intake in the previous 24 h. PMID- 3271609 TI - Voluntary blood pressure control using continuous systolic blood pressure biofeedback. AB - 1. Ability to alter blood pressure (BP) acutely with continuous systolic (SBP) BP biofeedback was assessed in volunteers using a new non-invasive finger BP monitor. 2. Reliability of finger BP measurement was demonstrated in six hypertensive subjects (21-60 years), by beat-to-beat comparison with brachial intra-arterial BP over 90 min. Wide variation of BP was achieved by physiological manoeuvres. Mean error of finger BP was -3.0/-2.2 mmHg with intra-subject s.d. of 7.2/5.4 mmHg. 3. Thirteen normotensives (21-51 years) were paid to undergo 30 trials of SBP biofeedback in six sessions over 3 weeks. The SBP trend was displayed on a monitor with appropriately 'shaped' targets; each trial consisted of BP-raising and -lowering periods of 45 and 90 s respectively with intervening 45 s baselines. 4. Nine subjects raised BP, on analysis of the last 10 trials, by an average of 18.8 mmHg while five of the 13 successfully lowered BP by an average of 10.0 mmHg. BP lowering was best achieved by diminishing respiratory rate and depth, and muscular relaxation. 5. Demonstration of large BP reductions in five of 13 normotensives using strategies applicable to longer training sessions warrants further investigations in hypertensive subjects, focusing on mediating mechanisms and transfer of effect beyond the laboratory. PMID- 3271610 TI - Time course of changes in baroreceptor reflex control of heart rate in conscious SHR and WKY: contribution of the cardiac vagus and sympathetic nerves. AB - 1. The aim of this study was to assess the vagal and sympathetic nerve contribution to the relationship between mean arterial pressure (MAP) and heart rate (HR) at 6, 9, 14 and 20 weeks of age in conscious Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) with methoxamine- and nitroprusside-induced steady-state changes in blood pressure. 2. MAP increased with age in both strains but was 17-23% higher in SHR. 3. By contrast baroreflex parameters (HR range: difference between upper and lower HR plateaus, and gain: average slope between inflection points of the logistic MAP-HR relationship) decreased with age in SHR but increased in WKY. 4. After methylatropine, no differences in the cardiac sympathetic baroreflex range or gain parameters were observed between strains or ages. 5. It was concluded that older SHR have normal sympathetic but reduced vagal capacity to control HR in response to changes in MAP, but that this deficit was not dependent on the absolute level of blood pressure. 6. Because the differences were confined to one effector, SHR may have different central rather than arterial baroreceptor afferent mechanisms. PMID- 3271611 TI - Effects of indomethacin on steroid-induced changes in pressor responsiveness in man. AB - 1. It has been shown previously that hydrocortisone (F) increases pressor responsiveness in normal subjects. The present study examined the role of vasodilator prostanoids in determining these changes. 2. Pressor responsiveness to angiotensin II (AII) (1-8 ng/kg per min) and phenylephrine (PE) (0.3-0.9 microgram/kg per min) was examined in six normal men receiving: no treatment (day 1); 100 mg indomethacin p.o. (INDO) in three divided doses over 20 h (day 2); 200 mg F for 5 days, 50 mg 6 hourly p.o. (day 6); F plus 100 mg INDO (day 7). 3. Blood pressure, body weight and plasma glucose rose with F and plasma potassium fell. F alone produced significant increases in response to AII at 2 ng/kg per min, for systolic pressure (SBP), diastolic pressure (DBP) and mean arterial pressure (MAP), and at 1 ng/kg per min for DBP. The threshold for SBP, DBP and MAP rises with AII was decreased by F. Responses to PE following F were greater at 0.6 microgram/kg per min for SBP, DBP and MAP and the threshold for all parameters fell. 4. INDO alone had no significant blood pressure or metabolic effects and no effect on the magnitude of the blood pressure rise with AII, but decreased the threshold dose for effects on MAP. INDO had no effect on the magnitude of the pressure rise with PE, but decreased the threshold dose for effects on SBP. 5. INDO did not modify responsiveness or threshold to AII following F. Responsiveness to PE was unchanged and threshold fell for SBP only during INDO.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3271612 TI - Three Alu repeated sequences associated with a human glandular kallikrein gene. AB - 1. Recently the complete primary structure of a human glandular kallikrein gene, hGK-1, was reported. The present paper presents further structural information. 2. Associated with the gene were three Alu repeated sequences; one in the second intron and two approximately 0.4 kb and 1.2 kb upstream. 3. The 5' non-coding and 5' flanking DNA was highly homologous to that in the mouse genes. 4. Different polyadenylation signals are used in different human kallikrein genes. PMID- 3271613 TI - High salt diet decreases longevity in the spontaneously hypertensive rat. AB - 1. Blood pressure, body weight and mortality rate were examined in female spontaneously hypertensive rats (SHR) of the Okamoto strain maintained on a lifelong high (5% NaCl w/w) or low (0.1% NaCl w/w) salt diet. 2. A high salt diet increased mortality and decreased body weight in SHR, but failed to significantly alter blood pressure up to 24 months of age. 3. Hence, a low salt diet does not appear to be a long-term risk factor and may protect the SHR from cardiovascular accidents. PMID- 3271614 TI - The effect of dietary fish oil and long-term salt loading on blood pressure and eicosanoid metabolism in spontaneously hypertensive rats. AB - 1. Dietary suppression of prostanoid synthesis with fish oils has had little effect on blood pressure in models of experimental hypertension in rats. However, a pressor effect of dietary fish oils was observed in spontaneously hypertensive rats (SHR) subject to 1 week of salt loading. 2. Animals were allocated to semisynthetic diets containing either 10% by weight Max EPA fish oil or a control diet of coconut oil, and studied after receiving 1.5% saline for 4 weeks. 3. Within the first week of salt loading, SHR-fed fish oil showed an increase in blood pressure (mean = 9 mmHg) relative to controls. This effect was transient, and after the first week of salt loading there was little difference in blood pressure between the two dietary groups. 4. Following dietary treatment there were substantial changes in plasma fatty acid composition with a 48% decrease in arachidonic acid content of fish oil-fed rats compared with control animals. Rats on the fish oil diet showed a threefold decrease in serum thromboxane generation. Prostacyclin production by incubated segments of aorta was reduced by more than 50% compared with the coconut oil-fed control group. 5. SHR on the fish oil diet showed increased urine volume and sodium excretion, presumably due to increased fluid and salt intake. 6. This study shows that dietary suppression of prostacyclin synthesis is associated with only a minor effect on blood pressure in long-term salt loading of SHR. PMID- 3271615 TI - Thermogenesis and the effect of injected catecholamines on the oxygen consumption of cafeteria-fed rats. AB - 1. The oxygen consumption (VO2) of unrestrained rats given a 'cafeteria' (high energy, high fat) or control diet was studied. The resting values of VO2 were the same in each dietary group, whether maintained at 26 degrees C or 6 degrees C. This negative finding suggests that cafeteria feeding is not an important cause of diet-induced thermogenesis (DIT). 2. The response of each group of rats to injected noradrenaline or dopamine was also studied. Each catecholamine could increase VO2 values but the response was much less in cold-adapted rats measured at 6 degrees C. In all experimental circumstances the dopamine response exceeded that of noradrenaline. There was no evidence that the cafeteria diet consistently increased the response to either catecholamine. 3. These results suggest that DIT cannot be equated with non-shivering thermogenesis (NST). Furthermore, it is suggested that dopamine would be a better agent for measuring the oxygen equivalent of NST, since it would stimulate the dopamine receptors as well as the alpha- and beta-adrenoreceptors of brown fat. PMID- 3271616 TI - Pre- and postjunctional effects of neuropeptide Y on the rabbit isolated ear artery. AB - 1. In the isolated perfused and superfused rabbit ear artery, neuropeptide Y (NPY, 0.3-100 nmol/l) had no direct vasoconstrictor action, but produced a concentration-dependent and reversible enhancement of vasoconstrictor responses to both sympathetic nerve stimulation and exogenous noradrenaline. 2. In arteries in which the noradrenergic transmitter stores had been radiolabelled with [3H] noradrenaline, 100 nmol/l NPY inhibited the stimulation-induced (1 Hz for 30 s) release of radioactivity, but the lower concentrations tested (10 and 30 nmol/l) had no effect. NPY (10, 30 and 100 nmol/l) had no effect on the resting release of radioactivity. 3. Thus, NPY in low concentrations enhances vasoconstrictor responses in the rabbit ear artery by a postjunctional action; prejunctionally, NPY inhibits stimulation-induced transmitter release when it is present in high concentrations. PMID- 3271617 TI - Action of mefloquine on agonist-induced contractions of the guinea-pig isolated ileum. AB - 1. Responses of the guinea-pig isolated ileum to cumulative concentrations of acetylcholine (ACh), histamine (H), and prostaglandin E2 (PGE2) were obtained in the presence or absence of mefloquine or quinine. 2. The effects of increasing the external calcium concentration and the presence of a low concentration (1.8 nmol/l) of PGE2 on the mefloquine- and quinine-induced inhibition of the ACh cumulative dose-response curves were also investigated. 3. Mefloquine (1-10 mumol/l) and quinine (50-100 mumol/l) both caused a dose-dependent non-parallel right shift of the log concentration-response curve of every agonist. Mefloquine is a more potent inhibitor of PGE2-induced responses whereas quinine inhibited all three agonist-induced responses to the same extent. 4. Increasing the external calcium concentration enhanced the inhibitory effects of both drugs on ACh-induced responses. Pre-incubation with 1.8 nmol/l PGE2 had a similar effect. 5. The actions of mefloquine on ACh- and H-induced contractions are non-specific, like other antimalarials, but its greater inhibitory action on PGE2 may involve a more complex effect. PMID- 3271618 TI - Endothelium-dependent inhibition of sympathetic vasoconstriction by frusemide administration to rats. AB - 1. Segments of the tail artery of the rat were cannulated at both ends and mounted in an organ bath filled with Krebs solution. 2. Using an extracorporeal circuit, blood was pumped at a constant 2 ml/min from the carotid artery of anaesthetized rats to perfuse the segment of tail artery and returned to the donor rat via the jugular vein. 3. Peri-arterial electrical stimulation of the ex vivo blood perfused tail artery at 5 Hz produced vasoconstriction and an increase in perfusion pressure. 4. The intravenous administration of frusemide 5 mg/kg to the donor rat resulted in an inhibition of the vasoconstrictor responses of the perfused tail artery segment. Diuresis-induced losses of volume and frusemide were prevented by a urinary bladder-venous shunt. 5. Removal of the endothelium from the tail artery segment, by perfusion with dry gas for 4 min, prevented the vasoconstrictor-inhibitory effect of frusemide administration. Removal of the endothelium was confirmed histologically and by the absence of a vasodilator response to acetylcholine. 6. On the basis of these and previous results it is concluded that parenteral frusemide administration releases an unidentified but non-prostanoid hormone from the kidney which produces an endothelium-dependent inhibition of sympathetic vasoconstriction. PMID- 3271619 TI - Effect of diabetes mellitus on salivary paracetamol elimination. AB - 1. Salivary elimination of paracetamol was studied in nine type I and ten type II diabetics. Ten healthy volunteers served as a control group. 2. A significant increase in the elimination half-life (t1/2) and apparent volume of distribution was observed in type I diabetics compared with controls. Clearance rate (CL) was not significantly altered. 3. In type II diabetics paracetamol elimination t1/2 was significantly increased with a corresponding decrease in CL. Apparent volume of distribution of the drug was not significantly different. 4. Paracetamol elimination t1/2 had significant correlation with fasting blood sugar values. PMID- 3271620 TI - Calmodulin-antagonist drugs and porcine malignant hyperpyrexia. AB - 1. Landrace swine were identified as malignant hyperpyrexia susceptible (MHS) or control by the contracture responses of gracilis muscle fibre bundles to 3% halothane, 2 mmol/l caffeine and 80 mmol/l KCl. The effects of calmodulin antagonist drugs on the contractile behaviour of control and MHS preparations were investigated in vitro. 2. Calmodulin-antagonists at micromolar concentrations induced contracture in both control and MHS muscle. Pretreatment of MHS muscle with calmodulin-antagonist drugs potentiated its response to halothane and caffeine. 3. These results suggest that calmodulin-antagonist drugs cause an increase in myoplasmic Ca2+ concentration in both control and MHS muscle. PMID- 3271621 TI - Effects of tubocurarine on end-plate current rundown and quantal content during rapid nerve stimulation in the snake. AB - 1. The effects of tubocurarine, pancuronium, vecuronium and trimethyl tubocurarine were examined on the amplitudes of end-plate currents (EPC) produced by repetitive nerve stimulation in cut voltage-clamped fibres of the costocutaneous muscle of the garter snake. The effects of tubocurarine were further studied on the amplitudes of miniature end-plate currents (MEPC) recorded immediately before the trains of nerve stimulation, thus allowing estimates to be made of EPC quantal content. 2. All four compounds increased the decline of EPC amplitude with successive impulses (rundown), compared with that observed in control end-plates. There was little effect on the decay time constants of EPC and the effects on rundown were not dependent on membrane potential, indicating that end-plate ion channel blockade was not a major effect in producing rundown. 3. In the presence of tubocurarine the quantal content of the EPC in the plateau phase of the trains was reduced when compared with control, indicating a reduction of transmitter mobilization. However tubocurarine had no significant effect on the quantal content of the first EPC of the trains, indicating that the decreased mobilization is not due to an initial effect on transmitter release. 4. It is suggested that the prejunctional effect of tubocurarine which results in increased EPC train rundown is primarily on transmitter mobilization. It is also suggested that the actions of tubocurarine and the other neuromuscular blockers tested are mediated through a prejunctional nicotinic receptor which may act as a positive feedback mechanism modulating transmitter mobilization. PMID- 3271623 TI - Artemisia herba-alba Asso. in diabetes mellitus. PMID- 3271622 TI - Effects of vasoactive intestinal polypeptide infusions on renal function in patients with liver disease. AB - 1. The effect of intravenous vasoactive intestinal peptide (VIP, 6 pmol/kg per min) on renal function in six patients with cirrhosis of the liver was examined. 2. VIP caused generalized vasodilation and increased plasma renin activity, but diminished the glomerular filtration rate by about one third. 3. The excretion of water, sodium, potassium and calcium also fell significantly. 4. These results differ from our findings in normal man in whom VIP diminished water and electrolyte secretion largely by increasing tubular reabsorption. 5. It is concluded that the elevated VIP levels present in patients with severe liver disease may affect renal function, but that the presence of liver disease may affect renal responses to VIP. PMID- 3271624 TI - Cardiovascular response to emotional stress and spontaneous blood pressure variability in genetically hypertensive rats of the Lyon strain. AB - 1. Intra-aortic blood pressure (BP) was continuously recorded in freely moving genetically hypertensive (LH), normotensive (LN) and low BP (LL) rats of the Lyon strains under basal conditions and during aversive stimulation (a jet of air for 20 min). Rats were studied when 5 and 14 weeks old. 2. The 24 h standard deviation (i.e., variability) of diastolic BP was significantly greater in LH rats of both ages than in LN and LL control rats. 3. In response to the stressor, LH rats showed larger increases in BP than age-matched controls. 4. The BP variability was related to the BP responses to stress in the whole series of rats. 5. It is concluded that the spontaneous BP variability and the BP responses to an experimental stressor rely upon a common regulatory mechanism in rats and that an increased lability of diastolic BP is a primary characteristic of Lyon hypertensive rats. PMID- 3271625 TI - Bupivacaine acute toxicity protection by diazepam in mice. AB - 1. The effects of acute and 8-day administration of diazepam (DZP) on the acute toxicity of bupivacaine in the mouse were studied. 2. Protection of bupivacaine induced acute toxicity by DZP appears to be dose-dependent after treatment for 8 days but not after acute treatment. PMID- 3271626 TI - The interrelationship of morphine and the parasympathetic nervous system in digoxin-induced arrhythmias in the guinea-pig. AB - 1. The role of the parasympathetic nervous system and the effect of morphine on cardiac arrhythmias induced by digitalis was assessed in guinea-pigs that had digitalis arrhythmias produced by digoxin 50 micrograms/kg intravenously plus 500 micrograms/kg per h. 2. Morphine produced a dose-dependent rightward shift in the relationship between digoxin dose and arrhythmias. Morphine 5 mg/kg subcutaneously (s.q.) was associated with significantly (P less than 0.05) higher digoxin doses both at the onset of ventricular arrhythmias and at development of fatal arrhythmias compared with the control group that received saline s.q. 3. Vagotomy and atropine prevented the effect of morphine so that the dose-response relationships and the mean digoxin dose at onset of ventricular arrhythmias and the development of fatal arrhythmias were not significantly different from the control group receiving saline. 4. These data indicate that morphine limits the development of digitalis arrhythmias and this effect is, at least in part, mediated through the parasympathetic nervous system. PMID- 3271627 TI - Inhibition by cocaine of noradrenaline release from sympathetic nerves in the rabbit ear artery. AB - 1. Effects of cocaine on release of noradrenaline (NA) from sympathetic nerves were studied in the isolated perfused central artery of the rabbit ear. Indices of release were the vasoconstrictor response to nerve stimulation and stimulation induced overflow of radioactivity after the nerves had been loaded with [3H]-NA. The overflow studies were carried out on phenoxybenzamine-treated arteries to eliminate the effect of cocaine on neuronal uptake. 2. Cocaine enhanced the constrictor responses of the artery to stimulation in concentrations of 3 and 30 mumols/l, but in higher concentrations (tested up to 300 mumols/l) the enhancement declined and was replaced by inhibition. Responses to extraluminal NA remained enhanced throughout the concentration range (tested up to 150 mumols/l). 3. In contrast, cocaine depressed the overflow of radioactivity, the effect being detectable in a concentration of 3 mumols/l (a decrease of 15%); the decrease was 40% at the highest concentration tested (90 mumols/l). 4. It is suggested that when assessed in terms of the vasoconstrictor response, inhibition of transmitter release by cocaine is masked by inhibition of neuronal uptake except in high concentrations of cocaine. PMID- 3271628 TI - Potassium excretion in renal failure in the rat: the role of distal tubule flow and aldosterone. AB - 1. This study examines the contribution of an increased distal tubule flow and of aldosterone to the handling of a potassium load in conscious rats with renal failure induced by subtotal nephrectomy or by gentamicin on a control of high K+ diet. 2. Glomerular filtration rate was reduced by subtotal nephrectomy to 40% and by gentamicin treatment to 60% of control. Subtotal nephrectomy induced significant hypertrophy of glomeruli and proximal and distal tubules, but gentamicin did not. Both experimental groups had a normal iothalamate space and plasma potassium after a 20 h fast. 3. Two hours after an acute KCl load rats with renal failure excreted less potassium than control rats. There was also a lesser natriuretic effect of KCl in the renal failure groups. 4. A high K+ diet, given for 5-7 days, increased excretion of an acute KCl load in control rats and rats with renal failure. 5. (UNaV + UKV) was used as an estimate of distal tubule flow. Potassium excretion, related to distal tubule flow, was similar in the renal failure and control rats when on the same diet. This is consistent with potassium excretion being strongly, but not necessarily solely, dependent on distal flow. 6. Adrenalectomy reduced, and aldosterone restored, potassium excretion in the renal failure and control groups. This suggests a role for aldosterone in excretion of an acute potassium load with this degree of renal failure. PMID- 3271629 TI - Effect of short course chemotherapy on salivary paracetamol elimination. AB - 1. Salivary elimination of paracetamol was studied in six male pulmonary tuberculosis patients on short course chemotherapy. 2. Peak paracetamol concentration showed a steady decrease at the end of first week and continued until the end of the study. 3. The elimination half-life of paracetamol decreased 5 weeks after the therapy with a corresponding increase in the clearance rate. 4. Adjustment of dosage of drugs that are metabolized by the microsomal enzymes may be required in patients on anti-tubercular drug regimen in which rifampicin is included. PMID- 3271630 TI - Comparison of the activity of circular and longitudinal myometrium from pregnant rats: co-ordination between muscle layers. AB - 1. Contractions and electrical activity were recorded from isolated segments of longitudinal (L) and circular (C) myometrium from rats on gestation days 16-17 and 21 before and during parturition. 2. The segments were arranged so that the activity of the two layers could be monitored simultaneously and independently. 3. Out of the 15 preparations from days 16-17, 13 showed no co-ordination of activity between the layers. In the other two preparations a large contraction of C occasionally initiated a contraction of L. Surgical separation of the layers disrupted the co-ordination and L then developed its independent rhythm. 4. On day 21 before delivery, eight of 10 preparations exhibited 1:1 co-ordination of activity between the two layers, but C did not consistently pace L. The pacing shifted from one layer to the other several times during an experiment. 5. During parturition there was a 1:1 co-ordination of activity in all 10 preparations examined. In nine of these L initiated the activity of the C. Surgical separation of the layers disrupted the co-ordination and C developed its independent rhythm. In one the pacing shifted from one layer to the other several times during the experiment. 6. In all cases where co-ordination between the layers was observed it was myogenic and apparently related to the spread of action potentials between the two muscles. PMID- 3271631 TI - Neurochemistry of the sympathetic innervation to the uterus. AB - 1. The uterus is supplied by numerous noradrenergic sympathetic nerve fibres, which supply the intramural vasculature and also, in some species at least, the myometrium. 2. Pregnancy is associated with progressive loss of catecholamine from these nerves. Although some direct mechanical damage due to stretching of the uterine wall contributes to this effect, it is primarily due to hormonal influences. 3. In animal experiments, the changes in uterine catecholamine occurring during pregnancy are mimicked by intra-uterine administration of progesterone. 4. The action of progesterone appears not to be selective for pelvic sympathetic neurons, or those in which transmitter turnover rate is particularly slow. The mechanism of depletion is probably through inhibition of tyrosine hydroxylase activity. 5. The functional role of this phenomenon during pregnancy, if one exists, seems likely to be related to protection of the fetoplacental blood supply against sympathetically mediated vasospasm. It is also possible that circulating progesterone may have a general inhibitory action on the female sympathetic nervous system. PMID- 3271632 TI - Catecholamine inactivation in uterine tissues: changes in pregnancy in the rat. AB - 1. In vitro metabolism of [3H]-(-)-noradrenaline (3H-NA), 0.2 mumol/l, was measured in rat endometrial and myometrial slices at different stages of gestation and compared with that in dioestrous rats. Metabolism of 3H-NA, 0.2 mumol/l, was measured in rat placental slices from day 14 of gestation onwards. 2. 3H-NA was metabolized mainly by deamination in rat myometrium, with [3H]-3,4 dihydroxyphenylethylene glycol, (3H-DOPEG) being the major metabolite. Cocaine, 30 mumol/l, inhibited 3H-DOPEG formation and the amount of 3H-NA remaining in the tissue. O-methylated metabolite formation was unaffected by cocaine. 3. O methylation and deamination were equally active pathways for metabolizing 3H-NA in rat endometrium. O-methylation to [3H]-normetanephrine (3H-NMN) predominated in the placenta. In both tissues O-methylated metabolite formation was inhibited by 30 mumol/l cocaine. 4. In myometrium, metabolite formation per gram was constant in the first half of pregnancy and was similar to that in dioestrous animals. By day 17 of gestation, however, [3H]-O-methylated deaminated metabolites (3H-OMDA), comprising 3-methoxy, 4-hydroxy-phenylethylene glycol and vanillylmandelic acid, and 3H-NMN formation were less than in dioestrous animals. 5. Endometrial 3H-NMN and 3H-DOPEG formation per gram were higher in rats at day 5 of gestation than in dioestrous rats but metabolite formation per gram declined thereafter to reach values equal to (3H-DOPEG) or less than (3H-OMDA and 3H-NMN) those in dioestrous rats. 6. 3H-NMN and 3H-OMDA formation per gram decreased from day 14 to day 20 of gestation in rat placentae.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3271633 TI - Effects of adrenaline, isoprenaline and forskolin on pregnant human myometrial preparations. AB - 1. The effects of adrenaline, isoprenaline and forskolin upon the evoked contractions of field-stimulated preparations of human, pregnant, isolated myometrium have been examined. Specimens were obtained at lower segment Caesarean section from patients at 31 (n = 1) and 36-40 (n = 10) weeks of gestation. 2. Adrenaline enhanced the electrically evoked contractions of all preparations studied, indicating that its predominant action on these pregnant myometrial tissues was at alpha- and not beta-adrenoceptors. 3. Isoprenaline in concentrations at and below 10 mumol/l produced inhibitory effects in eight of 11 experiments. In the remaining three experiments, tissues were not responsive to the inhibitory effects of isoprenaline. 4. In all preparations exposed to higher concentrations of isoprenaline (30 or 100 mumol/l), its effects were excitatory. 5. Forskolin produced inhibitory effects on preparations from all uteri, including those from which tissues unresponsive to isoprenaline had been obtained. 6. It is suggested that forskolin in the concentrations which were effective in this study produced its inhibitory effects largely through activation of adenylate cyclase. This implies that the lack of an inhibitory response of some preparations to isoprenaline was not due to reduced activity of the adenylate cyclase system, but that the failure of isoprenaline to produce an inhibitory effect could be due to diminished numbers of beta-adrenoceptors and/or increased numbers of alpha-adrenoceptors, or to a defect in the coupling of the receptors to the adenylate cyclase system. Alternatively, the presence of an endogenous antagonist of the effects of isoprenaline (for example, an eicosanoid), could mask its inhibitory effects. 7. The absence of an inhibitory effect of isoprenaline on some specimens of human gravid myometrium could have clinical implications, in view of the widespread use of beta 2-adrenoceptor agonists as uterine relaxants. PMID- 3271634 TI - Human placental acetylcholine content and release at parturition. AB - 1. Measurements were made of human placental acetylcholine (ACh) content and release into maternal and fetal circulations from placenta obtained before, during and after labours of both spontaneous and induced onsets. ACh content was determined in ex vivo placental biopsies using a radio-enzymatic assay. ACh release was determined by bioassay of the effluent from placental lobules perfused with amniotic fluid-like Kreb's containing physostigmine (2.4 mumol/l). 2. ACh content of placentae obtained after labour (spontaneous onset of labour, normal vaginal delivery) and during labour (spontaneous onset of labour, Caesarean section delivery) was significantly less than before labour (no labour onset, Caesarean section delivery). 3. Mean ACh output into maternal vessels 1.5 4.0 h after commencement of perfusion of placentae obtained after labour (spontaneous onset of labour, normal vaginal delivery) was significantly less than from those obtained before labour (no labour onset, Caesarean section delivery). No differences were found in ACh output into fetal vessels of placentae obtained before, during or after labour. 4. These results suggest a role for placental ACh in the events of human labour. The decrease in ACh content and maternal vascular release in placenta obtained after labour is consistent with a depletion of placental ACh during labour which may indicate ACh release at this time. The lack of any significant change in fetal vascular release of ACh in placenta obtained before, during or after labour, raises the possibility of different roles for ACh released into fetal and maternal vasculature. PMID- 3271635 TI - Effect of oral hygiene on phenytoin induced gingival hyperplasia. PMID- 3271636 TI - Antibiotic TA--a new adherent agent for the treatment of periodontal disease. PMID- 3271637 TI - Posterior composite resin restorations--yes or no. PMID- 3271638 TI - Clinical applications and techniques for CL II posterior composite resin restorations. PMID- 3271640 TI - Sulfur xenobiochemistry--metabolism, pharmacokinetics and toxicity of sulfur containing compounds. Proceedings of the 1st International Symposium on Sulfur Xenobiochemistry. London, England, 5-8 September, 1988. PMID- 3271639 TI - Oral health status, knowledge, attitudes and behaviour of Jewish primary school pupils in Johannesburg, South Africa. PMID- 3271641 TI - Studies on possible sulfadimethoxine toxicity to liver and liver drug metabolizing enzyme system of goats, quail and rats. AB - No significant increases in serum SDH, ALT and AST activities were observed in goats and rats receiving oral sulfadimethoxine at 5 times the therapeutic dose. The quail showed significantly higher activities of SDH and ALT when compared to control values. Moderate increases in liver microsomal cytochrome P-450 and aniline hydroxylase activity were observed in goats and quail but no appreciable change in benzphetamine N-demethylase activity was detected in any species. These results suggest a lack of hepatic toxicity of sulfadimethoxine to these species under the reported experimental conditions. PMID- 3271642 TI - Effect of sulphydryl drugs on paracetamol-induced hepatotoxicity in mice. AB - It has been shown that the major in vivo biotransformation of thiol-containing drugs such as captopril (CP) and penicillamine (PA) involve mixed disulphide formation with endogenous thiols derived from cysteine. At high doses, both drugs produced a dose-dependent depletion of glutathione (GSH) and may perturb GSH and related GSH-enzymes. In this study the possible interactions of these drugs with paracetamol, which produce hepatotoxicity after GSH depletion, were investigated. Following co-administration of CP (50-250 mg/kg) or PA (43-257 mg/kg) with paracetamol (300 mg/kg), the hepatotoxic effect produced by paracetamol was diminished. The protective effect was comparable to that produced by N acetylcysteine (500 mg/kg) and L-cysteine (500 mg/kg). However, pre-treatment with buthionine sulfoximine (BSO), a specific inhibitor of GSH synthesis, abolished the protective effects of CP, N-acetylcysteine and L-cysteine while the protective effect of PA was unaffected. This suggests that, although both CP and PA may act as alternative sulphydryl nucleophiles to GSH to prevent arylation of essential cellular macromolecules by the reactive metabolite of paracetamol, the underlying mechanisms of these drug interactions may be distinctly different. PMID- 3271643 TI - Inhibition of rat renal C-S lyase: assessment using kidney slice methodology. AB - Renal C-S lyase enzymes are implicated in the biotransformation of xenobiotics into potentially toxic metabolites by a deviation from the normal pathways of glutathione conjugate processing. C-S lyase enzymes occur in gastro-intestinal bacteria, and in liver as well as in mammalian and avian kidney. The renal enzyme cleaves the carbon-sulphur bond in cysteine conjugates derived from halogenated olefins (e.g. tetrafluoroethene, trichloroethene, and hexachlorobutadiene). Substituted S-nitrophenyl conjugates, which are analogues of a substrate for the hepatic C-S lyase enzyme (S-2,4-dinitrophenyl-L-cysteine), are demonstrated to display significant inhibition of rat renal C-S lyase using kidney slice methodology. They are also shown to disrupt the tubular uptake of organic cations and anions. PMID- 3271644 TI - Thiolytic cleavage and binding of the antitumour agent CI-921 in blood. AB - The antitumour agent 9-[[2-methoxy-4-[methylsulphonylamino]-phenyl]amino]-N,5 dimethyl- 4-acridinecarboxamide (CI-921; NSC 343499) is currently undergoing clinical evaluation. The plasma disposition of this compound together with its ability to bind to plasma proteins has been investigated in the mouse. Five minutes after intravenous administration of [acridinyl-G-3H]-CI-921 (57.7 mol/kg) to male BDF1 mice, plasma samples were taken and precipitated with acetonitrile. 17% of the total plasma radioactivity was found to be bound to plasma proteins, increasing to 31% by 30 min. To ascertain the mechanism of binding, [acridinyl-G 3H]-CI-921 was incubated at 37 degrees C in mouse blood or plasma and the radioactivity analysed after precipitation with acetonitrile. CI-921 and the cleavage product 4-amino-3-methoxy-methanesulphonanilide (MSA) were detected in the acetonitrile supernatants by HPLC using electrochemical and ultraviolet detection. After incubation for 1 h with blood, extensive association of radioactivity (80% of total) with plasma proteins, together with a rapid decrease in CI-921 concentration and a concomitant increase in MSA concentration, was observed. In blood samples from mice given CI-921, low concentrations (1 to 2 mumol/l) of MSA were detected up to 1 h after injection. The results suggest that in vivo at least part of the covalent binding in blood arises from the nucleophilic attack by protein thiols at the C-9 position of the acridine ring resulting in covalent protein adducts and release of MSA. PMID- 3271645 TI - S-oxygenation of 7 alpha-thiomethylspironolactone by the flavin-containing monooxygenase. AB - Liver microsomes and highly purified flavin-containing monooxygenase from uninduced hogs catalyze the NADPH and oxygen-dependent S-oxygenation of 7 alpha thiomethylspironolactone (7 alpha-TMSL), the major urinary metabolite of spironolactone, an effective antimineralocorticoid in humans. Studies on the biochemical mechanism of S-oxygenation of 7 alpha-TMSL suggests that this reaction is catalyzed exclusively by the flavin-containing monooxygenase and not by cytochrome P-450. This conclusion is based on the effects of selective cytochrome P-450 inhibitors as well as positive effectors and alternate substrates for the flavin-containing monooxygenase. The modest degree of stereoselective S-oxygenation of 7 alpha-TMSL may suggest steric inhibition of oxidation by the flavin-containing monooxygenase. PMID- 3271646 TI - Involvement of glutathione in the metabolism of the anilinoacridine antitumour agents CI-921 and amsacrine. AB - 4'-(9-Acridinylamino)methanesulphon-m-anisidide (amsacrine) and CI-921, the 4 methyl-5-(N-methyl-carboxamide) derivative of amsacrine, are two anilinoacridine antitumour agents in clinical use or trial. The elimination of these agents has been investigated in male BDF1 mice. 74% and 86% of the dose of [acridinyl-G-3H] amsacrine and -CI-921, respectively, was excreted in the faeces of mice by 72 hr after i.v. injection. Administration of both compounds also resulted in significant depletion of glutathione (GSH) in mouse liver, although the effect of CI-921 was delayed and reduced compared with amsacrine. In mouse bile, radiolabelled products which cochromatographed with amsacrine GSH conjugates at both the 5'- and 6'-positions of the anilino ring were present in similar amounts and constituted approximately 70% of the excreted radioactivity, the balance being minor, more polar metabolites. With hepatic microsomal fractions, both conjugates of amsacrine were formed but only the 6'- and not the 5'-conjugate was increased in the presence of cytosol. Preliminary evidence indicates the presence in mouse bile of at least the 5'-GSH conjugate of CI-921, and several other GSH derived products not seen with amsacrine. It is concluded that the elimination of CI-921 occurs by a mechanism similar to that of amsacrine. Further, the possible involvement of GSH transferase in the conjugation of amsacrine may have consequences for the hepatotoxicity of this agent. PMID- 3271648 TI - S-oxidation of thioridazine to psychoactive metabolites: an oral dose proportionality study in healthy volunteers. AB - Thioridazine has two major active metabolites, which are formed from S-oxidation of its 2-methylthio group; the sulphoxide, mesoridazine, and the sulphone, sulforidazine. Dose proportionality of the three compounds was investigated for the first time in 11 males after administration of three single oral doses (25, 50, and 100 mg) of thioridazine hydrochloride separated in each case by two weeks. Based on the plasma concentrations of the three analytes over 72 h following each dose, large intersubject variabilities in such parameters as AUCot and Cmax were observed for each of the three compounds. The relationships between dose and parameters such as AUCot and Cmax for each analyte were described by an equation for a straight line (r2 greater than or equal to 0.8). However, the mean apparent distribution and elimination rate constants for thioridazine and mesoridazine and the mean apparent oral clearance for thioridazine decreased significantly with increasing dose, suggesting non-linearity in the elimination of thioridazine at high dose. PMID- 3271647 TI - Mechanism of inhibition of hepatic bioactivation of paracetamol by dimethyl sulfoxide. AB - Prior work has shown that DMSO inhibits paracetamol hepatotoxicity. In this paper we show that DMSO and its reduced metabolite dimethyl sulfide (DMS) can inhibit in vitro hepatic dimethylnitrosamine N-demethylase. We also show that DMSO can inhibit in vivo production of glutathione conjugates of paracetamol. Glutathione is known to conjugate the bioactivated form of paracetamol. Also, the isozyme of cytochrome P-450 responsible for dimethylnitrosomine N-demethylase, cytochrome P 450j, is thought responsible for paracetamol bioactivation. We therefore propose that DMSO inhibits paracetamol hepatotoxicity due to inhibition of cytochrome P 450j-dependent paracetamol bioactivation by DMSO and its metabolite DMS. PMID- 3271649 TI - Application of high resolution 1H-NMR spectroscopy to the detection of penicillamine and its metabolites in human urine. AB - Preliminary studies on the use of high resolution 1H-NMR spectroscopy for the detection of the thiol drug penicillamine and its metabolites in human urine are described. The technique is rapid, simple and requires minimal sample pretreatment. Application of NMR to the qualitative analysis of penicillamine in urine is illustrated by penicillamine disulphide formation from penicillamine following spiking into human urine and the detection of penicillamine, penicillamine disulphide and penicillamine-cysteine disulphide (following oral administration of the drug to patients). PMID- 3271650 TI - HPLC-analysis of S-carboxymethylcysteine and its sulphoxide metabolites. PMID- 3271651 TI - An intraoral stent to improve examination of swallowing in a case involving gunshot wound to the face. PMID- 3271652 TI - Identification of unopposed intact muscle pair actions affecting swallowing: potential for rehabilitation. PMID- 3271653 TI - Posterior tongue grooving in deglutition and speech: preliminary observations. PMID- 3271654 TI - Relation of bolus size and pharyngeal swallow. PMID- 3271655 TI - Three treatment approaches and clinical factors in the reduction of drooling. PMID- 3271656 TI - Pressure-flow dynamics of the oral phase of swallowing. PMID- 3271657 TI - Nutritional correlates of dysphagia in individuals institutionalized with mental retardation. PMID- 3271658 TI - Manometric investigation of the entire esophagus in healthy subjects and patients with high-amplitude peristaltic contractions. PMID- 3271659 TI - Swallowing complaints and cineradiographic abnormalities of the pharynx. PMID- 3271660 TI - [Caries prevention in children and adolescents in Poland and the realization of the WHO health goals. 4. The possibility of realization till the year 2000]. PMID- 3271661 TI - [A rare case of internal dental granuloma in a girl aged 12 years]. PMID- 3271663 TI - [Clinical evaluation of the fillings made of glass ionomer-type cements manufactured by De-Trey]. PMID- 3271662 TI - [Trials of increasing the ability of enamel enrichment with fluorine by adding NaF and Na2PO3F to toothpastes. In vitro investigations]. PMID- 3271664 TI - [Analysis of pantomographic films in children with cleft palate]. PMID- 3271665 TI - [Evaluation of sialometric tests in patients with anemia]. PMID- 3271666 TI - [Effect of topical action of Polopiryna S on the inflammatory conditions of periodontal tissues in clinical and cytological investigations]. PMID- 3271667 TI - [The Fungizone preparation (amphotericin B) in the treatment of oral candidiasis]. PMID- 3271668 TI - [Oral mucosa in elderly subjects]. PMID- 3271669 TI - [Cytological assessment of the action of Mentadent C toothpaste on the gingival epithelium in patients with periodontal diseases]. PMID- 3271670 TI - [The effect of environmental pollution with heavy metals on the activity of acid and alkaline phosphatase in the saliva in schoolchildren]. PMID- 3271671 TI - [Biological investigations on the properties of modified zinc-oxide-eugenol cements and endomethasone]. PMID- 3271672 TI - [Clinical assessment of grade I pulpitis]. PMID- 3271673 TI - [Increased resistance of enamel to abrasion after application of various fluoride pastes]. PMID- 3271674 TI - [Nasal reconstruction after operations for skin cancer]. PMID- 3271675 TI - [Multistage treatment of extensive post-traumatic facial wounds. Case report]. PMID- 3271676 TI - [Familial occurrence of the orofaciodigital syndrome]. PMID- 3271677 TI - [A rare injury to the facial skeleton in a child caused by dog bites]. PMID- 3271678 TI - A perspective on chemical dependency in the health professions. PMID- 3271679 TI - Pulp capping with calcium hydroxide: diagnostic value of radiographic findings. PMID- 3271680 TI - Apical periodontitis and resorption of the root canal wall. PMID- 3271681 TI - Preliminary evaluation of the apical seal of root canals filled with a Teflon base material. PMID- 3271682 TI - The radicular palatal groove--a therapeutic modality. PMID- 3271683 TI - Correction of mandibular asymmetry with the ligated anterior repositioning splint. PMID- 3271684 TI - The occurrence of craniomandibular symptoms in healthy young adults with and without prior orthodontic treatment. PMID- 3271687 TI - Continual health status report--a necessary patient record. PMID- 3271685 TI - Compromise treatment of a deep-bite malocclusion in an adult who refused orthognathic surgery. PMID- 3271686 TI - What's in it for you? PMID- 3271688 TI - A method for improving your periodontal surgical skills. PMID- 3271689 TI - Team approach--what do we want from each other? PMID- 3271690 TI - The impacted tooth with pericoronal radiolucency. PMID- 3271691 TI - Diagnostic evaluation and management of inferior alveolar and lingual nerve injuries. PMID- 3271693 TI - A new denture gauge. PMID- 3271692 TI - The use of MRI (Magnetic Resonance Imaging) in diagnosis of TMJ disease. PMID- 3271694 TI - The accuracy of measuring tooth lengths from intraoral radiographs using computerized registration. PMID- 3271695 TI - Abnormalities of the temporomandibular joint in adults with rheumatic disease. A comparison of panoramic, transcranial and transpharyngeal radiography with tomography. PMID- 3271696 TI - Rheumatoid arthritis of the temporomandibular joint. Evaluation of three different radiographic techniques by assessment of observer performance. PMID- 3271697 TI - The radiologic features of true ankylosis of the temporomandibular joint. An analysis of 25 cases. PMID- 3271698 TI - The radiologic features of the nasopalatine duct cyst. An analysis of 46 cases. PMID- 3271699 TI - Chondrosarcoma initially diagnosed as a chondromyxoid fibroma: malignant transformation? PMID- 3271700 TI - Jaw involvement in sclerosteosis: a case report. PMID- 3271701 TI - Oral candidosis: 2. Diagnosis and management. PMID- 3271702 TI - Dental trauma: 3. Splinting, displacement injuries, and root fracture of immature permanent incisor teeth. PMID- 3271703 TI - Orofacial age changes and related disease. PMID- 3271704 TI - Reinforceable system of instructions for the orthodontic patient. PMID- 3271705 TI - Some academic reflections on casting alloy patents. PMID- 3271706 TI - Prediction of in vivo wear in posterior composite resins: a fracture mechanics approach. PMID- 3271707 TI - Biological evaluations of zinc hexyl vanillate cement using two in vivo test methods. PMID- 3271708 TI - Hardening, formation of cracks and adaptation of amalgam during condensation. PMID- 3271709 TI - The effect of removal of the smear layer on microleakage of Class V restorations in vitro. PMID- 3271710 TI - Issues of aging and oral health promotion. PMID- 3271712 TI - Oral health problems in the elderly: research recommendations. PMID- 3271711 TI - Recommendations for oral health promotion activities with older adults. Oral Health Working Group. PMID- 3271713 TI - Changing health perceptions of older patients and their implications for dentistry. PMID- 3271714 TI - Profile of geriatric patients visiting a dental college and hospital in India. PMID- 3271715 TI - Root caries prevalence in a Norwegian adult dental patient population. PMID- 3271716 TI - Caries and defective restorations in elderly faculty patients. A follow-up study. PMID- 3271717 TI - Radiographic alveolar process/mandibular height ratio as a predictor of osteoporosis. PMID- 3271718 TI - Status of geriatric education in Japanese dental schools. PMID- 3271720 TI - Neuroanatomy of the gustatory system. PMID- 3271719 TI - A retrospective study of oral mucosal diseases in three age groups. PMID- 3271721 TI - Clinical psychophysics of taste. PMID- 3271722 TI - Taste dysfunction in burning mouth syndrome. PMID- 3271723 TI - Need perception as a major determinant of dental health care utilization among the elderly. PMID- 3271724 TI - Need and demand for dental care in a group of Malaysian elderly. PMID- 3271725 TI - A case report of an unusual multidisciplinary treatment to reestablish masticatory efficiency. PMID- 3271726 TI - Miniature fiber optics for improved detection of root irregularities. PMID- 3271727 TI - Overdentures as treatment for severe hypodontia. PMID- 3271729 TI - Combining etched porcelain inlays and onlays with composite resins to restore posterior teeth. PMID- 3271730 TI - Systemic bacteremia following toothbrushing: a protocol for the management of patients susceptible to infective endocarditis. PMID- 3271728 TI - Surgical management of nonerupted canines during orthodontic therapy. PMID- 3271731 TI - Eating disorders: phenomenology, identification, and dental intervention. PMID- 3271732 TI - Bacterial airborne contamination with an air-polishing device. PMID- 3271733 TI - Bleaching of endodontically treated teeth: an update on cervical resorption. PMID- 3271734 TI - An attempt to reduce blood mercury levels of operatory staff during routine dental procedures. PMID- 3271735 TI - Microleakage of a posterior composite resin lined with glass ionomer. PMID- 3271737 TI - Radiopacity associated with the crown of a developing tooth. PMID- 3271736 TI - Extensive oral ulceration. PMID- 3271738 TI - Beating the odds with malpractice prophylactics. PMID- 3271739 TI - A narrative case report: Deborah L. Wine. PMID- 3271740 TI - [Angiomyoma (vascular leiomyoma). A clinicopathological study on 33 cases]. PMID- 3271741 TI - [Basic study on measurement of mandibular bone mineral content by PCPA method]. PMID- 3271742 TI - [Autotransplantation of both sides of impacted third molar: report of a case]. PMID- 3271743 TI - [A case of post-juvenile periodontitis]. PMID- 3271744 TI - Child survival. PMID- 3271745 TI - Control of communicable diseases & child survival. PMID- 3271746 TI - Prevention of blindness. PMID- 3271747 TI - Role of veterinary department in the control of zoonotic diseases. PMID- 3271748 TI - Environmental health. PMID- 3271749 TI - Dr. P. C. Sen memorial lecture on rural health practice. A study on the rural health practices in Kanyakumari district. PMID- 3271750 TI - Dr. P. C. Sen memorial lecture on rural health practice. Awareness of leprosy in a rural population of Andhra Pradesh. PMID- 3271751 TI - Environment and human health. PMID- 3271752 TI - Health in India, situation and trends. PMID- 3271753 TI - Time allocation pattern of multi purpose workers. PMID- 3271754 TI - Record of flagellate infection in Phlebotomus argentipes in some kala azar endemic areas of Bihar, India. PMID- 3271755 TI - Psycho-social aspects of workers of sugar factories in Distt Gorakhpur. PMID- 3271756 TI - Observations on complications in non-insulin dependent diabetes mellitus. PMID- 3271758 TI - A peep into knowledge attitude and practice of family planning among naval sailors family residing in Bombay. PMID- 3271757 TI - A study of psychosocial profile of institutionalised blind individuals in Pune. PMID- 3271759 TI - Health appraisal of nursing students. PMID- 3271760 TI - A clinico-bacteriological correlation of patients complaining of vaginal discharge. PMID- 3271761 TI - Prevalence of filariasis among naval community residing in Navy Nagar, Bombay. PMID- 3271763 TI - Drugs used in skin outpatient--cost analysis. PMID- 3271762 TI - Assessment of efficacy of BCG vaccination among slum children of Agra City. PMID- 3271764 TI - Progress of immunization programme. PMID- 3271765 TI - Pattern of health activity study. PMID- 3271766 TI - Primary Health Centre staff time utilization pattern. PMID- 3271767 TI - Analysis of burn injury cases among Armed Forces personnel and their families dependent on Command Hospital (Southern Command) Pune. PMID- 3271768 TI - A study on sore throat and beta haemolytic streptococcal pharyngitis among rural school children in Varanasi, with reference to age and season. PMID- 3271769 TI - An immunization: a least adopted practice. PMID- 3271770 TI - Childhood diarrhoea associated with cryptosporidium species in a rural community near Calcutta. PMID- 3271771 TI - Some aspects of feeding and weaning practices in an urban slum community. PMID- 3271772 TI - Hydatidosis among wildlife in India. PMID- 3271773 TI - Cat--a source of human parasitic infection. PMID- 3271774 TI - [Cephalometric standards: values of some skeletal parameters in an adult male population]. PMID- 3271775 TI - [The position of the upper and lower incisors with respect to the osseous base: cephalometric analysis]. PMID- 3271777 TI - [Mechanization in canal preparation]. PMID- 3271776 TI - [Vertical dimension: some cephalometric parameters in an adult male population]. PMID- 3271778 TI - [Complications in canal therapy]. PMID- 3271779 TI - [Dens in dente. Anatomico-morphological aspects]. PMID- 3271780 TI - [Fluoride prophylaxis for caries]. PMID- 3271781 TI - [Differential diagnosis of halitosis]. PMID- 3271782 TI - [Injuries to anterior teeth of children]. PMID- 3271783 TI - [The effect of an oral anticariogenic disinfectant mixture on the growth of Streptococcus mutans]. PMID- 3271784 TI - [Critical evaluation of various etiological factors in periodontal disease]. PMID- 3271785 TI - [Malignant oral neoplasms associated with early malignant lung tumors. Evaluation of risk factors]. PMID- 3271786 TI - [The "soft laser" in dentistry. Outline of personal research]. PMID- 3271787 TI - [Educational activities in oro-dental prevention (involvement and motivation of elementary school teachers)]. PMID- 3271788 TI - [Analysis of oro-dental pathology in a 6-year-old school population]. PMID- 3271789 TI - [Preliminary study on diagnostic cytology of lesions of the oral cavity]. PMID- 3271790 TI - [Epidemiological study of the incidence of malocclusion in a group of recruits from various Italian regions]. PMID- 3271791 TI - [Epidemiological study of dento-periodontal conditions in a group of recruits from various Italian regions]. PMID- 3271792 TI - [Clinical characteristics of marginal periodontal disease in diabetics: their possible correlation in retinopathic and nonretinopathic patients]. PMID- 3271793 TI - [Evaluation of hardness and water absorption in a composite resin for conservative or orthodontic use, polymerized with NM 904 laser light]. PMID- 3271795 TI - Criteria for selection and use of health education reading materials. PMID- 3271794 TI - [Therapeutic effect of a continuously emitting diode laser on cutaneous burns in the rat]. PMID- 3271796 TI - [Osseointegrated dental implants--preliminary report of a University of Montreal study project, Centre hospitalier de St. Mary]. PMID- 3271797 TI - [Dental care and the pregnant woman]. PMID- 3271799 TI - [Studies on lymph transport in halothane anesthesia]. PMID- 3271798 TI - [Odontometry of French-Canadian children: primary dentition]. PMID- 3271800 TI - [The production and localization of alpha-amylase during the embryonic development of mouse submandibular gland]. PMID- 3271801 TI - [A pharmacokinetic study on the tissue distribution of pyridonecarboxylic acids]. PMID- 3271802 TI - [Dental behavioral science. The relationship between perceptions of oral health and oral status in adults]. PMID- 3271803 TI - [An electromyographic study of masticatory muscle during chewing in patients with unilateral cleft lip and palate]. PMID- 3271804 TI - [Effects of tannic acid on acid-etched bovine dentin collagen. I. Demineralized collagen]. PMID- 3271805 TI - [Radiographic diagnosis of so-called globulomaxillary cyst]. PMID- 3271806 TI - Bending properties of light-curing type denture base resin "TRIAD". PMID- 3271807 TI - [Immunohistochemical localization of lysozyme in various organs of rats]. PMID- 3271808 TI - [Consideration on the shift of the mandibular bone fragments during intermaxillary fixation following sagittal split osteotomy]. PMID- 3271809 TI - [Effect of plaque control on masticatory function of patients with periodontal disease. Changes of electromyogram and clenching force]. PMID- 3271810 TI - [Dose distribution of scattered X-rays in computed tomography]. PMID- 3271811 TI - [Measurement of absorbed doses in computed tomography]. PMID- 3271812 TI - [A case report of pericoronitis of an upper wisdom tooth with symptoms like MPD syndrome (temporomandibular arthrosis type I)]. PMID- 3271814 TI - Saliva inhibits HIV infection. PMID- 3271813 TI - Enhanced dental implant diagnosis utilizing multiplanar reformation computer assisted tomography. PMID- 3271815 TI - The attitudes of patients to perforated cast metal bridges. PMID- 3271816 TI - Relationship between perceived need and treatment received in an adult Malaysian population. PMID- 3271817 TI - Factors influencing oral health behavior in the elderly. PMID- 3271818 TI - Physiological aspects of geriatric dentistry. PMID- 3271819 TI - Prescribing for older dental patients. PMID- 3271820 TI - Mobile dentistry: the low cost, low overhead alternative. PMID- 3271821 TI - Relationship of dental caries and diet--an epidemiological study in Andhra Pradesh. PMID- 3271822 TI - Ketamine hydrochloride in pediatric dentistry. PMID- 3271823 TI - Today's Sword of Damocles--the debacle called AIDS. PMID- 3271824 TI - Fluoride content of commonly consumed North Indian beverages. PMID- 3271825 TI - Prevalence of dental caries as related to risk factors in schoolchildren of South Kanara. PMID- 3271826 TI - An unusual case of dentigerous cyst involving the maxillary lateral incisor. PMID- 3271827 TI - Prepubertal periodontitis--a case report. PMID- 3271828 TI - Prevalence of dental caries in North-Eastern region of India. PMID- 3271829 TI - A follow-up study of 25 cases of natal/neo-natal teeth. PMID- 3271830 TI - Behavioral considerations in preventive dentistry: six lessons learned from the past. PMID- 3271831 TI - Hine sight: example is the school of mankind. PMID- 3271832 TI - A.B.C.'s periodontics. "X" is for Xerostomia. PMID- 3271833 TI - Posterior composite restorations: effect of margin design on microleakage. PMID- 3271834 TI - Delegation and supervision of duties to dental auxiliaries in Indiana. PMID- 3271835 TI - Gloves and the practice of dentistry. Part 2. Selection and clinical use. PMID- 3271836 TI - Pediatric fluoride usage and dental fluorosis. PMID- 3271837 TI - A.B.C.'s periodontics. "A" is for Antimicrobials. PMID- 3271839 TI - Smoking cessation for dental patients: hygienists want to help! PMID- 3271838 TI - The rubber dam as a means of infection control in an era of AIDS and hepatitis. PMID- 3271840 TI - A.B.C.'s periodontics. "F" is for generalized Fibrous gingival enlargement. PMID- 3271841 TI - Accidental aspiration of a cast crown during attempted delivery. PMID- 3271842 TI - Reported AIDS cases increase. PMID- 3271843 TI - Four case studies: use of chlorhexidine gluconate (0.12%) (Peridex Oral Rinse) to control plaque and maintain oral hygiene in post restorative phases of endosseous implant therapy. PMID- 3271844 TI - Dental office and laboratory cooperation vital for infection control. PMID- 3271845 TI - Attitudes about AIDS. PMID- 3271846 TI - Recommendations for preventing disease transmission while handling solid waste in Oregon. PMID- 3271847 TI - Case report of an immunocompromised patient. PMID- 3271848 TI - Survey tracks HIV test reporting. PMID- 3271849 TI - Third party payments. PMID- 3271850 TI - License recognition. PMID- 3271852 TI - AIDS commission report. PMID- 3271851 TI - Kansas Dental Association recommended procedure, 1987. PMID- 3271853 TI - AIDS journals. PMID- 3271854 TI - An open letter to members of the Kansas Dental Association. PMID- 3271855 TI - Informed consent doctrine in dental practice: a current case review. PMID- 3271856 TI - Relieving the doctor from liability for negligence: Part I. Contributory negligence by the patient. PMID- 3271857 TI - Biologic effects of stainless steel orthodontic band material. PMID- 3271858 TI - A rare case of oral moniliasis. PMID- 3271859 TI - Manila's that "certain smile" dental caries prevention and control program. PMID- 3271860 TI - Clinical techniques and practical aids. Assessment and management of mobile teeth. PMID- 3271861 TI - Pulp treatment for primary teeth. PMID- 3271862 TI - Behavioral problems: clinical and psychologic management of different types of pedodontic patients. PMID- 3271863 TI - Oral competence and facial configuration following mandibular resection for ameloblastoma. PMID- 3271864 TI - Pain!! PMID- 3271865 TI - An alternative approach to the management of trigeminal neuralgia. PMID- 3271866 TI - Cystic complex odontoma associated with an impacted canine. AB - An odontoma is a benign tumor containing all the various component tissues of teeth. Although it is the most common odontogenic tumor, it is usually discovered upon radiographic examination or later in life when it has developed into a cyst causing facial asymmetry and swelling of the face. Here is a case of a cystic complex odontoma associated with an impacted permanent canine. PMID- 3271867 TI - Dentigerous cyst with intracystic adenomatoid odontogenic tumor and complex odontoma. PMID- 3271868 TI - Distinction between octachlorostyrene and hexachlorobenzene in their potentials to induce ethoxyphenoxazone deethylase and cause porphyria in rats and mice. AB - The potentials of octachlorostyrene (OCS) and hexachlorobenzene (HCB) to induce liver microsomal ethoxyphenoxazone deethylation (an indicator of induction of 3 methylcholanthrene and beta-naphthoflavone-like cytochrome P-450 monoxygenase activity) and cause porphyria in male C57BL/6 and C57BL/10 mice and female F344 rats were compared. Ethoxyphenoxazone deethylation was induced much more by HCB than by OCS in both of these strains of mice (although neither OCS nor HCB greatly induced deethylation in the DBA/2 strain). In rats ethoxyphenoxazone deethylase was induced 26-fold by HCB but only four-fold by OCS, whereas dealkylation of pentoxyphenoxazone (an indicator of phenobarbital-like induction) increased 43- and 36-fold, respectively. Both chemicals were poor inducers of dealkylation of pentoxyphenoxazone in mice. When fed HCB continuously but not when given OCS, C57BL/6 and C57BL/10 mice (both after pretreatment with iron) and F344 rats developed porphyria with a depression of hepatic uroporphyrinogen decarboxylase activity. The results illustrate that in these species OCS and HCB cannot be considered as equally efficient agents for inducing ethoxyphenoxazone deethylation or causing porphyria. If these effects are mediated through binding to the aromatic hydrocarbon responsiveness (Ah) receptor, HCB would appear to have a much greater affinity than OCS despite the face that neither chemical possesses a structure currently considered to be necessary for efficient binding. PMID- 3271869 TI - Ca2+ homeostasis and cytotoxicity in isolated hepatocytes: studies with extracellular adenosine 5'-triphosphate. AB - The incubation of isolated rat hepatocytes with extracellular adenosine 5' triphosphate (ATP) resulted in an inhibition of Ca2+ efflux. The ATP-induced Ca2+ accumulation as determined by the increase in phosphorylase a activity and the Ca2+-sensitive fluorescent indicator (2-[(2-bis-[carboxymethyl]-amino-5 methylphenoxy)-methyl]-6-methoxy-8- bis-[carboxymethyl]aminoquinoline-tetrakis [acetoxymethyl]ester) (Quin 2-AM) was associated with both the hydrolysis of ATP and the phosphorylation of a 110 kDa protein. No significant alteration in the intracellular ATP level was observed. The appearance of surface blebs and cytotoxicity followed the rise in cytosolic Ca2+, suggesting that the increased free Ca2+ may be responsible for the loss of viability. When a calmodulin inhibitor, 1-[bis(4-chlorophenyl)methyl]-3-[ 2-(2,4-dichlorophenyl)-2-[(2,4 dichlorophenyl)methoxy] ethyl]-1H- imidazolium chloride (calmidazolium), was included in the medium prior to ATP addition, bleb formation was reduced and the loss of viability was completely prevented, indicating that a Ca2+-calmodulin process may be involved in the initiation of cytotoxicity. PMID- 3271871 TI - An examination of the oxidation of mercury vapor by rat brain homogenate. AB - The oxidation of mercury vapor (Hg degrees) to divalent inorganic mercury (Hg2+) was studied in rat brain homogenates. By using a "degassing" method, it was possible to speciate the mercury present in the homogenate and, for the first time, to measure the rate of oxidation as a function of the substrate (Hg degrees) concentration. Mercury oxidation was first-order with respect to substrate concentration at all concentrations tested, and the first-order rate constant for the oxidation process was proportional to homogenate concentration. The role of catalase compound I in mercury vapor oxidation by brain homogenate was examined by observing the effects of two inhibitors of catalase (catalase compound I) on homogenate mercury-oxidizing activity and catalase activity. Sodium azide (50 mM) completely inhibited both mercury-oxidizing activity and catalase activity. Aminotriazole (3-amino-1H-1,2,4-triazole) (50 mM) completely inhibited only mercury-oxidizing activity; some residual catalase activity was found in the aminotriazole-treated homogenate. It was concluded that catalase compound I plays a major role in the oxidation of Hg degrees, but the possibility that catalase-independent pathways make a minor contribution cannot be excluded. PMID- 3271870 TI - Oxidative metabolism of some hydrazine derivatives by rat liver and lung tissue fractions. AB - The enzyme systems in rat liver and lung responsible for the oxidative metabolism of hydrazine derivatives were studied to determine whether these enzymes, cytochrome P-450 and monoamine oxidase, were responsible for metabolically activating hydrazines to carcinogenic/toxic metabolites. Cytochrome P-450 preferentially oxidized the nitrogen to nitrogen bond of 1,2-disubstituted hydrazines and hydrazides, while monoamine oxidase oxidized the nitrogen to nitrogen bond of all the classes of hydrazine derivatives that were tested. Oxidation of the nitrogen to nitrogen bond led to the formation of stable azo intermediates in the case of 1,2-disubstituted hydrazines and to unstable monoazo (diazene) metabolites in the case of monosubstituted hydrazines and hydrazides. In addition, cytochrome P-450 preferentially oxidized the carbon to nitrogen bond of monoalkylhydrazines; this reaction resulted in the formation of aldehyde metabolites (via hydrazone intermediates). Monosubstituted hydrazines were shown to be potent, irreversible inhibitors of mitochondrial monoamine oxidase. In contrast, the 1,2-disubstituted hydrazines appeared to be good substrates for the monoamine oxidase and served as competitive inhibitors at high concentrations. There did not appear to be any monoamine oxidase isozyme (form A or B) specificity in the metabolism of either the 1,2-disubstituted hydrazines or the monoalkylhydrazines, ethyl- and n-propylhydrazine. PMID- 3271872 TI - Detection of in vivo lipid peroxidation using the thiobarbituric acid assay for lipid hydroperoxides. AB - Thiobarbituric acid (TBA) assays which have been modified for detection of lipid hydroperoxides appear to be useful for demonstration of in vivo lipid peroxidation. Since these methods require heating tissue membranes with the buffered TBA, there is a possibility of interference from the detection of autoxidation that occurs during heating. These studies were undertaken to investigate conditions which favor TBA color production from hydroperoxide while limiting autoxidation during the assay. An acetic acid-sodium acetate buffered (pH 3.6) TBA assay was used. Heating linoleic acid hydroperoxide with 50 microM ferric iron or under nitrogen nearly doubled color production compared to heating it with no added iron or under air. The lipid antioxidant butylated hydroxytoluene inhibited color production from fatty acid hydroperoxides. When tissue fractions, including liver and lung microsomes and lung whole membranes, were heated in the assay, color production was greater under air than under nitrogen and was much greater under oxygen. When liver microsomes from carbon tetrachloride-exposed rats were used, color was increased only when oxygen was present in the heating atmosphere. The results with tissue fractions appear to demonstrate autoxidation during color development rather than the presence of preformed hydroperoxides. Finally, it was found that color production from membrane fractions was dependent on the vitamin E content of the membranes. It appears that autoxidation during heating should be limited by heating under nitrogen and not by adding antioxidants, which inhibit color production from hydroperoxides. As the vitamin E effect demonstrates, antioxidant status must be considered, since a change in color production could result from a change in antioxidant content without the accumulation of lipid hydroperoxides. PMID- 3271873 TI - The binding of reactive metabolites of the carcinogen N-hydroxy-2 acetylaminofluorene to DNA and protein in isolated rat liver nuclei: effects of glutathione and methionine. AB - The covalent binding of reactive metabolites of the carcinogen N-hydroxy-2 acetylaminofluorene to DNA and protein in isolated, intact rat liver nuclei was studied. The chemically synthesized 2-acetylaminofluorene-N-sulfate became covalently bound to DNA and protein to form adducts, 50% to 60% of which retained the N-acetyl group. Glutathione decreased the covalent binding of acetylated adducts to DNA by 18% and to protein by 50%. Methionine was more effective; it decreased DNA binding by 52% and protein binding by 79%. N-Hydroxy-2 acetylaminofluorene was deacetylated by the nuclear preparation. Almost exclusively, deacetylated 2-aminofluorene adducts to DNA and protein were formed. Glutathione decreased the covalent binding of deacetylated adducts to DNA by only 14%. Protein binding, however, was decreased by 57%. Methionine had no effect on the formation of these adducts to DNA and protein. Formation of 2-aminofluorene glutathione conjugates was reduced by ascorbic acid by 65%. Covalent binding of deacetylated adducts to DNA and protein, however, was not decreased by ascorbic acid. These data suggest that "harder" nucleophiles like methionine can be used to protect macromolecules in vivo from damage by "hard" electrophiles such as those generated from the reactive 2-acetylaminofluorene-N-sulfate. However, such nucleophiles seem not to be effective with N-hydroxylamines, such as N-hydroxy-2 aminofluorene, formed by deacetylation of N-hydroxy-2-acetylaminofluorene. PMID- 3271874 TI - Antagonistic effect of magnesium chloride on the nickel chloride-induced inhibition of DNA replication in Chinese hamster ovary cells. AB - The degree of inhibition of semiconservative DNA replication induced by nickel chloride (NiCl2) was analyzed by radiolabeled-thymidine incorporation alone or with cesium chloride (CsCl) density gradient centrifugation. The onset and duration of this Ni2+-induced inhibition was time- and concentration-dependent, but the degree of inhibition was not. A maximal reduction in the rate of DNA synthesis was observed within the first hour of treatment with 2.5 mM NiCl2, which was the highest noncytotoxic concentration utilized. After six hours, 500 microM and 1 mM as well as 2.5 mM NiCl2 all produced the same 50% to 60% reduction in [3H]-thymidine incorporation into DNA. The inhibitory effect of nickel ions on DNA synthesis was reversible. The rate of DNA synthesis following a 500 microM or 1 mM NiCl2 treatment began to increase after washout of nickel, but a six-hour exposure of cells to 2.5 mM NiCl2 produced a sustained 50% to 60% suppression of DNA synthetic activity for at least 36 hours. At all concentrations of NiCl2 used in this study, some inhibition of DNA synthesis persisted for at least 48 hours, but by 72 hours after treatment, the rate of [3H]-thymidine incorporation was actually 10% above the control. Examination of autoradiographic slides of cells treated with 2.5 mM NiCl2 for six hours demonstrated a 60% reduction of silver grains, but there was no preferential reduction in the quantity of grains in the nucleolus or any other region. Cesium chloride density gradient analysis of the replication of nucleolar DNA in cells treated with 2.5 mM nickel supported the autoradiographic findings. The inhibitory effect of NiCl2 on DNA replication was prevented by the addition of magnesium chloride (MgCl2) to cells maintained in a simple salts/glucose medium (SGM). This effect did not appear to be due to an antagonism of the cellular uptake of nickel by Mg2+, since the maximally effective dose of Mg2+ reduced 63Ni2+ uptake by no more than 25% while the inhibition of replication was completely reversed. PMID- 3271875 TI - The effects of nonadecafluoro-n-decanoic acid on serum retinol and hepatic retinyl palmitate hydrolase activity in male Sprague-Dawley rats. AB - The effects of nonadecafluoro-n-decanoic acid (NDFDA) on serum retinol levels and hepatic retinyl palmitate hydrolase (RPH) activity were investigated in male Sprague-Dawley rats given a single intraperitoneal (IP) dose of 0, 50, or 100 mg/kg NDFDA and sacrificed at two, eight, or 11 days. Treated animals exhibited depressed serum retinol levels, lymphoid involution, and failure to gain weight in proportion to the dose. Hepatic RPH activities were depressed in both treatment groups at all time points and correlated with serum retinol levels. Hepatic retinol levels were also depressed by Day 11. Extraction of hepatic homogenates with acetone removed NDFDA and increased RPH activities twofold and threefold for the low- and high-dose groups, respectively. Analysis of partially purified RPH showed both NDFDA and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) to be noncompetitive inhibitors: KI = 450 and 750 microM, respectively. We conclude that NDFDA causes a decrease in the mobilization of vitamin A from the liver by noncompetitive inhibition of RPH. PMID- 3271876 TI - Identification of S-1,2,2-trichlorovinyl-N-acetylcysteine as a urinary metabolite of tetrachloroethylene: bioactivation through glutathione conjugation as a possible explanation of its nephrocarcinogenicity. AB - The elimination and metabolism of [14-C]-tetrachloroethylene (Tetra) was studied in female rats and mice after the oral administration of 800 mg/kg [14-C]-Tetra. Elimination of unchanged Tetra was the main pathway of elimination in both species and amounted to 91.2% of the dose in rats and 85.1% in mice. [14-C] Carbon dioxide (CO2) was found to be a trace metabolite of [14-C]-Tetra. Only a small part of the applied dose was transformed to urinary (rats = 2.3%, mice = 7.1%) and fecal (rats = 2.0%, mice = 0.5%) metabolites. The urinary metabolites were separated and quantified by high performance liquid chromatography (HPLC) and identified by gas liquid chromatography/mass spectrometry (GC/MS). The following metabolites could be identified: oxalic acid (8.0% of urinary radioactivity in rats, 2.9% in mice), dichloroacetic acid (5.1%, 4.4%), trichloroacetic acid (54.0%, 57.8%), N-trichloroacetyl-aminoethanol (5.4%, 5.7%), trichloroethanol, free and conjugated (8.7%, 8.0%), S-1,2,2-trichlorovinyl-N acetylcysteine (N-acetyl TCVC) (1.6%, 0.5%), and another conjugate of trichloroacetic acid (1.8%, 1.3%). The structures of the identified metabolites indicate two different pathways operative in Tetra biotransformation: cytochrome P-450-mediated epoxidation forming reactive metabolites in the liver and conjugation of Tetra with glutathione (GSH) catalyzed by glutathione transferase(s). The formation of reactive intermediates by renal processing of the glutathione conjugates may provide a molecular mechanism for the nephrotoxicity and nephrocarcinogenicity of Tetra in male rats. PMID- 3271877 TI - The in vitro metabolism and bioactivation of 1,2-dibromoethane (ethylene dibromide) by human liver. AB - The nematocide, grain fumigant, and gasoline additive 1,2-dibromoethane (DBE) is both a cellular and a genetic toxin that is metabolically activated in rats and mice by mixed function oxidases (MFO) as well as glutathione 5-transferases (GST). The purpose of this study was to determine whether DBE is similarly metabolized and bioactivated by human liver in vitro. Human liver microsomal and cytosolic metabolism of DBE was monitored by the production of aqueous-soluble metabolites from [14-C]-DBE. Reactive intermediates were detected as irreversibly bound adducts to protein or DNA. 1,2-Dibromoethane was metabolized by human liver cytosolic GST, microsomal GST, and microsomal MFO. Cytosolic GST activity (9 +/- 2 nmol/20 min/mg protein) was about four times greater than the other two activities. Only MFO activity resulted in adducts irreversibly bound to protein (1.5 +/- .4 nmol/20 min/mg protein) and was inhibited by the presence of glutathione. Both MFO and GST activity resulted in irreversibly bound adducts to DNA. Microsomal and cytosolic GST activity each produced about twice as many DNA adducts as microsomal MFO activity. These results suggest that human liver, like rat and mouse liver, metabolizes DBE to aqueous-soluble metabolites by both MFO and GST activity. Furthermore, each of these activities produces reactive metabolites that can irreversibly bind to cellular macromolecules. PMID- 3271878 TI - tert-Butylhydroperoxide-induced toxicity in isolated hepatocytes: contribution of thiol oxidation and lipid peroxidation. AB - Incubation of isolated rat hepatocytes with tert-butylhydroperoxide resulted in marked cytotoxicity preceded by intracellular glutathione depletion and extensive lipid peroxidation. Addition of antioxidants delayed, but did not prevent, this toxicity. A significant decrease in protein-free sulfhydryl groups also occurred in the presence of tert-butylhydroperoxide; direct oxidation of protein thiols and mixed disulfide formation with glutathione were responsible for this decrease. The involvement of protein thiol depletion in tert-butylhydroperoxide induced cytotoxicity is suggested by our observation that administration of dithiothreitol, which caused re-reduction of the oxidized sulfhydryl groups and mixed disulfides, efficiently protected the cells from toxicity. Moreover, depletion of intracellular glutathione by pretreatment of the hepatocytes with diethyl maleate accelerated and enhanced the depletion of protein thiols induced by tert-butylhydroperoxide and potentiated cell toxicity even in the absence of lipid peroxidation. PMID- 3271880 TI - Methoxyacetic acid and ethoxyacetic acid inhibit mitochondrial function in vitro. AB - Ethylene glycol monomethyl ether (EGME) and ethylene glycol monoethyl ether (EGEE) have recently been shown to be potent reproductive toxicants in laboratory animals. The toxicity of these compounds is believed to be due to their metabolites, methoxyacetic acid (MAA) and ethoxyacetic acid (EAA). Since the primary targets of EGME and EGEE appear to be tissues with rapidly dividing cell systems and high rates of respiration and energy metabolism, the effects of these compounds and their proposed metabolites on mitochondria were investigated. At concentrations beginning at 3.85 mM, MAA and EAA inhibited state 3 respiration and the respiratory control ratio (RCR) in hepatic mitochondria with either succinate or citrate/malate as substrates. Cytochrome c oxidase activity was also inhibited by both metabolites at similar concentrations. The effects of MAA, the metabolite from the more potent compound, on testicular mitochondria were found to be comparable. Neither EGME or EGEE appeared to affect mitochondrial function at concentrations as high as 238 or 113 mM, respectively. These results support the hypothesis that the toxicity of EGME and EGEE are due to their metabolites, MAA and EAA, and that these metabolites may exert their effects, in part, on mitochondrial function. PMID- 3271879 TI - Regulation of hepatic malic enzyme by perfluorodecanoic acid. AB - Perfluorodecanoic acid (PFDA) administration to adult male rats increased both the activity of hepatic malic enzyme and liver weight in a dose-dependent manner. Hepatomegaly and augmented activity of malic enzyme in liver were apparent within one day following PFDA administration and reached a plateau by three days posttreatment. Malic enzyme quantity per liver in PFDA-treated rats was elevated within one day following dosing and increased continually throughout five days posttreatment. Administration of PFDA to rats in the fed state also led to an increase in the specific activity of hepatic malic enzyme that peaked at three days following dosing. When compared to the fed condition, rats fasted for 48 hours had a decrease in both relative liver weight and the quantity of supernatant protein per liver. The total activity (U/liver) and specific activity of malic enzyme in the liver were also reduced in the fasted state. During the 24 hours after treatment in rats fasted for 48 hours, the body weight as well as the absolute and relative liver weight of animals receiving vehicle declined continuously in the absence of feed. Following the administration of PFDA to fasted rats, body weight was maintained until eight hours posttreatment but then declined at a rate similar to that found with the vehicle-treated group. Absolute and relative liver weight in PFDA-treated rats were increased significantly at eight hours posttreatment when compared to those receiving vehicle, and this increment was maintained throughout the rest of the 24 hours following dosing. While the activity and enzyme content of hepatic malic enzyme decreased in the vehicle-treated group, administration of PFDA to rats fasted for 48 hours prevented their decline. The specific activity of hepatic malic enzyme in 48 hours fasted rats receiving PFDA was also elevated significantly at 16 hours posttreatment. Thus, the administration of PFDA to the adult male rat in both the fed and fasted nutritional states was found to regulate hepatic malic enzyme by not only increasing enzyme quantity but also by augmenting the specific activity, (ie, catalytic state) of the enzyme. PMID- 3271881 TI - Cytochrome P-450-mediated denitrification of 2-nitropropane in mouse liver microsomes. AB - Enzymatic denitrification of 2-nitropropane (2NP) was investigated in an NADPH dependent hepatic microsomal system from male CD1 mice. The involvement of cytochrome P-450 (P-450) as the catalyst in 2NP denitrification was revealed by the induction of nitrite-releasing activity following phenobarbital (PB) pretreatment, by a decrease in activity with carbon tetrachloride pretreatment, by the inhibition of the reaction with classical P-450 inhibitors, and by the observation of a type I binding spectrum. Under optimal conditions, two pH dependent peaks of activity were observed at pH 7.6 and pH 8.8, each with its own optimal substrate concentration. Inhibition of the reaction by metyrapone and carbon monoxide (CO) (among others) produced differential responses dependent on pH. These results, along with two pH optima and two substrate optima, suggested the involvement of multiple P-450 isozymes. Average specific activities were 8.05 nmoles of nitrite released per minute per milligram microsomal protein at pH 7.6 and 6.44 nmoles of nitrite released per minute per milligram microsomal protein at pH 8.8. Acetone was identified as the second product of the reaction by gas chromatography/mass spectrometry (GC/MS). Stoichiometry studies indicated that the acetone production was slightly less than expected (about 70%) from nitrite release. Up to 25% residual activity was observed under anaerobic conditions. These results suggested that though the predominant reaction mechanism was oxidative, oxygen-independent metabolism of 2NP also occurred to some extent. In contrast to the reported lack of activity in untreated rat, the observed denitrification in uninduced mouse liver microsomes was significant and suggested that major species-specific differences exist in the in vitro metabolism of 2NP. PMID- 3271882 TI - The mechanism by which cyclopiazonic acid potentiates accumulation of tetraphenylphosphonium in cultured renal epithelial cells. AB - Cyclopiazonic acid (CPA), a fungal metabolite produced by Aspergillus and Penicillium, potentiated the accumulation of the quaternary cation tetraphenylphosphonium (TPP+) in cultured pig renal epithelial cells. This is the first report of a natural product mediating the tight and apparently nonsaturable binding of a membrane potential probe to subcellular compartments. The potentiated TPP+ accumulation was dose dependent, nonsaturable, and not a result of hyperpolarization across the plasma membrane. Cyclopiazonic acid-potentiated accumulation was completely inhibited by the protonophore carbonylcyanide-m chlorophenylhydrazone (CCCP). Dinitrophenol (DNP), tetrahexylammonium (THA), and n-ethylmaleimide (NEM) were also effective inhibitors of CPA-potentiated TPP+ accumulation. Although CPA-potentiated TPP+ uptake appeared to be energy dependent, TPP+ efflux (in the presence of CCCP) from CPA-treated cells was incomplete and most of the TPP+ accumulated in the presence of CPA was tightly bound. Dicyclohexylcarbodiimide (DCC), verapamil, and monensin also stimulated TPP+ accumulation, but the TPP+ which accumulated in the presence of these compounds was not tightly bound. As with controls, fractionation of cells which had accumulated TPP+ in the presence of DCC, verapamil, or monensin always resulted in near complete recovery (greater than 93%) of the TPP+ in the cytosolic fraction, whereas with CPA, greater than 88% of the TPP+ was recovered noncovalently bound in the plasma membrane and mitochondrial fractions. These results are consistent with the hypothesis that CPA-potentiated TPP+ accumulation is a result of potentiated partitioning of TPP+ into the plasma membranes and mitochondria of LLC-PK1 cells. PMID- 3271883 TI - Mechanisms of petroleum hydrocarbon toxicity: destruction of liver microsomal and mitochondrial calcium pump activities by a Prudhoe Bay crude oil. AB - Administration of Prudhoe Bay crude oil (PBCO) to rats resulted in an abrupt drop in liver mitochondrial and microsomal ATP-dependent calcium uptake activity. Also, in vitro incubations of either mitochondria or microsomes in the presence of a dimethyl sulfoxide (DMSO) extract of PBCO resulted in a dose-dependent inhibition of calcium influx. The release of calcium from calcium-loaded mitochondria and microsomes was also observed in the presence of the PBCO extract. At concentrations which effect calcium sequestration, the PBCO extract produced swelling of mitochondria. Microsomal ATPase activity in the presence or absence of calcium was unaffected by PBCO. The results indicate that increased permeability of the membranes to calcium is a contributory factor in the inhibition of calcium uptake by PBCO. PMID- 3271885 TI - Immunochemical characterization of human lung epoxide hydrolases. AB - Immunochemical techniques were used to investigate the biochemical properties of human lung epoxide hydrolases. Two epoxide hydrolases with different immunoreactive properties were identified. These two epoxide hydrolases were found in both cytosolic and microsomal cell fractions. Immunotitration of enzyme activity showed that enzymes that catalyze the hydration of benzo(a)pyrene 4,5 oxide react with antiserum to rat microsomal epoxide hydrolase; those that hydrate trans-stilbene oxide do not. Immunotitration and Western blot experiments showed that microsomal and cytosolic benzo(a)pyrene 4,5-oxide hydrolases have significant structural homology. Immunohistochemical staining of human lung benzo(a)pyrene 4,5-oxide hydrolase showed that the enzyme is localized primarily in the bronchial epithelium. No cell type-specific localization was observed. An enzyme-linked immunosorbent assay was developed which allows direct quantitation of benzo(a)pyrene 4,5-oxide hydrolase protein. Levels of enzyme protein detected by this assay correlated well with enzyme levels determined by substrate conversion assays. PMID- 3271884 TI - 2,3,7,8-Tetrachlorodibenzo-p-dioxin reduces high-affinity binding of epidermal growth factor to cell surface receptors in C3H 10T1/2 cells. AB - The effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on epidermal growth factor (EGF)-binding characteristics was studied in a cultured embryonic fibroblast cell line, C3H 10T1/2. At very low concentrations, TCDD was found to cause a persistent decline in EFG binding, the median effective concentration (EC 50) being 10(-12) M. This particular effect was most conspicuous when TCDD was added at the time of medium change with fresh Dulbecco's modified Eagle's medium. Cells at an early stage of confluency were more responsive to TCDD than those at a later stage. Although most reported TCDD-evoked biological changes are recognized to occur slowly during the course of a few days to weeks, the response of C3H 10T1/2 cells to TCDD was swift, showing a sign of decline of EGF binding as early as three hours after TCDD addition. C3H 10T1/2 cells appear to be an excellent in vitro model to study TCDD's biochemical action mechanisms. PMID- 3271886 TI - A matter of professional conscience: maximizing patient radiation safety. PMID- 3271887 TI - TMJ dysfunction litigation--Pandora's Box opens up. PMID- 3271888 TI - Cases of note: Michigan jury awards $850,000 in ortho case: a tempest in a teapot. PMID- 3271889 TI - Alcohol drinking. Biological data relevant to the evaluation of carcinogenic risk to humans. PMID- 3271891 TI - Worldwide production and use of alcoholic beverages. PMID- 3271890 TI - Alcohol drinking. Epidemiological studies of cancer in humans. PMID- 3271892 TI - Chemical composition of alcoholic beverages, additives and contaminants. PMID- 3271893 TI - Differential shortening of repeated content words produced in various communicative contexts. PMID- 3271895 TI - Morphological knowledge and early writing ability. PMID- 3271894 TI - Common ground in asking and understanding questions. PMID- 3271896 TI - Interaction involvement and the use of referential and formal anaphora in conversation. PMID- 3271897 TI - [Clinico-statistical observation of maxillofacial fractures for past five years in the Department of Oral Surgery of Haga Red Cross Hospital]. PMID- 3271898 TI - [Two cases of dislocation of the temporomandibular joint]. PMID- 3271900 TI - [On the infraorbital artery and its branches in the rabbit]. PMID- 3271899 TI - [14-month prognosis of conservative treatment of permanent anterior teeth with root fracture]. PMID- 3271901 TI - Dye penetration after root canal filling. Comparison between Gutta-percha point and various pastes. PMID- 3271902 TI - [An experimental study on related to brushing method and gingival damage]. PMID- 3271903 TI - [Properties of dental pulp lactate dehydrogenase. Effects of oxamate and oxalate]. PMID- 3271905 TI - [Serotypes and antibiotic susceptibility patterns of Veillonella spp. strains isolated from oral cavity of an individual]. PMID- 3271904 TI - [Clinical study of neck dissection]. PMID- 3271906 TI - [Sialidase in rat salivary glands. Solubilization of lysosomal sialidase from salivary glands and other organs]. PMID- 3271907 TI - [On the infraorbital artery and its branches in the dog]. PMID- 3271908 TI - [The effect of various cleaning agents on the root canal surface--on using possibility of dentin conditioner]. PMID- 3271909 TI - [Evaluation of stability of special type miniplate fixation following Le Fort I osteotomy]. PMID- 3271910 TI - [Lectin histochemical and ultrastructural studies on isoproterenol-induced changes of glycoconjugates in mouse submandibular gland]. PMID- 3271911 TI - [Immunohistochemical study on eosinophilic body in mucosal epithelium of oral mucosal lesions]. PMID- 3271912 TI - [Lectin binding patterns in oral squamous cell carcinomas. A comparative study of dysplastic and neoplastic epithelia]. PMID- 3271913 TI - [A clinical study of head and neck cancer in senile patients]. PMID- 3271914 TI - Measurement of split area in sagittal splitting osteotomy of the mandibular ramus. PMID- 3271915 TI - [Reconstruction of oral surgical sites using a cervical island skin flap and a denuded epithelium from the unutilized portion of the flap]. PMID- 3271916 TI - [Application of autotransfusion to oral and maxillofacial surgery]. PMID- 3271917 TI - [Orthodontic treatment of Turner's syndrome with severe anterior open bite]. PMID- 3271918 TI - [Tetrahydrobiopterin level and NADH-specific dihydropteridine reductase activity in chick embryo liver during development]. PMID- 3271919 TI - Clinical marker of diabetes mellitus (4). Detection of liver membrane antibodies and islet cell surface antibodies in patients with non-insulin-dependent diabetes mellitus and in KK mice. PMID- 3271921 TI - Condylar cartilage response to bite raising in growing rats. PMID- 3271922 TI - [Effects of aspirin DL-lysine on bone wound healing and bone growth in rats]. PMID- 3271920 TI - [Relationship between blood flow rate and salivary secretion in the perfused submandibular gland of the rat]. PMID- 3271923 TI - [Effects of miscellaneous steroid hormones on dexamethasone inhibition of bone growth and of bone wound healing]. PMID- 3271924 TI - [Immunobiological activity of lipopolysaccharide from Bacteroides gingivalis]. PMID- 3271925 TI - [Effects of transforming growth factor-beta and epidermal growth factor on pulp cells form rat incisor]. PMID- 3271926 TI - [Kinetics of human interleukin-1 production by lipopolysaccharide and inhibitory effect of prostaglandins on its production]. PMID- 3271927 TI - [Comparative intraocular pressure measurements with non-contact applanation tonometer (Topcon CT-10) and pneumotonograph (Alcon applanation pneumotonograph)]. PMID- 3271928 TI - [Incidence of sites of chromosomal fragility in the child]. PMID- 3271929 TI - [Influence of periodontal disease on pulp vitality]. PMID- 3271930 TI - [Mechanical study on the stability of the titanium mini plate in monocortical osteosynthesis]. PMID- 3271932 TI - [Use of a function regulator for treatment of a case of skeletal deep bite]. PMID- 3271931 TI - [Young's modulus and Poisson's ratio of compact bone of human mandibles]. PMID- 3271933 TI - [A case of peripheral osseo-cementifying fibroma arising in the maxillary frontal region]. PMID- 3271935 TI - [A case of facial asymmetry due to functional factor]. PMID- 3271934 TI - [A case of multiple myeloma]. PMID- 3271936 TI - Surgery of the temporomandibular joint. PMID- 3271937 TI - Natural infection of Lutzomyia ovallesi (Diptera: Psychodidae) with parasites of the Leishmania braziliensis complex in a restricted focus of cutaneous leishmaniasis in northern Venezuela. PMID- 3271938 TI - Susceptibility of Lutzomyia longipalpis to deltamethrin. PMID- 3271939 TI - Biosystematics and distribution of simuliid vectors of human onchocerciasis in South America. AB - A brief review is given of the taxonomic status, biology and medical importance, and distribution of the vectors of human onchocerciasis in Latin America. Key reference works are cited and distribution maps of each vector species in relation to the known onchocerciasis foci are given. PMID- 3271940 TI - Self-fertilization in the freshwater snails Helisoma duryi and Helisoma trivolvis. AB - Fifty specimens of five strains (10 per strain) of Helisoma duryi from Lima (Peru), St. Croix (Virgin Islands), Formosa (Brazil), Cartago (Costa Rica) and St. Vincent (Lesser Antilles), reared in isolation for about 150 days, laid 103 eggs. The numbers of eggs laid by the 10 specimens of each strain were respectively (viable eggs in parenthesis): 44 (26), 1 (1), 5 (0), 15 (7) and 38 (0). Egg production widely varied between the individuals of each strain, there being in all strains, except St. Vincent, a number of specimens (3 to 9) which did not lay any eggs. After the observation period the isolated specimens, including those that laid no eggs, readily engaged in cross-breeding when mated and brought forth large numbers of eggs. Self-fertilized F1S are fully interfertile, producing normal cross-fertilized offspring. Ten specimens of Helisoma trivolvis (strain from Zempoala, Mexico), also reared in isolation for about 120 days, laid 646 eggs, of which 74 were inviable. Our data, added to those from a few previous studies cited in the text, show that self-fertilization is not so efficient an alternative mode of reproduction in H. duryi as in many other planorbids (it is a little more efficient in H. trivolvis than in H. duryi). Thus, H. duryi benefits much less from functional hermaphroditism which, besides other advantages, enables a single virgin individual to found a new population. PMID- 3271941 TI - An outbreak of American cutaneous leishmaniasis (Leishmania braziliensis braziliensis) in a periurban area of Rio de Janeiro city, Brazil: clinical and epidemiological studies. AB - From July 1984 to September 1986, 105 cases of American cutaneous leishmaniasis were studied in a locality closely situated to an urbanized area of the city of Rio de Janeiro, Brazil. Settlement in this area was established at least 20 years ago but the first cases were noted six months prior to the beginning of this study. Cases were almost exclusively cutaneous and ulcerated, with one to six months of evolution. Montenegro's skin tests were positive in all cases and anti Leishmania antibodies were detected by indirect immunofluorescence test in 74.3% of the patients. Parasites were demonstrated in 69.5% of cases. Domestic animals were easily found infected: 32% of the examined dogs and 30.8% of the examined equines were positive to the presence of Leishmania in cutaneous ulcerated lesions. Parasite isolates from human, dog and equines were immunologically characterized and identified as L. b. braziliensis. 73.0% of the sandfly population were Lutzomyia intermedia mainly caught on human baits and on domestic animals. Our observations suggest that this is an area of recent established L. b. braziliensis infection and that transmission probably occurs indoors or outdoors close to the houses. PMID- 3271942 TI - [Epidemiology of tegumentary leishmaniasis in Merida, Venezuela. I. Diversity and dispersion of phlebotomine species at 3 altitude levels and its possible role in the transmission of the disease]. AB - As part of an epidemiological study on leishmaniasis in Merida, Venezuela, the diversity and dispersion of sandflies species found in 15 localities between 175 m and 1,960 m.a.s.l., are presented. From 7,126 collected sandflies (5,132 female and 1,994 male), 24 species were identified, 10 of them recognized as anthropophilic. The relation species-altitude is presented, and the species composition found in human dwellings, periodomestic and sylvatic areas, are recorded. The possible role of the identified species on the transmission of leishmaniasis in the andean region, is discussed. PMID- 3271943 TI - Circulation flow of enteropathogenic bacteria in institutionalized children. I. An epidemiologic study. AB - The circulation flow and maintenance of enteropathogenic bacteria were studied from May 1982 to April 1983 in a population of institutionalized children and adult staff contacts in the city of Rio de Janeiro, Brazil. Subjects were assigned to three groups: A and B, included, respectively, 105 and 46 children with diarrhea who were admitted in the institution in different periods, and group C with 82 adult contacts. Faecal cultures were positive in 35.2%, 39.1% and 19.7% of subjects of groups A, B, and C, respectively. It suggests that the transmission was probably fostered by the environment because of as high as 30% of faecal contamination was found in environmental samples. Higher rate of isolation and elevated antibodies levels pointed out that Escherichia coli (EPEC) was the prevalent agent. Shigella predominated in the serological tests. These findings suggest that the institution itself may play an important role in the epidemiology and transmission of enteric infections in the community. PMID- 3271944 TI - Prevalence of nits and lice in samples of cut hair from floors of barbershops and beauty parlors in Belo Horizonte, Minas Gerais State, Brazil. AB - A louse survey based on samples of cut hair collected from floors of barbershops and beauty parlors was conducted in Belo Horizonte, Minas Gerais State, Brazil, from October 1984 to April 1985, as an alternative way to determine the prevalence of pediculosis capitis in the population. Of 475 samples examined for nits, nymphs, or adults of Pediculus capitis, 140 were infested (29.5%). A total of 58 lice and 3,553 nits were found in 33,632.9 g of hair collected, giving a ratio of 0.10 nit/g. Almost 29% of the nits were viable and capable of being transmitted after hatching. There was significant difference among the infestation rates by socioeconomic levels, and samples from barbershops with male customers were the most infested. Based upon the number of haircuts in each sample, we estimated that 5 or 6% of the population might be infested by this species. PMID- 3271945 TI - Analysis of Toxoplasma gondii proteins after Triton X-114 solubilization and hydrophobic chromatography. AB - The distribution of the surface proteins of Toxoplasma gondii radiodinated were studied using the phase separation technique and ability of binding in the phenyl Sepharose column. Eight polypeptides with Mr 22 to 180 distributed exclusively in the detergent rich-phase, while six polypeptides with mol. wt. 15,000 to 76,000 distributed exclusively in the detergent poor-phase. Two polypeptides with 15,000 and 70,000 distributed in both phase. All the polypeptides present in the detergent rich-phase binding in the phenyl-Sepharose column, and can be isolated in two peak according with their relative hydrophobicities. Two polypeptides hydrophobic with Mr 60 and 66 recognized by human serum were isolated by the association of the two technique. Our result showed that the surface proteins of T. gondii present different degrees of hydrophobicity and that the use of hydrophobic interaction chromatography after Triton X-114 extraction may be an important isolation method of membrane proteins. PMID- 3271946 TI - Isolation of Leishmania guyanensis from lesions of the nasal mucosa. PMID- 3271948 TI - Case presentation: idiopathic gingival fibromatosis. PMID- 3271947 TI - Dental features of bulimia. PMID- 3271949 TI - Fire at sea. PMID- 3271950 TI - The Naval Reserve Medical Department. PMID- 3271951 TI - The "one-call" outpatient appointment system. PMID- 3271952 TI - Suicide in the Naval service. Part I: Demographics. PMID- 3271953 TI - Wounded warrior. PMID- 3271954 TI - Navy nurses in the selected reserve. PMID- 3271955 TI - Detachable power cords: a potential hazard to patient safety. PMID- 3271956 TI - Suicide in the Naval service. Part II: Incidence and rate. PMID- 3271958 TI - [Morphologic and functional factors taken into consideration for the orientation of the occlusal plane in the preparation of the Ricketts VTO]. PMID- 3271959 TI - [Introduction to differential tooth movement. The concept of tip-edge and the differential right arch technic]. PMID- 3271957 TI - [The occlusal plane]. PMID- 3271960 TI - [A comparative study of the effect of 3 treatment technics on the occlusal plane]. PMID- 3271961 TI - [A quantitative study of the transverse displacement of the premaxilla and the mandibular symphysis]. PMID- 3271962 TI - [A descriptive analysis of the morphological variations of the hyo-glosso pharyngeal region: a study of 50 cases]. PMID- 3271963 TI - [Proposals for the 3-dimensional architectural analysis of craniofacial structures]. PMID- 3271964 TI - [The molar bite plane and the sagittal maxillo-mandibular skeletal shift]. PMID- 3271965 TI - [Functional sensorimotor therapy in functional orofacial disorders in children with cerebral palsy, using the Castillo-Morales technic]. PMID- 3271966 TI - [The facial growth of 300 subjects with Angle Class II division 1 malocclusion]. PMID- 3271967 TI - [Kinesiographic cephalometry]. PMID- 3271968 TI - [Simultaneous bimaxillary surgery: technics, indications, results]. PMID- 3271969 TI - [Parietal-masticatory relations in 10 human populations]. PMID- 3271970 TI - [A multifactorial study of the linear parameters of the mandible in 3 human ethnic groups]. PMID- 3271971 TI - [The aging progression of the adult occlusal plan observed through 10 French standards constructed in the mid-Pyrenees]. PMID- 3271972 TI - [Modelling of the displacement of the occlusal plane in multi-bracket therapy]. PMID- 3271973 TI - [The age of orthodontic treatment. Panel discussion]. PMID- 3271974 TI - [Skeletal maturation and orthodontics]. PMID- 3271975 TI - [The effect of the J. Delaire orthopedic traction face-bow on the facial skeleton: results, new therapeutic trends]. PMID- 3271976 TI - [Treatment using an orthopedic face-bow: stability of the long-term results]. PMID- 3271977 TI - [Morphologic peculiarities and major discriminants in patients with sleep apnea]. PMID- 3271978 TI - [The direction of actual growth in treated skeletal Class III malocclusion: a computer technology and radiologic study]. PMID- 3271979 TI - [Occlusal analysis in everyday practice assisted by a computer]. PMID- 3271980 TI - [Peculiarities of the facial skeleton of Eskimos, disclosed by vestibular positioning]. PMID- 3271981 TI - [The posterior palatal canal. Contribution to craniofacial architectural analysis]. PMID- 3271982 TI - Spauligodon carbonelli n. sp. (Nematoda: Pharyngodonidae), parasite of some lizards (Lacertidae) in the Iberian Peninsula. AB - Spauligodon carbonelli n. sp. (Nematoda: Pharyngodonidae), a parasite from the caecum of the common wall lizard Podarcis muralis (Laurenti, 1768) and the Spanish wall lizard Podarcis hispanica (Steindachner, 1870) (Reptilia: Lacertidae) in the Pirineos Mountains, Spain, is described. S. carbonelli differs from the other known species of the same genus, mainly in the presence and length of the spicule, the morphology of the caudal end in the male and in the structure of the cephalic end of the female. PMID- 3271983 TI - [Study of Siphonaptera in Somalia]. AB - In the period 1982-1984 samples of fleas were collected from wild animals of the Middle Scebeli, Low Scebeli and Bay Regions of Somalia. In total 1,335 specimens (486 males and 849 females) were obtained from 17 species of mammalian hosts out of the 19 examined. The following species of fleas were identified: Echidnophaga gallinacea, E. larina, E. murina, Ctenocephalides felis strongylus, Synosternus burtoni, S. somalicus, S. burtoni, S. somalicus, C. felis strongylus and E. larina are known to be widespread in Somalia; on the contrary, the presence of E. gallinacea in this country has not been reported in the literature, though the flea collection of the Institute of Parasitology of the University of Rome owns five females of this species which were collected by Zavattari in South Somalia during the year 1933. Moreover, as far as it is known, E. murina has not been reported in Somalia until now. The spermatheca of the females identified as S. burtoni is described in detail as it shows characteristics which have not been apparently reported before. PMID- 3271984 TI - Cutaneous leishmaniasis in western Sicily (Italy) and preliminary survey of phlebotomine sandflies (Diptera: Psychodidae). AB - A survey of phlebotomine sandflies was carried out in two provinces of western Sicily (Italy), where 65 cases of cutaneous leishmaniasis (CL) had been diagnosed by the Dermatology Department of the University of Palermo, between 1977 and 1987. Eight collecting stations, distributed throughout the CL foci of the Agrigento and Palermo provinces produced a total of 2,410 specimens (12.78% males). Of these, 77.59% were Phlebotomus perfiliewi, 12.78% P. perniciosus, 0.74% P. major and 2.07% Sergentomyia minuta. P. perfiliewi, the probable vector of CL, was present in 7 out of the 8 collecting stations with very high densities in two localities. PMID- 3271985 TI - [Report of Micipsella numidica (Seurat, 1917) in Italy]. AB - The first record in Italy of Micipsella numidica (Seurat, 1917) is reported. The parasite was collected from the portal vein of two rabbits (Oryctolagus cuniculus). Morphological features of the worms (4 females, 3 males and microfilariae from uterus) are described and compared with those reported for African, European and Asiatic specimens found in hares. PMID- 3271986 TI - Digeneans of fishes from the Adriatic Sea with a description of Lecithaster atherinae n. sp. from Atherina (Hepsetia) boyeri. AB - A collection of whole mount preparations of digeneans was studied. The parasites were collected from several species of fishes caught in a fishing area of the South Adriatic Sea. A host-parasite list is given. Twenty species of fish were analysed and twenty-seven species of digeneans were found, twenty of which had previously been described in the same host, and six of which were observed in new hosts and/or localities. One digenean, hitherto undescribed, is illustrated in this paper and described as Lecithaster atherinae n.sp. The new species can be distinguished from L. bombayensis by the testes not being lobed; from L. extralobus by having four rather than five ovarian lobes; from L. indicus and L. maeoticus by the ovarian lobes not being finger-like; from L. leiostomi by having definitely smaller eggs. PMID- 3271987 TI - Ribosomal DNA-probes differentiate five cryptic species in the Anopheles gambiae complex. AB - This study describes the use of ribosomal DNA probes to identify the species of individual mosquitoes in the Anopheles gambiae complex, a group of six morphologically identical mosquito species among which are two of the principal vectors of malaria in Africa. The DNA probes are sequences of DNA derived from the ribosomal genes of An. gambiae. Each probe reveals a different sized restriction enzyme fragment specific to each of the five species in the complex that were examined in this study: An. gambiae, An. arabiensis, An. quadriannulatus, An. melas and An. merus. The probes detect highly repeated sequences of DNA, thus the method is sufficiently sensitive to be applied to a small portion of a mosquito. Furthermore, because the DNA can be extracted from desiccated or alcohol preserved specimens, the test is compatible with other mosquito assays performed on dried specimens such as blood meal and malaria sporozoite antigen ELISAs. Determination of the nucleotide sequences that underlie the species-specific restriction enzyme site differences detected by these probes will lead to the development of synthetic DNA probes that can be used to identify an individual mosquito to species on the basis of a simple dot blot or squash-blot. PMID- 3271988 TI - Pediculosis among urban and rural school children in Kumba, Meme division, south west Cameroon. AB - Pediculosis is an important and common health problem in both urban and rural areas of Kumba. Out of a total of 2,312 children examined (1,462 urban and 850 rural), there was a rather disquieting overall infestation rate of 31.6% in the urban and 32.6% in the rural schools, respectively, and there was a much higher incidence of infestation among girls (36.3% urban, 35.1% rural) than boys (26.9% urban, 30.0% rural). Pubic infestation was more rampant among girls aged 13-15 years (0.3%) than boys (0.1%) of the same age-group, an age which coincides with the characteristic pubertal development of pubic hair. There was a higher incidence of lice infestation in the 9-12 year age-group (33.6% urban, 33.3% rural) than in both the 5-8 year age-group (29.3% urban, 31.6% rural) and the 13 18 year age-group (31.1% urban, and 31.7% rural). Given the nature of Cameroonian society with its African extended family system and its peculiar hospitality traits, it was not possible to correlate socioeconomic status of the children with their infestation rates. Additionally, the schools studied were not class oriented thus social mixing occurred. Body hygiene has become a mere theoretical exercise in today's schools. Children are neither closely monitored for body cleanliness nor expelled for scandalously poor and unkempt hair and clothing. Inspection of children must be stepped up in order to improve these declining health standards. PMID- 3271989 TI - Further observations on chemoprophylaxis and prevalence of malaria using questionnaire data in urban and rural areas of Burkina Faso. AB - A cross-sectional study of malaria prevalence (98.6% Plasmodium falciparum) was carried out in Ouagadougou (Burkina Faso) and in 3 neighbouring villages on 2117 children, zero to five years old. Data on antimalarial prophylaxis and treatment were obtained from the child's parent using an interviewer-administered questionnaire. Regular weekly chloroquine consumption lowered the parasite rate but a significant increase with respect to parasite density was recorded in protected children from the rural area. No significant differences related to previous antimalarial treatments were observed in parasite rate or density. Antimalarial treatments were less frequent in children under chemoprophylaxis. Information about dosage and date of therapy was not recalled by most of the interviewed parents. Problems and suggestions for questionnaire data are briefly discussed. PMID- 3271990 TI - Intestinal parasites in the Camiri, Gutierrez and Boyuibe areas, Santa Cruz Department, Bolivia. AB - A parasitological study was carried out on 381 apparently healthy subjects from Camiri, Boyuibe, Gutierrez. Intestinal parasites and non-pathogenic protozoa were present in 78.7% of the population sampled; multiple infections were observed in 67.7% of the parasitized individuals. The protozoon most commonly found was Entamoeba coli (in 40.7% of specimens), followed by Giardia intestinalis (30.7%), Iodamoeba butschlii (10%), Chilomastix mesnili (8.7%). Other protozoon parasites also present were Enteromonas hominis (3.4%), Retortamonas intestinalis (2.4%), Cryptosporidium (2.1%), Endolimax nana (2.1%), Balantidium coli (1.8%) and Pentatrichomonas hominis (0.8%). The helminths observed were hookworms (28.6%), Trichuris trichiura (19.7%), Ascaris lumbricoides (9.7%), Hymenolepis nana (8.7%), Trichostrongylus (5.5%), Strongyloides stercoralis (1.8%), Taenia (5 cases) and Enterobius (6 cases). Prevalence for nematodes is probably underestimated in the 3-9 years age group because of a mebendazole treatment given 5 weeks before the survey, under a Program of P D C of the Ministry of Health. The sample from Camiri was found to be the most parasitized (84.1%). An extraordinarily high infection rate was found in two urban institutions, as well as in Itanambicua, a rural community close to Camiri. No significant differences were observed in parasitic prevalence between rural and urban environments. Exposure to contamination with human and animal faeces, overcrowding and poor sanitation habits are some of the factors responsible for the parasitic situation evidenced. PMID- 3271991 TI - [Larvivorous capacity of Barbus pobeguini and possibility of using this in the fight against Anopheles gambiae s.l]. AB - Permanent breeding sites for Anopheles gambiae s.l. were found to occur in the urban area of Ouagadougou and to have some importance in the maintenance of vector populations. In these breeding places Barbus pobeguini was found widespread and larvivorous as indicated by the presence of remnants of A. gambiae in its stomach contents. The use of B. pobeguini would avoid the introduction of non-local larvivorous fishes. A series of trials carried out in laboratory conditions with B. pobeguini of different size, showed: 1) a remarkable capacity to ingest larvae (at different stages) of A. gambiae; 2) pronounced tendency by bigger B. pobeguini specimens to cope with bigger larvae; 3) an indifferent attraction to A. gambiae and Culex quinquefasciatus larvae. PMID- 3271993 TI - TMJ: the media and the profession. An informal discussion. PMID- 3271992 TI - Caries prevention with xylitol: a symposium at the University of Michigan, Ann Arbor. PMID- 3271994 TI - Participation of the splanchnic nerves in the structure of the cranial mesenteric plexus of the rabbit. AB - In this study the branch points of the greater splanchnic nerve, lesser splanchnic nerve and lumbar splanchnic nerves from the sympathetic trunk of the rabbit were investigated and their participation in the structure of the cranial mesenteric plexus was estimated. PMID- 3271995 TI - [Studies of the course of the postpartum period in Polish Merino sheep.I. Macromorphological studies of the ovary and uterus]. AB - The aim of the conducted research was to establish postpartum oestrous cycles and approximate data for mating Polish Merino sheep. 34 sheep were examined. During sheep laparotomy observations of ovaries and uterus were made on definite days of the postpartum period (1-78). It was stated that after about one-week of postpartum inactivity, the growth and development of follicles occurred in ovaries. First ovulations were noticed from the 15th to 18th day of postpartum, while processes connected with uterus involution were not completed. From the 14th to 18th day of postpartum, casting off of pregnant tissues from caruncules' surfaces into uterus cavity occurred. In the majority of sheep, regeneration of caruncules and purification of uterus cavity were completed by the 30th day of postpartum. The observed compatibility of the phases of ovary cycle with macromorphologically determined functional state of uterus after 30 days of postpartum, in the majority of tested sheep, suggests possibility of successful mating of Polish Merino sheep. PMID- 3271996 TI - Serum cobalt-activated acylase as a marker of transplantable leukemia in mice. AB - The activity of cobalt-activated acylase was determined in the serum of mice with transplantable leukemia (P 388, L 1210 standard, L 1210/ara-C, L 1210/CH3-G, plasmocytoma ADJPC-5, lymphoma AKSL-4 and natural leukemia in mice NZB). A statistically significant increase in enzyme activity in all leukemias except lymphatic leukemia has been demonstrated. The results suggest possibility of using the enzymatic measurement as a marker of transplantable leukemia in mice. PMID- 3271997 TI - [Development of water space volumes in calves during the first month of life. I. Changes in the total amount of water]. AB - The experiment has been carried out on twelve cb. race calves, all being 5 to 31 days old. During the experimental period each calf was examined 12 times in order to determine the total water volume within its constitution by the antipyrine method. The total water amount in litres significantly increased during the experimental period and this fact found its statistical confirmation. The values obtained, proved to be in positive and essential correlation with the age of calf, its weight and body area. The observed total water volume increase was caused by a quickly increasing intracellular liquid volume. The total water volume per one kilogram of a calf body however, systematically decreased during the whole experimental period. The phenomenon was due to a significant reduction of the extracellular fluid amount in ml/kg. The results that have been obtained in the experimental appeared to be negatively but veritably correlated with the age of examined animals. The total water volume per square metre of a calf body area during the first month of animals life showed only slight and statistically negligible fluctuations. PMID- 3271998 TI - [Development of water space volumes in calves during the first month of life. II. Changes in the extracellular and intracellular volumes]. AB - The experiment has been performed on the same flock as mentioned in Part I. The extra cellular fluid amount was determined by the rhadonate method. The volume of intracellular fluid was calculated as a difference between the total water amount and the extracellular fluid volume. The absolute content of extracellular fluid in calves' constitutions between 5th and 31st day of animal lives fluctuated statistically only slightly. The observed stability of ECF volume in litres seems to be caused mainly by the changes in interstitial fluid content. The extracellular fluid volume calculated both per one kilogram of a calf body and per square metre of its body area became significantly reduced within the experimental period which fact found its statistical confirmation. The results appeared negatively and veritably correlated with animal ages. Expressed in litres as well as calculated per units of weight and body area of a calf the volume of intracellular fluid showed a statistically confirmed and significant increase for a period from calf's 5th to 31st day of life. The observed ICF volume increase appeared veritably correlated with ages, weights and body areas of the examined animals. PMID- 3271999 TI - [Development of water space volumes in calves during the first month of life. III. Changes in the plasma and circulating blood volumes]. AB - The experiment was performed on the flock mentioned in part I. The plasma and circulating blood volumes have been determined using Evans Blue (T-1824). The plasma volume expressed in litres increased slowly but systematically during the examination period. A clear and statistically significant correlation between fluctuations in the absolute plasma amount and a calf age, its weight and body area has been observed. Calculated per kilogram and square metre of a calf body the plasma volume decreased significantly during the experimental period which fact found its statistical confirmation. The results correlated veritably and negatively with ages of the animals. The absolute volume of circulating blood in calves constitutions between 5th and 31st day of animals lives has increased but the differences found could not be confirmed statistically. A positive and veritable correlation has been observed between the obtained results and ages, weights and body areas of the examined calves. The circulating blood volume calculated both in terms of animals' weights and body areas during the first month of their lives decreased which fact has been statistically confirmed. The values as obtained in the experiment appeared negatively but veritably correlated with ages of the animals. PMID- 3272000 TI - Early immunization of calves with an inactivated vaccine against trichophytosis. AB - The investigations demonstrated that the inactivated vaccine against trichophytosis, elaborated by the authors, induced immune response in calves, aged 5-8 days. The state of immunity was assessed in vitro by the leukocyte migration inhibition test, and in vivo by the allergic test and the challenge test. In all vaccinated calves (10 animals) there occurred delayed hypersensitivity and in six cases also a significant leukocyte migration inhibition. Vaccinated animals exposed to challenge were to a large extent resistant to experimental infection with the virulent strain of T. verrucosum. PMID- 3272001 TI - [Effect of liver bile on interdigestive electric activity of the stomach and small intestine in dogs]. AB - Utilizing the chronic experimental dog model the effect of intraduodenal administration of bile upon the interdigestive electric activity of the stomach and small intestine was examined. For this purpose the functional cholecystectomy was performed and common bile duct was cannulated with two catheters. Tubes connected over the skin allowed spontaneous bile circulation during control experiments and in between the experimental periods. Nine pairs of electrodes were implanted into the stomach and small intestinal wall for electromyography. During other experiments standard bile was infused intraduodenally at the rate 0.5 ml.min-1 for 300 min and whole hepatic bile was introduced at the rates 2 ml.min-1 for 60 min and 30 ml.min-1 for 2 min. Hepatic bile infusion at the low rate, when started during phase II of the migrating myoelectric complex, induced the premature phase III after 10 +/- 2 min and caused about 20% reduction of cycle duration in the duodenum as compared to control experiments (P less than 0.05). Fast administration of hepatic bile elicited the premature phase III in 8 +/- 2 min, caused 20-30% reduction of the duodeno-jejunal cycle duration (P less than 0.05) in comparison with control group and induced in 26% phase III in the stomach. Cycles were shortened at the expense of markedly decreased duration of phase I; for example in the duodenum phase I was reduced from 30 +/- 3 (control experiments) to 11 +/- 2 min, P less than 0.001. Standard bile infusion exerted less pronounced changes, apart from increasing the propagation velocity of phase III in the first jejunal segment from 6 +/- 0.5 cm.min-1 in control group to 13 +/- 3 cm.min-1, P less than 0.05. In two experiments rapid bile administration evoked an inhibitory response. Results obtained suggest that the luminal bile stimulates the interdigestive electrical activity of the stomach and small bowel of the dog. This stimulatory effect may represent the feedback mechanism preventing the prolonged retention of continuously inflowing bile in a bowel section and, particularly, in the duodenum. PMID- 3272002 TI - [Effects of carbachol and atropine on bile secretion in sheep]. AB - Experiments were performed on rams prepared surgically to make possible the control of bile flow and the maintenance of enterohepatic circulation of bile components. Carbachol and atropine were infused into the jugular vein for 2 hours in the amounts: 0.3 and 0.7 microgram/kg b.w./min. respectively. Carbachol administration did not affect significantly the bile production. Atropine led to the significant decrease in the bile flow (p less than 0.01) by diminished concentration of bile acids in the bile. On the basis of the obtained results the role of n. vagus in the regulation of biliary secretion is discussed. It is suggested, that in physiological conditions the biliary secretion is, to some extent, maintained as a result of the muscarinic receptor stimulation. This stimulation attains the maximum level and it is not possible to evoke rise in bile production after either n. vagus stimulation or administration of parasympathomimetic agents. PMID- 3272003 TI - [Arterial and venous vascularization of cow's ureter in the fetal and neonatal periods]. AB - Investigations of ureter perfusion in cattle during fetal and neonatal period were carried out on 84 fetuses and 10 female newborn cattle. The fetuses 78-1000 mm long were of the 9th-40th week of pregnancy, whereas the newborn ones were 2 or 14 days old. Pelvis blood vessels were filled with rubber latex stained with pigment. This was obtained with the help of a special automatic injector made by ourselves. After coagulation of injection substance the blood vessels were examined under a stereoscopic microscope, some microsurgical instruments adapted to our needs were used. The analysis of morphology and artery developmental markers as well as of ureter veins was carried out with reference to its proximal, middle and distal parts. On the basis of the results it was noticed that transformations of investigated vessels referred mainly to their number. place, kind of ostium and the area of ureter perfusion. Quantitative transformations of analyzed vessels occur first of all in fetuses of the 13th 40th week of pregnancy. Apart from main ureteral+ branches of examined organs as components of renal artery and vein, ovarian artery and vein. uterine branch of vaginal artery and vein, and umbilical artery, they have additional uretal branches, which at the end of pregnancy are reduced and do not take part in the ureter perfusion in newborn cattle. Main uretal branches occur both in fetuses and newborn cattle and they are characterized by increasing occurrence and tendency to widen perfusion range of the ureter wall. The average image of ureter arteries and veins, observed in the oldest fetuses (40th week of pregnancy) and newborn cattle, is similar to the species standard for the mature cattle as presented in other works. There are, however, different results of observations which are due to constant developmental and individual changes of the examined fetuses. PMID- 3272004 TI - [Differences in the reaction of the mucosa of the gastric fundus and pylorus to high concentration of ethanol]. AB - Histopathological morphometric analysis were made to determine the degree and extent of the stomach mucosa lesions in fundus and antrum of 36 rats after 15 min., 1, 24 and 96 hours after ethanol insult. At the early stage the intensity of the lesion caused by direct influence of ethanol was in both parts similar. Evident differences occurred after 1 hour, and especially after 24 hours, and were caused by secondary, endogenous agents. Among them the most important seems to be the specificity of the vascular net reaction to alcohol stimulus in each part of the stomach, differences in secretion intensity and composition of the superficial mucosal gel, as well as in the contents of some active substances. PMID- 3272005 TI - Primary oral health care. The concept and suggestions for practical approach. PMID- 3272006 TI - Prevalence of intraoral crown and root surface caries in an adult and older Saudi patients. PMID- 3272007 TI - Periodontal health and disease in Indonesia, measure by the WHO method CPITN. PMID- 3272008 TI - [Dental cellulitis in Kinshasa: etiologic aspects]. PMID- 3272009 TI - Patterns of tooth vulnerability to caries in 20-24-year-old subjects. PMID- 3272010 TI - [Is ethnicity a factor which influences the concentration of salivary lysozymes?]. PMID- 3272011 TI - [Epidemiologic aspects of dental caries in the urban area of Bamako (Rep. of Mali). Apropos of 1542 cases]. PMID- 3272013 TI - On pooled and stratified analysis of epidemiologic rates. PMID- 3272012 TI - A new statistical test for summarizing the results of independent epidemiologic studies. PMID- 3272014 TI - Application of pooling strategies to occupational cancer and occupational mortality studies. PMID- 3272015 TI - Environmental quality and sustainable development. PMID- 3272016 TI - The right to know: citizen action for the protection of the environment. PMID- 3272017 TI - [The stomatology community]. PMID- 3272018 TI - [Determining the cause of facial pain]. PMID- 3272019 TI - [Sensory receptors in the labial musculature]. PMID- 3272020 TI - [Results of the evaluation of a sodium fluoride mouthwash program for Cataluna children. Preliminary report]. PMID- 3272021 TI - [36 cases of rapidly progressive periodontitis. Analysis, treatment and results after 2 years]. PMID- 3272022 TI - [Apicoectomy: another endodontic adjunct]. PMID- 3272024 TI - [The relation between the structure and the properties of dimethacrylates]. PMID- 3272023 TI - [Odontogenic myxoma of the mandible]. PMID- 3272025 TI - [Effect of aliphatic dimethacrylate diluent on the properties of UDMA resin systems]. PMID- 3272026 TI - [Re-examination for some physical properties of luting cement--influence of powder/liquid ratio]. PMID- 3272028 TI - [Effect of dental metallic salts on the DSC phase transition properties of phospholipid-cholesterol liposomes]. PMID- 3272027 TI - [Disinfection of alginate impressions. Part 1. Effect of various disinfectants to the dimensional stability of alginate impression materials]. PMID- 3272029 TI - [The fracture toughness of composite resins]. PMID- 3272030 TI - [Evaluation of corrosion rates of dental Ag-based alloys by coulostatic method]. PMID- 3272031 TI - [Polishing of titanium prosthetics. (Part 4). Chemical polishing]. PMID- 3272032 TI - [Durability of composite resins in accelerated boiling water immersion]. PMID- 3272033 TI - [Self-setting apatite cement. V. Dissolution and remineralization]. PMID- 3272034 TI - [The factors of cytotoxicity of amalgams]. PMID- 3272035 TI - [Development of silver-samarium alloys by the powder metallurgy method]. PMID- 3272036 TI - [The electric discharge machining of ceramics]. PMID- 3272037 TI - [Syntheses and evaluation of polyfunctional monomers with acrylate and methacrylate groups. Application to visible light-cured resins]. PMID- 3272038 TI - Oral complications in a patient with acute lymphocytic leukemia: a report of case. AB - Herpes viruses and Candida albicans are among the most common opportunistic pathogens infecting patients with neoplastic disease, especially those patients receiving cancer chemotherapy. Herpes virus infections have increased as treatment of oncological disease has become more aggressive and immunosuppression disorders have become more prevalent. Herpes simplex virus on the lips and mouth of a patient receiving chemotherapy can progress to multiple lesions in the mouth, larynx, and in rare instances can lead to pneumonitis and widely disseminated infection. The management and dental findings of a 13-year-old patient with acute lymphocytic leukemia are described. PMID- 3272039 TI - The status of geriatric education in dental hygiene curricula. AB - To assess the status of geriatric education in dental hygiene curricula, a pretested survey was sent to a 55% random sample of the 198 US dental hygiene programs. Of the 109 surveys mailed, a 90% response rate showed that geriatric didactic material is most frequently presented via occasional lectures, rather than in a formal course or an organized series of presentations. Seventy-five percent of the programs have a geriatric clinical component. Baccalaureate programs and programs longer than 2 years are more likely than associate programs and programs shorter than 2 years, respectively, to teach geriatrics in a more formalized setting. There is no significant difference in the way geriatric material is presented between hygiene programs that are and are not within dental schools. PMID- 3272040 TI - Need for dental hygiene and dental care in Veterans Administration patients. AB - The Periodontal Treatment Needs System (PTNS) was used to classify needs of 102 patients, 97 males and five females, at the VAMC Dental Service. The PTNS is based on the presence or absence of plaque, calculus or overhangs, inflammation and pocket depth. In addition, need for restorative and prosthetic care was added to the PTNS based on dentists' diagnosis. All classification was done by quadrant. All subjects required dental hygiene or periodontal care; 45% of the subjects need restorative treatment, prosthetic treatment, or both. Differences in numbers of patients requiring each type of treatment were highly significant. Multiple regression showed that age was positively related to type of treatment needed, with a significant difference in dental hygiene or periodontal needs by quadrant. The results of this study show greater need for dental hygiene and periodontal treatment than for dental treatment in these patients. PMID- 3272041 TI - The hospital-sponsored ambulatory dental services program, Part II: An evaluation of dental services. AB - This paper examines the appropriateness and continuity of dental care rendered by the 25 hospital facilities participating in the Hospital-Sponsored Ambulatory Dental Services Program, a $10 million effort established by the Robert Wood Johnson Foundation from 1979 to 1983. Record review data on 5,200 patients in 13 of the hospitals show that a substantially greater number of patients entered as episodic users of the system in the final phase of the evaluation than in the baseline visit; fewer of these episodic patients made the transition to initial care in the final phase. A followup study on baseline patients indicates that only 28% of the sample had a visit after the year of first contact. The trend toward episodic care is reflected in a reduced amount of preventive and operative services from baseline to final assessments. Compared with a study of private practices in California, the emphasis on surgery in the hospitals is dramatic: a dental patient accessing a hospital clinic will lose approximately one tooth as compared with a half tooth in private practice. Private practices also perform more crown and fixed partial denture services and more services across-the-board than the hospital clinics. Telephone interviews show that overall patient satisfaction with the hospital dental services remained high during the study (87% to 89%). Fewer patient in the final sample, however, planned to return to the hospital for all or part of their care. These findings reveal that continuity of care is a problem for hospital dental clinics. The preponderance of episodic care raises questions as to the breadth of experience offered by these hospitals to general practice residents. PMID- 3272042 TI - Training dental and nondental professionals together: the oral health gerontology fellows program. AB - This project demonstrated the feasibility of training dental and nondental professionals to develop and implement programs in oral health care of older adults. Eight self-guided study modules were developed and tested. Trainees drawn from dentistry, dental hygiene, nursing, and planning/administration completed a 6-month individualized training program under the guidance of faculty mentors. Program structure, content, and implications are discussed. PMID- 3272043 TI - Design, evaluation, and use of a portable cephalometric cephalostat: the Porta Stat (an X-ray subsystem). AB - A portable and light-weight cephalostat (Porta-Stat) is described. Device design, clinical use, and evaluation to verify accuracy are presented. The basic design uses a mainframe to which the image receptor, head, and X-ray source are referenced for standardization of image and magnification distortion in cephalometric radiographs. In a test to verify the accuracy of image reproducibility, no statistically significant difference was found from a fixed cephalostat system. The Porta-Stat cephalostat has verified accuracy essentially equivalent to traditional cephalometric radiography. Anecdotal case presentations show the usefulness of the Porta-Stat in the dental office, hospital radiology department, and operating room for case documentation, growth monitoring, treatment effect, and clinical research purposes. The device has proved to be useful in the management of TMJ syndrome, orthodontics, oral and maxillofacial surgery, otolaryngology, plastic surgery, neurosurgery, and craniofacial growth monitoring. PMID- 3272044 TI - The broken dental needle--a hazard. AB - A case of a disposable needle broken during an inferior alveolar injection and its successful removal is reported. Methods of locating the needle and preventing this occurrence are discussed. PMID- 3272045 TI - Successful use of a feeding obturator for an infant with a cleft palate. AB - The report of case presents the postnatal and early infancy period for a child born with a cleft of the soft palate. The infant was admitted to the hospital several times for failure to thrive as a result of feeding difficulties. The feeding problems resulted from both the cleft and a lack of consistent and concerted effort by the family to nourish the infant. When the child was 3 months old, a feeding obturator was constructed that resulted in improvement in the child's weight gain. The feeding problems of an infant with a cleft palate and the pressures that these problems present to the parents are discussed. PMID- 3272046 TI - Retrospective study of emergency room dental patients retained in a hospital dental practice. AB - To maintain viability, hospital dental services must evaluate patient pools to help improve referrals and retention. Because the emergency room has traditionally been a source of new patients for the dental department, a retrospective study was done to determine any factors that might relate to the retention of emergency room dental patients. A total of 198 dental patient records were surveyed. Results indicated that certain similarities exist in those patients retained in the hospital dental practice. PMID- 3272047 TI - A communications seminar series for general practice residents. AB - This article describes a seminar series for general practice residents dealing with communication, interpersonal relations, self-image, and patient-dentist interactions. Objectives, content, and methods of evaluation are presented. PMID- 3272048 TI - The relationship of oral Candida tropicalis infection to systemic candidiasis in a patient with leukemia. AB - Oropharyngeal candidiasis is an extremely common complication in patients receiving chemotherapy for leukemia. Candida tropicalis appears to be the major infectious agent when these patients develop candidemia. In this article, a case of C tropicalis fungemia with oropharyngeal manifestations is presented. The relationship of oropharyngeal candidiasis to oral candidal infection is discussed. PMID- 3272049 TI - Age differences in responses to facial trauma. AB - This study examines age differences in causes, characteristics, and outcomes of facial trauma seen in a major trauma hospital. A retrospective analysis was undertaken of 615 cases of facial trauma that had occurred during a 5-year period. The greatest proportion of patients were aged 20 to 29; those older than age 60 represented just 6.8% of the total cases. Gender differences were not observed in the oldest age groups. The oldest patients (older than 70 years) were more likely to have had pedestrian accidents and less likely to have been assaulted than other age groups. Older patients had more multiple injuries but fewer treatment procedures than other age groups. Significant differences were found in death rates; the older patients were more likely to die as a result of their injuries. Implications for patient management based on age and treatment needs are discussed. PMID- 3272050 TI - Surgeon General's Workshop on Health Promotion and Aging. AB - The following report contains all of the recommendations of the working group on oral health that met during the Surgeon General's Workshop on Health Promotion and Aging, March 20-23, 1988, in Washington, DC, under the direction of Surgeon General C. Everett Koop and a number of leaders in geriatrics and gerontology. The working group was composed of 17 specialists, including Frank Martin, technical manager; Scott Presson, reporter; James Beck, chairman; and group members Ronald Ettinger, Jean Frazier, Mary Alice Gaston, Helen Gift, Neville Gilmore, Marc Heft, H. Asuman Kiyak, James Marshall, Roseann Mulligan, Linda Niessen, Vincent Rogers, Michele Saunders, Ruth Seigler, and Hongying Wang. The report also includes dental-related recommendations made by the working groups on medication, preventive health services, alcohol, physical fitness and exercise, injury prevention, mental health, smoking cessation, and nutrition. Eight workshops have been sponsored by the surgeon general since his appointment to office in 1981; this workshop was the first to focus on dentistry and aging. PMID- 3272051 TI - Dentistry and health maintenance organizations. AB - The following report, which considers the history of the medical health maintenance organization and its current application in the dental profession, was presented at the region II annual meeting of the American Association of Hospital Dentists in May 1987 at Mt. Sinai Hospital, New York City. PMID- 3272052 TI - Dental health of homeless adults. AB - As part of a community-based study, we were able to assess the number of grossly decayed and missing teeth, as well as recent use of dental services, among 529 homeless adults. We found that 27% reported having had a toothache during the previous month (only one-tenth of these individuals had sought help from a dentist for their toothache). Homeless adults, as compared with a general population, were half as likely to have made a dental visit within the preceding year (26.7% versus 55.0%) and had more grossly decayed teeth (means = 2.3 versus means = 1.4). Individuals with more tooth decay and missing teeth were more likely to be older, have physical health problems, smoke more cigarettes, use more alcohol, and have worse personal hygiene. Age, not length of homelessness, was the most important predictor variable of missing teeth. Thus, homeless adults have a higher degree of dental pathosis as well as a lower use of dental services than the general population. On the basis of these findings, more accessible dental services need to be designed for the homeless population. PMID- 3272053 TI - The relationship of growth hormone to alveolar ridge atrophy in an older male nursing home population. AB - Alveolar bone development has been shown by other investigators to be sensitive to growth hormone concentration in both humans and rodents. Many elderly people are deficient in growth hormone. The cyclic variation in plasma growth hormone concentration that complicates growth hormone measurement is not seen in the plasma somatomedin C (SmC) concentration. Furthermore, SmC is a dependable indicator of growth hormone secretion. It has been established that an SmC level of 0.24 or less is associated with decreased muscle mass and kidney size. We have investigated the relationship of the alveolar bone/supporting (basal) bone (A/B) ratio to the SmC in an elderly male population. These data suggest that growth hormone secretion is not the sole determinant of alveolar bone retention. PMID- 3272054 TI - Patient death and bereavement: what is the dentist's role? AB - The dentist's role following a patient's death has not been examined to date; neither has the attrition rate of a dental practice because of deaths of patients belonging to that practice. This topic was explored through a survey of 400 Oregon dentists. Seventy-two percent of dentists in active practice who participated in the survey had at least one patient death each year; the mean number of patient deaths per year was five. Following these deaths, most dentists reported providing some type of emotional support to the bereaved survivors. Dentists send sympathy cards 72% of the time and attend funerals 27% of the time; 55% of dentists regard the majority of their patient deaths as unexpected. These deaths are a source of emotional stress for dentists, as are subsequent discussions with survivors. Only 3% of the respondents reported having received formal education in death and bereavement, and 66% of dentists believe that some type of education in dying and bereavement should be included in dental school. PMID- 3272055 TI - Predictors of the use of dental services by older veterans. AB - By the year 2000, it is likely that more than 66% of all US males will be veterans as a result of the large World War II cohort. This growing population of older veterans will have a major influence on the use of dental services at Veterans Administration facilities. The objectives of the project reported here were to identify and examine factors that explain use of dental services by noninstitutionalized veterans older than 55 years; this was a secondary analysis of a VA commissioned survey of 3,013 community-based veterans older than 55 years. A behavioral model developed by Anderson and Aday that identified predisposing, enabling, and need factors that determined use of health care services was adopted to analyze the data. A linear regression analysis showed that need factors accounted for the greatest degree of explained variance in use of dental services (R2 = .15), whereas enabling factors accounted for the least degree of variance (R2 = .02). Perception of dental problems, positive perception of physical health, perception of ability to meet expenses, and levels of education and income were significant predictors of use of dental services. The findings of this study show the use of dental services by noninstitutionalized veterans and other noninstitutionalized older populations is influenced by similar factors. The findings can be useful in discussing and formulating dental health care policy for older veterans. PMID- 3272056 TI - An educational consultative model for general practice training programs. AB - A behavioral science consultant has been retained by two hospital-based general practice residency (GPR) programs and one advanced program in general dentistry at the University of Rochester, and Eastman Dental Center, NY. This consultant is available throughout the year and serves as an external consultant who knows the programs well, and can be used as a source of information on various existing and potential issues and problems. The model used by the consultant has been inductive and is based on the expressed needs of faculty members, trainees, and directors. A number of issues or problems were identified, including faculty member morale, evaluation of residents' growth, resident and supporting staff relations, curriculum development, cooperation with other departments and institutions, and dealing with patients' anxiety to dental treatment. For each, a specific plan was developed. Various types of experiential techniques were used, including brainstorming, role playing, and taping and feedback. Didactic activities included minicourses and workshops in which standard teaching methods were used, such as lectures, seminar discussions, literature study, and demonstration. The model has evolved, and as each activity has succeeded, more faculty members have sought help from the consultant. PMID- 3272057 TI - The importance of adequate health care for older persons. PMID- 3272058 TI - The resuscitation of threatened legs. PMID- 3272059 TI - Lloyd Roberts memorial lecture. Science, culture and wealth. AB - 1. This lecture defends the view that science, culture and wealth are linked and that, in the long run, the only way to maintain the spirit of excited intellectual enquiry leading to novel exploitable ideas is to attract the young by creating and maintaining a culture in which they respond to the intellectual challenge. 2. The pursuit of science is not independent of the culture in which it develops, nor is it a neutral activity. The objectivity of science neither requires nor entails its neutrality. 3. A comparison between American and British attitudes reveals a major cultural difference that leads otherwise similar political authorities to totally opposed views on the role of public funding of science. 4. The roots of this difference run deep in our culture and have a long history, stretching back at least to the early 19th century and Babbage's Decline of Science campaign. This seems to be a feature of the culture of the governing classes in Britain, at least in modern Britain. The general public perception (revealed by a recent opinion poll) is that more than 80% think that our national prosperity depends on science and technology and that it is important for Britain to be a leading nation in science. 5. The immediate cause of the present political malaise with regard to science funding is the perceived lack of correlation between science expenditure and industrial success in the 1960s. In fact, though, at the micro-economic level, there is a strong correlation between research investment and industrial competitiveness. Those industries that have invested have also succeeded. The general problem lies with a failure of major parts of industry to invest in research rather than in any major weakness or lack of exploitability in British science. 6. It will not solve that problem (which to compare with our main competitors requires an increased civil Research and Development expenditure of 3 pounds billion/annum by British government and industry combined) to try to squeeze funds from the much smaller fundamental science base, nor to impose expensive management structures on university science, which has fluorished in Britain precisely because the "young turks" have been given their head.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3272060 TI - Medical experiences in the Sudan and their relevance to western medicine. PMID- 3272061 TI - On medical education. PMID- 3272062 TI - [Workshop 1987. The Working Group on Clinical Respiratory Physiology. Linz, 15-17 October 1987]. PMID- 3272063 TI - [Physiologic respiratory aspects of depth in mining]. PMID- 3272065 TI - [Physiologic respiratory aspects of mountain climbing]. PMID- 3272064 TI - [Fitness for work and capacity to stay under hyperbaric conditions]. PMID- 3272067 TI - [Ambient temperature, air pressure and humidity and altitude adjustment]. PMID- 3272066 TI - [Physiologic respiratory aspects of flying]. PMID- 3272068 TI - [Long-term registration of respiratory parameters]. PMID- 3272069 TI - [Respiratory mechanics in fiber optic bronchoscopy]. PMID- 3272070 TI - [Effect of bronchoalveolar lavage on regional lung function and lung permeability]. PMID- 3272071 TI - [Whole body plethysmography studies in patients with deviated nasal septum before and following surgical correction]. PMID- 3272072 TI - [The effects of extrapulmonary diseases on lung function]. PMID- 3272073 TI - [Differences in blood collection for blood gas analysis in oxygen inhalation therapy]. PMID- 3272074 TI - [pO2 microelectrodes for measuring oxygen pressure of tissues in humans and experimental animals]. PMID- 3272075 TI - [Blood gas measurement or trend monitoring exemplified by oximetry]. PMID- 3272076 TI - [The value of transcutaneous measuring procedures of pO2 and pCO2 in physical stress]. PMID- 3272077 TI - [Quantifying pulmonary artery hypertension by Doppler echocardiography measurement of tricuspid valve insufficiency]. PMID- 3272078 TI - [The long-term course of primary pulmonary hypertension]. PMID- 3272079 TI - [The diagnosis of pulmonary embolism using simple clinical parameters]. PMID- 3272080 TI - [Various forms of hypoventilation syndromes]. PMID- 3272081 TI - [Specific inhalative provocation--late reaction]. PMID- 3272082 TI - [The effect of bronchoalveolar lavage on the frequency of human bronchial cilia]. PMID- 3272083 TI - [Practical application of the new standardized examination form]. PMID- 3272084 TI - [PEP mask physiotherapy: development of a high pressure method for mobilization of secretions in mucoviscidosis]. PMID- 3272085 TI - [Oxygen consumption/energy requirement of severely ill patients]. PMID- 3272086 TI - [Pulmonary occlusive disease in a patient with unilateral absent lung artery]. PMID- 3272087 TI - [Effect of a magic drug in asthma therapy]. PMID- 3272088 TI - [Significance of selected biologic and electrochemical in vitro investigations of non-precious metal and precious metal dental alloys]. PMID- 3272089 TI - [Dimensional stability of dental registration waxes]. PMID- 3272090 TI - [Surface properties of dental adhesives]. PMID- 3272092 TI - [Quality of surgical gloves]. PMID- 3272091 TI - [Marginal fit of porcelain crowns]. PMID- 3272093 TI - [Disinfection of impressions. Comparison of dimensional stability and hardness with gypsum]. PMID- 3272094 TI - [The functional regulator (Frankel appliance). Report of cases]. PMID- 3272095 TI - [Ultrasonic preparation of the root canal]. PMID- 3272096 TI - [Intolerance to collyria and contact lens storage solutions]. PMID- 3272097 TI - [General and local anesthetics: pharmacological aspects]. PMID- 3272098 TI - [Eye manifestations in drug addicts]. PMID- 3272099 TI - [Papillometry]. PMID- 3272100 TI - [Argon laser trabecular photocoagulation in the treatment of primary open-angle glaucoma]. PMID- 3272101 TI - [Gas tamponment in retinal detachment]. PMID- 3272102 TI - [Surgery of the crystalline lens displaced into the vitreous body: ectopy, subluxation, dislocation]. PMID- 3272103 TI - [The position on phacoemulsification]. PMID- 3272104 TI - [The position on the refractive surgery. Methods]. PMID- 3272105 TI - [Ocular pathology and travel]. PMID- 3272106 TI - [Acute aseptic endophthalmia and implantation]. PMID- 3272107 TI - [Ciliary fixation or capsular fixation of intraocular lenses: advantages and disadvantages]. PMID- 3272108 TI - [Indications for the use of YAG-laser on the posterior segment]. PMID- 3272110 TI - [Local and loco-regional anesthesia]. PMID- 3272109 TI - [Use of short-wave ultraviolet laser (193-208 nanometers) in ophthalmology]. PMID- 3272111 TI - [Ocular hypotonia and anesthesia]. PMID- 3272112 TI - [Effects of preoperative and postoperative drugs on anesthesia]. PMID- 3272113 TI - [Assessment of antioxidants intake via food]. PMID- 3272114 TI - [Congenital abnormalities and mother's occupation]. PMID- 3272115 TI - [Occupational health and computerization of the tertiary sector. A global approach to current working conditions]. PMID- 3272116 TI - [Nutritional potential of sunflower flour (Helianthus annuus)]. PMID- 3272117 TI - [Interactions between toxicology and ecotoxicology]. PMID- 3272118 TI - Treatment of solar keratoses. PMID- 3272119 TI - Home treatment of skin cancer and solar keratoses. PMID- 3272120 TI - The specific dermatoses of pregnancy: a reappraisal. PMID- 3272121 TI - African tick typhus (Mediterranean spotted fever) in Australian travellers. PMID- 3272122 TI - Family infections with dermatophytes: an overlooked problem? PMID- 3272123 TI - Moisturizer prescription patterns among Australasian dermatologists. PMID- 3272124 TI - Allergic contact dermatitis to Noogoora Burr and Bathurst Burr. PMID- 3272125 TI - Primula obconica sensitivity and testing with primin. PMID- 3272126 TI - Treatment of psoriasis with 6-thioguanine. PMID- 3272127 TI - Acrodermatitis associated with zinc deficiency: features and postulated mechanism. PMID- 3272128 TI - Australian Dermato-Pathology Society case presentation. Acute painful nodules on the head and neck. Cutaneous iododerma. PMID- 3272130 TI - Analytical solution to the three-compartment pharmacokinetic model. PMID- 3272129 TI - Epidermal Langerhans cells in patients with Behcet's syndrome. PMID- 3272131 TI - Comparisons of ruminal fermentation characteristics and microbial populations in bison and cattle. AB - Ruminal microbial populations, fermentation characteristics, digestibility, and liquid flow rates in two ruminally cannulated bison and two ruminally cannulated Hereford steers fed a prairie hay diet were compared. No significant differences in anaerobic bacterial counts, volatile fatty acid concentrations, or ruminal pHs were evident between bison and cattle. Also, no significant differences in neutral detergent fiber digestibility, indigestible fiber retention time, or intake were detected between bison and cattle, although cattle had higher levels (P less than 0.08) of ruminal dry matter and indigestible fiber than bison. Bison had a smaller (P = .02) ruminoreticular volume, faster liquid dilution rates, and faster liquid turnover times than cattle. The average ruminal ammonia nitrogen concentration was higher (P = 0.02) in bison (1.17 mg/dl) than in cattle (0.79 mg/dl). Total ciliate protozoal counts and cell volume were greater (P = 0.07) in bison (32.8 x 10(4)/g and 407.1 x 10(-4) ml/g, respectively) than in cattle (15.7 x 10(4)/g and 162.2 x 10(-4) ml/g, respectively). Bison harbored higher (P less than 0.02) numbers of Dasytricha spp., Eudiplodinium maggii, Eudiplodinium bursa, and Epidinium spp. than cattle and possessed a type B protozoan population. The cattle possessed a mixed type A-type B population that was characterized by Ophryoscolex spp. and Polyplastron spp. in association with low concentrations of Epidinium spp. and Eudiplodinium maggii. PMID- 3272132 TI - "Nurse abuse"? PMID- 3272133 TI - A collection of 56 topics with contradictory results in case-control research. AB - This research was done to learn more about the frequency and characteristics of conflicting research in case-control studies. In a survey of the epidemiological and medical literature, we found 56 topics in which the results of a case-control study were in conflict with the results from other studies of the same relationship. Cancer was the associated disease for 30 of the controversial topics. We suggest that much of the disagreement may occur because a set of rigorous scientific principles has not yet been accepted to guide the design or interpretation of case-control research. Consequently, the investigator's 'judgement' is the main precaution against scientific hazards and distortions in the validity of evidence. To correct this deficiency, we propose using the principles of an experimental trial to develop the scientific standards for case control research. PMID- 3272134 TI - Physical activity and colon cancer risk. AB - The association between low physical activity and colon cancer was examined in a Swedish 14-year follow-up study of 16,477 subjects. The relative risk (RR) of colon cancer in subjects with low physical activity was estimated at 3.6 (1.3 9.8, 95% confidence interval). An association was observed for both men and women, and for low physical activity during occupational hours (RR = 1.6, 0.8 2.9) as well as during recreational hours (RR = 1.6, 1.0-2.7). The relative risk for rectal cancer was not elevated. In the study we controlled for age, gender, domicile and, to some extent, for diet. A possible mechanism is that low physical activity could prolong the transit time of the stool in the colon and thereby the duration of contact between the mucosa and fecal carcinogens. PMID- 3272135 TI - Radiation-induced leiomyosarcoma of the small intestine. PMID- 3272136 TI - Partial posterior vertebrectomy. PMID- 3272137 TI - New glycopeptide antibiotics: II. The isolation and structures of chloroorienticins. PMID- 3272138 TI - Comparison of the in vitro cytotoxicity of cyclodisone with a series of structurally related analogues. AB - The in vitro cytotoxicity of a series of cyclic and linear sulfonate esters has been tested against the BE and HT-29 human colon carcinoma cell lines. Cyclodisone, a cyclic sulfonate ester, was found to be more toxic to the BE cell line when compared with the HT-29 cell line. In contrast, busulfan, a linear sulfonate ester, was equally toxic to both cell lines. Furthermore, alteration of the cyclodisone structure was found to produce marked differences in its cytotoxicity to these cell lines. These compounds would thus appear an excellent class of structures with which to produce new alkylating anti-cancer agents. PMID- 3272139 TI - Ellagic acid derivatives of Agrostistachys hookeri. PMID- 3272140 TI - Kinetic and analytic investigations on the formation of N-nitroso-N-methyl-N cyclohexylamine from bromhexine and nitrite. AB - Bromhexine (N-methyl-N-cyclohexyl-(2-amino-3,5-dibromobenzyl)-ammoniumhydr ochloride) forms N-nitroso-N-methyl-N-cyclohexylamine (NMCA) under the conditions of the WHO Nitrosation Assay Procedure (NAP-test). The formation kinetics of this compound was investigated. The formation of NMCA depends on the square of the nitrite concentration. The reaction has a narrow pH-optimum at pH 3. The reaction is quick: After 1 h about 70% of the maximum amount of NMCA is formed. To study this reaction kinetics sensitive assays with a detection limit up to 0.5 ng/ml NMCA were developed. The stability of the components of the system, especially that of NMCA and nitrite, were further studied. The latter is rather instable under conditions found in an acidic stomach. PMID- 3272141 TI - Crystal structure and molecular conformation of N-Boc-L-Pro-dehydro-Leu-OCH3. PMID- 3272142 TI - [Stimulation with quaterin of DNA replication and repair]. AB - Quaterine [3-(2,2,3-trimethylhydrasinium)propionate] possessing a wide spectrum of physiological activity has been studied for its effect on the intensity of replicative and reparative DNA synthesis in different rat tissues (liver, thymus, heart, intestine mucosa and spleen) in order to investigate molecular mechanisms of its action. It is shown that the pronounced stimulation of DNA synthesis in all tissues, as a rule, takes place 1-6h after quaterine administration in doses of 25 and 100 mg/kg. The estimation of the given compound effect on DNA synthesis after its multiple administration to animals (for 5, 10, 15 days in a dose of 100 mg/kg) permits supposing that 3-(2,2,2-trimethylhydrasinium)propionate is able of providing either stable proliferation of cells (thymus, spleen) or their hyperplasia and polyploidization (heart, liver). The data obtained make it possible to explain (to some extent) quaterine ability to activate immune responses, to stimulate healing of wounds and burns. PMID- 3272143 TI - The design, synthesis and antileukemic activity of 5-alkynyl-1-beta-D ribofuranosylimidazole-4-carboxamides. PMID- 3272144 TI - [Standardization of a form for analysis of antibiotic use and/or occurrence of hospital infection]. AB - In this study, a new report form was used in order to obtain information about the employment of antibiotics and/or the occurrence of infections at the Clinical Hospital of Federal University of Uberlandia. The authors show the results and analyze the variables related to the complete or incomplete accomplishment in using this form of report as a reliable data acquisition system, as well as suggest improvements to the methodology of collecting data when antibiotics and hospital infections are concerned. PMID- 3272145 TI - Application of the molecular replacement method to multidomain proteins. 1. Determination of the orientation of an immunoglobulin Fab fragment. AB - Multidomain proteins provide special problems in the application of the molecular replacement method of structure determination. The structure of the Fab fragment from the autoimmune poly(dT)-specific antibody HED10 has been determined using molecular replacement. An analysis of the effects of varying the model and the parameters used in the rotation function indicates that dividing the molecule into individual relatively rigid domains simplifies interpretation of the results, and that the optimal parameters depend on the molecule under study. PMID- 3272146 TI - Restrained refinement of two crystalline forms of yeast aspartic acid and phenylalanine transfer RNA crystals. AB - Four transfer RNA crystals, the monoclinic and orthorhombic forms of yeast tRNA(Phe) as well as forms A and B of yeast tRNA(Asp), have been submitted to the same restrained least-squares refinement program and refined to an R factor well below 20% for about 4500 reflections between 10 and 3 A. In yeast tRNA(Asp) crystals the molecules exist as dimers with base pairings of the anticodon (AC) triplets and labilization of the tertiary interaction between one invariant guanine of the dihydrouridine (D) loop and the invariant cytosine of the thymine (T) loop (G19-C56). In yeast tRNA(Phe) crystals, the molecules exist as monomers with only weak intermolecular packing contacts between symmetry-related molecules. Despite this, the tertiary folds of the L-shaped tRNA structures are identical when allowance is made for base sequence changes between tRNA(Phe) and tRNA(Asp). However, the relative mobilities of two regions are inverse in the two structures with the AC loop more mobile than the D loop in tRNA(Phe) and the D loop more mobile than the AC loop in tRNA(Asp). In addition, the T loop becomes mobile in tRNA(Asp). The present refinements were performed to exclude packing effects or refinement bias as possible sources of such differential dynamic behavior. It is concluded that the transfer of flexibility from the anticodon to the D- and T-loop region in tRNA(Asp) is not a crystal-line artefact. Further, analysis of the four structures supports a mechanism for the flexibility transfer through base stacking in the AC loop and concomitant variations in twist angles between base pairs of the anticodon helix which propagate up to the D- and T-loop region. PMID- 3272147 TI - Simple statistics for intensity data from twinned specimens. AB - The statistics of intensity data from hemihedrally twinned specimens are analyzed in terms of a new parameter and are shown to take a simple form in both the centrosymmetric and non-centrosymmetric cases. This analysis provides a sensitive method for determining the twinning fraction. The effects of intensity measurement errors on the observed statistics are discussed. PMID- 3272149 TI - Analysis of solvent structure and hydrogen exchange in proteins on the basis of neutron diffraction data from deuterated and hydrogenous crystals. AB - A method has been developed to determine the structure of bound solvent and the positions of exchanged hydrogens in proteins, on the basis of neutron diffraction from hydrogenous and deuterated crystals. In this method phases for the hydrogenous and for the deuterated model are refined simultaneously, and an average model is imposed in the volume occupied by non-hydrogen atoms. The densities in the areas of bulk solvent are replaced by their average values, while no modifications are performed in the vicinity of ordered solvents and potentially exchangeable hydrogens. The method was tested on 1.8 A neutron diffraction data collected from two crystals of bovine pancreatic trypsin inhibitor, one of them deuterated and the other hydrogenous. Significant improvement was observed for the densities corresponding to many partially occupied solvent sites, as well as to partially exchanged hydrogens. The algorithm presented here has been compared with a different approach published recently by Shpungin & Kossiakoff [Methods Enzymol.(1986), 127, 329-342]. PMID- 3272148 TI - Application of the molecular replacement method to multidomain proteins. 2. Comparison of various methods for positioning an oriented fragment in the unit cell. AB - The capabilities of several different methods to determine the correct translation of a model for the application of the molecular replacement method of structure determination to multidomain proteins have been analyzed. The structure of the Fab fragment of the autoimmune anti-poly(dT)-specific antibody HED10 was determined using molecular replacement and provides an example for comparing different methods of determining the correct translation of the model and for evaluating the importance of the parameters used. Expansion to space group P1 and phasing with a correctly oriented randomly positioned model was found to be superior to either the Crowther-Blow translation function [Crowther & Blow (1967). Acta Cryst. 23, 544-548] or a brute-force search when only a small part of the molecule was used as a model. PMID- 3272150 TI - The Gram-Charlier and multipole expansions in accurate X-ray diffraction studies: can they be distinguished? AB - The Gram-Charlier temperature factor formalism has been applied to a set of accurate low-temperature data on bis(pyridine)(meso tetraphenylporphinato)iron(II), and to a theoretical set of static structure factors on the hexaaquairon(II) ion. The refinements are compared with the multipole treatment for atomic asphericity due to chemical bonding. In a treatment of the experimental data in which only the iron atom asphericity is considered, the 'thermal motion' formalism is as efficient as the multipole formalism in accounting for the observations. It is slightly less efficient when applied to the static theoretical data, though model maps based on the two treatments are remarkably similar. A high-order Gram-Charlier refinement of the porphyrin data, followed by a multipole refinement of all data with the Gram Charlier parameters initially fixed, and later varied, shows that simultaneous refinement of anharmonic and aspherical effects is possible, though the resulting separation may not be accurate. A combined Gram-Charlier multipole refinement on the static data, however, leads to non-significant thermal parameters. It is concluded that the statistical Gram-Charlier formalism is remarkably successful in representing bonding effects in the valence charge density if these are not specifically accounted for in the scattering formalism. Statistical anharmonic thermal motion formalisms should only be used for X-ray data analysis in combination with a formalism accounting for the effect of bonding on the atomic charge density. PMID- 3272151 TI - Refinement at 1.4 A resolution of a model of erabutoxin b: treatment of ordered solvent and discrete disorder. AB - The latter stages in the refinement of the protein erabutoxin b are described. The crystal structure of the 62-residue protein has been refined to a conventional R factor of 0.144 by stereochemically restrained least-squares methods using diffraction data to a limit of 1.4 A spacings. Emphasis was placed on determining as accurately as possible the solvent structure and the structures of heterogeneous groups in the protein. The final model includes two conformers for each of seven side chains and for an octapeptide segment. A total of 111 sites for water molecules have been located as well as one sulfate ion with a total of 68 site occupancies. 65 of the solvent sites overlap either with protein atoms belonging to groups in two alternative conformations or with other solvent sites. Dual protein conformers and overlapping solvent sites were both included in the least-squares refinement. Individual thermal and occupancy parameters were refined for solvent molecules. An analysis of these parameters has provided useful structural information. PMID- 3272152 TI - Microtubule formation from maternal tubulins during sea urchin embryogenesis: measurement of soluble and insoluble tubulin pools. AB - The mass of tubulin protein in developing embryos of the sea urchin Lytechinus pictus was measured using a radiodilution immunoassay based on densitometric analysis of immunoprecipitated tubulins resolved electrophoretically. The tubulins constitute an average of 360 +/- 35 pg per egg, or 0.66% of the total protein, and there is no significant change in their concentration during embryogenesis. The masses of soluble and polymerized tubulin were measured for extracts prepared under conditions that stabilize microtubules. In eggs, a maximum of 14% of the tubulin is insoluble, and this increases throughout embryogenesis to 67% at pluteus stage (72 hr). The concentration of tubulin in eggs is at least 500 micrograms/ml, well above the critical concentration for tubulin assembly in vitro, yet microtubules have not been observed in eggs. The mass of newly synthesized tubulin, estimated from the mass of tubulin mRNA per embryo, accounts for a small fraction of the total tubulin by the end of gastrulation but for over half of the tubulin by the 72-hr pluteus stage. These observations are consistent with a model in which the declining level of unpolymerized tubulin controls the stability of tubulin mRNa, providing an autogenous regulation of the ontogenetic pattern of tubulin synthesis during sea urchin embryogenesis (Gong and Brandhorst, Development 102: 31-43). PMID- 3272153 TI - Cellular determination in the Xenopus retina is independent of lineage and birth date. AB - Xenopus embryos injected with tritiated thymidine throughout the stages of embryonic retinal neurogenesis showed that more than 95% of the embryonic retinal cells are born within a 25 hr period. While there are shallow central to peripheral, dorsal to ventral, and interlaminar gradients of neurogenesis in these eyes, throughout most of this 25 hr period, postmitotic cells are being added to all sectors and layers. Small clones of differentiated retinal neurons and glia derived from single neuroepithelial cells injected with HRP. These clones were elongated radially. They were also composed of many different combinations of cell types, suggesting a mechanism whereby determination is arbitrarily and independently assigned to postmitotic cells. Such a model, when tested statistically, fits our data very well. We present a scheme for cellular determination in the Xenopus retina in which a coherent group of clonally related cells stretch out radially as lamination begins. This brings different cells into different microenvironments. Local interactions in these microenvironments then lead the cells toward specific fates. PMID- 3272154 TI - Primary structure and expression of beta 2: a novel subunit of neuronal nicotinic acetylcholine receptors. AB - A new subunit, beta 2, of the neuronal nicotinic receptor family has been identified. This subunit has the structural features of a non-agonist-binding subunit. We provide evidence that beta 2 can substitute for the muscle beta 1 subunit to form a functional nicotinic receptor in Xenopus oocytes. Expression studies performed in oocytes have demonstrated that three different neuronal nicotinic acetylcholine receptors can be formed by the pairwise injection of beta 2 mRNA and each of the neuronal alpha subunit mRNAs. The beta 2 gene is expressed in PC12 cells and in areas of the central nervous system where the alpha 2, alpha 3, and alpha 4 genes are expressed. These results lead us to propose that the nervous system expresses diverse forms of neuronal nicotinic acetylcholine receptors by combining beta 2 subunits with different agonist-binding alpha subunits. PMID- 3272155 TI - Isolation and characterization of a Drosophila neuropeptide gene. AB - We have purified a 9 amino acid amidated neuropeptide, DPKQDFMRFamide, from whole adult D. melanogaster. This peptide exhibits sequence homology to the molluscan bioactive tetrapeptide FMRFamide and is a novel member of the FMRFamide peptide family. The gene encoding DPKQDFMRFamide has been cloned and characterized. It is present in a single copy per haploid genome, is expressed as a unique 1.7 kb mRNA species, and cytologically maps to 46C on the right arm of chromosome 2. Characterization of a cDNA clone indicates that the precursor protein is 347 amino acids in length and contains 5 copies of DPKQDFMRFamide, as well as 10 additional amidated peptides exhibiting varying degrees of structural relatedness. The Drosophila DPKQDFMRFamide gene and the Aplysia FMRFamide gene are ancestrally related; however, peptides display a higher degree of homology within a species than between species, suggesting intragenic concerted evolution of these neuropeptides. PMID- 3272156 TI - Antibody against myelin-associated inhibitor of neurite growth neutralizes nonpermissive substrate properties of CNS white matter. AB - CNS white matter from higher vertebrates and cultured differentiated oligodendrocytes are nonpermissive substrates for neurite growth and fibroblast spreading. Membrane proteins of 35 kd and 250 kd with highly nonpermissive substrate properties could be extracted from CNS myelin fractions. Monoclonal antibodies were raised against these proteins: IN-1 and IN-2 bound both to the 35 kd and 250 kd inhibitors and to the surface to differentiated cultured oligodendrocytes. Adsorption of nonpermissive CNS myelin or nonpermissive oligodendrocytes with either antibody markedly improved their substrate properties. Optic nerve explants injected with IN-1 or IN-2 allowed axon ingrowth of cocultured sensory and sympathetic neurons. We conclude that the nonpermissive substrate properties of CNS white matter are due to these membrane proteins on the surface of differentiated oligodendrocytes and to their in vivo product, myelin. PMID- 3272157 TI - Cortical axons branch to multiple subcortical targets by interstitial axon budding: implications for target recognition and "waiting periods". AB - We are studying how axons branch in vivo. Individual cortical neurons send axons to both the spinal cord and the basilar pons. Here we show that the corticopontine projection develops by an interstitial budding of collaterals from parent axons rather than a reported mechanism of axon branching, growth cone bifurcation. This mechanism is used regardless of whether the parent axon's postpontine segment, which forms the corticospinal projection, is permanent (motor cortex) or transient (visual cortex). Budding occurs days after the parent axons grow spinally past the pons, accounting for the "waiting period" reported in this system in contrast to an alternative explanation that the growth cones pause outside of their target. Timing and location of pontine collateral budding vary with cortical origin of the parent axon and are correlated with the temporal ordering of axon arrival. PMID- 3272158 TI - Modulation of the pattern of axonal projections of a leech motor neuron by ablation or transplantation of its target. AB - The sixth segmental ganglion in the ventral nerve cord of the leech H. medicinalis contains a bilateral pair of rostral penile evertor motor neurons (RPEs) that in the adult innervate the male genitalia. During embryogenesis, the RPEs extend numerous extraganglionic projections. Only two of these innervate the target and are normally retained in the adult, while the others retract. Early, but not late, removal of the male genitalia results in the indefinite retention and continued growth of projections that would normally retract. Any of these projections can innervate targets transplanted to ectopic locations. We conclude that an RPE motor neuron requires a signal, provided by its interaction with the target organ during a critical period, in order to stop extending axons, stabilize those axons that contact the target, and retract those that do not. PMID- 3272159 TI - Nerve growth factor (NGF) regulates adult rat cultured dorsal root ganglion neuron responses to the excitotoxin capsaicin. AB - An overlap between subpopulations of nerve growth factor (NGF)-responsive and capsaicin-sensitive dorsal root ganglion (DRG) sensory neurons has been suggested from a number of in vivo studies. To examine this apparent link in more detail, we compared the effects of capsaicin on adult rat DRG neurons cultured in the presence or absence of NGF. Capsaicin sensitivity was assessed histochemically by a cobalt staining method, by measuring capsaicin-induced 45Ca2+ uptake, and by electrophysiological recording of capsaicin-evoked membrane currents. When cultured with NGF, approximately 50% of these adult DRG neurons were capsaicin sensitive, whereas adult sympathetic neurons or ganglionic nonneuronal cells were insensitive. DRG cultures grown in the absence of NGF, however, were essentially unresponsive to capsaicin. Capsaicin sensitivity could be regained fully within 4 6 days of replacement of NGF. These results indicate that, at least in vitro, NGF can modify the capsaicin sensitivity of adult DRG neurons. PMID- 3272160 TI - Spatial regulation of axonal glycoprotein expression on subsets of embryonic spinal neurons. AB - The identification of surface proteins restricted to subsets of embryonic axons and growth cones may provide information on the mechanisms underlying axon fasciculation and pathway selection in the vertebrate nervous system. We describe here the characterization of a 135 kd cell surface glycoprotein, TAG-1, that is expressed transiently on subsets of embryonic spinal cord axons and growth cones. TAG-1 is immunochemically distinct from the cell adhesion molecules N-CAM and L1 (NILE) and is expressed on commissural and motor neurons over the period of initial axon extension. Moreover, TAG-1 and L1 appear to be segregated on different segments of the same embryonic spinal axons. These observations provide evidence that axonal guidance and pathway selection in vertebrates may be regulated in part by the transient and selective expression of distinct surface glycoproteins on subsets of developing neurons. PMID- 3272161 TI - Immunological evidence for a change in subunits of the acetylcholine receptor in developing and denervated rat muscle. AB - We used specific antibodies to gamma, delta, and epsilon subunits to characterize acetylcholine receptor (AChR) in extracts and at endplates of developing, adult, and denervated rat muscle. The AChRs in normal adult muscle were immunoprecipitated by anti-epsilon and anti-delta, but not by anti-gamma antibodies, whereas AChRs in denervated and embryonic muscles were precipitated by anti-gamma and anti-delta, but showed little or no reactivity to anti-epsilon antibodies. In immunofluorescence experiments, AChRs at neonatal endplates bound antibodies to gamma or delta, but not epsilon, subunit, whereas those in adult muscles bound antibodies to epsilon or delta, but not gamma, subunit. AChRs at denervated endplates and at developing endplates between postnatal days 9 and 16 bound all three antibodies. We conclude that the distribution of gamma and epsilon subunits of the AChR parallels the distribution of AChRs with embryonic and adult channel properties, respectively. PMID- 3272162 TI - Human GAP-43: its deduced amino acid sequence and chromosomal localization in mouse and human. AB - The growth-associated protein (GAP-43) is considered a crucial component of an effective regenerative response in the nervous system. Its phosphorylation by protein kinase C correlates with long-term potentiation. Sequence analysis of human cDNAs coding for this protein shows that the human GAP-43 gene is highly homologous to the rat gene; this homology extends into the 3'-untranslated region. However, the human protein contains a 10 amino acid insert. Somatic cell hybrids demonstrate localization of the GAP-43 gene to human chromosome 3 and to mouse chromosome 16. PMID- 3272163 TI - Cloning of human GAP-43: growth association and ischemic resurgence. AB - GAP-43 is a growth cone protein expressed in neurons especially during periods of axonal elongation. Poor repair in the adult mammalian CNS has been ascribed to restraints upon its expression. We have cloned human GAP-43 cDNA to investigate its potential involvement in neurological illness. Analysis of postmortem human brain tissue disclosed uniformly high expression of GAP-43 throughout the neonatal brain, whereas in the adult brain high levels of GAP-43 persist only in discrete regions. However, in the wake of ischemic injury in the adult brain, regions normally low in GAP-43 reexpress it at high levels, suggesting a role for GAP-43 in remodeling and repair of mature CNS neurons. PMID- 3272164 TI - Neuronal influence on glial enzyme expression: evidence from chimeric mouse cerebellum. AB - Cerebella, variably deficient in Purkinje cells, were obtained from aggregation chimeras of either Lurcher or Purkinje cell degeneration mutants. These cerebella were used to analyze the expression of glycerol-3-phosphate dehydrogenase (GPDH) in Bergmann glia. Immunocytochemistry showed apparently normal GPDH expression only in Bergmann glia in the immediate vicinity of surviving Purkinje cells. The number of GPDH-positive Bergmann glia cells associated with isolated Purkinje cells was close to that expected, based on measurements in Golgi-stained, normal cerebella of the Bergmann glia cell's domain. The results support the hypothesis that GPDH expression in Bergmann glia cells depends upon their sustained interaction with Purkinje cells, most likely involving direct cell-cell contact. PMID- 3272165 TI - A thermodynamic analysis of monovalent cation permeation through a K(+)-selective ion channel. AB - Ionic selectivity characteristics of the K+ channel from the sarcoplasmic reticulum were studied as a function of temperature in order to decompose the profile of Gibbs free energy along the conduction pore into its enthalpic and entropic components. For Li+, Na+, K+, and Rb+, the enthalpy of binding to the channel is close to zero. Activation enthalpies for transferring ions from bulk aqueous solution to the channel's selectivity region are 20-25 kJ/mol for Na+, K+, and Rb+ and substantially higher for Li+ and Cs+. Transfer of Li+ and Na+ to the selectivity region involved large favorable entropies. The results argue that the group IA cations shed about half their waters of hydration in permeating the selectivity region of this channel. PMID- 3272166 TI - The acetylcholinesterase genes of C. elegans: identification of a third gene (ace 3) and mosaic mapping of a synthetic lethal phenotype. AB - In C. elegans, the newly identified ace-3 is the third gene affecting acetylcholinesterase (AChE) activity. ace-3 II specifically affects class C AChE and is unlinked to ace-1 X or ace-2 I, which affect the other two AChE classes (A and B, respectively). Strains homozygous for an ace-3 mutation have no apparent behavioral or developmental defect; ace-1 ace-3 and ace-2 ace-3 double mutants are also nearly wild type. In contrast, ace-1 ace-2 ace-3 triple mutant animals are paralyzed and developmentally arrested; their embryonic development is relatively unimpaired, but they are unable to grow beyond the hatching stage. Based on the analysis of genetic mosaics, we conclude that in the absence of ace 2 and ace-3 function, the expression of ace-1(+) in muscle cells, but not in neurons, is essential for postembryonic viability. PMID- 3272168 TI - A surface protein expressed by avian myelinating and nonmyelinating Schwann cells but not by satellite or enteric glial cells. AB - Searching for specific markers of neural crest-derived cell lineages, we immunized mice with glycoproteins purified from adult quail peripheral myelin. We obtained a monoclonal antibody that reacts with myelin and peripheral glial cells. This antibody, to Schwann cell myelin protein (SMP), is specific for the membranes of all Schwann cells, irrespective of whether they are associated with myelinated nerves. SMP persists on Schwann cells in long-term cultures in vitro, but is absent from satellite cells of peripheral ganglia, both in vivo and in vitro. The antigen (a protein doublet of Mr 75,000-80,000) is present in, but not restricted to, the myelin lamellae, since it is distributed along the whole myelinating Schwann cell membrane. In the CNS, SMP appears as a single band of Mr 80,000. SMP is first detectable by immunofluorescence at E6 in the quail, which is at least 6 days earlier than the first appearance of already described markers related to myelination. PMID- 3272169 TI - Membrane currents of rat satellite cells attached to intact skeletal muscle fibers. AB - Muscle satellite cells play an important role in the postnatal growth of skeletal muscle and in the regeneration of damaged muscle during adult life. Little is known about the physiological properties of satellite cells in their dormant state as they lie adjacent to the intact muscle fibers, underneath the basement membrane. Our recent experiments, using patch clamp techniques, indicate that no tight electrical coupling is present between satellite cells and the muscle fiber dissociated from rat flexor digitorum brevis. Satellite cells possess sodium channels with low sensitivity to tetrodotoxin and at a much lower density than muscle. In addition, satellite cells are insensitive to acetylcholine (ACh) for at least 24 hr after having been removed from the animal, even when detached from their muscle fiber. However, we could measure ACh-evoked currents from satellite cells 48-72 hr in culture, indicating that ACh sensitivity develops with time. PMID- 3272167 TI - Nerve growth factor induces a gene homologous to the glucocorticoid receptor gene. AB - Nerve growth factor (NGF) is required for the development and survival of sympathetic and neural crest-derived sensory neurons. The mechanism of action of NGF has been extensively studied in the NGF-responsive rat pheochromocytoma cell line, PC12. When treated with NGF, PC12 cells initiate neurite outgrowth and differentiate into cells with a neuronal phenotype. This process is prevented by RNA synthesis inhibitors. NGFI-B is a gene, identified by differential hybridization, that is rapidly, but transiently induced in PC12 cells by NGF. The nucleotide sequence of the NGFI-B gene was determined, and it encodes a 61 kd protein with strong homologies to members of the glucocorticoid receptor gene family. The two regions of homology between NGFI-B and this family of ligand dependent transcriptional activators are the region corresponding to the DNA binding domain and the region comprising the ligand-binding domain near the COOH terminus. NGFI-B, as a possible ligand-dependent transcriptional activator induced by NGF, may play a role in initiating NGF-induced differentiation. PMID- 3272171 TI - Probes for rare mRNAs reveal distributed cell subsets in canary brain. AB - cDNA clones of 7 low-abundance canary brain RNAs hybridize in situ to different subsets of brain cells. Although these cell sets are distinct, they are dispersed in a variety of brain regions with overlapping anatomical distributions. These cDNA clones were initially selected by their relative hybridization to forebrain and rest-of-brain RNAs and represent a sampling of a much larger population of differentially expressed RNAs present at individual concentrations of 10(-7) to 10(-4) as a fraction of polyadenylated RNA mass. Our results suggest the existence of several thousand low-abundance brain mRNAs likely to be distributed in diverse and overlapping brain cell subsets. Furthermore, our experiments define a simple and general strategy for producing and analyzing molecular probes for subsets of brain cells and provide an initial set of useful reagents for further study of brain organization and development. PMID- 3272170 TI - cDNA clones coding for the structural subunit of a chicken brain nicotinic acetylcholine receptor. AB - Nicotinic acetylcholine receptors (AChRs) immunoaffinity-purified from brains are composed of only two kinds of subunits rather than the four kinds present in muscle-type AChRs. Here we report the N-terminal protein sequences of the structural subunits of AChRs from rat and chicken brains and the cloning of full length cDNAs for the chicken brain AChR structural subunit. Previously, the N terminal amino acid sequence of the ACh-binding subunit of AChR immunoaffinity purified from rat brain was shown to correspond to the cDNA alpha 4. Thus, cDNA sequences are now known for both of the subunits that form one AChR subtype in vivo. PMID- 3272172 TI - Interactive effects of serotonin and acetylcholine on neurite elongation. AB - Serotonin (5-HT) inhibits elongation of neurites of specific identified neurons. Here we report a novel, growth-enabling action of another neurotransmitter, acetylcholine (ACh). When applied simultaneously with serotonin, ACh prevents the inhibition of Helisoma neuron B19 neurite elongation that would occur in response to application of 5-HT alone. We also report that ACh prevents the rise in growth cone Ca2+ that would occur in response to application of 5-HT alone and that ACh blocks the electrical excitatory effect of 5-HT on neuron B19. These results support the hypothesis that growth cone motility and neurite elongation can be regulated by voltage-gated Ca2+ fluxes and suggest that the dynamics of neurite morphology may be complexly regulated by an array of neurotransmitters, as is functional electrical activity. PMID- 3272173 TI - A type III intermediate filament gene is expressed in mature neurons. AB - A cDNA (199E) specific for the 57 kd neural IF protein has been isolated from a PC12 cell lambda gt11 library. Antibody eluted from the fusion protein produced by 199E recognizes the 57 kd protein on immunoblots and, in PC12 cells, labels a pattern of fibrillar structures identical to that seen with 57 kd antiserum. In situ hybridization using antisense RNA transcripts labels areas of the nervous system known to contain the 57 kd protein. 199E hybridizes with a single mRNA species of approximately 2.0 kb from PC12 cells. A 199E-reactive message can be detected as early as E10 in rat embryos. Southern analyses suggest that there is only one gene for this protein. Amino acid sequence predicted from 199E indicates that the 57 kd protein is a type III IF protein like vimentin and desmin. Thus, expression of IF structural genes in neurons is not limited to the type IV neuronal IF triplet proteins. PMID- 3272174 TI - Cloning and expression of the human and rat m5 muscarinic acetylcholine receptor genes. AB - The human and rat genes for a fifth muscarinic receptor have been cloned and expressed in mammalian cells. The 532 amino acid human protein has 89% sequence identity to the 531 amino acid rat protein and is most closely related to the m3 receptor. Both proteins are encoded by single exons. The receptor has intermediate affinity for pirenzepine and low affinity for AF-DX 116, and it increases metabolism of phosphatidylinositol when stimulated with carbachol. Expression of mRNA has yet to be observed in brain or selected peripheral tissues, suggesting that either it is substantially less abundant than m1-m4 or its distribution is quite different. PMID- 3272175 TI - Multiple products of the Drosophila Shaker gene may contribute to potassium channel diversity. AB - K+ channels are known through electrophysiology and pharmacology to be an exceptionally diverse group of channels. Molecular studies of the Shaker (Sh) locus in Drosophila have provided the first glimpse of K+ channel structure. The sequences of several Sh cDNA clones have been reported; none are identical. We have isolated and examined 18 additional Sh cDNAs in an attempt to understand the origin, extent, and significance of the variability. The diversity is extensive: we have already identified cDNAs representing at least nine distinct types, and Sh could potentially encode 24 or more products. This diversity, however, fits a simple pattern in which variable 3' and 5' ends are spliced onto a central constant region to yield different cDNA types. These different Sh cDNAs encode proteins with distinct structural features. PMID- 3272176 TI - The NGF-inducible SCG10 mRNA encodes a novel membrane-bound protein present in growth cones and abundant in developing neurons. AB - We have characterized and sequenced cDNA clones corresponding to the neural specific SCG10 mRNA. The predicted amino acid sequence is novel and not strongly homologous to that of any known polypeptide. The protein is encoded by two mRNAs that differ in their choice of polyadenylation site. Immunocytochemical localization experiments using an affinity-purified antibody (against an SCG10 TrpE fusion protein) reveal accumulations of punctate staining in the perinuclear cytoplasm, axons, and growth cones of cultured neurons. SCG10 levels are maximal in the embryonic CNS but are dramatically reduced in the adult. Preliminary cell fractionation experiments suggest that the protein is tightly associated with membranes but is not itself an integral membrane protein. The apparent localization and timing of expression of the SCG10 protein are reminiscent of GAP 43, but the sequences of the two polypeptides are unrelated. Cross-hybridizing mRNAs and antigenically related proteins are found in several nonneuronal cell lines that do not express SCG10. PMID- 3272177 TI - Expression and regulation of neuronal acetylcholine receptor mRNA in chick ciliary ganglia. AB - A chicken genomic clone encoding a portion of the neuronal acetylcholine receptor (AChR) alpha 3 subunit was used to identify homologous mRNA in embryonic chick ciliary ganglia. In situ hybridization indicated that the mRNA was neuronal. Northern blot analysis revealed a major hybridizing species of 3.5 kb. Protection experiments confirmed that ganglionic RNA contained material indistinguishable by RNAase digestion from the 300 nucleotide probe used. No transcripts were detected by in situ hybridization or Northern blot analysis for chick neuronal AChR alpha 2 or alpha 4 genes. alpha 3 transcripts were present at all times examined (E6 to 1 year posthatch). Both postganglionic axotomy and preganglionic denervation of ciliary ganglia in newly hatched chicks produced declines in alpha 3 mRNA levels, implying regulation of neuronal AChR mRNA by cell-cell interactions. PMID- 3272179 TI - A cell type-specific enhancer drives expression of the chick muscle acetylcholine receptor alpha-subunit gene. AB - The regulation of acetylcholine receptor alpha-subunit gene expression was analyzed by transient expression assays. Using rabbit beta-globin cDNA as a reporter gene, we have confirmed that the 5'-flanking sequence of the chicken acetylcholine receptor alpha-subunit gene directs specific expression in differentiated C2C12 cells, a mouse muscle cell line, but not in undifferentiated C2C12 cells and mouse 3T3 fibroblasts. Testing chimeric plasmids containing Bal31 deletion mutants of the alpha-subunit gene upstream sequence, we found the -116 to -81 region of the alpha-subunit to be responsible for tissue- and stage specific expression. This 36 bp fragment stimulates the activity of both alpha subunit and SV40 promoters in a distance- and orientation-independent manner, thus fulfilling the criteria of an enhancer. PMID- 3272178 TI - Basic FGF induces neuronal differentiation, cell division, and NGF dependence in chromaffin cells: a sequence of events in sympathetic development. AB - To define further the molecules that control sympathoadrenal differentiation, we have investigated the effects of FGF, NGF, and glucocorticoid on cultured neonatal rat adrenal chromaffin cells. Basic FGF (bFGF), like NGF, induces cell division and neurite outgrowth from these cells. Dexamethasone inhibits neuronal differentiation but not proliferation induced by bFGF. Unlike NGF, bFGF will not support the survival of chromaffin cell-derived sympathetic neurons. However, bFGF induces a dependence on NGF. The overlapping but distinct responses to NGF and bFGF may underlie a sequence of events in sympathetic differentiation. bFGF (or another factor) may act locally in developing ganglia to stimulate mitotic expansion and initial axon outgrowth. Subsequent survival and maturation are then controlled by NGF, which is provided by peripheral targets of innervation. In the adrenal gland, glucocorticoids may permit bFGF to amplify the chromaffin population, while preventing neuronal differentiation. PMID- 3272180 TI - A subpopulation of cultured avian neural crest cells has transient neurogenic potential. AB - Neural crest cells of vertebrate embryos produce neurons, glia, pigment cells, and connective tissue in vivo and in vitro. To test the developmental potential of apparently undifferentiated crest cells, we have used the monoclonal antibody A2B5, which recognizes a cell surface glycolipid characteristic of neurons, to identify and immunoablate a subpopulation of cultured avian neural crest cells with a neuronal phenotype. Our results indicate that a limited neurogenic precursor subpopulation is present in cultures of avian neural crest cells and that the fate of this subpopulation can be influenced by environmental conditions arising when dispersal of neural crest cells is delayed. PMID- 3272181 TI - 5-HT3 receptors mediate rapid responses in cultured hippocampus and a clonal cell line. AB - Serotonin (5-HT) induces a large inward current accompanied by a conductance increase when applied focally to either neurons of mouse hippocampal cultures or cells of the NG108-15 clonal cell line. In both systems, the response is blocked by ICS 205-930, curare, and metoclopramide, while 2-methyl-5-HT is an agonist. The actions of ICS 205-930 and 2-methyl-5-HT indicate that the response is mediated by the 5-HT3 receptor. In NG108-15 cells the response activated in as little as 35 ms. The rapidity of the response suggests a direct coupling between the 5-HT3 receptor and a channel, which are probably both part of a single membrane protein. In both cell types, prolonged application of 5-HT resulted in desensitization; the rates of desensitization were accelerated by the adenylate cyclase activator forskolin. The 5-HT3 receptor has much in common with the nicotinic receptor and is probably involved in rapid synaptic transmission in the mammalian brain. Since this response is modulated by manipulations that elevate intracellular cAMP levels, the central synapses in which this receptor operates may exhibit plasticity. PMID- 3272182 TI - Cell lineage in the cerebral cortex of the mouse studied in vivo and in vitro with a recombinant retrovirus. AB - To analyze cell lineage in the murine cerebral cortex, we infected progenitor cells with a recombinant retrovirus, then used the retroviral gene product to identify the descendants of infected cells. Cortices were infected on E12-E14 either in vivo or following dissociation and culture. In both cases, nearly all clones contained either neurons or glia, but not both. Thus, neuronal and glial lineages appear to diverge early in cortical development. To analyze the distribution of clonally related cells in vivo, clonal boundaries were reconstructed from serial sections. Perinatally (E18-PN0), clonally related cells were radially arrayed as they migrated to the cortical plate. Thus, clonal cohorts traverse a similar radial path. Following migration (PN7-PN23), neuronal clones generally remained radially arrayed, while glial clones were variable in orientation, suggesting that these two cell types accumulate in different ways. Neuronal clones sometimes spanned the full thickness of the cortex. Thus, a single progenitor can contribute neurons to several laminae. PMID- 3272183 TI - At least two mRNA species contribute to the properties of rat brain A-type potassium channels expressed in Xenopus oocytes. AB - Fast transient K+ channels (A channels) of the type operating in the subthreshold region for Na+ action potential generation were expressed in Xenopus oocytes injected with rat brain poly(A) RNA. Sucrose gradient fractionation of the RNA separates mRNAs encoding A-currents (6-7 kb) from mRNAs encoding other voltage dependent K+ channels. A-currents expressed with fractionated mRNA differ in kinetics and pharmacology from A-currents expressed with total mRNA. The original properties of the A-currents can be reconstituted when small mRNAs (2-4 kb) are added to the large mRNA fraction. Thus the properties of the A-currents expressed with total poly(A) RNA depend on the presence of more than one mRNA species. mRNA(s) present in the large RNA fraction must encode channel subunits since they express an A-current by themselves. The small mRNA(s) may encode a second subunit(s) or a factor, such as an enzymatic activity that modulates the properties of the channels, which could play a role in generating A-channel functional diversity. PMID- 3272184 TI - Four cDNA clones from the Shaker locus of Drosophila induce kinetically distinct A-type potassium currents in Xenopus oocytes. AB - The Shaker gene encodes the A-channel of larval and pupal muscle, or one or more of its subunits. Alternative splicing produces messages for several different proteins; two mRNA species have previously been shown to induce the expression of A-currents in Xenopus oocytes. Two additional mRNAs have now been tested and found to produce A-currents in oocytes. The four currents differ in kinetics of inactivation, indicating that the Shaker products may contribute to kinetic diversity in A-channels of the fly and that sequences in both the amino- and carboxy-terminal regions are important for inactivation. PMID- 3272185 TI - Activity-dependent regulation of GABA expression in the visual cortex of adult monkeys. AB - Levels of the inhibitory transmitter, GABA, and its synthesizing enzyme, GAD, appear to be regulated in the visual cortex of young adult monkeys in an activity dependent manner. In monkeys subjected to monocular deprivation by eye removal, tetrodotoxin injection, or eyelide suture, the number of GABA and GAD immunoreactive neurons in deprived-eye columns of the cortex is reduced by up to 50%. This effect is unaccompanied by cell death and is reversible. After cessation of TTX injection or reopening of the eyes, the number of immunostained cells returns to normal. The effect appears after 4-5 days of eye removal or tetrodotoxin injection, but only after 7-16 weeks of eyelid suture. In the latter case, it is more severe in the younger monkeys. The reversible reduction in GABA and GAD immunostaining extends out of layer IVC into lay IVA and to neurons around but not in cytochrome oxidase periodicities of layer III. This may indicate selective vulnerability of GABA cells sensitive to high spatial frequency. PMID- 3272186 TI - Changes in densities and kinetics of delayed rectifier potassium channels during neuronal differentiation. AB - Single-channel K+ currents were recorded from young and mature spinal neurons cultured from Xenopus embryos to examine the bases of the developmental increases in density and in rate of activation of the macroscopic voltage-dependent delayed rectifier K+ current (IKv). K+ channels of three conductance classes (integral of 80, 30, and 15 pS) are present at both ages, but only the intermediate and small conductance classes are voltage-dependent and thus underlie IKv. The increase in the density of IKv is due to increases in the numbers of intermediate and small channels per cell, but not to changes in their open probabilities. The increase in rate of activation of IKv results from a change in the activation kinetics of the intermediate channel class alone. PMID- 3272187 TI - Growth and synapse formation among major classes of adult salamander retinal neurons in vitro. AB - Adult neurons, isolated from the salamander retina, were maintained in low density cell culture and examined for synapse formation by electrophysiological and electron microscopic techniques. Morphologically identifiable rod, cone, horizontal, bipolar, and amacrine/ganglion cells survived for many months, grew processes, and formed numerous cell contacts. Intracellular recordings showed the presence of a variety of voltage- and time-dependent conductances and both electrical and chemical transmission among these cells. At the ultrastructural level, gap junctions, monad ribbon synapses, and conventional synapses, like those present in the intact retina, were observed in sibling cultures. Thus, all major classes of adult retinal neurons, in addition to ganglion cells, are able to regenerate processes and reform synapses. The regenerated synaptic contacts are functional and structurally diverse. PMID- 3272188 TI - Acidic fibroblast growth factor stimulates adrenal chromaffin cells to proliferate and to extend neurites, but is not a long-term survival factor. AB - Acidic fibroblast growth factor (aFGF) is a heparin-binding polypeptide that is a mitogen for endothelial cells and glial cells, as well as a differentiation factor for PC12 cells and certain neurons. We show here that aFGF is as potent as nerve growth factor (NGF) in stimulating both neuritic outgrowth and proliferation in adrenal chromaffin cells from young rats, but it fails to support long-term survival. Heparin strongly potentiates aFGF-dependent neuritic outgrowth but not aFGF-dependent proliferation. As is the case with NGF, phorbol myristate acetate depresses aFGF-induced cell division and increases the outgrowth of neurites. On the other hand, dexamethasone antagonizes neuritic outgrowth elicited by both NGF and aFGF but inhibits only proliferation induced by NGF. The effects of basic FGF (bFGF) are similar but not identical to those of aFGF. Thus the regulatory pathways controlled by aFGF, bFGF, and NGF are partially distinct. PMID- 3272189 TI - The abnormal cerebellar organization of Weaver and reeler mice does not affect the cellular distribution of three neuronal mRNAs. AB - We used in situ hybridization of 35S-labeled antisense RNAs to study the cellular distribution of three neuronal mRNAs. We compared the expression of these RNAs in cerebellar Purkinje neurons in wild-type (C57Bl-6J) mice and in two mutants (Weaver and reeler) known to have abnormal cerebellar morphologies. In normal mice, GAD mRNA is present in four sets of neurons in the cerebellar cortex while calbindin mRNA is present only in Purkinje neurons. Proenkephalin mRNA is present in Golgi II neurons as well as in a set of neurons in the deep part of the molecular layer. Despite the dramatic differences in structural organization and inputs of Purkinje neurons in the cerebella of adult Weaver and reeler mice, the expression of these RNAs appears unchanged. These results support the hypothesis that Purkinje cell cytodifferentiation proceeds autonomously after its inception in early embryonic life. PMID- 3272190 TI - Electrophysiology of a chick neuronal nicotinic acetylcholine receptor expressed in Xenopus oocytes after cDNA injection. AB - Brain nicotinic acetylcholine receptors (nAChRs) are made up of protein subunits that differ from those constituting muscle nAChRs. To characterize the physiological properties of one class of avian brain nicotinic receptor, we injected the nuclei of Xenopus oocytes with full-length cDNAs for the ligand binding (alpha 4) and structural (n alpha) subunits. Injected oocytes had large ACh-induced currents in the microampere range that were insensitive to alpha bungarotoxin, as expected for neuronal nAChRs. We found that these brain nAChRs incorporate at least two alpha 4 subunits and that their functional properties differ from muscle nAChRs in at least two respects: the elementary conductance is considerably smaller (20 pS), and channels in outside out patches stop functioning within a few minutes. PMID- 3272191 TI - Denervation alters the size, number, and distribution of clusters of acetylcholine receptor-like molecules on frog cardiac ganglion neurons. AB - Acetylcholine receptor (AChR)-like molecules are found in clusters on the surface of parasympathetic neurons in the frog cardiac ganglion. Electron microscopy of immunoperoxidase-stained tissue reveals that in normally innervated ganglia most of these clusters are located at synaptic sites. Denervation for 2-3 weeks results in a 64% reduction in the total surface area occupied by AChR-like clusters; this change is brought about by the combined effects of a 4-fold decrease in cluster size and a 30% increase in cluster number. Denervation also changes the distribution of AChR-like clusters: clusters, normally restricted to portions of the cell surface, are more widely distributed following denervation. Denervation of amphibian skeletal muscle for a comparable period of time has no effect on the size or the number of synaptic clusters of AChRs. These results suggest that AChRs in nerve and in muscle are regulated differently by innervation. PMID- 3272192 TI - Light and electron microscopic immunocytochemical demonstration of intraepidermal CGRP-containing nerves in human skin. AB - The distribution of nerves immunoreactive to calcitonin gene-related peptide (CGRP) was studied in human skin with special reference to the intraepidermal nerve fibres. It was shown by light and electron microscopy that a small proportion of the CGRP immunoreactive nerves entered the epidermis. The majority of the nerves ended as free nerve terminals subepidermally. Intraepidermal nerve endings were mainly seen in skin areas, which have a dense sensory innervation, such as fingertips and foreskin. The role of the peptidergic nerves in human skin is discussed. PMID- 3272193 TI - Concentrations of isotretinoin and the arotinoid Ro 15-0778 in plasma and tissues of hamsters and rats. AB - The arotinoid Ro 15-0778 is a potent inhibitor of sebum secretion in rodents but not in humans, while isotretinoin (13-cis-retinoic acid, Accutane) inhibits sebum secretion in rodents and humans. The concentrations of Ro 15-0778 and isotretinoin were determined in plasma and target tissues of castrated, testosterone-stimulated hamsters after oral and topical dosing and in castrated, testosterone-stimulated rats after oral dosing. Comparison of this concentration data to that obtained in the plasma and sebum of humans after dosing with Ro 15 0778 and with isotretinoin did not explain why Ro 15-0778 was a potent inhibitor of sebum production in rodents but not in humans. PMID- 3272194 TI - Ciclosporin A initiates active hair growth in mice. PMID- 3272195 TI - Determinants of late survival of 105 patients operated for dissection of the aorta. AB - In the surgery of aortic dissection, only a small section of aorta compared to the extent of the aortic damage, is usually replaced. The disease is not cured by surgery and needs continuous postoperative surveillance and medical therapy. We report the follow-up of 105 patients who were operated upon between January 1970 and April 1986 and discharged from hospital. Overall actuarial survival was 90% at 5 years, 52% at 10 years and 39% at 15 years. There were 20 deaths, mostly (85%) related to cardiovascular causes. Survival times were correlated, using multivariate methods, with several pre-, peri- and postoperative variables to identify significant risk factors and to calculate actuarial survivals. We found that postoperative low output syndrome (p = 0.007) and stroke (p = 0.04) adversely affected survival and that previous aortic disease or operation (p = 0.004) was associated with an increased rate of dissection-related complications. On the contrary, preoperative hypertension was related to a significantly better survival (p = 0.01) and survival free of dissection-related complications (p = 0.001). When dissection was related to hypertension, adequate postoperative medical treatment neutralized the progression of the aortic damage and its consequences. When dissection was not due to hypertension, the observed survival was unsatisfactory, probably because of a more fragile aorta and inadequate medical follow-up therapy. PMID- 3272196 TI - Bronchogenic carcinoma staging: CT versus MR imaging. Assessment with surgery. AB - One hundred and twenty patients with bronchogenic carcinoma were prospectively studied by both computed tomography (CT) and magnetic resonance imaging (MRI) during the 2 weeks preceding thoracotomy or mediastinoscopy. MRI scans included contiguous axial and coronal slices. Results of CT and MRI studies were compared with the surgical and pathological findings on the basis of the TNM classification. Although no significant difference was found between the two imaging methods for the evaluation of tumour extent, MRI appears to be a valuable imaging technique for left upper lobe and apical neoplasms. Comparison between the two techniques for mediastinal node evaluation showed that sensitivity of MRI is superior to CT in the left paratracheal, aortopulmonary and subcarinal node areas. PMID- 3272197 TI - Combined chemotherapy and surgery for pulmonary metastases from osteogenic sarcoma. Results of 10 years experience. AB - Twenty-three patients presented with isolated pulmonary metastases from osteogenic sarcoma following primary treatment by amputation or limb salvage, combined with chemotherapy. The metastases were treated by conservative surgical excision combined with chemotherapy; surgical excision was repeated for recurrent pulmonary metastases, provided there were none elsewhere. Six patients are alive and disease-free following their initial surgery. Of the remaining 17, 10 had recurrence confined to the lungs, and 7 developed extra-pulmonary metastases. The 10 with isolated pulmonary metastases all had further thoracotomies but eventually 7 died, as did all those with extra-pulmonary metastases. There were in all 45 operations, with 1 hospital death and 1 serious complication. Actuarial survival at 1, 3, 5 and 7 years was 87%, 45%, 39% and 31%, respectively. In the 10 patients who had recurrence of isolated pulmonary metastases, survival at 1 and 3 years was 70% and 34%. PMID- 3272198 TI - Heterologous antigenicity induced in human aortic homografts during preservation. AB - A series of rabbit experiments has been carried out to investigate the potential antigenicity of the heat-treated foetal calf serum which is commonly used to enhance viability of preserved aortic homograft valves. In all presensitised animals, the calf serum content of the nutrient medium which infiltrated the aortic wall during preservation provoked a heavy second-set reaction. It is concluded that heat-treated foetal calf serum is a potent heterologous antigen and should not be used for preserving human tissue selected for transplantation. PMID- 3272199 TI - Management of an infected pseudoaneurysm following an aortoventriculoplasty. AB - An 11-year-old child developed prosthetic valve endocarditis with associated infection of the prosthetic and pericardial patches 6 months following an aortoventriculoplasty. Angiography revealed an associated false aneurysm which communicated with both the ascending aorta and the right ventricular outflow tract. This report discusses the surgical management of this patient. PMID- 3272200 TI - Closure of subarachnoid-pleural fistulae with fibrin sealant. AB - Subarachnoid-pleural fistulae are rare and require closure if conservative therapy has failed. A simple and effective method is described using a pleural graft sealed with fibrin glue. The closure is immediate and long lasting. PMID- 3272201 TI - Intravenous leiomyomatosis: a rare cause of right sided cardiac obstruction. AB - Intravenous leiomyomatosis involving the right side of the heart is an unusual cause of outflow obstruction. Evaluation of the patient should be directed not only at intracardiac chambers but also at the inferior vena cava. This should include angiography and MRI or CAT scanning. Echocardiography is an important contributory investigation. Surgical therapy should be directed at complete removal of the tumor as recurrence has been reported if a less than complete resection has been performed. Hormonal manipulation has been attempted with variable results. PMID- 3272202 TI - Simplified peroperative placement of temporary right atrial pacing leads. AB - A simple technique for securing right atrial pacing leads is described. The method relies on pressure fixation by haemostatic clips. Clinical experience over a 2 year period has demonstrated that this system provides safe, reliable and rapid lead attachment. No problems with lead removal have been encountered. PMID- 3272203 TI - Outcome and risk factors in surgery of descending thoracic aneurysms. AB - In a series of 100 consecutive patients operated upon for aneurysmatic lesions of the descending thoracic aorta, the mean age was 52 +/- 16 years (male = 81, female = 19). There were 31 dissections (acute 10, chronic 21); 28 post-traumatic aneurysms (ruptured 5, acute 7, chronic 16); 22 arteriosclerotic aneurysms (ruptured 1, chronic 21); 11 thoracoabdominal aneurysms, 5 anastomotic aneurysms and 3 mycotic aneurysms. No symptomatic patient was refused. Preoperative risk factors were graded on a scale of 6 by counting 1 point for each of the following elements: central nervous system disease; heart, pulmonary, and renal disease; arterial hypertension, age greater than 60. In-hospital mortality and paraplegia for the whole series were 25% and 7% respectively. In acute dissection, the mortality was 6/10 patients versus 2/21 in chronic events. In post-traumatic aneurysms, mortality was 2/5 in ruptured, 2/7 in acute and 0/16 in chronic events. In arteriosclerotic aneurysms, mortality was 1/2 in ruptured and 6/20 in chronic events. In thoracoabdominal aneurysms, mortality was 5/11, in anastomotic 1/5 and in mycotic 0/3 patients. The mean number of risk factors in non-survivors versus survivors was significantly higher in acute dissection, chronic dissection, chronic arteriosclerotic aneurysms and thoracoabdominal aneurysms. Rupture and acute events are related to a high surgical mortality. Non-survivors appear to have significantly more preoperative risk factors. PMID- 3272204 TI - Coronary ostial stenosis. AB - From January 1970 to December 1986, 2.7% (228/8509) of all patients having coronary artery bypass grafting had atherosclerotic coronary ostial stenosis of 50% or more. There were 126 males (55%) and 102 females (45%) with mean ages of 60.2 +/- 9.0 and 59.2 +/- 10.2 years (P = NS), respectively. The left ostium was involved in 176 (77.2%) patients, the right in 41 (18.0%) and both in 11 (4.8%). Isolated ostial stenosis (no associated coronary disease of 50% or more) was present in 38/228 (17%) with females predominating (29/38, 76%). Isolated ostial stenosis occurred more frequently on the right (10/41, 25%) than on the left (18/176, 16%). Associated coronary disease occurred in a single vessel in 42 patients, in two vessels in 72 and in three vessels in 76 resulting in a mean of 2.0 diseased vessels per patient. If patients with isolated ostial stenosis are excluded there were 2.3 diseased arteries per patient. There were 687 grafts performed in these patients, an average of 2.3 grafts per patient. One month surgical mortality was 4.8% (11/228), but has been 2% (2/104) in the last 4 years. Nine of 27 late deaths were noncardiac with a mean follow-up of 49 +/- 44 months. Ostial stenosis is hemodynamically equivalent to left main disease when the left ostium is involved. Symptomatic ostial lesions, whether right or left, require operative therapy. PMID- 3272205 TI - Simultaneous extensive extracranial and coronary revascularization. Long-term follow-up up to 13 years. AB - Simultaneous surgery for extensive extracranial and coronary revascularization was performed in 168 patients (mean age 61 years), from 1974 up to June 1987; 116 patients (69%) were in NYHA class III or IV, 133 (79%) had triple vessel disease and 51 (30%) had left main stem lesions. One or more previous myocardial infarctions were present in 96 patients (57%); normal preoperative left ventricular function was present in only 35%. In 22 cases, additional cardiac procedures were performed. Symptomatic extracranial disease was present in 76 patients (45%), arch vessel surgery was performed in 29 (17%) and bilateral haemodynamically significant carotid disease was present in 58 (35%). Operative mortality (3%) was mainly cardiac and operative morbidity mainly neurological (7%). Actuarial survival at 5 years (75%) and 10 years (57%) was mainly determined by the cardiac survival (87% at 5 years and 70% at 10 years), while neurological follow-up deaths were rare (neurological survival 97% at 5 years and 91% at 10 years). Late morbidity was more cardiac than neurologically determined; actuarial curves showed 72% to be free of all serious events or death at 5 years, and 47% at 10 years. PMID- 3272206 TI - Evaluation of corrective surgery for tetralogy of Fallot from late results by multivariate statistical analysis. AB - From 1966 to 1985, 469 pediatric patients with the tetralogy of Fallot (mean age, 4.9 years) were corrected (hospital mortality 11.9%). There were 9 late deaths (1.9%). In 186 patients, hemodynamic studies were performed 2-14 years postoperatively (mean age, 10.4 years). An increased cardiothoracic ratio (CTR) of 60% or more was found in 42 patients with impaired postoperative physical activity. The factors affecting the late results were investigated in relation to CTR by the quantification method of multivariate analysis. As for the enlarged CTR, pulmonary regurgitation was more of a contributing factor than pulmonary stenosis. In pulmonary regurgitation, the pulmonary artery area index (PAAI) and reconstruction of the right ventricular outflow tract (RVOT) were highly significant factors. For pressure gradient, the VSD site was the most significant factor. These analyses suggest that preservation and/or reconstruction of the pulmonary valve, or trans-annular patching with the necessary minimal area for the RVOT (PAAI) not to exceed 4 cm2/m2 at the time of operation is important for satisfactory late results. PMID- 3272207 TI - Successful resection of the tracheal bifurcation through a left thoracotomy. PMID- 3272208 TI - Clinical application and patient selection in the use of a total artificial heart as a bridge for transplantation. AB - Between April 1986 and July 1987, 21 patients underwent orthotopic implantation of a total artificial heart (Jarvik 7) at La Pitie Hospital. There were 18 men and 3 women with a mean age of 37.3 +/- 11.4 years. The device implanted was the 70 ml version in 10 patients and the 100 ml version in 11 patients. In the results, three variables were analysed: age, acute myocardial decompensation or chronic myocardial failure, and aetiology of the 21 patients treated. 10 (47.6%) had adequate support and were successfully transplanted. Eleven patients (52.4%) died during circulatory support. The main causes of death were sepsis and multiple organ failure. In only one patient was a mismatch between the heart and chest cavity present. There was no clinical evidence of thromboembolic complications. Patients of 40 years of age and less have an 80% chance of being successfully transplanted in comparison with a 25% success rate in older patients. Patients that developed sudden cardiac decompensation have a 75% success rate for transplantation in comparison with 44.4% success rate in patients with a chronic illness. Early implantation of the device, before the development of irreversible damage in other organs, is recommended in younger patients with acute or chronic disease and in older patients with acute myocardial failure. The use of this device is contraindicated in immunosuppressed patients due to the high risk of infection. PMID- 3272209 TI - Anticoagulation variability between centres: implications for comparative prosthetic valve assessment. AB - One of the major determinants in the choice of a mechanical prosthetic valve is that valve's thromboembolic record but the thromboembolic (TE) rates may be substantially influenced by the levels of anticoagulation achieved. A detailed study of anticoagulation variability was undertaken in 834 patients who received one or more of a particular prosthesis (Medtronic-Hall) in one centre during a 7 year period from 1979 to 1987, but who attended 27 different anticoagulant clinics spread over a wide area. In addition, a questionnaire was sent to all 89 practising cardiac surgeons in the UK asking for their preferred range of International Normalised Ratio (INR) for patients with mechanical prosthetic valves. Both the local study (with 16,866 INR observations) and the national questionnaire (with a 53% response) revealed an enormous amount of variability. Median INR values (semi-interquartile range) varied from 2.2 to 3.9 (0.8-2.5) according to the anticoagulant clinic attended. The range of INR preferred by UK cardiac surgeons, but presumably not necessarily achieved, varied from 1.8-2.2 to 3.0-4.8, with 64% of surgeons preferring an INR less than 3.0. In comparison, standard US practice is to maintain prothrombin times equivalent to INR values of 4.0-5.0. Unless anticoagulant practice can be standardised internationally, comparison of TE complications between centres is meaningless, and casts doubt on the validity of TE rates quoted for particular prostheses, unless accompanied by a detailed analysis of anticoagulant control. PMID- 3272210 TI - Pneumonectomy for severe inflammatory lung disease. Results in 64 consecutive cases. AB - Severe inflammatory lung disease resulting in severe unilateral pulmonary pathology necessitating pneumonectomy is still encountered in third world populations. A retrospective study of the last 64 patients undergoing pneumonectomy was performed. The underlying lung pathology was: destroyed lung due to tuberculosis in 33 patients; severe bronchiectasis in 25; necrotizing pneumonia in 4; lung abscess in 1 and hypoplastic lung in 1 patient. The perioperative management of these patients is outlined. Perioperative complications included respiratory failure in 4, secondary haemorrhage in 2 and post-pneumonectomy empyema in 5 patients. There were 2 mortalities (3.1%), both due to contralateral spillage with fulminant respiratory failure. Excellent results were achieved in 89% of the patients. PMID- 3272211 TI - Experience in non-contact Nd YAG laser in pulmonary surgery. A pilot study. AB - This paper presents our experience and the results of a pilot study in non contact Nd YAG laser in pulmonary surgery. During an 18-month period laser was used in 43 patients undergoing pulmonary surgery. All patients had a thoracotomy using a conventional surgical technique but the laser was employed for the pulmonary operation. The laser equipment consisted of Pilkington Fibrelase 100, delivering 10-100 watts energy in pulses of 1-9 s. The laser energy was applied using our sterile applicator and as a non-contact mode. Seven patients (group 1) had "coin" pulmonary lesions excised solely by laser evaporation and fulguration of 0.5-1 cm around the margin of the lesion. In 24 patients (group 2) laser was used in conjunction with conventional surgery in order to excise the residual disease and to provide better clearance with less loss of healthy parenchyma. In 17 patients (group 3) the laser was used to dispose of lymph nodes which were inaccessible for resection by conventional surgical methods. In 8 patients (group 4) laser was used for the purpose of haemostasis. Some patients in groups 2, 3 and 4 fell into categories other than that of their defined groups. There was no mortality or morbidity associated with the laser in these patients. This experience indicates the potential usefulness of laser in lung surgery and its particular value in pulmonary "coin" lesions and in association with conventional surgery in order to achieve conservative lung resection. PMID- 3272212 TI - Oesophagogastrectomy using stapling instruments. AB - Oesophagogastrectomy is generally considered to be the treatment of choice for resectable tumours of the oesophagus. We have, since January 1980, used stapling instruments whenever possible for the resection and anastomosis. We have also, since June 1983, employed a left thoracotomy approach for lesions of the gastric cardia and mid- or lower oesophagus. One hundred and sixty four patients underwent oesophagogastrectomy during a seven year period, 75 via left thoracotomy. The overall peri-operative mortality was 7.9%. Complications occurred in 17% of patients with anastomotic leakage in 1.8% and anastomotic strictures in 9.7%. Mean hospital stay was 14 days. In the left thoracotomy sub group mortality was 5%, the complication rate 23%, leak rate 3%, stricture rate 12% and mean hospital stay 13 days. PMID- 3272213 TI - Hemolysis and the St. Jude Medical valve. PMID- 3272214 TI - Severe haemolysis with the St. Jude Medical prosthesis. AB - The St. Jude Medical prosthesis has become one of the most widely used mechanical heart valves because of its excellent haemodynamic function. Although subclinical haemolysis has been described with this prosthesis, there has only been a single report of frank haemolysis in the absence of a paravalvular leak. We report the occurrence of severe haemolysis in five patients following St Jude Medical prosthesis implantation, four of whom had combined aortic and mitral valve replacements. In no patient could the haemolysis be attributed either to a paravalvular leak or an obvious valve malfunction. PMID- 3272215 TI - Mechanical versus biological heart valves: a ten-year comparison in a single centre. AB - Between January 1977 and December 1986, 1606 Bjork-Shiley tilting disc prostheses (BS) and 1346 Carpentier Edwards porcine prostheses (CE) were implanted in 1300 and 1156 patients, respectively, at the same institution. During the time of implantation, both valves have developed: the BS through standard disc and convexo-concave to monostrut, and the CE valves from standard to supra-annular. Newer valve types were used where applicable as they became available. Preoperative status in respect of age and cardiac rhythm were similar. There were significantly more females (64% BS: 54% CE, P less than 0.001); worse NYHA grade (74% Grade 111 and IV-BS: 56% 111 and IV-CE, P less than 0.001) more closed heart surgery (26% BS: 18% CE, P less than 0.001) and more previous open heart surgery (11.6% BS: 8.9% CE, P less than 0.001) in the BS group. All BS patients were anticoagulated and 49% of mitral CE patients and 7% of aortic CE patients were anticoagulated. There was no significant difference between the two groups in hospital mortality (BS 7.2%: CE 6.3%), late mortality (BS 2.5%/patient year: CE 3.2%/patient year) overall incidence of systemic embolism (BS 1.3%/patient year: CE 1.4/patient year), prosthetic valve endocarditis (BS 0.7%/patient year: CE 0.9%/patient year), valve failure (BS 0.5%/patient year: CE 0.9%/patient year) or peri-prosthetic leak (BS 1.2%/patient year: CE 1.3%/patient year). The incidence of systemic embolism in the aortic position was lower with the BS prosthesis (BS 0.2%/patient year: CE 1.2%/patient year, P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272216 TI - Incremental risk factors for hospital mortality after postinfarction left ventricular aneurysmectomy. AB - To identify risk factors for hospital mortality after postinfarction left ventricular aneurysmectomy (PILVA), 83 consecutive cases of PILVA were studied in a retrospective analysis. Hospital mortality was 14.4%. Most of the factors correlated with hospital mortality were associated with poor overall left ventricular (LV) function: preoperative digoxin (P = 0.001), diuretics (P = 0.03), intravenous (iv) inotropics (P = 0.002), interstitial oedema (P = 0.03) on chest X-ray, higher LV end-diastolic pressure (P = 0.02), congestive heart failure (CHF) (P = 0.003) especially as an indication for surgery (P = 0.001) and postoperative low output (P less than 0.001), intra-aortic balloon pump (IABP) (P less than 0.001) and renal failure (P less than 0.001). In addition, higher age at infarction (P = 0.002) and at PILVA (P = 0.008) were correlated with hospital mortality, as well as preoperative antiarrhythmics (P = 0.03) and incomplete coronary artery bypass grafting (P = 0.01). Multivariate analysis of preoperative factors showed digoxin, antiarrhythmics, CHF as an indication for surgery, iv inotropics and iv nitrates, in this order, to be the most discriminating risk factors, predicting hospital mortality with 89% specificity and 75% sensitivity. Multivariate analysis of all investigated factors showed postoperative renal failure and IABP, age at infarction, preoperative iv nitrates and antiarrhythmics, in this order, as the most discriminating risk factors, predicting hospital mortality after PILVA with 97% specificity and 83% sensitivity. PMID- 3272217 TI - Intraoperative assessment of myocardial revascularisation for the relief of ischaemia using monophasic action potential recordings. AB - We have been concerned with developing a method of assessing regional myocardial perfusion which is simple, quick and without hazard to the patient. Monophasic action potential (MAP) recordings provide a highly sensitive measure of localised myocardial ischaemia. We have developed a hand-held pressure contact silver/silver chloride electrode for recording MAP signals from the left ventricular epicardium. The design enables it to slide within the pericardium on the left ventricle/epicardium with minimal displacement of the heart. Three protocols were adopted providing different permutations of atrial pacing and graft occlusion. Protocol 1: after discontinuing bypass, atrial pacing was established. After 90 s, all grafts were occluded for a period of 90 s. Protocol 2: after discontinuing bypass, all grafts were occluded for 90 s in the absence of pacing. Protocol 3: atrial pacing was established for 60 s before grafting and bypass and repeated subsequent to grafting and discontinuing bypass. Our results show that the most promising method is protocol 3. The most important results were that when heart rate is taken into account, the ischaemic changes in the MAP were significantly less impressive (P less than 0.05) following grafting. With further refinement, this technique may be applicable to the assessment of individual grafts. PMID- 3272218 TI - Rupture of the right ventricular free wall. An unusual complication of mediastinitis after cardiac surgery. AB - Of 2171 patients who underwent open heart surgery between 1981 and 1986, 41 (1.8%) developed postoperative mediastinitis and were treated by closed irrigation drainage or open chest therapy. Six patients, (mean age 59 years) developed rupture of the right ventricular free wall. The primary procedures were: resection of akinetic fibrous plaque (2), mitral valve replacement (1), coronary bypass grafting (1), removal of a left atrial myxoma (1) and repair of post-infarction rupture of the left ventricle (1). In 2 patients, rupture occurred in the operating theatre during revision of the irrigation drainage. Both patients died after repair. In 4 patients, rupture occurred during coughing. One died before surgery. In the 3 other cases, the defects were repaired either by direct suture (2 patients) or with a pericardial patch (1 patient) with the aid of normothermic extracorporeal circulation. Three days later, a muscular flap (pectoral or dorso-lumbar) was mobilized to protect the mediastinal viscera. All 3 patients are alive and well. When bleeding occurs during treatment of mediastinitis, an immediate exploration with extracorporeal circulation to close the defect should be considered. PMID- 3272219 TI - Exclusive double outlet right ventricle with atrioventricular concordance and pulmonary stenosis. Results of reconstructive surgery. AB - Double outlet right ventricle associated with atrioventricular concordance, pulmonary stenosis and situs solitus of the atria is a subset of double outlet right ventricle related through the surgical treatment. From 1974 to 1985, 14 patients, 5 males, 9 females (mean age 8.9 years, range 13 months-22 years) were operated upon. All patients had infundibular stenosis and normal or large pulmonary arteries. The apex of the heart was to the right in 2 patients, the right and left ventricles were superior and inferior in 2 patients and 1 patient had both anomalies. The ventricular septal defect was subaortic in 11 patients (aorto-mitral discontinuity in 5) and non-committed in 3 patients. Three patients had 2 ventricular septal defects. The aorta was anterior in 3 patients and to the right of the pulmonary artery in 11 patients. All patients, through a transventricular and transatrial approach, had a reconstructive surgery. In 3 patients, an aortic homograft valved conduit was used. One patient had the ventricular septal defect enlarged. There was one early death (7.1%) from high residual right ventricle pressure and no late death. One patient had a transient atrioventricular block. One patient was reoperated upon for a residual ventricular septal defect. All survivors had a good clinical result. Re evaluation in 8 patients confirmed excellent haemodynamics: the right ventricle to pulmonary artery pressure gradient decreased from 80 mm Hg (range 60-95) preoperatively to 24 mm Hg (range 3-32) postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272220 TI - Should circulatory arrest with deep hypothermia be revised in aortic arch surgery? AB - Our experience (January 1982-May 1987) concerns 41 patients, operated upon for aortic dissection (30 patients) or aneurysm (11 patients) using circulatory arrest with deep hypothermia. There were 24 male and 17 female patients (mean age: 55 years 9 months, range 32-73 years). The mean circulatory arrest time in minutes was 41 +/- 3 (mean rectal temperature before circulatory arrest was 18.4 degrees C +/- 0.3 degrees C). Total (24 patients) or partial (16 patients) replacement of the aortic arch was performed. One patient with a sacciform aneurysm had the aortic wall defect closed. Hospital mortality was 22% +/- 7% (9 patients): 8 of 30 patients with aortic dissection (26.6%) and 1 of 11 patients with aortic aneurysm (9%). Neurological complications occurred in 3 patients. These data lead us to prefer circulatory arrest with deep hypothermia as the method of choice for aortic arch surgery. However, when a short circulatory arrest time (less than 30 min) for the repair is foreseeable, mild hypothermia (20 degrees C-24 degrees C) may be preferred. In patients who will not tolerate excessive cardiopulmonary bypass times, expected difficulties with the repair should suggest mild hypothermia and short circulatory arrest in easier cases or moderate hypothermia with brachiocephalic perfusion in the others. PMID- 3272221 TI - Therapeutic consequences of oesophageal function studies in patients with benign oesophageal disease. AB - Evaluation of oesophageal function was performed in 91 patients referred to a specialized department of cardiothoracic surgery for surgical treatment of benign oesophageal disease. Standard manometry was used in addition to radiology and endoscopy, and in some patients, an acid perfusion test, an acid clearing test, and a prolonged monitoring of pH in the distal oesophagus were additionally performed. The aim of this study was to evaluate whether assessment of oesophageal function is needed in such a patient group, and whether the results of these investigations were taken into account when making the final decision for therapy. Eleven percent of the patients referred with a diagnosis of hiatal hernia or reflux had achalasia or oesophageal spasm. Nine percent of the patients referred for motility disorders had reflux-related disease. The referral diagnosis was changed to a diagnosis with a different therapeutic approach in 16% of the patients. In 33%, a diagnosis of disordered oesophageal function was considered either at referral or during the routine assessment for oesophageal disease. Eighty-one percent of the patients with achalasia were treated in accordance with the manometric results. In all cases where an anatomical diagnosis was replaced by a diagnosis of disordered function, the treatment was in accordance with the findings of the motility studies. None of the patients with oesophageal spasm were suspected of having this disease. It is concluded, that not only anatomical features, but also functional considerations have to be taken into account when selecting treatment for benign oesophageal disease. Treatment failure and unnecessary surgical intervention can thus be avoided. PMID- 3272222 TI - Acute renal failure due to profound haemolysis--an unusual complication of cusp rupture in cardiac bioprostheses. AB - Haemolysis due to prosthetic cardiac valves is well documented in the literature, with an increased incidence in mechanical prostheses as compared to bioprostheses. We report this unusual complication in two patients who developed profound haemolysis rapidly resulting in acute renal failure following cusp rupture in mitral Ionescu-Shiley valves. One of the patients developed irreversible renal failure in spite of successful reoperation, while renal function normalized in the second case. PMID- 3272223 TI - Surgical approach to anterior septal accessory pathways in 20 patients with the Wolff-Parkinson-White syndrome. AB - Right anterior septal accessory pathways in the Wolff-Parkinson-White syndrome are generally defined by electrophysiological criteria, the most important being that earliest retrograde atrial activation during AV reciprocating tachycardia occurs at the anterior medial segment of the tricuspid annulus (His bundle catheter). The purpose of our study is to describe intraoperative mapping in 20 patients with anterior septal accessory pathways, and to assess if intraoperative mapping contributes to the operative approach. At surgery, all patients had identical early ventricular activation during pre-excitation at the infundibulum. However, two groups could be identified on the basis of retrograde atrial epicardial activation during AV reciprocating tachycardia or right ventricular pacing. Group 1 comprised 16 patients with earliest activation at the interatrial septum adjacent to the His bundle. Epicardial dissection failed to affect accessory pathway conduction. The accessory pathway was only ablated when a discrete endocardial approach to the atrial septum was used. Group 2 comprised 4 patients with early atrial activation "paraseptally" in the right coronary fossa. These accessory pathways were ablated by an epicardial approach without using cardiopulmonary bypass. We conclude that right anterior septal accessory pathways as defined by electrophysiological criteria can be divided into two groups on the basis of the atrial activation sequence: (1) right septal accessory pathways in the septal para-Hissian region and (2) right anterior 'paraseptal' accessory pathways. This classification is of practical importance because the latter can be ablated using an epicardial approach without the need for cardiopulmonary bypass or atriotomy. PMID- 3272224 TI - Surgical alternatives in the treatment of life-threatening ventricular arrhythmias. AB - We present our experience in the treatment of life-threatening ventricular tachycardia using electrophysiologically guided surgery (97 patients), automatic implantable cardioverter defibrillator (AICD) (42 patients), and orthotopic heart transplantation (15 patients). Eighty-three percent of these patients had ischemic and 17%, nonischemic heart disease. Our results of electrophysiologically directed surgery show an early mortality of 10% and a recurrence of 5% in the ischemic group. In the nonischemic group, the recurrence was 45%. The AICD was implanted in 31 patients with ischemic heart disease, in 5 with ventricular dysplasia, and in 6 with dilative cardiomyopathy, the ejection fractions ranging from 12% to 65%, with a mean of 30%. Early and late mortalities were 5% and 19%, respectively. The AICD was effective in all patients. Survival rate at 1 year was 83% +/- 6.4%. Thirteen of 15 patients have survived heart transplantation for 3-20 months (mean: 11 months). Ejection fractions prior to transplantation ranged from less than 10% to 34% (mean: 16%). We conclude that electrophysiologically guided surgery is highly effective in most cases of ischemia-related ventricular tachycardia. The AICD is considered a palliative alternative in patients with either poor ventricular function, no electrophysiological substrate, or multimorphological tachycardia. Heart transplantation has to be considered especially in young patients in whom progression of the underlying disease can be anticipated. Bridging by AICD is possible when transplantation is not immediately available or recommendable. PMID- 3272225 TI - Long-term results of conservative repair of rheumatic aortic valve insufficiency. AB - From July 1974 to January 1986, 50 patients underwent conservative repair for rheumatic aortic valvular disease at our institution. Eleven were male and 39 female, with an average age of 39.5 years (range 17-57). The aortic lesion was associated in all cases with a predominant mitral lesion. Twenty-five also had tricuspid disease which was surgically treated in 17. Twenty-six had aortic regurgitation and 24, a mixed lesion. The surgical techniques used were: (1) commissurotomy, (2) annuloplasty, (3) cusp free edge unfolding and (4) supra aortic crest enhancement. Two patients had one cusp extended with pericardium. There were 3 hospital deaths (6%). Six patients were lost to follow-up at different periods. Maximum follow-up was 12.58 years with a mean of 7.78 years per patient. Twelve required reoperation with 3 deaths. Three reoperations were due to failure of the mitral bioprosthesis without reoperation on the aortic valve. Of the remaining 9 patients who had aortic and mitral dysfunction, 4 had severe aortic insufficiency. The actuarial freedom from reoperation at 13 years was 75% and the overall actuarial survival was 86%. It is concluded that these surgical techniques can be applied successfully in moderate rheumatic aortic valve disease accompanying a predominant mitral lesion. This is particularly relevant when a mitral reconstruction has been performed. PMID- 3272226 TI - Results of surgical treatment of pulmonary metastases. AB - Surgical removal of one or several metastases with a potentially curative aim is possible in the case of isolated pulmonary metastases. Surgery is part of a combined oncological concept. Between 1972 and 1986, surgical resection was indicated in 368 patients and 419 thoracotomies were carried out. Of the patients, 38% had more uni- or bilateral metastases than expected even after the most careful preoperative diagnostic examinations. The 5-year survival probability of all patients operated on was 33%. Corresponding to a differentiation between potentially curative and non-curative resections, the operation was classified as potentially curative in 73%. In this group, the 5 year survival was 39%. Differentiation into tumour groups (carcinomas of caval type, carcinomas of portal type and sarcomas) revealed no statistically significant differences in prognosis. Due to the excellent chemotherapeutical regimens, testicular teratomas achieved the best results in the early postoperative years. Long-term survival is decisively influenced by the removal of all visible and palpable metastases. If complete removal of all tumour tissue is possible, the number of metastases does not influence survival significantly. Besides radicality, the duration of the disease-free interval showed prognostic differences which were statistically significant (P less than 0.001). Considering the metastatic route and the type of primary tumour, there were slight prognostic differences which were not statistically significant. Recently, the median sternotomy has become the preferred method of access. Predominating resection procedures are wedge and segmental resections which yield the best survival rates. PMID- 3272227 TI - Results of orthotopic heart transplantation with and without the use of maintenance steroids. AB - From March 1984 to June 1987, 51 patients underwent primary orthotopic heart transplantation at the Second University Department of Surgery, Vienna. Recipients were immunosuppressed with a combination of either ciclosporine and azathioprin (double drug regimen = DD, 10 patients), or ciclosporine, azathioprin and low-dose steroids (triple drug regimen = TD, 33 patients). Four patients who died intra- or perioperatively and 4 who were switched to conventional therapy were excluded from analysis. In both groups, ciclosporine was administered to obtain whole blood HPLC trough levels of 200-400 ng/ml in the 1st month, 150-250 ng/ml from the 2nd to the 6th and 100-150 ng/ml after the 6th month. Azathioprin 2 mg/kg per day was given, and in TD patients, an additional 0.2 mg/kg per day of prednisolon: all patients received prophylactic antithymocyte globulin for 7-10 days postoperatively. Five deaths from acute rejection in the DD group contrasted with none in the TD group. The high incidence of fatal rejection episodes was reflected in a 40% Kaplan-Meier 1-year survival for DD vs 84% for TD (p less than 0.0001). Analysis of endomyocardial biopsies (DD vs TD) demonstrated 20.4% vs 57.0% absent, 46.0% vs 29.5% mild, 31.2% vs 12.4% moderate and 2.4% vs 1.1% severe rejection. Fatal and nonfatal infections and toxic side effects occurred with the same frequency in both protocols. Calculation of mean ciclosporine levels resulted in 249.7 ng/ml (TD) and 206.0 ng/ml (DD) in the 1st month (p less than 0.05). Consequently, adjunctive maintenance low-dose steroids combined with increased ciclosporine levels in the early posttransplant course are considered responsible for the improved results. PMID- 3272228 TI - Energy state of the myocardium during long-term cold storage and subsequent reperfusion. AB - Long-term preservation of dog hearts was performed over 24 h using Bretschneider HTK cardioplegia and cold storage. Preservation was assessed in terms of conservation of myocardial tissue levels of high-energy phosphates (HEP) and functional outcome after cardiac transplantation. Serial left ventricular biopsies were taken and analysed for ATP, ADP, AMP, adenosine, inosine, hypoxanthine, xanthine and creatine phosphate. Myocardial structure was studied by electron microscopical examination of a similar biopsy specimen. Cardiac performance was measured before and after cardiac transplantation. Several techniques of cardioplegic arrest were studied: single dose cardioplegia, multidose cardioplegia and continuous perfusion with the cardioplegic solution. In all groups, the hearts were stored at 0.5 degree C for 24 h. In the group of single dose Bretschneider-HTK cardioplegia, myocardial ATP content after 24 h of cold storage was only 25% of control. The total sum of nucleotides at that time interval was however 65% of the control value. Reperfusion of these hearts using a support dog (whole blood reperfusion) did not result in any recovery of ATP. Creatinine phosphate however showed an overshoot. Accumulated nucleosides were washed out. The hearts showed electrical activity but were severely arrhythmic. Contractility was poor. In the group of multidose Bretschneider-HTK cardioplegia, HEP preservation was better than after single dose cardioplegia. ATP content was about 50% of control. The total sum of nucleotides was 85% of control. Ultrastructural assessment of the myocytes revealed only slight ischaemic damage to the mitochondria. Reperfusion on cardiopulmonary bypass after cardiac transplantation did not show any restoration of ATP, but a steady catabolism of HEP. The nucleosides adenosine and inosine were not washed out upon reperfusion. After cardiac transplantation, none of these hearts could be weaned from cardiopulmonary bypass due to irreversible low cardiac output. Histological examination demonstrated irreversible myocardial tissue damage. In the group of continuous cold Bretschneider cardioplegia, HEP content was completely preserved throughout the 24 h of perfusion. Ultrastructure of the myocytes was normal. Reperfusion of the transplanted hearts showed a mild breakdown of ATP to 70% of control values accompanied by a slight accumulation of nucleosides. Haemodynamic recovery however was perfect and none of the hearts needed positive inotropic support. Myocytes after reperfusion had a normal subcellular appearance.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3272229 TI - Lympho-epithelial thymomas. A retrospective study of 88 resections. AB - Of 113 lympho-epithelial thymomas retrospectively studied, 56 were epithelial, 20 lymphocytic, 30 mixed and 7 were undefined forms. There were 88 resections (20 stage I, 47 stage II, 13 stage III and 8 stage IV). There were 69 primary resections (followed by radiotherapy in 54 cases) of which 57 were complete and 12 were incomplete. There were 19 secondary resections after radiotherapy: 10 were complete and 9 were incomplete and 25 patients were not operated upon and were treated by radio- and chemotherapy. After primary resection, the actuarial 5 year survival is 64.07% and the 10-year survival is 50.86%. After a secondary resection, the 5 year-survival is 43.74%. After non-surgical treatment, it is 18.67%. After surgery, the prognostic importance of staging is confirmed as more important than the cellular structure. Myasthenic patients are subject to late accidents. Postoperative radiotherapy seems to be justified, but its effect is not statistically significant when resection is complete. Post-radiotherapy surgery is beneficial only in cases of complete resection. The metastatic evolution of thymomas has been underrated and seems to depend upon the local control of the tumour. The use of chemotherapy remains to be defined. PMID- 3272230 TI - Early and late determinants of survival after surgery of left ventricular aneurysm. AB - The fate of 103 patients consecutively operated upon for chronic left ventricular aneurysm between 1978 and 1986 was examined with a multivariate statistical approach to verify the operative indications and results. In the early risk phase, up to 39 days after operation, 15 patients (15%) died. Mortality was mostly due to a low output syndrome and was significantly related to older age and to functional (NYHA) and anginal (CCS) class. In the late risk phase, starting 1.9 years after surgery, 9 patients died (10%) and the significant risk factors were anterior aneurysm and older age at operation. Actuarial survival curves showed 82% survival at 5 years and 61% at 9.5 years. In 25 patients older than 50 years and with an anterior aneurysm, these rates were 51% and 34%, respectively. Improved functional class was observed in 87% of the patients interviewed, but 30% complained of angina or new infarctions. Survival free of ischemia was 64% at 5 years and 13% at 9.5 years. This development of ischemic recurrences was significantly related to older age and to incomplete revascularization despite multiple grafts. These results suggest modification of the grafting policy and of the techniques of repair in identified high-risk subsets. PMID- 3272231 TI - Long-term performance of porcine heart valve bioprostheses. AB - To assess the results after long-term implantation of porcine bioprosthetic heart valves, 320 patients with 381 valves were retrospectively reviewed. This group included all patients receiving one such xenograft in the mitral or aortic position (or both) in our institution between June 1974 and December 1976. The patients had a follow-up of 9-11.5 years. Actuarial patient survival rats (hospital mortality excluded) were 85%-90% at 6 years and 68%-79% at 11.5 years. Thromboembolic episodes did not show any significant clustering over the first weeks or months, in fact, they appeared at a constant rate. Actuarial rates of freedom from thromboembolism were greater than 90% for aortic patients at 11.5 years and greater than 80% for mitral and mitroaortic patients at 11.5 years. The linearized rate of anticoagulant-related haemorrhage for the whole group of patients was 0.4 events/100 patient years with a related mortality of 0.2 events/100 patient years. Prosthetic valve endocarditis and paravalvular leak appeared at linearized rates of 0.6 (0.1 of related mortality) and 0.4 (0.1 of related mortality) events/100 patient years. Primary tissue valve failure constituted the most prevalent complication (82 cases) in the long term but did not significantly worsen patient survival. Actuarial rates of freedom from primary tissue failure were 91% +/- 2% at 6, and 40% +/- 14% at 11.5 years for mitral valves, and 95% +/- 4% at 6 and 64% +/- 6% at 11.5 years for aortic valves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272232 TI - Oesophago-pericardial fistula and cardiac tamponade after oesophagoscopy. AB - A case of oesophago-pericardial fistula following oesophagoscopy and dilatation is reported. This is a rare and usually fatal complication of oesophageal instrumentation. This case is of further interest as cardiac tamponade following a Niopam swallow subsequently occurred, and the patient survived emergency surgery. PMID- 3272233 TI - Guidelines for reporting morbidity and mortality after cardiac valvular operations. PMID- 3272234 TI - Correction of coarctation of the aorta in neonates and young infants. An individualized surgical approach. AB - Because of the controversy concerning the ideal surgical repair for symptomatic coarctation of the aorta presenting in neonates and infants, our entire series of 179 children under the age of 12 months undergoing repair between January 1, 1976 and December 31, 1984 was reviewed. Of this group, 109 were neonates, 43 infants aged 31-90 days and 27 infants aged 90 days-12 months. Twenty patients had a simple coarctation and 159 had complex coarctation with additional intracardiac anomalies such as ventricular septal defect (37 patients also had pulmonary artery banding). One hundred and twenty-four were repaired with a subclavian flap operation, 32 with resection and end-to-end anastomosis and 23 with complex repairs (e.g. patch and reversed flap). Type of repair was the surgeon's choice and was selected on the basis of the anatomy of the coarctation. Total perioperative mortality was 15% (N = 27) while late mortality was 12% (N = 21). Twenty-one risk factors for mortality were evaluated by logistic analysis and the method of Cox. There was no risk difference between end-to-end versus subclavian flap repairs and all but one death occurred in patients with complex coarctations. Risk for in hospital death was increased by only one variable: the need for repair in the neonatal period. Risk for death in the first year of life was increased by the presence of congestive heart failure at initial presentation while later death correlated with intracardiac surgery. Recoarctation occurred in 28 patients (18.4%), all but 4 of these occurred in patients undergoing neonatal repairs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272235 TI - Anatomic repair of anomalies of ventriculo-arterial connection (REV). Results of a new technique in cases associated with pulmonary outflow tract obstruction. AB - From November 1980 to November 1986, 63 patients aged 4 months to 13 years (mean 3.4 years) underwent repair of anomalies of ventriculo-arterial connection with ventricular septal defect and pulmonary outflow tract obstruction, using a technique (REV) first described by us in 1982. The selection of patients was based on preoperative criteria, namely the measurement of the distance between the tricuspid and the semilunar valves. These measurements enabled us to select from patients with an abnormal ventriculo-arterial connection, those in whom the anomaly could be repaired by intra-ventricular partition alone. In the remaining cases, REV was indicated in the presence of pulmonary stenosis. The principles of the technique are: (1) resection of the infundibular septum creating a large, direct and subarterial communication between the left ventricle and the aorta; (2) construction of a straight left ventricle to aorta tunnel by intraventricular partition; (3) direct anastomosis of the pulmonary trunk to the right ventricle. There were 12 hospital deaths (19%). The mean follow-up was 32 months. One patient died suddenly 1 year after repair. Six patients required reoperation. All survivors are in NYHA class I, except for 3 patients who are in class II. No stenosis of the left ventricular outflow tract was found but 5 patients had a significant pressure gradient at the pulmonary outflow tract level. Our present experience suggests that in properly selected patients, REV allows anatomic repair in a wide variety of anomalies of the ventriculo-arterial connection associated with VSD and pulmonary outflow tract obstruction with an acceptable rate of mortality and morbidity. PMID- 3272236 TI - Congenital left ventricular inflow obstruction: is the outcome related to the site of the obstruction? AB - Between 1978 and 1987, 39 patients aged 1 day to 15 years underwent surgery for symptomatic left ventricular inflow obstruction. Four diagnostic groups were identified: cor triatriatum (6 patients), supravalvar mitral membrane (SVMM) with a normal mitral valve (7 patients), SVMM with an abnormal mitral valve (9 patients) and mitral stenosis (17 patients). Associated cardiac anomalies occurred in 26 patients (67%). There were 8 deaths (21%), 3 in patients with SVMM and an abnormal mitral valve and 5 in patients with mitral stenosis. Survival for patients with normal mitral valves was significantly better than that for patients with abnormal mitral valves (13/13 vs 18/26, P less than 0.05). There was also high morbidity in patients requiring prosthetic mitral valve replacement. These data suggest that the outcome of surgical treatment for left ventricular inflow obstruction may be predicted according to the site of the obstruction. This is best determined preoperatively by cross-sectional echocardiography which allows optimal planning of surgical strategy. PMID- 3272237 TI - Up to 9 years of follow-up after anatomic correction of simple transposition of the great arteries. AB - For a continued assessment of the two-stage anatomic correction, we have evaluated the postoperative results in terms of clinical status, ECG, ventricular function, aortic root size and stiffness for up to 9 years in all 18 survivors. Weight and height were normal, the ECG was normal except for complete (n = 3) and incomplete (n = 11) right bundle branch block and supraventricular tachyarrhythmias post Blalock-Hanlon septectomy (n = 1) and p-wave abnormalities (n = 6). The pressures and ejection fraction of the left and right ventricles were within normal limits. The end-diastolic and endsystolic left ventricular volume and the muscle volume index were elevated. Six of 17 patients were outside the normal range of the left ventricular ejection fraction-endsystolic stress relationship. The diameter of the aortic root was larger than normal in all patients. There was a relation between the size of the patients at banding and the stiffness of the aortic root after anatomic correction. Patients with simple transposition of the great arteries up to 9 years after anatomic correction develop normally without atrio-ventricular conduction delay, arrhythmias or signs of coronary and myocardial insufficiency. The stiff and enlarged aortic roots do not seem to dilate. The reasons for the elevated left ventricular volumes and muscle volume indices are not clear at present. Primary anatomic correction may prevent these abnormalities. PMID- 3272238 TI - Incidence and risk factors of prosthetic valve endocarditis. AB - To study the incidence and risk factors of prosthetic valve endocarditis (PVE) we followed 99.5% of 912 patients who had valve replacements from 1 January 1981 to 31 December 1985 for 1-6 (mean 3) years. PVE occurred in 27 patients (2.96% or 0.98% per patient-year). The incidence of PVE in the aortic position (3.9%) was significantly higher than in the mitral position (1.5%): chi-square = 6.1, P less than 0.025. PVE developed in 19 of 329 patients with bioprostheses (5.8%), and in 8 of 583 patients with mechanical valves (1.4%): chi-square = 14.48, P less than 0.005). Actuarially at 5-year follow-up, 90.7% +/- 2.16% of the bioprosthetic group and 98.4% +/- 0.56% of the mechanical valve group was free of PVE (P less than 0.001). Antecedent endocarditis increased both the incidence and relative risk of PVE 7-fold compared to patients without antecedent endocarditis (chi square = 32.0, P less than 0.0001). Bioprosthetic valve replacement in infective endocarditis increased the risk of PVE 12-fold compared to valve replacement by mechanical prostheses. IN CONCLUSION: in the order of importance, antecedent endocarditis, bioprostheses and aortic position are risk factors in the development of PVE. Bioprostheses implanted in patients with antecedent endocarditis further enhance the risk of PVE. PMID- 3272239 TI - Long-term clinical results after combined aortic and mitral valve replacement. AB - The results after 282 consecutive double (aortic & mitral) valve replacements (DVR) are compared with our previously reported experience after mitral (MVR, n = 810) and aortic valve replacement (AVR, n = 1753). All but one patient received Bjork-Shiley valves. The follow-up which closed on August 1, 1985 was 99.3% and covered 16,869 patient-years (mean 6.3 years/patient). Autopsies were performed in 74% of all fatalities. Early mortality rates were identical in the three patient groups, and late mortality did not differ between MVR and DVR patients. The fraction of valve-related mortality was similar in all groups. Anticoagulant related bleeding was equally common in all patient groups. The incidences of thromboembolism, reoperation and valve failure did not differ between MVR and DVR patients, but were significantly higher than among AVR patients. With the exception of a slightly increased incidence of prosthetic valve endocarditis, the results after DVR equal those after MVR. In cases with severe mitral valve disease but borderline aortic valve disease, primary DVR is clearly justified and eliminates the need for, and risks of, a secondary AVR. PMID- 3272240 TI - Clinical results after cardiac valve replacement with the Sorin prosthesis. A 6 year experience. AB - The mechanical valve produced by Sorin is a modified tilting disc device. Between March 1979 and November 1985, 763 Sorin prostheses were implanted in 710 patients. The study has been restricted to 504 isolated mitral or aortic valves. There were 238 females and 266 males whose ages ranged from 2 to 71 years (mean 43.8). Follow-up is 99.23% and covers 1045 patient-years. No structural failure has been observed. In the aortic position, 282 Sorin prostheses were implanted with the large orifice orientated towards the right coronary sinus. Hospital mortality was 5% (14/282). Actuarial survival at 78 months was 94.68% +/- 1.6% with a linearized mortality rate of 1.7% patient-years. There were 11 late deaths (9 valve-related and 2 non valve-related). The linearized rate of occurrence of embolic events was 0.32 patient-years (2/268). Actuarial survival complication free at 78 months was 90.88% +/- 2.83%. Preoperatively, 19.8% patients were in NYHA class II, 68.5% in III and 11.7% in IV; postoperatively, 79.3% patients were in NYHA class I, 19.5% in II and 1.2% in III. In the mitral position, 222 Sorin prostheses were implanted with the large orifice orientated anteriorly in 46 patients (group 1) and posteriorly-in 176 patients (group 2). Hospital mortality was 4.5% (10/222). Actuarial survival at 66 months was 93.25% +/- 2.1% with a linearized mortality rate of 2.8 patient-years. There were 12 late deaths (9 valve-related and 3 non valve-related). The 66-month actuarial freedom from embolic events was 95.8% +/- 1.89% with a linearized rate of occurrence of 1.44 patient-years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272241 TI - Reperfusion with nifedipine: improved functional recovery after cold cardioplegic arrest. AB - Nifedipine, an antagonist of myocardial calcium uptake, given after a period of a cold, cardioplegic arrest (150 min, 18 degrees C, St Thomas' cardioplegic solution) improved contractile recovery of the isolated working rat heart model of cardiopulmonary bypass. The hearts were reperfused with various concentrations of nifedipine in Krebs-Henseleit buffer (37 degrees C, 100 cm H2O) and their functional recoveries were compared with the control series reperfused without nifedipine. A bell-shaped dose/response curve was produced by the drug, and optimal protection observed with 0.1 mumol/l of nifedipine which improved the post-ischaemic recovery of the aortic flow from 56.8% +/- 3.7% to 80.1% +/- 3.2% (P less than 0.001). The importance of careful dose adjustment is stressed since it was noted that higher concentrations inhibit both functional and metabolic performance. This study supports the hypothesis that at the end of a cold cardioplegic arrest there are still reversibly injured cells which could restore their function if the cellular ingress of Ca++ during reperfusion is reduced by nifedipine. PMID- 3272242 TI - The superior approach to the mitral valve--is it worthwhile? AB - The mitral valve was approached through a modified incision in the roof of the left atrium in 100 consecutive patients to study exposure of the valve, complications of the method and the incidence of dysrhythmia. There were five deaths: one related to difficult atrial closure and another to breakdown of the atrial suture line. Two major and two minor non-fatal haemorrhagic complications occurred. Exposure of the valve was found to be superior to that of conventional atrial incisions in the great majority of cases. When comparing the incidence of perioperative dysrhythmia in our 100 patients with that of 56 patients approached through the conventional atrial incisions, no significant differences were found even though the sinus node artery is likely to be divided when incising the roof of the left atrium. PMID- 3272243 TI - Mitral stenosis in systemic lupus erythematosus. Successful management by mitral valve replacement. AB - A female Caucasian with a history of 18 years of systemic lupus erythematosus (SLE) developed symptoms and signs of mitral stenosis, but had no history of rheumatic fever. Investigations confirmed severe stenosis, and the diseased valve was replaced by a pericardial xenograft. Histological examination was compatible with steroid-modified Libman-Sacks endocarditis. She remains well 24 months postoperatively. PMID- 3272244 TI - Endogenous digoxin-like immunoreactive substance in patients undergoing coronary surgery. Preliminary report. AB - Perioperative digoxin concentrations were measured in 20 unselected adult patients undergoing coronary surgery. None of the patients were receiving treatment with digoxin. A digoxin-like immunoreactive substance was found in 16 patients postoperatively. This substance, if pharmacologically active, may have important clinical implications in the management of patients after open heart surgery. PMID- 3272245 TI - The modified Fontan operation for double inlet left ventricle. Surgical results, early haemodynamic and functional assessment. AB - Twenty-one patients with a double inlet left ventricle underwent a modified Fontan between May 1979 and August 1987. All but the first patient in this series were operated upon after August 1984. Their age at operation ranged from 4 to 23 years with a median age of 8 years. Initial palliation was required in 12 patients and the mean interval to repair was 77.1 months, ranging from 38 to 112. Only one of the criteria of Choussat was exceeded in 12 patients. The pulmonary vascular resistance was always less than 4 Um2. A direct atriopulmonary anastomosis was performed in 19 patients and an aortic homograft interposition was used in 2. There was one hospital death due to acute cardiac failure and no late deaths. The average of the mean right and left atrial pressures measured early postoperatively was 12.9 and 8 mmHg respectively. A prolonged hospitalization with a mean of 23 days, ranging from 9 to 69, was required because of recurrent pleural and pericardial effusions which usually resolved after the first 6 postoperative months. The need for early anticoagulation is recommended to prevent the risk of pulmonary thromboembolism observed in 2 of our patients. Cardiac catheterization performed in 19 patients within 1 year after surgery showed that the average of the mean right atrial pressure had decreased to 11.3 mmHg without a gradient across the anastomosis in any case. Two patients required reoperation: one for enlargement of a restrictive ventricular septal defect and the other for closure of a recurrent dehiscence of the patch used for closure of the right a-v valve. Three patients developed a significant subaortic obstruction and have been scheduled for reoperation. Ventricular function was assessed at a mean interval of 11.9 months (17 patients) and 25.5 months (13 patients) from surgery. Gated equilibrium radionuclide ventriculography showed that the ejection fraction was normal (greater than or equal to 50%) and it had increased with time in 10. Yet, the response to exercise was normal in only 5 of the 13 patients re-evaluated. Treadmill exercise testing showed an increase in exercise tolerance from a mean of 7.4 min to a mean of 8.7 min.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3272246 TI - Late results of total correction of tetralogy of Fallot in adults. AB - Between 1966 and 1986, 30 patients underwent total correction of the tetralogy of Fallot. Preoperative presenting features were: dyspnoea on exertion, clubbing, cyanosis and polycythaemia. Twenty-six patients had one or more palliative procedures prior to definitive repair. Preoperatively, all patients had a significant gradient across the right ventricular outflow tract (mean gradient 70 +/- 46 mmHg). Peak right ventricle to left ventricle systolic pressure ratio (pRV/LV) was 0.9 +/- 0.2. A functioning Blalock Taussig shunt was ligated in 11 patients prior to the institution of cardiopulmonary bypass. All patients had a patch closure of the ventricular septal defect. An additional muscle bundle resection from the right ventricular outflow tract was performed in 15, pulmonary valvotomy in 6 and enlargement of the right ventricular outflow tract in 2 patients. There was a significant fall in pRV/LV ratio postoperatively (P less than 0.05). There were 3 early and 2 late deaths. Mild right ventricular outflow tract obstruction has persisted in all survivors. Four patients have remained on antiarrhythmic drugs. Long term results after definitive repair were satisfactory in this group of adult patients who have survived due to palliative procedures performed during childhood. PMID- 3272247 TI - The surgical treatment of inflammatory and fibrous laryngotracheal stenosis. AB - Seventy-two patients with laryngeal or laryngo-tracheal stenotic lesions resulting from tracheal intubation or laryngo-tracheal injuries are reported. Prior to 1978, the method of surgical treatment consisted mainly of laryngoplasty supported by laryngeal stenting. Twenty-six patients were treated by this method with 2 mortalities. Twenty-one long term results were good and 3 were fair. After 1978, laryngo-tracheal resection was performed in 46 patients. Twenty-seven had a Pearson-type operation, 13 underwent total or subtotal cricoid plate resection and modelling, and the remaining 6 had modelling alone. Perfect results after resection depend on the treatment of infection and inflammation of the airway before surgery. Our preferred method is resection and end-to-end anastomosis whenever possible. In addition to the anatomical site of the lesion, the glottic opening has to be considered in planning the surgical operation since impairment necessitates enlargement of the glottis as part of the procedure. PMID- 3272248 TI - Surgical pathology of bullae with and without pneumothorax. AB - Experience with 2030 patients admitted for an actual episode of spontaneous pneumothorax, and with 370 patients hospitalized for bullous emphysema is thoroughly analyzed. Out of these groups, 400 patients (318 and 82 respectively) underwent an open thoracotomy. Macroscopic operative findings were divided into 8 groups. Descriptions of the aspect, size and site of bullae, respiratory function, mortality and follow-up data, are presented. Pathogenesis of the localised apical disease in comparison to the extended and diffuse types is outlined. Attention is drawn to the high operative risk in generalized emphysema and airway obstruction when associated with tension bullae and/or pneumothorax. More than 30% of the patients could not be included in either the juvenile type, isolated apical disease, or in the category of bullae associated with generalized emphysema. Reasons for an early rupture of apical subpleural blebs and the high resistance to check valve pressure of bullae following alveolar disruption are discussed. The observations lead to the conclusion that surgical pathology and treatment problems in bullous emphysema and in spontaneous pneumothorax have a lot in common and their arbitrary separation is not justified. PMID- 3272249 TI - Our experiences in surgical treatment of thoracic echinococcosis during the period 1977-1986. AB - Our experience is based on 147 patients with thoracic echinococcosis (TE) who underwent surgery. Of these, 131 (89.1%) patients had pulmonary TE, 3 (2.1%) had extra-pulmonary TE, and 13 (8.8%) had pulmohepatic TE Ninety-nine (67.3%) patients had uncomplicated TE, and 48 (32.7%) had complicated TE. All patients underwent surgery. In 129 (87.8%) patients, we performed cystectomy with capitonage and in 18 (12.2%) cases we performed a lung resection (lobectomy or segmentectomy). Postoperative complications occurred in 2 (1.4%) patients, and recurrence in 2 (1.4%) patients who previously had complicated TE. On admission, there was no evidence of allergic reactions in patients with complicated TE. The average time of postoperative treatment was 13 days. The results of surgical treatment were excellent. The conclusion reached is that a cystectomy with capitonage is the treatment of choice for pulmonary echinococcosis, while lung resection may be necessary if lung tissue has been destroyed by prolonged compression or infection. PMID- 3272250 TI - Surgical alternatives in ipsilateral recurrence of bronchogenic carcinoma. AB - In our unit, 5847 patients had pulmonary resections for bronchogenic cancer. Among them, 30 patients suffering from ipsilateral recurrence were operated upon. Recurrence because of incomplete first resection was found most frequently. Operations on ipsilateral recurrent tumours involve a high mortality. However, secondary resection of a recurrent bronchogenic carcinoma may sometimes be a suitable step towards achieving an appreciable survival. PMID- 3272251 TI - Results and prognostic factors after resection of pulmonary metastases. AB - One hundred and fifty-nine thoracotomies were performed in 122 patients with pulmonary metastases. The patients' ages ranged from 2 to 76 years, and 13 patients were younger than 18 years. The primary tumour was carcinoma in 83 cases, sarcoma in 29 cases and melanoma in 10 cases. The primary tumour in children was osteogenic sarcoma (6 patients), Ewing's sarcoma (2 patients) and Wilms' tumour (2 patients). With a minimum follow-up of 2 years, an actuarial 5 year survival rate of 38% was observed for carcinoma and 28% for sarcoma. Four of the children survived disease-free for 3 years or more after pulmonary metastasectomy. The primary tumour in these cases was osteogenic sarcoma and Ewing's sarcoma. A statistically significant difference in survival was found between the groups of carcinoma and sarcoma, but the prognosis for melanoma patients was markedly worse. In carcinoma patients the main prognostic factor was the duration of the disease-free interval. The actuarial postthoracotomy survival in patients with osteogenic sarcomas was 31% at 5 years, and 18% at 5 years in soft-tissue sarcomas. The size of the lesions, activity and disease-free interval correlated with survival in the osteogenic sarcoma group, and the number of lesions in the soft-tissue sarcoma group. An aggressive surgical approach towards pulmonary metastatic disease thus appears to be justified. PMID- 3272252 TI - A comparison of blood, crystalloid and oxygenated crystalloid cardioplegia solutions on myoglobin and creatine kinase release following cardiac surgery. AB - Oxygenated crystalloid cardioplegia was found not to produce better cardioprotection than blood or crystalloid cardioplegia, as assessed by myoglobin and creatine kinase MB (CPK-MB) isoenzyme, in patients undergoing coronary artery surgery. Myoglobin and CPK-MB levels were found to peak at 1 and 3 h, respectively, following release of the aortic cross-clamp. There was a good correlation between peak myoglobin and CPK-MB levels. CPK-MB of non-cardiac origin was found to represent a substantial proportion of total CPK-MB 4 h after the release of the aortic cross-clamp. PMID- 3272253 TI - Endarterectomy of the left main coronary artery stenosis by a 'transpulmonary artery approach'. AB - For better visualization of the left main coronary artery, a new technique involving transection of the main pulmonary artery is described. With this new method it was possible to perform endarterectomy of the left main coronary artery in 35 patients from February 1981 to July 1987. The endarterectomy incision was closed with a pericardial or venous patch. We had no mortality, and 91% are free from angina at a mean follow-up of 31 months. Angiographic evaluation was performed in 19 patients revealing good patency of the left main artery. This procedure is safe, and we recommend it in isolated left main coronary artery stenosis without distal involvement and with good left ventricular function. PMID- 3272254 TI - The Hancock pericardial xenograft: incidence of early mechanical failures at a medium-term follow-up. AB - The Hancock pericardial xenograft has been used in our Institution since August 1981 as an alternative to porcine bioprostheses. Up to July 1984, 97 Hancock pericardial xenografts have been implanted in 84 patients; of 76 operative survivors with a mean age of 55.2 +/- 13 years (range 13-75 years), 50 had undergone aortic valve replacement, 16 mitral valve replacement and 10 mitral aortic valve replacement. Follow-up ranged from 0.5 to 5.2 years with a cumulative duration of 239 patient/years and is 99% complete. Actuarial survival is 92% +/- 4% for patients with aortic valve replacement and 84% +/- 10% for patients with mitral valve replacement at 5 years, and 77% +/- 14% for those with mitral-aortic valve replacement at 4 years. Thromboembolic episodes occurred in 2 patients (1 after aortic and 1 after mitral valve replacement). The actuarial freedom from emboli is 100% for patients with mitral-aortic valve replacement at 4 years, and 96% +/- 3% for patients with aortic and 93% +/- 6% for patients with mitral valve replacement at 5 years. Reoperation was performed in 13 patients (9 aortic, 2 mitral and 2 mitral-aortic valve replacements), because of endocarditis in 3 (2 aortic and 1 mitral valve replacement), paravalvular leak in 1 (aortic valve replacement), and primary tissue failure in 9 (6 aortic, 1 mitral and 2 mitral-aortic valve replacements). Actuarial freedom from primary tissue failure is 72% +/- 9% for aortic and 83% +/- 8% for mitral Hancock pericardial xenografts at 5 years. Eleven xenografts explanted because of primary tissue failure were studied pathologically.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272255 TI - Unusual cause of recurrent arterial embolism: floating thrombus in the aortic arch surgically removed under hypothermic cardiocirculatory arrest. AB - A 46-year-old fully active, asymptomatic man suffered two episodes of major peripheral arterial embolism within 2 months. Heart disease was ruled out by appropriate investigations. Further diagnostic evaluation (angiography, CAT scan) revealed the extremely rare finding of a "floating mass" in the transverse aortic arch suspected to be the source of embolization. This mass was successfully removed using the technique of hypothermic cardiocirculatory arrest. The histological diagnosis was an aged intraluminal thrombus and moderate atherosclerosis of the thoracic aorta. For prevention of recurrent arterial embolism in cases without an initially apparent cause and site of origin, a thorough diagnostic, and in a given patient, an aggressive surgical approach for the elimination of the embolic source are advocated. PMID- 3272256 TI - Haemolysis and the St. Jude Medical valve. PMID- 3272257 TI - [Sudden unilateral neurosensory hypoacusis]. PMID- 3272258 TI - [Anatomo-pathologic study of otosclerosis and its clinical correlations]. PMID- 3272259 TI - [Cholesteatoma: clinical and surgical study]. PMID- 3272260 TI - [Subperichondral resection or septoplasty? Retrospective study of 465 operations]. PMID- 3272261 TI - [Results of a year of septo-pyramidal surgery]. PMID- 3272262 TI - [Malignant midline granuloma]. PMID- 3272263 TI - [Sudden deafness associated with abnormal cerebral venous drainage. Apropos of a case]. PMID- 3272264 TI - [Piringer-Kuschinka's lymphadenitis. Clinical and morphologic study. Apropos of a case]. PMID- 3272265 TI - [Laryngeal hamartoma. Apropos of a case]. PMID- 3272266 TI - [Descriptive study of cancer of the larynx in Guadalajara (1975-1985)]. PMID- 3272267 TI - [Bilateral postintubation vocal cord paralysis: apropos of a case]. PMID- 3272268 TI - [Cobalt therapy in the treatment of Osler-Rendu disease. Apropos of two cases]. PMID- 3272269 TI - [Incorporation of a stimulant of synthesis and secretion of a pulmonary surfactant (ambroxol) into the treatment of otitis serosa]. PMID- 3272270 TI - [Current concept of laryngeal leukokeratosis and its treatment]. PMID- 3272271 TI - [Multifactor analysis of endolaryngeal cancer]. PMID- 3272272 TI - [Morphology, cytology and topography of the vestibular and lateral line nucleus in the fish Rhinobatos]. PMID- 3272273 TI - [A hypothesis about the genesis of auditory recruitment]. PMID- 3272274 TI - [Changes in high frequency audiometry after stapedectomy]. PMID- 3272275 TI - [Morphometry of the stapes]. PMID- 3272276 TI - [Laryngo-tracheal injuries. Study of 20 cases]. PMID- 3272277 TI - [Melanoma of the larynx]. PMID- 3272278 TI - [Bell's paralysis and inverted acoustic reflex]. PMID- 3272280 TI - [Hygienic procedures in the dental laboratory]. PMID- 3272279 TI - [Relapsing polychondritis: a connective tissue disease of the ORL system]. PMID- 3272281 TI - [Microwave-cured prosthesis resins. First practical experience]. PMID- 3272282 TI - [Crown and inlay restoration. Function more important than esthetics. Case report]. PMID- 3272283 TI - [Somatic maturity and morphologic changes of the mandible with Herbst treatment]. PMID- 3272284 TI - [Orthodontic treatment after extraction of 6-year molars]. PMID- 3272285 TI - [Dangers of 6-year molar extraction from the viewpoint of joint-covered orthodontics]. PMID- 3272286 TI - Mechanisms underlying long lasting changes in neuronal properties: facts and perspectives. XIIth Gif Lecture in Neurobiology. Gif-Sur-Yvette, December 3-4, 1987. Proceedings. PMID- 3272287 TI - Neuronal mechanisms contributing to long-term sensitization in Aplysia. AB - 1.) Cellular processes that contribute to the acquisition and expression of long term sensitization have been examined in Aplysia. The tail-siphon withdrawal reflex was studied because the neural circuit for this reflex has been well characterized. Furthermore, the sensory neurons of this neural circuit exhibit cellular changes that accompany short-term sensitization. 2.) Repeated application of noxious stimuli to the animal produces a long-lasting enhancement of reflex withdrawal of the siphon when the animal is tested with a weak stimulus to the tail. These findings confirm the existence of long-term sensitization in Aplysia, first described by Pinkser et al. (1973). 3.) Biophysical correlates of long-term sensitization were examined in the first central relay of the tail siphon reflex circuit, the sensory neurons that innervate the animal's tail. The net outward membrane currents of these cells reduced after 24 hours as a consequence of long-term sensitization training. 4.) The intracellular signal for the induction of these changes in membrane currents was examined by intracellular injection of cAMP into individual sensory neurons. This procedure mimics at least some of the effects of sensitization training at the single-cell level. cAMP induced a long-term reduction of membrane K+ currents 24 hours after the cells were injected with cAMP. The membrane currents reduced by cAMP were similar to those reduced by long-term sensitization training. 5.) Preliminary experiments indicate that neurotransmitters and agents that induce an evaluation of cAMP in the sensory neurons also alter the incorporation of labeled amino acids into specific proteins in the sensory neurons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272288 TI - Circadian pacemaker neurons: membranes and molecules. AB - 1. A circadian pacemaker is located in the eyes of a variety of marine gastropods, including Aplysia and Bulla. It produces a circadian rhythm in the frequency of spontaneously occurring optic nerve (ON) compound action potentials (CAPs). The circadian pacemaker in Bulla includes a population of 100 retinal pacemaker neurons, that produce the rhythmic CAP output. Intracellular recording from the Bulla pacemaker neurons has yielded new insight into their time-keeping ability. 2. Intracellular injection of Lucifer yellow dye into a single pacemaker neuron results in the spread of dye to several neurons. This dye coupling is presumably mediated by the gap junctions among neurons that are responsible for the synchronous firing of the population of pacemaker neurons and the generation of ON CAPs. 3. The circadian pacemaker in each eye interacts with the paired pacemaker in the contralateral eye. The interaction results in the coordinating firing of CAPs from each eye and in the coordinated phasing of the circadian rhythms of CAP activity generated in each eye. This interaction occurs by reciprocal excitatory chemical synapses. These synaptic receptors occur in the ON as well as in the retinal neuropil and CAP synchrony occurs in the ON as well as in the basal retina. 4. Pacemaker neurons are depolarized by 5-HT and membrane permeable cAMP analogues. The membrane resistance increases during the depolarization suggesting a background potassium current is decreased. 5. The tetrapeptide FMRF-HN2 hyperpolarizes the pacemaker neurons. It reverses the effect of 5-HT and cAMP, suggesting 5-HT and FMRF-NH2 may be acting on the same membrane channel, the S channel.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272289 TI - Cerebellar Purkinje cells: membrane property changes on partial deafferentation. AB - The responses of the cerebellar Purkinje cell to removal of its climbing fiber input has been studied electrophysiologically in slices of rat cerebella. Using single electrode current clamp methods, membrane potentials were recorded in various conditions from normal and 3-AP deafferented Purkinje cells (PC). The membrane of the deafferented PC showed a rectification for hyperpolarizing currents which varied in degree with length of time after removal of the climbing fiber input. While this rectification was the most pronounced change in membrane properties provoked by the deafferentation, other more subtle effects were observed in experiments with changes in extracellular ionic compositions. Since the rectification began at membrane potentials near -60 mV, it could prevent membrane hyperpolarization by inhibitory synaptic inputs and thus produce an apparent hypersensitivity to excitatory inputs. PMID- 3272290 TI - Molecular approaches to the study of long-term sensitization in Aplysia californica. AB - In order to gain insight into the molecular mechanisms underlying the establishment and maintenance of long-term sensitization in Aplysia new tools are being used to study the synaptic facilitation in the sensory-motor connection which mediates the gill-and-siphon withdrawal reflex. The supposition that long term changes in neuronal properties share molecular pathways with other cells during development and differentiation points towards specific candidate genes as well as towards a general experimental strategy designed to find proteins which might mediate these changes. The unique properties of Aplysia cell biology may, in addition, provide a means to examine their specific roles in the triggering of the changes, as well as the nature of the changes themselves. PMID- 3272291 TI - Neuronal mechanisms of learning in an in vitro Aplysia preparation: sites other than the sensory-motor neuron synapse are involved. AB - Classical conditioning of the gill withdrawal reflex can be demonstrated in two different in vitro Aplysia preparations. The data obtained show that as conditioning of the gill withdrawal reflex proceeds there are changes in synaptic efficacy at the central sensory-motor neurone synapse. These changes in synaptic efficacy, however, are not necessary nor are they sufficient for the observed changes in gill reflex behaviour. Changes must be occurring at other loci within the nervous system to mediate the associative learning. We hypothesized, based on data obtained from one type of in vitro preparation, that changes occur in the ability of the motor neurone to elicit a gill withdrawal response as a result of classical conditioning training. In order to test this hypothesis we depolarized an identified gill motor neurone before and after classical conditioning and found that the motor neurone's ability to elicit a gill movement was facilitated following classical conditioning training. In control preparations that received an explicitly unpaired stimulus paradigm (which does not lead to classical conditioning of the reflex) there was a decrease in the efficacy of a gill motor neurone to elicit a gill withdrawal response. There are a number of possible sites within the integrated central (CNS) and peripheral (PNS) nervous systems where changes could occur to bring about the alterations in motor neurone efficacy. Our results suggest that changes in neuronal activity which underlie learning occur at multiple sites within the nervous system and that a complete understanding of the mechanisms of associative learning can only be obtained when all of these sites are taken into account. PMID- 3272292 TI - Formation of new cortico-rubral synapses as a possible mechanism for classical conditioning mediated by the red nucleus in cat. AB - 1.) By extracellular and intracellular recordings of the red nucleus (RN) cell activity, we investigated enhancement of signaling effectiveness at the cortico rubral synapses underlying the establishment of classical conditioning mediated by RN in the cat. The classical conditioning of forelimb flexion was produced by pairing the conditioned stimulus (CS) to the cerebral peduncle (CP) with the unconditioned stimulus (US) to the forelimb skin at an interval of 100 msec for about a week. 2.) The increased responsiveness of RN cells to the CS was correlated with acquisition of the conditioned forelimb flexion, i.e. RN cells responded to the CS with higher firing probability in the animals which received the paired conditioning than those in the animals which received the CS alone or pairing of the CS and the US at random intervals or those in the naive animals which did not receive any training. 3.) Monosynaptic excitation of RN cells in response to the single pulse to CP was most enhanced in the animals which received the paired conditioning. By contrast, response of RN cells, as well as the behavioral response, induced by stimulation of the cerebellar interpositus nucleus (IP) was not enhanced after the paired conditioning. The difference between the responses to the stimulation of CP and IP suggested that the primary site of neuronal change is the cortico-rubral synapses. 4.) In the animals that received the paired conditioning, the excitatory postsynaptic potentials (EPSPs) induced by stimulation of CP had fast-rising components superimposed on the normal slow-rising EPSPs. On the other hand, most of the CP-EPSPs recorded in the naive animals showed a slow time course. The slow time course of the CP-EPSPs has been attributed to the peripheral localization of the cortico-rubral synapses on the dendrites of RN cells. 5.) The electrotonic length of RN cells in the animals which received the paired conditioning was not shorter than that in the naive animals. Therefore, it was suggested that the appearance of the fast-rising component in the CP-EPSPs is cause by formation of the new cortico-rubral synapses on proximal portions of the soma-dendritic membrane of RN cells. 6.) Since it has been established that new synapses formed by collateral sprouting are retained for more than several months, the formation of new synaptic connections could underlie long-lasting behavioral modification. PMID- 3272293 TI - Long-term change of viability of neuron functioning and its possible behavioral consequences in the adult Aplysia. AB - 1. In Aplysia of different ages, three well defined behavioral responses and their substrates were examined. 2. Two of the behaviors and their substrates are age-sensitive, the gill withdrawal reflex, and osmoregulation. They are sensory dependent for their activation. The third, the gill respiratory pumping movements, GPM, and its substrates is age-invariant. It is initiated by a network in the CNS, and modulated by sensory input. 3. Age-sensitivity of a neuron appears dependent on its pathway: the pathways mediating sensory-initiated behavior are more vulnerable to aging than the pathway mediating CNS-initiated behavior. 4. a) The age-sensitive, GWR, gill withdrawal reflex, in unrestrained animals and in reduced preparations conforms to the age-dependent reduced functioning of L7, the major mediator of the reflex. b) Whereas, the age invariant GPM conforms to the age-independent functioning of LDG1, a major contributor to GPMs. c) The age-related slowing of osmoregulation is consistent with the lack of response in the putative water balance neuron, R15, to stimulation of osmoreceptors by dilute seawater. 5. Age-sensitivity of L7 is defined by its reduced function, decreased facilitation at its terminals, reduced input resistance, and remodeling of junctions in the muscles it innervates. This is in contrast to the age-invariance of these properties in LDG1 and of the junctions in muscles it innervates. Thus far, the age-sensitivity of R15 is revealed by its reduced responsiveness to synaptic input, reduced input resistance, and little response to osphradial stimulation. 6. Age-sensitivity of the GWR, osmoregulation and of their substrates is not necessarily maladaptive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272294 TI - Activation of protein kinase C by serotonin: biochemical evidence that it participates in the mechanisms underlying facilitation in Aplysia. AB - 1.) Application of serotonin to Aplysia sensory neurons can result in facilitated synaptic transmission, both short- and long-term. This facilitation is likely to be produced by a complex set of molecular mechanisms: serotonin activates adenylate cyclase, increasing cAMP and protein kinase (Cedar and Schwartz, 1972); serotonin also changes the subcellular distribution of the Ca2+/calmodulin dependent protein kinase (Saitoh and Schwartz, 1983). Recently, phorbol esters also have been shown to produce facilitation. We have therefore investigated how protein kinase C (PKC) participates in serotonin-mediated synaptic facilitation. 2.) We found that the Aplysia genome encodes PKC, which is expressed in nervous tissue as at least two abundant transcripts (about 0.003% of the total message). Its inferred amino acid sequence is 85% homologous to that of enzymes from mammals and Drosophila, and over 95% homologous if compared to both. The specific activity of the Aplysia kinase is comparable to that found in rat brain, with similar reaction parameters and dependencies on phosphatidylserine (PS), Ca2+, diacylglycerol and phorbol esters. While PKC is found on neuronal membrane in the basal state, the PKC activators, Ca2+ and phorbol esters, further translocate the kinase to membrane in crude extracts of neuronal tissue. The amounts of membrane bound PKC, as determined by 3H-phorbol-ester binding, are greatest in neuropil and nerve. 3.) Exposure of sensory neurons and their terminals in Aplysia pleural pedal ganglia to facilitating doses of either phorbol ester or serotonin results in the translocation of PKC from cytosol to membrane, activating the enzyme. cAMP does not produce this translocation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272295 TI - The role of ependymin in the development of long lasting synaptic changes. AB - 1.) Three types of training experiments (a complex motor task, avoidance conditioning and classical conditioning) in the goldfish and one in the mouse (T maze learning) indicate that the brain extracellular glycoprotein (ependymin) has a role in the consolidation process of long-term memory formation. 2.) Direct ELISA measures of the concentration of ependymin in the brain extracellular fluid (ECF) indicate that its level decreases after goldfish learn to associate a light stimulus (cs) with the subsequent arrival of a shock (US): paired CS-US gave changes whereas an unpaired presentation of CS-US gave no changes in comparison to unstimulated controls. 3.) Ependymin is released into ECF and CSF as mixtures of three types of disulfide-linked dimers of two acidic polypeptide chains (M. W. 37 kDa and 31 kDa). It contains 10% carbohydrate as an N-linked glycan. 4.) Ependymin has the capacity to polymerize in response to events that deplete Ca2+ from the brain extracellular environment. A molecular hypothesis relating polymerization properties to the process of formation of long-lasting synaptic changes is proposed. 5.) Investigations of the pattern of regeneration of goldfish optic nerve and the mechanisms of long-term potentiation (LTP) of rat brain hippocampal slices suggest that ependymin has a role in the formation of long-lasting synaptic changes. The E.M. data show that polymerized products which stain with anti-ependymin sera accumulate at synapses and in new spines after LTP. PMID- 3272296 TI - Prolonged primary afferent induced alterations in dorsal horn neurones, an intracellular analysis in vivo and in vitro. AB - 1.) Peripheral tissues injury produces long lasting sensory and motor disturbances in man that present as the post-injury hypersensitivity syndrome with a reduction in the threshold required to elicit either pain or the flexion withdrawal reflex and an exaggeration of the normal response to suprathreshold stimuli. 2.) Two mechanisms contribute to these changes; sensitization of the peripheral terminals of high threshold primary afferents and an increase in the excitability of the spinal cord; a phenomenon known as central sensitization. 3.) Central sensitization has previously been shown by our laboratory to be the consequence of activity in unmyelinated primary afferents. Brief (20 s) C-fibre strength conditioning stimuli have the capacity to produce both a prolonged heterosynaptic facilitation of the flexion reflex and an alteration in the response properties of dorsal horn neurones, that long outlast the conditioning stimulus. 4.) In the adult decerebrate-spinal rat preparation we have, using intracellular recordings of dorsal horn neurones, examined the time course of the central effects of different types of orthodromic inputs. The hemisected spinal cord preparation isolated from 12-14 day rat pups has been used to see whether prolonged alterations in dorsal horn properties induced by orthodromic inputs can be studied in vitro. 5.) Single stimuli applied to a cutaneous nerve at graded strengths to successively recruit A beta, A delta and C-afferents produce, in the majority of neurones recorded in the deep dorsal horn in vivo, a series of post synaptic potentials that last from between ten and several hundred milliseconds. 6.) Repeated low frequency stimulation of C but not A-afferent fibres results in a pattern of progressive response increment or windup in a proportion of dorsal horn neurones. In some of the neurones the windup is associated with a depolarization that outlasts the stimulus period for tens of seconds. 7.) Application of the chemical irritant mustard oil to the skin activates chemosensitive C-afferent fibres for 1-3 minutes. Such a conditioning stimulus results however in an expansion in the size and an alteration in the response properties of the receptive fields of dorsal horn neurones that lasts for tens of minutes. 8.) In dorsal horn neurones recorded intracellularly in the isolated hemisected spinal cord, both intrinsic membrane properties and the orthodromic responses to primary afferent input can be studied. Repeated stimulation of a dorsal root produces in some neurones a prolonged heterosynaptic facilitation with both an augmentation of the response to the conditioning root (homosynaptic potentiation) and to adjacent test roots (heterosynaptic potentiation).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3272297 TI - Modification of adenylate cyclase by photoaffinity analogs of forskolin. AB - Photoaffinity labeling analogs of the adenylate cyclase activator forskolin (PF) have been synthesized, purified and tested for their effect on preparations of membrane-bound, Lubrol solubilized and forskolin affinity-purified adenylate cyclase (AC). All analogs of forskolin significantly activated AC. However, in the presence of 0.1 to 0.3 microM forskolin, the less active forskolin photoaffinity probes at 100 microM caused inhibition. This inhibition was dose dependent for PF, suggesting that PF may complete with F for the same binding site(s). After cross-linking [125I]PF-M (see Figure 1 for structure) to either membrane or Lubrol-solubilized AC preparations by photolysis, a radiolabeled 100 110 kDa protein band was observed after autoradiography following SDS-PAGE. F at 100 microM blocked the photoradiolabeling of this protein. Radioiodination of forskolin-affinity purified AC showed several protein bands on autoradiogram, however, only one band (Mr = 100-110 kDa) was specifically labeled by [125I]PF-M following photolysis. The photoaffinity-labeled protein of 100-110 kDa of AC preparation of rat adipocyte may be the catalytic unit of adenylate cyclase of rat adipocyte itself as supported by the facts that [a] no other AC-regulatory proteins are known to be of this size, [b] the catalytic unit of bovine brain enzyme is in the same range and [c] this PF specifically stimulates AC activity when assayed alone, and weekly inhibits forskolin-activation of cyclase. These studies indicate that radiolabeled PF probes may be useful for photolabeling and detecting the catalytic unit of adenylate cyclase. PMID- 3272298 TI - Molecular cloning and sequence analysis of two distinct types of Xenopus laevis protein kinase C. AB - Two distinct types of protein kinase C cDNA clones were isolated from a Xenopus laevis oocyte cDNA library, and the complete nucleotide sequences were determined. The sequences encode a single open reading frame with a domain structure that consists of four constant (designated C1-C4) and five variable (designated V1-V5) regions. Comparison of the two sequences shows good homology at the nucleotide and deduced amino acid level. The differences reside primarily in the variable regions. Each clone encodes 671 and 676 amino acids, respectively, having extensive homology with published sequences of human, rat, and bovine protein kinase C. These results provide evidence that these two distinct types of protein kinase C are members of a multigene family in amphibian and mammalian species. PMID- 3272300 TI - [Noninvasive evaluation of the severity of mitral valve stenosis]. PMID- 3272299 TI - Types I alpha and I beta isozymes of cGMP-dependent protein kinase: alternative mRNA splicing may produce different inhibitory domains. AB - We recently described a novel isozyme of cGMP-dependent protein kinase (type I beta). It has a structure and peptide substrate specificity which is similar to that of type I alpha, but it has a different cGMP binding behavior, and autophosphorylation occurs almost entirely in serine instead of in both serine and threonine residues (Wolfe, L., Corbin, J.D., and Francis, S.H. (1989) J. Biol. Chem. 264, 7734-7741). An amino-terminal sequence of 31 amino acids derived from three proteolytic fragments of type I beta had 45% homology with a sequence beginning at type I alpha-47. However, sequences of three CNBr peptides of type I beta were identical to sequences of type I alpha beginning at type I alpha-202, 213, and -576 of 11, 27, and 30 residues. These sequences include portions of the catalytic domain and at least one cGMP-binding domain (site 1). Thus, types I alpha and I beta may be produced by alternative splicing of two unique mRNA segments to generate different amino acid sequences in the protein in a region that is amino-terminal to type I alpha-202. This segment in type I beta corresponds to the region in type I alpha that includes the major autophosphorylation site (Thr-58) which is within the domain that is proposed to inhibit catalytic activity. This region presumably interacts with the cGMP binding site(s) to account for the differences in cGMP-binding behavior between types I alpha and I beta. Even though the sequence of type I beta in the variable region lacks the residue corresponding to Thr-58, it includes a consensus phosphorylation site (KRQAISA) beginning at type I alpha-59, which is absent in type I alpha. The results imply flexibility in the design of the autophosphorylation site and, hence, of the inhibitory domain. PMID- 3272301 TI - [Liaison psychiatry--principles and goals]. PMID- 3272302 TI - [An approach to the treatment of hypertensive crisis]. PMID- 3272303 TI - [Use of cadaveric homologous homotransplantation for repair of dura mater defects]. PMID- 3272304 TI - [Calcium antagonists. Ambulatory and hospital use]. PMID- 3272305 TI - [The adult form of Gaucher's disease]. PMID- 3272306 TI - [Granulomatous epididymitis]. PMID- 3272307 TI - [Hereditary abnormalities of antithrombin III in patients with recurrent thrombophlebitis]. PMID- 3272308 TI - [Echocardiography in amyloidosis (case report)]. PMID- 3272309 TI - [Rational choice of cardiotonic agents in modern pediatrics]. PMID- 3272310 TI - [Vitamin D in renal insufficiency--metabolism, hormonal forms, its effect and importance in the therapy of renal osteodystrophy]. PMID- 3272311 TI - [Dentofacial deformities as a result of chronic adenoid vegetations]. PMID- 3272312 TI - [Lumbar sympathectomy in the treatment of peripheral arterial diseases in the lower extremities]. PMID- 3272313 TI - [Acute exacerbation of chronic otitis and endocranial complications]. PMID- 3272315 TI - [Diagnosis and therapeutic approach in various forms of thyroid gland hyperfunction at the Institute for Nuclear Medicine in Sarajevo]. PMID- 3272314 TI - [The cri-du-chat syndrome]. PMID- 3272316 TI - [Radioimmunologic analysis at the Institute of Nuclear Medicine in Sarajevo]. PMID- 3272317 TI - [Scintigraphy of the bones]. PMID- 3272318 TI - [Psychiatric evaluation of functioning in severe neuroses]. PMID- 3272319 TI - [Thrombi in the left ventricle in idiopathic dilated cardiomyopathy. Detection using 2-dimensional echocardiography]. PMID- 3272320 TI - [Etiologic moments and the prevention of blindness]. PMID- 3272321 TI - [Epilepsy, pregnancy and dysmorphogenesis]. PMID- 3272322 TI - [Epithelial dysplasia of the gastric mucosa and duodenogastric reflux]. PMID- 3272323 TI - [Pathogenesis and pathology of chronic secretory otitis in the light of new knowledge]. PMID- 3272324 TI - [Dilemmas in the treatment of ischemic cerebrovascular insult]. PMID- 3272325 TI - [Angiographic criteria for the morphologic and locational classification of angiomas]. PMID- 3272326 TI - [Personal experience in the detection of physical deformities; possibilities of treatment and prevention]. PMID- 3272327 TI - [The Dressler syndrome as an early complication of myocardial infarct]. PMID- 3272329 TI - [Dislocation of the knee associated with injury of the popliteal artery]. PMID- 3272328 TI - [Obstructive lesions of the urologic tract, their characteristics and complications]. PMID- 3272330 TI - [Review of a case of postoperative embolism of the heart]. PMID- 3272332 TI - [Hydroxypolyethoxydodecane in the treatment of enlarged veins in the lower extremities]. PMID- 3272331 TI - [Personal experience in the surgical treatment of congenital clefts of the lip, and the hard and soft palates]. PMID- 3272333 TI - [The effect of chromium and aluminum ions on lactate dehydrogenase isoenzymes in HeLa cells]. PMID- 3272334 TI - [Segmental abnormalities in left ventricular wall motion in idiopathic dilated (congestive) cardiomyopathies--detection using 2-dimensional echocardiography]. PMID- 3272335 TI - [Immunologic stimulation in the therapy of alopecia areata]. PMID- 3272336 TI - [The effect of cardioactive glycosides on atrioventricular conduction]. PMID- 3272337 TI - [Coronary disease, ageing, duration of diabetes and lipoprotein disorders]. PMID- 3272338 TI - Biomembranes. Part N. Transport in bacteria, mitochondria, and chloroplasts: protonmotive force. PMID- 3272339 TI - Cooperative proton-transfer reactions in the respiratory chain: redox bohr effects. PMID- 3272340 TI - Purification and reconstitution of bovine heart mitochondrial transhydrogenase. PMID- 3272341 TI - Isolation of the iron-sulfur-containing polypeptides of NADH: oxidoreductase ubiquinone. PMID- 3272342 TI - Isolation and hydrodynamic characterization of the uncoupling protein from brown adipose tissue. PMID- 3272343 TI - Refinements in oxygen-18 methodology for the study of phosphorylation mechanisms. PMID- 3272344 TI - Nuclear matrix bound terminal deoxynucleotidyl transferase in rat thymus nuclei. I. A possible site for TdT mediated function. AB - Approximately 80% of the terminal deoxynucleotidyl transferase (TdT) in thymus glands from 3-4 week old rats was found to be localized in the nucleus and the remaining 20% in the cytosol. Following endogenous nuclease digestion of the thymus nuclei, 70-85% of the nuclear TdT could be removed by low salt and high salt extractions, whereas 15-30% of the enzyme remained tightly bound to the residual nuclear matrix. Low salt and high salt extracts of the nuclei contained a mixture of 58, 56, 45 and 44 kDa species of TdT whereas only 58 kDa species of the enzyme was found to be associated with the matrix. In addition to TdT, 20-25% of the nuclear DNA polymerase alpha was also tightly bound to the isolated nuclear matrix. These observations lead us to propose that besides being the site of DNA replication via-matrix bound replicational complexes [Van der Velden H.M.W. & Wanka F., Molecular Biology Reports 12 (1987): 69], nuclear matrix may also be the site of TdT mediated function and that matrix bound TdT and free TdT could be the functional and nonfunctional forms of the enzyme, respectively, in the thymus gland. PMID- 3272345 TI - Nuclear matrix bound terminal deoxynucleotidyl transferase in rat thymus nuclei. II. Effect of ATP on free and matrix bound TdT. AB - Endogenous nuclease digestion of thymus nuclei from 3-4 week old rats followed by a step wise extraction with low salt, 0.5 M salt and 1 M salt removed approximately 70-85% of total nuclear terminal deoxynucleotidyl transferase (TdT) whereas approximately 15-30% of the enzyme remained tightly bound to the residual nuclear matrix. The cytoplasmic TdT as well as the bulk of nuclear TdT extracted in low salt and 0.5 M salt was found to be strongly inhibited at low concentration of ATP whereas matrix bound TdT and a significant portion of the enzyme in 1 M salt extract was completely insensitive to this nucleotide. The ATP resistant enzyme in the 1 M salt extract was unstable and slowly converted to ATP sensitive form upon prolonged preincubation on ice whereas under similar conditions it remained unaffected in the matrix bound form. These observations lead us to suggest that ATP resistant matrix bound TdT being capable of discriminating unnatural rNTPs against the natural dNTP substrates, may be the functionally organized form of the enzyme and that free TdT having lost the capability to distinguish between dNTP and rNTP may be the nonfunctional form of the enzyme in the thymus gland. PMID- 3272348 TI - [Cytotoxicity of formocresol on cultured mammalian cells]. PMID- 3272346 TI - Comparative filter binding study of H5 to nucleosome core particles, H1, H5 depleted chromatosomes and DNA fragments. AB - The filter-binding technique with PEI treated glass fiber is used to study the interaction of histone H5 to core particles, chromatosomes and DNA derived from it. By working at very low concentrations of interacting particles we are able to study the effective binding process independent of interfering insoluble complexes. The interactions are characterized by a very high affinity. An intrinsically higher affinity of H5 for cores and chromatosomes versus chromatosome derived DNA is demonstrated. Both chromatosomes and DNA derived from these bind about twice the amount as compared to core particles, which saturate at about one H5 per core particle. PMID- 3272349 TI - [Morphological studies on the lingual papillae and their connective tissue papillae of rats]. PMID- 3272347 TI - In vitro acetylation of the liver HMG non-histone proteins and its modulation by spermine and dexamethasone during aging of rats. AB - The in vitro acetylation of HMG proteins was studied using liver slices of young (18-week) and old (138-week) male rats. Acetylation of total HMG proteins is lower in old age. The incorporation of (14C) acetate into individual HMG proteins varies remarkably with advancing age. Whereas acetylation of high mol. wt. proteins (HMG 1 and 2) is higher, that of low mol. wt. proteins (HMG 14 and 17) is lower in the liver of young rats as compared to the old ones. Spermine stimulates the acetylation of HMG 1 and 14 in young and HMG 1, 2 and 14 in old age. It inhibits the acetylation of HMG 17 in both ages. Dexamethasone decreases the level of incorporation of (14C) into HMG 1 and 17 in young and HMG 14 and 17 in old rats. On the other hand, it stimulates the acetylation of HMG 14 by two fold in young and that of HMG 1 and 2 by more than three-fold in old rats. Such alteration in the acetylation of HMG proteins may account for age-related changes in the structure and function of chromatin. PMID- 3272351 TI - [Characteristics of the measurement system of a magnetic field for mandibular movement (sirognathograph)]. PMID- 3272350 TI - [Hardness and abrasion resistance of calcium phosphate crystalline ceramics]. PMID- 3272352 TI - [A case report treated with the Begg and straight wire technique: the combination anchorage technique (C.A.T.)]. PMID- 3272353 TI - [Articulator with electronic adjusting system]. PMID- 3272354 TI - [Biological and biochemical characteristics of the oral spirochetes isolated from focus of marginal periodontal patient in Taiwan]. PMID- 3272355 TI - [Histological study of oral glands of the anole lizard, Anolis carolinensis]. PMID- 3272356 TI - [Characteristics of the Actinomyces isolated from the focus of periodontal disease in humans]. PMID- 3272357 TI - [Formation of fluorapatite with cellulosic gels]. PMID- 3272358 TI - [Formation of fluorapatite with polyacrylic acid gels]. PMID- 3272359 TI - [Ultrastructural and histochemical studies on the lingual gland of the Japanese lizard. Japalura polygonata polygonata]. PMID- 3272360 TI - [Bone penetration of antimicrobial agents (ABPC and OFLX) to rabbits]. PMID- 3272361 TI - [Brief note on collagenolytic activity in oral treponemes]. PMID- 3272362 TI - [Equilibrium function in relation to the occlusion in preschool children by means of Stabilometer]. PMID- 3272363 TI - [The form of occlusion in denture wearers. The effect of lingualized occlusion on masticatory function]. PMID- 3272364 TI - [Cytotoxicity of zinc oxide on cultured mammalian cells]. PMID- 3272365 TI - [Marginal sealing of cervical restoration for wedge-shaped defect using a Photo Clearfill Bright System]. PMID- 3272366 TI - [X-ray scatter data at the image plane and exposure in air at the surface of the object in diagnostic radiology]. PMID- 3272367 TI - [About resistance and inductance]. PMID- 3272369 TI - [Cytotoxicity of thymol on cultured mammalian cells]. PMID- 3272368 TI - [A prosthetic treatment case where a central incisor of a child was extracted after a period of replantation]. PMID- 3272370 TI - [Scanning electron microscopic observation of dental plaque on human teeth]. PMID- 3272371 TI - [Measurement of blood flow rate of oral mucosa using the electrolytic regional blood flowmeter. Part 1. Studies on electrifying conditions and diffusion of hydrogen gas]. PMID- 3272372 TI - [Formation of fluorapatite with blended gel of high molecular compound mucilage]. PMID- 3272373 TI - [The relationship between the tooth contact on working side and the path of condyles and cusps in frontal plane. Studies with the three-dimensional measurement system]. PMID- 3272374 TI - [An experimental study of the effects of orthodontic force on the dynamics of periodontal cells]. PMID- 3272375 TI - [Human skin impedance diagram by finite alternating potential]. PMID- 3272376 TI - [Clinical study on the power spectral analysis of the masseter muscle electromyogram from surface electrodes]. PMID- 3272377 TI - [Experimental studies on effects of implanting two or more hydroxyapatite ceramic implant materials containing tricalcium phosphate on maxillary tissue]. PMID- 3272378 TI - [Synthesis of dimethylsilyldimethacrylate and changes of some properties of the polymer by addition to methylmethacrylate]. PMID- 3272379 TI - [An anatomical study of the human lateral pterygoid muscle. The correlation of myofibrous organization and articular disk]. PMID- 3272380 TI - [Distribution pattern of enzyme histochemical muscle fiber types in temporal muscles of rat]. PMID- 3272381 TI - [L- and D-lactate metabolisms by human salivary microorganisms]. PMID- 3272382 TI - [Effect of temperature on the lactate production by oral microorganisms]. PMID- 3272383 TI - [The condylar position of the removable denture wearers with remarkable alveolar ridge resorption]. PMID- 3272384 TI - [A clinical assessment of porous hydroxyapatite ceramics (APS-7) in dentistry]. PMID- 3272385 TI - [Clinical studies on electromyographic evaluation of the masticatory function]. PMID- 3272386 TI - [Clinical application of hydroxyapatite ceramics APS-7 in the field of oral surgery]. PMID- 3272387 TI - [A patient with a lung cancer exhibited extremely favorable effect of fever by naproxen: a case report]. PMID- 3272389 TI - [Myofibrous organization of the human medial pterygoid muscle]. PMID- 3272388 TI - [The healing process of the rabbit tongue coagulated by microwaves]. PMID- 3272390 TI - [Growth study on subgingival oral treponemes]. PMID- 3272391 TI - [Cytotoxicity of tetracycline hydrochloride on cultured mammalian cells]. PMID- 3272392 TI - [An analysis of fluorapatite crystallized upon tooth enamel with gel method with use of the measurement of diffracted X-ray from thin layer specimens]. PMID- 3272393 TI - [The morphological study of the Japanese maxillary protrusion with the "Wits" appraisal]. PMID- 3272394 TI - [The nitella resistance and capacitance at the transient and rest condition applied by the alternating potential]. PMID- 3272396 TI - [15th national meeting of the Italian Society of Parasitology. (Foggia, 1-5 June 1988). Abstracts]. PMID- 3272395 TI - [Effect of ultrafiltrate factors of saliva on lactate production by Streptococcus mutans]. PMID- 3272397 TI - [Pediatric orthognathic surgery (Statistical study)]. AB - A statistical study covering five years (1983-1987) of work by the Pediatric Orthognatic Surgery Clinic at pediatric hospitals in the Centro Medico Nacional and La Raza, Instituto Nacional del Seguro Social. The bases and rationale followed by the clinic to correct dentofacial deformities in patients under 15 are described, along with services involved and surgical procedures followed in 90 pediatric patients, as compared with 165 adult patients operated within that same period, favorably confirming the hypothesis propounded in practice. PMID- 3272398 TI - [Dental fluorosis in San Luis Potosi and its solution alternatives (pilot study)]. AB - A study exposing the situation affecting the population of San Luis Potosi in central Mexico, caused by dental fluorosis. Findings point to the need of implementing devices capable of regulating the concentrations of Fluorine ion (generating the efficient prevention of dental cavity incidence), to maintain them at optimal levels and without deletereal effects. PMID- 3272399 TI - [Leukemias]. PMID- 3272400 TI - [Dental malocclusion and bony abnormalities in girls with nasopharyngeal obstruction of allergic origin]. AB - A group of 15 cases with a history of allergic rhinitis and nasopharyngeal obstruction was selected in order to compare it with another group of equal size without pathological background, to determine, among both groups, the difference of the effects due to nasopharyngeal obstruction on the facial growth. The allergic patients characteristics were a high palate vault, retroinclinable maxillary incisors, increasement of total anterior facial elevation as well as the low third of facial elevation in addition to an augmented maxillary plane. Statistically, only the evaluation of the facial axis yielded a significant result. From a radiologic point of view, the measurement of the nasopharyngeal extent showed no difference although clinically and cephalometrically presented a typical facial growth deviation. Both groups measurements proved no difference mainly due to the fact of having observed but the lateral view x-rays, nontridimensionally. Allergic rhinitis, facial growth, malocclusion. PMID- 3272401 TI - [Orodental occupational risks]. AB - An approach to the origin of those diseases of the stomatognathic system which occur within the laboring media and may thus pose an occupational hazard to workers, is hereby attempted with the aim of creating consciousness in dentists as to the importance of occupational stomatology within the odontological field, in the hope of motivating them to explore and research further in the study of these pathologies. PMID- 3272402 TI - [Congenital oral pits: report of a case]. AB - Normal morphogenesis of oro-facial tissues includes a complete, step-by-step sequence of cell migration and of interaction between groups of cells; mechanisms responsible for dysmorphogenesis are, however, still unknown. Lips are frequent target structures for these malformations, a variety of which are congenital labial fistula. The present paper reviews current literature on the subject an submits a case history illustrating this alteration. PMID- 3272403 TI - [The relationship of gingival insertion and inflammation with gingival recession in children]. AB - Paper presents a study on 115 children, aged 5 to 15, to determine existing relationship between degree of inflammation and amount of gum insertion, with gingival recession. The study included true and false recession. PMID- 3272404 TI - [Ludwig's angina]. PMID- 3272405 TI - [Anatomy and physiology of the TMJ]. PMID- 3272406 TI - [Dental intervention in speech disorders]. PMID- 3272407 TI - [Cleft lip and palate in Campeche Mayas]. AB - It has been suggested that among American Indians, as in some genetically-related Asiatic ethnic groups, incidence of cleft lip and/or cleft palate is higher than among people of Caucasian extraction. Such hypothesis, plus growing demand for services observed at a center for the surgery of cleft lip and cleft palate in Campeche state, led the authors to undertake research among the Maya residents of that region. However, neither careful review of case histories nor field research performed in several Indian communities could confirm the hypothesis of a higher incidence among this ethnic community. PMID- 3272408 TI - [Classification and frequency of patients with cleft lip and palate in a hospital institution]. AB - A review of case histories of patients with cleft lip and/or cleft palate from the Department of Stomatology of the Federico Gomez Children's Hospital in Mexico City, rounded as preliminary material for starting a statistical record, classifying cases as to severity and schedule them for consultation, in order to provide them a better orthodontic attention. PMID- 3272409 TI - [Hodgkin's disease]. PMID- 3272410 TI - [The most common changes in the temporomandibular joint. Internal lesions]. PMID- 3272411 TI - [Toxicity of local anesthetics]. PMID- 3272412 TI - [Trigeminal neuralgia]. PMID- 3272413 TI - [Globulomaxillary cyst]. PMID- 3272414 TI - [Agranulocytosis]. PMID- 3272415 TI - [Arthroscopy of the temporomandibular joint]. AB - Arthroscopy was introduced in 1975, as a method for the diagnosis and treatment of the most common conditions involving the temporo-mandibular joint, with ample advantages over more sophisticated diagnostic techniques currently developed. The object of this report is to describe this method of diagnosis and treatment- arthroscopic technique--and list findings from 15 patients suffering from assorted abnormalities of the temporo-mandibular joint. PMID- 3272416 TI - [Compound odontoma with history of trauma: report of a case]. AB - Clinical and roentgenographical features are described for a compound odontoma in a ten-year old male with a history of trauma in the anterior region of the face. Diagnostical methods and surgical handling are discussed, with a review of the pertinent literature. PMID- 3272417 TI - [Compound complex odontoma (transitional): Report of a case]. AB - This paper reports the case history of a nine-year old female referred to consultation because of clinical absence of left upper central incisor, with persistence of lateral incisor of homologous side, and with discrete volume increase of that region. Surgical procedure and post-op treatment are described, with confirmation, in this case, of clinical and histopathological diagnosis of complex-compound (transition) odontoma. PMID- 3272418 TI - [Luxation of the temporomandibular joint]. PMID- 3272419 TI - [Supernumerary premolars]. PMID- 3272420 TI - [The dentist as an auxiliary to the law]. AB - Odontology has played an important role in identifying corpses of unknown persons, and different techniques have been tried to take best advantage of his practice toward that end, since one of the problems facing both the physician and the odontologist in the forensic area is the frequent lack of previous records, dental or from any other nature, which may allow for identification of the unknown. PMID- 3272421 TI - [Basics of dental surgery. Preparation for the operation (IX)]. PMID- 3272422 TI - [What should the dental assistant know about the rubber dam? (III)]. PMID- 3272424 TI - [Orthodontics in specialty area of the dental assistant (II)]. PMID- 3272423 TI - [Toothpastes and toothbrushing scrutinized]. PMID- 3272425 TI - [Possibilities and limits of virus inactivation in the home]. PMID- 3272426 TI - [Esthetics and function in the complete denture--difference between ready-made and esthetically modified teeth]. PMID- 3272427 TI - [Rehabilitation of upper mesial and lateral incisors--case report]. PMID- 3272428 TI - [Problem solving for preparation of restorations with Hi-Ceram and VMK-elements (II)]. PMID- 3272429 TI - [Intraoral effects of poor color and various cements in glass-ceramic crowns]. PMID- 3272430 TI - [Orthodontic appliance with imbedded motif]. PMID- 3272431 TI - [Rational model preparation with model-split-system (III)]. PMID- 3272432 TI - [Registration management for jaw relation determination in dentulous jaw with intraoral pantograph]. PMID- 3272433 TI - [Effect of a mineralizing solution (Minersol) on acid solubility resistance of enamel]. AB - Degree of mineralization of enamel is one of the parameters mediating in its resistance to acid dissolution and at the stage of teething, the enamel is immature and, therefore, present a higher susceptibility to dental caries. This investigation was carried out with 38 preschool children (means = 5.5 years) and 19 children coursing second grade (means = 7.6 years). They were treated with 10 oral rinsing with mineralizing solution in order to evaluate its effect on enamel resistance to acid dissolution; colorimetric technique was used for such purpose. A study in vitro was also performed in impacted third molars extracted by surgery and to two halves of the clinical crowns of such molars the treatment was applied; the other two halves were taken as control. Increase of enamel resistance found was 18.6% in the study of preschool children and 34.6% in the children attending to second grade school. In both groups, 89.5% of the children increased enamel resistance and in the study in vitro increaser enamel was 14.9%.. It is concluded that the use of risings with mineralizing solution at the outbreak of permanent teething increase, significatively, enamel resistance, and that at the age of seven the enamel is still immature, thus its resistance to acid dissolution can be also increased using mineralizing solution. PMID- 3272434 TI - [Comparative study of the increase in acid solubility resistance of enamel using different fluoride treatments]. AB - This investigation was performed to evaluate, comparatively, the effect of topical application of Duraphat, Flulak, Fluor-Protector, Bifluorid 12, Profilac, Fluoro-gel-P and Fluocal-gel. Colorimetric technique was used for such purposes. It was found that 67.5% of 283 children treated with those different treatments increased their enamel resistance to acid dissolution, although notable differences were found in the use of these products. Average of increase ranged between 10.7 and 23.5%. Lacs and varnishes provide best results than gels with regard to acid dissolution rate of enamel. Behave of the two national products evaluated (Flulak and Profilac) was similar to the rest of lacs and varnishes, justifying their use at national level for the prevention of caries, avoiding in that way unnecessary importations. PMID- 3272435 TI - [Evaluation of semiannual combined-treatment with fluoride-chlorhexidine varnish and toothbrushing with chlorhexidine toothpaste for 15 days every 3 months in hypercariogenic children]. AB - An investigation was carried out in hypercaries-producing children, who had have previously curative treatment. Twenty three children were treated with semestral applications of fluorine-chlorhexidine varnish and daily brushing for 15 days every three months, with dental creme with chlorhexidine, while 21 children were selected as control group. Four analysis of Str. mutants in saliva (Matsukubo technique) were performed to each child in both groups, during a year. It was found that children treated reduced, remarkably, the degree of infection by Str. mutans, while degree of infection did not suffer modification in those children of the control group. The final examination performed after one year showed that 15 children of the control group resulted affected by caries (71.4%) with an incidence of 27 caries (1.29 index), while in the group under treatment only a child resulted affected with a caries. Reduction found in the incidence of caries was 96.9%. Problematic of hypercaries-producing child is analyzed and it is concluded that it is necessary to control and record him, and that investment in a strict treatment, such as that successfully assayed by us, should be rentable, since it should reduce amount of extractions of teeth and to contribute in that way to a real promotion of oral health with the infantile population. PMID- 3272436 TI - [Preliminary study of the effects of propolis in the treatment of chronic gingivitis and oral ulceration]. AB - Since many years ago are known curative effects of propolis on different lesions due, mainly, to more than 30 biologically active elements isolated from it. It is a wordly accepted opinion that propolis is one of the most useful substances elaborated by bees. Despite it, its use in our country is relatively recent. Several investigators, specially in Matanzas, study curative effects of propolis in the field of human and animal medicine. In other countries it has been used in stomalogy, but we have no knowledge about its therapeutical effects in the periodontal disease or its effectiveness in oral ulcers. Therefore, a therapeutical form has been elaborated, which is provisionally called Propolan, for the treatment of two entities: chronic gingivitis and stomatitis of different etiology. The clinical cases supporting effectiveness found with the treatment applied in our setting are presented. PMID- 3272437 TI - [Primary herpetic gingivostomatitis in a group of children]. AB - The study of acute herpetic gingivostomatitis (AHGS) has been a very interesting theme for those dealing with periodontal practice. The majority of the authors states the application of symptomatic treatment for such disease and there is a nearly universal criterium that its lesions can be maintained up to 14 days. We decided to star a searching in the up-to-date literature and we found some very serious studies where was stated, among other statements, the application of a specific chemotherapy using an analogous pyrimidine: iodoxuridine. Since then, we started the study of AHGS in 20 children with clinical diagnosis of such disease. In 10 children a symptomatic treatment was applied and in the rest topical applications of collyrium of 0.1% iodoxuridine, three times a day. Both groups were appointed after three, seven and ten days of being under treatment in order to verify the evolution of symptoms (pain) and signs vesicles or ulcer). It was observed that either lesions or pain disappeared in a shortly time in those children treated with iodoxuridine, without side effects. It is concluded that the use of this drug was effective for our patients and, therefore, we suggest its study and application. PMID- 3272438 TI - [Microbiology of samples from patients with periodontal pockets]. AB - A microbiologic study was carried out in 39 patients with periodontal affections, who were surgically treated. A formulary was drawn up for the collection of the following data: age, sex, criteria of Russell periodontal index and microbiologic results. The contents of the periodontal pocket was collected at the time of the surgical procedure, and settled in assay tubes with culture medium to provide bacterial growth. The highest percentage of microorganisms were those of genus Peptostreptococci, and most common severity was caused by parodontitis. PMID- 3272439 TI - [Treatment of traumatic arthritis of the temporomandibular joint (TMJ)]. AB - A study of cases of patients with diagnosis of traumatic arthritis of the temporomandibular joint, assisted at the Department of Maxillo-facial Surgery, was carried out in order to value benefits obtained with a multidisciplinary attention in such cases. PMID- 3272441 TI - [Massive osteolysis. Report of a case involving the mandible]. AB - The case of a young man aged 18 years, attending to the Outpatient Service, Clinical and Surgical Teaching Hospital, Santa Clara, because of pathologic fracture in the anterior region of the jaw and history of hospitalization by pain and inflammation of mandibular gingiva with mobility of anterior teeth causing multiple extractions. The physical examination showed facial asymmetry by loss of normal chin configuration. Within investigations performed we had to rest on clinics, radiographical studies and anatomopathologic results. We think that the publication of this paper helps to enrich the scanty literature on this rare disease, which at international level is the tenth case involving the jaw and first in our country. PMID- 3272440 TI - [Dentigerous cyst. Report of an unusual case]. AB - An up-to-date review on dentigerous cysts is carried out and the fact that no report has been found in the medical literature on a similar case to that one of our patient is pointed out. The clinical picture, radiographic characteristics, diagnosis, treatment and prognosis of these cases are described. Peculiarity of our patient because of the amount of teeth contained in the cyst, as well as persistence of deciduous teeth, is outlined. PMID- 3272442 TI - [Some considerations on salt fluoridation]. PMID- 3272443 TI - [List of medications for dental use]. PMID- 3272444 TI - [Music as a communication aid in pediatric dentistry]. PMID- 3272445 TI - [Acquired immunodeficiency syndrome (AIDS): its relation to health and dental personnel]. PMID- 3272446 TI - [Controversy over nonprecious dental alloys and its implications for patients and dental technicians]. PMID- 3272447 TI - [The chronology of deciduous and permanent dentition in Japanese children. The Japanese Society of Pedodontics]. PMID- 3272448 TI - [Growth and development of the dentition during the first one year of life. Three dimension measurement on maxillary and mandibular alveolar arch morphological palate]. PMID- 3272449 TI - [A morphological study on the dentition using Fourier analysis. The relationship between deciduous dentition and permanent dentition. Part II. Comparison between normal occlusion and malocclusion]. PMID- 3272450 TI - [The relationship between deciduous dentition and permanent dentition. Part III. Examine for maxillary basal arch]. PMID- 3272451 TI - [The process of enamel maturation. II. Analyses of sections from bovine teeth]. PMID- 3272452 TI - [A case of fibrous hyperplasia of palatal gingiva associated with many epithelial islands in a 2-year 8-month-old girl]. PMID- 3272453 TI - [A case report on the Silver-Russell syndrome and its dental findings]. PMID- 3272454 TI - [The masticatory movement in children. Masticatory patterns in frontal view]. PMID- 3272456 TI - [The eating functional development of children. Part 1. The present state of things in one year and six months old children]. PMID- 3272455 TI - [Eruption sequestrum--report of a case with histopathological observation]. PMID- 3272457 TI - [Pit and fissure sealants. (2). Air-inhibited layer of the sealants]. PMID- 3272458 TI - [A basic study on "Prisma VLC Dycal"]. PMID- 3272459 TI - [The skull and the dentofacial complex in extremely immature infants and very low birth weight infants]. PMID- 3272460 TI - [The color of primary teeth (II)]. PMID- 3272461 TI - [Chromatical measuring of composite resin shade guides. The influence of the structural difference of the color difference meters and light guides on the chromatical values]. PMID- 3272462 TI - [Relationship between bite forces and EMG activities of masticatory muscles in children]. PMID- 3272463 TI - [The relationship between the labial tooth contour and its gingival shape in primary incisors]. PMID- 3272464 TI - [Self-cure dental acrylate resin reinforced with glass fiber. Part 1: Bending and tensile test]. PMID- 3272465 TI - [Electromyographic analysis of the masticatory disturbances in cerebral palsy children]. PMID- 3272466 TI - [Tissue affinity of tetracalcium phosphate cement and alpha-tricalcium phosphate cement. Biochemical and histological responses of rats to those cements]. PMID- 3272467 TI - [Masticatory movement during gum chewing in children]. PMID- 3272468 TI - [Factors affecting the measurement of electrical impedance of the tooth]. PMID- 3272469 TI - [A case of the Alagille syndrome. Dental findings]. PMID- 3272470 TI - [Space regaining after an extraction of a completely impacted second deciduous molar with caries: case report]. PMID- 3272471 TI - [A case of congenital microglossia]. PMID- 3272473 TI - [The relationship between the external shape of the morphology and cavity of the mandibular first deciduous molars. Three computerized dimensional analyses]. PMID- 3272472 TI - [A bacteriological study of periapical pathosis on deciduous teeth]. PMID- 3272474 TI - [The relationship between the external shape of the morphology and cavity of the mandibular second deciduous molars. Three computerized dimensional analyses]. PMID- 3272475 TI - [The eruption of the deciduous teeth which was observed continuously from infancy]. PMID- 3272476 TI - [The development of mastication in infants. The 2nd report: The relationship between the eruption of deciduous teeth and the methods of feeding baby foods]. PMID- 3272477 TI - [The difference from the point of view of masticatory function between normal occlusion and crowding, using Hellman's dental stage]. PMID- 3272478 TI - [Correlations between prevalence of caries and properties of salivary mutans streptococci isolated from Japanese children]. PMID- 3272479 TI - [The actual state of nutrition and dental caries in young patients]. PMID- 3272480 TI - [Severe degree of docal enamel hypoplasia of the lower second molar tooth with dentigerous cyst: report of a case]. PMID- 3272481 TI - [Clinical study on the restorations of primary teeth]. PMID- 3272482 TI - [Clinical study on the restorations of permanent teeth]. PMID- 3272483 TI - [Radiographic follow-up examination on vital pulp amputation in primary teeth. I. Treatment with calcium hydroxide paste]. PMID- 3272484 TI - [A case of an impacted maxillary second primary molar following surgical exposure and orthodontic guidance]. PMID- 3272485 TI - [The evaluation of cytotoxicity of amalgams in tissue culture]. PMID- 3272486 TI - [Inhibitory effect of laser irradiation with fluoride application on enamel demieralization of artificial caries-like lesions]. PMID- 3272487 TI - [Application of the Ricketts analysis to children in the primary dentition. First report: Examination concerning the reproducibility of the measuring points]. PMID- 3272488 TI - [Application of the Ricketts analysis to children in the primary dentition. Second report: A study of annual growth]. PMID- 3272489 TI - [The effect of taste adaptation on the parotid salivary flow rate in humans]. PMID- 3272490 TI - [The study on salivary clearance in children. 1. The diffusion of potassium chloride from artificial plaque]. PMID- 3272491 TI - [Epidemiological and microbiological surveys of juvenile periodontitis in Japanese high school students]. PMID- 3272492 TI - [Epidermolysis bullosa hereditaria in sister and brother]. PMID- 3272493 TI - [Clinical effect of preventive medicine for thumb sucking]. PMID- 3272494 TI - [Mesial inclination of the mandibular right second molar: report of case]. PMID- 3272495 TI - [The experience obtained following the first year of reimbursement of dental treatment of young patients]. PMID- 3272496 TI - [The contributing effects from the working conditions and type of work on dentist "burn out"]. PMID- 3272497 TI - [The importance of the positioning of orthodontic brackets using attached appliances]. PMID- 3272498 TI - [The side effects and interactions of medical compounds/solutions in children]. PMID- 3272499 TI - [Antimicrobial medication associated surgical procedures in the oral cavity]. PMID- 3272500 TI - [Oral fungal infections--predisposing conditions and prevention]. PMID- 3272501 TI - [Indications for the extraction of mandibular third molars]. PMID- 3272502 TI - [Different clinical manifestations with dental causes]. PMID- 3272504 TI - [Preprosthetic-surgical therapy concept--quo vadis?]. PMID- 3272503 TI - [Hands of dentists]. PMID- 3272505 TI - [Clinical valuation of function in removable cast partial prostheses]. PMID- 3272506 TI - [Dental model in orthodontics. Significance and production of the trimmer slide of Reinhardt]. PMID- 3272507 TI - [Premium wages for dental technicians with the personal computer]. PMID- 3272508 TI - [Application of small computers for improvement of stomatological care]. PMID- 3272510 TI - [Academic content of education and copyright. 1]. PMID- 3272509 TI - [Electric heated wax knife IfM M6 for melting wax]. PMID- 3272511 TI - Abstracts of the 7th bilateral Medical Week on "Problems in Gastroenterology". 28 November-3 December 1988. Abstracts. PMID- 3272513 TI - [Cholesterol and lipids in gastroenterology. A symposium. 23 April 1988]. PMID- 3272512 TI - [Epidemiological study of the pathogenicity of Clostridium difficile using a new serogrouping method]. PMID- 3272514 TI - [The liver: key organ in cholesterol metabolism]. PMID- 3272516 TI - [A survey of the prevalence of allergic diseases in school children in Taipei city--changes in the past 11 years]. PMID- 3272515 TI - [Pseudo-alcoholic lesions of the liver in obesity: role of weight loss or associated diabetes?]. PMID- 3272518 TI - [Clinical observation of spinal muscular atrophy]. PMID- 3272517 TI - [Clinical observation of lung bud anomalies in children]. PMID- 3272519 TI - [Neonatal varicella. Report of a case]. PMID- 3272520 TI - [Hypercalciuria with hematuria. A report of two cases]. PMID- 3272521 TI - [Histiocytosis-X with massive lymph node involvement. Report of two cases]. PMID- 3272522 TI - Hyperthyroidism in children. PMID- 3272523 TI - An etiological study of infectious diarrhea in infants and children in Taipei area. PMID- 3272524 TI - Antibiotic therapy for newborn infants with suspected infection. PMID- 3272525 TI - Auditory brainstem response in patients with a history of kernicterus. PMID- 3272526 TI - Aeromonas hydrophila infections in children. PMID- 3272527 TI - Urethral prolapse in female children: report of two cases. PMID- 3272528 TI - Reversible ventricular septal orientation following arterial switch procedure. PMID- 3272529 TI - Partial trisomy 13q: report of a case. PMID- 3272530 TI - [Ileal meconium obstruction: report of four cases]. PMID- 3272531 TI - [Gastrointestinal manifestations and endoscopic findings in children with Henoch Schonlein purpura]. PMID- 3272532 TI - [Clinical analysis of congenital syphilis in infancy]. PMID- 3272533 TI - [Clinical analysis of Kawasaki disease in infants below 6 months of age]. PMID- 3272534 TI - [Changes of bacteremia strains and their susceptibility to antibiotics: a five year survey]. PMID- 3272535 TI - [Absence of right pulmonary artery with ventricular septal defect: report of a case]. PMID- 3272536 TI - [Superior vena cava syndrome: report of a case]. PMID- 3272537 TI - [Autoimmune polyglandular syndrome: report of two cases]. PMID- 3272538 TI - Clinical evaluation of transcutaneous jaundice meter in full-term newborns. PMID- 3272539 TI - [Epidemiological survey of hemorrhagic disease due to vitamin K deficiency in infancy in Taiwan]. PMID- 3272540 TI - [Effects of coptidis rhizoma and decoction of artemisia rheum gardeniae on the reserve albumin binding capacity in serum of Chinese newborn infants]. PMID- 3272541 TI - [Neonatal jaundice and use of oxytocin]. PMID- 3272542 TI - Mesenchymal hamartoma of the liver: report of a case. PMID- 3272544 TI - [Recurrent suppurative thyroiditis due to pyriform sinus-thyroid fistula: report of a case]. PMID- 3272545 TI - [Congenital toxoplasmosis: report of a case]. PMID- 3272543 TI - [Hypoplasia of the depressor anguli oris muscle: report of 11 cases]. PMID- 3272546 TI - [Secretion of estradiol by the ovary of the hypophysectomized chick embryo]. AB - Ovaries from control and hypophysectomized chick embryos were cultured in vitro, and oestradiol released into the culture medium was determined by radioimmunoassay. At all 4 stages investigated, i.e., 11, 13, 15 and 17 days, the ovary of hypophysectomized embryos secreted less oestradiol than the ovary of control embryos. However, per unit weight of ovary, oestradiol production was clearly less in hypophysectomized than in control embryos only at the stage of 11 days. It is concluded that the hypophysis plays a part in oestradiol secretion by the ovary in the 11-day-old chick embryo. PMID- 3272547 TI - Morphogenesis of the ultimobranchial body and its colonizing cells in the chick embryo. AB - The development of the ultimobranchial body and its colonizing cells was studied in chick embryos in Hamburger-Hamilton's stages 21 to 46. The most significant observations included the following: 1.-The ultimobranchial body is a separate morphological entity with particular characteristics distinguishing it from the fourth pharyngeal pouch in all developmental stages. 2.-The fifth pharyngeobranchial ducts disappear in Hamburger-Hamilton's stage 27. 3.-From Hamburger-Hamilton's stage 27 on, the left ultimobranchial body is in contact with the caudal end of the left parathyroid IV primordium. 4.-The group made up of the ultimobranchial body and its colonizing cells at no time fuses with the thyroid gland. PMID- 3272548 TI - [Bichat's fat pad: anatomy and imaging]. AB - Topographic anatomy of the different parts of the corpus adiposum buccae is analyzed by coronal, transverse and sagittal sections. These sections are compared with those realized in the same planes by tomodensitometry and magnetic resonance. This comparison allows a better knowledge of the structures shown by imaging in the superficial and deep facial regions. PMID- 3272549 TI - Effect of melatonin and 5-methoxytryptamine administration on the testis and pineal gland activity of the fresh-water snake, Natrix piscator. AB - Effects of melatonin (aMT) and 5-methoxytryptamine (MT) were studied on the testicular activity cycle of the fresh-water snake, Natrix piscator. The subcutaneous implantation and the injections (morning as well as evening) of these two methoxyindoles prevented testicular recrudescence, retarded the testicular active phase, and accelerated the rate of regression of testes, while having no effect on the inactive testes. Contrary to this, these two compounds increased the pineal gland weight during different reproductive phases. These results revealed that both aMT and MT, whether they were continuously released through silastic capsule implants or administered through daily periodic injections, produced inhibitory effects on the testicular function. PMID- 3272550 TI - Effect of 5-methoxyindoles on testicular function of the Indian jungle bush quail Perdicula asiatica. AB - Melatonin (aMT) implantation during testicular inactive phase (January-March) brought an early initiation of testicular development in Perdicula asiatica. However, during the recrudescence (March-May), active (April-June), and regressive (May-July-September) phases both aMT and 5-methoxytryptamine (MT) implantation had inhibited testicular weight and activity significantly. Subcutaneous injections of aMT, MT and 5-methoxytryptophol (ML) during morning (7.30 a.m.-8.00 a.m. and evening (4.30 p.m.-5.00 p.m.) could not bring about any significant effect on the weight or activity of the testes during the inactive (January-February) phase, while inhibited testicular weight and activity during the active (May-June) phase when administered in the morning as well as in the evening hours. PMID- 3272551 TI - [In vitro antibacterial activity of imipenem]. PMID- 3272552 TI - [Pulmonary hypertension in chronic obstructive bronchitis]. PMID- 3272554 TI - [Psychopathologic factors of bronchial asthma]. PMID- 3272553 TI - [Ventilatory effects of nicardipine in chronic hypertensive asthmatic subjects]. PMID- 3272555 TI - [Pulmonary and aortic autograft: use in heart surgery]. PMID- 3272556 TI - [A case of leiomyosarcoma of the pulmonary artery]. PMID- 3272557 TI - [Blood gas analysis as an essential diagnostic test for a correct morphofunctional diagnosis of the respiratory system]. PMID- 3272558 TI - [Evaluation of variation in the endurance resistance index in athletes performing aerobic exercise]. PMID- 3272559 TI - [The lateral dental-basal height in Class II, division 1 malocclusion mesial type: growth from 6 to 18 years]. PMID- 3272560 TI - [The biologic basis of immunoprophylaxis of carious disease. Microbial ecosystem of the oral cavity. Etiopathogenesis of caries]. PMID- 3272561 TI - [The use of ribosomal vaccines in prevention of periodontal disease]. PMID- 3272562 TI - [Isolated gingival recession "without cause" localized to the lower incisors in Class II, 1 dental malocclusion. Further studies]. PMID- 3272563 TI - [The lateral dental-basal height in Class II, division 1 malocclusion, dolichol type: growth from 6 to 18 years]. PMID- 3272564 TI - [Gingival recession localized to the lower incisors in dental malocclusion]. PMID- 3272565 TI - [Osseous regeneration. 1. Physiology of bone]. PMID- 3272566 TI - [Relationship between isolated gingival recession localized to the lower incisor and dental crowding. Clinical-statistical study]. PMID- 3272567 TI - [Extraction of first permanent molars, without treatment: effect on direction of growth]. PMID- 3272568 TI - [1 year evaluation of dental-basal height in lip-bumper treatment]. PMID- 3272569 TI - [The local and general teratogenic effects of soft and hard drugs on the neonate]. PMID- 3272570 TI - [Immune response in periodontal disease]. PMID- 3272571 TI - [The importance of oral respiration in the etiopathogenesis of dental malocclusion]. PMID- 3272572 TI - [Seckel's syndrome]. PMID- 3272574 TI - [Experimental use of lysed lyophilized vaccines in immunoprophylaxis of periodontal disease]. PMID- 3272573 TI - [Gingival recession localized to the lower incisors in Class II, 1 dental malocclusion]. PMID- 3272575 TI - [The lateral dental-basal height in Class II, division 1 malocclusion, brachial type: growth from 6 to 18 years]. PMID- 3272576 TI - [Oral frenula]. PMID- 3272577 TI - [Changes in the transverse diameter of the upper arch after adenoidectomy]. PMID- 3272578 TI - [The genetic basis of anticaries immunity--the HLA system]. PMID- 3272579 TI - [The biological basis of immunoprophylaxis of periodontal disease]. PMID- 3272580 TI - [Effects of the chin cup on curvature of the cranial base in skeletal Class III treated with splints and intermaxillary elastics]. PMID- 3272581 TI - [Crouzon's syndrome]. PMID- 3272582 TI - [The immunological basis of vaccine prophylaxis of periodontal disease]. PMID- 3272583 TI - Standard treatments and antibiotic therapy for pneumonia in adults in Papua New Guinea. PMID- 3272584 TI - A simple technique to determine accurately intra-abdominal pressure. PMID- 3272585 TI - Intracranial pressure (ICP) monitoring as a guide to prognosis in a lightning injured, comatose child. AB - Every year there are many deaths due to lightning injuries in the United States. A case is presented of a young child who suffered cardiopulmonary arrest following being struck by lightning strike and in whom ICP monitoring was utilized. We postulate that ICP and CPP measurements may be useful as prognostic indicators for comatose lightning victims and, therefore, may help in the management of the patient. PMID- 3272586 TI - European perspectives on the classification of depression. PMID- 3272587 TI - Attitudes and habits of chiropractors concerning referral to other health care providers. AB - Referral attitudes and habits were examined in a survey of Minnesota chiropractors. A questionnaire was developed and mailed to 1160 chiropractic physicians that included items concerning referral methods and frequency, factors prompting referral, and providers to whom referrals were directed. Of 531 respondents in active practice, 97.2% reported making referrals during 1985. Most referrals were made to orthopedic surgeons and neurologists with 76.1% of respondents reporting that referrals were made to these specialists on four or more occasions. A majority of respondents (57%) reported that referrals often were made to established consultants [corrected]. Doctors frequently submitted requests to medical physicians for patient records (66.2%) and 71.1% [corrected] reported referring patients for CT scans. The most commonly reported factor leading to a decision to refer was the need for a second opinion, and patient insistence for referral was the least common. Doctor characteristics and demographic [corrected] factors such as age, practice setting (rural or urban location) and practice arrangement (solo or group) were generally unrelated to referral attitudes or habits. However, respondents under the age of 40 did report a slightly higher frequency of requests for patient records than doctors older than 40. PMID- 3272588 TI - Referral of women with chronic pelvic pain. PMID- 3272589 TI - National Inuit women health concern. PMID- 3272590 TI - National Inuit Tapirisat of Canada. PMID- 3272591 TI - Seasonal allergic pollenosis. PMID- 3272593 TI - The impact of imported foods on the traditional Inuit diet. PMID- 3272592 TI - Health and nutrition in circumpolar regions. PMID- 3272594 TI - Use of country foods by native Canadians in the Taiga. PMID- 3272595 TI - The food and nutrient intake of a Swedish Saami population. PMID- 3272596 TI - Environmental health considerations in the Arctic. PMID- 3272597 TI - Community profiles/Indian housing in Yukon Territory. PMID- 3272598 TI - Methylmercury in the Canadian Arctic environment past and present--natural or industrial? PMID- 3272599 TI - Recent changes in methylmercury exposure of the James Bay Cree of Quebec. PMID- 3272600 TI - Blood mercury concentrations in birthgiving Greenlandic women. PMID- 3272601 TI - Copper and cadmium binding proteins from liver and kidney of moose and reindeer. PMID- 3272602 TI - Radiation dose to Finnish Lapps--comparison of effects of fallout from atmospheric nuclear weapons tests and from the Chernobyl accident. PMID- 3272603 TI - Circumpolar health 87. Proceedings of the 7th International Congress. Umea, Sweden, June 8-12, 1987. PMID- 3272604 TI - The impact of Chernobyl on the economy and cultural-environment of northern Sweden. PMID- 3272605 TI - Biological rhythms: fundamental aspects. PMID- 3272606 TI - Seasonal and bright light changes of the phase position of the human melatonin rhythm in Antarctica. PMID- 3272608 TI - Genetic composition and variation in Saami populations in northern Norway compared with Nordic populations in middle Norway. A study of non-metric skull variants. PMID- 3272607 TI - Anthropometric measurements and growth charts for Cree children of James Bay, from 0 to 5 years old. PMID- 3272609 TI - Distinctive features of occupational health in the Arctic. PMID- 3272610 TI - Psychosocial factors and working conditions related to mental health of reindeer herders. PMID- 3272611 TI - Arctic health research--what--why--how? PMID- 3272612 TI - A sample of personality profiles of frostbite patients in Alaska 1980-86. PMID- 3272613 TI - Evaluation of prenosologic states in man in the Arctic. PMID- 3272614 TI - Cutaneous immune responses in Antarctica. A reflection of immune status? PMID- 3272615 TI - Perception of airway comfort in cold air increased by means of mouth-held breathing aid. PMID- 3272616 TI - Infrared hand temperature measurements during the 1986 and 1987 330km Iditaski Cross-Country Ski Race. PMID- 3272617 TI - Cold exposure and liver NADPH generating enzymes in genetically obese (ob/ob) mice. PMID- 3272618 TI - Angina pectoris in the cold. PMID- 3272619 TI - Recommendations for future Arctic health research. PMID- 3272620 TI - The effects of breathing warm air during cold exposure. PMID- 3272621 TI - Fat loss during moderate exercise in cold environments in relation to fitness level. PMID- 3272622 TI - The metabolic cost of exercising in cold air (-20 degrees C). PMID- 3272623 TI - Contribution to the panel on Arctic health research. PMID- 3272625 TI - Resort to folk healers in a Manitoba Ojibwa community. PMID- 3272624 TI - A Cree healer attempts to improve the competitive position of native medicine. PMID- 3272626 TI - New health initiatives for Canada's Native people. PMID- 3272627 TI - Special Premedical Studies Program--students' perspective. PMID- 3272628 TI - Evolution of health care system in the James Bay area. PMID- 3272629 TI - Medical reasons for a change in the management of health services for Canadian Indian and Inuit communities. PMID- 3272630 TI - The changing role of health program managers during a period of transfer of responsibility for health services to Indian people. PMID- 3272631 TI - The transfer of control of northern research to Canada's native people. PMID- 3272632 TI - Preliminary results of an evaluation of Canada's Northern Health Services. A longitudinal review of selected mortality rates. PMID- 3272633 TI - A plan for the transfer of control of health services to Indian communities in Manitoba. PMID- 3272635 TI - Rural community organizing and development strategies in Alaska Native villages. PMID- 3272634 TI - Strategies for involving Native people in the operation and control of health services. PMID- 3272636 TI - Supervision of primary health care workers in Alaska. One approach. PMID- 3272637 TI - The peculiarities of alcoholism in the north. PMID- 3272638 TI - Antarctica--lessons for health care planning and delivery to circumpolar populations. PMID- 3272639 TI - The establishment of an occupational health service for the British Antarctic Survey. PMID- 3272640 TI - Referral of patients from isolated northern Manitoba communities. PMID- 3272641 TI - Health communication problems in Canadian Inuit communities. PMID- 3272642 TI - Lost years of life in Greenland in the period 1968 to 1983. PMID- 3272643 TI - Problems concerning native and migrant populations, their nutrition, the physical environment, ecology and methodology of research. PMID- 3272644 TI - The role of non-aboriginal physician consultants to aboriginal people. PMID- 3272645 TI - Thermoinfusion--a system for giving warm intravenous infusion. PMID- 3272646 TI - Cold injuries. PMID- 3272647 TI - Circumpolar system safety engineering. PMID- 3272648 TI - Emergency Medical Services communications planning in Alaska. PMID- 3272649 TI - Safety and first aid curriculum for circumpolar and developing rural areas. PMID- 3272650 TI - Accidents in reindeer herding work. PMID- 3272651 TI - Snowmobile injuries in northern Newfoundland and Labrador 1985-86 winter season. PMID- 3272652 TI - Breakup of an isolate. PMID- 3272653 TI - The role of heredity in the oral health of Arctic and subarctic residents. PMID- 3272654 TI - Osteochondromatosis in an isolated community in Manitoba. PMID- 3272655 TI - Electrocardiographic findings in myotonic dystrophy. PMID- 3272656 TI - Familial amyloidotic polyneuropathy in northern Sweden. A cross-sectional and longitudinal study of cardiac function with echocardiography. PMID- 3272657 TI - Chronic noncommunicable diseases in native residents and newcoming populations of circumpolar areas. PMID- 3272658 TI - The University of Alaska--Siberian medical agreement. Its history, philosophy and implications for northern medicine. PMID- 3272659 TI - A health examination trial among males in northern Finland. PMID- 3272660 TI - Risk factors for diabetes among northern Indians. PMID- 3272661 TI - HLA B27 and rheumatoid arthritis in northern Sweden. PMID- 3272662 TI - Obesity in Icelandic youngsters and Canadian youngsters of Icelandic descent. A comparison. PMID- 3272663 TI - Changes in CHD "risk factors" and cerebrovascular death rates in Iceland 1967 1984. PMID- 3272664 TI - Arterial hypertension and risk factors of CHD in native and newcoming populations of some regions of Siberia and the Far North. PMID- 3272665 TI - Swedish polar research. PMID- 3272666 TI - Nutrition of native and newcoming population of Chukotka and CHD risk factors. PMID- 3272667 TI - Maternal health in northern Norway. Time trends. PMID- 3272668 TI - Obstetric care in the Keewatin. Changes in the place of birth 1971-1985. PMID- 3272669 TI - Inuit concerns about obstetric policy in the Keewatin region, N.W.T. PMID- 3272670 TI - The influence of twenty years on demographic and social factors related to parturients in northern Finland. PMID- 3272671 TI - The provision of maternity services in northern Labrador 1984-1986. PMID- 3272673 TI - Teenage pregnancy in northern Labrador. PMID- 3272672 TI - Having a baby in northern Quebec. Lessons for the future. PMID- 3272674 TI - Teenage pregnancy in the native community of Sheshatshit. PMID- 3272675 TI - Child health in circumpolar areas. PMID- 3272676 TI - Child survival in Greenland and Kenya. PMID- 3272677 TI - A sociobiological model for child survival in Greenland. PMID- 3272678 TI - The changing panorama of neonatal illness. A prospective birth cohort study in northern Finland in 1966 and 1985. PMID- 3272679 TI - Sudden infant death syndrome in Manitoba. Confirmation of high rates for Indians. PMID- 3272680 TI - A computerized analysis of matched infant death and birth certificates. PMID- 3272681 TI - Prevalence of diabetes mellitus among Indian children in Manitoba. PMID- 3272683 TI - Insulin-dependent diabetes mellitus in an Inuit child. PMID- 3272682 TI - High incidence of insulin-dependent diabetes mellitus (IDDM) in children in Finland. PMID- 3272684 TI - Psychological risk factors for sleep disturbances in a northern Finnish cohort of first and second born children. PMID- 3272685 TI - Changing patterns in dental caries and treatment needs in Labrador school children. PMID- 3272686 TI - Dental caries experience of Inuit children in the Keewatin region, Northwest Territories, 1983/84. PMID- 3272687 TI - Primary dental care in Canadian Arctic communities. PMID- 3272688 TI - The "travelling dentist" system of delivering dental care in Newfoundland and Labrador. Perceptions and observations. PMID- 3272689 TI - A survey of native mental health needs in Manitoba. PMID- 3272690 TI - Unique problems encountered in the delivery of mental health services to a Native Alaskan population. PMID- 3272691 TI - Screening and evaluating individuals held in protective custody under Title 47 in southwestern Alaska. PMID- 3272692 TI - Recognition of predisposing factors which affect the high suicide rate of Canadian Indians. PMID- 3272693 TI - Suicides by status Indians in Manitoba. PMID- 3272694 TI - Alcohol problems in conditions of the North. PMID- 3272695 TI - Alcohol related deaths in Greenland. PMID- 3272696 TI - Fire and ice. Natives, alcohol and spirituality, a northern health paradigm. PMID- 3272697 TI - From poverty to prosperity--a hazard to the health. PMID- 3272698 TI - Development of the cancer registry in the Northwest Territories and trends in cancer mortality 1950-1986. PMID- 3272699 TI - Development of a cancer registration system for the Inuit of Canada. PMID- 3272700 TI - Occupation-related cancer in a Nordic copper smeltery. PMID- 3272701 TI - Factors affecting health and social conditions in Labrador. PMID- 3272702 TI - A survey of health habits related to cancer in northwest Alaska Natives. PMID- 3272703 TI - Snuff dipping among Canadian Inuits and Indians with emphasis on nitrosamines, nitrite and intervention trials. PMID- 3272704 TI - Current trends in cancer incidence in Greenland. PMID- 3272705 TI - Cancer pattern among Greenlandic Inuit migrants in Denmark, 1968-82. PMID- 3272706 TI - Otitis media in a cross-sectional population from northern Finland. PMID- 3272707 TI - Otitis and hearing loss among northern Quebec Inuit. PMID- 3272708 TI - The role of Canadian native health workers in achieving self-government. PMID- 3272709 TI - Chronic middle ear inflammation and its sequelae in the population of Greenland. PMID- 3272710 TI - Antimicrobial susceptibility of beta-hemolytic streptococci isolated from pharynx and skin of residents of isolated northern native communities. PMID- 3272711 TI - Sexually transmitted diseases in Greenland. A statement with proposals for new strategies. PMID- 3272712 TI - Gonorrhoea in the Sukkertoppen medical district in Greenland in the period 1984 1985. PMID- 3272713 TI - A three months survey of gonorrhea in the VD-clinic of Nuuk, Greenland. PMID- 3272714 TI - Meningitis in Hudson's Bay, northern Quebec, Canada. PMID- 3272715 TI - Yersiniosis in Alaskan children: case reports and discussion of clinical and epidemiological variability. PMID- 3272716 TI - An ELISA test for diagnosis and screening of echinococcus multilocularis in a high-risk Inupiat Eskimo population. PMID- 3272717 TI - Parasitic zoonoses in relation to fish and wildlife harvesting by Inuit communities in northern Quebec, Canada. PMID- 3272718 TI - Endemic benign nephropathy (EBN) in the Nordic countries. PMID- 3272719 TI - Naturally acquired serum rabies neutralizing antibody in a Canadian Inuit population. PMID- 3272720 TI - Culture and high blood pressure: understandings of a chronic illness in an Ojibwa community. PMID- 3272721 TI - Workshop on hepatitis B in circumpolar countries. Summary of the hepatitis B workshop. PMID- 3272722 TI - Comprehensive seroepidemiologic study of hepatitis B virus infection in the Northwest Territories of Canada. PMID- 3272723 TI - The epidemiology of hepatitis B virus infection in northern Labrador, Canada. PMID- 3272724 TI - Prevalence of hepatitis B infection in Alaska's non-native population. PMID- 3272725 TI - Profile of factors affecting the acculturation of elderly Native Alaskans within long-term care facilities. PMID- 3272726 TI - Public health aspects of stray dogs in Barrow, Alaska. PMID- 3272727 TI - The militarization of Labrador: will research alter the course. PMID- 3272728 TI - Community trauma and community interventions. PMID- 3272729 TI - Trends in school achievement in Skolt Lappish and northern Finnish children as a function of cultural and psychological factors. PMID- 3272730 TI - Experience with medially based deltopectoral skin flap and tongue flap in the reconstruction of cancrum oris cheek defect. PMID- 3272731 TI - Strategies for improving oral health and reforming oral health care systems. PMID- 3272732 TI - Variability in the diagnosis of dental caries. PMID- 3272733 TI - Lip positions and incisor relationship in Nigerian children. PMID- 3272734 TI - Maxillary arch and palatal vault dimensions in a southern Nigeria population. PMID- 3272735 TI - Dental treatment demands in two cities in Tanzania. PMID- 3272736 TI - Developing alternative systems of oral health care delivery: the Botswana case. PMID- 3272737 TI - Radiochemical degradation of nucleic acids by 32-phosphorus. PMID- 3272738 TI - A quantitative analysis of 2-D gels identifies proteins in which labeling is increased following long-term sensitization in Aplysia. AB - Long-term memory for sensitization of the gill- and siphon-withdrawal reflex in Aplysia, produced by 4 days of training, is associated with increased synaptic efficacy of the connection between the sensory and motor neurons. This training is also accompanied by neuronal growth; there is an increase in the number of synaptic varicosities per sensory neuron and in the number of active zones. Such structural changes may be due to changes in the rates of synthesis of certain proteins. We have searched for proteins in which the rates of [35S]methionine labeling are altered during the maintenance phase of long-term memory for sensitization by using computer-assisted quantitative 2-D gel analysis. This method has allowed us to detect 4 proteins in which labeling is altered after 4 days of sensitization training. PMID- 3272739 TI - Acetylcholine receptor alpha-, beta-, gamma-, and delta-subunit mRNA levels are regulated by muscle activity. AB - Denervation of adult skeletal muscle results in increased sensitivity to acetylcholine in extrajunctional regions of the muscle fiber. This increase in acetylcholine sensitivity is accompanied by a large increase in the level of mRNAs coding for the alpha-, beta-, gamma-, and delta-subunits of the acetylcholine receptor. To determine whether muscle activity is sufficient to regulate expression of extrajunctional acetylcholine receptor mRNA levels, denervated muscles were stimulated with extracellular electrodes. Direct stimulation of denervated muscle suppresses both the increase in extrajunctional acetylcholine sensitivity and the expression of mRNA encoding the alpha-, beta-, gamma-, and delta-subunits of the acetylcholine receptor. These results show that muscle activity regulates the level of extrajunctional acetylcholine receptors by regulating the expression of their mRNAs. PMID- 3272740 TI - Anesthesia for the obstetric patient with multiple sclerosis. AB - Data on all obstetric patients delivering at the Brigham and Women's Hospital during the years 1982 through 1987 were collected. The anesthetic techniques used, the type and amount of anesthetic agents administered, and the postpartum relapse rate of multiple sclerosis patients were compared. Women who received epidural anesthesia for vaginal delivery did not have a significantly higher incidence of relapse than those who received local infiltration. However, all of the women who experienced postpartum relapses had received concentrations of bupivacaine greater than 0.25%. This finding may suggest that a higher concentration of drug over a longer period of time may adversely influence the relapse rate. PMID- 3272741 TI - Continuous monitoring of gas exchange and oxygen use with dual oximetry. AB - The utility of integrated pulse and pulmonary artery oximetry, known as dual oximetry, was evaluated by monitoring 10 critically ill surgical patients for a total of 208 patient hours. The ventilation-perfusion index (VQI), an estimate of venous admixture, and the oxygen extraction index (O2EI), an estimate of tissue oxygen utilization coefficient, previously described, were calculated on-line from arterial and mixed venous oxyhemoglobin saturations using a computer. Effective monitoring was accomplished 85% of the total time. The dual oximetry device was nonfunctional owing to equipment failure only 15% of the time, even though no undue attention was given to instructing the staff on operation of the oximeters. Accuracy of VQI and O2EI was reconfirmed by this study. Drift in the saturations, VQI, and O2EI during the 6-h period between calibrations was negligible. The 95% range of random variability was +/- 2% for SaO2, +/- 3% for SvO2, +/- 5% for VQI, and +/- 0.04 for O2EI. Thirty-six episodes of arterial blood desaturation below 90% were detected by continuous oximetry. In contrast, 74 routine arterial blood samples revealed only four such episodes. Dual oximetry appears to be a technically reliable and accurate method of monitoring pulmonary gas exchange and tissue oxygen utilization. The equipment provided stable readings for at least six hours without recalibration. Random variability is sufficiently small to allow early detection of alterations in pulmonary and circulatory function without blood sampling. PMID- 3272742 TI - Refractory bradycardia during retrograde pyelography and spinal anesthesia. AB - Bradycardia commonly occurs during spinal anesthesia as a result of vagally mediated slowing of sinoatrial (SA) node firing. Peritoneal traction or urinary bladder distension, for example, may serve as a stimulus for SA node inhibition, particularly when thoracic levels of spinal anesthesia interrupt function of the sympathetic limb of the autonomic nervous system. Although atropine dependably reverses such heart rate slowing, we recently encountered, during spinal anesthesia for cystoscopy and retrograde pyelography, bradycardia that was unexpected and refractory to treatment with atropine. PMID- 3272743 TI - Smart tech, standards, egos, and the need for technology assessments. PMID- 3272744 TI - Translaryngeal guided intubation solved a critical airway problem. AB - Airway obstruction during the induction of general anesthesia remains a persistent problem in modern anesthesia practice, particularly in obstetric patients. Generally, a careful preoperative airway evaluation uncovers most abnormalities that might make intubation difficult. The planning and preparation for additional intubation equipment facilitate an anticipated difficult intubation. However, situations may arise in which unanticipated airway obstruction occurs requiring prompt management. Although every anesthesia provider is trained to manage such acute airway problems, the provision of a patent airway is not always possible, particularly when repeated attempts at endoscopic or blind intubation have failed, leaving a bloody field that prevents optimal visualization, or when time does not allow to wake up the patient. In this article a difficult airway problem is reported in which translaryngeal guided intubation was lifesaving. PMID- 3272745 TI - Effects of systemic morphine and epidural bupivacaine on postoperative oxygen consumption during rewarming. AB - The alterations in hemodynamics and oxygen consumption as a consequence of continuous epidural infusions of bupivacaine at room temperature and conventionally administered morphine were studied during recovery from general anesthesia for total hip replacement. Twenty-four patients were randomized to receive either bupivacaine or morphine in the recovery room. The bupivacaine group received from 6 to 12 ml per hour of 0.25% bupivacaine epidurally. Patients in the morphine group received 0.1 mg/kg of morphine intramuscularly no more frequently than every 4 hours. A pulmonary artery flotation catheter was inserted into each patient to determine hemodynamics and oxygen consumption at three instances: before analgesia, when pulmonary artery blood temperature reached 36 degrees C, and when it reached 37 degrees C. During the rewarming there was a decrease in mean arterial blood pressure and the systemic vascular resistance index and an increase in heart rate. The whole body oxygen consumption index increased in the bupivacaine group at the last measuring point but was stable in the morphine group. There was no effect on the arterial-venous oxygen content difference in either group. At 37 degrees C, the cardiac index and oxygen consumption index were significantly higher in the bupivacaine group than in the morphine group. In contrast to regional analgesia, systemic morphine administration can partially antagonize cardiovascular response to postoperative rewarming because it induces a stable oxygen demand. PMID- 3272746 TI - Outward transcutaneous chemical migration: implications for diagnostics and dosimetry. AB - Chemical substances migrate outwards from within the body to the skin surface by diffusion from cutaneous capillaries across the epidermis. Heretofore, study of transepidermal chemical emissions have been restricted to substances which are in the vapor phase at skin surface temperature. We have investigated outward transcutaneous chemical migration of nongaseous chemicals by devising an occlusive transcutaneous chemical collection system, consisting of a tape-encased plug of gelled saline in which activated carbon is dispersed. Investigations of nine chemicals in 'fuzzy' rats, rhesus monkeys, and man provide data which are consistent with a general theory of outward transcutaneous chemical migration. This noninvasive continuous transcutaneous sampling technique provides a new method for investigating skin permeability in vivo and may provide a basis for convenient diagnosis and monitoring of chemical exposure. PMID- 3272747 TI - Hexadecane-induced skin hyperplasia in the hairless rat: time course of histological and biochemical events related to the synthesis of polyamines and DNA. AB - Several biochemical parameters including ornithine decarboxylase activity (ODC) and tissue polyamine levels were measured during the hexadecane-induced epidermal hyperplasia of hairless rat skin. Animals received three applications of 200 microliters pure n-hexadecane on day 1. ODC activity and polyamine levels (putrescine, spermidine and spermine) in the epidermis were significantly increased and reached maximum elevations at 12 h after the start of n-hexadecane treatment with DNA synthesis peaking at 24 h. Histological studies confirmed a significant cellular edema at 24 h after the beginning of the treatment followed at 48 h by an epidermal hyperplasia which was maximum at 72 h. These data support the view that ODC activation, increased biosynthesis of polyamines and DNA are early events in epidermal cell hyperproliferation. PMID- 3272748 TI - Evaluation of a new method of assessing pruritus and antipruritic drugs. AB - A new method (Pain-Track) for recording subjective symptoms was evaluated for its capacity to quantify clinical itch. The Pain-Track system includes portable data loggers carried by the patients, a personal computer with a software package for storage and analysis of the data and a terminal unit to connect the loggers and computer. Every 60 min a signal from the logger commands the patient to mark his presence and rate the itch intensity. During night time the hourly buzz can be turned off but the intensity rate can be adjusted whenever wanted. The antipruritic effect of betamethasone dipropionate and its cream base was studied according to a double-blind, crossover protocol in 30 adult outpatients with atopic dermatitis, 26 of whom completed the study. Analysis with parametric and nonparametric methods showed that the itch intensity was significantly lower during active treatment than with placebo. Onset of the antipruritic action was rapid. Examination of the 'itch profile' revealed that atopics have more intense itch both in the mornings and evenings than during the day. It is concluded that by using a drug with known antipruritic effect we have shown that Pain-Track is a useful tool for assessing clinical pruritus and the antipruritic effects of drugs. The main advantages are possibilities for frequent recordings, surveillance of compliance improving authenticity, and storage and analysis of a large amount of data. PMID- 3272749 TI - Human recombinant interleukin-1 alpha is proinflammatory in normal human skin. AB - The proinflammatory effects of recombinant human interleukin-1 alpha (HRIL-1 alpha) have been determined in the skin of normal human volunteers. Intradermal injection of 10, 50 and 100 U HRIL-1 alpha produced dose-related erythema which first appeared at 2 h, was maximal around 24 h, persisted for up to 48 h, and was associated with oedema. Histological examination revealed dermal mononuclear cell infiltrates, which were accompanied by neutrophils at 4 and 8 h. Injection of heat-treated HRIL-1 alpha (100 U) produced no erythema or oedema. These results demonstrate the potent proinflammatory properties of HRIL-1 alpha in human skin. PMID- 3272750 TI - Skin Pharmacology Society. 5th annual symposium. May 27-28, 1988, Paris. Abstracts. PMID- 3272752 TI - The spine. PMID- 3272751 TI - Investigation of the skin thinning effect of prednicarbate and other corticoids in mouse skin. AB - In this investigation skin fold thinning was determined after topical application of several potent corticosteroids in hairless mice using a simple mechanical measuring device. The skin thinning effect of prednicarbate was compared with other corticosteroids (amcinonide, beta-methasone-17-valerate, clobetasol-17 propionate, diflorasone-17,21-diacetate, hydrocortisone-21-acetate). Prednicarbate produced a clear thinning of skin. Like other tested dermatocorticoids prednicarbate caused a significant atrophy of the mouse tail epidermis. By prednicarbate the 3H-thymidine triphosphate incorporation into epidermal DNA was inhibited. PMID- 3272753 TI - Credentialing of the cardiac sonographer: the need for unification. PMID- 3272754 TI - Features of mildly dilated congestive cardiomyopathy compared with idiopathic restrictive cardiomyopathy and typical dilated cardiomyopathy. AB - Congestive cardiomyopathy was recognized in eight patients with only mildly dilated ventricles (an echocardiographic ventricular diastolic dimension index of less than 10% to 15% above the normal range) but with other features typical of end-stage congestive cardiomyopathy. Such patients with mildly dilated cardiomyopathy (MDCM) represented 5% of heart transplant recipients with cardiomyopathy, who were analyzed by us. The clinical, echocardiographic, and hemodynamic data, as well as the gross and microscopic pathologic findings of the hearts in this group were compared with similar data in five patients with idiopathic restrictive cardiomyopathy (IRCM) and 10 patients with typical dilated cardiomyopathy (DCM). Compared with IRCM and DCM, patients with MDCM had a higher incidence of familial cardiomyopathy (p less than 0.009). The echocardiographic features of patients with MDCM and DCM were virtually identical, showing globular hearts with predominant left ventricular dilation and diffuse poor left ventricular contraction. Patients with IRCM had marked atrial dilation but less abnormality of left ventricular size and contraction parameters. On the basis of echocardiographic data, patients with IRCM and MDCM could be well segregated. Cardiac index and light microscopic examinations were similar in the three groups. However, electron microscopy showed a lack of myofibrillar loss in patients with IRCM, little or no myofibrillar loss in those with MDCM, and almost total myofibrillar loss in those with DCM. Patients with MDCM have a high prevalence of familial cardiomyopathy. Absolute heart size and electron microscopic features of the MDCM group were intermediate between IRCM and DCM, but other clinical, echocardiographic and hemodynamic findings were similar to typical DCM. PMID- 3272755 TI - Topographic correspondence of contrast echocardiographic perfusion mapping and myocardial infarct extent after varying durations of coronary occlusion. AB - After acute coronary occlusion, the extent of dysfunction exceeds the extent of infarction by a variable amount. Contrast echocardiography has been shown to be a good predictor of the extent of acute infarction after permanent occlusion. We used hydrogen peroxide contrast echocardiography to study the temporal and topographic relationship between contrast enhancement and tissue viability during acute myocardial infarction in 32 dogs undergoing 1, 2, 3, or 4 hours of circumflex occlusion before reperfusion. To account for changes in collateral blood flow, contrast studies were performed by aortic root injection immediately before reperfusion. The area, circumference, and transmural extent of the region at risk in vivo by contrast echocardiography were statistically unchanged regardless of the duration of occlusion before reperfusion. Echo contrast defect analysis of the risk region predicted the area, circumference, and transmural extent of infarcts reperfused at 2 or more hours (r = 0.81, 0.84, 0.71, respectively). For the 1-hour occlusion group, contrast defect analysis predicted the circumference at risk but markedly overestimated the area and transmural extent of infarction. These data indicate that the circumferential extent of infarction can be identified by contrast echo and is fixed by 1 hour of occlusion. Infarction progression transmurally within the circumferential boundaries had nearly reached the transmural contrast extent by 2 hours of occlusion in this model. Assuming the development of a similar high contrast agent safe for human injection, aortic root contrast echocardiography could be useful to predict myocardium at risk of infarction early after occlusion. Late after occlusion it could be of value to predict the presence of still viable myocardial layers within the dysfunctional infarct region. PMID- 3272756 TI - Pulsed Doppler echocardiographic description of a circular flow pattern in spontaneous left ventricular contrast. AB - Pulsed Doppler echocardiography was performed in nine patients with spontaneous intracavitary dynamic echoes, revealing a circular flow pattern. All patients had a severely dilated left ventricle as a result of ischemic heart disease. The sample volume was placed in the apical four-chamber view near the lateral wall and near the interventricular septum, halfway between the mitral valve anulus and apex. A continuous (i.e., during both systole and diastole) positive signal was recorded near the lateral wall and a continuous negative signal at the interventricular septum. This indicates flow continuously toward the transducer along the lateral wall and away from the transducer along the interventricular septum. This is consistent with the circular flow pattern, as demonstrated by the spontaneous intracavitary dynamic echoes. In 22 normal volunteers a positive prominent shift was recorded during diastole near the lateral wall and either a negative (nine of 22) or no (13 of 22) shift at all during systole. Near the interventricular septum a negative systolic shift followed by a positive, early diastolic shift was consistently recorded. In the large majority (18 of 22) negative waves were recorded during middle and late diastole. A continuous positive or negative Doppler signal was consistently absent in healthy subjects. The angle between the proximal part of the interventricular septum and the anterior mitral valve leaflet during maximal early diastolic opening in the patients was 74 +/- 4.8 degrees (mean +/- SD), which may give rise to a preferential eccentric inflow and the maintenance of the circular apical flow pattern. PMID- 3272757 TI - Comparison of echocardiography at peak exercise and after bicycle exercise in evaluation of patients with known or suspected coronary artery disease. AB - To determine if echocardiography done immediately after bicycle exercise provides the same information as imaging at peak exercise, we evaluated 104 consecutive patients being studied for coronary artery disease. Interpretable exercise echocardiograms were obtained in 96 patients (92%), 29 of whom had a new wall motion abnormality detected with exercise echocardiography. Of these 29 patients, 10 had a wall motion abnormality detected in apical views obtained during peak exercise that resolved by the time apical imaging was performed after exercise. Three of these 10 patients, however, had wall motion abnormalities in parasternal views taken after exercise in areas adjacent to the wall motion abnormality imaged at peak exercise. The sensitivity of exercise-induced wall motion abnormality for the detection of significant coronary artery disease in those patients undergoing coronary arteriography was 70% for imaging done after exercise versus 100% for imaging done at peak exercise. Six patients' conditions would have been misclassified as normal if only imaging done after exercise had been performed. We conclude that the addition of echocardiographic imaging at peak exercise on a bicycle enhances the sensitivity for the detection of coronary artery disease with exercise echocardiography. PMID- 3272758 TI - A novel motion detection method for improving the quality of two-dimensional echocardiographic images. AB - Two-dimensional echocardiographic pictures from elderly patients are often technically unsatisfactory. It may be helpful or even necessary to improve the signal-to-noise ratio of these images before interpreting them. A novel picture averaging method for obtaining the improved image is described here. The procedure may be performed with either live video or video taped two-dimensional echocardiograms and does not require an electrocardiogram signal for triggering images from the same cardiac phase of successive heart beats. Instead, the triggering is performed by comparing video frames with a reference image, automatically selecting only the frames that are most nearly equivalent to the reference picture and averaging the selected images to obtain an enhanced, time averaged picture. Frames that are rejected by the method are those in which motion has been detected relative to the reference image, often caused by slight beat-to-beat image changes that accompany breathing. This enhancement may facilitate the interpretation and measurement of echocardiographic data, thus improving the diagnosis and management of heart disease in these patients. PMID- 3272759 TI - The effect of changes in afterload on Doppler echocardiographic indexes of left ventricular performance. AB - To investigate the influence of changes in afterload on Doppler echocardiographic determination of peak aortic blood velocity, mean acceleration, and systolic velocity integral, eight dogs with their chests opened were studied in four inotropic states at varying levels of heart rate and mean aortic blood pressure. Data were collected in the control state, at two different levels of dobutamine administration (5 and 10 micrograms/kg/min intravenously), and after administration of propranolol (0.5 mg/kg intravenously). In each inotropic state, phenylephrine was infused intravenously to produce at least two successive steady state increases of 10 mm Hg or more in mean aortic blood pressure. Within a given animal, peak velocity emerged as the Doppler index most closely correlated with changes in Qmax, dQ/dt, and dP/dt (r = 0.94, 0.91, and 0.89, respectively). Mean acceleration also correlated closely with the invasive indexes (r = 0.87, 0.89, and 0.89). The effect of changes in mean aortic blood pressure on Doppler index measurements was not statistically significant in any of the inotropic states and did not affect the closeness of their correlation with the invasive indexes. We conclude that Doppler echocardiographic measurements of aortic blood peak velocity and mean acceleration remained as sensitive to changes in the inotropic state under conditions of varying increases in afterload as did the conventional invasive indexes tested. PMID- 3272760 TI - Doppler atrial shunt flow patterns in patients with secundum atrial septal defect: determinants, limitations, and pitfalls. AB - Fifteen patients with uncomplicated secundum atrial septal defect underwent studies with real-time color-coded two dimensional flow imaging, pulsed Doppler echocardiographic examination, and simultaneous pressure recordings from the left and right atrium to determine the flow-pressure dynamics of the atrial shunt flow. In all 15 patients both the color flow mapping and pulsed Doppler studies revealed that the shunt flow was mainly from left to right, occurring both during ventricular systole and diastole. It started in early systole, reached a peak in late systole to early diastole, and lasted throughout diastole with an accentuation in late diastole during atrial contraction. The amplitude of the flow velocity, the direction, and the magnitude of the shunt flow, however, changed from phase to phase during the cardiac cycle. It correlated well with the phasic variation of the interatrial pressure difference, which usually revealed a peak pressure gradient that occurred in early systole between the x descent and v wave and during the period of v wave and a wave of the left atrial pressure tracing. Right to left shunt was not detected in any of the 15 patients by color flow mapping studies. A minor reversal of the shunt flow, however, was frequently detected at the beginning of ventricular systole and sometimes also in the middle of diastole by pulsed Doppler echocardiography. The reversal of shunt flow correlated with the minor reversal of pressure gradient that occurred during the z point, x descent, and y descent of the left atrial pressure tracing. In conclusion, left to right shunt flow occurs both during ventricular systole and diastole in uncomplicated secundum atrial septal defect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272761 TI - Echocardiographic diagnosis of atrioventricular septal perforation caused by an aortic valve vegetation. AB - A case of aortic valve endocarditis is presented in which a vegetation eroded through the atrioventricular septum and extended into the right atrium. This was diagnosed by echocardiography and confirmed at surgery. PMID- 3272762 TI - Inferior vena cava stenosis in scimitar syndrome: a case report. AB - The scimitar syndrome, first described by Chassinat in 1836, consists aessentially of an anomalous pulmonary vein draining whole or part of the right lung into the inferior vena cava. Associated anomalies are frequent, such as hypoplasia of the right lung, dextrocardia, malformations of the right pulmonary artery and bronchial tree, and abnormal arterial supply of the right lung (the so called sequestration). This article describes a scimitar syndrome associated with stenosis of the inferior vena cava, whose initial diagnosis was made by two dimensional echocardiographic Doppler color flow mapping. To our knowledge this is the first description of such an unusual association. PMID- 3272763 TI - Simplification of the Doppler continuity equation for calculating stenotic aortic valve area. AB - Determination of aortic valve area by the continuity equation is feasible and accurate but requires planimetry. Because the ratio of maximum velocities in the left ventricular outflow tract (LVOT) to aortic jet is quite similar to the ratio of velocity-time integrals at these sites, the continuity equation can be simplified by substituting maximum velocities for velocity-time integrals. Agreement with invasively determined aortic valve areas is similar with the conventional and simplified forms of the continuity equation. However, substitution of the average or sex-specific LVOT diameter for measured LVOT diameter in individual patients leads to less accurate aortic valve area determination. We conclude that simplification of the continuity equation, with measured LVOT diameter and maximum velocity and aortic jet maximum velocity, allows noninvasive calculation of the aortic valve area in a way that is simple and accurate. PMID- 3272764 TI - Hemodynamics for the sonographer. PMID- 3272765 TI - Exercise echocardiography. PMID- 3272766 TI - Echocardiographic assessment of left ventricular thrombi. PMID- 3272767 TI - Estimating severity of aortic regurgitation with Doppler techniques. PMID- 3272768 TI - Detection of remote myocardial infarction with quantitative real-time ultrasonic characterization. AB - We have previously shown that the intrinsic properties of myocardium can be characterized quantitatively by the assessment of ultrasonic integrated backscatter. In this study we utilized a novel, real-time, two-dimensional system capable of quantitative integrated backscatter imaging to determine whether zones of remote myocardial infarction in dogs could be delineated definitively by ultrasonic tissue characterization. Detection of such zones in patients is needed as a basis for management decisions related to thrombolysis, angioplasty, and coronary surgery. Integrated backscatter was measured through the closed chest from 25 myocardial sites. Zones of infarction exhibited time-averaged integrated backscatter values approximately 10 dB (9.5 +/- 0.5 dB, standard error of the mean) greater than those in normal regions (p less than 0.001). In addition, the physiologic cardiac cycle--dependent variation of integrated backscatter was blunted significantly in zones of infarction [0.8 dB +/- 0.3 vs. 3.8 +/- 0.6 (p less than 0.01) for normal regions]. Ultrasonic results matched the histopathologic features assessed directly. Thus quantitative ultrasonic tissue characterization can differentiate infarcted tissue from normal myocardium and offers promise for quantitative detection of histopathology in vivo. PMID- 3272769 TI - Analysis of Doppler-obtained velocity curves in functional evaluation of mechanical prosthetic valves in the mitral and aortic positions. AB - A total of 145 patients with 160 mechanical prostheses of the Bjork-Shiley or Starr-Edwards type (15 with double mitral plus aortic valves) underwent clinical and Doppler echocardiography analysis. In the mitral position (85 valves) 10 patients with valve-related symptoms, calculated prosthetic area less than or equal to 1 cm2, or mean transprosthetic gradient greater than 10 mm Hg by Doppler echocardiography were predefined as abnormal. Seven patients had operations, and prosthetic obstruction was confirmed in all. All patients had higher pulmonary pressures (p less than 0.001) before valve replacement. Clinical presentation was variable; however, all those with proved prosthetic thrombosis had a fulminant course and distinctive velocity curves on Doppler. In the 75 patients predefined as normal, calculated valve area (2.3 +/- 0.6 cm2, mean +/- SD, range 1.3 to 3.7 cm2) and mean gradient (4.9 +/- 1.7 mm Hg, range 1.5 to 9.5 mm Hg) were widely spread and were independent of prosthetic size greater than or equal to 27 mm. Clinically 37 of 75 patients were moderately to severely limited. Mean gradient above 5 mm Hg was associated with a higher incidence of chronic atrial fibrillation (p less than 0.05), significant tricuspid regurgitation, failure of the right side of the heart, and significant functional limitation (p less than 0.02 for all). In the aortic position (75 valves) peak gradients were 28.2 +/- 15 mm Hg (8 to 80 mm Hg). Mean gradients were 18 +/- 9.6 mm Hg (6.5 to 46.5 mm Hg). Averaged gradients derived from the average of peak and late systolic gradients were 22.4 +/- 12.7 mm Hg (6 to 62 mm Hg). In all five abnormal patients (two with endocarditis and three with hemodynamic decompensation) but also in 18 of 70 clinically normal valves, peak gradients were greater than or equal to 36 mm Hg (ranges 36 to 65 mm Hg in both). Gradients were unrelated to symptoms or to the duration of the valve in situ (3 weeks to 20 years). Gradients correlated with prosthetic size (r = 0.57) and were higher (p less than 0.001) across small (19 to 23 mm) versus large (25 to 31 mm) valves. Regurgitation was present in 40% of the mitral prostheses. It was detected in 32% of the mitral prostheses defined as normal and was estimated as mild in most. Aortic regurgitation was present in all five abnormal aortic prostheses, significant in four, and in 26 of the valves (37%) defined as normal, significant in two.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3272770 TI - Doppler ultrasound diagnosis of aortic subvalvular pseudoaneurysm with left ventricular fistula. PMID- 3272771 TI - Evaluation of the coronary arteries with echocardiographic and Doppler techniques. PMID- 3272772 TI - Assessment of pulmonary artery pressure with Doppler ultrasound. PMID- 3272773 TI - Tricuspid regurgitation in children: a pulsed Doppler, contrast echocardiographic and angiographic comparison. AB - Thirty-one children with congenital heart disease were examined for tricuspid regurgitation by four methods: (1) auscultation, (2) pulsed Doppler echocardiography, (3) saline contrast echocardiography, and (4) right ventricular angiography. Tricuspid regurgitation was detected in three children by auscultation, in 20 by pulsed Doppler echocardiography, in 21 by saline contrast echocardiography, and in 20 by right ventricular angiography. To determine the prevalence of tricuspid regurgitation in children suspected of having congenital heart disease, we reviewed 5417 Doppler echocardiograms performed between 1983 and 1985. Tricuspid regurgitation was detected in 399 of 4670 children (8.5%) with congenital heart disease and in 26 of 106 newborns (25%) with respiratory distress. By comparison, tricuspid regurgitation was detected in only 19 of 641 (3%) normal children. Tricuspid regurgitation is uncommon in normal children, but its incidence in children with congenital heart disease and/or respiratory distress is high. PMID- 3272774 TI - Ultrasound characterization of acoustic properties of acute intracardiac thrombi: studies in a new experimental model. AB - Echocardiographic differentiation among intracavitary thrombus, cavity noise, and adjacent myocardium can be difficult. As an initial step toward quantitative thrombus characterization with ultrasound, 11 dogs were studied with an in vivo intracardiac thrombus model to delineate the acoustic properties of acute thrombi. The apical coronary arteries were ligated, and subsequently injections of 5% sodium rescinoleate and 1000 units of thrombin at the endocardium-blood interface created left ventricular mural thrombi. Echocardiographic images were obtained in long- and short-axis views with a digital acquisition system, and a statistical analysis of echo intensities was performed in regions of interest in the thrombus, surrounding ventricular cavity and adjacent myocardium. Statistical measurements used to evaluate echo intensities in each region of interest included mean gray level, standard deviation, skewness, and kurtosis. The results showed that thrombus could be distinguished from myocardium (by mean gray level and standard deviation) only in short-axis views, where regions of interest could be placed at similar depths of field. Mean gray level, standard deviation, and skewness all distinguished thrombus from intracavitary blood regardless of the region of interest placement. The phase of the cardiac cycle at which data were acquired did not alter the results. We conclude that acute intracardiac thrombi can be distinguished from surrounding blood and myocardium with ultrasound tissue characterization techniques that may have the potential for clinical application. PMID- 3272775 TI - Echocardiographic diagnosis of bland thrombus on an aortic valve. AB - Echocardiography is a valuable modality for imaging thrombi and vegetations. Although patients with systemic lupus erythematosus may develop Libman-Sacks endocarditis, in which punctate verrucous plaques are found histologically on valvular endocardial tissue, these lesions are ordinarily too small for ultrasonic imaging. We describe a patient with systemic lupus erythematosus complicated by systemic embolization, who had a large mobile aortic valve thrombus, which was discovered with the aid of echocardiography and was confirmed by surgical resection. PMID- 3272776 TI - Avoidance of retrograde catheterization by Doppler echocardiographic diagnosis of Bjork-Shiley aortic valve dysfunction. AB - A 74-year-old man with a history of prior Bjork-Shiley aortic valve replacement was admitted with chest pain and dyspnea. Results of physical examination and cinefluoroscopy suggested a dysfunction of the prosthetic valve; imaging echocardiography was not helpful. Nonimaging continuous wave Doppler examination confirmed severe prosthetic aortic valve dysfunction, necessitating emergent replacement, and potentially hazardous retrograde catheterization of the prosthesis was avoided. PMID- 3272777 TI - Visualization of sinus venosus atrial septal defect by transesophageal echocardiography. AB - Atrial septal defect (ASD) is usually suspected clinically but requires a confirmative diagnostic procedure before surgical repair. Two-dimensional and Doppler echocardiography have high sensitivity and specificity for ASD, but the sensitivity of echocardiography is not as high in detecting sinus venosus ASD as it is in ostium primum or secundum defect because of the difficulty in visualizing the sinus venosus area from the subcostal window. For the posteriorly located cardiac structures, including the atrial septum, visualization is superior by transesophageal echocardiography. We describe a case in which sinus venosus ASD was not visualized by conventional transthoracic echocardiography but was diagnosed confidently by transesophageal echocardiography. PMID- 3272778 TI - The evolution of echocardiography. PMID- 3272779 TI - Quantitation of mitral stenosis. PMID- 3272781 TI - Pressure half-time does not always predict mitral valve area correctly. AB - A theory is presented elucidating factors that influence the pressure half-time. By combining the Bernoulli and continuity equations and making certain assumptions about the shape of the atrioventricular pressure difference decay, it can be shown that valve area, volume transported across that area, and initial pressure difference influence the pressure half-time according to a formula in which the pressure half-time is related to V/(Ao square root of delta po), where V is the transported volume across the orifice with the area Ao, and delta po is the initial pressure difference across that area. In a subsequent hydraulic model experiment pressure half-time was determined for three different hole areas, with various initial volumes and initial pressure gradients. We did not obtain a unique relation between the pressure half-time and area. Instead the results supported our theory, and we found a close linear relationship between area and V/(T0.5 square root of delta po) (correlation coefficient [r] = 0.998), as predicted in the theory (T0.5 = pressure half-time). Clinical examples in which the pressure half-time may be misleading in the assessment of severity of mitral stenosis are presented. PMID- 3272780 TI - Transesophageal echocardiography: better information at a higher price? PMID- 3272782 TI - Septal bounce, vena cava plethora, and pericardial adhesion: informative two dimensional echocardiographic signs in the diagnosis of pericardial constriction. AB - To assess the diagnostic value of three different two-dimensional echocardiographic signs of pericardial constriction (early diastolic septal bounce, plethora of the inferior vena cava with blunted respiratory response, and pericardial adhesion), two independent observers retrospectively evaluated echocardiograms in 100 patients, 39 of whom had pericardial constriction, 15 had hemodynamically insignificant pericardial thickening, 16 had restrictive cardiomyopathy, and 30 had normal hearts. Causes of pericardial disease included cardiac surgery, malignancy, and uremia. Sensitivity and specificity of the three signs for constriction were 62% and 93% for septal bounce, 79% and 80% for vena cava plethora, and 79% and 90% for pericardial adhesion, respectively. The presence of either vena cava plethora or pericardial adhesion increased sensitivity, whereas the presence of both plethora and adhesion increased specificity. Between the two readers, septal bounce was the most consistent and pericardial adhesion the least consistent sign. False positive results included right ventricular pacing or left bundle branch block (septal bounce), postpericardiotomy (pericardial adhesion), and right heart failure (vena cava plethora). False negative results were often caused by technical problems with imaging. We conclude that these three two-dimensional echocardiographic signs are useful in differentiating pericardial constriction from hemodynamically insignificant pericardial thickening or restrictive cardiomyopathy. PMID- 3272783 TI - Color Doppler flow mapping in the ultrasound diagnosis of total anomalous pulmonary venous connection. AB - With color Doppler flow mapping (CFM), we studied 16 children with total anomalous pulmonary venous connection (TAPVC), which was confirmed at cardiac catheterization, surgery, or autopsy in all but one case. The drainage was supracardiac in nine children, cardiac in four, and infracardiac in three. Obstruction to pulmonary venous return was present in seven children. Increased variance, reflecting disturbed blood flow, as well as increased velocities and aliasing were present in all patients. In patients without obstruction turbulence was present in the right atrium and throughout the common pulmonary venous structures. In patients with obstruction a discrete site of increased turbulence and velocity was identified at the site of obstruction. CFM allows rapid differentiation between normal and abnormal venous and arterial structures in TAPVC. In patients suspected of having TAPVC with obstruction, CFM complemented by pulsed Doppler facilitates the determination of the site of obstruction. CFM allows a more rapid appreciation of the anatomy in TAPVC than can be achieved by two-dimensional imaging alone. PMID- 3272784 TI - High flow velocity across a complicated atrial septal defect: Doppler findings and hemodynamic correlations. AB - An unusually high atrial shunt flow velocity pattern was recorded in a patient whose atrial septal defect was created iatrogenically during a transatrial septal approach to aortic valvuloplasty. The flow velocity pattern measured by Doppler echocardiography was predictive of the high transatrial pressure gradient noted later at catheterization. PMID- 3272785 TI - False inferior pseudoaneurysm: two-dimensional and Doppler echocardiographic findings. AB - The noninvasive differentiation of true aneurysm from pseudoaneurysm is sensitively and specifically accomplished with two-dimensional echocardiography. Recent reports suggest that Doppler flow patterns may further enhance the specificity of the diagnosis of pseudoaneurysm. We present a patient with ventriculographic and two-dimensional echocardiographic features of an inferior pseudoaneurysm. Doppler examination, however, failed to show phasic flow characteristic of a small communicating orifice between two larger chambers. At surgery, a large posterolateral true aneurysm was found. Thus the addition of Doppler flow patterns to imaging information may help to distinguish pseudoaneurysms from true aneurysms. PMID- 3272786 TI - Traumatic left ventricular false aneurysm with significant regurgitation from left ventricular outflow tract to left atrium: delineation by two-dimensional and color flow Doppler echocardiography. AB - A 22-year-old man was asymptomatic 23 months after an automobile accident but had clinical evidence of progressive mitral insufficiency. Two-dimensional and color flow Doppler echocardiography demonstrated a false aneurysm adjacent to the left ventricular outflow tract and significant regurgitation of blood through a traumatic channel from the left ventricular outflow tract to the left atrium. The patient underwent successful surgical closure of the false aneurysm and repair of the traumatic left atrial regurgitation. PMID- 3272787 TI - Echocardiographic diagnosis of pneumopericardium and hydropneumopericardium. AB - Pneumopericardium and hydropneumopericardium are rare conditions in which hemodynamic compromise is common. Loss of the M-mode and two-dimensional image coincident with the systolic phase of each cardiac cycle and swirling echogenic bubbles within the pericardial space produce a distinctive M-mode and two dimensional echocardiographic appearance. This provides an additional method for prompt diagnosis. PMID- 3272788 TI - Digital recording, display, and storage of echocardiograms. AB - Digital acquisition, display, and storage are new options available for handling echocardiographic images. These types of image management offer many practical advantages and are excellent supplements to standard videotape recordings. For routine M-mode and Doppler studies this digital approach, when combined with videotape, can virtually eliminate the necessity for strip chart recordings. Probably the principal advantage of digital storage techniques is for two dimensional echocardiography. The continuous loop display is extremely convenient for rapid review, quantitation, and serial studies. When considering the implementation of these techniques, there are many limitations and practical considerations that must be kept in mind. Recording two-dimensional echocardiograms in a continuous loop mode requires that the same number of frames or cells must be used if one wants to display more than one image simultaneously. When creating a continuous loop of a single cardiac cycle, the number of cells and the interval between cells are greatly influenced by the heart rate. One must be able to display simultaneous images with varying heart rates. Last, the number of cells, the resolution, and the gray scale determine the amount of digital information that has to be stored, retrieved, or transmitted. The cost and size of the medium and the speed with which the images can be retrieved or transmitted become factors in how one elects to digitally acquire this information. One approach that has been used, which seems to work quite well in most cases, is to use an eight-cell sequence for two-dimensional echocardiograms. When primarily interested in looking at ventricular function, especially regional wall motion, a 50 msec interval between frames is most appropriate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272789 TI - Manpower problems in echocardiography. PMID- 3272791 TI - Paradoxical motion of the posterior left ventricular wall seen in healthy subjects in the upright position. AB - Paradoxical motion of the posterior left ventricular wall in patients in the upright but not in the supine position was demonstrated in a high percentage of normal volunteers. There was no significant difference in age, body surface area, heart rate, and blood pressure between the groups, with or without paradoxical motion. This echocardiographic finding probably represents a physiologic phenomenon and should be taken into consideration during the interpretation of upright exercise echocardiograms. PMID- 3272790 TI - Two-dimensional echocardiographic analysis of the dynamic geometry of the left ventricle: the basis for an improved model of wall motion. AB - To establish an appropriate echocardiographic model for wall motion analysis we first determined the precise dynamic geometry of the left ventricle during systole, as visualized by two-dimensional echocardiography. With the epicardial apex and the aortic-ventricular and mitral-ventricular junctions as anatomic landmarks, we quantitatively analyzed apical long-axis views in 61 normal subjects, 41 patients with anterior myocardial infarction, and nine patients with posterior myocardial infarction. Thoracic impedance registration allowed exclusion of extracardiac motion from the measurements. In normal subjects the epicardial apex moved outwardly only 0.6 +/- 0.3 mm (mean +/- standard error). Examination of 15 hearts fixed in formalin revealed apical myocardial thickness of 1.5 +/- 0.2 mm. These data suggest that the observed inward motion of the endocardial apex (4.1 +/- 0.7 mm) resulted from obliteration of the apical cavity as a result of inward motion of the adjacent walls. Translation of the base was considerable in normal subjects (14.1 +/- 0.4 mm) and decreased in myocardial infarction (9.1 +/- 0.5 mm, p less than 0.0001). Unequal shortening of the adjacent walls in anterior and posterior myocardial infarction caused basal rotation in the opposite direction (-9.1 +/- 0.8 degrees and 9.7 +/- 1.4 degrees, respectively, p less than 0.0001 versus that of normal subjects, -3.4 +/- 0.7 degrees). Long-axis rotation was not clinically significant (less than 1 degree). We conclude that during ventricular contraction the apex serves as a stable point, whereas the base translates toward the apex because of shortening of the adjacent walls. We then propose a model for analyzing regional wall motion from two-dimensional echocardiograms on the basis of these observations. PMID- 3272792 TI - Clinical validation of an edge detection algorithm for two-dimensional echocardiographic short-axis images. AB - The purpose of this study was to validate an edge detection algorithm for short axis two-dimensional echocardiographic studies in a protocol that stimulated its implementation at multiple clinical laboratories. Six short-axis two-dimensional echocardiographic studies were solicited from each of five clinical laboratories. A single cardiac cycle from each of the resulting 30 studies was entered into the computer system. Five expert observers came to the laboratory on separate occasions and traced endocardial borders from the short-axis studies on 2 separate days. The computer algorithm generated borders on each frame of the cardiac cycles on the basis of regions of search defined by the observers. Of the 30 original studies, five were considered excellent, seven were good, nine were poor, and nine were technically inadequate by consensus of the five observers. The correlation coefficient for computer-defined borders with manually defined borders in the excellent quality studies was 0.985. Interobserver variability was expressed as the mean percent area difference for all possible pairings of observers. The mean percent area differences were decreased from +/- 9.8% to +/- 5.3%, +/- 12.5% to +/- 8.4%, and +/- 17.4% to +/- 15.6% when comparing observer with computer-generated borders in the excellent, good, and poor quality studies, respectively. Intraobserver variability was expressed as decrease in mean percent area difference on corresponding frames between days 1 and 2. Intraobserver variability was decreased from +/- 6.5% to +/- 4.5%, +/- 10.8% to +/- 7.0%, and +/- 14.0% to +/- 11.9%, respectively. All reductions in variability were statistically significant at p less than 0.01. Observer acceptance of computer defined borders was estimated at 94%, 93%, and 97% for excellent, good, and poor quality studies, respectively. Once the observer defined a region of search, computer process time to generate all borders in the cardiac cycle was approximately 4 minutes. The conclusion is that the algorithm produces accurate, reliable, and acceptable borders. PMID- 3272793 TI - Isolated thickening of one aortic cusp: preferential thickening of the noncoronary cusp. AB - Over a 2-year period we identified 197 patients with the previously undescribed finding of isolated thickening of one aortic cusp. The noncoronary cusp was involved most frequently in 56% (p less than 0.01), followed by the right coronary cusp in 35%, and the left coronary cusp in 9%. Isolated thickening of one aortic cusp occurs more commonly in male patients (64%) (p less than 0.01) and at an earlier age (65 years) than mitral annular calcification (70 years) (p less than 0.001). PMID- 3272794 TI - Diagnosis of patent ductus arteriosus by serendipity in the adult. AB - Seven patients with patent ductus arteriosus (PDA) were seen in our adult echocardiography laboratory. In five of seven patients the diagnosis was made on color Doppler when it was not suspected clinically. The diagnosis became apparent because of a turbulent retrograde jet seen on color Doppler in the main pulmonary artery. One of the patients had known congenital heart disease and heart surgery in the past, and the diagnosis of PDA was missed both on catheterization and in the operating room. PDA may be unsuspected in adult patients and may be missed by techniques other than color Doppler echocardiography. The striking findings on color Doppler may help to make this important diagnosis in such patients. PMID- 3272795 TI - Paradoxical (right-to-left) shunting across an iatrogenic atrial septal defect during Valsalva's maneuver: a transesophageal Doppler echocardiographic study. PMID- 3272796 TI - Doppler diagnosis of left ventricle to coronary sinus fistula: an unusual complication of mitral valve replacement. PMID- 3272797 TI - Two-dimensional echocardiographic features of complete transposition of the great arteries with posterior aorta. PMID- 3272798 TI - New developments in contrast echocardiography. PMID- 3272799 TI - Doppler echocardiographic measurement of outflow tract gradient in hypertrophic cardiomyopathy. PMID- 3272800 TI - Interleukin-3-specific modification of cell membrane "fluidity" of haemopoietic cells. AB - The work reported here clearly demonstrates that a specific growth factor, interleukin-3 (IL-3), which acts on multipotent haemopoietic stem cells as well as on committed myeloid progenitor cells of different lineages (Schrader, 1988; Whetton and Dexter, 1986), specifically induces a modification of the physical state ("fluidity") of the cell membranes of two IL-3-responsive and apparently normal haemopoietic cell lines. Furthermore, in a derived IL-3 independent myeloid leukaemic cell line, no such physical response to IL-3 binding was observed. The rapidity of the "normal" response suggests further that it may be associated with, or even constitute per se a critical early effect elicited by IL 3 in sensitive cells, the necessity for which is abrogated in the malignant derivative. PMID- 3272801 TI - Endothelial cells synthesize basic fibroblast growth factor and transforming growth factor beta. AB - Endothelial cells, including human umbilical vein endothelial cells (HUVEC), bovine aortic endothelial cells (BAEC), and bovine capillary endothelial cells (BCEC) in culture synthesize basic fibroblast growth factor (bFGF) and transforming growth factor type beta (TGF-beta). Basic FGF was cell-associated and synthesis was demonstrated by (i) the presence of bFGF mRNA species, (ii) binding to heparin-Sepharose and elution at 1.5 M NaCl, (iii) cross-reactivity with anti-bFGF antibodies when analyzed by electrophoretic blotting, and (iv) biological activity. Basic FGF was found in cell lysates at 2.3 ng/10(6) cells in HUVEC, 2.0 ng/10(6) cells in BCEC, and 13 ng/10(6) cells in BAEC. TGF-beta was secreted into media, and synthesis was demonstrated by (i) presence of TGF-beta mRNA species, (ii) cross-reactivity with anti-TGF-beta antibodies when analyzed by immunoprecipitation, (iii) competitive binding with authentic human platelet derived TGF-beta that was blocked by TGF-beta specific blocking antibodies, and (iv) inhibition of [3H]TdR incorporation in CCl-64 cells. TGF-beta was secreted in an inactive form and required acid activation for detection. HUVEC synthesized 2.0 ng TGF-beta/10(6) cells per 12 hr; BCEC, 3.5 ng; and BAEC, 3.5 ng. HUVEC proliferation was not affected by treatment with exogenous TGF-beta, while BCEC proliferation was decreased by treatment with TGF-beta. Vascular endothelium is thus a source for these two potent multifunctional regulatory molecules, both of which may affect the growth of endothelium and neighboring fibroblasts, smooth muscle cells and white blood cells. The activation or release of these factors by endothelium may be a precipitating event in important cellular processes such as wound healing, organogenesis, and angiogenesis. PMID- 3272802 TI - Post bending of the polypropylene flexible stent in mitral Hancock bioprostheses. AB - The occurrence of stent post deformity was investigated in 38 consecutive, polypropylene flexible-stented Hancock porcine bioprostheses (PB) recovered from the mitral position because of early postoperative death or late tissue failure. The degree of deformity was assessed for each explant by calculating the triangular area obtained by projecting the apex of the stent posts on a plane and comparing it with the same area calculated for unimplanted PBs of comparable size. A significant stent deformity (reduction of the triangular area greater than 40%) was observed only in 6 PBs explanted because of tissue failure after a mean function time of 69.6 +/- 28 months. In these PBs, scanning electron microscopy of the bare surface of the stent at the point of maximal flexion showed cracks 0.7-1 microns large, which represent the morphological substrate of the so-called "creep" of polypropylene. Inward stent post bending may occur after implantation in mitral PBs and when severe, it corresponds to a definite ultrastructural plastic deformity of polypropylene. PMID- 3272804 TI - Primary mediastinal tumors in children. AB - From 1950-1986, a total of 159 children (age 1 day-16 years) were treated for primary mediastinal tumors at our hospital. There were 77 malignant and 82 benign tumors. Tracheal compression causing respiratory distress was a significant symptom in 45.3% (24/53) of the children under 2 years of age. The diagnosis was based on the chest X-ray and the findings at surgery. Malignant lymphoma was usually diagnosed by cervical lymph node biopsy (23/39) but the treatment protocol was non-surgical. Non-lymphatic malignant tumors were completely or partially excised in 59.0% (23/39) of the cases. There was no early or late mortality in patients with benign tumors. At follow-up (0.5-24 years; mean 6.0 years), 62.3% (48/77) of the patients with malignant tumors were alive and symptom free. About half of the mediastinal tumors in children are malignant. Mediastinal tumors in small children can cause severe respiratory symptoms demanding urgent treatment. The treatment of choice is surgery (except in lymphomas) and the results are good even in malignant tumors. PMID- 3272803 TI - Improved energy preservation following gentle reperfusion after hypothermic, ischemic cardioplegia in infarcted rat hearts. AB - The influence of temperature and pressure during early reperfusion after 2 h of hypothermic, cardioplegic ischemia was investigated. Adenosine triphosphate (ATP) and creatine-phosphate (CP) were measured after 45-min reperfusion. The experiments were carried out in normal and previously infarcted rat hearts (the left coronary artery having been ligated 3 weeks earlier). Four groups, each containing six hearts, were studied. Group 1 consisted of normal hearts reperfused with an abrupt rise in temperature and pressure, group 2 of normal hearts exposed to slowly rising temperature and pressure, and group 3 and 4 of previously infarcted hearts. Reperfusion procedures in groups 3 and 4 were the same as in group 1 and 2, respectively. The study showed that previously infarcted hearts have a lowered tolerance to ischemia and that the reperfusion technique may influence the preservation of myocardial energetics, although this influence was not statistically significant in normal hearts following only 2 h of ischemia. The gently reperfused infarcted hearts had energy stores equal to the normal hearts after 2 h of ischemia and 45 min of reperfusion, whereas the infarcted hearts reperfused in a rougher mode had significantly lowered values (P less than 0.05 for ATP and P less than 0.01 for CP). PMID- 3272805 TI - Pulmonary resection using automatic stapling devices. AB - Between January 1980 and December 1986, 674 patients underwent pulmonary surgery at this institution under the supervision of one surgeon (RJD). Automatic stapling devices were used to close the bronchus in all but 12 patients. Malignant disease was the reason for 85% of resections. The operative mortality was 4.9% (3.2% in patients undergoing lobectomy and 8.3% in those undergoing pneumonectomy). The complication rate was 17.3%. Bronchopleural fistula (BPF) occurred in 11 patients, an incidence of 1.7%. The post-pneumonectomy incidence of BPF was 2.7% within 3 months of surgery and 4.5% overall. Stapled closure of one or more hilar vessels was employed in 153 patients. The role of staplers in pulmonary surgery with particular reference to the incidence of bronchopleural fistula is examined. PMID- 3272806 TI - Factors predisposing to wound infection in cardiac surgery. A prospective study of 517 patients. AB - Postoperative wound infection can greatly prolong hospital stay after cardiac surgery, so the identification of predisposing factors may help in prevention or early institution of treatment. Transfer of organisms from the leg to the sternum during coronary artery surgery has been proposed as a major additional cause of sepsis. The definition of wound infection is not standardised and therefore makes comparison between centres difficult. In a prospective study of 517 patients, a wound scoring method (ASEPSIS) has been used to register all abnormal wounds to maximise the chances of identifying factors predisposing to infection. Abnormal healing was noted in 99 (19%) sternal wounds and 29 (8%) leg wounds. Obesity was the principal risk factor (P less than 0.005). Diabetes, reoperation, length of preoperative hospital stay, age, sex, or previous cardiac surgery had little effect on wound healing. The range of bacteria isolated from chest wounds after coronary artery surgery was similar to that after valvular surgery, but the rate of isolation was significantly greater. With careful attention to technique, leg wound infection rarely presented a clinical problem and did not appear to be a source of bacteria infecting the chest wound. PMID- 3272807 TI - The incidence and significance of early pericardial effusion after open heart surgery. AB - The presence and severity of postoperative pericardial effusions were studied echocardiographically in 114 consecutive patients (70 males, 44 females; mean age 56 +/- 10 years). An effusion was present in 35 patients at 3-5 days. An effusion was less common when a drainage tube was inserted for 24-36 h in the posterior as well as the anterior mediastinum than when only an anterior drain was used. Patients with effusions differed from those without in having more supraventricular arrhythmias, more wound infections, smaller total blood drainage and longer postoperative hospital stay. Three patients with posterior pericardial effusions developed cardiac tamponade 5-18 days postoperatively. The data show that pericardial effusions are associated with postoperative complications and suggest that effusion formation can be reduced by using posterior as well as anterior chest drains. PMID- 3272808 TI - Acute type-A dissection of the aorta: which diagnostic modes remain for surgical indication? AB - The natural course of acute type-A dissection of the aorta (AADA) implies a mortality of 50% within the initial 2 days. Preoperative diagnostic tests have to be expeditious while avoiding hypertension and direct manipulation of the aneurysm to prevent aortic rupture. Since 1979, 51 patients have been operated upon for AADA. The diagnosis was established by one or more of the following methods: transthoracic echocardiography (TTE); transesophageal echocardiography (TEE); conventional angiography (CA); intravenous digital subtraction angiography (DSA); and computed tomography with bolus injection of contrast medium (CT). TTE (n = 26) showed a dissection in 72%, suggested an intimal flap in 25%, and missed the diagnosis in 1 case. CT (n = 15) and DSA (n = 10) failed to indicate dissection in 1 case each. CA (n = 27) demonstrated dissection in every case but was the most time-consuming and stressful method. Since the introduction of combined transthoracic and transesophageal echocardiography, no other diagnostic methods have been used. On the basis of this experience, we propose the following diagnostic plan: 1. in AADA, the demonstration of an intimal flap in the ascending aorta by TTE/TEE is an indication for immediate surgery without further diagnostic measures (10 patients: no false-positive findings); 2. if a dissection is suggested by TTE/TEE, then DSA is performed if the supra-aortic branches are suspected to be compromised; CT is preferred if an extrapericardial aortic rupture is suspected; 3. the time-consuming and stressful diagnostic approach of conventional angiography is no longer indicated. PMID- 3272809 TI - Extensive aneurysm of the aortic arch and descending aorta. Extra-anatomical reconstruction and exclusion of the aneurysmal sac. AB - A new technique for repair of extensive aneurysm reaching from the ascending aorta to the diaphragm is presented. The operation consists of the reconstruction of the aortic arch and descending aorta and the exclusion of the aneurysmal sac in a single operation. Two successful cases are presented. PMID- 3272810 TI - Partially unroofed coronary sinus associated with tricuspid atresia. An important associated lesion in the Fontan operation. AB - A case of tricuspid atresia associated with partially unroofed coronary sinus following a Fontan operation is described. A 4-year-old boy with tricuspid atresia showed persistent arterial desaturation immediately after a modified Fontan operation. At reoperation on the next day, a partially unroofed coronary sinus was recognized and repaired through a left atriotomy. Although uncommon, this associated anomaly should be kept in mind even in the absence of a persistent left superior vena cava and should be suspected if arterial desaturation occurs after a modified Fontan operation. PMID- 3272811 TI - Rhabdomyoma of the heart with intrapericardial expansion. AB - A rare case of a rhabdomyoma originating from the surface of the right atrium in a 20-year-old female is reported. The tumor showed electrical activity and caused both outflow obstruction and tamponade symptoms. It was successfully removed by a right-sided thoracotomy. The clinical course, diagnostic investigations, and the therapeutical approach of this rare lesion are discussed. PMID- 3272812 TI - A new look at acute type-A dissection of the aorta. AB - A new method of treating acute type-A dissection of the aorta is described and illustrated. It involves the reconstruction of both the valve and the ascending aorta. This procedure was employed in 17 patients, 2 of whom succumbed early of complications unrelated to the method while one committed suicide at a later date. One of the surviving patients required reoperation due to breakdown of a resuspended aortic commissure. Two patients show minor non-progressive valve regurgitation in the absence of annulo-aortic ectasia. Two patients have developed dilatation of the aortic root--one will require reoperation in the foreseeable future. In our hands, this method has served to make emergency operation for acute aortic dissection both simpler and safer. The limitations of its use are discussed. PMID- 3272813 TI - Uncommon Gm* haplotypes in the Tunisian population: further contribution to the genetics of the IgG immunoglobulins. AB - In this work, eight family studies were conducted to establish the suspected unusual Gm* haplotypes in 13 persons (among 418) showing uncommon Gm phenotypes. Usually, the Gm (21 and 28)--or Gm (g1 and g5)--allotypes are both present or absent. Exceptions to this rule were observed: on the one hand, only the Gm (28) allotype was present in 12 persons, and on the other hand, only the Gm (21) allotype was found in 1 person. Such events could be explained, in some cases, by equal crossovers or point mutations, and, more generally and very likely, by gene conversions. Other interesting results are also presented, as, on the one hand, silent genes homozygous at the C gamma 4 locus and, on the other hand, a homozygous multigene deletion encompassing the C alpha 1, psi gamma, C gamma 2 and C gamma 4 loci. PMID- 3272814 TI - Adverse effect of blood transfusion on the long-term outcome of kidney transplantation. AB - In 116 patients treated with azathioprine and prednisolone, 2-year patient survival and primary renal allograft survival was analyzed with regard to the effects of pretransplant blood transfusion and of matching for HLA-A, HLA-B, and HLA-DR. Two years after transplantation, patient survival was significantly lower in transfused patients than in non-transfused patients (81 vs. 97%, p less than 0.05). A detrimental effect of blood transfusion on graft survival was found in conjunction with HLA-A compatibility (p = 0.01 overall, and p = 0.003 for HLA-B mismatched transplants). Among transfused patients, enhanced graft survival was associated with incompatibility for HLA-A (p = 0.02 overall, and p = 0.008 for HLA-B mismatched transplants), and with compatibility for HLA-B (p = 0.0006 overall, and p = 0.005 for HLA-A mismatched transplants). The present results indicate that blood transfusion may have detrimental effect on patient survival. PMID- 3272815 TI - HLA-DR1 and HLA-DR3 phenotypes and insulin antibody production in diabetic Sicilian patients. AB - We have evaluated the role played by HLA antigens in the control of humoral response to exogenous insulin in a sample of Sicilian insulin-dependent diabetes mellitus patients. The results demonstrate that HLA-DR1-positive patients show the highest mean values of insulin antibody, whereas HLA-B18,DR3-positive patients show the lowest. Thus, present observations show that HLA-DR1- and HLA DR3-linked genes do play opposite roles in the humoral immune response to an exogenous protein, i.e. injected insulin. These results might be consistent with the findings concerning the mechanisms involved in the resistance and/or susceptibility to immunological diseases. In this regard, the fact that no immunological spontaneous disorder has been shown to be associated with HLA-DR1, whereas several have been shown to be associated with HLA-DR3, is intriguing. PMID- 3272817 TI - Genetics of complement. PMID- 3272816 TI - HLA, C4, Bf, Gm and autoantibodies in rheumatoid arthritis. AB - Sera from 48 subjects with rheumatoid arthritis (RA), more than 80% of which were seropositive, were examined for the presence of antibodies to intact nuclei (ANA) by immunofluorescence, extractable nuclear antigens (ENA), double-stranded DNA by immunoassay and immunoglobulins, i.e. rheumatoid factors (RF) by haemagglutination. The genetic markers of HLA, the fourth complement component (C4) and properdin factor (Bf), which are all coded for within the major histocompatibility complex and Gm immunoglobulin allotypic markers were all analysed in relation to various parameters of these autoantibodies. The only significant association to emerge was between low ENA antibody affinities and the Bf Fs phenotype (p less than 0.02). Although weak associations between individual autoantibody parameters and the other immunogenetic markers were detected, there were no significant HLA, C4 or Gm association with either ANA subsets or RF, a finding which agrees with, and also extends previous HLA studies of predominantly seropositive RA cohorts. PMID- 3272818 TI - Factor B subtypes in Japanese patients with IgA nephropathy and with idiopathic membranous nephropathy. AB - The present paper describes a method of subtyping of properdin factor B (BF) using polyacrylamide gel isoelectric focusing followed by immunoblotting, and the distribution of BF subtypes in Japanese patients with IgA nephropathy or idiopathic membranous nephropathy (IMN) along with controls. BF*F allele was splitted into two suballeles, named BF*FA and BF*FB. There were significant differences in the BF suballele frequencies between the IMN patient group and the control group. A significant association of IMN with the BF FA subtype (p less than 0.05) and with the BF FB subtype (p less than 0.001) was also found. BF*FB may be a susceptibility suballele to IMN rather than BF*FA. PMID- 3272819 TI - Appearance of rats sensitive to experimental autoimmune encephalomyelitis in a previously resistant strain. AB - Changes are described in the PVG strain with respect to susceptibility for induction of experimental autoimmune encephalomyelitis. During a period of 8 years, the strain changed from a nearly resistant to a partly susceptible strain. Selective breeding of susceptible and resistant rats showed that the cause was genetic. This could also be seen in the susceptibility of F1 hybrids with the resistant Brown-Norway strain; such hybrids were strongly susceptible at the beginning but showed about 40% susceptibility during the later part of the period. It is argued that the genetic changes probably occurred in loci regulating mechanisms of resistance. PMID- 3272820 TI - Macrophage oxidative activation potential in normal and endotoxin-treated Biozzi high and low antibody responder mice. AB - The present study is an attempt to verify the hypothesis that high (HI) and low (LI) antibody responder Biozzi mice, which differ strikingly in their macrophage capacities to catabolize antigens and to exert bactericidal activity (the LI being more potent than the HI line), demonstrate a similar genetic disparity in their macrophage oxidative metabolism activation potential. The production of reactive oxygen intermediates was measured by luminol-dependent chemiluminescence in cell suspensions from various sources including: bone marrow, peripheral blood, spleen, peritoneal exudate, thymus, and mesenteric lymph nodes. Chemiluminescence was determined both in the absence and presence of particulate (opsonized zymosan and latex) and soluble (phorbol myristate acetate and concanavalin A) membrane-stimulating agents. Lastly this investigation was conducted both in normal and endotoxin (lipopolysaccharide from Escherichia coli) treated HI and LI mice in an attempt to unmask the hypothesized difference by increasing the macrophage oxidative response capacity. Results obtained did not show the expected interline differences in reactive oxygen intermediate production regardless of cell origin, stimulating agent or lipopolysaccharide in vivo treatment. On the other hand, the well-documented enhancing effect of lipopolysaccharide on macrophage oxidative metabolism depended on the origin of the cell suspension. Indeed, it was not observed in bone marrow and peripheral blood from either HI or LI mice, was clearly demonstrated in the spleen and peritoneal exudate from both mouse lines, and surprisingly, in the thymus and lymph nodes from HI but not LI mice. PMID- 3272821 TI - Immunoglobulin allotypes and familial cutaneous malignant melanoma/dysplastic nevi. A family study. AB - Gm and Km allotypes were examined in 355 members of 14 large pedigrees segregating for autosomal dominant cutaneous malignant melanoma/dysplastic nevi. No evidence for linkage was found between the disease locus and the immunoglobulin loci. Furthermore, there was no association of G1m(2) or Gm(-1) with cutaneous malignant melanoma in the 14 independent family probands. PMID- 3272823 TI - Sulfhydryl reagents as model substances for eicosanoid research. AB - The rate of eicosanoid synthesis is controlled by the availability of free arachidonic acid. Recently we showed that inhibition of reacylation of liberated fatty acids by the sulfhydryl group-blocking agent thimerosal increased prostaglandin as well as leukotriene synthesis. In order to gain further insight into the basic regulatory mechanisms controlling cellular eicosanoid production, the effects of different sulfhydryl reagents on prostaglandin E2 synthesis in the macrophage-like cell line P388D1 were investigated. As these cells exhibit an enormous acyl turnover of cellular phospholipids even under basal conditions, any interference with their fatty acid deacylation-reacylation cycle should lead to a change in intracellular concentrations of the eicosanoid precursor arachidonic acid. Therefore, arachidonic acid release from prelabelled cells as well as arachidonic acid incorporation into different phospholipid species under the influence of mercuric chloride (HgCl2), ethylmercurithiosalicylate (thimerosal), p-hydroxymercuribenzoic acid (PHMB), 0-(3-hydroxymercuri-3 methoxypropyl)carbamoyl-phenoxyacetic acid (mersalyl), N-ethylmaleimide (NEM), and ethacrynic acid were examined. Additionally, direct effects of those substances on corresponding enzyme activities, i.e. phospholipase A2 (PLA2), acyl CoA synthetase, and lysophospholipid acyltransferase (LAT), on glutathione levels, and on cell viability were estimated. The results demonstrate that the organic mercury compound thimerosal was the most effective in enhancing free arachidonic acid levels, and concomitantly prostaglandin E2 synthesis in P388D1 cells, as result of a rather selective inhibition of the fatty acid reacylating enzyme LAT. PMID- 3272824 TI - Inhibition of hydrogen peroxide release from activated macrophages by prior ingestion of erythrocytes or haemoglobin. AB - Production of hydrogen peroxide by mouse peritoneal macrophages activated with Corynebacterium parvum was induced by incubating the cells with opsonised zymosan. H2O2 release was reduced by 47% when macrophages were preincubated with opsonised sheep erythrocytes. A significant decrease also occurred when the cells were preincubated with heat-denatured haemoglobin, but not when preincubated with opsonised erythrocyte ghosts, even though the latter were taken up by the macrophages. The ability of macrophages in an infected lesion to destroy microorganisms may therefore be impaired by ingestion of extravasated erythrocytes. PMID- 3272825 TI - Unusual cross-reactions among monoclonal antibodies to bacterial antigens: idiotypic and competitive binding analysis. AB - In a previous study, we have described unusual cross-reactions among monoclonal antibodies (Mabs) to bacteria and in particular to the Inaba and Ogawa serotypes of Vibrio cholerae. In this study, the extent to which the binding sites of both antibodies and antigens overlap has been investigated by competitive binding and idiotypic analysis. The competitive binding data indicate that the cross-reactive binding of the Inaba Mabs to the Ogawa vibrios can be abolished by incubation with higher affinity Ogawa Mabs. However, rabbit antiserum raised against the Inaba series does not react with the Ogawa series, indicating that anti-Inaba Mabs do not share idiotypic determinants with anti-Ogawa Mabs. The results therefore suggest that the two sets of antibodies recognise different determinants which are closely related in spatial terms, and which consequently do not permit simultaneous binding of the two types of monoclonal antibody. PMID- 3272822 TI - 12(S)-Hydroxy-5,8,10 (Z,E,E)-heptadecatrienoic acid (HHT) is preferentially metabolized to its 12-keto derivative by human erythrocytes in vitro. AB - The metabolism of [1-14C]-labelled 12 (S)-hydroxy-5,8,10 (Z,E,E) heptadecatrienoic acid (HHT) by crude 15-hydroxyprostaglandin dehydrogenase (PGDH) fractions from swine kidney and human erythrocytes has been investigated. HPLC radiochromatography analysis revealed that HHT was extensively converted into three metabolites by swine kidney cytosol in the presence of NAD+. They were identified by combined GLC mass spectrometry as 12-keto-5,8,10 (Z,E,E) heptadecatrienoic acid (KHT), 12-keto-5,8 (Z,E)-heptadecadienoic acid and 12 (RS) hydroxy-5,8 (Z,E)-heptadecadienoic acid, respectively. In contrast, HHT was metabolized only to the 12-keto derivative by human erythrocyte cytosol supplemented with NADP+, and HHT turnover was found to be enhanced severalfold when compared to prostaglandins E2 (PGE2) or F2 alpha. Since PGE2 was also converted only into 15-keto-PGE2, and no metabolism of KHT was detected with NADPH, there is probably no 15-ketoprostaglandin delta 13-reductase activity in human erythrocytes. Biosynthetic KHT (0.5-5 microM) inhibited the aggregation of human platelets to almost all agonists, probably by raising intracellular cAMP. KHT (between 0.01 and 1 microM) also induced the chemotaxis of human polymorphonuclear leukocytes. Among other still unrecognized effects, these biological activities of KHT may be of physiological significance with respect to its presumably exclusive formation in the blood. The potential use of KHT for monitoring thromboxane synthase activity in vivo is discussed. PMID- 3272827 TI - The effect of synthetic iron chelators on bacterial growth in human serum. AB - The effect of synthetic iron chelators of the 1-alkyl-3-hydroxy-2-methylpyrid-4 one class (the L1 series) and 1-hydroxypyrid-2-one (L4) on bacterial growth in human serum was compared with those of the plant iron chelators mimosine and maltol and of the microbial siderophore desferrioxamine. None of the synthetic chelators enhanced growth of 3 Gram-negative organisms (Yersinia enterocolitica, Escherichia coli and Pseudomonas aeruginosa); in some cases they were even inhibitory. L4 strongly stimulated growth of Staphylococcus epidermidis, but the L1 series had only a marginal effect. Maltol was mildly inhibitory to all 4 bacterial species, while mimosine enhanced the growth of S. epidermidis and Y. enterocolitica but had little effect on E. coli or P. aeruginosa. Desferrioxamine enhanced the growth of all except E. coli. These results suggest that the chelators of synthetic or plant origin may carry less risk of increasing susceptibility to bacterial infection in patients undergoing chelation therapy for iron overload than does desferrioxamine, the drug currently in clinical use. PMID- 3272826 TI - Determinants of immunity to murine salmonellosis: studies involving immunization with lipopolysaccharide-lipid A-associated protein complexes in C3H/HeJ mice. AB - We have earlier demonstrated that the C3H/HeJ Salmonella hypersusceptible mouse can be protected against infection with this organism by prior immunization with lipopolysaccharide (LPS)-lipid A-associated protein (LAP) complexes, but not with LPS alone. In the current studies, protection has been shown to correlate with the induction of LPS-specific antibody in immunized mice. LPS was demonstrated to be a relevant target antigen for Salmonella immunity since C3H/HeJ mice were afforded higher survival rates when they were challenged with Salmonella that shared the same LPS O-antigen as the vaccine. Although low levels of LPS-specific antibody can be detected 14 days after immunization with LAP-LPS, significant antibody is present only after 21-28 days. In addition, anti-LAP specific antibodies can be detected after 14 days of immunization with LAP-LPS. Adoptive transfer of either day 28 anti-LAP-LPS immune serum or day 28 LAP-LPS immune splenocytes alone to naive recipients affords mice minimal, if any, survival against lethal S. typhimurium LT2 challenge. In contrast, transfer of day 28 anti LAP-LPS immune serum and day 28 LAP-LPS immune splenocytes together is able to transfer Salmonella immunity to naive C3H/HeJ mice. Further, equivalent transfer of only day 28 anti-LAP-LPS immune serum to C3H/HeJ mice immunized 7 days previously with LAP-LPS provides protection similar to that found in mice adoptively transferred with immune cells and serum. These results suggest that a host cellular factor or factors responsive to LAP-LPS, in addition to day 28 anti LAP-LPS immune serum, may contribute to the protection afforded C3H/HeJ mice following immunization with LAP-LPS. PMID- 3272828 TI - How can we stop killing pulps? PMID- 3272829 TI - The role of implantology as an alternative to removable prostheses. PMID- 3272830 TI - Posterior restorative materials--decisions. PMID- 3272832 TI - Craniomandibular disorders and sequencing their treatment. PMID- 3272833 TI - Theory development. PMID- 3272834 TI - Rogerian practice: perspectives. PMID- 3272831 TI - Spatial relationships in the temporomandibular joint using lateral oblique transcranial radiographs. PMID- 3272835 TI - Beginnings ... a message from the president. PMID- 3272836 TI - Clinical use of the science of unitary human beings (SUHB). PMID- 3272838 TI - [10th annual meeting of the Section on Pediatric Endocrinology of the Spanish Association of Pediatrics. Pamplona, 21-22 October 1988. Proceedings]. PMID- 3272837 TI - [Endocrine, autocrine and paracrine factors in the regulation of growth of skeletal bones]. PMID- 3272839 TI - [Growth in congenital hypothyroidism]. PMID- 3272840 TI - [Gonadal dysgenesis. Follow up with special attention to body height]. PMID- 3272841 TI - [Familial short stature]. PMID- 3272842 TI - [Patterns of growth in congenital adrenal hyperplasia. Correlation between glucocorticoid therapy and stature]. PMID- 3272843 TI - All fluoride dentifrices are not the same. PMID- 3272844 TI - Long-term results of IOL implantation in traumatic cataracts. PMID- 3272845 TI - Sports-related ocular injuries. PMID- 3272846 TI - [The role of temporary balloon buckling in retinal detachment]. PMID- 3272847 TI - Traumatic retinal detachment. PMID- 3272848 TI - Marlex mesh in the reconstruction of blow-out fractures of the orbit. PMID- 3272849 TI - Light-induced maculopathy from the operating microscope. PMID- 3272850 TI - Penetrating eye injuries. A retrospective study. PMID- 3272852 TI - Water-electrolyte balance in overmature fetuses. AB - The water and electrolyte contents of various fetal and maternal tissues were studied at the final stage of embryogeny and during prolonged pregnancy. The data indicate that the placenta in prolonged pregnancy can act as a depot organ for water and sodium. PMID- 3272851 TI - Long-term outcome of one haploidentical live related donor transplantation in children. AB - We report on 69 children, 6 months to 18 years old, who received a one haploidentical live related donor transplantation from 11/72 through 4/89. Thirty patients were maternal and 22 were paternal recipients; 23 were Black, 27 Caucasian, 17 Hispanic, and 1 each Oriental and Arabic. The original diagnoses in these patients were aplastic/dysplastic kidneys 13%, obstructive uropathy 30%, focal segmental glomerulosclerosis (FSGS) 23% and lupus nephritis 10%. RESULTS: 1 , 5-, 10- and 15-year actuarial patient and graft survivals were 98, 84, 84, 84% and 94, 70, 41, 30% respectively. Actual 5-year graft survival of paternal recipients was better than maternal recipients (p less than 0.05). No differences were noted comparing actuarial graft survival between Blacks, Caucasians and Hispanics. 1/16 FSGS and 1/7 lupus nephritis patients had recurrence of their original disease. Posttransplant therapy in 37 patients consisted of azathioprine and prednisone while 32 patients received ciclosporin A (CSA) and prednisone. At transplantation, CSA and prednisone patients were younger, i.e., 10.7 years (range 0.5-18) compared to 13.3 years (range 4-18) and (p less than 0.03) in azathioprine and prednisone patients. The 5-year actuarial graft survival of azathioprine and prednisone patients was 57% compared to 76% in CSA and prednisone patients. 16/32 CSA and prednisone patients had their prednisone discontinued for a mean duration of 18 months (3-54 months). Ten of these 16 patients were prepubertal and had their growth hormone levels measured. All had an adequate level (greater than or equal to 10 ng/ml) poststimulation. Five of the 10 patients were less than 6 years of age and exhibited accelerated growth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3272853 TI - Growth evaluation in children with acute renal failure of unknown etiology. AB - We performed a retrospective study on 47 children over 1 year of age with severe acute renal failure (ARF) treated with hemodialysis (HD) at our Center from 1978 to 1986 in order to evaluate the diagnostic and prognostic value of growth indexes at hospital admission as a criterion to distinguish cases of ARF without previous chronic renal failure (CRF) from cases in which CRF was not previously diagnosed. The age of the patients ranged from 17 months to 13 years. The cause of ARF was identified in 41 children; 5 of them remained on HD for different reasons (hemolytic uremic syndrome with arteriolar involvement in 3 cases; renal vein thrombosis in 1; endoextracapillary glomerulonephritis in 1). No apparent cause of ARF was found in the other 6 children who remained on chronic HD. A careful history showed that these 6 children had had uremic symptoms for many years. When height was expressed as height standard deviation score (HSDS), the 6 children with ARF of unknown etiology showed significantly lower HSDS values compared with the other 41 children in whom a cause of ARF was diagnosed (p less than 0.001). In conclusion, growth failure in children requiring HD for ARF of unknown etiology is an important criterion that suggests a previously undiagnosed CRF and thus consequently a negative long-term prognosis. PMID- 3272854 TI - Purpura nephritis in Chinese children from northern Taiwan. AB - From Jan. 1976 to Feb. 1989, 101 pediatric patients were diagnosed as Henoch Schonlein purpura in Veterans General Hospital Taipei, 35 (35%) of whom were found to have purpura nephritis by both urinalysis and renal biopsy. All of them have been followed up for more than 4 months to 8 years. During this period, 7 (20%) of patients progressed to renal insufficiency or chronic renal failure, while 20 cases (57%) recovered from the renal disease completely, and the remaining 8 (23%) had urinary abnormalities till the last follow-up. The patients who had older onset age, who had acute nephritic syndrome, nephrotic syndrome as their initial renal manifestations or who had poor grading in renal pathology, had a relatively poor prognosis. Although most cases recovered completely from renal disease, a substantial minority of cases will have long-term renal morbidity. It is mandatory to combine clinical data, biopsy findings and close follow-up data in the management of pediatric purpura nephritis. The disease cannot be viewed as a benign disease in Chinese children. PMID- 3272855 TI - Standardization of renal function measurements in children: kidney size versus metabolic rate. AB - Body surface area is used to standardize renal function measurements in children. This is appropriate when relating renal function to kidney size. However, standardizing renal function by lean body mass could yield additional insights into the relationships of renal function, diet, growth and general metabolism that are not apparent using surface area. PMID- 3272856 TI - Isolated antinuclear antibody-negative lupus nephropathy in young children. AB - Systemic lupus erythematosus (SLE) is a multisystem disease in which the kidneys are frequently involved. The clinical and histopathologic diagnosis of SLE is based on the American Rheumatism Association (ARA) and the World Health Organization classification, respectively. A few adults who qualify as SLE by the ARA criteria but are antinuclear antibody (ANA)-negative have been reported. We found only one report of a child with SLE where renal disease was the only manifestation but who had a positive ANA. This report describes 3 children who presented with the nephrotic syndrome and in whom the renal histology is highly suggestive of SLE. Short-term follow-up as failed to demonstrate other systemic involvement and the ANA has continued to be negative. PMID- 3272857 TI - False uroradiologic pathology in children with urinary tract infection and fecal impaction. AB - Intravenous pyelography (IVP) in 5 children with urinary tract infection detected various uroradiologic abnormalities. Despite the lack of history of constipation, a common denominator to all 5 patients was the finding of fecal impaction in the rectosigmoid. In the first 3 patients, repeated complete IVP series done several weeks later and after preparatory bowel enema were normal. In the last 2 patients, the radiologic investigation was interrupted when the first exposure disclosed uroradiologic abnormalities and fecal impaction. Following immediate bowel enema, the studies were completed on the same settings to be found normal. It is concluded that in the face of fecal impaction, pathologic uroradiologic findings should be interpreted with great caution. Moreover, in such cases, intraprocedure cleansing enema is feasible and recommended. PMID- 3272858 TI - Maintenance of oral hygiene and dental health during orthodontic therapy. PMID- 3272859 TI - A comparison between autopolymerizing and visible-light-activated sealants. PMID- 3272860 TI - The effect of local application of a sustained release delivery system of chlorhexidine on plaque accumulation. PMID- 3272862 TI - Cytotoxic estimation of Ni-Cr base alloys by cell culture study. PMID- 3272861 TI - Mucosal-antral cysts: radiographic appearance and differential diagnosis. PMID- 3272863 TI - Impact properties of acrylic denture base resin. Part 1. A new method for determination of impact properties. PMID- 3272864 TI - Effect of monomer structure on the mechanical properties of light-cured unfilled resins. PMID- 3272865 TI - Dynamic shear modulus in torsion of human dentin. PMID- 3272866 TI - A new method for the evaluation of the wear of restorative materials on Class V cavity. PMID- 3272867 TI - Xerostomia and the geriatric patient. PMID- 3272868 TI - The 'how-tos' of dental consult writing. PMID- 3272869 TI - Gerodontology, its increasing role and relevance to dentistry. PMID- 3272870 TI - When another dentist is guilty. PMID- 3272871 TI - The coming of the age of oral medicine. PMID- 3272872 TI - Conscious sedation: is it dentistry or medicine? PMID- 3272874 TI - Diagnosis of combined endodontic and periodontal lesions. PMID- 3272873 TI - Developing successful referral relationships. PMID- 3272875 TI - Endodontic therapy: expect the unexpected. PMID- 3272876 TI - Effective irrigation: flushing for success. PMID- 3272877 TI - Aspects of paediatric craniofacial surgery. PMID- 3272878 TI - Clinical anatomy. The parotid gland. PMID- 3272879 TI - Test your diagnostic skills. Follicular cyst. PMID- 3272880 TI - [Mandibular hypoplasia: clinical case]. PMID- 3272881 TI - [Complete coronal fracture of an incisor. Description of a clinical case]. PMID- 3272882 TI - [Pigmented lesion of the palate. Description of a clinical case]. PMID- 3272883 TI - [Extraoral radiography: screen-film combinations]. PMID- 3272884 TI - [Antibiotics in prevention and treatment of periodontal disease]. PMID- 3272885 TI - ["Dynamic" osseointegration: endosseous implants in "forbidden" areas]. PMID- 3272886 TI - [Professional responsibility in implantology. Legal aspects. 1]. PMID- 3272887 TI - [Ergonomic furnishing and layout of the dental office]. PMID- 3272888 TI - [Oral implantology: historico-scientific report. 2]. PMID- 3272889 TI - [The third molar: evaluation of its role and indications for extraction]. PMID- 3272890 TI - Implants: implications for general dentists. PMID- 3272891 TI - FDA bends rules on experimental AIDS drug. PMID- 3272892 TI - Interview with the ADA president-elect. Dentistry is entering a new golden age. Interview by H. Ronald Combs. PMID- 3272893 TI - Computer imaging provides improved presentations. PMID- 3272895 TI - 10 commandments of financial arrangements. PMID- 3272894 TI - Dentistry continues on a steady course. PMID- 3272897 TI - The requirements of informed consent. PMID- 3272896 TI - Does your staff know what you expect? PMID- 3272898 TI - More money for dental research and AIDS. PMID- 3272899 TI - President Reagan endorsed some of the recommendations of his AIDS commission. PMID- 3272900 TI - Giving and receiving notice. PMID- 3272901 TI - Falmouth's showpiece laboratory. PMID- 3272902 TI - Laboratory costs and dentists. PMID- 3272903 TI - A method for observing crystal growth in gypsum products. PMID- 3272904 TI - Osseointegrated implants. PMID- 3272905 TI - Dental trauma: 4. Avulsion of immature incisor teeth. PMID- 3272906 TI - Oral surgery for the older patient. PMID- 3272907 TI - Orofacial manifestations of AIDS. PMID- 3272908 TI - Sensitivity to flavoured toothpaste. PMID- 3272909 TI - Ultrasonic instruments in dentistry: 2. Endosonics. PMID- 3272910 TI - Paediatric oral medicine: 5. The oral mucosa (ii). PMID- 3272911 TI - Dental pharmacology problems in the elderly. PMID- 3272912 TI - Skin conditions affecting the dental surgeon's hand. PMID- 3272914 TI - Pink teeth of the dead: II. Minor variations. PMID- 3272913 TI - The psychology of behaviour change and dental health. PMID- 3272915 TI - A comparison of radicular dentinal tubule size in two different age groups. PMID- 3272916 TI - The identification of a "necklace" murder victim. PMID- 3272917 TI - Pigmentation of teeth: a review. PMID- 3272918 TI - Identification, the dentist and the coroner in England and Wales. PMID- 3272919 TI - [The prevalence of Candida and denture stomatitis in complete denture wearers]. PMID- 3272920 TI - [Primary tuberculous ulcer of the gingiva: report of 1 case]. PMID- 3272921 TI - [Vertical height of complete dentures in a group of patients]. PMID- 3272923 TI - [The dental health problem among the malnourished primary school pupils 7-12 years old in Muang district of Si Sa Ket province]. PMID- 3272922 TI - [The utility arch wire in orthodontic treatment]. PMID- 3272924 TI - Nurses' attitude toward alcohol abuse and alcoholism. AB - Nurses have the opportunity to make significant contributions to primary, secondary and tertiary prevention of alcoholism because of their proximity to patients in inpatient, ambulatory and community settings. However, often nurses do not intervene because of attitudinal barriers. This paper addresses the attitudes of nurses toward alcohol abuse and alcoholism and how these attitudes are developed. Strategies for promoting attitude change are discussed. PMID- 3272925 TI - The impaired nurse: identification and intervention. AB - This paper explores the issue of impaired nurses' risk to patients, employers, health care delivery systems and themselves. Mood or mind altering substances inhibit the ability to function effectively by seriously impairing the nurse's judgment. Nursing managers and/or supervisors need skills to identify the impaired nurse and to be effective in intervention strategies. PMID- 3272926 TI - Consumer's perception of substance abuse by health-care providers. AB - Recent media attention on substance abuse and drug testing have made health-care consumers more aware of these issues. Consumer views on substance abuse among health-care providers have received little documentation; little is known about how this media exposure has affected consumers' views. This study investigates consumers' perceptions in three areas related to substance abuse (use of illegal drugs as well as abuse of legal drugs and alcohol) and health care providers (doctors, nurses, pharmacists, and physical therapists). PMID- 3272927 TI - Color drawings: a means of identifying problems in children. AB - Between the ages of seven and nine years, the child develops a schema or way to draw his version of the world. Drawings are revealing in that they can help assess a child's behavior. Figure drawings are useful in determining general cognitive development, self-image, and level of maturity (Harris, 1963; DiLeo, 1973; DiLeo, 1983; and Koppitz, 1968). As the child progresses through developmental stages in perceiving and using color, she similarly progresses in her drawing abilities. Distinction, identification and aesthetic reaction to color are thus functions of the cortex; they are developmental and educational results rather than instinctual and reactive responses (Scott, 1969). PMID- 3272928 TI - Nursing research needs of black Americans: 1989 and beyond. AB - This article identifies problems considered to be among the most important for Black American health and suggests specific areas of research to address these problems. Black professional nurses are urged to become active researchers in order to be effective in the treatment and/or prevention of these problems. PMID- 3272930 TI - Alcoholism: a major Black health problem. PMID- 3272929 TI - Summer program for pre-matriculating nursing students. AB - The National League for Nursing reported in 1984 that while Black nursing students represent 15.89% of admissions to baccalaureate programs in the southern region of the United States, they represent only 8.17% of the graduating nursing students. The average percentage of enrolled Black nursing students at the Medical College of Georgia School of Nursing for 1981-85 was only 7.68%. In view of the need for minority nursing students, it is necessary to increase the number of minorities enrolled and to improve retention rates of these students. A Nursing Student Educational Enrichment Program (S.E.E.P.), a summer pre matriculating curriculum, was developed for minority nursing students which utilized a variety of campus-wide services and was based in the School of Nursing. The S.E.E.P. nursing students attended classes with all campus S.E.E.P. students who were enrolled in other health profession classes, and also completed two courses specific for nursing students: Decision-Making and Therapeutic Communication. This article examines the development and implementation of the nursing courses, with a focus on the curriculum design, program evaluation, and program specifics. PMID- 3272931 TI - The medical record from a legal perspective: sources and guidelines for improvement. PMID- 3272932 TI - Ethical and legal duties of a parent to provide dental treatment to a minor. PMID- 3272933 TI - HIV-positive dental students and faculty: their right to provide patient care in light of federal constitutional and antidiscrimination laws. PMID- 3272934 TI - AIDS in dental education. PMID- 3272935 TI - Legal status of associate: employee or independent contractor? PMID- 3272936 TI - Person identification through dentistry. PMID- 3272939 TI - Some thoughts on halitosis. PMID- 3272937 TI - Peer review after Patrick v Burget. AMA Committee on Medicolegal Problems. PMID- 3272938 TI - Professional ethics instruction at Baylor College of Dentistry. PMID- 3272940 TI - Risk of AIDS is lower than health care workers think. PMID- 3272941 TI - Anonymous AIDS test shows dentists are alright. PMID- 3272942 TI - Researchers report saliva may inhibit AIDS infection. PMID- 3272943 TI - Influences on periodontal disease: 1. Nutritional and hormonal factors. PMID- 3272944 TI - [Phylogenesis and embryogenesis of the temporomandibular joint]. PMID- 3272945 TI - [Surgery of the temporomandibular joint (TMJ). Interview by P. Canal and E. Leyojeux..]. PMID- 3272946 TI - [TMJ imaging technics]. PMID- 3272947 TI - [Diagnostic approach to diseases commonly called M.P.D.S]. PMID- 3272948 TI - [Temporomandibular dysfunction: therapeutic approach]. PMID- 3272949 TI - [Physiology of the temporomandibular joint]. PMID- 3272950 TI - [Management of repositioning splints before and during active orthodontic treatment]. PMID- 3272951 TI - A comparison of HIV antibody and HIV viral findings in blood and saliva of HIV antibody-positive juvenile hemophiliacs. PMID- 3272952 TI - Clinical efficacy of 1 and 2% solutions of lidocaine. PMID- 3272953 TI - Histopathology of radiolucent furcation lesions associated with pulpotomy-treated primary molars. PMID- 3272954 TI - In vivo remineralization of enamel at the buccal and proximal sites using two fluoride regimens. PMID- 3272955 TI - Histology of primary incisor enamel in children with early onset celiac disease. PMID- 3272956 TI - Composite/sealant restoration: 6 1/2-year results. PMID- 3272957 TI - Treatment of children for primary acute herpetic gingivostomatitis with lactobacillus in aqueous suspension. PMID- 3272958 TI - Oral abnormalities in the Ellis-van Creveld syndrome: case report. PMID- 3272959 TI - Etiology of Class II malocclusions. PMID- 3272960 TI - Supervision of Class II discrepancies. PMID- 3272961 TI - Corrective methods for Class II patients. PMID- 3272962 TI - Introducing the superveneer. PMID- 3272963 TI - Molarization of the first upper deciduous molar. PMID- 3272964 TI - The morphology of the dental embrasure and reflections on its significance. PMID- 3272965 TI - Starch and dental caries. PMID- 3272966 TI - The future of dentistry and dental education. PMID- 3272967 TI - In vitro enamel fluoride uptake from two fluoride-containing dentifrices. PMID- 3272968 TI - The dentition of Nubians from Wadi Halfa, Sudan: an evolutionary perspective. PMID- 3272969 TI - Anodontia totalis fetalis in a trisomy 13 mosaic. PMID- 3272970 TI - Cleidocranial dysplasia in the South Western Cape: preliminary report. PMID- 3272971 TI - Tooth material in the hominidae. PMID- 3272972 TI - A cephalometric appraisal of the Herero-speaking negro male. PMID- 3272973 TI - Determining dental needs: self-assessment of oral health in relation to a clinical examination. PMID- 3272974 TI - Dental caries and malnutrition in rural South African Black ten- to twelve-year olds. PMID- 3272975 TI - They do clean burs ... don't they? PMID- 3272976 TI - Acute renal failure and mechanical ventilation. PMID- 3272977 TI - Traumatic rupture of the pericardium with intermittent cardiac herniation in a multiple-trauma patient. AB - This is a case report of an 18-year-old multiply injured patient with blunt chest trauma, a total rupture of the right pericardium and an intermittent cardiac dislocation. Intermittent signs suggestive of cardiac tamponade accompanied the cardiac herniations. Acute renal failure followed these acute hemodynamic disorders. Early diagnosis and therapy were responsible for the successful outcome. PMID- 3272978 TI - Chronic salicylate intoxication in infants and children. PMID- 3272979 TI - [Acute poisoning in children: a 10-year experience]. PMID- 3272980 TI - [Use of peak flow meter in children with bronchial asthma]. PMID- 3272981 TI - Thyroid adenoma--report of a case. PMID- 3272982 TI - Unilateral agenesis of the lung--report of a case. PMID- 3272983 TI - Congenital hepatic fibrosis in children--a report of three cases. PMID- 3272984 TI - [Scrub typhus--report of two cases]. PMID- 3272985 TI - [Moyamoya disease: report of three cases]. PMID- 3272986 TI - [A case report of fatal asthma in children]. PMID- 3272987 TI - Balloon atrial septostomy guided by two-dimensional echocardiography in infants with D-transposition of the great arteries. PMID- 3272988 TI - [Serum alpha-interferon and alpha-interferon antibody in children with allergic bronchial asthma and systemic lupus erythematosus]. PMID- 3272989 TI - [Normal blood cell values for Chinese children of various ages]. PMID- 3272990 TI - [Serum lipoprotein profiles in infantile cholestasis: the role of lipoprotein-X (LP-X) in the diagnosis of biliary atresia]. PMID- 3272992 TI - [A preliminary study on night waking and associated factors in infants]. PMID- 3272991 TI - [Meningitis associated with Rickettsia tsutsugamushi infection]. PMID- 3272993 TI - Myelodysplastic syndrome in childhood: report of a case. PMID- 3272994 TI - Infantile opsoclonus-polymyoclonus syndrome associated with presacral ganglioneuroma: report of a case. PMID- 3272995 TI - [Tuberculous peritonitis in children: report of nine cases]. PMID- 3272996 TI - [Transcatheter embolization in the management of spinal arteriovenous malformation: a case report]. PMID- 3272997 TI - [Theoretical considerations on psychological symptoms in a crisis situation. Psychotherapeutic consequences]. AB - The crisis comes from the breakdown of the usual frame in which one lives. This frame insures to the patient a feeling of continuity as well as his intra-psychic security. This crisis also creates an intra-psychic disturbance which appears under the form of multiple symptoms that are often hiding the internal conflicts. The psychotherapist's aim in a crisis situation is to give a meaning to the patient's crisis and to offer him by the relation and the new frame generated by this relation, a transitional field in which the subject will be able to solve his conflicts and work out new anaclisis. PMID- 3272999 TI - [The effect of cyclic loads on the dynamic strength of a filled premolar crown]. PMID- 3273000 TI - [The intensity of masticatory forces in front teeth]. PMID- 3272998 TI - [Efficacy of antidepressants selected as a function of erythrocyte membrane transport and plasma levels of L-tyrosine and L-tryptophan]. AB - The present study concerned 69 depressed patients (26 men, 43 women). The antidepressant drug was prescribed in accordance with perturbations of tyrosine and tryptophan membrane transports (MT) across the red cell, measured in vitro after a wash-out period of ten days. After two to four months of treatment, the clinical results were divided into two groups: normal mood (AMDP - Depression Scale less than 6) and no recovery (AMDP - Depression Scale greater than 6). The initial criteria (e.g. MT) was completed by using plasma tyrosine, tryptophan and the product MT by plasma level. Indeed, the success of this treatment was corresponding to precise abnormalities of variable: (i) tyrosine and tryptophan values for imipramine, (ii) tyrosine values, plasma tryptophan and tryptophan product for desipramine, (iii) tryptophan variables and plasma tyrosine for fluvoxamine (and indalpine). The analysis of clinical failures permitted to complete our previous choice of antidepressant drug. PMID- 3273001 TI - [Dental caries in eugnathic and dysgnathic pre-school children]. PMID- 3273002 TI - [Alterations in enamel microhardness in initial carious lesions]. PMID- 3273003 TI - [The influence of the type of polymerization upon the discoloration of composites]. PMID- 3273004 TI - [Ga-As laser in the treatment of adult periodontitis]. PMID- 3273005 TI - [Role of aerobic and anaerobic bacteria in odontogenic infections]. PMID- 3273006 TI - The possibilities of recognizing fear by the analysis of children's drawings. PMID- 3273007 TI - A new concept of vascular supply to the skin and classification of skin flaps according to their vascularization. AB - The success of fasciocutaneous flaps is based on the existence of epifascial vascular networks and reliable blood supply. However, there has been no thorough classification of the vascular anatomy of the fascia and skin and there is some confusion in regard to cutaneous vascular nomenclature. We divide the vascular systems involved in the cutaneous circulation into four categories. This permits classification of skin flaps into five types (cutaneous, fasciocutaneous, adipofascial, septocutaneous, and musculocutaneous flaps). Fasciocutaneous flaps can be further divided into six types, according to the patterns of the vascular input to the fasciocutaneous plexus. This classification has been demonstrated to be related to clinical effects. Nine new free and island flaps are discussed. PMID- 3273008 TI - Breast reconstruction by tissue expansion for congenital and burn deformities. AB - We have used tissue expanders to treat 10 patients with breast deformities, 2 the result of burns and 8 congenital in origin. The expanders are placed in the subglandular plane and expanded incrementally until the desired amount of growth is obtained. In patients with congenital deformities, the desired size of the reconstructed breast (implant size) is determined during the expansion phase. Reconstructions of the nipple-areola complex are done either at the time of the exchange or as separate procedures. Patients with burn deformities present a variety of problems not seen with the congenital deformities. The expander is placed in the subglandular plane and filled to the desired volume. We have noted a marked permanent softening of the scar and grafts encasing the breast, which persists after the expander is removed and the breast reconstructed. The interval between expansion and definitive reconstruction is delayed for several months to allow scar softening to take place. If the parenchyma is not burned and pedicle tissue is not required, the expander can be deflated and the skin coverage observed to determine if it will remain soft. If it does, the expander can be removed and the breast reconstructed. In patients who require pedicle coverage in the reconstruction and who have unburned scar surrounding the breast, massive overexpansion is carried out. The pedicle skin is used to resurface the breast after removal of the appropriate areas of scar and skin grafts. In all burned patients, the inframammary fold must be reconstructed if the breast is to be protuberant. The nipple-areola complex also requires reconstruction. To date there has been great acceptance by patients with both congenital and burn deformities; however, we believe that tissue expansion techniques offer possibilities that have not as yet been fully explored. PMID- 3273009 TI - Reconstruction of microtia with conchal remnant. AB - In microtia with conchal remnant (type B microtia), there are various degrees of deformity; consequently, different surgical procedures are required for individual cases. To clarify and simplify these complicated surgical techniques, type B microtia is divided into two types, type BI and type BII, from the standpoint of the emphasis on conchal creation. The methods of treatment are discussed. PMID- 3273010 TI - Squamous carcinoma in scars: clinicopathological correlations. AB - Twelve cases of squamous cell carcinoma arising in scars of the skin are analyzed. Correlation of tumor aggressiveness, tumor differentiation, intensity of small lymphocyte infiltration, and nature of adjacent collagen tissue to tumor stroma was investigated. All tumors were predominantly well differentiated. Nine patients had no metastasis or recurrence after surgical treatment of the primary tumor. Three patients developed widespread metastases and died less than 2 years after operation. The tumors of these latter patients contained areas of pleomorphic and spindle cells and had minimal infiltrates of small lymphocytes. In contrast, the 9 patients who remained free of tumor had moderate infiltrates of small lymphocytes, and in just 1 of 9 was an area of pleomorphic tumor cells found. Prognosis in scar carcinoma, therefore, may be related to tumor differentiation and the degree of host response with small lymphocytes to the tumor, rather than to the universally poor prognosis recorded in the past. PMID- 3273011 TI - Classification of mastectomy deformity. AB - This article proposes a classification system for mastectomy reconstruction based on skin and muscle deficiency. This system is helpful in planning surgery and in presenting lecture material. It could also be helpful in organizing material in future publications on mastectomy deformity by providing guidelines regarding the choice of procedure as it corresponds to the degree of deformity. Finally, it may enhance our ability to develop statistical measures for comparing different reconstructive techniques. PMID- 3273012 TI - A self-locking pin for fixation of small bones and phalanges: a preliminary report. AB - In this preliminary report, a new self-locking pin for small bones and phalanges is presented. Its mechanical characteristics were tested and compared with those of a pair of crossed Kirschner wires in cadaver phalanges and with results presented in the literature. Extraction of the pin after callus formation was tested in vivo (on an experimental animal). The results prove the mechanical fixation efficiency of the single small-diameter self-locking pin and its easy removal from the new callus. PMID- 3273014 TI - Pendulosity in regional flaps about the head and neck. AB - Pendulosity rarely occurs in flap transposition in the area of the head and neck. It is related to physical and physiological factors that derive from the volume of tissue transplanted, the neatness of its fit into the wound, its supportive facilities, its functional activity, its relation to gravity, and the effect of its perimeter scar tissue bed and venous drainage system. It is amazing that this condition does not appear more commonly when one considers that as much as 1,000 cc of inert tissue may be transposed as a volumetric mass, either with a singular vascular pedicle or as a singular microvascular anastomosis or a randomized soft tissue pedicle base. The difficulty is almost always compounded by the fact that the tissue does not contain a specific lymph drainage facility. The majority of these physiological handicaps, however, are accommodated by the receptiveness of the tissues of the wound and the venous drainage of the flap. If these should fail, edema and then pendulosity will occur. The condition can be improved by repositioning and a reduction in the size of the flap. PMID- 3273013 TI - Marginal vascular change in pedicle skin flaps. AB - The changes of vascular patterns in pedicle skin flaps were studied in rats at various intervals after operation using microangiography, with the following results: (1) Vascular change was observed in the marginal area of the flap after operation, possibly related to the release of an angiogenic factor during anaerobic metabolism. (2) Both primary and secondary revascularization were observed in the flap, but the main process was found to be primary revascularization. (3) Four days after operation, revascularization was observed. (4) Longitudinal rearrangement of the vessels in the flap could not be observed. (5) At sutured areas where the stitches remained, severe vascular reaction continued for a longer period. PMID- 3273016 TI - Re: Elsahy: ear reconstruction. PMID- 3273015 TI - Rhinoplasty results revisited. PMID- 3273017 TI - The effects of hematoma on implant capsules. AB - Hematoma surrounding an implant is one of the many factors that have been suggested as possible causes for scar capsule contracture. In this study, experiments were designed to determine the influence of hematoma on the incidence and severity of capsule contracture in rabbits. Two implants were placed in each animal, 1 with a surrounding hematoma and 1 control. Capsules were evaluated subjectively and compared objectively with measurements of deformability, surface area, and capsule thickness. No differences were found with any of the objective criteria, which suggests that hematoma may not be a noteworthy cause of implant capsule contracture. PMID- 3273018 TI - Salvage of the exposed breast implant. AB - Exposure of silicone breast implants may occur as a result of hematoma and infection, inadequate soft tissue coverage, use of steroids, or trauma. In various series the incidence of severe complications is reported to range from 1% to 4%. When exposure of the implant has occurred, most authors recommend removal with replacement four to six months later. In 11 patients we successfully salvaged the exposed breast implant. The technique was initially presented in 5 patients in 1974. Successful salvage of the exposed implant involved (1) wound cultures with preoperative and postoperative antibiotic therapy, (2) excisional debridement of the skin wound, (3) open capsulotomy to relieve tension, (4) wound irrigation with neomycin-polymyxin or povidone-iodine, (5) closed catheter drainage, and (6) replacement with a sterile prosthesis. Secondary closure of these wounds was successful in all of the patients. Of the 11 patients, 9 were seen at two years postoperatively with results comparable in appearance and softness to the opposite breast. One of the patients required subsequent bilateral capsulotomies for firmness. The use of this technique is recommended for selected patients in whom there are no systemic problems related to wound healing and in whom sufficient soft tissue coverage is possible. PMID- 3273019 TI - Fluorocarbon (FC-43) in augmentation of tissue oxygen and its experimental use for flap survival. AB - The tissue PO2 level in the skin of rats injected with fluorocarbon (FC-43) was measured by the microelectrode method and by a transcutaneous monitor. It was found that the tissue PO2 in the animals injected with FC-43 was two to three times higher than that of the control group. Neither the administration of FC-43 nor the inhalation of systemic oxygen improved flap survival in the rats. PMID- 3273020 TI - Hemodynamic alterations secondary to an electrical burn in the rat: a pilot study. AB - Rats subjected to a standard electrical burn of 250 volts for 10 seconds receive a severe injury stimulating a pronounced systemic circulatory response. Initial postinjury hyperemia is replaced by a low perfusion state within 24 hours. Our study demonstrates the difficulty in isolating regional microcirculatory alterations under such circumstances. Modification of the burn model or the method of fluid resuscitation may minimize the influence of this dynamic systemic response. PMID- 3273021 TI - Pharyngocutaneous fistulas: management with one-stage flap reconstruction. AB - After total laryngectomy, postoperative pharyngocutaneous fistula still constitutes a most troublesome and challenging problem. We present 9 cases of postoperative fistulas managed by one-stage flap reconstruction. Possible contributing factors related to earlier management or medical status are identified. When the posterior pharyngeal wall was intact in a large pharyngocutaneous fistula, 4 pectoralis major and 2 latissimus dorsi double island musculocutaneous flaps were used. Autogenous jejunal free grafts were used in 3 patients when circumferential reconstruction was required. The cervical esophagus was successfully reconstructed, facilitating swallowing function, in a one-stage procedure in each patient. PMID- 3273022 TI - Operative and nonoperative treatment of mallet finger. AB - Forty-four patients with 47 mallet fingers were reviewed to compare the results of operative (24 fingers) and nonoperative (23 fingers) treatment. Distal interphalangeal (DIP) joint extension, DIP flexion, total active motion of the DIP joint, proximal interphalangeal (PIP) extension, PIP flexion, total active motion of the PIP joint, cold intolerance, and persistent pain after treatment were not significantly different in patients treated by surgery or splinting. Secondarily, we compared fingers with and without a fracture of the distal phalanx, and the variables mentioned above were also unaffected by the presence or absence of fractures of the distal phalanx. About one-third of all patients had decreased PIP joint motion following treatment. In about 16% of all patients this loss of PIP motion was more important in determining finger function than DIP motion or symptoms related to the DIP joint. We recommend careful examination of the PIP joint and repeated monitoring of the joint motion. If the PIP joint becomes stiff, therapy and splinting should be used to minimize permanent stiffness. We believe a prospective randomized comparison of operative and nonoperative treatment of mallet finger should be conducted. Such a study would help determine the ideal treatment for mallet finger. PMID- 3273023 TI - An aesthetic approach for nasal tumors. AB - An elongated columella flap has been found to give excellent exposure to the nasal dorsum, allowing satisfactory removal of soft tissue nasal masses such as dermoid cysts or hemangiomas. This approach provides a more acceptable scar than the standard vertical dorsal nasal incision. PMID- 3273024 TI - Complications of liquid nitrogen cryosurgery for verrucae over bony prominences. AB - Liquid nitrogen cryosurgery is the most frequently used surgical treatment for verrucae. Its success rate is high and complications are rare. However, liquid nitrogen should be used with great care over bony prominences where skin and subcutaneous tissues are thin. We present 3 patients in whom the treatment of simple warts over bony prominences by liquid nitrogen resulted in full-thickness loss of skin. In 2 of them, extensor tendons of fingers were exposed and had to be covered with flaps. We conclude that expertise of the physician is of paramount importance in preventing similar complications in cryosurgery of verrucae. PMID- 3273025 TI - Osseous choristoma of the tongue. AB - A 5-year-old black female, the youngest patient so far reported, presented with osseous choristoma of the tongue. The lesion was located on the dorsum of the posterior tongue at the circumvallate papillae area. The origin of the tumor is unknown; however, ossification of remnants of the branchial arches is accepted by most authorities. The tumor was pedunculated with no associated symptoms, and its excision was not followed by recurrence to date. PMID- 3273026 TI - The use of uniform simulated models in the reconstruction of craniopagus twins. AB - A unique approach to the planning of the separation and subsequent reconstruction of craniopagus twins is presented. In consultation with medical artists and prosthetists, exact models of our patients were fabricated preoperatively. Models were made of a hard acrylic to simulate bone and silicone rubber to simulate skin. In this fashion, the surgical teams were given an opportunity to preplan the bony separation of the heads, as well as to design the best possible coverage for reconstruction of the resulting defects. Physiological, mechanical, and aesthetic considerations are discussed. Two surgical delay procedures were performed without complication prior to neurosurgical separation. A broad segment of inextricably interconnected cerebellar tissue and a shared sagittal sinus could not be overcome at the time of final separation and proved to be fatal for both twins. Owing to the untimely deaths, we can only postulate that the delayed compound musculocutaneous flaps would have produced the best possible results and physiological protection for the extensive bony defects in both skulls resulting from this separation. PMID- 3273028 TI - Re: Apfelberg et al: Comparison of argon and CO2 laser treatment of decorative tattoos. PMID- 3273027 TI - Nasal septal abscess: unusual causes, complications, treatment, and sequelae. AB - Abscesses of the nasal septum are most likely to occur after trauma. Proper management of a nasal septal abscess requires prompt diagnosis, adequate surgical drainage, and parenteral antibiotics to prevent the potentially dangerous spread of infection and the development of severe functional and cosmetic sequelae. Without a history of prior trauma, physicians should be alert to other, less obvious causes for nasal septal abscesses. A rare case of an isolated sphenoid sinus infection leading to a nasal septal abscess illustrates the surgical treatment of these entities. PMID- 3273029 TI - How "fine" is incisional biopsy of melanoma. PMID- 3273030 TI - Chain saw injuries to the face. AB - Chain saws may produce devastating facial injuries when the blade kicks back after striking a hard object. A review of experience with 12 male patients indicates that in addition to extensive ragged lacerations of skin and soft tissues, bone and teeth are frequently fractured. Eye injuries are rare, but the eyelids may be extensively damaged. Management includes debridement and exploration of the wounds, repair of soft tissues, removal of fractured roots, and application of arch bars if the jaw is fractured. PMID- 3273031 TI - Reconstruction of full-thickness chest wall defects using rectus abdominis musculocutaneous flap: a report of fifteen cases. AB - In 15 patients chest walls were excised because of recurrent breast cancer, radiation ulcer, or rib tumor. In most cases the full-thickness defect of the chest wall was about 10 x 10 cm. Reconstruction was performed using only a rectus abdominis musculocutaneous flap. No patient developed circulation problems in the flap or severe flail chest, and we had successful results in all our cases. These results show that the rectus abdominis musculocutaneous flap is quite effective and safe to use in the reconstruction of chest wall defects. PMID- 3273033 TI - Free autogenous pearl fat grafts in the face--a preliminary report of a rediscovered technique. AB - Free autogenous fat grafts between 4 and 6 mm (the size of a pearl) have been used successfully to correct pitting acne, nasolabial folds, eyelid depressions, facial atrophy, facial wrinkles, depressed scars, and in chin augmentation. Theoretical measures taken to ensure the maximum amount of survival of donor fat include exogenous vitamin E, treatment with insulin, small size of grafts, and atraumatic antiseptic technique. Numerous supportive clinical, historical, and laboratory references are cited, dating from 1893. Considering the abundance of fat tissue available and the prolific amounts discarded during blepharoplasty, liposuction, lipectomy, and platysma cervical lift, fat should be reconsidered as the soft tissue substitute. This is a preliminary report and further study is needed. PMID- 3273032 TI - Further applications of Archimedes' principle in the correction of asymmetrical breasts. AB - Archimedes' law of buoyancy has been extended to the preoperative bedside assessment of volume differences between breasts, whatever their cause. The simple method described has proved to be a helpful aid in surgical procedures for the correction of breast asymmetry. PMID- 3273034 TI - Postauricular skin slough in cervical facial rhytidectomy. AB - Postauricular skin slough in cervical facial rhytidectomy is a well-described complication, but statistics on its incidence are hard to obtain. Although technical errors are usually blamed for causing this condition, the exact causes remain vague. Previously described causes include thin dissection of the skin flaps, an acute angle in the configuration of the postauricular skin incision, trauma to the skin flap with instruments or digital pressure, hematoma under the flap, smoking in the postoperative period, and excessive tension by inappropriate placement of the anchor stitches in the postauricular area. Postoperative head position may be another key factor in the development of postauricular skin slough. Strict postoperative counseling should be employed to help avoid this complication. PMID- 3273035 TI - Collagen fiber alignment in the human preauricular dermis before and after rhytidectomy--a scanning electron microscopy study. AB - The microarchitecture of collagen fibers in preauricular dermis specimens that were obtained during two-phase rhytidectomy were visualized and recorded using the scanning electron microscope. Examination of photomicrographs revealed that both spatial arrangement and degree of convolution of the collagen fibers were completely different in the specimens of the two phases. The results are interpreted in terms of the viscoelastic properties of the skin. PMID- 3273036 TI - The tolerance of skin grafts to postoperative radiation therapy in patients with soft-tissue sarcoma. AB - During the last ten years at the National Cancer Institute, 11 patients have received 12 courses of postoperative adjuvant radiation therapy to skin grafts used for wound closure after the resection of soft-tissue sarcomas. The intervals between grafting and the initiation of radiation ranged between 3 and 20 weeks, and 4 patients received chemotherapy at the same time as their radiation. Ten of the 12 irradiated grafts remained intact after the completion of therapy. One graft had several small persistently ulcerated areas that required no further surgical treatment, and one graft required a musculocutaneous flap for reconstruction of a persistent large ulcer. Acute radiation effects on the grafted skin sometimes developed at slightly lower doses than usually seen with normal skin, but these acute effects necessitated a break in therapy on only five occasions. Concurrent chemotherapy and a relatively short interval between grafting and the initiation of radiation seemed to contribute to more severe radiation reactions. This experience indicates that postoperative adjuvant radiation therapy can be delivered to skin grafted areas without undue fear of complications, especially if the graft is allowed to heal adequately prior to initiating therapy and if chemotherapy is not given in conjunction with radiation. PMID- 3273037 TI - Amelioration of capsular contracture by motion restriction. AB - Surgical augmentation of the female breast has become a well-accepted and frequently performed operation since the introduction of the Cronin Silastic mammary prosthesis in 1963. A sleeve of scar tissue (collagenous capsule) consistently develops around every silicone implant. This "reactive bursa" is the normal healing response to this unique foreign body, and should not be referred to as a complication. It actually supports the prosthesis and contours the augmented breast. Operative technique includes precautions to prevent particulate or microbial contamination. Postoperative management involves restriction of motion of and around the mammary implant. (I realize this is a departure from currently accepted techniques. The methods presented, however, are based on physiologic principles of wound healing.) The results for all (private practice) patients who underwent augmentation mammaplasty during the four-year period of 1980 through 1983 were evaluated and codified. They suggest that the incidence of capsular contracture of the augmented breast can be decreased by taking precautions to ameliorate the foreign body reaction to silicone. PMID- 3273038 TI - Sixteen months' experience with the Illouz technique of lipolysis. AB - The Illouz technique of lipolysis was used in 167 patients over a 16-month period. Five hundred procedures were done in a variety of areas. The operation has been performed almost entirely as an outpatient procedure with excellent to good results in almost all areas and minimal complications. The technique is detailed, along with considerations of fluid replacement and postoperative care. PMID- 3273039 TI - Use of groin and mid-thigh flap in reconstruction of penis with penile and perineal urethra and a dorsal skin-lined socket for a removable prosthesis. AB - Absent or deformed genitalia give rise to profound psychological complexes. In such cases reconstruction of the phallus can help the patient return to leading a normal life. A reconstructed penis must have a normal appearance, feel, and function, which up to now has not been completely possible. Using the method described herein, the penis was reconstructed from a groin and mid-thigh flap. It has a skin-lined tube placed ventrally for urination and has a dorsal skin-lined socket for insertion of a removable prosthesis for artificial erection. Seven stages are required for reconstruction, including reconstruction of a perineal urethra. Appearance of the reconstructed organ is acceptable. The erection device is simple, stable, and not costly, and normal urination and procreation are possible. Part of this method is also applicable for loss of erection and in reconstruction of a perineal urethra only. PMID- 3273040 TI - Lateral nasal proboscis. AB - A rare congenital anomaly of the face has been encountered and reported: lateral nasal proboscis. It is characterized by a trunk-like tube arising from an eyelid and is coupled with hypoplasia of the nose, abnormal orbit and maxilla, and ophthalmic anomalies. The pathogenesis and treatment of this disorder are discussed and the original case report is quoted and illustrated. PMID- 3273041 TI - Malignant change in cysts of the skin. AB - The concept that squamous carcinoma arises with any frequency from common skin cysts is examined. We believe this to be extremely rare and suggest that many of the previously reported cases are pilar tumors or proliferating trichilemmal cysts, a benign but clinically impressive lesion occurring most commonly in the scalps of older women. An illustrative case is presented. PMID- 3273042 TI - Reconstruction of the amputated thumbtip with a narrow pedicled cross-finger flap. AB - We have achieved favorable results in our reconstruction of fingertips by using a narrow pedicled cross-finger flap, the shape of which resembles that of the so called flag flap. We applied this technique in several patients with defects of the thumbtip and obtained satisfactory results. PMID- 3273044 TI - The "triangle of truth". PMID- 3273043 TI - The quick-stick blepharoplasty. AB - A simple technique for temporary instant office blepharoplasty in selected patients is presented. PMID- 3273045 TI - The role of the superficial musculoaponeurotic system in face lift. AB - A study of 10 patients who underwent a unilateral dissection of the superficial musculoaponeurotic system (SMAS) is discussed. According to the different postoperative results, the patients were grouped into three classes, with either major, minor, or no obvious benefit from the SMAS dissection. The indications for and value of SMAS treatment in face lift are discussed, based on the results observed. PMID- 3273046 TI - Effect of external pulsing electromagnetic fields on the healing of soft tissue. AB - Since fibroblast behavior in bone healing can be altered electrically, it is plausible to hypothesize that fibroblast proliferation and function in soft tissue healing also would respond to an electromagnetically induced pulse. Reports of clinical impressions of accelerated closure of chronic skin wounds overlying areas being treated for nonunion have produced support for this hypothesis, but experimental data have been lacking. This study was designed to evaluate the effect of pulsed electromagnetic fields (PEMFs) with clinically employed wave-form parameters on the rate of closure of excisional wounds in normal animals and those with steroid retarded wound healing. Four groups, each containing 12 PEMF-treated rats and 12 control rats, were given different field exposures and two groups were treated with methylprednisolone. The wound areas were measured and tissue was harvested for histological examination at intervals for 28 days after wounding. There was no difference in the gross or microscopical appearance of wounds in each active group and its respective control group. Differences in the number of counted fibroblasts were not significant (p less than 0.5), and wound contraction and epithelialization proceeded at the same rate (t-test for equality of means, power = 90%). Electrical PEMF stimulation with the driving pulse used clinically for nonunion bony repair did not affect soft tissue healing in this model. No experimental support is provided for the reports of accelerated skin healing within therapeutic fields. It is possible that different wave-form characteristics are needed to provoke a response in soft tissue. PMID- 3273047 TI - Influence of soft tissue coverage on the healing of cortical defects in canine diaphyseal bone. AB - The influence of soft tissue coverage on bone healing was investigated in dogs. A standard diaphyseal bone defect was left open, closed with skin, or closed with skin and muscle. Specimen radiography, callus morphometry, microscopy, and fluorescent microscopy were used to assess bone healing. The defects healed in all groups. Defects left open produced significantly more periosteal callus (p less than 0.01). Abscess formation was observed in the callus. The trabecular structure was abnormally oriented. Histomorphometric measurements of the rate of bone formation were the same regardless of the presence or type of soft tissue coverage. Failure to disturb the intramedullary blood supply may have minimized the differences in healing among the 3 groups. Nevertheless, soft tissue coverage was observed to prevent bone infection and to accelerate the restoration of normal cortical architecture. PMID- 3273048 TI - Augmentation of critical skin flap survival following ibuprofen therapy. AB - Much research effort has attempted to identify pharmacological agents that will augment random skin flap survival. Unfortunately, the vast majority of these agents have been administered preoperatively, and as such their routine use is not often justified. Ibuprofen administered in the postoperative period significantly augments random skin flap survival in the rat. PMID- 3273049 TI - Limb allotransplantation in the rat: extended survival and return of nerve function with continuous cyclosporin/prednisone immunosuppression. AB - We report the variability of the rejection process among the several tissues of a limb allograft. We used a rat hind limb allograft model transplanting across a well-defined minor histocompatibility barrier (Fischer RT-1(1v1)), donor animals, and Lewis (RT-1(1)) recipient animals. Continuous cyclosporin and prednisone immunosuppression was used. Four immunosuppressive regimens all produced extended limb survival. The rejection process was most severe and difficult to control in the skin. Nonskin tissues reverted to a nearly normal appearance after a period of cellular infiltration 2 to 3 weeks posttransplantation. Clinical and electromyographic evidence of nerve regeneration and end-organ reinnervation was demonstrated in long-term surviving animals. PMID- 3273050 TI - Correction of the secondary nasal tip. AB - A technique used concomitantly with Rethi's incision to reach and treat the secondary nasal tip is described. The technique involves removing the cartilage remnants of both domes and placing a shaped cartilage autograft that is immobilized by sutures. No hypertrophic scarring has been observed in the 546 patients treated. PMID- 3273051 TI - Solitary nevus lipomatosus superficialis on the forehead. AB - Solitary nevus lipomatosus superficialis is a rare nevoid anomaly characterized by ectopic adipose tissue in the dermis without predirection. The case of a 14 year-old boy with a hemispherical solitary nevus lipomatosus superficialis on his median forehead is presented. The items that need special consideration during diagnosis and treatment of this tumor are described. PMID- 3273052 TI - A "do-it-yourself" distraction fixator for phalangeal bone loss. AB - A "do-it-yourself" external distraction fixator for fingers is presented. The device offers controlled and stable distraction and stabilization using a simple method and readily available, sterile, low-cost disposable 30- to 60-ml cc syringes. PMID- 3273053 TI - Re: Ryan and Bieniewicz: regeneration of upper femur after subperiosteal resection. PMID- 3273054 TI - The versatility of subcutaneous flaps: an introduction. PMID- 3273055 TI - Subcutaneous tissue in the scalp: anatomical, physiological, and clinical study. AB - The galea aponeurotica has been used by various surgeons either as a supporting sheet or as a blood carrier for bringing flaps to various areas of the face. In this study, we first reviewed the anatomy of the scalp vascularization by means of cadaver injections. The arteries and veins are mainly located in the galea and numerous anastomotic vessels are present over the vertex. The physiology of this vascularization has been studied by percutaneous PO2 registration after occlusion of various vessels by means of a tourniquet placed around the head. The superficial temporal arteries have been found to be the most important vessels for designing flaps over the head. On the basis of these experiments, several patients have been operated upon. The possibility of using a skin island from the retroauricular region based on subcutaneous tissue only is described. PMID- 3273056 TI - Combined osteocutaneous microvascular flap procedure for extensive bone and soft tissue defects in the tibia. AB - Recent experience with bone healing seems to advocate vascularized bone grafts in cases of large bone gaps or significant scarring, following irradiation, in the presence of low-grade infection, and in congenital pseudarthrosis of the tibia. When extensive bone and skin replacement are needed, the microvascular procedures currently available may not meet specific reconstructive requirements. To augment the advantages of the vascularized fibular graft for tibial substitution (strength, straightness, length, and predictability of vascular supply) with the benefits of free skin, muscle, or musculocutaneous flaps, separate on-demand harvesting of these tissue units and their microvascular combination can be useful in selected cases. In a study of 4 patients, the vascularized fibula was combined with a free latissimus dorsi flap. The procedure was facilitated and shortened by connecting the peroneal vessels to branches of the thoracodorsal or to the scapular circumflex artery and vein outside the operative field. The main supporting vessels of the combined composite tissue block were then anastomosed only to one pair of vessels in the leg. PMID- 3273057 TI - The role of microvascular free soft tissue transfer in reconstructive surgery. AB - Free vascularized transfers have recently provided new perspectives on soft tissue replacement. Their main advantage over conventional pedicle flaps is the shortened hospital stay and overall treatment, particularly in traumatic injuries of the lower leg. Our review of 15 consecutive cases of free flaps show a high rate of early complications (33% surgical revision) and a low rate of failure (1 partial loss). The indications for a free flap versus pedicle flap are discussed, as well as the choice of a skin flap or muscle flap or musculocutaneous flap, with regard to their results and their consequences at the donor site. PMID- 3273058 TI - Surgical repair of posttraumatic deformities with selective suction lipectomy. AB - From June 1982 to June 1984, selective suction lipectomy was performed successfully in 9 patients with posttraumatic fat deposit deformity. Seven patients had minor deformities that were repaired under local anesthesia on an outpatient basis. Two other patients sustained thigh deformities after a moped and a skiing accident, respectively, and were operated on under general anesthesia. Encouraging results have been obtained using the blunt dissection technique of Illouz. Indications for use of this technique and probable future developments are also discussed. PMID- 3273059 TI - Rhomboid flaps in surgery for decubital ulcers: indications and results. AB - Fasciocutaneous or musculocutaneous flaps have greatly enlarged the scope of surgical possibilities for repairing a decubital ulcer. In paralyzed patients, however, one must always reckon with recurrences, so larger flaps, which are often prone to complications, should be saved for possible recurrence. The use of muscle flaps in partially paralyzed patients or in patients recovering from neurological injury may lead to functional loss. The Limberg (rhomboid) flap is a very reliable surgical method in which the donor site and the associated tension in tissue lie outside the weight-carrying areas; the donor site lies in the perineal area, which is never used for other flaps. Our experience is presented with 23 Limberg flaps in 21 patients in a series of 103 operated decubital ulcers in 73 patients. PMID- 3273060 TI - The solution in functional rehabilitation after destruction of the larynx: the tracheostoma closed. AB - A bayonet-shaped airway allowing free respiration and undisturbed deglutition was reconstructed in 2 young women who had undergone tracheotomy and radiotherapy for thyroid carcinoma. The laryngeal vestibule, glottis, and subglottis had been destroyed, and the air passages were closed. An external gutter and an anterior tracheal wall were created in a multistage procedure. In 1 patient, the hypopharynx and upper esophageal segment were reconstructed with bilateral pectoralis major musculocutaneous flaps, which disfigured the breast. The two displaced nipple-areola complexes were properly repositioned using skin expanders and island flap transfer, and the breast was remodeled with prostheses. Our results suggest that this method of laryngotracheal reconstruction may also be applied in laryngectomized patients in whom only part of the epiglottis and the aryepiglottic folds remain. Although the procedure is lengthy and difficult, it is recommended for extensive lesions in fully cooperative patients. PMID- 3273061 TI - Surgery for the facial port-wine stain: technique and results. AB - The principle and the many technical details of surgical treatment for large facial port-wine stains are outlined. The treatment consists of subtotal excision of the port-wine stain, retaining the dermal base and covering the defects with carefully selected full-thickness skin grafts. Complications and results are discussed. PMID- 3273062 TI - One-stage phalloplasty in transsexuals. AB - Until now, phalloplasty in transsexuals has been done with cutaneous and musculocutaneous flaps from the abdomen or the thigh in multiple procedures over a long period. We report a one-stage phalloplasty in female transsexuals with a modified Chinese forearm flap, including the cutaneous nerves anastomosed to the genital branches of the ilioinguinal and iliohypogastric nerves and the perineal branches of the pudendal nerve to obtain true genital sensibility. Immediate hysterectomy and vaginal closure are performed, providing vaginal skin to complete the neoscrotum built up with the labia and to cover the glans. A vaginal flap draped around the catheter provides the urethra, which is stripped through the dermal tube of the forearm flap acting as a corpus spongiosum. Autogenous costal cartilage is used as a stent for reinforcement, substituting for the corpora cavernosa. The donor forearm area is covered with split skin. PMID- 3273063 TI - Rejuvenation of the lips. AB - One of the primary causes of labial wrinkling is soft-tissue volume loss. I suggest combining the various ancillary procedures with substantial tissue augmentation using autologous dermis grafts. PMID- 3273064 TI - Stimulation of peripheral nerve regeneration by an isolated nerve segment. AB - An experimental model in rats was used to assess the stimulant effect of an isolated nerve segment on peripheral nerve regeneration. In a first group of animals, 14 mm of the femoral nerve was removed unilaterally and the gap was bridged with femoral vein taken from the other side. In a second group, the intervention differed in that a 2-mm nerve segment was introduced at the center of the bridging vein. Histological examination was done three months after the operation. In the first group, a newly formed nerve structure was found in the proximal part of the vein, with incipient myelination of nerve fibers. The frequency of nerve fibers decreased with the distance from the proximal nerve stump, with no fibers present in the distal part of the vein. In the second group, a well-developed nerve structure was noted in both the proximal and the distal parts of the bridging vein, with myelination well advanced. Possible reasons for the positive effect of an isolated nerve segment in bridging nerve gaps are discussed. PMID- 3273065 TI - Lipomatosis of the neck (Madelung's neck). AB - Benign symmetrical lipomatosis of the neck is a rare disease that has to be differentiated from goiter, sialadenitis, obesity or a lymphatic tumor. Most patients are severe alcoholics, but they may have other endocrine disorders, such as diabetes mellitus, hyperuricemia, or hyperlipidemia. Aside from the cosmetic disfigurement and consequent psychological stress, respiratory distress may be the indication for surgical treatment. Excision of the lipomatosis requires technical skill because the extensive and sometimes infiltrative growth makes dissection of muscle and nerves difficult. The computer tomogram provides good information on the extent of the disease. Three of our 5 patients died 2 1/2 to 6 years after the first operation because of their primary disease. PMID- 3273066 TI - The effects of cold upon bone growth: a preliminary study. AB - The effects of various degrees of cold injury upon bone growth were experimentally studied. Young rabbits' feet, rendered ischemic by the application of a tourniquet, were cooled down by immersion in either an ice bath at 0 degrees C or an alcohol bath at -20 degrees C. The bone injuries were assessed clinically, radiologically, and histologically. Prolonged exposures to low temperatures above freezing do not cause any bone damage. Brief exposures to temperatures between -20 degrees C and -15 degrees C affect bone growth by inducing premature arrest of the epiphyseal plate, destruction of the epiphysis, and reactive-endosteal and periosteal bone formation. These effects lead to a statistically significant shortening and widening of the affected bones, which can be demonstrated radiologically. Low temperatures have a primary direct lethal effect upon the highly sensitive chondrocytes of the epiphyseal growth plate. Bone damage is independent of associated soft-tissue injuries and not linked to frostbite of the extremity or to solidification of tissues. PMID- 3273067 TI - Nonsurgical fat removal in cosmetic blepharoplasty: a new technique. AB - A new technique of minimally invasive fat removal during cosmetic blepharoplasty is described. This lipolytic diathermy technique has been used successfully in more than 100 patients during the last 3 years and is compared with routine excisional fat removal. The main advantage of this technique lies in its ability to dissolve the fat without surgical excision, thus obviating the inherent complications that arise from such dissection. The technique uses a diathermy unit to cause lipolysis of the fat pockets within their intact septal compartments and can be used for both upper and lower lid herniated fat. This procedure has been found to be exceptionally efficient and predictable and adds another level of safety to cosmetic blepharoplasty. PMID- 3273068 TI - Surgical indications and techniques for posterior pharyngeal flap revision. AB - Twenty-four patients underwent surgical revision of posterior pharyngeal flaps for correction of abnormal vocal resonance, nasal air escape, or sleep apnea. Anatomical findings upon operation are correlated with preoperative symptoms, and an operative approach is outlined. Overall, 67% of the total group (16 patients) were improved after revision, with the most marked improvement seen in those with preoperative hypernasality or airway obstruction. PMID- 3273069 TI - Elimination of lymphangioma circumscriptum by suction-assisted lipectomy. AB - Lymphangioma circumscriptum presents as cutaneous vesicles or skin tags that drain lymphatic fluid. Deep, sequestered lymphatic cisterns encircled by smooth muscle are thought to be the cause of the skin manifestations, and selective resection of the deep cisterns, not the involved overlying skin, has been suggested as the treatment of choice. We report a successful treatment of lymphangioma circumscriptum using suction-assisted lipectomy to obliterate the deep lymphatic cisterns and their vertical channels communicating to the skin. PMID- 3273070 TI - A practical method for oxygen administration during cosmetic facial surgery. AB - An effective and practical method of oxygen administration during cosmetic facial surgery under local anesthesia is described. A large volume of oxygen is delivered directly to the nasopharynx, and partial upper airway obstruction caused by the tongue falling into the pharynx is resolved, yet the apparatus does not interfere with execution of the operation. PMID- 3273071 TI - A filter and collection device for suction-assisted lipectomy. AB - The use of a stockinette as a collection and filtering device in suction-assisted lipectomy is described. Various sized stockinettes may be used depending on the volume of adipose tissue to be aspirated. PMID- 3273072 TI - Capsule calcification following mammaplasty: a survey. PMID- 3273073 TI - A comparative study of free and pedicle flaps for lower extremity wounds. AB - Sixty-four flaps were used to treat wounds in 58 patients over a 5-year period. In this series there was a high incidence of healing of both tibial fractures and chronic osteomyelitis when covered with muscle. Better contour is achieved with muscle covered with meshed skin grafts than with musculocutaneous flaps. The survival rate for free flaps was 93% and for pedicle flaps, 100%. Complication rates were higher for pedicle flaps (45%) than for free flaps (30%), although major complications for free flaps (14%) were higher than for pedicled flaps (9%). PMID- 3273074 TI - The Southern Illinois University Plastic Surgery Program. PMID- 3273075 TI - The growth potential of small arteries repaired by microsurgical technique. AB - A study to determine the growth potential of immature microvessels was carried out using rat femoral arteries. Immature rat arteries repaired with interrupted 10-0 nylon sutures grew in proportion to the animal. There were no areas of stenosis at repair sites, which in some animals appeared slightly dilated compared with control vessels. The ultrastructure of repaired arteries after growth was mildly altered in the internal and external elastic membrane layers while the intima and media appear normal. Neovascularization around anastomoses may explain an apparent increased blood flow velocity at repair sites and does not correspond to arterial narrowing in this model. PMID- 3273076 TI - Burns in patients under 2 and over 70 years of age. AB - A total of 246 consecutive burn patients younger than 2 years and older than 70 years of age admitted to a burn center were reviewed retrospectively to study morbidity and mortality specific to these two age groups. Of these patients, 165 were less than 2 years of age and 81 were over 70 years of age, representing 16% and 8% of the total patient population respectively. In patients under 2, scald burns occurred in 127 (77%) and flame burns in 18 (11%). In patients over 70, flame was the most common burn mechanism, occurring in 64 (79%) patients, while scalds occurred in 12 (15%). The mean total body surface area (TBSA) burned in the younger age group was 13.2% (2.4% full thickness, 10.8% partial thickness) and in the older age group was 25% (12.8% full thickness, 12.2% partial thickness). Only 1 death occurred in the younger age group (0.6% mortality), while 41 deaths occurred in the older age group (50.6% mortality). If the burn involved a total body surface area greater than 40%, all patients died (100% mortality). A total of 36 complications occurred in the younger age group (0.2 complications per patient) and 111 in the older age group (1.4 per patient). Burn wound sepsis was the most common complication in each group, occurring in 28 patients under 2 and 42 elderly patients, and was responsible for the 1 death in the younger age group. Although burn wound sepsis was the most common complication in those patients over 70, cardiovascular and pulmonary complications were the most deadly, accounting for 68% (28 patients) of total deaths in this group. PMID- 3273077 TI - Major injuries due to agricultural machinery. AB - Agricultural accidents are a frequent cause of severe injury. Sixty-four patients with such injuries were seen from October 1981 through September 1984. The patients ranged in age from 2 to 73 years. The highest incidence of injury occurred during spring planting (May through June) and fall harvesting (September through October). The tractor and grain auger were the most common injuring agents. The upper extremity was the most common site of injury, followed by the lower extremity. Because such injuries are usually of a crushing nature and are heavily contaminated, extensive debridement and irrigation are essential in their care. PMID- 3273078 TI - Experimental evaluation of free-tissue transfer to promote healing of infected wounds in dogs. AB - An experimental model was designed to evaluate the course of healing and the changes in bacterial concentrations of infected forelimb wounds with devascularized bone in dogs. Infected leg wounds were allowed to heal by secondary intention or were covered with a full-thickness or split-thickness skin graft, an epigastric skin/fat flap, or a gracilis musculocutaneous flap. All skin grafts failed. Gracilis muscle flaps were superior to epigastric skin/fat flaps in decreasing soft-tissue bacterial concentrations. Quantitative bone cultures, however, were positive at reexploration 6 weeks later in 33% of all legs covered with a flap. X-ray films were successful in predicting the presence or absence of bone infection in 70% of all legs. Postmortem arteriograms of legs covered with muscle flaps showed neovascularity to bone. This study suggests muscle flap coverage of wounds debrided of contaminated, necrotic, or infected bone and soft tissue to be an excellent method of providing well-vascularized soft tissue promoting healing and resolution of infection. PMID- 3273079 TI - Effect of temperature on blood flow and metabolism in a neurovascular island skin flap. AB - Using the buttock flap in 29 white Yorkshire pigs, blood flow and O2 consumption were measured at dermal temperatures between 35 degrees C and 15 degrees C. Flow was measured with an electromagnetic flowmeter and O2 consumption was calculated as the product of blood flow and the difference in flap A-VO2. Baseline flow was 6.6 +/- .9 (SE) ml/100 g/min at 35 degrees C and 3.1 +/- .02 (SE) ml/10 g/min at 15 degrees C. Blood flow through the flap stopped completely at a dermal temperature of 14 degrees C. Oxygen consumption was 0.16 +/- .02 (SE) ml/100 g/min at 35 degrees C and 0.04 +/- 0.01 (SE) ml/100 g/min at 15 degrees C. At 20 degrees C blood flow was 4.3 ml/100 g/min and metabolism was .04 ml/100 g/min. In other words, blood flow was 65% of baseline, while O2 consumption was only 25% of baseline. The therapeutic effect of local cooling at 20 degrees C deserves further investigation. The cessation of flow at 14 degrees C may be caused by increased plasma viscosity. PMID- 3273080 TI - Changes in blood flow and metabolism in a neurovascular island skin flap after a burn. AB - In 8 male white Yorkshire pigs weighing approximately 42 kg each, 12 buttock neurovascular island skin flaps were dissected. Baseline recordings were made of blood flow and O2 consumption in the flap. Two series of experiments were carried out. In control animals (5), the flap was dissected and the "cold" aluminum plate was applied for 10 seconds. In the burned flaps (7) a contact burn of 2.68 calories/cm2 was created with a heated aluminium plate applied to the skin for 10 seconds. After this the flaps were studied for 4 hours. In the control flaps, blood flow and O2 consumption did not change. The burned flaps showed no change in blood flow, while O2 consumption increased significantly from .07 +/- .01 (SE) ml/100 g/min to .18 +/- .08 (SE) ml/100 g/min (p less than .05). PMID- 3273081 TI - Fournier's gangrene of the penis: a report of two cases. AB - Fournier's gangrene is a rare disease involving the scrotum and penis with occasional extension up the abdominal wall. Both of our cases were unusual in that only the penis was involved. In addition, the occurrence of squamous cell carcinoma in an area previously affected by Fournier's gangrene has never been reported. The usual organism is an anaerobic streptococcus synergistic with some second organism. Early therapy is key, including debridement of the entire shaft of the penis distal to the devastated area, intravenous broad-spectrum antibiotics, and skin grafting. PMID- 3273082 TI - Ear replantation combined with local flaps. AB - Various techniques of reattachment of the amputated ear have been described. Some of these reattachments may be successful, and some may survive but without good aesthetic results owing to changes in the cartilaginous framework or its skin cover, while many others may result in complete failure. To improve the blood supply to the reattached ear, especially the venous return, local flaps have been devised to cover part of the ear. Eight patients with partial or complete amputation of their ears have been treated with this technique. They have had good postoperative results and at least 6 months of follow-up. PMID- 3273083 TI - The fate of transposed immature muscle and its clinical application. AB - Transposition of muscles with their intact neurovascular bundles is a well accepted procedure in the adult with a predictable outcome. The fate of transposed immature muscle, however, has not been studied. For this reason, muscles were transposed in three 6-week-old puppies and harvested when the puppies were 6 months old. The developing normal and transposed muscles were studied using serial biopsies, electromyography, and histochemical methods, and the growth in bulk was assessed by serial radiography and measurements of length, breadth, height, and weight of the muscles at death. As judged by these criteria, the transposed muscle developed normally. A patient with prune-belly syndrome, treated by muscle transpositions from thigh to abdomen with satisfactory results, is also described. PMID- 3273084 TI - Computed axial tomographic assessment of cranioorbital anatomy in unilateral clefts. AB - Anatomy of the cranioorbital region in the unoperated infant with cleft lip/palate, is not well known. In this study, computed axial tomography was performed in 7 infants with unoperated unilateral cleft lip combined with cleft palate but no recognized craniofacial syndromes, and on 5 age-matched control infants. Significant differences were found between the infants with cleft lip/palate and the normal infants. There was more plagiocephaly in the cleft group, and the flattened forehead on the involved side was associated with less facial projection. The angles of the petrous portions of the temporal bones and midsagittal plane were also significantly more obtuse in the cleft group. In the normal group the lateral orbital walls and petrous portions of the temporal bones formed a large symmetrical X. This X in the cleft groups was distorted and not readily recognizable. There were also trends indicating possible differences in the orbital and ethmoid orientations in the two groups. PMID- 3273085 TI - A dressing system providing fluid supply and suction drainage used for continuous or intermittent irrigation. AB - In this article a dressing system is described that is capable of providing continuous or intermittent wound irrigation. It is based on a felt dressing provided with an adhesive cover and ports for fluid supply and suction drainage. At continuous irrigation (approximate rate, 70 ml/h), a 1-L fluid bag and a siphon about 30 cm in height are used; at intermittent irrigation (approximate rate, 60 ml/min), a 60-ml fluid bag and a suction balloon are used. In an experimental set-up it was shown that the supplied fluid diffused throughout the dressing felt and that the felt was partly saturated both during continuous and after intermittent irrigation, the effect of gravity being counteracted by capillary force and suction. The suction pressure at the drainage port and within the occlusively applied felt showed a linear relationship. The drainage of particles, while relatively impeded at low flow rates, was satisfactory at rates recommended for clinical use. The dressing felt was inert to adherence of bacteria and white blood cells. This dressing system would seem to provide access to the whole wound surface for active therapy through fluid supply and suction drainage. PMID- 3273086 TI - The influence of dexamethasone on the regrowth of surgically removed fat. AB - We investigated the interaction between long-term dexamethasone administration and lipectomy on regional fat deposits in the rat. Seven-week-old Sprague-Dawley rats (N = 24) were divided into 3 test groups. Group 1 (control) received 0.5 ml/kg of saline intramuscularly daily; group 2, 1 microgram dexamethasone intramuscularly; group 3, 5 micrograms dexamethasone intramuscularly. At week 9 a lipectomy of 4 regional fat deposits on the right side of the animal was done: inguinal, epididymal, interscapular, and perirenal. Injections continued for an additional 27 weeks, at which time a lipectomy was done removing left-sided depots in addition to any "regrown fat" on the previously dissected right side. Several conclusions can be made. First, rats receiving 5 micrograms/kg reaccumulated more fat than the controls in the inguinal, perirenal, and interscapular depots. Second, fat cell size in this model greatly influenced the ultimate size of each depot. Third, fat depots vary in their response to steroids and lipectomy because of local and systemic factors. PMID- 3273087 TI - The nasal vestibule. PMID- 3273089 TI - A simple method to protect tissue from accidental cautery burns. AB - A simple and inexpensive method to protect tissue from accidental cautery burns is reported using the sleeve of an intravenous cannula, a material readily available in all operating rooms. PMID- 3273088 TI - Neurofibroma of the ear. AB - Neurofibromas cause unsightly and crippling deformities. These locally destructive tumors arise along the distribution of peripheral and cranial nerves. The 2 patients presented here had neurofibromas of the external ear. In one patient, the lesion was limited to the auricle. In the other, the tumor extended into the facial nerve and parotid gland. Preoperative computed tomographic scanning, a postauricular approach to the tumor, and careful dissection produced an aesthetic debulking of the auricular neurofibromas with preservation of facial nerve function and improvement in hearing. PMID- 3273090 TI - Re: Fisher: safe margins for melanoma excision. PMID- 3273091 TI - Your computer as your library. PMID- 3273092 TI - Surgical treatment of congenital breast asymmetry. AB - Congenital breast asymmetry of sufficient severity to prompt surgical consultation is rare. The present study evaluated 40 patients who were treated for breast asymmetry at the Indiana University Medical Center. Objective measurements have been correlated with a subjective evaluation of symmetry to elucidate the goals of successful treatment. The surgical experience of the entire group is summarized and the patients who returned for follow-up are assessed. PMID- 3273093 TI - Plastic surgery in a French teaching program. PMID- 3273094 TI - Aesthetic surgery of the medial thigh. AB - Aesthetic surgery of the medial thigh is indicated in three instances: excess of skin, localized steatomery, and diffuse obesity after loss of weight. In the first two cases it is possible to limit scarring to the gluteal fold. In obese patients the functional benefits of a combination excision-suction lipectomy outweigh the disadvantages of the scarring over the medial thigh. PMID- 3273095 TI - Current face lifting procedure: an attempt at evaluation. AB - There are many techniques currently available for face lifting. The individual choice should be made based upon solid knowledge of anatomy and physiology as well as upon knowledge of long-term results in operated patients. In the absence of scientific information regarding deterioration of skin and muscle tension after operation, the only valid basis for judgement is a combination of the surgeon's assessment and the patient's degree of satisfaction 10 years after the operation. The latter is often impossible to obtain. The recently proposed deep undermining of the superficial musculoaponeurotic system (SMAS) seems both excessive and potentially dangerous. An evaluation of 30 consecutive patients would seem to indicate that a segmental approach, along with tightening of the platysmal and genioparotid layers of the SMAS, gives good immediate results and may be responsible for longer-lasting results. PMID- 3273096 TI - Prevention and treatment of waves after suction lipectomy. AB - Suction lipectomy using a cannula to create multiple tunnels leaves multidirectional subcutaneous scars that, if deep enough, do not modify the appearance of the skin. The postoperative appearance of waves is due to either subcutaneous fat deficiency or to a relative excess of skin. Easy to distinguish clinically, these two kinds of waves may be avoided by a vertical aspiration technique. Fatty defects may be filled with fat obtained from the margins of the defect or from a distant site. The condition of excess skin must be foreseen and the patient warned that a skin resection will be necessary 6 months later. PMID- 3273097 TI - The fasciocutaneous flap as an alternative solution in difficult reconstructive problems. AB - Fasciocutaneous flaps are available anywhere in the body, literally from head to foot. Some hair-bearing flaps, the parasternal flap, and some forearm and lower extremity flaps may be useful for coverage of soft tissue defects when a relatively simple one-stage procedure is preferred. The fasciocutaneous flaps described here are long and narrow, with a length to width ratio of up to 5:1. Although these flaps are not the ultimate solution to all reconstructive problems, they are especially useful in the treatment of burn scar contractures and chronic ulcerations such as those that result from the extravasation caused by chemotherapeutic agents. Of particular importance is the fact that the use of these flaps does not preclude the use of other flaps later, should this be necessary. Specific indications for these flaps must always be kept in mind in relation to other reconstructive alternatives. PMID- 3273098 TI - Correction of mammary ptosis with glandular atrophy. AB - Excess skin and insufficient gland are two problems posed by the correction of the small ptotic breast. A single-stage operation can resolve these problems. Our technique used for 20 patients proved satisfactory with a low rate of complications. PMID- 3273099 TI - Risk and consequence of infection at the site of microsurgical repair: an experimental model. AB - The consequences of postoperative infection at the site of microsurgical repair were studied. The experiment used 60 Wistar rats which were divided into 3 groups of 20 each. The femoral artery, vein, and nerve were transected unilaterally and repaired using microsurgical techniques. Staphylococcus aureus was then inoculated into the wound of group 1. Beta-hemolytic Streptococcus was inoculated into the wound of group 2. Group 3 rats served as controls. Clinical, anatomical, bacteriological and histopathological examinations were performed on postoperative days 8 and 30. Wounds in which S. aureus was inoculated demonstrated a significant tendency toward vascular thrombosis with extensive tissue destruction. In the majority of these cases, the necrosis caused by the primary infection engendered an associated, opportunistic infection. Streptococcal inoculations in group 2 demonstrated less severe changes than in group 1. These changes were characterized by injury of the vascular structures themselves with a significant tendency for thickening of the arterial wall, perivascular inflammation, and hematoma formation at the site of the repair. This model allows demonstration of the enzymatic and toxic consequences of bacterial infection in a postoperative site characterized by cellular destruction and interstitial edema surrounding foreign bodies represented by sutures. PMID- 3273100 TI - Translocation of the fifth finger by intracarpal osteotomy. AB - We present an original technique of transposition of the fifth ray by intracarpal osteotomy. After a review of various techniques and their disadvantages, the principles of the procedure are described. It includes a resection of the whole fourth ray and translocation of the fifth ray following a wedge-shaped osteotomy of the lateral aspect of the hamate, and an arthrodesis between the capitate and the hamate. The details of this operation are presented. Seventeen cases are reported with a follow-up ranging from 17 months to 34 months, and the results are analyzed. PMID- 3273101 TI - Flexor tendon lengthening by tenotomy at the musculotendinous junction. AB - The author presents his experience with an established technique of flexor tendon lengthening by tenotomy at the musculotendinous junction. This technique can be used for digital stiffness of forearm origin when active extension is possible on flexion of the wrist. There must not be adherence in the carpal tunnel or in the digital sheath, and active flexion must be preserved. It can also be used for digital stiffness in addition to other techniques. This kind of lengthening has some advantages: there are no sutures in the tendon itself, and it allows early reeducation in association with dynamic extension splinting. Active flexion is preserved immediately and there is good tendon healing. It is possible to lengthen selectively the superficial flexor or the deep flexor and in some cases both. Results are presented according to cause. PMID- 3273102 TI - Second toe to thumb transfer with extensor digitorum brevis opponensplasty. AB - A second toe to hand transfer is described for thumb reconstruction which includes the extensor digitorum brevis as a simultaneous opponensplasty. This procedure was effective in a young man injured in a bomb explosion that completely destroyed the first ray. The second toe was dissected in continuity with the extensor digitorum brevis muscle, its nerve was anastomosed to the motor branch of the median nerve. Thus a one-stage operation allowed a complete reconstruction of the first ray proximally to the trapezium. Recovery at 2 years is good, and the muscle transfer can be demonstrated to work. PMID- 3273103 TI - A frontal pattern for frontocranial remodeling. AB - In early 1983 we developed a frontal pattern to aid in remodeling the forehead in craniosynostosis. We also designed a rigid wire to assist in checking the proper curvature of the supraorbital bar. In approximately 150 frontocranial remodelings the pattern has proved very useful and has simplified the procedure. PMID- 3273104 TI - Re: Clark and Bennett: Excision of giant nevi in children. PMID- 3273105 TI - Treatment of male baldness. AB - Indications for surgical treatment of male baldness are usually related to the capability and experience of the surgeon. Based on the technique of the one-stage vertical flap described at the VIIIth International Congress of Plastic Surgery (Montreal 1983), we propose a system for management of the different types of baldness. Flaps, bald scalp resections, and punch grafts are used, depending on the extent and the topography of the baldness. PMID- 3273106 TI - External cranial vault molding after craniofacial surgery. AB - Many congenital cranial vault deformities are only incompletely corrected by currently available surgical techniques. The supplementary use of external cranial vault molding devices after these surgical techniques, however, has resulted in consistently improved cranial vault from over what could be achieved by operation alone. These devices are inexpensive, easily individualized to abnormal skull shapes, and well tolerated by young patients. PMID- 3273107 TI - The influence of silicone bleed on capsule contracture. AB - The phenomenon of silicone bleed from breast implants has been recognized for several years, but its importance continues to be a source of controversy. Experiments were done in rabbits in which standard implants were compared with implants that had been modified to reduce silicone bleed. Contracture was seen with both types of implants, but both the incidence and severity were significantly reduced with the low bleed implants. PMID- 3273108 TI - Capsule around silicone implants in diabetic rats: histological and biochemical study. AB - Polydimethylsiloxane (silicone) implants were subcutaneously placed in the back of diabetic and normal rats. After three months the rats were killed and the fibrous capsule around the implants was histologically and biochemically examined. A significant quantitative difference (p less than 0.001) was found in the thickness of the capsules, which were two to three times thicker in the diabetic animals. The biochemistry showed an increase of neutral salt-soluble collagen in the diabetic group; electrophoresis revealed only type I collagen in the diabetic and type I and III in the normal rats. From this experimental trial it seems that diabetes mellitus is another factor in formation of a thick capsule around silicone implants. PMID- 3273109 TI - Microvenous graft length determination for arterial repair. AB - Varying lengths of femoral vein grafts from 36 New Zealand rabbits were used to bridge defects in the ipsilateral femoral artery in an attempt to estimate the correct length of vein graft needed to replace an arterial defect. Harvested venous segments contracted by 35% to 55% of their in vivo length. Short grafts subjected to linear tension had poor patency rates. Increasing the length improved patency. Long redundant grafts were initially tortuous, but lost their redundancy when studied long term. Silicone perfusion studies, however, revealed a persistence of luminal irregularity and tortuosity. Histologically, arterialized vein grafts thickened by accumulation of fibrous tissue in the medial layer, but otherwise maintained identifiable venous morphological characteristics. Scanning electron microscopic studies identified endothelial changes in vein grafts after arterialization. Based on these results, the ideal microvenous graft should be approximately 35% longer than the arterial defect to be bridged when measured in vivo to permit optimal balance between linear and radial deforming forces. PMID- 3273110 TI - Local infection following aesthetic rhinoplasty. AB - Local infection is a rare complication after aesthetic rhinoplasty. In the past serious complications and 1 death have been reported. We present 5 cases of local infection after primary and secondary procedures. Infection seems to have more to do with technical details during an operation, such as the external lateral osteotomy, than with the presence of saprophytic bacteria. Care must be taken in the management of cartilage grafts. There is not enough support for the use of prophylactic antibiotics. Usually the organism implicated is Staphylococcus aureus. Once the infection has developed, treatment should be aggressive in view of the grave complications reported in the literature. PMID- 3273112 TI - Studies on the nature of the flap/bed interaction in rodents--Part I: Flap survival under varying conditions. AB - A flap needs close contact with its bed for optimal flap survival. Using a rat dorsal flap model, flap/bed contact times were varied by use of a sterile polyethylene film. In addition, the flap was modified either by removing the panniculus carnosus or by converting the distal flap into a skin graft. Finally, the effect of using a dressing was assessed. Several observations were made: (1) The initial 6 to 12 hours of a flap's interaction with its bed is critical for optimal survival; (2) fluorescein accurately predicted flap survival upon polyethylene removal; (3) removing the panniculus carnosus increased flap and skin graft survival; (4) dressing allowed flaps and skin grafts to better withstand bed deprivation; and (5) distal flaps and skin grafts under various conditions responded differently to bed deprivation. PMID- 3273111 TI - Scrotal reconstruction after Fournier's gangrene. AB - After primary treatment for Fournier's gangrene, patients are left with skin defects in the genital region. In extensive lesions the whole scrotum may be lost. In these cases various methods for scrotal reconstruction have been recommended. In 3 patients we succeeded in reconstructing the scrotum and covering the penis using split-thickness skin grafts only. We found it a safe and relatively easy method giving the best possible cosmetic results and only minor functional sequelae. PMID- 3273113 TI - The combined composite pectoralis major and minor osteomusculocutaneous flap. AB - Combining the pectoralis major and minor into a single flap can provide a much longer vascularized segment of bony rib than if the pectoralis major is used alone. This result is possible because of the periosteal vessels emerging from the origins of the pectoralis major and minor. Both muscular attachments are contiguous. The particular characteristics of this flap make it useful for reconstructive surgery of the head and neck when transposed locally, or for other distant regions when microsurgery is attempted. PMID- 3273114 TI - Wound healing in vitamin C-deficient and nondeficient guinea pigs: a pilot study. AB - Wound contraction and scar contracture were studied in guinea pigs deficient (stage I) and nondeficient in vitamin C (stage II). Some vitamin C-deficient and some nondeficient animals were subjected to excision of an ellipse of skin measuring 40 X 20 mm in an area not containing panniculus carnosus. The wounds were approximated without undermining. In other animals, the same type of excision was carried out; however, the wounds were left unapproximated. Wound contraction was studied in the unapproximated group and scar contracture was studied in both groups for six months postoperatively. Scar contracture was found to be more significant in animals with unapproximated wounds who were on regular diets, implying a role for vitamin C in this process. Wound contraction was noted to take place in scorbutic and non-scorbutic groups at the same rate. These findings are in line with previous studies done in areas containing panniculus carnosus, implying that the role of this cutaneous muscle in contraction and contracture is not essential in either deficient or nondeficient states. Two animals also developed a remarkably thicker scar than their counterparts while in a deficient state. The relationship between vitamin C deficiency and the formation of hypertrophic scar in guinea pigs is postulated. PMID- 3273115 TI - Something of the nature of gross sutural growth. AB - A series of experiments was performed on monkeys, rabbits, and turtles to study gross sutural growth of bones. Radiopaque implants in conjunction with serial gross and radiographic measurements were employed. Differences in growth were observed between 5 facial sutures and also the same suture at different times. Growth was greatest at the zygomaticotemporal suture and least at the premaxillomaxillary suture. The nasal bone side of the frontonasal suture grew about twice as fact as the frontal bone side. In the turtle shell the midsagittal suture grew faster than a transverse suture. In all of the animals the rate of sutural growth decreased with increase in age. No gross regional growth disturbance was noted after resection of the frontonasal, midpalatine, or transpalatine sutures. After extirpation of the median palatine suture, it re formed, in an eccentric position, in a number of instances. We concluded that bone growth that occurred at sutures was secondary or compensatory to some other factor. PMID- 3273116 TI - Treatment of cervical burn contracture with two fasciocutaneous flaps. AB - A case of cervical obliteration following a chemical burn is reconstructed with 2 fasciocutaneous flaps transposed from the upper chest. The technique is rapid and yields good quality long-term results. It compares favorably with skin grafting and distant flap repair in ease of execution as well as aesthetic and functional results. The donor defect may be problematic in certain cases. PMID- 3273117 TI - Application of new advances to treatment of facial trauma. PMID- 3273118 TI - Some thoughts on the classification and treatment of Le Fort fractures. AB - A system is proposed which defines the Le Fort fracture pattern more precisely and allows one to compare fractures and describe them adequately. The system involves a description of the highest level of Le Fort fracture on each side, a description of the fragment that carries the maxillary dentition, and a description of accompanying nasoethmoidal or mandibular fractures. The areas that must be considered for open reduction are thus precisely defined and represent the weak structural areas of the maxilla as defined by Le Fort in his experiments. Open reduction should progress from stable bone to stable bone, replacing with bone grafts those areas that are unsatisfactory for interfragment wiring. Aesthetic results obtained are superior and more predictable than after treatment with classical Adam's fixation. PMID- 3273119 TI - Complex nasoethmoid-orbital and midfacial fractures: role of craniofacial surgical techniques and immediate bone grafting. AB - A detailed review of 104 patients with severe nasoethmoid-orbital injuries has facilitated the classification of these injuries into five types. The recognition and diagnosis of each specific injury pattern will define the correct treatment choice in each instance. Special attention should be focused on injuries with comminution and bone loss in the medial wall and floor of the orbit, loss of cartilaginous nasal support, and orbital displacement and dystopia. An open, direct approach to these fractures with meticulous reduction, internal fixation, and repair of the medial canthal ligaments provides optimal repair. The use of craniofacial surgical techniques and immediate bone graft replacement of missing or severely damaged bone will allow reconstruction of even the most difficult injuries in one stage. Three hundred and nine primary bone grafts have been used in 66 patients. No significant complications of their use have occurred. PMID- 3273120 TI - Management of soft tissue injuries. AB - The author presents a brief discussion of the causes, extent, and prevention of primarily automobile-related soft tissue maxillofacial injuries. This is followed by a practical approach to their management. Personal preferences relative to armamentarium and techniques that have withstood the test of time are given, together with several maxims useful in the treatment of soft tissue trauma. Personal bias and philosophy born of years of experience in the treatment of such injuries are freely given. PMID- 3273121 TI - Complications of facial trauma: principles of late reconstruction. PMID- 3273122 TI - A comparison between sternum and rib in osteomyocutaneous reconstruction of major mandibular defects. AB - Following major mandibular resection for intraoral malignancy, 6 patients underwent reconstruction using rib and 22 patients underwent reconstruction using the outer table of the sternum; the pectoralis major muscle was used as the vascular carrier for both bone and skin in all patients. Five of the 6 patients in the rib group encountered major complications. In the sternal group, loss of bone occurred in only 2 of 22 patients. Those aspects of technique considered important to the outcome are detailed. Results are discussed in terms of bone survival, intraoral features including denture placement, and the patient's appearance. The sternal transfer has consistently shown itself to be superior to rib, in terms of both early morbidity and later functional and aesthetic results. It is our present method of choice for reconstruction following major intraoral resection. PMID- 3273123 TI - Studies on the nature of the flap/bed interaction in rodents--Part II: Morphological and fluorescein kinetic data. AB - The current study in rats concerns two aspects of the flap/bed interaction: fluorescein kinetics and histological finding. In the control group of animals in the fluorescein kinetics experiment, flaps were raised and then reattached. In one experimental group, the flaps were raised and placed on a sterile polyethylene film. In two other groups, the flaps were raised and then the pedicle was cut, either immediately or at specific intervals. At intervals up to 24 hours several animals were injected with 5% fluorescein. In the control group fluorescein penetration increased with time, while it decreased in the polyethylene-film group. There was virtually no fluorescein staining in both cut pedicle groups. To study histological events, the animals were divided into groups with flaps and groups in which the distal end of each flap was severed to form a contiguous skin graft. Other conditions were varied. All flaps were cultured, and biopsy specimens were obtained from three areas at several time intervals. Histological sections from the distal flap were markedly different from the corresponding skin grafts. These results corroborate previously noted survival rates. PMID- 3273124 TI - Bone mineral content in patients with myasthenia gravis treated with cortisone. PMID- 3273125 TI - Distribution of pp'DDT in certain brain regions of rats treated with diazinon. PMID- 3273126 TI - Circulating histamine levels and lung function test in cotton mill workers. PMID- 3273127 TI - 8th Swedish-Yugoslav Occupational Health Days. Budva-Becici, October 22-23, 1987. Proceedings. PMID- 3273128 TI - Clinical examination of persons occupationally exposed in wood industry. PMID- 3273130 TI - Exposure, lung function and rhizopus antibodies in wood trimmers. A longitudinal study. PMID- 3273129 TI - Aerosol analysis, respiratory function and skin sensitivity testing in workers exposed to soft and hardwood dust. PMID- 3273131 TI - Hypersensitivity and respiratory function in wood industry. PMID- 3273132 TI - A longitudinal study of respiratory health hazards of exposure to terpenes in saw mills. PMID- 3273133 TI - Decreased lung function and exposure to formaldehyde in the wood working industry. A five-year follow-up. PMID- 3273134 TI - Asbestos-associated diseases in Sweden--a general view. PMID- 3273135 TI - Roentgenological criteria for early diagnosis of pleuropulmonary asbestosis. PMID- 3273136 TI - Asbestos-associated diseases in Swedish shipyard workers. PMID- 3273137 TI - Pulmonary function in workers with asbestosis. PMID- 3273138 TI - Mineral fibres, fibrosis, and asbestos bodies in lung tissue from deceased asbestos-cement workers. PMID- 3273139 TI - The relationship between asbestos bodies, serum immunoglobulin levels and X-ray changes in asbestos workers. PMID- 3273140 TI - Total and cause-specific mortality in cohorts of asbestos-cement workers and referents between 1907 and 1985. PMID- 3273141 TI - Some aspects of humoral immunity in ex-asbestos-workers. PMID- 3273142 TI - Risk identification by register epidemiology--a Swedish experience. PMID- 3273143 TI - Environmental exposure to chrysotile asbestos and cancer epidemiology. PMID- 3273144 TI - Risk assessment of non-occupational asbestos exposure--can it be done? PMID- 3273145 TI - TMJ--the diagnostic dilemma. PMID- 3273146 TI - Condylar position in correction of dentofacial deformities. PMID- 3273147 TI - Periodontal considerations for orthodontists. PMID- 3273148 TI - Statistical correlations between cells, blood vessels, oxytalan fibres and nerves in normal mouse molar periodontal ligament using transmission electron microscopy. PMID- 3273149 TI - Genetic and environmental determinants of dental occlusal variation in South Australian twins. PMID- 3273150 TI - Mandibular velocities in bruxists. PMID- 3273151 TI - Localisation of the unerupted maxillary canine: further observations. PMID- 3273152 TI - New approaches to the Begg technique. PMID- 3273153 TI - Dexamethasone nonsuppression in chronic schizophrenia. AB - It has been suggested that dexamethasone nonsuppression in schizophrenia is related to the presence of negative symptoms. In a sample of chronic schizophrenic outpatients we could find no relationship between dexamethasone nonsuppression and negative symptoms. In addition nonsuppression was not related to depressive symptoms, anxiety or age. The cause of hypothalamic pituitary adrenal dysregulation in schizophrenic patients remains unclear. PMID- 3273154 TI - The inhibitory effect of metoclopramide on plasma cholinesterase activity. AB - The in vitro effect of metoclopramide on plasma cholinesterase (PCHE) activity was studied to investigate a mechanism for metoclopramide-induced prolongation of succinylcholine action. The mean PCHE of the control samples was 0.86 +/- 0.02 unit.ml-1. PCHE activity in the presence of metoclopramide, at concentrations of 0.05, 0.10, 0.50, 1.0, 2.5 and 5.0 micrograms.ml-1, was reduced to 0.78 +/- 0.02, 0.69 +/- 0.04, 0.50 +/- 0.03, 0.39 +/- 0.02, 0.24 +/- 0.01 and 0.15 +/- 0.01 unit.ml-1, respectively. Our data demonstrated that PCHE activity was significantly depressed by metoclopramide at all concentrations studied (p less than 0.001). Our data also show that the concentration of metoclopramide required to inhibit 50 per cent of PCHE activity (I50) was 0.8 micrograms.ml-1 (2.4 x 10( 6) M). We recommend caution when succinylcholine and or ester type local anaesthetics are administered to patients who are also receiving metoclopramide, especially in high doses. PMID- 3273155 TI - Effect of injection site on circulation times during cardiac arrest. AB - Cardiopulmonary resuscitation requires effective, prompt drug administration. In order to analyze Advanced Cardiac Life Support (ACLS) recommendations for site of drug administration, we studied dye circulation times after central, femoral, and peripheral venous injection during both closed and open chest CPR using a canine arrest model. Measurements of circulation times were made after injection of indocyanine green dye at femoral, central, and peripheral venous sites. Circulation times during closed chest CPR were 62.7 +/- 19.6 sec after central injection, 86.6 +/- 23.5 sec after femoral injection, and 93.6 +/- 17.9 sec after peripheral injection (p less than .001). During closed chest CPR, peak dye concentration after central injection was significantly higher than that after peripheral injection (4.0 +/- 1.3 vs. 3.1 +/- 0.8 mg/L, p less than .01). Circulation times were significantly shorter during open chest CPR with times again shortest after central injection. This animal model suggests that prompt drug delivery during CPR is enhanced by central venous injection of medication. There appears to be no advantage in femoral over peripheral injection. PMID- 3273156 TI - The delusion of inanimate doubles. Implications for understanding the Capgras phenomenon. AB - The Capgras delusion has long been held to be specific for close personal relationships. This paper presents evidence that this is not the case and the implications of this for accepting psychodynamic explanations of the phenomenon are discussed. Parallels are drawn with the condition prosopagnosia and a hypothesis presented that any specificity is apparent rather than real. It is proposed that both prosopagnosia and the Capgras symptom represent abnormalities of visual perception occurring at different stages of this neurophysiological process. PMID- 3273157 TI - [Measurement of marginal disadaptation of nickel-chromium and Cerapall retainers using computerized image analysis]. PMID- 3273159 TI - [Routine aspiration and dental anesthesia. Study of 1,018 cases]. PMID- 3273158 TI - [Chondrosarcoma of the maxilla: apropos of a case]. PMID- 3273161 TI - [Recommendations in dentistry for prevention of blood transmitted infections]. PMID- 3273160 TI - [General physical basis of magnetotherapy]. PMID- 3273162 TI - [Intragingival presence of microorganisms associated with grade I active destructive periodontal lesions]. PMID- 3273163 TI - [Differential diagnosis of pulpoperiodontal changes]. PMID- 3273164 TI - [Body scheme, posture and the oral sphere: a concept with clinical illustrations]. PMID- 3273165 TI - [Dentistry and dentists in Japan]. PMID- 3273166 TI - [Odontogenesis and elaboration of alveolar bone after an organogenetic model within ovarian teratomas]. PMID- 3273167 TI - [Typology in orthodontics]. PMID- 3273168 TI - [Development of a canal obturation concept]. PMID- 3273169 TI - [Efficacy of a modified Hawley plate in treatment of pain dysfunction syndrome]. PMID- 3273170 TI - [Organization of study and dentistry in Portugal]. PMID- 3273171 TI - [Vision and ambiant light: visual fatigue. Concepts for the dental office]. PMID- 3273172 TI - [Glass ionomer cements: material or universal cement?]. PMID- 3273173 TI - [Restoration of gingival tissue loss around exposed roots]. PMID- 3273174 TI - [A dirigible balloon in surgery: tissue expansion]. PMID- 3273175 TI - [Two cases of baso-cellular nevomatosis]. PMID- 3273176 TI - [Major drug addiction and dentistry]. PMID- 3273177 TI - [Misuse of medications and drug addiction]. PMID- 3273178 TI - A simple BASIC program allows the rapid entry of DNA nucleotide sequences into personal computers. PMID- 3273180 TI - Patents and patent office resources in biotechnology. AB - Patents play an increasingly important role in the dissemination of information in many fast moving fields such as biotechnology and semiconductors. Quite a few new developments are introduced as patents, and only later, if at all, do they find their way into the scientific literature. In spite of this, patents lack wide acceptance as a source of information among scientists in academia and, to a lesser degree, industry. Patents share many similarities with scientific papers. They both are organized in a similar way and are carefully reviewed by experts in the field. Both can be effective and timely sources of information. Patents can be accessed through data bases, library collections, the "Official Gazette of the Patent and Trademark Office," or directly in the Patent and Trademark Office. This article is designed to serve as a guide to the type of information which can be found in patents, and alternatives for obtaining this information. PMID- 3273179 TI - Native genomic blotting: a novel approach to mapping DNase I hypersensitive sites and protein-DNA interactions at high resolution. AB - We have developed a new high resolution method for screening 400-600 base pairs of DNA in chromatin for DNase I hypersensitive sites and protein-DNA interactions. By separating the DNA isolated from nuclease-digested nuclei in small, native polyacrylamide gels prior to electroblotting onto nylon membranes, we increased the resolution by greater than 3-fold as compared with the traditional approach whereby the nuclease-digested DNA is fractionated electrophoretically in agarose gels (11). In addition, our native genomic blotting method has the advantage of combining the ability of the traditional agarose approach to detect DNase I hypersensitive sites, with the genomic sequencing method (2), where individual protein-DNA contacts can be observed. Native genomic blotting therefore permits for the first time the display of DNase I hypersensitive sites and protein-DNA interactions at high resolution on the same autoradiograph. This method allows us to investigate a new level of chromatin structure and to therefore obtain better insight into levels of gene structure, organization and gene regulation. PMID- 3273181 TI - Direct protein microsequencing from Immobilon-P Transfer Membrane. AB - Proteins separated by electrophoresis and electroblotted onto Immobilon-P Transfer Membrane can be sequenced directly in the gas-phase sequencer. Protein bands visualized by Coomassie Blue are placed in the sequencer cartridge without the addition of polybrene. Preconditioning sequencer cycles are eliminated, reducing reagent use and instrument operating time. The average initial yield for protein spotted or blotted onto the polyvinylidene-based membrane was determined to be 70 to 80% using 125I-labeled beta-lactoglobulin. Preliminary data indicate that proteins hydrolyzed in situ on Immobilon-P can further be characterized by amino acid compositional analysis. PMID- 3273183 TI - Rapid identification of M13 phage deletions for sequence analysis. PMID- 3273182 TI - Polymerase chain reaction. PMID- 3273184 TI - Use of a chemically modified T7 DNA polymerase for manual and automated sequencing of supercoiled DNA. PMID- 3273185 TI - Direct measurement of CAT activity by incubation of CAT-expressing cells in medium containing chloramphenicol. AB - We describe a simple, flexible, rapid, sensitive and accurate in vivo assay of the bacterial chloramphenicol acetyltransferase (CAT) enzyme expressed in mammalian cells. The assay is based on the ability of the substrate and products of this enzyme reaction (viz. chloramphenicol and its acetylated derivatives) to equilibrate rapidly between the cells and the surrounding tissue culture medium. We find that chloramphenicol added to the culture medium readily enters the cells and becomes acetylated by the intracellular CAT enzyme. The acetyl derivatives leave the cell and appear rapidly in the culture medium. Due to the large excess of the extracellular compared to the intracellular fluid and due to rapid equilibration of chloramphenicol and its derivatives between them, we find that the bulk of the chloramphenicol and its acetyl derivatives are present in the culture medium at any given time point. Chloramphenicol and its acetylated products are extracted from the medium with ethyl acetate and resolved by thin layer chromatography giving an accurate measurement of the intracellular CAT activity. Sensitive and accurate quantitation of CAT activity in this assay is made possible by the addition of trace amounts of 14C-labeled chloramphenicol to the medium. PMID- 3273186 TI - Analysis of trimethylpsoralen photoreactivity to Z-DNA provides a general in vivo assay for Z-DNA: analysis of the hypersensitivity of (GT)n B-Z junctions. AB - We have described an exonuclease III/photoreversal procedure to map, with base pair resolution, the bases which have photoreacted with 4,5',8-trimethylpsoralen (Me3-psoralen) forming either monoadducts or interstrand cross-links in DNA (20). This assay allows quantitation of relative rates of Me3-psoralen photobinding to bases in DNA at levels as low as one cross-link per 8,000 base pairs. This assay should be useful for a wide variety of applications of Me3-psoralen photobinding to DNA. Here, we demonstrate the applicability of the Me3-psoralen exo III assay for analysis of the conformation of the Z forming sequences (GT)12ATGT and GAATTC(TG)6TA(TG)6. We have shown previously that Me3-psoralen forms crosslinks in the 5'TA within the (CG)6TA(CG)6 sequence when it exists in the B conformation but not when it exists in the Z conformation (34). More recently we have confirmed this result with the exo III assay and have shown at least a hundred fold increase in Me3-psoralen photoreactivity at the 5'AT sequence within the EcoR I sites (GAATTC) which presumably represent B-Z junctions flanking (CG)6TA(CG)6 (20). Here we demonstrate both the characteristic decrease in psoralen photobinding to 5'TAs within (GT)12ATGT and (TG)6TA(TG)6 and the hyperreactivity of B-Z junctions. These characteristic properties of Me3-psoralen photobinding provide an assay for Z-DNA that is applicable in vivo. The general applicability of this approach for assaying Z-DNA in vivo is discussed. PMID- 3273187 TI - Using mini-prep plasmid DNA for sequencing double stranded templates with Sequenase. PMID- 3273188 TI - Computer programs for molecular biology: an overview of DNA sequencing and protein analysis packages. PMID- 3273189 TI - Using PC/GENE for protein and nucleic acid analysis. AB - This paper describes a series of protein analyses using the molecular biology software package PC/GENE, which runs on an IBM or compatible microcomputer. A nucleic acid sequence was first edited and then translated into an amino acid sequence. The amino acid composition, isoelectric point, molecular weight, and other properties of the sequence were determined. Programs to predict secondary structure, alpha helix membrane associations, hydrophobic and hydrophilic regions, and surface and antigenic sites from the amino acid sequence were also used. A search was made in a data base for sequences containing a region similar to a region in the protein sequence. Sequence alignments and queries of data bases can also be performed. PMID- 3273190 TI - PROPLASM: an Apple Mcintosh computer program for proportional plasmid map drawing. PMID- 3273191 TI - A convenient procedure for rapid release of protoplasts from Ustilago maydis. AB - Filtrates from cultures of Trichoderma harzianum, grown on a liquid mineral salts medium containing vitamin and trace element supplements, 0.5 g/l glucose and 2 g/l of dried residue of ethanol-extracted commercial mushrooms (Agaricus brunnescens), are a good source of enzymes for the release of protoplasts from the sporidia of Ustilago maydis. When concentrated 50-fold by (NH4)2SO4 precipitation, the enzymes liberated 95% of the protoplasts from the sporidia within 40 min. PMID- 3273193 TI - Double-stranded DNA sequencing with T7 polymerase. PMID- 3273192 TI - Supercoil sequencing using unpurified templates produced by rapid boiling. PMID- 3273194 TI - Small-scale preparation of RNase-free DNase. PMID- 3273195 TI - A modified protocol for the PZ523 spin columns: a legitimate purification alternative for plasmid DNA. PMID- 3273196 TI - Quantitation of IL-1 secretion from individual cells. PMID- 3273198 TI - High-efficiency generation of plasmid cDNA libraries using electro transformation. AB - A simple and efficient method for the construction of large cDNA libraries in plasmid vectors is described. Cloning efficiencies of greater than 1 x 10(6) recombinants per microgram starting RNA are easily obtained using electroporation. A detailed protocol for determining the optimal conditions using this novel approach is presented. PMID- 3273197 TI - Methods for solid phase peptide synthesis which employ a minimum of instrumentation. AB - Both automated and manual methods of solid phase peptide synthesis employ three basic steps: (a) Attachment of the first amino acid to a resin, (b) peptide synthesis via successive carbodiimide couplings and (c) cleavage and deblocking of the peptide. Instead of an automated peptide synthesizer, one can manually synthesize peptides with a sintered glass funnel as the only required piece of equipment. Following solid phase synthesis, one can cleave and deblock peptides without the use of anhydrous hydrofluoric acid (HF); hence, the need for specialized equipment required for handling HF can also be eliminated. In the procedure described in this report, cleavage and deblocking is carried out with trifluoromethane sulfonic acid (TFMSA) in glass vessels without the need for high pressure Teflon fittings. Since completion of the coupling reaction can be monitored during each cycle when manual methods are employed, one can avoid repetitive couplings and, thereby economize on reagents. Since TFMSA cleavage and deblocking can be carried out in open glass vessels, one can cleave and deblock large numbers of peptides at the same time. With the methods described, one can satisfactorily prepare large quantities of peptides at minimal cost. PMID- 3273199 TI - Optimizing electroporation parameters for a variety of human hematopoietic cell lines. AB - The parameters affecting electroporation of four human hematopoietic cell lines were investigated. The optimal conditions for electroporation are described for both transient and stable expression of foreign genes. A correlation exists between the levels of transient gene expression and stable transfection frequency. In addition, linear DNA yields higher stable transfection frequencies than supercoiled DNA. The cumulative results indicate that electroporation is a simple and useful method for obtaining transient and stable expression of foreign genes in human hematopoietic cells. PMID- 3273200 TI - Use of the chick embryo for pharmacological screening of retinoids. AB - Retinoic acid and some selected analogs were tested to evaluate their effect on skin morphogenesis and toxicity in the chick embryo. Retinoids dissolved in dimethyl sulfoxide were injected at doses varying from 10 pmol to 10 mumol into the amniotic cavity of 10-day-old chick embryos (n = 20). At 16 days of incubation, the eggs were opened to record the number of dead embryos and the number of embryos presenting club-shaped feathers. A lethal embryotoxic dose (LED50d16) which, at 16 days of incubation, provokes the death of 50% of the embryos and an effective dose (ED50) which induces production of club-shaped feathers in 50% of surviving embryos were then calculated using log-probit analysis. Retinoids could be classified according to their ED50. For example, arotinoid Ro 13-7410 appears approximately 1,000 times more active than all transretinoic acid. However, the analogs which are more active are also more toxic. The assay described in the present study appears to be a simple and useful model for the screening of retinoids. PMID- 3273201 TI - Measurement of epidermal thickness in normal skin and psoriasis with high frequency ultrasound. AB - In this study, we employed a high-frequency ultrasound system to measure the epidermal thicknesses of psoriasis plaques and normal skin in vivo. Eighty-four percent of the ultrasound measurements fell within the range of epidermal thickness determined by histology. The average thickness of untreated psoriasis measured by ultrasound was significantly greater than that of either treated psoriasis or normal skin. Ultrasound measurement of thickness was consistent with clinical assessment. Ultrasound measurements also demonstrated known variations in epidermal thickness by body site. Further development is needed to obtain measurements that are fully representative of the epidermis. PMID- 3273202 TI - 5th annual symposium of the Skin Pharmacology Society: highlights on selected lectures and posters. PMID- 3273203 TI - Ciclosporin inhibits phorbol-ester-induced hyperplastic transformation and tumor promotion in mouse skin probably by suppression of Ca2+/calmodulin-dependent processes such as phosphorylation of elongation factor 2. AB - This study deals with the mechanism of the inhibitory effect exerted by the immunosuppressant ciclosporin (CsA) on phorbol-ester-induced inflammation, epidermal hyperplasia and tumor promotion in mouse skin in vivo. This effect coincides with an inhibition of the phosphorylation of a 100-kilodalton protein (p100) in epidermal cytosol in vitro, which has been identified as elongation factor 2 (EF-2) of protein biosynthesis. Phosphorylation of EF-2 is dependent on Ca2+ and calmodulin, and inhibition of EF-2 phosphorylation by CsA is due to an interaction of CsA with calmodulin. The EF-2 phosphorylation system has a metabolic half-life of 1.5 h probably due to a rather rapid turnover rate of the EF-2 kinase. Since CsA inhibits specifically 12-O-tetradecanoylphorbol-13-acetate (TAP)-stimulated but not basal protein synthesis in epidermis, it is proposed that Ca2+/calmodulin-dependent phosphorylation of EF-2 is involved in the induction of the hyperplastic response by TPA and that CsA suppresses TPA effects by inhibition of EF-2-phosphorylation and perhaps other calmodulin-dependent processes. The potential applicability of calmodulin inhibitors in the treatment of hyperproliferative skin diseases is discussed. PMID- 3273204 TI - Investigative studies in von Hippel-Lindau disease. AB - Von Hippel-Lindau disease (VHLD) is an autosomal dominant disorder characterized by cerebellar, spinal cord, and retinal hemangioblastomas; cysts of the kidney, pancreas, liver, and epididymis; and an increased frequency of renal cancer (renal cell carcinoma or hypernephroma), pancreatic cancer, and pheochromocytoma. Since expression of the disorder is markedly variable, patients presenting with only one of these abnormalities should be investigated further to determine if the lesion is isolated or is indicative of VHLD. A retrospective review of charts of patients diagnosed at the Mayo Clinic between 1976 and 1981 as having VHLD or a retinal or central nervous system hemangioblastoma demonstrates that adequate investigations were not performed routinely in patients presenting with either type of hemangioblastoma. Of 28 patients with an apparently isolated central nervous system hemangioblastoma, 21 patients had ophthalmologic examinations. Of 7 patients with retinal hemangioblastoma, only 3 had computerized tomography (CT) of the head. Among 35 patients with either isolated central nervous system or retinal hemangioblastoma, only 8 had intravenous pyelograms and none had ultrasonography or CT of the abdomen. Recently, there has been increasing awareness of the need for additional investigations in patients presenting with apparently isolated hemangioblastomas. However, not all physicians are aware of this need. Furthermore, it must be recognized that a family history of an isolated lesion may be the first clue that a person has undiagnosed VHLD. PMID- 3273205 TI - The North American Study Group for Optic Glioma. PMID- 3273206 TI - Asymptomatic carotid bruit in patients who undergo coronary artery surgery. AB - The clinical significance of the presence of carotid bruit was evaluated in 643 patients who underwent coronary artery surgery alone or in combination with other cardiac procedures. Carotid bruit was heard in 31 patients (5%) who were neurologically asymptomatic. All of them underwent coronary artery surgery without additional carotid procedures, and none of them developed neurological deficits during the postoperative period. Of the remaining 612 patients, 18 were identified as having a history of focal neurological disorders, and 9 of them had carotid bruit. All were analyzed by means of noninvasive tests and angiography. Five underwent carotid endarterectomy prior to (2 patients) and simultaneously with (3 patients) a coronary bypass procedure. Seven patients developed neurological deficits postoperatively. Most of the deficits were not lateralized or focal but diffuse, which suggests global cerebral ischemia not related to carotid disease. Only 1 patient had proven carotid obstructive disease and underwent successful carotid thrombendarterectomy 10 days postoperatively. This study, although based on limited material, supports the hypothesis that patients with asymptomatic carotid bruit can safely undergo coronary artery surgery. In the group of patients without neurological symptomatology, postoperative neurological deficits were rarely caused by occlusive carotid disease. However, patients with asymptomatic carotid bruit should be closely followed with the goal of identifying those who are at risk of developing neurological deficits. PMID- 3273207 TI - A prospective comparison of bubble and membrane oxygenators in short and long perfusions. AB - In operations with perfusion times longer than 90 min, a hollow-fibre membrane oxygenator causes less damage to red cells and platelets than a standard bubble oxygenator. There is also a trend towards less post-operative pulmonary shunting when a membrane oxygenator is employed. PMID- 3273209 TI - Barrett's esophagus and adenocarcinoma. AB - Sixty-two cases of Barrett's esophagus were observed among 707 patients with hiatal hernia (8.7%). The symptomatology of this condition is described. An additional 10 adenocarcinomas were associated with a Barrett's esophagus--a carcinoma prevalence of 13.8%. Differences in pathology and clinical manifestations of nonmalignant and malignant cases were determined. Fifty-one patients with nonmalignant Barrett's esophagus were operated upon conservatively, while 11 underwent resection. Our results favor conservative surgery via an abdominal approach. The patients with adenocarcinomas underwent esophageal resection with six apparent cures from 6 months to 5 years. Histological study showed specialized epithelium in 8 of 10 cases and severe dysplasia in 5. Our clinical study of Barrett's esophagus shows an incidence of malignancy equal to 1 new case per 274 patient-years (1.72%). It is still not firmly established whether correction of reflux will influence the level of columnar epithelium in the esophagus, esophageal dysplasia, and the risk of malignancy. PMID- 3273208 TI - En bloc resection for T3 bronchogenic carcinoma with chest wall invasion. AB - From January 1960 to January 1986, 77 patients with lung cancer invading the chest wall underwent operations in the Department of Thoracic Surgery at the University of Rome. Chest pain, alone or with other symptoms, was the presenting complaint in 52 patients (67%). All patients underwent thoracotomy (25 pneumonectomy, 5 bilobectomy, 23 lobectomy, 2 wedge resection, 22 no pulmonary resection), with an operative mortality of 7.8%. At thoracotomy, mediastinal lymph node dissection was performed in 36 cases; after the operation 10 patients were classified as T3 N0 M0, 11 as T3 N1 M0, 15 as T3 N2 M0; 19 patients (34.5%) were staged T3 Nx M0 because mediastinal dissection was not performed. En bloc resection of the chest wall was performed on 37 patients. The actuarial 5-year survival of 55 patients following potentially curative resection was 15%. Five year survival was 22% for N0, 12% for N1 and 8% for N2 patients. Five-year survival for squamous cell, large cell, and adenocarcinoma was 22%, 10% and 14%, respectively. T3 N0 M0 patients with squamous cell carcinoma had a 5-year survival of 32%. Pain relief was achieved in 45% of our patients. Resection of pulmonary parenchyma and part of the thoracic wall for lung cancer yields palliation of pain in a fairly large number of patients and may result in long term survival in selected cases. PMID- 3273210 TI - Cardiovascular abnormalities in the relatives of patients operated upon for annulo-aortic ectasia. A clinical and echocardiographic study of 40 families. AB - This study is based on 40 consecutive patients operated on for annuloaortic ectasia at the Turku University Central Hospital between March 1970 and April 1983. Supracoronary graft insertion was used in the first nine patients, while the remaining patients were treated by radical repair using a composite graft and reimplantation of the coronary ostia. The mean age of the patients was 40.3 years (10 to 66 years). The patients were examined postoperatively for their physical, radiological, and ophthalmological parameters. Eight had the classic Marfan syndrome. The patients had 230 first-degree relatives, and 200 of them were alive. Three of the 30 deceased relatives had died due to rupture of an ascending aortic aneurysm; 187 of the living relatives were examined as above. In addition, echocardiography was performed. Twenty-six of the surviving relatives had dilatation of the aortic root; 24 were siblings, and two were children of the operated patients. Echocardiography of the relatives revealed an increased incidence of mitral valve prolapse and enlargement of the left ventricle and left atrium. None of the relatives examined had the classic Marfan syndrome, although the incidence of some Marfan features occurred more frequently in the Marfan families. It seems clear that annuloaortic ectasia, even without the Marfan syndrome, is a hereditary disease. To detect annuloaortic ectasia at an early stage, examination of the first-degree relatives of patients operated upon is recommended. PMID- 3273211 TI - Decreased incidence of supraventricular arrhythmias achieved by selective atrial cooling during aortic valve replacement. AB - Inadequate atrial hypothermia and subsequent ischemic injury have been recognized as the major causes of supraventricular arrhythmias (SVAs) and conduction defects following cold chemical cardioplegia. This study was designed to assess the effects of right atrial cooling (15 degrees-20 degrees C) during cardioplegic arrest upon the incidence of postoperative SVAs and conduction defects in 40 consecutive patients undergoing isolated aortic valve replacement. Atrial preservation was ensured by combining systemic (24 degrees C) and topical hypothermia with snared double caval cannulation during arrest. Myocardial temperatures in the right atrial septum and anterior wall of the right ventricle were recorded before and after each cardioplegic infusion and upon release of caval tapes. Postoperatively, the incidence of SVAs and conduction defects was assessed by continuous rhythm monitoring, bipolar atrial electrograms and, in ten patients, 24-h Holter recordings during the first postoperative day. With the venae cavae snared, temperatures in the right atrial septum were not significantly different from those measured simultaneously in the right ventricle. Release of caval tapes resulted in right atrial temperatures increasing to systemic temperature (from 17.1 +/- 2.9 degrees C to 25.9 +/- 5.6 degrees C [m +/- SD]; P less than 0.01). Atrial rewarming between cardioplegic infusions did not exceed 2.9 degrees +/- 3.2 degrees C. Postoperatively, four patients (10%) developed sustained atrial fibrillation. One additional patient had a single episode of paroxysmal atrial fibrillation and two patients experienced asymptomatic episodes of junctional rhythm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3273212 TI - Free radicals and cardioplegia. Free radical scavengers improve postischemic function of rat myocardium. AB - Oxygen-derived free radicals, such as the superoxide (O2-) anion, hydrogen peroxide (H2O2) and the hydroxyl (OH.) radical, may be involved in exacerbating myocardial injury during reoxygenation of ischemic tissue. The naturally occurring antioxidant enzymes, superoxide dismutase (SOD) and catalase (CAT), prevent the formation of the cytotoxic OH. radical during physiological conditions but may not be able to cope with the free radical generation that follows ischemia and reperfusion. We have used the isolated perfused working rat heart model of cardiopulmonary bypass and ischemic arrest to assess whether exogenous addition of SOD (20 IU/ml) and CAT (100 IU/ml) during ischemia and/or reperfusion can improve postischemic recovery of function following normothermic or hypothermic global ischemic arrest induced by St. Thomas' Hospital cardioplegic solution. Under conditions of normothermia, the addition of SOD alone or CAT alone to both the cardioplegic solution (CS) and the reperfusion solution (RS) had no effect on postischemic recovery (after 20-min working reperfusion) of aortic flow (27.9 +/- 2.7% and 16.1 +/- 6.3%, respectively) when compared with the nontreated control value of 28.1 +/- 3.7%. However, recovery was improved when SOD plus CAT were added to the CS alone (39.3 +/- 8.7%) and was significantly improved when they were added either to both the CS and the RS (48.4 +/- 6.0%; P = less than 0.02) or to the RS alone (51.3 +/- 3.7%; P = less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3273213 TI - Double valve replacement in a patient with osteogenesis imperfecta. AB - Successful mitral and aortic valve replacement in a patient with osteogenesis imperfecta (OI) is reported. The potential complications of valvular dehiscence and bleeding in patients with this connective tissue disorder is discussed with a short review of the reported experience of valvular surgery in patients with OI. PMID- 3273214 TI - Pneumocystis carinii pneumonia following heart transplantation. AB - Pneumocystis carinii pneumonia represents a rare complication that is associated with a high mortality following heart transplantation. The cases of two heart transplant recipients who developed Pneumocystis pneumonia within the first 3 postoperative months are reported. Both patients had severe clinical symptoms of the disease; the diagnosis was confirmed by bronchoalveolar lavage, and the patients were treated with a combination of trimethoprim and sulfamethoxazole. Both patients recovered and are well at the time of this report. PMID- 3273215 TI - Benign mediastinal teratoma causing pericardial tamponade and pleural effusion. AB - Mediastinal teratomas are known to adhere to and penetrate the pericardium, but perforation and tamponade are uncommon. We present a patient who developed a life threatening pericardial tamponade and pleural effusion, whose life was saved by timely surgery. We believe this to be the third successfully treated patient and the first to be reported from Great Britain. PMID- 3273216 TI - Emergency treatment of rupture of the proximal anastomosis of an infected thoracoabdominal aortic graft with bleeding into a postpneumonectomy empyema cavity. AB - The thoracic part of a huge thoracoabdominal aortic aneurysm was resected. A prosthetic graft was implanted between the descending aorta and the iliac arteries. The celiac, superior mesenteric, and the renal arteries were connected to the aortic prosthesis with two bifurcation grafts. A life-threatening hemorrhage into an empyema cavity occurred postoperatively. An emergency two stage procedure was employed involving: (1) exclusion of the infected intrathoracic segment and exclusion of an infected sutured aortic stump; (2) subsequent removal of necrotic and infected tissue, including the excluded segment of the aorta and the graft in a second operation. The patient recovered and is now well and works full-time. Angiography 3 years after the operation shows that all anastomoses are patent. A scheme of management of these rare cases is proposed. PMID- 3273217 TI - On-line sample clean-up and HPLC analysis of prostaglandins in urine, amniotic fluid, and plasma using a column-switching technique. AB - An automatable HPLC column switching technique was used for on-line sample clean up of prostanoids from body fluids. 6-Keto-PGF1 alpha, TxB2, PGF2 alpha and PGE2 in urine, amniotic fluid and plasma were purified by precolumn extraction prior to RP-HPLC-separation. Several precolumn stationary phases were tested, as was the influence of precolumn length and sample acidification. Further, chromatographic behaviour of urine reference compounds was studied. Optimal purification of prostanoids from urine was achieved with microBondapak C18/Corasil as precolumn adsorbent in 1-cm cartridges. Overall recoveries were 64.6 +/- 4.5% for 6-Keto-PGF1 alpha, 72.3 +/- 3.5% for TxB2, 89.6 +/- 3.8% for PGF2 alpha, and 80.4 +/- 3.3% for PGE2. Preliminary results obtained with amniotic fluid and plasma confirmed that precolumn extraction of prostaglandins is also applicable to other body fluids. In discussion, precolumn extraction is compared with the off-line technique using disposable C 18 cartridges. PMID- 3273218 TI - Problems in production of prostaglandin D2-specific antibody. AB - Antisera raised in rabbits against prostaglandin D2 (PGD2) cross-reacted significantly with its dehydrates, 9-deoxy-delta 9-PGD2 (PGJ2) and 9-deoxy-delta 9,delta 12-13,14-dihydro-PGD2 (delta 12-PGJ2), but not with the other metabolites. To obtain PGD2-specific antibodies, we carried out the systematic study of the stability of PGD2 under various conditions. In an aqueous solution, 30%-40% of PGD2 was dehydrated to PGJ2 for 12 h at 37 degrees C, but only about 10%, for 96 h at 4 degrees C. Spectrophotometric studies showed that PGD2 was negligibly decomposed during the coupling to carrier protein. PGJ2 formed nonenzymatically was further converted to delta 12-PGJ2 by albumin, suggesting that cross-reaction would arise from the chemical and metabolic instability of PGD2 immunogen in recipient animals. A specific and high-affinity antiserum was obtained by immunizing a rabbit with the stable PGD2 analogue PGD2-11-methoxime. The antiserum thus obtained will eliminate the uncertainty that results from the use of antibodies with undesirable specificities. PMID- 3273219 TI - Sulprostone and induction of labour. PMID- 3273220 TI - Protection of the rat myocardium from ischemic injury by dietary lamprey oil. AB - The lamprey (Entosphenus japonicus Martens) has been recommended in Japan as an efficacious diet for curing some of chronic inflammatory disorders. Fresh lamprey is rich in n-3 unsaturated fatty acids (e.g., eicosapentaenoic and docosahexaenoic acids) with minimal seasonal variation. The dietary effect of lamprey oil on acute myocardial ischemia was therefore investigated. Rats were fed a control diet or a diet supplemented with 5% safflower oil (SO) or 5% lamprey oil (LO) for 4 weeks. After coronary artery ligation, rats fed the LO diet demonstrated a higher 24-h survival rate and a reduced loss of creatine kinase activity from ischemic myocardium when compared with rats fed the control or SO diet. Moreover, the intracellular redistribution of lysosomal enzyme activity in the ischemic myocardium was significantly suppressed in the LO diet group. Analysis of the fatty acid composition of myocardial phospholipids in rats fed LO showed marked elevation of n-3 fatty acids, whereas arachidonic acid (n-6) content was significantly reduced. Hence, the n-3/n-6 ratio of myocardial phospholipids was markedly increased in the LO diet group. In addition, there was more than a 77% reduction in TXB2 synthetic capacity in whole blood in rats fed the LO diet when compared with rats fed either the control or SO diet. In conclusion, dietary supplementation with LO prevents sudden cardiac death and limits the extension of cellular damage from acute myocardial ischemia in rats. Both changes in thromboxane generation and altered membrane fatty acid composition may be involved in the observed reduction of ischemic damage in the heart. PMID- 3273221 TI - Conformational homologies among cytokines: interleukins and colony stimulating factors. AB - Some 30 cytokine amino acid sequences (mainly interleukins, colony stimulating factors and tumor necrosis factors) have been examined for evidence of secondary structure as well as longer-range interactions of a type likely to lead to stable alpha-helical bundles. Most, though not all, of the cytokines examined have a high predicted alpha-helical content (40-60%) and quasi-repeating heptads containing i/i + 3 apolar periodicities. This major subset of the cytokines is predicted to be characterized by molecules in which 4-alpha-helical bundles with an average length of 25A are the most marked conformational features. Based on these conclusions, we suggest structures for huG-CSF, huGM-CSF and muIL-5 in which defined loop segments at the ends of helical bundles are the most likely sites for binding and recognition by specific cell receptors. As such, they provide a means for testing or refining the three working models we have defined, using currently available methods of site-directed substitution and deletion mutagenesis, as well as synthetic peptides corresponding to the proposed loop sequences and the use of monoclonal antibodies of defined epitopic specificity. The structure arrived at for huGM-CSF is consistent with the limited data currently available concerning the residues which are important for binding and activity. PMID- 3273222 TI - Conformational and receptor binding properties of human EGF and TGF-alpha second loop fragments. AB - The solution conformation of the second loop fragment of human EGF, [Ala20] EGF (14-31), was determined using two-dimensional NMR homonuclear Hartmann-Hahn and rotating frame nuclear Overhauser enhancement spectroscopy. The results are compared with the conformation of the second loop fragment of human TGF-alpha, [Ala21] TGF-alpha(16-32), and with that of the second loop of intact EGF. Comparison of the two experimentally determined structures of the second loop fragments shows significant differences in the turn regions of each peptide. For the EGF fragment, hydrophobic side chain groups protrude away from the ring, whereas for the TGF-alpha fragment hydrophilic groups are directed away from the ring. Although these turn regions represent the putative receptor binding sites, neither second loop fragment binds to the EGF receptor. The biological activity is discussed in terms of the conformational differences found for the two second loop fragments. PMID- 3273223 TI - Transition of environmental polarity of tyrosine-76 of Trimeresurus flavoviridis phospholipase A2 upon active site ligand binding. AB - Modification of Trimeresurus flavoviridis phospholipase A2 with a 5-fold molar excess of tetranitromethane produced 40% active mononitrotyrosyl phospholipase A2 in which Tyr-76 was specifically nitrated. This is in contrast to the case of mammalian pancreatic phospholipases A2 where Tyr-70 but not Tyr-76 was nitrated. When Ca2+ was bound to T. flavoviridis mononitrotyrosyl phospholipase A2, nitrated tyrosine (Tyr(NO2))-76 moved from a less polar site to a polar site with the decrease of the pKa value of its hydroxyl group. Nitration of Tyr-76 did not influence the binding affinity to Ca2+. Addition of laurylphosphorylcholine to mononitrotyrosyl phospholipase A2 in the presence of Ca2+ caused the movement of Tyr(NO2)-76 from a polar environment to a less polar environment with the rise in the pKa value. Tyrosine-76 is located in the site whose environmental polarity is affected by the binding of the ligands to the active site. As Tyr-76 is located in the site not proximal to the active site, it could be assumed that the conformational change induced by the binding of the ligands extends to the region remote from the active site in T. flavoviridis phospholipase A2. This might provide evidence of long-range diffusional coupling between remote sites in the noncooperative globular protein. PMID- 3273226 TI - CT and MR of lung cancer. PMID- 3273224 TI - Zymogen activation: effect of peptides sequentially related to the bovine beta trypsin N-terminus on Kazal inhibitor and benzamidine binding to bovine trypsinogen. AB - The activating effect of peptides sequentially related to the Ile 16-Val17-Gly18 N-terminus of bovine beta-trypsin (namely Ile-Val-Gly, Ile-Val, Ile-Leu, Ile-Ala, Val-Val, Leu-Val, and Val-Leu) on the thermodynamic parameters for the binding of the porcine pancreatic secretory trypsin inhibitor (Kazal inhibitor) and benzamidine to bovine trypsinogen was investigated at pH 5.5 (Bis tris-HCl buffer, I = 0.1 M) and T = 21 +/- 0.5 degrees C. Thermodynamic parameters for Kazal inhibitor and benzamidine association to the binary peptide/zymogen adducts are more favorable than those observed for ligand binding to the proenzyme alone, although never as much as those reported for the formation of bovine beta trypsin/Kazal inhibitor and bovine beta-trypsin/benzamidine adducts. Analogously, the affinity of activating peptides for the binary proenzyme/Kazal inhibitor and binary proenzyme/benzamidine complexes is higher than that observed for peptide binding to free bovine trypsinogen. Differences in affinity for ligand binding to free bovine trypsinogen, to its binary adducts and to bovine beta-trypsin suggest the presence of different activation levels of the proenzyme, none of which structurally coincide with that achieved in bovine beta-trypsin. The existence of different discrete states suggests that the zymogen-to-active enzyme transition should not be considered as a two-state process but as a multistep event. PMID- 3273225 TI - Chemical probes reveal no evidence of Hoogsteen base pairing in complexes formed between echinomycin and DNA in solution. AB - Five different DNA fragments have been treated with a range of conformationally sensitive reagents in an effort to probe structural changes in DNA associated with binding of the bis-intercalating antibiotic echinomycin. For each probe, the intensity and pattern of its reactivity with DNA have been analyzed in order to elucidate the effect of antibiotic binding on the accessibility of a specific site or sites to chemical attack. It was found that in one of the DNA fragments, pTyr2 DNA, several purine residues exhibit enhanced reactivity to diethyl pyrocarbonate (DEPC) in the absence of bound antibiotic, and that this strongly sequence specific reaction is enhanced in the presence of quite low echinomycin concentrations. The echinomycin-dependent reactivities towards DEPC of three homologous DNA fragments, chosen for their subtly different antibiotic binding characteristics, were also investigated. It was found that small changes in base sequence generate striking changes in susceptibility to modification by DEPC. The abolition of one antibiotic binding site leads to the creation of a new, intense DEPC-reactive site. In the presence of moderate concentrations of echinomycin, specific thymidine residues exhibit enhanced reactivity towards osmium tetroxide. No differences in the reactivities of the DNA fragments towards bromoacetaldehyde, S1 nuclease, dimethyl sulphate or potassium tetrachloropalladinate were observed in the presence of the antibiotic. DEPC reactions were performed on tubercidin (7-deaza-adenosine) to determine the DEPC reactive positions in situation where N-7 is inaccessible. Tubercidin was found to be generally resistant to attack by DEPC followed by treatment with base. We conclude that the bulk of structural changes induced by the binding of echinomycin to DNA do not involve Hoogsteen base pairing, but rather are due to sequence-specific unwinding of the helix in a manner which is strongly dependent on the nature of surrounding nucleotide sequences. PMID- 3273227 TI - Gynecological imaging. PMID- 3273228 TI - MR in brain formation and malformation. PMID- 3273229 TI - Carcinoma of the prostate. PMID- 3273230 TI - Many facets of prostate carcinoma. PMID- 3273232 TI - Case study: Case No. 1. Mullerian duct cyst. PMID- 3273231 TI - Algorithms for patient care. PMID- 3273234 TI - State of the art orbital imaging. PMID- 3273233 TI - Case study: Case No. 2. Stage D prostate carcinoma. PMID- 3273235 TI - Peering over the horizon: the latest in imaging the eye. PMID- 3273236 TI - [Cytoarchitectonic and topographic study of somatomotor and neurovegetative nuclei in the rhombencephalon of rhinobatos (guitar fish)]. PMID- 3273237 TI - [Peptic pharyngitis]. PMID- 3273238 TI - [Therapeutic effectiveness of the intracordal implantation of Hydron gel. Electroglottographic and spectrographic study]. PMID- 3273239 TI - [Optico and ultrastructural morphologic study of Jacobson's organ in guinea pigs]. PMID- 3273240 TI - [Origin and distribution of nerve fibers immunoreacting with calcitonin gene related peptide (CGRP) in the nasal respiratory mucosa in mammals]. PMID- 3273241 TI - [Allergic rhinitis: diagnosis and clinical evaluation]. PMID- 3273242 TI - [Diagnostic value of radiology of the cavum in adenoid hypertrophy]. PMID- 3273243 TI - [Auditive training in sensorineural hearing loss]. PMID- 3273244 TI - [Labyrinth fistula and cholesteatoma]. PMID- 3273245 TI - [Meningioma of the nasal fossae. Apropos of a clinical case]. PMID- 3273247 TI - [Study of 17 patients with carcinoma of the nasopharynx]. PMID- 3273246 TI - [Laryngeal amyloidosis: apropos of a case]. PMID- 3273248 TI - [Melanosis of the larynx]. PMID- 3273249 TI - [Sympathetic ophthalmia: an autoimmune disorder]. PMID- 3273250 TI - [Beta-Curie contact therapy in the conservative treatment of uveal melanoma. Evaluation of the first 100 cases treated]. PMID- 3273252 TI - [Campimetry study of cyclotorsion]. PMID- 3273251 TI - [Evaluation of laboratory tests in uveitis: a study by the International Uveitis Study Group]. PMID- 3273253 TI - [Visual acuity scale printed in grey]. PMID- 3273255 TI - [The role of peripheral iridectomy in retinal detachment in aphakia and pseudo aphakia]. PMID- 3273254 TI - [Pigmentary changes of the retina in dialysis patients treated with deferoxamine]. PMID- 3273256 TI - [Irreversible areflexive mydriasis following extracapsular surgery for cataract]. PMID- 3273257 TI - [A rigid disk implant for small incisions]. PMID- 3273258 TI - [Changes in astigmatism following surgery for strabismus]. PMID- 3273260 TI - Formocresol: a brief look at the controversy. PMID- 3273259 TI - [The use of botulinum toxin in endocrine exophthalmos]. PMID- 3273261 TI - An update on digital radiography. PMID- 3273262 TI - Cephalometric analysis of changes in rabbit occlusion following premature coronal synostosis. PMID- 3273263 TI - Lymphoma of the palate: report of a case. PMID- 3273264 TI - The effect of altering angulation in T loops on the moment to force ratio. AB - The effect of changing angulation of a T loop on the force systems developed at the alpha and beta ends was determined. Standard 0.017'' X 0.25'' tMA T loops were used. The force systems were determined using testing apparatus developed in this laboratory. The relationship between moment to force ratio and activation is linear at higher activations (3mm-7mm), and becomes non-linear at lower activations (less than 3mm). The relationship between moment to force ratio and spring angulation is also linear. The clinical application of these findings is discussed. PMID- 3273265 TI - Deciding where to practice. PMID- 3273266 TI - Legislative update. Issues that will shape the practice of dentistry. PMID- 3273267 TI - The legislative battle for loan consolidation. PMID- 3273268 TI - Can TMJ and occlusal disorders be determined by patients' symptoms? PMID- 3273269 TI - Comparison of streptococci from different sites in the mouth. PMID- 3273270 TI - The identification and quantification of plasma proteins adhering to enamel surfaces exposed to the oral cavity. PMID- 3273271 TI - Erosive action of fresh commercially prepared guava juice on rat molars in vivo. PMID- 3273272 TI - Tissue expansion. PMID- 3273273 TI - Various devices available for tissue expansion and clinical experience. PMID- 3273275 TI - External injection domes. PMID- 3273274 TI - Skin expansion in reconstructive surgery. PMID- 3273276 TI - Clinical experience with tissue expansion. PMID- 3273277 TI - Nasal reconstruction with tissue expansion. PMID- 3273278 TI - Auricle reconstruction with the help of tissue expansion. PMID- 3273279 TI - Tissue expansion and flaps for surgical correction of male pattern baldness. PMID- 3273280 TI - Intraoperative expansion as an immediate reconstructive technique. PMID- 3273281 TI - Contraindications and complications in tissue expansion. PMID- 3273282 TI - Future aspects in tissue expansion. PMID- 3273283 TI - Gingival and periodontal parameters in a population of healthy adults, 22-90 years of age. PMID- 3273284 TI - Qualitative nutritional intake analysis of older adults with Sjogren's syndrome. PMID- 3273285 TI - Sorbitol gum in xerostomics: the effects on dental plaque pH and salivary flow rates. PMID- 3273286 TI - Ethnic and sex variations in dental care utilization patterns in a group of Malaysian elderly. PMID- 3273287 TI - Dental hygienists' and dental hygiene students' attitudes toward the elderly. PMID- 3273288 TI - [The effect of 30% nitrous oxide on auditory evoked middle latency responses]. PMID- 3273289 TI - [Clinical case report on the bleaching of discolored pulpless teeth by the walking bleaching method]. PMID- 3273290 TI - [Removable partial dentures and masticatory functions of mandibular resection patients]. PMID- 3273291 TI - Microleakage of retrograde fillings--a comparative investigation between amalgam and glass ionomer cement in vitro. PMID- 3273292 TI - Diffusion of hydrogen ion and hydroxyl ion from various sources through dentine. PMID- 3273293 TI - Structure and composition of tubular and non-tubular deposits in root canal systems of human permanent teeth. PMID- 3273294 TI - The response of the mechanically exposed pulp to prednisolone and triamcinolone acetonide. PMID- 3273295 TI - The incidence and pattern of oro-facial infection and swellings in Nigerian children. AB - Between the 2 of january and the 31 of december 1985 there was done a study of 215 children in ages between 0-15 years in the Department of Oral Diagnosis of the Ibadan University Hospital, where they were external patients with oral infections/swelling. The male-female proportion was 1.3:1. 42.33% were from 0 to 5. 70.24% belonged to the lowest social group of the community, with a high risk of oral-facial infections. The situation of their oral hygiene didn't reflect their social and economical state, and meant no predisposition to infection. The common infections were alveolar abscess, acute necrotizing ulcerative gingivitis and primary herpetic gingivo-stomatitis. They could be complicated with measles and for nutritive failure. Neoplasms were uncommon. Infections were frequent in jaw; antibiotic therapy and "depridement" were often enough to eliminate them. PMID- 3273296 TI - Effect of sodium fluoride mouthrinsing on enamel solubility and levels of fluoride in enamel and in whole saliva. PMID- 3273297 TI - Contribution to the problems of periodontitis in children. PMID- 3273298 TI - The oral health of pre-school children in a satellite town in Malaysia. PMID- 3273299 TI - The University of Southern California mobile dental clinic program: Twenty years of continuous operation. PMID- 3273300 TI - Consequence and therapy of primary tooth intrusion. AB - The consequences of primary tooth intrusion to the permanent successors are as follows: internal white enamel hypoplasy, external white or yellow-brown enamel hypoplasy, crown dilaceration and root angulation. Questions of therapy have also been discussed. PMID- 3273302 TI - Ultrastructure and X-ray microanalysis of natal and neonatal teeth. PMID- 3273301 TI - Tooth eruption in children with growth deficit. AB - The authors aim to study the relation existing between the chronology of tooth eruption and delayed growth, whether this is delayed growth with or without low genetic height or delayed growth caused by growth hormone deficit. The 50 children included in the sample were studied from the endocrine and dental points of view and it was found that children whose delayed growth is accompanied by a low genetic height or growth hormone deficit presented retardation in dentition and retardation in bone age. However, a retardation in bone age does not necessarily imply a retardation in dentition. PMID- 3273303 TI - The effect of selenium, fluoride and normal or protein deficient diet on the microhardness of the rat incisors and the breaking strength of femurs. PMID- 3273304 TI - Specialisation in dentistry: oral medicine. PMID- 3273305 TI - Trismus as a result of metoclopramide therapy. PMID- 3273306 TI - Orthodontic training patterns. PMID- 3273308 TI - The patient/operator interface. A tongue-in-cheek overview. PMID- 3273307 TI - An investigation of a simple method for screening periodontal patients in general practice. PMID- 3273310 TI - Compatibility of accessory gutta-percha cones used with two types of spreaders. PMID- 3273309 TI - A comparison of root surfaces following apical root resection with various burs: scanning electron microscopic evaluation. PMID- 3273311 TI - Ultrasonic compared with hand instrumentation: a scanning electron microscope study. PMID- 3273312 TI - Effect of three file types on the apical preparations of moderately curved canals. PMID- 3273313 TI - A comparison of the apical seal produced by two thermoplasticized injectable gutta-percha techniques. PMID- 3273314 TI - Cutting efficiency of endodontic hand instruments. Part 4. Comparison of hybrid and traditional instrument designs. PMID- 3273315 TI - An evaluation of coronal microleakage in endodontically treated teeth. Part III. In vivo study. PMID- 3273316 TI - Calcitonin as an alternative therapy in the treatment of root resorption. PMID- 3273317 TI - Thermoregulation during pentobarbital and ketamine anesthesia in rats. AB - 1.) Core temperature, tail temperature, metabolic heat production, and evaporative heat loss were measured in rats exposed to various ambient temperature conditions. 2.) Control rats increased heat production in the cold and heat loss in a warm environment, thus maintaining a relatively constant core temperature. 3.) Pentobarbital anesthesia reduced the thermoregulatory responses and caused core temperature to vary considerably with ambient temperature. Ketamine anesthesia resulted in minor thermoregulatory deficits. 4.) It is concluded that ketamine can be used in thermal physiological studies that require an anesthetised preparation, although it is not completely devoid of inhibitory effects on thermoregulatory responses. PMID- 3273318 TI - [Development of a new surgical technic for duodenectomy in the pig]. AB - We describe a new surgical technique of duodenectomy whose main step is the enucleation of the duodenum. The advantage of this technique is that it prevents occurrence of bleeding and thus the use of too many ligatures. Consumption, growth and reproduction performances were normal in the duodenectomized animals. PMID- 3273319 TI - [Surveillance of breast feeding]. PMID- 3273320 TI - [Clinical aspects of thyroid cancer in children]. PMID- 3273321 TI - [Thyroid cancer in children and adolescents]. PMID- 3273323 TI - [Central venous catheterization using a percutaneous route]. PMID- 3273322 TI - [Acute ileocecal enterocolitis (typhlitis) in patients with neutropenia associated with drug therapy]. PMID- 3273324 TI - [Radial defects, complicated cleft lip and ectrodactily syndrome]. PMID- 3273325 TI - [Fatal Kawasaki disease (mucoadenocutaneous syndrome)]. PMID- 3273326 TI - [Male pseudohermaphroditism with 45X/46XYq- mosaicism]. PMID- 3273327 TI - [Unexplainable sudden death syndrome in infants: risk and prevention]. PMID- 3273328 TI - [Reference values, interpretation criteria and results of spirometry]. PMID- 3273329 TI - [Extragonadal cystic teratoma: structural and histochemical analysis]. PMID- 3273330 TI - [Evaluation of superficial ganglionic biopsies]. PMID- 3273331 TI - [Cervicovaginal cytologic results in nulliparous and multiparous patients. Incidence of infections and cervical intraepithelial neoplasms]. PMID- 3273332 TI - [Antithrombin III and heparinemia in patients on hemodialysis]. PMID- 3273333 TI - [Influence of noise on the auditory capacity of traffic agents in the city of Cordoba]. PMID- 3273334 TI - [Conservative treatment of operable breast cancer. Analysis of 215 cases]. PMID- 3273335 TI - [Anemia in daily practice]. PMID- 3273336 TI - [Cardiomyopathy, polymorphous erythema and liver disease]. PMID- 3273337 TI - Genetics and pathogenicity of negative strand viruses. Abstracts of papers presented at the 7th International Meeting on Negative Strand Viruses. Dinard, France, 18-23 September 1988. PMID- 3273338 TI - [Recent progress and demands in pediatric health care with respect to the social change in the Republic of China]. PMID- 3273339 TI - [The fees and charges in the pediatric clinics in the Republic of China]. PMID- 3273340 TI - [Medical expenses of children with catastrophic illness in the Republic of China]. PMID- 3273341 TI - [Past, present and future of group health insurance in the labor, civil service, and agricultural organizations in the Republic of China]. PMID- 3273343 TI - [Feasibility study of health insurance for children]. PMID- 3273342 TI - [The changing family structure and the ability to cope with catastrophic illness]. PMID- 3273344 TI - [Child health care is a first priority in public health tasks]. PMID- 3273346 TI - Proceedings of the International Symposium on Child Health Care in the East and West. April 4, 1988, Taipei, Taiwan. PMID- 3273345 TI - [Pediatric health care, mortality rate and causes of death in the Republic of China]. PMID- 3273347 TI - The pediatrician and primary health care. PMID- 3273348 TI - Child health in Taiwan. PMID- 3273349 TI - Battered and abused children in the East and West. PMID- 3273350 TI - Influence of some Chinese traditional practices on child health. PMID- 3273351 TI - Congenital heart disease in the East and West. PMID- 3273352 TI - Childhood hypertension and hypercholesterolemia in the West. PMID- 3273353 TI - Childhood hypertension and hypercholesterolemia in Japan. PMID- 3273354 TI - The management and treatment of childhood asthma in New Zealand: a Western perspective. PMID- 3273355 TI - Childhood bronchial asthma in Taiwan. PMID- 3273356 TI - Child health insurance system in the U.S. PMID- 3273357 TI - Hepatitis B virus infection in children in Taiwan. PMID- 3273359 TI - [16th meeting of the Latin American Association of the Physiological Sciences. Buenos Aires, Argentina, 16-20 May 1988. Abstracts]. PMID- 3273358 TI - Child health insurance system in South Korea. PMID- 3273360 TI - Quantitation of uterine activity preceding preterm, term, and postterm labor. AB - To assess uterine activity before labor in patients delivering preterm, at term, and postterm, the maximum spontaneous contraction frequency per 10-minute window during the initial portion of antepartum fetal heart rate monitoring was analyzed. Patients with multiple gestation, third trimester bleeding, polyhydramnios, or premature rupture of membranes and those already diagnosed with preterm labor were eliminated from the study. Of the 2446 remaining patients (7247 antepartum fetal heart rate tests) who went into spontaneous labor, 237 did so before 37 completed weeks of gestation, 1077 entered labor at term (38 to 42 completed weeks), and 1132 did so after 42 weeks. There was a significant increase in maximum uterine activity per 10-minute window from 30 to 44 weeks of gestation (average 4.7% per week; r = 0.97, p less than 0.0001). When compared with patients delivering spontaneously at term, average maximum uterine activity per 10-minute window was greatest in the preterm labor group (p less than 0.05) and least in the postterm labor group (p less than 0.05). These differences were present for several weeks preceding the onset of spontaneous labor. All three groups showed a surge of uterine activity during the 3 days before the onset of spontaneous labor. PMID- 3273361 TI - Management of posterior fracture-dislocations of the shoulder. AB - Posterior fracture-dislocation of the shoulder is rare. Comprehensive treatment guidelines for posterior fracture-dislocation of the shoulder with fracture of the humeral head have not been previously published. Although open reduction and internal fixation of the proximal humerus for posterior fracture-dislocation has been reported in several series, the successful reconstruction of the articular surface by rigid internal fixation of a large osteochondral fragment has not been reported. This paper describes two cases of posterior fracture-dislocation of the shoulder with a substantial defect of the anteromedial humeral head resulting from the cleavage of a large osteochondral fragment. Preoperative computed axial tomographic (CAT) scanning of the injured shoulders helped in operative planning by precisely defining the extent of the articular injury. Accurate reconstruction of the articular surface restored joint stability and gave excellent clinical results. Large humeral head osteochondral fracture fragments require accurate reduction and internal fixation. PMID- 3273363 TI - Rewarming patients in the PACU: can we make a difference? PMID- 3273362 TI - CA 125 in tissues and amniotic fluid during pregnancy. AB - CA 125 was assayed in amniotic fluid and tissue extracts by immunoradiometric assay, and immunohistochemical studies were performed on paraffin-embedded sections of endometrium, decidua, and fetal membranes with the monoclonal antibody OC 125 used as primary antibody. The concentration of CA 125 in amniotic fluid changes during pregnancy so that levels of 800 to 1000 U/ml are found before 12 weeks. Thereafter, levels of 4000 to 10,000 U/ml are detected routinely. As term approaches, amniotic fluid CA 125 concentrations fall to a range of 1000 to 2000 U/ml. Levels of CA 125 in tissue extracts of secretory endometrium and decidua were 65,000 and 29,500 U/gm of tissue, respectively. CA 125 was readily detected on the apical surfaces of glandular epithelium and in the secretions of endometrial glands obtained throughout the menstrual cycle. It was also detected in the lumina of decidualized glands throughout pregnancy. No antigen was detectable within glandular epithelial cells. We have previously reported high concentrations of CA 125 in chorionic tissue extracts (42,000 U/gm) and low concentrations in amniotic tissue extracts (275 U/gm). In contrast to those findings, immunohistochemical techniques detected CA 125 within the intercellular canaliculi that surround amniotic epithelial cells but not in chorion. We conclude that the likely source of amniotic fluid CA 125 is the decidua and that it gains access to the amniotic fluid via the intercellular canalicular system that traverses the amniotic epithelium. PMID- 3273365 TI - National policy on immunization. Pros and cons. PMID- 3273364 TI - Torsion of a lung lobe: diagnosis and treatment. AB - Intraoperative lobar torsion occurred in 4 of about 2000 patients subjected to thoracotomy. Two of the patients died. Early diagnosis and proper management are of great importance to the outcome. Temporary deflation of the diseased lung by using double lumen endobronchial tube is a potential risk. Early progressive lobar opacity without signs of atelectasis on conventional chest radiograph is indicative of this serious complication. Computerized tomography and bronchoscopy are of diagnostic value. Exploratory thoracotomy must be performed without delay. The injured parenchyma should be sacrificed unless the diagnosis is obtained very early. When the injured lobe or lung is rotated back into normal position the airways may be flooded with serosanguinous fluid which promptly has to be removed. If an attempt is made to save the lobe or the lung, tracheostomy for frequent suction of the airways is indicated in order to prevent "spill-over" and dangerous postoperative hypoxia. PMID- 3273366 TI - Is globus hystericus? AB - Forty-six patients, 9 male, 37 female, presenting to an ear, nose and throat department with a principal complaint of globus sensation were investigated by radiology, manometry, endoscopy and prolonged ambulatory pH monitoring to exclude a physical basis for their symptoms. Patients also underwent assessment by the Eysenck Personality Inventory (EPI) and General Health Questionnaire (GHQ). The only organic abnormalities detected were an abnormal degree of oesophageal acid exposure (seven patients) and oesophageal spasm (one patient). Female patients were neurotic introverts on EPI testing; males were stable ambiverts. High GHQ scores were present in 13 females (35%) and one male and there was a significant correlation between N scores (in the EPI) and GHQ scores. We propose that globus is a useful, single-symptom model for the study of conversion disorders. PMID- 3273367 TI - The Hungerford shooting incident. AB - Thirty people sustained gunshot injuries on one afternoon in Hungerford, a small rural town in Berkshire. Fourteen people died at the scene of the shootings and three of the 16 patients who were admitted to hospital subsequently died. We describe the management of the 14 patients admitted to Princess Margaret Hospital, Swindon. PMID- 3273368 TI - Lifelong eccentricity and social isolation. I. Psychiatric, social, and forensic aspects. AB - Sixty individuals are described who have lifelong eccentricity and social isolation and who have sought psychiatric treatment as a direct or an indirect result. They were predominantly young and, as in other samples of autistic people, male (6M: 1F). Most of them were of normal intelligence. They were all profoundly socially handicapped: few had lived independently, had lasting sexual relationships or spent much time in employment. Nearly a half of the subjects had been involved in antisocial behaviour at some stage. Nearly a quarter had committed a criminal offence. Violence was usually domestic, most often directed against the mother. Forty-eight per cent of subjects had a second psychiatric disorder (11.7% had a psychosis). PMID- 3273369 TI - [Evaluation of Pervinox as an irrigating solution]. PMID- 3273370 TI - [Fundamentals of extraoral traction according to Ricketts]. PMID- 3273371 TI - [Chronology of eruption of permanent teeth. Urban population of Sabaneta]. PMID- 3273372 TI - [Oral epidermoid carcinoma. Statistical study]. PMID- 3273373 TI - [Masseter activity with changes in dental stability in canine guidance (preliminary results)]. PMID- 3273374 TI - [Temporomandibular joint (TMJ) dysfunction in children and adolescents in the Damasco district (Antioquia)]. PMID- 3273375 TI - [Serial extraction (clinical case)]. PMID- 3273376 TI - [Stomatology atlas]. PMID- 3273377 TI - [Analysis of factors associated with dental grinding in 5-year-old children]. PMID- 3273379 TI - [The scientific method in occlusion]. PMID- 3273378 TI - [Clinical and radiographic oral manifestations in patients with sickle cell anemia]. PMID- 3273380 TI - [Characteristics of dental applicants to the Antioquenas universities in the last two decades]. PMID- 3273381 TI - [Damasco. A dental assistance program]. PMID- 3273382 TI - [Orthodontic treatment of temporomandibular joint dysfunction (TMJ) during growth and development (clinical case)]. PMID- 3273383 TI - [Stomatologic atlas]. PMID- 3273384 TI - [Influence of nutrition on tooth eruption]. PMID- 3273385 TI - [Functional orthopedics]. PMID- 3273386 TI - [Differences between interdental and skeletal fixation in maxillofacial surgery]. PMID- 3273387 TI - [Analysis project of Colombian craniofacial and general growth and development, in two student groups of different socioeconomic levels (report of an investigation)]. PMID- 3273388 TI - [Stomatologic atlas. Epulis]. PMID- 3273389 TI - Use of Lotus 1-2-3 spreadsheet software for managing and analyzing genetic backcross data. PMID- 3273390 TI - Miniaturization of the BCA protein assay. PMID- 3273391 TI - Alternative methods of harvesting animal cell clones. PMID- 3273392 TI - A rapid non-radioactive procedure for plaque hybridization using biotinylated probes prepared by random primed labeling. AB - A simple, non-radioactive method has been developed for the rapid screening of phage libraries. In the present study, nanogram amounts of a small restriction fragment (135 bp) were biotinylated via random primed labeling and used to probe cDNA libraries using a modified plaque hybridization protocol. The high backgrounds that are seen typically with avidin/biotin-based methods for plaque hybridization were eliminated by incubation of filters with one of several different proteases prior to hybridization. A comparison of several detection systems indicated that streptavidin conjugated to calf intestinal alkaline phosphatase (AP) was the most sensitive, yielding signals comparable to those obtained with 32P-labeled probes. The times required for phage growth and pre hybridization were reduced substantially, permitting a convenient one-day screening protocol. Nitrocellulose filters gave the best signal to noise ratio, although "streaking" of plaque DNA was observed occasionally; this problem can be overcome by using nylon-based membranes, which allows exact visualization of the positive plaques. The method was highly reliable; 29 out of 33 putative clones retested positive and the authenticity of these was confirmed by DNA sequence analysis. The random primed biotinylation procedure has been utilized successfully with several different cDNA fragments and has proven useful for other hybridization-based methods (Northern and Southern blots), without the problems associated with the use of radiolabeled probes. PMID- 3273393 TI - Ultraviolet resonance Raman spectroscopy as a probe of protein structure in the fd virus. AB - Resonance Raman spectroscopy can provide details of molecular structure via the enhancement of specific vibrational bands in the spectrum of the scattered light when the laser excitation is tuned to electronic absorption wavelengths of the molecule. The availability of lasers operating in the deep ultraviolet region makes it possible to apply this technique to problems of protein structure. The backbone conformation and the environments of aromatic side chains can be probed via appropriate enhancement of selected vibrational modes. In this article we investigate ultraviolet resonance Raman (UVRR) spectra from the coat protein of the filamentous bacteriophage, fd, in the intact virus and in sodium dodecyl sulfate (SDS) suspension. The results indicate that 1) the protein is completely alpha-helical in the mature virus, but loses a large fraction of its helix content in the SDS micelles. 2) The two tyrosine residues appear to behave as H bond acceptors in the intact phage but this interaction is lost in the micelles. 3) The tryptophan residue is not solvent-exposed in either protein conformation, although in SDS it is accessible to H/D exchange with the solvent. 4) The three phenylalanine residues are involved in stacking interactions in the intact virus; these are disrupted in the SDS micelles. 5) The single proline residue appears to be in a trans conformation both in the virus and in the micelles. PMID- 3273394 TI - A new serum-free medium for monoclonal antibody production. AB - A new serum-free, defined-protein, medium for the growth of murine hybridoma cells and the production of monoclonal antibodies has been developed. Designated WRC 935 medium, this formulation supports the growth of hybridoma cells in higher numbers, and promotes better cell viabilities and increased monoclonal antibody levels compared to growth in DMEM supplemented with 10% fetal bovine serum or in a DMEM/F-12 serum-free mixture. In suspension cultures, WRC 935 medium typically promoted cell growth to densities over two million cells per milliliter. This medium also promoted the rapid growth of cells following their transfer from liquid nitrogen storage. WRC 935 medium is especially useful for high density cell culture production methods using hollow-fiber bioreactors. Hollow-fiber bioreactors using this medium produced antibody at an average rate of 11 mg/day, and the antibody concentration ranged from 10 to 40 mg/ml. PMID- 3273395 TI - Transverse alternating field electrophoresis (TAFE). AB - The rapid development of electrophoretic technology during the past five years has given us a stream of improvements in the area of pulsed-field separation techniques. This progression has culminated in the conception of TAFE, a simple, high resolution technique providing straight lane geometry and separation of fragments up to 9 million base pairs in length. Pulsed-field techniques will unquestionably play a major role in the forthcoming analysis of the human genome by facilitating restriction mapping and cloning of large fragments. We have no doubt that TAFE will allow scientists to do this type of genetic analysis, faster and better than ever before. PMID- 3273396 TI - Use of a gas chromatograph oven for DNA amplification by the polymerase chain reaction. PMID- 3273397 TI - Electrolyte gradient gels for DNA sequencing. PMID- 3273398 TI - High sample throughput using sodium dodecyl sulfate-polyacrylamide gel electrophoresis. PMID- 3273399 TI - Double-stranded sequencing, using mini-prep plasmids, in eleven hours. PMID- 3273402 TI - A rapid and economical method for the identification of anti-HIV antibodies by the western blot technique. PMID- 3273401 TI - The OPTIMIZOR: a graphic pulse analyzer to monitor electro cell fusion and electroporation experiments. AB - BTX has developed an instrument, the OPTIMIZOR, which allows the accurate monitoring and adjusting of electrical parameters to aid in electro cell fusion and electroporation experiments. The OPTIMIZOR can be used with the family of BTX generators and chambers, as well as home-made or other commercial systems with the appropriate adaptors. The microprocessor-based design allows great flexibility in further expansion of functions and possible mating to a fully automated laboratory system with robotic features. PMID- 3273400 TI - Protein assays for monoclonal antibodies. AB - Several techniques were evaluated for the quantitation of the total protein content of an IgG2a monoclonal antibody, KS1/4, and its deacetylvinblastine (DAVLB) conjugate. The UV assay is rapid, but it requires an extensive calibration of the response factor, and impurities may cause a high bias. Amino acid analysis (AAA) is an absolute method that has few interferences, but it requires evaluation of hydrolysis recovery factors. Kjeldahl nitrogen is very sensitive to minor impurities, and it requires a conversion factor to calculate percent protein. The Kjeldahl assay also is less precise (observed RSD of 3-4%) than the UV and AAA assays (observed RSD of 2-3% for both). The bicinchoninic acid assay, a representative of colorimetric assays, inherently requires comparison to a calibrated standard of the same material and tends to be less precise than the other assays. Thus, the UV and AAA assays are the techniques of choice for measurement of the total protein content of KS1/4 and its DAVLB conjugate. PMID- 3273403 TI - A rapid droplet method for Sanger dideoxy sequencing. AB - A method for performing the dideoxy sequence reaction on petri dishes is described. It allows rapid manipulation of clones and provides large amounts of sequence information quickly and without the need for elaborate laboratory equipment. PMID- 3273404 TI - Capillary electrophoresis. AB - While capillary electrophoresis, or historically related techniques, have been used for over a century, and recognition of the value of this separation methodology has certainly grown rapidly in the past few years, the technique has generally been used by analytical chemists, particularly in Europe and Japan, and small groups of researchers in the United States. Many of the basic instrumentation problems have been solved only relatively recently, and researchers using capillary electrophoresis are now turning their attention to studying specific applications which demonstrate the potential versatility of this electrophoretic technique. The appearance of standardized commercial instrumentation is imminent. With the availability of such technology, capillary electrophoresis will no longer be an academic curiosity, but rather a tool with the potential for routine separations of diverse samples of interest to analyst, researcher, and clinician. PMID- 3273405 TI - Base composition-independent hybridization in dried agarose gels: screening and recovery for cloning of genomic DNA fragments. PMID- 3273406 TI - Colored silver-intensified gold technique for light microscopy. AB - The development of silver-intensified immunogold-labeled antibodies for light microscopy described by Fritz et al. (4) has been investigated. Principles and chemistries used in color photographic science have been applied to immunogold enhancement. In this technique, colloidal gold acts as the catalytic center for the reduction of silver ions to metallic silver with subsequent color development in the presence of hydroquinone. Silver ions and hydroquinone are adsorbed onto the surface of colloidal gold. The reduction of silver ions to metallic silver is further catalyzed by autometallography. The colored-SIG technique offers several advantages. It has sensitivity comparable to the silver-intensified gold (SIG) method and greater sensitivity than immunoenzymatic procedures, takes approximately one hour, results in one of three color reaction products (magenta, cyan, or yellow), and produces better contrast between the reaction products and the background (Figure 1). Thus, this method should prove useful in double- and even triple-staining procedures. PMID- 3273407 TI - Use of a chemically modified T7 DNA polymerase for manual and automated sequencing of supercoiled DNA. AB - Procedures are presented for reliable and accurate nucleotide sequence analysis using as template supercoiled DNA prepared by a modified rapid boiling minipreparation protocol. This method yields DNA templates suitable for sequencing within 1 h of bacterial harvest. We describe optimal reaction conditions for supercoiled miniprep DNA sequencing using a modified T7 DNA polymerase (Sequenase) in dideoxynucleotide chain termination reactions. We demonstrate that under these conditions, the sequencing data obtained with miniprep DNA is indistinguishable from that obtained with CsCl purified supercoiled DNA or from that obtained using single stranded DNA templates. We further show that the supercoiled DNA sequencing reactions can be analyzed on a commercially available automated DNA sequencing system that detects 32P labeled DNA during its electrophoretic separation. Taken together, these developments represent a significant improvement in the process of nucleotide sequence analysis. PMID- 3273408 TI - Optimization of ligation reaction conditions in gene synthesis. AB - Several phosphorylation, annealing and ligation reaction conditions have been investigated for the enzymatic assembly of genes of interest. The use of longer oligodeoxyribonucleotides (40-60 bases long) also improved the enzymatic reaction. Furthermore, the use of longer oligonucleotides and the elimination of long stretches of G's or C's lowered the mutation rate. PMID- 3273409 TI - Calcium phosphate-mediated gene transfer: a highly efficient transfection system for stably transforming cells with plasmid DNA. PMID- 3273410 TI - Vascular changes in cutaneous neurofibromas. AB - A variety of vascular changes has been associated with neurofibromatosis, and morphological alterations of arteries have been described previously. However, little attention has been paid to structural modifications of the microvasculature in neurofibromas themselves. Small vessels of 10 cutaneous neurofibromas, excised from patients with neurofibromatosis, were studied by using transmission electron microscopy and compared with normal skin vessels. The major alterations were: (1) increased thickness of the cytoplasm of endothelial cells which send numerous long processes to the lumen and, in some instances, obliterate it; (2) larger numbers of endothelial cell processes on the abluminal surface which are apposed to pericyte processes; (3) increased amounts of filaments and free ribosomes in the cytoplasm of endothelial cells, and (4) abundant pericytes with bundles of cytoplasmic filaments and many small subplasmalemmal densities. Mitotic figures were not seen in any of the vascular elements. These changes were interpreted to be the result of a generalized malformative process of blood vessels in neurofibromas rather than a consequence of the action of a tumor angiogenesis factor. PMID- 3273411 TI - American paternal age data for selected years from 1876 to 1981. AB - For selected years in the time span of 1876 through 1981, mean average paternal ages are itemized and the methods for the calculation of these figures are illustrated. For this time period, mean average paternal ages dropped from a high of 36.9 years to 28.5 years in 1981. This change was accounted for by an absolute and relative decrease in the number of births to older fathers and by an absolute and relative increase in births to younger fathers. PMID- 3273412 TI - Breed differences in the frequency of bovine lymphocyte antigens. AB - Lymphocytes from 1,564 cattle of 18 breeds and cross-bred groups in Australia were tested for major histocompatibility system class 1 antigens. Gene frequencies were calculated for the Angus, Belmont Red, Brahman, Hereford and Holstein-Friesian breeds. There were substantial differences among these breeds in antigen and gene frequency. There were striking differences among all 18 breeds in the presence or absence of certain antigens. Two antigens, CA13 and CA36, were strongly associated in Hereford cattle but occurred independently of each other in the other breeds. PMID- 3273413 TI - Genetic difference in the proliferative response to T mitogens between Hi/PHA and Lo/PHA lymphocytes is independent of accessory cell function. AB - The role of the macrophage as accessory cell in the proliferative response of lymphocytes to phytohemagglutinin (PHA) was studied in two lines of mice genetically selected for high and low responsiveness to T mitogens. Adherent cell depletion of lymph node cells abrogated the low (Lo)/PHA response, but only partially inhibited the high (Hi)/PHA response. Addition of peritoneal cells provided either by Hi/PHA or by Lo/PHA mice equally restored Hi/PHA responsiveness but had only a slight reconstituting effect on the inhibited Lo/PHA response. Equivalent enhancement or suppression of proliferation of untreated lymph node cells was obtained by the addition of increasing percentages of each of the two peritoneal cell populations. However, the maximum level of the Lo/PHA response never reached that of Hi/PHA cells. These data indicate that the bidirectional selective breeding has not modified the potentialities of the macrophages as accessory cells but has resulted in an impaired response of Lo/PHA lymphocytes to the signals delivered either by accessory cells or by T mitogens. PMID- 3273414 TI - Association of DR4 with pemphigus. AB - HLA typing for the A, B, C, and D locus antigens was performed on 65 patients with pemphigus vulgaris and on 558 controls living in the Los Angeles area. The patients were divided into several categories. These included Jewish and non Jewish patients, patients with only mucous membrane involvement, only skin or both mucous membrane and skin involvement, and those with a single-episode or recurrent disease. Depending on the highest titer of anti-intercellular cement substance antibody titer, the patients were categorized into those whose titers were 0-80, 160-320, and 640 or greater. A statistically increased incidence of HLA-A25, HLA-B38, and HLA-DR4 antigens was observed in patients compared to controls. This incidence was significantly higher in Jewish compared to non Jewish patients. The correlations were insignificant in the group with an antibody titer of 0-80, but significant in those with a titer of 160-320, and even more significant in those with titers greater than 640. No significant differences were present between patients who had a single-episode or recurrent disease or in those that had only mouth or only skin involvement. In all categories tested, the association was stronger with DR4 than with A26 or B38. DR4 was present equally in B38-positive and B38-negative patients. The primary association of pemphigus vulgaris may be with the DR4 antigen, and it may be a marker for the severity of the disease. PMID- 3273415 TI - Serology and genetics of human monocyte antigens (HMA system). Antibody, population and family studies. AB - This study was conducted for the purpose of detecting monocyte-specific alloantibodies by screening of sera which had been retroplacentally obtained, and with a view to delimitating their reactivity pattern from B and T lymphocytes. The data presented provide evidence for an unambiguous distinction of seven different monocyte antigens, MA-1 to MA-7. Segregation analyses of 14 informative families with 69 children revealed HLA-linked autosomal, codominant inheritance of these human monocyte antigen (HMA) via two gene loci (HMA-A and HMA-B) each of them with multiple allelism. The following gene frequencies were established: 0.1340 for HMA-A1; 0.0315 for HMA-A3; 0.0315 for HMA-A5; 0.0146 for HMA-A6; 0.0657 for HMA-B2; 0.0289 for HMA-B4, and 0.0614 for HMA-B7. PMID- 3273416 TI - Monoclonal anti-H antibody A46-B/B10 suited for differentiating blood groups A1 and A2 reveals also heterogeneity within blood group B. AB - A monoclonal antibody (mAb) recognizing H antigen was obtained from a BALB/c mouse immunized with MCF-7 (human mammary carcinoma) cells. This antibody (A46 B/B10, IgM) has been tested on a total of 753 blood samples. It strongly agglutinates human erythrocytes of blood groups 0, A2 and A2B, but not or only very weakly A1 and A1B. This mAb promises to be useful in the determination of A and AB subgroups in blood group serology. Evidence is presented that this antibody might also be able to define B subgroups. Among 263 B blood samples, 45 (17.1%) were negative or only weakly positive with A46-B/B10. PMID- 3273417 TI - Concanavalin A-induced splenocyte supernatant causes a preferential increase in H 2K over H-2D and vice versa depending on culture conditions. AB - Mouse embryo fibroblasts (MEF) from BALB/c mice were exposed to the culture supernatant (CS) from concanavalin A-stimulated splenocytes for 16 h. This caused an increase in the amount of Kd and Dd antigens expressed on the cell surface of the MEF. However, on MEF cultures at 37 degrees C and subcultured daily for the first 5 days after embryonic trypsinization, CS caused the K antigens to increase significantly more than the D antigens, while on MEF cultured for 24 days with a combination of 37 degrees C and room temperature, CS invariably caused the D antigens to increase more than the K antigens. In another protocol involving MEF culture at 37 degrees C and subculture every 4 days, either response was possible when the MEF were exposed to CS. We propose that cells may differentially control K and D antigen increase and discuss how this may be useful in the eradication of viral infection in the animal. PMID- 3273418 TI - IgG (Gm) allotypes in acute measles encephalomyelitis and subacute sclerosing panencephalitis. AB - Gm phenotype or haplotype frequencies are known to be increased in some neurological diseases involving dysregulation(s) of the immune system. Therefore, possible associations between acute measles encephalitis (AME) or subacute sclerosing panencephalitis (SSPE) and alleles of the Gm system were investigated by comparison of children (41 AME subjects and 62 SSPE subjects) with 378 ethnically and geographically matched controls. Although the Gm3;..;11 haplotype displayed a very low frequency among SSPE children, no statistically significant departure in the distribution of Gm phenotypes could be evidenced between AME or SSPE, and controls. A further appraisal of combined Gm and HLA phenotypes may be warranted in both diseases since Gm/HLA interactions have been demonstrated in other immunopathological conditions. PMID- 3273419 TI - Discordance between red cell and saliva Lewis phenotypes in patients with hydatid cysts. AB - Patients with hydatid cysts and controls of the same Tunisian area were typed for ABO, Lewis and secretor phenotypes. A high incidence of red cell Le(a-b-) phenotype (34-37%) was found among hydatid cyst patients as compared to normal controls (13-16%). However, a large proportion of the patients with Le(a-b-) red cell phenotype had discordant red cell and saliva Lewis phenotypes since they secreted Lea and/or Leb antigens in saliva. In addition, 1 patient with Le(a+b-) red cell phenotype secreted Leb antigen in saliva. The remaining patients and all the controls had concordant red cell and saliva Lewis phenotypes. The discordant results between the phenotypes obtained in serum and saliva of hydatid cyst patients are probably the consequence of a decrease in the concentration of the circulating Lewis glycosphingolipids, secondary to the disease. PMID- 3273420 TI - Growth and metastasis in allogeneic hosts. Lack of H-2-negative or somatic hybrid variant selection. AB - In vitro cultured B16 melanoma cells, which were previously found to have an impaired expression of H-2Kb and Db (as evaluated by antisera absorption assay), were used to study growth and metastasis in allogeneic mice in relation to H-2 expression. The possible emergence of somatic hybrids with host cells was also examined. B16-A cells grown subcutaneously in allogeneic BALB/c mice (H-2d) did not show a lack of H-2b expression, nor the acquirement of H-2d antigens was found. Spontaneous lung metastases were found in about 30% of BALB/c mice with progressing B16 tumor. Single lung metastases showed higher H-2b levels than cells from the respective tumors, and did not express host H-2 antigens. Tumor take was concomitant to the rise of an anti-H-2b humoral response: disease outcome was independent from the serum titer. B16-A cells injected intravenously in BALB/c mice gave rise to lung colonies; different colonies showed a wide range of H-2b antigens levels and no H-2d expression. Lung colonization capacity in normal allogeneic BALB/c mice was significantly higher than in syngeneic C57BL/6 mice. Both syngeneic and allogeneic mice, when pretreated with cyclophosphamide (CY) to reduce natural killer cell activity, showed a significant increase in lung colonization by B16-A cells. CY-treated C57BL/6 mice showed significantly higher numbers of lung colonies than CY-treated BALB/c mice. In conclusion, B16 growth and metastasis in the allogeneic environment do not seem to be determined by a selection of H-2-negative variants or by the emergence of somatic hybrids with host cells. PMID- 3273421 TI - Syngeneic male graft rejection by B6 female mice primed with spleen and testes of Sxr and Sxr' mice. AB - Presence or absence of the mammalian male-specific H-Y transplantation antigen was investigated in Sxr and Sxr' mice. Groups of C57BL/6 (B6) female mice were primed with spleen cells or testicular homogenates of such mice and were subsequently grafted with syngeneic male skin. Median graft survival times (MSTs) were compared with the MSTs of control groups: (i) unprimed B6 females, (ii) B6 females primed with B6 female spleen, and, (iii) B6 females primed with B6 male spleen or testes. The MSTs of the groups primed with B6 male and Sxr spleen were significantly shorter than, and those of the groups primed with B6 female and Sxr' spleen similar to the MST of unprimed females. The MSTs of groups of B6 female mice primed with testicular homogenates of B6, Sxr, and Sxr' males did not differ from the MST of unprimed B6 females. Taken together, this indicates that spleen of B6, and Sxr males carry the H-Y transplantation antigen, while the antigen is lacking on spleen cells of B6 females and Sxr' males. The results of priming with testis are interpreted such that (i) either do testes of B6, Sxr and Sxr' males lack the antigen, or, (ii) priming with testes homogenates renders B6 females unresponsive to H-Y of male grafts. PMID- 3273423 TI - Linkage disequilibrium in the monocyte alloantigen system. PMID- 3273422 TI - Linkage disequilibrium between the monocyte alloantigen system and the HLA system. PMID- 3273424 TI - [Comparison of 2 non-invasive methods for the analysis of regional motility of the left ventricle in ischemic cardiopathy]. PMID- 3273425 TI - [Contribution of bidimensional and pulsed Doppler echocardiography for the diagnosis of septal rupture in acute myocardial infarct]. PMID- 3273426 TI - [Natural history of the surgically treated mitral stenosis. Study carried out 20 years after commissurotomy, in 188 patients]. PMID- 3273427 TI - [Holter electrocardiography in Portugal. Analysis of the results from a national survey]. PMID- 3273428 TI - [Rhythm profiles using Holter electrocardiography in sinoatrial dysfunction and conduction disturbances]. PMID- 3273429 TI - [Arrhythmic profile of patients with aortic valve diseases surgically treated]. PMID- 3273430 TI - [Holter electrocardiography in ischemic cardiopathy. Comparison with the exercise test]. PMID- 3273431 TI - [Unstable angina. Analysis of admissions at the coronary unit]. PMID- 3273432 TI - Percutaneous double balloon mitral valvotomy for rheumatic mitral stenosis; immediate and short-term follow-up in 50 patients. PMID- 3273433 TI - [Proconvertin activation in acute coronary disease. Preliminary results of a clinical and laboratory study]. PMID- 3273434 TI - [Acute coronary occlusion in percutaneous coronary angioplasty. Treatment using thrombolysis and redilatation]. PMID- 3273435 TI - [Arrhythmia caused by left ventricular hypertension. Development of an experimental model]. PMID- 3273436 TI - "Physiological pacing": comparison of DDD and VVI programming by three different non-invasive methods. PMID- 3273437 TI - [Hypertension in an accelerated phase. Cardiologic, ophthalmologic and hemorrheologic study]. PMID- 3273438 TI - [Results of mitral substitution surgery using the Ionescu-Shilley bioprosthesis (1979-1986)]. PMID- 3273439 TI - [Heart failure and complete atrio-ventricular block in a patient with acute myocardial infarct]. PMID- 3273440 TI - [Current situation and future perspectives of heart surgery in Portugal]. PMID- 3273441 TI - [Clinical and hemodynamic aspects of biventricular infarct]. PMID- 3273442 TI - [Clinical methods of evaluating infarct size and its anatomic correlations. Study carried out in 193 cases. I. Evaluation of infarct size using a QRS score. Electro-anatomic correlations]. PMID- 3273443 TI - [Alterations in rhythm in heart insufficiency]. PMID- 3273444 TI - [Cardiac pacing: experience at a district hospital]. PMID- 3273445 TI - [Septal rupture after acute myocardial infarct]. PMID- 3273446 TI - Correlation between QRS score system and peak creatine kinase for estimating myocardial infarct size in inferior infarction. PMID- 3273447 TI - [Pulsed 2D Doppler echocardiography in pulmonary arterial hypertension]. PMID- 3273448 TI - [Computerized registry of cardiac pacing]. PMID- 3273449 TI - [Chronic thresholds in ventricular endocavitary stimulation with porous vitreous carbon electrodes]. PMID- 3273450 TI - [Myocardial infarct in young drug addicts. Apropos of 2 clinical cases]. PMID- 3273452 TI - [Left ventricular function in acute myocardial infarct. Influence of the infarct size, the presence of ventricular aneurysm and previous infarcts. Anatomo hemodynamic correlations]. PMID- 3273451 TI - [Evolution of Rashkind's septotosomy method in the transposition of great arteries at the civil hospitals of Lisboa (1971-1987)]. PMID- 3273453 TI - [Ischemic cardiopathy and life events]. PMID- 3273454 TI - [Significance of transitory atrial fibrillation and flutter in acute myocardial infarct]. PMID- 3273456 TI - [The AIDS and dentistry conference of the Drs. Cueto]. PMID- 3273455 TI - Double balloon dilatation for discrete sub-aortic stenosis: immediate results and short term follow-up. PMID- 3273457 TI - [Acquired immunodeficiency syndrome and its relation to the dental profession and auxiliaries]. PMID- 3273458 TI - [The role of dentistry in the legal field]. PMID- 3273459 TI - [Resection of an odontoma of the upper jaw]. PMID- 3273460 TI - [Fibromyxoma of the lower jaw]. PMID- 3273461 TI - Induction of tumour necrosis factor by staphylococcal toxic shock toxin 1. AB - Staphylococcal toxic shock syndrome toxin 1 (TSST1) induced the release of tumour necrosis factor (TNF) from human and rabbit monocytes in vitro. Nanogram amounts of TSST1 were sufficient to induce TNF release. There was considerable variation in response between cells from different rabbits and different donors. Rabbit monocytes were slightly more sensitive to TSST1 than were human monocytes. Release of TNF in vivo could explain many of the symptoms of toxic shock syndrome. PMID- 3273463 TI - Promoting effects of 105K glycoprotein on cell proliferation in chicken lymphoblastoid cell lines. AB - The promoting effects on cell proliferation of the 105K glycoprotein (105Kgp), purified from sera of chickens to which a Marek's disease (MD) lymphoblastoid cell line, MDCC-MSB1-41C (MSB1-41C), had been transplanted, were examined using culture cells from various sources. The MSB1-41C line as well as the other chicken lymphoblastoid cell lines examined were sensitive to the 105Kgp. The growth-promoting effects of 105Kgp showed a biphasic pattern depending upon the amount of 105Kgp added into the culture medium. These findings indicate that the 105Kgp may be a promoting factor for chicken growing cells, especially lymphoblastoid cell lines. PMID- 3273462 TI - A sensitive chemiluminescence assay for pertussis toxin and for evaluation of cell-free pertussis toxoids. AB - Pertussis toxin (PT) inhibited luminol-enhanced chemiluminescence induced in rabbit peritoneal neutrophils by N'-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP) at doses as low as 0.8 ng.ml-1, even in the presence of a 10-fold higher concentration of filamentous haemagglutinin (FHA). A cell-free extract of Bordetella pertussis, containing predominantly PT and FHA, suppressed the neutrophil response to fMLP. After toxoiding with carbodiimide, the inhibitory activity of the extract was abolished and an enhancement of neutrophil chemiluminescence was observed due to FHA activity. Abrogation of the chemiluminescent response of neutrophils to fMLP is proposed as a sensitive, in vitro assay for pT, and may be useful for monitoring the residual toxin activity in pertussis toxoids and for determining the anti-toxic effects of anti-PT antibodies. PMID- 3273464 TI - A rapid detection of circulating antigens of Dirofilaria immitis in dogs by a dot enzyme-linked immunosorbent assay. AB - This report describes a dot enzyme-linked immunosorbent assay (Dot-ELISA) for detecting circulating antigens in the sera of dogs infected with Dirofilaria immitis (D. immitis). Circulating D. immitis antigens could be detected in 24 of 25 infected dogs. The remaining animal had two immature worms. However, non infected dogs and dogs infected with other parasites were all negative. Few cross reactions to different parasite antigens were observed. The advantages of the Dot ELISA include; 1) there is no need for pretreatment and dilution of sera and samples could be immediately bound to nitrocellulose paper set into microfiltration apparatus, 2) this assay could be carried out within 2 h at room temperature, 3) the resulting enzyme-reaction could be measured by both visual observation and densitometric reading. PMID- 3273465 TI - Hafnia alvei lipopolysaccharides: isolation, sugar composition and SDS-PAGE analysis. AB - Lipopolysaccharides (LPS) of 33 strains of Hafnia alvei were isolated and purified. LPS content of the dry bacterial mass ranged from 1.2 to 4.5%. All examined lipopolysaccharides contained glucose, glucosamine, heptose, 3-deoxy octulosonic acid and often galactose. Rhamnose, mannose, galactosamine, mannosamine and unidentified amino sugars were found in some H. alvei strains. Sialic acid was present in LPS of one strain. D-3-Hydroxybutyryl groups also were identified in lipopolysaccharides of 5 strains of this genus. SDS-PAGE of the lipopolysaccharides was presented in the paper. According to these results two core types exist in H. alvei. PMID- 3273466 TI - Identification and molecular cloning of a 70 kDa species-specific antigen common to Clostridium difficile. AB - Three common antigens (CB 1, 2 and 3), characteristic of Clostridium difficile species were identified by immunoblot analysis using homologous and heterologous rabbit antisera, raised against whole cells from 9 distinct strains of C. difficile. A gene library of C. difficile genomic DNA was constructed in Escherichia coli by cloning in Sau 3A-cleaved clostridial DNA fragments into the bacteriophage vector lambda EMBL3. OUt of 3000 plaques screened using the whole cell antisera, 27 clones were positively identified. One of these clones, designated gamma Cd21, expressed high levels of an antigen which could be immunologically identified using whole cell antisera against the 9 C. difficile strains. Antiserum raised against the clone gamma Cd21 identified a 70 kDa antigen (previously named CB1) as demonstrated by immunoblot analysis. Monospecific antiserum against gamma Cd21 recognises the 70 kDa antigen in all 97 strains of C. difficile derived from worldwide sources and does not cross-react with 17 strains from 13 other clostridial species. PMID- 3273467 TI - Hemagglutinating and adherence properties of Staphylococcus saprophyticus: epidemiology and virulence in experimental urinary tract infection of rats. AB - We studied hemagglutinating and adherence properties in Staphylococcus saprophyticus isolates originating from symptomatic urinary tract infections. 12/13 (92%) of strains adhered to Hep cells and 11/13 (85%) were able to agglutinate sheep erythrocytes. Adherence properties differed markedly between strains (P less than 0.0001). Two strains, one hemagglutinating and adherent and one negative for both properties were chosen for experimental urinary tract infections. Results indicate that presence of the hemagglutinin favours colonization of kidney tissue. PMID- 3273468 TI - [A protocol for use of osseous allografts in periodontics: cryopreserved cancellous bone]. PMID- 3273470 TI - [Different approaches to the problem of motivation in oral hygiene]. PMID- 3273469 TI - [The palatal-gingival groove in maxillary incisors. Frequency and effect on sulcus depth]. PMID- 3273471 TI - [Needs and periodontal care by tooth site]. PMID- 3273472 TI - [Abrasion: 1. Rheotribologic analysis of tooth contacts]. PMID- 3273473 TI - Interaction of Gc (vitamin-D binding protein) with membrane of activated natural cytolytic cells. AB - Gc (a vitamin D binding protein) has been speculated to play a role in the function of immune response, yet, it has not been examined for its biological response properties. Therefore, we tried to (a) characterize the appearance of membrane bound Gc (mGc) on non-activated and mitogen activated lymphocytes as well as on Interleukin-2 activated killer cells and (b) examine the role of serum isolated human Gc on human blastogenesis and cytotoxicity (natural killing and lymphokine-activated killing). Our data suggests that activated cells possess a greater number of cells with mGc than non-activated cells and that as a biological response modified we find modulation of blastogenesis and cytotoxicity to be consistently but not very significantly down-regulated. Anti-Gc antibody was observed to significantly inhibit NK activity. PMID- 3273474 TI - Incorporation of alpha-1-antichymotrypsin into human stomach adenocarcinoma cell nuclei and inhibition of DNA primase activity. AB - Incorporation of alpha-1-antichymotrypsin (ACT) into human stomach adenocarcinoma cell nuclei and the effect of ACT on DNA primase from the same carcinoma cells were studied. ACT or [125I]-ACT were observed in carcinoma cell nuclei and high specific radioactivity was detected in washed nuclear fraction when 0.4 mg of ACT or [125I] ACT (8 x 10(7) cpm) was intravenously injected into carcinoma bearing nude mice 2 h before killing. The molecular weight of radioactivity presented in cell nuclei was same as the intact ACT on SDS-polyacrylamide gel electrophoresis. ACT inhibited DNA primase activity and this inhibiting activity was stable than its chymotrypsin inhibiting activity. The results presented here show ACT is incorporated into carcinoma cell nuclei without modification of its molecular weight and may inhibit DNA primase activity. PMID- 3273476 TI - Alpha-1-antichymotrypsin (ACT) as an immune regulatory agent. AB - This study was carried out to elucidate the interaction of alpha-1 antichymotrypsin (ACT) with the immune reaction induced by interleukin-2 (IL-2). ACT, isolated from human sera and determined to be a single glycoprotein, was added to human peripheral T-cell cultured with IL-2. It was found that ACT effectively suppressed T-cell activation induced by IL-2, but the suppressive effect of ACT was inversely proportional to the concentration of IL-2. A similar effect was found when T-cells were stimulated with PHA. ACT had a suppressive effect when suboptimal concentrations of PHA were used, however this suppressive effect could not be found at the optimal PHA concentration. These findings suggest that ACT may be a regulatory agent in immune reactivity where low concentrations of IL-2 are present. Even under normal conditions, an individual is surrounded and invaded by numerous foreign elements and it may be that small amounts of IL-2 are constantly produced, which would indefinitely trigger chained immune reactions if there were no regulatory agent like ACT. PMID- 3273475 TI - Inhibition of DNA synthesis by alpha-1-antichymotrypsin. AB - The effect of alpha-1-antichymotrypsin (ACT), which is known as an efficient serum protease inhibitor and is detected in tumor cell nuclei, on DNA synthesis was studied. ACT inhibited the activity of DNA polymerase alpha purified from human stomach adenocarcinoma. Other human serum proteins including serum albumin, alpha-1-acidglycoprotein, alpha-1-antitrypsin, and immunoglobulin G, as well as other protease inhibitors, such as leupeptin, pepstatin, PMSF and chymostatin, did not affect the activity of DNA polymerase alpha. It was therefore concluded that the inhibitory action of ACT on DNA polymerase alpha was direct phenomenon unrelated to its protease inhibitory activity. Furthermore, the effect of ACT on DNA synthesis was also studied using lysolecithin-permeabilized cultured human stomach carcinoma cells. ACT added in the medium inhibited DNA synthesis and the degree of inhibition depended on incubation time. It was proportional to ACT concentration and the concentration of ACT required for 50% inhibition was 0.8 mg/ml. PMID- 3273477 TI - Binding of modified alpha-1-antichymotrypsin to mitogen-stimulated human lymphocyte membrane: a model for immune suppression. AB - Alpha-1-antichymotrypsin (ACT), an acute phase reactant protein elevated during acute inflammation, and its derivatives (asialo ACT and acid-exposed asialo ACT) were investigated their effect on lymphocyte proliferative responses, and evidence for binding to lymphocyte membranes as well as the characteristics of this binding were investigated. Acid-exposed asialo ACT significantly reduced 3H thymidine incorporation into human peripheral lymphocytes stimulated by phytohemagglutinin (PHA) though native ACT could not inhibit the mitogen-induced lymphoproliferation and asialo ACT moderately inhibited it. In order to determine the interaction of ACT and its derivatives to lymphocyte membranes, the binding of 125I-labelled ACT and its derivatives to membranes of intact lymphocyte and extracted lymphocyte membranes was examined. The binding of 125I-labelled native ACT and asialo ACT to resting and PHA-stimulated lymphocyte membrane was low. And the binding of 125I-labelled acid-exposed asialo ACT to resting lymphocyte membrane was also low. However, when lymphocytes were stimulated by mitogens the binding of 125I-labelled acid-exposed asialo ACT increased significantly. The binding of 125I-labelled acid-exposed asialo ACT to the membrane extracted from PHA-stimulated lymphocytes was time-dependent and saturation was reached at 120 min at 37 degrees C. One mg of membrane could bind a maximum of approximately 83 pmol of acid-exposed asialo ACT with dissociation constant of 0.73 microM. Other unlabelled serum glycoproteins such alpha-1-antitrypsin, alpha-1-acid glycoprotein, transferrin, and proteinase inhibitors including chymostatin, leupeptin and soy bean trypsin inhibitor did not compete with 125I-labelled acid exposed asialo ACT for binding sites in simultaneous competition assays. PMID- 3273478 TI - Successful resuscitation from cardiac arrest using high-dose epinephrine therapy. Report of two cases. AB - A patient with cardiac arrest failed to respond to prolonged standard therapy for multiple dysrhythmias. High-dose intravenous epinephrine hydrochloride was administered 22 and 26 minutes after arrest. Coarsening of ventricular fibrillation and defibrillation with subsequent return of spontaneous circulation occurred. The patient was neurologically intact when eventually discharged. In another patient, prolonged asystole failed to respond to standard advanced cardiac life-support therapy. High-dose epinephrine was given 38 minutes after arrest, and return of spontaneous circulation subsequently occurred. Intensive treatment efforts were discontinued after admission to the hospital, and the patient died. The temporal sequence in these patients suggests that high-dose epinephrine therapy caused the return of spontaneous circulation. Recent studies suggest that presently recommended epinephrine doses may be too low, and investigation of graded epinephrine doses for the treatment of cardiac arrest is indicated. PMID- 3273479 TI - Epidemic measles in a highly immunized rural West African (Gambian) village. AB - A measles epidemic occurred in a rural West African village, despite documented immunization in 90% of the less than 10-year age group. In contrast to previous epidemics, this outbreak caused no associated deaths among the 54 cases diagnosed. Immunization protected against infection--only 3.6% of immunized children developed measles, whereas 30.1% of those not immunized became ill (P less than .001). Thus, the vaccine efficacy rate was 90.1%. The average age at presentation was 72 months, and older patients were more likely to have severe disease. Nutritional status had no effect on susceptibility to measles infection or on outcome; weight loss (350 +/- 170 g) was most marked during the prodromal phase in young children. Infection was more severe when more than one case was diagnosed in a household (P less than .05) and in conditions of overcrowding, which were also associated with higher infection rates (P less than .02). Although immunization did not stop the spread of the epidemic within the village, a strict quarantine in the medical clinic probably prevented spread to other villages. PMID- 3273480 TI - The discount rate for capital expenditure analysis in health care. AB - The appropriate discount rate for evaluation of capital expenditures depends on leverage, taxation, cost-based reimbursement, and risk. A method is presented to account for these effects that is both practical and consistent with theory. PMID- 3273481 TI - Required request for organ donation: moral, clinical, and legal problems. PMID- 3273482 TI - Risk factors for spontaneous abortion and its recurrence. AB - Pregnancy histories of women interviewed as normal population controls during 1974-1981 in four case-control studies in the US and Canada were examined to identify risk factors for the occurrence of miscarriage. In total, 2,068 ever gravid women aged 20-79 years at interview (mean age, 50.3 years) described 6,282 pregnancies, including 805 miscarriages. The roles of previous pregnancy history, age at pregnancy, and other factors were evaluated using relative risk binomial regression methods (similar to logistic regression). Risk of miscarriage during a given pregnancy was found to increase directly with the number of previous miscarriages (the risk was closely approximated by (1 + number of prior miscarriages)1.01), but appeared to be unrelated to the order of miscarriages within all previous pregnancies. Maternal age was also highly related to risk after controlling for gravidity and previous miscarriages, with doubled risk (compared with age 20 years) seen for pregnancies in women older than age 40 years. Risk of miscarriage did not appear to be associated with years since previous pregnancy, height, weight or obesity, use of oral contraceptives within one year before pregnancy, or duration of oral contraceptive use. A slight increase in risk was seen for women who had ever regularly smoked cigarettes (relative risk = 1.14, 95 per cent confidence limits = 1.00, 1.30). Thus, the levels of risk of miscarriage found in this analysis are similar to those of previous studies, and the analytic methods suggest how age, obstetric history, and other factors can be simultaneously examined for associations with such risk. PMID- 3273483 TI - The clinical significance of food-induced changes in the absorption of theophylline from Uniphyl tablets. AB - To determine the effects of food on the absorption of theophylline from Uniphyl tablets (a once-daily sustained-release theophylline formulation), we performed a crossover evaluation in 20 adults with asthma. After 5 days of continuous dosing (at 6 PM), all patients received their regular Uniphyl dose under specified fasting conditions, and serum theophylline concentrations were measured sequentially during the following 24 hours. The patients' next Uniphyl dose was administered immediately after ingestion of a standardized high-fat meal, and theophylline concentrations were again measured during 24 hours. Five days later, the procedure was repeated in the opposite order. The patients' mean daily theophylline dose was 890.0 +/- 229.2 mg. We found relatively minor, but in some cases statistically significant, differences in pharmacokinetic parameters between food and fasting administration. When Uniphyl was administered with food, bioavailability was increased by 10% (p less than 0.01), the time of maximum concentration occurred 3 hours later (p less than 0.01), and the minimum or "trough" theophylline concentration was 0.7 mg/L greater (p less than 0.01), as compared to administration while patients were fasting. There was no evidence of "dose dumping" after either food or fasting administration of Uniphyl, and there was no significant difference in the maximum theophylline concentration attained between the two dosing conditions. There was no evidence of a difference in therapeutic efficacy between the two dosing conditions. All patients tolerated the drug well throughout the trial. PMID- 3273484 TI - Sudden infant death. PMID- 3273485 TI - Variability in 28-day outcomes for very low birth weight infants: an analysis of 11 neonatal intensive care units. AB - A retrospective study of all infants weighing 701 to 1,500 g born at 11 neonatal intensive care centers during 1983 and 1984 was performed to determine whether two specific 28-day outcomes, survival and survival without the need for supplemental oxygen, varied among the centers. Survival without the need for supplemental oxygen was chosen as a reflection of infants surviving without chronic lung disease. There were 1,776 live-born infants delivered during the 2 year study period. Of these infants, 85% (1,512) survived 28 days, a range of 80% to 92% at the individual centers. A total of 60% (1,056) of the infants were alive without supplemental oxygen on day 28, a range of 51% to 70% at the individual centers. Multivariate analysis demonstrated that both survival on day 28 (chi 2 = 23.9, P less than .01) and survival without supplemental oxygen on day 28 (chi 2 = 44.2, P less than .0001) varied significantly among centers after the effects of birth weight, gender, and race were taken into account. Female gender, nonwhite race, and increased birth weight were factors associated with improved rates of survival and survival without supplemental oxygen. The magnitude of outcome variation among centers was estimated by using the logistic regression models to predict what the outcomes would be if each center were to treat a standardized population consisting of all 1,776 study infants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3273486 TI - Epidural fentanyl for shaking in obstetrics. AB - This study assesses the efficacy of epidural fentanyl in the relief of shaking associated with epidural analgesia. Fifty mothers whose shaking was sufficient to cause distress were divided randomly to receive either fentanyl 25 micrograms in 5 ml sterile normal saline or 5 ml of saline through their in-situ epidural. Shaking stopped within 15 minutes in 18 out of 25 (72%) of those given fentanyl but in only 4 out of 25 (16%) of the saline group and this is statistically significant (p less than 0.01). Fentanyl can be recommended in this context. PMID- 3273487 TI - Results of optic nerve sheath fenestration for pseudotumor cerebri. The lateral orbitotomy approach. AB - Twenty-eight patients with pseudotumor cerebri underwent 40 optic nerve sheath fenestrations for relief of visual loss or to preserve vision. Twenty women and eight men underwent 16 unilateral fenestrations and 12 bilateral operations. Papilledema disappeared or was strikingly reduced in 24 of 28 patients. The other four patients had gliotic discs (two patients) or were followed up for only a short time. Visual acuity improved in 12 of 40 eyes and remained the same in 22 of 40 eyes. Seventeen eyes had preoperative visual acuity of 20/30 or better. In six eyes visual acuity decreased. Of eight eyes operated on that had visual acuity of 20/200 or worse, only three showed improvement. Visual fields improved in 21 of 40 eyes and remained the same in ten eyes. Five of the ten eyes that did not change had poor vision before surgery. Eight eyes in five patients continued to lose acuity postoperatively. Each of these eight eyes had a concomitant loss of visual field. An additional two eyes developed visual field loss with preserved visual acuity. The indications for surgery are early evidence of progressive loss of visual field or acuity in a patient with pseudotumor cerebri. Severe vision loss presents little opportunity for improvement but fenestration may be used in a last effort to preserve or restore vision. PMID- 3273488 TI - Cancer-causing substances in food, drugs, and cosmetics. The de minimis rule versus the Delaney clause. PMID- 3273489 TI - The emergency care of the VIP patient. PMID- 3273490 TI - The effects of exercise on catch-up growth of rats recovering from early undernutrition. AB - The effects of an 8-wk exercise program were studied on growth of rats following a period of normal nutrition or undernutrition. Male Wistar weanling rats, underfed by fasting on alternate days for 4 wk, gained 56% as much weight as ad libitum-fed rats (carcass: 47% as much fat; 63% as much lean mass), and had markedly smaller fat depots, visceral organs, brains and hindlimb muscles and bones. Rats in both groups were then allowed free access to feed and subdivided into exercise or non-exercise groups. Eight wk of treadmill exercise (speed, 24 m/min; duration, 75 min/d; frequency, 5 d/sk) reduced weight gain in both normal fed and underfed rats, but had a greater effect on underfed rats. Underfed rats that were exercised gained 76% as much weight (carcass: 54% as much fat; 92% as much lean mass), and tended to have lighter tissues than underfed rats that were not exercised. Data suggest that treadmill exercise following a postweaning period of undernutrition reduces "catch-up" growth in rats. PMID- 3273491 TI - Skeletal muscle blood flow in exercising dogs. AB - We have recently described the skeletal muscle blood flow response to maximal exercise in the foxhound as well as the skeletal muscle blood flow response to various levels of submaximal and maximal exercise in the mongrel dog using the radioactive microsphere technique. Results from these studies demonstrated that blood flow increased progressively up to VO2max in the gracilis, semitendinosus, and semimembranosus muscles of the dog; however, blood flow to the gastrocnemius leveled off during submaximal exercise. These studies have also shown that the magnitude of the blood flow response to maximal exercise in the different muscles examined is extremely varied and that some muscle blood flows exceeded 300 ml.100 g-1.min-1. Whether or not these high blood flows were the consequence of microsphere streaming effects was evaluated, and results from both studies suggest that these effects were minimal. Also, the high muscle blood flows appeared to be reasonable with respect to the maximal cardiac outputs generated by the dogs in both studies. Based on the data presented we conclude that the radioactive microsphere technique appears to be a reliable technique for measuring muscle blood flow in the exercising dog. Moreover, the skeletal muscle blood flow response to exercise in the dog is variable and highly dependent on the individual muscle(s) studied. PMID- 3273492 TI - Multivariate analysis of factors associated with unplanned admission in 'outpatient' ophthalmic surgery. AB - We performed a case-control study of patients undergoing planned "outpatient" ophthalmic surgery in order to identify risk factors associated with the need for unplanned admission to the hospital. factors associated with admission included time of completion of surgery, duration of operation, fentanyl dose, use of enflurane, and leukocytosis. A multiple logistic regression model found each of these variables except duration of operation to to be independently associated with unplanned admission with admission included age, present or past medical conditions, use of medications, blood pressure, hematocrit, serum sodium or potassium, and ASA Class. Identification and modification of these factors may help anticipate and/or reduced the incidence of unplanned admission to the hospital in patients undergoing planned outpatient surgery. PMID- 3273493 TI - Particulate-matter content of D5/NS for injection: manufacturer difference and conformance with USP limits. PMID- 3273494 TI - (-)-Phenylalkylamines more potent than (+)-isomers. Further promiscuity of phenylalkylamine Ca2+ antagonists. PMID- 3273495 TI - Amino acids are not un-charged (lipid-soluble) substances. Why we might as well forget pyroglutamate as an amino acid. PMID- 3273496 TI - [Neuro-oncology: challenge and reality]. PMID- 3273497 TI - [One-and-a-half syndrome of ischemic vascular origin: apropos of 7 cases]. PMID- 3273498 TI - [Growth of a cerebral hydatid cyst evaluated by CT study]. PMID- 3273500 TI - [Treatment with metronidazole of brain abscesses]. PMID- 3273499 TI - [Triple association: polymyositis, rheumatoid arthritis and neoplasia]. PMID- 3273501 TI - [Metastatic infiltration of the cavernous sinus]. PMID- 3273502 TI - [Syringomyelia associated with hydrocephalus: favorable course following ventriculo-peritoneal shunt. Proof using magnetic resonance]. PMID- 3273503 TI - [Guillain-Barre: the sensory form and the H-reflex]. PMID- 3273504 TI - [Is multiple sclerosis really a rare disease in Spain?]. PMID- 3273505 TI - [Platelet dysfunction in migraine: preliminary clinical study of this subgroup of patients]. PMID- 3273506 TI - [Double-blind study of the clinical usefulness of determinations of antiepileptics in serum]. PMID- 3273507 TI - [Neuropathological findings in patients subjected to orthotopic liver transplantation]. PMID- 3273508 TI - [Melkersson-Rosenthal syndrome and primary care]. PMID- 3273510 TI - [Late migrainous accompaniments]. PMID- 3273511 TI - [Dorsal disc hernia. Diagnosis using magnetic resonance]. PMID- 3273513 TI - [Postural paralysis among workers at archeological digs]. PMID- 3273512 TI - [Rendu-Osler-Weber disease and cerebral arteriovenous malformation]. PMID- 3273509 TI - [Bilateral paralysis of the VI cranial nerves following myelography with metrizamide]. PMID- 3273515 TI - [Cervical radiculopathy caused by Ewing's tumor]. PMID- 3273514 TI - [Paralysis of the vertical gaze caused by a hematoma of the caudate nucleus. A false localizing sign]. PMID- 3273516 TI - [Transient global amnesia following slight cranial injury]. PMID- 3273518 TI - [Classification of the spinocerebellar syndromes]. PMID- 3273517 TI - [Subacute meningoencephalitis caused by Rickettsia conorii]. PMID- 3273519 TI - [Auditory extinction in cerebrovascular pathology. Prospective study of 105 cases]. PMID- 3273520 TI - [Cervical disc herniations operated upon using a posterior approach]. PMID- 3273521 TI - [Risk factors and risk profile in atherothrombotic cerebral infarction. An OFRA study]. PMID- 3273522 TI - [Infarction of the superior cerebellar artery (Mills' syndrome). Clinico morphological and functional correlation]. PMID- 3273523 TI - [Chronic pain and lesion of the dorsal horns of the spinal cord in syringomyelia]. PMID- 3273524 TI - [Prevalence of multiple sclerosis in Spain]. PMID- 3273525 TI - [Growth of cerebral hydatid cysts]. PMID- 3273526 TI - [Somatosensory evoked potentials in syringomyelia and the Arnold-Chiari anomaly. Clinical and imaging correlations]. PMID- 3273527 TI - [New neuroradiological protocol in the diagnosis of lumbar disc hernia]. PMID- 3273528 TI - [Cortical and subcortical vascular dementia]. PMID- 3273529 TI - [Ischemic optic neuropathy. Blindness which can be reversed by carotid endarterectomy]. PMID- 3273530 TI - [2 forms of distal muscular spinal atrophy predominantly compromising the upper limbs]. PMID- 3273531 TI - [Carpal tunnel syndrome and cervical "whiplash"]. PMID- 3273532 TI - [Segmental spinal atrophy. Report of a case]. PMID- 3273533 TI - [Locked-in syndrome of mesencephalic origin]. PMID- 3273534 TI - [Gradenigo's syndrome following radiculography]. PMID- 3273535 TI - [Neurological toxicity caused by amiodarone]. PMID- 3273536 TI - [High-dose barbiturates in severe cranio-encephalic trauma]. PMID- 3273537 TI - [Comparison between the clinical and magnetic resonance findings in infarctions of the brain stem]. PMID- 3273538 TI - [Granulocytic sarcoma of the central nervous system]. PMID- 3273540 TI - [Angiographically occult cerebrovascular malformation: an entity to consider]. PMID- 3273541 TI - [Sensory neuralgia of the trigeminal nerve and system lupus erythematosus]. PMID- 3273539 TI - [Neurobrucellosis and cerebral vasculitis]. PMID- 3273542 TI - [Examination of the patient with tinnitus]. PMID- 3273543 TI - [Vestibular projections of cervical sensory fibers in the frog]. PMID- 3273544 TI - [Intelligibility of language as a function of its consonant sounds. Study conducted in adult individuals with normal hearing]. PMID- 3273545 TI - [Secretory otitis media in our environment]. PMID- 3273547 TI - [The phonatory implant as a method of vocal rehabilitation of the totally laryngectomized patient]. PMID- 3273546 TI - [Osteogenesis imperfecta and otosclerosis]. PMID- 3273548 TI - [The venous circle. Cervical reflux following functional neck evacuation]. PMID- 3273549 TI - [Esophageal foreign bodies. Study of 65 cases]. PMID- 3273550 TI - [Treatment of sudden-onset deafness and vertigo using hyperbaric oxygen]. PMID- 3273551 TI - [Tonsillar hypertrophy. An exceptional manifestation of sarcoidosis]. PMID- 3273552 TI - [Cold parapharyngeal tuberculous abscess. Presentation of a clinical case]. PMID- 3273553 TI - [Retropharyngeal abscess with mediastinal and retroperitoneal extension. Apropos of a case]. PMID- 3273554 TI - [Capillary hemangioma of the tympanum. Observations apropos of a case]. PMID- 3273556 TI - [Vocal prosthesis for language rehabilitation in laryngectomized patients]. PMID- 3273557 TI - [Phoniatric study of the course of laryngeal paralysis]. PMID- 3273555 TI - [Evaluation of the use of a drug combination in the clinical course of surgical trauma of the nasal fossae. Comparative study]. PMID- 3273558 TI - [The gerbil (Meriones unguiculatus) in auditory research]. PMID- 3273560 TI - [Vertigo and personalized medical care. A theoretical justification]. PMID- 3273561 TI - [Tubal dysfunction, the angle of the clivus and the base angle: a possible anthropometric relationship]. PMID- 3273562 TI - [Verrucous carcinoma of the larynx]. PMID- 3273559 TI - [Vestibular neurotomy using the retro-labyrinthine route]. PMID- 3273563 TI - [Auditory function and Paget's disease. Study of 28 cases]. PMID- 3273564 TI - [Fibrous dysplasia of the maxilla and sphenoid]. PMID- 3273566 TI - Metabolic and endocrine aspects of rheumatic disease. PMID- 3273565 TI - [Sudden deafness and mitral prolapse]. PMID- 3273567 TI - Family support--sharing the burden. PMID- 3273568 TI - Louse infestation--a lousy life. PMID- 3273569 TI - Inner city care--bridging two worlds. PMID- 3273570 TI - Children's medications--sweetening the pill? PMID- 3273571 TI - Child abuse--redressing the balance. PMID- 3273572 TI - Matters for concern--mixed classes. PMID- 3273573 TI - [Gastric cancer in young people: our experience in the last 10 years]. PMID- 3273574 TI - [Early postoperative hemodynamic changes after mitral valve substitution]. PMID- 3273575 TI - [An experimental physiopathologic model of incomplete stenosis of the gastroesophageal junction]. PMID- 3273576 TI - [Primary gastric lymphoma: our experience]. PMID- 3273577 TI - [Evaluation of the predictive value of the determination of sialic acid in the blood in neoplastic disease]. PMID- 3273578 TI - Transcutaneous electrical stimulation in the prevention of post-operative ileus and pain. PMID- 3273579 TI - Evaluation of combined use of indirect haemagglutination test and Casoni's skin test in diagnosis of hydatid disease. PMID- 3273580 TI - Salmonellosis of benign cystic teratoma of ovary (a case report). PMID- 3273581 TI - A bacteriological study of the vagina in non specific vaginitis (NSV). PMID- 3273582 TI - Non-ossifying fibroma of the metacarpal bone (a case report). PMID- 3273583 TI - Fetal death--a clinico-pathologic study. PMID- 3273584 TI - The effect of bengal gram feeding on the haemostatic status of rabbits with experimental atherosclerosis. PMID- 3273586 TI - Primary squamous cell carcinoma of breast (a case report). PMID- 3273585 TI - Adult polycystic liver and the Meyenburg complexes biliary ectasia. PMID- 3273587 TI - Malignant giant cell tumour of soft part (a case report). PMID- 3273588 TI - Immunopathological response to Anacarcin Forte in dogs. PMID- 3273590 TI - Cytological evaluation of tracheo bronchial mucus membrane during anesthesia. PMID- 3273589 TI - Vaginal cytology in normal nonpregnant women, in pregnancy and in threatened abortion. PMID- 3273591 TI - Report of bone registry, 1970-1982 (a twelve year study). PMID- 3273592 TI - A 10 year retrospective study of esophageal cancer from 1974-1983 in Punjab. PMID- 3273593 TI - [The susceptibility of Salmonella sp. to various antibiotics]. AB - In this study, the in-vitro activity of ampicillin, chloramphenicol, trimethoprim sulfamethoxazole (TMP-SMX), cefoperazone, ceftriaxone, cefotaxime, ceftizoxime, ofloxacin, pefloxacin, ciprofloxacin, and fleroxacin against recently isolated strains of S.typhi (20) and Salmonella group B (42) have been investigated. The minimum inhibitory concentrations (MICs) were determined using the microtube dilution technique except for TMP-SMX which was tested by agar dilution technique. All of S.typhi strains have been found to be susceptible to all antibiotics used in this study. In Salmonella group B bacteria relatively high percentage of resistance has been found against ampicillin (28.6%), chloramphenicol (33%), TMP-SMX (42.9%), cefoperazone (35.7%), and ceftizoxime (12%). All new quinolone derivatives tested were very active against all of the Salmonella strains. The antibiotic therapy proposals on salmonellosis in adults have been discussed in the light of our results, our clinical experience and the other studies. PMID- 3273594 TI - [The presence of Brucella antibodies in human sera and some milk samples]. AB - The brucella antibodies were investigated in 132 different milk samples and 150 human sera by the Ring Test. The guinea-pig tests were made to determine the antibody level and microorganism isolation using one seropositive milk sample. Increase of the antibody titre was observed. Brucella germs from blood, spleen and liver of guinea-pig didn't multiply. PMID- 3273595 TI - [The prevalence of Toxoplasma antibodies among the patients with symptoms of toxoplasmosis at the hospital of the Faculty of Medicine, University of Cukurova]. AB - The antibodies of Toxoplasma gondii were screened with Indirect Haemagglutination (IHA) method during 1983-1987 by different departments of faculty of medicine. University of Cukurova with the symptoms of toxoplasmosis. Of overall 4200 sera, 1327 belonged to babies, and 2873 to adults which were contained of 663 males and 2210 females. The rate of T.gondii antibodies found was 45.74% in babies, 39.67% in males and 53.53% in females all above 1/64 and high titers. Overall 48.88% (2053/4200) sera were positive for T.gondii antibodies. PMID- 3273596 TI - [House dust mold in Istanbul. I. Detection of mold flora in bed dust]. AB - In our study, mycological analyses were carried out on 110 randomly chosen houses for bed dusts. 748 mould strains belonging to 117 genus and species were isolated and identified. Air-borne pathogenic fungi, fungi that are causative agents of pulmonary allergy such as Cladosporium spp., Aspergillus glaucus group, Alternaria, Ulocladium, Aureobasidium pullulans, Aspergillus niger group were isolated. PMID- 3273597 TI - [The prevalence of intestinal parasites in the students of two primary schools in Ankara]. AB - Four hundred stool samples obtained from two different primary school students were examined for intestinal parasite. Cellophane tape technique was also applied in order to detect the Enterobiasis incidence. It has been observed that the parasite incidence were 13.5% in TED College Students whereas 30.5% in the Incesu Primary School. It has been also concluded that the highest infection rate was connected with two parasites, namely Giardia intestinalis (11.5%) and Enterobius vermicularis (8%). PMID- 3273598 TI - [Primary aspergillosis of the hand]. PMID- 3273599 TI - [Fournier's gangrene: report of 6 cases]. AB - 6 patients with Fournier's gangrene a rare but life threatening disease, who were successfully managed are presented. Mortality rates between 17-45 percent have been reported for this disease, but through the use of broad-spectrum antibiotics, aggressive surgical debridement and when possible with multiple drainage incisions to avoid skin defects, the mortality rate has been reduced to 0 percent. We have found an association with diabetes mellitus in 2 cases, which is one of the serious predisposition factors and should not be forgotten. PMID- 3273600 TI - [Susceptibility of Vibrio cholerae El-Tor strains to various antibiotics]. AB - In this study, the in-vitro activity of ampicillin, chloramphenicol, oxytetracycline, trimethoprim-sulfamethoxazole (TMP-SMX), cefoperazone, ceftriaxone, cefotaxime, ceftizoxime, ofloxacin, pefloxacin, ciprofloxacin, and fleroxacin against clinically isolated strains of V. cholerae biotype El-Tor have been investigated. The minimum inhibitory concentrations (MICs) were determined using the microtube dilution technique except for TMP-SMX which was tested by agar dilution technique. All of El-Tor strains tested have been found to be susceptible to all the antibiotics used in this study. The antimicrobial therapy proposals on cholera in adults reviewed. PMID- 3273601 TI - [The importance of tetracycline treatment of cervical Chlamydia trachomatis infections: control with cervical smears]. AB - Cervical Chlamydia trachomatis infection is extremely common, crucial and sexually transmitted disease. In order to prevent from this disease an effective treatment is necessary. Tetracycline is an effective antimicrobial medicine for treatment of cervical Chlamydia trachomatis infection. In our study, after we had established the diagnosis of Chlamydia trachomatis on the patient's cervical smear, Tetracycline was used for treatment. In control smear after treatment. Chlamydial intracytoplasmic inclusion bodies and atypical cellular changes which we observed in the first smear were not seen. PMID- 3273602 TI - [Fulminant meningococcemia]. AB - Fulminant meningococcemia is a rare clinical form of meningococcal disease which has been frequently fatal. In this case report, two patients with fulminant meningococcemia which have been cured completely were presented and the related literature was examined. PMID- 3273603 TI - [Immediate and delayed skin reactions against ten groups of antigens in 355 patients with urticaria and angioneurotic edema]. AB - Immediate and delayed skin reactions against ten group of allergens were investigated in 355 patients with urticaria and angioneurotic edema. The wheal and flare reaction were characteristic of the type I-IgE mediated hypersensitivity reaction in human skin. This reaction develops rapidly after injection of antigen, peaking 10-30 minutes, and then subsides within a few hours. However, careful observation for longer periods, has shown that in many instances a late inflammatory response also appears at the same site and is quite different in appearance from the initial reaction. In this study, we have investigated in immediate and also delayed-phase skin reactivity, incidence of the patients. PMID- 3273604 TI - [Influence of the age of Veronicellid slugs in Angiostrongylus costaricensis infection]. AB - In Costa Rica, Veronicellid slugs are the most important intermediate hosts for Angiostrongylus costaricensis. Apparently, these molluscs develop a resistant mechanism after being exposed to the infection. In naturally infected slugs, the higher infection rates were found in large slugs, but they usually bear few larvae. Large number of larvae were found in medium sized molluscs. Experimental infection in laboratory breed slugs produced an amebocytic reaction around developing larvae; later, the formation of a fibrotic capsule is observed. When there is a second infection, cell reaction is stronger and the larvae show degenerative signs. This cell-mediated resistant mechanism seems to explain why the biggest molluscs, although more probably exposed to infection, bear fewer larvae. PMID- 3273606 TI - Anticoagulant effect of myotoxic phospholipase A2 isolated from the venom of the snake Bothrops asper (Viperidae). PMID- 3273605 TI - [Human aldehyde dehydrogenase in a sample of the Costa Rican population]. AB - This is an electrophoretic study of ALDH isozymes in post-mortem tissue extracts. Three different electrophoretic variants of the isozyme ALDH3 were found in the 100 individuals examined. One liver sample showed lack of ALDH1 activity, but it remains unknown whether this is due to genetic mechanisms. The other two isozymes -ALDH2 and ALDH4--did not show any variations. PMID- 3273607 TI - The intermediate host of Angiostrongylus costaricensis in Honduras. PMID- 3273608 TI - 5th International Symposium on Pertussis. September 22-23, 1988, Copenhagen, Denmark. Proceedings. PMID- 3273609 TI - Epidemiology of pertussis in Japan. PMID- 3273610 TI - Age at pertussis immunization as it relates to current epidemiology and disease control. AB - Decisions about vaccine use involve the risks of disease, efficacy of the vaccine, and adverse events associated with the vaccine. The goal is to provide protection at the earliest possible age. Available data suggest that even very young infants develop a protective response to a multi-dose series of pertussis vaccine. There are not conclusive data to indicate that true reactions to pertussis vaccine are age-related. The approach in the United States has been to recommend pertussis vaccination early in infancy, usually giving pertussis vaccine in combination with tetanus and diphtheria toxoids as DTP at 2, 4 and 6 months of age with a fourth dose at 15-18 months and a booster dose at 4-6 years just prior to school entry. In recent years, concern about adverse effects possibly caused by pertussis vaccine have led to suggestions that the administration of DTP be delayed by varying periods. To estimate the effects of a 6-month delay in the primary vaccination series, we conducted a decision analysis, following two hypothetical cohorts of 3.7 million children each from birth to their fourth birthday. One cohort was vaccinated at 2, 4, 6 and 18 months of age (the current schedule) whereas the other cohort was vaccinated at 8, 10, 12 and 18 months of age (the proposed schedule). Under base case conditions, assuming no change in adverse events attributable to DTP, a 6-month delay in initiating DTP vaccination would result in 636 more reported cases of pertussis, many with complications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3273611 TI - Outbreaks of pertussis in the United States: the Wisconsin experience. AB - To identify risk factors for pertussis in older age groups and to examine the effectiveness of erythromycin therapy and prophylaxis in reducing secondary spread, epidemiologic investigations of two outbreaks involving teenagers and adults were conducted. The first outbreak occurred in 1984 among residents of a facility for developmentally disabled persons (median age 17 years). Rates of culture-and/or serologically confirmed infection ranged from 6% to 91% in exposed wards (42% overall), with transmission continuing over a five-month period. Although residents age 10-19 years experienced the highest rates of infection, they were also more likely to be exposed compared with residents in other age groups. Infection rates were significantly lower on wards where erythromycin treatment and prophylaxis were initiated less than 2 weeks after onset of illness in the index case (overall attack rate = 16% vs. 75% in wards where more than 4 weeks had elapsed; p less than .0001). Early treatment with erythromycin was also effective in reducing pertussis severity. The second outbreak occurred over a six month period among residents of a 3-county area in central Wisconsin in 1985, with adults accounting for 38% of 161 culture-positive cases. Exposure outside the home was the most important predictor of community-acquired infection (p less than .001), with adolescents being at higher risk than persons in other age groups (odds ratio 3.2; p less than .001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3273612 TI - An ongoing surveillance study of persistent crying and hypotonic-hyporesponsive episodes following routine DTP immunization: a preliminary report. AB - Hypotonic-hyporesponsive episodes and persistent crying are specific complications of pertussis immunization. Hyperinsulinemia, hypoglycemia, and leukocytosis have been noted after pertussis vaccine administration in a murine model. Five children with hypotonic-hyporesponsive episodes and 6 children with persistent crying following DTP immunization were studied. The children were found to have leukocytosis acutely, similar to findings reported in children following routine DTP immunization. No abnormalities were noted in plasma insulin or serum glucose. Five of 6 children with persistent crying had severe local reactions, suggesting that localized inflammation may be a cause of persistent crying. PMID- 3273613 TI - Relationship of pertussis immunization to the onset of epilepsy, febrile convulsions and central nervous system infections: a retrospective epidemiologic study. AB - A change in the pertussis immunization schedule in Denmark allowed a retrospective study examining the relationship of the time of onset of selected neurologic disorders with the time of pertussis immunization in two core cohorts of children. Records of 2,199 children with febrile seizures were reviewed and a significant association between first febrile seizures and the scheduled age of pertussis immunization was noted (p = 0.004). The occurrence of epilepsy and CNS infections did not appear to be related to the time of pertussis immunization. PMID- 3273614 TI - Severe neurological illness: further analyses of the British National Childhood Encephalopathy Study. PMID- 3273615 TI - Reports on cases of neurological illnesses occurring after administration of acellular pertussis vaccines in Japan. PMID- 3273616 TI - Structure and functions of the Bordetella tracheal cytotoxin. AB - Of the various toxins and virulence-related factors produced by Bordetella pertussis, only one has been demonstrated to reproduce the specific respiratory epithelial cytopathology characteristic of the pertussis syndrome. That molecule is tracheal cytotoxin (TCT), which is released by B. pertussis during log phase growth. An HPLC-based method has allowed us to purify TCT from culture supernatants, resulting in a preparation with undetectable levels of endotoxin and which is homogeneous by all analytical criteria, including fast atom bombardment-mass spectrometry (FAB-MS). Exposure to purified TCT specifically damages ciliated epithelial cells, causing ciliostasis and extrusion of these cells. Other species of Bordetella, which generate remarkably similar respiratory tract infections and ciliated cell-specific pathology, produce a chemically identical TCT. Compositional analysis and FAB-MS have unambiguously defined the structure of TCT as N-acetylglucosaminyl-1, 6-anhydro-N-acetylmuramylalanyl-gamma glutamyl-diaminopimelylalanine+ ++. This particular disaccharide-tetrapeptide composition and arrangement reveals that TCT is apparently formed by cleavage of peptidoglycan. Unlike other gram-negative bacteria, however, B. pertussis seems to be very selective in its release of cell wall fragments: greater than 95% of soluble peptidoglycan in culture supernatants is TCT. The structure of TCT places it in the "muramyl peptide" family, a group of structurally related molecules that are responsible for a diverse array of biological activities. Neisseria gonorrhoeae also releases muramyl peptides (one of which is identical to TCT) that can cause ciliated cell-specific damage like that seen during gonococcal infection of fallopian tube mucosa. In addition, TCT is absolutely identical in structure to FSu, a potent sleep-promoting factor isolated from humans.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3273617 TI - Mechanism of action of Bordetella heat-labile toxin on vascular smooth muscle strips and cells. AB - The mechanism of action of Bordetella heat-labile toxin (HLT) was analyzed in vitro using vascular smooth muscle strips (VSMS) and cultured cells (VSMC), from aortas of pig, guinea pig, rabbit, rat or mouse. HLT induced contractions to both VSMS and VSMC, but not other types of tissues and cells. HLT induced the increase of Ca2(+)-influx in parallel with the contraction. These HLT activities were not influenced by the addition of verapamil, diltiazem, or TMB-8, though a certain extension of the lag period was seen. The contractile action on VSMC was not influenced by a various blockers of cascades or systems. The HLT-induced contraction in VSMC was completely inhibited by H-7, but not by H-8. HLT did not induce specific activation of the protein kinases in VSMC. HLT induced the permeability changes in VSMS or VSMC membranes to cyclic nucleotides or trypan blue. Both HLT-induced contraction and permeability change were inhibited by dextran of M.W. 8,000. 125I-HLT bound immediately to VSMC depending on the HLT dose. At 37 degrees C, the binding ratio in maximum was approximately 0.8% of total HLT added at 60 min after exposure. At 4 degrees C, it was less than 20% of that at 37 degrees C. The labeled HLT binding to VSMC was released readily by washing. From these results, possible mechanism of HLT action was discussed. PMID- 3273618 TI - Overview of currently available Japanese acellular pertussis vaccines and future problems. AB - Acellular pertussis diphtheria, tetanus vaccine (APDT) was licensed in 1981 in Japan. This vaccine contains pertussis toxin (PT), filamentous hemagglutinin (FHA) and agglutinogen (AGG) as the main protective antigens. The new APDT vaccine produced by each company differs slightly in composition. There are two representative types of vaccine. One vaccine (B type) contains PT and FHA in a ratio of 1 to 1 and the other one (T type) contains PT and FHA in a ratio of 4 to 1 or 9 to 1 and also contains different amounts of AGG. We have been comparing the effectiveness of these two types of vaccine. The adverse reactions of APDT were local reactions such as redness and swelling, with a few febrile cases. No central nervous system adverse reactions were observed. The antibody protective level of this vaccine is also being investigated. After we changed from conventional vaccine to APDT, the frequency of serious adverse reactions was reduced and the number of pertussis infections also gradually decreased. This vaccine should be used for the children world-wide. PMID- 3273619 TI - Efficacy of acellular pertussis vaccine in Japan--comparison of two areas, one area where immunization started at 6 months and the other area at over 2 years of age--Regional Surveillance Committee on Tuberculosis and Infectious Diseases of Osaka. AB - In the Osaka area, a very satisfactory surveillance system of infectious diseases has been achieved with the establishment of a weekly facsimile network, and computer aided graphics and feedback system. A mathematical formula has been devised for calculating the number of reported cases in exactly 100,000 of the population using the constant reported number of cases of exanthema subitum every week. With this method, we compared the incidence of pertussis patients in two areas, one where acellular pertussis vaccine is given to children after 6 months of age and the other where it is given at more than 2 years of age. The former area has the one fifth the incidence of pertussis patients of the latter. PMID- 3273620 TI - Pertussis and pertussis vaccine in the developing world. PMID- 3273621 TI - Pertussis vaccine acceptance rates and incidence of pertussis in forty seven districts (prefectures) in Japan since 1977. PMID- 3273622 TI - Pertussis and pertussis vaccine in the industrialized world. PMID- 3273623 TI - The current epidemiology of pertussis in the developed world: UK and West Germany. AB - The existence of well established national reporting systems for monitoring pertussis incidence and vaccine uptake in the United Kingdom has allowed the epidemiology of whooping cough and the impact of vaccination to be studied in detail. The increase in pertussis morbidity that followed the decline in vaccine uptake in recent years confirms the continuing need for mass vaccination in a developed country. There is also evidence that pertussis may be responsible for many more deaths than official mortality statistics show. A national study of vaccine efficacy demonstrated over 80% protection against clinical disease during the first 5 years after vaccination. However, there is evidence that the current whole cell vaccine may protect less well against infection with agglutinogen serotype 3 than type 2 organisms which supports the view that both these antigens should be included in acellular vaccines to achieve good protection. In West Germany, unlike the UK, there are no national statistics on pertussis incidence, no national vaccination policy and no figures for vaccine uptake. Local studies have shown that vaccination rates are low and that pertussis is prevalent, particularly in the 2-4 year age-group, which is typical of a country with low uptake; similarly serotype 2 predominates. PMID- 3273624 TI - Effects of anabolic-androgenic steroids on hair waves in castrated mice. AB - The effects of nandrolone phenylpropionate and decanoate, androstanolone and testosterone propionate, in daily doses from 3 to 100 micrograms during a month, on the diffuse hair wave seen after gonadectomy, were studied in male C 57 mice. The androgenic effects upon anterior prostate weight and the anabolic effects upon levator ani muscle and submaxillary gland weight, were also evaluated. The four steroid compounds used in these experiments had a strong inhibitory effect upon the hair growth waves which was stronger in the anabolic steroids than with testosterone propionate. PMID- 3273625 TI - Atropine enhancement of aldosterone induced renal sodium reabsorption in dogs. AB - The aim of the present study was to investigate the effect of atropine on renal tubular membranes, as we suggested in a previous work. Mongrel dogs were anesthetized and i.v. infused with isotonic NaCl solutions. Ureters were catheterized and urine samples collected every 10 minutes. Different groups of dogs received single i.v. doses of aldosterone (2 and 4 ug/kg body wt); atropine (1 ug/kg body wt); atropine prior to the low dose of aldosterone; and saline solution (1 ml). The administration of atropine prior to the low dose of aldosterone enhanced the antinatriuretic effect of the latter and furthermore produced an anticipation in time for the effect. The results obtained seem compatible with an atropine effect producing changes in the tubular membranes modifying its permeability or transport capacity. PMID- 3273626 TI - Effect of triiodothyronine in the regulation of haem biosynthetic pathway. AB - Triiodothyronine administration to thyroidectomized animals, decreased cytochrome P-450 content by 50%. Haem oxygenase was not modified by triiodothyronine treatment, either alone or with a suboptimal dose of CoCl2. Under the same conditions hepatic delta-amino-laevulinic acid synthase activity was not affected. Triiodothyronine caused a two fold increase in tryptophan pyrrolase activity. Both the hole and total enzyme were increased to the same degree. Porphobilinogen deaminase-Uroporphyrinogen III Co-synthase activity was induced by 67% over thyroidectomized values, in triiodothyronine treated rats, and only 32% above the sham operated controls. Our results suggest that under triiodothyronine stimulation, the decrease in cytochrome P-450 content is not due to an enhanced rate of degradation of the haem moiety, but it rather dissociates to increase the cellular haem pool, and saturates in part the newly synthesized apotryptophan pyrrolase. PMID- 3273627 TI - A simple method for concentrating erythropoietin activity in plasma and in other body fluids. AB - The method here described is based on the property of erythropoietin to remain in water solution in the presence of up to 60% ethanol. More than 90% of inert proteins precipitate in the process and can be eliminated without significant loss of the activity. The addition of sulfuric ether produces the separation of the water phase and of its solutes which can be recovered in the solid material obtained by lyophilization. Using this method a marked erythropoietin activity can be demonstrated in extracts of the plasma from mice with a moderate reduction of the hematocrit. PMID- 3273628 TI - [Theoretical discussion on stress and its projection to pathology]. AB - The stress is presented in the perspective of an automatic response related to hereditary behavior, where the threat played the role of a a basic stressor. Thus only offensive or disagreeable agents are accepted as stressors, a point of theoretical important implications. The demonstration that only the inescapable chronic stressor produces immunodepression enriched the transformation of a pathogenic factor into a pathological event by means of the repeated stress reaction. PMID- 3273630 TI - Nomenclature for liver anatomy and surgery. PMID- 3273629 TI - Influence of sympathetic denervation of the thyroid by superior cervical ganglionectomy on the growth processes in the gland in basal conditions and after hemithyroidectomy. AB - The aim of the present study has been to examine the effects of superior cervical ganglionectomy (SCGx) on the hypertrophic (thyroid lobe weight) and hyperplastic (thyroid mitotic activity) response of the rat thyroid gland in basal conditions or after hemithyroidectomy (hemiTx), both being assessed 14 days after the surgeries. It has been shown that: 1) Ipsilateral and/or bilateral SCGx brought about the growth (both hypertrophy and hyperplasia) of thyroid lobes in the animals with intact thyroid; the strongest hypertrophic reaction occurred after ipsilateral SCGx and the strongest hyperplastic response followed bilateral SCGx. 2) Unilateral SCGx, when performed ipsilaterally to the remaining thyroid lobe after hemiTx amplified the hypertrophic, but not hyperplastic response of this lobe. Both contralateral and bilateral SCGx had no effect on the hypertrophy of the remaining thyroid lobe. Unexpectedly, both bilateral and contralateral SCGx exerted the suppressive effect on the hyperplastic response of the thyroid lobe following hemiTx. These results indicate that the sympathetic innervation plays an important role in the control of thyroid growth of intact animals and/or after hemiTx. PMID- 3273631 TI - Changes in the blood biochemistry following experimental flap ischaemia. AB - The purpose of this study was to elucidate tissue changes occurring within an ischaemic flap by monitoring the blood biochemistry, and to evaluate these changes in relation to ultimate flap viability. A rabbit epigastric free flap was made ischaemic for 4 days at 6 degrees C, then revascularized by anastomosis of its femoral artery and vein. An identical free flap immediately revascularized in another group of rabbits served as a control. The viability of the free flap, as well as various biochemical parameters studied by drawing blood from a catheter in the ear vein, were observed daily. Immediately after the revascularization of ischaemic flaps, there was a 16-fold increase in the plasma levels of creatine kinase (CK) and a smaller but significant 1.5-fold to 2.0-fold increase in lactate dehydrogenase (LDH) and aspartate aminotransferase (AST). In flaps which ultimately failed by 7 days post-ischaemia, the plasma levels of CK, LDH and AST peaked at day 2 post-ischaemia at 68, 13 and 8 times normal respectively, whereas in flaps which survived, the levels of these enzymes recovered to normal by day 3 post-ischaemia. These enzymic changes are probably due to a combination of ischaemic changes in the flap vasculature, ischaemic changes in the flap muscle, and inflammatory changes in the surrounding abdominal tissue. The plasma levels of CK at any time post-ischaemia, and particularly in the first 24 h, were significantly higher in ischaemic flaps which failed compared with those which survived. This parameter is therefore proposed as a possible means of predicting potential flap failure after ischaemic insult, in time to make appropriate surgical intervention. PMID- 3273632 TI - Large-scale isolation of plasmid DNA using high speed centrifugation methods. PMID- 3273633 TI - A procedure for electro-elution of DNA from agarose gels. AB - A simple device is described for efficient and reproducible electro-elution of DNA resolved in agarose gels. DNA (greater than 1 micrograms) is recovered with consistent yields of over 70% into preset elution volumes of 100 to 500 microliters. PMID- 3273634 TI - Decreasing the concentration of nonlimiting deoxynucleotides. PMID- 3273635 TI - Large-scale production of monoclonal antibodies. PMID- 3273636 TI - Electroporation of eukaryotes and prokaryotes: a general approach to the introduction of macromolecules into cells. PMID- 3273637 TI - A plasmid-based method to quantitate homologous recombination frequencies in gram negative bacteria. AB - A method is described which enables quantitative evaluation of the ability of gram-negative bacterial cells to perform homologous recombination between DNA molecules. This method is particularly useful in cases where the stringency of rec mutations is to be determined. The procedure is based on a wide-host-range vector (pRK404) in which two unequally truncated and overlapping fragments of the neo gene were cloned. When introduced into gram-negative bacteria either by transformation or by conjugation, molecules of this plasmid, pBX404-7, undergo unequal crossing-over leading to the restoration of a functional neo gene. The stringency of putative rec mutations can thus be determined by measuring the frequency at which kanamycin-resistant colonies appear in bacterial strains harboring pBX404-7. PMID- 3273638 TI - Large-scale production of murine monoclonal antibodies using hollow fiber bioreactors. AB - We have produced large quantities of murine monoclonal antibodies for in vivo human clinical trials using hollow fiber bioreactors (HFBRs). Thirty-three different hybridoma cell lines have been evaluated in various HFBR systems. Monoclonal antibody (Ab) productivity is highly dependent on the intrinsic secretory rate of each cell line. Other factors that affect Ab production include capillary membrane molecular weight cutoff, and HFBR design. Studies comparing HFBRs to static and suspension culture systems revealed similar Ab productivity. An advantage of the HFBR is that the Ab is concentrated in the extracapillary space, simplifying downstream processing. PMID- 3273639 TI - Derivatization of controlled pore glass beads for solid phase oligonucleotide synthesis. AB - An improved and simplified procedure for the attachment of nucleosides onto long chain alkylamine controlled pore glass beads (LCAA-CPG) is presented. This procedure uses 1-(3-dimethylamino-propyl)-3-ethylcarbodiimide (DEC) to couple nucleoside 3'-succinates directly to the LCAA-CPG. The preparation of nucleoside 3'-succinate anhydrides, p-nitrophenyl, or pentachlorophenyl esters and the use of highly toxic dicyclohexylcarbodiimide (DCC) is no longer required. Procedures involving acidic activation of the LCAA-CPG before derivatization and a pre synthesis capping are also described, which prevent the formation of oligonucleotides linked by 3'-phosphates to the LCAA-CPG. Evidence is presented indicating that this type of linkage is responsible for the apparently greater than 100% coupling yields observed for the first coupling cycle. PMID- 3273640 TI - Automation of dideoxynucleotide DNA sequencing reactions using a robotic workstation. AB - We report here a system for automation of the dideoxynucleotide DNA sequencing method. The system consists of a Beckman Biomek 1000 robotic workstation which has been modified by the addition of a thin heater/cooler block directly on the instrument table. The heater/cooler block, which is regulated by a user-specified program integrated into the Biomek software, facilitates the use of both single- and double-stranded DNA sequencing procedures. Using this system, we are able to perform 24 sets of dideoxynucleotide DNA sequencing reactions in approximately 45 min. The reactions are performed in 96-well microtiter plates, using a prepared reagent pack which includes primer, enzyme, nucleotide mixes and radioactive label. Using standard gel electrophoresis technology, we are able to resolve over 500 nucleotides per sequencing reaction in about 5 h. Currently, we are able to perform three runs of 24 samples each, with subsequent gel analysis per 8-h period. Excluding autoradiography, this represents a daily data output of 36,000 base pairs. PMID- 3273642 TI - [Various technics that affect the fracture resistance of ceramo-metal parts]. PMID- 3273641 TI - [Prosthetic and endodontic treatment of a patient with tooth discoloration from tetracycline]. PMID- 3273643 TI - [Management of a clinical case of impacted canine, crown fracture of a deciduous tooth, and posterior fixed prosthesis connection]. PMID- 3273644 TI - [Oral rehabilitation of a patient with periodontal disease]. PMID- 3273645 TI - [Concept of quality]. PMID- 3273647 TI - [Cosmetic dentistry]. PMID- 3273646 TI - [Insertion procedures for complete dentures]. PMID- 3273648 TI - [Compressed air in the dental laboratory]. PMID- 3273650 TI - Biotechnology and comparative medicine. PMID- 3273649 TI - [Evaluation of new materials for laminate veneers: the "GC Cosmotech" System]. PMID- 3273651 TI - A design approach to the structural analysis of interleukin-2. AB - A semi-synthetic protein design approach has been employed for the structural investigation of a putative helical region at the C-terminus of Interleukin-2. With crystallographic or NMR derived conformational data as yet unavailable, we have relied only on primary sequence information and computer-assisted modelling to direct the analysis. By employing both chemical peptide synthesis and recombinant DNA methods, the C-terminus of IL-2 was modified according to a strategy designed to stabilize helical secondary structure. A semi-synthetic protein incorporating 12 simultaneous amino acid replacements was constructed, which possessed potentiated biological activity and displayed a far UV circular dichroism spectrum comparable to a hybrid protein with the authentic sequence. By comparison, another hybrid protein containing a C-terminal region designed to contain helix breaking residues was totally devoid of bioactivity. These findings provide evidence that the modelling method correctly identified a helix necessary for the formation of a bioactive tertiary fold. Moreover, by employing semi synthesis it was possible to circumvent the difficulties associated with the preparation, purification and analysis of multiple recombinant proteins, and also to avoid the unreliability of total chemical synthesis for proteins greater than 100 residues. PMID- 3273652 TI - Theoretical analysis of compartmented coupling in linear enzyme systems. AB - Exact equations which describe the kinetic patterns of enzyme/enzyme complexes, when compartmented coupling occurs between them, are presented. Compartmented coupling refers to the creation of a local environment in which the concentration of an intermediate, shared by two enzymes, is higher than its solution concentration. This results in a higher coupling enzyme activity, a condition reflected in a shorter transition time for the system. In this paper, equations are presented which allow experimenters to quantitate the effect of compartmented coupling in terms of changes in the apparent Km and Vmax values. The equations presented in this paper are more exact than those previously derived since they do not incorporate first order assumptions before derivation. PMID- 3273653 TI - Analysis and use of the serum albumin binding domains of streptococcal protein G. AB - Streptococcal protein G is an IgG-binding receptor with a molecular weight of 63 kDa as predicted from the sequence of the corresponding gene. Here we show that a truncated recombinant protein of 23 kDa still has IgG-binding capacity and also interacts specifically with human serum albumin (HSA). This demonstrates that protein G is a bifunctional receptor. To investigate the structures needed for IgG- and albumin-binding, different parts of the receptor molecule were produced in E. coli using a coupled expression/secretion system. Affinity chromatography, using IgG or HSA immobilized on Sepharose, showed that the two binding activities are structurally separated. From these experiments, it was concluded that a region of 64 amino acid residues is sufficient for albumin-binding. The structure of this part of the protein suggests either a divalent or a trivalent binding capacity. The specific interaction to albumin was used to purify a heterologous protein by affinity chromatography to yield a pure fusion protein in a one-step procedure. The implication of this novel affinity system as a tool to facilitate protein immobilization and purification is discussed. PMID- 3273654 TI - The design and synthesis of mimetics of peptide beta-turns. AB - The synthesis of an 11 membered ring bis-lactam, a system which is designed as a conformationally restricted mimetic of type I and type II beta-turns is described. Computer assisted molecular modeling was used to compare the predicted low energy conformers of the turn mimetic with idealized type I and type II turn structures. Initial computational analysis indicates that the basic ring structure will provide an excellent foundation for the development of a varieity of beta-turn mimetics. PMID- 3273655 TI - Estrogen receptor interaction with immobilized metals: differential molecular recognition of Zn2+, Cu2+ and Ni2+ and separation of receptor isoforms. AB - We have utilized iminodiacetate (IDA) gels with immobilized Zn2+, Cu2+ and Ni2+ ions to evaluate the metal binding properties of uterine estrogen receptor proteins. Soluble (cytosol) receptors labeled with [3H]estradiol were analyzed by immobilized metal affinity chromatography (IMAC) before as well as after (1) 3 M urea-induced transformation to the DNA-binding form, and (2) limited trypsin digestion to separate the steroid- and DNA-binding domains. Imidazole (2-200 mM) affinity elution and pH-dependent (pH 7-3.6) elution techniques were both evaluated and found to resolve several receptor isoforms differentially in both the presence and absence of 3 M urea. Individual receptor forms exhibited various affinities for immobilized Zn2+, Cu2+ and Ni2+ ions, but all intact receptor forms were strongly adsorbed to each of the immobilized metals (Ni2+ greater than Cu2+ much greater than Zn2+) at neutral pH. Generally, similar results were obtained with IDA-Cu2+ and IDA-Ni2+ in the absence of urea. Receptors were tightly bound and not eluted before 100 mM imidazole or pH 3.6. Different results were obtained using IDA-Zn2+; at least four receptor isoforms were resolved on IDA-Zn2+. Receptor-metal interaction heterogeneity and affinity for IDA-Zn2+ and IDA-Cu2+, but not IDA-Ni2+, were substantially decreased in the presence of 3 M urea. The receptor isoforms identified and separated by IDA-Zn2+ chromatography were not separable using high-performance size-exclusion chromatography, density gradient centrifugation, chromatofocusing or DNA-affinity chromatography. The affinity of trypsin-generated (mero)receptor forms for each of the immobilized metals was decreased relative to that of intact receptor. High-affinity metal binding sites were mapped to the DNA-binding domain, but at least one of the metal-binding sites is located on the steroid-binding domain. Recovery of all receptor forms from the immobilized metal ion columns was routinely above 90%. These results demonstrate the differential utility of various immobilized metals to characterize and separate individual receptor isoforms and domain structures. Receptor-metal interactions warrant further investigation to establish their effects on receptor structure/function relationships. In addition to the biological implications, recognition of estrogen receptor proteins as metal binding proteins suggests new and potentially powerful receptor immobilization and purification regimes previously unexplored by those in this field. PMID- 3273657 TI - [Studies on the application of restrained selection in wheat breeding]. PMID- 3273656 TI - Anhydroelastase: enhanced affinity toward product-type ligands revealed by affinity chromatography. AB - Anhydroelastase was effectively isolated by a single operation of affinity chromatography from a complex mixture produced by phenylmethylsulfonylation and alkaline treatment of porcine pancreatic elastase. The adsorbent used for the chromatography was 6-aminohexanoyl-trialanine, which corresponds to a product of elastase action, immobilized on Sepharose 4B. Successful resolution by the operation indicated that this immobilized ligand possesses the highest affinity for anhydroelastase among various proteins including regenerated elastase in the mixture. Comparative affinity chromatography on immobilized anhydroelastase and on immobilized native elastase further confirmed the stronger interaction of anhydroelastase with the product-type peptides. Immobilized anhydroelastase was also found to be useful in the purification and search for naturally occurring proteinase inhibitors. PMID- 3273658 TI - [Purification of HMGs and HP1 from Beijing duck and their effects on nuclei transcription activity in vitro]. PMID- 3273659 TI - [The determination of the 5' terminal site of 18S rRNA gene using S1 mapping]. PMID- 3273660 TI - [Study on LDH isoenzymes of hybrid yue-carp and its parents]. PMID- 3273661 TI - [Use of synthetic oligonucleotides in the detection of beta-thalassemia mutation in Chinese]. PMID- 3273662 TI - [Study on homology between two kinds of human thymidine kinase gene by Southern blot analysis]. PMID- 3273663 TI - [Isolation and characterization of the antifreeze polypeptide messenger RNA from the shorthorn sculpin]. PMID- 3273664 TI - [Changes in patterns of protein synthesis during retinoic acid induced differentiation of F9-1 embryonal carcinoma cells]. PMID- 3273665 TI - [Variations during developmental process of AchE isoenzyme in susceptible strain and dipterex-resistant strain of the Culex pipiens pallens Coq]. PMID- 3273666 TI - [The genetic polymorphism of serum cholinesterase in Yi, Tibetan and Hani ethnic groups of China]. PMID- 3273667 TI - [A further study on the relationship between the HLA and longevity or aging]. PMID- 3273668 TI - [The theory of general selection index]. PMID- 3273669 TI - [Effects of cadmium on spermatogenic cells of male mice]. PMID- 3273670 TI - [Analysis of synaptonemal complexes in spermatocytes of the hybrid F1 between red deer and sika deer]. PMID- 3273671 TI - [Study on the plasmids of thermophilic Streptomyces]. PMID- 3273672 TI - [A new method on in situ nick-translation of human metaphase chromosomes]. PMID- 3273673 TI - [Prevalence and mode of inheritance of major genetic eye diseases in China]. PMID- 3273674 TI - [Comparative studies on synaptonemal complexes in spermatocytes of Chinese muntjac Muntiacus reevesi, black muntjac M. crinifrons and Indian muntjac M. muntjak]. PMID- 3273675 TI - [An electrophoretic comparison (Sds-page) of the serum protein in 8 species of animals]. PMID- 3273676 TI - [Mode of inheritance of congenital deaf-mutism]. PMID- 3273677 TI - [A genetic difference model of the population with selection, mutation and migration]. PMID- 3273678 TI - [Synaptonemal complex karyotyping of silk worm (Bombyx mori)]. PMID- 3273680 TI - [Effect of negative ions on spontaneous and cyclophosphamide-induced micronucleus frequency in mouse bone marrow polychromatophilic erythroblasts]. PMID- 3273679 TI - [Studies on chromosome ultrastructure in several animal species]. PMID- 3273681 TI - [Synthesis and cloning of lengthy cDNA segments of 3'-poly(A)-RNA virus]. PMID- 3273682 TI - [Photometric scanning of area and relative content of DNA in human metaphase chromosome with a microscope photometer]. PMID- 3273683 TI - [Genetic analysis of two families with van der Woude's syndrome (lip pits, cleft palate, and cleft lip syndrome)]. PMID- 3273684 TI - [Reciprocal circulant plan for animal cross]. PMID- 3273685 TI - [Comparative studies on renaturation kinetics of Alligator sinensis and Alligator mississippiensis and their organization of the genomes]. PMID- 3273686 TI - [Genetic polymorphism of complement component C6 in four Chinese populations in Guangdong province: three new variants]. PMID- 3273687 TI - [A kindred of metaphyseal chondrodysplasia, Schmid type]. PMID- 3273688 TI - [Screening and identification of HLA homozygous cells in Chinese population]. PMID- 3273689 TI - [Heat generated by light curing composite system]. PMID- 3273690 TI - Risk factor of hepatitis B virus infection in dental students. PMID- 3273691 TI - [Silver cone caused a chronic urticaria: a case report]. PMID- 3273692 TI - [Lymph node of head and neck]. PMID- 3273693 TI - Histologic study on the incudomalleal joint in the mouse. PMID- 3273694 TI - A morphological study on the craniofacial complex and dental arch of Chinese children with primary dentition. PMID- 3273695 TI - Periodontitis. An infection to be treated like an infection. PMID- 3273697 TI - How to sue your lawyer. Errors and omissions. PMID- 3273696 TI - The effect of two fluoride tooth pastes on dentinal sensitivity. A clinical evaluation. PMID- 3273698 TI - [Gingival hyperplasia produced by an antianginal drug (Nifedipine)]. PMID- 3273699 TI - [Swallowing of dentures]. AB - The problem of swallowing of dental prosthetic works is introduced. Kinds of prostheses found are listed and causes and circumstances of its swallowing are mentioned, as well as the consequences. Emphasis upon prevention of such a situation is made and some preventive measure are proposed. PMID- 3273700 TI - [Fluoride varnishes]. PMID- 3273702 TI - [Radectomy]. PMID- 3273701 TI - [Porcelain veneers. An alternative cosmetic solution]. PMID- 3273703 TI - [Chronic orofacial pain produced by bruxism and the use of therapy and counseling]. PMID- 3273704 TI - [Chronology of permanent tooth eruption in Argentinian children]. AB - The knowledge of the ages at which individual teeth emerge in a given ethnic group is essential for the planning of preventive measures and the treatment on malocclusion within a population. A number of factor such as sex, ethnic characteristics, etc, have been found to be related to emergence timing of the permanent teeth; however ages assessed in other countries cannot be used because of considerable variation from one country to another. This investigation was performed on a cross-sectional sample of 4735 randomly-selected caucasian and amerindian children from 10 geographic regions of Argentina, including the Federal District. Mean ages of eruption were computed using probit procedure. Mean times of emergence of the permanent (except third molars) showed practically no difference between the two ethnic groups. In both samples all teeth emerged earlier in girls. Since it seems that the mean time of emergence of the permanent teeth occurs at least one year before the commencement of schooling, preventive measures should be applied before that age. PMID- 3273705 TI - [Clinico-radiological changes in a repositioned young permanent central incisor]. PMID- 3273706 TI - [Apicoectomy in the posterior sector]. PMID- 3273708 TI - [Mortality trends from oropharyngeal cancer in Chile between 1980-1985]. PMID- 3273707 TI - [Temporary splinting]. PMID- 3273709 TI - [An easily constructed cassette holder]. PMID- 3273710 TI - [Pathology and treatment options in 32 cases of intra-dental resorption]. PMID- 3273711 TI - [Determination of active chloride content in different commercial brands of Dakin's solution]. PMID- 3273712 TI - [The influence of some restorative materials on calcium hydroxide cements]. PMID- 3273713 TI - [Comparative study of antimitotic and antiphlogistic properties of Imuran and of Imuran/Zyloric and Imuran/Dectancil combinations]. PMID- 3273715 TI - [Adaptation of amalgam in modified Class II cavities--manual vs. mechanical condensation]. PMID- 3273714 TI - [Radiographic study of mandibulofacial bone growth in white patients from the age of 5, using elipsopantomography]. PMID- 3273716 TI - [Determination of the terminal hinge axis with the T.T. and Di Pietro cinematic face bows]. PMID- 3273717 TI - [Effect of film storage temperature on radiographic density and contrast]. PMID- 3273718 TI - Surgical anatomy of the facial nerve and the parotid gland. PMID- 3273719 TI - Scanning electron microscopy of the pulp chamber walls in human deciduous upper incisor. PMID- 3273720 TI - [Ameloblastic fibrodontoma: report of a case]. PMID- 3273721 TI - [Chronic suppurative osteomyelitis of the maxilla: report of a case]. PMID- 3273722 TI - [Dental records and notation: general considerations]. PMID- 3273723 TI - [Bleaching of devitalized teeth: comparison of three technics]. PMID- 3273724 TI - [Effects of nonsteroidal anti-inflammatory drugs (indomethacin, phenylbutazone, sulindac, naproxen, benzydamine and neflumic acid) on rat leukograms with a chronic inflammatory process]. PMID- 3273725 TI - Correlation between clinical and chemical methods for the evaluation of dental plaque. PMID- 3273726 TI - [Comparative study of two technics for registration of centric relation]. PMID- 3273727 TI - [Measurement of anxiety in oral surgery patients]. PMID- 3273728 TI - ["In vitro" evaluation of number and time of permanence of absorbent paper points, and the effect of final aspiration on root canal drying]. PMID- 3273729 TI - [Pantomographic study of radiographic image magnification in Nisei and Sansei groups]. PMID- 3273730 TI - [Sexual dimorphism in linear analysis of the mandible using elipsopantomographic pantomograms]. PMID- 3273731 TI - [Radiographic interpretation of experimentally produced bone lesions in dry human mandible (1)]. PMID- 3273732 TI - [The sealing capacity of Sealapex cement alone or with iodoform]. PMID- 3273733 TI - [Color changes in composite resins. 1. The effect of coffee, tea and wine]. PMID- 3273734 TI - [Correlation between total length of permanent upper central incisors and their crowns and the height-width of the face in facial types of white Brazilians]. PMID- 3273735 TI - Sialotoxins: a family of toxic substances isolated from the submandibular glands of the male mice. PMID- 3273736 TI - [Color changes in some restorative lesions. 2. Smooth, rough and glazed surfaces]. PMID- 3273737 TI - [Prevalence of the loss of the eye. 1. Study of side, etiology and sex variables]. PMID- 3273739 TI - [Community and orthodontics. 1. A new focus]. PMID- 3273738 TI - [Control processes in postnatal growth of mandibular condyle cartilage]. PMID- 3273740 TI - [Sequence of dental eruption studied in primary children of E.G.B]. PMID- 3273741 TI - [Biometrics: orofacial analysis in orthodontics]. PMID- 3273742 TI - [Clinical suggestions. Fenestration of canines]. PMID- 3273743 TI - [Clinical guidelines after a diagnosis of dental agenesis]. PMID- 3273744 TI - [Application of the step by step multiple linear regression model to the problem of estimation of the mesiodistal width of unerupted canines and premolars]. PMID- 3273745 TI - [Needs and demands for composite resins in the posterior sector in metropolitan Caracas]. PMID- 3273746 TI - [Cultural, social and economic profiles of the Venezuelan and his oral health]. PMID- 3273747 TI - [Viral infections of dental interest]. PMID- 3273748 TI - [The ultrastructure of odontoblasts]. PMID- 3273749 TI - [Functions of the stomatognathic system and occlusopathics]. PMID- 3273750 TI - [Report of a clinical case: anterior crossbite]. PMID- 3273751 TI - Reflex sympathetic dystrophy syndrome in pregnancy. PMID- 3273752 TI - Water swallows versus food ingestion as manometric tests for esophageal dysfunction. AB - Data from 100 consecutive patients with chest pain or dysphagia, or both, who underwent esophageal testing with standard water swallows and upright food ingestion were retrospectively evaluated. In addition to having manometric patterns monitored, patients were asked to relate symptoms during testing. Of 77 patients with a history of dysphagia, significantly more had abnormal manometry during the test meal than with water swallows (79 vs. 43%, p less than 0.005). Additionally, dysphagia, although reported in only 8% of these patients during standard testing, occurred in 47% during the test meal (p less than 0.001). Of 60 patients with chest pain, symptoms were rarely reported (5%) with water or with food ingestion. We conclude that manometry with food ingestion should be used as a provocative test in anatomically normal patients with dysphagia. PMID- 3273753 TI - Occult biochemical pregnancy: fact or fiction? AB - Daily urine samples were obtained from 38 women of proven fertility, who were attempting to conceive, to assess the frequency of clinically unsuspected "biochemical pregnancies' on the basis of late luteal phase rises of hCG. In 25 clinically confirmed conception cycles, the earliest pregnancy-induced hCG rises from baseline occurred 8 days after the endocrinologically defined date of ovulation (mean 11.1 days, SD 1.3). Urine samples obtained throughout 50 non conception ovulatory cycles provided no evidence of any 'biochemical pregnancies' on the basis of late luteal phase rises of hCG occurring 8 or more days after the endocrinologically defined date of ovulation. If, as in previous studies, the date of ovulation had been estimated on the basis of menstrual cycle length and only the relatively non-specific NIH antiserum had been used in RIAs, 7 of the 50 (14%) cycles would have been classified as resulting in biochemical pregnancies on the basis of hCG greater than 50 m-i.u./ml on one occasion or greater than 20 m-i.u./ml on two or more occasions after day 20 of the cycle. These levels of 'hCG' occurred at or soon after ovulation and could be explained by LH cross reacting in the RIA. The rises of 'hCG' were not confirmed when the urine samples were retested with an antiserum (Wellcome 895) of very high specificity for hCG. These results raise the possibility that the frequency of clinically unsuspected 'biochemical pregnancy' may have been substantially overestimated. PMID- 3273754 TI - Is it necessary to put vinegar on the penis when looking for warts? PMID- 3273755 TI - Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. AB - Since 1983, we have conducted national surveillance of health care workers exposed to blood or body fluids from persons infected with the human immunodeficiency virus (HIV), to assess the risk of HIV transmission by such exposures. As of July 31, 1988, 1201 health care workers with blood exposures had been examined, including 751 nurses (63 percent), 164 physicians and medical students (14 percent), 134 laboratory workers (11 percent), and 90 phlebotomists (7 percent). The exposures resulted from needle-stick injuries (80 percent), cuts with sharp objects (8 percent), open-wound contamination (7 percent), and mucous membrane exposure (5 percent). We concluded that 37 percent of the exposures might have been prevented. Of 963 health care workers whose serum has been tested for HIV antibody at least 180 days after exposure, 4 were positive, yielding a seroprevalence rate of 0.42 percent (upper limit of 95 percent confidence interval, 0.95 percent). Three subjects experienced an acute retroviral syndrome associated with documented seroconversion; serum collected within 30 days of exposure was not available from the fourth person. Two exposures that resulted in seroconversion were caused by coworkers during resuscitation procedures. We conclude that the risk of HIV infection after exposure to the blood of a patient infected with HIV is low, but at least six months of follow-up is recommended. Many exposures can be prevented by careful adherence to existing infection control precautions, even during emergencies. PMID- 3273756 TI - Prospective comparison of double contrast barium enema plus flexible sigmoidoscopy v colonoscopy in rectal bleeding: barium enema v colonoscopy in rectal bleeding. AB - Rectal bleeding often heralds serious colonic disease. The literature suggests that colonoscopy is superior to barium enema plus sigmoidoscopy, although no good comparative studies exist. Seventy one patients with overt rectal bleeding had prospectively flexible sigmoidoscopy, double contrast barium enema and colonoscopy completed independently. Against the gold standard, the sensitivity and specificity of colonoscopy were 0.69 and 0.78 respectively for a spectrum of colonic lesions, while for combined flexible sigmoidoscopy and double contrast barium enema these values were 0.80 and 0.56, respectively. When assessing adenoma or carcinoma, colonoscopy was more sensitive at 0.82 v 0.73, while flexible sigmoidoscopy plus double contrast barium enema was superior for detecting diverticular disease. The positive predictive value for colonoscopy was 0.87 against 0.81 for flexible sigmoidoscopy and double contrast barium enema. This study confirms that colonoscopy should be a first line investigation in subjects likely to require biopsy or therapeutic intervention. PMID- 3273757 TI - Day-case cataract surgery. AB - The results of a series of 40 cataract extractions with lens implantation performed on day-case patients under local anaesthesia are reported. The ways in which modern surgical techniques have rendered this a safe procedure are described, and the potential benefits of day-case intraocular surgery are discussed. PMID- 3273758 TI - Attitudes, behaviour and infection control among Zambian dental personnel concerning HIV and BHV infections. PMID- 3273759 TI - Periodontal disease, dental caries and tooth loss in two Nigerian populations. PMID- 3273760 TI - Dental awareness among mothers attending MCH clinics in Bagamoyo District, Coast Region, Tanzania. PMID- 3273761 TI - Effect of tannic acid and aqueous extract of Nigerian chewing sticks on the acid base metabolism of salivary sediment and dental plaque. PMID- 3273762 TI - The prevalence of fractured permanent incisors in 13 to 15-year-old school children in Nairobi. PMID- 3273764 TI - Moving frontiers in veterinary immunology. PMID- 3273763 TI - Effects of prolonged storage on physical-mechanical properties of a chemically polymerizing restorative composite. PMID- 3273765 TI - Modes of spontaneous chromosomal mutation and karyotype evolution in ants with reference to the minimum interaction hypothesis. AB - Aspects of chromosomal mutation and karyotype evolution in ants are discussed with reference to recently accumulated karyological data, and to detailed karyotype analyses of several species or species complexes with low chromosome number and unusual chromosomal mutations (the complexes of Myrmecia pilosula (Smith) (n = 1, 5 or 9 to 16); M. piliventris Smith (n = 2, 3-4, 17 or 32), and Ponera scabra Wheeler (n = 3 or 4, 2n = 7 or 8). Translocations and Robertsonian polymorphisms are confirmed to be non-randomly distributed among ants -the former are found at high frequencies in species with low chromosome numbers (n less than or equal to 12), while the latter predominate in those with high numbers (n greater than 12). This situation is consistent with the minimum interaction hypothesis of Imai et al. (1986), under which translocations are expected to occur most frequently in low-numbered karyotypes, and that the resulting genetic risks are minimized by increases in chromosome and/or arm numbers through centric fission and pericentric inversion. Centric fusion is considered to be a transient event in karyotype evolution, resulting from telomere instability in acrocentric chromosomes. PMID- 3273766 TI - Silver-banded karyotypes of the rainbow trout and the brook trout and their hybrids: disappearance in allotriploids of Ag-NORs originated from the brook trout. AB - Silver-banded karyotypes of the rainbow trout Salmo gairdneri, the brook trout Salvelinus fontinalis, and their hybrids were described. Diploid-type and triploid-type hybrids were obtained. Triploid-type hybrids had two maternal genomes of the rainbow trout and one paternal genome of the brook trout. The rainbow trout had one pair of M or SM with Ag-NORs near the satellite. In the brook trout, Ag-NORs were observed in four pairs of chromosomes, but each cell had different number of chromosomes with Ag-NORs. In all observed cells of triploid-type hybrids, Ag-NORs originated from the brook trout were not recognized, whereas those from the rainbow trout were found. PMID- 3273767 TI - Metaphase chromosomes of four species of the Drosophila nasuta subgroup. AB - Metaphase chromosomes of four species of the Drosophila nasuta subgroup, D. nasuta, D. kepulauana, D. kohkoa, and D. neveifrons, were analysed by the C banding method to clarify the chromosomal differentiation during speciation. Four species were different in heterochromatic regions of their chromosomes, especially microchromosomes of the fourth chromosomes and the Y chromosomes. Intraspecific variations of heterochromatic regions were also found among isofemale lines from various localities of D. nasuta, D. kepulauana, and D. kohkoa. Intraspecific variations of heterochromatic regions were not different from interspecific variations morphologically. From these results, the evolutionary process of heterochromatic regions was discussed. PMID- 3273768 TI - Detection of H-2K mRNA in mouse 8-cell embryo by cDNA cloning. AB - Mouse MHC class I gene expression in 8-cell embryo was examined by cDNA cloning. We constructed a cDNA library from 8-cell embryos of ICR mice and isolated a class I cDNA from 3.0 x 10(5) phage clones of the library. Sequencing analysis of this clone revealed it to include the cDNA fragment extending from the exon 6 of the cytoplasmic portion to 3' untranslated region 1 of H-2K gene. Qa, Tla or other embryonic class I cDNA have not been isolated in the library. PMID- 3273769 TI - Tripeptide, Arg-Gly-Asp, inhibits the transfection of protein-linked DNA of bacteriophage M2. AB - The effect of tripeptide, Arg-Gly-Asp (RGD), on the transfection activity of Bacillus phage M2 DNA was examined. The transfection activity decreased when M2 DNA was preincubated with RGD before it was added to competent cells. PMID- 3273770 TI - [Extramedullary plasmacytoma. Amyotrophic lateral sclerosis]. PMID- 3273771 TI - [Forestier disease and dysphagia]. PMID- 3273772 TI - [Polymorphic reticulosis. Clinical cases]. PMID- 3273773 TI - [Study of a biological response modifier in the treatment of infections of the ORL region]. PMID- 3273775 TI - [Solitary plasmacytoma of the larynx. Presentation of a case]. PMID- 3273774 TI - [Clinical incidence of juvenile otosclerosis]. PMID- 3273776 TI - [Gingival abrasion and plaque removal with manual vs. electric toothbrushes]. AB - In a clinical study, the relative incidence of gingival injuries after standardized tooth brushing was tested by 22 volunteer dental assistants whose teeth were brushed with a soft multi-tufted toothbrush, a manual V-form toothbrush, and an electric toothbrush. At the beginning of the study, a dental hygienist cleaned the right or left side of the jaw of each subject with a manual V-form toothbrush or an electric toothbrush; the other side was manually cleaned with a multi-tufted toothbrush. At the second cleansing one week later, the same dental hygienist cleaned the side contralateral to that brushed in the first test week with the multi-tufted brush; the manual V-form brush was used instead of the electric toothbrush and vice versa. The number of new gingival lesions was recorded after each brushing. The cleansing effect was established by determining the amount of residual plaque. The subjects did not know which type of toothbrush was used to cleanse the evaluated side of the jaw. The results showed that the manual V-form toothbrush abraded the gingiva more than the electric toothbrush (p less than 0.005). A similar difference was found between the manual multi-tufted and the electric toothbrush (p less than 0.05). No significant differences could be established with respect to the plaque-removing properties of the three types of toothbrush tested. PMID- 3273777 TI - [Removability of tooth deposits by cleaning with toothbrushes and toothpaste]. AB - The abrasion strength of the exogenous pellicle (EP) was investigated in in vitro experiments on extracted human teeth. The aim of the study was to elucidate the effect of daily brushing on the EP. EP-coated tooth specimens were cleansed under in vivo-like conditions. Five toothpastes with different degrees of abrasiveness were variously diluted with artificial saliva. The evaluation was done on the transmission electron microscope. The individual toothpastes differed significantly with respect to their abrasive effect on EP, which extended from only a slight effect on EP, which extended from only a slight effect to extensive removal of the pellicle. EP abrasion was considerably reduced by increasing dilution of the pastes with artificial saliva. No changes of the EP could be observed after brushing with only the toothbrush and saliva. PMID- 3273778 TI - [Caries occurrence and periodontal condition in 100 dental students in their clinical semester. A clinical study]. AB - The purpose of this study was to examine the prevalence of caries and periodontal condition of 100 randomly selected clinical dental students (73 males, 27 females) in the age range of 22-37 years (means = 26.1 +/- 3.3 years). The statistical analysis revealed the following results: DMF-T Index (Klein & Palmer 1940) = 12.61 +/- 5.41 Plaque Index (Silness & Loe 1964) = 0.37 +/- 0.23 Gingiva Index (Loe & Silness 1963) = 0.39 +/- 0.20 Periodontal pocket depth = 1.65 +/- 0.27 mm. In relation to the results of other studies, clinical dental students had a decreased DMF-T Index and were in a better state of oral health and restaurations as compared to other groups of the same age. Female students had significantly less carious teeth, plaque and gingival disease than the male students. Increasing age had a highly significant correlation to DMF-T Index. Gingiva Index and pocket depth, whereas Plaque Index was correlated to a lesser degree. Plaque was confirmed as the essential factor of gingival disease. PMID- 3273779 TI - [Caries epidemiological study of 7-10-year old school children in Weil am Rhein]. AB - Children aged between 7 and 10 in four years at the primary schools in the town of Weil am Rhein were examined for the prevalence of tooth decay by a team which had already carried out the same investigations, applying the same criteria, in other towns. The data were analyzed with a standardized computer program. PMID- 3273780 TI - [Caries preventive effectiveness of Fluor Protector and fluoride lacquer, Duraphat under very cariogenic conditions]. AB - Fluoride varnishes Durpahat and Fluor Protector are commonly used and have proven to be effective as caries preventive agents. In the first part of this paper the features of fluoride varnishes in terms of fluoride uptake, caries prevention and toxicological safety are discussed. The effect of both varnishes under high cariogenic conditions is discussed in the second part. In the presented study, 8 patients carried 3 enamel specimens (Fluor Protector, Duraphat, Control) intra orally during 4 months. They kept plaque accumulation intact on the specimen and avoided fluoride administration from other sources. After 4 months of substantial cariogenic challenge, the enamel was analysed by microradiography and the degree of caries protection obtained for each varnish type was calculated. The results show that under high-risk caries conditions enamel treated with Fluor Protector was significantly better protected (65%) than enamel treated with Duraphat (3%). PMID- 3273781 TI - [Sugar consumption of lower Franconian peoples]. AB - Parents, teachers and pupils altogether seem to be highly interested in the subject of the study. In addition, most of the pupils show good knowledge of the relationship between sugar consumption and the development of dental caries. Nevertheless, in spite of the above mentioned facts, 75% of the pupils prefer sweetened to non-sweetened alternatives. As there are no symptoms of a behavioural change, the hope of nutrition-guidance being an effective means of caries reduction cannot be supported--at least for the present situation in the Federal Republic of Germany. PMID- 3273782 TI - ["Denta-Solar"--clinical study of new toothbrush with integrated TiO2 semi conductor]. AB - The aim of this work is to answer the question as to whether the TiO2 semiconductor integrated into the toothbrush "Denta-Sola" has any effect on the removal of plaque. The clinical study shows that the Silness/Loe and Quigley/Hein plaque indices improved when the "Denta-Solar" was used over a four-week study period, whereas they deteriorated when the toothbrush was used without the semiconductor. PMID- 3273783 TI - [What can a comprehensive youth dental program do? Results of 30 years caries prevention in Stuttgart]. PMID- 3273784 TI - [Remarks on the radioisotopic determination of dentifrice abrasivity]. PMID- 3273785 TI - [The influence of fluoridated water on dentition in six- and seven-year-old children of Lublin]. PMID- 3273786 TI - [Estimation of the effectiveness of ethanol extract of propolis on obligate anaerobes of oral cavity]. PMID- 3273787 TI - [Iatrogenic damage of the visual organ]. PMID- 3273788 TI - [Relative changes of pulse rate in patients of different age after application of impulse electroanalgesia]. PMID- 3273789 TI - [Cephalometric analysis of side-teleradiogram by R.M. Ricketts' method]. PMID- 3273790 TI - [Estimation of Trakis apparatus (Hungary) for preparation of pantomographic and teleradiographic films]. PMID- 3273792 TI - The relationship between oral health and systemic infections among elderly residents of chronic care facilities: a review. PMID- 3273791 TI - Psychosocial antecedents and consequences of periodontal disease: a new agenda. PMID- 3273793 TI - Aging and the accuracy of jaw muscle control. PMID- 3273794 TI - Evaluation of teaching of eclectic psychotherapy in a multidisciplinary setting. PMID- 3273795 TI - Psychotherapy in Israel: identity and direction. PMID- 3273796 TI - Clinical psychology: identity and direction. PMID- 3273797 TI - Martin Buber's "inclusion"--an answer to a dilemma of the psychotherapist. PMID- 3273798 TI - Franz Rosenzweig's philosophy and psychotherapy: religious anthropology as a therapeutic stimulus. PMID- 3273799 TI - Schafer's contribution: comments on its continuity and development. PMID- 3273800 TI - Depression Pro Parto. PMID- 3273801 TI - Paradoxical interventions embedded in a focal approach to family therapy. PMID- 3273802 TI - On loneliness. PMID- 3273803 TI - On loneliness and alienation. PMID- 3273804 TI - On loneliness--the theory of the double. PMID- 3273805 TI - Seminar on loneliness: an overview. PMID- 3273806 TI - [The problem of the extraction of the tooth in the fracture-line]. PMID- 3273807 TI - [Horizontal and vertical dimensions of the mandible in orthopantomogram. Study in vitro]. PMID- 3273808 TI - [Naevus of Ota with oral lesions. Report of a case]. PMID- 3273809 TI - [A new technique of immobilization in the anterior mandibular osteotomy]. PMID- 3273810 TI - [Anterior maxillary osteotomy in patients with upper posterior edentulous areas]. PMID- 3273811 TI - [The composed flap of temporal myo-fascia and aponeurotic galea, as method of reconstruction of hemifacial microsomia]. PMID- 3273812 TI - [Iatrogenic fractures of the mandible]. PMID- 3273813 TI - [Blow-out fractures of the orbital floor]. PMID- 3273814 TI - [Cheek island flap]. PMID- 3273816 TI - [Closure of extensive oroantral and oronasal fistulas]. PMID- 3273815 TI - [The frequency of impacted teeth as revealed by radiographic investigation in 1644 patients]. PMID- 3273818 TI - [Idiopathic bone cavity of mandible (Stafne's bone cavity)] off. PMID- 3273817 TI - [Traumatic cysts of the jaws]. PMID- 3273819 TI - [Root resorption caused by impacted teeth. Report of cases]. PMID- 3273820 TI - [Lymphamgioma of the lower lip, the submandibular and subgenial region]. PMID- 3273821 TI - [Mucoepidermoid tumor of minor salivary gland with oncocytes]. PMID- 3273822 TI - [In vivo study on acid resistance of enamel after treatment with toothpaste with various abrasives with and without fluoride content]. PMID- 3273823 TI - [Reduction of dental caries by irradiation with IAG-Neodynium laser. Experiment with rats]. PMID- 3273824 TI - [Bacterioscopic studies on gum margin of students students--stomatologists]. PMID- 3273825 TI - [Treatment of erosive form of lichen planus by helium-neon laser LG-75]. PMID- 3273827 TI - [Determination of the form of the head in man in frontal view by a complex quantitative index]. PMID- 3273826 TI - [Difficult cutting of the lower wisdom tooth and its connection with the asymmetry of the mandible in man]. PMID- 3273828 TI - [Documentation for clinical application of intraosseous dental implants]. PMID- 3273830 TI - [Local plastic closing of tracheostoma inferior persistens]. PMID- 3273829 TI - [Atypical fibroxanthoma of the face]. PMID- 3273831 TI - [A case of granuloma pyogenicum in maxillofacial region]. PMID- 3273832 TI - [Solitary plasmocytoma of the lower jaw]. PMID- 3273834 TI - [A patient with phlegmon on the bottom of the oral cavity, complicated with mediastinitis, with a lethal end]. PMID- 3273833 TI - [Clinical solution of two cases with absence of upper central incisor in dentition]. PMID- 3273835 TI - [Oral changes in children with acute leukosis]. PMID- 3273837 TI - [Clinical-statistical study on the reasons for fear of stomatological treatment]. PMID- 3273836 TI - [Application of gingival bandage SK-1 in stomatological practice]. PMID- 3273838 TI - Twin-twin transfusion syndrome: the surgical removal of one twin as a treatment option. AB - The twin-twin transfusion syndrome, associated with acute polyhydramnios in the 18th to 28th week of gestation, has a high perinatal mortality rate. Patients managed without intervention have essentially a 100% mortality rate for the involved twins. Different methods of intervention have been described, including therapeutic amniocentesis, selective feticide, and placental vessel puncture. In this case report we describe selective removal of one twin at 21 weeks of gestation by hysterotomy in a patient with the twin-twin transfusion syndrome. PMID- 3273839 TI - Diagnosis and treatment of feto-maternal hemorrhage in a fetus with homozygous von Willebrand's disease. AB - In a fetus with severe type-III von Willebrand's disease, fetal blood sampling by cordocentesis was associated with feto-maternal hemorrhage, fetal hypovolemia, and persistent bradycardia. The fetal condition improved after intracardiac transfusion of blood. PMID- 3273840 TI - Effects of intrauterine treatment on nonimmunologic hydrops fetalis. AB - In 44 cases with nonimmunologic hydrops fetalis (NIHF), perinatal management was performed based on our protocol. Twenty-one cases were treated by albumin and/or packed red blood cell (PRC) injection into the fetal abdominal cavity, and 8 cases were treated by transplacental digitalization. Among the cases treated by albumin and/or PRC injection, 5 of 7 cases without pleural effusion recovered in utero, and all 5 cases are alive at the time of writing. However, of 14 cases with pleural effusion, none recovered in utero, and only 1 case is alive. Of 8 cases treated by transplacental digitalization, 2 cases recovered in utero, and 1 case is alive. All fetuses with congenital heart anomaly died. This evidence indicates that albumin and/or PRC injection into the fetal abdominal cavity is an effective procedure for in utero treatment of NIHF without pleural effusion, but suggests that in NIHF resulting from either congenital heart anomaly and/or heart failure, the survival rate may not be increased by transplacental digitalization. PMID- 3273841 TI - Antenatal phenobarbital in preventing intraventricular hemorrhage in premature newborns. AB - In a randomized prospective study, we investigated the effect of antenatal phenobarbital on neonatal intraventricular hemorrhage in 39 women destined to deliver babies of less than 32 weeks of gestation. The treatment group received an intravenous loading dose of 700 mg of phenobarbital, followed by a daily maintenance dose until delivery. The newborns were treated with phenobarbital for the first 96 h. Ultrasound examinations of the infants' heads were performed. Intraventricular hemorrhage was significantly less frequent in the treated group: 2 of 21 (9.5%) versus 9 of 18 (50%; p less than 0.006). Moreover no severe hemorrhage (grade 3-4) occurred in the treated babies: 0 of 21 versus 5 of 18 (27.7%; p less than 0.01). PMID- 3273842 TI - [Scanning electron microscope study of early bacterial penetration of human enamel in initial caries]. AB - Bacterial penetration of enamel during initial manifestations of the carious process was studied in intact buccal enamel of 8 impacted third permanent molars. After cleaning them from organic plaque, each buccal plane was cut into five segments, one of them serving as a control specimen and the other four being fixed into slots on partial prostheses of our volunteers. The specimens were left in oral cavity for 7, 14, 21 and 28 days, where they were exposed to the action of cariogenic factors. After removal of the organic plaque, the specimens were broken in two and the bacterial penetration into enamel was observed on the fractured cross-section using scanning electron microscope. In 4 specimens from the group orally exposed during a 7-day period, individual coccoid or bacilliform bacteria were found to have penetrated 5-10 microns deep. The number of bacteria and the depth of their penetration into enamel increased with the duration of oral exposition. Among the specimens orally exposed during 28 days, bacteria were observed to be present both individually and in colonies, penetrating to the depth of 60-90 microns. These bacteria could quite easily communicate with saliva and plaque via the pore system, which allowed them to produce metabolites, including lactic acids. This, in turn, allowed them to penetrate through the enamel, thus altering both the course and rate of the carious process progression. PMID- 3273843 TI - [Microbial flora of dental plaque in subjects wearing total acrylate dentures]. PMID- 3273844 TI - [Periodontal disease, dental caries and treatment needs for population of Zagreb]. PMID- 3273845 TI - [Oral manifestations in AIDS]. PMID- 3273846 TI - [Determination of terminal hinge axis]. PMID- 3273847 TI - Object oriented programming and general principles of modelling complex biological systems. PMID- 3273848 TI - Thalamocortical reverberation circuit simulation using the simula language. PMID- 3273849 TI - Evolutional approach to extremization of vector criteria of simulation models. PMID- 3273850 TI - On the interpretation of "mean +/- s". Several notes on an old misunderstanding. PMID- 3273851 TI - Abstracts of the nineteenth annual meeting of the Environmental Mutagen Society. Charleston, South Carolina, March 27-31, 1988. PMID- 3273852 TI - Analysis and purification of synthetic DNA fragments with NuSieve agarose mini gels. AB - We outline in this note a new method for analyzing the crude product from long (greater than 40 bp) DNA synthesis reactions. This procedure is quick, and provides direct visualization of the end product. As described here, this method is not quantitative. However, densitometry of the stained gel could be used to quantitate the amount of DNA in the full-length peak. Without quantitation, our experience indicates that if a full-length fragment in the size range of 60 to 106 bases cannot be visualized with up to 1 microgram of crude material, re synthesis is indicated. The 1 microgram value will no doubt increase with longer fragments. This system has also been used to purify ligated fragments for cloning. We have not attempted to purify full-length single-stranded oligomers from the crude reaction mix using the agarose mini-gel system, because of the lack of resolution at the n-1 level, and also because of the small loading capacity of the gel. PMID- 3273853 TI - Strip-comb dot immunobinding: a rapid, easy and sensitive method to screen monoclonal antibodies. PMID- 3273854 TI - No runs, no drips, no errors: a new technique for sealing polyacrylamide gel electrophoresis apparatus. PMID- 3273855 TI - Detection of DNA-protein binding in western blots by phosphorus-labeled and biotinylated DNA probes. AB - Eukaryotic DNA-binding proteins can be detected by a filter binding assay combining protein blotting on nitrocellulose, incubation with DNA by filtration, and the application of radioactively or nonradioactively labeled DNA probes. Basic nuclear and non-nuclear standard proteins are assayed in dot blots as well as in Western blots from sodium dodecyl sulfate gels. The DNA-binding ability of fractionated proteins is compared employing two different blotting techniques, conventional electro-transfer and protein-renaturating capillary transfer. Biotinylated DNA probes exhibit high sensitivity and a distinct discrimination of detection signals corresponding only to defined DNA-binding proteins. In contrast, phosphorus-labeled DNA probes show higher sensitivity, but less effective resolving power, especially for bands localized close to each other. Using the DNA-incubation procedure described, biotinylated DNA probes are preferable to radioactively-labeled probes for screening DNA-binding proteins in complex protein fractions. PMID- 3273856 TI - Assaying the quality of cDNA libraries. AB - Once a cDNA library has been constructed, it is very useful to be able to easily assess the quality of the library. Because actin is a ubiquitous sequence, this assessment has been accomplished by probing filter lifts and Southern blots of libraries with an actin cDNA probe. These methods provide information about the percent of actin-positive clones and the degree of completeness of cDNA clones in a library. Results of these methods are correlated with the success of finding full-length clones of interest. PMID- 3273857 TI - The Nucleic Acid Blot Analyzer II. ANALYZE, an image analysis software package for molecular biology. AB - The Nucleic Acid Blot Analyzer, a new instrument providing high-speed imaging of 32P labeled nucleic acids, captures, stores and presents images in digital form, thus lending itself to rapid data handling and analysis as well as replacing conventional X-ray film autoradiography for many applications. A software package called ANALYZE has been specifically designed for the instrument in order to provide automatic or semi-automatic analysis for molecular biological techniques. The software includes image display manipulation, quantitative and positional analysis, as well as file maintenance utilities. The specific application of the software/hardware to various techniques is presented. PMID- 3273858 TI - Multisample photometric biochemical analysis using Vmax and SOFTmax. PMID- 3273859 TI - A new, reliable cartridge for the rapid purification of synthetic DNA. PMID- 3273860 TI - [Doppler echocardiography. Perspectives for the 1990's. Symposium, Munich, 2 and 3 December 1989. Abstracts]. PMID- 3273861 TI - Perspectives on Clinical Therapeutics: a review of the past ten years and a look forward to the next decade. PMID- 3273862 TI - Old docs, new technology, journal reading, and quality patient care--are they related? PMID- 3273863 TI - Evaluation of antacid tablets and liquid in fasting and fed men and women. AB - In view of in vitro tests suggesting good performance of an experimental tablet formulation of an aluminum hydroxide-magnesium hydroxide antacid, a study was conducted to evaluate the efficacy in vivo. Twenty-three healthy men and women were enrolled in the study, which was carried out in two parts: fasting and postprandial. Eight of the volunteers failed to qualify because of repeated baseline pH greater than 2.5. In the 15 participants who qualified, the intragastric pH was monitored for up to 240 minutes after the administration of one or two experimental tablets, 5 or 10 ml of a commercially available liquid antacid, or placebo. In the fasting subjects (n = 10), the antacids rapidly increased the mean pH. One antacid tablet and 5 ml of liquid antacid yielded similar results, with mean peak pH values of 5.2 and 4.8 and durations above pH 3.5 of 25 and 40 minutes, respectively. When the doses were doubled, 10 ml of liquid produced a peak pH of 6.7 and maintained the pH above 3.5 for 40 minutes, whereas two tablets produced a peak pH of 4.8 and maintained pH above 3.5 for 15 minutes. In the fed subjects (n = 10), neither antacid formulation at either dose significantly raised intragastric pH. Further studies are needed to establish the optimal time for postprandial administration of antacids. PMID- 3273864 TI - Long-term treatment of essential arterial hypertension with nitrendipine. AB - The efficacy and safety of long-term treatment with oral nitrendipine were evaluated in 34 patients with essential arterial hypertension. Nitrendipine alone significantly lowered systolic and diastolic blood pressure levels in 28 patients who completed the preliminary four-week dose-setting phase. Twenty-one patients completed the one-year treatment. Blood pressure control was maintained by nitrendipine alone in 11 patients. Ten patients not adequately controlled at the end of the dose-setting phase were successfully treated with nitrendipine combined with acebutolol or muzolimine. It is concluded that nitrendipine is a promising calcium antagonist for the treatment of arterial hypertension. PMID- 3273865 TI - Once-daily cefadroxil versus oral penicillin in the pediatric treatment of streptococcal pharyngitis. AB - Thirty-two patients with pharyngitis were randomly assigned to receive either 30 mg/kg of cefadroxil every 24 hours orally or 15 mg/kg of penicillin V potassium every eight hours orally for ten days. Sera for antistreptolysin-O, streptozyme, and anti-DNAase were compared before and after treatment. Twenty patients finished the study and had a confirmed throat culture for the group A streptococcus and at least one fourfold antibody rise. Of these 20 patients, seven of eight in the penicillin group and all 12 in the cefadroxil group were cured at the end of therapy. One patient in the penicillin group had a positive culture at the end of therapy; one patient in each group was recolonized at follow-up culture 10 to 20 days after ending therapy. Seven other patients who finished the study had a positive throat culture but no antibody response and were presumed carriers; these included five in the penicillin and two in the cefadroxil group. One of these presumed carriers had a persistent infection and relapsed two days after the end of therapy. Both therapies appeared to be equally successful and no serious side effects occurred. PMID- 3273866 TI - Imidazole salicylate in the treatment of osteoarthrosis and musculoskeletal trauma: a postmarketing survey. AB - A postmarketing survey was conducted by 37 orthopedists and traumatologists among 700 patients of both sexes, aged 7 to 87 years, to evaluate the efficacy and tolerability of imidazole salicylate. The 467 patients with osteoarthrosis received 750-mg tablets (TID) for up to one month and 233 patients with traumatic pathologies received imidazole salicylate gel (BID-TID) for ten days, or tablets (BID-TID), or both gel and tablets combined. The treatment was satisfactory in both patient groups, significantly reducing the intensity of pain and swelling and improving articular function. No adverse experiences that had not been reported previously were recorded; only some gastrointestinal side effects exceeded an incidence of 1%. PMID- 3273867 TI - Clinical therapeutics resurgent. PMID- 3273868 TI - Anxiety profiles and treatment. PMID- 3273869 TI - Controlled-release ketoprofen in rheumatoid arthritis and osteoarthritis: comparison of two doses in Thailand. AB - Thirty-one hospital outpatients in Thailand, 14 with rheumatoid arthritis and 17 with osteoarthritis, received 100 mg (15 patients) or 200 mg (16 patients) of controlled-release ketoprofen daily for 12 weeks. At the start of treatment, at day 42, and at day 84 (end of treatment) the patients were assessed for pain, duration and severity of morning stiffness, duration of daytime inactivity needed to produce stiffness, the duration of that stiffness, and overall clinical state. Blood and urine samples were taken to monitor hematological, renal, and carbohydrate function. On all clinical measures the patients improved during the study to a highly significant extent in both treatment groups, with no significant between-group differences. No ketoprofen-induced side effects were reported. No clinically important changes in laboratory variables were found. It is concluded that controlled-release ketoprofen is effective and well-tolerated in the treatment of the symptoms of arthritis in Thailand. On the basis of this study, there appears to be no advantage in increasing the dose above 100 mg daily. PMID- 3273870 TI - Twenty-eight-day oral contraceptives: physician and user attitudes. AB - A 28-day regimen of oral contraceptives that uses seven iron tablets (each containing 75 mg of ferrous fumarate) instead of seven sugar placebos was designed to encourage user compliance. To determine professional and user attitudes toward the 28-day regimen, 192 obstetrician-gynecologists and 469 women who used oral contraceptives were surveyed. Over two-thirds of the physicians stated that they approved both the 28-day regimen and the inclusion of the seven iron tablets. Over 80% of the women surveyed expressed approval of a 28-day regimen that included seven iron tablets. PMID- 3273871 TI - Availability of iron from four prenatal multivitamin/multimineral products. AB - Iron absorption from four prenatal multivitamin/multimineral preparations was compared in 36 healthy pregnant women in their second or third trimester of pregnancy. The products studied were the currently marketed formulations of Stuartnatal 1 + 1, Stuart Prenatal, Materna, and Natalins Rx. Each fasted subject received each of the four preparations, according to a randomized sequence, at intervals of three to seven days between drug administrations. Stuartnatal 1 + 1 demonstrated the best iron absorption. Total iron absorbed from Stuartnatal 1 + 1 and Stuart Prenatal was well above the additional daily 3.5 mg recommended during pregnancy. Following administration of Materna the amount of iron was only slightly above that recommended, and following Natalins Rx it was well below. All formulations were generally well tolerated by the subjects. PMID- 3273872 TI - [Nosocomial pneumonia caused by Legionella pneumophila at Sagunto Hospital. Epidemiology and preventive measures]. PMID- 3273873 TI - [Registration of cases at the mental health services in Asturias: its establishment and use for the evaluation of health care]. PMID- 3273874 TI - [Current strategies in the campaign against human trypanosomiasis in the Equatorial Republic of Guinea]. PMID- 3273875 TI - [Health tests in health personnel. A panorama of clinical findings]. PMID- 3273876 TI - [Characterization of atmospheric aerosols]. PMID- 3273877 TI - [Inorganic components of bone and liver tissue from building workers using the "edax" technic]. PMID- 3273878 TI - [Microbiological contamination of the sand from the Barcelona city beaches]. PMID- 3273879 TI - [Vaccines: action in a school population from an at risk area]. PMID- 3273880 TI - [Bacterial contamination of wells in rural areas of Galicia]. PMID- 3273881 TI - [Planification and results of a program for prevention of glaucoma. I]. PMID- 3273882 TI - Fractures and fracture-dislocations of the tarsometatarsal joint. AB - We are reporting the results in a consecutive series of forty adults in whom, between 1978 and 1984, forty-one tarsometatarsal fracture-dislocations were treated with open reduction followed by temporary internal fixation with AO screws. Ninety per cent of the patients had an intra-articular or a periarticular fracture. An anatomical or nearly anatomical reduction was achieved in all but a few patients, and there was no loss of fixation or displacement. For thirty-four patients (thirty-five injuries), the length of follow-up averaged 3.4 years, and a good or excellent functional result was obtained in all but two of the thirty in whom an anatomical reduction had been achieved. Of the six patients who had a fair or a poor result, five had an associated grade-II or grade-III open injury. The development of post-traumatic arthritis was directly related to damage to the articular surfaces or to inadequate reduction, or to both. PMID- 3273883 TI - Gonorrhea rates: what denominator is most appropriate? AB - We used traditional crude population denominators and four different definitions of sexual activity to calculate progressively more refined gonorrhea rates among reproductive age women. Refining denominators to take sexual activity into account had the largest impact on morbidity rates for young women. Traditional denominators severely underestimate gonorrhea rates in teenagers, and understate the real magnitude of gonorrhea risk among sexually active teenagers. PMID- 3273884 TI - Absorbed dose comparison among commercial ionization chambers in polystyrene and acrylic phantoms. AB - Using the AAPM Task Group 21 protocol, photon and electron doses were compared in polystyrene and acrylic phantoms. The ionization chambers used were a Farmer graphite chamber, a PTW acrylic chamber, a homemade polystyrene chamber, and an Exradin air-equivalent chamber, all being of cylindrical type. A Memorial parallel-plate polystyrene chamber was also included. 60Co, 4-, 6-, and 18-MV x rays as well as 9- and 20-MeV electron beams were investigated. PMID- 3273885 TI - Levator repositioning and palatal lengthening for submucous clefts. AB - Submucous clefts of the palate may present with velopharyngeal incompetence (VPI) or a history of recurrent otitis media. Many surgeons have favored a pharyngeal flap as primary treatment of the velopharyngeal incompetence associated with this disorder. The increasing number of case reports of sleep apnea and airway compromise associated with pharyngeal flaps prompted the use of levator muscle repositioning with palatal lengthening as initial therapy in 15 patients in an attempt to correct the pathologic anatomy while avoiding the postoperative sequelae. Patients were divided into two groups: group A (N = 8) had surgery before age 2 (11.8 +/- 5.7 months), and group B (N = 7) had surgery after 2 years of age (64.3 +/- 24.2 months). No patient in group A required a secondary operative procedure for velopharyngeal incompetence. Normal speech was obtained in 75 percent (N = 6), and slight velopharyngeal incompetence not requiring secondary correction was obtained in 25 percent (N = 2). Group B obtained less dramatic speech results: normal in 14 percent (N = 1), slight velopharyngeal incompetence in 58 percent (N = 4), and no improvement or severe velopharyngeal incompetence requiring a secondary procedure in 28 percent (N = 2). Patients with preoperative otologic disorders (N = 10) obtained significant improvement in 90 percent of cases (p = 0.002). Early surgical intervention in patients with abnormal speech prior to age 2 appears to result in normal speech in the majority of instances. Late repair with levator repositioning and palatal lengthening provided improved speech in 72 percent of patients. PMID- 3273886 TI - Severe daytime somnolence in patients treated with an MAOI. AB - Eight patients with hypersomnolent, anergic major depression benefited markedly from treatment with relatively high doses of phenelzine or tranylcypromine but experienced intense afternoon somnolence and disrupted sleep. Reducing the dose of monoamine oxidase inhibitor (MAOI) or substituting isocarboxazid sometimes provided relief, but altering the schedule of drugs or meals did not. Bedtime sedation alleviated the disrupted sleep but had little effect on daytime somnolence. The mechanism underlying this side effect is unknown; sleep deprivation, narcolepsy, or hypotension does not account for it. Patients given an MAOI should be assessed for this disturbance and cautioned to avoid risk of injury when it occurs. PMID- 3273888 TI - An evaluation of eight peripheral nerve stimulators for monitoring neuromuscular blockade. AB - The features of eight commercially available peripheral nerve stimulators were compared with those evolved as ideal for monitoring neuromuscular blockade. The pulse waveforms were satisfactory except for that delivered by the CIG series 80 nerve/muscle stimulator. The error in timing of the stimulation patterns was up to 60% in the Professional Instruments NS-2C compared with 8% or less in the other devices. All of the stimulators had maximum current outputs suitable for monitoring with surface stimulating electrodes. The current delivered by the CIG series 80 nerve/muscle stimulator and the Stimlocator SL1.4 sagged by 21% and 25% respectively during a tetanus. The Digistim III, Bard Biomedical 750 digital and the Professional Instruments NS-2C had accurate digital readouts of delivered current. PMID- 3273887 TI - The effect of relaxin on calcium fluxes in the rat uterus. AB - Relaxin is a polypeptide hormone that inhibits rat uterine contractions. To test the hypothesis that the mechanism of action of this effect may involve shifts in calcium ions, the biologic action of relaxin on isolated rat uterine horns was directly correlated with measurements of 45Ca2+ efflux from and uptake into the tissues. Kinetic analysis demonstrated that the efflux of 45Ca2+ from rat uterine horns was significantly faster when tissue was incubated with 25 ng/ml relaxin as compared with control tissues incubated with no relaxin. In addition, at the end of the efflux experiments, control uteri contained 3.9% of the starting 45Ca2+, whereas the relaxin-treated uteri contained only 2.55%, indicating greater total Ca2+ efflux from the relaxin-treated horns (p less than 0.05). The effect of relaxin on 45Ca2+ uptake by uterine tissue was also studied. Analysis of uptake curves by linear regression demonstrated that relaxin treatment leads to less total uptake of 45Ca2+ in the uterine tissue, although the differences are not statistically significant. These experiments demonstrate that relaxin inhibition of rat uterine contractions in vitro is associated with a decrease in intracellular free Ca2+, caused, at least in part, by the promotion of Ca2+ efflux. These results represent the first step in defining the mechanism of action of this hormone. PMID- 3273889 TI - [Value of microbiological caries activity tests from clinician's viewpoint]. PMID- 3273890 TI - [Determination of an individual's caries risk--assumptions for measuring prevention]. PMID- 3273891 TI - [Recall: dental necessity or illegal advertising?]. PMID- 3273892 TI - [Thumbsucking in early childhood: reference to healthy or pathological development?]. PMID- 3273893 TI - [Morphology and plaque accumulation]. PMID- 3273894 TI - [Plaque and caries]. PMID- 3273895 TI - [Plaque--gingivitis--periodontitis (1). Microbiology and pathogenesis of periodontitis]. PMID- 3273896 TI - Understanding the culture of health care. PMID- 3273897 TI - Creating tomorrow out of today. PMID- 3273898 TI - A place at the table: when nurses are members of a medical center's governing board. PMID- 3273899 TI - Shared governance: a human resources viewpoint. PMID- 3273900 TI - Decentralizing to nursing's advantage. PMID- 3273901 TI - Hospital cost accounting preparation for the department of nursing. PMID- 3273902 TI - The fine art of tough negotiation. PMID- 3273903 TI - The transformation of bedside nursing: the challenge. PMID- 3273904 TI - Shortage solutions: refining the science of managing nursing resources. PMID- 3273905 TI - Dealing with stress and anxiety in clinical situations. PMID- 3273906 TI - Chemical dependency and the dental student. PMID- 3273907 TI - Preparing students to treat HIV-infected patients. PMID- 3273908 TI - Periodontics. The unifying force in the practice of dentistry. PMID- 3273909 TI - Licensure examinations: are they relevant? PMID- 3273910 TI - Thinking your way from distress to success. PMID- 3273911 TI - Anesthesia systems. AB - We evaluated 5 anesthesia systems from 3 manufacturers. All systems can safely deliver general anesthesia and are rated Acceptable. Because selection factors vary among hospitals, no unit is ranked higher than another. Purchasing decisions should be based on design, the method of monitor integration, the type of breathing system used, cost, and staff preferences and practice. PMID- 3273912 TI - Electrical safety analyzers. AB - We evaluated five electrical safety analyzers from four manufacturers. All of the evaluated units are rated Acceptable and can be used for basic hospital electrical safety testing. Features to consider when selecting a unit are performance, testing time, and cost. Ease of use and preference for particular controls, attachments, and layouts may be deciding factors. PMID- 3273913 TI - Novametrix 902 neonatal monitors. PMID- 3273914 TI - Inappropriate phototherapy replacement tubes. PMID- 3273916 TI - Air-Shields Vickers C-86 infant incubators. PMID- 3273915 TI - Cobe Centry 2 and Centry 2Rx hemodialysis units. PMID- 3273918 TI - Who defends the defenders? PMID- 3273917 TI - Air-Shields Vickers, Narco Bio-Systems, and SpaceLabs 4045 defibrillator/monitor resistors. PMID- 3273919 TI - Hypo/hyperthermia machines. AB - We evaluated three hypo/hyperthermia machines from three manufacturers. [Because each manufacturer's blankets can be used with other brands of hypo/hyperthermia machines, we evaluated them separately; see our report in this issue.] Two units are rated Acceptable, and one is rated Acceptable-Not Recommended. Purchasing considerations include safety features, status and warning indicators, ease of use, and ease of servicing. PMID- 3273920 TI - Inspection and preventive maintenance procedure: pulmonary resuscitators (gas powered). PMID- 3273921 TI - Barotrauma from anesthesia ventilators. PMID- 3273922 TI - Eastman Kodak Ektachem 400 clinical chemistry analyzers. PMID- 3273923 TI - Physio-control develops Mains Power switch cover. PMID- 3273924 TI - Pacemaker pseudomalfunction. PMID- 3273925 TI - Disposable pressure transducers and multiple-pressure-channel physiologic monitors. PMID- 3273926 TI - Catheter balloon overinflation. PMID- 3273927 TI - Electrosurgical units. AB - We evaluated twelve ESUs--three medium-power units (180 W maximum) and nine high power units--from six manufacturers. Of the medium-power units, two were rated Acceptable, and one was rated Conditionally Acceptable. Of the high-power units, three were rated Acceptable. Of the high-power units, Acceptable, and one was rated Acceptable-Not Recommended. Although we considered performance and human factors, we based our ratings primarily on risk factors such as the level of protection from patient burns, the capability to activate multiple outputs, and the adequacy of activation-tone alarms. Acceptable units have adequate safety features, and Acceptable-Preferred units have a safety feature that we believe is more effective in preventing injuries. PMID- 3273928 TI - Anesthesia systems. AB - We evaluated twelve disposable pressure transducers from eleven manufacturers. All were rated Acceptable and were ranked in four groups. The first two groups had similar performance characteristics. Groups three and four were ranked primarily according to the effect of fluid spills and the ease of achieving accurate dynamic response. PMID- 3273929 TI - Disposable pressure transducers. AB - We evaluated twelve disposable pressure transducers from eleven manufacturers. All were rated Acceptable and were ranked in four groups. The first two groups had similar performance characteristics. Groups three and four were ranked primarily according to the effect of fluid spills and the ease of achieving accurate dynamic response. PMID- 3273930 TI - Portable volume ventilators. AB - We evaluated five portable volume ventilators from four manufacturers. Ventilation requirements in general patient care areas in the hospital differ from those for home care; therefore, we considered use of the units for these applications separately. None of the units was ideal for either application because of the limitations and risks of each ventilator. All units were rated Conditionally Acceptable, but were ranked for hospital use only. The primary conditions for acceptable hospital use were that exhaled-volume monitoring be performed for all patients and that O2 monitoring be performed both when setting FIO2 and continuously when FIO2 levels are critical. For home care, users should carefully weigh the advantages and disadvantages of each unit and base their choice of a unit primarily on individual patient needs, ease of use, and safety factors. PMID- 3273931 TI - Patient-controlled analgesic infusion pumps. AB - We evaluated seven PCA infusion pumps from seven manufacturers. The condition for acceptable use of six of the units was that they not be used at low volumes that could result in overinfusion from the stored volume when an occlusion is cleared. Our ratings and ranking were based primarily on safety, security, and overall ease of use. All pumps met most accuracy, electrical safety, and performance criteria. Two of the pumps were suitable for ambulatory use but were not recommended for general hospital or home care bedside use. One of the pumps was totally disposable and nonelectronic. PMID- 3273933 TI - Ultrasound cardiac output units. AB - We evaluated two dedicated units that calculate CO for teenage and adult ranges. We also tested a unit designed for use on neonatal to pediatric patients and discussed this device separately. Both of the evaluated units were rated Acceptable. Because of the limitations of ultrasound (US) technology, we found these units to be best suited for trending CO; however, the utility of US CO for this application far outweighs its limitations. PMID- 3273932 TI - Autotransfusion machines. AB - We evaluated three autotransfusion machines, from three manufacturers, that automatically or manually process RBCs from whole blood salvaged from surgical and trauma wounds. All units were rated Acceptable, and ranking was based primarily on safety and ease of use. PMID- 3273934 TI - Blood glucose monitors. AB - We evaluated eight blood glucose monitors (BGMs), from six manufacturers, that are lightweight, portable, battery-powered, relatively inexpensive handheld reflectance photometers that use test strips for self-monitoring of blood glucose levels. We primarily considered the issues of operator training and human factors in rating the units for both hospital and home use. Seven of the units were rated Acceptable for both uses, and the Larken Glucochek SC was rated Unacceptable for both hospital and home use. PMID- 3273935 TI - Gates rechargeable lead-acid batteries. PMID- 3273936 TI - Scleral and corneal burns during phacoemulsification with viscoelastic materials. PMID- 3273937 TI - Unusual occlusion of small tracheal tubes. PMID- 3273938 TI - PCA long-interval volume monitors. PMID- 3273939 TI - High-risk equipment. PMID- 3273940 TI - Impounding incident-related devices. PMID- 3273941 TI - PCs and networks: power tools for clinical engineers. PMID- 3273942 TI - Facilities construction: involving the clinical engineer. PMID- 3273943 TI - Isothermal Omniflex connectors. PMID- 3273944 TI - Misuse of "quick-look" defibrillator paddles. PMID- 3273945 TI - Bard biocath hydrophilic-coated Foley catheters. PMID- 3273946 TI - Miles Tissue-Tek VIP tissue processors. PMID- 3273947 TI - Who should service anesthesia equipment? PMID- 3273948 TI - Special care beds require special attention. PMID- 3273949 TI - USSC auto suture disposable surgical staplers. PMID- 3273950 TI - YSI Model 2100 tele-thermometers. PMID- 3273951 TI - Disposable pressure transducers. AB - We evaluated 12 disposable pressure transducers from 11 manufacturers. All are rated Acceptable and are ranked in four groups. The first two groups have similar performance characteristics. Groups three and four are ranked primarily according to the effect of fluid spills and the ease of achieving accurate dynamic response. Although list prices are somewhat high, negotiated prices are usually lower. Users should weigh advantages and disadvantages against clinical preference and price. PMID- 3273952 TI - Hospital-owned, nonpatient-care equipment. PMID- 3273953 TI - Patient-owned equipment. PMID- 3273954 TI - Mismating of Laerdal exhalation diverters and Intertech masks. PMID- 3273955 TI - Valleylab upsets a delicate balance. PMID- 3273956 TI - Patient-controlled analgesic infusion pumps. AB - We evaluated 7 PCA infusion pumps from 7 manufacturers. The condition for acceptable use of 6 of the units is that they not be used at low volumes that could result in overinfusion from the stored volume when an occlusion is cleared. Our ratings and ranking are based primarily on safety, security, and overall ease of use. All pumps meet most accuracy, electrical safety, and performance criteria. Two of the pumps are suitable for ambulatory use but are not recommended for general hospital or home care bedside use. One of the pumps is totally disposable and nonelectronic. Purchasing decisions should also take into consideration the cost of disposables, application, and medication security. PMID- 3273957 TI - Xenon systems used with improper breathing circuits. PMID- 3273958 TI - Operating microscopes in ophthalmic surgery. PMID- 3273959 TI - Baxter PAC-X automated PD cyclers. PMID- 3273961 TI - Isolated power systems. PMID- 3273960 TI - Home health care equipment. PMID- 3273962 TI - Custom equipment. PMID- 3273963 TI - Vacuum regulators. PMID- 3273964 TI - Interchanging Laerdal and Solco resuscitators and components. PMID- 3273966 TI - American Omni Medical SG-30 Silent Guard ball valves. PMID- 3273965 TI - Instrumentation Laboratory Genesis 21 clinical chemistry analyzers. PMID- 3273967 TI - Ladd/Steritek P3000 intracranial pressure monitors. PMID- 3273968 TI - Automated intraoperative processing autotransfusion machines. AB - We evaluated 3 autotransfusion machines, from 3 manufacturers, that automatically or manually process RBCs from whole blood salvaged from surgical and trauma wounds. All units are rated Acceptable, and ranking is based primarily on safety and ease of use. PMID- 3273969 TI - Lifepak 8 defibrillator/monitors. PMID- 3273970 TI - Physio-Control Lifepak 6 and 6s defibrillator/monitors. PMID- 3273971 TI - IVAC 2080A intermittent electronic thermometers. PMID- 3273973 TI - Hemodialysis water purification. PMID- 3273972 TI - Calibration of test equipment. PMID- 3273974 TI - Shortwave diathermy units. PMID- 3273975 TI - CITECH--the new mark of excellence. PMID- 3273976 TI - Blood glucose monitors. AB - We evaluated eight blood glucose monitors, from six manufacturers, that are lightweight, portable, battery-powered, relatively inexpensive handheld reflectance photometers that use test strips for self-monitoring of blood glucose levels. We primarily considered the issues of operator training and human factors in rating the units for both hospital and home use. Seven of the units are Acceptable for both uses, and the Larken Glucochek SC is Unacceptable for both hospital and home use. PMID- 3273977 TI - Complications during cataract extraction by phacoemulsification. PMID- 3273978 TI - Lifepak 8 defibrillator/monitors. PMID- 3273979 TI - Pre-use anesthesia check fails to find faults. PMID- 3273980 TI - Mismatch between Hewlett-Packard 78205D pressure modules and disposable pressure transducers. PMID- 3273981 TI - Pre-use pressure transducer calibration procedure. PMID- 3273982 TI - Medical air compressors. PMID- 3273983 TI - [Use of the nasolabial flap for the reconstruction of the anterior floor of the mouth]. PMID- 3273984 TI - [Statistical methods in oral diagnosis]. PMID- 3273985 TI - [Comparative study of periapical radiographs and orthopantomographs]. PMID- 3273986 TI - [Use of orthopantomograph in the diagnosis of lesions of the jaws]. PMID- 3273987 TI - [Paget's disease of the jaw bones]. PMID- 3273988 TI - [Application of lateral selective tomography of the T.M.J. during surgical and orthodontic procedures on patients with mandibular excess]. PMID- 3273989 TI - [Mandibular foramen during sagittal split osteotomy]. PMID- 3273990 TI - [Signs and symptoms of anemias in the mouth]. PMID- 3273991 TI - [Acute leukemia of the oral cavity]. PMID- 3273992 TI - [Supernumerary teeth in the upper jaw--a clinical study of 93 cases]. PMID- 3273993 TI - [Quality of water from public sources and private wells, in special reference to the Municipal District of Vigo. Official opinion]. PMID- 3273994 TI - [Approximations in studying environmental noise and its consequences in Santiago de Compostela]. PMID- 3273995 TI - [Results of a health education program for hypertensive patients]. PMID- 3273996 TI - [Microbial quality and self-purification capacity of the Tormes River]. PMID- 3273997 TI - [Isolation of free-living amoebae, potentially pathogenic for humans, from 3 species of saurians from the western Canary Islands]. PMID- 3273998 TI - [Etiopathogenic study of digestive cancer in Viscaya, with special emphasis on the role of diet and alcohol and tobacco use]. PMID- 3273999 TI - [Prevalence of anti-rubella antibodies in pregnant women in Catalonia]. PMID- 3274001 TI - [Dental research in Greece, yesterday, today, tomorrow]. PMID- 3274000 TI - [Toxicity in rats of orally administered zinc]. PMID- 3274002 TI - [The future of dentistry in Europe]. PMID- 3274004 TI - [Positive approaches for tomorrow's practice]. PMID- 3274003 TI - [The future of dentistry in the U.S.A., yesterday--today--tomorrow]. PMID- 3274005 TI - [Dental education in Greece--yesterday--today--tomorrow]. PMID- 3274006 TI - [Injuries of the inferior mandibular nerve. Report of 4 cases]. PMID- 3274007 TI - [The horizontal localization of the mental foramen to a sample of Greek population]. PMID- 3274008 TI - [Denture papillary hyperplasia. A clinicostatistical study]. PMID- 3274009 TI - [Missing upper lateral incisors. Etiology--diagnosis--treatment]. PMID- 3274010 TI - [Fibrous dysplasia of the jaws. Report of four cases]. PMID- 3274011 TI - [Histochemical study of the glycoproteins of the normal submandibular glands of man]. PMID- 3274012 TI - [Panoramic innominate line and related roentgen anatomy of the posterior wall of the maxillary sinus]. PMID- 3274013 TI - [Periapical lesions and microbial flora of pulpless teeth]. PMID- 3274014 TI - [Histological study of the pulpal reaction to a new adhesive agent (Scotchbond). Experimental study on dogs]. PMID- 3274015 TI - [Surgery as a method in the treatment of the T.M.J. disturbances]. PMID- 3274017 TI - [Biologic behaviour of restorative materials to the pulp]. PMID- 3274016 TI - [Hemimandibular hyperplasia. Case report and its surgical treatment]. PMID- 3274018 TI - [Hemifacial transection with primary laceration and repair of Stenon's duct. A case report]. PMID- 3274019 TI - [Restricted mouth opening due to bilateral ankylosis of TMJ and coronoid processes enlargement--surgical treatment]. PMID- 3274020 TI - [Intensive care in psychiatry]. PMID- 3274021 TI - Pirenzepine as anti-inflammatory drug in a model of experimental colitis in rat. AB - Pirenzepine has been widely used for the treatment of gastric and duodenal ulcer. In this work we have proved that this drug could prevent the inflammatory reaction induced in the colon with an intraluminal stimuli as the acetic acid. These data suggest the cholinergic participation in the inflammatory colonic response. PMID- 3274022 TI - The effect of verapamil and Ca free solution on mechanical and electrical properties in fast twitch mammalian skeletal muscle. AB - The effects of verapamil (0.01-0.1 mM) and Ca-free solutions (0 Ca, 3 mM MgCl2, 5 mM EGTA) upon mechanical and electrical properties of a fast twitch mammalian skeletal muscle (extensor digitorum longus) have been studied. Ca-free saline reduces twitch and tetanus tension. The response to single pulses was not affected in the presence of verapamil, but as the rate of stimulation increased, peak tensions were lower and a gradual decrease of tension was observed: frequency-dependent effect. Caffeine (30 mM) contracture was significantly reduced by both solutions. The fibers in Ca-free saline were depolarized (6 mV) and +dV/dt, -dV/dt and overshoot of the AP's were reduced. On the other hand, verapamil did not affect Vm. The presence of 0.1 mM verapamil hindered the ability of the fibers to generate AP's at high rates of stimulation. Lower concentration of verapamil (0.01) did not affect the repetitive electrical activity, but tetanic tension was decreased. These findings support partially the hypothesis about the dependence of mammalian skeletal muscle from external Ca. Verapamil would have several mechanisms of action: a) Ca-channel blocker action, b) local anaesthetic effect, and c) reduction of Ca release from the sarcoplasmic reticulum. PMID- 3274023 TI - Cardiovascular regulation in the acute decerebrate rat. AB - Male Wistar rats were decerebrated at precollicular level, by aspiration, under ether anaesthesia. The experiments employed rats instrumented for chronic electrocardiogram (ECG) recordings or mean blood pressure (MBP) and heart rate (HR) determination. Immediately after surgery, decerebrate (D) and sham operated (SO) animals presented a small and similar increase in their HR. Three and a half hours after surgery, SO group presented a normal HR, whilst D animals continued to show an increase in their HR up to 4.5 h, when it stabilized. Twenty four hours after surgery both groups presented similar MBP (D:110 +/- 6; SO:108 +/- 1 mmHg) but displayed marked differences on their HR (D:550 +/- 11; SO:335 +/- 5 beats/min). The blockade of parasympathetic tonus induced significant increases in the HR of both groups, without major changes in their MBP. Beta-adrenergic blockade reduced HR of both groups, bringing HR of D almost to control level. Simultaneously there was a reduction in MBP of D but not of SO animals. When parasympathetic blockade was superimposed to beta-adrenergic blockade, there was a significant increase in HR of SO, but not of D or in MBP of both groups. Thus we conclude that the decerebrate rat presents normal MBP with simultaneous tachycardia mainly caused by increased sympathetic outflow to the heart. PMID- 3274024 TI - [Comparative cardiovascular effects of nifedipine in anesthetized dogs]. AB - "In vitro" experiments in our laboratory, using coronary conductance arteries, showed that nifedipine produced selective relaxant action. The aim of the present experiments was to demonstrate if this selective vasodilating effect was also detected on coronary resistance vessels of the whole animal. The experiments were performed in anesthetized dogs. In one of the groups a dose-response curve to nifedipine was obtained. In the other group a single dose was infused to each dog. The doses used were: 0.5, 1, 5 and 10 micrograms x kg-1 x min-1. The following parameters were measured: systolic, diastolic (DAP) and mean arterial pressure (MAP); systolic, diastolic (DCF), and mean coronary blood flow; developed tension (DT), heart rate (HR) and cardiac output (CO). Diastolic coronary resistance (DCR) was calculated as the ratio of DAP and DCF. Systemic resistance (SR) was calculated as the ratio of MAP and CO. DAP, MAP, DT and HR remained unchanged with the lowest doses used (0.5 and 1 micrograms x kg-1 x min 1). DCF increased 28 +/- 7% (P less than 0.05) with 0.5 microgram x kg-1 x min-1 and 49 +/- 11% (P less than 0.05) with 1 microgram x kg-1 x min-1. CO increased 13 +/- 3% (P less than 0.05) and 20 +/- 6% (P less than 0.05) respectively. DCR decreased 31 +/- 4% (P less than 0.05) with 0.5 microgram x kg-1 x min-1 and 36 +/- 6% (P less than 0.05) with 1 microgram x kg-1 x min-1. SR decreased 19.5 +/- 5% (P less than 0.05) and 19 +/- 7% (P less than 0.05) respectively. With 5 micrograms x kg-1 x min-1 DAP, MAP and DT decreased 31 +/- 2% (P less than 0.05), 26 +/- 4% (P less than 0.05), and 15 +/- 4% (P less than 0.05) respectively. HR remained unchanged. DCF and CO increased 39 +/- 13% (P less than 0.05) and 35 +/- 11% (P less than 0.05) respectively. DCR and SR decreased 49 +/- 5% (P less than 0.05) and 43 +/- 5% (P less than 0.05) respectively. DAP, MAP and DT decreased 34 +/- 3% (P less than 0.05), 29 +/- 1% and 31 +/- 5% (P less than 0.05) respectively, with 10 micrograms x kg-1 x min-1. HR decreased 9 +/- 3% (P less than 0.05). DCF and CO remained unchanged. DCR and SR decreased 47 +/- 9% (P less than 0.05) and 36 +/- 6% (P less than 0.05) respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3274025 TI - [Inhibitory effect of propranolol on myocardial relaxation not mediated by beta blockade]. AB - The effect of d- and d,l-propranolol (10(-5)M) on myocardial relaxation was studied in the isolated cat heart beating at constant rate and perfused at constant coronary flow. Infusion of d,l-propranolol 10(-5)M produced a significant decrease in maximal velocity of contraction (+T) of 48 +/- 1.5%, P less than 0.05, and a proportionally greater decrease in maximal velocity of relaxation (-T) of 58 +/- 2%, with a significant increase in the ratio between both maximal velocities (+T/-T) of 28.4 +/- 6.2% (from 1.35 +/- 0.03 to 1.74 0.09). The time constant of tension decline computed from the time of -T (Tau) was significantly prolonged by 64 +/- 17.5% (from 38 +/- 1.4 to 61 +/- 6 msec) (P less than 0.05). Similar results were obtained with d-propranolol (10(-5)M). A decrease in +T of 52.2 +/- 4.1% elicited by perfusion with low calcium (0.05 mM) also produced a slight increase in +T/-T and Tau by 11 +/- 4.5% and 27 +/- 6% respectively, P less than 0.05). These increases were, however, lower than those produced by both d,l- and d-propranolol (P less than 0.05). The effect of low calcium on +T, +T/-T and Tau were fully reversible, whereas the complete reversal by calcium of the negative inotropic effect of d- and d,l-propranolol did not reverse the significant decrease in -T and increase in +T/-T, and Tau elicited by the drug. Similar results were obtained in catecholamine depleted hearts. d propranolol (10(-5)M) did not affect the calcium sensitivity of the chemically skinned cat right ventricular trabeculae. The calcium uptake of cat cardiac sarcoplasmic reticulum was significantly inhibited by d-propranolol from a concentration of 3 X 10(-4) M. The results suggest that propranolol 10(-5)M has an antirelaxant effect, not mediated by its negative inotropic action and independent of its beta blocking action. This antirelaxant effect might be mediated by the SR calcium uptake inhibition produced by the drug and might be a possible mechanism by which high concentrations of these agents negatively affect myocardial contractility. PMID- 3274026 TI - [Evaluation of deferoxamine capacity to revert a severe porphyria induced by hexachlorobenzene]. AB - The purpose of the present work is to investigate the ability of desferrioxamine (DF) as an iron chelator to revert or decrease a severe experimental porphyria induced by hexachlorobenzene (HCB) in rats; DF treatment started after 17 weeks of HCB intoxication and was continued until the 27th week. The urinary excretions of -aminolevulinic acid (ALA), porphobilinogen and porphyrins were weekly quantitated. At the end of the experiment the animals were sacrificed and hepatic porphyrins, ALA-synthase and porphyrinogen carboxy-lyase activities were determined. The results obtained indicated that, under the present conditions, the administered iron chelator does not improve the disturbance promoted by HCB on the haem pathway. These results were compared with those obtained when the DF was given simultaneously with HCB from the beginning of fungicide administration. In this last situation the chelator was able to delay and diminish the porphyrinogenic effect of HCB. PMID- 3274028 TI - On RCTs--and the art of nursing. PMID- 3274027 TI - [Effect of alkaline tobacco smoke on neutrophil elastase activity and stability of complexes of pancreatic elastase and serum protease inhibitors]. PMID- 3274029 TI - Socioemotional development. PMID- 3274030 TI - [Obstetric care in rhe continental region (Rio Muni) of the Republic of Equatorial Guinea]. PMID- 3274031 TI - [Epidemiological study of frequent consultants in the Primary Care. Centro de Salud. Unidad Docente de Medicina Familiar y Comunitaria. Toledo]. PMID- 3274032 TI - [Collection efficiency of 2 analytical methods for atmospheric sulfur dioxide (thorin and TCM-PRA)]. PMID- 3274033 TI - [Health education in schools]. PMID- 3274034 TI - [The training of health personnel in the European Economic Community]. PMID- 3274035 TI - [Rio Guadalhorce. A health and hygiene study]. PMID- 3274037 TI - [Epidemiologic study of alcohol and tobacco among adolescents of the Autonomous Basque Community]. PMID- 3274036 TI - [Risk factors in the epidemiology of glaucoma. II]. PMID- 3274038 TI - [The incidence of nosocomial infection]. PMID- 3274039 TI - Occurrence of spontaneous malignant lymphoma in the course of idiopathic myelofibrosis. AB - The spontaneous development of malignant non-Hodgkin lymphoma in a patient with idiopathic myelofibrosis is described. The tumor appeared 3 years after clinical diagnosis of the latter. Implications of the association between myeloproliferative and lymphoproliferative disorders at a pathogenetic level are briefly discussed. PMID- 3274041 TI - Warning headache in aneurysmal subarachnoid hemorrhage. A case-control study. AB - Thirty consecutive patients with aneurysmal subarachnoid hemorrhage (SAH), 20 patients with ischemic stroke, and 100 controls were extensively interviewed about previous episodes of sudden headache, according to a standard pro forma. Thirteen patients with SAH (43%) had a history of a forewarning headache, compared with only one of the patients with ischemic stroke and none of the controls. The interval from the warning headache to the admission rupture was between one week and two months in all patients but one with SAH. Only half of the 13 patients with a warning headache consulted their physician. The outcome was slightly worse in patients with a warning headache, but the differences did not reach statistical significance. These data emphasize the frequent occurrence of warning headaches in SAH. Measures to increase the recognition of sudden headaches should be considered. PMID- 3274040 TI - Anaphylaxis to human serum albumin. AB - During her 26th week of pregnancy a 20-year-old woman developed generalized pruritus, urticaria, flushing, tinnitus, and tachycardia during plasmapheresis with 5% human serum albumin (HSA) as adjunctive treatment for anti-Kell isoimmunization. The reaction was controlled with intravenous diphenhydramine. Despite pretreatment with diphenhydramine and betamethasone a subsequent attempt to perform plasmapheresis with infusion of 5% HSA resulted in a more severe reaction which progressed to respiratory distress. Intradermal skin testing with 5% HSA produced a 9 x 11-mm wheal and 17 x 21-mm erythema at 15 minutes. An enzyme-linked immunoassay was positive for IgE antibody to 5% HSA before and after dialysis for removal of Na caprylate. These results are consistent with an IgE-mediated basis for this patient's reaction to HSA. PMID- 3274042 TI - Necrotizing vasculitis and atherosclerosis. AB - We describe five patients aged 50 years or above who had severe atherosclerosis and necrotizing vasculitis. The vasculitis was seen in the small vessels of four patients and in the medium-sized vessels of one. All five patients had multiple necrotic ulcerative skin lesions, and two underwent amputation. Our cases suggest that the relationship between the two disorders changes and exacerbates the clinical and pathological expression of each disease. PMID- 3274043 TI - Blood components contribute to rise in gerbil brain levels of leukotriene-like immunoreactivity after ischemia and reperfusion. AB - The mean +/- SEM concentrations of immunoreactive leukotriene C4 and D4 (iLTD4) and prostaglandin D2 (iPGD2) increased from 3.0 +/- 1.2 and 0.71 +/- 0.33 to 16.3 +/- 4.7 and 3.0 +/- 1.14 ng/g forebrain, respectively (p less than 0.05, iLTD4; p less than 0.01, iPGD2), in the forebrains of 12 gerbils after 15 minutes of bilateral common carotid artery occlusion and 15 minutes of reperfusion. Removal of blood from ischemic brain of 11 gerbils by intracardiac perfusion with ice cold saline for 10 minutes decreased iLTD4 concentrations significantly to 7.0 +/ 0.9 (p less than 0.05) but did not change iPGD2 concentrations. Severe granulocytopenia (4.98 +/- 1.79 to 0.05 +/- 0.03 x 10(3)/mm3, p less than 0.01) in seven gerbils following intraperitoneal injection of 50 mg/kg busulfan was associated with decreased iLTD4 accumulation in the brain to 3.46 +/- 1.36 ng/g forebrain (p less than 0.01). Taken together, our results suggest that blood components (most likely leukocytes) are a source of leukotriene-like immunoreactivity in the ischemic and reperfused brain. PMID- 3274044 TI - Unfavourable outcomes of drug therapy--subjective probability versus confidence intervals. AB - To investigate how individual predictions compare with confidence intervals, we asked 50 medical residents and 28 graduate students with biostatistics training to estimate unfavourable outcomes of drug therapy (therapeutic failures and side effects) in groups of 10 and 20 patients. The predictions made by physicians and graduate students were similar for both sample sizes and types of outcome. The majority (58%) of estimates were greater than the upper limit of the 95% confidence interval, a bias that may hamper the correct interpretation of therapeutic risks in medical decision-making. PMID- 3274045 TI - Antibodies to ovine lymphocytes exist in bovine alloantisera. AB - Forty-six percent of 149 reagents against class 1 antigens of the bovine major histocompatibility system reacted with lymphocytes from 1 or more sheep in a microlymphocytotoxicity test. The reactions fell into six groups. The majority of antisera defined an antigen present on both erythrocytes and lymphocytes. This antigen is probably the R blood group antigen and the reactions were unrelated to the presence of anticlass I activity and are probably due to the additional presence of antibodies of R specificity. The other antigens are not identical to any of the 14 red blood cell factors or seven lymphocyte antigens examined, nor did they correspond to any of the class I bovine lymphocyte antigens defined by the alloantisera. PMID- 3274046 TI - Heterozygosity at the Km locus associated with humoral immunity to Campylobacter jejuni. AB - Serum samples from 43 Caucasian subjects convalescing from acute Campylobacter jejuni infection were typed for nine Gm and two Km determinants. The sera were also used to measure IgA, IgG, and IgM classes of antibody to acid-labile surface proteins of C. jejuni by an enzyme-linked immunosorbent assay. A highly significant association (p = 0.004) was found between Km1/Km3 heterozygotes and the level of IgA antibodies. These results suggest the existence of complementary immune response genes which in the heterozygous condition permit a humoral response to C. jejuni. PMID- 3274047 TI - Self-tolerance and H-2 antigen expression in semi-allogeneic radiation chimeras are controlled by the extrathymic host environment. AB - Experiments with thymus-grafted radiation chimeras have implicated the H-2 type of the radio-resistant portion of the thymus as determining self for H-2 restricted T-cell responses. (P1 X P2)F1----P1 chimeras, shown to be fully reconstituted with donor haemopoietic cells, have displayed intolerance to P2 H-2 antigens and expressed aberrant levels of P2 H-2 on their spleen cells. We used semi-allogeneic radiation chimeras grafted with fetal thymuses from parental strain donors to compare the relative contributions of the thymus and the extrathymic periphery in determining self-tolerance and in modulating the H-2 phenotype of heterozygous chimeric spleen cells. As analysed by the rosetting titres of anti-H-2 antisera on chimeric spleen cells, by parental skin graft rejection, and by spleen cell anti-parent cytotoxicity after culture with parental stimulators, the decreased expression of non-host parental H-2 antigens was associated with anti-P2 T-cell reactivity, regardless of the H-2 type of the thymus. The donor thymus did not affect tolerance to parental H-2 or cause aberrant expression of H-2 antigens on spleen cells of syngeneic F1----F1 thymus grafted chimeras. PMID- 3274048 TI - Genetic polymorphism of IgG in mink. II. A genetic analysis of allotypes. AB - Population distribution and inheritance pattern were analyzed in mink IgG allotypes: L1 (L chains), H2, H3, H4, H6, H7, and H8 (the constant region of the H chains, i.e. C gamma-allotypes) and conformational allotype 5 with unknown chain localization. Contrary to expectation, neither allelism, nor close linkage were demonstrated for these allotypes. The major feature of the inheritance of H2, H3, and H4 C gamma-allotypes, as well as allotype 5, was significant excess of negative (without these allotypes) progeny in the F1 generation from monohybrid cross. The explanation offered for this departure of the C gamma allotypes from normal Mendelian genetics suggests widespread latencies of their expression in mink. PMID- 3274049 TI - Human polymorphic APO-LDL investigated by high-resolution two-dimensional electrophoresis. AB - The APO part of a human polymorphic low density lipoprotein (LDL) was investigated by two-dimensional electrophoresis. Since these allotypic LDL were purified from sera by specific immunochromatography, the data presented here refer to only one molecular species of LDL. The two-dimensional electrophoresis revealed the presence of isoforms which were correlated to the serological phenotype. A hypothesis about APO-LDL gene organization is outlined. PMID- 3274050 TI - Supertypic HLA-Bw4 antigen detected by a new monoclonal antibody. AB - A monoclonal antibody, HLAO1, was prepared by immunizing BALB/c mice with human lymphocytes of known HLA genotype. The monoclonal antibody is cytotoxic, of the IgG 2b isotype and binds to a protein of Mr 43,000 noncovalently associated with the beta 2-microglobulin. Genetic analysis proved complete concordance in the expression of the antigenic determinant defined by this monoclonal antibody and the presence of a supertypic (public) antigen, the HLA-Bw4. As expected, the monoclonal antibody also reacted with the antigens of HLA-A locus, A23, A24, and A32. The computer analysis of HLAO1 antibody binding to the Bw4/Bw6 heterozygous lymphocytes gave the approximate number of antigenic determinants, n = 2.2 X 10(4)/cell, and Ka = (5.9 +/- 0.8) X 10(9) M-1. Besides its potential immunochemical applications, the HLAO1 monoclonal antibody can become a useful tool in routine cytotoxicity typing of HLA antigens on peripheral lymphocytes. PMID- 3274052 TI - S-s-U-phenotype in a Caucasian family. AB - The S-s-U-blood group phenotype, commonly detected in Black populations, was found in a Caucasian family in which 4 homozygous U-negative members exhibit this phenotype. The erythrocyte blood group antigens and membrane glycoproteins from these donors have been serologically and electrophoretically characterized and compared to the U-negative red cells from Black people. Caucasian and Black S-s-U red blood cells behaved identically since both lack Ss and U antigens and the minor red-cell membrane glycophorin B. PMID- 3274051 TI - Influence of class I H-2 gene expression on local tumor growth. Description of a model obtained from clones derived from a solid BALB/c tumor. AB - A BALB/c methylcholanthrene-induced tumor was studied for class I and II H-2 expression. GR9 was adapted to tissue culture without any passage in vivo to avoid immunoselection mechanisms. Forty-three clones were obtained and typed for H-2 antigens. A variety of techniques were used for typing, for example, 51Cr release assay, radiobinding assay; absorption with anti H-2 monoclonal antibodies or H-2 allo-antisera and alloreacting cytotoxic T lymphocytes. A heterogeneity of H-2 expression was detected in these clones with clones H-2 K+/D+, to clones H-2K D-. This heterogeneity was also evident when several GR9 clones were tested for in vivo growth in syngeneic BALB/c mice. Two clones, A7 and B9, were selected for further studies and injected into syngeneic animals to measure local tumor growth. A7 (K+/D+) was rather immunogenic while B9 (K-/D-) was not. These differences were probably due to an immunoresponse, since both clones grow similarly in irradiated syngeneic BALB/c mice. Immunoprecipitations of H-2 antigens and SDS-PAGE analysis confirmed the results obtained in serology. Three isoenzymes were also determined in GR9 clones and their electrophoretic mobility was always identical to that obtained in normal BALB/c tissues. These results suggest that K and D molecules are important structures for an immunoresponse against tumor-associated antigens. PMID- 3274053 TI - Specificity of hemagglutinin of Falcata japonica which reacts with blood group active N-acetyl-D-galactosamine residues. AB - Saline extract of the seeds of Falcata japonica has been shown to have hemagglutinating activity for saline red cells of group A, Cad positive and Tn. In titration the extract agglutinates more strongly A2 red cells than the extract of Dolichos biflorus. Because the extract of F. japonica has no ability to agglutinate A3 red cells, it could be used to distinguish the subgroups of A in comparison with the agglutinability of human anti-A serum and D. biflorus lectin. F. japonica extract agglutinates much more strongly with papain-treated A red cells, and papain-treated O and B red cells come to be agglutinated with the extract. The agglutination reactions of lectin of F. japonica with untreated A, and papain-treated A and O red cells are inhibited by A secretor saliva and A substances from human and hog gastric linings. N-Acetyl-D-galactosamine is a potent inhibitor of the hemagglutination reaction in monosaccharides tested. It is directed against terminal GalNAc structures either alpha- or beta-linked. PMID- 3274054 TI - HLA in Buerger's disease. AB - Recent studies have focused on the possible genetic factor(s) in the pathogenesis of Buerger's disease as well as in Takayasu's disease. We investigated HLA-A, B, C, DR, and DQ antigens in 59 patients with Buerger's disease to confirm statistically significant high frequencies of Aw24, Bw40, Bw54, Cw1, and DR2 antigens and a low frequency of DR9 and DRw52 as compared with those in 152 normal Japanese individuals. As the haplotpye Aw24-Bw54-Cw1-DR4 is known to be common among Japanese, a significantly high frequency of haplotype Bw54-DR2 found in cases of Buerger's disease, instead of that of Bw54-DR4, may suggest a possible cross-linkage occurrence in chromosome 6, which could prove to be an important causative phenomenon in the pathophysiology of Buerger's disease. PMID- 3274056 TI - [Hyperkinetic syndrome as initial manifestation of AIDS]. PMID- 3274055 TI - Phenotypic similarity between T-cell antigen binding molecules. AB - T-cell antigen binding molecules (TABM) specific for trinitrophenol (TNP), oxazalone, azobenzenearsonate or sheep erythrocytes were purified by affinity to antigen, adsorption to monoclonal antibodies to antigen binding molecules or were synthesized by translation of immunopurified mRNA for TABM in vitro. These molecules and a T-cell line, BW5147, membrane protein bound by rabbit antibodies to TABM were radiolabeled by 125I, digested with Staphylococcus V8 protease, and peptides of the proteolytic digest were resolved by 2D-gel peptide mapping. Comparison of the peptide maps of these proteins and amino acid analysis of T cell antigen binding molecules specific for TNP or sheep erythrocytes indicate similarities and distinctions suggesting variable and constant domains in these molecules. PMID- 3274057 TI - [Polymyositis and ulcerative colitis. A new form of association?]. PMID- 3274058 TI - [Conjugal amyotrophic lateral sclerosis]. PMID- 3274059 TI - [Vascular dementia]. PMID- 3274061 TI - [Current diagnosis of tuberculous meningitis]. PMID- 3274060 TI - [Myasthenia gravis: analysis of the factors which influence the prognosis of thymectomy in 62 patients]. PMID- 3274062 TI - [Acute cerebellar vascular pathology. A clinical study of 38 cases]. PMID- 3274063 TI - [Clinical characteristics and diagnostic difficulties in 35 cases of tuberculous meningitis]. PMID- 3274064 TI - [Clinical and diagnostic aspects of dolichoectasia of the basilar artery. Apropos of 5 cases]. PMID- 3274065 TI - [Cerebral toxoplasmosis with acquired immunodeficiency syndrome (AIDS) in 2 young former heroin addicts]. PMID- 3274066 TI - [Acute subdural hematoma and meningioma of the pterygium]. PMID- 3274067 TI - [Intravenous erythromycin in the treatment of neurosyphilis]. PMID- 3274068 TI - [Carcinomatous leptomeningitis as a complication of solid tumors. Presentation of 17 cases]. PMID- 3274069 TI - [The nucleus accumbens: is it an exclusive component of the dopaminergic system of the basal ganglia?]. PMID- 3274070 TI - [Acquired myasthenia gravis and HLA system]. PMID- 3274071 TI - [Migraine and cerebrospinal fluid alterations: are they an expression of viral meningoencephalitis?]. PMID- 3274072 TI - [Anticoagulation in cerebral infarct of cardiac origin. A study of 58 patients in acute phase]. PMID- 3274074 TI - [Myopathy caused by perhexiline maleate]. PMID- 3274073 TI - [Subclinical leukoencephalopathy caused by methotrexate]. PMID- 3274075 TI - [Laboratory diagnosis of herpetic encephalitis]. PMID- 3274076 TI - [Delayed epilepsy as presenting form of agenesis of the corpus callosum]. PMID- 3274077 TI - [Pituitary apoplexy and ocular murmur]. PMID- 3274079 TI - [Special meeting of the Spanish Society of Neurology. 2d Hispano-Portuguese Meeting on Neurology. Salamanca, May 30-31, 1986. Abstracts]. PMID- 3274078 TI - [Acute spontaneous subdural hematoma]. PMID- 3274080 TI - [3d Winter Seminar on Neurology. Candanchu, 25-31 January 1987. Abstracts]. PMID- 3274081 TI - [39th annual meeting of the Spanish Society of Neurology. Barcelona, 10-12 December 1987. Abstracts]. PMID- 3274082 TI - [40th annual meeting of the Spanish Society of Neurology. Barcelona, 15-17 December 1988. Abstracts]. PMID- 3274083 TI - Separation of human milk oligosaccharides by recycling chromatography. First isolation of lacto-N-neo-difucohexaose II and 3'-Galactosyllactose from this source. AB - Lacto-N-neo-difucohexaose II, beta-D-Galp-(1----4)-[alpha-L-Fucp-(1----3)]-beta-D Glcp-NAc-(1----3)-beta-D-Galp-(1----4)-[alpha-L-Fucp-(1----3)]-D-Glc, and 3' galactosyllactose, beta-D-Galp-(1----3)-beta-D-Galp-(1----4)-D-Glc, were isolated for the first time from human milk by means of a recycling chromatography technique. Through this method, carried out mainly on columns of K+ ion-exchange resins and either Bio-Gel P-4 or TSK 40 W(S) gel filtration media, up to one gram of an oligosaccharide mixture could be handled and lacto-N-neo-difucohexaose II separated from isomeric lacto-N-difucohexaose I, alpha-L-Fucp-(1----2)-beta-D Galp-(1----3)-[alpha-L-Fucp-(1----4)]-beta-D-GlcpNAc-(1----3)-beta-D-Galp-(1--- 4)-D-Glc, and II, beta-D-Galp-(1----3)-[alpha L-Fucp-(1----4)]-beta-D-GlcpNAc-(1- --3)-beta-D-Galp-(1----4)-[alpha-L-Fucp-(1----3)]-D-Glc. This method also permitted resolution of isomeric mixtures of the trisaccharides 2' fucosyllactose, alpha-L-Fucp-(1----2)-beta-D-Galp-(1----4)-D-Glc, and 3 fucosyllactose, beta-D-Galp-(1----4)-[alpha-L-Fucp-(1----3)]-D-Glc, the tetrasaccharides lacto-N-tetraose, beta-D-Galp-(1----3)-beta-D-GlcpNac-(1----3) beta-D-Galp-(1----4)-D-Glc, and lacto-N-neo-tetraose, beta-D-Galp-(1----4)-beta-D GlcpNAc-(1----3)-beta-D-Galp-(1----4)-D-Glc, and the pentaoses 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, II, beta-D-Galp-(1----3)-[alpha-L-Fucp-(1----4)] beta-D-GlcpNAc-(1----3)-beta-D-Galp-(1----4)-D-Glc, and III, beta-D-Galp-(1----4) [alpha-L-Fucp-(1----3)]-beta-D-GlcpNAc-(1----3)-beta-D-Galp-(1----4)-D-Glc, which have proved difficult if not impossible to separate by other means. The isolation of these and other milk oligosaccharides is described herein. The 500-MHz 1H n.m.r. spectra of lacto-N-neo-difucohexaose II and 3'-galactosyllactose, and their alditols, are recorded. 1H-n.m.r. data on some other milk oligosaccharides, both natural and reduced, are also given. PMID- 3274084 TI - Structural analysis of normal and transforming mil(raf) proteins: effect of 5' truncation on phosphorylation in vivo or in vitro. AB - The phosphorylation sites of the cellular proto-oncogene product p71/73c-mil(raf) from quail and from human cells were analyzed by two-dimensional peptide mapping and compared to the sites phosphorylated in proteins encoded by three transforming alleles of c-mil(raf). These alleles all were 5'-truncated resulting from either retroviral transduction (v-mil, v-raf) or promoter insertion mutagenesis (LTR-c-raf). The normal cellular proteins each were phosphorylated in vivo on three major sites, two of which were identical in the two protein species. MH2 p100gag-mil, murine sarcoma virus 3611 p75gag-raf, and LTR-c-raf p45 50 delta c-raf were phosphorylated in vivo on several sites. One site was shared between these transforming proteins and was also conserved in both avian and human p71/73c-mil(raf). All normal and transforming mil(raf) proteins were phosphorylated on serine in vivo while p100gag-mil and p75gag-raf occasionally also contained low levels of phosphothreonine. No specific phosphorylation of p71/73c-mil(raf) was detected in vitro under conditions that readily revealed presumed autophosphorylation of p100gag-mil, p75gag-raf, and p45-50 delta c-raf. However, the in vitro phosphorylated sites of these proteins were different to each other and to the sites phosphorylated in vivo. In contrast to the predominant threonine phosphorylation of the two viral proteins, only phosphoserine could be detected in p45-50 delta c-raf phosphorylated in vitro. PMID- 3274085 TI - A rearranged transforming gene, tre, is made up of human sequences derived from chromosome regions 5q, 17q and 18q. AB - The transfection recombinant transforming gene, tre, originated from discontinuous human genetic elements after transfection of NIH3T3 cells with genomic DNA from a Ewing's sarcoma cell line. Probes for the three normally discontinuous human elements involved in the transfection recombinant were subcloned and used in conjunction with a panel of rodent-human hybrid cells to determine their normal location in the human genome. The leftmost (5') element derives from the long arm of chromosome 5 (5q); the internal fragment derives from human chromosome 18 proximal to the bcl-2 gene; and the rightmost (3') element derives from the long arm of chromosome 17 (17q) distal to an acute leukemia breakpoint at 17q21. In situ hybridization of the same probes to human metaphase chromosomes confirmed localization of these sequences to regions 5q23-- -q31, 18q12, and 17q12----q22. PMID- 3274087 TI - [Handbook for the district physician. II. Occupational health care]. PMID- 3274086 TI - The human erg gene maps to chromosome 21, band q22: relationship to the 8; 21 translocation of acute myelogenous leukemia. AB - There is accumulating evidence to support that genes on chromosome 21 play an important role in the development of pathologies associated with leukemia, Down's syndrome, and Alzheimer's disease. We have previously described erg, a human gene related to the ets oncogene. In this study, we have regionally assigned the erg gene to chromosome 21q22.3 by using somatic cell hybrids and in situ hybridization analysis. In light of this chromosome assignment, the relationship of erg to the 21q translocation breakpoint characteristic of acute myelogenous leukemia (AML) was considered. By using a DNA probe that is specific for the erg gene, a panel of rodent-human cell hybrids was analyzed by the Southern technique to study specific chromosome translocations occurring in acute myeloblastic leukemia. The erg gene was found to translocate from chromosome 21 to 8 in the t(8; 21) (q22; q22), a non-random translocation found in patients with acute myelogenous leukemia of the subgroup M2 (AML-M2). The localization of the erg gene to chromosome 21q22 raises the possibility that this gene may be involved in the pathogenesis of AML-M2. PMID- 3274089 TI - [Current viruses. Biological aspects]. PMID- 3274088 TI - [Importance of forensic dentistry in individual identification]. PMID- 3274090 TI - [Decontamination of materials and protection of personnel]. PMID- 3274091 TI - [Current viruses: prevention and therapeutic aspects]. PMID- 3274092 TI - [Periodontology and the child, or "the attitude of the practitioner toward gingival inflammation in the young"]. PMID- 3274093 TI - [Gingival plaque anaerobic bacteria in periodontal disease]. PMID- 3274094 TI - [Functional dental anatomy: basis of current dentistry]. PMID- 3274095 TI - [Role of atypical deglutition in the development of masticatory apparatus dysfunction]. PMID- 3274096 TI - [New postoperative technic in maxillary cancer surgery]. PMID- 3274097 TI - [Progress in clinical imaging: dental applications]. PMID- 3274099 TI - [Influence of physiological and etiopathogenetic concepts on TMJ surgery]. PMID- 3274098 TI - [Sequential anatomic imaging of the human TMJ: macroscopic and microscopic study in three dimensions]. PMID- 3274100 TI - [Epidemiology of cancers of the upper aerodigestive tract in France]. PMID- 3274101 TI - [The prevention phenomena in society]. PMID- 3274102 TI - Effect of nitrogen dioxide, ozone, and peroxyacetyl nitrate on metabolic and pulmonary function. AB - The metabolic and pulmonary function responses were investigated in 32 non smoking men and women (8 men and 8 women 18-26 years of age, and 8 men and 8 women 51-76 years of age) who were exposed for 2 hours to each of 8 conditions: 1) filtered air (FA), 2) 0.13 ppm peroxyacetyl nitrate (PAN), 3) 0.45 ppm ozone (O3), 4) 0.60 ppm nitrogen dioxide (NO2), 5) 0.13 ppm PAN + 0.45 ppm O3 (PAN/O3), 6) 0.13 ppm PAN + 0.60 ppm NO2 (PAN/NO2), 7) 0.60 ppm NO2 + 0.45 ppm O3 (NO2/O3), and 8) 0.13 ppm PAN + 0.60 ppm NO2 + 0.45 ppm O3 (PAN/NO2/O3). The subjects alternated 20-min periods of rest (n = 3) and cycle ergometer exercise (n = 3) at a work load predetermined to elicit a ventilatory minute volume (VE) of approximately 25 L/min (BTPS). Functional residual capacity (FRC) was determined pre- and post-exposure. Forced vital capacity (FVC) was determined before and after exposure, and 5 min after each exercise period. Heart rate was monitored throughout each exposure, and VE was measured during the last 2 min of each exercise period. Exposure to FA, PAN, NO2, and PAN/NO2 had no effect on any measure of pulmonary or metabolic function. Ozone was primarily responsible for the pulmonary function effects observed. There was no significant difference between the responses to O3 exposure and the responses to the three O3 mixtures, indicating no interactions between the pollutants. The results suggest that women may be somewhat more responsive to O3 exposure than men, and that older people (51-76 years of age) may be less responsive to O3 than younger people (18-26 years of age). PMID- 3274103 TI - DNA adducts of nitropyrene detected by specific antibodies. AB - Rabbit antisera containing polyclonal antibodies specific for the 1-nitropyrene derivatives, (1-acetylaminopyrene, 1-acetylamino-6-nitropyrene, 1-acetylamino-8 nitropyrene) and the major nitropyrene-DNA adduct, C-8-aminopyrene deoxyguanosine, were obtained from New Zealand White male rabbits that were immunized with 1-nitrosopyrene-modified keyhole limpet hemocyanin (KLH). The affinity constants of the rabbit antisera for these derivatives ranged from 1 to 3 x 10(8) liters/mole. The ability of the antisera to detect 1-nitrosopyrene and the parent 1-nitropyrene was 25- to 30-fold less than the sensitivity to other metabolites. Female BALB/c and AJ mice were also immunized with 1-nitrosopyrene modified KLH and 4 out of 18 surviving animals produced a low titer response when measured by an [3H] acetylaminopyrene-based radioimmunoassay. Mice that were immunized with a diazotized derived 1-aminopyrene bovine gamma globulin, 1 nitrosopyrene adducted bovine gamma globulin, and 1-nitrosopyrene-bound bovine serum albumin, produced very low immune responses. Spleen cells from selected mice were fused with myeloma cells but failed to produce stable clones that secreted nitropyrene-specific monoclonal antibodies. Therefore, the use of a 1 nitrosopyrene modified keyhole limpet hemocyanin to elicit an immune response specific for the nitropyrene moiety in one animal species (rabbit) was successful in producing a specific antisera. The immune response produced in mice and rabbits was much lower when compared to that produced by other chemically derived antigens we have used, such as the aflatoxins and 4-aminobiphenyl. The rabbit data encourages a continued attempt to produce monoclonal antibodies specific for nitropyrene. Such antibodies can be used in the development of preparative and analytical techniques to isolate and quantify nitropyrenes in biological samples from exposed human populations. PMID- 3274104 TI - [Pituitary apoplexy as the first neurologic manifestation of hypophyseal adenoma. A study of 8 cases]. PMID- 3274105 TI - [Epidemiology of multiple sclerosis in the province of Malaga (Spain). A prevalence study]. PMID- 3274106 TI - [Vascular abnormalities in a case of tuberous sclerosis]. PMID- 3274107 TI - [Transcortical motor aphasia and motor negligence]. PMID- 3274108 TI - [Lesch-Nyhan syndrome with total deficiency of the enzyme hypoxanthine phosphoribosyltransferase]. PMID- 3274109 TI - [EEG with peak focal discharges in children without epileptic crises]. PMID- 3274110 TI - [Mitochondrial encephalomyopathy. 2 cases with Kearns-Sayre syndrome]. PMID- 3274111 TI - [Prosopagnosia. Bilateral occipital infarct observed in computerized tomography]. PMID- 3274112 TI - [2d Winter Seminar on Neurology. Candanchu, 26 January-2 February 1986. Abstracts]. PMID- 3274113 TI - [The pyramidal fascicle: which is its function?]. PMID- 3274114 TI - ["Lacunar" syndromes caused by spontaneous cerebral hemorrhage]. PMID- 3274116 TI - [Neurologic implications of sphenoid sinusitis]. PMID- 3274115 TI - [Severe cranio-encephalic trauma. Prognosis factors and results in 142 cases]. PMID- 3274117 TI - [Pseudotumor cerebri and unilateral papillary edema. Presentation of a case]. PMID- 3274118 TI - [Reflex epilepsy induced by thought]. PMID- 3274119 TI - [Reaction time in Parkinson disease]. PMID- 3274120 TI - [Cerebral vascular pathology]. PMID- 3274121 TI - [Orbital myositis]. PMID- 3274123 TI - [Elemental microanalysis of the CNS using X rays]. PMID- 3274122 TI - [Oligoclonal bands in multiple sclerosis]. PMID- 3274124 TI - [Herpetic encephalitis with rhombencephalitis]. PMID- 3274125 TI - [Encephalopathy of the acquired immunodeficiency syndrome (AIDS) in childhood. A clinicopathological study]. PMID- 3274126 TI - [Neurologic manifestations caused by Mycoplasma pneumoniae. Presentation of 4 cases]. PMID- 3274127 TI - [Anomalous reinnervation of the third cranial nerve pair]. PMID- 3274128 TI - [Olive pickers' paralysis]. PMID- 3274129 TI - [Cinnarizine and Parkinson disease]. PMID- 3274130 TI - [Adenosine deaminase in tuberculous meningitis]. PMID- 3274132 TI - [Width of human molar enamel at different levels of the cervical third]. PMID- 3274131 TI - Carbohydrate-binding specificities of five lectins that bind to O-Glycosyl-linked carbohydrate chains. Quantitative analysis by frontal-affinity chromatography. AB - The carbohydrate-binding specificities of lectins purified from Agaricus bisporus (ABA-I), Arachis hypogaea (PNA), Bauhinia purpurea (BPA), Glycine max (SBA), and Vicia villosa (VVA-B4) have been studied by affinity chromatography on columns of the immobilized lectins, and quantitatively analyzed by frontal affinity chromatography. These five lectins could be classified into two groups with respect to their reactivities with typical mucin-type glycopeptides, beta-D-Galp (1----3)-alpha-D-GalpNAc-(1----3)-Ser/Thr (2) and alpha-D-GalpNAc-(1----3) Ser/Thr (3). One group, which consists of ABA-I, PNA, and BPA, preferentially binds to 2, and the other, which consists of SBA and VVA-B4, shows higher affinity for 3 than for 2. Among the lectins tested, only ABA-I was found to bind to a sialylated glycopeptide, whic which was prepared from human erythrocyte glycophorin A and contains three three tetrasaccharide chains having the structure of alpha-NeuAc-(2----3)-beta-D-GAlp-(1----3)-NeuAC-(2----6)]-alpha-D Galp NAc-(1----, with an association constant of 15 microM, whereas the association constants of the other four lectins for this sialylated glycopeptide were less than 3.5 mM. On the other hand, removal of the beta-D-galactopyranosyl group from a glycopeptide containing sequence 2 resulted in decreased association constants for the three lectins of the first group, especially ABA-I and PNA. The two lectins of the second group showed a high affinity for 3, but SBA preferentially interacted with oligosaccharides containing the alpha-D-GalpNAc-(1 ---3)-beta-D-Galp-(1----3)-D-GlapNAc sequence, prepared from a blood group A active oligosaccharide. PMID- 3274133 TI - [Preliminary report. Internal rigid fixation in orthognathic surgery]. PMID- 3274134 TI - [Technical note. Localization of foreign bodies using angular variation in cranial radiography]. PMID- 3274135 TI - [Analysis of the use of fluoridated dentifrices in Curitiba]. AB - The use of fluoride dentifrices in Curitiba (Brazil) was studied. The scholarity and socio-economical levels of the population were related to the use of fluoride dentifrices. The sample was composed of 155 persons, men and women. The results showed that 96.8% used dentifrices, but only 36.2% used fluoride dentifrices. The use of fluoride dentifrices was more significant among the higher socioeconomical and school levels. PMID- 3274136 TI - [Orthodontic aspects of third molars]. AB - This paper deals with an orthodontic approach of the third molars. A technique was presented with the purpose of predicting the space available for eruption and occlusion. A review of the literature led to the conclusion that the third molars do play a role during the anterior crowding process but it is not considered as its main etiological factor. Enucleation of third lower molars at early age is suggested when space is not adequate for its further eruption. PMID- 3274137 TI - [A maxillary second molar with five canals]. PMID- 3274138 TI - [Adherence of oral bacteria to restorative materials. Adherence to a composite resin]. PMID- 3274140 TI - [Effects of indium and tin addition to Ag-Cu alloys on the biocompatibility]. PMID- 3274139 TI - [The effect of air-powder abrasive instrument on prosthodontic materials]. PMID- 3274141 TI - [Relationship between biting force and intelligence test]. PMID- 3274142 TI - [Dose-response relationship of cadmium or radiation-induced embryotoxicity in mouse whole embryo culture]. PMID- 3274143 TI - Adhesive strength of mesh veneer plate with adhesive resin. PMID- 3274144 TI - [Contamination of tissue conditioning material with "KREGARD"]. PMID- 3274145 TI - [Reproduction accuracy in sirognathographic pattern production]. PMID- 3274146 TI - [Effect of experimental occlusal interference on the chewing cycle of lower incisal point]. PMID- 3274147 TI - [A case of Class I malocclusion with high cuspids treated with modified Northwest technique]. PMID- 3274148 TI - [A case report of high-canine treated with the Vari-Simplex-Discipline]. PMID- 3274149 TI - [A case of Class II malocclusion with mandibular retrusion]. PMID- 3274150 TI - [A case report of skeletal Class III open bite treated with orthognathic surgery]. PMID- 3274151 TI - A case of oral mucosal ulcer due probably to the adhesive used for fixation of mandibular kinesiograph magnet. PMID- 3274152 TI - [Five cases of gingivitis in puberty]. PMID- 3274153 TI - [The clinical use of Hotz-type orthopedic plate]. AB - In the present study a Hotz type orthopedic plate was used to improve feeding and physiological growth. In 2 patients with cleft lip it was used to improve feeding and swallowing. In 4 patients with cleft lip and palate it was used to normalize functions and aid physiological growth. The effects of the Hotz orthopedic plate were determined by recording body weight growth, milk volume per day, feeding time and comparison of the study model between before and after using Hotz orthopedic plate. Good physiological growth and improved feeding, were obtoincdinalmostall the patients who wore the Hotz type orthopedic plate correctly. PMID- 3274154 TI - The effect of adventitious deafness on the perception and production of voice onset time in Thai: a case study. PMID- 3274156 TI - [Mucoceles of the paranasal sinus: report of 5 cases]. AB - AA. report 5 cases of mucoceles that they have seen during a 5 years period; all the etiological factors that have been reported are present. Flogosis, trauma and neoplasm may create a mechanical obstacle to mucoid fluid flow; the intrasinusal pressure increases and erode the osseus wall and thus the mucoceles con herniate into adjacent structures. PMID- 3274155 TI - Effects of metrical foot structure on syllable timing. PMID- 3274157 TI - [Pseudocyst of the maxillary sinus: a proposal for treatment]. AB - AA. discussed the term "mucocele" from the standpoint of its clinical findings, incidence, pathogenesis and confusion in terminology. They thought that the removal, through sinuscopy, may be useful in order to break the cist and to draw a sample for pathological purpose. This simple procedure establishes the diagnosis and, in the same instance, may be curative. PMID- 3274158 TI - [Tooth heterotopy with endosinus localization]. AB - Among the various cases of etherotophy, the only and multiple, that has observed, the Authors consider only a few among the significant ones and with endosinusal localization-after examining the probable mechanism patogenetic we pay attention to the necessity of an exact diagnostic judgement and on the opportunity of a precocious and exact treatment. PMID- 3274160 TI - [Iatrogenic peripheral facial paralysis]. AB - The Authors have made a research on the peripheric palsy of the facial nerve caused by surgical operations and anesthetic methods; they emphasize the importance of the prevention of the esthetic and functional damage that results from the injury. This prevention not always is possible in relation to the anatomic conditions and to the anomalies of the course of the nerve. PMID- 3274159 TI - [Amalgam gingival tatoo]. AB - The Authors present (5) cases of gingival tattooing resulted by rapport between argentum amalgam and prosthetic reconstruction with aurum or combination. Theu concluded is opportune to substitute the stumps reconstructions in amalgam with other materials not cause of electrogalvanism. So we avaid principally the antiaesthetic aspect of pigmentation. PMID- 3274161 TI - [Elevation-rotation surgical technic of the edentulous upper alveolar process in cases of latero-posterior vertical collapse]. AB - This paper presents and discusses an original surgical technique designed to solve edentular problems in lateral-posterior sectors involving one or both opposing arches, where insufficient prosthetic reconstruction not infrequently gives rise to vertical collapse which then obliges the dental surgeon to prepare space for suitable prosthetic reconstruction. The surgical, requiring segmental osteotomy of the lateral-posterior edentulous region is presented. PMID- 3274162 TI - [Autotransplantation of human tooth germs]. AB - The Author presents three cases of tooth germ transplantation which were periodically checked by x-rays to show the progressive root development. The clinical result obtained were quite satisfactory. The situations requiring the transplantations in the 3 cases were all rather unusual: in one case the tooth germ was inside a large follicular cyst; in the other two the tooth germs were mesiodistally rotated 90 degrees which made eruption impossible. The cases described differ from cases frequently found in literature in that the transplanted tooth germs were in the initial stage of development; the roots, in fact, had not yet begun to develop. All the tooth germs transplanted, once their growth was completed, presented two types of morphological alternations. A reduction in the volume of the pulpar chamber and a pad of radiopaque tissue around the neck of the tooth. We have attempted to give an explanation for both of these alterations. The cases as well as the surgical procedures are described in detail. PMID- 3274163 TI - [Epidemiological survey of dento-periodontal pathology in a group of Palermo Public School children]. PMID- 3274164 TI - [Costs and dental operating levels in a group of Palermo children]. AB - The authors, after evaluating the necessity of dental treatment in a school children sample, analyzed operative time and costs. the collected data show these therapeutic time and costs are very high. these therapeutic procedures will determinate a significative decrease of complexes therapeutic trails. PMID- 3274165 TI - [Dietary habits and oral health indices in a group of public school children]. AB - The authors explain some fundamental concepts regarding the effect of diet on chemical plaque composition and the influence of carbohydrates on some bacterial species. They besides report the results of their epidemiological research in order to emphasize the influence of the alimentary habits on some index of oral health. PMID- 3274167 TI - [Prevention and treatment of hypermotive syndromes in patients needing dental care. 1. Classification, epidemiology, prevention]. AB - In the present work the Authors analyze the frequence and the intensity of emotive reactions in patients undergoing odontoiatric treatment. They also suggest various simple systems for the dentist to prevent excessive emotive reaction of patient which include the quality of staff and equipment employed in the environment of work. PMID- 3274166 TI - [Variations in load-flexion relationship in orthodontics: clinical applications]. AB - Authors emphasize role of load-deflection rate in orthodontic appliance designing. They also show, throught some clinic examples, the chance of the use of new titanium alloy. PMID- 3274168 TI - [Therapeutic choices in myeloma]. AB - After having considered the elements which can rightly address to a precox diagnosis of the multiple myeloma, the AA. analyse the principal laboratory exams. Then, they refer about different therapeutic certificates underlining that the obtained results by the Prof. Reizenstein and Mathe teams are nearly corresponding. They discuss about the compositions and posologies of the most present therapeutic certificates underlining the importance of a precox diagnosis. PMID- 3274170 TI - [Lowering of the mental nerve]. AB - After an analysis of the prosthetic troubles about atrophic edentulous ridges, the Authors describes the lowering mental nerve operation and consider its therapeutic benefit. PMID- 3274169 TI - [Recent advances in diagnosis of Sjogren's syndrome]. AB - In this paper the authors review the classification and the clinical features of primary and secondary Sjogren's syndrome. Particular attention in focused on differential diagnosis, on clinical examination of the patients with chronic xerostomia and on its functional and pathological sequelae: rampant dental caries and oral candidiasis. Advanced in diagnostic procedures are described: salivary flow rate, salivary gland scintigraphy, parotid and submandibular scialography, Schirmer's test, Rose Bengal staining, minor salivary gland biopsy and serum immunological examinations. The relationships between scintigraphic and histologic result are discussed. The clinical features and the course of the disease provide further insight into the immunological pathogenesis of this syndrome. PMID- 3274171 TI - [Endosseous-endodontic implants: indications and technic]. AB - The endodontic endosseous implants were used to a lot of clinic indication. The Authors suggest their use in the median fractures of roots and describe the operative technic, of which they consider the long-term results. PMID- 3274172 TI - [Ionic implantation in the dental field]. AB - Authors present the physics bases and the experimental equipment to obtain ion implant in metals. This new technique is already used in orthopaedic field to increase the metal surface quality as adherence and biocompatibility. In Dentistry field this technique can be employed to increase the surface hardness, the resistance to corrosion processes and the resistance to wear of implanted prosthesis. PMID- 3274173 TI - [Structural modifications induced by ionic implantation on functional surfaces of prosthetic attachments]. AB - Authors present the results on N+ ion implantation of an inox steel matrix set. They show the main utilization of prothesis attachments and their actual classification in prothesis field. The bombarded surfaces show a resistance increase to oxide-reduction processes respect to non implanted ones. Using the SEM technique to different magnifications, Authors demonstrate that the ion implantation increase the material hardness and the wear resistance of treated surfaces. The modifications, that not involve the matrix volume but only the superficial layers, produce an increase in attachment duration and affidability. Authors conclude valuing the possible application on this new technique for material treatment in Dentistry field. PMID- 3274174 TI - [Influence of condylar position and translation movement in the development of temporomandibular dysfunction]. AB - In this work we have examined a population of symptomatic patients (group A, B, C) for troubles to the TMJ and we analyzed the sagittal relation condyle-fossa using the cephalometric analysis on latero-lateral radiograms: we have compared the results with those obtained from a population of asymptomatic TMJ people. We have observed a great variability in the position of the condyle as to the glenoid fossa: we have not noted any significant statistically difference in the middle position of the condyle between the considered groups and the controlled group. PMID- 3274175 TI - [Comparative studies on lactate, proteins and enzymes in saliva of healthy and periodontitis sick juveniles]. AB - Total protein, lactate and enzyme activity of alkaline and acid phosphatase and lactate dehydrogenase were determined in mixed non-stimulated saliva of healthy and periodontitis sick patients, aged from 15 to 17. Enzyme determination, expressed in U/l was performed with ready tests of Boehringer; total protein in g%--according to Netelsson, lactate--in mg/100 ml. Increased activity of alkaline phosphatase was observed, depending on the inflammatory processes of periodontium. With acid phosphatase the discrepancies were more negligible but with a marked tendency to increased enzyme activity. The changes in lactate quantity were also indicative. No statistically significant differences were established for lactate dehydrogenase and total protein. Conclusions have been drawn for the practice. PMID- 3274177 TI - [Central incisors--implants]. AB - Two clinical cases are presented in the paper with one of the most common defects of dentitions as an indication for implantation-prosthesis--the absence of the upper central incisors as a results from acute trauma. A good functional and aesthetic effect has been attained. The constructions are in good order and have no changes in the teeth and implants during the almost two-year period. PMID- 3274176 TI - [Contacts in anterior, left and right lateral occlusion]. AB - The objective of the work is to establish a regular connection in the distribution of the contact of the teeth in anterior, left and right lateral occlusion. It has been established that the upper central incisors, in anterior occlusion, have an individual contact in 71.85% and in 41.48%--parallel of the lower central and lateral incisors. Out of all contacts in anterior occlusion 3.82% involve the canines. Canines participate in the contact in 93.89% in case of lateral occlusion. The statistical processing of the results reveals that there is a poor regular connection in the distribution of the contacts in anterior, left and right lateral occlusion. PMID- 3274178 TI - [Accelerated orthodontic treatment with a device for one-way pushing of teeth]. AB - A device for the treatment of dental-jaw deformities with teeth in medio- disto- and transposition is proposed. The device is successfully applied for pushing of teeth, in medio- and disto-position, to their normal place along the dentition. A modification of an intraoral apparatus, the device proposed is a combination of a palatal plaque with a segment guaranteeing one-way pushing of single teeth medially or distally, depending of the deformity. It is distinguished for its light technological manufacture of materials with low prime cost. Its better effectiveness and applicability than the so far known orthodontic apparatuses have been confirmed on the base of data reported about clinical, paraclinical and X-ray studies of children with dental-jaw deformities--healed. PMID- 3274179 TI - [Information level of mothers children from 0 to 3 years about the problems of stomatological prophylaxis]. AB - The information of the mothers as regards the possibilities of realization of complex prophylaxis of dental caries and periodontopathis is of great importance for such prophylaxis. The objective of this work is a sociological study, by the inquiry method, at the information level about those problems of 500 mothers of children, aged from 0 to 3 years in the town of Pernik. The results from the study reveal that the information level of the mothers is unsatisfactorily due to the insufficient work of the stomatologist in prenatal and well baby clinic. That raises the problem for exact regulation of prophylactic time of work with the pregnant and the mothers of little children. PMID- 3274180 TI - [Results from the epidemiological study on periodontal diseases of the population from the town of Razgrad by CPITN-index]. AB - The authors present data about the incidence of periodontal diseases among the population of the town of Razgrad obtained by mass prophylactic examinations and making use of CPITN index. The analysis of the results, obtained after the processing of the data, allows the specification of the therapeutic needs of 1151 workers examined as regards the periodontal diseases. PMID- 3274181 TI - [Epidemiological study on dental caries and periodontium state of students from HChTI "A. Zlatarov"]. AB - The authors carried out an epidemiological study on dental caries and periodontium state of 247 students from HChTI "A. Zlatarov--Burgas in an age standardized group of 20-24 years. WHO index CPITN was used for the determination of periodontium state. The data from the study reveal that the epidemicity of the dental caries in the group examined reaches to 97.98% with an intensity of 7.89. A total of 26.03% of the carious teeth have not been treated and 40.90% from the students have extracted teeth. Only 19.71% of the females and 4.54% of the males have 3 or more sound sextants according to CPITN. Those data raise the problem of the necessity of complex prophylactic measures among the students. PMID- 3274182 TI - [A new improved medico-statistical document for registration of the therapeutic work and planned prophylactic activity of the stomatologist]. AB - A complete description is presented of the new registration document "Stomatologist's journal", used for planning, registration, analysis and evaluation of the stomatological activity. The main requirements for keeping the journal are interpreted which will facilitate the stomatological personnel in its implementation in the practice. The authors think that the "Stomatologist's journal" could be used as a personal service record of each stomatologist. PMID- 3274183 TI - [Humoral immune response against Trichomonas tenax in patients with chronic catarrhal gingivitis before and after specific Fasigyn treatment]. AB - The following parameters were studied in 71 subjects, aged from 7 to 38 with chronic catarrhal gingivitis, invaded by T. tenax: oral-hygienic index of Green and Vermillion before the specific Fasigyn treatment and on 3, 7, 14 and 30 days after the treatment; the presence of complement-combining antibodies against T. tenax and the dynamics of antibody synthesis by 3, 6, 12 and 15 month after the treatment. Thirty one subjected with chronic catarrhal gingivitis, non invaded by T tenax were studied as controls. It has been established that in 53.52% of the subjects with chronic catarrhal gingivitis, invaded by T tenax, the inflammatory changes in gingiva disappeared as early as the third day after the specific Fasigyn treatment and in the rest--by 30 day. Higher values of complement combining antibodies against T. tenax with a titre from 1:40 to 1:2569 were established in 65.34% from the subjects with chronic catarrhal gingivitis, invaded by T. tenax. The titre of antibodies sharpy decreased by month 3 and was normalized by months 6-12 after Fasigyn treatment. PMID- 3274184 TI - [A rare case with hyperdontia in deciduous and hypodontia in the permanent dentition]. AB - Brief literature data are presented about the incidence of the anomalies in the number of teeth: decreased--hypodontia and increased--hyperdontia, and the possibilities of their manifestation in the deciduous and later in the permanent dentition. A rare case is described with hyperdontia in the deciduous but hypodontia in the permanent dentition, namely: supernumerary II and absent 5[25/5[5 in a boy aged 4 years and 7 months. No family loaded anamnesis has been established nor any deviations in the physical and neuro-psychic development of the child. The necessity of an early and accurate diagnosis in similar cases are stressed upon as well as their follow up care with a view to intentional orthodontic treatment for the best arrangement of the permanent dentition. PMID- 3274185 TI - [Traumatic aneurysm of facial artery]. AB - Traumatic aneurysms of the peripheral arteries are observed exceptionally rarely. With the localization in the maxillofacial region it presents a diagnostic and therapeutic problem. The authors report the successful treatment of a patient with traumatic aneurysm of facial artery, directing the attention to the necessity of a diagnostic puncture in case of traumatic swelling with pulsations. PMID- 3274186 TI - [On the incidence and treatment of cheilitis among workers from blast-furnace production]. AB - Studies have been carried out on the incidence of cheilitis in case of occupational noxae: temperature, lead, manganese and carbon monoxide. The result from the treatment with temperature protective and some other pharmaceuticals is described. PMID- 3274189 TI - [Effect of nutrition on etiopathogenesis of caries and metabolic diseases]. PMID- 3274188 TI - [Improvement of the clinical application of the elastic open activator of Klamt]. AB - Changes are proposed in the technology and construction of the elastic open activator of Clamt aiming at its improved clinical application. In order not to stand in the way of the cutting of the permanent lateral teeth as well as of their correct arrangement after their cutting, the vestibular bars are proposed to come out lingually in the space between the upper and lower teeth at the approximate level of the expected occlusion plane after the cutting of the teeth. In case of retrusion of the frontal teeth, the vestibular bars are made compensatory omega-like bends which allow an easy and fast correction of the frontal part of the bar with no change vertically. Similar omega-like compensatory bends are used also for the correction of the proposed wire elements that support the pelota for the stimulation of the development of the apical base in the frontal region. PMID- 3274190 TI - [Comparative epicutaneous study on allergy to mild-fibrosing agents]. AB - In connection with clinical observations and literature data about allergic manifestations in the oral cavity in the treatment of periodontal pockets with mild-fibrosing agents, we performed a comparative epicutaneous study on the preparations most often used in our country: Phytodont, maraslavin, zemisvet and preparation P. The method of Jadahsson and Block was used in patients with manifested periodontosis. Positive allergic tests with zemisvet and preparation P have not been established so far, whereas they were 5.71% with maraslavin and 8.57%--with phytodont. That provided grounds to recommend the fibrosing therapy in the single courses to be performed with various mild-fibrosing agents so as to reduce the possibilities of sendibilization. In the presence of data about drug allergy, the patients should be tested for allergy to the respective mild fibrosing agents prior to the fibrosing therapy. PMID- 3274191 TI - [Acute caries model in albino rats]. AB - The author used high-saccharose fine-powdered diet of Stephan 580 for the reproduction of acute caries model as well as 6-week experimental period for 50 "Wistar" 21-days old rats, distributed into two groups--experimental and control. The carious lesions were established by a modified index, guaranteeing a complex evaluation of the lesions developing upon the fissurae, approximal and smooth tubercular surfaces. A high caries index was established. The involvement of the main transversal fissurase and of the contact approximal surfaces of rat molars in the upper and lower jaws was separately established. PMID- 3274187 TI - [Method for assessment and control of deposited plaque upon removable plastic orthodontic apparatuses]. AB - The keeping of oral hygiene is of great importance during orthodontic treatment- for prophylaxis of caries and gingivae. The authors propose and Index for the hygiene of orthodontic apparatuses (IHOA) for the broad orthodontic practice, that is based on staining and scraping of the accumulated plaque by four fields of the removable orthodontic apparatus--in contact with the dental-gingival and mucosal surfaces. The scores from 0 to 3 enable the modification of the behaviour of the stomatologist and parents as regards the motivation, control and necessity of additional means for attaining the desired hygiene of the orthodontic apparatus. PMID- 3274192 TI - [Analysis of interdental contacts during experimental mastication]. AB - The author established that during mastication of experimental silicon morsel the teeth get get in contact in 3/4 of the 32 subjects examined, with 6.25 close contacts on the average for each half jaw. The observations on the separate stages of masticatory cycle reveal that the morsel is turned round between dentition, cheek and tongue, and about 90 degrees the closing of dentition follows to contact, continued to the final fragmentation of the morsel. PMID- 3274193 TI - [Comparative study of four methods for determination of centric position of the lower jaw]. AB - The objective of the study is the comparison of four (methods for the determination of the centric position of the lower jaw. The methods are as follows: Motor-reflex, described by B. Bojanov, method with swallowing described by A. Hromatka, phonetic method described by N. Popov, and G. Georgiev, reflex method described by the author. The study was performed with 50 subjects with complete and partial teeth extraction. No statistically significant differences were established with the comparison of the four methods. Coincidence between the position centric occlusion and centric relation was observed in 26 per cent of the cases. PMID- 3274194 TI - [Application of bioceramic implants in the treatment of dentition defects]. AB - The author shares his own experience in application of bioceramic implants in the treatment of small defects of dentition. According to the author, the bioceramic implants are preferable to the ordinary treatment methods in the restoration of small defects in the frontal region of dentition in case of strict adherence to the indications. PMID- 3274195 TI - [Level of information and motivation for complex stomatological prophylaxis of polyvalent stomatologists]. AB - The level of scientific knowledge in the field of the complex stomatological prophylaxis of the polyvalent stomatologists is studied in the present paper, who are the direct executors of the complex prophylactic programmes. Their motivation for an actual realization of the prophylaxis was studied. A sociological study was carried out based on the inquiry method with 110 polyvalent stomatologists. The testing carried out revealed that the level of information of those stomatologists as regards the complex prophylaxis of the stomatological diseases was low, that their motivation was rather impoper necessitating a reconsideration of the training and pre-training of those important executive personnel in that field of the stomatological science and practice. PMID- 3274196 TI - [Organization of mass orthodontic prophylaxis and participation of pedodontists and district stomatologists]. AB - Based on experimental and clinical-statistical studies of many years as well as on literature data, the author proposes a new form of orthodontic prophylaxis- mass orthodontic prophylaxis, with three sections: primary, secondary and organization determining the respective participation of the pedodontists and district stomatologists. The material covers the following problems a) improved follow-up care of the organized pediatric groups; b) determining the scope of the primary and secondary orthodontic prophylaxis; c) studies on the necessity of personnel and its qualification and d) model of organization of the mass orthodontic prophylaxis. New posts are proposed: ortodontist of orthodontic prophylaxis and a nurse of orthodontic prophylaxis and rehabilitation. PMID- 3274197 TI - [Case of total auriculoplastics]. AB - An operation method for total auriculoplastics in two stages is proposed. The skeleton of auricle is prepared of biologically compatible colourless plastics. It is worked at the laboratory from the mirror-image imprint of the sound one. The periphery of the skeleton is reduced with 2 mm and holes along the whole plane are made with a view to the sameness of both auricles. The thus prepared skeleton is subcutaneously implanted and orientated symmetrically to the sound auricle during the first stage. After four months the seconds stage is proceeded to when the skin had been accreted to the implant. The skin incision is made 1 cm outside the skeleton enabling the proper formation of the helix. The wound surface behind the auricle is covered with a skin flap. PMID- 3274198 TI - [Case of reimplanted tooth with long-lasting clinical effect]. AB - The author describes a case of reimplantation of 44 of a 35-year-old woman, 19 years ago. Later, 10 years after the reimplantation apical osteotomy, according to indications, was performed to the same tooth. The X-ray, performed in 1985, shows that resorptive processes around the tooth and root has not advances as yet. It started after the root treatment on the adjecent 46 in 1985. The author thinks that the mass failure of teeth reimplantation (short-term therapeutic effect of 5-6 years and not with all reimplantations) reduces the interest of the researchers in it without any grounds. The case described shows that, very likely, under certain conditions and certain operation technique, unconsciously blended in the case described, very good therapeutic effect could be relied on via the reimplantation. It is presumed that the initiation of resorption has been provoked by the devitalization of an adjacent tooth, possibly due to disturbed trophicity in the region around it. It has been concluded that a great many problems, still unknown, of teeth reimplantation wait their proper solution. PMID- 3274200 TI - [Clinical method for objectivization of the effect of oral-hygienic agents on dental plaque and gingiva]. AB - The authors propose a model complex of methods for objectivization of the effect of oral-hygienic agents. Attention is drawn to the selection and preparation of the probands for the clinical experiment, describing also the conditions of the experiment. The most appropriate indices for the evaluation of the effect of the oral-hygienic agents also presented: 1. Doublet plaque-index according to T. Dzemileva and M. Drjankova--enabling the parallel differential evaluation and recording of the incidence and thickness of the dental plaque. 2. Index of Fjodorov and Volodkina--particularly adequate for investigation of the agents for mechanical removal of dental plaque. 3. PMA-index--giving an idea of the therapeutic-prophylactic action of the oral-hygienic agents on gingival status. 4. Supragingival and bilateral probe-imprint--according to the well known method of T. Dzemileva et al. The proper selection of the methods for objectivization of the effect of the oral-higienic agents will guarantee the reliability of the results. PMID- 3274199 TI - [Pre-prosthetic plastics of labial vestibule in patients with toothless lower jaws]. AB - The acquired practical experience in the treatment of 20 in-patients is shared. All of them had advanced and severe atrophy of alveolar process and the body of mandibule. Two methods of vestibuloplastics were mainly applied: according to K. Schuchardt and the method of H. Pichler. The very good early and late results attained as regards the prosthetic field enabled the accomplishment of functionally fit prosthetic construction. PMID- 3274201 TI - [Teeth as an identification tool]. AB - The signs and varieties of the teeth, dentitions and maxillar bones are described that could be used for identification. The anatomic, morphological, physiological and functional signs upon the teeth are so numerous that, according to the formula of submultitudes, their possible combinations are calculated in millions, hence they are strictly individual and unique. By the twins method it has been confirmed that many signs and varieties of the teeth and some dental-jaw anomalies and defects are hereditary, with a rather high predomination of hereditary factors over the factors of environment. It has been established tahat the theoretical problems for identification and differentation the humans by the teeth and dention are rather well and reliably studied and described but for the needs of forensic medicine and criminology specific methods have to be developed. PMID- 3274202 TI - [Marking of plastic removable dentures with a view to identification]. AB - An easy, cheap and easy to perform method is described for marking of plastic removable dentures that could be used for identification. The method consists of the following: the personal civil number of dentures carrier is typed upon a thin steel band. The band is incorporated in the material for prosthesis during its production or in an already made one. The marking is properly. legible, it is not changed with the use of prosthesis and resistant to temperature over 1000 degrees C. PMID- 3274203 TI - [Follow-up care of the children and students from the town of Pestera]. AB - The incidence of dentad caries reahes to 83.33 per cent for the milk and to 95.9 per cent for the permanent teeth as established on the base of epidemiological studies on 5817 children and students, aged from 3 to 18 years, from the town of Pestera. PMID- 3274204 TI - [Effect of Furacillin antiseptic tablets on dental plaque]. AB - According to the modern concepts the ideal oral hygiene is decisive for the prophylaxis of caries and periodontal diseasese. However, its realization is not easy since dental plaque rapidly and ceaslessly cumulates upon all dental surfaces and is difficult to remove by the ordinary means for oral hygiene (tooth brush and tooth paste). Lately hope is centered on the antiseptics, being the base of various preparations as solutions for mouth wash for inhibition of dental plaque. The action of Furacillin tablets on the dental plaque was studied in 10 volunteers with sanated dentition, with on diseases of gingiva and periodontium. The probands sucked one tablet every three hours (6 tablets daily) in the course of 5 days with interrupted oral-hygienic cares. Dentalplaque was controlled by the oral higienic index of the whole dentition daily, after staining with 1 per cent alkaline fuxin. Probands, left on an ahygienic regimen for 5 days served as a control. The results from the study show an essential inhibitory effect of the tablets on trial upon the dental plaque and the possibilities to use the tablets for some patient groups with restrictions as regards the maintenance of oral hygiene via the ordinary means. PMID- 3274205 TI - [Two-stage replantation of molars and premolars in acute and exacerbated chronic periodontitis]. AB - The author reports about the clinical and X-ray study of 25 patients who were replanted 25 teeth in two stages -- 12 teeth of the upper and 13 of the lower jaw during acute and exacerbated periodontitis. Lyophilized spongiosis chips were deposited in the alveoli before the replantation of 5 teeth. During the first stage, the extracted tooth is mechanically cleaned, washed with hudrogen peroxide and alcohol and then preserved in a solution of penicillin and physiological salt solution in the refrigerator at a temperature from +2 to +5 degrees C. During the second stage, the tooth is taken from the refrigerator after two to five 24 hours, obturated and replanted. The results allowed the conclusion that the method could be applied only in exceptional cases. The use of lyophilized spongiosis chips in replantation of teeth should be studied thoroughly in the future, presuming that it will contribute to the longer-term survival of replanted tooth. PMID- 3274206 TI - [Working model for experimental stomatoscopy]. AB - The authors, for the first time in our country, created working conditions for stomatoscopy on materials and trial-copies to be studied in advance, approaching in type and form to the oral cavity mucosa in norm and pathology. The magnifying possibilities of stomatoscope in observation of working trial-copies are clearly illustrated. Stomatoscopy is recommended as a diagnostic method in pathology of oral cavity mucosa after acquiring the necessary habits and skill, based on the experimental stomatoscopy described. PMID- 3274207 TI - [Basic principles of colposcopy and possibilities of its application in stomatology]. PMID- 3274209 TI - Abnormal copper metabolism: another "non-Wilson's" case. AB - We describe a patient with extrapyramidal neurologic disease and an abnormal copper profile with hepatic copper accumulation, but no cirrhosis histologically, thus excluding a diagnosis of Wilson's disease (WD). We compared and highlighted the differences between similar previously reported cases of abnormal copper metabolism and true WD and suggest a spectrum of disease due to abnormal copper metabolism resulting in varied histochemical expression. PMID- 3274208 TI - Occurrence of both hemolytic anemia and thrombocytopenic purpura (Evans' syndrome) in systemic lupus erythematosus. Relationship to antiphospholipid antibodies. AB - Ten of 12 patients with systemic lupus erythematosus (SLE) who had hemolytic anemia and thrombocytopenic purpura (Evans' syndrome) during their course had evidence of antiphospholipid antibodies either because they had a false positive VDRL test (8 patients), a prolonged partial thromboplastin time (5 patients), a lupus anticoagulant (3/4 patients), and/or anticardiolipin antibodies as determined by an ELISA method (7 patients). Antibodies to cardiolipin were found in very high levels (up to 38 standard deviations above the mean of normal controls) and were of both IgG and IgM isotypes. The 2 patients with SLE and Evans' syndrome who did not have evidence of antiphospholipid antibodies were studied at the onset of SLE which occurred with Evans' syndrome. Although cardiolipin is not a constituent of the cell wall of either platelets or erythrocytes, other phospholipids that cross react antigenically with cardiolipin are and can be exposed through cell damage. This could be a mechanism whereby hemolytic anemia and thrombocytopenia could occur in the same patient with SLE. Whether absorption of the antiphospholipid antibody during the acute episode of hemocytopenia could occur, and thus prevent its detection at such time, remains undetermined. PMID- 3274210 TI - [Heart diseases in the elderly. 16th meeting of Clinical Cardiology. Tokyo, January 23, 1988. Proceedings]. PMID- 3274211 TI - [Clinical characteristics of ischemic heart disease in the aged: significance of coronary revascularization and role of PTCA]. AB - We investigated exercise capabilities of the elderly patients with significant coronary artery lesions and angina pectoris. The heart rate increased according to workload, but there were few cases in which maximal heart rate was obtained. There was a marked increase in VO2 at endpoint before sufficient work load was achieved. It suggested an increase in O2 demand of the myocardium and entire body. Left ventricular dysfunction from skeletal muscle fatigue and work load induced myocardial anoxia were also suggested. The conditions of coronary arteries of aged patients and the method of treatment were studied on the basis of coronary angioplastic findings and exercise tolerance. We reviewed percutaneous transluminal coronary angioplasty (PTCA) performed in 49 aged patients (older than 70 years) with angina and investigated long-term results. In this group including 18 patients (43%) with multivessel disease, there was a high success rate (90%), and significant improvements in workload responses were achieved in early stages after PTCA. The rate of recurrence was higher in this group than non aged patients, however, angioplasty was repeated successfully in all of the patients. Dilated sites were recognized as patent in a majority of patients. Late cardiac events occurring six months after PTCA were acute myocardial infarction in only one case (2.2%) and unstable angina in three cases (6.8%). There was no cardiac death. The five-year cumulative survival rate was high (97%). During a follow-up interval of averaged 32 months, chest pain disappeared in 70% of patients and 48% enjoyed daily life without restriction. Since the quality of life appears to be improved and long term results are sufficiently acceptable, we concluded that PTCA is highly recommended for the elderly patients. PMID- 3274212 TI - [Valvular heart diseases in the aged]. AB - A total of 458 cases (11.5%) with valvular heart diseases in the aged (greater than or equal to 60 years) were found among 4,000 consecutive autopsies. They included 204 cases (45%) of aortic regurgitation (AR), 171 cases (37%) of mitral regurgitation (MR), followed by 45 (10%) of aortic stenosis (AS) and 27 cases (6%) of mitral stenosis (MS). As an etiology of the valvular diseases, degenerative type was found in 195 cases (43%), ischemic origin in 91 cases (20%), followed by inflammatory origin such as syphilitic in 51 and infective endocarditis in three, aortitis in two and rheumatic in 49 (11%). Congenital origin was also found in 18 cases (4%). Among various types of valvular diseases in the aged, degenerative AR was most frequently found in 140 cases, followed by MR due to papillary muscle dysfunction in 91 cases. The clinical characteristics in cases with valvular diseases were as follows: atrial fibrillation was prominent in MS; congestive heart failure was found in 60% of cases except those with degenerative AR; cardiac death was frequent in syphilitic and rheumatic AR; association of hypertension was found in 50% of cases with MR and degenerative AR. In this article the characteristics of the valvular heart disease in the aged and additionally its diagnosis and treatment were discussed. PMID- 3274213 TI - [Cardiac surgery in the aged]. AB - One hundred and seven patients aged greater than or equal to 60 years with cardiac surgery were reviewed. These patients underwent open heart surgery at University Hospital of Tokyo and JR Tokyo General Hospital during 1981 to 1987. Prevalence of the elderly with 60 years or older in all patients with cardiac surgery increased 4.1% to 20% during these seven years. Surgery for ischemic heart disease has become more common. There were less number of cases with valvular heart disease referred for surgery, but, not a few cases with calcified aortic valve or floppy mitral valve had valve replacement. Operative results were as follows: Hospital death was 6/107 patients (5.6%) and three patients died after discharge. This group of old patients was occasionally associated (14/107, 13%) with a variety of diseases including bronchial asthma, diabetes mellitus, and other atherosclerotic lesion or liver dysfunction. Valvular heart disease was not rarely complicated with ischemic heart disease. Postoperative complications were mainly due to renal failure, respiratory failure or low output syndrome, possibly related to associated disease. Intra-aortic balloon pumping was performed in seven of 107 patients, four of whom eventually died. In conclusion, there is a relatively high risk in cardiac surgery in old aged patients with associated diseases. We have to manage carefully old patients to avoid major postoperative complications including cardiac, respiratory and renal events. Much more old patients will have open heart surgery in the future. PMID- 3274214 TI - [Current status of cardiac surgery in the elderly]. AB - Current status of cardiac surgery in the elderly is described. Coronary artery bypass grafting or uncomplicated valve replacement can be safely performed in the septuagenarian. Ventricular septal rupture has been successfully repaired in the octogenarian. Atrial septal defect in the sexagenarian can be closed without complication. Late results of pacemaker implanted in the octogenarian have been as good as in the sexagenarian. PMID- 3274215 TI - [Cranial neuropathy in patients with systemic cancer]. PMID- 3274216 TI - [Cerebral vascular pathology in the area of Sabadell. 1 year's experience (april 1984-march 1985) at its district hospitals. A prospective study]. PMID- 3274217 TI - [Benign essential tremor. Review of a series of cases]. PMID- 3274218 TI - [Familial paroxysmal ataxia]. PMID- 3274220 TI - [Neuropathy caused by pressure on the posterior tibial nerve, secondary to post traumatic aneurysm]. PMID- 3274219 TI - [Moyamoya's syndrome. A familial presentation]. PMID- 3274221 TI - [Lower maxillary nerve blockade as treatment of trismus secondary to pontomesencephalic hemorrhage]. PMID- 3274222 TI - [Acute spontaneous subdural hematoma of arterial origin]. PMID- 3274223 TI - [Cerebellar syndrome as the first manifestation of multiple myeloma]. PMID- 3274224 TI - [Sustained hemipiloerection as a manifestation of focal neurologic dysfunction]. PMID- 3274225 TI - [Painful ophthalmology secondary to metastatic infiltration of the cavernous sinus]. PMID- 3274226 TI - [Metrizamide and diplopia]. PMID- 3274228 TI - [Internal medicine and neurology]. PMID- 3274227 TI - [Definitions and concepts in evolutive neurology]. PMID- 3274229 TI - [Multiple sclerosis: a retrospective epidemiologic study in Aragon (1975-1985)]. PMID- 3274230 TI - [Computerized tomography in the diagnosis of neurologic complications of cervical spondylosis]. PMID- 3274231 TI - [Experimental study of myopathy caused by exercise]. PMID- 3274232 TI - [Hypopotassemic myopathy caused by topical administration of 9 alpha fluoroprednisolone]. PMID- 3274234 TI - [Dolichoectasia of the basilar artery: magnetic resonance]. PMID- 3274233 TI - [Tetraparesis appearing before hyponatremia correction in a case of central pontine myelinolysis]. PMID- 3274235 TI - [Meningitis caused by Candida in a patient with acquired immunodeficiency syndrome]. PMID- 3274236 TI - The nurse executive in a community hospital. PMID- 3274238 TI - Emerging legal issues for the nurse executive. PMID- 3274237 TI - The nurse executive in a nursing organization. PMID- 3274239 TI - New patterns of professional relationships internal to the organization. PMID- 3274240 TI - Research issues for nurse administrators. PMID- 3274241 TI - New patterns of professional relationships external to the organization. PMID- 3274242 TI - The nurse executive in 2000 A.D. Role and functions. PMID- 3274243 TI - The evolving role of the nurse in ambulatory care. PMID- 3274244 TI - The nurse executive role in not-for-profit multi-institutional systems. PMID- 3274245 TI - The nurse executive in a for-profit multi-institutional setting. PMID- 3274246 TI - [Expression of epithelial and nervous-system-related antigens on pleomorphic adenoma of the salivary glands--an analysis of 20 cases]. AB - The expression of cytokeratin (40-52 kD), carcinoembryonic antigen (CEA), vimentin, neuron-specific enolase (NSE), S-100 protein, glial fibrillary acidic protein (GFAP) were investigated in 20 cases of pleomorphic adenoma of the salivary glands and 10 cases of normal salivary glands, in order to analyze and correlate the antigens' expressions with the probably histogenetic mechanisms of the various histopathological differentiations in pleomorphic adenoma of the salivary glands and their probably original cells in normal salivary glands. Immunohistochemistry has provided some evidence for the relationship of the tumor cells to normal salivary glands: In the normal glands, the acinic cells exhibited cytokeratin, CEA and focal, predominantly nuclear S-100 protein staining. In both normal glands and pleomorphic adenomas, the duct-lining cells were immunoreactive for cytokeratin, CEA and had both cytoplasmic and nuclear S-100 positivity; The myoepithelial cells of the normal glands as well as the periduct cells, epithelial nests/cords, squamous metaplasia and the stellate/spindle/cartilaginous cells in the myxomatous-chondroid areas of the pleomorphic adenoma contain immunoreactive vimentin, NSE, S-100 proteins and GFAP, and lesser amounts cytokeratin (40-52 kD)/CEA. The varicosities of the terminal axon may lie directly on the basal membrane, or penetrate the basal membrane and lie in direct contact with the effector cells (duct-acinar myoepithelial cells) of the salivary glands. The peripheral neurons and axons of the autonomic nervous system were identified by vimentin, NSE, S-100 proteins and GFAP. The combination of epithelial cytokeratin and nervous system-related vimentin, NSE, S-100 and GFAP immunostaining in myoepithelium of the normal glands and in all component elements (particularly the periduct cells) of pleomorphic adenoma reflects pleomorphic adenoma of the salivary glands is an epithelial tumor, the probably original cells or the probably histogenetic mechanisms of the various histopathological differentiations is correlated not only with "duct-acinar-myoepithelial cells" but also with the neuroectoderm in the normal salivary glands." PMID- 3274247 TI - [Immediate and delayed effects of working interferences on human mastication]. AB - The purpose of the present study was to observe the effects of working interferences on masticatory movements. Metal overlays were inserted on buccal cusps of upper 2nd premolar and 1st molar of healthy human subjects. Jaw movements were recorded by using the LED system at five sessions: before application (Wo), immediately after (W1), and one day (W2), one week (W3), and one month (W4) after application. It was found that (1) TMJ disorder or MPDS was not found in 10 subjects. (2) Six of the 10 subjects had extended border area after overlay insertion, and 4 subjects had restricted border area. (3) The mean closing angle at Wo was 41.2 +/- 13.3 degrees while at session W1 it was 28.1 +/- 14.7 degrees. The difference was significant (P less than 0.05). At sessions W2, W3 & W4 this angle was around 30 degrees. (4) The axis of the chewing cycle on frontal plane became more medially oriented at sessions W1, W2, W3, and W4. (5) Two distinctive types of chewing cycle were seen in few subjects at session W1. The first type had more vertical displacement with a twisted or deflected closing path. The second type occurred after about ten strokes of chewing, and the axis became more medially or vertically oriented. The vertical displacement was shorter and the horizontal displacement was relatively wider. (6) Ninety % of all subjects showed increased opening velocity and decreased closing velocity at session W1. The opening velocity and closing velocity increased consistently at sessions thereafter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3274248 TI - [Evaluation of the apical seal produced by a hybrid root canal filling method, combining lateral condensation and thermomechanical compaction]. AB - The present study measured apical leakage to a dye in roots filled by a hybrid root canal filling method, combining lateral condensation and thermomechanical compaction. The canals of 52 extracted human maxillary anterior teeth were endodontically prepared and divided into 3 groups. Lateral condensation was used in one group. The roots of the second one were filled using thermomechanical compaction. The roots of the third group were filled using hybrid method. After immersion in Procion Brilliant Green, the roots were cleared for measuring the depth of penetration of the dye under stereomicroscope. The roots filled with the hybrid method leaked less than the lateral condensation group, yet the difference was not significant (P greater than 0.05). The roots filled with both hybrid method and lateral condensation leaked significantly less (p less than 0.05) than the thermomechanical compaction group. PMID- 3274249 TI - Effects of diflunisal on cutaneous sensory and pain thresholds. AB - The analgesic activity of diflunisal was evaluated through the measurement of cutaneous sensory and pain thresholds after electrical stimulation. Twelve healthy volunteers were examined at baseline and five hourly intervals after oral administration of 500 mg and 1 gm of diflunisal. The results showed that the sensory threshold was not modified by diflunisal, but that the pain threshold was significantly increased two and three hours after 500 mg of diflunisal and one, two, and three hours after 1 gm of diflunisal. At two hours the pain threshold was significantly higher after 1 gm than after 500 mg of diflunisal. It is concluded that diflunisal produces an actual increase of the pain threshold in healthy human subjects and that the amplitude, latency, and duration of its effect are dose related. PMID- 3274250 TI - Bioavailability of iron in prenatal multivitamin/multimineral supplements administered to pregnant teenagers. AB - Absorption of elemental iron from three single-daily-dose prenatal multivitamin/multimineral supplements was compared in bioavailability studies of subjects under fasting and postprandial conditions. Each of the supplements (Stuartnatal 1 + 1, Stuart Prenatal, and Materna 1.60) contained 60 or 65 mg of iron. The subjects, teenagers in the second trimester of pregnancy, were assigned to the fasting or postprandial conditions at intervals of three to seven days. For the postprandial condition, subjects took the supplement after eating a standardized meal that had been designed to provide a minimal amount of iron and no caffeine (which inhibits iron absorption); blood was drawn at 0, 1, 3, 6, and 8 hours. Bioavailability studies showed that all three supplements provided adequate levels (at least 3.5 mg) of absorbed iron when taken postprandially. The highest quantity of net iron transport as well as the most rapid intestinal transport in either condition was yielded by Stuartnatal 1 + 1 taken in the fasting state. In the postprandial condition, Materna 1.60 demonstrated the fastest transport time and highest net iron transport; when given to a subject in the fasting condition, however, this supplement provided less than the recommended 3.5 mg of absorbed iron. These results suggest that iron absorption is influenced by supplement formulation as well as the presence or absence of food. Considering variations in compliance when iron is to be taken on an empty stomach as well as variable absorption in the fasting state, the most reliable supplementation would appear to be achieved by instructing pregnant women to take multivitamin/multimineral supplements at mealtime. PMID- 3274251 TI - Treatment of common warts with high-potency (26%) salicylic acid. AB - Treatment of common warts with topical keratolytic solutions is generally estimated to result in cure rates of 60% to 80% in 12 weeks. Problems with keratolytic solutions include irritation of surrounding normal skin and poor patient compliance. A product containing 26% salicylic acid in a novel polyacrylic vehicle was evaluated in 27 patients and found to cure or provide much improvement in 22 (81%) after only two weeks of treatment. This rapid response was accompanied by a low incidence of irritation. The results of this study suggest that high-potency salicylic acid promotes prompt resolution of warts, which may enhance patient compliance. PMID- 3274253 TI - [Late eruption of permanent teeth. Early loss of deciduous teeth]. PMID- 3274252 TI - [Sexual hormones and mast cell population in the salivary glands]. PMID- 3274254 TI - [Natal and neonatal teeth. Study of prevalence and approach to treatment]. PMID- 3274255 TI - [Vital tooth autotransplantation]. AB - Ten cases of dental transplants belonging to the authors' set of cases were selected and they proved to be successful according to the factors these authors' believe to be important. The operations were carried out on young patients by transplanting the not fully formed third molar to the place of the first molar, following the technique described in the text. The success of a vital dental autotransplant depends on some factors: the tooth to be transplanted should have completed the amelogenesis so that two thirds of its root and the floor of the pulp chamber are also formed; the receiving alveolus must be prepared before the giving area, thus reducing the time in which the third molar remains dislocated out of its alveolus and the lack of communication between the two surgical beds. PMID- 3274256 TI - [Arcial growth of the mandible. Long range prediction (Ricketts)]. PMID- 3274258 TI - [General anesthesia in pedodontics]. PMID- 3274257 TI - [Morphogenesis of the lingual glands of chick embryos]. PMID- 3274259 TI - [Histological study of peri-implant tissues. Intraosseous implants in surgical chromium-cobalt molybdenum]. PMID- 3274261 TI - [A proposed work plan for the final elective period of clinical practice in the clinical prosthodontic department III--"B"]. PMID- 3274262 TI - [The cleft lip and palate child (C.L.P.) and his treatment. Multidisciplinary focus]. PMID- 3274260 TI - [Comparative study of salivary gland and ovarian mast cells during the estrus cycle]. PMID- 3274264 TI - Exocrine secretion of canine pancreas segmental grafts one year after transplantation compared with that of fresh segments prepared in situ. PMID- 3274263 TI - Allogeneic intrasplenic hepatocyte transplantation in the Gunn rat using cyclosporine A immunosuppression. PMID- 3274266 TI - Segmental pancreas transplantation into an intestinal pouch: a promising approach. PMID- 3274265 TI - Combined pancreas-spleen transplantation in the rat. PMID- 3274268 TI - Cause and importance of donor neurogenic myocardial injury in cardiac transplantation. PMID- 3274267 TI - Histological appearance following rescue retransplantation of rejecting rat vascularized pancreatic allografts. PMID- 3274269 TI - Cardiac allograft survival in ABO blood group incompatible baboons. PMID- 3274270 TI - Cardiopulmonary transplantation and regulation of breathing. PMID- 3274271 TI - Experimental lung transplantation in the rat: study of rejection monitoring using monoclonal antibodies. PMID- 3274272 TI - Obliterative bronchiolitis in the transplanted rat lung. PMID- 3274273 TI - Evidence for an accelerated rejection response to cardiac allografts in antigen treated mice which then resolves. PMID- 3274274 TI - Different rates of cardiac and pulmonary rejection in combined heart-lung grafts in rats. PMID- 3274275 TI - The intramyocardial electrogram: a reliable marker of allograft rejection in orthotopic heart transplantation? PMID- 3274277 TI - The expanded scope of effectiveness of nuclear magnetic resonance imaging to determine cardiac allograft rejection. PMID- 3274276 TI - Uptake of myocardial imaging agents by transplanted hearts. PMID- 3274278 TI - Use of myocardial pressure measurements to monitor rejection in transplanted hearts. PMID- 3274279 TI - The influence of immunosuppression on organ pressure measured in rejecting heart and kidney transplants. PMID- 3274280 TI - Effect of catalase and/or allopurinol, or N-t-butyl-alpha-phenylnitrone on hepatic ischemia. PMID- 3274281 TI - The graft's own regenerative potential suppresses rejection of hepatic transplants. PMID- 3274283 TI - Metabolic changes of the isograft after orthotopic liver transplantation in the rat. PMID- 3274284 TI - Quantitative hepatic scintigraphy to evaluate ischemic/reperfusion injury in porcine liver transplantation. PMID- 3274282 TI - Signs of hyperacute rejection of liver grafts in rhesus monkeys after donor specific presensitization. PMID- 3274285 TI - Oxygen consumption by peripheral blood mononuclear cells: a predictor of canine renal allograft rejection. PMID- 3274286 TI - Demonstration of an extra-renal mechanism in post-deoxycorticosterone hypertension. PMID- 3274287 TI - Functional recovery in the rat limb transplant model: a preliminary study. PMID- 3274288 TI - Two new composite tissue allograft models in rats to study neuromuscular functional return. PMID- 3274289 TI - Nutritional and metabolic aspects of total small bowel transplantation in inbred rats. PMID- 3274290 TI - Analysis of nutrient transport in successful small bowel transplants. PMID- 3274291 TI - Cyclosporine absorption in total orthotopic small bowel transplantation in dogs. PMID- 3274292 TI - Immunogenetic aspects of neural transplantation. PMID- 3274293 TI - Graft-versus-host disease: a model for studying the neural regulation of immune function. PMID- 3274294 TI - Rejection pattern of nerve allografts--changes in graft and host cell determinants. PMID- 3274295 TI - Combined total lymphoid irradiation and cyclosporine promote xenograft survival. PMID- 3274297 TI - Delayed rejection of rabbit kidneys transplanted into baby pigs. PMID- 3274296 TI - Improvement in hare-to-rabbit kidney transplant survival. PMID- 3274298 TI - Cardiac transplantation using discordant xenografts in a nonhuman primate model. PMID- 3274299 TI - Delayed rejection of liver xenografts compared to heart xenografts in the rat. PMID- 3274300 TI - Hepatic xenografts from hamster to rat. PMID- 3274301 TI - Role of host immunosuppression and pretransplant 95% oxygen organ culture in prolongation of fetal pancreas xenograft survival. PMID- 3274302 TI - Synergistic effect of cyclosporine A, cyclophosphamide, and steroids in rabbit-to rat skin xenotransplantation. PMID- 3274303 TI - Influence of cyclosporine on in situ cellular and humoral immune responses during allograft rejection. PMID- 3274304 TI - Suppression of lymph node CTL generation by spleen cells from cyclosporine treated cardiac-allografted rats. PMID- 3274305 TI - Cyclosporine A modulates the proliferation of T-lymphocyte colony forming cell subpopulations. PMID- 3274306 TI - Epidermal Langerhans cells in the early phase of immunosuppression. PMID- 3274308 TI - Mutagenicity of cyclosporine against human cells. PMID- 3274307 TI - Age and dose dependence of cyclosporine G nephrotoxicity in BALB/c mice. PMID- 3274309 TI - The influence of renal allograft function upon cyclosporine blood levels. PMID- 3274310 TI - Long-term residual cyclosporine levels following short-term administration in various allograft models demonstrating extensive survival prolongation. PMID- 3274311 TI - Effect of liver dysfunction on cyclosporine pharmacokinetics. PMID- 3274313 TI - Cyclosporine A: graft survival and cardiotoxicity in murine cardiac allografts. PMID- 3274312 TI - Role of bile and bile salts on cyclosporine absorption in dogs. PMID- 3274314 TI - Comparative pharmacokinetics of cyclosporine and NVa2-cyclosporine in dogs. PMID- 3274315 TI - Ketoconazole potentiates cyclosporine immunosuppression and toxicity in mice. PMID- 3274316 TI - Immunosuppression induced by monoclonal anti-Thy-1,2 antibodies, cyclosporine A, and lentil lectin in mice. PMID- 3274317 TI - Low-dose azathioprine is synergistic with low-dose cyclosporine in rabbit skin allograft survival. PMID- 3274318 TI - Alternate-day cyclosporine A and azathioprine in experimental dog renal allografts. PMID- 3274319 TI - Inhibition of lymphocyte-specific enzymes: a promising approach for selective immunosuppression. PMID- 3274320 TI - Didemnin B: an immunosuppressive cyclic peptide that stimulates murine antibody responses in vivo and in vitro. PMID- 3274321 TI - Free radical scavenger therapy in transplant rejection. PMID- 3274322 TI - The effect of antiplatelet therapy on acute rejection in canine renal transplantation. PMID- 3274323 TI - Predictable viability assay of isolated canine liver using hypothermic continuous machine perfusion. PMID- 3274324 TI - The synergistic effect of superoxide dismutase and adenosine triphosphate-MgCl2 on acute hepatic ischemia. PMID- 3274326 TI - Prostaglandin E1 but not E2 is cytoprotective of energy metabolism and reticuloendothelial function in the ischemic canine liver. PMID- 3274325 TI - Protective effects of free radical scavenger and antioxidant administration on ischemic liver cell injury. PMID- 3274327 TI - Plasma amino acid clearance predicts hepatic recovery after normothermic anoxia and cold preservation. PMID- 3274328 TI - The protective effect of superoxide dismutase during reperfusion of the ischemic lung. PMID- 3274329 TI - Successful 48-hour simple hypothermic preservation of canine lung transplants. PMID- 3274330 TI - Twenty-four hour heart-lung preservation and oxygen free radical scavengers. PMID- 3274331 TI - Protective effects of calmodulin inhibitor in canine kidney preservation. PMID- 3274332 TI - Assessment of warm ischemia time in donor kidneys by analysis of purine metabolism. PMID- 3274334 TI - Intermediate normothermic hemoperfusion doubles safe cold preservation of rat kidneys. PMID- 3274333 TI - Mechanism of action of ex vivo blood rescue in six-day preserved kidneys. PMID- 3274335 TI - The importance of O2-derived free radical injury to organ preservation and transplantation. PMID- 3274336 TI - In vivo potentiation of cyclosporine immunosuppression by calcium antagonists. AB - We have shown that the addition of verapamil, a calcium channel blocking agent, or trifluoperazine, a phenothiazine, to a regiment using the immunosuppressive agent Cs significantly enhances heterotopic cardiac allograft survival in an ACI to Lewis transplant model. This work verifies previous in vitro work from our laboratory and offers a potential therapeutic strategy to decrease the dose of Cs needed for effective immunosuppression while perhaps lessening its dose-related side effects. PMID- 3274337 TI - The effect of hydergine on cyclosporine-induced nephrotoxicity in kidney allografted rats. PMID- 3274338 TI - Nephrotoxicity of cyclosporine G and A in the Sprague-Dawley rat. PMID- 3274339 TI - Mitochondrial alterations after cyclosporine and ischemia: insights on the pathophysiology of nephrotoxicity. PMID- 3274340 TI - Pretransplant transfusion of donor-specific class I major histocompatibility complex antigen in dogs. PMID- 3274341 TI - Effect of posttransplant injection of peripheral blood lymphocytes on skin graft prolongation in mice treated with antilymphocyte serum (ALS) or ALS plus donor bone marrow. PMID- 3274342 TI - The mechanism of platelet-induced rat renal allograft prolongation. PMID- 3274343 TI - Prolonged heart allograft survival following postoperative blood transfusion. PMID- 3274344 TI - The effect of repeated transfusion and cyclosporine A administration on alloantibody levels in sensitized rats. PMID- 3274345 TI - Spontaneous reversal of rejection episodes in renal allografted dogs. PMID- 3274346 TI - Attempts to ameliorate transfusion-induced sensitization to heart grafts by additional multiple blood transfusions. PMID- 3274347 TI - Abrogation of cyclosporine/transfusion-induced enhancement of rabbit skin allografts by increased cyclosporine dosage. PMID- 3274348 TI - The blood transfusion effect: characterization of T cell alloantigen-specific receptors by sera from transfused mice. PMID- 3274349 TI - Dendritic cells in the blood transfusion effect. PMID- 3274350 TI - Effect of prostaglandin inhibitors on transfusion-induced immune suppression. PMID- 3274351 TI - Immunomodulation after blood transfusion in the rat. PMID- 3274353 TI - Blood transfusions lower natural killer cell activity. PMID- 3274352 TI - Examination of the clonal deletion hypothesis following transfusions in rat cardiac transplants. PMID- 3274354 TI - Blood transfusion induces specific cytotoxic cells. PMID- 3274355 TI - T cell-specific monoclonal antibodies abrogate the blood transfusion effect on kidney allograft survival in rhesus monkeys. PMID- 3274356 TI - Enhancement of renal allografts by simultaneous cyclosporine and donor-specific blood transfusion. PMID- 3274357 TI - The donor transfusion phenomenon in a rat kidney allograft model. PMID- 3274358 TI - Modified graft rejection by transfusion of the donor: a role for dendritic cells. PMID- 3274359 TI - Promotion of tumor growth by blood transfusions. PMID- 3274360 TI - The blood transfusion effect and colorectal cancer recurrence. PMID- 3274361 TI - Living-related donation: a sibling controlled study. PMID- 3274362 TI - Living donors in renal transplantation: a long-term study. PMID- 3274363 TI - The impact of renal donation: long-term follow-up of living donors in a single center in Mexico. PMID- 3274364 TI - Prognostic significance of psychosocial donor-recipient interaction in renal transplantation. PMID- 3274365 TI - Living-related and unrelated donor kidney transplantation: comparison between ABO compatible and incompatible grafts. PMID- 3274366 TI - Donor-specific transfusion in living-unrelated renal donor-recipient combinations. PMID- 3274367 TI - Nonrelated living donors for renal transplantation. PMID- 3274368 TI - Transplantation of cadaver kidneys from donors under 10 years of age. PMID- 3274369 TI - Renal transplantation in Nordic children. PMID- 3274370 TI - Long-term results of cadaveric kidney transplantation in children. PMID- 3274371 TI - Elimination kinetics of cyclosporine following oral administration to children with renal transplants. PMID- 3274372 TI - Early acute tubular necrosis, late rejection in pediatric renal transplantation with donor-specific transfusions. PMID- 3274373 TI - Cyclosporine kinetics in pediatric patients with congestive heart failure. PMID- 3274374 TI - A comparison of three immunosuppressive protocols in patients aged over 50 years. PMID- 3274375 TI - Impact of donor age and quality of donor kidneys on graft survival. PMID- 3274376 TI - Frequency of diabetes-related complications in renal allograft recipients prospectively randomized to cyclosporine or azathioprine. PMID- 3274377 TI - Pretransplant coronary arteriography for diabetic renal transplant recipients. PMID- 3274378 TI - Cyclosporine toxicity in amyloidotic patients. PMID- 3274379 TI - Outcome of renal transplantation in blacks. PMID- 3274380 TI - Cadaveric renal transplantation without previous chronic dialysis treatment as an alternative approach to the treatment of end-stage renal disease. PMID- 3274381 TI - Can renal transplantation be done safely without prior dialysis therapy? PMID- 3274382 TI - Limiting dilution analysis: a new approach to study allograft acceptance. PMID- 3274383 TI - In vitro steroid sensitivity and interleukin 2 synthesis in normal subjects. PMID- 3274384 TI - Recipient sensitization against donor cells in pre- and/or posttransplantation sera is inversely correlated with graft survival. PMID- 3274385 TI - Release of interleukins during tolerance and rejection of human renal allografts. PMID- 3274386 TI - In vitro interleukin 2 and natural killer activity in renal allograft recipients. PMID- 3274387 TI - Abnormal expansion of a large granular lymphocyte subset that lacks natural killer activity in long-term renal allograft recipients. PMID- 3274388 TI - Diagnosis of human allograft rejection by flow cytometry using two-color fluorescence and monoclonal antibodies. PMID- 3274389 TI - Correlation between blood eosinophilia and rejection crisis in renal transplants. PMID- 3274390 TI - Quantitative expression of T cell surface antigens in renal transplantation. PMID- 3274391 TI - The prognostic value of the postrejection treatment biopsy in renal transplantation. PMID- 3274392 TI - Cyclosporine nephrotoxicity: pathogenetic factors and prevention. PMID- 3274393 TI - Rejection and recurrence of SLE nephritis in cyclosporine-treated kidney transplant recipients. PMID- 3274395 TI - The components of the leucocyte infiltration of human renal allografts are not equally sampled by fine needle aspiration and needle core biopsy. PMID- 3274394 TI - Distinction between cortex and medulla in kidney transplant aspiration cytology and relevance to interpretation of results. PMID- 3274396 TI - Confirmation of the utility of the fine needle aspiration biopsy of the transplanted kidney. PMID- 3274397 TI - Correlation between histopathology and aspiration cytology of kidney grafts in 43 cases. PMID- 3274398 TI - Monitoring of renal allograft rejection with fine needle aspiration biopsy and serum C-reactive protein determinations. PMID- 3274399 TI - The impact of transplant aspiration cytology on management of cyclosporine A treated renal transplant recipients. PMID- 3274400 TI - Lymphocyte subpopulations in renal biopsies of transplant patients treated with cyclosporine. PMID- 3274402 TI - Flow cytometry analysis of urinary cytology in renal transplantation. PMID- 3274401 TI - Correlation between urine sediment cytology analysis and clinical state in cyclosporine-treated renal recipients. PMID- 3274403 TI - The 99M-TC-SN colloid uptake in the diagnosis of acute renal allograft rejection. PMID- 3274404 TI - Elevation of serum C-reactive protein levels during graft rejection. PMID- 3274405 TI - Possibility of recognizing immunologic and cyclosporine A damage by urinary neopterin excretion in kidney transplant recipients. PMID- 3274406 TI - Neopterin excretion for kidney transplant monitoring: relationship with antilymphocyte globulin treatment. PMID- 3274407 TI - Effect of age on cyclosporine pharmacokinetics in marrow transplant recipients. PMID- 3274408 TI - Optimizing cyclosporine use in pediatric patients by measuring pretransplant blood levels. AB - A method for measuring pretransplant CsA levels to predict posttransplant pharmacokinetic behavior was studied in a total of seven pediatric patients. Comparison of drug levels and single-dose pharmacokinetic characteristics in the pretransplant and posttransplant study periods suggest that this method (1) is useful in predicting early posttransplant blood levels and beta-phase half-life; (2) may prevent early episodes of acute allograft rejection associated with subtherapeutic cyclosporine immunosuppression; and (3) may identify those patients who should not be empirically treated with only cyclosporine and prednisone in the early posttransplant period. PMID- 3274409 TI - Development of a new carrier for cyclosporine A with selectivity for lymphatics. PMID- 3274410 TI - Measurements of cyclosporine A by RIA in different centers are not comparable. PMID- 3274411 TI - The potential of monoclonal antibodies for cyclosporine monitoring. PMID- 3274413 TI - Cyclosporine pharmacokinetics in the early course of renal transplantation. PMID- 3274412 TI - Comparison of oral and intravenous cyclosporine A in kidney transplants. PMID- 3274414 TI - Is cyclosporine administration in twice daily dose advantageous? PMID- 3274415 TI - RIA plasma cyclosporine values six hours after oral administration (T6)--an easy solution to a difficult therapeutic problem: a retrospective and prospective study. PMID- 3274416 TI - Tailoring cyclosporine according to kinetic profiles: does it allow a low-dose therapeutic schedule? PMID- 3274418 TI - Measurement of cyclosporine bioactivity in serum of renal transplant recipients: development and comparison with RIA. PMID- 3274417 TI - Cyclosporine--high-dose steroid interaction in renal transplant recipients: assessment by HPLC. PMID- 3274419 TI - Dihydroergotoxine (hydergine) to prevent cyclosporine nephrotoxicity in kidney transplant recipients. PMID- 3274420 TI - Cyclosporine: glomerular hemodynamics. PMID- 3274421 TI - The effect of cyclosporine on long-term function in patients undergoing kidney transplant from living donors. PMID- 3274422 TI - Glycosuria: an index of cyclosporine nephrotoxicity. PMID- 3274423 TI - The differentiation of acute renal allograft rejection and cyclosporine nephrotoxicity by simple urine cytology. PMID- 3274424 TI - The clinical efficacy of cytodiagnostic urinalysis in the diagnosis of acute renal allograft rejection: a clinical-pathologic correlation of 122 urine specimens. PMID- 3274425 TI - Hepatobiliary complications of cyclosporine therapy following renal transplantation. PMID- 3274426 TI - Deep venous thrombosis in patients undergoing renal transplantation--effects of cyclosporine A. PMID- 3274427 TI - Cyclosporine A and intravascular coagulation. PMID- 3274429 TI - Impairment of liver synthetic function and decreased liver flow during cyclosporine A therapy. PMID- 3274430 TI - Cyclosporine nephrotoxicity and cyclosporine--digoxin interaction prior to heart transplantation. PMID- 3274428 TI - Increased plasma LDL cholesterol after renal transplantation associated with cyclosporine immunosuppression. PMID- 3274431 TI - Cyclosporine A treatment for human immunodeficiency virus-infected transplant recipients. PMID- 3274432 TI - Human fetal pancreas: potential for transplantation. PMID- 3274433 TI - Influence of tissue culture on the survival of major histocompatibility complex compatible fetal pancreas allografts in the mouse. PMID- 3274434 TI - Suppression of donor lymphocyte reactivity by pretreatment with recipient type UV irradiated blood. PMID- 3274435 TI - Allogeneic and syngeneic pancreas transplantation in non-obese diabetic mice. PMID- 3274436 TI - Prothymocyte development in diabetes-prone BB rats: description of a defect that predisposes to immune abnormalities. PMID- 3274437 TI - Reversal of liver failure in rats by ultraviolet-irradiated hepatocyte transplantation. PMID- 3274439 TI - Factors influencing kidney graft survival in the cyclosporine era: a multivariate analysis. PMID- 3274440 TI - The effect of cyclosporine A in cadaver donor retransplants: a surprising effect of the sex of the donor. PMID- 3274441 TI - Does cyclosporine eliminate the need for preparatory blood transfusions? PMID- 3274442 TI - Renal transplantation in presensitized patients treated with cyclosporine. PMID- 3274443 TI - Primary cadaveric renal transplantation using cyclosporine in patients over fifty years of age. AB - Patient and allograft survival for the older transplant recipient (greater than 50 years of age) is comparable to that of their younger counterparts. These patients require less aggressive immunosuppression and tolerate over immunosuppression poorly. The older uremic patient should not be excluded from renal transplantation. PMID- 3274444 TI - Cadaveric renal transplantation after pulsatile perfusion, histocompatibility matching, and conversion to cyclosporine therapy. PMID- 3274445 TI - Sequential antilymphoblast globulin and cyclosporine for renal transplantation. PMID- 3274446 TI - Use of antithymocyte globulin and cyclosporine to treat steroid-resistant rejection episodes in renal transplant recipients. PMID- 3274447 TI - Antilymphoblast globulin treatment of steroid-resistant rejection in cyclosporine immunosuppressed renal transplant recipients. PMID- 3274448 TI - Immunosuppression with monoclonal anti-T3 antibody (WT32) in renal transplantation. PMID- 3274449 TI - Rescue of severe steroid-resistant rejection with OKT3.PAN. PMID- 3274450 TI - Anti-T12 monoclonal antibody therapy of acute renal allograft rejection. PMID- 3274451 TI - Potent immunosuppression overcomes retransplantation, presensitization, and historical positive crossmatch as transplant risk factors. PMID- 3274452 TI - Quadruple therapy for cadaver renal transplantation. PMID- 3274453 TI - Immunosuppression with cyclosporine, azathioprine, and prednisolone in cadaver renal allograft recipients. PMID- 3274454 TI - Intermodal immunosuppression for cadaver renal transplantation: results using antilymphocyte globulin, azathioprine, cyclosporine, and prednisone. PMID- 3274455 TI - Cox regression analysis of outcome risk factors in 519 renal allograft recipients. PMID- 3274456 TI - Pretreatment of human renal allografts with monoclonal antibodies to induce long term tolerance. PMID- 3274457 TI - Results of the South-Eastern Organ Procurement Foundation strategy for transplanting sensitized patients. PMID- 3274458 TI - Renal allograft survival in highly sensitized patients treated with cyclosporine. PMID- 3274459 TI - Early postoperative monitoring of natural anti-A and anti-B isoantibodies in ABO incompatible living donor renal allografts. PMID- 3274460 TI - The impact of selected risk variables on the outcome of renal transplantation. PMID- 3274461 TI - Effects of pretransplant splenectomy: univariate and multivariate analyses. PMID- 3274462 TI - Prolonged cyclosporine therapy to induce solid engraftment after renal transplantation. PMID- 3274463 TI - Conversion from azathioprine and/or prednisolone to cyclosporine A in renal allograft recipients. PMID- 3274464 TI - Safe conversion from cyclosporine. PMID- 3274465 TI - Corticosteroid withdrawal with substitution of azathioprine in cyclosporine treated primary cadaveric renal transplant recipients. PMID- 3274466 TI - Effects of HLA matching and panel reactive antibodies in the development of rejection after conversion of cyclosporine to azathioprine. PMID- 3274467 TI - Usefulness of radionuclide scintiphotography to evaluate preserved kidney viability. PMID- 3274468 TI - A controlled comparison of kidney preservation by two methods: machine perfusion and cold storage. PMID- 3274469 TI - The causes and consequences of failure of cadaver kidneys to function: a case control study. Ontario Renal Transplant Research Group. PMID- 3274470 TI - Successful long-term preservation and transplantation of human cadaveric kidneys. PMID- 3274471 TI - The influence of cold ischemia on the function of cadaveric renal transplants in cyclosporine A-treated patients. PMID- 3274472 TI - Does the donor age influence graft survival in renal transplantation? PMID- 3274474 TI - The effect of acute tubular necrosis on cyclosporine-treated kidney transplants. PMID- 3274473 TI - Successful use of cyclosporine in renal grafts with prolonged ischemic times. PMID- 3274476 TI - The long-term deleterious effect of delayed graft function in cyclosporine treated renal allograft recipients. PMID- 3274475 TI - Increase in N-acetyl-beta-glucosaminidase excretion as a marker of kidney damage in cyclosporine-treated renal allografts. PMID- 3274477 TI - First kidney transplants in children 5 years of age or younger. PMID- 3274478 TI - Long-term survivors of kidney transplantation, mortality, rehabilitation, and immunologic reactivities. AB - 1. The overall patient and graft survival rates (83.6% and 82% respectively) up to 23 years posttransplant of the group who survived a minimum of 10 years is reasonably good regardless of the donor source. 2. The primary grafts that survived a minimum of 10 years and were lost during the subsequent 12 years (17.7%) were equally due to rejection and the death of the patient. 3. Rehabilitation of the long-term survivor has been very good. Cardiovascular disease is becoming a significant morbidity among pediatric-aged recipients reaching the thirties. 4. The causes of death after 10-year survival are evenly distributed among infection, cardiovascular disease, neoplasms, dialysis, and hepatic failure. 5. The selected studies of immunologic reactivities in the long term survivors show their failure to generate significant killing against donor specific antigens while displaying normal MLR response against donor and third party. Significant depressions in their ability to respond in vitro to soluble antigens was also demonstrated. PMID- 3274479 TI - Prevention of chronic rejection by cyclosporine and prednisone. PMID- 3274480 TI - Renal transplantation in hepatitis B surface antigen-positive patients. PMID- 3274481 TI - Prognostic significance of hepatitis B surface antigenemia in cadaveric renal transplant patients. PMID- 3274482 TI - Hepatitis B and renal transplantation. AB - Renal transplantation in HBsAg+ chronic carriers has a relative low risk of progressive liver disease, with mortality associated with liver disease at 7%. In contrast, HBsAg+ recipients who acquired their disease in the early posttransplant period had a mortality of 60%. HBeAg-positive patients who remain persistently positive are a subgroup with a poor prognosis and should not be offered a renal transplant. PMID- 3274483 TI - The value of human T-lymphotropic III screening at the time of cross-match. PMID- 3274484 TI - Human T-lymphotropic virus III antibody screening in kidney transplant recipients and patients receiving maintenance hemodialysis. PMID- 3274486 TI - T cell subset analysis predicts virus infection but not rejection in cyclosporine A-treated renal allograft recipients. PMID- 3274485 TI - HTLV-III/LAV infection in kidney and liver transplantation. PMID- 3274487 TI - Cell cycle analysis of activated mononuclear blood cells of renal allograft recipients. PMID- 3274489 TI - Rejection of the ureter: a new component of renal allograft rejection. PMID- 3274490 TI - Percutaneous interventional radiologic procedures for diagnosis and treatment of urologic complications in renal transplant patients. PMID- 3274488 TI - Monitoring of the serum neopterin/creatinine ratio in renal transplantation. PMID- 3274491 TI - Percutaneous interventional procedures in the management of urologic complications of renal transplantation. PMID- 3274492 TI - The incidence of membranoproliferative glomerulonephritis in renal allografts. PMID- 3274493 TI - Disappearance of mesangial IgA deposits from the kidneys of two donors after transplantation. PMID- 3274494 TI - Parameters governing function in 100 consecutive cadaveric kidney transplants. PMID- 3274495 TI - Cancers following cyclosporine therapy. PMID- 3274497 TI - Human antibody response to antilymphocytic preparations in renal transplant patients. PMID- 3274496 TI - Cancer incidence in renal transplant patients treated with azathioprine or cyclosporine. PMID- 3274498 TI - Deep venous thrombosis after renal transplantation. PMID- 3274499 TI - Mechanism of liver cell injury from iron overload in renal transplant recipients. PMID- 3274500 TI - Symptomatic renal osteodystrophy after renal transplantation: treatment with 1 alpha-hydroxycholecalciferol. PMID- 3274501 TI - Transmission of medulloblastoma from cadaver donor to three organ transplant recipients. PMID- 3274502 TI - Kaposi's sarcoma after renal transplantation. PMID- 3274503 TI - Chromosome aberrations in kidney transplant recipients. PMID- 3274504 TI - Donor specific transfusions: a five-year experience with alternative protocols. PMID- 3274505 TI - Evaluation of the risk factors associated with donor specific blood transfusion. PMID- 3274506 TI - The effects of donor specific transfusion and cyclosporine A on graft outcome. PMID- 3274507 TI - Donor specific blood transfusions do not improve graft survival in living related donor transplantation. PMID- 3274508 TI - Renal retransplantation from living related donors using donor specific blood transfusions. PMID- 3274509 TI - Simultaneous pancreas and kidney transplantation: long-term results and comparison of two surgical techniques. PMID- 3274510 TI - Metabolic control at two months to 4.5 years after pancreatic transplantation, with special reference to the role of cyclosporine. PMID- 3274511 TI - Quadruple immunosuppressive therapy in whole pancreas transplantation. PMID- 3274512 TI - Critical analysis of mortality and graft loss following simultaneous renal pancreatic duodenal transplantation. PMID- 3274513 TI - Preservation of human pancreatic allografts in cold storage for six to 24 hours. PMID- 3274514 TI - Incidence of fistulas following human pancreas transplantation--positive influence of reabsorption of pancreatic secretions by the peritoneum. PMID- 3274515 TI - Are late diabetic complications reversible after pancreas transplantation? A new method of follow-up of microcirculatory changes. PMID- 3274516 TI - Effects of successful combined pancreatic and renal transplantation on advanced diabetic neuropathy: a one-year follow-up study. PMID- 3274517 TI - Role of pancreas graft biopsies in the diagnosis and treatment of rejection after pancreas transplantation. PMID- 3274518 TI - Synchronous pancreatic and renal allografts with urinary tract drainage of the pancreas. PMID- 3274519 TI - Effect of human fetal pancreas transplantation on secretion of C-peptide and glucose tolerance in type I diabetics. PMID- 3274520 TI - Experience with human fetal pancreatic allografts over a three-year period. PMID- 3274521 TI - Intraportal transplantation of cryopreserved human fetal pancreata. PMID- 3274523 TI - Development of class I-directed lymphocytotoxic antibodies after liver transplantation. PMID- 3274522 TI - A positive lymphocyte cross-match and major histocompatibility complex mismatching do not predict early rejection of liver transplants in patients treated with cyclosporine. PMID- 3274524 TI - Incidence and outcome of donor arterial anomalies in liver allografts. PMID- 3274525 TI - Orthotopic liver transplantation for secondary malignancies of the liver. PMID- 3274526 TI - Designation of liver transplant centers in the United States. PMID- 3274527 TI - Vascular problems in liver transplantation. PMID- 3274528 TI - Experience with veno-venous bypass in human liver transplantation. PMID- 3274529 TI - Hemodynamics during liver transplantation with veno-venous bypass. PMID- 3274530 TI - Vasopressin use in human liver transplantation. PMID- 3274531 TI - Prognostic perioperative factors predicting the outcome of liver transplantation. PMID- 3274532 TI - Beneficial effect of topical ice cooling in donor hepatonephrectomy. PMID- 3274533 TI - Conversion from standard cyclosporine to low-dose cyclosporine and azathioprine therapy as treatment for cyclosporine-related complications in liver transplant patients. PMID- 3274534 TI - Results and problems in pediatric liver transplantation in the Cambridge/Kings College Hospital series: 1968 to July 1986. PMID- 3274536 TI - Orthotopic liver transplantation in humans: monitoring by serial graft biopsies. PMID- 3274535 TI - Use of triple therapy and percutaneous needle biopsy to minimize graft failure following liver transplantation. PMID- 3274537 TI - An analysis of histological prognostic features of liver allograft rejection based on 270 serial biopsies. PMID- 3274538 TI - Correlation of amino acid metabolism and liver biopsies in preoperative and postoperative patients receiving hepatic transplants. PMID- 3274539 TI - Class I major histocompatibility complex antigens are induced on hepatocytes in rejecting human liver grafts. PMID- 3274540 TI - Consequences of hepatic artery pathology after orthotopic liver transplantation. PMID- 3274541 TI - Safety and utility of a simple technique of liver biopsy following liver transplantation. PMID- 3274542 TI - Diagnosis of rejection in liver transplantation. PMID- 3274543 TI - The influence of HLA matching in cardiac allograft recipients receiving cyclosporine and azathioprine. PMID- 3274544 TI - Current results with triple therapy for heart transplantation. PMID- 3274546 TI - Clinical heart transplantation. PMID- 3274545 TI - Immediate graft failure treated with partial cardiopulmonary bypass and emergency cardiac retransplantation. PMID- 3274547 TI - Selected characteristics of 444 heart donors. PMID- 3274548 TI - The effect of blood pretransfusion on orthotopic cardiac transplantation. PMID- 3274549 TI - Late acute rejection after cardiac transplantation: incidence and treatment. PMID- 3274550 TI - Neurologic complications after heart transplantation: the influence of immunosuppression. PMID- 3274552 TI - Individualized immunosuppression in heart transplant recipients. PMID- 3274551 TI - Are there indications for heterotopic heart transplantation today? PMID- 3274553 TI - Determinants of cyclosporine nephrotoxicity following cardiac transplantation. PMID- 3274554 TI - Results of "immunoconversion" from cyclosporine to azathioprine in heart transplant recipients with progressive nephrotoxicity. PMID- 3274556 TI - Increase in transferrin receptors as a marker for rejection and infection in human cardiac transplantation. PMID- 3274555 TI - Avoidance of perioperative renal toxicity by a modified immunosuppression protocol. PMID- 3274557 TI - Cytoimmunologic monitoring for the noninvasive diagnosis of cardiac rejection. PMID- 3274558 TI - First pass radionuclide scintigraphy for long-term follow-up after heart and heart-lung transplantation. PMID- 3274559 TI - Appearance of cells bearing the interleukin-2 receptor in peripheral blood of cardiac transplant patients and their correlation with rejection episodes. PMID- 3274560 TI - Immunological monitoring of heart allograft recipients. PMID- 3274561 TI - The role of bronchoalveolar lavage in diagnosing pulmonary rejection after heart lung transplantation. PMID- 3274563 TI - Circadian variation of heart rate but not of blood pressure after heart transplantation. PMID- 3274562 TI - Frequency analysis of surface electrocardiogram and two-dimensional echocardiography for noninvasive diagnosis of rejection after heart transplantation. PMID- 3274564 TI - Biopsy assessment of donor hearts prior to and during transplantation. PMID- 3274565 TI - Sequential studies of major histocompatibility complex antigen expression (common class I and class II determinants, DR and DQ) in cardiac biopsies following human cardiac transplantation. PMID- 3274566 TI - Transvenous lung biopsy: a new technique. PMID- 3274567 TI - The importance of HLA-DR matching in corneal transplant recipients treated with cyclosporine A. PMID- 3274568 TI - Use of locally injected anti-T monoclonal antibodies in the treatment of acute corneal graft rejection. PMID- 3274569 TI - Allogeneic bone marrow transplantation without graft-v-host disease: true tolerance of graft against the host through depletion of donor T lymphocytes pregrafting in malignant and nonmalignant disorders. PMID- 3274570 TI - Bone marrow transplantation for acute leukemia: a preliminary report from the International Bone Marrow Transplant Registry. PMID- 3274571 TI - Bone marrow transplantation in leukemia using family donors other than HLA identical siblings: a preliminary report from the International Bone Marrow Transplant Registry. PMID- 3274572 TI - Long-term follow-up of patients who received transplants for aplastic anemia or leukemia. PMID- 3274573 TI - Increased HLA-DR compatibility between patients with acute myeloid leukemia and their parents: implication for bone marrow transplantation. PMID- 3274574 TI - Fibronectin restores defective in vitro proliferation of lymphocytes from patients after marrow grafting. PMID- 3274575 TI - Prediction of leukemic relapse soon after bone marrow transplantation. PMID- 3274577 TI - Acute graft-versus-host disease: pathogenesis and prevention with a monoclonal antibody in vivo. PMID- 3274576 TI - Acute graft-versus-host disease following bone marrow transplantation in humans: prognostic factors. Advisory Committee of the International Bone Marrow Transplant Registry. PMID- 3274578 TI - Haploidentical bone marrow transplantation using soybean agglutinin-processed, T depleted marrow. PMID- 3274579 TI - Characteristics and functions of inflammatory cells isolated from acute graft versus-host disease target organs after bone marrow transplantation in the rat. PMID- 3274580 TI - Reduction of acute graft-versus-host disease-related mortality and cytotoxic T lymphocyte induction after pretreatment of the recipient with anti-asialo GM1 antibody in the murine P-to-F1 model. PMID- 3274581 TI - Transfusion effect on graft-versus-host disease and leukemic relapse in HLA matched bone marrow transplantation. PMID- 3274582 TI - Immunogenetic analysis of fully allogeneic rat bone marrow transplantation. PMID- 3274583 TI - Ex vivo depletion of human bone marrow T lymphocytes by soybean lectin fractionation followed by treatment with an anti-pan-T cell (CD5) ricin A- chain immunotoxin. PMID- 3274584 TI - HLA-DP matching in allogeneic bone marrow transplantation. PMID- 3274585 TI - Lymphocyte reconstitution in children receiving soybean agglutinin T-depleted bone marrow transplants. PMID- 3274586 TI - Transfer of B memory cells to a T-dependent antigen in murine bone marrow transplantation. PMID- 3274587 TI - Transplantation of T cell-depleted bone marrow in histoincompatible rabbits: improved engraftment and long-term chimeras after the addition of irradiated donor buffy coat cells and irradiated autologous cryopreserved bone marrow. PMID- 3274588 TI - [Emergency care in traumatology]. PMID- 3274589 TI - [Statistics for health personnel]. PMID- 3274590 TI - [Handbook for the district physician. I]. PMID- 3274591 TI - [Principles in the fight against communicable diseases. II]. PMID- 3274592 TI - [Protection of patients and health personnel in radiodiagnostic examinations]. PMID- 3274593 TI - [The role, organization and activity of national health institutes]. PMID- 3274594 TI - [Colonisation of diseased periodontal and endodontic tissues by microorganisms and their pathogenic potential]. PMID- 3274596 TI - [Attitude towards orthodontic treatment--a questionnaire study among 12-year old school children]. PMID- 3274595 TI - [Neutrophil chemotaxis function in patients with localized juvenile periodontitis]. PMID- 3274597 TI - [Multimodal treatment of inoperable oral and maxillofacial squamous cell carcinoma]. PMID- 3274598 TI - [Maxillary repair after shotgun injury using the osteocutaneous scapular flap]. PMID- 3274599 TI - [Transdental titanium pin fixation (Dildei Pins)]. PMID- 3274600 TI - [Jaw movements in patients with full dentures]. PMID- 3274601 TI - [Advances in reconstructive maxillofacial surgery]. PMID- 3274602 TI - [Late results after transplantation of teeth--analysis and consequences for the surgical technique]. PMID- 3274603 TI - [Diagnostic potential of computerized tomography in orthodontics and oral surgery]. PMID- 3274604 TI - [Titanium--a new material for implant suprastructures]. PMID- 3274605 TI - [Problems of professional responsibility in orthodontic practice in the public sector]. AB - Characteristics aspects of orthodontics profession are emphasized. Problems about patient consent for treatment, his information and operator obligation to attend to treatment goals on particularly considered. Orthodontist behaviour errors causing a damage to the patient during diagnosis, treatment planning, orthodontic appliance planning and/or carrying out and therapy execution are analysed. Biologic factors having a significant influence on treatment effects are illustrated. Damages possibility even after long time from therapy are evaluated. PMID- 3274606 TI - [Clinical and immunological aspects of Lichen ruber planus]. AB - Clinical and histopathologic features of lesions in lichen r. planus are characteristic of inflammatory reaction: this it is possible some pondering on immunologic performance related to uncertain etiology of the disease. PMID- 3274607 TI - [Paradoxical fluoride phenomena in a Sardegna district]. AB - The authors in epidemiologic research on dental caries of primary-school children in a village having optimufluorotic water, put in evidence fluorine paradox phenomena founding high percentual of cariopatic subjects. PMID- 3274608 TI - [Histocompatibility antigens expressed in the epithelium of the oral mucosa during various diseases]. AB - The AA. report the expression of the Class I and II major histocompatibility antigens on oral mucosa Class I and II antigen expression varied between various disease states exhibiting proliferative or destructive tissue responses, and this expression is consistent with major histocompatibility complex (M.H.C.) restricted cellular interactions. Oral mucosa doesn't express HLA-DQ antigens. PMID- 3274609 TI - [Ossifying fibroma of the upper jaw of probable periosteal origin]. AB - The AA. describe a case of bone producing fibroma rising in a young patient after the drawing of a tooth. Histological reports, effected with different methods, confirmed this diagnosis. PMID- 3274610 TI - [Chondroma]. AB - Chondroma: the A.A. describe the characteristics of etiopathogenetic, anatomy pathological, clinical, diagnostic and therapeutical order of this uncommon pathology. PMID- 3274611 TI - [Injury to the TMJ in dental practice: criteria for review and evaluation in the public sector]. AB - The Authors point out dental fields when a treatment error may cause considerable civil TMJ damages. Various damage kinds were examined and diagnosis standards to point them out were illustrated. Evaluation hypothesis using a table system when a sagittal mandibular excursion permanent deficit is present was suggested. The propose analysed the main percentages be bunded in Literature. The distance between upper and lower first bicuspid in maximum non forced mouth opening was considered as a necessary landmark to estimate the mandibular function deficit. PMID- 3274612 TI - [Clinico-statistical survey of neoplasms of the oral cavity in a Sardinian population]. AB - The AA. examine 14,987 bioptic investigations comings from Anatomy and Pathologic Histology Institute of Cagliari University relieved during the period 1936-1968 (twenty-eight years). They stop on main data giving prominence to: incidence of stomatologic cases, of benignant and malignant tumours, of inflammatory and precancerous states in the mouth. They moreover describe neoplasia frequency in reference to histologic type, to sex, to age and to localization. PMID- 3274613 TI - [Keratoacanthoma]. AB - The A.A. describe the characteristics of etiopathogenetic, anatomy-pathological, clinical, diagnostic and therapeutical order of keratoacanthoma. PMID- 3274614 TI - [Orthodontic planning in treatment of single dental disharmonies of the anterior segment]. AB - The Authors examined epidemiology and diagnosis of dental discrepancy in frontal teeth. An accurate orthodontic planning for its treatment is suggested. Bolton index and Ballard and Wylie diagram are considered illustrating their usefull in evaluating proportional dimensions in upper and lower dental arches. PMID- 3274615 TI - [Apicectomy and replantation. Report of a clinical case]. AB - The AA. report a case treated with cyst-enucleation, apicaectomy and tooth replantation and then prosthetic management, which they control for the last twenty years, and beyond initial expectations, they could establish an astonishing result indeed. PMID- 3274616 TI - [Gardner syndrome. A clinical case]. AB - The Authors describe an operation of extirpation of jaw's osteomas in a patient with Gardner's Syndrome. PMID- 3274617 TI - [Force systems for correction of lower molar inclination]. AB - The authors analyzed the uprighting movement and suggested forces system developing wished movements considering M/F ratio generated on brackets. The effects of these system on anchorage segment were evaluated. Use of concurrent or non-concurrent was analyzed in the light of their "cohernce" with treatment goals. PMID- 3274618 TI - [Profilometric evaluation in orthodontico-surgical treatment planning]. AB - The Authors propose the use of three profilometric analysis to obtain a total aesthetic evaluation of facial proportion and balance. Each analysis is commented explaining specific advantages in orthodontic-surgical treatment planning. PMID- 3274619 TI - [Heterotopia of the third molar in the coronoid process. Clinical case]. AB - The A.A. present an uncommon case of eterotopy of the wisdom-tooth placed in the coronoid process, examining etiopthogenesis of this pathology after an attentive analysis of the literature. PMID- 3274620 TI - [Cephalometric evaluation of lower incisor position]. AB - The Authors examined some cephalometric values usually utilized to evaluate lower incisors inclination or anteroposterior position. Mean values and standard deviations of these parameters in a 194 subjects sample was calculated. Validity of these valued in different typology and skeletric classes was finally verified. PMID- 3274621 TI - [AIDS]. PMID- 3274622 TI - [Overview of AIDS]. PMID- 3274623 TI - [Prevention of AIDS in the dental area]. AB - After a brief analysis of the present epidemiological situation both international and of our country, on the possibility of early diagnosis on clinical and laboratory bases, the A.A. dwell upon the most frequent dental pathologies in case of AIDS and upon the possibilities of singling patients suffering from the so-called "spy-lesions" of the oral cavity, which are characteristic in most cases. The A.A. conclude by reporting the methodologies (materials and methods) which are to be used, from time to time, in order to carry out a careful and correct anti-AIDS prophylaxis in dentistry, either of individuals and medical personnel or of instruments and work-environments. PMID- 3274624 TI - [Morphological and structural S.E.M. analysis of a new type of orthodontic bracket]. AB - The SEM analysis, the metallographic analysis, the microhardness and the mechanic resistance before and after recycling treatment, are compared with the analysis made on a bracket earlier produced by the same firm. PMID- 3274625 TI - [A new experimental approach to evaluate the use of thermoplasticized gutta percha for canal obturation]. AB - The author describes a new method of thermoplasticized gutta-percha and examines the problems of this modern technique; particularly he discusses the problem of apical extension of root canal fillings, describing the results of an experimental study. PMID- 3274626 TI - [Sjogren's syndrome (autoimmune exocrinopathy)]. PMID- 3274627 TI - [Therapy for angiomas of the oromaxillofacial region]. AB - The AA, describe the treatment of the hemangiomas of the oral and maxillofacial district, on the light of the last acquisitions. PMID- 3274628 TI - [Finishing and polishing of an anterior hybrid composite--Herculite XR. SEM evaluation]. AB - A study was a conducted in order to discover finishing and polishing effectiveness, by particular operative method, on HERCULITE XR, sub-micron hybrid composite. The study was realized on 35 incisors extracted for periodontal reasons, treated with "labial veneers" according to Jordan (1987), divided into 7 groups each containing 5, and finished with different technique. After treatment, the teeth were subjected to SEM examination. The results showed that the high speed finishing technique by twelve and thirty fluted carbide burs and final polishing with Command Ultrafine Luster Paste produces the smoothest and flatest surface of HERCULITE XR. Furthermore the HERCULITE XR/enamel margin doesn't appear fractured or disrupted. Since finishing and polishing rotary techniques in accordance with the characteristic of each type of composite resins. PMID- 3274629 TI - [Esthetic restorations in conservative dentistry]. AB - The AA. discuss how to use some esthetic materials, as the Masking Agents and Tints, considering their technique characteristics and tackling the problem of right dental color remark. PMID- 3274630 TI - [Quadrilateral analysis of lower face: an individualized and differential assessment for orthognathic surgery]. AB - The authors describe the method of cephalometric diagnosis known as "quadrilateral analysis", proposed by Di Paolo R.J.: this method offers an accurate assessment of skeletal dysplasia, particularly for--orthodontic surgery. PMID- 3274631 TI - [Cavernous hemangioma confined to the tongue]. AB - The authors relate on a case of an isolated cavernous haemangioma of the body of the tongue characterized by considerable size. Such neoplasms, usually described within the more extensive chapter of the more common angiomatous lesion of the oral cavity, are relatively rare. The authors describe a personal case discussing the diagnostic spects of such lesion and emphasizing the importance of the arteriography of the carotid artery and the of the selective arteriography of the lingual arteries, especially in considering surgery. Biopsies are not recommended. After discussing the histopathological and clinical aspects of such lesions the Authors emphasize the therapeutic ones. Even though radiotherapy, cryotherapy, laser therapy, medical treatment, injection of sclerosing substances and the selective embolization, of the lingual artery seem to have some efficacy, the authors conclude that surgery in the therapy of choice in the isolated vascular lesions of the body of the tongue. PMID- 3274633 TI - HLA-A antigen incompatibility and HLA-B antigen compatibility associated with enhanced kidney allograft survival in blood-transfused patients. AB - The combined effect on 2-year primary kidney allograft survival of pretransplant blood transfusion, HLA-DR matching, HLA-A matching, HLA-B matching and other factors was analyzed in 116 azathioprine- and prednisolone-treated patients. The results show an hitherto unreported, statistically significant association between incompatibility for HLA-A antigens and enhanced graft survival in transfused recipients of transplants mismatched for HLA-DR (p = 0.005) and for HLA-B (p = 0.008). As expected, compatibility for HLA-B antigens was significantly associated with increased graft survival in transfused recipients of both HLA-DR compatible (p = 0.004) and HLA-DR incompatible (p = 0.01) grafts. If confirmed, the findings foreshadow new aspects of HLA matching in kidney transplantation and might explain the beneficial effect of blood transfusion on renal allograft survival. PMID- 3274632 TI - Burkitt lymphoma and genetic markers of immunoglobulin. AB - The Ig allotype G3m (c3) was numerically more frequent among 70 Kenyan Burkitt lymphoma (BL) cases than in 70 Kenyans with other tumors of the neck (0.02 greater than p greater than 0.01). The distribution of allotypes G1m (a, x) and G3m (b5) did not differ between 50 Caucasian BL cases and blood donors. PMID- 3274636 TI - [Inaugural discourse for the Chair of Neurology at the Universidad del Pais Vasco]. PMID- 3274634 TI - [Teaching internal medicine at the School of Medicine]. PMID- 3274635 TI - [Ischemic cerebrovascular accidents in young patients]. PMID- 3274637 TI - [Neurological resources under the Public Medical Assistance System in Spain. Apropos of a survey performed by the National Commission of Neurology]. PMID- 3274638 TI - [Myopathy caused by potassium depletion. Report of 5 cases]. PMID- 3274639 TI - [Parkinsonism and epilepsy]. PMID- 3274640 TI - A family-genetic study of dementia of Alzheimer type. AB - A family study of 22 rigorously diagnosed subjects with dementia of Alzheimer type (DAT) and 24 nondemented controls revealed a morbid risk of DAT to first degree relatives of probands of 41% by age 83 years compared with a risk of 23% by age 85 years in control relatives. Senescent forgetfulness, defined as consistent but not incapacitating memory deficit, may have represented early DAT in some instances. When such cases were included as secondary cases, the morbid risk to first-degree relatives of probands was 67% by age 86 years while risk to comparable control relatives remained 23%. No cases of Down's syndrome were observed. A significant excess of hematologic malignant neoplasms was found among first-degree relatives of probands, supporting an association with DAT. Overall, the findings add further evidence of the action of familial-genetic factors in the etiology of DAT. The magnitude of the effect is consistent with an autosomal dominant mode of inheritance, with penetrance nearly complete by age 85 years. The probands were not selected on the basis of factors posited by some to indicate a familial form of DAT, suggesting that such a genetic mechanism may be involved in the occurrence of DAT in general. PMID- 3274641 TI - Recent application of DNA analysis to issues of paternity. PMID- 3274642 TI - [Dopamine and aging: physiopathological basis of the neurobiological deficit in subjects over 50 years of age]. PMID- 3274644 TI - [Nursing services in Turkey in relation to maternal health. Maternal health services and public health nursing]. PMID- 3274643 TI - [Problems and solutions in Turkey in relation to maternal health]. PMID- 3274645 TI - [Maternal health services at the health center level]. PMID- 3274647 TI - [Nurses' responsibilities in intra-aortic balloon pumping]. PMID- 3274648 TI - [How to make a child reluctant to drink milk a milk-drinker]. PMID- 3274646 TI - [The importance of nutrition in maternal health and economy in nutrition]. AB - Iron requirement of women in child bearing age are higher than normal level. During pregnancy and lactation women also need extra food to meet the increasing iron and other nutrient requirements. When women can not meet these requirements, they use their own tissues. This in turn cause deteriation of mother and child health. In our country, one third of mothers have various health problems and half of them are anemic. The principal factors for nutritional and health problems are poverty, lack of nutritional knowledge, frequent pregnancy and child birth. Effective and continuing nutrition education, beside supplementary food aid for poor mothers will help to improve nutritional and health status of mothers and children. PMID- 3274649 TI - [Practical applications in nursing care]. PMID- 3274650 TI - [Hints for being healthy and well-groomed: from your specialist]. PMID- 3274651 TI - Wool proteins of New Zealand Romney sheep. AB - Proteins extracted from the wool of 65 Romney ewes were analysed qualitatively by one- and two-dimensional polyacrylamide gel electrophoresis. Romney wool proteins could be classified into the low-sulfur, high-sulfur, and high-tyrosine protein groups described for wool from other breeds. The wool protein pattern of an individual sheep remained constant despite changes in season, age or nutritional status of the sheep, and did not vary between different body positions. There were between-sheep differences in protein pattern, most variation occurring in the high-sulfur protein group. These differences were presumed to reflect genetic differences between the sheep. PMID- 3274653 TI - Genetic architecture and adaptation: quantitative analysis of sheep and refuse tip populations of the Australian sheep blowfly, Lucilia cuprina. AB - Phenotypic differentiation between geographic areas and between sheep and adjacent refuse tip populations was assessed by quantitative analysis of population samples of L. cuprina from New South Wales (Lismore) and Victoria (Mansfield). In addition the genetic structure of populations has been defined and compared by biometrical analysis techniques. For all morphological and fitness characters examined significant phenotypic differentiation was observed both between geographic localities and between sheep and non-sheep populations of each locality. Diallel analysis of the populations revealed architectural differences between sheep and non-sheep populations for both fecundity and egg hatchability. Sheep populations only, regardless of locality, displayed dominant gene effects on these fitness traits. The results suggest that refuse tip populations may be other than transients and that the differentiation may reflect differing patterns of adaptation and history of selection of the populations. The relevance of such differentiation to the successful establishment of a chemical and/or autocidal control zone is considered. PMID- 3274655 TI - Stimulation of the hypothalamic-pituitary-adrenal axis and inhibition of growth hormone release via increased central noradrenaline neuronal activity by urethane anaesthesia in the rat: blockade by clonidine. AB - Computerized gas chromatography-mass spectrometry was used to measure precisely the hypothalamic levels of noradrenaline (NA), dopamine and serotonin together with those of their major neuronal metabolites 3,4-dihydroxyphenylethyleneglycol (DHPG), 3,4-dihydroxyphenylacetic acid and 5-hydroxyindoleacetic acid in normal male rats 45 min after stimulation of hypothalamic-pituitary-adrenal function by urethane (1.3 g/kg) administration. Urethane treatment resulted in a significant elevation of central noradrenergic neuronal activity (NNA) as assessed from marked rises in hypothalamic DHPG concentrations and the ratio (DHPG/NA). At the same time there was significant stimulation of ACTH and corticosterone release and inhibition of growth hormone release. These hormonal and central effects of urethane (but not anesthesia) were inhibited when the alpha 2-agonist clonidine (150 micrograms/kg) was co-administered. Urethane had no major effect on hypothalamic dopamine or serotonin status. We propose that the release of ACTH and the suppression of growth hormone release following urethane anaesthesia is a result of activation of central NNA and suggest that the hormonal responses are mediated via hypothalamic noradrenergic facilitation of corticotrophin releasing factor and somatostatin release to the anterior pituitary. PMID- 3274656 TI - [Development of cavity design for amalgam. Current concepts]. PMID- 3274657 TI - [Caries prediction tests based on study of lactobacillus]. PMID- 3274658 TI - [Electronic methods for detection of demineralized zones in dental pits and fissures]. PMID- 3274659 TI - [The AIDS virus and saliva. Risk of infection for dentists]. PMID- 3274660 TI - [The professional, occupational and social situation of dentists in Uruguay]. PMID- 3274661 TI - [Introduction to myofunctional diagnosis and therapy. Its integration in maxillofacial orthopedic treatment. (3 of 3)]. PMID- 3274662 TI - [Influence of fatty acids on caries incidence in rats]. PMID- 3274663 TI - [Anatomoradiographic study of the temporomandibular region, using transfacial, transcranial and tomographic technics]. PMID- 3274664 TI - ["In vitro" formation of dental plaque by unrefined sugar]. PMID- 3274665 TI - [Space closure after orthodontic extraction]. PMID- 3274666 TI - [Glass ionomer cement and composite resin mixed restorations]. PMID- 3274667 TI - [Non-obstetric abdominal surgery in pregnancy]. PMID- 3274668 TI - [Microbiological study of vaginitis and cervicitis]. PMID- 3274670 TI - [Tubal aspiration. A conservative alternative in uncomplicated tubal pregnancy]. PMID- 3274669 TI - [Vaccination with SolcoTrichovac in vaginal trichomoniasis]. PMID- 3274671 TI - [Gynecomastia]. PMID- 3274672 TI - [Non-stress fetal monitoring. Experience at the Hospital Ernesto Torres in Iquique]. PMID- 3274673 TI - [Ophthalmologic manifestations of AIDS in Africa]. PMID- 3274674 TI - [Results obtained by the Moroccan Association of Ambulatory Ophthalmologists during 1 year (1987-1988)]. PMID- 3274676 TI - New immunological findings in vernal conjunctivitis. PMID- 3274675 TI - A double-blind comparison of picloxydine dihydrochloride (Vitabact eye drops) and sulfacetamide eye drops in the topical therapy of trachoma. PMID- 3274677 TI - [Surveillance of trachoma and glaucoma in areas of endemic trachoma. Evaluation (1966-1987) and perspectives]. PMID- 3274679 TI - Human sexuality and the family. PMID- 3274678 TI - Research in human sexuality: its importance to family practice. PMID- 3274680 TI - The frequency of sexual problems among family practice patients. AB - Two hundred-twelve patients attending a family practice center participated in a questionnaire study of their sexual identity and function. Using conservative definitions of problems, 75% were identified as having at least one specific sexual problem area. Most of these problems were functional in nature and involved desire, arousal, or orgasm. While the frequency of sexual problems was high in both sexes among all age groups, identity problems were primarily seen among the young, and desire problems among older adults. The prevalence rate of reporting sexual problems did not differ significantly by sex. However, females reported more specific sexual problems than males. Only 26% of the subjects summarized their overall sexual lives as problematic and the vast majority of patients thought their family physicians were able to help with such problems. This study reaffirms the high prevalence of sexual disorders in the population. Given adequate training, family physicians may be the ideal providers of assistance for these problems. PMID- 3274681 TI - Sex problems in family practice. AB - This study surveyed a group of 76 practicing family practice physicians and a group of 139 residents. They were asked the importance of sex counseling, the value of different kinds of education, who and when they asked about sexual problems, and their ability to deal with 24 problems or issues. Dealing with patient sexual problems was seen as important to both groups and they estimated 20% of their patients to have a problem or concern. A major concern of both groups was sexual abuse. Since the majority indicated they only ask about sexuality if there appears to be a "psycho-sexual sign," it is critical that they receive training in recognizing the signs of sexual problems. Continuing medical education courses were seen to be the most valuable form of training by the practicing family physician in learning about dealing with patient sexual issues and problems. PMID- 3274682 TI - Women's expectations of physicians in sexual health concerns. AB - This study surveyed 56 women to assess their expectations for the primary care physician to inquire about sexual concerns and to diagnose and treat sexual problems. The study indicates that the physician is the professional most frequently consulted about sexual concerns and that patients expect even more leadership from the physician in raising the issue of sexual health. Women look for empathy, warmth, confidentiality, and professional competence in discussions with their doctor about sexual matters; and they are open to referrals for treatment of sexual problems and physician-sponsored sex education programs. PMID- 3274683 TI - Association of race, sex, religion, family size, and desired number of children on college students' preferred methods of dealing with unplanned pregnancy. AB - College students (N = 704) from two southeastern universities--one predominantly white and the other predominantly black--were surveyed by questionnaire to assess their order of preference of five methods for dealing with an out-of-wedlock, unplanned pregnancy: a) marriage, b) abortion, c) adoption, d) raising the child as a single parent, and e) having grandparents raise the child. Although, there has been a liberalization of society's attitudes toward options available to young people facing an unplanned pregnancy, results indicate that the majority of these students would prefer to marry, if possible. Abortion was their second preference. Of the remaining options, raising a child as a single parent was preferable to allowing a third party to raise the child, either through adoption or extended family. Race, sex, religiosity, religious preference, number of siblings, and number of desired children were significantly associated with these students' preferences of the five methods for dealing with unplanned pregnancy. PMID- 3274684 TI - Evaluation and treatment of impotence: a pragmatic approach addressing organic and psychogenic components. AB - Twelve patient referrals for evaluation of impotence comprise the subjects of a pilot study examining psychogenic and biogenic factors of erectile dysfunction. A structured interview format (KCII) was developed which allowed the clinician to estimate the likelihood of the presence of three organic factors (hormonal, neurological, cardiovascular) and three psychogenic factors (intrapsychic, relational, and behavioral) as well as the presence of relevant lifestyle factors (alcohol, smoking, exercise patterns). The results demonstrated a good ability of the KCII to accurately identify impotent patients (on the basis of history) who would have positive or negative signs of hormonal factor or neurological factor confirmed by laboratory results or physical examination. The sample of patients who had significant vascular findings did not allow for adequate comparison with interview findings. The majority of patients had significant psychogenic components to their impotence and might have been incorrectly classified as "solely psychogenic" if they had not been simultaneously evaluated for organic factors. The most important finding was that impotence, in most cases, involved multifactorial etiological components and required a comprehensive evaluation and treatment program. PMID- 3274685 TI - Evaluation of serum testosterone and luteinizing hormone levels in sex offenders. AB - Testosterone levels were analyzed in a group of nonviolent sex offenders and compared to normal controls; the offenders had significantly lower levels (P = 0.0016). This finding differs from reports of violent offenders who have been shown to have higher testosterone levels than normals, but concurs with a previous study done at the University of Minnesota, Department of Family Practice and Community Health, which found nonviolent sex offenders to have significantly lower testosterone levels than normals. Luteinizing hormone levels were in the normal range for both groups. PMID- 3274686 TI - A new dural elevator for use during removal of the sphenoid wing. Technical note. AB - A new dural elevator is described that simultaneously lifts and retracts the dura from the frontal and temporal surfaces of the sphenoid wing, allowing safe removal of this structure during pterional craniotomy. PMID- 3274688 TI - Vignette in cardiac care: U wave and coronary artery disease. PMID- 3274687 TI - 'Do not resuscitate' orders. Accepting responsibility. PMID- 3274689 TI - Chronic recessive atrophy of periodontium. Destruction without pocket formation. PMID- 3274690 TI - A locum tenens. In the dental office. PMID- 3274691 TI - Oral surgery. Treatment of the geriatric patient. PMID- 3274692 TI - "In my hands". Can we use randomized trials in our practices? PMID- 3274693 TI - Drug therapy. Patients seeking care at a university dental school. PMID- 3274694 TI - The negligent dentist. A hospital's liability. PMID- 3274695 TI - The primary dentition. Orthodontic treatment. PMID- 3274696 TI - Predictable and unforeseen consequences following pulpal necrosis in primary teeth. A report of three cases. PMID- 3274697 TI - Sweeteners and prevention of dental caries. Special reference to xylitol. PMID- 3274698 TI - Professional incorporation. Let's go for it! PMID- 3274699 TI - Clinicopathologic conference. Condyloma acuminatum. PMID- 3274700 TI - [Ceramo metal endosseous implant]. PMID- 3274701 TI - [Advances in restorative dentistry. Comment on educational television]. PMID- 3274702 TI - [Eosinophilic granuloma of the maxillofacial region]. PMID- 3274703 TI - [Bone loss reconstruction using macroporous hydroxyapatite. Preliminary report]. PMID- 3274704 TI - [Sexual dimorphism in third molars]. PMID- 3274705 TI - [Corrosion resistance of commercial copper-aluminum alloys]. PMID- 3274706 TI - [Desmoid tumors of the maxillofacial region]. PMID- 3274707 TI - [Analysis of morbidity and mortality in patients over 65 years of age hospitalized with acute myocardial infarction]. PMID- 3274708 TI - [Rapid diagnosis of pneumococcal and meningeococcal infection using specific antigens]. PMID- 3274709 TI - Noninvasive methods in coronary artery disease. Resting STI and exercise tolerance after bypass surgery. PMID- 3274710 TI - [Evaluation of iron "status" in heterozygote beta-thalassemia. Indications and counterindications for martial treatment]. PMID- 3274711 TI - [Recurrent benign intrahepatic cholestasis: a review and description of a clinical case]. PMID- 3274712 TI - [A form of extrapulmonary TBC with pancreatic localization and laterocervical lymphadenitis]. PMID- 3274713 TI - [The behavior of HBV DNA in acute HBV hepatitis: considerations on a case]. PMID- 3274714 TI - [Two cases of acute pulmonary legionella. Case studies]. PMID- 3274715 TI - [Comparative evaluation of bacterial flora present in the external auditory canal in diabetic and normal subjects]. PMID- 3274716 TI - [Antrochoanal polyps]. PMID- 3274717 TI - [Evaluation of odonto-stomatologic changes in thalassemic patients]. PMID- 3274718 TI - [Clinical study of etizolam in patients with anxiety and insomnia]. PMID- 3274719 TI - [Controlled release trazodone: kinetic study in healthy subjects]. PMID- 3274720 TI - [Interactions of levodropropizine and bronchodilator drugs on respiratory muscle activity in healthy subjects]. PMID- 3274721 TI - Carbenoxolone and hypokalaemic hypertension: case report. PMID- 3274722 TI - [Cardiac herniation through a pericardial breach in a patient undergoing pneumonectomy in lung neoplasia]. PMID- 3274724 TI - Physiopathological aspects of tourniquet ischaemia: clinical studies. PMID- 3274723 TI - Melituria in muscular dystrophy. PMID- 3274725 TI - [AntiHBcIgM: critical observations]. PMID- 3274726 TI - [Prevention of recurrence of nasal polyps after surgical intervention: effectiveness of topical corticosteroid preparations]. PMID- 3274727 TI - High-pressure liquid chromatographic (HPLC) determination of indomethacin in plasma. PMID- 3274728 TI - Diagnosis of food allergy in children is often a difficult task. PMID- 3274729 TI - Serum vitamin A and E after their oral administration in cancer patients. PMID- 3274730 TI - [Improved cardiac performance with fructose-1,6-diphosphate in patients with ischemic heart disease]. PMID- 3274731 TI - [A white tumor: a fatal case of multiple vertebral hydatidosis]. PMID- 3274732 TI - [Serum plasminogen and alpha-2-antiplasmin levels in chronic bronchopneumopathology with respiratory insufficiency]. PMID- 3274733 TI - [Primary cerebral lymphoma in subjects with platelets seropositive for HIV]. PMID- 3274734 TI - [The incidence of isolation of A. israelii in women with an IUD]. PMID- 3274735 TI - Reviewing one's own activity: day care treatment of asthma in children. PMID- 3274736 TI - [Asphyxiating thoracic dystrophy (Jeune syndrome). Description of a clinical case]. PMID- 3274737 TI - [Effectiveness of ciprofloxacin in bacterial infections of the respiratory and gastrointestinal tract]. PMID- 3274738 TI - [Mesotherapy with naproxin sodium in musculoskeletal diseases]. PMID- 3274739 TI - [Community participation in health promotion. Introductory address]. PMID- 3274740 TI - [Global approach in the prevention of drug addiction]. PMID- 3274741 TI - [Should adults cooperate among themselves for the health of children in school?]. PMID- 3274742 TI - [Coordination of home care services oriented toward the elderly. The general practitioner's viewpoint and that of his patient]. PMID- 3274743 TI - [An experience of intersector and community action in the framework of health education at O.N.E (Office of Childbirth and Infancy)]. PMID- 3274744 TI - [Maternal and child welfare in Quart Monde--status and viewpoint of a research action in Brussels]. PMID- 3274745 TI - [Development of diagnostic criteria for Enterobacteria infections, especially for Salmonella]. PMID- 3274746 TI - [Combined treatment of a lithiasis patient by litholysis and extracorporeal lithotripsy of urinary calculi]. PMID- 3274747 TI - Implementing preventive services. Based on papers prepared for the International Symposium on Preventive Services in Primary Care: Issues and Strategies. L'Esterel, Quebec, Canada, October 4-7, 1987. PMID- 3274749 TI - An agenda for research and a plan of action. PMID- 3274748 TI - Summary of workshop sessions of the International Symposium on Preventive Services in Primary Care: Issues and Strategies. PMID- 3274750 TI - Health promotion and preventive services in primary care. PMID- 3274751 TI - The present and future of preventive services. PMID- 3274752 TI - Scientific imperatives in primary care policy. PMID- 3274753 TI - Limitations in testing for attitudes toward cancer. AB - A Cancer Attitude And Knowledge Questionnaire was administered to two groups of incoming first year medical students and to one of these groups at the end of their second year. The same questionnaire, except for the questions dealing with cognitive knowledge, was also used to assess the attitudes of practicing oncologists. There was a wide variation in the responses to the attitudinal items in all groups. In view of many inconsistencies in the results, a rigorous analysis of the instrument was carried out. The subscales derived from the Cancer Attitude Survey were found to lack adequate reliability. The only part of the attitudinal test found to be reliable and discriminatory was the semantic differential developed by the authors. It is, therefore, concluded that the currently used techniques are inadequate, and there is a need for a new multidimensional approach to the assessment of attitudes toward cancer. PMID- 3274754 TI - A newsletter evaluation using the Title Rating Method. AB - The Title Rating Method is used to measure readership interests and predict readership topics for future issues, in message ideas. This methodology was used to plan types of articles in a newsletter published through the Cancer Communication Network contract. This article describes evaluation results of the newsletter for health professionals, North Carolina Cancergram. Retrospective and prospective titles were assigned to seven categories: psychosocial, treatment, drugs, nursing issues, rehabilitation, education, and detection. Interest in the titles in each category was evaluated according to five occupational groups: nurses, pharmacists, physicians, allied health, and others. The rank order of most popular to least popular categories was: drugs, treatment, education, psychosocial, rehabilitation, detection, and nursing issues. The most popular article overall across occupational groups was an article directed primarily to physicians, "Informing the patient requires honesty, sensitivity." The readership was primarily white, female, over 35 years of age with a college degree or higher. Most of the readership work in a health related setting although 67.6 percent of the respondents spent less than ten percent of their time working with cancer patients. This is in keeping with the intent of the publication to reach health professionals outside the Cancer Center. PMID- 3274755 TI - Sunshine and skin cancer: a school-based skin cancer prevention project. AB - Over 50 percent of the cancers diagnosed in the U.S. are skin cancers. The incidence in Arizona far exceeds the national average for all types of skin cancers, currently having the second highest incidence and prevalence in the world. Results from skin cancer prevention programs elsewhere have suggested that awareness, attitudes, and behavior could be changed by educational efforts with eventual decreases in measurable outcomes such as morbidity and mortality. Sensible sun habits develop early in life. Most health educators agree that the ideal place to begin to teach values regarding health choices is with school-aged children. We have evaluated a primary skin cancer prevention education program in a controlled situation. The target population was chosen in a formal school setting and represented pre-adolescents and early adolescents, who were just beginning to develop "sun-worshipping" tendencies as a part of their increasing preoccupation with appearance. Two unique comprehensive "Sunshine and Skin Cancer" curricula comprised of six units about the sun, its benefits and disadvantages, the skin, cancer and skin cancer, and sun damage prevention were developed. The curricula were very well received by the school system, teachers, children, and the community, and have received local, national, and international attention. This program was shown to significantly change the knowledge and the self-reported behavior (p less than .001) of the children with respect to skin cancer prevention. Steps are being taken to integrate this curriculum into all Arizona middle schools. PMID- 3274756 TI - Attitudes of medical students and faculty toward cancer. AB - The Cancer Attitude Survey (CAS) was administered to second year students before, during, and after a year-long "Introduction to Clinical Medicine" course. The course contained a 14-hour oncology segment. Faculty of the Clinical Medicine Course and nonclinical faculty teaching oncology related topics also responded to the CAS. The CAS contains four scales: Attitudes toward: I, the patient's inner resources to cope with cancer; IIA, the value of early diagnosis; IIB, aggressive treatment; and III, personal immortality and preparation for and acceptance of death. At the beginning of the course, student attitudes were positive; there was no change in attitudes across the three testing periods. Among faculty, dedicated oncologists had the most positive attitudes; students and nononcology clinical faculty exhibited similar trends in attitudes; nonclinical faculty teaching oncology related material had least positive attitudes. PMID- 3274757 TI - Assessment of dental students' attitudes toward cancer using a paired comparison technique. AB - The purpose of this paper is to present a description of the development of an instrument to measure attitudes towards cancer. The instrument used a paired comparison technique to assess dental students' attitude toward patients with cancer in relation to other diseases of patients they would encounter in practice. Nine diseases including cancer were paired in 36 combinations. A shift in the ranking of cancer when compared with other serious diseases would indicate a change in attitude. The attitude instrument was administered to 67 students at the beginning and end of a junior oncology course. Analysis of the paired comparison resulted in rankings for the diseases from least to most preferred. The ranking for cancer moved from second to fourth indicating a positive attitude change. The importance of the students' attitude toward encountering patients with cancer and implications for this technique in attitude measurement are discussed. PMID- 3274758 TI - The use of goal attainment scaling to evaluate a cancer research training program for high school and college students. AB - Goal attainment scaling has been used frequently in the evaluation of mental health services. The purpose of this study was to assess the usefulness of the goal attainment scaling methodology in the evaluation of a cancer research training program. Subjects were 62 high school and college students participating in a summer research program. Prior to the program, all students were asked to predict the specific outcomes they expected to attain in relation to eight independent dimensions of the research training program. At the close of the program students were asked to indicate the outcome they attained for each dimension. Students also ranked the importance of each dimension. The analyses indicated that participants entered the program with accurate expectations of their ultimate achievement and satisfaction with the program. Significant differences were found for expected outcomes on a number of program dimensions for the high school and college students at the preprogram assessment. Significant differences were also found for the high school and college students' importance rankings at both the pre-program and post-program period. Goal attainment scaling proved to be a valuable and flexible technique for the evaluation of a cancer research training program. PMID- 3274759 TI - Evaluation of pediatric oncology objectives developed by the American Association for Cancer Education. AB - Educational objectives in pediatric oncology for medical students developed at the Fall, 1981 meeting of the American Association for Cancer Education (AACE) were reviewed. These six terminal (general) and 40 enabling (specific) objectives were converted into 130 statements which were ranked from essential (rank 5) to not required (rank 0). The 58 pediatric oncology respondents gave broad support to the AACE pediatric oncology objectives. Primary importance was given to medical students knowing to refer pediatric malignancies. Principles of therapy, psychosocial management, management of infection, and complications during long term surveillance ranked high. Objectives were not ranked differently when related to number of new pediatric patients seen, type of hospital, or whether the institution had a core undergraduate pediatric training site. The list of terminal, enabling and supplemental pediatric oncology objectives developed by AACE appears valid for inclusion in the core curriculum of medical students. PMID- 3274760 TI - A full color graphic model to display the eight possible combinations of any three variables. PMID- 3274761 TI - [Bacterial flora of the external ear: preliminary data]. PMID- 3274762 TI - Ability of interleukin-4 to elicit an immunoreaction against a murine tumor. AB - A T cell-derived lymphokine, IL-4, has been shown to have activating and growth promoting properties on macrophages, T cells and B cells. IL-4 could thus be used to augment immunoreactivity in the treatment of tumors. To evaluate its ability to promote an immune reaction capable of hampering tumor growth, we injected mice with small amounts of recombinant IL-4 perilymphatically daily for ten days near the challenge site of a poorly immunogenic syngenic fibrosarcoma (CE-2). These low doses activated such a strong immune reaction that incipient syngenic tumors were rejected. Our results suggest that the host immune system plays a fundamental role in this IL-4 dependent lymphokine-activated tumor inhibition (LATI). PMID- 3274763 TI - [Effect of entomopathogenic fungus inoculum on the control of Corythycha ciliata Say adults, wintering on plane-trees of city groves]. AB - Within a three years research program, infection tests were carried on adults of Corythucha ciliata wintering on the plane-trees of same city avenues, inoculating entomopathogenic deuteromycetes Beauveria bassiana, Verticillium lecanii, Paecilomyces farinsus, microorganisms which are known to be naturally present in such an environment. Inoculated fungi were able to settle only where the trees were free from any kind of disturbance, while this failed to occur in the areas of intense car traffic. Number of treatments efficiently affected pathogens diffusion in the trees. The persistency of the parasites on the insects, even one year after the treatment, seems to indicate the possibility of their use for the limitation of C. ciliata. PMID- 3274764 TI - [Role of Chlamydia trachomatis in women with vulvovaginitis]. PMID- 3274765 TI - [Urinary infections caused by non-typhoid Salmonella]. AB - Between January 1986 and January 1989, 524 non-typhoid salmonella strains, of which 4 (0.8%) from urine, were isolated at the Microbiology Laboratory of Department of Biomedicine (University of Pisa). These strains were isolated from a man with systematic lupus erythematosus, from two little girls with structural defects of the lower urinary tract, and from a woman with ulcerous colitis. Except the last case, the others were associated with immunological or structural abnormalities that are thought to predispose to salmonella infections. PMID- 3274766 TI - [Isolation of Chlamydia trachomatis in non-gonococcal urethritis]. PMID- 3274767 TI - The immunopharmacology of graft rejection. PMID- 3274770 TI - Optimal use of kidneys from living donors. PMID- 3274768 TI - T cell depletion in allogeneic bone marrow transplantation. PMID- 3274769 TI - Bone marrow transplantation for leukemia: effects of T lymphocyte depletion of donor bone marrow. PMID- 3274771 TI - Living donors: con. PMID- 3274772 TI - Three patterns of renal major histocompatibility complex product expression. PMID- 3274773 TI - Persistent expression of donor antigens in endothelium of long-standing skin xenografts and vulnerability to destruction by specific antibodies. PMID- 3274774 TI - Colorimetric assay for monocyte-expressed antigens in humans. PMID- 3274775 TI - Decreased detection of class II major histocompatibility complex antigens on blood mononuclear cells from transplant recipients receiving immunosuppressive drugs: influence of cycloheximide and monensin. PMID- 3274776 TI - Major histocompatibility complex antigens are presented by murine host accessory cells. PMID- 3274777 TI - Immunogenic potential of capillary bed components in rat renal allografts. PMID- 3274778 TI - Purified hepatocytes can stimulate allospecific cytolytic T lymphocytes in a mixed lymphocyte-hepatocyte culture. PMID- 3274779 TI - Is secreted interleukin 1 necessary for T cell activation? PMID- 3274781 TI - Cellular requirements for first-set renal allograft rejection. PMID- 3274780 TI - Effect of cyclosporine and retinoic acid on dendritic cell function. PMID- 3274782 TI - The role of natural killer cells in the allograft response. AB - NK cells, present in sponge allografts between all genetic barriers tested, are present at the graft site several days before alloimmune CTL are detected. Both NK and alloimmune CTL possess the AGM1 surface marker. Systemic as well as local treatment with AGM1 antisera depletes NK activity as well as alloimmune CTL at the graft site. NK cells may function at the graft site to facilitate development of alloimmune CTL and/or NK cells may themselves differentiate into alloimmune CTL. PMID- 3274783 TI - The influence of cyclosporine on cellular infiltration in rat renal allografts. AB - In this study donor specific blood transfusion of PVG recipients prevented rejection of DA strain kidneys but, paradoxically, failed to prevent the rapid and progressive accumulation of large numbers of mononuclear cells within enhanced grafts. Morphometric analysis showed that the percentage cellular infiltrate at day 3 was significantly greater in enhanced than in rejecting grafts but a notable feature in the phenotypic analysis of day 5 infiltrates was a markedly reduced number of MRC OX8 positive cells (Tc/s and NK cells) in enhanced grafts. Both rejecting and enhanced allografts showed a marked induction not only of class I but also of class II MHC antigens, and quantitative absorption analysis of donor class I MHC antigens indicated that induction occurred more rapidly in enhanced grafts. Taken together, these findings suggest that blood transfusion sensitizes the recipient, resulting in a more rapid allograft response, but that even in the presence of massive MHC/antigen induction and large numbers of infiltrating cells, immunoregulatory mechanisms are able to suppress the rejection response. PMID- 3274784 TI - Replacement of donor Kupffer cells by recipient cells after orthotopic rat liver transplantation. PMID- 3274785 TI - Suppression of the immune response in rejected sponge matrix allografts. PMID- 3274786 TI - Compartmentalization and lymphocyte traffic after allograft challenge. PMID- 3274787 TI - Infiltration pattern of rat heart allografts during rejection. PMID- 3274788 TI - Lymphocyte-mesenchymal cell interaction in acute renal transplant rejection: an electron microscopy study. PMID- 3274789 TI - Associations between rat renal allograft function, inflammation, and host immunity. PMID- 3274790 TI - Functional analysis of lymphocytes recovered from human allograft undergoing rejection. PMID- 3274791 TI - In situ analysis of cells involved in irreversible acute rejection of human renal allografts. PMID- 3274793 TI - Function and phenotypes of T lymphocytes cloned from human rejected grafts. PMID- 3274792 TI - Functional characterization of renal infiltrating cells following allograft nephrectomy. PMID- 3274794 TI - Phenotypes of in vivo-activated T lymphocytes from a pancreas allograft. PMID- 3274795 TI - The propagation of HLA-specific T cells from failed corneal grafts. PMID- 3274796 TI - Cloned T cells do not require host H-2 restrictions to elicit delayed-type hypersensitivity. PMID- 3274797 TI - Immune effector mechanisms in organ allograft rejection. VIII: Inflammatory mediators and cytotoxins in rejecting rat cardiac allografts. PMID- 3274798 TI - Is delayed-type hypersensitivity the pathway of hyperacute rejection in transplanted mouse hearts? PMID- 3274799 TI - Comparison of spontaneous cell-mediated cytotoxicity with immunologically specific cytotoxicity in rat skin allografts. PMID- 3274800 TI - Rejection of allogeneic lymphocytes and heart allografts from the same donor is mediated by different mechanisms. PMID- 3274801 TI - Arachidonic acid metabolism and renal allograft rejection. PMID- 3274802 TI - Role of donor T cells in the induction and transfer of allograft tolerance. PMID- 3274803 TI - Synergistic effect of UV-irradiated donor-specific transfusions with peritransplant cyclosporine on cardiac allograft survival in rats. PMID- 3274804 TI - Importance of the presence of antigen for induction of transplantation tolerance. PMID- 3274805 TI - Three phases of immunologic unresponsiveness following liver grafting in rats. PMID- 3274806 TI - Transplantation tolerance following conditioning with C1q-affinity anti-Thy-1 monoclonal antibodies. PMID- 3274807 TI - Induction of long-term rat renal allograft survival: a specific synergistic effect of limited pretransplant cyclosporine combined with multiple nonspecific blood transfusions. PMID- 3274808 TI - Suppression of renal allograft rejection in the rat using purified plasma membrane and endoplasmic reticulum preparation expressing donor class I major histocompatibility complex antigen. PMID- 3274809 TI - Augmentation by donor bone marrow of the survival of neonatal skin transplants to ALS-treated recipients. PMID- 3274810 TI - Specific tolerance to canine renal allografts following treatment with fractionated bone marrow and antilymphocyte serum. AB - These results suggest (1) that ALS + BM fractions can be used to promote tolerance in long-term graft survivors; (2) that the presence of apparent BM cells of donor origin in the allograft in normally functioning kidneys may be related to the mechanism of allograft prolongation, and (3) that some promise of possible specific long-term immunosuppression exists clinically. PMID- 3274811 TI - Prolonged cardiac allograft survival following portal venous inoculation of allogeneic cells: what is "hepatic tolerance"? PMID- 3274812 TI - Induction of immunologic tolerance in bursal stem cells. PMID- 3274813 TI - W3/25+ T cells mediate specific unresponsiveness in enhanced allograft recipients. PMID- 3274814 TI - Transplantation tolerance to total chicken major histocompatibility complex (B complex) antigen disparity is impaired by interleukin 2. PMID- 3274816 TI - Increased ultraviolet radiation-induced skin cancers in cyclosporine-treated mice. PMID- 3274815 TI - Immunologic significance of hepatocytes in tolerance induction after liver transplantation. PMID- 3274817 TI - Possible mechanism of non-rejection of the feto-placental allograft: trophoblast resistance to lysis by cellular immune effectors. PMID- 3274819 TI - Suppression of specific allograft reactivity of normal rat lymphocytes by treatment in vitro with serum from liver-grafted rats. PMID- 3274818 TI - Localization of the pregnancy-associated and the class I transplantation antigens on the placenta and fetus. PMID- 3274820 TI - Regulation of major histocompatibility complex antigen expression during pregnancy. PMID- 3274821 TI - Dendritic accessory cells in the pregnant and nonpregnant rat uterus. PMID- 3274822 TI - Effect of a single allogeneic pregnancy on the alloantibody response to a subsequent transfusion in rats. PMID- 3274823 TI - Specific inhibition of heart allograft rejection by serum from liver-grafted rats. PMID- 3274824 TI - Effect of antilymphocyte serum-treated bone marrow on skin graft survival in rats. PMID- 3274825 TI - Specific destruction of allogeneic tumor cells in vivo by a bismuth-212 immunotoxin. PMID- 3274826 TI - A new, rapid, high-capacity chromatographic purification of IgG 1 monoclonal antibodies directly from mouse ascites fluid. PMID- 3274827 TI - Immunosuppression by anti-interleukin-2 receptor antibody but not anti-L3T4 requires terminal complement components. PMID- 3274828 TI - Prolongation of murine cardiac allograft survival by the anti-interleukin-2 receptor monoclonal antibody AMT-13. PMID- 3274829 TI - UV-induced suppression of the immune response to alloantigens. PMID- 3274830 TI - A comparison of the in vitro and in vivo immunologic activities of concanavalin A and its succinylated derivative. PMID- 3274831 TI - Is cyclosporine a match for tissue typing centers? Role of the zero HLA-A, B, and DR mismatch effect. PMID- 3274832 TI - The impact of cyclosporine A on the DRw6 effect in renal transplantation. PMID- 3274833 TI - Beneficial HLA matching: its phase of impact on graft survival. PMID- 3274836 TI - Local use of kidneys with poor HLA matches is as good as shared use with good matches in the cyclosporine era: an analysis at one and two years. PMID- 3274835 TI - The impact of HLA-A,B match of primary renal allografts subsequent to transplant failure. PMID- 3274834 TI - Factors important in ten-year kidney graft survival. PMID- 3274837 TI - HLA-DR1 recipients have the highest kidney transplant survival. PMID- 3274838 TI - Major histocompatibility complex-sublocus differences in orthotopic rat liver transplantation and their influence on graft survival and transplantation tolerance. PMID- 3274839 TI - HLA matching assessed from early graft function. PMID- 3274840 TI - The impact of HLA-DR incompatibilities on kidney graft function and on the number of rejection treatments. The Dutch Study Group of Renal Transplantation. PMID- 3274841 TI - Impact of HLA-DR and combined HLA-B and HLA-DR matching on early graft outcome under cyclosporine therapy. PMID- 3274843 TI - HLA-DR tissue typing may be ignored for first but not subsequent cadaver renal transplants. PMID- 3274844 TI - Correlation between HLA-DR mismatch and rejection episodes in cardiac transplantation. PMID- 3274842 TI - Dissection of the respective importance of HLA-A,B,DR matching in 3,789 prospective kidney transplants. PMID- 3274845 TI - Cross-reactive antigens and HLA matching. AB - Anti-HLA-A2 and anti-B17 reactivity of 87 broadly reactive sera was studied by inhibition of monoclonal Ab binding. These Abs were detected as often in patients bearing Ags cross-reactive with A2 or B17 as in those not bearing such Ags. These results indicate that predictions of negative cross-matches based on Ag cross reactivity or reactivity against public epitopes will not be accurate in a high proportion of cases. PMID- 3274846 TI - Recipient HLA-DR phenotypes influence survival of living-related donor renal allografts. PMID- 3274847 TI - Influence of HLA matching, donor age, and cyclosporine on unrelated pediatric renal allograft survival. AB - Results in this study demonstrate that HLA matching has a beneficial effect on the survival of renal allograft in pediatric recipients. The introduction of a child-match procedure may have led to a lower degree of HLA well-matched grafts because of the small size of the pediatric waiting list. The poor results obtained in the group of children aged less than 6 years may have been due to a difference in physical condition at the moment of transplantation. This may explain why 4 of 20 (20%) of the failures in that age-group were due to patient death. The best results with the child-match procedure were obtained if the donor and recipient were both aged between 6 and 15 years. The overall graft survival in all children was improved by the use of Cs. An increase of approximately 10% was observed in this group of patients. The numbers in this group are too small, however, to permit any meaningful analysis of the influence of Cs on HLA matching. Finally, the overall results in this report demonstrate that renal transplantation is an effective form of therapy for end-stage renal disease in children. PMID- 3274848 TI - Effect of DR and DR6 matching on cadaver kidney transplant survival. PMID- 3274849 TI - Association between blood transfusion, HLA-DRW6, and response to dinitrochlorobenzene skin test. PMID- 3274850 TI - Detrimental effect of ABO mismatching in renal transplantation. PMID- 3274851 TI - Effects of the RT1.C region in rat allotransplantation. PMID- 3274852 TI - Graft outcome in the multiple transplant patient with a positive donor cross match with non-current sera. PMID- 3274853 TI - The positive cross-match: antibody class and specificity correlate with graft outcome. PMID- 3274854 TI - Plasma exchange and immunosuppressive therapy before renal transplantation in highly sensitized patients. PMID- 3274855 TI - Outcome of kidney transplantation in highly sensitized patients in Scandiatransplant. PMID- 3274856 TI - Organ sharing for highly sensitized patients. PMID- 3274857 TI - Cyclosporine A, hyperimmunized patients, and renal retransplantation. PMID- 3274858 TI - Desensitization--which renal allograft recipients are suitable? PMID- 3274859 TI - Reduction of anti-HLA antibody using small-dose single-donor blood transfusion. PMID- 3274860 TI - B cell antibodies after planned transfusions. PMID- 3274861 TI - The importance of sharing major histocompatibility complex and minor antigens between blood and graft donors in the blood transfusion effect. PMID- 3274862 TI - Serologic response to donor-specific blood transfusions under azathioprine immunosuppression. PMID- 3274863 TI - Transplant outcome of desensitized recipients after donor-specific transfusion. PMID- 3274864 TI - Anti-idiotypic autoantibodies after donor-specific blood transfusions. PMID- 3274865 TI - Anti-idiotypic antibodies to HLA and their influence on patient sensitization. PMID- 3274866 TI - Flow cytometry crossmatching in human cadaver kidney transplantation. PMID- 3274867 TI - Successful sequential liver-kidney transplantation in a patient with performed lymphocytotoxic antibodies. PMID- 3274868 TI - Renal transplantation in the highly sensitized recipient. PMID- 3274869 TI - Influence of pretransplant antibodies on early renal allograft rejection. PMID- 3274870 TI - Molecular specificities of lymphocytotoxic alloantibodies from sensitized chronic renal failure patients. PMID- 3274871 TI - Evaluation of autolymphocytoxic antibody in the highly presensitized patient. PMID- 3274872 TI - Extra reactivities detected in flow-cytometry-positive, CDC-negative crossmatches are definable HLA specificities. AB - In this preliminary study, additional reactions were detected in sera that were not found by T-AHG-CDC. The reactions had definable HLA specificities. In our laboratory, the procedures described in this article had the following relative sensitivities for detecting class I HLA alloantibody specificities: FC = B-AHG CDC greater than T-AHG-CDC greater than B-CDC greater than T-CDC. This study supports the concept that some FC-positive crossmatches, negative by T-AHG-CDC, can be associated with reduced renal allograft survival, since many of the additional reactions detected by FC appear to be due to HLA Class I antibodies. PMID- 3274873 TI - Renal allograft survival in patients with positive donor-specific B lymphocyte crossmatches. PMID- 3274874 TI - Results of transplantation with remote-positive proximate-negative T cell antiglobulin crossmatches. PMID- 3274875 TI - A prospective study of the clinical relevance of the current serum antiglobulin augmented T cell crossmatch in renal transplant recipients. PMID- 3274876 TI - Dithiothreitol treatment of crossmatch sera in highly immunized transplant recipients. PMID- 3274877 TI - Serum-computed analysis for transplantation of highly immunized kidney recipients. PMID- 3274879 TI - T cell recognized polymorphism associated with HLA-DR2 haplotypes. PMID- 3274878 TI - Molecular cloning of a testis-specific gene from mouse chromosome 17. PMID- 3274881 TI - Unique HLA-D region heterogeneity in American blacks. AB - American blacks and whites show heterogeneity in serologically detected and lymphocyte-defined HLA-D region antigen frequencies. Also, alterations in linkage relationships are seen in DR and DQ specificities. Since homozygous typing cells probably identify a cluster of specificities that are usually found in linkage disequilibrium in a given population, it is not surprising that blacks have unique HLA-D types. The significance of the observed differences in the function of class II molecules is being investigated. PMID- 3274880 TI - DR3 heterogeneity recognized by HTC and alloproliferative T cell clones. PMID- 3274882 TI - HLA-reactive T cell clones: analysis of specificity. PMID- 3274883 TI - Characterization of the B6.C-H-2bm-1 (H-2bm-1) cytotoxic T lymphocyte clonal response to EL4. PMID- 3274885 TI - Specific HLA antibody production following renal transplantation. PMID- 3274884 TI - A probable mechanism for allograft rejection in HLA-identical combinations. PMID- 3274886 TI - Transplant-induced donor-specific antibodies and graft outcome. PMID- 3274888 TI - Firearm availability and the incidence of suicide and homicide. AB - The present studied explored the validity of several indirect measures of firearm ownership in the states of the USA: the percentage of homicides and suicides committed with firearms, the accidental death rate from firearms, the strictness of state handgun control laws, and subscription rates to firearm magazines. These measures were then correlated with rates of suicide and homicide, and it was found that states with a greater availability of firearms had higher firearm suicide rates and higher firearm homicide rates. PMID- 3274887 TI - Autolymphocytotoxins and virus infection in renal transplantation. PMID- 3274889 TI - Pockets of violence: a study of regional variation in suicide and homicide rates. AB - The states of America were classified on the basis of the homicide and suicide rates into violent, nonviolent, inwardly violent and outwardly violent. Social differences between these four groups of states were identified. The usefulness of this type of regional analysis was discussed. PMID- 3274890 TI - State prison clergy counselor role self-perceptions. AB - The effectiveness of state prison clergy counselors is, in part, due to the function of the individuals in their fulfillment of roles. The following research was conducted to find out the specific variables associated with state prison clergy counselor role self-perceptions. It examined those variables considered most important to the clergy counselors in self-perceptions based on role expectations and role performance. Results indicated self-perceived variables of pastoral, advisor, reality, insight, and development, respectively. PMID- 3274891 TI - Group therapy in addition to lithium therapy in patients with bipolar disorders. AB - In patients with a bipolar disorder and well regulated lithium prophylaxis many psychological and social problems still remain. These can lead to non-compliance and relapse, which often increases the problems especially in the patient's direct environment. After group therapy, the self-confidence of 20 patients appeared to have improved compared with 14 control patients on the waiting-list for group therapy. The most important discovery for most of the patients was that their condition is not unique. They also gained the insight that they were potentially able to solve some of their problems themselves. PMID- 3274892 TI - Purification and characterization of a bovine colostrum-derived growth factor. AB - A growth factor in bovine colostrum was purified to homogeneity by a combination of acid extraction, boiling, cation exchange chromatography, isoelectric focusing, and reverse phase HPLC. The bovine colostrum growth factor (BCGF) had an isoelectric point of about 10, a native mol wt of about 30,000, was resistant to inactivation by boiling and exposure to pH 1, but was inactivated by dithiothreitol. BCGF appeared to be structurally related to human platelet derived growth factor (PDGF) and competed with human PDGF in a radioreceptor assay. However, while human PDGF appeared to be a heterodimer of 17,000 and 14,000 mol wt subunits, BCGF appeared to be a homodimer of 20,000 mol wt subunits. Purified BCGF had a specific activity in stimulating 3T3 cell proliferation of about 3-6 U/ng and was active at about 1-2 ng/ml. PMID- 3274893 TI - Characterization of complementary deoxyribonucleic acid for human adrenocortical 17 alpha-hydroxylase: a probe for analysis of 17 alpha-hydroxylase deficiency. AB - To provide a basis for investigation of the molecular mechanisms underlying the hormonal regulation of steroid 17 alpha-hydroxylase (P-450 17 alpha) activity in adrenal, ovary, and testis as well as human 17 alpha-hydroxylase deficiency, we have isolated from a human fetal adrenal cDNA library a cDNA sequence complementary to the mRNA that encodes the human P-450 17 alpha enzyme. Of 75,000 colonies from the library that were screened by use of a nick-translated 5' specific bovine P-450 17 alpha cDNA probe, 10 positive colonies were isolated and the clone with the longest insert (pcD-17 alpha H) was selected for further characterization. pcD-17 alpha H encodes the complete human P-450 17 alpha protein having approximately 78% homology at the nucleotide level and 71% homology at the amino acid level when the sequence of pcD-17 alpha H is compared to the bovine P-450 17 alpha cDNA sequence. By transient expression of the human P-450 17 alpha cDNA clone in COS 1 cells, we have demonstrated that the 17 alpha hydroxylase and 17,20 lyase activities reside within the same human P-450 17 alpha polypeptide chain. The insert was also used as a probe to investigate, by means of Southern blot analysis, possible alterations in the P-450 17 alpha gene sequence in DNA isolated from skin fibroblasts from three patients with clinically characterized 17 alpha-hydroxylase deficiencies. No changes were detected in the DNA of any of the patients by this analysis. PMID- 3274894 TI - The Xenopus laevis estrogen receptor: sequence homology with human and avian receptors and identification of multiple estrogen receptor messenger ribonucleic acids. AB - We have isolated and sequenced a cDNA clone encompassing the entire protein coding region of the Xenopus laevis estrogen receptor (xER). The Xenopus ER, the first steroid hormone receptor to be sequenced from a cold-blooded organism, exhibits two regions of striking amino acid homology with the human and avian ERs. In the putative DNA binding region, the amino acid sequence of the xER differs from those of the human and avian ERs at only one of 83 amino acids. The putative hormone binding region contains 44 and 46 amino acid blocks in which the sequence is identical in the Xenopus and human ERs. Blot hybridizations of Xenopus liver RNA suggest that the xER is encoded by four mRNAs with lengths of approximately 9, 6.5, 2.8, and 2.5 kilobases. In contrast, hybridization of human RNA to a human ER cDNA clone reveals only a single major ER RNA, approximately 6.7 kilobases in length. PMID- 3274895 TI - Rat corticotropin-releasing hormone gene: sequence and tissue-specific expression. AB - The rat corticotropin releasing hormone (CRH) gene has been isolated and characterized by DNA sequence analysis. The gene exhibits a structural organization similar to that of the human CRH gene. The nucleotide sequence encoding the entire rat CRH precursor is located on the second exon, while exon I encodes the 5'-untranslated region of the mRNA. Analysis of the nucleotide sequence homology between the human and rat CRH genes reveals several highly conserved regions including the CRH peptide-encoding sequence and the 5'-flanking sequence. RNA blot analysis demonstrates that CRH mRNA can be observed in numerous regions of the rat brain as well as the spinal cord, adrenal gland, pituitary, and testis. PMID- 3274896 TI - Initial studies of a phytoestrogen-deoxyribonucleic acid interaction. AB - Molecular modeling studies show that estrogens such as estradiol complement the topography of spaces between base pairs in unwound DNA and simultaneously hydrogen bond phosphate moieties on opposite strands. We demonstrate here that the phytoestrogen coumestrol has this capability, in addition to its documented properties of UV absorbance at lambda greater than 300 nm and fluorescence. The latter properties enable spectroscopic examination of interactions with DNA by methods not possible with estrogenic steroids. On exposure to calf thymus DNA, the UV spectrum of coumestrol displays a bathochromic shift and simultaneous hypochromic effect with an isosbestic point at 370 nm, suggesting a shift between coexisting free and bound states. Similar results are observed with the intercalating agents adriamycin, ethidium bromide, and acridine. The fluorescence spectrum of coumestrol is quenched on exposure to DNA as are those of adriamycin and acridine. Coumestrol differs from the intercalators in that denatured DNA does not affect its UV spectrum or alter its relative fluorescence yield. Unlike classical intercalators, coumestrol has no influence on the thermal stability of calf thymus DNA. Preliminary electrophoretic analysis of DNA plasmid conformers indicates that coumestrol is incapable of significantly altering DNA superhelical density, in contrast to ethidium bromide. These initial physicochemical data provide evidence for the DNA base-estrogen electronic and/or hydrophobic interactions suggested by modeling studies, yet tend to rule out classical intercalation as an explanation for these phenomena. PMID- 3274897 TI - Regulation of 70-kilodalton heat-shock-like messenger ribonucleic acid in vitro and in vivo by prolactin. AB - A cDNA clone, pNb29, was isolated from a library made from mRNA of Nb2 rat lymphoma cells stimulated by PRL. The nucleotide sequence of pNb29 was found to be identical to the 70-kilodalton heat-shock-like (hsp-70-like) mRNA. The levels of this mRNA increased 8 +/- 3-fold after PRL stimulation of arrested Nb2 cells, and is expressed in different amounts in the normal rat tissues analyzed. To determine whether hsp-70-like mRNA was PRL responsive in vivo, ovine PRL was administered to hypophysectomized rats. A 5 +/- 2-fold increase in hepatic hsp-70 like mRNA was observed 9 h after injection. Thus PRL appears to regulate a heat shock-like mRNA both in vitro and in vivo. This novel finding extends the already wide range of biological effects ascribed to PRL. PMID- 3274898 TI - Estrogen-induced decrease of glucocorticoid receptor messenger ribonucleic acid concentration in rat anterior pituitary gland. AB - Using Northern blots and hybridization techniques, we have identified an approximately 6.5 kilobase glucocorticoid receptor mRNA species in rat anterior pituitary gland. Ovariectomy resulted in an approximately 2-fold increase in glucocorticoid receptor mRNA concentrations. This effect was maximal 8 days after surgery and glucocorticoid receptor mRNA levels remained elevated for at least up to 4 weeks. Administration of 17-beta-estradiol completely reversed the ovariectomy-induced increase in glucocorticoid receptor mRNA content of pituitary gland. Treatment of rats with corticosterone did not influence the ovariectomy induced increase in glucocorticoid receptor mRNA content, indicating that this increase is not mediated via effects on circulating glucocorticoid levels or availability. In situ hybridization experiments confirmed the ovariectomy-induced increase in glucocorticoid receptor mRNA content and indicated that this action is widely distributed throughout the anterior pituitary gland. PMID- 3274899 TI - [Free serum lipid levels and hypolipid/hypocaloric diets in obese subjects]. PMID- 3274900 TI - [Epidemiologic and clinical study of HIV in jails: personal experience]. PMID- 3274901 TI - D-penicillamine in patients with postnecrotic liver cirrhosis. PMID- 3274902 TI - [Osteogenesis imperfecta: description of a case]. PMID- 3274903 TI - [Leiomyosarcoma of the larynx: presentation of a clinical case]. PMID- 3274904 TI - [Stability of drugs]. PMID- 3274905 TI - Preventive education and mental code of the verbal language. An applied neuropsychological essay to medicopedagogical sciences. PMID- 3274906 TI - [Treatment with aztreonam of gram negative infections in patients seropositive for HIV]. PMID- 3274907 TI - [Prophylaxis of surgical infections. Short-term administration of aztreonam. Personal cases]. PMID- 3274908 TI - [Sensitization to olive pollen in a population of residents of the city of Rome]. PMID- 3274909 TI - Bay o 9867 (ciprofloxacin) in the treatment of urinary tract infections in elderly patients. PMID- 3274910 TI - AIDS in children: the slaughter of innocents. PMID- 3274911 TI - [Treatment of peritonsillar abscess by needle aspiration. Experience at an ambulatory clinic]. PMID- 3274912 TI - [A diagnostic approach to achalasia]. PMID- 3274913 TI - [Local anesthetic action of metadizina, a new N-alkoxy-xylidide derivative]. PMID- 3274914 TI - Effect of S-adenosyl-L-methionine on the gastric ulcer in rats. PMID- 3274915 TI - The regular education initiative: patent medicine for behavioral disorders. PMID- 3274916 TI - Control theory and type A behaviour. AB - As a test of 'control theory', 75 Type A/B undergraduates completed a multidimensional health locus-of-control measure. Type A behaviour correlated significantly with beliefs regarding personal control over health, but not with beliefs regarding chance or powerful others. These findings suggest Type As' desire for control is multidimensional. PMID- 3274917 TI - Non-participation of opal suppressor phosphoseryl-transfer ribonucleic acid (tRNA) in phosphoserine aminotransferase catalysis. PMID- 3274918 TI - [Axonal neuropathy and chronic Codobromyl poisoning]. AB - We report a 56 year-old woman with a severe axonal neuropathy due to a chronic intoxication by a cough soothing (Codobromyl). Symptoms of codeine and alcohol intoxication were present. The problems of self medication are considered. PMID- 3274920 TI - Health differentials based on living conditions. Future lines of research on health profiles. PMID- 3274919 TI - Comparisons of ketoconazole, PR 969-566, PR 967-234, and PR 967-248 as antifungals in vitro and in the rat model of candidal vaginitis based on efficacy/safety profiles. PMID- 3274921 TI - Some thoughts on the production and utilization of knowledge. PMID- 3274922 TI - Health profiles, Argentina, 1980-1982. PMID- 3274923 TI - Alcoholism and substance abuse, Colombia 1987. PMID- 3274924 TI - Modification of human amniotic membrane stability after addition of magnesium salts. AB - Membrane stability is determined by the measure of two electrical parameters: the total ionic conductance (Gt) and the ionic fluxes (F1, F2). These two categories of interaction between the membrane polar groups and magnesium explain its effects on membrane stability. The screening interaction is characterized by the fact that the polar groups are masked by magnesium and by a decrease of Gt, F1 and F2. The membrane stability increases. The binding interaction is characterized by the fact that the polar groups are accessible to other ions and by an increase of Gt, F1 and F2. The membrane stability decreases. Among the different magnesium salts studied, MgCl2, Mg acetate and Mg citrate increase then decrease the stability on the two faces of the amnion. MgSO4, Mg lactate and Mg nitrate increase the stability on the maternal side, but decrease it on the fetal side. MgCl2, Mg acetate and Mg citrate have an identical effect on the two faces of the amnion which does not influence the transfer ratio. PMID- 3274925 TI - Analysis of magnesium membraneous effects: binding and screening. AB - There are two categories of electrostatic interactions between cations and negatively membrane charged surfaces. First, there is the usual type of electrostatic binding where the cations complex to anionic surface moieties. There exists, however, a second type of association, often referred to as screening. In this case, the cations remain mobile, being held loosely in a diffuse layer close to the surface. When divalent cations are added in the bathing medium, a screening effect (S) induces a reduction of Gt, a binding effect (B) induces an increase of Gt and a screening-binding effect (S-B) induces a reduction, then an increase, of Gt. In the isolated human amnion, among the magnesium salts studied, only MgCl2, Mg citrate and Mg acetate have a S-B effect on both faces of the membrane. PMID- 3274926 TI - Magnesium interactions with lithium and sodium salts of adenosine triphosphate: an investigation by phosphorus-31 nuclear magnetic resonance spectroscopy. AB - Phosphorus NMR spectra were recorded for complexes of Na2ATP and Li4ATP with varying concentrations of magnesium, calcium and lithium. Each ion caused a shift in the phosphorus resonances, usually downfield, and a decrease in the 31P-31P coupling constant. The sodium ATP formed a 1:1 complex with each ion and a 1:2, ATP:Mg complex with magnesium whilst lithium ATP gave evidence to suggest the formation of bis(nucleotide) complexes. PMID- 3274927 TI - Renal excretion of lactate and magnesium in mitral valve prolapse. AB - A strong positive correlation between urinary magnesium and lactate was found in 17 magnesium-depleted patients with echocardiographically proved mitral valve prolapse. The strong correlation over all the range of urinary magnesium values and the significantly increased excretion of lactate suggest urinary magnesium loss in this syndrome. PMID- 3274928 TI - Metabolic studies in primary tubular hypomagnesaemia-hypokalaemia. AB - 13 1/2 year old boy with short stature and pubertal delay had infrequent episodes of tetany. Biochemical determinations demonstrated low plasma and high urinary magnesium and potassium levels, hypocalciuria, slightly increased plasma bicarbonate, slightly reduced fractional distal reabsorption of chloride and sodium, high plasma renin activity and high urinary excretion of prostaglandins (E2, F2 alpha). The other parameters of renal functions were normal. Endocrine evaluation of short stature and pubertal delay was normal. Intracellular magnesium and potassium levels in lymphocytes and erythrocytes were within normal limits. Cyclooxygenase blockade with Indomethacin 2.5 mg/kg daily during 4 weeks normalized urinary excretion of prostaglandins and corrected in part low plasma and high urinary potassium levels, but had no effect on magnesium, calcium, sodium and chloride handling. These data raise the possibility that tubular hypomagnesaemia-hypokalaemia could be solely explained by a low renal threshold for magnesium. PMID- 3274929 TI - 10th Hohenheim Magnesium Symposium. Hohenheim, FRG, 25-26 September 1987. Abstracts. PMID- 3274930 TI - Extramural training and education programs of the National Cancer Institute. AB - The support of research training, initiated by the National Cancer Institute (NCI) in 1938, was reaffirmed in 1974 by the National Research Service Act (NRSA). The guiding principles for operating this program have been based upon considerations including the continuity of knowledge, the occurrence of field switching, the difficulty of predicting future advances and needs, and the interdependence of science and technology. The NCI guidelines for its extramural training programs emphasize high quality, flexibility, and multidisciplinarity. In Fiscal Year 1985 more than 1650 research trainees were supported by institutional grants, fellowships, and awards, and the nature of these is described. Cancer Education Grants are institutional grants for medical, dental, nursing, and public health schools, which are intended to encourage cancer curriculum development with emphasis on preventive oncology, research experiences for students, and continuing education programs. Recent trends and problems with applications for these Grants are described. PMID- 3274931 TI - The professional education program of the American Cancer Society. AB - The American Cancer Society is the major organization that provides cancer education to health professionals in the United States. This is implemented not only by the National Office but through 58 Divisions and over 3000 local Units. Objectives for professional education emphasize informing physicians and the multiple disciplines of health professionals engaged in primary care about cancer detection and prevention, particularly for breast, lung, colon, rectal, and cervical cancers. A plan is now being developed for a professional education program to the year 2000. Cancer control programs sponsored or planned by the Society include the Colorectal Health CHECK program, Smoke Free Young America, Breast Cancer Detection Awareness, and Cancer Risk Reduction. These programs demonstrate an effective partnership between professionals and lay volunteers. The Society also offers Clinical Fellowships, Medical and Nursing Professorships, and Nursing Scholarships to further professional education. National conferences are sponsored by the Society, as are special graduate courses for physicians from foreign countries. In addition, numerous publications and audiovisuals are available through Units to supplement professional, as well as lay, education. PMID- 3274932 TI - "How to avoid dying from cancer ... now and later"--a course to reach the lay public. AB - The context, history, course description, measures and foundations for success, and future enhancements are described for the Health Education course, "How to Avoid Dying from Cancer ... Now and Later." Since 1981 this course has been offered once annually at The Ohio State University for academic credit and has averaged an enrollment of 354 undergraduate, graduate, and continuing education students. Over the years this course, originated by a surgical oncologist, has earned its own title and entry in the academic course offerings and has demonstrated success both quantitatively and qualitatively. Quantitative indicators of success include enrollment trends, diversities of students enrolled, student evaluations of the course, and data on the instructional effectiveness of this course. Qualitative indicators of success include favorable publicity through the local media, top ratings for summer radio programs based on this course, and the National University Continuing Education Faculty Service Award given to one of the authors in 1985. Four factors account for much of the success of this course. PMID- 3274933 TI - Graduate education and training in surgical oncology. AB - Training programs in surgical oncology have been developed at a number of institutions in the United States, employing guidelines developed by the Society of Surgical Oncology. Eight training programs have been approved by the Society. The program at the UMDNJ-New Jersey Medical School is described in detail with comments on its evolution and current methods of training. The extensive advanced training in cancer surgery is complemented by rotations in medical oncology, radiation oncology, surgical pathology, and by both laboratory and clinical research experience. In addition, a course in the basic science of oncology is given. Increasing numbers of surgeons-in-training are applying to such programs. A list of selected publications in surgical oncology is provided. PMID- 3274934 TI - Funding for cancer education. PMID- 3274935 TI - Impact of presence and discontinuation of federal support of cancer education programs. PMID- 3274936 TI - On the loss of the Cancer Education Grant: the New York Medical College experience. PMID- 3274937 TI - Both points of view. PMID- 3274938 TI - A cancer education study in The Netherlands based on the AACE/NCI Cancer Education Survey. AB - A Dutch Cancer Education Study demonstrated that the data collection instruments developed for the U.S. AACE/NCI Cancer Education Survey could also be used for the same kind of studies in foreign countries. Where needed, the data collection instruments were modified to the Dutch national situation. In this way, an impression was obtained on several aspects concerning undergraduate cancer education in the Dutch medical schools. Based on the combined findings of the U.S. Cancer Education Survey and the Dutch Cancer Education Study, a number of recommendations can be made for application to student cancer education in The Netherlands. PMID- 3274939 TI - Evaluation of fellowship and residency programs in a comprehensive cancer center. AB - A Dental Oncology residency and fellowship program was evaluated annually from 1980-1984 by each trainee. Nineteen training program variables were assessed on an Exit from Training Questionnaire using 0-100 mm linear scales. The five annual scores for each variable were subjected to trend analysis. Implication of the results to the training program are discussed. The evaluation method may be used to establish a departmental training program benchmark in relation to which future performance can be measured and as a guide to program modification. The method may be applied to all departmental training programs and, when combined, to the institution as a whole. PMID- 3274940 TI - Community health practicum with an oncology nursing focus. AB - A Community Health Practicum in Oncology Nursing for senior nursing students in a baccalaureate program is described. The practicum was designed to meet two objectives in the undergraduate curriculum: (1) to give students experience in the care of patients and families in the community by using cancer as a model of a life-threatening disease requiring acute and chronic care, rehabilitation, etc. and (2) to provide knowledge about cancer care and prevention and give an opportunity for students to participate in a small-scale cancer prevention project. Patient and family reactions to care provided by students were evaluated with a semi-structured telephone interview. Evaluations of the students' clinical performances and cancer prevention projects were made by instructor observation. Pre/post-tests given to those being taught during the projects provided additional evaluations of the students' projects. Evaluation of the students' reactions to the learning experience was made by their responses to items on an evaluation tool. PMID- 3274941 TI - [Intraepithelial neoplasms of the vulva: treatment by skinning vulvectomy]. PMID- 3274942 TI - [Platelet activation in pregnancy-related hypertension]. PMID- 3274943 TI - [Usefulness of the modified fetal biophysical profile in intrahepatic cholestasis of pregnancy]. PMID- 3274944 TI - [Endometrial adenocarcinoma, a current therapeutic approach]. PMID- 3274945 TI - [Amenorrhea, anovulation and infertility associated with breast feeding in a selected group of urban women]. PMID- 3274946 TI - [The uterine inhibition in the management of premature labor. Comparing the efficiency of various methods]. PMID- 3274947 TI - [The third and fourth lives of women]. PMID- 3274948 TI - [Respiratory distress of the newborn infant. Use of artificial surfactant in the prevention and management of neonatal respiratory distress]. PMID- 3274949 TI - International Commission on the Taxonomy of Fungi (ICTF): name changes in fungi of microbiological, industrial and medical importance. Part 3. PMID- 3274950 TI - Mycobacteria in public water supplies: comparative resistance to chlorine. AB - The isolation of mycobacteria from municipal and hospital water supplies prompted an investigation of the susceptibility of environmental and clinical isolates of mycobacteria other than Mycobacterium tuberculosis and Mycobacterium bovis to free chlorine. Experiments revealed that free chlorine concentrations of 1.0 mg l 1 eliminated 100,000 c.f.u. of the mycobacterial strains tested within 8 hours of exposure, whereas a concentration of 0.15 mg l-1 had virtually no bacteriocidal effect. Free chlorine residual levels of 0.1 mg l-1 or less, depending on the water temperature, within Boston, suggest that current disinfection procedures may not be adequate for effective control of potentially pathogenic mycobacteria in public water supply systems serving a population with increased risk factors. PMID- 3274951 TI - Not as simple as ABC. PMID- 3274952 TI - Greasy proteins. PMID- 3274953 TI - [Frankel functional appliance]. PMID- 3274954 TI - [Timing and treatment procedure (preventive, interceptive, restorative orthodontic-orthognathic treatment) of dentofacial deformities]. PMID- 3274955 TI - [Oral habits]. PMID- 3274956 TI - [Mandibular position in relation to the anterior cranial base]. PMID- 3274957 TI - Identification of foreign metallic substances inducing hyperpigmentation of skin: light microscopy, electron microscopy and x-ray energy spectroscopic examination. AB - Identification of foreign metallic substances that induce hyperpigmentation is now possible with the use of x-ray energy spectroscopy (XES), an ultrastructure, nondestructive technique that allows the correlation of the presence of foreign substances with localized tissue and cellular histological changes. This new analytic technique will be an innovative adjunctive technique in the practice of diagnostic pathology and dermatopathology. It is certain that further evaluation of hyperpigmentation will allow for better identification of possible etiological causes, especially in the evaluation of cutaneous hyperpigmentation secondary to metal toxicity. PMID- 3274958 TI - Nasal reconstruction with full thickness skin graft: a cosmetic procedure. PMID- 3274959 TI - Methods for separating temporally overlapping sources of neuroelectric data. AB - The localization of intracranial sources of EEG or MEG signals can be misled by the combined effect of several sources, as illustrated by simulated MEG data in which two of the three dipolar sources have slightly out of phase activity and partly complementary scalp topographies. These data were analysed by three different source localization methods. Fitting a single source to each sequential topography worked perfectly when only one source was active; this could also account for as much as 95% of the spatial variance of topographies resulting from two overlapping sources, although the solution was then far from any source. A principal component analysis approach followed by an oblique rotation (fitting one source to the spatial aspect of each component) correctly localized two of the sources but severely mislocated the source that was never active alone. Spatio-temporal source modeling (simultaneously fitting a set of sources to all consecutive topographies) correctly localized all three sources, provided that the parameter optimization method could escape sub-optimal local minima of the error function. Temporally overlapping sources can thus be separated and correctly identified if the mathematical model is adequate and the optimization procedure is well adapted. PMID- 3274960 TI - The normal scalp topography of the middle latency auditory evoked potential Pa component following monaural click stimulation. AB - The scalp topography of the middle latency auditory evoked potential (MLAEP) Pa component following left and right ear click stimulation was investigated in 15 normal hearing and neurologically intact right-handed subjects. An unbiased reference was employed. The Pa component showed a broad voltage field that was recorded maximally at the Cz and Fz leads regardless of which ear was stimulated. A broad negative voltage field that occurred coincident in time with the Pa component was recorded posterior to the T3, P3, Pz, P4 and T4 electrode leads. This negative voltage field peaked in amplitude at the T5, O1, Oz, O2, and T6 electrode leads. An unexpected finding was that the peak latency of the Pa component occurred significantly earlier following stimulation of the right ear. PMID- 3274961 TI - Facts and artifacts in brain electrical activity mapping. AB - As computerized EEG (CEEG) analysis and display methods become increasingly powerful the user is lured toward increasingly abstract representations of data in which artifacts can easily go unrecognized. The presence of even small amounts of artifact can lead to distortion of CEEG results due to the sensitivity of the analysis methods employed. Several common artifacts are discussed, their distortion of CEEG data illustrated, and remedial measures suggested. Some of these artifacts (EOG, EMG, photomyoclonic, tremor, ECG, 60 Hz, volume conducted cortical activity) are familiar to traditional EEG (aliasing, extrapolation) are unique to CEEG and may be inadvertently introduced by workers not specifically trained in CEEG methods. PMID- 3274962 TI - Probability mapping: power and coherence analyses of cognitive processes. AB - In recent years different mapping techniques have proved to be an efficient means in studying cognitive processes. Our approach is based on recordings with 19 EEG channels and the computation of spectral parameters. Power and coherence values are obtained from the EEG of control recordings and recordings during the performance of cognitive tasks and are compared for significant differences. The statistical procedures used yield descriptive error probabilities for the rejection of the null hypothesis which are mapped either colour coded or by black and white squares. The usefulness of this method is demonstrated on a mental cube rotation study involving 31 students, 13 males and 18 females. One essential result during the performance of this test is an increase of theta power only in females. As far as local coherence and the theta band are concerned, males show increased values right parietally and right temporo-occipitally; opposed to this, in females the left hemisphere is more affected. In the beta bands, local coherence increases in males right parietally and left temporo-occipitally. Contrary to this, in females the parietal increase of local coherence is more accentuated in the left hemisphere but temporo- occipital coherence is increased in the right hemisphere. In both sexes interhemispheric parietal coherence increases during cube rotation suggesting increased functional couplings between the hemispheres. This study demonstrates that the inclusion of the coherence parameter in brain mapping furthers the detection of sex and hemispheric differences during the performance of cognitive tasks. PMID- 3274963 TI - Multichannel intracranial recording device using a color imaging brain mapping system. AB - A procedure is described for the manufacture and use of a multichannel (up to 20) intracranial recording device. Electrodes are arranged in a horizontal plane, and can be controlled by a conventional microdrive. Data from multiple channels are visualized and analyzed utilizing a commercially available color imaging brain mapping system. Potential research applications include studies of neural generators of evoked responses through the simultaneous recording of intracranial and scalp potentials. PMID- 3274964 TI - Bimodal initiation of smokeless tobacco usage: implications for cancer education. AB - One hundred fifty (150) randomly chosen adult male subjects (average age 37) drawn from a university general dental clinic were classified by self-report into three equal categories of fifty smokeless tobacco users, fifty cigarette smokers (non-smokeless tobacco users), and fifty non-tobacco users. According to questionnaire results, a bimodal curve was exhibited among smokeless tobacco users with the two peaks of initiation at ages 12 and 18 compared to a unimodal age of initiation for cigarette smokers at age 16. Two different cohorts of smokeless tobacco users based on age of initiation were observed with differences reported in level of education, urban versus rural origin, average length of time in using smokeless tobacco, and the type of smokeless tobacco product used. Young initiators appeared to be primarily from rural communities having a strong parental or familial influence when initiating smokeless tobacco usage, whereas older initiators appeared to be primarily from more urbanized regions with peer influences as the most significant for initiating smokeless tobacco usage. Other characteristics associated with one or the other cohort were also reported, pointing to different educational measures that may be necessary for prevention and intervention, based on the age of initiating smokeless tobacco usage, as well as place of residence. PMID- 3274965 TI - Thought, time, and truth: contributions to research by medical students. PMID- 3274966 TI - The impact of an educational workshop on colorectal screening practices. AB - Since its establishment in 1983, the Virginia Colorectal Cancer Control Project has emphasized the importance of routine screening of asymptomatic adults for colorectal cancer. This has been accomplished through educational workshops that are offered to primary care physicians. These workshops provide didactic information on current concepts in screening and individualized instruction on the use of the flexible sigmoidoscope. Eleven workshops have been conducted since the fall of 1984. During the spring of 1986, a survey was mailed to workshop participants to determine whether changes had occurred in their screening practices. A total of 115 physicians responded to the survey. Prior to the workshop, 86 physicians performed the digital rectal examination; now 100 do. Prior to the workshop, 68 physicians performed the fecal occult blood test; now 89 do. Prior to the workshop, 34 physicians used a flexible scope; now 71 do. Participants found the workshop to be extremely effective in providing individualized instruction. PMID- 3274967 TI - Mass screening for colorectal cancer--the Philadelphia experience. AB - On May 18, 1985, the Philadelphia Division of the American Cancer Society and WCAU-TV entered into a jointly-sponsored colorectal health day to do mass screening throughout the greater Philadelphia area. This was preceded by a week long series of television awareness programs, and an organization based on having individual hospital coordinators for those hospitals participating. A total of 46 hospitals in Pennsylvania alone participated in this project, and over 16,000 people were screened in a single day. 410 patients had positive stools for occult blood on site, and 359 were positive on take-home 3-packs. Rectal pathology was diagnosed initially in 502 patients. 13 colorectal cancers and 38 polyps have been diagnosed directly as a result of this screen. Total cost to the Cancer Society was $13,300, meaning each diagnosed cancer cost $1,023 and each cancer or polyp cost $266 in actual funds expended for the screen. This overwhelming response by the public to such a mass screening effort indicates the potential for such programs for colorectal cancer, and the techniques employed in planning, implementing, and following up on data retrieval are discussed. This mass screening effort should serve as a model for future projects, and emphasize the importance not only of interrelationships with the media, but also liaison efforts with a network of area hospitals and individual hospital coordinators. PMID- 3274968 TI - The 1986 Samuel C. Harvey lecture: partners in cancer education. AB - I have attempted to highlight the important contributions of a voluntary health organization committed solely to cancer research, education, and patient service. The involvement of many thousands of volunteers has allowed the American Cancer Society to provide the country with a private sector alternative to government programs. Progress in cancer control through changes in lifestyle will not occur simply through the intervention of federal regulations. It will happen through private initiatives in neighborhoods across the country. It is in these communities that volunteers become the spark for the mission of cancer control. The financial contributions of millions of Americans along with their neighbors' enthusiasm and labors enable the American Cancer Society to provide all of us with vital ways to help ourselves, to train health professional leaders, and to unlock the mysteries of cancer through research. The American Cancer Society and the American Association for Cancer Education are truly partners in cancer education. PMID- 3274969 TI - A first-year medical school pilot program for early clinical exposure. AB - A weekly out-patient elective in a medical oncology clinic was established for first- and some second-year medical students. Interviews were carried out immediately after the elective experience and two years later to evaluate the degree of success in achieving specific goals in this elective. Such clinical experience appeared to introduce the medical students to some of the major medical and psychosocial issues involved in the clinical care of patients, to be highly motivating for the students with regard to their standard concurrent basic science curriculum, and to relieve the impatience that first-year medical students have for clinical exposure. The usefulness of the elective, as perceived by the participating students, appeared to increase from the first to the second interview, that is as the students entered the clinical teaching program. The clinical setting was perceived by the students as more useful than either their increased understanding of medicine or observation of physicians as role models. The students' perception and understanding of physician-patient communication, and of the problems facing an oncology patient, appeared to be more favorably influenced than increasing confidence in the ability of the student to deal with patient interaction. Thus, a clinical oncology out-patient experience for first year medical students appears to be sufficiently rewarding to justify the time and effort to develop such an elective. PMID- 3274970 TI - Integrated oncology course for first-year medical students. AB - In this report an oncology course for first-year medical students is described. The course is characterized by a high level of integration of the involved basic and clinical sciences and is designed according to the principles of problem based learning. A limited number of lectures provides a frame of reference. A series of case histories introduces the students to various aspects of neoplastic disease and after group discussions leads the students to individual learning activities. During the course only general principles are touched upon. Students, as well as teaching staff, appear to be highly appreciative of the integrated approach. PMID- 3274971 TI - Results of the fellowship matching plan in oncology. AB - The Medical Specialties Matching Program provides a means for fellowship applicants and participating institutions to rank their preferences. The first attempt in 1986 resulted in a wide variation in the percentage of matched positions according to specialty. For oncology, the programs ranged near the median, ie, of 255 enrolled positions, 207 (81.2%) were actually offered. Of these, 148 (71.5%) were filled. In 76 programs, 61% of the positions were not filled. Oncology directors have expressed reluctance to participate in this Matching Program in the future. PMID- 3274972 TI - Application of cancer prevention knowledge: a longitudinal follow-up study of medical students. AB - Measuring the clinical application of knowledge and skills acquired in specific medical school courses is a critical part of curriculum evaluation. Second-year Cancer Prevention Course (CPC) students and a comparison group were surveyed by questionnaires, cognitively tested, and a subsample participated in in-depth interviews. The 6-month and 18-month follow-up interviews indicated that more CPC students practiced prevention in their clinical rotations than did the comparison group. Direct, one-on-one access to patients during clinical training was an important mediating factor in the practice of prevention skills. In addition, a behavioral intent inventory showed that CPC students, in their future careers, intend to perform certain specific cancer prevention activities more than others. Long-term retained knowledge (75% correct) stabilized at levels significantly higher (p less than .001) than baseline test scores prior to the Cancer Prevention Course. At the time of the two follow-up exams of cognitive knowledge, the comparison group of students was able to do no better than had the CPC students at baseline before the course. Positive beliefs about cancer prevention improved over the study period. More than twice as many cancer course students attended subsequent optional lectures and reported optional reading on cancer prevention topics than did the comparison group. Overall, the study showed a lasting effect of the elective course in cancer prevention, in terms of tested knowledge, and self-reported measures of attitudes, beliefs, practice of prevention in clinical rotations, and intent to apply prevention in future practice. PMID- 3274973 TI - A program model for nurses involved with cancer education of black Americans. AB - In the last 30 years, cancer incidence rates for black Americans have increased 27% in contrast to an increase of 12% for white cancer rates. In answer to this obvious need for intervention to lower the incidence and mortality rates, the Oncology Nursing Society held a one-day workshop which focused on the primary prevention of cancer in black Americans. For the 40 workshop openings, 540 black nurses from 40 states responded to a call for applicants. The impact of the workshop was measured by four pre- and post-tests which provided both qualitative and quantitative data and indicated that the experience made a significant impact on the participants. The workshop content focused on the epidemiology of the cancers which are most frequently found in blacks, cultural attitudes toward these cancers, and techniques for early detection. The success of the workshop was due to the active involvement of the participants in the learning process and serves as a model for training minority nurses for active, creative roles which can be instituted in the community to help lower the high cancer incidence rate among black Americans. PMID- 3274974 TI - An integrated oncology course for second year medical students. AB - A required course for second year medical students explores an integrated approach to the patient with cancer. Lectures detail the role of each medical discipline in the management of cancer. Panel discussions illustrate the cooperation necessary between clinical specialties in the diagnosis and treatment of these diseases. A small group session provides a problem-solving exercise around a patient with cancer, and laboratory sessions present the opportunity for students to receive hands-on experience in detecting tumor masses in anatomical models as well as the opportunity for students to test their stools for occult blood. Evaluation of the course has shown that students increase significantly their knowledge about cancer, that "practice-effect" is not a factor from pre- to post-test, and that although students improve in their capacity to solve problems they are less proficient in this than retention of facts. Student surveys have indicated generally good acceptance of most aspects of the course. PMID- 3274975 TI - A survey of housestaff attitudes towards terminal care education. AB - Medical and surgical housestaff have received little formal training to treat the medical or psychosocial problems associated with terminal illness. That more postgraduate terminal care education is needed is generally not debated but what should be taught and how it should be taught are unresolved issues. This paper presents data from a questionnaire given to 173 internal medical and surgical residents intended to provide information on their perceived needs in this area of education. Questions were developed to address four major areas: (1) whether and how terminal care issues should be taught; (2) residents' perceptions of their clinical competence in this area; (3) how personal issues affect care; (4) the residents' roles vis a vis the dying patient and family. A significant portion of the residents were able to acknowledge the importance of their own experience and the need to personally address these issues during training. Thirty-five percent of the sample indicated the need for more training in treating severe pain and 28% felt the need for more training in treating shortness of breath. About 50% of the sample felt that they needed more training in psychosocial areas. This paper presents a method by which training directors can survey their housestaff's perceptions and needs in this area in order to increase the likelihood that terminal care training will match the learning needs and styles of the particular resident group. PMID- 3274976 TI - Women's knowledge and beliefs about breast cancer risk factors, symptoms, detection methods, and treatments. AB - This paper presents results from a survey of adult women that assessed knowledge, beliefs, and practices regarding the causes, symptoms, detection methods, and treatment of breast cancer. The study population was determined through random selection of household telephone numbers from the Buffalo, New York area telephone directory. Completed interviews were collected from 563 women over the age of 18. Telephone interviews were conducted by trained interviewers, between April and July of 1985. Survey results are compared to those found in the 1979 National Cancer Institute nationwide survey on breast cancer to evaluate if ther have been changes in public awareness about the disease. Differences in knowledge, beliefs, and practices regarding breast cancer were also studied in relation to age, race, and educational background. Overall, women's knowledge about breast cancer has significantly increased since the 1979 survey. However, while more women can name mammography as a diagnostic tool only 15% of women who have heard of mammography reported having had a mammogram. Generally, younger women, white women and those with some college education were more knowledgeable about breast cancer risk factors, symptoms, detection methods, and treatments. Results from this study suggest that although knowledge about breast cancer has improved, women have not adopted recommended early detection practices. Special efforts need to be directed toward health professionals, making mammography more accessible to women who are nonwhite, older and with no college education. PMID- 3274977 TI - Measuring common public misperceptions about cancer. AB - A 32 item criterion-referenced knowledge questionnaire was developed to measure the level of common misperceptions about the nature of cancer and cancer treatments held by the public. A sample of 353 respondents were contacted and agreed to complete the questionnaire through a random telephone survey technique (Random Digit Dialing). An extensive analysis of the responses to the survey was performed and supported the validity and reliability of the instrument. Results of the survey indicate that the prevalence of misperceptions held by the public is high. The total mean score correct on the questionnaire was only 17.2 out of a possible 32. No differences were found for total mean score on the questionnaire based on the respondents' age, sex, or whether they or someone close to them had ever had cancer. Statistically significant differences, however, were found for the total mean score on the questionnaire based on the respondent's level of education and how they responded to two attitudinal questions on the questionnaire. The most prevalent misperceptions about cancer related to questions about side effects from the treatment for cancer, followed by questions about proven cancer treatments and unproven or quack cancer treatments. The least prevalent misperceptions about cancer related to questions about the nature of cancer. PMID- 3274978 TI - Design, implementation, and evaluation of a longitudinal cancer curriculum. AB - The University of Massachusetts Medical School's two year preclinical curriculum is organized by organ system and controlled by the basic science departments. It is followed by two years of required and elective clinical clerkships. An evaluation of cancer teaching in the preclinical curriculum using criteria derived from the Cancer Education Objectives for Medical Schools was conducted. Deficiencies in cancer teaching were documented and the need for an organized cancer education program established. The administration then allotted 18 hours for cancer teaching spread over the two years of the preclinical curriculum. Supported by an R25 Cancer Education Grant, the Longitudinal Cancer course (LCC), was developed in an attempt to effectively utilize the scattered class time to meet a significant number of American Association for Cancer Education Objectives. In addition, interdisciplinary teaching of the more common cancers was facilitated and faculty were supported in their use of cancer related examples to illustrate relevant materials in the basic sciences. Evaluation of the LCC after a three-year trial has shown that, without strong administrative support, it is a very inefficient method of cancer teaching. While students appreciated class content and met a significant number of course objectives, they found the longitudinal format of the course unsatisfactory and recommended that the course be consolidated into a block. R25 grant support was being sought to implement a proposal to consolidate cancer teaching when the R25 program was suspended. Without external support, implementation will be difficult because it will require serious disruption of an established course. Such a change will require resources that are not readily available in this era of fiscal constraint. PMID- 3274979 TI - A cancer screening skills laboratory for medical students. AB - At St. Louis University School of Medicine a 15-hour Integrated Oncology Module is part of the required second-year Introduction to Medicine course. In place of a one-hour lecture in the module, a required one-hour laboratory was introduced to teach cancer screening as a means of secondary cancer prevention. This activity follows completion of the Introduction to Physical Diagnosis course. The laboratory utilized anatomically correct models to instruct students in fundamental screening procedures for cervical, breast, prostate, and colorectal cancer. Emphasis was placed on a professional interaction with the patient. The Cancer Prevention Laboratory sessions were conducted by registered nurses with specialized training in cancer screening. The Socratic method was employed by the instructors as each of 157 students moved through a series of stations screening appropriate models. The student described the procedure as it was performed, and answered questions pertinent to the activity. The instructors assessed performance using a checklist developed for this purpose. Questions relative to secondary cancer prevention and proper physical detection of cancer appeared on the final exam of the Integrated Oncology Module. One hundred fifty-seven students completed the screening laboratory. Four nurse instructors were employed at each session. Thirty-nine hours were required for all students to complete the lab. Student critique of the activity was overwhelmingly positive, particularly in the acceptance of the registered nurse instructors. Eighty-six percent of the 157 students reported that the teaching methodologies used by the nurses were excellent. The nurses were also perceived as knowledgeable and nonthreatening. PMID- 3274980 TI - Youth cancer education through a combined American Cancer Society-Boy Scouts of America pilot program. AB - A pilot cancer education program for Boy Scouts in grades six through nine was developed. Motivation to complete requirements was provided by awarding a "Cancer Awareness Patch." Content of the program included health issues related to smoking and tobacco use, diet, and sun exposure, plus education about the practice of testicular self-examination, and sunscreen usage. Retention of factual material was good up to 18 months post-program. Participants developed positive attitudes toward lifestyle development and volunteerism. The program is recommended for supplementation of school health promotion curricula. PMID- 3274982 TI - Nuclear war--the ultimate health threat. PMID- 3274981 TI - Collecting cancer registry data with a Cancer Patient Questionnaire. AB - Tumor registries provide a valuable source of treatment, survival, and epidemiologic data but have been faulted for incomplete and insufficient collection of data. An eight page, 38-item Cancer Patient Questionnaire (CPQ) was developed to collect more extensive information for the tumor registry. The CPQ identified significantly more patients with a family history of cancer than had previously been detected by chart review by the tumor registrar. The CPQ agreed with data collected by the tumor registry in 96% of cases for place of birth, 84% of cases for occupational history, 91% of cases for tobacco use, and 88% of cases for number of pregnancies or live births. The Cancer Patient Questionnaire is complete and easy to use and may replace the chart review in the collection of these data. PMID- 3274983 TI - Abortion counseling. PMID- 3274984 TI - How to file a grievance. PMID- 3274985 TI - Mitotic Schwann cells in normal mature spinal roots. AB - Some rare mitotic Schwann cells (one in about a thousand) were found in normal mature spinal roots of adult lizards. Mitotic cells retained their relationships with unmyelinated axons, a finding consistent with the hypothesis that the stimulation of Schwann cell proliferation requires direct contact between axons and Schwann cells. The observation presented in this paper shows that Schwann cells and the satellite cells of sensory and autonomic ganglia behave in the same way also with regard to their mitotic activity. PMID- 3274986 TI - [Epistemiological reflections on biological theories]. PMID- 3274987 TI - [Study of the peripheral nerve fibers during aging in the rat]. AB - An histological study of the peripheral nervous fibres has been performed at various anatomical levels during aging: the spinal ganglion, the dorsal and the ventral nerve roots, the spinal and the sciatic nerves. During aging the various alterations occurring in a peripheral nerve can be summarized as following. In the myelinated fibres, the axoplasm was progressively invaded by several inclusions: glycogen granules, granulo-filamentous bodies and lipofuscins. The crystalloid networks arising from the cytoskeleton were mainly localised in the intraganglionic fibres. Among the axoplasmic organelles, the mitochondria were the most affected. The myelinic sheath split, became dystrophic and then was totally disrupted. The inner schwann cell compartment was invaded by several inclusions like Hirano bodies and dense residual deposits. Further, macrophages phagocytosed the axon and the myelin sheath. In the non-myelinated fibres, the alterations were less important and less precocious. When these results are analysed from a chronological point of view it is established that the alterations appear at the same time in each observed level but their amount differ from each other. In the 24-month-old-rats, the ventral root and the sciatic nerve present many dystrophies whereas in the spinal ganglion and in the dorsal root they are less numerous. From these results, it can be suspected that the motor fibres are more vulnerable during aging. Moreover, the myelinated fibres of large diameter are the first affected. Furthermore, only the ventral root and the sciatic nerve show typical regeneration pictures at 32 months. PMID- 3274988 TI - [Kelly-Paterson, Plummer-Vinson syndrome or sideropenic dysphagia apropos of a case in a child]. PMID- 3274989 TI - [Effects of in vitro lipid peroxidation on the activity of membrane enzymes involved in drug metabolism]. PMID- 3274990 TI - [Gastric Crohn's disease (1st African case seen at the Hopital Principal in Dakar)]. PMID- 3274991 TI - [Apert syndrome or type I acrocephalosyndactylia. Apropos of a case]. PMID- 3274992 TI - [Pleuropulmonary parasitoses seen in Dakar]. PMID- 3274993 TI - [Apropos of a case of coarctation of the aorta with delayed manifestation]. PMID- 3274994 TI - [Postoperative thyrotoxic crisis. (Apropos of 3 cases hospitalized in the surgical clinic of the Hopital A. Le Dantec)]. PMID- 3274995 TI - [Precocious congenital syphilis in Dakar (apropos of 8 observations)]. PMID- 3274996 TI - [Ogilvie syndrome]. PMID- 3274997 TI - [Gaseous phlegmon of the perineum]. PMID- 3274998 TI - [Etiologies of acute gastroenteritis in a pediatric hospital. Analysis of 939 stools at th Hopital dEnfants Albert Royer of the UHC of Dakar]. PMID- 3274999 TI - [Apropos of a case of extrinsic allergic alveolitis caused by malathion]. PMID- 3275000 TI - [Acanthosis nigricans and pancreatic cancer]. PMID- 3275001 TI - [Effects of swimming on various anthropometric and spirometric measurements among the Senegalese]. PMID- 3275002 TI - [AIDS and asymptomatic HIV seropositivity at the Hopital Prinicipal. Epidemiological and clinical aspects]. PMID- 3275003 TI - [Iron deficiency anemia, geophagia and hepato-splenic manifestations in the child]. PMID- 3275004 TI - [Normovolemic hemodilution (preliminary study)]. PMID- 3275005 TI - [Perihepatitis of venereal origin or Fitz-Hugh-Curtis syndrome. Apropos of 7 cases seen at the Hopital Prinicpal]. PMID- 3275006 TI - [Role of Chlamydia trachomatis in the etiology of bacterial conjunctivitis in Dakar (preliminary results)]. PMID- 3275007 TI - [Radiologic diagnosis of fibromuscular dysplasia of the carotid system in the African black (apropos of 8 cases)]. PMID- 3275008 TI - [Infantile acropustulosis: 1st Senegalese cases]. PMID- 3275009 TI - [Value of esophago-gastro-duodenal fibroscopy in upper digestive hemorrhages (apropos of an experience in Dakar)]. PMID- 3275010 TI - ANA certification: purpose, process, and value. PMID- 3275011 TI - Report on confidential enquiries into maternal deaths in England and Wales 1979 1981. PMID- 3275012 TI - Guidance on the preparation of summaries of data on chemicals in food, consumer products and the environment submitted to DHSS. PMID- 3275013 TI - The use of very low calorie diets in obesity. Report of the Working Group on Very Low Calorie Diets. Committee on Medical Aspects of Food Policy. PMID- 3275014 TI - Report on Health and Social Subjects. 32. Present day practice in infant feeding: third report. Report of a working party of the Panel on Child Nutrition Committee on Medical Aspects of Food Policy. PMID- 3275015 TI - Third report of the Sub-committee on Nutritional Surveillance. Committee on Medical Aspects of Food Policy. PMID- 3275016 TI - [Transparietal needle biopsy in the diagnosis of isolated lesions of the lung]. PMID- 3275017 TI - [The role of bronchoalveolar lavage in the diagnostic evaluation of alveolo septal diffuse pneumopathy]. PMID- 3275018 TI - [Statistico-epidemiologic investigation on a statistic group: secondary and high schools in the community of Ostuni]. PMID- 3275019 TI - Chain-fluorinated polyamines as tumour markers. III. Determination of geminal difluoropolyamines and their precursor 2,2-difluoroputrescine in normal tissues and experimental tumours by in vitro and in vivo 19F NMR spectroscopy. AB - Treatment of laboratory animals bearing transplantable tumours with alpha difluoromethylornithine, an inhibitor of ornithine decarboxylase, followed by 2,2 difluoroputrescine allows the partial replacement of the endogenous polyamines spermidine and spermine by their fluorine-containing analogs 6,6 difluorospermidine and 6,6-difluorospermine. Quantitative determination of the chain-fluorinated polyamines in excised tumor tissue by in vitro 19F NMR spectroscopy at 11.7 T gave results similar to those obtained by extraction and HPLC analysis. The NMR methods allowed the observation of several as yet unidentified geminal difluoropolyamine metabolites with a detection threshold as low as 1 nmole/g. Using a surface coil at 2.4 T, it was possible to detect in 10 20 min fluorinated polyamines in tumour, liver and bladder (urine) of mice in vivo at concentrations of the order of 50-100 nmol/g, i.e., when 2-5% of the natural polyamines have been replaced by their fluoro analogs. Since 6,6 difluorospermidine and 6,6-difluorospermine preferentially accumulate in tumours and specific tissues with enhanced polyamine metabolism, it is expected that these compounds may serve as probes for the application of 19F NMR methods for tumour diagnosis and therapy control. Since significant quantities of additional fluorine-containing polyamine metabolites were detected in some tissues, 19F NMR spectroscopy will contribute to our knowledge of polyamine metabolism in normal and tumour tissue. PMID- 3275020 TI - Carbohydrate metabolism of the rat C6 glioma. An in vivo 13C and in vitro 1H magnetic resonance spectroscopy study. AB - Surface coil 13C nuclear magnetic resonance (NMR) spectroscopy was used to investigate the in vivo carbohydrate metabolism of rat C6 gliomas during and after infusion with [1-13C] glucose. In vivo 1H-decoupled 13C NMR spectra of the glioma following infusion with [1-13C]glucose revealed the direct production of [3-13C]lactic acid, [1-13C]glycogen, and [4-13C], [3-13C], and [2 13C]glutamate/glutamine. Lactate levels of in vivo gliomas increased and reached steady state levels during [1-13C]glucose infusion, and decreased following termination of infusion. Complementary in vitro studies using supernatant media collected from C6 glioma cells incubated with media containing [1-13C] or [6 13C]glucose and glutamine were examined by 1H NMR spectroscopy. The [3 (13C/12C)]lactate ratios obtained from 1H spectra of supernatant media containing [1-13C]glucose revealed the percentage of glucose metabolized through the hexose monophosphate shunt to be 10.01 +/- 0.85% (n = 3), while similar measurements of media containing [6-13C]glucose and glutamine showed that glutaminolysis contributed 9.0 +/- 1.0% of total lactate production under these conditions. Enzymatic analysis of media determined lactate production to be 139 +/- 9 nmol per 10(6) cells per h (n = 4). These measurements demonstrate the ability of NMR to monitor brain tumor carbohydrate metabolism both in vitro and in vivo. PMID- 3275021 TI - Alterations in relative phosphocreatine concentrations in preclinical mouse muscular dystrophy revealed by in vivo NMR. AB - Using in vivo 31P NMR spectroscopy, the early postnatal development of lower hindleg muscles of normal and dystrophic mice was investigated. Ratios of phosphocreatine and inorganic phosphate, and of phosphocreatine and ATP increased exponentially during normal postnatal growth and differentiation. In dystrophic skeletal muscles, however, the ratios were already considerably lower during the early postnatal period, before histopathological features were observed. The ratios remained lower, relative to normal muscles, at least into the young adult stage. A deficiency in the sequestering of creatine or a defect in the phosphocreatine shuttle is proposed to explain the pathological features observed in this disorder. PMID- 3275022 TI - Hyperlipidemia as a biochemical basis of magnetic resonance plasma test for cancer. AB - An increase in the plasma levels of apoprotein B-containing lipoproteins is the basis of the magnetic resonance (MR) test for cancer. The narrow MR line width reported by Fossel and co-workers to be associated with the presence of malignant disease is due to a relative increase of very low density lipoprotein. In contrast, the plasma from healthy controls, which has a much broader spectrum, has a higher proportion of high density lipoprotein. However, plasma from patients with hyperlipidemia unrelated to cancer also show narrow MR line widths and are therefore a confounding variable. We used magnetic resonance spectroscopy (MRS) to assess the plasma from 253 patients with a range of lipid related diseases and cancer, and 28 controls. A significant difference (p less than or equal to 0.0005) of 10 Hz exists between the mean line width of the controls and hyperlipidemics without malignant disease. However, in patients with solid tumours a difference of 7 Hz (p less than or equal to 0.0005) in the mean values is recorded although there is an overlap of 6 Hz compared with the controls. Moreover the MRS method was not found to distinguish patients with lymphomas from the control population. The index was not found to be related to patient age or tumour burden. PMID- 3275023 TI - Phosphate metabolites in rat skin. AB - A model for studying the 31P NMR spectrum of rat skin without contribution from other tissue signals has been developed by creating a skin pedicle. 31P NMR spectra were obtained with a solenoidal coil, which was separated from the flank of the rat by a Faraday shield. Phosphomonoesters, inorganic phosphate (Pi) (1.63 +/- 0.12 mumols per g wet wt), phosphodiesters, phosphocreatine (PCr) (1.4 +/- 0.12 mumols per g wet wt) and ATP (1.35 +/- 0.22 mumols per g wet wt) were observed, superimposed on broader signals, probably due to phospholipids. Extracts of freeze-clamped pedicles contained concentrations of phosphorus metabolites similar to those seen by NMR. The exception was Pi which was twofold higher in the extract. The presence of the broader phospholipid contribution suggests that the signals did not arise solely from the panniculus carnosus muscle of rat skin, although this muscle was evident on histological examination of the pedicles. In extracts of normal rat skin levels of creatine, ATP, ADP and Pi were similar to those of pedicles, whereas PCr was about twofold higher. Signals from rat skin are likely to contribute to spectra of subcutaneous organs and tumours. Two kinds of rat hepatoma that contained no PCr frequently gave PCr signals from the overlying skin, whereas in three other subcutaneous tumours the contribution from skin was negligible. PMID- 3275024 TI - Four-dimensional phosphorus-31 chemical shift imaging of carcinoid metastases in the liver. AB - Four-dimensional chemical shift imaging was used to map spatial variations in phosphorus metabolites in a patient with carcinoid metastases in the liver. The results were compared to those from an age and sex matched volunteer, with no known previous history of liver disease. In the patient local abnormalities were observed. These included elevated phosphomonoester and decreased phosphodiester concentrations relative to adenosine triphosphate. The regions of abnormality corresponded to regions containing metastases identified with x-ray computed tomography and magnetic resonance imaging. PMID- 3275025 TI - In vivo 31P NMR spectroscopy of the rat cerebral cortex during acute hepatic encephalopathy. AB - During the development of acute hepatic encephalopathy, induced by acute liver ischemia, changes in brain 31P NMR spectra and EEG spectra were studied over 8:45 h in eight rats. At the end of this period the brain amino acid concentrations were determined. The results were compared with the same measurements in four normal and three portacaval shunted rats. Signs of acute HE, as judged by the EEG left index, started 5 h after the induction of acute liver ischemia. No accompanying significant changes in the cortical relative phosphocreatine and ATP concentration and intracellular pH were observed. The cortical relative Pi concentration had only slightly increased at t = 8 h. The concentrations of almost all measured brain amino acids, especially glutamine had increased at t = 8:45 h. At t = 8 h, rats with very severe HE had a small, but significant decrease of brain ATP concentrations. Their brain amino acid concentrations were more disturbed than in rats with less severe HE. It is concluded that a change in the cortical cerebral energy rich phosphate concentration is not an important pathophysiological mechanism during the development of acute HE. The observed changes in brain amino acids concentrations could be either part of a multifactorial pathogenesis or could be epiphenomena. PMID- 3275026 TI - Passive electrical isolation of double coil probes for localized spectroscopy and imaging. AB - A circuit is described for the electrical isolation of double coil probes where separate transmitter and receiver coils are both tuned to the same frequency and are coupled by mutual inductance. There are only passive components in the probe, and so no additional control signals are required for switching between transmit and receive conditions. An analysis of the operation of the circuit is included together with details of component selection and setting-up procedures, thus facilitating the implementation of the design for a variety of applications in both imaging and spectroscopy. PMID- 3275027 TI - A 31P nuclear magnetic resonance study in vivo of metabolic abnormalities in rats with acute liver failure. AB - 31P NMR spectroscopy was used in conjunction with conventional biochemical techniques to study metabolic abnormalities in normal rats, in rats with CCl4 induced acute liver failure and in rats with paracetamol-induced acute liver failure. Studies were carried out before and after a metabolic challenge in the form of a fructose infusion. Prior to fructose infusion the ATP levels in the groups with acute liver failure were significantly lower than in control rats, despite their having a similar ATP/Pi ratio. Following a fructose infusion in control animals, the changes in phosphomonoesters, ATP and inorganic phosphate were consistent with previously reported findings. However, in both test groups the percentage changes in phosphomonoesters and ATP were significantly smaller. Intracellular pH declined in control animals, but did not change significantly in the animals with acute liver failure. Fructose clearance from the blood in control animals was not significantly different from that in animals with CCl4 induced acute liver failure. Metabolic changes measured using a horizontal magnet were very similar to those obtained with a vertical magnet. PMID- 3275028 TI - Effects of repeated ischemia on cerebral blood flow and brain energy metabolism. AB - To determine if cerebral blood flow (CBF) and cerebral metabolic alterations during partial ischemia are affected by a prior interval of ischemia, 13 neonatal piglets were studied during two successive protocols (termed A and B), each consisting of an interval before, during and after partial ischemia induced by hypotension. Piglets were studied with either microspheres (n = 6) to measure CBF and calculate cerebral uptake of O2 and glucose or 31P nuclear magnetic resonance spectroscopy (n = 6) to measure intracellular pH (pHi) and cerebral phosphorylated metabolites. One piglet was used to determine time effects. Control values of all variables were similar during protocol A and B. In each protocol hypotension was associated with similar reductions in CBF and cerebral O2 uptake but cerebral glucose uptake differed (0.10 +/- 0.05 vs 0.05 +/- 0.02 mmol.min-1.100 g-1 during hypotension of A and B, respectively, p less than 0.05). During hypotension of protocol A and B similar changes in phosphorylated metabolites and pHi occurred and were characterized by a reduction in pHi, phosphocreatine and adenosine triphosphate and an increase in inorganic phosphate. Changes in phosphate metabolites and pHi were reversible within 25 min following hypotension in both protocols. Thus, changes in CBF, cerebral O2 uptake, pHi and cerebral energy metabolism are similar during repeated episodes of partial ischemia. However, differences in cerebral glucose uptake in protocol A and B raise the possibility that the balance between energy production and utilization is altered, or alternative substrates are metabolized or enzymatic activity in the glycolytic pathway is changed. PMID- 3275029 TI - The relationship between serum water proton T1 and protein content in the P388 leukemic mouse and the effect of chemotherapy by cis diamminedichloroplatinum(II). AB - Proton NMR longitudinal relaxation times (T1; 10.7 MHz; 37 degrees C) were measured in the kidneys and blood serum of mice inoculated with P388 leukemia, and/or treated with the chemotherapeutic drug cis-diamminedichloroplatinum(II) (cis-Pt). In parallel, serum total protein content, urea and creatinine levels were determined and protein fractions were separated electrophoretically. Serum T1 was found to be 1518 +/- 73 ms (1 SD) in control mice, 1670 +/- 69 ms in leukemic mice, and 1380 +/- 71 ms in the healthy and the leukemic cis-Pt treated mice. The T1 increase in leukemic serum and T1 decrease in the serum of cis-Pt injected mice are attributed to decreased and increased protein contents respectively. A detailed analysis in terms of electrophoretic fractions of serum proteins reveals that the serum relaxation rate 1/T1 is a multilinear function of the mass concentrations of the main serum protein fractions, explaining all serum T1 effects. This makes T1 a non-specific blood parameter. The kidney T1 was found to be 311 +/- 12 ms in normal mice and 334 +/- 20 ms in leukemic mice. A dramatic T1 increase is observed when the mice are injected with cis-Pt; the values are 400 +/- 38 ms and 407 +/- 39 ms for healthy and leukemic mice, respectively. This effect is related to the nephrotoxicity of the drug, as evidenced by serum urea and creatinine levels and protein content being higher than normal. PMID- 3275030 TI - pH and compartmentation of isolated perfused rat liver studied by 31P and 19F NMR. AB - The phosphorus NMR spectra of isolated perfused rat liver displays a prominent inorganic phosphate peak at 2.76 +/- 0.05 ppm relative to liver glycerolphosphocholine at 0.49 ppm. From titration curves of phosphorus containing compounds this corresponds to a pH of 7.4. The spectra also display a shoulder on the prominent inorganic phosphate peak at 2.22 +/- 0.55 ppm corresponding to a pH of 7.0. Fructose is phosphorylated in the C1 position by the liver and the resulting fructose-1-phosphate is located in the cytosol. From the titration curves, this compound was at pH 7.0. When inorganic phosphate was added to the perfusate, 13 of 25 livers showed two inorganic phosphate peaks resolved in the difference spectra, one originating from the perfusate, the other at pH 7.0. When large (50 mM) fructose doses were administered to the liver, the prominent peak decreased allowing two peaks to be resolved. FCCP treatment of the liver caused the two peaks to coalesce with the final pH of both the fructose-1 phosphate and inorganic phosphate being the same. 19F NMR of difluoromethylalanine gave an intracellular pH of 7.4 for the isolated perfused liver. The data presented do not lend themselves to satisfactory interpretation, and call into question the correctness of the traditional assignment of liver inorganic phosphate being cytosolic in origin. PMID- 3275032 TI - Blood donors to be screened for cancer virus. PMID- 3275031 TI - Recent progress in the treatment of seminoma. AB - Effective treatment for seminoma of the testicle has improved markedly since the initial reports utilizing orthovoltage radiotherapy. Contributing to this progress have been the use of chemotherapy in advanced disease and the development of a staging system to predict outcome for patients treated with radiation therapy alone. Those groups of patients manifesting poor survival with radiation have benefited from cisplatin-based chemotherapy. At the present time, 80-100% of patients with limited disease and 60-80% of patients with more advanced disease will become long-term survivors. Areas requiring further investigation include the significance of elevated HCG, extragonadal primaries, residual radiographic abnormalities following chemotherapy, and the treatment of relapse after chemotherapy. PMID- 3275033 TI - Three-drug therapy plus marrow transplants effective against metastatic breast Ca. PMID- 3275034 TI - Treatment selection in T1 and T2 vocal cord carcinoma. AB - Radiation therapy is the treatment of choice for most patients with T1 and T2 carcinomas of the vocal cord, resulting in high rates of local control and preservation of voice. Though surgical options also result in high rates of local control, vocal quality is inferior. Endoscopic laser surgery has been used only on small numbers of selected T1 lesions. Its role needs to be defined as vocal quality tends to be inferior to radiation therapy and substantial numbers of patients require additional treatment. PMID- 3275035 TI - Cranial base surgery center develops new surgical approaches. PMID- 3275036 TI - Measuring and reducing fatigue among cancer patients. PMID- 3275037 TI - More on the question of radiation vs surgery for vocal cord cancer. PMID- 3275038 TI - Adjuvant chemotherapy improves survival for colorectal cancer patients. PMID- 3275039 TI - Liposomal antibiotic more effective and less toxic in curing fungal infections. PMID- 3275040 TI - Increasing patient compliance at inner city health clinics. PMID- 3275041 TI - Long-term breast feeding linked to lower incidence of breast cancer among Chinese women. PMID- 3275042 TI - Breast cancer: management of the opposite breast. AB - Women who have or had cancer in one breast are at especially high risk for developing cancer in the contralateral breast. Other risk factors for second primary breast tumors include age, the use of radiation in treating the index cancer, and pathological characteristics of the original cancer. Management approaches range from close clinical and mammographic surveillance only to immediate prophylactic contralateral mastectomy. Routine and selective biopsy of the opposite breast at the time of treatment of the initial cancer have their proponents. The authors discuss these methods and the effect of a second cancer on overall prognosis. PMID- 3275043 TI - Three unresolved issues in the surgical treatment of melanoma. AB - The authors discuss the results of recent clinical trials on what constitutes an adequate resection margin in primary melanomas of varying thickness, concluding that it is still uncertain whether wider margins reduce the risk of regional cutaneous recurrences. Inherent in the issue of whether or not to perform elective node dissection is the difficulty of identifying patients who might benefit from the procedure. Proponents point to two recent studies, but actually the sample sizes were small. Isolated limb perfusion, while producing complete responses with long-term survival in some cases of regionally recurrent disease, is still questionable as a prophylactic treatment for high-risk primary disease. PMID- 3275044 TI - Magnetic resonance imaging. National Institutes of Health Consensus Development Conference statement. PMID- 3275045 TI - Another effective chemotherapy combination for colorectal cancer. PMID- 3275046 TI - Intraoperative radiation used to treat base-of-skull tumors. PMID- 3275047 TI - CA 125 assay--should it be used with other tests? PMID- 3275048 TI - Thin slice CT scans useful in detecting spread of oral cancer. PMID- 3275049 TI - Endobronchial brachytherapy helps lung cancer patients breathe easier. PMID- 3275050 TI - Nursing care of the head and neck cancer patient. AB - Because head and neck cancer and its treatment cause such severe morbidity, very specialized nursing care is required before, during, and after therapy and rehabilitation. All aspects of nursing, especially physical care, health teaching, and psychosocial counseling, are crucial in helping the patient and his family deal with his illness, its treatment, and the consequences. PMID- 3275051 TI - Prostaglandin antagonist being tested to help restore immune function. PMID- 3275052 TI - Managing carcinomas of unknown primary site. AB - Patients with carcinoma of unknown primary site are heterogeneous with respect to tumor biology, clinical characteristics, and response to therapy. These patients should no longer be considered uniformly "untreatable"; careful evaluation can identify treatable subsets. The initial light microscopic findings should be used to categorize patients into one of three groups: Well-differentiated adenocarcinoma, poorly differentiated carcinoma (or adenocarcinoma), and squamous carcinoma. Subsequent evaluation and treatment differ for these three groups. Poorly differentiated carcinomas are often responsive to cisplatin-based chemotherapy; effective systemic treatments are also available for some subsets of patients with adenocarcinoma. Surgery and/or radiotherapy is often beneficial for patients with squamous carcinoma, especially those who have isolated cervical lymphadenopathy. PMID- 3275053 TI - Marrow transplant and radiation improve survival in leukemia patients. PMID- 3275054 TI - Liposomal forms of doxorubicin and cisplatin in phase I trials. PMID- 3275055 TI - Minimizing the toxicity of pelvic radiation therapy in rectal cancer. AB - The acute and delayed complications of pelvic radiation therapy for rectal cancer occur with distinct clinical courses and pathological manifestations. Acute complications are common during treatment, are usually transient, and resolve within a few weeks following the completion of radiation. Delayed complications occur less frequently but are substantially more serious, with the most common being small bowel damage. With the use of more sophisticated radiation techniques, methods to exclude the small bowel from the pelvis during radiotherapy, and possibly elemental diets, the toxicity can be minimized. PMID- 3275056 TI - Diagnosing cervical cancer by measuring DNA content. PMID- 3275057 TI - Differing views of radiation vs surgery for oral cavity cancer. PMID- 3275059 TI - Many cancer patients continue strenuous exercise. PMID- 3275058 TI - Radiotherapist comments on the treatment of pharyngoesophageal Ca. PMID- 3275060 TI - The role of the CA 125 assay in the management of ovarian cancer. AB - The monoclonal antibody-based serum assay for CA 125 is a reliable indicator of tumor status in patients with ovarian cancer. This noninvasive technique also permits individualization of therapy as well as early detection of recurrence. CA 125 levels are elevated in over 80% of patients with epithelial ovarian cancers. While the level of CA 125 also is elevated in some patients with benign disease, nevertheless this assay can help differentiate benign from malignant pelvic masses, using 35 U/ml as a normal reference value. Rising, stable, or falling levels correlate with tumor progression, stability, or regression in over 90% of cases, though a rising CA 125 level may be a more reliable predictor than a falling level. Evaluation of serial CA 125 levels during initial chemotherapy is a good indicator of a patient's response to therapy as well as a good predictor of eventual outcome. Because of its high specificity, it is also hoped that the CA 125 assay will soon be used to screen for ovarian cancer. PMID- 3275061 TI - Estimating tumor doubling time via flow cytometry. PMID- 3275062 TI - Does chemotherapy really help patients with CNS gliomas? PMID- 3275063 TI - Cost of therapy should be considered in accruing patients into clinical trials. PMID- 3275065 TI - Survival rate doubles in children with non-Hodgkin's lymphoma. PMID- 3275064 TI - Thalidomide back in good graces--seems to help GVHD patients. PMID- 3275066 TI - Medulloblastoma: presentation, diagnosis and management. AB - Primitive neuroectodermal tumor or medulloblastoma (PNET/MB) is the most common malignant tumor of the brain in children. Recent progress in the management of this once almost uniformly fatal disease is illustrative of both the advances which have been made in the management of childhood brain tumors and the gaps in our understanding of childhood central nervous system malignancies. Using aggressive surgery and radiotherapy, more than 50% of children with this tumor can be expected to be alive and free of disease five years later. With detailed postoperative evaluation, children with PNET/MB can be stratified into two major subgroups: Those with an average prognosis and those with a poor prognosis. The addition of chemotherapy for children at the highest risk of relapse after treatment with radiotherapy results in an improved duration and rate of survival. However, treatment often results in significant endocrinological and intellectual sequelae. PMID- 3275067 TI - NCI mounts campaign to increase number of patients in clinical trials. PMID- 3275068 TI - The advantages of laser treatment of tumors of the larynx. AB - The carbon dioxide (CO2) laser is safe and efficacious when used in conjunction with endoscopic excision of selected premalignant and malignant tumors of the larynx. Cure rates parallel those obtained with traditional surgical instruments. Advantages of laser excision of early glottic carcinomas include greater accuracy in establishing the true extent of the disease, minimal morbidity, and cost effectiveness. PMID- 3275069 TI - Head and neck cancer patients benefit from accelerated radiotherapy. PMID- 3275070 TI - [The teaching of leprosy in medical schools]. AB - All post graduated young doctors should be conscious of our major public health problems and should be able to diagnose and treat these endemic diseases. Hanseniasis is an infectious disease that has a special affinity by peripheric nerves and for that a high potential to produce disability and deformity leading to stigma and social out cast. There are 5,546,000 known patients on the world and the WHO estimates that the real figure is around 12 million in Brasil the registered number of patient is 259,000 but realistic estimations would increase it up to half a million. The disease spreads out all over Brasil but, in absolute figures the southeast region has the highest load. To cope with this problem one the basic actions is training and the teaching of hanseniasis in medical school is essential. As a systemic disease it should be present in all specialities involved leading to an increase of time devoted to the teaching of hanseniasis. This approach, which could be extended to other endemic diseases, will contribute to the eradication of many diseases that afflict our population. There is no reason for public health budget if there is no trained personal to use it. PMID- 3275071 TI - [Current status of surgery in the comprehensive treatment of Hansen's disease]. AB - In the last decades the neural component of Hansen's disease has achieved its place of prime importance among other manifestations of the disease. Provided that there is a close relationship between neural involvement and deformities and that hitherto antileprosy drugs are able only to kill and prevent bacillary growth and not able to interrupt the immunological features of the disease, we can expect a significant load of patients with some degree of disability, including those in regular treatment. Surgery plays an important role in control programmes since it has not just the single aim to restore lost function but also to prevent further damage and to improve patient's self-confidence. PMID- 3275072 TI - [Virchowian Hansen's disease, Lucio's phenomenon, cryptococcosis]. AB - A 75 years old white male, for 3 years on treatment for virchowian hanseniasis, was admitted with active HD lesions, infiltration on the base of right lung, leg ulcer and malaise. After two days he developed purpura and hemorrhagic blisters in the limbs. The biopsy of these lesions revealed Lucio phenomenon. The patient worsened with mental confusion, psychomotor agitation and anisocoric pupils. In the 18th day of internation the patient died. Necropsy revealed virchowian infiltration plenty of bacilli in the skin and viscera as well as tuberculoid granuloma with acid-fast bacilli in the liver, spleen and bone marrow. These findings lead us to review the patient's classification from virchowian to borderline. In the lungs, leptomeninge, renal papile, prostate and thyroid it was found loose tuberculoid granuloma with a great amount of fungi surrounded by a gelly halo resembling Criptococcus neoformans. These findings and the onset of Lucio phenomenon are discussed in a patient that has been treated for 3 years and still having several virchowian lesions and a great amount of acid-fast bacilli. PMID- 3275073 TI - [13th International Congress on Hansen's Disease. Haia, Holanda, Sept. 1988. Abstracts]. PMID- 3275074 TI - Hypo/hyperthermia blankets. PMID- 3275075 TI - Gas-powered resuscitators. PMID- 3275076 TI - Professional liability: nurses need protection. PMID- 3275077 TI - Competence: a career-long responsibility. PMID- 3275078 TI - [Prospective study of risk factors in pregnant adolescents]. PMID- 3275079 TI - [Co-existence of intraepithelial neoplasms of the uterine cervix and condyloma latum. Analysis of diagnostic distortions induced by condylomas]. PMID- 3275081 TI - State legislative changes affecting nursing. PMID- 3275080 TI - [Parametrial evaluation by puncture biopsy in recurrent uterine cervix cancer]. PMID- 3275082 TI - Regulation of allied health practitioners. PMID- 3275083 TI - Legislation related to acquired immune deficiency syndrome. PMID- 3275084 TI - Nurse appointment to boards and commissions. PMID- 3275085 TI - Legal issues affecting nursing. PMID- 3275086 TI - State legislative changes affecting nursing. PMID- 3275087 TI - Nurse appointment to boards and commissions. PMID- 3275088 TI - Malpractice and testing legislation. PMID- 3275089 TI - A supplement published by the Medico-Geographical Section of the Hungarian Geographical Society on behalf of the Working Group on Geography of Health of the International Geographical Union. PMID- 3275090 TI - Brucellosis in the upper Nile region--Melut district, Sudan (report). AB - In the Melut district, South Sudan human and animal blood samples were investigated for Brucella abortus and Brucella melitensis. 9.2% of the investigated cattle and 16.2% of the green long-tailed monkies were Brucella abortus-positive. School children revealed a 3.7% positivity rate, Melut's hospital patients 5.2% and village children and adults 2.2%. However, only a small number of hospital patients was investigated. A small percentage of sheep and goats was investigated for Brucella melitensis revealing 12% positive results. 8.7% of cattle were positive. 2.2% of school children reacted in high titers against Brucella melitensis, 5.2% of Melut's patients and in the Melut district 3.6% of children and adults. PMID- 3275091 TI - The importance of toilet facilities and their proper use by the population of Melut, South Sudan. AB - Particularly in recent years one has recognized the great importance of hygienic removal of faeces in the prophylaxis of intestinal infectious diseases and parasitosis. Numerous models have been carried out in various areas and the World Bank has financed its own projects for this purpose. The models however, had to be suited to each country and district and also the living habits and conditions of the ground-water etc. The often desired water flushing toilets (or even chemical camping toilets) from certain people in the developing countries are at present to be carefully considered due to the insoluble drainage and fresh water problems. PMID- 3275092 TI - Noninvasive quantification of regional myocardial blood flow and ammonia extraction fraction using nitrogen-13 ammonia and positron emission tomography. AB - This report describes the theoretical basis and a method to quantitate regional myocardial blood flow (RMBF) and ammonia extraction fraction (E) in man, noninvasively, with N-13 ammonia and positron emission tomography (PET). Two patients with hypertrophic cardiomyopathy, whose left ventricular (LV) walls were markedly thick, were employed in this study to avoid partial volume effects and cross contamination between LV walls and blood pool. RMBF and E were calculated from time-activity curves of myocardial tissue and left atrium derived from serial 6-second PET images of the heart. The time-activity curve of left atrium was used as an arterial input function. The results were RMBF = 67 +/- 4 ml/min/100 g, E = 80 +/- 13% and 65 +/- 10 ml/min/100 g, 81 +/- 16% for each patient. The validity of the present method was discussed. PMID- 3275093 TI - Measurements of serum-free thyroid hormone concentrations by ultrafiltration--a comparison with equilibrium dialysis and mathematical calculation. AB - An ultrafiltration method (UF) for measuring free thyroxine (FT4) and free triiodothyronine (FT3) using the Diaflow YM membrane (Centricon-10) is described. The results are compared with those by equilibrium dialysis (ED) and also by mathematical calculations derived from T4, T3, and binding protein concentrations. The precision with the UF method was excellent. The normal ranges of FT4 and FT3 by the three methods are all comparable. There was a high degree of correlation of FT4 or FT3 results by UF with those by ED and by calculation (r = 0.940-0.974, n = 161, P less than 0.001). FT4 and FT3 by all methods agreed well for hyperthyroidism, hypothyroidism, and for patients with low T4-binding globulin. The mean FT3 in pregnancy was lower than the normal value for all methods, and FT4 concentrations by UF and calculation also decreased in late pregnancy. The mean FT4 by UF and ED in low T3 syndrome were significantly higher than in the normal controls, while the calculated FT4 was lower. The FT3 in low T3 syndrome distributed normal to subnormal in all methods. These results indicate that a) the UF method is a reliable reference method for measuring FT4 and FT3 concentrations; b) the UF results agree well with those by ED and also with theoretically derived values in subjects with thyroid diseases and TBG abnormalities; c) for patients with low T3 syndrome, the FT4 results obtained by UF and ED are similarly discrepant from the calculated results, implying the existence of binding inhibitor(s) which affect both UF and ED measurements. PMID- 3275094 TI - Evaluation of diffusely high uptake by the calvaria in bone scintigraphy. AB - The present study was undertaken to evaluate the finding of diffusely high uptake by the calvaria in a series of 994 consecutive whole body scans in regard to the incidence and degree, and to discuss the mechanism. A total of 86 patients had positive scans (73 women and 13 men) and there were 71 malignant (27 breast, 16 lung, and 28 other malignancies), and 15 benign disease cases (5 degenerative bone, 3 blood, and 7 miscellaneous diseases). Positive rate of the finding was 8.7% in total, 14.9% in women, and 2.6% in men. The difference between women and men was significant (P less than 0.001). The finding was significantly correlative with the ages of patients. Also the finding is shown to be predominant in women ranging 50-59 years of age. On the other hand, the same finding as was made by Creutzig and his coworker was confirmed in malignant cases under high-dose anticancer drug therapy. On the basis of these results, the finding may be not only a side effect of intensive cytotoxic medication on the skeleton, but also a physiological event relative to bone change with age and postmenopausal osteoporosis. PMID- 3275095 TI - Iodine-123 IMP SPECT before and after bypass surgery in a patient with occlusion of left anterior and middle cerebral arteries with basal abnormal telangiectasis (unilateral Moyamoya disease). AB - A case of left anterior and middle cerebral arterial occlusion with angiographic features similar to Moyamoya disease was reported. IMP SPECT of the patient revealed the success of bypass surgery clearly. The patient complained of transient right hemiparesis with aphasia 4 times. The cerebral arteriography disclosed occlusions of left anterior and middle cerebral arteries at their proximal portions. Right internal carotid and its branches were normal. I-123 IMP SPECT study showed hypoperfusion in left temporal lobe, basal ganglia with incomplete reperfusion on the delayed (4 hours after injection) SPECT images. After the superficial temporal-middle cerebral artery anastomosis, I-123 IMP SPECT showed improvement of the brain blood flow. I-123 IMP SPECT was very useful in detecting the ischemic areas and evaluating the revascularizing surgery in this case. PMID- 3275096 TI - Scintigraphic assessment of double-chambered right ventricle. AB - A double-chambered right ventricle is often clinically misdiagnosed and may be missed even during cardiac catheterization. We encountered a 56-year-old male who had abnormal right ventricular thallium-201 uptake and a photon deficient area in the right ventricle by radionuclide cardioangiography. These findings strongly suggested the existence of anomalous muscle band in the right ventricle. It was demonstrated by contrast angiography that the right ventricle was divided into two chambers by a hypertrophic muscular band; the pressure gradient in the right ventricle was 98 mmHg. PMID- 3275097 TI - Metabolism of 2-deoxy-2-[18F]fluoro-D-glucose: presence of 2-deoxy-2-[18F]fluoro D-glucose 6-phosphate in plasma of mice, rats, and humans. PMID- 3275098 TI - Evolutionary changes in left and right ventricular function in acute myocardial infarction. AB - To determine the evolutionary changes in right and left ventricular function in acute myocardial infarction, 3 serial gated blood pool scans were performed in 76 patients within 24 hours (24 H), at 10 days (10 D) and 3 months (3 M) following the onset of myocardial infarction. The patients were divided into 3 groups: ANT (anterior MI), INF (inferior MI without right ventricular dysfunction) and RVF (inferior MI with right ventricular dysfunction). LVEF in ANT was significantly lower than that of INF and RVF at 24 H, 10 D and 3 M. The ratio of right ventricular volume to LV volume (RVV/LVV) was compared among 3 groups. The mean values of RVV/LVV in RVF were 1.3 through 24 H and 3 M and they were significantly higher than the other two groups. The RVV/LVV in ANT and INF were around 1.0. LVEDVI in RVF was rather smaller than that of ANT and INF. LVESVI in ANT at 24 H was significantly larger than that of INF and RVF and the mean value of LVESVI in ANT were around 60 ml/M2 from 24 H to 3 M. LVEF in ANT, RVF and INF did not increase significantly during peak exercise at 3 M. However, quantitative regional wall motion analysis revealed that regional wall motion of R2 (posterolateral wall motion) in ANT and R5 (septal wall motion) in INF decreased significantly during peak exercise. These impairments in regional wall motion might be due to the exacerbation of ischemia of non-infarcted area. PMID- 3275099 TI - Radioimmunodetection of human pancreatic tumor xenografts using DU-PAN II monoclonal antibody. AB - The potential of DU-PAN II, monoclonal antibody (IgM), which was raised against the human tumor cell line, was evaluated for radioimmunodetection of human pancreatic tumors (PAN-5-JCK and EXP-58) grown in nude mice. 125I-labeled DU-PAN II was accumulated into PAN-5-JCK producing DU-PAN II antigen with a tumor-to blood ratio of 2.72 +/- 3.00, but it did not localize in EXP-58 because of insufficient DU-PAN II. There was no significant uptake of 125I-nonimmunized IgM in PAN-5-JCK. These facts indicated the specific tumor uptake of DU-PAN II. Excellent images of the tumor PAN-5-JCK were obtained 3 days after the injection of 125I-DU-PAN II. Gel chromatography was also investigated with respect to the plasma taken from mice injected with antibody, or incubated with antibody in vitro. The results indicate that circulating antigen affected the tumor uptake of DU-PAN II: The more the tumor grew, the higher the amount of antigen excreted into the blood, leading to the degradation of DU-PAN II before it reached the tumor sites. Consequently, the immunoscintigram of the small tumor was remarkably clear. The catabolism and the radiolysis of the labeled IgM injected are critical points in applying immunoscintigraphy. PMID- 3275100 TI - Quantitative assessment of cerebral blood flow using technetium-99m-hexamethyl propyleneamine oxime: Part I, Design of a mathematical model. AB - To design a mathematical model for quantifying cerebral blood flow using 99mTc hexamethyl-propyleneamine oxime (HM-PAO), basic studies were performed in animals and human volunteers. Microautoradiography revealed that HM-PAO crossed the blood brain barrier. Thin layer chromatographic studies demonstrated the rapid disappearance of free HM-PAO in the brain tissue. Back diffusion from brain to blood was found negligible. From these observations, the familiar microsphere model was employed in the measurements of blood flow with HM-PAO. This, however, resulted in much lower flow values than simultaneously obtained values with the labeled microspheres. This underestimation was ascribed to the high affinity of HM-PAO to blood cells and serum protein. Taking the binding of HM-PAO to blood components into consideration, the following model equation was designed for quantifying cerebral blood flow: Ce(t) = Ca(t)-kCa(t)*exp(-kt), Cb(T) = F integral of T0 Ce(t)dt, where Ce and Ca are the free HM-PAO concentration in the intravascular space and the arterial whole-blood concentration of HM-PAO, respectively, as a function of time (t), Cb is the brain activity concentration, k is the rate constant for the binding of HM-PAO to the blood components, F is the blood flow value, T is time of measurement, and * denotes the operation of convolution. In clinical studies, Ca(t) and Cb(T) are obtainable from a dynamic single photon emission computerized tomographic study of the brain and multiple arterial blood sampling, respectively. The values for F and k can be estimated using a nonlinear least squares fitting method. PMID- 3275101 TI - Radioimmunoscintigraphy of xenografted human thyroid carcinoma. AB - We developed monoclonal antibodies against human thyroid cancer-associated antigen by fusing mouse myeloma cells with mouse spleen cells immunized by insoluble fraction of homogenized thyroid papillary carcinoma cells. One monoclonal antibody (KTC-3, IgM) was selected to evaluate basic usefulness for radioimmunoscintigraphy in xenografted human thyroid carcinoma. KTC-3 was labeled with 131I by Iodogen method of 20 to 1 Iodogen to IgM molar ratio. It was also labeled with 111In by cyclic DTPA anhydride method of 20 to 1 DTPA to IgM molar ratio. The labeling efficiency and specific activity for 131I labeling were 16.5% and 0.66 mCi/mg IgM respectively, and those for 111In labeling were 12.7% and 1.6 mCi/mg IgM. Imaging and biodistribution of labeled KTC-3 were evaluated in nude mice bearing thyroid anaplastic carcinoma (THC-5-JCK). The tumors were well visualized 3 and 5 days after injection of 131I KTC-3. Tumor uptake of 131I KTC-3 on day 7 was 0.52 +/- 0.27% ID/g and tumor to blood ratio was 1.98 +/- 0.76 (n = 6). Those of 111In KTC-3 were 0.88 +/- 0.09% ID/g and 5.51 +/- 3.36 (n = 6). In conclusion, KTC-3 is promising for radioimmunoscintigraphy of thyroid cancer. PMID- 3275102 TI - Experimental study of iron effect on the liver function. AB - The effect of iron on the liver function was studied in rats. A total of 40 rats were divided into four groups. Group 1 was given iron; Group 2, carbon tetrachloride; Group 3, a combination of iron and carbon tetrachloride; and Group 4 was the control. The changes in liver function were evaluated by using hepatobiliary and liver scintigraphy as the index of hepatocyte function and reticuloendothelial system function, respectively. Determination of liver CT number and a histological study were made at the same time. The administration of iron activated the reticuloendothelial system function per unit of liver weight. However, because of the decrease in liver weight, the total reticuloendothelial system function did not change at all. In the group given iron and carbon tetrachloride, liver cirrhosis and siderosis in the reticuloendothelial system occurred. Dysfunction in the reticuloendothelial system was more severe in this group than in the group given carbon tetrachloride only, by hepatocyte dysfunction was more mild. It is doubtful that the administration of iron after liver dysfunction had developed, which caused acceleration of fibrosis and reduction of liver blood flow, led to the enhancement of the reticuloendothelial system dysfunction. PMID- 3275103 TI - Gallium-67 scintigraphy in patients with hemochromatosis treated by deferoxamine. AB - Gallium scintigraphy was performed as an aid for determining the presence or absence of malignant neoplasm in two patients with hemochromatosis treated by deferoxamine. However, gallium scan images could not be obtained. So gallium scintigraphy was performed once more to investigate the cause of low activity. Both patients had heavy urinary excretion of gallium in the first 24 hrs after the injection, and activity was very low on the day of examination. This phenomenon may be attributed to the effect of deferoxamine which is highly bound to the gallium. PMID- 3275104 TI - Mucociliary clearance in pulmonary vascular disease. AB - The mucociliary clearance function was studied by radioaerosol inhalation lung cinescintigraphy and its quantification in 8 patients with pulmonary vascular diseases; pulmonary embolism, 5 cases, and right pulmonary artery hypoplasia, pulmonary arteriovenous fistulas, aortitis syndrome, 1 case each. The mucociliary clearance function was found to be well maintained in pulmonary vascular diseases unless ventilation was disturbed. There was no difference in the mucociliary clearance function between pulmonary embolism and other pulmonary vascular diseases. PMID- 3275105 TI - Increased accumulation of iodine-123-IMP in the pulmonary inflammatory lesion surrounding a lung cancer. AB - In a patient with primary lung cancer, increased accumulation of I-123-IMP was observed in a pulmonary inflammatory lesion surrounding a lung cancer which was delineated as a photon deficient area. Ga-67-citrate uptake was observed in both the inflammatory and cancerous areas. These findings suggest that I-123-IMP may have the potential to accumulate differently in a variety of pathological conditions of the lung and thus may be a clinically useful lung imaging agent. PMID- 3275106 TI - Measurement of arterial time-activity curve by monitoring continuously drawn arterial blood with an external detector: errors and corrections. AB - Accurate description of the arterial time-activity curve (ATAC) is of paramount importance in quantitative determination of the regional cerebral blood flow (rCBF) using positron tomography following bolus i.v. injection of 0-15 labeled water. Frequent manual sampling from an arterial catheter does not permit sampling in less than 5-sec intervals and runs the risk of missing the arrival time or the peak count. A continuous ATAC monitoring system has been developed. This system consists of a single bismuth germinate detector in a lead shield and a constant-flow aspirator. The arterial blood was drawn continuously from a catheter within the brachial artery into an extended tube and its activity was monitored by the detector as the detector time-activity curve (DTAC). Comparison with the manual sampling from the contralateral brachial artery in the same run revealed that the DTAC differed from the manual sampling not only in delayed arrival but also in the shape of the curve, which was dispersed because of viscosity and the width of the detector field of view. However, deconvolution of DTAC using the experimentally obtained system step response provided an accurate arterial time course, which successfully filled in the gaps of the manual sampling. Moreover, water and blood showed different dispersion in the step response, suggesting that the system function should be determined using blood or a fluid of similar hydrodynamic nature. PMID- 3275107 TI - Improved image quality with elliptical orbits and distance-weighted backprojection SPECT reconstruction. PMID- 3275108 TI - Chemical properties of technetium-99m-DL-homocysteine, a possible tumor-imaging agent. AB - The chemical properties of 99mTc-DL-homocysteine (99mTc-Hcy) showing high accumulation in several experimental tumors were investigated. The form of tumor tropic 99mTc-Hcy was a polymeric complex which appeared at void volume on Sephadex G-15 by eluting with 5 mM Hcy. This complex changed into smaller complexes of ca. 600 molecular weight in the presence of 150 mM NaCl and 5 mM Hcy, suggesting that 99mTc-Hcy was a complex composed of smaller polymers which are weakly bound together by an ionic bond. The complex showed a negative charge. The Hcy/Tc molar ratio in the complex was approximately 2 and no Sn was detected. PMID- 3275109 TI - The effect of FeCl3 on the accumulation of gallium-67 into inflammatory and normal tissues. AB - The effect of FeCl3 on the uptake of 67Ga by inflammatory and normal tissues was studied to clarify the role of transferrin in 67Ga uptake by inflammatory tissue. The administration of FeCl3 5 min before the injection of 67Ga decreased the uptake of 67Ga by liver and spleen, but had little effect on the uptake of 67Ga by the inflammatory tissue. These results suggest that 67Ga is taken up by normal tissues in a transferrin-bound form but in an unbound form by inflammatory tissue. On the other hand, when FeCl3 was simultaneously injected with 67Ga, the uptake of 67Ga by liver and spleen was markedly increased but the uptake by inflammatory tissue was decreased. PMID- 3275110 TI - Analysis of thallium-201 myocardial SPECT images using fuzzy set theory. AB - Using the fuzzy set theory, a method was developed for analyzing the extent and severity of ischemia by comparing the exercise and delayed SPECT images with Thallium-201. For each short axial image (slice) for exercise and delayed study, a defect probability matrix (DPM) is created so that it shows the severity of ischemia of myocardium in that slice. Each slice is divided into 8 equi-angle sectors, and the left ventricle (LV) also is divided into 8 equi-angle vertical sectors from apex to base. Using DPMs, the defect probability is calculated for each slice, sectors of each slice and vertical sectors of the LV. The results are displayed on a CRT by means of images, curves and histograms. They show what percentage of the area of each slice and that of the lateral, anterior, septum and inferior portions have how much defect. They provide comprehensive and easily understood information about the condition of the LV in exercise and delayed stages. Persistent and transient ischemia can be diagnosed by visual comparison of patients' curves and histograms with their corresponding normal limits. PMID- 3275111 TI - Development of new immunoradiometric assay for CA 125 antigen using two monoclonal antibodies produced by immunizing lung cancer cells. AB - CA 125 is an antigen associated with non-mucinous epithelial ovarian cancer, which is defined by OC 125 antibody developed by immunizing ovarian cancer cells. We have produced two monoclonal antibodies, 130-22 and 145-9, by using the human lung adenocarcinoma cell line PC-9. Both 130-22 and 145-9 antibodies recognized CA 125 antigen. However, the binding sites seemed to be separate from those of OC 125. Testing by 9 immunoradiometric assays (IRMA), using different combinations of the 3 monoclonal antibodies 130-22, 145-9 and OC 125 demonstrated that the best standard curve for detecting CA 125 could be obtained by a "simultaneous sandwich" assay based on a mixture of 125I-labeled OC 125 and 130-22 or 145-9 coated beads. One-step IRMA, using 130-22 as a tracer and 145-9 as an immunoadsorbent, also showed good reproducibility and sensitivity for measuring CA 125. Antigens were detectable in the culture supernatants of PC-9 cells and 5 of 6 ovarian cancer and endometrial adenocarcinoma cells. These results indicate that one-step IRMA using 130-22 and 145-9 is useful for detecting CA 125 antigen. PMID- 3275112 TI - A case of unexpected gallium-67 uptake by sternum in non-Hodgkin's lymphoma with pleuritis. AB - A case of non-Hodgkin's lymphoma with pleural effusion was presented. Pleural effusion is not a common manifestation of this disease and 67Ga-citrate scintigraphy gave the clue for the diagnosis. The possibility of malignant lymphoma should be considered in cases with pleural effusion, and we showed that 67Ga-citrate scintigraphy can be useful in a case with pleural effusion of undetermined cause. PMID- 3275113 TI - Phase plane (volume to volume-time function loop) display of data from radionuclide ventriculography obtained by single cardiac probe system. AB - To assess the left ventricular (LV) performance more sensitively, a new display method of phase plane (PP), displaying volume and volume-time function (dV/dt) in a single image, was applied to radionuclide ventriculography obtained by a single cardiac probe system. The sampling interval was 10 msec and the data acquisition time was 60 sec. The LV volume curve was smoothed by fitting a fourth order polynomial curve of Fourier's analysis. Then the dV/dt was calculated. In this single image PP display, the width of the horizontal axis indicates relative LV volume, and the height of the vertical axis indicates dV/dt. The direction of the rotation of this loop is clockwise. We classified 126 patients with various heart diseases into seven groups, according to the configuration of the loop. The most interesting finding was that the distortion of the loop during diastole was frequently seen in patients with hypertension and angina pectoris, whereas their ejection fraction was within normal limits. We concluded that the single image PP display is a sensitive method for assessing the abnormality of the LV function, not only by evaluating the conventional parameters, but also by analyzing the configuration of the volume to volume-time function loop. PMID- 3275114 TI - Time range analysis of evoked potential fields. AB - Potentials evoked by contrast reversing grating stimuli of different spatial frequency and orientation were recorded in 16 channels from twelve healthy adults. The amount of electrical brain activity was quantified independent of the reference electrode by the computation of global field power (GFP). Maxima of the GFP function over times, determined component latencies which turned out to be influenced by spatial frequency and orientation. Both effects were statistically significant. Analysis of GFP at component latencies demonstrated the significant influence of spatial frequency on the amount of activity in the potential fields, whereas different stimulus orientations yielded brain activity of similar strength. Component location on the scalp determined at P100 latency showed no systematic variation with spatial frequency or orientation of the grating pattern. A reference-free topographic segmentation procedure based on the statistical recognition of stable potential field configurations disregarding amplitude characteristics, was used for all subjects and stimulus conditions. Segments were identified over the whole recording epoch and were interpreted as time epochs with identical potential field configurations, that were compatible with identical neuronal generators. The sequence of such segments was further analysed and compared statistically between subjects and stimulus conditions. The results showed topographical differences that were not observed when only selected time points at component latency were considered. PMID- 3275115 TI - Topographic distribution of the 40 Hz auditory evoked-related potential in normal and aged subjects. AB - Galambos, Makeig and Talmachoff (1981) described what they called the 40 Hz event related potential (ERP). This steady-state response is an EEG following response to repetitive auditory stimulation which becomes sinusoidal in form and maximal in amplitude at rates between 35 and 45 Hz. The present study was designed to examine the scalp topography of the 40 Hz ERP in order to complement previous magnetoencephalographic studies which implicate auditory cortex in the generation of the response. In addition, this study was designed to collect normative data on an aged sample in order to assess the effects of aging on the response. 40 Hz ERP's were recorded from a group of seven audiometrically and neurologically normal elderly subjects (mean age = 69.6 years) and a younger group of five normal adults (mean age = 38.0 years), using 1000 Hz tones presented binaurally at 40 per second. A 21 channel recording system was used to obtain a comprehensive picture of the scalp distribution of the response. Recorded ERP's were Fourier transformed to enhance the signal-to-noise ratio. No significant differences were found in phase or amplitude of the 40 Hz ERP between the two age groups, indicating that the normal aging process does not have an effect on this response. Topographic maps of the 40 Hz ERP showed reversals of electrode potential in temporal regions, supporting an interpretation of bilateral sources in temporal cortex. The data presented in this study complement previous studies of the 40 Hz event-related magnetic field and support the position that temporal cortex is involved in the generation of the response. PMID- 3275116 TI - Statistical classification of spikes in benign rolandic epilepsy. AB - The occurrence of spikes during an electroencephalogram is a basic feature of Benign Rolandic Epilepsy of Childhood (BREC). In this study we addressed the question of whether the interictal spike structure is different between "typical" and "atypical" BREC patients. Atypical BREC patients are characterized by having other neurological abnormalities in addition to the typical BREC symptoms. This question is of interest given the good prognosis associated with the typical form of BREC. We analyzed data from 12 typical and 12 atypical BREC patients using ten variables to describe spike morphology and topography. The non-parametric method of "classification and regression trees" (CART) was used to detect discriminating features and construct a classification rule. In this way the location and amplitude of the spike were found to provide satisfactory discrimination, suggesting that the two groups may be affected by different epileptic processes. The study showed the effectiveness of the CART methodology in dealing with the categorical and non-normal variables that can be obtained from EEG records. It illustrates a simple but logical approach to the analysis of potentially complex topographic data. PMID- 3275117 TI - Brain mapping or spatial analysis? PMID- 3275118 TI - The view of an EEG-EP mapper. PMID- 3275119 TI - An eigenfunction approach to the inverse problem of EEG. AB - A mathematical method of extracting salient features from electroencephalographic data called eigenfunction analysis is presented. It allows the reduction of 21 channels of EEG data to a few components which can be separated into those which are likely to originate relatively close to the surface and others of deeper origin. It was demonstrated that the original tracings can be reconstituted from these few components. The eigenvectors given an indication of the location of sources and the degree to which the eigenfunction appears on source derivation and average reference recordings allows an estimation of relative depth. The method has been successfully applied to EEG tracings from 10 patients and is illustrated in the case of a young woman suffering from complex partial seizures associated with a deep left temporal lesion. The implications for marked data reduction and the development of objective assessment of clinical neurophysiologic data are discussed. PMID- 3275120 TI - Topographic mapping of the EEG: an examination of accuracy and precision. AB - The accuracy and precision of topographic maps depicting scalp potentials and scalp potentials squared have been examined. Electrode placement was that specified by the International 10-20 System and the methods of interpolation bilinear and bicubic spines. The results indicate that, for these interpolation methods, the maximum error expected between the measured scalp quantities and those predicted by interpolation is positively correlated to the root-mean-square value of the measured quantity. Both interpolation methods produce accurate estimates of the interelectrode quantities. Both methods produce precise estimates of the scalp potential in the delta, theta and alpha frequency bands but only poor estimates in the beta band. The precision of the estimates of the scalp potentials squared is poor in all frequency bands. This result indicates that another look at the now common practice of topographically mapping the power spectral components of the EEG is in order. In general, the bilinear and bicubic spline methods of interpolation perform about equally. This result is used to suggest that because of its additional computational complexity, use of the bicubic method for potential mapping may not be warranted. Advantages of the bicubic method, particularly in radial-current mapping, are however discussed. PMID- 3275121 TI - The use of immobilized ferrite to enhance the depth selectivity of in vivo surface coil NMR spectroscopy. AB - Ferrite particles immobilized on a flexible support and arranged in a specific pattern will produce localized gradients in the homogeneous B0 magnetic field. The screening gradients are strong enough to cause inhomogeneous broadening of the NMR signals arising from the region of a specimen which is adjacent to the ferrite particles. This technique allows improvement of the depth selectivity in non-invasive surface coil NMR spectroscopy while optimizing both the signal-to noise ratio and the data acquisition time of in vivo NMR experiments. The ferrite screen method also facilitates the routine application of high resolution NMR pulse sequences to in vivo experiments. The technique is readily implemented without special hardware or software and displays a great versatility in the size, shape and depth of the screening effect. PMID- 3275122 TI - Direct determination of ADP in hypoxic porcine carotid artery using 31P NMR. AB - 31P-NMR spectroscopy was performed on vascular smooth muscle (VSM; porcine carotid artery) superfused with a substrate-free high K(+)-PSS. Scans were collected before (control), during (hypoxia), and after (post-control) hypoxia, and chemical measurements of ATP (0.070 +/- 0.13 mumoles/g wet wt.) and creatine (2.04 +/- 0.14 mumol/g wet wt.) were made. During hypoxia, well-defined beta-ADP signals were consistently resolved. Their areas indicated that after 30, 60, and 90 min of hypoxia, free ADP was 0.05 +/- 0.01, 0.09 +/- 0.01, and 0.12 +/- 0.01 mumol/g wet wt., respectively. The apparent tissue equilibrium constant (Kck) for creatine kinase (CK) was calculated using 90 min hypoxic data and was 7.6 +/- 0.6 x 10(8) M-1. It was used to compute free ADP levels (mumol/g wet wt.) for control (0.028 +/- 0.002) and post-control (0.23 +/- 0.003) periods, since ADP signals could not be directly detected, and for the 30 and 60 min hypoxic periods (0.05 +/- 0.01 and 0.08 +/- 0.01, respectively). The Kck-dependent ADP values for the 30 and 60 min hypoxic periods periods were the same as the ADP values determined directly from the beta-ADP peak areas, suggesting that the CK reaction is in equilibrium in smooth muscle. These data show that 31P-NMR provides a means of directly measuring free ADP in hypoxic smooth muscle and a more accurate means of computing free ADP levels in normoxic VSM through the use of an in situ tissue Kck vs an assumed or in vitro Kck. PMID- 3275123 TI - The effect of methotrexate upon tumour ATP as determined by in vivo 31P inversion spin transfer. AB - The effect of methotrexate upon tumour growth in the hind leg muscle of rats containing a transplanted mammary adenocarcinoma was investigated by 31P magnetic resonance spectroscopy. Using inversion-transfer techniques, ATP resonances arising from the tumour could be distinguished from those arising from surrounding skeletal muscle. Methotrexate was shown to inhibit, but not prevent, tumour growth as evidenced by the tumour ATP resonances of methotrexate treated animals compared to those of control animals. These findings correlated with decreased tumour volume and enhanced life expectancy. PMID- 3275124 TI - Evaluation of manual methods for integration of in vivo phosphorus NMR spectra. AB - Eight human subjects measured peak integrals from a set of simulated 31P NMR spectra by triangulation, by extrapolation of tangents from the baseline of computed integrals, and by cursor demarcation of computed integrals using standard commercial software. The test spectra were qualitatively similar to phosphorus spectra routinely acquired from mammalian skeletal muscle. All three of the above methods were found to underestimate the areas of relatively broad peaks (e.g., ATP peaks were underestimated by 20-40%), even when the peak signal/rms-noise ratio was better than 8/1. This bias resulted in major errors in calculated metabolite ratios. Of the three methods, triangulation was the least accurate, and showed the greatest variation between subjects. Cursor demarcation of computed integrals was the most accurate manual method. The same test spectra were also integrated by two fully-automated fitting algorithms. Although not free of bias, these methods were generally superior to the manual methods. PMID- 3275125 TI - Spectroscopy and imaging with a 4 tesla whole-body MR system. AB - Magnetic resonance (MR) spectroscopy and imaging experiments on humans were performed with a whole-body MR system at a static field of 4 tesla. Spectroscopic studies focussed on 1H, 13C, and 31P. Imaging of humans turned out to be possible, although below the optimum at this field. This holds especially for body imaging, since RF penetration effects and dielectric resonances influence the RF field homogeneity. Excellent volume selective proton spectra of the human cerebrum and cerebellum were obtained using the stimulated echo method. Natural abundance carbon spectra of the human calf were acquired both undecoupled and with narrowband decoupling, resolving the various triglyceride resonances. Broadband decoupling, however, would have violated SAR guidelines. Liver glycogen was detected on natural abundance 13C spectra. PMID- 3275126 TI - Regional spheres of immunologic influence. PMID- 3275127 TI - Prevention of suppression of alloreactive capacity following intravenous injection of neuraminidase-treated allogeneic cells by co-injection of agents competing for asialoglycoprotein receptor. AB - Intravenous (i.v.) administration of neuraminidase (Nase)-treated allogeneic lymphocytes resulted in the complete abrogation of the capacity to develop delayed-type hypersensitivity (DTH) responses to the relevant alloantigens (tolerance induction). The Nase treatment did not influence the antigenicity of allogeneic lymphocytes, as subcutaneous inoculation of Nase-treated cells was capable of generating comparable anti-allo-DTH responses to those induced by untreated allogeneic cells. However, Nase-treated lymphocytes were revealed to exhibit strikingly enhanced reactivity to the lectin peanut agglutinin (PNA) as well as adhesion to hepatocytes in the primary culture. Such enhanced PNA reactivity was inhibited by lactose but not by maltose, and enhanced hepatocyte adhesion was also inhibited by N-acetyl-galactosamine (GalNAc) but not by N acetyl-glucosamine (GlcNAc), indicating augmented reactivity of Nase-treated cells to Gal/GalNAc-specific receptors on hepatocytes. It was also demonstrated that i.v. infusion of Nase-treated, 51Cr-labeled lymphocytes leads to an increased radioactivity in the liver and that this enhanced retention of radioactivity can be inhibited by the co-injection of Nase-treated, unlabeled syngeneic erythrocytes. Most importantly, the co-injection of Nase-treated allogeneic lymphocytes and Nase-treated erythrocytes resulted in the prevention of the suppression of anti-allo-DTH responses as induced by the injection of Nase treated allogeneic cells alone. These results indicate that Nase-treated allogeneic cells are entrapped in the liver in a strikingly increased way through their enhanced reactivity to Gal/GAlNAc receptor of the liver and suggest that such enhanced entrapment by the liver has a crucial role in inducing anti-allo DTH tolerance. PMID- 3275128 TI - Intraduodenal application of cholera holotoxin increases the potential of clones from Peyer's patch B cells of relevant and unrelated specificities to secrete IgG and IgA. AB - Although it has been established that cholera toxin is both an effective mucosal immunogen and adjuvant, the mechanism by which it acts has not been determined. The relative contributions of the pharmocologic and binding capacities of holotoxin have been assessed by comparing holotoxin, acid dissociated B subunit, and B subunit from the Texas Star variant, which is deficient in production of the A subunit, for their ability to generate toxin-specific precursors in vivo that give rise to clones secreting exclusively IgA in vitro. In this way we demonstrated that although B subunit is as immunogenic as the holotoxin, pharmacologic activity appears to play a role in the generation of IgA-committed precursors. In addition, intraduodenal (i.d.) application of holotoxin can act to alter the isotype display of previously primed B cells in Peyer's patches (PP) specific for a chemically unrelated hapten resulting in an increase in the proportion of their clones that secrete IgA or IgG and a decrease in the proportion that secrete IgM following antigen-dependent in vitro clonal expansion. Intraduodenal application of cholera toxin did not appear to nonspecifically increase the proportion of IgA-committed precursors as judged by staining for sIgA and mRNA alpha levels. However, following i.d. application of cholera toxin, an overall downward shift in the levels of sIgD and s kappa was observed in the PP B cell population. We suggest that the holotoxin can nonspecifically affect the isotype display of PP B cells by altering their responsiveness to the stimuli present in the in vitro cultures. PMID- 3275129 TI - Recombinant bovine interferon-alpha I 1 inhibits the migration of lymphocytes from lymph nodes but not into lymph nodes. AB - Recombinant bovine interferon-alpha I 1 (IFN-alpha) was tested for effects on lymphocyte migration into and out of the lymph nodes of sheep. Chronic lymph drainage methods were used to monitor the efferent lymph of single lymph nodes of unanaesthetized animals. When IFN-alpha was injected into the drainage area of the lymph node, infused directly via an afferent lymphatic, or injected intravenously, a marked decrease in cell output was observed. Nanogram quantities of IFN-alpha produced an effect that lasted several hours. To test whether this effect was specific for lymphocytes, we first stimulated a lymph node with Staphylococcus aureus so that large numbers of neutrophils and lymphocytes were present in efferent lymph. When IFN-alpha was then injected, the lymphocytes disappeared from efferent lymph but the neutrophils did not. Normal efferent lymph cells were labeled with radioisotopes and injected intravenously during the IFN-alpha induced effect. The entry of lymphocytes from the blood was significantly enhanced at a time coinciding with the suppressed cell exit in the efferent lymph. Recovery data indicated that the lymphocytes were retained temporarily in the lymph node but were not destroyed. Furthermore, the bovine IFN alpha does not appear to be conspicuously antigenic in sheep. It is not yet certain whether IFN-alpha enhances the interactions of cells within the lymph node thereby potentiating immunologic reactions. PMID- 3275130 TI - Immunoregulatory effects of lymphokine-driven placental cells on cloned T cells in vitro. AB - Successful pregnancy is associated with maternal immune sensitization to placental antigens. Placental trophoblast cells at the maternal-fetal interface express histocompatibility antigens of both the maternal and paternal haplotypes. In particular, these paternal-type antigens have the potential to stimulate alloreactive maternal immune responses and, as a result, maternal T cells appear in the decidua shortly after class I major histocompatibility complex encoded antigens are expressed. Despite this maternal immune recognition, immunologic destruction of the fetus rarely occurs. In fact, recent evidence suggests that the interaction between maternal T cells and placental cells results in an "immunotrophic" effect that stimulates placental growth and fetal survival. To better understand the contribution of fetally derived placental cells in the activation of maternal immunity, we have developed a murine lymphokine-dependent long-term placental cell line termed "FRD." FRD cells can stimulate syngeneic, semi-syngeneic, and allogeneic murine spleen cells to proliferate in a mixed lymphocyte-placental cell reaction. Coculture experiments with T hybridomas show that unlike conventional antigen-presenting cells, FRD can activate T cells to secrete lymphokines in the absence of specific antigen. In addition, lymphokine activated FRD cells release factors that directly stimulate proliferation of the IL 1 responsive T cell line D10.G4.1. These observations suggest that placental cells stimulate T cells via novel mechanisms that may play a role in producing a maternal T cell response that in turn is beneficial to fetally derived tissues during pregnancy. PMID- 3275131 TI - Interleukin 1 induces T cell mediated differentiation of murine Peyer's patch B cells to IgA secretion. AB - Peyer's patches (PP) represent an important source of cells potentially capable of secreting IgA, yet, under normal circumstances, little IgA is produced in the PP. This study has evaluated the regulatory role of cytokines in the differentiation of PP B cells. When recombinant human interleukin 1 alpha (rIL 1) was added to cultured PP cells in a concentration as low as 0.75 U/ml (5 pg/ml protein concentration) IgA secretion was increased four- to six-fold. This action of rIL 1 was T cell dependent, in that rIL 1 did not induce IgA differentiation in PP cultures previously depleted of T cells. The addition of rIL 1 to cultures containing splenic T cells and PP B cells or PP T cells and splenic B cells did not result in IgA secretion. Thus, the in vitro stimulatory action of rIL 1 required that both B cells and T cells be of PP origin. Additionally, when irradiated (3000 R) PP T cells were cultured with PP B cells in the presence of rIL 1, no IgA secretion was observed. The indirect stimulatory effect of IL 1 on PP B cells could not be reproduced when PP B cells were cultured with recombinant preparations of interleukins 2 and 4. These experiments strongly suggest that IL 1 is capable of stimulating IgA production by PP cells in vitro by means of activating an intermediate T cell that, in turn, regulates IgA differentiation in PP B cells. PMID- 3275132 TI - Tropical medicine and health in the developing world. PMID- 3275133 TI - In vitro synthesis of immunoglobulins in cutaneous leishmaniasis. AB - In an in vitro study, IgG was synthesized in large amounts by tissue from cutaneous leishmaniasis lesions. IgA and IgM were produced in the minority of the cultures in distinct and small amounts, respectively. Synthesis of complement (C3 and C4) could not be detected, but lysozyme was produced sporadically. The significance of these findings is discussed. PMID- 3275134 TI - Immunoprecipitation of Fasciola hepatica mRNA in vitro translation products using infection and hyperimmune sera. AB - Total RNA containing messenger RNA has been isolated from adult Fasciola hepatica and translated in vitro using the rabbit reticulocyte lysate system. L-[35S] methionine labeled translation products have been immunoprecipitated with sera collected from rabbits infected with F. hepatica, rabbits immunized with adult worm homogenate, and a rabbit and 5 calves immunized with a Fasciola/Schistosoma cross-reactive, cross-protective antigen, denoted FhSmIII(M). Precipitated antigens were analyzed by SDS-polyacrylamide gel electrophoresis. The major antigens recognized by hyperimmune sera had apparent molecular weights of 12,500, 13,500, 14,000, 26,500, and 27,000. The rabbit anti-FhSmIII(M) serum precipitated a 13,500 Mr antigen. Sera collected from calves immunized with FhSmIII(M) also precipitated a 13,500 Mr antigen together with a 26,500 Mr molecule. Antibody with specificity for F. hepatica mRNA translation products could be detected in rabbit serum 2 weeks after infection. PMID- 3275135 TI - Cryopreservation of Trichinella spiralis muscle stage larvae. AB - A cryopreservation protocol for Trichinella spiralis muscle stage larvae is described. Larvae are pretreated in 10% bile at 37 degrees C for 1 hr to induce an increase in surface permeability, than incubated in 20% v/v ethanediol at 37 degrees C for 10 min, transferred to 0 degrees C for a second incubation step of 15 min in a v/v mixture of 33% ethanediol: 33% methanol: 34% saline at 0 degrees C followed by rapid cooling (approximately 5,100 degrees C min-1) of aliquots distributed onto glass coverslips. The larvae are thawed by dropping the coverslips into 2 ml saline at room temperature (20 degrees C) and immediately agitating, which simultaneously dilutes (1:100) the cryoprotectants. Groups of 6 mice were infected with muscle stage larvae by gastric intubation. Five days post infection 14.5 +/- 3.2% of control untreated unfrozen MSL and 16.5 +/- 4.1% of unfrozen bile and cryoprotectant treated controls were recovered as adult worms from the small intestine. Of the cryopreserved larvae, 1.1 +/- 0.4% were recovered as adults, which represents 7.6% compared to the untreated unfrozen controls. When the bile pretreatment step was omitted fewer adult worms (0.09 +/- 0.04%) were recovered and no second generation muscle stage larvae were produced. Modifying this technique by omitting the first incubation step in 20% ethanediol and extending the second incubation step to 25 min yielded 72.3% recovery of T. nativa adult worms 5 days post-infection compared to unfrozen controls. The reproductive capacity index of bile treated cryopreserved T. spiralis was 2.5 +/- 0.6 compared to 51.8 +/- 18.8 for normal muscle stage controls. PMID- 3275136 TI - The finding of Angiostrongylus cantonensis in rats in New Orleans. AB - Twenty of 94 (21.4%) Rattus norvegicus trapped in New Orleans, Louisiana, between April 1986 and February 1987 were infected with Angiostrongylus cantonensis (3-62 worms per rat). This is the first report of the parasite from North America. A carnivorous snail, Euglandina rosea, was found experimentally to be able to serve as both an intermediate and a paratenic host. Other locally occurring gastropods that were successfully infected experimentally included Mesodon thyroidus, Anguispira alternata, Bradybaena similaris, Subulina octona, Polygyra triodontoides, Vaginulus ameghini, Philomycus carolinianus, Deroceras laeve, Limax flavus, and Lehmannia poirieri. Laboratory reared, 4- to 5-week-old M. thyroidus and D. laeve were able to support the development of small numbers of larvae to the third stage. First stage larvae of A. cantonensis in the feces of experimentally infected rats were found not to migrate out of the fecal pellet; this behavior favors the infection of feces-consuming gastropods. Twenty heavily infected L. flavus were observed over a period of 2 months, and shedding of third stage larvae of A. cantonensis was never seen. While factors support the spread of A. cantonensis in rats in the southern United States, the probability of human infection is uncertain since the parasite is transmitted primarily by ingestion of raw intermediate and paratenic hosts. PMID- 3275137 TI - The effect of diethylcarbamazine citrate on incidence and recovery rates of Brugia malayi microfilaremia in Sabah, Malaysia. AB - Mass drug administration via 3 modes of delivery reduced the incidence and prevalence rates and intensity of Brugia malayi infection in 3 rural villages in the Bengkoka Peninsula, Sabah, in 1982-1983. A dosage of 6 mg diethylcarbamazine citrate (DEC-C)/kg body weight was administered either daily or weekly (total of 6 doses, 36 mg/kg body weight), and impact on B. malayi cases were comparable in the 3 villages. A total of 384 people participated in the DEC-C regimens, and all pregnant women and children under 2 years were excluded from the study. Bekessy's method of estimation of incidence and recovery rates was applied to data on B. malayi microfilaremia before drug administration. Treatment with DEC-C by any of the 3 modes of delivery drastically reduced the number of episodes of patent microfilaremia, incidence and prevalence, and median microfilarial density. Reduction was sustained for at least 18 to 24 months after treatment. PMID- 3275138 TI - Large scale production of the vertebrate infective stage (L3) of Onchocerca volvulus (Filarioidea: Onchocercidae). AB - Laboratory-derived Simulium yahense and S. sanctipauli females were used to produce large numbers of Onchocerca volvulus infective stage larvae (L3) for use in assessing the possible chemoprophylactic potential of ivermectin in the chimpanzee model. Engorgement rates and subsequent post-prandial survival were correlated with the time at which adult flies were offered a carbohydrate source following emergence and the age of flies that fed on microfiladermic volunteers. PMID- 3275139 TI - Cysticercosis of the breast. AB - A painless lump in the breast in a 43-year-old Chinese woman was found on surgical excision to be a cysticercus presumed to be that of Taenia solium. Routine investigations failed to reveal infection at any other site. PMID- 3275140 TI - Shigellosis associated with recreational water contact in Los Angeles County. AB - An outbreak of shigellosis associated with swimming at a human-made lake during the Labor Day weekend occurred in Los Angeles County in 1985. Sixty-eight persons had onset of diarrheal illness within 1 week following exposure at the recreational site. Thirty-three of these cases were culture-confirmed as shigellosis (29 Shigella sonnei, 4 Shigella boydii). Fifteen persons were hospitalized. Illness was highly associated with water contact, specifically swallowing water while swimming (P less than 0.001) and age less than 15 years (P less than 0.001). Water samples from the swimming area had high fecal coliform counts; however, dye testing showed no evidence of sewage contamination. Direct bather contamination of the swimming area may have occurred in the context of large crowds, inadequate restroom facilities, poor water exchange, and the absence of a mechanism of disinfection. PMID- 3275141 TI - Tourniquet application after cobra bite: delay in the onset of neurotoxicity and the dangers of sudden release. AB - The effects of tourniquet application were prospectively studied in 36 hospitalized patients who developed neurotoxic symptoms after bites by the Philippine cobra (Naja naja philippinensis). Tourniquets had been applied in 94% of cases and delayed the onset of symptoms. Four patients were asymptomatic prior to the release of their tourniquet and in 11 patients symptoms worsened precipitously. Most importantly, 4 patients developed complete respiratory paralysis requiring artificial ventilation on its removal. Medical personnel seeing patients after a possible cobra bite should remove any tourniquet very gradually with both specific therapy and ventilatory support at hand. We recommend tourniquet application in the Philippines only after the bite of a definitely identified cobra and when removal can take place under controlled hospital conditions. PMID- 3275142 TI - A simple method for assessment of association between synanthropic flies and trachoma. AB - In some areas of endemic trachoma, muscoid flies may play a significant role in transmission of this serious eye infection. A simple and practical method of quantifying the relative household density of synanthropic flies has been developed for use in epidemiological field surveys. The method uses two boards moistened with a 10% sucrose solution. The fly scores showed good reproducibility at the same sampling site during the day and on different days. The only flies identified were Musca sorbens, showing their local density and a significant association of this fly with the presence of inflammatory trachoma in children. PMID- 3275143 TI - Prevalence of paralytic poliomyelitis in rural and urban populations in Ethiopia: report of a house-to-house survey. AB - A house-to-house survey was carried out to determine the prevalence of poliomyelitis. During the survey 37,219 households were visited and 17,941 children 5-9 years old were found. Of 231 lame children, lameness compatible with paralytic poliomyelitis was found in 131, of these 91% had their condition before the age of 3 years. Nineteen percent needed a stick support for walking while 12% were unable to walk even with support. This problem was more common in rural populations. The prevalence of paralytic poliomyelitis was 7.3/1,000 children 5-9 years old. PMID- 3275144 TI - Secular trends in body mass in the United States, 1960-1980. AB - Data from four National Health Examination Surveys conducted of the US population from 1960 to 1980 were analyzed to determine secular trends in obesity for white and for black adolescents and young adults of both sexes. Body mass index was categorized into four levels using cut points determined by the 50th, 75th, and 85th percentiles at the first survey in 1960-1962. The weighted proportions of persons in these body mass categories were determined, and statistical models were developed to describe secular trend and race effects. No consistent secular trends were found for white or black youths aged 12-17 years. No significant secular trends in obesity were found for white or black young males aged 18-34 years. Both for white and for black adult females, there were significant secular increases in the proportion of adult females in each of the successively heavier categories of body mass index. These increases were identical for white and for black adult females on the log-odds scale, but black adult females were already significantly heavier at the first survey. This race effect persisted throughout the entire time interval. PMID- 3275145 TI - Trends in use of oral hypoglycemic agents 1964-1986. AB - Oral hypoglycemic (OH) agents have been available in the United States for the treatment of non-insulin-dependent diabetes mellitus (NIDDM) for almost 30 yr. During this time they have been subject to considerable controversy. In this article, we present pharmaceutical marketing research data that provide a review of several facets of OH use. The number of OH prescriptions dispensed peaked in 1973, decreased through 1980, and has been increasing since that year. In 1986, OH agents accounted for 21.5 million prescriptions: 1% of all prescriptions dispensed that year. Chlorpropamide is currently the most frequently ingested OH agent; it is used by 33% of the market. The two OH agents introduced in 1984, glyburide and glipizide, had acquired 41% of the OH market by the end of 1986. The rate of OH use per 1000 diabetes mellitus visits increases with patient's age. Patients aged 60 yr and older received OH prescriptions at a rate of 478 per 1000 diabetes mellitus visits in 1986. Data estimating both the number of patients diagnosed with diabetes and the number of diabetic patients taking OH agents indicate that the percentage receiving OH treatment has increased over the past 5 yr, with approximately 35% of all diabetic patients taking OH agents in 1986. PMID- 3275146 TI - Cases from the aerospace medicine residents' teaching file. Case #28. An aviator with exertional migraines. PMID- 3275148 TI - Second HIV vaccine approved for human testing. PMID- 3275147 TI - [Reduction of dental caries after two years with a combination of mouthwashes and topical fluorides]. AB - The study's purpose was to evaluate the reduction of dental caries incidence by the association of two preventive methods. 246 students of both sexes aged from 7 to 11 years registered in "Escola de Educacao Basica da Universidade Federal de Uberlandia" and living in the urbana area of Uberlandia, state of Minas Gerais, were examined. The sample was distributed into two groups: children from Group 1, which received a semestral topical application of Acidulated Fluor Phosphate at 1.23% and children from Group II, that besides the topical application above related (Group I) also received weekly mouthwashes of sodium fluoride aquesus solution at 0.2%. After two years of study DMFS index were tabled and statistically analysed. It was verified a reduction of 33.97% in the incidence of dental caries (in the permanent dentition). The difference between the Groups was significant at 5% level of confidence. PMID- 3275149 TI - Computer program correlates CT, MRI, and PET images. PMID- 3275150 TI - Folic acid instead of leucovorin for 5-FU modulation? PMID- 3275151 TI - Localized breast Ca: are bone scans necessary? PMID- 3275152 TI - Synthetic vitamins used to reverse oral leukoplakia. PMID- 3275153 TI - Agreements and disagreements on the management of anal cancers. PMID- 3275154 TI - Hydrazine sulfate may promote caloric intake and increase survival. PMID- 3275155 TI - Gout medication analogue being tested against advanced solid tumors. PMID- 3275157 TI - Patients with chronic pain deserve choice of constant medication. PMID- 3275156 TI - Limited liver metastasis treated with interstitial radiation. PMID- 3275158 TI - Breast irradiation for recurrence in a patient with a silicone implant. PMID- 3275159 TI - Easing the side effects of IL-2-LAK cell therapy. PMID- 3275160 TI - Comprehensive program for families at risk of hereditary cancer. PMID- 3275161 TI - Low-grade lymphomas--will they respond to marrow transplants? PMID- 3275162 TI - Adult health practices in the United States and Canada. AB - The prevalence levels of 12 health practices in the United States and Canada are compared in this study: smoking; drinking status; average daily alcohol consumption; physical activity; eating breakfast; use of seatbelts and child safety restraints; ownership of smoke detectors; recency of blood pressure checks, breast examinations, and Pap tests; and practice of breast self examination. Data for two additional variables--drinking and driving and blood pressure awareness--are shown for the two countries, but the statistics cannot be strictly compared. Data are presented for four age groups by sex and for three levels of education. Trends in smoking and seatbelt use between 1979 and 1985 are also discussed. PMID- 3275163 TI - Magnetic resonance imaging in musculoskeletal primary malignant tumors. PMID- 3275164 TI - [Maximal gastric secretion during physical exertion and restitution in patients with chronic duodenal ulcer]. AB - The purpose of this work was determination of the effect of physical exercise on maximal gastric output. The study was carried out in 21 men aged 20-56 years with chronic duodenal ulcer. The control group comprised 17 healthy men aged 20-28 years. During three successive hours the maximal acid output was determined at rest, during one-hour exercise on a cycle ergometer and during one-hour restitution. Gastric secretion was stimulated with pentagastrin administered subcutaneously in a dose of 6 mcg/kg at the beginning of each hour of the study. Besides that the parameters of acid-base equilibrium were determined before the beginning of resting MAO measurement, immediately after its completion, and then after one hour of exercise and one hour of restitution. Physical exercise caused in the group of patients a significant increase of MAO (p less than 0.001), which was due to increased volume of gastric juice (p less than 0.001) and the concentration of acid in it (p less than 0.02). During the restitution the value of MAO was significantly below that obtained at rest. On the other hand, in healthy subjects exercise caused a significant reduction of MAO value (p less than 0.005) as a result of decreased volume of gastric juice (p less than 0.005). During MAO determination at rest a rise was observed in the pH of blood, increased concentration of bicarbonates and base excess (p less than 0.05). During the exercise with further aspiration of gastric juice a further significant increase of pH and pO2 and reduction of pCO2 (p less than 0.05) was observed. Exercise caused in patients an increase of gastric secretion in contrast to healthy subjects. Changes in acid-base balance showed a tendency for metabolic alkalosis with hypocapnia, and were similar in both groups. PMID- 3275165 TI - [Endogenous digoxin-like substance level in essential arterial hypertension, renal failure and acromegaly]. AB - The endogenous digoxin-like substance seems to play an important role in the aetiology and pathogenesis of essential and secondary hypertension. Immunoreactive digoxin-like substance was determined in 52 subjects: 17 healthy ones, 15 patients with essential hypertension, 10 cases of chronic renal failure and 10 patients with acromegaly. The substance was not found in healthy subjects, in acromegaly and essential hypertension. In chronic renal failure detectable concentrations of the substance were observed but they showed no correlation with the creatinine level and other clinical data. PMID- 3275166 TI - [4 cases of poisoning with the extract of yew (Taxus baccata) needles]. AB - Four prisoners drank a decoction of yew (Taxus baccata) needles containing the toxic alkaloid taxine++ B. Two died in prison (one in the cell, the other shortly after admission to prison hospital, death was caused in both cases by cardiac arrest). Two other prisoners were admitted to the Warsaw Poisons Control Centre. One of them was in deep coma, with severe ventricular arrhythmias and had several episodes of ventricular fibrillation controlled with defibrillatory procedures. After an initial improvement (return of consciousness) his general condition deteriorated suddenly, he lost consciousness again, his circulation stopped and he died on the fourth day of hospitalization. The other patient drank a much smaller amount of the decoction. He was conscious, had bradycardia requiring transient endocavitary pacemaking, and had mild ventricular arrhythmia. He left the hospital in a very good condition after ten days of treatment. In both these cases long-standing excessive diuresis and corresponding considerable hypokalemia were observed. A synergism of the toxic effects of taxine++ B, digitalis glycosides and hypokalemia is considered very likely. In both cases atropine was effective for a short time in the control of bradycardia. PMID- 3275167 TI - [The role of aluminum in the development of osteomalacia in patients on chronic hemodialysis]. AB - On the basis of a retrospective assessment of aluminium content in the bones and morphometric findings in spongy bones of patients maintained on long-term dialyses a trial was undertaken of demonstration of a possible causative effect of this metal on the development of osteomalacia. The analysis included also the role of aluminium in the development of intravitally occurring fractures of bones in these patients. A biopsy specimen was taken from the iliac ala with a modified Bartelheimer's needle. The study comprised two groups of patients. The first one included 10 patients in a mean age of 38.2 +/- 6.6 years remaining, on the average, since 72.3 +/- 33.6 month who had previously evidence of fractures demonstrated clinically and radiologically. In the second group 12 patients of a mean age of, 41.9 +/- 6.8 years on dialyses since 40.3 +/- 12.2 months with demonstrated subperiosteal resorption, and patients with normal radiological appearance of the skeleton were studied. The patients were dialysed using a dialysate prepared from water not previously adapted and containing Al in a concentration of 0.135 +/- 0.102 mg/l. The diagnosis of osteomalacia was based on the morphometric method of Bordier (6). In both studied groups a highly significant rise was demonstrated in the concentration of Al in the spongy bone, and pathological fractures were closely related to the morphometric markers of osteomalacia. Aluminium cumulation in the bone tissue of patients with fractures exerted a significant effect on an increase of osteoid volume and reduction of mineralization fronts, and demonstrated a directly proportional relationship with the time of treatment with dialyses and overall exposure to aluminium in the dialysing fluid. In the group with osteomalacia a linear trend was observed in the increase of osteoid volume related to aluminium retention in spongy bone. PMID- 3275168 TI - [Rejection of allogeneic bone marrow transplant. Case report]. AB - In a patient aged 22 years with acute myeloblastic leukaemia during complete remission an allogenic transplant of bone marrow identical in the HLA antigen range was rejected despite administration before transplantation of a full marrow ablating dose of busulphan (16 mg/kg) and severe graft-versus-host disease. Graft rejection manifested itself as disappearance of its haemopoietic function which was confirmed during the life and on autopsy. The case deserves attention in view of the rarity of HLA-identical marrow graft rejections in patients treated for leukaemias. PMID- 3275169 TI - [Prevalence of caries in first permanent molars in students living in regions with and without fluoridated drinking water (comparative study based on clinical and radiographic examinations)]. AB - To analyze the prevalence of dental caries by means of the DMF-S index and verify their distribution on the occlusal, buccal, lingual, mesial and distal surfaces using the intrabuccal interproximal technique, this comparative study included a sample of 360 seven to twelve year old boys and girls, without distinction of race, from the low social-economic class who, since birth, have lived in the cities of Teresina and Barras located in the state of Piaui in Brazil. The average level of fluor in first; city's public water supply is 0.68 ppm, while the second city lacks this halogen. A statistical analysis of the results verified that children in Teresina presented a DMF-S index 26.10% less than the children in Barras. The "T" Test of Student was significant for the seven, eight, nine, 10, and 12 years olds and for the sample as a whole in Teresina as well as for the types of surfaces regardless of age and sex. Children in the same community showed no significant difference when analyzed according to sex. In the two communities, the annual increase of the DMF-S index for all ages shows the cumulative and progressive aspect of dental caries; however, the increase was less in the city with fluoridated water. PMID- 3275170 TI - [Morphometric determination of changes in mastocyte population in cutaneous wound granulation tissue in hypothyroid and parotidectomized rats]. AB - The authors have done a morphometric study by determination of mastocyte population of cutaneous wound's granulation tissue of parotidectomized rats and rats which were submitted to daily administration of 25 mg of 6-propyl-2 thiouracil (hypothyroid). The animals were sacrificed after four, eight and 12 post-operative days. The results analysis permitted to observe a statistically significant diminution of mastocyte population in the hypothyroid and parotidectomized animals granulation tissue in the fourth and 12th postsurgical days. PMID- 3275171 TI - [Tooth extraction wound healing after administration of vitamin B6 (pyridoxine). Histological study in rats]. AB - Male rats with 250 grs of weight were injected daily with 0.1 ml of B6 vitamin by peritoneal (way paths). The animal were sacrificed at three, seven, 10, 15 and 21 day after the upper incisor extraction. Its hemimaxila were retired and fixed in 10% formalin and after had been embedded in paraffin sections were cut with 6 micrometers pick. The analysis of the sections stained by hematoxylin and eosin when compared with the controls showed that: 1) the blood clot and fibrin net are substituted more rapidly by the granulation tissue; 2) granulation tissue is more plentiful, early and mature; 3) the bone tissue is more plentiful and mature. PMID- 3275172 TI - [Hydroalcoholic, prophylenic, hydropropylenic and glycerinated solutions of PMCF. Their use in endodontics. "In vitro" and "in vivo" study]. AB - This work aims to test the efficiency of hand instrumentation allied to paramonochlorophenol dressing in cases of pulp necrosis, when this substance is diluted in water and alcohol, propylenoglicol and glycerin. Superficial pression and pH were verified to test them afterwards facing to bacteria that could be found in infected root canals and avaible to study in our bacteria lab. Solution more effective "in vitro" and of less cytotoxicity "in vivo" were selected to be employed in patients from the Dental Clinics at School of Dentistry--Federal University of Minas Gerais. It was concluded that: 1. the relationship between cytotoxicity and bacterial activity was proportionally the reverse to superficial pression, except to Hydropropylenic solution of PMCF 5% and 10%; 2. in the study with patients (40 cases) the growth anaerobic microorganisms were present in 97.5% of examined teeth; 3. from solutions used for intracanal dressing hydroalcoholic solution of PMCF at 5% was the on which showed more effectiveness; 4. studies must be carried out on glycerin solution of PMCF, to turn viable its employment in Endodontia. PMID- 3275173 TI - [Comparative study of clinical and radiographic examinations for detection of proximal caries in posterior deciduous teeth]. AB - Statistical analysis on data obtained through clinical and radiographical interproximal exams was the main purpose of this study. Posterior deciduous teeth of 450 children of both sex, of low social and economical level, without distinction of colour, aging seven to ten years were examined. PMID- 3275175 TI - [Anatomical variations of the clinoid process of the human sphenoid bone]. AB - The authors analysed 270 human adult skulls of both sexes, in order to demonstrate the fusion of clinoid process of sphenoid. It was verified only 38 cases under several shapes. According to our results obtained, may be concluded: a) the fusion between the anterior and medium clinoid processes occurred in 17 cases (6.27%), being that in 11 cases (4.05%) bilaterally; b) between the medium and posterior clinoid processes occurred in six cases (2.22%); c) between the anterior and posterior clinoid processes occurred bilaterally in six cases (2.22%); d) between the three processes occurred in nine cases (3.04%). PMID- 3275174 TI - [Infection control procedures used in dental offices in Belo Horizonte]. AB - Survey data from 300 randomly selected private dental practitioners working in Belo Horizonte, Minas Gerais, were used to evaluate the infection control procedures routinely practiced here. The function of this report might be to alert the teaching team from Dental Schools and the dentists to the problems that potentially contribute to the transmission of infectious disease as a first step for additional specific recommendations to an effective and safe infection controL program that we intend to discuss later. PMID- 3275176 TI - Saskatchewan health data bases: a developing resource. PMID- 3275177 TI - Infant medication and sudden infant death syndrome. PMID- 3275178 TI - Possible cardioprotective effects of allopurinol. PMID- 3275179 TI - Pharmacoepidemiology in hospitals using automated data systems. PMID- 3275180 TI - [Significance of continuous monitoring of arterial blood pressure in the diagnosis of hypertension]. PMID- 3275181 TI - [Epigastric pain in the main diseases of the upper tract of the digestive system. Computerized analysis of the symptom in 900 cases subjected to esophagogastroduodenoscopy]. PMID- 3275182 TI - [Corticosteroids administered in bolus in lupus nephropathy]. PMID- 3275183 TI - [Diagnostic definition of urine albumin isolated by determining tubular antigen excretion using monoclonal antibodies]. PMID- 3275184 TI - [Idiopathic myelodysplastic syndromes. A caseload contribution]. PMID- 3275185 TI - [A case of legionellosis treated with erythromycin]. PMID- 3275186 TI - [A new type of autoantibody reacting against human nuclear antigens]. PMID- 3275187 TI - [Blood coagulation problems during long-term extracorporeal circulation]. PMID- 3275188 TI - [Celiac disease in adults and gluten free diet]. PMID- 3275189 TI - [Immunologic diagnosis of human hydatidosis]. PMID- 3275190 TI - [Selective and generalized hypogammaglobulinemia in patients with rheumatoid arthritis in treatment with gold salts]. PMID- 3275191 TI - [Immunosuppressors in Behcet's disease]. PMID- 3275192 TI - Current perspectives on the diagnosis of drug allergy. PMID- 3275193 TI - [Effects of anti-adrenergic drugs on thrombin-induced platelet aggregation and thromboxane B2 production]. PMID- 3275194 TI - [Acute ischemic cerebral infarction: a possible role of hemorheologic changes caused by ischemia in the interpretation of pathological findings]. PMID- 3275195 TI - [Genetic and immunoneuromodulatory aspects in hemicrania]. PMID- 3275196 TI - [Therapy of idiopathic thrombocytopenic purpura: the role of human immunoglobulins]. PMID- 3275197 TI - XIV Conference of the Latin American and Caribbean Association of Schools of Public Health. PMID- 3275198 TI - Epidemiological status of malaria. Region of the Americas 1986. PMID- 3275199 TI - Research on health profiles. Background information on mortality analysis projects. PMID- 3275200 TI - Health profiles, Brazil, 1984. PMID- 3275201 TI - The magnesium, calcium, sodium, potassium and chloride contents of the term human placenta. AB - The ion content of the human term placenta was determined. When ordered decreasingly according to their placental content, the series of ions was: Na greater than Cl greater than K greater than Ca greater than Mg. These levels, plotted as a function of the tissue dry weight, showed an exponential distribution. Using Cl as an extracellular marker, Na and K cellular concentrations were evaluated. The equilibrium potentials derived from these values were very different from the measured syncytial membrane potential or from the value usually recorded in non-innervated tissues. PMID- 3275202 TI - Consequences of low dietary magnesium and high dietary calcium on pregnancy outcome and tissue mineralization in rats. AB - Weanling female Sprague-Dawley rats were fed purified diets to determine the influence of excess dietary calcium upon tissue content of magnesium and calcium, and reproductive outcome. Two levels of calcium (5000 and 16,000 ppm) and magnesium (200 and 1200 ppm) in a 2x2 factorial design (adequate magnesium and calcium = C; low magnesium adequate calcium = L; high calcium adequate magnesium = CHC; and high calcium low magnesium = LHC) were used during the study which included growth and breeding (10 weeks), and gestation and lactation (6 weeks). Depressed weight gain during growth and gestation occurred in response to calcium excess. Renal calcium accumulation was reduced in LHC dams as compared to L dams. In dams fed excess calcium, magnesium concentrations of bone, serum, and kidney were depressed while serum alkaline phosphatase activity increased. The adverse effects of high calcium seen in the dams were not apparent in LHC pups. These pups were heavier and more viable during lactation than pups in the L group. High dietary calcium in combination with low dietary magnesium during one reproductive cycle resulted in altered mineral levels in tissues and improved growth and viability of pups when compared to magnesium-deficient animals. PMID- 3275203 TI - Effects of high magnesium intake on central catecholamines in spontaneously hypertensive rat. AB - Spontaneously hypertensive rats (SHR) received a highly magnesium enriched diet during the development of hypertension, which caused plasma Mg concentrations to be markedly increased. Arterial blood pressure was reduced in supplemented animals. Levels of noradrenaline, 3-dihydroxyphenylacetic acid and homovanillic acid in cortex, hypothalamus, striatum and brain stem remained unchanged. Dopamine levels in the cortex, hypothalamus and striatum were also unchanged. Dopamine levels in brain stem increased. However the correlation between treatment with magnesium, dopamine-related variables in the brain and decrease in blood pressure in SHR remains hypothetical. PMID- 3275204 TI - Ex vivo study of the vascular reactivity to some vaso-active agents in isolated thoracic aorta from dietary magnesium-deficient rats. AB - We have reported that dietary magnesium (Mg) deficiency induced both histaminaemia and hypomagnesaemia in rats. In this study, the effects of dietary Mg deficiency on the reactivity of the isolated thoracic aorta to some vaso active amines were studied ex vivo. Adult male Wistar rats were fed on a Mg deficient diet (Mg 0.001%) and a control diet (Mg 0.07%) for 30 d. Sensitivity to KCl and adrenaline showed no significant change during Mg deficiency. In Mg deficient rats, the sensitivity to noradrenaline was higher than in the control group. Removal of calcium ions from the medium in the tissue bath resulted in a greater decay of noradrenaline-induced contraction in Mg-deficient rats than in the control rats. Endothelium-dependent relaxation was also examined in isolated aortic strips precontracted with noradrenaline. In rats which were fed with the Mg-deficient diet for 15 days, histamine produced less relaxation than in the control group, but acetylcholine produced the same degree of relaxation as in the controls. These results showed that hypomagnesaemia and histaminaemia might influence the reactivity of the aorta in vivo. PMID- 3275205 TI - Effect of magnesium on juvenility and rejuvenescence of plant cells, and its possible mechanism. AB - A correlation was discovered between the age of plant cells and their protein and magnesium content. The protein and magnesium contents were found to be in inverse ratio to the age of cells. The molar weight distribution of the protein content shifted with age towards fractions with larger molar weights because of the reduced rate of protein synthesis of the ribosomes. The deactivation of the ribosomes is caused by a decrease in the number of polyribosomes. The lowered concentration of magnesium is responsible for this structural change of the ribosomes (depolymerization). The restoration of the polymer structure is thought to be due to the stimulation of protein synthesis brought about by the introduction of exogenous magnesium. Magnesium has an influence not only on the ribosome structure but also on the biosynthesis of some hormones involved in protein synthesis (gibberellines, auxins, cytokinins). The activity of the catalase enzyme is also increased by the rising level of magnesium, which has a protective effect on auxins. It can thus be established that magnesium exercises a direct influence on juvenility by stabilizing the polyribosome structure, and an indirect effect by increasing hormone and enzyme activity. PMID- 3275206 TI - Reduction of erythrocyte magnesium concentration in heterozygote beta thalassaemic subjects and in normal subjects submitted to physical stress. AB - Erythrocyte and serum magnesium (Mg) concentrations have been assayed in a group of sedentary heterozygote beta-thalassaemic subjects (beta-thal), in a group of non-thalassaemic well trained runners before and after a 25 km running race, and in a group of sedentary healthy controls. The mean erythrocyte Mg concentration (EMg) found in beta-thal (2.72 mEq/litre) and in runners, both before and after the race (2.58 mEq/litre before, 3.10 after), was significantly lower than the EMg values from the control group (3.69 mEq/litre). We propose various hypotheses to explain the reductions observed. PMID- 3275207 TI - Changes in serum and erythrocyte magnesium and blood lipids after distance swimming. AB - The effect of a 30 min. swimming exercise (freestyle) on plasma magnesium and other biochemical variables was assessed on 6 well trained swimmers. Blood samples were taken before, right after, 30 min. and 24 hours after exercise. Serum Mg concentration decreased significantly during exercise, returning to base line 24 hours after. Erythrocyte content in Mg did not show any significant changes. Plasma total cholesterol level decreased significantly 30 min. after exercise. A significant positive correlation found at rest between plasma Mg levels and plasma total H.D.L. cholesterol disappeared after exercise but was observed again 24 hours later. PMID- 3275208 TI - Relationship between magnesium, carcinogenic metals and ionic permeability of the human amnion. AB - The effects of the well established carcinogenic metals or metalloids (As, Be, Cr, Ni), hypothetically carcinogenic but well-established cocarcinogenic metals (Cd, Pb, Co) and weak co-carcinogenic metals (Al, Cu, Fe, Zn) and the antagonism between Mg and these metals were studied on the ionic transfer through the isolated human amnion. The ionic transfer is estimated by the measure of the membrane potential (delta psi), the cationic number transference t+ and the ionic fluxes (F1, F2). All carcinogenic metals increase delta psi (+) and reduce t+, F1 and F2. Mg has an opposite action with regard to Cd, Pb and Ni, but may act as a co-carcinogenic agent by increasing the effects of Al, Cu and Zn. PMID- 3275209 TI - Multifocal atrial tachycardia responsive to parenteral magnesium. AB - Two groups of patients with multifocal atrial tachycardia (MAT) were treated with the intramuscular and continuous intravenous magnesium sulphate regimens used in pre-eclampsia. Both routes of administration were successful in causing reversion to sinus rhythm but the intramuscular regimen, by attaining a higher and more sustained serum magnesium concentration, converted the arrhythmia to normal sinus rhythm in a shorter period of time (1-2 hours) than the intravenous regimen (4-8 hours). Magnesium-sparing diuretics should be used in the treatment of patients with chronic obstructive pulmonary disease and congestive heart failure, which are both conditions associated with magnesium deficiency and MAT. PMID- 3275210 TI - Magnesium in daily practice: clinical significance and therapeutic implications. Antwerp, 3-4 April 1987. Abstracts. PMID- 3275211 TI - Abstracts of the 7th Japanese Congress on Magnesium Research. PMID- 3275212 TI - Locally and systemically derived natural killer cells participate in defense against intranasally inoculated influenza virus. AB - Previous studies have indicated that the pulmonary natural killer (NK) cells are important in early defense against influenza virus (PR8/34) infection by the intratracheal route. Since the natural route of virus entry into the lung is via the upper respiratory tract, the present study was to elucidate the role of NK cells in early defense to intranasal (IN) inoculation of influenza virus. Rabbit anti-Asialo GM1 (RAGM1) serum was administered by IN, intravenous (IV), or both routes, 24 hours before IN infection with a median lethal dose (LD50) of PR8/34 previously shown to kill 50% of the inoculated mice (B6D2F1 or nu/nu) by day 8. IN or IV inoculation of 20 microliters of RAGM1 (whole rabbit serum) had no effect on the survival of the mice to virus administered by the IN route. When RAGM1 was given IV (10 microliters) and IN (10 microliters) 24 hours before PR8/34 IN, 60% of the mice (B6D2F1 or nu/nu) died by day 4. Influenza virus titers were at least one log higher in the lungs of B6D2F1 mice and two logs higher in IN/IV NK-depleted nu/nu mice than in lungs of mice who received RAGM1 by IV or IN route alone or who were untreated. NK activity was depleted in lungs but not blood of mice treated IN with RAGM1 and was depleted in both lungs and blood if RAGM1 was given IV. These data support the hypothesis that NK cells are important to early defenses against influenza virus in the upper respiratory tract and that they are derived from both a local and systemic population of NK cells. PMID- 3275213 TI - Pathogenesis of acute pulmonary inflammation in strain 2 and strain 13 guinea pigs. AB - An acute inflammatory response was elicited in the lungs of strain 2 and 13 guinea pigs following immunization and aerosol challenge with ovalbumin. The pulmonary inflammatory response, characterized by hemorrhage and influx of inflammatory cells, progressed from initiation at 12-hours postchallenge through resolution at 96-hours postchallenge. Inflammatory and immunoregulatory cells, recovered by bronchoalveolar lavage, showed quantitative changes in their relative contribution to the bronchoalveolar cell infiltrate over the course of inflammation. Changes in concentrations of macrophages and T cells, in particular, are discussed in terms of their possible contributions to initiation and resolution of acute pulmonary inflammation. PMID- 3275214 TI - Ultrastructural localization of HLA-DR and HLA-DQ molecules in Langerhans cells and B cells: an immunoelectronmicroscopic study. AB - Using the immunoelectronmicroscopic techniques of Lowicryl embedding and ultracryomicrotomy, the intracellular distribution of HLA class II molecules was investigated on a human B cell line and on human Langerhans cells. These techniques enabled us to localize the HLA class II molecules on fixed specimens in which mobilization or clustering induced by cross linkage with antibodies is ruled out. Compared with Lowicryl embedding, the ultracryomicrotomy clearly showed more labeling. Both in B cells and Langerhans cells, the HLA-DR molecules were predominantly found in intracellular vesicular structures and on the plasma membrane. The HLA-DQ molecules were less abundant than HLA-DR molecules in the B cells and Langerhans cells. In the B cells, HLA-DQ molecules were found on the plasma membrane and in the cytoplasm. In the Langerhans cells, some HLA-DQ molecules were also found in intracellular vesicular structures. These experiments show a different localization of HLA-DR and -DQ antigens both in Langerhans cells and B cells, suggesting a different function for these molecules. The localization of HLA-DR molecules may indicate that these molecules take part in the recycling process of the plasma membrane in B cells and Langerhans cells. The HLA-DQ molecules are not internalized or recycled by the B cells, and a limited internalization of these molecules takes place in Langerhans cells. Finally, no HLA class II or clathrin molecules were found on the Birbeck granules, suggesting that, when no cross-linking with antibodies takes place, Birbeck granules, suggesting that, when no cross-linking with antibodies takes place, Birbeck granules do not play a role in recycling of HLA class II molecules in Langerhans cells. PMID- 3275215 TI - Experimental allergic conjunctivitis: production of different isotypes of antibody by conjunctival-associated lymphoid tissue in culture. AB - Long-term (greater than 2 years) topical, conjunctival application of fluoresceinyl ovalbumin (FL-OA) induced allergic conjunctivitis-like lesions and hyperplasia of conjunctival-associated lymphoid tissue (CALT) in guinea pigs. Single-cell suspensions of CALT and spleen were prepared by collagenase digestion and cultured with or without FL-OA or lipopolysaccharide; the culture supernatants were assayed for IgG, IgA, IgM, and IgE antibody. Absolute values (ng Ab protein/ml) of anti-FL-OA IgG subclasses (IgG1 and IgG2) were measured using purified preparations of IgG1 and IgG2 anti-FL-OA antibody standards in an enzyme-linked immunosorbent assay. Immunohistochemical studies were performed using frozen sectioned CALT tissues as well as cultured single cells. IgG1, IgG2, IgA, IgM, but not IgE, anti-FL-OA antibodies were detected in the culture supernatants of both CALT and spleen. IgG- and IgA-secreting plasma cells were demonstrated in immunoperoxidase-stained CALT and single-cell cultures. The ratio of IgG1 to IgG2 isotypes produced by CALT in vitro was significantly higher than that produced by spleen and also that found in serum. These findings indicated that a site-specific regulation of antibody isotypes may exist within the hyperplastic CALT induced by the long-term topical exposure to FL-OA. PMID- 3275216 TI - Maternal T cells regulate placental size and fetal survival. AB - The placental immunotrophism hypothesis states that maternal T cells, through their lymphokines, exert a positive influence on placental growth, which can lead to improved chances of fetal survival. We report here that deleting maternal T cells by monoclonal antibody injection during midgestation is accompanied by increased fetal resorption and decreased placental weight and phagocytosis in two different strain combinations of mice. Conversely, mice with T-cell proliferative disease show increased placental weight and phagocytosis, which can be reversed following T-cell depletion during pregnancy. Furthermore, female mice that are prone to fetal resorption show improved fetal survival if injected with spleen cells from mice with T-cell proliferative disease. These results are in accord with predictions of the placental immunotrophism hypothesis and imply that maternal T cells can participate in the prevention of spontaneous fetal resorption. PMID- 3275217 TI - Hospital use in Poland and the United States. AB - This report presents national statistics on hospital use from the U.S. National Hospital Discharge Survey and the Polish General Hospital Morbidity Study. Comparisons are made of discharge rates, average lengths of stay, rates of patient care days, and fatality rates by sex, age, and diagnostic category. The similarities and differences between the two countries in population characteristics, health status, health services systems, and health care resources are also described. PMID- 3275218 TI - Educating physicians for the twenty-first century--some proposals for cancer education. PMID- 3275219 TI - Teaching the emotional aspects of cancer care. AB - In response to an awareness of the emotional needs of cancer patients and their families, a psychosocial oncology conference was begun at the Veterans Administration Medical Center in Houston, TX approximately 10 years ago. Its goal has been to educate medical staff about the mental health issues of cancer patients and to educate mental health professionals regarding the medical problems facing cancer patients. This article discusses the development of the conference, its objectives, its format, and its accomplishments. Patients are selected for the conference on the basis of the presenting problem and the potential for optimal education of staff members. The patient's case is presented, a live interview with the patient is conducted, and a discussion of the pertinent issues follows. Illustrative case examples are presented in order to demonstrate the value of this meeting for the participants. Throughout its history, the conference has undergone a number of changes, primarily in response to the reactions and needs of those involved. These modifications are described, along with the results which have been achieved and the implications for the expansion of this concept. PMID- 3275221 TI - Standardized international cancer staging. PMID- 3275220 TI - Obstacles to effective professional education programming by a voluntary health association: findings from a national survey. AB - The American Cancer Society (ACS) conducted a nationally representative survey of ACS professional education committee volunteer chairpersons and ACS staff responsible for professional education programs in Divisions and Units of the Society. The survey questionnaire included a set of 25 items (15 in the chairperson questionnaires) representing potential obstacles to effective professional education programming. Subjects rated these obstacles on a four point scale indicating the extent to which they were perceived as problems in professional education. The survey identified which potential obstacles to professional education programming by a voluntary health association were considered to be most problematic. These included competition from other providers of oncology professional education, outdated audiovisuals and publications, and the recruitment and retention of physician volunteers. The survey verified that there were differences within the organizational structure of the association. In particular, small Units of the Society faced more problems than did Divisions and large Units. The survey found differences in perceived problems between volunteers and staff, particularly in that staff found outdated audiovisuals and publications to be more of a problem than did chairpersons. In general, however, there was a commonality of opinion among all respondents as to which obstacles posed more of a problem than others in professional education. PMID- 3275222 TI - Asbestos as a health hazard: a course for college students. PMID- 3275223 TI - The general practitioner as educator of the cancer specialist in The Netherlands. PMID- 3275224 TI - Teaching oncology to medical students in Israel. PMID- 3275225 TI - Educational objectives for a cancer control course for Israeli medical students. PMID- 3275226 TI - Undergraduate teaching of oncology in Argentina. AB - Cancer is a public health problem in Argentina, and the role of the country's physicians in the fight against this disease is very important. Whether they are general physicians or specialists, including clinical oncologists, they must have basic knowledge and permanent updating in oncology. Unfortunately, the teaching of oncology is deficient in this country, the deficiencies being already noticeable at the undergraduate level where the teaching is incomplete and dispersed. In order to ascertain the level of oncologic information which medical students about to graduate had acquired, 15-hour courses were organized in 1983 to 1984 for students of the Universities of Buenos Aires, La Plata, and Del Salvador. The participants had to fill in a questionnaire of 50 questions of increasing complexity before and after the course. The comparison of both inquiries clearly showed the usefulness of the course, particularly regarding cancer control, early diagnosis, treatment, and curability. The overall error decreased by 50% after the course. However, some erroneous ideas still existed and it became evident that certain of the subjects must be studied in greater depth. PMID- 3275227 TI - Public cancer education in India. PMID- 3275228 TI - In situ/invasive cervical cancer ratios: impact of cancer education and screening. AB - A study of cancer incidence rates in Newark, NJ showed an increase in invasive cervical cancer among black women between 1970 and 1976. The incidence was substantially higher than that found in the Third National Cancer Survey and the Surveillance Epidemiology End Results Program. The ratio of in situ/invasive cervical cancer incidence among black women was 1:1, far below the national ratio of about 3:1. It seemed that the high-risk population in Newark might not be having regular Papanicolaou smears. From 1976 through 1981, intensive educational and cervical cancer screening programs were carried out in the city of Newark. A review was made of cervical cancer cases (1976-1981) reported to the tumor registries or recorded on discharge diagnoses in hospitals where Newark residents are known to have sought care. The findings showed that the ratio of in situ to invasive cervical cancer had increased dramatically: the overwhelming majority of cancers were found to be in situ carcinomas. The improvement was far more impressive among black women than among white women. Since the intervention campaign had been directed primarily toward the black female population, a group at extremely high risk, this suggested that efficacy of the intervention program. PMID- 3275229 TI - Dentists' knowledge, case-finding behavior, and confirmed diagnosis of oral cancer. AB - A questionnaire was developed for dental general practitioners that was used to measure three types of clinician knowledge believed to be central to the early detection and management of oral cancer. Oral cancer management issues (case finding behavior and clinician knowledge of patient outcomes) were also studied. The hypothesis that clinician knowledge is associated with oral cancer case finding behavior could not be validated, but the hypothesis that clinician case finding behavior is associated with knowledge of confirmed oral cancer or precancerous diagnoses was substantiated. PMID- 3275230 TI - Postmastectomy educational needs and social support. AB - Due to shorter hospitalization periods and changes in surgical procedures, breast cancer patients have less inpatient contact with rehabilitation resources. A questionnaire related to educational needs and social support was mailed statewide to 2,000 postmastectomy women who had received a Reach to Recovery visit. The findings are based on quantitative data reported by 933 women and from 27 women in follow-up interviews. Respondents ranked their educational needs in six categories from greatest to least importance as follows: (1) information about breast cancer, (2/3) personal hygiene/exercise and nutrition/weight control (both ranked of equal importance), (4) prosthesis/clothing information, (5) social support, and (6) sexual issues. Performance on the knowledge assessment correlated directly with the amount of educational experience and inversely with age. Respondents who lived in communities of less than 2,500 were less informed than those from other locations. Participation in formalized support groups was infrequent (11%). The major source of information was the media, with 88% indicating they would watch television programs about breast cancer. Thirty-three percent of the respondents indicated they owned a video cassette recorder (VCR); about 93% said VCRs were available for rent in their community. Work associates were identified as a group that encouraged information seeking; health care professionals were the most successful in motivating women to participate in support groups. PMID- 3275231 TI - Appropriate medical education. PMID- 3275232 TI - Essay questions on exams. PMID- 3275233 TI - Live models for clinical teaching. PMID- 3275234 TI - AIDS education. PMID- 3275235 TI - Increasing cancer prevention services calls for modification of continuing medical education. PMID- 3275236 TI - Challenging issues facing medical education. PMID- 3275237 TI - The development of "coordinating councils" for cancer education in Europe, Latin America, and the Asian-Pacific region. AB - This article described progressive interest in cancer education on three continents with an increasing number of national and multinational groups having a formalized role in cancer. A great deal of this activity has been stimulated by the International Union Against Cancer (UICC) through surveys, regional conferences, courses, etc. Further action at the continental, national, and local level will be strengthened considerably with the formation of new "coordinating councils" for cancer education in Europe, Latin America, and the Asian-Pacific region. These "coordinating councils" include representatives of most organizations with an interest in cancer education. A long list of projects for possible consideration by these councils is noted. PMID- 3275238 TI - Undergraduate oncology education in Scandinavia. AB - An overview of undergraduate education in general oncology in 18 medical schools in Scandinavia demonstrated that insufficient resources were allocated to this activity, and that there was a lack of integrated multidisciplinary educational activities. Further, there was a lack of clear consensus about the contents of a curriculum in oncology. To remedy this situation a minimal list of recommendations is suggested for the undergraduate education in oncology in Scandinavia. The main points are: (1) a better coordination of the curriculum in general oncology with the curricula of other specialty disciplines, (2) a two week period of clinical clerkship in the department of general oncology early in the study, (3) a two-week concentrated course in general oncology late in the study, (4) a final knowledge test, and (5) adequate funding of cancer educators. PMID- 3275239 TI - A demographic profile of the American Association for Cancer Education. PMID- 3275240 TI - Public perceptions and behaviors regarding cancer control. AB - A random digit dialing method was used to select a stratified random sample of 413 residents from 5 counties in Northwest Ohio for the purpose of assessing public perceptions and behaviors regarding cancer. A fatalistic attitude was expressed by 46% of respondents, who agreed that it seems that almost everything causes cancer. Twenty-four percent agreed that one can do little to prevent cancer. Respondents expressed greater concern with cancer than with several major diseases, including AIDS (acquired immune deficiency syndrome). Eighty percent of females and 74% of males favored smoking restrictions in work areas, and 62% of females and 52% of males favored a total smoking ban in work areas. The majority of respondents reported having made some health protective behavior changes in the last year, but reported use of cancer screening procedures was low. A relationship was found between confidence in media reports about causes of cancer and a fatalistic attitude about cancer. Implications for public education about cancer are discussed. PMID- 3275241 TI - The long-term impact of a training program in maxillofacial prosthodontics. AB - A follow-up survey of trainees in a National Cancer Institute-sponsored program in maxillofacial prosthodontics was conducted. Information about the trainees' current professional activities indicated that the majority work in private practice or a dental school, are primarily involved in clinical work or teaching, and see few cancer patients. Inadequate reimbursement and lack of collaboration with surgeons were cited as barriers to involvement in cancer patient care. It is suggested that barriers to applying training expertise in actual practice settings require emphasis in the planning and curricula of training programs. PMID- 3275242 TI - Experiences with multiphasic screening for cancer. AB - This study reports on our experiences with a multiphasic cancer screening clinic for the detection of early-stage cancers. The clinic under review is the Prevention-Detection Clinic (PDC) housed at Roswell Park Memorial Institute in Buffalo. The PDC offers both free cancer screening examinations and risk reduction education and counseling. Since its inception in May 1979 through 1984, over 13,000 individuals have been screened and counseled. Names of screenees were recently matched against the files of the Western New York Tumor Registry, a population-based cancer registry, to identify screenees subsequently diagnosed with cancer. Matching identified a total of 332 individuals with a cancer diagnosis. Of these, 98 individuals were found to have been diagnosed prior to screening. Of the remaining 234 individuals, 135 were diagnosed after referral from the PDC, 23 went undetected at screening, and 76 were either diagnosed several years after screening or with recurrent disease. The majority of cancers (67%) were detected with in situ/localized stages of disease. PMID- 3275243 TI - Changes in the inpatient and outpatient cancer patient population at a teaching institution over a three-year period. AB - Admission and outpatient clinic records of cancer patients seen by members of the University of Nebraska Medical Center Section of Oncology/Hematology in that section's clinic and on that section's hospital service were studied over a three year period to determine if the tumor types of patients differed importantly from year to year. Cancer patients seen in other clinics or on other clinical services in the medical center were not included in this study. Some striking variations were found. The percentage of cancer patients with lymphoma admitted to the hospital increased significantly, from 23% to 41% (p less than .00001), and the percentage of those patients seen in the outpatient area increased correspondingly. In contrast, the percentage of colorectal cancer patients fell from 11% in 1984 to 4% in 1985 and to 3% in 1986 (p less than .00001). A similar decrease was found in the outpatient clinics as well. In addition, the percentage of breast cancer patients admitted to the hospital fell from 17% in 1984 to 12% in 1985 and to 11% in 1986 (p = .003); there was also a similar decline in the outpatient clinic (p = .00001). Other tumor types were equally represented in all three years in the inpatient and outpatient setting. The patient mix can vary markedly from year to year and should be monitored, so that changes in the teaching program can be made to assure the desired emphasis of all tumor types. PMID- 3275244 TI - Surgical oncology education in US and Canadian medical schools. PMID- 3275245 TI - Breast cancer examination experience of medical students and residents. AB - A survey of fourth-year medical students and residents at three institutions revealed a low experience in examining patients with primary breast cancer. Although the experience was low, there was high confidence in their ability to examine the breast. Changes in learning experiences are necessary. PMID- 3275246 TI - The planning, execution, and evaluation of a breast cancer detection awareness program. AB - A Breast Cancer Detection Awareness Program (BCDAP) was conducted in Western New York during the spring of 1987 in conjunction with a national effort by the American Cancer Society. The importance of screening mammography was promoted by public education through the media combined with promotion of breast cancer screening services available from 26 health care providers. Women were instructed to call a hot line to receive a coupon for a low-cost mammogram, if eligible to participate. A provider directory was included to facilitate scheduling appointments. The program resulted in 6,355 women requesting a coupon. From this population 3,178 women utilized the coupon to receive a mammogram. Although the screening rate of 50% was encouraging, approximately half of the callers to the hot line did not receive a mammogram. To increase the screening rate in future programs, it would be useful to determine why some women did not take advantage of the discount coupon. PMID- 3275247 TI - A comparison of cancer educational resources to prevent smokeless tobacco usage in India and the United States. PMID- 3275248 TI - A curriculum in palliative care for internal medicine housestaff: a pilot project. AB - Despite dramatic growth in the number of hospice programs over the past 15 years, palliative care skills and principles receive minimal attention in medical schools and residency training programs. Northwestern University Medical School and Northwestern Memorial Hospital have developed a program in palliative care education for internal medicine housestaff. Residents, working with a multidisciplinary team of hospice staff, have primary responsibility for the care of terminally ill patients in the home. An inpatient unit is available for acute care when needed. A formal lecture series on symptom management, accompanied by a bibliography and defined learning objectives, provides a guide to the clinical experience. Participating residents also attend seminars focusing on physicians' coping skills and attitudes toward death and dying. Evaluation of the program in its first year shows a definite perception of educational benefit by residents, and enthusiasm for continued involvement in palliative care. PMID- 3275249 TI - Profiles of cigarette smoking among patients in a cancer center. AB - Although cancer patients who continue to smoke are at high risk for subsequent malignancies, especially in tobacco-exposed tissues, they are rarely the target of intervention strategies. We present smoking behavior profiles on 2,531 adult patients registered at The University of Texas M.D. Anderson Cancer Center over a 15-month period. The data are derived from self-administered risk-factor questionnaires. Prevalence data are compared with 1985 data from the National Center for Health Statistics. Percentages of current smokers were similar for men (34.6%) and women (31.8%) and comparable with national survey data. Black men had the highest percentage of current smokers (41%), while Hispanic and black females had the lowest (26.1% and 26.7%, respectively). There were proportionately fewer quitters among women compared with men (19.1% v 37.8%) and among black men and women (20.5% and 11.5%, respectively) compared with whites and Hispanics. Fifty five percent of male patients smoked over 25 cigarettes daily, compared with 33% of men in the national data. The comparable estimates for women were 31% and 21%. While there was a clear inverse association between educational attainment and smoking prevalence, those college-educated men who did smoke were heavier smokers than their less-educated counterparts. These data highlight the importance of tailoring educational programs to correspond with the specific smoking and demographic characteristics of the patient population. PMID- 3275250 TI - [Prevalence of canine function and tooth contacts on the nonfunctional side]. PMID- 3275251 TI - [Leukoplakia of the oral mucosa. Analysis of 206 cases]. PMID- 3275252 TI - [Maxillodental morphology in contemporary Chilean populations of different ethnic origins]. PMID- 3275253 TI - [Physiology of the salivary glands]. PMID- 3275254 TI - [Bite marks or imprints. Their forensic and legal value]. PMID- 3275255 TI - [Antimicrobial properties of sanguinaria, stannous fluoride and zinc chloride on the growth and acid production of Streptococcus mutans (in vitro)]. PMID- 3275256 TI - [Morphological changes in the temporomandibular joint in rheumatoid arthritis. Use of Parma technic]. PMID- 3275257 TI - [Radiographic study of the temporomandibular joint in patients with rheumatoid arthritis. Efficacy of Schuller's technic]. PMID- 3275258 TI - [Agenesis of the permanent dentition in cleft palate patients]. PMID- 3275259 TI - [Anatomo-radiographic study of the mesial roots of upper first molars]. PMID- 3275260 TI - [Analysis of permanent tooth eruption in cleft palate and normal individuals]. PMID- 3275261 TI - [Comparative study of clinico-radiographic diagnosis and histopathological examination of pulp necrosis]. PMID- 3275262 TI - [Follow-up of a pilot program for training of dental auxiliaries in oral health promotion and prevention]. PMID- 3275263 TI - [Temporomandibular joint involvement in osteoarthrosis. A radiographic study]. PMID- 3275264 TI - [Orthopedic-orthodontic treatment planning for the cleft palate child]. PMID- 3275265 TI - [Oral administration of drugs. Influence of diet, alcohol and smoking habits]. PMID- 3275266 TI - [Human genetics and its connections with dentistry]. PMID- 3275267 TI - [New contributions to presurgical treatment of neonates with bilateral cleft lip with or without cleft palate]. PMID- 3275268 TI - [Comparative study of root development in the permanent dentition of cleft palate and normal individuals]. PMID- 3275269 TI - [Mercury: toxic element in dentistry?]. PMID- 3275270 TI - [Oral hygiene in dental students at the University of Chile]. PMID- 3275271 TI - [Design of retainers with metal framework for patients with cleft lip and cleft palate]. PMID- 3275272 TI - [19th national cardiology meeting of the National Association of Hospital Cardiologists. Florence, 18-21 May 1988. Abstracts]. PMID- 3275273 TI - Conclusions concerning the round table on "Medical education in Italy and in the EEC countries". PMID- 3275274 TI - [Pulmonary thromboembolism in the elderly]. PMID- 3275275 TI - [Evaluation of the effects on the composition of alveolar surfactant of 2 chemotherapeutic protocols for carcinoma of the lung: peptichemio and MACC]. PMID- 3275276 TI - [Antimyocardial autoimmunity in ischemic coronary disease]. PMID- 3275277 TI - [Single photon emission myocardial tomoscintigraphy (SPECT) in the evaluation of the extension of the infarct area. Correlation with enzymatic, electrocardiographic and angiocardioscintigraphic data]. PMID- 3275278 TI - [TAC-positive lymphocytes in Basedow's disease]. PMID- 3275279 TI - [Blood CA 19-9 in the diagnosis of carcinoma of the pancreas: a critical approach]. PMID- 3275280 TI - [Changes in the urine composition induced by indapamide in subjects with recurrent calcic calculosis: a possible alternative to thiazide diuretics]. PMID- 3275281 TI - Etiologic patterns of chronic active hepatitis in relation to age. PMID- 3275282 TI - [Chronic HBsAg-negative liver disease. Presence of the markers of hepatitis B virus (HBV) infection and their possible meaning]. PMID- 3275283 TI - [Clinical course of primary glomerulonephritis with mesangial deposits of IgA]. PMID- 3275284 TI - [T-lymphocyte subpopulations in the conjunctiva of subjects with secondary Sjogren's syndrome]. PMID- 3275285 TI - [1-year follow-up of patients with acute urethral syndrome resistant to conventional therapy]. PMID- 3275286 TI - [HIV and nervous system: 8 cases of neurologic syndromes probably caused by the neuropathogenic action of the virus]. PMID- 3275287 TI - [Blood cryoglobulins and liver diseases]. PMID- 3275288 TI - [Binding of sexual steroids to the serum carrier proteins in acute viral hepatitis]. PMID- 3275289 TI - [Non-invasive evaluation of left ventricular function in myotonic dystrophy]. PMID- 3275290 TI - Between clones and clinic. PMID- 3275291 TI - Mode of antitumor action of recombinant human tumor necrosis factor on the sarcoma Meth A transplanted in the mouse. AB - The mode of antitumor action of rHu-TNF was elucidated in BALB/c mice bearing Meth A fibrosarcoma 7 days after transplantation with respect to time course, dose-response relationships and selectivity of the effects. The maximal cytotoxic effect on tumor cells revealed by inhibition of DNA synthesis and maximal lesional effect on tumor vasculature revealed by change in blood pool-size in the tissue were detected at 30 min and 1 h after administration of rHu-TNF, respectively. The dose-response relationship between cytotoxic and tumoricidal effects of rHu-TNF was irrespective of administration route. ED50s of these antitumor effects after i.v. administration of rHu-TNF were about 50 times as high as ED50s after i.t. administration. ED50 of i.t. given rHu-TNF for vascular effect was about 20 times as high as that for cytotoxicity while ED50 of i.v. rHu TNF for vascular effect was only 2-3 times as high as that for cytotoxicity. The whole body autoradiographies with [125I]HSA given i.v. to see the blood influx into tumor tissue and [14C]thymidine given i.v. to see DNA synthesis in the whole body after administration of rHu-TNF revealed that the distribution of radioactivity was markedly changed in the tumor alone without any detectable change in other whole body tissues. In conclusion, the in vivo antitumor effect of rHu-TNF given i.t. or i.v. appears to be exerted through the direct action on Meth A sarcoma rather than indirectly on tumor vasculature. Under present conditions, the effect of rHu-TNF in the whole body tissues seems rather selective on cells and vasculature of the tumor. PMID- 3275292 TI - Effect of water activity on growth and enterotoxin D production of Staphylococcus aureus. AB - Four enterotoxin D-producing strains of Staphylococcus aureus, were cultured at 37 degrees C in brain heart infusion broth adjusted to various water activity (aw) levels by means of NaCl. For high cell inocula growth of all strains and enterotoxin D production were observed within 6 days at aw levels down to 0.86. PMID- 3275293 TI - The effect of pH on the initiation of growth of cottage cheese spoilage bacteria. AB - The influence of pH on strains of Pseudomonas spp. and Enterobacter agglomerans that cause spoilage of cottage cheese varieties during storage at 7 degrees C has been investigated. In a culture medium adjusted to the required pH with HCl, 57 of 64 strains of Pseudomonas spp. grew at pH 4.8 when incubated at 7 degrees C but a very low proportion of strains grew at pH 4.7 or pH 4.6 and none at pH 4.5. At 20 degrees C some of the pseudomonads grew at pH 4.4. Three out of nine strains of E. agglomerans grew at pH 3.8 when incubated at 7 degrees C and at pH 3.6 when incubated at 20 degrees C. In cultures of E. agglomerans at controlled pH and 20 degrees C, after a lag phase the doubling time at pH 4.1 was 2 h, and at pH 7.0 was 1.4 h. PMID- 3275294 TI - Proposed guidelines for maximum acceptable air-borne microorganism levels in dairy processing and packaging plants. AB - From the total number of air-borne microorganisms present per m3 of air, 1.5% were found to contaminate a dairy product while being packed into a container with an opening of 100 cm2 if it was exposed for 60 s. This value was used to compile a proposed guideline of maximum acceptable number of air-borne microorganisms per m3 which, if complied with, could ensure that no significant air-borne contamination of the product being packaged would take place. PMID- 3275295 TI - Production of enterotoxins and thermonuclease by Staphylococcus aureus in cooked egg-noodles. AB - Production of enterotoxin A (SEA), enterotoxin C (SEC), and thermonuclease (TNase) by Staphylococcus aureus was determined during growth in cooked egg noodles at different temperatures (15-37 degrees C). Both SEA and SEC and TNase were detected when greater than or equal to 4.0 x 10(7) colony forming units (cfu)/g were present. The contents of SEA, SEC, and TNase in egg-noodles mainly increased at the end of the exponential growth phase. In contrast with SEA and SEC the production of TNase always continued till the end of each experiment. Recovery rates of SEA and TNase in cooked noodles were dependent on their amounts. High amounts (64 ng SEA/g; 1 unit TNase/g) were recovered at a rate of 93% (SEA) and 54% (TNase) respectively, whereas low concentrations (1 ng SEA/g; 0.004 units TNase/g) were recovered at a rate of only 45% (SEA) and 1.1% (TNase). TNase usually is produced at all conditions which allow growth of S. aureus. Evidence of TNase was proposed for screening for staphylococcal enterotoxins (SE) in foods. But sometimes foods contain no TNase but SE. For this reason the ELISA test which is simple and sensitive should be used for determination of SE production in foods. PMID- 3275296 TI - Predicting microbial growth: growth responses of salmonellae in a laboratory medium as affected by pH, sodium chloride and storage temperature. AB - The growth responses of salmonellae (mixed inoculum of Salmonella thompson, S. stanley and S. infantis) as affected by NaCl concentration, pH level and storage temperature were studied in laboratory medium. Growth curves were obtained at 5 concentrations of NaCl (0.5-4.5%, w/v), 5 pH levels (5.6-6.8) and 5 storage temperatures (10-30 degrees C). Sigmoid curves (Gompertz form) were fitted to the data and the curve parameters used to produce a polynomial model from which predicted growth curves could be generated for any combination of NaCl, pH and storage temperature within the limits studied. From those growth curves values for growth rate, generation time, lag time and other values such as time to a 1000-fold increase in numbers were derived. Such a model offers a cost-effective approach to understanding the microbial growth response in foods, and forms a data-base against which other controlling factors could be evaluated. Some problems of fitting curves to microbial growth data and of modelling such data are discussed. PMID- 3275297 TI - Influence of temperature on growth rate and lag phase of fungi isolated from Argentine corn. AB - The influence of temperature on the growth of nine strains of fungi belonging to the genera Eurotium, Aspergillus, Penicillium and Fusarium has been investigated for the temperature range 15-35 degrees C. The lag phase and the growth rate were evaluated by using a laboratory medium. The maximum growth rate for E. repens, A. wentii and P. chrysogenum was observed at about 25 degrees C, for P. citrinum near 30 degrees C and for F. semitectum and F. moniliforme between 20 and 25 degrees C. The growth rate of A. niger, A. flavus and A. parasiticus increased with increasing temperatures in the range studied. For all strains studied it appeared that the higher the growth rate the lower the lag phase was. PMID- 3275298 TI - Influence of organic acids on heat resistance characteristics of Talaromyces flavus ascospores. AB - Three strains of Talaromyces flavus were investigated for their tolerance to organic acids during and after exposure to elevated temperatures. Fumaric, sorbic and benzoic acids were clearly more lethal than acetic, malic, citric and tartaric acids, and lethality was enhanced as the pH of the heating medium was reduced from 5.0 to 2.5. The effects of sorbic and benzoic acids on viability of ascospores varied depending upon the strain and were influenced by other constituents in the heating medium. Ascospores of a T. flavus strain with greater heat tolerance were larger and less ellipsoid in shape than ascospores of a less heat-tolerant strain, as observed by scanning electron microscopy. While both strains are known to develop heat resistance with age, no external differences in shape, degree of ornamentation and size could be discerned between ascospores as influenced by age (11 and 51 day old) of cultures. PMID- 3275299 TI - Characteristics of lactobacilli isolated from dry fermented sausages. AB - A study of the microflora of Spanish dry fermented sausages showed a similar pattern to that observed in other sausages during ripening. Lactic acid bacteria and organisms growing on Mannitol-salt-agar increased during the first five days, remaining at constant levels afterwards. From MRS agar, 368 strains were isolated and characterized. All Lactobacillus strains (343) could be separated into three groups according to their reactions in the API-50 L system. The biochemical characteristics of the Lactobacillus strains analyzed were those typical of isolates from sausages and other meat products. The extracellular and intracellular lipolytic activities of some strains of the three groups were also studied. It is concluded that lipolytic activity of lactobacilli is mainly directed against mono- and diglycerides and short-chain fatty acid triglycerides. PMID- 3275300 TI - Automated turbidimetry for rapid determination of the bacteriological quality of raw meat and processed meat products. AB - A fully automated centrifugal spectrophotometer for turbidimetric measurements linked to a computer for data processing was used to record and analyze growth of different types of bacteria associated with spoilage of raw meat and processed meat products (sliced meat for sandwiches) in order to predict bacterial counts. Media for this specific analysis were developed to enumerate total viable count, lactic acid bacteria. Brochothrix thermosphacta and Pseudomonas spp. Correlation coefficients of -0.91 to -0.97 were obtained between the conventional plate count technique and the turbidimetric method (linear regression). Lactic acid bacteria in the range 10(3) to 10(9) cfu/g could be detected within 48 h, whereas total viable count, Brochothrix thermosphacta and Pseudomonas spp. generally could be detected within 24 h. Counts exceeding 10(7) cfu/g could be detected within 6 h. PMID- 3275301 TI - Study of the Bacillus flora of Nigerian spices. AB - Bacteriological examination of 230 samples of five different unprocessed spices (aligator pepper, red pepper, black pepper, thyme and curry powder) collected randomly from Port Harcourt main markets revealed that the spices were highly contaminated, with bacterial counts ranging from 1.8 x 10(4) to 1.1 x 10(8) per gram. Bacillus cereus was isolated in high numbers in the majority of the 230 samples examined. It was also observed that other Bacillus spp. including B. subtilis, B. polymyxa and B. coagulans occurred in significant numbers. PMID- 3275302 TI - The design and application of a model system to investigate physical factors affecting container leakage. AB - A model system was designed and constructed to investigate the mechanisms of food container leakage. Factors which were found to affect the leakage of microorganisms into the container, included the presence of a vacuum, the size and shape of the leakage channel and the volume of liquid passing through the channel. Differences were observed among the test organisms used. PMID- 3275303 TI - Enumeration of Yersinia enterocolitica O:3 from the porcine oral cavity, and its occurrence on cut surfaces of pig carcasses and the environment in a slaughterhouse. AB - The number of Yersinia enterocolitica serogroup O:3/biovar 4 recovered from five porcine tongues, ranged from 0-186/cm2, the corresponding range for the tonsils was, 0-1720/cm2. This bacterium was isolated from the oral cavity of 25 (83.3%) of 30 freshly eviscerated slaughter pigs. The isolation rates obtained from the different cut surfaces were: cranial incision, 46.7%; abdominal incision, 43.3%; and circumanal incision, 26.7%. Seven pigs harboured the bacteria in the oral cavity only, and one pig yielded Y. enterocolitica serogroup O:3/biovar 4 only from the abdominal incision. In eighteen pigs the bacteria was obtained from the oral cavity and at least one of the cut surfaces, four of these pigs yielding the bacteria from all sites sampled. Y. enterocolitica O:3/biovar 4 was isolated from samples taken from the following sites in the slaughterhouse: the floor in the bleeding area, the floor in the eviscerating area, the viscera table, and the floor next in line after the meat inspection area. The organism was not found on the floor in the meat inspection area. It is concluded that modern slaughtering technology and the routines followed by meat inspection personnel have probably contributed to the relatively high rates of this bacteria on carcass cut surfaces detected in this study. The results of this investigation thus emphasize the need to consider the introduction of changes in slaughtering technology and meat inspection practices presently being employed in Norwegian slaughterhouses. PMID- 3275304 TI - Changes in aerobic microflora of skin and gills of Mediterranean sardines (Sardina pilchardus) during storage in ice. AB - Sardines from the Adriatic Sea were examined fresh and after 4 and 8 days of storage in ice. A total of 1500 strains isolated were identified from the gills and the surface of the fish. Pseudomonadaceae, Neisseriaceae, Flavobacterium/Cytophaga, Enterobacteriaceae, coryneform bacteria and Micrococcaceae were the most common bacteria in fresh fish. During storage the pseudomonads (mainly the non-fluorescent strains) increased and became the dominating microflora; the Neisseriaceae (Moraxella, Psychrobacter and Acinetobacter) showed a distinct increase during the first 4 days in ice; the percentage of the other bacterial groups clearly decreased. On the gills the quantitative changes in the microflora were less pronounced than on the surface. PMID- 3275305 TI - Water activity influence on aflatoxin accumulation in corn. AB - The influence of water activity on the production of B1, B2, G1 and G2 aflatoxins in corn has been examined. Viable corn kernels were conditioned at three water activity levels (0.87, 0.90 and 0.97) and inoculated with Aspergillus parasiticus at 30 degrees C. Aflatoxin accumulation was determined at selected times by thin layer chromatography. For the strain used total aflatoxin accumulation was greater at water activity 0.90 than at 0.87 and 0.97 for the incubation times studied. PMID- 3275306 TI - The effect of lactic acid sprays on the keeping qualities of meat during storage. AB - Spraying the meat surface of skinned cow heads with 1% v/v lactic acid resulted in significant reduction in total viable counts of bacteria at storage temperatures of 4, 15 and 20 degrees C. The number of coliform bacteria was also reduced at all three temperatures but the reductions were not statistically significant on most occasions. However, after five and two days at 15 degrees C and 20 degrees C, respectively, when the initial effect of acid appeared to be lost, the number of coliforms on sprayed heads exceeded those on unsprayed heads. The shelf lives of all sprayed heads were observed to have been extended for about three days at 4 degrees C and one day for both 15 degrees C and 20 degrees C. PMID- 3275307 TI - The detection of enterotoxin and toxic shock syndrome toxin-1 production by strains of Staphylococcus aureus with commercial RPLA kits. AB - Two reversed passive latex agglutination kits (SET-RPLA and TST-RPLA) were used to detect enterotoxin and toxic shock syndrome toxin-1 (TSST-1) production by 334 strains of Staphylococcus aureus isolated from clinical sources and from outbreaks of food poisoning. The results were compared to those obtained with the traditional gel diffusion method. All strains positive by gel diffusion were also positive by RPLA. Seventeen strains produced low levels of TSST-1 or enterotoxins C or D which were only detected by the RPLA method. Some non-specific reactions were obtained with the SET-RPLA kit, but not with the TST-RPLA kit. PMID- 3275308 TI - A medium for the detection of yeasts using a conductimetric method. AB - A new medium is described for the detection of yeasts using a Malthus microbial growth analyser which measures conductivity. This medium is superior to previous media devised for use in the Malthus, and allows the detection of a wide range of yeasts including those important in food spoilage. The new medium was inferior to existing media used to detect yeasts in the Bactometer 32 instrument which measures impedance. PMID- 3275309 TI - The growth of Aeromonas hydrophila K144 in ground pork at 5 degrees C. AB - The influence of NaCl, pH, atmosphere, and background microflora on the growth and/or survival of Aeromonas hydrophila K144 was studied in ground pork held at 5 degrees C. In ground pork, A hydrophila was sensitive to pH values below 6.0 in the form of either a low starting pH in the pork itself or induced by lactic acid bacteria action on added glucose. Growth of the organism is inhibited by NaCl levels of 3% (w/w) (approx. 4% brine content). A hydrophila grew in vacuum packaged ground pork; its growth was diminished by the presence of the naturally occurring meat microflora. Except for pH values below 6.0, conditions which inhibited growth permitted survival of the organisms for extended periods. Data indicate that the growth of A. hydrophila in ground pork can be controlled by factors such as NaCl, pH, and background microflora. In general, measures designed to control other foodborne pathogens appear adequate to limit A. hydrophila. PMID- 3275310 TI - Microbiological safety of traditional and starter-mediated processes for the manufacture of Italian dry sausage. AB - Microbiological changes occurring during the commercial manufacture of Italian dry sausages (Genoa and salametti) were studied in two urban Canadian centres over a 5 month period. A comparison was made between 6 plants which used bacterial starter cultures and 4 plants where more traditional processes (without starters) were used. A total of 600 samples of raw, fermented and finished products were tested for the presence of coliforms, salmonellae, staphylococci, streptococci, the rate of pH reduction and final water activity (aW). Numbers of total bacteria peaked earlier and were significantly higher in sausages at the fermentation stage produced with starter cultures than in those traditionally manufactured. This corresponded with a more rapid drop in pH of the starter inoculated products. Staphylococci and streptococci were significantly higher in starter-fermented Genoa sausages at the fermentation stage, but no significant differences were seen in the microbiological content or aW of mature finished sausages manufactured by the two different techniques. Of 128 randomly chosen isolates of coagulase-positive staphylococci, 34.4% were enterotoxin producers and 80% of these produced type A toxin. Enterotoxigenic staphylococci were found in 2 different samples of finished salametti and one sample of finished Genoa made with starter cultures and in one sample of finished Genoa made without added culture. Total numbers of staphylococci in these samples were not greater than 500/g. No correlation between the method of manufacture and presence of enterotoxigenic staphylococci could be made. Five subsamples from one lot of raw Genoa were the only samples positive for Salmonella during this study. Results indicated that low temperature traditional fermentations can yield products which are as safe as those produced by the higher temperature starter-controlled process. One of the most important elements in the traditional process was believed to be the selection and use of raw materials of the highest possible quality. PMID- 3275311 TI - Occurrence and significance of streptococci in fermented Italian type dry sausage. AB - Commercial cultures used in Canada for the manufacture of Italian dry sausage were examined to determine their microbial composition and suitability for low temperature (less than or equal to 20 degrees C) meat fermentations. Temperature optima in both laboratory media and commercial meat mixtures were generally too high to allow these cultures to be of substantial advantage in this application. In addition, media used currently for the enumeration of streptococci and related organisms from fermented meat products were found to be inadequately specific and often required confirmatory inspection of colonies by conventional phase contrast microscopy. Streptococci were isolated from Italian dry sausage manufactured commercially with and without added starter cultures. Streptococci persisted in sausages produced by both techniques with slightly higher numbers present in starter-acidulated sausages. About 55.5% of the 312 streptococci studied were enterococci (Lancefield's Group D). Streptococci were found in several samples of commercial starter cultures but it was felt that elevated ripening temperatures used for sausage manufactured by the starter-mediated process and meat handling practices were more important factors influencing streptococci recovery from sausage material. PMID- 3275312 TI - Water relations of Paecilomyces variotii, Eurotium amstelodami, Aspergillus candidus and Aspergillus sydowii, xerophilic fungi isolated from Indonesian dried fish. AB - The water relations of four xerotolerant fungi, Paecilomyces variotii, Eurotium amstelodami, Aspergillus candidus and Aspergillus sydowii, isolated from dried salt fish, were examined at 25 degrees C, on media in which water activity (aW) was controlled by NaCl or a glucose/fructose mixture. All fungi were less tolerant of NaCl than glucose/fructose at low aW. P. variotii grew 2 to 3 times faster on glucose/fructose media than on NaCl. The minimum aW permitting germination varied from 0.753 for E. amstelodami and, 0.776 for A. candidus and A. sydowii to 0.793 for P. variotii. At low aW germination was not always followed by growth. In most cases the minimum for growth was 0.02 aW units above that for germination. PMID- 3275313 TI - Synergistic effect of fungicides on resistant strains of Penicillium italicum and Penicillium digitatum. AB - In vitro and in vivo tests were carried out to study the inhibitory effect of mixtures of sodium orthophenylphenate, methyl-1-(butyl-carbamoyl)-2-benzimidazole ('Benomyl') and sodium orthophenylphenate, 2-(4-thiazolil)-benzimidazole ('Thiabendazole') on growth of strains of Penicillium italicum and P. digitatum resistant to sodium orthophenylphenate, 'Benomyl' and 'Thiabendazole'. 'In vitro' tests showed a synergistic effect of the mixtures; 10 ppm of sodium orthophenylphenate and 10 ppm of the benzimidazolic compound in most cases resulted in complete growth inhibition. Navel oranges inoculated with P. italicum spores showed no damage after 7 days of incubation at 25 degrees C and 80-90% relative humidity when treated with a mixture of 100 ppm of sodium orthophenylphenate and 100 ppm of Thiabendazole. PMID- 3275314 TI - Production of penitrem A by Penicillium crustosum isolated from foodstuffs. AB - Sixty one isolates of Penicillium crustosum originating from various foodstuffs were screened for penitrem A production by thin-layer chromatography. The highest producers of penitrem A (4 isolates) were grown in various liquid media. Skimmed milk (2%)/potato extract (2%)/sucrose (2%) (SPS) medium supported the highest toxin production and P. crustosum Sp 1552 was selected as the best producer of penitrem A. Optimal conditions for the production of penitrem A were to grow the isolate Sp 1552 (stationary) in 100 ml of SPS medium (with 4% sucrose) in 500-ml flasks for 3 weeks at 25 degrees C with initial pH 5.7. The isolation and purification of penitrem A is described. Approximately 246 mg of pure penitrem A was obtained from 200 flasks each containing 100 ml of SPS medium. PMID- 3275315 TI - The evaluation of the recovery capacity of media for heat-treated Bacillus stearothermophilus spore strips. AB - Six media were assessed for their capacity to recover spores of Bacillus stearothermophilus from three commercially available types of spore strip heated for up to 5 min at 121 degrees C in steam. All media recovered similar numbers of spores from unheated strips; however, there was considerable difference in survivor counts when the media were used to recover heated spores. Media containing starch consistently recovered the highest number of spores. The greatest difference in recovery capacity between the media was observed when spore strips were heated for 5 min at 121 degrees C. PMID- 3275316 TI - Temperature influence on Penicillium citrinum thom growth and citrinin accumulation kinetics. AB - To study the temperature influence on both Penicillium citrinum growth and citrinin accumulation, a 20, 25 and 30 degrees C. Radial and 30 degrees C. Radial growth rate and lag phase were determined from the increase in colony diameter with time. The optimal temperature for P. citrinum growth was 30 degrees C. Citrinin extracted from the agar medium was determined by thin layer chromatography. Citrinin accumulation kinetics were analyzed by fitting the data to curves generated by using a logistic function. The parameters obtained from this equation demonstrated, for all temperatures studied, that the maximum citrinin accumulation by P. citrinum on Czapek agar with maize extract was at about 30 degrees C. At 37 degrees C a rapid decrease in the citrinin concentration was observed after a maximal value was reached. PMID- 3275317 TI - Physiology of Sporolactobacillus strains isolated from different habitats and the indication of in vitro antagonism against Bacillus species. AB - In an ecological study only low numbers of Sporolactobacillus were found in habitats such as the faeces of herbivores, the rumen of cattle and the final waste water of an abattoir. Their presence in the final waste water of an abattoir indicates their possible association with food, and, more specifically, with meat. Differences were found in some physiological characteristics. One isolate (L2404) differed from the authentic Sporolactobacillus ATCC 15538 by its inability to ferment inulin, its growth in presence of 6.5% NaCl and in 0.2% tellurite, by the isomer(s) of lactic acid produced and the mol% G + G in the DNA. One Sporolactobacillus isolate (L2407) showed antagonism against Bacillus cereus, Bacillus cereus var, mycoides, Bacillus megaterium and Bacillus subtilis. PMID- 3275318 TI - Resistance of vegetative cells and endospores of Sporolactobacillus to gamma irradiation. AB - Vegetative cells of Sporolactobacillus showed average resistance to gamma irradiation compared to other vegetative bacteria with D10 values ranging from 0.350 to 0.525 kGy. Endospores of Sporolactobacillus showed higher resistance to gamma-irradiation than most Bacillus species but were close to that of Clostridium species. The average D10 value for Sporolactobacillus endospores was 2.5 kGy. PMID- 3275319 TI - Use of MRSD medium and the hydrophobic grid membrane filter technique to differentiate between pediococci and lactobacilli in fermented meat and starter cultures. AB - Modifications of MRS medium were made by incorporation of 0.1 M L-arginine-HCl, 0.0025% phenol red, 100 IU polymyxin B sulfate, by deletion of meat extract, use of only 1.2% (w/v) glucose and increase of Mn2+ to 1000 ppm. In addition, adoption of the hydrophobic grid membrane filter (HGMF) system with 0.025% Fast Green FCF dye and adjustment of the agar medium to pH 5.5 gave MRSD (differential) medium. Incubation at 25 degrees C anaerobically under N2 or CO2 followed by a post-growth staining procedure involving use of 0.4% (w/v) bromocresol purple yielded conditions under which pediococci colonies were blue whereas homo- and heterofermentative lactobacilli were green in color. Under these conditions, 7 pediococci, 16 lactobacilli, and 18 commercial meat starter cultures were successfully analyzed by plate count to yield a differential assessment of the lactobacilli and pediococci present without interference from the 9 other genera tested. Streptococcus lactis and Leuconostoc spp. produced blue and green colonies, respectively, at 25 degrees C which might interference but these organisms are not present in significant numbers in fermented meats. Pediococcus parvulus and Streptococcus faecalis produced green and blue colonies, respectively, but their very poor growth at 25 degrees C prevented their interference. Use of the developed MRSD medium was described for enumeration of both pediococci and lactobacilli in starter cultures and in fermenting dry sausages to enable documentation of starter culture performance. PMID- 3275320 TI - The response of Campylobacter jejuni and Campylobacter coli in the Sydney rock oyster (Crassostrea commercialis), during depuration and storage. AB - Sydney Rock Oysters, when allowed to feed in waters containing approximately 10(4) cfu of Campylobacter cells per ml, concentrated between 10(2) and 10(3) cfu of the organism per g of oyster tissue, within 1 h. When these contaminated oysters were subjected to depuration, they were effectively cleaned in 48 h. The survival of Campylobacter jejuni and Campylobacter coli was also investigated. Oysters contaminated by feeding and injection were processed as half shells and bottled oysters and were held at 3 and 10 degrees C. Half shells were also stored at -20 to -24 degrees C. At all these temperatures the organism survived for periods varying between 8 to 14 days and in oysters contaminated by feeding, the survival was substantially greater. Survival was better at 3 than at 10 degrees C in half-shelled oysters. Campylobacter survived better in bottled oysters than in half shells stored at the same temperature. In frozen half shelled oysters previously contaminated by feeding, the organisms were viable for months. In contaminated unopened oysters stored at 20 and 30 degrees C, C. jejuni and C. coli failed to multiply as expected. They survived for periods varying from 2 to 9 days. PMID- 3275321 TI - Enterotoxigenicity of Staphylococcus intermedius of canine origin. AB - Seventy-three staphylococcal strains isolated from pyrodermatitis in dogs were classified as Staphylococcus intermedius (52 strains) or Staphylococcus aureus (21 strains) on the basis of acetoin formation, anaerobic mannitol fermentation, aerobic maltose fermentation, pigmentation, coagulation of human plasma, and reaction on crystal violet agar. Enterotoxin was produced by 13 of the 52 S. intermedius strains and 6 of the S. aureus strains. The highest percentage of enterotoxigenic strains produced enterotoxins C (6 strains), D (7 strains), and E (6 strains). Four strains produced the toxic shock syndrome toxin-1. There was little difference in the antibiotic susceptibility between the enterotoxigenic and non-enterotoxigenic strains. PMID- 3275322 TI - Contamination of freshly slaughtered pig carcasses with human pathogenic Yersinia enterocolitica. AB - Evidence is presented for the extent of contamination of freshly slaughtered pig carscasses with human pathogenic Yersinia enterocolitica and shows the significance of faecal contamination as a source of infection. Swab samples collected from the rectum and the surface of a total of 1458 pig carcasses were examined for the presence of human pathogenic Y. enterocolitica. Y. enterocolitica, biovar IV, serogroup 0:3, were isolated from the rectum of 360 pigs (24.7%). The organism was isolated from carcass surfaces with varying frequencies depending on the evisceration technique. Manual evisceration was found to correspond with high frequencies of contamination: 26.3% on the medial hind limb and 12.9% on the split sternum. The use of a mechanised bung cutter was found to reduce the rate of contamination, especially when the bung cutter was used in connexion with enclosing the anus and rectum in a plastic bag to minimise faecal contamination. When carcasses were eviscerated in this way, it was possible to reduce carcass contamination to 1.9% on the medial hind limb, 1.0% in the pelvic duct, and 2.2% on the split sternum. PMID- 3275323 TI - Mould spoilage of cereals during transportation by sea from Latin America to Europe mechanisms, impact and management. AB - Safe water contents of consignments of cereals to be shipped overseas can be calculated from the relation between mould-free storage time and storage conditions (temperature of the environment, aw of the cereal), corrected for heterogeneity of water distribution, content of damaged kernels and degree of infestation by insects. The validity of this model was substantiated by the inspection of shipments and theoretical data from the literature. This predictive model can usefully be substituted for previously used, ill-defined criteria like average or any portion's water content and should prompt the trade to sell consignments of cereals on the basis of dry substance. PMID- 3275324 TI - Spoilage relating to the storage and transport of cereals and oil seeds. AB - Cereal grains are liable to damage during shipment as a result of mould growth that generates both heat and moisture. Such heating, like that for insect infestation, results in moisture migration that can cause damage to other parts of the stow. Increasing storage temperature may also increase equilibrium relative humidity (ERH) above the threshold for mould growth. To avoid damage, the initial water content and the loading temperature have to be considered together to prevent any part of the stow exceeding this threshold. Temperature differences between the centre of the grain and its periphery, whether due to mould or insect heating, shipboard sources of heat or decreasing ambient temperatures, must be minimised and the period of time from loading to discharge kept as short as possible. PMID- 3275325 TI - Mould deterioration of agricultural commodities during transit: problems faced by developing countries. AB - Huge quantities of agricultural commodities are being either imported or exported by the developing countries. The commodities have to be transported from the fields of cultivation to the centres of consumption, considerable time being taken for the movement not only because of long distances but also because of various socio-economic, environmental and biological reasons. These commodities are likely to be damaged by mould growth and subsequent aflatoxin accumulation. If the contamination occurs during transit, often no insurance cover for the risk is available. Because of different methods of sampling followed in the exporting and importing countries it is often difficult to define the exact responsibility of the development of aflatoxin as having taken place during transit. The statistics of the export of aflatoxin high-risk commodities like red pepper (chillies), cotton seed and groundnut extractions clearly, for the last decade, demonstrate the extent of loss suffered by the exporting countries because of aflatoxins. The problem of mould damage and mycotoxin contamination can be minimised by improving facilities for storage at ports and transit points as well as on ships. PMID- 3275326 TI - The relationship of insects to the deterioration of stored grain by fungi. AB - The data presented tests the hypothesis that knowledge of basic biological relationships between insects and fungi in the stored grain ecosystem can open new paths for management of the system. Evidence indicates: (1) some storage insect species are disseminators of storage fungi and some are exterminators; (2) some storage fungi attract storage insects and promote their population increases and other repel and secrete toxins harmful to insects; (3) certain morphophysiologic, biochemical similarities of fungi and the early developmental stages of insects suggest that new protective chemicals, 'insecticidal fungicides', could be designed or specifically sought. A specific example of a naturally occurring compound with dual action, sorbic acid (2,4-hexadienoic acid), is given and its effect on both insects and fungi is discussed. Sorbic acid is the only compound in the U.S. presently labelled by the FDA (Food and Drug Administration) as GRAS (Generally Regarded as Safe) and registered by the EPA (Environmental Protection Agency) for use on grain (maize) in storage. PMID- 3275327 TI - Ecological determinants of mould growth in stored grain. AB - Grain entering store carries a microflora of 'field' and 'storage' fungi. Field fungi require readily available water and therefore seldom develop in store. By contrast, storage fungi, especially Aspergillus spp., are able to grow at low water activities (aw, 0.70-0.75) enabling them to initiate grain spoilage. The ability of storage fungi to germinate, grow and sporulate in stored grain is dependent on the availability of water in the substrate, temperature and the intergranular gas composition. These factors may interact to have a profound influence on the initiation of spoilage of stored grain by fungi. An understanding of the ecological determinants of mould growth may help to develop improved and safer methods of grain storage. PMID- 3275328 TI - Effect of environmental conditions during soya-bean fermentation on the growth of Staphylococcus aureus and production and thermal stability of enterotoxins A and B. AB - During tempe manufacture, Staphylococcus aureus was able to survive in newly started soya-bean soaks (final pH 4.7), whereas it died during soaks with accelerated souring (final pH 4.0). No S. aureus were detected after subsequent heat treatment of soaked beans. S. aureus strain S6 could produce enterotoxins A and B if inoculated on cooked soya-beans. Its growth and enterotoxin production were not influenced by inoculation rate nor by the presence of actively growing Rhizopus oligosporus, the fungus responsible for tempe formation. Enterotoxin levels were highest after 48 h fermentation. Presence of lactobacilli (L. brevis or L. plantarum) during the tempe fermentation did not influence staphylococcal growth, but enterotoxin levels were reduced. Reduced oxygen pressure did not affect staphylococcal growth, but resulted in lower enterotoxin levels after 48 h incubation. The thermal stability of enterotoxin A in tempe was significantly lower than in Brain Heart Infusion broth of comparable pH. Heating of enterotoxin containing tempe mash reduced enterotoxin A by 99.7% as measured with ELISA and animal feeding methods. PMID- 3275329 TI - Estimation of human dose of staphylococcal enterotoxin A from a large outbreak of staphylococcal food poisoning involving chocolate milk. AB - An outbreak of gastroenteritis in a school district in the United States was determined to be staphylococcal food poisoning due to 2% chocolate milk containing staphylococcal enterotoxin A (SEA). Twelve one-half pint (approx 0.28 l) cartons of the 2% chocolate milk from this outbreak were analyzed for the quantity of SEA present in the milk. The amount of SEA in the cartons varied from 94 to 184 ng with the average being 144 ng (mean = 139 +/- 45). The attack rate for vomiting among those who consumed more than one carton was greater (38.3%) than among those who consumed only one carton (31.5%) with the highest attack rate among those who consumed three or more cartons (44.4%). PMID- 3275330 TI - Identification of major contamination sources during processing of emulsion sausage. AB - The extent of contamination of an emulsion type of sausage with lactic acid bacteria was determined along the processing line. This was done by aseptically removing sausages after five different processing stages (heat processing, chilling, cold storage, cutting down and packing). Removed sausages were vacuum packed and stored at 8 degrees C. The microbial growth was followed during storage and the microbiological shelf-life obtained at the different stages of the processing was determined. The spoilage flora of stored sausages was identified/grouped. Two major hygienic problems were identified: (1) a heat tolerant flora of Lactobacillus viridescens which survived the heat processing and was never outgrown by the recontaminating flora; (2) recontamination with a flora dominated by Lactobacillus sp. group 5, which occurred in the cold storage room; this flora dominated in the absence of L. viridescens. The heat tolerant L. viridescens SMRICC 193 survived at 68 degrees C for 40 min. Being exposed to a slowly increasing temperature, only a 10 cfu/ml decrease took place when the temperature increased from 60 degrees C to 70 degrees C over a period of 30 min. PMID- 3275331 TI - Ropy slime formation in vacuum-packed cooked meat products caused by homofermentative lactobacilli and a Leuconostoc species. AB - This paper deals with the cause of the formation of ropy slime on the surface of vacuum-packed cooked meat products. Two different homofermentative lactobacilli and a Leuconostoc strain were isolated from different ropy vacuum-packed meat products. The strains were able to produce slime experimentally on vacuum-packed cooked sausages. The slime had a molecular weight in the range of 70000-30000 and contained glucose and galactose in a ratio 10:1-10:2. The formation of ropy slime also occurred on sausages without added sugars. PMID- 3275332 TI - The role of partial liver resection for metastatic cancer. AB - Major progress has been made during the last decade in the safety and results of partial liver resection for metastatic cancer. Survival rates of 20% to more than 40% for five or more years can now be achieved. PMID- 3275333 TI - Patterns of care: how American oncologists are treating stage II breast cancer. PMID- 3275334 TI - Surgery vs radiation for localized prostate cancer. AB - With the increased incidence of prostate cancer, decisions regarding its treatment are now both complex and frequent. Accurate staging is crucial. Then appropriate treatment can be decided on, using nondogmatic common sense. PMID- 3275335 TI - More on the question of chemotherapy for CNS glioma. PMID- 3275336 TI - The current approach to breast reconstruction. AB - Over the last 30 years, breast reconstruction has become a standard part of the care of the breast cancer patient. While it may take another 30 years for many of the traditional oncologic concerns about reconstruction to be answered, indications are that reconstruction does not alter the patient's prognosis in any way. The increased understanding of breast cancer as a disease which is systemic from early in its course has removed many of the former objections to reconstruction. Reconstruction can be performed after almost any type of mastectomy. Chemotherapy does not interfere with reconstruction, as long as the timing of doses is considered. However, therapeutic radiation does present problems which may preclude reconstruction. Conversely, having had reconstruction does not interfere with later chemo or radiation therapy. The author describes reconstructive options and their relationship to oncological decisions and concerns. PMID- 3275337 TI - Should all patients with CNS lymphomas be tested for HIV? PMID- 3275338 TI - What role for oophorectomy in this patient? PMID- 3275339 TI - When is adjuvant treatment of stage IIIA breast cancer recommended? PMID- 3275340 TI - Diagnosis and management of plasmacytomas. AB - Although no optimal dose-response relationship has been defined for the local control of extramedullary plasmacytomas, the author recommends high local doses of 5000 cGy or more and field sizes sufficient to cover the primary mass, all its extensions as evident by CT scan, and the regional lymph nodes. Plasmacytomas of bone also should be treated aggressively. PMID- 3275341 TI - Controversy over surgery vs radiation for localized prostate cancer. PMID- 3275342 TI - The usefulness of chromosome analysis in clinical oncology. AB - Chromosome studies are useful in clinical oncology. They can help establish an accurate diagnosis, guide treatment, and determine the prognosis. The author discusses situations where chromosome studies are indicated. PMID- 3275343 TI - Concerns about intracavitary chemotherapy. PMID- 3275344 TI - More on surgery vs radiation for localized prostate cancer. PMID- 3275345 TI - Cancer control objectives for the year 2000. AB - A 50% reduction in the cancer mortality rate can be achieved by the year 2000. This is the stated goal of the National Cancer Institute which has set national cancer control objectives focusing on prevention, screening and detection, and treatment. Prevention in terms of reducing tobacco use and modification of diet, and state-of-the-art treatment are expected to bring about the greatest reductions in mortality. This article summarizes the deliberations and recommendations of the NCI's four working groups. PMID- 3275347 TI - "Stow biases" in treating localized prostate cancer. PMID- 3275346 TI - A promising regimen for stage IIIB breast cancer. PMID- 3275348 TI - A question on intracavitary chemotherapy. PMID- 3275349 TI - Is Hodgkin's disease an AIDS-associated disease? PMID- 3275350 TI - On the efficacy of radiotherapy for lymphomas in AIDS patients. PMID- 3275351 TI - [Transparency of ocular lenses. I. Basic scale of absorption spectrophotometry, methods of measuring transparency in vitro]. PMID- 3275352 TI - [Transparency of the cornea and ocular lens]. PMID- 3275353 TI - [A simple method of measuring ocular lens transparency]. PMID- 3275354 TI - [Examination of lens transparency in vitro depending on temperature]. PMID- 3275355 TI - [Examination of the transparency of a posterior chamber lens removed from the eye after 6 months]. PMID- 3275356 TI - [Examination of transmitting spectra in lenses with cataracts]. PMID- 3275357 TI - [Examination of the influence of certain factors on the transmission of light by the lens]. PMID- 3275358 TI - [Changes in light transmission by the lens depending on age]. PMID- 3275359 TI - [Examination of changes in light transmission in normal lenses and lenses with cataract]. PMID- 3275360 TI - [Spectrum of the ocular lens in infrared light. I. Preparation of the sample for measurement]. PMID- 3275361 TI - [Spectrum of the ocular lens in infrared light. II. Characteristics of selected lenses on the basis of their spectra in infrared light]. PMID- 3275362 TI - [Measurements of fluorescence spectra in transparent and cataractous lenses]. PMID- 3275363 TI - [Fluorescence excitation spectra of opacified lenses]. PMID- 3275364 TI - [Preparation of human and animal lenses for observation by an electron scanning microscope]. PMID- 3275365 TI - [Suspensory ligament of the lens under a scanning electron microscope]. PMID- 3275366 TI - [Scanning microscopy of a posterior chamber lens extracted from the eye after 6 months]. PMID- 3275367 TI - [The content of zinc in opaque human lenses]. PMID- 3275368 TI - [Glycosylation and concentration of water soluble proteins in the rabbit lens]. PMID- 3275369 TI - [Relaxation of protons in animal lenses]. PMID- 3275370 TI - [Present possibilities of utilizing nuclear magnetic resonance tomography in the examination of the human lens]. PMID- 3275371 TI - [Risk factors for complications in cataract surgery using cryoextraction methods]. PMID- 3275372 TI - [250 implantations of posterior chamber artificial lenses]. PMID- 3275373 TI - [Implantation of intraocular lenses into the lens capsule using the envelope method]. PMID- 3275374 TI - [Posterior chamber lens implants--personal material]. PMID- 3275375 TI - [Implantation of posterior chamber lenses after extracapsular cataract extraction]. PMID- 3275376 TI - [Results and complications of artificial lens implantation based on personal experience]. PMID- 3275377 TI - [Complications after implantation of intraocular lenses on the basis of personal observations]. PMID- 3275378 TI - [Condition of the posterior lens capsule after extracapsular cataract extraction with artificial lens implantation]. PMID- 3275379 TI - [Traumatic cataracts and intraocular implants in 10 years of material]. PMID- 3275380 TI - [Artificial intraocular lenses in traumatic cataract]. PMID- 3275381 TI - [Pseudophakia in children and youth]. PMID- 3275382 TI - [Artificial intraocular lenses in children and youth]. PMID- 3275383 TI - [Determination of refraction of the intraocular lens]. PMID- 3275384 TI - [Review of formulas used for calculating the power of artificial lenses]. PMID- 3275385 TI - [Refraction after cataract extraction with implantation of an artificial lens]. PMID- 3275386 TI - [Astigmatism after implantation of an artificial posterior chamber lens]. PMID- 3275387 TI - [Binocular vision after cataract extraction]. PMID- 3275388 TI - [Evaluation of the effect of intravenous administration of streptokinase in acute myocardial infarction]. PMID- 3275389 TI - [Anti-thyroglobulin, anti-microsomal and anti-membrane antibodies and serum thyroglobulin level in patients with simple goiter]. PMID- 3275390 TI - [Condition after removal of one kidney]. PMID- 3275391 TI - [Bronchoalveolar lavage (BAL) in pulmonological diagnosis]. PMID- 3275392 TI - [Evaluation of the effect of mazindol on the metabolism and lipolysis in obese women]. PMID- 3275393 TI - [Effect of laser irradiation on arteriosclerotic changes in coronary arteries. Preliminary report]. PMID- 3275394 TI - [Evaluation of bone marrow granulopoiesis in patients on the long-term hemodialysis program]. PMID- 3275396 TI - [The phlebotomus sandflies (Diptera, Psychodidae) of Hoggar]. PMID- 3275395 TI - [Activity of factor XIII and various lipid components of blood serum in patients with diabetes mellitus]. PMID- 3275397 TI - [Contribution of the duodenal biopsy in the diagnosis of kala-azar]. PMID- 3275398 TI - [Epidemiology of cholera in Algeria from 1971 to 1985]. PMID- 3275399 TI - [Serological diagnosis of hydatidosis: application of a simple technic for mass screening]. PMID- 3275400 TI - [Importance of parasitological monitoring of the stools of employees of public food establishments (initial results of a survey performed in the city of central Algiers)]. PMID- 3275401 TI - [Production of monoclonal antibodies against rabies virus]. PMID- 3275402 TI - [The pre-S/anti-pre-S system in viral hepatitis B]. PMID- 3275403 TI - [Importance of blood culture in septicemia, particularly bacterial endocarditis]. PMID- 3275404 TI - [Consumption of goat cheese and human brucellosis in Ghardaia (Algeria)]. PMID- 3275405 TI - [House-dust mites and the diagnosis of respiratory allergies]. PMID- 3275406 TI - Serum immunoglobulin E after myocardial infarction. PMID- 3275407 TI - Serotonin and serotonin-immunoreactive neurons in the nervous system of insects. PMID- 3275408 TI - Specificity of connections in the ventroposterior nuclei of the thalamus. PMID- 3275409 TI - Effects of coronary laser radiation. PMID- 3275410 TI - Biopsy diagnosis of myocarditis. AB - In closing, we can only note that none of the classification schemes for myocarditis has been perfect for clinicians, pathologists, and researchers alike. The definition and classification protocol offered by the "Dallas" group is based solely on histology, but we urge its use by physicians and other researchers as a means of imposing some standardization on the study of myocarditis. The question of optimum treatment, particularly immunosuppressive therapy, has never been definitively answered, but it is now clear that a large, multicenter randomized trial is the only proper method to search for such an answer. Standard nomenclature is a prerequisite for this study. In the meantime, the clinical correlates and prognostic utility of these histologic categories may be defined; these morphologic groupings will probably be shown to be clinically heterogeneous. In the end, we hope a hybrid clinical-pathologic scheme for the diagnosis and classification of myocarditis will be forged. Such a protocol, ideally, will allow the correlation of structure with function and also reliably predict clinical behavior and response to treatment so that someday we may be able to both counsel and cure persons with myocarditis. PMID- 3275412 TI - Evaluation of operatively excised cardiac valves. PMID- 3275411 TI - Cardiac transplantation. AB - Cardiac transplantation offers an excellent chance of long-term survival and functional rehabilitation for the carefully selected patient with end-stage heart disease. The part played by the pathologist in the care of these patients is crucial. It is vital to make the diagnosis of acute rejection before it becomes irreversible and also before it causes chronic damage to the coronary arteries. It is also vital that the pathologist does not either miss the diagnosis of an infectious myocarditis in the immunosuppressed patient or misdiagnose myocarditis as rejection, because the treatments for each one of these conditions are diametrically opposed. The role of the pathologist has become one of an important clinical colleague in the management and survival of patients with cardiac allografts. PMID- 3275414 TI - Floppy mitral valve syndrome. PMID- 3275413 TI - Coronary thrombosis and acute myocardial infarction. PMID- 3275415 TI - Complications of mechanical heart valve prostheses. PMID- 3275416 TI - Bioprosthetic valve failure. PMID- 3275417 TI - Atherosclerosis: activation of the injured vessel wall. PMID- 3275418 TI - Pathology of pulmonary hypertension. PMID- 3275419 TI - The very elderly heart. PMID- 3275420 TI - Aortocoronary saphenous vein bypass grafts. PMID- 3275421 TI - Hemoglobin. PMID- 3275422 TI - Structure and function of bacterial hemoglobin and related proteins. PMID- 3275423 TI - Immunocytochemical localization of the 35-kDa sea urchin egg trypsin-like protease and its effects upon the egg surface. AB - Trypsin-like protease in sea urchin eggs is thought to reside in cortical granules since it is secreted at fertilization and has been isolated with cortical granule fractions from unfertilized eggs. A 35-kDa serine protease has been purified from Strongylocentrotus purpuratus eggs by soybean trypsin inhibitor-affinity chromatography. For this report the protease was localized by immunocytochemistry before and after fertilization, and its potential biological activity was examined by application of the isolated enzyme to the unfertilized egg surface. The protease was localized on sections by immunofluorescence and immunoelectron microscopy, and was found to reside in the spiral lamellae of S. purpuratus cortical granules and in the electron-dense stellate core of Arbacia punctulata granules. At fertilization the enzyme is secreted into the perivitelline space and accumulates only very briefly between the hyaline layer and the nascent fertilization envelope. Shortly thereafter the enzyme is lost from the perivitelline space and immunological reactivity is no longer associated with the egg surface. The 35-kDa cortical granule protease has vitelline delaminase activity but does not appear to destroy vitelline envelope sperm receptors as judged by the fertility of protease-treated eggs. PMID- 3275424 TI - Neural crest migration in 3D extracellular matrix utilizes laminin, fibronectin, or collagen. AB - The trunk neural crest originates by transformation of dorsal neuroepithelial cells into mesenchymal cells that migrate into embryonic interstices. Fibronectin (FN) is thought to be essential for the process, although other extracellular matrix (ECM) molecules are potentially important. We have examined the ability of three dimensional (3D) ECM to promote crest formation in vitro. Neural tubes from stage 12 chick embryos were suspended within gelling solutions of either basement membrane (BM) components or rat tail collagen, and the extent of crest outgrowth was measured after 22 hr. Fetal calf serum inhibits outgrowth in both gels and was not used unless specified. Neither BM gel nor collagen gel contains fibronectin. Extensive crest migration occurs into the BM gel, whereas outgrowth is less in rat tail collagen. Addition of fibronectin or embryo extract (EE), which is rich in fibronectin, does not increase the extent of neural crest outgrowth in BM, which is already maximal, but does stimulate migration into collagen gel. Removal of FN from EE with gelatin-Sepharose does not remove the ability of EE to stimulate migration. Endogenous FN is localized by immunofluorescence to the basal surface of cultured neural tubes, but is not seen in the proximity of migrating neural crest cells. Addition of the FN cell-binding hexapeptide GRGDSP does not affect migration into either the BM gel or the collagen gel with EE, although it does block spreading on FN-coated plastic. Thus, although crest cells appear to use exogenous fibronectin to migrate on planar substrata in vitro, they can interact with 3D collagenous matrices in the absence of exogenous or endogenous fibronectin. In BM gels, the laminin cell binding peptide, YIGSR, completely inhibits migration of crest away from the neural tube, suggesting that laminin is the migratory substratum. Indeed, laminin as well as collagen and fibronectin is present in the embryonic ECM. Thus, it is possible that ECM molecules in addition to or instead of fibronectin may serve as migratory substrata for neural crest in vivo. PMID- 3275425 TI - Combinations of monoclonal antibodies distinguish mesenchymal, myogenic, and chondrogenic precursors of the developing chick embryo. AB - Monoclonal antibodies (MAbs) were used as probes for molecular differences in the surfaces of nonterminally differentiated cells of the developing chick limb. The specificity of the MAbs was determined by immunofluorescent localization performed on cultured breast muscle and limb bud cells and cryosections of a variety of embryonic (stages 15-37) and neonatal tissues. Subpopulations of MAb positive and -negative cells were isolated by fluorescence-activated cell sorting and their developmental potential was assessed in vitro. Cells of the compacted somite, lateral plate mesoderm, and early limb bud were labeled with the CSAT MAb. Myogenic precursors of the dermatome and limb bud were labeled with the CSAT and L4 MAbs. Chondrogenic precursors of the sclerotome and limb bud were labeled with the CSAT, L4, and C5 MAbs. These precursors were distinguished from fibroblasts which were labeled with the CSAT and C1 MAbs. The differentiation and maturation of muscle and cartilage were accompanied by alterations in the labeling patterns of the MAbs. These results indicate that combinations of these MAbs can be used to distinguish mesenchymal, myogenic, and chondrogenic precursors, identify their site of origin during development, and isolate subpopulations of embryonic cells. PMID- 3275426 TI - Identification and localization of proteins encoded by two DIF-inducible genes of Dictyostelium. AB - We show that pDd56 and pDd63, two related DIF-inducible genes of Dictyostelium, respectively encode the ST310 and ST430 polypeptides identified by Morrissey, Devine, and Loomis (1984, Dev. Biol. 103, 414-424). We localize the two proteins by immunoelectron microscopy to the extracellular matrix surrounding the stalk cells and the stalk tube. Coupled with their predicted amino acid sequence and biochemical properties, this suggests that they are structural proteins of the stalk. PMID- 3275428 TI - "They don't cite us!". PMID- 3275427 TI - An analysis of the role of microfilaments in the establishment and maintenance of asymmetry in Caenorhabditis elegans zygotes. AB - Microfilaments are needed to generate asymmetry during the first cell cycle in Caenorhabditis elegans zygotes. To investigate when and how microfilaments participate in this process, we have "pulsed" zygotes with the microfilament inhibitor cytochalasin D (CD) at different times during the cell cycle. We have shown that microfilaments are only required during a narrow time interval approximately three-quarters of the way through the first cell cycle for the manifestations of asymmetry that occur during and subsequent to this interval. When CD treatment spans this critical time interval, pseudocleavage, pronuclear migration, germ-granule segregation (all of which occur during the interval), and movement of the mitotic spindle to an asymmetric position (which occurs later in the cell cycle) are perturbed. In contrast, embryos briefly treated with CD before or after the critical time interval manifest normal asymmetry. Our results suggest that in C. elegans microfilaments participate in the generation of zygotic asymmetry by providing spatial cues and/or serving as a part of the necessary machinery only during a brief period in the first cell cycle, and are not required to maintain asymmetries that have already been established. PMID- 3275429 TI - Neurons of layer Vb of rat sensorimotor cortex atrophy but do not die after thoracic cord transection. AB - Albino rats six weeks (wk) of age underwent transection of the spinal cord at the level of the seventh thoracic vertebra. They were killed ten wk later by several schedules of formaldehyde-glutaraldehyde, formaldehyde and formaldehyde-ethanol acetic acid perfusion-fixation. Layer Vb of the sensorimotor cortex, the site of origin of corticospinal axons severed by the operation, was searched by light and electron microscopic methods for evidence of neuronal necrosis. Cord-transected rats were compared with control, unoperated animals of identical age. Nerve cell death was not evident to qualitative study, although shrunken, deeply-staining neurons of artefactitious origin occurred capriciously in paraffin sections when fixation was initiated with a dilute formaldehyde-glutaraldehyde solution. Quantitative light and electron microscopic studies were also negative for indications of neuronal death. However, mild somal atrophy could be substantiated for layer Vb neurons of cord-transected rats by light microscopic, morphometric methods. Neuronal atrophy was unaccompanied by qualitative or quantitative ultrastructural alterations. Subcellular organelles and the per cent of neuronal plasma membrane apposed by axosomatic boutons were unchanged. Neuroglia and neuronal processes always had a normal electron microscopic appearance. PMID- 3275430 TI - Biochemistry of fusion mass consolidation in the sheep spine. AB - We report here the biochemistry of fusion mass consolidation in sheep spines during a 1-year period following autogenous cortical-cancellous bone grafting and stabilization with Harrington distraction rods. Biochemical analysis of vertebral fusion mass included determination of wet weight and dry weight and quantification of glycosaminoglycan, collagen, calcium, and phosphate following extraction with neutral EDTA and proteolytic hydrolysis with papain. Our results showed that at 1 week after surgery, the fusion mass consisted of original cortical and cancellous bone graft material. The cortical bone graft was partially resistant to EDTA-papain treatment, resulting in a residue containing hydroxyproline and mineral. At 12 weeks after surgery, the fusion mass had become a homogeneous material, which, like cancellous bone graft, was completely susceptible to treatment by EDTA-papain. Collagen content of consolidating fusion mass was highest at 16 weeks after surgery when normalized to dry weight; glycosaminoglycan content was highest within 6 weeks after surgery. Mineral content was lowest at the 6-week stage but by 12 weeks after surgery, it was comparable with original bone grafting material. At 24 and 52 weeks after surgery, fusion mass consolidation was characterized by an increase in the proportion of organic and mineral components resistant to EDTA-papain. The appearance of the EDTA-papain-resistant material in the fusion mass coincided with formation of lamellar bone and successful consolidation. PMID- 3275431 TI - Tendon synovial cells secrete fibronectin in vivo and in vitro. AB - The chemistry and cell biology of the tendon have been largely overlooked due to the emphasis on collagen, the principle structural component of the tendon. The tendon must not only transmit the force of muscle contraction to bone to effect movement, but it must also glide simultaneously over extratendonous tissues. Fibronectin is classified as a cell attachment molecule that induces cell spreading and adhesion to substratum. The external surface of intact avian flexor tendon stained positively with antibody to cellular fibronectin. However, if the surface synovial cells were first removed with collagenase, no positive reaction with antifibronectin antibody was detected. Analysis of immunologically stained frozen sections of tendon also revealed fibronectin at the tendon synovium, but little was associated with cells internal in tendon. The staining pattern with isolated, cultured synovial cells and fibroblasts from the tendon interior substantiated the histological observations. Analysis of polyacrylamide gel profiles of 35S-methionine-labeled proteins synthesized by synovial cells and internal fibroblasts indicated that fibronectin was synthesized principally by synovial cells. Fibronectin at the tendon surface may play a role in cell attachment to prevent cell removal by the friction of gliding. Alternatively, fibronectin, with its binding sites for hyaluronic acid and collagen, may act as a complex for boundary lubrication. PMID- 3275432 TI - Production of a polyhedral particle in Escherichia coli from a cDNA copy of the large genomic segment of bacteriophage phi 6. AB - A polyhedral particle that resembles in composition and structure the procapsid of bacteriophage phi 6 was produced in Escherichia coli containing cDNA copies of the entire large genomic segment inserted into expression vector plasmids under the control of lac or tac promoters. The particles were composed of proteins P1, P2, P4, and P7 in the same stoichiometry as in the intact virion. In electron micrographs of negatively stained samples, the particles appeared as hexagons, stars, or rings of 10 knobs, which are characteristic of the five-, three-, and twofold axes of symmetry characteristic of phi 6 procapsids. Stable particles were also produced from cDNA deletions that produce only P1 and P4. Other cDNA deletions producing P1 and P7 and P1 alone resulted in unstable particles which could only be visualized in electron micrographs of thin sections of E. coli transformed by the recombinant plasmids. Our results indicate that the assembly of the phi procapsid is independent of other phage proteins and of normal phage RNA. PMID- 3275433 TI - Molecular cloning and characterization of cytoplasmic polyhedrosis virus polyhedrin and a viable deletion mutant gene. AB - The double-stranded RNA genome of Bombyx mori cytoplasmic polyhedrosis virus (CPV) was converted to double-stranded DNA and cloned into plasmid pBR322. The complete nucleotide sequence of cloned genome segment 10, which encodes virus polyhedrin polypeptide, was determined. The CPV polyhedrin gene consists of 942 based pairs and possesses a long open reading frame that codes for a polypeptide of 248 amino acids (molecular weight, 28,500), consistent with an apparent molecular weight of 28,000 previously determined for purified polyhedrin. No sequence homology was found between CPV polyhedrin and polyhedrins from several nuclear polyhedrosis viruses. In addition to the polyhedrin gene, we completed the sequence analysis of a small deletion mutant gene derived from the polyhedrin gene. This mutant gene consists of two subset domains of the polyhedrin gene, i.e., the 5'-terminal 121 base pairs and the 3'-terminal 200 base pairs. An in vitro transcription demonstrated that the small mutant gene is transcribed by virion-associated RNA polymerases. These data confirm the importance of CPV terminal sequences in virus genome replication. PMID- 3275434 TI - Sigma 1 protein of mammalian reoviruses extends from the surfaces of viral particles. AB - Electron microscopy revealed structures consisting of long fibers topped with knobs extending from the surfaces of virions of mammalian reoviruses. The morphology of these structures was reminiscent of the fiber protein of adenovirus. Fibers were also seen extending from the reovirus top component and intermediate subviral particles but not from cores, suggesting that the fibers consist of either the mu 1C or sigma 1 outer capsid protein. Amino acid sequence analysis predicts that the reovirus cell attachment protein sigma 1 contains an extended fiber domain (R. Bassel-Duby, A. Jayasuriya, D. Chatterjee, N. Sonenberg, J. V. Maizell, Jr., and B. N. Fields, Nature [London] 315:421-423, 1985). When sigma 1 protein was released from viral particles with mild heat and subsequently obtained in isolation, it was found to have a morphology identical to that of the fiber structures seen extending from the viral particles. The identification of an extended form of sigma 1 has important implications for its function in cell attachment. Other evidence suggests that sigma 1 protein may occur in virions in both an extended and an unextended state. PMID- 3275435 TI - Identification and gene mapping of a 14,700-molecular-weight protein encoded by region E3 of group C adenoviruses. AB - Early region E3 of adenovirus type 5 should encode at least nine proteins as judged by the DNA sequence and the spliced structures of the known mRNAs. Only two E3 proteins have been proved to exist, a glycoprotein (gp19K) and an 11,600 molecular-weight protein (11.6K protein). Here we describe an abundant 14.7K protein coded by a gene in the extreme 3' portion of E3. To identify this 14.7K protein, we constructed a bacterial vector which synthesized a TrpE-14.7K fusion protein, then we prepared antiserum against the fusion protein. This antiserum immunoprecipitated the 14.7K protein from cells infected with adenovirus types 5 and 2, as well as with a variety of E3 deletion mutants. Synthesis of the 14.7K protein correlated precisely with the presence or absence of the 14.7K gene and with the synthesis of the mRNA (mRNA h) which encodes the 14.7K protein. The 14.7K protein appeared as a triplet on immunoprecipitation gels and Western blots (immunoblots). PMID- 3275436 TI - Quantitative basic residue requirements in the cleavage-activation site of the fusion glycoprotein as a determinant of virulence for Newcastle disease virus. AB - Newcastle disease virus exhibits a wide range of pathogenicity and virulence which, as with all paramyxoviruses, is directly related to the cleavability of a precursor (F0) of the fusion glycoprotein by cellular proteases. Sequence analyses of the cleavage site of several virulent and avirulent isolates of the Newcastle disease virus serotype reveal a correlation between virulence or pathogenicity and a high content of basic amino acid residues at the cleavage site. A similar correlation has been seen for other paramyxoviruses. PMID- 3275437 TI - Financing indigent care: short- and long-term strategies. PMID- 3275438 TI - Impact of molecular genetics on clinical neurology. PMID- 3275439 TI - Molecular basis of isovaleric acidemia and the study of the acyl-CoA dehydrogenase family. PMID- 3275440 TI - Insulin receptors in Friedreich's ataxia: studies on cultured fibroblasts. PMID- 3275441 TI - The inherited ataxias. PMID- 3275442 TI - The third Jubilee-Anniversary volume. Dedicated to Melvin M. Figley, M.D. PMID- 3275443 TI - A tribute to a pioneer radiologist: Alfred Leftwich Gray, M.D. (1873-1932). PMID- 3275444 TI - Gallbladder and bile duct abnormalities in AIDS: sonographic findings in eight patients. AB - Gallbladder and biliary tract abnormalities were observed on sonography in eight patients with AIDS. The studies were obtained to evaluate right upper quadrant pain (two patients), tenderness (three patients), and abnormal liver function tests (eight patients). The two major sonographic findings were gallbladder wall thickening (eight patients), which often was marked, and bile duct dilatation (two patients). Gallbladder wall thickness varied from 4 to 15 mm and was greater than 1 cm in four patients. Follow-up sonograms in five patients showed increasing wall thickness in four and decreasing thickness in one, but these findings did not correlate well with the clinical status of the patient. Pericholecystic fluid was shown in three cases. None of the patients had gallstones. Common bile duct dilatation varied from 12 to 15 mm; no specific cause for dilatation was found by cholangiography. Mycobacterium avium intracellulare was recovered from the gallbladder in one patient, and Cryptosporidium was recovered from the duodenum in two patients. AIDS should be considered in the differential diagnosis of gallbladder wall thickening or bile duct dilatation in the appropriate clinical setting. These findings may indicate opportunistic infection of the biliary tract. A disparity may exist between the mild symptoms and signs (or lack of symptoms and signs) related to the gallbladder and bile ducts and the sometimes marked sonographic abnormalities. PMID- 3275445 TI - Neuroimaging and head injuries: where we've been--where we're going. PMID- 3275446 TI - Endometrial abnormalities: evaluation with transvaginal sonography. AB - The value of transvaginal sonography in detecting gynecologic disease currently is being defined. To evaluate transvaginal depiction of the endometrium, transvaginal sonograms were compared with conventional transabdominal scans in 29 patients whose sonograms revealed endometrial abnormalities. The two techniques were compared for image quality and ability to provide unique diagnostic information. Sonographic findings included fluid collections (16), thickened and/or echogenic endometria (10), endometrial irregularities (two), and echogenic foci (two). Clinical diagnoses included early intrauterine pregnancies (five), pseudogestational sacs of ectopic pregnancy (one), intrauterine contraceptive devices (two), endometrial carcinoma (one), and intrauterine synechiae with amenorrhea (Asherman syndrome) (two). In most cases (77%), diagnostic information was obtainable by either transabdominal or transvaginal sonograms, although in 23% transvaginal scanning provided unique diagnostic information not available with the transabdominal technique. In no case did transabdominal sonography contribute diagnostic information not provided transvaginally. The quality of the transvaginal image was judged to be better than that of the transabdominal image in 63% of cases; image quality was the same in 33% of cases and worse in 3% of cases. The results show that transvaginal sonography is often superior to transabdominal scanning in the evaluation of endometrial abnormalities. Transvaginal sonography may be the preferred technique in these cases. PMID- 3275447 TI - Carcinoid of the kidney: radiologic findings. PMID- 3275448 TI - Three-dimensional CT reconstructions of an ancient human Egyptian mummy. PMID- 3275449 TI - American Journal of Roentgenology: historical reflections. PMID- 3275450 TI - Future advances and directions in imaging research. PMID- 3275451 TI - Roentgen examinations for head injuries. By A.L. Gray, 1914. PMID- 3275452 TI - The left ventricular echogenic focus: a normal finding. PMID- 3275453 TI - Persistent shoulder pain following a motor vehicle accident. AB - A 29-year-old woman had intermittent left shoulder pain during a 4-month period following a motor vehicle accident. Sudden development of a pleuritic component was noted. An elevated left hemidiaphragm of the chest radiograph prompted an ultrasound examination of the abdomen, which revealed a 15-cm complex mass in the left upper quadrant. At surgery, a tumor mass attached to the splenic artery, stomach, and diaphragm was removed. Pathologic studies revealed an encapsulated adrenal hematoma. This case represents an unusual cause of persistent shoulder pain due to diaphragmatic irritation by an adrenal hematoma. PMID- 3275454 TI - Cardiopulmonary needle embolization: a complication of central venous drug abuse. AB - A great variety of complications secondary to drug abuse have been reported in the literature. We report a case of multiple cardiopulmonary needle embolization. A drug addict who had resorted to central venous drug abuse was found on chest roentgenograms to have multiple asymptomatic needle fragments within her chest. In this instance chest roentgenograms and tomographs were more helpful in needle localization than computed tomography. Complications of intracardiac foreign bodies are also briefly reviewed. In attempts to diagnose this complication, a high index of suspicion is necessary as central venous drug abuse becomes increasingly more prevalent. PMID- 3275455 TI - Diagnosis and management of testicular torsion: pitfalls and perils. AB - When a patient presents with acute scrotal pain and physical findings do not permit confident exclusion of testicular torsion, the initial step in management is immediate consultation with a urologist, pediatric surgeon, or general surgeon. Scrotal imaging is fallible and takes time that may be critical to salvage of the testis. Manual detorsion may be indicated when specialty support is not immediately available, but even if this technique is apparently successful, the patient should be transferred to specialty care without delay. PMID- 3275456 TI - Statistical reasoning in clinical trials: hypothesis testing. AB - Hypothesis testing is based on certain statistical and mathematical principles that allow investigators to evaluate data by making decisions based on the probability or implausibility of observing the results obtained. However, classic hypothesis testing has its limitations, and probabilities mathematically calculated are inextricably linked to sample size. Furthermore, the meaning of the p value frequently is misconstrued as indicating that the findings are also of clinical significance. Finally, hypothesis testing allows for four possible outcomes, two of which are errors that can lead to erroneous adoption of certain hypotheses: 1. The null hypothesis is rejected when, in fact, it is false. 2. The null hypothesis is rejected when, in fact, it is true (type I or alpha error). 3. The null hypothesis is conceded when, in fact, it is true. 4. The null hypothesis is conceded when, in fact, it is false (type II or beta error). The implications of these errors, their relation to sample size, the interpretation of negative trials, and strategies related to the planning of clinical trials will be explored in a future article in this journal. PMID- 3275458 TI - Strategic planning for hospices: a case study. PMID- 3275457 TI - Toxicology: an annotated bibliography of the recent literature. PMID- 3275459 TI - Vietnam nursing. PMID- 3275460 TI - The influence of ATP on sugar uptake mediated by the constitutive glucose carrier of Saccharomyces cerevisiae. AB - The glucose carrier of Saccharomyces cerevisiae transports the phosphorylatable sugars glucose, mannose, fructose and 2-deoxy-D-glucose (2-dGlc) and the non phosphorylatable sugar 6-deoxy-D-glucose (6-dGlc). Reduction of the ATP concentration by, for example, incubating cells with antimycin A, results in a decrease in uptake of 2-dGlc and fructose. These uptake velocities can be increased again by raising the ATP level. These results establish a role of ATP in sugar transport. Transport of glucose and mannose is less affected by changes in the ATP concentration than 2-dGlc and fructose uptake, while the 6-dGlc transport is independent of the amount of ATP in the cells. Also, reduction of the kinase activity by incubation with xylose diminished transport of 2-dGlc and fructose, while the uptake of glucose and mannose remained unchanged. It is discussed that these results are due to transport-associated phosphorylation with ATP as substrate and the hexokinases and the glucokinase as phosphorylating enzymes. PMID- 3275461 TI - Simulation of all-or-none K+ efflux from yeast provoked by xenobiotics. AB - In experiments dealing with the effect of xenobiotics upon the efflux of K+ from yeast cells, one should be aware that when this efflux proceeds via an all-or none process, the K+ being released from the intoxicated cells can again be accumulated into the still unaffected cells. Therefore, the measured net efflux of K+ will be less than the efflux from the intoxicated cells. The difference between these two magnitudes can be minimalized by incubating the cells for only a short period and on applying yeast densities that are not too high. When the cells are permeabilized relatively slowly but ultimately to a great extent, the kinetics of K+ efflux may be quite complicated. PMID- 3275462 TI - Transport and metabolism of D-glucose in human adipocytes. Studies of the dependence on medium glucose and insulin concentrations. AB - Uptake and metabolism of the physiologically labelled D-glucose (D-[U 14C]glucose) has been characterized in human adipocytes at several unlabelled D glucose concentrations in the absence and presence of insulin. Following a 90 min incubation, about 80% of the intracellular radioactivity was incorporated into total lipids at tracer glucose concentration, as well as at higher glucose concentrations in basal and insulin-stimulated cells, whereas 20% was recovered as hydrophilic metabolites. The only 14C-labelled metabolite escaping the cells in detectable amounts was CO2, which accounted about 4%. At trace glucose concentrations (5 mumol/l), the rate of glucose uptake was linear with time. Comparative studies of initial glucose uptake after 10 s and tracer D-glucose conversion to total lipids after 90 min showed high coefficients of correlation between basal rates (r = 0.87), maximal response above basal level to insulin (r = 0.92) and insulin sensitivity (r = 0.78). Thus, under these conditions glucose transport is rate-limiting for net glucose uptake, and measurements over long time intervals of rates for total cell-associated radioactivity or lipogenesis may serve as reliable estimates of initial glucose influx rates. However, the conversion rate of tracer glucose to metabolites decreased progressively with the glucose concentration and with an apparent Km of about 0.2 mmol/l. The three metabolic pathways exhibited similar percentage decreases in their activities, suggesting that a common enzymatic step is rate-limiting. In comparison, the Km for initial D-glucose uptake rate was about 7 mmol/l. Hence, the capacity for total glucose metabolism comprised only a small fraction of the glucose transport capacity at medium glucose concentrations above tracer concentrations. Both basal, half-maximal and maximal insulin-stimulated rates of adipocyte glucose utilization were dependent on the glucose concentration. Thus, comparing lipogenesis at tracer and at 0.5 mmol/l medium glucose concentration, it was shown that the higher medium glucose concentration was associated with a 60% lowering of the basal rate, a 35% reduction in the percentage response above baseline to maximal insulin stimulation and a 4-fold increase in the insulin sensitivity. Obviously, these findings reflect some intracellular step(s) being rate-limiting at medium glucose levels above tracer values. PMID- 3275463 TI - Control of ribosomal protein gene expression. PMID- 3275464 TI - Circular intermediates with missing nucleotides in the conversion of supercoiled or nicked circular to linear duplex DNA catalyzed by two species of BAL 31 nuclease. AB - The extracellular nucleases from Alteromonas espejiana BAL 31 can catalyze the endonucleolytic and/or exonucleolytic hydrolysis of duplex DNA in response to a variety of alterations, either covalent or noncovalent, in DNA structure. The nuclease can exist as at least two kinetically and molecularly distinct protein species. The two species that have been studied, called the 'fast' (F) and 'slow' (S) nucleases, both readily convert negatively supercoiled DNAs to linear duplex molecules and accomplish this conversion through the formation of a circular duplex intermediate containing usually a single interruption in one strand. It is further shown that most of these intermediates contain gaps arising from the removal in a processive manner of one or more nucleotide residues after the introduction of the initial strand break (nick). Considering only the intermediates with gaps, the average number of missing residues is 6.3 +/- 0.5 and 2.8 +/- 0.3, respectively, for DNA acted upon by the F and S enzymes independently of the extent of conversion of supercoiled DNA. The nicks and gaps are bounded by 3'-hydroxyl and 5'-phosphoryl termini. When singly nicked circular DNA is used as the substrate, conversion to the linear duplex form occurs predominantly through a gapped circular intermediate with the same average numbers, within experimental error, of missing nucleotides for the respective nuclease species as found when supercoiled DNA is the substrate. The conversion to linear duplex DNA is much slower when nicked circular DNA is the substrate compared to that found when supercoiled DNA is the starting material. PMID- 3275465 TI - Protein synthesis in polyamine-deficient bacteria during amino-acid starvation. AB - Amino-acid starvation in polyamine-auxotrophic bacteria grown in the presence of putrescine provokes a marked inhibition of protein synthesis. This inhibition is almost completely relieved in polyamine-depleted cells. The differential behaviour of bacterial protein synthesis depending on the endogenous levels of polyamines is not due to a change in the uptake of amino acids used to measure protein synthesis, nor to the decreased growth rate of polyamine-depleted cells. During leucine starvation, cells grown with putrescine synthesized a somewhat lower amount of high-molecular-weight proteins than polyamine-depleted bacteria. In addition, cells with normal endogenous levels of polyamines accumulated significant amounts of 62 and 41 kDa polypeptides as well as several low molecular-weight peptides. PMID- 3275466 TI - Studies on ras proteins. Catalytic properties of normal and activated ras proteins purified in the absence of protein denaturants. AB - Normal (Gly12) and activated (Val12) Ha-ras proteins were produced in Escherichia coli, and purified to an apparent homogeneity without using any protein denaturants. The purified proteins contained an equimolar amount of GDP. They were stable in the presence of 5 mM Mg2+ and 25% (v/v) glycerol when incubated at 60 degrees C for 5 min. The binding of GDP to the protein was greatly stabilized by Mg2+. In the presence of 10 mM Mg2+, the bound GDP hardly exchanged with external guanine nucleotides, even at 30 degrees C. The exchange reaction was markedly enhanced in the presence of 10 mM EDTA or 120 mM ammonium sulfate. The rate-limiting step of the exchange reaction was the dissociation of the bound GDP from the ras protein, and this step was facilitated 40- to 100-fold by the addition of EDTA or ammonium sulfate. The dissociation rate of the normal (Gly12) ras protein was 2- to 3-fold faster than that of the activated (Val12) protein. The dissociation constants (Kd) for GDP of the normal and activated ras proteins were 1.2 X 10(-8) and 3.1 X 10(-9) M, respectively. The overall turnover rate of GTPase activity of the normal ras protein (10.8 mmol.mol-1.min-1) was about 10 fold higher than that of the activated protein (1.1 mmol.mol-1.min-1) in the absence of Mg2+ (less than 10(-8) M). PMID- 3275467 TI - Oxidation of a methionine residue in subtilisin-type proteinases by the hydrogen peroxide/borate system--an active site-directed reaction. AB - Subtilisin-type proteinases (thermitase, subtilisin Carlsberg, alkaline proteinase ZIMET 10911, proteinase K) are partially inactivated by hydrogen peroxide in the alkaline pH range only in the presence of boric acid or phenylboronic acid. A model is presented to describe the inactivation mechanism. Both boric acid and perboric acid existing in equilibrium in the presence of hydrogen peroxide bind competitively at the active site of the enzyme. The inactivation, which is known to be caused by sulfoxide formation from the methionine residue in the active site (Stauffer, C.E. and Etson, D. (1969) J. Biol. Chem. 244, 5333-5338), is due to the enzyme-bound perboric acid species. The dissociation constants for the boric acid-thermitase and perboric acid thermitase complexes are 36 +/- 7 and 4 +/- 1 mM, respectively. The first-order rate constant of inactivation is k = 0.63 +/- 0.14 min-1. The same mechanism of inactivation holds true for phenylboronic acid in alkaline hydrogen peroxide solutions. PMID- 3275468 TI - The amino-acid residues on the C-terminal side of the cleavage site of angiotensinogen influence the species specificity of reaction with renin. AB - The N-terminal sequences of human and canine angiotensinogen and two hybrid sequences were synthesized and used to determine whether the species specificity of renin is influenced by amino-acid residues adjacent to the cleavage site. kcat/Km for the generation of angiotensin I from the N-terminal tridecapeptide of human angiotensinogen by canine renin is 0.37% of that observed when the N terminal tetradecapeptide from canine angiotensinogen is used as a substrate. Replacement of the valine residue at P'1 in the human tridecapeptide with the leucine residue from the canine sequence triples kcat and improves Km 4-fold. Replacement of isoleucine residue at P'2 with the valine residue from the canine sequence enhances Km 8-fold. Substitution of the histidine residue at P'3 with the tyrosine serine sequence of canine angiotensinogen increases kcat an order of magnitude. Results obtained with the synthetic substrate are similar to those observed with the protein substrates. Canine renin does not cleave human angiotensinogen. Also, kcat/Km of canine renin for its homologous substrate is about 6-times greater than the kcat/Km value for human renin acting on human angiotensinogen. PMID- 3275469 TI - The functional cell surface glycoprotein CD9 is distinguished by being the major fatty acid acylated and a major iodinated cell-surface component of the human platelet. AB - We showed that a 22 kDa protein (which comigrated with the leukocyte differentiation antigen CD9 as determined by immunoblotting with the platelet activating mAb 50H.19) is a major iodinated component of the platelet surface. The iodinated protein was identified as CD9 by limited proteolysis analysis. The major acylated protein in platelets incubated with [3H]palmitic acid also had a mobility of 22 kDa. The radiolabelled fatty acid in CD9 appears to be ester bonded, as it is removed by treatment with hydroxylamine. Non-enzymatic ligation of the fatty acid is not involved. Since platelets lack protein synthetic capacity, the palmitolation of a surface protein indicates the existence of a plasma-membrane located transacylase which functions independently of protein synthesis. Limited proteolysis analysis of the palmitylated protein obtained by immunoprecipitation with mAb 50H.19 confirmed its identity as CD9. An additional novel minor component of 27 kDa was detected in platelets by immunoprecipitation of 125I-surface-labelled, or [3H]palmitic acid-labelled protein, and by immunoblotting with mAb 50H.19. The analogous cleavage patterns obtained by the limited proteolysis analysis of the 22, 24 and 27 kDa glycoproteins suggest that they may be differently modified variants of a single polypeptide. PMID- 3275470 TI - The history of psychiatry. PMID- 3275471 TI - Serotonin and anxiety revisited. PMID- 3275472 TI - Tissue factor and hemostasis. PMID- 3275473 TI - Relationship between an activated N-ras oncogene and chromosomal abnormality during leukemic progression from myelodysplastic syndrome. AB - The relationship between chromosomal abnormality and oncogene activation was investigated during leukemic progression in two patients with myelodysplastic syndrome (MDS). Both patients had partial or complete deletion of chromosome 5 in metaphase cells obtained throughout the progression to leukemia. Analysis with specific oligonucleotide probes revealed that bone marrow cells containing an activated N-ras oncogene proliferated in a dominant manner during the process of leukemic conversion in both patients. These observations suggest that the chromosomal abnormality may precede activation of the N-ras gene in these patients, and that both the chromosomal abnormality and the activated N-ras oncogene contribute to the development of leukemia. PMID- 3275474 TI - Expression of tissue factor and factor VIIa/tissue factor inhibitor activity in endotoxin or phorbol ester stimulated U937 monocyte-like cells. AB - Previously, unstimulated cells of the human monocytic tumor cell line U937 have been shown to possess a negligible cell-surface tissue factor (TF) activity, and to secrete a small amount of factor VIIa/tissue factor (VIIa/TF) inhibitor activity. On stimulation with endotoxin or with phorbol myristate acetate (PMA), TF of these cells is known to be increased approximately fourfold. In this report, we demonstrate that VIIa/TF inhibitor is also increased on stimulation of U937 cells with endotoxin (approximately equal to threefold) or with PMA (approximately equal to 20-fold). Notably, the secretion of the inhibitor persisted after the cell surface TF had started to decline. Further, when serum free media from PMA stimulated cells was electrophoresed on a sodium dodecyl sulfate (SDS) gel, we eluted two inhibitor activity peaks corresponding to Mr approximately equal to 47,000 and Mr approximately equal to 36,000. The molecular weights of these peaks are similar to those obtained earlier from human plasma for this inhibitor(s). PMID- 3275475 TI - Alteration and abnormal expression of the c-myc oncogene in human multiple myeloma. AB - Structural alterations of the c-myc oncogene in human Burkitt's lymphoma and mouse plasmacytoma suggest that this oncogene is involved in several B cell neoplasms. The possibility of c-myc alterations in human myeloma has not been explored, probably because the low proliferative activity characteristic of this tumor impairs the propagation of representative cell lines for the performance of adequate cytogenetic studies. This report describes alterations in the c-myc locus with concomitant elevated expression of mRNA in the tumor cells of two of 37 patients with multiple myeloma. In one case, somatic cell hybrid studies revealed that the cloned rearranged DNA was entirely derived from chromosome 8, thus indicating a novel mechanism of c-myc activation different from that in Burkitt's lymphoma. Seven other patients exhibited five- to 12-fold overexpression of c-myc RNA when compared with normal marrow cells. Elevated mRNA expression in about one fourth of our patients suggests that the c-myc oncogene has a pathogenetic role in the evolution of multiple myeloma. PMID- 3275476 TI - Thrombospondin mediates the cytoadherence of Plasmodium falciparum-infected red cells to vascular endothelium in shear flow conditions. AB - Cerebral malaria is thought to involve specific attachment of Plasmodium falciparum-infected knobby red cells to venular endothelium. The nature of surface ligands on host endothelial cells that may mediate cytoadherence is poorly understood. We have investigated the effects of soluble thrombospondin, rabbit antiserum raised against thrombospondin, and human immune serum on cytoadherence of parasitized erythrocytes in ex vivo mesocecum vasculature. Preincubation of infected red cells with soluble thrombospondin or human immune serum inhibits binding of infected red cells to rat venular endothelium. Infusion of the microcirculatory preparation with rabbit antithrombospondin antibodies before perfusion of parasitized erythrocytes also resulted in decreased cytoadherence. In addition, incubation of infected cells with human immune sera obtained from malaria patients significantly inhibited the observed cytoadherence. Our results indicate that thrombospondin mediates binding of infected red cells to venular endothelium and may thus be involved in the pathogenesis of cerebral malaria. PMID- 3275477 TI - Level I and level II ultrasonography. PMID- 3275478 TI - Evaluation of the quality of bedside monitoring of the blood glucose level in a teaching hospital. AB - We evaluated the precision and accuracy of monitoring of the blood glucose level in the laboratory and at the bedside with one of four glucose meters by an experienced operator and by 39 nurses in a teaching hospital. For precision studies aqueous quality control materials were used. A total of 85 blood samples were tested. The precision of the glucose meters (expressed as the coefficient of variation [CV]) in the hands of the experienced operator ranged from 6.7% to 11.1%. The correlation between the values obtained by the experienced operator and the reference values obtained in the laboratory was high (0.95 to 0.98). The precision of the values obtained by the nurses using the meters ranged from 13.7% on medical wards to 45.7% in the intensive care unit (ICU). The correlation between these values and those obtained in the central laboratory ranged from 0.72 to 0.82. Twenty-four percent of the glucose values determined on medical wards and 62% of those determined in the ICU deviated from the reference value by at least 20%. Of the 85 patients 12 (14%) would have received different insulin dosages had the reference value been available at the same time as the glucose meter reading: in 3 of the patients the discrepancy was 6 units of insulin or greater. Continuous quality control of bedside monitoring of the blood glucose level is needed. In addition, personnel who use glucose meters should receive adequate training. PMID- 3275479 TI - The future of new oral antibiotics including the quinolones. AB - It is estimated that more than 110 million dollars' worth of oral antibiotics will have been sold in Canada in 1987. In the next few years several new oral antimicrobial agents will reach the market, including beta-lactamase inhibitors, cephalosporins, monobactams, erythromycins and quinolones. Most of these new agents have a broader spectrum of antibacterial activity than the presently available oral antibiotics. A few have a longer half-life and can be administered once a day. The new oral drugs, especially the quinolones and possibly beta lactams, will now be used to treat infections that in the past could be treated only parenterally. Exacerbations of pulmonary infections due to Pseudomonas aeruginosa in cystic fibrosis can now be successfully treated at home with the new quinolones. Osteomyelitis, arthritis, pneumonia and pyelonephritis will most likely be treated at home in the future. In severe infections patients will be admitted to hospital for short courses of parenteral therapy, followed by oral treatment. If used appropriately the new oral agents may lead to new approaches to the treatment of infectious diseases. PMID- 3275481 TI - Mastering environmental emergencies with your computer. PMID- 3275480 TI - Neuroleptic malignant syndrome. PMID- 3275482 TI - Dr. Robert Tait McKenzie: a man for all seasons. PMID- 3275484 TI - Familial occurrence of malignant lymphoepithelial lesion of the parotid gland in a Finnish family with dominantly inherited trichoepithelioma. AB - A rare malignant lymphoepithelial lesion (MLEL) of the parotid gland is described in a mother and daughter within one Finnish family. Several cases of dominantly inherited trichoepithelioma were observed in the same family. This is the third published case of familial MLEL, and the first in whites. The simultaneous occurrence of MLEL with hereditary trichoepithelioma is a new finding and may suggest a common genetic background and/or etiology. PMID- 3275483 TI - Chemicals, birth defects and stillbirths in New Brunswick: associations with agricultural activity. AB - We describe a series of investigations that were conducted in support of the Task Force on Chemicals in the Environment and Human Reproductive Problems in New Brunswick. Geographic and temporal analyses and case-control studies, with the use of vital statistics, hospital records, the Canadian Congenital Anomalies Surveillance System and chemical databases, revealed no association between pesticides used in forestry and reproductive problems. Evidence of an association between the potential exposure to agricultural chemicals and three major anomalies combined as well as spina bifida without hydrocephalus was found. More plausible was an association between stillbirths and such exposure during the second trimester of pregnancy. This finding, along with the cyclic patterns of stillbirth in the agricultural Saint John River basin and the somewhat higher stillbirth rates in New Brunswick than in adjacent provinces or in Canada as a whole, suggests that further attention should focus on possible associations between agricultural activity and stillbirths. PMID- 3275485 TI - 5-Fluorouracil-associated cardiotoxicity. AB - Cardiotoxicity manifested as myocardial ischemia is not generally recognized as a side effect of 5-fluorouracil. However, there have been at least 35 cases reported since 1975. In only one of these cases was a somewhat detailed evaluation done to rule out underlying coronary disease. The case reported here of 5-FU cardiotoxicity included an extensive cardiac evaluation to rule out underlying coronary disease and to assess spasm. The literature on 5-FU cardiotoxicity is also reviewed, and its possible mechanisms are analyzed. PMID- 3275486 TI - The Intergroup Rhabdomyosarcoma Study-I. A final report. AB - The results of treatment of 686, previously untreated patients younger than 21 years with rhabdomyosarcoma or undifferentiated sarcoma, who were entered on Intergroup Rhabdomyosarcoma Study-I (IRS-I) were analyzed after a minimum potential follow-up time of 7 years. Patients in Clinical Group I (localized disease, completely resected) were randomized to receive either vincristine, dactinomycin, and cyclophosphamide (VAC) or VAC + radiation. At 5 years, approximately 80% of patients given either treatment were still disease-free and there was no significant difference between treatments in the overall percentages of patients surviving of 93% and 81%, respectively (P = 0.67). Patients in Clinical Group II (regional disease, grossly resected) were randomized to receive either vincristine and dactinomycin (VA) + radiation or VAC + radiation. At 5 years, 72% and 65% of the patients, respectively, were disease-free and there was no evidence of a difference between treatments (P = 0.46). The overall survival percentage at 5 years was approximately 72% for both treatments. Patients in Clinical Groups III (gross residual disease after surgery) and IV (metastatic disease) were randomized to receive either "pulse" VAC + radiation or "pulse" VAC + Adriamycin (doxorubicin) + radiation. The complete remission (CR) rate was 69% in Clinical Group III and 50% in IV, with no statistically significant difference in CR rates between treatments in either group. Those who achieved a CR had a nearly 60% chance of staying in remission for 5 years in Clinical Group III compared with approximately 30% in Clinical Group IV. The overall survival percentage at 5 years was 52% in Clinical Group III compared to 20% in Clinical Group IV (P less than 0.0001). The 5-year survival percentage for the entire cohort of 686 patients was 55%. Survival after relapse was poor, being 32% at 1 year and 17% at 2 years. The risk of distant metastasis was much greater than the risk of local recurrence within each clinical group, and there was no evidence of differing types of relapses between treatments. Primary tumors of the orbit and genitourinary tract carried the best prognosis, whereas tumors of the retroperitoneum had the worst prognosis. The authors conclude that for the therapeutic regimens evaluated there was no therapeutic advantage to including radiation in the treatment of Clinical Group I disease, or cyclophosphamide given as a daily low-dose oral regimen in the treatment of Clinical Group II disease or Adriamycin in the treatment of Clinical Groups III and IV diseases. PMID- 3275487 TI - Tumor markers in pleural effusion diagnosis. AB - In order to discriminate between malignant and benign effusions, the values of carcinoembryonic antigen (CEA), ferritin, beta2-microglobulin (BMG), acid-soluble glycoprotein (ASP), tissue polypeptide antigen (TPA), adenosine deaminase (ADA), and immunosuppressive acidic protein (IAP) were measured in the pleural fluid of 54 patients with lung cancer, 20 with malignancies other than lung cancer, 18 with tuberculous pleurisy, and 22 with benign diseases other than tuberculosis. CEA levels in malignant effusions were significantly higher than those in benign effusions. At a cutoff level of 5 ng/ml, 68% of the patients with lung cancer and 44% of the patients with other malignancies showed elevated pleural fluid CEA levels. In 13 lung cancer cases with negative pleural fluid cytology, nine cases had elevated pleural fluid CEA levels. The mean pleural fluid BMG level of patients with benign diseases was significantly higher than that of patients with malignant diseases, but there was a marked overlap between those with malignant and benign diseases. No significant differences were found in the pleural fluid ferritin, ASP, TPA, and IAP levels between malignant and benign conditions. ASP and IAP pleural fluid levels showed significant correlations with the pleural fluid C-reactive protein (CRP) concentrations suggesting that they also reflect inflammatory activity. The mean ADA activity in tuberculous effusion was significantly higher than that resulting from other causes of pleural effusion. PMID- 3275488 TI - Trisomy 11 in chronic myelomonocytic leukemia: report of two cases and review of the literature. AB - Two cases of chronic myelomonocytic leukemia (CMMoL) with trisomy 11 as the sole chromosome abnormality are reported. A simple trisomy 11 also has been reported in 11 patients with myeloproliferative disorders, including CMMoL and acute nonlymphocytic leukemia (ANLL) in the literature. From data on these 13 patients, leukemia with trisomy 11 may be characterized by a nonlymphoid origin and myelomonocytic features. Patients with this abnormality were mostly elderly, and often had a preleukemic phase and a short survival. We propose that trisomy 11 and nonlymphocytic leukemia with myelomonocytic features may be a new association in human neoplasia. PMID- 3275489 TI - Generation of homozygosity at the c-Ha-ras-1 locus on chromosome 11p in an adrenal adenoma from an adult with Wiedemann-Beckwith syndrome. AB - Generation of homozygosity for the human c-Ha-ras-1 locus on the short arm of chromosome #11 (11p) has been demonstrated for an adrenal adenoma from an adult with Wiedemann-Beckwith syndrome (WBS). This is the first demonstration of loss of somatic heterozygosity for a locus on 11p in an adrenal neoplasm and is the first instance where a tumor of any type, from a patient with WBS, shows loss of heterozygosity in this region of the genome. Generation of homozygosity in an adenoma, rather than a carcinoma, demonstrates that this mechanism is an early event in tumorigenesis rather than a late event associated with tumor progression. PMID- 3275490 TI - Analysis of double minutes and double minute-like chromatin in human and murine tumor cells using antikinetochore antibodies. AB - Antikinetochore antibodies from patients with the calcinosis, Raynaud's phenomenon, esophageal dismobility, sclerodactyly, telangiectasia-(CREST) syndrome of scleroderma were used as immunofluorescent probes to discriminate between the presence and absence of kinetochores in minute chromosomes not previously seen by conventional banding methods. Double minute chromosomes (DM) consistently lack the antigenic component of the kinetochore, which is direct evidence for the fact that they do not have a centromere. Although somatically stable in malignant cell populations, DM are unable to attach to the mitotic spindle. Conversely, despite their structural similarity to DM, chromosome fragments and supernumerary marker chromosomes exhibit intensely fluorescing kinetochores and, thus, are subject to a precise anaphasic distribution. PMID- 3275491 TI - Protein kinase C as the receptor for the phorbol ester tumor promoters: sixth Rhoads memorial award lecture. PMID- 3275492 TI - Biotechnology products in cancer therapy: a colloquium. PMID- 3275493 TI - Molecular pathways of adhesion in spontaneous rosetting of T-lymphocytes to the Hodgkin's cell line L428. AB - Spontaneous rosetting of T-lymphocytes to Reed-Sternberg cells has been observed both in vitro and in vivo but its molecular mechanism has not been defined. We have investigated such rosetting using the Hodgkin's cell line L428. L428 expresses high levels of LFA-3 and ICAM-1, both of which are ligands for T-cell adhesion. Monoclonal antibody inhibition of spontaneous rosetting indicated that it is not dependent on the T-cell receptor complex but is largely mediated by interaction of T-cell CD2 (T11/E-rosette receptor) with its ligand LFA-3 on L428 cells. Studies using an alternate assay of adhesion (conjugate formation) confirm the roles of CD2/LFA-3 and also implicate a second mode of binding via LFA-1 on T cells to ICAM-1 on L428. These data explain the previously reported finding of T cell rosetting with Reed-Sternberg cells as an exaggeration of normal antigen independent T-cell adhesion. PMID- 3275494 TI - Biomarkers of increased susceptibility to gastrointestinal cancer: new application to studies of cancer prevention in human subjects. PMID- 3275495 TI - The effects of acetaldophosphamide, a novel stable aldophosphamide analogue, on normal human and leukemic progenitor cells in vitro: implications for use in bone marrow purging. AB - Acetaldophosphamide (A-ALD), a novel in vitro active and stable derivative of aldophosphamide, kills human bone marrow-derived granulocyte-macrophage colony forming cells (GM-CFC) independent of the cell cycle. The surviving fraction of GM-CFC is an exponential function of the drug concentration and time of exposure. Variation of marrow light-density cell concentration between 2 x 10(6) and 10 x 10(6)/ml does not significantly influence its GM-CFC toxicity. Marrow depleted of GM-CFC by A-ALD subsequently generates GM-CFC when grown in suspension cultures. During the early period after treatment with A-ALD the number of surviving GM-CFC (size of surviving GM-CFC compartment) does influence the speed of the GM-CFC repopulation in suspension cultures. The importance of the number of surviving GM CFCs for the growth and maintenance of GM-CFC population in such suspension cultures diminishes with time. No significant differences are observed after 2 wk, indicating that the ancestor stem cell population and its regenerative potential responsible for in vitro hematopoiesis have not been significantly affected by the drug treatment. A-ALD-treated progenitor cells retain their ability to integrate with the previously established marrow stromal cell layer and generate GM-CFC within this layer to an extent comparable to that of untreated marrow cells. The effect of A-ALD on human hematopoiesis is comparable to that of 4-hydroperoxycyclophosphamide. Its advantage over 4 hydroperoxycyclophosphamide is a greater stability in vitro. It has sparing effect on GM-CFC ancestor cells. Its toxicity to myeloid leukemia cell line (KBM 3)-derived clonogeneic cells is higher than to the GM-CFC. It is similar in doxorubicin-sensitive (KBM-3) and -resistant (KBM-3/DOX) leukemic cells. Thus, A ALD appears to be a promising drug for in vitro purging of bone marrow cells. PMID- 3275496 TI - Normal and malignant human urothelium: in vitro response to blockade of polyamine synthesis and interconversion. AB - To assess the effect of polyamine blockade on urinary epithelium, growth of normal human urothelial cell cultures and human transitional cell carcinoma (TCC) cell lines in the presence of various inhibitors of polyamine synthesis was evaluated. All four human TCC cell lines tested were quite sensitive to the specific inhibitor of ornithine decarboxylase, alpha-difluoromethylornithine (DFMO), requiring less than or equal to 1.0 mM DFMO to double generation time. Alternatively, all three human urothelial cultures tested required 5-20-fold higher DFMO concentrations to achieve similar growth inhibition. The inhibitory effect of DFMO on TCC was found to act synergistically with that of the inhibitor of S-adenosylmethionine decarboxylase, methylglyoxal bis(guanylhydrazone), and additively with that of recombinant beta-serine interferon. Addition of individual polyamines entirely prevented the inhibitory effects of DFMO and/or methylglyoxal bis(guanylhydrazone) but not that of beta-serine interferon. It appears that inhibition of polyamine synthesis and/or interconversion holds promise in the management of TCC and that the in vitro model described will be of value in investigating such clinical applications. PMID- 3275497 TI - Immunoenzymatic assay of Mr 52,000 cathepsin D in 182 breast cancer cytosols: low correlation with other prognostic parameters. AB - The Mr 52,000 cathepsin-D-like protease induced by estrogens in MCF7 human breast cells was assayed in 182 primary breast cancer cytosols prepared for receptor assays from pre- and post-menopausal patients. Using two solid-phase sandwich immunoenzymatic assays, we quantified the total Mr 52,000 cathepsin D (52K-cath D) (the Mr 52,000 precursor protein and its Mr 48,000 and 34,000 processed forms) and the Mr 52,000 precursor alone. The value of total 52K-cath-D varied between 3 and 165 pmol/mg protein and the proportion of the precursor varied from 0 to 28% of total 52K-cath-D. There was no correlation between the concentrations of 52K cath-D and estrogen receptor, but the estrogen receptor status (greater than or less than 10 fmol/mg protein) was correlated to the 52K-cath-D status (greater than or less than 15 pmol/mg protein) according to the chi 2 test (P less than 0.001). The correlation with progesterone receptor concentrations and status was low (r = 0.43) and absent, respectively. There was no correlation with Scarff and Bloom stages, tumor size, or patient's age. The percentage of patients with invaded lymph nodes was significantly higher (80%) in the subgroup with the highest total 52K-cath-D levels (greater than or equal to 42 pmol/mg protein), representing only 12% of the population but not in the total population. On the basis of this prospective study, before clinical follow-up can be evaluated, we conclude that in the total population examined, the 52K-cath-D concentration was only correlated with estrogen receptor status, but not with any other prognostic parameter. PMID- 3275498 TI - Oncogenes of DNA tumor viruses. PMID- 3275499 TI - Identification of an anionic form of glutathione transferase present in many human tumors and human tumor cell lines. AB - Glutathione transferase (GST) activity and GST isoenzyme composition have been determined for 24 human neoplasms and 6 human tumor cell lines. Substantial activity (40-1010 milliunits/mg protein) was identified in all tumor specimens examined and three of the tumor cell lines. Three tumor cell lines, the human small cell carcinoma line SW2-10S, the Burkitt's lymphoma derived cell line Raji, and the human breast carcinoma cell line MCF-7, contained minimal GST activity. Although the small size of the tumor samples precluded isoenzyme analysis by substrate specificities, analysis of GST activity following sample separation by isoelectric focusing indicated that the predominant (comprising at least 70% of the 1-chloro-2,4-dinitrobenzene-conjugating activity) GST isoenzyme in each of these primary tumor (17 of 17) and tumor cell line (3 of 3) extracts was anionic (isoelectric point, 4.5-4.8). In three tumor samples, adenocarcinomas of the lung, colon, and stomach, analysis by isoelectric focusing identified minor but detectable (10-20% of total) cationic GST. The anionic form of GST has been purified to homogeneity from three primary human tumors: a malignant melanoma; a mesothelioma; and a breast carcinoma. GST from these tumors consists of two subunits each of Mr 25,200. On Western blot analysis, antibodies raised against the anionic GST purified from mesothelioma detect protein of Mr approximately 25,000 in extracts of both normal kidney and tumors containing anionic GST activity but not in extracts of human liver that did not contain detectable anionic activity. The amino acid compositions of these proteins were quite similar to that previously described for GST-pi and the amino-terminal amino acid sequences for these tumor-derived isoenzymes are identical to one another and to that previously described for GST-pi from human placenta. GST is a major enzymatic activity in many human malignancies, comprising as much as 3% of the cytosolic protein of some tumors. Anionic GST is the predominant form of glutathione transferase activity in many human tumors and human tumor cell lines. In selected tumor samples the predominant anionic GST isoenzyme has been identified as a member of the pi class of this enzyme family. In addition, at least 3 of 17 tumor samples contained lesser but detectable amounts of cationic GST, probably of the alpha class. By conjugating glutathione with electrophilic anticancer drugs, the substantial levels of GST in human tumors may have a role in the innate or acquired resistance of these neoplasms to anticancer therapy. PMID- 3275501 TI - A novel replica technique for localization of caries-associated bacteria on tooth surfaces: development and initial experience. PMID- 3275500 TI - Biological and karyotypic characterization of a new cell line derived from human gliosarcoma. AB - A cell line (NCE-G28) was established from the biopsy material of a human gliosarcoma of low histological differentiation. The initial cultures showed a mixed population of cells which in later stages became more uniform due to loss of slower growing constituents. The cells have been growing steadily for 20 months. A suspension of NCE-G28 cells injected s.c. as well as i.p. into nude mice produced solid tumors in all cases. Histologically these tumors closely resembled the original tumor. The original tumor, the nude mouse tumor, and NCE G28 cells were immunochemically positive for glial fibrillary acidic protein as well as for neural plasma membrane antigen A2B5 expression. Two cell strains, 9B2C and 9B2E, were obtained by cloning of the initial cultures and another strain, NCE-G28T, was derived after explantation of a mouse heterotransplant. The two subclones were negative for glial fibrillary acidic protein expression but stained for cell surface fibronectin. NCE-G28T cells initially were positive for glial fibrillary acidic protein but lost this property within 8 months of cultivation. Karyotype analysis of NCE-G28 and the three strains revealed hyperdiploidy and six structurally altered marker chromosomes five of which were shared by nearly all cells. Receptors for epidermal growth factor were detected in all cell lines with the highest levels (about 300,000 receptors/cell) in the parental cell line. The epidermal growth factor receptors had an affinity of 2.5 nM (Kd) and by affinity cross-linking analysis a molecular weight of 170,000 was found. Initially, NCE-G28 cells responded to epidermal growth factor as well as fibroblast growth factor with increased rates of proliferation, while platelet derived growth factor had no effect. In higher passages the growth factor sensitivity was reduced. Using antibodies directed against synthetic protooncogene peptides the production of c-sis immunoreactive material was detected. NCE-G28 cells produce an autocrine factor which stimulated proliferation. This factor is present in conditioned medium and is active on cultured meningiomas and other glioma cell lines. NCE-G28 cells can be maintained in serum-free defined medium on plastic coated with fibronectin or an extracellular matrix from bovine corneal endothelial cells. The NCE-G28 cell line with its strains provide an in vitro model system in which the complexity of gliosarcoma cell populations and the interaction of the cloned cellular constituents can be studied. PMID- 3275502 TI - Formation and persistence of O6-(2-hydroxyethyl)-2' -deoxyguanosine in DNA of various rat tissues following a single dose of N-nitroso-N-(2-hydroxyethyl)urea. An immuno-slot-blot study. AB - Rabbit antibodies against O6-(2-hydroxyethyl)-2'-deoxyguanosine (O6-HEdg) were used to develop a highly sensitive immuno-slot-blot assay for this promutagenic base which enabled the quantitation of greater than or equal to 3.6 mumol O6 HEdG/mol deoxyguanosine, corresponding to greater than or equal to 5 fmol in a 3 mug DNA sample. This assay was used to study DNA hydroxyethylation by N-nitroso-N (2-hydroxyethyl)urea (HENU) in adult male F344 rats. Initial amounts of O6-HEdG 2 h after a single i.v. dose of 50 mg/kg were highest in kidney (81 mumol O6 HEdG/mol deoxyguanosine), followed by lung and liver (67 and 55 mumol/mol dG respectively). Formation of O6-HEdG in cerebral DNA was considerably lower (18 mumol O6-HEdG/mol deoxyguanosine), probably reflecting delayed crossing of the blood-brain barrier by HENU due to its hydrophilicity. The formation of O6-HEdG in liver and kidney was strictly proportional to dose over a range of 5-50 mg HENU/kg. Repair of O6-HEdG was very rapid in liver (apparent half-life, 12 h), and somewhat slower in kidney and lung (approximate half-life, 40 h and 48 h respectively). In contrast, 62% of the initial amount of O6-HEdG in cerebral DNA was still present after 7 days. Saturation of the hepatic O6-alkyl-guanine-DNA alkyltransferase by pretreatment with N-nitroso-dimethylamine (20 mg/kg) almost completely inhibited the removal of O6-HEdG, indicating that O6-HEdG is predominantly repaired by this repair enzyme. PMID- 3275503 TI - Mutation spectrum of the mutagen 3-N,N-acetoxyacetylamino-4,6 dimethyldipyrido[1,2-a:3',2'- d]imidazole in Escherichia coli. AB - The mutation frequency and mutation spectrum resulting from 3-N-acetylamino-4,6 dimethyldipyrido[1,2-a:3',2'-d]imidazole (AGluP3) DNA adducts using a previously developed forward mutation assay were established. AGluP3-induced mutagenesis requires the umuC gene product(s) and exhibits similar amounts of base pair substitution and frameshift mutation. Comparison between these results and those obtained with the isosteric amine 2-N-acetylaminofluorene suggests the involvement of deacetylated adduct in the molecular mechanisms of AGluP3-induced mutagenesis. PMID- 3275504 TI - Tumor promoters induce a transient expression of tumor-associated genes in both basal and differentiated cells of the mouse epidermis. AB - The effect of tumor promoters on the in vivo expression of tumor-associated, overexpressed genes was studied. Two of the tumor-associated genes, mal 1 and mal 2 were overexpressed already in the benign papilloma stage of mouse skin carcinogenesis. Overexpression of the other two genes, mal 4 and transin, was specific for the malignant state. Treatment of the normal adult epidermis with the complete tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) and the incomplete, second-stage promoter 12-O-retinylphorbol-13-acetate (RPA) enhanced transiently the expression of the mal sequences and transin. Fractionation of the adult epidermis on Percoll gradients into basal cells and differentiated, suprabasal cells showed that expression of the mal sequences was enhanced by TPA in both basal and differentiated cells. In contrast, transin expression, which was undetectable in cells of the normal epidermis, was enhanced in only the basal cells of the TPA-treated epidermis. The non-tumor-promoting hyperplastic agent, ethylphenyl propiolate (EPP), applied to the skin at a hyperplastic dose level did not enhance the expression of the mal 4 or transin sequences in the epidermis and had only a slight enhancing effect on the levels of mal 1 and mal 2 transcripts in the epidermis. Our results suggest that the observed stimulated expression of mal 1 and mal 2 is related to proliferative processes, whereas stimulated expression of mal 4 and transin reflects tumor-promoter-specific responses. PMID- 3275505 TI - Marked platelet activation in vivo after intravenous streptokinase in patients with acute myocardial infarction. AB - We assessed thromboxane biosynthesis as an index of platelet activation in 6 patients with acute myocardial infarction receiving intravenous streptokinase. Urinary 2,3-dinor-thromboxane B2 and plasma 11-dehydro-thromboxane B2, major enzymatic metabolites of thromboxane A2, were markedly increased after intravenous streptokinase (11,063 +/- 2758 pg/mg creatinine and 33 +/- 10 pg/ml, respectively) compared with levels in patients not receiving thrombolytic therapy (502 +/- 89 pg/mg creatinine and 3 +/- 0.7 pg/ml). Prostacyclin biosynthesis also increased markedly after streptokinase coincident with the increase in thromboxane A2 formation. Administration of aspirin between the time of onset of coronary thrombosis and reperfusion both in man and in a canine preparation demonstrated that this reflected thromboxane biosynthesis de novo and not metabolism of preformed inactive thromboxane B2 washed out from the coronary circulation. Since the platelet is the major source of thromboxane A2, these findings suggest that there is marked platelet activation after coronary thrombolysis with streptokinase. Studies in vitro demonstrated that streptokinase enhanced platelet activation in a dose-dependent manner, resulting in the secondary release of thromboxane A2. The increase in platelet activation and thromboxane A2 biosynthesis may limit the therapeutic effect of intravenous streptokinase in acute myocardial infarction. PMID- 3275506 TI - Cardiorespiratory responses to exercise training after orthotopic cardiac transplantation. AB - We have tested the feasibility and effectiveness of a 2 year (average 16 +/- 7 months) walk/jog exercise program on 36 male orthotopic cardiac transplant patients (21 to 57 years old) seen initially 2 to 23 months after surgery. Comparison of initial exercise test results with those in 45 age-matched normal men showed the patients to have a lesser lean body mass (56 +/- 7 vs 63 +/- 8 kg, p less than .001), with a higher resting heart rate (104 +/- 12 vs 77 +/- 14 beats/min, p less than .001) and systolic (138 +/- 16 vs 129 +/- 17 mm Hg, p less than .001) and diastolic (95 +/- 14 vs 84 +/- 10 mm Hg, p less than .001) blood pressures. Peak power output was less than normal (101 +/- 27 vs 219 +/- 41 W, p less than .001), as was peak heart rate (136 +/- 15 vs 176 +/- 13 beats/min, p less than .001), peak oxygen intake (VO2max) (22 +/- 5 vs 34 +/- 6 ml.kg.min-1, p less than .001), and absolute anaerobic threshold (1.18 +/- 0.40 vs 2.04 +/- 0.40 liters.min-1, p less than .001). Peak ventilatory equivalent was higher (48 +/- 9 vs 37 +/- 61.1-1, p less than .001). Cardiac output (Q), as estimated by the CO2 rebreathing method, was slightly above normal at rest (p less than .01), but below normal at two submaximal work rates. The group's average weekly training distance was 24 km, with eight highly compliant patients progressing to 32 km or more weekly. After training, lean tissue increased (+2.4 +/- 3.1 kg, p less than .001), and resting values were reduced for heart rate (-4 +/- 11 beats/min, p less than .05), systolic (-13 +/- 20 mm Hg, p less than .001), and diastolic (-9 +/- 17 mm Hg, p less than .001) blood pressures. There were significant reductions in submaximal values for minute ventilation (VE), ratings of perceived exertion, and diastolic blood pressure at equivalent workloads. Peak values increased for power output (+49 +/- 34 W, p less than .001), VO2max (+4.0 +/- 6.0 ml.kg.min-1, p less than .001), VE (+20 +/- 20 l.min-1, p less than .001), and heart rate (+13 +/- 17 beats/min, p less than .001), and decreased for diastolic blood pressure (-8 +/- 15 mm Hg, p less than .001).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3275507 TI - The momentum of coronary sinus interventions clinically. PMID- 3275508 TI - Interleukin-1 stimulation of human B-lymphoblast differentiation. AB - Transformed B-cell lines have provided useful tools for analyzing B-cell responses to growth and differentiation factors. SKW 6.4 is a human B lymphoblastoid line that differentiates in response to B-cell differentiation factor (BCDF) but not to other T-cell-derived lymphokines. The present studies were undertaken to determine whether monocyte-derived factors such as interleukin 1 (IL-1) could also promote the maturation of SKW 6.4 cells. Cells were cultured with and without supernatants derived from adherent monocytes of normal individuals. The number of Ig-producing plaque-forming cells in control media cultures gradually increased over a period of 4 days. Monocyte supernatants caused a 3- to 10-fold further increase in the number of IgM-secreting cells over that found in control media cultures. This stimulation by monocytes supernatants was maximal on the third or fourth day of culture and was not accompanied by an increase in proliferation. Recombinant IL-1 added to cultures of SKW 6.4 also produced a dose-related increase in the number of IgM-secreting cells without stimulating proliferation. A polyclonal antiserum against IL-1 prevented the increase in IgM-secreting cells which occurred with the addition of monocyte supernatants. Finally, IL-1 activity was detected in unstimulated SKW 6.4 supernatants. We conclude from these studies that SKW 6.4 cells both secrete IL-1 and differentiate in response to exogenous IL-1. SKW 6.4 may therefore provide a useful tool for future studies on mechanisms of IL-1-induced B cell maturation. It is possible that the basal numbers of IgM-secreting cells seen in unstimulated cultures results from an autocrine mechanism of IL-1-induced differentiation. Finally, care should be taken to exclude IL-1 from supernatants that are being tested for BCDF activity using SKW 6.4 cells. PMID- 3275509 TI - Rifampicin quinone is an immunosuppressant, but not rifampicin itself. AB - Rifampicin as a potential immunosuppressive agent was tested in the rat. A freshly made-up solution of this labile antibiotic in a daily dosage of 20 mg/kg iv did not affect mean graft survival time in a heterotopic heart transplant model. However, when stored solutions of rifampicin were used mean graft survival time was significantly prolonged (from 8.2 +/- 0.4 days with the controls to 18.1 +/- 1.2 days). A similar prolongation was observed when rifampicin quinone, the major rifampicin oxidation product, was administered. We conclude that the immunosuppressive effect ascribed to rifampicin is in fact due to its oxidation product, rifampicin quinone. PMID- 3275510 TI - The compartment syndrome. An experimental and clinical study of muscular energy metabolism using phosphorus nuclear magnetic resonance spectroscopy. AB - In an experimental ischemic compartment syndrome in dogs, phosphorus (31P) nuclear magnetic resonance (NMR) spectroscopy was used to determine the tissue pressure threshold at which resting skeletal muscle begins to use anaerobic energy sources due to insufficient cellular oxygen delivery. The interactive effects of systemic perfusion pressure and moderate muscle trauma on this anaerobic threshold were also evaluated. The severity of cell injury produced by various degrees of compartment pressurization over an eight-hour period was concomitantly studied using muscle biopsy and electron microscopy. Clinical correlation of a preliminary patient series studied using 31P-NMR demonstrated that the threshold for cellular metabolic derangement in skeletal muscle subjected to increased tissue pressure was more closely associated with the difference between mean arterial blood pressure (MABP) and compartment pressure than with the absolute compartment pressure alone. The difference is termed MABP compartment pressure, or delta P. The lowest delta P at which a normal cellular metabolic state can be maintained is approximately 30 mmHg in normal muscle and 40 mmHg in moderately traumatized muscle. It is imperative to interpret compartment pressure measurements in light of the degree of soft tissue trauma sustained and the patient's blood pressure, as well as the clinical signs and symptoms. PMID- 3275511 TI - Emphysematous septic arthritis due to Klebsiella pneumoniae. AB - A 60-year-old woman with rheumatoid arthritis developed acute emphysematous septic arthritis of the knee due to Klebsiella pneumoniae. She was brought to the hospital in septic shock with disseminated intravascular coagulation and had striking physical signs and roentgenograms showing distention of the knee with gas. She also had an infection of the hand with subcutaneous gas. After surgical drainage and institution of antibiotic therapy, she remained critically ill for several days but gradually improved. Two months later, she was ambulating independently. Emphysematous septic arthritis is rare. Four cases have previously been reported, but none were caused by Klebsiella. PMID- 3275512 TI - Chronic osteomyelitis of the hand caused by Salmonella typhimurium. A case report. AB - Salmonella osteomyelitis of the hand unassociated with hemoglobinopathy developed in a 39-year-old woman. After 11 debridement and curettage operations on the affected finger, she was successfully treated with excision of the diseased bone and reconstruction with a silicone prosthesis and extensor indicis transfer. This patient, examined 19 years after the onset of symptoms, illustrates that Salmonella osteomyelitis may persist for an exceedingly long period when limited curettage is the only method of treatment. PMID- 3275513 TI - Infection with Candida albicans of a total knee arthroplasty. Case report and review of the literature. AB - Infection with Candida albicans of a total knee arthroplasty developed in an immunosuppressed 52-year-old woman with rheumatoid arthritis who initially presented with clear drainage from the incision, which cultured negative initially. Successful treatment consisted initially of debridement and a course of intravenous antibiotics, followed by staged arthrodesis with an intramedullary rod. PMID- 3275514 TI - Osteocalcin. Biochemical considerations and clinical applications. AB - The vitamin K-dependent protein of bone, osteocalcin (bone Gla protein) is a specific product of the osteoblast. A small fraction of that synthesized does not accumulate in bone but is secreted directly into the circulation. Upon catabolism of osteocalcin, its characteristic amino acid, gamma-carboxyglutamic acid (Gla), is excreted into the urine. Both serum osteocalcin and urine Gla are currently being used for the clinical assessment of bone disease. The authors summarize the current understanding of the structure and function of osteocalcin in bone and evaluate the clinical studies done using serum osteocalcin and urinary Gla to monitor bone turnover. Factors that affect the measurement of osteocalcin concentrations in the blood are osteoblastic synthesis, content of Gla in the protein, drug-induced alterations in osteocalcin's affinity for bone, hormonal status, renal function, age, sex, timing of blood collection, and specificity of the radioimmunoassay. With these considerations, serum osteocalcin measurements provide a noninvasive specific marker of bone metabolism. PMID- 3275515 TI - The history of bone grafts. AB - Bone autografts, allografts, and even vascularized bone grafts are currently used in nearly every orthopedic center throughout the world. The recent interest in bone graft surgery is because of the increased demand for bone grafts for skeletal reconstruction in limb salvage surgery for bone tumors and for reconstruction of failed arthroplasties. This reconstruction of large skeletal deficiencies presents a challenging problem to orthopedists; treatment of these defects has advanced significantly during the past two decades. Bone transplantation has been the subject of many experimental and clinical studies. This is a review of the history of different types of bone grafts used in the past and currently. PMID- 3275516 TI - Interposition of vitallium plates in arthroplasties of the knee. Preliminary report. By Willis C. Campbell, 1940. PMID- 3275517 TI - Revision total knee arthroplasty. AB - Revision total knee arthroplasty can be very successful if careful preoperative planning has been carried out and the surgeon is equipped to handle potential problems encountered with restoration of static alignment, stability, and deficient bone stock. Special femoral and tibial component extractors are indispensable tools. A high-speed burr is helpful. Posterior cruciate ligament preserving prostheses often can be used, but prostheses with extra degrees of constraint must be available. Long-stemmed components for both the femoral and tibial sides should be available. Access to a bone bank to obtain allogeneic bone for grafting is essential. The surgeon must be familiar with techniques other than bone grafting for restoration of deficient stock, such as the use of bone screws and cement, custom-augmented components, and metal wedge spacers. PMID- 3275518 TI - Bone grafting and noncemented revision arthroplasty of the knee. AB - Revision of failed cemented total knee arthroplasties with cementless stemmed components and allogeneic bone grafts was performed on 22 patients, with clinical results comparable to those in primary arthroplasty. On roentgenograms, most of the allogeneic grafts appeared to be incorporated in the host bone. Various bone reactions not fitting any particular pattern, occurred around the stems. PMID- 3275519 TI - Intracranial hemorrhage in small-for-gestational-age neonates: comparison with weight-matched appropriate-for-gestational-age infants. AB - In a comparative study of 93 small-for-gestational-age (SGA) infants against 93 weight-matched, appropriate-for-gestational-age (AGA) neonates, the SGA group exhibited a significantly lower incidence of periventricular-intraventricular type intracranial hemorrhage (ICH) at the first ultrasound scan than did the AGA neonates (9/93 vs 21/93; p less than 0.02). This apparent advantage was no longer maintained in later scans of the first week (16/93 vs 27/93; NS), despite the fact that the SGA group were 4 weeks advanced in gestational age and had fewer respiratory problems than the AGA controls. It is prudent, therefore, to follow SGA infants closely for ICH by repeat ultrasound examinations even if the first scan is negative. Evaluation of the subgroup of SGA infants with ICH against the total SGA population revealed lower admission body temperature and Apgar scores, and higher incidence of asphyxia, resuscitation, and mortality. The above observations in SGA infants with ICH and the lack of a similar trend between the AGA infants with ICH and the total AGA population suggest that SGA status, hypothermia, and ICH are interrelated. Hypothermia, therefore, can be used as a convenient marker for the possibility of ICH in low birth weight SGA infants. The authors' data is consistent with the view that hypothermia and ICH are both the consequences of perinatal asphyxia in SGA infants and probably reflect the magnitude of stormy perinatal events. PMID- 3275521 TI - Streptococcal pharyngitis in preschool children. PMID- 3275520 TI - Congenital ocular motor apraxia. Case reports and literature review. AB - Two children with congenital ocular motor apraxia (C-OMA) associated with congenital malformations of the central nervous system (CNS) are presented, and the literature is reviewed. C-OMA is an abnormality of ocular motility characterized by defective or absent voluntary horizontal gaze, associated with a characteristic head thrust. Although not rare, it is infrequently recognized. C OMA is not a specific disease entity, but a sign. It may be associated with other static congenital CNS disorders and must be distinguished from acquired ocular motor apraxias (A-OMA) seen in progressive brain disorders and in certain serious systemic diseases. Therefore, when movements typical of C-OMA are observed, a careful systemic and neurologic examination should be performed, including immunoglobulin screening, cranial computerized tomography scanning, and adequate follow-up. Close relatives also should be examined. PMID- 3275522 TI - Trough levels and concentration time curves of cyclosporine in patients undergoing renal transplantation. AB - We determined the AUC of cyclosporine (24 hours) nonspecifically by RIA and specifically by HPLC after an oral and an intravenous dose of cyclosporine in 58 patients undergoing renal transplantation. The RIA/HPLC concentration ratio of cyclosporine changed continuously during the first 12 hours after administration. The ratio was higher after oral than after intravenous administration and varied from patient to patient. The predictive value of trough levels for the corresponding AUCs was better when trough levels were assessed 24 than 12 hours after administration. Trough levels assessed by RIA poorly predicted AUCs measured specifically by HPLC. Therefore if, in the future, therapeutic cyclosporine monitoring has to be improved, trough levels should be assessed 24 hours after the last dose by means of a specific HPLC method. PMID- 3275523 TI - A clinical trial of buprenorphine: comparison with methadone in the detoxification of heroin addicts. AB - The efficacy of buprenorphine and methadone was compared in the outpatient detoxification of heroin addicts. Forty-five patients were randomized to receive either sublingual buprenorphine or oral methadone under double-dummy and double blind conditions to study the pharmacology of buprenorphine in a 90-day detoxification protocol. The patients were administered either 2 mg buprenorphine or 30 mg methadone for 3 weeks followed by 4 weeks of dose reductions and 6 weeks of placebo medication. No significant between-group differences were seen on measures of treatment retention, drug use, or symptom report. During the hydromorphone challenge, methadone attenuated opioid effects to a greater extent than did buprenorphine on both physiologic (pupil constriction) and self-report measures. However, this did not result in greater abuse of illicit opioid drugs by subjects taking buprenorphine. The results of this clinical trial indicated that buprenorphine was acceptable to patients and as effective as methadone in the detoxification treatment of heroin addicts. PMID- 3275524 TI - In memoriam Henry Hugh Dukes 1895-1987. PMID- 3275525 TI - Oral vs repository corticosteroid therapy in acute asthma. AB - Acutely ill asthmatic patients treated in the usual fashion in an emergency room setting and discharged within six hours were studied to determine whether therapy with a single injection of a repository corticosteroid (methylprednisolone sodium acetate) could be as effective as a tapering course of oral corticosteroids in decreasing asthma symptomatology and relapse within seven days. Seventeen patients (18 episodes of asthma) formed the study population. Eight episodes occurred in patients who received depot methylprednisolone (group 1) and ten episodes in patients who received oral corticosteroid treatment (group 2). All patients in both groups improved following emergency room treatment. Relapse occurred in two of ten patients in group 2 and none in group 1. Symptoms attributable to asthma recurred in significantly more patients in group 2 than in group 1 (9 vs 0, p less than .01). Side effects from therapy with corticosteroids were rare. This study indicates that intramuscular repository corticosteroids are at least as effective as oral corticosteroids in the management of the acute asthmatic outpatient, with a distinct advantage with regard to patient compliance. PMID- 3275526 TI - Lithium and the heart. Unanswered questions. PMID- 3275528 TI - The mythical mystical cardiac afterload. PMID- 3275527 TI - The Greenfield vena cava filter. PMID- 3275529 TI - Giovanni Paladino: true father of the accessory myocardial conduction pathways. PMID- 3275530 TI - Distribution of bronchial nonspecific reactivity in the general population. AB - We investigated 654 subjects of a small Lombardy (Italy) town between 15 and 64 years of age who were representative of the general population. By clinical examination, the sample included 535 normal subjects (164 normal smokers, 341 normal nonsmokers, 30 normal subjects with acute upper respiratory illness within 30 days before the challenge), 50 with chronic bronchitis, 26 with asthma, and 43 with allergic rhinitis. Subjects whose FEV1 was 75 percent or more than the predicted value (654) underwent methacholine bronchial challenge by means of 1 percent metered-dose solution. The test result was considered positive at a drop of more than 15 percent in FEV1 (compared with buffer). Normal smokers and all of the groups with disease had a significantly different distribution of reactivity compared with normal nonsmokers. The difference between asthmatic and these "normal" subjects was highly significant; nevertheless, a clear cut-off between the two groups does not appear to exist. PMID- 3275531 TI - Community-acquired pneumonia. Importance of initial noninvasive bacteriologic and radiographic investigations. AB - During a one-year epidemiologic survey of acute community-acquired pneumonia, we prospectively investigated in 116 adult nonimmunocompromised patients (a) the importance of initial noninvasive investigations (ie, blood culture and quantitative sputum culture) and the value of the initial radiologic type of pneumonia in diagnosing of the etiologic agent, and (b) the management of pneumonia. Quantitative sputum culture or blood culture (or both) permitted bacteriologic diagnosis in 44 percent of the cases. The radiologic types found were segmental or alveolar densities in 75 patients (65 percent), patchy alveolar densities in 11 (9 percent), mixed opacities in 26 (22 percent), and interstitial infiltrates in four (3 percent). We observed that (a) the prognosis was identical whether a bacteriologic diagnosis was made or not, (b) the Gram stain, an inexpensive procedure, was as contributive for bacteriologic diagnosis as quantitative sputum culture, diagnosis as (c) blood cultures were poorly contributive in patients without severe infections, and (d) alveolar densities were associated with a bacterial infection in 90 percent of the cases of known etiology. On the basis of these results, a pragmatic strategy of initial management of community-acquired pneumonia is proposed. PMID- 3275532 TI - [Bone marrow transplantation as therapy in chronic myeloid leukemia]. AB - Between April 1982 and December 1986, HLA-identical bone marrow transplantations were performed on 25 patients with Philadelphia chromosome-positive chronic myelocytic leukaemia (CML), 18 in the chronic phase, 7 in acceleration or blast crisis. Twelve of the 18 patients (67%) in the chronic phase are still alive a median period of 570 days after transplantation, but only two of the seven (29%) in acceleration or blast crisis a median period of 227 days after transplantation (P less than 0.025). The duration of the chronic phase was of great importance for survival after transplantation: 86% of patients in the chronic phase for less than two years survived, but all patients in the chronic phase for over two years died (P less than 0.001). CML relapses occurred in one patient in a late chronic phase and in two in an advanced stage of the disease. These results confirm the unfavorable outcome of bone marrow transplantation in the accelerated phase or blast crisis, as well as in the late chronic phase. Since at present there are no reliable risk factors for the occurrence of acceleration or blast crisis, bone marrow transplantation should be undertaken as early as possible in the chronic phase of CML. PMID- 3275533 TI - Identification and characterization of an estrogen-inducible glycoprotein (uterine secretory protein-1) synthesized and secreted by rat uterine epithelial cells. AB - An estrogen-inducible 97-kilodalton (kDa) secretory glycoprotein, designated as uterine secretory protein (USP)-1, synthesized by rat uterine epithelial cells was identified and characterized. Uterine luminal fluid (ULF) proteins were labeled by direct administration of [35S]methionine into uterine lumen of rats. Incorporation of [35S]methionine into ULF proteins was negligible in ovariectomized rats. However, when 17 beta-estradiol (E2) was administered in the ovariectomized rat as sc paraffin pellets, a marked increase of [35S]methionine incorporation was noted after 2 days of treatment, showing that the de novo synthesis and secretion of ULF proteins were induced by E2. Six estrogen inducible polypeptides (130, 110, 97, 65, 42, and 39 kDa) were identified in the analysis of the labeled ULF proteins by sodium dodecylsulfate-polyacrylamide gel electrophoresis and fluorography. Four of these polypeptides (110, 65, 42, and 39 kDa) were adsorbed by the immobilized antibody against rat serum proteins, indicating that these polypeptides are antigenically similar to serum proteins. Two polypeptides (130 and 97 kDa) not adsorbed by the antibody column were suggested to be uterine-specific secretory proteins. The 97-kDa protein (USP-1) was further purified by preparative sodium dodecylsulfate-polyacrylamide gel electrophoresis and electroelution. Reactivity of purified USP-1 to various lectins and carbohydrate composition analysis suggested that USP-1 possesses biantennary N-linked complex-type carbohydrate chain with fucose. Rabbit polyclonal antibody which can specifically immunoprecipitate [35S]methionine labeled USP-1 was developed. Dot blot enzyme immunoassay showed that 4-day E2 treated ULF contains 78.3 +/- 24.1 (+/- SE) micrograms USP-1/mg protein. Immunohistochemical staining of rat uterine tissue showed that this protein localized only in the epithelial cells treated with estrogen (E2 and diethylstilbestrol). Testosterone, progesterone, and dexamethasone failed to induce synthesis and secretion of USP-1 as assessed by dot blot enzyme immunoassay, immunoprecipitation of [35S]methionine-labeled ULF proteins, and immunohistochemical staining of uterine tissue. The present result, for the first time, revealed that estrogen can induce synthesis and secretion of specific secretory protein which could be the useful marker to analyze the molecular mechanism of estrogen action in rat uterine epithelial cells. PMID- 3275534 TI - Transforming growth factor-beta stimulates meiotic maturation of the rat oocyte. AB - The effect of transforming growth factor-beta (TGF beta) on meiotic maturation was analyzed in oocytes from immature rats treated with PMSG. TGF beta accelerated the maturation of both follicle-enclosed oocytes and cumulus-oocyte complexes, as measured by an increase in the percentage of oocytes with germinal vesicle breakdown. Concentrations of the growth factor as low as 1 pM (25 pg/ml) increased oocyte maturation by 50% above control values, and 100 pM TGF beta caused a maximal 2-fold rise in the maturation rate. Germinal vesicle breakdown was significantly increased by TGF beta during the first 4 h of incubation, and stimulatory effects were observed as early as 1 h. However, by 8 h over 90% of the oocytes showed maturation in the absence or presence of TGF beta, indicating that the growth factor enhanced the spontaneous rate of oocyte development. TGF beta had no effect in denuded oocytes, demonstrating that the growth factor altered maturation through an action on the surrounding cumulus cells. Oocyte maturation was not accelerated by TGF beta in the presence of inhibitors of germinal vesicle breakdown, such as cAMP and hypoxanthine. Other growth factors, including IGF-I (50 ng/ml) and IGF-II (50 ng/ml), also stimulated oocyte maturation, while platelet-derived growth factor (100 ng/ml) and insulin (1 microgram/ml) had minimal effects on germinal vesicle breakdown. Although epidermal growth factor (EGF; 100 ng/ml) also increased the maturation of oocytes, lower concentrations of TGF beta (1-10 pM) suppressed EGF action by up to 30%. TGF beta, EGF, and insulin-like growth factors had minimal effects on cAMP production by cumulus-oocyte complexes. These results demonstrate that TGF beta and other growth factors are potent in vitro stimulators of oocyte maturation in the rat. Such effects of growth factors in vivo, in the presence of endogenous follicular factors and gonadotropic hormones, may regulate the selection and meiotic maturation of oocytes during follicular development. The rapidity of growth factor action in the oocyte provides a defined model to study signal transduction pathways of growth factors in relationship to their biological activity. PMID- 3275535 TI - Effects of platelet-derived growth factor and somatomedin-C/insulin-like growth factor I on the deoxyribonucleic acid replication of fetal rat islets of Langerhans in tissue culture. AB - The effects of platelet-derived growth factor (PDGF) on DNA replication and release of insulin and somatomedin-C/insulin-like growth factor I (SM-C/IGF-I) from cultured fetal rat islets have been studied. In medium containing 1% fetal calf serum and 16.7 mM glucose, both PDGF (2-10 ng/ml) and SM-C/IGF-I (100 ng/ml) stimulated DNA replication 2-fold. The growth stimulatory effects of the two peptides were additive. In the absence of serum, SM-C/IGF-I, but not PDGF, stimulated DNA replication. Under conditions of PDGF-stimulated DNA replication there was no increased release of either insulin or SM-C/IGF-I into the culture medium. An antibody against SM-C/IGF-I which inhibited SM-C/IGF-I-stimulated DNA replication did not affect PDGF-stimulated DNA replication. Similarly, an antibody against PDGF did not affect DNA replication stimulated by SM-C/IGF-I. It is concluded that PDGF stimulates islet cell DNA replication. This is the first demonstration of a tissue of nonmesodermal origin responding to PDGF. Stimulation of DNA replication appears to be independent of SM-C/IGF-I release, and furthermore, the results indicate that the islets do not produce PDGF-like substances themselves. It is suggested that PDGF is of importance for fetal islet development. PMID- 3275536 TI - Production and partial characterization of a monoclonal antibody to rat anterior pituitary somatotrophs. AB - A cell type-specific monoclonal antibody (Mab) against a cell surface antigen of rat anterior pituitary somatotrophs has been generated by fusion of a nonsecreting mouse myeloma line with spleen cells from a mouse immunized with enzymatically dispersed anterior pituitary cells of adult random cycling female rats. Hybridomas were initially screened for antibodies to cell surface antigens by an enzyme-linked immunosorbant assay using rat anterior pituitary cells and smooth muscle cells of aorta as positive and negative controls, respectively. Positive clones were further checked for cell type specificity by immunofluorescence. Mab WHC-1 is an immunoglobulin M (IgM) with kappa-light chains and is cytotoxic in the presence of complement. Based on double immunofluorescence, this Mab reacted with 22.5 +/- 2.0% (+/- SEM) of the anterior pituitary cells of adult random cycling female rats. Among them, about 93.5 +/- 1.4% were somatotrophs, and only 4.1 +/- 1.2% were mammotrophs. Approximately two thirds of the somatotrophs were Mab WHC-1-positive. The reaction of this Mab with gonadotrophs, thyrotrophs, or corticotrophs were negligible. The percentage of Mab WHC-1-positive cells derived from immunoperoxidase staining was significantly greater than that from immunofluorescence. The cell surface antigen defined by Mab WHC-1 is expressed heavily on GH3 cells, but not on smooth muscle cells. It is resistant to trypsin digestion, but sensitive to ethanol treatment, and exhibits the solubility property of a glycolipid. Mab WHC-1 cross-reacts with the anterior pituitary cell of rabbits, but not mice. These results provide the immunological evidence for heterogeneity among somatotrophs and demonstrate the feasibility of making pituitary cell type-specific Mabs. PMID- 3275537 TI - Autocrine regulation of cell proliferation by estradiol and hydroxytamoxifen of transformed mouse Leydig cells in serum-free culture. AB - We have previously reported that the cloned cell line (B-1-A-2) derived from an estrogen-responsive mouse Leydig cell tumor shows an estrogen-dependent enhancement of cell proliferation in medium supplemented with charcoal-dextran stripped fetal bovine serum. To avoid the involvement of unknown factors present in the serum in the pathway for estrogen-dependent cell growth, the present study was designed to establish a serum-free culture system to which growth factors could be added. To this end, we subcloned B-1 cells from the parental tumor cell line. The proliferation of B-1 cells was markedly stimulated by the addition of 10(-11)-10(-8) M estradiol into the serum-free medium [Eagle's Minimum Essential Medium-Ham's F-12 (1:1, vol/vol) containing 0.2% (wt/vol) BSA]. Epidermal growth factor (0.1-50 ng/ml) or insulin (0.1-50 micrograms/ml) alone or in combination with 10(-8) M estradiol did not affect the proliferation rate of B-1 cells. In contrast, a greater than 10-fold molar excess of 4-hydroxytamoxifen blocked estradiol-induced cell proliferation, while 4-hydroxytamoxifen alone failed to show a stimulatory effect on cell multiplication. Additionally, the conditioned medium collected from estradiol-stimulated cells was found to contain a growth promoting factor(s) whose activity was not antagonized by 4-hydroxytamoxifen. Nonstimulated cells secreted a significant but low level of the growth-promoting factor. Finally, B-1 cells were found to be estrogen dependent for cell proliferation in BALB/c mice. Their growth was markedly inhibited by the administration of tamoxifen to the host mice. These results indicate that the serum-free culture system presented here is suitable for studying the autocrine mechanisms of cell growth regulated by estrogens as well as triphenylethylene compounds. PMID- 3275538 TI - Control of progesterone receptors in fetal uterine cells in culture: effects of estradiol, progestins, antiestrogens, and growth factors. AB - Cells from the fetal uterus of the guinea pig have been grown as monolayer cell cultures both as primary cultures and through several passages. The cells have a fibroblast-like morphology and ultrastructure, and the subcultures are estrogen responsive. Estradiol induced a 2- to 3-fold increase in specific binding of [3H]R5020 by 9 days in culture, with no effect on proliferation. This binding has the characteristics of the progesterone receptor from the fetal guinea pig uterus (saturable, high affinity, specific for progestins). The increase in progesterone receptor depended on the dose of estradiol, with a half-maximal response at about 5 X 10(-11) M. Progesterone receptor concentrations were inhibited to below basal levels by progesterone and R5020 and the nonsteroidal antiestrogens, tamoxifen, and 4-hydroxytamoxifen. Both progestins and antiestrogens antagonized the stimulatory effect of estradiol. None of these compounds had any effect on cell growth. On the other hand, insulin and epidermal growth factor caused a great increase in cell proliferation. Insulin alone had no effect on progesterone receptor concentrations, but epidermal growth factor stimulated the progesterone receptor about as much as estradiol. Furthermore, coincubation of insulin with estradiol produced a synergistic effect. Estrogen receptor levels were low or undetectable at any time in either the primary culture or the subcultures. It is concluded that fetal uterine cells in culture can serve as a good in vitro model for study of the control of the progesterone receptor in a fetal target tissue. PMID- 3275539 TI - Immunoreactive methionine-enkephalin in cerebrospinal fluid and blood plasma during acute stress in conscious sheep. AB - The opioid peptide methionine-enkephalin (Met-enkephalin) was measured in plasma and cerebrospinal fluid (CSF) of sheep in which the cisterna magna, carotid artery, and jugular vein were chronically cannulated. Venous blood plasma and CSF were collected before and after stress treatment and in control studies in conscious animals. Plasma and CSF were extracted with octadecylsilica and oxidized, and Met-enkephalin was measured as its Met-sulfoxide derivative by specific RIA. The molecular form of immunoreactive Met-enkephalin was characterized by peptide size exclusion chromatography of an octadecylsilica extract of sheep plasma through Bio-Gel P2, followed by reverse phase liquid chromatography, and was identical to Met-enkephalin and Met-sulfoxide-enkephalin. Insulin-induced hypoglycemia produced an elevation of plasma cortisol and an increase in the plasma concentration of Met-enkephalin. Acute hemorrhage led to an earlier and greater rise in plasma cortisol than that associated with insulin induced hypoglycemia, but did not increase the concentration of Met-enkephalin in plasma. Neither form of acute stress increased the concentration of Met enkephalin in CSF. These studies confirm that secretion of Met-enkephalin into blood can be dissociated from stimulation of the pituitary-adrenocortical system. They also show that circulating Met-enkephalin is elevated in conscious sheep during acute hypoglycemic stress, but plasma Met-enkephalin is unlikely to exert effects on the opiate receptors of periaqueductal or spinal nociceptive neurons under these conditions, since it does not enter cerebrospinal fluid in significant amounts. PMID- 3275540 TI - Intrarenal effects of [Ala-Pro-Gly-(Ile3-Val5)] angiotensin II in the conscious dog. AB - Amphibian skin has functional characteristics of epithelium in the mammalian distal nephron and plays an important role in sodium and water metabolism in these animals. A peptide extracted from the skin of the Australian frog Crinia georgiana has been purified, has been determined to have the amino acid sequence of [Ala-Pro-Gly-(Ile3-Val5)]angiotensin II, and recently has been synthesized. We studied the renal effect of synthetic frog skin angiotensin II (FSAII) infused via the renal artery in doses that were confined to the kidney. FSAII was infused intrarenally at 0.2, 2, and 4 pmol/kg.min in uninephrectomized conscious dogs (n = 5) in metabolic balance at a sodium intake of 80 meq/day. FSAII was confined to the kidney, as demonstrated by the absence of any systemic pressor response and/or any increase in plasma aldosterone concentrations during intrarenal FSAII infusion at rats of 0.2 and 2 pmol/kg.min. At 4 pmol/kg.min, FSAII traversed the kidney in amounts sufficient to stimulate aldosterone secretion (P less than 0.05). All three doses of FSAII caused significant antidiuresis and antinatriuresis, and decreased fractional excretion of sodium. There were no changes in the glomerular filtration rate (GFR) or renal plasma flow (RPF) during FSAII infusion at 0.2 and 2 pmol/kg.min. At 4 pmol/kg.min, FSAII engendered a significant decrease in GFR and RPF, while the filtration fraction increased. There were no significant changes in arterial blood pressure at any dose of FSAII. When confined to the kidney, FSAII caused antidiuresis and anti natriuresis in the absence of a change in GFR and RPF. These results provide evidence that angiotensin acts directly at the renal tubular level to alter renal function. PMID- 3275541 TI - In memoriam: J.S.L. Browne, M.D., Ph.D. PMID- 3275542 TI - A gonadotropin-releasing hormone (GnRH) antagonist decreases androgen production and spermatogonial multiplication in frog (Rana esculenta): indirect evidence for the existence of GnRH or GnRH-like material receptors in the hypophysis and testis. AB - The effects of a GnRH antagonist (GnRHA) on GnRH agonist (GnRH*)-induced androgen production and spermatogonial multiplication were studied in the frog, Rana esculenta, in vivo and in vitro. Intact and hypophysectomized (PDX) animals were kept at 22 +/- 2 C and treated with GnRH (45 ng/g BW) and GnRH* plus 1X and 10X concentrations of GnRHA on alternate days for 2 weeks. Androgen concentration in GnRH* plus GnRHA-treated animals decreased in the testis by about 50% with the 10X dose whereas the increase obtained in GnRH*-treated PDX group was completely abolished with the 1X dose. Histological sections were evaluated with respect of the mitotic index (MI) of the primary spermatogonia. Both GnRHA-treated intact and PDX frogs showed a dose-dependent MI decrease which reached 59% and 57% of control, respectively. In vitro incubations were carried out on testis halves at 15 C for 0, 2, 4, 6, and 8 h with the addition of 1 microgram GnRH* and 1 microgram GnRH* plus 1 or 10 micrograms GnRHA. The stimulatory effect of GnRH* and the inhibitory effect of GnRHA were apparent within 2 h. The basal mitogenic activity was affected by antagonist treatment and the inhibitory effect on the MI was evident within 2-4 h in the 10X-treated groups or within 6-8 h in the 1X treated groups. Since GnRH* and GnRHA bind to the same receptor these data strongly indicate that the effects of putative GnRH-like materials in the frog, Rana esculenta, are mediated throughout stereospecific recognition sites in both pituitary and testis. PMID- 3275543 TI - Measurement of the kinetics of DNA repair synthesis after uv irradiation using immunochemical staining of incorporated 5-bromo-2'-deoxyuridine and flow cytometry. AB - The kinetics of unscheduled DNA synthesis in normal human fibroblasts was characterized by flow cytometry utilizing the immunofluorescent detection of 5 bromo-2'-deoxyuridine (BrdUrd) incorporated into cellular DNA during the repair process. Quiescent normal human fibroblasts were irradiated with ultraviolet light and incubated in the presence of BrdUrd during a postirradiation repair period. The amount of unscheduled DNA synthesis was then quantified in the quiescent cells by immunofluorescence staining using monoclonal antibodies against BrdUrd incorporated into the DNA. Significant amounts of unscheduled DNA synthesis were measured after doses as low as 0.1 J/m2 and for time periods as short as 15 min. The initial repair rate was found to be linear with time at all doses tested until repair neared completion. Interestingly, the initial repair rate was constant for doses over the range of 5 to 40 J/m2, whereas the time to completion of repair was dose dependent. These results suggest that above 5 J/m2 in normal human fibroblasts, the repair process is saturated but continues to function until all available regions are repaired. Using this methodology for measuring unscheduled DNA synthesis in combination with second and third flow markers, it is now possible to measure unscheduled DNA synthesis in heterogeneous mixtures of cells. PMID- 3275544 TI - The metabolism of ribosomal proteins microinjected into the oocytes of Xenopus laevis. AB - When the total proteins from Xenopus laevis 60 S ribosomal subunits (TP60) were 3H-labeled in vitro and injected back into X. laevis oocytes, most 3H-TP60 are integrated into the cytoplasmic 60 S subunits via the nucleus during 16 h of incubation. In the oocytes whose rRNA synthesis is inhibited, 3H-TP60 are rapidly degraded with a half-life of 2-3 h. This degradation ceased as soon as rRNA synthesis was resumed, suggesting that ribosomal proteins unassociated with nascent rRNA are unstable in the oocytes. The degradation of 3H-TP60 in the absence of RNA synthesis was inhibited by iodoacetamide, a cysteine protease inhibitor, resulting in the accumulation of 3H-TP60 in the nucleus reaching about a threefold concentration in the cytoplasm. Considering the results with enucleated oocytes, we suggest that the X. laevis nucleus has a limited capacity to accumulate ribosomal proteins in an active manner but that those ribosomal proteins accumulated in excess over rRNA synthesis are degraded by a cysteine protease in the nucleus. By contrast, ribosomal proteins from Escherichia coli only equilibrate between the nucleus and the cytoplasm and are degraded by serine protease(s) in the cytoplasm without being integrated in the form of ribosomes in the nucleus. PMID- 3275545 TI - Metabolic inhibitors and intermediate filament organization in human fibroblasts. AB - A number of metabolic inhibitors including the mRNA transcription inhibitor actinomycin D; the protein synthesis inhibitors emetine, cycloheximide, and puromycin; the energy metabolism inhibitors sodium azide and oligomycin; the amino acid analog L-azetidine-2-carboxylic acid; sodium fluoride; and acrylamide each cause the collapse of vimentin filament organization while leaving microtubule organization apparently unaffected in the human fibroblastic cell line MCH23. The protein kinase inhibitor N-[2-(methylamino)ethyl]-5 isoquinolinesulfonamide dihydrochloride (H8) caused a partial collapse of vimentin organization but its effect was more difficult to discern, since it also induced a dramatic change in cellular morphology. Each of these drugs produced a significant inhibition of protein synthesis at concentrations that affected vimentin organization. The mechanisms by which these drugs affect intermediate filament organization are unclear, but our results demonstrate that intermediate filament organization in MCH23 cells is affected by a wide range of drugs and that such drugs cannot be used without great caution as reagents for the study of intermediate filament organization and function. PMID- 3275546 TI - The structural gene for the M1 subunit of ribonucleotide reductase maps to chromosome 11, band p15, in human and to chromosome 7 in mouse. AB - The genes for the M1 subunit of the enzyme ribonucleotide reductase have been mapped in the human and the murine species by use of two independently derived mouse cDNA clones. Southern blot analysis of rodent x human somatic cell hybrid DNAs confirmed the assignment of RRM1 to the short arm of human chromosome 11. In situ hybridization to human metaphase chromosomes revealed a peak of silver grains over the distal third of band 11p15, a region corresponding to subbands p15.4----p15.5. The mouse Rrml locus was assigned to chromosome 7, where it forms part of a conserved syntenic group of at least seven other genes assigned to human chromosome band 11p15. PMID- 3275547 TI - Differential expression of fibronectin in a rat histiocytoma: possible role of fibronectin in tumor cell adhesion. AB - The specific role of fibronectin in tumor cells has been investigated using the transplantable histiocytic tumor line AK-5 [A. Khar (1986) J. Natl. Cancer Inst. 76, 871]. These cells, capable of growth as both ascites and solid tumors in rats, can be separated into four subpopulations by buoyant density centrifugation on Percoll. These subpopulations are shown to contain different amounts of fibronectin on the cell surface when studied by immunofluorescent staining followed by cytofluorometric analysis. Cells which contain high amounts of fibronectin can grow both as ascites and as solid tumors while those cells which contain low amounts of fibronectin cannot grow as solid tumors but can grow as ascitic tumors. Pretreatment of high-fibronectin-containing cells with anti fibronectin antibody abolished their capacity to grow as solid tumors; however, the cells retained their capacity to grow as ascitic tumors. These results have been discussed with reference to the specific role of fibronectin in tumor forming cells. PMID- 3275548 TI - Detection of human megakaryocyte antigens by solid-phase radioimmunoassay. AB - Many studies report the presence of platelet-megakaryocyte-associated antigens on human immature and mature megakaryocytes as well as progenitor cells of this lineage. However, studies of purified megakaryocytes or megakaryocyte colonies yield little information on the effect(s) of growth factors in regulating antigenic expression, the kinetics of expression, or the relative content of antigens expressed. We report the detection of human megakaryocyte antigens using a solid-phase radioimmunoassay. The assay is linear, specific, and detects a range of approximately 300-10,000 megakaryocytes per aliquot. Analyses of unstimulated and stimulated suspension cultures indicate that activities known to influence megakaryocyte development in vitro also increase total megakaryocyte antigenic content. Additionally, studies on human erythroleukemia cells show that those cells constitutively express megakaryocyte antigens and increase these antigens when stimulated. Finally, since the specificity of the assay is that of the primary antibody, this procedure is easily extended to analysis of antigenic expression in other lineages. PMID- 3275549 TI - Effects of hypoglycemia on kindling seizures in suckling rats. AB - The effects of insulin-induced hypoglycemia on epileptic disorders of suckling rats were examined using an amygdala kindling model. Kindling stimulations were conducted at 16 and 17 days of age with electrodes implanted in the amygdala 2 days earlier. In 18-day-old kindled rats, which acquired generalized behavioral seizures (stages 4 and 5; Moshe's score) by kindling stimulations, the duration of afterdischarge and behavioral seizures evoked by the stimulation at a threshold intensity to produce a generalized seizure was significantly prolonged after an injection of insulin (25 U/kg, i.p.). The prolongation was not observed in kindled rats that exhibited normal blood glucose concentrations after the application of saline or insulin together with glucose. There were no apparent changes in the amplitude of the afterdischarge, the score of behavioral seizure stages, or the generalized seizure threshold. A similar, marked prolongation of afterdischarge and behavioral seizures following the application of insulin, as in the kindled rats, was also observed during the course of the kindling acquisition without accelerating the development of kindling seizure scores. These results indicate that insulin-induced hypoglycemia easily increases the risk of prolonged seizures in immature brain without precipitating the secondarily generalizing mechanism. PMID- 3275550 TI - Role of temperature in regulation of spermatogenesis and the use of heating as a method for contraception. PMID- 3275551 TI - Linear regression analysis of ultrasound follicular growth series: evidence for an abnormality of follicular growth in endometriosis patients. AB - Follicular diameter growth is a highly linear function of time. Recently, the potential utility of linear regression-derived parameters for describing and comparing cycles of follicular growth was described. The linearity of growth, growth rate constant (K), calculated date of growth onset (Do), total growth period (TGP), menstrual age at apparent ovulation (MAov), and peak follicular diameter (PFD) have been calculated from the follicular growth series of a group of patients with laparoscopically diagnosed endometriosis (n = 46). These parameters were compared with those of a group of normal volunteers (n = 18). The authors found significant differences between endometriosis patients and controls in follicular growth rate and total growth period. The effect of patients' clomiphene citrate usage on growth parameters in these patients was examined. Abnormalities in interrelationships between the growth parameters were detected, suggesting the possibility of subtle defects in the regulation of follicular growth in these patients. PMID- 3275552 TI - Uterine growth in the follicular phase of spontaneous ovulatory cycles and during luteinizing hormone-releasing hormone-induced cycles in women with normal or polycystic ovaries. AB - The uterine response to follicular growth in luteinizing hormone-releasing hormone (LH-RH)-induced ovulatory cycles was assessed by serial ultrasound measurement of uterine cross-sectional area and endometrial thickness in 23 cycles in women with normal ovaries and 24 cycles in women with polycystic ovaries. Nine women with spontaneous ovulatory cycles also were studied. The authors correlated uterine cross-sectional area and endometrial thickness with follicle diameter (FD) and serum estradiol-17 (E2). In women with either normal or polycystic ovaries, there was an E2-related increase in uterine cross sectional area and endometrial thickness, but both uterine area and endometrial thickness were greater in the late follicular phase of women with polycystic ovaries compared with those with normal ovaries. PMID- 3275553 TI - Influence of aging on hepatic and peripheral glucose metabolism in humans. AB - Mechanisms of glucose intolerance with aging were studied by comparing the metabolic response to glucose ingestion in 10 young (20-23 yr) and 10 elderly (73 80 yr) normal men with the simultaneous application of the forearm and double isotope techniques. The latter technique consisted of a primed-constant infusion of [3-3H]glucose followed by the administration of an oral glucose load (mean +/- SE, 90.7 +/- 0.7 g) containing [1-14C]glucose. Fasting plasma glucose and insulin concentrations were similar in young and elderly subjects, but in the elderly, glucose tolerance was markedly impaired. Although in the elderly the initial rise in insulin levels (delta, i.e., the incremental area under the curve) from 0 to 30 min was delayed (P less than .02), the response from 0 to 45 min, 0 to 60 min, and thereafter equaled that in the young group, and from 90 to 240 min insulin concentrations in the elderly exceeded those in young subjects. Basal hepatic glucose output (HGO) was similar in young and elderly men (2.13 +/- 0.10 and 1.97 +/- 0.14 mg.kg-1.min-1, respectively). Similar proportional reductions in HGO from 0 to 270 min after glucose loading occurred in young (59.7 +/- 10.3%) and elderly (50.3 +/- 4.9%) subjects but was delayed in the elderly. Suppression of HGO was observed in the young 30 min after glucose ingestion (P less than .02), but not before 60 min in the elderly subjects (P less than .05). The systemic appearance of ingested glucose (0-270 min) was slowed with age (80.7 +/- 3.1 and 66.9 +/- 4.3% of the oral load in the young and elderly groups, respectively; P less than .02). Initial increments in both total glucose disappearance (Rd) and forearm glucose uptake (FGU) from 0 to 60 min after glucose loading were decreased in the elderly (Rd, 4.1 +/- 0.7 vs. 11.5 +/- 1.3 g, P less than .001; FGU, 17.2 +/- 1.4 vs. 24.6 +/- 2.5 md/dl forearm, P less than .02). The overall increment (delta, 0-270 min) in Rd was reduced with age (47.2 +/- 2.9 and 34.5 +/ 3.6 g, P less than .02 in the young and elderly, respectively), but the corresponding data for FGU were similar in the two groups.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3275554 TI - Evidence of IgG autoantibodies against human proinsulin in patients with IDDM before insulin treatment. AB - IgG proinsulin autoantibodies (IgG-PAAs) have been found in a fraction of sera from patients with newly diagnosed insulin-dependent diabetes mellitus (IDDM) before onset of insulin treatment. Only sera lacking insulin antibodies have been analyzed, to avoid interference. Competitive inhibition studies provide specificity for human proinsulin but not for insulin. IgG-PAAs largely cross react with human C-peptide. Precursors of insulin thus are involved in the immune process of IDDM. PMID- 3275555 TI - Low-dose streptozocin-induced diabetes in mice. Electron microscopy reveals single-cell insulitis before diabetes onset. AB - We investigated the morphology of mouse islets 5 days after completion of low dose streptozocin treatment of C57BL/6 mice by electron microscopy. At this stage, mice were still normoglycemic and light microscopy did not reveal massive islet infiltration. The electron-microscopic investigation revealed two characteristics indicative of ongoing islet cell destruction. In all islets investigated, lysed islet beta-cells were recognized by disrupted plasma membranes and concomitantly decreased plasma contrast. Many of the lysed islet beta-cells still contained numerous insulin granules. We also found immunocytes scattered throughout the islets, most of which could be identified as macrophages. Some were found engaged in phagocytosis of islet beta-cell debris. This early stage of islet lesion termed single-cell insulitis is followed by the well-known later stage of massive infiltration easily recognized in light microscopy. Administration of silica particles to mice treated with low-dose streptozocin inhibited macrophage infiltration of islets as shown by immunocytochemistry with macrophage-specific monoclonal antibody F4/80. In parallel, the development of hyperglycemia was suppressed. The observations favor a pathogenic role of macrophages in islet destruction. PMID- 3275556 TI - Additive hypoglycemic effects of drugs that modify free-fatty acid metabolism by different mechanisms in rats with streptozocin-induced diabetes. AB - In this study the effect of two drugs [etomoxir and nicotinic acid (NA)] on plasma glucose, free-fatty acid (FFA), and triglyceride (TG) concentrations was determined in rats with streptozocin (STZ)-induced diabetes. The two compounds modify FFA metabolism by different mechanisms, etomoxir (ethyl-2-[6-(4 cholorophenoxyl)-hexyl]oxirane-2-carboxylate) by inhibiting hepatic fatty acid oxidation, and NA by inhibiting lipolysis in adipose tissue. Diabetes was induced in male Sprague-Dawley rats, weighing approximately 400 g, by STZ injection (30 mg/kg i.v.), and the metabolic effects of the two drugs were studied 7-10 days later. The acute administration of either etomoxir or NA lowered plasma glucose concentrations in diabetic rats by approximately 150 mg/dl (P less than .001) in 4 h. However, the two drugs differed dramatically in their effects on plasma FFA and TG concentrations. Specifically, etomoxir produced striking increases in plasma FFA and TG concentrations, whereas NA administration caused a marked decrease. However, when NA was given in conjunction with etomoxir, NA prevented the increase in plasma FFA and TG concentration seen with etomoxir; the combination of NA and etomoxir approximately doubled the decrease in plasma glucose concentration produced by NA or etomoxir when given alone. Because plasma insulin concentrations did not change in response to either drug, whether administered singly or in combination, these metabolic effects do not result from a change in insulin secretion. These results suggest that modulation of FFA metabolism at the level of the adipocyte or the liver can have dramatic effects on carbohydrate and lipid metabolism. PMID- 3275557 TI - Correlation between minimal secretory capacity of pancreatic beta-cells and stability of diabetic control. AB - The significance of the minimal secretory capacity of pancreatic beta-cells for the stability of the plasma glucose level was studied in 20 patients with insulin dependent diabetes mellitus. Changes in plasma concentrations of major counterregulatory hormones in response to hypoglycemia were also investigated in these patients to clarify their contribution to diabetic brittleness. beta-Cell function was evaluated on the basis of elevation of plasma C-peptide immunoreactivity (CPR) during the intravenous glucagon test with a highly sensitive assay for plasma CPR that could detect as little as 0.03 ng/ml. After stimulation with glucagon, a significant increase in plasma CPR was observed in 10 of the patients whose beta-cell function had been evaluated as completely depleted by a conventional assay for plasma CPR. A clear inverse correlation was found between the secretory capacity of pancreatic beta-cells measured in this way and the degree of glycemic instability (r = -.74, P less than .01). Infusion of insulin at a rate of 0.15 U.kg-1.h-1 for 60 min caused a continuous decrease in the plasma glucose level, resulting in neuroglycopenia in 7 of the 10 CPR nonresponders but only 2 of the CPR responders. During insulin-induced hypoglycemia, plasma glucagon immunoreactivity did not increase in the CPR nonresponders but increased significantly in the CPR responders. A positive correlation was found between the minimal residual beta-cell capacity and the responsiveness of alpha-cells to hypoglycemia (r = .65, P less than .01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3275558 TI - Structural beta-cell changes and transient hyperglycemia in mice treated with compounds inducing inhibited citric acid cycle enzyme activity. AB - An initial transient hyperglycemia was seen in mice injected with asparagine, fluoroacetate, hydroxylamine, or malonate plus methionine, whereas an initial triphasic blood glucose response and a transient "secondary" hyperglycemia were exhibited in those injected with hydroxylamine plus arsenite, and a delayed hypoglycemia was observed in those treated with fluoroacetate or arsenite. The glucose-induced insulin secretion was significantly decreased in isolated pancreatic islets incubated with hydroxylamine plus arsenite. Light and electron microscopy, pyroantimonate technique, and X-ray microanalysis disclosed mitochondrial damage, degeneration, and necrosis among the beta-cells in the islets of mice injected with hydroxylamine plus arsenite. Glycogen depletion and microvesicular fatty change were seen in the liver of mice treated with fluoroacetate, arsenite, or hydroxylamine plus arsenite. These observations support the view that inhibition of the activity of citric acid cycle enzymes and associated reactions in the beta-cells play a role in the induction of diabetic features. PMID- 3275559 TI - Organ-specific autoimmunity and HLA-DR antigens as markers for beta-cell destruction in patients with type II diabetes. AB - Islet cell antibodies (ICAs), thyrogastric antibodies, and HLA-DR antigens were determined in 204 patients with type II (non-insulin-dependent) diabetes controlled with diet and/or oral hypoglycemic agents (NIR) and in 108 age-matched patients who required insulin to control their hyperglycemia (IR). beta-Cell function measured as C-peptide response to glucagon was evaluated in relation to the presence of ICAs and HLA-DR antigens. The IR patients differed from the NIR patients with respect to higher frequency of ICAs (P less than .001), thyroid antibodies (P less than .02), and the HLA antigen DR4 (P less than .02). The highest frequency of ICAs and thyroid antibodies was observed in female insulin treated subjects (51.2 and 46.4%). Patients who were heterozygous for HLA-DR3/DR4 showed significantly higher frequency of ICAs (P less than .01) and complement fixing ICAs (P less than .001) than patients without the heterozygous form DR3/DR4. Neither the presence of ICA alone nor DR3/DR4 alone was associated with a significant impairment of beta-cell function. However, when both ICA and DR3/DR4 were present in a diabetic individual, beta-cell function was markedly impaired (P less than .001), suggesting that both genetic and autoimmune factors are necessary to facilitate the process leading to beta-cell destruction of the patients. Our findings suggest that type II diabetes is a heterogeneous disorder including at least two major subgroups, which can be further characterized by HLA DR antigens and organ-specific antibodies. PMID- 3275560 TI - Interactions of cancer cells with the microvasculature during metastasis. AB - Metastasis of cancer via the bloodstream is a major factor in the diagnosis, treatment, and prognosis of patients with cancer. Key events in hematogenous metastasis occur in the microvasculature. This is a brief, selective review of some interactions involving cancer cells and the microvasculature in pathological sequence, specifically: 1) intravasation of cancer cells; 2) the arrest of circulating cancer in the microvasculature; 3) cancer cell trauma associated with arrest; 4) microvascular trauma; 5) the inflammatory and 6) coagulative responses associated with arrest; and 7) the fate of arrested cancer cells. The evidence shows that in addition to providing routes for cancer cell dissemination and arrest sites for cancer cell emboli, the microvasculature, through a series of complex interactions with cancer cells, controls the efficiency of and acts as a rate regulator for the metastatic process. PMID- 3275561 TI - Effects of the protein matrix on glycan processing in glycoproteins. AB - In the biosynthesis of glycoproteins containing asparagine-linked glycans, a number of regulatory factors must be involved in converting the single glycan precursor into the variety of different final structures observed in different eukaryotic species. Among these factors are the kind of glycan-processing enzymes available in the Golgi apparatus of different cells, the specificity and regulatory properties of these enzymes, and the unique properties of the protein matrix in which a given glycan resides during the biosynthetic processing. In examining the role of this latter regulatory factor, we have considered a simplified model in which a few key steps are common to all cells, regardless of the nature of the processing enzymes available. The protein-bound oligomannose precursor Man8GlcNAc2-, arriving in the Golgi after the initial trimming in the endoplasmic reticulum (ER), first undergoes a series of preprocessing steps to yield Man5GlcNAc2- in animals and plants or Man13-15GlcNAc2- in yeast. At this stage the key commitment step--to process or not to process--determines whether the above intermediates will remain as unprocessed oligomannose structures or be initiated into a new series of reactions to yield processed structures characteristic of the organisms involved (complex or hybrid for vertebrates, polymannose for yeast, xylosylated glycans for plants and some invertebrates, or Man3GlcNAc2- structures for other invertebrates). It is proposed that this commitment step, along with the obligatory preprocessing steps, is regulated primarily by each glycan's unique exposure on its protein matrix. Subsequent processing steps leading to complex or hybrid structures, fucosylation, extent of branching, and specific structures at the nonreducing terminals are most likely determined primarily by the enzyme makeup of the individual processing machineries, but with the protein matrix still playing a significant role. PMID- 3275562 TI - How antibodies work: focus on Fc receptors. AB - It is increasingly appreciated that the part of an antibody not involved in the binding of antigen--the Fc region--plays an important biological role. It activates a variety of receptors not only on so-called effector cells such as macrophages and granulocytes, but also on lymphocytes, and it can thereby modulate the immune response itself. Over the past 2 years much new information has been gained about the structure of such receptors, in large part through molecular genetics. In this review we describe the structure and some aspects of the function of the most complicated of the cellular Fc receptors so far identified: the receptor with high affinity for immunoglobulin E (IgE) on mast cells. The structure of its IgE-binding chain is strikingly similar to the corresponding polypeptide of an immunoglobulin G receptor. Like the latter and like a receptor that binds polymeric immunoglobulin, segments of the protein resemble immunoglobulin sequences. It is surprising that other IgE-binding proteins that putatively serve related functions have completely different structures. PMID- 3275563 TI - Hepatitis B virus and hepatitis B-related viral infection in renal transplant recipients. A prospective study of 90 patients. AB - Hepatitis B virus (HBV) infection may induce severe hepatitis and affect long term survival of kidney transplant recipients. Persistent viral infection has been shown to occur despite the absence of usual serologic markers. The liver and serum HBV deoxyribonucleic acid (DNA) status of 90 patients were studied prospectively; recently transplanted patients, both hepatitis B virus surface antigen (HBsAg)-positive and negative, with and without liver disease, were investigated with HBV serology, serum HBV DNA, and liver histology. Thirty-four patients had detectable HBsAg, and 21 had viral multiplication at the time of transplantation. Serial HBV DNA determinations performed in 57 of 90 patients disclosed (a) reactivation of HBV replication in 11 of 12 HBsAg-positive patients, (b) increase of viral replication when positive on the initial sample in 6 of 11 patients, and (c) development of HBV replication in 7 of 35 of the HBsAg-negative patients. Moreover, liver HBV DNA studies showed a statistical correlation between the presence of integrated liver HBV DNA and chronic hepatitis in HBsAg-negative patients. This study demonstrates prospectively the significant association of HBsAg-positive as well as HBsAg-negative HBV infection with chronic hepatitis and suggests that immunosuppressive therapy may enhance the viral replication in both HBsAg-positive and negative subjects. PMID- 3275564 TI - A new quantitative ultrasonic method for diagnosis of chronic parenchymal liver disease. AB - The degree of echogenicity of the hepatic parenchyma was measured by an objective method comparing patient's sonograms with a tissue-mimicking phantom obtained with available real-time ultrasound machines. A single sonographic image of the liver and the phantom was taken using identical setting in each case. The ratio of the mean density of the phantom to that of the liver was obtained. The mean of the ratio in 30 normal subjects was 1.04 +/- 0.01, in 26 patients with early alcoholic liver disease 1.23 +/- 0.04, and in 74 cirrhotic subjects 1.54 +/- 0.03, with a significant difference among the three groups (p less than 0.05). A significant correlation was also obtained between the ratio and a modified Child's classification (r = 0.553, p less than 0.05) in cirrhotic subjects. Follow-up studies were available in a limited number of patients with early alcoholic liver disease showing progression or improvement paralleling alcohol use. Using this method, ultrasound may have considerable potential in the diagnosis and follow-up of alcoholic liver disease. PMID- 3275565 TI - Origin and fate of biliary sludge. AB - Biliary sludge is a collection of mucus, calcium bilirubinate, and cholesterol crystals that is usually recognized by characteristic echoes on ultrasonography. Its pathogenesis, clinical significance, and ultimate prognosis remain uncertain. We therefore studied the origin of biliary sludge ultrasonic echoes, using an ex vivo liver-gallbladder preparation, and determined the outcome of a group of patients identified to have gallbladder sludge by ultrasonography. Echoes were not generated by either an increase in the total solid concentration or by the graded addition of partially purified mucus glycoprotein. Cholesterol monohydrate crystals (greater than 50 micron) mixed with mucus produced echoes that were indistinguishable from gallbladder sludge observed in patients. To determine the natural evolution of gallbladder sludge in patients, we prospectively followed 96 patients found to have biliary sludge for a mean of 37.8 mo by serial ultrasound scans every 6 mo. In 17 patients (17.7%) biliary sludge disappeared and did not recur for at least 2 yr, in 58 patients (60.4%) biliary sludge disappeared and reappeared, and in 8 patients (8.3%) asymptomatic gallstones developed. There were 12 cholecystectomies performed: six were done for symptomatic gallstones (6.3%) and the other six for sludge associated with severe biliary pain attacks with or without recurrent acute pancreatitis. The finding of sludge represented precipitates being formed in bile. In some patients, it was a precursor form of gallstone disease. PMID- 3275566 TI - Management of foreign bodies of the upper gastrointestinal tract. AB - In the United States, 1500 people die yearly of ingested foreign bodies of the upper gastrointestinal tract. The flexible esophagogastroduodenoscope has had a major impact on the treatment of these foreign bodies. The following discussion includes the management of coins, meat impaction, sharp and pointed objects, button batteries, and cocaine packets; and it reflects both a personal experience and a review of the literature. The uses of the rigid and the flexible endoscopes, the Foley catheter, glucagon, papain, and gas-forming agents are presented. The cost-effectiveness impact of the flexible endoscope is also detailed, and morbidity and mortality rates for foreign body management are included. PMID- 3275567 TI - Renal transplantation and hepatitis B. PMID- 3275568 TI - Treatment of pruritus in primary biliary cirrhosis with rifampin. Results of a double-blind, crossover, randomized trial. AB - The cause of pruritus of cholestasis is unknown. We have hypothesized that pruritus may be caused by an indirect effect of high hepatic concentrations of toxic bile acids. To test this hypothesis, we have conducted a double-blind, controlled, crossover clinical trial of rifampin, an agent that inhibits hepatic bile acid uptake and may detoxify hepatic bile acids by stimulation of mixed function oxidases. Nine patients with primary biliary cirrhosis received 300-450 mg/day of rifampin and placebo sequentially, in random order. Each treatment was administered for 14 days, with a 14-day washout between treatments. Endpoints included patient preference, changes in a daily visual analogue scale pruritus score, and amount of cholestyramine ingested. Antipyrine elimination rates and serum bile acids were tested at the end of each treatment period. All 9 patients completed the trial and 8 of them preferred rifampin to placebo (p = 0.03). There were no adverse reactions. Visual analogue scale pruritus scores showed no significant placebo response or any effect from the order of treatment, but did show a highly significant reduction in pruritus in response to rifampin (p less than 0.002). This effect was evident within the first week of rifampin treatment. Rifampin produced a 33% reduction in antipyrine plasma half-life, but no change in fasting total serum bile acids. Cholestyramine usage did not change significantly. We conclude that rifampin is useful for short-term relief of pruritus in primary biliary cirrhosis; however, the mechanism of this effect is unknown. Longer trials are needed, as are trials in other cholestatic disorders. PMID- 3275569 TI - Current status of small-bowel transplantation. AB - Patients who have lost such a large portion of their small bowel that they permanently require total parenteral nutrition for survival would greatly benefit by receiving a small-intestinal transplant. Over the past two decades, many experimental studies have delineated the specific problems surrounding small bowel transplantation and provided strategies for their control. Control of rejection, the most difficult problem, may be achieved with a combination of cyclosporine, azathioprine, prednisone, antithymocyte globulin, and monoclonal antibodies. The threat of graft-versus-host disease originating from the allogeneic lymphatic tissues in the allograft is abolished by in vitro x irradiation of the cold, nonperfused graft with 1000 rads. Monitoring of the intestinal allograft is possible with the combination of a function test (maltose absorption, glucose absorption, or any other function test) and repeated graft biopsy. Effective short-term preservation of small-bowel segments for up to 18 h is possible by intravascular flushing with a balanced electrolyte solution containing 3% fructose and by subsequent hypothermic storage. Clinical small bowel transplantation is certainly not an imminent therapeutic tool. However, clinical trials in highly selected patients could be envisioned on the basis of our present understanding of small-bowel transplantation and of transplantation biology in general, and in view of the clinical successes achieved with duodenal grafts transplanted in conjunction with pancreatic grafts. PMID- 3275570 TI - 1988: time for a responsible Medicare policy. PMID- 3275571 TI - AIDS-testing issues top state agendas in '88. PMID- 3275572 TI - Look to the future: medicine via phones. PMID- 3275573 TI - Stark: how to win friends and influence people. Interview by Jeffrey Finn. PMID- 3275574 TI - Capital reimbursement: a compromise at hand? PMID- 3275575 TI - HCFA: mortality data are only the beginning. PMID- 3275576 TI - Congress targets above-average capital outlays. PMID- 3275577 TI - Hospitals win retroactive reimbursement. PMID- 3275578 TI - Strategies change--strategy paradigm cannot. PMID- 3275579 TI - Expression of intestinal mucin antigens in the gastric epithelium and its relationship with malignancy. AB - The expression of large and small intestinal mucin antigens (LIMA and SIMA) was investigated in 30 gastrectomy specimens of carcinoma and in 11 controls resected for various pathologic conditions. One hundred eighty-five samples of normal mucosa, hyperplasia, intestinal metaplasia (types I, II, and III), dysplasia, and tumor were studied to identify phenotypes indicative of premalignant change. Our results showed LIMA and SIMA were not detected in normal gastric epithelium from either control or carcinoma specimens. SIMA characterized goblet cell mucin in all types of intestinal metaplasia and was not discriminatory between controls and carcinoma groups. On the other hand, LIMA was extensively expressed in columnar and goblet cells in carcinoma-bearing stomachs (97 per cent) but was absent in controls. There was a crescendo intensity and frequency of LIMA staining in an inverse relation to the degree of cell maturation and differentiation from type I intestinal metaplasia (60 per cent) to type II (85 per cent), type III (100 per cent), and dysplasia (100 per cent). In contrast, intestinal metaplasia of any type in controls did not show LIMA. The distribution of LIMA seemed to be intimately related to cell differentiation in the proliferative zone at the base of metaplastic glands. Carcinomas revealed antigenic phenotype heterogenicity. Our data indicate that LIMA sharpens the diagnosis of dysplasia, discriminates between reactive and preneoplastic epithelium (particularly within intestinal metaplasia), and detects abnormal phenotypes that may represent early stages in carcinogenesis. PMID- 3275580 TI - In memoriam. Arkadi M. Rywlin, MD, 1923-1987. PMID- 3275581 TI - The glomerular distribution of type IV collagen and laminin in human membranous glomerulonephritis. AB - The glomerular distribution of type IV collagen and laminin, the major collagenous and noncollagenous components of the glomerular basement membrane, was studied by immunofluorescence microscopy in idiopathic and lupus membranous glomerulonephritis. Affinity-purified antibodies against type IV collagen reacted preferentially with the inner aspect and irregularly with the adjacent outer area of the thickened basement membrane. In contrast, laminin was detected along the inner aspect of the glomerular basement membrane, in subepithelial basement membrane protrusions ("spikes"), and in the newly formed basement membrane layer above the immune deposits. We conclude that type IV collagen and laminin do not codistribute in the newly formed matrix. This aberrant antigenic distribution may reflect a loss of coordinate biosynthesis or degradation of these matrix components by visceral epithelial cells. PMID- 3275582 TI - H-Y and the transplanted mouse heart. PMID- 3275583 TI - Control of endotoxin activity and interleukin-1 production through regulation of lipopolysaccharide-lipoprotein binding by a macrophage factor. AB - Lipopolysaccharides (LPSs) extracted from gram-negative bacteria are much less active when bound to serum lipoproteins. We present evidence here that the binding of radiolabeled LPS extracted from Escherichia coli O113 and Salmonella typhimurium to lipoproteins in rabbit serum is increased 8 to 24 h after a single intravenous injection of homologous or heterologous LPS. Supernatants of activated macrophages containing interleukin-1 also stimulate increased binding. The isolated product of this binding does not induce the production of interleukin-1 by macrophages in vivo or in vitro and is unable itself to stimulate increased binding of LPS to lipoprotein. Normal rabbit sera spiked with lipoprotein fractions prepared from tolerant but not normal rabbit sera bind increased amounts of LPS. These data suggest that there may exist a self regulated mechanism for decreasing the toxicity of LPS and the production of LPS induced interleukin-1; this mechanism is controlled by a macrophage factor and functions through altering the binding of LPS to certain serum lipoproteins. PMID- 3275584 TI - Enterotoxigenic Escherichia coli diarrhea in an endemic area prepares the intestine for an anamnestic immunoglobulin A antitoxin response to oral cholera B subunit vaccination. AB - We examined whether infection with enterotoxigenic Escherichia coli (ETEC) producing the heat-labile enterotoxin (LT) can prime the gut immune system to respond more efficiently to the immunologically related cholera B subunit component of a recently developed oral B subunit-whole-cell cholera vaccine (B WCV). Nine Bangladeshi adults who had been hospitalized for watery diarrhea caused by LT-producing ETEC were given a single oral immunization with B-WCV on day 28 after hospital admission. The vaccine preparation used was adjusted to contain a lower-than-usual dose of B subunit, which had been found in previous studies to elicit a significant gut mucosal immunoglobulin A antitoxin response mainly in individuals with previous toxin-specific priming of their gut immune system. For comparison, nine patients convalescing from severe cholera disease and eight healthy subjects with no recent history of either cholera or ETEC infection were given the same oral vaccination with B-WCV. Vaccination in the ETEC convalescents induced an immunoglobulin A antitoxin response in intestinal lavage fluid which was comparable with that in the vaccinated cholera convalescents and superior to that in the vaccinated, previously uninfected controls. By contrast, only the cholera patients responded with anamnestic-type anti-cholera lipopolysaccharide antibody titer rises in the intestine after vaccination. These data support the specificity of the anamnestic anti-cholera toxin response in the ETEC patients after vaccination with cholera B-WCV. PMID- 3275585 TI - Effect of recombinant human interleukin-2 on the course of experimental chronic respiratory tract infection caused by Klebsiella pneumoniae in mice. AB - The effect of recombinant human interleukin-2 (rIL-2) on the course of experimental chronic respiratory tract infection caused by Klebsiella pneumoniae in mice was examined. rIL-2 was administered subcutaneously once a day for 7 or 14 days, starting 2 weeks after the mice were infected. Administration of 2 or 20 micrograms of rIL-2 per mouse daily for 7 days reduced bacterial counts in the lungs dose dependently. At a dose of 0.2 microgram per day, proliferation of bacteria in the lungs was suppressed after 14 days of administration. Agglutinin titers in serum were not affected by rIL-2 treatment. Monocyte and lymphocyte counts in peripheral blood were increased by administration of 20 micrograms of rIL-2 daily for 14 days but not by treatment for 7 days. In addition, clearance of bacteria from the lungs after aerosol exposure was enhanced by treatment for 7 days before infection. Thus, rIL-2 acted therapeutically or prophylactically in the presence or absence, respectively, of a specific antigen. These effects were not abolished by anti-asialo GM1 antibody. This suggests that activation of natural killer cells does not play a critical role in the therapeutic and prophylactic effects of rIL-2. PMID- 3275586 TI - Killing of Proteus mirabilis by polymorphonuclear leukocyte granule proteins: evidence for species specificity by antimicrobial proteins. AB - Low-molecular-weight (Mr, ca. 3,800) polypeptides containing human defensins HNP 1 and HNP-2 (T. Ganz, M. S. Selsted, D. Szlarek, S. L. Harwig, K. Daher, D. F. Bainton, and R. I. Lehrer, J. Clin. Invest. 76:1427-1434, 1985) prepared in our laboratory from acid extracts of human polymorphonuclear granulocyte granules and purified human defensins were found to exert potent bactericidal action against Proteus mirabilis. The antimicrobial action of the extracts of human polymorphonuclear leukocytes granules against P. mirabilis appears to be due to the presence of the defensins. Because P. mirabilis resists the antimicrobial action of other granule proteins, we interpret the present results to mean that the various antimicrobial proteins display species specificity in their microbicidal action. PMID- 3275587 TI - Cyclosporin A inhibits the growth of Cryptococcus neoformans in a murine model. AB - Cryptococcus neoformans is a frequent opportunistic infectious agent in patients with decreased T-lymphocyte-mediated immune function, including those with acquired immune deficiency syndrome. Cyclosporin A (CsA), a potent inhibitor of T lymphocyte function, was administered subcutaneously to mice to study the pathogenesis of C. neoformans infections in the setting of impaired T-cell function. Surprisingly, survival was prolonged indefinitely in animals that received immunosuppressive doses of CsA following either intratracheal or intravenous inoculations of C. neoformans. Furthermore, following intratracheal inoculation, mice treated with CsA cleared C. neoformans from their lungs more rapidly than did control mice. CsA directly inhibited the growth of C. neoformans when it was added to cultures in vitro at concentrations comparable to the blood levels achieved in experimental mice. Thus, CsA inhibited both in vitro and in vivo growth of C. neoformans. While these results must be extended to studies in humans, these data suggest that patients who now receive CsA-immunosuppressive therapy may be fortuitously protected against infections with C. neoformans. Furthermore, research into cyclosporin derivatives may yield compounds with less immunosuppressive properties and enhanced antifungal activity. PMID- 3275589 TI - Immunohistochemical detection of c-Ha-ras oncogene p21 product in pre-neoplastic and neoplastic lesions during hepatocarcinogenesis in rats. AB - An immunohistochemical study of c-Ha-ras expression was performed on preneoplastic and neoplastic stages of diethylnitrosamine (DENA)-induced hepatocarcinogenesis in rats, using an antibody raised against a peptide sequence of the Ha-ras p21 product. Moderate to high immunostaining intensity was observed in the following hepatocytic lesions: (1) hepatocellular carcinomas (14/14) and associated neoplastic nodules (8/8) and foci of phenotypic alterations (35/40) (after 13-20 months of treatment); (2) neoplastic nodules (6/6) and associated foci (42/50) (after 5-9 months); (3) foci (10/10) (after 2 months); and (4) small, slowly growing foci (26/40) found 9 months after treatment with DENA without prior partial hepatectomy, resulting in low number of nodules and no tumor even after 15 months. No c-Ha-ras p21 was detected immunohistochemically in normal nor in regenerating rat liver. Our results indicate that increased Ha-ras expression is an early and stable event in liver lesions associated with hepatocarcinogenesis. They also imply that increased Ha-ras expression is insufficient (if at all implicated) for inducing fully malignant hepatocyte transformation. It might be indicative of cell populations at an increased transformation risk. PMID- 3275588 TI - Genetic and physicochemical characterization of the recombinant DNA-derived 47 kilodalton surface immunogen of Treponema pallidum subsp. pallidum. AB - Previous work has established the importance of the 47-kilodalton (kDa) surface immunogen of Treponema pallidum subsp. pallidum (T. pallidum) in the immunopathogenesis of syphilis; the 47-kDa immunogen gene was cloned and expressed in Escherichia coli (M. V. Norgard, N. R. Chamberlain, M. A. Swancutt, and M. S. Goldberg, Infect. Immun. 54:500-506, 1986). To facilitate additional structural-functional analysis of this protein for immunopathogenesis studies, the recombinant DNA-derived molecule was examined with respect to its genetic expression and physicochemical properties. Subcloning of partial PstI digests of the original 47-kDa antigen-encoding DNA segment localized the 47-kDa antigen gene to a 1.3-kilobase (kb) T. pallidum DNA fragment. A 20- to 100-fold enhanced expression of the 47-kDa antigen was obtained when a 2.85-kb DNA insert containing the entire 1.3-kb structural gene was subcloned into a T7 RNA polymerase-dependent expression vector system. Under these conditions, several derivatives of the recombinant 47-kDa protein possessing different molecular masses were observed that were identical to those previously detected on Western blots of native T. pallidum antigens with monoclonal antibodies. Sarkosyl extraction of E. coli recombinant cell envelopes localized the 47-kDa protein to both the inner and outer membranes of E. coli. The absolute requirement of detergents (N-lauroylsarcosine, 3-[(3-chloramidopropyl)dimethylammonio]-1-propane sulfonate, N-octyl-beta-D-glucopyranoside, or Nonidet P-40) for solubilization of the antigen from E. coli cell envelopes and the observation that the recombinant protein partitioned into the detergent phase on Triton X-114 solubilization were consistent with the fact that it is a hydrophobic, integral membrane protein. Western blots of the 47-kDa antigen purified by immunoaffinity chromatography supported results of previous reports that the 47-kDa protein is specific to pathogenic treponemes. PMID- 3275590 TI - Mutation analysis of the N-ras proto-oncogene in active and remission phase of human acute leukemias. AB - DNA isolated from blood or bone-marrow samples from 18 patients with acute non lymphocytic leukemia (ANLL) and 14 patients with acute lymphocytic leukemia (ALL) was analyzed for the presence of mutations in the N-ras gene. Using synthetic oligonucleotide probes we detected mutations in 5 cases of ANLL; 4 GGT----GAT transitions in codon 12 and one CAA----AAA transversion in codon 61. One case exhibited homozygosity for the mutation. No mutations could be detected at these codons in the DNA of the 14 ALL patients. In a follow-up study with 3 of the above 5 patients, the mutation could no longer be detected in 2 cases following successful induction of clinical remission by chemotherapy. However, the mutated N-ras persisted in one patient who did not achieve remission. We show that oligonucleotide hybridization is a sensitive assay for the detection of N-ras point mutations, which in ANLL could be used to follow the fate of the leukemic clone during (and after) therapy. PMID- 3275591 TI - Mouse tumor-associated macrophages do not generate procoagulant activity in response to different stimuli. AB - Mononuclear phagocytes, an integral part of the lymphoreticular infiltrate of human and experimental tumors, might contribute to fibrin deposition within malignant tissues through the production of procoagulant activity (PCA). We have studied the PCA of tumor-associated macrophages (TAM) in 2 poorly immunogenic, metastatic murine sarcomas (mFS6 and MN/MCA1); peritoneal macrophages (PM) from tumor-bearing and control animals were also studied, as reference cell populations. PCA was evaluated by a one-stage clotting assay immediately after isolation (basal PCA) and following in vitro stimulation. Basal PCA was very low (less than 1 U/10(4) macrophages) in all cell preparations. Exposure of PM from both normal and tumor-bearing animals to bacterial endotoxin (lipopolysaccharide, LPS), phorbol myristate acetate (PMA) or the chemotactic peptide formyl-methionyl leucyl-phenylalanine (FMLP) resulted in 10-, 7- and 3-fold increases in PCA, respectively. In contrast, TAM from mFS6 and MN/MCA1 consistently failed to generate PCA in response to different concentrations of the same stimuli. Treatment of TAM with aspirin did not affect cell unresponsiveness. Fluorescence microscopy showed that almost all PM were stained with fluorescein isothiocyanate (FITC)-LPS, while less than 10% of the TAM were stained. These data, coupled with previous evidence that TAM have a lower number of specific binding sites for phorbol esters than PM, suggest that the defective responsiveness of TAM to endotoxin, PMA and, possibly, FMLP, is due to the lack, or very low expression, of binding sites for these agents on the cell surface. The tumor environment may orient the functional status of in situ macrophages in a direction less favorable to the host. PMID- 3275592 TI - Corneal changes in nine-banded armadillos with leprosy. AB - Leprosy is the third leading cause of blindness worldwide; however, little is known about the ocular changes that occur during the disease process. We have studied the eyes of two nine-banded armadillos with experimental Mycobacterium leprae infection by light and electron microscopy. Both animals had been inoculated intracutaneously, one 5 years and the other 2 years previously. Light microscopy revealed invasion by acid-fast bacilli which were seen in keratocytes and mononuclear phagocytes in all layers of the corneal stroma. In both animals, large macrophage granulomas were observed in the deep stroma, which was vascularized. Acid-fast bacilli were also were found in macrophages and vascular endothelial cells. By electron microscopy, numerous bacilli were found in the keratocytes, macrophages, and Schwann cells of myelinated and unmyelinated axons, and in the endothelial cells of blood vessels. The localization of M. leprae and the presence of inflammatory cells in the ocular tissue of both animals suggest that the bacilli reach the eye by the neural and/or vascular route. One animal showed much more extensive disease and bacillary yield than the other, indicating that ocular involvement may be independent of the generalized infection. Further studies of early ocular involvement in the armadillo and other animals could help to clarify the pathogenesis of this potentially blinding infection. PMID- 3275594 TI - 1987 Distinguished Scientific Achievement Award presented to William C. Roesch. PMID- 3275593 TI - Cell culture of the human lamina cribrosa. AB - The extracellular matrix of the lamina cribrosa may be important in the changes in the optic nerve head associated with glaucoma. To investigate the cell biology of this tissue, human lamina cribrosa was explanted in tissue culture and two cell types grown from this tissue were characterized. The most common cell type obtained was a large, flat, polygonal cell which was negative for glial fibrillar acidic protein (GFAP) and could be serially subcultured. This cell type synthesized collagens type III and type IV, fibronectin and elastin. Much less commonly grown was a cell type with conspicuous long processes and which was positive for GFAP. This presumed astrocyte synthesized collagen type IV and fibronectin. Fibroblastic cells were not obtained from this tissue but were easily grown from sclera. The cells that we have cultured from the human lamina cribrosa may produce the extracellular matrix present in the cribriform plates of this tissue and be important in the glaucomatous process. PMID- 3275595 TI - 1987 Distinguished Scientific Achievement Award presented to Harald H. Rossi. PMID- 3275596 TI - 1987 Founders Award presented to John A. Auxier. PMID- 3275597 TI - 1987 Elda E. Anderson Award presented to Edward T. Lessard. PMID- 3275598 TI - 1987 Distinguished Scientific Achievement Award presented to Frank Herbert Attix. PMID- 3275599 TI - Dynamic stereotactic radiosurgery. AB - Two radiosurgical procedures using a stereotactic frame and a linear accelerator X ray beam with a circular field diameter between 0.5 and 3 cm are presented. One technique is based on a single plane rotation (single plane radiosurgery) whereas the other uses simultaneous and continuous motions of both the gantry (approximately 360 degrees) and couch (approximately 180 degrees) during the radiosurgical procedure (dynamic radiosurgery). The dose, typically a few thousand cGy, is prescribed to the 90% isodose line which just covers the target volume. The dose fall-off outside the spherical target volume is considerably sharper for the dynamic rotation than for the single plane rotation, and is comparable to the dose fall-off obtained with the two presently known dedicated radiosurgical techniques: one based on focused cobalt beams and the other on proton beams. The dose fall-off in the dynamic radiosurgery discussed here is also comparable to that of previously described linear accelerator based multiple converging are techniques, making the dynamic radiosurgery an attractive alternative to presently known radiosurgical procedures. The radiation beam parameters are discussed and the stereotactic frame described. The dose distributions for both radiosurgical techniques are calculated in a single plane and then corrected for the attenuation effects in the stereotactic frame (approximately 2%) and for the effects of the dynamic rotation (approximately 2%). The skin doses are 0.7% and 2%, and the lens doses, if the beam passes through the eyes, are 2.5% and 3.5% for the dynamic rotation and single plane rotation, respectively. The scatter and leakage dose for the radiosurgical procedures is typically 0.2% to the patient's thyroid, 0.06% to the breast, and 0.02% to the gonads. PMID- 3275600 TI - Sir Brian Windeyer. PMID- 3275602 TI - Neutrons and other clinical trials: impossible dreams: rebuttal. PMID- 3275601 TI - Total lymphoid irradiation for multiple sclerosis. AB - Although chemical immunosuppression has been shown to benefit patients with chronic progressive multiple sclerosis (MS), it appears that chemotherapy has an appreciable oncogenic potential in patients with multiple sclerosis. Accordingly, we developed a modified total lymphoid irradiation (TLI) regimen designed to reduce toxicity and applied it to a randomized double blind trial of TLI or sham irradiation in MS. Standard TLI regimens were modified to reduce dose to 1,980 rad, lowering the superior mantle margin to midway between the thyroid cartilage and angle of the mandible (to avert xerostomia) and the lower margin of the mantle field to the inferior margin of L1 (to reduce gastrointestinal toxicity by dividing abdominal radiation between mantle and inverted Y), limiting spinal cord dose to 1,000 rad by custom-made spine blocks in the mantle and upper 2 cm of inverted Y fields, and also protecting the left kidney even if part of the spleen were shielded. Clinical efficacy was documented by the less frequent functional scale deterioration of 20 TLI treated patients with chronic progressive MS compared to to 20 sham-irradiated progressive MS patients after 12 months (16% versus 55%, p less than 0.03), 18 months (28% versus 63%, p less than 0.03), and 24 months (44% versus 74%, N.S.). Therapeutic benefit during 3 years follow-up was related to the reduction in lymphocyte count 3 months post-irradiation (p less than 0.02). Toxicity was generally mild and transient, with no instance of xerostomia, pericarditis, herpes zoster, or need to terminate treatment in TLI patients. However, menopause was induced in 2 patients and staphylococcal pneumonia in one. Our data suggest that this modified TLI regimen has clinical efficacy and sufficiently low toxicity to make it suitable for investigative immunosuppressive treatment of patients with progressive MS or other non malignant conditions. PMID- 3275603 TI - Analysis of the histopathology of radiation myelopathy. AB - An analysis of published histopathology reports of patients with radiation myelopathy was performed. Radiation lesions in the spinal cord were classified as primarily white matter parenchymal lesions (type 1), primarily vascular lesions (type 2), or a combination of vascular and white matter lesions (type 3). The presence or absence of a mononuclear inflammatory reaction was also noted. Type 1 and type 3 lesions had comparable latent periods, both significantly shorter than those observed for type 2 lesions. The anatomical level of the irradiation did not appear to influence the type of lesion. Inflammatory reaction was observed with greater frequency in type 3 lesions. For all types of lesions, the average latent periods in patients with inflammatory reactions were shorter than in those without inflammation. In the cases in which disease status was evaluated, 70% of the patients were free of disease or had no evidence of recurrence at autopsy. PMID- 3275604 TI - Clinical applications of self-esteem and locus of control to adolescent health. AB - Self-esteem and locus of control are two associated constructs representing, respectively, a generalized self-evaluation and an assessment of personal control. Measures representing these constructs generally rely on self-report. These measures have been applied to adolescent health as predictors and outcomes. Most studies rely on chi 3, t-test, and ANOVA analysis and report mixed results in attaining significant group comparisons on issues including contraceptive use, adolescent pregnancy, and substance abuse. Few studies employ multiple regression or discriminant function analysis assessing the relative influence or predictive accuracy and sensitivity of these measures. Studies using these analyses report limited or nonsignificant contributions of these measures to clinical issues (e.g., adolescent fatherhood, adolescent pregnancy, substance abuse, medical management) relative to variables such as patient age, social class, parental attitudes, and peer relationships. Our discussion of these results addresses the validity of self-reports of self-esteem and locus of control versus observation procedures assessing these constructs by verbal and nonverbal presentation of self, analytic procedures appropriate to clinical prediction of behavior by person and situation characteristics, and procedures to advance the clinical adoption of behavioral measures. PMID- 3275605 TI - Derepression of specific genes promotes DNA repair and mutagenesis in Escherichia coli. PMID- 3275606 TI - Identification of a repressor gene involved in the regulation of NAD de novo biosynthesis in Salmonella typhimurium. AB - Mutations at the nadI locus affect expression of the first two genes of NAD synthesis, nadA and nadB, which are unlinked. Genetic data imply that the regulatory effects of nadI mutations are not due to indirect consequences of physiological alterations. Two types of mutations map in the nadI region. Common null mutations (nadI) show constitutive high-level expression of the nadB and nadA genes. Rare nadIs mutations cause constitutive low-level expression of nadB and nadA. Some nadIs mutations shut off the expression of the biosynthetic genes sufficiently to cause a nicotinic acid auxotrophy. Spontaneous revertants of auxotrophic nadIs mutants have a NadI- phenotype, including some with deletions of the nadI locus. The nadI locus encodes a repressor protein acting on the unlinked nadA and nadB genes. PMID- 3275607 TI - Requirement of heat-labile cytoplasmic protein factors for posttranslational translocation of OmpA protein precursors into Escherichia coli membrane vesicles. AB - The involvement of possible cytoplasmic factors in ATP-dependent postttranslational translocation of proteins into Escherichia coli membrane vesicles was examined. The precursor of OmpA protein was partially purified by DEAE-cellulose chromatography, and its translocation was found to require material from the soluble cytoplasmic fraction. The fractionated active cytoplasmic translocation factor (CTF) was protease sensitive, micrococcal nuclease insensitive, N-ethylmaleimide resistant, and heat labile. The heat sensitivity of the CTF allowed its specific and preferential inactivation in the crude-precursor synthesis mixture, which provided a simple and rapid assay procedure for the factor during purification. Two active fractions were detected upon further fractionation: the major one was about 8S in sucrose gradient centrifugation and 120 kilodaltons by Sephadex filtration, whereas the other was about 4S and 60 kilodaltons in sucrose gradient centrifugation and by Sephadex filtration, respectively. The active fractions could also be fractionated by DEAE Sepharose chromatography. These CTFs are apparently different from the previously reported 12S export factor (M. Muller and G. Blobel, Proc. Natl. Acad. Sci. USA 81:7737-7741, 1984). PMID- 3275608 TI - Nucleotide sequence of the hexA gene for DNA mismatch repair in Streptococcus pneumoniae and homology of hexA to mutS of Escherichia coli and Salmonella typhimurium. AB - The Hex system of heteroduplex DNA base mismatch repair operates in Streptococcus pneumoniae after transformation and replication to correct donor and nascent DNA strands, respectively. A functionally similar system, called Mut, operates in Escherichia coli and Salmonella typhimurium. The nucleotide sequence of a 3.8 kilobase segment from the S. pneumoniae chromosome that includes the 2.7-kilobase hexA gene was determined. An open reading frame that could encode a 17-kilodalton polypeptide (OrfC) was located just upstream of the gene encoding a polypeptide of 95 kilodaltons corresponding to HexA. Shine-Dalgarno sequences and putative promoters were identified upstream of each protein start site. Insertion mutations showed that only HexA functioned in mismatch repair and that the promoter for hexA transcription was located within the OrfC-coding region. The HexA polypeptide contains a consensus sequence for ATP- or GTP-binding sites in proteins. Comparison of the entire HexA protein sequence to that of MutS of S. typhimurium, which was determined by Haber et al. in the accompanying paper (L. T. Haber, P. P. Pang, D. I. Sobell, J. A. Mankovitch, and G. C. Walker, J. Bacteriol. 170:197-202, 1988), showed the proteins to be homologous, inasmuch as 36% of their amino acid residues were identical. This homology indicates that the Hex and Mut systems of mismatch repair evolved from an ancestor common to the gram-positive streptococci and the gram-negative enterobacteria. It is the first direct evidence linking the two systems. PMID- 3275609 TI - Nucleotide sequence of the Salmonella typhimurium mutS gene required for mismatch repair: homology of MutS and HexA of Streptococcus pneumoniae. AB - The mutS gene product of Escherichia coli and Salmonella typhimurium is one of at least four proteins required for methyl-directed mismatch repair in these organisms. A functionally similar repair system in Streptococcus pneumoniae requires the hex genes. We have sequenced the S. typhimurium mutS gene, showing that it encodes a 96-kilodalton protein. Amino-terminal amino acid sequencing of purified S. typhimurium MutS protein confirmed the initial portion of the deduced amino acid sequence. The S. typhimurium MutS protein is homologous to the S. pneumoniae HexA protein, suggesting that they arose from a common ancestor before the gram-negative and gram-positive bacteria diverged. Overall, approximately 36% of the amino acids of the two proteins are identical when the sequences are optimally aligned, including regions of stronger homology which are of particular interest. One such region is close to the amino terminus. Another, located closer to the carboxy terminus, includes homology to a consensus sequence thought to be diagnostic of nucleotide-binding sites. A third one, adjacent to the second, is homologous to the consensus sequence for the helix-turn-helix motif found in many DNA-binding proteins. We found that the S. typhimurium MutS protein can substitute for the E. coli MutS protein in vitro as it can in vivo, but we have not yet been able to demonstrate a similar in vitro complementation by the S. pneumoniae HexA protein. PMID- 3275610 TI - Efficient expression of the yeast metallothionein gene in Escherichia coli. AB - The yeast metallothionein gene CUP1 was cloned into a bacterial expression system to achieve efficient, controlled expression of the stable, unprocessed protein product. The Escherichia coli-synthesized yeast metallothionein bound copper, cadmium, and zinc, indicating that the protein was functional. Furthermore, E. coli cells expressing CUP1 acquired a new, inducible ability to selectively sequester heavy metal ions from the growth medium. PMID- 3275611 TI - Formate-nitrate respiration in Salmonella typhimurium: studies of two rha-linked fdn genes. AB - Localized mutagenesis was used to obtain rha-linked mutations in Salmonella typhimurium, resulting in defects in the nitrate reductase-linked formate dehydrogenase (FDHN). The fdn mutants obtained fell into two groups which differed in several respects. Group I isolates lacked FDHN activity under all conditions examined and exhibited wild-type levels of the hydrogenase-linked formate dehydrogenase (FDHH). Group II isolates appeared defective in FDHN only when freshly prepared extracts were assayed; restoration of both FDHN and formate nitrate reduction activity occurred on incubation of extracts for 2 to 3 h. Protease inhibitors prevented restoration. Group II isolates were also characterized by a conditional FDHH activity; this activity was absent unless the growth medium designed to optimize wild-type FDHH was altered either by lowering glucose concentration or by adding thiosulfate. Cotransduction of fdn with rha ranged from 4 to 22% for the group I isolates and from 20 to 40% for the group II isolates. Temperature-sensitive isolates from both groups synthesized FDHN activity with altered thermostability. In vitro complementation occurred in mixed extracts of amber mutants of the two respective classes. The results are consistent with two distinct rha-linked fdn genes, for which we suggest using the designations fdnB (group I) and fdnC (group II). PMID- 3275612 TI - Characterization of an Escherichia coli rff mutant defective in transfer of N acetylmannosaminuronic acid (ManNAcA) from UDP-ManNAcA to a lipid-linked intermediate involved in enterobacterial common antigen synthesis. AB - The rff genes of Salmonella typhimurium include structural genes for enzymes involved in the conversion of UDP N-acetyl-D-glucosamine (UDP-GlcNAc) to UDP N acetyl-D-mannosaminuronic acid (UDP-ManNAcA), the donor of ManNAcA residues in enterobacterial common antigen (ECA) synthesis. An rff mutation (rff-726) of Escherichia coli has been described (U. Meier and H. Mayer, J. Bacteriol. 163:756 762, 1985) that abolished ECA synthesis but which did not affect the synthesis of UDP-ManNAcA or any other components of ECA. The nature of the enzymatic defect resulting from the rff-726 lesion was investigated in the present study. The in vitro synthesis of GlcNAc-pyrophosphorylundecaprenol (lipid I), an early intermediate in ECA synthesis, was demonstrated by using membranes prepared from a mutant of E. coli possessing the rff-726 lesion. However, in vitro synthesis of the next lipid-linked intermediate in the biosynthetic sequence, ManNAcA-GlcNAc pyrophosphorylundecaprenol (lipid II), was severely impaired. Transduction of wild-type rff genes into the mutant restored the ability to synthesize both lipid II and ECA as determined by in vitro assay and Western blot (immunoblot) analyses done with anti-ECA monoclonal antibody, respectively. Our results are consistent with the conclusion that the rff-726 mutation is located in the structural gene for the transferase that catalyzes the transfer of ManNAcA from UDP-ManNAcA to lipid I. PMID- 3275613 TI - Regulation of nitrogenase synthesis in histidine auxotrophs of Klebsiella pneumoniae with altered levels of adenylate nucleotides. AB - A histidine auxotrophic (hisA) mutant of Klebsiella pneumoniae is phenotypically Nif- when grown with 20 micrograms of histidine ml-1 but Nif+ when supplied with histidine at 100 micrograms ml-1. Reversion to Nif+ at 20 micrograms of histidine ml-1 occurs phenotypically by the addition of 2-thiazolyl-DL-alanine or genetically by mutation in hisG; 2-thiazolyl-DL-alanine inhibits and hisG encodes phosphoribosyl phosphotransferase, the first enzyme of the histidine biosynthetic pathway which consumes ATP. Physiological studies of the hisA mutant JS85 showed that after removal of NH4+ from a culture of the mutant grown with 20 micrograms of histidine ml-1, synthesis of nitrogenase polypeptides occurred at a rate similar to that in the wild type for about 3 h and acetylene reduction activity reached about 10% of the fully derepressed wild-type level. Shortly thereafter the concentration of intracellular adenylates decreased; in particular, ATP fell to about 10% of normal levels. Also, nitrogenase proteins (nifHDK products) and the nifJ gene product stopped being synthesized. These effects were not due to impairment of growth or protein synthesis by histidine starvation. Inhibition of phosphoribosyl phosphotransferase with 2-thiazolyl-DL-alanine restored nitrogenase activity and synthesis, indicating that the effect of the hisA mutation on nif expression was probably a consequence of lowered energy resources that occurred during anaerobic N starvation. The loss of ATP was not associated with nitrogenase synthesis or activity, since hisA nifA and hisA nifH double mutants underwent a loss of ATP in derepressing conditions. Transcription from the nifL, nifN, and nifH promoters was examined in hisA strains with Mu d(Ap lac) fusions in these nif genes. Transcription was not significantly influenced under conditions where adenylates were decreased in concentration. Also nif mRNA apparently accumulated in cultures unable to synthesize nitrogenase, suggesting that translational control of nif gene product synthesis occurs under unfavorable energetic conditions. PMID- 3275614 TI - Structure and transcription of the allantoate permease gene (DAL5) from Saccharomyces cerevisiae. AB - We determined the nucleotide sequence of the DAL5 gene, which encodes a component of the allantoate transport system. Translation of the sequence revealed that the DAL5 gene product is highly hydrophobic. It possesses an alternating motif of hydrophilic sequences that can potentially be folded into alpha-helices and hydrophobic sequences that can potentially be folded into beta-pleated sheets. These are expected characteristics of an integral membrane protein, which correlate well with DAL5 gene function. S1 protection fragments generated by DAL5 transcripts exhibited high heterogeneity over a 30-base-pair range. This pattern of fragments was not affected by growth conditions of the cells or the conditions of the assay. PMID- 3275615 TI - Isolation and sequencing of a genomic clone encoding aspartic proteinase of Rhizopus niveus. AB - A gene encoding Rhizopus niveus aspartic proteinase was isolated from an R. niveus genomic library by using oligonucleotides probes corresponding to its partial amino acid sequence, and its nucleotide sequence was determined. By comparing its deduced amino acid sequence with the amino acid sequence of rhizopuspepsin (5, 26), we concluded that the R. niveus aspartic proteinase gene has an intron within its coding region and that it has a preproenzyme sequence of 66 amino acids upstream of the mature enzyme of 323 amino acids. PMID- 3275616 TI - Molecular cloning of the wild-type phoM operon in Escherichia coli K-12. AB - A metastable bacterial alkaline phosphatase (Bap) phenotype is seen in phoR mutants, which alternately express a Bap-constitutive or -negative phenotype. The alteration is affected by mutations in the phoM region near 0 min. By molecular cloning of the wild-type phoM operon onto a multicopy plasmid and recombining onto the plasmid the pho-510 mutation that abolishes variation, the phoM operon, rather than some nearby gene, was shown to control variation. Complementation tests indicated that the wild-type phoM allele is dominant to the pho-510 mutation when both are in single copy, but whichever allele is present in higher copy appears as dominant when multicopy plasmids are examined. The alternating phenotypic variation of BAP synthesis was not seen in phoR+ cells with multicopy wild-type phoM plasmids, thus showing that the variation is associated with phoM dependent Bap expression. The alternation acted at the level of phoA transcription; it was also recA independent. BAP clonal variation is phenotypically similar to Salmonella phase variation, which is controlled by a DNA rearrangement. No evidence was found for a DNA change near the phoM operon that might be responsible for the variable Bap phenotype. PMID- 3275617 TI - Isolation and characterization of an Escherichia coli K-12 mutant deficient in glutaredoxin. AB - Mutants of Escherichia coli K-12 deficient in glutaredoxin were isolated and partially characterized. The mutants have detectable but significantly reduced glutaredoxin activity in assays of whole cells made permeable with ether as well as in assays of crude extracts coupled to ribonucleotide reductase. In vivo, the mutants appear to be deficient in both sulfate and ribonucleotide reduction, suggesting that in vivo glutaredoxin is the preferred cofactor for ribonucleotide reductase and adenosine 3'-phosphate 5'-phosphosulfate reductase. Complementation of the mutant phenotype by transformants was used to clone the wild-type glutaredoxin allele. The transformants had a high level of glutaredoxin activity and contained a plasmid with an insert that had a restriction endonuclease pattern identical to that predicted by the DNA sequence for glutaredoxin determined by Hoog et al. (J.-O. Hoog, H. von Bahr-Lindstrom, H. Jornvall, and A. Holmgren, Gene 43:13-21, 1986). PMID- 3275618 TI - DNA sequence of the D-serine deaminase activator gene dsdC. AB - We have determined the DNA sequence of dsdC, the gene that encodes the D-serine deaminase activator protein of Escherichia coli K-12. The sequence contains a single open reading frame that terminates in a UGA codon. One the basis of the size of the protein, 33 kilodaltons, and the amino acid sequence encoded by the open reading frame, we identified a likely translation initiation codon 731 base pairs upstream of the translation initiation codon for the divergently transcribed D-serine deaminase gene. There is a broad range of codon usage, not surprising in view of the weak expression of the gene. The N-terminal two-thirds of the activator is arginine-lysine rich and quite polar; the remainder is more neutral. The segment of the protein that seems most likely to have potential to form the helix-turn-helix structure characteristic of DNA-regulatory proteins is located near the end of the polar region. The protein contains a region with significant homology to lambda attB. PMID- 3275619 TI - Identification and characterization of starvation-regulated genetic loci in Salmonella typhimurium by using Mu d-directed lacZ operon fusions. AB - We used the technique of Mu d-directed lac operon fusion formation in an effort to identify loci in Salmonella typhimurium which are transcriptionally regulated by nutrient starvation conditions. We identified lacZ operon fusions in eight genetic loci, all of which exhibited increased transcription when starved for two or more of the following nutrients: nicotinate, phosphate, ammonium, glucose, and sulfate. The loci have been designated stiA to stiH for starvation-inducible loci. Mutations in two sti loci (stiC and stiD) significantly decreased cell viability during prolonged periods of nicotinate starvation, stiA and stiD are linked and map at 30 min. The stiC, stiE, stiG, and stiH loci mapped at approximately 77, 43, 88, and 56 min, respectively, on the S. typhimurium linkage map. PMID- 3275620 TI - Bacterial catalysis of nitrosation: involvement of the nar operon of Escherichia coli. AB - We have developed a rapid and sensitive fluorimetric method, based on the formation of a fluorescent product from nitrosation of 2,3-diaminonaphthalene, for measuring the ability of bacteria to catalyze nitrosation of amines. We have shown in Escherichia coli that nitrosation can be induced under anaerobic conditions by nitrite and nitrate, that formate is the most efficient electron donor for this reaction, and that nitrosation may be catalyzed by nitrate reductase (EC 1.7.99.4). The narG mutants defective in nitrate reductase do not catalyze nitrosation, and the fnr gene is essential for nitrosation. Induction by nitrite or nitrate of nitrosation, N2O production, and nitrate reductase activity all require the narL gene. PMID- 3275621 TI - Comparative nucleotide sequence analysis of growth-rate-regulated gnd alleles from natural isolates of Escherichia coli and from Salmonella typhimurium LT-2. AB - A comparative study of gnd genes from Escherichia coli strains isolated from natural populations and laboratory strains and from Salmonella typhimurium was undertaken. In the accompanying paper (G. J. Barcak and R. E. Wolf, Jr., J. Bacteriol. 170:365-371, 1988), we showed that the growth-rate-dependent regulation of gnd expression was conserved among four natural E. coli isolates and E. coli B/r in a manner qualitatively similar to that of the gene from E. coli K-12. Here, we report the DNA sequence of the 5' regulatory region and the first 125 codons of the structural gene for the five E. coli gnd genes and the gnd gene from S. typhimurium LT-2. The sequences differed from one another by 5% on the average. All sequences defined putative secondary structures of the mRNA leader, which were previously proposed to be important in the regulation of the K 12 gene. In addition, a sequence between codons 69 and 74, which is highly complementary to the ribosome-binding site of the mRNA, was conserved in all the genes. The sequence data are discussed with respect to potential regulatory consequences. PMID- 3275622 TI - Metabolism of L-fucose and L-rhamnose in Escherichia coli: aerobic-anaerobic regulation of L-lactaldehyde dissimilation. AB - L-Lactaldehyde is a branching point in the metabolic pathway of L-fucose and L rhamnose utilization. Under aerobic conditions, L-lactaldehyde is oxidized to L lactate by the enzyme lactaldehyde dehydrogenase, while under anaerobic conditions, L-lactaldehyde is reduced to L-1,2-propanediol by the enzyme propanediol oxidoreductase. Aerobic growth on either of the methyl pentoses induces a lactaldehyde dehydrogenase enzyme which is inhibited by NADH and is very stable under anaerobic conditions. In the absence of oxygen, the cell shifts from the oxidation of L-lactaldehyde to its reduction, owing to both the induction of propanediol oxidoreductase activity and the decrease in the NAD/NADH ratio. The oxidation of L-lactaldehyde to L-lactate is again restored upon a change to aerobic conditions. In this case, only the NAD/NADH ratio may be invoked as a regulatory mechanism, since both enzymes remain active after this change. Experimental evidence in the presence of rhamnose with mutants unable to produce L-lactaldehyde and mutants capable of producing but not further metabolizing it points toward L-lactaldehyde as the effector molecule in the induction of lactaldehyde dehydrogenase. Analysis of a temperature-sensitive mutation affecting the synthesis of lactaldehyde dehydrogenase permitted us to locate an apparently single regulator gene linked to the ald locus at 31 min and probably acting as a positive control element on the expression of the structural gene. PMID- 3275623 TI - Isolation of Salmonella typhimurium cys genes by transduction with a library of recombinant plasmids packaged in bacteriophage P22HT capsids. AB - We have prepared a library of Salmonella typhimurium genomic fragments cloned in pBR322 and packaged in P22HT capsids. Plasmids carrying 24 of 26 specific genes searched for were isolated by transduction at frequencies of 1 to 344 per 10(6) plasmid transductants. All 11 known genes of the cysteine regulon were isolated from this library, including cysK, which we had previously been unable to clone in a recombinant plasmid with an Escherichia coli host. This library provides a simple and rapid method for isolating most S. typhimurium genes by using S. typhimurium itself as a host and should be particularly useful for cloning genes that might be deleterious to E. coli. PMID- 3275624 TI - Rate and topography of cell wall synthesis during the division cycle of Salmonella typhimurium. AB - The rates of synthesis of peptidoglycan and protein during the division cycle of Salmonella typhimurium have been measured by using the membrane elution technique and differentially labeled diaminopimelic acid and leucine. The cells were labeled during unperturbed exponential growth and then bound to a nitrocellulose membrane by filtration. Newborn cells were eluted from the membrane with fresh medium. The radioactivity in the newborn cells in successive fractions was determined. As the cells are eluted from the membrane as a function of their cell cycle age at the time of labeling, the rate of incorporation of the different radioactive compounds as a function of cell cycle age can be determined. During the first part of the division cycle, the ratio of the rates of protein and peptidoglycan synthesis was constant. During the latter part of the division cycle, there was an increase in the rate of peptidoglycan synthesis relative to the rate of protein synthesis. These results support a simple, bipartite model of cell surface increase in rod-shaped cells. Before the start of constriction, the cell surface increased only by cylindrical extension. After cell constriction started, the cell surface increased by both cylinder and pole growth. The increase in surface area was partitioned between the cylinder and the pole so that the volume of the cell increased exponentially. No variation in cell density occurred because the increase in surface allowed a continuous exponential increase in cell volume that accommodated the exponential increase in cell mass. Protein was synthesized exponentially during the division cycle. The rate of cell surface increase was described by a complex equation which is neither linear nor exponential. PMID- 3275625 TI - Leucine uptake and protein synthesis are exponential during the division cycle of Escherichia coli B/r. AB - The rate of leucine uptake, which is a measure of protein synthesis, was measured during the division cycle of Escherichia coli B/r by the membrane elution technique. The rate of leucine uptake was exponential, indicating that protein synthesis is exponential, and not linear, during the division cycle. These results, coupled with the results of other work on the exponential rate of RNA synthesis during the division cycle, indicate that the accumulation of mass in E. coli and other gram-negative organisms is exponential during the division cycle. PMID- 3275626 TI - ATP-liganded form of aspartate transcarbamoylase, the logical regulatory target for allosteric control in divergent bacterial systems. AB - In Escherichia coli, the mechanism for regulatory control of aspartate transcarbamoylase is clear; CTP allosterically inhibits catalysis in direct competition with ATP. However, both CTP and ATP may be activators or may have no effect on aspartate transcarbamoylases from other enteric bacteria. A common regulatory logic observed was that the ATP-activated enzymes were rendered less active as the result of competition with CTP, regardless of the independent effects. PMID- 3275627 TI - Changes in buoyant density and cell size of Escherichia coli in response to osmotic shocks. AB - The buoyant density of Escherichia coli was shown to be related to the osmolarity of the growth medium. This was true whether the osmolarity was adjusted with either NaCl or sucrose. When cells were grown at one osmolarity and shocked to another osmolarity, their buoyant density adjusted to nearly suit the new osmolarity. When cells were subjected to hyperosmotic shock, they became denser than expected. When cells were subjected to hypoosmotic shock they occasionally undershot the new projected density, but the undershoot was not as dramatic as the overshoot seen with hyperosmotic shocks. Shrinkage and swelling of the cells in response to osmotic shocks could account for the change in their buoyant density. The changes in cell size after osmotic shocks were measured by two independent methods. The first method measured cell size with a Coulter Counter, and the second method measured cell size by stereologic analysis of Nomarski light micrographs. Both methods gave qualitatively similar results and showed the cells to be flexible. The maximum swelling recorded was 23% of the original cell volume, while the maximum shrinkage observed was 33%. PMID- 3275628 TI - Sufficiency of the Klenow fragment for survival of polC(Ts) pcbA1 Escherichia coli at 43 degrees C. AB - Escherichia coli cells with the pcbA1 allele and temperature-sensitive DNA polymerase III mutations survived at a restrictive temperature if DNA polymerase I activity was present. The Klenow fragment of DNA polymerase I was capable of supporting cell survival as well. PMID- 3275629 TI - Genetic and molecular characterization of the guaC-nadC-aroP region of Escherichia coli K-12. AB - The guaC (GMP reductase), nadC (quinolinate phosphoribosyltransferase), and aroP (aromatic amino acid permease) genes of Escherichia coli K-12 were located in the 2.5-min region of the chromosome (muT-guaC-nadC-aroP-aceE) by a combination of linkage analysis, deletion mapping, restriction analysis, and plasmid subcloning. The guaC locus expressed a product of Mr 37,000 with a clockwise transcriptional polarity, and the GMP reductase activities of guaC+ plasmid-containing strains were amplified 15- to 20-fold. PMID- 3275630 TI - Rapid identification of bacterial genes that are lethal when cloned on multicopy plasmids. AB - A procedure to identify genes that are lethal when cloned on multicopy plasmids was developed. It depends on the ability of mini-Mu plasmid elements to be used for both in vivo cloning and generalized transduction of enterobacterial genes. The feasibility of this procedure was demonstrated by using the tetA gene of Tn10, which is lethal when in multiple copies in the presence of 25 micrograms of tetracycline per ml. PMID- 3275631 TI - Flagellin domain that affects H antigenicity of Escherichia coli K-12. AB - Escherichia coli K-12 mutants with altered flagellum antigenicity were isolated by introducing random deletions into the flagellin gene. The deletions were identified in the central region of the gene. It is suggested that this region corresponds to the flagellin domain molecule which affects flagellum antigenicity. PMID- 3275632 TI - Nucleotide sequence of the iucD gene of the pColV-K30 aerobactin operon and topology of its product studied with phoA and lacZ gene fusions. AB - Gene iucD of the aerobactin operon of the Escherichia coli plasmid ColV-K30 encodes a membrane-bound enzyme synthesizing N6-hydroxylysine, the first product of the aerobactin biosynthesis pathway. The entire nucleotide sequence of the cloned iucD gene was determined, from which the primary and some aspects of the secondary structure of the encoded peptide were deduced. E. coli cells harboring multicopy plasmid pVLN12 (iucD+) hyperproduced an approximately 50-kilodalton peptide which was purified and identified as the product of the gene by examination of its amino-terminal sequence. Two iucD'-'lacZ gene fusions were constructed in vitro and four iucD'-'phoA gene fusions were generated in vivo by mutagenesis of iucD with transposon TnphoA (Tn5 IS50L::phoA). Analysis of the corresponding fusion proteins suggested at least two domains of attachment of the IucD protein to the inner side of the cytoplasmic membrane. The first apparent membrane-bound domain was found within the first 25 amino acids of the protein and showed a sequence which resembled that of the signal peptides. PMID- 3275633 TI - Isolation and characterization of respiratory-deficient mutants of Escherichia coli K-12. AB - Several mutants of Escherichia coli K-12 defective in aerobic metabolism were isolated. One such mutant was found to be deficient in cytochromes, heme, and catalase. Aerobically grown cells did not consume oxygen and could grow only on fermentable carbon sources. Supplementation of the growth medium with delta aminolevulonic acid, protoporphyrin IX, or hemin did not restore aerobic metabolism. The lack of heme and catalase in mutant cells grown on glucose was not due to catabolite repression, since the addition of exogenous cyclic AMP did not restore the normal phenotype. When grown aerobically on complex medium containing glucose, the mutant produced lactic acid as the principal fermentation product. This pleotropic mutation was attributed to an inability of the cells to synthesize heme, and preliminary data mapped the mutation to between 8 and 13 min on the E. coli genome. PMID- 3275634 TI - ECT versus tricyclic antidepressants in depression: a review of the evidence. AB - The claim is often made that ECT is more effective and works more rapidly than antidepressant drugs in the treatment of depression. The author reviews the nine controlled studies comparing the two treatments that appear in the literature. All of the studies were methodologically deficient, especially concerning definition of depression, sample size, dose of drug, and statistical analysis. No conclusive answer is available to the question whether ECT is superior to antidepressants in the treatment of depression. Pivotal studies are needed. PMID- 3275635 TI - DNA replication. PMID- 3275636 TI - The contribution of magnetic susceptibility effects to transmembrane chemical shift differences in the 31P NMR spectra of oxygenated erythrocyte suspensions. AB - Triethyl phosphate, dimethyl methylphosphonate, and the hypophosphite ion all contain the phosphoryl functional group. When added to an oxygenated erythrocyte suspension, the former compound gives rise to a single 31P NMR resonance, whereas the latter compounds give rise to separate intra- and extracellular 31P NMR resonances. On the basis of experiments with intact oxygenated cell suspensions (in which the hematocrit was varied) and with oxygenated cell lysates (in which the lysate concentration was varied), it was concluded that the chemical shifts of the intra- and extracellular populations of triethyl phosphate differ as a consequence of the diamagnetic susceptibility of intracellular oxyhemoglobin but that this difference is averaged by the rapid exchange of the compound across the cell membrane. The difference in the magnetic susceptibility of the intra- and extracellular compartments contributes to the observed separation of the intra- and extracellular resonances of dimethyl methylphosphonate and hypophosphite. The magnitude of this contribution is, however, substantially less than that calculated using a simple two-compartment model and varies with the hematocrit of the suspension. Furthermore, it is insufficient to fully account for the transmembrane chemical shift differences observed for dimethyl methylphosphonate and hypophosphite. An additional effect is operating to move the intracellular resonances of these compounds to a lower chemical shift. The effect is mediated by an intracellular component, and the magnitude of the resultant chemical shift variations depends upon the chemical structure of the phosphoryl compound involved. PMID- 3275637 TI - Preliminary crystal structure of Acinetobacter glutaminasificans glutaminase asparaginase. AB - The preliminary structure of a glutaminase-asparaginase from Acinetobacter glutaminasificans is reported. The structure was determined at 3.0-A resolution with a combination of phase information from multiple isomorphous replacement at 4-5-A resolution and phase improvement and extension by two density modification techniques. The electron density map was fitted by a polypeptide chain that was initially polyalanine. This was subsequently replaced by a polypeptide with an amino acid sequence in agreement with the sizes and shapes of the side chain electron densities. The crystallographic R factor is 0.300 following restrained least squares refinement with data to 2.9-A resolution. The A. glutaminasificans glutaminase-asparaginase subunit folds into two domains: the aminoterminal domain contains a five-stranded beta sheet surrounded by five alpha helices, while the carboxyl-terminal domain contains three alpha helices and less regular structure. The connectivity is not fully determined at present, due in part to the lack of a complete amino acid sequence. The A. glutaminasificans glutaminase-asparaginase structure has been used successfully to determine the relative orientations of the molecules in crystals of Pseudomonas 7A glutaminase-asparaginase, in crystals of Vibrio succinogenes asparaginase, and in a new crystal form of Escherichia coli asparaginase (space group 1222, one subunit per asymmetric unit). PMID- 3275638 TI - Reversibility of strand invasion promoted by recA protein and its inhibition by Escherichia coli single-stranded DNA-binding protein or phage T4 gene 32 protein. AB - When recA protein promotes homologous pairing and strand exchange involving circular single strands and linear duplex DNA, the protein first polymerizes on the single-stranded DNA to form a nucleoprotein filament which then binds naked duplex DNA to form nucleoprotein networks, the existence of which is independent of homology, but requires the continued presence of recA protein (Tsang, S. S., Chow, S. A., and Radding, C. M. (1985) Biochemistry 24, 3226-3232). Further experiments revealed that within a few minutes after the beginning of homologous pairing and strand exchange, these networks began to be replaced by a distinct set of networks with inverse properties: their formation depended upon homology, but they survived removal of recA protein by a variety of treatments. Formation of this second kind of network required that homology be present specifically at the end of the linear duplex molecule from which strand exchange begins. Escherichia coli single-stranded DNA-binding protein or phage T4 gene 32 protein largely suppressed the formation of this second population of networks by inactivating the newly formed heteroduplex DNA, which, however, could be reactivated when recA protein was dissociated by incubation at 0 degrees C. We interpret these observations as evidence of reinitiation of strand invasion when recA protein acts in the absence of auxiliary helix-destabilizing proteins. These observations indicate that the nature of the nucleoprotein products of strand exchange determines whether pairing and strand exchange are reversible or not, and they further suggest a new explanation for the way in which E. coli single stranded DNA-binding protein and gene 32 protein accelerate the apparent forward rate of strand exchange promoted by recA protein, namely by suppressing initiation of the reverse reaction. PMID- 3275639 TI - Avidin binding of radiolabeled biotin derivatives. AB - Three N-acyl derivatives of biotinylethylenediamine were prepared: I, biotinylamidoethyl-3-(3-[125I]iodo-4-hydroxyphenyl)propionamide; II, biotinylamidoethyl-[3H]acetamide; and III, biotinylamidoethyl-3-(3,5-[125I]diiodo 4-hydroxyphenyl)propionamid e. Each compound was combined with a large excess of avidin, yielding 1:1 molar complexes. Aside from a small fraction of each complex that dissociated more rapidly, the dissociation half-lives of these complexes were: I, 41 days; II, 4.4 days; and III, 148 days. The iodo- (mono or di) hydroxyphenylpropionyl moieties of I and III, therefore, contribute significantly to the binding strength of these compounds toward avidin. We also formed 4:1 complexes of I, II, and III with avidin (compound in excess), each of which exhibited biphasic dissociation, with initial half-lives of 4, 3.2, and 24 days, respectively. Thus, I or especially III potentially can be used as a sensitive tracer in quantitative studies with avidin. PMID- 3275640 TI - Increased binding of operator DNA by trp superrepressor EK49. AB - The mechanism of superrepression by the mutant trp repressor EK49 was examined. This superrepressor has a glutamic acid-to-lysine change at residue 49. The purified EK49 trp repressor was found to have a 10-fold higher affinity than wild type repressor for trp operator DNA. This increased affinity was shown to be due to a decrease in dissociation rate. The binding of trp operator DNA by EK49 trp repressor in the filter binding assay was more sensitive to high salt concentrations than binding by wild type repressor. PMID- 3275641 TI - Facilitated diffusion of p-nitrophenyl-alpha-D-maltohexaoside through the outer membrane of Escherichia coli. Characterization of LamB as a specific and saturable channel for maltooligosaccharides. AB - LamB, an outer membrane protein of Escherichia coli, is a component of the maltose-maltooligosaccharide transport system. We used p-nitrophenyl-alpha-D maltohexaoside, a chromogenic analog of maltohexaose, and a periplasmic amylase that hydrolyzes this compound to study the LamB-mediated diffusion of p nitrophenyl-alpha-D-maltohexaoside into the periplasm. Using this approach, we were able to characterize LamB in vivo as a saturable channel for maltooligosaccharides. Permeation through LamB follows Michaelis-Menten kinetics, with a Km of 0.13 mM and a Vmax of 3.3 nmol/min/10(9) cells. Previous studies suggested that maltose-binding protein increases the rate of maltooligosaccharide diffusion through LamB. We show here that, at least in strains that are unable to transport maltooligosaccharides into the cytoplasm, maltose-binding protein does not influence the rate of substrate diffusion. The periplasmic amylase had been previously described as being of the alpha-type. We have now purified this protein and analyzed its mode of action using chromogenic maltooligosaccharides of varying length. Analysis of the hydrolytic products revealed that the enzyme recognizes its substrate from the nonreducing end and preferentially liberates maltohexaose, in contrast to the behavior of classical alpha-amylases that are endohydrolases. Using p-nitrophenyl-alpha-D-maltohexaoside as a substrate, we determined a Km of 3 microM and a Vmax of 0.14 mumol/min/mg of protein. PMID- 3275642 TI - Alterations to the signal peptide of an outer membrane protein (OmpA) of Escherichia coli K-12 can promote either the cotranslational or the posttranslational mode of processing. AB - The signal sequence of the precursor of the Escherichia coli outer membrane protein OmpA was altered by oligonucleotide insertions into the corresponding gene. In one case, OmpA-S1, the hydrophobic core of the signal peptide, is reduced from 12 to 10 residues, and one positive charge is added near the NH2 terminus. In another case, OmpA-P1, the hydrophobic core is extended from 12 to 16 residues. The pro-OmpA protein is normally processed partially co- and partially posttranslationally. Processing of the pro-OmpA-S1 protein was entirely posttranslational and that of the pro-OmpA-P1 protein strictly cotranslational. Evidence is presented which strongly suggests that posttranslational processing reflects posttranslational translocation across the plasma membrane. The generation times of cells expressing pro-OmpA-P1 or pro-OmpA-S1 were identical and the pro-OmpA-S1 polypeptide could be chased into the mature protein in the absence of protein synthesis. Hence, it does not matter which mode of processing, or rather translocation, is used. The same oligonucleotides were inserted into the ompA gene of plasmid pRD87; a plasmid which leads to overproduction of the protein and to massive accumulation of both the mature protein and the precursor. In the OmpA signal sequence encoded by pRD87-P2 the hydrophobic core is extended from 12 to 20 residues. This peptide was also rapidly removed. Therefore, regardless of whether the hydrophobic core contains 12, 16, or 20 lipophilic residues, not only does the signal sequence always function correctly to mediate export, but in each case, the cleavage site is always accessible to the signal peptidase. PMID- 3275644 TI - Yeast LEU4 encodes mitochondrial and nonmitochondrial forms of alpha isopropylmalate synthase. AB - The LEU4 gene of Saccharomyces cerevisiae is the major structural gene involved in the production of alpha-isopropylmalate synthase. It was recently proposed that LEU4 should be capable of encoding two forms of alpha-isopropylmalate synthase, based mainly on the observation that two of four major transcription start sites are located downstream from the ATG at the beginning of the LEU4 open reading frame (Beltzer, J. P., Chang, L. L., Hinkkanen, A. E., and Kohlhaw, G. B. (1986) J. Biol. Chem. 261, 5160-5167). The two forms with molecular weights of 68,000 and 65,000, respectively, would differ only in the N-terminal region, and only the larger of the two forms would be imported into the mitochondria. We have now constructed LEU4'-'lacZ translational fusion plasmids that contain either a normal LEU4' portion (expected to express both the long and the short forms of the fusion protein) or a modified LEU4' portion in which productive translation is possible only from the second in-frame AUG (expected to express only the short form of the fusion protein). beta-Galactosidase measurements and immunoblotting of crude mitochondrial and cytoplasmic fractions of yeast cells transformed with the fusion plasmids indicate that two forms of hybrid protein are produced and that only the larger form is targeted to the mitochondria. The distinguishing feature of the targeting sequence appears to be its ability to form an 18-residue long amphiphilic helix. Expression of the native short form of LEU4-encoded alpha isopropylmalate synthase behind a strong yeast promoter has enabled us to show that the short form is functional in leucine biosynthesis, is inhibited by leucine with an apparent inhibitor constant of approximately 0.4 mM, and exists as a cytoplasmic dimer. PMID- 3275643 TI - Identification of the insulin receptor tyrosine residues undergoing insulin stimulated phosphorylation in intact rat hepatoma cells. AB - Tyr(P)-containing proteins were purified from extracts of insulin-treated rat hepatoma cells (H4-II-E-C3) by antiphosphotyrosine immunoaffinity chromatography. Two major insulin-stimulated, Tyr(P) proteins were recovered: an Mr 95,000 protein (identified as the insulin receptor beta subunit by its immunoprecipitation by a patient-derived anti-insulin receptor serum and several anti-insulin receptor (peptide) antisera) and an Mr 180,000 protein (which was unreactive with all anti-insulin receptor antibodies). After purification and tryptic digestion of the Mr 95,000 protein, tryptic peptides containing Tyr(P) were purified by sequential antiphosphotyrosine immunoaffinity, reversed-phase, anion-exchange chromatography. The partial amino acid sequence obtained by gas- and solid-phase Edman degradation was compared to the amino acid sequence of the intracellular extension of the rat insulin receptor deduced from the genomic sequence. Approximately 80% of all beta subunit [32P]Tyr(P) resides on two tryptic peptides: 50-60% of [32P]Tyr(P) is found on the tryptic peptide Asp-Ile Tyr-Glu-Thr-Asp-Tyr-Tyr-Arg from the tyrosine kinase domain, which is recovered mainly as the double phosphorylated species (predominantly in the form with Tyr(P) at residues 3 and 7 from the amino terminus; the remainder with Tyr(P) at residues 3 and 8), with 10-15% as the triple phosphorylated species. A second tryptic peptide is located near the carboxyl terminus, contains 2 tyrosines, and has the sequence, Thr-Tyr-Asp-Glu-His-Ile-Pro-Tyr-Thr-; this contains 20-30% of beta subunit [32P]Tyr(P) and is identified primarily in a double phosphorylated form. Approximately 10% of beta subunit [32P]Tyr(P) resides on an unidentified tryptic peptide of Mr 4,000-5,000. The insulin-stimulated tyrosine phosphorylation of the insulin receptor in intact rat hepatoma cells thus involves at least 6 of the 13 tyrosine residues located on the beta subunit intracellular extension. These tyrosines are clustered in several domains in a distribution virtually identical to that previously found for partially purified human insulin receptor autophosphorylated in vitro in the presence of insulin. This multisite regulatory tyrosine phosphorylation is the initial intracellular event in insulin action. PMID- 3275645 TI - Characterization of the internal signal-anchor domain of Escherichia coli leader peptidase. AB - Leader peptidase, an integral transmembrane protein of Escherichia coli, is synthesized without a cleavable amino-terminal leader peptide. Of the five domains that participate in the membrane assembly of this protein, one is an internal "signal" region. We have used oligonucleotide-directed mutagenesis to examine the properties of the internal signal that are crucial for leader peptidase assembly. For this purpose, the net charge at the amino terminus of the internal signal was changed from +2 to +1 and -1 and, at the carboxyl terminus of the signal, from 0 to -1 or +1. These mutations had no effect on the membrane assembly of leader peptidase, suggesting that the charges have little role in the signal function. The apolar core of this signal was disrupted by substitution of basic amino acids for apolar residues. Substitution of an arginyl residue at position 70, or two arginyl residues at position 67 and 69, prevented membrane assembly. However, substitution of an arginyl residue at position 66 or either arginyl or lysyl residue at position 68 was without effect. Thus, while the apolar character of the internal signal is important, the precise position of a charged residue determines its effect on assembly. PMID- 3275646 TI - Cloning and expression of a Streptomyces plicatus chitinase (chitinase-63) in Escherichia coli. AB - 4-Methylumbelliferyl (4-MU) glycosides of N-acetylglucosamine oligosaccharides were used as substrates to detect expression of a Streptomyces chitinase in Escherichia coli. Low levels of enzyme were detected when S. plicatus DNA was cloned into a bacteriophage lambda vector (EMBL-4). Subcloning into E. coli plasmids also gave low but detectable levels of enzyme expression. High level expression was achieved by resection of the cloned S. plicatus DNA with Bal31 followed by in-frame fusion to the amino-terminal peptide sequence of beta galactosidase found in the pUC vectors. The Streptomyces chitinase was secreted into the periplasmic space of E. coli, and its signal sequence was removed. We characterized the activity of the cloned enzyme and compared it to three other purified Streptomyces plicatus chitinases with respect to hydrolysis of the 4-MU oligosaccharides. We found that two of the enzymes form 4-methylumbelliferone much more rapidly from the 4-MU disaccharide than from the trisaccharide. These same enzymes convert the 4-MU trisaccharide primarily to diacetylchitobiose and the 4-MU monosaccharide, a nonfluorescent product. The latter compound is not hydrolyzed appreciably by any of the enzymes. On the basis of these results, we suggest a new definition of "exo" and "endo" chitinase that differs from that found in the literature. We propose that exochitinase activity be defined as processive action starting at the nonreducing ends of chitin chains with release of successive diacetylchitobiose units, and that endochitinase activity be defined as random cleavage at internal points in chitin chains. PMID- 3275647 TI - Replicase of L-A virus-like particles of Saccharomyces cerevisiae. In vitro conversion of exogenous L-A and M1 single-stranded RNAs to double-stranded form. AB - Virus-like particles that contain L-A double-stranded RNA are known to have transcriptase activity whose product is L-A single-stranded plus RNA. In low salt conditions, these particles release their double-stranded RNA and can then use added plus L-A or plus M1 single-stranded RNAs as templates to synthesize their respective double-stranded RNAs. The reaction requires dialyzed L-A virus-like particles as the source of the enzyme, a partially purified cell extract (host factor(s)), added single-stranded RNA as a template, and polyethylene glycol 6000, along with four NTPs. Crude host factor extracts prepared from mak3 or mak10ta mutants also support the reaction as effectively as that from a wild type strain, while a crude extract prepared from a pet18 mutant grown under the nonpermissive conditions is less effective. Template specificity of the in vitro reaction is the same as that expected for the enzyme reaction in vivo. Plus L-A and plus M1 single-stranded RNAs, but not 18 S rRNA, are converted to their respective double-stranded RNAs with net RNA synthesis. The newly synthesized strand of M1 double-stranded RNA is a full-length minus strand. This demonstration of replicase activity in the mature L-A virus-like particles which contain L-A double-stranded RNA is consistent with our previous L-A double stranded RNA replication model; the difference between the mature L-A virus-like particles and L-A double-stranded RNA-synthesizing particles (expected to be replication intermediates in vivo) is just that the former contain L-A double stranded RNA, while the latter contain L-A plus single-stranded RNA. PMID- 3275648 TI - Organization of the oxygen-evolution enzyme complex studied by butanol/water phase partitioning of spinach photosystem II particles. AB - The oxygen-evolving photosystem II particles prepared from spinach chloroplasts with brief sonication and Triton X-100 treatment were subjected to butanol/water phase partitioning. Three peripheral proteins of photosystem II having relative molecular masses of 33,000, 24,000, and 18,000 daltons and a part of the manganese atoms associated with photosystem II were partitioned into the aqueous phase, depending on the concentration of salt which was included in the suspension of the photosystem II particles. Quantitative analysis of the phase partitioning of the photosystem II particles under the various ionic conditions at pH 6.5 suggested the following: (a) two of the four atoms of manganese associated with photosystem II are located at a relatively hydrophilic environment and easily extracted from the membrane; (b) one of these "hydrophilic manganese atoms" is structurally in close proximity to the protein of the relative molecular mass of 33,000 daltons and stabilized by the protein specifically; (c) the protein of the relative molecular mass of 24,000 daltons as well as that of 33,000 daltons is involved in the stabilization of the other "hydrophilic manganese" in the membrane; (d) each of the three proteins has an independent binding site on the membrane and organizes a specific catalytic domain where oxidation of water is carried out efficiently in collaboration with the reaction center of photosystem II. PMID- 3275649 TI - The yeast VAS1 gene encodes both mitochondrial and cytoplasmic valyl-tRNA synthetases. AB - S1 mapping on the VAS1 structural gene indicates the existence of two classes of transcripts initiating at distinct in-frame translation start codons. The longer class of VAS1 transcripts initiates upstream of both ATG codons located 138 base pairs away and the shorter class downstream of the first ATG. A mutation that destroys the first AUG on the long message results in respiratory deficiency but does not affect viability. Mutation of the ATG at position 139 leads to lethality because the initiating methionine codon of the essential cytoplasmic valyl-tRNA synthetase has been destroyed. N-terminal protein sequence data further confirm translation initiation at ATG-139 for the cytoplasmic valyl-tRNA synthetase. From these results, we conclude that the VAS1 single gene encodes both mitochondrial and cytoplasmic valyl-tRNA synthetases. The presequence of the mitochondrial valyl-tRNA synthetase shows amino acid composition but not the amphiphilic character of imported mitochondrial proteins. From mutagenesis of the ATG-139 we conclude that the presequence specifically targets the cytoplasmically synthesized mitochondrial valyl-tRNA synthetase to the mitochondrial outer membrane and prevents binding of the enzyme core to cytoplasmic tRNAVal. PMID- 3275650 TI - Interaction of T7 RNA polymerase with DNA in an elongation complex arrested at a specific psoralen adduct site. AB - We have probed the interaction of T7 RNA polymerase with DNA in an elongation complex arrested by a site specifically placed psoralen diadduct or furanside monoadduct using DNase I footprinting techniques. The psoralen derivative, HMT (4'-hydroxy-methyl-4,5',8-trimethylpsoralen), was first placed at a specific site in the middle of a chemically synthesized double-stranded DNA fragment containing a T7 RNA polymerase promoter at one end. The psoralen molecule was photochemically attached either to 2 adjacent thymidine residues on opposite strands as a diadduct or to only 1 thymidine residue on the coding strand as a furan-side monoadduct. Using these psoralen-modified DNAs as templates for transcription, we found that T7 RNA polymerase was blocked at the psoralen adduct site and that the arrested elongation complex protected about 15 nucleotides upstream from the adduct on the coding strand and 20 nucleotides around the adduct on the noncoding strand from DNase I digestion. The two psoralen-modified DNA templates yielded identical RNA transcripts and DNase I footprints. In contrast, T7 polymerase protected only the coding strand from -20 to +8 in the initiation complex. These results suggest that the RNA polymerase undergoes a marked conformational change upon converting from an initiation complex to an elongation complex. PMID- 3275651 TI - Protein components of the erythromycin binding site in bacterial ribosomes. AB - Two derivatives of erythromycin have been prepared carrying either an aryl azide or a 4-nitroguaiacol as a photoreactive group. Both derivatives bind to the specific erythromycin ribosomal site as shown by saturation and competition studies. The derivatives were isotopically labeled either with tritium or with 125I, and radioactivity is covalently incorporated to the ribosome upon irradiation at the appropriate wavelength. The ribosomal proteins labeled were identified by either mono- and two-dimensional gel electrophoresis or high performance liquid chromatography. It has been found that protein L22 is the protein mainly, and under some conditions exclusively, labeled by the erythromycin derivatives. These results were confirmed using ribosomes from erythromycin-resistant mutants having a protein L22 with modified electrophoretical mobility. Protein L15 is also labeled in both cases, and the aromatic azide derivative labels to a lesser extent proteins L2 and L4. Competition experiments with erythromycin indicate that labeling in protein L22, and probably in L15, is specific, while the specificity of labeling in proteins L2 and L4 is questionable. These results indicate that the erythromycin derivatives label different ribosomal proteins than the spiramycin type of macrolides (Tejedor, F., and Ballesta, J.P.G. (1985) Biochemistry 24, 467) suggesting that the binding sites of both macrolide types are probably not identical. PMID- 3275652 TI - The role of polypeptide growth factors in phenotypic transformation of normal rat kidney cells. AB - A serum-free assay has been established for studying the role of polypeptide growth factors in inducing loss of density-dependent inhibition of growth of normal rat kidney (NRK) cells. The process has been characterized by measuring the time course of [3H]thymidine incorporation into confluent, quiescent NRK cultures stimulated by defined polypeptide growth factors, in combination with cell counting studies, increases in DNA content, and cell cycle analysis by means of a fluorescence-activated cell sorter. It is shown that none of the growth factors tested (epidermal growth factor, platelet-derived growth factor, transforming growth factor-beta, and retinoic acid) is able to induce loss of density-dependent inhibition of growth by itself, but strong synergism was observed when combinations of growth factors were tested. None of the above factors was found to be essential, however, since any combination of three of the above four growth factors strongly induced the process. Strong parallels were observed between the growth factor requirements for inducing loss of density dependent inhibition of growth under serum-free conditions and the requirements for induction of anchorage-independent proliferation under growth factor-defined assay conditions. This indicates that most likely the same cellular processes underlie these two aspects of phenotypic transformation, although data indicate that anchorage-independent proliferation may be a more restricted property of phenotypic transformation than loss of density dependence of proliferation. It is concluded that phenotypic transformation of NRK cells does not require specific polypeptide growth factors, but reflects the ability of these cells to respond to multiple growth factors. PMID- 3275653 TI - Interaction of OmpR, a positive regulator, with the osmoregulated ompC and ompF genes of Escherichia coli. Studies with wild-type and mutant OmpR proteins. AB - The OmpR protein is a positive regulator involved in osmoregulatory expression of the ompC and ompF genes that specify the major outer membrane proteins OmpC and OmpF, respectively. We purified the OmpR protein not only from wild-type cells but also from two ompR mutants (ompR2 and ompR3) exhibiting quite different phenotypes as to osmoregulation of the ompC and ompF genes. The OmpR2 protein has an amino acid conversion in the C-terminal portion of the OmpR polypeptide, whereas the OmpR3 protein has one in the N-terminal portion. Comparative studies on these purified OmpR proteins were carried out in terms of their interaction with the ompC and ompF promoters. The nucleotide sequences involved in OmpR binding were determined in individual promoter regions by deoxyribonuclease I footprinting. The OmpR3 protein as well as the wild-type OmpR protein appeared to bind, to similar extents, to both the ompC and ompF promoters. In contrast, the OmpR2 protein bound preferentially to the ompF promoter and failed to protect the ompC promoter against DNAse I digestion. These results support the view that the C-terminal portion of the OmpR protein is responsible for the binding of the OmpR protein to the ompC and ompF promoter DNAs. Based on these results, the structure and function of the OmpR protein are discussed in relation to the mechanism of osmoregulation. PMID- 3275654 TI - Overproduction and rapid purification of the biotin operon repressor from Escherichia coli. AB - The Escherichia coli biotin operon repressor protein (BirA) has been overexpressed at the level of 0.5-1% of the total cellular protein from the plasmid pMBR10. Four lines of evidence demonstrated that authentic BirA protein was produced. First, birA plasmids complemented birA mutants for both the repressor and biotin holoenzyme synthetase activities of BirA. Second, biotin holoenzyme synthase activity was increased in strains containing the overproducing plasmids. Third, deletion of sequences flanking the birA gene did not alter production of the 35-kDa BirA protein, but insertion of oligonucleotide linkers within the birA coding region abolished it. Fourth, the 35-kDa protein copurified with the biotin binding activity normally associated with BirA. The birA protein has been purified to homogeneity in a three-step process involving chromatography on phosphocellulose and hydroxyapatite columns. PMID- 3275655 TI - A unique protease responsible for selective degradation of a yolk protein in Bombyx mori. Purification, characterization, and cleavage profile. AB - A yolk protein, egg-specific protein, synthesized and accumulated in the developing ovaries of Bombyx mori serves not only as the nutritive source for embryogenesis but also for the reorganization of the yolk system through limited degradation. Using the purified egg-specific protein as a substrate, a protease responsible for its limited hydrolysis was identified in embryonating eggs and purified to homogeneity. The protease had an apparent molecular mass of 30,500 with one subunit of 29,000 daltons. It hydrolyzes synthetic substrates at carbonyl bonds of Arg or Lys residues, and the hydrolysis is strongly inhibited by diisopropylfluorophosphate, phenylmethanesulfonyl fluoride, and leupeptin, suggesting that it is a trypsin-like protease. The protease shows an extremely high degree (over 2,000-fold) of specificity for egg-specific protein compared to other yolk proteins. Intact egg-specific protein is cleaved into three fragments in two steps; the first releases a 8.7-kDa peptide as an end product and a 55-kDa peptide intermediate, and in the second the intermediate is cleaved into 36- and 17.2-kDa peptides. By relating the NH2-terminal amino acid sequences of these peptides to the sequence of the intact egg-specific protein, the protease was shown to cleave first at a Lys-Asn site and secondly at Arg-Asp. Proteolytic activity abruptly appears mid-way in embryogenesis and increases steeply during completion of larval differentiation. PMID- 3275656 TI - Transcription attenuation. AB - Prokaryotic transcription attenuation mechanisms are described in which different metabolic signals and sensing events are used to regulate transcription termination at sites preceding structural genes. Suggestive eukaryotic examples also are mentioned. PMID- 3275657 TI - Stimulation by insulin of glucokinase gene transcription in liver of diabetic rats. AB - The purpose of this work was to investigate the molecular mechanism responsible for the induction of hepatic glucokinase in diabetic rats acutely treated with insulin. Experimental diabetes was provoked by injection of streptozotocin 8-10 days before the experiments. Regular insulin was given by three intraperitoneal injections at 8-h intervals, and the time course of glucokinase induction was followed over a time period of 24 h. The amount of glucokinase in liver was estimated by Western blotting of total cytosol protein with affinity-purified antibodies, as well as by conventional enzyme activity assay. Both measurements showed that glucokinase was reduced by more than 90% in the livers of diabetic rats as compared to normal controls. Following insulin administration, the amount (and activity) of glucokinase increased in a time-dependent fashion, after an initial lag of 4 h, to reach 65% of the nondiabetic control level 24 h after the initial dose of insulin. Northern blot analysis with a cloned cDNA probe was used to quantitate glucokinase mRNA. In contrast with the slow onset of enzyme accumulation, the amount of glucokinase mRNA was shown to be increased dramatically as early as 1 h after insulin administration. The abundance of specific mRNA increased until 8 h after the initial dose of insulin. Subsequently, the level of the mRNA decayed rapidly so that little message was left after 16 h and virtually none after 24 h. Run-on transcription experiments with isolated nuclei showed that the rate of transcription of the glucokinase gene was increased about 20-fold within 45 min of insulin administration and returned to the prestimulation level after 8 h. From these data, it was concluded that the induction of glucokinase resulted primarily from a burst in the transcriptional activity of the gene, leading to a short-term accumulation of glucokinase mRNA. The more sustained elevation of the enzyme level can be accounted for by the long half-life of the enzyme (greater than 30 h). The virtually immediate activation of glucokinase gene transcription suggests a direct effect of insulin on the liver cell. PMID- 3275658 TI - Effect of neurophysin on enzymatic maturation of oxytocin from its precursor. AB - We examined the extent to which rates of enzymatic conversion of the oxytocin biosynthetic precursor to mature peptide are modulated by intramolecular and intermolecular assembly of precursor and polypeptide intermediates. The biosynthesized precursor contains hormone and neurophysin sequences linked by a Gly-Lys-Arg sequence and undergoes enzymatic processing reactions which include endoproteolytic cleavage at the Lys-Arg dibasic sequence, carboxypeptidase B-like exoproteolytic cleavage, and enzymatic amidation. We evaluated the effect of neurophysin on such processing reactions using semisynthetic precursors of oxytocin/bovine neurophysin I and synthetic oxytocinyl precursor intermediates as substrates. Neurophysin I at high concentration (0.7 mM) reduced the rates of carboxy-peptidase B-like conversion of oxytocinyl-Gly-Lys-Arg to oxytocinyl-Gly and the enzymatic amidation of oxytocinyl-Gly to mature (C-terminal amidated) oxytocin. The dependence of rate suppression on the concentrations of peptide substrate and neurophysin I suggested that suppression is due to intermolecular formation of hormone-neurophysin complexes which are aggregated at least to dimers. An analogous intramolecular neurophysin effect was found for endoproteolytic processing of semisynthetic precursors. Endoproteinase Lys-C cleaved the Lys11-Arg12 peptide bond in a native-like semisynthetic precursor at a significantly slower rate than it did an assembly-deficient precursor analogue. The difference in semisynthetic precursor endoproteolysis rates is most substantial at the high concentrations at which the native-like precursor would form dimers but the assembly-deficient analogue would not. The native-like semisynthetic precursor was more stable than the assembly-deficient precursor analogue to tryptic digestion. The concentration-dependent effects of neurophysin, both intramolecularly as a precursor domain and intermolecularly as an interacting protein, are likely to occur in the secretory granules in which the biosynthetic precursors are packaged. The molecular organization of both hormone/neurophysin precursors and the noncovalently complexed hormone neurophysin intermediates can be expected to play a role in modulating enzymatic processing reactions that lead to mature neurohypophysial hormones. PMID- 3275659 TI - Valyl-tRNA synthetase gene of Escherichia coli K12. Molecular genetic characterization. AB - We report the subcloning and characterization of the molecular elements necessary for the expression of the Escherichia coli valS gene which encodes the enzyme valyl-tRNA synthetase (EC 6.1.1.9). The valS gene was subcloned from the Clarke Carbon plasmid pLC26-22 by genetic complementation of the valS temperature sensitive mutant strain, AB4141. The protein-coding region of the valS structural gene was determined by in vitro DNA directed coupled transcription-translation assays. Assays of cellular extracts of cells transformed with a plasmid containing a full length copy of the valS gene enhanced in vivo valyl-tRNA synthetase-specific activity 12-fold. The DNA sequences of the 5'- and 3' terminal regions of the valS structural gene are presented. The transcription initiation sites of the valS gene were determined, in vivo and in vitro, by S1 nuclease protection studies, primer-extension analysis and both alpha-32P labeled and gamma-32P-end-labeled in vitro transcription assays. In vivo, valS transcription initiates from tandem overlapping promoters separated by seven nucleotides. In vitro, only the upstream promoter is active. The presence of several regions of hyphenated dyad symmetry overlapping the tandem promoter region are noted. The valS translational start codon (AUG) is located 93 base pairs downstream from the major transcription initiation site. The valS transcriptional unit encodes only the valyl-tRNA synthetase gene since the 3' terminus of the amino acid-coding region of this gene is followed closely (26 base pairs) by an efficient rho-independent transcription termination site. PMID- 3275660 TI - Valyl-tRNA synthetase gene of Escherichia coli K12. Primary structure and homology within a family of aminoacyl-TRNA synthetases. AB - The DNA nucleotide sequence of the valS gene encoding valyl-tRNA synthetase of Escherichia coli has been determined. The deduced primary structure of valyl-tRNA synthetase was compared to the primary sequences of the known aminoacyl-tRNA synthetases of yeast and bacteria. Significant homology was detected between valyl-tRNA synthetase of E. coli and other known branched-chain aminoacyl-tRNA synthetases. In pairwise comparisons the highest level of homology was detected between the homologous valyl-tRNA synthetases of yeast and E. coli, with an observed 41% direct identity overall. Comparisons between the valyl- and isoleucyl-tRNA synthetases of E. coli yielded the highest level of homology detected between heterologous enzymes (19.2% direct identity overall). An alignment is presented between the three branched-chain aminoacyl-tRNA synthetases (valyl- and isoleucyl-tRNA synthetases of E. coli and yeast mitochondrial leucyl-tRNA synthetase) illustrating the close relatedness of these enzymes. These results give credence to the supposition that the branched-chain aminoacyl-tRNA synthetases along with methionyl-tRNA synthetase form a family of genes within the aminoacyl-tRNA synthetases that evolved from a common ancestral progenitor gene. PMID- 3275661 TI - DNA polymerase III from Saccharomyces cerevisiae. I. Purification and characterization. AB - Yeast cells from a wild type or protease-deficient strain were lysed in the absence or presence of protease inhibitors and the extracts analyzed by analytical high pressure liquid chromatography on diethylaminoethyl silica gel. Conditions that inhibited protease action caused elution of a novel DNA polymerase activity at a position in the gradient distinct from the elution positions of both DNA polymerase I and II. In large scale purifications, this DNA polymerase, called DNA polymerase III, copurified with a single-stranded DNA dependent 3'-5' exonuclease activity, exonuclease III, to near homogeneity. Glycerol gradient centrifugation partially dissociated the complex to yield two peaks of exonuclease III activity, one at 7.7 S together with the DNA polymerase, and one at 4.0 S without polymerase activity. Gel filtration indicated that the complex has a molecular mass greater than 400 kDa. Polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate indicated that the complex consists of several subunits: 140, 62, 55, and 53 kilodaltons, some of which may be proteolysis products. The exonuclease component of the complex can excise single nucleotide mismatches providing a base-paired primer-template which can be elongated by the DNA polymerase. Under replication conditions, the complex exhibits a measurable turnover rate of dTTP to dTMP and it contains no primase activity. The enzymatic activities of the 3'-5' exonuclease are consistent with a proofreading function during in vivo DNA replication. A second exonuclease activity, exonuclease IV, separated from the complex late in the purification scheme. It degrades both single-stranded and double-stranded DNA in the 5'----3' direction. PMID- 3275662 TI - Diaminopropionate ammonia-lyase from Salmonella typhimurium. Purification and characterization of the crystalline enzyme, and sequence determination of the pyridoxal 5'-phosphate binding peptide. AB - We have found a wide occurrence of alpha,beta-diaminopropionate ammonia-lyase in bacteria and actinomycetes. Considerable amounts of this enzyme were found in Salmonella typhimurium. The enzyme was purified and crystallized from S. typhimurium (IFO 12529). The relative molecular mass of the native enzyme, estimated by the ultracentrifugal equilibrium method, is 89,000 Da, and the enzyme consists of two subunits identical in molecular mass. The enzyme exhibits absorption maxima at 278 and 413 nm and contains 2 mol of pyridoxal 5' phosphate(pyridoxal-P)/mol of enzyme. The enzyme catalyzes the alpha,beta elimination reaction of both L- and D-alpha,beta-diaminopropionate, the most suitable substrates, to form pyruvate and ammonia. The L- and D-isomers of serine were also degraded, though slowly. After the internal Schiff base with pyridoxal P had been reduced with sodium borohydride, followed by trypsin or lysyl endopeptidase digestion of the enzyme, we determined the sequence of about 20 amino acid residues around the lysine residue which binds pyridoxal-P. No homology was found in either the amino acid sequence of the pyridoxal-P binding peptide or the amino-terminal amino acid sequence between the enzyme and other pyridoxal-P-dependent enzymes. PMID- 3275663 TI - Unusual DNA structures. PMID- 3275664 TI - Insulin stimulates incorporation of 32Pi into nuclear lamins A and C in quiescent BHK-21 cells. AB - The in vivo effect of insulin upon the incorporation of 32Pi into nuclear proteins was investigated in quiescent baby hamster kidney fibroblasts (BHK-21). Insulin has previously been shown to be mitogenic in these cells (Richman, R. A., Johnson, R. A., and Friedman, D. L. (1981) Proc. Soc. Exp. Biol. Med. 168, 196 203). Incorporation into two proteins (Mr = 62,000 and 72,000) in the 0.4 M salt resistant nuclear fraction was enhanced 2-6-fold by insulin. The effect of insulin (20 nM) was observable within 5 min of treatment, reached a maximum at 15 min, and continued for at least 90 min. The half-maximal effect of insulin was obtained at a concentration of approximately 1 nM. Analysis of nuclear matrix preparations indicated that the two insulin-sensitive proteins were prominent nuclear matrix proteins and suggested that they were lamins A and C. This was confirmed by immunostaining with lamin antibodies and by two-dimensional electrophoresis. These studies indicate that insulin rapidly stimulates the incorporation of phosphate into nuclear lamins A and C in quiescent BHK-21 fibroblasts. PMID- 3275665 TI - Recombinant human parathyroid hormone synthesized in Escherichia coli. Purification and characterization. AB - Recombinant human parathyroid hormone (hPTH) was expressed in Escherichia coli harboring a plasmid containing a synthetic human parathyroid hormone gene under the control of the E. coli lac promoter. Three major forms of the hormone were isolated by acid extraction and purified to homogeneity by high performance liquid chromatography. By amino acid analysis and NH2-terminal sequencing, these were identified as hPTH-(1-84), formyl-methionyl-hPTH-(1-84), and hPTH-(8-84). The recombinant hPTH-(1-84) was immunologically indistinguishable from a World Health Organization standard of extracted native hPTH-(1-84). Recombinant hPTH-(1 84) was also bioactive in renal and skeletal adenylate cyclase assays. In the skeletal bioassay performed in UMR 108 osteosarcoma cells its activity was identical to that of an hPTH-(1-84) standard. In this bioassay, formyl-methionyl hPTH-(1-84) had 10% of the activity of hPTH-(1-84) and hPTH-(8-84) was inactive. The results demonstrate the importance of isolating hPTH-(1-84) from other recombinant forms and metabolites to achieve full hormonal bioactivity and indicate that purified recombinant hPTH-(1-84) can thereby be obtained which should be a useful source of hormone for both basic and clinical studies. PMID- 3275666 TI - Cells transformed by adenovirus type 12 but not by type 5 are dependent on insulin or insulin-like growth factor I for their proliferation. AB - We have investigated the responsiveness to growth factors (GFs) of primary baby rat kidney (BRK) cells transformed by the E1 region of adenovirus 5 or 12. The in vitro growth of non-oncogenic adenovirus 5-transformed BRK cells is largely independent of serum GFs, whereas growth of highly oncogenic adenovirus 12 transformed cells is strictly dependent on GFs present in serum. For the growth of adenovirus 12 E1-transformed BRK cells serum can be replaced by insulin or insulin-like growth factor-I but not by epidermal growth factor. To maintain the in vitro growth of adenovirus 12-transformed cells physiological levels of insulin-like growth factor-I, but not of insulin, are sufficient. Similar results have been found with adenovirus-transformed primary murine cells and with transformants of an established rat cell line, NRK 49F. This indicates that the observed GF responsiveness is not dependent of the cell type used but is determined by the serotype of the adenovirus-transforming region. Using hybrid E1 regions consisting of E1A of one serotype and E1B of the other, we show that the pattern of GF-responsiveness correlates with the origin of the E1A region. The differences in the GF-responsiveness of the adenovirus 5-transformed and adenovirus 12-transformed cells will be discussed in terms of the oncogenicity of these cells. PMID- 3275667 TI - 3' processing of tRNA precursors in ribonuclease-deficient Escherichia coli. Development and characterization of an in vitro processing system and evidence for a phosphate requirement. AB - In order to determine the mechanism and enzyme(s) responsible for 3' processing of tRNA precursors, we have developed an in vitro processing system that uses as substrates two SP6 RNA polymerase-generated transcripts of the gene for tRNA(Tyrsu3)+ that contain 49 extra 5'-nucleotides and either 5 or 25 extra 3' nucleotides. A high speed supernatant fraction from an Escherichia coli strain deficient in five ribonucleases was found to accurately process both tRNA precursors in this system to the size of mature tRNA(Tyr). Final 3' end processing of each precursor occurs in an exonucleolytic manner to generate the correct 3' terminus; however, a prior endonucleolytic cleavage also is observed in processing of the longer precursor. The system requires Mg2+ and works optimally at about 50 mM KCl and pH 8-9. Dialysis of the supernatant fraction leads to loss of processing activity but can be restored to normal by the addition of inorganic phosphate or arsenate. Furthermore, nucleoside diphosphates are a product of the processing reaction. These data indicate that 3' processing in RNase-deficient extracts involves a phosphorolytic reaction. On the other hand, phosphate is not required for processing in RNase+ extracts, although it does aid in processing of the longer precursor. The usefulness of this in vitro system for studies of tRNA processing and the identity of the phosphate-requiring enzyme are discussed. PMID- 3275668 TI - Autoregulation of the yeast copper metallothionein gene depends on metal binding. AB - The yeast CUP1 gene product, copper metallothionein, acts to repress the basal transcription of its own structural gene. By creating a series of truncation and amino acid substitutions in CUP1, we show that the ability of the protein to autoregulate is directly correlated to its ability to bind and detoxify copper. These results support a model in which metallothionein controls the level of free intracellular copper available to interact with positive transcription factors. In addition, mutations in chemically equivalent cysteine residues were functionally dissimilar, suggesting that partial sites in the molecule are critical for the formation of the sulfur-metal cluster. PMID- 3275669 TI - Skeletal amyloidosis due to beta microglobulinemia in a patient on hemodialysis. A case report. PMID- 3275670 TI - Total sacrectomy and reconstruction for primary tumors. Report of two cases. PMID- 3275671 TI - Restoration of functional control by electrical stimulation in the upper extremity of the quadriplegic patient. PMID- 3275672 TI - Spondylolysis and spondylolisthesis. Treatment by internal fixation and bone grafting of the defect. AB - Eighteen patients who had symptomatic spondylolysis or Grade-I spondylolisthesis, and whose symptoms had not been relieved by non-operative treatment, were operated on using the Buck method for bone-grafting and internal fixation of the defect of the pars interarticularis with screws. There were six male and twelve female patients and the average age was twenty years (range, fourteen to thirty eight years). The amount of slipping ranged from zero to ten millimeters. After an average period of follow-up of forty-one months (range, twenty-four to seventy two months), the result was excellent in ten, good in five, and poor in three patients. Thus, a satisfactory result was obtained in 83 per cent of the patients. PMID- 3275673 TI - Dihydroergotamine/heparin in the prevention of deep-vein thrombosis after total hip replacement. A controlled, prospective, randomized multicenter trial. AB - In a randomized, double-blind, placebo-controlled multicenter trial, the efficacy and safety of dihydroergotamine mesylate/heparin sodium as a prophylactic agent for deep-vein thrombosis were evaluated in 148 patients who were forty years old or more and who underwent total hip replacement. The incidence of venographically proved postoperative deep-vein thrombosis was 52 per cent in the placebo group and 25 per cent in the dihydroergotamine mesylate/heparin sodium group (p = 0.002). Proximal thrombi developed in only 5 per cent and extensive thrombi, in only 10 per cent of the patients who received dihydroergotamine mesylate/heparin sodium. In contrast, proximal thrombi and extensive thrombi developed in 19 and 25 per cent, respectively, of the patients in the placebo group (p less than 0.05). Adverse reactions in the two groups did not differ significantly: in the treatment group they consisted primarily of hematoma at the site of injection (9 per cent), hematoma at the wound (5 per cent), and excessive postoperative bleeding, and in the placebo group there was hematoma at the site of injection (3 per cent). It was concluded that the combination agent dihydroergotamine mesylate/heparin sodium was effective and safe prophylaxis against deep-vein thrombosis for the patients who underwent total hip replacement in this study. PMID- 3275674 TI - Failed arthrodesis of the spine for severe spondylolisthesis. Salvage by interbody arthrodesis. AB - Four patients who had had grade-III or grade-IV symptomatic spondylolisthesis and a failed posterior or posterolateral arthrodesis were treated with transperitoneal anterior lumbosacral interbody arthrodesis and fixation with a fibular graft; the procedure was sometimes followed by posterolateral arthrodesis of the spine. The patients were examined ten to twenty-two years after the salvage operation. At follow-up, all had a solid fusion of the fifth lumbar to the first sacral vertebra. No neurological deficits had worsened and no iatrogenic neurological deficits had developed. The slip angle had improved by an average of 23.2 degrees (range, 12 to 35 degrees). PMID- 3275675 TI - Replantation of an autoclaved autogenous segment of bone for treatment of chondrosarcoma. Long-term follow up. AB - Seven patients who had a low-grade chondrosarcoma of the proximal part of the humerus or femur were treated by resection, autoclaving of the excised segment, and reinsertion of that segment with supplementary fresh autogenous grafts. The length of follow-up ranged from fourteen to twenty-four years, and sequential roentgenograms were made during the follow-up period. A biopsy of the autoclaved segments was done in one patient eleven years after the operation, and examination of the specimen showed predominantly live bone; there were very few spicules of dead bone. Although the principal roentgenographic changes were demonstrated by the end of the first year, serial roentgenograms showed a continuing process of remodeling for two decades. No secondary procedures were required for treatment of fracture, resorption, infection, or loss of function. PMID- 3275676 TI - Non-union of fractures of the distal end of the humerus. AB - The records of twenty patients who had been treated for a non-union of the distal end of the humerus at the Massachusetts General Hospital from 1968 to 1984 were reviewed. Thirteen of the fractures were extra-articular and seven were intra articular. Seven fractures had been open and nine had been associated with multiple trauma. Eight had been initially treated by open reduction and internal fixation; five, by closed reduction and immobilization; four, by skeletal traction; two, by external fixation; and one, by debridement and immobilization. The average time from the original fracture to the treatment of the non-union was twenty months (range, three to 120 months). All but one patient had pain and instability, and fifteen (75 per cent) had limited motion of the elbow. Radiographically, eleven were considered to have a reactive non-union and nine, a non-reactive non-union. Seventeen (94 per cent) of the eighteen non-unions ultimately united. Two patients underwent excision of the distal end of the humerus and replacement with an allograft. At follow-up (average, 3.6 years), function in one patient was rated as excellent; in six, as good; in seven, as fair; and in six, as poor. The patients who had an extra-articular supracondylar non-union had the best over-all results, while those who had a non-union that was associated with an intra-articular component or severe soft-tissue trauma did less well. It should be emphasized, however, that most of the patients in this study continued to have a major long-term disability, despite the fact that union was successful. PMID- 3275677 TI - Mitogenic stimulation of human breast cancer cells in a growth factor-defined medium: synergistic action of insulin and estrogen. AB - The cooperative action of 17 beta-estradiol (E2) and polypeptide growth factors in stimulating proliferation of human breast cancer cells in vitro was investigated. To prevent background estrogenic stimulation, only phenol red-free media were used. When cultured in media supplemented with steroid-stripped serum in which all polypeptide growth factor activity had been chemically inactivated, MCF7 cells were unable to proliferate and became virtually quiescent. In the additional presence of insulin, epidermal growth factor (EGF), and E2, however, cells proliferated as rapidly as did cells cultured in media supplemented with fetal calf serum. Analysis by DNA flow cytometry showed that in the absence of external growth factors, MCF7 cells became arrested predominantly in the G1/G0 phase of the cell cycle. Upon addition of insulin in combination with EGF and E2, however, cells reentered the cell cycle with a high degree of synchrony. When added alone, E2 induced only slight mitogenic effects under these growth factor defined conditions. In contrast, this steroid induced optimal proliferation in conventional steroid-stripped serum, which in itself contained considerable mitogenic activity. Insulin (at 10 micrograms/ml) was the most potent stimulator of MCF7 cell proliferation under growth factor-defined conditions, resulting in a more than sixfold increase in cell number after 96 hours. Other growth factors such as platelet-derived growth factor (PDGF), transforming growth factor beta (TGF beta), and EGF had little effect by themselves and only slightly influenced insulin-induced proliferation. At suboptimal concentrations of insulin (10-100 ng/ml), however, strong synergism was observed between E2 and insulin in inducing MCF7 proliferation. Using the CG5 cell line, a highly E2-sensitive MCF7 variant, synergism with E2 was already observed at 1 ng/ml insulin. It is concluded that MCF7 cells require insulin (or insulin-like growth factors) for proliferation. At suboptimal insulin concentrations, E2 acts synergistically with insulin, possibly by inducing autocrine production of polypeptide growth factors by these cells. PMID- 3275678 TI - Preadipocyte differentiation in vitro: identification of a highly active adipogenic agent. AB - A highly active adipogenic agent was identified in an in vitro adipose conversion system. This agent, ADD 4743 (or ADD), was synthesized by Takeda Chemical Industries (Osaka) as a 3-hydroxy derivative of an oral antidiabetic agent, ciglitazone, and has been presumed to be an active metabolite of the latter substance. When ST 13 mouse preadipose cells were treated with micromolar concentrations of ADD they rapidly and uniformly converted into lipid accumulating adipocytelike cells within 8-11 days after cell seeding. The degree of adipose conversion and lipid accumulation induced by ADD far exceeded those of the previously known inducing agents such as indomethacin plus insulin. The highly potent adipogenic activity of ADD was confirmed with two other preadipose cell lines (3T3 L1 and RMT rat preadipose cells). In addition to adipogenic activity, ADD inhibited cell proliferation of preadipose cells specifically. Activity of ADD induced lipid accumulation and growth inhibition of ST 13 cells, exhibiting very similar dose-response relationships. Cell proliferation or triacylglycerol content of nonadipocytic mesenchymal cells or epithelial cells were not affected by ADD. These observations strongly suggest that ADD-induced growth inhibition is not due to the nonspecific toxicity of the drug but is tightly associated with the adipocytic character of the treated cells. The present observation provides evidence that ADD would be a powerful agent in studies that involve preadipocyte differentiation. PMID- 3275679 TI - Stimulation of DNA replication by growth factor and hormones in Swiss 3T3 cells: comparison of the rate of entry into S phase with in vitro DNA synthesis and DNA polymerase alpha activity. AB - An approach to the investigation how growth factors and hormones regulate mammalian cell proliferation is to study the activity of enzymes involved in DNA replication. Quiescent cultures of Swiss mouse 3T3 cells were stimulated with prostaglandin F2 alpha, insulin, and/or hydrocortisone for a time at which less than 50% of the cells had initiated DNA synthesis. Such cells were lysed with a Ca++-containing hypotonic buffer and incubated with a nucleotide mixture including [3H]thymidine-triphosphate for 1 hr at 37 degrees C. The amount of radioactive label incorporated into the trichloroacetic acid (TCA)-precipitate and the percentage of labeled nuclei correlated with the in vivo stimulation. Analysis of radioactively and density-labeled DNA in sucrose and CsC gradients indicated that the incorporation of label reflected semiconservative replication. DNA polymerase activities were assayed in supernatants from whole-cell lysates prepared with a hypotonic buffer not containing Ca++. Using various templates, it was shown that the increase in activity of DNA polymerase alpha correlated with the percentage of cells in S phase upon the different stimulation, while DNA polymerase beta activity after various times of stimulation showed that this activity increased only when cells began to enter S phase, regardless of the combination of growth factor and hormones. PMID- 3275680 TI - Fibroblast-dependent growth of mouse mast cells in vitro: duplication of mast cell depletion in mutant mice of W/Wv genotype. AB - In spite of the apparent depletion of mast cells in tissues of mutant mice of W/Wv genotype, cells with many features of mast cells do develop when bone marrow cells of W/Wv mice are cultured in the presence of pokeweed mitogen-stimulated spleen cell-conditioned medium (PWM-SCM). In order to resolve this discrepancy and facilitate the analysis of the W mutation, we attempted to establish an in vitro system in which the in vivo defect of W/Wv mice can be reproduced. Cultured mast cells (CMC) were developed from bone marrow cells of either W/Wv or congenic +/+ mice, and then co-cultured with NIH/3T3 mouse fibroblasts in media supplemented only with fetal calf serum (i.e., in the absence of PWM-SCM). Under this condition, CMC from +/+ mice continued to divide and were maintained for more than 4 weeks. The supportive effect of NIH/3T3 cells required close-range interactions with CMC and was not due to synthesis of the known mast cell growth factors, interleukins 3 and 4. By contrast, CMC from W/Wv mice were not maintained, and the number of mast cells remaining after 4 weeks of co-culture was only 1% of the normal +/+ counterparts. Thus, the humoral factor-independent and cell contact-dependent system presented here revealed the intrinsic defects in growth and differentiation of CMC derived from W/Wv mice and might be useful for biochemical and molecular analysis of the gene product(s) encoded at the W locus. PMID- 3275681 TI - Rheumatologic causes of pain: rheumatoid arthritis. PMID- 3275682 TI - The relationship of cardiac diastolic dysfunction to concurrent hormonal and metabolic status in type I diabetes mellitus. AB - The presence of diabetic cardiomyopathy and its relationship to concurrent hormonal and metabolic status have not been defined in patients with uncomplicated type I diabetes mellitus. Accordingly, radionuclide left ventricular angiograms and simultaneous metabolic profiles were obtained in 8 type I diabetic patients who had no major diabetic complications and in 11 normal subjects. Occult coronary artery disease was excluded by electrocardiogram exercise testing. Hemodynamics and systolic function did not differ between the groups. However, the peak filling rate (PFR; end-diastolic volumes per s) was less in the diabetic patients at rest [mean, 4.1 +/- 0.2 (+/- SE) vs. 4.8 +/- 0.2; P less than 0.05] and during aerobic (6.8 +/- 0.2 vs. 8.30 +/- 0.3; P less than 0.01) and anaerobic exercise (8.8 +/- 0.3 vs. 9.8 +/- 0.4; P less than 0.05). The time to PFR was prolonged in the diabetic patients at rest (174 +/- 10 vs. 133 +/- 7 ms; P less than 0.01) and during anaerobic exercise (126 +/- 5 vs. 103 +/- 6 ms; P less than 0.01). Plasma glucose and insulin levels were elevated in the diabetic patients at rest and during exercise. Otherwise, the metabolic and hormonal levels did not differ between the groups. In the diabetic patients, no single metabolic or hormonal parameter correlated with PFR or time to PFR. Impairment of diastolic filling also did not correlate with level of glycosylated hemoglobin or duration of diabetes. The alteration in diastolic filling present in type I diabetic patients who have no other diabetic complications may represent the earliest functional effect of diabetic cardiomyopathy. PMID- 3275683 TI - Reverse phase high performance liquid chromatographic analysis of circulating insulin in the insulin autoimmune syndrome. AB - Some patients with the insulin autoimmune syndrome have circulating insulin that is heterogeneous. We used reverse phase high performance liquid chromatographic analysis to identify the forms of plasma insulin in patients with this syndrome and compared the results with those in patients with insulin-treated diabetes and patients with hyperinsulinism. Under acidic conditions, free insulin dissociated from insulin antibodies eluted from Bio-Gel P-30 columns as a single peak. When such insulin fractions were applied to reverse phase high performance liquid chromatography, a major insulin peak emerged with the same retention time as standard human insulin in all six patients with the syndrome. In addition, a minor insulin peak was consistently found at relatively high acetonitrile concentrations. However, this hydrophobic insulin also was found in two of four insulin-treated diabetic patients and in one of two hyperinsulinemic patients who did not have insulin antibodies. Preliminary characterization of the variant insulin revealed that it has a molecular size between those of proinsulin and insulin and retains the immunoreactivity of insulin, but not C-peptide. It may be an aggregate of insulin molecule or proinsulin intermediates. Since the variant insulin was not found only in patients with the insulin autoimmune syndrome, it seems unlikely that an altered endogenously produced insulin induces the generation of autoantibodies to insulin in this syndrome. PMID- 3275684 TI - Prolactin-lowering effect of acute and once weekly repetitive oral administration of cabergoline at two dose levels in hyperprolactinemic patients. AB - To further evaluate the potency and time course of the PRL-lowering effect of single oral doses of cabergoline, two doses of the drug were given to 51 hyperprolactinemic patients who also received 2.5 mg bromocriptine according to a randomized cross-over design. One group (n = 26) received 0.3 mg, and the other (n = 25) received 0.6 mg. Both cabergoline doses induced a significant fall in serum PRL levels, which lasted, on the average, from 3 h to 5 days after 0.3 mg and from 3 h to 14 days after 0.6 mg; the mean maximum decrease after 0.3 mg was 65 +/-4% (+/- SEM), significantly (P less than 0.05) less than that after bromocriptine (group mean, -73 +/- 4%), and it was -76 +/- 3% after 0.6 mg, not significantly different from that induced by bromocriptine (group mean, -71 +/- 4%). The effect of 0.6 mg cabergoline was significantly greater than that of 0.3 mg (P less than 0.01). In a second study designed to evaluate the possible therapeutic use of the new drug, 0.3 or 0.6 mg cabergoline was administered orally once weekly for 9 weeks to 2 groups of 15 and 16 hyperprolactinemic patients, respectively. Serum PRL levels fell significantly by the first week and reached a plateau after 2 doses in the 0.6 mg cabergoline-treated group and after 5 doses in the 0.3 mg-treated group; the absolute PRL decrease was greater in the former. Ten patients in each group achieved normal serum PRL levels, and a marked decrease (greater than 50% of pretreatment values) occurred in all patients treated with 0.6 mg and in 13 treated with 0.3 mg weekly. Resumption of menses occurred during the treatment period in 15 of the 17 premenopausal women with amenorrhea. Six patients who had poor responses had better responses when given higher drug doses for 4 weeks, and serum PRL levels became normal in the 3 receiving 0.6 mg twice weekly. These data confirm that cabergoline is a long acting oral dopaminergic drug and suggest that it may be a useful agent for the treatment of patients with hyperprolactinemia. PMID- 3275685 TI - Detection of a potential progenitor cell in the human fetal pituitary that secretes both growth hormone and prolactin. AB - The structural similarities between human PRL (hPRL) and human GH (hGH) suggest a common evolutionary origin of the two hormones. The existence of these similarities also suggests the existence of a developmental intermediate cell type which has the potential to produce and secrete both hPRL and hGH. We have applied reverse hemolytic plaque assays to monitor the secretions of individual fetal human pituitary cells to determine if any of these cells secrete both hPRL and hGH. When hPRL and hGH assays were performed sequentially on cells obtained from five fetuses of 18-22 weeks gestational age, we consistently found a subpopulation of cells that formed plaques in both assays, i.e. they secreted both hPRL and hGH. The majority of fetal cells secreting hPRL also secreted hGH at this stage of development. These data were corroborated with light and electron microscopic immunocytochemical localization of hPRL and hGH in a subpopulation of previously identified fetal somatotrophs. These findings suggest that in addition to the classical somatotrophs and lactotrophs, the fetal human pituitary contains an additional cell type which secretes both hPRL and hGH. The dual hormone-secreting cell may represent a common progenitor of these classical cell types. It also may be the cell of origin of those pituitary tumors that secrete both PRL and GH. PMID- 3275686 TI - In memoriam J.S.L. Browne, M.D., Ph.D. PMID- 3275688 TI - International Neuropsychological Society. Directory. PMID- 3275687 TI - Brain damage is a family affair. AB - Behavioral alterations due to brain damage that compromise the quality of patients' lives also affect the well-being of patients' families. Family distress following head injury has been well-documented. With other cerebral disorders, similar emotional burdens and family disruptions are experienced by the immediate family. Most families suffer many of the core problems arising from the patient's dependency and cognitive inefficiency, and from social reactions to the patient's disability. Moreover, emotional disturbances and executive disorders associated with the site or nature of the lesion(s) affect patients' interaction with their families differentially creating distinctive patterns of family burden. Specific family problems may be relieved through education, counselling, and emotional support. PMID- 3275689 TI - Ultrasound examination in the diagnosis of congenital hip dysplasia of newborns. AB - Ultrasonic examination is an established technique for the diagnosis of congenital hip dysplasia. The procedure is outlined and results of screening examinations of 2,000 newborn hips according to the classification of Graf are presented. A differentiated diagnostic-therapeutic concept is available for each sonographic hip type. Social and economic advantages call for an ultrasonic screening examination of newborn hips worldwide. PMID- 3275690 TI - Current techniques of limb lengthening. AB - Limb lengthening is still a major procedure with potentially serious complications. It does not, however, deserve the reputation it gained over the last few years. With a proper understanding of the biology, biomechanics, and strategies of lengthening, excellent results can be consistently obtained with relatively few complications. PMID- 3275691 TI - Choosing cases and controls: the clinical epidemiology of "clinical investigation". PMID- 3275692 TI - Heterogeneity of beta-type myosin isozymes in the human heart and regulational mechanisms in their expression. Immunohistochemical study using monoclonal antibodies. AB - To investigate the existence of heterogeneity of beta-type myosin isozymes (HC beta) in human hearts, immunohistochemical studies using monoclonal antibodies (MoAbs) raised against human ventricular myosin heavy chains were performed. Two types of MoAbs recognized some muscle fibers in the atrium, whereas both reacted with all ventricular muscle fibers. Since atrial muscle fibers reactive with each MoAb were found to be clearly different, the existence of two immunologically distinct HC beta (beta 1, and beta 2) was suggested in the atrium. By using affinity chromatography, two molecular variants of HC beta were isolated from the bovine atrium, and differences in the primary structure of beta 1 and beta 2 were confirmed by analysis of peptides produced by chymotryptic digestion. In pressure overloaded human atria, myofibers containing beta 1 and/or beta 2 increased in accordance with decrement of myofibers containing alpha-type myosin isozyme (P less than 0.01). But they differed in expression during the developmental stage, since beta 2 did not exist in the early embryonic bovine heart, but beta 1 did. Thus, there are two distinct HC beta whose expression is regulated by at least two factors: pressure overload and developmental stage. PMID- 3275693 TI - Effects of aging on insulin synthesis and secretion. Differential effects on preproinsulin messenger RNA levels, proinsulin biosynthesis, and secretion of newly made and preformed insulin in the rat. AB - Aging in men and rodents is associated with a marked decline in glucose stimulated insulin secretion by pancreatic beta cells (B cells). Secreted insulin is the end result of a series of steps along the biosynthetic protein-secretion pathway, including insulin gene transcription, processing of transcripts to preproinsulin mRNA, translation of mRNA, segregation and processing of newly made proinsulin in secretory vesicles, proinsulin to insulin conversion, transport of vesicles to the plasma membrane, and exocytosis. We have examined the influence of age at three stages along this pathway: preproinsulin mRNA levels, proinsulin synthesis, and secretion of newly made and preformed insulin, using Fischer rats, a widely studied rodent model of aging. Pancreatic weights and total insulin contents, islet sizes, and mean insulin content per islet were the same in young adult (4-5 mo) and senescent (21-22 mo) animals. There was no effect of age on preproinsulin mRNA levels in whole pancreata of fed animals, or in isolated islets cultured for 16 h in 5.5 mM glucose. Proinsulin biosynthesis and the secretion of newly made insulin were compared in isolated islets preincubated in 5.5 mM glucose. After a pulse label at 16.7 mM glucose, proinsulin synthesis, assayed by immunoprecipitation, was decreased 16% in 7 mo islets and 39% in 21-22 mo islets, compared with 4-5 mo islets, though total protein synthesis was not reduced. When chased at 2.8 mM glucose, 4-5 month and 21-22 mo islets showed no difference in release of preformed or newly made insulin. When chased at 16.7 mM glucose, there was a significant decrease in the secretion of newly made insulin in the old islets compared with the young islets. There was preferential release of newly made insulin over preformed insulin in both young and old islets. However, since secretion of preformed insulin was decreased much more than secretion of newly made insulin in senescent islets, these displayed a two- to threefold increase in the proportion of newly made insulin relative to total immunoreactive insulin released compared with young adult islets. The differential effects of aging on these steps in the insulin synthesis-secretion pathway may be due to varying impairments in signals transducing the glucose stimulus into the wide range of B cell responses to glucose. PMID- 3275695 TI - CT detection of sacral osteomyelitis associated with pelvic abscesses. AB - In three patients the diagnosis of sacral osteomyelitis was made when CT demonstrated intraosseous (two) and intraforaminal (one) gas. Two of the three patients also had radionuclide bone scans, one of which was unremarkable. In the other case, radionuclide scintigraphy greatly underestimated the extent of the disease process when compared with CT. All three patients had contiguous pelvic abscesses as a cause of the osteomyelitis. Although there was a high clinical suspicion for an intraabdominal process, the diagnosis of superimposed osteomyelitis of the sacrum was unsuspected. The detection of intraosseous gas is a pathognomonic, albeit uncommon, manifestation of osteomyelitis. Although the radionuclide bone scan is the method of choice for detecting osteomyelitis, CT should be used as a complementary study in certain patients. PMID- 3275694 TI - Functional response of healthy and diseased glomeruli to a large, protein-rich meal. AB - Differential solute clearances and hormone assays were used to characterize the effect of a large, protein-rich meal (1.5 g/kg) on glomerular function in 12 healthy volunteers (group I) and 12 patients with chronic glomerular disease (group II). Changes from baseline during 3 h after the meal included an elevation of plasma osmolality, progressive urinary concentration, and increasingly positive fluid balance. Plasma renin activity and arginine vasopressin levels (measured in group II only) increased significantly. Nevertheless, the rate of peak postmeal renal plasma flow became elevated by 13 and 33% in groups I and II, respectively. Corresponding peak increases in postmeal glomerular filtration rate exceeded baseline by 10 and 16%. In the proteinuric subjects of group II the fractional clearances of albumin, IgG and uncharged dextrans in the radius interval 36-54 A, declined significantly after the meal. A similar depression of the fractional dextran-clearance profile was observed also in group I. Applying the fractional clearances of relatively permeant dextrans (radii less than or equal to 44 A) to a model of hindered solute transport through an isoporous membrane, we estimate that transmembrane hydraulic pressure difference increased by 12% in group I and by between 0 to 12% in group II after protein ingestion. We conclude (i) that oral protein ingestion increases glomerular ultrafiltration pressure and rate in both normal and diseased glomeruli, (ii) that this hemodynamic response may be mediated in part by the glomerulopressor hormones angiotensin II and arginine vasopressin, and (iii) that the foregoing hemodynamic changes exert no acute adverse effect on glomerular barrier size-selectivity. PMID- 3275696 TI - Improvement of cerebral CT abnormalities following liver transplantation in a patient with Wilson disease. AB - Cerebral CT performed in patients with Wilson disease (hepatolenticular degeneration) often reveals abnormalities of the putamen, globus pallidus, thalamocapsular region, cerebral cortex, dentate nucleus, and brain stem. We report a patient with Wilson disease who demonstrated rapid reversal of CT abnormalities following orthotopic liver transplantation. PMID- 3275697 TI - Quantitation of intracardiac shunts by cine-CT. AB - Quantitation of intracardiac shunts is important in the evaluation of congenital heart disease and ventricular septal defects postmyocardial infarction. Shunt detection and quantitation is currently performed by either oximetry or radionuclide angiography. Oximetry is an invasive technique and radionuclide angiography, although noninvasive, does not have sufficient spatial resolution to provide detailed anatomic information. The present study evaluated a new technique for quantitating right-to-left shunts by analysis of indicator dilution curves acquired noninvasively using cine-CT. This technique was evaluated in a phantom and in postoperative dogs with a surgically created variable shunt. The phantom model demonstrated the accuracy and reproducibility of the curve analysis algorithm, and the canine model permitted the comparison of oximetry with cine-CT for shunt quantitation. Cine-CT accurately estimated right-to-left shunt fraction when compared with oximetry (r = 0.91) and is more sensitive than oximetry in detecting small shunts. The results of this study suggest that contrast enhanced cine-CT provides a precise noninvasive technique for measuring shunt lesions in congenital and acquired heart diseases. PMID- 3275698 TI - Right adrenal gland hemorrhage as a complication of liver transplantation: CT appearance. AB - Three patients presented with right adrenal gland hemorrhage as a complication of orthotopic liver transplantation. The CT appearance, possible pathophysiologic mechanism, and significance of this finding are discussed. PMID- 3275700 TI - The Castroviejo needle holder. PMID- 3275699 TI - Essentials of Mohs micrographic surgery. PMID- 3275701 TI - Electrosurgery principles: cutting current and cutaneous surgery--Part I. AB - Cutting current is a valuable tool in the office surgical practice due to its speed, efficiency, and economy. Most electrosurgical generators produce a blended wave form that coagulates the tissue as it is cut. Care should be taken to see that the patient is adequately grounded with a dispersive electrode to prevent cutaneous burns. The cutting of the tissue should be brisk and with the smallest electrode and power setting possible. By using careful electrosurgical technique, the surgeon can produce an incised wound that heals as well as one created by cold steel excision. PMID- 3275702 TI - Anesthesia for dermatologic surgery. AB - The increased scope and complexity of dermatologic surgery has led to a need for greater skill in the preoperative administration of local and regional anesthesia. This article reviews the mechanism of action of local anesthetic agents, their pharmacologic properties and adverse reactions, and describes accepted techniques for safely and effectively establishing local and regional anesthesia for skin surgery. The presentation is limited to those techniques of greatest use to the office practitioner. PMID- 3275703 TI - Dilated cardiomyopathy in infants and children. AB - The outcome of medical treatment of dilated cardiomyopathy in infants and children was reviewed to develop a predictive index for selection of patients likely to benefit from cardiac transplantation. The clinical findings, laboratory investigations, treatment and outcome of 20 patients (Group 1) less than 2 years of age at presentation and 12 patients (Group 2) greater than 2 years of age at onset were compared. Of 20 Group 1 patients, 5 (25%) died. Available autopsies (four patients) showed endocardial fibroelastosis. Of 15 survivors, 10 showed improvement in cardiac status and 5 remained unchanged. Ninety-three percent of survivors had dilated cardiomyopathy consistent with endocardial fibroelastosis by angiocardiography. All 12 Group 2 patients died. In addition to age at presentation and poor outcome, Group 2 differed from Group 1 in having a higher incidence of other family members with cardiomyopathy, more significant rhythm disturbances at presentation and a more rapid course to death. Risk factors of poor outcome in both groups included persistent cardiomegaly and the development of significant arrhythmias by Holter electrocardiographic monitoring. Cardiac transplantation is recommended for children with dilated cardiomyopathy presenting after age 2 years who survive 1 month. Those patients less than 2 years old at presentation whose condition has not improved after 1 year and who have persistent cardiomegaly or complex ventricular arrhythmias may also benefit from transplantation. PMID- 3275704 TI - Dilated cardiomyopathy in children. PMID- 3275705 TI - William Likoff: in memoriam. PMID- 3275706 TI - Selection and outcome of patients referred for cardiac transplantation. PMID- 3275707 TI - Densitometric regional ejection fraction: a new three-dimensional index of regional left ventricular function--comparison with geometric methods. AB - Densitometric regional ejection fraction obtained by computer analysis of digital subtraction ventriculography was evaluated as a new, quantitative, three dimensional index of regional left ventricular performance. Eighteen patients with coronary artery disease and seven control subjects had right anterior oblique ventriculography at rest and immediately after rapid atrial pacing using central venous injection of contrast material. Regional left ventricular ejection fraction was determined by densitometry in six segments drawn around the end diastolic center of gravity, and compared with two conventional indexes of segmental wall motion: area and radial regional ejection fraction. Densitometric, area or radial regional ejection fraction was classified as abnormal if it fell at least 2 standard deviations below the corresponding mean value in the normal group. The densitometric method did not require outlining of the end-systolic left ventricular silhouette and was the easiest and fastest to perform of all three techniques. In addition, intra- and interobserver reproducibilities were higher with the densitometric method (r = 0.97 and 0.95) than with either the area (r = 0.84 and 0.82) or the radial method (r = 0.82 and 0.76). Regional left ventricular dysfunction as assessed by the densitometric, area and radial techniques allowed the detection of coronary artery disease in 50, 50 and 44% of the patients at rest and in 83, 67 and 61% of the patients in the post-pacing period, respectively. Post-pacing regional left ventricular dysfunction accurately predicted the presence or absence of greater than 70% diameter stenosis in the supplying coronary artery in 75, 67 and 56% of the cases, respectively. Thus, densitometric analysis of digital subtraction ventriculography allows a fast and reproducible three-dimensional determination of regional left ventricular ejection fraction. Using this technique, pacing induced regional dysfunction can be detected in most patients with coronary artery disease and corresponds well with the location of significant coronary artery lesions. PMID- 3275708 TI - Cost containment and the elderly: conflict or challenge? PMID- 3275709 TI - A new decalcifying technique for immunohistochemical studies of calcified tissue, especially applicable to cell surface marker demonstration. AB - We have developed a new decalcifying technique for use in light and electron microscopy studies utilizing immunohistochemical staining of calcified tissues. Specimens containing calcified tissues can be adequately decalcified at a pH of 7.1-7.4 and temperature of -5 degrees C, without freezing, by use of a solution containing EDTA, sodium hydroxide, and glycerol. In this study, Leu-2a, Leu-3a, Leu-4, Leu-7, Leu-12, Leu-14, Leu-M1, Leu-M2, Leu-M3, and HLA-DR-positive cells in destructive lesions of bone tissues from patients with rheumatoid arthritis and osteomyelitis were successfully detected immunohistochemically. Furthermore, the presence of HLA-DR antigen on the surface of the infiltrating cells in the same lesions could be demonstrated using the immunoelectron microscopic technique. The results reported here have not previously been obtainable using conventional decalcifying techniques. PMID- 3275710 TI - Immunohistochemical antigen demonstration in plastic-embedded lymphoid tissue. AB - We describe a method for post-embedding immunohistochemical demonstration of a wide range of antigens in glycol methacrylate-embedded tissue. Rat spleen and thymus tissues were fixed by immersion in fixatives containing different concentrations of paraformaldehyde, washed in sucrose phosphate buffer, dehydrated in acetone, infiltrated in a glycol methacrylate mixture in which the commonly used softener 2-butoxyethanol was replaced by butaandiol monoacrylate, and embedded. Trypsin was used to re-expose the masked antigenicity. Excellent results were obtained with a panel of monoclonal antibodies (MoAbs) directed against T-cells, B-cells, Ia-positive cells, macrophages, follicular dendritic cells, and leucocyte common antigen-bearing cells. The method described combines exact localization of antigens with optimal tissue morphology. PMID- 3275711 TI - Immunocytochemical localization of ornithine transcarbamylase in rat intestinal mucosa. Light and electron microscopic study. AB - We investigated light and electron microscopic localization of ornithine transcarbamylase (OTC) in rat intestinal mucosa. In the immunoblotting assay of OTC-related protein, a single protein band with a molecular weight of about 36,500 is observed in extracts of liver and small intestinal mucosa but is not observed in those of stomach and large intestine. For light microscopy, tissue slices of the digestive system were embedded in Epon and stained by using anti bovine OTC rabbit IgG and the immunoenzyme technique. For electron microscopy, slices of these and the liver tissues were embedded in Lowicryl K4M and stained by the protein A-gold technique. By light microscopy, the absorptive epithelial cells of duodenum, jejunum, and ileum stained positively for OTC, but stomach, large intestine, rectum, and propria mucosa of small intestine were not stained. Electron microscopy showed that gold particles representing the antigenic sites for OTC were confined to the mitochondrial matrix of hepatocytes and small intestinal epithelial cells. However, the enzyme was detected in mitochondria of neither liver endothelial cells, submucosal cells of small intestine, nor large intestinal epithelial cells. Labeling density of mitochondria in the absorptive epithelial cells of duodenum, jejunum, and ileum was about half of that in liver cells. PMID- 3275712 TI - Identification, cellular localization, isolation, and characterization of human Clara cell-specific 10 KD protein. AB - Human lung lavage proteins were fractionated by centrifugation and molecular sieving. An antiserum to the post-albumin fraction of the soluble proteins reacted with a 10 KD protein and this protein was isolated by conventional chromatography. The protein, which has a pI of 4.8, consists of two 5 KD polypeptides and is rich in glutamic acid, leucine, serine, and aspartic acid amino acids. The protein does not bind to concanavalin A, pancreatic elastase, leukocyte elastase, or trypsin, and lacks anti-protease activity. It constitutes about 0.15% of the soluble proteins in lung lavage. Antibodies to the 10 KD protein specifically and exclusively stain Clara cells in human, dog, and rat. Staining of granules of Clara cells was prominent in the distal bronchioles; however, the non-ciliated cells of respiratory bronchioles did not stain for the 10 KD protein. This 10 KD protein appears in fetal lungs at 21 weeks of gestation, and was present in about 10% of the primary pulmonary adenocarcinomas. As a specific marker for Clara cells, this protein could be useful in the study of development, regulation of secretion, and pathobiology of these cells. PMID- 3275713 TI - Localization of immunoreactive epidermal growth factor receptors in human nervous system. AB - Epidermal growth factor is a well-defined peptide which stimulates cell growth and elicits cell responses in a variety of tissues by binding to specific receptors, EGF-R. A specific antiserum against the EGF receptor, which has previously been used to characterize EGF-R in human skin, fibroblasts, and smooth muscle, was used to survey the distribution of EGF-R in human nervous system. Portions of formalin-fixed, paraffin-embedded autopsy specimens were examined by use of immunohistochemical staining (PAP technique) with EGF-R antiserum. Many types of nerve cells, e.g., cerebral cortical pyramidal cells, hippocampal pyramidal cells, Purkinje cells, anterior horn cells, and dorsal root ganglion neurons, contained immunoreactive EGF-R. However, immunoreactive EGF-R were not detected in astrocytes, oligodendrogliocytes, and other small neurons such as granule cells. Intense immunostaining for EGF-R was also detected in ependymal cells from choroidal and extrachoroidal locations. Although immunoreactive EGF-R is widely distributed in human nervous system, the functional role of EGF and its receptor in the nervous system remains unknown. PMID- 3275714 TI - Analysis of hepatocyte plasma membrane domains during rat development using monoclonal antibodies. AB - The plasma membrane of adult rat hepatocyte consists of three domains, which have been identified by the monoclonal antibodies A39 and A59 as markers of the sinusoidal domain, B1 of the lateral, and B10 of the canalicular domains (Eur J Cell Biol 39:122, 1985). These monoclonal antibodies were used to study, by indirect immunocytochemistry, formation of the hepatocyte plasma membrane domains during development, from day 15 of gestation to day 35 post partum. The antigens defined by A39, B1, and B10 were detected, from day 15, over the major part of the hepatocyte plasma membrane except for the membranes of newly formed bile canaliculi, which were not labeled by B1 and only poorly labeled, if at all, by A39 and B10. As soon as fetuses were 16 days old, B1 labeled predominantly the lateral domain, as in the adult. Labeling with B10 progressively intensified on the membranes of bile canaliculi, but localization was not exclusively canalicular until day 21 post partum. A39 intensely labeled the canalicular membranes at 19-21 days of gestation, while at 35 days post partum it exhibited the predominantly sinusoidal labeling observed in adult hepatocytes. The antigen defined by A59 was not detected before birth and was found exclusively on the sinusoidal domain, as in the adult. These results show that the patterns of antigen distribution on different plasma membrane domains establish themselves at different rates. The marked differences observed between fetal or neonatal and adult hepatocytes might be responsible for immaturity of liver functions in the neonate. PMID- 3275715 TI - Protease treatment combined with immunohistochemistry reveals heterogeneity of normal and neoplastic basement membranes. AB - Heterogeneity of normal tissue and neoplastic basement membranes was investigated immunohistochemically with monoclonal antibodies and polyclonal antisera to laminin and collagen type IV. Cryostat sections of normal and neoplastic human tissues were digested with bacterial protease or trypsin. The duration of digestion and the concentration of enzyme were varied to determine whether laminin and collagen type IV could be removed differentially from basement membranes from distinct anatomic sites. After digestion, the residual antigenicity of glycoprotein was assessed immunohistochemically. Laminin could be removed more easily from all tissues than could collagen IV, and also much more easily from malignant tumors than from benign tumors or normal tissues. On the basis of susceptibility to proteolytic digestion, basement membranes from normal human tissues were classified as susceptible (e.g., heart and smooth muscle of gastrointestinal tract and uterus), moderately resistant (e.g., nerve, skeletal muscle, epithelial basement membrane of skin, smooth muscle of arteries), and very resistant (e.g., glomerulus). Differential susceptibility to proteolytic digestion most likely reflects quantitative and possibly also qualitative differences in the composition of basement membranes. PMID- 3275717 TI - Both the Lyt-2+ and L3T4+ T cell subsets are required for the transfer of diabetes in nonobese diabetic mice. AB - The nonobese diabetic mouse is a model of spontaneous type I diabetes mellitus. It is possible to induce diabetes in young, irradiated nonobese diabetic mice by using adoptive transfer of splenocytes or splenic T cells obtained from diabetic donors. This study demonstrates that the induction of diabetes in the adoptive transfer system is dependent on both the L3T4+ and Lyt-2+ subsets of T cells. Neither of these T cell subsets alone mediates the development of severe insulitis or diabetes when adoptively transferred to young, irradiated recipients. In addition, we show that both the L3T4+ and Lyt-2+ subsets must be obtained from diabetic donors in order to transfer diabetes; neither subset can be replaced with cells obtained from young, nondiabetic donors. PMID- 3275716 TI - Synergistic interactions of interleukin 1, interferon-beta, and tumor necrosis factor in terminally differentiating a mouse myeloid leukemic cell line (M1). Evidence that interferon-beta is an autocrine differentiating factor. AB - The effect was investigated of combinations of cytokines known to be cytostatic for some tumor cells, namely interleukin 1 alpha (IL-1 alpha), interferon-beta (IFN-beta), and tumor necrosis factor (TNF), on the growth and differentiation of the mouse myeloid leukemic cell line, M1, cells. IL-1 alpha, IFN-beta, and TNF by themselves are antiproliferative for M1 cells. Treatment of cells with a mixture of any two of the three cytokines resulted in at least additive growth inhibition. None of these cytokines by themselves induced differentiation of M1 cells as assessed by increased expression of Fc receptors (FcR), stimulation of phagocytic activity and by morphologic criteria. However, as little as 1 U/ml IL 1 alpha in conjunction with IFN-beta or TNF increased FcR expression, phagocytic activity and morphologic changes in addition to inhibiting the growth of M1 cells. The combination of IFN-beta and TNF did not induce differentiation, although the growth of the cells was markedly inhibited. Both TNF and lipopolysaccharide (LPS) induced the in vitro production of IFN activity by M1 cells. Furthermore, the induction of differentiation of M1 cells by a combination of IL-1 alpha with either IFN-beta, TNF, or LPS was inhibited by antibody against mouse IFN-beta. Therefore, it appears that IFN-beta provides one of the two required signals for differentiation of M1 cells by these combinations of stimulants, the other being IL-1. Furthermore, the cytostatic effect of TNF by itself on M1 cells was also partly blocked by anti-IFN-beta antibody, suggesting that IFN-beta is also involved in the growth inhibitory effect of TNF for M1 cells. In contrast, the cytostatic effect of IL-1 on M1 cells was not blocked by anti-IFN-beta antibody. In conclusion, both the cytostatic and differentiative effect of TNF appear to be mediated by IFN-beta. Thus, the combination of IL-1 and IFN-beta or inducers of IFN-beta resulted in terminal differentiation of M1 cells. Northern blot analysis using cDNAs for murine IFN-beta1 or human IFN-beta2 showed an increased expression of mRNA for IFN-beta1 but not for IFN-beta2 by stimulation with TNF or LPS, strongly suggesting that IFN-beta 1 rather than IFN beta 2 is responsible for TNF or LPS effects. PMID- 3275718 TI - Expression of T cell antigen receptor genes in the thymus of irradiated mice after bone marrow transplantation. AB - Sequential appearance of the expression of T cell antigen receptor genes was investigated in the thymus of irradiated mice at the early stage after transplantation of Thy-1 congeneic H-2 compatible allogeneic bone marrow cells. The first cells to repopulate the thymus on day 7 after bone marrow transplantation were intrathymic radioresistant T cell precursors, which expanded mainly to CD4+CD8+ host-type thymocytes by day 14. A high level of gamma gene expression but a much reduced level of alpha and beta gene expression were detected in the host-type thymocytes on day 7. During regeneration of these cells, gamma-chain messages fell to low level and alpha and beta mRNA levels increased. The thymus of the recipients began to be repopulated by donor-derived T cells about 2 wk after bone marrow transplantation and was almost completely replaced by the third week. An ordered expression of gamma then beta and alpha chain gene transcript was also observed in the donor-type thymocytes at the early stage after bone marrow transplantation. The use of thymocytes at early stage in whole-body irradiated bone marrow chimera provides a pertinent source for investigating the molecular mechanism of T cell differentiation in adult thymus. PMID- 3275719 TI - Assessment in humans of a synthetic peptide-based vaccine against the sporozoite stage of the human malaria parasite, Plasmodium falciparum. AB - Eleven volunteers were injected with an anti-malaria (Plasmodium falciparum) sporozoite vaccine candidate consisting of a synthetic peptide, Ac-Cys-(NANP)3, coupled to tetanus toxoid (TT) and adsorbed to aluminum hydroxide. Two of the volunteers had no previously known exposure to TT. Eight volunteers made detectable antipeptide, anticircumsporozoite protein or antisporozoite antibodies, whose titers increased after multiple injections in four individuals. The maximum antisporozoite titer obtained in an immunofluorescence assay was 1280. In those individuals who produced antipeptide antibody, the overall correlation between IgG anti-Ac-Cys-(NANP)3 antibody in enzyme-linked immunosorbent assay and IgG antisporozoite reactivity in immunofluorescence was highly significant. However, the fine specificity of antibody varied among volunteers with two individuals producing mostly antipeptide antibody. Anti-TT antibody responses increased in all volunteers with the exception of that person who had the highest pretrial anti-TT titer; this individual was one of the two pre-TT-immunized volunteers who failed to produce anti-Ac-Cys-(NANP)3 or sporozoite antibody. For the two non-TT preimmunized volunteers, one produced an antisporozoite fluorescence titer of 320; the other made no detectable antibody against either Ac-Cys-(NANP)3 or sporozoites during a primary response. For the three volunteers monitored, after the first injection, significant T cell proliferative responses to (NANP)3 were observed, which increased up to 4 wk after immunization, when a second injection was given. Responsiveness then declined to background levels and did not reappear after further immunizations. In contrast, a marked TT-specific proliferation was observed for the duration of the study. PMID- 3275720 TI - Characterization and growth factor requirements of SJL lymphomas. I. Development of a B cell growth factor-dependent in vitro cell line, cRCS-X. AB - Reticulum cell sarcomas (RCS) of SJL mice are completely dependent on host cells for their growth and therefore fail to grow in vitro. RCS cells induce marked proliferation in SJL Ly-1+2- T cells accompanied by lymphokine production. In an attempt to fully understand the host-tumor cell interaction, an RCS cell line, cRCS-X, was established in vitro from a transplantable tumor by the addition, every 3 wk, of gamma-irradiated syngeneic lymph node (LN) cells to the culture. cRCS-X maintains all of the characteristics of the parent tumor, RCS-X, including cell surface phenotype (Ks and I-As positive, Ds negative and B cell marker 14.8 positive), ability to stimulate host T cells, and ability to grow in nonirradiated but not in gamma-irradiated SJL mice. The growth factor requirements of cRCS-X were examined. It was found that human BCGF can replace gamma-irradiated LN cells in the maintenance of long term in vitro growth of cRCS X. cRCS-X cells respond to human B cell growth factor (BCGF) or to recombinant murine interleukin (IL)-5 in a short term proliferation assay [( 3H]thymidine incorporation) in a dose-dependent manner in the presence and absence of fetal calf serum. BCGF also promotes colony formation in soft agar by cRCS-X cells. Although both IL-1 and interferon-gamma can synergize with BCGF in the induction of cRCS-X proliferation, these lymphokines, as well as IL-2, IL-3, granulocyte macrophage colony-stimulating factor, and IL-4 have no effect on cRCS-X growth when added alone. In addition, it was shown that SJL LN cells produce both IL-4 and BCGF II activities as assayed on murine B cells, after stimulation with gamma irradiated cRCS-X cells. In light of these results it is postulated that IL-5, [corrected] produced by syngeneic T cells [corrected] after stimulation with RCS, is essential for RCS growth, both in vitro and in vivo. PMID- 3275721 TI - Interleukin 1 induces CD1 antigen expression on human gingival epithelial cells. AB - The CD1 (T6) antigen is a highly specific marker for human Langerhans cells (LC). Previous studies have demonstrated that crude preparations containing murine interleukin-1 (IL-1) or a human epithelial cell-derived IL-1 inhibitor (ILS) modulate CD1 expression by LC in organ culture. This study examined the effect of organ-culture derived human IL-1, recombinant human IL-1, and purified ILS on CD1 expression in dispersed epithelial cell cultures. Both IL-1 preparations stimulated CD1 expression in whole and CD1-depleted cultures. The optimal dose level for this effect was 0.5 U/ml. Higher dose levels did not result in an increase in CD1 expression, implying that a limited pool of CD1 negative EC are induced to express CD1 by IL-1. Induction of CD1 expression on whole and depleted EC was abrogated by ILS. These results indicate that human IL-1 and an IL-1 inhibitor act in combination to modulate CD1 expression on Langerhans cells in the gingival epithelium. PMID- 3275722 TI - Reliable detection of individuals seropositive for the human immunodeficiency virus (HIV) by competitive immunoassays using Escherichia coli-expressed HIV structural proteins. AB - We molecularly cloned the gag and env genes of the human immunodeficiency virus (HIV) and expressed fragments of these genes in Escherichia coli. Using the recombinant core and envelope proteins, we developed two competitive immunoassays (CIAs). Samples that recognized either the envelope or core proteins were considered positive for antibodies to HIV. This test system was comparable with western blot in detecting antibodies in patients with AIDS or AIDS-related complex that were repeatably reactive in the HIV screening test. All 360 individuals who were positive by western blot were positive by the CIA. A total of 844 samples repeatably reactive by an ELISA screening test were negative both by western blot and by the CIA; 48 samples positive by ELISA, but negative or indeterminate by western blot, were positive by the CIA. Alternate research procedures verified the positivity of these individuals. These data indicate that the CIA described here may be useful as an adjunct or alternative to the western blot. PMID- 3275723 TI - Escherichia coli urethritis in women with symptoms of acute urinary tract infection. PMID- 3275724 TI - Immunoperoxidase slide test for detecting antibodies to Borrelia burgdorferi. PMID- 3275725 TI - Specificity of antibodies from patients with pinta for antigens of Treponema pallidum subspecies pallidum. AB - Inhabitants of a remote Panamanian village were examined for clinical and serological evidence of pinta infection. Of 104 persons examined, 21 (20%) had clinical evidence of active or inactive pinta, and 54 (52%) were seropositive. Sera were evaluated for antibody to individual Treponema pallidum antigens. Sera from all four patients with active pinta contained antibody to the 47-48 kilodalton major antigen; the intensity of reactivity and the number of antigens recognized increased with age and, presumably, duration of infection. Sera from six children with inactive pinta reacted strongly with multiple T. pallidum antigens, whereas adults with inactive pinta had less intense reactivity against fewer molecules. Seronegative controls demonstrated only weak reactivity to fewer than five molecules. The development of antibody reactivity to the full spectrum of T. pallidum antigens during the course of infection demonstrates the high degree of antigenic relatedness of T. pallidum and Treponema carateum and is similar to the development of humoral responsiveness during syphilis infection. PMID- 3275726 TI - Oral immunization with live, avirulent fla+ strains of Salmonella protects mice against subsequent oral challenge with Salmonella typhimurium. AB - Some strains of Salmonella, when fed to mice, establish a nonlethal, limited infection in the Peyer's patches of the small intestine. When such mice are later challenged orally with a normally lethal dose of virulent Salmonella typhimurium, a protective effect of the prior vaccination is seen. In an effort to characterize the determinant(s) of the avirulent strains responsible for this protective effect, we examined the cell envelope protein profiles of five such protective strains and of eight strains of Salmonella that were both nonpersistent and nonprotective when fed to mice. The protective strains produced high levels of flagellin. We made otherwise isogenic fla+ and fla- derivatives of two such strains and showed that although the fla- derivatives colonized mice as well as did the fla+ strains, the fla- derivatives given orally showed a much reduced ability to protect mice from S. typhimurium challenge. Both fla+ and fla- strains induced cellular immunity in vaccinated mice. PMID- 3275727 TI - Lung antibacterial defense mechanisms in infant and adult rats: implications for the pathogenesis of group B streptococcal infections in the neonatal lung. AB - We investigated factors that may contribute to lung infections in infants by studying the intrapulmonary responses to aerosols of three different types of organisms--group B streptococcus with and without type-specific capsule, Pseudomonas aeruginosa, and Staphylococcus aureus--in infant (12-h-old or 24-36-h old) and adult (150 g, 6-w-old) rats. After aerosol exposure, the lung clearance rate of each organism varied inversely with the age of the animals, and the magnitude of the clearance defect was related more strongly to animal age than to the bacterial species. Fewer alveolar macrophages from infant animals phagocytosed each type of organism in vivo, and the rate of neutrophil accumulation in the lungs of infant animals was delayed. The neonatal lung functioned effectively, however, as an antibacterial barrier, as newborn animals survived an aerosolized inoculum that exceeded the LD50 by the subcutaneous route. PMID- 3275728 TI - Cryptosporidium and Isospora belli infections. PMID- 3275729 TI - Selman A. Waksman and the first use of streptomycin. PMID- 3275730 TI - Cigarette smoking, lung inflammation, and the development of emphysema. PMID- 3275731 TI - Prostaglandin synthesis inhibitors potentiate the antihypertensive effect of heparin in spontaneously hypertensive rats. AB - We have shown that heparin lowers blood pressure significantly in hypertensive rats. This study was initiated to examine whether prostaglandin (PG) mediates the antihypertensive action of heparin. To this end, the effect of three different PG synthesis inhibitors (indomethacin, aspirin, meclofenamate) on the cardiovascular and renal actions of heparin was studied in spontaneously hypertensive rats (SHR). During 4 weeks of treatment, heparin reduced blood pressure significantly (P less than 0.01) in SHR. This was accompanied by significant decrements in hematocrit and total peripheral resistance but a significant increment in cardiac output. All of the PG inhibitors used significantly potentiated the antihypertensive effect of heparin and further reduced blood pressure by about 20%. Although heparin alone increased plasma renin activity, heparin and PG inhibitors together prevented this effect. When compared with heparin-treated rats, SHR treated with heparin and PG inhibitors combined had significantly (p less than 0.05 to 0.01) lower plasma aldosterone levels. These levels, however, were not different from SHR treated with PG inhibitors alone. Like blood pressures, the renal histopathologic lesions in SHR treated with heparin or heparin and PG inhibitors combined were significantly less severe than those in untreated SHR or SHR treated with PG inhibitors alone. Finally, captopril was shown to potentiate the effect of heparin. In conclusion, the antihypertensive effect of heparin does not appear to be PG mediated, but may be related to the structural changes in renal arterioles, inhibition of angiotensin-converting enzyme, or both. PMID- 3275732 TI - Glycolipid induced proliferation of lipopolysaccharide hyporesponsive C3H/HeJ splenocytes. AB - Although the C3H/HeJ mouse is hyporesponsive to lipopolysaccharides (LPS), certain forms of the lipid A fraction have been shown to stimulate cells from this mouse strain. To determine the role of the oligosaccharide chain length on the lipid A-induced proliferation of C3H/HeJ splenocytes, a panel of glycolipids from R-chemotypes (Re, Rc, and Rd) and a nontoxic monophosphoryl lipid A (MPL) were tested. The MPL cells isolated from the MPL of Salmonella minnesota, Salmonella typhimurium, and the Reglycolipids isolated from Escherichia coli were found to be effective at stimulating the LPS-hyporesponsive spleen cells. A Re glycolipid isolated from a different strain of E. coli cells was inactive, as were the S. minnesota Rc and Rd chemotypes. Proliferation induced by MPL and the active Re preparations was dose dependent and was inhibited by polymyxin B. Thus, if contamination of the Re-LPS or MPL with lipid A-associated protein occurred, it was below functional levels. The data suggest that the C3H/HeJ spleen cells are capable of responding to certain glycolipids, but they may lack the ability to convert native LPS into a stimulatory signal. In addition, a monosaccharide precursor of lipid A (lipid X), and a monoacyl glucosamine phospholipid derivative of lipid X (MaGP), were capable of inhibiting the proliferation induced by the MPL and Re-glycolipids. These data are compatible with the existence of a spleen cell receptor for lipid A. PMID- 3275733 TI - Diversity of the human monocyte/macrophage system as detected by monoclonal antibodies. AB - Four monoclonal antibodies against the human monocyte/macrophage system, termed Ki-M1, Ki-M6, Ki-M7, and Ki-M8, are described with regard to their immunohistochemical tissue distribution pattern and their subcellular reactive sites. The differences found applying these analyses are also reflected by the various molecular weights of the recognized antigens. Based on these data it is proposed that the monocyte/macrophage system can be divided into the phagocytosing compartment on one hand and the immune accessory compartment on the other hand; the latter constitutes the interdigitating reticulum cells, the indeterminate dendritic cells, and the Langerhans cells, as well as the follicular dendritic cells (dendritic reticulum cells) as the accessory cells for T- and B-cell immune response, respectively. PMID- 3275734 TI - The contributions of adrenal hormones, hemodynamic factors, and the endotoxin related stress reaction to stable prostaglandin analog-induced peripheral lymphopenia and neutrophilia. AB - Stable prostaglandin analogs are known to induce lymphopenia and neutrophilia in a dose-dependent fashion after subcutaneous injection in rats. The purpose of the present investigation is to determine whether the prostaglandin-induced changes in circulating leukocytes might be secondary to hypotension with the ensuing release of adrenal hormones. The adrenal medullary catecholamine epinephrine was found to induce neutrophilia in both intact and adrenalectomized rats, and the glucocorticosteroid analog dexamethasone induced a profound lymphopenia in rats as reported by previous investigators. A stable analog of PGF2 alpha (15-S-15 methyl PGF2 alpha; M-PGF2 alpha) at the dose of 1 mg/kg induced marked systemic hypotension 1 h after injection, with lymphopenia and neutrophilia 6 h after injection. The non-prostanoid hypotensive agent captopril, at a dose of 63 mg/kg, induced a hypotension of similar magnitude and kinetics to that induced by prostaglandin. Captopril also induced lymphopenia and neutrophilia at 6 h, although the neutrophilia was of lesser magnitude than that induced by prostaglandins. The prostaglandin-induced lymphopenia was found to be mediated, at least in part, by the hypotension-induced release of adrenal hormones, as evidenced by the abrogation of lymphopenia in prostaglandin-treated adrenalectomized rats. Captopril-treated adrenalectomized rats, however, did develop a significant lymphopenia, suggesting that hypotension can result in lymphopenia even in adrenalectomized rats. The M-PGF2 alpha-induced neutrophilia in adrenalectomized rats, by comparison to captopril-induced neutrophilia in adrenalectomized rats, was greater than the neutrophilia expected as the result of hypotension alone. Indeed, the M-PGF2 alpha-induced neutrophilia in adrenalectomized rats was greater than the captopril-induced neutrophilia in sham adrenalectomized rats. Thus, a portion of the neutrophilia induced by M-PGF2 alpha in intact rats may be mediated through adrenal-independent, hemodynamic independent mechanisms. The possibility that M-PGF2 alpha might be inducing neutrophilia via an endotoxin-like stress reaction was investigated by examining changes in circulating white blood cells in intact and adrenalectomized C3H/HeN (endotoxin-sensitive) and C3H/HeJ (endotoxin-resistant) mice after prostaglandin administration. No quantitative differences in the prostaglandin-induced neutrophilia were noted in C3H/HeJ mice as compared to the C3H/HeN mice.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3275735 TI - Role of the mononuclear phagocyte system in the development of acquired immunodeficiency syndrome (AIDS). AB - This review describes current understanding of the role of cells of the mononuclear phagocyte system in the development of acquired immunodeficiency syndrome (AIDS). Monocyte-macrophage like cells have been shown to harbor human immunodeficiency virus type 1 (HIV-I) infection in both peripheral blood and bone marrow as well as in target organs such as brain, lungs, lymph nodes, and skin. Mononuclear phagocytes that have been infected by HIV-I do not undergo significant cytopathic changes, suggesting that they may be important viral reservoirs. These and related cells may also promote the slow, persistent nature of HIV-I infections by escaping host immunologic surveillance mechanisms. There is evidence that HIV-I infections in monocytes and premonocytes can initially be latent but progress to an active viral replication state upon differentiation and/or maturation. Functional abnormalities in the mononuclear phagocyte system following infection by HIV-I have also been described, and these may be partially responsible for the severe immunosuppression characteristic of AIDS and AIDS related disorders. These defects may be mediated by quantitative and qualitative changes in the T-helper population. Although the role of mononuclear phagocytes as viral reservoirs and as mediators of immunosuppression is still largely speculative, increasing evidence suggests that these cells influence the course of HIV-I infections. PMID- 3275736 TI - Characterization of surface markers of continuously growing murine resident macrophages. AB - Conditions have been described which allow an in vitro indefinite multiplication of differentiated murine macrophages (Lombard et al: Biol Cell 53, 219, 1985). R. and MAY-1 cell lines, which were obtained, respectively, from mouse (Balb/c) spleen and resident peritoneal macrophages, have been further characterized. They present at their surface, besides the Mac-1 antigen and Fc-receptor, a mannose receptor which was characterized for its binding properties. This receptor is responsive for a specific phagocytosis of mannosylated particles, i.e., mannosylated latex beads or oil droplets containing mannosylated bovine serum albumin. Moreover, R and MAY-1 cells present an ectoenzyme profile (NAD+ glycohydrolase and nucleotide pyrophosphatase) similar to those of the corresponding resident macrophages. PMID- 3275737 TI - Allelic forms of gp195, a major blood-stage antigen of Plasmodium falciparum, are expressed in liver stages. AB - Mature exoerythrocytic (EE) forms of two cloned lines (3D7 and HB3) of Plasmodium falciparum were obtained in the livers of splenectomized chimpanzees. Sectioned preparations were examined by immunofluorescence (IFA) using mAbs that distinguished allelic variants of the blood-form antigen gp195 and mAbs that recognized multiple conserved epitopes of gp195. EE forms and blood schizonts exhibited identical IFA reactions for each respective clone, showing that the antigen was expressed identically in liver and blood-stage parasites. A third chimpanzee was infected with sporozoites derived from a mixture of 3D7 and HB3 gametocytes that had undergone cross-fertilization in the mosquitoes. IFAs on the EE forms in this animal showed that segregation of each gp195 allele had occurred earlier in the life cycle, providing evidence that the parasite is haploid for the whole of its mammalian development. PMID- 3275738 TI - Mind-body. Monistic dual aspect interactionism. AB - It is difficult to imagine a more perennially vexing topic to philosophers, scientists, and physicians than the mind-body problem. Recent literature bears out its continued vital interest for psychiatrists. This article briefly recapitulates the major perspectives on the problem, examines the relationship of meaning and mind to psychosocial and biological explanatory programs and to materiality, and promotes a monistic dual aspect interactionist approach to mind and body in health and illness. From this thesis conclusions are drawn in regard to the ultimate possibility of a psychiatric unitary field theory, the question of the autonomy of the psychological and biological explanatory programs, and the identity of the psychiatrist. PMID- 3275739 TI - Purification and characterization of two soluble Cl(-)-activated arginyl aminopeptidases from human brain and their endopeptidase action on neuropeptides. AB - Two closely related Cl(-)-activated arginyl aminopeptidases (I and II) were purified from a soluble extract of postmortem human cerebral cortex by anion exchange chromatography and preparative gel electrophoresis. The electrophoretic mobility of II was approximately 80% that of I; the molecular mass of both enzymes was approximately 70 kilodaltons (kDa) (gel filtration). The aminopeptidase action of I and II on aminoacyl-7-amido-4-methylcoumarin (AMC) substrates was restricted to the Arg and Lys derivatives. Both enzymes had significant endopeptidase activity, hydrolysing several biologically active peptides including neurotensin, bradykinin, angiotensin-I, substance P, luliberin, and somatostatin at internal bonds. Other peptides [Leu-enkephalin, proctolin, thyroliberin, adrenocorticotropin18-39 (ACTH18-39), ACTH11-24, and dynorphin (1-13)] were not appreciably hydrolysed. The amino- and endopeptidase activities had pH optima at 6.5 and 7, respectively, and were both inhibited by metal ion chelators and sulphydryl group blocking agents. The aminopeptidase activity was stimulated 20-fold by Cl- ions, whereas the endopeptidase activity was unaffected by the latter. Km values for neurotensin degradation were 20 microM (I) and 37 microM (II) and for Arg-AMC hydrolysis they were 167 microM (I) and 125 microM (II). The endopeptidase activity was not inhibited by the aminopeptidase inhibitors arphamenine or bestatin (IC50 = 9 nM and 0.1 microM, respectively, with Arg-AMC substrate). PMID- 3275740 TI - Biochemical characterization of different molecular forms of the neural cell adhesion molecule L1. AB - The neural cell adhesion molecule L1 is a phosphorylated, integral membrane glycoprotein that is recovered from adult mouse brain tissue by immunoaffinity chromatography as a set of polypeptides with apparent molecular masses of 200, 180, 140, and 80 kilodaltons (L1-200, L1-180, L1-140, and L1-80, respectively). It has been shown that L1-140 and the phosphorylated L1-80 is generated from L1 200 by mild proteolytic treatment of intact cells. In the present study we have investigated the structural relationships between the different molecular forms of L1 and their location with regard to the surface membrane. We could show that L1-200 has two preferred cleavage sites, one that generates the amino terminal, extracellularly exposed L1-140 and the carboxy terminal L1-80 that spans the membrane. Cleavage at the other site leads to the generation of the amino terminally located L1-180 and the membrane-attached, phosphorylated carboxy terminal L1-30. This site is cleaved during treatment of live cultured cells with broad-spectrum, protease-free phospholipase C (but not phosphatidylinositol specific phospholipase C) or exposure to sodium azide or cyanogen bromide. Other conditions that cause damage to cells do not lead to the generation of L1-180 and L1-30, suggesting a particular cell-intrinsic cleavage mechanism. L1-180 is truly soluble in aqueous solutions, since it can be recovered from culture supernatants and in the supernatant of a crude membrane fraction after incubation for 2 h at 37 degrees C. Although trypsin treatment alone does not release L1-140 into the supernatant, combination of phospholipase C and mild tryptic treatment leads to the release of L1-140 and L1-50, the latter being most likely the extracellularly exposed domain of L1-80 that is complementary to the membrane-integrated phosphorylated L1-30. Phase separation experiments with Triton X-114 show that the released forms of L1-180 and L1-140 distribute into the aqueous phase, whereas they distribute into the detergent phase when in association with L1-200 or L1-80. However, when L1-80 is cleaved to yield the soluble L1-50 and membrane anchored L1-30, L1-140 is released into the supernatant together with L1-50. A strong affinity of L1-200, L1-140, and L1-80 to each other is also indicated by the fact that they incorporate together into liposomes and separate only under strong detergent conditions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3275742 TI - The Journal of Clinical Epidemiology: same wine, new label for the Journal of Chronic Diseases. PMID- 3275741 TI - Levels and distribution of the calcium-modulated proteins S100 and calmodulin in rat C6 glioma cells. AB - To understand better the mechanisms involved in the transduction of a calcium signal into an intracellular response via multiple calcium-modulated proteins, we have examined the calcium-modulated proteins, S100 and calmodulin, and their intracellular targets in rat C6 glioma cells. Subconfluent, confluent, and postconfluent C6 cells contain predominantly, if not exclusively, the S100 beta polypeptide. The level of S100 beta in C6 cells increases approximately 20-fold from subconfluency to postconfluency whereas the level of calmodulin increases only about two-fold. The subcellular distribution of S100 beta and calmodulin in mitotic cells is similar. However, the subcellular distribution of these proteins in interphase cells is different and appears to change with cell density. Gel overlay analysis demonstrated that the S100- and calmodulin-binding protein profiles are significantly different and that some of the binding proteins appear to change in intensity with cell density. These data demonstrate that S100 beta is the predominant S100 polypeptide in C6 cells and suggest that changes in S100 beta and S100 beta-binding proteins may be involved in regulating S100-mediated intracellular processes in C6 cells. Our studies also suggest that the levels of S100 and calmodulin may be differentially regulated in C6 cells. PMID- 3275743 TI - Diagnostic factors in pediatric primary headache. AB - Primary headaches are frequent in children. They are difficult to diagnose because there is much disagreement about the interpretation of the historical data and the use of signs and/or symptoms in diagnosis. It would be useful, therefore, to standardize this procedure. We used linear discriminant analysis to determine a classification rule capable of diagnosing new cases of chronic and recurrent primary headache in children. We considered 23 symptoms in 118 patients. Through discriminant analysis we chose five variables: frequency of the attacks, type of pain, neurologic deficits, nausea, and vomiting. With this classification rule, we obtained a total correct classification of 84.7% for migraine, psychogenic headache, and non-defined headache in respect to the diagnoses formulated by a pediatrician and a child neuropsychiatrist after 3 months of follow-up. Our method for diagnosing migraine has a sensitivity of 95% and a specificity of 100%. The algorithm, validated on another 105 pediatric patients, produced a total correct result of 82.9%. PMID- 3275744 TI - Development and evaluation of modifications to the Sickness Impact Profile for head injury. AB - Three modifications were made to the Sickness Impact Profile, a behavior-based measure of health status, to improve its sensitivity to the effects of head injury. (1) Additional items were included to capture head injury sequelae and behaviors typical of young adults, the age group to which head injury most frequently occurs. (2) Subjects individually excluded behaviors irrelevant to them, thus allowing the score to better reflect injury-related changes. (3) The different areas of functioning on the Sickness Impact Profile were reweighted to reflect global judgments of the construct's contribution to overall functioning rather than the sum of the item contributions. Only the first modification is head-injury specific. The others, are relevant to any disease or injury. The performance of the modifications was evaluated in a longitudinal study of 102 head injured and 102 comparison subjects tested at 1 and 12 months after injury. The evaluation of the modifications was based on their ability to distinguish head injury from comparison subjects and on the strength of their relationship with measures of brain dysfunction. Despite a few statistically significant improvements in discrimination, differences of a practical degree were not obtained. The standard Sickness Impact Profile performed well and is recommended for evaluation of day-to-day functioning in head injury studies. PMID- 3275745 TI - The effect of comorbidity on appropriateness ratings for two gastrointestinal procedures. AB - We evaluated the effect of patients' comorbidity on the appropriateness of performing esophagogastroduodenoscopy or cholecystectomy. A nine-member national physician panel rated 1118 brief clinical scenarios for patients without comorbidity. Ratings were then repeated for patients with increasing degrees of comorbidity. As comorbidity changed from none to medium, 60% of those scenarios that were originally rated as appropriate for endoscopy and cholecystectomy remained appropriate. As high comorbidity was introduced, only 13% of such scenarios remained appropriate for endoscopy, while 33% remained appropriate for cholecystectomy. These findings suggest that, although clinical reasons for performing procedures are a powerful determinant of when they should be used, comorbidity is also important and needs to be included in any assessment of the appropriateness of procedure use. PMID- 3275746 TI - The role of elective lymph node dissection in melanoma: rationale, results, and controversies. AB - Elective lymph node dissection (ELND) for patients with clinically occult metastatic melanoma in regional lymph nodes has the goal of curing metastases with a surgical treatment. This is in contrast to the low probability for surgical cure in patients with clinically detectable lymph node metastases. The rationale for elective node dissection is based on a hypothesis that melanoma metastasizes sequentially via lymph nodes and then to distant sites. A subgroup of melanoma patients with high risk for regional node micrometastases but low risk for distant micrometastases has been identified from prognostic factors analysis of large patient series, as well as surgical results of nonrandomized clinical trials. However, two nonrandomized surgical trials have failed to show a survival benefit for ELND. These studies were largely performed in female patients with extremity melanomas and there were limitations that preclude a definitive conclusion. No randomized trials have been conducted involving melanomas of the trunk or head and neck. Two prospective randomized surgical trials are now being conducted in North America and in Europe. Until the results of these trials are available, physicians are encouraged to enter patients into these ongoing clinical trials or consider ELND in selected patients where the benefit-risk ratio justifies it. Factors to be considered in this decision include intermediate tumor thickness (ie, 1 to 4 mm thickness), anatomic site, histology (ulceration and growth pattern), and the risk of the operation in individual patient settings. PMID- 3275747 TI - Chemotherapy and hormonal therapy in combination. AB - The advantage of adding hormones to chemotherapy for the treatment of patients with breast carcinoma is uncertain, and benefits and disadvantages have been reported. An analysis of published randomized clinical trials reveals that the growth function (differentiation-inducing function v mitogenic function) of the hormone used may determine the ultimate benefit of combined modality treatments. PMID- 3275749 TI - "Prophylactic" lymph node dissection in melanoma: does it help? PMID- 3275748 TI - Preliminary results of a randomized study of adjuvant radiation therapy in resectable adult retroperitoneal soft tissue sarcomas. AB - Between January 1980 and September 1985, 35 adult patients with resectable retroperitoneal soft tissue sarcomas were entered on a randomized trial comparing two forms of adjuvant radiation therapy. Fifteen patients received the experimental therapy consisting of intraoperative radiotherapy (IORT) to 20 Gy using high-energy electrons followed by low-dose (35 to 40 Gy) postoperative external beam irradiation. Twenty patients received standard therapy consisting of high-dose (50 to 55 Gy) postoperative external beam irradiation. With a minimum follow-up of 15 months, there is no significant difference in the actuarial disease-free survival (DFS) and overall survival (OS) comparing the two groups (median DFS, 34 months; median OS, 38 months). At 5 years follow-up, approximately 40% of patients are alive and 20% of patients remain disease-free. Although there is a trend towards an improvement in in-field local control in the experimental arm, the predominant pattern of failure in both groups was locoregional within the retroperitoneum and/or peritoneal cavity. Acute and late radiation enteritis were significantly reduced in the experimental group. However, four experimental patients developed late (greater than 6 months following treatment) peripheral neuropathy believed related to the use of IORT; all four recovered. We conclude that there is no difference in the therapeutic effectiveness of the combination of IORT and low-dose external beam radiation compared with conventional high-dose radiation as adjuvant treatment in retroperitoneal sarcomas, although the former appears to be less toxic. Newer combined modality treatment strategies are discussed to improve the prognosis in these patients. PMID- 3275750 TI - Lymphoblastic lymphoma in children--a randomized trial comparing LSA2-L2 with the A-COP+ therapeutic regimen: a Pediatric Oncology Group Study. AB - From May 1979 to March 1983, 76 evaluable patients with lymphoblastic lymphoma (LBL) were treated by members of the Pediatric Oncology Group (POG). Forty-six children treated by the six-drug A-COP+ regimen (Adriamycin [doxorubicin; Adria Laboratories, Columbus, OH], vincristine, prednisone, cyclophosphamide, methotrexate, and hydrocortisone) were compared in a prospective randomized trial with 30 patients receiving the modified ten-drug LSA2-L2 (cyclosphosphamide, vincristine, methotrexate, Daunomycin [daunorubicin cerubidine; Wyeth Laboratories, Philadelphia], prednisone, cytarabine, thioguanine, asparaginase, hydroxyurea, and carmustine) regimen. After adjusting for stage (I and II v III v IV), there was no statistically significant difference (P = .19) between A-COP+ and LSA2-L2 regimens on the basis of 3-year survival and disease-free survival (62% v 72% and 53% v 58%, respectively for the two treatment regimens) but the power of analysis and thus the ability to detect a clinically meaningful difference in the outcome with the two regimens was limited by the small number of patients. Neither therapy was effective for most patients with stage IV disease, with failure occurring in six of seven children receiving A-COP+ regimen and eight of 11 patients receiving LSA2-L2. Although the LSA2-L2 regimen was more toxic during the induction of remission, the toxicity during maintenance was acceptable and similar for both treatments. CNS relapse was not a significant problem whether cranial radiation with intrathecal (IT) therapy (A-COP+) or IT therapy alone (LSA2-L2) were used. Our results confirm the overall effectiveness of the LSA2-L2 regimen in children with LBLs, especially those initially free of bone marrow or CNS involvement, but were inconclusive as to the inferiority or superiority of this regimen over the A-COP+ regimen. PMID- 3275751 TI - Histopathology of childhood sarcomas, Intergroup Rhabdomyosarcoma Studies I and II: clinicopathologic correlation. AB - Histopathologic material from 1,782 patients registered in the Intergroup Rhabdomyosarcoma Study Committee (IRS)-I and -II were reviewed by the IRS Pathology Committee in order to provide a uniform approach to classification and correlate patient survival with tumor type. Categories considered eligible were the four types of rhabdomyosarcoma (RMS) (criteria of Horn and Enterline), extraosseous Ewing's tumor (EOE), and a group of somewhat variable undifferentiated sarcomas designated small round cell sarcoma, type indeterminate (STI). Tumors that were clearly sarcomas but were unclassifiable also were included (NOS). The committee diagnoses were embryonal (Emb) RMS in 877 (54%), alveolar (Alv) RMS in 343 (21%), botryoid (Botr) RMS in 88 (5%), pleomorphic (Pleo) RMS in 11 (1%), STI in 135 (8%), and EOE in 84 (5%). One in nine were mixtures of types, eg, Emb and Alv. Five percent of the sarcomas could not be classified because of inadequate material. In general, there was close agreement (94%) between the review committee and institutional pathologists in the diagnosis of RMS, but not in the specific types, particularly Alv RMS (41%) and STI (36%). This observation is important, since patients with Alv RMS and STI tumors had decreased survival compared with the other histologies. The prognosis varied by histology, with Botr having the best, Alv RMS and STI the worst, and Emb RMS and EOE an intermediate prognosis. PMID- 3275752 TI - Relapse of breast cancer after adjuvant treatment in premenopausal and perimenopausal women: patterns and prognoses. AB - Eight hundred eighteen premenopausal or perimenopausal breast cancer patients with axillary node metastases were treated with adjuvant chemotherapy (CMF) with or without endocrine treatment (prednisone, oophorectomy) in two concurrent prospective trials. Three hundred fifty-two (43%) had recurrent disease at a median follow-up time of 6 years. The 2-year survival percentages from time of first relapse were 16% for patients with initial metastases in visceral or multiple sites (including bone and soft tissue), 41% for those with regional metastases or skeletal relapse alone and 70% for patients with isolated local recurrence or contralateral breast cancer. The features that most influenced prognosis within the categories defined by site of first relapse were disease free interval (less than 24 months v greater than or equal to 24 months), and estrogen receptor content in the primary tumor. These features had clinical importance (identifying patients with at least a 50% 2-year survival percentage) only in those patients with local, contralateral breast, regional, or bony disease alone. The treatment of individual patients after relapse must be directed toward optimized palliation. The results of this study are important for defining groups of patients who relapse after CMF for whom the subsequent therapeutic approach might be differentiated (eg, experimental treatments for dire prognosis, accent on minimal side effect treatment for intermediate prognosis, and investigation of adjuvant systemic therapy for isolated local recurrence). PMID- 3275753 TI - Chemotherapy for malignant gliomas. AB - There continues to be an extensive effort to develop chemotherapeutic approaches to the treatment of malignant gliomas of the brain. In the past 5 years there have been literally hundreds of trials of new agents, combinations of old and new agents, and even new routes and approaches to the delivery of chemotherapy. In this review, the literature has been studied and the individual reports analyzed to evaluate the impact of the new findings on clinical management of the patient with malignant glioma of the brain. The major areas of progress include the addition of new drugs with varying modes of action, the use of combinations of drugs in a synergistic fashion, and the development of new routes of drug delivery. None of the advances has brought about the revolution in clinical care that is so eagerly sought, but clearly the amount of new knowledge gained by these studies helps in understanding how to use chemotherapy more effectively. Furthermore, the remarkable degree of interest and involvement in the use of chemotherapy promises that an even greater number of patients with malignant gliomas will be considered for vigorous and enthusiastic clinical management programs even if chemotherapy itself is not the key modality in the treatment of a specific patient. PMID- 3275754 TI - The effect of fetal hypothalamus grafts on weight gain resulting from lesions of the ventromedial hypothalamus. AB - Bilateral ventromedial hypothalamic lesions in female adult rats which resulted in hyperphagia and rapid weight gain were followed by placement of fetal brain tissue in the anterior third ventricle. The treatment group received fetal hypothalamus grafts, and fetal cortical tissue of identical age was grafted into the control group. A significant reduction in average daily weight gain was noted from 4 to 12 weeks following transplantation in the treatment group. At 12 weeks posttransplantation, the animals were sacrificed for histological analysis. Examination of the hypothalamus grafts revealed neurons, ependymal clusters, and axonal processes which appeared to infiltrate the surrounding hypothalamic parenchyma. PMID- 3275755 TI - Gliomas of the optic nerve or chiasm. Outcome by patients' age, tumor site, and treatment. AB - A review of the literature revealed 623 cases of optic gliomas with sufficient information to permit actuarial (life-table) analysis concerning the prognosis of this disease by the patients' age, tumor site, treatment, and presence of concomitant neurofibromatosis or extension into the hypothalamus or ventricle. All of these factors are important. The development of mathematical models led to the conclusion that these tumors, generally regarded histologically as low-grade astrocytomas, actually have a very wide but continuous range of growth rates. Some grow rapidly enough to be explained by simple exponential doubling at a constant rate, but most behave as though their growth decelerates. Decelerating growth rates make comparisons of various groups of patients difficult. No support is found for the classical hypothesis that some may be hamartomas. Inadequately treated gliomas of the optic nerve or chiasm bear about the same poor prognosis. However, tumors of the optic nerve (intracranial as well as intraorbital) have an excellent prognosis following complete surgical excision and only a slightly poorer prognosis following irradiation. About 5% of optic nerve gliomas recur in the chiasm following "complete" intraorbital excision. Patients with neurofibromatosis have about twice the recurrence rate following complete excision of an intraorbital glioma. Optic chiasmal gliomas appear to respond to irradiation with doses above 4500 rads. Patients with neurofibromatosis have about the same prognosis as patients without neurofibromatosis following irradiation of a chiasmal glioma. PMID- 3275756 TI - Localization of human sensorimotor cortex during surgery by cortical surface recording of somatosensory evoked potentials. AB - The traditional means of localizing sensorimotor cortex during surgery is Penfield's procedure of mapping sensory and motor responses elicited by electrical stimulation of the cortical surface. This procedure can accurately localize sensorimotor cortex but is time-consuming and best carried out in awake, cooperative patients. An alternative localization procedure is presented that involves cortical surface recordings of somatosensory evoked potentials (SEP's), providing accurate and rapid localization in patients under either local or general anesthesia. The morphology and amplitude of median nerve SEP's recorded from the cortical surface varied systematically as a function of spatial location relative to the sensorimotor hand representation area. These results were validated in 18 patients operated on under local anesthesia in whom the sensorimotor cortex was independently localized by electrical stimulation mapping; the two procedures were in agreement in all cases. Similar SEP results were demonstrated in an additional 27 patients operated on under general anesthesia without electrical stimulation mapping. The following three spatial relationships between SEP's and the anatomy of the sensorimotor cortex permit rapid and accurate localization of the sensorimotor hand area: 1) SEP's with approximately mirror-image waveforms are recorded at electrode sites in the hand area on opposite sides of the central sulcus (P20-N30 precentrally and N20-P30 postcentrally); 2) the P25-N35 is recorded from the postcentral gyrus as well as a small region of the precentral gyrus in the immediate vicinity of the central sulcus: this waveform is largest on the postcentral gyrus about 1 cm medial to the focus of the 20- and 30-msec potentials; and 3) regardless of component identification, maximum SEP amplitudes are recorded from the hand representation area on the precentral and postcentral gyri. PMID- 3275757 TI - Ultrasonic visualization of tablets in the gastrointestinal tract. PMID- 3275758 TI - Radionuclide detection and localization of the site of gastrointestinal bleeding. PMID- 3275759 TI - Method for measurement of differential renal function. PMID- 3275760 TI - Purification and properties of biologically active chromium complex from bovine colostrum. AB - A biologically active, low-molecular-weight, chromium-binding substance present in milk (M-LMCr) was isolated from bovine colostrum and purified more than 2000 times by means of ethanol precipitation and successive ion-exchange and Sephadex gel chromatographies. The purified M-LMCr appeared to be an anionic organic Cr compound with a molecular weight of 1500, as determined by gel permeation chromatography. It contained aspartic acid, glutamic acid, glycine and cysteine in a ratio of 5:4:2:1 and no detectable carbohydrate. Although we were unable to detect nicotinic acid, some ultraviolet-absorbing (lambda max 260 nm) chemical structure was shown to be a constituent. Purified M-LMCr stimulated the rates of both [U-14C]glucose oxidation and [3-3H]glucose conversion into lipid in rat epididymal adipocytes at Cr concentrations greater than 1.5 ng/mL in relation to insulin action. This substance appears to have properties similar to those of glucose tolerance factor in yeast and the low-molecular-weight, chromium-binding substance present in mammalian liver. The role of M-LMCr in Cr nutrition and detoxication is discussed. PMID- 3275761 TI - Taurine: is it required for infant nutrition? PMID- 3275762 TI - Endoscopy of the airway in infants and children. AB - We believe that many of our readers will appreciate having some familiarity with the procedures described in this manuscript. For those who have had difficulty in deciding whether the need for diagnosis justifies the risk of a procedure, this perspective will shed new light on the problem. It is appropriate to warn our readers that complete unanimity on several points is not yet evident. For example, the indications for flexible bronchoscopy, by whom the procedure should be done, and even more specific technical aspects are questions not completely resolved. However, this article is not an effort to instruct anyone in how to do the procedure. Rather, it is an effort to acquaint our readers with progress in the field. With that in mind, we are confident that the remaining questions will be answered on the basis of the training, experience, and, ultimately, the good judgment of all the physicians involved. PMID- 3275763 TI - The dose response of theophylline in the treatment of apnea of prematurity. AB - In an effort to establish the minimum effective dose of theophylline in the treatment of idiopathic apnea of prematurity, a prospective trial of 22 infants with at least 0.33 episodes of apnea per hour were studied. Apnea was diagnosed exclusively by continuous recording of heart rate, respiratory impedance, end tidal CO2, and either or both transcutaneous oxygen and pulse oximetry. Four discrete serum concentrations of theophylline (23 mumol/l or 4.2 mg/L, 47 mumol/L or 8.5 mg/L, 70 mumol/L or 12.7 mg/L, and 84 mumol/L or 15.3 mg/L) were attained by using repeated loading doses of 4 mg/kg and increasing the maintenance dose from 1 to 1.5 mg/kg to 2 to 2.5 mg/kg, given every 8 hours. Before treatment and 24 hours after each loading dose, airway occlusions and measures of tidal volume, minute ventilation, and respiratory timing were performed. The effectiveness of therapy was assessed by either a continuous computer data-acquisition system or paper recording for the duration of the study. Of the 22 infants, three responded at level 1, three at level 2, and 10 at level 3. One of the four infants loaded to the fourth level had a sustained response for a total cumulative response of 77%. The five remaining infants required additional treatment with doxapram or continuous positive airway pressure. There was a significant increase in inspiratory pressure 100 msec after airway occlusion, maximum inspiratory pressure during airway occlusion, tidal volume, ratio of tidal volume to inspiratory time (mean inspiratory flow), and minute ventilation from the pretreatment measurements to those at the maximum dose of theophylline. The apnea response did not correlate with these improvements in ventilation measures. PMID- 3275764 TI - Prenatal detection of triploidy. PMID- 3275765 TI - In re ribavirin: a case of premature adjudication? PMID- 3275766 TI - Achondrogenesis type I: delineation of further heterogeneity and identification of two distinct subgroups. AB - Achondrogenesis has traditionally been divided into type I (Parenti-Fraccaro) and type II (Langer-Saldino). We studied the clinical, radiologic, and morphologic features of 17 cases previously diagnosed as achondrogenesis type I to define whether there is even further heterogeneity. On radiographic analysis, two distinct groups of patients were defined based on the presence or absence of rib fractures and ossification of the vertebral pedicles, ischium, and fibula. Two distinct chondroosseous morphologic patterns were observed that directly correlated with the radiographic grouping. One group had round vacuolated chondrocytes with inclusion bodies; the other had collagenous rings around the chondrocytes. We conclude that achondrogenesis type I (Parenti-Fraccaro) consists of two distinct disorders: type IA, which corresponds to the cases originally published by Houston et al. and Harris et al., and type IB, which corresponds to the case originally published by Fraccaro. Analysis of Parenti's case suggests the diagnosis of achondrogenesis type II. All three types of achondrogenesis appear to be inherited as autosomal recessive traits. PMID- 3275767 TI - Growth acceleration in children after orthotopic liver transplantation. PMID- 3275768 TI - Does infant nutrition affect adiposity and cholesterol levels in the adult? PMID- 3275769 TI - Immunosuppressive therapy of HBsAg-positive chronic active hepatitis in childhood: a multicentric retrospective study on 139 patients. AB - We analyzed retrospectively the effect of immunosuppressive therapy in 139 children with HBsAG-positive chronic active hepatitis (CAH) observed in four liver units in Italy from 1974 to 1982. All children had been observed for at least 12 months. Of these 139 patients, 38 were treated with steroids (prednisolone or prednisone from 1 to 2 mg/kg daily), 78 with combination therapy (prednisolone or prednisone 1 mg/kg daily in combination with azathioprine, 2 mg/kg daily) and 23 were not treated. The outcome of the disease was assessed by evaluating clinical, biochemical, and histological parameters on the basis of preselected criteria. Untreated patients deteriorated more frequently than those treated with steroids (34.8% versus 13.2%, p less than 0.05) or those receiving combination therapy (34.8% versus 10.3%, p less than 0.01). Remission or improvement was observed more frequently in steroid-treated and combination treated patients than in the untreated ones (p less than 0.001 and p less than 0.01, respectively). At the end of the study, only one untreated patient had died of liver failure. Remission was observed in about 10% of patients in the two groups of treatment, but in the untreated one, this event never occurred. Although this study is retrospective and presents some shortcomings, the data clearly indicate that steroid and combination therapy are not deleterious, and are possibly helpful, to children with HBsAg-positive CAH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3275770 TI - The role of prostanoids in the mediation of responses to KC-404, a novel cerebrovasodilator. AB - The purpose of this study was to characterize the nature of the response to KC 404 in the cerebral microcirculation of the newborn pig. Pial arterioles were observed directly using a closed cranial window in chloralose-anesthetized piglets. Topical application of 100, 300, 1000, 3000 and 10,000 ng/ml of KC-404 produced concentration-dependent increases in pial arteriolar diameter. Diameters were 168 +/- 18, 190 +/- 19 and 238 +/- 21 mu for control, 100 ng/ml and 10,000 ng/ml of KC-404, respectively. Responses to KC-404 (3-isobutyryl-2 isopropylpyrazolo-[1,5a]-pyridine) were blocked by indomethacin (5 mg/kg i.v.). Moreover, KC-404, topically applied to the cerebral cortex, produced small but significant increases in cortical subarachnoid cerebrospinal fluid levels of 6 keto-prostaglandin (PG) F1 alpha and PGE2, whereas thromboxane B2 levels were unchanged. Similar to topical application, i.v. KC-404 (0.5 mg/kg) produced pial arteriolar dilation without significantly altering arterial blood pressure. Intravenous KC-404 also increased cerebrospinal fluid levels of 6-keto-PGF1 alpha and PGE2, whereas thromboxane levels were unchanged. Further, topically applied KC-404 (1 microgram/ml) potentiated dilator responses to PGE2 and PGI2, whereas responses to isoproterenol were unchanged. These data indicate that KC-404 is a potent dilator of cerebral arterioles in newborn pigs. These data also suggest that KC-404 produces cerebral vasodilation predominantly by potentiating prostanoid-mediated dilation. PMID- 3275771 TI - Characterization of the functional antagonism and antihypertensive activity displayed by a monoclonal antibody to angiotensin II. AB - In the present study, we have characterized the specificity and potency of KAA8, a monoclonal antibody displaying a high affinity for angiotensin II (AII), as a functional antagonist of AII in vitro and in vivo. In addition, we have studied its antihypertensive effect in the awake renal artery-ligated rat, whose elevated levels of plasma renin activity and sensitivity to captopril and saralasin define it as a renin-angiotensin system-dependent hypertensive model. Our results utilizing isolated rabbit aorta strips and pithed rats suggest that KAA8 is a specific AII functional antagonist because it selectively inhibited the AII response in these models without altering the effects of norepinephrine and vasopressin. In renal artery-ligated rats, KAA8, at 15 mg/kg i.v., decreased mean blood pressure from 148 +/- 3 to 119 +/- 4 mm Hg at 10 min postinjection (n = 9) and greatly inhibited the pressor response to AII but not to vasopressin. In contrast, a control immunoglobulin G1 molecule did not change mean blood pressure or influence the pressor effect of AII in this model. Pretreatment with captopril or saralasin, but not prazosin or hydralazine, blocked the antihypertensive effect of KAA8 in these renal hypertensive rats. These results suggest that the antibody KAA8 displays specific functional AII antagonism and, as such, may represent a specific probe for studying the physiologic roles of AII. PMID- 3275772 TI - Comparison of nasal, rectal, buccal, sublingual and intramuscular insulin efficacy and the effects of a bile salt absorption promoter. AB - The purpose of this investigation was to develop a method to quantitate insulin absorption, and to compare insulin absorption from various noninjection sites of administration. Log dose/effect curves were established for i.m. insulin in adult male rats. The effects measured were the maximum change in plasma glucose concentration and the cumulative percentage of change in plasma glucose concentrations from 0 to 4 hr. Both log dose/effect curves gave similar results when calculating the efficacy of other routes, relative to i.m. Nasal, buccal, sublingual and rectal absorption sites were isolated by ligation procedures or with physical barriers. Rectal insulin was more efficacious than nasal, buccal and sublingual insulin, when administered without an absorption-promoting adjuvant. However, the efficacy relative to i.m. insulin was low for each route, probably due to a combination of slow membrane permeation and metabolism at the absorption site. Administration in a solution containing 5% sodium glycocholate, an absorption-promoting adjuvant, increased insulin efficacy by each route. The rank order was nasal greater than rectal greater than buccal greater than sublingual, with nasal and rectal insulin being roughly half as efficacious as i.m. insulin. Orally administered insulin, at doses 5 times higher than administered by other routes, and with Na glycocholate, produced no hypoglycemic response. PMID- 3275773 TI - Evaluation of the in vivo dose-response relationship of immunosuppressive drugs using a mouse heart transplant model: application to cyclosporine. AB - We have developed a 2-week bioassay that quantitates the effect of immunosuppressive drugs on organ allograft rejection. This assay is not only rapid and reliable, but also simple and relatively inexpensive and sparing of test substances. We refined the method by which neonatal mouse hearts are transplanted into pouches in the pinnae of ears of adult recipient mice and used cyclosporine treatment as an example of how this method might be generally applied to study the dose-response relationship of immunosuppressive drugs. Five- to 10-week-old C3H/km mice were used as cardiac recipients, and unsexed newborn BALB/c (allograft) or C3H/km (isograft) mice (24-48 hr old) were used as cardiac graft donors. The heart grafts were examined by two independent observers every other day at 10- to 20-fold magnification for up to 14 days. The immunosuppressive effect of cyclosporine was studied at doses of 3, 7.5, 15, 22.5 and 30 mg/kg per day administered i.p. The accrued data were analyzed by two methods: dose-response curves at days 12 and 14 and mean survival scores from day 8 to day 14. The dose-response curves on days 12 and 14 were similar, and the calculated ED50 values were 9.83 and 15 mg/kg/day, respectively. The results of this study demonstrate the potential usefulness and the sensitivity of the ear heart transplantation bioassay for relative potency evaluations of immunosuppressive drugs. PMID- 3275774 TI - Acute exposure of the neonatal rat to triethyltin results in persistent changes in neurotypic and gliotypic proteins. AB - Measurements of neuron-specific (neurotypic) and glia-specific (gliotypic) proteins were used to characterize the toxic effects of triethyltin (TET) on the developing central nervous system. Six proteins, each of which is associated with specific aspects of neuronal and glial development, were evaluated as follows: 1) neurofilament-200, an intermediate filament protein of the neuronal cytoskeleton; 2) synapsin I, a synapse specific, synaptic vesicle localized protein; 3) p38, another synaptic-vesicle localized protein; 4) myelin basic protein, a protein unique to myelin-forming oligodendroglia; 5) glial fibrillary acidic protein, the intermediate filament protein of astrocytes; and 6) beta-tubulin, a constituent primarily of neuronal microtubules. The amount of each protein in homogenates of hippocampus, forebrain and cerebellum, brain regions with different developmental profiles, was determined by radioimmunoassay. After a single administration on postnatal day 5, TET (3 or 6 mg/kg i.p.) caused permanent dose- and region dependent decrements in brain weight, with the hippocampus being the most affected. These effects were not associated with light microscopic evidence of cytopathology but were accompanied by large dose-, time- and region-dependent alterations in all neurotypic and gliotypic proteins evaluated. On a per structure (total) basis, TET caused permanent decreases in most neurotypic and gliotypic proteins in all areas. On a per milligram of tissue protein (concentration) basis, changes in specific proteins also were observed in all regions but were most prevalent in hippocampus and cerebellum. In hippocampus and cerebellum, decrements in the concentration of neurotypic and gliotypic proteins were observed in the absence of TET-induced decreases in the weights of these structures. The data indicate that 1) neonatal exposure to TET causes permanent deficits in neuronal as well as glial development, 2) the effects of TET are region-dependent but do not appear to be related to region-dependent stages in development and 3) assays of neurotypic and gliotypic proteins may be used to characterize the temporal and regional patterns of neuronal and glial responses to toxic exposures of the developing central nervous system. PMID- 3275775 TI - Prostaglandins mediate the increased sensitivity of left ventricular reflexes after captopril treatment in conscious dogs. AB - Captopril administration has been shown to result in the release of prostaglandins (PGs) in experimental animals and patients. Also, PGs, particularly prostacyclin (PGI2), have been shown to stimulate left ventricular receptor reflexes. Thus, the hypothesis that captopril administration results in sensitization of left ventricular reflexes via increased circulating levels of PGs was tested in conscious instrumented dogs. Left ventricular reflexes were stimulated by injecting veratridine into the left circumflex coronary artery through a nonocclusive catheter. Under control conditions, injection of veratridine resulted in a decrease in mean arterial pressure of -25 +/- 4.7% from a base line of 97 +/- 4.7 mm Hg and a decrease in heart rate of -28 +/- 3.7% from a base line of 91 +/- 6.6 beats/min. After administration of captopril, veratridine injection resulted in a decrease in mean arterial pressure of -43 +/- 4.9% and a decrease in heart rate of -51 +/- 8.5%, both significantly greater effects than before captopril (P less than .05); N = 7). Subsequent administration of the cyclooxygenase inhibitor, indomethacin (5 mg/kg), in the presence of captopril reversed the potentiation of the response to veratridine. Thus, after indomethacin, injection of veratridine decreased mean arterial pressure -29 +/- 4.4% and decreased heart rate -28 +/- 4.1%; changes not significantly different from the control response. Similar findings were observed in a separate set of experiments in which heart rate was held constant by cardiac pacing (N = 6).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3275776 TI - Evaluation of the importance of hydrophobic interactions in drug binding to dihydrofolate reductase. AB - The interaction of dihydrofolate reductase (DHFR) from Escherichia coli with drugs such as methotrexate (MTX) and 2,4-diamino-6,7-dimethylpteridine (DAM) has been studied by means of site-directed mutagenesis, fluorescence spectroscopy, and steady-state as well as transient kinetics. A strictly conserved residue at the dihydrofolate binding site of DHFR, phenylalanine-31, has been replaced with tyrosine or valine to ascertain the importance for binding of this hydrophobic amino acid, which interacts with both the pteridine ring and the p-aminobenzoyl moiety. The first mutation (Phe-31----Tyr) has a minimal effect on the binding of the classical inhibitor, DAM. On the other hand, the second mutation (Phe-31--- Val) has increased the dissociation constant of DAM from the DHFR.NADPH.DAM ternary complex over 150-fold (greater than 3 kcal/mol). The dissociation constant of DAM from the (Val31-DHFR).DAM binary complex was too large to be measured fluorometrically. More importantly, these mutations have decreased the overall tight binding of MTX, from 100- to 140-fold (corresponding to a loss of binding energy of 2.2-2.4 kcal/mol) for the Tyr-31 and Val-31 mutants, respectively. These results indicate that hydrophobic interactions between MTX and DHFR are at least as important as formation of the MTX.DHFR salt bridge in the tight binding of MTX. PMID- 3275777 TI - Design, structure-activity, and molecular modeling studies of potent renin inhibitory peptides having N-terminal Nin-For-Trp (Ftr): angiotensinogen congeners modified by P1-P1' Phe-Phe, Sta, Leu psi[CH(OH)CH2]Val or leu psi[CH2NH]Val substitutions. AB - A structure-conformation-activity investigation of several angiotensinogen (ANG) based inhibitors of human renin modified by either Phe-Phe, Sta, Leu psi[CH2NH]Val, or Leu psi[CH(OH)CH2]Val at the P1-P1' clevage site and P5 Trp(Nin For) (Ftr) was performed. Specifically, Ac-Ftr-Pro-Phe-His-Phe-Phe-Val-Ftr-NH2 (1) provided a potent (KI = 2.7 X 10(-8) M) P1-P1' Phe-Phe substituted renin inhibitor to initiate these studies. Substitution of the P1-P1' Phe-Phe in compound 1 by Sta effected a 1,000-fold increase in biological potency for the resultant octapeptide Ac-Ftr-Pro-Phe-His-Sta-Val-Ftr-NH2 (10; KI = 6.7 X 10(-11) M). Kinetic analysis of compound 10 showed it to be a competitive inhibitor of human renin catalyzed proteolysis of human ANG. Chemical modifications of the compounds 1 and 10 were evaluated on the basis of comparative human plasma renin inhibitory activities (IC50 values) in vitro. Carboxy-terminal truncation studies on compound 10 showed that the P2' Val and P3' Ftr residues could both be eliminated without significant loss (ca. 10-fold) in renin inhibitory activity as exemplified by the pentapeptide Ac-Ftr-Pro-Phe-His-Sta-NH2 (12; IC50 = 3.8 X 10( 9) M). In addition, the corresponding P1-P1' Leu psi[CH(OH)CH2]Val and Leu psi[CH2NH]Val derivatives of compound 12 were potent renin inhibitors: Ac-Ftr-Pro Phe-His-Leu psi[CH(OH)CH2]Val-NH2 (13; IC50 = 3.1 X 10(-10) M) and Ac-Ftr-Pro-Phe His-Leu psi[CH2NH]Val-NH2 (14; IC50 = 2.1 X 10(-8) M). The structure-conformation activity properties of the N-terminal Ftr substitution of these human renin inhibitors was examined by (1) comparative analysis of several analogues of 1 and Ac-Ftr-Pro-Phe-His-Sta-Ile-NH2 (17; IC50 = 1.0 X 10(-10) M) having P5 site modifications by Trp, His, D-Ftr, and D-His, (2) deletion of the N-terminal Ftr residue from compounds 12 and 17, to provide Ac-Pro-Phe-His-Sta-Ile-NH2 (16; IC50 = 3.1 X 10(-8) M) and Ac-Pro-Phe-His-Sta-NH2 (15; IC50 = 5.6 X 10(-6) M), and (3) computer modeling and dynamics studies of compounds 1 and 17 bound to CKH-RENIN, a simulated human renin model, which were focused on identifying potential intermolecular interactions of their common P5-P2 sequence, Ac-Ftr-Pro-Phe-His, at the enzyme active site.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3275778 TI - Studies on prodrugs. 7. Synthesis and antimicrobial activity of 3-formylquinolone derivatives. AB - Several 3-formylquinolone derivatives (8a-c) were synthesized to assay the antibacterial activity both in vitro and in vivo. In vitro, all of the compounds 8a-c showed lower activity than that of the corresponding 3-carboxyl compounds 1a c, and in vivo, they showed higher activity than that of compounds 1a-c. After oral administration of 3-formyl compounds 8a-c to mice, the compounds were rapidly metabolized into 3-carboxyl compounds 1a-c. In particular, the 3-formyl derivative (8a) of norfloxacin (NFLX, 1a) gave a 2-fold higher serum level than that of NFLX and functioned as a prodrug of NFLX. PMID- 3275779 TI - Rifampicin-resistant strains of Mycobacterium leprae may have reduced virulence. AB - A strain of Mycobacterium leprae resistant to rifampicin (RMP) failed to infect normal mice when injected into the foot pads (FP) at a dose of 10 or 100 bacilli/FP, although it could be maintained by serial passage in mice by the use of inocula of 10(4) bacilli/FP; normal mice can be infected by RMP-sensitive M. leprae at a dose of 10 bacilli/FP. By contrast, nude (athymic) mice could be infected with an inoculum of 10 bacilli/FP of the RMP-resistant strain. It is suggested that the strain concerned possessed reduced virulence for normal mice, and the implications of this for the probability of occurrence of human disease caused by RMP-resistant strains of M. leprae are discussed. PMID- 3275780 TI - Production and properties of haemolysins from clinical isolates of the Proteeae. AB - A collection of 198 clinical isolates of strains belonging to the tribe Proteeae was examined for haemolytic activity on blood agar and in Brain Heart Infusion Broth. The strains were of diverse bacteriocin and O-antigenic types and from a wide variety of sources. They included representatives of all species of Morganella, Proteus and Providencia. Approximately half of the M. morgani strains were haemolytic on blood agar. This activity was not associated with any particular bacteriocin type. The haemolysin was also produced during exponential growth in broth and was thermolabile and calcium dependent. All P. mirabilis strains and some P. vulgaris strains were non-haemolytic on blood agar. However, most strains of the Proteus spp., irrespective of their bacteriocin and antigenic type, produced, over a short period during exponential growth in broth, a heat stable, cell-associated calcium-independent haemolysin. A smaller proportion of P. vulgaris and P. penneri strains produced, in addition, a thermolabile, calcium dependent haemolysin which was associated with the formation of large haemolytic zones on blood agar. The relationship of these haemolysins to Escherichia coli haemolysin and their possible role in virulence is discussed. Haemolysin production was not found in any of the 74 strains of four species of Providencia. PMID- 3275781 TI - A survey of IgA protease production among clinical isolates of Proteeae. AB - A collection of 100 strains of Proteeae, in which all species within the tribe were represented, was examined for IgA protease production. The strains were isolated from various clinical specimens from sick and healthy persons in several countries. IgA protease-producing strains were not found amongst species of Providencia and Morganella but were common in Proteus spp. All the strains of P. mirabilis and P. penneri and many of the strains of P. vulgaris examined produced an EDTA-sensitive protease that cleaved the IgA heavy chain outside the hinge region. The proteus enzyme was different in this respect from the EDTA-sensitive, hinge-cutting proteases of other bacteria. The ability to produce IgA protease was unrelated to the O antigenicity, biotype or bacteriocin type of the strain. IgA protease production may be an important virulence mechanism for Proteus strains. PMID- 3275782 TI - Experimental Escherichia coli peritonitis in immunosuppressed mice: the role of specific and non-specific immunity. AB - An experimental Escherichia coli septicaemia-peritonitis model was adapted to immunosuppressed mice. The mice were made neutropenic by a sublethal dose of cyclophosphamide, which resulted in a 100-fold increase in their susceptibility to intraperitoneal injection of E. coli O18:K1. A lethal infection could be prevented by passive immunisation with anti-K1 capsular or anti-O18 LPS antibodies but not with anti-J5 bacterial antibodies. The anti-K1 and anti-O18 antisera were able to increase the LD50 of the E. coli challenge by factors of 50 and 5, respectively. The role of non-specific, lipopolysaccharide (LPS)-mediated resistance to infection was also investigated in this model, in which only long living phagocytic cells such as macrophages are believed to be functional. Pretreatment of mice with LPS was shown to prevent growth of the bacterial challenge in the peritoneal cavity and blood and to result in a five-fold increase in the LD50 of the challenge strain. These findings suggest an important role for macrophages as effector cells in defence against E. coli infection. PMID- 3275783 TI - Electronmicroscopic studies on the location of salmonella proliferation in the murine spleen. AB - Highly susceptible inbred male C57BL/6 mice were infected intraperitoneally with 2 x 10(7) cfu of a virulent Salmonella typhimurium strain. Tissue sections were taken from the spleen 2 and 3 days after infection for examination by electronmicroscopy. Rapid infiltration of polymorphs and macrophages was evident at the site of infection. These inflammatory phagocytes displayed avid destructive action against ingested bacteria. Bacterial multiplication occurred primarily in extracellular locations within sinusoids or in lesions containing disintegrating host cells. PMID- 3275784 TI - Colin Panton Beattie, 11 September 1902-16 July 1987. PMID- 3275785 TI - Heritage of ophthalmology. Herman Snellen, 1834-1908. PMID- 3275786 TI - Assessment of the developmental risks resulting from occupational exposure to select glycol ethers within the semiconductor industry. AB - This risk assessment evaluates the potential human hazards of adverse developmental effects posed by exposure to 2-ethoxyethanol (2-EE), 2 ethoxyethanol acetate (2-EEA), 2-methoxyethanol (2-ME), and 2-methoxyethanol acetate (2-MEA) as they are currently used in semiconductor manufacturing. These glycol ethers are contained in positive photoresists used in the wafer fabrication process. The available data on the developmental toxicology of these glycol ethers indicates that each can selectively affect the offspring of pregnant animals that have been exposed to relatively low vapor concentrations. For these chemicals, the ratio of the lowest dose which adversely affected the pregnant animals (A) and the lowest dose which produced developmental effects in offspring (D), e.g., A/D ranged from 1-5. Approximately 400 workplace air samples of 4-8 h duration, both personal and area, from seven different companies were used to assess the degree of inhalation exposure during the manufacture of wafers. The geometric mean results obtained during personal sampling of workplace air for 2-EE, 2-EEA, 2-ME, and 2-MEA were 0.36, 0.02, 0.10, and 0.01 ppm, respectively. These levels are 14- to 500-fold lower than the applicable threshold limit value (TLV) currently recommended by the American Conference of Governmental Industrial Hygienists (ACGIH). Specifically, the margins of safety between the typical occupational exposure and the TLV for 2-ME, 2-EE, 2-MEA, and 2-EEA are 50, 14, 500, and 250, respectively. The TLVs for these chemicals were set at levels considered sufficiently low to protect workers and their offspring from adverse effects and are about 2- to 10-fold lower than the various no observed-effect levels (NOELs) obtained in animal tests. Based on more recent data, lower TLVs are indicated. The safety-factor approach, rather than mathematical models developed for estimating cancer risks, was used in this analysis. Historical data have shown that the application of safety factors of 10 100 to the NOEL, as determined in Segment II developmental toxicology tests in animals, should be adequate to protect humans. In its risk assessment guidelines, the U.S. Environmental Protection Agency (EPA) selected the uncertainty-factor approach as the most reasonable one for evaluating the hazards of developmental toxicants. This assessment indicates that the airborne concentrations of these glycol ethers in the semiconductor industry are, in general, sufficiently low to protect employees against their adverse developmental and reproductive effects as well as any other toxic effects as long as dermal exposure is minimal. PMID- 3275787 TI - A new imaging approach to quantitative evaluation of pulmonary vascular endothelial metabolism. AB - There has been no noninvasive, readily available method for clinically evaluating changes in pulmonary metabolism of biogenic aminelike substances. Such metabolic changes, which almost surely take place on the surface or within the endothelial cells that line the pulmonary vasculature, are likely to be significant components of the overall clinical response of the lung to many disorders. Radioiodinated metaiodobenzylguanidine (MIBG) shows properties in isolated, perfused lung preparations that simulate those of biogenic amines (eg, its uptake is sodium-dependent and virtually abolished by ouabain). New data from studies in sheep and humans indicate that changes in first transit pulmonary extraction of this compound can easily be monitored externally using conventional gamma camera computer systems. MIBG labeled with iodine 123 may provide an important new means for clinical assessment of changes in pulmonary endothelial metabolism. PMID- 3275788 TI - Genomic clones of bovine parvovirus: construction and effect of deletions and terminal sequence inversions on infectivity. AB - Genomic clones of the autonomous parvovirus bovine parvovirus (BPV) were constructed by blunt-end ligation of reannealed virion plus and minus DNA strands into the plasmid pUC8. These clones were stable during propagation in Escherichia coli JM107. All clones tested were found to be infectious by the criteria of plaque titer and progressive cytopathic effect after transfection into bovine fetal lung cells. Sequencing of the recombinant plasmids demonstrated that all of the BPV inserts had left-end (3')-terminal deletions of up to 34 bases. DNA isolated from progeny virions arising from transfected infectious clones was found to be indistinguishable from wild-type DNA by restriction enzyme analysis. Defective genomes could also be detected in the progeny DNA even though the infection was initiated with homogenous, cloned DNA. Full-length genomic clones with 3' flip and 3' flop conformations were constructed and were found to have equal infectivity. Analysis of low-molecular-weight DNA isolated from lysates of cells transfected with these clones demonstrated that rescue and replication of BPV DNA could be detected 3 to 8 days after transfection. Expression of capsid proteins from transfected genomes was demonstrated by hemagglutination, indirect immunofluorescence, and immunoprecipitation of [35S]methionine-labeled cell lysates. Use of appropriate antiserum for immunoprecipitation showed the synthesis of BPV capsid and noncapsid proteins after transfection. Independently, a series of genomic clones with increasingly larger 3'-terminal deletions was prepared from separately subcloned 3'-terminal fragments. Transfection of these clones into bovine fetal lung cells revealed that deletions of up to 34 bases at the 3' end lowered but did not abolish infectivity, while deletions of greater than 52 bases were lethal. End-label analysis showed that the 34-base deletion was repaired to wild-type length in the progeny virus. PMID- 3275789 TI - Tumorigenicity of adenovirus-transformed cells: collagen interaction and cell surface laminin are controlled by the serotype origin of the E1A and E1B genes. AB - A library of cells transformed with recombinant adenoviruses was used to study tumorigenicity and interaction with extracellular matrix. Cells expressing the complete E1 region of highly oncogenic adenovirus type 12 (Ad12) are tumorigenic, adhere preferentially to type IV collagen, and express cell surface laminin. Weakly tumorigenic cells, which express the E1A oncogene of Ad12 and the E1B genes of Ad5, also attach preferentially to type IV collagen but do not contain laminin on their surface. Cells which express the E1A oncogene of Ad5 and the E1B genes of Ad12 are nontumorigenic and do not preferentially attach to type IV versus type I collagen but have laminin on their surface. There is no significant difference in the amounts of laminin secreted into the culture medium among cells expressing the E1B genes of Ad5 or Ad12. In vitro assays show that cells which express the E1B genes of Ad12, irrespective of the origin of the E1A genes, can bind three times more exogenously added laminin than cells expressing the E1B genes of nononcogenic Ad5. The interaction of adenovirus-transformed cells with collagen is controlled by the serotype origin of the E1A oncogene, whereas cell surface laminin is controlled by the serotype origin of the E1B genes. PMID- 3275790 TI - Strain variation and nuclear association of Newcastle disease virus matrix protein. AB - Five monoclonal antibodies to the matrix (M) protein of Newcastle disease virus (NDV) Australia-Victoria (AV) strain were generated and characterized. In competitive antibody-binding assays, the antibodies fell into three discrete groups. The antigenic sites described by these antibody groups were designated M1, M2, and M3. Each antibody reacted with a panel of NDV strains in a manner unique to its group, confirming the grouping by competitive antibody binding. Only site M1 was found on all 12 of the strains tested and may be a "pan-NDV" epitope. A large portion of the M protein of strain AV was detected in the nuclei of infected cells by all five monoclonal antibodies. In addition, the antibodies only stained the nuclei of cells infected with NDV strains expressing M protein containing the corresponding antigenic site. These results confirm that the immunoreactivity in the nucleus is actually caused by the M protein and not by a cross-reacting host protein induced by viral infection. PMID- 3275792 TI - Inverted papilloma of renal pelvis associated with contralateral ureteral malignancy and bladder recurrence. AB - We report a case of an inverted papilloma of the renal pelvis diagnosed at the same time as transitional cell carcinoma of the contralateral ureter. The diagnostic studies and surgical management are presented. Recurrence of an inverted papilloma in the bladder 1 year after treatment was confirmed histologically. Recurrence of this lesion and the association with urothelial malignancy suggest the need for close followup of patients with an inverted papilloma. PMID- 3275793 TI - Toothpick obstruction of the ureter. AB - We report an unusual case of ureteral obstruction from a toothpick that migrated from the cecum to the right ureter. PMID- 3275791 TI - Characterization of adenovirus particles made by deletion mutants lacking the fiber gene. AB - H2dl802, H2dl807, and H5dl1021 are defective deletion mutants of human adenovirus which do not make the capsid protein fiber yet which can make substantial amounts of virus particles. Virions made by the mutants contain very little fiber (which comes from helper virus contaminants in the deletion virus stocks): less than 6% as much as that contained by wild-type virions. This demonstrates that fiber is not an essential structural component of the adenovirus virion and suggests that fiber is nonessential for virion assembly. These fiber-deficient particles are poorly adsorbed to cells, consistent with the proposed role of fiber in virus attachment. Further, virion protein precursors, including that of the virion protease, are poorly processed in these particles, suggesting a relationship between the presence of fiber and the maturation of the virus particle. PMID- 3275794 TI - Pure primary testicular carcinoid: a case report and discussion. AB - We report a case of pure primary testicular carcinoid tumor and review the literature. Distinctions are emphasized among the 3 subgroups of testicular carcinoids and their clinical significance. Criteria to establish the diagnosis of pure primary testicular carcinoid are offered. PMID- 3275795 TI - Leiomyosarcoma of the scrotum in a man who had received scrotal irradiation as a child. PMID- 3275796 TI - The role of silicone ureteral stents in extracorporeal shock wave lithotripsy of large renal calculi. AB - Between November 1984 and December 1985 extracorporeal shock wave lithotripsy was used to treat 1,645 kidneys at our institution. A total of 646 kidneys with stone burden greater than 14 mm. was evaluated with regard to the impact of silicone ureteral stents in post-extracorporeal shock wave lithotripsy morbidity. Our results indicate that small stones were pulverized and eliminated with minimum morbidity. Larger stones frequently were associated with post-treatment ureteral obstruction by sand and fragments. Of 283 kidneys with stone burden exceeding 25 mm. pretreatment placement of silicone ureteral stents reduced complications from 26 to 7 per cent and auxiliary procedure rates from 15 to 6 per cent. Silicone ureteral stents protect the kidney from ureteral obstruction, and allow for safe and effective extracorporeal shock wave lithotripsy of large renal calculi. PMID- 3275797 TI - Epidermal growth factor in the normal and neoplastic kidney and bladder. AB - Epidermal growth factor (EGF) is a cell-regulating polypeptide that appears important to the maintenance and function of some benign tissues and to the transformation and proliferation of certain malignancies. In humans the highest concentrations of EGF are found in the urine. We investigated possible interactions between EGF and normal and neoplastic tissues of the urinary system with indirect immunohistochemical staining of paraffin-embedded tissue sections. A polyclonal antibody directed against mouse EGF but shown to react with human EGF was used in the assays. Positive staining was granular in nature and confined to the cytoplasm. Staining of the renal parenchyma (N = 5) was observed in the epithelium of the proximal and distal tubules and the collecting ducts. There was staining of clear cell (N = 6) and papillary (N = 3) carcinomas of the kidney. Staining of the normal urothelium (N = 5) was limited to superficial cells. All transitional cell (N = 21) and squamous (N = 2) carcinomas of the bladder stained. Subjectively, the staining intensity of the transitional cell carcinomas correlated inversely with tumor differentiation. In light of evidence that internalized, receptor-bound EGF is rapidly degraded, the striking immunohistochemical demonstration of cytoplasmic EGF suggests active synthesis. EGF synthesized by urothelial and renal carcinomas may be involved in an autocrine mechanism of malignant proliferation. PMID- 3275798 TI - Free radical production by high energy shock waves--comparison with ionizing irradiation. AB - Fricke chemical dosimetry is used as an indirect measure of the free radical production of ionizing irradiation. We adapted the Fricke ferrous sulfate radiation dosimeter to examine the chemical effects of high energy shock waves. Significant free radical production was documented. The reaction was dose dependent, predictably increased by acoustic impedance, but curvilinear. A thousand shocks at 18 kilovolts induced the same free radical oxidation as 1100 rad cobalt-60 gamma ionizing irradiation, increasing to 2900 rad in the presence of an air-fluid zone of acoustic impedance. The biological effect of these free radicals was compared to that of cobalt-60 ionizing irradiation by measuring the affect on Chinese hamster cells by clonogenic assay. While cobalt-60 irradiation produced a marked decrease in clonogenic survivors, little effect was noted with high energy shock waves. This suggested that the chemical effects produced by shock waves were either absent or attenuated in the cells, or were inherently less toxic than those of ionizing irradiation. PMID- 3275799 TI - Nonoperative management of impotence. PMID- 3275800 TI - Fetal and postnatal testis shows immunoprivilege as donor tissue. AB - We evaluated the immunogenicity of the testis by transplanting adult, postnatal, and fetal rat testicular tissue into outbred adult female and male rats for 10 days. Testis grafts were evaluated morphometrically and histologically, and selectively compared to renal grafts previously reported in part. Testis grafts from days 15 to 21 of gestation, and from three, nine, 12 and 15 days after birth showed an overall increase in growth, with maintenance of architecture and minimal lymphocytic infiltrate. In contrast, only fetal renal tissue from days 15 to 17 demonstrated an increase in growth with maintenance of architecture and minimal lymphocytic infiltrate; grafts from later in gestation grew only slightly and showed progressive deterioration in architecture with an increasing lymphocytic infiltrate. Fifteen day fetal testis grafts were also implanted for longer intervals up to 45 days. The fetal testis grafts implanted for 20 and 30 days showed an increase in size with maintenance of architecture and minimal lymphocytic infiltrate. The observed fetal and postnatal testis growth in the non immunosuppressed adult host makes compelling further studies directed at determining those factors contributing to the decreased immunogenicity of this organ. PMID- 3275801 TI - Nephrogenic adenoma of the bladder: report of 10 cases. AB - Nephrogenic adenoma is an uncommon metaplastic lesion of the lower urinary tract that usually is associated with antecedent inflammation or surgical procedures. We report 10 new cases, 8 of which followed renal transplantation and 1 of which followed partial cystectomy for squamous cell carcinoma of the bladder. No predisposing factors could be identified in 1 patient. The nephrogenic adenomas, all of which were located in the bladder, were treated by either biopsy with fulguration or transurethral resection. The lesion recurred locally in 1 patient. PMID- 3275802 TI - Scrotal ultrasonography: a predictor of complicated epididymitis requiring orchiectomy. AB - The decision between continued medical therapy and surgical exploration in patients with complicated epididymitis is difficult. We evaluated scrotal ultrasonography as a noninvasive aid in such problematic cases. During a 48-month period 95 patients were hospitalized for treatment of epididymitis; 23 underwent scrotal ultrasonography and 10 required orchiectomy. Analysis of the 21 cases with abnormal findings demonstrated that orchiectomy was necessary in 1 of the 10 patients (10 per cent) with epididymal enlargement only, in 2 of 8 (25 per cent) with epididymal enlargement plus hypoechoic testes and in all 3 with epididymal enlargement plus testicular inhomogeneity (p equals 0.0099). Patients with progressive testicular changes on serial ultrasound examinations uniformly required orchiectomy (5 of 5). Sonographic findings of testicular inhomogeneity correlated with testicular infarction and findings of decreased testicular echogeneity correlated with acute or chronic orchitis. In the appropriate clinical setting gray scale ultrasonography provides objective information supporting the need for surgical intervention in selected patients with complicated epididymitis. PMID- 3275804 TI - Multicystic dysplastic kidneys and diagnostic confusion on renal scan. AB - The combination of ultrasound and renal scan usually provides a reliable means of differentiating congenital ureteropelvic junction obstruction with hydronephrosis from multicystic dysplasia in the newborn with an abdominal mass. Rarely, a multicystic kidney will show definite function on a renal scan. We describe 2 newborns who were thought to have hydronephrosis based on a renal scan but who had typical multicystic dysplastic kidneys at operation. PMID- 3275803 TI - Clinical significance of sacral and pudendal nerve anatomy. AB - The neuroanatomy and neurophysiology of the external urethral closure mechanisms still are under debate because the motor fibers that emanate from the sacral plexus and pudendal nerve to supply this segment have not been traced, nor has their functional interrelationship been established. Therefore, we dissected 3 male human cadavers (aged 31 to 69 years) by tracing the entire sacral plexus, particularly the pudendal nerve, from the cauda equina throughout the branching of the nerves to their final destination. The dissection demonstrated that the extrinsic urethral sphincter, formed by the rhabdosphincter around the membranous urethra as well as the levator ani muscle and pelvic floor (especially the transversus perinei muscle), is innervated by somatic nerve fibers that emanate primarily from sacral roots S2 and S3. In 5 patients with neurogenic lower urinary tract dysfunction electrostimulation of the sacral root and pudendal nerve markedly increased intraurethral closure pressures. Stimulation of the pudendal nerve or its transversus perinei branch alone resulted in an increase in intraurethral closure pressure to 60 to 70 cm. water--an increase similar to that produced by stimulation of the sacral root without neurotomy. By means of neurotomy and/or neural blockade with lidocaine we were able to differentiate between the contributions of each muscular element to the external sphincteric mechanism. Almost 70 per cent of the closure pressure of the external urethral sphincter is induced by stimulation of the S3 ventral root, while the other 30 per cent derives from S2 and S4 neuronal impulses. PMID- 3275805 TI - Measurement of the plasma clearance of urographic contrast media for the determination of glomerular filtration rate. AB - Further experience with a new method to determine glomerular filtration rate is presented. The method depends on measurement by an x-ray fluorescence technique of the plasma disappearance of the injected iodine in standard nonionic radiographic contrast media used during excretory urography. The results of comparison of contrast clearance with 99m technetium diethylenetriaminepentaacetic acid clearance in 33 cases showed excellent agreement with a correlation coefficient of 0.95. Reproducibility of the contrast clearance method was confirmed by repeated examination of 10 plasma samples at weekly intervals for 6 weeks, the results of which showed no significant differences. The contrast clearance technique for the measurement of glomerular filtration rate during excretory urography is simple, quick and accurate, and merits further development. PMID- 3275806 TI - The life and work of Geza de Takats, 1892-1985. Remembrances of a friend and admirer. PMID- 3275807 TI - Relationship of venous reflux to the site of venous valvular incompetence: implications for venous reconstructive surgery. AB - To evaluate the relationship of the site of venous valvular incompetence to the severity of venous reflux, legs of 71 patients with suspected chronic venous insufficiency were evaluated with Doppler ultrasonography and photoplethysmography. A venous recovery time (VRT) of less than 20 seconds after calf muscle exercise was considered indicative of significant reflux. Average VRTs were brief in 15 legs with stasis changes (10 +/- 7 seconds), longer in 42 legs with edema (26 +/- 23 seconds), and normal in 64 asymptomatic legs (37 +/- 24 seconds) and 16 legs with pain (53 +/- 19 seconds). Average VRTs in limbs with incompetent saphenous veins were abnormal. In limbs with competent superficial veins, only those with incompetent distal deep veins (popliteal and posterior tibial) had abnormal VRTs (14 +/- 10 seconds). VRTs in limbs with no detectable valvular incompetence and in those with incompetence limited to the proximal deep veins (common and superficial femoral) were normal (47 +/- 23 and 42 +/- 27 seconds, respectively). When superficial veins were incompetent, an ankle tourniquet normalized VRTs in 63% of legs with proximal deep venous incompetence and in only 33% of legs with distal deep venous incompetence. It is concluded that venous reflux is largely determined by saphenous and distal deep valvular function and that competence of the proximal valves has little effect. Decreased venous reflux would not be expected after proximal valvular reconstruction. PMID- 3275808 TI - Multicenter prospective study of nonruptured abdominal aortic aneurysms. I. Population and operative management. AB - This article describes the patient population and operative management of 666 patients with nonruptured aneurysms of the abdominal aorta. Statistical significance of variables was determined by the chi-square test and logistic regression analysis. There were no statistically significant differences (p greater than 0.05) in mortality rate for abdominal aortic aneurysm (AAA) on the basis of indication for surgery (asymptomatic, 3.9%; asymptomatic but with evidence of enlargement, 4.9%; and symptomatic, 7.2%) or the urgency of operation (elective operation, 4.5%; and urgent operation, 7.1%). Characteristics of the 72 participating surgeons did not influence the operative mortality rate. A family history of AAA was documented in 6.1% of cases and was more common if the patient was female (p = 0.03) and less than 65 years of age (p = 0.04). Patients without clinical evidence of coronary artery disease had a 0.8% mortality rate from cardiac disease compared with 6.2% if any stigmata of coronary disease were present. Prior aortocoronary bypass surgery did not reduce the incidence of postoperative cardiac events or operative mortality rate. Patients having "routine" angiography did not have a less complicated operative course, fewer thrombotic complications, or lower mortality rate than those not having it. Those patients with an inflammatory AAA (4.5%) did not have a significantly higher incidence of pain. Heparin administration (84.8%) did not reduce the complications of graft thrombosis, "trash," distal thrombosis, and/or amputation. The 6.8% of patients requiring suprarenal aortic cross-clamping had a higher incidence of postoperative renal dysfunction (p = 0.02) and intraoperative blood loss (p less than 0.001), but cardiac events were not more frequent. When the aortic cross-clamping time was prolonged (more than 70 minutes), the requirement for crystalloid fluid administration increased (p less than 0.001) and postoperative myocardial infarction was more common (p = 0.004). After ligation of the left renal vein in 7.9%, renal damage or dialysis was more frequent (p = 0.01). Patients having an intra-abdominal graft (tube, 38.5% and biiliac, 30.7%) had fewer wound infections (p = 0.02) and graft thromboses (p less than 0.001) than the patients with a femoral anastomosis. When the internal iliac artery flow was interrupted bilaterally (12%), diarrhea (p = 0.03) and ischemic colitis (p = 0.03) were more frequent complications. Reimplantation of the inferior mesenteric artery was carried out in 4.8%. After renal artery bypass in 2.1%, the mortality rate was not increased, but the incidence of transient renal dysfunction was increased (p = 0.03).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3275809 TI - Institut Pasteur begins its second century. PMID- 3275811 TI - Use of patient-controlled analgesia for management of acute pain. AB - Patient-controlled analgesia (PCA) provides improved titration of analgesic drugs, thereby minimizing individual pharmacokinetic and pharmacodynamic differences. Patient-controlled analgesia decreases patient anxiety resulting from delays in receiving pain-relieving medication and from the slow onset of analgesic action when these drugs are administered either intramuscularly or in the extradural space. With PCA therapy, patients are reportedly able to maintain a near optimal state of analgesia with minimal sedation and few side effects. The potential for overdose can be minimized if small bolus doses are used with a mandatory lockout interval between successive doses. Finally, studies of the cost effectiveness of PCA therapy are important if this therapeutic approach is to achieve more widespread acceptance. PMID- 3275810 TI - Analysis of the use of HIV antibody testing in a Minnesota hospital. AB - We retrospectively studied the clinical use of human immunodeficiency virus (HIV) antibody serology at one 450-bed medical center and affiliated clinics from April 1985 through August 1986. No restrictions were placed on the use of HIV antibody serology during that time, although it was recommended that consent be obtained and risk-reduction information be provided. Testing was performed for 275 patients; results for 25 (9%) of these were positive. Nearly half (44%) of the patients had no recognized risk factor for HIV infection recorded in their charts. For an additional 44% of the patients, the test was medically indicated but consent and counseling were not documented. For only 10% of HIV antibody tests was there notation that consent was obtained and that risk-reduction information was provided. These results indicate that HIV antibody testing is often done without consent and that opportunities to provide risk-reduction counseling are being missed. PMID- 3275812 TI - Sensitivity, specificity, and predictive value of body surface cultures in a neonatal intensive care unit. AB - We analyzed 24,584 cultures obtained from 3371 infants during a three-year period to determine how frequently body surface culture isolates matched those obtained subsequently from body fluids. The sensitivity, specificity, and predictive values of surface cultures were calculated daily for the two weeks up to and including the day that a body fluid culture was obtained. Isolates from cultures of material from the ear canal, nasopharynx, axilla, umbilicus, groin, rectum, stomach, and endotracheal tube were rarely the same as those recovered from blood or fluids of the cerebrospinal, joint, pleural, pericardial, and peritoneal spaces. With a frequency of sepsis of 3.3% among patients in our neonatal intensive care unit, the optimum sensitivity, specificity, and positive predictive values of surface cultures were 56%, 82%, and 7.5%, respectively. These values did not improve substantially for any specific times of surface cultures prior to sepsis, for anatomic sites cultured, or for pathogens recovered. We conclude that surface cultures are of limited value in predicting the etiology of sepsis in neonates. PMID- 3275813 TI - Magnetic resonance imaging of the cardiovascular system. Present state of the art and future potential. Council on Scientific Affairs. Report of the Magnetic Resonance Imaging Panel. AB - State-of-the-art magnetic resonance imaging (MRI) generates high-resolution images of the cardiovascular system. Conventional MRI techniques provide images in six to ten minutes per tomographic slice. New strategies have substantially improved the speed of imaging. The technology is relatively expensive, and its cost-effectiveness remains to be defined in relation to other effective, less expensive, and noninvasive technologies, such as echocardiography and nuclear medicine. The ultimate role of MRI will depend on several factors, including the development of specific applications such as (1) noninvasive angiography, especially of the coronary arteries; (2) noninvasive, high-resolution assessment of regional myocardial blood flow distribution (eg, using paramagnetic contrast agents); (3) characterization of myocardial diseases using proton-relaxation property changes; and (4) evaluation of in vivo myocardial biochemistry. The three-dimensional imaging capability and the ability to image cardiovascular structures without contrast material give MRI a potential advantage over existing noninvasive diagnostic imaging techniques. This report analyzes current applications of MRI to the cardiovascular system and speculates on their future. PMID- 3275814 TI - A reappraisal of nitrate therapy. AB - Nitroglycerin and the long-acting nitrates are beneficial in stable and unstable angina pectoris and acute myocardial infarction and as adjunctive therapy in congestive heart failure. Nitroglycerin compounds relax vascular smooth muscle, producing venous, arterial, and arteriolar dilatation. These actions are modulated by stimulation of intracellular cyclic guanosine monophosphate. Nitrate efficacy in ischemic heart disease is due to peripheral venous and arterial vasodilatation that results in decreased myocardial oxygen consumption. Nitrates also dilate coronary arteries and collaterals, reverse coronary vasoconstriction, and enlarge some coronary atherosclerotic lesions. Nitrates improve exercise performance in stable angina pectoris. Intravenous nitroglycerin should be used in the initial treatment of unstable angina. Nitrates may be beneficial in myocardial infarction for control of ischemic pain, acute hypertension, and left ventricular failure. In subjects with congestive heart failure, nitrates reduce symptoms and improve exercise tolerance. Nitrate tolerance is a problem with continuous nitrate therapy. Tolerance is most likely to occur with frequent dosing or the use of long-acting nitrates, particularly transdermal nitroglycerin disks, and can be prevented or reversed with intermittent-dosing regimens. PMID- 3275815 TI - The association between malaria, blood transfusions, and HIV seropositivity in a pediatric population in Kinshasa, Zaire. AB - Since Plasmodium falciparum malaria is a frequent cause of anemia among African children, and blood transfusions, unscreened for human immunodeficiency virus (HIV) antibody, are used frequently in the treatment of children with severe malaria, the relationships between malaria, transfusions, and HIV seropositivity were investigated in a pediatric population in Kinshasa, Zaire. In a cross sectional survey of 167 hospitalized children, 112 (67%) had malaria, 78 (47%) had received transfusions during the current hospitalization, and 21 (13%) were HIV seropositive. Ten of the 11 seropositive malaria patients had received transfusions during the current hospitalization; pretransfusion specimens were available for four of these children and were seronegative. Of all blood transfusions, 87% were administered to malaria patients, and there was a strong dose-response association between transfusions and HIV seropositivity. A review of 1000 emergency ward records demonstrated that 69% of transfusions were administered to malaria patients, and 97% of children who received transfusions had pretransfusion hematocrits of 0.25 or less (less than or equal to 25%). The treatment of malaria with blood transfusions is an important factor in the exposure of Kinshasa children to HIV infection. PMID- 3275816 TI - Clarification and standardization of substance abuse terminology. AB - A four-stage Delphi survey of substance abuse experts was conducted to help achieve greater clarity and uniformity in terminology associated with alcohol and other drug-related problems. This multidisciplinary group of experts was asked to reach a consensus on alcohol and other drug-related terms and definitions. Results produced a list of 50 substance abuse terms deemed important, along with the most agreed on definition for each term. PMID- 3275817 TI - Neural tube defects. AB - Neural tube defects (NTDs) are a group of malformations of the brain and spinal cord that originate at various times during gestation. The most common NTDs are anencephaly and meningomyelocele, which arise during the process of neurulation, a well-defined period between the 17th and 30th day after ovulation. These NTDs are clinically apparent by being open, ie, leaving nervous tissue exposed, in contrast to postneurulation NTDs that are skin covered. The incidence of NTDs is declining in several areas of the world, including the United States. While the reasons for this are unclear, there seems to be some effect from prenatal diagnosis, genetic counseling, and possibly nutritional supplementation. PMID- 3275818 TI - Leads from the MMWR. Update: serologic testing for antibody to human immunodeficiency virus. PMID- 3275819 TI - Right ventricular myocardial infarction. PMID- 3275820 TI - Report of the organ transplant panel. Corneal transplantation. Council on Scientific Affairs. AB - Corneal transplantation is the most common form of organ transplantation practiced in the United States. Two procedures for transplantation are utilized. Penetrating keratoplasty is used in about 90% of the cases, with lamellar keratoplasty being utilized in the remaining situations. Demand for corneal transplantation exceeds the available supply of corneas. Advances in procurement and preservation must continue to meet this demand. Finally, these procedures are not without complications, and these are discussed to provide a clear risk benefit analysis. PMID- 3275821 TI - The rise and fall (and rise?) of rheumatic fever. PMID- 3275822 TI - Artificial heart can be reassuring backup for surgeons, says pioneer. PMID- 3275823 TI - As for heart transplants... PMID- 3275824 TI - Additional artificial heart studies funded. PMID- 3275825 TI - The selection of cadaver kidney recipients. PMID- 3275826 TI - Surgical technique for implantation of the Jarvik-7-100 total artificial heart. PMID- 3275828 TI - Permanent heart substitution: better solutions lie ahead. PMID- 3275827 TI - The physician, the media, and the 'spectacular' case. PMID- 3275829 TI - Permanent implantation of the Jarvik-7 total artificial heart: a clinical perspective. PMID- 3275830 TI - Artificial heart implantation: what limitations are imposed by infectious complications? PMID- 3275831 TI - Fetal susceptibility to viral and chemical carcinogens. PMID- 3275832 TI - Mammalian glucocerebrosidase: implications for Gaucher's disease. PMID- 3275833 TI - Effect of glucan on neutrophil dynamics and immune function in Escherichia coli peritonitis. AB - Previous studies from our laboratory have demonstrated that glucan, a nonspecific immunomodulator, modifies the course of murine Escherichia coli peritonitis. The protective effect of glucan was mediated, in part, by macrophages. In the present study, leukocyte dynamics in the peritoneal cavity and peripheral blood of glucan treated mice following E. coli challenge was examined. Additional studies examined in vitro bone marrow proliferation, as well as phagocytosis and intracellular killing of E. coli by neutrophils following glucan administration. ICR/HSD mice were injected ip with glucan (150 mg/kg) or dextrose (5% w/v) on Days 5 and 3 prior to ip challenge with 1 X 10(8) E. coli. Glucan increased (P less than 0.05) total peritoneal neutrophil numbers prior to and following septic challenge. Examination of peripheral blood revealed that ip glucan treatment in E. coli peritonitis significantly (P less than 0.001) increased the number of circulating neutrophils. Additionally, neutrophils from glucan-treated mice showed increased phagocytosis of E. coli in vitro. Glucan therapy also increased bone marrow proliferation. We conclude that (1) glucan enhances peritoneal neutrophil levels, (2) peripheral blood neutrophils are increased following glucan and E. coli, (3) ip glucan increases bone marrow proliferation, and (4) neutrophils from glucan-treated mice showed enhanced phagocytosis of E. coli in vitro. Thus, the beneficial effect of glucan is mediated not only by activated macrophages, but also by the neutrophilic leukocyte. PMID- 3275834 TI - Pepsinogen: biological and pathophysiologic significance. PMID- 3275835 TI - Immunohistochemical study of carcinoembryonic antigen (CEA) in gastric tumors: correlation with preoperative serum levels, histologic type, and grade of anaplasia of the tumor. AB - The occurrence of carcinoembryonic antigen (CEA) was studied in 45 cases of gastric tumors by the immunoperoxidase technique. CEA-positive staining was found in 48.8% of tumors. A correlation was found between preoperative CEA values and tumor CEA staining. All patients with serum CEA values below 2.5 ng/ml showed CEA negative staining of tumor. In patients with serum CEA values between 2.6 and 10 ng/ml, the tumors showed a minority of CEA-positive cells; but in patients with serum CEA values above 10 ng/ml, the tumors contained a majority of CEA-positive cells. CEA-positive staining was found in 34.4% of tumors of the diffuse type, and in 75% of tumors of the intestinal type. A high percentage of CEA positivity was seen in well-differentiated tumors (87.7%) compared to the moderately differentiated (69.2%), and to the undifferentiated (28.7%). A faint CEA positivity was observed in intestinal metaplasia, while normal gastric mucosa was CEA-negative. PMID- 3275836 TI - Growth of the aortic anastomosis in pigs. Comparison of continuous absorbable suture with nonabsorbable suture. AB - Growth at the anastomotic site after continuous vascular anastomosis in the pediatric patient remains a problem. Primary end-to-end anastomosis of the infrarenal aorta was performed with absorbable Maxon suture or nonabsorbable Prolene suture in 20 piglets. Ten of the Maxon suture group and nine of the Prolene suture group survived; one pig died of infection. The animals were put to death 6 months after the operation. Each abdominal aorta was removed and a roentgenogram was obtained. The aorta was then burst-tested to 300 mm Hg, measured, and examined both grossly and histologically. All anastomoses were patent and no burst failures were observed in either group. However, Prolene sutures protruded into lumen and were partially embedded in the aortic wall in all animals in the Prolene suture group. Thrombus adhered to the intraluminal Prolene suture in six of nine animals. The growth of the anastomotic area was wider in the Maxon suture group (446.4% +/- 131.8% versus 317.6% +/- 121.5%, p less than 0.05). Stenosis was more common in the Prolene suture group (7/9) than in the Maxon suture group (1/10) (p less than 0.01), but the distal segment was widely patent in both groups. Dilatation at the anastomotic site was present in eight of 10 pigs in the Maxon suture group and in two of nine in the Prolene suture group. Histologic study showed that the area of tissue reaction was more prominent in the Prolene suture group. No sutures were observed in the Maxon suture group. We therefore recommend the use of absorbable Maxon sutures for anastomoses in which the suture line must be able to grow. PMID- 3275837 TI - Simultaneous aortic and mitral valve replacement for lupus endocarditis: report of a case and review of the literature. AB - Severe aortic and mitral valvular insufficiency developed in a 52-year-old woman with systemic lupus erythematosis after previous treatment with corticosteroids, splenectomy, and cyclophosphamide for immune thrombocytopenia and hemolytic anemia. After aggressive management of the thrombocytopenia, simultaneous prosthetic replacement of both valves was satisfactorily performed; pathologic examination revealed myxoid degeneration. The patient was doing well with excellent valve function 26 months after the operation. The relationship of steroid therapy to lupus valvulitis is reviewed. PMID- 3275838 TI - A simple technique for multiorgan preservation. AB - A simple technique for multiorgan preservation with no ischemic time was developed. In five mongrel dogs, the heart and lungs were separated and removed with the liver, pancreas, kidneys, and a small portion of intestine en bloc while they were being self-perfused. A respirator was used for oxygenation. Arterial and venous blood pressures were measured by indwelling catheters. Fresh blood, glucose, electrolytes, mannitol, prednisolone, and a fat emulsion (Soyacal) were infused through the portal vein. The organs were experimentally perfused for 12 hours. Aortic systolic pressure ranged from 75 to 125 mm Hg, central venous pressure from 0 to 5 mm Hg, portal venous pressure from 0 to 3 mm Hg, bile output from 5 to 20 ml/hr, urine output from 10 to 70 ml/hr, and hematocrit value from 35% to 55%. The heart and lungs were normal and physiologically functional during the preservation time. The pancreas and small intestine appeared normal. Three of the livers showed some congestion. The kidney in one organ block appeared to have some edematous swelling after 16 hours. The technique for multiorgan preservation presented here is simple and effective. The preliminary data are encouraging and suggest further evaluation. PMID- 3275839 TI - Experimental and clinical double lung transplantation. AB - We have previously demonstrated the technical feasibility of an en bloc double lung transplantation in acute canine experiments. We have now conducted survival experiments in cynomolgus monkeys. Profound hypothermia and circulatory arrest were used to avoid the need for cardiopulmonary bypass in these very small animals. Because of the complexities of this technique, few long-term survivals resulted, but these experiments did confirm excellent lung function and satisfactory tracheal healing. On the basis of these experiments, we have performed our first clinical double lung transplantation on a 42-year-old woman with end-stage emphysema caused by alpha 2-antitrypsin deficiency. The patient has returned to normal activities with excellent lung function. PMID- 3275840 TI - Noninvasive assessment of donor and native heart function after heterotopic heart transplantation. AB - The contribution of the donor heart to total circulatory performance after heterotopic heart transplantation has been difficult to assess. First-pass nuclear angiocardiography and directional Doppler echocardiography were used to examine separately left and right ventricular function of the donor heart after heterotopic transplantation. A comparison was made between two patients, one with a low initial pulmonary vascular resistance and one with a high, relatively fixed pulmonary vascular resistance. In both cases, currently available noninvasive techniques allowed confirmation of the expectation that the donor left ventricle can function effectively as a left ventricular bypass. In neither case was recovery of the native heart demonstrated. The contribution of the donor right ventricle to total right ventricular output appeared to be dependent on the condition of the donor heart and on the pulmonary vascular resistance. In situations with a high pulmonary vascular resistance and end-stage right ventricular failure, it was concluded that the donor heart may not at first constitute an effective assist for the native right ventricle. Native right ventricular failure may then become a major factor influencing survival after heterotopic heart transplantation. PMID- 3275841 TI - Evaluation of TestPack Strep A for the detection of group A streptococci in throat swabs. AB - The performance of TestPack Strep A (Abbott Laboratories), a rapid enzyme immunoassay, was compared with a culture-based method for the detection of group A streptococci in 648 throat swabs. The rapid test correctly detected 99 of the 128 positive and 511 of the 520 negative specimens, a sensitivity of 77% and a specificity of 98%. Although highly specific, TestPack Strep A is less sensitive than culture techniques for the detection of group A streptococci in throat swabs. PMID- 3275842 TI - Photography of medical specimens: experiences from teaching cardiovascular pathology. AB - Preparation of high-quality 35-mm slides for the teaching of cardiovascular pathology involves little more time and expense than the preparation of poor quality slides. Attention to proper focusing and exposure times, the use of diffusion screens to eliminate reflections, and the use of nonobtrusive black backgrounds are recommended. Specimens should be fixed before being photographed, and perfusion-fixation is recommended for cases in which tomographic dissections are performed. Hearts dissected by the inflow-outflow method may require pinning so that specific abnormalities may be demonstrated optimally. Lesions may be highlighted with probes and arrows or by comparison with a normal specimen. Use of composite slides is particularly recommended for visual conceptualization of mechanisms and pathogenesis of disease. These techniques are also applicable for the preparation of teaching slides in areas of pathology other than cardiovascular. PMID- 3275843 TI - Rheumatoid arthritis: can the long-term outcome be altered? AB - Although several agents (for example, intramuscularly administered gold, auranofin, D-penicillamine, hydroxychloroquine, and methotrexate) are of clinical benefit in the management of rheumatoid arthritis (RA), their effect on the long term outcome of the disease is controversial. Assessment of the influence of therapeutic interventions in RA is difficult because the natural history of the disease remains poorly defined and unpredictable, and neither the traditional clinical and laboratory measurements of inflammation nor radiographic analyses of progression of joint destruction provide an accurate estimate of the long-term outcome of RA. Furthermore, there is little evidence that second-line agents yield benefits beyond 3 years. Therefore, adequately tested comprehensive measures should be used in large, long-term, multicenter controlled clinical trials to determine whether the long-term outcome of RA can be altered. PMID- 3275844 TI - Legionella bozemanii pneumonia in an immunocompromised patient. AB - Legionella bozemanii, a rare cause of pneumonia, has a predilection for patients with impaired cellular immunity and underlying disease. We report the 12th culture-proven case of this infection, acquired in the community by a patient undergoing chemotherapy for chronic lymphocytic leukemia. The diagnosis was established when studies of bronchoalveolar lavage fluid produced a positive reaction with species-specific fluorescent antibody and growth on selective culture media. Although erythromycin was administered within 48 hours after the initial examination, the clinical condition did not improve substantially until rifampin was added to the antimicrobial regimen. PMID- 3275845 TI - Otto Heinrich Warburg. PMID- 3275846 TI - Platelets, antiplatelet therapy, and diabetic nephropathy. PMID- 3275847 TI - Neoadjuvant chemotherapy for invasive bladder carcinoma. PMID- 3275848 TI - HMO enrollment and Medicaid. Survival analysis with a Weibull function. AB - This paper analyzes the length of enrollment in Health Maintenance Organizations (HMOs) by performing secondary data analysis. It estimates a Weibull survival function using only simple regression. For middle-class enrollees in one HMO, the hazard rate (the disenrollment rate for the remaining members of a cohort) falls sharply with the length of enrollment. For medicaid beneficiaries allowed to remain in the fee-for-service sector, the hazard rate in another HMO is much greater but falls less sharply. Limiting the choice of Medicaid beneficiaries to HMOs would increase their length of enrollment, lowering a major barrier to HMOs' participation in Medicaid. PMID- 3275849 TI - Directory of otolaryngologic societies. PMID- 3275850 TI - Laryngeal paraganglioma: update on diagnosis and treatment. AB - Sixty-one cases of laryngeal paraganglioma have been reported in the world literature. Histologic and clinical similarities between this neuroendocrine neoplasm and other organoid laryngeal tumors have led to uncertainty regarding the malignant potential and prognosis of this entity. Immunohistochemical assays have identified biogenic amines and hormonal peptides in these tumors which may prove useful as diagnostic markers. Computer tomography (CT) scanning demonstrates an enhancing lesion and can determine the location and extent of the tumor. The generally small size and constant blood supply of the laryngeal paraganglioma make preoperative angiography unnecessary. Accordingly, intraoperative ligation of the arterial blood supply negates the need for embolization. Partial laryngectomy remains the mainstay of treatment. A case is reported of a patient with a paraganglioma of the larynx who was unsuccessfully treated by laser excision and required surgical resection. PMID- 3275851 TI - Amphetamine and chlorpromazine modify cerebral insulin levels in rats. AB - Rats treated with chlorpromazine (CPZ) (1 mg/kg/day i.p.) experienced a marked decline in cerebral insulin levels (0.057 +/- 0.01 ng/g wet weight) with respect to a control group (0.38 +/- 0.05 ng/g wet weight), while rats given D amphetamine bitartrate (AMPH) chronically (20 mg/kg/day p.o.) showed a rise in cerebral insulin (0.55 +/- 0.04 ng/g wet weight). Combined treatment with both drugs at the same dosages produced lower cerebral insulin levels (0.46 +/- 0.10 ng/g wet weight) than in the AMPH animals. In the groups of rats treated with CPZ and with AMPH + CPZ, there was a slight elevation in serum insulin levels. Serum glucose values did not vary. PMID- 3275852 TI - Superfused pituitary cell cultures: comparative responsiveness of cells derived from various stages of the estrous cycle to LHRH stimulation administered as short duration pulses. AB - We have reinvestigated the question of maintenance of differential LHRH sensitivity in culture and further investigated the role of pulsatile LHRH in the in vitro release of pulsatile LH and FSH at different stages of the estrous cycle. Pituitaries were collected on each day of the 4 day cycle at 0800. In addition, pituitaries were also collected at 1500 and 1900 on proestrous. The cells were dispersed and exposed 48 hrs later to short duration 4 ng LHRH pulses; this dose was optimized for LH release and was applied at a frequency of 1 pulse/60 min. In terms of absolute magnitude of LH response, observed responsiveness was ranked in the following order: proestrous 1900 greater than estrous 0800 greater than diestrous 1 0800 greater than proestrous 1500 greater than diestrous 2 0800. Responsiveness was significantly greater at proestrous 1900 (p greater than 0.01), estrous 0800 (p greater than 0.05) and diestrous 1 0800 (p greater than 0.05) when compared to either of the other stages tested. The heightened LHRH sensitivity of proestrous was therefore maintained in cell culture indicating that the system should be valid for conducting studies on the control of gonadotropin secretion during this period. FSH did not respond in pulsatile manner to the LHRH levels employed further substantiating recent evidence that LHRH seems to function somehow less directly in FSH as compared to LH secretion. PMID- 3275853 TI - Effect of cholesterol-rich diet on the susceptibility of rodent malarial parasites to chloroquine chemotherapy. AB - Mice were fed a cholesterol-rich diet and then subsequently infected with chloroquine-sensitive strains of either Plasmodium berghei or P. chabaudi. Chloroquine therapy, which was started 24 hours post-infection and continued for 3-4 days, was significantly less effective in cholesterol-fed animals compared to controls. The consequences of these findings to the resistance of P. falciparum in man to chloroquine, are discussed. PMID- 3275854 TI - Effects of chronic nicotine administration on insulin, glucose, epinephrine, and norepinephrine. AB - There is an inverse relationship between nicotine administration and body weight. Previous research indicates that this relationship results partially from effects of nicotine on energy intake. The present research includes two animal studies designed to investigate the effects of chronic nicotine administration on biochemical responses that affect energy utilization. The results indicate that chronic nicotine administration is accompanied by significant decreases in circulating insulin levels. Nicotine increases levels of catecholamines, but this effect is short-lived. The effects of nicotine on insulin are consistent with the conclusion that nicotine administration increases energy utilization. PMID- 3275855 TI - Repeated cocaine administration results in supersensitivity of striatal D-2 dopamine autoreceptors to pergolide. AB - Groups of rats administered cocaine-HC1 (10 mg/kg, i.p.) or saline either acutely or once daily for 8 or 14 days were killed 24 hrs after the last dose. In striatal slices prelabelled with [3H]DA, modulation of [3H]-overflow by pergolide was used to measure D-2 autoreceptor activity. Compared to the contemporaneous control group pergolide produced a greater inhibition only in striatal slices from rats treated repeatedly with cocaine. In radioligand binding studies using striatal membranes from control rats, pergolide had a 500-fold greater affinity for the D-2, as opposed to the D-1, dopamine (DA) receptor subtype. These results indicate that repeated treatment with cocaine produces supersensitive striatal D 2 release-modulating autoreceptors consistent with a compensatory change to diminish the effect of elevated synaptic concentrations of DA produced by cocaine. In contrast, supersensitivity of D-2 receptors was not detected in [3H]spiperone binding assays. PMID- 3275856 TI - Primary angiitis of the central nervous system. Report of 8 new cases, review of the literature, and proposal for diagnostic criteria. AB - Primary angiitis of the central nervous system (PACNS) is a rare form of angiitis limited to the central nervous system. The diagnosis and classification of this disorder has been problematic, owing to the lack of uniform diagnostic criteria and the difficulty in obtaining pathologic material for diagnosis. This study proposes to establish diagnostic criteria for PACNS which would include 1) the presence of an unexplained neurologic deficit after thorough clinical and laboratory evaluation; 2) documentation by cerebral angiography and/or tissue examination of an arteritic process within the central nervous system; and 3) no evidence of a systemic vasculitide or any other condition to which the angiographic or pathologic features could be secondary. Utilizing these criteria, 8 new cases are reported and are combined with 40 previously diagnosed cases from the literature. The clinical findings of the combined series revealed that headache was the most common symptom (58%) with a combination of focal and diffuse neurologic deficits described in 79% of the group. The diagnostic approach to PACNS should include a variety of laboratory tests and examination of the cerebral spinal fluid primarily to rule out mimicking conditions. Special procedures including electroencephalography, computed axial tomography, and magnetic resonance imaging appear only marginally helpful in securing the diagnosis, but are extremely important in ruling out other conditions. Angiography appears to be the first invasive diagnostic procedure of choice and it has a high predictive value when properly interpreted. Leptomeningeal and cortical biopsy can be accomplished with acceptable mortality and should be performed along with a normal or non-diagnostic angiogram when the diagnostic likelihood is high. Therapy of PACNS with a combination of cytotoxic drugs and high-dose corticosteroids has greatly improved the prognosis for this condition. PMID- 3275857 TI - Quantification of the relative impairment in actions of insulin on hepatic glucose production and peripheral glucose uptake in non-insulin-dependent diabetes mellitus. AB - In non-insulin-dependent diabetes mellitus (NIDDM), both liver and peripheral tissues are resistant to insulin, but the relative severity and contribution of these abnormalities to fasting hyperglycemia are poorly understood. We, therefore, determined the dose-response characteristics for insulin-mediated suppression of hepatic glucose production (GP) and stimulation of peripheral glucose uptake (GU) in 14 NIDDM subjects and 14 age- and weight-matched nondiabetic volunteers (NV) using the glucose clamp sequential insulin infusion technique along with isotopic estimation of glucose flux. Postabsorptive rates of both GP (94 +/- 7 v 72 +/- 2 mg/M2/min in NV, P less than .01) and GU (88 +/- 5 v 72 +/- 2 in NV, P less than .01) were significantly increased in NIDDM subjects. The ED50 (half-maximally effective plasma insulin concentration) in NIDDM subjects for suppression of GP (64 +/- 14 microU/mL) and stimulation of GU (118 +/- 20 microU/mL were both increased more than twofold above normal (26 +/- 2 and 58 +/- 5 microU/mL, respectively, both P less than .01) and were significantly correlated with one another (r = .68, P less than .01). Although GP could be totally suppressed in the NIDDM subjects, their maximal GU was reduced 30% (287 +/- 20 v 372 +/- 15 mg/m2/min in NV, P less than .01). Nevertheless, at all physiologically relevant plasma insulin concentrations studied, there was comparable impairment in GP and GU responses. Moreover, fasting plasma glucose concentrations in NIDDM subjects were highly correlated with their increased basal rates of GP (r = .81, P less than .005) but not with their reduced GU.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3275858 TI - Effect of alanine concentration independent of changes in insulin and glucagon on alanine and glucose homeostasis in the conscious dog. AB - The effect of an alanine load per se on hepatic alanine balance and hepatic glucose production is unclear. To examine this question, alanine was infused into six postabsorptive dogs at a rate of 6 mumol/kg-min, while maintaining insulin and glucagon levels using the pancreatic clamp technique. The arterial alanine concentration rose from a basal level of 227 +/- 16 mumol/L to 497 +/- 40 mumol/L during alanine infusion (P less than .01). The net hepatic fractional extraction of alanine remained unchanged, while hepatic alanine uptake increased from 3.0 +/ 0.3 to 6.0 +/- 0.4 mumol/kg-min (P less than .01). Conversion of alanine into glucose increased 87% to 2.7 +/- 0.3 mumol/kg-min during alanine infusion (P less than .01) while gluconeogenic efficiency remained essentially unchanged. Despite the increased gluconeogenic rate, the total rate of glucose production was unchanged. These data suggest that an increase in the alanine load to the liver causes a proportional increase in net hepatic alanine uptake and the gluconeogenic rate, but that in an overnight fasted animal this increase is insufficient to significantly increase glucose production. PMID- 3275859 TI - Insulin action on glucose uptake by soleus muscles of nonobese diabetic mice and streptozotocin diabetic mice. AB - To elucidate the insulin action in skeletal muscles in insulin-dependent diabetes, the glucose uptake by isolated soleus muscles was studied in streptozotocin (STZ)-diabetic mice and nonobese diabetic (NOD) mice that develop insulinopenic diabetes spontaneously. The maximally insulin-stimulated uptake of 2-deoxyglucose was significantly decreased in spontaneously diabetic NOD mice with 3 to 6 weeks duration of diabetes (10.18 +/- 0.58 v 12.80 +/- 0.44 nmol/muscle/20 min, P less than .005), while basal 2-deoxyglucose uptake was not significantly altered in them. The net insulin-stimulated uptake measured individually was also significantly reduced in spontaneously diabetic NOD mice (1.33 +/- 0.23 v 4.07 +/- 0.40 nmol/muscle/20 min, P less than .001). This was the case with STZ-diabetic ICR mice with 6 weeks duration of diabetes and STZ diabetic NOD mice with 2 weeks and 6 weeks durations of diabetes as well. The submaximal effect of insulin on 2-deoxyglucose uptake by the soleus muscle, defined as the percent of the maximal effect achieved at 10 ng/mL of insulin, was not significantly altered in STZ-diabetic NOD mice. These data suggest that a prolonged insulinopenic state might reduce the insulin-stimulated glucose uptake in skeletal muscles by diminishing the insulin responsiveness and cause the insulin resistance in diabetic animals. PMID- 3275860 TI - The disposal of an oral glucose load in patients with non-insulin-dependent diabetes. AB - Following glucose ingestion, tissue glucose uptake is enhanced and endogenous glucose production is inhibited, thus contributing to the maintenance of normal glucose tolerance. To examine whether these responses are disturbed in diabetes, glucose kinetics after oral glucose administration were studied in 12 non-insulin dependent diabetic and 10 age- and weight-matched control subjects. A double tracer approach was used, whereby the endogenous glucose pool was labeled with 3 3H-glucose and the oral load with 1-14C-glucose. The two glucose tracers were separated in plasma by a two-step chromatographic procedure, and the two sets of isotopic data were analyzed according to a two-compartment model for the glucose system. Basally, glucose production was slightly higher in diabetics than in controls (2.51 +/- 0.24 v 2.28 +/- 0.11 mg/kg.min, NS) even though the former had higher plasma glucose (189 +/- 19 v 93 +/- 2 mg/dL, P less than .001) and insulin (23 +/- 4 v 12 +/- 1 microU/mL, P less than .05) concentrations. Following the ingestion of 1 g/kg of glucose, oral glucose appeared in the peripheral circulation in similar time-course and amount in the two groups (75 +/- 2% of the load over 3.5 hours in the diabetics v 76 +/- 3% in controls). Endogenous glucose production was promptly inhibited in diabetic and normal subjects alike, but the mean residual hepatic glucose production after glucose ingestion was significantly greater in the diabetic group (17 +/- 2 v 10 +/- 3 g/3.5 h, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3275862 TI - Prevalence of antibody to Legionella pneumophila in aborigines and non-aborigines in Western Australia. AB - Three hundred and sixty-two sera were examined by the Legionella pneumophila indirect fluorescent antibody test, with serogroups 1 to 6 as antigens. Three age and sex-matched population groups were tested: 200 non-aborigines from Perth; 100 aborigines from the Kimberley region; and 62 aborigines from Jiggalong Mission in the Pilbara region. Each population group was composed of 50% male and 50% female subjects, all within the age range of 20 to 40 years. The seropositivity rate for serogroup 1 (Philadelphia) was 13% for the Perth population group, 26% for the Kimberley group and 35.5% for the Jiggalong group. Seropositivity rates with the other 5 serogroups for the Perth population group were as follows: serogroup 2, 1%; serogroup 3, 5%; serogroup 4, 3%; serogroup 5, 3%; and serogroup 6, 9.5%. In both of the aboriginal population groups more subjects were seropositive to serogroups 3 and 5 than to serogroup 1. Multiple serogroup specificities and the occurrence of high titres were more common among the aboriginal groups. These findings indicate that there is considerable variation in the prevalence of L. pneumophila antibodies among ecologically distinct groups within Western Australia. PMID- 3275861 TI - Two-week stimulation or blockade of the sympathetic nervous system in man: influence on body weight, body composition, and twenty four-hour energy expenditure. AB - Seven lean healthy young men were studied for 6 weeks during exposure to pharmacologic inhibition or stimulation of the sympathetic nervous system. For a period of 2 weeks their beta-adrenergic receptors were either blocked with propranolol hydrochloride (160 mg/d) or stimulated with terbutaline sulphate (15 mg/d). After a further 2 weeks of placebo administration (500 mg lactose/d), the subjects crossed over to the drug they had not been taking at the beginning of the experiment for another 14 days. During the last five days of each 2-week period, the subjects consumed a weight-maintaining diet, composed of 12% protein, 48% carbohydrate, and 40% fat. They consumed exactly the same menus on the same days during the subsequent study periods. Body weight and physical activity were measured every day for 6 weeks. Daily heart rate and nitrogen excretion were measured continuously for days at the end of each 2-week period, the last two days of which were spent in a respiration chamber where energy expenditure and a variety of metabolic parameters were measured. In the respiration chamber on the propranolol, placebo, and terbutaline treatments, respectively, significant differences were observed in mean daily heart rate (65 +/- 3, 75 +/- 4, and 84 +/ 4 beats/min), mean sleeping heart rate (51 +/- 2, 56 +/- 3, and 62 +/- 3 beats/min), nitrogen excretion (13.6 +/- 0.7, 12.6 +/- 0.6, and 11.9 +/- 0.6 g/d), fat oxidation (+1,045 +/- 95, +1,243 +/- 148, and +1,278 +/- 84 kcal/d) and thyroid hormones (12.0 +/- 0.7, 15.7 +/- 0.9, and 17.2 +/- 1.0 T3/T4 ratio).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3275863 TI - Insulin and its administration: changes continue. PMID- 3275864 TI - Cytochrome P-450 b and c in the rat brain and pituitary gland. AB - A quantitative assessment of the levels of cytochromes P-450 b and P-450 c in the brains and pituitary glands of untreated and beta-naphthoflavone (BNF)-pretreated rats was made with polyclonal antibodies raised against hepatic P-450 b and c and the sensitive fluorometric assay of P-450 catalytic activity, namely, the O deethylation of ethoxycoumarin (ETC). In the microsomal fraction of brains of untreated rats, the rate of formation of 7-hydroxycoumarin from ETC ranged between 0.1 and 20 pmol/min/mg of microsomal protein, which is approximately 0.01 2% of the level of hepatic microsomes of phenobarbital-induced rats. This brain activity was completely inhibited by anti P-450 b antibodies but was unaffected by anti P-450 c antibodies. As with hepatic P-450 b, metyrapone and chloramphenicol (100 microM) were good inhibitors of catalytic activity, whereas alpha-naphthoflavone (1 microM) was a poor inhibitor. No ETC O-deethylase activity was detectable in microsomes prepared from the pituitary glands of untreated rats. Upon pretreatment of rats with BNF, there was induction of ETC O deethylase activity in the pituitary gland to a level of 3.3 +/- 1.5 pmol/min/mg of microsomal protein, but there was no significant increase in the level of activity in brain microsomes. Despite this, there was evidence of induction of P 450 c in both the brain and pituitary of BNF-pretreated rats since anti P-450 c antibodies inhibited brain activity by 55% and pituitary activity by 84%. The regional distribution of P-450 b and c in the hypothalamic-preoptic area and olfactory bulbs was examined. The level of ETC O-deethylase activity in the hypothalamic-preoptic area was not different from that in the whole brain, but in the olfactory bulbs activity was higher than that in whole brain, with a range of 0.1-52 pmol/min/mg of microsomal protein. The catalytic activity in the whole brain and in the olfactory bulbs was inhibited by anti P-450b but not by anti P 450c antibodies. Neither estradiol, testosterone, dehydrotestosterone, nor 5 alpha-androstane,3 beta,17 beta-diol (100 microM) competitively inhibited ETC O deethylase activity, indicating that P-450 b is not responsible for the steroid hydroxylations previously reported in the brain. BNS pretreatment of rats did not cause a consistent increase in ETC O-deethylase upon BNF induction. However, there was an induction of P-450 c in the olfactory bulbs since catalytic activity was inhibited with anti P-450c antibodies.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3275865 TI - Complex translocation disrupts c-myc regulation in a human plasma cell myeloma. AB - A complex translocation has interrupted the third exon of the c-myc gene in human plasma cell myeloma tumor cells and a derivative cell line (NCI-H929). As a result of this rearrangement, a chimeric mRNA is expressed which commences 5' of the c-myc coding region and includes sequences introduced by the translocation event. All of the detectable c-myc-containing mRNA in the tumor and cell line was derived from this rearranged c-myc allele. This chimeric c-myc mRNA, in which most of the germ line c-myc 3' untranslated region has been replaced, was greater than sevenfold more stable than c-myc transcripts with intact 3' ends. This suggests that the 3' untranslated region may play an important role in c-myc mRNA stability. PMID- 3275866 TI - The accumulation of three yeast ribosomal proteins under conditions of excess mRNA is determined primarily by fast protein decay. AB - The suggestion that compensation for overabundant mRNA of the genes for Saccharomyces cerevisiae ribosomal protein (r-protein) L3, L29, or rp59 occurs by translation repression has been reinvestigated. First, analysis of the distribution of these three mRNAs in polysome profiles revealed no differences between normal and mRNA-overproducing strains, indicating that initiation of r protein translation is not repressed under conditions of mRNA overaccumulation. Second, experiments involving radioactive pulse-labeling of proteins were done by using a modified method of data collection and analysis that allows quantitation and correction for fast decay during the pulse. These measurements revealed that the synthesis rate of the three r-proteins is increased when their mRNA levels are elevated and that their decay rate is also high, with half-lives ranging from a fraction of a minute to more than 10 min. We conclude that accumulation of excess r-protein mRNA has no effect on translation rate; rapid decay of protein during the course of the labeling period can account for the apparent discrepancy between mRNA levels and protein synthesis rates. Yeast r-proteins, when produced in excess, are among the most rapidly degraded proteins so far described. PMID- 3275867 TI - Two DNA-binding factors recognize specific sequences at silencers, upstream activating sequences, autonomously replicating sequences, and telomeres in Saccharomyces cerevisiae. AB - Two DNA-binding factors from Saccharomyces cerevisiae have been characterized, GRFI (general regulatory factor I) and ABFI (ARS-binding factor I), that recognize specific sequences within diverse genetic elements. GRFI bound to sequences at the negative regulatory elements (silencers) of the silent mating type loci HML E and HMR E and to the upstream activating sequence (UAS) required for transcription of the MAT alpha genes. A putative conserved UAS located at genes involved in translation (RPG box) was also recognized by GRFI. In addition, GRFI bound with high affinity to sequences with the (C1-3A)-repeat region at yeast telomeres. Binding sites for GRFI with the highest affinity appeared to be of the form 5'-(A/G)(A/C)ACCCANNCA(T/C)(T/C)-3', where N is any nucleotide. ABFI binding sites were located next to autonomously replicating sequences (ARSs) at controlling elements of the silent mating type loci HMR E, HMR I, and HML I and were associated with ARS1, ARS2, and the 2 micron plasmid ARS. Two tandem ABFI binding sites were found between the HIS3 and DED1 genes, several kilobase pairs from any ARS, indicating that ABFI-binding sites are not restricted to ARSs. The sequences recognized by ABFI showed partial dyad-symmetry and appeared to be variations of the consensus 5'-TATCATTNNNNACGA-3'. GRFI and ABFI were both abundant DNA-binding factors and did not appear to be encoded by the SIR genes, whose products are required for repression of the silent mating type loci. Together, these results indicate that both GRFI and ABFI play multiple roles within the cell. PMID- 3275868 TI - Primary structure of the human fgr proto-oncogene product p55c-fgr. AB - Normal human c-fgr cDNA clones were constructed by using normal peripheral blood mononuclear cell mRNA as a template. Nucleotide sequence analysis of two such clones revealed a 1,587-base-pair-long open reading frame which predicted the primary amino acid sequence of the c-fgr translational product. Homology of this protein with the v-fgr translational product stretched from codons 128 to 516, where 32 differences among 388 codons were observed. Sequence similarity with human c-src, c-yes, and fyn translational products began at amino acid position 76 of the predicted c-fgr protein and extended nearly to its C-terminus. In contrast, the stretch of 75 amino acids at the N-terminus demonstrated a greatly reduced degree of relatedness to these same proteins. To verify the deduced amino acid sequence, antibodies were prepared against peptides representing amino- and carboxy-terminal regions of the predicted c-fgr translational product. Both antibodies specifically recognized a 55-kilodalton protein expressed in COS-1 cells transfected with a c-fgr cDNA expression plasmid. Moreover, the same protein was immunoprecipitated from an Epstein-Barr virus-infected Burkitt's lymphoma cell line which expressed c-fgr mRNA but not in its uninfected fgr mRNA negative counterpart. These findings identified the 55-kilodalton protein as the product of the human fgr protooncogene. PMID- 3275869 TI - Distinct binding sites for zinc and double-stranded RNA in the reovirus outer capsid protein sigma 3. AB - By atomic absorption analysis, we determined that the reovirus outer capsid protein sigma 3, which binds double-stranded RNA (dsRNA), is a zinc metalloprotein. Using Northwestern blots and a novel zinc blotting technique, we localized the zinc- and dsRNA-binding activities of sigma 3 to distinct V8 protease-generated fragments. Zinc-binding activity was contained within an amino terminal fragment that contained a transcription factor IIIA-like zinc-binding sequence, and dsRNA-binding activity was associated with a carboxy-terminal fragment. By these techniques, new zinc- and dsRNA-binding activities were also detected in reovirus core proteins. A sequence similarity was observed between the catalytic site of the picornavirus proteases and the transcription factor IIIA-like zinc-binding site within sigma 3. We suggest that the zinc- and dsRNA binding activities of sigma 3 may be important for its proposed regulatory effects on viral and host cell transcription and translation. PMID- 3275870 TI - The 5' untranslated sequence of the c-sis/platelet-derived growth factor 2 transcript is a potent translational inhibitor. AB - c-sis/platelet-derived growth factor 2 (PDGF-2) is a prototype growth factor with transforming potential. The c-sis/PDGF-2 transcript contains a long 5' untranslated sequence (UTS) that is highly G.C rich. To examine the influence of this sequence on sis/PDGF-2 expression, we localized the c-sis/PDGF-2 promoter and used this promoter or the simian virus 40 early promoter to drive expression of the bacterial chloramphenicol acetyltransferase or sis/PDGF-2 gene. The 5' UTS of c-sis/PDGF-2 mRNA had no effect on RNA expression but was shown to exert a potent inhibitory effect on translation. By deletion analysis, we demonstrated that the 5' UTS inhibited protein expression by as much as 40-fold. The inhibitory effect was independent of reporter gene, cell type, or promoter used. A highly G.C-rich 140-base-pair sequence immediately preceding the c-sis/PDGF-2 initiation codon was shown to be nearly as effective as the entire 5' UTS in translational inhibition. Transfection analysis demonstrated that the 5' UTS significantly reduced the transforming efficiency of the sis/PDGF-2 gene as well. Thus, our findings raise the possibility that changes in regulation at the level of sis/PDGF-2 translation may play a role in development of the neoplastic phenotype. PMID- 3275871 TI - Differential regulation of the yeast CDC7 gene during mitosis and meiosis. AB - The product of the CDC7 gene of Saccharomyces cerevisiae is known to be required in the mitotic cell cycle for the initiation of DNA replication. We show that changes in transcript levels do not account for this stage-specific function, since the steady-state mRNA concentration remains constant at 1 copy per cell throughout the cell cycle. By measuring the cell division capacity of a cdc7::URA3 mutant after loss of a single-copy plasmid containing the CDC7 gene, we show that the CDC7 protein is present in at least 200-fold excess of the amount required for a single cell division. These results appear to exclude periodic transcription or translation as a means by which CDC7 function is regulated. In contrast, the CDC7 protein is known to be dispensable for meiotic S phase, but is required for synaptonemal complex formation and recombination. We found that the CDC7 transcript level does vary during meiosis, reaching a maximum near the time at which recombination occurs. Meiotic spores containing a cdc7 null allele germinate but fail to complete cell division. Apparently the excess CDC7 product present in mitotic cells is physically excluded from the spores (or becomes inactivated) and must be produced de novo after germination. The cdc7-1 allele had previously been shown to confer a reduction in the rate of induced mutation. We show that the cloned wild-type CDC7 gene not only complements this defect, but that when the CDC7 gene is on a multiple copy plasmid, induced mutagenesis is increased. Therefore, in contrast to the excess CDC7 activity for cell division, the level of activity for some error-prone repair process may be normally limiting. PMID- 3275872 TI - Identification of a DNA segment that is necessary and sufficient for alpha specific gene control in Saccharomyces cerevisiae: implications for regulation of alpha-specific and a-specific genes. AB - STE3 mRNA is present only in Saccharomyces cerevisiae alpha cells, not in a or a/alpha cells, and the transcript level increases about fivefold when cells are treated with a-factor mating pheromone. Deletions in the 5' noncoding region of STE3 defined a 43-base-pair (bp) upstream activation sequence (UAS) that can impart both modes of regulation to a CYC1-lacZ fusion when substituted for the native CYC1 UAS. UAS activity required the alpha 1 product of MAT alpha, which is known to be required for transcription of alpha-specific genes. A chromosomal deletion that removed only 14 bp of the STE3 UAS reduced STE3 transcript levels 50- to 100-fold, indicating that the UAS is essential for expression. The STE3 UAS shares a 26-bp homology with the 5' noncoding sequences of the only other known alpha-specific genes, MF alpha 1 and MF alpha 2. We view the homology as having two components--a nearly palindromic 16-bp "P box" and an adjacent 10-bp "Q box." A synthetic STE3 P box was inactive as a UAS; a perfect palindrome P box was active in all three cell types. We propose that the P box is the binding site for a transcription activator, but that alpha 1 acting via the Q box is required for this activator to bind to the imperfect P boxes of alpha-specific genes. Versions of the P box are also found upstream of a-specific genes, within the binding sites of the repressor alpha 2 encoded by MAT alpha. Thus, the products of MAT alpha may render gene expression alpha or a-specific by controlling access of the same transcription activator to its binding site, the P box. PMID- 3275873 TI - Genetic analysis of the repetitive carboxyl-terminal domain of the largest subunit of mouse RNA polymerase II. AB - The carboxyl-terminal domain (CTD) of the mouse RNA polymerase II largest subunit consists of 52 repeats of a seven-amino-acid block with the consensus sequence Tyr-Ser-Pro-Thr-Ser-Pro-Ser. A genetic approach was used to determine whether the CTD plays an essential role in RNA polymerase function. Deletion, insertion, and substitution mutations were created in the repetitive region of an alpha-amanitin resistant largest-subunit gene. The effects of these mutations on RNA polymerase II activity were assayed by measuring the ability of mutant genes to confer alpha amanitin resistance after transfection of susceptible rodent cells. Mutations that resulted in CTDs containing between 36 and 78 repeats had no effect on the transfer of alpha-amanitin resistance, whereas mutations with 25 or fewer repeats were inactive in this assay. Mutations that contained 29, 31, or 32 repeats had an intermediate effect; the number of alpha-amanitin-resistant colonies was lower and the colonies obtained were smaller, indicating that the mutant RNA polymerase II was defective. In addition, not all of the heptameric repeats were functionally equivalent in that repeats that diverged in up to three amino acids from the consensus sequence could not substitute for the conserved heptamer repeats. We concluded that the CTD is essential for RNA polymerase II activity, since substantial mutations in this region result in loss of function. PMID- 3275874 TI - Transcriptional and posttranscriptional control of c-fos gene expression in human monocytes. AB - We examined the mechanisms that are responsible for the regulation of c-fos gene expression in human monocytes. Levels of c-fos mRNA were low or undetectable in resting monocytes. Results of run-on transcription assays, however, demonstrated that both the first two and last two exons of the c-fos gene were transcribed at similar rates, and that only the sense strand of this gene was transcribed. These findings suggest that the level of c-fos transcripts in resting human monocytes is controlled at a posttranscriptional level. Activation of resting monocytes with phorbol ester was associated with a rapid and transient increase in c-fos mRNA levels. This increase in c-fos transcripts was related to an enhanced rate of c-fos transcription. Moreover, exposure of resting monocytes to inhibitors of protein synthesis induced (i) a rapid and marked (300-fold) increase in c-fos mRNA levels, despite only a 9-fold increase in c-fos transcription, and (ii) a prolongation of the half-life of c-fos mRNA. Thus, while posttranscriptional control was responsible for the down-regulation of c-fos transcripts in both resting and activated human monocytes, transcriptional mechanisms were responsible for the transient increase in c-fos expression induced by phorbol ester. Furthermore, the marked increases in c-fos mRNA associated with inhibition of protein synthesis were regulated by both transcriptional and posttranscriptional mechanisms. These findings may be related to recent observations which indicate that both positive and negative factors transcriptionally regulate c-fos gene expression and that sequences found in the 3'-untranslated region of the c-fos mRNA are responsible for the stability of this transcript. PMID- 3275875 TI - Saccharomyces cerevisiae SUP53 tRNA gene transcripts are processed by mammalian cell extracts in vitro but are not processed in vivo. AB - We describe the results of our studies of expression of a Saccharomyces cerevisiae amber suppressor tRNA(Leu) gene (SUP53) in mammalian cells in vivo and in cell extracts in vitro. Parallel studies were carried out with the wild-type (Su-) tRNA(Leu) gene. Extracts from HeLa or CV1 cells transcribed both tRNA(Leu) genes. The transcripts were processed correctly at the 5' and 3' ends and accurately spliced to produce mature tRNA(Leu). Surprisingly, when the same tRNA(Leu) genes were introduced into CV1 cells, only pre-tRNAs(Leu) were produced. The pre-tRNAs(Leu) made in vivo were of the same size and contained the 5'-leader and 3'-trailer sequences as did pre-tRNAs(Leu) made in vitro. Furthermore, the pre-tRNAs(Leu) made in vivo were processed to mature tRNA(Leu) when incubated with HeLa cell extracts. A tRNA(Leu) gene from which the intervening sequence had been removed yielded RNAs that also were not processed at either their 5' or 3' termini. Thus, processing of pre-tRNA(Leu) in CV1 cells is blocked at the level of 5'- and 3'-end maturation. One possible explanation of the discrepancy in the results obtained in vivo and in vitro is that tRNA biosynthesis in mammalian cells involves transport of pre-tRNA from the site of its synthesis to a site or sites where processing takes place, and perhaps the yeast pre-tRNAs(Leu) synthesized in CV1 cells are not transported to the appropriate site. PMID- 3275876 TI - Complex regulation of heat shock- and glucose-responsive genes in human cells. AB - We have isolated a human genomic clone that encodes the glucose-responsive protein GRP78 and have used this cloned gene probe, together with a cloned HSP70 gene, to study the expression of both stress-induced genes in response to inhibitors of cellular metabolism. On the basis of the effects of this group of chemicals on GRP78 and HSP70 expression, we have identified three classes of stress gene inducers. The first class induces GRP78 expression and includes inhibitors of glycoprotein processing. The second class results in coordinate activation of both GRP78 and HSP70 synthesis and includes amino acid analogs and heavy metals. Chemicals in the third class coordinately induce GRP78 and repress HSP70 expression; this class includes the calcium ionophore A23187 and the glucose analog 2-deoxyglucose. Whereas induction of GRP78 or HSP70 expression is primarily due to transcriptional activation, chemicals that repress HSP70 expression act through posttranscriptional regulation. These results reveal that the regulation of GRP78 and HSP70 expression is complex and may be dependent on the specificity and magnitude of physiological damage. PMID- 3275877 TI - Regulated expression of a transfected human cardiac actin gene during differentiation of multipotential murine embryonal carcinoma cells. AB - P19 embryonal carcinoma (EC) cells are multipotential stem cells which can be induced to differentiate in vitro into a variety of cell types, including cardiac muscle cells. A cloned human cardiac actin (CH-actin) gene was transfected into P19 cells, and stable transformants were isolated. Low levels of CH-actin mRNA were present in transformed EC cells, but a marked increase in the level of CH actin mRNA was found as these cells differentiated into cardiac muscle. The accumulation of CH-actin mRNA paralleled that of the endogenous mouse cardiac actin mRNA. A chimeric gene, which consisted of the CH-actin promoter linked to the herpes simplex virus thymidine kinase coding region, was constructed and transfected into P19 cells. In these transformants, the thymidine kinase protein was located almost exclusively in cardiac muscle cells and was generally not detectable in EC or other nonmuscle cells. These results suggest that the transfected CH-actin promoter functions in the appropriate developmental and tissue-specific manner during the differentiation of multipotential EC cells in culture. PMID- 3275879 TI - Repair of (6-4)photoproducts correlates with split-dose recovery in UV-irradiated normal and hypersensitive rodent cells. AB - Chinese hamster ovary cells and two UV-hypersensitive derivatives were used to determine the importance of DNA excision repair for split-dose recovery. In the wild-type cells 75% of the maximum theoretical recovery was observed when the fractions were delivered at 2-h intervals. Very little recovery was evident in the two hypersensitive cell lines. Using radioimmunoassays specific for (6 4)photoproducts and cyclobutane dimers, the ability of UV-irradiated repair deficient cells representing 5 complementation groups to repair these 2 photoproducts was determined. Removal of antibody-binding sites specific for (6 4)photoproducts was 80% complete in 6 h and was defective in the UV-sensitive cells. In contrast, only 20-60% of antibody-binding sites specific for cyclobutane dimers were removed 18 h post-irradiation, and the extent of removal was the same in normal and defective cell lines. We conclude that repair of (6 4)photoproducts accounts for split-dose recovery. In addition, we conclude that a consequence of DNA repair in CHO cells is modification rather than removal of cyclobutane dimers. PMID- 3275878 TI - An adenylate cyclase from Saccharomyces cerevisiae that is stimulated by RAS proteins with effector mutations. AB - Conservative amino acid substitutions were introduced into the proposed effector regions of both mammalian Ha-ras (residues 32 to 40) and Saccharomyces cerevisiae RAS2 (residues 39 to 47) proteins. The RAS2[Ser 42] protein had reduced biological function in the yeast S. cerevisiae. A S. cerevisiae strain with a second-site suppressor mutation, SSR2-1, was isolated which could grow on nonfermentable carbon sources when the endogenous RAS2 protein was replaced by the RAS2[Ser 42] protein. The SSR2-1 mutation was mapped to the structural gene for adenylate cyclase (CYR1), and the gene containing SSR2-1 was cloned and sequenced. SSR2-1 corresponded to a point mutation that would create an amino acid substitution of a tyrosine residue for an aspartate residue at position 1547. The SSR2-1 gene encodes an adenylate cyclase that is dependent on ras proteins for activity, but is stimulated by Ha-ras and RAS2 mutant proteins that are unable to stimulate wild-type adenylate cyclase. PMID- 3275880 TI - Inhibitors of N-nitroso compounds-induced mutagenicity. AB - N-Nitroso compounds are environmental mutagens that are present in the air, water, soil etc. or can be formed by nitrosation of various nitrosatable compounds. The present paper gives a survey of inhibitors of N-nitroso compounds induced mutagenicity. Inhibitors covered include: thiols, metals, vitamins, phenolic acids, complex mixtures of plant, animal and human origin, organic solvents, inhibitors of mixed-function oxidases etc. Data on inhibitors that prevent the formation of N-nitroso compounds are not covered in this review. PMID- 3275881 TI - Acrylamide: its metabolism, developmental and reproductive effects, genotoxicity, and carcinogenicity. AB - Monomeric acrylamide is an important industrial chemical primarily used in the production of polymers and copolymers. It is also used for producing grouts and soil stabilizers. Acrylamide's neurotoxic properties have been well documented. This review will focus on pertinent information concerning other, non-neurotoxic, effects observed after exposure to acrylamide, including: its genotoxic, carcinogenic, reproductive, and developmental effects. It will also cover its absorption, metabolism, and distribution. The data show that acrylamide is capable of inducing genotoxic, carcinogenic, developmental, and reproductive effects in tested organisms. Thus, acrylamide may pose more than a neurotoxic health hazard to exposed humans. Acrylamide is a small organic molecule with very high water solubility. These properties probably facilitate its rapid absorption and distribution throughout the body. After absorption, acrylamide is rapidly metabolized, primarily by glutathione conjugation, and the majority of applied material is excreted within 24 h. Preferential bioconcentration of acrylamide and/or its metabolites is not observed although it appears to persist in tests and skin. Acrylamide can bind to DNA, presumably via a Michael addition-type reaction, which has implications for its genotoxic and carcinogenic potential. The available evidence suggests that acrylamide does not produce detectable gene mutations, but that the major concern for its genotoxicity is its clastogenic activity. This clastogenic activity has been observed in germinal tissues which suggest the possible heritability of acrylamide-induced DNA alterations. Since there is 'sufficient evidence' of carcinogenicity in experimental animals as outlined under the U.S. EPA proposed guidelines for carcinogen risk assessment, acrylamide should be categorized as a 'B2' carcinogen and therefore be considered a 'probable human carcinogen.' The very limited human epidemiological data do not provide sufficient evidence to enable one to judge the actual carcinogenic risk to humans. Acrylamide is able to cross the placenta, reach significant concentrations in the conceptus and produce direct developmental and post-natal effects in rodent offspring. It appears that acrylamide may produce neurotoxic effects in neonates from exposures not overtly toxic to the mothers. Acrylamide has an adverse effect on reproduction as evidenced by dominant lethal effects, degeneration of testicular epithelial tissue, and sperm-head abnormalities. PMID- 3275882 TI - Modulation of the mutagenic effects of 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and 2-amino-3,4-dimethylimidazo[4,5-f]quinoline (MeIQ) in bacteria with rat liver 9000 x g supernatant or monolayers of rat hepatocytes as an activation system. AB - An in vitro protocol was designed to separate the process of metabolic activation from the mutational events. Cultured rat hepatocytes were first incubated with the food mutagens 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) or 2-amino-3,4 dimethylimidazo[4,5-f]quinoline (MeIQ). After the incubation period the medium was removed and further incubated with Salmonella typhimurium TA98. A high direct mutagenic activity of the culture medium was then measured. The half-lives of the mutagenic metabolites formed from IQ and MeIQ were in the order of 45 min. The presence of the cytochrome P450 inhibitors alpha-naphthoflavone and metyrapone during the pre-incubation period reduced the accumulation of mutagenic metabolites. No effects of ascorbate on the mutagenic effects of IQ and MeIQ were seen. (+)-Catechin, another antioxidant and free-radical scavenger, markedly enhanced the number of IQ/MeIQ-induced revertants when added to the hepatocytes. In contrast, (+)-catechin clearly decreased the number of revertants when 9000 X g supernatant from rat liver (S9) was used as an activation system. No marked effect of pentachlorophenol, an inhibitor of hepatocyte sulfation and bacterial O acetylation, was seen using hepatocytes as an activation system, while the mutagenic activity of both IQ and MeIQ was reduced by 90% in the S9/Salmonella system. The addition of an inhibitor of glucuronidation, galactosamine, or the nucleophile glutathione caused no or only minor decreases in the genotoxic effects of the IQ compounds. With both S9 and hepatocytes as activation systems the relative mutagenic effects observed in the S. typhimurium strains TA98 and TA98 NR were in the same order of magnitude, while a large decrease was seen with TA98/1,8-DNP6. The results show that this in vitro test protocol may be useful as a tool to study mechanisms involved in the formation of mutagenic metabolites. PMID- 3275883 TI - Effects of excess thymidylate on thymidylate low-requiring strains of Saccharomyces cerevisiae: high mutagenicity and absence of DNA strand breaks. AB - dTMP exposure concentrations of 0.1 mM or higher are genotoxic in exponentially growing cells of thymidylate low-requiring mutants of Saccharomyces cerevisiae. Mutagenicity of excess dTMP is highest in an exposure concentration 10-fold of that needed for external supplementation of endogenously blocked thymidylate synthesis. Still higher dTMP concentrations are primarily cytotoxic. The canavanine forward-mutation system shows excess dTMP to be as potent a mutagen as irradiation by ultraviolet light. Mutagenicity of excess dTMP, however, differs from that of direct DNA-attacking mutagens in that it is highest in the absence of significant toxicity. Alkaline sucrose gradient centrifugation shows that excess dTMP does not induce significant numbers of DNA single- or double-strand breaks, while conditions of thymidylate deprivation lead to DNA-strand breaks and thymineless death. PMID- 3275884 TI - Interpretation of UV-survival curves of Aspergillus conidiospores. AB - Semi-logarithmic dose-response curves for survival of UV-irradiated conidiospores of A. nidulans have an initial shoulder (at low doses) followed by a decline which becomes linear. To explain the initial shoulder and the resulting extrapolation number (log S intercept of the linear extrapolation line) a general model is presented, which includes multi-target (n) and multi-hit (h) effects and allows for the effect of initial repair and of a compound parameter k, which stands for inherent sensitivity of the spores and for dose received inside the spores. From experiments on (a) the modification of k (spore wall colour and shelter effects), (b) a repair-deficient strain (shoulderless) and (c) preincubation during which DNA-replication takes place, it is concluded that the shoulder is generated by initial repair rather than by a multi-hit nature of the cell-killing process. In experiments where k takes different values (sub a and c), notably the position of the point of intersection of the linear lines gives conclusive information. In general, the log S intercept of the linear extrapolation line cannot be used to estimate the target number. PMID- 3275885 TI - Nonmutagenicity of maleic acid and its sodium salts in salmonella assays. AB - Maleic acid (cis-butenedioic acid) and its mono- and disodium salts are shown to be non-mutagenic in the standard Ames Salmonella/mammalian microsome assay in the absence and presence of Aroclor-1254-induced rat liver S9. This lack of activity occurred despite depression of top agar pH in accordance with the degree of protonation of this polybasic acid. These results indicate that when chemical compounds which are maleate salts show activity in this assay, the effect is attributable to the base moiety rather than maleate or pH depression per se. PMID- 3275886 TI - Instability of a yeast centromere plasmid under conditions of thymine nucleotide stress. PMID- 3275887 TI - Relationship between the induction of mitotic gene conversion and the formation of thymine glycols in yeast S. cerevisiae treated with hydrogen peroxide. AB - The effects of hydrogen peroxide on yeast Saccharomyces cerevisiae were assessed by measuring gene conversion at the trp 5 locus and the amount of thymine glycols in DNA using a monoclonal antibody specific to this base modification. Our results show that: (a) hydrogen peroxide-induced mitotic gene conversion in yeast strain D7M1 was dose-dependent in the low dose range where no toxicity was observed; (b) in the low dose range, the frequency of gene conversion depended on the temperature of the treatment, with more conversion at 25 degrees C than at 15 degrees C; (c) thymine glycols were induced in DNA in a dose-dependent manner following exposure of cells to up to 400 mM hydrogen peroxide; (d) there was little difference in the amount of thymine glycols formed in DNA when treatment occurred at either 25 degrees C or 15 degrees C. PMID- 3275888 TI - Enhancement and inhibition of benzo[a]pyrene-induced SOS function in E. coli by synthetic antioxidants. AB - 8 antioxidants were tested in the SOS chromotest for induction of SOS function and for modulation of benzo[a]pyrene-induced SOS function. None of the antioxidants leads to increased beta-galactosidase activity by itself. Butylated hydroxytoluene at concentrations between 10(-5) M and 3 X 10(-4) M enhances benzo[a]pyrene-induced SOS function at benzo[a]pyrene concentrations between 10( 6) M and 3 X 10(-5) M. Butylated hydroxyanisole, ethoxyquin, propyl gallate and octyl gallate also slightly enhance benzo[a]pyrene-induced SOS function at concentrations up to 3 X 10(-4) M though to a lesser degree than butylated hydroxytoluene. Dodecyl gallate, vitamin C and alpha-tocopherol do not increase benzo[a]pyrene action. In concentrations exceeding 3 X 10(-4) M all synthetic antioxidants tested but not vitamin C and alpha-tocopherol decrease beta galactosidase activity both in the absence and, more extensively, in the presence of benzo[a]pyrene. Preliminary data suggest that the apparent suppression of benzo[a]pyrene-induced SOS function is not due to an effect on the formation of benzo[a]pyrene metabolites by the metabolizing system used. PMID- 3275889 TI - Initiating and withdrawing life support. Principles and practice in adult medicine. PMID- 3275890 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 1-1988. Fever and renal dysfunction in a 22-year-old diabetic woman after renal and pancreatic transplantation. PMID- 3275891 TI - Myolysis and acute renal failure in a heart-transplant recipient receiving lovastatin. PMID- 3275892 TI - Rhabdomyolysis in patients receiving lovastatin after cardiac transplantation. PMID- 3275893 TI - The decline and fall of deregulation. PMID- 3275894 TI - A controlled trial of nimodipine in acute ischemic stroke. AB - Recent investigations suggest that increased cellular calcium concentrations may be implicated in neuronal death after ischemia. To determine whether treatment with a calcium-channel blocker would improve survival and neurologic outcome in acute ischemic stroke, we enrolled 186 patients in a prospective, double-blind, randomized, placebo-controlled trial of nimodipine (30 mg every six hours), begun within 24 hours of the onset of symptoms of an acute ischemic stroke. During the four-week treatment period, mortality from all causes was significantly reduced with nimodipine as compared with placebo (8 deaths [8.6 percent] vs. 19 [20.4 percent]). The improvement in survival was restricted to men. During the follow up period of six months, an additional eight patients in each group died. A significantly better neurologic outcome, as assessed by the Mathew scale of neurologic deficit, was also observed in the nimodipine group. The improvement in neurologic status was greatest in patients with a moderate to severe deficit at base line. There were no important side effects except for one episode of reversible azotemia that may have been related to treatment with nimodipine. Our data suggest that patients with acute ischemic stroke may benefit from early treatment with nimodipine, but this therapeutic effect appears to be limited to men. PMID- 3275895 TI - Progression of diabetic retinopathy after pancreas transplantation for insulin dependent diabetes mellitus. AB - We studied the effect of successful pancreas transplantation and consequent normoglycemia (mean total hemoglobin A1, 7.0 percent; range, 5.8 to 8.3) on visual function and diabetic retinopathy in 22 patients with Type I diabetes mellitus (study group). Sixteen similar patients in whom pancreas transplantation had been unsuccessful (mean total hemoglobin A1, 12.0 percent; range, 8.0 to 18.0) served as a control group. The majority of patients in both groups had advanced proliferative retinopathy. At a mean follow-up of 24 months we found no significant difference between the groups in the rate of progression of retinopathy, expressed as a score. Success of the transplantation did not prevent progression of retinopathy across the range of retinopathy studied. Progressive retinopathy was observed more commonly in patients with low retinopathy scores (nonproliferative or mild proliferative retinopathy) at base line in both the study group (13 of 17 eyes, or 76 percent) and the control group (7 of 12 eyes, or 58 percent). Further analysis suggested the possibility that after three years of euglycemia, the study group had less deterioration than the control group, particularly in eyes with advanced retinopathy. We observed no difference in the rate of loss of vision between the two groups. This study provides evidence that pancreas transplantation and subsequent normoglycemia neither reverse nor prevent the progression of diabetic retinopathy. PMID- 3275896 TI - Effect of transplantation on the Medicare end-stage renal disease program. AB - The Medicare end-stage renal disease program has received considerable attention as a model of government funding for high-cost medical treatment. This paper examines how the program has been influenced by renal transplantation. In the past decade, the number of kidney transplantations has increased substantially, and the success rate of these procedures has improved. From 1980 to 1985, the number of transplantations increased by 10 percent per year. During that time, the survival rates for grafts from cadavers and living related donors increased by 7 and 3 percent, respectively, in part because of the introduction of cyclosporine. As a result, the fastest-growing group of beneficiaries of the Medicare end-stage renal disease program are those with functioning grafts. As of the end of 1985, these patients accounted for 18 percent of all beneficiaries and 32 percent of all beneficiaries less than 55 years of age. In the youngest groups, transplantation has reached a level sufficient to reduce the absolute numbers of patients on dialysis, beginning in 1983. Increases in transplantation are not evenly distributed among subgroups of beneficiaries. Relatively few patients 65 years of age and older receive transplants; blacks receive transplants at a rate roughly half that among whites, but the rate is increasing. Because the costs of maintaining patients with functioning grafts are only one third of those for patients on dialysis and because the quality of life is usually much better, renal transplantation is causing a convergence of the best clinical and economic outcomes for patients with end-stage renal disease. PMID- 3275898 TI - Equipoise and clinical research. PMID- 3275897 TI - Aspirin for the primary prevention of myocardial infarction. PMID- 3275899 TI - Preliminary report: Findings from the aspirin component of the ongoing Physicians' Health Study. PMID- 3275900 TI - Luis F. Leloir (1906-1987). PMID- 3275901 TI - The ribosome returns. AB - Fashions come and go in biochemistry. The discovery that some RNAs are enzymes is reviving interest in the long-neglected ribosome. PMID- 3275902 TI - Duchenne muscular dystrophy: high frequency of deletions. AB - DNA probes are available for Duchenne muscular dystrophy (DMD) carrier detection and prenatal diagnosis. With probes for about 25% of the proximal portion of the gene, we found the proximal probes detected deletions in 23% of nonselected DMD boys, while a single distal probe detected 17% more as deletions. The combined percentage was 39% for all probes tested. Prenatal diagnosis and carrier detection are more accurate if deletions are mapped rather than by use of restriction fragment length polymorphism analysis. The effort involved in screening all affected boys for deletions is considerably less, and provides an accurate genetic marker for subsequent prenatal diagnosis in the family and prospective counseling for female relatives. It seems likely that, once the entire gene (cDNA) is available for screening, most DMD boys will show deletions. PMID- 3275903 TI - Cerebrovascular complications of L-asparaginase therapy. AB - L-Asparaginase, commonly used in combination chemotherapy in the treatment of acute lymphoblastic leukemia, has been associated with hemorrhagic and thrombotic cerebrovascular events. Thrombosis of the cerebral veins or dural sinuses is common, and may be associated with either hemorrhage or infarction. This syndrome generally occurs after a few weeks of therapy, and may occur after L-asparaginase therapy is completed. Complications appear to result from depletion of plasma proteins involved in coagulation and fibrinolysis. We now report two additional cases of cerebrovascular complications associated with L-asparaginase therapy. We review the previously reported cases and discuss the clinical presentation, pathophysiology, and suggested treatment of this syndrome. PMID- 3275904 TI - Clinical and genetic investigation in autosomal dominant limb-girdle muscular dystrophy. AB - Limb-girdle muscular dystrophy is a syndrome of progressive myopathic weakness affecting shoulder and hip girdle and proximal arm and leg muscles. The disease occurs either sporadically or inherited as an autosomal recessive trait. Autosomal dominant inheritance is rare. We report a large family with apparent autosomal dominant inheritance. Sixteen members were affected with a disease characterized by proximal weakness, leg greater than arm, onset in the third decade, elevated CK and CK MB levels, and myopathic EMGs and muscle biopsies. Linkage analysis revealed no conclusive linkage. PMID- 3275906 TI - Making the most of your time. PMID- 3275905 TI - Home care agencies and community health services accredited by NLN October 1987. PMID- 3275907 TI - Ultrasound diagnosis of defects in the scarred lower uterine segment during pregnancy. AB - A prospective study was begun using ultrasound to diagnose defects in the lower uterine segment. Seventy patients were examined and delivered by cesarean section, including 58 at risk because of previous cesarean section and 12 nulliparous controls not at risk. Of the at-risk patients, 12 had confirmed defects, for an incidence of 20.7%. All the controls were normal. The false positive rate for at-risk patients was 7.1%, and the positive and negative predictive values were 92.3 and 100%, respectively. For the diagnosed cases, the sonographic lower uterine segment seemed to form earlier (P less than .01) and was thinner (P less than .01) than that in the negative cases or the controls. Although our study design was observational and did not allow us to test the performance of the lower uterine segment when a defect was found, we discuss the use of a three-stage classification system to assist in identifying sonographically detected defects in a future trial of labor protocol. We conclude that sonographic surveillance is a reliable and practical means of evaluating the lower uterine segment after conception and before labor or delivery. PMID- 3275908 TI - Preeclampsia: a review of the role of prostaglandins. AB - The etiology of preeclampsia remains unknown. Because of their widespread and varied effects in the human body, prostaglandins--specifically PGI2, thromboxane A2, PGE, and PGF2 alpha--have come under much investigation as possible etiologic factors. The vasodilating, platelet-disaggregating prostaglandins (PGI2 and PGE) are increased during normal pregnancy and may account for many of the observed hemodynamic changes, which begin as early as the first trimester. In contrast, a relative increase in the vasoconstricting, platelet-aggregating prostaglandins (thromboxane A2 and PGF2 alpha) is seen in preeclampsia. The disruption in the delicate balance between these two opposing pairs of prostaglandins may play an important role in the causation of preeclampsia. The growing body of literature that deals with the relationship between prostaglandins and preeclampsia is discussed. PMID- 3275909 TI - Lipid and lipoprotein changes associated with oral contraceptive use: a randomized clinical trial. AB - To determine the effects of oral contraceptives on lipids and lipoproteins over a six-month period, we randomized 266 women into four oral contraceptive groups: ethinyl estradiol 35 micrograms plus ethynodiol diacetate 1 mg, ethinyl estradiol 30 micrograms plus levonorgestrel 0.15 mg, ethinyl estradiol 35 micrograms plus norethindrone 1 mg, and ethinyl estradiol 35 micrograms plus norethindrone 0.5 and 1 mg (biphasic). For all groups, total cholesterol increased 5.9-9.1% from baseline values over the six months. Triglycerides increased with all preparations, with the ethynodiol diacetate group (37.6%) and the biphasic norethindrone group (45.3%) showing the greatest increase. Low-density lipoprotein cholesterol increased 10-15.6% among the groups; low-density lipoprotein-apolipoprotein B changed proportional to the low-density lipoprotein cholesterol increases. All groups except the ethynodiol diacetate group showed a decrease of high-density lipoprotein cholesterol, with the levonorgestrel group (8.7%) and biphasic norethindrone group (4.5%) showing the largest declines. Apolipoprotein A-1 increased in all groups, with the ethynodiol diacetate preparation (19.3%) showing the greatest increase and the levonorgestrel preparation (3.2%) showing the smallest increase from baseline values. The changes in apolipoprotein A-1 were out of proportion to the changes in high density lipoprotein cholesterol, suggesting that the high-density lipoprotein particle may be undergoing some type of metabolic alteration. PMID- 3275910 TI - Urinary prostacyclin and thromboxane metabolites in drinking pregnant women and in their infants: relations to the fetal alcohol effects. AB - To study the effect of maternal ethanol consumption on the production of prostacyclin and thromboxane, we measured urinary 6-keto-prostaglandin F1 alpha (a hydration product of prostacyclin), 2,3-dinor-6-keto-prostaglandin F1 alpha (generated from 6-keto-prostaglandin F1 alpha through beta oxidation), and thromboxane B2 (a hydration product of thromboxane A2) using consequent high performance liquid chromatography and radioimmunoassays in 39 drinking women and 16 abstinent controls, and in their infants. Thirty-one drinkers and two control women smoked. Maternal ethanol consumption was accompanied by increased output of prostacyclin and thromboxane metabolites in the mothers, but no relationship was apparent between the increased metabolites and development of fetal alcohol effects in 22 mothers. There were no differences between smoking and nonsmoking drinkers in the excretion of these prostanoids. All the infants born to the drinkers had increased thromboxane B2 excretion, but the excretion of prostacyclin metabolites was increased only in infants with fetal alcohol effects. The ratio between prostacyclin and thromboxane was reduced in infants with fetal alcohol effects. Thus, maternal ethanol consumption is associated with enhanced prostacyclin and thromboxane synthesis, perhaps in the kidneys and/or systemic circulation and vascular bed. Similar changes may also occur in the fetus and/or newborn with fetal alcohol effects. PMID- 3275911 TI - Spontaneous abortion rate in ultrasonographically viable pregnancies. AB - In a prospective study of 500 patients who had an ultrasonically viable pregnancy at less than 12 weeks' gestation, the spontaneous abortion rate was 2% overall. In those women with a history of spontaneous abortion, the abortion rate increased tenfold. Spontaneous abortion at less than ten weeks' gestation was up to three times higher than that at greater than ten weeks' gestation; this may have implications when deciding on the timing of first-trimester diagnostic procedures. PMID- 3275912 TI - Intraperitoneal fetal transfusion under direct ultrasound guidance. AB - The outcomes of 77 fetal intraperitoneal transfusions in 35 pregnancies managed with direct ultrasound guidance and intensive perinatal management were reviewed. Patients were monitored with amniocentesis, and standard indications were used for timing of transfusions. The mean gestational age at first transfusion was 27.3 weeks (range 22-33). The overall mortality rate was 14% (five of 35). No immediate transfusion-related deaths occurred; all fetuses who were not hydropic at first transfusion survived (26 of 26). The mean gestational age at delivery was 33.6 weeks (range 25-36). One infant developed respiratory distress syndrome (RDS). Transfusion-related complications occurred in five cases (fetal colon infusions in two, fetal retroperitoneal infusion in two, and fetal abdominal wall hematoma in one). None of these infants required urgent delivery or suffered long term sequelae. In nonhydropic fetuses, intraperitoneal transfusions under direct ultrasound guidance had a low incidence of morbidity and no mortality. These results should provide baseline data against which to compare new techniques, such as direct cord transfusion. With neonatal mortality rates of 10% and significant morbidity rates of 10-20% in infants delivered at 32 weeks who develop RDS, intraperitoneal transfusion should be considered in the 32- to 33 week fetus with marked pulmonary immaturity. PMID- 3275913 TI - Chlamydial infection in a Chinese gynecologic outpatient clinic. AB - In an attempt to detect the presence, if any, of cervical chlamydial infection, we obtained endocervical smears from 1000 female patients attending the outpatient gynecologic and family planning clinics at Women's Hospital, Zheijiang Medical University, Hangzhou, People's Republic of China. Using direct immunofluorescent monoclonal antibody staining technique, we identified elementary bodies typical of the Chlamydia trachomatis organism in ten of the 1000 slides (1%). The only characteristic of statistical significance in this small group of infected women was the complaint of infertility for more than two years' duration, noted in six of the ten cases. PMID- 3275914 TI - Group B streptococcus and preterm rupture of membranes. AB - The effect of cervical group B streptococcus on the conservative management of preterm premature rupture of membranes was examined in 140 consecutive patients. Upon the patient's admission, we obtained cervical cultures for group B streptococcus, genital mycoplasmas, and chlamydia. Patients with and without group B streptococcus were compared. Group B streptococcus patients had earlier rupture of membranes (30.7 versus 31.6 weeks) and shorter latent periods (76.8 versus 138.5 hours). Intra-amniotic infection (six of 16 versus 26 of 120) and endometritis (four of ten versus three of 94) were significantly more common in group B streptococcus patients. Neonates of mothers positive for group B streptococcus were smaller (1749 +/- 844 versus 2100 +/- 779 g) and more likely to have infectious complications (eight of 16 versus 29 of 120; P less than .01). Control for the presence of mycoplasmas, chlamydia, listeria, or gonorrhea failed to change the significance of these results. The usual policy was to use intrapartum ampicillin prophylaxis in asymptomatic group B streptococcus patients. However, only four of 16 remained asymptomatic and had latent periods long enough for the results of cultures obtained on admission to be available. We conclude that group B streptococcus significantly complicates the conservative management of preterm premature rupture of membranes and that the effectiveness of intrapartum prophylactic ampicillin may be compromised by awaiting the results of conventional cultures to define colonized patients. PMID- 3275915 TI - Endotoxin stimulates prostaglandin E2 production by human amnion. AB - The studies presented in this report were designed to evaluate whether bacterial endotoxin alters the rate of biosynthesis of prostaglandin E2 (PGE2) by human amnion. Amnion cells were established in primary monolayer culture from women undergoing elective cesarean sections. Endotoxin from Escherichia coli and Salmonella typhosa were incubated with amnion cells for 16 hours, and radioimmunoassay was used to measure PGE2 released into the media. Bacterial endotoxin demonstrated a concentration-dependent stimulatory effect on the rate of PGE2 synthesis by amnion cells. These observations suggest a mechanism for the onset of labor associated with intra-amniotic infection. PMID- 3275916 TI - Controversies in the management of cervical adenocarcinoma. AB - Adenocarcinoma of the uterine cervix appears to be more prevalent now than a decade ago, and currently constitutes 10-20% of invasive cervical cancers. Because precursor lesions arise within the endocervical canal, identification and diagnosis of invasive disease is often more difficult than for squamous carcinoma. There is disagreement regarding the optimal treatment of adenocarcinoma. Adenocarcinoma may have a poorer prognosis than squamous carcinoma because it may be more difficult to detect and because it tends to metastasize earlier in its course. The controversies in the diagnosis and management of adenocarcinoma and adenosquamous carcinoma of the uterine cervix are reviewed. PMID- 3275917 TI - The eighth-month fetus: classical sources for a modern superstition. AB - Among obstetric patients from diverse backgrounds, we found a superstition that the prognosis for preterm infants born at eight months' gestation is poorer than for those born at seven months. After several women on a high-risk inpatient unit spontaneously expressed fears caused by this belief, we investigated its origin. A treatise attributed to Hippocrates is devoted to the idea, which appears to have been current in the Greek world by the fifth century BC. The doctrine was elaborately developed by subsequent Greek physicians and philosophers. It appears in the Talmud and in medieval texts, as well as in early modern medical writings. The unquestioning citation of a dogma of the Ancients until modern times is a common phenomenon in medical history. The persistence of this ancient scientific doctrine as an "old wives' tale" causing inappropriate patient anxiety makes it interesting to the modern obstetrician. PMID- 3275918 TI - A rapid screening test for the diagnosis of endocervical group B streptococci in pregnancy: microbiologic results and clinical outcome. PMID- 3275919 TI - Intraneural microcirculation. AB - Peripheral nerve trunks are well-vascularized structures where a well-developed collateral system may compensate for local vascular damage. Interference with intraneural blood flow is reflected rapidly in disturbances in nerve function. In compression lesions and nerve entrapments, the microvascular factor plays an important pathophysiologic role for development of symptoms. Although endoneurial capillaries normally constitute a BNB helping to optimize endoneurial environment, damage to the vessels may induce a miniature closed compartment syndrome by increasing the permeability, thereby contributing to increased endoneurial fluid pressure and development of an intrafascicular edema. Surgeons, performing intraneural dissections, should be aware of the potential risks associated with intraneural bleedings, edema, and intraneural fibrosis. PMID- 3275920 TI - Carpal tunnel syndrome. A scientific basis for clinical care. AB - The series of experimental studies reviewed in this article supports a classification of median nerve compression at the wrist into early, intermediate, advanced, and acute nerve compression. The findings correlate well with experimental studies on the pathophysiology of nerve compression. A patient specific management approach is recommended based upon the clinical and electrophysiologic findings which can be correlated with previously demonstrated intraneural pathologic changes. PMID- 3275921 TI - Avoiding complications of surgery for nerve compression syndromes. AB - This article discusses ways in which the operating surgeon can avoid complications in surgery for thoracic outlet syndrome, cubital tunnel syndrome, and carpal tunnel syndrome. Postoperative problems also are discussed. PMID- 3275922 TI - The double crush syndrome. AB - Multilevel lesions along a peripheral nerve trunk do occur. In the double crush syndrome as postulated by Upton and McComas, the presence of a more proximal lesion does seem to render the more distal nerve trunk more vulnerable to compression. While the exact pathophysiologic mechanism of this interaction is not yet elucidated, it most likely relates to disturbances in axonal flow kinetics and the disruption of the neurofilament architecture. On a practical level our studies show that given a more proximal root compression less involvement of the median nerve across the carpal tunnel was required to produce symptoms. Furthermore, the surgical outcome of carpal tunnel release in this double crush group was poorer than in that group with isolated carpal tunnel involvement. It is important to preoperatively identify those patients who may have double crush lesions and thus anticipate a less than optimal result from surgical release of the peripheral nerve. Finally, when the double crush syndrome is present, both entrapments may require treatment for optimal results. PMID- 3275923 TI - Repetitive trauma and nerve compression. AB - Repetitive movement of the upper extremity, whether recreational or occupational, may result in various neuropathies, the prototype of which is the median nerve neuropathic in the carpal canal. The pathophysiology of this process is incompletely understood but likely involves both mechanical and ischemic features. Experimentally increased pressures within the carpal canal produced reproducible progressive neuropathy. Changes in vibratory (threshold-type) sensibility appears to be more sensitive than two-point (innervation density type) sensibility. The specific occupational etiologies of carpal neuropathy are obscured by methodologic and sociological difficulties, but clearly some occupations have high incidences of CTS. History and physical examination are usually sufficient for the diagnosis, but diagnostic assistance when required is available through electrophysiological testing, CT scanning, and possibly MRI. Each of these tests has limitations in both sensitivity and specificity. Treatment by usual conservative means should be combined with rest from possible provocative activities. Surgical release of the carpal canal is helpful in patients failing conservative therapy. Occupational modifications are important in both treatment and prevention of median neuropathy due to repetitive trauma. PMID- 3275924 TI - Nonsurgical management of pain secondary to peripheral nerve injuries. AB - Physicians and surgeons dealing with peripheral nerve injuries have long been plagued by the chronic intractable pain which often follows these injuries. Early recognition of the associated problems and prompt intervention by a multidisciplinary team approach to the pain is essential. Although the techniques reviewed here were presented as separate choices, the treatment of the patient should employ a combined approach of good surgical repair, positive encouragement, non-addicting medications, appropriately timed nerve blocks, aggressive physical and occupational therapy, and electrical stimulation techniques as the patient's physical recovery permits. The importance of early psychological assessment and intervention in this complex phenomenon cannot be overemphasized. Together these techniques may succeed in reducing the morbidity associated with peripheral nerve injuries. PMID- 3275925 TI - Treatment of painful neuromas. AB - The management of symptomatic neuromas is an unsolved problem. This article attempts to review the various management regimens that have been proposed in the past and their success rate. The authors propose an algorithm for the management of symptomatic neuromas based upon this information. PMID- 3275926 TI - Nerve repair by laser. AB - The unique properties of lasers have made their applicability to clinical medicine, particularly reconstructive surgery, a subject of continuing interest. Some studies have shown their potential usefulness in peripheral nerve repairs. PMID- 3275927 TI - A review of experimental methods measuring peripheral nerve regeneration in animals. AB - We have reviewed the morphologic, electrophysiologic, biochemical, and functional methods of evaluating PN regeneration in animal models. There are a large number of anatomic techniques that can provide clear insights into the processes of peripheral nerve regeneration. Since many of these are costly in terms of labor, careful selection of the technique appropriate for the question asked is important. Two of the more important questions are: 1) What are the neurotrophic factors produced by the distal segment that attract the growing axon tip? and 2) What are the components of the basal lamina that facilitate the directed growth of the axons? To answer these questions, whole mount preparations provide the means to economically evaluate the result of experimental manipulation of the environment. Automated nerve fiber counts will be increasingly used to help interpret electrophysiologic studies. Quantitative as well as descriptive ultrastructural analyses will continue to provide valuable data that will be needed in the interpretation of biochemical and histochemical studies. Immunohistochemical probes are sure to become more important as the range of their specificities broadens. With the diversity of anatomic methods available and their capacity to help us visualize the processes occurring during nerve regeneration they will remain a key tool in these studies. Electrophysiologic methods that integrate the CAP and correlate it with the number of functioning NF are most useful. Functional methods are beginning to become more objective and quantitative. The most precise measurements are muscle weight and the isometric response of muscle to tetanic contraction. Sensory function has now been measured objectively by Horch. Single methods of measuring PN regeneration give only limited data, but by combining methods a better understanding of PN regeneration is possible. While understanding the limitations of each method and technique, multi-parameter animal models may provide data most helpful clinically. However, because of great species variability in the reparative response, caution must be given not to extrapolate too much from animal studies. We urge investigators to use the most objective methods available to measure nerve regeneration. Recognizing these limitations, however, animal studies will continue to provide significant insights into PN regeneration and should point the way to improved clinical practice. PMID- 3275928 TI - Sensibility evaluation and rehabilitation. AB - Sensibility assessment plays a vital role in the care of peripheral nerve injuries. Preoperative testing can assist the physician in determining the need for surgical intervention and, in addition, provides an ongoing record of recovery. Rehabilitation of peripheral nerves will require many varieties of treatment. Only those aspects pertaining to desensitization and sensory re education were addressed in this brief presentation; however, it is important to remember that the motor component of peripheral nerve injury is equally necessary for functional use of the hand. PMID- 3275929 TI - Fascicular nerve repairs. A comparative study of epineurial and fascicular (perineurial) techniques. AB - At present, fascicular nerve repairs produce almost identical results to epineurial repairs. There are still theoretical advantages to the improved alignment potentially offered by fascicular nerve repair, and fascicular technique already offers an advantage in partial nerve injuries. As fascicular capabilities improve, fascicular nerve repair may still offer the best solution for nerve recovery. PMID- 3275930 TI - Interfascicular nerve grafting. AB - We have reviewed the technique of interfascicular nerve grafting and reviewed the results of 60 nerve grafts in 33 patients. After reviewing our results and comparing them with the literature on nerve grafts and direct repairs, the results are comparable and, in some series, better with nerve grafts. These observations support Millesi's original reports of favorable results from interfascicular nerve grafting. Although Millesi's results are better than reports by others, the overall results indicate nerve grafting is a preferable option to repair under tension. The minor sensory loss from the sural nerve donor defect was not bothersome in our patients. We will continue to prefer nerve grafting to extensive mobilization or more than moderate joint flexion to overcome gaps in nerves. Although the critical gap distance remains controversial, the following advantages of nerve grafts remain: increasing comfort in use of the microscope, the ability to do better technical apposition of the nerve fascicle groups, the ability to locate the nerve away from scarred bed, and the ease of repair of the nerve with the joint in a neutral position. These advantages far outweigh the disadvantage of increased operating time and the small sensory loss from the donor nerve harvest. We believe interfascicular nerve grafting is the contemporary standard for closing significant gaps in peripheral nerves. PMID- 3275931 TI - Vascularized nerve grafts. A practical approach. AB - VNGs theoretically have several advantages over CNGs and therefore may produce better functional results. Use of VNGs is indicated in severely scarred recipient beds, but in beds that are less compromised, VNGs may not perform better than CNGs. The anatomy of the nerve's blood supply, methods of vascularizing a nerve graft, methods of forming cable grafts and maintaining vascular supply, and techniques for monitoring the VNG must all be understood before the surgeon can successfully transfer one of the six potential VNGs. Some clinical evidence indicates that VNGs may be superior to CNGs in moderately scarred recipient beds and, with more certainty, in digital nerve reconstruction. PMID- 3275932 TI - Renal calcification incidence in very low birth weight infants. AB - Serial ultrasound examinations were performed on 31 neonates with birth weights of less than 1,500 g for the detection of renal calcifications. Renal calcifications occurred in 20 (64%) of the infants at a mean age of 39.3 +/- 26.7 days of life. Infants with renal calcifications had shorter gestations (28.2 +/- 1.8 v 31 +/- 1.4 weeks, P less than .004) and lighter birth weights (924 +/- 195 v 1,338 +/- 100 g, P less than .004) than those infants without renal calcifications (n = 11). Furosemide administration was more common in the infants with renal calcifications (65% v 9.1%, P less than .001). The mean total dose of furosemide administered before renal calcifications were noted was 9.59 +/- 7.25 mg/kg. The 20 neonates with renal calcifications had a mean urine calcium level of 12.0 +/- 6.8 mg/kg/24 hours, mean urine calcium to creatinine ratio of 1.32 +/ 1.03 (range 0.3 to 4.45), and a mean alkaline phosphatase concentration of 961 +/- 327 IU. Initial parathyroid hormone levels were not different between the two groups, and subsequent determinations in infants with renal calcifications did not differ significantly from initial values. Renal calcifications are fairly common among very low birth weight infants, particularly in those receiving supplemental calcium and furosemide therapy. Although long-term implications of such findings are not known, close monitoring of renal function by serial determinations of urine calcium and urine calcium to creatinine ratios may identify those infants at risk for renal calcifications. PMID- 3275933 TI - Localized cerebral infarction in the premature infant: an ultrasound diagnosis correlated with computed tomography and magnetic resonance imaging. AB - Findings on cranial ultrasonography strongly suggested the diagnosis of a localized infarct in four premature infants. CT was performed to differentiate between hemorrhagic and nonhemorrhagic lesions, and magnetic resonance imaging was used to obtain information about the late effect of the lesions. The clinical findings, imaging findings, and later outcome in these premature infants were compared with the existing knowledge of this type of lesion in the full-term infant. A localized infarct appears to carry a good prognosis in the premature infant and should be differentiated from other types of lesions, such as periventricular leukomalacia or parenchymal hemorrhage, which are more common in the premature infant and carry a worse prognosis. PMID- 3275934 TI - Group B streptococcal cellulitis in infants: a disease modified by prior antibiotic therapy or hospitalization? AB - Among 78 cases of group B streptococcal infections in children hospitalized at our institution during 1981 to 1985, five cases of cellulitis in infants were identified. Age at onset was 4 to 11 weeks. Group B streptococci were isolated from each of two aspirate cultures, all four blood cultures obtained before administering antibiotics, and none of four spinal fluid cultures obtained. All five infants had previously been treated with IV antibiotics in the hospital. Two infants had been previously treated for group B streptococcal infections (one each meningitis and neonatal sepsis). In contrast, among the 29 other patients with late-onset (2 weeks of age or older) group B streptococcal infection, four had prior treatment with IV antibiotics (P less than .001). These data suggest that hospitalization and/or parenteral antibiotic therapy may be a risk factor for development of group B streptococcal cellulitis. PMID- 3275935 TI - Role of apnea in the sudden infant death syndrome: a personal view. AB - Evidence supporting a role for abnormal apnea in sudden infant deaths is predominantly circumstantial. Investigations of infants having cyanotic episodes have shown four mechanisms for abnormal apnea. The most frequent, prolonged expiratory apnea, is particularly dangerous because it is associated with the rapid onset and progression of hypoxemia and other features suggesting alveolar ventilatory-perfusion mismatch. Seizure-induced apnea, maternally imposed obstructive apnea, and sleep-related upper airway obstructive apnea may also produce severe hypoxemia. Attempts to identify infants at risk of sudden death using measurements of cardiorespiratory variables have to date had limited success. Nevertheless, techniques for more precise, yet non-invasive, monitoring of respiratory function, including oxygenation, have been recently developed and such attempts to identify "at risk" infants must continue. Epidemiologic and pathologic studies have provided considerable support for the "abnormal apnea hypothesis" and need to be integrated with studies on the physiology of living infants. On the basis of the presently available evidence concerning prolonged apnea, it may be possible to prevent a proportion of sudden infant deaths by reducing the exposure of young infants to pertussis, respiratory syncytial virus, or other respiratory tract infections and by improving the prenatal environment. PMID- 3275936 TI - Human growth hormone therapy and Creutzfeldt-Jakob disease: a drama in three acts. PMID- 3275937 TI - Antifungal agents. Which and when to use. PMID- 3275938 TI - Preventing recurrent myocardial infarction. Use of calcium-channel blockers. AB - Although mortality in the first month after myocardial infarction is only 8% for patients who have non-Q-wave infarction, these patients are highly vulnerable to reinfarction and death throughout most of the first year. Repeated episodes of non-Q-wave infarction result in a cumulative amount of injury so that two years after the initial episode, survival rates of these patients are similar to those of patients with Q-wave infarction. Prophylactic diltiazem (Cardizem) given 24 to 48 hours after admission reduced the incidence of early reinfarction and severe angina in patients who had non-Q-wave infarction. PMID- 3275939 TI - Fiberoptic bronchoscopy. Indications, complications, contraindications. PMID- 3275940 TI - Computer searching made easy. Program to find medical articles quickly. AB - GRATEFUL MED is a computer program for searching the medical literature, designed with the novice in mind. It contains an extensive list of medical subject headings, so the user does not have to page through an index of key words before starting the search. Because of its efficiency and ease of operation, the program is a useful tool for immediate patient care. The program itself is inexpensive, and the hardware needed is minimal. PMID- 3275941 TI - Photorefractoriness in birds and comparison with mammals. PMID- 3275942 TI - Freeze tolerance in animals. PMID- 3275943 TI - A simple method for securing a bolster in position over a split-thickness skin graft. PMID- 3275944 TI - Reconstruction of the burned palm: full-thickness versus split-thickness skin grafts--long-term follow-up. AB - The long-term results of full-thickness (N = 11) and split-thickness (N = 14) skin grafts for reconstitution of the palmar surface following release of palmar burn scar contractures in pediatric patients are compared. Patients treated with full-thickness skin grafts required 1.2 +/- 0.4 operations (mean +/- SD). Patients treated with split-thickness skin grafts required 1.3 +/- 0.6 operations (mean +/- SD). No significant difference in the number of operative procedures was noted. No functional difference existed between the two groups. The use of split-thickness skin grafts provided comparable function without increased operative procedures and was less deforming. Increased use of split-thickness skin grafts following release of palmar burn scar contractures in pediatric patients should be considered. PMID- 3275945 TI - The inhibition of skeletal changes in a rat burn model with a local muscle flap. AB - The effects of early wound closure using a local muscle flap on the development of periosteal new bone formation in a rat burn model were studied. Following a full-thickness burn to one hind limb, periosteal new bone formation along the tibial diaphysis was measured by the use of the fluorochrome agent calcein and an image-analysis system. Prostaglandin E levels, a known inflammatory mediator, from the bone beneath the burn also were measured. Periosteal new bone formation was inhibited by 50 percent in animals that had debridement and wound closure with a gastrocnemius muscle flap and skin graft on postburn day 2 compared to untreated controls or animals closed with skin grafts only. There was a trend toward reduced prostaglandin E measurements from tibial sections in the early closure group compared to untreated controls. This study demonstrates that early wound closure using a local muscle flap inhibits the periosteal new bone formation which is possibly associated with the inflammation in a rat burn model. PMID- 3275946 TI - Smooth-muscle tumors of the oral cavity. AB - Smooth muscle tumors of the oral cavity are rare. The world literature revealed 80 leiomyomas and 21 leiomyosarcomas. We presented one new case of each lesion in this report and discussed diagnostic and treatment considerations and prognosis. Treatment recommendations for leiomyoma and leiomyosarcoma require an en bloc excision with at least 1-cm margins of normal tissue. Both lesions may look alike clinically and may not even be definitively differentiated histologically; therefore, a follow-up period of 5 years is suggested. PMID- 3275947 TI - Breast capsulorrhaphy. AB - The malposition of breast prostheses without capsular contracture has become an increasingly frequent event. In our experience with 40 patients over the last 5 years, we have found multiple-layer breast capsulorrhaphy to be a simple, safe, and reliable technique. With this method, repositioning of the breast is easier, more accurate, and more permanent than single-layer closures, which attempt ideal correction of the malpositioned implant on the first try. PMID- 3275948 TI - The dysplastic nevus: recognition and management. AB - The recognition of atypical or dysplastic nevomelanocytic nevi potentially provides clinicians with another means of identifying individuals at increased risk for cutaneous malignant melanoma. However, a great deal of controversy still surrounds these lesions, their significance, and the clinical and histologic criteria needed for their diagnosis at present. In general, dysplastic nevi tend to be asymmetrical and larger (greater than 5 mm) than ordinary acquired nevi, have a macular component, irregular and ill-defined borders, and haphazard (variegate) coloration. A clinical diagnosis of dysplastic nevi must be confirmed by histopathology, since not all clinically atypical nevi are dysplastic. While precise histopathologic criteria for dysplastic nevi are lacking, most authorities agree that an abnormal nevomelanocytic proliferative pattern as manifested by increased numbers of basilar melanocytes and/or abnormal junctional nevomelanocytic nesting in the setting of lentiginous epidermal hyperplasia, variable degrees of nevomelanocytic nuclear atypia, and a lymphocytic host response are consistent with a histologic diagnosis of dysplastic nevi. Current data for individuals with dysplastic nevi and a family history of cutaneous malignant melanoma (at least two family members with cutaneous malignant melanoma) indicate a relative risk for cutaneous malignant melanoma about 148 times that of the general population. In comparison, cutaneous malignant melanoma risk seems lower for individuals with familial dysplastic nevi (but without familial cutaneous malignant melanoma) and "sporadic" dysplastic nevi. With respect to progression to melanoma, probably the vast majority of dysplastic nevi remain stable or possibly regress. Management of individuals with histologically confirmed dysplastic nevi involves periodic skin examinations. Regional overview and life-size photography are helpful in following these patients. Patients should also be instructed in the examination of their own skin. While a definite relationship between sun exposure and dysplastic nevi remains unproved, the use of sunscreens and avoidance of unnecessary sun exposure are advised. Examination of family members for atypical melanocytic lesions is also recommended. PMID- 3275949 TI - Vitamin E: facts and fallacies. PMID- 3275950 TI - Ultrasonography of the musculoskeletal system. PMID- 3275951 TI - Spinal ultrasonography. Intraoperative and pediatric applications. AB - Ultrasonography has had limited usefulness in the diagnosis of diseases of the spine and spinal cord in older children and adults. However, its use intraoperatively in patients of all ages, and nonoperatively in infants and young children, is finding increased application. The authors, who perform and rely on spinal sonography in both clinical situations, present an overview of technique, normal anatomy, and selected pathologic entities based on their experience and the literature. PMID- 3275952 TI - Ultrasound examination of the hand and foot. AB - The use of ultrasound in the examination of the distal extremities is a recent application of sonography of the musculotendinous system. Real-time sonography is unique in providing a dynamic study of complex anatomic structures such as the flexor tendons of the hand. The normal anatomic appearance of the hand and foot are reviewed as well as the sonographic appearance of pathologic conditions of the distal extremities. PMID- 3275953 TI - Ultrasound of soft tissue abnormalities of the extremities. AB - Ultrasound may be the preferred initial diagnostic modality for the painful swollen extremity, the palpable extremity mass, and the injured extremity. The role of ultrasound in extremity soft tissue abnormalities, including muscle hemorrhage and injury, inflammatory processes, and soft tissue neoplasms, is the subject of this review. PMID- 3275954 TI - Interventional ultrasound in the musculoskeletal system. AB - This article highlights the multiple applications of ultrasound as a guidance modality for interventional procedures in the musculoskeletal system. The percutaneous aspiration, drainage, and biopsy of musculoskeletal abscesses, masses, and focal muscular pathology in the extremities, trunk, and neck using ultrasound as the guidance system is described. Techniques for biopsy, fluid aspiration, catheter insertion, and needle visualization by ultrasound are discussed. PMID- 3275955 TI - Clinical aspects of shoulder injuries. AB - The reader is presented with the important anatomical and biomechanical aspects of the shoulder and the most commonly seen injuries of the soft tissues. Ultrasonography is most efficacious in terms of noninvasiveness, accuracy, and cost during the initial presentation by patients with complaints, physical signs, and negative roentgenograms. It allows the practitioner to make treatment decisions when therapeutic modalities have their maximum benefit, that is, as soon after the injury as possible. PMID- 3275956 TI - Sonographic evaluation of the rotator cuff. AB - This article emphasizes the utility of ultrasound examination in the diagnosis of rotator cuff disease. A complete description is given of the way in which ultrasound examination of the shoulder is performed, the illustrations demonstrating normal anatomy as well as staging of the disease. The use of ultrasound in this setting can help to prevent a great deal of the pain associated with shoulder injury by establishing the nature and stage of injury before rotator cuff tear occurs. PMID- 3275957 TI - Sonography in pediatric hip disorders. AB - Real-time ultrasonography of the infant hip has proven to be a reliable and safe method of evaluating the joint for dislocation or instability. A number of techniques for diagnosing and quantifying these disorders have been developed. Several other applications of ultrasound in pediatric hip disorders have also been described, most notably the detection of joint fluid. PMID- 3275958 TI - Ultrasonography in the knee. Clinical aspects. AB - In at least three types of soft tissue injuries of the knee, meniscal, tears, ligament tears, and patellar tendinitis, ultrasound can be a useful diagnostic adjunct. In some cases, the use of ultrasonography may reduce the morbidity associated with more invasive diagnostic techniques, such as arthrography and arthroscopy. More work needs to be done comparing ultrasonographic findings with surgical findings. As more experience is gathered by the ultrasonographer, this technique may replace arthrography and possibly diagnostic arthroscopy in predicting anatomic injury. PMID- 3275959 TI - Ultrasonography of the knee. AB - Sonography is a useful modality in the diagnosis of a wide variety of knee disorders, including lesions of the articular cartilage, tendons and ligaments, menisci, synovial space, and adjacent vessels and muscles. Sonography is noninvasive, rapidly performed, widely available, readily accepted by patients, uses no ionizing radiation, and is relatively inexpensive compared to other conventional imaging studies of the menisci, making it a potentially attractive screening examination for knee injuries. Although it is difficult to state the exact place of sonography in the diagnostic workup of knee disorders, we feel that sonography is vastly underutilized. With additional refinements in ultrasound technology and scanning techniques, we expect further expansion of its role in the evaluation of the knee. PMID- 3275960 TI - Ultrasonography of the popliteal fossa and lower extremities. AB - In this article, the numerous proven applications of diagnostic ultrasound to the assessment of disease processes affecting the popliteal fossa and lower extremities have been discussed. Popliteal cysts and aneurysms, hematomas, cellulitis, abscesses, soft tissue neoplasms, and other space-occupying fluid collections are readily identified using this technique. In addition, post traumatic and inflammatory disorders affecting tendons, synovial thickening and effusion, derangement of articular cartilage, meniscal tears, and alterations in soft tissue thickness as well as foreign bodies are amenable to detection by sonography. With future technologic improvements in transducer design and computerized image reconstruction, diagnostic capabilities of this method in the lower extremities should continue to expand. PMID- 3275961 TI - Ultrasound examination of tendons. AB - This article reviews the type of equipment used in sonography of the tendons, the method of approach in viewing normal tendon anatomy, and the sonographic appearance in pathologic conditions of the tendons. The role of ultrasound in follow-up studies is also emphasized because of its noninvasive nature. PMID- 3275962 TI - MR imaging of the brain. PMID- 3275963 TI - Fetal abnormalities: diagnosis or treatment with percutaneous umbilical blood sampling under continuous US guidance. AB - Percutaneous umbilical blood sampling has become an important tool in maternal fetal medicine and allows direct access to fetal blood. In 52 patients, 100 successful consecutive blood sampling procedures were done for a variety of indications, including 20 intravascular intrauterine fetal transfusions for isoimmune disease. Indications, technique, and complications in this series of percutaneous umbilical blood sampling procedures are described. PMID- 3275964 TI - Yolk sac calcification: a sonographic finding associated with intrauterine embryonic demise in the first trimester. AB - Two cases of the sonographic demonstration of yolk sac calcification associated with first-trimester intrauterine embryonic demise are reported. Histologic verification was obtained in one case. Yolk sac calcification may reflect typical dystrophic changes or be more specifically related to a yolk sac calcium-binding protein. Awareness of this sonographic finding--which the authors believe to be previously undescribed--may prevent diagnostic errors. PMID- 3275965 TI - Cavernous hemangioma of the liver: role of percutaneous biopsy. AB - Fifteen patients with liver masses detected with imaging were strongly considered clinically to have malignant disease. In each case, the possibility of a hepatic cavernous hemangioma was raised upon review of the images. With use of a 20-gauge Franseen needle, a percutaneous hepatic biopsy was performed in all 15 cases, and the diagnosis of cavernous hemangioma was confirmed. There were no complications from the biopsy. Twelve biopsies were performed on an outpatient basis. On the basis of the biopsy results, the care and treatment of each patient were significantly altered. When imaging data are not sufficient to determine that a liver mass is benign, even if the possibility of cavernous hemangioma is entertained, a percutaneous biopsy can be safely performed and can yield a specific histologic diagnosis. PMID- 3275966 TI - Infected bile lakes following pediatric liver transplantation: nonsurgical management. AB - Infected bile lakes complicated orthotopic liver transplantation in two pediatric patients. Retransplantation was avoided by means of percutaneous transhepatic internal drainage of the bile lakes. Internal drainage maintained the enterohepatic cycle of cyclosporine and allowed the bile ducts to heal. PMID- 3275967 TI - Characteristics of partial flip angle and gradient reversal MR imaging. PMID- 3275968 TI - Radiology work-load measurements reflecting variables specific to hospital, patient, and examination: results of a collaborative study. AB - The authors coordinated the efforts of 44 hospitals in the United States to develop average times required for technologists to perform each of 19 radiologic examinations. When applicable, the overall average times were compared with extant Canadian work-load statistics. In six of the 14 examinations for which Canadian standards exist, the average times differed by 25% or more. The data were further analyzed to adjust time estimates for the effects of different hospital characteristics (e.g., number of beds, teaching status), patient characteristics (e.g., ambulation, outpatient status), and examination characteristics (e.g., number of views, resident involvement). The key factors and the magnitude of their effects varied from examination to examination, but the effects were generally large enough to have managerial significance. The factors can be evaluated by individual hospitals to produce customized estimates of average examination times. The data presented in this report can be used in management control systems by radiology departments in hospitals of varying sizes and teaching characteristics. PMID- 3275969 TI - Appropriate use of ultrasound in early pregnancy. PMID- 3275970 TI - A new catheter design for percutaneous cholecystostomy. AB - A catheter specifically designed for percutaneous cholecystostomy was inserted into the gallbladders of 17 hospitalized patients who were thought to have acute cholecystitis. Cholecystostomies were performed in all patients without complications, and catheters were inserted in the intensive care unit with use of portable sonographic guidance in all but two patients. The catheter was inadvertently dislodged in one patient but there were no sequelae. Therefore, for all subsequent patients the catheter was modified to include a Cope loop to prevent migration of the catheter out of the gallbladder. The sonographically detectable catheter may be placed via a Seldinger technique or trocar method. Because it is short, the catheter is easily maneuverable. PMID- 3275971 TI - Reminiscences of the transition years. PMID- 3275972 TI - Amniotic sac development: ultrasound features of early pregnancy--the double bleb sign. AB - The amniotic sac-embryo-yolk sac complex can be seen with ultrasonography (US) as two small blebs of almost equal size attached to the wall of the early gestational sac. We have called this the double bleb sign. Since the developing embryo and its cardiac pulsation are located between these two blebs, the size of an early embryo can be measured. The crown-rump length thus measured corresponds well to that described in embryologic textbooks, and an embryo as small as 2 mm (5 weeks 3 days) can be measured with use of this method. Three stages of development of the amniotic sac-embryo-yolk sac complex can be identified with US, and they are useful in dating the pregnancy. These three stages are 1, a simple double bleb, 2, a double bleb with a stalk, and 3, a double bleb with a separating yolk sac. As the amniotic sac enlarges, strands of echoes may be seen within the chorionic cavity and should be differentiated from amniotic bands, which may cause serious fetal abnormality. Separation of the amniotic from the chorionic membrane before the 13th week is normal but may be abnormal after the 17th week of gestation. Separation of the chorionic membrane from underlying decidua, however, is abnormal at any stage of pregnancy. PMID- 3275973 TI - MR imaging of the spine. PMID- 3275974 TI - MR imaging of the liver, kidneys, and adrenal glands. PMID- 3275975 TI - MR imaging of the musculoskeletal system: a 5-year appraisal. PMID- 3275976 TI - Gynecologic imaging: comparison of transabdominal and transvaginal sonography. AB - The sonographic findings in 200 patients who underwent concurrent transabdominal and transvaginal pelvic ultrasound were reviewed. The sonographic techniques were compared for image quality, completeness of anatomic detail depicted, and unique diagnostic information. Transvaginal image quality was better in 79%-87% of scans; transabdominal image quality was better in 3%-5% of scans; images of both techniques were equally good in 10%-18% of scans. The techniques provided equivalent diagnostic information in 60%-84% of cases. Transvaginal sonography was particularly helpful when exclusion of ectopic pregnancy was the clinical concern. Individual organs and fine structures were better seen transvaginally, but the regional survey offered by the transabdominal full-bladder approach remains necessary to provide anatomic orientation, particularly when the patient has not been studied previously. PMID- 3275977 TI - Adnexal and cul-de-sac abnormalities: transvaginal sonography. AB - Sixty-seven patients selectively chosen from 354 undergoing conventional transabdominal (TA) sonography for evaluation of a clinically suspected adnexal mass subsequently underwent transvaginal (TV) sonography either because the TA sonograms were technically suboptimal or because it was not possible to characterize with certainty an abnormality identified with TA sonography. TV sonography added diagnostically useful information in 25 of 28 patients with cystic pathologic changes in the adnexa uteri. Eight of 12 patients with tuboovarian abscess and nonspecific adnexal masses visualized with TA sonography had tube-shaped fluid collections characteristic of pyosalpinx identified with TV sonography. TV sonography added diagnostically useful information in all seven patients with diseases of the cul-de-sac (rectouterine fossa) and allowed differentiation of adnexal from primary uterine disease in three patients with TA sonograms on which findings were equivocal. It also expedited the diagnosis of a tubal pregnancy in ten of 14 patients and was useful in the detection of adhesions and perforated intrauterine devices. These results indicate that adjunctive TV sonography can provide important diagnostic information. PMID- 3275978 TI - Deep venous thrombosis in pregnancy: noninvasive diagnosis. AB - In pregnant patients, venous thrombosis usually affects the left-side iliofemoral deep vein. Vascular ultrasound (US) offers distinct advantages in confirming the clinical suspicion of disease or suggesting the need for further tests. The authors encountered three consecutive cases of antepartum proximal vein thrombosis during a 6-month period (0.6 case per 1,000 deliveries). Lack of venous flow accentuation and lack of diameter change at the common femoral vein during the Valsalva maneuver are indications for iliac venography and suggest the diagnosis of iliac vein thrombosis. In distal iliac and proximal femoral vein thrombosis, noncompressibility of the vein and the presence of echogenic material within are indicative of acute thrombus. PMID- 3275979 TI - Antibiotic prophylaxis in vascular and interventional radiology: a rational approach. AB - The current medical and surgical literature was reviewed to determine the rationale for the use of prophylactic antibiotics during surgical procedures. Specifically, the experimental basis for the timing and duration of administration of the antibiotics was considered, and the expected pathogens in each type of surgery were cataloged. High-risk patient groups were identified. The risk of infectious complications during interventional radiologic procedures was reviewed, and appropriate choices of drugs were determined by analogy to the corresponding surgical procedures. PMID- 3275980 TI - CT-guided aspirations for the body: comparison of hand guidance with stereotaxis. AB - Forty computed tomography (CT)-assisted aspirations performed with only hand guidance were prospectively compared with 40 performed with a CT body-stereotaxic system. Although there was no statistically significant difference in lesion size and path length between the two groups, use of stereotaxis compared with hand guidance decreased by 75% the number of needle manipulations required to place a needle within a lesion. With the stereotaxic method, only 43 needle manipulations were required to confirm a needle placement in 40 lesions, with no lesion requiring more than two attempts. Use of stereotaxis decreased the number of localization scans by 80% and biopsy time by 50%. It is concluded that CT-guided needle placements with hand guidance are often inaccurate and, unless the lesion is large, require multiple needle manipulations to place a needle within the lesion. Stereotaxis-guided biopsies, on the other hand, decrease radiation exposure, biopsy time, and trauma from multiple needle punctures. PMID- 3275981 TI - Carcinoma of the hepaticopancreatic ampullar region: role of US. AB - Hepaticopancreatic ampullar tumors are so called because they are located at the confluence of the bile duct, pancreatic duct, and duodenum. Jaundice is an early sign of the disease and often leads to early diagnosis and favorable prognosis compared with other tumors that occur in this area. Of eight patients who underwent ultrasound (US) in the past 5 years, six (75%) were found to have tumor. The sizes of the tumors ranged from 1.6 to 2 cm. An intraluminal, polypoid mass in the distal part of the common bile duct was seen in four patients. In the other two patients, a sharply delineated mass gave rise to abrupt termination of the distal duct. Improved US resolution, more experience with this modality, and accurate diagnosis of these tumors with US will contribute to improved detection and prompt treatment. PMID- 3275982 TI - Hepatosplenic candidiasis: wheels within wheels. AB - Eight immunocompromised cancer patients with tissue-proved candidiasis underwent serial abdominal ultrasound (US) and computed tomography (CT). At US, four patterns of hepatic and splenic candidiasis were recognized, one of which the authors call a "wheels-within-wheels" pattern. In addition, periportal linear areas of increased attenuation, possibly calcified, were identified at follow-up, nonenhanced CT. Some abscesses were better seen on nonenhanced CT scans, while others became visible only with enhancement. Although lesions not seen at US were often seen at CT, the opposite was also true. In two cases, pathologic proof of candidiasis was established even when all imaging studies were normal. For maximum imaging sensitivity, patients should be studied with US and nonenhanced and enhanced CT. Even when both US and CT scans are negative, if there is a strong clinical suggestion of candidiasis, open biopsy is recommended. PMID- 3275983 TI - Palpable solid breast masses: retrospective single- and multimodality evaluation of 201 lesions. AB - The diagnostic virtues and limitations of single- and multimodality testing in the evaluation of solid palpable breast masses were studied. Two hundred one consecutive patients who had a solid palpable breast mass and who underwent biopsy between September 1982 and July 1986 were included for blinded retrospective analysis of their physical examination, mammographic, ultrasonographic (US), thermographic, and pathologic characteristics. Benign breast disease was diagnosed histologically in 106 women, while carcinoma was established in 95. The sensitivities of physical examination, mammography, US, and thermography were 0.88, 0.94, 0.78, and 0.49, respectively. US alone had the highest sensitivity in correct diagnosis of a benign solid breast mass and had the highest accuracy (0.84). Use of four modalities increased the preoperative diagnostic true-positive rate to 0.97, with some decline in specificity. Multimodality testing seems particularly beneficial in pre- and perimenopausal patients. PMID- 3275984 TI - Acute pulmonary embolism: diagnostic value of digital subtraction angiography. AB - Digital subtraction angiography (DSA) performed via a peripheral vein was compared prospectively with selective conventional pulmonary angiography (CPA) in 54 patients suspected of having pulmonary embolism (PE). All patients also underwent ascending venography. In contrast to the conventional pulmonary angiograms, all of which were considered satisfactory, 13 of 54 digital subtraction angiograms (24%) were technically unsatisfactory. The interpretable digital subtraction angiograms had 81% sensitivity and 64% specificity. With DSA, one cannot exclude the diagnosis of PE on the basis of normal angiograms (27% false-positive results) as one can with perfusion scanning. On the other hand, DSA showed good sensitivity (94%) in medium to major PE. Therefore it may be the technique of choice in the screening of life-threatening PE for which curative emergency treatment with thrombolytic agents or embolectomy is often necessary. PMID- 3275985 TI - Quantitative CT for determination of bone mineral density: a review. AB - One of the major uses of quantitative computed tomography (CT) has been the measurement of bone mineral density (BMD) at various skeletal sites. The published literature on this subject from 1974 to the present is extensive. Because many investigators and clinicians are just now starting to explore the utility of this technique, the author reviewed this literature to provide both the historic perspective and current status of BMD measurement with CT. The physical and physiologic bases of the method, accuracy, reproducibility, radiation dose, and clinical utility are all discussed. PMID- 3275986 TI - A radiologist looks at AIDS: imaging evaluation based on symptom complexes. AB - Many other symptom complexes could be discussed that affect virtually every organ system of patients with AIDS or ARC. While important and interesting, these are less likely to come to the attention of the radiologist for assistance in diagnosis and management. The scope of this review has also precluded discussion of infection control, although an effective plan for handling AIDS patients in a radiology department is absolutely vital. My hope is that this review will serve as a reasonable introduction or summary of the current role of the radiologist in dealing with AIDS. Obviously, new developments are coming at an extraordinary pace, and all radiologists must avail themselves of the most current sources of information. PMID- 3275987 TI - Intraoperative US. PMID- 3275988 TI - Third Distinguished Scientist, Department of Radiologic Pathology, Armed Forces Institute of Pathology (Roger K. Harned). PMID- 3275989 TI - Reperfusion therapy of acute myocardial infarction. PMID- 3275990 TI - Echocardiography in coronary artery disease. PMID- 3275991 TI - The relationship of hypercholesterolemia to atherosclerosis with particular emphasis on familial hypercholesterolemia, diabetes mellitus, obstructive jaundice, myxedema, and the nephrotic syndrome. PMID- 3275992 TI - The microbial degradation of 2,4-dichlorophenoxyacetic acid in soil. PMID- 3275993 TI - Hexachloro-1,3-butadiene: toxicology, metabolism, and mechanisms of toxicity. PMID- 3275994 TI - Trichloroethylene: water contamination and health risk assessment. PMID- 3275995 TI - Cleaning protective apparel to reduce pesticide exposure. PMID- 3275996 TI - Teratologic testing: status and issues after two decades of evolution. PMID- 3275997 TI - Bioaccumulation behavior of persistent organic chemicals with aquatic organisms. PMID- 3275999 TI - Nursing opportunities. PMID- 3275998 TI - Cellular toxicology. PMID- 3276000 TI - Finding a way through the licensing maze. PMID- 3276001 TI - Orphan interferon finds a new home. PMID- 3276002 TI - Breast cancer study vetoed. PMID- 3276003 TI - Structural and functional roles of glycosyl-phosphatidylinositol in membranes. AB - Glycosylated forms of phosphatidylinositol, which have only recently been described in eukaryotic organisms, are now known to play important roles in biological membrane function. These molecules can serve as the sole means by which particular cell-surface proteins are anchored to the membrane. Lipids with similar structures may also be involved in signal transduction mechanisms for the hormone insulin. The utilization of this novel class of lipid molecules for these two distinct functions suggests new mechanisms for the regulation of proteins in biological membranes. PMID- 3276004 TI - Perivascular microglial cells of the CNS are bone marrow-derived and present antigen in vivo. AB - A crucial question in the study of immunological reactions in the central nervous system (CNS) concerns the identity of the parenchymal cells that function as the antigen-presenting cells in that organ. Rat bone marrow chimeras and encephalitogenic, major histocompatability--restricted T-helper lymphocytes were used to show that a subset of endogenous CNS cells, commonly termed "perivascular microglial cells," is bone marrow-derived. In addition, these perivascular cells are fully competent to present antigen to lymphocytes in an appropriately restricted manner. These findings are important for bone marrow transplantation and for neuroimmunological diseases such as multiple sclerosis. PMID- 3276005 TI - A 13-kilodalton maize mitochondrial protein in E. coli confers sensitivity to Bipolaris maydis toxin. AB - The Texas male-sterile cytoplasm (cms-T) of maize carries the cytoplasmically inherited trait of male sterility. Mitochondria isolated from cms-T maize are specifically sensitive to a toxin (BmT-toxin) produced by the fungal pathogen Bipolaris maydis, race T, and the carbamate insecticide methomyl. A mitochondrial gene unique to cms-T maize, which produces a 13-kilodalton polypeptide associated with cytoplasmic male sterility, was expressed in Escherichia coli. After addition of BmT-toxin or methomyl, inhibition of whole cell respiration and swelling of spheroplasts were observed in Escherichia coli cultures producing the novel mitochondrial protein; these effects are similar to those observed with isolated cms-T mitochondria. The amino-terminal region of the 13-kilodalton polypeptide appears to be essential for proper interaction with the BmT-toxin and methomyl. These results implicate the 13-kilodalton polypeptide in conferring toxin sensitivity to mitochondria of cms-T maize. PMID- 3276006 TI - Treatment of radiation victims in Brazil. PMID- 3276007 TI - The syphilis epidemic and its relation to AIDS. AB - This article presents an overview of the history of medical and public health responses to syphilis in the 20th-century United States and briefly evaluates the relevance and significance of these approaches for the AIDS epidemic. The parallels are numerous: they relate to science, public health, civil liberties, and social attitudes concerning sexually transmitted infection. The strengths and limits of past approaches to controlling sexually transmitted diseases are explored as a possible guide for AIDS policy. PMID- 3276008 TI - To be an Army Doc. PMID- 3276009 TI - Clonidine versus chlordiazepoxide in acute alcohol withdrawal: a preliminary report. AB - The findings presented here are from the first reported comparison and double blind evaluation of 20 patients randomly assigned to either chlordiazepoxide (n = 10) or clonidine (n = 10) for the treatment of acute alcohol withdrawal syndrome. Analysis of the study data demonstrated more favorable scores on tests of alcohol withdrawal symptoms (AWS), and better control of blood pressure, pulse, and respiratory rate with clonidine than with chlordiazepoxide therapy. In all other comparisons, clonidine was at least as efficacious. Clonidine may 'represent a new and possibly even superior pharmacologic treatment in the management of acute alcohol withdrawal syndrome. PMID- 3276010 TI - Chest pain: a rheumatologist's perspective. AB - Chest pain is a frequent patient complaint that requires a careful history and physical examination to determine its cause. Cardiac and esophageal causes of chest pain are common, but musculoskeletal disorders such as Tietze's syndrome, chest wall pain syndromes, fibrositis, inflammatory arthritic conditions, cervical osteoarthritis, and disease of the thoracic spine may also result in chest pain. Musculoskeletal diseases must be differentiated from other causes of chest pain, since specific treatment of these rheumatic conditions often produces good results. PMID- 3276011 TI - Coke's the one: the centennial of the "ideal brain tonic" that became a symbol of America. PMID- 3276012 TI - Idiopathic thrombocytopenic purpura in adults. AB - Idiopathic thrombocytopenic purpura (ITP) is a primary immune thrombocytopenia that is typically manifested in adults by acute bleeding, severe thrombocytopenia, and normal to increased megakaryocytes in the bone marrow. Labeling studies suggest that most patients with ITP have an IgG antibody directed against the platelet membrane resulting in sequestration in the spleen, and that sequestration in other organs such as the liver bodes a poor prognosis. Splenectomy and/or corticosteroids remain the mainstay of therapy, with permanent remissions induced in 75% of patients. We review alternative forms of therapy such as immunosuppressive agents, high-dose gamma-globulin, and others to enable the practicing physician to select the best treatment for patients refractory to standard therapy. Age appears to influence response to therapy and morbidity, with advancing age imparting a poorer prognosis. PMID- 3276013 TI - Anal anastomosis using the "fish hook" needle. PMID- 3276014 TI - Monoclonal antibody treatment of human allograft recipients. AB - Antilymphocyte antibody immunosuppression has evolved to the use of therapeutic antibodies which are monoclonal in content. An antibody is termed monoclonal if each immunoglobulin molecule is produced by a single clone of cells and, thus, is identical in both the heavy and light chain structure to every other molecule in the preparation. Monoclonal preparations provide more consistent bioefficacy and predictable toxicity than do polyclonal products. Studies in nonhuman primate allograft recipients have established the immunosuppressive efficacy of several mAb. The results of pilot trial studies using a pan-T-cell mAb, OKT3, either prophylactically or at the time of acute rejection have revealed OKT3 to be remarkably immunosuppressive in man. OKT3 has subsequently been shown in multicenter, randomized trials to be more effective than conventional suppression in reversing renal and hepatic allograft rejection. In uncontrolled trial studies, similar efficacy in reversing cardiac rejection has been reported. Despite these impressive results, several limitations to OKT3 therapy persist. These include febrile and other systemic symptoms after the first or second infusion, a frequency of recurrent rejection episodes and the development of antibodies to the murine protein which may preclude subsequent treatment with the same mAb. Other murine mAb, such as CBL1 and anti-T12, have been noted to produce less side effects; however, these mAb have not been as effective. The next generation of mAb will be selected to minimize these limitations. It is anticipated that future mAb protocols will specifically suppress only selected subsets of T cells, and that these mAb may be chimeric or even human in structure to limit their immunogenicity. PMID- 3276015 TI - Rapid control of hemorrhage of the scalp in the patient with trauma. AB - The use of Leroy-Rainey clips is rapid and effective in controlling extensively bleeding wounds of the scalp. They are a valuable aid in assessment and stabilization of patients with trauma. PMID- 3276016 TI - The Danish pediatrician Harald Hirschsprung. PMID- 3276017 TI - Intraoperative peritoneal lavage. AB - The successful management of the contaminated or septic abdomen rests on at least three tenets: The use of systemic perioperative antibiotics, the control of the source of infection and the aspiration of the gross contaminants. The additional use of any modality of IOPL is well entrenched in modern surgical practice. It does, however, owe more to force of habit or prejudice than to sound scientific evidence. Most, if not all, experimental or clinical studies suggesting the benefits of IOPL suffer from many deficiencies, some of which we made a point of emphasizing. In broad terms, one could recognize three major pitfalls invalidating these studies. First, the design of some of the experimental studies bears no resemblance to clinical situations. For example, laparotomy was omitted in either both arms of the trial or in the control arm. Second, far too frequently, the data were drawn from retrospective or uncontrolled trials. Although the value of such studies cannot be denied, the literature is replete with examples of perpetuation of erroneuos concepts through lack of properly designed prospective, randomized controlled studies. Third, many of the trials were performed before the revolutionary introduction of perioperative antibiotics in clinical practice. Of greater concern is the existence of studies which, for unexplained reasons, have ignored this principle. From this review, it seems that neither the benefit nor the safety of IOPL with crystalloid or antiseptic solution has been established beyond any reasonable doubt. The theory for the addition of judicious antibiotics to the IOPL may be stronger, although no absolute proof exists to suggest that this practice will decrease mortality rates from intra-abdominal infections. Obviously, there is a need for well constructed, controlled, prospective clinical trials to examine the role of IOPL in modern surgical groups of patients assembled under the label intra-abdominal infection. Until some stratification of peritonitis in various clinical studies is undertaken, either by how ill the patient is or the source of contamination and its duration, it will be difficult to compare studies from different centers. PMID- 3276018 TI - Evaluation of memory and language function pre- and postthalamotomy with an attempt to define those patients at risk for postoperative dysfunction. AB - Memory and language dysfunction has been sporadically reported following stereotaxic thalamotomies. In order to determine which patients are at greatest risk and to better define the nature of this dysfunction, we have prospectively evaluated 18 patients undergoing stereotaxic thalamotomies for movement disorders (MDs). Patients were evaluated clinically, with computed tomography (CT) and with memory and language protocols (MLPs) pre- and postoperatively. Patients exhibiting postoperative deficits were again evaluated with the MLP on follow-up visits to the clinic. Significant changes in memory and language function occurred in 7 out of 18 patients. These 7 patients had diverse etiologies for their MDs. Five of the 18 patients had undergone previous thalamotomies on the contralateral side. Three of these 5 patients with bilateral thalamotomies experienced postoperative functional impairments in memory and language while only 4 of 13 patients with a unilateral thalamotomy experienced these problems. The postoperative functional impairments noted were primarily those requiring orientation and speech. All patients with postoperative memory and language impairments were again evaluated with MLPs months after the operation. In 3 of 7 patients, no improvement was noted, while the remaining 4 did recover to baseline. More severe deficits tended to occur in those patients with ventriculomegaly or evidence of other major cerebral tissue loss by preoperative CT scan and in those patients with lower MLP scores preoperatively. Postoperative memory and language dysfunction was not correlated with the number or size of the lesions made, the postoperative general neurologic examination or CT scans, or the clinical response of the MDs. From our data, it appears that patients with more profound neurologic compromise and/or bilateral involvement as evidenced by poor performance on the MLP, tissue loss on CT scanning, or previous thalamic lesion, are most at risk for memory and language dysfunction postoperatively. However, this dysfunction is not necessarily permanent. Preoperative evaluation with MLPs and CT scanning appear to be of value in predicting those patients at greatest risk for postoperative and language dysfunction. PMID- 3276019 TI - Intracranial arterial aneurysms in early childhood. AB - Cerebral saccular aneurysms are rare in early childhood. Seventy-one cases in children under 5 years of age found in the literature, plus one case of our own, are analyzed. In early childhood these aneurysms seem to have features that distinguish them from the same variety in adults. In children a congenital pathogenesis appears more convincing because of the higher frequency in the first 2 years of life, the often peripheral site (41.6%), the high frequency of large (50%) or giant (26.8%) aneurysms, and the association with other cerebral and vascular congenital abnormalities. Onset was nonhemorrhagic in 18.1% of cases compared with 2.5% in adults. The surgical outcome seems better in children than in adult patients in terms of both morbidity and mortality. PMID- 3276020 TI - Slobodan Kostic. PMID- 3276021 TI - Magnetic resonance imaging of infiltrating angiolipoma of the neck. AB - Although infiltrating angiolipomas are histologically benign, recurrence has been reported in more than 50% of patients after partial extirpation. The authors have treated a 14-year-old female with a large infiltrating angiolipoma of the neck, in whom magnetic resonance imaging was more valuable than x-ray computed tomography and angiography in delineating the extent of the tumor. Total removal of the tumor was performed with the aid of an operating microscope. To our knowledge, this is the first description of the magnetic resonance imaging of an infiltrating angiolipoma. When other neuroradiologic examinations cannot be considered to demonstrate the extent of the tumor accurately, magnetic resonance imaging may be recommended. PMID- 3276022 TI - Multicentric glioma presenting with hemorrhage. AB - We report a case of multicentric malignant astrocytoma occurring simultaneously in both cerebrum and cerebellum, presenting with hemorrhage into the cerebellar tumor. Hemorrhage into a cerebellar glioma in an adult is very rare. None of the cases of multicentric glioma described in the literature presented with intratumoral hemorrhage. This combination in our patient has prompted us to report this case and to reaffirm the need to consider the diagnosis of malignant glioma in patients with multiple intracranial tumors. PMID- 3276023 TI - 100 years of publication--the Chinese Medical Journal. PMID- 3276024 TI - Epidural lipomatosis and renal transplantation. AB - A 34-year-old man presented with progressive myelopathy 4 months after cadaveric renal transplant for endstage renal disease. Radiographic evaluation gave findings consistent with epidural lipomatosis and compression of the thoracic thecal sac. Decompressive laminectomy resulted in dramatic improvement of his neurologic deficit. This case is unusual in the brevity of steroid treatment prior to onset of the myelopathy, as well as the relatively small dose. The 10 previous cases of epidural lipomatosis are also reviewed. PMID- 3276025 TI - Acute spontaneous subdural hematoma of arterial origin. AB - Acute spontaneous subdural hematoma of arterial origin is very rare. We have encountered two such cases and verified the arterial origin of the bleeding at operation. Both patients had no history of head trauma and developed progressive neurological deficits, becoming comatose. The source of bleeding was identified as a cortical artery located on the temporal lobe near the Sylvian region. This type of lesion is reviewed in the literature and the etiology is discussed. PMID- 3276026 TI - Tracy Jackson Putnam. PMID- 3276027 TI - Halsted's "deathbed statement". PMID- 3276028 TI - The effect of contralateral disease on carotid Doppler frequency. AB - Continuous-wave Doppler frequency analysis is one standard of noninvasive evaluation for stenotic carotid disease. Interpretation is most commonly based on frequency recorded at the site of stenosis. If flow velocity is increased because of contralateral disease, this criterion may overstate the degree of stenosis. To investigate this, three centers contributed 167 patients to a study of carotid Doppler frequency analysis. Each patient underwent bilateral carotid studies by a standard protocol with use of continuous-wave 5 MHz Doppler probe. There were 309 patent and 25 occluded internal carotids seen on subsequent angiographs. Each patient side was categorized by the severity of ipsilateral disease (less than 45%, 45% to 70%, 71% to 99%, occlusion) and then subgrouped by contralateral disease. For all carotid arteries, the optimal peak frequency to detect 45% or more stenosis was 5500 Hz, with an overall accuracy of 92.2%. Within the three classifications of ipsilateral stenosis, a trend was noted that related increasing peak frequency to greater degrees of contralateral disease. This was most apparent when the contralateral internal carotid artery was occluded. Of all false-positive errors, 43% were accounted for by this subset that represented 15% of the total population. For the 25 patients with occlusion opposite a stenosis, the 5500 Hz cutoff of Doppler peak frequency yielded only 76% accuracy; an ROC curve showed that a cutoff value of 8500 Hz improved overall accuracy to 92% for these patients. By applying two cutoff criteria--5500 Hz for those with patent contralateral internal carotids and 8500 Hz for those in whom a contralateral Doppler signal was not detected--the overall accuracy for all patients improved to 93.3%. It is concluded that contralateral occlusion affects Doppler peak frequency by increasing the velocity in the companion carotid artery, whereas severe contralateral stenosis did not result in a consistent pattern of increased velocity. PMID- 3276029 TI - Complications in cardiac transplant patients requiring general surgery. AB - With the advent of cyclosporine A, heart transplantation has become a widely accepted treatment for patients with end-stage cardiac disease that is not amenable to medical or surgical treatment. Between July 1982 and December 1985, 86 heart transplantations were performed at the Texas Heart Institute with cyclosporine A and prednisone used for immunosuppression. Thirty patients had complications requiring general surgical consultation. The pancreas and biliary tracts were most commonly affected. Pancreatitis developed in sixteen patients; five patients required operative intervention, resulting in a 40% mortality rate. Five of nine patients with cholecystitis required cholecystectomy. All patients survived the procedures. Other gastrointestinal complications included colonic ileus, bowel perforation, gastrointestinal bleeding, gastric outlet obstruction, and perirectal abscess. Patients who have undergone cardiac transplantation are susceptible to life-threatening infections and are at risk of serious complications requiring general surgical intervention. Better results can be obtained in these complex clinical situations when complications are identified early and managed aggressively through the adjustment of immunosuppression, adequate selection of antimicrobial agents, and proper timing of surgical intervention. PMID- 3276030 TI - John Syng Dorsey (1783-1818). AB - John Syng Dorsey is one of the unsung heroes of American surgery. In 1811 he performed this country's first successful ligation of the external iliac artery, for a massive aneurysm in the right groin. Two years later he wrote America's first systematic textbook of surgery. In addition, he held the professorial chairs of Materia Medica and Anatomy at the University of Pennsylvania. All this was accomplished in a life that ended at 35 years. The memory of Dorsey is dimmed by the passage of time, but his bold and innovative approach to surgical problems is a stirring chapter in the history of American surgery. Through research with the use of primary archival and secondary source material in the form of previously unpublished manuscripts, correspondence, and background information, a biographical sketch is presented. PMID- 3276031 TI - Aseptic bone necrosis after renal transplantation. AB - Osteonecrosis is a common complication of renal transplantation and is an obstacle to rehabilitation. While prednisone has long been implicated as causative, the sporadic nature of aseptic necrosis (ASN) is poorly understood. Four hundred forty-four patients received kidney transplants (TX) between January 1978 and December 1984. Fifty-two patients (16%) have developed ASN. This retrospective study was developed in an attempt to define potential etiologic factors. Age, sex, donor, source, primary renal disease, duration of dialysis, and pre-TX parathyroidectomy did not correlate with ASN. Prednisone administration and duration of use prior to transplantation was equally common in ASN and control patients. Black recipients had a twofold frequency of ASN, although this association did not quite reach significance (p = 0.07). Pretransplant x-ray evidence of either osteopenia or renal osteodystrophy was significant (p less than 0.01) and apparent in 23 of 52 patients (44%). ASN was associated with a history of early acute rejection (p less than 0.02), higher final serum creatinine (p = 0.07), and greater mean prednisone (p less than 0.0001). The mean linear trend of daily prednisone dose was also significant (p less than 0.03). This study suggests that ASN is three times more likely to occur if radiographic evidence is apparent before TX. Rejection and higher daily steroid dosage correlate with a greater incidence of ASN, and blacks appear to be at greater risk. PMID- 3276032 TI - The prostaglandin response to cholesterol feeding by the rabbit gallbladder in vitro. AB - Eleven rabbits (five female, six male) were fed a high (2%) cholesterol diet for 2 weeks. Twelve control rabbits (six female, six male) were fed standard rabbit chow. As expected, the cholesterol feeding raised serum and bile cholesterol concentrations and increased the lithogenic indexes. The gallbladders were harvested, and the mucosa and serosa were separately exposed to arachidonic acid in an in vitro incubation chamber at 37 degrees C. Cholesterol feeding stimulated the rates of synthesis of PGI2, but this effect was limited to the serosa (and not the mucosa) of gallbladders from female (but not male) animals. In contrast, cholesterol did not induce any changes in PGE biosynthesis. PMID- 3276033 TI - Ozone, nitrogen dioxide and lung cancer: a review of some recent issues and problems. AB - Lung cancer in man is a common disease. There is some recent concern that oxidant air pollutants might be a contributing risk factor. Experimental data show that ozone and NO2 increase incidence and multiplicity of lung tumors in strain A mice; however, the data are not always statistically significant. Also it depends on experimental design whether ozone enhances or inhibits the development of lung tumors in mice. Similarly, ozone and nitrogen dioxide enhance lung colonization by cancer cells injected intravenously following exposure to the air pollutants, whereas NO2 kills lung metastases if cells are injected prior to exposure. Both ozone and NO2 modulate the proliferation of pulmonary neuroendocrine cells, the precursor cells for small cell lung cancer. It is concluded that there is little evidence to implicate ozone or NO2 directly as pulmonary carcinogens, but that they might modify and influence the carcinogenic process in the lung. PMID- 3276034 TI - Ferritin: an expanded role in metabolic regulation. AB - Synthesis of ferritin, a constitutive protein, is increased by iron. This protein is well recognized as a protein which detoxifies, stores and transports iron. The 24 subunits of ferritin assemble to form a protomer of Mr 480,000. This protein shell can sequester up to 4500 g atoms of iron as ferrichydroxyphosphate. Ferritin in vitro and in vivo binds other metal ions such as Cu, Zn, Cd, Pb, Be and Al. Next to Fe it binds large quantities of Be. Therefore, in vitro ferritin protects against and reverses the inhibition by Be of enzymes susceptible to this metal ion. Also, rats pretreated with Fe survive otherwise toxic levels of either pulmonary or intravenous exposure of Be. Liver ferritin from rats injected with Zn contains some of the injected metal ion. Incubation of such ferritin-zinc complex with zinc-requiring apoenzymes restores their activity. Fe(III) of ferritin is released only after its reduction to Fe(II) by a reductant. Incubation of phosphoglucomutase, a phosphoserine containing enzyme with ferritin and a reductant causes irreversible inactivation of the enzyme and removes 70% of its phosphate. Some other phosphoproteins are similarly inactivated but without the loss of the bound phosphate. Thus, uncontrolled release of iron from ferritin, in the presence of a reductant and oxygen can modify several biomolecules and can affect metabolic processes. A subclass of ferritin, acidic isoferritins, have been implicated in leukemia-associated inhibitory activity and has been suggested to inhibit production of Ia+ macrophage progenitors. PMID- 3276035 TI - Stroke in blacks. AB - In an attempt to answer unresolved questions and to suggest directions for future research concerning stroke in black populations, data from the National Center for Health Statistics were examined and published studies were reviewed. Stroke was the third leading cause of death among U.S. blacks in 1982, accounting for 18,698 deaths, 8.25% of the total. Black men aged 35-74 years were 2.5 times and black women 2.4 times as likely as whites to die of stroke. A long-term decline in stroke mortality rates continued through 1982, with the declines since 1968 probably due to improved hypertension control. Data on morbidity trends are lacking. About 7% of black men and 11% of black women in the U.S. noninstitutionalized population aged 65 and over reported having had a stroke in 1977, black women having the highest prevalence of any group. In several studies, black women had higher incidence rates of stroke than white women in each age group. Black men had higher incidence rates than whites up to age 75 years. Survivorship and outcome following stroke may have been poorer in blacks than in whites. Advanced age and elevated blood pressure were the only putative risk factors for stroke for which published data were adequate to firmly establish the association in blacks. Thus, data are needed to examine trends in stroke incidence and survivorship in blacks and to assess the relation of many variables to the risk of stroke. PMID- 3276036 TI - Duplex scanning in extracranial vertebral artery dissection. AB - Ultrasonic (duplex scanning and continuous-wave Doppler) and angiographic findings in three patients with bilateral extracranial vertebral artery dissection are reported. A pattern of ultrasonic anomalies diagnostic of dissection is described, including association of a localized increase in diameter of the artery with hemodynamic signs of stenosis or occlusion at the same level and decreased pulsatility and presence of intravascular echoes in the enlarged segment. PMID- 3276037 TI - In memoriam. Sir Peter Medawar--February 18, 1915-October 2, 1987. PMID- 3276038 TI - Evidence that pretransplant donor blood transfusion prevents rat renal allograft dysfunction but not the in situ cellular alloimmune or morphologic manifestations of rejection. AB - The effects of preoperative donor-specific blood transfusion (DSBT) on the physiologic, morphologic, and immunologic aspects of allograft responsiveness were evaluated in a rat renal transplant model, using the ACI (RT1a) into PVG (RT1c) high-responder strain combination. Indefinite graft survival (mean greater than 63 days) could be induced by DSBT administration alone. In comparison, animals receiving autologous blood transfusion (ABT) all died within 7 days posttransplantation. As assessed by clearance of inulin and paraaminohippurate, renal allograft function in DSBT-pretreated recipients at 6 days was equivalent to that of isograft recipients, and in contrast to the significant reduction seen in ABT treated rats. Likewise, thromboxane B2 (TXB2) production by ex-vivo perfused allografts from DSBT-treated recipients was comparable to that of isografts, and significantly lower than that of allografts from ABT-treated rats. A significant inverse correlation was found between renal TXB2 production and inulin clearance. Despite these substantial differences in renal function and eicosanoid metabolism, morphologic evaluation of renal allografts from DSBT enhanced and ABT-rejecting recipients at comparable time points showed equivalent histologic manifestations of rejection. In addition, immunohistologic labeling of renal allograft sections and fluorescence-activated cell sorter analysis of cells eluted from allografts showed the same phenotype and pattern of infiltrating T cell subsets in both groups. Specific antidonor cytotoxic T lymphocyte precursor (pCTL) frequencies of cells eluted from kidney grafts were equivalent in DSBT and ABT-pretreated animals, and both groups expressed significantly higher (but equivalent) pCTL frequencies in the kidneys than spleens. Comparisons of the lysis of PVG.R1 (RT1.Aa on a PVG background) and ACI targets indicated that cytotoxic responses from effector cells freshly eluted from DSBT and ABT kidneys were primarily directed against allogeneic class I major histocompatibility complex (MHC) specificities, whereas several long term T cell lines generated from 6-day kidney transplants of both groups expressed a predominant W3/25+ (T helper) phenotype and cytotoxic activity against donor specificities other than RT1.Aa class I MHC. Specific antidonor proliferative T lymphocyte (pPTL) precursor frequencies of cells eluted from renal allografts were also equivalent for both DSBT- and ABT-treated recipients, and the range of pPTL frequencies for allograft cell eluates was similar to that in spleens, regardless of the source of the transfusion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3276039 TI - The use of single pediatric cadaver kidneys for transplantation. AB - We have reviewed our experience with 126 single pediatric cadaver kidneys (donor ages 9 months to 16 years) transplanted over a 10-year period. There were 17 donors aged 0-2 years, 55 donors aged 0-6 years, 34 donors aged 7-12 years, and 37 donors aged 13-16 years. One-year patient and graft survival was 88.2%/76.5%, 91%/74%,88.3%/69.1%, and 94.4%/80.6% for the respective groups. One-year patient and graft survival for an adult donor control group was 93%/69%. The percentage of recipients requiring dialysis in the early posttransplant period was 70.6%, 54.5%, 52.9%, 51.4%, and 52.4% for all groups, respectively. The time to reach a nadir creatinine was similar in all groups (24-30 days). While the functional outcome was comparable to cadaver transplantation utilizing adult donor kidneys, a higher incidence of infections and technical complications were encountered in the young-donor-age groups. Overall, there were 12 ureteral complications (8 fistulas, 4 stenoses), 3 bladder fistulas, and 4 renal artery stenoses. The urologic complication rate in kidneys from donors 0-2 years of age was 23.5% (all ureteral fistulas) versus 5% in the kidneys from adult donors. Only one graft was lost due to a technical complication. We conclude that, while cadaver kidneys from donors in the young age groups may be utilized successfully for transplantation, a higher incidence of urologic complications may be associated with their use. Careful harvesting and intraoperative techniques may minimize complications when utilizing kidneys from these donors. PMID- 3276040 TI - Factors influencing early renal function in cadaver kidney transplants. A case control study. AB - We performed a multicenter study to investigate the problem of cadaver kidney transplants that never achieve function, or that recover after a period of delayed function, and we used multivariate techniques to model the results. Sixty nine patients who received cadaver kidney transplants that never functioned (NF) were compared with 69 kidney recipients with early graft function (EF), and 69 with delayed but recovering graft function (DF), matched for transplant hospital and time. The results were analyzed using an unconditional logistic regression model. Risk factors for never-function transplants compared to immediate-function transplants were as follows: previous failed transplant, no polyclonal antilymphocyte globulin (ALG) prophylaxis, increasing anastomosis time, decreasing donor blood pressure, and prior transfusions in first but not subsequent transplant recipients. When technical failures were excluded, 88% of NF grafts displayed severe rejection, suggesting that rejection in a poorly functioning kidney is the principal cause of the NF outcome. Risk factors for delayed function compared to immediate function were these: increasing anastomosis time, no ALG, increasing total cold ischemia time, duration of end stage renal disease (ESRD), and male sex. Thus ischemic and immunologic risk factors contributed to the DF and NF outcomes. This study suggests that efforts to reduce the delayed and never-function outcomes should be directed to the use of ALG prophylaxis and to the reduction of cold ischemia and anastomosis times, particularly in recipients who have lost a previous transplant. PMID- 3276041 TI - Cyclosporine and skin allografts for the treatment of thermal injury. II. Development of an experimental massive third-degree burn model demonstrating extensive graft survival. AB - We have previously reported the successful treatment and apparent development of skin allograft tolerance in a patient sustaining massive burns, utilizing skin allografts and cyclosporine. We now report the experimental correlate via successful achievement of a 75% body surface area (BSA) scald burn cyclosporine skin allograft model in Lewis (LEW) rats. Cyclosporine (8 mg/kg/day) was given to the experimental animals daily for the first 20 days and then three times a week thereafter. Two experimental groups were studied: one received standard posttrauma care and the second critical posttrauma care. Controls (n = 22) and experimental groups 1 (n = 28) and 2 (n = 4) had average survival times of 13.8 +/- 12.8 days, 44.2 +/- 132.5 days, and 172.0 +/- 19.4 days, respectively. The allografts on the surviving experimental animals appeared normal and healthy and had nearly perfect hair growth. These results indicate that the model follows the clinical burn wound course, and treatment of massive burns with primary excision, skin allografts, and low doses of cyclosporine could provide immediate and complete functional repair of the burn wound. PMID- 3276042 TI - Adenine nucleotide metabolism and its relation to organ viability in human liver transplantation. AB - The relationship between adenine nucleotide metabolism and ischemic damage was studied in human liver. Thirty transplanted grafts were divided into two groups according to their functional outcome. Cellular adenine nucleotide levels were assayed by high-performance liquid chromatography. During cold ischemia, the adenosine triphosphate (ATP) level was not correlated with graft function, but two grafts with low total adenine nucleotides (TAN) levels showed poor function after transplantation. After recirculation, the ATP level showed good recovery in grafts that functioned satisfactorily (n = 24, 5.47 +/- 1.51 mumol/g dry weight), but remained low in poorly functioning grafts (n = 6, 3.30 +/- 1.68 mumol/g dry weight) (P less than 0.01). The level of recovery of ATP was inversely related to the period of warm ischemia during implantation (P less than 0.01). Bile production, used as a parameter of initial function, was observed shortly after implantation in 17 of 24 grafts that functioned satisfactorily, but in only 1 of 6 poorly functioning grafts. It is concluded that loss of adenine nucleotides and lack of bile production during transplantation are good markers of damaged grafts in human liver transplantation. PMID- 3276043 TI - Serum immunoreactive interleukin 1 in renal transplant recipients. Association of raised levels with graft rejection episodes. AB - A solid-phase radioimmunoassay was used for monitoring serum interleukin 1 levels in 12 renal transplant recipients. From 10-fold to 20-fold elevations of interleukin 1 occurred in association with 10 of 12 graft rejection episodes. The interleukin 1 elevation preceded the clinical rejection diagnosis by an average of one day in transplant recipients with initially functioning grafts, and by two days in recipients with delayed onset of graft function. The results show that the release of interleukin 1 into the circulation is an early event in renal allograft rejection and demonstrate the potential utility of interleukin 1 antigenic assays in the early diagnosis of rejection. PMID- 3276044 TI - Determination of warm ischemia time at donor nephrectomy. AB - To assess the warm ischemia time of kidneys with obscure donor histories we attempted to develop an index for the duration of ischemia by analysis of adenine nucleotides and their degradation products in cortical biopsies of canine kidneys. Two biopsy harvesting techniques were compared. The use of a laboratory technique (dentist's drill) resulted in higher concentrations of adenosine triphosphate (ATP) in normoxic tissue specimens as compared with a clinical method of harvesting biopsies (wedge biopsy). However the sum of adenine nucleotides (AN) (ATP, adenosine diphosphate [ADP], and adenosine monophosphate [AMP]) was not significantly different in both groups (P less than 0.05). Therefore, wedge biopsies were used to study the degradation of AN following 0, 30, 60, 90, and 120 min of ischemia. Adenine nucleotides and their degradation products were assayed by high-performance liquid chromatography. Concentrations of individual adenine nucleotides did not show a consistent correlation with warm ischemia time. However, as the sum of the AN and the sum of their degradation products (DP) decreased and increased, respectively, the balance between these metabolites offered a good correlation with duration of warm ischemia. The ratio of DP to AN was significantly different at each interval (P less than 0.05). To study the influence of temperature on the degradation process, ischemia was induced at 37 degrees C and 32 degrees C. Lowering of the temperature reduced the catabolic rate of the AN. The ratio of DP to AN was significantly different from corresponding values at 37 degrees C. In biopsies of nonischemic human donor kidneys, concentrations of adenine nucleotides and their degradation products were measured. Biopsies weighing less than 0.01% of total renal mass were large enough to meet analytical demands. The ratio of DP to AN in human kidney biopsies was in the same range as in the corresponding dog kidney biopsies. These findings demonstrate that the ratio of DP to AN, as determined from concentrations of purine metabolites in canine cortical wedge biopsies, is a sensitive and potentially useful index of warm ischemia time. PMID- 3276045 TI - Synergy between subtherapeutic doses of cyclosporine and immunologic enhancement in rat recipients of cardiac allografts. AB - We have analyzed the adjunctive effect of subtherapeutic doses of cyclosporine (CsA, 1.5 mg/kg/day x 7 or 14 days) on cardiac allograft survival in actively and passively enhanced rats. This CsA dose, one tenth of the effective dose, when administered after, but not before, transplantation into enhanced hosts produced permanent graft acceptance; cardiac allografts survive c. 25 days in recipients enhanced only and 1 week in untreated animals. Adoptive transfer of spleen T cells of OX8+ or W3/25+ phenotype from long-term (greater than 200 days) graft recipients prolonged donor-specific test graft survival in naive rats (c. 16 days and c. 14 days, respectively, P less than 0.001) and delayed rejection in reconstituted B rats from 7 days to 21-23 days (P less than 0.001). Indeed, both T subsets were separately equally potent and with no overlap responsible for the suppressor activity. The phenotypic profile of the immune cells in the maintenance phase of enhanced or enhanced + CsA-treated recipients was comparable to naive or isografted controls as demonstrated by flow cytometry and immunohistologic studies. Furthermore, the activation status of the graft infiltrate in long-term survivors was similar regardless of the initial immunosuppressive protocol. CsA contributed selectively to the enhancing regimen in the induction phase of unresponsiveness, diminishing the cellularity of graft infiltrate and preventing intragraft T cell activation. These studies stress synergy between subtherapeutic doses of CsA and immunologic active/passive enhancement, 2 immunosuppressive modalities that spare T cells with suppressor capabilities but differ in the inhibition of T helper cell activation. PMID- 3276046 TI - Cellular pathways for rejection of class-I-MHC--disparate skin and tumor allografts. AB - We have investigated the relative roles of the Lyt-2+ and L3T4+ T lymphocyte subsets in rejection of class-I-MHC-antigen-disparate skin and tumor allografts. To deplete T cells in vivo, rat anti-Lyt-2 or anti-L3T4 monoclonal antibodies (mAb) were administered to adult-thymectomized (ATX) recipient mice prior to transplantation. BALB/c (H-2d) recipient mice rejected the Ia- Sarcoma I (Sa1) (H 2a) tissue culture-derived tumor after depletion of the L3T4+ T cell subset in vivo. In contrast, depletion of the Lyt-2+ T cell subset permitted lethal tumor growth in all recipient mice. To determine the role of particular T cell subsets in rejection of Ld class-I-MHC-antigen-disparate allografts, BALB/c skin was transplanted to BALB/c-H-2dm2 recipient mice. Skin grafts were rejected by control mice with a mean survival time (MST) of 14.5 days. The MST of skin grafts for mice treated with anti-L3T4 mAb was 16.6 days. In contrast, administration of anti-Lyt-2 mAb alone (MST = greater than 47 days) or together with anti-L3T4 mAb (MST = greater than 50 days) caused prolonged or indefinite graft survival in all recipient mice. Depletion of specific T cell subsets was confirmed by flow cytometric analysis and by analysis of T cell function in vitro. These results suggest that Lyt-2+ T lymphocytes are essential for rejection of class-I-MHC disparate allografts; indirect presentation of alloantigen to L3T4+ T cells may not be necessary for rejection. PMID- 3276047 TI - 31P nuclear magnetic resonance study of renal allograft rejection in the rat. AB - Phosphorus (31P) nuclear magnetic resonance (NMR) spectroscopy was used to serially evaluate heterotopic renal allograft rejection in the rat. Renal allografts transplanted to the groin of recipient animals were studied using a 1.89 Tesla horizontal bore magnet. The relative intracellular concentrations of phosphorus metabolites such as adenosine triphosphate and inorganic phosphate as well as intracellular pH were determined by 31P NMR on days 4, 7, 10, and 14 following transplantation across a major histocompatibility mismatch. Recipient rats chosen to be rejectors received no immunosuppression while animals chosen to be nonrejectors received cyclosporine during the first 7 days following transplantation. By day 7, all rejector rats could be distinguished from nonrejector rats by their higher relative concentration of inorganic phosphate and their lower relative concentration of adenosine triphosphate. These NMR findings correlated with histologic findings of renal infarction probably related to vascular rejection in the allografts. 31P NMR spectroscopy may have application as a noninvasive tool in the differential diagnosis of posttransplantation renal insufficiency. PMID- 3276048 TI - Loss of F1 hybrid resistance to bone marrow grafts after injection of parental lymphocytes. Demonstration of parental anti-F1 T killer cells and general immunosuppression in the host. AB - B6D2F1 mice acutely reject parental C57Bl/6 bone marrow grafts, a phenomenon that is known as hybrid resistance. Injection of C57Bl/6 splenocytes into B6D2F1 recipients prior to bone marrow transplantation had previously been shown to facilitate growth of C57Bl/6 marrow grafts. We show in this report that for this effect to occur, radiation-sensitive T cells have to be present in the splenocyte inoculum. Loss of hybrid resistance following injection of C57Bl/6 splenocytes into B6D2F1 mice coincides with the appearance of T killer cells of C57Bl/6 origin that are specific for H-2 histocompatibility antigens of DBA/2. The parental T killer cells in unresponsive B6D2F1 mice express in vitro cytotoxic activity on H-2d targets and appear to be responsible for the acquired in vivo rejection of H-2d bone marrow grafts. Appearance of donor-derived T killer cells coincides with marked suppression of host immunity: lymphocytes from unresponsive B6D2F1 mice do not proliferate in mixed lymphocyte reactions and fail to respond to sheep erythrocytes in vitro, nor do they express natural killer (NK) activity. Concomitant with the suppression of NK activity, hybrid resistance to C57B1/6 marrow grafts disappears. This loss of resistance to bone marrow transplants is unspecific since third-party SJL marrow grafts are not rejected. It is concluded that suppression of hybrid resistance by injection of parental splenocytes into B6D2F1 mice is caused by a severe nonspecific suppression of host immune responsiveness by parental T cells that recognize disparate histocompatibility antigens in the host. PMID- 3276049 TI - Domination by epidermal cell-reactive autoantibodies in attempts to raise antibodies to Epa-1 alloantigens. AB - Despite extensive efforts to produce polyclonal sera and monoclonal antibodies (MoAbs) to Epa-1, a non-H-2 alloantigen expressed by murine epidermal cells (EC) but not lymphoid cells (LC), we were unsuccessful. In total, we screened nearly 3000 hybridoma culture supernatants--a sampling of B cells from 37 mice in 27 fusions--without finding significant evidence of Epa-1-reactive antibodies, an effort greater than that made to produce antibodies to other histocompatibility (H) antigens. Although mice immunized with Epa-1+ contained high levels of EC reactive antibodies that showed little crossreactivity with LC targets, these were autoantibodies rather than alloantibodies because they reacted as strongly with syngeneic as with allogeneic EC targets. In the course of these studies, we found that even sera of normal mice contain EC-reactive autoantibodies, and that these could be further boosted by immunization with allogeneic EC. These data indicate that the humoral response to allogeneic EC is dominated by the response to a group of tissue-restricted autoantigens expressed on EC. These findings are discussed in the light of the general inability to produce antibodies to minor H antigens. PMID- 3276050 TI - Donor-specific transfusions before transplantation. A comparison of results in children and adults at the same institutions. PMID- 3276051 TI - Production of indefinite renal allograft survival in the rat by pretreatment with viable and nonviable hepatocytes or liver membrane extracts. PMID- 3276052 TI - Treatment of chronic renal allograft rejection with cyclosporine and prednisone. PMID- 3276053 TI - Failure of antithymocyte serum postgrafting to overcome "resistance" to DLA nonidentical canine marrow grafts. PMID- 3276054 TI - Graft stability in a heart transplant recipient whose immunosuppressive therapy was discontinued for 8 months. PMID- 3276055 TI - Additional total-lymphoid irradiation in preventing graft failure of T-cell depleted bone marrow transplantation from HLA-identical siblings. Results of a prospective randomized study. PMID- 3276056 TI - Failure to decrease antibody levels in sensitized patients by repeated transfusions from one donor and cyclosporine. PMID- 3276057 TI - Graft-versus-host-like disease in a heart allograft recipient. A possible autoimmune phenomenon. PMID- 3276058 TI - Effect of disopyramide in a cyclosporine-treated patient. PMID- 3276059 TI - Successful transplantation of 100 untransfused cyclosporine-treated primary recipients of cadaveric renal allografts. AB - This report examines the effect of pretransplant (pre-Tx) blood transfusions (BT) on the patient and graft survival results of 320 cyclosporine (CsA) and prednisone (Pred)-treated primary (1 degree) recipients of cadaveric (CAD) donor renal allografts. The 320 CsA-Pred treated 1 degree-CAD recipients included 100 pre-Tx untransfused (O-BT) and 220 transfused patients. The overall patient survival at 12, 24, and 36 months post-Tx were 94%, 94%, and 93%, respectively. There were no differences observed in graft survivals at 12, 24, or 36 months post-Tx whether patients received 0, 1-4, greater than or equal to 5-10 or greater than 10 pre-Tx BTs. A mean serum creatinine of 1.9 +/- 0.7 mg/dl was comparable among all BT groups at 12, 24, and 36 months post-Tx. The frequency of rejection episodes--namely, 37% for O-BT and 36% for greater than O-BT were identical. High-risk patients (greater than 45 years of age, diabetics, or blacks) were comparably distributed in O-BT and greater than O-BT groups and did not impact on the data. Similarly, increasing panel-reactive antibodies (PRA), associated with increasing numbers of pre-Tx BTs, did not influence the data. When HLA A, B, and DR matching results were combined with the BT groupings no differences were observed in patient or graft survivals. Poorly matched and untransfused recipients did as well as well-matched, transfused recipients. These findings suggest that CsA-Pred immunosuppressive therapy allows for successful 1 degree-CAD renal allograft transplantation without the need for pretransplant blood transfusion conditioning or matching of donor HLA A, B, and DR antigens to recipients. PMID- 3276060 TI - Kidney retransplantation in the cyclosporine era. AB - The results of kidney retransplantation in the cyclosporine era remain to be determined. Over a 42-month period, 76 nonprimary renal transplants (66 second, 7 third, 3 fourth allografts) were performed in 73 recipients under cyclosporine immunosuppression. The patient population was predominantly white (90.4%) with a mean age of 32.3 years. Twenty-one recipients (28.8%) were diabetic, and 36 (49.3%) were highly sensitized (panel-reactive antibody [PRA] greater than 50%). Sixty-two patients received cadaver donor grafts while the remaining donations were living-related (12) or living-unrelated (2). A sequential antilymphocyte globulin/cyclosporine protocol was employed, with cyclosporine therapy delayed until adequate renal function occurred. Overall patient and graft survival is 92.1% and 60.5%, respectively, after a mean follow-up of 20.0 months. The mean serum creatinine is 1.64 mg/dl in the 46 functioning allografts. Graft survival is 63.6% for secondary grafts, 28.6% for tertiary grafts, and 66.7% for fourth kidney transplants. In second transplants, recipients of cadaver donor kidneys have a graft survival of 58.5%, while living-related donor graft survival is 84.6% (P = 0.07). In the cadaver retransplant population, duration of previous transplant function greater than one year and HLA-DR matching were associated with increased graft survival, while age over 39 and presence of diabetes mellitus with reduced graft survival. However, these trends were not significant. Peak PRA above 50% did demonstrate a significant negative impact on graft survival both in the univariate and multivariate analyses of risk factors. Acute rejection occurred in 50 patients (65.8%), and was successfully reversed 50% of the time. Of the 30 grafts lost, 25 (83.3%) occurred within four months of retransplantation. Transplant nephrectomy was performed in 20 patients. Cyclosporine was not administered in 21 (70%) of these early graft failures, negating any potential beneficial effect. Retransplantation can be performed safely, with living-donor graft survival superior to cadaver retransplant rates. Rejection and early graft loss are common, especially in the highly sensitized patient. The impact of cyclosporine immunosuppression in renal retransplantation is much less dramatic than in primary transplantation in a protocol that delays cyclosporine therapy until allograft function is demonstrated. PMID- 3276061 TI - Long-term results and complications in renal transplant recipients. Observations in the second decade. AB - In this study, we analyzed the incidence of complications and clinical results of 57 patients who received kidney transplants at our institution and survived with a functioning allograft for 10 years or longer. All patients received their care at our center and their clinical and laboratory data were monitored routinely at minimum monthly intervals. In this second decade, during a mean follow-up of 2.8 +/- 2.2 years (range 0.4-7.8 years), 7 patients suffered graft loss (chronic rejection 6; irreversible acute tubular necrosis from aminoglycosides 1) and 7 others died with a functioning allograft (causes: hepatic failure 2, sepsis 2, malignancy 2, and cardiac infarction 1). The cumulative patient survival was 96% at 11 years and 85% at 15 years. The corresponding graft survival rate was 92% at 11 years and 71% at 15 years. Of the 43 patients currently followed, 38 are fully rehabilitated, 4 are partially rehabilitated, and 1 is medically disabled. The complications observed were: infection in 25 patients (44%), hypertension in 24 (42%), hyperlipidemia in 23 (40%), liver disease, 22 (39%) musculoskeletal problems in 21 (37%), cataracts in 19 (33%), rejection in 15 (26%), malignancy in 9 (16%), vascular occlusive disease in 9 (16%), gastrointestinal disorders in 9 (16%), and other problems not included in the above categories in 26 (46%). Our observations suggest that renal transplant recipients experience significant morbidity and mortality even in the second decade. Continued medical follow-up is therefore essential for an early diagnosis and management of these late complications. Measures directed at prevention and therapy of these late complications may further enhance the long-term success rate of renal transplantation. PMID- 3276062 TI - Complete replacement of methylprednisolone by azathioprine in cyclosporine treated primary cadaveric renal transplant recipients. AB - In cyclosporine (CsA)-treated renal transplant recipients complete corticosteroid withdrawal followed by CsA monotherapy has been associated with severe rejection episodes in a significant proportion of patients. We report the results of replacement of steroids by azathioprine (AZA) in 25 primary cadaveric renal transplant recipients initially treated with CsA and methylprednisolone (MP). MP taper was started 8.8 +/- 5.6 months posttransplant when the MP dose was either 10 mg/day or 20 mg every other day. MP was tapered off over a 5-month period. At the initiation of MP taper, AZA was added at 1 mg/kg/day and increased to 1.5 mg/kg/day after two months. The CsA dose was adjusted to maintain trough serum levels as measured by radioimmunoassay (RIA) of 50-75 ng/ml, during and after MP withdrawal. Seventeen patients have remained continuously off MP for 14.6 +/- 5.0 months with stable renal function. Reinstitution of MP at 10 mg/day was required in 8 patients, 6 for rejection (1.8 +/- 0.7 months after MP withdrawal), 1 for AZA-induced leukopenia, and 1 for de novo glomerulopathy. Renal function returned to baseline in all 6 patients with rejection after reinstitution of MP. Two of these patients have again been successfully retapered off MP. In the patients withdrawn from MP, body weight and mean arterial blood pressure had decreased by 2.1 +/- 1.3 kg (P less than .05) and 11 +/- 7 mmHg (P less than .05), respectively, at the time of the most recent follow-up compared with values at the initiation of steroid withdrawal. The number of blood pressure medications per patient decreased by 38% (P less than .05) and 6 patients were able to discontinue all antihypertensive drugs after cessation of steroids. Discontinuation of MP also resulted in a decrease in serum cholesterol concentration from 248 +/- 50 to 217 +/- 55 mg/dl (P less than .05). We conclude that steroids can be replaced by AZA in the majority of CsA-treated primary cadaveric renal transplant recipients by the end of the first posttransplant year without an adverse effect on graft survival. This protocol resulted in significant reductions in serum cholesterol, mean arterial blood pressure, and body weight, and may avoid the long-term side effects of steroid therapy. PMID- 3276063 TI - Comparison of intravenous digital subtraction angiography and conventional arteriography in defining renal anatomy. AB - Intravenous digital subtraction renal angiography (IV-DSRA) is frequently used in the preoperative evaluation of living-related (LR) kidney donors. However, the true accuracy of IV-DSRA in the donor population is difficult to assess since abnormalities of the kidney and its circulation are uncommon in this group. Therefore, we evaluated IV-DSRA in a group of patients more likely to have anomalies and abnormalities that would affect LR donor selection, donor nephrectomy, and subsequent transplantation. Hypertensive adults being evaluated for renovascular hypertension had IV-DSRA and conventional renal arteriograms, which were interpreted independently. We determined the accuracy of IV-DSRA, compared with conventional arteriography, in detecting multiple renal arteries, renal artery stenosis, fibromuscular dysplasia, and abnormal renal parenchyma. Technically unsatisfactory studies were excluded from analysis. Of 59 patients evaluated, 37 had abnormalities or anomalies. IV-DSRA failed to detect 28 of 50 findings in these 37 patients. In 21 patients with multiple renal arteries, IV DSRA underestimated the number of main renal arteries in 8. Significant renal artery stenosis, present in 16 patients, was undetected by IV-DSRA in 3 of these patients. Mild fibromuscular dysplasia was not detected by IV-DSRA in any of the 5 patients with this condition, and abnormalities of renal parenchyma were not detected in 6 of the 8 patients with scarred or cystic kidneys. When compared with conventional renal arteriography in a hypertensive population, the IV-DSRA does not accurately detect abnormalities of the kidney and its circulation. If these data are confirmed in nonhypertensive subjects, preoperative evaluation of LR kidney donors using IV-DSRA alone may fail to detect potentially important anatomic abnormalities. PMID- 3276064 TI - Microalbuminuria and hypertension in long-term renal donors. AB - In order to determine whether the proteinuria observed in some renal donors was glomerular or tubular in origin, and to determine whether creatinine clearance was an accurate index of glomerular filtration rate (GFR) in subjects with reduced nephron mass, 29 donors were evaluated 9-18 years after uninephrectomy. Results were compared with those in 31 age-, sex-, and race-matched controls evaluated at the same time. Mean creatinine clearance (Ccreat) in donor was 78% that of controls, which was similar to the 85% ratio of inulin clearance (Cin) in donors compared with that of controls. Furthermore, the ratio of Ccreat/Cin was similar in both donors and controls. One third of the renal donors had an elevated albumin excretion compared with controls (microalbuminuria [12-220 mg/24 hr] in seven patients; 301 and 1084 mg/24 hr in two patients). There was no correlation between albuminuria and blood pressure, nor was there a demonstrable clinical cause for the albuminuria in most patients. In contrast to these results, excretion of beta-2 microglobulin, an index of tubular proteinuria, was normal in all but one patient. The prevalence of hypertension was higher in donors compared with the expected prevalence adjusted for age, sex, and race. These results verify that creatinine clearance is a reliable measure of GFR in long-term renal donors. They also demonstrate an increased frequency of glomerular proteinuria and hypertension in renal donors. Despite these mild abnormalities, GFR is well preserved for up to 18 years postuninephrectomy. PMID- 3276065 TI - Delayed response to orthoclone OKT3 treatment for renal allograft rejection resistant to steroid and antilymphocyte globulin. AB - Since February 1986, 23 patients have received Orthoclone OKT3 treatment at our transplant center for renal allograft rejection resistant to steroids and antilymphocyte globulin (ALG). They have been followed for at least 4 months as of this study time (range: 4-15 months). We report here our experience with OKT3, including five late responders--as late as 116 days after OKT3 treatment. Overall rejection was reversed in 19/23 (83%). Rejection was controlled in 95% of primary and 50% of nonprimary transplants; 89% of the male and 80% of the female patients were treated successfully; 94% of the cadaver-donor and 80% of the living-donor transplants responded successfully. The one-year rerejection rate after OKT3 was 50%, and 38% of rerejection episodes were treated successfully. Time (days) required to reverse the episodes of acute graft rejection after the start of OKT3 is plotted, and it shows a distinctive bimodal distribution: first, early responders with a mean +/- SD of 12 +/- 5 days (range: 4-20 days) and second, late responders with a mean +/- SD of 58 +/- 31 days (range: 30-116 days). We conclude that OKT3 is very effective in treating steroid- and ALG-resistant acute rejection episodes, and also that it is important to be aware of the potential late response to OKT3 antirejection therapy and recommend delaying transplant nephrectomy or immunosuppressive withdrawal for as long as possible (probably up to 4 months) for patients who have received OKT3 treatment. PMID- 3276066 TI - Increased infections associated with the use of OKT3 for treatment of steroid resistant rejection in renal transplantation. AB - We compared the infections encountered in 23 renal transplant patients given the monoclonal anti-T-cell antibody, Orthoclone OKT3 (OKT3), for treatment of steroid resistant rejection in 1986 and in 23 control patients from 1984 to 1985 with resistant rejection matched demographically, for severity of rejection and for risk factors predisposing to infection, who did not receive OKT3; recipients of OKT3 received substantially less prednisone, cyclosporine, and antilymphocyte globulin (ALG) than control patients for treatment of the rejection episode. Fourteen (61%) patients given OKT3 developed one or more infections in the 3 month period following treatment as compared with 9 control patients (39%) given conventional antirejection therapy with high-dose steroids and, usually, ALG. Patients given OKT3 were significantly more likely to develop serious infections (pneumonia, bacteremia, meningitis, or severe viral infection; 16 episodes vs. 4, P = .02). Six recipients of OKT3 (26%) acquired infections typically encountered in states associated with depressed cell-mediated immunity (CMI)--Listeria sepsis (2), disseminated nocardiosis and Mycobacterium tuberculosis infection (1), cytomegalovirus (CMV) pneumonia (1), Yersinia infection with severe dermatophytosis (1), and Epstein-Barr virus-associated lymphoproliferative syndrome (1)--as compared with 1 case of mild CMV infection in the control group (P = .08). Trimethoprim-sulfamethoxazole (TMP-SMZ) was given to 19 patients in each group; all 4 recipients of OKT3 who did not receive TMP-SMZ prophylaxis developed life-threatening infection, 3, bacteremia (2 with Listeria) and 1, disseminated nocardiosis and M tuberculosis infection. These data suggest that OKT3 given for treatment of resistant rejection in renal transplantation predisposes the patient to serious infection, particularly with opportunistic pathogens characteristically associated with depressed cell-mediated immunity. Prophylaxis with TMP-SMZ, which is safe, well tolerated, and effective for reducing the incidence of infection in renal transplantation, may be especially important during OKT3 therapy. PMID- 3276067 TI - Cyclosporine and skin allografts for the treatment of thermal injury. I. Extensive graft survival with low-level long-term administration and prolongation in a rat burn model. AB - The hypothesis tested in the present and accompanying study is that an effective treatment for severe burns involves early excision of necrotic tissue followed by skin allografting and cyclosporine (CsA) immunosuppressive therapy. LEW (RT1) rats served as recipients of thermal injury and/or skin allografts. BN x LEW F1 (LBN, RT1(l+n)) rats served as skin donors. LEW burn recipients received a hot water (90 degrees C for 10 sec) 30% body surface area (BSA) full-thickness burn. As expected, LEW recipients treated with CsA (25 mg/kg/day for 20 days) demonstrated significant graft prolongation compared with controls (P less than 0.005). Skin graft survival was similarly prolonged in LEW recipients undergoing burn injury, primary wound excision, and CsA administration compared with burn skin allograft controls (P less than 0.001). Mortality was not increased in the thermal injury-CsA-treated recipients compared with burn controls. A final experiment was initiated to investigate how low-level long-term (greater than 100 days) maintenance CsA treatment influenced skin allograft survival for possible future consideration in burn trauma. Recipients receiving skin allografts plus CsA (20 days, 8mg/kg/day, followed by every other day thereafter) did not reject their grafts. However, a possible early sign of rejection (a single small ulcerative lesion) was noted in five of these long-term CsA-treated animals at a mean of 34 +/- 11 (SD) days. The lesion in these animals did not progress any further during CsA administration. Histopathologic study of selected animals removed from the CsA maintenance regimen for greater than 50 days following long term administration revealed a number of interesting chronic lesions similar to those previously reported in the skin component of composite tissue (limb) allografts following long-term low-level CsA intervention. In conclusion, CsA was very successful in preventing rejection of skin allografts in a rat burn model without apparent adverse effects. PMID- 3276068 TI - Blood transfusions and HLA matching--an either/or situation in cadaveric renal transplantation. AB - Cyclosporine-treated recipients of primary cadaver donor renal transplants had a one-year graft survival rate of 79% if they received pretransplant blood transfusions (n = 5308). The one-year survival rate for nontransfused recipients (n = 709) was significantly lower at 69% (P less than 0.001). The transfusion effect was larger in black recipients (a 17% difference) than in white recipients (5%). The effect was also larger in recipients of grafts poorly matched for HLA A, B, -B, DR, or -DR antigens than in recipients of well-matched grafts. Transfusions did not significantly improve graft survival in recipients with zero or one HLA-A, B or -B, DR, or zero -DR-mismatched grafts. However, transfusions accounted for increases of 10%, 14%, and 17% in patients receiving grafts mismatched at 2, 3, or 4 HLA-B, DR antigens, respectively. Several factors including cyclosporine and HLA matching have contributed to improving graft survival rates in nontransfused recipients. Sensitization was noted in 20% of transfused patients awaiting primary renal transplants in Southern California, as compared with 10% in transplanted patients, suggesting a tendency to transplant nonsensitized patients. Of the sensitized patients, 75% were female. Based on these data, we suggest that high survival of primary kidney allografts in the cyclosporine era can best be maintained by the continued use of pretransplant transfusions for the majority of recipients--or, alternatively, by HLA matching for patients who are at higher risk of becoming sensitized. PMID- 3276069 TI - Serum cyclosporine kinetic profile. Failure to correlate with nephrotoxicity or rejection episodes following sequential immunotherapy for renal transplantation. AB - Cyclosporine (CsA) level monitoring in renal transplant recipients has been thought to aid in separating clinical episodes of nephrotoxicity from rejection. Twenty-four-hour CsA pharmacodynamic profiles were obtained from 85 consecutive primary renal transplant recipients in the immediate peritransplant period in order to determine the value of this test in predicting subsequent episodes of nephrotoxicity or rejection. All patients were treated with sequential antilymphoblast globulin/CsA following transplantation. Serum samples from each recipient were analyzed for CsA levels estimated by radioimmunoassay (RIA) four days after initiation of a daily single oral CsA dose (10 mg/kg/day). A total of 52 episodes of rejection and 303 episodes of nephrotoxicity occurring within the first six months posttransplant were correlated with selected parameters from the immediate posttransplant CsA kinetic profile. For each profile these parameters were maximum CsA level, time to maximum CsA level, minimum CsA level, 95% clearance time of CsA, and total CsA accumulation and clearance during the 24 hr following ingestion of CsA. No significant correlation was found between any of these parameters and either the incidence or frequency of rejection or nephrotoxic episodes, as determined by least-squares linear regression analysis. Furthermore, following a single oral dose of CsA (10 mg/kg/day), no correlation could be found between the dose and the absorption, accumulation, metabolism, and clearance of the drug. In conclusion, maximum CsA level, time to maximum CsA level, minimum CsA level, 95% clearance time of CsA, and total CsA accumulation and clearance measured from CsA kinetic profiles cannot be correlated with or predict the incidence of rejection or nephrotoxic episodes that subsequently occur during the first six months following renal transplantation. PMID- 3276070 TI - Associations between cyclosporine therapy and interstitial fibrosis in renal allograft biopsies. AB - A retrospective masked study of 120 consecutive renal transplant biopsies was performed to evaluate the potential associations of cyclosporine (CsA) therapy and other factors on the degree and progression of interstitial fibrosis (IF). Allograft biopsies were obtained from patients receiving CsA (CsA+; n = 59) and not receiving CsA (CsA-; n = 46); pretransplant donor biopsies were used as controls (n = 15). IF was evaluated by histologic grading (0-3+) as well as by quantitative morphometric measurements of Masson's trichrome stain positive material. Other biopsy measurements included the pattern of IF (focal, diffuse; graded 0-3+), and tubular epithelial cell reactivity, necrosis, and vacuolization (each graded 0-3+). Potential confounding variables were also considered, including time interval between transplant and biopsy; creatinine levels at the time of biopsy, 2 weeks and 10 weeks postbiopsy, and the last stable (baseline) creatinine prior to biopsy; recipient age, clinical evidence of rejection, and duration of rejection reactions; transplant number; and postbiopsy graft outcome. No significant difference in any measure of IF was found between all CsA+ vs. CsA patients, although both groups showed a highly significant increase in IF compared with control pretransplant donor biopsies. Similarly, no differences in tubular changes or the patterns of fibrosis were identified between CsA groups. However, since the mean interval between transplant and biopsy was significantly (P less than 0.04) greater for the CsA- group, measures of creatinine and IF were normalized by the time interval between transplant and biopsy, and were stratified into biopsies obtained before or after 6 months posttransplant. By this stratification and normalization, both the baseline creatinine (P less than 0.01) and the degree of IF as measured by morphometry (P less than 0.04) were significantly higher in the CsA+ group, but only for biopsies obtained greater than 6 months posttransplant. Evaluation of biopsies less than 6 months posttransplant normalized by interval showed no suggested differences between the CsA+ and CsA- groups in terms of creatinine levels or any measure of IF. Tubular epithelial changes were not different in the CsA+ and CsA- groups within either period. These results suggest that CsA therapy is not associated with increased interstitial fibrosis in renal allografts prior to 6 months posttransplant, after which there is a significant increase in fibrosis relative to patients not receiving CsA. PMID- 3276071 TI - Waveguides in medical ultrasonics. AB - Propagation of ultrasound in a number of thin solid elastic waveguides is described from the Pochhammer theory. The waveguides discussed have radii equal to the radii of stylets of the most frequently used biopsy needles. The group velocities of the modes and the form of the particle amplitudes of the lowest longitudinal and flexural modes in each of the styles at a frequency of 3.5 MHz are presented. PMID- 3276072 TI - Influence of parameter estimation on integrated backscatter: a model study. AB - This paper studies the influence of parameter estimation on integrated backscatter using a computer model. The study is specifically aimed at applications to the heart muscle; however, the validity of the conclusions drawn from this work should be confirmed by in vivo tests. PMID- 3276073 TI - Acute unilateral obstruction of ureter. Disparity in divided renal function calculated from 131I-hippuran and 99mTc-DTPA renography. AB - Fifteen patients with acute unilateral obstruction of ureter and 30 control patients were studied with simultaneous 131I-Hippuran and 99mTc-DTPA gamma camera renography. In severe outflow obstruction the relative function of the obstructed kidney was higher when calculated with Hippuran than with DTPA. No difference was found in the control subjects. This means that the glomerular filtration rate of an obstructed kidney may be relatively more reduced than the renal blood flow. Therefore, measurement of the single kidney fraction of total glomerular filtration rate has to be calculated with a glomerular filtered tracer, e.g., 99mTc-DTPA. PMID- 3276074 TI - Reversal of acute polyhydramnios after fetal renal decompression. AB - Polyhydramnios and premature labor at twenty-seven weeks secondary to an intrafetal renal cyst are described. Antenatal fetal cyst decompression successfully reversed the polyhydramnios and prevented premature delivery, resulting in a full-term healthy infant delivered vaginally at thirty-nine weeks. Urologic investigation postpartum revealed a probable congenital ureteropelvic junction obstruction. PMID- 3276075 TI - Mycotic aneurysm and renal transplantation. AB - A case of mycotic aneurysm secondary to suppuration of a renal transplant is reported. This aneurysm was responsible for ischemia of the leg and was treated successfully by ligation and venous bypass grafting. PMID- 3276076 TI - Differential detergent treatment allows immunofluorescent localization of the Newcastle disease virus matrix protein within the nucleus of infected cells. AB - Paramyxoviruses are cytoplasmic viruses and presumably do not require any nuclear function for their replication. However, recent studies using monoclonal antibodies directed against the Newcastle disease virus matrix (M) protein have found a large portion of the M protein apparently associated with the nucleus of infected cells. Whether the M protein is associated with the cytoplasmic surface of the nucleus or whether the M protein is actually located within the nucleus has not been clearly determined. To examine this question, conditions for selectively permeabilizing the cytoplasmic membrane were sought. After treating fixed cells with a low concentration (0.02%) of the nonionic detergent Triton X 100, the cytoplasmic antigen vimentin was stained with a monoclonal antibody, but nuclear antigens were not. Apparently, 0.02% Triton permeabilizes the plasma membrane while leaving the nuclear membrane intact. Under these conditions, monoclonal antibodies directed against the NDV phosphoprotein and hemagglutinin/neuraminidase glycoprotein stained infected cells, but a monoclonal antibody to the M protein did not. The inability of the anti-M monoclonal antibody to stain the nucleus, even though the outer nuclear membrane is accessible under these conditions, indicates that the M protein is not associated with the outer membrane of the nucleus. The nuclei of infected cells treated with a higher concentration (0.05%) of Triton X-100 were stained both with antibodies to nuclear antigens and with the anti-M monoclonal antibody. PMID- 3276077 TI - Postoperative changes in vaginal smears after vaginal reconstruction with a free skin graft. AB - Surgical vaginal reconstruction was performed by a free skin graft in two patients without a vagina. The postoperative changes in vaginal smears collected from the artificial vaginas were observed for about two years. Marked operation induced inflammatory changes were observed until the second postoperative month. After the third postoperative month, the background became relatively clear. Cyanophilic and eosinophilic superficial cells, intermediate cells and Doderlein bacilli were observed occasionally in addition to keratotic cells. Six to 12 months after surgery, the vaginal smears showed little abnormality, except for the presence of keratotic cells. The changes in the vaginal smears after the third month show that the artificial vaginal epithelium changed cytologically to an almost normal vaginal mucosa that, although not histologically complete, responded to hormones. The presence of Doderlein bacilli suggests that the regional environment of the artificial vagina was almost the same as that of the normal vagina. PMID- 3276078 TI - Application of the avidin-biotin-complex method for the light microscopic analysis of lymphocyte subsets with monoclonal antibodies on air-dried smears. AB - A study was undertaken of the application of the avidin-biotin-peroxidase complex (ABC) method to the monoclonal antibody MAbs staining of mononuclear cells in hematologic and cytodiagnostic materials. Satisfactory cell morphology and immunoreactivity of surface antigens were observed when the slides were fixed in 80% acetone in phosphate-buffered saline or in 60% acetone in 0.03 M citric acid buffer solution (pH 5.4). Unstained air-dried preparations could be preserved for two weeks at room temperature in a desiccator and for one year at -70 degrees C after fixation. An excellent immunoreaction, even with a weak surface antigen, was observed by inhibition of endogenous peroxidase after the secondary antibody reaction; reactions of weak antigens tended to be obscured when the inhibition was performed before the first antibody reaction. Use of the Giemsa stain as a counterstain made it possible to readily observe the cell morphology; therefore, white blood cell analysis could be performed simultaneously when peripheral blood smears were studied. The positive rate of immunoreaction by an immunofluorescent method was well correlated with that obtained by the ABC method. The ABC method proved to be an excellent immunocytochemical technique for detecting cell surface antigens with high sensitivity and specificity; furthermore, it is useful for cell morphology studies and yields permanent preparations. PMID- 3276079 TI - Immunoperoxidase detection of carcinoembryonic antigen in fine needle aspirates of breast carcinoma. Correlation with studies in tissue sections. AB - The peroxidase-antiperoxidase technique was used to demonstrate the presence of carcinoembryonic antigen (CEA) in fine needle aspirates and the corresponding tissue sections in 50 cases of carcinoma of the breast. The incidence of CEA positivity in the aspiration smears was 76%. A good correlation was observed between the results in the aspiration smears and in the tissue sections: 82% in the initial correlation and 90% when additional tissue sections from four of nine discordant cases proved to be positive for CEA. Five cases remained positive for CEA in the aspiration smears and negative for CEA in the tissue sections. This preliminary data indicates that aspiration smears can be used to demonstrate the CEA status in mammary carcinomas. PMID- 3276080 TI - AJR: the 50 most frequently cited papers in the past 50 years. PMID- 3276081 TI - Mono-osteitic Paget's disease as a clinical entity. Roentgenologic observations in nine cases. By J. A. Groh, 1943. PMID- 3276082 TI - Paget disease of bone: current status and a look back to 1943 and earlier. PMID- 3276083 TI - Pretreatment with corticosteroids to prevent reactions to i.v. contrast material: overview and implications. PMID- 3276084 TI - Lung cancer: update on staging classifications. AB - The AJC for Cancer Staging has improved the TNM system for lung cancer by breaking up the large category of advanced disease into several groups with different treatment implications. Radiologists should be familiar with this system so that they can direct the imaging part of the workup efficiently. The ATS classification of regional lymph nodes also has been updated both to take into account the growing recognition of superior diaphragmatic nodes in lung cancer and to change the supraclavicular lymph nodes from distant metastases to thoracic nodes (in keeping with the revised TNM system). Use of this classification helps radiologists record accurately which nodes are involved and also prompts the film reader to examine all parts of the mediastinum carefully and systematically. The use of CT for staging lung cancer is well established, but its appropriate use and limitations should be recognized. The usefulness of MR in special cases is now well described, but the hoped-for tissue specificity for tumor has not been realized. Imaging techniques have a primary role in screening for spread of disease, but confirmation by tissue biopsy is a required step in correct management. PMID- 3276085 TI - Gastrointestinal inflammation after bone marrow transplantation: graft-versus host disease or opportunistic infection? AB - Gastrointestinal inflammation after allogeneic bone marrow transplantation may be due to acute graft-versus-host disease (GVHD) and/or superinfection with opportunistic organisms. Twenty-eight patients with barium studies suggesting gastrointestinal inflammation after bone marrow transplantation and either acute GVHD, viral infection, or both were studied to characterize the radiographic appearances of each disease and to determine whether acute GVHD could be distinguished from viral superinfection on the basis of radiographic findings. Thirteen patients had minimal or no acute GVHD, with viral infection proved in eight and strongly suspected in four others; the remaining patient was thought to have nonspecific inflammatory bowel disease. Five patients had pure acute GVHD, and 10 patients had viral enteritis superimposed on acute GVHD. Radiographic abnormalities were found in the gastrointestinal tract in both acute GVHD and viral infection and were more extensive than previously reported. Findings were similar in both entities, although gastric abnormalities were not seen in pure acute GVHD but only in viral infection, either alone or together with acute GVHD. Prolonged small bowel barium coating occurred in both viral infection and acute GVHD. Fold thickening evolved into fold effacement with a shaggy contour in two patients with viral infection. Colonic findings in all groups mimicked ulcerative colitis. Our data indicate that differentiation between acute GVHD and viral enteritis is not possible on the basis of radiographic findings alone. Both entities should be considered when gastrointestinal inflammation occurs after bone marrow transplantation. PMID- 3276086 TI - MR imaging of portal venous thrombosis: correlation with CT and sonography. AB - Fourteen patients with portal venous thrombosis (PVT) diagnosed by CT and/or sonography were studied with MR. Three of the 14 had portal hypertension. The MR findings were compared with those of eight patients with portal hypertension, but without CT or sonographic evidence of PVT. MR imaging showed portal venous thrombosis in all 14 PVT cases. Intraluminal thrombi of less than 5 weeks duration appeared markedly hyperintense relative to liver and muscle on both T1- and T2-weighted images. Older thrombi appeared hyperintense relative to liver and muscle in eight of 11 cases, but only on T2-weighted images. MR showed thrombi in 11% more portal vessels than did CT (MR = 30, CT = 27) and in 28% more vessels than did sonography (MR = 32, sonography = 25). MR also showed 24% more collateral vessels than did CT (MR = 31, CT = 25) and 50% more vessels than did sonography (MR = 33, sonography = 22). Third-echo images (echo time = 96 msec, repetition time = 1500-2150 msec) verified the presence of venous thrombi in 28 (93%) of 30 PVT vessels, and they differentiated flow-related intravascular signal from true thrombi in six (17%) of 36 portal hypertension vessels. We conclude that MR is a valuable tool for imaging portal vein thrombosis. MR is a good substitute for CT and can be more informative than sonography. PMID- 3276087 TI - Hepatic venocclusive disease after bone-marrow transplantation: diagnosis with duplex sonography. PMID- 3276088 TI - Renal transplant dysfunction: MR evaluation. AB - The results of 45 MR examinations were prospectively compared with the clinical course and biopsy results in 38 renal transplant patients to determine the role of MR in evaluating allograft dysfunction. Twenty-six patients underwent allograft biopsy. In eight patients in whom the biopsy was performed more than 48 hr after MR examination and in 19 patients who did not have a biopsy, the subsequent clinical course was sufficiently diagnostic to determine the specific cause of the transplant dysfunction. Corticomedullary differentiation, graded from 0 to 3, was not helpful in separating rejection (n = 20) from acute tubular necrosis (n = 9), drug toxicity (n = 7), pyelonephritis (n = 2), or normal grafts (n = 7) because of overlap between groups (sensitivity =; 60%, specificity = 60%). In the six patients with two or more MR studies, serial changes in corticomedullary differentiation were not consistent and could not be used to diagnose rejection. When any abnormality of allograft sinus fat, size or shape, or corticomedullary differentiation was considered, the sensitivity for the diagnosis of rejection approached 80%; however, specificity was low (48%). We conclude that MR imaging is not sufficiently accurate to replace transplant biopsy and therefore has a limited role in the evaluation of transplant dysfunction. PMID- 3276089 TI - Edward B. D. Neuhauser, 1908-1987. PMID- 3276090 TI - Chest radiography in infant cardiac allotransplantation. AB - Heart transplants were performed in seven infants at Loma Linda University Medical Center from 1985 to 1987. Five of these seven patients survived. In this report, the radiographic appearance of the chest is presented before surgery, immediately after surgery, and during a documented episode of rejection. The most current available chest radiograph is also presented. Acute rejection was confirmed by clinical, echocardiographic, and ECG findings. The only pulmonary infection encountered was mycoplasma pneumonitis. Four patients developed gastrointestinal rotavirus infections and were shown to have dilated proximal small-bowel folds on upper gastrointestinal studies. At the time of this writing, the prognosis for the five surviving infants is good. We conclude that the radiographs of infants who have received heart transplants show an unusual cardiac contour and slight cardiomegaly. Increasing cardiomegaly can alert one to early rejection. Prominent folds in the small bowel are of uncertain origin and significance, but they may be related to infection resulting from immunosuppression. PMID- 3276091 TI - Third-trimester fetal sonography: meconium simulating a presacral mass. PMID- 3276092 TI - Color-flow Doppler imaging of carotid artery abnormalities. PMID- 3276093 TI - Cysticercosis. AB - Cysticercosis is probably more common in the United States than is generally realized. The most frequent sites of involvement are the brain, the eye and the skeletal muscle. Normally, the larval stage of the pork tapeworm occurs in pig muscle. Occurrence in humans follows the ingestion of ova. PMID- 3276094 TI - Industrial respirators: certifying the worker. AB - The Occupational Safety and Health Act requires medical evaluation of workers prior to certification for industrial respirator wear. For proper evaluation, the physician must understand the physiologic effects of respirators, the stresses of the work and the health of the worker. Most of the information needed to make certification decisions can be obtained from the history, the physical examination and observation of the worker exercising while wearing a respirator. Pulmonary function testing or cardiac stress testing may be helpful in difficult cases. PMID- 3276095 TI - Dermatoses of pregnancy. AB - Hormonal alterations contribute to the physiologic skin changes in pregnancy, which include hyperpigmentation and melasma, striae gravidarum and vascular phenomena, such as spiders, palmar erythema and varicosities. Hair, nails and sweat glands may also be affected. Dermatoses associated with pregnancy include herpes gestationis, impetigo herpetiformis, pruritic urticarial papules and plaques of pregnancy and papular dermatitis of pregnancy. Some skin tumors are affected by or are unique to pregnancy. PMID- 3276096 TI - Improving compliance with antihypertensive therapy. AB - Optimal control of hypertension may be impeded by poor patient-physician communication, excessive dietary sodium, cost of antihypertensive medications and laboratory studies, and drugs that antagonize antihypertensive agents. The physician is responsible for removing as many of these obstacles as possible. Prescribing an effective, inexpensive, once-daily medication with minimal side effects will improve patient compliance considerably. PMID- 3276097 TI - Communicating with patients who have psychiatric problems. AB - Psychiatric or emotional problems may become barriers to effective communication. These barriers may include factors that the physician cannot control, factors that can be controlled and factors that stem directly from psychopathology. External factors include language differences or hearing impairment. Internal factors generally stem from prejudices, maladaptive attitudes or misinformation on the part of the physician. All of these barriers must be surmounted in the interest of enhancing patient care. PMID- 3276098 TI - The well-baby examination. AB - Most abnormalities that occur in infancy are detected by the child's parents or by the physician during routine well-baby examinations. Growth parameters should be measured and discussed with the parents. Vision, hearing and speech should be assessed on a regular basis. Emotional disturbances are missed less often if a social-behavioral assessment is included in the evaluation. PMID- 3276099 TI - Allergic bronchopulmonary aspergillosis. AB - Allergic bronchopulmonary aspergillosis is primarily an immunologic disorder manifested by episodic bronchial obstruction (asthma or chronic obstructive pulmonary disease). The host response to local Aspergillus antigens gradually results in irreversible pulmonary injury. A high index of suspicion is required to make the diagnosis. Early and aggressive treatment is important in preventing the serious consequences of central bronchiectasis, pulmonary fibrosis and cor pulmonale. PMID- 3276100 TI - The asymptomatic patient with a positive VDRL test. AB - Although VDRL and RPR tests are excellent screens for syphilis, false-positive reactions do occur. A positive VDRL or RPR test must be confirmed with an FTA-ABS test. Patients with positive serologic tests should have a thorough physical examination to determine the stage of syphilis. A patient with a low-titer VDRL or RPR may have active disease and may require lumbar puncture to rule out neurosyphilis. PMID- 3276101 TI - The battered woman. AB - The possibility of physical abuse is seldom raised when battered women seek medical treatment. Physicians are often reluctant to broach the subject, and many of these women do not want to reveal their situations. Apart from the injuries incurred in a battering incident, subtle manifestations of an abusive relationship include psychosomatic complaints, stress, anxiety, fear and depression. Suicide may be contemplated or attempted. The children are always affected. PMID- 3276102 TI - Protecting against HIV exposure in family practice. AB - The magnitude of the AIDS epidemic is exceeding the predictions of a short time ago. Since AIDS patients are being encountered more frequently in family practice, the possibility of accidental exposure to HIV has become a source of concern. By exercising specific precautions and by minimizing misconceptions about the epidemiology of AIDS, physicians can provide reassurance and protection to their employees in the family practice setting. PMID- 3276103 TI - Sheehan's syndrome. AB - Sheehan's syndrome, or postpartum pituitary necrosis, is rarely seen today, but it may occur in women who have more difficult deliveries. The syndrome may be subclinical in some patients and may manifest only if these patients are stressed. Diagnosis is based on laboratory studies, including hormone levels and hormone stimulation tests. Replacement hormone therapy, with careful follow-up of laboratory and clinical results, is the treatment. PMID- 3276104 TI - The child with short stature. PMID- 3276105 TI - Human insulin preparations. PMID- 3276106 TI - Fat pad signs in the diagnosis of subtle fractures. AB - Scrutinizing the soft tissue as well as the bone is essential when reading bone films. Fat pad signs can be invaluable in the diagnosis of subtle fractures and other injuries. At some sites, such as the elbow and the wrist, these signs can be almost pathognomonic of a fracture, even if radiographic findings are otherwise negative. PMID- 3276107 TI - The comparative effects of clonidine hydrochloride and nifedipine in the treatment of hypertensive crises. PMID- 3276108 TI - Exercise and sudden cardiac death. PMID- 3276109 TI - Total ischemic burden: effect of vasoactive agents. AB - Treatment of the total ischemic burden is dependent on adequate documentation of both painful and painless episodes of myocardial ischemia, an understanding of the pathophysiologic mechanisms involved, and knowledge of prognosis for affected patients. Because a vasoconstrictive component appears to be an important element in the genesis of many episodes of myocardial ischemia, those vasoactive drugs that produce increased flow in the coronary circulation should be clinically useful. Nitrates and calcium blockers--especially nifedipine--have been found to be particularly valuable in this regard in both experimental and clinical trials. PMID- 3276110 TI - The total vascular burden, peripheral and coronary: vasodilator effects of nifedipine. AB - While the total ischemic burden on the left ventricle represents the combined effects of both symptomatic and asymptomatic myocardial ischemia, the total vascular burden has many components including an increased systemic peripheral vascular resistance, an increased pulmonary vascular resistance, and an increased coronary vascular resistance. These factors may all influence ventricular function. Hypertension contributes significantly to the vascular burden, especially when combined with left ventricular hypertrophy, which predisposes to ischemia by multiple mechanisms. In patients with hypertension and cardiomegaly, sublingual nifedipine has been shown to increase left ventricular (LV) ejection fraction and the average diastolic filling rate. In the presence of acute myocardial infarction, nifedipine moves the LV function curve onto a better Frank Starling relationship as pulmonary wedge pressure falls or stays the same and cardiac output rises. However, because of the delicate balance between myocardial perfusion and the benefits of afterload reduction, including improved remodelling, nifedipine should be given only to selected patients. In congestive heart failure, low-dose nifedipine reduces the afterload and has been shown to have beneficial effects in the majority of patients. Two specific adverse outcomes in only two patients have been reported, one with initial hypotension and one given high-dose nifedipine. Combination nifedipine-beta blocker therapy has been shown to be favorable in the treatment of all varieties of angina, hypertension, and hypertrophic cardiomyopathy. Therefore, when administered appropriately, nifedipine reduces the total vascular burden on the heart in a variety of cardiovascular diseases, with consequent improvement in LV function and a diminished threat of potential myocardial ischemia. PMID- 3276111 TI - Decrease in frequency of anginal episodes by control of thrombin generation with low-dose heparin: a controlled cross-over randomized study. AB - Increased thrombin generation is frequently associated with an increase in anginal activity. A cross-over, single-blind, completely randomized study was planned in order to evaluate whether the control of thrombin generation affected the increase in anginal activity. After discharge from the hospital, 24 patients (18 men and 6 women, aged 40 to 69 years) suffering from spontaneous angina were followed up to 12 months and were alternatively treated during two consecutive 6 month periods with calcium heparin, 12,500 IU by the subcutaneous route, or with placebo by the intramuscular route, in addition to the usual antianginal medications. Thrombin generation and clinical activity of angina were assessed every 15 days by measuring fibrinopeptide A (FPA) plasma levels and by grading in three classes (symptomless, mildly symptomatic, and severely symptomatic) the anginal activity on the basis of the number and the time concentration of the ischemic attacks and ECG changes. Low-dose heparin treatment significantly reduced both the FPA plasma level (from 4.1 +/- 3.7 to 2.3 +/- 1.8 ng/ml, p less than 0.001) and the clinical activity of angina. During heparin treatment, the frequency of the observations in the severely and mildly symptomatic classes decreased, respectively, by 53% and by 30%, whereas that in the symptomless class increased by 23% (p less than 0.001) in comparison with the period on placebo. Present results indicate that the control of thrombin generation obtained by low dose heparin treatment favorably affects the degree of anginal activity in patients with spontaneous angina. PMID- 3276112 TI - Are 24 hours of ambulatory ECG monitoring necessary for a patient after infarction? AB - The Beta-Blocker Heart Attack Trial was a randomized clinical trial of propranolol versus placebo in 3837 patients after myocardial infarction. A 24 hour ambulatory ECG was obtained before therapy in 3290 patients 2 to 21 days after myocardial infarction. Sensitivity, specificity, positive and negative predictive values, and prevalence were calculated for four definitions of ventricular arrhythmia with either total or sudden death (death in less than 1 hour of observed symptoms) as an endpoint. These indexes were obtained using the first 1, 2, 4, 6, 12, and 24 hours plus a random hour, a random daytime hour, and a random nighttime hour of the 24-hour ECG of 1336 placebo patients. For both total death and sudden death, as the duration of monitoring increased, (1) prevalence increased, (2) sensitivity increased, (3) specificity decreased, (4) positive predictive value either changed very little or decreased, and (5) negative predictive value was high (greater than 90%) and increased slightly. None of the 3 random hours offered anything beyond the first hour. The Beta Blocker Heart Attack Trial data, which were based on an average follow-up of 25 months, show that as the number of hours of ambulatory monitoring increase, the percentages of patients identified at risk or not at risk (the positive and negative predictive values) do not change much. Twenty-four hours of monitoring does not appear to be the optimal time duration for deciding whether to treat arrhythmias in patients after infarction. PMID- 3276113 TI - The cardiovascular pathology of smoking. AB - Atherosclerosis, the process underlying coronary heart disease, peripheral vascular disease, and stroke, begins in childhood and progresses through several stages to result in clinically manifest disease in middle age and later. Elevated plasma low-density lipoprotein cholesterol levels, lowered high-density lipoprotein cholesterol levels, and elevated blood pressure are associated with more extensive and more severe atherosclerosis and also with greater risk of clinical disease. Cigarette smoking is firmly established as a risk factor for coronary heart disease and peripheral vascular disease. It is associated with more severe coronary atherosclerosis, but not enough to account for the twofold or greater risk of coronary heart disease among smokers. Smoking is associated with much more severe atherosclerosis of the abdominal aorta, which is consistent with the much greater risk of aortic aneurysm and peripheral vascular disease among smokers. Smoking induces a wide variety of physiologic responses, some of which appear likely to be involved in accelerating atherogenesis or increasing the probability of thrombosis. These responses include reduction in plasma high density lipoprotein cholesterol concentration, elevation in plasma fibrinogen concentration, and elevation in white blood cell count. The rapid amelioration of the risk of cardiovascular disease after cessation of smoking suggests that these processes are readily reversible. PMID- 3276114 TI - Smoking and mechanisms of cardiovascular control. AB - In humans short-term administration of nicotine, whether by smoking or intravenous injection, will typically raise blood pressure by 5 to 10 mm Hg and heart rate by 10 to 25 bpm. Smoking causes reduced myocardial contractility and left ventricular function in patients with angina pectoris or heart failure. Nicotine's mechanism of action is more complex than the classic concept of nicotinic ganglionic stimulation can account for. Nicotine exerts a potent pressor effect in the ventral lateral medulla (C-1 area). Little current data are available documenting the efficacy of centrally acting antihypertensive agents and converting-enzyme inhibitors with regard to preventing nicotine's acute cardiovascular effects. PMID- 3276115 TI - Effects of smoking on the heart and peripheral circulation. AB - Cigarette smoking increases heart rate, arterial blood pressure, and plasma catecholamine levels. In healthy subjects the increase in heart rate occurs in the absence of peripheral vasoconstriction. In the studies reported here, short term beta-blockade increased peripheral vascular resistance during smoking, more so for the nonselective beta-blocker propranolol than for the beta 1-selective blocker atenolol. However, after 3 months of continuous treatment of hypertensive patients with beta-blockers, smoking produced similar increases in blood pressure for atenolol and propranolol. Smoking attenuated the beneficial blood pressure lowering effect of beta-blockers. Short-term clinical studies with the nonselective alpha-inhibitor phentolamine have suggested that blockade of arteriolar alpha-receptors may eliminate the increase in blood pressure response to smoking. Treatment with alpha-inhibitors also increased coronary sinus blood flow in patients with atherosclerotic artery disease. For patients who smoke, alpha-inhibiting drugs may provide beneficial therapy for hypertension and other cardiovascular disorders. PMID- 3276116 TI - Cigarette smoking and hemostatic function. AB - Epidemiologic studies clearly link cigarette smoking with vasoocclusive cardiovascular disease. Postmortem studies provide evidence of accelerated atherogenesis in asymptomatic smokers. However, the rapid regression of cardiovascular risk within the first year of quitting smoking is difficult to explain solely in terms of vascular disease. Recent evidence indicates that plasma fibrinogen, which has been prospectively associated with the risk of ischemic heart disease, is elevated in smokers. Similarly, results from studies investigating thromboxane metabolite excretion in urine confirm those involving radiolabeled platelet turnover, suggesting that platelets are activated in the circulation of chronic smokers. Altered hemostatic function, either as a direct result of smoking or caused by smoking-induced vascular damage, may account for the more rapidly reversible component of cardiovascular risk observed in chronic smokers. PMID- 3276117 TI - Age and antihypertensive drugs (hydrochlorothiazide, bendroflumethiazide, nadolol and captopril). AB - Three double-blind Veterans Administration Cooperative Studies are reviewed to determine age-related changes in response to antihypertensive agents. In the first study 312 patients received hydrochlorothiazide titrated from 25 to 100 mg twice daily to lower diastolic blood pressure (BP) to less than 90 mm Hg. Of 121 patients aged 55 to 65 the decrease in BP averaged -21.8/-12.9 mm Hg, while in the 191 patients younger than 55 the reduction averaged -15.7/-11.5 mm Hg (p less than 0.001; p = 0.048, respectively). Both systolic and diastolic BP reductions averaged significantly more in older whites; in older blacks it was systolic BP only. An additional 298 patients received titrated doses of propranolol alone. In this group there were no significant differences in BP response between younger patients and patients aged 55 to 65 except in the subgroup of white patients older than 60, in whom the systolic reduction was significantly less than in the younger patients. In a second study of bendroflumethiazide alone and with nadolol, systolic BP decreased more in older than in younger patients but there was no age-related reduction with nadolol alone. In the third trial captopril was first given alone and later with hydrochlorothiazide. There were no age-related differences with captopril alone, but after the addition of hydrochlorothiazide there was a trend toward a greater antihypertensive response in the patients aged 55 to 69. Thus, responsiveness of older patients varies with the type of antihypertensive drug. Age appears to increase the antihypertensive response to thiazide diuretics but not to beta-adrenergic blocking drugs or to captopril. PMID- 3276118 TI - Double-orifice mitral valve: a study of 27 postmortem cases with developmental, diagnostic and surgical considerations. AB - What is double-orifice mitral valve anatomically and embryologically? In 27 postmortem cases, an anomaly of the tensor apparatus was always found. These malformations may be summarized as: (1) chordal ring; (2) accessory papillary muscle or muscles; (3) subdividing muscular ridge; (4) fused papillary muscles (parachute mitral valve); (5) crossing chordae tendineae; and (6) central fibrous subdivision. More than 1 of these anomalies often coexisted per case. Double orifice mitral valve almost always consisted of abnormal holes in essentially normal leaflets, rather than of abnormal fibrous bridges or adhesions between normal leaflets. Since these fibrous "bridges" between the smaller accessory orifice and the larger main orifice are composed of mitral leaflet tissue and chordae, not fibrous adhesions, these bridges should not be transected surgically, to avoid iatrogenic mitral regurgitation. The accessory (smaller) orifice was at the anterolateral commissure in 11 cases (41%), at the posteromedial commissure in 12 (44%) and there was a central fibrous subdivision with approximately equal-sized orifices in 4 (15%). The atrioventricular (AV) canal was normally divided in 12 cases (44%) and a common AV canal was present in 15 (56%). When the accessory orifice was at the anterolateral commissure, the AV canal usually was normally divided (8 of 11, 73%). But when the accessory orifice was at the posteromedial commissure, a common AV canal almost always was present (11 of 12, 92%). Functionally, the mitral valve was normal in 13 (48%), regurgitated in 7 (26%) and stenotic in 7 (26%). The key to the diagnostic and surgical understanding of the double-orifice mitral valve is the underlying tensor apparatus. PMID- 3276119 TI - Asymptomatic form of left pulmonary artery sling. AB - Eight patients with left pulmonary artery sling, which were asymptomatic at the time of the last consultation, are described: 2 adults and 1 child with no history of symptoms, 3 children with mild forms of airways obstruction and 2 patients with typical severe symptoms of airways obstruction in infancy. The mean follow-up of these 8 patients was 10 years (range 4 to 23), and in 1986, all were in good health and free of respiratory symptoms. The long-term prognosis is usually good. PMID- 3276120 TI - Coarctation of the aorta, bicuspid aortic valve and abnormal ascending aortic wall. PMID- 3276121 TI - Antiarrhythmic therapy for asymptomatic ventricular arrhythmias. AB - The rationale for treatment of patients with nonsustained asymptomatic ventricular arrhythmias is the theoretical benefit of preventing more serious ventricular arrhythmias and sudden cardiac death. Because of the high costs involved and the serious side effects, such as proarrhythmia, associated with this therapy, the decision to treat this patient group for a potential protective effect must be weighed carefully. Risk factors identifying those patients most likely to have further complications include the presence of heart disease and left ventricular dysfunction, and the relative severity of these conditions. Those patients who fit into high-risk groups are the ones most likely to benefit, although this benefit is still unproved. If antiarrhythmic therapy is given, it is recommended that it be started in the hospital and that the efficacy of treatment be assessed by serial electrophysiologic-pharmacologic testing or noninvasive means. Empiric treatment, especially started out-of-hospital, is discouraged because it is least likely to benefit the patient and most likely to cause harm. PMID- 3276122 TI - Reflections on arrhythmia therapy. PMID- 3276123 TI - Mechanisms for arrhythmias. AB - Two broad descriptors have been applied to the genesis of cardiac arrhythmias: abnormalities of impulse initiation and abnormalities of propagation. The first category include arrhythmias that are automatic, arising over a wide range of membrane potentials, and those that are triggered by early or delayed afterdepolarizations. Among conduction abnormalities, the mechanisms most widely referred to are reentry and reflection. Although it is relatively easy to distinguish among mechanisms at the cellular electrophysiologic level, distinction is far more difficult in the intact heart and in the clinic. The patterns of response to electrical stimulation of the heart are reviewed to demonstrate the confusion that can occur when one attempts to distinguish mechanisms. In addition, means to aid in the process of distinction are suggested. PMID- 3276124 TI - Surgical treatment of arrhythmias. AB - Surgical treatment of arrhythmias is often more expeditious and more cost effective in the long run than pharmacologic therapy. In the past, surgical treatment of arrhythmias has been reserved for patients with disabling paroxysmal or incessant tachycardia refractory to medical management, severe life threatening arrhythmia or aborted episodes of sudden death. However, tachyarrhythmias that are refractory to pharmacologic therapy because of drug inefficacy, noncompliance or limiting side effects are not uncommon. Although nonpharmacologic treatment of arrhythmias carries with it a one-time period of higher risk (i.e., when the patient undergoes surgery), it is curative and often preferable to the uncertainty and possibly higher cumulative risk associated with medical management. PMID- 3276125 TI - Electrical devices for treatment of arrhythmias. AB - Electrical devices can be used for preventing and terminating tachycardia and for achieving hemodynamic improvement during a continuing tachycardia. Conventional approaches to tachycardia prevention include pacing at physiologic rates to prevent brady-cardia-related tachycardia or tachycardias associated with prolonged QT-interval syndromes. More exotic techniques, such as those involving stimulation during the refractory period, are undergoing investigation. Some tachycardias cannot be easily terminated or recur incessantly. Hemodynamics can be improved by pacing methods that result in a narrower QRS complex by coupled pacing and, in supraventricular tachycardias, by pacing rapidly enough to create atrioventricular block. Most clinical tachycardias are caused by reentry. Careful analysis of the timing of individual stimuli that successfully terminate tachycardias indicate that critical relations exist in the conduction velocity, refractoriness and physical properties and dimensions of the reentry circuit and the remaining myocardium. Elucidating these relations has permitted inferences into the mechanisms by which pacing terminates or accelerates tachycardias. A vast number of pacing patterns have evolved for use in tachycardia termination. None of these appear to be foolproof. There is widespread and justified concern about the risk of acceleration of tachycardia when antitachycardia pacing is used in the ventricle. Experience indicates that only a few patients are suitable for termination of ventricular tachycardia by pacing, but these carefully selected patients may do well. Both the results and the potential for widespread use may be better with pacing for termination of supraventricular tachycardia. Life threatening tachycardias or fibrillation can be terminated by direct-current countershock. Although many technical problems remain, implantable cardioverter defibrillators, possibly combined with antitachycardia pacemakers, will play an increasing role in the management or serious arrhythmias. PMID- 3276126 TI - Proarrhythmic events. AB - Virtually all antiarrhythmic agents can, under certain circumstances, be arrhythmogenic. The expected therapeutic and potentially arrhythmogenic effects of these agents may be altered if there is (1) an increase or decrease in the serum concentration of the antiarrhythmic agent due to interaction with other drugs, renal or hepatic disease or altered pharmacokinetics; (2) an idiosyncratic reaction to the antiarrhythmic agent; (3) an alteration in serum potassium or magnesium concentration; (4) interaction between the antiarrhythmic agent and the autonomic nervous system or between the autonomic nervous system and the heart, or (5) alteration of myocardial performance and the peripheral vascular system by the antiarrhythmic agent. Because of the lack of uniform reporting of data, guidelines have been suggested to evaluate proarrhythmic events. Of 412 patients receiving 1,080 drug trials for treatment of ventricular tachycardia or ventricular fibrillation, proarrhythmic events occurred in 33 patients (8%) and 43 drug trials (4%). The proarrhythmic event occurred more often during treatment for sustained ventricular tachycardia than for ventricular fibrillation or nonsustained ventricular tachycardia. The initial step in treating a proarrhythmic event is to discontinue the offending drug. Further recommendations are based on the nature of the particular arrhythmia. PMID- 3276127 TI - An approach to therapy for paroxysmal supraventricular tachycardia. AB - A variety of options are available for managing recurrent paroxysmal supraventricular tachycardia. These options include empirical drug therapy on a trial and error basis, drug therapy based on the results of electrophysiologic testing and nonpharmacologic treatment including operative therapy, catheter ablation and antitachycardia devices. Empirical drug therapy is appropriate when the tachycardia is relatively well tolerated and the patient has access to a medical facility. Therapy guided by electrophysiologic testing is more appropriate for patients with severe symptoms during tachycardia, patients with a potential for more serious arrhythmias such as atrial fibrillation in the Wolff Parkinson-White syndrome and in patients who have failed to respond to empirical trials of drug therapy. Electrophysiologic testing usually provides information about the precise mechanism responsible for the tachycardia and allows verification of drug efficacy. It is a strict prerequisite for operative, ablative or antitachycardia device therapy. The choice of therapy depends a great deal on local expertise, patient preference and individual considerations. Operative therapy is very successful in patients with supraventricular tachycardia associated with the Wolff-Parkinson-White syndrome and should be given high priority as an option in younger patients facing a lifelong commitment to antiarrhythmic drugs. PMID- 3276128 TI - Chronic ventricular arrhythmias: which drug for which patient? AB - Many agents, including a number of drugs recently approved by the Food and Drug Administration, are now available for the treatment of chronic ventricular arrhythmias. The so-called first-generation agents--quinidine, procainamide and disopyramide--have been used in large numbers of patients for many years, and the safety and efficacy profiles of these drugs are well established. The "second generation" antiarrhythmic agents recently approved by the Food and Drug Administration offer promising new alternatives; however, their safety and efficacy profiles have yet to be confirmed for broad populations over extended periods of time. Although it is recognized that the choice of agent for treatment of a particular patient is a "therapeutic trial," with an unpredictable outcome of efficacy and adverse effects, certain "descriptors," such as patient age or co existing medical conditions, are often helpful in determining which agent is most likely to be clinically effective, and which agents are most likely to produce adverse effects. When other medical conditions such as hepatic or renal failure are present, the appropriate choice of drug and dosage is required for optimal management of the arrhythmia and for prevention of overdosage, exacerbation of other medical problems and deleterious interactions. Combination therapy with multiple antiarrhythmic agents is often quite effective for increasing arrhythmia control without increasing adverse effects. However dosage modifications are often necessary when an antiarrhythmic drug is given in conjunction with another such agent, or with agents that also have electrophysiologic activity or modify metabolic or elimination functions. The following report is one clinician's approach for optimizing efficacy and minimizing toxicity while using the difficult class of drugs called antiarrhythmic agents. It will encourage the use of certain drugs before others, based on considerations of efficacy, safety, ease of administration, follow-up, and other factors. PMID- 3276129 TI - Mechanisms of clinical tachycardias. AB - Animal data suggest that cardiac arrhythmias can result from a variety of mechanisms. In clinical settings, arrhythmias that are easily initiated and terminated with programmed electrical stimulation are often designated as reentry tachycardias. However, proof of reentry is contingent upon demonstration of the entire circuit; this relation has been proposed for arrhythmias associated with large circuits, such as those seen in the Wolff-Parkinson-White syndrome. Reentry has also been proposed as the mechanism responsible for a variety of other tachycardias, including bundle branch and atrioventricular nodal reentry tachycardia, permanent junctional reentrant tachycardia, reentry tachycardia associated with nodoventricular Mahaim fibers and inducible atrial and ventricular tachycardia. Documentation of triggered rhythms as the mechanism responsible for clinical arrhythmias has been even more difficult. Examples of arrhythmias resulting from triggered activity may include those associated with digitalis toxicity arising from the atria, the atrioventricular junction or the ventricles. Clinical arrhythmias due to triggered activity in the absence of digitalis have also been described. Cardiac arrhythmias that cannot be induced by electrical stimulation are presumably due to normal or abnormal automaticity. Examples of normal automaticity in the human heart are sinus rhythm and junctional and idioventricular escape rhythms. Tachycardias by abnormal automaticity have seldom been investigated for the purpose of documenting the mechanism and therefore the limited data available make it difficult to draw any final conclusions. PMID- 3276130 TI - Combination therapy for cardiac arrhythmias. AB - Combinations of antiarrhythmic agents are often used when single agents are ineffective, only partly effective or poorly tolerated. The theoretical and experimental basis for combination therapy for arrhythmias is the dissimilar electrophysiologic properties of antiarrhythmic agents. Until more is known about the mechanism of drug synergism and drug interactions, the experience gained clinically remains essential to our understanding. Published reports contain numerous data on the effectiveness of various combinations of antiarrhythmic agents, including combinations of class I agents, the combination of a class I agent and a beta-blocking agent or amiodarone, and combinations including a calcium-antagonist agent. Adverse drug interactions, however, can occur, and combinations of certain agents must be avoided or used with caution. PMID- 3276131 TI - Effects of dietary protein on renal function and on the progression of renal disease. PMID- 3276132 TI - Effect of dietary phosphate restriction on renal function and deterioration. AB - Dietary phosphate restriction has been shown to be effective in preventing proteinuria, renal histological changes, and progressive renal functional deterioration in experimental renal disease. By use of rats and dogs, this effect has been noted in renal ablation, glomerulonephritis, and an experimental type of diabetic renal disease. Although a beneficial effect of dietary phosphate restriction for human renal disease has not been established, the fact that it is effective in multiple types of experimental renal disease in two distinct species suggests that phosphate restriction could be effective in retarding the progression of renal failure in man. PMID- 3276134 TI - Intensive insulin therapy justifies simplification of the diabetes diet: a prospective study in insulin-dependent diabetic patients. PMID- 3276133 TI - Hyperlipidemia and the progression of renal disease. AB - Focal glomerulosclerosis (FGS) is commonly seen in human and in experimental models of chronic renal disease. Although considerable experimental data suggest that hypertension is important in progressive nephron damage, recent studies also have indicated that abnormal lipid metabolism may be an independent risk factor in the pathogenesis of FGS. Indeed, the synergistic impact of hypertension and hyperlipidemia in the pathogenesis of FGS may be analogous to the role of these factors in the pathogenesis of atherosclerosis. This review focuses on some of the recent and pertinent data that support a role of lipid-mediated glomerular injury in the pathogenesis of progressive renal disease. PMID- 3276135 TI - An immunoassay for human transferrin. AB - The laboratory measurement of serum transferrin is a valuable adjunct in the assessment of both iron and protein nutritional status. Conventional assays based on the Fe-binding properties of this protein are tedious to perform, susceptible to Fe contamination, and require volumes of serum that can only be obtained by venous sampling. We describe in this report a two-site enzyme immunoassay (EIA) developed with the use of monoclonal antibodies. Ten microliters serum is diluted 1:20,000 before assay, reflecting a high degree of sensitivity. The variability of this EIA is comparable to conventional colorimetric assays for total iron binding capacity (TIBC), and excellent correspondence was observed between these methods over a range in TIBC of 150-500 micrograms/dL (27-90 mumol/L). No consistent difference was observed with the EIA when performed on venous and capillary specimens obtained simultaneously. This method will facilitate the evaluation of Fe and protein status in nutritional surveys. PMID- 3276136 TI - Application of glycemic index to mixed meals. AB - Plasma glucose and insulin responses to six different meals were determined and compared with values predicted by published glycemic indices of the component foods. The test meals were of different ethnic origins: Indian (lentil curry with rice), Italian (spaghetti bolognaise), Chinese (stir-fried vegetables and chicken with rice), Greek (lentil stew), Western (sirloin chop and vegetables); and Lebanese (sandwich with unleavened bread and hummos). Eight healthy volunteers were given 50 g carbohydrate portions of the above meals after an overnight fast. The glycemic and insulin indices were highest for the Lebanese meal and lowest for the Greek with significant differences among the meals (ANOVA, p less than 0.05). The observed glycemic indices correlated well with the predicted glycemic indices (r = 0.88, p less than 0.01) and insulin responses parallelled the glycemic responses (r = 0.83, p less than 0.05). These results suggest that the glycemic index approach will be useful in planning diets for diabetic people. PMID- 3276137 TI - Summary of the Centers for Disease Control human immunodeficiency virus (HIV) performance evaluation surveys for 1985 and 1986. AB - During 1985 and 1986, the Centers for Disease Control conducted eight surveys to evaluate laboratory performance in testing for antibody to human immunodeficiency virus (HIV). (Other names for this virus include "human T-lymphotropic virus type III" and "lymphadenopathy associated virus.") The first survey was conducted with ten samples and 50 laboratories; the remaining surveys used six samples, but enrollment increased to as many as 475 laboratories. The purpose of these surveys was to measure test performance by the laboratories under the actual conditions of use. The surveys contained duplicate samples to permit measurement of within- and between-survey reproducibility. One survey included positive and negative reference materials as evaluation samples. Results of the Western blot (WB) test were not always positive on samples that were positive by enzyme immunoassay (EIA), and sometimes they were positive on samples that had negative results by EIA. The percentage of positive results reported by laboratories using Electronucleonics tests was lower than that reported by users of Abbott and of Litton tests. positive results on the negative reference material were reported by 13.7% of the Abbott EIA test users. The tests do not seem to be calibrated against an equivalent standard. Within-survey reproducibility was usually above 95% for EIA and WB methods and for the major manufacturers of EIA tests. Between survey reproducibility was usually above 90%. Reproducibility was below 75% for some combinations of samples, method, and manufacturer. The test performance observed in these surveys may be lower than is actually achieved on patient samples because the samples were selected to measure technical competence and contain a higher frequency of samples with low reactivity than would be encountered with clinical samples. Stratification and weighting of the results in these surveys to estimate performance parameters for a blood bank population indicate that the tests are performing well in this application. If single EIA tests at the performance levels achieved in these surveys were used (no repeat and no confirmation), about 1 sample with positive results in every 50,000 samples tested would be missed and about 2.5% would be false positive results. Because tests are duplicated and confirmed in blood banks, better performance would be expected. Testing for antibody to HIV virus continues to undergo rapid change because of the introduction of new tests, changes in technical aspects of existing tests, and application of testing to changing populations. Such dynamic factors necessitate an ongoing, comprehensive monitoring of test performance. PMID- 3276138 TI - Immunohistochemical identification of Trichosporon beigelii in histologic section by immunoperoxidase method. AB - An indirect immunoperoxidase method capable of identifying an opportunistic fungus, Trichosporon beigelii, in formalin-fixed, paraffin-embedded tissue has been developed. The authors studied autopsy materials from 19 patients with various fungal infections, including 3 patients with disseminated T. beigelii infection, 8 patients with localized or systemic candidiasis, 4 patients with invasive aspergillosis, 2 patients with pulmonary mucormycosis, and 2 patients with systemic cryptococcosis. T. beigelii could be successfully visualized in tissue sections from all three patients with this infection and a patient with systemic candidiasis who was found to have concomitant infection by T. beigelii. The capsule of Cryptococcus neoformans was also stained, indicating the presence of cross-reactive antigen between T. beigelii and C. neoformans. C. neoformans absorbed antiserum was reactive with T. beigelii but not with other fungi, including C. neoformans. PMID- 3276139 TI - Del(14)(q22) in diffuse B-cell lymphocytic lymphoma. AB - Some recurrent chromosomal abnormalities have recently been found to be associated with distinctive histologic subtypes of non-Hodgkin's lymphoma (NHL). In a study of 62 patients with NHL whose karyotypes was determined at diagnosis, 3 patients were found to have a deletion of the long arm of chromosomes 14 at band 22 (del[14][q22]). All had a diffuse lymphoma with generalized lymphadenopathy and bone marrow involvement. All three lymphomas were of B-cell origin, as shown by the presence of surface immunoglobulin and monoclonal antibody phenotyping. For each patient, a trisomy 12 was associated with del(14)(q22) in a clone. These data suggest that del(14)(q22), perhaps in association with trisomy 12, could identify a subtype of NHL and that band 22 of chromosome 14 may be implicated in the B-cell ontogeny. PMID- 3276140 TI - Leukocyturia in cyclosporine-treated renal allograft recipients. AB - Five hundred eighty-seven daily urine specimens were examined from 179 consecutive renal allograft recipients with the use of quantitative cytodiagnostic urinalysis. Specimens were divided between those patients receiving cyclosporine (CyA) and steroid immunotherapy (73 patients) and those receiving standard azathioprine (Aza) and steroid immunotherapy (106 patients). When patients with urinary tract infections were excluded, an increase in leukocyturia was observed in the CyA-treated patients. Ninety-three percent of the CyA-treated patients had at least one specimen with more than 1,000 neutrophils/10 high-power fields (HPFs) versus 62% of the 106 Aza-treated patients. Sixty-four percent of the specimens examined from the CyA-treated group had more than 1,000 neutrophils/10 HPFs compared with only 18% of specimens from Aza-treated patients. It appears that CyA is a cause of sterile leukocyturia in renal allograft recipients. The significance of leukocyturia in CyA nephrotoxicity needs further definition. PMID- 3276141 TI - Evaluation of laboratory methods for the classification of oxacillin-resistant and oxacillin-susceptible Staphylococcus aureus. AB - The purpose of this study was to examine the efficacy of the oxacillin disk diffusion test and the methicillin and oxacillin agar screen tests as predictors of oxacillin resistance as defined by the reference broth microdilution method. A total of 444 clinical isolates of Staphylococcus aureus collected from individual patients over a four-year period were tested by (1) the oxacillin disk diffusion test, with particular attention to the presence of fine growth of a resistant subpopulation within the zone of inhibition (Ox Grow interpretive criteria); (2) the agar screen method using agar plates with 4% NaCl and either 6 mg/L oxacillin or 10 mg/L methicillin; and (3) the oxacillin and methicillin broth microdilution test methods with 2% NaCl supplementation. Overall, 62 (14%) isolates were resistant and 382 (86%) isolates were susceptible to oxacillin with the use of the reference broth microdilution system. The results indicate that the disk diffusion test with the use of the Ox Grow criteria had a high sensitivity (94%) and negative predictive value (98%) but a low specificity (67%) and positive predictive value (32%) when compared with the reference broth dilution test. Similarly, the agar screen tests had a high sensitivity (95-97%) and negative predictive values (99%) but low specificity (64-74%) and positive predictive values (30-37%). These data indicate that the agar screen tests and the oxacillin disk test with the use of the Ox Grow interpretive criteria may be useful as screening tests for detecting resistance to the penicillinase-resistant penicillins but that all resistant isolates should be confirmed by the reference broth dilution method because of the large number of false-resistant screening test results. PMID- 3276142 TI - Sensitivity, specificity, and bias. PMID- 3276143 TI - Determination of estrogen receptor by monoclonal antireceptor antibody in aspiration biopsy cytology from breast carcinoma. AB - The authors evaluated the ability of a monoclonal antibody immunoperoxidase procedure (ERICA [Estrogen Receptor Immunocytochemical Assay], information from Regulatory Affairs Department, Abbott Laboratories, North Chicago, IL) to detect estrogen receptor in aspiration biopsy cytology (ABC) specimens from breast cancer routinely taken by fine-needle aspiration during office diagnostic evaluation. Results were correlated with biochemical values determined from dextran-coated charcoal (DCC) assay on tumor tissue obtained subsequently at operation. ERICA had positive results in 32 of 41 DCC-positive cases (sensitivity, 78%) and in 5 of 17 DCC-negative cases (specificity, 71%). The semiquantitative degree of ERICA positivity correlated with the concentration of estrogen receptor by DCC. Results of both assays correlated with the histologic grade of the tumor and patient age. Estrogen receptor can be determined by immunocytochemistry in ABC specimens in a community hospital. However, the sensitivity and specificity of this procedure compared with biochemical assay, and eventual response to hormonal therapy, require further investigation. PMID- 3276144 TI - Rehydration of air-dried smears with normal saline. Application in fine-needle aspiration cytologic examination. AB - In fine-needle aspiration cytologic examination, nuclear features are often better assessed in hematoxylin and eosin (H and E) or Papanicolaou- (Pap) stained than Romanowsky-stained smears. However, both H and E and Pap stains require the use of immediately wet-fixed smears for cytomorphologic preservation. Some degree of air drying is usually inevitable. Placing air-dried smears in normal saline for 30 seconds before fixation in 95% alcohol is found to be a simple means of rehydrating the cells. The quality of the rehydrated smears is superior or identical to that of the immediately wet-fixed smears, provided that the period of drying does not exceed 30 minutes. PMID- 3276145 TI - Splenic hematopoiesis in polycythemia vera. A morphologic and immunohistologic study. AB - Spleens from 42 patients with polycythemia vera were studied with immunohistologic technics to assess the degree of hematopoietic cellularity in an attempt to clarify the pathogenesis of the splenomegaly characteristic of this disorder. The 22 spleens obtained in the erythrocytotic phase showed striking congestion with mature erythrocytes but no significant extramedullary hematopoiesis. However, the 20 spleens obtained in the spent phase showed prominent trilinear extramedullary hematopoiesis. Increasing splenomegaly with extramedullary hematopoiesis correlated with the development of increased medullary reticulin and peripheral blood leukoerythroblastosis. Splenic myeloid metaplasia is not a feature of uncomplicated polycythemia vera, and its presence indicates progression to the spent phase, or postpolycythemic myeloid metaplasia. The authors' findings indicate that the presence of hematopoietic precursors in the spleen in the spent phase of polycythemia vera and in agnogenic myeloid metaplasia is a result of their filtration from the peripheral blood. PMID- 3276146 TI - The effect of a fluoride program on white spot formation during orthodontic treatment. PMID- 3276147 TI - Exposure reduction and image quality in orthodontic radiology: a review of the literature. AB - This article summarizes the use of rare earth screen technology to achieve high quality panoramic and cephalometric radiographs with sizable reductions in patient radiation dosage. Collimation, shielding, quality control, and darkroom procedures are reviewed to further reduce patient risk and improve image quality. PMID- 3276148 TI - A precise and time-saving method of setting up an indirectly bonded retainer. AB - A lingual retainer characterized by precise fit and minimum tissue damage is presented. Experience based on the use of 94 retainers is reported and the reasons for failure discussed. PMID- 3276149 TI - The hepatobiliary manifestations of human immunodeficiency virus infection. AB - Liver abnormalities are common in patients with acquired immune deficiency syndrome. These relate to 1) coincident exposure to hepatotropic viruses, 2) complications, either infectious, neoplastic, or iatrogenic, of the immunosuppressed state, or 3) nonspecific changes associated with chronic debilitating illness. We review the hepatobiliary manifestations of acquired immune deficiency syndrome, and discuss our approach to the clinical evaluation of these problems. PMID- 3276150 TI - Treatment of candida esophagitis in AIDS patients. AB - We conducted a randomized prospective study to compare the efficacy of oral miconazole and ketoconazole in the treatment of candida esophagitis in acquired immune deficiency syndrome (AIDS) patients in Haiti. Twelve AIDS patients with endoscopic and microscopic diagnoses of candida esophagitis were placed on either oral miconazole or ketoconazole for 10 days. All six patients receiving oral miconazole, and four of the six receiving ketoconazole had complete resolution of their esophageal lesions at the end of treatment. We conclude oral miconazole is at least as effective as ketoconazole in the treatment of candida esophagitis in AIDS patients. PMID- 3276151 TI - Ultrasonographic findings with bleeding and nonbleeding esophageal varices. AB - Real time ultrasonography was carried out in 49 cirrhotic patients within 10 days of esophagoscopy, and in 20 normal subjects. Among the cirrhotic patients, 42 had varices and 18 of these had hematemesis within 3 months of study. The varices were graded 0 to 4+ endoscopically; the diameter of the portal vein, the splenic vein, the hepatic artery, and the maximal length of the spleen were determined on ultrasound. In addition, portal collateral veins and the sudden amputation of portal vein branches in the liver were identified when present. There was a significant correlation of the diameter of the portal vein and the maximal spleen length with the magnitude of varices on endoscopy; there was no significant relationship between the splenic vein or the hepatic artery diameter. Less than half the patients with varices had sonographically demonstrated collaterals or portal vein branch amputation. A sonoscore was derived allotting one point each for enlarged portal vein (greater than 1.3 cm), enlarged spleen, collaterals or two or more amputated veins. The sonoscore correlated better with the endoscopic grade of varices than any other marker. The sonoscore among the patients with varices who bled was significantly higher (p less than 0.01) than any of the other measures. It is concluded that real time ultrasound can be used to screen for varices and to identify the need for endoscopy. PMID- 3276152 TI - Obstructive jaundice from benign, nonparasitic hepatic cysts: identification of risk factors and percutaneous aspiration for diagnosis and treatment. AB - Obstructive jaundice due to benign, nonparasitic hepatic cysts is rare, with only 11 previously reported cases. We report a case in which relief of jaundice was obtained by percutaneous cyst aspiration. For the elderly, infirm, or high-risk patient, percutaneous aspiration is recommended to relieve obstructive jaundice. Immense size and porta hepatis proximity are major risk factors for developing jaundice from simple hepatic cysts. Abdominal pain of recent onset and rising alkaline phosphatase are warning signs that this complication is developing. In these situations, treatment prior to developing jaundice is recommended. PMID- 3276153 TI - Serum levels of retinol, beta-carotene, and alpha-tocopherol in older adults. AB - Levels of retinol, beta-carotene, and alpha-tocopherol were determined in the serum of 415 adults over age 35 years who had volunteered in 1974 to donate blood for cancer research in Washington County, Maryland. Males had higher levels of serum retinol, lower levels of beta-carotene, and only slightly lower levels of alpha-tocopherol than did females. No clear-cut association was noted with age. Smokers had decreased serum levels of beta-carotene. Vitamin supplementation was associated with higher serum levels. Persons taking medication for high blood pressure had higher levels of retinol and alpha-tocopherol, but lower levels of beta-carotene. PMID- 3276154 TI - Self-reported stressors and hypertension: evidence of an inverse association. AB - This paper presents an analysis of self-reported stressors and blood pressure in a population of 1,428 San Francisco bus drivers surveyed from 1983 to 1985 as part of an occupational health study. To test the hypothesis of a positive association between psychosocial stressors and hypertension, the authors derived a stressor index from a survey instrument that assessed subjects' appraisal of work-related problems. A logistic regression analysis revealed an unexpected inverse association between the stressor index and hypertension that remained significant after adjustment for 12 potential confounding variables (standardized odds ratio = 0.84, p = 0.038). An analysis restricted to the 1,040 normotensive subjects, with mean blood pressure level as the outcome variable, also yielded inverse findings. To assess whether the results were specific to blood pressure, the authors repeated the multiple logistic analysis for gastrointestinal, respiratory, and musculoskeletal problems. In contrast to the inverse association found for hypertension, highly significant positive associations were found between the stressor index and these health problems. When prevalence of disease was examined by level of stressor score, a significant inverse gradient was observed for hypertension and significant positive gradients were observed for gastrointestinal, respiratory, and musculoskeletal problems (p values less than 0.001). An etiologic implication of these findings is that there may be a direct inverse association between subjective appraisal of stressors and blood pressure. A methodological implication is that subjective appraisal of stressors by persons with heightened blood pressure may be an invalid measure of objective, verifiable stressors. PMID- 3276155 TI - Excess incidence of treatment of end-stage renal disease in Mexican Americans. AB - Mexican Americans are the second largest minority group in the United States (8.73 million people according to the 1980 US census) and are known to have an excess prevalence of obesity and non-insulin-dependent diabetes mellitus, but similar or lower rates of hypertension when compared with non-Hispanic whites. To our knowledge, no data are available on incidence of end-stage renal disease in this population. Using a data base from the Texas Kidney Health Program, a division of the Texas Department of Health, and the 1980 US census for the state of Texas, the authors calculated age-adjusted incidence of treatment of end-stage renal disease in Mexican Americans, non-Hispanic whites, and blacks for the years 1978-1984. Mexican Americans and blacks have an excess of treatment of end-stage renal disease (all etiologies combined) compared with non-Hispanic whites (incidence ratios of 3 and 4, respectively). For diabetes-related end-stage renal disease, Mexican Americans have an incidence ratio of 6, while blacks have an incidence ratio of 4 compared with non-Hispanic whites. For Mexican Americans, this excess is higher than would be expected on the basis of their underlying prevalence of diabetes. The incidence of hypertensive end-stage renal disease in Mexican Americans was 2.5 times higher than in non-Hispanic whites, which is higher than expected given the lack of excess in their underlying prevalence of hypertension. The high prevalence of diabetes in Mexican Americans explains some, but not all, of the excess of treatment of end-stage renal disease in this population. PMID- 3276156 TI - Depressive symptoms among Mexican Americans: a three-generation study. AB - The distribution of depressive symptoms and rates of high depressive symptomatology are examined with data from a three-generation study of 1,074 Mexican Americans conducted in San Antonio, Texas, during 1981 and 1982. The purpose of this analysis is to contribute to the available data on the mental health status of Mexican Americans as well as to compare the effects of several relevant sociodemographic factors on prevalence of depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale in different generations. In general, previous findings with respect to the associations between sociodemographic variables and depressive symptoms are replicated, although this sample of Mexican Americans experiences comparatively low levels of depressive symptoms, particularly among males. However, the results indicate that interaction effects may exist between generations and other relevant variables typically found to be related to distribution of depressive symptoms in the general population. PMID- 3276157 TI - The postponement of neonatal deaths into the postneonatal period: evidence from Massachusetts. AB - Part of the slow decline in the postneonatal mortality rate and the rapid decline in the neonatal mortality rate during the 1970s may have been due to a postponement of some neonatal deaths into the postneonatal period. The authors hypothesized that any such postponement should be accompanied by a lack of decline, or even an increase, in late neonatal and postneonatal mortality rates among low birth weight babies and babies dying of conditions originating in the perinatal period. To examine this theory, the authors used vital records data to compare infant mortality rates in Massachusetts during 1970-1972 with rates during 1978-1980. Log-linear hazard models were used to calculate death rates, while controlling for changes in maternal age, race, education, and prior reproductive history. The authors found that babies of birth weight under 1,500 g had no decline in late neonatal mortality rates and babies of birth weight under 2,500 g had no decline in postneonatal mortality rates. Babies of birth weight 500-999 g had an increased postneonatal mortality rate (rate ratio = 2.4; 95% confidence limits = 1.0-5.4). These unimproved or increased death rates were due in part to conditions originating in the perinatal period. The authors conclude that, although infant mortality rates have declined, this postponement was real, and that efforts to monitor infant mortality will benefit from its routine quantification. PMID- 3276158 TI - Links between categories of interaction. PMID- 3276159 TI - The epidemiology of measles in a partially vaccinated population in an African city: implications for immunization programs. AB - A large outbreak of measles was reported in Pointe-Noire, Congo, between October 1984 and March 1985. An investigation was conducted to determine the epidemiology of measles in this community in which, in 1985, 54% of the children 12-23 months of age had documented evidence of vaccination against measles. The investigation included hospital and clinic record reviews and a community survey. Measles has been continuously transmitted in Pointe-Noire since at least 1979, with seasonal epidemics. In early 1984, the expected epidemic did not occur, and at least 1,000 measles hospital admissions and 100 measles deaths were prevented. Between October 1984 and March 1985, 1,942 measles cases were hospitalized, of which 306 (15.8%) died. During the epidemic, the proportion of nonpreventable cases (cases occurring before nine months of age) was 17%, reflecting the change in age distribution of measles cases in childhood since the immunization program started in Pointe-Noire in 1982. From the community survey, it was estimated that 13% of all children under age five years acquired measles in Pointe-Noire in 1985. Vaccine efficacy was calculated from community and hospital samples to be between 78% and 87%. Our findings suggest that increasing vaccination coverage levels to well above 50% is necessary to substantially reduce measles morbidity and mortality in African cities. PMID- 3276160 TI - Epidemiology and health policy. PMID- 3276161 TI - Serum vitamin E and risk of cancer among Finnish men during a 10-year follow-up. AB - The association between serum alpha-tocopherol levels and the subsequent incidence of cancer was investigated in a longitudinal study of 21,172 men initially aged 15-99 years in six geographic areas in Finland. The baseline examination was conducted in 1968-1972, and during the follow-up of 6-10 years, 453 cancers were diagnosed. The serum alpha-tocopherol levels were measured from stored serum samples from these men and from 841 male controls, matched for municipality and age, who did not develop cancer during the follow-up. The mean levels of serum alpha-tocopherol among the cancer cases and controls were 8.02 and 8.28 mg/liter, respectively. A high serum alpha-tocopherol level was associated with a reduced risk of cancer. The relative risk of cancer in persons in the two highest (threshold 8.70 mg/liter) quintiles of serum alpha-tocopherol was 0.64 (95 per cent confidence interval = 0.49-0.85) in comparison with those in the three lowest quintiles. The association was strongest for the combined group of cancers unrelated to smoking and varied between subgroups of the study population as well as between different cancers. The association persisted when adjusted for serum cholesterol, serum vitamin A, serum selenium, and various confounding factors. It also persisted when subjects with possible signs of cancer at the time when the blood samples were drawn or with cancers diagnosed during the first two years of follow-up were excluded. These findings agree with the hypothesis that high vitamin E intake protects against cancer. PMID- 3276162 TI - An epidemiologic appraisal of the associations between the fatty acids esterifying serum cholesterol and some cardiovascular risk factors in middle-aged men. AB - The relations between the fatty acids of cholesterol esters and some cardiovascular risk factors have been investigated in a sample of 3,348 middle aged men examined at entry into the Paris Prospective Study 2. The partial associations between the risk factors and the various fatty acids have been evaluated using a special regression method that takes into account the structural dependencies among the percentages of fatty acids. The results show that palmitoleic acid is strongly associated with alcohol consumption and blood pressure and that its association with blood pressure is absent in nondrinkers. High density lipoprotein cholesterol and apolipoprotein A1 are negatively associated with palmitic and dihomogammalinolenic acids and positively associated with oleic and linoleic acids. An inverse relation of low density lipoprotein cholesterol and apolipoprotein B to these fatty acids is also observed. Simultaneous high levels of palmitic and dihomogammalinolenic acids and low levels of oleic and linoleic acids could then be related to profiles of lipids and apolipoproteins exposing one to a high risk of coronary heart disease. These associations may be of interest in interpreting the relations observed in other studies between the fatty acid composition of cholesterol esters or other lipids and coronary heart disease. PMID- 3276163 TI - Physical activity, insulin sensitivity, and the lipoprotein profile in young adults: the Beaver County Study. AB - Higher levels of physical activity have been related to higher concentrations of high density lipoprotein (HDL) cholesterol and lower concentrations of triglycerides. To test the hypothesis that the association between physical activity and the lipoprotein profile is mediated at least in part through increased insulin sensitivity, the authors measured fasting serum levels of HDL cholesterol, triglycerides, insulin, and glucose in 87 men and 83 women (aged 20 24 years) from a population-based survey in Beaver County, Pennsylvania, in 1981 1982. An insulin sensitivity index was calculated as the reciprocal of the insulin and glucose product multiplied by 10,000. Univariate analysis among men indicates that HDL cholesterol was positively related to insulin sensitivity (r = 0.24, p less than 0.05) and to the physical activity score as assessed with Paffenbarger's questionnaire (r = 0.21, p less than 0.05). Insulin sensitivity and physical activity score were positively related (r = 0.14), although not significantly (p = 0.21). Triglycerides were inversely related to both physical activity (r = -0.22, p less than 0.05) and insulin sensitivity (r = -0.19, p = 0.07). No significant findings among women were noted. Multivariate results indicate that the relation between physical activity and the male lipoprotein profile is reduced after controlling for the effects of insulin sensitivity (p greater than 0.10). The authors conclude that in these young men the beneficial effect of physical activity is likely to be partially mediated by increased insulin sensitivity. The lack of findings among women suggests that sex hormones may influence the association between insulin sensitivity and lipoprotein lipids. PMID- 3276164 TI - Potential for bias in case-control studies of oral contraceptives and breast cancer. PMID- 3276165 TI - The diet-heart idea. Outline of a history. PMID- 3276166 TI - A case-control study of congenital malformations and occupational exposure to low level ionizing radiation. AB - In a case-control study, the authors investigated the association of parental occupational exposure to low-level external whole-body penetrating ionizing radiation and risk of congenital malformations in their offspring. Cases and controls were ascertained from births in two counties in southeastern Washington State, where the Hanford Site has been a major employer. A unique feature of this study was the linking of quantitative individual measurement of external whole body penetrating ionizing radiation exposure of employees at the Hanford Site, using personal dosimeters, and the disease outcome, congenital malformations. The study population included 672 malformation cases and 977 matched controls from births occurring from 1957 through 1980. Twelve specific malformation types were analyzed for evidence of association with employment of the parents at Hanford and with occupational exposure to ionizing radiation. Two defects, congenital dislocation of the hip and tracheoesophageal fistula, showed statistically significant associations with employment of the parents at Hanford, but not with parental radiation exposure. Neural tube defects showed a significant association with parental preconception exposure, on the basis of a small number of cases. Eleven other defects, including Down syndrome, for which an association with radiation was considered most likely, showed no evidence of such an association. When all malformations were analyzed as a group, there was no evidence of an association with employment of the parents at Hanford, but the relation of parental exposure to radiation before conception was in the positive direction (one-tailed p value between 0.05 and 0.10). Given the number of statistical tests conducted, some or all of the observed positive correlations are likely to represent false positive findings. In view of strong contradictory evidence, based on no demonstrated effects in genetic studies of atomic bomb survivors in Hiroshima and Nagasaki, it is unlikely that these correlations result from a cause and effect association with parental radiation exposure. PMID- 3276167 TI - The relation between degree of blood pressure reduction and mortality among hypertensives in the Hypertension Detection and Follow-Up Program. AB - The relation between degree of diastolic blood pressure reduction and mortality was examined among hypertensive persons in the Hypertension Detection and Follow up Program. This program, conducted from 1973-1979, was a multicenter community based trial, which followed 10,940 hypertensive participants for five years. The one-year annual visit was the first occasion on which change in blood pressure could be measured on all participants. During the subsequent four years of follow up on 10,053 participants, 568 deaths occurred. With time-dependent life tables and time-dependent Cox life table regression analyses, the existence of a quadratic function which modeled the relation between diastolic blood pressure reduction and mortality was supported, even after adjusting for other risk factors. The minimum mortality hazard ratio, based on a particular model, occurred at a diastolic blood pressure reduction of 26.2 mmHg (standard error = 13.4) in the whole population and 10.0 mmHg (standard error = 5.3) in the baseline diastolic blood pressure stratum 90-104 mmHg. After this reduction, there was a small increase in the risk of death. There was no evidence of the quadratic function after fitting the same model with systolic blood pressure. Methodological issues involved in studying a particular degree of blood pressure reduction were considered. The confidence interval around the change corresponding to the minimum hazard ratio was wide, and the obtained blood pressure level should not be interpreted as a goal for treatment. Blood pressure reduction was attributed not only to pharmacologic therapy but also to regression to the mean, and to other factors unrelated to treatment. PMID- 3276168 TI - Abstracts of the annual scientific meeting. National Kidney Foundation. PMID- 3276169 TI - Characterization of immune cells in kidneys from patients with Sjogren's syndrome. AB - The association of interstitial nephritis, the most common renal lesion in Sjogren's syndrome, to the other manifestations of the disease is unclear. To begin to address this issue, the infiltrating cells in frozen kidney tissues from two patients with interstitial nephritis secondary to Sjogren's syndrome were characterized by indirect immunofluorescence. T cells predominated, the majority of which were helper/inducer cells (OKT4+). Both kidneys contained nodules of B cells. The increased proportion of OKT4+ T cells in salivary gland and in interstitial renal lesions of Sjogren's syndrome contrasts with some other forms of interstitial renal disease and suggests that the renal and salivary gland lesions have a similar pathogenesis. PMID- 3276170 TI - Vasoactive hormones in the renal response to systemic sepsis. AB - The pathophysiology of renal dysfunction in generalized sepsis remains unknown. In this study, 24 hours after surgical induction of peritonitis in 20 volume loaded sheep, three patterns of renal function were seen. In group 1 (n = 8), glomerular filtration rate (GFR) decreased by 70%, urine volume by 85%, absolute sodium excretion by 95%, and fractional sodium excretion by 83%. Group 2 (n = 4) exhibited similar sodium retention but GFR did not fall. Group 3 (n = 8) showed no change in GFR or urine volume and only minimally reduced sodium excretion. Mean arterial pressure fell 17% in group 1 only; central venous pressure, pulmonary capillary wedge pressure, and plasma volume were maintained at or above presepsis values in all groups. Cardiac index was either increased or unchanged, and renal plasma flow was maintained in all groups; there was thus no hemodynamic evidence to suggest volume contraction. Histologic examination showed only minor changes with no consistent pattern. Renal functional changes correlated with other manifestations of severe sepsis--GFR and sodium retention correlated significantly with increased cardiac index, decreased systemic vascular resistance, pulmonary arterial hypertension, leukopenia, hypoproteinemia, and hypoglycemia. All of these changes were most marked in group 1. In groups 1 and 2, plasma renin activity (PRA) increased and urinary kallikrein excretion decreased. PRA correlated inversely with GFR, urine volume, and sodium excretion; urinary kallikrein excretion correlated positively with urine volume and sodium excretion. Urinary excretion of 6-keto-PGF1 alpha was increased in groups 1 and 2 and correlated inversely with mean arterial pressure in group 1 animals. During sepsis, urinary thromboxane B2 excretion continued at presepsis values in all groups. The results suggest that unusual reciprocal changes in activity of the renin-angiotensin and renal kallikrein-kinin systems may play a role in the renal response to sepsis. PGI2 synthesis is increased and may affect systemic hemodynamics and renal function; the role of thromboxane A2 in this context is unknown. PMID- 3276171 TI - Acute focal bacterial nephritis. AB - Clinical and radiographic characteristics of 12 patients with acute focal bacterial nephritis (AFBN) are presented along with review of the literature. Most patients presented with symptoms of an inflammatory or infectious process. Fever and pyuria were the most frequently encountered clinical characteristics. Imaging modalities that were used to establish a definitive diagnosis of focal bacterial nephritis included ultrasound, computed tomography, and intravenous urography with nephrotomography. Ultrasound was found to be the most effective and least costly method of diagnosis. Misdiagnosis of AFBN as abscess or tumor, which it may stimulate, could lead to inappropriate surgical therapy. PMID- 3276172 TI - Characteristics of glomerular lesions in hepatitis B virus infection. AB - In an attempt to clarify a participation of hepatitis B virus (HBV) in the development of hepatic glomerulopathy in adults, kidney specimens obtained from 151 patients with liver diseases were studied. Although mesangial proliferation was more severe in patients with chronic hepatitis or liver cirrhosis than in those with acute hepatitis, no significant difference was observed between 82 serum hepatitis B surface antigen (HBsAg)-positive (HBV-related group) and 69 negative patients (HBV-nonrelated group). However, double contours of the glomerular capillary walls were observed more often in the former group (18/82, P less than .01), especially in the HBeAg-positive subgroup (8/24, P less than .001), than in the latter (3/69). In addition, glomerular capillary spike formation or a bubblelike appearance was observed in seven patients of the former group. Of these, all five patients examined were HBeAg-positive in their serum. By electron microscopic studies, subendothelial dense deposits and mesangial interpositions were observed more frequently in the HBV-related group, and subepithelial deposits were found only in the HBeAg-positive subgroup. The immunofluorescence study revealed IgA-dominant mesangial deposition in both HBV related and nonrelated groups. As for the capillary wall deposits, however, IgG was dominant in 13 of the HBV-related group, but only one of the nonrelated group (P less than .01). Furthermore, one patient in the HBV-related group showed capillary wall-dominant HBeAg combined with IgG deposition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276173 TI - Evaluation of an outpatient culture device in continuous ambulatory peritoneal dialysis. AB - From August 1983 through August 1986, we used a dipstick culture device for outpatient dialysate cultures among patients undergoing continuous ambulatory peritoneal dialysis. The device was used in 42% of 531 peritonitis episodes. In 21% of the peritonitis episodes, patients elected to be hospitalized for treatment and, therefore, did not obtain a dialysate culture. The frequency of noncompliance was 18%. All samples were received within four days of mailing. Forty percent of isolates were gram-positive organisms, 30% were gram-negative, 3% were fungal organisms, and 27% of the cultures failed to yield a growth. Aside from a greater incidence of failure to define a bacterial growth responsible for peritonitis, the spectrum of organisms was similar to culture results obtained from the patients who elected, during this same period, to be hospitalized. We believe the dipstick device may be used effectively for outpatient dialysate cultures. PMID- 3276175 TI - Book reviews: training health care professionals. PMID- 3276174 TI - Genetic counselor training: a review and considerations for the future. AB - The first training program for genetic counselors began in 1969. Since then a number of other programs have been developed and more than 650 individuals have graduated from these programs. This article reviews the development and current status of training opportunities for genetic counselors. Twelve programs that currently grant a master's-level degree in genetic counseling are reviewed. Other areas, such as certification and licensure, that reflect genetic counseling training or such issues of professional growth as continuing education and career advances are addressed. PMID- 3276176 TI - Book reviews: undergraduate genetics. PMID- 3276177 TI - Gene conversions, deletions, and polymorphisms in congenital adrenal hyperplasia. PMID- 3276178 TI - The William Allan memorial award address: X-chromosome inactivation and the location and expression of X-linked genes. PMID- 3276179 TI - A new chest mass in a 49-year-old man with a transplanted kidney. PMID- 3276180 TI - To help the sick: an historical and ethical essay concerning the refusal to care for patients with AIDS. PMID- 3276181 TI - Listeriosis: an uncommon opportunistic infection in patients with acquired immunodeficiency syndrome. A report of five cases and a review of the literature. AB - Between January 1985 and March 1986, five cases of listeriosis were reported in Los Angeles County in patients with the acquired immunodeficiency syndrome (AIDS). All patients were homosexual men with no other risk factors for AIDS. Two patients had sepsis only, two patients had sepsis and meningitis, and one patient had sepsis and signs of meningitis. Sixty percent of the cases (three patients) had a prior or concurrent gastrointestinal illness. Eighty percent of the cases (four patients) also had no prior history of antibiotic administration. Both of these findings may have predisposed these AIDS patients to be at increased risk for listeriosis. Although listeriosis is an infrequent illness in AIDS patients, people with AIDS or human immunodeficiency virus infection should probably refrain from ingesting food items associated with listeriosis. These food items include improperly pasteurized dairy products, and raw fruits and vegetables not properly washed. PMID- 3276182 TI - Lymphoma presenting with adrenal insufficiency. Adrenal enlargement on computed tomographic scanning as a clue to diagnosis. AB - A 73-year-old woman who presented with primary adrenal insufficiency and enlarged adrenal glands on computed tomographic scanning was ultimately found to have a large-cell lymphoma that had initially involved the adrenals and the stomach. A search of the English language medical literature revealed only seven other cases of lymphoma presenting with hypoadrenalism, none of which involved the stomach. As in this case, in most of those cases adrenal enlargement was documented on computed tomographic scanning. Despite its rare occurrence, lymphoma should be searched for in patients presenting with Addison's disease and enlarged adrenal glands. PMID- 3276183 TI - Post-transplantation T-cell lymphoblastic lymphoma. PMID- 3276184 TI - Association of hyperinsulinemia with chlorpropamide toxicity. AB - Clinical and metabolic features of chlorpropamide toxicity are described in two patients with diabetes mellitus and accidental chlorpropamide overdosage. Elevated serum insulin levels were found during hypoglycemia in both patients. The world's literature was reviewed for other cases of chlorpropamide toxicity in which insulin levels have been measured during hypoglycemia. A consistent feature of chlorpropamide toxicity is hyperinsulinemia. It is concluded that stimulation of the pancreatic beta cells during chlorpropamide toxicity leads to hyperinsulinemia and hypoglycemia. PMID- 3276185 TI - Dietary supplementation with omega-3 polyunsaturated fatty acids in patients with stable coronary heart disease. Effects on indices of platelet and neutrophil function and exercise performance. AB - It has been suggested that omega-3 polyunsaturated fatty acids (PUFAs) may alter the course of coronary artery disease by influencing platelet and neutrophil function, arachidonic acid metabolism, and circulating lipid concentrations. To examine this hypothesis, placebo or omega-3 PUFAs as Max-EPA (equivalent to 3.2 g of eicosapentaenoic acid and 2.2 g of docosahexaenoic acid daily) was administered to eight patients with stable coronary artery disease and positive exercise stress test results in a randomized, double-blind, crossover fashion over a 12-week period. With Max-EPA administration, platelet aggregation threshold to epinephrine was increased in only two patients, but neutrophil aggregation and chemotaxic functions decreased consistently (both p less than or equal to 0.01 compared with preceding placebo phase) in all eight. Serum and platelet-rich plasma thromboxane B2 concentrations decreased 40 percent and 28 percent, respectively (both p less than or equal to 0.05). Neutrophil leukotriene B4 formation decreased 23 percent (p less than or equal to 0.01) and synthesis of leukotriene B5 became apparent in all subjects. Serum triglyceride concentrations fell 52 percent (p less than or equal to 0.05) without significant change in total cholesterol, high-density lipoprotein-cholesterol, or low-density lipoprotein-cholesterol concentrations. Systolic blood pressure and the double product (heart rate X systolic blood pressure) were lower (p less than or equal to 0.05) at the end of the Max-EPA phase than in the preceding placebo phase. Heart rate, systolic blood pressure, and the double product were also lower (p less than or equal to 0.05) at three as well as at six minutes of an exercise stress test, indicating a significant reduction in myocardial oxygen demand. Despite these alterations in platelet and neutrophil function, arachidonic acid metabolism, serum triglyceride concentrations, and myocardial oxygen demand, there were no significant changes in subjective parameters of coronary artery disease during the Max-EPA phase (angina frequency 3.7 versus 2.8 episodes per week, nitroglycerin consumption 3.0 versus 1.9 tablets per week, both p = NS). Similarly, exercise times to ST-segment depression (6.5 versus 4.1 minutes) and to onset of angina (5.4 versus 5.0 minutes) were not altered by administration of Max-EPA. Thus, short-term dietary supplementation with omega-3 PUFAs to patients with stable coronary artery disease does not appear to alter subjective or objective parameters of myocardial ischemia. PMID- 3276186 TI - Effect of positive end-expiratory pressure on right ventricular performance. Importance of baseline right ventricular function. AB - Thirty-six patients with diverse baseline right ventricular function were evaluated during incremental positive end-expiratory pressure (PEEP) application. Right heart pressures, cardiac output, right ventricular ejection fractions, and ventricular volumes were obtained at each PEEP level. Right ventricular peak systolic pressure-end-systolic volume relations were analyzed as an index of contractile function. Patients with severely depressed baseline right ventricular ejection fractions (30 percent or less) had an increase in end-diastolic (270 +/- 74 to 391 +/- 76 ml, 0 to 20 cm water (H2O) PEEP, p less than 0.05) and end systolic volumes (210 +/- 70 to 321 +/- 70 ml, 0 to 20 cm H2O PEEP, p less than 0.05). These patients also had a decline in estimated right ventricular contractile function at 20 cm H2O PEEP as estimated by the slope of systolic pressure-volume relations (0.12 to 0.04 mm Hg/ml, 0 to 15 and 15 to 20 cm H2O PEEP, respectively, p less than 0.05). Patients with normal (40 percent or more) or moderately depressed (31 to 40 percent) baseline right ventricular ejection fractions had no change in right ventricular volumes or estimated contractile function. Therefore, the effect of PEEP on right ventricular function differs depending on the baseline right ventricular ejection fraction. PMID- 3276187 TI - Cefoperazone versus combination antibiotic therapy of hospital-acquired pneumonia. AB - Cefoperazone monotherapy was compared with combination antibiotic therapy in a randomized prospective evaluation of patients with hospital-acquired pneumonia. Cefoperazone was as effective as either clindamycin/gentamicin or cefazolin/gentamicin (cure rate: 45 of 52 cefoperazone-treated patients [87 percent], versus 44 of 61 combination-therapy patients [72 percent], p = 0.069). With the exception of hypoprothrombinemia in those patients who did not receive prophylactic vitamin K, there was no difference in the incidence of side effects. In addition, no difference was noted in the incidence of superinfections or secondary pneumonias. When antibiotic costs, administration costs, and laboratory costs were considered, cefoperazone monotherapy was the least expensive antibiotic regimen. Cefoperazone is a suitable alternative to combination antibiotic therapy for the treatment of hospital-acquired pneumonia. PMID- 3276188 TI - Reduced insulin clearance in normal subjects due to extreme hyperinsulinemia. AB - Insulin clearance was assessed in five normal subjects infused with insulin at a rate of 10 mU.kg-1.min-1 for 12-16 hours, which produced insulin levels of 1500 2000 microU/ml (approximately 10(-8) M). This level approximates the Kd of low affinity insulin binding sites, whereas previous clearance studies had been performed at insulin concentrations of 10(-9) M or less, approximating the Kd of the high affinity insulin receptor. The metabolic clearance rate for insulin during the infusion averaged 214 +/- 29 ml.min-1.m-2, which is half of that reported previously when lower insulin levels were achieved. Upon termination of the insulin infusion, the disappearance of insulin was markedly prolonged with an average "half-life" of 62 minutes. The rapidity with which hyperinsulinemia altered clearance suggested that down-regulation of insulin receptors was probably not the explanation for the reduced clearance. To elucidate the cause for the observed decrease in insulin clearance, five additional subjects were studied. If insulin was infused for 3.0-4.5 hours, the half-life of insulin disappearance was intermediate between that for an insulin bolus dose and that for a 12-16 hour insulin infusion. Administration of an insulin bolus dose at the end of a 12-hour infusion, while the insulin concentration was still approximately 10(-8) M, or 140 min later, when the insulin concentration was 10( 9) M, was followed by rapid disappearance with half-lives of 1.5 and 6-8 minutes, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276189 TI - Diseases with DNA damage-processing defects. AB - Xeroderma pigmentosum, Cockayne's syndrome, ataxia telangiectasia, Fanconi anemia, and Bloom's syndrome are autosomal recessive diseases with cellular defects in the ability to process DNA damage. Although these diseases are rare, they are seen occasionally in practice and provide insight into the mechanisms of DNA repair and replication in humans. The authors will review the clinical and cytological presentation of each disease, the genetic heterogeneity, as inferred by complementation analysis, and the differentiating characteristics of each. The authors will conclude with a discussion of the state of current research on each disease and possible directions for future research. PMID- 3276190 TI - Bacteremia and ecthyma caused by Streptococcus pyogenes in a patient with acquired immunodeficiency syndrome. AB - Ecthyma is an ulcerated form of impetigo due to Streptococcus pyogenes, seen primarily in children with poor hygiene. The authors report a homosexual man with acquired immunodeficiency syndrome (AIDS) who developed severe ecthyma and bacteremia caused by S. pyogenes. Opsonizing antibody to the M protein of S. pyogenes is important in immunity to this organism. Patients with AIDS may have defective humoral immunity as well as defective cellular immunity, and such a defect may have rendered this patient abnormally susceptible to severe infection with S. pyogenes. PMID- 3276191 TI - Relapsing, bacteremic Klebsiella pneumoniae meningitis in an AIDS patient. AB - The acquired immunodeficiency syndrome (AIDS) is manifested by severe immunologic (predominantly T-lymphocyte) abnormalities and opportunistic infections. Central nervous system (CNS) infections are frequent. Pathogens causing CNS infections in AIDS patients include parasites, fungi, and viruses and are similar to those reported in other states of impaired cell mediated immunity (CMI). A case of relapsing, bacteremic Klebsiella pneumoniae meningitis in an AIDS patient is presented. PMID- 3276192 TI - Esophageal achalasia syndromes. AB - Esophageal achalasia, characterized by failure of the lower esophageal sphincter to relax normally with swallowing and esophageal aperistalsis, may be primary or secondary to another disorder (in the United States most often cancer). Primary achalasia is of unclear etiology but almost certainly is a disorder of the innervation of the smooth muscle portion of the esophagus. This article reviews the classification and clinical features of achalasia syndromes, as well as current concepts of pathogenesis, diagnosis, complications, and therapy of this group of disorders. PMID- 3276193 TI - Prophylactic antibiotics for suction curettage abortion: results of a clinical controlled trial. AB - The prophylactic use of 300 mg doxycycline at the time of an abortion was evaluated in a randomized controlled trial. In the group with negative chlamydia screening results, only two (0.4%) of 502 patients who received prophylactic treatment developed pelvic infection, compared with 15 (3.0%) of 497 patients who received placebos (p = 0.001). The same effectiveness was found in women with positive chlamydia screening results. Vomiting was the major side effect of the medication and could limit its use. A simulation of selective prophylaxis in women with negative chlamydia screening results showed that its selective use in patients with a history of gonorrhea or in nulliparous women with multiple sex partners could be nearly two thirds as effective as general prophylaxis. PMID- 3276194 TI - Ultrasonographic assessment of gestational age with the distal femoral and proximal tibial ossification centers in the third trimester. AB - A prospective sonographic evaluation of the distal femoral and proximal tibial epiphyseal ossification centers in 228 normal pregnant women was carried out from 28 to 40 weeks' gestation. The mean gestational age at which the distal femoral epiphysis and proximal tibial epiphysis were imaged was 34 and 38 weeks, respectively. The distal femoral epiphysis was not identifiable before 28 weeks but was observed in 72% of fetuses at 33 weeks and in 94% of fetuses at 34 weeks' gestation. The presence of a distal femoral epiphysis measuring 1 or 2 mm was associated with a gestational age of greater than 33 weeks in 87.0% of fetuses, whereas a distal femoral epiphysis measuring greater than or equal to 3 mm was associated with a gestational age greater than 37 weeks in 85% of fetuses. The proximal tibial epiphysis, which was absent before 34 weeks' gestation, was observed in 56% of fetuses at 36 weeks, in 80% of fetuses at 37 weeks, and in 100% of fetuses at 39 weeks of gestation. The presence of a proximal tibial epiphysis of 1 or 2 mm was associated with a gestational age of greater than 36 weeks in 88% of fetuses, whereas a proximal tibial epiphysis greater than or equal to 3 mm was associated with a gestational age of greater than 38 weeks in 94% of fetuses. The sonographic evaluation of distal femoral epiphysis/proximal tibial epiphysis can be used as independent markers for estimation of gestational age during the third trimester, a period in which standard fetal biometric estimates of gestational age are least accurate. PMID- 3276195 TI - The yolk sac in early pregnancy failure. AB - An attempt was made to visualize the yolk sac in 845 patients scheduled for chorionic villi sampling. The distribution of yolk sac diameters and the interpolating growth curve up to 11 weeks of development were analyzed in 239 pregnant women who were delivered of normal infants. The highest visualizing rate of the yolk sac in normal pregnancies was 97 at 7 weeks of gestation. A total of 130 miscarriages occurred before chorionic villi sampling. In these cases, the diameter of the yolk sac versus crown-rump length tended to be larger than found in normal pregnancies. The visualizing rate of the yolk sac in miscarriages after the embryo had been formed was significantly higher in those women who demonstrated fetal heart activity (82.1%) than in those who did not (54.5%). On the other hand, the yolk sac was observed in 44% of miscarriages without a visible embryo. These findings suggest different types of missed abortion. An abnormal karyotype was observed in 23 of 29 chromosomal analyses performed on aborted specimens. An abnormal karyotype was observed in all eight cases with only a yolk sac-like structure within the gestational sac. PMID- 3276196 TI - Epidermolysis bullosa letalis: an immunogenetic disease of extraembryonic ectoderm? AB - A newborn male infant with epidermolysis bullosa letalis died at age 6 weeks of septicemia. He had many congenital ectodermal abnormalities and a rudimentary thymus. The spleen had no germinal centers and the lymph nodes lacked follicles. Cytotrophoblast of the amniochorion was sparse and the amniotic epithelium was distorted. Immunohistologic studies of amniotic epithelium revealed the unprecedented presence of trophoblast antigens. Before birth of the patient, the parents had a 5-year history of infertility; after death of the patient, the mother sustained a ruptured tubal pregnancy that necessitated blood transfusions and surgical removal of the tube. She subsequently became pregnant a third time and was delivered of a normal child. The wife shared four major histocompatibility (HLA) antigens with her husband. The parents' immunogenetic characteristics and the immunopathologic features and extraembryonic membranes of the child are considered in terms of maternal responses to trophoblast antigens. PMID- 3276197 TI - Fetal jejunoileal atresia with persistent omphalomesenteric duct. AB - A case of fetal jejunoileal atresia in association with persistent omphalomesenteric duct is presented. The dilated stomach and proximal and distal duodenum produced a multiple bubble sign on the prenatal sonogram. The neonate underwent exploratory laparotomy, excision of the persistent omphalomesenteric duct, gastrotomy, and colostomy. Possible causes of jejunoileal atresia are presented. PMID- 3276198 TI - The theory and practice of ovulation induction with gonadotropin-releasing hormone. AB - Gonadotropin-releasing hormone therapy has undergone sufficient basic and clinical investigation as a tool for ovulation induction that it should now be considered a safe and effective infertility therapy for office practice. Nevertheless, there remains sufficient mystique about patient selection, optimal dosage and route of delivery, and apprehension on the part of both physicians and patients about cost and inconvenience of medication pumps that gonadotropin releasing hormone therapy has not enjoyed the widespread acceptance it deserves. This article presents straightforward guidelines for therapy that are based on a detailed review of current literature, together with new information about evolving pump technologic characteristics, that should offer reassurance to the practitioner considering use of gonadotropin-releasing hormone therapy in her/his practice. PMID- 3276199 TI - Group B streptococci in the lower urogenital tract and late abortions. AB - The occurrence of group B streptococci in the lower urogenital tract of 150 women with signs of abortion and 100 women with uncomplicated pregnancy was studied. Group B streptococci appeared significantly more frequently in the urine (p less than 0.001) and in the uterine cervix (p less than 0.01) of women with abortion. Delivery resulted in 85% of patients with group B streptococci in the urine and in 42% of patients with no group B streptococci (p less than 0.001). Group B streptococci were cultured from amniotic fluid from three of eight women with intact membranes and were isolated from the urine and cervix. These bacteria were antibody coated as demonstrated by an immunofluorescence technique. Group B streptococci were recovered from blood or liver in six fetuses, including two who had group B streptococci in the amniotic fluid. The study demonstrates an association between the occurrence of group B streptococci in the urine and cervix and late abortions. PMID- 3276200 TI - The value of adnexal sonographic findings in the diagnosis of ectopic pregnancy. AB - A prospective study of 383 patients with suspected ectopic pregnancy was carried out at Yale-New Haven Hospital to determine the value of adnexal sonographic findings in the diagnosis of ectopic pregnancy. In patients with adnexal sonographic results and human chorionic gonadotropin titers less than 6000 mIU/ml (n = 220), the presence of a noncystic mass had a positive predictive value of 83%, and the presence of a cystic mass had a positive predictive value of 35%. The combination of a noncystic mass and fluid in the cul-de-sac (found in 22% of all patients with ectopic gestations) was the best predictor of an ectopic pregnancy with a 94% positive predictive value. It is suggested that the demonstration of a non-cystic mass, alone or in the presence of fluid in the cul de-sac, be used as an indication for diagnostic laparoscopy. PMID- 3276201 TI - The sequential use of estradiol and prostaglandin E2 topical gels for cervical ripening in high-risk term pregnancies requiring induction of labor. AB - We compared the safety and efficiency of 200 mg of estradiol valerate prepared as a topical cervical gel as a preripening agent when used 6 hours before the application of 2 mg of prostaglandin E2 gel for the purpose of cervical ripening in 40 high-risk obstetric patients before indicated oxytocin induction of labor. When compared with a placebo prostaglandin E2 dosage, the estradiol had no effect on the change of Bishop score, length of labor, amount of oxytocin required, or the cesarean delivery rate. While no uterine contractions were noted after the application of the estradiol, 85% of patients had recordable uterine activity after the application of prostaglandin E2, suggesting that even at the 2 mg dosage this sequential regimen is not appropriate for local cervical ripening. PMID- 3276202 TI - Correlation of an enzyme immunoassay with the radioimmunoassay for CA-125. AB - Serum CA-125 concentrations from 60 women were determined by radioimmunoassay and an enzyme immunoassay. Correlation of the CA-125 values obtained by the two methods indicated a linear relationship between 13 and 73 U/ml, lower values in the enzyme immunoassay, and a lower sensitivity of the enzyme immunoassay as compared with the radioimmunoassay. PMID- 3276203 TI - The Lenz microphthalmia syndrome. AB - We examined two patients with the Lenz microphthalmia syndrome. When findings from these two patients and those from ten other patients in the literature were combined, the following abnormalities were observed: microphthalmos in all patients; developmental retardation in 11 patients (92%); external ear abnormalities in ten patients (83%); microcephaly in ten patients (83%); blepharoptosis in nine patients (75%); skeletal anomalies (excluding digital anomalies) in eight patients (67%); dental abnormalities of number and position in eight patients (67%); digital anomalies in seven patients (58%); urogenital anomalies in six patients (50%); and cleft lip and palate abnormalities in four patients (33%). Cardiac anomalies, imperforate anus, hearing loss, spastic diplegia, sacral pits, webbed neck, and abnormal dermatoglyphs were rarely seen. One of our two patients had a dislocated lens and retinal detachment. PMID- 3276204 TI - Postkeratoplasty crystalline deposits mimicking bacterial infectious crystalline keratopathy. AB - Three corneal transplant patients developed white, crystalline, anterior stromal lesions in their grafts while receiving long-term topical corticosteroid therapy. A presumed diagnosis of infectious crystalline keratopathy was made in each case. However, histologic examination of the lesions failed to show gram-positive cocci. A fungal infiltrate was present in the first two patients, and calcium deposits produced the lesion in the third patient. PMID- 3276205 TI - Decreased expression of HLA class II antigens on human uveal melanoma cells after in vivo X-ray irradiation. AB - In order to determine the presence of HLA antigens on human uveal melanomas, we tested anti-HLA monoclonal antibodies on tissue sections of these tumors. A great variety in expression of HLA class I and II antigens was present. A significantly lower expression of HLA class II antigens was present on uveal melanomas that had been irradiated before enucleation. These tumors lacked a lymphocytic infiltrate in comparison with nonirradiated tumors. These data suggest that radiotherapy affects expression of histocompatibility antigens on tumors. PMID- 3276206 TI - Immunolocalization of islet amyloid polypeptide (IAPP) in pancreatic beta cells by means of peroxidase-antiperoxidase (PAP) and protein A-gold techniques. AB - A novel putative polypeptide hormone identified as islet amyloid polypeptide (IAPP) was recently purified from islet amyloid (IA) of diabetic humans and cats, and also from amyloid of a human insulinoma. Although the function of IAPP is yet unknown, its occurrence in pancreatic endocrine tissue and its partial amino acid sequence identity with calcitonin gene-related peptide (CGRP) suggests an endocrine regulatory effect. In the present investigation, the authors utilized antisera to insulin, glucagon, somatostatin, pancreatic polypeptide, synthetic human CGRP, and a synthetic human IAPP (7-17) undecapeptide to immunohistochemically (PAP technique) document the presence of IAPP immunoreactive cells in the islets of the cat, dog, mouse, and rat, but not in the islets of the horse or calf. In serial sections of islets from these species it was shown that IAPP immunoreactivity occurred in insulin-reactive beta cells. This observation was confirmed immunocytochemically in cat islets by means of protein A-gold probes. With protein A-gold labeling techniques, IAPP immunoreactivity was localized to the outer lucent compartment of the beta cell secretory granule, whereas insulin immunoreactivity was associated with the electron-dense core. These findings provide strong evidence that IAPP or an IAPP precursor is synthesized by beta cells and is stored in beta cell granules for subsequent co-secretion with insulin. The conservation of IAPP in humans and multiple animal species and the localization of IAPP to pancreatic beta cells provide further evidence that IAPP has an important endocrine regulatory function. The propensity of IAPP to polymerize and form IA fibrils in diabetes associated with aging may indicate that IAPP is in some way also linked to the development of Type 2 diabetes. PMID- 3276207 TI - High endothelial differentiation in human lymphoid and inflammatory tissues defined by monoclonal antibody HECA-452. AB - Lymphocyte traffic into lymph nodes and into mucosa-associated lymphoid tissues is regulated by specialized postcapillary high endothelial venules (HEVs). The authors have produced a rat monoclonal antibody, HECA-452, that detects a human endothelial cell differentiation antigen selectively expressed on high endothelium. In immunoperoxidase studies, HECA-452 intensely stains all HEVs within lymphoid organs. In normal nonlymphoid tissues the antibody stains no vascular endothelium. The antibody, in addition to reacting with high endothelium, cross-reacts with a set of monocytic cells. In pathologic states such as autoimmune thyroiditis and Crohn's disease, known for the development of dense, frequently organized, lymphocytic infiltrates, HECA-452 detects HEV-like vessels containing luminal and intramural lymphocytes, presumably in the process of extravasating. The antigen was not expressed at detectable levels by venules in less heavily infiltrated chronic inflammatory sites nor in acutely inflamed tissues. In lymphoid malignancies, the only vessels stained were morphologically characteristic HEVs in association with areas of residual normal lymphoid tissue or reactive lymphocytic infiltrates. The specificity of HECA-452 for high endothelial cells confirms the highly specialized nature of these vessels and will permit studies of the regulation of high endothelial cell differentiation in vivo and in vitro. The HECA-452 antigen is preserved in paraffin sections of sublimate formaldehyde- and also routinely formalin-fixed tissues. Thus, HECA-452 will be widely applicable for the immunohistologic detection of endothelium specialized for the support of highly increased lymphocyte extravasation in inflammatory sites. PMID- 3276208 TI - Major histocompatibility complex gene product expression on pancreatic beta cells in acutely diabetic BB rats. AB - Type I diabetes mellitus was induced in young, diabetes-prone BB rats by the passive transfer of concanavalin A-activated T lymphocytes from the spleens of acutely diabetic BB rats. The pancreas of the recipients was examined 1-2 days after the onset of glycosuria by immunocytochemistry by means of monoclonal antibodies for determining whether 1) Class I and/or II major histocompatibility gene complex (MHC) products were expressed on beta cells and 2) the mononuclear cell infiltrates were represented by T cells. Marked expression of Class I MHC gene products was evident on beta cells. In contrast, Class II MHC gene products were not identified on normal-appearing beta cells. Dendritic cells dispersed throughout the acinar and interstitial pancreas were markedly increased in number. The mononuclear cell infiltrate contained few cells (1-15%) recognized by a pan-T cell marker. Although it is possible that this passive transfer model might differ considerably from the spontaneously occurring diabetic state in the rat, this study suggests that 1) Class I, rather than Class II, MHC gene expression may be pivotal to beta-cell injury in diabetic rats, and 2) non-T cells may constitute an effector cell population central to beta-cell necrosis in Type I diabetes mellitus. PMID- 3276209 TI - A monoclonal antibody specific for cells of the melanocyte lineage. AB - A monoclonal antibody, NKI/beteb, was prepared against membranes from a human melanoma metastasis, and in immunoprecipitates of melanoma cell lysates specific 100- and 7-kd glycoproteins were found. The large glycoproteins were also present in conditioned medium of melanoma cell lines. The antigen is located on the inner side of membranes of (pre)melanosomes and premelanosomelike vesicles. The antibody reacted in the immunoperoxidase test on frozen tissue sections with 27 of 28 nevocellular nevi (15/16 common, 12/12 dysplastic), 39/39 primary melanomas (3 intraepidermal, 24 cutaneous, 12 choroidal), 56/63 melanoma metastases, and 4/4 clear-cell sarcomas (melanoma of soft tissue). With sections of formalin fixed paraffin-embedded tissues, the reaction was less sensitive. No reactivity was detected with frozen sections of 185 other tumors, except for 1 case of non Hodgkin's lymphoma in which macrophages were positive. With the exception of melanocytes, all frozen sections of adult tissues that were tested were negative with NKI/beteb. On the basis of its tissue distribution so far, the antigen recognized by NKI/beteb seems to be a specific and sensitive diagnostic marker for cells of the melanocyte lineage. PMID- 3276210 TI - Antibody specific to muscle actins in the diagnosis and classification of soft tissue tumors. AB - A series of soft tissue tumors, melanomas, carcinomas, and lymphomas were studied immunohistochemically for the presence of muscle actins (MA) with the monoclonal antibody HHF-35, and for the presence of desmin for comparison. In nonneoplastic tissues, MA immunoreactivity was present in skeletal and smooth muscle cells, in the pericytes of small vessels, and in the myoepithelial cells. Desmin immunoreactivity had a similar distribution, except that the pericytes of small vessels and myoepithelial cells were negative. All 17 rhabdomyosarcomas were positive for both MA and desmin. Of leiomyosarcomas, 31/32 were positive for MA, and 29/32 for desmin. In pleomorphic undifferentiated sarcomas (malignant fibrous histiocytomas) MA and desmin-positive cells were present in 9/35 and 5/35 cases, respectively. Three of five pleomorphic liposarcomas showed MA-positive tumor cells, which were also desmin-positive in one case. Desmoid tumors often showed a moderate number of both desmin- and MA-positive cells. Hemangiopericytoma, Kaposi's sarcoma, and endometrial stromal sarcoma showed MA-positive staining only in the pericytes and not in the neoplastic cells. In various types of carcinomas, melanomas, and lymphomas, MA- or desmin-positive neoplastic cells were not identified. MA, but not desmin, was present in the desmoplastic stroma in many carcinomas. Both MA and desmin are good markers for muscle differentiation and especially serve to identify rhabdomyosarcomas and leiomyosarcomas. These markers are also present in some sarcomas currently regarded as nonmuscle tumors. This may suggest that some of these tumors have differentiation properties related to true myosarcomas. The absence of muscle actin, a pericytic marker, in hemangiopericytoma does not confirm the concept of pericytic nature of this tumor. PMID- 3276211 TI - Glomerular immune deposits in experimental IgA nephropathy. A continuum of circulating and in situ formed immune complexes. AB - Studies were undertaken to elucidate the primary pathogenetic mechanisms responsible for immunoglobulin (Ig) A immune complexes formation and glomerular deposition in vivo. Monomeric (mIgA) and polymeric IgA (pIgA) anti-dinitrophenyl (DNP) were purified from MOPC 315 myeloma. A DNP-conjugated Ficoll was used as an antigen. For simulation of natural conditions of in vivo immune complex formation, 131I-DNP-Ficoll and 125I-IgA were administered through the intravenous and intraperitoneal routes, respectively. The kinetics half-life (t1/2) of the antigen (2.9 hours) and either the pIgA (7.2 hours) or mIgA (6.3 hours) in the experimental groups was not significantly different from the control. Glomerular IgA immune deposits were detectable only in mice that received pIgA and DNP Ficoll. Plasma samples analyzed by gradient polyacrylamide gel electrophoresis revealed formation of large- and intermediate-sized pIgA complexes in circulation prior to glomerular deposition. Although mIgA failed to interact with such complexes in the circulation, it did bind to the pIgA immune deposits in the glomerulus. These results indicate that glomerular IgA immune deposits evolve from the localization of preformed circulating pIgA complexes that eventuates an in situ mIgA-mediated complex formation. PMID- 3276212 TI - Histologic evolution of the reactions to hemorrhage in the premature human infant's brain. A combined ultrasound and autopsy study and a comparison with the reaction in adults. AB - With the development and routine use of real-time ultrasound scanning, it has been possible to collect 20 autopsy cases of infants in whom the ultrasound scan was first normal and then showed evidence of subependymal/intraventricular hemorrhage (SEH/IVH). Analysis of these cases with known postnatal origin of the hemorrhage permitted the development for the first time of a time scale to characterize the temporal evolution of the histopathologic reactions to hemorrhage in the premature human brain. This time scale was then used to define the histologic stage of the lesions in 27 other cases of infants who had a scan demonstrating SEH/IVH prior to death but who had not a previously normal scan. Only 2 cases were found to lie off the original scale, indicating a prenatal onset of the hemorrhage in about 5% of the total cases. Thus, postnatal events immediately preceding the onset of the hemorrhage are more likely to be implicated in the pathogenesis of SEH/IVH than prenatal or obstetric events. Comparison with similar reactions in the adult indicate that the early reactions by macrophages occur at about the same rate but the routine transfer of iron from macrophages to astrocytes and the much slower rate of absorption to form a cyst in the adult combine to form a complicated pattern that requires a different set of criteria for the intermediate and late stages in the adult. PMID- 3276213 TI - A simple method for continuous measurement of the volume of cells in suspension. AB - A simple electrical method for continuous monitoring of the volume of cells in suspension is described. The procedure consists of placing cells in a medium containing an impermeant quaternary ammonium ion, such as tetramethylammonium (TMA), which behaves as an extracellular volume marker, and monitoring the activity of this ion with a quaternary ammonium ion-specific minielectrode. Changes in the activity of the cell impermeant TMA ion in the extracellular medium quantitatively reflect movements of water into, or out of, cells and, therefore, provide a direct measure of alterations in cell volume. A direct linear relation between the fractional decrease in rat red blood cell volume and the fractional increase in medium osmolality was observed using this method. The osmotically active water volume of these red blood cells, calculated from the slope of this relationship, was 73.6 +/- 0.7% of total cell volume, a value similar to that defined by other techniques. This method should be easily adaptable for use with virtually any type of separated cell, including epithelial cells. PMID- 3276214 TI - Adrenergic blockade does not abolish elevated glucose turnover during bacterial infection. AB - Infusions of adrenergic antagonists were used to investigate the role of catecholamines in infection-induced elevations of glucose kinetics. Infection was produced in conscious catheterized rats by repeated subcutaneous injections of live Escherichia coli over 24 h. Glucose kinetics were measured by the constant intravenous infusion of [6-3H]- and [U-14C]glucose. Compared with noninfected rats, infected animals were hyperthermic (+1.4 degrees C) and showed increased rates of glucose appearance (45%), clearance (43%), and recycling (140%) as well as mild hyperlacticacidemia. Plasma catecholamine concentrations were increased by 50-70% in the infected rats, but there were no differences in plasma glucagon, corticosterone, and insulin levels. Adrenergic blockade was produced by primed constant infusion of both propranolol (beta-blocker) and phentolamine (alpha blocker). A 2-h administration of adrenergic antagonists did not attenuate the elevated glucose kinetics or plasma lactate concentration in the infected rats, although it abolished the hyperthermia. In a second experiment, animals were infused with propranolol and phentolamine beginning 1 h before the first injection of E. coli and throughout the course of infection. Continuous adrenergic blockade failed to attenuate infection-induced elevations in glucose kinetics and plasma lactate. These results indicate that the adrenergic system does not mediate the elevated glucose metabolism observed in this mild model of infection. PMID- 3276215 TI - Evidence of a defect in insulin-receptor recycling in adipocytes from older rats. AB - Although insulin-stimulated glucose uptake is known to be decreased in adipocytes isolated from old obese rats, the cause of this defect is not totally understood. In the present study, we examined the possibility that insulin resistance is associated with defects in the intracellular processing of the insulin-receptor complex. Adipocytes were isolated from control (2-mo-old rats) and obese, insulin resistant rats (12-mo-old rats), and the following measurements were made: 1) insulin-stimulated glucose uptake; 2) insulin binding; 3) insulin-receptor internalization and recycling; 4) accumulation of insulin within the cell; and 5) rate of loss of insulin from the cell. The results indicated that maximal insulin stimulated glucose uptake was significantly reduced in adipocytes from obese, insulin-resistant rats (increase over basal value was 500 +/- 53% in obese rats and 1,200 +/- 96 in control rats, P less than 0.01). 125I-insulin (A14) binding (cell-associated radioactivity) and the internalization of the hormone-receptor complex were not different in the two groups of animals studied. In contrast, insulin-receptor recycling was significantly decreased in adipocytes from obese rats (72.0 +/- 6.1 vs. 93.6 +/- 2.6%, P less than 0.01). In addition, loss of intracellular radioactivity was significantly prolonged in insulin-resistant rats (t1/2 = 12.05 +/- 0.9 vs. 9.4 +/- 0.3 min, P less than 0.05). Thus adipocytes isolated from the older rats were resistant to the insulin effect on glucose uptake, and this defect was not associated with a reduction in insulin binding. However, there was a decrease in insulin receptor recycling, and this phenomenon may be related to the insulin resistance present in these cells. PMID- 3276216 TI - Dissociating antifertility effects of GnRH-antagonist from its adverse effects on mating behavior in male rats. AB - Antagonist analogues of gonadotropin-releasing hormone (GnRH-A) alone inhibit spermatogenesis in experimental animals, but concomitant decline in serum testosterone leads to abolition of mating behavior. We assessed if the antifertility effects of GnRH-A could be dissociated from its effects on mating behavior by combining it with a small dose of androgen. Seven groups of six adult male Wistar rats were treated for 70 days as follows: I) controls, II) GnRH-A alone (250 micrograms/day), III) GnRH-A + 0.05 mg testosterone enanthate (TE), IV) GnRH-A + 0.15 mg TE, V) GnRH-A + 0.50 mg TE, VI) GnRH-A + 1.50 mg TE, and VII) GnRH-A alone (recovery group). Testes, prostate, and seminal vesicle weights were markedly reduced by GnRH-A treatment alone. Doses of TE required to maintain prostate and seminal vesicle weights were between 0.15 and 0.50 mg. Testis weights were not restored to normal even by the highest dose of TE. Intratesticular sperm counts were markedly decreased by GnRH-A treatment and restored only at the highest dose of TE (1.50 mg). Five out of six animals in group II, six out of six animals in group III, and one out of six in group IV were azoospermic. When mated with normal females, all animals in groups I and VI were fertile, all animals in groups II, III, and IV were infertile, whereas only four out of six animals in group V were fertile. All measures of mating behavior were impaired by GnRH-A treatment and restored by the smallest dose of TE (0.05 mg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276217 TI - Change of insulin action with aging in conscious rats determined by euglycemic clamp. AB - To clarify the mechanism responsible for age-related changes in insulin action, the euglycemic clamp technique was performed with graded doses of insulin in conscious rats aged 2, 4, 10, and 20 mo. Insulin binding (IB) to muscle membranes was also studied. Maximal response of insulin-induced glucose disappearance rate (Rd) was decreased significantly between 2 and 4 mo of age. Dose-response curves shifted to the right progressively up to 20 mo of age. However, IB to the muscle membrane diminished between 1 and 4 mo of age without a decrease thereafter. When Rd was plotted against insulin bound to the membranes, the resulting curves shifted to the right with aging, suggesting a coupling defect between the binding and effector unit. In conclusion, insulin action alters in rats between 2 and 20 mo of age. The most pronounced impairment in IB and maximal response of insulin induced Rd occurs during early life stage (through maturation) and then a coupling defect seems to be superimposed with further aging. However, we cannot exclude the possibility that these changes may be secondary to obesity or reduced physical activity, rather than aging per se. PMID- 3276218 TI - Glutathione modulates toxic oxygen metabolite injury of canine chief cell monolayers in primary culture. AB - Cultured canine gastric chief cells exposed to a toxic oxygen metabolite generating system (xanthine plus xanthine oxidase) demonstrated minimal cytolysis, suggesting that these cells have important endogenous antioxidant mechanisms. We have quantified the role of glutathione for protection against toxic oxygen metabolites by measuring cell lysis by lactate dehydrogenase release after variable depletion and repletion of cellular glutathione content. In the absence of exogenous oxidant stress, the glutathione content of chief cells can be depleted to less than 0.2 nmol total glutathione/micrograms DNA or 22% of control without cell lysis over 5 h. However, when challenged with the oxygen metabolite-generating system, cytolysis was greatly enhanced by glutathione depletion. Oxygen metabolite-mediated cytolysis after glutathione depletion was inhibited by exogenous catalase, thiourea, and deferoximine, but not superoxide dismutase or mannitol. These data suggested that hydrogen peroxide and hydroxyl radical mediated cytolysis in glutathione-depleted chief cells. If a substrate for glutathione synthesis, N-acetyl-L-cysteine, was provided to the depleted cells for 1 h before challenge with the oxygen radical-generating system, cell lysis was markedly decreased. However, if glutathione synthesis was blocked during the repletion period by buthionine sulfoximine, protection was not restored. The data supported an important role for glutathione as an endogenous antioxidant, which modulated the sensitivity of cultured chief cells to toxic oxygen metabolite injury. PMID- 3276219 TI - Indomethacin and patent ductus arteriosus: effects on renal function in preterm lambs. AB - To examine the independent effects of a patent ductus arteriosus and of indomethacin therapy on the renal function of the preterm newborn, we created a preterm lamb model in which ductus diameter could be regulated. We studied 24 preterm newborn lambs. Eight lambs (group 1) had their ductus closed at delivery and received no indomethacin. Eight lambs (group 2) had their ductus closed and then received indomethacin (0.3 mg/kg) at 5.5 h; eight lambs (group 3) had their ductus kept open and then received indomethacin at 5.5 h. Hemodynamic and renal function measurements were made at 5 h (pretreatment) and at 12.5 h. In group 2 lambs there was a significant reduction in inulin clearance (GFR) and osmolal clearance after indomethacin. In contrast, lambs with an open ductus (group 3), when compared with lambs with a closed ductus (groups 1 and 2) at 5 h, already had significantly decreased blood pressure, GFR, urine volume, and osmolal clearance. Following indomethacin treatment, group 3 lambs showed no further decrease in renal function. We suggest that in preterm lambs with patent ductus, the apparent lack of renal dysfunction following indomethacin treatment reflects underlying diminished renal function. PMID- 3276220 TI - Influence of vasoconstrictor systems on leg vasodilation during heating of dehydrated baboons. AB - This study, carried out in two parts, sought to determine the importance of vasopressin (VP), the renin-angiotensin system (RAS), and the sympathetic nervous system in the dehydration-produced attenuation of hindlimb (cutaneous) vasodilation during environmental heating (EH). Baboons, chronically instrumented for blood sampling and for measurement of mean iliac blood flow (MIBF), arterial pressure, and core temperature (Tc), were subjected to EH while in euhydrated and dehydrated (64-72 h of water deprivation) states. EH consisted of exposure to an elevated ambient temperature (40-42 degrees C) until Tc reached 39.5 degrees C. In part I, indexes of the above vasoconstrictor systems were measured. Base-line plasma renin activity (PRA) and VP and norepinephrine concentrations were all significantly elevated by dehydration. In addition, the increase in PRA during EH was accentuated by dehydration. In part II, the effects of blockades of the RAS, the pressor action of VP, and the innervation of the hindlimb on hindlimb vasodilation during EH were assessed. None of these blockades, singly or together, reversed the dehydration-produced attenuation of the increase in MIBF during EH. Thus we conclude that other mechanisms are responsible for the dehydration-produced attenuation of cutaneous vasodilation in baboons during EH. PMID- 3276221 TI - Hypoxemia and hypercapnia in conscious dogs: opioid modulation of catecholamines. AB - The role of endogenous opioids in systemic and renal circulatory changes during combined acute hypoxemia and hypercapnic acidosis was evaluated in seven conscious female mongrel dogs in rigid sodium balance. Animals were studied 2 wk apart in separate protocols of combined acute hypoxemia (arterial O2 tension = 33 +/- 1 mmHg) and hypercapnic acidosis (arterial CO2 tension = 56 +/- 1 mmHg, pH = 7.19 +/- 0.01) of 40 min duration during 1) naloxone, 5 mg/kg iv bolus followed by an intravenous infusion of 5 mg.kg-1.h-1, and 2) vehicle (5% dextrose in water) alone. Systemic circulatory changes during the combined acute blood-gas derangement including increased mean arterial pressure, heart rate, and cardiac output and decreased total peripheral resistance were comparable between naloxone and vehicle treatments. However, in striking contrast to the brief fall in renal hemodynamic function during combined acute hypoxemia and hypercapnic acidosis with vehicle, naloxone administration during the combined acute blood-gas derangement resulted in a sustained decrease in effective renal plasma flow, glomerular filtration rate, and filtered sodium load and enhanced rise in circulating norepinephrine and epinephrine. Changes in plasma renin activity were comparable between vehicle and naloxone protocols except that plasma renin activity increased from the first to the second 20-min periods of combined hypoxemia and hypercapnic acidosis with naloxone. These observations suggest that endogenous opioids may contribute to preservation of renal hemodynamic function during acute blood-gas derangements, possibly through attenuation of sympathetic nervous system and renin-angiotension activation. PMID- 3276222 TI - Cardiac arrhythmias during arousal from hibernation in three species of rodents. AB - Cardiac activity was monitored during arousal from deep hibernation in three species of hibernators (Citellus tridecemlineatus, Marmota monax, and Mesocricetus auratus). Individuals of each species showed marked arrhythmias, and these were confined to a body temperature range of between 11 and 20 degrees C, measured orally or rectally. The arrhythmias consisted of intermittent periods of asystole and bradycardia and were sometimes marked by the appearance of premature ventricular contractions and elevated or depressed S-T segments. Surgical manipulation of euthermic M. monax, under pentobarbital sodium anesthesia, indicated that none of the arrhythmias observed was inducible by injections of cold saline into the vena cava. PMID- 3276223 TI - Cardiac output distribution in thermally dehydrated rodents. AB - The effect of thermal dehydration (37 degrees C) on the integrated response of the circulation was studied in conscious laboratory rats and in the desert species Psammomys obesus, the latter being studied prior to and following acclimation to heat. Cardiac output (CO) and its distribution were measured using labeled microspheres with the reference organ technique. At low dehydration (7-9% body wt loss) rats showed peripheral vasodilation coincidentally with splanchnic vasoconstriction, whereas the desert species exhibited an increased CO and peripheral vasodilation with no change in splanchnic blood perfusion. At severe dehydration (10-18% body wt loss), closure of skin arteriovenous anastomoses together with splanchnic vasodilation was observed in both species. These changes were discussed in relation to plasma volume conservation mechanism and its deterioration. Acclimation to heat resulted in no change in CO, whereas blood flow to splanchnic and skin capillaries increased remarkably. Dehydration in heat acclimated P. obesus (5-10% body wt loss) brought about a significant fall in CO. However, most organs maintained relatively stable blood flow. This might contribute to better survival during heat stress. PMID- 3276224 TI - Mechanisms of altered sodium excretion after preoptic hypothalamic lesions. AB - These experiments investigated cardiovascular and hormonal responses during the natriuresis and subsequent sodium retention following electrolytic lesions of the periventricular tissue surrounding the anteroventral third ventricle (AV3V-X) in the rat. Four hours following treatment, AV3V-X resulted in a significant increase in blood pressure (18 +/- 3 mmHg), bradycardia (-68 +/- 20 beats/min), and natriuresis (212 +/- 36 mu eq/h), compared with control-operated (control: 2 +/- 4 mmHg, -14 +/- 18 beats/min, 89 +/- 34 mu eq/h) and unanesthetized control (UC) animals (-1 +/- 3 mmHg, -5 +/- 12 beats/min, 74 +/- 25 mu eq/h). Preventing the hypertensive response in AV3V-X rats abolished the natriuresis. Twenty-four hours after treatment, blood pressure, heart rate, urine flow, and sodium excretion were similar between experimental groups. However, sodium excretion by AV3V-X rats was significantly smaller than control 24-48 h following treatment. AV3V-X rats had significantly elevated plasma concentrations of aldosterone and corticosterone 4, 24, and 48 h and increased plasma renin 24 and 48 h after treatment. These data suggest that the acute natriuresis following AV3V-X is mediated by increased arterial blood pressure, whereas the subsequent sodium retention could be due to activation of the renin-aldosterone system. PMID- 3276225 TI - Developmental psychiatry comes of age. AB - Although Meyer and Freud believed that the seeds of mental health are sown in childhood, systematic research has proved difficult and disappointing, and theory has remained intensely controversial. Research of the past two decades by developmental psychologists using an ethologically based theory of socioemotional bonds, however, is yielding findings that consistently confirm predictions. The author outlines this research, giving examples of the results, which are shown to be compatible with findings of epidemiological studies of depressed adults. He holds that a person's degree of vulnerability to stressors is strongly influenced by the development and current state of his or her intimate relationships. PMID- 3276226 TI - Significance and meaning of neurological signs in schizophrenia. AB - The authors review studies of abnormal signs on clinical neurological examination of schizophrenic patients. In spite of a number of methodologic limitations, the cumulative evidence strongly argues that there are more neurological signs in schizophrenic patients than in nonpsychiatric control subjects. Although less consistent, there is considerable evidence of more neurological signs in schizophrenic patients than in patients with affective disorders or with mixed, nonpsychotic disorders. The existing literature suggests several preliminary hypotheses with respect to neuroanatomical localization of neurological signs, subtyping of schizophrenia, and utility of studies of relatives at high risk and family history studies. Directions for future research in these areas are described. PMID- 3276227 TI - Use of ECT in the United States. PMID- 3276228 TI - Atenolol in seasonal affective disorder: a test of the melatonin hypothesis. AB - To test the hypothesis that the antidepressant effects of bright light in seasonal affective disorder are mediated by the suppression of melatonin, 19 patients with this disorder were given atenolol, which suppresses melatonin secretion, and placebo in a double-blind crossover study. No difference in antidepressant efficacy was found between drug and placebo in the sample as a whole, which argues against the melatonin hypothesis of phototherapy. However, in three of the patients atenolol provided repeated, marked, and sustained relief of symptoms, suggesting that it may be useful in treating the winter depressive symptoms of some patients with seasonal affective disorder. PMID- 3276229 TI - Rectifying an archaic payment policy. PMID- 3276230 TI - Condoms, spermicides, and the transmission of human immunodeficiency virus: a review of the literature. PMID- 3276231 TI - The impact of Medicare on early cancer detection in the elderly. AB - In an analysis of 23 sex-specific tumors in the Connecticut Tumor Registry, only seven tumors showed more than a 20 per cent increase in the ratio of localized tumors detected post-Medicare (1967-75) versus ante-Medicare (1960-65) in the 65 75 year age group compared to the 60-64 year age group. Of these seven, the information was more convincing for lung cancer in males. Overall, however, Medicare had little if any impact on early tumor diagnosis in the elderly. PMID- 3276232 TI - Hemolytic-uremic syndrome: a population-based study in Washington, DC and Baltimore, Maryland. AB - A population-based study of hemolytic-uremic syndrome (HUS) revealed that 20 child residents of Washington, DC and Baltimore, Maryland were hospitalized with HUS from January 1979 through September 1983. The number of cases peaked during the summer and fall; none occurred during the winter. Incidence of hospitalized cases was higher in Whites and girls than in Blacks or boys, and the average annual incidence was 1.08 cases/100,000 children less than 5 year old. This study demonstrates that HUS is not unique to the West Coast, as previously suggested. PMID- 3276233 TI - Competition for Medicaid dollars. PMID- 3276234 TI - Epidemic giardiasis caused by a contaminated public water supply. AB - In the period November 1, 1985 to January 31, 1986, 703 cases of giardiasis were reported in Pittsfield, Massachusetts (population 50,265). The community obtained its water from two main reservoirs (A and B) and an auxiliary reservoir (C). Potable water was chlorinated but not filtered. The incidence of illness peaked approximately two weeks after the city began obtaining a major portion of its water from reservoir C, which had not been used for three years. The attack rate of giardiasis for residents of areas supplied by reservoir C was 14.3/1000, compared with 7.0/1000 in areas that received no water from reservoir C. A case control study showed that persons with giardiasis were more likely to be older and to have drunk more municipal water than household controls. A community telephone survey indicated that over 3,800 people could have had diarrhea that might have been caused by Giardia, and 95 per cent of households were either using alternate sources of drinking water or boiling municipal water. Environmental studies identified Giardia cysts in the water of reservoir C. Cysts were also detected in the two other reservoirs supplying the city, but at lower concentrations. This investigation highlights the risk of giardiasis associated with unfiltered surface water systems. PMID- 3276235 TI - Selecting patients when resources are limited: a study of US medical directors of kidney dialysis and transplantation facilities. AB - This study reports and discusses responses of 453 medical directors of renal dialysis and transplantation facilities to detailed patient selection questionnaires. The questionnaires examine selection criteria being used today as well as those which would be employed were resources to remain or become scarce relative to need. Selection criteria examined (and the number of directors supporting them when resources are limited) are: qualitative prognosis, psychological stability, likelihood of medical benefit, quantitative prognosis, medical benefit (virtually all); willingness, age (very large majority); unique moral duties, disproportionate resources, environment, progress of science, social value (majority); ability to pay, random selection, constituency (very large minority); sex (virtually none). Qualitative prognosis, quantitative prognosis, medical benefit, ability to pay, and especially age are the criteria employed today whose influence would increase if resources are further limited. Some of the ethical implications of various criteria are discussed. PMID- 3276236 TI - Effective and ineffective use of fear in health promotion campaigns. AB - Health promotion campaigns are typically designed to elicit fear, yet the use of fear is often ineffective in achieving the desired behavior change. Campaigns which attempt to use fear as part of a punishment procedure are unlikely to succeed. Consistent with established principles of learning, fear is most likely to be effective if the campaign allows for the desired behavior to be reinforced by a reduction in the level of fear. This entails five requirements: 1) fear onset should occur before the desired behavior is offered; 2) the event upon which the fear is based should appear to be likely; 3) a specific desired behavior should be offered as part of the campaign; 4) the level of fear elicited should only be such that the desired behavior offered is sufficient to substantially reduce the fear; 5) fear offset should occur as a reinforcer for the desired behavior, confirming its effectiveness. Under some circumstances it may be difficult to ensure that these requirements are met. In general, a positive reinforcement approach may prove to be more effective than the use of fear. PMID- 3276237 TI - The occurrence of a peripheral T-cell lymphoma in a chronically immunosuppressed renal transplant patient. AB - A 32-year-old man received a cadavaric renal transplant in 1975 for end-stage renal disease and, thereafter, was treated with azathioprine and methylprednisolone for chronic immunosuppression. In 1985, he presented with fever and pancytopenia that persisted despite withdrawal of the immunosuppressive agents. Lymph node and liver biopsies demonstrated malignant lymphoma within the sinuses of the node and the sinusoids of the liver. A splenectomy was performed for persistent pancytopenia, and the spleen demonstrated malignant lymphoma of the diffuse mixed large and small cell type exclusively within the cords of the red pulp. The immunophenotype of the tumor cells was obtained by frozen section immunoperoxidase staining with monoclonal antibodies and flow cytometric analysis. The tumor cells were positive for the Pan T cell markers CD3 and CD2, but were negative for the subset markers CD4 and CD8. A DNA hybridization study conducted on the splenic tissue conclusively identified the clonal nature of the malignant T cells by demonstrating rearrangement of the T cell receptor beta gene. In spite of multiple chemotherapeutic regimens, the patient developed increasing peripheral blood involvement and died with disseminated lymphoma. This case appears to be unique in that it is the first report of a chronically immunosuppressed transplant recipient to develop a malignant lymphoma of the mature T cell type, and several of the pathologic features of the tumor have not been observed previously. PMID- 3276238 TI - Awakening concentrations of isoflurane are not affected by analgesic doses of morphine. AB - A randomized, double-blind study was performed to determine how morphine 0.1 mg/kg IV, or placebo administered 80 +/- 11 (means +/- SE) minutes before the end of surgery affect recovery from isoflurane/oxygen anesthesia. End-tidal isoflurane remained constant at 1.10 +/- 0.02% (means +/- SE) in both groups intraoperatively, and no other anesthetics were given after the administration of the morphine or placebo. Duration of anesthesia did not differ significantly between the morphine (172 +/- 7 minutes) and placebo (163 +/- 18 minutes) groups. Times from discontinuation of isoflurane until eye-opening in response to verbal command were similar in the morphine (19 +/- 2 minutes) and placebo (22 +/- 3 minutes) groups. At the time of eye-opening, end-tidal isoflurane concentrations did not differ between subjects receiving morphine (0.20 +/- 0.02%) and placebo (0.18 +/- 0.01%). It is concluded that the awakening concentration (MAC-awake) during recovery from isoflurane anesthesia is approximately 0.19% and is not affected by analgesic doses or morphine. PMID- 3276239 TI - Cardiopulmonary bypass and myocardial protection: management problems in cardiac surgical patients with cold autoimmune disease. PMID- 3276240 TI - Gluco-regulatory response to intravenous glucose infusion in children undergoing surgery. PMID- 3276241 TI - Effect of PEEP and jugular venous compression on canine cerebral blood flow and oxygen consumption in the head elevated position. AB - Cerebral blood flow (CBF) (radiolabelled microspheres) and oxygen consumption (CMRO2) were studied in nine dogs during 30 min of either neck vein compression or application of positive end-expiratory pressure (PEEP) ventilation. With the animal in the prone position, elevation of the head from horizontal to 30 cm above the heart markedly decreased cisterna magna (PCSF) and dorsal sagittal sinus pressure (PCV). With the head elevated, compression of neck veins using neck tourniquet (pressure 40 mmHg) increased PCSF and PCV from 3.6 +/- 2.2 to 6.8 +/- 4.8 and -2.5 +/- 2.7 to 2.3 +/- 2.3 mmHg (mean +/- SE, P less than 0.05), respectively, while total or regional CBF and CMRO2 remained unchanged. Application of PEEP (15 cm H2O) increased right atrial pressure (-4.7 +/- 1.7 to 0.1 +/- 3.4 mmHg, P less than 0.05), but did not affect PCSF or PCV (3.4 +/- 3.3 to 3.3 +/- 3.7 and -3.5 +/- 2.6 to -4.1 +/- 2.4 mmHg, respectively, P greater than 0.05). Total or regional CBF and CMRO2 were also unaffected. These data demonstrate that, although neither maneuver affects CBF or CMRO2, neck vein compression elevates PCV above atmospheric pressure, but PEEP does not. In patients at risk for cerebral venous embolism, intermittent neck vein compression should be used as a prophylactic measure to prevent air embolism. PMID- 3276242 TI - Aerosols--therapeutic use and delivery in childhood asthma. AB - Aerosol therapy has dramatically improved the lifestyle of the children with asthma, reflecting both the availability of more effective and safer drugs and alternative methods for their delivery. Inhaled treatment with bronchodilators, cromolyn, and inhaled corticosteroids, used singly or in various drug combinations, can control all but the most intractable asthmatic. It is essential that the inhalational device prescribed is appropriate for the child's age and that careful instructions are given as to optimal inhalation technique. Infants and young children with asthma should be given a trial of inhaled bronchodilators, recognizing the limitations this treatment may have in this age group. PMID- 3276243 TI - Late onset reactions in humans: correlation between skin and bronchial reactivity. AB - We carried out sequential measurements of the intensity of simultaneously occurring late onset skin and bronchial reactivity in seven atopic subjects following skin and inhalation challenge with pollen antigen. All subjects demonstrated dual bronchial and cutaneous reactions. Although the intensity of the late onset bronchial responses correlated temporally and quantitatively with the degree of increase in serum neutrophil chemotactic activity, the intensity of the late onset skin responses correlated with the level of specific antigen-IgE in the serum. This suggests that even in the same subjects, different factors govern the intensity of late onset skin and bronchial responses. PMID- 3276244 TI - Bela Schick lecture. The future of allergy. PMID- 3276245 TI - Oxygen free radicals and myocardial reperfusion injury. AB - Diseases involving tissue reperfusion following ischemia are gaining significance in emergency medicine. The significance of reperfusion injury and the probable role of oxygen-derived free radicals has been described in many tissues, particularly the heart. During myocardial reperfusion a burst of oxygen-derived free radicals overwhelms normal cellular defenses. These radicals may have several detrimental effects. They can oxidize lipids, leading to membrane dysfunction. They can also alter nucleic and other proteins. Cellular dysfunction and death may ensue. Prevention of oxygen-derived free radical injury appears possible and may be feasible for several disease processes, including myocardial reperfusion after infarction. PMID- 3276246 TI - Appendicitis: evaluation by Tc-99m leukocyte scan. AB - Diagnosing appendicitis may be difficult. We report the use of a new technetium 99m-albumin colloid white blood cell (TAC-WBC) scan in the evaluation of appendicitis. In a synthesis requiring 75 minutes, autologous neutrophils and macrophages from 40 mL of whole blood were labelled with technetium-99m-albumin colloid and administered to 100 patients with possible appendicitis. The entire process, from labelling the cells to completion of the scan took a maximum of 5 1/4 hours. Two patients had second scans on separate hospitalizations. Twenty-six patients had appendicitis; 12 had perforations, five of whom had an abscess. Eighty-five scans were read as either positive or negative for appendiceal pathology with a sensitivity of 89%, a specificity of 92%, and an accuracy of 92% in diagnosing appendicitis. Seventeen scans were indeterminant; eight of these patients had appendicitis. The value of the TAC-WBC scan in the evaluation of appendicitis lies in its ability to be used emergently, its high negative predictive value for men and women (NPV = 97%), and its high positive predictive value for men (PPV = 93%). At present, the scan does not appear to be reliable in diagnosing appendicitis in women (PPV = 43%). It is most useful in those patients in whom diagnosis is uncertain, and should not be used in patients with clear-cut appendicitis in whom its use will delay definitive surgical care. PMID- 3276247 TI - Detection of coronary artery disease from the normal resting ECG using nonlinear mathematical transformation. AB - In order to enhance subtle changes not apparent in resting ECGs by conventional criteria, a computerized signal processing technique, biopotential coordinate transformation (BCT), has been developed to increase the physician's perceptibility of CAD in seemingly "normal" resting ECGs. ECGs initially read as normal then can be tested with this process to predict the presence or absence of CAD. A blinded, retrospective study of 93 Caucasian patients with normal ECGs was performed using coronary angiography as the test standard. The BCT process identified the presence or absence of CAD with an 84.3% sensitivity and 81.8% specificity in 62 men. Similarly, a 76.2% sensitivity and 80% specificity was obtained for 31 women. These results suggest that the BCT process may provide the emergency physician with a noninvasive screening test for the detection of CAD in patients with apparently normal resting ECGs. Further studies are necessary for process refinement and verification. PMID- 3276248 TI - Evaluation of theophylline overdoses and toxicities. AB - Patients presenting with elevated theophylline concentrations and manifestations of toxicity may be categorized as being either overdose or iatrogenic toxic. In addition to severe cardiac and neurologic toxicities, such as arrhythmias and seizures, OD patients probably require monitoring for manifestation of gastrointestinal hemorrhage, electrolyte abnormalities, and hypotension. The possibility of a delayed peak theophylline concentration after sustained release product ingestion must be considered. Patients with initial serum concentrations of less than 60 mg/L may receive a single dose of oral activated charcoal and have repeat concentrations drawn to ensure the avoidance of continued absorption. The presence of a serum concentration exceeding 60 mg/L in OD patients warrants initiation of elimination-enhancing modalities. Oral activated charcoal is the fastest and most readily available. Multiple-dose oral activated charcoal should be given until serum theophylline concentrations of 60 mg/L or less are reached. Cardiac monitoring and seizure precautions are recommended. Admission to the intensive care unit should be considered when serum concentrations do not decline after several hours of charcoal therapy or when seizures and severe cardiovascular manifestations occur. Patients having initial concentrations exceeding 100 mg/L and/or rapidly rising concentrations 100 mg/L over baseline values should be considered as candidates for CHP or RHP if available. If both CHP and RHP are unavailable or will be excessively delayed, HD is a reasonable alternative. Patients on chronic theophylline therapy (IA patients) presenting with symptoms of toxicity must be evaluated carefully. If serum concentrations are less than 20 mg/L, short-term observation or a reduction in dose should be sufficient. Patients with concentrations between 20 and 60 mg/L should be candidates for seizure precautions and cardiac monitoring. Oral activated charcoal may be started and continued until levels are below 20 mg/mL. Patients with concentrations in excess of 60 mg/L require intensive monitoring (including seizure precautions and cardiac monitoring) as well as initiation of MOAC or CHP/RHP as situation, availability, and patient tolerance dictate. Again, HD may be a reasonable alternative if the others are unavailable or contraindicated. PMID- 3276249 TI - Adult Reye's syndrome. AB - A 40-year-old woman with a history of alcohol abuse, drug-related suicide attempts, and depression presented with a flu-like illness, vomiting, and changes in mentation. On admission, therapeutic blood levels of salicylates, trazadone, and acetaminophen were found. A tentative diagnosis of a psychotic crisis with possible superimposed drug overdose was made. The etiology of the patient's acute encephalopathy remained unclear until a plasma ammonia and liver biopsy established the diagnosis of Reye's syndrome. The patient was given supportive therapy and recovered completely. PMID- 3276250 TI - Overwhelming postsplenectomy infection. AB - A characteristic case of overwhelming postsplenectomy infection in a previously healthy, 25-year-old man is presented. The patient progressed from influenza-like symptoms to irreversible septic shock and death within 24 hours. His spleen had been removed nine years earlier because of abdominal trauma. Aggressive therapy, including IV fluids, antibiotics, vasopressers, steroids, heparin, packed red blood cells, platelets, cryoprecipitates, and fresh frozen plasma, failed to alter the course of this fulminant septic syndrome. The cause, treatment, and certain prevention options are presented. PMID- 3276251 TI - Mediators of pulmonary injury induced by inhalation of bacterial endotoxin. AB - The purpose of this study has been to further define the pathophysiologic aspects of lung injury caused by the inhalation of endotoxin (LPS) using the morphometric approach to identify mediators that influence distal lung structure and function. Hamsters were divided into 3 groups 24 h prior to low dose LPS inhalation exposure (4 micrograms/m3 for 5 h): (1) pretreated with cobra venom factor to deplete complement in vivo, (2) pretreated with indomethacin to block prostaglandin production, and (3) untreated control group. Both pretreatments abolished LPS-induced decreases in lung volume as well as increases in capillary PMN and platelets seen in untreated control animals. Neither pretreatment had any effect on the LPS-induced decreases of other capillary leukocytes. Similarly, both methods of pretreatment failed to block increases in cellular interstitium of distal capillary septa induced with LPS alone. LPS provoked changes in capillary endothelium, especially seen as an increase in numerical density of endothelial pinocytotic vesicles. Decomplementation failed to alter this increase, but indomethacin pretreatment blocked the effect. Neither treatment had any effect on their size. Low dose LPS inhalation also altered pulmonary capillary permeability to a 125I-BSA probe, which was found in significantly greater amounts in LPS-exposed lungs than in those of saline aerosol control lungs, but was not present in the air space as evidenced by negligible counts in bronchoalveolar lavages. It is evident that endotoxin on the epithelial side of the air-blood barrier leads to changes on the other side of that barrier.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276252 TI - Does de novo immunoglobulin synthesis occur on the epithelial surface of the human lower respiratory tract? AB - Although synthesis of immunoglobulins by cells in the human lower respiratory tract has never been directly demonstrated, local production of immunoglobulins by cells within lung parenchyma is thought to play an important role in protecting the normal human lung against a variety of pathogenic organisms, and may contribute to the development of some interstitial lung diseases. To determine whether or not the epithelial surface of the human lower respiratory tract is a site of immunoglobulin synthesis, immunoglobulin production by cells recovered by bronchoalveolar lavage and lung parenchymal tissue from normal subjects and patients with idiopathic pulmonary fibrosis (IPF) or sarcoidosis was evaluated using a reverse hemolytic plaque assay and by measuring incorporation of [35S]methionine into immunoglobulins. Although the reverse hemolytic plaque assay demonstrated immunoglobin-releasing cells to be present on the surface of the lower respiratory tract of normal subjects, and present in increased numbers in patients with IPF or sarcoidosis, these plaque-forming cells were not actively synthesizing immunoglobulins, since preincubation of lavage cells in order to remove immunoglobulin bound to the surface of the cells reduced the number of plaque-forming cells, and inhibition of protein synthesis by cycloheximide did not further reduce the number of plaque-forming cells. Furthermore, direct evaluation of immunoglobulin synthesis using radiolabeling, immunoprecipitation and SDS-polyacrylamide gel electrophoresis failed to detect de novo IgG production by cells recovered from the alveolar surface of 15 of 17 subjects, IgM by 17 of 17, and IgA by 16 of 17.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276253 TI - Decision analysis for isoniazid preventive therapy: take it or leave it? PMID- 3276254 TI - Pulmonary clearance of 99mTc-DTPA in infants who subsequently develop bronchopulmonary dysplasia. AB - The lung clearance of inhaled and deposited 99mTc-DTPA is biphasic, with a very rapid initial clearance in premature infants with acute hyaline membrane disease (HMD). Infants who rapidly recover from HMD revert to a monophasic slower clearance rate prior to successful extubation. This raises the possibility that a persistently fast clearance might identify infants who will not recover and in whom bronchopulmonary dysplasia (BPD) will subsequently be diagnosed. To examine this possibility, we reviewed our experience using this technique and identified infants who had subsequently developed BPD. These 8 intubated, ventilator dependent, premature infants inhaled a submicronic aerosol containing 99mTc-DTPA on 14 occasions during the second, third, and fourth weeks of life. Clearance was biphasic, with very rapid initial lung clearance (T1/2 less than 2 min) on 5 occasions in 4 infants during their second or third week of life. The other infants had monophasic clearances that were much slower (T1/2 = 52 +/- 26 SD min). At Day 28 of life, all infants with BPD were ventilator-and/or oxygen dependent. We conclude that lung clearance of 99Tc-DTPA is very rapid during acute HMD, but that it can normalize before 28 days of life in infants in whom BPD is subsequently diagnosed. PMID- 3276255 TI - Isoniazid for the tuberculin reactor: take it or leave it. AB - The management of the adult tuberculin reactor who has no other risk factors for the development of active tuberculosis is controversial. We performed a decision analysis to address the issue of whether adults 20 to 80 yr of age should take isoniazid to prevent the development of active disease. The analysis uses a Markov simulation, a regression model to calculate the risk of developing tuberculosis at any given time after the discovery of a positive skin test, and estimates from the literature for other probabilities. The analysis favors withholding INH for all age groups, but by only 4 to 17 days of life expectancy, depending on the age of the patient. Quality adjusting and discounting change neither the preferred strategy nor the closeness of the outcome. Sensitivity analyses also underscore the narrowness of the margin. Our analysis reaches different conclusions from previously published analyses. More important than the actual strategy preferred is the minute difference in expected utilities between administering and withholding INH. We suggest that the individual patient decide whether or not these differences are meaningful. PMID- 3276256 TI - Health effects and sources of indoor air pollution. Part II. PMID- 3276257 TI - Dosage and time effects of inhaled budesonide on bronchial hyperreactivity. AB - In a double-blind study of 2 parallel groups of 15 allergic asthmatic patients each, we investigated whether treatment with inhaled budesonide has a dose- and time-dependent effect on the degree of bronchial hyperreactivity. The patients were randomly allocated to treatment with either 200 or 800 micrograms budesonide per day for a period of 8 wk. The active treatment period was preceded by a selection period of 3 wk, and a single-blind placebo period of 2 wk. During these initial 5 wk the maintenance treatment of the patients, including cromolyn sodium and inhaled corticosteroids, was withheld. Spirometry and inhalation provocation tests with methacholine were carried out, and the symptom score was recorded every 2 wk. The methacholine provocation concentrations (geometric mean) causing a decrease in FEV1 of 20% (PC20) in the 200 and 800 micrograms/day treatment groups just before the active treatment period were 0.90 and 0.91 mg/ml, respectively. These values increased significantly to 1.21 and 1.84 mg/ml after 2 wk of treatment (p less than 0.05 and p less than 0.001, respectively) and to 1.55 and 2.74 mg/ml after 8 wk of treatment (p less than 0.01 and p less than 0.001). During the whole study period budesonide in a dosage of 800 micrograms/day induced a significantly larger change in PC20 than in a dosage of 200 micrograms/day. The FEV1 before treatment was 91 +/- 3% (SEM) and 84 +/- 2% of the predicted value in the 200 and 800 micrograms/day treatment groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276258 TI - Adult respiratory distress syndrome as a specific manifestation of a general permeability defect in trauma patients. AB - To establish whether a general dysfunction, i.e., an increase in permeability, had occurred in 16 trauma patients (6 with adult respiratory distress syndrome [ARDS]), we measured beta 2-microglobulin (beta 2MG), myoglobin (MG), immunoglobulin G (IgG), and transferrin (TF) concentrations in bronchoalveolar lavage fluid (BAL), serum, and urine as well as extravascular lung water content (EVLW) over a period of 14 days. Our results show a positive correlation (p = 0.03) between increases of EVLW, reflecting lung edema, and beta 2MG concentrations in urine of all patients with ARDS, indicating systemically increased permeability. Generalized increase of permeability can also explain the elevation of MG urine concentrations (p = 0.03) together with an EVLW increase, and an increase of BAL protein concentrations (IgG, TF, p less than 0.01) in the early post-trauma phase during the first 48 h after admission. In contrast, commonly used kidney function tests remained unchanged over the time course of 14 days. PMID- 3276259 TI - Cholecystostomy. Expected outcome in primary and secondary biliary disorders. AB - Cholecystostomy is used for biliary-tree drainage when simplicity and speed are of prime importance. Its frequency of use and the subsequent mortality rates, vary among surgeons and institutions. This review analyzes 50 cholecystostomies performed over 6 years at one institution, and defines outcome as related to presenting symptoms. Twenty five patients (Group 1) presented with symptoms of acute cholecystitis, and underwent cholecystostomy. Twenty (80%) had gallstones and five (20%) were acalculous. Two patients died, a mortality rate of 8 per cent. Twenty five other patients (Group 2) developed signs suggesting cholecystitis during hospitalization for an unrelated illness. Only 50 per cent (13/25) of Group 2 patients were found to have cholecystitis at operation (eight calculous, five acalculous). Mortality was 62 per cent (8/13) in the Group 2 patients with inflammatory cholecystitis, and 50 per cent (6/12) for the patients with normal gallbladders. A positive outcome may be anticipated if cholecystostomy is used in patients admitted with acute cholecystitis who present too great a surgical risk for formal cholecystectomy. In contrast, the diagnosis of cholecystitis in the critically ill patient can be difficult and the prognosis for survival is not good, even after cholecystostomy. PMID- 3276260 TI - Abdominal complications of ventriculoperitoneal shunts. Case reports and review of the literature. AB - Ventriculoperitoneal (VP) shunting of cerebrospinal fluid (CSF) is the standard therapy for the management of hydrocephalus. Before the advent of silastic, early abdominal complications were frequent and finally led to the abandonment of this technique for management of hydrocephalus. With the use of silastic shunt tubing, VP shunts have once again gained favor as the procedure of choice. Although there are now considerably fewer complications from VP shunts, the presence of an intraperitoneal catheter can still initiate various complications. Abdominal complications of VP shunts are reported to be from 10-30 per cent, thus remaining clinically important for early recognition and treatment in patient management. An awareness of these complications is necessary in creating an index of suspicion for the primary physician whose patients harbor a VP shunt and present with abdominal symptoms. This report presents five cases of children with abdominal complications of VP shunts (four pseudocysts and one umbilical granuloma with spontaneous drainage of CSF). Additional abdominal complications of VP shunts are discussed, as well as diagnostic and therapeutic alternatives in order to improve and expedite accuracy in diagnosis and provide simplicity and efficiency in treatment. PMID- 3276261 TI - Posttest probability calculation by weights. A simple form of Bayes' theorem. AB - This article reintroduces a different form of Bayes' theorem that allows calculation of posttest probabilities by adding quantities known as "weights." A weight combines information found in both a test's sensitivity and specificity. A single value can describe how a given test result changes the posttest probability of disease. The use of weights and this form of Bayes' theorem should allow more widespread understanding and use of probability theory in clinical practice. PMID- 3276262 TI - What makes the patient-doctor relationship therapeutic? Exploring the connexional dimension of medical care. AB - Physicians do not receive from the medical model the same explicit guidance in relating to their patients as in making diagnoses and prescribing pharmacologic and other treatments. To meet this need, we offer a framework for expanding the model. Therapeutic contact takes place within a connexional, or transpersonal, dimension of human experience, within which basic human needs for connection and meaning are met. Although seldom explicitly recognized, connexional experience is basic to medical care. Awareness of this dimension of experience leads clinicians to appreciate that establishing a therapeutic relationship is one of the principal goals of medical practice. It also reframes the doctor's task to make clinical uncertainty more tolerable and situations in which there is no appropriate biomedical response (such as care of the terminally ill) less frustrating and more fulfilling. PMID- 3276263 TI - Occult carbon monoxide poisoning. PMID- 3276264 TI - Transmission of human immunodeficiency virus (HIV) by transplantation: clinical aspects and time course analysis of viral antigenemia and antibody production. AB - The human immunodeficiency virus (HIV) was transmitted to a patient who received a cadaveric renal transplant from a donor who had received massive blood component replacement. A negative HIV antibody test was obtained on serum drawn immediately after transfusion. After transplantation, pretransfusion sera and sera obtained several hours after transfusion tested positive for HIV antibody, suggesting that transfusions had transiently diluted the patient's serum and resulted in a false-negative HIV antibody test. Immediately after transplantation, the recipient showed a transient increase in HIV antigen levels followed by a more sustained increase representing de-novo antigen synthesis. Antibodies to HIV were detected 51 days after transplant. The recipient has shown no signs or symptoms of HIV infection after 1 year. In potential cadaveric organ donors, HIV antibody testing should be performed on pretransfusion sera or on sera obtained several hours after massive transfusion of blood products. PMID- 3276265 TI - Subnormal pancreatic polypeptide and epinephrine responses to insulin-induced hypoglycemia identify patients with insulin-dependent diabetes mellitus predisposed to develop overt autonomic neuropathy. AB - Sixteen patients with insulin-dependent diabetes mellitus with no current evidence of autonomic dysfunction underwent an insulin tolerance test during which plasma pancreatic polypeptide and epinephrine responses were determined. Compared to 11 age- and weight-matched nondiabetic volunteers, 9 diabetic subjects had subnormal plasma pancreatic polypeptide responses (n = 6) or plasma epinephrine responses (n - 8). When autonomic function was reassessed 2 to 3 years later by standard cardiovascular reflex tests and clinical examination, 8 of 9 diabetic subjects with subnormal hormonal responses to hypoglycemia developed either abnormal cardiovascular reflexes (6 of 9) or overt symptoms consistent with diabetic autonomic neuropathy (6 of 9), whereas none of the subjects with previously normal plasma pancreatic polypeptide and epinephrine responses did (P less than 0.01). Diminished pancreatic polypeptide and epinephrine responses to hypoglycemia can predict the development of overt autonomic neuropathy in patients with insulin-dependent diabetes mellitus; identification of patients with a predilection to develop autonomic neuropathy may permit earlier treatment. PMID- 3276266 TI - The clinical significance of Campylobacter pylori. AB - Campylobacter pylori has recently been isolated from gastric mucosal biopsy specimens. Campylobacter pylori has many attributes in common with other campylobacters but it may represent a new genus. It produces abundant quantities of urease, and this property has been used to develop a rapid diagnostic test. The organism is found predominantly beneath the gastric mucus layer that lines the surface epithelium of the stomach. Infection with C. pylori causes an acute histologic gastritis which may become chronic. The bacterium is the etiologic agent in type-B gastritis. Prevalence of the organism in asymptomatic persons appears to be age related. Campylobacter pylori is found commonly in patients with peptic ulcer disease, always in association with chronic gastritis. Eradication of the organism is associated with healing of the gastritis and a lower relapse rate in duodenal ulcer disease. A role for the organism in other upper gastrointestinal diseases is unproven. PMID- 3276267 TI - Artificial intelligence in medical diagnosis. AB - In an attempt to overcome limitations inherent in conventional computer-aided diagnosis, investigators have created programs that simulate expert human reasoning. Hopes that such a strategy would lead to clinically useful programs have not been fulfilled, but many of the problems impeding creation of effective artificial intelligence programs have been solved. Strategies have been developed to limit the number of hypotheses that a program must consider and to incorporate pathophysiologic reasoning. The latter innovation permits a program to analyze cases in which one disorder influences the presentation of another. Prototypes embodying such reasoning can explain their conclusions in medical terms that can be reviewed by the user. Despite these advances, further major research and developmental efforts will be necessary before expert performance by the computer becomes a reality. PMID- 3276268 TI - Hepatic candidiasis in cancer patients: the evolving picture of the syndrome. AB - Focal hepatosplenic candidiasis has been recognized with increasing frequency in recent years. We reviewed the cases of eight patients seen between 1982 and 1985, and information on 60 patients whose cases have been reported in the world literature. The characteristics of focal hepatosplenic candidiasis include persistent fever in a neutropenic patient whose leukocyte count is returning to normal, often coupled with abdominal pain; an elevated alkaline phosphatase level; and less commonly, rebound leukocytosis. The characteristic "bull's eye" lesions seen with hepatic ultrasound examination or computed tomography generally are not detectable until neutrophil recovery has occurred. Diagnosis can be established only by biopsy evidence of yeasts or pseudohyphae in the granulomatous lesions. Cultures are frequently negative, however, especially in patients who have been pretreated with antifungal agents. We review the evolving nature of hepatosplenic candidiasis, focusing on diagnosis and treatment. PMID- 3276269 TI - [Historical course of surgery in rectal cancer in Japan]. AB - Rectal cancer surgery in Japan started to first step of Lisfranc type resection by T. Sato in 1887. Since H. Ito (1902) published in success of three cases of abdominosacral excision (ASE), ASE occupied the main position of rectal cancer surgery in Japan. In 1944, however, M. Kuru reported the superiority of abdominoperineal resection (APR), an orient of surgery had changed to APR from ASE with time. His operative mortality was 2.0% or less, and 5-year survival rate was more than 50%. D. Jinnai (1961) introduced endorectal pull-through operation, and in 1972 he exhibited an excellent survival and satisfying function following sphincter preserving operation, such as anterior resection and pull-through, for mid and upper rectal cancer. T. Kajitani (1975) and Y. Koyama (1977) improved the survivals through an extended pelvic nodes dissection. Today, the principle of rectal cancer surgery in Japan is a limited resection for early cancer, sphincter preserving operations for upper and mid-rectal cancer and extended pelvic nodes dissection for advanced lower rectal cancer. PMID- 3276270 TI - Ichthyosiform dermatosis and deafness. Report of a case and review of the literature. AB - A patient suffering from an ichthyosiform dermatosis, partial deafness, and pes cavus is described. Most of the body surface was covered by fine white scales; red scaling plaques were present on the arms. There were slight hyperkeratoses of the palms and soles, keratosis pilarislike lesions with perifollicular redness on the trunk, and multifocal alopecia. A biopsy specimen of the scaly erythematous plaque demonstrated hyperkeratosis with follicular plugging, papillomatosis, and acanthosis. Direct immunofluorescence studies of lesional skin using monoclonal antibodies to epidermal prekeratin, filaggrin, and involucrin revealed normal staining patterns. The patient's cultured keratinocytes were morphologically unremarkable and contained profilaggrin, involucrin, and a normal complement of cytokeratins. The expression of the disease may not occur in cultured cells, because they lack many features of fully keratinized cells. A review of the literature concerning ichthyosis and deafness reveals that the constellation of cutaneous and extracutaneous abnormalities in this case does not exactly conform to that in previously reported cases. Precise classification of the patient's disorder will require demonstration of the basic defect(s). PMID- 3276271 TI - Antibiotic use during major head and neck surgery. AB - The appropriate use of prophylactic antimicrobial therapy in patients undergoing major contaminated surgery is an important issue for the head and neck surgeon. A series of five sequential, prospective, randomized, double-blind clinical trials of antibiotics for patients undergoing major contaminated oncologic head and neck surgery are reviewed and summarized. The information generated from the study of these 547 patients indicates that a number of drugs or drug combinations have similar efficacy when employed in adequate dosage. The bacteriologic spectrum of the prophylactic drug should include oral microflora, especially anaerobic bacteria. The administration of antibiotics effective against gram-negative aerobic bacteria may be unnecessary. Perioperative antibiotic administration should be initiated prior to surgery. To date, no evidence exists to support prolonged administration of antibiotics beyond the first 24 hours following surgery. PMID- 3276272 TI - The complications of pancreatectomy. AB - This paper analyses the early postoperative complications after 285 pancreaticoduodenectomies performed during the past 15 years in the Surgical University Clinic, Mannheim. There were 235 partial (Whipple) and 52 total pancreatectomies performed for pancreatic and periampullary tumors (181 patients) and complicated chronic pancreatitis (104 patients). A total of 92 complications requiring relaparotomy in 42 patients ended fatally in nine patients. The overall operative and hospital mortality rate was 3.1%. The most frequent and most dangerous were complications at or around the pancreaticojejunal anastomosis, which occurred 25 times with five deaths. Postoperative hemorrhage was seen in 16 patients; endoscopic treatment in four patients and operation in 12 patients was successful in stopping the bleeding in all but one patient. Eight biliary fistulae either ceased spontaneously (3 patients) or after operative reintervention (5 patients) without any mortality. Control of these complications depends on four lines of approach: (1) before operation: optimal preparation of the jaundiced patient including endoscopic transpapillary decompression of the common duct; (2) during operation: a meticulous and standardized technique is mandatory; (3) after operation: continuous observation in the surgical intensive care unit is essential for the timely detection of possible complications; and (4) early reintervention can salvage the great majority of these patients with deleterious complications. PMID- 3276273 TI - Minor role of ketone bodies in energy metabolism by skeletal muscle tissue during the postoperative course. AB - To evaluate changes of peripheral ketone body (KB) metabolism after operation, muscle metabolism in postsurgical patients was studied at 3 hours (SI) and 24 hours (SII) after surgery by the forearm catheter technique. Data were compared to those of equivalent fasted controls (CI, CII). In a manner consistent with enhanced mobilization of endogenous substrate stores, arterial concentrations of free fatty acids (FFA), 3-hydroxybutyrate (3-HOB), and acetoacetate (AcAc) were markedly elevated immediately after surgery. This increase was accompanied by a rise in muscular utilization of AcAc (SI: 0.21 +/- 0.05 mumol/100 g/min; CI: 0.08 +/- 0.05, p less than 0.05) and 3-HOB (SI: 0.24 +/- 0.06 mumol/100 g/min; CI: 0.11 +/- 0.01, p less than 0.05). Surprisingly, on the first postoperative day, concentrations of AcAc and 3-HOB fell below those of fasting controls. Concomitantly, the utilization rate of AcAc by muscle (SII: 0.07 +/- 0.03 mumol/100 g/min; CII: 0.27 +/- 0.04, p less than 0.05) was significantly lower in patients than in controls. Reduction of the fractional extraction rate of AcAc (SI: 38.4 +/- 3.8%; SII: 24.0 +/- 6.1%, p less than 0.05), as well as a net production of 3-HOB by muscle (SII: -0.08 +/- 0.05 mumol/100 g/min; CII: 0.49 +/- 0.13, p less than 0.05) 24 hours after surgery indicated a reduced peripheral capacity for KB removal. Since this finding was related to a significantly higher rate of muscular glycerol production (SII: -0.13 +/- 0.03 mumol/100 g/min; CII: 0.06 +/- 0.02, p less than 0.05), one may suggest that increased intramuscular availability of FFA from triglyceride hydrolysis was responsible for the impairment of peripheral KB utilization. These results indicate that KBs contribute little to energy metabolism in skeletal muscle tissue in the late postoperative phase. PMID- 3276274 TI - Claude Beck and cardiac resuscitation. AB - The problem of sudden death due to derangement of the cardiac mechanism remained poorly defined into the 20th century. The physiologist Carl J. Wiggers proposed maintenance of the circulation by manual massage of the heart, followed by electrical defibrillation at a suitable time. His surgical colleague Claude S. Beck, with several associates, defined a precise sequence of steps for management of cardiac arrest in the operating room and was able to apply them clinically with complete success. Subsequently, patients were resuscitated outside the operating room as well; and finally, massage and defibrillation across the intact chest have made cardiac resuscitation available at any place or time. PMID- 3276275 TI - Aortico-left ventricular tunnel: a clinical review and new surgical classification. AB - This is a collective review of aortico-left ventricular tunnel (ALVT) in the English-language literature. We include the long-term follow-up of a previously reported patient, and a report on 2 new patients. To date, 37 cases of ALVT have been reported. Controversies regarding the definition, etiology, local anatomy, and treatment are discussed. The ages of the patients ranged from 1 day to 25 years old, and the male to female ratio was 2:1. There were associated anomalies in 27% of the patients, and moderate to severe heart failure in 59% of them. Mortality was 100% in the medically managed group; the surgical mortality was 16%. Previous surgical techniques utilized were simple closure, patch closure of the aortic end, and obliteration of the tunnel on both ends. Progressive aortic incompetence seems to be a common, but not well-documented problem on long-term follow-up. We have classified the lesion into four types (I, II, III, and IV) that have a bearing on the appropriate surgical techniques of repair, and describe a new technique for the repair of type III ALVT in which septal aneurysm is present. PMID- 3276276 TI - Lymphocyte subpopulation monitoring in cyclosporine-treated patients following heart transplantation. AB - Circulating lymphocyte subpopulations were studied in 18 consecutive patients treated with cyclosporine-prednisone immunosuppression during the first month following heart transplantation. Eleven patients showed no evidence of graft rejection. There were eight episodes of acute rejection demonstrated at endomyocardial biopsy in 7 patients. Three patients were treated with corticosteroids, 3 were treated with rabbit antithymocyte globulin (RATG), and 1 died before treatment (early mortality: 5.6%). Using the monoclonal antibody technique, 150 determinations of lymphocyte subpopulations were performed and were correlated with 72 endomyocardial biopsy specimens. Cyclosporine immunosuppression caused a significant (p less than 0.05) decrease in total lymphocyte count (38%) and in the number of OKT3 (52%) and OKT4 cells (55%). During acute rejection, total lymphocytes and OKT3, OKT4, and OKT8 cells all increased significantly, but the T4 to T8 ratio did not change significantly. Treatment of rejection with corticosteroids resulted in a moderate but not significant decrease in all T-cell types, whereas RATG caused a marked but not selective decrease in all T-cell groups. In conclusion, T cells decrease with cyclosporine immunosuppression and with treatment of rejection and increase at onset of rejection, but the T4 to T8 ratio has no predictive value for the diagnosis and severity of rejection, and the sensitivity of the method does not permit its use to assess the degree of immunosuppression with cyclosporine following heart transplantation. PMID- 3276277 TI - Early reconstruction of pharynx and esophagus following corrosive injury with radial forearm flap in preparation for colon interposition. AB - In 24 patients, corrosive injuries involving the floor of the mouth, the pharynx, and the esophagus were repaired in two stages using a combined free forearm flap and colon for functional restoration of the alimentary tract. The results were satisfactory. Morbidity was decreased, complications were minimal, and there were no failures. In the first stage, early reconstruction with a forearm flap for the oral floor, the pharynx, and the cervical esophagus can be done safely 3 months after the original injury when the acute inflammation of the tissue has disappeared. The forearm flap is thin and pliable, and has a good blood supply for primary healing without failure or stricture. Dysphagia is eliminated because food passes down by gravity. There is no constriction or hyperperistalsis of the colon, both of which are occasionally seen with the traditional colon interposition. In the second stage, the traditional method is used to finish the reconstruction of the remainder of the esophagus. PMID- 3276278 TI - Intermittent cough, sulfur-tasting sputum, and hypersalivation associated with captopril. PMID- 3276279 TI - Comparison of oxprenolol vs methyldopa as second-line antihypertensive agents in the elderly. AB - Direct within-patient comparisons of the effects of centrally acting sympathetic inhibitors and beta-blockers on blood pressure (BP) of the elderly have not been done. In the present study, 32 elderly hypertensive patients were treated with a diuretic. Methyldopa (500 mg/d) (16 patients, subgroup A) or slow-release oxprenolol (80 mg/d) (subgroup B) was added as a second-step antihypertensive agent for a period of eight weeks, after which the second-step agents were switched, respectively, for another period of eight weeks. In subgroup A the supine BP dropped from 193/99 to 169/93 mm Hg and the standing BP from 183/100 to 163/92 mm Hg, whereas in subgroup B the supine BP fell from 190/103 to 182/97 mm Hg and the standing BP from 187/101 to 172/95 mm Hg. After switching the drugs, the respective BP values were 177/91 and 170/95 mm Hg and 170/90 and 156/89 mm Hg. In the doses given, methyldopa therapy is more effective than oxprenolol therapy in lowering the BP of elderly hypertensive patients. PMID- 3276280 TI - Pharmacotherapy of borderline personality disorder. Alprazolam, carbamazepine, trifluoperazine, and tranylcypromine. AB - Sixteen female outpatients with borderline personality disorder and prominent behavioral dyscontrol, but without a current episode of major depression, were studied in a double-blind, crossover trial of placebo and the following four active medications: alprazolam (average dose, 4.7 mg/d); carbamazepine (average dose, 820 mg/d); trifluoperazine hydrochloride (average dose, 7.8 mg/d); and tranylcypromine sulfate (average dose, 40 mg/d). Each trial was designed to last six weeks. Tranylcypromine and carbamazepine trials had the highest completion rates. Physicians rated patients as significantly improved relative to placebo while receiving tranylcypromine and carbamazepine. Patients rated themselves as significantly improved relative to placebo only while receiving tranylcypromine. Patients who tolerated a full trial of trifluoperazine showed improvement, those receiving carbamazepine demonstrated a marked decrease in the severity of behavioral dyscontrol, and those receiving alprazolam had an increase in the severity of the episodes of serious dyscontrol. As an adjunct to psychotherapy, pharmacotherapy can produce modest but clinically important improvement in the mood and behavior of patients with borderline personality disorder. As a research tool, patterns of pharmacological response may provide clues to biological mechanisms underlying dysphoria and behavioral dyscontrol. PMID- 3276281 TI - An efficacy study of isocarboxazid and placebo in depression, and its relationship to depressive nosology. AB - Isocarboxazid and placebo were evaluated in 130 anxious depressives. Drug was superior to placebo on depression, anxiety, interpersonal sensitivity, and global measures, and on symptoms of hostility, anxiety, obsessiveness, and psychological cognitive components of depression. There were no significant differences between treatment effects on psychomotor and typical vegetative symptoms. Isocarboxazid was more effective than placebo in major, but not in minor, depression. It was significantly more effective in depression classified as endogenous depression or melancholia by various diagnostic criteria. Drug was more effective than placebo in atypical depression with vegetative reversal and in Brief Psychiatric Rating Scale (BPRS)-derived profiles of anxious and hostile depression; there were no drug-placebo differences in atypical depression without vegetative reversal, or in BPRS retarded and agitated/excited depression. Interpersonal sensitivity emerged as an important drug-responsive dimension. PMID- 3276282 TI - Antidepressant specificity in atypical depression. AB - One hundred nineteen patients who met specific criteria for atypical depression completed six weeks of double-blind, randomly assigned treatment with phenelzine sulfate, imipramine hydrochloride, or placebo. The overall response rates were 71% with phenelzine, 50% with imipramine, and 28% with placebo. Phenelzine was widely superior to placebo and also showed superiority to imipramine. Phenelzine superiority appeared even greater after an additional six-week continuation phase. Imipramine was only moderately effective in this atypical depressive sample. Unexpectedly, the superiority of either phenelzine or imipramine to placebo was largely confined to patients in subsets of the study sample who were prospectively judged to also have a history of spontaneous panic attacks and/or show hysteroid dysphoric features. This is consonant with some but not other recent findings and requires replication. Overall, the concept of atypical depression as a subtype that is preferentially responsive to monoamine oxidase inhibitors is supported. PMID- 3276283 TI - Serotonergic responsivity in obsessive-compulsive disorder. Effects of chronic clomipramine treatment. AB - Clomipramine is a potent serotonin reuptake blocker that decreases the symptoms of obsessive-compulsive disorder (OCD). To investigate whether clomipramine treatment in OCD affects brain serotonergic responsiveness, metachlorophenylpiperazine (mCPP), a selective serotonin agonist, and placebo were given under double-blind conditions to nine patients with OCD before and after treatment with clomipramine. Unlike our previous observations of a marked transient increase in obsessional symptoms and anxiety following 0.5 mg/kg of mCPP, readministration of mCPP after four months of treatment with clomipramine did not significantly increase obsessional symptoms and anxiety. Similarly, the hyperthermic effect of mCPP observed before treatment was eliminated after treatment with clomipramine. These findings are consistent with the development of adaptive subsensitivity to the serotonergic agonist mCPP during clomipramine treatment. A similar alteration in the response to endogenous serotonin may mediate clomipramine's antiobsessional effects. PMID- 3276284 TI - Influence of age on the proliferation and peripheralization of thymic T cells. AB - Bone marrow cells obtained from B10.Thy-1.1 mice (H-2b, Thy-1.1) were injected directly into the thymus of C57BL/6 mice (H-2b,Thy 1.2) of various ages. Thymocyte precursors in the injected donor-bone marrow cells could proliferate in the thymic microenvironment in the following manner: first, preferentially proliferating into the subcapsular cortex; and second, spreading to the whole layer of the cortex, a portion of them gradually moving into the medulla. The proliferation of donor-type thymocytes was most pronounced when intrathymic injection of bone marrow cells (ITB) was performed in newborn mice and especially prominent in week-old mice; it took approximately ten weeks for donor-type thymocytes to finish the whole course of proliferation, differentiation, and emigration to the periphery. When ITB was performed in mice 4 weeks of age and older, the proliferation of donor-type thymocytes was retarded at onset, less pronounced in magnitude, and disappeared earlier. Emigration of donor-type T cells from the thymus to the peripheral lymphoid tissues occurred most rapidly when ITB was performed in newborn mice, and these T cells continued to reside thereafter in the peripheral lymphoid tissues. However, when ITB was performed in mice 4 weeks of age and older, the number of emigrated T cells in the spleen decreased (about a tenth of that in newborn mice) and, moreover, these T cells resided only transiently in the spleen. It was suggested that T cells emigrating from the thymus of mice from newborn to 2 weeks of age are long-lived, whereas those from the thymus in mice 4 weeks of age and older are short-lived. However, when 4-week-old young adult mice were treated by irradiation or hydrocortisone, the thymic capacity was enhanced in terms of proliferation and peripheralization of thymocytes, and emigrated T cells became long-lived. PMID- 3276285 TI - Differential prostacyclin production by human umbilical vasculature. AB - Using the avidin-biotin immunohistochemical technique with rabbit antihuman 6 keto-prostaglandin (PG)-F1 alpha (6KPGF), we studied the distribution of the stable prostacyclin metabolite, 6KPGF, in 14 formaldehyde-fixed human umbilical cords. All umbilical veins demonstrated intense endothelial cell staining. None of the arteries stained. To corroborate the immunohistochemical findings, three fresh umbilical cords were dissected to separate arteries from veins and then were incubated in oxygenated tissue baths containing Ringer's lactate (37 degrees C) for 30 minutes. Cumulative 6KPGF production as measured by radioimmunoassay of tissue effluents was markedly different between arteries and veins with the umbilical vein producing the largest quantity of 6KPGF. Thus, immunohistochemistry and ex vivo capacitance studies suggest that there is a differential distribution of 6KPGF in human umbilical arteries and veins. PMID- 3276286 TI - Applications of gene rearrangement analysis in the diagnosis of Hodgkin's disease. PMID- 3276287 TI - Urinary bladder paragangliomas. An immunohistochemical study. AB - The immunohistochemical characteristics of three cases of urinary bladder paragangliomas are presented. These are compared with similar studies on paragangliomas from other anatomic sites and the clinical and pathologic implications are discussed. PMID- 3276288 TI - Neuron-specific enolase reactivity in hyperplasias and neoplasms of the thyroid. PMID- 3276289 TI - Immunohistochemical detection of the ras oncogene product p21 in advanced ovarian cancer. Lack of correlation with clinical outcome. AB - The monoclonal antibody RAP 5 immunoreactive with the ras gene product p21 was used in an immunohistochemical study of 57 patients with advanced ovarian cancer and in 28 normal ovaries. The pattern of the staining of various tumor specimens was similar to the germinal epithelium of normal ovaries, whereas the intensity of staining was more enhanced in carcinomas than in normal ovaries. However, we found a lack of correlation among staining intensity of RAP 5 and the histologic type, the histologic grade, the ploidy class, and the clinical outcome. PMID- 3276290 TI - In vitro susceptibility of Cryptococcus neoformans isolates from patients with acquired immunodeficiency syndrome. AB - Cryptococcus neoformans strains from 26 individual patients with acquired immunodeficiency syndrome (AIDS) and three isolates from patients without AIDS were tested for their susceptibility to amphotericin B, flucytosine, ketoconazole, and miconazole nitrate. Ninety percent of the C neoformans isolates from patients with AIDS were inhibited by drug concentrations within achievable serum levels. The minimum fungicidal concentration of the four tested antifungal agents, however, exceeded obtainable cerebrospinal fluid levels. PMID- 3276291 TI - Clear-cell epithelial neoplasms of the large intestine. AB - We report four cases of primary clear-cell adenoma and adenocarcinoma of the large intestine. The neoplasms grossly resembled ordinary colonic adenomas and adenocarcinomas but microscopically were composed of uniform cells with optically clear cytoplasm. Mucin stains were negative, and the clear nature of the cytoplasm was due to glycogen accumulation. Areas of transition between normal colonic epithelial constituents and the clear-cell lesion were observed. Three of the four cases stained strongly positively for carcinoembryonic antigen. These lesions are apt to give rise to considerable diagnostic confusion and, in particular, resemble metastatic renal cell carcinoma. The usual strong positive carcinoembryonic antigen reaction is helpful in establishing this diagnosis. PMID- 3276292 TI - Secondary prevention in stroke: a primary rehabilitation concern. AB - Stroke is a recurrent disease. Approximately one in four hospital admissions for stroke is due to recurrence; patients who have had a stroke are five times as likely to have another stroke as matched controls without stroke. While attention has been focused on the problem of primary prevention of stroke in patients with hypertension and/or transient ischemic attacks, the important problem of preventing stroke recurrence has been addressed to only a limited extent. In this paper, we review known risk factors for recurrence as well as possible medical and surgical approaches to reducing the probability of stroke recurrence. At this point, there appears to be no intervention which has unequivocal proven benefit, although several large-scale clinical trials are now in progress. Further clinical research on this problem is needed. An opportune time to institute and conduct research on interventions directed toward reducing the risk of stroke recurrence may be during the subacute recovery phase while patients are engaged in a program of comprehensive medical rehabilitation. Prevention of recurrent stroke and related vascular events for which stroke patients have increased risk (eg, myocardial infarction) should be of major concern in stroke rehabilitation practice. PMID- 3276293 TI - Ultrasonic guided percutaneous transhepatic bile drainage for cholangitis due to intrahepatic stones. AB - Acute cholangitis due to intrahepatic stones is frequently associated with biliary sepsis. Emergency surgery for these high-risk patients is usually associated with a high mortality. Therefore, we recommend nonoperative methods for the management of this acute disease. Percutaneous transhepatic cholangiography and drainage (PTCD) combined with antibiotic and fluid treatment was used successfully in the management of 41 patients with acute pyogenic cholangitis due to intrahepatic stones. The general condition of these patients improved after treatment with PTCD. Repeated cholangiography should be performed so that the entire biliary tree and lesions can be viewed. Elective surgery (21 patients) or removal of the stone through the sinus tract via PTCD (14 patients) was performed when the patients' general condition improved following emergency PTCD. Therefore, we recommend PTCD over emergency surgery in the treatment of acute septic intrahepatic stones. PMID- 3276294 TI - An experiment in surgical education--the first international exchange of residents. The letters of Halsted, Kuttner, Heuer, and Landois. AB - Dr William Halsted firmly believed that the young physician achieved greater surgical maturity by observing the practice of surgery in countries in addition to his own. To promote this belief, Halsted initiated the concept of exchanging residents between training programs in different lands. This article presents a review of that historic first international exchange of residents. This glimpse into the past is accomplished by presenting previously unpublished letters of Halsted; Hermann Kuttner, director of a surgical clinic in Germany; George Heuer, a resident from The Johns Hopkins Hospital, Baltimore; and Felix Landois, a resident from Kuttner's clinic. PMID- 3276295 TI - Diagnosis and operative indications for polypoid lesions of the gallbladder. AB - In 411 patients undergoing cholecystectomy, benign polyps were present in 32 gallbladders and malignant polyps were present in eight. Histologically, cholesterol polyps accounted for most of the benign lesions, and all the malignant lesions were adenocarcinomas. Gallstones coexisted in 50% of the malignant lesions and endoscopic retrograde cholangiography revealed anomalous pancreaticobiliary junctions in three of five patients with malignant lesions. Sixty-nine percent of patients with benign lesions were under 60 years of age, whereas 75% of those with malignant lesions were over 60. Ninety-four percent of the benign lesions were under 1.0 cm in diameter, while 88% of the malignant lesions exceeded this size. Spread and size of the tumor showed a close correlation. Therefore, size of the tumor is a vital indicator in the treatment of polypoid lesions of the gallbladder, and a malignancy should be considered when the tumor exceeds 1.0 cm in diameter. PMID- 3276296 TI - To drain or not to drain in thyroid surgery. A controlled clinical study. AB - Drainage after thyroid surgery is widely used to prevent postoperative complications by evacuation of blood and fluids. However, to our knowledge no study has shown the benefit of drainage. Therefore, we performed a prospective, randomized study on the rate of complications after drainage or no drainage in thyroid surgery. One hundred fifty patients were allocated to drainage or no drainage. No difference was seen between the two groups according to the experience of the surgeon, type of operation, diagnosis, weight of thyroid specimens, operation time, and hospital stay. All complications were recorded and resulted in two patients receiving reoperation because of bleeding, two permanent laryngeal nerve palsies, one case of permanent hypocalcemia, ten minor hematomas, one wound infection, and one lymphatic leakage. No difference was seen between the groups. This study does not support prophylactic routine drainage after uncomplicated thyroid surgery. PMID- 3276297 TI - Isolated Crohn's disease of the appendix. Two case reports and a review of the literature. AB - Two patients were diagnosed and treated at St Elizabeth Hospital Medical Center, Youngstown, Ohio, for isolated Crohn's disease of the appendix. Including these two patients, 75 such patients have been described in the world literature from 1953 to July 1986, to our knowledge. Crohn's disease of the appendix should be considered in patients who are in their second and third decades of life, who have pain and tenderness in the right lower quadrant of the abdomen, and whose symptoms are protracted (longer than three days) and/or recurrent. Intraoperatively, if the appendiceal wall appears hypertrophic, thickened, and chronically inflamed, a frozen section may confirm the diagnosis. Crohn's disease of the appendix is a diagnosis of exclusion. Appendectomy may be performed safely and has a low morbidity and mortality. The incidence of enterocutaneous fistula and the recurrence rate are much lower than for Crohn's disease of the small and large bowel. PMID- 3276298 TI - Controlled pilot trial of monthly intravenous cyclophosphamide in multiple sclerosis. AB - Monthly intravenous cyclophosphamide treatment was compared with placebo treatment for one year in a controlled trial of 14 patients with relapsing/remitting multiple sclerosis. Eight patients received placebo and six patients received cyclophosphamide. The cyclophosphamide group showed a definite trend to have less frequent and less prolonged episodes than the placebo group. When each group served as their own controls, the cyclophosphamide group had a significant decrease in episodes while the placebo group did not. When the placebo group was then given cyclophosphamide, they also had a significant decrease in episodes. When all patients who were receiving cyclophosphamide were combined for analysis, the decrease in episodes was even more evident. Complications were minimal. These results suggest that monthly intravenous doses of cyclophosphamide may influence the frequency and duration of episodes of relapsing/remitting multiple sclerosis. PMID- 3276299 TI - Prolonged serum levodopa levels with controlled-release carbidopa-levodopa in the treatment of Parkinson's disease. AB - Twenty parkinsonian patients (Hoehn and Yahr scale, I through III) were treated with controlled-release carbidopa-levodopa (CR-2 or CR-3) and standard carbidopa levodopa (Sinemet, 25 mg/100 mg) in a double-blind, crossover pharmacokinetic and clinical efficacy study. The controlled-release agents had a slower rise to peak plasma values and flatter pharmacokinetic curves than did the standard. The area under the curve for CR-3 was significantly increased by 55.5% as compared with standard agent and by 84.2% as compared with CR-2. No differences in clinical efficacy were found between controlled-release agents and the standard agent for this group of parkinsonian patients with mild to moderate severity. The dissociation between the prolonged serum levodopa levels and unimproved clinical efficacy may have resulted from the absence of patients with prominent motor fluctuations and/or substantial serum levodopa variability that was especially prominent with CR-3. PMID- 3276300 TI - Rezso Balint and his most celebrated case. AB - In 1907, Rezso Balint (1874-1929), a young Hungarian physician, recorded observations he had made on a patient who suffered from a remarkable constellation of symptoms--fixation of gaze, neglect of objects in the visual surround, and misreaching--following damage to the posterior parietal lobes. Although Balint's syndrome, the name now given to these disorders of attention and visuomotor control, is well established in the neurologic literature, there remain problems of interpretation. Balint's own attempts to understand exactly what was wrong with his patient offer a unique insight into the nature of neurologic thought at the beginning of this century. PMID- 3276301 TI - Norms of care in British and American neurologic practice. AB - At a Consensus Development Conference on the Scope of Neurological Practice in the United Kingdom, 26 British specialists in the field of neurology constructed norms of care for patients with 11 neurologic disorders. For each disorder, these specialists specified the percentage of all patients who should see a physician, as well as the percentage who should see a consultant neurologist, the appropriate duration of the initial patient encounter, and the appropriate frequency of follow-up visits per annum. When compared with American estimates used in health manpower planning, British neurologists generally make a far greater allowance for patient self-care, as well as care by nonphysician health care providers, allow less time for patient encounters, and see a need for follow up care less frequently. These marked differences in the perceptions of specialists of a normative character may determine, in part, the different "practice styles" of physicians in different regions that cannot be explained in economic terms. Results suggest that the practice style concept should be broadened to include the use of health personnel of many types, the scope of specialty medicine, and the role definition of primary care. PMID- 3276302 TI - Lyme disease and its neurologic complications. AB - Lyme disease is recognized as a cause of illness involving multiple organ systems. The transmission of the Borrelia burgdorferi spirochete depends on a complicated vector life cycle, involving multiple mammalian and avian hosts. Although the illness is reported worldwide, variable clinical presentations on different continents raise questions about disease mechanisms. Multiple neurologic syndromes can occur alone or in combination, producing peripheral neuropathies, radiculopathies, myelopathies, encephalitides, meningitides, and pain syndromes. These may be noted with dermatological, rheumatological, and cardiological syndromes. Several pathophysiologic mechanisms are reviewed. Antibiotic therapy for different clinical presentations is discussed. PMID- 3276303 TI - Temporary tarsorrhaphy enhances reepithelialization after epikeratoplasty. PMID- 3276304 TI - Primary orbital leiomyosarcoma. A case report and review of the literature. AB - An 82-year-old woman presented with a five-week history of painless proptosis. Results of clinical evaluation, including computed tomography, were consistent with a benign orbital tumor. Biopsy followed by surgical resection disclosed leiomyosarcoma. We reviewed the literature and studied the clinical spectrum of this rare disease of the orbit. PMID- 3276305 TI - Immunohistochemical staining of the human anterior segment. Evidence that resident cells play a role in immunologic responses. AB - We examined human corneoscleral tissue for cells that are phenotypically similar to known antigen-presenting cell (APC) populations. Antigen-presenting cells are involved in the uptake and processing of antigen for presentation to T lymphocytes, thereby playing a central role in induction of the immune response. The recognition of antigen by T lymphocytes requires that an APC express major histocompatibility complex class II molecules. Using immunoperoxidase staining techniques, the presence of cells expressing class II glycoproteins and T-cell subsets were determined. The staining patterns of the trabecular meshwork, ciliary body, cornea/sclera, and conjunctive are described for monoclonal antibodies OKT6, OKM1, HLA-DR, and HLA-DQ, and T-cell markers OKT8, Leu-3a, and Leu-4. The results of the present study demonstrate that the anterior chamber contains a network of immunocompetent cells. The presence of a subpopulation of cells within the anterior chamber that express class II glycoproteins of the major histocompatibility complex suggests this tissue may play an important role in immune regulation within the eye. PMID- 3276306 TI - Monensin is obligatory for the cytotoxic action of a disulfide linked methotrexate-anti-transferrin receptor conjugate. AB - Methotrexate (MTX) in the form of a gamma-cysteinylglycine derivative was disulfide linked to a monoclonal antibody reactive with the human transferrin receptor to give an antibody-MTX conjugate (anti-TfR-MTX). Antibody directed delivery of MTX to cell surface receptors was readily detected by flow cytometry using an anti-MTX antibody plus a secondary fluorescent antibody probe. Despite the presence of ample drug on the cell membrane, the conjugate alone was not cytotoxic over the course of several days. Expression of specific toxic activity, however, was obtained in conjunction with the carboxylic ionophore monensin, in whose presence anti-TfR-MTX displayed an IC50 of 8 X 10(-8) M. These results suggest that the ionophore causes antibody-drug conjugate to bypass the normal transferrin receptor cyclic pathway, allowing sufficient drug to reach, bind to, and inactivate intracellular dihydrofolate reductase. PMID- 3276307 TI - Partial purification and characterization of hepatocyte proliferation stimulatory factor from liver of rats treated with D-galactosamine. AB - The partial purification and characterization of a hepatocyte proliferation stimulatory factor (HPSF) isolated from the liver of D-galactosamine-treated rats are described. The HPSF was a heat-labile, acid-stable and trypsin-sensitive protein. The partially purified HPSF stimulated DNA synthesis and increased the labeling index of parenchymal hepatocytes at 5 micrograms/ml and maximally at 50 micrograms/ml. The effect of HPSF in stimulating DNA synthesis was synergistic with that of insulin plus epidermal growth factor (EGF). The HPSF was scarcely detected in normal rat liver. The results obtained indicate that this HPSF is distinct from insulin, multiplication-stimulating activity (MSA), EGF and other hepatocyte growth factors previously reported, and suggest a plausible role for HPSF in the regeneration of liver tissue following hepatotoxic damage. PMID- 3276308 TI - Calcium-mediated hemagglutination by serum amyloid P component and the inhibition by specific glycosaminoglycans. AB - Human serum amyloid P component (SAP) was found to agglutinate erythrocytes in the presence of calcium ion. The hemagglutination was strongly inhibited by hyaluronic acid as well as by heparan sulfate and dermatan sulfate, but not by chondroitin 4-sulfate and keratan sulfate. A specific binding of SAP to hyaluronic acid, heparan sulfate, and dermatan sulfate was also confirmed by the fact that these glycosaminoglycans blocked the binding of SAP to agarose, a specific ligand of SAP. PMID- 3276309 TI - A new prostaglandin E1 analogue (TFC-612) prevents a decrease in motor nerve conduction velocity in streptozocin-diabetic rats. AB - A new prostaglandin E1 analogue (TFC-612) was orally given to streptozocin diabetic rats for 4 weeks after the induction of diabetes and its effects on motor nerve conduction velocity were studied. The compound significantly prevented a decrease of the velocity but did not reverse abnormal sorbitol and myo-inositol contents of the sciatic nerve. The results suggest that TFC-612 has a potent effect on diabetic nerve dysfunction via other mechanism than the correction of sorbitol and myo-inositol metabolisms and could be a potential compound for therapy of diabetic polyneuropathy. PMID- 3276310 TI - Dual effect of glucose on cytoplasmic Ca2+ in single pancreatic beta-cells. AB - The cytoplasmic Ca2+ concentration (Ca2+i) was measured in single pancreatic beta cells from ob/ob-mice using the fluorescent indicator fura-2. Raising the glucose concentration from 3 to 20 mM resulted in 25% initial lowering of Ca2+i, followed by 250% rise above the basal level of 49 +/- 3 nM. Tolbutamide (100 microM) was as effective as glucose in increasing Ca2+i, although its action was more rapid and not preceded by any reduction. The results support the concept that stimulated removal of Ca2+ from the cytoplasm is an essential part of the physiological glucose effect on the pancreatic beta-cells. PMID- 3276311 TI - Proton NMR studies of the GDP.Mg2+ complex of the Ha-ras oncogene product p21. AB - Two-dimensional proton NMR studies were performed on the c-Ha-ras encoded proto oncogene product p21C. COSY and NOESY spectra of the p21C.GDP.Mg2+ complex show that the ribose H1 proton of the bound GDP is in close proximity to the aromatic side chain of a phenylalanyl residue. From sequence homology with the bacterial elongation factor Tu (EF-Tu) and the known X-ray structure of the EF-Tu.GDP.Mg2+ complex it may be inferred that the Phe residue in question is either Phe78 or Phe82 in the p21 sequence. PMID- 3276312 TI - Purification and characterization of placental protein 5. AB - This report describes the purification of placental protein 5, PP5, from the human placenta by two affinity chromatography steps, the first with Heparin Sepharose and the second with Sepharose-linked monoclonal anti-PP5 antibody. The final purification is achieved by reversed-phase high performance liquid chromatography. In SDS-polyacrylamide gel electrophoresis under reducing or nonreducing conditions, PP5 purified in this study migrates as one major band at 36 kD. The previously purified PP5 is more heterogeneous: under nonreducing conditions it migrates at 30 kD and, after reduction, it gives three bands at 16.8 kD, 18.3 kD, and 19.0 kD. In Western blot analysis, both purified proteins react with polyclonal and monoclonal anti-PP5 antibodies. Three N-terminal amino acid sequences are obtained for the previously purified PP5, whereas the N terminal of PP5 purified in this study is blocked. These results suggest that PP5 previously purified in the absence of protease inhibitors, does not represent the native form of PP5. Computer comparison of the obtained amino acid sequences revealed no significant homology to known protein sequences. PMID- 3276313 TI - Biomolecular handedness. Origins and significance. PMID- 3276314 TI - The metabolic chiral inversion and dispositional enantioselectivity of the 2 arylpropionic acids and their biological consequences. AB - The 2-arylpropionic acids are currently an important group of non-steroidal anti inflammatory agents. They contain a chiral centre, and in vitro studies on inhibition of prostaglandin synthesis show that their activity resides almost exclusively in the S(+)-isomers. However, this stereoselectivity of action is not manifest in vivo, due to the thus-far-unique unidirectional metabolic inversion of the chiral centre from the inactive R(-)-isomers to the S(+)-antipodes. Available evidence strongly suggests that this reaction proceeds via the formation of the acyl CoA thioesters of the 2-arylpropionates, but the participation of enzyme(s) in the inversion process remains uncertain. Although the chiral inversion is seemingly a general feature of the fate of 2 arylpropionates, there do occur important combinations of acid and species where the reaction is not extant. The stereochemistry of the chiral centre of these acids also influences other aspects of their disposition, including the oxidative metabolism of the aryl/arylakyl moiety, glucuronidation of the -COOH group and plasma protein binding, and the importance of certain of these becomes more evident when renal function is impaired. The biological consequences of the metabolic chiral inversion and enantioselective disposition of the 2 arylpropionates have been summarized in terms of their implications for the development and use of safer and more effective drugs of this class. PMID- 3276315 TI - Structure-activity relationships in the beta-lactam family: an impossible dream. AB - The difficulty of establishing structure-activity relationships in the beta lactam family of antibiotics stems from the fact that: (1) The targets in various bacteria exhibit widely different sensitivities. (2) Some bacteria produce beta lactamases, enzymes capable of destroying the antibiotics. The rates of the reactions with the beta-lactamases and the target enzymes are not necessarily related. (3) In Gram-negative bacteria, the diffusion rate through the outer membrane varies independently from the two other factors. PMID- 3276316 TI - Molecular basis of the activity of antibiotics of the vancomycin group. PMID- 3276317 TI - Warfarin: metabolism and mode of action. AB - The various stages involved in the transport, pharmacological action and elimination of warfarin involve the specific binding of warfarin to a chiral macromolecular complex. However, it seems that the degree of stereoselectivity is variable, which presumably reflects the importance of the side-chain in binding to each type of macromolecule. It would appear that there is greater stereoselective control in the interaction of warfarin with cytochrome P-450 enzymes than that observed for interaction with the receptor, vitamin K1 epoxide reductase. Indeed, warfarin has been developed as a powerful stereochemical probe for in vitro studies of the terminal enzyme in the mixed-function oxidase system, cytochrome P-450. Warfarin undergoes hydroxylation in the 6, 7 and 8-positions of the aromatic ring which must interact with the active (haemoprotein) portion of the molecule, leaving the side-chain, which contains the chiral centre, free for recognition by the substrate binding site. In vitro studies indicate that the interaction of warfarin at its receptor, vitamin K1 epoxide reductase, is completely non-stereoselective. This suggests that only the 4-hydroxycoumarin ring portion of the drug binds to the enzyme. Consistent with this hypothesis, salicylate, which can mimic part of the 4-hydroxycoumarin ring system, produces hypothrombinaemia by inhibition of vitamin K1 epoxide reductase. These findings suggest that the coumarin ring system is largely responsible for the pharmacodynamic properties of warfarin, whereas the side-chain dictates the disposition and metabolism of the drug. PMID- 3276318 TI - Positron emission tomography in assessment of regional stereospecificity of drugs. AB - PET imaging has much to offer the pharmaceutical industry in the design and development of drugs, beginning with the radiolabelling of drugs to facilitate pharmacokinetic studies and extending to measurement of the effects of drugs on regional metbolism, such as that of glucose and oxygen, or in stimulating or blocking receptors, occupying enzymes or affecting substrate transport processes. PMID- 3276319 TI - Stereoselectivity of cytochrome P-450 isozymes and epoxide hydrolase in the metabolism of polycyclic aromatic hydrocarbons. AB - Enantiomeric compositions of epoxides formed in the metabolism of planar benz[a]anthracene (BA), benzo[a]pyrene (BaP), and chrysene (CR), and nonplanar benzo[c]phenanthrene (BcPh), 12-methylbenz[a]anthracene (12-MBA) and 7,12 dimethylbenz[a]anthracene (7,12-DMBA) by liver microsomes from untreated, phenobarbital-treated, and 3-methylcholanthrene-treated rats are determined either by direct chiral stationary phase HPLC analysis or by the enantiomeric compositions of metabolically formed trans-dihydrodiols. Cytochrome P-450 isozymes contained in various liver microsomal preparations have varying degrees of stereoselectivity in catalyzing the epoxidation reactions at various formal double bonds of the polycyclic aromatic hydrocarbons studied. In general, cytochrome P-450c, the major cytochrome P-450 isozyme contained in liver microsomes from 3-methylcholanthrene-treated rats, has the highest degree of stereoselectivity. Regardless of absolute configuration, non-K-region epoxides are converted to trans-dihydrodiols by epoxide hydrolase-catalyzed water attack at the allylic carbon. The S-center of K-region S,R-epoxide enantiomers derived from planar BA, BaP and CR is the major site of epoxide hydrolase-catalyzed water attack. In contrast, the R-center of K-region S,R-epoxide enantiomers derived from nonplanar BcPh, 12-MBA and 7,12-DMBA is the major site of epoxide hydrolase catalyzed water attack. However, the K-region R,S-epoxide enantiomers of the six polycyclic aromatic hydrocarbons studied are hydrated by microsomal epoxide hydrolase with varying degrees of regioselectivity. Thus the enantiomeric composition of a metabolically formed dihydrodiol is determined by (i) the stereoselective epoxidation at a formal double bond of a parent hydrocarbon by microsomal cytochrome P-450 isozymes and (ii) the enantioselective and regioselective hydration of the metabolically formed epoxide by microsomal epoxide hydrolase. PMID- 3276320 TI - Interactions of hepatic cytochromes P-450 with steroid hormones. Regioselectivity and stereospecificity of steroid metabolism and hormonal regulation of rat P-450 enzyme expression. PMID- 3276321 TI - Substrate and product stereoselectivity in monooxygenase-mediated drug activation and inactivation. AB - In this overview, stereoselective aspects of drug metabolism have been examined in a biochemical and pharmacodynamic perspective. From the facts and concepts presented, the conclusion to emerge is that the pharmacokinetic behaviour of mixtures of stereoisomers (e.g. racemates) is not always the simple addition of the behaviour of individual stereoisomers; as a consequence, stereoisomeric mixtures might display pharmacodynamic effects differing somewhat from those caused by the separate eutomers and distomers. In some circles, the notion of "isomeric ballast" is being mentioned with increasing regularity, leading almost fatally to the conclusion that eutomers should be purified from their distomeric ballast for therapeutic use. A number of examples discussed here show that in vitro and also in vivo, a racemate often displays a pharmacokinetic and pharmacodynamic behaviour which is not the mere addition of the behaviour of its separate enantiomers. This may seem as an additional argument for the therapeutic use of pure eutomers since a number of interactions are thus avoided. But does this imply that distomers must always be considered as detrimental ballast? Enforcing compulsory resolution of stereoisomeric mixtures, in particular racemates, would increase severalfold the cost of many drugs. This is a small price to pay if the benefit is an improved therapeutic index. But, to reword the question, would such a legislation automatically result in therapeutic benefits? PMID- 3276322 TI - Stereoselectivity of bioactive xenobiotics. A pre-Pasteur attitude in medicinal chemistry, pharmacokinetics and clinical pharmacology. PMID- 3276323 TI - Pharmacokinetic and pharmacodynamic consequences of stereoselective drug metabolism in man. AB - The examples discussed demonstrate the importance of stereoselective drug metabolism and raise the question of whether the therapeutic use of racemic drugs is still justified. There is no straightforward answer to this question. If only quantitative differences in therapeutic activity exist and the less active enantiomer is not predominantly responsible for side effects, the therapeutic benefit gained by using the more active enantiomer is only marginal and does not justify the substantial increase in costs involved in manufacturing such a drug preparation. However, if stereoselectivity in therapeutic activity is pronounced and adverse drug reactions are caused mainly by the less active isomer then an isomeric pure drug preparation should be used. PMID- 3276324 TI - DNA recombinant and monoclonal antibody directed methods for determining cytochrome P-450 specificity. PMID- 3276325 TI - Signal recognition by pancreatic B-cells. PMID- 3276326 TI - Mouse liver dihydrodiol dehydrogenases. Identity of the predominant and a minor form with 17 beta-hydroxysteroid dehydrogenase and aldehyde reductase. AB - A major and a minor form of dihydrodiol dehydrogenase were co-purified with 17 beta-hydroxysteroid dehydrogenase and aldehyde reductase, respectively, to apparent homogeneity from liver cytosol of male ddY mice. The activities of dihydrodiol dehydrogenase and testosterone dehydrogenase or aldehyde reductase of the two enzyme forms comigrated electrophoretically. The major form of the enzyme oxidized 17 beta-hydroxysteroids and nonsteroidal alicyclic alcohols and reduced 17-ketosteroids and various synthetic carbonyl compounds, showing higher affinity for steroids than for xenobiotics. The activity of this enzyme form toward benzene dihydrodiol and testosterone exhibited identical thermostability and susceptibility to inhibition by quercitrin, SH-reagents, nonsteroidal estrogens and anti-inflammatory agents. On the other hand, the minor form of the enzyme, which oxidized benzene dihydrodiol but not 17 beta-hydroxysteroids, also reduced various aldehydes well and was specifically inhibited by barbiturates and sorbinil. These results indicate that the major form of dihydrodiol dehydrogenase is identical to 17 beta-hydroxysteroid dehydrogenase and the minor enzyme form to aldehyde reductase. PMID- 3276327 TI - Properties of N-hydroxy-N'-aminoguanidine derivatives as inhibitors of mammalian ribonucleotide reductase. AB - In previous studies, N-hydroxy-N'-aminoguanidine (HAG) derivatives were demonstrated to suppress growth and clonogenicity of tumor cells which correlated with the inhibition of ribonucleotide reductase and DNA synthesis. The present work has focused on the properties of five HAG derivatives as inhibitors of the ribonucleotide reductase from Ehrlich ascites tumor cells. HAG derivatives acted as non-competitive inhibitors of ribonucleotide reductase with respect to the substrates CDP and ADP. The apparent Ki values for the various HAG derivatives as inhibitors of CDP reductase ranged from 3.4 to 543 microM. However, the apparent Ki values for these inhibitors with respect to ADP reductase were 2- to 10-fold lower than the respective values for CDP reductase. After a preincubation of HAG derivatives and ribonucleotide reductase in the absence of substrates, an increased inhibition was observed. The activity of the inhibited enzyme could be restored by passage over a Sephadex G-25 column and subsequent incubation with dithioerythritol. The addition of either the non-heme iron subunit or the effector-binding subunit to the intact enzyme in the assay mixture resulted in a diminished inhibition of ADP reduction. Inhibition by HAG derivatives of ribonucleotide reductase activity in the test tube was not enhanced by iron chelators. However, a combination of HAG compounds and iron chelators synergistically inhibited the growth of L1210 cells. PMID- 3276328 TI - Mobilization of arachidonic acid from diacyl and ether-linked phospholipids in FMLP stimulated alveolar macrophages. AB - Exposure of [1 14C]AA labeled guinea-pig alveolar macrophages to FMLP for 15 min induced an extensive mobilization of AA from phospholipids. PC and PI mainly contributed to the AA release, and labeled PE remained unchanged. Analysis of ether-linked phospholipids showed a significant breakdown of labeled diacyl and alkyl-acyl PC and an increase in labeled alkenyl-acyl PE. PMID- 3276329 TI - Ethylketocyclazocine and N-cyclopropylmethyl-norazidomorphine are antagonists of morphine-induced analgesia in frog spinal cord. PMID- 3276330 TI - Pre-retirement planning and the role of the occupational health nurse. PMID- 3276331 TI - Rate of spontaneous abortion after first trimester sonographic demonstration of fetal cardiac activity. AB - The incidence of spontaneous abortion once embryonic development has reached the stage of sonographically demonstrable cardiac activity has not been precisely determined in a large population. This retrospective study was designed to determine the risk of pregnancy loss after first trimester sonographic confirmation of fetal cardiac activity. A total of 840 patients were referred for ultrasound examination to the Perinatal Center, University of Cincinnati, between January 1, 1979 and December 31, 1985 who fulfilled the criteria of singleton pregnancy with sonographically visible fetal cardiac activity and crown-rump length consistent with gestational age less than or equal to 12 weeks. Patients were grouped into two categories based on the absence (control) or presence of vaginal bleeding (bleeding) prior to or at the time of the ultrasound examination. The abortion rates for the two groups were 5.2 and 16.4%, respectively (P less than 0.001). The relative risk of abortion in patients with vaginal bleeding was nearly four-fold greater than the control population. In the control group there was a significantly greater incidence of pregnancy loss in the greater than or equal to 34 years age group compared to less than 34 years age patients (4.4 versus 11.1%, P less than 0.05). Although there was no significant effect of race on abortion rates, low socioeconomic status almost doubled the relative risk of miscarriage. We conclude that the presence of visible fetal cardiac activity in the first trimester predicts a decreased risk for spontaneous abortion compared to generally reported rates. The significant risk factors for increased chance of abortion are vaginal bleeding, advanced maternal age, and low socioeconomic status. PMID- 3276332 TI - Sonographic assessment of the first trimester fetus. A cautionary note. AB - Ultrasound has the potential for diagnosing fetal abnormalities in utero with a high degree of accuracy. During the first trimester, peculiarities of fetal development may suggest to the novice sonographer an abnormality where one does not exist. Similarly, particular anatomic structures may appear normal in the first trimester, yet evolve into an obvious abnormality later in gestation. For these reasons, the ultrasonic diagnosis or exclusion of a congenital anomaly in the first trimester should be made only with caution. PMID- 3276333 TI - Varicella pneumonia during pregnancy. Treatment of two cases with acyclovir. AB - Pneumonia is a rare but serious complication of varicella during pregnancy. Maternal mortality has been reported to be 41% with fetal and neonatal mortality at 65%. Treatment has included respiratory support and prophylactic antibiotics. Acyclovir has been prescribed with the intent to decrease the impact of the infection. It was added to the treatment protocol of two cases of varicella pneumonia in pregnancy. Despite the high maternal and perinatal mortality both pairs of patients and infants survived. Acyclovir did not appear to adversely influence the fetus, and may have contributed to the survival of mother and child. PMID- 3276334 TI - The relationship of placental grade to fetal size and growth at term. AB - Among 246 term patients undergoing ultrasonic evaluation within 1 week of delivery, a grade-three placenta was found in 39.4%. Advanced placental maturity was not associated with altered fetal growth rates or an increase in small- or large-for-gestational infants. At term, advanced placental maturity is not associated with aberrant fetal growth. PMID- 3276335 TI - Cerebrospinal fluid shunts in pregnancy. Report of two cases and review of the literature. AB - With the introduction of silicone indwelling cerebrospinal fluid (CSF) shunts in the 1960s, the prognosis for children with hydrocephalus changed dramatically. These individuals are leading normal and productive lives today. Many women with CSF shunts are not entering the childbearing years. Previously, only 13 cases of pregnancy occurring in patients with CSF shunts have been reported. We present two cases here and review the complications and outcome of the other reported cases. Shunt malfunction appears to be common in pregnancy due to increased intraperitoneal pressure and the enlarging uterus. Rarely is surgical correction or premature delivery necessary. A successful pregnancy ending in the vaginal delivery of a term infant can be expected in the majority of these patients. PMID- 3276336 TI - Prophylactic oral nystatin and fungal infections in very-low-birthweight infants. AB - Prevention of systemic fungal infection in the very-low-birthweight infant is important since it is associated with a high morbidity and mortality. To determine if oral nystatin administration could prevent fungal colonization and infection, we evaluated 67 preterm infants with birthweights less than 1250 gm. Thirty-three infants received 1 ml (100,000 units/ml) of nystatin inside the mouth every 8 hours until 1 week after extubation. Oropharyngeal, rectal, blood, and urine cultures were obtained on the 1st day of life and weekly. Endotracheal cultures were obtained three times a week from intubated infants. Four (12%) of the 33 nystatin-treated infants had positive cultures, two (6%) developed systemic infection. The control group consisted of 34 infants, 15 (44%) had positive fungal cultures and 11 (32%) developed systemic infection. Fungi isolated were Candida species and Torulopsis glabrata. Colonized infants were dependent on the respirator (P less than 0.001), had indwelling catheters (P less than 0.01), and received antibiotics (P less than 0.05) for a longer period than infants free from fungi and their mortality was significantly higher (P less than 0.05). We conclude that prophylactic administration of oral nystatin reduces fungal colonization and infection in very-low-birthweight infants. PMID- 3276337 TI - Sonography of brain abscesses complicating Citrobacter neonatal meningitis. AB - The incidence of cerebral complications from citrobacter meningitis is high, and these problems are often difficult to diagnose clinically. Cranial sonography provides the ideal imaging modality to detect the early complications of meningitis and the problems that may occur during or after treatment. Early and serial use of cranial sonography should help to preserve brain tissue and minimize the long-term neurologic deficits that arise from this disease. PMID- 3276338 TI - Multiple simultaneous predictors of gestational age. An application of Bayes' theorem. AB - Most obstetricians share the belief that an estimate of gestational age based on several clinical measures that agree with one another is more accurate than an estimate based on a single measurement. This paper presents a formal justification for this belief by applying Bayes' theorem to calculate the probability of a fetus being a certain gestational age by using information from several clinically established single predictors. The application of Bayes' theorem justifies the use of multiple measures of gestational age in individual ultrasound examinations and the use of serial ultrasound studies in the third trimester to more accurately estimate gestational age. The same technique could be applied to obstetric research studies that need to establish accurate gestational dating. PMID- 3276339 TI - Early prenatal diagnosis of amniotic band syndrome. AB - A case of amniotic band syndrome diagnosed at 16 weeks gestation is presented. The pregnancy was complicated by cervical incompetence. Restriction of fetal head movement was important in sonographic diagnosis. PMID- 3276340 TI - Resolving polyhydramnios. A sign of improved fetal status. AB - Four cases of transient polyhydramnios are reviewed. It is proposed that by taking note of changes in amniotic fluid volume, one can more accurately assess a fetal-maternal unit that is affected by a number of specific disease processes. PMID- 3276341 TI - Alcohol as a risk factor for drownings: a review of the literature (1950-1985). AB - We identified 36 English language studies (1950-1985) on alcohol and drownings. The majority of these were descriptive, reporting on the percent of drowning victims positive for alcohol upon autopsy. Most studies fell into one of three categories: Type A--complete ascertainment, duration of submergence specified; Type B--complete ascertainment, duration of submergence unspecified; Type C- partial ascertainment. Among Type A studies, percent of positives for alcohol ranged from 29% to 47%. Among Type B studies, percents ranged from 15% to 69%. Among Type C studies, percents ranged from 18% to 86%. We conclude that (1) between 25% and 50% of adult drowning victims have been exposed to alcohol and that (2) without data on the frequency of alcohol consumption among non-victims engaged in aquatic activities, the causal role of alcohol in drownings is uncertain. Suggestions for further research are offered. PMID- 3276342 TI - Safety belt promotion: theory and practice. AB - The purpose of this paper is to provide practitioners a rationale and description of selected theoretically based approaches to safety belt promotion. Theory failure is a threat to the integrity and effectiveness of safety belt promotion. The absence of theory driven programs designed to promote safety belt use is a concern of this paper. Six theoretical models from the social and behavioral sciences are reviewed with suggestions for application to promoting safety belt use and include Theory of Reasoned Action, the Health Belief Model, Fear Arousal, Operant Learning, Social Learning Theory, and Diffusion of Innovations. Guidelines for the selection and utilization of theory are discussed. PMID- 3276344 TI - Gaucher's disease involving the maxillary sinuses. AB - A 46-year-old man with a long history of Gaucher's disease involving the spleen, bone marrow, and multiple bones presented with apparent sinusitis. He had radiologic opacification and histologically documented involvement by Gaucher's disease of the maxillary antra. Bony involvement of the mandible and maxilla has rarely been reported. To the best of our knowledge, this represents the first reported case of paranasal sinus involvement by Gaucher's disease. PMID- 3276343 TI - A comparative study of amoxicillin-clavulanate and amoxicillin. Treatment of otitis media with effusion. AB - A double-blind randomized clinical trial was conducted at two sites comparing amoxicillin-clavulanate potassium (Augmentin) and amoxicillin trihydrate for the treatment of otitis media with effusion ("secretory otitis media"). One hundred eight subjects were randomly assigned to receive a ten-day course of either drug regimen. Clinical response was assessed at ten days and four weeks after entry. For those without middle ear effusion at four weeks, recurrence rates were measured at 8, 12, and 16 weeks after entry. At ten days following entry, 29 (51.8%) of 56 subjects in the amoxicillin-clavulanate-treated group were effusion free compared with 16 (32.0%) of 50 subjects in the amoxicillin-treated group (P = .06). At four weeks following entry, 26 (50.0%) of 50 subjects in the amoxicillin-clavulanate-treated group were effusion free compared with 23 (51.1%) of 45 subjects in the group given amoxicillin. By the 16-week visit, eight (36.4%) of 22 subjects in the amoxicillin-clavulanate-treated group who were effusion free at four weeks had recurrence of effusion, compared with 12 (63.2%) of 19 subjects in the amoxicillin-treated group. This study suggests that there was a favorable clinical response immediately following treatment in the amoxicillin-clavulanate--treated subjects as compared with those treated with amoxicillin, but this benefit was not sustained at the four-week end point. PMID- 3276345 TI - Disinfection of impressions in UK dental schools. PMID- 3276346 TI - Reflections from general dental practice. PMID- 3276347 TI - 'The etch-retained metal restoration in hospital clinical use'. PMID- 3276348 TI - Porcelain veneers: a preliminary review. PMID- 3276349 TI - Molecular structure of free radicals and their importance in biological reactions. PMID- 3276350 TI - Phospholipid composition modulates the Na+-Ca2+ exchange activity of cardiac sarcolemma in reconstituted vesicles. AB - Na+-Ca2+ exchange activity in cardiac sarcolemmal vesicles is known to be sensitive to charged, membrane lipid components. To examine the interactions between membrane components and the exchanger in more detail, we have solubilized and reconstituted the Na+-Ca2+ exchanger into membranes of defined lipid composition. Our results indicate that optimal Na+-Ca2+ exchange activity requires the presence of certain anionic phospholipids. In particular, phosphatidylserine (PS), cardiolipin, or phosphatidic acid at 50% by weight results in high Na+-Ca2+ exchange activity, whereas phosphatidylinositol and phosphatidylglycerol provide a poor environment for exchange. In addition, incorporation of cholesterol at 20% by weight greatly facilitates Na+-Ca2+ exchange activity. Thus, for example, an optimal lipid environment for Na+-Ca2+ exchange is phosphatidylcholine (PC, 30%)/PS (50%)/cholesterol (20%). Na+-Ca2+ exchange activity is also high when cardiac sarcolemma is solubilized and then reconstituted into asolectin liposomes. We fractionated the lipids of asolectin into subclasses for further reconstitution studies. When sarcolemma is reconstituted into vesicles formed from the phospholipid component of asolectin, Na+-Ca2+ exchange activity is low. When the neutral lipid fraction of asolectin (including sterols) is also included in the reconstitution medium, Na+-Ca2+ exchange activity is greatly stimulated. This result is consistent with the requirement for cholesterol described above. Proteinase treatment, high pH, intravesicular Ca2+ and dodecyl sulfate all stimulate Na+-Ca2+ exchange in native sarcolemmal vesicles. We examined the effects of these interventions on exchange activity in reconstituted vesicles of varying lipid composition. In general, Na+ Ca2+ exchange could be stimulated only when reconstituted into vesicles of a suboptimal lipid composition. That is, when reconstituted into asolectin or PC/PS/cholesterol (30:50:20), the exchanger is already in an activated state and can no longer be stimulated. The one exception was that the Na+-Ca2+ exchanger responded to altered pH in an identical manner, independent of vesicle lipid composition. The mechanism of action of altered pH on the exchanger thus appears to be different from other interventions. PMID- 3276351 TI - Effects of Cl- deficiency on the membrane potential in mouse pancreatic beta cells. AB - The membrane potential of mouse pancreatic beta-cells was measured with microelectrodes. In the resting cell (3 mM D-glucose), the membrane potential was -63 +/- 3 mV (mean +/- S.E. for four experiments). In the presence of 3 mM D glucose, total Cl- substitution by isethionate induced a depolarization by 3-4 mV, and readmission of Cl- induced a hyperpolarization by 3-5 mV. At 10 mM glucose, reduction of Cl- to 12 mM by substituting isethionate for Cl- reversibly shifted the repolarization potential by 6-9 mV in the positive direction and stimulated the burst activity during the initial 2-3 min by increasing the fraction of plateau phase. This was followed by a gradual inhibition of electrical activity, including decrease in fraction of plateau phase and slow wave amplitude. Total substitution of Cl- by isethionate or methyl sulphate reversibly shifted the repolarization potential by 3-4 mV in the positive direction and rapidly inhibited the electrical burst pattern without any initial stimulation. Glucose-induced (10 mM) insulin release (15 min) and 45Ca2+ uptake (3 min) were strongly inhibited by reducing the Cl- concentration to 10 mM (isethionate as substitute) and were further inhibited by further reduction of the Cl- concentration. It is suggested that beta-cells are equipped with on electrogenic Cl- flux, which can affect the burst pattern of electrical activity. The inhibitory effects of Cl- substitution may be explained by an influence of Cl on the voltage-controlled Ca2+ channels. PMID- 3276352 TI - New insight into protein secondary structure from resolution-enhanced infrared spectra. PMID- 3276353 TI - The binding of glucose and nucleotides to hexokinase from Saccharomyces cerevisiae. AB - The binding of glucose, ADP and AdoPP[NH]P, to the native PII dimer and PII monomer and the proteolytically-modified SII monomer of hexokinase (ATP:D-hexose 6-phosphotransferase, EC 2.7.1.1) from Saccharomyces cerevisiae was monitored at pH 6.7 by the concomitant quenching of protein fluorescence. The data were analysed in terms of Qmax, the maximal quenching of fluorescence at saturating concentrations of ligand, and [L]0.5, the concentration of ligand at half-maximal quenching. No changes in fluorescence were observed with free enzyme and nucleotide alone. In the presence of saturating levels of glucose, Qmax induced by nucleotide was between 2 and 7%, and [L]0.5 was between 0.12 and 0.56 mM, depending on the nucleotide and enzyme species. Qmax induced by glucose alone was between 22 and 25%, while [L]0.5 was approx. 0.4 mM for either of the monomeric hexokinase forms and 3.4 for PII dimer. In the presence of 6 mM ADP or 2 mM AdoPP[NH]P, Qmax for glucose was increased by up to 4% and [L]0.5 was diminished 3-fold for hexokinase PII monomer, 6-fold for SII monomer, and 15-fold for PII dimer. The results are interpreted in terms of nucleotide-induced conformational change of hexokinase in the presence of glucose and synergistic binding interactions between glucose and nucleotide. PMID- 3276354 TI - Isolation and characterization of two new low-molecular-weight protein proteinase inhibitors from the granule-rich fraction of equine neutrophilic granulocytes. AB - A new species of protein proteinase inhibitors was detected in the granule-rich fraction of equine neutrophilic granulocytes. Five isoinhibitors were identified with a narrow enzyme specificity towards two microbial proteinases, e.g., proteinase K and subtilisin. Two isoinhibitors were purified and partially characterized. They had an Mr of 11,300 and 7400, respectively, and were resistant to perchloric acid and heat treatment at 100 degrees C for 20 min. The inhibitors retained their activity over a broad range of pH (1-9 and 1-12, respectively). The possible biological function of this species of protein proteinase inhibitors as defensins (= endogenous antibiotics) is tentatively discussed. PMID- 3276356 TI - [Immunoenzyme detection of the NS-2 brain antigen as a criterion of changes in the permeability of the blood-brain barrier in mice following gamma-irradiation]. PMID- 3276355 TI - The action of phenylarsine oxide on the stereospecific uptake of D-glucose in basal and insulin-stimulated rat adipocytes. AB - Phenylarsine oxide (PAO) has been used to inhibit the stereospecific uptake of D glucose in basal and insulin-stimulated rat adipocytes. The inhibition is dose dependent and is partially reversed by dithiothreitol. The results are consistent with a direct interaction between the glucose transporter and PAO. By manipulating the sequence of exposure of cells to PAO and insulin it is possible to differentiate between the effects of PAO on transport into cells with receptor rich and transporter-rich plasma membranes. PAO rapidly inhibits transport in insulin-stimulated adipocytes but at low concentrations inhibition is transient and recovery of stereospecific uptake takes place after approx. 20 min. The results can be interpreted in terms of the recruitment mechanism of insulin stimulation of transport and demonstrate that a relatively large intracellular pool of transporters exists after insulin stimulation. It also follows that sulphydryl groups probably play a critical role in the mechanism of glucose uptake. PMID- 3276357 TI - [Ammonia release and binding processes and the activity of acid proteinase and glycolysis enzymes in the dynamics of experimental toxic adrenal encephalopathy]. AB - The content of ammonium, glutamine, glutamate, aspartate and GABA, glutamine synthetase activity, acid proteinase, hexonase, phosphohexoisomerase and dehydrogenase glucose-6-phosphate were studied in dog brain homogenates after individual injections of Bacillus coli endotoxin (10 micrograms/kg) and adrenaline (75 micrograms/kg) into veins and their combined injections into the carotid artery. Isolated injections of endotoxin and adrenaline were shown to cause transient metabolic compensatory changes. Combined injections caused stable progressing brain metabolic disorders. It is suggested that neurochemical changes influence endogenous development of toxic adrenal encephalopathy. PMID- 3276358 TI - [Effect of human regulatory myelopeptides on the elaboration of a factor inhibiting leukocyte migration]. AB - Some properties of the regulatory peptides from human bone marrow have been investigated. It has been determined that the activity of the regulatory peptides was different in healthy donors and patients with agammaglobulinemia and paraproteinemia. PMID- 3276359 TI - [Monoclonal antibodies against the alpha-chain of human lymphocyte function associated antigen-1]. AB - The goal of the investigation was to further characterize ICO-II monoclonal antibodies. ICO-II have been shown to block NK activity of mononuclear cells from the blood of healthy donors against K-562 and Molt-4 target cells, cytotoxic T lymphocytes induced in a 7-day mixed lymphocyte culture, the reaction of lymphocyte blast cell transformation to phytohemagglutinin and the formation of En-rosettes. The molecular weight of the antigen detected by ICO-II is 180 KD. ICO-II are shown to detect alpha-subunit of human lymphocyte function-associated antigen-I (LFA-I). PMID- 3276360 TI - Cyclosporine v methotrexate for graft-v-host disease prevention in patients given marrow grafts for leukemia: long-term follow-up of three controlled trials. AB - One hundred seventy-nine patients with acute nonlymphoblastic leukemia in first remission (n = 75), chronic myelocytic leukemia in chronic or accelerated phase (n = 48) or leukemia in advanced stage (n = 56) were given HLA-identical marrow grafts and randomized to receive methotrexate or cyclosporine for prevention of graft-v-host disease (GVHD). The current report updates the three prospective trials with follow-ups ranging from 3.2 to 6.2 years after marrow grafting. Results were analyzed separately for each individual study and for all three studies combined. Overall, 40% of patients given cyclosporine and 55% of those given methotrexate developed acute GVHD (P = .13); the incidence of chronic GVHD was 42% and 48%, respectively (P = .67). Twenty-two percent of cyclosporine treated patients and 30% of methotrexate-treated patients developed interstitial pneumonia of any etiology (P = .25), and the figures for cytomegalovirus pneumonia were 18% and 20%, respectively (P = .41). The overall incidence of leukemic relapse was 31% in cyclosporine-treated patients and 36% in methotrexate treated patients (P = .75). The probabilities of survival for cyclosporine-v methotrexate-treated patients were comparable for all three study groups: 52% v 48% in patients with acute nonlymphoblastic leukemia (P = .42), 55% v 60% for those with chronic myelocytic leukemia (P = .61), 12% and 12% for those with advanced leukemia (P = .93), and 39% v 38% overall (P = .72). We conclude that cyclosporine and methotrexate are comparable regarding the likelihood of acute/chronic GVHD, interstitial pneumonia, leukemic relapse, and long-term survival. PMID- 3276361 TI - Augmentation of donor bone marrow engraftment in histoincompatible murine recipients by granulocyte/macrophage colony-stimulating factor. AB - T cell depletion of donor bone marrow can prevent graft v host disease (GVHD) in human and murine marrow graft recipients. However, engraftment in the recipient may be compromised as a consequence of donor marrow T cell depletion. The effect of recombinant murine granulocyte/macrophage colony-stimulating factor (rmu GM CSF) on engraftment and hematologic reconstitution was evaluated in a murine allogeneic bone marrow transplantation (BMT) model involving T cell depletion of marrow. Before transplantation into irradiated mice differing at major and minor histocompatibility loci, rmu GM-CSF was preincubated with T cell-depleted donor marrow. When low degrees of engraftment were noted in control recipients, treatment of donor marrow with high concentrations of rmu GM-CSF led to enhanced engraftment. Ex vivo donor graft incubation with rmu GM-CSF or a single in vivo injection of rmu GM-CSF were both effective means of promoting engraftment. When the engraftment rate in control recipients was high, rmu GM-CSF did not have an identifiable effect. Only slight increases in hematologic recovery were detected regardless of the rate of engraftment. Neither post-BMT survival nor marrow stem cell capacity was affected by rmu GM-CSF incubation. Furthermore, growth factor administration did not have a significant effect on the incidence of GVHD in recipients of non-T cell-depleted bone marrow splenocyte preparations. In vitro natural killer-mediated target cell lysis was not altered by incubation of effector cells with rmu GM-CSF. These results demonstrate the potential of ex vivo rmu GM-CSF treatment of donor marrow to facilitate engraftment across extensive histo-compatibility barriers. PMID- 3276362 TI - The correlation of breakpoint cluster region rearrangement and p210 phl/abl expression with morphological analysis of Ph-negative chronic myeloid leukemia and other myeloproliferative diseases. AB - The chromosome 22 derivative, the Philadelphia (Ph) chromosome, results from a reciprocal translocation t(9;22) (q34;q11) and is associated with chronic myeloid leukemia (CML). The translocation can be identified at the DNA level in Ph positive CML by using a probe to the breakpoint cluster region (bcr). In addition, as a result of this translocation an abl-related 210-kd protein with protein tyrosine kinase (PTK) activity is produced. We analyzed 28 cases of Ph negative CML for rearrangement of the chromosome 22 sequences and found that eight of the 28 show rearrangement of the bcr. When 12 of the Ph-negative cases were independently reviewed, five were indistinguishable from Ph-positive CML on the basis of morphology, peripheral blood film and clinical details. These five also showed bcr rearrangement. The other seven were reclassified as six atypical CML (aCML) and one chronic myelomonocytic leukemia (CMML). None of these seven showed bcr rearrangement. In addition 11 cases of bcr- CML were assayed for abl related PTK, and no detectable activity was present, whereas p210 phl/abl PTK was observed both in Ph-positive (three cases examined) and Ph-negative, bcr + (four cases examined) CML. Therefore, bcr + CML, whether or not the Ph chromosome is cytogenetically apparent, involves a similar molecular alteration and produces the 210-kd protein with enhanced PTK activity. Furthermore, these cases can be distinguished from Ph-negative bcr- CML by careful evaluation of clinical and hematologic data. PMID- 3276363 TI - c-sis but not c-fos gene expression is lineage specific in human myeloid cells. AB - Expression of both the c-fos and c-sis protooncogenes during myeloid differentiation has been detected in cells of the monocytic lineage. Since an increase in c-fos transcripts was not detected during dimethylsulfoxide induced HL-60 granulocytic differentiation, it was suggested that within the myeloid series c-fos gene expression might be lineage specific. In the present study, we have determined whether expression of the c-fos and c-sis genes is indeed specific for the monocytic pathway or rather common to both the granulocyte and monocyte pathways. C-fos and c-sis gene expression was analyzed in freshly isolated human granulocytes and monocytes, in human HL-60 promyelocytic leukemia cells induced to differentiate along the granulocytic or monocytic pathway, in myeloblasts from five patients with the M1 or M2 subtype of acute myeloblastic leukemia (AML) and in blasts from six patients with M4 myelomonocytic leukemia. The level of c-fos mRNA was fifteen times higher in granulocytes as compared with monocytes. An increase in c-fos expression was also found in HL-60 cells differentiated along the granulocytic pathway after exposure to hypoxanthine, hexamethylene bisacetamide, and the combination of retinoic acid and dibutyryl adenosine 3'5' cyclic monophosphate. Three of 5 M1 and M2 leukemic myeloblast preparations depleted of lymphoid and monocytic cells and all six M4 leukemic cells expressed c-fos transcripts. In contrast, c-sis gene transcripts were detectable in monocytes and during drug induced monocytic differentiation of the HL-60 cells but not in granulocytes during granulocytic differentiation of the HL 60 cells or in AML samples. Thus, in the myeloid series, c-sis gene expression is lineage specific while expression of the c-fos gene is found in both lineages and may be related to metabolic pathways common to both granulocytes and monocytes. PMID- 3276365 TI - Arthritis and interleukins. PMID- 3276364 TI - High-dose cytosine arabinoside: pharmacological and clinical aspects. PMID- 3276366 TI - Is measurement of beta 2-microglobulin worthwhile? PMID- 3276367 TI - Splenectomy and renal allograft survival in the rat. AB - The effect of splenectomy on renal allograft survival is not clear. In the rat, spleens isolated from recipients with functioning grafts have been shown to be a major source of cells that are capable of suppressing the rejection response (suppressor T lymphocytes). Thus the removal of the spleen in these allograft recipients could be detrimental to renal allograft survival. This study investigates this hypothesis, and looks for the presence of suppressor cells in other lymphoid organs apart from the spleen. In the rat renal allograft model, donor Lewis spleen cells given to DA recipients intravenously 1 week before transplantation of a Lewis kidney leads to indefinite allograft survival (median survival time (MST) greater than 100 days). Splenectomy before or after pretreatment with donor spleen cells failed to abrogate this effect (MST greater than 100 days). Experiments were performed in which cells or serum were prepared from long-term surviving splenectomized animals which had already been pretreated and transplanted, and then were injected into untreated recipients (adoptive transfer experiments). This was done to determine if cells capable of suppressing graft rejection were present in lymphoid organs outside the spleen in these splenectomized recipients. Thus the IV transfer of 10(8) lymph node cells harvested from splenectomized DA recipients with a long-term surviving LEW graft (LTS), into untreated but lightly irradiated (200 rad) DA recipients resulted in indefinite survival of a fresh Lewis kidney (MST greater than 100 days). In contrast, adoptive transfer of normal DA lymph node cells was ineffective (MST 13 days). Thus splenectomy is not necessarily detrimental to graft survival, as cells capable of preventing graft rejection are found in other lymphoid organs, such as lymph nodes, in splenectomized recipients. PMID- 3276368 TI - Abdominal tuberculosis. PMID- 3276369 TI - Triple therapy in cadaver renal transplantation. AB - One hundred consecutive first (n = 72) and regrafted (n = 28) cadaver renal allograft recipients were immunosuppressed with cyclosporin, azathioprine and prednisolone (triple therapy) and followed for a median of 17.3 months (range, 7 26 months). Actuarial patient survival at 12 and 24 months was 97.7 per cent. Actuarial graft survival at 12 and 24 months was 79.5 per cent (first graft recipients 81.3 per cent and regrafted recipients 75 per cent). HLA-DR matching significantly improved graft survival which was 93 per cent at 1 year in patients given HLA-DR compatible kidneys, compared with 83 and 54 per cent, respectively, in patients who received kidneys mismatched for one or two HLA-DR antigens. There were 0.8 (s.d. = 0.7) episodes of acute rejection per patient during the first 3 months after transplantation. Triple therapy provides effective immunosuppression without evidence of over immunosuppression and reduces the incidence of cyclosporin side-effects. Although acute nephrotoxicity was uncommon, serum creatinine remained elevated 6 and 12 months after transplantation. PMID- 3276370 TI - Cesarean section. AB - Cesarean section has become a common operation, but its complexity should not be underestimated. Often it must be done as an emergency without skilled assistants; at the same time the surgeon must deal with the maternal disorder that prompted the cesarean section and ensure the well-being of the fetus. Of further concern is the operative blood loss, which can be massive, and the postoperative morbidity, which is often high. The operative technique has evolved from an intraperitoneal vertical incision on the body of the uterus (classical cesarean section) to a near-complete reliance on a retroperitoneal transverse incision (lower segment cesarean section). The historic reason for this change was the fear of peritonitis postoperatively. Present-day practice favours the lower segment operation and emphasizes the reduced operative blood loss and the more secure uterine scar as reasons for the choice. Operative complications (injury to the fetus, lacerations of the uterus and vagina) are the result of inadequate uterine incisions. The classical incision has the advantage of being easily extended and thus has a continued purpose. Postoperative febrile morbidity is attributed to endometritis; the mixed aerobic and anaerobic bacteria of the vagina are the causal organisms. Febrile morbidity can be prevented by antibiotics given prophylactically. PMID- 3276371 TI - Staple versus suture closure of skin incisions in a pig model. AB - The purpose of this study was to find out whether skin staple closure was a reasonable alternative to conventional nylon suture closure. Mechanical strength, histologic characteristics and time of closure were compared in skin incisions made on the backs of Yorkshire swine. The results showed that stapled and sutured wounds have similar mechanical strength up to 21 days. Stapled wounds are substantially narrower and are associated with less inflammation than sutured wounds. Staple closure is much less time-consuming than suture closure. PMID- 3276372 TI - Coagulopathy induced by aortoiliac aneurysms. AB - Diffuse intravascular coagulopathy (DIC) or consumptive coagulopathy is infrequently associated with aortic aneurysms. When the two coexist, they create a difficult clinical problem that requires optimal medical and surgical care. Two cases of coagulopathy associated with aortoiliac aneurysm are presented to exemplify the broad clinical picture that can be present. The definitive treatment of DIC is removal of the underlying cause. The following recommendations are made for the management of patients with aortic aneurysms and possible coagulopathy: preoperatively examine the patient for hematomas and ecchymoses; measure levels of fibrinogen, platelets and fibrin degradation products and the prothrombin and partial thromboplastin times; perform arteriography and check puncture sites for spontaneous bleeding afterwards; at aneurysm repair ensure meticulous hemostasis and compensate for excessive blood loss by high-speed autotransfusion. PMID- 3276373 TI - The carotid endarterectomy study. PMID- 3276374 TI - Results of bone grafting of tibial defects in uncemented total knee replacements. AB - Bony defects of the articular surface are frequently encountered in total knee replacement. As an alternative to excising more tibia and using a thicker tibial component, autogenous bone grafts have been used to fill these defects. The authors have analysed 43 cases in which bone grafts were used in conjunction with an uncemented tibial component. The follow-up was 2 to 7 years. The results in these cases were compared with those in a similar group using uncemented components in which bone grafting was not required. There were 15 central grafts and 28 edge grafts. All the edge grafts and seven large central grafts were fixed with screws. If the graft size was more than 1 cm2, patients were not permitted to bear weight for 4 to 6 weeks. In the others, weight bearing was allowed immediately. All grafts united, most within 6 months, and substantial collapse was not observed. Notable sinking of the tibial component occurred in one late case, in which a rotatory subluxation developed due to patellar dislocation. Collapse of the graft in a recent case, however, suggests that when large grafts are used, a heavy central stem should be used on the tibial component. PMID- 3276375 TI - Total replacement of the transverse aortic arch with the Gott aneurysm shunt. AB - A new method of temporary external shunting for total replacement of the aortic arch is described. Its greatest advantage is that systemic heparinization is not required. In a 46-year-old man total body perfusion was achieved with two 9-mm Gott aneurysm shunts inserted between the ascending aorta and both femoral arteries. Blood supply to the brain was maintained with the cut halves of a 7-mm Gott shunt connected as side branches to one of the 9-mm shunts, allowing cannulation of both carotid arteries. The total cardiac output, measured at 4.7 L/min by the thermodilution technique through a Swan-Ganz catheter, was propelled through these preheparinized multibranch shunts. A flowmeter adapted on one of the 9-mm Gott shunts demonstrated a shunt flow of 2000 ml/min and it was deduced that the other 2700 ml of the total cardiac output was delivered by the other shunt. During the 29 minutes of cross-clamping, there was no change in the filling pressure of either the right heart (central venous pressure 5 cm H2O) or the left heart (pulmonary wedge pressure 8 mm Hg). Aortic continuity was reestablished with the interposition of a 34-mm tubular woven Dacron prosthesis, on which two 10-mm woven Dacron side branches were anastomosed to the innominate and left common carotid arteries. The patient had no neurologic deficit and had normal physiologic function of all other organs. PMID- 3276376 TI - Elderly long-stay surgical patients. AB - This paper examines long hospital stays (more than 30 days) among 196 surgical patients over 65 years of age in two acute-care hospitals. Patients in the long stay group--54 (28%) of the 196--were not demographically different from the others but showed a significantly (p less than 0.05) higher rate of cognitive impairment, dependence before admission and admission through the emergency department. Although these patients more often required catheterization and were nursed in bed or in "gerichairs", many were suitable for discharge to the community if appropriate accommodation could have been found. PMID- 3276377 TI - Chloroquine-resistant Plasmodium falciparum malaria from Cameroon. PMID- 3276378 TI - The irritable bowel syndrome. AB - The irritable bowel syndrome (IBS) is an extremely common disorder. It is believed to occur usually after emotional stress and perhaps because of behavioural and dietary factors. There is definite evidence of disturbed gastrointestinal function associated with IBS; however, a diagnostic marker remains elusive. The current trend is to diagnose IBS on the basis of the patient's history and the findings at physical examination and after minimal investigation. The physician-patient relationship remains the most important factor in the management of IBS. Long-term benefit may be achieved with the use of dietary fibre supplements or stool-bulking agents. The evaluation of currently available drugs is difficult because of the placebo effect. Drug therapy should be aimed at specific symptoms and used mainly during the initial phase of treatment. PMID- 3276379 TI - Anthracyclines in the treatment of malignancy in pregnancy. AB - This article reports two cases and reviews the literature regarding chemotherapy using anthracyclines during pregnancy. Twenty-six additional cases using this class of agents to treat malignancy during pregnancy are summarized from 18 reports for a total of 28 pregnancies. Final outcome of pregnancy is analyzed with regard to the following factors: diagnosis, gestational age at start of therapy, total dose of anthracycline, number and type of agents used, neonatal pathologic findings and months of follow-up of infants. Final outcome of 28 pregnancies resulted in 24 normal infants including a set of twins in the current report. Limited pharmacokinetic information is inconclusive with regard to the appearance of anthracyclines and their known metabolites in placental or fetal tissue. PMID- 3276380 TI - Congenital self-healing histiocytosis (Hashimoto-Pritzker). An ultrastructural and immunohistochemical study. AB - Congenital self-healing histiocytosis (CSHH) is a rare primary histiocytic skin disorder. Only a few cases have been studied by ultrastructure and immunohistochemistry. Here we report a new case that was investigated using an electron microscope and a panel of monoclonal (MCA) and polyclonal (PCA) antibodies. CSHH cells were found to bear the immunohistochemical phenotype of normal epidermal Langerhans cells (LC) and histiocytosis X (HX) cells (CD1a/c+, CD1b-, CD4+/-, human leukocyte antigen [HLA]-DR/DQ+, S-100+). However, an electron microscope showed a paucity of Birbeck granule (BG)-containing cells. This contrasted with their immunophenotype. This finding, along with other ultrastructural characteristics of CSHH cells, suggests that histologic differences exist between CSHH and HX. However, because no absolute histologic criterion is known that allows unequivocally the differential diagnosis between the two diseases, this distinction currently has to rely on clinical criteria, mainly the regressive course observed within a few months in CSHH. The precise nosologic position of CSHH among other histiocytic syndromes remains unsettled. PMID- 3276381 TI - Alveolar soft part sarcoma. A cytologic and immunohistochemical study. AB - Alveolar soft part sarcoma is an uncommon soft tissue tumor that has seldom been studied by cytologic methods. The cytomorphologic features of two cases of this sarcoma are described. To enhance diagnostic accuracy in a suspected alveolar soft part sarcoma, the authors present the differential diagnosis and the application of immunocytochemical procedures to cytologic specimens. PMID- 3276382 TI - Vertebral compression fracture as a presenting feature of acute lymphoblastic leukemia in children. AB - Twenty-four (1.6%) of 1466 children with acute lymphoblastic leukemia (ALL) treated at St. Jude Children's Research Hospital had vertebral compression fractures at diagnosis. When compared with patients without this complication, they were more likely to have good prognostic features, including a leukocyte count of greater than 25 X 10(9)/l, a leukemic cell DNA index of greater than 1.15, and hyperdiploidy (greater than 50 chromosomes). Complete remission of ALL was induced in all patients, and symptoms of vertebral compression fractures abated following antileukemia therapy. Although the diagnosis of ALL was delayed for some patients because this unusual presenting complication was not recognized as such, their treatment outcome was as good as that for other children with "standard-risk" ALL. PMID- 3276383 TI - Sarcoma metastatic to the brain. AB - Five patients with nonlymphomatous sarcoma metastatic to the brain are presented and the literature reviewed. In 50 patients, brain metastasis was verified pathologically and some case data were available, including the five reported here. In five patients, there was pathologic verification but no case data. Thirty-nine other patients were found without such verification. Reportedly, most types of sarcomas are able to metastasize to the brain, and are represented in these 94 patients. Fibrosarcoma and alveolar soft-part sarcoma tumors metastasize to the brain without regard to treatment technique. There may be a group of tumors, including malignant fibrous histiocytoma, rhabdomyosarcoma, and perhaps leiomyosarcoma and osteosarcoma, in which the incidence of brain metastases has increased with improved sarcoma chemotherapy (CT). In this group particularly, but also in alveolar soft-part sarcoma and others, the presence of lung metastases may increase the probability of brain metastasis occurring subsequently. PMID- 3276384 TI - The role of regional hyperthermic cytostatic perfusion in the treatment of extremity melanoma. AB - To evaluate the effectiveness of regional hyperthermic cytostatic perfusion in patients with malignant melanomas of the extremities, 107 patients were included in a prospective randomized study. In a control group (A, n = 54) the tumors were widely excised, and the regional lymph nodes were dissected. The patients in the perfusion group (B, n = 53) received additional hyperthermic (42 degrees C) perfusion with melphalan. The disease-free survival time was chosen as the criterion for success. An intermediate evaluation (average follow-up observation period of 550 days) revealed a highly significant difference between the groups (P = 0.0001): 21 recurrences in the control group versus four recurrences in the perfusion group. In a second analysis 3 1/2 years after premature discontinuation, 26 recurrences were diagnosed in Group A, whereas only six recurrences were noted in Group B (P = 0.0001). A retrospective analysis of the entire test group revealed the following figures. In Group A seven recurrences in Stage I were diagnosed, seven in Stage II, and 12 in Stage III. In Group B one was observed in Stage I, one in Stage II, and four in Stage III. The level of significance was calculated to be P = 0.05 in Stage I, P = 0.05 in Stage II, and P = 0.01 in Stage III. The results of the study show that additional perfusion in the treatment of extremity melanomas is superior to conventional methods. PMID- 3276385 TI - Diagnostic application of panels of antibodies in mucosal melanomas of the head and neck. AB - This article describes the use of panels of antibodies in the histopathologic diagnosis of ten malignant melanomas arising in the mucosa of the head and neck. The immunohistochemistry analysis was performed in a step-by-step manner. In the first step a panel of antibodies discriminating between carcinoma, malignant lymphoma, and melanoma was used. Staining with antivimentin and the melanoma associated antigen, moAb NKI/C-3, was found to occur in all cases. The NKI/C-3 stained nine of 10 specimens from the first biopsy. Anti-S-100 protein, anti-HMW MAA, and NKI-beteb was used as a panel in the second step. These stained ten of ten, five of six, and seven of seven cases, respectively. The diagnosis for melanin was confirmed by extensive sampling and a diligent search for melanin and (pre)melanosomes in different biopsy and surgical specimens. These results indicate that a step-wise application of immunohistochemistry is a very useful tool in the diagnosis of mucosal melanoma of the head and neck. PMID- 3276386 TI - Immunohistochemical demonstration of steroid C-21 hydroxylase in normal and neoplastic salivary glands. AB - The presence of steroid C-21 hydroxylase in normal and neoplastic salivary glands was investigated immunohistochemically with the use of antibody against cytochrome P-450 specific for steroid 21-hydroxylation (P-450C21). In normal salivary glands, P-450C21 was exclusively present in the excretory duct system (intercalating, striated and large excretory ducts), and not observed in acini. In salivary gland tumors, P-450C21 was observed in most epithelial cells of duct origin within pleomorphic adenomas including cells of amorphous groups scattered in myxoid areas, and in adenolymphoma. Some mucous cells in mucoepidermoid tumor also were positive for this enzyme. These findings in the normal and neoplastic salivary gland suggest that the expression of P-450C21 is closely related to ductal differentiation. PMID- 3276387 TI - Immunohistochemical distribution of S-100 protein in tumors and tumor-like lesions of bone and cartilage. AB - Various tumors and tumor-like lesions of bone and cartilage were examined for S 100 protein using the avidine-biotin-peroxidase complex (ABC) immunostaining method. The most intense reactivity for S-100 protein was found in well differentiated chondrocytes of enchondromas, osteochondromas and chondrosarcomas, and in normal epiphyseal cartilage. S-100 protein was positive in both polygonal stromal cells and chondrocytes of chondroblastomas and in chondrocytes of mesenchymal chondrosarcoma. In osteosarcomas not only chondroblastic areas but also osteoblastic areas showed positive cells. Reticulum histiocytic cells of eosinophilic granulomas and chordoma cells were positive for S-100 protein. The study yielded three main conclusions: (1) S-100 protein could be the marker for tumors of cartilaginous origin and differentiation, notochord origin, and T-zone histiocyte origin; (2) chondroblastoma can be distinguished from other histologically confusing giant cell lesions by using ABC to detect S-100 protein; and (3) S-100 protein has some relationship with tumoral calcification not only in cartilaginous tumors but also in osteosarcoma. PMID- 3276388 TI - Ectopic insulin production by a primary ovarian carcinoid. AB - An insulin-containing ovarian carcinoid was found at the autopsy of a 63-year-old woman with a 12-year history of episodic hyperinsulinemic hypoglycemia. In terms of histology, the carcinoid displayed both insular and trabecular patterns and contained a small focus of mucinous cystadenoma. Beta secretory granules were demonstrated by electron microscopy, and immunoreactivity for insulin was demonstrated in tumor cell cytoplasm by immunohistochemistry. Additional autopsy findings included a solitary parathyroid adenoma and a microscopic focus of pituitary hyperplasia. This is the first recorded case of insulin production by a primary ovarian neoplasm. The patient's constellation of endocrine findings may represent a variant of the syndrome of type I multiple endocrine neoplasia. PMID- 3276389 TI - Estimating the quality of life in a clinical trial of patients with metastatic lung cancer using the Karnofsky performance status and the Functional Living Index--Cancer. AB - Serial assessments of Karnofsky performance status (KPS) and of the Functional Living Index--Cancer (FLIC) have been used to estimate the quality of life (QOL) of patients in a prospective, randomized trial of supportive care versus supportive care given with combination chemotherapy to patients with metastatic non-small cell lung cancer. There was a good correlation between KPS and FLIC scores at study entry, thus confirming results originally reported using the FLIC. However, a number of unexpected problems were encountered in data collection and quality control with this QOL assessment instrument. This made it impossible to look for differences in treatment effect on QOL in this clinical trial. It is believed that QOL assessment should be an integral part of cancer clinical trials; however, investigators must acknowledge the difficulties in collecting this type of data. The development of new instruments and the refinement of old ones will facilitate the collection of data for this important aspect of clinical trials research. PMID- 3276390 TI - Osteosarcoma of the limbs. Report of the EORTC-SIOP 03 trial 20781 investigating the value of adjuvant treatment with chemotherapy and/or prophylactic lung irradiation. AB - The European Organization for Research on Treatment of Cancer (EORTC) trial 20781, concerning osteosarcoma of the limbs is reported. After definitive treatment of the primary tumor with amputation or irradiation, adjuvant treatment was given, randomized into either 9 months of chemotherapy according to a modified Rosen schedule, or elective bilateral lung irradiation of 20 Gy, or 3 months of chemotherapy followed by lung irradiation. The 4-year disease-free survival and total survival were 24% and 43%, respectively, with no difference between the treatment arms. In the radiotherapy arms the lung metastases were more frequently suitable for surgical treatment. The survival of patients with either tibia localizations or higher age was somewhat better. Local recurrences occurred in 16% of patients, 50% of them with distant metastases. The trial was executed from 1978 to 1983; 205 patients were evaluable and eligible, and three toxic deaths occurred in the chemotherapy arms. Elective lung irradiation provided the same survival as the adjuvant chemotherapy given in that time. PMID- 3276391 TI - Caffeine ingestion and breast cancer. A negative correlation. AB - The potential association of breast cancer and caffeine intake was examined using international aggregate data. Death rates from breast cancer were correlated with caffeine ingestion from tea and coffee sources in 44 countries. By using multiple regression analysis, the authors demonstrated that 85% of the international variation in breast cancer rates is associated with variations in fat intake. When this is accounted for, the partial correlation of breast cancer rates with caffeine intake is negative (and significant at P less than 0.05). When the data are weighted by populations in each country, the negative partial correlation of caffeine with breast cancer disappears, but the strong positive association with fat intake remains unchanged. Although there have been suggestions that caffeine exacerbates fibrocystic disease of the breast and may be a causal factor in breast cancer, data from this study do not support a positive association between caffeine intake and subsequent development of breast cancer. PMID- 3276392 TI - Immunohistochemical demonstration of ras p21 oncogene product in normal, benign, and malignant human thyroid tissues. AB - The p21 protein product of the cellular oncogene ras, designated ras p21, has been detected immunohistochemically in normal, benign and malignant human thyroid tissues. With the monoclonal antibody RAP-5 generated against a synthetic peptide corresponding to amino acid positions 10 to 17 of the ras p21 protein and an avidin-biotin-peroxidase complex (ABC), the expression of the ras p21 was evaluated in paraffin-embedded sections. Western blot analysis using fresh thyroid carcinoma tissue revealed double protein bands, one band was at molecular weight 21,000 and the other was a more rapidly migrating band at the molecular weight 17,500. Immunohistochemically, papillary adenocarcinomas of the thyroid showed moderate to intense stainings for ras p21 in most cases. Cytoplasmic and apical surface stainings were the most common patterns of immunoreactivity. Adenomas showed variable ras p21 positivity in cytoplasm and apical surface stainings of adenomas were negative to borderline in most cases. The cytoplasm of tissues of Hashimoto's thyroiditis, Graves' disease, and normal thyroid tissues was uniformly ras p21 positive, but the apical cell surface was nonreactive for ras p21 in all tissues. Judging from the findings obtained on this large series of normal, benign, and malignant thyroid tissues, the elevation of ras p21 may be a common event in thyroid neoplasm, and especially elevated ras expression in the apical cell surface may be characteristic to papillary carcinomas of the thyroid. This suggests that apical surface expression of ras p21 may be important in the development of thyroid carcinomas and be useful in differentiation of papillary adenocarcinoma. PMID- 3276393 TI - An immunochemical and immunohistochemical study of S100 protein in renal cell carcinoma. AB - The authors localized S100 protein in renal tubules and renal cell carcinoma by immunohistochemical study and quantitative analysis by enzyme immunoassay. The alpha subunit of S100 protein (S100-alpha) was localized in epithelial cells of proximal tubules, thin limbs of loops of Henle, collecting tubules, and a few of Bowman's capsules. The beta subunit (S100-beta) was immunostained in the distal tubules, thick and thin loops of Henle, collecting tubules, and a few proximal tubules. In renal cell carcinoma, S100-alpha was immunohistochemically demonstrated in 82% (41/50) of patients including sarcomatoid variants, whereas S100-beta was detected in 46% (23/50). Both the number of positively stained tumor cells and the staining intensity were greater in S100-alpha than in S100 beta. Concentrations of S100-alpha in the cortex were 80.3 +/- 22.5 ng/mg protein (n = 7), whereas those of renal cell carcinoma were 387 +/- 533 ng/mg protein (n = 19), i.e., about five times higher. Concentrations of S100-beta in both normal kidney (1.96 +/- 0.74 ng/mg protein) and renal cell carcinoma (2.05 +/- 2.16 ng/mg protein) were much lower than those of S100-alpha. The authors also localized S100-alpha and S100-beta in tissues of other renal tumors and tumors arising from other organs. S100a0 appears to be a useful immunohistochemical marker for renal cell carcinoma. PMID- 3276394 TI - Imaging diagnosis of bile duct cystadenocarcinoma. AB - Two patients with surgically resected biliary cystadenocarcinoma are presented. Both were asymptomatic and the cancer was incidentally found by ultrasonography (US). In the first case, a huge multilocular tumor (21 X 15 cm in diameter) having many papillary projections and septa within it and small daughter lesions occupied both the right anterior and left medial areas of the liver. They were clearly demonstrated on US and computed tomography (CT). Angiography disclosed tumor vessels in some area of the lesion, these features strongly suggested cystadenocarcinoma. The second case had a solid mass (7 X 7 cm) in the left hepatic lobe, in which many septal structures within the lesion were seen on enhanced CT and light dot like stains were recognized on angiography. The former findings coincided with the internal gross feature of the resected specimen. Both patients are doing well 8 months and 1 year and 6 months after operation, respectively. PMID- 3276395 TI - Dual-parameter flow cytometry of transitional cell carcinomas. Quantitation of DNA content and binding of carbohydrate ligands in cellular subpopulations. AB - Quantitative DNA measurements and estimates of blood group-related carbohydrate antigen expression have been used as predictive parameters in transitional cell carcinomas (Ca). To obtain an accurate quantitative characterization of cellular subpopulations on the basis of these parameters, the authors developed a dual parameter flow cytometric method using a fluorescence-activated cell sorter. With this method single-cell suspensions from 26 transitional cell carcinomas were analyzed by means of propidium iodide (red fluorescence) as DNA ligand, and peanut agglutinin (PNA), wheat germ agglutinin (WGA), and anti-blood group A antibody (aBGA) as carbohydrate ligands. The latter ligands were visualized directly or indirectly by FITC (green fluorescence). The carbohydrate ligand binding was correlated to the DNA content of cell populations in the way that aneuploid populations showed a higher PNA binding (P less than 0.0002) and a lower WGA (P less than 0.01) and aBGA (P less than 0.04) binding than did diploid cell populations. The binding of PNA to aneuploid populations could be further increased (P less than 0.004) by neuraminidase treatments. Thus, aneuploid cells express both neuraminic acid substituted and unsubstituted PNA receptors. The carbohydrate ligand binding was cell cycle-dependent, as it was reduced (less than 0.008) in the G2-M phase. A low WGA (P less than 0.004) or aBGA (P less than 0.02) binding was correlated to tissue invasion. Immunohistochemistry with the carbohydrate ligands showed a good correlation between aBGA (P less than 0.0005) and PNA (P less than 0.004) binding to tumor cells and flow cytometric assay of these, as well as a correlation (P less than 0.003) between cellular location of WGA receptors and flow cytometric assay of these. It seems that dual-parameter flow cytometry represents an important tool in the characterization of bladder tumors. PMID- 3276396 TI - Clinical evaluation of tumor characteristics predisposing serum thyroglobulin to be undetectable in patients with differentiated thyroid cancer. AB - This study delineates tumor characteristics which predispose serum thyroglobulin (TG) to be undetectable in patients in spite of persistent or recurrent differentiated thyroid cancer. Three hundred seventy four thyroid carcinoma patients with completed thyroid ablation were investigated by means of conventional diagnostic procedures (131 iodine total-body scan, x-ray, TG determination) and, in addition, with high-resolution sonographic study of the neck. Sensitivity of TG for the detection of metastases amounted to 83% under TSH stimulation and 50% under thyroxine (T4) treatment. Specificity proved to be 95% under TSH stimulation and 99% under T4 treatment. Common features of the tumors associated with false-negative TG determinations (n = 16) were papillary histologic characteristics, manifestation in lymph nodes of the neck or mediastinum, and small size. It is therefore necessary for the early detection of persistent or recurrent papillary cancer metastases to perform in addition to 131 iodine scans high-resolution sonography of the neck in combination with the determination of TG serum concentrations under endogenous TSH stimulation. PMID- 3276397 TI - Expression of Ha-ras oncogene products in human neuroblastomas and the significant correlation with a patient's prognosis. AB - Neuroblastomas represent a spectrum of diseases categorized by histological subtypes, age of the patient, and extent of tumor (stage) at diagnosis. In this study we analyzed Ha-ras p21 (protein with molecular weight of 21,000) expression immunohistochemically on 47 primary human neuroblastomas resected at diagnosis. The data demonstrate that the amount of the Ha-ras product correlates with a favorable prognosis (P less than 0.001) and early stages of disease at diagnosis (P less than 0.05). These findings from unmanipulated human neuroblastomas indicate that the Ha-ras gene product (p21) might play a role in the mechanism(s) controlling aggressiveness in this type of tumor in vivo and that the Ha-ras p21 detected by a simple and reproducible immunohistochemical procedure may be of clinical importance in predicting prognosis in patients with this malignancy. PMID- 3276398 TI - Increased resistance to cis-diamminedichloroplatinum(II) in NIH 3T3 cells transformed by ras oncogenes. AB - The genetic basis of cellular resistance to the anticancer drug cis diamminedichloroplatinum(II) (CP) is not well understood. In the course of identifying genes from human tumors capable of conferring resistance to CP, we tested the ability of several types of cellular and viral ras oncogene (H, K, and N) to alter the CP response of mouse cells. Using clonogenic assays, we found that NIH 3T3 fibroblasts transformed with missense mutation-activated ras oncogenes demonstrated substantially increased resistance to 1-h exposures to CP (P less than 0.05 to less than 0.001, at different drug concentrations), with 50% inhibitory concentration ratios (compared to NIH 3T3) of 4.5-8.5. Cells transformed with v-mos v-fms, and with a normal ras protooncogene activated by overproduction driven by an MLV ltr, demonstrate intermediate resistance (50% inhibitory concentration ratio, approximately 2.0). Cells transfected with the pSV2neo plasmid or with human genomic DNA that is not transforming had survival curves no different from those of NIH 3T3. ras genes are highly conserved in mammalian cells. Should these findings also prove to apply to human tumors, the presence of activated ras genes might help predict clinical response to CP. PMID- 3276399 TI - Leukemia L1210 cell lines resistant to ribonucleotide reductase inhibitors. AB - Leukemia L1210 cell lines, ED1 and ED2, were generated which were resistant to the cytotoxic effects of deoxyadenosine/erythro-9-(2-hydroxyl-3-nonyl)adenine and deoxyadenosine/erythro-9-(2-hydroxyl-3-nonyl)adenine plus 2,3-dihydro-1H pyrazole[2,3a]imidazole/Desferal, respectively. The ED1 and ED2 were characterized to show that these cell lines had increased levels of ribonucleotide reductase as measured by CDP reduction. The reductase activity in crude cell-free extracts from the ED1 and ED2 cells was not inhibited by dATP. For CDP reductase, the activation by adenylylimido diphosphate and inhibition by dGTP and dTTP in these extracts from the ED1 and ED2 cells were the same as for the wild-type L1210 cells. The ED1 and ED2 cells were highly cross-resistant, as measured by growth inhibition, to deoxyguanosine/8-aminoguanosine, 2 fluorodeoxyadenosine, and 2-fluoroadenine arabinoside. While the ED2 cells showed resistance to 2,3-dihydro-1H-pyrazole-[2,3a]-imidazole/Desferal (6-fold), the ED1 and ED2 cell lines showed less resistance to hydroxyurea, 4-methyl-5-amino-1 formylisoquinoline thiosemicarbazone, and the dialdehyde of inosine. These data indicate that the mechanisms of resistance to the ribonucleotide reductase inhibitors are related to the increased level of ribonucleotide reductase activity and to the decreased sensitivity of the effector-binding subunit to dATP. PMID- 3276400 TI - Transforming growth factors produced by normal and neoplastically transformed rat liver epithelial cells in culture. AB - The secretion of transforming growth factors (TGFs) alpha and beta by normal, chemically transformed, and malignant rat liver epithelial cell lines was investigated. The WB-F344 normal cultured rat liver epithelial cell line does not secrete an epidermal growth factor-like (putatively TGF-alpha) activity, but several clonal cell strains derived from WB-F344 cells which had been treated with N-methyl-N'-nitro-N-nitrosoguanidine, especially those that expressed high levels of gamma-glutamyl transpeptidase, secreted TGF-alpha-like activity into their conditioned media. Cell lines obtained from tumors which were produced by these cell strains varied in their abilities to secrete TGF-alpha, even though they all expressed high levels of gamma-glutamyl transpeptidase activity. When two of the non-TGF-alpha-secreting tumor cell lines were transplanted into isogeneic rats, the tumors that formed contained high levels of TGF-alpha-like activity. Although epidermal growth-factor (hence, TGF-alpha also) inhibited the proliferation of several of these tumor cell lines in monolayer cultures, this growth factor often paradoxically stimulated the anchorage-independent growth of the same cell lines. In contrast to TGF-alpha-like activity, all cell lines/strains released TGF-beta activity into their conditioned media. However, while both normal or chemically transformed cell strains typically produced the inactive form of TGF-beta, the tumor cell lines tended to produce activated TGF beta de novo. Anchorage-independent growth of cell lines that produced active TGF beta was either stimulated, inhibited, or unaffected by TGF-beta. Cell lines that were inhibited by TGF-beta concurrently produced TGF-alpha which was usually able to overcome the negative "autocrine" effect of TGF-beta. We conclude that both TGF-alpha and TGF-beta, singly or in combination, are variously involved in the growth of transformed rat liver epithelial cells. TGF-alpha has a predominantly positive autocrine action on the growth of rat liver epithelial tumor cell lines. The "paracrine" effect of TGF-beta may be at least as important as its autocrine effect in the growth of these transformed epithelial cell lines. PMID- 3276401 TI - L-arabinose resistance test with Salmonella typhimurium as a primary tool for carcinogen screening. AB - The L-arabinose resistance test with Salmonella typhimurium (Ara test) is a forward mutation assay which selects a single phenotypic change (from L-arabinose sensitivity to L-arabinose resistance) in a unique tester strain (an araD mutant). The present study examined the ability of the Ara test to identify as mutagens different classes of chemical carcinogens, including six with detection problems in most bacterial assays. A noncarcinogen related in chemical structure to the selected carcinogen was included whenever possible. A total of 25 organic compounds was assayed by means of a standard mutagenesis procedure: the plate incorporation test in the presence (if required) of 10% S9 from rat liver induced with Aroclor 1254. Chemicals giving negative or inconclusive results were then retested using other common in vitro mutagenesis conditions. The Ara test detected as mutagens all but one (Urethane) of the 15 established carcinogens and six out of the nine chemicals with questionable or nonassayed carcinogenicity. The compound mutagenic at the lowest dose was ethionine (0.57 nmol), one of the carcinogens undetected by the popular histidine reverse mutation assay (Ames test) or by the SOS chromotest. Actually, only benzo(a)pyrene was found mutagenic at a dose (0.77 nmol) close to that of ethionine. The data reported in this paper suggest that the Ara forward mutation test is less prone than the His reverse mutation test or the SOS chromotest to misclassify as negative carcinogenic compounds. Consequently, it should be considered as an alternative to other bacterial assays in general, massive, and primary screening for genotoxic carcinogens. PMID- 3276402 TI - Detection of a low frequency of activated ras genes in human melanomas using a tumorigenicity assay. AB - We have used an assay combining DNA-mediated gene transfer and tumorigenicity in Swiss athymic mice to look for activated ras genes in solid human sporadic melanomas. This assay can detect ras oncogenes mutated at codons 12, 13, or 61. We examined a panel of 13 independent surgical specimens of primary tumors and metastases. No H- or K-ras oncogenes were detected; an N-ras oncogene, mutated at codon 61, was identified in one of the 13 samples. No N-ras genes mutated at codon 13 were detected. Thus, the tumorigenicity assay detects a low frequency of ras gene activation in melanomas. PMID- 3276403 TI - Characterization of a factor(s) which synergizes with recombinant interleukin 2 in promoting allogeneic human cytolytic T-lymphocyte responses in vitro. AB - Supernatants from PHA-activated human peripheral blood mononuclear cells, depleted of virtually all IL-2 activity by an anti-rIL-2 immunoadsorbent column, contain a factor(s) which synergizes with rIL-2 in facilitating the generation of allogeneic human CTL responses in vitro. This factor, provisionally termed CTL maturation factor (TcMF), did not appear to promote CTL responses in the absence of rIL-2. Furthermore, it acted later than IL-2 in facilitating CTL responses and could not be replaced by recombinant IFN-gamma. In this report we show that rIFN alpha, rIL-1 alpha, and rIL-1 beta likewise lack TcMF activity. The TcMF activity in lymphokine-containing culture supernatants could be eliminated by trypsin or pronase but not by neuraminidase or RNase. Gel filtration revealed two peaks of TcMF activity, one at 12,000 to 25,000 Da and the other at 45,000 to 65,000 Da. Isoelectrofocusing demonstrated substantial charge heterogeneity. The majority of TcMF activity was recovered between pI 4.0 and pI 5.5 with a minor component at pI 6.5, corresponding to the areas in which IL-1 activity was also found. However, TcMF activity could be separated from IL-1 by reverse-phase HPLC. Moreover, TcMF recovered following reverse-phase HPLC was also found to be depleted of IL-4 activity. These studies suggest that TcMF activity is mediated by a protein(s) distinct from IL-1, IL-2, IL-4, and interferon-alpha or-gamma. PMID- 3276404 TI - Induction of anomalous killing activity from antigen-specific CTL clones by adding high doses of human recombinant interleukin 2. AB - Four out of six long-term murine cytotoxic T lymphocyte (CTL) clones specific for trinitrophenyl (TNP)-modified spleen cells could develop an anomalous cytotoxicity against syngeneic and allogeneic tumor cells upon stimulation with TNP-modified spleen cells and high doses of human recombinant interleukin 2 (rIL 2). On FACS analysis, hyperactivated CTLs were positive for Thy-1, Ly 2 and LFA 1, but negative for L3T4 and asialo GM1. The staining profile of the cells with each antibody indicated that the CTL clones consisted of just one cell type. Monoclonal anti-Ly 2.2 and anti-LAA (lymphokine-activated cell-associated antigen) antibodies inhibited cytolysis of CTL and hyperactivated CTL clones against TNP-modified spleen cells, but failed to inhibit the anomalous killing of the hyperactivated CTL. The cold target competition test suggested the degeneracy of antigen specificity. The present study demonstrated that the CTL clone acquired a new specificity for tumor target cells upon stimulation with a high dose of rIL-2. PMID- 3276405 TI - Intestinal absorption of proteins and macromolecules and the immunological response. AB - Progress in the field of biotechnology has renewed interest in the oral delivery of macromolecules, in particular, proteins and peptides. While small quantities of proteins may be absorbed from the gastrointestinal tract intact, enzymatic degradation and poor absorption have historically limited protein administration to the parenteral route. By consideration of the mechanisms of macromolecular absorption from the gut, it may be possible to exploit physiological processes to promote protein uptake. However, the response of the immune system to intestinally absorbed antigen may limit the oral delivery of proteins but could provide an attractive alternative to parenteral immunization. PMID- 3276406 TI - Gastrointestinal dynamics and pharmacology for the optimum design of controlled release oral dosage forms. AB - This article encompasses a brief discussion of the principles of pharmacodynamics of different types of drugs and the mechanisms of absorption at different sites in the gastrointestinal tract. The importance of factors such as the pH, the unstirred layer or microclimate, gastric emptying, intestinal contact time, metabolism in the gut wall, and bacterial degradation in the colon is discussed. Methods that can be used to alter the absorption of drugs such as formulation in a viscous form, a form that floats in the stomach, position release forms, combination with other drugs that may influence absorption, etc. are examined in detail. PMID- 3276407 TI - Isolation and identification of mutagens from a fried Norwegian meat product. AB - Two samples of a typical Norwegian minced meat emulsion were fried at 215 degrees C. One had the regular composition while 4.2% creatine was added to the second sample prior to frying. Mutagens in both samples were purified using aqueous acid extraction, XAD-2 adsorption and a series of semipreparative and analytical high performance liquid chromatography (HPLC) purification steps monitored by the Ames/Salmonella mutagenicity test. Mutagenic activity in the creatine-fortified product was enhanced 15-fold. Mutagenicity profiles from reverse-phase and normal phase HPLC were qualitatively similar for both samples indicating no major production of new mutagens due to the presence of additional creatine. A total of 8 distinct mutagenic peaks could be separated after three additional HPLC steps. These compounds fall into a class of compounds called amino-imidazoazaarenes (AIA). The majority of mutagenic activity is made up by the known cooking mutagens 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), 2-amino-3,4,8 trimethylimidazo[4,5-f]quinoxaline (DiMeIQx), 2-amino-3-methylimidazo[3,5 f]quinoline (IQ) and 2-amino-n,n,n-trimethylimidazopyridine (TMIP). Smaller contributions are from 2-amino-3-methylimidazo- [4,5-f]quinoxaline (IQx), 2-amino n,n-dimethylimidazopyridine (DMIP), 2-amino-1-methyl-6-phenylimidazo[4,5 b]pyridine (PhIP) and two oxygen-containing AIA. With respect to mass, MeIQx and PhIP were the dominating mutagens. PMID- 3276408 TI - The links between basic and clinical cardiac electrophysiology. PMID- 3276409 TI - The Western Washington Intravenous Streptokinase in Acute Myocardial Infarction Randomized Trial. AB - Three hundred sixty-eight patients were randomly assigned to receive intravenous streptokinase (IVSK) (n = 191) or standard therapy (n = 177) to determine the efficacy of IVSK in the treatment of acute myocardial infarction. The mean time to treatment was 3.5 hr. At 14 days there were 12 deaths in the treatment group (6.3%) and 17 deaths in the control group (9.6%) (p = .23). Early mortality was related to infarct location. Fourteen day mortality for anterior infarctions was 10.4% for treatment with IVSK and 22.4% for control patients (p = .06) and was similar for IVSK-treated patients with inferior infarctions, 4.0% vs 1.8% (p = .32). For those randomized under 3 hr, 14 day mortality tends to be lower in treated patients, 5.2% vs 11.5% (p = .11). There was significant improvement in long-term survival for patients with anterior infarction; 2 year survival was 81% for IVSK-treated patients and 65% for control patients (p = .05). There was no improvement in survival for patients with inferior myocardial infarction (p = .27). We conclude that patients with anterior myocardial infarction have improved survival when treated within the first 6 hr of symptoms. Patients with inferior infarction do not appear to have improved survival with thrombolytic therapy. Some of this improvement in survival in patients with anterior infarction may be due to a higher frequency of revascularization procedures in the treatment group. PMID- 3276410 TI - Quantitative assessment of regional left ventricular function by densitometric analysis of digital-subtraction ventriculograms: correlation with myocardial systolic shortening in dogs. AB - Conventional wall motion analysis of contrast ventriculograms assesses only that part of the wall that is tangential to the x-ray beam. To assess regional left ventricular function in three dimensions, a new computerized method based on densitometric analysis of digital subtraction left ventriculograms was developed and validated in nine open-chest dogs instrumented with a circumflex coronary artery occluder and sonomicrometers in the anterior and posterior walls. Each dog underwent digital subtraction ventriculography at baseline and at five levels (I to V) of dysfunction of the inferior wall induced by progressive stenoses of the circumflex coronary artery. The ventriculogram was divided into six segments around the end-diastolic center of gravity. Time-volume curves were obtained by densitometry in the normal anterior and ischemic inferior segments containing the sonomicrometers. From these curves, regional ejection fraction (R-EF), regional peak ejection rate (R-PER), and regional phase (R-PH) and amplitude (R-AMP) of the first Fourier harmonic were derived. From baseline to level V of dysfunction, myocardial systolic shortening determined by sonomicrometry decreased by 124 +/- 34% of control (mean +/- SD; p less than .001) in the ischemic wall, while it increased by 12 +/- 19% (NS) in the normal wall. At the same time, R-EF, R-PER, and R-AMP decreased in the ischemic segment by 65 +/- 12%, 46 +/- 30%, and 45 +/- 15% of control, respectively (all p less than .01), while they remained unchanged or increased in the normal segment. R-PH was delayed by 14 +/- 5% (p less than .01) in the ischemic segment, but remained unchanged in the normal segment, reflecting the asynchrony of regional left ventricular contraction during ischemia. Densitometric indexes of regional function correlated well with sonomicrometric systolic shortening both in normal and ischemic segments, with r values of .84 for R-EF, .80 for R-AMP, .64 for R-PER, and .55 for R-PH (all p less than .0001). Thus, densitometric analysis of digital subtraction left ventriculograms allows three-dimensional assessment of the extent, velocity, and synchrony of regional left ventricular contraction. Densitometric indexes of regional contraction correlate well with direct measurements of myocardial systolic shortening and are useful in quantitating regional left ventricular dysfunction. PMID- 3276411 TI - Quantification of absolute luminal diameter by computer-analyzed digital subtraction angiography: an assessment in human coronary arteries. AB - Determination of absolute lumen diameters has been shown to be useful in predicting the functional importance of a coronary stenosis. In this study, both single-plane and orthogonal biplane digital subtraction angiograms were obtained in human cadaver coronary arteries. A single absolute diameter was calculated at the site of greatest narrowing in 20 segments by two automated computerized algorithms. Minimum and maximum diameters at the site of the stenosis were measured from pathologic sections prepared after pressure fixation. Method 1, which determines the edges by means of the first derivative of the videodensity curve, derived absolute diameters that fell between the pathologic minimum and maximum in 10 of 20 segments. Method 2, which determines the edges by an average of the first and second derivatives of the videodensity change, derived absolute diameters that fell between the pathologic minimum and maximum diameters in 15 of 20 segments. Method 1 correlated well with the maximum pathologic diameter (r = .76) and less well with the minrmum pathologic diameter (r = .67). Method 2 correlated very well with the maximum pathologic diameter (r = .79) and also correlated well with the minimum pathologic diameter (r = .74). As would be expected, the computerized algorithms tended to overestimate the minimum pathologic diameter and to underestimate the maximum pathologic diameter. In six segments, two orthogonal views were analyzed; no further accuracy was discernible over single-plane determinations. Thus quantitative coronary angiography by digital subtraction angiography is sufficiently accurate to be of use in the measurement of the severity of a coronary stenosis. PMID- 3276412 TI - A rapid toxicology screen for emergency and routine care of patients. AB - I have adapted, for use with a centrifugal analyzer, reagents from 10 different EMIT (Syva Co.) enzyme immunoassay urine drug-detection kits, reagents from another five serum kits, and reagents for determining ethanol. Assays for individual drugs in 100 microL of urine and in 100 microL of serum are performed simultaneously rather than sequentially in less than 15 min, with one-tenth the usual amount of reactants (sample + reagents). These assays, when combined with other easily performed tests, provide a rapid toxicology screen well-suited for evaluating acute emergency patients, and for performing a small number of daily routine screens. The total screen requires 500 microL of urine and 500 microL of serum. I summarize my experience with this procedure in its first year of use, and discuss differences between testing for the care of patients compared with searching for evidence of illegal drug use. PMID- 3276413 TI - Effect of captopril and other inhibitors of angiotensin-converting enzyme on plasma prolidase activity. PMID- 3276414 TI - Assessment of Abbott's enzyme immunoassay for progesterone receptor in breast cancer samples. PMID- 3276415 TI - The EMIT-St system adapted for use in the CentrifiChem 400. PMID- 3276416 TI - Heat inactivation of serum prior to measurement of HIV antibody by enzyme immunoassay. PMID- 3276417 TI - Liquid-chromatographic measurement of cyclosporin A and its metabolites in blood, bile, and urine. AB - Using solid-phase extraction columns and "high-performance" liquid chromatographic (HPLC) analysis, we could determine cyclosporin A and nine of its metabolites in blood, bile, and urine. To facilitate calculations of concentrations of cyclosporin A and its metabolites from the chromatograms, we used cyclosporin D as internal standard. For the HPLC analysis we used two sequential 250-mm analytical columns filled with reversed-phase octyl (C8) sorbent, eluting with a concave gradient of water, adjusted to pH 3.0 with phosphoric acid, and acetonitrile. Peaks were detected at 205 nm. For characterization of the chromatographic peaks, we isolated, by semi-preparative HPLC, 32 fractions representing peaks potentially related to cyclosporin A metabolites and re-injected them into the HPLC system under the same conditions as authentic cyclosporin A metabolites. Analytical recovery was 70-80%. The inter assay CV for bile was 7.2%, for urine 12.3%. The method was used for routine monitoring of cyclosporin A and its metabolites. PMID- 3276418 TI - Glomerular and serum immunoglobulin G subclasses in membranous nephropathy and anti-glomerular basement membrane nephritis. AB - The distribution of human IgG subclasses among the glomerular deposits of 53 patients with glomerulonephritis was examined by immunofluorescence (IF) with subclass-specific monoclonal antibodies (Mab). A subclass restriction was observed in idiopathic membranous nephropathy (MN) with glomerular deposits predominantly containing IgG4 (81% of the studied biopsies) and IgG1 (75%). In de novo MN, occurring after transplantation, the restriction was markedly different, with a predominance of IgG1 (100%) and IgG2 (69%). In anti-glomerular basement membrane (a-GBM) nephritis the restriction was considerable with deposits containing almost exclusively IgG1 (91%) and IgG4 (73%). The same restriction was observed for circulating anti-GBM antibodies detected by indirect IF assay. By contrast IgG1, IgG2, and IgG3 deposits were identified in lupus proliferative glomerulonephritis. Serum IgG subclass levels were measured in 29 patients with idiopathic MN and a-GBM nephritis by an indirect competitive immunoenzymatic assay using Mab. Mean percentage of IgG2 serum level was significantly lower in patients. In spite of high variations from patient to patient, a serum IgG subclass imbalance was clearly present in 10 cases with low IgG2 and high IgG1 and IgG3 levels. The imbalance in these patients was not due to urinary loss since it was observed with a similar frequency in hypo- and normoimmunoglobulinemic patients. In 5 out of these 10 patients IgG2 levels were very low, analogous to those observed in selective IgG2 deficiency. Whether the important subclass restriction of glomerular IgG (in which patterns differed according to the type of glomerulonephritis) and the serum subclass imbalances were due to a clonally restricted antibody response to a particular antigen or to a host immune response defect, or both, remains to be elucidated. PMID- 3276419 TI - Successive changes of the cellular composition in lymphoid organs of MRL-Mp/lpr lpr mice during the development of lymphoproliferative disease as investigated in cryosections. AB - To analyze the tissue distribution of lymphocyte subsets of autoimmune MRL/Mp lpr/lpr mice, we have studied cryostat sections of the lymphoid organs at different stages of the disease using monoclonal antibodies directed against Ly 1 (MAb 53-7.3), Ly 2 (MAb 53-6.7), B 220 (MAb 14.8), and mu heavy chain (MAb b.7.6). We have observed an increase of a characteristic subpopulation of lymphocytes (Ly 1+ (dull), Ly 2-, B 220+, sIgM-), first seen at age of 8 weeks. In lymph nodes, these cells are first organized follicle-like with sIgM+ cells in the center. Later (20th-29th weeks), mu+ cells are found almost exclusively in small areas between the follicles. In the spleen, the cells first appear in the outer periarteriolar lymphatic sheath. Later, they are distributed within the follicles. sIgM+ cells disappear from the follicles; few remain within the marginal zone. In the thymus, some mice show a highly increased number of mu+ cells in the medulla. In Peyer's Patches, these Ly 1+ (dull) B 220+ cells are found predominantly in the interfollicular zone. PMID- 3276420 TI - Pelvic mass causing vesical compression after total hip arthroplasty. Case report. AB - A 59-year-old woman developed a histiocytic response to methylmethacrylate debris in a loose total hip arthroplasty. This reaction eroded through the medial wall of the acetabulum, producing a pelvic mass and presenting with urinary symptoms. A combination of an abdominal approach for removal of the pelvic mass and a lateral approach for revision of the total hip arthroplasty was required. This condition should be considered in the differential diagnosis of a mass adjacent to a loose prosthesis. PMID- 3276421 TI - Trabecular bone strength at the knee. AB - The axial strength of trabecular bone at the knee is critical for the maintenance of support and fixation of the prosthetic components after total surface knee arthroplasty. The resistance of trabecular bone to penetration was measured posteriorly, centrally, and anteriorly in each of the tibial and femoral condyles in 150 consecutive total knee arthroplasties. Forty-seven rheumatoid knees and 88 osteoarthritic knees were evaluated. The correlation of bone strength with selected clinical parameters was found to be too poor to predict bone strength. Tibial bone strength was lower in rheumatoid than in osteoarthritic knees. Steroid medication did not influence tibial bone strength in rheumatoid arthritis. The distribution of bone strength between the medial and lateral condyles was closely dependent on knee alignment, with high medial strength in varus knees. At the unloaded condyle, strength was reduced relative to the findings for normally aligned knees. At the tibia, strength decreased with depth from the resection surface, while at the femur the converse was true. Tibial bone strength, both condylar and overall average, was lower than values reported in studies of normal cadaver knees. Evaluation of the absolute bone strength at the tibial condyles suggested that the values too low to meet load-bearing requirements after well-aligned knee replacement were infrequent. PMID- 3276423 TI - The history and development of Harrington instrumentation. by Paul R. Harrington, 1973. PMID- 3276422 TI - Interfascicular neurolysis in the severe carpal tunnel syndrome. A prospective, randomized, double-blind, controlled study. AB - There is significant difference of opinion whether an adjunctive interfascicular neurolysis will improve the results of lysis of the transverse carpal ligament in patients with severe carpal tunnel syndrome (thenar atrophy and/or fixed sensory deficit). Fifty such cases were prospectively and consecutively selected and then randomized into two groups prior to surgery. Half were treated by standard ligament release alone; the other half also had adjunctive interfascicular neurolysis. All patients had neurologic examination and nerve conduction studies performed by a "blind" examiner at one and three months postoperatively with comparison of these findings with preoperative data. Analysis of the data revealed no significant difference between the two groups and, therefore, demonstrated no benefit from adjunctive interfascicular neurolysis. Additionally, as the majority of patients in both groups improved significantly, the study demonstrated frequent benefit from transverse carpal ligament release even in the presence of fixed neurologic deficit in severe carpal tunnel syndrome. PMID- 3276424 TI - The first description of the spinal fluid. By Domenico Cotugno, 1775. PMID- 3276425 TI - Thoracolumbar fractures in ankylosing spondylitis. High-risk injuries. AB - Ankylosing spondylitis may affect the spine segmentally or diffusely. Because all the ligaments become ossified in the involved areas, fractures that occur through this involved segment traverse both bone and ligaments, producing an extremely unstable situation similar to a shearing type of fracture. With a pre-existing severe kyphosis, it may be dangerous to turn the patient to a supine position, because this opens up the fracture and can cause neurologic complications. The radiologic assessment of the spine in ankylosing spondylitis is difficult because the bone is frequently osteoporotic and the disc spaces are poorly outlined. Minor displacements should be looked for, as well as discontinuity of ossified ligaments (especially the interspinous ligaments). Of the seven patients reported in this series, six had fractures undiagnosed at the time of the preliminary examination. Therefore, patients known to have ankylosing spondylitis should be counseled regarding the possibility of a fracture, and if pain persists after an injury, they should be thoroughly investigated radiologically to rule out a potentially serious problem. Reduction of the displacement and stabilization is best achieved with a Luque rectangular rod system, and laminectomy is not indicated. PMID- 3276426 TI - Intravascular injuries from intramuscular penicillin. AB - Benzathine penicillin, procaine penicillin, and mixtures of both are opaque preparations for intramuscular injection. Visualization of aspirated blood, the fail-safe for avoiding intravascular injection, is predictably problematic. A spectrum of injuries, sometimes permanent, to the gluteal region, distal extremities, perineum, and spinal cord probably results from inadvertent intra arterial injection, possibly due to vascular occlusion by large crystals of the penicillin salt(s). Since the arterial injurie disproportionately affect infants, use of these preparations in that age group should be minimized. The corresponding intravenous injection probably is Hoigne's syndrome, a procaine induced central nervous system syndrome. Though usually brief and transient complications may be profound, including coma, convulsions, and death. Careful attention to details of anatomy and manufacturer's recommendations is critical. PMID- 3276427 TI - Ultrasound diagnosis of deep vein thrombosis. PMID- 3276429 TI - Towards the more effective use of diagnostic radiology: a review of the work of the Royal College of Radiologists Working Party on the more Effective Use of Diagnostic Radiology, 1976 to 1986. PMID- 3276430 TI - Diagnosis and grading of chronic pancreatitis by morphological criteria derived by ultrasound and pancreatography. AB - The most commonly used modalities in the diagnosis of chronic pancreatitis are ultrasonography, computed tomography (CT) and endoscopic retrograde pancreatography (ERP). Computed tomography scanning is only of value in severe chronic pancreatitis. Both ultrasound and pancreatography are capable of showing ductal changes in mild forms of the disease, but comparison of the two methods has been difficult. A scheme of morphological criteria and descriptive terminology of pancreatitis was applied to 58 out of 85 patients with a firm clinical diagnosis of chronic pancreatitis. Twenty-seven patients were excluded from the study, four with a faulty clinical diagnosis and 23 with non-diagnostic pancreatograms. There was an exact classification into normal, equivocal, mild, moderate or marked chronic pancreatitis in 50 out of 58 patients (86%) and an almost perfect correlation (+ or - one grade) in 54 out of 58 (93%). There were four discrepancies. Ultrasound examination missed focal pancreatitis in the tail, a small cavity in the uncinate process and a variant of chronic pancreatitis. One ultrasound scan was of poor quality. Morphological grading by different techniques is feasible and use of this scheme can reduce diagnosis to a simple and specific set of rules. PMID- 3276428 TI - Aerosol lung scintigraphy in the detection of bronchiectasis. AB - Twenty patients were studied to assess the value of aerosol ventilation scintigraphy, using 99Tcm diethylene triamine penta-acetic acid (DTPA) as a screening test for bronchiectasis. All patients had previously undergone bronchography for suspected bronchiectasis. Nine had cylindrical bronchiectasis and 11 had no demonstrable abnormality. Only two of the 20 patients had features suggestive of bronchiectasis on their chest radiographs. Segmental defects in ventilation were demonstrated by scintigraphy in five of the nine patients with bronchiectasis (56%). Regional ventilation appeared normal in 26 of the 27 lungs which were bronchographically normal (96%). Whilst the sensitivity of aerosol ventilation scintigraphy in detecting bronchiectasis is low (56%), it compares favourably with that of the chest radiograph (22%) in this group of patients with mild disease and non-specific symptoms. Thus, in some, it may obviate the need for bronchography. PMID- 3276431 TI - A comparison of real-time ultrasonography with intravenous urography in the follow-up of patients with spinal cord injury. AB - Patients with spinal cord damage require an expert urological assessment at regular intervals. Seventy-five patients with neurogenic bladder dysfunction associated with spinal paralysis attending for routine assessment of the upper urinary tract had both intravenous urography (IVU) and renal ultrasonography. The combination of a plain radiography of the abdomen and an ultrasound scan of the kidneys was found to be a cheap, safe and reliable alternative to intravenous urography for the regular follow-up of these patients. PMID- 3276432 TI - Atypical simple bone cysts of the jaws. I: Recurrent lesions. AB - The aetiology, clinical and radiographic features and the treatment of simple bone cysts of the jaws are discussed. Recurrence of jaw lesions is unusual. Two cases are presented of simple bone cyst in the mandible which recurred following conventional treatment. The importance of clinical and radiographic follow-up is emphasised. PMID- 3276433 TI - Atypical simple bone cysts of the jaws. II: A possible association with benign fibro-osseous (cemental) lesions of the jaws. AB - Four cases are described of simple bone cysts of the mandible arising concurrently with benign fibro-osseous (cemental) lesions. Previous reports of such findings, and a possible relationship to the so-called 'cementoma' of the long bones, are considered. The relevance of this to the aetiology is addressed, and it is suggested that at least some cases diagnosed as simple bone cysts are closely related to the fibro-osseous lesions. PMID- 3276434 TI - How accurate is the index finger? A comparison of digital and ultrasound examination of the prostatic nodule. AB - The per-rectal ultrasound scans and digital assessments of 193 patients with prostatic nodules were analysed retrospectively. There were 88 histologically proven cancers and per-rectal ultrasound demonstrated extracapsular spread of tumour in 36 of these patients. In the diagnosis of prostatic cancer, ultrasound had a sensitivity of 97.6% and a specificity of 93.8% whereas digital examination had a sensitivity of 96.5% and a specificity of 53.3%. PMID- 3276435 TI - The dedication of the National Institutes of Health. 1940. President Franklin D. Roosevelt. PMID- 3276437 TI - Nuclear magnetic resonance spectroscopy in the study of inborn errors of metabolism. PMID- 3276436 TI - Pathophysiological features of episodic gonadotropin secretion in man. PMID- 3276439 TI - Genetic co-segregation of renal haemodynamics and blood pressure in the spontaneously hypertensive rat. AB - 1. To determine the relevance of renal circulatory abnormalities found in the immature spontaneously hypertensive rat (SHR) to the genetic hypertensive process, glomerular filtration rate and renal blood flow were measured in conscious F2 rats, derived from cross-breeding SHR and normotensive Wistar-Kyoto rats (WKY), at 4, 11 and 16 weeks of age by determining the renal clearances of 51Cr-ethylenediaminetetra-acetate and 125I-hippuran respectively. Plasma renin activity was measured at 11 and 16 weeks of age. 2. Mean arterial pressure, glomerular filtration rate and renal blood flow increased between 4 and 11 weeks of age. Between 11 and 16 weeks the mean glomerular filtration rate and renal blood flow did not alter, although the mean arterial pressure rose significantly. At 11 weeks of age, during the developmental phase of hypertension, a significant negative correlation between mean arterial pressure and both glomerular filtration rate and renal blood flow was noted. However, by 16 weeks when the manifestations of genetic hypertension were more fully expressed, no correlation between mean arterial pressure and renal blood flow or glomerular filtration rate was observed. Plasma renin activity was negatively correlated with both glomerular filtration rate and renal blood flow, but the relationship was stronger at 11 than at 16 weeks of age. 3. These results suggest that the reduction in renal blood flow and glomerular filtration rate, found in immature SHR, is genetically linked to the hypertension and may be of primary pathogenetic importance. It is proposed that the increased renal vascular resistance in these young animals stimulates the rise of systemic arterial pressure which returns renal blood flow and glomerular filtration rate to normal. PMID- 3276438 TI - Acute effects of surgery on carbohydrate production and utilization in the fed rat. AB - 1. The work utilized a model of uncomplicated abdominal surgery (laparotomy under ether anaesthesia) to delineate the effects of abdominal trauma on glucose homoeostasis in the fed rat. 2. Regulation of glucose production and utilization was investigated by observing the response to the administration of glucose, insulin plus glucose and 5-methylpyrazole 3-carboxylic acid. 3. Glucose administration suppressed hepatic glucose output as assessed by portal-venous concentration differences in control or surgically stressed rats. In contrast, glycaemia was increased and lactaemia decreased in the latter group. Portal venous concentrations differences for lactate were unaffected. 4. Surgery increased plasma fatty acid concentrations and the antilipolytic response to glucose or glucose plus insulin was diminished. Post-operative increases in fatty acid concentrations were associated with inhibition of hepatic pyruvate dehydrogenase complex which was reversed by insulin, indicating a differential sensitivity of adipose tissue and liver to the hormone. 5. The model of surgical stress utilized, while affecting extrahepatic glucose disposal, did not elicit depletion of liver glycogen or inactivation of L-pyruvate kinase. 6. It is concluded that the initial response to uncomplicated abdominal surgery involves carbohydrate conservation rather than increased glucose production, with effects to decrease extrahepatic glucose uptake and hepatic glucose oxidation. PMID- 3276440 TI - Factors contributing to bronchial hyper-responsiveness in asthma. PMID- 3276441 TI - Influence of hyperinsulinaemia on intracellular amino acid levels and amino acid exchange across splanchnic and leg tissues in uraemia. AB - 1. To examine whether insulin resistance in uraemia extends to amino acid metabolism, the effect of physiological hyperinsulinaemia on plasma amino acid concentrations was studied in 17 chronically uraemic and 28 healthy subjects by using the euglycaemic insulin clamp technique. 2. In six uraemic and seven control subjects, splanchnic and leg exchange of amino acids was quantified with hepatic and femoral venous catheterization, and in five uraemic and eight control subjects intracellular free amino acid concentrations were determined in muscle tissue obtained by needle biopsy. 3. In response to hyperinsulinaemia the plasma concentrations of all amino acids except alanine decreased by 10-50% in both uraemic and control subjects. Splanchnic alanine uptake declined by 20% and leg amino acid release tended to decrease in both groups. 4. The intracellular levels of all measured amino acids except alanine fell significantly and to a similar extent in uraemic and control subjects. 5. These results indicate that insulin mediated alterations in regional amino acid exchange and in plasma and intracellular amino acid concentrations are similar in uraemic and control subjects. 6. It is concluded that tissue insensitivity to insulin in uraemia does not extend to uptake or release of amino acids and that resistance to insulin can be selective in its effect on different metabolic functions. PMID- 3276442 TI - The ratio between ankle and brachial systolic pressure in patients with sustained uncomplicated essential hypertension. AB - 1. The ratio between ankle (ASP) and brachial (BSP) systolic pressures was studied using Doppler ultrasound in 66 male subjects, 33 with sustained uncomplicated essential hypertension and 33 age-matched normal controls. 2. Based on covariance analysis, the ASP-BSP relationship was significantly different in the two populations, the ASP/BSP ratio (mean +/- SEM) being significantly lower in hypertensive subjects (106 +/- 1 vs 132 +/- 2; P less than 0.001). 3. While the ASP/BSP ratio was negatively correlated with age in normal subjects, no significant correlation was observed in hypertensive subjects. 4. The diameter of the terminal abdominal aorta measured by echography was significantly greater in hypertensive subjects, while full examination with Doppler ultrasound excluded any significant arterial stenosis of the lower limbs. 5. The study suggested that, in patients with sustained uncomplicated essential hypertension, the lower ASP/BSP ratio is related to changes in arterial wave transmission. PMID- 3276443 TI - Abnormal diurnal variation in salt and water excretion in patients with obstructive sleep apnoea. AB - 1. In healthy individuals, sleep is associated with a fall in urine and sodium output. 2. Seven male patients with obstructive sleep apnoea exhibited a paradoxical rise in both urine and sodium output during the hours of sleep. 3. Continuous positive airway pressure applied via the nose abolished both the apnoea and the nocturnal rise in urine and sodium output, thereby restoring the diurnal pattern towards normal. PMID- 3276444 TI - Genetic basis of cell surface polymorphisms encoded by the major histocompatibility complex in humans. AB - In this review, the authors have analyzed the relationship between molecularly defined HLA gene polymorphisms and the diversity of HLA antigens detected serologically and by T-cell allorecognition. Although many relevant publications were not included, examples of the studies described here provide evidence for the strong association between polymorphisms defined at the gene and at the cell surface product levels. The concordance between RFLP and alloantigenic reactivity patterns may represent strong linkage disequilibrium between specific restriction enzyme variations in the coding and noncoding regions. It has become apparent that the allelic variations detected by molecular techniques are far greater than those defined by serological and cellular typing. This observation provides an impetus to identify reagents which define additional cell surface polymorphisms potentially important in immunoregulation, disease susceptibility, and transplant immunity. PMID- 3276445 TI - Future prospects for vaccine adjuvants. AB - Since the landmark experiments of Ramon 60 years ago, attempts have been made to augment the humoral and cellular responses to administered antigens in order to develop more potent and less toxic vaccines. The need for an acceptable adjuvant suitable for clinical use has been underscored by recent advances in recombinant biotechnology and synthetic chemistry which have made it possible to create antigens that are smaller and better characterized, yet less immunogenic, than before. It is likely that these antigens will require an adjuvant to achieve protective immunity. Some of these same technological advances, together with a better understanding of the immune system in general, have permitted the study of adjuvants to evolve from an empirical field to a developmental one. This article discusses the currently known agents capable of immunopotentiation and possible strategies for their use in future vaccines. PMID- 3276446 TI - Intravenous immunoglobulins in association with antibiotics: a therapeutic trial in septic intensive care unit patients. AB - The therapeutic use of iv immunoglobulins of the G class in association with antibiotics in patients with severe sepsis is reported. As compared to the randomized control group of patients treated with antibiotics alone, patient survival was only slightly improved (from 25% to 42%; NS); however, the defervescence time was significantly shorter (10 vs. 16 days), and a greater percentage of microbiologically positive cultures became negative (40% vs. 8%; p less than .01). The percentage of days on antibiotic treatment during ICU hospitalization was consequently reduced (38% vs. 95%; p less than .01). The therapeutic use of iv immunoglobulin G is discussed in terms of antibody substitution and modulation of the immune system. PMID- 3276447 TI - Acute epiglottitis: a different approach to management. AB - Between January 1979 and October 1986, 349 patients with epiglottitis were admitted to the Royal Children's Hospital, Melbourne, Australia. Forty-five (13%) patients were not intubated, 291 (83%) were managed by nasotracheal intubation and spontaneous respiration without sedation, three (1%) received continuous positive airway pressure, and ten (3%) were ventilated. The 294 patients who were not ventilated were intubated for a mean of 18 +/- 9.5 (SD) h; 90% were extubated within 24 h. Criteria for extubation included resolution of fever (less than 37.5 degrees C), passage of time (12 to 16 h), and improvement in the general appearance of the child. Laryngoscopy was not performed before extubation. Providing there is always a doctor present who can reintubate if accidental extubation occurs, routine use of sedation, paralysis and mechanical ventilation, and pre-extubation laryngoscopy are not required for the management of children with uncomplicated epiglottitis, and their use may prolong the period of intubation. PMID- 3276448 TI - Effect of positive end-expiratory pressure on extravascular lung water in porcine acute respiratory failure. AB - Recent studies of acute respiratory failure suggest that PEEP causes increased pulmonary interstitial fluid collection and therefore increased extravascular lung water (EVLW). We examined the effect of increasing levels of PEEP on EVLW in 20 to 25-kg pigs with acute respiratory failure induced by continuous infusion of live Pseudomonas aeruginosa (2 X 10(8) organisms/20 kg.min). Animals were intubated, paralyzed, and ventilated at 15 ml/kg tidal volume and an FIO2 of 0.4. Pigs in group 1 were given 4 ml/kg.h of iv fluid (lactated Ringer's solution) with no PEEP administered. Animals in groups 2 through 5 were given 0, 4, 17, and 44 ml/kg.h of lactated Ringer's solution, respectively, and PEEP was added at 5 cm H2O increments per half-hour, starting one hour after beginning P. aeruginosa infusion. EVLW in PEEP animals was less than or equal to that in controls despite variation in the administration of lactated Ringer's solution. This suggests that PEEP may slow EVLW accumulation over time and provide a protective effect that allows increased amounts of crystalloid fluids to be administered. PMID- 3276449 TI - Pupil size and light reactivity during cardiopulmonary resuscitation: a clinical study. PMID- 3276450 TI - Fellowship programs in critical care medicine: 1988/1989. Compiled and edited by The Society of Critical Care Medicine. PMID- 3276451 TI - Ranitidine produces minimal hemodynamic depression in stable intensive care unit patients: a double-blind, prospective study. AB - Ranitidine, a furan H2 receptor antagonist, is increasingly prescribed in the ICU setting. Before the availability of parenteral ranitidine, cimetidine had been the sole H2 blocker used to decrease gastric acidity in this setting. However, cimetidine has recently been shown to transiently, but significantly, reduce mean arterial pressure due to direct vasodilation in a critically ill population. Therefore, this double-blind prospective study was designed to examine the hemodynamic effects of iv ranitidine in an ICU population. Twenty-six critically ill hemodynamically stable patients were studied; all patients were already receiving ranitidine and had an arterial line and a pulmonary artery catheter in place. This study demonstrated that an iv infusion of ranitidine did not produce clinically significant hemodynamic effects in this patient population. PMID- 3276452 TI - Ultrasonographic evaluation of pleural and chest wall invasion of lung cancer. AB - The significance of ultrasonography was tested in evaluation of cancerous invasion into the pleura and chest wall in patients with lung cancer. The degree of the invasion was ultrasonographically classified into four grades, that is, uP 0, uP-1, uP-2 and uP-3, corresponding with the classification proposed by the Japan Lung Cancer Society, which is graded by surgical findings. The total accuracy of this method was 77 percent. Especially for uP-3, which is the most critical grade regarding decisions on surgical intervention, this figure was 100 percent. It is suggested that this approach can delineate cancerous invasion into the pleura and chest wall sufficiently well for daily clinical use and staging of patients with lung cancer. PMID- 3276453 TI - Influence of infused adenosine on bronchial tone and bronchial reactivity in asthma. AB - Adenosine has been found to contract human bronchial smooth muscle in vitro and to induce bronchoconstriction in asthmatic patients when administered by inhalation. The aim of the present study was to investigate if elevation of circulating levels of adenosine influence bronchial tone or bronchial reactivity. Seven patients with bronchial asthma in whom bronchial hyperreactivity had been confirmed in a pretrial bronchial histamine challenge (PC20 FEV1 0.064 to 2.45 mg/ml) received intravenous infusions of adenosine in increasing doses (10, 30 and 50 micrograms/kg/min, 6 min on each dose step) or placebo (saline solution) on two different days in a randomized, single-blind manner. Heart rate, blood pressure and lung function (lung volumes, flow-volume loops and airway conductance) were measured on each dose step. Infusion rate was held constant (at 50 micrograms/kg/min) throughout the trial and a bronchial methacholine challenge was performed during the infusion of adenosine or placebo. Infusions of adenosine and placebo did not influence heart rate, blood pressure or bronchial tone on either day and bronchial reactivity was similar on both days. We conclude that bronchial tone and bronchial reactivity in asthmatic patients are not increased by intravenously administered adenosine at a dose level which, in other studies, has been shown to induce regional effects in the systemic arterial circulation. PMID- 3276454 TI - The effect of bronchoalveolar lavage on bronchial responsiveness in patients with airflow obstruction. AB - This study assessed the effect of bronchoalveolar lavage (BAL) on nonspecific bronchial responsiveness in 31 patients. Of these, 20 had airflow obstruction; 11 control subjects had normal pulmonary function. Bronchial responsiveness to methacholine, expressed as the dose of inhaled methacholine required to provoke a 20 percent fall in forced expiratory volume in one second (PD20 FEV1), was measured before and after BAL. We found no evidence for the induction of responsiveness by BAL in 11 control subjects with negative methacholine tests prior to the procedure. There were small but significant falls in FEV1 following BAL in both the control group and in patients with airflow obstruction. Thus, BAL does not appear to induce nonspecific bronchial hyperresponsiveness in subjects without airflow obstruction, nor does it affect airway responsiveness in emphysema patients. Among asthmatics, bronchial responsiveness can be increased as a result of BAL; this increase was greatest in patients who were most responsive initially. PMID- 3276455 TI - A hazard of pressure support ventilation. AB - Many of the newer models of mechanical ventilators include the pressure support (PS) mode of ventilation as a standard feature. The mechanism for the termination of a pressure support breath varies considerably among the various ventilators. The potential for the sudden inadvertent application of a high, unremitting pressure support breath or continuous positive airway pressure (CPAP) clearly exists with some ventilators and is illustrated in two cases. The potentially adverse consequences of high levels of CPAP are predictable and have been well described. Standard ventilator monitoring systems which do not include mean airway pressure monitoring may not detect this problem before significant adverse consequences have occurred. Even when detected, this unfamiliar complication may be difficult to recognize by the uninitiated. Physicians utilizing this mode of ventilation must be familiar with the terminating mechanism of their particular ventilator and choose appropriate monitoring. PMID- 3276456 TI - Methacholine bronchial reactivity testing in patients with chronic congestive heart failure. AB - To assess the role of bronchial hyperresponsiveness in chronic congestive heart failure (CHF), we performed standard methacholine bronchial provocation testing on nine patients with chronic CHF in New York Heart Association functional class 4. Mean pulmonary capillary wedge pressure and mean stroke volume index for the group at the time of study were 27 +/- 3 mm Hg and 27.9 +/- 8.9 ml/m2, respectively. Mean MMEFR was 71 percent of normal and mean delta to FEV1% was 76.3 percent. Only one patient, who was a 50-pack-year smoker, had a greater than 20 percent decrease in FEV1 with methacholine challenge, and this was at the highest concentration (25 mg/ml). We conclude that, in stable CHF, bronchial reactivity as assessed by standard methacholine challenge is not increased. PMID- 3276457 TI - Occupational asthma update. PMID- 3276458 TI - Management of supraventricular tachyarrhythmias. AB - Supraventricular tachyarrhythmias are common and treatment is based on the frequency and hemodynamic severity caused by these arrhythmias. Empiric therapy with currently available medications often satisfactorily controls symptomatic arrhythmias. Nonpharmocologic therapy with permanent antitachycardia pacemakers, percutaneous catheter ablation or surgery can be effective for selected patients with medically refractory supraventricular tachyarrhythmias after thorough electrophysiologic evaluation. In selected patients with life-threatening supraventricular tachyarrhythmias due to the WPW syndrome, surgical ablation is the therapy of choice. PMID- 3276459 TI - Bronchial stenosis after aspiration of an iron tablet. AB - Stenosis of the right intermediate bronchus was found in a 60-year-old woman four months after aspiration of an iron tablet. Right middle and lower lobe lobectomies were performed. By light microscopy, small amounts of foreign, iron positive material surrounded by giant cells, large collections of hemosiderin containing macrophages, and severe fibrosis with only minimal inflammation were observed in the bronchial wall. Early diagnosis and management are stressed in order to avoid the stenosing process which is also possible after aspiration of some tablets. PMID- 3276460 TI - Landmarks of tobacco use in the United States. AB - The idea of inhaling smoke from cigarettes is historically new, actually less than a century old. Consumption of tobacco has changed from chewing tobacco and pipe smoking to smoking cigarettes; smokeless tobaccos are growing tremendously in popularity. The modern smoker is confronted with a highly engineered, complex composite of specially designed paper, tobacco, tobacco additives, and a panoply of filters, a far cry from the hollow reed Columbus saw. Tobacco has been glibly referred to as a form of revenge by native Indians. There is little similarity between ceremonial use of tobacco by the Indians and the robotic puffing of the modern smoker. The real culprit is the cigarette. PMID- 3276461 TI - Nicotine dependence. Interface between tobacco and tobacco-related disease. PMID- 3276462 TI - The physicians's contribution to smoking cessation in the workplace. PMID- 3276463 TI - Implications for the practicing physician of the psychosocial dimensions of smoking. AB - The multifaceted nature of smoking includes its physiologic, social, and psychologic dimensions and its career features. It develops over time, through phases such as experimentation or conditioning. It also is given up over time, often after several unsuccessful attempts. Several repetitions of a sequence of considering cessation, attempting to quit, and relapsing are likely to precede permanent cessation. Those who are not ready to commit themselves to quitting may be reached by low-key information more than by too forceful exhortation. Those who are ready to quit may select from among a range of approaches, including group clinics, "self-help" manuals, and physician counseling. Maintenance requires as much attention as does cessation. Cooperation from those around the quitter, reminders to use skills for coping with stressors or temptations, and continued encouragement from the physician may all encourage long-term abstinence. Owing to the multifaceted nature of smoking and quitting and the multiple approaches to cessation and its maintenance, the physician may best be viewed as a catalyst for nonsmoking. If appropriate to his or her practice, this may include extended patient counseling, but those unable to provide this may still make great contributions through brief information on why it is important to quit, encouragement to do so, timely referral to other staff or to materials and programs available in the community, and continued expression of interest in the patient's efforts and/or success. All these may catalyze quitting without demanding excessive time or skills beyond those commonly employed by the physician. In catalyzing nonsmoking, the physician can also be an effective proponent of community or voluntary agency programs as well as institutional and governmental policies to limit smoking in health care facilities and public places. The American College of Chest Physicians' policy encouraging nonsmoking among its Fellows and in their offices is an excellent example of this catalyst role. PMID- 3276464 TI - Counseling minors without parental consent. AB - Counseling services provided to minors without parental knowledge or consent are based on uncertain and often conflicting policies and procedures. This article examines these services from legal and psychological perspectives, explores current agency policies and practices, and makes recommendations with regard to the counseling needs and rights of minors. PMID- 3276465 TI - Closure of the internal opening for treatment of complex fistula-in-ano. AB - The surgical management of complex fistula-in-ano can be difficult, and often requires a seton suture or a colostomy. An alternative procedure is presented, based on principles that have been used successfully in the treatment of rectovaginal fistulas. The essential components of the technique are closure of the internal opening (when possible by an endorectal advancement flap), wide external drainage, and curettage of the fistulous tract. Seven patients with complex fistulas-in-ano were treated by this method. Six were cured and had excellent functional results up to 32 +/- 36 months postoperatively. The time to complete healing was 2.1 +/- 0.75 months. One patient developed a recurrent abscess. The procedure described is an alternative to conventional methods used in the treatment of complex fistula-in-ano. PMID- 3276466 TI - Colonic complications in renal transplant recipients. AB - Complications involving the colon occurred in 28 of 325 patients who received renal transplants. Pseudomembranous colitis, the most common complication, affected 15 patients, two of whom required surgery. Three instances of diverticulitis were complicated by free perforation in two cases, and by colovesical fistula in one. Appendicitis occurred in two cases. The other complications were hemorrhage (from diverticulosis or angiodysplasia), nonspecific colitis, and ischemic colitis. Spontaneous colonic perforation did not occur. Two thirds of the colonic complications occurred within 30 days after transplantation. All cases of colon perforation, however, occurred later than one month after transplantation. It is concluded that pseudomembranous colitis is the most common colonic complication in renal transplant recipients, that it usually occurs early, and that it carries a good prognosis. Colonic perforations occurred later in this series and were treated successfully. All cases of ischemic colitis were part of terminal multiorgan system failure. PMID- 3276467 TI - A 25-year review of adenocarcinoma of the appendix. A frequently perforating carcinoma. AB - A study was undertaken to compare the age, sex, preoperative diagnosis, and operative findings of patients who had adenocarcinoma of the appendix with patients who had adenocarcinoma of the colon. The study consisted of an analysis of 316 case reports and collective reviews of adenocarcinoma of the appendix that were reported in the literature between 1960 and 1985. The mean age of patients with this disease was 57.1 years and the male-to-female ratio for adenocarcinoma of the appendix was 1.4:1. Only rarely was a malignancy suspected, as 68 percent of the patients presented with signs and symptoms of inflammatory disease of the appendix. The tumor was perforated in 55 percent of patients, making it the most frequently perforating carcinoma of the entire gastrointestinal tract. One half of these perforations were localized as abscesses. The presence of perforation did not necessarily predispose a poor prognosis. Synchronous appendiceal and other colonic neoplasms occurred in 2.7 percent of patients. Pseudomyxoma peritonei occurred as a presenting feature in 5.6 percent of patients and was generally a poor prognostic indicator. Carcinomatosis peritonei was found at initial exploration in 10.3 percent of patients and these patients rarely survived one year. PMID- 3276468 TI - Carl Thiersch 1822-1895. Concerning prolapse of the rectum with special emphasis on the operation by Thiersch. PMID- 3276469 TI - Antimicrobial bowel preparation. Oral, parenteral, or both? AB - It has been suggested that wound infection rates after colorectal operations are influenced more by the presence of adequate tissue levels of antimicrobials at the time of contamination than by the extent of bacterial colonization of the intestinal lumen. There are, however, theoretical grounds for the belief that both levels are important. The authors therefore conducted a random control trial in 119 consecutive patients undergoing elective colorectal operations, comparing the results in a group receiving purely parenteral antimicrobial prophylaxis with those in one having a combined oral and parenteral regimen. The results in 83 contemporary nonrandomized patients, all of whom had the combined prophylactic regimen, are also reported. Oral bowel preparation resulted in a significantly smaller number of operation cultures showing growth of fecal gram-negative aerobes and anaerobes than did the purely parenteral regimen. There were more isolations of enterococci in the combined group but the excess did not achieve statistical significance. The rates of infective complications were higher in the parenteral than in the combined group, the difference in wound infection rates being statistically significant; the figures were 27.6 percent and 13.9 percent, respectively (P = .04). It is concluded that, in colorectal operations, it is advisable not only to ensure adequate tissue levels of antimicrobials but also to reduce the risk of endogenous bacterial infection by partially decontaminating the bowel. PMID- 3276470 TI - Gallbladder kinetics in obese patients. Effect of a regular meal and low-calorie meal. AB - Gallbladder contractility has been studied in 21 obese patients (greater than 130% ideal weight) and 30 nonobese subjects before and at regular intervals after the administration of a regular solid-liquid meal, and after a low-calorie, low fat meal used conventionally for weight-loss purposes (Modifast). Gallbladder volume was determined by means of real-time ultrasonography, using a linear array scanner with a 3.5 MHZ probe. In seven of the obese patients, gallbladder contractility was also evaluated after a 10-day regimen with Modifast. The obese group showed a statistically significant greater gallbladder fasting volume and blunted contractility than controls both after the ordinary and the low-calorie meal. The 10-day low-calorie regimen was associated with a statistically significant increment in fasting gallbladder volume, while the percent volume reduction after Modifast did not change. It is suggested that, in addition to metabolic factors, gallbladder hypocontractility in the obese may contribute to the high incidence of cholesterol gallstones noted in these patients. A low calorie, low-fat diet augmenting gallbladder volume may favor bile stasis and therefore the likelihood of developing gallstones. PMID- 3276471 TI - A biochemical and pharmacological approach to the genesis of ulcer disease. I. A model study of ethanol-induced injury to gastric mucosa in rats. AB - Present concepts of acute ulceration in the gastric mucosa include the hypothesis that mucosal ischemia is an important initiating event. The evidence for this is based upon observations on tissue metabolism and determinations of gastric mucosal blood flow. Using the model of gastric mucosal injury in the rat with ethanol, we have found that mucosal injury could be detected at a time when tissue oxygenation as determined by biochemical, and pharmacological studies of ATP metabolism were not compatible with ischemia. We also found that drugs acting at different subcellular levels were able to both inhibit gastric acid secretion in 4 hour pylorus-ligated rats and gastric mucosal injury after ethanol. Certain drugs, such as histamine and pentagastrin, stimulated acid secretion but inhibited the injury to the mucosa by ethanol indicating that increased cellular activity could occur during the development of mucosal injury. PMID- 3276472 TI - Relationship between the gastric myoelectric and mechanical activity in the genesis of ulcers in indomethacin-insulin-treated rats. AB - We have proposed that gastric contractile activity mechanically induces ulcers in the nonsteroid antiinflammatory drug (NSAID)-treated rat. This study examines first the relationship between number (dose) of peristaltic contractions applied to the mucosa and the ulcer score. Second, it examines the relative roles of: altered gastric myoelectrical activity (MEA) resulting from indomethacin (Indo) pretreatment, insulin-induced gastric peristalsis, and a combination of the two in the generation of mucosal lesions. Third, it examines the effect of exogenous prostaglandin on the Indo-altered MEA and relates it to ulcerogenesis. Indo pretreatment increased gastric tone and MEA. In such animals, the dose of peristaltic contractions applied to the gastric wall was related to the ulcer score in a dose-dependent manner. Exogenous prostaglandin (PG) reversed the MEA effect of Indo and reduced ulceration. It is postulated that an altered smooth muscle state secondary to inhibition of prostaglandin synthesis (PG-S) renders the mucosa vulnerable to injury by peristaltic action. PMID- 3276473 TI - Metabolic and hormonal changes in IDDM during long-distance run. AB - Hormonal and metabolic changes were compared in five insulin-dependent diabetic men and five control men during a 3-h marathon-training run. Insulin was withheld 16-26 h before the start of the run, and a normal breakfast was finished 2.5 h before the start of the run. Blood glucose concentrations decreased significantly in the diabetic subjects but remained constant in the control subjects. During the run, plasma free fatty acids, beta-hydroxybutyrate, and alanine concentrations behaved similarly in both groups. Only postexercise ketosis was more pronounced in the diabetic subjects. Peripheral serum free-insulin concentrations were slightly lower in the diabetic subjects at the start of the study, but these insulin concentrations became significantly elevated afterward compared with the control subjects. Plasma glucagon levels increased in the diabetic but not in the control subjects. Growth hormone levels increased sharply and to significantly higher levels in the diabetic than in the control subjects, who presented a slow gradual increase. Plasma cortisol levels were slightly, but at some moments significantly, higher in the diabetic subjects. The plasma catecholamine concentrations increased in both groups but to significantly higher levels in the diabetic subjects. There is no evidence from this study for an insufficient secretion of counterregulatory hormones if a hypoglycemic reaction occurs during a long-distance run in reasonably well controlled, well-trained diabetic subjects without long-term complications. PMID- 3276474 TI - Impaired glucose tolerance, hyperinsulinemia, and hypertriglyceridemia in Australian aborigines from the desert. AB - A cross section of adult full-blooded Aborigines from three small isolated communities in the desert region of northwest Australia was surveyed for diabetes, impaired glucose tolerance (IGT), insulin levels, and lipoprotein lipids. Sixty-three men and 86 women from a total adult population of 330 were tested. Of the people tested, 67.6% had normal glucose tolerance, 25% had IGT, and 7.4% had diabetes. Both diabetes and IGT were strongly age related. Fasting insulin levels and insulin responses to oral glucose (elevation above basal) were elevated. Although fasting insulin rose with age, insulin response did not rise after adjustment for body mass index (BMI). Plasma triglyceride levels were high, particularly in men greater than 35 yr old (3.13 +/- 0.32 mM), but cholesterol levels were not elevated. Multiple regression analysis of fasting glucose, 2-h glucose, plasma triglyceride, fasting insulin, and insulin response for the nondiabetic subjects revealed 1) BMI was an independent risk factor for elevated 2-h glucose levels in women but not in men and was strongly related to fasting insulin concentrations in both genders; 2) fasting insulin concentration was an independent risk factor for increases in fasting glucose, insulin response, and triglyceride levels; 3) insulin response was related to the 2-h glucose level; 4) fasting and 2-h glucose levels and fasting insulin and triglyceride concentrations all rose with age in both genders, with the rate of increase generally greater in men. The most striking difference between these desert Aborigines and previously studied coastal Aborigines from the same geographical region was the significantly higher insulin response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276475 TI - Anti-adrenal medullary antibodies in IDDM subjects and subjects at high risk of developing IDDM. AB - Previous reports have noted the presence of anti-adrenomedullary antibodies in subjects with insulin-dependent diabetes mellitus (IDDM). We initiated a study to evaluate the presence of complement-fixing anti-adrenomedullary antibodies (CF ADM) in the following subjects: group 1 (age 4-60 yr), anti-islet cell antibody positive (ICA+) subjects at high risk of developing diabetes, in which 9 (32%) of 28 were positive for CF-ADM; group 2 (age 6-41 yr), anti-ICA negative (ICA-) subjects at high risk of developing diabetes, in which 0 (0%) of 15 were positive for CF-ADM; group 3 (age 1-58 yr), ICA+ diabetic subjects, in which 7 (30%) of 23 were positive for CF-ADM; group 4 (age 5-68 yr), ICA- diabetic subjects, in which 1 (4%) of 24 was positive for CF-ADM; group 5 (age 20-56 yr), volunteer blood bank donor controls, in which 2 (6%) of 32 were positive for CF-ADM; and group 6, known healthy controls, in which 0 (0%) of 14 were positive for CF-ADM. CF-ADM were increased in group 1 compared with group 2 (P less than .02) and both control groups (P less than .02). CF-ADM were increased in group 3 compared with group 4 (P less than .03) and both control groups (P less than .03 vs. group 5, P less than .05 vs. group 6). Presence of CF-ADM was associated with presence of ICA in group 1 (P less than .02) and group 3 (P less than .03).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276476 TI - Effects of accidental intramuscular injection on insulin absorption in IDDM. AB - Recent studies have shown that with the injection technique presently recommended to diabetic patients, accidental intramuscular injection of insulin is liable to occur quite frequently. In this study, the simultaneous absorption of 125I labeled soluble human insulin (5 U) from subcutaneous and intramuscular injection sites in the thigh and abdomen was measured for 3 h in 10 insulin-dependent diabetic subjects to evaluate the importance of accidental intramuscular injection for insulin absorption in the resting state. Injection sites were located with computed tomography of the thigh and abdomen. From a superficial part of the thigh musculature, the absorption rate was at least 50% higher than from the adjacent subcutaneous tissue, the time until 50% of the initial activity remained (t1/2) being 123 +/- 14 and greater than 180 min, respectively (P less than .001). No difference in absorption rates was found between the two tissues in the abdomen (t1/2 84 +/- 6 vs. 93 +/- 7 min, NS). The results suggest that in the thigh, accidental intramuscular injections will considerably increase the variability of insulin absorption and may impair glycemic control in insulin dependent diabetic patients. Furthermore, the influence of accidental intramuscular injection on insulin absorption seems to vary among injection regions. PMID- 3276477 TI - Perioperative management of diabetic subjects. Subcutaneous versus intravenous insulin administration during glucose-potassium infusion. AB - The purpose of this study was to validate methods for the perioperative management of diabetic patients that meet the prerequisites of simplicity, applicability in the absence of a diabetologist, and flexibility, to rapidly meet changing metabolic requirements. The patients were divided into two groups that were comparable for age, sex distribution, type of diabetes, and type of surgical procedures. The results show that intravenous insulin administration achieved better glycemic control during the intraoperative period, whereas it did not offer advantages over the subcutaneous route during the pre- and postoperative periods. The satisfactory degree of steady glycemic control achieved and the absence of hypoglycemic episodes indicate that the separate administration of insulin and glucose plus electrolytes is an effective and safe management modality for diabetic patients undergoing major surgery. PMID- 3276478 TI - Treatment of allergy to heterologous monocomponent insulin with human semisynthetic insulin. Long-term study. AB - Eight type II (non-insulin-dependent) diabetic subjects (7 women, 1 man, aged 42 61 yr), initially treated with oral hypoglycemic agents and intermittently treated with conventional insulins, were identified as developing allergic reactions to porcine and mixed-species monocomponent insulin. Allergy was systemic (urticaria and nonthrombocytopenic purpura) and local delayed in two subjects and local immediate or biphasic in six subjects. Lipoatrophy was present in two subjects. After treatment with human semisynthetic insulin (Monotard HM and Actrapid HM), systemic allergy disappeared. Local allergy disappeared in five subjects and was reduced in three subjects. No lipoatrophy occurred in new injection areas. The clinical results were accompanied by a significant decrease in serum insulin-specific IgE after 6, 12, 18, 24, 30, and 36 mo. Insulin specific IgG showed an evident decrease in five of eight patients, but the difference in mean values was not significant after 6, 18, 24, 30, and 36 mo. With one exception, intradermal skin tests were positive to human, bovine, and porcine insulin before and after human insulin treatment. PMID- 3276479 TI - Hypoglycemic effect of Opuntia streptacantha Lemaire in NIDDM. AB - To assess the hypoglycemic effect of the nopal Opuntia streptacantha Lemaire (O. streptacantha Lem.), three groups of patients with non-insulin-dependent diabetes mellitus (NIDDM) were studied. Group one (16 patients) ingested 500 g of broiled nopal stems. Group 2 (10 patients) received only 400 ml of water as a control test. Three tests were performed on group 3 (6 patients): one with nopal, a second with water, and a third with ingestion of 500 g broiled squash. Serum glucose and insulin levels were measured at 0, 60, 120, and 180 min. After the intake of O. streptacantha Lem., serum glucose and serum insulin levels decreased significantly in groups 1 and 3, whereas no similar changes were noticed in group 2. The mean reduction of glucose reached 17.6 +/- 2.2% of basal values at 180 min in group 1 and 16.2 +/- 1.8% in group 3; the reduction of serum insulin at 180 min reached 50.2 +/- 8.0% in group 1 and 40.3 +/- 12.4% in group 3. This study shows that the stems of O. streptacantha Lem. cause a hypoglycemic effect in patients with NIDDM. The mechanism of this effect is unknown, but an increased insulin sensitivity is suggested. PMID- 3276480 TI - Quantitative importance of dietary constituents other than glucose as insulin secretagogues in type II diabetes. AB - In seven type II (non-insulin-dependent) diabetic patients, given either 50 g glucose or a mixed meal potentially containing 61 g glucose as starch and sucrose, the postmeal plasma glucose area integrated over 4 h was less after the mixed meal. The insulin area was considerably greater (2.1-fold). The greater increase in insulin could be explained largely, but not entirely, by the protein and fructose in the mixed meal (85%) which, in addition to glucose, are known insulin secretagogues. The residual unexplained increase may be due to a synergistic interaction of these secretagogues, an unidentified insulin secretagogue, or by a reduced insulin removal rate. These possibilities remain to be explored. PMID- 3276481 TI - Stress and autonomic nervous system in type II diabetes. A hypothesis. PMID- 3276482 TI - Neurobehavioral complications of type I diabetes. Examination of possible risk factors. AB - There is increasing interest in the possibility that diabetes mellitus may be associated with a series of neurobehavioral, or neuropsychological, changes; i.e., learning, memory, problem solving, mental and motor speed, and eye-hand coordination may sometimes be disrupted in diabetic children and adults, and this disruption may be a consequence of certain disease-related variables. To date, four neurobehavioral risk factors have been identified. For children and adolescents, the most potent risk factors appear to be age at diagnosis and the occurrence of schoolroom-related problems. Children who develop diabetes early in life are more likely to show serious cognitive impairments on virtually all measures. In addition, diabetic children with school attendance problems tend to score lower than expected on verbal IQ tests and school achievement tests. For adults, the most carefully studied risk factor is degree of metabolic control. Adults in poor control are far more likely to manifest subtle changes on measures of mental efficiency. This may be particularly evident on tasks that require the development and deployment of sophisticated information-processing strategies. A fourth variable--severe episodes of hypoglycemia--is known to disrupt functioning in diabetic subjects of any age, although it has not yet been studied systematically in large-scale studies. Indeed, because virtually all extant studies have been based on limited neurobehavioral and biomedical assessments of relatively few volunteer subjects, this list of risk factors must be considered tentative at best. PMID- 3276483 TI - Let us set an example. PMID- 3276484 TI - CSII in management of insulin allergy. PMID- 3276485 TI - New devices for patients with diabetes mellitus: a reply. PMID- 3276486 TI - Biphasic patterns of peripheral insulin and glucose concentrations after meals. PMID- 3276487 TI - [Therapy of renal anemia with recombinant human erythropoietin]. AB - The effectiveness of recombinant human erythropoietin (r-HEPO) was tested in 15 haemodialysis patients. The dosage was started at 24 IU/kg three times weekly, as an intravenous bolus at the end of the dialysis session, and then doubled every two weeks as long as the rise in haemoglobin was less than 2 g/dl. During treatment the reticulocyte count rose from 31 +/- 5 x 10(3)/microliters to 152 +/ 11 x 10(3)/microliters after 16 weeks. The haematocrit rose from 0.24 +/- 0.01 to 0.36 +/- 0.002. At the beginning of treatment the haemoglobin level was 7.3 +/ 0.3 g/dl and rose during treatment to 11.3 +/- 0.2 g/dl. Three patients developed hypertension and in two their Cimino shunt closed. but there were no toxic side effects, organ damage, allergic reactions or antibodies against the hormone. The results show that the anaemia of patients on chronic dialysis can be treated effectively and without serious side effects with r-HEPO. PMID- 3276488 TI - [Diagnosis of primary biliary cirrhosis]. PMID- 3276489 TI - [Therapy of primary biliary cirrhosis]. PMID- 3276490 TI - [Asymptomatic myocardial ischemia]. PMID- 3276491 TI - [Johann Christian Doppler? Or Christian Andreas Doppler?]. PMID- 3276492 TI - [Immunomodulating therapy in chronic polyarthritis with thymopentin. A multicenter placebo-controlled study of 119 patients]. AB - In a multicenter, placebo-controlled and randomized double-blind trial 119 patients with rheumatoid arthritis were treated with thymopentin, an immunoregulating drug. The data of 107 patients were complete enough to be evaluated: 51 were given intravenous injections over ten minutes of 50 mg thymopentin three times weekly, 56 were similarly treated with a placebo solution. Significant improvement of five among nine clinical criteria were obtained with thymopentin after the third week of treatment. The response rate (improvement of a clinical parameter by at least 40%) was significantly greater for all clinical parameters in the thymopentin group. Regression to a functionally more favourable class (Steinbrocker's classification) occurred in seven thymopentin-treated, but in none of the placebo-treated patients. The improvement gradually subsided over four weeks after the end of treatment. There were no changes during the trial with respect to immunological, biochemical or haematological findings. Except for one systemic allergic reaction there were no side effects. PMID- 3276493 TI - [Diagnosis of malignant cutaneous lymphomas]. PMID- 3276494 TI - [Beta 2-microglobulin-induced amyloidosis. A new complication of long-term hemodialysis]. PMID- 3276495 TI - [Therapy of malignant lymphoma of the skin]. PMID- 3276496 TI - [Chemotherapy of metastasized breast carcinoma]. PMID- 3276497 TI - [Bases of the planning of diagnostic studies]. PMID- 3276498 TI - Effects of opioid peptides on aldosterone production: stimulatory effect of leu enkephalin. AB - The effects of several opioid peptides (Leu-enkephalin, Met-enkephalin, D-Ala2,D Leu5-enkephalin, and peptide E) on aldosterone secretion have been studied in isolated bovine adrenal glomerulosa cells. Leu-enkephalin significantly increased aldosterone production in a dose-dependent manner (10(-10)-10(-7) M). Similar results on steroidogenesis were obtained with the synthetic opioid D-Ala2,D-Leu5 enkephalin, whereas much higher concentrations of Met-enkephalin were required. Peptide E did not affect steroidogenesis. Naltrexone or naloxone (10(-5) M) potentiated the effect of Leu-enkephalin on aldosterone secretion. The effect of a general opioid antagonist (diprenorphine) or an agonist (etorphine) was also studied. The stimulation by Leu-enkephalin of aldosterone secretion was only partially blocked by diprenorphine. Etorphine (10(-6) and 10(-8) M) had no effect on basal steroidogenesis. It is proposed that the stimulatory effect of Leu enkephalin on aldosterone production could be mediated by a different receptor than the classical opioid receptors presently known. PMID- 3276499 TI - The acute effects of growth hormone on amino acid transport and protein synthesis are due to its insulin-like action. AB - GH has acute stimulatory effects on amino acid transport and protein synthesis in a variety of tissues, but it has not been established whether these effects are expressions of the growth-promoting property of GH or of its separate insulin like action. The 20,000-dalton structural variant of human GH (20K hGH) has been shown to have a high ratio of growth-promoting to insulin-like activity compared to native hGH (22K hGH), suggesting that it could be used as a tool to address the above question. Therefore, experiments were conducted to compare the relative abilities of native 22K hGH and 20K hGH, when added in vitro, to stimulate amino acid transport and protein synthesis in the isolated diaphragm of the female hypophysectomized rat. Paired intact hemidiaphragms were preincubated for 1 h in the absence or presence of various concentrations of 22K or 20K hGH. Then, 3-O [14C]methylglucose was added to the medium to measure sugar transport as a test of insulin-like activity, and either alpha-[3H]aminoisobutyric acid acid or [3H] phenylalanine was also added to measure amino acid transport or protein synthesis, respectively, during a final hour of incubation. When the responses to the various concentrations of 22K and 20K were compared, 20K hGH was only about 20% as effective as 22K in stimulating 3-O-methylglucose transport, reflecting its markedly attenuated insulin-like activity on the diaphragm. Similarly, 20K hGH was only 20% as effective as 22K hGH in stimulating alpha-aminoisobutyric acid transport and phenylalanine incorporation into protein in the same muscles. Therefore, these findings support the idea that the rapid stimulatory effects of GH on amino acid transport and protein synthesis are expressions of the insulin like action of GH and are not components of the response of target cells to its growth-promoting action. PMID- 3276500 TI - Effects of diabetes on uterine condition, decidualization, vascularization, and corpus luteum function in the pseudopregnant rat. AB - The effects of alloxan-induced diabetes on uterine decidualization and the associated changes in uterine blood flow (UBF) and corpus luteum activity were evaluated in rats between days 4-9 of pseudopregnancy (day 0 = ovulation). Rats were made diabetic (D) with a 40 mg/kg injection (iv) of alloxan on day 1 of pseudopregnancy. Saline-treated rats served as controls (C). Uterine weights were depressed in D rats between days 6-7 of pseudopregnancy in association with elevated blood glucose levels (greater than 300 mg/dl) relative to control values. UBF rates were also depressed in D rats between days 6-7 of pseudopregnancy compared with control values. Insulin replacement therapy (6 IU bovine/day) effectively normalized both uterine weight and UBF in diabetic rats. Decidual tissue (DT) growth was impaired in D rats between days 7 and 9 of pseudopregnancy (DT induction on day 4 of pseudopregnancy) compared with controls. Tissue blood flow rates were severely depressed throughout pseudopregnancy in D rats, but insulin treatment normalized both uterine parameters to control levels. Serum progesterone levels were lower in D rats than in controls between days 7 and 9 of pseudopregnancy. Daily insulin treatment normalized luteal function to control levels. The depressed DT weights in D rats were mimicked by the experimental reduction of DT blood flow in control rats. These results indicate that the uterine atrophy and poor endometrial decidualization that characterized the D rat are accompanied by impaired UBF and luteal activity. These findings suggest that the D-associated depression in female reproductive performance is related to the lack of proper hormone support of tissue vascular dynamics. PMID- 3276501 TI - [Cryoglobulinemias]. PMID- 3276503 TI - [Cholestasis]. PMID- 3276502 TI - Primary acquired myelodysplastic syndromes. PMID- 3276505 TI - From DNA damage to mutation in mammalian cells: a review. PMID- 3276504 TI - [Effect of various forms of oral decontamination on bacterial colonization in children with neutropenia]. PMID- 3276506 TI - Comments on the mutagenicity of alpha,beta-unsaturated aldehydes in Salmonella and the adequacy of experimental data to demonstrate a hypothesis. PMID- 3276507 TI - Aneuploidy induction in Saccharomyces cerevisiae by two solvent compounds, 1 methyl-2-pyrrolidinone and 2-pyrrolidinone. AB - A number of solvent compounds that were tested in Saccharomyces cerevisiae were potent inducers of aneuploidy, although they did not induce any other genetic effects. As an extention of these earlier findings, 1-methyl-2-pyrrolidinone was tested and was found to induce aneuploidy. Several structurally related compounds were also tested; 2-pyrrolidinone induced aneuploidy, but succinimide, pyrrolidine, 1-methylpyrrolidine, 1-methyl-3-pyrrolidinol, and 2 pyrrolidineethanol did not. Maleimide and its N-hydroxy, N-methyl, and N-ethyl derivatives were also negative for aneuploidy induction. PMID- 3276508 TI - A method for studying the mutagenicity of some gaseous compounds in Salmonella typhimurium. AB - A dynamic flow-through exposure system was designed for mutagenicity studies of gaseous compounds in Salmonella. Salmonella typhimurium strain TA100 was the primary tester strain. The dose ranges were 0.5-20% of vinyl chloride, ethene, propene, and 1,3-butadiene, 1-200 ppm of ethylene oxide, 0.5-20 ppm of nitrogen dioxide, and 0.1-3.5 ppm of ozone. The gas flow rate was 250, 500, or 1,000 ml/min, and the exposure time was 6 or 7 hours. Of the tested gases, vinyl chloride, ethylene oxide, and nitrogen dioxide were mutagenic. Ethene, propene, and 1,3-butadiene were not mutagenic in this system. Ozone is bacteriotoxic, and no mutagenic effect could be demonstrated in the nontoxic dose range. The exposure system was considered suitable for studies on gaseous chemicals. PMID- 3276509 TI - Photochemical formation of mutagenic compounds from alkenes and ozone or nitrogen dioxide. AB - In order to investigate the possible formation of mutagenic compounds from alkenes emitted in ambient air, laboratory experiments were performed with Salmonella typhimurium strain TA100 in a small-scale flow-through exposure system. The reaction time for mixtures of alkenes with ozone or nitrogen dioxide was 40 minutes, and the exposure time for bacteria was 6 hours. Ozone gave rise to a small mutagenic effect in combination with 1,3-butadiene or vinyl chloride, with and without ultraviolet (UV) irradiation, but not in combination with ethene or propene. Nitrogen dioxide gave rise to a mutagenic effect in combination with propene, 1,3-butadiene, or vinyl chloride, but only after UV irradiation. The mutagenic activity was highest with butadiene and seemed to be dose-related to the concentration of nitrogen dioxide. Nitrogen dioxide with ethene did not produce a mutagenic effect. A mixture of ethene, propene, and butadiene, tested with ozone or nitrogen dioxide with UV irradiation, did not potentiate each other's mutagenic effect. PMID- 3276510 TI - A case of conjoined twins, with a brief historical review. PMID- 3276511 TI - The 13th Kellersberger memorial lecture, 1987. A view of vaccines against leprosy and a reflection on "appropriate science" and the Third World. PMID- 3276512 TI - NMR analysis of the interdomain region of yeast phosphoglycerate kinase. AB - Previous proton and phosphorus nuclear magnetic resonance studies with yeast phosphoglycerate kinase have been extended using a higher-resolution spectrometer and a greater variety of binding agents. The new study shows that, apart from a few isolated mobile side chains distributed over the protein surface, there is a mobile section of phosphoglycerate kinase associated with the inter-domain region of the molecule. This region gives relatively well resolved resonances which are quite distinct from those originating from the remainder of the protein. This suggests that the molecule fluctuates between many states including several open or substrate binding forms in addition to the closed and supposedly catalytically competent form of the enzyme. The occupancy of these states appears to be affected by several anions including sulphate, phosphate and cobalticyanide, as well as substrates and their analogues. PMID- 3276513 TI - Properties and crystallization of a genetically engineered, water-soluble derivative of penicillin-binding protein 5 of Escherichia coli K12. AB - Derivatives of the Escherichia coli penicillin-binding protein 5 (PBP5) with truncated carboxyl terminals were obtained by altering the carboxyl-coding end of the dacA gene. After cloning the modified dacA gene into a runaway-replication control plasmid, one clone that overproduced and excreted the desired protein into the periplasm was used as a source for the isolation of a water-soluble PBP5 (i.e. PBP5S). In PBP5S the carboxyl-terminal 21-amino-acid region of the wild type protein was replaced by a short 9-amino-acid segment. Milligram amounts of PBP5S were purified by penicillin affinity chromatography in the absence of detergents or of chaotropic agents. PBP5S was stable and possessed DD carboxypeptidase activity without added Triton X-100. Upon reaction with [14C]benzylpenicillin it was converted into a rather short-lived acyl-enzyme complex, as observed with PBP5. Both PBP5 and PBP5S were crystallized. In contrast to PBP5, PBP5S yielded enzymatically active, well-formed prismatic crystals suitable for X-ray analysis. PMID- 3276514 TI - Elongation factor 1 beta gamma from Artemia. Purification and properties of its subunits. AB - The guanine nucleotide exchange factor, elongation factor 1 beta gamma (EF-1 beta gamma) has been purified from Artemia cysts using an improved method. The protein consists of two distinct polypeptides with relative molecular masses of 26,000 (EF-1 beta) and 46,000 (EF-1 gamma). A nucleoside diphosphate phosphotransferase activity often found in EF-1 beta gamma preparations has been completely separated from the actual guanine nucleotide exchange stimulatory activity of EF 1 beta gamma, thus indicating that nucleotide diphosphate phosphotransferase is not an intrinsic property of EF-1 beta. Both EF-1 beta gamma and EF-1 beta have been shown to stimulate the following three reactions to a comparable degree: (a) exchange of GDP bound to EF-1 alpha with exogenous GDP; (b) EF-1 alpha-dependent binding of Phe-tRNA to ribosomes; (c) poly(U)-dependent poly(phenylalanine) synthesis. However, a significantly higher nucleotide exchange rate was observed in the presence of EF-1 beta gamma compared to EF-1 beta alone. Concerning elongation factor 1 gamma (EF-1 gamma) the following observations were made. In contrast to EF-1 beta, pure EF-1 gamma is rather insoluble in aqueous buffers, but the tendency to precipitate can be partially suppressed by the addition of detergents. In particular, EF-1 gamma partitions solely into the detergent phase of Triton X-114 solutions. EF-1 gamma is also more susceptible to spontaneous, specific fragmentation. It is remarkably that about 5% of the cellular pool of EF 1 beta gamma was found to be present in membrane fractions, under conditions where no EF-1 alpha was detectable in these fractions. Furthermore it was noted that EF-1 beta gamma copurified strongly with tubulin on DEAE-cellulose. Moreover, it was observed that from a mixture of EF-1 beta gamma and tubulin, EF 1 gamma coprecipitates with tubulin using a non-denaturating immunoprecipitation technique. These findings suggest that EF-1 gamma has a hydrophobic domain and interacts with membrane and cytoskeleton structures in the cell. PMID- 3276515 TI - Insect immunity. Purification and characterization of a family of novel inducible antibacterial proteins from immunized larvae of the dipteran Phormia terranovae and complete amino-acid sequence of the predominant member, diptericin A. AB - Injury or injection of live bacteria into third instar larvae of the dipteran insect Phormia terranovae results in the appearance in the haemolymph of at least five groups of heat-stable, more or less basic peptides with antibacterial activity against Escherichia coli. Three of these peptides have been purified. The amino acid sequence has been completely established for one of these and partially (first 40 residues from the N-terminus) for the two others. The sequences show marked homologies indicating that the three peptides belong to a common family. They are not related to other known antibacterial peptides from insects [lysozymes, cecropins (including sarcotoxin I) and attacins]. We propose the name of diptericins for this new family of antibiotic molecules. PMID- 3276516 TI - Metabolism of 2-oxoaldehyde in mold. Purification and characterization of two methylglyoxal reductases from Aspergillus niger. AB - Two kinds of methylglyoxal reductases were purified to apparent homogeneity from Aspergillus niger and designated MGR I and MGR II. Both enzymes consisted of a single polypeptide chain with a relative molecular mass of 36,000 (MGR I) and 38,000 (MGR II). NADPH was specifically required for the activities of both enzymes and Km values for NADPH were 54 microM (MGR I) and 6.8 microM (MGR II). MGR I was specific to 2-oxoaldehydes [glyoxal, methylglyoxal (Km = 15.4 mM) and phenylglyoxal], whereas MGR II was active on both 2-oxoaldehydes [glyoxal (Km = 10 mM), methylglyoxal (Km = 1.43 mM), phenylglyoxal (Km = 4.35 mM) and 4,5 dioxovalerate] and some aldehydes (propionaldehyde and acetaldehyde). Optimal pH values for MGR I and MGR II activities were 9.0 and 6.5 respectively. Both enzymes were inactivated by a brief incubation with 2-oxoaldehydes (glyoxal, methylglyoxal and phenylglyoxal) in the absence of NADPH. MGR I activity was competitively inhibited by NADP+ and the Ki value for NADP+ was calculated to be 0.49 mM. On the other hand, the inhibition of MGR II activity by NADP+ was of mixed type, the Ki value for NADP+ being 45 microM. MGR I was different from MGR II in amino acid composition. PMID- 3276518 TI - Association of glyceraldehyde-3-phosphate dehydrogenase with mono- and polyribosomes of rabbit reticulocytes. AB - It has been shown recently that glyceraldehyde-3-phosphate dehydrogenase (GAPD) is one of the three major RNA-binding proteins of rabbit reticulocytes [Ryazanov, A. G. (1985) FEBS Lett. 192, 131-134]. It was suggested that, due to its RNA binding capacity, GAPD can form loose dynamic complexes with polyribosomes. This communication reports that a considerable amount of GAPD activity can be found in the mono- and polyribosome fraction after sucrose gradient centrifugation of rabbit reticulocyte lysate. An increase of ionic strength, as well as the addition of exogenous RNA to the extract, result in the removal of GAPD from the complex with mono- and polyribosomes. It appears that GAPD forms the complex with polyribosomes due to the interaction with some exposed RNA regions of these structures. Although the interaction of GAPD with ribosomes is weak, it can be detected under physiological ionic conditions by the difference boundary sedimentation velocity technique. Association of GAPD with mono- and polyribosomes can be prevented by a low concentration (10 microM) of NADH, but not NAD+. A nitrocellulose filter binding assay also shows that NADH has a stronger inhibitory effect on the enzyme-RNA complex formation, as compared with NAD+. We propose that the RNA-mediated association of GAPD with mono- and polyribosomes can provide compartmentation of the energy-supplying system on these structures within the cell. This can maintain a high local concentration of ATP and GTP near the sites of protein synthesis. PMID- 3276517 TI - The tubulin genes of Trypanosoma cruzi. AB - The organization of the alpha- and beta-tubulin genes in the genome of Trypanosoma cruzi have been analysed by Southern blotting using tubulin probes derived from Trypanosoma brucei. The tubulin array appears to be more complex in this organism than in other members of the same family. Some tubulin genes are tightly clustered in an alternating (alpha-beta)n array with a basic repeat unit length of 4.3 kb. However, other pairs of alternating alpha- and beta-tubulin sequences appear to be physically separated from the basic group. This finding indicates that the tubulin gene cluster present in T. cruzi is less perfectly conserved than in T. brucei. T. (Herpetosoma) rangeli is similar to T. (Schizotrypanum) cruzi in its tubulin gene organization whereas most of these genes are tandemly clustered in the genome of T. (Trypanozoon) evansi, with a basic repeat unit length of 3.6 kb as previously described for T. (Trypanozoon) brucei. Two overlapping recombinant clones containing T. cruzi tubulin sequences have been isolated from a genomic cosmid library of T. cruzi epimastigotes using the T. brucei tubulin probes. Partial sequencing of the T. cruzi beta-tubulin gene has confirmed its identity and shows more than 70% homology with the sea urchin, chicken and T. b. rhodesiense beta-tubulin reported gene sequences. Analysis of tubulin gene organization through the parasite life cycle does not show evidence of major rearrangements within the repeat unit. Several T. cruzi strains and cloned lines whilst sharing the 4.3-kb tubulin repeat unit, exhibited very variable tubulin gene organization with tubulin probes. These striking differences in the organization of this structural gene among T. cruzi strains and cloned lines suggest that the heterogeneity previously reported in parasite populations may be related to a very dynamic, diploid genome. PMID- 3276519 TI - Engineered rat insulin I analogue having a B16 Tyr/Asp replacement exhibits unchanged susceptibility to cleavage by insulin proteinase. AB - An analogue of rat insulin I was produced by oligonucleotide-directed mutagenesis of a cloned rat preproinsulin I cDNA, followed by expression of a resulting mutant gene in Escherichia coli K-12 and proteolytic cleavage of mutant proinsulin isolated from this bacterium. The Tyr-to-Asp replacement at residue B16 in the insulin analogue had been expected to diminish the rate of cleavage of the molecule by the enzyme insulin proteinase, since the bond TyrB16-LeuB17, invariant in all mammalian species, had been proposed by other authors as one of the early, major sites of proteolytic attack. In the event the substitution had no measurable effect on the rate of degradation by insulin proteinase. Thus we find no support in these experiments for the hypothesis that the site in question is of primary importance in the degradation of rat insulin I by the enzyme. PMID- 3276520 TI - S100a0 (alpha alpha) protein in cardiac muscle. Isolation from human cardiac muscle and ultrastructural localization. AB - S100 protein, an acidic and calcium-binding protein, was believed to be localized in the nervous tissue, but recently it has been reported to be mainly present in the cardiac and the skeletal muscles of various mammals in the alpha alpha form (S100a0) at much higher levels than the nervous tissues. We isolated here S100 protein from human cardiac muscles. The isolated cardiac muscle S100 protein showed a single band on electrophoresis at the same position as that of human skeletal muscle S100a0. The amino acid composition of the purified S100 protein was quite similar to that of human skeletal muscle S100a0 or bovine brain S100a0. The immunohistochemical study by use of antibodies monospecific to the alpha subunit of S100 protein (S100-alpha) revealed that S100-alpha was strongly labeled in human myocardial cells, whereas the beta subunit of S100 protein (S100 beta) was not detected in the cells. These results suggest that a predominant form of S100 protein in human myocardial cells is not S100a (alpha beta) or S100b (beta beta), but S100a0 (alpha alpha). In order to determine the ultrastructural localization of S100a0 in mouse cardiac muscle, the direct peroxidase-labeled antibody method was employed. S100a0 was mainly localized in the polysomes in the interfibrillar spaces, the fine filamentous structure of the Z line and fascia adherens of the intercalated disc and in the lumen of junctional sarcoplasmic reticulum. PMID- 3276521 TI - Primary structure of the uracil transport protein of Saccharomyces cerevisiae. AB - We present in this paper the nucleotidic sequence of the FUR4 gene encoding the uracil permease in the yeast Saccharomyces cerevisiae. The deduced amino acid sequence of the permease has 633 residues; it consists of many hydrophobic stretches, only the N-terminal and C-terminal ends of the protein (about 100 and 50 amino acids respectively) being mostly hydrophilic. No N-terminal hydrophobic signal peptide is present, although it is shown in this work that the biosynthesis of the uracil permease goes through the secretion/glycosylation pathway. Using the results of three different methods, allowing the prediction of transmembrane alpha helices in proteic sequences, we drew a model of folding of the permease in the membrane. PMID- 3276522 TI - Site of action of a Vero toxin (VT2) from Escherichia coli O157:H7 and of Shiga toxin on eukaryotic ribosomes. RNA N-glycosidase activity of the toxins. AB - The site of action of a Vero toxin (VT2 or Shiga-like toxin II) from enterohemorrhagic Escherichia coli and Shiga toxin from Shigella dysenteriae 1 on eukaryotic ribosomes was studied. Treatment of eukaryotic ribosomes with either toxin caused the release of a fragment of 400 nucleotides from 28S ribosomal RNA when the isolated ribosomal RNA was treated with aniline. Release of this fragment with aniline treatment was accompanied by inhibition of protein synthesis and of elongation-factor-1-dependent aminoacyl-tRNA binding to ribosomes. Analysis of the nucleotide sequence of the 3'-terminal fragment of 553 nucleotides of 28S rRNA of rat liver 60S ribosomal subunits suggested that an adenine base at position 4324 (A-4324) was absent in toxin-treated 28S rRNA. Further analysis by thin-layer chromatography demonstrated quantitative release of adenine from rat liver ribosomes on treatment with the toxins. These results indicate that both VT2 and Shiga toxin inactivate 60S ribosomal subunits by cleaving the N-glycosidic bond at A-4324 in 28S ribosomal RNA. PMID- 3276523 TI - Osteopathia striata, cranial sclerosis with cleft palate and facial nerve palsy. AB - Osteopathia striata (OS) is a rare bone dysplasia characterized by longitudinal sclerotic striations of the long bones. It is of no clinical importance, but OS associated with cranial sclerosis represents a separate entity with a high incidence of palatine malformations and deafness. Only 19 cases of this entity have been reported in the literature. One patient of this series also had facial nerve paralysis. This paper presents a second case of OS, cranial sclerosis, palatine pathology and recurrent facial nerve paralysis. This incidence of 2/20 (10%) does not seem to be coincidental but raises the possibility that facial nerve palsy is one of the clinical manifestations of this specific bone abnormality. PMID- 3276524 TI - Tetrahydrobiopterin deficiency: assay for 6-pyruvoyl-tetrahydropterin synthase activity in erythrocytes, and detection of patients and heterozygous carriers. AB - 6-Pyruvoyl-tetrahydropterin synthase (PTS), a key enzyme in the synthesis of tetrahydrobiopterin in man, is defective in the most frequent variant of tetrahydrobiopterin-deficient hyperphenylalaninaemia (atypical phenylketonuria). An assay for PTS activity in erythrocytes was developed. It is based on the PTS catalysed formation of tetrahydrobiopterin from dihydroneopterin triphosphate in the presence of magnesium, sepiapterin reductase, NADPH, dihydropteridine reductase, and NADH, and fluorimetric measurement of the product as biopterin by high performance liquid chromatography (HPLC) after oxidation with iodine. The PTS activity was higher in younger erythrocytes, including reticulocytes, than in older ones. Fetal erythrocytes showed approx. four times higher activities than those of adults. Using a more purified human liver sepiapterin reductase fraction which gave a lower yield than a crude preparation, adult controls (n = 8) showed a mean erythrocyte PTS activity of 17.6 (range 11.0-29.5) microU/g Hb. Nine of 11 patients with typical PTS deficiency showed activities between 0% and 8% of the mean of controls, and two of 11 showed 14% and 20%, respectively. The obligate heterozygotes (n = 16) had activities of 19% (range 8%-31%) of the mean of controls, i.e., significantly less than the expected 50%. Four patients with the "peripheral" type of the disease showed 7%-10% of the mean of controls. Thus, the assay did not distinguish between patients and heterozygotes in every family. The assay is well suited to the identification of heterozygotes of PTS deficiency in family studies. PMID- 3276525 TI - Schistosomiasis in childhood. AB - Schistosomiasis is a parasitic disease of the tropics which is estimated to affect up to 300 million people worldwide. In endemic areas the childhood age group has the highest prevalence and intensity of infection. There are several distinct species of schistosomes. The principal organ system involved in Schistosoma haematobium infection is the urinary tract since parasite eggs penetrate the bladder and are excreted in the urine. Hematuria, proteinuria, leukocyturia and symptoms like dysuria or nocturia are the most common clinical presentations. Heavily infected patients show obstructive uropathy of different severity which may lead to renal failure. Intestinal schistosomiasis is caused by Schistosoma mansoni infection. Initial symptoms can be diarrhea and blood-tinged stool. Chronic infection is characterized by fibrotic involvement of the liver and consecutive portal hypertension. The diagnosis of schistosomiasis depends on the demonstration of schistosome eggs in human excreta or biopsy material. Imported cases of schistosomiasis to Europe show an increasing tendency due to expanding international travel. Furthermore imported cases are usually not diagnosed until years after the patients have left an endemic area. The treatment of choice is a single dose of praziquantel 40 m/kg bodyweight resulting in cure rates of around 90% and considerable reversibility of pathological abnormalities due to schistosome infections. PMID- 3276527 TI - Intrauterine development of posthaemorrhagic hydrocephalus. AB - Differential diagnosis of intrauterine hydrocephalus includes various types of cerebral malformations. In about 30% of cases the pathogenesis remains unknown. During 1983-1985 we diagnosed intrauterine posthaemorrhagic hydrocephalus (IPHH) in four newborns. In three of the reported cases intraventricular haemorrhage (IVH) could already be proven in the fetus. Due to these observations, IPHH has to be considered with the differential diagnosis of congenital hydrocephalus. Haemorrhagic diathesis and multiple pregnancy are discussed as possible risk factors for this severe fetal complication. PMID- 3276526 TI - Surfactant replacement therapy in neonatal respiratory distress syndrome. A multi centre, randomized clinical trial: comparison of high- versus low-dose of surfactant TA. AB - We conducted a prospective, randomized, controlled trial comparing the efficacy of two doses of a reconstituted bovine surfactant (Surfactant TA) in premature infants requiring mechanical ventilation shortly after birth for respiratory distress syndrome. Forty-six infants weighting 1000-1499 g were randomized into two groups: a low-dose group (23 infants given a single dose of 60 mg surfactant lipid/kg) and a high-dose group (23 infants given a single dose of 120 mg/kg). The mean (SD) age at which surfactant was given was 5.5 (+/- 1.2) h in the low dose group and 6.0 (+/- 1.5) h in the high dose group. Both treatments improved oxygenation (increased arterial-alveolar PO2 ratio) with decreased mean airway pressure, the high-dose surfactant having a more beneficial effect in prolonging the response. Infants in the high-dose group had significantly less (P less than 0.05) incidence of both intraventricular haemorrhage and bronchopulmonary dysplasia. This prospective trial documents that a greater benefit can be obtained by increasing the dose of surfactant (120 mg/kg) beyond 60 mg/kg treatment of premature infants with severe respiratory distress syndrome (RDS). PMID- 3276528 TI - Facial paralysis at the age of 2 months as a first clinical sign of van Buchem disease (endosteal hyperostosis). AB - In this paper we report a 7.5-year-old physically normal boy with van Buchem disease (endosteal hyperostosis). Vague complaints of headache were the indication for X-ray examination. At the age of 2 months a left-side peripheral facial nerve palsy suddenly occurred in this boy. Skull X-rays gave normal results at that age, suggesting that encroachment of the cranial nerves in van Buchem disease may occur as early as in the postnatal period, even before sclerosis of the skull has become radiologically visible. PMID- 3276529 TI - Cellular and molecular aspects of neoplastic progression in the mammary gland. PMID- 3276530 TI - Cellular aspects of breast cancer: workshop report. AB - It has not been possible in this review to cover all the submitted posters nor indeed all the points discussed during the workshop session. It is hoped, however, that major points of interest have been presented and that areas where there is consensus and areas where controversy remains concerning the clinical value of particular investigations have been highlighted. It is also hoped that some new potential growth areas for investigation of tumour biology have been defined. PMID- 3276531 TI - The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer. AB - The protective effect of early menopause shows that ovarian hormones increase the risk of breast cancer: it is likely that this is because they stimulate breast cell division. The mitotic rate of breast cells is higher during the luteal phase of the menstrual cycle than during the follicular phase, suggesting either that progesterone and oestrogen together induce more mitoses than oestrogen alone (the 'oestrogen plus progestagen hypothesis') or that oestrogen alone induces breast cell mitoses in a dose-dependent manner and that progesterone has no effect (the 'oestrogen alone hypothesis'). Both hypotheses are consistent with the known effects of reproductive history, obesity, combined oral contraceptives and oestrogen replacement therapy (ERT) on breast cancer risk, but while the oestrogen alone hypothesis predicts that hormone replacement therapy with oestrogen and a progestagen (HRT) will cause the same increase in risk as ERT, the oestrogen plus progestagen hypothesis predicts that HRT will cause a greater increase in risk than ERT. Both hypotheses suggest that the risk of breast cancer could be reduced by delaying the onset of regular ovulatory menstrual cycles and by minimizing the therapeutic use of oestrogens, and possibly of progestagens, in postmenopausal women. It may be possible to design hormonal contraceptives that will decrease breast cancer risk. PMID- 3276532 TI - Activities of the EORTC Breast Cancer Co-operative Group: an overview. [European Organization for Research and Treatment of Cancer]. PMID- 3276533 TI - Screening for breast cancer: a review. PMID- 3276534 TI - Imaging techniques in breast cancer. What is new? What is useful? A review. PMID- 3276535 TI - Surgery in the management of early breast cancer: a review. PMID- 3276536 TI - Radiotherapy in the management of early breast cancer: a review. AB - Breast conserving therapy with adequate radiotherapy results in similar local control and survival in patients with early breast cancer. Radiotherapy has proven to be an integral part of this treatment as in the NSABP trial a significant reduction of breast recurrences occurred after irradiation, compared with tumorectomy alone. The entry criteria of the performed randomized trials were initially limited to patients with tumours up to 2 cm diameter, but even patients with incompletely excised tumours up to 5 cm have been accepted in the recently closed EORTC trial 10801. This means that this conservative approach is now accessible for a much larger group of patients with breast cancer. A few factors related to a somewhat higher recurrence rate in the breast are: extensive ductal carcinoma in situ, younger age and incomplete excision. These factors are, however, not absolute contra-indications for breast conserving therapy because wide reexcision of the primary tumour or a high booster dose are likely to correct for these unfavourable factors. Future clinical research is required to optimize the irradiation with reduction of side-effects and maintaining a high local control rate. PMID- 3276537 TI - Adjuvant systemic treatment for early breast cancer: a review. PMID- 3276538 TI - Involvement of serum factor(s) adsorbed to the dish in the response of cycloheximide-pretreated BP-A31 cells to serum pulses. AB - The mitogenic effect of serum pulses, observed previously in quiescent BP-A31 cells, is an artifact due to adsorption of (unknown) serum mitogens to the culture dish; the continuous presence of growth factors is necessary for these cells to traverse the G1 phase. When pretreated with cycloheximide (CH) during the last 8-24 h of quiescence, the BP-A31 cells are particularly sensitive to the adsorbed serum mitogens, as well as to low concentrations of fetal calf serum (less than 0.25%) and to basic fibroblast growth factor. In contrast, the mitogenic activity of insulin was not influenced by CH pretreatment. The expression of the "competence genes" c-myc and JE was only transiently elevated in quiescent BP-A31 cells during CH exposure and did not correlate with the enhancement of the cells' sensitivity to mitogens. PMID- 3276539 TI - Maintenance of normal rat mammary epithelial cells by insulin and insulin-like growth factor 1. AB - Normal rat mammary epithelial cells were cultured within a rat tail collagen gel matrix formed under improved conditions for controlling pH and osmolarity. Under these conditions, growth can be maintained for up to 3 weeks with a 10- to 15 fold increase in cell number. The cells grow in response to prolactin, progesterone, epidermal growth factor, and cholera toxin, in a medium of DME: Ham's F12 supplemented with BSA and insulin at 10 micrograms/ml. When the insulin concentration was reduced to more physiological levels (10 ng/ml) the cells did not grow. However, at these more physiological concentrations it could be shown that insulin had a concentration-dependent effect on the maintenance of the cells with an optimum concentration around 25 ng/ml. The cells could be maintained in hormone-supplemented medium with low levels of insulin in a quiescent state for up to 14 days. The high levels of insulin needed for optimal growth could be replaced by insulin-like growth factor 1 (IGF-1) at much lower concentrations (25 50 ng/ml). The superphysiological level of insulin required for optimum growth is probably due to its acting weakly through an IGF-1-mediated growth-promoting mechanism. Insulin's effect on cell maintenance occurs at physiological levels and may better reflect its role in mammary cell growth. PMID- 3276540 TI - Correlation between electrophoretic types B1 and B2 of carboxylesterase B and host-dependent factors in Escherichia coli septicaemia. AB - Electrophoretic types B1 and B2 of carboxylesterase B produced by strains of Escherichia coli isolated from 100 septicaemia cases were correlated with alpha haemolysin and mannose resistant haemagglutinin (MRHA) production and with clinical data including eventual underlying diseases, origin of septicaemia and evolution. Electrophoretic type B2 was phenotypically linked with alpha haemolysin and MRHA production. The proportion of type B2 isolates varied significantly with occurrence of an underlying illness (45% for patients without an underlying disease and 22% for compromised patients) and with the site of origin of the septicaemia (40% for those of urinary origin and 18% for infection of digestive origin). In the former infections, type B2 isolates were obtained in the majority from male patients while type B1 isolates predominated in women. The septicaemias associated with type B1 were characterized by a lower proportion of isolates producing alpha-haemolysin and MRHA and by a greater frequency of septic shock and death than those associated with type B2. These facts emphasize the importance of host-dependent factors in E. coli septicaemia. PMID- 3276541 TI - Degradation of cartilage proteoglycans by myeloid leukemia cells. AB - Polymorphonuclear leukocytes contain proteases that are capable of degrading articular cartilage matrix in disease states such as rheumatoid arthritis and osteoarthritis. In this study, the HL-60 human promyelocytic leukemia cell line was examined for ability to degrade cartilage proteoglycans. The HL-60 cells contained proteoglycan-degrading enzymes, which may contribute to the joint inflammation sometimes seen in acute leukemia. However, the protease activity was much less than in mature neutrophils and was not enhanced by the induction of myeloid maturation with dimethyl sulfoxide or retinoic acid. The diminished enzyme activity of induced HL-60 cells compared to normal neutrophils is another functional deficiency of these cells. PMID- 3276542 TI - Enhanced capacity of cytosine-arabinoside-treated murine bone marrow to maintain hematopoiesis in long-term culture. AB - A study of bone marrow of C57B1 mice administered cytosine-arabinoside (Ara-C) was carried out in long-term bone marrow culture (LTBMC). Two days after administration of two consecutive i.p. Ara-C injections (200 mg/kg each) at 6-h intervals, the bone marrow becomes hypocellular, yet in the process of regeneration, with an enriched and/or concentrated content of progenitors and stem cells. Ara-C-treated marrow was observed to sustain hematopoiesis in vitro better than physiological marrow; it produced a higher cell yield, a higher proportion of young-type myeloid cells, and higher levels of granulocyte macrophage colony-forming cells and colony-forming units in diffusion chamber than control marrow. In addition, stromal cell cultures (SCC), devoid of hematopoiesis and engrafted with hematopoietic cells from LTBMC of Ara-C-treated marrow, were observed to produce hematopoietic cells for longer periods of time than SCC engrafted with control cells. In view of its increased capacity for regeneration, it is suggested that regenerative marrow should be used in autologous bone marrow transplantation in humans. PMID- 3276543 TI - Exocrine secretion of immunoreactive erythropoietin from the rat submaxillary gland. AB - The physiological role of immunoreactive erythropoietin (iEp) in rodent submaxillary glands (SMG) is largely unknown. We studied in vivo the effects of cholinergic and adrenergic agents in male rats with respect to exocrine secretion of iEp into saliva. Intravenous administration of metacholine (20 micrograms/kg), norepinephrine (30 micrograms/kg), and isoproterenol (30 micrograms/kg) resulted in equal volumes of saliva over 1 h. None of the drugs altered circulating plasma levels and kidney concentrations of iEp. Salivary secretions induced by either norepinephrine or isoproterenol, both adrenergic agonists, contained high levels of iEp and a significant depletion of gland content was observed, suggesting that SMG exocrine iEp secretion is mediated by adrenergic receptors. In contrast, metacholine-stimulated glands retained their full iEp content and iEp was undetectable in saliva, indicating that cholinergic activity is not associated with exocrine secretion of iEp from SMGs. PMID- 3276544 TI - Preclinical studies of the combination of mafosfamide (Asta-Z 7654) and etoposide (VP-16-213) for purging leukemic autologous marrow. AB - In the present study we evaluated the effect of etoposide (VP-16-213) compared to mafosfamide-cyclohexylamine (Asta-Z 7654) on normal granulocyte-macrophage colony forming unit (GM-CFU) growth, T-cell response to mitogens, and a clonogenic promyelocytic cell line (HL-60). The incubation time (30 min vs 60 min) appeared to be a fundamental parameter. The GM-CFU recovery was 14.4% +/- 7.3% and 1.4% +/ 2.3%, respectively, at 50 micrograms/ml Asta-Z 7654, and 17.6% +/- 8.6% and 3.00% +/- 2.4%, respectively, at 50 micrograms/ml VP-16. ASTA-Z at 50 micrograms/ml was effective in inhibiting the T-cell response to phytohemagglutinin (98.7% +/- 1.2%), whereas VP-16 was not (2.3% +/- 1.7%). With the combined chemical agents ranging from 10 to 20 micrograms/ml for each drug, we obtained a better GM-CFU recovery (five to ten times) using a middle term liquid culture (21-day incubation) than with the standard colony assay (plated immediately after treatment). When using HL-60 cells as the target, the antileukemic activity of VP-16 was lower than of Asta-Z 7654. Both compounds, at 20 micrograms/ml, resulted in 3.3- and 2.3-log cell killing, respectively. On the other hand, lower doses of Asta-Z 7654 combined with VP-16 (ranging from 10 to 15 micrograms/ml each) induced greater than 4-log cell killing after 60 min incubation time. These data suggest that VP-16 could be combined with Asta-Z provided that the dose is reduced for both drugs (less than 20 micrograms/ml). PMID- 3276545 TI - Autologous bone marrow transplantation in breast cancer: separation of clonogenic tumor cell colonies by gradient fractionation. AB - A major obstacle to successful autologous bone marrow transplantation in breast cancer is infiltration of the marrow by malignant cells. We layered bone marrow samples from seven breast cancer patients on a discontinuous bovine albumin gradient, then assessed hematopoietic potential (colony-forming units-culture [CFUc]) and clonogenic tumor cells (TCFUc) by standard techniques. We found that 78% of CFUc concentrated in fraction 3 of the gradient, which contained 10% of the total nucleated cell population. TCFUc were distributed across the gradient with 14% of colonies identified in this marrow fraction. We applied these techniques to two patients with metastatic breast cancer who were treated with high-dose mitomycin-C, doxorubicin, and cyclophosphamide before receiving 1.9 x 10(9) and 1.2 x 10(9) total cells, respectively, from CFUc-rich fraction 3. We observed tumor colony growth in three patients only in separated marrow fractions, suggesting that colony growth may be a function of the cell composition after fractionation or that growth factors may be separable. Ninety percent of clonogenic breast cancer cells can be separated from hematopoietic cells by discontinuous density gradient fractionation, a technique that is applicable to the large volumes necessary in bone marrow transplantation and that may be an important initial step in marrow purging for autologous transplantation. PMID- 3276546 TI - Thrombopoietin: its biology, purification, and characterization. AB - The existence of thrombopoietin, a hormone that controls blood platelet production, was proposed almost 30 years ago, but it has been only during the past 10-15 years that sufficient knowledge was obtained to establish that this humoral factor is a major in vivo controlling factor of thrombocytopoiesis. This concise review attempts to summarize the hormone's history, background, effects on megakaryocytes and platelet production, sources, and purification and characterization, along with the current status of research on this hematopoietic stimulating factor. New evidence for biological and chemical similarities of thrombopoietin from thrombocytopenic animals and human embryonic kidney cells is also presented. PMID- 3276547 TI - Effect of 5-hydroxytryptamine on the rate of cerebrospinal fluid production in rabbit. AB - Infusion of 5-hydroxytryptamine in mock cerebrospinal fluid of rabbits lowered cerebrospinal fluid production dose-dependently by nearly 30%. The effect was amplified in the presence of the monoamine oxidase inhibitor, nialamide. The 5 hydroxytryptamine-induced inhibition was partly counteracted by ketanserin, and further addition of practolol completely blocked the reduction in cerebrospinal fluid formation, suggesting that both 5-hydroxytryptamine receptors and beta 1 adrenergic receptors were involved in the response mediated by both the secretory epithelium and the vascular bed of the plexus. PMID- 3276548 TI - Schistosoma mansoni: development of the cercarial glycocalyx. AB - The development of the cercarial glycocalyx of Schistosoma mansoni was studied by transmission electron microscopy and immunofluorescence light microscopy employing antibodies raised against extracted and chromatographed glycocalyx. By electron microscopy, cercariae present in the brood chamber of daughter sporocysts were surrounded by an electron-dense granular and fibrillar matrix. This material appeared structurally distinct from the glycocalyx which was coarsely fibrillar and located only on the surface of organisms that had developed a final tegument. The thickness of the glycocalyx apparently increased with the maturation of the tegument, since teguments that had many spines also had the thickest glycocalyx. Immunofluorescent staining of frozen sections of infected snail hepatopancreas showed that glycocalyx antigens were present on the surface of the cercariae and not in the matrix within the brood chamber or in snail tissues. Immunofluorescent staining of isolated larval cercariae showed staining of some but not all parasites with partially elongated tails. These studies suggest that the glycocalyx develops late in cercarial development (late in Stage 6 or in Stage 7 of Cheng and Bier), is made by the cercariae themselves, and is not a product of either the sporocyst wall cells or snail hepatopancreas. PMID- 3276549 TI - Plasmodium fragile: detection of a ring-infected erythrocyte surface antigen (RESA). AB - A ring-infected erythrocyte surface antigen (RESA) has been detected by modified immunofluorescence assay in erythrocytes infected with the simian malaria parasite, Plasmodium fragile. This RESA, of Mr 95,000, shares many characteristics with the RESA initially found in the human malaria parasite P. falciparum. Both antigens are found in the membrane of erythrocytes infected with young asexual parasite stages, in merozoite-enriched preparations, and in parasite culture supernatant. Since the RESA of P. falciparum has been shown to confer protective immunity and since P. fragile infection of rhesus monkeys mimics P. falciparum infection in humans, the finding of a RESA in P. fragile underlines the importance of this species as an animal model for antimalarial vaccines. PMID- 3276550 TI - Giardia lamblia: localization of hydrolase activities in lysosome-like organelles of trophozoites. AB - Homogenates of Giardia lamblia trophozoites exhibited the following hydrolase activities: acid phosphatase (EC 3.1.3.2), proteinase (EC 3.1.4) with urea denatured hemoglobin and N-benzoyl-DL-arginine-2-naphthylamide as substrates, deoxyribonuclease (EC 3.1.4.5), and ribonuclease (EC 2.7.7.16). beta-N Acetylglucosaminidase (EC 3.2.1.30), beta-galactosidase (EC 3.2.1.23), beta glucuronidase (EC 3.2.1.31), alpha-D-glucosidase (EC 3.2.1.20), beta-D glucosidase (EC 3.2.1.21), and beta-D-xylosidase (EC 3.2.1.37) activities were below the level of detection. Differential and isopycnic centrifugation of homogenates demonstrated that giardial hydrolases were localized in a single particle population sedimenting at 7200g for 30 min. The particles had a buoyant density in sucrose of 1.15 and exhibited latency. Latency was completely destroyed by Triton X-100 or 15 cycles of freezing and thawing. After centrifugation of Triton- or freeze-thaw-treated particle fractions, the hydrolase activities, though no longer latent, were still sedimentable suggesting tight binding to the organelle membrane. Latency was destroyed simultaneously for all hydrolases, in direct proportion to the amount of Triton added to a particle preparation or to the number of times a particle preparation was subjected to freezing and thawing. These results support the suggestion that the hydrolases of G. lamblia trophozoites are localized in a single-particle population of lysosome like organelles. PMID- 3276551 TI - Stage-dependent processing and localization of a Plasmodium falciparum protein of 130,000 molecular weight. AB - A Plasmodium falciparum protein of 130,000 molecular weight (m.w.) has been identified, cloned in Escherichia coli, and completely sequenced (Kochan et al. 1986). The protein appeared to bind to soluble glycophorin, a host erythrocyte surface protein. In the present study, extracts of parasites from different intraerythrocytic stages were immunoblotted with antibodies, raised against a 30,000 m.w. fusion protein corresponding to the 3' end of the 130,000 m.w. protein. It was demonstrated that the protein is synthesized at the trophozoite stage, accumulates at the schizont stage, and is processed at the merozoite stage to a triplet of three polypeptides. The processed proteins are present in the culture supernatant at the time of merozoite burst from the red cell. Immunofluorescent staining of the parasite at different intracellular stages indicates that the protein is localized on the parasite at the trophozoite stage. At late trophozoite stage, it appears to be transported to the erythrocyte cytoplasm, where it is present in small vesicles or inclusions. In mature schizonts the protein accumulates around the plasma membrane of the erythrocyte. At the segmenter stage, just prior to merozoite release, it appears also to surround the intracellular merozoite, as well as the erythrocyte plasma membrane. The soluble 130,000 m.w. protein binds to erythrocytes but binds significantly greater to erythrocyte membranes, suggesting it binds to an internal domain of glycophorin rather than the domain exposed on the surface. The 130,000 m.w. protein is present in 11 different geographic isolates of P. falciparum from diverse geographic origins. Its molecular weight is similar in all isolates. PMID- 3276552 TI - Identification and isolation of core histones from Schizosaccharomyces pombe. AB - Core histones have been isolated from Schizosaccharomyces pombe and compared electrophoretically to core histones from Saccharomyces cerevisiae and rat liver. The molecular masses of all cognate histones examined were found to be very similar as determined by SDS gel electrophoresis. Histones H3, H2A and H2B from Sch. pombe migrated almost identically to their respective counterparts from S. cerevisiae as determined by acid/urea gel electrophoresis. Two-dimensional gel electrophoresis with a Triton X-100 acid/urea gel in the first dimension followed by an SDS gel in the second dimension was used to separate Sch. pombe histones from contaminating ribosomal proteins. PMID- 3276553 TI - Does the channel for nascent peptide exist inside the ribosome? Immune electron microscopy study. AB - MS2 phage RNA-directed synthesis of an N-terminal polypeptide of the phage coat protein on Escherichia coli 70 S ribosomes was initiated in a cell-free system with the N-dinitrophenyl derivative of methionyl-tRNAFMet) and performed in the absence of tyrosine, lysine, cysteine and methionine. As a result, the translating ribosomes carried peptides up to 42 amino acid residues in length with the dinitrophenyl hapten at the N-ends. Using the immune electron microscopy technique the positions of the nascent peptide N-ends on the 70 S ribosomes have been visualized. It has been found that (i) the N-ends of nascent peptides of these lengths are accessible to antibodies, (ii) the exit site of a nascent peptide is the pocket between the base of the central protuberance and the L1 ridge on the 50 S subunit, i.e. presumably its peptidyl transferase center, and (iii) the further pathway of a nascent peptide seems to proceed along the groove on the external surface of the 50 S subunit. PMID- 3276554 TI - Binding of ras p21 to bands 4.2 and 6 of human erythrocyte membranes. AB - The direct binding protein(s) of ras p21 was (were) investigated in inside-out vesicles of human erythrocyte ghosts using the pure v-Kirsten (Ki)-ras p21 synthesized in E. coli. The bound ras p21 was detected immunochemically using an anti-v-Ki-ras p21 monoclonal antibody, ras p21 bound to vesicles. Prior digestion of the vesicles with trypsin reduced this binding significantly. When ras p21 was laid over vesicle proteins immobilized on a nitrocellulose sheet by transfer from the gel of SDS-polyacrylamide gel electrophoresis, ras p21 bound to bands 4.2 and 6. ras p21 binding to these proteins was reduced by prior incubation of ras p21 with the purified band 4.2 or 6 protein. These results indicate that v-Ki-ras p21 can bind directly to bands 4.2 and 6 of human erythrocyte membranes as far as tested in an in vitro cell-free system. PMID- 3276555 TI - Native cytokines do not bind to uromodulin (Tamm-Horsfall glycoprotein). AB - Uromodulin bound with high affinity to human tumour necrosis factor (TNF) coated on microtitre plates. This interaction was not competitively inhibited by native TNF in solution. No interaction was observed between immobilized uromodulin and TNF in the liquid phase unless conditions were chosen which denatured the latter protein. Recombinant interleukin-1 alpha adsorbed on microtitre plates also interacted with uromodulin. However, gel filtration experiments demonstrated no interaction between the proteins in the liquid phase. These and additional results indicate that uromodulin interacts with denatured cytokines, but not with native, soluble cytokines. PMID- 3276556 TI - Remarks on the article 'Cleavage of the Arg-Ile bond in the polypeptide chain of human pancreatic stone protein' by P. Rouimi, J. Bonicel, M. Rovery and A. De Caro. PMID- 3276557 TI - Dissociation between intracellular calcium mobilization and insulin secretion in isolated rat islets of Langerhans. AB - The neuropeptide bombesin provoked a dose-dependent stimulation of 45Ca2+ efflux from pre-loaded islets of Langerhans. This response occurred rapidly, was not sustained and did not depend on the presence of extracellular calcium, suggesting that it resulted from the mobilization of intracellular calcium stores. Under conditions when large increases in 45Ca2+ efflux were observed, bombesin completely failed to stimulate the rate of insulin secretion. Similar results were also obtained with the muscarinic cholinergic agonist, carbachol. The data suggest that the release of calcium from intracellular pools is not sufficient to induce an increase in insulin secretion in normal islet cells. PMID- 3276558 TI - GTP gamma S activation of proto-oncogene expression in transiently permeabilised Swiss 3T3 fibroblasts. AB - A technique of transient permeabilisation has been used to show that the introduction of guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S), a non hydrolysable analogue of GTP, into intact Swiss 3T3 fibroblasts stimulates phosphoinositide hydrolysis, cyclic AMP accumulation and the activation of c-fos and c-myc proto-oncogenes. Of a number of nucleotide triphosphates introduced into the cells, only GTP and its non-hydrolysable analogues activated inositol phosphate release, suggesting that this response is mediated by guanine nucleotide regulatory (G) protein(s). The data demonstrate that transient permeabilisation provides a method of examining the involvement of G-proteins in nuclear activation. PMID- 3276559 TI - Inhibition of insulin-stimulated glucose transport in rat adipocytes by nucleoside transport inhibitors. AB - In isolated rat adipocytes, basal as well as insulin-stimulated 3-O-methylglucose transport was inhibited nearly completely (maximal inhibition: 95%) by the nucleoside transport inhibitors dipyridamole (IC50 = 5 microM), nitrobenzylthioguanosine (20 microM), nitrobenzylthioinosine (35 microM) and papaverine (130 microM). Transport kinetics in the presence of 10 microM dipyridamole revealed a significant increase in the transport Km value of 3-O methylglucose (3.45 +/- 0.6 vs 2.36 +/- 0.29 mM in the controls) as well as a decrease in the Vmax value (4.84 +/- 0.95 vs 9.03 +/- 1.19 pmol/s per microliter lipid in the controls). Half-maximally inhibiting concentrations of dipyridamole were one order of magnitude higher than those inhibiting nucleoside (thymidine) uptake (0.48 microM). The inhibitory effect of dipyridamole (5 microM) reached its maximum within 30 s. The agent failed to affect insulin's half-maximally stimulating concentration (0.075 nM) indicating that it did not interfere with the mechanism by which insulin stimulates glucose transport. Further, dipyridamole fully suppressed the glucose-inhibitable cytochalasin B binding (IC50 = 1.65 +/- 0.05 microM). The data indicate that nucleoside transport inhibitors reduce glucose transport by a direct interaction with the transporter or a closely related protein. It is suggested that glucose and nucleoside transporters share structural, and possibly functional, features. PMID- 3276560 TI - The endocrinology of varicoceles. AB - There is good evidence of an associated abnormality in testicular hormone production and spermatogenesis in some men with varicoceles. This abnormality can be demonstrated with dynamic tests of the hypothalamic-pituitary-testicular axis and by measuring seminal plasma androgen levels. A high proportion of oligozoospermic men who have abnormal hormone profiles will respond favorably to correction of their varicosities. Several oligozoospermic men with varicoceles have normal hormonal profiles. To date, in our unit, none of these men has had an improvement in seminal characteristics after varicocelectomy. This result would suggest that these men have incidental varicoceles. It is not clear what the testicular defect is leading to abnormal spermatogenesis in these men. Clearly, more studies are required in this group of men and in the men with sperm densities greater than 30 X 10(6)/ml, the majority of whom have normal responses to GnRH infusion. More information is needed regarding the intratesticular control of hormone production and spermatogenesis. As our knowledge of the paracrine system within the testis increases, so should our understanding of the mechanisms involved in the association of varicoceles and infertility. PMID- 3276561 TI - In vitro fertilization/embryo transfer in the United States: 1985 and 1986 results from the National IVF/ET Registry. Medical Research International. The American Fertility Society Special Interest Group. AB - This is the first report of the United States Registry of in vitro fertilization/embryo transfer (IVF/ET) and related practices. Summary data from 1985 and 1986, collected from retrospective reporting, are presented. There were 2389 and 2864 IVF cycles with embryos transferred in 1985 and 1986, respectively. In 1985 and 1986, 337 (14.1%) and 485 (16.9%) of the transfer cycles, respectively, resulted in clinical pregnancies. The number of cycles with frozen embryos transferred increased from 26 to 112 between 1985 and 1986. In 1986, there were 7 clinical pregnancies through frozen ET. In 1985, there were 56 gamete intrafallopian transfer (GIFT) procedures, whereas in 1986 there were 466 such treatment cycles. The number of clinical pregnancies by GIFT increased from 3 to 108 between 1985 and 1986. PMID- 3276562 TI - Secretory dynamics of bioactive and immunoreactive prolactin in polycystic ovary syndrome. AB - To further investigate prolactin (PRL) secretion in polycystic ovary syndrome (PCO), the authors evaluated immunoreactive (immuno) and bioactive (bio) PRL levels in the basal state and in response to provocative testing with intravenous dopamine (DA), metoclopramide (MCP), and gonadotropin-releasing hormone (GnRH), before and after disulfiram. Basal measurements of immuno-PRL, bio-PRL, and the ratio of bio/immuno-PRL were similar in PCO and controls. The immuno-PRL decrement after DA was greater than that of bio-PRL in both groups (P less than 0.05). After MCP, immuno-PRL increased more than bio-PRL in PCO (P less than 0.01), and this immuno-PRL increment was greater than that of controls (P less than 0.05). Bio-PRL and immuno-PRL increased after GnRH in PCO, but not controls, and these responses were inhibited by disulfiram. These data confirm PRL hypersecretion in some women with PCO, which is better expressed by immunoreactivity than bioactivity. Given the assay systems and patients studied, bioactivity PMID- 3276563 TI - Oocyte donation and gamete intrafallopian transfer in premature ovarian failure. AB - Gamete intrafallopian transfer (GIFT) was performed in eight patients with premature ovarian failure (POF), using donated oocytes. The steroid replacement protocol consisted of the administration of increasing dosages of 17 beta estradiol (E2) and progesterone (P). Hormonal replacement was maintained until day 100 of gestation. All patients underwent an evaluation cycle in which serum levels of E2 and P were monitored and an endometrial biopsy was performed on day 21 or 22. All cases of GIFT were performed between days 12 and 15. Six clinical pregnancies were achieved in eight cycles (75% success rate). Three patients delivered and three are in their second or third trimester. No ectopics or miscarriages occurred. These results offer a promising approach for the establishment of fertility in agonadal patients. PMID- 3276564 TI - Complications and problems in transvaginal sector scan-guided follicle aspiration. AB - Complications and problems in the first 181 transvaginal sector scan-guided follicle aspirations in a recently established in vitro fertilization (IVF) unit were studied. No major complications occurred and, in only 3% of patients, it appeared impossible to aspirate the follicles because of method-related problems (i.e., localization of ovaries too high above the vaginal top and/or ovaries too mobile). The method is easily mastered and the oocyte yield of this method is already high, even though it is early in the learning phase of the procedure. The mean duration of the procedure decreased from more than 30 minutes to less than 20 minutes in the first 7 months after the introduction of this technique in the IVF program. The authors believe this method soon will be the choice for follicle aspiration in all major IVF programs. PMID- 3276565 TI - Sector ultrasound in the diagnosis and treatment of hematometria secondary to Asherman's syndrome. AB - Sector ultrasound in patients with post-traumatic amenorrhea (Asherman's) performed at BBT-determined "menses" will diagnose patients with hematometria secondary to outlet obstruction. These patients can be treated in the outpatient setting using real-time ultrasound as a guide for intrauterine manipulation. PMID- 3276566 TI - Ethical considerations of the new reproductive technologies. By the Ethics Committee (1986-87) of The American Fertility Society in light of Instruction on the Respect for Human Life in its Origin and on the Dignity of Procreation issued by the Congregation for the Doctrine of the Faith. AB - In September 1986, The American Fertility Society issued a report, Ethical Considerations of the New Reproductive Technologies, setting forth the then-held ethical position of the Society on the various new reproductive technologies. In 1987, the Congregation for the Doctrine of the Faith issued the Instruction on the Respect for Human Life and Its Origin and on the Dignity of Procreation. While both documents state that very similar moral criteria were used to derive ethical positions with respect to various reproductive procedures, the conclusions as to the ethical acceptability of the various procedures differ sharply in the two documents. The question can be raised about the procedure used by the Congregation of the Faith to derive its conclusions from the stated premises. Thus, while stating that "the individual integrally and adequately considered" is to be the basis of the moral judgment, the fact is that most conclusions are based on and referenced to past Catholic statements. While the difference in conclusion from similar premises may be troubling to society, it can be especially paralyzing to four groups: (1) those who face problems that might be solved by one or another of the new reproductive technologies; (2) those who are involved in applying them; (3) those who are responsible for institutional policies where such techniques may be applied; and (4) those who are in a position to influence public policy in a legislative or regulatory way. Because of the conflicting conclusions of the two documents, the present Ethics Committee (1986-87) of The American Fertility Society was convened and considered these guidelines in the light of the Instruction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276567 TI - The computerized dental office of the future. AB - The computer will soon become an indispensable tool for the private dental practitioner. It will aid in planning, managing, operating and even become part of the delivery of service to patients. The key is in understanding the need for a patient oriented approach to dental service and applying the appropriate technologies to accomplish it. PMID- 3276568 TI - Graft versus host reaction: why is it important for the dermatologist? PMID- 3276569 TI - Clinical, histological and immunological studies in 50 patients with bullous pemphigoid. AB - Fifty patients with bullous pemphigoid were investigated over periods of up to 7 years. Sequential studies of circulating basement membrane zone (BMZ) antibody titres revealed two groups of patients: 44% had a high initial titre (greater than 1:160) and 56% had a low initial titre (less than 1:160). Subjects with titres greater than 1:160 continued to have high titres, whereas in those with lower titres the BMZ antibodies usually became undetectable after 4 months. The BMZ antibody titres were of no prognostic value. High titres remained high even in patients who were in remission and off treatment, and in these subjects, there was no evidence of a change in the IgG subclass. The initial BMZ IgG antibody titres showed a highly significant correlation with total serum IgE concentrations. A significant correlation also existed between total serum IgE and IgG4 concentrations, although not between the serum IgE and the peripheral blood eosinophil count. No anti-BMZ antibody of IgE class was found, nor specific IgE against inhalants and foods identified, and the significance of the high total serum IgE remains unexplained. The majority of those followed for more than 2 years were able to stop their steroid therapy without further blistering: this confirms that pemphigoid tends to be a self-limiting disease. Nine patients had a recent history of malignant disease, and this is no more than would be expected for this age group of patients: however, 3 patients presented with pemphigoid and figurate erythema and all died of neoplastic disease, suggesting that such patients should be investigated thoroughly for neoplasia. PMID- 3276570 TI - Translational regulation of the novel haploid-specific transcripts for the c-abl proto-oncogene and a member of the 70 kDa heat-shock protein gene family in the male germ line. AB - Expression of the c-abl proto-oncogene in the mouse testis is characterized by the production of a unique 4.7-kb transcript present in germ cells that have entered the haploid phase of spermatogenesis. A similar developmental stage specificity of expression is observed for a member of the 70-kDa heat-shock protein (hsp 70) gene family. A unique-sized hsp 70 transcript (T-hsp 70) is produced in haploid spermatids and is stable throughout spermatogenesis. In the present study, we examined the regulation of expression of these genes by examining their association with polyribosomes. The germ cell-specific c-abl and T-hsp 70 mRNA variants were both associated with the polysomal fractions of mouse testis cells, suggesting that they are functional mRNAs. However, both c-abl and T-hsp 70 mRNAs were also found in the ribonucleoprotein particle fractions. The distribution of these mRNAs in both the polysomal and nonpolysomal fractions is comparable to that seen for the mRNA of protamine-1, a gene whose expression in the testis is known to be regulated at the level of translation. In contrast, transcripts from the beta-tubulin gene were seen predominantly in the polyribosomal fractions. These findings suggest that translation of the novel c abl and T-hsp 70 transcripts is confined to subpopulations of testicular cells. PMID- 3276571 TI - Molecular cloning of the ets proto-oncogene of the sea urchin and analysis of its developmental expression. AB - The locus SU(Lv)-ets-2 of the sea urchin Lytechinas variegatus related to the oncogene v-ets of avian erythroblastosis virus E26 has been molecularly cloned. The cloned DNA was found to contain a region with a high degree of homology to E26 v-ets. The sea urchin homology with v-ets starts at a consensus splice acceptor sequence and stops at the point where homology between v-ets and human c ets ends. This region corresponds to the Hu-ets-2 homologous sequences defined by Watson et al. (1985, Proc. Natl. Acad. Sci, USA 82, 7294-7298). Ninety-one out of 97 (or 94%) predicted amino acids are identical between sea urchin c-ets and E26 v-ets over the region of homology. This degree of homology exceeds the maximum homology previously found between any oncogene and an invertebrate homolog. A somewhat weaker homology with the Hu-ets-2 sequences continues beyond, for 13 codons, ending at a common termination codon. Northern blot analysis of mature unfertilized eggs and early embryos from sea urchins of the species Strongylocentrotus purpuratus revealed a single 6.8-kb ets-related RNA that is expressed at a maximum level during the early stages of embryonic development. This RNA species is polyadenylated indicating that it is the message for the sea urchin ets-2 gene. PMID- 3276572 TI - The ontogeny of drinking evoked by activation of brain angiotensin in the rat pup. AB - Renin (1 ng) was injected into the 3rd ventricle of the brain of rat pups at various ages, and their ingestion was measured by weighing them either after 40 min of oral infusion of water or milk while they were away from their dam (off dam), or after 40 min of suckling from their dams (on-dam). Beginning at 3-5 days of age, renin increased ingestion of milk and water off-dam. After 15 days of age, milk ingestion off-dam was no longer increased by renin, but intake of water continued to be evoked. In contrast, renin did not increase intake by suckling at any age. These findings reveal that the adult characteristics of the dipsogenic action of the renin-angiotensin system in the brain emerge at 15 days, at which age the increased intake becomes entirely specific for water. This finding confirms the precocity of the neural controls of drinking in the rat and shows that, like the controls of independent feeding, they are dissociated from those of suckling. It adds support to the idea that the neonatal mammalian brain contains separate neurological systems for suckling and for independent ingestion. PMID- 3276573 TI - Studies in gnotobiotic piglets on non-O157:H7 Escherichia coli serotypes isolated from patients with hemorrhagic colitis. AB - A number of verotoxin-producing Escherichia coli strains isolated from sporadic cases of hemorrhagic colitis in the United States over the last 5 yr were shown to belong to serogroups other than O157:H7-the serotype originally implicated in this disease. Experimental infection of gnotobiotic piglets with five such strains (0111:NM, 0145:NM, 045:H2, 04:NM, and Ound:NM) caused diarrhea resulting from mucosal lesions in the cecum and colon that were indistinguishable from those previously described in piglets infected with E. coli O157:H7. This suggests that, as with other categories of pathogenic E. coli, several serotypes cause hemorrhagic colitis in humans. The five E. coli strains that were compared with one O157:H7 strain and with an enteropathogenic calf strain (serotype 05:NM) caused a spectrum of disease ranging from moderate diarrhea (O157:H7) to severe illness (including septicemia and death) (0111:NM). Characteristic lesions, which were identical for all seven pathogenic strains, included bacterial attachment, effacement of the microvillus border, and dissolution of the cell membranes of surface and glandular epithelium, resulting in complete cell destruction. Some piglets exhibited neurologic signs of convulsions and ataxia. It is concluded that a number of E. coli serotypes, in addition to O157:H7, fulfill the present limited criteria for enterohemorrhagic E. coli, which include association with hemorrhagic colitis, production of one or more verotoxins, possession of a large plasmid (50-70 megadaltons), and induction of distinct mucosal lesions in the large bowel of gnotobiotic piglets. PMID- 3276574 TI - Efficacy of quantitative hepatobiliary scintigraphy and fatty-meal sonography for evaluating patients with suspected partial common duct obstruction. AB - In this study we evaluated by blinded design the diagnostic efficacy of two noninvasive techniques, quantitative hepatobiliary scintigraphy (QHS) and fatty meal sonography (FMS), for evaluating patients with suspected partial common duct obstruction. Quantitative hepatobiliary scintigraphy was performed on 56 cholecystectomized individuals (22 asymptomatic controls, 28 patients with suspected partial common duct obstruction, and 6 nonjaundiced cirrhotics) and FMS was done in 51 cases. For QHS, time-activity curves were generated for regions of interest over the liver, hepatic hilum, and common duct. For FMS, we measured common duct diameter before and 45 min after a fatty meal (Lipomul, 1.5 ml/kg). Each of the 28 patients with suspected partial common duct obstruction and 6 cirrhotic patients underwent endoscopic retrograde cholangiography, often accompanied by sphincter of Oddi manometry. Findings from these examinations were taken as the gold standard to determine the presence or absence of conditions that could account for intermittent symptomatic partial common duct obstruction. The most sensitive indicators for a positive test were a 45-min isotope clearance of less than 63% for QHS and a common duct increase of greater than or equal to 2 mm after the fatty meal for FMS. Of 28 patients with suspected partial common duct obstruction, 15 were judged to be true-positive and 13 true-negative. The 6 cirrhotic patients were without common duct obstruction. The study findings showed that each test had a 67% sensitivity that improved to 80% when the findings from both test results were combined. The specificity of QHS was 85% and that of FMS was 100%. All 6 cirrhotic patients had negative findings on FMS and 4 were false-positive on QHS. The true-positives included 8 patients with a small common duct stone and 6 with obstructive sphincter of Oddi dysfunction (4 stenosis, 2 dyskinesia). We conclude that noninvasive QHS and FMS afford good sensitivity and specificity for evaluating cholecystectomized patients with suspected partial common duct obstruction. PMID- 3276575 TI - Experimental portal fibrosis produced by intraportal injection of killed nonpathogenic Escherichia coli in rabbits. AB - An attempt was made to develop an animal model for the study of the etiology of noncirrhotic portal fibrosis or idiopathic portal hypertension based on the assumption that it is related to chronic abdominal infection. Rabbits were given killed nonpathogenic Escherichia coli intraportally or intravenously. The animals to which a mixture of killed E. coli and rabbit antiserum (aggregated E. coli) was given intraportally developed remarkable histologic changes in the liver. The early inflammatory reactions in the portal area and parenchyma were followed by rapid disappearance of inflammation and development of portal fibrosis with bile duct proliferation. Three intraportal challenges with aggregated E. coli were sufficient to produce pronounced portal fibrosis, although there was considerable variation in response among individual animals. This procedure also produced splenomegaly, and in some animals marked portal hypertension. Injection of nonaggregated killed E. coli into the portal vein or aggregated E. coli into the ear vein also caused similar hepatic changes, but they were milder in degree. These histologic changes resemble portal fibrosis seen in idiopathic portal hypertension and, less closely, pericholangitis associated with inflammatory bowel disease in humans. PMID- 3276576 TI - Intestinal endotoxemia. Clinical significance. PMID- 3276577 TI - Neuroendocrine potential of the colon and rectum. PMID- 3276578 TI - Approaches to deep venous thrombosis and pulmonary embolism in aging patients. AB - Deep venous thrombosis and its complication, pulmonary embolism, are common clinical problems in the elderly and are responsible for significant morbidity and mortality. Diagnosis on clinical grounds alone is notoriously unreliable, and objective tests are necessary to avoid overtreatment or undertreatment. Etiology, clinical evaluation and testing, diagnostic strategies, and prophylaxis are reviewed to present a current perspective on this serious problem. PMID- 3276579 TI - Geriatric hypertension: the growing use of calcium-channel blockers. AB - The recognition of essential hypertension as a heterogeneous entity mandates that therapy be individualized according to the subset of hypertension that characterizes each patient. Choosing the most appropriate therapeutic regimen in elderly hypertensives is complicated by a greater susceptibility to side effects from medications, and by concomitant diseases. Calcium-channel blockers address the pathophysiologic mechanisms of generic hypertension, thus providing clinicians with more specific pharmacologic tools for treating elderly hypertensives. In addition, these agents will avoid many of the side effects of other antihypertensive agents and can ameliorate certain concomitant diseases. PMID- 3276580 TI - Osteoporosis: diagnostic screening and its place in current care. AB - Osteoporosis, or decreased total bone mass, results from a number of factors: accelerated trabecular bone loss in postmenopausal women; age-related loss of trabecular and cortical bone; and multiple chronic diseases and medications. Routine laboratory and radiographic tests are not helpful in assessing bone turnover. However, a ratio of urinary calcium to creatinine exceeding 0.16 on a spot urine sample obtained in the fasted state suggests high bone turnover. Both single and dual photon absorptiometry are useful research tools but are unproved screening tests, especially in light of the more frequent use of preventive measures, such as postmenopausal hormone replacement therapy, calcium supplementation, and weight-bearing exercise. PMID- 3276581 TI - Squamous carcinoma arising in dermoid cysts and associated with hypercalcemia: a clinicopathologic study of six cases. AB - Six cases of squamous carcinoma arising in dermoid cysts are reported. In four out of five cases in which serum calcium was measured hypercalcemia was present and increased pari passu with increases of tumor size. The presence of hypercalcemia in association with an ovarian tumor may therefore point to the possibility of this background. In all cases survival was short, ranging from 3 to 17 months. Five patients were treated with cisplatin, etoposide, and bleomycin but without great benefit. These cases, together with a review of the literature, suggest that a new treatment will be needed to improve survival in all but a few stage I cases. PMID- 3276582 TI - Pure primary ovarian squamous cell carcinoma. AB - A 65-year-old woman with pure primary ovarian squamous cell carcinoma invading the fallopian tube and the terminal ileum is described. The tumor recurred shortly after surgery in spite of complete resection. No response to chemotherapy was observed and the patient expired 6 months after diagnosis. In order to establish the diagnosis of pure primary ovarian squamous cell carcinoma extragenital and genital tumors containing squamous elements as well as endometriosis have to be excluded. PMID- 3276583 TI - Forensic medicine in the Indo-Pacific region: history and current practice of forensic medicine. AB - A brief history of forensic medicine in the Indo-Pacific region followed by the extent of medical education imparted to undergraduates and current practice in various countries of the region are examined. PMID- 3276584 TI - The evolution of methods for estimating the time of death from body temperature. AB - A chronological survey is offered of the development of concepts and techniques to use body temperature in the estimation of time since death. For a century and a half, this method has been investigated, though accuracy still cannot be claimed, especially in operational conditions. PMID- 3276585 TI - Primary biliary cirrhosis and mitochondrial autoantigens--insights from molecular biology. PMID- 3276586 TI - Prophylactic propranolol: the first big step. PMID- 3276587 TI - Therapeutic strategies for hepatic fibrosis. PMID- 3276588 TI - IgA deposition and synthesis in alcoholic liver injury. PMID- 3276589 TI - Long-term culture of hepatocytes: effect of hormones on enzyme activities and metabolic capacity. AB - (i) Hepatocytes isolated from adult rats were cultured for 2 to 3 weeks on collagen in a modified, serum-free Waymouth medium containing fatty acids and varying concentrations of glucocorticoid, insulin and glucagon. (ii) In the presence of all three hormones, it was possible to maintain the content of DNA, the activity of glucokinase, pyruvate kinase, hexokinase and lactate dehydrogenase at initial levels for 2 to 3 weeks. The activity of glucokinase and pyruvate kinase was affected by the concentration of insulin. (iii) The activity of alcohol dehydrogenase was stable for 3 days and declined to about 25% of the initial level after 2 weeks of culture, irrespective of the presence of hormones. (iv) Maintenance of albumin secretion was dependent on the presence of glucocorticoid, and glucocorticoid and insulin showed an additive or, at some time points, a synergistic effect on its secretion. (v) The content of cytochrome P-450 could be kept at 65% of the initial level, provided that a relatively high concentration of dexamethasone was present (10(-6) M). (vi) In the absence of hormones, urea synthesis was 70% of initial levels throughout the experimental period. With insulin and glucocorticoid present, a high concentration of glucagon (10(-8) M) was required to maintain the synthesis of urea at this level. (vii) It is concluded that hepatocyte cultures as described in the present study may be a useful, well-defined system for long-term metabolic, pharmacologic and toxicologic studies. PMID- 3276590 TI - Tissue localization and kinetics of pit cells or large granule lymphocytes in the liver of rats treated with biological response modifiers. AB - The numbers of Kupffer cells (macrophages) and pit cells (large granular lymphocytes) were counted by light and electron microscopy in perfusion-fixed liver sinusoids. After a single intravenous injection of the biological response modifiers zymosan, Propionibacterium acnes and OK-432, a 4- to 6-fold increase in the number of pit cells and a 2- to 4-fold increase in the number of Kupffer cells were observed within a period of 4 to 7 days. The mechanisms of the pit cell accumulation were further studied by the metaphase arrest method and by selective irradiation of the liver, or of the rest of the body, with a dose of 8.5 Gy. Stimulated pit cells showed mitotic activity in the liver and to a lesser extent in peripheral blood. The zymosan-induced increase in pit cell number was inhibited by irradiation of the liver but not by irradiation of the rest of the body (with shielded liver). It is concluded that the hepatic pit cell population, which has been shown to have natural tumoricidal activity, can be induced to expand by biological response modifiers, and local division of preexisting cells contributes significantly to this expansion. PMID- 3276592 TI - Localization of woodchuck hepatitis virus in the liver. AB - Localization of woodchuck hepatitis virus in liver tissue from 10 infected woodchucks was investigated immunohistochemically and ultrastructurally. Woodchuck hepatitis virus surface antigen was detected by immunoperoxidase methods in the cytoplasm of hepatocytes with a fine granular and/or inclusion body appearance. Woodchuck hepatitis virus surface antigen positive hepatocytes were often found in the peripheral zone of hepatic lobules. In contrast to human hepatitis B core antigen, woodchuck hepatitis virus core antigen was observed only in the cytoplasm of hepatocytes, but not in the nuclei. In hyperplastic foci, woodchuck hepatitis virus antigen-positive hepatocytes were found in 3 of 8 animals. Furthermore, in 1 of 5 animals with hepatocellular carcinoma, woodchuck hepatitis virus surface antigen and woodchuck hepatitis virus core antigen were present in carcinoma cells. Electron microscopic examination revealed many filamentous structures (18 to 20 nm in diameter) in the cisternae of the endoplasmic reticulum. Noncoated core particles (18 to 20 nm in diameter) were found in the cytoplasm of the hepatocytes, but not in the nuclei. The coated particles (42 to 45 nm in diameter) were observed in the cisternae of the endoplasmic reticulum. These coated particles were shown to be morphologically identical to the virus particles in serum. These results indicate that woodchuck hepatitis virus core antigen is produced and assembled mainly in the cytoplasm of hepatocytes, and seems to be rapidly assembled into virion. The similarity of woodchuck hepatitis virus infection to human hepatitis B virus infection makes the woodchuck an excellent experimental model for the study of hepadna virus oncogenesis. PMID- 3276591 TI - Nadolol can prevent the first gastrointestinal bleeding in cirrhotics: a prospective, randomized study. AB - Propranolol has been reported to prevent the risk of hemorrhage in patients who survived episodes of variceal rupture. Since the first bleeding episode can be lethal, we did a prospective, randomized trial to see whether beta-blockers could also prevent the first hemorrhage. Seventy-nine consecutive cirrhotics with large esophageal varices by endoscopy and who had never bled were randomly allocated to one of the following treatments: placebo; ranitidine (300 mg per day), or nadolol (40 to 120 mg per day)--which is not cardio-selective, reduces portal hypertension and does not interfere with renal flow. Since no significant differences between ranitidine and placebo treatment were observed, the two groups were combined as the control group and compared with the nadolol group. After a mean follow-up of 24 months, only 1 of the 30 patients in the nadolol group had bled, while 11 of the 49 patients in the control group had bled. The percentages of patients who had not bled 1 and 2 years after the inclusion were 100 and 94.4% for the nadolol group and 81.2 and 70.2% for the control group (p less than 0.02), respectively. There were no differences in the mortality rate. In conclusion, nadolol significantly protects against the first gastrointestinal bleeding episode in cirrhotics. PMID- 3276593 TI - NIMH report. NIH consensus conference stresses need to identify reversible causes of dementia. PMID- 3276594 TI - Physical and psychological problems associated with exposure to diethylstilbestrol (DES). AB - The synthetic hormone diethylstilbestrol (DES) was widely prescribed between 1943 and 1971 to minimize pregnancy complications. It has caused serious physical and psychological damage to the women who took it and to their offspring. DES-exposed mothers may suffer a higher incidence of breast cancer, their exposed daughters are at risk for reproductive tract cancers and infertility, and their exposed sons are more likely to have genital abnormalities and reproductive dysfunction. Psychiatric disorders among DES-exposed persons are reportedly twice as common as for nonexposed persons, with anger, anxiety, low self-worth, identity confusion, and guilt the most frequent symptoms. The author describes therapeutic interventions designed to alleviate these problems. PMID- 3276595 TI - Regional rates soften blow of national prices. PMID- 3276596 TI - Budget bill seeks to aid rural hospitals. PMID- 3276597 TI - Medicaid fails many poor: study. PMID- 3276598 TI - NAIC targets celebrity ads for Medigap policies. PMID- 3276599 TI - Capitated care for Medicaid growing (slowly). PMID- 3276600 TI - Lawsuits over Medicaid payments increasing. PMID- 3276601 TI - Budget includes home care, outpatient radiology. PMID- 3276602 TI - Congress acts to enforce Medicaid adjustment. PMID- 3276603 TI - Days vs. cost-based outlier payments? PMID- 3276604 TI - Life after PIP: cash flow worse, HFMA survey says. PMID- 3276605 TI - Do physician-managers raise hospital costs? PMID- 3276606 TI - The physician payment debate begins. Interview by Michele Robinson. PMID- 3276607 TI - Part B reform: get ready to rebundle services. PMID- 3276608 TI - CIOs have limited say in business planning. PMID- 3276609 TI - The margins controversy: a long-run headache? PMID- 3276610 TI - ProPAC: margins still near 15-year high. PMID- 3276611 TI - ProPAC seeks outlier policy changes. PMID- 3276613 TI - Local HMO plans struggle with changing market conditions. PMID- 3276612 TI - AIDS cases haven't increased HMO costs--yet. PMID- 3276614 TI - New chairman sees complex role for PRRB. PMID- 3276615 TI - C-anaphases in lymphocyte cultures versus premature centromere division syndromes. AB - Different cases in which chromosomes obtained from short-term lymphocyte cultures appear with separated centromeres are reviewed. These include: (1) C-anaphases in the colchicine-resistance mutation, (2) C-anaphases as a common variant, (3) premature centromere division (PCD) in elderly women, (4) PCD in Alzheimer's disease, (5) early splitting and puffing of centromeres in Roberts' syndrome. PMID- 3276616 TI - Simultaneous development of cells with large granular lymphocyte (LGL) morphology and natural killer (NK) cell lytic activity after bone marrow (BM) transplantation in mice. AB - In the present study we investigated the development of natural killer (NK) cell lytic activity, and its correlation with the appearance of cells with large granular lymphocyte (LGL) morphology after bone marrow transplantation (BMT). NK activity was first found 7 days after bone marrow (BM) reconstitution, simultaneously with the appearance of the first LGLs. The number of LGLs, as well as the lytic activity, increased until Day 16 after BM reconstitution, after which they started to decrease, reaching the normal values of controls in 30 days. These early appearing LGLs differed somewhat from mature-type LGLs; they were larger, blast-like cells (found in the lower density fractions of Percoll gradient) and had a basophilic cytoplasma, in contrast to a pale cytoplasm in mature LGLs, but they expressed the asialo GM 1 (AGM 1) antigen like normal NK cells. Those NK cells that appeared first also tended to be lytically more effective than their mature counterparts. Taken together, these data suggest that the correlation between LGL morphology and NK lytic activity also holds true during the development of NK cells from their non-lytic precursors in the bone marrow. PMID- 3276617 TI - The effect of protein malnutrition on the IgA immune response in mice. AB - The influence of protein malnutrition on the IgA immune response was determined in BALB/c mice fed isocaloric diets containing 20% (control), 4%, or 2% protein. We describe here a severely protein-deficient state (6 weeks on a 2% protein diet) and a moderately malnourished state (6-8 weeks on a 4% protein diet). The total IgA concentration in intestinal washes, as determined by radial immunodiffusion, was reduced at 6 and 8 weeks in the 4% diet group and at 6 weeks in the 2% diet group, compared to the controls. Serum IgA levels were significantly elevated in both the 2% and 4% diet-fed groups at all time intervals. The IgA anti-sheep red blood cell (SRBC) plaque-forming cell (PFC) response generated after oral immunization with SRBC did not differ between the control and the 4% diet group at any time interval, yet the IgA PFC/spleen response was significantly reduced in the 2% diet group at all time intervals studied. However, the IgA PFC/10(6) spleen cells was reduced only with the 2% protein diet group at 6 weeks. Severely protein-deficient mice replenished with the control diet for 3 weeks showed a recovery to values similar to the 8-week control group of both the IgA PFC response and the total IgA concentration in intestinal washes. These results suggest that protein deprivation leads to a reversible reduction in the IgA response to antigens encountered at the intestinal mucosa. PMID- 3276618 TI - Intermolecular complexes between three human CD1 molecules on normal thymus cells. AB - The first cluster of differentiation (CD1) defines at least three distinct human thymic cell-surface differentiation antigens-CD1a, CD1b, and CD1c. We looked for structural homology of the three CD1 heavy chains at their peptide level by two dimensional peptide maps. We show here that the CD1a Mr 49,000 heavy chain and the CD1b Mr 45,000 heavy chain appear to be more homologous to each other than to the CD1c Mr 43,000 heavy chain and that only one tyrosil peptide is common to the three heavy chains. Study of the CD1 heavy chains from several individuals reveals a very limited polymorphism of these molecules. We also demonstrate here that CD1a or CD1a-like molecules and other CD1 molecules can form intermolecular complexes on the surface of normal thymus cells. Molecules that are structurally very similar to CD1a molecules are associated noncovalently either with CD1c molecules or with CD1b molecules, and only CD1a molecules can associate covalently with CD8 molecules. In contrast, we could not find these intermolecular complexes on the surface of leukemic T-cell lines in culture. PMID- 3276619 TI - Biochemical complexity of serum HLA class I molecules. AB - Human serum was found to contain a variety of class I-like molecules by Western blotting with anti-class I heavy chain reagents: major bands usually are observed around Mr 44,000, 40,000, and 35,000-37,000. HLA-A24-positive individuals are distinguished by higher serum levels of Mr 44,000 and 40,000 class I-like molecules than those found in HLA-A24-negative individuals. The Mr 44,000 serum molecules are probably intact class I molecules that have been shed from the cell membrane, because they contain both a transmembrane segment (TM), as deduced from detergent-binding experiments, and a cytoplasmic tail (CT), as inferred from reactivity with an antipeptide serum specific for the cytoplasmic domain of class I antigens (RaCT). The Mr 35,000 and 37,000 molecules contain neither a TM nor a CT region and therefore are probably proteolytic breakdown products of cellular and/or serum Mr 44,000 molecules, although the existence of Q10-like molecules in man cannot be ruled out. The Mr 40,000 molecules do not contain a TM region. Mr 40,000 molecules reactive with the RaCT serum were found in the minority (2/13) of sera tested. We conclude that alternative splicing resulting in a precise excision of the TM exon plays a minor role in the generation of serum HLA class I antigens. PMID- 3276620 TI - Intracellular sodium and the response to nitrendipine or atenolol in African blacks. AB - The relationship between the hypotensive effect of nitrendipine (N), 20 mg/day (n = 17), or atenolol (A), 100 mg/day (n = 17), and the erythrocyte sodium [( Na]i) and potassium [( K]i) concentrations was investigated in hypertensive African blacks during a randomized double-blind study. After 6 weeks, both treatments significantly reduced supine and standing blood pressures; however, the magnitude of the decrease in supine systolic (-22.0 +/- 2.0 vs -12.1 +/- 3.4 mm Hg) and diastolic (-14.1 +/- 1.3 vs -7.6 +/- 2.1 mm Hg) pressures and in standing diastolic pressure (-16.0 +/- 1.7 vs -9.2 +/- 2.0 mm Hg) was more pronounced (p less than 0.05) in the N-treated than in the A-treated group. Pulse rate, plasma aldosterone, and plasma renin activity were lower (p less than 0.05) in the A treated patients. Neither treatment had significant influence on [Na]i, [K]i, or ouabain-sensitive sodium efflux. The N-induced changes in supine systolic and diastolic pressure correlated (p less than 0.05) with age (r = -0.65 and r = 0.58, respectively) and pretreatment plasma renin activity (r = 0.71). Multiple regression analysis demonstrated a negative association between pretrial [Na]i and the change in systolic pressure during N treatment that was independent of age, pretreatment blood pressure, and change in pulse rate. Age and the change in supine pulse rate were also independently correlated with the change in diastolic pressure during N treatment. The results show a greater antihypertensive efficacy of N than A in the patients entered in this study and suggest that a higher intracellular sodium concentration could predict a better hypotensive response to N. PMID- 3276621 TI - Cardiopulmonary receptor modulation of plasma renin activity in normotensive and hypertensive subjects. AB - Cardiopulmonary receptors modulate renin release in several animals species. However, their involvement in reflex control of this humoral substance in humans is controversial. Furthermore, no information is available on the alteration of this control in hypertension. We studied the modulation of plasma renin activity (radioimmunoassay) in 12 normotensive subjects and in 12 age-matched subjects with untreated hypertension of mild or moderate degree. Cardiopulmonary receptors were stimulated by increasing central venous pressure (right atrial catheter) and cardiac volume (echocardiographic measurement) through passive leg raising and deactivated by reducing central venous pressure and cardiac volume through lower body negative pressure. The stimuli were maintained for 20 to 30 minutes, and their degree was set to avoid changes in blood pressure (indirect or direct measurements) and heart rate, thus avoiding involvement of arterial baroreceptors. In normotensive subjects, deactivation of cardiopulmonary receptors induced a progressive rise in plasma renin activity and stimulation of cardiopulmonary receptors induced a progressive fall. The reflex gain (ratio between plasma renin activity and central venous pressure or cardiac volume changes) was similar for deactivation and stimulation. During cardiopulmonary receptor deactivation, the gain corresponded to that obtained by dividing the increase in plasma renin by the reduction in central venous pressure induced by tilting. Cardiopulmonary receptor deactivation and stimulation also induced clear cut changes in plasma renin activity in hypertensive subjects, but the percent magnitude of the reflex plasma renin activity excursion was less than that in normotensive subjects. These observations indicate that cardiopulmonary receptors modulate plasma renin activity in humans.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276622 TI - Variable expression of a surface determinant during proliferation of Candida albicans. AB - The surface expression of an antigenic determinant that is present in the cell wall of Candida albicans was investigated with monoclonal antibody 24 (MAb24), an immunoglobulin M MAb. The proportion of the cell population that expressed the epitope under different growing conditions was determined by indirect immunofluorescence microscopy. More than 90% of stationary-phase yeast cells of strain B311 grown at 28 degrees C expressed the antigen. Less than 50% of yeast cells grown exponentially at 28 degrees C or either growing or stationary-phase yeast cells cultivated at 37 degrees C expressed the epitope. Germ tubes, which were induced at 37 degrees C from stationary-phase yeast cells grown at 28 degrees C, expressed the determinant on the parent yeast but not the hyphal portion of the germ tube. The change in antigen expression by stationary-phase cells grown at 28 degrees C, when they resumed growth by bud formation, suggested that antigen expression was lost by cells in the inoculum prior to the first cell division. By using the same assay, strong positive reactions were observed in stationary-phase cultures of other isolates of C. albicans, C. guilliermondii, C. stellatoidea, and C. tropicalis, but not with isolates of C. krusei, C. parapsilosis, or Torulopsis glabrata. The identification of the antigenic determinant as a carbohydrate was based on three observations: (i) interaction with a mannan preparation from the same organism, (ii) sensitivity of the antigen to periodate but not proteases, and (iii) coincidence of the migration of antigen during electrophoresis with material which stained intensely with carbohydrate but not with protein reagents. These observations suggest that the expression of the antigenic determinant of MAb24 is dependent on the growth conditions, growth state, and morphology of the cell and that the topography of the cell surface is dynamic. PMID- 3276623 TI - Role of immunoglobulin G in killing of Borrelia burgdorferi by the classical complement pathway. AB - The antibody and complement requirements for killing of Borrelia burgdorferi 297 by normal human serum (NHS) and NHS plus immunoglobulin G (IgG) were examined. B. burgdorferi activated both the alternative and classical complement pathways in NHS. In NHS chelated with 10 mM ethylene glycol-bis(beta-aminoethyl ether) N,N,N',N'-tetraacetic acid plus 4 mM MgCl2 (Mg-EGTA) to block classical pathway activation, consumption (activation) of total hemolytic complement, complement component 3 (C3), and C9 by B. burgdorferi was observed. Furthermore, challenge of unchelated NHS with 297 cells resulted in the consumption of C4, in addition to an increase in C3 and C9 consumption over that observed in chelated serum. In spite of complement activation, B. burgdorferi was resistant to the nonspecific bactericidal activity of NHS. The addition of human anti-B. burgdorferi IgG to NHS, however, resulted in the complete killing of 297 cells. Bactericidal activity of this serum was abrogated if NHS was immunochemically depleted of C1, indicating that killing was mediated by the classical pathway. The manifestation of bactericidal activity was accompanied by a large increase in total complement and C3 consumption over that observed in NHS alone. Under similar conditions, only a minimal increase in C9 consumption was observed. No increase in total complement consumption was observed if NHS plus anti-B. burgdorferi IgG was treated with Mg-EGTA prior to challenge. The results of these experiments demonstrate that B. burgdorferi is resistant to the nonspecific bactericidal activity of NHS, in spite of classical and alternative complement pathway activation. B. burgdorferi is sensitive to serum, however, in the presence of IgG, which mediates bacterial killing through the classical complement pathway. PMID- 3276624 TI - Oral immunization of rabbits with enterotoxigenic Escherichia coli protects against intraintestinal challenge. AB - The development of a successful oral vaccine against enterotoxigenic Escherichia coli depends upon the identification of appropriate protective antigens which can be delivered effectively to intestinal mucosa. We have determined in a modified RITARD model the relative protection against intraintestinal challenge afforded by oral immunization with live enterotoxigenic E. coli carrying different candidate antigens. Studies were done with both wild-type strains and genetically manipulated strains of enterotoxigenic E. coli (parent strain E1392/75 2A) which carried plasmids containing intact heat-labile toxin (LT) gene sequences or various mutations of the LT genes. Immunizations were done by orogastric tube inoculation on days 0, 7, and 14; challenges were done on day 33. Protection against diarrhea with a homologous challenge was found to be 84 to 100% (P less than 0.01). Protection against diarrhea with challenges in which specific antigens could be tested included the following: (i) O and H antigens (O6:H16), 87 to 100% protection with different E. coli strains with identical O and H antigens (P less than 0.01) but no protection against a heterologous challenge; (ii) LT or the B subunit of LT only, approximately 50% protection (P less than 0.02). These findings suggest that O antigens are highly protective in this model but afford only serotype-specific protection and that the B subunit (with or without the A subunit) affords less protection but confers cross-protection against heterologous strains producing LT. This model should be useful in further defining appropriate protective antigens for candidate enterotoxigenic E. coli vaccine strains. PMID- 3276625 TI - Characterization of aromatic- and purine-dependent Salmonella typhimurium: attention, persistence, and ability to induce protective immunity in BALB/c mice. AB - Stable transposon-generated auxotrophic mutations in aroA, purA, and purE or aroA and purA together were introduced into Salmonella typhimurium strains which were virulent in mice. Strains harboring any of these mutations were attenuated when tested in BALB/c mice. purE strains were less attenuated than aroA or purA strains. Both aroA and purA mutants persisted for several weeks in the livers and spleens of the mice after intravenous infection, although the numbers of viable cells detected at various times after infection differed. aroA strains persisted at a higher level than purA strains and were effective live vaccines given intravenously or orally. purA strains were ineffective as oral vaccines and were poor intravenous vaccines. Strains harboring both aroA and purA mutations together were ineffective vaccines when administered orally or intravenously even though they persisted in the livers and spleens of the mice for long periods after intravenous infection. PMID- 3276626 TI - Affinity-purified antibodies to ring-infected erythrocyte surface antigen do not correlate with merozoite invasion inhibition in Plasmodium falciparum. AB - We affinity purified, from malaria-immune serum, antibody to the ring-infected erythrocyte surface antigen (RESA), using petri dishes containing a monolayer of Plasmodium falciparum ring-infected erythrocytes. Except for one out of eight samples, the purified antibody positive by RESA-immunofluorescent assay was not inhibitory to the in vitro invasion of merozoites into erythrocytes in three geographically distinct strains of P. falciparum. However, the initial high level of merozoite-inhibiting antibodies of the intact serum samples remained in the immunoglobulin G fraction from which the RESA antibodies had been removed by affinity chromatography. These results suggest that, although in some cases RESA immunofluorescent assay-positive antibodies may be inhibitory to merozoite invasion, there are more important antibodies capable of merozoite invasion inhibition. PMID- 3276628 TI - Role of PCF8775 antigen and its coli surface subcomponents for colonization, disease, and protective immunogenicity of enterotoxigenic Escherichia coli in rabbits. AB - The role of the PCF8775 antigen and its antigenic subcomponents, in particular, the coli surface (CS) antigen CS6, as colonization factors and protective antigens was studied in the reversible intestinal tie adult rabbit diarrhea model. This was done by testing the abilities of different mutants which carried one or two of the CS components to colonize the intestine and to induce protective immunity against reinfection with PCF8775-positive enterotoxin producing Escherichia coli. Infection with enterotoxigenic E. coli carrying CS4 CS6, CS5-CS6, or CS6 alone induced diarrhea in 75% or more of the rabbits, whereas the corresponding nonenterotoxigenic mutants, as well as enterotoxigenic but CS-negative strains, induced diarrhea in only a few cases. Mutants carrying CS6 alone colonized the intestine equally as well as strains carrying CS4-CS6 or CS5-CS6 did, whereas CS-negative mutants were excreted in the stool for a significantly shorter period. Rabbits previously infected with mutants carrying CS6 alone or CS6 in combination with CS4 or CS5 developed diarrhea with a significantly lower frequency after reinfection with a normally highly diarrheagenic dose of enterotoxigenic CS4-CS6-positive E. coli bacteria than did animals immunized with corresponding CS-negative mutants. Fecal excretion of the rechallenge strain was also of considerably shorter duration than that observed after initial infection with corresponding strains in 27 of the 30 animals (90%) immunized with strains carrying CS6 alone or in combination with CS4 or CS5. Such reduced shedding of the challenge strain was only seen in a few rabbits (3 of 12) initially infected with CS-negative bacteria. These results suggest that the CS6 component of PCF8775 is a colonization factor in rabbits and that it is also capable of inducing protective immunity. PMID- 3276627 TI - Identification and localization of integral membrane proteins of virulent Treponema pallidum subsp. pallidum by phase partitioning with the nonionic detergent triton X-114. AB - Integral membrane proteins of Treponema pallidum subsp. pallidum (T. pallidum) were identified by phase partitioning with the nonionic detergent Triton X-114; antigens with apparent molecular masses of 47, 38, 36, 34, 32, 17, and 15 kilodaltons (kDa) were identified in the detergent phase. Immunoblotting with murine monoclonal antibodies directed against pathogen-specific 47- and 34-kDa T. pallidum antigens confirmed their presence in the detergent phase. Endoflagellar proteins of T. pallidum were not detected in immunoblots of detergent-phase proteins when monospecific antisera directed against endoflagella of the nonpathogenic T. phagedenis biotype Reiter were used. At detergent concentrations (0.02 and 0.1%) which appeared to solubilize selectively the outer membranes of treponemes radiolabeled with 35S in vitro, limited amounts of detergent-phase proteins were immunoprecipitated. Greater amounts of detergent-phase proteins were extracted at higher detergent concentrations (0.5 and 2.0%) which resulted in both outer membrane solubilization and ultrastructural derangements of the residual cytoplasmic bodies. Furthermore, Triton X-114 extraction of both intact treponemes and organisms without outer membranes yielded detergent phases with similar protein profiles. The results of these experiments indicate that the hydrophobic proteins identified by Triton X-114 are not located exclusively in the T. pallidum outer membrane. The results are also consistent with the hypothesis that the T. pallidum outer membrane is a protein-deficient lipid bilayer. PMID- 3276629 TI - Cloning and expression of DNA coding for the major house dust mite allergen Der p 1 in Escherichia coli. AB - A cDNA clone coding for the major house dust mite allergen Der p 1 was isolated from a lambda gt 11 library. Its sequence correlates with known amino acid sequences of Der p 1 and it produces a fusion protein which reacts with rabbit anti-Der p 1 antiserum. PMID- 3276630 TI - Involvement of the outer wall layer of Cladosporium cladosporioides in an IgG mediated hypersensitivity. AB - The serum of an individual hypersensitive to the fungus Cladosporium cladosporioides reacted with the outer wall layer of germinating spores, immature hyphae, and, to a lesser extent, mature mycelium, as detected by the indirect immunofluorescence assay when goat anti-human IgG, but not goat anti-human IgE, was employed. The outer wall layer of ungerminated spores, however, did not react with the patient's serum and the anti-human IgG probe. When ungerminated spores were vortexed in physiological saline for 1 min, approximately 8 pg of protein/spore was released; this rapid release of protein may have been the cause of the loss of antigenic activity from the outer wall layer of ungerminated spores during the immunoassay process. Immunoblotting revealed the presence of a high molecular weight antigen in all the extracts of the fungus at various stages of the life cycle, including ungerminated and germinating spores, hyphae in the logarithmic phase, mature mycelium, and a culture filtrate of C. cladosporioides. PMID- 3276631 TI - Factors affecting the clinical course of Treponema pallidum infection in guinea pigs. AB - The clinical course of infection with Treponema pallidum (Nichols) in inbred strain 2 guinea pigs was shown to be affected by age, sex and site of inoculation. PMID- 3276632 TI - P53 expression in breast cancer. AB - Immunohistochemical evaluation of 200 primary breast cancers with the anti-p53 mouse monoclonal antibody (MAb) PAb421 showed positivity in nuclei of malignant cells in 31 cases (15.5%). PAb421+ cases were significantly more frequently epidermal growth factor receptor (EGF-R)-positive (67.7%; p less than 0.001) and estrogen receptor (ER)-negative (73.3%; p less than 0.001); they displayed surface histocompatibility class-1 (80.6%; p less than 0.01) and 11 (74.2%; p less than 0.05) antigens. Low values for progesterone receptor (mean 67.20 +/- 25.2 fmol/mg; p less than 0.05) and a high number of cells positive for the proliferation-associated antigen Ki-67 (log mean 6.88 +/- 0.33; p less than 0.01) were found in PAb421+ tumors as well as a high number of grade-3 infiltrating duct carcinomas (70%; p = 0.01). Of the 200 cases of mammary carcinoma, 88 were further analyzed using another human specific anti-p53 MAb PAb1801, and 40 (45.5%) were found positive. This MAb stained all the PAb421+ cases and was significantly associated with negative ER status (39.5%; p less than 0.05) and high Ki-67 scores (log mean 6.93 +/- 0.24; p = 0.001). Analysis of PAb1801+/Pab421- cases for HLA antigens, EGF-R and ER showed a phenotype similar to that of the p53-ve/ER+ carcinomas, except for the high Ki-67 score. No differences in age of the patient, number of involved nodes, tumor size, ploidy or labelling index scores were evident between p53+ and carcinomas. We concluded that p53 in mammary carcinomas is associated with ER-negative, growth factor receptor-positive, high-grade tumors, and is a promising new parameter to evaluate the cellular biology and prognosis of breast cancer. PMID- 3276633 TI - Soft-tissue sarcomas of the head and neck in adults and children: experience at a single institution with a review of literature. AB - Ninety-four soft-tissue sarcomas of head and neck occurring among 10,700 malignancies, seen during the period 1953-1980 in the head-and-neck surgical department, were studied with reference to age, sex, ethnic origin, site, histological type and survival. The objective was to review our own experience with sarcomas in these sites seen in the Department of Pathology, A.C. Camargo Hospital. The predominant site was the head. Fibrosarcoma was the most frequent type in adults and rhabdomyosarcoma, located exclusively in the head, was the most frequent in children. PMID- 3276634 TI - Generation of monoclonal antibodies reactive with nuclear proteins of human primary breast tumors. AB - Nuclear proteins were extracted from purified nuclei of human primary breast tumors (BrT) and bladder tumors and of human normal breast, kidney and lymphocytes by enzymatic treatment. SDS-Polyacrylamide gel electrophoresis of nuclear proteins from breast tumors showed different bands in the molecular weight zones from 25 to 220 kDa which were absent or present only as traces in normal breast tissue. Murine monoclonal antibodies (MAbs) have been produced using nuclear extracts of human primary breast tumors as immunogens. Approximately 2,000 hybridomas were generated from 5 hybridizations. According to their reactivity to BrT nuclear extracts and mammary carcinoma cell line MCF-7, seven hybridomas were selected and cloned. They were further characterized with histological immunoperoxidase assays of formaldehyde-fixed BrT paraffin tissue sections. MAb 6A3 particularly gave strong nuclear staining with all BrT specimens while MAb 1D8 showed both nuclear and cytoplasmic staining with only some of them. Specimens from mammoplasty did not react with these MAbs. Immunoblotting of BrT nuclear extracts as developed with MAbs 6A3 and 1D8 revealed major protein bands with molecular weight of 120 and 130 kDa. The potential use of these MAb-defined BrT-related nuclear proteins as markers for human breast cancer was suggested. PMID- 3276635 TI - Monoclonal antibodies against mesothelial membrane antigen discriminate between malignant mesothelioma and lung adenocarcinoma. AB - Monoclonal antibodies (MAbs) were generated by immunizing mice with the mesothelioma cell line SPC111 and selected by indirect immunofluorescence on viable cells. Indirect immunofluorescence staining and radioimmunoassays demonstrated selective binding of the antibodies ME1 and ME2 with the surface membrane of mesothelioma, but not with lung adenocarcinoma cell lines. Lung small cell carcinoma cell lines were unreactive, while staining was seen in a proportion of lung squamous-cell carcinoma cell lines. The antibodies were unreactive with other cell lines, including breast, colon, ovarian, and renal cell carcinoma, leukemia, and lung fibroblast. The antibodies stained normal mesothelial cells, but were unreactive with normal bronchial epithelial cells in primary cultures, or peripheral blood cells. Immunohistochemical staining of cryostat sections of tumor tissues confirmed the ability of the antibodies to distinguish between mesothelioma and lung adenocarcinoma. All 12 mesothelioma tissues, but none of 9 lung adenocarcinomas or large-cell carcinomas, stained with the MAbs. Staining of malignant mesothelioma tissues was very homogeneous. Some lung squamous-cell carcinomas and breast carcinomas were stained focally by both, and some ovarian carcinomas by one antibody. Solid-phase radioimmunoassays demonstrated antigen sensitivity to chymotrypsin digestion and binding competition between the antibodies. The antibodies ME1 and ME2 identify a surface membrane antigen with preferential expression on normal and malignant mesothelial cells. They distinguish malignant mesothelioma from lung adenocarcinoma on cryostat sections and promise to be useful tools in biological studies of mesothelial cells. PMID- 3276636 TI - Biochemical and cellular mechanisms of low-dose effects. AB - Low-dose irradiation is usually considered to be rather ineffective in producing biologically relevant effects. Yet, individual radiation absorption events within cell nuclei or whole cells interact stochastically with subcellular structures due to the multiple ionizations along primary or secondary particle tracks, depending on ionization density. Whereas radiation effects are usually seen in the context of structure and function of DNA, other cellular effects, perhaps influencing DNA by secondary biochemical mechanisms, also warrant attention. Thus, previous work from this laboratory with bone marrow that was obtained from whole-body exposed mice, has shown that single or few instantaneous radiation absorption events per cell from gamma-rays produce an acute and temporary partial inhibition of the enzyme thymidine kinase; the effect appears within about 1 h after the event, reaches its maximum at approximately 4 h and disappears completely within another 6 h. This pattern of enzyme inhibition is fully concordant with the pattern of inhibition of uptake of tritiated thymidine or 125I-labelled deoxyuridine into the DNA; also concordant is a temporary increase in the concentration of free thymidine in the blood serum of the exposed mice. The particular response of thymidine kinase was considered to relate to some, thus far unknown, repair systems and/or to a defence mechanism of the hit cells. In order to further elucidate the role of the acute and temporary partial inhibition of thymidine kinase in cellular metabolism, experiments were carried out in which mice were acutely exposed to 0.01 or 0.1 Gy and again exposed to the same dose at different times up to 12 h after the first exposure. At regular time intervals after the second exposure bone marrow cells were obtained and thymidine kinase activity was studied by various assays. The results indicate that the first acute irradiation conditioned the cells in such a way that the second acute irradiation produced either an enhanced inhibition and recovery of thymidine kinase activity, or no effect at all was seen, when the second irradiation was given between about 3 and 8 h after the first irradiation. From 8 to 12 h after the first irradiation the cells apparently resumed their original state, so that the second irradiation produced effects quite similar to those seen after a single irradiation in unconditioned cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3276637 TI - Preliminary molecular studies on two chromosome 2 encoded genes, c-abl and beta 2M, in radiation-induced murine myeloid leukaemias. AB - The majority of radiation-induced murine myeloid leukaemias are characterized by deletion and/or translocation of an interstitial region of chromosome 2, and there is evidence that such events may occur very early in myeloid leukaemogenesis. Analyses presented and discussed here on the structure and function of two possibly relevant chromosome 2 encoded genes (c-abl and beta 2M) lead to the preliminary conclusion that neither are directly involved nor activationally changed by the characteristic chromosome 2 rearrangements. PMID- 3276638 TI - Survival of cells in mammalian tissues after low doses of irradiation: a short review. AB - A survey of data in the literature indicates that the radiosensitivity of cells to doses less than 1 Gy varies widely within cell lineages and less so between lineages. This is due in large part to the differentiation status and division capacities of the cells, and possibly also to the grouping of cells into 'viable units'. In addition, the mode of cell death is important, and cells susceptible to natural apoptosis are particularly radiosensitive. There are also quite marked differences in cell sensitivity between species. PMID- 3276639 TI - Molecular and epidemiologic study of multiresistant Serratia marcescens infections in a spinal cord injury rehabilitation unit. AB - Between March 1984 and February 1986, ten patients admitted to a spinal cord injury/stroke rehabilitation unit became bacteriuric with a strain of Serratia marcescens resistant to ampicillin, cephalothin, cefoxitin, ticarcillin, cotrimoxazole, gentamicin, and tobramycin. All the patients were catheterized, and in most, bacteriuria was asymptomatic. The organism was also recovered from their hospital environment (sinks, toilets, urine-collecting basins). Analysis of total plasmid content of multiresistant isolates revealed the presence of two plasmids (7 kilobase, 25.5 kilobase), not found in aminoglycoside susceptible strains of Serratia marcescens. Restriction endonuclease analysis and Southern hybridization (DNA probe: 25.5 kilobase plasmid) verified that these plasmids were identical. The 25.5 kilobase plasmid was purified, introduced by transformation into an Escherichia coli strain C recipient, and was found to mediate resistance to gentamicin and tobramycin. The emergence of multiresistant Serratia marcescens coincided with an increase in antibiotic usage on the ward. The reservoir seemed to be the urinary tracts of asymptomatic catheterized patients and their contaminated hospital environment. PMID- 3276640 TI - A causal link between handwashing and risk of infection? Examination of the evidence. AB - To examine evidence of a causal link between handwashing and risk of infection, a review of published literature from 1879 through 1986 was conducted. In the 107 years studied, 423 articles specifically related to handwashing were found. Articles were categorized as studies to evaluate products (50.8%), review articles (29.1%), behavioral studies (10.9%), methodologic studies (2.8%), studies linking handwashing to infection (3.3%), and other (3.1%). There was an increase in the proportion of handwashing articles published in the 1980s with the rate (9.4/10(5) citations/year) being almost double that of any other period studied. Nonexperimental and experimental studies related to handwashing were reviewed and evidence for a causal association evaluated. Except for specificity, all the elements for causality, including temporality, strength, plausibility, consistency of the association, and dose response were present. It was therefore concluded that emphasis on handwashing as a primary infection control measure has not been misplaced and should continue. PMID- 3276641 TI - The use of intraperitoneal antibiotics to treat dialysis-associated peritonitis. PMID- 3276642 TI - Effect of preoperative shampoos with chlorhexidine or iodophor on emergence of resident scalp flora in neurosurgery. AB - Wound contamination with endogenous bacterial scalp flora plays an important role in the pathogenesis of postoperative neurosurgical infections. To assess the effect of preoperative antiseptic shampoos on the emergence of resident scalp flora during surgery and subsequent wound contamination, we randomized 151 neurosurgical procedures into four study groups: group A--preoperative shampoos with chlorhexidine, surgical scalp preparation with chlorhexidine; group B--no shampoos, surgical preparation with chlorhexidine; group C--shampoos with iodophor, surgical preparation with iodophor; group D--no shampoos, surgical preparation with iodophor. Quantitative cultures of the scalp were obtained preoperatively and at the end of surgery, and qualitative wound cultures were taken prior to wound closure. Group A had the lowest concentration of bacteria on the scalp both preoperatively and postoperatively (median range = 30 [0-5.7 x 10(5)] and 0 [0-2.5 x 10(3)] respectively). Group A also had significantly fewer positive postoperative scalp cultures (29%) than groups B (51%), C (58%), and D (53%) (P less than 0.05), as well as fewer positive wound cultures (20% v 25%, 42%, and 30% respectively). A density of bacteria on the scalp of greater than 10(2)/4cm2 best predicted the presence of bacteria in the wound. Repeated preoperative shampoos with chlorhexidine reduce intraoperative emergence of resident skin flora and subsequent contamination of the wound. PMID- 3276643 TI - Topically applied cyclosporine in azone prolongs corneal allograft survival. AB - The purpose of this study was to develop and test a topical ocular delivery system for the immunosuppressive drug cyclosporine. To this end, cyclosporine was dissolved in the penetration enhancer, Azone, and applied topically to allografted rabbit eyes. The concentration of cyclosporine in the cornea, the aqueous humor, and blood of the treated rabbits was determined by radioimmunoassay. The effect of the cyclosporine-Azone preparation on the survival of corneal allografts was assessed by clinical evaluation of the grafts and by histopathologic and immunohistologic evaluation of the cellular infiltrate in the grafts. Clinically significant concentrations of cyclosporine were measured in the treated corneas but little or no drug was found in the aqueous humor or blood of the treated animals. Cyclosporine in Azone resulted in suppression in the severity and incidence of graft rejection. The suppression of graft rejection was borne out by the immunohistologic observations. Cyclosporine treated grafts contained significantly fewer infiltrating T lymphocytes than did the drug/solvent-treated allografts, indicating that the topical application of cyclosporine actively inhibited the entry of T cells into the grafts. This study, for the first time, presents a solvent that is apparently not toxic but is effective in delivering immunologically active concentrations of cyclosporine following topical application to the cornea. PMID- 3276644 TI - Imaging of the adrenal glands. PMID- 3276646 TI - Journal publications in radiology education. A review of the literature, 1966 1986. AB - Published scholarly activity pertaining to radiology education is relatively uncommon compared with an extensive clinical literature. To guide future radiology educational efforts in a time of changing priorities and practice patterns, the authors undertook an in-depth review and analysis of the existing radiology education literature covering the 20-year period from 1966 to 1986. A total of 194 articles was identified via a computerized literature search and manual cross-checking of cited references. Articles pertinent to medical student radiology education (36.6%) or radiology resident education (29.9%) predominated. The majority of published radiology education articles were editorials (35.5%) or expository in nature (49.5%). Surveys (5.1%) and experimental research (8.7%) comprised the balance. Although editorial opinions and personal reflections are important and valuable resources for radiology educators, a substantial lack of empirical research in radiology education exists. Additional knowledge in underdeveloped research areas is essential for future curriculum planning and development in radiology education. PMID- 3276645 TI - Accurate analysis of blood vessel sizes and stenotic lesions using stereoscopic DSA system. AB - We have developed a technique to determine accurately the magnification factor and three-dimensional orientation of a vessel segment from a stereoscopic pair of digital subtraction angiograms (DSA). Our DSA system includes a stereoscopic x ray tube with a 25-mm focal spot shift. The magnification and orientation of a selected vessel segment are determined from the distance and direction of the focal spot shift and the stereoscopic discrepancy in image positions for that segment. Our results indicate that the accuracies of determining the magnification and orientation are less than 1% and approximately 5 degrees, respectively. After the magnification and orientation are determined accurately, an iterative deconvolution technique for the measurement of vessel image size is applied to the selected vessel segment. This iterative deconvolution technique provides the best estimate of vessel image size by taking into account the unsharpness of the digital system. With this technique, the vessel image size can be determined to an accuracy of approximately 1.0 mm, which corresponds to one third the pixel size of our DSA system. Information derived from stereoscopic analysis and iterative deconvolution thus allows accurate calculation of actual vascular dimensions from DSA images. PMID- 3276647 TI - Alexis St. Martin now rests in peace. PMID- 3276648 TI - Inhalation injury: a review of the literature. PMID- 3276649 TI - Malnutrition and wound healing. AB - Hospital malnutrition occurs in a majority of surgical patients and contributes to delayed wound healing, a longer recovery time, increased morbidity and mortality rates, an increased infection rate, and decreased stamina. With the advances in the past 10 years in safe delivery of amino acids and fat emulsions peripherally, and with the ability to deliver hyperalimentation by a central venous line, patients can be fed enough calories, fat, and protein to prevent malnutrition or to treat it. Recognition and prevention of hospital malnutrition is a mandatory aspect of delivering good patient care. Offering advanced technology, skilled surgeons, and advanced-practice nursing care to the patient, without acknowledging his basic needs, reminds one of the ironic saying, "The operation was a success, but the patient died." The nurse has a special role in assessment and treatment of malnutrition in the hospitalized patient. PMID- 3276650 TI - Use of steroids in cerebral edema: therapeutic implications. PMID- 3276651 TI - Esmolol, the first ultra-short-acting intravenous beta blocker for use in critically ill patients. AB - Esmolol is the first intravenous, short-acting, titratable beta-blocker available for use in critical care and surgical settings. The predominant pharmacodynamic actions of the drug include a reduction in HR, BP, rate-pressure product, LVEF, and cardiac index. A desirable pharmacokinetic feature of esmolol is its esterase induced rapid metabolic inactivation, which results in a return of all hemodynamic parameters to pretreatment levels within 30 minutes after discontinuation of the infusion. Control over the magnitude and duration of beta blockade and the relative cardioselectivity of esmolol make it an ideal agent for use in critically ill patients, including those who, because of other conditions, are at risk if treated with beta-blockers. The clinical indications for esmolol therapy include SVT and perioperative tachycardia and hypertension. In patients with myocardial ischemic conditions (acute myocardial infarction and unstable angina), esmolol was safe and produced clinically significant reductions in HR and rate-pressure product. In general, untoward reactions to esmolol have been minimal, mild, and transient. Although attention must be given to the possibility of systolic hypotension during esmolol administration, this complication often occurs at doses beyond those which provide optimal therapeutic response and may be avoided by titrating to the minimal effective dose. If systolic hypotension occurs, it is reversible by either reducing the dose or discontinuing the esmolol infusion. A nursing plan of care should be developed for patients receiving esmolol therapy. Dosage and administration must be individualized. Careful titration of the esmolol infusion and monitoring of therapeutic and safety parameters by nursing professionals will promote the achievement of maximum beta blocker effect while avoiding persistent and unnecessary adverse reactions. PMID- 3276652 TI - Definitive irradiation for early stage breast cancer: The University of Pennsylvania experience. AB - From 1977 to 1984, 552 breast cancers in 548 women were treated with definitive irradiation following breast-conserving surgery at the Hospital of the University of Pennsylvania and the Fox Chase Cancer Center. All patients had invasive carcinoma and were AJC clinical Stage I or II. Pathologic axillary lymph node staging was known for all cases. The 5-year actuarial survival for the entire group was 93% with an NED survival of 81%. The 5-year survival for clinical Stage I and II patients was 97 and 87%, respectively, with a corresponding NED survival of 87 and 73%, respectively. For pathologic Stage I and II patients, the corresponding survival figures were 97 and 89%, respectively, with NED survival rates of 86 and 76%, respectively. The overall 5-year actuarial local failure rate was 6%, and the rate of local only as the first failure was 3%. The overall local-regional failure rate was 13% with a local-regional only first failure rate of 8%. These results compare favorably with other reported series and contribute a substantial number of patients to the increasing experience with definitive irradiation following breast-conserving procedures. The relatively low incidence of breast recurrence may be related to the emphasis on integrating the surgical, pathologic, and radiotherapeutic aspects of treatments, as well as the emergence of a re-excision policy for patients at high risk to have residual tumor. PMID- 3276653 TI - The outcome of treatment of 313 patients with T-1 (UICC) prostate cancer treated with external beam irradiation. AB - Three hundred and thirteen patients with UICC T-1 N-0 M-0 prostate cancer were treated with external beam irradiation in 1973 and 1974 or in 1978, and their outcome determined 3-10 years after treatment. Survival over the first 5 years was comparable to that expected for a group of age matched normal males (77% vs. 81%), but during the second 5-year interval, there was a decrease in survival below that expected (51% vs 62%), a reflection of death in patients who developed metastasis as a first recurrence (18%). Overall, 72% of patients were free of any recurrence at 5 years and, 88% free of infield recurrence. The development of metastatic recurrence was significantly related to grade; at 5 years 87% of grade I, 79% of grade II and 69% of grade III patients were free of metastasis. There was a trend for increased local recurrence with increasing grade, but it was not statistically significant. There was a dose/response relation for complications, and radiation doses above 6500 cGy are associated with an increase in complication from 6% to 11% (p = .09). Complications requiring hospitalization for evaluation or management occurred in 30 (10%) of 313 patients. There were no deaths from complications and less than 2% of patients required surgical correction of complications. External beam radiation offers the patient with early prostate cancer a favorable opportunity for cure without the morbidity of impotence, incontinence, and occasional death experienced following LND and radical prostatectomy. Lymph node dissection does not seem necessary for most patients with T-1 prostate cancer as the positive yield in those with Grades I and II cancers is less than the complications of the procedure, and extensive involvement can be detected by non-invasive means. PMID- 3276654 TI - Radiation therapy for the treatment of non-eight nerve intracranial neurilemmoma. AB - The records of 19 patients treated for intracranial neurilemmomas, other than of the eighth nerve, at the University of California, San Francisco from 1945 through 1983 were reviewed. One patient who died within 30 days following surgery was excluded from the analysis. The 5th and the 9/10/11th nerve complex were the most common sites of tumor origin. Patients were classified by the extent of surgical resection: total (90-99% resection, NTR), subtotal (less than 90% resection, STR) and biopsy. Five patients had total excision of their tumor without post-operative irradiation and none had recurred. One of the 2 patients who had STR and did not receive post-operative irradiation recurred, while 2 of the 3 patients who received post-operative irradiation following STR recurred. One of the 2 patients who had NTR and did not receive post-operative irradiation recurred, while 1 of the 3 patients who received post-operative irradiation following NTR recurred. Two patients were treated with post-operative irradiation following biopsy and one recurred. One patient was treated with planned preoperative irradiation to reduce tumor vascularity, followed by total resection. Because of the small number of patients, no firm conclusion regarding the efficacy of irradiation for non-eighth nerve intracranial neurilemmoma can be made. PMID- 3276655 TI - A system for stereotactic radiosurgery with a linear accelerator. AB - A small field irradiation technique to deliver high doses of single fraction photon radiation to small, precisely located volumes (0.5 to 8 cm3) within the brain has been developed. Our method uses a modified Brown-Roberts-Wells (BRS), CT-guided, stereotactic system and a 6 MV linear accelerator equipped with a special collimator (diameters of 12.5 mm to 30.0 mm projected to isocenter) located 23 cm from isocenter. Target localization via planar angiography has been added. Treatment consists of a series of arcing beams using both gantry and couch rotations. During treatment, the patient's head is immobilized independently of the radiotherapy couch and is precisely positioned without reference to room lasers or light field. A precise verification of alignment precedes each treatment. Extensive performance tests have shown that a target, localized by CT, can be irradiated with a positional accuracy of 2.4 mm in any direction with 95% confidence. If angiography is used for localization, the results are better. The dose 1.0 cm outside the target volume is less than 20% of the prescribed dose for a medium sized collimator. PMID- 3276656 TI - The rule of empathy: Sandor Ferenczi's pioneering contributions to the empathic method in psychoanalysis. PMID- 3276657 TI - Effects of cyclic mechanical stimulation of the cellular components of the heart: in vitro. AB - The response of the cellular components of the heart to cyclic mechanical stimulation is of particular importance because these cells are continually subjected to mechanical forces as a result of changes in blood volume and pressure. To directly investigate how mechanical tension affects these cellular components of the heart, an in vitro system that exposes the particular cell type (cardiac myocytes, endothelial cells, or fibroblasts) to a calibrated increase in cyclical linear stretch was developed. Cells were grown on silastic membranes coated with laminin and subjected to a 10% cyclical distention 10 times a minute for 72 h. Within 24 h of being exposed to the mechanical stretch, the cells became elongated and oriented perpendicular to the direction of the stretch. These results indicate that cyclical mechanical stimulation directly influences the cellular organization of the heart cells in vitro. PMID- 3276658 TI - Identification of the uvrA6 mutation of Escherichia coli. AB - The uvrA6 mutation has been cloned on a multicopy plasmid by using a chloramphenicol resistance marker introduced next to the uvrA gene in the Escherichia coli chromosome. The mutation was shown to reside in the N-terminal part of the uvrA gene. Sequencing part of this region of the mutant gene revealed a frameshift mutation at positions 207 to 209, which leads to a stop codon at position 262. A marker rescue experiment showed that this frameshift is the only mutation responsible for the UV-sensitive phenotype of the UvrA6 mutant. The method presented is suitable for the cloning of every chromosomal uvrA mutation and can be useful for the study of the functional domains of the UvrA protein. PMID- 3276659 TI - Cloning of the Escherichia coli K-12 hemB gene. AB - An Escherichia coli heme-requiring, heme-permeable mutant had no detectable 5 aminolevulinate dehydratase or porphobilinogen deaminase activities. The gene which complemented this mutation was cloned to a high-copy-number plasmid, and porphobilinogen deaminase activity was restored to normal levels, but the synthesis of 5-aminolevulinate dehydratase increased 20- to 30-fold. A maxicell procedure confirmed that the gene cloned was hemB. PMID- 3276660 TI - Surface protein composition of Aeromonas hydrophila strains virulent for fish: identification of a surface array protein. AB - The surface protein composition of members of a serogroup of Aeromonas hydrophila which exhibit high virulence for fish was examined. Treatment of whole cells of representative strain A. hydrophila TF7 with 0.2 M glycine buffer (pH 4.0) resulted in the release of sheets of a tetragonal surface protein array. Sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis analysis showed that this sheet material was composed primarily of a protein of apparent molecular weight 52,000 (52K protein). A 52K protein was also the predominant protein in glycine extracts of other members of the high-virulence serogroup. Immunoblotting with antiserum raised against formalinized whole cells of A. hydrophila TF7 showed the 52K S-layer protein to be the major surface protein antigen, and impermeant Sulfo-NHS-Biotin cell surface labeling showed that the 52K S-layer protein was the only protein accessible to the Sulfo-NHS-Biotin label and effectively masked underlying outer membrane (OM) proteins. In its native surface conformation the 52K S-layer protein was only weakly reactive with a lactoperoxidase 125I surface iodination procedure. A UV-induced rough lipopolysaccharide (LPS) mutant of TF7 was found to produce an intact S layer, but a deep rough LPS mutant was unable to maintain an array on the cell surface and excreted the S-layer protein into the growth medium, indicating that a minimum LPS oligosaccharide size was required for A. hydrophila S-layer anchoring. The 52K S-layer protein exhibited hear-dependent SDS-solubilization behavior when associated with OM, but was fully solubilized at all temperatures after removal from the OM, indicating a strong interaction of the S layer with the underlying OM. The native S layer was permeable to 125I in the lactoperoxidase radiolabeling procedure, and two major OM proteins of molecular weights 30,000 and 48,000 were iodinated. The 48K species was a peptidoglycan associated, transmembrane protein which exhibited heat-modifiable SDS solubilization behaviour characteristic of a porin protein. A 50K major peptidoglycan-associated OM protein which was not radiolabeled exhibited similar SDS heat modification characteristics and possibly represents a second porin protein. PMID- 3276661 TI - An N-terminal domain of the tetracycline resistance protein increases susceptibility to aminoglycosides and complements potassium uptake defects in Escherichia coli. AB - Expression of extrachromosomal tet genes increased the susceptibility of gram negative bacteria to specific aminoglycoside antibiotics. The magnitude of the increase in susceptibility was dependent on the amount and the class of the tet gene product (designated Tet) and the bacterial species in which the tet gene was expressed. Truncated Tet proteins that contained more than the first 33, but not more than the first 97, N-terminal amino acids of Tet also increased the susceptibility to aminoglycosides and complemented the potassium uptake defects in Escherichia coli. The primary structure of this N-terminal Tet fragment has the hydropathic characteristics of a multimeric, transmembrane structure and is highly conserved in three different classes of Tet proteins. PMID- 3276662 TI - The frdR gene of Escherichia coli globally regulates several operons involved in anaerobic growth in response to nitrate. AB - Fumarate reductase catalyzes the terminal step of anaerobic electron transport with fumarate as a terminal electron acceptor. Transcription of the fumarate reductase (frdABCD) operon in Escherichia coli is repressed in the presence of the preferred terminal electron acceptors, oxygen and nitrate. To identify trans acting genes involved in regulation by nitrate, a number of E. coli mutants were generated in which expression of a frdA'-'lacZ protein fusion was no longer fully repressed by nitrate. One of these mutants, strain LK23R35, exhibited 17-fold higher beta-galactosidase activity than the wild-type strain when grown anaerobically in the presence of nitrate. When grown aerobically in the presence of nitrate, it contained three- to fourfold more beta-galactosidase activity than the wild-type strain did. Oxygen regulation of frd expression, however, was unaffected by the mutation, since the level of beta-galactosidase activity in both strains was nearly identical when they were grown in the absence of nitrate either aerobically or anaerobically. To confirm that the mutation acts in trans to frdABCD, we measured fumarate reductase levels and found them to parallel FrdA'-beta-galactosidase activity under all growth conditions tested. The effect of the mutation is pleiotropic, since the levels of nitrate reductase in LK23R35 were not induced by the addition of nitrate. The frdR mutant was also derepressed for nitrate control of the trimethylamine-N-oxide reductase and alcohol dehydrogenase enzymes. The mutation maps in a region between trp and hemA at 27 min on the E. coli chromosome. This gene, where we call frdR, is involved in both positive and negative regulation of electron transport and fermentation associated genes. A cloned 4.9-kilobase fragment of chromosomal DNA was found to complement the frdR mutation; both repression of fumarate reductase gene expression and activation of nitrate reductase gene expression were restored. PMID- 3276663 TI - Metabolism of periplasmic membrane-derived oligosaccharides by the predatory bacterium Bdellovibrio bacteriovorus 109J. AB - Membrane-derived oligosaccharides (MDO), a class of osmotically active carbohydrates, are the major organic solutes present in the periplasm of Escherichia coli and many other gram-negative bacteria when cells are grown in a medium of low osmolarity. Analyses of growing cells of Bdellovibrio bacteriovorus, a gram-negative predator of other bacteria, have confirmed that they also synthesize a characteristic MDO-like class of oligosaccharides. The natural growth environment of bdellovibrios is the periplasm of other gram negative bacteria. Because of this location, prey cell MDO constitute a potential source of organic nutrients for growing bdellovibrios. Using cells of E. coli whose MDO were 3H labeled, we examined the extent to which B. bacteriovorus 109J metabolizes these prey cell components. Interestingly, there was neither significant degradation nor incorporation of prey cell MDO by bdellovibrios during the course of their intracellular growth. In fact, bdellovibrios had little capability either to degrade extracellular MDO that was made available to them or to transport glucose, the major monomeric constituent of prey cell MDO. Instead, periplasmic MDO were irreversibly lost to the extracellular environment during the period of bdellovibrio attack and penetration. Thus, although prey cell periplasmic proteins are retained, other important periplasmic components are released early in the bdellovibrio growth cycle. The loss of these MDO may aid in the destabilization of the prey cell plasma membrane, increasing the availability of cytoplasmic constituents to the periplasmic bdellovibrio. PMID- 3276664 TI - Termination of DNA replication in Escherichia coli requires a trans-acting factor. AB - The terminus region of the Escherichia coli chromosome contains two sites that inhibit the progression of DNA replication forks. These termination sites, designated T1 and T2, are separated by 7.5 min (350 kilobases [kb]) on the genetic map and are located at the extremities of the terminus region. They demonstrate polarity (they stop replication forks traveling in one direction but not the other) and inhibit replication forks that have passed through and are about to leave the terminus. We have used deletion mutations in the terminus region to map the locations of T1 and T2 more accurately and to initiate studies on the mechanism of replication fork inhibition. We have narrowed the boundaries of T1 and T2 to 20 and 4 kb, respectively. T1 maps between kb 80 and 100 on the physical map of the terminus region (J. P. Bouche, J. Mol. Biol. 154:1-20, 1982), and T2 maps between kb 438 and 442. In addition, we report here that deletion of the region containing the T2 termination site inactivated T1. Supplying the T2 region on a plasmid restored T1 function, demonstrating that inhibition of replication at T1 requires a trans-acting factor which maps in the vicinity of termination site T2. We have called this newly identified terminus function the termination utilization substance (tus). PMID- 3276665 TI - Molecular evolution of streptococcal M protein: cloning and nucleotide sequence of the type 24 M protein gene and relation to other genes of Streptococcus pyogenes. AB - The structural gene for the type 24 M protein of group A streptococci has been cloned and expressed in Escherichia coli. The complete nucleotide sequence of the gene and the 3' and 5' flanking regions was determined. The sequence includes an open reading frame of 1,617 base pairs encoding a pre-M24 protein of 539 amino acids and a predicted Mr of 58,738. The structural gene contains two distinct tandemly reiterated elements. The first repeated element consists of 5.3 units, and the second contains 2.7 units. Each element shows little variation of the basic 35-amino-acid unit. Comparison of the sequence of the M24 protein with the sequence of the M6 protein (S. K. Hollingshead, V. A. Fischetti, and J. R. Scott, J. Biol. Chem. 261:1677-1686, 1986) indicates that these molecules have are conserved except in the regions coding for the antigenic (type specific) determinant and they have three regions of homology within the structural genes: 38 of 42 amino acids within the amino terminal signal sequence, the second repeated element of the M24 protein is found in the M6 molecule at the same position in the protein, and the carboxy terminal 164 amino acids, including a membrane anchor sequence, are conserved in both proteins. In addition, the sequences flanking the two genes are strongly conserved. PMID- 3276666 TI - Novel regulatory loci controlling oxygen- and pH-regulated gene expression in Salmonella typhimurium. AB - Three new loci were discovered, each of which participates in the regulation of anaerobic gene expression. The regulatory gene earA negatively regulates the expression of the anaerobiosis-inducible gene aniG as well as that of at least three other genes, as determined by two-dimensional polyacrylamide gel electrophoresis. The earA locus maps at 86 min. The expression of aniG was also shown to be controlled by changes in external pH under aerobic and anaerobic conditions. Maximal expression was observed under anaerobic conditions at an external pH of 6.0. Significant transcriptional activity was also observed under aerobic conditions at pH 6.0. This was in contrast to hyd, whose expression was dependent upon anaerobiosis and varied with external pH. The pH dependence disappeared under fully aerobic conditions. Mutations in earA had no effect upon hyd expression. The two other regulators identified were oxrF, which controls aniH, and oxrG, which, in concert with oxrA and oxrB, controls aniC and aniI. The oxrG locus was mapped to 88 min and appears to code for a positive regulator. Various oxr mutants were subjected to two-dimensional polyacrylamide electrophoretic analysis of anaerobiosis-inducible proteins. Several pathways of anaerobic control were observed by means of these techniques. PMID- 3276668 TI - Exogenous factors in panic disorder: clinical and research implications. AB - Because panic disorder has an underlying biologic and probably genetic basis, the role of factors outside the organism in initiating and sustaining panic is often overlooked. The authors review certain exogenous factors that seem capable of triggering attacks and/or increasing their frequency and intensity: self administered pharmacologic agents (caffeine, alcohol, nicotine, over-the-counter cold preparations, cannabis, cocaine); habits (sleep deprivation, diet, exercise, relaxation, hyperventilation); and aspects of the environment (fluorescent lighting, life stressors). There may be a specificity to the action of some of these factors, because certain factors previously thought to trigger panic attacks (e.g., pain, hypoglycemia) have been proved not to have this effect. Although the clinical significance of many of the exogenous factors discussed still awaits empirical confirmation, attention to such factors during the initial evaluation of a patient with panic disorder may be helpful in formulating a successful treatment plan. PMID- 3276667 TI - Cloning and expression of the Escherichia coli K-12 sad gene. AB - The Escherichia coli K-12 sad gene, which encodes an NAD-dependent succinic semialdehyde dehydrogenase, was cloned into a high-copy-number vector. Minicells carrying a sad+ plasmid produced a 55,000-dalton peptide, the probable sad gene product. PMID- 3276669 TI - Chronic neuropharmacology of cocaine: progress in pharmacotherapy. AB - Cocaine dependence has long been thought of as a psychological addiction without a physiological withdrawal syndrome. In animals, chronic cocaine administration produces multiple neurophysiological adaptations that may decrease activity in brain reward pathways. Recent clinical research suggests that cocaine abstinence symptoms include anhedonia, which is consistent with the decreased reward in preclinical studies. Thus, severe cocaine abuse appears to produce a neurophysiological addiction having a primarily psychological clinical expression. Recent research has produced encouraging preliminary data on general pharmacological therapies for cocaine abuse and on specific agents for treating cocaine abusers who have coexisting axis I psychiatric disorders. PMID- 3276670 TI - Pharmacological and behavioral treatments of cocaine dependence: controlled studies. AB - The cocaine epidemic has stimulated novel treatments aimed at reducing relapse to this extremely addicting drug. After detoxification and standard treatment, former cocaine users continue to exhibit strong cocaine craving and physiological changes when presented with cocaine-related stimuli. Because these conditioned responses may increase the risk of relapse, a new treatment has been developed to extinguish such responses. The extinction process, consisting of repeated presentations of cocaine-related stimuli until the stimuli gradually lose their ability to evoke conditioned responses, is integrated into a comprehensive rehabilitation program. Cocaine dependence is often combined with opiate dependence. Desipramine has been added to methadone maintenance in an attempt to reduce dependence on both substances. Methadone impedes catabolism of desipramine so that relatively low doses of desipramine may produce antidepressant effects and possibly reduce the desire to use cocaine. Preliminary evidence from a placebo-controlled study of desipramine in combination with methadone suggests that desipramine produces significant improvements in psychological functioning, but its effects on reduction of cocaine use are less dramatic. PMID- 3276671 TI - Evaluation and clinical management of cocaine abusers. AB - The development of an individualized treatment program for cocaine abusers requires a comprehensive assessment of the psychobiological, social, and pharmacological elements that determined the drug abuse behavior as well as those elements that resulted from the behavior. A working knowledge of the "disease model" of chemical dependency, as well as other relevant models, is mandatory. Although the existing outcome data are insufficient, there is a large array of possible treatment options and facilities; the clinician should attempt to match the patient with the program based on relevant clinical and anecdotal information. Clinicians should be familiar with the ethos and procedures of the "12-Step programs"; they are often a critical element in treatment. PMID- 3276672 TI - Behavioral pharmacology of cocaine. AB - Laboratory data suggest that animals self-administer cocaine in patterns similar to those seen in humans. Conditions of availability and species are relatively unimportant determinants of cocaine self-administration. Furthermore, studies have shown that animals will continue to self-administer the drug, even in the face of severe toxic side effects. The data indicate that cocaine is a potent reinforcer with significant abuse liability. The animal self-administration model and laboratory data concerning self-administration in humans show cross-species generality and provide useful information about cocaine's behavioral mechanisms of action. PMID- 3276673 TI - Identification of c-fos sequences involved in induction by insulin and phorbol esters. AB - We evaluated the mechanism of insulin and phorbol ester induction of the proto oncogene c-fos in Chinese hamster ovary fibroblasts stably transformed with high levels of genes expressing normal or truncated human insulin receptors. Both insulin and the tumor-promoting phorbol ester phorbol 12-myristate 13-acetate (PMA) induced c-fos mRNA accumulation in cells expressing high numbers of normal human insulin receptors; PMA but not insulin was effective in the cells expressing the mutant receptor. Transient expression studies with plasmid constructions containing c-fos 5'-flanking sequences ligated to the bacterial chloramphenicol acetyltransferase gene indicated that sequences corresponding to the serum response element were required for induction of c-fos transcription by both insulin and PMA. The insulin-sensitive cells contained a nuclear factor, presumably a protein, which bound specifically to this sequence of the c-fos gene; the apparent affinity of this factor to the normal serum response element was not affected by prior treatment of the cells with insulin or PMA. This c-fos binding factor may prove to be important in the regulation of c-fos expression by insulin and activators of protein kinase C. PMID- 3276674 TI - Bacterial N-succinyl-L-diaminopimelic acid desuccinylase. Purification, partial characterization, and substrate specificity. AB - The enzyme N-succinyl-L-diaminopimelic acid desuccinylase from Escherichia coli has been purified 7,100-fold to apparent homogeneity. The enzyme is part of the diaminopimelic acid-lysine pathway in bacteria and catalyzes the hydrolysis of N succinyl-L-diaminopimelic acid to produce L-diaminopimelic acid and succinate. The enzyme exists as a mixture of dimeric and tetrameric species of identical subunits of molecular weight approximately 40,000. Activity was completely abolished following dialysis of the enzyme against metal chelators. Cobalt(II) and zinc were effective in restoring the activity. The apparent affinities of the apoenzyme for cobalt and zinc were similar (Kd values near 1 microM) and the cobalt enzyme was 2.2-fold more active than the zinc enzyme. The Km and turnover number for the hydrolysis of the natural substrate, N-succinyl-L-diaminopimelic acid, were 0.4 mM and 16,000 min-1, respectively. The substrate specificity of the enzyme was defined by preparing a number of substrate analogues that systematically lack the various functional groups present in the molecule. These studies show that the enzyme is highly specific for the natural substrate. These properties of N-succinyl-L-diaminopimelic acid desuccinylase and the fact that the enzyme is essential for bacterial growth make it an ideal target for the development of inhibitors with potential antibacterial activity. PMID- 3276675 TI - A novel method for producing anti-peptide antibodies. Production of site-specific antibodies to the T cell antigen receptor beta-chain. AB - Peptide antigens used to generate site-specific antibodies to proteins are of interest in the development of vaccines. The need to conjugate them to a carrier protein for optimal immunogenicity results in a number of problems including a possible immune response to the carrier. Here we describe a new method of synthesizing an immunogenic peptide antigen, referred to as multiple antigenic peptide (MAP), which may render the need for a carrier protein obsolete. A 14 residue sequence derived from the human T cell antigen receptor beta-chain constant region was selected, and the peptide was synthesized directly onto a branching lysine core with 8 copies of the 14-residue peptide linked to the core by the COOH-terminal amino acid. The molecular weight of this structure was 13,422 of which only 7% represents the lysine residues of the core. The octameric MAP was highly immunogenic in mice and rabbits, allowing production of polyclonal and monoclonal antibodies. The majority of these antibodies reacted with the peptide in its monomeric form as well as its octameric form. Moreover, the antibodies reacted with the intact beta-chain protein. The antigenic determinants of the peptide that were recognized by the antibodies included continuous determinants and conformational determinants. The NH2-terminal residues of the octameric MAP appeared to be most immunogenic. There were no antibodies to the central lysine core. This method of direct synthesis of a polymeric peptide provides accurate knowledge of the conformation and quantity of the peptide prior to immunization, which is usually not the case when peptides are conjugated to carriers. The method is versatile because the possibility exists to synthesize MAP with 16 or 32 peptide arms or to synthesize polymers containing two different peptides. PMID- 3276676 TI - Signals sufficient for rho-dependent transcription termination at trp t' span a region centered 60 base pairs upstream of the earliest 3' end point. AB - We have characterized the functional attributes of a 211-base pair region containing the Escherichia coli tryptophan operon rho-dependent terminator trp t', utilizing a series of constructs that alter the orientation, location, or extent of the trp t' sequences with respect to the trp promoter. In each instance, the extent of the rho-dependent response was monitored in vivo by read through expression into a distal galactokinase gene and was compared with the results of transcription assays in vitro. As expected, transcription termination in vivo is dependent on the proper orientation of the terminator, and a tandem repeat of the terminator increases termination proportionally. Placing the terminator fragment only 14 nucleotides from the promoter does not affect termination significantly, supporting the belief that sequences outside of the 211-base pair fragment itself are dispensable. One construct, which lacks 116 base pairs, including the region encoding the normal RNA end points, still reduces galK activity in vivo and terminates transcription in vitro. Our results indicate that the rho response depends primarily on sequences in this 95-base pair segment, causing RNA polymerase to terminate transcription in a region 15-45 nucleotides further downstream. PMID- 3276677 TI - Identification of the reactive cysteines of Escherichia coli 5 enolpyruvylshikimate-3-phosphate synthase and their nonessentiality for enzymatic catalysis. AB - Reaction of 5-enolpyruvylshikimate-3-phosphate synthase of Escherichia coli with the thiol reagent 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB) leads to a modification of only 2 of the 6 cysteines of the enzyme, with a significant loss of its enzymatic activity. Under denaturing conditions, however, all 6 cysteines of 5-enolpyruvylshikimate-3-phosphate synthase react with DTNB, indicating the absence of disulfide bridges in the native protein. In the presence of shikimate 3-phosphate and glyphosate, only 1 of the 2 cysteines reacts with the reagent, with no loss of activity, suggesting that only 1 of these cysteines is at or near the active site of the enzyme. Cyanolysis of the DTNB-inactivated enzyme with KCN leads to elimination of 5-thio-2-nitrobenzoate, with formation of the thiocyano enzyme. The thiocyano-enzyme is fully active; it exhibits a small increase in its I50 for glyphosate (6-fold) and apparent Km for phosphoenolpyruvate (4-fold) compared to the unmodified enzyme. Its apparent Km for shikimate 3-phosphate is, however, unaltered. These results clearly establish the nonessentiality of the active site-reactive cysteine of E. coli 5-enolpyruvylshikimate-3-phosphate synthase for either catalysis or substrate binding. Perturbations in the kinetic constants for phosphoenolpyruvate and glyphosate suggest that the cysteine thiol is proximal to the binding site for these ligands. By N-[14C]ethylmaleimide labeling, tryptic mapping, and N-terminal sequencing, the 2 reactive cysteines have been identified as Cys408 and Cys288. The cysteine residue protected by glyphosate and shikimate 3-phosphate from its reaction with DTNB was found to be Cys408. PMID- 3276678 TI - Spectroscopic identification of ortho-quinones as the products of polycyclic aromatic trans-dihydrodiol oxidation catalyzed by dihydrodiol dehydrogenase. A potential route of proximate carcinogen metabolism. AB - The homogeneous dihydrodiol dehydrogenase of rat liver cytosol catalyzes the NADP dependent oxidation of polycyclic aromatic trans-dihydrodiols, a reaction that may suppress their carcinogenicity provided the products of the reaction are noncarcinogenic. This report demonstrates that the products of naphthalene and benzo[a]pyrene trans-dihydrodiol oxidation are electrophilic o-quinones, which arise via autoxidation of catechols produced from the dihydrodiols by the action of dihydrodiol dehydrogenase. Oxidation of the trans-1,2-dihydrodiol of naphthalene or the 7,8-dihydrodiol of benzo[a]pyrene by the homogeneous rat liver dehydrogenase in 50 mM glycine at pH 9.0 led to the formation of multiple products by TLC, none of which co-migrated with the corresponding o-quinone standards. An identical result was obtained when these standards were incubated with buffer alone, suggesting that o-quinones were formed enzymatically from the dihydrodiols, and then underwent addition reactions with the glycine buffer. In subsequent reactions, the o-quinones formed from the enzymatic oxidation of the trans-dihydrodiols of naphthalene and benzo[a]pyrene were trapped by conducting the reactions in phosphate buffer containing 2-mercaptoethanol. The products of these reactions were identified by 500 MHz nmr and electron impact mass spectrometry as adducts of the 1,2-quinone of naphthalene (m/e M+ = 234) and the 7,8-quinone of benzo[a]pyrene (m/e M+ = 358), which contained mercaptoethanol as a thioether at C-4 and C-10, respectively. Kinetic analysis of the reactivity of the 1,2-quinone of naphthalene showed that the cellular nucleophiles, cysteine and glutathione, react very rapidly with the quinone. The 7,8-quinone of benzo[a]pyrene also reacted with glutathione and cysteine to form water-soluble metabolites, but did not react with adenosine or guanosine. These results suggest that o-quinones formed by enzymatic dihydrodiol oxidation may be effectively scavenged by cellular nucleophiles, resulting in their detoxification. PMID- 3276679 TI - Degradation products of insulin generated by hepatocytes and by insulin protease. AB - The enzymatic mechanisms for insulin breakdown by hepatocytes have not been established, nor have the degradation products been identified. Several lines of evidence have suggested that the enzyme insulin protease is involved in insulin degradation by hepatocytes. To identify the products of insulin generated by insulin protease and to compare them with those produced by hepatocytes, we have incubated insulin specifically iodinated at either the B-16 or the B-26 tyrosines with insulin protease and with isolated hepatocytes, separated the products on high performance liquid chromatography (HPLC), and identified the B-chain cleavages. Insulin-sized products were obtained by Sephadex G-50 filtration. These insulin-sized products were injected on reverse-phase HPLC, and the peaks of radioactivity were identified. The product patterns generated by the enzyme and by hepatocytes were essentially identical with both isomers. The products were also sulfitolized to prepare the S-sulfonate derivatives of the B-chain and B-chain peptides. Again, the patterns on HPLC generated by the enzyme and by hepatocytes with both isomers were identical. Each of the original product peaks was also sulfitolized and injected separately on HPLC to relate B-chain peptides with product peaks. Again, the peptide compositions of the product peaks for both enzyme and hepatocytes were essentially identical. To identify the cleavage sites in the B-chain of insulin produced by insulin protease, the peptides from the degradation of [125I]iodo(B-26)insulin were purified and submitted to automated Edman degradation to identify the cycle in which radioactivity appeared. Seven peptides with cleavages on the amino side of the B26 residue were identified, and the cleavage sites were determined. Cleavages were found between B-9 and B-10 (Ser-His), B-10 and B-11 (His-Leu), B-14 and B-15 (Ala-Leu), B-13 and B-14 (Glu Ala), B-16 and B-17 (Tyr-Leu), B-24 and B-25 (Phe-Phe), and B-25 and B-26 (Phe Tyr). Peptides were also isolated from [125I]iodoinsulin incubated with isolated hepatocytes, and the cleavage sites in several of these were determined. These agreed exactly with the cleavage sites identified generated by the enzyme. The major peptides generated by the degradation of [125I]iodo(B-16)insulin were also isolated and sequenced, again showing identical cleavage sites.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3276680 TI - Site-directed mutants of a soluble form of penicillin-binding protein 5 from Escherichia coli and their catalytic properties. AB - Soluble, truncated mutant and wild-type forms of penicillin-binding protein 5 (sPBP 5) from Escherichia coli were produced in large amounts by placing the dacA gene that encodes PBP 5 under the control of the trp-lac fusion promoter. The 3' end of the dacA gene used in this study contains a stop codon that results in the deletion of 15 amino acids from the carboxyl terminus and the production of a soluble protein. Using oligonucleotide-directed mutagenesis, the role of cysteine 115 in the mechanism of sPBP 5 was investigated. Alkylation of cysteine 115 with sulfhydryl reagents has previously been shown to inhibit severely the D-alanine carboxypeptidase activity of PBP 5. Alkylation also inhibits the hydrolysis of bound penicillin G, with only a slight effect on its binding. Cysteine 115 in sPBP 5 was changed to either a serine (sPBP 5C-S) or an alanine (sPBP 5C-A) residue. The wild-type and mutant sPBPs were purified in milligram amounts from induced cultures by ampicillin affinity chromatography. The mutant PBPs showed only a 2-fold increase in the half-life of the penicilloyl-PBP complex, and had a binding affinity for penicillin G identical to wild-type PBP 5. The Km for the release of D-alanine from the peptide L-Ala-D-gamma-Glu-L-Lys-D-Ala-D-Ala was 5.0, 3.5, and 7.8 mM for PBP 5, PBP 5C-S, and PBP 5C-A, respectively, while the values for Vmax were 2.5, 3.3, and 5.1 mumol/min/mg. From these data it was concluded that the cysteine residue does not directly participate in the enzymatic mechanism. PMID- 3276681 TI - Substrate specificity of eukaryotic signal peptidase. Site-saturation mutagenesis at position -1 regulates cleavage between multiple sites in human pre (delta pro) apolipoprotein A-II. AB - We have previously described a novel mutant of human preproapolipoprotein A-II (pre(delta pro)apoA-II) in which the wild-type 18-amino acid-long signal sequence (Gly18 decreases) was functionally redefined to 20 amino acids in length (Ala 20 decreases). We have used this mutant as a model preprotein to probe the substrate specificity of eukaryotic signal peptidase. Site-saturation mutagenesis was performed resulting in the substitution of 13 different amino acids (acidic, basic, aromatic, hydrophobic, and small-neutral) for Ala20 (or position -1). The effects of these substitutions were assessed using an in vitro transcription/translation/microsomal membrane processing system. NH2-terminal sequence analysis of the 13 mutant proteins demonstrated that amino acids which occupy position -1 in a signal peptide are critical in establishing a good context for signal peptidase cleavage and that two or more potential sites of cleavage may compete for recognition by signal peptidase. PMID- 3276682 TI - Interaction of the regulatory subunit of a type II cAMP-dependent protein kinase with mammalian sperm flagellum. AB - We have reported previously (Horowitz, J. A., Toeg, H., and Orr, G. A. (1984) J. Biol. Chem. 259, 832-838) that most of the type II cAMP-dependent protein kinases in rat sperm are associated with the flagellum. We have now identified flagellar polypeptides which are capable of forming tight complexes with the regulatory subunit of type II cAMP-dependent protein kinase (RII). Flagellar RII-binding polypeptides were identified using an RII overlay/immunoblot procedure and had apparent subunit Mr of 120,000, 80,000, and 57,000 in rat and 120,000 and 57,000 in bovine flagella. RII is released from the flagellum by disulfide reducing agents, e.g. 1 mM dithiothreitol (DTT). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Coomassie Blue staining of the DTT-released material shows that a limited subpopulation of flagellar polypeptides are solubilized by disulfide-reducing agents. Neither tubulin, the dynein ATPase, or any of the RII binding proteins are released by 1 mM DTT, and thin section electron microscopy revealed that the morphology of the flagellum is unaltered by reducing conditions. Our data established that RII is not linked to the flagellum via a direct disulfide bridge. We propose that RII is released from the flagellum, a highly disulfide cross-linked structure, due to structural changes in the flagellum which disrupts the interaction between RII and its binding proteins. PMID- 3276683 TI - Transport of secretory and membrane glycoproteins from the rough endoplasmic reticulum to the Golgi. A rate-limiting step in protein maturation and secretion. PMID- 3276684 TI - Native-like intermediate on the folding pathway of Escherichia coli succinyl-CoA synthetase. AB - The transition between the native and denatured states of the tetrameric succinyl CoA synthetase from Escherichia coli has been investigated by circular dichroism, fluorescence spectroscopy, cross-linking by glutaraldehyde and activity measurements. At pH 7.4 and 25 degrees C, both denaturation of succinyl-CoA synthetase by guanidine hydrochloride and refolding of the denatured enzyme have been characterized as reversible reactions. In the presence of its substrate ATP, the denatured enzyme could be successfully reconstituted into the active enzyme with a yield of 71-100%. Kinetically, reacquisition of secondary structure by the denatured enzyme was rapid and occurred within 1 min after refolding was initiated. On the other hand, its reactivation was a slow process which continued up to 25 min before 90% of the native activity could be restored. Both secondary and quaternary structures of the enzyme, reconstituted in the absence of ATP, were indistinguishable from those of the native enzyme but the renatured protein was catalytically inactive. This observation indicates the presence of catalytically inactive tetramer as an intermediate in the reconstitution process. The reconstituted protein could be reactivated by ATP even 10 min after the reacquisition of the native secondary structure by the refolding protein. However, reactivation of the protein by ATP 60 min after the regain of secondary structure was significantly less, suggesting that rapid refolding and reassociation of the monomers into a native-like tetramer and reactivation of the tetramer are sequential events; the latter involving slow and small conformational rearrangements in the refolded enzyme that are likely to be associated with phosphorylation. PMID- 3276685 TI - In vitro mutagenesis of Escherichia coli citrate synthase to clarify the locations of ligand binding sites. AB - In vitro mutagenesis techniques have been used to investigate two structure function questions relating to the allosteric citrate synthase of Escherichia coli. The first question concerns the binding site of alpha-keto-glutarate, which is a structural analogue of the substrate oxaloacetate and yet has been suggested to be an allosteric inhibitor of the enzyme. Using oligonucleotide-directed mutagenesis of the cloned E. coli citrate synthase gene, we prepared missense mutants, designated CS226H----Q and CS229H----Q, in which histidine residues at positions 226 and 229, respectively, were replaced by glutamine. In the homologous pig heart citrate synthase it is known (Wiegand, G., and Remington, S. J. (1986) Annu. Rev. Biophys. Biophys. Chem. 15, 97-117) that the equivalent of His-229 helps to bind oxaloacetate, while the equivalent of His-226 is nearby. Kinetic and ligand binding measurements showed that CS226H----Q had a reduced affinity for oxaloacetate and alpha-ketoglutarate, while CS229H----Q bound oxaloacetate even less effectively, and was not inhibited by alpha-ketoglutarate at all under our conditions. This parallel loss of binding affinities for oxaloacetate and alpha-ketoglutarate, in two mutants altered in residues at the active site of E. coli citrate synthase, strongly suggests that inhibition of this enzyme by alpha-ketoglutarate is not allosteric but occurs by competitive inhibition at the active site. The second question investigated was whether the known inhibition by acetyl-CoA of binding of NADH, an allosteric inhibitor of E. coli citrate synthase, occurs heterotropically, as an indirect result of acetyl CoA binding at the active site, or directly, by competition at the allosteric NADH binding site. Using existing restriction sites in the cloned E. coli citrate synthase gene, we prepared a deletion mutant which lacked 24 amino acids near what is predicted to the acetyl-CoA-binding portion of the active site. The mutant protein was inactive, and acetyl-CoA did not bind to the active site but still inhibited NADH binding. Thus acetyl-CoA can interact with both the allosteric and the active sites of this enzyme. PMID- 3276686 TI - Purification, structure, and properties of Escherichia coli tRNA pseudouridine synthase I. AB - The RNA modification enzyme, tRNA pseudouridine synthase I has been isolated in 95% purity from an Escherichia coli strain harboring a multicopy plasmid with a 2.3-kilobase pair insert from the hisT operon. Its molecular size, amino acid composition, and amino-terminal sequence correspond to those predicted by the structure and expression of the hisT gene. Enzyme activity, as measured by a 3H release assay, is unaffected by pretreatment of tRNA pseudouridine synthase I with micrococcal nuclease and is optimized by the addition of a monovalent cation and thiol reductant. The activity is inhibited by all tRNA species tested, including substrates, modified tRNAs, nonsubstrates, or tRNAs containing 5 fluorouridine. Binding of tRNA pseudouridine synthase I occurs with both substrate and nonsubstrate tRNAs and does not require a monovalent cation. Our findings are consistent with a multistep mechanism whereby tRNA pseudouridine synthase I first binds nonspecifically and then forms transient covalent adducts with tRNA substrates. In the absence of other proteins, purified tRNA pseudouridine synthase I forms psi at all three modification sites known to be affected in hisT mutants. The 36.4-kDa polypeptide product of the gene adjacent to hisT, whose translation is linked to that of tRNA pseudouridine synthase I, is not a functional subunit for tRNA pseudouridine synthase I activity, nor is it a separate synthase acting at one of the three loci. PMID- 3276687 TI - Insulin-stimulated phosphorylation of calmodulin by rat liver insulin receptor preparations. AB - Insulin stimulates autophosphorylation of the beta subunit of its receptor and activates the associated tyrosine kinase. This kinase, in turn, phosphorylates a number of specific protein substrates; however, the functional and structural identity of these substrates is largely unknown. In this study, we demonstrate that insulin also stimulates the phosphorylation of calmodulin by rat hepatocyte insulin receptors partially purified by wheat germ agglutinin affinity chromatography. Phosphorylation occurred predominantly on tyrosine residues and had an absolute requirement for insulin receptors, divalent cations, and certain basic proteins. Maximal 32P incorporation was observed at an insulin concentration of 5 X 10(-9) M, and the K0.5 for insulin was approximately 4 X 10( 10) M. Phosphorylation of calmodulin was dependent upon ATP, saturating at 100 microM ATP with a K0.5 of 30 microM. Insulin-stimulated phosphorylation of calmodulin was also dependent upon Mg2+ or Mn2+, but was approximately 12-fold greater in the presence of Mg2+. Maximal phosphorylation was observed in the absence of Ca2+ and was inhibited at Ca2+:EGTA ratios greater than 0.8 (0.16 microM free Ca2+). Certain basic proteins, such as polylysine, histone Hf2b, and protamine sulfate, were necessary to observe insulin-stimulated phosphorylation of calmodulin. The relative amount of insulin-stimulated phosphorylation of calmodulin observed in the presence of each of these proteins differed. Maximal insulin-stimulated phosphorylation was observed in the presence of polylysine. These data suggest that both Ca2+ and calmodulin may participate in the early post-receptor events in the cellular mechanism of insulin action in hepatocytes. PMID- 3276688 TI - Processing of histidine transfer RNA precursors. Abnormal cleavage site for RNase P. AB - The 5'-terminal guanylate residue (G-1) of mature Escherichia coli tRNA(His) is generated as a result of an unusual cleavage by RNase P (Orellana, O., Cooley, L., and Soll, D. (1986) Mol. Cell. Biol. 6, 525-529). We have examined the importance of the unique acceptor stem structure of E. coli tRNA(His) in determining the specificity of RNase P cleavage. Mutant tRNA(His) precursors bearing substitutions of the normal base G-1 or the opposing, potentially paired base, C73, can be cleaved at the +1 position, in contrast to wild-type precursors which are cut exclusively at the -1 position. These data indicate that the nature of the base at position -1 is of greater importance in determining the site of RNase P cleavage than potential base pairing between nucleotides -1 and 73. In addition, processing of the mutant precursors by M1-RNA or P RNA under conditions of ribozyme catalysis yields a higher proportion of +1-cleaved products in comparison to the reaction catalyzed by the RNase P holoenzyme. This lower sensitivity of the holoenzyme to alterations in acceptor stem structure suggests that the protein moiety of RNase P may play a role in determining the specificity of the reaction and implies that recognition of the substrate involves additional regions of the tRNA. We have also shown that the RNase P holoenzyme and tRNA(His) precursor of Saccharomyces cerevisiae, unlike their prokaryotic counterparts, do not possess these abilities to carry out this unusual reaction. PMID- 3276689 TI - Evidence of histidine phosphorylation in isocitrate lyase from Escherichia coli. AB - Escherichia coli isocitrate lyase (EC 4.1.3.1.) can be phosphorylated in vitro by an ATP-dependent reaction. The enzyme becomes phosphorylated by an endogenous kinase when partially purified sonic extracts are incubated with [gamma-32P]ATP. Treatment of isocitrate lyase with diethyl pyrocarbonate, a histidine-modifying reagent, blocked incorporation of [32P]phosphate from [gamma-32P]ATP. The isoelectric point of the enzyme was altered by treatment with phosphoramidate, a histidine phosphorylating agent, which suggests that isocitrate lyase can be phosphorylated at a histidine residue(s). Immunoprecipitated 32P-labeled isocitrate lyase was subjected to alkaline hydrolysis, mixed with chemically synthesized phosphohistidine standards, and analyzed by anion exchange chromatography. Characterization of the phosphoamino acid was based on the demonstration that the 32P-labeled product from alkali-hydrolyzed isocitrate lyase comigrated with synthetic 1-phosphohistidine. In addition, loss of catalytic activity after treatment with potato acid phosphatase indicates that catalytically active isocitrate lyase is the phosphorylated form of the enzyme. PMID- 3276690 TI - Remodeling of the rough endoplasmic reticulum during stimulation of procollagen secretion by ascorbic acid in cultured chondrocytes. A biochemical and morphological study. AB - The cellular and molecular mechanisms regulating the reversible accumulation of nonhelical, underhydroxylated procollagen in the rough endoplasmic reticulum (RER) remain obscure. To clarify these mechanisms, we isolated chondrocytes from chick vertebral cartilage and kept them in scorbutic monolayer cultures. By Day 9 of culture, the chondrocytes had accumulated a large amount of underhydroxylated Type II procollagen in their RER. Within 1 h of ascorbate treatment, the accumulated procollagen was hydroxylated; this was accompanied by a slight stimulation of procollagen secretion and was followed by a marked stimulation starting between 2 and 3 h of treatment. Secretion of the accumulated procollagen was completed by about 24 h of treatment. Strikingly, the marked stimulation of procollagen secretion at 2-3 h of treatment was associated with marked remodeling of the RER. This organelle came to consist of a few, unusually large cisternae ("sacs") and many flat cisternae while the RER in untreated cells consisted of uniform, oval cisternae. The RER remodeling was accompanied by a comparable redistribution of the accumulated Type II procollagen stored in it. The RER sacs and flat cisternae invariably communicated directly and were still detectable by 8 h but not by 24 h of treatment. RER remodeling and procollagen redistribution also occurred in untreated chondrocytes that had been shifted to 23 degrees C for 2-3 h. Together, the data indicate that folding of the accumulated procollagen molecules into their normal helical configuration is followed by procollagen redistribution within, and remodeling of, the RER. These processes may have a role in stimulating procollagen export from the RER and secretion. PMID- 3276691 TI - Pore-forming activity of the Tsx protein from the outer membrane of Escherichia coli. Demonstration of a nucleoside-specific binding site. AB - The Tsx protein from the outer membrane of Escherichia coli is known to be involved in the permeation of nucleosides across the outer membrane under limiting substrate conditions. We purified Tsx from an E. coli strain that overproduces Tsx. The purified protein was still functional since it could neutralize the Tsx-specific bacteriophage T6 in vitro. When the purified Tsx was reconstituted into a lipid bilayer, there was a large increase of the membrane conductance, indicating pore-forming activity of Tsx in vitro. This increase could be strongly blocked with adenosine and to a much lesser extent with cytidine. Titration of the pore conductance with adenosine or cytidine suggested the presence of a binding site for nucleosides in the Tsx pore, with a Ks of 6 X 10(-4) and 2 X 10(-2) M for adenosine and cytidine, respectively. We propose that the Tsx protein functions in vivo as a pore that specifically facilitates the permeation of nucleosides across the outer membrane due to its binding site for nucleosides. PMID- 3276692 TI - 3-Hydroxy-3-methylglutaryl coenzyme A reductase in the sea urchin embryo is developmentally regulated. AB - The activity of 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase, an enzyme which plays a regulatory role in the synthesis of cholesterol, dolichol, and coenzyme Q, has been measured in the developing embryo of the sea urchin. Enzyme activity increased at least 200-fold during development from the unfertilized egg to the pluteus stage embryo. Mixing experiments suggested that the low level of enzyme activity found at early stages was not due to the presence of inhibitor(s) in the egg or zygote. The enzyme in the sea urchin embryo exhibited properties different from that found in mammals: only a fraction of the activity could be solubilized from microsomes, and mild trypsinization inactivated the enzyme without releasing any of it from the microsomes in soluble form. To further study the sea urchin HMG-CoA reductase, a genomic clone was identified by hybridization to a cDNA encoding hamster HMG-CoA reductase. Sequence analysis of this clone revealed a coding region that shares a high degree of homology with the carboxyl terminal domain of hamster HMG-CoA reductase. Analysis of sea urchin embryo HMG CoA reductase mRNA levels using a restriction fragment derived from the genomic clone revealed a 5.5-kilobase poly(A)+ mRNA that increased 15-fold during development from the egg to the gastrula stage and then decreased 1.5-fold at the pluteus stage. Since the relative increase in HMG-CoA reductase mRNA was less than the increase in enzyme activity (15-fold versus 200-fold) factors in addition to the level of mRNA may control the activity of this enzyme during embryogenesis. PMID- 3276693 TI - Structure determination of a monoclonal Fab fragment specific for histidine containing protein of the phosphoenolpyruvate: sugar phosphotransferase system of Escherichia coli. AB - Jel 42 is a monoclonal antibody specific for histidine-containing protein, a small phosphocarrier protein required for sugar transport in Escherichia coli. Fab fragments prepared from this antibody by papain digestion consisted of three major isoelectric forms which were separated on a chromatofocusing column. Two of these forms produced large crystals in space group P21 and unit cell dimensions a = 117.48 A, b = 66.56 A, c = 67.31 A, and beta = 118.7 degrees, with two Fab fragments per asymmetric unit. Data were collected to 3.5-A resolution. The structure of Fab Jel 42 was solved by the Molecular Replacement method (least squares refined to R = 0.282) using the known structure of Fab HED 10 (12) as the search model; the amino acid residues of the hypervariable and elbow regions of Fab HED 10 were omitted from the starting model. A Fourier map calculated at this stage revealed electron density which corresponded to the hypervariable loops forming the antigen-binding crevice and the elbow region of Fab Jel 42. The elbow angles for the two independent Fab molecules are 159 and 167 degrees, similar to that of the Fab HED 10 search model which has an elbow angle of 162 degrees. There is no local noncrystallographic axis of symmetry relating the two molecules in the asymmetric unit. PMID- 3276694 TI - Acceptance of genetic services: a study of physicians in Colombo, Sri Lanka. PMID- 3276695 TI - Reproduction: the Canadian family in transition. PMID- 3276696 TI - Breast-feeding practice in Norway 1860-1984. PMID- 3276697 TI - Pelvic ring fractures: should they be fixed? PMID- 3276698 TI - Bone and joint lesions associated with pustulosis palmaris et plantaris. A clinical and histological study. AB - We have reviewed 41 patients with pustulotic arthro-osteopathy (PAO), all having both the typical skin rash of pustulosis palmaris et plantaris and bone lesions. The most common bones affected were the clavicle, sternum and ribs. Changes in the clavicle started, not as an enthesopathy, but with periosteal bone formation, indicative of a bone marrow disorder. About 30% of the patients also had lesions in the spine, sacroiliac region or the peripheral joints. Bone and joint lesions followed a variable and intermittent clinical course over a long period of time. Biopsies in eight cases showed similar inflammatory changes in skin, bone and synovium, with infiltration of lymphocytes and polymorphonuclear leucocytes. This suggests that there is a common pathogenesis in the three tissues. PMID- 3276699 TI - Suturing arthroscopy wounds: brief report. PMID- 3276700 TI - Repair of juxta-articular ligament avulsion: brief report. PMID- 3276701 TI - Detecting haematomas by ultrasound: brief report. PMID- 3276702 TI - The shelf operation in the management of late presentation of congenital hip dysplasia. AB - Shelf operations performed on 24 patients (27 hips) for late presentation of congenital hip dysplasia were evaluated. The mean age at operation was 14 years 9 months and the mean follow-up 16 years 8 months. Two-thirds of the hips had good clinical results at follow-up. Patients operated on under the age of 20 years and with little or no radiological evidence of degenerative joint changes had the highest likelihood of success. The shelf operation was found to provide good cover of the femoral head and, should failure occur, also provides adequate superior support for the seating of an acetabular prosthesis. PMID- 3276703 TI - Joint-preserving operations for idiopathic avascular necrosis of the femoral head. Results of core decompression, grafting and osteotomy. AB - We have reviewed 54 hips in 46 patients from 2 to 14 years after a joint preserving operation for idiopathic avascular necrosis of the femoral head. The choice between core decompression (17 hips), bone grafting (18), rotation osteotomy (15) or varus osteotomy (4) was determined by the stage and location of the area of necrosis. The overall success rate was unexpectedly low at 60%. Core decompression and bone grafting by our techniques gave poor long-term results, but those of rotation or varus osteotomies, performed with care for the correct indications, were better. The indications for each procedure are discussed: osteotomy is best when the area of necrosis is shallow and localised in the medial or anterior portion of the femoral head. PMID- 3276704 TI - Development and treatment of false aneurysm following vascular intervention. AB - The development and treatment of false aneurysm after cardiovascular intervention is discussed. At the Cardiovascular Surgical Clinic of Semmelweis Medical University (Budapest) 6900 reconstruction operations were performed. Ninety-five false aneurysms were operated on. According to the cause leading to the complication the patients are classified into 8 groups. To treat the false aneurysm 14 types of operation were carried out. Operative mortality was 12.6 per cent, but the outcome was successful in 70 per cent of the patients. The technique of surgical treatment is described. A review of the literature is presented. PMID- 3276705 TI - Intra-atrial insertion of a prosthetic mitral valve. AB - Infectious lesions of the mitral ring sometimes cause so much damage that insertion of the prosthesis in its normal place is impossible. In such cases, artificial valves with a dacron flange can be implanted into the left atrium, just above the mitral ring, and sutured to the atrial wall. These valves are generally used in first or second re-operations for recurrent desinsertion, but they have proved so reliable that their use can be extended to primary mitral valve replacement in cases where extreme calcification of the mitral ring throws considerable doubt on the success of conventional techniques. PMID- 3276706 TI - Femoro-popliteal venous graft entrapment. AB - The authors report a case of femoropopliteal venous bypass graft entrapped between the inner femoral condylar epiphysis and the medial head of the gastrocnemius muscle, the graft being inadvertently placed medially to this tendinous structure. What makes the case exceptional is that the indication for the venous bypass graft was a femoropopliteal thrombosis, secondary to an initially overlooked popliteal artery entrapment syndrome. In the discussion, the authors made an extensive review of the literature on this rare abnormal relationship between the popliteal artery and the medial head of the gastrocnemius (embryology, anatomical variations, clinical features, diagnostic measures and treatment). PMID- 3276707 TI - Fibromuscular dysplasia of the posterior auricular artery: an unusual aneurysmal lesion. AB - A 67-year-old patient was admitted to hospital with a pulsatile mass behind his left ear. The clinical diagnosis was a posterior auricular artery aneurysm, and this was confirmed on Digital Subtraction Angiography. The aneurysm was excised and sent for pathology. The findings were felt to be consistent with fibromuscular dysplasia. This appears to be only the second reported case in the literature of a posterior auricular artery aneurysm. PMID- 3276708 TI - Isolated internal iliac artery aneurysm. Report of one case and review of the literature. AB - Isolated atherosclerotic aneurysms of the hypogastric artery are rare and present most commonly with gastro-intestinal or genito-urinary symptoms. The difficulty of the diagnosis and the surgical management are presented with a review of the literature. PMID- 3276709 TI - Acute aortic dissection. Personal experience. AB - Aortic dissection is a catastrophic event with a high mortality rate for untreated patients. One hundred and thirteen patients with acute aortic dissection were observed in the IInd Surgical Department of Milan University from 1974 to 1985; 55 had type I and II aortic dissection and 58 had type III aortic dissection. All patients with type I and II and about 50% of patients with type III aortic dissection underwent surgical correction. In the second type III group the aortic lesion was surgically corrected only when visceral ischaemia or ischaemia of the lower limb was recognized. In the other type III cases, medical treatment was preferred. The mortality rate was lower after medical treatment (15%) than after surgical treatment (37%). Follow-up was performed for the majority of patients and was recently completed with non-invasive techniques like Magnetic Resonance. It accurately shows the residual dissection and follows, the development of occlusion of the false lumen without any risk to the patients. PMID- 3276710 TI - Enhanced stability of microtubules enriched in detyrosinated tubulin is not a direct function of detyrosination level. AB - Interphase cultured monkey kidney (TC-7) cells contain distinct subsets of cellular microtubules (MTs) enriched in posttranslationally detyrosinated (Glu) or tyrosinated (Tyr) alpha tubulin (Gundersen, G. G., M. H. Kalnoski, and J. C. Bulinski. 1984. Cell. 38:779-789). To determine the relative stability of these subsets of MTs, we subjected TC-7 cells to treatments that slowly depolymerized MTs. We found Glu MTs to be more resistant than Tyr MTs to depolymerization by nocodazole in living cells, and to depolymerization by dilution in detergent permeabilized cell models. However, in cold-treated cells, Glu and Tyr MTs did not differ significantly in their stability. Digestion of permeabilized cell models with pancreatic carboxypeptidase A, to generate Glu MTs from endogenous Tyr MTs, did not significantly alter the resistance of the endogenous Tyr MTs toward dilution-induced depolymerization. Furthermore, in human fibroblasts that contained no distinct Glu MTs, we observed a population of nocodazole-resistant MTs. These data suggest that Glu MTs possess enhanced stability against end mediated depolymerization, yet detyrosination alone appears to be insufficient to confer this enhanced stability. PMID- 3276711 TI - Microfilament modification by dihydrocytochalasin B causes retinoic acid modulated chondrocytes to reexpress the differentiated collagen phenotype without a change in shape. AB - Primary monolayers of rabbit articular chondrocytes synthesize high levels of type II collagen and proteoglycan. This capacity was used as a marker for the expression of the differentiated phenotype. Such cells were treated with 1 microgram/ml retinoic acid (RA) for 10 d to produce a modulated collagen phenotype devoid of type II and consisting of predominantly type I trimer and type III collagen. After transfer to secondary culture in the presence of RA, the stability of the RA-modulated phenotype was investigated by culture in the absence of RA. Little reexpression of type II collagen synthesis occurred in this period unless cultures were treated with 3 X 10(-6) M dihydrocytochalasin B to modify microfilament structures. Reexpression of the differentiated phenotype began between days 6-8 and was essentially complete by day 14. Substantial reexpression occurred by day 8 without a detectable increase in cell rounding. Colony formation, characteristic of primary chondrocytes, was infrequent even after reexpression was complete. These data suggest that the integrity of microfilament cytoskeletal structures can be a source of regulatory signals that mechanistically appear to be more proximal to phenotypic change than the overt changes in cell shape that accompany reexpression of subculture-modulated chondrocytes in agarose culture. PMID- 3276712 TI - Alterations in chondrocyte cytoskeletal architecture during phenotypic modulation by retinoic acid and dihydrocytochalasin B-induced reexpression. AB - The differentiated phenotype of rabbit articular chondrocytes was modulated in primary culture by treatment with 1 microgram/ml retinoic acid (RA) and reexpressed in secondary culture by treatment with the microfilament-disruptive drug dihydrocytochalasin B (DHCB) in the absence of RA. Because the effective dose of DHCB (3 microM) did not elicit detectable cell rounding or retraction, the nature and extent of microfilament modification responsible for induction of reexpression was evaluated. The network of microfilament stress fibers detected with rhodamine-labeled phalloidin in primary control chondrocytes was altered by RA to a "cobblestone" pattern of circularly oriented fibers at the cell periphery. Subsequent treatment with DHCB resulted in rapid changes in this pattern before overt reexpression. Stress fibers decreased in number and were reoriented. Parallel arrays of long fibers that traversed the cell were evident, in addition to fiber fragments and focal condensations of staining. Immunofluorescent staining of intermediate filaments revealed a marked decrease in complexity and intensity during RA treatment but no change during reexpression. An extended microtubular architecture was present throughout the study. These results clearly identify microfilaments as the principal affected cytoskeletal element and demonstrate that their modification, rather than complete disruption, is sufficient for reexpression. The specificity of DHCB and the reorientation of these filaments before reexpression of the differentiated phenotype suggests a causative role in the mechanism of reexpression. PMID- 3276713 TI - Endocrine secretory granules and neuronal synaptic vesicles have three integral membrane proteins in common. AB - In response to an external stimulus, neuronal cells release neurotransmitters from small synaptic vesicles and endocrine cells release secretory proteins from large dense core granules. Despite these differences, endocrine cells express three proteins known to be components of synaptic vesicle membranes. To determine if all three proteins, p38, p65, and SV2, are present in endocrine dense core granule membranes, monoclonal antibodies bound to beads were used to immunoisolate organelles containing the synaptic vesicle antigens. [3H]norepinephrine was used to label both chromaffin granules purified from the bovine adrenal medulla and rat pheochromocytoma (PC12) cells. Up to 80% of the vesicular [3H]norepinephrine was immunoisolated from both labeled purified bovine chromaffin granules and PC12 postnuclear supernatants. In PC12 cells transfected with DNA encoding human growth hormone, the hormone was packaged and released with norepinephrine. 90% of the sedimentable hormone was also immunoisolated by antibodies to all three proteins. Stimulated secretion of PC12 cells via depolarization with 50 mM KCl decreased the amount of [3H]norepinephrine or human growth hormone immunoisolated. Electron microscopy of the immunoisolated fractions revealed large (greater than 100 nm diameter) dense core vesicles adherent to the beads. Thus, large dense core vesicles containing secretory proteins possess all three of the known synaptic vesicle membrane proteins. PMID- 3276714 TI - Insulin-induced translocation of glucose transporters from post-Golgi compartments to the plasma membrane of 3T3-L1 adipocytes. AB - A semiquantitative method using immunocytochemistry on ultrathin cryosections and the protein A-gold technique was performed to study the effect of insulin on the cellular distribution of the glucose transporters in cultured 3T3-L1 adipocytes. In basal cells a substantial portion of the label was present in a tubulovesicular structure at the trans side of the Golgi apparatus, likely to represent the trans-Golgi reticulum, and in small vesicles present in the cytoplasm. Treatment with insulin induced a rapid translocation of transporters from the tubulovesicular structure to the plasma membrane. The transporter labeling of the plasma membrane increased three-fold and that of the tubulovesicular structure decreased by half. There was no effect of insulin on the degree of label in the small cytoplasmic vesicles. Removal of insulin from stimulated cells rapidly reversed the distribution of transporters to that seen in basal cells. This study thus provides the first morphological evidence for the occurrence of transporter translocation in insulin action and identifies for the first time the intracellular location of the responsive transporters. PMID- 3276716 TI - Fibroblasts on the move. PMID- 3276715 TI - Heterogeneity in lymphocyte spectrin distribution: ultrastructural identification of a new spectrin-rich cytoplasmic structure. AB - Spectrin-like proteins are found in a wide variety of non-erythroid cells where they generally occur in the cell cortex near the plasma membrane. To determine the intracellular distribution of alpha-spectrin (alpha-fodrin) in lymphocytes, we have developed an immunoperoxidase method to localize this protein at the ultrastructural level. Of considerable interest, particularly with regard to our efforts to determine the function of spectrin in this cell type, was the finding that its subcellular localization and its relationship with the plasma membrane can vary dramatically. Based on its position in the cell, alpha-spectrin can occur in two forms in lymphocytes: one that associates closely with the plasma membrane and another that occurs at some distance from the cell periphery, either as a single large aggregate or as several smaller ones. The single large aggregate of spectrin is a stable feature in a number of lymphocyte cell lines and hybrids which were used to examine its ultrastructural characteristics. A previously undescribed cellular structure, consisting of a meshwork of spectrin filaments and membranous vesicles, was identified in these cells. This structure could be induced to dissipate in response to membrane perturbants (e.g., hyperthermia and phorbol esters, known effectors of lymphocyte function and differentiation) and the patterns resulting from the redistribution of spectrin were a reflection of those observed routinely in lymphocytes in situ. The correlation between naturally occurring spectrin localization patterns and those seen after membrane perturbation suggested the possibility that spectrin distribution is indicative of particular maturation stages or functional states in lymphocytes. The implications of these findings with regard to the role of spectrin in lymphocyte function are discussed. PMID- 3276717 TI - Role of extracellular electrolytes in the activation of ribosomal protein S6 kinase by epidermal growth factor, insulin-like growth factor 1, and insulin in ZR-75-1 cells. AB - Activation of ribosomal protein S6 kinase by epidermal growth factor (EGF), insulin, and insulin-like growth factor 1 (IGF1) was studied in the human mammary tumor cell line ZR-75-1 in isotonic buffers. In contrast to growth factor dependent S6 phosphorylation which is strongly dependent on extracellular pH (Chambard, J. C., and J. Pouyssegur. 1986. Exp. Cell Res. 164:282-294.) preincubation of cells in buffers with different pH values ranging from 7.5 to 6.5 had no effect on basal or EGF-stimulated S6 kinase activity. Replacement of extracellular Na+ with choline or replacement of extracellular Ca++ with EGTA also did not inhibit stimulation of S6 kinase by EGF. When intracellular Ca++ was buffered with the permeable Ca++ chelator quin2, EGF stimulation was reduced 50%. A similar inhibition of the EGF response was observed when cells were incubated in buffers with high K+ concentrations or in the presence of the K+ ionophore valinomycin. Insulin and IGF1 stimulation of S6 kinase were also inhibited by high K+ concentrations and by buffering intracellular Ca++. In contrast to the responses to EGF, insulin- and IGF1-activation of S6 kinase was enhanced when glucose was present and depended on the presence of bicarbonate in the medium. The results indicate that ionic signals generated by growth factors and insulin, such as increases in intracellular pH or Na+, do not seem to be involved in the activation of S6 kinase. However, effects of growth factors or insulin on membrane potential and/or K+ fluxes and redistribution of intracellular Ca++ may play a role in the activation process. Furthermore, the mechanism of insulin activation of S6 kinase is distinct from the growth factors by its dependency on extracellular bicarbonate. PMID- 3276718 TI - Regulation of the synthesis and activity of urokinase plasminogen activator in A549 human lung carcinoma cells by transforming growth factor-beta. AB - Transforming growth factor-beta (TGF beta) is a regulator of cellular proliferation which can alter the proteolytic activity of cultured cells by enhancing the secretion of endothelial type plasminogen activator inhibitor and affecting the secretion of plasminogen activators (PAs) in cultured fibroblastic cells. We used the TGF beta-responsive malignant human lung adenocarcinoma cell line A549 to study the relationships between the known TGF beta-induced growth inhibition and the effects of TGF beta on the secretion of PA activity by A549 cells. PA activity was quantitated by caseinolysis assays, and characterized by urokinase mRNA analysis, immunoprecipitation, and zymography assays. PA-inhibitor production was observed in autoradiograms of SDS-polyacrylamide gels and reverse zymography assays. It was found that TGF beta enhanced the production of PA activity by these cells, in accordance with an enhancement of urokinase mRNA levels. A concomitant stimulation of type 1 PA-inhibitor production was also observed in A549 cells in response to TGF beta. In contrast to the observations of A549 cells, TGF beta caused a decrease in the expression of both urokinase and the tissue-type PA mRNA in human embryonic WI-38 lung fibroblasts indicating opposite regulation of the expression of PAs in these cells. The results suggest that TGF beta may play a role in the regulation of the invasive, proteolytically active phenotype of certain lung carcinoma cells. PMID- 3276720 TI - Astrotactin: a novel neuronal cell surface antigen that mediates neuron astroglial interactions in cerebellar microcultures. AB - A microculture system for mouse cerebellar cells has been used to identify an immune activity, raised in rabbits against postnatal cerebellar cells, that blocks neuron-glial interactions in vitro. In the presence of blocking antibodies, stable neuron-glial contacts did not form and neuronal induction of glial process outgrowth did not occur. Subsequently, neurons were randomly arranged in the cultures rather than organized along the arms of astroglia. We have named the immune activity that blocks neuron-astroglial interactions anti astrotactin. Partial purification of the anti-astrotactin blocking antibodies was obtained by cellular absorption with PC12 cells, a clonal cell line which expresses both the N-CAM and NILE (Ng-CAM, L1) glycoproteins. Subsequent absorption with purified cerebellar granule cells, but not with astroglial cells, removed the blocking activity, suggesting that the antigen(s) bound by blocking antibodies are neuronal. Immunoprecipitation of [35S]methionine- or [3H]fucose radiolabeled Triton extracts of early postnatal cerebellar cells showed that the unabsorbed antiserum recognized a large number of proteins. Among these were bands with apparent molecular masses of N-CAM (180 and 140 kD) and NILE (230 kD). After absorption of the immune serum with PC12 cells, the number of bands recognized by the antiserum was reduced to a prominent band at 100 kD and a diffuse smear of material between 80 and 90 kD. The prominent band at 100 kD was removed by subsequent absorption of the immune serum with granule cells, a step which removed the blocking activity in the cerebellar microculture assay. Further evidence suggests that the astrotactin activity is missing or defective on granule cells from the neurological mutant mouse weaver, an animal that suffers a failure of glial-guided neuronal migration. When anti-astrotactin Fab fragments were pre-absorbed with weaver cerebellar neurons and then tested in the functional assay of neuron-glial interactions, the immune blocking activity was not removed. In contrast, wild-type cerebellar neurons removed the anti astrotactin blocking activity under the same conditions. Subsequently, when [3H]fucose-radiolabeled Triton extracts of weaver and normal cells were immunoprecipitated with whole or PC12-absorbed anti-astrotactin antiserum, the intensity of the band at 100 kD was reduced by 95% in weaver cells. PMID- 3276719 TI - Neural cell adhesion molecule regulates cell contact-mediated changes in choline acetyltransferase activity of embryonic chick sympathetic neurons. AB - E10 chick sympathetic ganglion cells display a cell contact-dependent rise in choline acetyltransferase (ChAT) specific activity over the first several days in culture. This effect can be mimicked by addition of crude membrane fractions prepared from E10 retina and adult chicken brain, but not by those from E10 brain. The effects of both cell-cell and membrane-cell contact are inhibited by the addition of anti-NCAM Fab fragments. The membranes capable of increasing ChAT and those which are ineffective all contain NCAM, however their relative levels of NCAM polysialic acid differ. Whereas membranes with high polysialic acid NCAM are ineffective, selective enzymatic removal of polysialic acid renders them capable of producing an increase in ChAT. The inhibition of NCAM-mediated adhesion produced by Fab fragments can be compensated for by addition of wheat germ agglutinin, but only with membranes whose NCAM has low levels of polysialic acid. Taken together, these data suggest that NCAM can regulate cell contact mediated increases in ChAT activity. We propose that NCAM-mediated adhesion promotes contact between cell membranes to allow the transmission of an otherwise NCAM-independent signal. In addition, NCAM's polysialic acid moiety appears to influence the ability of cells to transmit this signal, even in the presence of an alternative adhesion mechanism. PMID- 3276721 TI - Changes in plasma lipoproteins during various androgen suppression therapies in men with prostatic carcinoma: effects of orchiectomy, estrogen, and combination treatment with luteinizing hormone-releasing hormone agonist and flutamide. AB - Cardiovascular complications are a well recognized side-effect of antihormonal therapy in men with prostatic carcinoma. We studied changes in plasma lipoproteins in patients with prostate cancer during treatment with several androgen suppression therapies. Estrogen, orchiectomy, and a combination of LHRH agonist and antiandrogen (flutamide) reduced plasma testosterone concentrations (89-92%) and plasma estradiol decreased by 85%, 44%, and 54%, respectively. Estrogen induced hypertriglyceridemia and elevation of plasma HDL cholesterol, phospholipid, and apolipoprotein A-I and A-II concentrations. Low density lipoprotein (LDL) cholesterol decreased but LDL apolipoprotein B did not. These results suggest that the cardiovascular complications that occur during estrogen administration are not mediated through changes in lipoprotein profile, other than the hypertriglyceridemic effect. Orchiectomy caused hypercholesterolemia and an increase in both total and LDL apolipoprotein B, all of which are strong determinants of cardiovascular disease. The high density lipoprotein (HDL) concentration was not affected despite a reduction in plasma testosterone, perhaps due to a simultaneous decrease in estradiol. Combination therapy had no effect on plasma lipid and apolipoprotein B concentrations, but very low density lipoprotein (VLDL) apolipoprotein B decreased, and LDL apolipoprotein B increased. The HDL cholesterol and apolipoprotein A-I concentrations increased but A-II and phospholipids did not. These results suggest enhanced lipoprotein lipase activity, consistent with the reciprocal changes in VLDL and LDL apolipoprotein B levels, apolipoprotein B enrichment of LDL particles, and increase in HDL cholesterol. The higher apolipoprotein A-I to A-II ratio indicates an increase in HDL2 subfraction due to inhibition of endothelial hepatic lipase, increased secretion of apolipoprotein A-I, or both. These effects are attributed to estradiol, which decreased less than after orchiectomy, and to additional adrenal androgen inhibition by flutamide. We conclude that estradiol plays an important role in determining plasma lipoprotein concentrations in men, and androgens exert an antagonist effect. The lipoprotein profile resulting from the combination treatment is more beneficial than that resulting from orchiectomy or estrogen administration. PMID- 3276722 TI - The acute effect of fat on insulin secretion. AB - Previous studies suggest that the rate of rise of the plasma glucose-dependent insulinotropic peptide (GIP) concentration, rather than the steady state level achieved, may be the stimulus of the increased insulin secretion that occurs when fat is ingested with carbohydrate. To test this hypothesis six normal men were given a 5-g iv bolus dose of glucose 15 min after a carbohydrate meal with or without fat. At the time of the iv glucose injection after the fat-containing meal, the rate of rise of plasma GIP was maximum, but the level was only 40% of the achieved by 30 min. Plasma GIP did not change after the meal without fat. After the fat meal, peak insulin and C-peptide levels in response to iv glucose were 60% greater than those after carbohydrate alone despite similar peak blood glucose levels. The calculated insulin clearance was not altered by the fat meal. We conclude that glucose-stimulated insulin secretion is increased early after fat ingestion, possibly due to a rise in GIP or other incretins. PMID- 3276723 TI - Zona glomerulosa function after life-long suppression in two siblings with the hypertensive virilizing form of congenital adrenal hyperplasia. AB - The function of the adrenal zona glomerulosa was studied in two pubertal siblings with the hypertensive virilizing form of congenital adrenal hyperplasia who had never been treated. Initially, their plasma 11-deoxycortisol and 11 deoxycorticosterone (DOC) levels were very high, PRA was suppressed, and plasma aldosterone and 18-hydroxycorticosterone (18-OHB) were undetectable. To selectively study zona glomerulosa function, the patients and five normal subjects were given dexamethasone (2 mg/day; thus suppressing zona fasciculata function), and their sodium intake was restricted to 10 mmol/day. After 3-5 days, the zona glomerulosa was stimulated with either angiotensin II or potassium chloride. The same protocol was repeated in the patients at various intervals up to 39 months after beginning maintenance therapy with dexamethasone (0.25 mg twice daily). PRA, plasma aldosterone, and 18-OHB remained low during the first 6 months of treatment. After the first year, PRA recovered, and the zona glomerulosa began to respond. Plasma aldosterone and 18-OHB levels reached normal basal and stimulated values in one of the patients after 2 yr of treatment, but remained subnormal after 39 months of treatment in the other patient. Both patients, however, had persistently elevated plasma DOC concentrations, suggesting slight but definite impairment of 11 beta-hydroxylation in the zona glomerulosa. We conclude that in spite of a severe and persistent 11 beta-/18 hydroxylation deficiency in the zona fasciculata, the zona glomerulosa can recover almost completely after prolonged treatment. Appropriate stimulation, however, discloses a minor 11 beta-hydroxylation impairment also in the zona glomerulosa. In addition, the lack of parallelism in zona glomerulosa 11 beta- and 18-hydroxylation of DOC provides evidence for the concept of different 18 hydroxylating systems in the adrenal cortex. PMID- 3276724 TI - Occurrence of thyrocyte HLA class II expression in a wide variety of thyroid diseases: relationship with lymphocytic infiltration and thyroid autoantibodies. AB - The proteins of the major histocompatibility system (HLA in humans) play an essential role in the regulation of immune responses due to their involvement in the presentation of antigen to T lymphocytes. Thyroid follicular cells (thyrocytes) from patients with Graves' disease and Hashimoto's thyroiditis demonstrate increased expression of HLA class I and aberrantly or inappropriately express class II antigens, a phenomenon that may play an important role in the pathogenesis of these autoimmune diseases. To establish if these changes in the expression of HLA molecules are characteristic of thyroid autoimmune disease, the immunopathological features (including class I and class II antigen expression) of 100 thyroidectomy specimens from patients with nonautoimmune thyroid disease were studied by indirect immunofluorescence, and the results compared with the findings in specimens from 14 patients with Graves' disease and 12 subjects undergoing laryngectomies for carcinoma. Increased class I product expression was found in 61% of all tissues studied, with maximal occurrence in papillary carcinomas (100%) and Graves' disease (86%), but it was also detected in 50% of the glands containing nodular lesions and in 16% of the control glands. Inappropriate class II molecule expression was found in Graves' disease (71%), hyperplastic nodules (53%), multinodular glands (44%), papillary carcinomas (38%), and 16% of the control glands. In summary, an increase in inappropriate HLA class I and class II expression was very common in nonautoimmune thyroid glands, but it generally occurred in the context of lymphocytic infiltration and thyroid autoantibodies (i.e. focal thyroiditis). Multiple correlation analyses of these 4 phenomena indicated heterogeneity in the mechanism leading to the inappropriate expression of thyrocyte class II antigens in the different conditions studied. PMID- 3276725 TI - Plasma renin and prorenin (inactive renin) in diabetes mellitus: effects of intravenous furosemide. AB - PRA, active renin, and prorenin were measured in 32 normotensive diabetic patients and 14 normal subjects of similar ages before and after iv injection of 40 mg furosemide. The majority of the diabetic patients had normal PRA and active renin levels before and after furosemide, but in 4 normal subjects and 5 diabetic patients PRA did not rise after furosemide treatment to at least 0.25 ng angiotensin I/(L.s) as previously found in 90% of normal subjects. Two thirds of the diabetic patients had higher plasma prorenin levels than the normal subjects. Four of the 5 diabetic patients whose PRA failed to rise to the usual level after furosemide treatment attained a plasma prorenin level higher than any normal subject, suggesting that furosemide stimulated synthesis and secretion of prorenin, but that conversion of prorenin to active renin was impaired. These 5 diabetic patients also had higher plasma creatinine and potassium levels as well as an increased frequency of albuminuria compared with the other diabetic patients. In contrast, the 4 normal subjects whose PRA failed to reach the usual level after furosemide treatment had low unresponsive prorenin levels, indicating that furosemide did not evoke the expected increase in prorenin or renin synthesis. We conclude that the inability of some diabetic patients to increase PRA after furosemide treatment is not dependent on failure of renin synthesis, but reflects an impairment of the normal processing of prorenin, leading to high levels of prorenin in plasma. PMID- 3276726 TI - Growth factors and the regulation of bone remodeling. PMID- 3276727 TI - Regulation of lipoprotein lipase immunoreactive mass in isolated human adipocytes. AB - Previous studies of human adipose tissue lipoprotein lipase (LPL) have focused on enzyme catalytic activity, and have not measured the LPL protein directly. To study the regulation of the LPL protein, an antibody against purified bovine LPL was used. To demonstrate the specificity of the antiserum, adipose homogenates were Western blotted, and adipocytes were radiolabeled and the cell homogenates immunoprecipitated, yielding a single specific band at 53 kD. Breakdown products of LPL were demonstrated at 35 and 20 kD by Western blotting. An ELISA for human adipose LPL was established, in which LPL was sandwiched between affinity purified antibody and biotinylated affinity-purified antibody. The standard curves for bovine LPL and human adipose LPL were parallel, and LPL activity correlated strongly with LPL immunoreactive mass. Thus, the bovine LPL standard curve was used to estimate LPL immunoreactive mass from human adipose tissue. The regulation of LPL activity and immunoreactive mass were compared in cultured adipocytes in the presence an absence of insulinlike growth factor-I/somatomedin C (IGF-I), insulin, and fetal bovine serum. IGF-I and a high insulin concentration (70 nM) stimulated only the heparin-releasable (HR) component of LPL activity and immunoreactive mass, and neither IGF-I nor insulin affected LPL specific activity. In contrast, 10% fetal bovine serum stimulated HR activity, HR mass, and cellular extractable (EXT) immunoreactive mass, with no effect on EXT activity. This resulted in a decrease in EXT specific activity in response to serum. The effects of the locally produced nucleosides adenosine and inosine were studied in a similar manner. As with serum, adenosine stimulated HR activity, HR mass, and EXT immunoreactive mass, resulting in a decrease in EXT specific activity. Inosine stimulated an increase in HR activity and HR mass, but had no effect on EXT, and thus did not change LPL specific activity. Thus, a sensitive ELISA for adipose tissue LPL has been developed using a specific, well characterized antibody. Regulation of human LPL immunoreactive mass was demonstrated in vitro by IGF-I, serum, high concentrations of insulin, adenosine, and inosine. This method will permit further investigations into the regulation of the LPL protein. PMID- 3276728 TI - Purification and partial characterization of hepatocyte growth factor from plasma of a patient with fulminant hepatic failure. AB - Human hepatocyte growth factor (hHGF) has been purified approximately 209,000 fold with 18% yield from plasma of a patient with fulminant hepatic failure. The purification involves heat treatment of plasma, ammonium sulfate precipitation, and chromatography on Affi-Gel Blue, heparin-Sepharose, and hydroxylapatite. Purified hHGF shows several bands with molecular weights between 76,000 and 92,000. Each band shows growth-stimulating activity on cultured hepatocytes which is proportional to the intensity of the band. After reduction of the sample with 2-mercaptoethanol, SDS-PAGE yields two chains with molecular weights of 31,500 34,500 and 54,000-65,000. The effect of hHGF on DNA synthesis by hepatocytes is half-maximal at 3.5 ng/ml. hHGF stimulates proliferation of cultured hepatocytes more effectively than human epidermal growth factor (hEGF) or insulin, and the effect of hHGF is additive or synergistic with the maximal effects of hEGF and insulin. These results suggest that hHGF is a new growth factor which is different from hEGF. PMID- 3276729 TI - Quantitative study of insulin secretion and clearance in normal and obese subjects. AB - The secretion and hepatic extraction of insulin were compared in 14 normal volunteers and 15 obese subjects using a previously validated mathematical model of insulin secretion and rate constants for C-peptide derived from analysis of individual decay curves after intravenous bolus injections of biosynthetic human C-peptide. Insulin secretion rates were substantially higher than normal in the obese subjects after an overnight fast (86.7 +/- 7.1 vs. 50.9 +/- 4.8 pmol/m2 per min, P less than 0.001, mean +/- SEM), over a 24-h period on a mixed diet (279.6 +/- 24.2 vs. 145.8 +/- 8.8 nmol/m2 per 24 h, P less than 0.001), and during a hyperglycemic intravenous glucose infusion (102.2 +/- 10.8 vs. 57.2 +/- 2.8 nmol/m2 per 180 min, P less than 0.001). Linear regression analysis revealed a highly significant relationship between insulin secretion and body mass index. Basal hepatic insulin extraction was not significantly different in the normal and obese subjects (53.1 +/- 3.8 vs. 51.6 +/- 4.0%). In the normal subjects, fasting insulin did not correlate with basal hepatic insulin extraction, but a significant negative correlation between fasting insulin and hepatic insulin extraction was seen in obesity (r = -0.63, P less than 0.02). This finding reflected a higher extraction in the six obese subjects with fasting insulin levels within the range of the normal subjects than in the nine subjects with elevated fasting insulin concentrations (61 +/- 3 vs. 45 +/- 6%, P less than 0.05). During the hyperglycemic clamp, the insulin secretion rate increased to an average maximum of 6.2-fold over baseline in the normal subjects and 5.8-fold in the obese subjects. Over the same time, the peripheral insulin concentration increased 14.1-fold over baseline in the normals and 16.6-fold over baseline in the obese, indicating a reduction in the clearance of endogenously secreted insulin. Although the fall in insulin clearance tended to be greater in the obese subjects, the differences between the two groups were not statistically significant. Thus, under basal, fasting conditions and during ingestion of a mixed diet, the hyperinsulinemia of obesity results predominantly from increased insulin secretion. In patients with more marked basal hyperinsulinemia and during intense stimulation of insulin secretion, a reduction in insulin clearance may contribute to the greater increase in peripheral insulin concentrations that are characteristic of the obese state.+ PMID- 3276730 TI - Twenty-four-hour profiles and pulsatile patterns of insulin secretion in normal and obese subjects. AB - The pattern of endogenous insulin secretion over a 24-h period, which included three mixed meals, was evaluated in 14 normal volunteers and 15 obese subjects. Insulin secretory rates were calculated from plasma C-peptide levels using individually derived C-peptide kinetic parameters and a validated open two compartment model of peripheral C-peptide kinetics. Insulin secretion rates were consistently elevated in the obese subjects under basal conditions (11.6 +/- 1.2 vs. 5.4 +/- 0.5 nmol/h) and in the 4 h after breakfast (139 +/- 15 vs. 63 +/- 5 nmol/4 h, P less than 0.001), lunch (152 +/- 16 vs. 67 +/- 5 nmol/4 h, P less than 0.001), and dinner (145 +/- 18 vs. 65 +/- 6 nmol/4 h, P less than 0.001). In the normal subjects, basal insulin secretion represented 50 +/- 2.1% of total 24 h insulin production, insulin secretion returned to baseline between meals, and equal quantities of insulin were secreted in the 4 h after breakfast, lunch, and dinner, despite the fact that subjects consumed half the number of calories at breakfast compared to lunch and dinner. Overall glucose responses were also similar after the three meals. In contrast, the pattern of insulin secretion in obese subjects was largely normal, albeit set at a higher level. However, the insulin secretion rate after meals did not return to baseline, and the secretion rate immediately before lunch (350.5 +/- 81.9 pmol/min) and dinner (373.6 +/- 64.8 pmol/min) was considerably higher than the secretion rate immediately before breakfast (175.5 +/- 18.5 pmol/min). In these overweight subjects, the glucose response after lunch was lower than after dinner. Analysis of individual 24-h insulin secretory profiles in the normal subjects revealed that insulin secretion was pulsatile. On average 11.1 +/- 0.5 pulses were produced in each 24-h period. The most prevalent temporal distribution of postmeal secretory pulses was two pulses after breakfast and three pulses after both lunch and dinner. Insulin secretion was also pulsatile during the period without meal stimuli: 3.9 +/- 0.3 pulses occurred during the period of overnight sampling and in the 3-h period before ingestion of the breakfast meal. In the obese subjects, the number and timing of secretory pulses was similar to those of normal volunteers, although the amplitude of the pulses was significantly greater. In both groups of subjects, greater than 80% of insulin pulses were concomitant with a pulse in glucose concentration in the postmeal period. The concomitancy rate was significantly lower in the interval without the meal stimuli, averaging 47% in both groups. Thus in obesity, although hypersecretion of insulin can be documented, the temporal pattern of secretion i s largely unaltered, which suggests that the functioning beta cell mass is enhance, but normal regulatory mechanisms influencing secretion are still operative. PMID- 3276731 TI - Interleukin 1: a mitogen for human vascular smooth muscle cells that induces the release of growth-inhibitory prostanoids. AB - There is much interest in defining the signals that initiate abnormal proliferation of cells in a variety of states characterized by the presence of mononuclear phagocytes. Since IL-1 is a major secretory product of activated human monocytes we examined whether this cytokine can stimulate the growth of human vascular smooth muscle cells (SMC). Neither recombinant IL-1 (rIL-1) alpha (less than or equal to 5.0 ng/ml) nor beta (less than or equal to 100 ng/ml) stimulated SMC growth during 2-d incubations under usual conditions. IL-1 did stimulate SMC to produce prostanoids such as PGE1 or PGE2 that can inhibit SMC proliferation. When prostaglandin synthesis was inhibited by indomethacin or aspirin both rIL-1 alpha and beta (greater than or equal to 1 ng/ml) markedly increased SMC growth. In longer-term experiments (7-28 d) rIL-1 stimulated the growth of SMC even in the absence of cyclooxygenase inhibitors. The addition of exogenous PGE1 or PGE2 (but not PGF1 alpha, PGF2 alpha, PGI2) to indomethacin treated SMC blocked their mitogenic response to rIL-1. Antibody to IL-1 (but not to platelet-derived growth factor [PDGF]) abolished the mitogenic response of SMC to rIL-1. Exposure of SMC to rIL-1 or PDGF caused rapid (maximal at 1 h) and transient (baseline by 3 h) expression of the c-fos proto-oncogene, determined by Northern analysis. We conclude that IL-1 is a potent mitogen for human SMC. Endogenous prostanoid production simultaneously induced by IL-1 appears to antagonize this growth-promoting effect in the short term (2 d) but not during more prolonged exposures. IL-1 produced by activated monocytes at sites of tissue inflammation or injury may thus mediate both positive and negative effects on SMC proliferation that are temporally distinct. PMID- 3276732 TI - Platelet glycoproteins Ia, Ic, and IIa are physicochemically indistinguishable from the very late activation antigens adhesion-related proteins of lymphocytes and other cell types. AB - The very late activation antigens (VLA) are a subset of the superfamily of cell surface glycoproteins that serve as receptors from extracellular matrix proteins. One or more of the VLA heterodimers are present on T lymphocytes and most other cell types, including platelets. We have used VLA-specific monoclonal antibodies to isolate the reactive platelet membrane molecules. We have identified them as previously characterized platelet surface glycoproteins and have compared them with VLA molecules isolated from lymphocytes and other cells. Utilizing one dimensional SDS-PAGE, two-dimensional O'Farrell gel electrophoresis, and nonreduced-reduced two-dimensional gel electrophoresis, we show that reduced VLA molecules of platelets are composed of three chains of molecular weights 165,000, 145,000, and 140,000 that possess the physicochemical properties of platelet glycoproteins GPIa, GPIc alpha, and GPIIa. GPIa corresponds to the VLA 165,000 alpha 2-chain, GPIIa corresponds to a 145,000 Mr VLA beta-chain, and GPIc alpha corresponds to a 140,000 Mr VLA alpha-chain. The polypeptide structure of VLA molecules on platelets and lymphocytes are very similar or identical. Platelet proteins GPIa and GPIIa exist as a mixed heterodimer in detergent lysates and correspond with the VLA-2 heterodimer found on activated T lymphocytes and other cell types. The platelet glycoproteins GPIIa and GPIc form a second mixed heterodimer. The mAb A-1A5, which binds to the VLA beta chain, binds to platelet GPIIa and precipitates both the GPIIa-GPIa and GPIIa-GPIc heterodimers, and binds to 4,926 +/- 740 sites per platelet. A VLA-2-specific mAb, 12F1, which binds to the VLA alpha 2-chain reacts with GPIa and immunoprecipitates only the GPIIa-GPIa heterodimer, and binds to 1,842 +/- 449 sites per platelet. The similarity of VLA chains and platelet GPIIa, GPIa, and GPIc molecules suggests that these molecules may have similar functions on various cell types. PMID- 3276733 TI - Interactions of spectrin in hereditary elliptocytes containing truncated spectrin beta-chains. AB - An abnormal spectrin, in which one subunit is truncated, has been detected in a large German family. The inheritance is autosomal dominant. The affected members of the family suffer in widely varying degree from a microcytic hemolytic anemia. The red cell morphology varies correspondingly from smooth elliptocytes to predominantly poikilocytes. The abnormal spectrin makes up approximately 30% of the total and is almost entirely present as the dimer. The truncated chain is not phosphorylated by the endogenous cAMP-independent kinase, and it has been identified as a chain of beta-type, using monoclonal antibodies. Because a univalent terminal spectrin alpha-chain fragment will bind to normal dimers with an association constant lower by only a factor of two than that for the self association of the dimers, it would be expected that the mutant dimers (alpha beta') would readily enter into an association with normal (alpha beta) dimers to give alpha 2 beta beta' tetramers (though not with each other). In dilute solution this is indeed observed, and the diminution in tetramer concentration when 30% of normal spectrin is replaced by alpha beta' dimers, amounts to only a small proportion. Moreover, in the membrane skeleton, if there is pairwise apposition of dimer units, only 9% of pairings will be between units that cannot associate. We have shown that the failure of alpha beta' dimers to enter into heterologous associations in situ is not due to the elimination of the ankyrin binding site near the truncated end of the beta-chain: this site is fully functional, as judged by rebinding to spectrin-depleted vesicles. When the spectrin is extracted from the membrane in the cold, the material released initially consists almost entirely of alpha beta' dimers; when the spectrin of normal membranes is partly dissociated to dimers in situ by warming at low ionic strength, extraction in the cold then leads similarly to much more rapid release of the dimer than of the tetramer. The similar rates of liberation of normal and abnormal dimer make it unlikely that the interaction of the latter with the membrane is in any way defective. When mixtures of alpha beta and alpha beta' dimers are bound to spectrin-depleted inside-out membrane vesicles from normal cells and tetramers are allowed to form by equilibration at 30 degrees C, the proportion of the abnormal species appearing in the tetramer is much lower than would be expected on a statistical basis. The relation of the self-association equilibrium on the membrane to that of spectrin in dilute solution is analyzed. PMID- 3276734 TI - Oral carnitine therapy in children with cystinosis and renal Fanconi syndrome. AB - 11 children with either cystinosis or Lowe's syndrome had a reduced content of plasma and muscle carnitine due to renal Fanconi syndrome. After treatment with oral L-carnitine, 100 mg/kg per d divided every 6 h, plasma carnitine concentrations became normal in all subjects within 2 d. Initial plasma free fatty acid concentrations, inversely related to free carnitine concentrations, were reduced after 7-20 mo of carnitine therapy. Muscle lipid accumulation, which varied directly with duration of carnitine deficiency (r = 0.73), improved significantly in three of seven rebiopsied patients after carnitine therapy. One Lowe's syndrome patient achieved a normal muscle carnitine level after therapy. Muscle carnitine levels remained low in all cystinosis patients, even though cystinotic muscle cells in culture took up L-[3H]carnitine normally. The half life of plasma carnitine for cystinotic children given a single oral dose approximated 6.3 h; 14% of ingested L-carnitine was excreted within 24 h. Studies in a uremic patient with cystinosis showed that her plasma carnitine was in equilibrium with some larger compartment and may have been maintained by release of carnitine from the muscle during dialysis. Because oral L-carnitine corrects plasma carnitine deficiency, lowers plasma free fatty acid concentrations, and reverses muscle lipid accumulation in some patients, its use as therapy in renal Fanconi syndrome should be considered. However, its efficacy in restoring muscle carnitine to normal, and the optimal dosage regimen, have yet to be determined. PMID- 3276735 TI - Lipoprotein metabolism during acute inhibition of lipoprotein lipase in the cynomolgus monkey. AB - To clarify the role of lipoprotein lipase (LPL) in the catabolism of nascent and circulating very low density lipoproteins (VLDL) and in the conversion of VLDL to low density lipoproteins (LDL), studies were performed in which LPL activity was inhibited in the cynomolgus monkey by intravenous infusion of inhibitory polyclonal or monoclonal antibodies. Inhibition of LPL activity resulted in a three- to fivefold increase in plasma triglyceride levels within 3 h. Analytical ultracentrifugation and gradient gel electrophoresis demonstrated an increase predominantly in more buoyant, larger VLDL (Sf 400-60). LDL and high density lipoprotein (HDL) cholesterol levels fell during this same time period, whereas triglyceride in LDL and HDL increased. Kinetic studies, utilizing radiolabeled human VLDL, demonstrated that LPL inhibition resulted in a marked decrease in the catabolism of large (Sf 400-100) VLDL apolipoprotein B (apoB). The catabolism of more dense VLDL (Sf 60-20) was also inhibited, although to a lesser extent. However, there was a complete block in the conversion of tracer in both Sf 400 100 and 60-20 VLDL apoB into LDL during LPL inhibition. Similarly, endogenous labeling of VLDL using [3H]leucine demonstrated that in the absence of LPL, no radiolabeled apoB appeared in LDL. We conclude that although catabolism of dense VLDL continues in the absence of LPL, this enzyme is required for the generation of LDL. PMID- 3276736 TI - Kniest dysplasia is characterized by an apparent abnormal processing of the C propeptide of type II cartilage collagen resulting in imperfect fibril assembly. AB - Epiphyseal and growth plate cartilages from four cases of Kniest dysplasia have been studied. In each case collagen fibril organization appeared abnormal by electron microscopy compared with age-matched normal cartilages: fibrils were much thinner, of irregular shape and did not exhibit the characteristic banding pattern. This was associated with the absence (compared with normal cartilage) of the C-propeptide of type II collagen (chondrocalcin) from the extracellular matrix of epiphyseal cartilages, although it was detected (as in normal cartilages) in the lower hypertrophic zone of the growth plate in association with calcifying cartilage. The C-propeptide was abnormally concentrated in intracellular vacuolar sites in Kniest cartilages and its total content was reduced in all cases but not in all cartilages. Moreover, it was not a part of the procollagen molecule. In contrast, type II collagen alpha-chain size was normal, indicating the formation of a triple helix. Also type II collagen content was normal and it was present in extracellular sites and only occasionally detected intracellularly. These observations suggest that the defect in Kniest dysplasia may result from the secretion of type II procollagen lacking the C propeptide and abnormal fibril formation, and that the C-propeptide is normally required for fibril formation. PMID- 3276737 TI - Intermediate bone grafting of alveolar clefts. AB - During the five year period 1980 to 1985 bone grafting was performed in 37 cleft patients before the eruption of the canine tooth (group IBG) and in 30 patients after the eruption of the canine tooth (group SGB). The initial healing was more favourable in the IBG group. In 72.5% of the clefts oro-nasal fistulae were present preoperatively. In all cases the fistulae were successfully closed. In the IBG group with orthodontic closure of the gap in the dental arch the interdental bone height in the grafted area was more than 75% of normal bone height in all clefts. In group SBG this situation was found in only 66% of the bone-grafted areas. There seems to be a clear relation between the age or the developmental stage of the canine tooth on the one hand and the possibility of orthodontic closure of the gap in the dental arch and good interdental bone height on the other hand. This also leads to the suggestion that if bone grafting to the alveolar cleft is required the operation should be performed before the eruption of the canine tooth on the cleft side. PMID- 3276738 TI - The pectoralis major myocutaneous flap. Experience in 100 consecutive cases. AB - The authors have made a study of 100 consecutive cases in whom a pectoralis major myocutaneous flap was employed for reconstruction after surgical ablation of advanced malignant tumours in the head and neck. The results obtained show that primary healing took place in 74% of cases with a relatively low incidence of complications. The authors therefore confirm the reliability of the pectoralis major myocutaneous flap, which, owing to its rich blood supply, offers the possibility of providing large cutaneous islands, and its proximity to the site of ablation provides a simple and reliable method which may be used in the majority of cases of immediate or delayed reconstruction of the cervico-maxillo facial area. PMID- 3276739 TI - Drugs and the periodontium. AB - The periodontium and periodontal disease activity can be affected by systemic drug therapy. Many drugs can have an adverse effect on the periodontium, i.e., gingival hyperplasia. Alternatively, some drugs can modify the inflammatory and immunological responses of the periodontal tissues to bacterial plaque. The aim of this review is to evaluate the effects of drug therapy on the periodontium and periodontal disease activity, and where possible, to relate such changes to the pharmacodynamics of the drugs considered. Drugs which have been reported to affect the periodontium can be categorised as follows: anti-epileptics, immunosuppressants, corticosteroids, non-steroidal anti-inflammatory drugs and hormones. Those drugs whose pharmacodynamics are clearly established and which affect the rate of periodontal disease activity, may provide information on the mechanisms of periodontal destruction. Finally, the mechanisms of drug-induced gingival hyperplasia (overgrowth) are discussed in relationship to the drugs' pharmacodynamics and pharmacokinetics. PMID- 3276740 TI - Computer-assisted densitometric image analysis in periodontal radiography. A methodological study. AB - A videobased computer assisted densitometric image analysis (CADIA) system to quantify alveolar bone density changes on standardized dental radiographs was tested. An algorithm was used for grey level correction of a subsequent image to the baseline image. Quantitative information regarding positive and/or negative grey level changes were obtained automatically. Comparison of the ability of CADIA to detect surgically induced bone loss with interpretation of digital subtraction images and conventional radiographic interpretation revealed that CADIA was the most sensitive of the 3 methods, followed by interpretation of digital subtraction images which was considerably more sensitive than conventional radiographic interpretation. CADIA was capable of assessing differences in alveolar bone changes due to periodontal surgery between sites exposed to ostectomy/osteoplasty and control sites and sites exposed to periodontal surgery without ostectomy/osteoplasty. Finally, CADIA was capable of assessing differences in remodeling activity over 4-6 weeks after periodontal surgery between 45 surgical sites and 45 control sites. The system offers an objective method to quantitatively follow alveolar bone density changes over time and appears to be the most sensitive of previously described radiographic interpretation techniques. PMID- 3276741 TI - The herpes simplex problem. AB - Most of the world's population is eventually infected with herpes simplex virus type 1, type 2, or both. Most infected persons harbor latent virus in nerve ganglia for the rest of their lives. True primary infections, nonprimary first episode infections, and recurrent infections can be asymptomatic or clinical, but all of these are contagious. Past estimates of recurrent herpes affecting 20% to 40% of the population are probably low because of inadequate studies of asymptomatic shedding and genital recurrences. Herpes infections are spread primarily by close personal contact but some are contracted by fomites and medical-dental procedures. Latent virus harbored by almost everyone with frequent reactivation to produce symptomatic or asymptomatic, infectious recurrent disease poses a huge problem for control or eradication of herpes simplex infections. Public health measures will probably fail because they require too much alteration of the public's life-styles. So far, antiviral drugs do not eliminate latent virus from infected ganglia. That naturally infected persons can be reinfected, superinfected, or autoinoculated raises serious questions whether vaccines will eradicate the disease, although they might control some serious manifestations and limit some spreading. The problem of eradicating herpes is different from that of eradicating smallpox, where latent infections with infectious recurrences did not exist. PMID- 3276742 TI - First-episode, recurrent, and asymptomatic herpes simplex infections. AB - Genital herpes simplex virus infections should be classified into first-episode and recurrent infections. First-episode infections include true primary infections in patients with seronegative results who have never been infected with any type of herpes and nonprimary first-episode infections in patients who have been infected before and have serum antibody and humoral immunity, an example being genital infection with type 2 in adolescence after orolabial infection with type 1 in childhood. First-episode infections show more extensive disease, more systemic symptoms, and greater viral shedding than do recurrent infections. Ten percent to 15% of patients with first-episode primary genital herpes have oropharyngeal infections with the same virus strain. Herpesvirus can be isolated from the urethra in about 30% of male patients with first-episode infections. In recurrent vulvar herpes, virus can be isolated from the cervix in 10% to 15% of patients. Many genital lesions that clinically suggest something else turn out to be herpes; herpes may be diagnosed 5% of the time clinically but cultures are positive 14% of the time. Primary genital herpes type 2 infections recur about 95% of the time whereas type 1 infections recur about 50% of the time. Recurrences are highly unpredictable from patient to patient and time to time. The role of asymptomatic shedding in the spread of herpes is a major area for future study. Antiviral treatment is probably going to change the epidemiology of herpetic infections very little. PMID- 3276743 TI - Antiviral treatment of herpes simplex infection in neonates and pregnant women. AB - Herpes simplex infections in neonates include (1) infections beginning in skin or mucous membranes, (2) infections of the central nervous system, and (3) disseminated herpes of the newborn. Early recognition of infections beginning in skin or mucous membranes is essential because 75% will disseminate internally if untreated. Skin lesions provide important diagnostic clues in herpes of the nervous system and disseminated herpes, but they often appear late and in only about 60% of infected neonates. Acyclovir and vidarabine are effective therapies but they must be administered early to prevent serious damage or death. Herpetic skin lesions in neonates may be confused with pyodermas. Direct immunofluorescence and cultures are reliable diagnostic tests. Congenital herpes may cause widespread skin involvement and multiple eye and nervous system diseases. The mother is the source of neonatal herpes in about two thirds of cases. Asymptomatic genital shedding of virus late in pregnancy does not accurately predict whether maternal cultures will be positive at the time of delivery. The risk of the infant acquiring neonatal herpes from a mother with recurrent herpes at birth is about 5%, but the risk is much higher if the mother has true primary genital infection. PMID- 3276744 TI - Marginal adaptation of composite resins and dentinal bonding agents. AB - The purpose of this in vitro study was to determine the bonding qualities of three commercially available dentin bonding agents, namely Dentin Adhesit/Heliomolar, Creation Bond/Visar Fil and Scotchbond/P30. Microleakage tests and a scanning electron microscopy study of the interface between dentin and resin were performed. In eighteen specimens, the penetration of 0.5 percent basic fuchsin solution was studied across the enamel and dentin interfaces with the resin. Half of the specimens in each group of products were thermocycled. Leakage was evaluated after sectioning under a light optical stereomicroscope at 20 x magnification, using a classification reported by Eriksen and Buonocore. The interface between the restorative resin and the dentin axial walls of the preparation and its floor were examined by scanning electron microscopy (SEM). The results showed that leakage was commonly found at the resin/dentin interface and SEM showed gaps between the restoration and walls and floor of the preparation. It was concluded that the dentin bonding agents failed to provide a bond between restorative resin and dental tissue. PMID- 3276745 TI - The effect of VLC Scotchbond and an incremental filling technique on leakage around Class II composite restorations. AB - The object of this study was to determine the effect of VLC Scotchbond and of an incremental filling technique on microleakage around class II composite restoration in vitro. Four groups of 15-16 teeth each, were filled with the resin P-30 by one of the following techniques: A, Scotchbond and incremental filling; B, Scotchbond and bulk filling; C, Enamel Bond and incremental filling; D, Enamel Bond and bulk filling. The teeth were thermocycled, insulated up to 1 mm from the restorations, immersed in 2 percent basic fuchsin, embedded in acrylic resin and ground off to various depths, parallel to the plane through the vertical and the mesiodistal axes. Marginal leakage was assessed from the degree of dye penetration at the sections. Dye penetration at the occlusal margins was similar for all groups. Dye penetration at the cervical margins for the different groups increased in the sequence: A/C/B/D. Incremental filling resulted in a significantly lower dye penetration at cervical margins for both bonding agents. The differences resulting from the use of Scotchbond were not significant, if the same packing technique had been used. Best results were obtained with Scotchbond and incremental filling. PMID- 3276746 TI - The invasive pit-and-fissure sealing technique in pediatric dentistry: an SEM study of a preventive restoration. AB - From the dental literature, it is clear that the clinical application of pit-and fissure sealants is a necessity in pedodontics. The choice between the non invasive and the invasive techniques remains a matter of debate. In this SEM study, a comparison is made between different types of burs in order to obtain the best fissure preparation before the application of a sealant. The results of this study clearly show that, by applying the invasive sealing technique, the choice of an adequate bur is important to obtain a caries-free fissure, with a minimal loss of tooth substance. Two types of burs were found to perform best, according to the amount of tooth substance removed. Moreover, from a clinical point of view they were also found to be the most efficient ones. A detailed review is given concerning the choice of the actual preventive restorations for use in pedodontics. PMID- 3276747 TI - An alternative approach to prevention: computer-assisted patient education. AB - Computer-assisted instruction is a reliable, viable, and increasingly popular method for patient education. CAI programs are easy to use, nonintimidating to the patient, and enjoyable. CAI is a relatively new, but effective method of "spreading the word" to those who most desperately need the information. As technology advances, more computer-based patient education programs will become available to the dental health-care profession. The computer based education center will become a useful and integral component of the dental office of the future. PMID- 3276748 TI - Hygiene in dental practice--Part I: Potential pathogens and possibilities of contamination. AB - In order to ensure adequate reduction of risks of contamination in dental practice, potential pathogens should be known and insight should be gained into possibilities of contamination. The first part of this article presents brief descriptions of the most relevant pathogenic microorganisms such as the causative agents of tuberculosis, gonorrhoea, syphilis, herpes simplex, hepatitis, AIDS and legionnaires' disease. Possibilities of contamination in dental practice are considered next, with special reference to various ways in which microorganisms can be transmitted: Hand instruments. Rotating instruments, multiple-function syringe and ultrasonic scaler. Instruments used in endodontics. Hands and face. Clothing. Treatment unit. Measures that can be taken in order to minimize the risk of contamination will be discussed in Part II. PMID- 3276749 TI - Hygiene in dental practice. Part II: Measures to reduce the risk of contamination. AB - On the basis of the description of potential pathogens and possibilities of contamination during dental treatment in Part I, Part II discusses several measures to be taken, in order to reduce the risk of contamination for patients as well as for dental personnel. The hygienic measures mostly concern the treatment of patients, including some unidentified infected patients. In this context, direct and indirect behavior of dental personnel, protective measures, domestic cleaning, disinfection, and sterilization are discussed in detail. In addition, possible supplementary measures to be taken in the treatment of identified infected patients are discussed, with special reference to hepatitis B and HIV. Finally, hygienic measures to protect personnel not directly involved in dental treatment are discussed. PMID- 3276750 TI - Oral manifestations of Crohn disease: update of the literature and report of case. AB - Crohn disease, a devastating chronic illness, often develops in the childhood years. The disease is a segmental transmural intestinal disease that may involve one or more segments of the gut from the mouth to the anus. Crohn disease is frequently confused with ulcerative colitis. Frequent oral manifestations include persistent oral ulcerations, diffuse gingival swelling, mucosal hyperplasia and fissuring, cheilitis, and pyostomatitis vegetans. Frequently, oral biopsy is essential in establishing a correct diagnosis of the disease. Although no cure is currently available for the Crohn disease, the proper diagnosis of the problem is essential for providing symptomatic relief. A case report is presented documenting the value of the proper diagnosis of the disease. The literature is reviewed and updated. PMID- 3276751 TI - Compensation, kickbacks, and the law. PMID- 3276752 TI - Comparison of predictions based on observational data with the results of randomized controlled clinical trials of coronary artery bypass surgery. AB - Clinical decisions are most secure when based on findings from several large randomized clinical trials, but relevant randomized trial data are often unavailable. Analyses using clinical data bases might provide useful information if statistical methods can adequately correct for the lack of randomization. To test this approach, the findings of the three major randomized trials of coronary bypass surgery were compared with predictions of multivariable statistical models derived from observations in the Duke Cardiovascular Disease Databank. Clinical characteristics of patients at Duke University Medical Center who met eligibility requirements for each major randomized trial were used in the models to predict 5 year survival rates expected for medical and surgical therapy in each randomized trial. Model predictions agreed well with randomized trial results and were within the 95% confidence limits of the observed survival rates in 24 (92%) of 26 clinical subgroups. The overall correlation between predicted and observed survival rates was good (Spearman coefficient 0.73, p less than 0.0001). These results suggest that carefully performed analyses of observational data can complement the results of randomized trials. PMID- 3276753 TI - Early and late hemodynamic evaluation after cardiac transplantation: a study of 28 cases. AB - Right heart catheterization was performed in 28 patients 1 week and 6 to 24 months after orthotopic cardiac transplantation. All patients were receiving cyclosporine and methylprednisolone orally. At early catheterization, right heart pressures as well as pulmonary capillary wedge pressure still remained above normal values in the majority of patients. Systemic arterial hypertension was already present in 29% of the patients and cardiac index was usually in the normal range, without any inotropic support. Results of late catheterization showed continuing improvement with return of right heart pressures to normal values in most but not all patients. Systemic arterial hypertension was noted in nearly all patients and is likely to be the result of hypervolemia secondary to cyclosporine-induced sodium retention. The increase in cardiac index, which was above normal values in 39% of the patients, was also consistent with hypervolemia in the setting of cardiac denervation. Thus, cardiac function at rest is satisfactory at short- and long-term assessment after cardiac transplantation, but the development and persistence of systemic arterial hypertension associated with cyclosporine use are a matter of concern in such patients. PMID- 3276754 TI - Automatic methods for detection of tachyarrhythmias by antitachycardia devices. AB - Electrical devices play an increasingly important role in the control of tachyarrhythmias. Antitachycardia pacing and automatic defibrillation have been severely limited by the poor specificity of tachycardia discrimination in commercially available devices. Although absolute heart rate has been the principal means of automatic diagnosis, several new detection algorithms and methods are being investigated. Multiple electrode timing comparison, signal processing and pattern recognition are employed in these newer techniques. Although each offers some improvement over present technology, none is capable of identifying all arrhythmias. The methods employing comparison of atrial and ventricular rates, without additional criteria, are unable to detect ventricular tachycardia in the presence of 1:1 retrograde conduction. Electrographic analysis techniques require very stable electrodes and may not tolerate normal morphologic variations. A combination of two or more approaches may ultimately be required. All techniques will require that certain critical variables be programmable to allow for individualization in each clinical situation. Soft-ware-controllable devices and those capable of sensing from both the atria and the ventricles will provide the sophistication necessary for the implementation of complex tachycardia detection algorithms. This report reviews automatic tachycardia detection techniques in current use and under investigation. PMID- 3276755 TI - Influence of altered inotropy and lusitropy on ventricular pressure-volume loops. AB - Each cardiac cycle can be characterized by a pressure-volume loop that graphically depicts the external work of the ventricle. The pressure-volume loop is determined to a large extent by end-diastolic and end-systolic conditions, each of which reflects the properties of the heart and circulation at these two critical times in the cardiac cycle. The pressure and volume at end-diastole and end-systole, in turn, are determined by interactions between the heart and the circulation. End-diastolic pressure and volume reflect preload (venous return) and the lusitropic (relaxation) state of the ventricular walls, and end-systolic pressure and volume are determined by the afterload (peripheral and pulmonary resistance) and the inotropic (contractile) state of the myocardium. Alterations in inotropic and lusitropic state lead to predictable changes in the pressure volume loop that, when combined with knowledge of preload and afterload, can facilitate understanding of the pharmacologic and pathophysiologic responses of the heart. PMID- 3276756 TI - Nonallergic airway responsiveness. PMID- 3276757 TI - Allergen-induced airway hyperresponsiveness. AB - Allergen inhalation in the laboratory can lead to an early (0 to 2 hours) and late (3 to 12 hours) asthmatic response and an increase in airway hyperresponsiveness to a variety of bronchoconstrictor mediators. Also, environmental allergen exposure increases airway responsiveness, symptoms of asthma, and the amount of treatment needed to control symptoms. Allergen inhalation causes an acute inflammatory response with an influx of predominantly neutrophils and/or eosinophils into the airway in both animal preparations and sensitized human subjects. The development of airway hyperresponsiveness is most likely a consequence of the inflammatory response. The mediators involved in initiating the inflammatory response or airway hyperresponsiveness have not yet been clearly identified. However, potent chemotactic factors, such as leukotriene B4 and platelet-activating factor can initiate both airway inflammation and airway hyperresponsiveness. In addition, in some animal preparations, cyclooxygenase products of arachidonate metabolism, possibly thromboxane, play a central role in the pathogenesis of airway hyperresponsiveness after inhalation of inflammatory stimuli such as allergen. PMID- 3276758 TI - The role of calcium antagonists in bronchial reactivity. AB - Calcium (Ca) ions play an important pathophysiologic role in allergic reactions. Thus, mediator release from mast cells, synthesis of some newly formed chemical mediators, airway smooth muscle contraction, and nerve-impulse conduction are all dependent on the availability and flux of Ca ions. It is likely, therefore, that Ca antagonists would modify allergic bronchoconstriction. In vitro, Ca antagonists have been demonstrated to inhibit mediator release (histamine, slow reacting substance of anaphylaxis, and platelet-activating factor) from mast cells, passively sensitized human lung fragments, and leukocytes. Ca antagonists have also been found to inhibit synthesis of leukotrienes in rat lungs and cyclooxygenase products in sheep, possibly by inactivating phospholipase A2 and/or 5-lipoxygenase. In addition, nifedipine, verapamil, and gallopamil have demonstrated inhibition of airway smooth muscle contractions to histamine, carbachol, and antigen in various species. In vivo effects of Ca antagonists are variable, depending on the species, experimental design, the stimulus or the agonist, and the Ca antagonist used. Animal studies have demonstrated the inhibition of histamine, methacholine, citric acid, and prostaglandin F2 alpha induced bronchoconstriction in guinea pigs and dogs by intravenous nifedipine. In contrast, verapamil inhibited antigen-induced bronchoconstriction in allergic sheep without any effect on histamine- and carbachol-induced responses. Ca antagonists (nifedipine and verapamil) have been of limited value in human subjects and generally have no significant bronchodilating activity. Both nifedipine and verapamil prevent the exercise-induced asthma and partly attenuate the histamine and methacholine-induced bronchoconstriction. Oral nifedipine is generally more effective than oral verapamil against acute antigen-induced bronchoconstriction; however, this efficacy may be limited by systemic side effects. Inhaled Ca antagonists may be more effective and free of systemic side effects, as demonstrated by greater efficacy of inhaled verapamil. A new Ca antagonist, gallopamil (a methoxy derivative of verapamil), is being investigated as an aerosol, and preliminary studies in animals and humans have found it fourfold to seventeenfold more potent than verapamil. In sheep, gallopamil has been found to attenuate histamine, carbachol, and platelet-activating factor induced bronchoconstriction, as well as to inhibit early and late-phase allergic airway responses. Studies in human subjects have also demonstrated the inhibition of antigen-induced bronchoconstriction by inhaled gallopamil, with efficacy comparable or better than cromolyn sodium.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3276759 TI - The role of platelet-activating factor in asthma. PMID- 3276760 TI - Platelet-activating factor and asthma. PMID- 3276761 TI - An open study of auranofin in the treatment of steroid-dependent asthma. AB - To determine the efficacy of oral gold in asthma, 20 patients with steroid dependent asthma received auranofin at a dose of 3 mg by mouth, twice daily, in a 24-week open clinical trial. Prospective evaluation of bronchial responsiveness to methacholine was determined before and 8 and 16 weeks after initiation of auranofin therapy. Serial spirometry (FEV1 and FVC), lung volumes, and diffusing capacities (single breath carbon monoxide diffusing capacity of the lungs) were measured before and at 10 and 20 weeks after treatment. All subjects were required to record concomitant medications, symptom scores, and morning and evening peak expiratory flow rates. In vitro immunologic studies performed before and after 8 and 20 weeks of auranofin therapy included leukocyte histamine release in response to antihuman IgE, lymphocyte blast transformation in response to concanavalin A and phytohemagglutinin, and leukocyte inhibitory factor activity in response to Candida albicans and tetanus toxoid antigens. In 18 patients evaluated, there were no significant differences between baseline and posttreatment spirometry, single breath carbon monoxide diffusing capacity of the lungs, and lung volumes. At week 16 of treatment, the steroid cumulative dose or the total prednisone dose administered from 7 days before through 10 days after each methacholine test day decreased from a mean of 293 +/- 125 mg at baseline to 192 +/- 115 mg. At week 16, nine of 18 patients (50%) exhibited decreased methacholine responsiveness as defined by a more than one-half log10 increase in the concentration of methacholine causing a 20% decrease in FEV1. A significant correlation (r = 0.60) was observed between the increase in the concentration of methacholine causing a 20% decrease in FEV1 and the decrease in steroid cumulative dose after 16 weeks of treatment. Leukocyte histamine release to anti IgE exhibited significant reductions from baseline at week 20 to 10(-2) (p less than 0.002) and at 10(-3) (p less than 0.005) dilutions. At week 20, leukocyte inhibitory factor activity in response to Candida increased from baseline at the 0.1 mg per well (p = 0.025) and 1 mg per well (p = 0.05) concentrations; similarly, the responses to tetanus toxoid increased at the 1 mg per well (p less than 0.05) and 0.1 mg per well (p less than 0.01) concentrations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3276762 TI - Psychologic and somatic interrelationships in allergy and pseudoallergy. AB - A wide range of mental, behavioral, and nonspecific subjective somatic symptoms can be observed commonly in the course of the classic allergic diseases of the atopic syndrome (asthma, rhinitis, eczema, etc). These symptoms do not necessarily imply the presence of psychiatric disorder, nor do they indicate that allergic processes have a direct effect on cerebral function. These changes are the indirect result of the allergy and are usually secondary to extracerebral physical dysfunctions. The potential importance of the cerebral effects of hypoxemia in asthma, and of the central nervous system side effects of antiallergy medication, has received inadequate attention and requires more research. Failure to recognize the true significance of such valid clinical observations, combined with failure to recognize the importance of the use of techniques to overcome the effects of the placebo, suggestion, and observer bias have led to several misconceptions concerning the role of foods and inhalants in psychiatric and somatic syndromes unassociated with atopy. It is apparent that publicity directed to such views, and the use of unorthodox or unproven "allergy" procedures, can cause significant harm. PMID- 3276763 TI - Surgical perspectives on allergic airway disease. PMID- 3276764 TI - Diagnosis and treatment of drug allergy. PMID- 3276765 TI - Environmental mycological studies on the causative agent of summer-type hypersensitivity pneumonitis. AB - Environmental mycological studies were carried out in 22 homes of patients with summer-type hypersensitivity pneumonitis and in 195 homes of control subjects. In 10 patients' homes, indoor sampling was performed by open-plate culture, house dust culture, and swab culture (group 1), but in the other 12 patients' homes, sampling was only by house dust culture (group 2). We isolated 302 strains of yeasts from the 22 patients' homes and 962 strains of yeasts from the homes of control subjects. The incidence of yeasts, except genera Trichosporon, was not significantly different between homes of patients and control subjects when homes were assessed by three culture methods. T. cutaneum was isolated from seven of 10 patients' homes in group 1, and their colonizing places were revealed by the swab culture method. In group 2, the cells were isolated from four of 12 patients' homes. No T. cutaneum, however, was isolated from the control subjects' homes. Among the isolated yeasts from patients' homes, 23 strains were reactive to the patients' sera at 1:128 or higher in indirect fluorescent antibody titers; 10 yeasts were T. cutaneum, isolated from 10 homes of 14 patients, but the other 13 yeasts were each a different species isolated from 10 different homes. Furthermore, inhalation challenge with the culture-filtrate antigen prepared from T. cutaneum was performed on the nine patients of six homes in group 1 and the two asymptomatic family members. Of the nine patients, six were positive, one was probable, and two patients were negative. Neither of the two asymptomatic family members responded. These results suggest that T. cutaneum is a major causative agent of summer-type hypersensitivity pneumonitis. PMID- 3276766 TI - Nursing homes as acute care providers. A pilot study of incentives to reduce hospitalizations. AB - This program was designed to encourage treatment of episodes of acute illness in skilled nursing facilities in order to avoid costly and potentially traumatic admission to hospital. It is part of the Monroe County Long Term Care Program, Inc, system of case management and Medicare and Medicaid waivers, and consists of financial incentives, paid by Medicare, to facilities and to responsible physicians to evaluate and care for acutely ill patients in the SNF's when medically safe and feasible. A retrospective evaluation using a physician assessment committee concluded that among the first 112 patients in the program, 76% were very probably saved hospitalization or at least an emergency room visit. Acute bacterial infection was the most common category of episode, occurring in 46% of cases. Considerable savings to both Medicare and Medicaid were estimated to have resulted. PMID- 3276767 TI - Prescribing for the elderly. Part I: Sensitivity of the elderly to adverse drug reactions. PMID- 3276768 TI - Primary hyperparathyroidism and delirium in the elderly. PMID- 3276769 TI - Health maintenance organizations and the elderly. Misconceptions and a challenge. PMID- 3276770 TI - Aging, alcohol, and the liver. PMID- 3276771 TI - Falls and instability in the elderly. PMID- 3276772 TI - Influenza--a controllable disease? PMID- 3276773 TI - "A coarse sieve": basic science boards and medical licensure in the United States. PMID- 3276774 TI - The professional context of electrotherapeutics. PMID- 3276775 TI - The concept of disease in an ancient Chinese medical text, the Discourse on Cold Damage Disorders (Shang-han Lun). PMID- 3276776 TI - Evidence for an accessory role of LFA-1 in lymphocyte-high endothelium interaction during homing. AB - In a variety of lymphocyte interactions, lymphocyte function-associated antigen-1 (LFA-1) plays an important role as an accessory mechanism mediating cell adhesion. We tested the possibility that LFA-1 could also be involved in the specific binding of lymphocytes to high endothelial venules (HEV) during homing. Antibodies against LFA-1 but not against various other cell surface molecules (except the putative gp90 homing receptor defined by the MEL-14 antibody) were found to inhibit in vitro adherence of lymphocytes to HEV in frozen sections of lymph nodes. Binding of T cell lines to HEV was also inhibited by anti-LFA-1 antibody. Using sublines selected for differential expression of the MEL-14 antigen, MEL-14 high cells (which bind well to HEV) were less susceptible to inhibition by anti-LFA-1 than poor binders with low levels of the homing receptor, supporting the model of LFA-1 being an accessory mechanism strengthening weak interactions between cells. Parallel results were found in vivo where anti-LFA-1 antibodies reduced the migration of normal lymphocytes into lymph nodes and Peyer's patches by 40 to 60%. Localization in the lung, especially of activated lymphocytes, was also impaired, although to a lesser extent. These findings suggest that LFA-1 plays an accessory role in cellular interactions relevant for lymphocyte migration. PMID- 3276777 TI - Influence of major histocompatibility complex H-2LD class I molecules on spleen colony-forming units. AB - To test whether the major histocompatibility complex class I genes are involved in the regulation of hemopoiesis, the stem cell activities of BALB/c-H-2dm2 (Dm2) mice, which are defective in the expression of H-2L antigens, have been compared with those of the wild-type, BALB/c-Kh, in in vivo and in vitro stem cell assays. In spleen colony-forming unit assays, Dm2 as hosts consistently supported a smaller number of colonies than did BALB/c-Kh. However, both Dm2 and BALB/c-Kh supported a comparable number of colonies in in vitro granulocyte-macrophage colony-forming unit and erythroid colony-forming unit assays. These observations together suggest that the mutation in Dm2 has not affected the hemopoietic potential of the stem cells but may probably affect the hemopoietic microenvironment for the development of the stem cells. PMID- 3276778 TI - Regulation of lymphocyte homing. I. Alterations in homing receptor expression and organ-specific high endothelial venule binding of lymphocytes upon activation. AB - Upon activation, lymphocytes display profound alterations in their in vivo migration behavior. In an attempt to understand some of the cellular mechanisms responsible for this altered behavior, in vitro stimulated lymphocytes have been analyzed for their expression of a putative homing receptor (HOR) (defined by mAb MEL-14) and for their ability to bind to specialized lymphoid organ high endothelial venules (HEV) in vitro. The results indicate that signals related to lymphocyte activation induce complex alterations in HOR expression and organ specificity of HEV-binding: 1) submitogenic stimuli induce an increase in MEL-14 antigen expression. This applies to almost all lymphocytes in autologous cultures, for the fraction of cells in periodate, LPS- or Con A-treated cultures not fully activated and for cultures stimulated with suboptimal doses of Con A. 2) Full blast transformation is associated with a decrease or complete loss of MEL-14 antigen expression on the majority of blasts in all activating systems used, but a subset of up to 30 to 40% of fully activated cells may nonetheless express very high levels of the MEL-14 antigen. 3) Functional assays reveal that Con A and periodate stimulation lead to a selective, nearly complete suppression of the lymphocytes binding to HEV of Peyer's patches, even under conditions where overall binding to peripheral node HEV is increased. This indicates a differential regulation of the two respective receptors, with the mucosa system specific HOR being more prone to down-regulation during in vitro activation by these mitogens. PMID- 3276779 TI - Mechanism of spontaneous activation of B cells in patients with systemic lupus erythematosus. Analysis with anti-class II antibody. AB - The mechanism of spontaneous activation of B cells in patients with systemic lupus erythematosus (SLE) was analyzed by using anti-class II monoclonal antibodies in vitro. B cells from SLE patients showed enhanced proliferation and Ig production by in vitro culture without any stimulation. The number of Ig producing cells increased during a 5-day culture period, but the addition of anti class II antibodies such as anti-HLA-DR, DQ, or DP monoclonal antibodies inhibited these B cell responses in a dose-dependent manner. Anti-class I and anti-B1 antibody gave no effect. The inhibitory effect of anti-class II antibodies on B cell responses became more remarkable when B cells were cultured on a longer period. By a Percoll gradient density centrifugation, Ig-producing cells were enriched in the lower density fraction, but became depleted in the higher density fraction. However, B cells of the higher density fraction developed into Ig-producing cells after 5 days of culture and anti-class II antibodies inhibited this development. When mitomycin C- and cycloheximide treated B cells were added to the in vitro culture of B cells as a stimulator, B cell responses were enhanced in a dose-dependent manner. T cells treated with mitomycin C and cycloheximide had no enhancing effect on B cell responses. Furthermore, the enhancing effect of the stimulator B cells was inhibited by the pretreatment of stimulator B cells with anti-class II antibodies. These results suggest that in patients with SLE the abnormality exists in B precursor cells which are easily activated by interacting with other B cells to differentiate into Ig-producing cells and anti-class II antibodies inhibit the B cell activation by interfering with this cellular interaction. PMID- 3276780 TI - Monoclonal antibodies to the major feline allergen Fel d I. II. Single step affinity purification of Fel d I, N-terminal sequence analysis, and development of a sensitive two-site immunoassay to assess Fel d I exposure. AB - Two mAb were used to develop new techniques for the purification and quantitation of the major feline salivary allergen, Felis domesticus allergen I (Fel d I). The allergen was purified from aqueous house dust extract with a high Fel d I content by affinity chromatography over a monoclonal immunosorbent and elution with 4 mM HCl, pH 2.5. This single step procedure gave 40 to 50% recovery of 90% pure allergen which, following final purification by size exclusion HPLC, showed a single line on immunodiffusion and crossed immunoelectrophoresis against monospecific anti-Fel d I and polyclonal anti-cat dander antibodies. The m.w. of native Fel d I was 39,000 on size exclusion HPLC, and 17,000 under nonreducing conditions on gel electrophoresis. The N-terminal amino acid sequence (33 residues) showed no homology with other known protein sequences. The combination of the SDS-PAGE and N-terminal sequence data suggests that Fel d I is a non covalently linked homodimer. A two-site RIA was developed using mAb directed against different epitopes on Fel d I. This assay was species-specific, highly sensitive (0.0004 U/ml), and showed an excellent correlation with a polyclonal inhibition RIA (n = 27, r = 0.93, p less than 0.001). Cat allergen extracts used for immediate skin tests showed marked differences in Fel d I content (from 0.1 to 30 U/ml). Consistently high Fel d I levels were found at monthly intervals in six dust samples from four houses with cats (10 to 100 U/g of dust). Comparisons of Fel d I and mite and pollen allergen levels showed that house dust can contain greater than 100 micrograms/g of either of these allergens and is a potent source of foreign environmental antigens. Monoclonal affinity chromatography provides a major breakthrough in the purification of Fel d I, from a source material that would otherwise have been considered impossible (house dust). The mAb assay for Fel d I is both more sensitive and more easily standardized than existing techniques. These techniques will allow full structural and antigenic analysis of Fel d I and more detailed studies on the relationship between cat antigen exposure and the development of asthma. PMID- 3276781 TI - Granulocyte/macrophage colony-stimulating factor induces interleukin 1 production by human polymorphonuclear neutrophils. AB - The purpose of this study was to determine whether human polymorphonuclear neutrophils (PMN), which share a common cell lineage with macrophages, could produce factors such as IL-1. We show by Northern blot analysis and bioassays that PMN can be induced to accumulate mRNA specific for IL-1 alpha and IL-1 beta indistinguishable in size from IL-1 mRNA synthesized by activated human macrophages and consequently to release IL-1-like activity in their culture supernatants, that could be neutralized by a mAb to IL-1. The granulocyte macrophage colony-stimulating factor was identified as a major physiologic inducer for PMN-IL-1. PMID- 3276782 TI - Recombinant human tumor necrosis factors alpha and beta stimulate fibroblasts to produce hemopoietic growth factors in vitro. AB - The influences of TNF alpha and TNF beta were evaluated for their stimulatory and inhibitory effects on in vitro colony formation by human bone marrow granulocyte macrophage (CFU-GM), erythroid (BFU-E), and multipotential (CFU-GEMM) progenitor cells. Both TNF alpha and TNF beta induced fibroblasts to produce stimulators of CFU-GM, BFU-E, and CFU-GEMM in a dose-dependent fashion. Similar results were seen when equivalent concentrations of TNF alpha and TNF beta were used. Prior incubation of the TNF alpha and TNF beta with their respective antibodies inactivated the ability of the TNF preparations to induce the release of granulocyte-macrophage, erythroid, and multipotential colony-stimulating activity from fibroblasts. In addition, incubation of the TNF-induced fibroblast supernatant with antibody before colony assay resulted in enhanced colony formation, suggesting that the TNF carried over into the colony assay suppressed colony formation. Additional proof of this suppression by TNF was evident when TNF was added directly to the CFU-GM, BFU-E, and CFU-GEMM colony assays. IL-1 does not appear to function as an intermediary in growth factor production by fibroblasts stimulated with TNF because antibody to IL-1 displayed no effect. Furthermore, assay of TNF-induced fibroblast supernatant was negative for IL-1. These results suggest that TNF alpha and TNF beta exert both a positive and negative influence on in vitro hemopoietic colony formation. PMID- 3276783 TI - Pre-B cell generation potentiated by soluble factors from a bone marrow stromal cell line. AB - Two bone marrow stromal cell lines isolated from the adherent layer of a Dexter type long term bone marrow culture differ markedly in their hemopoietic support capacity. S17 supports myelopoiesis and the differentiation of early B cell precursors into B lymphocytes while S10 supports myeloid cell differentiation and not B lymphopoiesis. The identification of a stromal cell line with B cell support capacity prompted an investigation of whether the effects of S17 were mediated via soluble factors. Results presented herein indicate that medium conditioned by S17 but not S10 contains an activity that can induce the expression of the 220,000 m.w. 14.8 antigen and cytoplasmic mu H chain of Ig in B lymphocyte progenitors that have not yet expressed these markers. Bone marrow cells were depleted of 14.8+, cytoplasmic mu+ pre-B cells on antibody-coated petri dishes. After 24-h liquid culture newly generated pre-B cells were enumerated as cells that expressed cytoplasmic mu H chain of Ig but not Ig L chains by immunofluorescence. Expression of Ly5(220) was monitored by 14.8 antibody binding. This pre-B cell differentiation activity was abrogated by digestion with pronase, aminopeptidase, or carboxypeptidase. Isoelectric focusing data revealed the activity to have isoelectric point of 5.9 to 6.2. S17 conditioned medium was fractionated using HPLC and each fraction tested for pre-B cell-generating activity. Fractions collected from a Superose 12 gel filtration column were found to have two peaks of activity associated with molecules of apparent m.w. of approximately 60,000 and 10,000. Virtually identical peaks of activity were observed when medium conditioned by heterogeneous stromal cell cultures was fractionated. Separation of S10-conditioned medium revealed no cryptic activity. S17-conditioned medium was further characterized by anion exchange chromatography and the majority of the pre-B cell generating activity shown to be associated with the void volume that eluted from a MonoQ column. These fractions were rechromatographed on Superose and the activity again found to be associated with two fractions corresponding to apparent m.w. of 60,000 and 10,000. The S17 pre-B cell differentiation activity appears to result from the presence of a novel molecule because other well characterized mediators had no activity in this short-term liquid culture system. No pre-B cell-generating activity was observed when IL-1 or conditioned medium containing IL-2, IL-3, or IL-4 (B cell stimulatory factor 1) were added to cultures.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3276784 TI - Molecular mechanisms involved in T cell activation. III. The role of extracellular calcium in antigen-induced lymphokine production and interleukin 2 induced proliferation of cloned cytotoxic T lymphocytes. AB - The role that extracellular calcium plays in activating resting cloned cytotoxic T lymphocytes (CTL) to proliferate and to produce lymphokines was examined. In these cells, stimulation with interleukin 2 (IL-2) induced a proliferative response without a concomitant production of macrophage-activating factor (MAF), whereas stimulation with antigen or lectin (in the absence of IL-2) induced MAF production but not proliferation. In the case of IL-2-induced proliferation, extracellular calcium was required to initiate proliferation as well as to prevent cellular arrest later in the G2 + M phase of the cell cycle. In MAF production extracellular calcium was required both to activate the phosphatidylinositol signal-transducing mechanism and to mobilize intracellular calcium in antigen- or lectin-stimulated cytotoxic T lymphocytes. Further, extracellular calcium was required for only 8 of the 18 hr of stimulation time which was needed to achieve maximal MAF production, indicating that both calcium dependent and -independent events exist in the signal pathway. Additional experiments with calcium ionophores and activators of protein kinase C indicated that although both intracellular calcium mobilization and de novo protein phosphorylation are involved in MAF production, an optimal increase in the level of intracellular calcium by itself is insufficient to induce the production of this lymphokine. PMID- 3276785 TI - Heart-reactive antibodies in rabbit anti-Streptococcus mutans sera fail to cross react with Streptococcus mutans. AB - Immunization of rabbits with Streptococcus mutans antigens results in the production of serum antibodies that bind in vitro to human, rabbit, and monkey cardiac muscle. Antibodies to heart, however, have also been reported to occur at lower titers in the sera of unimmunized rabbits. In this study, the specificities of heart-reactive antibodies (HRA) in sera of unimmunized and S. mutans-immunized rabbits were compared using indirect immunofluorescence, Western blot, and Bio Dot immunoassays. Both groups of sera gave striational indirect immunofluorescence-staining patterns on thin sections of native human and monkey cardiac muscle. Western blot analyses revealed that antibodies in normal sera bound 9 to 20 components of human, rabbit, and monkey heart. The major bands had Mr of 205,000, 160,000, 135,000, and 70,000. Several of the normal sera did not have antibody activity to S. mutans antigens, indicating that these HRA do not cross-react with these bacteria. Although immunization of rabbits with S. mutans caused increased titers of HRA (two to three doubling dilutions), Western blot assays using anti-S. mutans sera showed banding patterns qualitatively similar to those of normal sera on heart extracts. Antibodies to skeletal muscle myosin were detected in both serum groups. Of eighteen normal rabbit sera sixteen had antimyosin titers of 10 to 40, whereas all eighteen anti-S. mutans sera had titers of 10 to 160. Affinity-purified antimyosin antibodies isolated from anti S. mutans serum did not bind to S. mutans components. Conversely, affinity purified antibodies to S. mutans antigens did not bind to myosin or to other cardiac muscle components. Among these were antibodies to the 185-kDa cell wall protein (also known as B, I/II, IF, Spa A, and P1) previously believed to possess antigenic mimicry. HRA were removed from anti-S. mutans sera by absorption with S. mutans but this effect was not specific, because a non-cross-reactive internal standard antibody was also absorbed to the same extent. Because previous evidence for antigenic mimicry between S. mutans and cardiac muscle was based on serum cross-absorption experiments, this immunologic relationship is not substantiated. These results indicated that naturally occurring antibodies to cardiac muscle components are present in the sera of unimmunized rabbits and that immunization with S. mutans does not stimulate production of new heart-reactive antibody, but rather serves to boost antibody production by preexisting clones of self-reactive B-lymphocytes. PMID- 3276786 TI - Transcriptional regulation of the interferon-beta 2/B cell differentiation factor BSF-2/hepatocyte-stimulating factor gene in human fibroblasts by other cytokines. AB - Levels of mRNA for IFN-beta 2/B cell differentiation factor2/hepatocyte stimulating factor (IFN-beta 2) in confluent quiescent cultures of human diploid fibroblasts (FS-4 strain) are enhanced by TNF, IL-1 alpha and beta, platelet derived growth factor (PDGF) and IFN-beta 1. Of these cytokines, IL-1 alpha and beta cause a particularly strong increase in the accumulation of IFN-beta 2 mRNA in fibroblasts. We have evaluated whether the IFN-beta 2 gene is regulated at the transcriptional level by using nuclear run-on transcription assays. We observed that the IFN-beta 2 gene is transcribed at a low level in uninduced FS-4 cells and that this transcriptional activity is increased 2- to 3-fold in cycloheximide treated cells, 20- to 35-fold in IL-1 alpha-treated cells, and 5- to 15-fold in TNF-treated cells. PDGF and IFN-beta 1 enhance transcription across the IFN-beta 2 gene 2- to 3-fold. The enhancing effect of IL-1 alpha on IFN-beta 2 gene transcription, but not that of TNF, PDGF, or IFN-beta 1, is inhibited by cycloheximide, suggesting that newly-synthesized protein is involved in the increase in IFN-beta 2 transcription in response to IL-1 alpha but not in the response to the other stimuli. Furthermore, the enhancement of IFN-beta 2 transcription is sustained for up to 14 h after IL-1 alpha induction but is transient and declines to base line levels within 6 h after TNF addition. These observations suggest that there are important differences in the mechanisms by which IL-1 alpha and TNF increase IFN-beta 2 gene transcription in fibroblasts. PMID- 3276787 TI - T11/CD2 activation of cloned human natural killer cells results in increased conjugate formation and exocytosis of cytolytic granules. AB - The T11 (CD2) antigen has been found to be an alternate pathway for antigen independent activation of resting T cells. T11 triggering also results in activation of NK cells and enhancement of their cytolytic function. The present studies were carried out to further define the mechanisms whereby cytotoxicity is enhanced after T11 activation. A series of clonal human NK cell lines were analyzed after incubation with monoclonal anti-T112 and anti-T113 antibodies specific for different epitopes of the CD2 protein. Anti-T112/3 triggering resulted in increased cytotoxicity against a variety of target cells. Similar results were obtained with F(ab')2 fragments of anti-T112/3, indicating that this effect was not mediated through binding of FcR. The induction of cytotoxicity was found to be associated with increased formation of effector cell-target cell conjugates and with release of secretory granule-localized 35S-labeled proteoglycans. Both enhanced conjugate formation and cytotoxicity could be blocked by anti-lymphocyte function-associated antigen (LFA-1) mAb. Ultrastructural analysis of NK cells after T11 activation demonstrated increased adherence of effector cells to targets and other NK cells as well as a directional reorientation of cytoplasm and intracellular granules toward the area of contact between cells. Discharge of granules occurred into pockets bounded by closely apposed plasma membranes. In the presence of anti-LFA-1 and anti-T112/3, the close apposition and formation of pockets between effector cells and target cells did not occur but the cells exocytosed their intracellular granules. T11 activation of NK cloned cells also resulted in the formation of the homotypic conjugates and autocytotoxicity. As seen with resistant allogeneic targets, autocytotoxicity was mediated by F(ab')2 fragments of T112/3 antibodies and could be blocked by anti-LFA-1 antibody. Ultrastructural analysis of NK cloned cells after T11 activation confirmed the presence of homotypic conjugates with reorientation of effector cells toward one another and discharge of cytolytic granules into pockets formed between NK cloned cells. Taken together, these results indicate that T11-induced cytolytic function of NK cells is, in part, mediated through increased binding of effector cells and targets and that enhanced conjugate formation is at least in part mediated by the LFA-1 antigen. In addition, T11 activation results in the triggering of the cytolytic mechanism of NK cells and the exocytosis of cytolytic granules and their constituents. PMID- 3276788 TI - Two-site immunoenzymometric assays for serum IgG subclass infant/maternal ratios at full-term. AB - Improvements were made in the range, precision, convenience, automation, and reliability of our previously published two-site immunoenzymometric assays using mouse monoclonal antibodies specific for human IgG and its subclasses. The serum concentration ratios for these immunoglobulin isotypes were measured in neonatal/maternal paired sera from 119 normal full-term deliveries. These ratios are significantly different than 1.0 (P = 0.001) for total IgG, IgG1, and IgG2 (show non-equality of paired neonatal/maternal sera concentrations) but are not significantly different than 1.0 for IgG3 and IgG4. On average, IgG1 is elevated 61%, and IgG2 is depressed 11% in the full-term neonate with respect to its own mother. In some pregnancies, active transport of IgG1 may be selectively enhanced by low material IgG1 concentration and selectively inhibited by high levels. PMID- 3276789 TI - A simple and sensitive enzyme immunoassay for determination of soluble type specific polysaccharide from group B streptococci. AB - A method was developed for the determination of soluble group B streptococcal type-specific polysaccharide in diluted culture supernatant. The type-specific antigen was immobilized to the solid phase of an enzyme immunoassay using wheat germ agglutinin as a link between the plastic surface and the polysaccharide. The binding of monovalent rabbit antiserum to the type-specific polysaccharide was quantitated by an anti-rabbit IgG-enzyme conjugate. Antisera against each of the polysaccharide types Ia, Ib. II and III gave strong and specific reactions against the respective antigen. The ultimate sensitivity of the assay was 70 pg/ml, as determined for type III polysaccharide. Using this technique, it was found that the concentration of soluble type-specific antigen in a GBS, type III culture supernatant reached a steady-state approximately 3 h after the beginning of the stationary growth phase of the bacteria. Ten type III strains were investigated for synthesis of type-specific polysaccharide, and a positive correlation between the production of capsular and soluble type III antigen was found. There was also an inverse correlation between soluble antigen production and the buoyant densities of these strains. The method described may be used for the serotyping of encapsulated GBS and/or determination of soluble type-specific antigen synthesis. PMID- 3276790 TI - Detection of human white cell proliferative responses by immunoenzymatic measurement of bromodeoxyuridine uptake. AB - The proliferative response of human white cells to stimuli such as foreign histocompatibility antigens or mitogens is traditionally assessed by measuring the amount of [3H]thymidine which the cells can incorporate in culture. In the present paper a new approach is described in which bromodeoxyuridine (BrdUrd) is used in place of thymidine and measurement of incorporation of this molecule is performed by an immunoenzymatic assay (using monoclonal anti-BrdUrd). The procedure avoids the expense, time and hazards associated with scintillation counting, and is simpler to perform. It also appears to be particularly sensitive to low levels of proliferation, and may thus detect such responses more effectively than thymidine incorporation. PMID- 3276791 TI - The use of Tween 20 alone as a blocking agent for immunoblotting can cause artefactual results. AB - The use of Tween 20 as a suitable blocking agent in immunoblotting studies was evaluated by screening a panel of monoclonal antibodies (MoAbs) against a selection of blotted proteins which were unrelated to the antigens used to raise the MoAbs. Using Tween 20 alone to block the nitrocellulose membranes clear reactions were observed between the panel of MoAbs and several components of the blotted protein mixture. In contrast, when haemoglobin was used to block the membranes such reactions were not observed. In the absence of added protein the use of Tween 20 alone as a blocking agent for immunoblotting appears to lead to false positive reactions by non-specific antigen-antibody complexes. PMID- 3276792 TI - An easy and rapid method to screen large numbers of antibodies against internal cellular determinants. AB - A rapid and easy method is described to screen great numbers of antisera or antibodies against internal cellular antigens including viral antigens or to screen various target cells for proper expression of antigens; the method can also be applied to determine fluorescent foci to enumerate non-cytopathic viruses. Cells, infected with a particular virus or uninfected, adhering to flat bottomed 96-well microtiter plates were fixed with conventional phosphate buffered saline containing 4% formaldehyde for 10 min, alternatively, cells were first fixed with 3% paraformaldehyde for 10 min and were then treated with Trition X-100 for another 10 min. After two washes, either fluorescein-labelled antiviral antibodies or first antiviral antibodies followed by labelled anti species antibodies were applied, incubated and washed off as usual. A few drops of a balanced salt solution were kept in the well and were drained off gently just before the plates were examined. The plates were viewed directly in an inverted UV microscope or were inspected and photographed bottoms up with a conventional UV microscope mounted with an old-fashioned uncorrected objective (20 X) which, because of its shorter length, permitted proper focussing. For most cases studied, sensitivity was comparable to the fluorescence analysis method of cells on slides. The plates could be stored for several months in a dark refrigerator if kept moist. The method is rapid because it avoids individual handling of samples for the washing procedures and does not need growing and mounting of cells on slides; up to 1000 samples can be tested by one person in a day. PMID- 3276793 TI - Quantitation of proteins by dot-immunobinding assay. A comparison of visualization methods using eukaryotic initiation factor 2 and a monospecific antibody. AB - Various visualization methods were compared for quantitation of proteins by the dot-immunobinding assay. Comparisons were carried out using a multi-subunit protein, eukaryotic initiation factor 2, and monospecific antibodies directed against two of the factor's subunits. The protein was spotted onto nitrocellulose and the membranes were incubated with primary antibody. The antigen-antibody complex was visualized by one of six methods using either alkaline phosphatase-, horseradish peroxidase-, or glucose oxidase-conjugated IgG, or colloidal gold labelled IgG, colloidal gold-labelled IgG with silver enhancement, or 125I labelled protein A. The amount of secondary antibody bound was quantitated by densitometric scanning of the nitrocellulose membrane after staining or autoradiography. The sensitivity of each of the methods was similar; each of the visualization methods could detect less than 1 ng of protein by the dot immunobinding assay. Curves of protein concentration vs. densitometric absorbance were found to fit a parabolic relationship (r2 = 0.99) over a wide range of concentrations. PMID- 3276794 TI - The use of a fluorescent lipid as a non-covalent bound tracer of integral membrane proteins. AB - Solubilized and affinity purified major histocompatibility class I and class II antigens (MHC-I, MHC-II) were incorporated into liposomes, which contained a fluorescent lipid, by adsorption of the detergent to Biobeads SM-2. The fluorescent lipid was used as a non-covalently bound tracer to detect antibody mediated agglutination of liposomes with MHC antigens. After incorporation of the membrane proteins into liposomes of different lipid composition, phosphatidylcholine was chosen as a lipid matrix. The use of a fluorescent lipid as a tracer of membrane proteins was demonstrated by the detection of human beta 2-microglobulin association with mouse MHC-I. Furthermore the method was used to measure the amount of liposomes containing two different membrane proteins. PMID- 3276795 TI - An inhibition enzyme immunoassay for estimating relative antibody affinity and affinity heterogeneity. AB - A method to measure the relative affinity of antibodies using an inhibition enzyme immunoassay is described. It is validated using monoclonal antibodies of defined affinity characteristics and by comparison with conventional methods of affinity measurement. The method allows measurement of the relative affinity of low levels of antibody, and the calculation of an empirical estimate of the heterogeneity of affinity in antibody populations. PMID- 3276796 TI - Improved quantitation of delayed-type hypersensitivity responses to sheep erythrocytes in the mouse footpad by estimation of 125I-fibrin deposition. AB - Footpad swelling in response to subcutaneous antigen challenge is widely used to assess delayed-type hypersensitivity responses to xenogeneic erythrocytes in mice. We report here that quantitation of the deposition of 125I-fibrin, compared with that of 125I-human serum albumin, following intravenous isotope administration, provides a less subjective, convenient and antigen specific index of cell-mediated immunity. Moreover, the results obtained correlate well with in vitro assessment of antigen-specific T cell responses. PMID- 3276797 TI - A reliable method for the analysis of human MHC class II alpha and beta chains by Western blotting of IEF gels. AB - The solubility and ensuing transfer problems associated with IEF separation and blotting of membrane proteins have been eliminated by confining NP40 to the sample region of the gel and replacing it with octylglycoside in the separating gel. This permitted excellent separation of both the alpha and beta chains of the human MHC antigens and their subsequent detection by Western blotting. PMID- 3276798 TI - The extracellular matrix in pathology. PMID- 3276799 TI - A radiolabel ratio method for measuring pulmonary clearance of intratracheal bacterial challenges. AB - Calculation of bacterial clearance is a fundamental step in any study of in situ lung antibacterial defenses. A method is described whereby about 85% of a radiolabeled bacterial inoculum was consistently introduced into the bronchopulmonary tree of a mouse by the intratracheal route. Mice were then killed 1 and 4 hours later; their lungs were removed aseptically and homogenized, and viable bacteria and radiolabel counts were determined. Radiolabel counts fell slowly, and more than 80% of the original radiolabel was still present in homogenized lung samples from animals sacrificed 4 hours after challenge. Bacteria/isotope ratios for the bacterial inoculum and homogenized lung samples from animals sacrificed immediately after challenge were very similar. Bacterial clearance values were the same whether computed from bacterial counts alone or according to a radiolabel ratio method whereby the change in the bacteria/isotope ratio in ground lung aliquots was divided by a similar ratio from bacteria used to inoculate animals. Some contamination resulted from oral streptococci being swept into the bronchopulmonary free during the aspiration process. This contamination was not a problem when penicillin was incorporated into the agar and penicillin-resistant strains were used for the bacterial challenges. PMID- 3276800 TI - Transvascular flux and tissue accrual of Evans blue: effects of endotoxin and histamine. AB - We investigated the relationship between the pharmacokinetics of exogenous molecules and transcapillary flux by studying the intravascular and tissue content and the histologic distribution of Evans blue in guinea pigs. Pharmacokinetic analysis demonstrated that 87% of the decline in intravascular Evans blue during the first 3 hours after administration was a result of transvascular flux to tissue compartments. Rapidly and slowly equilibrating compartments were identified. Greater than 90% of the clearances in lung and heart were rapid compartment clearances. Histologically, the distribution of Evans blue in these tissues was predominantly extracellular and similar to the distribution of fluorescein-labeled dextran. By contrast, the accumulation in kidney and liver was kinetically similar to characteristics of the slowly equilibrating compartment. This corresponded histologically to the predominant intracellular uptake of Evans blue in these tissues. Generalized increases in capillary permeability were produced by endotoxin or histamine infusion. Both treatments were associated with a more rapid initial decline in intravascular content of Evans blue than was found in control animals. Although the histologic distribution of Evans blue in tissues was not altered, endotoxin was associated with a more rapid appearance of Evans blue in the lung and heart than was seen in controls. We conclude that the initial decline in intravascular content of Evans blue corresponds to the intercompartmental clearance and to transcapillary macromolecular flux. The initial decline in serum concentrations may therefore be useful in studying disorders of generalized capillary permeability. Furthermore, the initial accrual of Evans blue in the lung and heart may be used as a marker of transcapillary macromolecular flux in those tissues. PMID- 3276801 TI - Evaluation of bone marrow megakaryocyte ploidy distributions in persons with normal and abnormal platelet counts. AB - Using bone marrow smears of the type prepared routinely in clinical practice, we determined megakaryocyte ploidy distributions in five normal persons, eight patients with both normal platelet counts and normal bone marrow morphology, and 18 patients with quantitative platelet disorders. To include 2N and 4N megakaryocytes in the ploidy distribution histograms, all megakaryocytes were identified by serial immunologic labelling with rabbit antiserum to human platelet glycoproteins and rhodamine-conjugated goat anti-rabbit igG. Cell nuclei were concurrently Feulgen stained with bis-aminophenyl-oxdiazole, and the nuclear fluorescent signals were quantified photometrically. A modal megakaryocyte ploidy value of 32N was seen in 10 of the 13 persons with normal platelet counts, and geometric mean megakaryocyte ploidy values averaged 24.9N +/- 7.0N (arithmetic mean +/- SD). In these normal control individuals, 2N and 4N megakaryocytes accounted for 11.1% of all megakaryocytes, and 2.6% of the megakaryocytes were 128N. Shifts to a higher mean ploidy were observed in five of seven patients with idiopathic thrombocytopenic purpura, resulting from increased percentages of 64N and 128N megakaryocytes at the expense of 4N, 8N, and 16N cells. Shifts to lower ploidy were demonstrated in two patients with acute myelogenous leukemia and one patient each with thrombotic thrombocytopenic purpura and isoimmune thrombocytopenia. Four of five patients with essential thrombocythemia had strikingly abnormal megakaryocyte ploidy histograms characterized by the presence of unusually high ploidy 256N and 512N megakaryocytes. These 256N and 512N cells were virtually unique to the patients with essential thrombocythemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276802 TI - Monoclonal antibodies reacting with placental protein 5: use in radioimmunoassay, Western blot analysis, and immunohistochemistry. AB - Monoclonal antibodies were raised reacting with placental protein 5 (PP5), a glycoprotein with properties of a serine protease inhibitor. Immunization was carried out with an antigen purified from late pregnancy placenta tissues. After fusion with myeloma cells, clones producing antibodies reacting with PP5 were isolated. Antibodies produced by two of the established hybridoma clones were characterized. The Ka of the antibodies was 0.22 x 10(9) L/mol and 0.3 x 10(8) L/mol. in Western blot analysis, both monoclonal antibodies reacted with the purified antigen that had a relative molecular weight (Mr) of 30 kd, but minor components of Mr 27 kd, 56 kd, and 62 kd were also identified. In polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate under reducing conditions, the purified protein yielded three polypeptides (Mrs of 16.4 kd, 16.8 kd, and 18.3 kd) that did not react with the monoclonal antibodies in Western blot analysis. By immunoperoxidase staining with monoclonal and polyclonal antibodies, PP5 was localized to the syncytiotrophoblast, cytotrophoblast, and endothelium of early and late pregnancy placenta tissues, whereas various other tissues were PP5-negative. In immunofluorescence staining, isolated endothelial cells were stained with both monoclonal antibodies. Endothelial cells in monolayer culture released into the medium a substance that is immunologically similar to purified PP5. PMID- 3276803 TI - Dr. Walter Heymann (1901-1985). PMID- 3276804 TI - Implications of the learning disabilities definition for the regular education initiative. PMID- 3276805 TI - Examining the research base of the regular education initiative: efficacy studies and the adaptive learning environments model. PMID- 3276806 TI - Redefining the applied research agenda: cooperative learning, prereferral, teacher consultation, and peer-mediated interventions. PMID- 3276807 TI - Pulsatile administration of gonadotrophin-releasing hormone stimulates, in oestrogen-treated anaesthetized ovariectomized ewes, a surge release of LH qualitatively and quantitatively different from that induced by oestradiol in conscious ovariectomized ewes. AB - The nature of the gonadotrophin-releasing hormone (GnRH) stimulus of the pituitary necessary for the oestrogen-induced plasma LH surge was studied in ovariectomized ewes. The sheep were treated with oestradiol benzoate (50 micrograms i.m.) at 0 h, and the hypothalamic contribution to the LH surge was blocked by pentobarbitone anaesthesia over the time during which the surge was expected (11-31 h). Pituitary responsiveness to exogenous GnRH (100 ng) administered i.v. in a pulsatile mode (once per hour or once per 20 min) over the period 15-30 h was assessed from plasma concentrations of LH. Neither of the GnRH treatments induced patterns of LH secretion similar to those seen in conscious ovariectomized ewes given oestrogen only. Plasma LH secretion in response to hourly GnRH pulses was less (P less than 0.01) than that associated with oestrogen-induced plasma LH surges in conscious control ewes. With pulses of GnRH administered every 20 min the amount of LH released was greater (P less than 0.05) than that in oestrogen-treated conscious control ewes. In contrast to the single surge induced by oestradiol in conscious ewes, GnRH pulses given every 20 min elicited phasic patterns of LH secretion consisting of two or three distinct surges. The failure of GnRH treatment to elicit an LH surge similar to an oestrogen-induced surge could reflect inappropriate GnRH treatment regimens, and/or inadequate priming of the pituitary with GnRH after induction of anaesthesia but before GnRH treatment. PMID- 3276808 TI - How much androgen is required for maintenance of spermatogenesis? PMID- 3276809 TI - Detection of and screening for endometrial cancer. AB - Endometrial cancer occurs more than twice as frequently as cervical cancer. The main risk factors are age, estrogen use, and obesity. Increasing life expectancy and more liberal use of estrogen to prevent postmenopausal bone loss will probably increase the magnitude of the problem. Endometrial cancer is a heterogeneous disease. Good prognosis is associated with obesity and estrogen use and with carcinomas preceded by precancerous hyperplasia. A bad prognosis may be found in women without major risk factors and is associated with a normal or atrophic endometrium. Because of a high prevalence of asymptomatic disease (6.9 per 1,000) and because the group with a poor prognosis is usually asymptomatic, all postmenopausal women should be screened at least one time. For screening, the use of one of the cytologic instruments is recommended; these instruments are safe, easy to handle, and can be used in the office setting without anesthesia. Yields are comparable to dilation and curettage. Family physicians are encouraged to familiarize themselves with cytologic instruments and to use them for screening postmenopausal women in their office. PMID- 3276810 TI - Responses to questions by medical students about family practice. AB - Medical students frequently have questions about the specialty of family practice. Responses to 30 questions commonly asked about family practice are presented with a review of recent literature. These responses may assist medical students and their advisors in considering the choice of family practice as a career. PMID- 3276811 TI - A preventive approach to the suicidal patient. AB - Physicians may have the opportunity to prevent suicide. An awareness of suicide risk factors, such as depression, alcoholism, drug abuse, schizophrenia, and chronic pain or disease, may facilitate suicide prevention. Recognition of acute and chronic suicidal vulnerability occurs through direct questioning. Psychiatric consultation is indicated for patients exhibiting clear self-injury risk, as exemplified by expressed suicide intent, an overt plan for death, or a "gesture." Hospitalization is usually recommended for socially isolated patients presenting with overt suicidal ideation, complicated by injurious self-harm, encephalopathy, or substance abuse. Family involvement and a "no-suicide" contract with the patient, coupled with close outpatient follow-up appointments, should suffice for those exhibiting milder or transient thoughts of suicide without manifest intent to die. PMID- 3276812 TI - Stridor in infants and children. PMID- 3276813 TI - Reactive psychosis. I. Does the pre-DSM-III concept define a third psychosis? AB - Reactive psychosis, schizoaffective disorder, and schizophreniform disorder have each been considered as possible third psychoses that are separate from schizophrenia and the affective psychoses. We review the history of one of these diagnoses, reactive psychosis, and critique studies that attempt to validate the category. Studies using modern research methods with well-defined criteria based on experience with patients who have received this diagnosis should test this category more rigorously. The salient features of the diagnosis are delineated by considering the rationale for its existence and examining the empirical form it has taken. In a second paper, we explore how these features may form a basis for criteria that may provide a more meaningful category in subsequent revisions of the DSM. PMID- 3276814 TI - Reactive psychosis. II. Does DSM-III-R define a third psychosis? AB - The DSM-III and DSM-III-R criteria for "brief reactive psychosis" change the original concept of this disorder in a manner so restrictive as to virtually eliminate the diagnosis. In a companion paper to this one, we have reviewed the original concept and data supporting further study of this classification. We now argue that the operational criteria of the DSM-IIIs do not enhance the study of this putative disease entity, but rather thwart this goal by restricting the diagnosis so severely that too few cases will be found to test the third psychosis hypothesis. We suggest revised criteria that will retain the essential features of the traditional concept while defining explicit criteria in the style of the DSM-IIIs. PMID- 3276815 TI - Mechanisms of mania after brain injury. 12 case reports and review of the literature. AB - Twelve patients who developed mania after a brain lesion are reported. Ages ranged from 20 to 83 years. Five patients had brain tumors (three frontal meningiomas, one temporal meningioma, and one temporal astrocytoma), four patients had stroke lesions (one frontal, one temporal, and two thalamocapsular), two patients had a traumatic frontal closed head injury, and one patient had a pituitary adenoma resection. Although seven patients had lesions restricted to the right hemisphere, four had bilateral or midline damage and one had a left hemisphere lesion. Damage to structures functionally connected to the obitofrontal cortex, mainly in the right hemisphere, seems to be associated with secondary mania. The possible roles of monoaminergic, genetic, and perinatal factors in the pathogenesis of secondary mania are discussed. PMID- 3276816 TI - Transient and persistent depolarization-induced changes of protein phosphorylation in a molluscan nervous system. AB - Phosphoproteins in the CNS of the nudibranch mollusc, Hermissenda crassicornis, were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography. After preincubation in artificial sea-water containing 32P, nervous systems were exposed to elevation of external K+ (100 or 300 mM) for a period (e.g., 30 min) approximating a period of depolarization which occurs during classical conditioning. Elevated external K+ was found to change the state of phosphorylation of three distinct proteins (Mr 56,000, 25,000, and 20,000) in three distinct ways without consistently changing that of any other proteins. Phosphorylation of an Mr 56,000 protein was increased by high K+ about twofold only in the presence of external Ca2+ [( Ca2+]o). Phosphorylation of Mr 25,000 protein, on the other hand, was decreased up to 10-fold by high K+, irrespective of the level of [Ca2+]o. The effect of depolarization on Mr 25,000 protein phosphorylation most likely represents dephosphorylation rather than proteolysis. This interpretation is consistent with the observations that (a) reappearance of the Mr 25,000 protein occurred in the presence of the protein synthesis inhibitors cycloheximide, puromycin, or anisomycin, and (b) the Hermissenda nervous system apparently contains a NaF- and EDTA-sensitive protein phosphatase capable of dephosphorylating Mr 25,000 protein. High K+ also reduced Mr 20,000 protein phosphorylation which was dependent on [Ca2+]o even in normal low K+ (10 mM) medium. Removal of [Ca2+]o enhanced reduction of Mr 20,000 phosphorylation due to the high K+ treatment. Interestingly, reduction of the Mr 25,000 protein phosphorylation was long-lasting, i.e., its phosphorylation did not fully recover to a control level for at least 30 min after the high K+ conditions had been removed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276817 TI - A brief history of neurochemistry in Britain and of the Neurochemical Group of the British Biochemical Society. PMID- 3276818 TI - Spinal cord trauma: in search of the meaning of granular axoplasm and vesicular myelin. AB - The rapid appearance of selective axonal calcification following experimentally induced spinal cord impact injury has suggested that there is a sudden influx of intracellular calcium which mediates many of the pathological changes subsequent to the trauma. Granular dissolution of axoplasm and vesicular disruption of myelin are the most characteristic alterations in the affected white matter. These changes, which appear early and progress, are identical to those that can be induced by exposing myelinated axons to increased extracellular calcium or to calcium ionophores. These observations have led us to develop the hypothesis that calcium mediates the destruction of traumatized axons in the spinal cord by stimulating calcium-activated neutral proteinases (CANP), which in turn degrade axonal and myelin proteins. A rapid increase in CANP activity has been demonstrated in our experimental rat trauma model and a CANP has been isolated from rat spinal cord myelin which degrades both neurofilament and myelin proteins. However, the interpretation of the role of calcium has been complicated by the fact that granular axoplasm and vesicular myelin can be induced under conditions other than those favorable for CANP enhancement. The ultimate proof of the calcium hypothesis will depend on analyzing early intracellular ionic fluxes and correlating these with the localization of calcium-mediated enzymes and the evolution of pathological events. PMID- 3276820 TI - The epipodophyllotoxin teniposide in therapy for childhood acute lymphocytic leukemia. PMID- 3276819 TI - Anesthetic mishaps and the cost of monitoring: a proposed standard for monitoring equipment. AB - Review of insurance data indicates that approximately 1.5 claims are paid per 10,000 anesthetic procedures, a conservative estimate of the incidence of preventable serious injury associated with anesthesia. Insurance data permit estimation of the premium cost for the anesthesiologist and hospital, per operating room per year, of $69,429.00. We propose the use of an enhanced monitoring standard requiring a pulse oximeter, capnograph, spirometer, halometer, automatic sphygmomanometer, breathing circuit oxygen analyzer, stethoscope, electrocardiographic monitor, and temperature monitor. We suggest that this premium cost, together with the estimate that 50% of incidents would be avoided, predicts a resultant saving of over $27,000/operating room/year, a savings equal to the entire cost of the enhanced monitoring system in approximately 8 months, or a yearly savings of over five times the annualized expense of the monitoring system. Thus, in addition to the moral imperative to monitor a patient during anesthesia to avoid injury and death, there is an economic incentive to monitor effectively. PMID- 3276821 TI - Protein A immunoadsorption in the treatment of malignant disease. AB - Circulating immune complexes (CIC) are known to be present in cancer patients and are responsible for much of the cancer-associated immunosuppression. Removal or modulation of these "blocking factors" can reverse the immunosuppression. Protein A from Staphylococcus aureus has the unusual property of binding to CIC with high avidity. Use of protein A as an immunoadsorbent in extracorporeal immunotherapy affinity columns has resulted in antitumor and antiviral responses in animals. Our group developed a multicenter trial to assess toxicity and antitumor response with this biologic response modifier alone. Overall, 24% (21 of 87 patients) had objective tumor regressions including both partial responses (PR) and less than PR. No complete responses (CR) were observed. Responses were observed in acquired immune deficiency syndrome (AIDS)-related Kaposi's sarcoma (six of 17 PR; two of 17 less than PR; overall, 47%), breast adenocarcinoma (five of 22 PR; three of 22 less than PR; overall response, 36%), colon adenocarcinoma, (one PR, one less than PR; overall response, 11%), and non-oat cell lung carcinoma (two of seven less than PR). The procedure was well tolerated and could be performed on an outpatient basis. No adverse reaction was observed in 735 of 1,113 treatments (66%). The most common adverse effect was an "influenza-like" syndrome consisting of fever and chills. Pain was present in 12% of the patients. There were no study related deaths. Serum IgG and CIC levels did not statistically change due to therapy in responding or nonresponding patients. Complement levels remained within the normal range. Liver and renal tests remained stable throughout the study. In summary, protein A immunoadsorption of plasma is well tolerated in the outpatient clinic, has demonstrated antitumor activity in resistant solid tumors, and functions as a biologic response modifier. PMID- 3276822 TI - Allogeneic bone marrow transplantation in adults with acute lymphoblastic leukemia in first complete remission. AB - Twenty-seven patients ranging in age from 15 to 36 years participated in a pilot study, and underwent allogeneic bone marrow transplantation (BMT) for acute lymphoblastic leukemia (ALL) in first complete remission (CR) in four French centers. All patients were grafted from human leukocyte antigen/mixed leukocyte culture (HLA/MLC) identical sibling after conditioning regimen consisting of cyclophosphamide and total body irradiation (TBI). Sixteen patients are alive in persistent first remission, with a median follow-up of 56 months (range, 41 to 82 months). The 6-year Kaplan-Meier probability of disease-free survival (DFS) is 59%. Only three patients relapsed (5, 7, and 7 months after transplantation). These interesting results have led us to propose, in accord with a French multicentric protocol, allogeneic BMT for adults under 40 years of age during the first CR of ALL. PMID- 3276823 TI - The characteristics and outcome of patients with late relapse acute myelogenous leukemia. AB - The characteristics and outcome of 58 patients with acute myelogenous leukemia (AML) who experienced relapse after a first remission duration longer than 18 months (late-relapse AML) were analyzed and compared with those of 278 patients with earlier relapses. Late-relapse AML was associated with a lower incidence of antecedent hematologic disorder, leukocytosis, and elevated creatinine and lactic acid dehydrogenase (LDH) levels. A favorable karyotype (inversion of chromosome 16; translocations between chromosomes 8 and 21, or 15 and 17) was more frequent in patients whose first remission was 12 months or longer compared with less than 12 months (30% v 10%; P less than .0001). An unfavorable karyotype (chromosome 5 and 7 abnormalities, trisomy 8, other changes) was more frequent in the latter category (16% v 42%; P less than .0001). Thirty-seven of the 58 patients (64%) with late-relapse AML achieved complete remission (CR). The incidence of CR increased significantly with an increased first remission duration from less than 12, 12 to 18, and greater than 18 months (17% v 41% v 64%; P less than .0001), while the incidence of resistant disease was significantly lower (59% v 36% v 19%; P less than .0001). When effective antileukemic regimens were considered, remission rates were also significantly increased by the duration of first remission (24% v 48% v 72%; P less than .001). Compared with patients with earlier relapse, those with late-relapse AML had a longer median survival from salvage therapy (3.5 v 12 months; P less than .01), and longer median second remission durations (3.5 v 11 months; P less than .01). We conclude that late relapse AML has unique clinical, cytogenetic, and prognostic characteristics, and remains extremely sensitive to chemotherapy with a potential cure fraction. The duration of first remission is an important prognostic parameter in AML relapse and may be useful in the design and analysis of future salvage programs. PMID- 3276824 TI - Combination chemotherapy with mastectomy or radiotherapy for stage III breast carcinoma: a Cancer and Leukemia Group B study. AB - One hundred thirteen evaluable patients with previously untreated stage III breast carcinoma were treated with three monthly cycles of cyclophosphamide (CYC), doxorubicin (DOX), 5-fluorouracil (5-FU), vincristine (VCR), and prednisone (PRED) (CAFVP). Subsequently, 91 (81%) were deemed operable. Patients were then randomized to receive surgery or radiotherapy (RT) to determine which of these modalities afforded better local tumor control. All patients also received 2 additional years of CAFVP in a further attempt to eradicate local disease and systemic micrometastases. Forty-one of the randomized patients have relapsed. Approximately half of the initial relapses in each arm were local. The overall duration of disease control was similar following either modality, with a median of 29.2 months for surgery patients and 24.4 months for RT patients. Similarly, there was no major difference in survival related to randomized treatment with an overall median of 39 months (median follow-up 37 months). Pre- or perimenopausal status and inflammatory disease were associated with shorter disease control and survival. Treatment was generally well tolerated and toxicity was acceptable. This study demonstrates that prolonged control of stage III breast carcinoma can be achieved with combined modality therapy in which cytotoxic chemotherapy precedes and follows treatment directly primarily at the breast tumor, using either surgery or RT. Nevertheless, new regimens must be designed if significant advances that may lead to the cure of this disease are to be achieved. PMID- 3276825 TI - Prediction of long-term survival by flow cytometric analysis of cellular DNA content in patients with advanced ovarian cancer. AB - The prognostic value of cellular DNA content in ovarian cancer (malignant common epithelial tumors) was investigated by flow cytometric analysis of paraffin embedded tumor blocks from 128 previously untreated patients with International Federation of Gynecology and Obstetrics (FIGO) stage III and IV ovarian cancer entered in a prospective clinical trial of combination v sequential therapy with chlorambucil and cisplatin. Seventy-three percent of tumors were aneuploid and 27% were diploid. Multivariate analysis using a Cox model showed that cellular DNA content (P less than .001) and FIGO stage (P less than .02) were the only significant independent prognostic variables. The median survival was 13 months for patients with aneuploid tumors and 60 months for patients with diploid tumors (P less than .0001). Further analysis indicated that the good prognosis associated with diploid tumors was limited to patients with stage III disease, all patients with stage IV (spread beyond the peritoneal cavity or liver metastases) disease having a poor prognosis irrespective of ploidy. On pathological review, nine borderline ovarian tumors (of low malignant potential) were identified, and seven of these were diploid. These tumors have an unusually favorable prognosis, despite apparent dissemination within the peritoneal cavity, a paradox which is often difficult to explain using conventional histological criteria. Although the vast majority of tumors in this study (93%) were classified as invasive epithelial ovarian cancers, it is possible that some of the patients with stage III diploid tumors may have had malignancies that were predominantly of low malignant potential, thus accounting in part for the prognostic significance of DNA content. By incorporating flow cytometric DNA analysis with careful histopathological assessment, it may be possible to better identify patients with an inherently good prognosis. This assumes particular importance, as the relatively favorable prognosis of patients with stage III diploid ovarian tumors appears to be independent of the type of treatment. PMID- 3276826 TI - Phase II testing of melphalan in children with newly diagnosed rhabdomyosarcoma: a model for anticancer drug development. AB - We describe events that led to successful testing of melphalan, one of the nitrogen mustard compounds, in children with newly diagnosed, poor-risk rhabdomyosarcoma (RMS). Preclinical studies with xenografts of human RMS, growing in the flanks of immune-deprived mice, had indicated superior oncolytic activity by melphalan compared with other agents commonly used to treat this tumor. However, in a conventional phase II trial, melphalan failed to produce partial responses in 12 of 13 heavily pretreated patients with recurrent tumors. Subsequent comparison of the drug's pharmacokinetics in mice and patients indicated that its poor clinical performance was not the result of interspecies differences in drug disposition. Therefore, we elected to retest melphalan in untreated patients, before they were enrolled in a phase III study. Of 13 children who received the drug for 6 weeks, ten had partial responses, confirming the significant antitumor activity seen in the xenograft system. These findings illustrate the inherent limitations of phase II drug trials in previously treated patients and suggest a useful paradigm for the development of antineoplastic drugs. PMID- 3276827 TI - Teniposide in the treatment of leukemia: a case study of conflicting priorities in the development of drugs for fatal diseases. AB - Teniposide, a semisynthetic epipodophyllotoxin, was found to be highly active against murine leukemias, and the combination of teniposide with cytosine arabinoside (ara-C) was curative in murine leukemia models. The antitumor activity in preclinical models prompted introduction of teniposide into the clinic in 1971. Although teniposide as a single agent rarely produced a complete remission in heavily pretreated leukemia patients, teniposide plus ara-C produced complete remissions in some patients with refractory and relapsed acute lymphoblastic leukemia (ALL). Innovative front-line and salvage regimens using teniposide have been developed that incorporate a multi-drug strategy with early intensification, rotation of drug combinations in maintenance, and regional therapy in an effort to improve the cure rate in leukemia. However, as the complexity of these regimens increases, the contribution of an individual component such as teniposide becomes less clear. Although some of these regimens for newly diagnosed and relapsed ALL are now thought to represent the best available therapy, teniposide remains an investigational agent. In this review, we outline and discuss the conflicts arising from the need to answer drug specific issues, and, at the same time, facilitate the implementation of innovative, curative regimens. PMID- 3276828 TI - Therapy-related acute nonlymphocytic leukemia of FAB type M4 or M5 with early onset and t(9;11) (p21;q23) or a normal karyotype: a separate entity? PMID- 3276829 TI - Circadian clock in cell culture: I. Oscillation of melatonin release from dissociated chick pineal cells in flow-through microcarrier culture. AB - The avian pineal gland contains circadian oscillators that regulate the rhythmic release of melatonin. We have developed a dissociated chick pineal cell culture system in order to begin a cellular analysis of this vertebrate circadian oscillator. Dissociated pineal cells maintained in cyclic light conditions (LD 12:12) released melatonin rhythmically. The release of melatonin was elevated during the dark and low during the light. A circadian oscillation of melatonin release persisted for at least 5 cycles in constant darkness with a period close to 24 hr; however, there was a gradual damping of the amplitude. Analysis of the rhythm revealed that the observed damping was consistent with either desynchronization of multiple oscillators within the cultures or damping of individual oscillators. The circadian oscillation of melatonin release persisted for up to 4 cycles under conditions of constant light; however, the oscillation was strongly damped and the period of the oscillation was lengthened significantly. Thus, dissociated pineal cells express a persistent circadian oscillation of melatonin release in constant darkness, and properties of this oscillation are modulated by light treatment in vitro. This flow-through cell culture method for dissociated chick pineal cells should provide a useful model for the analysis of a vertebrate circadian system at the cellular level. PMID- 3276830 TI - Protein phosphorylation in nerve terminals: comparison of calcium/calmodulin dependent and calcium/diacylglycerol-dependent systems. AB - Rat cerebral cortical synaptosomes that had been prelabeled with 32P orthophosphate were exposed to either (1) K depolarization which causes Ca2+ influx and hence would be expected to activate Ca2+-dependent enzymes, including Ca2+/calmodulin-dependent and Ca2+/diacylglycerol-dependent protein kinases (Ca/CaM kinases and protein kinase C, respectively); or (2) phorbol esters or 1 oleoyl-2-acetyl-glycerol (OAG), which selectively activate protein kinase C. Proteins whose state of phosphorylation was affected by these treatments could be divided into 3 classes. Class A includes 5 phosphoproteins that showed rapidly increased phosphorylation by synaptosomal depolarization but not by OAG or phorbol ester. Four of these proteins, synapsins Ia and Ib and proteins IIIa and IIIb, are neuron-specific, synaptic vesicle-associated proteins known to be substrates for Ca/CaM kinases I and II. These phosphoproteins were rapidly dephosphorylated upon synaptosomal repolarization. Class B is composed of 2 phosphoproteins that showed rapidly increased phosphorylation by either synaptosomal depolarization or treatment with phorbol ester or OAG. These 2 acidic proteins of Mr87 and 49 kDa are known from in vitro studies to be specific substrates for protein kinase C. Thermolytic peptide mapping indicated that the 87 kDa protein in synaptosomes was phosphorylated by protein kinase C in situ. These 2 phosphoproteins were slowly dephosphorylated upon synaptosomal repolarization. Class C comprises 4 phosphoproteins that were rapidly dephosphorylated upon synaptosomal depolarization and may be substrates for Ca2+ activated protein phosphatase(s). These data suggest that Ca2+ influx into nerve terminals activates Ca/CaM kinases I and II, protein kinase C, and unidentified protein phosphatase(s).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276831 TI - Distribution of protein kinase C-like immunoreactive neurons in rat brain. AB - Distribution of protein kinase C in the CNS of rat is presented based on immunohistochemical analysis with monoclonal antibodies against this protein kinase. Protein kinase C-like immunoreactivity was discretely localized and associated with neurons. Most, if not all, glial cells were not significantly stained. The greatest density of the immunoreactive material was seen in the following regions: the olfactory bulb (external plexiform layer), olfactory tuberculum, anterior olfactory nucleus, cerebral cortex (layers I and IV), pyriform cortex, hippocampus (strata radiatum and oriens), amygdaloid complex (central and basolateral nuclei), cerebellar cortex (molecular layer), dorsal cochlear nucleus, nucleus spinal tract of the trigeminal nerve, and dorsal horn of the spinal cord (substantia gelatinosa). Image analysis revealed that the regional distribution of the protein kinase C-like immunoreaction generally agreed with that of phorbol ester-binding sites. Immunoreactive perikarya were found in the following areas: the cerebral cortex (layers V and VI), caudate putamen, hippocampus, thalamus, amygdaloid complex, medial and lateral geniculate nucleus, superior colliculus, cerebellar cortex, nucleus spinal tract of the trigeminal nerve, dorsal cochlear nucleus, and dorsal horn of the spinal cord. Intense protein kinase C-like immunoreactivity in the neuron was observed both in the membrane and cytoplasm of the perikarya, dendrites, axons, and axon terminals, while weak immunoreaction was seen in the nuclei but almost never in the nucleoles. A map of protein kinase C-containing neurons was constructed. Such an uneven distribution in the brain suggests that this enzyme may play roles in controlling neuronal function in the areas noted. PMID- 3276832 TI - Corticotropin-releasing factor in cerebellar afferent systems: a combined immunohistochemistry and retrograde transport study. AB - The flocculus and paraflocculus of cat and sheep cerebellum were studied with immunohistochemical methods, using antisera to corticotropin-releasing factor (CRF). CRF immunoreactivity was present within 3 populations of varicose nerve fibers. One population of CRF-immunoreactive (CRF-IR) fibers appeared to appose Purkinje cell somata and to follow their dendrites into the molecular layer. This arrangement suggested they were climbing fibers. A second group of CRF-IR profiles reminiscent of mossy fibers was widely distributed throughout the granule cell layer. A third population of CRF-IR fibers was present as a beaded plexus lying parallel to the pial surface, above and subadjacent to the Purkinje cell layer. The fibers of this plexus extended into the Purkinje cell layer and surrounded these somata. The source of some of the CRF-IR fibers within the flocculus and paraflocculus was determined by a retrograde axonal transport study utilizing the fluorescent tracer Fast blue (FB) in combination with the immunohistochemical localization of CRF. It was determined that CRF-IR perikarya within the inferior olivary nucleus gave rise to a population of climbing fibers within those lobules. Furthermore, all divisions of the inferior olive were found to contain CRF-IR somata. This latter finding suggests the potential for CRF-IR climbing fiber projections from the inferior olive to other regions of the cerebellar cortex. The existence of CRF-IR mossy fibers and fibers within the ganglionic plexus suggests the possibility of CRF-IR afferent projections from other regions of the brain stem to the flocculus and paraflocculus. PMID- 3276833 TI - Distribution of a novel 57 kDa intermediate filament (IF) protein in the nervous system. AB - A 57 kDa protein, that is not vimentin, is the major component of intermediate filaments (IF) obtained after 2 cycles of in vitro assembly from PC12 cells (Parysek and Goldman, 1987). By use of an antiserum to the 57 kDa protein, a cross-reacting antigen (of identical molecular weight) was detected on immunoblots of IF preparations and by immunofluorescence of various rat tissues. Immunolocalization studies on 3-4 micron frozen sections of tongue, small intestine, and adrenal gland showed bright labeling of nerve bundles and fine caliber nerve fibers. The chromaffin cells and ganglion cells of the adrenal medulla also were labeled. In the nervous system, intense labeling was seen in small-caliber nerve fibers in sciatic nerve and spinal cord dorsal roots, as well as in the dorsal white columns and dorsal root ganglia. Of the ganglion cells, preferential labeling was seen in small-sized ganglion cells, whereas a monoclonal antibody to the 150 and 200 kDa neurofilament triplet (NFT) components labeled the large-sized ganglion cells. In the areas of the brain thus far examined with 57 kDa antiserum, there was labeling of components of cranial nerves and labeling of thin fibers in several areas, including the granular layer of the cerebellum and the corticospinal tract in the brain stem. For each tissue, adjacent sections treated with vimentin or glial fibrillary acidic protein antibody revealed labeling patterns distinct from that seen with either the 57 kDa or NFT antibodies. These results indicate that the 57 kDa IF protein is a neural IF component. Furthermore, this protein is distributed in only certain neuronal elements; these elements may be unified by an as yet unrecognized pattern of function in the nervous system. PMID- 3276834 TI - Immunological and biochemical strategies for the identification of brain tumor associated antigens. AB - Various strategies have been used to identify and characterize the antigens associated with human brain tumors. These approaches have included the raising of polyclonal and monoclonal antibodies against tumor antigens and, more recently, efforts toward the direct biochemical identification of such proteins. This review summarizes the progress made in this area, suggests reasons for the broad antigenic cross-reactivity and heterogeneity revealed by these studies, and proposes additional methods for deciphering the complex antigenic composition of human brain tumors. PMID- 3276835 TI - Trauma-triggered migraine: an explanation for common neurological attacks after mild head injury. Review of the literature. AB - This paper reviews the literature on complex temporary disturbances of brain function triggered by mild blows to the head in children, adolescents, and young adults. It consolidates the evidence by which these attacks have been identified as classical or complicated migraines, and provides a historical account of the descriptions and proffered explanations of these attacks. The clinical features and the electroencephalography, angiography, computerized tomography, and cerebrospinal fluid findings of trauma-induced migraine are presented and compared to those of spontaneous migraine. Ideas about the pathogenesis of this condition are related to current thinking on the neurological phenomena of migraine in general. PMID- 3276836 TI - Stereotaxic intracavitary irradiation for cystic craniopharyngiomas. AB - Stereotaxic intracavitary irradiation with instillation of phosphorus-32 (32P) colloidal chromic phosphate was performed in nine patients with cystic craniopharyngiomas. Serial neurological, ophthalmological, neuroendocrinological, and radiological examinations were performed before and after treatment. Dosimetry was determined based on a computerized tomography (CT) estimation of tumor volume, and was calculated to provide a tumoricidal dose (200 to 300 Gy) to the cyst wall. The follow-up period ranged from 14 to 45 months (mean 27 months). After treatment, all nine patients showed improvement of symptoms and radiological evidence of cyst regression. Because of an expanding solid component producing recurrent symptoms, one patient required a craniotomy 14 months after isotope instillation. Three of five patients with impaired visual acuity before surgery had significant improvement in acuity after treatment. Preoperative visual field defects in eight patients improved in four after 32P therapy. Of seven patients with preoperative endocrine abnormalities, one individual showed almost complete normalization and another had improvement in endocrine function. Patients who exhibited residual neuroendocrine function before isotope instillation developed no significant deterioration in endocrine status during the follow-up period. The findings suggest that stereotaxic intracavitary irradiation is a safe and effective treatment which should be considered as the initial surgery for cystic craniopharyngiomas. PMID- 3276837 TI - Immunohistological evaluation of macrophage infiltrates in brain tumors. Correlation with peritumoral edema. AB - Peritumoral edema is one of the most serious complications of intracranial neoplasms; however, the exact pathogenesis of this condition is still unknown. To explore the effect of macrophages in brain tumors on the pathogenesis of peritumoral edema, 42 specimens of primary or metastatic brain tumors were studied. Frozen sections were examined by an immunoperoxidase staining technique with anti-Leu-M3 monoclonal antibody. Eight of 14 gliomas demonstrated Leu-M3 positive cell (macrophage) infiltration. The two glioblastomas showed a moderate or marked degree of macrophage infiltration. Twelve of 16 meningiomas demonstrated varying degrees of macrophage infiltration. All six metastatic brain tumors exhibited prominent macrophages in intra- and peritumoral tissues. Four acoustic neurinomas and two hemangioblastomas showed a slight to moderate degree of macrophage infiltration. Excellent correlation was found between the degree of macrophage infiltration seen on immunoperoxidase staining and the peritumoral edema detected on computerized tomography brain scans of patients with supratentorial tumors, especially meningiomas. Macrophages are known to secrete various substances (including arachidonate metabolites) that may interfere with vascular permeability. These data suggest that macrophages infiltrating brain tumors may play an important role in the pathogenesis of peritumoral edema. PMID- 3276838 TI - Profound pulmonary shunting without edema following stereotaxic biopsy of hypothalamic germinoma. Case report. AB - Hypoxemia is a nearly constant accompaniment of head injury. Diverse theories have been proposed to explain this relationship. The authors report the case of a patient who suffered an episode of severe, transient, arterial oxygen desaturation during "controlled" brain trauma: an otherwise uneventful stereotaxic biopsy of a small germinoma of the hypothalamus. Evidence is provided that pure ventilation-perfusion mismatching, without pulmonary edema, underlay the hypoxemia. The hypothalamus is intimately involved in matching pulmonary ventilation to perfusion; the hypoxemia of various brain injuries may be mediated by perturbation of this structure. PMID- 3276839 TI - Health care for the poor: where has all the money gone? AB - Federal budget cuts and health care rationing have had an adverse impact on health care for the poor. These effects are described and alternatives to the traditional health care delivery to the poor are presented. Nursing administrators must be aware of the changes in the economics of health care and how these changes have affected the health care delivery system so they may participate in shaping the future directions of health care in the United States. PMID- 3276840 TI - Plan development for a nurse recruitment-retention program. AB - The key to resolving the nursing shortage starts with the long-term commitment and support of hospital administrators. Many articles address the reasons for registered nurse turnover and for job dissatisfaction. They also address recruitment and retention incentives, motivators, and hygienes. This discussion focuses on what hospital administrators can do to create and to monitor a nurse recruitment-retention program that addresses the long-term problem of nurse turnover and job dissatisfaction, based on the concept that retention of nurses begins at the time of recruitment. PMID- 3276842 TI - JONA's Semiannual Directory of Consultants to Nursing Administration. PMID- 3276841 TI - Nursing administration research in hospitals and schools of nursing. AB - "Nursing service administration is in the most desperate need of research..." So said Herman Finer, well-known professor at the University of Chicago and in 1952, director of the Kellogg Nursing Service Administration Research Project. Today, 35 years later, the same need holds true. Administrators in hospitals and schools of nursing were canvassed to discover the nature of nursing administration research already in progress. Information about what is being studied, and amounts and sources of funding can be useful to nurse executives who are planning to implement research projects that build on existing knowledge. Findings from the study can also contribute to development of an overdue national research agenda for nursing administration. PMID- 3276843 TI - The fertility history card. Clinical use in improving contraceptive efficacy. PMID- 3276844 TI - Management of common minor discomforts in pregnancy. Part II: Managing minor pain in pregnancy. PMID- 3276845 TI - Methods of fetal heart rate monitoring during labor. A selective review of the literature. PMID- 3276846 TI - Herman Boerhaave on nutrition. PMID- 3276847 TI - Responses of blood glucose, insulin and cortisol concentrations to common equine diets. AB - Two experiments were conducted to determine the response of blood glucose, insulin and cortisol levels to four common equine diets. Experiment 1 was designed to determine the diurnal variation of glucose and two glucoregulatory hormones, insulin and cortisol, in four fasting geldings. No diurnal variation was observed in either glucose or insulin levels during the 24-h sampling period. However, cortisol levels did exhibit a circadian rhythm, with elevated values observed in the morning and low values in the evening. Experiment 2 investigated the response of glucose, insulin, cortisol and selected amino acids to four isoenergetic equine diets. Four 2-yr-old quarter horse geldings were used in a Latin square design. Pelleted isoenergetic diets were composed as follows on a digestible energy basis: 100% alfalfa (diet A), 50% alfalfa and 50% corn (diet AC), 100% corn (diet C) and 90% corn and 10% corn oil (diet CO). A single meal was fed after an overnight fast. Blood samples were taken via a jugular catheter from 0800 to 1700 h. Analysis of variance by repeated measures and mean response area for glucose showed no difference between diets. However, postprandial peak glucose levels were elevated (P less than 0.01) over prefeeding levels in diets AC and C. Analysis of variance by repeated measures and mean response area for insulin showed differences (P less than 0.05) between diets. Cortisol showed no meal-related responses to any of the diets within its expected circadian rhythm. PMID- 3276848 TI - Update: dietary protein and microbial protein contribution. AB - Factors influencing microbial protein synthesis in the rumen have been reviewed several times in recent years. Original publications in the past 3 yr have reported microbial and feed protein nitrogen contribution postruminally when feeding a variety of dietary proteins. Ammonia is a satisfactory source of nitrogen for growth of the majority of rumen species, but substitution of intact protein for urea (source of ammonia) usually stimulates microbial protein production. Protein sources such as soybean meal appear to possess properties (perhaps rate of degradability) that optimize microbial growth in vivo. Protein sources more undegradable than soybean meal, when fed as the major nitrogen source, sometimes reduce microbial growth. However, nondegradable proteins may compensate for less microbial protein by supplying intact dietary protein postruminally, so the amino acids potentially available may be equal to or greater than those available when readily degradable protein is fed. Soybean meal may reduce microbial growth in diets containing grass silage at protein exceeding 16.8%. Various measurements of microbial and intact dietary protein postruminally show that the contribution of each can be manipulated. Accuracy of quantitative predictions of postruminal contribution depends on several factors that require more research. PMID- 3276849 TI - Influence of major minerals on rumen microbiota. AB - The supply of minerals needed to meet rumen microbe requirements should match the amount of energy available for fermentation. Therefore, we attempt to assess microbial requirements for phosphorus (P), sulfur (S) and magnesium (Mg) in terms of fermentable organic matter at the rumen level (OMF) or in terms of digestible matter in the total tract (OMD). In vivo, about 5 g of P and 1.8 g of S/kg OMD should be available (a) in the rumen. Pa is provided mostly by salivary secretion, which depends on several dietary factors as well as on the physiological state of the animal; dietary S supply with natural diets depends on dietary S availability, which can be particularly low for some roughages. Dietary Mg concentration should be in the range 1.5-2.5 g/kg OMD. The circumstances in which major minerals may be used to manipulate rumen fermentation are discussed. With a high concentrate diet the addition of a mineral buffer may help to maintain an adequate pH for cellulolysis and enhance the efficiency and quantity of the microbes produced. Some inconsistent results are obtained, possibly because of the sensitivity of rumen microbes to high osmolality. It is concluded that, as the margin between optimal stimulatory concentration and toxic excess is narrow, rumen fermentation should be manipulated cautiously when using minerals. PMID- 3276850 TI - Potential opportunities and problems for genetically altered rumen microorganisms. AB - Rumen microbiologists are beginning to use genetic engineering techniques, and researchers should carefully consider both the potentials and limitations of using this technology to manipulate the rumen microbial ecosystem. Despite encouraging rhetoric, it is difficult to identify specific examples where genetic engineering would enhance ruminal performance. Many practical problems (lactic acidosis, deamination, etc.) might be better served by genetic engineering approaches that delete rather than add genes. The difficulty with this approach is that a highly selective means of preventing wild types from recolonizing the rumen would be needed. The addition of specific genes is confounded by 1) the fact that the rumen microorganisms are already adapted to the rumen, 2) the diversity of species inhabiting the rumen and 3) the complexity of interactions among these species. Aspects such as increased rates of cellulose digestion and changes in amino acid composition of the microflora are particularly sensitive to these biological constraints. Genetic engineering has, however, the potential to alleviate new limitations that humans have imposed on the rumen (detoxification, resistance to low pH, the digestion of novel feed materials, etc). A particular strategy of moving acid-resistant cellulose genes into noncellulytic, but acid resistant, rumen bacteria is described. PMID- 3276852 TI - Phenytoin syndrome developing after administration of dilantin for an enflurane induced seizure. PMID- 3276853 TI - Persistent cemento-ossifying fibroma of the mandible: report of a case and review of literature. AB - This case report describes an unusual recurrence of a cemento-ossifying fibroma and illustrates the diagnostic difficulties that may be encountered when treating fibro-osseous lesions. PMID- 3276854 TI - Primary hyperparathyroidism presenting as a "peripheral" giant cell granuloma. AB - A case of primary hyperparathyroidism is reported in which the initial presentation was an intraoral lesion clinically resembling a peripheral giant cell granuloma. A brief review of hyperparathyroidism is included. Of interest is the fact that most cases of hyperparathyroidism today are found in asymptomatic patients in whom the disease is discovered on routine blood chemistry analysis. PMID- 3276851 TI - Cigarette smoking: the physician's role in cessation and maintenance. PMID- 3276855 TI - Repair of a palatal defect associated with late congenital syphilis using a tongue flap. AB - A case is presented outlining the surgical correction of a palatal defect resulting from a gumma using a tongue flap. The defect was successfully closed, and the patient responded well. Speech and deglutition were restored to normal. The manifestations of congenital syphilis are reviewed. PMID- 3276856 TI - Reconstruction of the maxilla with bone grafts supported by the buccal fat pad. AB - In the usual reconstruction of maxillary contour, the grafts are usually exposed to the antral or nasal cavities. This leads to postponed remodelling and a higher rate of resorption and sequestration. To avoid exposure of the grafts, the buccal fat pad is rotated into the maxillary sinus and lined to the bone grafts. The vascularized buccal fat pad not only contributes to a better integration of the bone grafts but also enables the restoration of normal physiologic function of the maxillary sinus. PMID- 3276857 TI - In vitro effects of low intensity direct current generated silver on eukaryotic cells. AB - An examination of the effects of low intensity direct current generated silver, (LIDC Ag) on several types of eukaryotic microorganisms and cell culture lines suggests that LIDC Ag has an appropriate selective toxicity for prokaryotic cells. It appears that levels of this agent could be obtained clinically that would have marked bacteriostatic activity and yet have little or no effect on mammalian cells. PMID- 3276858 TI - Caravaggio's "toothpuller". PMID- 3276859 TI - The transmandibular implant for reconstruction following radiotherapy and hemimandibulectomy: report of a case. PMID- 3276860 TI - The lower border rib graft for mandibular atrophy. AB - Eight patients treated by a modified lower border rib grafting technique for severe mandibular atrophy have been followed for between two and eight years. The clinical results have been very satisfactory and resorption has been less than 12% after two years. PMID- 3276861 TI - Adult respiratory distress syndrome in pediatric patients. I. Clinical aspects, pathophysiology, pathology, and mechanisms of lung injury. PMID- 3276862 TI - Carbohydrate and lipid metabolism in Turner syndrome: effect of therapy with growth hormone, oxandrolone, and a combination of both. AB - To evaluate the effects of growth-promoting therapy on carbohydrate metabolism in girls with Turner syndrome, we determined glucose and insulin concentrations during oral glucose tolerance tests (OGTTs) at baseline and after 5 days, 2 months, and 12 months of treatment with growth hormone (GH), oxandrolone, or a combination of GH and oxandrolone, or after the same intervals with no therapy. Before therapy, subjects had a significantly greater glucose response during OGTT than published normal control values. There were no significant changes in mean fasting glucose, cholesterol, or triglyceride concentrations in any of the treatment groups. The integrated glucose concentrations rose significantly over baseline values in the oxandrolone group at 2 and 12 months and in the combination group at 5 days. There were significant increases in the mean integrated insulin concentrations at 2 and 12 months for the group receiving oxandrolone alone and at all three times for the group receiving combination therapy. Thus oxandrolone, alone or in combination with GH, had significant effects on carbohydrate metabolism in subjects with Turner syndrome, whereas GH alone did not. PMID- 3276863 TI - Tracheal and bronchial injury in high-frequency oscillatory ventilation and high frequency flow interruption compared with conventional positive-pressure ventilation. AB - We compared the histopathologic changes in the airways of premature baboons treated with conventional positive-pressure ventilation (PPV) with those seen after high-frequency oscillatory ventilation (HFOV) and high-frequency flow interruption (HFFI). Twenty-six animals were treated with ventilation for 24 hours (five PPV, 10 HFOV, 11 HFFI), and 18 were treated with ventilation for 96 hours (six PPV, six HFOV, six HFFI). A semiquantitative scoring system was used to grade tissue changes in the trachea, carina, and both main-stem bronchi. Alterations were produced by all forms of mechanical ventilation. The degree of injury was similar and relatively mild for the PPV- and HFOV-treated animals at both 24 and 96 hours. Eleven of 17 baboons treated with HFFI ventilation (8/11 at 24 hours; 3/6 at 96 hours) had severe airway damage characterized by diffuse submucosal necrosis, extensive hemorrhage, dense polymorphonuclear leukocyte infiltration, sloughed epithelium, focal basophilia, and intraluminal debris. HFOV resulted in no greater degree of airway damage than did PPV. The use of HFFI, with the particular strategy we employed, resulted in a far greater degree of damage than either PPV (P less than 0.01) or HFOV. PMID- 3276864 TI - A randomized, controlled trial of parenteral clindamycin in neonatal necrotizing enterocolitis. AB - For an assessment of the efficacy of clindamycin in preventing bowel necrosis (intestinal gangrene or perforation), 42 premature infants with radiographically confirmed necrotizing enterocolitis (NEC) (pneumatosis, intraportal gas, or both) were randomly assigned to receive parenterally either ampicillin and gentamicin (control group, n = 22) or ampicillin, gentamicin, and clindamycin (n = 20), 20 mg/kg/d at 8-hour intervals for 10 to 14 days. Infants who had received antibiotics for greater than 24 hours before randomization and those developing intestinal gangrene or perforation less than 12 hours after randomization were excluded. Intestinal gangrene or perforation developed in four infants in the control group and six in the clindamycin group. Four in each group died of NEC. In the control group, one of 18 survivors developed a late stricture requiring surgical resection, whereas six of 15 survivors in the clindamycin group developed such strictures (P = 0.022). Routine inclusion of clindamycin in medical treatment of NEC does not reduce the frequency of intestinal gangrene or perforation and may be associated with an increase in late stricture formation. PMID- 3276865 TI - Plasma infusion for hemolytic-uremic syndrome in children: results of a multicenter controlled trial. AB - The results of a controlled trial to ascertain the usefulness of plasma infusion for the treatment of hemolytic-uremic syndrome (HUS) are reported. Criteria for admission were (1) observation within 8 days from first symptoms, (2) dialysis treatment required, and (3) no special treatments and no more than 25 ml blood/kg previously received. Children were subdivided according to age (less than or more than 3 years) and then randomly assigned to treatment with plasma or symptomatic therapy. Thirty-two children ranging in age from 4 months to 6 years entered this study; 17 received plasma (P+ group) and 15 only symptomatic therapy (P- group). The mean follow-up period was 16 months in both groups. Surgical renal biopsy was performed 29 to 49 days after onset in 11 P+ and 11 P- children, and 33 histologic findings were semiquantitatively evaluated. No death occurred in either group. No differences were found in blood pressure, proteinuria, or hematuria at the end of the follow-up period; in no case were severe arteriolar lesions found. There were no significant differences for the scores of the individual histologic measurements; on electron microscopy, no vascular changes were observed in seven children of the P+ group, whereas in five of seven of the P- group, thickening of the lamina rara interna and arteriolar damage were present. The ability of plasma to stimulate prostacyclin (PGI2) production, measured as its stable derivative 6-keto-PGF1 alpha, was within the normal range for all patients. In our patients with predominant glomerular involvement who were treated in a very early phase of HUS, infusions of plasma did not significantly influence the short- and medium-term clinical outcome and were not effective in severe HUS when given later in the course of the disease. A longer follow-up is needed to ascertain whether the presence of endothelial damage, demonstrated by electron microscopy in children who were not given plasma, is of clinical relevance. PMID- 3276867 TI - Renal transplantation in the very young patient. PMID- 3276866 TI - Identification of insulin-dependent diabetes mellitus before the onset of clinical symptoms. PMID- 3276868 TI - Microbiological and immunological studies of adult periodontitis in patients with noninsulin-dependent diabetes mellitus. AB - The subgingival microflora and serum antibody response was examined in periodontitis patients with noninsulin-dependent diabetes mellitus (NIDDM), impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). The predominant cultivable microflora was determined for subgingival plaque sampled from two deep periodontal pockets in each of eight adult periodontitis patients with NIDDM. Indirect immunofluorescence for Bacteroides intermedius, Bacteroides gingivalis, and Haemophilus actinomycetemcomitans was used to examine these same samples as well as 186 additional subgingival plaque samples from 47 patients with moderate to severe generalized periodontitis including 25 subjects with NIDDM, six subjects with IGT, and 16 subjects with NGT. Serum antibody levels to 13 microorganisms including seven oral bacterial species and one nonoral control species were measured by enzyme-linked immunosorbent assays (ELISA) in 377 subjects including 84 normal subjects without periodontal disease, 112 normal subjects with periodontitis, 19 periodontally normal subjects with IGT, 65 periodontitis patients with IGT, 15 periodontally normal subjects with NIDDM, and 82 periodontitis patients with NIDDM. Three hundred eighty-two bacterial isolates were recovered from the eight patients. B. intermedius was the most frequently isolated microorganism constituting 16% of the total isolates followed by Wolinella recta and B. gingivalis, which each accounted for 13% of the total. Streptococcus sanguis was the most prevalent microorganism, which was found in 75% of the sites. Subgingival plaque samples examined by immunofluorescence demonstrate a high prevalence of black-pigmented Bacteroides and suggest that the proportion of B. gingivalis but not B. intermedius is higher in NIDDM with periodontitis than in other groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276869 TI - Cell populations associated with conversion from bleeding to nonbleeding gingiva. AB - The purpose of this study was to observe changes in cell populations of the interdental gingival tissue, which accompanied the conversion of a bleeding to a nonbleeding state induced by scaling and improved oral hygiene. Fifteen bleeding and 18 stopped-bleeding interproximal gingival biopsies were obtained from 33 patients and processed for light microscopic evaluation. The morphometric analysis of eight connective tissue components revealed that the percentage volume density of all inflammatory cells decreased, and the percentage of fibroblasts and collagen increased, when the gingiva changed from a bleeding to a nonbleeding state. Furthermore, the inflammatory cell infiltrate in bleeding and stopped-bleeding specimens was dominated by mononuclear cells of the lymphocyte/macrophage/monocyte group, while plasma cells and polymorphonuclear leukocytes comprised only a small fraction of the inflammatory cells present. Significant repair of gingival connective tissue had occurred in the stopped bleeding specimens. PMID- 3276870 TI - Improved color matching of metal-ceramic restorations. Part III: Innovations in porcelain application. PMID- 3276871 TI - Prosthetic status: the formation of a schedule. PMID- 3276872 TI - Metal cingulum and loop technique for retaining resin base material and mandibular incisors. PMID- 3276873 TI - Use of a modified reversible hydrocolloid syringe for stick modeling compound. PMID- 3276874 TI - Use of a paralleling post for cast orientation when fabricating removable partial denture abutment crowns. PMID- 3276875 TI - A technique for removal of etched metal resin-bonded fixed partial dentures. PMID- 3276876 TI - Restoring retention form to rimmed trays. PMID- 3276877 TI - Comparison of fit of two types of all-ceramic crowns. PMID- 3276878 TI - Overcontouring in resin-bonded prostheses: plaque accumulation and gingival health. PMID- 3276879 TI - Interfacial bond strengths between layers of visible light-activated composites. AB - The bond strengths between composite layers either cured to themselves or to other types (classes) of composites of similar or different brands were measured by using a direct tensile test (true tension). The diametral compression test for tension for each material tested was also conducted according to ADA specification No. 27. The values were used for comparison. 1. The interfacial bond strengths were generally found to be higher than the cohesive strengths of the weaker materials when cured to different types of composites or of the weak region in the specimen when composites were cured to themselves. 2. The cohesive tensile failure of the materials occurred at much lower stress levels than their corresponding diametral tensile strength (ranging from 1/4 to 1/3 of the diametral strength). 3. When two types of composites were bonded together the cohesive failure occurred consistently within the materials with lower diametral strength. Correlation was observed between the values of cohesive strength of material measured with true tension and the diametral test. 4. A urethane dimethacrylate microfilled composite bonded weakly to BIS-GMA composite, therefore, their combined use should be avoided. 5. Incremental placement produced a clinically acceptable bond strength because it exceeded or was at least comparable to the cohesive strength of the material. PMID- 3276880 TI - Penetration of etched enamel by bonding agents. PMID- 3276881 TI - Two-dimensional photoelastic simulation of a castable ceramic fixed partial denture. AB - Two-dimensional photoelastic models were used to determine the optimum design and loading conditions for a three-unit castable ceramic fixed partial denture. Findings relating to design and material variables can be summarized as follows. 1. Higher modulus cements impart more rigidity to the fixed partial denture design and result in lower stresses. 2. A short connector results in higher stress than a long connector; however, the length of the connector should not exceed one half the mesial-to-distal length of the pontic. 3. An intermediate thickness of cement results in the best stress distribution. 4. The male connector is best attached to the bulkier abutment. 5. Occlusal cement eccentricity is less desirable than cervical eccentricity. 6. The most undesirable loading site is directly above the connector. PMID- 3276882 TI - Need and effective demand for prosthodontic treatment. AB - The unmet and met need for prosthodontic services in the United States have been estimated and projected to the year 2000. Based on need-for-treatment estimates within the U.S. population collected by oral examination in 1971 to 1974, some 214.7 million hours of unmet need were estimated. By the year 2000, the projected need is expected to increase to approximately 264.7 million hours (if edentulism is assumed to be zero) or to approximately 293.8 million hours (if prevalence of prosthodontic need is assumed to remain stable). A concomitant rise in effective demand is also expected from 44.7 million hours in 1976 to 1977 to approximately 62.2 million hours in the year 2000. Thus, despite an assumption of declining edentulism, the unmet need for prosthodontic services will remain high. PMID- 3276883 TI - Indications for coronary artery surgery. PMID- 3276884 TI - Management of the hyperlipidaemic patient. PMID- 3276885 TI - A history of asthma. The FitzPatrick lecture 1987. PMID- 3276886 TI - Asbestos in drinking water and cancer. PMID- 3276887 TI - Effects of antibiotics and medium supplements on steroidogenesis in cultured cow luteal cells. AB - Corpora lutea were removed from regularly cycling dairy cows, dissociated with collagenase and cultured for 8 or 10 days in Ham's F-12 medium. In Exp. 1 treatment with insulin, or an insulin-transferrin-selenium combination (ITS), increased progesterone production from basal levels on Day 4 of culture to 234% (P less than 0.01) above controls on Day 10. LH alone increased progesterone production 45% above controls on Day 10 (P greater than 0.05). When LH was combined with insulin or ITS, progesterone production was stimulated to an average of 1802% (P less than 0.01) above controls on Day 10 of culture. Transferrin or selenium without insulin did not allow LH to stimulate progesterone synthesis. In Exp. II, LH alone or LH plus gentamicin or penicillin streptomycin increased progesterone production from basal levels on Day 2 steadily to an average of 468% (P less than 0.01) above controls (no antibiotics) by Day 8 of culture. The addition of amphotericin-B, alone or in combination with the other antibiotics, inhibited all LH-stimulated progesterone synthesis, but did not affect basal progesterone levels. We conclude that insulin is essential for maximal steroidogenesis in a bovine luteal cell culture system, and that LH stimulated progesterone production is inhibited in the presence of amphotericin B, but is not inhibited by gentamicin or penicillin-streptomycin. The elimination of amphotericin-B, coupled with the addition of insulin to the cell culture system increased the responsiveness of the cells to LH. These culture conditions represent the first report in which LH increased total progesterone production for 10 days, maintaining luteal function in a chemically-defined culture system. PMID- 3276888 TI - Continuous infusion of GnRH reduces the LH response to an intravenous GnRH injection but does not inhibit endogenous LH secretion in cows. AB - Plasma LH concentrations were monitored in 6 Hereford X Friesian suckled cows at about 80 days post partum, before and during a 14-day period of continuous s.c. infusion of GnRH (20 micrograms/h). Blood samples were collected at 10-min intervals on Days -2, -1, 1, 2, 3, 4, 7, 10, 13 and 14 (Day 1 = start of infusion). Plasma LH concentrations rose from mean pretreatment levels of 1.3 +/- 0.20 ng/ml to a maximum of 17.1 +/- 3.09 ng/ml within the first 8 h of GnRH infusion, but returned to pretreatment levels by Day 2 or 3. In 4/6 animals, the initial increase was of a magnitude characteristic of the preovulatory LH surge. In all animals, an i.v. injection of 10 micrograms GnRH, given before the start and again on the 14th day of continuous infusion, induced an increase in LH concentrations but the increase to the second injection was significantly (P less than 0.01) less (mean max. conc. 6.4 +/- 0.76 and 2.3 +/- 0.19 ng/ml). Mean LH concentrations (1.0 +/- 0.08, 1.1 +/- 0.08 and 0.9 +/- 0.06 ng/ml) and LH episode frequencies (3.3,4.3 and 3.2 episodes/6 h) did not differ significantly on Days 2,7 and 13. However, the mean amplitude of LH episodes was significantly lower (P less than 0.05) on Day 13 (1.3 +/- 0.10 ng/ml) than on Day -2 (1.8 +/- 0.16 ng/ml). Therefore, although the elevation in plasma LH concentrations that occurs in response to continuous administration of GnRH is short-lived and LH levels return to pre-infusion values within 48 h of the start of infusion, these results show that the pituitary is still capable of responding to exogenous GnRH, although the LH response to an i.v. bolus injection of GnRH is reduced. In addition, this change in pituitary sensitivity is not fully reflected in endogenous patterns of episodic LH secretion. PMID- 3276889 TI - Effect of time after castration on secretion of LHRH and LH in the ram. AB - Hypophysial portal blood and peripheral blood were obtained from conscious, unrestrained rams to measure simultaneously the secretion of LHRH and LH in entire rams and rams which had been castrated for 2-15 days (short-term castration) and for 1-6 months (long-term castration). The apparatus for portal blood collection was surgically implanted using a transnasal trans-sphenoidal approach and, 4-5 days later, portal blood and peripheral blood were collected simultaneously at 10-min intervals for 8-9 h from 15 sheep. LHRH was clearly secreted in pulses in all three physiological conditions, but there were marked differences in pulse frequencies, which averaged 1 pulse/2-4 h in entire rams, 1 pulse/70 min in short-term castrated rams and 1 pulse/36 min in long-term castrated rams. In entire and short-term castrated animals, LH profiles were also clearly pulsatile and each LHRH pulse in hypophysial portal blood was associated with an LH pulse in the peripheral blood. In long-term castrated animals, LH pulses were not as well defined, because of the high basal levels and small pulse amplitudes, and the temporal relationship between LHRH and LH pulses was not always clear. These results demonstrate the pulsatile nature of LHRH secretion under the three physiological conditions and suggest that the irregular LH profiles characteristic of long-term castrates are due to an inability of the pituitary gland to transduce accurately the hypothalamic signal. The very high frequency of the LHRH pulses may be one of the major reasons for this, and is probably also responsible for the high rate of LH secretion in the long-term castrated animal. PMID- 3276891 TI - Quantitative structure-activity relationships for the inhibition of Escherichia coli dihydrofolate reductase by 5-(substituted benzyl)-2,4-diaminopyrimidines. AB - Quantitative structure-activity relationships for the inhibition of Escherichia coli (MB 1428) dihydrofolate reductase (DHFR) by 61 5-(substituted benzyl)-2,4 diaminopyrimidines are reported and analyzed. The 61 compounds include 17 congeners whose activities have not been previously reported, five of which have a 5'-substituent larger than a methoxy group. The correlation equations indicated that the molar refractivity (MR) values of the 5'-substituent, just as with the 3'- and 4'-substituents, contributed maximally at the value of 0.79 with no increment of binding for compounds with MR larger than 0.79 (which corresponds to a 5'-methoxy substitution). This experimental result is in agreement with the crystal structure of the Escherichia coli DHFR-trimethoprim complex, which shows a reasonably large trimethoprim-binding site. The inhibition of E. coli (MB 1428) DHFR by nine of the 17 new benzylpyrimidines is at lower concentrations than for trimethoprim. However, all 17 are much less potent than trimethoprim in inhibition of growth of E. coli (1515). PMID- 3276890 TI - Renin inhibitors. Design and synthesis of a new class of conformationally restricted analogues of angiotensinogen. AB - Molecular modeling methods have been used to design a novel series of conformationally constrained cyclic peptide inhibitors of human renin. Three goals were defined: enhanced inhibitory potency, high specificity for renin, and increased metabolic stability. Three cyclic compounds were synthesized with ring sizes 10, 12, and 14, based upon a linear hexapeptide inhibitor with a reduced amide replacing the scissile bond at the active site. When tested, the 14 membered-ring compound was as potent an inhibitor of human renin as the parent while the 12-membered-ring compound was 6-fold more potent than the parent against mouse renin. However, the 10-membered-ring compound was inactive against both renins. The lack of potency of the 10-membered compound was explained by using NMR and molecular modeling techniques. It forms another conformation in solution that is inconsistent with binding at the active site. The cyclic compounds did not inhibit either pepsin or cathepsin D significantly. The cyclic modification rendered these inhibitors significantly resistant to cleavage by chymotrypsin and thus prevented loss of activity by this enzyme. Thus, the goals of enhanced inhibitory potency, high specificity, and metabolic stability were achieved in the series of compounds. PMID- 3276892 TI - The Abraham Flexner Award for distinguished service to medical education. Frederick C. Robbins, M.D. PMID- 3276893 TI - The AAMC Award for distinguished research in the biomedical sciences. Joseph Larner, M.D., Ph. D. PMID- 3276894 TI - Goals for educating residents in the use of blood components. PMID- 3276895 TI - Medical education: is it? PMID- 3276896 TI - Effects of pH on killing of Staphylococcus aureus and Escherichia coli by constituents of the neutrophil phagolysosome. AB - Lysosomotropic weak bases impair in-vitro neutrophil functions including intracellular killing of Staphylococcus aureus strain 502a. To investigate whether prevention of phagosomal acidification could account for impaired microbicidal activity, a model phagosome was formulated with a freeze-thawed granule extract as a source of lysosomal enzymes and H2O2 as a source of toxic oxygen metabolites. The lysosomal extract alone killed Escherichia coli strain S15 efficiently at pH 5.5 and 7.0, but had little activity against S. aureus 502a. Sublethal concentrations of the two agents, when combined, acted synergically against either organism. Each organism was killed more effectively at pH 5.5 than at pH 7.0 by the lysosome extract-H2O2 combination, but the killing of E. coli was more rapid than that of S. aureus in the same conditions. These findings suggest that impairment of neutrophil antistaphylococcal activity by weak bases may be mediated by their ability to raise phagosomal pH, and that persistence of E. coli in similar conditions does not occur because the latter is killed by lysosomal constituents in a non-pH-dependent fashion. PMID- 3276897 TI - Expression of an antigen in strains of Salmonella typhimurium which reacts with antibodies to cholera toxin. AB - Six strains of Salmonella typhimurium (W118, TML, SL1027, LT7, M206 and Thax 1) of different virulence were examined for the presence of antigens which react with antibodies to cholera toxin (anti-CT). A fluorescent-antibody-labelling technique employing anti-CT was used to analyse antigen expression. A rapid increase in the proportion of cells producing a CT-related antigen was demonstrated in cells in early log phase (1-4 h growth) followed by a rapid decline during mid-late log phase in each of the six strains. The nature of the CT-related antigen was analysed by immunoblotting using anti-CT. An antigen of mol. wt equivalent to a high-mol. wt species of CT B subunit was detected in polymyxin-B extracts of all strains but greater amounts were observed in the strains that we consider avirulent. Nothing equivalent to a CT A-related subunit was observed in any of the strains. The relatedness of the salmonella antigen to CT was limited. The high-mol. wt antigen was not disrupted in the denaturing conditions of SDS-PAGE; nothing was detected by enzyme-linked immunosorbent assays with either ganglioside or anti-CT as anchor. PMID- 3276898 TI - Immuno-electronmicroscopic demonstration of capsules on group-B streptococci of new serotypes and type candidates. AB - The location of type polysaccharides on the cells of reference strains of group-B streptococci of serotypes IV and V and new type candidates NT6 and 7271 was investigated by electronmicroscopy of the bacteria after incubation with homologous type-specific antiserum. A distinct capsular layer was found on the surface of the cells of all these strains. Sialic acid, an integral part of all the conventional type polysaccharides of group-B streptococci, was also detected in all the strains examined. PMID- 3276899 TI - Rapid antibiotic susceptibility tests on Enterobacteriaceae by ATP bioluminescence. AB - The susceptibility of 76 clinical isolates of Enterobacteriaceae to ampicillin, piperacillin and gentamicin was assessed by ATP bioluminescence in a 4-h test. For most organisms tested (Escherichia, Klebsiella, Enterobacter and Serratia), there was good correlation with traditional MIC values estimated on 18-h cultures. However strains of Proteus mirabilis showed false resistance to the beta-lactam agents with the ATP method; and concordance was achieved only after manipulation of the growth conditions. Our method is simpler than those described previously, though currently it is still labour-intensive and expensive. PMID- 3276900 TI - Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer: results from NSABP protocol R-01. AB - Information is presented from 555 patients with Dukes B and C rectal cancers treated by curative resection who were entered into the National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol R-01 between November 1977 and October 1986. Their average time on study was 64.1 months. The patients were randomized to receive no further treatment (184 patients), postoperative adjuvant chemotherapy with 5-fluorouracil, semustine, and vincristine (MOF) (187 patients), or postoperative radiation therapy (184 patients). The chemotherapy group, when compared with the group treated by surgery alone, demonstrated an overall improvement in disease-free survival (P = .006) and in survival (P = .05). Employing the proportional hazards model, a global test was used to determine the presence of treatment interactions. Investigation of stratification variables employed in this study indicated that sex, and to a lesser extent age and Dukes stage, made individual contributions to the disease-free survival and the survival benefit from chemotherapy. When evaluated according to sex, the benefit for chemotherapy at 5 years, both in disease-free survival (29% vs. 47%; P less than .001; relative odds, 2.00) and in survival (37% vs. 60%; P = .001; relative odds, 1.93), was restricted to males. When males were tested for age trend with the use of a logistic regression analysis, chemotherapy was found to be more advantageous in younger patients. When the group receiving post-operative radiation (4,600-4,700 rad in 26-27 fractions; 5,100-5,300 rad maximum at the perineum) was compared to the group treated only by surgery, there was an overall reduction in local-regional recurrence from 25% to 16% (P = .06). No significant benefit in overall disease-free survival (P = .4) or survival (P = .7) from the use of radiation has been demonstrated. The global test for interaction to identify heterogeneity of response to radiation within subsets of patients was not significant. In conclusion, this investigation has demonstrated a benefit from adjuvant chemotherapy (MOF) for the management of rectal cancer. The observed advantage was restricted to males. Postoperative radiation therapy reduced the incidence of local-regional recurrence, but it failed to affect overall disease-free survival and survival. PMID- 3276901 TI - Postoperative adjuvant chemotherapy or BCG for colon cancer: results from NSABP protocol C-01. AB - Data are presented from 1,166 patients with Dukes B and C carcinoma of the colon who were entered into the National Surgical Adjuvant Breast and Bowel Project (NSABP) Protocol C-01 between November 1977 and February 1983. Patients were randomized to one of three therapeutic categories: 1) no further treatment following curative resection (394 patients); 2) postoperative chemotherapy consisting of 5-fluorouracil, semustine, and vincristine (379 patients); or 3) postoperative BCG (393 patients). The average time on study was 77.3 months. A comparison between patients receiving postoperative adjuvant chemotherapy and those treated with surgery alone indicated that there was an overall improvement in disease-free survival (P = .02) and survival (P = .05) in favor of the chemotherapy-treated group. At 5 years of follow-up, patients treated with surgery alone were at 1.29 times the risk of developing a treatment failure and at 1.31 times the likelihood of dying as were similar patients treated with combination adjuvant chemotherapy. Comparison of the BCG-treated group with the group treated with surgery alone indicated that there was no statistically significant difference in disease-free survival (P = .09). There was, however, a survival advantage in favor of the BCG-treated group (P = .03). At 5 years of follow-up, patients randomized to the surgery-alone arm were at 1.28 times the risk of dying as were similar patients treated with BCG. Further investigation disclosed that this survival advantage in favor of BCG was a result of a diminution in deaths that were non-cancer related. When analyses were conducted on which events not related to cancer recurrence were eliminated, the survival difference between the BCG and control groups became nonsignificant (P = .40); the cumulative odds at 5 years decreased from 1.28 to 1.10. The findings from this study are the first from a randomized prospective clinical trial to demonstrate that a significant disease-free survival and survival benefit can be achieved with postoperative adjuvant chemotherapy in patients with Dukes B and C carcinoma of the colon who have undergone curative resection. PMID- 3276903 TI - Progress in a desert: oasis or mirage? PMID- 3276902 TI - Activation of H-ras oncogene in rat bladder tumors induced by N-butyl-N-(4 hydroxybutyl)nitrosamine. AB - Ras-oncogene activation was investigated in the bladder tumors of F344 male rats given N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) in drinking water. DNA from one of the nine transitional cell carcinomas contained an H-ras oncogene detectable by the NIH/3T3 transfection assay. Analysis of p21 ras proteins suggested that the activating mutation resided within codon 61 of the H-ras gene and that such activating mutations were not present in other tumors. In contrast to mutational activation of ras genes, enhanced expression of p21 was observed in all tumors examined by immunohistochemical techniques with the use of Formalin-fixed paraffin-embedded tissue sections and an anti-ras p21 antibody, RAP-5. Further histochemical analysis of bladder tissues at various stages of the BBN-induced carcinogenic process indicated that the enhanced expression of p21 appeared early; the reactivity with RAP-5 was observed in diffuse hyperplastic epithelia after 5 weeks of exposure to BBN. The frequency of ras oncogenes, activated either by point mutations or overexpression of p21, in BBN-induced rat bladder carcinomas has thus been shown to be similar to that observed in human bladder carcinomas. PMID- 3276904 TI - Stevens-Johnson syndrome: a review of the literature. AB - Stevens-Johnson syndrome is both a physically and psychologically devastating disease. This paper primarily deals with the physiological complications of the disease process, but the psychological trauma often associated with such an initially disfiguring disease leaves wounds that are not visible. Constant support of both the patient and the nursing staff is necessary to relieve some of the anxiety associated with this syndrome. Education and reassurance should be as much a part of the treatment process as drug therapy.Although minimal drug therapy is required in the treatment of Stevens-Johnson syndrome, early aggressive management is necessary. Treatment should include management of pain and fluid losses as well as supportive care of the respiratory and ocular complications. It is essential that nutrition be maintained and that treatment of infections is appropriate to the identified cultures. Antacids, H(2) receptor antagonists, or both have proven beneficial in the prevention or reduction of gastrointestinal ulcers. Most important, however, is psychological support of the patient. PMID- 3276906 TI - Occurrence of bacteremia during and after hemorrhagic shock. AB - In recent research, hemorrhagic shock and septic shock have been studied as two separate entities. We have developed a treated model of hemorrhagic shock in which unrestrained and unanesthetized rats are bled to a mean arterial pressure of 30 torr until 80% of the maximum shed volume must be returned. Rats are maintained preshock and treated post shock with a 20% glucose-electrolyte solution. Survival of these animals is 62% at 24 hours post shock and all animals are dead at 72 hours post shock. Blood cultures obtained during shock become positive at 2 hours into the shock period and are significant compared to controls at 3 to 5 hours of shock (p less than 0.0001). Blood cultures obtained after the period of shock are significantly positive at 24 and 48 hours post shock (p less than 0.05) compared to controls. Intrashock cultures are monomicrobial; the majority of post-shock cultures are polymicrobial. All cultured organisms are normal rat enteric flora. Histologic changes of renal failure are also demonstrated post shock. We suggest that bacterial invasion, possibly from the gut, plays a role in the sepsis seen in patients following severe hemorrhagic shock. Sepsis may precede rather than follow the immune incompetence which accompanies shock. PMID- 3276907 TI - Medical knowledge--an important factor in disarmament negotiations and increased international cooperation. PMID- 3276905 TI - Co-factors, host susceptibility, and AIDS: an argument for stress. AB - Acquired immune deficiency syndrome (AIDS) is perhaps the most serious communicable public-health disease of modern society. The human and societal devastation associated with this disease is tremendous. To date, a retrovirus (HTLV-III) has been implicated in the etiology of AIDS. There remains several critical questions, however, that only a more eclectic approach, certainly with a social science input, can more adequately address. Such questions have to deal with, for example, why are there differential out-comes regarding initiation, progress, and severity of AIDS?Realizing this need, this paper argues for the possible co-factor contribution of stress to host immune suppression and, ultimately, host susceptibility to the AIDS virus and its associated outcomes. A conceptual sociopsychophysiologic model of the entire stress process, ie, from onset, reaction up to and including effect, is presented and discussed. Within the context of the model, stress is viewed as a physiologic reaction and stressors are viewed as initiators of the stress process. The possible stress AIDS experience is discussed using the model as a conceptual guiding tool. The paper concludes with the need for health educators to educate the general public, at-risk groups, and the medical and associated professions about the nature of stress, or in short, how best to cope with and manage stress within the context of available resources. PMID- 3276908 TI - The organization of surgical care in the partisan war in Yugoslavia and aspects relevant to training of surgeons for modern warfare. PMID- 3276909 TI - The surgical effects of wound ballistics of October war weapons. PMID- 3276910 TI - The effect of trauma to the leg on the first-pass uptake of bacteria by the lung. AB - Our previous studies have shown that the first-pass pulmonary uptake of lidocaine and serotonin were not impaired by bullet wounding of the leg. Since there is decreased resistance to bacterial infection with trauma, it was of interest to study the uptake of bacteria. First-pass pulmonary uptake of 51-chromium-labeled, killed Salmonella typhimurium bacteria was studied in 26 pigs. In 16 controls, four injections at hourly intervals revealed an initial uptake of 84.5% +/- 1.5 (Mean +/- S.E.M.) and a 95% first-pass uptake of 78.6% +/- 2.4, and no significant change with time. In the ten traumatized animals only the values at 5 hours were significantly lower than the controls. It is concluded that repeated injections of killed Salmonella typhimurium bacteria without trauma do not interfere with the ability of the lung to remove these bacteria during their first passage through the lung, but that with trauma to the leg do to a slight degree. PMID- 3276911 TI - Experimental study of treatment of high-velocity projectile wounds with bacterial neutral protease. PMID- 3276912 TI - British military surgery, 1945-1985. PMID- 3276913 TI - Ultrasound evaluation of hip position in the Pavlik harness. AB - Fifty infants undergoing treatment in the Pavlik harness for congenital hip dysplasia (CDH) were serially evaluated with ultrasound. Comparison with clinical and radiographic examinations showed sonography to be 100% sensitive and highly specific. Discrepancies between the studies are attributed to the greater sensitivity of the technique compared with the physical examination and/or radiographs. Using this method, it is possible to significantly reduce radiation exposure to the infant being treated for CDH. PMID- 3276914 TI - Appendices epiploicae of the large bowel. Sonographic appearance and differentiation from peritoneal seeding. AB - Solid hyperechogenic nodules of different sizes and shapes surrounded by ascitic fluid were seen growing from the peritoneal surface of the large bowel in three patients with biopsy-proven alcoholic liver cirrhosis; they were spaced at regular intervals along the course of the colon. The same images were visible during in vitro examination of two surgical specimens of the large bowel and corresponded to appendices epiploicae of different sizes. The appendices epiploicae can be identified by sonography only when surrounded by fluid; their shape may be similar to that of peritoneal tumors. Careful analysis of both the relationships of the appendices epiploicae with the outer surface of the large bowel and of their regular spacing along the course of the colon itself may help to avoid possible misinterpretations. PMID- 3276915 TI - Fracture of the clavicle in the newborn. An ultrasound diagnosis. AB - Forty-one cases of clavicle fracture in newborn babies were examined by both radiographic and ultrasonic methods. No substantial difference has been found between these two modalities. It is suggested that ultrasound should be the procedure of choice in the diagnosis of clavicle fracture. This is especially true in those cases where impaired movement of the arm is the only clinical sign. PMID- 3276916 TI - The ultrasonic appearance of common pulmonary vein atresia in utero. PMID- 3276917 TI - Infantile glomerulonephritis mimicking polycystic kidney disease. PMID- 3276918 TI - Sonographic demonstration of iliac venous thrombosis in the maternity patient. PMID- 3276919 TI - Gas-containing gallstones. The sonographic "double echo sign". PMID- 3276920 TI - The varied ultrasonographic appearance of laminaria. PMID- 3276921 TI - Inadvertent iatrogenic introduction of air into myometrium. Sonographic demonstration. PMID- 3276922 TI - The safety of Doppler ultrasound. PMID- 3276923 TI - Early detection of intrauterine pregnancy with ultrasound. AB - Vaginal scanning is a relatively new technique for scanning early pregnancy. In a consecutive series of 27 patients on an in vitro fertilization program (and therefore certain dates of ovulation) we have demonstrated that pregnancies may be seen within the uterus even before 5 weeks amenorrhoea and have documented their size. Ultrasound examination at this early stage may be of clinical value, particularly in patients suspected of having an ectopic pregnancy. PMID- 3276924 TI - Recombination between two integrated proviruses, one of which was inserted near c myc in a retrovirus-induced rat thymoma: implications for tumor progression. AB - Of 17 Moloney murine leukemia virus (MoMuLV)-induced rat thymomas, 2 contained rearrangements in c-myc. In one of these tumors the observed rearrangement was not due to the insertion of an intact MoMuLV provirus. The rearranged c-myc DNA fragment from this thymoma was cloned and examined by restriction endonuclease mapping, hybridization to MoMuLV proviral DNA probes, and DNA sequence analysis. These analyses revealed that the c-myc rearrangement in this tumor was due to the presence of a partially duplicated MoMuLV long terminal repeat (LTR) 5' to c-myc exon 1. The orientation of this LTR structure was opposite to the transcriptional orientation of c-myc. The sequences at the 3' flanking side of the LTR structure were derived from a cellular DNA region which maps to the same chromosome as c myc (chromosome 7), although to a site distant from this proto-oncogene. These findings present evidence for a homologous recombination event occurring between sequences of two proviruses integrated on the same chromosome, one of which was inserted near the c-myc proto-oncogene. The recombination product contains three copies of the MoMuLV LTR 72-base-pair direct repeat and is associated with a high level of c-myc expression. The reciprocal product of this recombination was not detected. We propose that recombination between homologous sequences may play a significant role in the generation of chromosomal rearrangements and therefore in tumor induction and progression. PMID- 3276925 TI - S phase fraction of human bladder tumor measured in situ with bromodeoxyuridine labeling. AB - A total of 18 patients with transitional cell bladder cancer was given a 0.5-hour intravenous infusion of bromodeoxyuridine at the time of endoscopic biopsy or transurethral resection to label tumor cells in the deoxyribonucleic acid synthesis phase (S phase). The tumor specimens were fixed with 70 per cent ethanol, embedded in paraffin, sectioned and stained by an indirect immunoperoxidase method with anti-bromodeoxyuridine monoclonal antibody as the first antibody. The bromodeoxyuridine labeling index, S phase fraction, was determined by counting the number of bromodeoxyuridine-labeled cells in the tissue sections. All grade 1 tumors had an S phase fraction of lower than 10 per cent. The average S phase fractions for noninvasive (11 cases) and invasive (7) tumors were 9.8 and 20.0 per cent, respectively. Two distant metastatic bladder tumors showed an average S phase fraction of 25.3 and 30.0 per cent. Thus, transitional cell bladder cancers with an S phase fraction of greater than 10 per cent appears to grow faster and be more invasive more often than those with an S phase fraction of less than 10 per cent. The higher S phase fraction may indicate greater biological malignancy. Our preliminary results suggest that measurement of the bromodeoxyuridine labeling index in bladder tumors may be a new objective and quantitative assay of biological potential of individual tumors. PMID- 3276926 TI - Sonourethrography in the evaluation of urethral strictures: a preliminary report. AB - A total of 17 patients with suspected stricture disease underwent conventional retrograde urethrography and sonourethrography. When the length of the stricture as assessed by each imaging modality was compared to measurements at open urethroplasty in 7 patients, sonourethrography was consistently more accurate. Distension of the urethra with saline during the ultrasound examination enabled classification of the degree of spongiofibrosis, which was confirmed by full depth biopsy in 5 patients. Sonourethrography cannot adequately image the posterior urethra, even when the transcrotal approach is used. However, because it is a dynamic 3-dimensional study and can be repeated without risk of radiation exposure, sonourethrography is preferable to radiographic retrograde urography to evaluate patients with suspected anterior urethral strictures. PMID- 3276927 TI - Biliary obstruction complicating extracorporeal shock wave lithotripsy. AB - An elderly woman with a solitary right kidney and unrecognized cholelithiasis underwent extracorporeal shock wave lithotripsy for renal calculi. Postoperatively, biliary obstruction developed that required emergency surgery. Pathological evaluation of the biliary calculi revealed superficial fragmentation. It is suggested that extracorporeal shock wave lithotripsy was responsible for the gallstone fragmentation and resultant bile duct obstruction. PMID- 3276928 TI - Testicular papillary cystadenomatous tumor of low malignant potential: a case report and discussion of the literature. AB - We report the fifth case of a rare testicular serous papillary cystadenomatous tumor of low malignant potential. All patients presented with a testicular mass. Histologically, the tumor can be differentiated from testicular papillary cystadenocarcinoma. The natural history of this rare tumor is yet to be determined. PMID- 3276929 TI - Re: Effect of furosemide on dialysis requirement following cadaveric kidney transplantation. PMID- 3276930 TI - Effect of chronic nitrofurantoin on the rabbit urinary bladder. AB - Interstitial cystitis is a pathological condition whose symptoms mimic urinary tract infection and include urgency, frequency, and moderate to severe pain. Many more women than men are affected, with antibiotic therapy being the usual first treatment approach based on symptomology. Some clinicians believe that chronic antibiotic therapy may play an etiological role in interstitial cystitis; however neither clinical nor experimental data support their opinion. The implied pathogenesis of antibiotic injury is an alteration of the bladder mucosa and its protective mucin coating to allow urine-mediated damage to the bladder wall. The purpose of this study is to evaluate rabbit urinary bladder function and morphology during chronic nitrofurantoin administration. The results demonstrate that up to twelve months of chronic nitrofurantoin administration produce no changes in 1) bacterial adherence to the rabbit bladder mucosa, 2) specific antibacterial adherence activity of the bladder mucin, and 3) ultrastructure of the mucosa, submucosa, and muscularis. PMID- 3276931 TI - Role of fibronectin in intravesical BCG therapy for superficial bladder cancer. AB - Intravesical bacillus Calmette-Guerin (BCG) has been demonstrated to be effective both for prophylaxis and treatment of superficial bladder cancer. In order to identify the progression of events that result in BCG-mediated antitumor activity, studies were performed to evaluate the mechanism of binding of BCG within the bladder. Histological and quantitative studies in a mouse model revealed that BCG attached to the bladder wall only in areas of urothelial damage. Preliminary in vitro data showed that BCG attached to surfaces coated with extracellular matrix proteins. Further studies were then performed using purified extracellular matrix proteins to identify the proteins responsible for attachment. BCG were observed to attach to surfaces coated only with purified fibronectin (FN) but not to other purified proteins including laminin, collagen or fibrinogen. The attachment of BCG to purified FN in vitro was dose dependent and was inhibited by anti-FN antibodies. Moreover, BCG attachment in vivo to bladders with damaged urothelial surfaces was inhibited more than 95% by anti-FN antibodies, but binding was not affected by anti-laminin antibodies or preimmune serum. A survey of commercially available BCG vaccines (Pasteur, Tice, Glaxo, Connaught) showed that only Glaxo BCG did not attach to FN-coated surfaces. Glaxo BCG also was shown to express inferior antitumor activity suggesting that the absence of FN binding by Glaxo may have been associated with the absence of antitumor activity of the vaccine. PMID- 3276932 TI - Vascular complications associated with spontaneous aortic dissection. AB - Three hundred twenty-five cases of spontaneous aortic dissection seen at two institutions between 1965 and 1986 were reviewed to assess the incidence, morbid sequelae, and specific management of aortic branch compromise. Noncardiac vascular complications occurred in 33% of the study group, and in these patients the overall mortality rate (51%) was significantly (p less than 0.001) higher than in patients without (29%) such complications. Although aortic rupture was the strongest correlate of mortality (90%), death specifically related to vascular occlusion was common when such occlusion occurred in the carotid, mesenteric, and renal circulation. There was a strong correlation between stroke and carotid occlusion (22/26 cases), yet specific carotid revascularization was only used during the chronic phase of the disease. Similarly, peripheral operation was ineffective in reducing the mortality rate in the setting of mesenteric (87%) and renal (50%) ischemia. Fifteen patients required either fenestration or graft replacement of the abdominal aorta for acute obstruction, rupture, or chronic aneurysm development. Thirty-eight patients (12%) demonstrated some degree of lower extremity ischemia, and one third of these required a direct approach on the abdominal aorta or iliofemoral segments to restore circulation. Selected patients with acute aortic dissection may require peripheral vascular operation in accordance with a treatment strategy that directs initial attention to the immediate life-threatening complications. PMID- 3276934 TI - Duplex ultrasound scanning in the diagnosis of renal artery stenosis: a prospective evaluation. AB - Since ultrasonic energy can be used to interrogate vessels at great depth, it is only natural that it should be applied to deeply placed arteries in the abdomen. Early studies suggested that high-grade stenoses of the renal artery could be detected by this approach as long as the peak systolic velocity in the renal artery was normalized by that measured in the abdominal aorta. A retrospective study comparing the peak velocity in the renal artery to that from the adjacent abdominal aorta (the renal aortic ratio) showed that if this value exceeded 3.5, it is likely to be associated with a greater than 60% diameter-reducing stenosis. To test this hypothesis, we used duplex scanning to prospectively evaluate 58 renal arteries in 29 patients in whom arteriograms were available. There were 39 renal arteries with 0% to 59% stenosis, 14 with 60% to 99% stenosis, and five occlusions by angiography. Renal duplex scanning accurately diagnosed 38 of 39, 11 of 14, and four of five of these, respectively, giving a sensitivity of 84%, a specificity of 97%, and a positive predictive value of 94% for the detection of a greater than 60% diameter-reducing stenosis. The overall agreement with angiography was 93%. These data show that renal duplex scanning can be used to diagnose renal artery stenosis in patients with hypertension or renal dysfunction, thus providing a rational basis for the selection of patients for angiography. PMID- 3276933 TI - Benefits of carotid patching: a randomized study. AB - Advocates of carotid artery patching claim a reduced incidence of recurrent stenosis after endarterectomy. A prospective study was undertaken to determine its value with random selection between primary closure and saphenous vein patching. A consecutive series of 129 carotid endarterectomies was evaluated by duplex scanning at 3, 6, and 12 months after operation. Intravenous digital subtraction angiography (DSA) was performed in the first postoperative days for control of the surgical technique and after 1 year to serve as a reference for the duplex scanning. Sixty-two patients were selected to have primary closure and 67 were chosen for the patching technique. Both groups were identical with regard to risk factors (mean age 63 years, 74% were men, 57% had hypertension, 41% had coronary disease, 37% had peripheral arterial disease, and 9% had diabetes mellitus), side of operation (55% left), symptoms (18% were asymptomatic), and postoperative DSA (81% were normal, 17% had residual lesions, and 2% had occlusions). A complete 1-year follow-up was obtained in 105 cases (81%); duplex scanning showed recurrent stenosis of more than 50% in 12 cases (11%). This was significantly higher after primary closure (10 of 48 patients = 21%) compared with patch closure (2 of 57 = 3.5%; p = 0.006) and also in women (6 of 25 = 24%) compared with men (6 of 80 = 7.5%; p = 0.03). Recurrent stenosis was present in 6 of 11 women with primary closure (55%), 4 of 37 men with primary closure (11%), 2 of 43 men with patching (5%), and none of 14 women with patch closure (0%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3276935 TI - Weighing alternatives. PMID- 3276936 TI - The benefits and risks of exercise training in patients with chronic coronary artery disease. PMID- 3276937 TI - Alcoholism and orthotopic liver transplantation. PMID- 3276938 TI - Ultrasound in prostatic cancer. PMID- 3276939 TI - Impaired arginine-vasopressin secretion associated with hypoangiotensinemia in hypernatremic dehydrated elderly patients. AB - Nine elderly patients, some with preceding dementia, presented with adipsia, progressive dehydration, impaired consciousness, and hypernatremia following common acute infections without gastrointestinal disturbance. Studies before rehydration revealed inappropriately low plasma arginine-vasopressin (AVP) levels for plasma osmolality, insufficiently concentrated urine, absolutely or relatively low plasma angiotensin II (A-II) concentrations (compared with plasma renin activity and plasma angiotensin I concentrations), and low serum angiotensin I-converting enzyme activities. The plasma AVP concentrations were positively correlated with the plasma A-II concentrations (r = .677) but not with plasma osmolality. The plasma AVP level was raised by an intravenous infusion of A-II in one patient. These findings suggest the following sequence of events: impaired A-II production caused impairment of thirst perception, renal concentrating capacity, and AVP secretion and contributed to development of hypernatremic dehydration in these elderly patients. PMID- 3276940 TI - Diagnosis and treatment of aphasia. Part I. PMID- 3276941 TI - Herpes simplex encephalitis in a patient with lymphoma. Relapse following acyclovir therapy. PMID- 3276943 TI - Leads from the MMWR. AIDS due to HIV-2 infection--New Jersey. PMID- 3276942 TI - Compelled medical treatment of pregnant women. Life, liberty, and law in conflict. PMID- 3276944 TI - Leads from the MMWR. Lyme disease--Connecticut. PMID- 3276945 TI - The importance of adverse reaction reporting by physicians. Suprofen and the flank pain syndrome. AB - The role of spontaneous reporting in detecting the suprofen-associated flank pain syndrome was examined, including the specific effect of the "Dear Doctor" letter in accelerating the information-gathering process once the initial signal was generated. We believe this to be a noteworthy example of the ability of spontaneous reporting to produce a timely and unequivocal signal of drug-related risk. It also serves to demonstrate the need for vigilant postmarketing surveillance for all newly marketed drugs in the United States, even though considerable premarketing and postmarketing drug experience may exist from use in countries outside of the United States. PMID- 3276946 TI - Diagnosis and treatment of aphasia. Part II. PMID- 3276947 TI - Magnetic resonance imaging of the central nervous system. Council on Scientific Affairs. Report of the Panel on Magnetic Resonance Imaging. AB - This report reviews the current applications of magnetic resonance imaging of the central nervous system. Since its introduction into the clinical environment in the early 1980s, this technology has had a major impact on the practice of neurology. It has proved to be superior to computed tomography for imaging many diseases of the brain and spine. In some instances it has clearly replaced computed tomography. It is likely that it will replace myelography for the assessment of cervicomedullary junction and spinal regions. The magnetic field strengths currently used appear to be entirely safe for clinical application in neurology, except in patients with cardiac pacemakers or vascular metallic clips. Some shortcomings of magnetic resonance imaging include its expense, the time required for scanning, and poor visualization of cortical bone. PMID- 3276948 TI - New population, new HIV vaccine in clinical trials. PMID- 3276949 TI - The physician's ethical obligation to take care of patients in times of plague. PMID- 3276950 TI - Routine preoperative screening for HIV. Does the risk to the surgeon outweigh the risk to the patient? PMID- 3276951 TI - [The history and present status of the Japanese Society for Gastric Cancer]. AB - The Gastric Carcinoma Study Group was established in 1962. Its purpose are two fold to prepare a common guideline for those engaged in the diagnosis and treatment of gastric carcinoma, and to obtain more satisfactory results from the diagnosis and treatment of this carcinoma. Initially, guidelines, were prepared mainly for the surgical treatment and pathological examination of gastric carcinomas. Later, however, other guidelines were prepared for the chemotherapy and radiotherapy of these carcinomas. The Study Group holds its regular meetings twice a year. In this communication, the history and present situation of the Study Group are discussed. In addition, information is given on the results of surgical operations conducted on gastric carcinomas that have been reported throughout the country. PMID- 3276952 TI - [Primary ileal carcinoma]. AB - Recently encountered is a case of a primary ileal carcinoma in which radical resection was performed. The history follows. A 76-year-old male was admitted to Miyako Hospital on January 12, 1986 complaining of abdominal pain of ten days duration. Pre-operative treatment extended over an eleven-day period without any symptomatic remission. A barium enema and roentgenographic examination that followed a barium ingestion revealed no abnormality in the large bowel, but a mechanical obstruction, typical of a carcinoma, was detected in the small intestine. On January 23, 1986, under a general anesthesia, the abdomen was opened through a midline rectus incision. A tumor was found in the terminal ileum 14 cm proximal to the ileocecal valve, and was causing almost total obstruction of the intestine. This tumor, with involved ileal and regional lymph-nodes, was resected, followed by an end-to-end anastomosis. The tumor, grossly circumscribed, was roughly circular in outline and protruded from the ileal wall. No lymph-node metastasis was found in histological sections. The diagnosis was a primary adenocarcinoma of the ileum. Few reports have been reported in Japan on radically resected primary carcinomas of the ileum. The future course of this case deserves careful study. PMID- 3276954 TI - [An analysis of needle biopsy under ultrasonography of the thyroid gland]. AB - A multivariate analysis of 47 thyroid nodules and 34 diffuse goiters has been employed to determine the cause of failure in thyroid biopsy under ultrasonography. In the thyroid nodule cases, 30 percent were found to have been misdiagnosed or judged to be an inappropriate sampling. The most important factor leading to failure is a size of tumor. Only one fourth of the small tumors of less than 1 cm were correctly diagnosed and, in cases of a relatively large cystic tumor or a peripherally located nodule, an exact diagnosis was difficult, though 90 percent of the diffuse goiters were difficult, though 90 percent of the diffuse goiters were correctly diagnosed by this method. This result indicates that needle biopsy of the thyroid gland is reliable in cases of a diffuse goiter but problems remain to be resolved in cases of small or cystic tumors and peripherally located nodules. PMID- 3276953 TI - [A case of ovarian granulosa cell tumor with invasive adenocarcinoma of the endometrium]. AB - A case of an ovarian granulosa cell tumor with an invasive adenocarcinoma of the endometrium, and a review of the relevant Japanese literature is reported. A 47 year-old woman was admitted to Ichinomiya Citizens' Hospital complaining of irregular uterine bleeding. On operating, an ovarian tumor was found with a broad based polypoid mass extending into the endometrium. These lesions were histologically diagnosed as a granulosa cell tumor with an invasive adenocarcinoma of the endometrium. We have found 4 cases of a granulosa cell tumor with adenocarcinoma of the endometrium in the Japanese literature and have determined that our case with an endometrial cancer showing an invasion to the myometrium of the uterus is unique among previously reported cases. PMID- 3276955 TI - [Clinicopathological study of early multicentric gastric carcinomas]. AB - During a two-year period, from August, 1983 to July, 1985, 144 gastric cancer patients have been treated at the National Tohsei Hospital. Among them, 57 patients were determined as having an early gastric carcinoma. Four patients (7.0%) of this number were found to have a multicentric type, 3 manifesting a double II c type, and 1 patient having both a I type and II a type. Pathologically these two types carcinomas were found in only one patient, in a so called kissing position. PMID- 3276956 TI - [A case of early gastric cancer forming a large abdominal tumor from a lymph node metastasis]. AB - A 37-year-old male was admitted to our hospital because of an abdominal tumor, about the size of a fist, located anterior to the pancreas head. This tumor oppressed the antrum of the stomach to the left, and an operation was performed, the tumor being diagnosed as a leiomyosarcoma of the stomach, determined from image findings. After histopathological examination, however the tumor proved to be an adenocarcinoma. An early gastric cancer was found at the anterior wall of the antrum during the operation, and the tumor was thought to be a metastatic lymph node. Lymph node metastasis also was observed at the root of the mesentery. PMID- 3276957 TI - The importance of arachidonate metabolism by immune and nonimmune cells. PMID- 3276958 TI - Human amyloidosis, Alzheimer disease and related disorders. PMID- 3276959 TI - Human nevocellular nevus cells are surrounded by basement membrane components. Immunohistologic studies of human nevus cells and melanocytes in vivo and in vitro. AB - Dermal nevus cells in the skin are surrounded by electron-dense deposits resembling a basement membrane (BM), and epidermal melanocytes rest on the epidermal BM. Using antibodies directed against various BM components, we have determined that the BM-like structure surrounding nevus cells in vivo contains type IV collagen, laminin, and BM-1 proteoglycan, analogous to BM throughout the body, but not bullous pemphigoid antigen or epidermolysis bullosa acquisita antigen that are keratinocyte-associated proteins present in the epidermal BM. Moreover, in vitro, both nevus cells and melanocytes derived from adult donors display intracellular and extracellular fibronectin, BM-1 proteoglycan, type IV collagen, and laminin. In contrast, newborn melanocytes maintained under identical culture conditions display none of these BM components, emphasizing the influence of donor age on cell behavior. The data suggest that dermal nevus cells manufacture a BM in vivo, as do certain other neural crest-derived cells. The apparent shared ability of cultured nevus cells and melanocytes to synthesize BM components, coupled with other previously noted behavioral and morphologic similarities in vitro, suggests that these cell types are very closely related; and that morphologic or histochemical differences present in vivo are the result of environmental influences rather than intrinsic differences. PMID- 3276960 TI - Distribution of enkephalinase (membrane metalloendopeptidase, E.C. 3.4.24.11) in rat organs. Detection using a monoclonal antibody. AB - A monoclonal antibody to enkephalinase (membrane metalloendopeptidase E.C. 3.4.24.11) raised by immunizing mice with rabbit renal cortical cells (mAb 85A2) was used to assess the tissue distribution of the enzyme in adult rats. When incubated with enkephalinase purified from renal brush border or with solubilized brush border proteins in the presence of antimouse IgG, the mAb specifically precipitates active enkephalinase as assessed by thiorphan inhibitable hydrolysis of [3H]-(D.Ala2, Leu5)]enkephalin. Immunoprecipitation and sodium dodecyl sulfate polyacrylamide gel electrophoresis studies of radiolabeled brush border proteins indicate that mAb 85A2 binds specifically an antigen with an apparent molecular weight of 90 kilodaltons, corresponding to published values for enkephalinase. This antibody was used to localize enkephalinase by autoradiographic and immunofluorescence techniques. Immunohistochemical data show intense expression of this ubiquitous enzyme in brain, kidney, thyroid, parts of intestine, lung, seminal vesicle, and prostate. Specific areas of the brain contain more enkephalinase than others. Similarly, specific intense localization demonstrated in pulmonary alveolar cells and along the brush borders of the gut and the pars recta of the renal proximal tubule indicates that only select cell populations and/or cell compartments express this enzyme. PMID- 3276961 TI - The rise of organized pediatrics in South Carolina: a brief history of the South Carolina Pediatric Society and of the South Carolina Chapter of the American Academy of Pediatrics. PMID- 3276962 TI - George Roswell Dean, M.D. 1844-1911. PMID- 3276963 TI - The characterization of Ia+ cells in human parathyroid and islets. AB - Recent studies in animals have shown prolonged survival of endocrine allografts after treatment of the graft with Ia antibody prior to transplant. In this study, we documented the presence of Ia bearing passenger cells in human parathyroid and islets of Langerhans. Furthermore, we characterized these cells with regard to their expression of HLA-DQ and HLA-DR molecules using indirect immunofluorescence. We found that passenger cells in parathyroid express both HLA DQ and HLA-DR. In contrast, islets express only HLA-DR. Parathyroid tissue treated first with polyclonal anti-DR or anti-DQ and complement eliminated cells that reacted with monoclonal anti-DR or -DQ probes, respectively. Similarly, islets treated with polyclonal anti-DR and complement eliminated cells that reacted with monoclonal anti-DR reagents. We believe that further characterization of Ia+ cells in human endocrine tissue will provide information that could be used to enhance allograft survival. PMID- 3276965 TI - Experimental and clinical assessment of lung injury by measurement of extravascular lung water and transcapillary protein flux in ARDS: a review of current techniques. PMID- 3276964 TI - Modification of catecholamine and prostaglandin tissue levels in E. coli endotoxin-treated rats. AB - Epinephrine and norepinephrine adrenal levels were depleted in Escherichia coli endotoxin-treated (10 mg/kg) male Wistar rats from 504 +/- 203 to 119 +/- 77 ng/mg in control and from 200 +/- 97 to 123 +/- 66 ng/mg wet wt, respectively. However dopamine increased from 4.2 +/- 1.9 to 14.9 +/- 3.4 ng/mg. After endotoxin administration, norepinephrine content in peripheral organs, heart 1.27 +/- 0.19 ng/mg, spleen 1.52 +/- 0.59 ng/mg, liver 0.15 +/- 0.05 ng/mg, and kidney 0.24 +/- 0.09 ng/mg wet wt. decreased by 34, 36, 47, and 18%, respectively. Indomethacin treatment kept the catecholamine levels constant in endotoxic rats, but naloxone had no effect. PGF2 alpha tissue levels (12.0 +/- 10.1 pg/mg protein in spleen and 1.85 +/- 0.6 pg/mg protein in liver) were increased twofold by endotoxin treatment: PGE2 content in spleen and liver 0.5 +/- 0.2 pg/mg protein and 2.3 +/- 1.9 pg/mg protein, respectively, increased by only 27 and 26%. In the kidneys of endotoxin-treated animals, PGF2 alpha and PGE2 levels were lower than in control. Indomethacin treatment decreased PGF2 alpha and PGE2 and increased the norepinephrine content in the same organs. It is suggested that prostaglandins play a participative role in the control of norepinephrine tissue levels in endotoxemia. PMID- 3276966 TI - Medicare revisited. PMID- 3276967 TI - The Samson aura and era. PMID- 3276968 TI - A clinical comparison of mitral valve repair versus valve replacement in ischemic mitral regurgitation. AB - Severe mitral regurgitation caused by acute myocardial infarction has been a particularly difficult management problem with disappointing clinical results. Over a 75-month period, ending March 31, 1987, 611 patients underwent mitral valve operations at Duke University Medical Center. Within this group, 55 patients had clearly defined ischemic mitral regurgitation, and 37 of these required emergency operations. Thirty-one of the 55 patients had isolated posterior papillary muscle dysfunction, nine had papillary muscle rupture, and 15 had severe ventricular dysfunction and generalized annular dilatation. Thirty-two patients were treated with primary mitral valve replacement, and 23 had mitral valve repair. In 18, repair was accomplished by a transventricular approach, combining the techniques of commissural annuloplasty, papillary muscle shortening or reimplantation, and infarct exclusion. Transventricular mitral valve repair proved to be safe, expeditious, and effective in restoring valve competence. Although the repair and replacement groups were similar with respect to all relevant baseline characteristics, improved operative survival was observed after valve repair, as compared to replacement, both for the overall group (p = 0.03) and for acute papillary muscle dysfunction (p = 0.05). These data suggest that a policy of predominant mitral valve repair, when appropriately applied in patients with ischemic mitral regurgitation, offers the potential for improving therapeutic results. PMID- 3276969 TI - The protection of ischemic lung with verapamil and hydralazine. AB - The optimum method for lung preservation in preparation for transplantation remains unresolved. In this study, we evaluated the effectiveness of two pharmacologic agents for prolonging the preservation time of the ischemic lung. We compared hydralazine, a vasodilator, and verapamil, which is both a vasodilator and a calcium channel blocker, in regard to their effectiveness in promoting functional recovery of the ischemic dog lung in a new experimental model. The model consists of exposing the left lung of each dog to normothermic ischemia after clamping the pulmonary artery, vein, and bronchus. After ischemic periods of 1 to 5 hours, pulmonary circulation was reestablished. The functional integrity of the left lung was then evaluated by ligating the right bronchus, so that the dog was completely dependent on the previously ischemic lung. The left lung of eight dogs was perfused with 200 ml of Collins-Sachs solution alone in group A, with Collins-Sachs solution containing 20 mg of hydralazine in group B (n = 8), and with Collins-Sachs solution containing 5 mg of verapamil in group C (n = 8). The mean ischemic time was 2.3 hours in group A, 3.0 hours in group B, and 3.1 hours in group C. One dog in group A survived after 1 hour of ischemia, two dogs in group B survived after 1 and 3 hours of ischemia, and six dogs in group C survived 2 to 4 hours of ischemia. Oxygen tension in room air after bronchial ligation was 39.9 +/- 10.2 mm Hg in group A, 59.4 +/- 35.3 in group B, and 76.1 +/- 32.9 in group C. Statistical significance existed between groups A and C (p less than 0.05). Pulmonary vascular resistance after bronchial ligation was 428.9 +/- 158.8 dynes.sec.cm-5 in group A, 219.9 +/- 51.9 in group B, and 208.3 +/- 84.5 in group C. Thus tissue damage caused by ischemia was significantly less with verapamil than with the vasodilating drug hydralazine. PMID- 3276970 TI - Transposition of the great arteries with intact ventricular septum. Arterial switch in the first month of life. AB - Twenty-three infants with simple transposition of the great arteries and intact ventricular septum were operated on from October 1983 to October 1986. The age at operation in 22 infants ranged from 2 to 21 days and in one was 35 days (mean 9.82 +/- 6.86 days). The infants were evaluated with cardiac catheterization at 1 to 27 days of age. Twenty-two infants had balloon atrial septostomy, and 22 received prostaglandin E1 infusion. The left ventricular diastolic wall thickness, assessed by M-mode echocardiograms, varied between 2.8 and 4 mm. There were two hospital deaths in this group of 23 infants (mortality 8.6%), and there were no late deaths. All surviving patients are doing well clinically. One patient had asymptomatic nonsustained ventricular tachycardia necessitating phenytoin. Postoperative echocardiographic assessment performed on 15 patients at 0.93 +/- 0.61 years of age and cardiac catheterization and angiographic studies on seven patients at 1.07 +/- 0.13 years after operation revealed excellent ventricular performance, good semilunar valve function, and mild gradient at the right ventricular outflow with a mean right ventricular pressure of 37.4 +/- 4.1 torr. PMID- 3276971 TI - Mucous gland adenoma of the trachea: case report and literature review. AB - Adenoma arising from bronchial mucous glands is extremely rare. Such tumors are truly benign, in contradistinction to other tumors previously grouped under the term "bronchial adenoma." We present the first case reported of mucous gland adenoma arising in the trachea. This case was initially misdiagnosed as asthma, a common error with obstructing tracheo-bronchial lesions. PMID- 3276972 TI - Postdilution hemofiltration in the management of acute hepatic failure: a pilot study. AB - We conducted a pilot study to assess the feasibility and efficacy of postdilution hemofiltration (PDHF) in the management of acute hepatic failure. From January 1984 through May 1986, we encountered seven patients with acute hepatic failure and entered these consecutive patients in the study; three had non-A, non-B hepatitis and one each had type B hepatitis, fulminant Wilson's disease (hepatolenticular degeneration), acute allograft (liver) failure, and acute fatty liver of pregnancy. Two of these seven patients were unable to undergo PDHF because of a precarious hemodynamic status. Of the five patients treated with PDHF, four had amelioration of hepatic encephalopathy; in two of these patients, a close temporal relationship was noted between the improvement and the procedure. Four patients had appreciable thrombocytopenia related to PDHF and bleeding complications. Our preliminary results support a possible role for PDHF as a temporary artificial liver support system for patients with acute hepatic failure. PMID- 3276974 TI - Age-related changes in normal human hearts during the first 10 decades of life. Part II (Maturity): A quantitative anatomic study of 765 specimens from subjects 20 to 99 years old. AB - Heart weights, ventricular wall thicknesses, and valve circumferences were measured in 765 autopsy specimens from normal hearts from persons 20 to 99 years old. Body weight was a better predictor of normal heart weight than was body surface area or height, and mean heart weights were greater in men than in women at all ages. When heart weights were indexed (divided by body surface area), the mean values per decade increased significantly in women between the 3rd and 10th decades of life (P less than 0.01) but remained relatively constant with time in men. We found no significant differences in ventricular wall thicknesses between men and women. Although indexed mean values for left and right ventricular wall thicknesses remained relatively constant in all decades, ventricular septal thickness increased significantly between the 3rd and 10th decades of life (P less than 0.001). Beyond the seventh decade of life, the mean ratio of septal to left ventricular free wall thicknesses exceeded 1.20, and the upper 95% confidence limit exceeded 1.50--an important consideration in evaluation of hypertrophic cardiomyopathy in elderly patients. Mean valve circumferences were usually greater in men than in women, but the opposite pertained when values were indexed by body surface area. In both sexes, all indexed mean valve circumferences increased progressively throughout adult life, although this trend was greater for semilunar than for atrioventricular valves. The mean circumference of the aortic valve surpassed that of the pulmonary valve in the 4th decade and approached that of the mitral valve by the 10th decade of life. Thus, in evaluation of annuloaortic ectasia, investigators should take into account the normal age-related changes in aortic valve dimensions. PMID- 3276973 TI - Age-related changes in normal human hearts during the first 10 decades of life. Part I (Growth): A quantitative anatomic study of 200 specimens from subjects from birth to 19 years old. AB - Heart weight, ventricular wall thicknesses, and valve circumferences were measured in 200 autopsy specimens of normal hearts from persons who ranged from birth to 19 years old. During this period of body growth, all cardiac measurements increased progressively and correlated with both age and body size (height, weight, and surface area). For most measurements, the mean predicted values were greater in male than in female subjects. Heart weight correlated better with body weight and body surface area than with body height or age of patients. In contrast, ventricular wall thicknesses and valve circumferences correlated better with age of the patients than with measurements of body size. In both sexes at all ages, the thickness of the left ventricle was greater than that of the right ventricle and was generally less than that of the ventricular septum. The circumference of the tricuspid valve usually exceeded that of the mitral valve, but aortic and pulmonary valve circumferences were similar. On the basis of these data, equations were derived and reference tables were constructed to predict normal values for heart weight, ventricular wall thicknesses, and valve circumferences. PMID- 3276975 TI - Immunoglobulin G and its function in the human respiratory tract. AB - Immunoglobulin G--which can be subdivided into four classes, each with different functional characteristics--is an important component of the host defense system of the respiratory tract. An excessive amount can be produced or can accumulate after airway irritation (exposure to cigarette smoke) or from immunologic stimulus of B-lymphocyte-plasma cells in types of hypersensitivity and interstitial lung diseases. Specific antibody activity can be identified in organic dust-induced hypersensitivity pneumonitis and asthma that contributes to disease pathogenesis. The availability of opsonic antimicrobial antibodies is essential for optimal function of phagocytes in uptake and containment of bacteria. With an absolute or functional deficiency of IgG, recurrent and chronic types of sinopulmonary infections occur. These extremes of IgG availability, either high levels (presumably excessive) or deficient, are discussed in this review. PMID- 3276976 TI - Paget's perspectives in pathology. PMID- 3276977 TI - The puzzle of prostatic carcinoma. PMID- 3276978 TI - Fulminant hepatic failure and the need for artificial liver support. PMID- 3276979 TI - What is the role of testing for IgM antibody to core antigen of hepatitis B virus? PMID- 3276980 TI - Jeanne Mance: founder of Hotel Dieu of Montreal. PMID- 3276981 TI - The structure and function of dental-care markets. A review and agenda for research. AB - The growth of dental health services over the past 15 years has produced several issues in dentistry. Because economic markets are the cornerstone of dental delivery in the US, informed responses to these issues require a thorough understanding of dental-care markets. The empirical literature is reviewed to examine the structure of dental markets, to assess the major determinants of market equilibrium, and to examine the social and health consequences of dental care markets. Results reveal that while dental markets are imperfectly competitive, it is unclear whether prices exceed competitive levels. Little is known about the effects of dental markets on public oral health and society. Future research is proposed in two broad areas: 1) updating early studies conducted when few Americans had dental insurance benefits; and 2) path-breaking research to advance our knowledge of dental-care markets in particular and medical-care markets in general. PMID- 3276982 TI - Content of prenatal care in the United States. A historic perspective. AB - The purpose of this study was to describe the content of prenatal care in the United States over time. Secondary data sources were reviewed and selected data were analyzed, mainly in the last two decades. Data reviewed included special surveys from the National Center for Health Statistics, advice given by professional organizations, obstetric textbooks, commercial advertisements in obstetric journals, and occasional surveys. The data suggest that American prenatal care has emphasized screening for biomedical problems, while health education and support functions have been less central. It appears that some prenatal practices from earlier years, such as strict weight-gain restriction, wide use of diuretics and some other drugs, use of x-ray, have been harmful. PMID- 3276983 TI - Platelets and antiplatelet therapy in ischemic heart disease. AB - Blood platelets have been shown to play an important role not only in thrombosis, but also in the pathogenesis of coronary artery disease and its complications. Drugs that affect platelets have been shown to reduce mortality in survivors of acute myocardial infarction, to reduce the risk of myocardial infarction in patients with unstable angina, and to preserve the potency of saphenous venous grafts used to bypass obstructed coronary arteries. The drugs may also play a role in the primary prevention of arteriosclerosis and in preventing thrombotic complications following coronary angioplasty. PMID- 3276984 TI - Antianginal drug therapy for silent myocardial ischemia. AB - Many of the available nitrate preparations, beta-adrenergic blockers, and calcium antagonists appear to be useful in patients with painful and silent ischemic episodes detected on the ECG (Table 1). More controlled studies need to be done using standardized methodologies for assessing silent myocardial ischemia, to evaluate and compare the different antianginal medications. It is fortunate, however, that the nitrates, beta-blockers, and calcium antagonists, used alone and in combination, appear to have favorable effects not only on painful ischemic episodes but also on those ischemic episodes not associated with pain. PMID- 3276985 TI - Thrombolytic therapy in acute myocardial infarction: Part I. AB - Thrombolytic therapy with pharmacologic agents is an exciting approach to the treatment of myocardial infarction. The results of several clinical studies indicate that perfusion can be restored with intravenous therapy and may be associated with a reduction in infarct size and improved left ventricular function. In a trial involving more than 11,000 patients, thrombolytic therapy reduced acute and long term mortality. Pharmacologic thrombolysis, however, is not without problems. When administered intravenously, the agents currently available, streptokinase and urokinase, are associated with a relatively low recanalization rate as well as a risk of adverse effects, most commonly a systemic lytic state and risk of bleeding complications. Although intracoronary administration is associated with a higher rate of recanalization, the need for cardiac catheterization limits its applicability and results in a delay in the initiation of thrombolytic therapy (which diminishes salvage of myocardium). The trials assessing the existing agents have shown that time is a critical variable in the success of thrombolytic therapy. This had led investigators to focus more attention on intravenous agents that can be administered rapidly. The newer agents now under investigation, acylated streptokinase and single-chain urokinase, may represent improvements of currently available products and may offer potentially increased benefits. A fibrinogen-sparing agent, such as t-PA, in addition to being highly effective, may offer advantages through minimizing the systemic lytic effect. Additional randomized, controlled clinical trials currently are underway to determine the effect on mortality of this "fibrinolytic" therapy as part of a total treatment regimen. The current status of our knowledge concerning thrombolytic therapy in acute myocardial infarction can be summarized as follows: 1. Transmural (that is, Q wave) myocardial infarction usually is caused by an obstructing coronary thrombus. 2. The thrombus can be lysed with intravenous therapy in the majority of cases, particularly with newer, well-tolerated fibrin-specific agents. 3. There is considerable evidence suggesting that reperfusion reduces the acute morbidity and mortality when therapy is administered successfully within the initial 3 to 4 hours (and possibly up to 6 hours) after onset of symptoms. 4. Data on long term prognosis after thrombolysis are very encouraging, although limited. 5. Conventional agents lead to significant fibrinogen depletion and therefore an increased risk of bleeding; the new fibrin-selected agents cause less fibrinogen degradation and may reduce the risk of hemorrhagic complications.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3276986 TI - Coenzyme Q10: a new drug for myocardial ischemia? AB - A biochemical rationale for using CoQ in treating certain cardiovascular diseases has been established. CoQ subserves an endogenous function as an essential cofactor in several metabolic pathways, particularly oxidative respiration. As an exogenous source in supraphysiologic doses, CoQ may have pharmacologic effects that are beneficial to tissues rendered ischemic and then reperfused. Its mechanism of action appears to be that of a free radical scavenger and/or direct membrane stabilizer. Initial clinical studies performed abroad and in the United States indicate that CoQ may be effective in treating certain patients with ischemic heart disease, congestive heart failure, toxin-induced cardiotoxicity, and possibly hypertension. The most intriguing property of CoQ is its potential to protect and preserve ischemic myocardium during surgery. Currently, CoQ is still considered an experimental agent and only further studies will determine whether it will be useful therapy for human cardiovascular disease states. PMID- 3276987 TI - New drug therapy in peripheral vascular disease. AB - New drug therapy for peripheral vascular disease includes the use of nifedipine or sympathetic blocking agents for Raynaud's phenomenon and the use of lower doses of warfarin to prevent recurrence of thromboembolic disease. In prophylaxis of deep venous thrombosis, minidose heparin with or without dihydroergotamine and pneumatic boots are effective. Exercise regimens and the cessation of smoking remain the best therapy for intermittent claudication. PMID- 3276988 TI - Calcium channel blockers. AB - The calcium channel blockers initially were approved for the treatment of classical and variant angina pectoris. Recent studies indicate that these agents also are useful in such diverse conditions as pulmonary and systemic hypertension, hypertrophic cardiomyopathy, arrhythmias, asthma, Raynaud's syndrome, esophageal spasm, myometrial hyperactivity, cerebral arterial spasm, and migraine. PMID- 3276989 TI - Hysteria at the Edinburgh Infirmary: the construction and treatment of a disease, 1770-1800. PMID- 3276990 TI - A jury of matrons. PMID- 3276991 TI - Lunatics and idiots: mental disability, the community, and the poor law in North East England, 1600-1800. PMID- 3276992 TI - The origins of the English drug "scene" 1890-1930. PMID- 3276993 TI - 'Discourses on the Human Physiology' by Alexander Monro primus (1697-1767). PMID- 3276994 TI - Practice makes perfect. Essay review. PMID- 3276995 TI - Cricothyroidotomy versus tracheotomy: an otolaryngologist's perspective. AB - A series of 655 elective cricothyroidotomies presented by Brantigan and Grow in 1975 has fueled a recent explosion in the number of cricothyroidotomies being performed for elective tracheal access. This article reviews Jackson's classic 1921 paper on cricothyroidotomy, Brantigan and Grow's series, seven recent clinical series of elective cricothyroidotomies, and our experience. Voice change is the most frequent complication of cricothyroidotomy occurring in up to 50% of cases. Chronic subglottic stenosis occurs in approximately 2% of cases. Contraindications to cricothyroidotomy include prolonged intubation, airway obstruction following extubation, and laryngeal pathology of any kind. PMID- 3276996 TI - Gonadotropin-releasing hormone (GnRH) inhibits ovulation induced with luteinizing hormone (LH) in proestrous hypophysectomized rats. AB - In this paper we present evidence that a single low dose of the natural synthetic gonadotropin-releasing hormone (GnRH), inhibits ovulation induced by LH in proestrous-hypophysectomized rats. Rats hypophysectomized by the parapharyngeal route in the morning of proestrus received an intravenous injection of 100 or 300 ng GnRH at 1400 h immediately followed by 1.0 microgram LH per 100 g bw. In control groups, either one or both hormones were replaced with 0.9% NaCl. Ovulation was assessed the following morning by counting the ova present in oviductal flushings. All the rats treated with LH alone ovulated, and the addition of GnRH reduced significantly the number of ovulating rats and the number of ova per ovulating rat. In other groups of rats hypophysectomized in the morning of proestrus and treated in the same way, ovarian or adrenal secretory rates of estradiol and/or progesterone were measured after cannulation of the corresponding vein, in the afternoon of proestrus. In these animals, GnRH failed to inhibit either the ovarian progesterone surge observed 2 h after LH administration, or the adrenal progesterone secretion. All hypophysectomized rats showed lower ovarian secretory rate of estradiol than intact rats; this rate was not affected by treatment with LH or LH plus GnRH. The systemic estradiol levels in plasma of hypophysectomized rats were distributed within a range of 20 pg/ml to 50 pg/ml. The number of rats whose levels were above 21 pg/ml on estrus day was significantly higher in rats receiving 300 ng GnRH as compared to those receiving 100 ng GnRH, reaching values that surpassed the concentration found in intact, untreated animals at the same time of estrus. This effect did not depend on LH administration. PMID- 3276998 TI - Geomagnetic field detection in rodents. AB - In addition to behavioral evidence for the detection of "earth-strength" magnetic fields (MF) by rodents, recent investigations have revealed that electrophysiological and biochemical responses to MF occur in the pineal organ and retina of rodents. In addition, ferrimagnetic deposits have been identified in the ethmoidal regions of the rodent skull. These findings point to a new sensory phenomenon, which interfaces with many fields of biology, including neuroscience, psychophysics, behavioral ecology, chronobiology and sensory physiology. PMID- 3276997 TI - Adrenocortical suppression and other endocrine effects of etomidate. AB - (+/-) Etomidate is a short-acting general anaesthetic given by the intravenous route. It has strong adrenal suppression capability initially shown in the rat and then observed in man. At present, the drug seems the most effective adrenocortical inhibitor on a molar basis in vitro. 11 beta-hydroxylase is the most sensitive target enzyme; 16 alpha-, 17 alpha-hydroxylase and cholesterol side-chain cleavage are inhibited by higher concentrations. (+) Etomidate was more active than the (+/-) and far more than the (-) stereoisomer. Etomidate blood concentrations greatly exceed those needed to block adrenal steroidogenesis both when used inappropriately by infusion for long-term sedation (such previously unrecognized drug-induced adrenal suppression has often proved fatal in severely-injured patients) and also when given in very low doses as an induction anaesthetic. Reactive ACTH increase is currently observed. Etomidate, in vivo, does not appear to affect testicular steroidogenesis although it shares an imidazole moiety with fungicide phenylimidazoles endowed with such an action. However, testosterone production may be reduced by high concentrations in vitro. Other gonadal hormones seem unchanged. Both basal and stress-induced blood prolactin levels are lowered by etomidate in the rat but probably not in man arguably through interference at brain level where the GABA-benzodiazepine receptor complex could be directly involved. Hence, endocrine and neuroendocrine interferences are unique non-anaesthetic effects of etomidate. PMID- 3277000 TI - The last fearsome taboo: medical aspects of planned death. PMID- 3276999 TI - Buprenorphine detoxification from opioid dependence: a pilot study. AB - Sixteen opioid dependent patients were assigned to treatment with buprenorphine for one month at three doses--2 mg (n = 10), 4 mg (n = 4), 8 mg (n = 2). Treatment retention was excellent--only one patient left due to withdrawal symptoms. Illicit opioid use was infrequent, with only 22% of the urines containing illicit opioids. Although buprenorphine dose was not associated with retention or illicit opioid use, patterns of withdrawal symptoms differed among dosage groups during the 30 day study. The 4 mg group had a substantial decline in symptoms, while the other two groups did not. Symptom levels were comparable to those during successful clonidine detoxification and much lower than those found in clonidine failures. PMID- 3277002 TI - The therapeutic component of evaluation of competence. PMID- 3277001 TI - Conditions for judicial emergence of the doctrine of informed consent: an American-Australian comparison. PMID- 3277003 TI - Hospital and medical staff relations in the USA. I. Legal aspects. PMID- 3277004 TI - Hospital and medical staff relations in the USA. II. Criteria for privileges. PMID- 3277005 TI - State mandated Medicare assignment. PMID- 3277006 TI - Data assessing the usefulness of screening obstetrical ultrasonography for detecting fetal and placental abnormalities in uncomplicated pregnancy: effects of screening a low-risk population. AB - To investigate the usefulness of screening in low-risk populations, the authors evaluated the yield of ultrasonography for detecting abnormalities in 678 clinically uncomplicated pregnancies. The yield of ultrasonography in high-risk women who were referred for amniocentesis was remarkably similar to the yield in other women. All four diagnoses of twins were correct, but overall only six of 12 initial ultrasound diagnoses of fetal demise or fetal anomalies were confirmed at delivery. Of the eight major fetal anomalies present at delivery, including two cases of Down's syndrome, three had been detected by ultrasonography; none of the nine minor anomalies had been detected, usually because they were too small or might be detectable only at a later gestational age. Although ultrasonography may have a nearly perfect predictive value for certain anomalies, on average, in this study, positive ultrasonography increased the probability of an adverse outcome of pregnancy from 5.3% to 36%, while a normal ultrasound examination decreased the probability to 4.4%. These data, which emphasize the implications of screening a low-risk population, suggest that recommendations regarding routine screening obstetrical ultrasonography should await sufficiently large controlled trials demonstrating consistent clinical benefit, in terms of reassurance or of providing a baseline for future comparison or in terms of improved outcome at a reasonable cost. PMID- 3277007 TI - Poisson processes and gamma distributions. PMID- 3277009 TI - [Radionuclide evaluation of postoperative catabolism in breast cancer]. AB - The paper is concerned with the results of investigation of the body composition and albumin circulation using a method of whole-body radiometry, extracellular liquid volume--by a 40K-RP, the level of cortisol, T3, insulin, C-peptide in the blood plasma by a radioimmunoassay in 30 breast cancer patients. A decrease in cellular body mass, an increase in extracellular body mass and total body fat, a decrease in the sizes of all pools and albumin synthesis rate were revealed before the initiation of specific cancer therapy. Ten days after the discontinuation of therapy the above indices returned to normal. PMID- 3277008 TI - The prognostic value of the duration of the ambulatory electrocardiogram after myocardial infarction. AB - The purpose of this study was to examine the value of various durations of ambulatory ECG recording with regard to providing useful prognostic information. The authors explored a decision theoretic approach to determine the most useful period of monitoring for making a treatment decision based upon postulated benefit-to-risk ratios of antiarrhythmic therapies. They used data collected as part of the Beta-Blocker Heart Attack Trial (BHAT), a randomized clinical trial of propranolol versus placebo in 3,837 post-myocardial-infarction patients. In BHAT, 1,336 placebo-treated patients had a 24-hour ambulatory ECG that had at least 23 readable hours. Sensitivity and specificity were calculated for eight definitions of ventricular arrhythmia using either total mortality or sudden death (death within one hour of symptoms) as an endpoint. These indices were obtained using the first 1, 2, 4, 6, 12, and 24 hours plus a random hour, a random daytime hour, and a random nighttime hour of the 24-hour ECG of 1,336 placebo-treated patients. The study showed that in the case of high-risk, low benefit therapies, no test is needed to make a treatment decision. No one should be treated. In the case of high-benefit, low-risk therapies, again, no test is required. Everyone should be treated. For therapies in the middle benefit-to-risk ratio range the most appropriate test for a treatment decision changes from the very specific to the most sensitive. Twenty-four hours of ambulatory monitoring is usually not necessary for a treatment decision, since four hours is likely to be sufficient. PMID- 3277010 TI - [Tumor-seeking mechanisms of labeled compounds]. PMID- 3277011 TI - Obesity is associated with impaired insulin-mediated potassium uptake. AB - The ability of insulin to promote extrarenal potassium uptake and to stimulate glucose uptake was examined in eight obese and ten normal weight control subjects. Insulin was infused at three rates to produced plasma insulin concentrations of approximately 100, 1,900, and 19,000 microU/mL. Insulin mediated potassium, as well as glucose uptake, was diminished during the lowest dose insulin clamp study (100 microU/mL) but could be normalized at pharmacologic plasma insulin concentrations. These results indicate that obese subjects are resistant to the ability of insulin to stimulate potassium uptake by extrarenal tissues. Impaired potassium uptake at physiologic plasma insulin levels, with normalization at supraphysiologic insulin concentrations, is most consistent with a decrease in the number of insulin receptors on insulin target tissues. PMID- 3277012 TI - Perturbation of glycerolipid content and biosynthesis in hepatocytes of rats continuously infused with Escherichia coli endotoxin. AB - The effect of chronic, nonlethal endotoxemia on the endogenous content and de novo biosynthesis of glycerolipids was investigated in rat hepatocytes. Continuous E. coli endotoxin (ET) infusion for 30 hours through a subcutaneously implanted mini-pump greatly altered the composition of membrane phospholipids. Sphingomyelin (SPH) and phosphatidylserine (PS) content increased by 56% and 29%, respectively, while the content of phosphatidylcholine (PC) decreased slightly (6%) as compared with saline-infused rats. These effects contrasted with those observed in pair-fed rats (whose food intake was matched to that voluntarily consumed by ET-infused animals). Food restriction induced a great depletion of phospholipid content, mainly phosphatidylethanolamine (PE), PC, phosphatidylinositol (PI), and PS, with no changes at the level of SPH as compared with control (fed ad libitum) rats. Triacylglycerol (TG) content was greatly decreased (66%) in ET-infused rats and the magnitude of the change and the fatty acid composition followed a pattern similar to that observed in pair fed rats. The kinetics of [2-3H]-glycerol incorporation reflected efficient utilization of the precursor for de novo biosynthesis of glycerolipids. Labeling of the intermediate metabolite phosphatidic acid (PA) peaked at an earlier time (1 min) in ET-infused, and in pair-fed rats, as compared with saline-infused and control rats (3 min) respectively, and was followed by a later peak in diacylglycerol (DG) labeling. The metabolic flux thereafter in endotoxemia reflected a redirection toward the synthesis of TG and PI, while in pair-fed animals the label went mainly to PC, concomitantly with a great reduction in the uptake of label into PI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277013 TI - Atherosclerosis in diabetes: the role of hyperinsulinemia. AB - Non-insulin-dependent diabetes (NIDDM) is a major cause of premature morbidity and mortality among adults. Macrovascular disease of coronary and peripheral vessels is the primary cause of death in these patients. Numerous experimental and epidemiologic studies have suggested that hyperinsulinemia accelerates the development of atherosclerosis. In experimental models, insulin promotes diet induced lesion development and overrides lesion regression and estrogen protection against atherosclerosis. Local hyperinsulinemia induced by selected arterial infusion accelerates atherosclerosis in the perfused artery. Insulin has been shown to stimulate subintimal smooth muscle and fibroblast cells in culture, and to increase the uptake and local synthesis of lipid by these cells. Insulin may also induce inhibition of fibrinolysis. Several prospective studies performed on nondiabetic patients show that either fasting or postprandial insulin levels are a sensitive predictor of the development of coronary disease independent of other risk factors. Two recent studies in NIDDM patients confirm this finding and suggest that glycemic control may not be a significant factor in the development of macrovascular disease. Diseases of carbohydrate tolerance, ie, NIDDM, impaired glucose tolerance, obesity, are frequently associated with elevated circulating insulin levels, either physiologically or secondary to treatment. Given the high prevalence of cardiovascular disease in these populations, modifying therapy to minimize hyperinsulinemia should be an important consideration in a treatment program. Use of oral agents such as glipizide or gliclazide, which induce less diurnal hyperinsulinemia, may be advantageous when compared to traditional oral agent or insulin therapy. PMID- 3277014 TI - Programs target Michigan's high infant mortality rate. PMID- 3277015 TI - Coffee and heart disease: the hypothesis re-examined. PMID- 3277016 TI - Congenital syphilis has not disappeared. AB - Thirty-three cases of congenital syphilis that were seen at The Children's Hospital, Camperdown, over a 34-year period were reviewed. Twenty-nine cases were examples of early congenital syphilis, as the patients developed clinical features in the first two years of life, and the other four cases were examples of late congenital syphilis, with the clinical features developing between two years and nine months of age and 10 years of age. Twenty-five patients were symptomatic at the time of admission to hospital. The most common clinical feature on the patient's presentation to hospital was a maculopapular or vesiculobullous skin eruption which occurred in 13 of the infants. Hepatic and splenic enlargement were present in 12 cases, and nine children had the "snuffles". Five of the children died. Patient follow-up occurred in fewer than 40% of cases and three of the children who were followed-up suffer from developmental delay. Congenital syphilis can occur in all social groups but is most common in infants who are premature or are small for gestational age and are born to young, unmarried mothers of low socioeconomic status. The treatment of congenital syphilis is simple and effective although the patients may need to be linked with community-health facilities to assist in their compliance with follow up appointments. PMID- 3277017 TI - Perinatal risk factors in preterm infants with moderate-to-profound hearing deficits. AB - The perinatal histories of 16 preterm infants with confirmed moderate-to-profound hearing loss were examined to determine the perinatal factors that might have been associated with their abnormal auditory development. Of the 11 factors that were examined, eight factors occurred significantly more frequently in hearing impaired infants when they were compared with 226 preterm infants who were cared for in the same intensive care unit in 1984. However, when the histories of the 16 infants with hearing loss were compared with those of 16 infants with normal hearing, who were matched according to gestational age, birthweight percentile and sex, there were no differences. The prevalence of aminoglycoside therapy was high in both groups of infants, but the mean duration of therapy in the infants with a hearing deficit was significantly longer (15 days compared with eight days; P less than 0.025). These observations suggest that younger, smaller, preterm infants with a complicated perinatal course and prolonged aminoglycoside therapy are at higher risk of auditory handicap. We recommend that the early identification of preterm infants with a hearing deficit should be achieved by recording brainstem auditory-evoked responses just before discharge from the intensive care unit. PMID- 3277018 TI - An investigation of nutrition-related risk factors in an isolated Aboriginal community in northern Australia: advantages of a traditionally-orientated life style. AB - Australian Aborigines develop a high frequency of type-2 diabetes mellitus when they make the transition from a traditional to an urban life-style. Preliminary studies were conducted at an outstation in northeastern Arnhem Land where the Aborigines have been exposed to Western influence for approximately 20 years only and where they continue to follow a life-style that is largely traditional. At the time of the study 31 persons were resident at the outstation, 20 persons were over 15 years of age (adults) and 11 persons were under 15 years of age (children). Eighteen adults and six children were tested. By standard criteria for body mass index these persons were all underweight (less than 20 kg/m2). In spite of this, they displayed no biochemical evidence of malnutrition. Their plasma fatty-acid profiles were consistent with a low dietary fat intake and a high consumption of lean meat. Levels of linoleic acid were much lower and those of arachidonic acid were much higher than are those in persons who consume a Western diet. Fasting glucose and cholesterol concentrations were low relative to those of urbanized Aborigines and white Australians. However, their fasting insulin and triglyceride levels were inappropriately high for their very low body mass index and fasting glucose levels. The mild elevation of triglyceride and fasting insulin levels is consistent with insulin resistance and suggests that these Aborigines (in common with other Aborigines) may become susceptible to obesity and diabetes if they became urbanized further. PMID- 3277019 TI - The management of cytotoxic-drug extravasation: guide-lines drawn up by a working party for the Clinical Oncological Society of Australia. PMID- 3277020 TI - Retraction of research findings. International Committee of Medical Journal Editors. PMID- 3277021 TI - The fitness and physical activity of adolescents. PMID- 3277022 TI - Nutrition and adolescents: an overview of concerns in Western society. PMID- 3277023 TI - Food beliefs and food choices in adolescents. PMID- 3277024 TI - Ciprofloxacin. PMID- 3277025 TI - Vasodilators for chronic congestive heart failure. PMID- 3277026 TI - New copper IUD. PMID- 3277027 TI - Subcellular localisation and sedimentation behaviour of antigen 60 from Mycobacterium bovis BCG. AB - Preparation, composition and immunological properties of A60 of Mycobacterium bovis BCG were previously described (Cocito and Vanlinden 1986). The present study focused on the intracellular distribution of this antigen. Fractionation of mycobacterial homogenates by ultracentrifugation indicated that most of A60 was present within the cytoplasm. Some of the antigen was located within the cell wall, from which it was released by extraction with alkali. Submission of cytoplasm to high speed centrifugation caused A60 to cosediment with ribosomes; however, dissociation of ribosomes in low-Mg buffer did not alter the sedimentation pattern of A60. Labelled A60, after ultracentrifugation in sucrose density gradients without Mg2+, was distributed throughout the entire gradient: treatment of (125I)A60 with urea or detergents produced a peak of radioactivity located in the upper part of the gradient. It is concluded that A60 is represented by a heterogeneous family of molecules of increasing sizes: polymerization being enhanced by Mg2+ and reversibly prevented by urea. Some or all of the biological properties hitherto attributed to ribosomal particles may, in fact, be due to their contamination with cosedimented A60. PMID- 3277028 TI - Aerobactin production of serotyped Escherichia coli from urinary tract infections. AB - Aerobactin production was examined by a bioassay in 467 Escherichia coli urinary strains from girls. All strains were of known O:K:H serotype. 139, 119 and 112 strains were isolates from pyelonephritis (Py), cystitis (Cy) and asymptomatic bacteriuria (ABU), respectively, and 97 were from fecal samples of healthy girls (FN). The incidence of aerobactin production was significantly higher among Py strains than among ABU and FN strains (P less than 0.001) and also significantly higher than among Cy strains (P less than 0.01). Aerobactin production was associated with serotype, e.g. the majority of O6:K2:H1 strains and of O16:K1:H6 were positive while e.g. the O6:K13:H1 strains were negative. There was no consistent pattern of coappearance of aerobactin and hemolysin. PMID- 3277029 TI - Congenital anomalies associated with rhabdomyosarcoma: an autopsy study of 115 cases. A report from the Intergroup Rhabdomyosarcoma Study Committee (representing the Children's Cancer Study Group, the Pediatric Oncology Group, the United Kingdom Children's Cancer Study Group, and the Pediatric Intergroup Statistical Center). AB - Congenital anomalies were identified in 37 of 115 (32%) children and adolescents autopsied with rhabdomyosarcoma. An analysis of sex, age, site, and histology of cases with or without congenital anomalies showed no significant differences. Of the 45 identified anomalies, 14 were considered major and 31 minor. The distribution of the anomalies by system included central nervous (9), genitourinary (10), gastrointestinal (13), and cardiovascular systems (4). Ten patients had complex or miscellaneous anomalies. There was one child with each of the following: Rubinstein-Taybi syndrome, neurofibromatosis, single horseshoe kidney, hemihypertrophy, and Arnold-Chiari malformation. Aniridia was not noted in any case of rhabdomyosarcoma. Individuals with rhabdomyosarcoma have an increased incidence of genitourinary anomalies similar to that in Wilms' tumor. Recent molecular genetic investigations have suggested that rhabdomyosarcoma, Wilms' tumor, and hepatoblastoma share a common pathogenetic mechanism involving chromosome 11. The uniquely increased association of central nervous system anomalies with rhabdomyosarcoma and absence of aniridia would support a different gene locus operative on chromosome 11 for individuals with rhabdomyosarcoma compared to Wilms' tumor. Extensive epidemiologic studies now in progress in patients with rhabdomyosarcoma should provide the incidence of congenital anomalies and potential linkage with prenatal events. PMID- 3277031 TI - Clinical uses for interferon in the treatment of cancer. A critical review. PMID- 3277030 TI - Referral of pediatric oncology patients for marrow transplantation and the process of informed consent. AB - A survey of 24 pediatric oncologists from 21 institutions not performing bone marrow transplants found that 156 patients were referred for transplants in the years 1984/85; only 10 of these patients were not transplanted. No patient in good clinical condition whose disease was under control was denied transplantation after evaluation at a transplant center. The decision for transplantation was made by the families and the referring pediatric oncologists, almost always before the patient was seen at a transplant center. The fact that almost all patient and family evaluations at transplant centers take place after a family has decided to have a marrow transplant has obvious implications regarding informed consent. Referring pediatric oncologists must attempt to provide the best possible information to families when decisions regarding marrow transplantation are actually being made. PMID- 3277032 TI - Gemfibrozil therapy in patients with coronary heart disease. PMID- 3277033 TI - Hepatic cytochrome P-450j induction in the spontaneously diabetic BB rat. AB - Hepatic microsomal cytochrome P-450j has been studied using the male spontaneously diabetic BB rat as a model for insulin-dependent diabetes. This approach avoids any direct hepatotoxic effects from chemical diabetogenic agents. Both diabetic rats maintained on insulin and nondiabetic littermates were used as controls. Levels of cytochrome P-450j were increased approximately 3-fold in the diabetics 4 days after the cessation of insulin therapy. In addition, cytochrome P-450j-catalyzed enzymatic activities, aniline hydroxylation, and N nitrosodimethylamine N-demethylation were increased by the diabetic state at this same time period. Cytochrome P-450f remained at control levels in all groups of animals. In order to test the hypothesis that ketone bodies are involved in the increase in cytochrome P-450j in the diabetic state, plasma beta-hydroxybutyrate levels were monitored. Hepatic aniline hydroxylation, N-nitrosodimethylamine N demethylation, and cytochrome P-450j levels in individual animals were found to correlate with plasma beta-hydroxybutyrate levels (r = 0.59-0.71 p less than 0.001). In contrast, no significant correlation between levels of cytochrome P 450j and plasma glucose, insulin, or cholesterol was observed in individual animals (r = 0.07-0.23, p greater than 0.4). We conclude that cytochrome P-450j is induced in the livers of spontaneously diabetic rats, and that this induction may be associated directly or indirectly with elevated plasma ketone levels. PMID- 3277034 TI - Insect morphogenesis. PMID- 3277035 TI - Interaction of lipid peroxidation products with DNA. A review. PMID- 3277036 TI - A comparative analysis of data on the clastogenicity of 951 chemical substances tested in mammalian cell cultures. AB - A literature review was conducted using original papers published during 1964 1985 on the in vitro clastogenicity of chemical substances. Results of tests on 951 chemical substances were abstracted from over 240 reports to form the database. The evaluation of these data relied on each author's original conclusion on a positive or negative outcome. Of these 951 substances, 447 (47%) were consistently positive either with or without activation; 417 (44%) were negative in the direct test but not tested with metabolic activation systems; 4 were negative but tested only with activation; and 30 (3%) were clearly negative both with and without activation. The remaining 53 substances gave variable results when tested under different experimental protocols or in different cell types, but were positive in at least one test. Although discrepant results were found associated with some cell types, the addition of metabolic activation systems tended to eliminate such variability. No one cell appeared to be superior in response to all clastogens. For screening purposes, the choice of cell may thus depend more on the general usefulness and reliability of a cell type than on a strong response to a particular chemical. However, the use of a suitable metabolic activation system does appear to be of critical importance. The concentration at which clastogenic effects were detected varied extensively for different test substances, ranging from a minimum of 4.3 X 10(-8) to 6.9 X 10(2) mM. Possible mechanisms of action for substances active at only high levels are discussed, but no satisfactory explanation is available at this time. The relevance of tests conducted at concentrations high enough to alter significantly the osmolarity and other culture conditions is considered, and caution urged in the interpretation of test results obtained under physiologically stressful conditions. The clastogenic potential was compared quantitatively using an index of effective concentration (D20) and one which estimates the number of cells with exchange aberrations expected per mg/ml (TR) for data obtained by using a uniform protocol and cultures of Chinese hamster lung (CHL) cells. Both values were distributed over a wide range, demonstrating the variety of genotoxic potential in chemicals. In general, a substance which was active at only high concentrations produced fewer exchange-type aberrations. In vivo activity, as measured by tumourigenic effect and formation of micronuclei in bone marrow, tended to be greater for substances with a D20 below 10(-2) mg/ml and a TR value over 10(3).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3277037 TI - Griseofulvin. AB - Griseofulvin (GF) is a mycotoxin produced by various species of Penicillium including P. griseofulvum Dierckx, P. janczewski (P. nigricans) and P. patulum. It is active against dermatophytic fungi of different species in the genera Microsporum, Trychophyton and Epidermophyton. Because of its capacity to concentrate in the keratinous layer of the epidermis and its relatively low toxicity in man, it has been extensively used in the therapy of dermatophytoses by oral administration. The biological activity of GF towards fungi is manifested as nuclear and mitotic abnormalities followed by distortions in the hyphal morphology. Mitotic segregation is also induced in fungi by GF treatment. In higher eukaryotes the cytostatic action of GF is essentially due to a mitotic arrest at late metaphase/early anaphase. The cytological effects observable both in vivo and in vitro on different plant and animal cell systems, include C mitoses, multipolar mitoses and multinuclearity. Prolonged GF treatment in experimental animals provokes biochemical changes consisting mainly of disturbances of porphyrin metabolism, variation in the microsomal cytochrome levels and formation of Mallory bodies. In mice these alterations are followed by the development of multiple hepatomas. Evidence of tumor induction by GF has been obtained in mice and rats, but not in hamsters. GF may also act either as a promoting or a co-carcinogenic agent, depending on the circumstances of its administration. It has been found to increase the frequency of cell transformation induced by polyoma virus, but not to induce cell transformation per se. Induction of sperm abnormalities has been observed in GF-treated mice. The embryotoxic and teratogenic action of GF has been demonstrated in pregnant rats exposed during organogenesis. Genetic effects of GF have been investigated by the following tests: Salmonella/microsome mutagenicity assay, point mutations in mammalian and plant cells, DNA damage and repair, SCE, chromosome aberrations, micronuclei, dominant lethals, aneuploidy in lower and higher eukaryotes. A positive response has been obtained in the assays on numerical chromosome changes in all the systems analyzed; limited or inconclusive evidence has been obtained for SCE and structural chromosome changes. Doubled or highly polyploid sets can be detected in all types of cells during or immediately after GF treatment. A marked increase in chromosome number variation is observed at various times after withdrawal of the drug, with prevailing hyperdiploid and reduced sets in animal cells and plant cells respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3277038 TI - The use of cell-free systems in plant activation studies. PMID- 3277039 TI - Mutagenic activation of xenobiotics by plant enzymes. AB - Genetic evidence has indicated that plants can activate certain xenobiotics to mutagens, but biochemical evidence is as yet scarce. Nevertheless, plant microsomal enzymes and peroxidases have been shown to form reactive intermediates, the best studied examples being 2-aminofluorene, benzo[a]pyrene and pentachlorophenol. The latter two xenobiotics are converted to quinoid derivatives which are, in principle, able to redox cycle and generate active oxygen species. In analogy to results obtained in mammalian systems, covalent binding of reactive intermediates to DNA as well as fragmentation of DNA, are proposed as major mechanisms of action of mutagenic plant metabolites. PMID- 3277040 TI - The plant cell/microbe coincubation assay for the analysis of plant-activated promutagens. AB - The preincubation and suspension procedures of the plant cell/microbe coincubation assay are described and the activation of 2-aminofluorene and m phenylenediamine by cultured tobacco, cotton, carrot and maize cells is compared. The assay measures the plant activation of promutagens into genotoxins detected in Salmonella typhimurium as well as toxicity in plant and microbial cells. At concentrations of 2-aminofluorene 0-0.5 mumoles/reaction tube, the rank order of the efficiency of activation by plant cells was tobacco much greater than cotton greater than carrot. Cultured maize cells did not activate 2-aminofluorene. The tobacco cell activation of 2-aminofluorene was inhibited 50% by 750 microM diethyldithiocarbamate under conditions that did not affect the cell viability. Tobacco cells were also the most efficient plant cells in activating m phenylenediamine (0-5 mumoles/reaction tube). The 'biological affinity' of m phenylenediamine for the activation system in tobacco cells was approximately 100 microM. PMID- 3277041 TI - Mutagenic activity of promutagens in plants: indirect evidence of their activation. AB - This review summarizes data concerning mutagenic activity of promutagens in various plant in vivo assays. These data are compared with the present knowledge about the metabolism of xenobiotics and activation of promutagens in plants obtained by biochemical studies and by the separation of the activation process from the genetic endpoints assayed for the mutagenicity. The article documents a differential response of plant species in the endogenous transforming of various classes of promutagens into mutagens. Attention is devoted to the following types of promutagens: nitrosamines, polycyclic aromatic hydrocarbons and aromatic amines, aflatoxins, pyrrolizidine alkaloids, diallate, styrene, vinylchloride, ethanol, cycasin, nitrofurans, sodium azide, s-triazine herbicides, 1,2 dibromoethane and maleic hydrazide. PMID- 3277042 TI - Studies on the use of plant extracts in assessing the effects of plant metabolism on the mutagenicity and toxicity of pesticides. AB - We have carried out studies on the effects of plant metabolism on the mutagenicity of agricultural chemicals. Our approach is to use a cell-free plant extract, as a source of metabolic enzymes, in a standard Ames test. Using a number of test compounds, we observe that plant metabolism can alter the mutagenicity of several pesticides, and can in some instances give rise to metabolites apparently unique from those which are formed in animal cells. A number of parameters of the assay have been examined, and we find that the assay temperature and preincubation of the pesticide with the extract can significantly alter the outcome of the test. We also have devised a method of controlling for the effects that natural extracts can have on the spontaneous reversion rate of the Salmonella tester strains, in an effort to distinguish slight mutagenic responses from the effects of nutrients (e.g. histidine for his- bacteria) in the assay. PMID- 3277043 TI - Metabolic activation of environmental chemicals by microsomal enzymes of higher plants. PMID- 3277044 TI - The plant activation of m-phenylenediamine by Tradescantia clone 03 and clone 4430 cells in liquid suspension culture. AB - In this study, we expanded the use of the genus Tradescantia to investigate the plant activation of promutagens and further refine the methodology of the plant cell/microbe coincubation assay. Liquid suspension cell cultures of Tradescantia clone 03 and Tradescantia clone 4430 were used to activate the promutagen m phenylenediamine into a mutagenic compound which was detected by Salmonella typhimurium strain TA98 in the plant cell/microbe coincubation assay. Optimum treatment parameters were established for both plant cell lines. Optimum was defined as the lowest concentration or shortest time period that provided consistently positive results and high rates of revertants. Preliminary experiments with both cell lines defined 2.5 mumoles m-phenylenediamine per plate as the optimum concentration to be used in the determination of the optimal coincubation period and the optimal concentration of plant cells. These experiments also determined the optimal physiological stage at which both clones should be used in the coincubation assay. Differences were found in the optimal of coincubation (1h for clone 03, 2 h for clone 4430) and growth stage (mid-log for clone 03, mid- to late-log for clone 4430). Similar activation responses were seen for both clones when the concentration of plant cells (mg/ml) was varied. Under optimized conditions, clone 03 cells demonstrated an approximately 10% higher activation response than clone 4430. PMID- 3277045 TI - Response of the L-arabinose forward mutation assay of Salmonella typhimurium to frameshift-type mutagens. AB - The present study was designed to evaluate the capacity of the L-arabinose resistance test of Salmonella typhimurium in the detection of frameshift-type mutagens. To this end the response of the Ara test was examined with respect to 15 chemicals which had been previously described as able to revert the Ames tester strain TA97. The mutagenicity of each compound was determined by the liquid test under experimental conditions which optimize the mutagenic response of the Ara test with the tester strain BA9. Strain TA97 was used simultaneously with BA9. The Ara forward-mutation assay efficiently detected the mutagenic activity of 14 out of the 15 chemicals assayed. PR toxin was the only compound which gave a weak dose response without doubling the spontaneous mutant level. In comparison with the Ara test, a total of 3 chemicals (HZ, PE and PR toxin) were not found to be mutagenic with strain TA97. In most cases (11/15) the mutagenic response of the Ara test was comparatively greater than that of strain TA97. Three chemicals (DEO, PRF and 9-AA) were detected with quite similar degrees of sensitivity by both mutation assays. ICR-191, which seems highly specific in reverting frameshift mutations with added cytosines in a run of cytosines, was the only chemical with a lower mutagenic activity in the Ara test than in strain TA97. The results enhance the interest of the L-arabinose forward-mutation assay as an alternative to the set of specific tester strains used by the histidine reverse-mutation assay in massive, general and primary screening for genotoxic agents. PMID- 3277046 TI - Mammalian cell mutagenesis, Banbury Conference. PMID- 3277047 TI - Chemical structure, Salmonella mutagenicity and extent of carcinogenicity as indicators of genotoxic carcinogenesis among 222 chemicals tested in rodents by the U.S. NCI/NTP. AB - A survey has been conducted of 222 chemicals evaluated for carcinogenicity in mice and rats by the United States NCI/NTP. The structure of each chemical has been assessed for potential electrophilic (DNA-reactive) sites, its mutagenicity to Salmonella recorded, and the level of its carcinogenicity to rodents tabulated. Correlations among these 3 parameters were then sought. A strong association exists among chemical structure (S/A), mutagenicity to Salmonella (Salm.) and the extent and sites of rodent tumorigenicity among the 222 compounds. Thus, a approximately 90% correlation exists between S/A and Salm. across the 115 carcinogens, the 24 equivocal carcinogens and the 83 non carcinogens. This indicates the Salmonella assay to be a sensitive method of detecting intrinsic genotoxicity in a chemical. Concordance between S/A and Salm. have therefore been employed as an index of genotoxicity, and use of this index reveals two groups of carcinogens within the database, genotoxic and putatively non-genotoxic. These two broad groups are characterized by different overall carcinogenicity profiles. Thus, 16 tissues were subject to carcinogenesis only by genotoxins, chief among which were the stomach, Zymbal's glands, lung, subcutaneous tissue and circulatory system. Conclusions of carcinogenicity in these 16 tissues comprised 31% of the individual chemical/tissue reports of carcinogenicity. In contrast, both genotoxins and non-genotoxins were active in the remaining 13 tissues, chief among which was the mouse liver which accounted for 24% of all chemical/tissue reports of carcinogenicity. Further, the group of 70 carcinogens reported to be active in both species and/or in 2 or more tissues contained a higher proportion of Salmonella mutagens (70%) than observed for the group of 45 single-species/single-tissue carcinogens (39%). 30% of the 83 non carcinogens were mutagenic to Salmonella. This confirms earlier observations that a significant proportion of in vitro genotoxins are non-carcinogenic, probably due to their non-absorption or preferential detoxification in vivo. Also, only 30% of the mouse liver-specific carcinogens were mutagenic to Salmonella. This is consistent with tumors being induced in this tissue (and to a lesser extent in other tissues of the mouse and rat) by mechanisms not dependent upon direct interaction of the test chemical with DNA. Detection of 103 of the 115 carcinogens could be achieved by use of only male rats and female mice.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3277048 TI - The genetic toxicity of human carcinogens and its implications. AB - 23 chemicals and chemical combinations have been designated by the International Agency for Research on Cancer (IARC) as causally associated with cancer in humans. The literature was searched for reports of their activity in the Salmonella mutagenicity assay and for evidence of their ability to induce chromosome aberrations or micronuclei in the bone marrow of mice or rats. In addition, the chemical structures of these carcinogens were assessed for the presence of electrophilic substituents that might be associated with their mutagenicity and carcinogenicity. The purpose of this study was to determine which human carcinogens exhibit genetic toxicity in vitro and in vivo and to what extent they can be detected using these two widely employed short-term tests for genetic toxicity. The results of this study revealed 20 of the 23 carcinogens to be active in one or both short-term tests. Treosulphan, for which short-term test results are not available, is predicted to be active based on its structure. The remaining two agents, asbestos and conjugated estrogens, are not mutagenic to Salmonella; asbestos is not likely to induce cytogenetic effects in the bone marrow and the potential activity of conjugated estrogens in the bone marrow is difficult to anticipate. These findings show that genetic toxicity is characteristic of the majority of IARC Group 1 human carcinogens. If these chemicals are considered representative of human carcinogens, then two short-term tests may serve as an effective primary screen for chemicals that present a carcinogenic hazard to humans. PMID- 3277050 TI - Real-time ultrasound imaging of muscles. AB - A prospective study was done on 222 consecutive new patients referred to our pediatric muscle clinic to assess the diagnostic value of ultrasound imaging. Ultrasound scans were interpreted without knowledge of clinical presentation or results of other tests. Muscular dystrophy produced a brightly speckled pattern of increased echo from the muscle, whereas spinal muscular atrophy showed a moderate increase in muscle echo and associated muscle atrophy. Acute dermatomyositis produced a moderate increase in echo that varied markedly with the direction of the ultrasound beam in relation to the muscle fibres. The ultrasound scan was normal in children with hypotonia of cerebral origin, Prader Willi syndrome, ligamentous laxity, and other "nonneuromuscular" causes. In eight patients ultrasound scanning showed a striking degree of selective involvement of individual components of the quadriceps muscle, which provided considerable diagnostic help for selective needle biopsy. Ultrasound scanning in children has the major advantage of being a noninvasive and pleasant out-patient procedure, which can be readily done on multiple sites. It is a valuable screening test in the investigation of children with neuromuscular disorders. PMID- 3277049 TI - Detection, characterization, and staging of polyneuropathy: assessed in diabetics. AB - The reported prevalence of diabetic polyneuropathy varies from 5 to 80%. This unsatisfactory state may relate to evaluation of different patient groups, different minimal criteria for the diagnosis of neuropathy, and different degrees of surveillance. To made matters worse, patients with polyneuropathy tend to be equated ignoring differences in severity. To remedy this situation, four recommendations are made: (1) population-based patients should be studied, (2) nerve conduction should be used to set minimal criteria for neuropathy because the test is objective, sensitive, and repeatable, (3) validated tests of symptoms and deficits should also be used because clinical manifestations of neuropathy cannot be accurately inferred from electrophysiologic measurements, and (4) approaches to staging severity of neuropathy should be developed and used in expressing abnormality. To this end minimal criteria for the diagnosis of diabetic polyneuropathy have been proposed, and validated tests to assess neuropathic symptoms and sensory deficits have been developed. In this report we also propose a staging approach utilizing nerve conduction and neurologic history and examination and validated tests of neuropathic symptoms and deficits. PMID- 3277051 TI - Heterotopic prosthetic ventricles as a bridge to cardiac transplantation. A multicenter study in 29 patients. AB - Heterotopic prosthetic ventricles were used to support the circulation in 29 candidates for heart transplantation who were expected to die before procurement of a donor heart. Twenty-one of these patients (average age, 36 years) underwent successful transplantation after 8 hours to 31 days of circulatory support. The other eight patients died because their condition could not be stabilized for transplantation, despite restoration of blood flow. Fourteen patients received biventricular support; 15 received only left ventricular support, with pharmacologic assistance of right heart function. Before transplantation, blood flow from the left prosthetic ventricle averaged 2.8 +/- 0.4 liters per minute per square meter of body-surface area, and from the right prosthesis 2.4 +/- 0.4 liters, as compared with an average flow of 1.6 +/- 0.5 liters per minute per square meter before implantation. Of the 21 patients who received heart transplants, 20 were discharged from the hospital after a median of 31 days. Nineteen patients were alive at 7 to 39 months, and 11 of the first 12 were alive at one year. We conclude that heterotopic placement of prosthetic ventricles as a bridge to transplantation provides an effective method of temporarily supporting cardiac function in critically ill patients without removing the natural heart. The early survival rate after transplantation is similar to that with elective cardiac transplantation. PMID- 3277052 TI - Digitalis. Mechanisms of action and clinical use. PMID- 3277053 TI - Beta-Lactam antibiotics (1). PMID- 3277054 TI - Drug therapy. Beta-lactam antibiotics (2). PMID- 3277055 TI - Seroprevalence of human immunodeficiency virus among childbearing women. Estimation by testing samples of blood from newborns. AB - Attempts to predict the course of the epidemic of acquired immunodeficiency syndrome (AIDS) have been hampered by the lack of an objective, practical way to estimate the prevalence of infection with the human immunodeficiency virus (HIV) in the general population. Testing for the prevalence of HIV infection in women should be a sensitive means to track the epidemic and to study the potential for perinatal transmission. Antibodies in maternal blood are contained in neonatal blood specimens routinely collected on absorbent paper for other purposes, such as screening for phenylketonuria; we therefore tested for HIV antibody in these specimens. Analysis of batches of individually blinded specimens from selected hospitals protected the anonymity of the mothers and babies and was cost efficient. Using the newborn's blood as an indicator of the mother's serologic status, we concluded that 1 of every 476 women (2.1 per 1000) giving birth in Massachusetts was positive for HIV antibody by immunofluorescence assay or enzyme linked immunosorbent assay, both confirmed by immunoblot (Western blot) testing. The prevalence of HIV infection varied according to the type and location of the maternity hospitals; rates of seropositivity were highest in inner-city hospitals (8.0 per 1000), lower in mixed urban and suburban hospitals (2.5 per 1000), and lowest in suburban and rural hospitals (0.9 per 1000). This method is useful for collecting data needed to plan and evaluate prevention strategies and to predict the health care resources that will be needed to care for women and children who contract AIDS. Because other states have newborn screening programs similar to the Massachusetts program, this approach can be used for national surveillance of AIDS in women. PMID- 3277056 TI - Cardiovascular effects of n-3 fatty acids. PMID- 3277057 TI - Pathogenesis and treatment of polycystic ovary syndrome. PMID- 3277058 TI - Recombinant human granulocyte-macrophage colony-stimulating factor in AIDS. PMID- 3277059 TI - ICAM-1 a ligand for LFA-1-dependent adhesion of B, T and myeloid cells. AB - Cell-cell adhesion is essential for many immunological functions. The LFA-1 molecule, a member of a superfamily of adhesion molecules, participates in adhesion which is critical to the function of each of the three major subsets of leukocytes: lymphocytes, monocytes and granulocytes. Putative LFA-1 ligands have been identified functionally in different laboratories using three different monoclonal antibodies that inhibit LFA-1-mediated leukocyte adhesion in particular model systems; however, there may be more than one LFA-1 ligand. We have directly compared the three relevant monoclonal antibodies, and show that each binds to the same molecule, intercellular-adhesion molecule-1 (ICAM-1). Most important, B, T and myeloid cells adhere specifically to purified ICAM-1-coated surfaces; such adhesion has distinctive requirements for Mg2+ and Ca2+. This constitutes biochemical evidence that ICAM-1 functions as a ligand for LFA-1 dependent adhesion by a variety of leukocytes. PMID- 3277060 TI - Identity of the 19S 'prosome' particle with the large multifunctional protease complex of mammalian cells (the proteasome). AB - There have been many reports that eukaryotic cells contain ring-shaped 19S or 20S particles which are composed of numerous polypeptide subunits ranging in size between 25 and 35 kilodaltons. Because these particles seemed to copurify with inactive mRNA, they were assumed to function in regulating mRNA translation and hence were named 'prosomes' (for 'programmed-o-some'). A number of properties have been reported for these structures, including an association with specific RNA species or with certain heat-shock proteins and involvement in tRNA processing or aminoacyl tRNA synthesis. However, these proposed activities have not been supported by definitive evidence. During studies of the proteolytic systems in mammalian tissues, we noted many similarities between these 19S particles and the high molecular weight protease complexes that are present in most or all eukaryotic cells. This (700 kilodalton) enzyme complex, designated here as LAMP for 'large alkaline multi-functional protease', contains three distinct endoproteolytic sites which function at neutral or alkaline pH and are specific for hydrolysis of proteins, hydrophobic peptides, or basic peptides. This protease also exists in a latent form which can be activated by polylysine, fatty acids, or ATP. In this report, we show that the prosomes and these protease complexes are very similar or identical with respect to their size, polypeptide composition, immunological cross-reactivity, appearance in the electron microscope, radial symmetry of subunits, subcellular localization, and proteolytic activities. Therefore, the 'prosome' probably plays a critical role in intracellular protein breakdown, and we propose that it be renamed 'proteasome'. PMID- 3277061 TI - Protein-disulphide isomerase and prolyl isomerase act differently and independently as catalysts of protein folding. AB - Two enzymes are now known that catalyse slow steps in protein folding. Peptidyl prolyl cis-trans isomerase catalyses the cis-trans isomerization of Xaa-Pro peptide bonds in oligopeptides and during the refolding of several proteins. The other enzyme, protein-disulphide isomerase, accelerates the reactivation of reduced proteins, presumably by catalysis of thiol-disulphide exchange reactions. Recent evidence indicates that the beta-subunit of prolyl 4-hydroxylase, an enzyme involved in collagen biosynthesis, is identical with disulphide isomerase. On the basis of this important finding, it was suggested that disulphide isomerase accelerates protein folding, not by 'reshuffling' incorrect disulphide bonds, but in the same way as prolyl isomerase by catalysing proline isomerization which is known to be important for the folding of collagen and other proteins. Here we show that the catalytic activities of these two enzymes are different. Disulphide isomerase accelerates the reformation of native disulphide bonds during protein reoxidation. We find no evidence that this enzyme can catalyse the isomerization of proline peptide bonds, a reaction efficiently accelerated by prolyl isomerase. When both enzymes are present simultaneously during protein folding, they act independently of one another. PMID- 3277062 TI - Chromosome movement in vitro. PMID- 3277063 TI - Invertebrate neuroendocrinology. Insulin found at last? PMID- 3277065 TI - Cognitive neurophysiology. The lifeblood of language. PMID- 3277064 TI - Japanese AIDS scandal over trials and marketing of coagulants. PMID- 3277066 TI - Positron emission tomographic studies of the cortical anatomy of single-word processing. AB - The use of positron emission tomography to measure regional changes in average blood flow during processing of individual auditory and visual words provides support for multiple, parallel routes between localized sensory-specific, phonological, articulatory and semantic-coding areas. PMID- 3277067 TI - Heterologous expression of a bacterial haemoglobin improves the growth properties of recombinant Escherichia coli. AB - Rational design of novel as well as improved cellular biocatalysts by genetic manipulation of cellular metabolism has recently attracted considerable interest. A wide range of bacteria have been genetically modified by integrating new enzymatic functions into their metabolic network. A central problem in the aerobic growth of any cell culture is the maintenance of dissolved oxygen (DO) concentrations above growth-limiting levels especially in high cell-density fermentations which are usually of a fed-batch type. The optimal rate of nutrient addition (and consequently the productivity) is ultimately limited by the rate at which cells can aerobically catabolize the carbon source without generating growth-inhibitory metabolites such as lactate and acetate. All approaches thus far have concentrated on improving the oxygen mass transfer rates by manipulating various environmental parameters. We have isolated the gene for a haemoglobin like molecule, expressed by the aerobic bacterium Vitreoscilla in poorly oxygenated environments, and expressed it in Escherichia coli. The recombinant cells contain enhanced haem as well as active haemoglobin, and they grow faster and to considerably greater cell densities than comparable plasmid-containing cells which do not express haemoglobin. This haemoglobin increases the rate of oxygen use, especially when dissolved oxygen is less than 5% of air saturation. PMID- 3277068 TI - Plummer's nails. PMID- 3277069 TI - [Passive smoking and lung cancer]. PMID- 3277070 TI - [The Angelchik prosthesis in the treatment of gastroesophageal reflux: a failed experiment]. PMID- 3277071 TI - [Consensus diagnosis of a suspicious neck lymph node]. PMID- 3277072 TI - [Use of non-steroidal anti-inflammatory drugs and gastric and duodenal complications]. PMID- 3277074 TI - Continuous ambulatory peritoneal dialysis and vitamin D. PMID- 3277073 TI - [Congenital deficiency of the fibrinolysis inhibitor alpha 2-antiplasmin as a cause of hemorrhagic diathesis]. PMID- 3277075 TI - Glomerulonephropathy with amyloid-stain-negative microfibrillar glomerular deposits. AB - A 44-year-old man demonstrated proteinuria, microhematuria and renal dysfunction during the course of hyperthyroidism. Neither cryoglobulinemia nor paraproteinemia including light chains was found. No systemic signs suggestive of amyloidosis appeared. Histological findings showed a diffuse mesangial matrix increase with slight mesangial proliferation and diffuse granular depositions of IgG, IgA, C3, C4, Clq, kappa and lambda light chains. Ultrastructurally, microfibrils of about 20 nm in width were seen to be deposited diffusely in mesangial areas and in glomerular basement membranes. Congo red and thioflavin T staining were negative. These findings support the possible existence of a specific glomerular disease different from amyloidosis. PMID- 3277076 TI - Immunoglobulin A subclass-containing plasma cells in the jejunum in primary IgA nephropathy and in Henoch-Schonlein purpura. AB - We studied the distribution of IgA1- and IgA2-containing plasma cells in the jejunum of 5 patients with primary IgA nephropathy and of 2 patients with Henoch Schonlein purpura. The percentage of IgA-containing cells (62.3 +/- 4.6) was below the level found in normal (79.4 +/- 5.1) (p less than 0.001). The percentage of IgA1-containing plasma cells relative to the total IgA-containing cells was too low in 2, normal in 3 and too high in 2 subjects (mean percentage 68.1 +/- 9.6; normal 69.0 +/- 3.8). Our data do not support an increased production of IgA1 in the jejunal mucosa of patients with primary IgA nephropathy or with Henoch-Schonlein purpura. PMID- 3277077 TI - Tetracycline-induced renal hypophosphatemia in a patient with a syndrome of inappropriate secretion of antidiuretic hormone. AB - A third case of acquired phosphate diabetes associated with a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), related to a pulmonary tuberculosis, is reported. Renal hypophosphatemia in this patient was caused by the erroneous intake of 1 g doxycycline. It is likely that the selective nephrotoxicity in these 3 patients with SIADH was induced by tetracycline. PMID- 3277078 TI - The influence of preexisting vascular disease on the outcome of renal transplantation in diabetic patients. AB - We analyzed the impact of prior vascular disease on the outcome of renal transplantation in 99 insulin-dependent diabetic patients. Thirty-three patients (group A) had clinical evidence of vascular disease prior to renal transplantation and 66 patients (group B) had no clinical vascular events in the pretransplant period. The median follow-up in group A patients was 14 months and in group B it was 23 months. The group A patients with preexisting vascular disease had a significant increase in mortality (33%) compared to group B (11%) (A vs. B; p = 0.01). The rate of graft loss was not significantly different between the two groups (45 vs. 42%; p = 0.94). Our data suggest that preexisting clinical vascular disease has a significant negative effect on patient survival in diabetic recipients of cadaver kidney transplants. PMID- 3277079 TI - The pragmatic approach to stroke trial design: stroke register, pilot trial, assessment of neurological then functional outcome. AB - Assessment of the results of medical intervention in acute stroke presents particular difficulties. Firstly the condition is extremely variable both in its clinical presentation and in its underlying pathology. Secondly, extreme care must be taken over the methods used to assess outcome. A reduction in mortality is no indication of success if there is a consequent increase in the number of survivors with extreme disability. Nor is it valid to compare functional or neurological outcome in survivors, since differences in mortality between treatment groups may upset the balancing effect of initial randomisation. Furthermore, overall 'neurological scores' are of dubious validity when the progress of patients with different patterns of disability has to be compared. Despite these difficulties a pragmatic approach can be used in which the design and conduct of a stroke trial closely resemble the normal clinical situation. This requires a knowledge of the range and natural history of stroke cases seen, best obtained from a stroke register. A pilot trial is then needed to assess the extent of variation in outcome and thus to estimate the numbers needed for the main study. The latter should then be conducted in two stages. Initially 'neurological benefit' should be assessed by counting the number of individual neurological signs which show improvement or deterioration in patients in each treatment group. Finally, a simple functional end-point should be compared in large numbers of patients with death being treated as equivalent to the worst possible non-fatal outcome. These principles are now being applied in a large, double-blind, placebo-controlled trial of low-dose beta-blockers in conscious stroke victims. PMID- 3277080 TI - Creutzfeldt-Jakob disease in Benghazi, Libya. PMID- 3277081 TI - Influences of photoperiod on nuclear androgen receptor occupancy in neuroendocrine tissues of the golden hamster. AB - Day length regulates the negative feedback potency of gonadal steroids upon luteinizing hormone (LH) in seasonal breeders such as the golden hamster. We have used an exchange assay employing 3H-R1881 to determine whether nuclear androgen plus receptor levels in the preoptic area, medial basal hypothalamus, or anterior pituitary differ between male hamsters maintained in long or short days. Cell nuclear androgen plus receptor levels in brain and anterior pituitary were significantly lower in intact males maintained in short days; these differences reflected significant decreases in testis size and serum testosterone (T levels upon exposure to inhibitory photoperiods. In castrated males in which serum T levels were 'clamped' by the insertion of T-filled Silastic capsules, exposure to short days was not correlated with an increase in preoptic area, medial basal hypothalamus, or anterior pituitary receptor occupancy even though T's negative feedback actions upon LH were clearly enhanced. In contrast, there were instances in which androgen receptor occupation was elevated in males exposed to long days. Our results suggest that in the male golden hamster, the well-documented increase in the ability of T to suppress LH secretion in short photoperiods cannot be attributed to an increase in receptor-mediated uptake and nuclear accumulation of androgen in target cells in the brain and anterior pituitary gland. PMID- 3277082 TI - Treatment of status epilepticus: a prospective comparison of diazepam and phenytoin versus phenobarbital and optional phenytoin. AB - In a randomized, nonblinded clinical trial, 36 consecutive patients with generalized convulsive status epilepticus were treated with either combination diazepam and phenytoin (DZ/DPH) or phenobarbital (PB). Phenytoin was added to the PB regimen if seizures persisted for 10 minutes after beginning therapy. The cumulative convulsion time (total time spent in active convulsive movements) was shorter for the PB group than for the DZ/DPH group (median, 5 versus 9 minutes, p less than 0.06); the response latency (elapsed time from initiation of therapy to the end of the last convulsion) was also shorter for the PB group (median, 5.5 versus 15 minutes, p less than 0.10). The median cumulative convulsion time is between 0 and 14 minutes shorter for the PB regimen than for the DZ/DPH regimen (95% confidence interval). Similarly, the median response latency for the PB regimen is between 1 minute longer and 20 minutes shorter than that for the DZ/DPH regimen (95% confidence interval). The frequencies of intubation, hypotension, and arrhythmias were similar in the two groups. Eleven of 18 patients in the PB group responded to phenobarbital monotherapy. We conclude that the PB regimen is rapidly effective, comparable in safety, and enjoys certain practical advantages in comparison with the DZ/DPH regimen. PMID- 3277083 TI - A double-blind trial of clonazepam in the treatment of parkinsonian dysarthria. AB - We studied the effect of clonazepam in a double-blind trial on 12 parkinsonian patients with hypokinetic dysarthria. Speech samples were judged on 14 of the dimensions used in the Mayo Clinic dysarthria study. Of the 11 patients who completed the study, 10 showed improvement. The effective dosage of clonazepam was 0.25 to 0.5 mg/d with higher dosage than that less effective. Clonazepam has a definite role in the management of parkinsonian dysarthria. PMID- 3277084 TI - [Facial paralysis in newborn infants and children. Clinical and therapeutic aspects]. AB - Paralysis of the facial nerve in newborns and infants is described with a list of the various types including Bell's idiopathic paralysis, forms caused by congenital malformations and labour traumas, fractures of the temporal bone, tumours, infections and high blood pressure. Current approaches to treatment including physiotherapy, pharmacological and surgical treatment are then described. PMID- 3277085 TI - [Onset of polycythemia in idiopathic myelofibrosis. Description of a clinical case and review of the literature]. AB - The case of a patient with myelofibrosis who developed polycythaemia vera after corticosteroid therapy, splenectomy and Busulphan therapy is reported. The possible pathogenetic role of each of these agents is discussed. PMID- 3277086 TI - Immunohistochemical identification of quinolinic acid phosphoribosyltransferase in glial cultures from rat brain. AB - Glial cell cultures were shown to contain 3 identifiable classes of cells which could be specifically stained with antibodies directed against quinolinic acid phosphoribosyltransferase (QPRT), the catabolic enzyme of the endogenous excitotoxin quinolinic acid. Some, but not all, QPRT-positive cells also contained glial fibrillary acidic protein. These cultures may constitute an in vitro system in which cerebral quinolinic acid metabolism and function can be examined. PMID- 3277087 TI - Feline 'C'-type terminals possess synaptic sites associated with a hypolemmal cistern and Nissl body. AB - Previous findings suggest that axosomatic 'C'-type terminals on rat spinal motoneurones possess 'active' synaptic sites associated with the characteristic subsynaptic cistern and postsynaptic Nissl body, but 'C'-terminals in cat do not. A re-examination of feline 'C'-terminals undertook to compare the synaptic ultrastructure in aldehyde-fixed material stained by either osmium or ethanolic phosphotungstic acid (E-PTA). In agreement with previous findings osmicated cat 'C'-terminals failed to reveal synaptic complexes in regions possessing the subsynaptic cistern ('cisternal regions'). In contrast, cisternal regions of E PTA stained 'C'-terminals exhibited a linear array of presynaptic dense projection all opposed by a single extended postsynaptic density which abutted directly onto both postsynaptic membrane and the cistern. This close topographical relationship is suggested to be functionally significant in the trans-synaptic trophism previously demonstrated for feline 'C'-terminals. PMID- 3277088 TI - Conflicting role expectations for the director of nursing position: a new standard. PMID- 3277089 TI - The role of breast milk in the development of the gastrointestinal tract. PMID- 3277090 TI - Nutrition Classics. Proceedings of the National Academy of Sciences of the United States of America, October 1978, Volume 75, Number 10: Human milk stimulates DNA synthesis and cellular proliferation in cultured fibroblasts. By Michael Klagsbrun. PMID- 3277091 TI - Dietary fat and insulin receptor function in rat adipocytes. PMID- 3277092 TI - Retinoic acid biosynthesis from retinol. PMID- 3277093 TI - Evaluation and management of the muscle contraction headache. AB - Headache was the seventh most frequent reason for a visit to primary care providers specified in the 1977-1978 National Ambulatory Care Survey. Muscle contraction headaches (MCH) constitute 90 percent of all headaches. Following a discussion of the epidemiology of headache, this article describes the pathophysiology, history, psychological profile of the typical MCH patient, common objective findings of MCH versus intracranial mass, physical findings and diagnosis. The management section includes a discussion of education and appropriate pharmacologic treatment, along with non-pharmacologic treatments such as massage, acupressure, biofeedback and stress management. Acupuncture is briefly described. Referral criteria for the MCH is included. PMID- 3277096 TI - From school to war. Interview by Buzz Hope. PMID- 3277094 TI - Reducing neurologic trauma in sports. PMID- 3277095 TI - Abdominal tuberculosis. PMID- 3277097 TI - What is it like to to pioneer a nurse-administered evaluation unit (NAU)? PMID- 3277098 TI - Thomas O'Dowd Sweet. 1988 President of the DSSNY. PMID- 3277099 TI - Application of the Maryland Bridge to a difficult case: a clinical report. PMID- 3277100 TI - A tenacious temporization. A case report. PMID- 3277101 TI - Prevention of preterm birth: new initiatives based on microbial-host interactions. AB - Preterm delivery remains a preeminent problem in reproductive and pediatric care worldwide. Recent data suggest that cervicovaginal microflora and/or the inflammatory response they engender produce factors which can cause or predispose to preterm labor and rupture of membranes. Microorganisms mediating such processes may not be "recognized pathogens" and are often considered normal flora. These microorganisms may act singly, additively, or synergistically with host factors released during an induced inflammatory response. Quantitative, as well as qualitative aspects of cervicovaginal microflora may be important. Multiple cervicovaginal microorganisms produce IgA protease, neuraminidase, and mucinase which may facilitate passage of these and other agents past cervical barriers and into the lower uterine segment. Multiple microflora also produce phospholipases A2 and C, each of which can locally augment production of eicosanoids within the uterus which are important in cervical ripening and labor. Similar microflora produce various proteases, including collagenase, which can focally weaken the amniochorion and predispose to premature rupture of membranes and cervical ripening. Intrauterine microorganisms induce inflammatory reaction and may engender local release of similar proteases, phospholipases, as well as platelet-activating factor (PAF) and lymphokines which can also initiate or further potentiate labor-inducing mechanisms. Recognition of microbe-induced pathogenesis of some cases of preterm birth offers the hope of specific treatment and prophylaxis. In recent studies, administration of erythromycin and tocolytic agents was associated with an improved outcome in selected women with preterm labor. Further microbiological and clinical studies are ongoing. "Just why so many gravidas go into labor prematurely and hence give birth to infants who often are unable to cope with extrauterine conditions is one of the great unsolved problems of obstetrics." PMID- 3277102 TI - A proposed mechanism for premature rupture of membranes. PMID- 3277103 TI - Splenosis: report of a case and review of the literature. AB - Splenosis is the autotransplantation of splenic tissue that usually follows traumatic rupture of the spleen. These splenic implants may be located anywhere within the peritoneal cavity. Although a relatively rare entity, when present these implants may mimic endometriosis or even metastatic carcinoma. As splenosis may compensate in part for the asplenic state, it is recommended that these splenic implants not be removed. It is important to correctly diagnose this condition to avoid unnecessary therapy. Diagnosis and management are discussed as well as a review of the literature. PMID- 3277104 TI - The incidence of preoperative endothelial dystrophy in pseudophakic bullous keratopathy. AB - To investigate the contribution of endothelial dystrophy to the subsequent development of pseudophakic bullous keratopathy, we retrospectively reviewed the clinical records and histopathologic specimens of pseudophakic patients who had undergone penetrating keratoplasty for corneal decompensation. Conclusive evidence of endothelial dystrophy was found in a majority (18 of 27, 67%) of patients who developed pseudophakic bullous keratopathy following implantation of a posterior chamber intraocular lens. By contrast, the incidence in a comparable group of 51 pseudophakic bullous keratopathy patients with anterior chamber intraocular lenses was low (six of 51, 12%) (P less than 0.01). In analyzing the relative risk of post-surgical corneal decompensation, one cannot implicate a particular intraocular lens without considering pre-existing endothelial dystrophy. PMID- 3277105 TI - Detection of three-walled infrabony defects by subtraction radiography. AB - An in vitro investigation was undertaken to establish the sensitivity of subtraction radiography for three-walled infrabony defect detection. After the creation of defects of controlled sizes in the interproximal regions of a dried mandible, subsequent radiographs were taken with the help of an occlusal stent. The radiographs were then digitized, and the images were enhanced by frame summation and averaging to reduce electronic noise. Further standardization was facilitated by the use of a step wedge on each radiograph and a computer program to correct variations in processing and exposure. The results show that defect resolution depended not only on the diameter of the defect but also on the mass of the adjacent bone. The smallest detectable lesion was 0.5 mm in diameter in the interproximal region of the premolars. In addition, a change in depth of 1 mm could be detected at the base of three-walled infrabony defects. PMID- 3277106 TI - Osteoporotic bone marrow defect: radiographic features and pathogenic factors. AB - The literature on osteoporotic bone marrow defect (OBMD) is reviewed, and an analysis of 20 additional cases is presented. The findings in this study are consistent with previous reports that the radiographic appearance may be indistinguishable from that of pathologic conditions; in some cases, the condition may be confused with aggressive tumors. It may also be significant that, in 16 of our 20 cases, the defects were found in regions where there had been previous extractions. PMID- 3277107 TI - Rigid fixation: a review of concepts and treatment of fractures. AB - Rigid fixation has been given considerable attention in the current literature. The concepts of treatment and the philosophies of the different systems vary, as do the results reported by different authors. This article reviews the basic tenets of rigid fixation and points out where systems are similar or diverge. Advantages and disadvantages of each system are covered. PMID- 3277108 TI - Bacteremia following intraoral suture removal. AB - Following dental extractions, prophylactic antibiotic protection of patients at high risk of cardiovalvular infection is usually discontinued before suture removal. To determine whether bacteremia is created upon removal of intraoral sutures, twenty healthy patients who required extractions of at least five erupted teeth and placement of several sutures were selected without regard to sex, age, or race. Blood samples were drawn preoperatively, immediately after the extractions, before suture removal, and immediately following removal of the intraoral silk sutures. The samples were cultured in prereduced and aerobic media suitable for quantitative colony counts. Fourteen of 16 patients yielded positive blood cultures following tooth extractions. One of 20 patients yielded a positive blood culture following suture removal. Even though the incidence of bacteremia following intraoral suture removal is relatively low (5%), this study suggests that intraoral suture removal is not a benign procedure for those persons who are considered high-risk cardiac patients. PMID- 3277109 TI - Surgical anatomy of the orbit. AB - A firm knowledge of orbital anatomy is mandatory for any surgical specialist dealing with this important region. An understanding of orbital anatomy can be acquired systematically by studying each of its component systems (skeletal, fascial, vascular, neural and muscular, and lacrimal). Frequent review of this topic, and the study of anatomic detail in cadaver and surgical dissections, should result in safer, more secure surgery in this complex area. PMID- 3277110 TI - Nasolacrimal evaluation and surgery. AB - The lacrimal drainage system is a very important functional and anatomic assembly in the orbit and midface. For surgeons who intend to become involved in its repair or reconstruction, it is mandatory to understand the full range of anatomic, physiologic, and diagnostic considerations prior to embarking upon a surgical course. Proper eyelid function depends upon the integrity of its constituent parts, including the margin, tarsus, muscle, and globe apposition. The lacrimal pump mechanism is produced by proper eyelid function and structure, and must be adequately assessed. The puncta and canaliculi are delicate structures and must be manipulated with care and gentleness. The lacrimal sac is a static structure that serves as a collecting sphere but also may be forced to evacuate its contents into the nasolacrimal duct by the "squeezing" action of the investing tendons. Proper tendon position must be maintained after surgery or trauma to facilitate this action. The nasolacrimal sac may be damaged after facial fractures or blocked from intranasal conditions. If the blockage cannot be relieved, it must be bypassed by performing a dacryocystorhinostomy. The use of long-term, indwelling silicone intubation catheters greatly facilitates the successful reconstruction of the lacrimal drainage system. Proper attention to all of these points will be appreciated by the patient. PMID- 3277111 TI - Clinical and radiographic evaluation of the orbit. AB - A complete clinical examination of the orbit must include a detailed physical evaluation of the eye and its associated structures. Whether the examination is for a traumatic, infectious, inflammatory, or neoplastic condition of the orbit, the main concern is determination of the visual status and preservation of vision. PMID- 3277112 TI - Surgical access to primary orbital tumors. AB - The basics of evaluation and surgical access to primary orbital tumors as well as paranasal or intracranial neoplasms that invade the orbit are presented. PMID- 3277113 TI - Optic nerve decompression. AB - Post-traumatic deterioration of vision requires thorough ophthalmologic evaluation, as well as computed tomographic scanning of the orbits and central visual pathways if no obvious ocular origins of the visual decrement are detected. When optic nerve trauma is a suspected etiology, the patient should be treated with megadose intravenous steroids, as well as optic nerve decompression performed after 12 to 24 hours if improvement of vision fails to occur. PMID- 3277114 TI - Evisceration, enucleation, and exenteration. AB - The removal of the intraocular contents, the globe itself, or the entire orbital contents are three procedures that each present distinct pre- and postoperative problems. These procedures and the management challenges they present are discussed in this article. PMID- 3277115 TI - Complications of orbital surgery. PMID- 3277116 TI - Orbital rehabilitation: surgical and prosthetic. AB - Restoration of facial symmetry is the goal in rehabilitation of an orbit disfigured by trauma or tumor extirpation. Successful rehabilitation may require replacement of repositioning of the orbital walls and/or construction of a complex orbital prosthesis. Preoperative communication among the head and neck surgeon, ophthalmologist, and maxillofacial prosthodontist is essential. PMID- 3277117 TI - Orbital reconstruction in hypertelorism. AB - Orbital hypertelorism as defined by increased bony interorbital distance is a complex manifestation of many congenital anomalies. As such, it is associated with a multitude of orbital, adnexal, and surrounding soft-tissue deformities. Treatment of these problems requires extensive experience and a comprehensive team, permitting adequate preoperative evaluation, diagnosis, and treatment. The results obtained may be dramatic. The overall safety of the procedures has been demonstrated. Continued refinements and long-term follow-up will undoubtedly continue to make significant improvements. PMID- 3277118 TI - Management of orbital trauma and foreign bodies. AB - Blunt and penetrating trauma to the orbital region can have a devastating effect both functionally and cosmetically for the orbit. Penetrating injuries to the orbit should be suspected whenever there is a history of trauma to the regions of the eyelids. Meticulous inspection of the eyelids and globe should be undertaken, and if there is any suspicion of a foreign body retained within the orbital soft tissues, then a CT scan should be obtained. It is possible that the foreign body is not opaque, and exploration of the soft tissues may be indicated. Blow-out fractures of the orbit should be explored and repaired when the evidence clearly indicates that a blow-out is present. This includes the clinical presence of diplopia, evidence of muscle entrapment with forced duction testing, and CT scan showing orbital wall fracture with explosion of the orbital contents into the paranasal sinuses. If these signs or symptoms are equivocable, then a waiting period of 10 to 14 days is indicated to rule out the presence of a nerve palsy, which should improve. However, a CT scan showing a large blow-out defect of the orbit should be repaired regardless of the clinical signs at the time because of the late sequelae of enophthalmos and hypophthalmos. It is very difficult to secondarily repair an orbit that is contracted owing to loss of volume from an orbital blow-out fracture. Procedures of this sort involve the reintroduction of autogenous fat into the orbital contents and are very difficult technically. Although orbital fractures should not be routinely explored, each should be viewed with its own merit and an aggressive approach developed if there is clinical evidence of a blow-out fracture. PMID- 3277119 TI - Unilateral proptosis. AB - Unilateral proptosis is not uncommonly encountered by the otolaryngologist. A thorough understanding of the potential causes and the appropriate diagnostic evaluation will ensure a successful outcome. PMID- 3277120 TI - Infectious and inflammatory diseases of the orbit. AB - Patients presenting with orbital inflammation must be diagnosed promptly and treated aggressively. Appropriate therapy is based on the specific diagnosis and is highly effective and rewarding. PMID- 3277121 TI - Management of paranasal sinus neoplasms invading the orbit. AB - Sinus tumors can readily invade the orbit through their shared walls. The initial symptoms of a sinus neoplasm are often due to orbital invasion. A comprehensive overview of the pathology, diagnosis, and treatment of these tumors is presented. PMID- 3277122 TI - Management of endocrine orbitopathy. AB - Endocrine ophthalmopathy remains the most common cause of proptosis in adults. In a small but significant percentage of patients, vision can be threatened, requiring prompt intervention. In the patients who fail to respond to medical management with high-dose steroids, surgical decompression is indicated. The Walsh-Ogura antral-ethmoidal decompression is the most widely used approach at this time. Radiation therapy is a therapeutic modality that is probably best reserved for patients who fail to respond to steroids or surgery, or in whom these two approaches are not possible. The management of endocrine orbitopathy continues to be directed toward relief of symptoms. A multidisciplinary approach, involving the endocrinologist, ophthalmologist, otolaryngologist-head and neck surgeon, and oculoplastic surgeon is often required to achieve the best outcome. PMID- 3277123 TI - Psychoanalysis: the unknown profession. PMID- 3277124 TI - Management of the fetus and neonate with hydronephrosis detected by prenatal ultrasonography. PMID- 3277125 TI - Hypospadias. PMID- 3277126 TI - Urologic problems--prenatal and postnatal. PMID- 3277127 TI - Host defense development in gut and related disorders. AB - The gastrointestinal tract serves as an important interface between ingested elements from the external environment and the internal milieu of the person. Maturation of this intestinal barrier appears to occur along with the normal development of other organ systems. Evidence is presented for this maturational process, and the relation of this immature barrier to certain disease states seen in the neonatal period (e.g., infectious diarrhea, necrotizing enterocolitis, and allergic disease) is discussed. PMID- 3277128 TI - Gastroesophageal reflux: update on pathogenesis and diagnosis. AB - The study of GER has been hindered by the lack of a good animal model and by the presence of some reflux in all normal individuals. By the painstaking process of studying normal infants, children, and adults, it is becoming evident that abnormalities of acid clearance, especially in the recumbent position (or during sleep), may be critical to an understanding of this disorder. As more is learned about the conditions surrounding "normal" reflux, it will be possible to refine the techniques of diagnosis and thereby identify the abnormal with more security. PMID- 3277129 TI - Fiberoptic upper intestinal endoscopy in infants and children. AB - Fiberoptic upper intestinal endoscopy has been shown in the last decade to be the most sensitive technique to diagnose upper gastrointestinal disease. Diagnostic endoscopy has been shown to be safe, with a low complication rate of less than 2 per cent, and most of those reported have been minor. Furthermore, therapeutic endoscopy has been used to treat bleeding varices by sclerotherapy, avoiding the need for shunting procedures, which often fall in young children. Dilation of strictures with wire-guided dilators, endoscopic incision of antral mucosal diaphragms, and percutaneous placement of gastrostomy tubes are other ways endoscopy is being used as a means of treatment. Electrocoagulation and photocoagulation of bleeding upper gastrointestinal lesions have not been used. PMID- 3277130 TI - Gluten-sensitive enteropathy in childhood. AB - Genetic and environmental factors (breast feeding, probably viral infections) play a role in the expression of the disease. Prevalence of GSE in childhood did not substantially decrease in the last 15 years in all European countries, where GSE is still more common in infantile age and presents frequently gastrointestinal symptoms. A decrease has been reported in childhood in several United Kingdom areas and in Finland, where the clinical presentation is changing, shifting upward with age and coming closer to the adult type of the disease. The following clinical problems have been reported in the recent literature: enamel hypoplasia; monosymptomatic short stature; arthritis and other immunologic diseases; association with diabetes, atopy, Iga deficiency, and probably Down's syndrome. Delay in puberty and other peculiar problems of the disease have been described in adolescents. Tests assessing the permeability of the small intestine and the blood levels of antigliadin antibodies have recently gained success as noninvasive tools for the diagnosis of the GSE. The gluten should be withdrawn from the diet and the challenge with gluten should be performed not before 12 months of gluten-free diet with an accurate timing of the biopsy on the basis of the antigliadin and antireticulin antibodies, to avoid clinical and growth damage. Celiac children do require a permanent gluten-free (and not poor) diet. In reality, too many celiac adolescents are off-diet. PMID- 3277131 TI - Protein intolerance and immunocyte and enterocyte interaction. AB - Food allergy is an untoward immunologic reaction to food. The number of conditions that need to be considered in the differential diagnosis is large and includes adverse reactions to foods that do not have an immunologic basis. Intestinal immune elements are an integral feature of the intestinal mucosa and, besides modulating gastrointestinal function, represent a significant part of the host's overall immune system. Despite increasing knowledge, the precise disturbances in immune function that lead to the appearance of food allergy are still unclear. Food allergy will remain primarily a clinical diagnosis, relying on history and response to dietary elimination and rechallenge until more specific tests become available. PMID- 3277132 TI - The transport of electrolytes in the gut and the use of oral rehydration solutions. AB - This presentation summarizes the recent advances in knowledge of the physiologic and pathophysiologic process underlying the transport of electrolytes across the small intestine and formulate a rationale for the use of oral electrolyte solutions in diarrheal diseases. PMID- 3277133 TI - Steatorrhea and disorders of chylomicron synthesis and secretion. AB - Knowledge concerning the absorptive phase of fat remains relatively scanty as compared to the wealth of information available on the digestive phase. However, the past years have seen important developments in our understanding of chylomicron formation and secretion. This has come about thanks to clinical studies of rare congenital disorders of chylomicron synthesis and exocytosis and to the creation of experimental models. PMID- 3277134 TI - Bacterial gastroenteritis. AB - Acute diarrhea is a major cause of childhood morbidity. Important advances in the understanding of bacterial gastroenteritis have been made in the past two decades. This article reviews the epidemiology, pathogenesis, and methods of diagnosis of bacterial gastroenteritis. Bacterial enteric pathogens common to North America are discussed in more detail. PMID- 3277135 TI - Viral enteritis. AB - Rotavirus has emerged as the major enteric pathogen causing acute diarrhea in young children throughout the world. Other viral pathogens have been recognized and additional candidate agents are suspected but none approaches rotavirus in its global impact. A strong appropriate emphasis has been placed on preventive therapy. Although vaccines are not yet available, it is clear that improved hygienic practices, particularly in pediatric institutions, and breast feeding can do much to prevent serious illness during the early months when babies are so vulnerable. During the past decade, from clinical studies and animal models, much has been learned about the pathogenesis of rotavirus diarrhea. These findings provide a sound basis for the use of rational oral fluid therapy, early feeding, and avoidance of drugs during active management. Among the many challenges that remain are the elucidation of the full spectrum of enteric viral pathogens, their impact on man, and their prevention and active therapy. PMID- 3277136 TI - "Pneumatic reduction of ileocolic intussusception in children". Questions and historical notes on pneumatic reduction of ileocolic intussusception. PMID- 3277137 TI - Idiopathic fibrosing pancreatitis: a cause of obstructive jaundice in childhood. AB - Idiopathic fibrosing pancreatitis is a chronic process of unknown etiology characterized by extensive infiltration of the pancreatic parenchyma by fibrous tissue. This disease process is uncommon in the pediatric patient and is consequently rarely considered in the differential diagnosis of abdominal pain and jaundice in the child. The sonographic demonstration of a dilated biliary tree and common bile duct compressed by an enlarged pancreas may be the first suggestion of this entity. Two patients with idiopathic fibrosing pancreatitis and obstructive jaundice are reported with a review of the clinical, radiographic, and pathologic findings. PMID- 3277138 TI - Dominant and recessive polycystic kidney disease in children: classification by intravenous pyelography, ultrasound, and computed tomography. AB - Both dominant and recessive polycystic kidney disease appear in childhood. We have analyzed findings of intravenous pyelography, ultrasound and computed tomography in genetically classified cases of dominant (13 children) and recessive polycystic kidney disease (5 children) and thus defined criteria by which sporadic cases of childhood polycystic kidney disease can be classified to dominant or recessive polycystic kidney disease. PMID- 3277139 TI - Imaging of uretero-pelvic junction obstruction with stimulated diuresis. With consideration of the reliability of ultrasonography. AB - Eighty-nine kidneys of 81 infants and children with uretero-pelvic junction obstruction were investigated using ultrasonography (US), diuretic urography (DUR) and diuretic renography (DREN). Results of the US were false-negative in 14%. This can be avoided by ensuring that the patients get an amount of fluid appropriate to their age before the examination or by performing diuretic ultrasonography with frusemide. False-positive results were found with US in 15%, but obstruction was excluded by using the DUR and/or the DREN. During post operative follow up the DUS is useful and after 6 months the clearance with 123 iodine hippurate combined with the DREN should be performed. The performance of the Whitaker-test is unnecessary. PMID- 3277140 TI - Ultrasound diagnosis of multiple cystic encephalomalacia. AB - Following bacterial meningitis thirty cases of enlarging head were evaluated on ultrasound to find out the cause. Nine out of 30 patients had multiple cystic lesions in both cerebral hemispheres with or without ventriculomegaly. Three patients showed debris in the cysts suggesting pus, which was confirmed on ultrasound-guided aspiration in two and on surgery in one case. Seven out of nine patients had died at the time of writing this communication, suggesting the need for its early detection and timely family counselling. It is stressed that multiple cystic encephalomalacia has a characteristic appearance on ultrasound and all patients with meningitis should be screened routinely so as to detect it at an early stage. PMID- 3277141 TI - Late ultrasonographic pattern in congenital nephrotic syndrome of Finnish type. PMID- 3277142 TI - Imaging of lipoma of the corpus callosum and intracranial dermoids in the Goldenhar syndrome. PMID- 3277143 TI - Aortic thrombosis diagnosed by ultrasound. AB - A neonate developed aortic thrombosis following catheterization of the umbilical artery. The thrombus was identified and followed up by ultrasonography. Fibrinolytic therapy led to the almost complete disappearance of the aortic thrombus but the child died of cerebral haemorrhage. Physicians should be alerted to the possibility of aortic thrombosis in neonates following umbilical arterial catheterization. Ultrasonography is an appropriate method for diagnosis and follow-up in these cases. PMID- 3277144 TI - Sonography of focal foveolar hyperplasia causing gastric obstruction in an infant. AB - A young infant is presented with a mass partially obstructing the distal stomach. Sonography demonstrated the superficial origin of the lobulated lesion which proved to be focal foveolar hyperplasia, the most common cause of a gastric polypoid mass in adults but rare in children. PMID- 3277145 TI - Transient protein-losing gastropathy (Menetrier's disease) in childhood. AB - Two cases of transient protein-losing gastropathy (PLG) or Menetrier's disease in childhood are described. Both cases presented with an abrupt onset of edema due to hypoalbuminemia and were diagnosed by an upper gastrointestinal series. One of the cases was further diagnosed and followed by ultrasound. We believe that this is the first description of the ultrasonic picture of transient PLG in children. In both cases complete recovery was evident after a few weeks. PMID- 3277146 TI - Percutaneous drainage for post-traumatic hepatic abscess in children under ultrasound imaging. AB - Hepatic abscess is rare in children. A patient with a post-traumatic hepatic abscess was successfully treated by ultrasound-guided percutaneous drainage. Although he underwent a drainage operation for the perihepatic abscesses, high fever continued. It was then considered that the traumatic hematoma had been infected and had become an abscess. Sonographically-guided percutaneous aspiration is useful for the definite diagnosis of hepatic abscess. Subsequent percutaneous drainage under ultrasound imaging is a safe and useful therapeutic method even in a poor-risk patient. PMID- 3277147 TI - Edward B.D. Neuhauser, M.D. PMID- 3277148 TI - Pediatric spinal sonography. Part I: Anatomy and examination technique. AB - Ultrasonography with high resolution technique enables the differentiation of intra- and paraspinal structures in a significant way. Conditions, examination technique, and sonographic anatomy of the os sacrum, the lumbar and dorsal spinal canal as well as the cranio-cervical junction are presented. PMID- 3277149 TI - Longitudinal development of specific and functional antibody in very low birth weight premature infants. AB - We evaluated the formation of specific and functional antibody in preterm infants born weighing less than 1500 g (mean 1088 g) and less than 32 wk gestational age (mean 28.8 wk). Plasma IgG antibody against tetanus and diphtheria toxoids were measured by an enzyme-linked immunosorbent assay. Opsonic activity of heat inactivated plasma was measured using radiolabeled bacteria, adult polymorphonuclear leukocytes and exogenous human complement. In the presence of complement, the strain of coagulase negative staphylococcus used was opsonized by IgG antibody, and the strain of Escherichia coli by IgM. Geometric mean plasma levels of tetanus and diphtheria IgG antibody fell from birth to 4 months chronological age, but rose significantly by 9 months (approximately 2 months after the third dose of diphtheria, tetanus, pertussis vaccine). However, at 9 months they remained lower than the respective geometric mean levels in 9-month old term infants (tetanus: p less than 0.001; diphtheria: p = 0.02). The preterm infants' mean plasma IgG staphylococcal opsonic activity fell from birth to 2.5 months, but by 9 months was comparable to that of term infants of the same age. Mean IgM opsonic activity for E. coli was very low at birth in both preterm and term infants. It rose with chronological age, correlating with the rise in total IgM (r = 0.48, p less than 0.001) and by 9 months the mean preterm and term infants' levels of IgM opsonic activity for E. coli were comparable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277150 TI - Functional activity of class-specific antibodies to type III, group B streptococcus. AB - The functional activity of naturally acquired IgG and IgM with specificity for the capsular polysaccharide of type III, group B Streptococcus (III-GBS) was compared. Sera collected during convalescence from 14 infants who had developed specific antibodies following III-GBS infection were employed for separation of IgG from IgM by ion-exchange chromatography. Bactericidal killing of III-GBS was similar for IgG- and IgM-rich samples (37 and 42%, respectively) in reactions containing a mean of 1.0 or 1.9 micrograms/ml of III-GBS specific IgG or IgM antibody. Purified IgA lacked opsonophagocytic activity for III-GBS. These results indicate that III-GBS-specific IgG and IgM antibodies in infant sera promote opsonophagocytosis at low concentrations, and that their functional capacity is comparable. PMID- 3277151 TI - Hemodynamic responses of chronically instrumented piglets to bolus injections of group B streptococci. AB - Group B beta-hemolytic Streptotocci cause pulmonary hypertension when injected into animals and may precipitate the persistent pulmonary hypertension syndrome in infected human neonates. We used chronically instrumented piglets to study the effects of repeated injections of heat-killed group B Streptococcus (GBS) type III. Daily exposure to GBS was associated with a 2-fold or greater potentiation of pulmonary and systemic hypertensive responses after 1 wk. Throughout experimentation, pulmonary pressure changes were more marked than systemic changes. After establishing a dose-response relationship, we chose a control dose that produced intermediate hypertensive responses. We then evaluated the effects of antibody and various drugs on the hypertensive responses. Preincubation of organisms with rabbit antiserum containing type-specific antibody enhanced the responses. Beta endorphin blockade with naloxone had little or no effect; leukotriene synthesis inhibition also did not affect responses. Both indomethacin, a cyclooxygenase inhibitor, and dazmegrel, a specific thromboxane synthesis inhibitor, blocked the hypertensive responses to GBS. It appears that repeated doses of GBS potentiate the hypertensive responses, a process that we hypothesize may be mediated by development of type-specific antibody as type specific antibody levels rose during potentiation. It is likely that thromboxane A2 is the effector of the pulmonary and systemic hypertensive responses to GBS injection, because thromboxane inhibition by dazmegrel was as effective as indomethacin in blocking these effects. Thromboxane synthesis blockade may prove useful in management of hemodynamic disturbances accompanying severe bacterial infections in humans. PMID- 3277152 TI - False positive results with the use of chlamydial antigen detection tests in the evaluation of suspected sexual abuse in children. AB - The presence of rectal or genital infection with Chlamydia trachomatis in children is frequently considered an indicator of sexual abuse. The diagnosis of chlamydial infection in these children has been complicated by the use of antigen detection methods instead of culture. We report five cases in which the use of chlamydial antigen detection tests in the evaluation of suspected child abuse gave false positive results. An enzyme immunoassay was used in two cases (Chlamydiazyme; Abbott Diagnostics) and a direct fluorescent antibody test was used in the remaining three cases (Microtrak; Syva). The sites examined were the urethra, vagina and rectum. In all cases chlamydial cultures obtained several days later with no interim antibiotic therapy were negative. Four of the five children examined were probably victims of sexual abuse. The enzyme immunoassay and direct fluorescent antibody tests have been evaluated primarily for urethral and cervical cultures from adults; neither test has been approved or evaluated for rectal or genital sites in children. At these sites use of both tests may be associated with a large proportion of false positives caused by contamination with fecal flora which can cross-react with the antibodies used in the test. These tests also have limited utility in populations where the prevalence of chlamydial infection is low (less than 10%), as has been reported for sexually abused children. Because of the medicolegal implications only "gold standard" methods (i.e. culture) performed by a competent laboratory should be used in evaluating chlamydial infection in sexually abused children. PMID- 3277153 TI - Five vs. ten days of therapy for acute otitis media. AB - In a double blind study 175 patients with acute otitis media were randomized into 2 treatment groups: 10 days of therapy with cefaclor or 5 days of therapy followed by 5 days of placebo. The dosage of cefaclor was 40 mg/kg/day administered orally in equally divided doses at 12-hour intervals. Tympanocentesis before treatment yielded specimens that contained Streptococcus pneumoniae or Haemophilus influenzae or both in 55% of specimens. Branhamella catarrhalis was isolated from 21% of specimens. Culture of material from the ear canal of patients with spontaneous perforation of the tympanic membrane of less than 24 hours duration yielded pneumococci or H. influenzae or both in 38% of specimens and staphylococci in 31%. Patients were scheduled for follow-up examinations at 5 or 6, 10, 30, 60 and 90 days. Of the 175 children 151 were evaluable at 10 days. There were 123 patients with both tympanic membranes intact at the time of diagnosis. There were 6 (10%) treatment failures of therapy in the 59 patients assigned to 5 days of therapy and 4 (6%) failures and 1 (2%) early relapse in the 64 assigned to 10 days of therapy (difference not significant). There were 28 evaluable patients with spontaneous perforation. There were 8 (53%) failures in the 15 children assigned to 5 days of therapy and only 1 (8%) failure in the 13 children assigned to receive 10 days of therapy (P = 0.016, Fisher exact test). Rates of reinfection and persistent middle ear effusion at 10, 30, 60 and 90 days follow-up were not significant different in patients assigned to 5 to 10 days of therapy. In patients with acute otitis media with intact tympanic membranes we have not been able to show any advantage of the standard duration of 10 days of therapy over a shortened course of 5 days. A 5-day course of antibiotic therapy does not appear to be sufficient for children with acute otitis media and spontaneous purulent drainage. PMID- 3277154 TI - Double blind study of ketoconazole and griseofulvin in dermatophytoses. AB - Ketoconazole and griseofulvin were compared in a double blind fashion in 47 children with dermatophytosis and positive fungal culture. After 6 weeks of therapy there was clinical and mycologic cure or improvement of the lesions in 92% of patients treated with ketoconazole (Group A) and in 76% of those given griseofulvin (Group B). A patient in Group A showed clinical deterioration of the lesions after 4 weeks of treatment, although modification of antifungal therapy was not necessary to achieve final healing. One ketoconazole-treated patient relapsed within 7 days after cessation of therapy. In Group B the antifungal agent was changed in five cases due to worsening or slow resolution of the lesions and persistence of positive cultures after 6 weeks of treatment. Both ketoconazole and griseofulvin were useful drugs for treatment of dermatophytoses in children. PMID- 3277155 TI - Reactive arthritis. PMID- 3277156 TI - Changing patterns in the diagnosis of hypertrophic pyloric stenosis. AB - The records of 216 infants who had surgical correction of hypertrophic pyloric stenosis between 1980 and 1984 at the Children's Hospital of Alabama were reviewed. A significant increase in the reliance on upper gastrointestinal roentgenographic series and abdominal sonography for confirmation of the diagnosis of hypertrophic pyloric stenosis was noted in our patients when compared to previous reports. Despite the preoperative presence of a palpable pyloric mass in 192 (89%) of the patients, 174 (81%) had a diagnostic imaging procedure. Similar high rates of imaging studies were noted when the records of patients with hypertrophic pyloric stenosis from 1980 and 1984 were reviewed at three other institutions. Palpation of a hypertrophied pylorus is diagnostic of hypertrophic pyloric stenosis. Careful physical examination makes diagnostic imaging unnecessary in the majority of infants with symptoms suggesting hypertrophic pyloric stenosis. Diagnostic imaging for suspected hypertrophic pyloric stenosis should be used only for those infants with persistent vomiting in whom careful and repeated physical examinations fail to detect a palpable pyloric mass. PMID- 3277157 TI - Interaction of iron deficiency and lead and the hematologic findings in children with severe lead poisoning. AB - Microcytic anemia, long considered an effect of lead poisoning, may in fact result from coexisting iron deficiency. In this study, how RBC size, hemoglobin, and zinc protoporphyrin vary as a function of iron status in a group of children with high lead levels was examined. Charts of all children (N = 51) admitted to Cook County Hospital for treatment of lead poisoning in 1981 to 1983 were reviewed for data on age, blood lead level, hemoglobin concentration, MCV, transferrin saturation and zinc protoporphyrin level. The mean lead level was 86 micrograms/dL and the range was 63 to 190 micrograms/dL. Children with transferrin saturation values less than 7% had a mean MCV of 56 microL, hemoglobin of 8.9 g/dL, and zinc protoporphyrin of 693 micrograms/dL; for those with saturations of 7% to 16%, the values were 61 microL, 10.1 g/dL, and 581 micrograms/dL, respectively; the children with saturations greater than 16% had normal mean MCVs and hemoglobin concentrations (74 microL and 11.4 g/dL) and a mean zinc protoporphyrin value of 240 micrograms/dL (P less than .0005). Multiple linear regression was used to correct for effect of age, and transferrin saturation remained the most important predictor of MCV, hemoglobin, and zinc protoporphyrin levels; the addition of lead did not improve the models. Results of this study suggest that iron deficiency is strongly associated with some of the observed toxicities of lead. Also, lead poisoning can exist without producing microcytosis or anemia, and zinc protoporphyrin concentration may not be a sensitive indicator of lead level in the absence of iron deficiency. PMID- 3277158 TI - Bilirubin beyond the blood-brain barrier. AB - We evaluated the utility of recording neural signals, such as auditory brainstem responses, as potential new criteria for treatment of neonatal jaundice. Findings from recent studies of auditory brainstem responses and behavior of jaundiced infants reinforce the notion that asymptomatic and even symptomatic neurotoxicity caused by bilirubin may occur relatively frequently at relatively low serum bilirubin concentrations. Evidence suggests that this is transient and reversible. Whereas current criteria for the prevention of kernicterus are based on the idea that bilirubin entry to the CNS should be averted, the existence of transient subclinical and clinical bilirubin-induced neurotoxicity suggests that the focus of prevention might be shifted to events beyond the blood-brain barrier. With the use of "finer tools" to detect neurotoxicity, it may be possible to recognize a prior stage of neurotoxicity, described here as "transient subclinical bilirubin-induced neurotoxicity." Recordings of neural signals might be used as either predictors of kernicterus or as immediately available "outcomes" or end points with which biochemical predictors (serum bilirubin and "unbound" bilirubin concentrations) might be correlated, to determine their relative value as predictors of entry of bilirubin to the CNS. It is suggested that the results of studies to determine the relative risks associated with the various predictive criteria, namely, a prospective cohort analysis, may not be available for many years and that randomized controlled trials of new criteria for exchange transfusion are even further removed from reality. PMID- 3277159 TI - Crosslinking of the anticodon of P site bound tRNA to C-1400 of E.coli 16S RNA does not require the participation of the 50S subunit. AB - Crosslinking of the 5'-anticodon base of ribosomal P site bound AcVal-tRNA to residue C-1400 of 16S RNA or to its equivalent in 18S RNA has been shown to occur on 70S or 80S ribosomes of both prokaryotes and eukaryotes [Ciesiolka, J., Nurse, K., Klein, J. and Ofengand, J. (1985) Biochemistry 24, 3233-3239]. In the present work, we show that the crosslinking rate, crosslinking yield, and site of crosslinking are all unchanged when the 50S subunit is omitted. Therefore, all of the positional features of tRNA-ribosome complexes which allow crosslinking to occur are entirely contained in the 30S subunit. Blockage of reverse transcription by crosslink formation was used to determine the site of crosslinking. This analysis revealed that RNA modifications which do not directly block base-pairing ligands sometimes allow the modified base to be transcribed, leading to doublet band formation even when there is only a single crosslink site. PMID- 3277160 TI - Beta-amyloid gene dosage in Alzheimer's disease. PMID- 3277161 TI - Mechanism of autonomous control of the Escherichia coli F plasmid: purification and characterization of the repE gene product. AB - E protein, the 29 Kd repE gene product, is essential for the replication of the Escherichia coli F plasmid. The repE gene has been cloned and expressed in an inducible ATG-fusion vector, and the protein product has been purified to homogeneity. The purified E protein is present as a dimer in solution and binds specifically to both the 19-bp direct repeats (incB) found within the mini-F origin of replication ori2 and the repE operator DNA. Examination of the amino acid sequence of E protein revealed a consensus sequence for DNA binding. PMID- 3277163 TI - The DNA content of nongerminative variants of Candida albicans. PMID- 3277162 TI - Characterization and heterospecific expression of cDNA clones of genes in the maize GSH S-transferase multigene family. AB - We have isolated from a constructed lambda gt11 expression library two classes of cDNA clones encoding the entire sequence of the maize GSH S-transferases GST I and GST III. Expression of a full-length GST I cDNA in E. coli resulted in the synthesis of enzymatically active maize GST I that is immunologically indistinguishable from the native GST I. Another GST I cDNA with a truncated N terminal sequence is also active in heterospecific expression. Our GST III cDNA sequence differs from the version reported by Moore et al. [Moore, R. E., Davies, M. S., O'Connell, K. M., Harding, E. I., Wiegand, R. C., and Tiemeier, D. C. (1986) Nucleic Acids Res. 14:7227-7235] in eight reading frame shifts which result in partial amino acid sequence conservation with the rat GSH S-transferase sequences. The GST I and GST III sequences share approximately 45% amino acid sequence homology. Both the GST I and the GST III mRNAs contain different repeating motifs in front of the initiation codon ATG. Multiple poly(A) addition sites have been identified for these two classes of maize GSH S-transferase messages. Genomic Southern blotting results suggest that both GST I and GST III are present in single or low copies in the maize (GT112 RfRf) genome. PMID- 3277164 TI - The evolution of nursing in Nicaragua. PMID- 3277165 TI - Medicaid: a public program in distress. PMID- 3277166 TI - Ultrasound for the primary care physician. Applications in family-centered obstetrics. AB - Ultrasound imaging is a noninvasive diagnostic tool that enhances the patient's and physician's understanding of prenatal care. According to a multisite study, use of ultrasound by primary care physicians appears to improve prenatal patient education and support early formation of the family unit. Other potential benefits include early detection of fetal abnormalities, savings in time and cost, and enhanced continuity of care. However, consultation with and referral to specialists, when appropriate, remain essential ingredients for state-of-the-art healthcare. Further studies defining the role and boundaries of ultrasound in primary care are needed. PMID- 3277167 TI - How to evaluate the patient after a first seizure. AB - The primary care physician who is approached by a patient or the parents of a patient who has had a first seizure must determine that a seizure has indeed occurred and then ascertain the type of seizure before any treatment is prescribed. While there is a variable recurrence risk after generalized tonic clonic and partial seizures, certain types, such as absence seizures, have a high recurrence risk. Studies disagree on whether all patients with a first seizure require treatment, especially considering the side effects that can accompany anticonvulsant drugs. If the diagnosis is uncertain, waiting for a second seizure before starting treatment is usually a good idea. Electroencephalography should be done and, depending on results, followed by electrocardiography, a fasting glucose test, and/or computed tomography. If the diagnosis is certain, computed tomography or magnetic resonance imaging is useful in ruling out structural lesions as the cause of the seizure. The dosage of an anticonvulsant drug that is appropriate for the patient can then be determined by slowly increasing the dosage of one drug at a time until the patient becomes seizure-free without clinical toxicity. PMID- 3277169 TI - HT-29 cells are an in vitro model for the generation of cell polarity in epithelia during embryonic differentiation. AB - A monoclonal antibody that recognizes a membrane glycoprotein specific for the apical membrane of human colonic epithelial cells has been used to follow the differentiation and polarization of a cell line, HT-29, derived from a human colon adenocarcinoma. When these cells formed a polarized epithelium, the antigen was concentrated at the apical plasma membrane. It was also found intracellularly in vesicles and vacuoles. When HT-29 cells were undifferentiated and unpolarized, the antigen was not expressed significantly at the plasma membrane but was found concentrated in the membranes of intracellular vacuoles. Cells not yet organized into an epithelium may thus synthesize a membrane protein specific for their future apical membranes and store it intracellularly until the polarization process takes place. Intermediary stages of differentiation were occasionally recognized. They are characterized by a small number of cells surrounding an intercellular lumen. These lumina displayed apical membrane features (the presence of the apical antigen, of some microvilli, and of junctional complexes), although the cells were not fully differentiated. The differentiation process in HT-29 cells is apparently similar to that observed during embryonic development of the intestine. Therefore, HT-29 cells represent a useful model system to study epithelial differentiation in vitro. PMID- 3277168 TI - Nuclear matrix proteins reflect cell type of origin in cultured human cells. AB - The low abundance proteins of the nuclear matrix (NM) were separated from the intermediate filament (IF) proteins and analyzed by two-dimensional gel electrophoresis. Three human breast carcinoma lines had virtually identical patterns of 37 NM proteins. In contrast, cell lines derived from diverse tissues had qualitatively different NM protein patterns. Together, the five cell types examined here had a total of 205 distinguishable NM proteins with 125 of these proteins unique to a single cell type. The remaining NM proteins were shared among cell types to different degrees. Polyclonal antisera, obtained by immunization with total NM proteins as antigens, preferentially stained the nuclear interior and not the exterior IF. These observations suggest that the NM proteins, localized to the interior of the nucleus, vary in a cell-type-specific manner. PMID- 3277170 TI - Developmentally regulated expression by Trypanosoma cruzi of molecules that accelerate the decay of complement C3 convertases. AB - We recently showed that culture-derived metacyclic trypomastigotes (CMT), but not epimastigotes (Epi), of the Miranda 88 strain of Trypanosoma cruzi evade lysis by the human alternative complement pathway because of inefficient binding of factor B to complement component C3b on the parasite surface. These results suggested that CMT and tissue-culture-derived trypomastigotes (TCT), which also activate the alternative pathway poorly, might produce a molecule capable of interfering with factor B binding to C3b. We now demonstrate that CMT and TCT lysates, as well as molecules spontaneously shed from CMT and TCT but not Epi, accelerate decay of 125I-labeled factor Bb from the alternative-pathway C3 convertase (C3bBb) assembled on zymosan or Epi and also accelerate decay of the classical pathway C3 convertase (C4b2a) on sheep erythrocytes. Parasites metabolically labeled with [35S]methionine spontaneously shed a limited number of radioactive components ranging in molecular mass from 86 to 155 kDa for trypomastigotes and 25 to 80 kDa for Epi. Decay-accelerating activity within supernatants is inactivated by papain and is coeluted with 35S-containing polypeptides on FPLC anion-exchange chromatography, suggesting that the active constituents are protein molecules. Molecules with decay-accelerating activity may explain the developmentally regulated resistance to complement-mediated lysis in infective and vertebrate stages of the T. cruzi life cycle. PMID- 3277171 TI - Characterization of the TPR-MET oncogene p65 and the MET protooncogene p140 protein-tyrosine kinases. AB - The proteins encoded by the human TPR-MET oncogene (p 65tpr-met) and the human MET protooncogene (p140met) have been identified. The p65tpr-met and p140met, as well as a truncated TPR-MET product expressed in Escherichia coli, p50met, are autophosphorylated in vitro on tyrosine residues. Using the immunocomplex kinase assay, p140met activity was detected in various human tumor epithelial cell lines. In vivo, p65tpr-met is phosphorylated on both serine and tyrosine residues, while p140met is phosphorylated on serine and threonine. p140met is labeled by cell-surface iodination procedures, suggesting that it is a receptor like transmembrane protein-tyrosine kinase. PMID- 3277173 TI - Cell-cell recognition in yeast: isolation of intact alpha-agglutinin from Saccharomyces kluyveri. AB - The heat-labile sexual agglutinin from Saccharomyces kluyveri strain 17 (alpha agglutinin) has been isolated in an apparently intact form from wild-type and mnn1 (glycosylation-defective) cells. The wild-type agglutinin is polydisperse, due to variable degrees of glycosylation, and migrates on native gels with an apparent mass of greater than 400 kDa, whereas under denaturing conditions it appears somewhat smaller. The mnn1 agglutinin is also heterogeneous but has a lower molecular mass due to the presence of shorter N- and O-linked polymannose chains. Both agglutinins are converted sequentially by proteolysis to active fragments of approximately equal to 150 and 60 kDa, but the rate of proteolysis of the more highly glycosylated wild-type agglutinin is much slower than that of the mnn1 agglutinin. The 60-kDa fragment was isolated by HPLC and found to contain 46% carbohydrate as mannose, all of which was linked to serine and threonine. Thus, the N-linked oligosaccharides are restricted to that part of the agglutinin molecule that presumably anchors the agglutinin in the cell wall. PMID- 3277172 TI - Amino acid sequence of the BSC-1 cell growth inhibitor (polyergin) deduced from the nucleotide sequence of the cDNA. AB - The complete amino acid sequence of the BSC-1 cell growth inhibitor, including its precursor polypeptide, is reported. The sequence was deduced from the nucleotide sequence of the cDNA. The N-terminal amino acid sequence of the mature bioactive BSC-1 cell growth inhibitor is identical with the N-terminal sequences of the factors that have been called type beta 2 transforming growth factor and cartilage-inducing factor B, suggesting that these are identical. The complete amino acid sequence of the mature BSC-1 cell growth inhibitor differs from that of human type beta transforming growth factor in 32 of the 112 amino acids. Polyergin is proposed as the name for the BSC-1 cell growth inhibitor. PMID- 3277174 TI - Uptake of oleate by isolated rat adipocytes is mediated by a 40-kDa plasma membrane fatty acid binding protein closely related to that in liver and gut. AB - A portion of the hepatocellular uptake of nonesterified long-chain fatty acids is mediated by a specific 40-kDa plasma membrane fatty acid binding protein, which has also been isolated from the gut. To investigate whether a similar transport process exists in other tissues with high transmembrane fatty acid fluxes, initial rates (Vo) of [3H]oleate uptake into isolated rat adipocytes were studied as a function of the concentration of unbound [3H]oleate in the medium. Vo reached a maximum as the concentration of unbound oleate was increased (Km = 0.30 +/- 0.03 microM; Vmax = 2470 +/- 90 pmol/min per 5 X 10(4) adipocytes) and was significantly inhibited both by phloretin and by prior incubation of the cells with Pronase. A rabbit antibody to the rat liver plasma membrane fatty acid binding protein inhibited adipocyte fatty acid uptake by up to 63% in dose dependent fashion. Inhibition was noncompetitive; at an immunoglobulin concentration of 250 micrograms/ml Vmax was reduced from 2480 +/- 160 to 1870 +/- 80 pmol/min per 5 X 10(4) adipocytes, with no change in Km. A basic (pI approximately equal to 9.1) 40-kDa adipocyte plasma membrane fatty acid binding protein, isolated from crude adipocyte plasma membrane fractions, reacted strongly in both agar gel diffusion and electrophoretic blots with the antibody raised against the corresponding hepatic plasma membrane protein. These data indicate that the uptake of oleate by rat adipocytes is mediated by a 40-kDa plasma membrane fatty acid binding protein closely related to that in liver and gut. PMID- 3277175 TI - Disulfide bonds and thermal stability in T4 lysozyme. AB - Disulfide bonds are thought to serve a stabilizing role in extracellular globular proteins, but little is known about the modes of stabilization or their mechanisms. Thermodynamic data presented here demonstrate that an engineered 3-97 disulfide bond previously shown to stabilize T4 lysozyme in vitro against irreversible thermal inactivation also stabilizes the molecule against reversible thermal unfolding. In this paper, we explore the relationship between the disulfide's thermodynamic contribution to protein folding and its role in providing resistance to irreversible thermal inactivation. In T4 lysozyme (C54V/C97S), a non-crosslinked mutant lacking the two cysteines found in the wild type, sensitivity toward irreversible thermal inactivation increases dramatically at temperatures above the melting temperature of the molecule. In addition, most of the lost activity can be restored by denaturation/renaturation with guanidine hydrochloride. In contrast, the crosslinked mutant T4 lysozyme (13C-97C/C54V) inactivates relatively slowly, even above its melting temperature, and the lost activity is not restored by denaturation/renaturation. These observations suggest that the predominant inactivation pathways for non-crosslinked T4 lysozymes are conformation related, while those for the crosslinked variant are insensitive to the conformational route and thus are susceptible only to slower processes of a chemical nature. We also show that multiple mutants, constructed to contain the 3 97 disulfide plus a temperature-sensitive lesion, are more stable than the wild type to irreversible inactivation even though they are less stable to reversible thermal unfolding. These findings together suggest that the 3-97 disulfide provides stability to irreversible inactivation primarily via a pathway that is independent of its thermodynamic contribution. The 3-97 disulfide may stabilize T4 lysozyme by restricting the unfolded state to a class of more compact structures with less exposed hydrophobic surface, compared to the unfolded states of non-crosslinked T4 lysozymes. The results have implications both for the use of the stabilizing potential of disulfide bonds in protein engineering and for their roles in protein function and evolution. PMID- 3277176 TI - Tumor promoter induces reorganization of actin filaments and calspectin (fodrin or nonerythroid spectrin) in 3T3 cells. AB - We have used immunofluorescence, differential-interference-contrast, and interference-reflection microscopy to examine the translocation of actin filaments and calspectin (fodrin or nonerythroid spectrin) in 3T3 cells induced by phorbol 12-myristate 13-acetate (PMA). The two cytoskeletal proteins were observed to localize in dot structures that corresponded to the cell-substratum contact sites (focal contact) of the cytoplasmic surface of the plasma membrane. The induction of these cytoskeletal changes was specific for tumor promoters. High-resolution microscopy revealed that calspectin was intensely concentrated in ring-like structures surrounding actin dots. It was also located within the areas of actin dots, but to a lesser extent. Trifluoperazine and other phenothiazine derivatives inhibited the formation of those dot structures that appeared after the addition of PMA. Some serine protease inhibitors were also demonstrated to influence cytoskeletal changes by PMA. Our results provide evidence that calspectin is closely associated with actin filaments in dot structures induced by PMA. Possible mechanisms for these cytoskeletal changes produced by PMA are discussed. PMID- 3277177 TI - Injection of an antibody against a p21 c-Ha-ras protein inhibits cleavage in axolotl eggs. AB - The presence of a ras protein was demonstrated in cleaving axolotl eggs by selective immunoprecipitation with a polyclonal antibody against a peptide encoded by the c-Ha-ras oncogene, cellular homolog of the v-Ha-ras oncogene of Harvey rat sarcoma virus. Injection of this antibody into axolotl oocytes subjected to progesterone treatment does not prevent meiotic maturation. Injection of the same antibody into a blastomere of axolotl eggs at the 2- or 4 cell stage causes cleavage arrest in the descendants of the injected blastomere. Cytological observations of the injected eggs show, in the arrested blastomeres, enlarged nuclei always surrounded by an intact nuclear envelope and containing uncondensed chromatin. The possible role of ras protein in meiosis and mitosis is discussed. PMID- 3277178 TI - Generation of telomere-length heterogeneity in Saccharomyces cerevisiae. AB - Chromosome ends in the lower eukaryotes terminate in variable numbers of tandem, simple DNA repeats. We tested predictions of a model in which these telomeric repeats provide a substrate for the addition of more repeats by a terminal transferase-like mechanism that, in concert with DNA polymerase and primase, effectively counterbalances the loss of DNA due to degradation or incomplete replication. For individual chromosome ends in yeast, the mean length of any given telomere was shown to vary between different clonal populations of the same strain and to be determined by the initial length of that telomere in the single cell giving rise to the clone. This type of variation was independent of the major yeast recombination pathway. The length heterogeneity at each telomeric end increased with additional rounds of cell division or DNA replication. Lengths of individual telomeres within a single clone varied independently of each other. Thus, this clonal variability is distinct from genetic regulation of chromosome length, which acts on all chromosome ends coordinately. These in vivo phenomena suggest that lengthening and shortening activities act on yeast telomeres during each round of replication. PMID- 3277179 TI - Molecular cloning, sequence analysis, and expression in Escherichia coli of the cDNA for guanidinoacetate methyltransferase from rat liver. AB - Five cDNA clones encoding rat liver guanidinoacetate methyltransferase (S adenosyl-L-methionine: guanidinoacetate N-methyltransferase, EC 2.1.1.2) were isolated from a lambda gt11 cDNA library by use of a polyclonal antibody to the purified enzyme. Sequence analysis of the longest cDNA indicated that it consisted of 711 base pairs (bp) of coding region, 51 bp of 5' noncoding region, and 162 bp of 3' noncoding region excluding the poly(A) tail. The amino acid sequence deduced from the cDNA contained the sequences of NH2-terminal and three tryptic peptides. The predicted amino acid composition and molecular weight were in excellent agreement with those obtained with the purified enzyme. Introduction of the cDNA into plasmid pUC118 having the lac promoter resulted in a production in Escherichia coli of a Mr 26,000 polypeptide in the presence of isopropyl beta D-thiogalactopyranoside. This protein represented as much as 5% of the bacterial soluble protein and showed the guanidinoacetate methyltransferase activity. Sequence analysis and tryptic peptide mapping indicated that the enzyme obtained by the recombinant DNA procedures was structurally identical to the liver enzyme, except for the absence of the NH2-terminal blocking group. Also, the enzyme showed kinetic properties indistinguishable from those of the liver enzyme. PMID- 3277180 TI - Specific interaction between a Saccharomyces cerevisiae protein and a DNA element associated with certain autonomously replicating sequences. AB - We have isolated a protein from Saccharomyces cerevisiae that binds specifically to a nucleotide sequence associated with the autonomously replicating sequence (ARS) ARS120, located in the telomeric region of a yeast chromosome. "Footprinting" analysis revealed that a 26-base-pair DNA sequence, 5' CAAGTGCCGTGCATAATGATGTGGGT-3', was protected by this protein from DNase I digestion. A plasmid containing 48 direct tandem repeats of this oligonucleotide was constructed and used to affinity-purify the binding activity. The purified protein, OBF1 (origin binding factor), showed specific binding to ARS120. The 26 base-pair OBF1-protected sequence was sufficient for the recognition and binding of the protein, since the mobility of a DNA fragment containing the synthetic binding site was retarded in agarose gels when incubated with OBF1. By performing competition experiments with a number of different ARSs, we showed that OBF1 binds tightly to some but not all ARSs. Interestingly, OBF1 does not appear to have a discernible affinity for ARS1 or the ARSs associated with mating type loci, HML alpha and HMRa, which are substrates for a DNA-binding activity reported by others. Since OBF1 appears to bind to DNA associated with a number of ARSs, we suggest that this protein may have a function related to ARS activity, perhaps in the initiation of DNA replication at selected ARSs. PMID- 3277181 TI - Structure and expression of spinach leaf cDNA encoding ribulosebisphosphate carboxylase/oxygenase activase. AB - Ribulosebisphosphate carboxylase/oxygenase activase is a recently discovered enzyme that catalyzes the activation of ribulose-1,5-bisphosphate carboxylase/oxygenase ["rubisco"; ribulose-bisphosphate carboxylase; 3-phospho-D glycerate carboxy-lyase (dimerizing), EC 4.1.1.39] in vivo. Clones of rubisco activase cDNA were isolated immunologically from spinach (Spinacea oleracea L.) and Arabidopsis thaliana libraries. Sequence analysis of the spinach and Arabidopsis cDNAs identified consensus nucleotide binding sites, consistent with an ATP requirement for rubisco activase activity. A derived amino acid sequence common to chloroplast transit peptides was also identified. After synthesis of rubisco activase in vitro, the transit peptide was cleaved and the protein was transported into isolated chloroplasts. Analysis of spinach and Arabidopsis nuclear DNA by hybridization indicated a single rubisco activase gene in each species. Leaves of spinach and Arabidopsis wild type contained a single 1.9 kilobase rubisco activase mRNA. In an Arabidopsis mutant lacking rubisco activase protein, mRNA species of 1.7 and 2.1 kilobases were observed under conditions of high-stringency hybridization with a wild-type cDNA probe. This observation indicates that the lesion in the mutant arises from an error in mRNA processing. PMID- 3277182 TI - High-voltage electroporation of bacteria: genetic transformation of Campylobacter jejuni with plasmid DNA. AB - Electroporation permits the uptake of DNA by mammalian cells and plant protoplasts because it induces transient permeability of the cell membrane. We investigated the utility of high-voltage electroporation as a method for genetic transformation of intact bacterial cells by using the enteric pathogen Campylobacter jejuni as a model system. This report demonstrates that the application of high-voltage discharges to bacterial cells permits genetic transformation. Our method involves exposure of a Campylobacter cell suspension to a high-voltage exponential decay discharge (5-13 kV/cm) for a brief period of time (resistance-capacitance time constant = 2.4-26 msec) in the presence of plasmid DNA. Electrical transformation of C. jejuni results in frequencies as high as 1.2 x 10(6) transformants per microgram of DNA. We have investigated the effects of pulse amplitude and duration, cell growth conditions, divalent cations, and DNA concentration on the efficiency of transformation. Transformants of C. jejuni obtained by electroporation contained structurally intact plasmid molecules. In addition, evidence is presented that indicates that C. jejuni possesses DNA restriction and modification systems. The use of electroporation as a method for transforming other bacterial species and guidelines for its implementation are also discussed. PMID- 3277183 TI - Antimicrobial activity of synthetic magainin peptides and several analogues. AB - We have previously reported the isolation of two broad-spectrum antimicrobial peptides ("magainins") from the skin of the African clawed frog Xenopus laevis. These natural peptides are active against many species of bacteria and fungi and also induce osmotic lysis of protozoa. In this report we demonstrate that synthetic magainin peptides appear to be indistinguishable from the natural products with respect to chromatographic properties and biological activity. These studies demonstrate conclusively that the magainin peptides are potent antimicrobial substances. PMID- 3277184 TI - Insulin and phorbol ester stimulate conductive Na+ transport through a common pathway. AB - Insulin stimulates Na+ transport across frog skin, toad urinary bladder, and the distal renal nephron. This stimulation reflects an increase in apical membrane Na+ permeability and a stimulation of the basolateral membrane Na,K-exchange pump. Considerable indirect evidence has suggested that the apical natriferic effect of insulin is mediated by activation of protein kinase C. However, no direct information has been available documenting that insulin and protein kinase C indeed share a common pathway in stimulating Na+ transport across frog skin. In the present work, we have studied the interaction of insulin and phorbol 12 myristate 13-acetate (PMA), a documented activator of protein kinase C. Preincubation of skins with 1,2-dioctanoylglycerol, another activator of protein kinase C, increases baseline Na+ transport and reduces the subsequent natriferic response to PMA. Preincubation with PMA markedly reduces the subsequent natriferic action of insulin. This effect does not appear to primarily reflect PMA-induced internalization of insulin receptors. The insulin receptors are localized on the basolateral surface of frog skin, but the application of PMA to this surface is much less effective than mucosal treatment in reducing the response to insulin. Preincubation with D-sphingosine, an inhibitor of protein kinase C, also reduces the natriferic action of insulin. The current results provide documentation that insulin and protein kinase C share a common pathway in stimulating Na+ transport across frog skin. The data are consistent with the concept that the natriferic effect of insulin on frog skin is, at least in part, mediated by activation of protein kinase C. PMID- 3277185 TI - Chimeric proteins define variable and essential regions of Ha-ras-encoded protein. AB - The biological role of amino acid differences between the human 21-kDa Ha-ras protein (p21) and the human 23-kDa R-ras protein (p23) was investigated by engineering mutant Ha-ras p21 molecules containing divergent amino acid sequences from R-ras p23. Variant amino acids from R-ras p23 regions 1-30, 52-57, 67-78, 1 30 and 67-78 together, and 112-124 were substituted for the corresponding Ha-ras p21 amino acid regions 1-4, 26-31, 41-52, 1-4 and 41-52 together, and 86-98, respectively. Rat fibroblasts transfected with genes encoding these position-12 valine-substituted chimeric Ha-ras proteins displayed the same properties of morphological transformation and anchorage-independent growth as Ha-ras T24 oncogene-transformed fibroblasts. However, substitution of variant amino acids from the 80 C-terminal residues (amino acids 138-218) of R-ras p23 for the corresponding p21 amino acids (residues 112-189) inactivated the transforming activity of position-12 valine-substituted p21. The converse substitution of Ha ras p21 C-terminal residues into R-ras p23 did not result in transformation by position-38 valine-substituted p23. These data are discussed in terms of the structure of ras proteins and the nature of interactions determining the specificity of effector function. PMID- 3277187 TI - Biochemical and physical characterization of an unmodified yeast phenylalanine transfer RNA transcribed in vitro. AB - A recombinant plasmid was constructed with six synthetic DNA oligomers such that the DNA sequence corresponding to yeast tRNA(Phe) is flanked by a T7 promoter and a BstNI restriction site. Runoff transcription of the BstNI-digested plasmid with T7 RNA polymerase gives an unmodified tRNA of the expected sequence having correct 5' and 3' termini. This tRNA(Phe) transcript can be specifically aminoacylated by yeast phenylalanyl-tRNA synthetase and has a Km only 4-fold higher than that of the native yeast tRNA(Phe). The Km is independent of Mg2+ concentration, whereas the Vmax is very dependent on Mg2+ concentration. Comparison of the melting profiles of the native and the unmodified tRNA(Phe) at different Mg2+ concentrations suggests that the unmodified tRNA(Phe) has a less stable tertiary structure. Using one additional DNA oligomer, a mutant plasmid was constructed having a guanosine to thymidine change at position 20 in the tRNA gene. A decrease in Vmax/Km by a factor of 14 for aminoacylation of the mutant tRNA(Phe) transcript is observed. PMID- 3277186 TI - Human promyelocytic leukemia HL-60 cell proliferation and c-myc protein expression are inhibited by an antisense pentadecadeoxynucleotide targeted against c-myc mRNA. AB - The human promyelocytic leukemia cell line HL-60 overexpresses the c-myc protooncogene. A calculated secondary structure for c-myc mRNA placed the initiation codon in a bulge of a weakly base-paired region. Treatment of HL-60 cells with 5' d(AACGTTGAGGGGCAT) 3', complementary to the initiation codon and the next four codons of c-myc mRNA, inhibited c-myc protein expression in a dose dependent manner. However, treatment of HL-60 cells with 5' d(TTGGGATAACACTTA) 3', complementary to nucleotides 17-31 of vesicular stomatitis virus matrix protein mRNA, displayed no such effects. These results agree with analogous studies of normal human T lymphocytes [Heikkila, R., Schwab, G., Wickstrom, E., Loke, S. L., Pluznik, D. H., Watt, R. & Neckers, L. M. (1987) Nature (London) 328, 445-449], except that only one-third as much oligomer was needed for a comparable effect. Proliferation of HL-60 cells in culture was inhibited in a sequence-specific, dose-dependent manner by the c-myc-complementary oligomer, but neither the oligomer complementary to vesicular stomatitis virus matrix protein mRNA nor 5' d(CATTTCTTGCTCTCC) 3', complementary to nucleotides 5399-5413 of human immunodeficiency virus tat gene mRNA, inhibited proliferation. It thus appears that antisense oligodeoxynucleotides added to myc-transformed cells via culture medium are capable of eliciting sequence-specific, dose-dependent inhibition of c-myc protein expression and cell proliferation. PMID- 3277188 TI - In situ hybridization of nucleus basalis neurons shows increased beta-amyloid mRNA in Alzheimer disease. AB - To determine which cells within the brain produce beta-amyloid mRNA and to assess expression of the beta-amyloid gene in Alzheimer disease, we analyzed brain tissue from Alzheimer and control patients by in situ hybridization. Our results demonstrate that beta-amyloid mRNA is produced by neurons in the nucleus basalis of Meynert and cerebral cortex and that nucleus basalis perikarya from Alzheimer patients consistently hybridize more beta-amyloid probe than those from controls. These observations support the hypothesis that increased expression of the beta amyloid gene plays an important role in the deposition of amyloid in the brains of patients with Alzheimer disease. PMID- 3277189 TI - Differential regulation of amyloid-beta-protein mRNA expression within hippocampal neuronal subpopulations in Alzheimer disease. AB - We have mapped the neuroanatomical distribution of amyloid-beta-protein mRNA within neuronal subpopulations of the hippocampal formation in the cynomolgus monkey (Macaca fascicularis), normal aged human, and patients with Alzheimer disease. Amyloid-beta-protein mRNA appears to be expressed in all hippocampal neurons, but at different levels of abundance. In the central nervous system of monkey and normal aged human, image analysis shows that neurons of the dentate gyrus and cornu Ammonis fields contain a 2.5-times-greater hybridization signal than is present in neurons of the subiculum and entorhinal cortex. In contrast, in the Alzheimer disease hippocampal formation, the levels of amyloid-beta protein mRNA in the cornu Ammonis field 3 and parasubiculum are equivalent. These findings suggest that within certain neuronal subpopulations cell type-specific regulation of amyloid-beta-protein gene expression may be altered in Alzheimer disease. PMID- 3277190 TI - Gel retardation at low pH resolves trp repressor-DNA complexes for quantitative study. AB - The affinity and stoichiometry of DNA binding by Escherichia coli trp repressor were studied by electrophoresis in nondenaturing gels. The ability of trp repressor to retard the electrophoretic mobility of an operator DNA fragment depends on the pH of the gel system. Above the pI of the protein, little retardation of DNA is observed, although complex formation can be detected by other assays. As the pH of the gel is lowered, retardation is enhanced. The apparent dissociation constant for the interaction between trp repressor and trpEDCBA operator fragments is 0.5 nM under the conditions used here. Nonspecific binding occurs with only about 200-fold weaker affinity. The stoichiometries of specific and nonspecific complexes were determined directly by using trp repressor labeled in vivo. High-affinity operator binding requires a single dimer of trp repressor. DNase I-protection analysis ("footprinting") was used to confirm the dissociation constants and to locate the binding site. PMID- 3277191 TI - Construction and characterization of glutaredoxin-negative mutants of Escherichia coli. AB - Deoxyribonucleotides, the precursors of DNA, are formed de novo by ribonucleotide reductase, and in vitro thioredoxin or glutathione plus glutaredoxin have been isolated as hydrogen donors. The in vivo hydrogen donor for ribonucleotide reductase is not known. To study this, the Escherichia coli glutaredoxin gene (255 base pairs) was inactivated by inserting a 2-kilobase kanamycin-resistance fragment into the coding sequence of the cloned gene. The inactivated gene was inserted into the E. coli chromosome and mapped to about 18.5 min. A gene replacement technique was used to obtain a strain, A407, that lacked glutaredoxin by radioimmunoassay and by enzymatic assay with ribonucleotide reductase. Glutaredoxin was found not to be essential for viability of E. coli. Thioredoxin is also not essential for viability, as had been shown earlier, but a double mutant lacking glutaredoxin and thioredoxin could not be obtained by P1 transduction on a defined medium, indicating that either thioredoxin or glutaredoxin is essential. In rich medium, very slowly growing, unstable transductants were obtained that at high frequency gave rise to better growing cells. One such isolate, A410, was shown to still lack glutaredoxin and thioredoxin. PMID- 3277192 TI - Selective thromboxane synthetase inhibition by picotamide and effects on endotoxin-induced lethality. AB - The efficacy of N,N'-bis-(3-picolyl)-methoxyisophthalamide (picotamide) as an in vitro thromboxane synthetase inhibitor and its effect on endotoxin (LPS)-induced lethality in rats were assessed. Picotamide at 0.5 and 1.0 mM concentrations significantly (P less than 0.05) inhibited basal and LPS-stimulated synthesis of TxA2 measured by its stable immunoreactive (i) metabolite TxB2 in rat peritoneal macrophages. This compound did not inhibit synthesis of i6-keto-PGF1 alpha, the stable metabolite of PGI2, and produced significant shunting to i6-keto-PGF1 alpha. For lethality studies rats were pretreated, by gavage with picotamide, at either 75, 150, 300, or 600 mg/kg 2 hr prior to iv S. enteritidis (LPS, 20 mg/kg). Both 150 and 300 mg/kg doses of picotamide significantly (P less than 0.05) improved survival in endotoxin shock at 48 hr. These studies demonstrate that picotamide is a selective thromboxane synthetase inhibitor, and that it may be useful during disease states characterized by increased TxA2 synthesis. PMID- 3277193 TI - Calcium metabolism in experimental hypertension. PMID- 3277194 TI - Plasma lipoproteins in atherosclerosis: from quantity to quality. PMID- 3277195 TI - Low density lipoprotein metabolism. PMID- 3277196 TI - WHO's activities in the field of prevention of cardiovascular diseases. PMID- 3277197 TI - Human hypo- and hyperresponders to dietary cholesterol and fatty acids. PMID- 3277198 TI - Hypolipidemic effects of dietary omega-3 fatty acids in humans. PMID- 3277199 TI - Pharmacologic modulation of the low density lipoprotein receptor pathway. PMID- 3277200 TI - Portacaval shunt surgery and liver transplantation in the treatment of homozygous familial hypercholesterolemia. PMID- 3277201 TI - Effect of fenofibrate on apolipoprotein B containing lipoprotein particles. PMID- 3277202 TI - Plasma exchange and LDL apheresis. PMID- 3277203 TI - Extracorporeal plasma therapy: the HELP system for the treatment of hyper-beta lipoproteinemia. PMID- 3277204 TI - New diagnostic tests for assessing coronary heart disease risk. PMID- 3277205 TI - The Lipid Research Clinics Primary Prevention Trial and its aftermath. PMID- 3277206 TI - Structure and pharmacology of elapid cytotoxins. PMID- 3277207 TI - Environmental factors affecting drug metabolism. PMID- 3277208 TI - Drug metabolism in the elderly. PMID- 3277209 TI - Metabolism of steroid-modifying anticancer agents. AB - The application of steroid-modifying drugs as a strategy for the treatment of hormone-dependent cancers has gained increasing popularity during the past decade. However, it is important to point out and emphasize that very few of the agents were originally designed for their current application. Most were designed for other purposes, predominantly fertility control (e.g. LHRH agonists and the antiestrogens). Nevertheless, now it is possible to integrate their actions to design rational therapies. There are many reasons for the current interest in antisteroidal drugs. The initial euphoria over the potential ability of combination chemotherapy to cure breast and prostatic carcinoma has proved to be premature. Combination chemotherapy has many severe side-effects which limits patient acceptability, especially if the patient realizes that the likelihood of a cure is remote. In the main, antisteroidal therapies do not have many side effects and those that do, e.g. aminoglutethimide, are the focus of increased efforts in drug design to produce increased drug specificity. Finally, there is a growing realization that hormone-dependent cancer control with a nontoxic, antisteroidal therapy may be the most acceptable approach currently available for early disease management. Chemotherapy would then be reserved as the final option for treatment. The description of drug metabolism has been central to the development of synthetic LHRH analogs and an understanding of the mode of action of nonsteroidal antiestrogens and antiandrogens. The discovery of steroid synthetic pathways has been essential for the development of the aromatase inhibitors. This whole area of endeavor has now become a major focus of attention for the medicinal chemist. A new generation of agents is entering clinical evaluation which will provide a wealth of valuable information about the successful (or unsuccessful?) methods to control hormone-dependent disease. Since the success or failure of a drug can often depend upon formulation, pharmacokinetics, bioavailability or metabolism, it is our hope that this overview might help solve some of the future problems. PMID- 3277210 TI - Physiology and therapeutic implications of negative work. A review. AB - Energy efficiency is an important attribute of negative work (W neg). Eccentric muscle contractions characteristic of W neg can generate greater force at reduced oxygen cost and perceived exertion compared with concentric muscle contractions in positive work (W pos). Thus, activities incorporating W neg could have important implications in improving the functional capacity of an individual with limited physiologic reserves or ability to use these reserves. Other characteristics of W neg such as muscle trauma or soreness and increased total heat production and cutaneous blood flow, however, may be counter-therapeutic and even hazardous. The purpose of this review is to describe the physiology and therapeutic implications of W neg. Because the body of knowledge with respect to the therapeutic effects of W neg is relatively scant compared with W pos, clinical trials are needed to establish the indications, contraindications, possible limitations, guidelines for prescription, and therapeutic efficacy of W neg. PMID- 3277212 TI - Bone graft survival in expanded skin. AB - The effect of tissue expansion on iliac bone graft (onlay) survival was studied on the skulls of 35 New Zealand white rabbits. Wet bone weights at the time of grafting and at sacrifice in control animals (group I) were compared to three experimental groups. Histologic sections of the developing and resolving pseudosheath and skin envelope were performed. A self-inflating 5-mil-thick silicone expander was used for soft-tissue expansion over the rabbit snout. Bone grafts were subsequently placed in this site. Elliptical snout excision without expansion (group II) demonstrated no statistically significant difference in bone graft survival when compared to controls (group I) (p = 0.350). Full tissue expansion followed by immediate bone grafting (group III) within the pseudosheath cavity likewise demonstrated no statistically significant difference in bone graft survival when compared to controls (group I) (p = 0.500); however, when full tissue expansion was followed by delayed (2 weeks) bone grafting to allow for resolution of the giant cell inflammatory reaction of the pseudosheath (group IV), a statistically significant increased bone graft survival was achieved (p less than 0.001). The study demonstrates that the increased vascularity in the pseudosheath and in the expanded soft-tissue envelope significantly increased bone graft survival only when bone grafting was delayed. PMID- 3277211 TI - Development of the orbicularis oris muscle in normal and cleft lip and palate human fetuses using three-dimensional computer reconstruction. AB - As part of an ongoing study of cleft lip and palate fetal morphology, normal and dysmorphic development of the human fetal orbicularis oris muscle was studied in a cross-sectional sample of 29 human fetuses (20 "normal" and 9 cleft lip and palate) ranging in age from 8 to 21 postmenstrual weeks. The specimens were embedded in celloidin and sectioned at 20 microns, and every tenth section was stained with hematoxylin and eosin. A computer reconstruction technique was applied to produce three-dimensional representations of the orbicularis oris muscle. The orbicularis oris muscle in the normal fetal sample with discernible lip fibers (N = 15) increased symmetrically in both fiber density and complexity from 12 to 21 weeks. Metrically, muscle volume and thickness growth curves were consistent with qualitative observations. In contrast, the unilateral cleft lip and palate fetal specimens with discernible lip fibers (N = 3) exhibited a 3.5 week delay in overall muscle development, asymmetrical fiber distribution, and abnormal fiber insertions. However, quantitatively, no significant (p greater than 0.05) differences were noted in orbicularis oris muscle thickness or volume between the normal and cleft lip and palate fetal specimens through 21 weeks. Findings suggest that orbicularis muscle deficiency, noted clinically in cleft lip and palate neonates, may be a result of perinatal functional dysmorphogenesis rather than congenital mesenchymal reduction or deficiency. PMID- 3277213 TI - More on female genital self-mutilation. PMID- 3277214 TI - Psychiatric qualifiers for heart transplant candidates. PMID- 3277215 TI - Organic psychosis. PMID- 3277216 TI - Psychosocial treatments for social phobia. PMID- 3277217 TI - Cardiac transplantation: clinical correlates of psychiatric outcome. PMID- 3277218 TI - Mitotic recombination in continuously gamma-irradiated diploid yeast. AB - A diploid yeast strain heterozygous at the canavanine locus was subjected to long term gamma exposure in continuous chemostat cultures. Radiation induces canavanine resistance presumably by mitotic recombination. The efficiency of this process increased with lower dose rate. Experiments using a split-dose protocol showed that radiation possibly induces a recombinogenic activity. PMID- 3277219 TI - Treatment for victims of nuclear accidents: the role of bone marrow transplantation. PMID- 3277220 TI - Magnetic resonance imaging of spinal dysraphism. AB - MR imaging has become the definitive diagnostic procedure for the evaluation of suspected spinal dysrhaphic processes. Techniques for spinal MR imaging are discussed and MR findings in patients with surgically verified dysrhaphic spinal lesions are reviewed. PMID- 3277221 TI - Pediatric musculoskeletal magnetic resonance imaging. AB - MRI has demonstrated clinical applicability and improved diagnostic capability in the musculoskeletal system to a degree rivaling its success in the neurologic system. For certain regions such as the joints, the superficial nature of these structures is ideal for the application of localized radiofrequency coils, enabling considerably improved signal, spatial resolution, and detectable contrast. The multiplanar capability is often invaluable in assessing such regions as the weight-bearing surfaces of the hips. It has been shown to be the most sensitive single test for diagnosing avascular necrosis, and has yielded very high resolution images of the internal architecture of the joints and soft tissues in an entirely noninvasive manner and without the need for the administration of exogenous contrast agents. Short TE images are quite useful in evaluating fatty background regions of interest, such as the bone marrow and subcutaneous tissue, whereas long TR and TE studies are frequently more suitable for soft tissue pathology. The lack of ionizing radiation and the continued failure of intensive research to disclose any deleterious effects at the levels used for clinical diagnostic imaging make this tool especially appealing for application to the pediatric population. With the continual development of new pulsing sequences, contrast agents, and further advances in imaging/spectroscopic correlation, magnetic resonance imaging of the musculoskeletal system is ensured of a solid role in the clinical diagnostic evaluation of the pediatric population. PMID- 3277222 TI - CT and MR of congenital heart disease. AB - CT and MR join echocardiography in the noninvasive evaluation of the child with congenital heart disease. This article discusses the uses of these modalities in the assessment of the cardiovascular system in children. PMID- 3277223 TI - Chest MRI in children. AB - MRI of the pediatric chest appears useful in evaluating the mediastinum, the bony thorax, and the lung parenchyma. MR seems to be more useful than other imaging modalities in evaluation of the mediastinum, particularly in defining the extent of the lesions. Coronal images provide additional information to those obtained axially. MR can in a selected number of cases replace x-ray CT in evaluation of the pediatric chest. PMID- 3277224 TI - Prenatal diagnosis of fetal anomalies using ultrasound and MRI. AB - In conclusion, it is unlikely that MRI will replace ultrasound as the primary obstetric imaging modality in the near future. Ultrasound has a proven record of accuracy and safety in addition to its easy access and low cost. MRI has promise, however, in providing crucial information in patients with underlying medical or surgical conditions that would ordinarily require ionizing radiation for evaluation. Currently, MRI is helpful in evaluating gross fetal anomalies and disturbances of fetal growth and development when ultrasound is limited by oligohydramnios or maternal obesity. Further experience is required to determine the value of spectroscopy and quantitative relaxation times regarding fetal metabolism and fetal well-being. Technologic improvements and software updates will reduce imaging time and increase spatial resolution, thus rendering MRI more competitive with existing imaging techniques. The ultimate role, however, that MRI will have in the evaluation of the fetus is currently undefined. PMID- 3277225 TI - Upper airway and tracheal obstruction in infants and children. AB - The radiologist plays a key role in the diagnosis of airway obstruction in children. Most diagnoses are made on the basis of plain films. In more complicated or complex entities, CT and MRI give excellent anatomic detail in defining the airway, associated soft tissues, and vascular relationships. PMID- 3277226 TI - Abnormal pulmonary aeration in infants and children. AB - There are many intrinsic and extrinsic, and congenital or acquired lesions that cause aeration disturbances in infants and children. The radiographic diagnosis of these entities and the pathophysiologic mechanisms by which they produce overinflation or underinflation are discussed. Longstanding airway compression may have serious effects on the developing lung and its vascular supply. PMID- 3277228 TI - Radiologic evaluation of the diaphragm. AB - Recent technical advancements allow us to better evaluate the diaphragm and juxtadiaphragmatic lesions. Plain radiographs demonstrate morphology of the diaphragm in most cases. Function of the diaphragm can easily be evaluated by ultrasonography and fluoroscopy. Ultrasonography can be performed at bedside and should be used before fluoroscopy in infants and children. Ultrasonography can also demonstrate congenital anomalies of the diaphragm in utero. CT clearly discloses the underlying pathology and the extent of most juxtadiaphragmatic lesions. The newest modality, MRI, is quite promising and may become the procedure of choice for evaluation of diaphragmatic as well as juxtadiaphragmatic lesions in the very near future. PMID- 3277227 TI - Usual and unusual radiologic manifestations of acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection in children. AB - AIDS is being recognized with ever-increasing frequency in children. This article includes a discussion of the common radiographic manifestations of AIDS as well as some rarely encountered problems. It is hoped that with heightened awareness of this spectrum of radiographic findings, radiologists may contribute to a prompt diagnosis of AIDS so that appropriate short-term therapy and counseling may be instituted. PMID- 3277229 TI - Pulmonary pseudofibrosis and pseudomass lesions. AB - Abnormal size and/or number of the pulmonary and bronchial vessels and lymphatics may mimic pulmonary parenchymal lesions (pseudofibrosis). Abnormalities of the central pulmonary artery, pulmonary vein, thoracic aorta, and brachiocephalic branches may mimic intrathoracic mass lesions (pseudomass lesions). Radiologists should interpret these radiographic findings in the light of other accompanying radiographic findings and the clinical presentation. PMID- 3277230 TI - The vomiting infant: recent advances and unsettled issues in imaging. AB - The evaluation of infantile vomiting is bound up with many unresolved questions and continually evolving imaging technologies. This article addresses three specific areas of interest: the use of newer low-osmolality, water-soluble contrast media in the infant's gastrointestinal tract; the ever-controversial subject of gastroesophageal reflux; and the burgeoning role of gastrointestinal ultrasonography. PMID- 3277231 TI - Radiographic evaluation of children with urinary tract infections. AB - Any child with urinary tract infection needs a radiologic work-up to determine his or her potential risk for sustaining renal damage. VCUG, either fluoroscopic or isotopic, should always be performed. If the infection responds to treatment and the VCUG is normal, ultrasonography should be performed. However, when the VCUG demonstrates reflux, radionuclide scan or, less preferably, excretory urography is indicated to assess renal parenchymal damage and function. When a urinary tract infection does not respond to treatment, ultrasonography or CT scan should be obtained to check for renal or perirenal abscess. If the findings are normal, medical treatment to control the infection is indicated. Further evaluation of the urinary tract may be temporarily delayed. In an infant with urinary tract infection and sepsis, renal ultrasonography is indicated. If the sonogram is normal, VCUG can be delayed until the infant responds to medical treatment. If ultrasonography is abnormal, VCUG and radionuclide scan such as 99mtechnetium DTPA with furosemide to evaluate gross morphology and function should be obtained. Complicated medical problems, such as urinary tract infection in combination with a history of intravenous drug abuse or with findings of fever and a mass, deserve immediate evaluation with ultrasonography or CT scan. A patient with fever of unknown origin and normal urine culture should have a radionuclide scan using gallium67 citrate or indium111-tagged leukocytes, both of which can demonstrate an extrarenal or unsuspected intrarenal site of infection. A variety of imaging modalities are available today for investigating urinary tract infections in the pediatric patient. Used intelligently, singly or in combination, these examinations provide information for the clinical evaluation as well as short-and long-term management of infections, their causes and complication, and their effect on renal function. PMID- 3277232 TI - Recent advances in pediatric nuclear medicine. AB - The applications of nuclear medicine in pediatrics have grown parallel with the development of higher resolution complementary imaging modalities such as computed tomography, ultrasound, digital angiography, and magnetic resonance. The purpose of this article is to present clinically significant advances in pediatric nuclear imaging, with emphasis on newer techniques less often associated with pediatric patients. PMID- 3277233 TI - Pediatric interventional radiology. AB - In the last several years, we have witnessed a steady growth in both the number and the complexity of interventional procedures in the pediatric population. This article presents our approach to interventional techniques in children of different ages, specifying our methods of sedation, patient monitoring, and selection or modification of equipment. We present our experience with nonvascular and vascular intervention. In the nonvascular group, we have focused on genitourinary and gastrointestinal procedures, outlining the techniques we have found to be safe and effective. Percutaneous aspiration, drainage, and biopsy can be successfully accomplished in the majority of cases, even in the smallest child. Over this same period, the indications for vascular intervention have dramatically increased. Embolization has become an important asset for treatment of vascular malformations, management of hemorrhage, and medical renal ablation. In our institution, embolization is now the preferred method in many cases previously considered only amenable to surgery. Percutaneous transluminal angioplasty and the use of fibrinolytic therapy are considered effective in all age groups, but continue to have limited indications in the pediatric population. It is our hope that this experience will stimulate others to continue development of pediatric interventional techniques, thereby making them more widely available to children of all ages. PMID- 3277234 TI - Disturbances of bone growth and development. AB - "What is growth anyway? Can one talk about positive growth in childhood, neutral growth in maturity, and negative growth in old age?" Our goal is to help promote normal positive growth in infants and children. To achieve this, we must be cognizant of the morphologic changes of both normal and abnormal bone formation as they are reflected in the radiographic image of the skeleton. The knowledge of the various causes and the pathophysiologic mechanisms of the disturbances of bone growth and development allows us to recognize the early radiographic manifestations. Endocrine and metabolic disorders affect the whole skeleton, but the early changes are best seen in the distal ends of the femurs, where growth rate is most rapid. In skeletal infections and in some vascular injuries two-or three-phase bone scintigraphy supercedes radiography early in the course of the disease. MRI has proved to be very helpful in the early detection of avascular bone necrosis, osteomyelitis, and tumor. Some benign bone tumors and many bone dysplasias have distinct and diagnostic radiographic findings that may preclude further studies. In constitutional diseases of bone, including chromosomal aberrations, skeletal surveys of the patient and all family members together with biochemical and cytogenetic studies are essential for both diagnosis and genetic counseling. Our role is to perform the least invasive and most informative diagnostic imaging modalities that corroborate the biochemical and histologic findings to establish the definitive diagnosis. Unrecognized, misdiagnosed, or improperly treated disturbance of bone growth can result in permanent deformity usually associated with disability. PMID- 3277235 TI - Diagnosis of congenital dislocated hips (CDH). AB - Radiology imaging, along with clinical orthopedic assessments, plays an important role in the diagnosis and treatment of Congenital Dislocated Hips. The validity of the radiologic examinations relies heavily on the examiner or technologist. This article explains some of these examinations and describes the benefits, disadvantages, and important facts to be aware of while performing them. PMID- 3277236 TI - Personality characteristics of radiologic technology educators: a descriptive profile and its implications. AB - This study was designed to establish a descriptive profile of the personality characteristics of radiologic technology educators in order to draw inferences to the roles the characteristics play in radiologic technology education. The results of the study indicate that R.T. educators tend to be field-dependent, high in integrative complexity, low in dogmatism, and Concrete Sequential in learning style. These results suggest that the educators approach their roles in a structured, open-minded, sequential manner and exercise a high level of interpersonal skills. PMID- 3277237 TI - Implications of small, peripheral hypoechoic lesions in endorectal US of the prostate. AB - Endorectal ultrasound (US) can demonstrate small, nonpalpable, or subtly palpable lesions of the prostate. However, differentiation of benign from malignant processes has not always been possible. Because early diagnosis may have immense clinical implications, the possibility that endorectal US can be used to diagnose early prostate cancer has been suggested. The authors prospectively evaluated with endorectal US 80 small (less than 1.5 cm) peripherally oriented hypoechoic lesions in 79 patients with a normal or questionably abnormal digital rectal examination. In all patients at least two biopsies per lesion were performed. The transperineal sonographically guided biopsies were performed with both cytologic and core biopsy techniques. Seventeen of the 80 lesions (21.3%) were malignant. These findings suggest a low, but perhaps clinically significant, rate of diagnosis of small prostate cancers. While these data are interesting, they are insufficient to recommend use of endorectal US as a screening tool for prostate cancer. PMID- 3277238 TI - Amniotic sheets. AB - Seventeen cases of an aberrant sheet of tissue in the amniotic cavity are described to expand and clarify previous observations of this entity. The sheet of tissue demonstrates a thickened base and a free edge that undulates. The fetus moves freely about the sheet of tissue. There are no associated fetal deformities, and infants have no manifestations of the amniotic-band syndrome. Evidence suggests that these sheets may originate from "wrapping" of the amniochorionic membrane over a uterine synechia. These benign sheets of tissue should not be confused with the amniotic-band syndrome. PMID- 3277239 TI - Small renal cell carcinomas: resolving a diagnostic dilemma. AB - Thirty-nine patients with pathologically proved renal cell carcinomas 3 cm or les in diameter were examined. Results of intravenous urography (n = 30) were true positive in 20 patients and false negative in ten (sensitivity, 67%). Renal ultrasound (US) (n = 29) had true-positive results in 23 patients and false negative results in six (sensitivity, 79%); computed tomography (CT) (n = 36) had true-positive results in 34 and false-negative results in two (sensitivity, 94%). For selective renal angiography (n = 35%), the results were true positive in 26 and false negative in nine (sensitivity, 74%), with typical hypervascular renal cell carcinomas demonstrated in 17. Finally, the findings of percutaneous fine needle aspiration biopsy were true positive in one of five patients when US guidance was used (sensitivity, 20%) and in five of eight when CT guidance was used (sensitivity, 62%). Small renal cell carcinomas are more frequently encountered in clinical practice than heretofore realized, and they are best imaged by CT. PMID- 3277240 TI - In utero exposure to diagnostic ultrasound: a 6-year follow-up. AB - A 6-year follow-up study of height and weight was conducted between 1975 and 1983 in a total of 149 sibling pairs of the same sex, one of whom had been exposed to diagnostic ultrasound in utero. The data were analyzed for the entire sample group, as well as for subgroups defined by sex, gestational age at delivery, birth order, and gestational age at time of first exposure to ultrasound. No statistically significant differences of head circumference at birth or of height and weight between birth and 6 years of age were found between ultrasound-exposed and unexposed siblings. In our sample population, exposure of fetuses to ultrasound did not significantly affect growth in childhood up to 6 years of age. PMID- 3277241 TI - Fetal rhombencephalon: normal US findings. AB - Using ultrasound (US), the authors examined 25 embryos that were 8-10 menstrual weeks old for gestational age and the presence of a small cystic structure (3-4 mm) in the posterior aspect of the cranium. This structure was seen in all embryos. The US images of an in vitro embryo at 8 weeks menstrual age were also evaluated for anatomic correlation. Analysis of these US images determined that the cystic structure was the open rhombencephalon or hindbrain. Follow-up US studies or postpartum clinical examinations of the 25 in utero embryos demonstrated no abnormal posterior cranial cystic structures or neurologic deficits. This first-trimester structure should be considered a normal finding, since it develops into the normally proportioned fourth ventricle after the 11th menstrual week. PMID- 3277242 TI - Campylobacter ileocolitis mimicking acute appendicitis: differentiation with graded-compression US. AB - In nine patients with clinical symptoms of acute appendicitis, graded-compression ultrasound (US) did not depict the appendix but instead demonstrated mural thickening of the terminal ileum and part of the colon, as well as moderately enlarged mesenteric lymph nodes. In one patient a normal appendix was removed; eight patients recovered without treatment. Infection with Campylobacter jejuni was proved in all nine patients. In four patients, an unnecessary appendectomy was avoided because of the US findings. Graded-compression US enables differentiation between acute appendicitis and Campylobacter ileocolitis, a vital differentiation, since surgery is almost certainly not indicated for the latter. PMID- 3277243 TI - Crohn disease of the ileocecal region: US visualization of the appendix. AB - In three of 52 consecutive patients with a painful mass in the right lower quadrant, ultrasound (US) disclosed severe mural thickening of the terminal ileum and cecum and moderate mural thickening of the appendix. In all three, the tentative diagnosis of Crohn disease was subsequently confirmed. If these US features are found in a patient with a suspected appendiceal mass, the diagnosis of Crohn disease must be seriously considered, and further evaluation is imperative. PMID- 3277245 TI - Widespread Castleman disease: CT and US findings. AB - The widespread form of Castleman disease is a rare condition that has been recognized only recently as a disease with an aggressive, often malignant course. The authors present computed tomographic (CT) findings in six patients with this condition and ultrasound (US) findings in four of the six. CT demonstrated splenomegaly and retroperitoneal lymphadenopathy in all six patients. In one patient, CT also showed additional widespread mesenteric and peripancreatic lymphadenopathy, a large mesenteric mass adherent to the descending colon in another, and mediastinal lymphadenopathy in a third. Three patients had peripheral axillary or inguinal lymphadenopathy. Enlarged lymph nodes were 1-4 cm in diameter, and none displayed contrast enhancement on CT scans obtained with drip infusion of contrast media. On US scans, the nodes were poorly echogenic in all four cases. In no case was focal liver or splenic infiltration seen on either CT or US scans. PMID- 3277244 TI - Colorectal tumors: scintigraphy with In-111 anti-CEA monoclonal antibody and correlation with surgical, histopathologic, and immunohistochemical findings. AB - A prospective clinical study of 17 patients with a histologic diagnosis of colorectal carcinoma proved at colonoscopy and surgery was performed with indium 111 anticarcinoembryonic-antigen (CEA) monoclonal antibody (MoAb), ZCE-025. MoAb scanning depicted nine of 16 primary colorectal carcinomas on planar scintigrams (true-positive findings = 56%) and ten of 16 lesions on single-photon emission computed tomography (SPECT) scans (true-positive findings = 62%). Liver metastases were detected in three of three patients, and lymph node metastases were detected in one of four patients. Immunohistochemical examination for CEA in resected colorectal cancer tissues demonstrated a positive correlation between MoAb imaging of primary lesions and cytoplasmic-stromal intracellular CEA distribution. There was no correlation between CEA serum levels and lesion detectability with MoAb scanning. PMID- 3277246 TI - Fetal hyaloid artery: timing of regression with US. AB - Large-aperture, dynamically focused ultrasonic imaging permits noninvasive, anatomic study of the eye at the millimeter level in the second and third trimesters of pregnancy. The authors report their observations of the hyaloid artery in 210 of 219 fetuses examined with this technique. This vessel is seen in fetuses of 20 weeks gestational age or less and regresses spontaneously at the start of the third trimester. The 210 subjects included 100 who were examined at gestational ages of 16-32 weeks or more and 85 healthy fetuses and 25 with pathologic findings at birth who were examined at 34 weeks gestational age to term. The presence of the hyaloid artery in the mid third trimester was uncommon in healthy subjects (less than 1%) and was not seen in any beyond 29.9 weeks gestational age. However, in nine of the 25 fetuses with abnormalities (five with trisomy syndromes), the vessel was seen at 30.8-36.8 weeks gestational age. The temporarily delayed regression of the hyaloid artery may occur with trisomy 21 syndrome and other forms of retarded brain development. PMID- 3277247 TI - Imaging of the aging brain. Part I. Normal findings. AB - A thorough knowledge of the normal changes that occur in the brain with age is critical before abnormal findings are analyzed. Magnetic resonance (MR) imaging improves the ability to distinguish normal and abnormal findings in the brain. The major changes that may occur in elderly individuals without neurologic deficits include enlargement of the ventricles, cortical sulci, and vermian subarachnoid spaces; multifocal areas of hyperintensity in the white matter and basal ganglia; a progressive prominence of hypointensity on T2-weighted images of the putamen, almost equal to that of the globus pallidus; an increase in the oxygen extraction ratio with normal or mildly decreased neuron metabolism; arteriosclerosis in large and small arteries and amyloid angiopathy in leptomeningeal cortical vessels; and decreased dopamine receptor binding in the corpus striatum. Since approximately half of the elderly population exhibits only negligible brain alterations, MR imaging may facilitate the distinction between usual (no neurologic dysfunction) and successful (no brain or vascular changes) aging. PMID- 3277248 TI - Imaging of the aging brain. Part II. Pathologic conditions. AB - The most common pathologic disorders in the elderly result in dementia, movement disorders, and/or focal neurologic deficit. Neuroimaging, particularly magnetic resonance (MR), provides a unique window into the diagnosis and understanding of such diseases. The most common cause of dementing illness is Alzheimer disease (enlarged cerebrospinal fluid spaces, focal medial temporal lobe abnormal signal intensity, cortical iron). Since the initiation of MR imaging, important questions are being asked about the role of white matter disease (signal hyperintensities) in primary degenerative dementia and the nosology of vascular dementia. Parkinsonian disorders are characterized by generalized brain atrophy and dopaminergic site (e.g., putamen, pars compacta of the substantia nigra) iron or pigmentary accumulation best visualized in disease that responds poorly to dopamine replacement therapy. A key role of imaging in the elderly is the noninvasive exclusion of mass lesion (e.g., hematoma, neoplasm). MR imaging is exquisitely sensitive for the detection of the two common abnormalities that cause focal neurologic deficit in the elderly--infarction and intracerebral hematoma. PMID- 3277249 TI - Acute cervical spine trauma: evaluation with 1.5-T MR imaging. AB - Twenty-one patients with acute neurologic deficits following cervical spine trauma were evaluated with magnetic resonance (MR) imaging (n = 21), computed tomography enhanced with intrathecal contrast material (CT myelography) (n = 18), myelography (n = 13), cervical spine radiography (n = 21), and intraoperative sonography (n = 7). MR imaging proved superior to other modalities in demonstrating parenchymal spinal cord injuries and cervical intervertebral disk herniation. Although both T1- and T2-weighted studies appear necessary to evaluate the anatomic relationship of the spinal cord, thecal space, intervertebral disks, and surrounding osseous and ligamentous structures, T2 weighted sequences were more sensitive than T1-weighted studies for detection of spinal cord injury. CT myelography was superior to MR imaging in demonstrating cervical spine fractures. In most cases, myelography revealed no information that was not apparent from both CT and MR imaging studies. Preliminary experience with MR imaging of acute cervical spine trauma suggests that it should be the study of choice in symptomatic patients who are otherwise clinically stable. CT may still be required in selected patients to evaluate complex fractures. PMID- 3277250 TI - Inborn errors of metabolism in the molecular age. PMID- 3277251 TI - Gene therapy of somatic cells: status and prospects. PMID- 3277252 TI - Prenatal diagnosis and carrier detection by DNA analysis. PMID- 3277253 TI - Recombinant DNA methods: applications to human genetics. PMID- 3277254 TI - Recombinant DNA analysis of multifactorial disease. PMID- 3277256 TI - The future of genetic testing. PMID- 3277255 TI - Commercial uses of recombinant DNA technology in human genetic disease. PMID- 3277257 TI - The varieties of mutation. PMID- 3277258 TI - Clinical applications of gene mapping and diagnosis. PMID- 3277259 TI - Prevalence of mutans streptococci and lactobacilli in elderly Swedish individuals. AB - The number of Streptococcus mutans, Streptococcus sobrinus, and lactobacilli in stimulated whole saliva was examined in 149 elderly persons. More than 10(6) CFU/ml of mutans streptococci were found in 57% of the subjects and 85% had more than 10(5) lactobacilli per ml of saliva. There was no difference in the prevalence of mutans streptococci between edentulous and dentate subjects whereas significantly more lactobacilli were detected in denture wearers. S. mutans was most frequent and was found in 72% of the subjects. S. sobrinus, which was carried by 44% of the persons, was found proportionally in more subjects with dentures than in dentate individuals. In most persons with S. sobrinus, S. mutans was also present but in 8% of the subjects only S. sobrinus was detected. The subjects with both S. mutans and S. sobrinus had higher salivary levels of mutans streptococci than individuals with only S. mutans or S. sobrinus. PMID- 3277260 TI - Ultrastructure of a novel anaerobic gram-positive nonsporing rod from dental root canal. AB - A novel anaerobic Gram-positive rod, strain ES4C, was isolated from a dental root canal infection. The isolate did not produce acids from carbohydrates and showed no glycosidase activity. Most biochemical reactions were identical to Clostridium malenominatum with the exception of the production of three aminopeptidases. In addition, no spores were detected. A tetragonally arranged surface layer was consistently found by electron microscopy. The ultrastructure of closely related Eubacterium spp. was also studied, but no crystalline surface structures were found. The physiologic and ultrastructural characteristics of ES4C did not allow identification as any known species. The periapical lesion responded to routine root canal therapy, but after 18 months observation the radiologic signs indicated partial healing only. PMID- 3277261 TI - Regulation of complement. PMID- 3277262 TI - Morphology of rat cardiac allografts with permanent survival induced by antithymocyte globulin. AB - In a rat heart transplantation model, permanent graft survival was achieved by anti-thymocyte globulin (ATG) treatment of Wistar Kyoto (WKy) recipients before grafting with PVG/c hearts. Nine hearts with palpable and electrocardiographic (ECG) function 8-20 months after transplantation were studied with histological and immunohistochemical methods. The dominating findings were fibrosis, intimal thickening, thrombosis of vessels, cellular infiltrates, and a high number of cells expressing class II antigens. These findings suggest that reactions compatible with a chronic rejection can be found in long-term surviving rat heart allografts. This rat model may thus be used in further studies of a chronic rejection process. PMID- 3277263 TI - The complete amino acid sequence of rat beta 2-microglobulin. AB - The primary structure of rat beta 2-microglobulin (beta 2m) was determined. It is a polypeptide of 99 amino acids with the following sequence: IQKTPQIQVY SRHPPENGKP NFLNCYVSQF HPPQIEIELL KNGKKIPNIE MSDLSFSKDW SFYILAHTEF TPTETDVYAC RVKHVTLKEP KTVTWDRDM. The primary structure was determined by NH2-terminal sequence analysis together with sequence determination of one cyanogen bromide fragment and one tryptic peptide. Of other known beta 2m sequences, rat beta 2m is most homologous to mouse beta 2m (83% identity). The rabbit, human, and guinea pig sequences are more distant, with 24, 27, and 31% differences, respectively. PMID- 3277264 TI - [Crown margins in wax and after casting: a scanning electron microscopy comparison with the model]. PMID- 3277265 TI - [Para-occlusal axiography: the Bennett angle during complete occlusion--a clinico experimental study]. PMID- 3277266 TI - AIDS vaccine trial expanded. PMID- 3277267 TI - Welfare dependence within and across generations. AB - A central question in the debate about the effects of welfare programs is whether their intended positive results--providing needed resources to recipients and their children--outweigh any unintended negative results--for example, the breaking up of families, reduction in work effort, or the fostering of a welfare "culture" that is passed on from parent to child. Recent research shows that although work effort is affected adversely by the generosity of welfare programs, effects on family structure appear quite weak, most welfare experiences are relatively short, and the majority of women who grew up in homes heavily dependent on welfare do not rely on those programs when they are young adults. PMID- 3277268 TI - Pathogenesis of dengue: challenges to molecular biology. AB - Dengue viruses occur as four antigenically related but distinct serotypes transmitted to humans by Aedes aegypti mosquitoes. These viruses generally cause a benign syndrome, dengue fever, in the American and African tropics, and a severe syndrome, dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), in Southeast Asian children. This severe syndrome, which recently has also been identified in children infected with the virus in Puerto Rico, is characterized by increased vascular permeability and abnormal hemostasis. It occurs in infants less than 1 year of age born to dengue-immune mothers and in children 1 year and older who are immune to one serotype of dengue virus and are experiencing infection with a second serotype. Dengue viruses replicate in cells of mononuclear phagocyte lineage, and subneutralizing concentrations of dengue antibody enhance dengue virus infection in these cells. This antibody-dependent enhancement of infection regulates dengue disease in human beings, although disease severity may also be controlled genetically, possibly by permitting and restricting the growth of virus in monocytes. Monoclonal antibodies show heterogeneous distribution of antigenic epitopes on dengue viruses. These epitopes serve to regulate disease: when antibodies to shared antigens partially neutralize heterotypic virus, infection and disease are dampened; enhancing antibodies alone result in heightened disease response. Further knowledge of the structure of dengue genomes should permit rapid advances in understanding the pathogenetic mechanisms of dengue. PMID- 3277270 TI - Questions raised about anti-wrinkle cream. PMID- 3277269 TI - Prevention of type I diabetes in nonobese diabetic mice by virus infection. AB - The nonobese diabetic (NOD) mouse is an animal model of type I diabetes and develops a characteristic autoimmune lesion in the islets of Langerhans with lymphocytic infiltration and destruction of pancreatic beta cells. The result is hypoinsulinemia, hyperglycemia, ketoacidosis, and death. Diabetes usually begins by the sixth month of age but can occur earlier when young NOD mice are infused with lymphocytes from older NOD donors. When newborn or adult NOD mice were infected with a lymphotropic virus they did not become diabetic. The interaction between viruses and lymphocytes is pivotal in aborting diabetes, as established by experiments in which lymphocytes from virus-infected donors failed to transfer diabetes. In contrast, lymphocytes from age- and sex-matched uninfected donors caused disease. Therefore, viruses and, presumably, their products can be developed to be beneficial and may have potential as a component for treatment of human diseases. Further, these results point to the utility of viruses as probes for dissecting the pathogenesis of a nonviral disease. PMID- 3277271 TI - AIDS: an international perspective. AB - The acquired immunodeficiency syndrome (AIDS) and infection with the human immunodeficiency virus type 1 (HIV-1) constitute a worldwide public health problem. Whereas in Europe and in most of the Americas transmission of HIV-1 has occurred predominantly among homosexual men and intravenous drug abusers, in Africa a distinct epidemiologic pattern has emerged that indicates that HIV-1 infection is mainly heterosexually acquired. Heterosexual transmission appears to be increasing in some parts of Latin America and the Caribbean, and possibly in the United States. In addition to HIV-1, at least one other human retrovirus, namely HIV-2, has been implicated as a cause of AIDS in Africa and Europe. Factors that influence heterosexual transmission of HIV-1 include genital ulcerations, early or late stages of HIV-1 infection in the index case, and possibly oral contraception and immune activation. The rate of perinatal transmission is enhanced when the mother's illness is more advanced. AIDS and HIV 1 infection may have a significant impact not only on public health, but also on the demography and socioeconomic conditions of some developing countries. Programs for the prevention and control of AIDS should be an immediate priority in all countries. PMID- 3277272 TI - The brain in AIDS: central nervous system HIV-1 infection and AIDS dementia complex. AB - Infection with human immunodeficiency virus type 1 (HIV-1) is frequently complicated in its late stages by the AIDS dementia complex, a neurological syndrome characterized by abnormalities in cognition, motor performance, and behavior. This dementia is due partially or wholly to a direct effect of the virus on the brain rather than to opportunistic infection, but its pathogenesis is not well understood. Productive HIV-1 brain infection is detected only in a subset of patients and is confined largely or exclusively to macrophages, microglia, and derivative multinucleated cells that are formed by virus-induced cell fusion. Absence of cytolytic infection of neurons, oligodentrocytes, and astrocytes has focused attention on the possible role of indirect mechanisms of brain dysfunction related to either virus or cell-coded toxins. Delayed development of the AIDS dementia complex, despite both early exposure of the nervous system to HIV-1 and chronic leptomeningeal infection, indicates that although this virus is "neurotropic," it is relatively nonpathogenic for the brain in the absence of immunosuppression. Within the context of the permissive effect of immunosuppression, genetic changes in HIV-1 may underlie the neuropathological heterogeneity of the AIDS dementia complex and its relatively independent course in relation to the systemic manifestations of AIDS noted in some patients. PMID- 3277273 TI - The economic impact of AIDS in the United States. AB - This analysis of several previous studies of the cost of AIDS suggests that the lifetime cost of medical care per patient will not exceed +80,000, an amount similar to the cost of treating other serious illnesses. If current projections of future AIDS cases are accurate, the cumulative lifetime costs of 270,000 cases diagnosed between 1981 and the end of 1991 will not exceed +22 billion. This amount is small compared with total U.S. medical spending. The economic impact of AIDS on San Francisco, New York, and some other cities, however, is likely to be more serious. The AIDS epidemic will also highlight the financial problems of Americans who face large medical bills without adequate insurance. PMID- 3277274 TI - The human immunodeficiency virus: infectivity and mechanisms of pathogenesis. AB - Infection with the human immunodeficiency virus (HIV) results in a profound immunosuppression due predominantly to a selective depletion of helper/inducer T lymphocytes that express the receptor for the virus (the CD4 molecule). HIV also has tropism for the brain leading to neuropsychiatric abnormalities. Besides inducing cell death, HIV can interfere with T4 cell function by various mechanisms. The monocyte serves as a reservoir for HIV and is relatively refractory to its cytopathic effects. HIV can exist in a latent or chronic form which can be converted to a productive infection by a variety of inductive signals. PMID- 3277275 TI - Replacements of Pro86 in phage T4 lysozyme extend an alpha-helix but do not alter protein stability. AB - To investigate the relation between protein stability and the predicted stabilities of individual secondary structural elements, residue Pro86 in an alpha-helix in phage T4 lysozyme was replaced by ten different amino acids. The x ray crystal structures of seven of the mutant lysozymes were determined at high resolution. In each case, replacement of the proline resulted in the formation of an extended alpha-helix. This involves a large conformational change in residues 81 to 83 and smaller shifts that extend 20 angstroms across the protein surface. Unexpectedly, all ten amino acid substitutions marginally reduce protein thermostability. This insensitivity of stability to the amino acid at position 86 is not simply explained by statistical and thermodynamic criteria for helical propensity. The observed conformational changes illustrate a general mechanism by which proteins can tolerate mutations. PMID- 3277276 TI - The ras oncogenes increase the intrinsic resistance of NIH 3T3 cells to ionizing radiation. AB - Identification of genes that function to protect cells from radiation damage is an essential step in understanding the molecular mechanisms by which mammalian cells cope with ionizing radiation. The intrinsic radiation resistance (D0) of NIH 3T3 cells was markedly and significantly increased by transformation with ras oncogenes activated by missense mutations. This radiobiologic activity appeared to be a specific consequence of the ras mutations rather than of transformation, since revertant cells that contained functional ras genes (but were no longer phenotypically transformed) retained their increased D0's. PMID- 3277278 TI - New approaches to the production of monoclonal antibodies. PMID- 3277277 TI - Molecular phylogeny of the animal kingdom. AB - A rapid sequencing method for ribosomal RNA was applied to the resolution of evolutionary relationships among Metazoa. Representatives of 22 classes in 10 animal phyla were used to infer phylogenetic relationships, based on evolutionary distances determined from pairwise comparisons of the 18S ribosomal RNA sequences. The classical Eumetazoa are divided into two groups. Cnidarians arose from a protist ancestry different from the second group, the Bilateria. Within the Bilateria, an early split gave rise to Platyhelminthes (flatworms) and the coelomate lineage. Coelomates are thus monophyletic, and they radiated rapidly into four groups: chordates, echinoderms, arthropods, and eucoelomate protostomes. PMID- 3277279 TI - Advances in vertebrate cell culture methods. PMID- 3277280 TI - Information technology and the conduct of science. PMID- 3277281 TI - Recent trends in electrophoresis. PMID- 3277282 TI - Breast cancer study. AB - In the report "Spacelab-2 plasma depletion experiments for ionospheric and radio astronomical studies" by M. Mendillo et al. (27 Nov., p. 1260), figure 5A (p. 1263) was misplaced with respect to figure 5B so that the scale of figure 5A was incorrectly represented. A correct figure 5 is printed below. PMID- 3277283 TI - Cortical flow in animal cells. AB - A concerted flow of actin filaments associated with the inner face of the plasma membrane may provide the basis for many animal cell movements. The flow is driven by gradients of tension in the cell cortex, which pull cortical components from regions of relaxation to regions of contraction. In some cases cortical components return through the cytoplasm to establish a continuous cycle. This cortically located motor may drive cell locomotion, growth cone migration, the capping of antigens on a lymphocyte surface, and cytokinesis. PMID- 3277285 TI - Clathrin: a matter of life or death? PMID- 3277284 TI - Site-directed mutagenesis of two trans-regulatory genes (tat-III,trs) of HIV-1. AB - Point mutations were introduced into the overlapping trans-regulatory genes (tat III and trs) of human immunodeficiency virus type 1 (HIV-1), and the mutants were evaluated for virus expression. The results showed that tat-III has a positive transacting role and is required for transcriptional activation. A chain terminating mutation early in the trs gene resulted in an increase in transcription of viral messenger RNA as measured by nuclear transcription experiments, but only one major species of viral messenger RNA (1.8 kilobases) was detected, and little or no viral structural proteins were made. Thus, the trs gene product is essential for expression of virus structural proteins but, at the same time, may have a negative trans-regulatory role in transcription. Cotransfection of the point mutant proviruses defective in tat or trs with each other or with a complementary DNA clone containing tat and trs sequences restored the normal transcription pattern and subsequent virus production. PMID- 3277286 TI - Assessment of monocyte function in breast disease. AB - Monocyte dysfunction has been reported in patients with cancer. The generation of a procoagulant tissue factor is a marker of the monocyte's activation. Since the only blood cell capable of generating tissue factor is the monocyte, the incubation of citrated blood with either saline (control) or endotoxin (monocyte activator) followed by determination of the recalcification time should yield a measure of monocyte activation. The recalcification times of the saline-incubated samples were similar for healthy women and those with cystic hyperplasia, but were significantly shortened in patients with breast cancer. The recalcification times of the endotoxin-activated samples were significantly shorter in patients with breast cancer than in those with cystic hyperplasia, which in turn was significantly shorter than in healthy women. PMID- 3277287 TI - Quality assurance review: improving diagnostic accuracy of percutaneous needle biopsy. AB - Adequate pathologic slide preparation of percutaneous fine-needle biopsy (PFNB) specimens is necessary to maximize sensitivity and yield a tissue diagnosis. We present a quality control review of our biopsy technique and results in 71 aspiration biopsies done in 59 patients. Immediate cytology slide preparation in the radiology suite enabled us to increase our diagnostic yield from 53% to 84%, and allowed us to preserve PFNB, rather than open biopsy, as the primary diagnostic modality. We recommend regular review of biopsy techniques to confirm adequate diagnostic yields of these procedures. PMID- 3277288 TI - Use of the anion gap in clinical medicine. AB - The anion gap (AG) in the serum equals the concentrations of Na-(Cl + HCO3). It is becoming increasingly useful in the interpretation of acid-base disorders and in the diagnosis of other conditions. In an acidemic patient, an elevated AG usually indicates the presence of an organic acidosis, rhabdomyolysis, nonketotic hyperglycemic coma, uremia, or certain intoxications. An increased AG with alkalemia suggests severe alkalosis with hemoconcentration or use of anionic antibiotics (eg, carbenicillin) or salts of organic acids (eg, citrate). An elevated AG with a normal serum pH could be an artifact caused by prolonged exposure of the serum sample to air before processing. A decreased AG with a normal serum pH may indicate hypoalbuminemia, cationic paraproteinemia, halide poisoning, or lithium intoxication. The delta AG/delta HCO3 ratio and the urinary AG may also be quite useful in analyzing complex acid-base disorders. PMID- 3277289 TI - Health care in the 1990s: old wine in new bottles. PMID- 3277290 TI - Rational medicine and social processes. PMID- 3277291 TI - Gertrude Stein's neuroanatomic investigations: roses or thorns? PMID- 3277292 TI - Genetic analysis of tumorigenesis. XXXI: Retention of short arm of chromosome 3 in suppressed CHEF cell hybrids containing c-Ha-ras (EJ) gene. AB - Hybrids between nontransformed Chinese hamster embryo fibroblast (CHEF) cells and their c-Ha-ras (EJ) -transformed derivatives are suppressed for tumor-forming ability when tested at early passage. Hybrid subclones with suppressed (fibroblastic) or transformed appearance have now been selected by multiple recloning. Morphology, but not serum or anchorage requirement, was a sensitive indicator of suppression: Subclones with normal morphology were nontumorigenic, subclones with transformed morphology were highly tumorigenic, and intermediate subclones (7-70% normal colonies) formed tumors with a frequency of 17-50%. Suppressed lines retained the short arm of chromosome 3, but transformed and tumor-derived lines had lost this region (greater than or equal to 1 copy). Transformed and tumor-derived cells exhibited additional chromosome changes, including the loss of at least one copy of chromosomes 7 and/or 8. These findings suggest that a tumor suppressor gene lies on the short arm of chromosome 3, consistent with prior studies from this laboratory. Other suppressor genes may be located on chromosomes 7 and 8. PMID- 3277293 TI - Aspergillus fumigatus infection of the maxillary sinus. A case report. AB - The diagnosis and radiological findings in a 48-year-old woman with paranasal sinus Aspergillus fumigatus infection is described. The patient had had chronic post-nasal discharge and sinusitis for 7 years. She was treated by total removal of all infected material. PMID- 3277294 TI - Ocular reticulum cell sarcoma. A case report. AB - A case of ocular reticulum cell sarcoma (RCS) is described. Its relationship to systemic and central RCS and the eye signs, pathology and treatment are discussed. The importance of early diagnosis is stressed and vitreous biopsy should be considered in any unexplained vitritis in patients over the age of 40 years. Chemotherapy should be added to the usual dosage of radiation and may improve the survival period. PMID- 3277295 TI - Percutaneous nephrolithotomy. Experience with renal and proximal ureteral calculi at Tygerberg Hospital. AB - Percutaneous nephrolithotomy (PCN) enables the urologist to remove upper urinary tract stones through a percutaneous nephrostomy tract. The principal advantages of PCN are the low morbidity, shortened hospital stay and rapid recovery. Percutaneous puncture failed in 5 (11%) of the first 44 patients with upper tract urolithiasis treated by PCN at Tygerberg Hospital. In 35 patients (80%) PCN cleared the kidney of stones but in 4 patients (9%) all stone fragments were not removed during the procedure. If the puncture and dilatation was successful, then 90% of patients were stone-free after PCN. Complications were minimal except for a diabetic who died of septicaemia. PCN is an alternative to open renal surgery in the management of most upper urinary tract stones. The technique is readily mastered by any urologist experienced in endoscopic surgery. PMID- 3277296 TI - Ultrasonographic estimation of fetal weight during labour. Evaluation and comparison of two formulae. AB - Estimation of fetal weight is a major component of obstetric practice and is important in determining management of the high-risk patient in particular. Many patients at high risk for perinatal morbidity and mortality present for the first time in established labour. As clinical methods in these circumstances are of limited accuracy, ultrasonography is increasingly being used for this purpose. The commonly used formulae relating ultrasound measurements to fetal weight were derived from a different population from our at-risk population, and we therefore measured abdominal circumference and biparietal diameter in 51 patients to assess the accuracy of two such formulae. While one of the formulae was superior to the other, the overall accuracy of both was disappointing and we feel that ultrasonographic estimation of fetal weight in labour is of limited value. PMID- 3277297 TI - Review of southern African spiders of medical importance, with notes on the signs and symptoms of envenomation. AB - Medically important spiders in southern Africa are discussed in terms of their morphological features and distribution, the signs and symptoms of envenomation and the possible treatment thereof. A simple pictorial key is provided to enable the non-specialist to identify the neurotoxic and cytotoxic species. The following spiders are now known to be medically important in southern Africa: Latrodectus indistinctus (neurotoxic), Chiracanthium lawrencei (cytotoxic), Loxosceles sp. (cytotoxic) and Sicarius sp. (cytotoxic - haemotoxic). PMID- 3277298 TI - Use of new beta-lactam antibiotics for surgical infections. AB - The availability of beta-lactam antibiotics with extended spectra of activity against organisms commonly seen in surgical infections suggests that aminoglycoside-based therapy is no longer needed for most such community-acquired infections. The primary problems with specific beta-lactams are lack of activity against Bacteroides species and variable activity against Pseudomonas aeruginosa and enterococci. The pharmacokinetic properties of the newer beta-lactams vary considerably. This variation suggests specific settings in which these properties may be taken advantage of to improve clinical outcome. PMID- 3277299 TI - Multiple system organ failure. AB - Multiple system organ failure represents the final common pathway to a fatal outcome in severely infected patients. Despite the development of extensive support technology, the mortality rate in this group of patients remains high: in excess of 50 per cent. This rate underscores the need for newer treatment modalities. Numerous mediators/effectors appear to play a role in the complex evolution of the process. The independent and interactive effects of these numerous mediators/effectors remain to be elucidated. Future therapies will need to address immunomodulation of the host and biochemical manipulation of the fundamental process before significant improvement in outcome can be expected. PMID- 3277300 TI - Use of scoring systems to assess patients with surgical sepsis. AB - Several scoring systems for patients with severe surgical infections are described, compared, and contrasted. All show a strong relation between a high score and high mortality risk. Each has strengths and weaknesses. All of the systems need further refinement. Future investigations of patients with serious infections should incorporate one of the published severity scores as part of the patient description. PMID- 3277301 TI - Imaging techniques for infections in the surgical patient. AB - Gallium-67 citrate is easy to use and readily available, but the need to delay imaging for 2 to 4 days after injection hinders rapid diagnosis. Moreover, normal gastrointestinal activity limits its usefulness in evaluating the abdomen. Labeling leukocytes with Indium-111 oxine is a time-consuming, technically involved process, yet the images obtained at 24 hours will usually reveal sites of inflammation or infection. Although the techniques have similar sensitivities, the higher specificity of In-111 makes it the superior agent for many clinical situations. When there are localizing signs or symptoms or a reason to suspect a specific body region, CT or ultrasonography is the imaging modality of choice. Guided needle aspiration can then be performed and is usually diagnostic. Radionuclide imaging with either Ga-67 or In-111 is available as an adjunct if needle aspiration cannot be performed or is inconclusive. Since it provides total body surveillance, radionuclide imaging is particularly useful for screening when there are no localizing signs and in cases of occult sepsis or fever of unknown origin. If positive, it can direct further imaging with CT or ultrasound. PMID- 3277302 TI - Infections in prosthetic devices. AB - Infection in prosthetic devices is a rare but potentially serious complication of prosthesis implant surgery. Infections associated with a variety of permanently implanted devices are reviewed in the context of recent knowledge of the host prosthesis interaction. PMID- 3277303 TI - Infection in the compromised host. AB - In spite of the development of successive generations of more powerful antibiotics, sepsis remains a common cause of death in the surgical patient. This fact is not surprising, since it is of little importance which organism is causing the infection if the patient's intrinsic antibacterial defenses cannot respond. Realization of the limitations of antibiotic therapy has prompted many investigators to study the immune and inflammatory systems with the ultimate goal of improving host defenses and increasing survival. In this article the local and systemic antibacterial defense systems have been reviewed. It is clear that the immunocompromised state is associated with multiple defects of the humoral and cellular components of both the nonspecific host defense system and the specific immune defense system. However, although consensus has not been reached on either the mediators responsible for the immunocompromised state or the prognostic and clinical significance of many of the described defects, work in this field is progressing rapidly. Nonetheless, knowledge that the host's antibacterial defense systems can be aided by good surgical technique, nutrition, appropriate use of antibiotics, and the sterile care of invasive catheters, lines, and tubes is critical in the prevention of fatal infections in the immunocompromised patient. When more information becomes available concerning the complex interrelations between the various cellular and humoral components of the host defense systems and their mediators and the symbiotic relations between man and his bacterial flora, it should be possible to develop specific strategies for the clinician to use to reduce the risk of infection in the high-risk surgical patient. Thus, in the future it may not be unusual for the clinician to alter the immunologic system of the host by the use of immunomodulators or vaccines to increase the host's resistance to infection. On the other hand, by manipulating the complex interrelations between the host and the indigenous bacterial flora, it may be possible to prevent the development of opportunistic infections originating from the gastrointestinal tract. PMID- 3277304 TI - Necrotizing soft-tissue infections. AB - A variety of infections are encountered by the practicing surgeon. Uncommonly, a patient presents with minimal external manifestations of a deep surgical soft tissue infection. Early aggressive intervention is required to minimize the morbidity in these often debilitated patients. PMID- 3277305 TI - Detection of sepsis in the postoperative patient. AB - It becomes evident, therefore, that there is no one indicator, either clinical or laboratory, sufficient to diagnose infection in the postoperative patient. Only a skillful clinician using the multiple modalities available and combining them with a careful history and physical examination and a high index of suspicion will be able to diagnose and treat infection in a timely manner and so avoid the physical, emotional, and fiscal costs of a late or missed diagnosis. PMID- 3277306 TI - The open abdomen. The Marlex mesh and zipper technique: a method of managing intraperitoneal infection. AB - In conclusion, a zipper technique has been outlined that allows effective continuing drainage of the septic abdomen, permits early diagnosis of organ damage, is rapid and cost effective, minimizes ventilator dependency and gastrointestinal complications, is well tolerated by the patients, and has produced a modest 65 per cent survival rate in the first 34 critically ill patients in whom it was used. Selection of patients is critical. It is a technique that must not be undertaken lightly but that appears to have life saving potential. PMID- 3277307 TI - Clinical assessment of host defense. AB - Host defense mechanisms are a determinant of infection. Anergy in surgical patients is a signal of broadly based immune deficits, which include abnormalities in specific and local nonspecific antibacterial defenses and related life-threatening sepsis. Analysis of these abnormalities and other risk factors allows us to generate a long-predictive equation of individual probability of death. PMID- 3277308 TI - Vascular-access infections in hospitalized patients. AB - Vascular catheters are a common source of nosocomial infections, although many of these infections are potentially preventable. A long duration of catheterization, multiple catheter manipulations, the inexperience of some inserters, use of transparent plastic dressings, violations of aseptic technique, the use of multilumen catheters, and inadequate sterilization of reusable pressure transducers all increase the risk of these infections. The only interventions that have been proved to reduce the risk are standardized insertion and maintenance technique by an intravenous-therapy team, preinsertion skin preparation with chlorhexidine gluconate, and the use of topical antibiotics at the insertion site. The goal of the physician should be to prevent catheter infection, because the treatment of established infection can be difficult and costly. Treatment must be individualized for each patient on the basis of the clinical presentation and the causative organism. PMID- 3277309 TI - AIDS and the surgeon. AB - Several issues related to the AIDS virus concern the surgeon. This article discusses the common presentations of AIDS in each body system with special emphasis on conditions that require surgical intervention, alternatives to surgical procedures for diagnosis, and precautions for the handling of tissue and body secretions of individuals suspected of harboring the AIDS virus. PMID- 3277310 TI - Status of percutaneous catheter drainage of abscesses. AB - The definitive role of catheter drainage in the therapy of abscesses has not yet been totally elucidated. The resolution rate of intra-abdominal infection with catheter drainage is highly variable, depending on the inclusion criteria employed. Certain infections are very effectively treated (i.e., abscesses that are single, not communicating with abdominal viscera, noncancerous, and bacterial) with simple catheter drainage, whereas others (i.e., infected pancreatic tumor phlegmon) prove to be much more resistant to simple catheter drainage. When all intra-abdominal "abscesses" are collected, the success of catheter drainage ranges from 47 per cent to 73 per cent. The wide variation should be seen not so much as a reflection of differences in technical ability of the radiologist to introduce a catheter, but rather as emblematic of the highly variable nature of the cause of intra-abdominal infection and the definition of an abscess. Hospitals with a large number of complex problems such as malignancy, transplant and other immunosuppressed patients, and referrals of patients with complex long-standing intra-abdominal infections are likely to have a much lower rate of success with percutaneously placed catheters than are those institutions that derive their series from post-traumatic or primary diseases such as appendiceal or diverticular disease. In the former series, a higher morbidity and mortality rate would be expected from any form of treatment when compared to a series from a practice based on more primary care problems. Intra-abdominal infections are a heterogeneous set of processes, and the role of interventional radiology in the diagnostic and therapeutic approach cannot be underestimated. In planning for the care of a patient with a presumed intra-abdominal infectious process, percutaneous aspiration of a fluid mass is an effective tool for establishing the diagnosis of an abscess. The brief introduction of a catheter has rarely led to contamination of an otherwise sterile collection. However, it often effects dramatic symptomatic relief if the fluid collection is infected. It has therefore been an evolving recommendation to employ the techniques of interventional radiology aggressively in a diagnostic capacity. Subsequently, therapeutic interventions can be undertaken in joint agreement among the physician, surgeon, and radiologist. The diagnosis and treatment of intra abdominal infections can often times be carried out in a relatively easy and non morbid manner that effects cure in a significant percentage of patients.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3277311 TI - Whole body X-irradiation and impact of dietary factors on brain and testes of albino rats. AB - The study was undertaken to investigate the radioprotective effect of protein diet on the irradiated brain and testes. The study indicated that the less availability of protein in the diet caused a marked reduction in the protein and nucleic acid (DNA and RNA) contents of brain after irradiation. Further, the protein deficiency in diet brought about an increased deamination of protein in the brain of irradiated rats. It was noted that in response to irradiation the testes of protein deficient diet fed rats got adversely affected as compared to high protein diet fed animals. This paper gives evidence that feeding of protein enriched diet provides protection against ionizing radiation. PMID- 3277312 TI - Physiology and pathophysiology of gastrin: a review. AB - Recent advances in understanding the physiology and pathophysiology of the gastrointestinal hormone, gastrin, are reviewed. Details of gastrin biosynthesis, secretion, and cellular actions may have broad implications for other peptide hormones. Potentially useful antigastrin drugs are described. Areas of future development are suggested. PMID- 3277314 TI - Special operative events in the first case of liver grafting after heart transplantation. AB - Combined heart-liver transplantation is the only therapeutic possibility for patients with familial hypercholesterolemia IIa. A 12-year-old boy with this metabolopathy underwent a double transplant in two steps (different donors). This original alternative was chosen to assure a safer procedure in this critical situation. Details of intraoperative events are described. Cholesterol and LDL decreased to physiologic levels after liver transplantation. The child's condition is optimal 1.5 years after surgery. PMID- 3277313 TI - Hemodynamic and pathologic effects of prostacyclin on oleic acid-induced pulmonary injury. AB - Oleic acid (OA) injection into the lungs of dogs produces pulmonary edema and decreased cardiac output, and the result is combined hypoxic and stagnant hypoxia. Prostacyclin (PGI2) has some effects that may be beneficial in the alleviation of hypoxia. We studied 18 anesthetized dogs that were divided into three groups: (1) Six dogs acted as controls and did not receive OA or PGI2, (2) six dogs received OA but no PGI2, and (3) six dogs were first given OA and 1 hour later an infusion of PGI2 (100 ng/kg/min) was started and continued for 4 hours. All dogs were killed at the end of the study and their lungs were removed for weighing and preparation for microscopic examination. Compared with controls, OA caused a low cardiac output, high systemic and pulmonary vascular resistance, and increased right-to-left intrapulmonary shunt. The group that received OA and PGI2 demonstrated a well-maintained cardiac output and a low systemic vascular resistance. Right-to-left intrapulmonary shunt, however, increased in these dogs compared with the dogs not given PGI2. All animals given OA had similar wet/dry lung weights and histologic appearances. Our results suggest that the only beneficial effect of PGI2 in OA-induced lung injury is to improve the stagnant hypoxia, but this is associated with an aggravation of the hypoxic hypoxia. The result of these competing effects appears to be a mild overall improvement in oxygen delivery as suggested by the slightly higher mixed venous PO2 in the group that received PGI2. PMID- 3277315 TI - [Atopic dermatitis in dogs: symptomatology and diagnosis]. AB - The immunological backgrounds of canine atopy, and in particular of atopic dermatitis, are described in the present review. The significance of the history, the intradermal allergic test and the determination of allergen-specific antibodies in the diagnosis of canine atopy is discussed. PMID- 3277316 TI - [Atopic dermatitis in dogs: current diagnostic criteria]. AB - The diagnostic features of atopic dermatitis in man and dogs are compared in the present paper. On this basis, reconsidering the diagnostic criteria to be applied in the canine diseases, is suggested. PMID- 3277318 TI - Mutagenicity of monochlorodibenzofurans detected in the environment. AB - Recently, monochlorodibenzofuran, which is formed by the reaction of dibenzofuran with residual chlorine, has been detected in tap water in one region of Japan. The mutagenicities of 1-, 2-, 3-, and 4-chlorodibenzofuran were tested using Salmonella typhimurium TA98 and TA100. 1-Chlorodibenzofuran and 4 chlorodibenzofuran proved to be practically non-mutagenic, while 2 chlorodibenzofuran was weakly mutagenic. Unlike these three isomers, 3 chlorodibenzofuran was markedly mutagenic, and the intensity of its mutagenicity in TA98 was about one-fifth and in TA100 about one-twentieth of that of benzo[a]pyrene. PMID- 3277317 TI - Detection and mechanism of formation of the potent direct-acting mutagen 2 bromoacrolein from 1,2-dibromo-3-chloropropane. AB - The nematocide 1,2-dibromo-3-chloropropane (DBCP) was converted to products which are mutagenic for Salmonella typhimurium TA 100 in the presence of rat liver microsomes, NADPH, and oxygen. Typical in vivo and in vitro inhibitors of cytochrome P-450 decreased DBCP mutagenicity in the presence of microsomes. Addition of glutathione to cytosolic preparations failed to bioactivate DBCP to mutagenic metabolites. Mutagenicity studies with selectively deuterated analogs showed that substitution of deuterium for hydrogen at C-1 or C-3 of DBCP modestly decreased mutagenicity, but that deuteration at both C-1 and C-3 markedly decreased mutagenicity. The formation rates of the potent direct-acting mutagen, 2-bromoacrolein (2-BA), in incubations of DBCP and its deuterated analogs with rat liver microsomes, correlated with the isotope effects on mutagenicity. Characterization of 2-BA was accomplished by gas chromatography-mass spectrometry using positive-ion chemical ionization. Mass spectral analysis of 2-BA formed from specifically deuterated analogs of DBCP indicated that initial oxidative dehalogenation at C-1 followed by a spontaneous beta-elimination reaction was the preferred pathway in the formation of 2-BA from DBCP. These results demonstrate that mutagenic metabolites of DBCP are formed by cytochrome P-450-mediated oxidative metabolism, and that 2-BA is a major mutagen formed. PMID- 3277319 TI - Mutagenic activity of some textile dyes in different test systems. AB - The Salmonella/microsome mammalian test, the micronucleus and the dominant lethal tests on mice were used to study mutagenic effects of three dyes widely used in the textile industry. Direct Black 19:1, Direct Red 81 and Acid Blue 62 increased the frequency of micronucleated polychromatic erythrocytes in bone marrow of mice. Out of all dyes tested, only Direct Black 19:1 appeared to be an indirect mutagen inducing reverse mutations in two strains of Salmonella typhimurium TA 1538 and TA 98. None of them produced dominant lethal mutations in germ cells of male mice. PMID- 3277320 TI - Selective elution of HLA antigens and beta 2-microglobulin from human platelets by chloroquine diphosphate. AB - To determine whether chloroquine can specifically elute HLA antigens and beta 2 microglobulin (beta 2-M) from the platelet surface, quantitative immunofluorescence flow cytometry and monoclonal antibodies were used to show that HLA antigens and beta 2-M were proportionally eluted from the platelet surface without affecting the membrane glycoproteins IIb and IIIa. Second, an autoradiogram of electrophoresed I125-labeled platelets showed that only beta 2-M but not other I125-labeled membrane proteins could be eluted. Although HLA antigens were poorly labeled by I125 and could not be detected on the autoradiogram, the eluted HLA antigens could be detected by anti-HLA monoclonal antibody and immunoblotting techniques. No loss of plasma membrane integrity was observed by transmission electron microscopy after chloroquine treatment of platelets. The results indicate that chloroquine selectively elutes HLA antigens and their noncovalently associated beta 2-M without affecting other integral platelet membrane proteins. PMID- 3277321 TI - Specificity of enzyme immunoassay for hepatitis B core antibody used in screening blood donors. PMID- 3277322 TI - A self-limiting midline cerebellar syndrome. Is falciparum malaria the cause? PMID- 3277323 TI - Declining incidence of wound infection in cadaveric renal transplant recipient. AB - Over a five-year period 100 cadaveric renal transplants were performed. In 91 of these recipients, a prophylactic parenteral antibiotic (cefoperazone) was administered and closed wound drainage was used. Of these 91 patients, 33 received azathioprine/prednisone immunosuppression, whereas cyclosporine/prednisone with or without azathioprine was used in the remaining 58. The incidence of wound infections was significantly reduced from 12 per cent (4/33) in the azathioprine group to 1.7 per cent (1/58) in the cyclosporine group (p less than 0.01). When conventional immunosuppression (azathioprine/prednisone) is employed in renal transplantation, triple antibiotic prophylaxis that includes an aminoglycoside is most effective in preventing wound infections. A single non nephrotoxic antibiotic, cefoperazone, offers similar protection in the cyclosporine/prednisone-treated renal transplant recipient. PMID- 3277324 TI - Misleading testicular masses. AB - Benign intrascrotal neoplasms of the testicle account for less than 10 per cent of all intrascrotal masses in postpubertal males. Radical inguinal orchiectomy is standard treatment for a firm, intratesticular mass. Of those patients so treated, 93 per cent of patients with this finding will have had the appropriate operation. There are misleading conditions, however, that can cause firm lesions in the testicle. There is a controversy over whether or not our current technology preoperatively can detect these benign lesions accurately. We encountered five different benign testicular masses within a twelve-month period. We present our findings and comments on some of the difficulties in dealing with these. PMID- 3277325 TI - Quality control of radiation therapy in multi-institutional randomized clinical trial for localized prostate cancer. AB - The National Prostatic Cancer Project (NPCP) from 1978 through 1985 compared definitive radiation therapy for Stages B2, C, D1 lesions in those who received only radiation treatment to those who received two years of additional cyclophosphamide (Cytoxan) or estramustine phosphate (Emcyt) chemotherapy. Two hundred fifty-four patients were entered and 229 evaluated for compliance of the spatial localization of the prostate through review of the simulation and port films. In 78 per cent this was satisfactory, whereas in 12 per cent it was unsatisfactory, and another 10 per cent were not evaluable. The principle cause of an unsatisfactory rating was failure to adequately cover the prostatic target volume, especially the apex which was found to be variable in location. Routine use of retrograde urethrocystography is urged as part of the localization method in patients to receive definitive external beam radiation therapy for prostate cancer. The role and impact of quality assurance programs for radiotherapy in cooperative clinical study groups is reviewed and discussed. PMID- 3277326 TI - James Barry, M.D., inspector general of hospitals. Man or woman? PMID- 3277327 TI - Short-course chemotherapy and role of surgery in adult and pediatric genitourinary tuberculosis. PMID- 3277328 TI - Functional mapping of an AcNPV immediately early gene which augments expression of the IE-1 trans-activated 39K gene. AB - An early gene which augments the expression of the delayed early/late 39K gene of the baculovirus Autographa californica nuclear polyhedrosis virus (AcNPV) was identified by functional mapping. Transient expression of the plasmid p39CAT, containing the bacterial chloramphenicol acetyltransferase coding sequences under the control of the promoter of the 39K protein, was observed in cells cotransfected with AcNPV DNA digested with several restriction endonucleases. However, when p39CAT was cotransfected with viral DNA digested with Bg/II restriction endonuclease, no CAT activity could be detected. To map the location of the Bg/II-sensitive sequences required for efficient expression of 39CAT, p39CAT and Bg/II-digested viral DNA were cotransfected with a PstI library of AcNPV DNA. The PstI-N fragment restored 39CAT activity. A major early 1.3-kb transcript from this fragment was mapped by S1 nuclease analysis. Transient assay experiments indicated that this major transcript of the PstI-N fragment was produced by an immediate early gene, named IE-N. The PstI-N fragment alone did not activate expression of p39CAT but was required when IE-1 was present in limiting quantities. PMID- 3277329 TI - Transcription stimulates recombination. II. Generalized transduction of Escherichia coli by phages T1 and T4. AB - Phage Mu was inserted in the trpE gene of one donor Escherichia coli strain and in the lac promoter of another. Strains with Mu prophage mutations which permitted transcription of genes whose transcription had been polarly blocked by the Mu insertion were isolated and called "bypass" strains. The transducing phages T1am, and T1am,ST, and, in one instance, T4GT7 were grown on both the bypass and the original strains. After growth on the bypass strains transducing phages were able to transduce Trp+ and Lac+, respectively, to a variety of Trp- and Lac- strains more efficiently than after growth on nonbypass strains. These results support the idea that crossovers required for generalized transduction occur more efficiently if the specific region is transcribed by both interacting parental molecules. PMID- 3277330 TI - [Rehabilitation of patients with radical mastectomies]. PMID- 3277331 TI - [Clinical assessment of the complex diagnosis of pancreatic cancer]. AB - Ultrasound examination, X-ray computed tomography, endoscopic retrograde pancreatocholangiography and angiography offer an effective means for pancreatic cancer diagnosis. Precise topic diagnosis and extent of tumor lesion cannot be established by application of either method. Preoperative diagnosis can be improved and lesion extent assessed by the complex use of said procedures. Complex examination saves time and allows the choice of a rational treatment modality. PMID- 3277333 TI - [Nitrosomethylurea in the clinical chemotherapy of malignant tumors]. PMID- 3277332 TI - [Diagnostic potential of indirect radionuclide angiography in kidney cancer]. AB - Indirect radionuclide angiography was performed in 95 suspects for renal tumor. The data obtained by the said procedure were compared to those yielded by surgery, autopsy and X-ray contrast angiography. The majority of renal tumors were found to have specific angionephroscintigraphic features. The sensitivity of the method in detecting renal carcinoma was 90.2%, specificity--86.3 and diagnostic reliability--88.4%. The procedure proved functional, sparing and highly informative. PMID- 3277334 TI - New developments in the pathogenesis of smoke inhalation-induced pulmonary edema. AB - Smoke inhalation causes most of the deaths in fire-related injuries, with pulmonary edema as a major determinant in the outcome of smoke-inhalation injury. The pathophysiology of pulmonary edema is thought to be related to the products of incomplete combustion. Damage to the integrity of the alveolar epithelium is one of the determinants of the development of smoke-induced pulmonary edema. In recent studies using lung clearance of aerosolized pentetic acid (DTPA [diethylenetriaminepentaacetic acid]) labeled with technetium Tc 99m to assess the permeability of the alveolar epithelium, several factors were identified that may increase a person's susceptibility to smoke-induced acute lung injury. These are increased initial alveolar permeability and alterations in the number and activity of alveolar macrophages. Clinical measurement of (99m)TcDTPA clearance may provide a sensitive and convenient method for the early detection and serial assessment of smoke-induced alveolar epithelial permeability changes. PMID- 3277335 TI - Rattlesnake bites in southern California and rationale for recommended treatment. AB - Rattlesnake bite is most common in young men who often are intoxicated and have purposely handled a venomous snake. The incidence of bites is highest in the spring and early summer months, and they most often occur in the afternoon. The hands and feet only are involved in 95% of all bites. First-aid therapy should be limited to splinting the extremity and transporting the victim to a medical facility. Definitive therapy is administering antivenin (Crotalidae) polyvalent intravenously in adequate initial doses and repeating every two hours until the venom is completely neutralized. Serum sickness usually follows all doses of more than five vials but is readily controlled by giving corticosteroids. Bites are avoided by protecting the hands and feet, not handling venomous snakes, and using utmost caution while in the snakes' habitat. PMID- 3277337 TI - Modern techniques of pain management. AB - Even clinicians who keep up with the research literature on pain mechanisms may find themselves uncertain when trying to bring these new theories down to practical application for a patient with pain. The areas of dysfunction to be attacked should be systematically outlined, a complementary set of treatments be decided on, and follow-through be done in a reasonable number of visits. Physicians must also know when to refer a patient who goes beyond their own assessment and treatment skills. PMID- 3277336 TI - Coffee and pancreatic cancer in a rural California county. AB - In a study of the risk of fatal pancreatic cancer according to intake of regular and decaffeinated coffee, cases (N = 30) and controls (N = 47) were identified from death certificates and matched for age (+/- 5 years), sex, ethnicity, and date of death (+/- 5 years). Telephone interviews were completed with survivors of about 80% of both groups. In smokers, the relative risk for high (3 + cups) versus low (<3 cups) intake of regular coffee was 4.3 (P < .05), and high verus low decaffeinated coffee, 5.5 (P < .05). In nonsmokers, neither type of coffee influenced the risk. Mean daily intakes of alcohol and cigarettes were virtually identical in cases and controls, although cases had accumulated nonsignificantly more pack-years. Intakes of regular and decaffeinated coffee were uncorrelated, and the smoking-coffee interaction could not be readily explained by recall bias. If coffee intake increases the risk of pancreatic cancer, the mechanism could depend heavily on smoking. PMID- 3277338 TI - Cystic fibrosis. PMID- 3277339 TI - A synthetic peptide to the predicted 6.9K translation product of the HindIII H/EcoRI-D region of the AcNPV genome induces antibodies to the basic DNA-binding protein. AB - The sequence of the HindIII-H/EcoRI-D region of the AcNPV genome revealed a 55 codon methionine-initiated open reading frame (Wilson, M.E., Mainprize, T.H., Friesen, P.D. and Miller, L.K., 1987, J. Virol. 61, 661-666). This open reading frame predicts a 6.9K translation product with an amino acid composition nearly identical to the basic virion DNA-binding protein. A synthetic peptide was prepared to a region of the predicted 6.9K protein and used to induce antibodies in rabbits. Western blots of viral proteins, infected cell-specific proteins (24 h p.i.), and basic chromatin-associated proteins (24 h p.i.) were probed with anti-6.9K antisera. In all immunoblots, the anti-6.9K antisera were specific for the basic DNA-binding protein. This investigation provides further evidence that the basic DNA-binding protein of the virion is a viral-encoded gene transcribed from the HindIII-H/EcoRI-D region of the genome. PMID- 3277340 TI - Evaluation of phenotype of mononuclear host cells isolated from primary tumour and peripheral blood of patients with laryngeal carcinoma. AB - Mononuclear host cells isolated from primary laryngeal carcinoma were assessed by means of indirect immunofluorescence with a panel of monoclonal antibodies against various lymphocyte subsets and macrophages. Tumours of various staging groups were examined in parallel with cells isolated from patient and donor peripheral blood (PBL). It was found that percentage values of cells bearing T3 and T4 phenotype were reduced both in tumour infiltrating cells (TIC) and in PBL population. The fall in T4+ cells in PBL from cancer patients in T3 and T4 staging groups was statistically significant (p less than 0.01) as compared with donor cells. Corresponding values for T8+ cells from TIC were increased in T1 and T2 staging groups of cancer, but showed a gradual fall in advanced stages. The T4+/T8+ cell ratio was decreased in both TIC and PBL cells. The HNK-1+ (NK) cell pattern in TIC was analogous to that for T8+ cells, i.e. the cell percentage decreased with advance in tumour growth. Corresponding values for OKM-1+ were increased in TIC and in patient blood, though in TIC they grew in proportion to tumour growth. Ia+ (HLA-DR+) cells in peripheral blood were significantly increased in patients versus those of donors (p less than 0.01), but only in T3 and T4 staging groups of examined cancer. These results show that subsets of tumour infiltrating cells in laryngeal carcinoma are a complex phenomenon, associated with growth and progression of tumour. PMID- 3277341 TI - Immunobarriers of the mucosa of the upper respiratory and digestive pathways. AB - The mucosa that lines the upper respiratory and digestive pathways is protected by a secretory immune system which is under complex and only partly understood immunoregulatory control. B cells of relatively immature memory clones with a potential for J-chain expression, are initially stimulated in mucosa-associated lymphoid tissue (probably including the tonsils) and migrate thereafter through lymph and blood to glandular sites where they are subjected to terminal differentiation and become immunoglobulin (Ig)-producing immunocytes. Most locally produced Ig is normally dimeric IgA which is selectively transported through the serous type of glandular cells by means of an epithelial receptor protein called the secretory component (SC). IgM is also subjected to SC-mediated transport. In patients with selective IgA deficiency, secretory IgA is lacking, but may be satisfactorily replaced by protective secretory IgM. In other IgA deficient patients, however, immunoregulatory compensation gives rise to a large number of IgD-producing cells in respiratory mucosa. IgD cannot act as a secretory antibody and these patients are prone to have recurrent infections. These observations show that there are large individual variations in the secretory immune system. PMID- 3277342 TI - Ginger root against seasickness. A controlled trial on the open sea. AB - In a double-blind randomized placebo trial, the effect of the powdered rhizome of ginger (Zingiber officinale) was tested on seasickness. Eighty naval cadets, unaccustomed to sailing in heavy seas reported during voyages on the high seas, symptoms of seasickness every hour for 4 consecutive hours after ingestion of 1 g of the drug or placebo. Ginger root reduced the tendency to vomiting and cold sweating significantly better than placebo did (p less than 0.05). With regard to vomiting, a modified Protection Index (PI) = 72% was calculated. Remarkably fewer symptoms of nausea and vertigo were reported after ginger root ingestion, but the difference was not statistically significant. For all symptom categories, PI = 38% was calculated. PMID- 3277343 TI - The evolution of mammography. PMID- 3277344 TI - Small intestinal enema. By Richard Schatzki, 1942. PMID- 3277345 TI - Richard Schatzki, M.D.: a biography. PMID- 3277346 TI - Small intestine enema. PMID- 3277347 TI - MR diagnosis of pancreatic transplant rejection. AB - To determine the role of MR imaging in the assessment of pancreatic transplant rejection, we prospectively obtained 13 MR scans in nine transplant patients. The presence of rejection was verified pathologically by pancreatic transplant biopsies in five patients. In two additional patients, rejection was proved by concordant renal transplant biopsy as well as by compatible clinical and laboratory data. In the remaining two patients, in whom no biopsy was done, clinical and laboratory data showed no evidence of rejection. The mean T2 of the seven pancreata undergoing rejection was significantly elevated (86 msec) compared with the mean T2 of the two transplants not undergoing rejection (59 msec) (p less than .002). These preliminary results suggest that MR may be useful in the noninvasive diagnosis of pancreatic rejection. PMID- 3277348 TI - Gallbladder disease in patients with primary sclerosing cholangitis. AB - We evaluated the gallbladders of 121 patients who had well-documented primary sclerosing cholangitis. Sonograms, cholangiograms, and CT scans were reviewed, and the findings were correlated with surgical or autopsy findings, when available. Pathologic examination of the gallbladder was available in 55 (45%) of the 121 patients; of these, 49 (89%) had abnormal gallbladders. Ninety-three of the 121 patients had one or more radiologic examinations of the gallbladder: 77 had sonograms, 80 had cholangiograms, and 18 had CT scans. Seventy-five (62%) of the 121 patients had abnormal gallbladders on histologic examination or had positive findings on one or more imaging study. By excluding 25 patients who had histologic changes of borderline significance and/or patients who had thick walled gallbladders attributable to end-stage liver disease, we concluded that 50 (41%) of the 121 patients had intrinsic abnormalities of the gallbladder. Thirty two (26%) had gallstones, 18 (15%) had probable primary sclerosing cholangitis involving the gallbladder, and five (4%) had benign or malignant neoplasms. Our study indicates that gallbladder abnormalities are common among patients with primary sclerosing cholangitis, and sonography is the most useful technique for evaluating these conditions. PMID- 3277349 TI - The effervescent gallbladder: a sonographic sign of emphysematous cholecystitis. PMID- 3277350 TI - Vaginally induced pneumoperitoneum during pregnancy. PMID- 3277351 TI - Avulsion of the innominate artery associated with fracture of the sternum. PMID- 3277352 TI - Diagnosis of femoropopliteal venous thrombosis: comparison of duplex sonography and plethysmography. AB - Duplex sonography and impedance plethysmography were correlated with contrast venography to compare the sensitivity, specificity, and accuracy of the two noninvasive techniques for the diagnosis of femoropopliteal venous thrombosis. Sensitivity, specificity, and accuracy of duplex sonography were 90%, 100%, and 97%, respectively, when compared with venography in 32 patients. Sensitivity, specificity, and accuracy of plethysmography were 100%, 63%, and 72%, respectively, when compared with venography in 25 patients. In 21 patients, plethysmography was either nondiagnostic or could not be done because of clinical difficulties. Eighteen of these patients had diagnostic duplex examinations. Duplex sonography exhibits similar sensitivity but higher specificity than plethysmography. Duplex sonography also permits diagnostic examinations in patients in whom diagnostic plethysmography cannot be performed. PMID- 3277353 TI - Sonography of the radial artery at the wrist. AB - The radial artery as a superficial structure at the wrist is susceptible both to direct penetrating injury and to blunt trauma, with the potential development of both false and true aneurysms. This report summarizes the sonographic features of seven consecutive patients who were referred for evaluation of the radial artery. The diagnoses include two cases of radial artery aneurysm, one tortuous nonaneurysmal artery, two cases of arteriovenous fistulae (one surrounded by fluid and one aneurysmal), a ganglion, and an inflammatory mass of the wrist. Although radial aneurysms are unusual and angiography may be required to define the nature and extent of distal embolization to the hand, the nature of a palpable aneurysm in this region, vascular vs avascular, is easily and quickly assessed with high-resolution sonography. PMID- 3277354 TI - The "to-and-fro" sign: duplex Doppler evidence of femoral artery pseudoaneurysm. PMID- 3277355 TI - Acute scrotal abnormalities in children: diagnosis by combined sonography and scintigraphy. AB - Both scintigraphy and real-time sonography have been used to assess acute symptoms involving the scrotum. However, because of its high sensitivity and ability to document physiologic abnormalities, scintigraphy has been the procedure of choice. Scintigraphy, however, lacks specificity; its value lies mainly in serving to distinguish torsion from nontorsion. The purpose of this study was to supplement scrotal scintigraphy with sonography to determine if the combination improves diagnosis and management compared with scintigraphy alone. Forty-three scrotal scintigrams and sonograms were performed on 40 consecutive patients with acute scrotal symptoms. The interpretation of the scintigram was altered by sonography in six (14%) of the combined scans, directly affecting clinical management. In three patients with acute hydroceles diagnosed by sonography, exploratory surgery was avoided despite scintigraphic findings suggesting testicular torsion. Scintigraphy was normal in two patients with spontaneous testicular detorsion, whereas sonography showed recent spermatic-cord torsion that required subsequent orchiopexy. In a patient with epididymitis and orchitis, sonography showed a complicating scrotal abscess, which was not apparent on scintigraphy and which required antibiotic treatment. The addition of sonography to the scintigraphic evaluations of children with acute scrotal abnormalities changed the diagnosis and clinical management in 14% of the patients studied. PMID- 3277356 TI - Sonographic evaluation of ovarian torsion in childhood and adolescence. AB - Emergency sonographic examination of the pelvis was performed in 41 girls (mean age, 13 years old) with clinical suspicion of ovarian torsion. Sonographic features consistent with diffuse swelling of the ovarian parenchyma and follicular enlargement in the cortical zone were detected in eight patients and were considered highly suggestive for torsion of the ovary. Surgery revealed ovarian torsion in seven of these cases and hemorrhagic ovarian cyst in one case. A cystic or complex ovarian mass was detected by sonography in five additional cases, and ovarian torsion was included in the differential diagnosis. Surgery revealed ovarian torsion in four of these cases and hemorrhagic ovarian cyst in one. A 100% sonographic sensitivity for space-occupying disease of the ovary was obtained with a positive predictive value of 88% for the diagnosis of ovarian torsion. The specificity of the method was 93%. Sonography appears to be an excellent method to evaluate patients with suspected torsion of the ovary. PMID- 3277357 TI - Sonographic tissue pattern in neuroblastoma. PMID- 3277359 TI - The target sign in sonographic diagnosis of fetal hydrocele. PMID- 3277358 TI - Biliary atresia and gallbladder contraction. PMID- 3277360 TI - Noninfectious complications of long-term central venous catheters. PMID- 3277361 TI - Dipyridamole cardiac imaging. AB - Dipyridamole cardiac imaging is a useful alternative technique to exercise stress testing in the evaluation of patients with ischemic heart disease. Intravenous dipyridamole is still in the investigational phase, while oral dipyridamole is widely available. The hemodynamic effects of dipyridamole include an increase in coronary blood flow (due to coronary vasodilation) which is in excess of the increase in myocardial oxygen consumption and cardiac output. The disparity in the increase in coronary blood flow relative to the cardiac output results in an increase in myocardial thallium activity and an increase in the myocardial/background activity ratio. The quality of the thallium images is better or similar to that of exercise thallium images. The optimal dose of intravenous dipyridamole is 0.56 mg/kg, and of the oral dose it is 300 to 400 mg, although higher doses may be necessary in some patients. Analysis of the thallium images has been to a large extent based on visual inspection of the planar images. Delayed images are helpful to establish the nature of the perfusion abnormalities (transient or fixed). The process of redistribution is based on disparate rates of washout from the normal and abnormal zones. The sensitivity and specificity of dipyridamole thallium imaging, whether intravenous or oral, have been shown in a number of studies to be quite adequate and comparable to that achieved during exercise thallium imaging. Dipyridamole two-dimensional echocardiography has also been used in the detection of coronary artery disease; transient (new or worsening of preexisting) wall motion abnormalities have been found to be a specific marker of coronary artery disease. Transmural as well as regional coronary steal phenomena have been postulated as the mechanism for dipyridamole-induced regional wall motion abnormalities. Compared to exercise two dimensional echocardiography, dipyridamole echocardiography provides high-quality studies and in higher proportions of patients. The results of dipyridamole thallium imaging have also been extremely important in identifying high-risk patients after acute myocardial infarction or patients with peripheral vascular disease undergoing elective vascular surgery; the presence of a dipyridamole induced perfusion abnormality identifies patients at high risk for future cardiac events. Thus, dipyridamole cardiac imaging is helpful in the diagnosis of coronary artery disease and in risk stratification. PMID- 3277362 TI - Sucrose, coronary heart disease, diabetes, and obesity: do hormones provide a link? PMID- 3277363 TI - Calcium antagonists in acute myocardial infarction. AB - Calcium antagonists have proved effective in stable angina, unstable angina and vasospastic angina. However, despite a strong theoretical rationale for their use and promising experimental data, these agents have not reduced infarct size in acute myocardial infarction (AMI) in the large clinical trials performed to date. Their role as adjunctive therapy in combination with reperfusion needs to be examined. Diltiazem has been demonstrated to reduce angina and reinfarction in the 2-week period after AMI in patients receiving multidrug therapy. Results of the single large trial of a calcium antagonist (verapamil) for secondary prevention after AMI were negative; however, several well-designed studies are currently ongoing. PMID- 3277364 TI - Detection and prognosis of the asymptomatic patient with silent myocardial ischemia. AB - Detection of asymptomatic silent ischemia relies mainly on exercise screening procedures in (1) selected patient subgroups with increased likelihood of having latent coronary artery disease and (2) patients after infarction with uncomplicated courses. Prognosis in these patients varies, depending on the extent of disease and left ventricular dysfunction. The worst prognosis is found in patients with prior infarctions, 3-vessel disease and poor exercise tolerance. Prognosis is excellent in totally asymptomatic patients with only 1-vessel disease and good ventricular function. PMID- 3277365 TI - Death after acute myocardial infarction: interrelation between left ventricular dysfunction, arrhythmias and ischemia. AB - Patients who survive an acute myocardial infarction face an increased risk of sudden death for approximately 6 months after hospital discharge; their prognosis is determined by the severity of their coronary arteriosclerosis and the degree of left ventricular dysfunction. Frequent ventricular premature complexes and evidence of ischemia either spontaneously or on treadmill are also markers for early morbidity and mortality in patients who are discharged from the hospital after acute myocardial infarction. The degree of left ventricular dysfunction is the strongest predictor of mortality; patients who have both left ventricular dysfunction, frequent premature ventricular beats and evidence of ischemia are at the highest risk of mortality after hospital discharge. It appears likely that all 3 of these risk factors interact and that therapy to reduce morbidity and mortality after myocardial infarction should aim at the amelioration of each of these risk factors. A model for the interaction of these risk factors is proposed and an approach to treatment for patients at high risk of mortality after hospital discharge after myocardial infarction is suggested. PMID- 3277367 TI - Timing of cardiac transplantation in idiopathic dilated cardiomyopathy. AB - Seventy-nine patients with idiopathic dilated cardiomyopathy were assessed and followed up to evaluate 9 variables that might predict duration of survival after assessment for cardiac transplantation. Patients with ischemic heart disease, alcoholic and peripartum cardiomyopathy were excluded. There were 38 deaths (48%) during the 18-month (mean) follow-up. Patients underwent determination of left ventricular ejection fraction by radionuclide scan, echocardiography, cardiac catheterization and myocardial biopsy. Only left ventricular ejection fraction determined by radionuclide study correlated significantly with time to death in nonsurvivors (r = 0.38, p less than 0.05). Multivariant analysis and Cox multivariate regression analysis revealed that the single consistent determinant of prognosis was radionuclide-determined ejection fraction. It was an excellent predictor of survival to 3 months (p less than 0.0001) and a reasonable predictor of survival to 6 months (p less than 0.05). There was no variable that efficiently predicted survival for any period greater than 6 months. In 15 of 70 patients (21% of the entire group), clinical status and radionuclide ejection fraction improved after assessment but only one of these had an ejection fraction less than or equal to 0.10. No patient with a radionuclide ejection fraction greater than or equal to 0.20 died within 6 months of assessment. For those with ejection fraction between 0.11 and 0.19, survival after cardiac transplantation exceeded that of the natural history of their disease; this suggests that transplantation should be undertaken within 6 to 12 months of assessment. Left ventricular ejection fraction less than or equal to 0.10 predicts an extremely poor prognosis (6-month survival was 17%) and such patients should be transplanted with minimal delay. PMID- 3277368 TI - Randomized trial of prostacyclin infusion in acute myocardial infarction. PMID- 3277366 TI - A controlled trial of digoxin in congestive heart failure. AB - Because of conflicting results from studies examining the usefulness of digoxin in congestive heart failure (CHF) patients in sinus rhythm, a cross-over trial was conducted in which 20 patients received 7 weeks of digoxin titrated to a level of 1.54 to 2.56 nmol/liter and 7 weeks of matched placebo. The order of treatments was determined by random allocation and patients, clinicians and research staff were blind to allocation. In patients with deteriorating condition, the treatment period was terminated and outcome measures were obtained. If deterioration occurred during the first period, the patient was crossed over without the code being broken. Seven patients required premature termination of study periods because of increasing symptoms of CHF. All 7 were taking placebo at the time (p = 0.016). Small differences in dyspnea (p = 0.044), walking test score (p = 0.055), clinical assessment of CHF (p = 0.036) and ejection fraction (p = 0.004) favored the digoxin treatment group. Patients with more severe CHF were more likely to benefit from digoxin administration. It was concluded that oral digoxin, in doses titrated to produce a serum level of 1.54 to 2.56 nmol/liter, improved quality of life and functional exercise capacity in some patients with CHF in sinus rhythm. PMID- 3277369 TI - Diurnal variations of QT interval after cardiac transplantation. PMID- 3277370 TI - A XII century description of congestive heart failure. PMID- 3277371 TI - Glucagon secretion in anorexia nervosa. AB - Patients with anorexia nervosa frequently manifest impaired glucose tolerance. However, alterations in pancreatic glucagon secretion have also been associated with alterations in diabetes mellitus. For this reason, pancreatic alpha- and beta-cell responses to glucose load were measured in 25 anorexic patients both before and after treatment. The baseline glucose challenge failed to suppress plasma glucagon levels in the patients. However, in the control subjects and patients after treatment, glucagon levels were suppressed after glucose ingestion. Plasma glucose levels during the baseline challenge were significantly higher than those of the control subjects; however, after treatment glucose responses were nearly normal. Finally, insulin responses at baseline and after treatment were lower in the patients than in control subjects. These results suggest that the impaired glucose tolerance manifested by anorexic patients may be attributable to significant alterations in both pancreatic alpha- and beta cell secretions and in pancreatic alpha-cell and glucose interrelationships. PMID- 3277372 TI - Phase I trial of cisplatin and razoxane (ICRF-159) (NSC #119875) in advanced squamous cell carcinoma of the cervix. A Gynecologic Oncology Group Pilot Study. AB - Both cisplatin and razoxane have shown activity in squamous carcinoma of the cervix. Cisplatin at a dose of 50 mg/m2 intravenously every 21 days was combined with razoxane at two dose levels--750 mg/m2 weekly and 1150 mg/m2 weekly. Three patients were treated at the first dose level and six patients were treated at the second dose level of razoxane. No objective regressions were observed, and three patients refused to continue therapy at the higher dose of razoxane because of nausea and vomiting. Further study of this regimen in cervical cancer is not recommended. PMID- 3277373 TI - A phase II study on escalating interferon doses in advanced ovarian carcinoma. AB - Twenty-four patients with advanced and therapy-resistant ovarian carcinoma were treated with escalating daily doses of human leukocyte interferon (IFN). Doses ranged from 3 X 10(6) to 27 X 10(6) IU/day. Fatigue, fever, thrombocytopenia, and leukopenia were the limiting factors in the escalation of doses. Of nine patients treated for at least 2 months, there were two patients with partial remissions and six with stable disease. Ascites production present in four patients became reduced in three. The level of 2',5'-oligoadenylate synthetase in peripheral blood lymphocytes increased following initiation of IFN therapy. We conclude that IFN-alpha can exert an antitumor effect in some patients with ovarian carcinoma that have previously failed on other therapy regimens. PMID- 3277374 TI - Percutaneous hepatic arterial infusion of cisplatin-vinblastine for refractory breast carcinoma metastatic to the liver. AB - We treated 34 patients with breast carcinoma metastatic to the liver and refractory to prior chemotherapy with sequential hepatic arterial infusion of cisplatin and vinblastine in an attempt to enhance their antitumor activity. Following the administration of cisplatin at 100 mg/m2 i.v., the patients received a continuous arterial infusion of vinblastine at 1.7 mg/m2 daily for 5 consecutive days. Of 33 patients evaluable for response, eleven (33%) achieved partial responses and eight (24%) had minor responses. Median time to progression for responding patients was 31 weeks (range, 6+ to 74), and median survival was 11 months (range, 5-19). The adverse effects of the regimen were considerable, and seven failures were related to treatment intolerance or major toxicity. One patient who received vinblastine 2.0 mg/m2 daily developed a transient inappropriate secretion of antidiuretic hormone. Percutaneous hepatic arterial infusion of cisplatin and vinblastine has significant activity in the treatment of breast cancer metastatic to the liver, but subjective and objective treatment intolerance hamper the therapeutic value. PMID- 3277375 TI - Phase II trial of recombinant alpha-2b-interferon and low-dose cyclophosphamide in advanced melanoma and renal cell carcinoma. AB - The combination of Interferon and low-dose cyclophosphamide synergistically inhibits the growth of human breast cancer xenografts, explanted human non-small cell lung carcinoma, and other experimental tumors. To determine whether this combination would demonstrate clinical efficacy against refractory solid tumors, we used recombinant alpha-2b-Interferon, 10 MU/m2 subcutaneously three times per week, and cyclophosphamide, 25 mg orally twice daily, in 42 patients (25 renal cell carcinoma, 17 melanoma). Two patients were inevaluable due to premature removal from the study. The toxicity profile did not differ substantially from that of Interferon alone with malaise, fatigue, fevers, and chills predominating. Sixteen percent of patients experienced an alteration in mental status. Of 40 patients evaluable for response, there were two partial responders (one renal cell carcinoma, one melanoma) and four minor responders (all renal cell carcinoma). The responder with melanoma had previously failed therapy with dacarbazine (DTIC). Seventeen patients remained stable for a median follow-up of 6 months. We conclude that this regimen is well tolerated; however, the combination of Interferon and low-dose cyclophosphamide used in this way does not appear to be superior to the same dose and schedule of Interferon used alone. PMID- 3277376 TI - A phase I/II trial of whole-abdominal plus pelvic irradiation for Astler-Coller stage beta 2, C colorectal cancer. AB - From 1982 to 1986, after radical surgery (S) for carcinoma of the rectum and rectosigmoid colon, 25 consecutive patients were entered into a Phase I/II study exploring adjuvant radiation (RT). The latter was given with a single fraction of whole abdomen (mid-body) irradiation (MBI), followed by conventional whole pelvis irradiation (WPI). The minimum follow-up time was 12 months, and the maximum was 44 months. There was escalation of the single MBI dose: 5 Gy in 11 patients, 6 Gy in two patients, and 8 Gy in 10 patients. The 2-year survival rate has been 100 and 45% for Stages B2 and C patients. Only 1/7 Astler-Coller Stage B2 patients failed; this failure was in the lungs. Seven of 15 patients with Stage C failed: one locally, three in the liver, and three in the lungs. Single MBI doses greater than 5 Gy have yielded a high incidence of intestinal obstruction when combined with routine WPI. Consequently, this combination requires both some modification and careful attention if used in future trials exploring new treatment approaches for colorectal cancer. PMID- 3277377 TI - The consensus statements on adjuvant chemotherapy in breast cancer. Fact or artifact. AB - The decision of the National Cancer Institute, in November of 1985, in favor of adjuvant chemotherapy in the treatment of the premenopausal patient was based on the analysis of randomized clinical trials. The authors have carefully evaluated five papers dealing with the trials and found in each of them some problem in the performance or statistics which makes us question the interpretation of the findings of a statistically significant advantage for adjuvant chemotherapy in premenopausal patients. In view of this, we suggest that all the studies being considered need to be checked for their validity and if a significant number have similar flaws to those in the five trials noted, then we suggest that it is not possible to come to conclusions reported by the consensus panel. PMID- 3277378 TI - Tailgut cysts. Report of 53 cases. AB - Fifty-three examples of developmental "tailgut cysts" in the retrorectal space occurred predominantly in women and caused symptoms of mass effect or pain in 51%. The lesions were usually multicystic and lined by a variety of epithelial types, including ciliated columnar, mucin-secreting columnar, transitional, and squamous epithelium. Inflammation was present in 50%. In one patient a poorly differentiated adenocarcinoma was present. These cysts are most likely derived from remnants of the embryonic tailgut and differ from teratomas. Complete excision of the multilocular and multicystic process prevents recurrent draining sinuses and eliminates the possibility of malignant change. PMID- 3277379 TI - A tumor-associated antigen in carcinoma of the pancreas defined by monoclonal antibody B72.3. AB - A retrospective analysis of 25 primary adenocarcinomas of the pancreas, 16 metastatic pancreatic tumors, 8 cases of chronic pancreatitis, and 3 adult normal pancreas was performed to ascertain the reactivity of monoclonal antibody (MAb) B72.3 to malignant and nonneoplastic pancreatic lesions. Formalin-fixed, paraffin embedded sections of pancreas were evaluated by immunohistochemical techniques (avidin-biotin-peroxidase complex [ABC] method). Twenty-one of 25 malignant primary tumors were reactive, and all 16 metastatic sites expressed the B72.3 antigen. In contrast, all cases of pancreatitis and normal pancreas were either weakly reactive or nonreactive. Ten malignant and two benign pancreatic fine needle aspirates provided results similar to those seen with fixed tissues. Because MAb B72.3 has selective reactivity for primary and metastatic pancreatic cancer, it may be of value as a diagnostic adjunct in cytologic examination or for radioimmunodetection of regional and/or distant metastases of adenocarcinoma of the pancreas. PMID- 3277380 TI - Immunohistochemical analysis of oral lichen-planus-like eruption in graft-versus host disease after allogeneic bone marrow transplantation. AB - Immunohistochemical analysis of oral lichen-planus-like eruption (LPLE) in graft versus-host disease (GVHD) using monoclonal antibodies (MoAbs) was performed on five patients after allogeneic bone marrow transplantation (BMT) for leukemia. In the mucosal lesions of LPLE in GVHD, the major population of infiltrated lymphocytes in the areas of upper lamina propria (Lp), basal cell layer (Bc), and epithelium above the basal cell layer (Ep) were T-cells (Leu-1+, Leu-4+) and expressed the phenotype associated with suppressor/cytotoxic T-cells (Leu-2a+) rather than helper/inducer T-cells (Leu-3a+). Some of the infiltrated lymphocytes in the areas of Lp, Bc, and satellite cell necrosis (SCN) bore interleukin-2 (IL 2) receptor. HLA-DR antigen was expressed on keratinocytes in the LPLE lesions. Immunoelectron micrographs showed various degrees of degeneration of keratinocytes to which Leu-2a+ cells attached, whereas those with accidentally attached Leu-3a+ cells preserved normal structures. These findings suggest that cellular immunity mediated by cytotoxic T-cells may play a major role in the pathogenesis of oral LPLE in GVHD. PMID- 3277381 TI - Penicillin-resistant Streptococcus pneumoniae. Report of a case and results of a clinical laboratory proficiency survey in Minnesota. AB - An elderly woman with Streptococcus pneumoniae meningitis relatively resistant (minimum inhibitory concentration, [MIC] = 0.12 micrograms/mL) to penicillin is reported. The occurrence of penicillin-resistant pneumococcal infections is reviewed and management discussed. Because of the importance of recognition of resistant pneumococci, a state-wide clinical laboratory survey was conducted to determine the accuracy of susceptibility testing for this isolate. Of 111 laboratories completing the survey, only 26 performed the 1-microgram oxacillin disk test as recommended by the National Committee for Laboratory Standards (NCCLS). When laboratories were analyzed according to hospital size, the proficiency in performing the proper susceptibility testing was 55% (6 of 11) for hospitals with more than 400 beds versus 3% (2 of 58) for hospitals with fewer than 100 beds (P less than 0.0001 by Fisher's exact test). This contrasts with reported surveys by the College of American Pathologists (CAP), and reasons for this are explored. Guidelines for laboratory testing of S. pneumoniae are reviewed, and additional study of clinical proficiency with attention to laboratory size is recommended. PMID- 3277383 TI - A laboratory evaluation of the tensile bond strength of some orthodontic bonding resins to enamel. AB - In this in vitro study, the tensile bond strengths of three two-paste and four no mix orthodontic bonding resins applied to etched enamel were determined. One hundred ninety-six extracted human teeth were used to prepare 14 bonded test specimens for each of the seven resin systems evaluated. The tensile bond strengths were expressed in MN.m-2 and the data were analyzed by a one-way analysis of variance at the 5% level of significance and with a procedure of multiple comparisons with the best resin. The tensile bond strengths were not significantly different (P = 0.5065). PMID- 3277382 TI - 1987 H. P. Smith award lecture. Eyes for the epidemiologist: the pathologist's role in shaping our understanding of the asbestos-associated diseases. AB - Asbestosis was first recognized as an entity at autopsy by a pathologist in 1900. Pathologists also discovered the unique relationship of mesothelioma and bronchogenic carcinoma with exposure to asbestos. The observations of preceding pathologists have provided insights that have served as the basis for epidemiologic studies associating asbestos with disease in humans. PMID- 3277385 TI - Renal transplantation in the infant and young child. AB - Fourteen renal transplantations were performed in 13 children, aged 5 years or younger, including three infants. The mean duration of follow-up was 68 months, with a range of 14 to 203 months. Eleven children are alive; of these, nine had prolonged graft function. Graft survival rate was 92% at one year and 73% at two and five years following surgery. Sustained catch-up growth occurred in all growth-retarded children who underwent successful transplantation. At this writing, the oldest patient is 20 years of age and a junior in college; all school-age children are functioning at the appropriate grade level, except one, who is one year behind. The youngest child is 3 years old and is developing normally. Infants and young children appear to be good candidates for renal transplantation. PMID- 3277384 TI - Short-term hemodynamic effects of captopril in infants with congestive heart failure. AB - We studied the short-term hemodynamic effects of captopril in ten infants with congestive heart failure secondary to large left-to-right shunts who were refractory to routine medical management with digoxin and diuretics. During cardiac catheterization, captopril (0.5 to 1.0 mg/kg) was administered by nasogastric tube. For the entire group, mean systemic blood flow, pulmonary blood flow, and the pulmonary-to-systemic blood flow ratio did not change significantly after captopril administration. However, in the seven patients in whom baseline systemic vascular resistance was greater than 20 U/m2, captopril decreased the pulmonary-to-systemic blood flow ratio. In contrast, in the three patients in whom baseline systemic vascular resistance was less than 20 U/m2, captopril increased the pulmonary-to-systemic blood flow ratio. We conclude that captopril acutely decreases the pulmonary-to-systemic blood flow ratio in infants with large left-to-right shunts who have elevated systemic vascular resistance. Renal function must be monitored closely when using captopril. PMID- 3277386 TI - The AJDC archives. January 1911. Amaurotic family idiocy. By Isaac A. Abt. PMID- 3277387 TI - Short-course antibiotic therapy for urinary tract infections in children. A methodological review of the literature. AB - We performed a methodological review of 14 published clinical trials of short course (less than or equal to 4 days) vs conventional (seven to ten days) antibiotic therapy for urinary tract infection in children. Four reviewers independently assessed each study, without knowledge of authorship, according to 35 criteria, 14 of which were considered critical for this type of study. Reviewer ratings were summed so that any study could receive a potential score of 140 for all criteria and 56 for the critical criteria. Only one study met more than 75% of all the criteria, whereas four studies met 75% of critical criteria. Two studies found short-course antibiotic therapy significantly less effective than conventional therapy. The remaining 12 had insufficient sample size to warrant the conclusion that the two therapies were equivalent. We conclude that there is insufficient evidence to warrant the use of short-course antibiotic therapy for urinary tract infection in children and that a much larger study, with attention to some of the details described, is warranted. PMID- 3277388 TI - The effect of prophylactic acetaminophen administration on reactions to DTP vaccination. AB - To determine the effect of prophylactic acetaminophen on reactions after diphtheria and tetanus toxoids and pertussis vaccination, 282 children received either acetaminophen or placebo in a double-blind, randomized fashion before and 3, 7, 12, and 18 hours after vaccination. Fever and local and systemic reactions were monitored. Switching to known acetaminophen was permitted if the patient's temperature was 38.9 degrees C or higher or for moderate pain. Overall, the reaction score of acetaminophen recipients was significantly less than that of placebo recipients. The rates of occurrence of fever and fussiness and the degree of pain at the injection site were significantly reduced by acetaminophen administration. Children who received acetaminophen were less likely to be switched to "open" acetaminophen than placebo recipients. It is concluded that prophylactic acetaminophen as given in this study had a moderating effect on fever, pain, and fussiness after diphtheria and tetanus toxoids and pertussis immunization. PMID- 3277389 TI - Herpes zoster in children with acute lymphocytic leukemia. AB - Herpes zoster (HZ) occurred in 25% (28/88) of a population of children with acute lymphocytic leukemia (ALL) who were seropositive for varicella zoster virus antibody before its onset; 16.5% (33/199) of the total group of children with ALL developed HZ. There were no deaths and only one significant complication, cutaneous disseminated disease, as a result of HZ. The small number of patients studied may have accounted for the failure to find a significant association between the occurrence of HZ and the type of ALL or chemotherapy protocol employed. Although HZ seemed to be more common in those patients who experience relapses of their leukemia, it did not portend a poor outcome for ALL. PMID- 3277390 TI - Imaging evaluation of the human nipple during breast-feeding. AB - A new real-time ultrasound technique was employed to document in vivo the anatomic characteristics of the human nipple during breast-feeding. The study quantifies human nipple deformation and provides a description of the mechanics of normal sucking derived from 16 normal infants aged 60 to 120 days. This in vivo imaging technique has great potential value in the study of feeding dysfunction. PMID- 3277391 TI - Infant botulism in Asia. PMID- 3277392 TI - Efficacy of TAC topical anesthetic for repair of pediatric lacerations. AB - A prospective evaluation of 103 consecutive children who received TAC (tetracaine, epinephrine [adrenaline], cocaine) liquid topical anesthetic for the repair of their minor dermal lacerations was performed. A unique method of TAC application was used that consisted of applying the medication to the inner margins of the wound cavity and allowing it to stand for several minutes prior to the application of a TAC-saturated gauze pad to the wound surface. Of 670 sutures placed, 637 (95%) were done without eliciting pain. The TAC topical anesthetic was more than 95% effective in providing complete anesthesia for wounds located on the face and lip; it was equally efficacious in anesthetizing larger wounds (greater than or equal to 5 cm in length and/or greater than or equal to 5 mm in depth). No adverse reactions resulted from the application of TAC. A single wound healing complication occurred in 103 patients. TAC is a safe, effective method for anesthetizing minor lacerations of the skin in children. Its painless method of application relieves patient discomfort and maximizes patient compliance during the repair procedure, both of which enhance the accurate approximation of lacerated tissue. PMID- 3277393 TI - Thyroid scanning, ultrasound, and serum thyroglobulin in determining the origin of congenital hypothyroidism. AB - Congenital hypothyroidism (CH) can be due to an absent gland (athyrosis), an ectopic gland (usually lingual), or an inborn metabolic error (goiter). In this study, radionuclide scanning was compared with ultrasound (US) and serum thyroglobulin (Tg) concentration as a method of determining the cause of CH in 50 newborns. Mean serum Tg values were significantly lower in athyrotic children (7.9 pmol/L) than in either those with goitrous (149.1 pmol/L) or ectopic (60.5 pmol/L) glands, but there was marked overlap among all three groups. With the interpreter "blinded" to the radionuclide diagnosis, a cervical gland could be delineated reliably on US. All 12 goiters and five of five normal glands were identified. In contrast, the correlation between US and radionuclide scanning was poor in patients in whom there was no cervical thyroid tissue. Ultrasound failed to identify 13 lingual glands and was reported as normal in four of 12 children with no radionuclide uptake in the neck and biochemical hypothyroidism. Two children with absent thyroid glands on scanning were biochemically euthyroid. The serum of two others who had normal results of radionuclide studies showed persistent hypothyroidism. Thyroid scanning remains the most accurate diagnostic modality to determine the cause of CH. Serum Tg and cervical US have not been established as reliable alternatives. PMID- 3277394 TI - The current role of computerized tomography in inflammatory disease of the bowel. AB - CT has had a major and still evolving role in the diagnosis and management of inflammatory diseases of the bowel. The advantages of CT over conventional contrast examinations in these conditions include direct visualization of the bowel wall, detection of extramural disease, definition of the type and severity of such disease, visualization of all of the abdominal structures in one examination, and the noninvasive nature of the procedure. The current role of CT in diagnosis and management of these disorders varies. In diverticulitis, we believe CT should be used as the primary method of investigation, as well as for evaluation of complications. If surgical resection is not contemplated, the CT diagnosis should be confirmed by CE. In most cases of appendicitis, the diagnosis is still most accurately made clinically; radiographic evaluation should be reserved for cases with atypical clinical presentations. We advocate the use of CT as the first diagnostic procedure in these patients; if CT does not offer conclusive evidence of the diagnosis, contrast enema can be performed. In Crohn's disease, conventional barium studies remain the examinations of choice for diagnosis; CT should be used to evaluate possible complications and as a guide for proper management. Inflammatory colitides other than Crohn's disease primarily affect the mucosa, and are therefore best evaluated by barium enema; CT offers little additional information in these disorders. In all cases, conventional contrast studies and CT should be considered complimentary rather than exclusive procedures. In difficult cases, both examinations may be needed for complete evaluation. PMID- 3277395 TI - Coexisting adenocarcinoma and malignant lymphoma of the stomach: case report and review of the Japanese literature. AB - After a diagnosis of advanced carcinoma, a 77-yr-old female underwent gastrectomy. A 6 X 5 cm ulcerative mass in the angle was shown to be differentiated adenocarcinoma in the surrounding wall, and malignant lymphoma in the bottom. Carcinomatous infiltration was limited to the muscularis mucosae. Neither generalized lymphoma nor locoregional lymph node metastasis of either neoplasm was noted. A survey of 35 Japanese patients, including our own case with the two coexistent neoplasms in the stomach, revealed that the male-to-female ratio was 2.3:1, with no significant difference between the mean age of the sexes. The prevalence of adenocarcinoma in its early stage (60% of 35 patients) and of a histologically differentiated type (85% of 27 patients) of adenocarcinoma is quite different from that of usual Japanese gastric carcinoma, and it may suggest that there are some factors influencing the coexistent development of both neoplasms. PMID- 3277396 TI - Squamous papilloma of the esophagus: a case report and review of the literature. AB - A case of squamous cell papilloma of the esophagus in a 70-yr-old white woman is reported. The literature is reviewed, summarized, and tabulated. This study found that the average age of a person with a squamous cell papilloma of the esophagus was 51.5 yr, with an associated male:female ratio of 1.8:1 (39M:22F). Additionally, most squamous papillomas were single (52) rather than multiple (9), most were located in the distal one-third of the esophagus (41), and symptoms at presentation were diverse, although epigastric pain was the chief complaint in 27 patients. PMID- 3277397 TI - Benzene and leukemia. A review of the literature and a risk assessment. AB - Benzene is widely recognized as a leukemogen, and the Occupational Safety and Health Administration is currently attempting to limit exposure to it more strictly. The proposed new regulation is a limit of an eight-hour time-weighted average of 1 ppm in place of the current limit of 10 ppm. The fundamental rationale for the change is a perception that the current standard is associated with an inordinate excess of leukemia. The epidemiologic literature on benzene and leukemia supports the inference that benzene causes acute myelocytic leukemia. However, the available data are too sparse, or suffer other limitations, to substantiate the idea that this causal association applies at low levels (i.e., 1-10 ppm) of benzene. Nonetheless, under the assumption that causation does apply at such low levels, a number of authors, including ourselves, have performed risk assessments using similar data but different methodologies. The assessments that we consider acceptable suggest that, among 1,000 men exposed to benzene at 10 ppm for a working lifetime of 30 years, there would occur about 50 excess deaths due to leukemia in addition to the baseline expectation of seven deaths. However, this estimate is speculative and whether or not enough confidence can be placed in it to justify a lower occupational benzene standard remains a decision for policy makers. PMID- 3277398 TI - The community-based randomized trials of pharmacologic treatment of mild-to moderate hypertension. AB - The value of pharmacologic treatment of mild-to-moderate hypertension remains controversial despite the availability of data from eight community-based randomized trials including over 34,000 subjects with entry diastolic blood pressures ranging from 85 to 120 mmHg. To obtain more reliable estimates of the effects of treatment, the authors conducted an overview of the data from all of these individual trials, and they found a significant 18% reduction in vascular mortality among subjects allocated to treatment, due chiefly to reductions in fatal stroke and myocardial infarction. Subjects allocated to treatment experienced highly significant reductions of approximately 40% in all stroke (typical odds ratio = 0.60, 95% confidence interval = 0.51-0.71) and fatal stroke (0.58, 0.44-0.77). For myocardial infarction, the proportional reductions were much smaller than those for stroke and were 9% for all and 8% for fatal events. While suggestive of protective effects, the typical odds ratios did not achieve statistical significance for either all (0.91, 0.82-1.01) or for fatal myocardial infarction (0.92, 0.78-1.08). This overview demonstrates a significant benefit of pharmacologic treatment of mild-to-moderate hypertension on vascular mortality and on all as well as fatal stroke. It also suggests possible benefits of treatment on all and fatal myocardial infarction which should be investigated further. PMID- 3277399 TI - Metastatic extramedullary plasmacytoma: a case report and review of the literature of a rare pseudocarcinoma. AB - Extramedullary plasmacytomas are unusual plasma cell tumors arising outside the bone marrow. Most extramedullary plasmacytomas are solitary, but occasionally they disseminate, usually in conjunction with systemic myelomatosis. The authors report a case of disseminated extramedullary plasmacytoma with a picture suggestive of metastatic pancreatic carcinoma. This unusual presentation reconfirms the need for tissue diagnosis in all suspected cases of pancreatic carcinoma and demonstrates that extramedullary plasmacytoma can be an aggressive cancer without any sign of osseous or systemic disease. PMID- 3277400 TI - Early use of OKT3 monoclonal antibody in renal transplantation to prevent rejection. AB - OKT3 monoclonal anti-T cell antibody was used during the first 2 weeks following cadaveric renal transplantation to prevent rejection. When compared with a control group receiving triple immunosuppression with cyclosporine, azathioprine, and prednisone, the OKT3, azathioprine, and prednisone group had significantly fewer acute rejections during the first month (6% v 50%; P less than 0.01), and the mean time of onset of the first rejection was significantly delayed (day 47 v day 8; P less than 0.01) in the OKT3 prophylaxis group. OKT3 was administered intraoperatively safely and without complications on the day of transplantation. The well-reported first dose reaction to OKT3 was similar in these patients when compared with patients receiving OKT3 for treatment of rejection. Anti-OKT3 antibody development occurred in half of the patients receiving OKT3, and did not prevent the subsequent use of OKT3 in these patients, whose rejections following OKT3 prophylaxis were steroid reversible. There were no deaths among the patients receiving prophylactic OKT3, and during a 15-month follow-up, only three of 34 kidneys were lost for any reason. In addition to its use for primary and steroid resistant rejection, OKT3 may be useful early after transplantation to prevent rejection. PMID- 3277402 TI - Immunologic monitoring during and after OKT3 therapy. AB - Immunologic monitoring should be undertaken during and for 6 weeks after OKT3 treatment. CD3 absolute cell determinations should be obtained three times per week during therapy. A progressive increase of the absolute CD3 cell count above 10/microL is suggestive of an inadequate OKT3 serum level, most often due to an early antimurine response. Weekly posttherapy antimurine response should be determined. The presence or absence of an antimurine response can be suggestive of a successful response to a second therapeutic course of OKT3. PMID- 3277401 TI - Complications and monitoring of OKT3 therapy. AB - Complications of OKT3 therapy were studied in 122 treatment episodes in renal allograft recipients (83 for rejection treatment, 39 for immunosuppression induction). A febrile first-dose reaction to OKT3 was common; no severe pulmonary complications were encountered. Other toxicities of OKT3 therapy were observed later in the treatment course. Most severe were the occurrence of aseptic meningitis in four patients (3%), and seizures in eight (6%). Seizures occurred only when OKT3 was given to patients with nonfunctioning grafts due to acute tubular necrosis. Infections were the only significant late adverse sequelae of OKT3 therapy and occurred more frequently after multiple exposures to the drug (53%) than after a single exposure (22%). IgG antibodies to OKT3 developed after 45% of exposures to the drug in the 74 patients in whom appearance of anti-OKT3 antibodies was monitored. In two patients (3%), anti-OKT3 antibodies were detected before the end of the OKT3 treatment course, neutralizing the immunosuppressive property of the drug. In five patients (7%), strong anti-OKT3 antibody responses were present at the time of subsequent rejection, which precluded reuse of the drug. In 17 other cases, no or only a weak anti-OKT3 response was detectable at the time of rejection following initial OKT3 exposure. Retreatment with OKT3 was successful in reversing rejection in 15 cases (88%). No untoward sequelae were noted after reexposure to OKT3, except the high incidence of subsequent infections. PMID- 3277403 TI - The use of monoclonal antibodies in fine needle aspiration biopsy of the renal transplant. AB - This report deals with the clinical application of monoclonal antibody techniques to fine needle aspiration biopsy (FNAB) of the renal transplant. The technique was deemed to be quite helpful in corroborating cell type analysis made by classical cytochemistry (Giemsa staining), and determination of the nature of the lymphoid subset at play in rejection. The role of activation marker analysis and class 2 alloantigen analysis in particular for rejection was also discussed. PMID- 3277404 TI - OKT3 monoclonal antibody in heart transplantation. AB - OKT3 monoclonal antibody (OKT3) has already proved to be a valuable edition to the immunosuppression armamentarium available in cardiac transplantation. It is highly effective in treating refractory rejection, where approximately 90% of subjects may be salvaged. It may be even more valuable in prophylaxis, where in combination with an antibody suppression strategy and low-dose, "delayed" cyclosporine it appears to afford near complete protection against rejection. Moreover, OKT3-based prophylaxis seems to impact favorably on the rejection rate after the prophylaxis course has been completed. Adverse reactions are common and generally manageable, although occasional serious clinical events do occur. PMID- 3277405 TI - Experience with OKT3 in vascularized pancreas transplantation. AB - With refinements in technical aspects of whole organ pancreas transplantation, allograft rejection is currently the major cause of graft failure. The monoclonal antibody OKT3 has emerged as a highly effective antirejection therapy in renal and hepatic allograft recipients, but its efficacy in pancreas transplantation remains to be determined. During a 12-month period, 28 vascularized whole organ pancreas transplants were performed with pancreatico-cystostomy. Sixteen episodes of allograft rejection were treated with monoclonal antibody OKT3. Indications for OKT3 use included steroid- or antilymphocyte globulin (ALG)-resistant allograft rejection in isolated pancreas (n = 8) or simultaneous kidney-pancreas (n = 8) transplants. A total of 34 rejection episodes occurred in the 16 patients (mean, 2.1; range, one to five). The diagnosis of rejection was based on clinical criteria, a reduction in urinary amylase clearance, radionuclide scanning, hyperglycemia, or associated renal allograft dysfunction in combined engraftments. Postoperative immunosuppression consisted of cyclosporine, prednisone, azathioprine, and prophylactic ALG. OKT3 was administered for a full 14-day course concomitant with low-dose steroids, azathioprine, and cyclosporine. The mean age of the patient population was 32.1 years (range 24 to 39) with a mean duration of insulin-dependent diabetes mellitus (IDDM) of 20.9 years. Monoclonal antibody therapy was instituted in two clinical settings: early rejection (within 3 months of transplant, n = 10); and late rejection (after 3 months, n = 6). OKT3 successfully reversed allograft rejection in ten (62.5%) cases, including six early (60%) and four late (66.7%) episodes. In isolated pancreas transplants, OKT3 therapy reversed pancreas allograft rejection in only two patients (25%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277406 TI - Treatment of acute graft-versus-host disease with anti-CD3 monoclonal antibodies. AB - A dose-escalation trial was carried out to determine the efficacy and safety of using an IgG2a anti-CD3 monoclonal antibody to treat acute graft-v-host disease (GVHD) in marrow transplant recipients. Two patients received the antibody as the initial treatment of GVHD, and 22 patients received the antibody after failure of initial treatment with corticosteroids, cyclosporine, antithymocyte globulin (ATG), or combined ATG and cyclosporine. Antibody was administered at four dose levels, beginning at approximately 0.015 mg/kg/d and increasing by threefold increments. The initial doses of antibody were nearly always associated with fever and chills, and treatment had to be discontinued in one patient because of intolerable side effects. Improvement in skin disease could be reliably achieved at a dose of 0.15 mg/kg/d, but threefold higher doses appeared to be necessary for improvement in the liver or gut. In no case was there complete resolution of all manifestations of disease, and all patients surviving after antibody treatment required additional immunosuppressive treatment. Four patients developed Epstein-Barr virus (EBV)-associated lymphoproliferative disorders within seven to 18 days after starting antibody therapy. The overall risk of this complication in patients not given anti-CD3 monoclonal antibody is less than 1%. Anti-CD3 antibody represents an effective immunosuppressive agent for treatment of acute GVHD, but this treatment is associated with a substantial risk of EBV associated lymphoproliferative disorders. PMID- 3277407 TI - Monoclonal antibodies for organ transplantation: prospects for the future. AB - Monoclonal antibodies (MoAbs) have the potential to facilitate the induction of transplantation tolerance. Realization of this potential requires both a better understanding of the cellular events concerned with rejection and tolerance, and a more detailed approach to improving antibodies for therapy. This report reviews work in our laboratory directed toward these goals. PMID- 3277408 TI - Evaluation of the lysis-centrifugation system for culturing dialysates from continuous ambulatory peritoneal dialysis patients with peritonitis. AB - Recovery of organisms from continuous ambulatory peritoneal dialysis (CAPD) patients with peritonitis presents special problems to the laboratory. The Isolator (Dupont Co, Wilmington, DE), based on lysis and centrifugation, is generally used for the recovery of blood isolates. This study determined the efficacy of the Isolator relative to the Bactec System (Johnston Laboratories, Inc, Towson, MD) for the culture of dialysates from CAPD patients with peritonitis. On the basis of clinical criteria, 31 episodes of peritonitis were included for our study. Dialysate was inoculated into an Isolator and Bactec 6B and 7D bottles. A causative agent was isolated by the Isolator in 29 of 31 episodes, by the Bactec in 29 of 31, and by one or both techniques in 30 of 31 episodes (overall sensitivity 97%). The Isolator failed to detect a Pseudomonas luteola and the Bactec failed to detect a coagulase-negative staphylococcus. Coagulase-positive and negative staphylococci represented 58.1% of the isolates. The Isolator detected 21.4% (six of 28) of the isolates 24 to 72 hours earlier than the Bactec; the Bactec was faster in this regard in 3.6% (one of 28). Time to positivity for the remaining 21 cultures was the same in both systems. Isolate identification and antimicrobial sensitivity was available 24 hours earlier using the Isolator in 96.4% (27 of 28). The Isolator was more rapid and as sensitive as the Bactec system in detecting causative organisms of peritonitis in CAPD patients. PMID- 3277409 TI - Membranous nephropathy in a bone marrow transplant recipient. AB - A bone marrow transplant recipient is described who had development of nephrotic syndrome in association with chronic graft-versus-host disease (GVHD) and on cyclosporine (CsA) treatment withdrawal. Renal biopsy revealed a membranous glomerulonephritis (MG). The possible relationship between this autoimmune disorder, the immunological features of GVHD in experimental animals, and the influence of CsA is discussed. PMID- 3277410 TI - Multiple myeloma in a renal transplant recipient. PMID- 3277411 TI - National Kidney Foundation Conference. Use of monoclonal antibodies in organ transplantation. June 26-27, 1987, Scottsdale, Arizona. Proceedings of a consensus conference. PMID- 3277413 TI - Use of a brief steroid trial before initiating OKT3 therapy for renal allograft rejection. AB - OKT3 (Ortho Pharmaceutical, Raritan, NJ) has been employed in a protocol where all patients received cyclosporine as part of their baseline immunosuppressive regimen and, after the diagnosis of rejection was established, were treated with up to three pulses of methylprednisolone before monoclonal antibody therapy was initiated. Use of this protocol has allowed 46% of rejection episodes encountered to be treated on an outpatient basis without resorting to inpatient use of OKT3, but has avoided delaying OKT3 therapy until after all other methods of rejection treatment were found to be ineffective. Of 83 rejection episodes treated with OKT3 between March 1985 and May 1987, 78 (94%) were reversed. Overall graft survival is 84% and patient survival is 96% in OKT3-treated patients. Of the 17 rejection episodes where OKT3 treatment was a second or third exposure to the drug, rejection was successfully reversed in 15 (88%). In cadaver donor allograft recipients transplanted between March 1985 and May 1986, actual 1-year graft survival is 80% for 30 patients requiring no rejection therapy, 80% for 20 patients with rejection episodes responding quickly to steroids, and 82% for 28 patients with OKT3-treated, steroid-insensitive rejections. Mean serum creatinine at 1 year posttransplant is 1.5 +/- 0.5; 1.9 +/- 0.7; and 2.1 +/- 0.8, respectively, for these groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277412 TI - A comparison of OKT3 monoclonal antibody and corticosteroids in the treatment of acute renal allograft rejection. AB - The monoclonal antibody OKT3 (Ortho Pharmaceutical, Raritan, NJ) was utilized in two separate protocols for treatment of acute renal allograft rejection in patients receiving cyclosporine, azathioprine, and prednisone for maintenance immunosuppression. In Group I, 54 patients received steroids for primary treatment of acute rejection with OKT3 used for resistant rejections and second rejection episodes. In Group II, 34 patients received OKT3 as primary treatment of acute rejection while steroids were used for rescue and second rejection episodes. OKT3 successfully reversed 82% of initial acute rejection episodes in Group II as compared with a 63% reversal with steroids in Group I. Rescue treatment was required in only 15% of Group II patients compared with 33% of Group I patients. Overall patient survival was 96% and 94%, respectively, for steroid primary and OKT3 primary treatments. Allograft survival at 3 months was identical, 74% in both groups. Based on allograft survival data, OKT3 is equally effective either as primary treatment for allograft rejection, or for rescue therapy if initial corticosteroid treatment fails. PMID- 3277414 TI - Assessment of indapamide in elderly hypertensive patients with special emphasis on well-being. AB - One hundred forty-nine patients between 56 and 80 years of age with mild to moderate hypertension received indapamide (2.5 mg per day) monotherapy for 12 weeks. In addition to studies of the efficacy and tolerance of indapamide, the study comprised an assessment of well-being, which was carried out objectively by the physician, and subjectively by the patient himself, by means of a list of complaints and a visual analogue scale. The mean blood pressure was lowered from 179/91 mm Hg (supine) before treatment to 149/81 mm Hg at the end of the treatment. The general well-being of the patients, as judged by the physician, showed a markedly positive evolution. The patients themselves indicated that their most frequent symptoms, such as sleep disorders, functional organic disturbances, and sensory and motor fatigue, had improved by 65 to 85 percent, indicating a tendency to better compliance. PMID- 3277415 TI - Sodium and large arteries in hypertension. Effects of indapamide. AB - Epidemiologic studies evaluating arterial pulse wave velocity together with blood pressure indicate that: (1) salt intake has an independent effect on arteriolar tone and arterial wall properties, with the former indirectly and the latter directly contributing to increased arterial stiffness with age; and (2) normotensive adult subjects who follow a low sodium diet have reduced arterial stiffness and this effect is independent of blood pressure. Conversely, in elderly persons with isolated systolic hypertension, isotonic saline infusion causes a predominant increase in systolic pressure due to an increase in the stiffness of the arterial wall. The diuretic indapamide produces a decrease in blood pressure without significant change in brachial artery diameter. The result indicates a shift of the pressure-diameter curve, reflecting for the first time in humans a pharmacologic effect of the drug on arterial vessel. Furthermore, diuretic drugs may increase arterial distensibility and compliance in hypertensive patients, but this effect seems to be more pronounced in older than in younger subjects. In the latter, either activation of the sympathetic nervous system or potassium depletion, or both, might counteract the improvement in arterial distensibility caused by blood pressure reduction and sodium depletion. Based on epidemiologic, clinical, and pharmacologic studies, this critical review suggests that, in patients with essential hypertension, changes of sodium intake in diet or administration of diuretics, or both, affect the status of large arteries independently of blood pressure changes. PMID- 3277416 TI - Effect of indapamide on phosphate metabolism and vascular reactivity. AB - The effect of indapamide, a nonthiazide diuretic, on urinary electrolytes, renal hemodynamics, and tissue inorganic phosphate was examined in normal anesthetized rats, as well as on vascular reactivity in vitro. Intravenous injections of 0.5 ml/kg of 1 x 10(-5), 1 x 10(-4), and 1 x 10(-3) M indapamide solutions reduced mean arterial pressure from 123 to 114, 130 to 113, and 128 to 114 mm Hg and the plasma phosphate concentrations from 6.4 to 4.2, 6.6 to 4.8, and 7.0 to 4.5 mg/dl, respectively. Similarly, there was a dose-dependent effect of indapamide on fractional excretion of phosphate, which increased from 17 to 44, 24 to 53, and 18 to 75 percent in animals receiving increasing doses of indapamide. This effect of indapamide on the external phosphate balance was associated with significant reduction of kidney cortex and skeletal muscle total inorganic phosphate. In contrast, fractional sodium excretion augmented by 2.6, 2.5, and 2.5 percent, respectively, at each dose of indapamide. This compound also reduced significantly the contractions of strips of rabbit aorta and mesenteric artery elicited by norepinephrine (0.01 to 1.0 micrograms/ml). These results suggest that indapamide-induced reduction of blood pressure could be mediated by an effect of this drug on phosphate balance, and probably on vascular reactivity. PMID- 3277417 TI - Current controversies in the treatment of hypertension. AB - Three controversies in the treatment of hypertension are reviewed. The first involves the decision whether to treat mild hypertension. Little consensus currently exists in this area and recent trial evidence is reviewed. Second, the basis of choosing specific drugs is discussed; biochemical profiling has not been overly successful, but demographic profiling and benefit profiling are to be commended. Third, the salt controversy is reviewed. On a population basis, lowering salt intake may be beneficial. PMID- 3277418 TI - Importance of well-being to hypertensive patients. AB - Well-being may be adversely affected in hypertensive patients by the disease process and its complications, other concomitant diseases, especially depression and anxiety, and the treatment prescribed. The adverse consequences of both pharmacologic and nonpharmacologic treatment are discussed, with emphasis on the psychologic consequences of such treatment. The wider impact of side effects on the daily lives of patients is discussed--the quality-of-life approach. Areas considered include work performance and leisure activities. The problem of interpreting any changes in quality-of-life measures is considered. PMID- 3277419 TI - Analysis of well-being and 24-hour blood pressure recording in a comparative study between indapamide and captopril. AB - The effects of indapamide and captopril on office and ambulatory blood pressure control and on general well-being were investigated in 30 active, randomly selected patients from 25 to 68 years old, with mild to moderate essential hypertension (diastolic blood pressure, 92 to 114 mm Hg). Twenty-four-hour ambulatory blood pressure monitoring using an ICR model 5200 portable recorder and evaluation of general well-being were performed prior to and at the end of three months of therapy with indapamide 2.5 mg given once daily, or captopril 12.5 to 50 mg given twice daily. Indapamide and captopril were equally effective in controlling blood pressures in clinic and during 24-hour activities. Although general well-being and subjective symptomatology improved with both treatments, the only significant difference between the two drugs was improvement in the sleep dysfunction scale with indapamide (p less than 0.02). The results shown in this study suggest that both indapamide (2.5 mg) once daily and captopril (12.5 to 50 mg) twice daily are suitable drugs for initial therapy of active patients with mild to moderate hypertension. A fixed once-daily dosage of an antihypertensive agent may, however, increase patient compliance and convenience. PMID- 3277420 TI - Tolerability and well-being with indapamide in the treatment of mild-moderate hypertension. An Italian multicenter study. AB - Since hypertension is an important risk factor of cardiovascular morbidity and mortality that can be at least in part decreased by pharmacologic reduction in elevated blood pressure, it is necessary that an antihypertensive agent be effective, but at the same time well tolerated and, according to some recent hypotheses, have no deleterious effect on serum electrolyte levels, as well as lipoprotein and glucose tolerance. However, due to different cultural and social backgrounds, lifestyles, and so on, the tolerability may differ from one population to another and the conclusions drawn from a population cannot be extrapolated to people of other countries. For these reasons, the well-being of patients, as well as the tolerability of indapamide, a non-thiazide diuretic, have been investigated in patients with hypertension of mild and moderate degree from different parts of Italy with a satisfactory blood-pressure response to this drug (-22.8 +/- 0.6/-17.1 +/- 0.5 mm Hg). Simultaneous to the significant blood pressure reduction, the only significant change among the metabolic effects was a slight reduction in plasma potassium levels (-0.37 +/- 0.03 meq/liter). The tolerability was, on the whole, very good with a tendency toward an improvement of well-being in patients, the majority of whom were already asymptomatic before starting the treatment. PMID- 3277421 TI - Renal function in hypertension. AB - Hypertension certainly accelerates the age-related changes in renal structure and function, mainly in the glomerulus. Both sodium handling and the renin angiotensin system are involved in the aging process. Among the available classes of antihypertensive agents, the eventual deterioration of renal function induced by angiotensin-converting enzyme inhibitors in bilateral stenosis and stenosis of a single functioning kidney suggests that changes in glomerular pressure may participate in the changes of renal function. In essential hypertension and other conditions, it is possible that at a certain stage an increase in intraglomerular capillary pressure plays a role in the acceleration of the loss in renal function. As a consequence, it is proposed that in treating hypertension we should aim at reducing systemic blood pressure together with an attempt to reduce intraglomerular pressure using agents that act predominantly on post-glomerular resistance in order to have renal protection. PMID- 3277422 TI - The atherogenic risk of antihypertensive therapy. AB - The past 20 years have demonstrated the unqualified success of antihypertensive therapy in reducing morbidity and mortality from cardiovascular and cerebrovascular disease. Evidence mounts, however, that certain antihypertensive agents may, themselves, have an adverse effect on the development and progression of cardiovascular disease. The dramatic reductions in the incidence of cerebrovascular events and congestive heart failure among patients receiving antihypertensive therapy have not been paralleled by similar reductions in cardiac morbidity or mortality. Several lines of evidence now point to the possibility that adverse metabolic changes are induced by certain antihypertensive drugs. These changes may offset, negate, or even reverse the potential benefit afforded by successful blood pressure control. PMID- 3277423 TI - Antihypertensive therapy in diabetic patients. The use of indapamide. AB - Abnormalities in glucose tolerance in nondiabetic patients and rapid alteration in non-insulin-dependent diabetics have been reported with antihypertensive drugs such as beta-blockers or thiazide diuretics. Such deleterious effects on a cardiovascular risk factor could limit the long-term benefit of an antihypertensive treatment. Indapamide is a nonthiazide antihypertensive agent that appears to respect the glucose tolerance in hypertensive patients. The present study was conducted to assess the effects of indapamide 2.5 mg in 10 hypertensive non-insulin-dependent diabetic patients treated for a one-year period. Glucose tolerance was evaluated using a 50-g oral glucose test, with measurements of plasma glucose and insulin before and after treatment. At the end of the one-year treatment, both systolic and diastolic blood pressure were significantly reduced, whereas there was no significant alteration in either plasma glucose or plasma insulin levels. Thus, indapamide appears as an effective antihypertensive agent in the diabetic patient, with no adverse effects on the glucose tolerance. PMID- 3277424 TI - Hypertension in the elderly. AB - The incidence of definite hypertension increases with advancement of age, and one third of the elderly population is affected. Isolated systolic hypertension is frequent in this population (10 to 12 percent in subjects between 65 and 74 years of age). The role of hypertension as a cardiovascular risk factor has been confirmed in the elderly population by the increase in cerebrovascular accidents, and by the incidence of myocardial infarction with the rise in blood pressure. The relationship between elevated diastolic and systolic blood pressure and mortality rates in the elderly is also well documented (Framingham). Effective treatment of hypertension significantly reduces the risk of associated complications: cardiovascular death, congestive heart failure, and stroke. However, the goal of antihypertensive therapy in the elderly should be not only to reduce morbidity and mortality rates, but also to do so without adverse effects on the functional well-being of patients. PMID- 3277425 TI - Diabetes and exercise. PMID- 3277426 TI - Home care charting dos and don'ts. PMID- 3277427 TI - Pulmonary hypoplasia testing in clinical obstetrics. AB - An ultrasound-based diagnostic test for predicting pulmonary hypoplasia antenatally by measurements of fetal chest circumference was applied prospectively to 45 patients at risk for developing this disorder. The outcome for the newborn infant and the autopsy findings were correlated with the antenatal prediction. The results of this test demonstrated a sensitivity and a specificity of 88% and 96%, respectively. The application of this test to clinical practice is recommended. PMID- 3277428 TI - The effects of some synthetic prostanoids on the contractility of the human lower uterine segment in vitro. AB - We have investigated the ability of three synthetic prostanoids to directly influence uterine contractility by studying the effects in vitro. Strips of lower uterine segment smooth muscle were obtained from women undergoing elective cesarean section at term. The ability of these strips to develop tension in the presence of cumulative additions of prostanoids or oxytocin was assessed. Spontaneous contractions were inhibited by ZK 96.480, a stable synthetic analog of prostaglandin I2, with a 50th percentile effective concentration (EC50) of 8 nmol/L. Both sulprostone, an analog with selectivity for some of the actions of prostaglandin E2, and U-44069, a stable thromboxane A2 mimetic, caused excitation with EC50s of 20 and 16 nmol/L, respectively. The EC50 for oxytocin was 6 nmol/L. There were no significant differences in the maximal tensions developed in response to the excitatory prostanoids or oxytocin. PMID- 3277429 TI - Ultrasonic evaluation of fetal body movements over twenty-four hours in the human fetus at twenty-four to twenty-eight weeks' gestation. AB - Continuous 24-hour observations of fetal gross body movements were performed in 20 women between 24 and 28 weeks of gestation by means of real-time ultrasound examination. At 24 to 26 weeks, fetuses moved 13.1% +/- 0.3% of the time, which was not significantly different from the incidence of 12.4% +/- 0.8% at 26 to 28 weeks' gestation. An examination of the number of movements per hour demonstrated that fetuses at 24 to 26 weeks' gestation moved on the average 53.4 +/- 1.6 times/hr, which was significantly different from 26 to 28 weeks' gestation when fetuses made 46.2 +/- 1.4 movements/hr. When examined on an hourly basis, fetuses in both age groups demonstrated a significant increase in the number of movements overnight from 2300 to 0800 hours. Intermovement intervals were also examined. Ninety-nine percent of intervals less than 6 minutes in both age groups contained movement. The longest observed quiescent interval was 24 minutes in both age groups. These data suggest that the incidence of fetal body movements is different than that observed in fetuses during the last 10 weeks of gestation. Fetuses at 24 to 28 weeks' gestation exhibit a diurnal pattern of fetal movement and move more frequently than do older fetuses. However, these movements are of a sporadic nature and relatively short duration. Thus these fetuses do not appear to have well-defined periods of rest and activity. PMID- 3277430 TI - Patterns of fetal breathing activity in the human fetus at 24 to 28 weeks of gestation. AB - Continuous 24-hour observations of fetal breathing were performed in 20 normal, pregnant women between 24 and 28 weeks' gestation by real-time ultrasound. Fetuses made breathing movements approximately 14% of the time. No change in breathing activity after a maternal meal was observed, but a significant increase in the incidence of fetal breathing activity was noted overnight. Fetuses at 24 to 28 weeks' gestation breathed at a rate of 44 breaths per minute, and the longest period of apnea noted was 14 minutes. These data suggest that the pattern and incidence of fetal breathing at 24 to 28 weeks' gestation are different from those of fetuses observed in the last 10 weeks of pregnancy. A maturational process in the control of fetal breathing may explain these observations. PMID- 3277431 TI - Obstetric consequences of postmaturity. AB - The obstetric management of 340 pregnancies delivered 2 or more weeks postterm and 1408 pregnancies delivered at 41 weeks is compared with that of 5915 pregnancies delivered at 39 to 40 weeks. In all patients menstrual dating was confirmed by early ultrasonographic examination. Postterm labor in primiparas resulted in a high cesarean section rate because of failure to progress; this increased rate was observed even after controlling for induction of labor and the size of the infant. We suggest that primiparas who go postterm often have increased uterine dysfunction. Uterine dysfunction accounts for the increase in the cesarean section rate and is a partial explanation for "failed" inductions. PMID- 3277432 TI - Transabdominal chorionic villus sampling in the second trimester. AB - Transabdominal chorionic villus sampling under ultrasound guidance was carried out in 19 patients in the second trimester. We found that needle size combination 17/19 provided the best results with consistently adequate samples of tissue. Transabdominal chorionic villus sampling is a potentially useful technique for providing relatively rapid prenatal genetic diagnosis in patients at high risk in the second trimester. PMID- 3277433 TI - Sonographic detection of fetuses with trisomies 13 and 18: accuracy and limitations. AB - Nine fetuses having trisomy 13 and 15 fetuses with trisomy 18 were diagnosed by cytogenetic studies and also underwent a sonogram between 15 and 40 weeks. All nine fetuses with trisomy 13 had been prospectively identified as having sonographic findings suggestive of trisomy 13. Twelve of the 15 fetuses with trisomy 18 had sonographic abnormalities compatible with trisomy 18. Findings included abnormalities of the face and head, extremities, and diaphragmatic hernia. This report examines criteria for the ultrasound diagnosis of trisomies 13 and 18 and describes the accuracy of prenatal sonography for these diagnoses. PMID- 3277434 TI - Management of quintuplet pregnancy by selective embryocide. AB - Selective embryocide was performed as a two-stage procedure in a patient with a quintuplet pregnancy in the first trimester. No complications occurred, and the patient was delivered of healthy twins at term. This procedure may be offered to selected patients with pregnancies with greater than five embryos. PMID- 3277435 TI - A comparison of mezlocillin versus clindamycin/gentamicin for the treatment of postcesarean endomyometritis. AB - In a prospective, randomized study of 96 patients after cesarean section who had endomyometritis, there was a therapeutic cure in 35 of 47 (74.5%) patients who received mezlocillin, in comparison with 42 of 49 (85.7%) patients who received clindamycin and gentamicin (p = 0.17). Only wound infections in the study population were predictive for therapeutic outcome. Four of the five patients who received mezlocillin and none of the three patients who received clindamycin and gentamicin with wound infections were associated with therapeutic failures. This suggests mezlocillin may not be as effective as clindamycin and gentamicin in successfully treating wound infections. The number of vaginal examinations in patients sectioned for cephalopelvic disproportion was associated with increased febrile morbidity, suggesting that an excessive number of vaginal examinations should be avoided in the laboring patient. PMID- 3277437 TI - The diagnosis and treatment of bilateral masked superior oblique palsy. AB - I reviewed retrospectively the records of 147 consecutive patients who had superior oblique palsy. Of the 147 patients, 28 had bilateral superior oblique palsies, and in nine of the 28 the involvement was so asymmetric that the palsy in the lesser affected eye was either completely masked or almost masked preoperatively. Relying on preoperative diagnostic criteria such as the presence of bilateral objective torsion, cover testing in the oblique fields of gaze, size of the subjective cyclotropia, amount of the "V" shift, and subjective symptoms, all nine patients underwent bilateral surgery at the time of their initial operation and obtained satisfactory results. No patient was later found to have bilateral masked superior oblique palsy after unilateral surgery. PMID- 3277436 TI - A double-masked comparison of carteolol and timolol in ocular hypertension. AB - We performed a double-masked study in which 98 patients with ocular hypertension who had been previously treated with timolol received either timolol 0.25% or carteolol 1%, a beta-blocker with intrinsic sympathomimetic activity. The drugs were administered topically twice daily for one month after a one-week washout period. Intraocular pressure was measured at baseline and after one and four weeks of treatment. The appearance of the fundus, external eye, visual fields, tear secretion, blood pressure, and pulse were recorded. Adverse symptoms were elicited using a menu-type questionnaire and an overall judgment of therapy was recorded. Carteolol was as effective as timolol in reducing intraocular pressure. There were significantly fewer patients reporting adverse events overall (P = .019), and eye irritation specifically (P = .02), in the group treated with carteolol. PMID- 3277438 TI - Absence of Chlamydia in trachomatous lacrimal sacs. AB - We performed lacrimal sac biopsies in 35 patients who underwent dacryocystohinostomies in Saudi Arabia. The nasolacrimal duct obstructions were presumably secondary to trachoma in 22 cases and unknown in the remaining 13 cases. Lacrimal sac specimens were submitted for routine histopathologic examination and the direct-smear fluorescent antibody test. All specimens were negative for chlamydia. Possible reasons for the low detection rate of chlamydia in the trachomatous group were the frequent finding of clinically inactive disease, common canalicular obstruction, and loss of the epithelial lining in the lacrimal sac. PMID- 3277439 TI - Systemic factors affecting diabetic macular edema. PMID- 3277440 TI - Evidence for the nonmuscle nature of the "myofibroblast" of granulation tissue and hypertropic scar. An immunofluorescence study. AB - Contraction is an important phenomenon in wound repair and hypertrophic scarring. Studies indicate that wound contraction involves a specialized cell known as the myofibroblast, which has morphologic characteristics of both smooth muscle and fibroblastic cells. In order to better characterize the myofibroblast, the authors have examined its cytoskeleton and surrounding extracellular matrix (ECM) in human burn granulation tissue, human hypertrophic scar, and rat granulation tissue by indirect immunofluorescence. Primary antibodies used in this study were directed against 1) smooth muscle myosin and 2) nonmuscle myosin, components of the cytoskeleton in smooth muscle and nonmuscle cells, respectively, and 3) laminin and 4) fibronectin, extracellular glycoproteins mediating cell-matrix attachment in smooth muscle and nonmuscle cells, respectively. Myofibroblasts can be identified by their intense staining of actin bundles with either anti-actin antibody or NBD-phallacidin. Myofibroblasts in all tissues stained for nonmuscle but not smooth muscle myosin. In addition, nonmuscle myosin was localized as intracellular fibrils, which suggests their similarity to stress fibers in cultured fibroblasts. The ECM around myofibroblasts stains intensely for fibronectin but lacks laminin, which suggests that a true basal lamina is not present. The immunocytochemical findings suggest that the myofibroblast is a specialized nonmuscle type of cell, not a smooth muscle cell. PMID- 3277441 TI - Mechanism of pseudoductular (tubular) formation during pancreatic carcinogenesis in the hamster model. An electron-microscopic and immunohistochemical study. AB - Electron-microscopic and immunohistochemical studies performed during pancreatic carcinogenesis in hamsters demonstrated that hypertrophy and hyperplasia of centroacinar cells were the earliest changes occurring in the pancreas. These altered centroacinar cells differentiated into either endocrine-type cells or elongated agranular cells with remarkably long cytoplasmic processes (CyPs). These CyPs seemed gradually to overlie and underlie the adjacent acinar cells and resulted in progressive degeneration and loss of acinar cells, which subsequently were replaced by altered centroacinar cells. The initially rather tiny and slender CyPs were characterized by the expression of blood group substances, which were also found in the surface of altered ductal cells. Because these antigens could not be demonstrated in normal pancreatic cells, they seemed to represent specific markers for altered ductal/ductular (centroacinar) cells. In no instance was there evidence of dedifferentiation of acinar cells into ductlike cells. The present data, along with our previous findings, demonstrate that centroacinar cells are the foundation for pseudoductular structures and are the progenitor cells of tumors arising from them. PMID- 3277443 TI - The effect of geochemical factors on prevalences of dental diseases for prehistoric inhabitants of the state of Missouri. AB - In previous epidemiological studies, it has been suggested that geochemical factors besides fluoride may affect the prevalences of dental diseases. Our objective in this study was to determine whether the prevalences of periodontal diseases, coronal caries, and root caries for prehistoric inhabitants vary between geochemical regions of the state of Missouri. Burial sites were located on unique maps that depict geochemical variation among regions of the state. Data on dental caries and alveolar bone loss were gathered from 179 of the best preserved skeletal remains of the Late Woodland (A.D. 400-900) and Mississippian (A.D. 900-1700) periods. Mean caries scores and proportions of individuals with caries were calculated for these geochemical regions. Average alveolar bone loss was regressed on age for the individuals of these regions. Significant differences in caries and bone loss were found between several regions. These differences cannot be adequately explained by fluoride concentrations or by diet. It is suggested that geochemical factors, in addition to fluoride, may have affected the prevalences of dental diseases. PMID- 3277444 TI - A note on the presence of blood groups A and B in pre-Columbian South America. AB - The results of ABO typing in Chilean mummies, a review of published South American paleoserological studies and a systematic discrepancy of admixture estimates based on ABO and Gm genes support the hypothesis that Andean pre Columbian populations possessed the A (and perhaps the B) gene in small frequencies. PMID- 3277442 TI - A heparin-binding angiogenic protein--basic fibroblast growth factor--is stored within basement membrane. AB - The basement membranes of bovine cornea are found to contain an angiogenic endothelial cell mitogen, basic fibroblast growth factor (FGF), as determined by heparin-affinity chromatography, immunoblotting, immunofluorescence, and stimulation of capillary endothelial cell proliferation. The growth factor appears to be bound to heparan sulfate and is released from the cornea by treatment with heparin, a hexasaccharide heparin fragment, heparan sulfate, or heparanase, but not by chondroitin sulfate or chondroitinase. These findings indicate that basement membranes of the cornea may serve as physiologic storage depots for an angiogenic molecule. Abnormal release of this growth factor could be responsible for corneal neovascularization in a variety of ocular diseases. Physiologic and pathologic neovascularization in other tissues may also be initiated by release of stored angiogenic factors from the basement membrane. The sequestration of angiogenic endothelial mitogens in the basement membrane may be a general mechanism for regulating their accessibility to vascular endothelium. PMID- 3277445 TI - Diachronic patterns of change in structural properties of the femur in the prehistoric American Southwest. AB - Diachronic patterns of change in the femoral diaphysis are examined in archaeological skeletal samples from the American Southwest. Three cultural periods differing in subsistence-settlement strategies are represented: Early Villages (A.D. 500-1150), Abandonments (A.D. 1150-1300), and Aggregated Villages (A.D. 1300-1540). Relevant properties of cross-sectional geometry and bone density were obtained using computerized tomography. Temporal trends in geometry suggest that activity levels increased between Early Villages and Abandonments, then declined during Aggregated Villages. In both sexes, femoral shape became more circular, and bending stresses were reduced in the a-p plane through time. Compared to the other periods, bone density was the lowest during Abandonments in both sexes. The reduction in bone density may reflect declining nutritional quality through time that was especially poor during the Abandonments period. Patternings in sexual dimorphism suggest that Abandonments males may have been more sensitive to nutritional stress than contemporary females. PMID- 3277446 TI - Possible case of hyperparathyroidism in a Roman period skeleton from the Dakhleh Oasis, Egypt, diagnosed using bone histomorphometry. AB - A histomorphometric study of thin femoral head sections of a skeletal sample from the Dakhleh Oasis, Egypt, dated from circa 36 B.C. to 400 A.D., identified an adult female (Dk31-A1) in her mid-50s with a high percentage resorption surface with tunneling resorption as is typically found in hyperparathyroidism. Five static histomorphometric bone parameters were measured with the following results for this individual: 1) mean wall thickness, 41.94 micron, 2) trabecular bone volume, 18.54%, 3) surface volume, 4,070 mm2/cm3, 4) mean trabecular diameter, 132 microns, and 5) total resorption surface, 12.31%. The overall histomorphometric features and differential diagnosis support the diagnosis of hyperparathyroidism. We conclude that histomorphometry of dried bone, particularly in this case where preservation is ideal, is a valuable investigative technique for paleopathology. PMID- 3277447 TI - What is "truth"? Some philosophical contributions to psychiatric issues. AB - Philosophical perspectives, although eminently relevant to clinical investigation and practice, are rarely brought to bear on psychiatric topics. The author attempts to raise professional consciousness of core issues in the philosophy of science by examining the status of truth, theory, and observation in psychiatry. He evaluates prominent approaches to the problem of knowledge, particularly those of the "subjectivists" and "relativists," such as Schafer and Spence, and the "empiricists" and "inductivists," such as the proponents of DSM-III. Drawing on contemporary philosophy of science, the work of William James, and the classical Greek conviction that more truth resides in the middle than at either extreme, the author mediates between these rival points of view. PMID- 3277448 TI - Cerebral structural pathology in schizophrenia: evidence for a selective prefrontal cortical defect. AB - To replicate earlier findings of central and cortical cerebral structural abnormalities and to further examine specific prefrontal cortical irregularities in schizophrenia, the authors examined computerized tomographic (CT) scans of 71 patients with chronic schizophrenia and 30 normal volunteer control subjects for ventricle-brain ratio (VBR), third ventricle width, and prominence of cortical markings in a generalized (parieto-occipital) distribution compared with the prefrontal area. Patients showed significantly larger VBRs and third ventricle widths than control subjects. Patients also showed significantly greater prefrontal markings in terms of both the number of individuals affected and the degree of difference. The relative differences on measures of VBR and prefrontal atrophy did not appear gender related, but the difference in third ventricle width between schizophrenic and control women was greater than that between schizophrenic and control men. PMID- 3277450 TI - A controlled trial of brief psychotherapy and mutual-help group treatment of conjugal bereavement. AB - Sixty-one women who sought treatment for unresolved grief reactions 4 months to 3 years after the death of their husbands were randomly assigned to either brief dynamic psychotherapy with experienced clinicians or mutual-help group treatment led by nonclinicians. Women in both groups experienced a reduction in stress specific and general symptoms as well as improvement in social and work functioning. Women in the brief psychotherapy group showed a greater decline in one measure of general symptoms, and there was greater attrition in the group treatment condition. When two subgroups who had completed the majority of sessions were compared, treatments were found to be equally effective. PMID- 3277449 TI - Cognitive, behavioral, and emotional problems among school-age children of alcoholic parents. AB - Sixty-four children from 37 families with an alcoholic parent were compared with 80 children from 45 families that did not have an alcoholic parent on measures of intelligence, cognitive achievement, psychological and physical disorders, impulsivity-hyperactivity, social competence, learning problems, behavior problems, and self-esteem. On nine of 17 tests, the children of alcoholic parents scored less well than did the children of nonalcoholic parents, although both were within normal ranges. Factor analysis yielded significant differences between the two samples in emotional functioning and cognitive abilities and performance; marginally significant differences were found with respect to behavior problems. PMID- 3277451 TI - Psychiatry under prospective payment: experience in the first year. AB - The authors present data on changes in resource use by Medicare psychiatric patients in general hospitals after the introduction of the prospective payment system in 1984. Length of stay and charges per discharge during fiscal year 1984 fell 13.8% and 15.9%, respectively, after the new system began, even though 31.8% of the discharges for Medicare psychiatric cases were from exempt psychiatric units. The decrease in length of stay was considerably larger (23.2%) in hospitals with no psychiatric units, which were not exempt from prospective payment. PMID- 3277452 TI - Live or inactivated poliomyelitis vaccine: an analysis of benefits and risks. AB - Using decision analysis we evaluated the benefits and risks of continued primary reliance on oral poliomyelitis vaccine (OPV) compared to use of inactivated poliovirus vaccine (IPV). We followed a hypothetical cohort of 3.5 million children from birth to age 30 assuming 95 per cent coverage with 98 per cent effective vaccine. Primary reliance on IPV would result in more cases of paralytic poliomyelitis as well as more susceptibles remaining in the population than would be expected with continuing OPV use (74.1 vs 10.0 cases and 5.9 per cent vs 1.1 per cent susceptibles, respectively). However, with OPV use, most cases of paralysis seen would be associated with the vaccine. Our analysis supports a continuation of current US policy placing primary reliance on OPV but the conclusion is heavily dependent on assumptions of risk of exposure to wild virus in the United States. Major declines in risk of exposure to wild virus could alter the balance significantly. PMID- 3277453 TI - Polio immunization policy in the United States: a new challenge for a new generation. AB - The primary reason that live poliovirus vaccine is recommended in the United States today is because it may immunize contacts who have not otherwise chosen to be vaccinated. This policy places contacts at risk of paralysis from an untested, unlicensed "spread virus" vaccine and places infants at risk for an unproven, theoretical benefit to others, not themselves. The licensed killed poliovirus vaccine provides equivalent protection to those vaccinated, with no risk to recipients or contacts. The preceding analysis by Hinman, et al, is an interesting exercise in modeling, but many of their assumptions are open to question. Their sweeping conclusions are not justified by the type of analysis performed, which should yield an overall assessment of a decision environment not a single optimal choice. No measure of perceived social consequence or patient attitude is included, although this is of central importance today. Their report lends an aura of credibility to one conclusion, but this credibility is illusory at best. The major social issue today is not which vaccine to use, but how should polio immunization policy be evaluated. PMID- 3277454 TI - Decision analysis and polio immunization policy. AB - Dr. Salk's comments on our paper fall into four major categories: our use of the techniques of decision analysis, the assumptions we used, the fact that we did not include individual and social values in the model, and the way in which vaccine policies are developed in the United States. We believe that the methods were used correctly, that the assumptions we used are defensible, and that our conclusions were both appropriate and appropriately worded. We explicitly did not include individual and social values since we were addressing the scientific and epidemiologic issues rather than ethical and moral issues. Vaccine policy development in the United States is carried out in public forums with opportunity for presentation of all sides of an issue. PMID- 3277455 TI - Solomon Jacob Axelrod, MD, MPH, national leader in medical care organization (September 25, 1912-September 21, 1987). PMID- 3277456 TI - Expedited handling of transplantation biopsies. AB - The workload from the rapid handling of transplantation biopsies is increasing in many pathology laboratories. By using a novel tissue processor (the MED'LASS Paraffinator, F.R.G.) that employs continuously distilled acetone for tissue dehydration, it is possible to prepare high-quality hematoxylin-and-eosin sections in under 90 min. The slides are comparable to those processed by traditional methods and yield excellent results with special stains and immunohistochemical techniques. PMID- 3277457 TI - Bancroftian filariasis in Haiti: preliminary characterization of the immunological responsiveness of microfilaremic individuals. AB - Patent infections with the lymphatic filariae, Wuchereria bancrofti and Brugia malayi, are associated with suppressed in vitro cellular responsiveness to filarial antigens. In studies of bancroftian filariasis in Haiti, a significant number of microfilaremic individuals can be characterized as "responders" to filarial antigens. Cells from 37/74 untreated microfilaremic subjects responded to B. pahangi antigen (stimulation ratio greater than 2) as detected by in vitro blastogenesis. A comparison of responders to nonresponders revealed a significant difference in mean B. pahangi reactivity (15,822 vs. 4,538 cpm, P less than 0.001), but no significant differences with respect to age, microfilaremia, PPD or PHA reactivity, or B. pahangi-specific antibody levels. Subtle differences may exist between these groups with respect to recognition of specific antigens on Western blots. PMID- 3277458 TI - Analysis of dose-response curves for the in vitro susceptibility of Plasmodium falciparum to antimalarials using a pocket computer. AB - A small pocket computer, Sharp PC-1500, was programmed to analyze the dose response curves generated by the in vitro assay of antimalarials against field isolates of Plasmodium falciparum. Using nonlinear regression the analysis provided an estimate of the 50% inhibitory concentration with 95% confidence limits and a graph of the data points and regression function line. The pocket computer with the nonlinear regression program offers a powerful, portable, and inexpensive data analysis system suitable for field use. PMID- 3277459 TI - Evaluation of an in vitro assay system for drug susceptibility of field isolates of Plasmodium falciparum from southern Thailand. AB - An in vitro assay system has been developed to evaluate the susceptibility of field isolates of Plasmodium falciparum to standard and new antimalarials. The assay used drugs which were serially diluted in the field and determined effective drug concentrations by quantitating schizont maturation after a variable incubation period. Based on the ID50 values, a series of isolates from Yala in southern Thailand were shown to be resistant to chloroquine (187 nM) but only moderately resistant to amodiaquine (23.7 nM), a structurally related 4 aminoquinoline. Five aminocarbinols were evaluated. The parasites were resistant to quinine (219 nM), but comparatively much more susceptible to mefloquine (9.04 nM), halofantrine (1.23 nM), and enpiroline (6.23 nM). The isolates were also relatively sensitive to WR 194,965 (9.04 nM). Two dihydrofolate reductase inhibitors (WR 99,210 and pyrimethamine) were tested. The isolates were comparatively sensitive to a dihydrotriazine, WR 99,210 (2.85 nM). The in vitro values for pyrimethamine (1,870 nM) were higher than the values for the other drugs tested, but were less than values from other regions of Thailand. As compared to a survey conducted in this region four years previously, values for chloroquine, pyrimethamine, amodiaquine, and mefloquine have remained relatively unchanged. However, there was a greater than 20-fold rise in the susceptibility values for quinine, suggesting the introduction of quinine-resistant isolates from eastern Thailand into southern Thailand during this period. PMID- 3277460 TI - In vitro activity of pyronaridine against field isolates and reference clones of Plasmodium falciparum. AB - Pyronaridine, a 9-substituted 1-aza-acridine, was assayed for in vitro activity against clinical and field isolates as well as characterized clones of Plasmodium falciparum. The in vitro antimalarial activity of pyronaridine was compared to activities of standard antimalarials against multidrug-resistant isolates of P. falciparum from eastern and northern Thailand using an assay based on the inhibition of schizont maturation. Isolates from eastern Thailand (n = 30) were susceptible to pyronaridine (IC50 8.40 nM), mefloquine (IC50 6.97 nM), and amodiaquine (IC50 12.7 nM) and resistant to chloroquine (IC50 361 nM), quinine (IC50 388 nM), and pyrimethamine (IC50 11,800 nM). The isolates from northern Thailand (n = 7) showed no statistical difference in susceptibility to pyronaridine (IC50 10.1 nM), amodiaquine (IC50 7.29 nM), and mefloquine (IC50 5.48 nM); however, isolates were significantly more susceptible to chloroquine (IC50 167 nM), quinine (IC50 248 nM), and pyrimethamine (IC50 1,980 nM). These data suggest a lack of cross-resistance between pyronaridine and either chloroquine, quinine, or pyrimethamine. Using the same assay system the in vitro activity of pyronaridine was evaluated against isolates from treatment failures of mefloquine or enpiroline from eastern Thailand. The IC50 values for mefloquine against five recrudescent isolates were significantly higher (IC50 16.4 nM) than the field isolates collected from the same region (IC50 6.97 nM); however, there was no significant difference in the pyronaridine susceptibility between the isolates from the field study (IC50 8.89 nM) and the isolates from the treatment failures (IC50 8.40 nM). These observations suggest a lack of cross-resistance to mefloquine following treatment failure with either mefloquine or enpiroline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277461 TI - Field applications of an immunoradiometric assay for the detection of Plasmodium falciparum antigen in a population in a malaria-endemic area in Thailand. AB - Two surveys were made in people living in a malaria-endemic area in West Thailand in October 1985 (a transmission season) and in May 1986 (a nontransmission season) to detect Plasmodium falciparum antigen using the immunoradiometric assay (IRMA). In the first survey involving 101 people, the IRMA-positive rate was 56.4% and then significantly declined to 16.5% during the second survey involving 79 people of the same group. The parasitological-positive rates were likewise decreased from 11.9% to 1.3% (P = 0.015) during these two seasons. IRMA-positive rates were significantly higher than the corresponding parasitological-positive rates (P less than 0.0001 and 0.002 for the first and the second surveys, respectively). The geometric mean IRMA binding activity of samples collected in the first survey (1,726 cpm) was significantly higher than those collected during the second survey (920 cpm, P = 0.001). Regression analysis showed that IRMA activities were linearly correlated with the parasite counts by microscopic examination (r = 0.629, P = 0.022). IRMA was specific for P. falciparum since all 30 healthy controls and 6 of 7 vivax malaria cases were negative. PMID- 3277462 TI - Morphological effects of pyronaridine on malarial parasites. AB - The ultrastructural changes caused by a new antimalarial drug, pyronaridine, were investigated using mice infected with erythrocytic forms of Plasmodium berghei and P. falciparum cultivated in vitro in human erythrocytes. The first changes observed in both parasites after exposure to pyronaridine occurred in the food vacuoles. This suggests that the target organelle of this drug may be the food vacuole of malarial parasites. In addition, rapid alterations were also noted within the pellicular complex of both plasmodia. PMID- 3277463 TI - Lymphocyte responsiveness to a candidate malaria sporozoite vaccine (R32tet32) of individuals with naturally acquired Plasmodium falciparum malaria. AB - Lymphocyte proliferative responses to the candidate malaria sporozoite vaccine antigen R32tet32 were evaluated in 29 patients with acute Plasmodium falciparum malaria, 20 convalescent patients, 11 nonimmune individuals, and 22 healthy residents of two endemic malarious areas in Thailand. The results indicate that 14 of 20 (70%) convalescent patients and 14 of 22 (64%) residents of endemic areas responded to the R32tet32 antigen. However, only 8 of 29 (28%) patients with acute P. falciparum malaria responded. When 4 of the convalescent patients who remained in a malaria-free area were restudied 5-10 months after the acute infection, they were either not responsive or their responses had greatly diminished. These findings show that sensitization to R32tet32 occurs following a natural P. falciparum infection, but the cellular immune response to sporozoite antigens may be short-lived and may be suppressed during acute P. falciparum malaria. PMID- 3277464 TI - Diversity of Plasmodium vivax-induced antigens on the surface of infected human erythrocytes. AB - Antigens were demonstrated on the surface of Plasmodium vivax schizont-infected erythrocytes by an indirect immunofluorescence test using fresh unfixed infected erythrocytes from acute vivax malaria patients. Surface immunofluorescence was used to show that sera of P. vivax-infected individuals contain antibodies directed against these surface antigens. Thirteen different isolates were screened for reactivity of surface antigens with a panel of 8 heterologous human immune sera and an immune rabbit serum. Surface immunofluorescence was detected in several isolates with some but not all the human sera, and not all sera reacted with the "positive" isolates. These results indicate a high degree of polymorphism of the surface antigens of different P. vivax isolates. Sera from patients who had suffered multiple malaria attacks and the immune rabbit serum (which was raised by immunizing with 7 different isolates) recognized surface antigens on more isolates than sera from patients who had experienced only one attack of malaria, indicating that repeated exposure to the disease confers immunity against a spectrum of variants of a polymorphic malarial antigen(s) prevalent in nature. PMID- 3277465 TI - Canine American cutaneous leishmaniasis: a clinical and immunological study in dogs naturally infected with Leishmania braziliensis braziliensis in an endemic area of Rio de Janeiro, Brazil. AB - Clinical and immunological findings from 35 dogs infected with Leishmania braziliensis braziliensis are described. The majority of the dogs had ulcerated single lesions on the ears. Sera from all infected dogs showed detectable Leishmania-induced antibodies using an indirect fluorescent antibody test. Antimonial therapy resulted in prompt healing of the lesions in 80.9% of the animals followed by a significant reduction in the anti-Leishmania antibody titers. However, treatment follow-up showed recurrences at the site of the primary lesion in 42.8% of the cases. These data were correlated with a persistence of the parasite in clinically healed lesions as well as with a negative intradermal test (leishmanin-delayed type hypersensitivity) observed in all animals but one. PMID- 3277466 TI - Glomerulopathy in squirrel monkeys with acute Plasmodium falciparum infection. AB - The renal pathology of 9 squirrel monkeys (Saimiri sciureus) with acute Plasmodium falciparum infection was studied by light and electron microscopy. Endocapillary proliferative glomerulonephritis was the major pathological change observed. The peroxidase anti-peroxidase method demonstrated the presence of IgG, IgM, and P. falciparum antigens in the mesangium and basement membrane. These findings were consistent with those seen in humans with acute P. falciparum infection and indicates that squirrel monkeys are likely to be a good model for the study of renal pathology in malaria research. PMID- 3277467 TI - Regulation of pancreatic polypeptide secretion in the isolated perfused human pancreas. AB - The isolated perfused human pancreas was used as a model to assess factors mediating the pancreatic polypeptide cell response to glucose, insulin, gastric inhibitory polypeptide, and splanchnic nerve stimulation. Pancreases obtained from 18 cadaveric organ donors were isolated and perfused by way of the splenic artery utilizing a Krebs bicarbonate buffer in a single-pass perfusion system. Hormonal stimulation and inhibition of pancreatic polypeptide secretion were assessed, as was the influence of direct electrical stimulation of celiac neural fibers innervating the pancreas. In this in vitro human model, pancreatic polypeptide cell secretion was inhibited by hyperglycemia, although the presence of gastric inhibitory polypeptide augmented the pancreatic polypeptide cell response. Perfusion with low levels of insulin and splanchnic nerve stimulation augmented the response of the pancreatic polypeptide cell to hyperglycemia and gastric inhibitory polypeptide. Since the immunoreactive pancreatic polypeptide response was augmented when insulin and somatostatin release was inhibited by perfusion insulin or nerve stimulation, we conclude that the pancreatic polypeptide cell is regulated by the ambient degree of somatostatin release, insulin release, or both. These findings support a centrifugal pattern of intraislet blood flow. PMID- 3277468 TI - Duplex ultrasonography as a noninvasive technique for assessing portal hemodynamics. AB - Duplex ultrasonography was evaluated as a noninvasive, quantitative technique of assessing portal hemodynamic characteristics. Portal blood flow measured by duplex ultrasonography was significantly decreased in patients with portal hypertension (450 +/- 86 ml/min) compared with control subjects (874 +/- 44 ml/min; p less than 0.001). Quantitative assessment of portal blood flow by duplex ultrasound correlated with qualitative portal perfusion grading by angiography, and direction of flow was always accurately determined by duplex ultrasonography. Although the angiographic portal perfusion grade did not change significantly in the early postoperative period after distal splenorenal shunting, a decrease in mean portal blood flow of more than 50 percent was documented by duplex ultrasonography. Duplex ultrasonography appears to be at least as accurate as angiography and is an acceptable alternative to this more invasive technique for the longitudinal assessment of portal blood flow. PMID- 3277469 TI - High-resolution real-time ultrasonography. A new tool in the diagnosis of acute appendicitis. AB - A prospective study was performed to assess the sensitivity and specificity of ultrasonographic evaluation in 44 patients with suspected appendicitis. We found ultrasonographic evaluation to have a sensitivity rate of 89 percent, a specificity rate of 86 percent, and an overall accuracy rate of 87 percent. These results are very similar to those in other recently reported studies. We also identified certain patients in whom nondiagnostic studies are likely. Our results suggest that ultrasonographic evaluation may be of particular use in selected patients who do not demonstrate the classical signs and symptoms of acute appendicitis. PMID- 3277470 TI - The gut as source of sepsis after hemorrhagic shock. AB - In a model of severe hemorrhagic shock in rats, blood culture findings became positive within 2 to 4 hours of shock. The organisms cultured were primarily gram negative. To test the hypothesis that the gut was the source of the bacteria, E. coli labeled with carbon-14 oleic acid were fed to rats undergoing hemorrhagic shock. Their plasma was then assayed for carbon-14 activity. Seven of the 14 shocked animals demonstrated increased plasma carbon-14 activity during or after shock. The mortality rate was 100 percent 80 hours postshock, and all animals had E. coli on subsequent blood culture. The seven rats without increased plasma carbon-14 activity had a survival rate of 83 percent postshock. Sham-shocked animals did not exhibit plasma carbon-14 levels greater than the background levels. These data suggest that bacterial translocation occurs during hemorrhagic shock and that the gut is the source of the bacteremia seen during hemorrhagic shock. PMID- 3277471 TI - Diagnostic imaging techniques in thyroid cancer. AB - With the refinement of fine-needle aspiration, the specific applications of thyroid imaging techniques need to be reevaluated for efficiency and cost containment. No thyroid imaging test should be routinely obtained. Radionuclide scanning is most beneficial in evaluating the functional status of thyroid nodules when fine-needle aspiration is inadequate, the findings are benign, or when there is no discrete nodule that is palpated in an enlarged gland. When fine needle aspiration is unavailable or unreliable, radionuclide scanning becomes a first-line diagnostic tool. Ultrasonography should be used primarily for identifying a solid component of a cystic nodule, determining the size of nodules on thyroxine suppression that are not easily palpable, or for performing guided fine-needle aspiration. Computerized tomography and magnetic resonance imaging both have a definite role in the evaluation of thyroid tumors. Magnetic resonance imaging is superior to computerized tomography for the evaluation of metastatic, retrotracheal, or mediastinal involvement of large thyroid tumors or goiters. Careful selection of the diagnostic techniques will ensure more accurate diagnosis and reduce unnecessary patient costs in the treatment of thyroid cancer. PMID- 3277472 TI - Surgical gauze pseudotumor. AB - Gauze forgotten at operations can be potentially life threatening, but such cases are seldom reported because of the medicolegal implications. We have presented a series of seven patients with long-term surgical gauze retention, four after pelvic operations, one after cholecystectomy, one after laryngectomy, and one after mastectomy. The median time interval between operation and gauze removal was 5 years. In three patients this was diagnosed as a tumoral mass, in three as an intestinal occlusion, and in one the gauze was found incidentally. All foreign bodies were removed and no patient died. The clinical and diagnostic aspects of retained surgical gauze have been discussed and the need for radiopaque markers in them have been emphasized. PMID- 3277473 TI - Suturing techniques of surgeons utilizing two different needle-holder grips. AB - Sixteen surgeons familiar with grip 1 or grip 2 were randomly selected to test the accuracy of their suture method. The accuracy was tested in two ways: suture with and suture without wavering, while searching for an expected exit point after suturing started and by the distance deviated from a point in a 2 cm suture stride. With grip 1, the first and fourth fingers were put in the rings and the second finger was put around the leg of the holder, whereas with grip 2, all the fingers were put around the holder. Without waver, the mean value was 2 +/- 1.5 mm with grip 1 and 1.4 +/- 1.1 mm with grip 2 (p less than 0.01) and with waver, 1.2 +/- 1.1 mm and 1.1 +/- 10.9 mm (p value not significant). Wavering reduced the deviation (p less than 0.01 and p less than 0.05, respectively). In conclusion, the accuracy was not as precise as the surgeon expected and grip 2 was more accurate, although equivalent accuracy was gained by more wavering with grip 1, thus, there was a greater potential for injuring the tissue. PMID- 3277474 TI - Anticoagulation: a surgical perspective. AB - Heparin combines with antithrombin III, and the resulting complex inactivates several clotting factors (all are serine proteases) in the coagulation cascade, but the most important steps are inhibition of the conversion of factor X to Xa and the antithrombin effect. Heparin pharmacokinetics are poorly understood, but when the usual doses are given intravenously, heparin is rapidly removed from the blood and has a half-life of approximately 90 minutes. Warfarin is not a true anticoagulant but is readily absorbed after oral administration. It interrupts the coagulation mechanism by interfering with the vitamin K-dependent synthesis of prothrombin and factors VII, IX, and X. This process takes 4 to 5 days. The drug has a long half-life, and its activity is enhanced or blunted by many chemicals. The effective treatment of thromboembolism with heparin, followed by warfarin, requires a basic understanding of the complex pharmacologic aspects and drug interactions. PMID- 3277475 TI - Incidence and treatment of candida esophagitis in patients undergoing renal transplantation. Data from the Minnesota prospective randomized trial of cyclosporine versus antilymphocyte globulin-azathioprine. AB - Of 224 consecutive renal transplant patients in a prospective, randomized immunosuppressive trial, candida esophagitis developed in 5 despite nystatin prophylaxis. No differences were noted between cyclosporine and antilymphocyte globulin-azathioprine immunosuppressive treatment. All patients were diabetic, and four were recipients of cadaver kidneys. Candida esophagitis occurred within 6 months after transplantation, and only one patient had recurrence. All patients responded to treatment consisting of 2 to 6 days of intravenous amphotericin B (0.2 to 2 mg/kg total dose). The prevalence of candida esophagitis was not related to rejection episodes. Three of five patients eventually died, one 2 weeks after resolution of candida esophagitis from a hypoglycemic episode, one from acute exacerbation of pulmonary failure and relapsing pancreatitis in association with candida esophagitis and therapy-resistant candidemia, and one 17 months after candida esophagitis from pulmonary edema. Our findings show that candida esophagitis by itself is an easily managed complication, but is also a sign of potentially increased morbidity in these patients. PMID- 3277476 TI - Topical antibiotics in the high-risk biliary surgical patient. A prospective, randomized study. AB - This randomized, prospective study has evaluated the efficacy of topical antibiotics in preventing infective complications in patients undergoing high risk biliary surgery. Sixty-nine patients who underwent bile duct exploration, choledochoenteric anastomosis, or cholecystectomy, either for acute cholecystitis or because they were older than 65 years of age, were randomized to the following three groups: Group I, topical antibiotics alone (22 patients); Group II, cefoxitin and topical antibiotics (24 patients); and Group III, penicillin, tobramycin, clindamycin, and topical antibiotics (23 patients). The incidence of infective complications was no different among the groups. There was one wound infection in each group, one episode of bacteremia in Group II, and no intraabdominal abscesses. This study has demonstrated that parenteral antibiotics administered prophylactically in the perioperative period offer no additional benefit over the use of effective topical antibiotics used intraoperatively in patients undergoing high-risk biliary surgery. PMID- 3277477 TI - Bacterial microflora, endogenous endotoxin, and prostaglandins in small bowel obstruction. AB - The objective of this experimental study of small bowel obstruction was to investigate luminal bacterial colonization and assess the most likely mediator substances responsible for the pathophysiologic alterations, those being endogenous endotoxin and prostaglandins. Eighteen pigs with small bowel obstruction and 11 sham-operated control animals given constant infusion therapy were investigated over 7 days. Bacteria determinations were performed at operation and at sacrifice. Endotoxin levels were determined three times and prostaglandin levels, twice daily in portal and central venous blood. In the pigs with small bowel obstruction, greatly increased microflora with a predominance of E. coli bacteria was observed in the obstructed bowel. Endotoxin measurements proved general release into the circulation, with potentially toxic levels in the systemic circulation arising relatively late on the fourth postobstruction day. Beginning on the first postobstruction day, stimulation of the prostaglandin system occurred which was initially limited to the gastrointestinal tract but spread systemically when the obstruction persisted for more than 5 days. Vasoactive eicosanoids were predominantly involved. The control animals showed none of the alterations seen in the animals with small bowel obstruction. PMID- 3277478 TI - Mini-dose intrathecal morphine for the relief of post-cesarean section pain: safety, efficacy, and ventilatory responses to carbon dioxide. AB - To determine the safety, efficacy, and the ventilatory responses to carbon dioxide (CO2) of mini-dose intrathecal morphine, 33 healthy women who underwent cesarean section with spinal anesthesia using 0.75% bupivacaine in 8.25% dextrose were studied. Patients were randomly assigned to receive, in a double-blind fashion, either morphine 0.25 mg (group I, n = 11), morphine 0.1 mg (group II, n = 10), or saline (group III, placebo group, n = 12) in 0.5 ml volume mixed with the bupivacaine. In both groups I and II excellent postoperative analgesia with long duration was obtained (27.7 +/- 4.0 and 18.6 +/- 0.9 hours, respectively, X +/- SEM). All patients in group III required an analgesic (8 mg subcutaneous morphine) within 3 hours of spinal anesthesia. Seven patients in group I and four patients in group II developed mild pruritus that did not require treatment. Ventilatory responses to CO2 showed no evidence of depression attributable to either the 0.25 or 0.1 mg of morphine, but significant depression of the CO2 responses was observed in group III patients after administration of subcutaneous morphine. It is concluded that a dose as low as 0.1 mg of intrathecal morphine gives excellent analgesia with minimal to no side effects and that subcutaneous morphine is associated with marked depression of the ventilatory variables. PMID- 3277479 TI - The effect of incremental positive end-expiratory pressure on right ventricular hemodynamics and ejection fraction. AB - The effects of incremental positive end-expiratory pressure (PEEP) on right ventricular (RV) function were evaluated in 36 (n = 36) ventilated patients. Positive end-expiratory pressure was increased from 0 (baseline) to 20 cm H2O in 5-cm H2O increments and RV hemodynamics and thermally derived right ventricular ejection fraction (RVEF), right ventricular end-diastolic volume index (RVEDVI), and right ventricular end-systolic volume index (RVESVI) were computed. Right ventricular contractility was determined from the analysis of RV systolic pressure-volume relations. Right ventricular ejection fraction declined from 42 +/- 8% at baseline to 30 +/- 9% at 20 cm H2O PEEP. Right ventricular end diastolic volume index declined between 0 and 5 cm H2O PEEP (103 +/- 42 to 92 +/- 34 ml.m-2) and then increased to 113 +/- 40 at 20 cm H2O PEEP. Right ventricular end-systolic volume index increased from 60 +/- 31 ml.m-2 at baseline to 79 +/- 34 ml.m-2 at 20 cm H2O PEEP. The slope (E) of the relation of RV peak systolic pressure to RV end-systolic volume index decreased from 0.26 mm Hg.m2.ml-1 between PEEP of 0-15 cm H2O to 0.05 mm Hg.m2.m-1 at PEEP greater than 15 cm H2O. It is concluded that low levels of PEEP have a predominant preload reducing effect on the RV. Above 15 cm H2O PEEP, RV volumes increase and E decreases, consistent with increased RV afterload and a decline in RV contractility. PMID- 3277481 TI - Oral atropine premedication in infants attenuates cardiovascular depression during halothane anesthesia. AB - The efficacy of oral atropine premedication in attenuation of the cardiovascular depression associated with halothane anesthesia has not been previously evaluated. A solution containing either oral atropine 0.04 mg/kg (HI), 0.02 mg/kg (LO), or a placebo (NO) was randomly administered to 36 infants 1-6 months old and 36 infants 7-15 months old 30-90 minutes before induction of anesthesia. The onset of action of atropine was approximately 25 minutes after administration as determined by a 15% increase in heart rate (HR) above baseline levels. Heart rate, systolic blood pressure (SBP), and mean arterial blood pressure (MAP) were then measured at 1-minute intervals starting just before induction of anesthesia and continuing until onset of surgical stimulation during anesthesia with halothane (up to 3%), nitrous oxide (60%), and oxygen (40%). In infants 1-6 months old, either dosage of oral atropine preserved HR and SBP as compared with placebo. In infants 7-15 months old, either dosage preserved HR but not SBP. The severity of hypotension was greatest in infants 1-6 months of age given placebos. No significant differences existed between oral atropine 0.04 mg/kg or 0.02 mg/kg in either age range. It is concluded that premedication with oral atropine 0.02 mg/kg is effective in attenuating the cardiovascular depression associated with halothane anesthesia in infants. PMID- 3277482 TI - One-lung ventilation of the newborn with tracheoesophageal fistula. PMID- 3277480 TI - Ionized hypocalcemia after fresh frozen plasma administration to thermally injured children: effects of infusion rate, duration, and treatment with calcium chloride. AB - A number of cardiac arrests and severe hypotensive episodes have been witnessed associated with the intravenous infusion of fresh frozen plasma (FFP). To clarify the possible role of hypocalcemia, 28 thermally injured anesthetized pediatric patients with massive blood loss were studied to examine the cardiovascular responses (mean arterial pressure [MAP], heart rate, ECG) to 49 infusions of FFP. Rapid, statistically significant reductions in ionized calcium ([Ca2+]) followed each of four rates (1.0, 1.5, 2.0, and 2.5 ml.kg-1.min-1 for 5 minutes) of FFP infusion (P less than 0.0001). The slowest rate resulted in significantly less reduction in [Ca2+] than did the higher infusion rates (P less than 0.002). In five children MAP decreased greater than or equal to 20% below baseline levels, but this was not correlated with rate of FFP administration or decrease in [Ca2+]. The decreases in [Ca2+] and MAP were inversely related to age and unrelated to anesthetic technique. Changes in the Q-oTc interval were not related to [Ca2+]. Adverse cardiovascular responses and reduced [Ca2+] were not significantly different between 5- and 10-minute FFP infusions. Fewer fluctuations in MAP occurred when calcium chloride (CaCl2) was administered; the least fluctuation in [Ca2+] occurred when CaCl2 was administered during the plasma infusion. It is concluded that in thermally injured children 1-17 years old: 1) Rapid infusions of FFP produce sudden but evanescent decreases in [Ca2+]; more rapid infusions result in greater reductions in [Ca2+]. 2) There is no correlation between [Ca2+] and systemic hypotension. 3) Clinically important decreases in MAP occasionally accompany the rapid infusion of FFP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277483 TI - Antihypertensive mechanism of ketanserin in postoperative hypertension after cardiopulmonary bypass. AB - The effect of ketanserin (0.15 mg/kg followed by an infusion at 6 mg/hr) was studied in 13 patients who developed hypertension (blood pressure greater than 150/90 mm Hg) after cardiopulmonary bypass (CPB) for coronary artery bypass grafting. Eleven patients responded to ketanserin with a decrease of arterial pressure from 159 +/- 15/83 +/- 10 mm Hg to 131 +/- 9/70 +/- 12 mm Hg (P less than 0.01), which was sustained during the subsequent infusion of ketanserin. Mean plasma ketanserin concentrations were maintained at 187 micrograms/L (range 118-525). No significant changes in plasma levels of 5-hydroxyindoles or in platelet 5-hydroxytryptamine content were observed during or after CPB, or after administration of ketanserin. Plasma epinephrine (398 +/- 124 pg/ml) and norepinephrine (1161 +/- 673 pg/ml) concentrations were markedly increased during the hypertensive period after CPB. Plasma epinephrine concentrations decreased (P less than 0.01) during ketanserin infusion to 213 +/- 101 pg/ml, whereas plasma norepinephrine concentrations did not change. The pressor response to three graded doses of phenylephrine was decreased during CPB (P less than 0.01), and a further decrease (P less than 0.05) occurred during infusion of ketanserin. The hypotensive effect of ketanserin after CPB may be attributable to alpha 1 adrenoceptor blockade rather than to its antiserotoninergic effect. Serotonin does not appear to be involved in the short-term disturbances of arterial pressure during or after CPB. PMID- 3277484 TI - A single-blind study of pulse oximetry in children. AB - Oxygen saturation determined by pulse oximetry was monitored in 152 pediatric surgical patients divided into two groups. In one group, the oximeter data and alarms were available (N = 76) to the anesthesia team, and, in the other group, these data were unavailable (N = 76). A trained observer recorded all intraoperative hypoxic episodes and informed the anesthesia team of all major events (i.e., oxygen saturation less than or equal to 85% for greater than or equal to 30 s) (PaO2 approximately 52 mmHg). Thirty-five major events occurred: 24 in the unavailable group, and 11 in the available group (P = 0.021). A greater number of major events occurred in children less than or equal to 2 yr of age (P = 0.013). Hypoxic events diagnosed by the oximeter, but not by the anesthesiologist, were more frequent in the unavailable group (13) than in the available group (5) (P = 0.0495). ASA Physical Status 3 and 4 patients were more likely to suffer a major event (P = 0.009 available, 0.006 unavailable). The pulse oximeter diagnosed hypoxemia before the signs and symptoms of hypoxemia were apparent (i.e., prior to observed cyanosis or bradycardia). Major hypoxic events were unrelated to duration of anesthesia. Major events were evenly distributed among induction, maintenance, and awakening from anesthesia; a greater number of hypoxic events occurred during induction in the unavailable group (P = 0.031). No morbidity was documented in any patient who suffered an hypoxic event.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277485 TI - Premedication and high-dose fentanyl anesthesia for myocardial revascularization: a comparison of lorazepam versus morphine-scopolamine. AB - Using a randomized double-blind placebo-controlled experimental protocol, the authors compared two premedication regimens in 42 patients undergoing elective myocardial revascularization. Group L patients (n = 23) received lorazepam 0.06 mg/kg po 90 min preoperatively, while group M patients (n = 19) received morphine 0.1 mg/kg im, plus scopolamine 0.006 mg/kg im 60 min preoperatively. Anesthesia was induced with fentanyl 100 micrograms/kg and atracurium 0.50 mg/kg administered over 10 min. The treatment groups did not differ significantly with respect to the degree of sedation or anxiolysis achieved, or the rapidity of induction with fentanyl. Premedication significantly influenced the hemodynamic response to anesthetic induction. Hemodynamics were stable post-induction in group M, but cardiovascular depression was noted in group L. Control heart rate (HR) was lower in group L. The HR, arterial pressure, and cardiac index were significantly lower, following both induction and intubation, in group L. Following sternotomy hemodynamics were identical in both groups. Serum fentanyl concentration was significantly higher during intubation in group L, probably secondary to the pharmacokinetic consequences of a decreased CI. New electrocardiographic evidence of myocardial ischemia did not occur in either group. Based on their findings with fentanyl-at-racurium, and their review of the literature, the authors speculate that premedication exerts a significant hemodynamic effect during induction with other narcotic-relaxant combinations. PMID- 3277486 TI - Nalbuphine antagonism of fentanyl-induced ventilatory depression: a randomized trial. AB - The authors anesthetized 18 patients with good pulmonary and ventricular function for coronary artery bypass grafting with high doses of fentanyl. When the patients were arousable and their vital signs stable in the intensive care unit, the authors administered nalbuphine or placebo (randomly and double-blinded) until extubation criteria were met, and subsequently gave nalbuphine for analgesia. In one of ten placebo patients, tracheal extubation was accomplished without nalbuphine. This patient then retained CO2 and required nalbuphine; the other nine placebo patients could not be extubated after placebo trials and were given nalbuphine. In all other patients in both groups, tracheal extubation was successful following nalbuphine (median dose 60 micrograms/kg, range 30-180 micrograms/kg). One patient became renarcotized 4 h after tracheal extubation without an increase in plasma fentanyl concentration; he received an additional dose of nalbuphine and recovered without further incident. Nine patients required treatment with vasoactive agents or beta-blockers for hypertension or tachycardia associated with the administration of nalbuphine. Eight of 18 patients were not satisfied with nalbuphine analgesia, and required morphine for relief of their pain. Recurrent elevations of fentanyl concentrations in plasma were observed and appeared to be related to increasing motor activity. Nalbuphine is an effective opioid antagonist after fentanyl anesthesia, but its use is associated with side effects, and analgesia for the post-sternotomy patient may be unsatisfactory unless the dose is carefully titrated to the minimum required to antagonize respiratory depression. PMID- 3277487 TI - Improving arterial oxygenation during one-lung ventilation. PMID- 3277488 TI - Improvement of walking distance in patients with intermittent claudication by chronic local therapy with isosorbide dinitrate ointment. AB - Isosorbide dinitrate ointment (100 mg tid) was directly applied to 30 male patients with stable, documented intermittent claudication on the areas where ischemic pain was experienced. The symptom-free distance walked (DWA) and the maximum distance reached (MDR) basally, after one, three, six, and twelve months were evaluated by means of treadmill stress tests (TSTs) (angle 0 degree-velocity constant/patient). After the basal TST, patients were randomly divided into two groups: placebo group and therapy group (double blind), and a further TST was administered one month later. DWA results were 74 +/- 8 m vs 297 +/- 83 m and MDR results were 163 +/- 22 m vs 506 +/- 86 m in the therapy group (basal vs one month TST: p less than .01) and 94 +/- 24 m vs 96 +/- 15 m and 232 +/- 53 m vs 183 +/- 26 m in the placebo group, respectively (basal vs one month TST: NS). Being confident that a significant placebo effect was absent, the authors opened the trial and treated all patients, repeating further TSTs at three, six, and twelve months. The following results were obtained: DWA was 84 +/- 13 m, 316 +/- 63 m, 374 +/- 55 m, and 452 +/- 61 m; and MDR was 197 +/- 29 m, 431 +/- 59 m, 514 +/- 57 m, and 547 +/- 59 m, respectively, in basal conditions and after three, six, and twelve months of treatment (p less than .01 for all the values for both DWA and MDR vs basal values).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277489 TI - The small right coronary artery: angiographic implications--case reports. AB - Two patients with small right coronary arteries are presented. Possible complications during coronary angiography and methods of preventing them are discussed. It is stressed that the time of occlusion of the artery by the catheter tip should be kept to a minimum. The use of newly available angiographic catheters with side holes is also illustrated. PMID- 3277490 TI - A new syndrome: angiotensin-converting enzyme dysfunction syndrome: differential diagnosis and pathogenesis--case reports. AB - The authors previously reported a new syndrome, angiotensin-converting enzyme dysfunction syndrome (ACEDS), which is clinically characterized by mild systemic hypertension, a hypokalemic alkalosis, and hyperreninism with a high concentration of angiotensin-I (ANG-I), a normal angiotensin-II (ANG-II) value, and a normal aldosterone level. In the present study, they investigated the diagnosis and differentiation of diseases concomitant with hyperreninism, such as ACEDS, Bartter's syndrome, familial periodic paralysis, and renovascular hypertension treated with captopril for two months, and discussed the pathogenesis of ACEDS. PMID- 3277491 TI - Calcium antagonists as a new treatment modality in hypertension. AB - The long-term vasoconstriction which is characteristic of human hypertension may be mediated by entirely different mechanisms in various hypertensive patients. In some whose hypertension is related to activation of the renin-angiotensin aldosterone control system, appropriate antirenin therapy is effective. Recent studies indicate that calcium ions may play a special role in the etiology of low renin essential hypertension. Specific abnormalities in calcium and magnesium metabolism which are related to deviations in the renin system have been identified. Antihypertensive therapy with calcium antagonist drugs such as nitrendipine appears to be most effective in patients with low levels of renin activity and serum ionized calcium. These observations support the concept of the heterogeneity of human hypertension and could represent a significant step towards more specific antihypertensive drug therapy. PMID- 3277492 TI - The safety of nitrendipine in the treatment of essential hypertension--a review of 61 clinical studies. AB - To assess the safety of the calcium channel blocker nitrendipine, data from 61 clinical studies conducted in the United States and involving 1,245 patients were reviewed. The drug appeared to be tolerated in the majority of patients and the dropout rate was low. The most common side effects associated with nitrendipine administration were headache and edema. Most side effects were mild and were tolerated or disappeared with continued therapy. No serious adverse biochemical, hemodynamic, renal, or humoral effects of nitrendipine were apparent. Nitrendipine produced a prompt, smooth, and sustained reduction in systolic and diastolic blood pressures in both the supine and standing positions. The blood pressure response was maintained for six months to one year with no evidence of resistance or tachyphylaxis. Sex and race had no influence on the antihypertensive effect of nitrendipine, but patients sixty years of age and older appeared to respond better to the drug than younger patients. PMID- 3277493 TI - Nitrendipine in the treatment of mild to moderate hypertension. PMID- 3277495 TI - New advances in diagnosing nosocomial pneumonia in intubated patients. Part I. PMID- 3277494 TI - Calcium antagonists: use in hypertension evaluation of calcium antagonists in combination with diuretics. AB - Hypertensive patients whose elevated blood pressure was not controlled with diuretics alone have received calcium antagonists in addition in several studies reported in the literature. These studies are summarized in this report. The combination was found to be effective in lowering blood pressure to desirable levels with minimal side effects. In the present era lowered doses of antihypertensive agents, particularly diuretics, are advised. The combination of low dose diuretic and calcium blocker is an attractive alternative for those patients for whom a beta-blocker is contraindicated. PMID- 3277496 TI - Advances in preventing nosocomial pneumonia. Part II. PMID- 3277497 TI - Inhibition of methacholine-induced bronchoconstriction in patients with chronic obstructive pulmonary disease. AB - Patients with COPD have increased airway responsiveness to pharmacologically induced bronchoconstriction when compared with normal healthy subjects. We questioned whether an inhaled bronchodilator such as isoproterenol would benefit patients with COPD by inhibiting inducible bronchoconstriction. Ten patients with COPD were found to be more sensitive to methacholine by inhalation bronchial challenge testing than were normal control subjects. (PD35 = 58 +/- 110 versus 238 +/- 220 cumulative dose units). Neither group as a whole demonstrated significant inhibition of methacholine-induced bronchoconstriction by prior inhalation of isoproterenol (200 micrograms at mouth). However, within the COPD group, there was a significant negative correlation between both baseline lung function and airway responsiveness (PD35-SGaw) with inhibition of methacholine induced bronchoconstriction. (r = -0.8, p less than or equal to 0.003). This suggests that those patients with COPD and significantly reduced lung function (%FEV1 less than 50%) demonstrate airway hyperresponsiveness to a degree recorded in asthma and may benefit from therapy that inhibits airway responsiveness. PMID- 3277499 TI - Elastic behavior of the transplanted lung. Exponential analysis of static pressure-volume relationships. AB - We compared indices of muscle strength, parameters of mechanical lung function, and static pressure-volume curves in 12 heart-lung transplant (HLT) recipients to determine whether observed restrictive ventilatory defects represented abnormal elastic behavior of the transplanted lungs. Pressure-volume curves were analyzed using an exponential equation to generate the shape constant K, which describes the nonlinear behavior of pressure-volume relationships over a substantial range. For the group, K was 91% predicted, implying that there was not a diffuse abnormality of elastic properties of the transplanted lungs despite a mean TLC of 80% predicted. However, the mean maximal transpulmonary pressure (PLmax) was significantly low at 23.4 cm H2O (61% predicted) possibly related to the effects of surgery on thoracic cage mobility, but also in keeping with a reduction in power and efficiency of the thoracic musculature. The ability to achieve predicted TLC post-HLT was related to the preservation of optimal inspiratory force as TLC (% predicted) was highly correlated with maximal inspiratory pressure (PImax) (% predicted) (r = 0.83) (p less than 0.001). The ratio (TLC post-HLT)/(TLC pre-HLT) was 1.00 +/- 0.18 (r = 0.82) (p less than 0.005), suggesting donor organs were well matched to recipient chest cavities, but also emphasizing that the recipients had a low TLC prior to HLT. We conclude that the presence of a stable restrictive defect post-HLT is determined primarily by the volumetric constraints of the recipient chest cavity and within these constraints by the strength and efficiency of the thoracic musculature rather than a diffuse intrinsic abnormality of pulmonary elastic properties as a consequence of the transplantation process. PMID- 3277498 TI - Lower respiratory illness in early childhood and lung function and bronchial reactivity in adolescent males. AB - We examined the relationship between lower respiratory illness (LRI) experience in early childhood and lung function and bronchial reactivity in 57 boys, 11 to 22 yr of age, whose histories of outpatient physician visits for wheezing and nonwheezing LRI had been documented prospectively during their first 6 yr of life. These boys were a subpopulation of 159 children whose early childhood LRI experience and spirometric performance had been studied an average of 4 yr previously. The majority of boys had been free of chronic respiratory symptoms in the 2 yr before evaluation. Boys with histories of 2 or more preschool wheezing illnesses had lower mean levels of performance for FEV1, FEF25-75, FEF50, FEF75, and FEV1/FVC than did boys who had zero or 1 preschool wheezing illness, replicating observations that had been made when the boys had been studied 4 yr previously. Boys with lower spirometric performance relative to the study population on initial testing continued to have lower relative levels of spirometric performance 4 yr later. Neither preschool wheezing nor nonwheezing illness experience was associated with the degree of methacholine sensitivity measured in adolescence. Increasing degrees of methacholine sensitivity were associated with lower levels of spirometric performance; however, preschool wheezing illness experience remained a significant correlate of spirometric performance after adjustment for level of methacholine sensitivity. We conclude that recurrent preschool wheezing illness in these adolescent boys was associated with persistently lower lung function, but not enhanced methacholine sensitivity, during the middle to late school years. PMID- 3277500 TI - Monoclonal antibodies to surfactant proteins SP28-36 label canine type II and nonciliated bronchiolar cells by immunofluorescence. AB - The major 28,000- to 36,000-dalton proteins of pulmonary surfactant (SP28-36) have been shown by various techniques to be synthetic and secretory products of alveolar type II cells. Surfactant lipids are also secreted by these cells. Immunocytochemical studies of human and rodent lungs have indicated that nonciliated epithelial cells of small bronchioles appear to contain SP28-36 in their synthetic organelles and secretory granules. Because these observations were obtained with polyclonal antibodies against SP28-36, it was possible that bronchiolar cell staining was due to contaminant antibodies not detected by biochemical analyses. To clarify the role of bronchiolar cells in the metabolism of SP28-36, we have prepared 5 monoclonal antibodies against canine SP28-36. Electrophoresis and immunoblots of surfactant showed that each antibody reacted with SP32 and 36, as well as SP28, the nonglycosylated species. This indicates that the antibodies are directed against the protein rather than carbohydrate moieties of SP28-36. Immunoblot analysis of collagenase-treated SP28-36 showed that the antibodies DS-3 and DS-1 were directed against the noncollagen region of the protein. Immunoblot analysis of whole canine lung homogenates showed that a single protein species was recognized by the antibodies. Immunofluorescence studies of cryostat sections of canine lung showed that both type II and nonciliated bronchiolar cells were specifically labeled with each antibody. These and previous data are consistent with and support the idea that bronchiolar cells synthesize and secrete SP28-36. PMID- 3277501 TI - Accumulation of Langerhans' cells on the epithelial surface of the lower respiratory tract in normal subjects in association with cigarette smoking. AB - Langerhans' cells are a defined subpopulation of the mononuclear phagocyte system known to accumulate in the lung in histiocytosis X, an interstitial lung disorder strongly linked to cigarette smoking. To evaluate the hypothesis that cigarette smoking itself may be associated with the accumulation of Langerhans' cells in the lung, normal nonsmokers (n = 5) and normal smokers (n = 10) were evaluated by bronchoalveolar lavage for the presence of Langerhans' cells as identified by the OKT6 monoclonal antibody and by transmission electron microscopy. While the OKT6 antibody identified 0.1 +/- 0.1% of the cells recovered from nonsmokers, it labeled 1.1 +/- 0.3% of those recovered from smokers (p less than 0.01). Furthermore, while electron microscopy demonstrated no Langerhans' cells among the lavage cells from nonsmokers, 0.4 +/- 0.1% of the cells recovered from normal smokers contained characteristic intracytoplasmic Birbeck granules, positively identifying them as Langerhans' cells. We conclude that cigarette smoking is associated with an expansion in the population of Langerhans' cells on the epithelial surface of the lower respiratory tract. While the mechanisms underlying this accumulation are unknown, it is possible that the properties of these cells contribute to the derangements of the pulmonary parenchyma found in cigarette smoking and establish a biologic link to the already observed epidemiologic association between histiocytosis X and cigarette smoking. PMID- 3277502 TI - Effect of catalase on endotoxin-induced acute lung injury in unanesthetized sheep. AB - Administration of endotoxin intravenously to unanesthetized sheep causes an acute lung injury characterized by increased microvascular barrier permeability and subsequent pulmonary edema. Endotoxin-induced sheep lung injury can be attenuated by leukocyte depletion, and may be mediated by toxic metabolites of oxygen. We studied effects of administering catalase, which catalyzes conversion of hydrogen peroxide to oxygen and water, to sheep subsequently infused with endotoxin to test the hypothesis that hydrogen peroxide plays a role in the pathogenesis of lung injury. We found that infusions of endotoxin (1 microgram/kg) into untreated sheep caused the expected biphasic response, a transient, early, marked pulmonary arterial hypertension followed by a prolonged increase in protein-rich lung lymph flow characteristic of increased microvascular permeability filtration in the lungs. Intraperitoneal injections of catalase (50 mg/kg) prior to infusing endotoxin in these same sheep resulted in substantial catalase activity in plasma and in lung lymph, and attenuated the expected changes in pulmonary arterial pressure, lung lymph flow, and arterial leukocyte counts and oxygen tension after endotoxin infusions. Furthermore, mechanical elevation of hydrostatic pressure in the lungs of a catalase-treated sheep infused with endotoxin resulted in increased lung lymph flow with a decreased protein concentration, indicating that the microvascular barrier to fluid and protein was functionally intact. Administration of catalase that was inactivated by reaction with hydrogen peroxide in the presence of aminotriazole or administration of the catalase vehicle, thymol, had no effects on the sheep responses to endotoxin. We conclude that hydrogen peroxide plays a role in the pathogenesis of endotoxin-induced acute lung injury in sheep. PMID- 3277503 TI - The pulmonary toxicity of beryllium. PMID- 3277504 TI - NHLBI Workshop summary. Cellular mechanisms of airway secretion. PMID- 3277505 TI - Polypectomy or colectomy? Management of 106 consecutively encountered colorectal polyps. AB - Although malignant sessile colorectal polyps usually require colectomy for proper treatment, the majority of malignant pedunculated polyps can be removed colonoscopically. A polyp is considered malignant if the proliferating cells have penetrated the muscularis mucosa. Total excisional biopsy is necessary to properly assess an adenoma microscopically. Forceps biopsy is inadequate. Virtually all malignant pedunculated polyps can be removed colonoscopically, provided one can reach the lesion, and provided one is experienced with snare electro-surgical techniques. Certain sessile polyps can also be removed colonoscopically, if the lesion is soft and nonulcerated, and if one is familiar with piecemeal polypectomy technique developed by Shinya. If the adenoma is malignant, special attention microscopically must be given to the margin of transection, to the specimen's lymphatics, and to the degree of differentiation of the malignancy. If the margin transection and lymphatics are free of tumor cells, if the malignancy is well differentiated, and if follow-up endoscopic exam reveals no residual or recurrence at the polypectomy site (i.e., Morson criteria), the malignant polyp can be considered cured by colonscopic polypectomy alone. The author's experience with 106 consecutively encountered malignant colorectal polyps over a 10 year period is reviewed. Sixty two lesions were removed by colonscopic polypectomy alone. All patients in this group have done well, except for one patient who had tumor involvement at the margin of polyp transection, who was considered inoperable because of severe medical problems, and who died from hepatic metatases 5 months later. Forty four patients underwent colectomy; 26 of these colectomies were preceded by colonoscopic polypectomy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277506 TI - Treatment of left-sided ulcerative colitis with 4-aminosalicylic acid enemas. A double-blind, placebo-controlled trial. AB - Twenty-five patients with active left-sided ulcerative colitis were randomly assigned to receive either 2 g of 4-aminosalicylic acid (para-aminosalicylic acid) or placebo in a 60-mL volume as a nightly retention enema. The duration of treatment was 8 weeks. Disease activity was assessed by grading clinical symptoms of blood, mucus, urgency, sigmoidoscopic findings, and degree of histologic inflammation in rectal biopsies. At 8 weeks, 10 of 12 patients (83%; 95% confidence interval [CI], 55% to 97%) who received 4-aminosalicylic acid showed improvement in clinical, sigmoidoscopic, and histologic variables. In contrast, only 2 of 13 patients (15%, 95% CI, 4% to 38%) who had received placebo showed clinical improvement (P less than 0.005). The 11 patients in the placebo group who showed no improvement were treated subsequently with open-label 4 aminosalicylic acid enemas. Of the 11, 9 showed clinical, sigmoidoscopic, and histologic improvement. No adverse effects were seen. 4-Aminosalicylic acid enemas are a safe and effective means of treating left-sided ulcerative colitis. PMID- 3277507 TI - Lipids and lipoprotein changes after heart and liver transplantation in a patient with homozygous familial hypercholesterolemia. AB - Changes in lipids and lipoprotein fractions were studied 6 months after a combined heart and liver transplantation in a patient with terminal ischemic heart disease due to homozygous familial hypercholesterolemia. The double transplant was followed by striking decreases in total and low-density lipoprotein cholesterol levels (-71% and -79%) and content of apolipoprotein B in the low-density-lipoprotein fraction (-74%). There was also an increase in high density-lipoprotein cholesterol (+7.8%). These changes are greater than those reported with portacaval shunt or plasma exchange. Liver transplantation may be considered in selected patients with homozygous familial hypercholesterolemia. PMID- 3277508 TI - Norfloxacin: a new targeted fluoroquinolone antimicrobial agent. AB - Norfloxacin is an oral fluoroquinolone antimicrobial agent recently released for the treatment of uncomplicated and complicated urinary tract infections. The drug antagonizes DNA gyrase, an enzyme essential for bacterial DNA replication. Norfloxacin is more potent and broader in spectrum than the earlier developed analogue, nalidixic acid, and is active in vitro against virtually all bacterial pathogens causing urinary tract and gastrointestinal infections, aerobic gram negative bacilli causing sepsis in neutropenic patients, and Neisseria gonorrhoeae. The drug is administered orally twice daily and achieves high concentrations in urine, stool, renal tissue, and bile. Norfloxacin was at least as effective as currently used agents in treating urinary tract infections, and, in limited studies, bacterial gastroenteritis, gonorrhea, bacterial prostatitis, and prevention of gram-negative bacillary infection in neutropenic patients. Adverse drug effects were mild and included disturbances of the gastrointestinal tract and the central nervous system. Norfloxacin shows promise as an antibacterial agent for genitourinary and gastrointestinal infections. PMID- 3277510 TI - Bedside diagnosis: a new annotated bibliography. PMID- 3277509 TI - Factitious hypoglycemia due to surreptitious administration of insulin. Diagnosis, treatment, and long-term follow-up. AB - Ten patients had factitious hypoglycemia due to surreptitious insulin injections diagnosed and were followed for up to 15 years (median, 5 years; range, 2 months to 15 years). When available, demonstration of anti-insulin antibodies was the most helpful diagnostic test. Decreased plasma C-peptide levels corroborated the diagnosis. Young women (nine of ten) with knowledge of the medical profession or relatives with diabetes mellitus predominated in the sample. Five of the patients had a history of insulin-requiring diabetes mellitus. Two patients eventually committed suicide despite the best efforts at therapy. Only three of ten patients made a successful transition into productive life after the diagnosis of factitious hypoglycemia was established. Factitious hypoglycemia remains a difficult diagnosis to make, and the long-term outcome after the diagnosis is established is unpredictable. All efforts have to be made to confirm the diagnosis before the patients are approached. The confrontation is to be made by an experienced team of health care professionals who have gained the patient's confidence through an understanding but firm manner. Long-term therapy must be planned and initiated before the patient's discharge. PMID- 3277511 TI - Retraction of research findings. International Committee of Medical Journal Editors. PMID- 3277512 TI - Antimicrobial therapy for Salmonella infections in the acquired immunodeficiency syndrome (AIDS) PMID- 3277513 TI - Human immunodeficiency virus (HIV) infection of the uterine cervix. AB - Human immunodeficiency virus (HIV) has been detected in cervical secretions from HIV-infected women. We report the isolation of HIV from four cervical biopsy specimens. Cervicitis was shown by immunohistochemical staining in cervical biopsy specimens from four HIV-seropositive women; cervicitis was not found in cervical biopsy specimens from four HIV-seronegative women. We found HIV antigens in monocyte-macrophages and endothelial cells within the submucosa of three of these cervices by specific immunohistochemical staining. Small numbers of HIV infected cells resembling lymphocytes also were found in the cervical mucosa. The virus was not shown by culture or immunohistochemistry in cervical biopsy specimens from the four HIV-seronegative women. These findings suggest that HIV enters cervical secretions from selected infected cell populations within the cervical tissue. The HIV-infected cells in cervical tissue may be involved in transmission of HIV by heterosexual contact and to neonates born to HIV-infected women. PMID- 3277514 TI - Magnetic resonance imaging of the brain and spine. Is clinical efficacy established after the first decade? AB - STUDY OBJECTIVE: Evaluation of demonstrated clinical efficacy of magnetic resonance (MR) imaging in the central nervous system. DESIGN: Information synthesis of studies before January 1987. SETTING: Reports were classified by the level of clinical efficacy studied (technical capacity, diagnostic impacts, and therapeutic or patient outcome impacts) and were judged by the validity of their methods, especially avoidance of diagnosis review, test review, and work-up biases. MAIN RESULTS: Magnetic resonance imaging probably is superior to computed tomography for detection and characterization of posterior fossa lesions and spinal cord myelopathies, imaging in multiple sclerosis, detecting lesions in patients with refractory partial seizures, and detailed display for guiding complex therapy, as for brain tumors. In other diseases, the efficacy of MR imaging is similar to that of computed tomography (cerebrovascular, radiculopathy, and infection). Magnetic resonance imaging is less invasive than intrathecal or intravenous contrast-enhanced computed tomography and costs 20% to 300% more than computed tomography, although avoidance of hospital stays may offset some costs. Generally, the quality of MR images probably exceeds that of computed tomographic (CT) scans. However, published evidence does not show that the clinical efficacy of MR imaging is generally superior to that of existing imaging modalities such as computed tomography. Only six studies avoided major methodologic biases, and lower true-positive rates for MR imaging were reported in these studies than reported in multiply biased studies. Few studies of the potential of MR imaging for false-positive diagnosis have been done. CONCLUSIONS: Use of standards for quality of evidence leads to more conservative conclusions than those of reports describing the clinical potential of MR imaging. Some applications of MR imaging were confirmed by rigorous studies, whereas others were not well supported by reports free of methodologic biases. If the diagnostic alternative is invasive (for example, myelography and cisternography), MR imaging is preferred, but adequate diagnosis for many conditions (head trauma, simple stroke, and dementia) may not require the detail of an MR imaging study. In general, more rigorous clinical research studies are needed for new technologies such as MR imaging. Because the field of MR imaging is changing, review of its clinical efficacy will need to be revised frequently. PMID- 3277515 TI - Pulmonary hypertension from chronic pulmonary thromboembolism. AB - Pulmonary hypertension may develop whenever chronic obstruction of pulmonary arterial blood flow occurs. Although repeated pulmonary embolism is thought to be the usual underlying cause, there is little clinical evidence to support this theory. Studies of the pulmonary vascular endothelium have shown that perturbations of the normal endothelium can create a procoagulant environment, which could lead to the development of thrombosis in situ at the level of the large or smaller pulmonary vessels. Some patients develop proximal pulmonary thromboemboli, which may be the result of retrograde propagation of thrombus after an initial pulmonary embolus. Others present with unexplained pulmonary hypertension secondary to thrombotic occlusion of the pulmonary microvasculature. A perfusion lung scan will show abnormalities that should lead to correct clinical diagnosis and confirmatory evaluation. Thromboendarterectomy in selected cases provides dramatic clinical improvement in patients with proximal thromboemboli. Vasodilators may be effective in some patients with obstruction at the arteriolar level. Both groups should be treated with chronic warfarin anticoagulant therapy to protect against progression of thromboembolism. PMID- 3277516 TI - Dealing with uncertainty, risks, and tradeoffs in clinical decisions. A cognitive science approach. AB - To generate hypotheses about how physicians make difficult clinical decisions, we analyzed transcripts of the "thinking aloud" behavior of expert clinicians making a testing or treatment decision with an uncertain diagnosis. We compared the clinicians' reasoning with a decision analysis of the same problem. The experts did not formulate a global outline of their decision, but chained together a sequence of decisions based on available and incomplete information. Despite effective and efficient problem solving, the clinicians used numeric terms only as symbolic representations of likelihood, used limited information in choosing among alternatives, and dismissed the possibility that a less conventional strategy, empiric therapy, might yield equivalent outcome. We describe cognitive problem-solving strategies and knowledge representations that permit persons to make successful decisions despite limited processing resources. The same cognitive procedures probably contribute to observed errors in decision-making under uncertainty. PMID- 3277517 TI - Indications for antiarrhythmic therapy: a wealth of controversy, a dearth of data. PMID- 3277519 TI - The acquired immunodeficiency syndrome (AIDS) and infection with the human immunodeficiency virus (HIV). Health and Public Policy Committee, American College of Physicians; and the Infectious Diseases Society of America. PMID- 3277518 TI - Humoral hypercalcemia of malignancy. PMID- 3277520 TI - Financing the care of patients with the acquired immunodeficiency syndrome (AIDS). Health and Public Policy Committee, American College of Physicians. PMID- 3277521 TI - Idiopathic nephrotic syndrome and renal biopsy. PMID- 3277522 TI - A library for internists VI. Recommendations from the American College of Physicians. PMID- 3277523 TI - Cholesteatoma in the pediatric age group. AB - The diagnosis and management of cholesteatoma in children remains controversial. In the past 15 years, the senior author (S.C.P.) has treated 320 patients with cholesteatoma. Patients 18 years and younger composed 40% (125) of the overall group and are the basis for this report. The patient data were compiled using the history, physical examination, audiograms, radiographs, patient questionnaires, surgical findings, and postoperative observations. The surgical treatment selected was determined by the extent of disease, the configuration of the mastoid, and a clinical assessment of eustachian tube function. A middle ear tympanotomy approach was used in 17% of the patients, a canal wall up procedure in 31%, and a canal wall down procedure in 52.3%. The average clinical follow-up was 3.9 years, with the range being from 3 months to 13.5 years. Hearing was maintained or slightly improved in a majority of cases. Residual disease occurred in 8% of patients, and recurrent disease in only 3%. PMID- 3277524 TI - Cholesteatoma surgery: canal wall down procedures. AB - We prefer the intact canal wall technique for tympanoplasty with mastoidectomy, but use a canal wall down procedure in up to 25% of cases. Creating a round cavity with a large meatus is imperative if one is to obtain a trouble-free ear. The five types of canal wall down procedures are defined, as are our indications for using them. Results in 19 only hearing ears and 19 labyrinthine fistula cases are presented, along with 64 tympanoplasty cases. PMID- 3277525 TI - Hearing preservation in unilateral acoustic neuroma surgery. AB - This paper reviews the principal English literature on hearing preservation in unilateral acoustic neuroma surgery. Seventeen case reports and 13 surgical series are included. In addition, we report ten cases of our own, two with successful hearing preservation. The purpose of this report is to study feasibility, success rate, and associated problems. Previous reports have been compared in terms of criteria that we have selected. A classification system similar to Silverstein's is used. The total number of cases under review is 621, with 221 reported successes. Cases limited to those having a unilateral acoustic neuroma, with valid supportive audiometry, were 394, with 131 successes. The approximate overall rate of success is 33%. There are five cases of hearing preservation with unilateral acoustic neuromas 3 cm or larger when supporting audiometric data are available, the largest being "4-5 centimeters." Problems included mixing of unilateral acoustic neuromas with other types of tumors and failure to include comprehensive data, particularly audiometry. We conclude 1) that hearing preservation is a reasonable goal in unilateral acoustic neuroma surgery, although the number of available candidates is relatively small and 2) that intelligent selection of patients and high quality surgical technique are the keys to success. PMID- 3277526 TI - Free transplantation of tissues: problems and complications. AB - On the basis of my own material, I discuss the problems and complications encountered in the course of performing 75 free transplantations of tissues. The causes and management of both common and uncommon complications occurring after incorrect as well as faultless surgery are discussed, and numerous examples are described. PMID- 3277527 TI - Use of hybridoma libraries in the study of the genetics and development of Drosophila. PMID- 3277528 TI - Sublethal effects of neurotoxic insecticides on insect behavior. PMID- 3277529 TI - Lipid transport in insects. PMID- 3277530 TI - Vector aspects of the epidemiology of onchocerciasis in Latin America. PMID- 3277531 TI - Equipment planning process. Organizing purchases. AB - Equipment planning for a new or renovated OR space is an essential part of the overall facility planning process. It can be accomplished by in-house staff or by outside equipment consultants. If outside consultants are hired to organize the process, it is important that the nursing and medical staff be involved because they use the equipment and will determine the ultimate success of the new facility. PMID- 3277532 TI - Evidence for a cytochrome f-Rieske protein subcomplex in the cytochrome b6f system from spinach chloroplasts. AB - The cytochrome b6f complex of spinach chloroplasts was prepared with minor modification according to the method of E. Hurt and G. Hauska (1981) Eur. J. Biochem. 117, 591-599) replacing, however, the final ultracentrifugation step by hydroxyapatite chromatography as suggested by M. F. Doyle and C.-A Yu (1985) Biochem. Biophys. Res. Commun. 131, 700-706). The purified complex was partially dissociated by treatment with 4 M urea or 0.1% sodium dodecyl sulfate (SDS) in the absence of reducing agents. A binary subcomplex consisting of cytochrome f and the Rieske iron-sulfur protein was observed under these conditions by three different methods: (a) hydroxyapatite chromatography; (b) extraction with an isopropanol/water/trifluoroacetic acid mixture; and (c) gel filtration in the presence of low SDS concentrations. The subcomplex dissociated into its components by treatment with mercaptoethanol. These results suggest a close interaction of the cytochrome f with the Rieske protein involving SH groups which under reducing conditions leads to complete dissociation of the subcomplex. PMID- 3277534 TI - Substrate as a source of thermodynamic nonideality in enzyme kinetic studies: invertase-catalyzed hydrolysis of sucrose. AB - Expressions for the effects of thermodynamic nonideality arising from the use of high concentrations of small substrate in enzyme kinetic studies are derived. Their application to experimental results for the hydrolysis of sucrose by yeast invertase (pH 4.9, 37 degrees C) signifies that the progressive decrease in initial velocity at high sucrose concentration is consistent with the occurrence of isomeric expansion during the transition of an enzyme-substrate complex to its activated state. Ultracentrifuge studies on the yeast enzyme preparation are then used to establish the physical acceptability of the volume change required to account for the kinetic effects in these terms: the postulated expansion of 1.3 liter/mol would represent a mere 0.16% increase in hydrated volume (or a corresponding increase in extent of asymmetry). Finally, although originally interpreted to signify an effect of sucrose on water concentration, published results for the invertase-sucrose system [J. M. Nelson and M. P. Schubert (1928) J. Amer. Chem. Soc. 50, 2188-2193] also find a rational explanation in terms of the present analysis based on effects of thermodynamic nonideality in enzyme kinetic studies. PMID- 3277533 TI - Multiple molecular forms of mouse liver arginase. AB - Hepatic arginase (L-arginine amidinohydrolase, EC 3.5.3.1) is an oligomer composed of three or four subunits. The present studies indicate heterogeneity in the size and charge of arginase subunits in mouse liver. Two types of arginase subunits with molecular weights of approximately 35,000 and 38,000 have been found. These two subunits are detected in liver cytosol or in purified preparations of arginase after sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting. Two dimensional SDS-PAGE revealed multiple ionic forms of arginase for both the 35,000 and 38,000 subunits; the subunits contain basic proteins (pI range 7.8-9.1) and acidic proteins (pI range 5.8-6.4). Limited proteolysis by trypsin eliminated the molecular weight differences between the subunits without substantially affecting either their isoelectric points or activity. Comparative peptide maps and amino acid analyses of the 35,000- and 38,000-Da subunits showed that they were very similar. The data indicate that a neutral peptide (approx 3000 Da) is responsible for the differences in subunit molecular weight and that the multiple sized and charged forms are variants of the same protein. PMID- 3277535 TI - Purification to homogeneity and some properties of squalene synthetase. AB - Squalene synthetase has been purified to homogeneity from yeast. It is a single polypeptide of Mr 47,000. This enzyme catalyzes the synthesis of squalene from farnesyl diphosphate via presqualene diphosphate. In the presence of reduced pyridine nucleotides, presqualene diphosphate and squalene are produced in a ratio of 6:1 from either the purified protein or the crude microsomal fraction. PMID- 3277537 TI - Rat hepatic glutaminase: purification and immunochemical characterization. AB - A method for the purification of phosphate-activated glutaminase from the liver of streptozotocin-diabetic rats is described. The procedure involves solubilization of glutaminase activity from isolated mitochondria by sonication, followed by ammonium sulfate precipitation, polyethylene glycol precipitation, and sequential chromatography on DEAE, hydroxylapatite, and zinc-chelated resins. The enzyme was purified 600-fold to a specific activity of 31-57 U/mg protein. The purified enzyme has an apparent subunit molecular mass of 58,000-Da and is greater than 80% pure by scanning densitometry of sodium dodecyl sulfate polyacrylamide gels. The purified enzyme has an apparent Km for glutamine of 17 mM and a pH optimum between 7.8 and 8.2. The physical and kinetic properties of this enzyme are similar to those of the enzyme from normal rat liver. Polyclonal antibodies raised against the enzyme specifically inhibit hepatic glutaminase activity and react primarily with a 58,000-Da peptide in liver fractions on immunoblots. These antibodies were used in equivalence point titrations and immunoblots to provide evidence for increased concentration of glutaminase protein in the liver of diabetic rats with no change in specific activity of the enzyme. In addition, the antibodies cross-react, at low affinity, with kidney type glutaminases. On immunoblots, the antibodies did not react with fetal liver, mammary gland, or lung. Antibodies to rat hepatic glutaminase should prove useful as tools to study the long-term regulation of the enzyme. PMID- 3277536 TI - Identification of latent procathepsin H in microsomal lumen: characterization of proteolytic processing and enzyme activation. AB - Procathepsin H in kidney and liver microsomal lumen was identified to have a molecular mass of 41 kDa by immunoblot analysis. The proenzyme was then concentrated by applying the microsomal contents to a concanavalin A-Sepharose column. When the concanavalin A-adsorbed fraction was incubated at pH 4.0 at 20 degrees C, the activity measured with synthetic substrate increased 3.5 times over that of the control after 24 h incubation. Immunoblot analysis showed that acidic treatment caused the disappearance of procathepsin H. Thus the proenzyme might be processed to the mature enzyme under acidic conditions. The marked increase of enzymatic activity and the conversion of proenzyme were completely blocked with pepstatin which is a potent inhibitor of aspartic proteases. These results suggested that a protease for processing procathepsin H might be cathepsin D, a major lysosomal aspartic protease. Therefore, procathepsin H seems to be synthesized first in the enzymatically inactive form in endoplasmic reticulum and successively converted into the active form in lysosomes during biosynthesis. PMID- 3277538 TI - Hexose metabolism in pancreatic islets. Metabolic and secretory responses to D fructose. AB - D-Fructose (3.3 to 33.0 mmol/liter) caused a concentration-related increase in insulin output from rat islets exposed to D-glucose (3.3 to 7.0 mmol/liter), such an increase not being more marked in mouse islets. The fructose-induced increment in insulin release, relative to that evoked by D-glucose, was two times higher in islets exposed to D-glucose than in islets stimulated by D-mannose, 2 ketoisocaproate, or nonnutrient secretagogs. Likewise, the metabolism of D fructose in islet cells was significantly different in the absence or presence of D-glucose. Thus, the ketose was largely channeled into the pentose phosphate pathway in glucose-deprived, but not so in glucose-stimulated, islets. In both glucose-deprived and glucose-stimulated islets, however, the magnitude of the secretory response to D-fructose was commensurate with the increase in ATP production attributable to its catabolism. These findings indicate that the metabolic fate of hexoses--and, hence, their insulinotropic capacity--is not ruled solely at the level of their phosphorylation. PMID- 3277539 TI - The insulinomimetic effects of the polar head group of an insulin-sensitive glycophospholipid on pyruvate dehydrogenase in both subcellular and whole cell assays. AB - The polar head group that was released by treating an insulin-sensitive glycophospholipid with a phosphatidylinositol-specific phospholipase C (PI-PLC) stimulated pyruvate dehydrogenase (PDH) in both subcellular and whole cell assays. Stimulation of PDH activity in the subcellular assay was detected after gel filtration chromatography of the polar head group. This stimulation was not due to the presence of contaminating calcium and magnesium. The PDH-stimulating activity was proportional to the amount of polar head group added to the assay. The effect of the polar head group on PDH in the subcellular assay was blocked by sodium fluoride, suggesting that the polar head group activated the PDH phosphatase. In the whole cell assay, the polar head group stimulated PDH activity to an equal or greater extent as a physiological concentration of insulin. The effect of the polar head group was detected at 5 min, peaked at 10 min, and declined thereafter. In contrast, insulin stimulated PDH activity more slowly, but consistently. The PDH-stimulating activity eluted after bacitracin but ahead of ATP during gel filtration chromatography, and it was destroyed by exposure to NH4OH or alkaline phosphatase and by boiling in water. These data support the proposal that an early step in insulin action is the release of insulinomimetic polar head group from the insulin-sensitive glycophospholipid. PMID- 3277540 TI - Effects of alcohols on the reactivity and stability of Azotobacter vinelandii hydrogenase. AB - The effects of alcohols on the reactivity of Azotobacter vinelandii hydrogenase were investigated. Hydrogenase catalyzed H2 oxidation coupled to methylene blue, benzyl viologen, or phenazine methosulfate when in the presence of solvents containing 15 or 40% ethanol or 40% methanol or 2-propanol. In general, the Km's for the electron acceptors were increased substantially by the presence of the alcohols, while the Km for H2 was not altered in a solvent containing 40% ethanol. Calculation of the apparent maximum velocities for H2 oxidation in the presence of alcohols indicated that the maximum velocity was not decreased in most cases. In contrast, the rates of both H2 evolution and isotope exchange by hydrogenase were substantially decreased when solvent containing alcohol. Hydrogenase was inactivated by 100% ethanol with a half-life of 17 s. Hydrogenase from A. vinelandii was stable when stored in alcohol/buffer solvents at 20 degrees C or below. However, the thermal stability of hydrogenase was greatly decreased by inclusion of an alcohol in the solvent. When incubated at 55 degrees C in a solvent containing 40% ethanol, activity decreased in a first-order process with a half-life of 7 min. When incubated at the same temperature in aqueous buffer, no loss of activity was observed over 30 min. PMID- 3277541 TI - Proteases of the nematode Caenorhabditis elegans. AB - Crude homogenates of the soil nematode Caenorhabditis elegans exhibit strong proteolytic activity at acid pH. Several kinds of enzyme account for much of this activity: cathepsin D, a carboxyl protease which is inhibited by pepstatin and optimally active toward hemoglobin at pH 3; at least two isoelectrically distinct thiol proteases (cathepsins Ce1 and Ce2) which are inhibited by leupeptin and optimally active toward Z-Phe-Arg-7-amino-4-methylcoumarin amide at pH 5; and a thiol-independent leupeptin-insensitive protease (cathepsin Ce3) with optimal activity toward casein at pH 5.5. Cathepsin D is quantitatively most significant for digestion of macromolecular substrates in vitro, since proteolysis is inhibited greater than 95% by pepstatin. Cathepsin D and the leupeptin-sensitive proteases act synergistically, but the relative contribution of the leupeptin sensitive proteases depends upon the protein substrate. PMID- 3277542 TI - Pemphigus vulgaris. Combined treatment with intravenous corticosteroid pulse therapy, plasmapheresis, and azathioprine. AB - A 13-year-old child is described who presented with generalized pemphigus vulgaris associated with extraordinarily high titers of circulating autoantibodies against the pemphigus antigen. Because of the lack of response to treatment with reasonably high doses of oral corticosteroids, as well as the very high titer of circulating autoantibodies observed, this patient was treated with intravenous corticosteroid pulse therapy followed by plasmapheresis and then by combination immunosuppressive therapy (prednisone and azathioprine). A rapid clinical response was induced, correlating with reduction and subsequent elimination of the circulating pemphigus autoantibodies. Using such combination therapy, a remission of 12 months was achieved, and prednisone therapy was completely, albeit temporarily, tapered and then discontinued. Subsequent disease flare was then easily controlled with a short course of low-dose oral corticosteroid therapy. PMID- 3277543 TI - Congenital self-healing (transient) mechanobullous dermatosis. AB - A neonate with a congenital mechanobullous disorder is described and compared with similar patterns from the literature. The blisters were subepidermal, remitted within a few months, and have not recurred on long-term follow-up. The relation of the congenital self-healing mechanobullous dermatoses to epidermolysis bullosa is unclear. PMID- 3277544 TI - Persistent subepidermal blistering in split-thickness skin graft sites. Ultrastructural and antigenic features simulating dystrophic or immunofluorescence-negative acquired epidermolysis bullosa. AB - We describe a child who began developing subepidermal blisters in the recipient sites of split-thickness skin grafts; this process has continued for almost a year and continues to spare nongrafted skin. Routine histologic and immunofluorescence mapping studies demonstrated this disorder to be a relatively noninflammatory one characterized by sub-lamina densa blister formation. Results of direct immunofluorescence were negative. By electron microscopy, anchoring fibrils were sparse in number and in some areas appeared malformed; otherwise, the basement membrane zone was morphologically unremarkable. Bullous pemphigoid antigen, laminin, type IV collagen, epidermolysis bullosa acquisita antigen, and LDA-1 were all normally expressed along the dermoepidermal junction. In contrast, KF-1 antigen was absent. These findings suggest a disease process confined to skin graft recipient sites with features identical to those previously described with recessive dystrophic or immunofluorescence-negative acquired epidermolysis bullosa. PMID- 3277545 TI - Blunt trauma to the liver. Analysis of management and mortality in 323 consecutive patients. AB - This study represents a 6 year 4 month experience with blunt trauma to the liver of patients from the Maryland Institute for Emergency Medical Services Systems, a major regional trauma center. The significance of this study is that it describes a large, relatively homogeneous population and analyzes what the state of the art for liver trauma has been in a center dedicated solely to trauma that has a full time staff of trained traumatologists. Three hundred twenty-three consecutive patients with blunt liver trauma are presented, representing 3.5% of 9271 patients admitted to the institute over the period of this study. Ninety per cent had associated traumatic injuries requiring operative intervention. A mortality rate of 31% (101 patients) was noted; 41.5% of the deaths, due primarily to liver injury, occurred intraoperatively during the initial operation following admission. The use of simple suture techniques and resectional debridement to control hemorrhage are advocated. Anatomic lobectomy, intracaval shunting, and hepatic artery ligation were uniformly unsuccessful. The use of drains was associated with a significantly increased incidence of infectious complications (p less than 0.00002). PMID- 3277547 TI - Congenital angiodysplasia of the superficial venous system of the lower extremities in children. AB - Congenital angiodysplasia of the superficial venous system (SVS) of the lower extremities was diagnosed in 24 children 3-15 years of age. Nine patients presented with painful swelling in the affected limb. Venectasia and spongy venous masses were the main morphologic changes in the current series. Selective ascending functional phlebography and superficial phlebography were used to assess the anatomic extension of the lesions and to evaluate the functional status of the involved extremity: 14 patients had only SVS angiodysplasia, in 10 patients additional pathologic features of the deep veins (DV) were found. Venous reflux was demonstrated in 16 patients and significant venous insufficiency was detected in five patients. The patients were classified into three groups according to the severity of the disease: mild (11 patients), moderate (8 patients), and severe (5 patients). The prognostic and the long-term outcome of surgical treatment can be predicted by the depth and the extension of the angiodysplastic lesions. PMID- 3277546 TI - Neuroendocrine (Merkel cell) carcinoma of the skin. Its natural history, diagnosis, and treatment. AB - Over 400 cases of neuroendocrine (Merkel cell) carcinoma of the skin (NCS) have been reported. This tumor continues to pose problems in diagnosis and effective treatment for physicians unfamiliar with its biological characteristics. Reported here are five additional cases of NCS and the literature for this rare neoplasm is comprehensively reviewed. An early and accurate diagnosis is made possible by combining clinical presentation with results of histologic study, immunoperoxidase staining for neuron-specific enolase (NSE), epithelial membrane antigen (EMA), cytokeratins, and electron microscopy. NCS is an aggressive tumor. Depending on the length of follow-up, up to 40% of tumors locally recur, 55% develop regional nodal metastases, and 36% undergo distant metastasis. Survival is sex, but not age, dependent, with an overall 2-year survival rate of 72% (males 58% vs. females 79%). No standard procedure for initial and/or follow-up treatment for NCS exists. The authors recommend that NCS be treated, whenever possible, using the same rationale as applied for the treatment of squamous cell carcinoma of the skin. PMID- 3277549 TI - Cardiac transplantation after 60 years of age. PMID- 3277548 TI - Varicocele in youth. A therapeutic dilemma. AB - The need for treatment of asymptomatic varicocele in youth is controversial. In the current study testicular volume and seminal variables were evaluated in three groups: young varicocele patients with undetermined fertility potential, infertile varicocele patients, and a control group of young males. The testicular volume was determined by ultrasonographic measurements. The results revealed a significant loss of "testicular mass" in both varicocele groups compared with the control group. The seminal findings disclosed a severe disturbance of spermatogenesis in the older varicocele group, whereas in the younger varicocele patients only the total spermatic count was significantly depressed. This difference in severity of functional impairment between the younger and older varicocele groups possibly points towards progressiveness of damage to the testicles. A more decisive therapeutic approach to the young male with asymptomatic varicocele and unknown fertility status could be justified. PMID- 3277550 TI - Cardiac transplantation in patients over 60 years of age. AB - Cardiac transplant programs have routinely excluded patients over 55 years of age from consideration as transplant candidates. The Texas Heart Institute modified this policy of using age as a contraindication to transplantation. Between July, 1982, and August, 1987, a total of 200 cardiac transplants were performed, 28 (14%) of which were in patients over 60 years of age, the eldest being 66 years old at the time of transplant. Our immunosuppressive regimen consisted primarily of cyclosporine and prednisone. In 1985, azathioprine was added in an effort to decrease dosages of cyclosporine, thereby decreasing its associated nephrotoxicity. The incidences of rejection and infection were 1.2 and 1.4 episodes/patient, respectively, for those over 60 years of age versus 1.7 and 1.3 episodes/patient, respectively, for those less than 60 years of age. Of the 28 patients, 23 are alive and well. Four deaths were caused by infection, and the other by diffuse coronary arteritis. The one-year actuarial survival for patients over 60 years of age was 83%, compared with 75% for the other transplant patients. We conclude that persons over 60 years of age can undergo cardiac transplantation with results equal to or perhaps better than those of other heart transplant patients. Our experience suggests that advanced age should not be considered a major contraindication to cardiac transplantation. PMID- 3277551 TI - Transthoracic esophagectomy: a safe approach to carcinoma of the esophagus. AB - Transthoracic esophagogastrectomy is a safe operation. Mechanical staplers and a cervical anastomosis have been emphasized to avoid catastrophic consequences of anastomotic leaks in the chest. Transhiatal esophagectomy has been proposed to bring the anastomosis into the neck. It is meant to be a palliative procedure and consequently denies the patient the best chance for surgical cure. The emphasis should be on anastomotic technique and sound principles of surgical oncology. Since 1980, we have performed 104 esophagectomies for carcinoma of the esophagus. We used a left thoracoabdominal incision for distal tumors (64) and the Ivor Lewis technique (40) for more proximal tumors. A two-layer inverting interrupted silk suture technique was used for all anastomoses. More than 90% of the procedures were performed by resident staff. The operative mortality was 2.9% (3 patients). There were no anastomotic leaks. Five patients required between one dilation and three dilations postoperatively. A positive smoking history was present in 83 patients and substantial alcohol use, in 33. Median estimated blood loss was 500 ml, and 60% of patients required no transfusions. Major complications included pneumonia (12 patients) and reexploration for bleeding (2). Minor complications included atelectasis (71 patients), atrial fibrillation (9), ventricular arrhythmias (9), urinary tract infection (3), and wound infection (2). Squamous cancer was present in 31 patients and adenocarcinoma, in 73. Positive lymph node metastases were present in 75%. Anastomotic recurrence was documented in 6 patients. Standard techniques of esophagogastrectomy and a two-layer anastomosis will give excellent results with low mortality and acceptable morbidity. PMID- 3277552 TI - The combined Collis-Nissen operation for esophageal reflux strictures. AB - This report evaluates the efficacy of the combined Collis-Nissen operation in achieving long-term reflux control in patients with reflux strictures. A Collis Nissen procedure with dilation of a reflux stricture was performed in 64 adults. The strictures were mild (easily dilated) in 37, moderate (requiring some force to dilate) in 17, and severe (requiring very forceful dilation) in 10. Two strictures were perforated intraoperatively. There was 1 postoperative death, and 4 patients have been lost to follow-up. The remaining 59 patients have been followed from 2 to 120 months (average, 43 months) after operation. Subjectively, reflux is absent in 48 (81%), mild in 4 (7%), moderate in 5 (9%), and severe in 2 (3%). Objectively, intraesophageal pH studies show good or excellent reflux control in 94% at 1 year and 66% at 2 to 5 years. Dysphagia has been eliminated in 71%, is mild in 10%, moderate (requiring occasional dilation) in 12%, and severe (requiring regular dilations) in 7%. The combined Collis-Nissen operation provides good long-term reflux control and relief of dysphagia in most patients with reflux strictures. However, patients with reflux strictures after previous repairs are likely to have unsatisfactory results and may best be managed with resectional therapy. Resection may also ultimately prove to be a better option for patients with more severe strictures. PMID- 3277553 TI - Value of urinary polyamines as noninvasive markers of cardiac allograft rejection in the dog. AB - A noninvasive marker of cardiac allograft rejection would be useful clinically. Lymphocyte proliferation and organ rejection may cause changes in urinary polyamine excretion. To test this hypothesis, cervical heterotopic heart transplantations were performed in a group of 6 nonimmunosuppressed dogs and in a group of 9 dogs treated with cyclosporine (N = 3) or cyclosporine and steroids (N = 6). A group (N = 3) having a sham operation was also studied. Serial biopsies of the transplanted hearts were performed. Urinary polyamine levels were measured daily by high-pressure liquid chromatography of urine specimens. Between 2 and 4 days after transplantation, the transplanted hearts of all animals without immunosuppression demonstrated histological rejection. An early increase in putrescine levels and in total urinary polyamine levels was observed in this group. In the treated groups, histological rejection appeared from the second to the eighth day after transplantation. Each episode of rejection occurred from 1 day to 4 days after a significant increase in urinary polyamine levels compared with the preoperative baseline level (p less than 0.01). In contrast, polyamine excretion in 3 dogs after sham operations remained unchanged. Thus, urinary excretion of polyamines increases before the appearance of histological rejection; this suggests that changes in urinary polyamine levels may be a useful marker of cardiac allograft rejection. PMID- 3277554 TI - Heart valve replacement with the Bjork-Shiley Monostrut valve: early results of a multicenter clinical investigation. AB - To evaluate the clinical performance of the Bjork-Shiley Monostrut prosthesis, five centers combined their early experience. Between May, 1982, and June, 1985, 537 prostheses were implanted in 486 patients at these centers: 246 patients had aortic valve replacement (AVR), 163 underwent mitral valve replacement (MVR), and 47 had double-valve replacement (DVR). Thirty patients underwent other, more complex procedures. Concomitant cardiac procedures were performed in altogether 25%. Overall hospital (30 days) mortality was 5.1% (3.6% for AVR, 4.3% for MVR, 8.3% for DVR, and 16.6% for other procedures). The patients were followed up at 6 to 9-month intervals from 6 to 48 months (mean follow-up, 33 months). Follow-up was 99.6% complete. Late mortality was 7.2%. The three-year survival rate was 91.0% for AVR, 92.3% for MVR, and 76.2% for DVR. There was no structural failure of the prosthesis. No instances of valve thrombosis and fatal thromboembolism occurred in anticoagulated patients. The three-year incidence of freedom from thromboembolic events (including TIA) was 89.8% for AVR, 94.9% for MVR, and 90.2% for DVR. Preoperative and postoperative data for the assessment of mechanical hemolysis was available in 60% of the patients. The degree of mechanical hemolysis was low and did not change with time. Although the follow-up is still short, the Bjork-Shiley Monostrut prosthesis appears to represent an improvement over previous Bjork-Shiley models, particularly with regard to durability. PMID- 3277555 TI - The surgical treatment of aortic regurgitation secondary to aortitis. AB - We describe the operative and perioperative management of 11 patients with aortic regurgitation due to aortitis. All patients required aortic valve replacement because of severely uncoapted cusps secondary to dilatation of the ascending aorta. The right coronary ostium was narrowed in 5 patients and consequently necessitated a smaller coronary tip for the administration of cardioplegic solution. To implant the prosthetic valve, pledgeted 2-0 Tevdek sutures were placed through the aortic valve annulus either from the ventricular side or from outside the aortic wall. Steroids were administered to 4 patients preoperatively and 8 patients postoperatively. Postoperative dehiscence of the prosthesis was seen in 1 of the 3 patients not given any steriods. We conclude that it is important to arrest the inflammatory reaction before operation and if the aortic valve must be replaced, to reinforce the implanted prosthesis with pledgeted sutures. Also, we suggest the possible importance of steroid therapy. PMID- 3277556 TI - The changing face of cardiac transplantation: the Washington University Program, 1985-1987. AB - Since January, 1985, 59 patients have undergone 62 heart transplantations at Washington University School of Medicine. The experience in this program serves as a useful microcosm of the field of cardiac transplantation as a whole to demonstrate certain trends that are becoming evident. Of the patients, 47% had coronary artery disease compared with 40% with cardiomyopathy. Fourteen patients (24%) were 55 years old or older at the time of transplantation. Sixteen patients (27%) required mechanical support of respiration or circulation or both prior to transplantation. Six patients were maintained with a left ventricular or biventricular assist device, and all survived; 1 patient received extracorporeal membrane oxygenation and lived; 7 patients were maintained with an intraaortic balloon pump, 6 of whom survived; and 2 were maintained with a mechanical ventilator and survived. The preoperative waiting period averaged 51 days for the group as a whole. Status-3 patients experienced an average 81-day waiting period, and those in blood group O waited 155 days. In contrast, critically ill patients (status 0) underwent transplantation within an average of 9 days. Actuarial survival at 12 months for all patients, operative survivors, patients age 55 years old or more, and patients bridged to transplantation was 87%, 92%, 84%, and 87%, respectively. Utilizing the combination therapy of cyclosporine, azathioprine, and prednisone introduced by one of us in 1983 and administered to all patients in this series, 50% of patients were rejection free and 56% were infection free at 12 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277557 TI - A technique to repair type I left ventricular rupture following mitral valve replacement. AB - Rupture of the posterior left ventricle is a serious complication following mitral valve replacement. A successful method of repair is illustrated. The causes, other methods of repair, and means to prevent this complication are discussed. PMID- 3277558 TI - Cholesterol-lowering effects of psyllium hydrophilic mucilloid for hypercholesterolemic men. AB - The effect of psyllium hydrophilic mucilloid on serum cholesterol levels was investigated in 26 men with mild to moderate hypercholesterolemia (range of cholesterol level, 4.86 to 8.12 mmol/L [188 to 314 mg/dL]) in a double-blind, placebo-controlled parallel study. Following a two-week baseline period, subjects were treated for eight weeks with 3.4 g of psyllium or cellulose placebo at mealtimes (three doses per day). All subjects maintained their usual diets, which provided less than 300 mg of cholesterol per day and approximately 20% of energy from protein, 40% from carbohydrate, and 40% from fat. Eight weeks of treatment with psyllium reduced serum total cholesterol levels by 14.8%, low-density lipoprotein (LDL) cholesterol by 20.2%, and the ratio of LDL cholesterol to high density lipoprotein cholesterol by 14.8% relative to baseline values. The reductions in total cholesterol and LDL cholesterol became progressively larger with time, and this trend appeared to be continuing at the eighth week. Psyllium treatment did not affect body weight, blood pressure, or serum levels of high density lipoprotein cholesterol, triglycerides, glucose, iron, or zinc. No significant changes in serum lipid levels, body weight, blood pressure, or other serum parameters were observed with placebo treatment. Subject adherence to psyllium treatment was excellent, and no adverse effects were observed. Results of this study show that psyllium is an effective and well-tolerated therapy for mild to moderate hypercholesterolemia. PMID- 3277559 TI - Extraintestinal manifestations of idiopathic inflammatory bowel disease. AB - Ulcerative colitis and Crohn's disease have reported associations with a spectrum of extraintestinal diseases. This association has been appropriately termed as extraintestinal manifestations because large case studies have demonstrated that between 25% to 36% of patients with either type of inflammatory bowel disease will have at least one such associated disease. The spectrum of diseases reported associated with either ulcerative colitis or Crohn's disease involves many organ systems. Some of these extraintestinal manifestations are related to active colitis--joint, skin, ocular, and oral; small bowel dysfunction--cholelithiasis and nephrolithiasis; and nonspecific manifestations such as amyloidosis and hepatobiliary diseases. The purpose of this review is to update the clinicians with the most recent literature concerning the etiology, clinical course and the therapy of the extraintestinal manifestations associated with both forms of idiopathic inflammatory bowel disease. PMID- 3277560 TI - Nontraumatic prehospital sudden death in young adults. AB - The clinical and/or autopsy records of 83 consecutive adults presenting with nontraumatic prehospital sudden death (NPSD) in a single county were reviewed. Coronary artery disease (CAD) was the primary cause of death in individuals 36 to 45 years old. Non-CAD cardiac disease was the second most common cause of NPSD in this age group. Between the ages of 18 and 35 years, non-CAD cardiac disease was the primary cause and toxic ingestions were the second most common. Patients with rhythms other than ventricular fibrillation/tachycardia, asystole, or electromechanical dissociation on presentation to the emergency room (ER) were more likely to survive. Patients with asystole in the ER were more likely to die in the ER than were patients with other rhythms. Patients with toxic ingestions tended to have a better prognosis for successful resuscitation and for ultimate survival. Age, sex, bystander cardiopulmonary resuscitation, and time in the field were not significant prognostic variables. Patients with abdominal hemorrhage (eight of 83) as the cause of NPSD may represent a subgroup for whom a special approach is warranted. None of these patients survived. Early detection by culdocentesis or paracentesis in female patients of reproductive age and nasogastric lavage or stool occult blood testing could lead to more vigorous fluid resuscitation and early surgical intervention in abdominal hemorrhage. PMID- 3277561 TI - Random urine bile acids in prediction of liver abnormality in asymptomatic alcoholics. AB - We evaluated bile acids for prediction of abnormal serum liver profile in a random sample of urine (URNBA). Seventy-four subjects with excessive alcohol intake, self-referred for outpatient detoxification, had no history or physical findings of liver disease. Surprisingly, in 49% (36/74) of alcoholics, two or more of these were elevated: serum bile acids, aspartate aminotransferase (AST), alanine aminotransferase, alkaline phosphatase (ALP), and/or total bilirubin. All subjects were subdivided into 39 URNBA normal and 35 URNBA abnormal, using 2.6 mumol/g of creatinine as a dividing value. Serum tests confirmed the subgrouping made with URNBA. Compared with alanine aminotransferase, URNBA had better sensitivity, specificity, and overall diagnostic accuracy predicting abnormal serum bile acids, AST, and alkaline phosphatase values. A predictive potential for a multivariate discriminant function of laboratory tests, known to best identify biopsy-documented mild liver disease, was only mildly inferior for URNBA when compared with AST. Multiple abnormalities of liver test results are unexpectedly frequent in asymptomatic alcoholics. The URNBA are helpful in the detection of liver abnormality in its clinically latent phase, because of the convenience of testing a spot sample of urine. PMID- 3277562 TI - Blinded comparison of cefuroxime to cefaclor for lower respiratory tract infections. AB - Cefuroxime axetil was compared with cefaclor for the therapy for lower respiratory tract infections. Sixty-one patients were randomized to receive the following drug dosages: (1) cefuroxime axetil, 250 mg orally every 12 hours (21 patients); (2) cefuroxime axetil, 500 mg orally every 12 hours (21 patients); and (3) cefaclor, 500 mg orally every eight hours (19 patients). Of these 61 patients, 80% were male, with a mean age of 59.5 years; 56% had acute pneumonia, and the remainder had an acute bronchitis. Causative pathogens included typical respiratory tract pathogens. Overall, 23 of 27 patients with bronchitis were clinically cured at the end of therapy. Thirty-one of 34 pneumonias were clinically cured or improved at the end of therapy; the three pneumonia treatment failures occurred in the lower dose cefuroxime (n = 2) and cefaclor (n = 1) treatment groups. Overall, bacteriologic cure occurred in 86% of patients treated with 500 mg of cefuroxime axetil compared with 60% of cefaclor-treated patients. Adverse clinical effects were uncommon. From this study, it was concluded that cefuroxime given every 12 hours is at least as clinically efficacious as cefaclor; it is a new oral cephalosporin with pharmacologic and bacterial spectrum advantages over many older agents. PMID- 3277563 TI - Mechanisms of hyperkalemia in systemic lupus erythematosus. AB - We found that nearly 10% of 142 patients with systemic lupus erythematosus (SLE) had persistent, unexplained hyperkalemia. Renal mineralocorticoid resistance has been suggested to account for the hyperkalemia in SLE. We studied the renin aldosterone response to intravenous furosemide (60 mg) and upright posture and the renin response to converting enzyme inhibition (captopril, 50 mg) and upright posture in five patients with SLE and hyperkalemia (group 1) and five normokalemic patients with SLE (group 2). Renal function was comparable. Plasma chloride level was higher and bicarbonate level slightly lower in group 1 than in group 2. Plasma cortisol level was normal in all patients. None of the patients was receiving nonsteroidal anti-inflammatory drugs or corticosteroids at the time of study. Basal plasma renin concentration and plasma aldosterone level were not significantly different between the two groups, although both tended to be higher in group 2. However, four of the five patients in group 1 had significantly blunted renin response to captopril compared with group 2. The same four patients also had blunted renin and aldosterone responses to furosemide. Thus, the majority of hyperkalemic patients with SLE had an impaired renin and aldosterone response to stimulation. We conclude that hyporeninemic hypoaldosteronism plays a key role in the pathogenesis of hyperkalemia in SLE. PMID- 3277564 TI - Cancer of the nongastric hollow organs of the gastrointestinal tract after gastric surgery. AB - To estimate the risk of esophageal, gallbladder, small-bowel, and colon cancers after gastric surgery for benign disease, all 337 residents of Olmsted County, Minnesota, who had surgical treatment of benign peptic ulcer disease during the years 1935 through 1959, were followed up. Patients were followed up for 6552 person-years of observation. No esophageal cancers developed (0.8 were expected). Members of the cohort developed one small-bowel malignant neoplasm (0.2 were expected), two gallbladder cancers (1.1 was expected), and four colon cancers (11.2 were expected), but these figures do not reflect a significant increase in the risk of these malignant neoplasms. In particular, the relative risk of developing colon cancer was only 0.4 when this analysis had 88% power to detect a relative risk of two or more. When the present investigation and two previous studies of this cohort were taken together, there was no strong evidence for an increased risk of any gastrointestinal cancer following gastric surgery. PMID- 3277565 TI - Vertebral osteomyelitis presenting as spinal compression fracture. Six patients with underlying osteoporosis. AB - Six patients with osteoporosis had vertebral osteomyelitis (VO) with infection of a single vertebra that presented with a collapsed vertebral body, thought to be a simple compression fracture. The resulting delay in correctly diagnosing VO was associated with disabling sequelae in a high proportion of cases. This distinctive presentation accounted for 13% of all hospitalized patients with VO and 2.4% of inpatients with osteoporotic compression fractures during the last five years; it may be more common than suggested by the paucity of published cases. In patients with osteoporosis and vertebral compression fractures, osteomyelitis should be considered when there is severe back pain, persistent unexplained fever, unexplained elevation of the erythrocyte sedimentation rate, or bacteremia without an obvious extravertebral focus of infection, particularly if the patient is immunocompromised. Early biopsy and culture of the collapsed vertebral body will facilitate diagnosis and therapy. PMID- 3277566 TI - Willem Einthoven--the man. The string galvanometer electrocardiograph. AB - Despite the universal use of the electrocardiogram for cardiac evaluation, surprisingly few physicians are aware of the individual, Willem Einthoven, who in 1901 reported and in 1924 received the Nobel Prize for the development of the string galvanometer electrocardiograph. Following the development of this comparatively simple device, there has been a succession of increasingly, electrically exotic, electrocardiographs, none of which surpass the original Einthoven instrument in recording accuracy. The resolution of mechanical problems in the laboratory, incident to development of the Einthoven instrument, is of interest in view of the primitive laboratory equipment available during the period the device was developed. Einthoven's preference for funds for additional laboratory assistants and equipment, in lieu of a new laboratory building as a monument to his name and his subsequent disposal of half of the Nobel Prize money, reveal the basic character of this great man, rightfully called the Father of Electrocardiography. PMID- 3277567 TI - Ludwig's angina. Report of a case and review of the literature. AB - In the preantibiotic era, Ludwig's angina frequently caused asphyxiation and death. Recognized less often today, this rapidly progressive submaxillary cellulitis may still be fatal. A case associated with Haemophilus influenzae bacteremia in an adult is presented. Twelve additional cases of cellulitis of the neck in adults with H influenzae bacteremia are summarized. One hundred forty-one cases of Ludwig's angina reported since 1945 are reviewed and compared with 315 earlier cases. In the cases reported in the antibiotic era, the mean age of the patients was 29 years. Most patients were previously healthy but had evidence of dental disease. Submandibular swelling, elevation of the tongue, fever, dysphagia, and trismus were each present in more than one half of patients. Streptococci and anaerobes were most frequently isolated from soft-tissue cultures. Untreated, this illness is fatal in one half of patients. Early recognition is therefore essential. Appropriate therapy includes maintenance of the airway, antibiotics, and surgical drainage when indicated. PMID- 3277568 TI - Intravenous dilevalol. Effects of the R-R optical isomer of labetalol in patients with severe hypertension. AB - Dilevalol hydrochloride, the R-R optical isomer of labetalol hydrochloride, was administered intravenously to subjects with severe hypertension. Twelve subjects with supine diastolic blood pressure of more than 115 mm Hg (mean, 124 +/- 2 mm Hg) were studied. Initial doses of 25 mg of dilevalol administered as a slowly given bolus reduced blood pressure by 14/16 mm Hg. With subsequent additional boluses to a total dose of up to 600 mg, supine diastolic blood pressure was reduced to less than 95 mm Hg in ten of 12 subjects studied (mean reduction, 28 mm Hg). Side effects were minimal and upright blood pressure at the time of reduction of blood pressure to goal was not significantly different from supine blood pressure. Plasma renin activity decreased in 11 of 11 subjects studied. Plasma epinephrine concentrations did not change significantly, whereas plasma norepinephrine concentrations increased 2 1/2-fold, probably reflecting the effect of beta 2-agonism on norepinephrine release. Dilevalol appears to be a safe and effective way of lowering blood pressure short term when intravenous antihypertensive therapy is indicated. PMID- 3277569 TI - Concomitant administration of terazosin and atenolol for the treatment of essential hypertension. AB - The safety and efficacy of once-daily terazosin hydrochloride administered concomitantly with once-daily atenolol for the treatment of essential hypertension were evaluated in this double-blind, multiclinic, placebo-controlled study. After each patient received 50 mg of atenolol daily for eight weeks, patients with a supine diastolic blood pressure (DBP) of 95 to 110 mm Hg and whose supine DBP had decreased at least 5 mm Hg were randomized to receive either terazosin (plus atenolol) or placebo (plus atenolol) for ten weeks. Patients assigned to the terazosin hydrochloride treatment group received increasing dosages (1,2,5, and 10 mg daily) [corrected] of terazosin at two-week intervals until the maximum dose was reached or until the supine DBP was decreased to less than 90 mm Hg. Terazosin-treated patients (n = 43) had significant mean decreases from the baseline in supine BP (systolic/diastolic = -8.8/-8.5 mm Hg) and standing BP (-10.9/-9.5 mm Hg), whereas the decreases in BP in the placebo treated patients (n = 49; supine, -2.3/-2.6 mm Hg; standing, -1.4/-1.3 mm Hg) were not significant. When terazosin and placebo were compared, the differences in BP were significant. Terazosin-treated patients had significantly greater decreases in mean percent change of total cholesterol (-4.8%) and low-density lipoprotein plus very-low-density lipoprotein cholesterol (-6.3%) levels, compared with the placebo-treated patients (+0.6% and +1.1%, respectively). Concomitant administration of terazosin and atenolol to patients with essential hypertension was found to be safe and efficacious. PMID- 3277570 TI - Potassium homeostasis in liver cirrhosis. AB - Extrarenal mechanisms are important in the defense against hyperkalemia. During a potassium load, cellular uptake is essential to avoid severe hyperkalemia. Liver and muscles represent the major buffering system, partially mediated by insulin, in the distribution of potassium between intracellular and extracellular fluids. To study the potential role of the liver, we administered an oral load of potassium (0.75 mEq/kg) to nine male patients with compensated cirrhosis and ten normal subjects of similar age, sex, and weight. Despite identical renal excretion, cirrhotic patients had higher potassium levels two and three hours after oral administration. Moreover, only cirrhotic patients presented a clear cut increase in serum C-peptide concentration after the potassium load without any change in glucose level. It is likely that, in cirrhosis, liver failure contributes to the decrease in hepatic cellular potassium uptake despite insulin hypersecretion. PMID- 3277571 TI - Long-term follow-up of 369 diabetic patients undergoing dialysis. AB - We studied the long-term outcome (after four years) in 233 patients with type I and 136 with type II diabetes mellitus treated with long-term dialysis between 1966 and 1982. The seven-year cumulative survival improved from 12% before 1976 to 20% after 1976. Sixty-eight of the patients survived for more than four years, and 25 are still alive. Of deaths, 51% were due to cardiovascular disease, 24% to the discontinuation of dialysis, 14% to infections, and 11% to other causes. Over the course of the study, older and sicker patients were increasingly accepted for dialysis, and younger and healthier patients were increasingly accepted for transplantation. The 25 patients who are still alive and undergoing dialysis were hospitalized 1.4 times per patient year for 19 hospital days per patient year the first year and for eight days per patient year after that. Two became blind, three had amputations, seven worked full-time. The results of long-term dialysis in patients with diabetes have improved greatly over the last two decades. PMID- 3277572 TI - Group B streptococcal sepsis in adults and infants. Contrasts and comparisons. AB - Group B streptococcal infection may result in significant morbidity and mortality in both infants and adults. The experience with group B streptococcal disease was analyzed at one medical center over a ten-year period from 1975 to 1984. Streptococcus agalactiae bacteremia was observed in 29 adults and 26 infants, with an attack rate of 0.2 cases per 1000 adult admissions and 3.2 cases per 1000 live births, respectively. The majority of adult infections apparently occurred as a result of nosocomial acquisition and was associated with a high mortality rate of 38%. Risk factors for group B streptococcal sepsis in adults include diabetes mellitus, malignancy, and hepatic failure. The majority (73%) of neonatal cases occurred within seven days of birth and occurred in a setting of maternal fever, prolonged rupture of membranes, or prematurity. The mortality rate in infants was remarkably low at only 15%. Fatalities occurred in both adults and infants, despite appropriate antimicrobial therapy. Infection control strategies against group B streptococcus must address potential nosocomial dissemination in adults as well as vertical transmission in infants. PMID- 3277573 TI - Successful intravenous immune globulin therapy for human immunodeficiency virus associated thrombocytopenia. AB - High-dose intravenous (IV) immune globulin was used to treat human immunodeficiency virus (HIV)-associated thrombocytopenia four times in three patients. The average platelet count at initiation of therapy was 12 x 10(9)/L (12 x 10(3)/mm3), and the platelet count after therapy was 159 x 10(9)/L (159 x 10(3)/mm3), giving a mean increase of 147 x 10(9)/L (147 x 10(3)/mm3) (1225%). The conditions of two of these patients were refractory to corticosteroids, but giving IV immune globulin along with steroids appeared to enhance the response to IV immune globulin. A review of the literature revealed that 53 (88%) of 60 patients with HIV-associated thrombocytopenia responded to IV immune globulin with platelet counts greater than 50 x 10(9)/L (50 x 10(3)/mm3). We conclude that IV immune globulin therapy achieves transient elevations in platelet counts to levels that control bleeding and permit surgery in patients with severe, HIV associated thrombocytopenia. PMID- 3277575 TI - Necrotizing fasciitis in adults due to group B streptococcus. Report of a case and review of the literature. AB - Necrotizing fasciitis is an uncommon severe infection involving subcutaneous tissues and advancing along fascial planes. Group B streptococcal infections occur disproportionately in diabetics and pregnant women. Although fasciitis secondary to group B streptococcus has been described in infants and adult women in the postpartum period, we report the first case, to our knowledge, of group B streptococcal necrotizing fasciitis in an adult diabetic unrelated to obstetric complications. PMID- 3277574 TI - Candida pericarditis and tamponade in a patient with systemic lupus erythematosus. AB - Candida pericarditis and tamponade developed in a patient with sterile purulent pericarditis secondary to systemic lupus erythematosus. Therapy with amphotericin B and properly timed surgical intervention led to a clinical and microbiological cure. This article emphasizes the importance of differentiating an infected pericardial effusion from the sterile pericarditis of systemic lupus erythematosus and provides suggested guidelines for the management of that complication. PMID- 3277576 TI - Guillain-Barre syndrome following Campylobacter jejuni enteritis. Report of three cases and review of the literature. AB - We describe three cases of Guillain-Barre syndrome (GBS) associated with Campylobacter jejuni enteritis and review the data from eight other cases described in detail in the literature. The recent recognition of this association is probably due to improved stool culture technique. In comparison with GBS associated with respiratory infections, the delay between the first symptoms of infection and the development of GBS is somewhat longer, an observation in accordance with GBS associated with gastrointestinal symptoms of unidentified etiology. The clinical picture and the outcome do not seem to differ from those of GBS associated with other disorders. Campylobacter jejuni appears to be a pathogen capable of triggering GBS and will probably become increasingly recognized if appropriate culture and serologic tests are performed. PMID- 3277577 TI - Shigella bacteremia. PMID- 3277578 TI - Inpatient family intervention: a randomized clinical trial. II. Results at hospital discharge. AB - Although family intervention is practiced in most psychiatric hospitals, to our knowledge, no adequately controlled studies of its efficacy exist. This study was designed to answer, in part, the question of the relative efficacy of hospitalization with family intervention as compared with hospitalization without family intervention for patients (1) with major psychiatric disorders, (2) in need of hospital treatment, and (3) for whom both treatments are judged clinically feasible. This article compares treatment results at the time of hospital discharge for 169 patients randomly assigned to the inpatient Family Intervention or comparison conditions. Inpatient Family Intervention had greater efficacy than the comparison treatment, mostly attributable to its effect on female patients, especially those patients (and their families) with affective disorder. PMID- 3277580 TI - Family and genetic studies of affective disorders. AB - This article summarizes discussion, conclusions, and recommendations of participants in a National Institute of Mental Health-sponsored workshop dealing with major issues in family and genetic studies of affective disorders. Key up-to date findings in the field are reviewed with emphasis on areas of agreement. Remaining controversies and problems are identified, and a set of overall conclusions and recommendations for future research activities in the field is presented. PMID- 3277579 TI - Imipramine treatment for chronic depression. AB - Antidepressant drugs in the treatment of chronic depressions have received little systematic study. We used a two-week, single-blind placebo washout followed by a six-week, double-blind comparison of imipramine hydrochloride and placebo in a sample of 76 outpatients with DSM-III dysthymic disorder entered into a trial at two centers. Subjects were preponderantly female, had insidious onset at an early age, and had depressions of moderate severity; 96% also met the DSM-III criteria for major depressive disorder at the time of presentation. Sixty percent had a history of persistent depressive symptoms sufficient to meet criteria for major depression for longer than two years. Markedly favorable responses occurred in 45% of imipramine-treated (n = 29) and 12% of placebo-treated (n = 25) patients and, respectively, 59% and 13% of those who completed the study. Imipramine produced significant advantage in measures of depressive symptoms, global severity of illness, and self-rated social and vocational function. Recovered patients experienced remission from both long-standing symptoms and deficits as well as more recently exacerbated aspects of their syndrome. Patients with pure dysthymic disorder of a mild, subsyndromal type were uncommon in these clinical settings. However, anti-depressant medication was effective for many moderately severe chronic depressions, which had previously been untreated or undertreated, presumably related to misdiagnosis. PMID- 3277581 TI - Postresidency fellowships: an investment in the future. Presidential address. PMID- 3277582 TI - Treatment of severe intra-abdominal sepsis and/or necrotic foci by an 'open abdomen' approach. Zipper and zipper-mesh techniques. AB - Undrained necrotic tissue or septic foci contribute to continued "activation" of host processes that in turn lead to multiple organ failure and death. We hypothesized that if wide-open drainage of the abdominal cavity is provided, thus not allowing intra-abdominal collections to form, mortality in these patients can be reduced. Since 1982 we have treated 49 patients with necrotic pancreatitis and related infections and 15 patients with severe intra-abdominal sepsis from intestinal perforations. The surgical treatment was based on the provision for daily laparotomies in the intensive care unit with the patient under epidural anesthesia by using an "open-abdomen" technique (zipper alone or a zipper-mesh combination). The APACHE II score and the functional classification were used to derive expected mortalities. The patients with intraabdominal sepsis had a mean APACHE II score of 25 and an expected mortality of 45%, vs the 26.5% mortality that we observed. The lowest mortality in the necrotic pancreatitis group was associated with noninfected pancreatic necrosis (6%) and single abscess (9%) vs 22% mortality rate in the patients with infected pancreatic necrosis. The mean expected mortality in this group was 47%, vs the observed 22%. We attributed this result to the daily abdominal explorations that achieved a complete excision of infected or necrotic tissue. PMID- 3277583 TI - The comparative clearance rates of the pleural and peritoneal cavities. AB - We compared the rates of bacterial clearance from the pleural and peritoneal cavities of rats after contamination with 1 x 10(6) live Escherichia coli. Pleural clearance was enhanced beginning at 30 minutes after injection and extended to at least six hours. At 24 hours, the clearance was similar for both the pleural and peritoneal groups. Blood and organ bacterial cultures were similar between these two groups. White blood cell populations were similar at rest, but there was a greater increase in the leukocyte population in the pleural cavity six hours after E coli stimulation. We postulate that the increased clearance of E coli from the pleural cavity may be due to differences in lymphatic absorption, recruitment of leukocytes, or fibrin trapping of bacteria. PMID- 3277585 TI - Red blood cell deformability in human and experimental sepsis. AB - Red blood cell (RBC) "deformability" is necessary for maintenance of normal microcirculation. To determine whether RBC deformability was affected in human or murine sepsis, a deformability index was determined in a human study and a murine model. Deformability was decreased postoperatively in patients with sepsis (0.49 +/- 0.12) compared with patients without sepsis (1.62 +/- 0.13) and normal control volunteers (1.51 +/- 0.17). Deformability was decreased in rats that had undergone cecal ligation and puncture (0.37 +/- 0.06) compared with that of sham operated rats (0.76 +/- 0.12), as well as in endotoxemic rats (0.38 +/- 0.4) compared with control rats (0.82 +/- 0.11). These data suggest that RBC deformability decreases in both human and murine sepsis. This effect could be an important factor in the disordered oxygen utilization noted in human sepsis, and its correction could lead to better tissue oxygenation and preserved organ function. PMID- 3277584 TI - Terminal complement complexes and anaphylatoxins in septic and ischemic patients. AB - Terminal complement complex (TCC) and anaphylatoxin formation in 18 patients with sepsis and 20 patients with acute limb ischemia were studied before the start of treatment and seven days later. The septic or ischemic patients had elevated levels of plasma TCC before start of therapy. In successfully treated patients these concentrations were within the normal range one week later. Similarly, the plasma anaphylatoxin level was increased before therapy and returned to the normal range within seven days. Escherichia coli incubated in vitro in fresh human serum at body temperature started formation of TCC in a dose-related manner. As complement will induce cellular lysis via TCC and edema via anaphylatoxins, anemia and impaired respiration in these patients may be influenced by increased concentrations of terminal complement complexes and of C3a and C5a. PMID- 3277586 TI - Enhancement of mitochondrial function in sepsis. AB - Recent reports from our laboratory have challenged the concept that sepsis selectively damages or interferes with mitochondrial function. To address the lingering skepticism that mitochondrial assays in surviving animals might not detect this "injury," we injected rats with a lethal dose of Escherichia coli endotoxin and compared hepatic, cardiac, and skeletal muscle mitochondrial function in these animals with that of control rats. Mitochondrial function was serially determined during a four-hour postmortem period by measuring the respiratory control ratio, the adenosine diphosphate-oxygen ratio, and protein levels. Hepatic mitochondria ceased to function within 30 minutes of the time of death. Cardiac and skeletal muscle mitochondria functioned normally up to four hours after death in both septic and control animals. Mitochondria from septic animals had a significantly higher respiratory control ratio than those from control rats. Thus, sepsis appears to enhance rather than damage mitochondrial function up to four hours after death. PMID- 3277587 TI - Prospective study comparing imipenem-cilastatin with clindamycin and gentamicin for the treatment of serious surgical infections. AB - Surgical infection remains a leading cause of hospital morbidity and mortality. We compared the efficacy and toxicity of imipenem-cilastatin sodium in 32 patients with that of clindamycin phosphate and gentamicin sulfate in 25 patients. In the imipenem-cilastatin group, 87.5% had a favorable outcome, with a 12.5% failure rate and 13 adverse reactions. In the clindamycin-gentamicin group, 80% had a favorable outcome, with a 20% failure rate and ten adverse reactions. Two significant superinfections with Pseudomonas and Candida were noted in patients treated with impenem-cilastatin. Each group had one case of Clostridium difficile-associated colitis. Cost analysis showed no differences between treatment arms, except in the appendicitis subgroup. For serious surgical infections, single-agent therapy with imipenem-cilastatin appears to be as efficacious as combination therapy with clindamycin and gentamicin. PMID- 3277588 TI - Duration of preventive antibiotic administration for open extremity fractures. AB - The necessary duration of antibiotic administration after open fracture has not been established. In a double-blind prospective trial we randomized 248 patients with open fractures to receive one or five days of cefonicid sodium therapy or five days of cefamandole nafate therapy as part of the initial treatment. Rates of fracture-associated infections in the three groups were ten (13%) of 79, ten (12%) of 85, and 11 (13%) of 84, respectively. The 95% confidence limit for the difference in infection rates between the one-day group and the combined five-day groups was 0% to 8.3%. The actual difference was 0.2%. A brief course of antibiotic administration is not inferior to a prolonged course of antibiotics for prevention of postoperative fracture-site infections. PMID- 3277589 TI - Pulmonary microvascular changes following fluid resuscitation in an ovine model of endotoxemia. AB - Fluid resuscitation is complicated in hypotensive septic patients by their susceptibility to pulmonary edema. This problem was evaluated in the ovine model of endotoxemia with a chronic lung lymph fistula. Escherichia coli endotoxin (lipopolysaccharide, 1.5 micrograms/kg) was given intravenously over 30 minutes. Group M (n = 9) continued to receive baseline fluids (2 mL/kg/h), while group R (n = 6) received 7 mL/kg/h of Ringer's lactate. After an initial drop in cardiac index, animals in both groups developed a hyperdynamic state. The fall in mean arterial pressure seen in group M was absent from group R. The higher fluid volume resulted in a rise in left atrial pressure and pulmonary microvascular pressure. The lung lymph flow and permeability index were elevated in both groups but were higher in group R. The calculated filtration coefficient showed a threefold increase in both groups. Augmented fluid resuscitation during endotoxemia resulted in an elevated interstitial fluid flux and permeability index secondary to an increase in pulmonary microvascular pressure and greater surface area of the injured microvascular beds being perfused. PMID- 3277590 TI - Injury to segmental bile ducts. A reappraisal. AB - No principles have so far been applied to the management advocated for injuries to segmental bile ducts. On the basis of experimental data and clinical evidence related to the pathophysiological sequelae of segmental bile duct obstruction, and given the potentially harmful complications of reconstructive surgery in combination with its uncertain outcome, it is suggested that simple ligation of injured segmental ducts is the treatment of choice, irrespective of their size. PMID- 3277591 TI - Toothbrush swallowing. AB - We encountered four cases of toothbrush swallowing and reviewed the literature on this subject. A total of 31 toothbrushes within the gastrointestinal tract have been reported. None have passed spontaneously. Several have caused significant complications related to pressure necrosis, including gastritis, mucosal tears, and perforation. The recommended treatment is endoscopic retrieval and postoperative monitoring for 24 hours in case of esophageal or gastric injury. PMID- 3277592 TI - Effective technique of sternum closure in high-risk patients. AB - A successful technique of closing the sternum in a selected group of poor-risk patients involves the combination of a mattress suture and a fixative single-wire suture, both of 0 stainless-steel monofilament. Our technique was used on 100 high-risk patients and compared with double control groups, one consisting of 200 normal-risk patients and the second of 100 high-risk patients. We found that the incidence of wound infections was reduced to 1% with our new technique compared with 3% and 1% in the control groups (the high- and normal-risk groups, respectively). There was neither dehiscence nor mediastinitis in the study group, compared with 1% and 0.5% incidences of these complications in the controls. Also, there was no mortality in the combined-closure group compared with mortality of 0.5% and 1% in the control groups. We believe that this closure effectively strengthens the complex of bone and wire, improving the stability of the chest by giving a correct axis to the sternum. It is also cost-effective and easy to perform and does not prolong operation time. PMID- 3277593 TI - Proteases involved in the processing of viral polyproteins. Brief review. PMID- 3277595 TI - Intracellular processing of measles virus fusion protein. AB - Intracellular processing of measles virus fusion (F) protein was studied by radiolabeling and immunoprecipitation with a monoclonal antibody against F protein. The cleavage of F protein into F1 and F2 subunits was complete after 5 hours of chase during which the growth of oligosaccharide chains on the F2 domain of F protein continued. The addition of terminal sialic acid conferred a strong negative charge on the F2 subunit. F protein expressed on the cell surface was removed by a fungal semi-alkaline protease, providing a method to follow the kinetics of its transport to the cell surface. The transport of the F protein was faster than that of the hemagglutinin (HA) protein. Uncleaved F protein, as well as cleaved subunits became digestible by the protease, indicating that a portion of the F protein reaches the cell surface uncleaved. The treatment of measles virus-infected cells with tunicamycin resulted in the synthesis of unglycosylated HA (65 kilodaltons, Kd) and F (48 Kd) proteins. Unglycosylated F protein was not cleaved into smaller subunits, nor was it transported to the cell surface. Unglycosylated HA protein likewise failed to reach the cell surface. PMID- 3277594 TI - Can potential hazard of Creutzfeldt-Jakob disease infectivity be reduced in the production of human growth hormone? Inactivation experiments with the 263K strain of scrapie. Rapid communication. AB - Scrapie infectivity is reduced 5-6 logs following filtration through 100,000 MW cut-off filter plus overnight treatment with 6 M urea. These steps, applied to purified human Growth Hormone (hGH), increase the margin of safety of hGH. PMID- 3277596 TI - Leuko-araiosis: the brain interstitial atrophy (atrophie interstitielle du cerveau) of Durand-Fardel. PMID- 3277597 TI - Glutamate antagonist therapy reduces neurologic deficits produced by focal central nervous system ischemia. AB - Ischemia may increase synaptic concentrations of glutamate, which may cause neuronal damage. Drugs that antagonize glutamate's effects may reduce this type of damage. MK-801, an N-methyl-D-aspartate receptor antagonist that readily enters the central nervous system, was evaluated in two focal central nervous system ischemia models: a multiple cerebral embolic model and a rabbit spinal cord ischemia model. When animals were treated five minutes after the onset of injury, MK-801 was effective in reducing ischemic damage in both models. In the multiple cerebral embolic model, the average dose of microspheres trapped in the brain increased from 344.8 +/- 51.4 micrograms (n = 29) in controls to 534 +/- 41.4 micrograms (n = 17) in the MK-801-treated group. Similarly, in the rabbit spinal cord ischemia model, the average ischemia duration increased from 28.9 +/- 1.7 minutes (n = 52) in controls to 50.6 +/- 3.9 minutes (n = 12) in the MK-801 treated group. These results suggest that this glutamate antagonist should be useful for the treatment of stroke. PMID- 3277598 TI - The first American case of myasthenia gravis. AB - Reported here is an account of the illness of Indian Chief Opechankanough (died 1644), which may represent the first recognized case of myasthenia gravis. Historical publications based on colonial correspondence with England are the sources for this article. To my knowledge, this is the first article in the medical historical literature to mention this famous and influential Indian. Historical accounts state that Opechankanough was so weak as to be unable to walk, making it necessary that he be carried about on a litter. Moreover, his eyelids were so weak they had to be raised by his attendants. Additionally, a hint of improvement in this weakness after rest is suggested by one historical account. The differential diagnosis of Chief Opechankanough's weakness is discussed. The historical setting of this famous chief in Colonial America and Colonial Virginia is described, as well. PMID- 3277599 TI - Amyotrophic lateral sclerosis. Recent advances in pathogenesis and therapeutic trials. AB - We reviewed the current status of pathogenesis and therapeutic trials in amyotrophic lateral sclerosis (ALS). Clinical studies have identified several rare but definable causes for apparent ALS. Certain clinical features previously considered unlikely to occur in ALS are found on careful examination. Epidemiologic surveillance and recent studies of neurotoxic plant seeds used in Guam have shed light on the pathogenesis of endemic ALS. Extensive analyses of biochemical, metabolic, immunologic, viral, and toxic factors have provided provocative results requiring further studies. Reflecting on some of these hypotheses, therapeutic trials have been performed more vigorously than ever. Amyotrophic lateral sclerosis is now investigated at the molecular genetic level. Human autopsy and experimental animal studies have expanded our understanding of basic mechanisms involving motoneuronal degeneration. In the future, we must continue a relentless search for the pathogenesis of ALS, prospective clinical studies to define the limits of ALS, and well-designed, controlled therapeutic trials. PMID- 3277600 TI - Transcranial Doppler sonographic findings in middle cerebral artery disease. AB - The transcranial Doppler sonographic findings of 61 patients with middle cerebral artery (MCA) disease were compared with those of 535 controls. According to computed tomographic, angiographic, and/or autopsy findings, the patients were classified as having MCA occlusive lesions in the central (sphenoidal) part or in peripheral branches or MCA stenosis. With MCA lesions, the MCA flow velocity (FV) was reduced. At the same time the anterior cerebral artery FV increased because of collateral flow over leptomeningeal anastomoses. Central MCA lesions showed less marked changes than did peripheral lesions. In MCA stenosis a steep rise of MCA FV appeared inside the stenotic segment. If there was a high-grade stenosis or occlusion of the internal carotid artery, a collateral circulation over the anterior part of the circle of Willis was seen in addition to the changes caused by the MCA disease. From these hemodynamic changes, transcranial Doppler sonographic diagnostic criteria for MCA occlusive and stenotic lesions were established. PMID- 3277601 TI - Prophylactic volume expansion therapy for the prevention of delayed cerebral ischemia after early aneurysm surgery. Results of a preliminary trial. AB - From June 1986 to June 1987, 47 consecutive patients with ruptured intracranial aneurysms were treated with immediate aneurysm surgery and prophylactic volume expansion therapy for ten to 14 days after subarachnoid hemorrhage (SAH). Twenty four patients were admitted within three days of SAH. Twenty-three of these patients had an excellent result, and one patient died. There were no cases of delayed cerebral infarction. In 18 of 23 patients admitted more than three days after SAH, there was an excellent result. The other five patients had permanent morbidity related to the original SAH. These preliminary data suggest that immediate aneurysm surgery and aggressive postoperative prophylactic volume expansion in all patients can substantially reduce rebleeding and delayed cerebral ischemia, potential causes of morbidity, after aneurysmal subarachnoid hemorrhage. A more extensive prospective trial of this approach will be required to test this hypothesis. PMID- 3277603 TI - New optic hole configuration for iris fixation of posterior chamber lenses. PMID- 3277602 TI - The first neurology book. De Cerebri Morbis...(1549) by Jason Pratensis. AB - In 1549, Jason Pratensis published De Cerebri Morbis...(DCM), the first separate book on the general subject of neurologic disease. The publication of DCM reflected two trends in 16th century medicine: (1) interest in the anatomy and function of specific organs, and (2) retranslation of the works of Galen, who emphasized the primacy of the brain in behavioral and motor functions. Brain diseases in DCM were classified in terms of symptom complexes. Some of the 33 chapters discuss tremor, tetanus, vertigo, epilepsy, and hemicrania. Concepts of diseases, and their pathogenesis and treatment, reflected the writings of Greek, Roman, and Arabic authors, as well as newer concepts of astrology and pharmacy that were prevalent during the Renaissance. There were few new bedside or clinical observations in DCM. However, DCM is an important text, crystallizing several 16th century trends to provide the first compendium of brain disorders. PMID- 3277604 TI - Cuts in cataract fees, other changes in Medicare budget. PMID- 3277605 TI - Laser trabeculoplasty for glaucoma in aphakic and pseudophakic eyes after penetrating keratoplasty. AB - We used argon laser trabeculoplasty to treat medically uncontrolled glaucoma after penetrating keratoplasty in ten eyes that were aphakic or pseudophakic. These patients were examined over an average of 22.8 months (range, 12 to 37 months) after treatment. We found an average decrease in intraocular pressure of 9.1 mm Hg (range, +8 to -19), from an average of 30.6 mm Hg before treatment to an average of 21.5 mm Hg after treatment. Eight of ten eyes had a reduction of greater than 5 mm Hg, and six of ten eyes had intraocular pressure of less than 20 mm Hg. Visual function remained stable, and complications were rare. We now prefer argon laser trabeculoplasty to cyclocryotherapy for the initial treatment of patients with medically uncontrolled glaucoma who have predominantly open angles and a clear penetrating keratoplasty. PMID- 3277607 TI - Return of human corneal sensitivity after penetrating keratoplasty. AB - To evaluate the reinnervation of corneal grafts, we studied 91 eyes of 79 patients for the return of sensitivity one month to ten years following penetrating keratoplasty for various corneal disorders including keratoconus, Fuchs' dystrophy, herpes simplex keratitis, aphakic and pseudophakic bullous keratopathy, glaucoma, trauma, and interstitial keratitis. Using the Cochet Bonnet esthesiometer, a sensation was recorded in the center of the graft no earlier than 18 months. We found a progressive return of sensitivity from the periphery toward the center of the graft. Regression analysis indicated a rate of return of sensitivity that averaged 0.029 mm/mo for each diagnostic category except herpes simplex keratitis. The slope of the return of sensitivity in the group with herpes simplex keratitis was essentially flat, showing no central progression. None of the eight patients with herpes simplex keratitis had a sensation recorded further than 0.5 mm from the wound margin. PMID- 3277606 TI - Oral zinc in macular degeneration. AB - Macular degeneration associated with age and drusen, an important cause of severe visual loss in older persons, is of unknown cause. The sensory retina and retinal pigment epithelium, which are cell layers in zinc, appear to be prominently involved in the disease process. Because zinc plays a role in the metabolic function of several important enzymes in the chorioretinal complex, we undertook a prospective, randomized, double-masked, placebo-controlled investigation of the effects of oral zinc administration on the visual acuity outcome in 151 subjects with drusen or macular degeneration. Although some eyes in the zinc-treated group lost vision, this group had significantly less visual loss than the placebo group after a follow-up of 12 to 24 months. This is the first controlled oral intervention study to show a positive, if limited, treatment effect in macular degeneration, a major public health problem. Because of the pilot nature of the study and the possible toxic effects and complications of oral zinc administration, widespread use of zinc in macular degeneration is not now warranted. PMID- 3277608 TI - Impact of vitamin A supplementation on xerophthalmia. A randomized controlled community trial. AB - The value of biannual distribution of 200,000 IU of vitamin A in preventing xerophthalmia was assessed in a randomized, controlled community-based trial involving 25,000 preschool children in 450 villages of northern Sumatra. Results indicate that distribution was associated with a dramatic decline in xerophthalmia prevalence; that concurrent controls were critical for distinguishing spontaneous from program-related changes; and that the apparent level of benefit depended on the choice of clinical indicator(s). Night blindness ceases to be an accurate reflection of impact when prevalence rates are low, and comparison of Bitot's spot rates should be confined to new cases of disease. PMID- 3277609 TI - Electrosurgical keratoplasty. Clinicopathologic correlation. AB - A patient with keratoconus who could not tolerate a contact lens underwent electrosurgical keratoplasty. Postoperatively, the central cornea was markedly flattened, but five weeks later the central steepening had recurred. Six months after the procedure, a penetrating keratoplasty was performed. Pathologic examination of the corneal button revealed an intact epithelium and basement membrane. Bowman's membrane was completely destroyed in the treated areas. Stromal scarring extended to involve the anterior two thirds of the corneal stroma. The collagen in this area was contracted and folded. The keratocytes and stromal collagen of the posterior third of the cornea were normal by light microscopy. Descemet's membrane and the endothelium also were normal. Despite the short-lived flattening of corneal topography, this procedure dramatically altered the stromal collagen in the anterior two thirds of the cornea. PMID- 3277610 TI - A suction trephine block for marking donor corneal buttons. AB - We describe a technique to accurately align the circumferences of the donor button and host cornea during penetrating keratoplasty. The donor cornea is trephined on a block into which four narrow, intersecting, equally spaced radial cuts are made. Suction is applied to the donor cornea through the four cuts, resulting in four radial marks in the donor corneal epithelium. Four radial marks are also made in the host cornea before trephination, using a radial keratotomy marker. When the donor button is placed within the recipient opening, the radial marks are aligned and used as guides for the cardinal sutures. This simple technique allows for matching of the donor and host circumferences, even if there is some collapse of the peripheral host cornea and sclera at surgery, and should minimize astigmatism resulting from donor/host misalignment. PMID- 3277611 TI - Apolipoprotein E polymorphism and atherosclerosis. AB - The apo E locus contributes to determining the variation in plasma cholesterol levels of healthy and diseased populations. It also influences the expression of hyperlipidemia and appears to modulate the susceptibility to atherosclerosis in a complex multifactorial interaction. There is evidence that the presence of apo E2 is protective, whereas that of apo E4 predisposes to coronary artery disease. The burden of proof, however, lies on future, well-designed clinical trials and prospective studies. The study of the biological significance of the apo E polymorphism in humans has emphasized the importance of gene-gene and gene environment interactions in the pathogenesis of hyperlipidemia and atherosclerosis. The apo E polymorphism involves the coding region of the apo E gene and results in alterations of the gene product which, in turn, either directly or secondarily affect the metabolic fate of the lipoprotein particles. Rapid advances in knowledge over the last decade have provided a metabolic explanation for the observation of the opposite effects of the epsilon 4 and the epsilon 2 alleles on lipoprotein levels. Apo E2 has lower receptor binding affinity which results in delayed clearance of apo E2-bearing lipoprotein particles from plasma. Apo E4 is distributed differently from apo E3 between VLDL and HDL, is degraded more rapidly than apo E3, and may enhance the catabolism of E4-bearing particles, leading to other alterations in lipoprotein metabolism which result in elevated levels of LDL. In view of the significant opposite impacts of the epsilon 4 and the epsilon 2 alleles on plasma LDL cholesterol concentrations, it is evident that determination of the apo E phenotype will become a useful adjunct to the assessment of the cardiovascular risk profile of an individual. In addition, the relationship between the epsilon 2 allele and type III hyperlipoproteinemia provides a valuable model for the study of complex genetic interactions in the pathogenesis of hyperlipidemia. The further study of apo E and its interactions shows great promise for a deeper comprehension of the pathogenesis of atherosclerosis. PMID- 3277613 TI - Applied relaxation vs progressive relaxation in the treatment of panic disorder. PMID- 3277612 TI - Prostacyclin, thromboxane A2, and prostaglandin E2 formation in atherosclerotic human carotid artery. AB - Prostaglandin (PG) formation in 16 atherosclerotic human carotid endarterectomy specimens was compared systematically with that of normal carotid artery from seven white pigs and six rhesus monkeys. Prostacyclin (PGI2) formation (picomoles 6-keto-PGF1a/2 min/100 micrograms homogenate protein plus 2 mM glutathione [GSH]) of nonatheromatous intima adjacent proximal (276 +/- 32, mean +/- SEM) or distal (271 +/- 14) to carotid plaque was comparable to that of normal carotid artery from white pig (272 +/- 25, NS) and rhesus monkey (219 +/- 41, NS), and was greater than stenotic intima (156 +/- 17, p less than 0.01), subintimal plaque (168 +/- 14, p less than 0.01), and ulceration (65 +/- 16, p less than 0.01). GSH modulated PGI2 synthesis in all carotid specimens except areas of ulceration (p less than 0.05), but did not restore PGI2 formation in atheromatous fractions to basal level. No detectable arterial thromboxane A2 (TXA2) formation or GSH dependent PGE2 isomerase activity was observed. The decrement in atherosclerotic carotid artery PGI2 formation was focal (confined to the plaque) and may have been related to loss of effective GSH modulation. These conditions could contribute to a localized imbalance between arterial PGI2 and platelet TXA2 with adverse vascular thromboregulatory consequences. PMID- 3277614 TI - Three studies on the relation of process to outcome in the treatment of essential hypertension with relaxation and thermal biofeedback. PMID- 3277615 TI - Involvement of hormone processing in insulin-activated glucose transport by isolated cardiac myocytes. AB - Isolated muscle cells from adult rat heart were used to study the relationship between myocardial insulin processing and insulin action on 3-O-methylglucose transport at 37 degrees C. Internalization of the hormone as measured by determination of the non-dissociable fraction of cell-bound insulin increased linearly up to 10 min, reaching a plateau by 30-60 min at 3 nM-insulin. At this hormone concentration the onset of insulin action was found to be biphasic, with a rapid phase up to 8 min, followed by a much slower phase, reaching maximal insulin action by 30-60 min. Insulin internalization was totally blocked by phenylarsine oxide, whereas dansylcadaverine had no effect on this process. Initial insulin action (5 min) on glucose transport was not affected by chloroquine and dansylcadaverine, but was completely abolished by treatment of cardiocytes with phenylarsine oxide. This drug effect was partly prevented by the presence of 2,3-dimercaptopropanol. Under steady-state conditions (60 min), the stimulatory action of insulin was decreased by about 60% by both chloroquine and dansylcadaverine. This study, demonstrates that insulin action on cardiac glucose transport is mediated by processing of the hormone. The data suggest dual pathways of insulin action involving initial processing of hormone-receptor complexes and lysosomal degradation. PMID- 3277617 TI - Identification of radioactive insulin fragments liberated by insulin proteinase during the degradation of semisynthetic [3H]GlyA1]insulin and [3H]PheB1]insulin. AB - (1) We [Muir, Offord & Davies (1986) Biochem. J. 237, 631-637 and Davies, Muir & Offord (1986) Biochem. J. 240, 609-612] have previously identified a major product in the degradation of insulin by insulin proteinase (the N-terminal fragment produced by cleavage between residues LeuA13 and TyrA14, SerB9 and HisB10) together with evidence for a minor cleavage site between HisB10 and LeuB11 or between LeuB11 and ValB12. (2) We now present evidence for minor sites of cleavage between TyrA14 and GlnA15, GluB13 and AlaB14 as well as HisB10 and LeuB11. PMID- 3277616 TI - Qualitative and quantitative comparison of glucose transport activity and glucose transporter concentration in plasma membranes from basal and insulin-stimulated rat adipose cells. AB - Conditions are described which allow the isolation of rat adipose-cell plasma membranes retaining a large part of the stimulatory effect of insulin in intact cells. In these membranes, the magnitude of glucose-transport stimulation in response to insulin was compared with the concentration of transporters as measured with the cytochalasin-B-binding assay or by immunoblotting with an antiserum against the human erythrocyte glucose transporter. Further, the substrate- and temperature-dependencies of the basal and insulin-stimulated states were compared. Under carefully controlled homogenization conditions, insulin-treated adipose cells yielded plasma membranes with a glucose transport activity 10-15-fold higher than that in membranes from basal cells. Insulin increased the transport Vmax. (from 1,400 +/- 300 to 15,300 +/- 3,400 pmol/s per mg of protein; means +/- S.E.M.; assayed at 22 degrees C) without any significant change in Km (from 17.8 +/- 4.4 to 18.9 +/- 1.4 nM). Arrhenius plots of plasma membrane transport exhibited a break at 21 degrees C, with a higher activation energy over the lower temperature range. The activation energy over the higher temperature range was significantly lower in membranes from basal than from insulin-stimulated cells [27.7 +/- 5.0 kJ/mol (6.6 +/- 1.2 kcal/mol) and 45.3 +/- 2.1 kJ/mol (10.8 +/- 0.5 kcal/mol) respectively], giving rise to a larger relative response to insulin when transport was assayed at 37 degrees C as compared with 22 degrees C. The stimulation of transport activity at 22 degrees C was fully accounted for by an increase in the concentration of transporters measured by cytochalasin B binding, if a 5% contamination of plasma membranes with low-density microsomes was assumed. However, this 10-fold stimulation of transport activity contrasted with an only 2-fold increase in transporter immunoreactivity in membranes from insulin-stimulated cells. These data suggest that, in addition to stimulating the translocation of glucose transporters to the plasma membrane, insulin appears to induce a structural or conformational change in the transporter, manifested in an altered activation energy for plasma membrane transport and possibly in an altered immunoreactivity as assessed by Western blotting. PMID- 3277618 TI - Identification by fast atom bombardment mass spectrometry of insulin fragments produced by insulin proteinase. AB - We describe the isolation by reversed-phase h.p.l.c. of a number of products of the degradation of insulin by insulin proteinase and their direct analysis by fast atom bombardment mass spectrometry (f.a.b.-m.s.). Various semisynthetically labelled insulins were used, including [[2H2]GlyA1]insulin and [18O]LysB29]insulin. The results obtained confirm and extend the results obtained by non-mass-spectrometric methods [Davies, Muir, Rose & Offord (1988) Biochem. J. 249, 209-214, and papers cited therein]. Cleavage sites were identified between positions A13-A14, A14-A15, B9-B10, B13-B14, B24-B25 and B25-B26. The advantages and disadvantages of the application of f.a.b.-m.s. to such studies are discussed. PMID- 3277619 TI - Glutathione reductase directly mediates the stimulation of yeast glucose-6 phosphate dehydrogenase by GSSG. AB - Yeast glucose-6-phosphate dehydrogenase was inhibited by low NADPH concentrations in cell-free extracts, and de-inhibited by GSSG; extensive dialysis of the crude extract did not diminish the GSSG effect. Immunoprecipitation of glutathione reductase abolished the de-inhibition of glucose-6-phosphate dehydrogenase by GSSG. Purified glucose-6-phosphate dehydrogenase was inhibited by NADPH but not de-inhibited by GSSG, and upon addition of pure glutathione reductase GSSG completely de-inhibited the glucose-6-phosphate dehydrogenase. PMID- 3277620 TI - Short- and longer-term regulation of very-low-density lipoprotein secretion by insulin, dexamethasone and lipogenic substrates in cultured hepatocytes. A biphasic effect of insulin. AB - 1. The precise effects of insulin, dexamethasone and lipogenic precursors on the secretion of very-low-density lipoprotein (VLDL) cholesterol and triacylglycerol were dependent on the age of the culture and the duration of treatment. 2. The rates of secretion of triacylglycerol and cholesterol gradually declined with the age of the culture, although there was no detectable decrease within a given 24 h period. 3. Between 4 h and 24 h after cell preparation, insulin inhibited VLDL secretion. Inhibition was maximal between 6 and 12 h after addition of insulin. Longer-term treatment (24-48 h) with insulin resulted in a stimulation of VLDL secretion. This effect was less apparent when dexamethasone was simultaneously present. The secretion of triacylglycerol and cholesteryl ester was more sensitive to insulin than was that of non-esterified cholesterol. 4. Dexamethasone alone stimulated the secretion of VLDL to an extent which increased with the age of the culture. In young cultures (up to 24 h old) dexamethasone protected against inhibition by insulin, but was ineffective in older cultures. 5. In young cultures the stimulatory effect of lipogenic precursors (lactate and pyruvate) on the secretion of triacylglycerol and cholesterol was more pronounced in the presence of dexamethasone. In cultures older than 24 h, the secretion of these components was less sensitive to short-term stimulation by lactate and pyruvate. PMID- 3277621 TI - Sequencing and overexpression of the Escherichia coli aroE gene encoding shikimate dehydrogenase. AB - The Escherichia coli aroE gene encoding shikimate dehydrogenase was sequenced. The deduced amino acid sequence was confirmed by N-terminal amino acid sequencing and amino acid analysis of the overproduced protein. The complete polypeptide chain has 272 amino acid residues and has a calculated Mr of 29,380. E. coli shikimate dehydrogenase is homologous to the shikimate dehydrogenase domain of the fungal arom multifunctional enzymes and to the catabolic quinate dehydrogenase of Neurospora crassa. PMID- 3277622 TI - Regulation of protein metabolism and DNA synthesis by fibroblast growth factor in BHK-21 cells. AB - 1. Acidic and basic fibroblast growth factors (aFGF, bFGF) were shown to inhibit protein breakdown in BHK-21 cells, with the latter exhibiting approx. 6-fold greater sensitivity. 2. The maximum response achieved was less than observed with insulin or insulin-like growth factor-1 (IGF-1), and was not additive with those growth factors over the 4 h measurement period. The inhibition of protein breakdown followed the same time course with all the growth factors tested, and was enhanced equally by NH4+ ions. Taken together, these results suggest similar mechanisms for effects of the different growth factors on protein breakdown. 3. Protein synthesis was stimulated by bFGF, insulin and IGF-1, with partial additivity evident between bFGF and the other peptides. Increases in cell-culture protein content paralleled the changes in the rate of protein synthesis. 4. DNA synthesis was stimulated more effectively in BHK-21 cells by aFGF or bFGF than by insulin or IGF-1, with partial additivity between the two groups of growth factors. 5. Since each of the growth factors independently produced both relatively rapid effects on protein metabolism and more prolonged increases in DNA synthesis, some caution is warranted before classifying them into truly distinct groups as either competence or progression factors. PMID- 3277623 TI - Role of carnitine palmitoyltransferase I in the regulation of hepatic ketogenesis during the onset and reversal of chronic diabetes. AB - 1. The kinetic properties of overt carnitine palmitoyltransferase (CPT I, EC 2.3.1.21) were studied in rat liver mitochondria isolated from untreated, diabetic and insulin-treated diabetic animals. A comparison was made of the time courses required for the changes in these properties of CPT I to occur and for the development of ketosis during the induction of chronic diabetes and its reversal by insulin treatment. 2. The development of hyperketonaemia over the first 5 days of insulin withdrawal from streptozotocin-treated rats was accompanied by parallel increases in the activity of CPT I and in the I0.5 (concentration required to produce 50% inhibition) of the enzyme for malonyl-CoA. 3. The rapid reversal of the ketotic state by treatment of chronically diabetic rats with 6 units of regular insulin was not accompanied by any change in the properties of CPT I over the first 4 h. Higher doses of insulin (15 units), delivered throughout a 4 h period, resulted in an increase in the affinity of CPT I for malonyl-CoA, but the sensitivity of the enzyme to the inhibitor was still significantly lower than in mitochondria from normal animals. 4. Conversely, when insulin treatment was continued over a 24 h period, full restoration of the sensitivity of the enzyme to malonyl-CoA was achieved. However, the activity of the enzyme was only decreased marginally. 5. These results are discussed in terms of the possibility that the major regulatory sites of the rate of hepatic oxidation may vary in different phases of the induction and reversal of chronic diabetes. PMID- 3277624 TI - Factors influencing the altered thermogenic response of rat brown adipose tissue in streptozotocin-diabetes. AB - 1. Adipocytes were isolated from the interscapular brown fat of male rats maintained at 21 degrees C. These animals were controls, streptozotocin-diabetics or 2-day insulin-treated diabetics. 2. With adipocytes from diabetic animals, maximum rates of noradrenaline-stimulated O2 uptake were decreased by 58%, and the Bmax. of [3H]GDP binding to mitochondria was decreased by 55%. Insulin administration reversed both of these changes. 3. Streptozotocin-diabetes increased basal lipolysis in adipocytes incubated with adenosine deaminase (1 unit/ml), decreased the EC50 (concn. giving 50% of maximum effect) for noradrenaline, but did not change the maximum rate of noradrenaline-stimulated lipolysis. Except for some small differences at very low concentrations (10-100 pM), diabetes or insulin treatment did not alter the sensitivity of noradrenaline stimulated lipolysis or O2 uptake to the inhibitory effect of N6 phenylisopropyladenosine. It is therefore concluded that the lesion(s) in thermogenesis in diabetes are not attributable to any changes in lipolysis. 4. Blood flow through interscapular brown fat, measured by accumulation of [14C]DDT [14C-labelled 1,1,1-trichloro-2,2-bis-(p-chlorophenyl)ethane] was increased by 2.3-fold 70 min after a single administration of insulin to diabetic rats. This treatment decreased blood flow through epididymal white fat by 58%. 5. Propranolol treatment of diabetic rats muted the ability of insulin treatment to increase the maximum rate of noradrenaline-stimulated O2 uptake, suggesting that this action of insulin may be a secondary one rather than a direct effect of the hormone on the adipocytes. PMID- 3277625 TI - Subcellular localization of two porphyrin-synthesis enzymes in Pisum sativum (pea) and Arum (cuckoo-pint) species. AB - The subcellular location of the two porphyrin-synthesis enzymes 5 aminolaevulinate dehydratase (ALAD) and porphobilinogen deaminase (PBGD) was investigated in Pisum sativum (pea) leaves and spadices of Arum (cuckoo-pint). Throughout the tissue-fractionation procedures the distribution of the two enzymes paralleled that of the plastid marker enzyme (ADP-glucose pyrophosphorylase), even in Arum, a tissue where the synthesis of non-plastid haem is predominant. The distribution of cytosolic marker enzyme (lactate dehydrogenase) was significantly different from that of ALAD and PBGD and, although purified mitochondria from both species had some residual activity, this was always less than contaminating plastid marker enzyme. The results suggest that ALAD and PBGD are exclusively plastid enzymes. The significance of this for the role of plastids in cellular porphyrin synthesis is discussed. PMID- 3277626 TI - Antibody-independent activation of the complement system by mitochondria is mediated by cardiolipin. AB - Non-immune activation of the first component of complement (C1) by the heart mitochondrial inner membrane has been investigated. Cardiolipin, the only strong activator of C1 among phospholipids, is present in large amounts in the heart mitochondrial inner membrane. We therefore studied its contribution to C1 activation by mitochondria. The proteins of the mitochondrial inner membrane were found to activate C1 only weakly, in contrast with the phospholipid fraction which induces strong C1 activation. Furthermore, the digestion of mitochondrial inner membranes with proteolytic enzymes did not affect C1 activation. Additional support in favour of cardiolipin being the responsible activator came from competition experiments with mitochondrial creatine kinase (mt-CPK) and adriamycin, known to bind to cardiolipin. Both mt-CPK and adriamycin displaced C1q from the mitochondrial inner membrane. In addition, C1q displaced mt-CPK bound to mitoplasts. PMID- 3277627 TI - Synthesis of lipoprotein lipase in the liver of newborn rats and localization of the enzyme by immunofluorescence. AB - In newborn rats, lipoprotein lipase (LPL) activity was higher in the liver than in several other tissues, such as heart, diaphragm or lungs, and accounted for about 3% of total LPL activity in the body. There was no significant correlation between LPL activity in liver and in plasma. Thus transport of the enzyme from extrahepatic tissues was probably not the major source of LPL in liver. To study LPL biosynthesis directly, newborn rats were injected intraperitoneally with [35S]methionine, and LPL was isolated by immunoprecipitation and separation by SDS/polyacrylamide-gel electrophoresis. Radioactivity in LPL increased with a similar time course in all tissues studied, including the liver. Substantial synthesis of LPL was also demonstrated in isolated perfused livers from newborn rats, whereas synthesis was low in livers from adult rats. There was strong LPL immunofluorescence in livers from newborn rats, mainly within sinusoids and along the walls of larger vessels. This labelling disappeared after perfusion with heparin, which indicates that much of the enzyme is in contact with blood and can take part in lipoprotein metabolism. PMID- 3277628 TI - Nucleotide sequence for the hemD gene of Escherichia coli encoding uroporphyrinogen III synthase and initial evidence for a hem operon. AB - 1. The hemD gene, encoding uroporphyrinogen III synthase, has been located adjacent to the hemC gene at 85 min on the Escherichia coli chromosome. 2. The entire nucleotide sequence (741 base pairs) of the hemD gene is reported. 3. E. coli strains harbouring plasmics containing the hemD gene produce greatly elevated levels of uroporphyrinogen III synthase. 4. Purified uroporphyrinogen III synthase, isolated from the hemD-containing strain ST1046, has an Mr of 29,000, in close agreement with that predicted from the nucleotide sequence. 5. The existence of a hem operon is suggested. PMID- 3277629 TI - Insulin action on brain microvessels; effect on alkaline phosphatase. AB - The effects of insulin on brain alkaline phosphatase activity have been examined. Insulin inhibited the activity of alkaline phosphatase on brain microvessels in in vitro experiments. The inhibition observed was of the non-competitive type. These observations indicate that the hormone is able to induce neurochemical modifications revealed in this case as changes in the phosphate transfer enzymes in brain microvessels. PMID- 3277630 TI - Insulin-degrading enzyme is capable of degrading receptor-bound insulin. AB - In the investigation of the intracellular sites of insulin degradation, it might be important whether receptor-bound insulin could be a substrate for insulin degrading enzyme (IDE). Insulin receptor and IDE were purified from rat liver using a wheat germ agglutinin column and monoclonal anti-IDE antibody affinity column, respectively. [125I]insulin-receptor complex was incubated with various amounts of IDE at 0 degree C in the presence of disuccinimidyl suberate and analyzed by reduced 7.5% SDS-PAGE and autoradiography. With increasing amounts of IDE, the radioactivity of 135 kd band (insulin receptor alpha-subunit) decreased, whereas that of 110 kd band (IDE) appeared then gradually increased, suggesting that IDE could bind to receptor-bound insulin. During incubation of insulin receptor complex with IDE at 37 degrees C, about half of the [125I]insulin was dissociated from the complex. However, the time course of [125I]insulin degradation in this incubation was essentially identical to that of free [125I]insulin degradation. Cross-linked, non-dissociable receptor-bound [125I]insulin was also degraded by IDE. Rebinding studies to IM-9 cells showed that the receptor binding activity of dissociated [125I]insulin from insulin receptor complex incubated with IDE was significantly (p less than 0.001) decreased as compared with that without the enzyme. These results, therefore, show that IDE could recognize and degrade receptor-bound insulin, and suggest that IDE may be involved in insulin metabolism during receptor-mediated endocytosis through the degradation of receptor-bound insulin in early neutral vesicles before their internal pH is acidified. PMID- 3277631 TI - Reversal of insulin-induced negative cooperativity by monoclonal antibodies that stabilize the slowly dissociating ("Ksuper") state of the insulin receptor. AB - Two monoclonal antibodies to the insulin receptor, MA-5 and MA-20, unlike other monoclonal antibodies, do not mimick the accelerating effect of insulin on the dissociation of 125I-insulin from the receptors (negative cooperativity). On the contrary, MA-5 and MA-20 markedly slow down the dissociation rate. We show now that MA-5 and MA-20 are potent antagonists of the negative cooperativity induced by insulin, and reverse the insulin-induced acceleration whether added simultaneously with insulin or after insulin. The reversal of the insulin-induced acceleration is almost immediate. These data strengthen the concept therefore that the insulin-receptor complex has access to alternative conformational states that can be stabilized by ligand-induced site-site interactions. PMID- 3277632 TI - In vitro and in vivo DNA interaction with carbonyl-labeled (m)ethylnitrosoureas. AB - 1. The carbonyl group of (m)ethyylnitrosoureas was found to interact with DNA both in vitro and in vivo. 2. (14C-carbonyl)radioactivity remained associated to DNA after a number of ethanolic precipitations as well as after RNase and protein digestion treatments, but was extremely labile to DNA enzymic and acid digestion. 3. Detectable amount of (14C-carbonyl)-radioactivity was still found in DNA of various rat tissues 18 days after i.p. administration of carbonyl-labeled methylnitrosourea. PMID- 3277633 TI - Effect of phorbol ester on contractile response of aorta from endotoxic rats. AB - The influence of phorbol ester on the isometric contractile response of aorta from endotoxic rats was examined. In endotoxic rat aorta, the contractile responses to KCl and phorbol 12,13-dibutyrate (PDBu) were both remarkably diminished, compared to those in control rat aorta. Preincubation with PDBu augmented the aortic contractile response to KCl in both control and endotoxic rats. This augmentative effect of PDBu was significantly more pronounced in endotoxic rats than in controls. When the contractile response to 80 mM KCl reached a plateau after PDBu pretreatment, addition of 5 mM CaCl2 (final concentration) to the organ bath completely reversed the diminished contractile response of endotoxic rat aorta to the control level. These results suggest that the hyporesponsiveness of endotoxic rat aorta to KCl may be caused by decreases in both protein kinase C mediated response and calcium sensitivity of vascular smooth muscle cells. PMID- 3277634 TI - Dissociation of c-fos from ODC expression and neuronal differentiation in a PC12 subline stably transfected with an inducible N-ras oncogene. AB - In order to develop a model system for investigating the role of ras genes in neuronal differentiation, a construct consisting of a mouse N-ras oncogene linked to a dexamethasone-inducible promoter was devised and transfected into a subline of the PC12 rat pheochromocytoma cell line. Clonal lines were isolated which extended neurite-like processes within one day of exposure to dexamethasone. N ras had a strong antiproliferative effect on these cells. These effects were reversible after removing dexamethasone. Elevation of mRNA for ornithine decarboxylase (ODC) was detected 6-18 hours after induction of N-ras by dexamethasone. The effects of ras on cell division, differentiation and cell size were analogous, but not identical to the effects of NGF on PC12 cells. One NGF action, induction of c-fos mRNA did not occur in ras-induced cells indicating that c-fos induction is unnecessary for both neurite outgrowth and for subsequent induction of ODC mRNA. The ability of ras to induce ODC, a division promoting enzyme, may also be relevant to the transforming actions of ras oncogenes. PMID- 3277635 TI - Inhibition of protein synthesis by aminoglycoside antibiotics in polyamine requiring bacteria. AB - The effect of streptomycin and other aminoglycosides on protein synthesis has been studied using various streptomycin-sensitive strains unable to synthesize polyamines. We have confirmed and extended our previous results showing that the strong inhibition of translation caused by the antibiotic in polyamine supplemented bacteria was markedly reduced in polyamine-starved cells. The analysis of polypeptides synthesized in the absence and presence of streptomycin in bacteria grown with and without putrescine has shown that the antibiotic provoked the accumulation of low molecular weight peptides partially bound to ribosomes in polyamine-unstarved cells. On the contrary, the drug did not induce major alterations in the patterns of proteins obtained from polyamine-depleted bacteria. The addition of the antibiotic did not evoke any change of proteolytic activity. PMID- 3277636 TI - Can anticancer therapy be improved by sequential use of cytotoxic and cytostatic (differentiating or immunomodulating) agents to suppress tumor cell phenotypic diversification? PMID- 3277637 TI - Albumin--an important extracellular antioxidant? PMID- 3277638 TI - Possible involvement of cytochrome P-450 in the epithelium-modulated response to methacholine in guinea pig trachea. PMID- 3277639 TI - Trifluoperazine does not inhibit the acute metabolic effects of insulin in rat adipocytes. PMID- 3277640 TI - ASHA interviews Sandra C. Holley, 1988 president. PMID- 3277641 TI - Growth, challenge, and change. 1986-1987 annual report (AHSA). PMID- 3277642 TI - Some observations about us and private practice. PMID- 3277643 TI - Private practice: are you ready? PMID- 3277644 TI - A quality-oriented solo private practice. PMID- 3277645 TI - Great rewards from a smaller practice. PMID- 3277646 TI - Buying and selling a private practice. PMID- 3277647 TI - Determining fees in private practice. PMID- 3277648 TI - The Tax Reform Act of 1986 and the private practice incorporation decision. PMID- 3277649 TI - Malpractice in audiology and speech-language pathology. PMID- 3277650 TI - Ethical dilemmas in occupational health nursing. PMID- 3277651 TI - Denture plaque control--past and present. PMID- 3277652 TI - Factors affecting the fit of porcelain jacket crowns. PMID- 3277653 TI - Badges of the dental profession. The European Prosthodontic Association. PMID- 3277654 TI - Digital subtraction contrast echocardiography: a new method for the evaluation of regional myocardial perfusion. AB - The potential of contrast enhanced digital subtraction echocardiography to demonstrate and quantitate myocardial perfusion was evaluated in 36 patients undergoing routine coronary arteriography or angioplasty. In 24 technically successful studies, multiple cross sectional echocardiographic images, obtained before and after intracoronary (sonicated contrast) injection, were stored by high speed, real time data transfer to an on line minicomputer. Subsequent digital subtraction processing of the stored image data provided composite images in which the distribution of myocardial perfusion was easily seen. Quantitative analysis of peak enhanced myocardial grey level and washout half time successfully differentiated between myocardial segments in which angiography had suggested normal, reduced, and grossly impaired or absent perfusion. The results suggest that this new method of digital image capture and quantitative processing has substantial advantages over previous off line qualitative techniques. It is likely to be of considerable value for routine coronary arteriography, angioplasty, and coronary thrombolysis. PMID- 3277655 TI - Chronic constrictive pericarditis caused by self-mutilation with sewing needles. A case report and review of published reports. AB - A 34 year old woman with a history of self-mutilation developed severe constrictive pericarditis with sterile, calcified intrapericardial abscess cavities as a result of inserting sewing needles into her chest seven years previously. After pericardiectomy she made a good recovery. PMID- 3277656 TI - Arrival-time analysis of intravenous digital aortograms in aortic dissection. AB - Arrival-time analysis was applied to intravenous digital aortograms. A single static image was produced by representing the time to 90% maximum density for each image pixel on a grey scale. Arrival-time analysis confirmed the diagnosis in four of six patients with aortic dissection that had been shown by image subtraction. In a further three patients with no dissection the arrival-time images were normal. In two patients with surgical repair of the ascending aorta, residual false lumens were shown by both subtraction and arrival-time analysis. In one of these cases arrival-time analysis prompted reanalysis of the subtraction image that had previously been interpreted as showing a normal aorta. Arrival-time analysis provides a static image of aortic dissection, which helps to overcome subtraction artefact. PMID- 3277657 TI - Early treatment of unstable angina in the coronary care unit: a randomised, double blind, placebo controlled comparison of recurrent ischaemia in patients treated with nifedipine or metoprolol or both. PMID- 3277658 TI - Detection of type III collagen in skin fibroblasts from patients with Ehlers Danlos syndrome type IV by immunofluorescence. AB - Immunofluorescence showed that cultured skin fibroblasts from 15 out of 17 patients with Ehlers-Danlos syndrome type IV retained abnormal amounts of type III collagen within the cytoplasm. This was not shown by fibroblasts from normal subjects or from patients with other inherited connective tissue diseases. The diagnosis of Ehlers-Danlos syndrome type IV may be facilitated by this finding. PMID- 3277659 TI - The use of chemically split tissue in the detection of circulating anti-basement membrane zone antibodies in bullous pemphigoid and cicatricial pemphigoid. AB - Human skin and mucous membranes were used to detect circulating auto-antibodies by indirect immunofluorescence in 20 patients with bullous pemphigoid and eight with cicatricial pemphigoid. The tissue substrate was used intact and after chemical separation through the basement membrane zone (BMZ) by incubation with I M NaCl. Chemically split skin and oral mucosa provided a more sensitive assay for demonstrating circulating anti BMZ antibodies. Use of a battery of substrates increased the number of positives in bullous pemphigoid from 30% detected on monkey oesophagus to 100% (tissue battery). In cicatricial pemphigoid there was an increase in the proportion of positive sera from 13% (monkey oesophagus) to 88% (tissue battery). In addition, a different class of antibody was frequently detected on split tissue substrate suggesting that new antigens are exposed by this procedure. PMID- 3277660 TI - Epithelial distribution of a myelomonocytic antigen LI in relation to cutaneous malignancies and melanocytic naevi. AB - The distribution of LI antigen in four common skin tumours was examined immunohistochemically in 40 samples of formalin-fixed routine biopsy material. Presence of LI in the dermis depended on the extent and composition of the inflammatory infiltrate; LI was found mainly in reactive histiocytes and neutrophils. Intense epidermal staining was seen adjacent to squamous cell carcinoma, basal cell carcinoma and malignant melanoma, but not adjacent to melanocytic naevi. In specimens of melanocytic naevi, LI staining around pilosebaceous units was weak or absent. Around the three malignant types of lesion, epidermal LI positivity faded distally--thereby indicating the extent of the tumour. LI was, in addition, expressed by the most highly differentiated cells in squamous cell carcinomas, whereas the other neoplasms were negative. Antibody to LI may, thus, be a useful adjunct for distinction between various types of skin tumours. PMID- 3277661 TI - Mucosal involvement in bullous and cicatricial pemphigoid. A clinical and immunopathological study. AB - Thirty-six patients with bullous pemphigoid (BP) and 15 with cicatricial pemphigoid (CP) were studied for evidence of mucosal involvement both clinically and by direct immunofluorescence. Twenty-one patients with BP and all those with CP had lesions of the mucous membranes. Eighteen patients with BP and 14 patients with CP had involvement of the oral mucosa. Lesions of the eyes, nose, pharynx, vulva and urethra also occurred in both groups. The lesions tended to be more widespread in CP patients. Twenty-one patients with BP and 14 with CP were examined by an ophthalmologist. Fine scarring of the tarsal conjunctiva was found in both groups, but also in elderly controls. However, symblepharon occurred in one patient with BP as well as in three patients with CP, but was not seen in a group of 20 controls. Direct immunofluorescence (IF) studies showed linear deposition of IgG or C3 or both in the basement membrane zone of the skin, oral mucosa and conjunctival mucosa in both groups. The frequency of positive immunofluorescence was higher in the conjunctiva than in the lip mucosa or skin in both BP and CP patients. The significance of these findings and the relationship between BP and CP is discussed. PMID- 3277662 TI - Choice of oxytocic preparation for routine use in the management of the third stage of labour: an overview of the evidence from controlled trials. AB - Prophylactic use of oxytocics reduces the risk of postpartum haemorrhage by about 40%. The analysis presented in this paper assesses which oxytocic preparation is associated with the least risk of postpartum haemorrhage and examines the relative effects of different preparations on the length of the third stage, the risk of manual removal of the placenta, blood pressure and other side-effects. A mixture of oxytocin and ergometrine (Syntometrine) appears to be the safest and most effective prophylactic of the alternatives which have been compared, but the quality of the evidence is not satisfactory. There is scope for a randomized comparison of Syntometrine with oxytocin to obtain unbiased and more precise estimates of their relative effects on postpartum haemorrhage, blood pressure and unpleasant side-effects. PMID- 3277663 TI - The effects of routine oxytocic administration in the management of the third stage of labour: an overview of the evidence from controlled trials. AB - Recent claims that routine active management of the third stage of labour increases rather than decreases maternal and neonatal morbidity have prompted us to conduct a systematic review of the relevant controlled trials. In this paper we have analysed data derived from a total of nine published reports of controlled trials in which an oxytocic drug was compared with either a placebo or no routine prophylactic. Oxytocic drugs used routinely appear to reduce the risk of postpartum haemorrhage by about 40% (typical odds ratio 0.57, 95% confidence interval 0.44-0.73) implying that for every 22 women given such an oxytocic, one postpartum haemorrhage could be prevented. The available data are insufficient to assess the possible effects of this policy on the incidence of retained placenta, hypertension and other possible adverse effects. PMID- 3277664 TI - A double-crossover trial comparing the effects of topical carteolol and placebo on intraocular pressure. AB - The effect of topical carteolol 2% on the intraocular pressures of 12 patients suspected of having glaucoma was measured in a double-crossover trial of six weeks' duration. Carteolol produced a significant reduction in intraocular pressure (p less than or equal to 0.001), when compared with placebo. This represented reductions of 11% and 14%, after one and two weeks of treatment. PMID- 3277665 TI - Epithelial cyst in the anterior chamber after penetrating keratoplasty: a rare complication. AB - We report the case of a 25-year-old man who had a penetrating keratoplasty for keratoconus. A year and a half after surgery a cyst was noted in the anterior chamber, which was observed to enlarge over six months. Because of anxiety about endothelial touch, it was removed surgically. Histologically the cyst was composed of stratified, non-keratinized squamous epithelium attached to loose fibrovascular tissue including islands of melanin-containing epithelial cells. This was interpreted as an epithelial implantation cyst of the anterior chamber of corneal origin attached to iris tissue. PMID- 3277666 TI - Incidence of keratoconus in spring catarrh. AB - Five hundred and thirty cases of spring catarrh were studied at the Department of Ophthalmology, Khyber Hospital Peshawar, Pakistan. Corneal complications occurred in 259 patients, of which 48 cases were of keratoconus, consisting of 41 male and seven female patients. Most of the patients affected (37) were between the ages of 10 and 30 years. Six patients developed acute hydrops, which in one case affected both eyes, though after an interval of a few months. Keratoconus was progressive in many patients, resulting in gross visual loss, often not correctable with glasses or contact lenses and thus requiring keratoplasty. The importance of association of keratoconus with atopic disorders is discussed and its association with spring catarrh is stressed. PMID- 3277667 TI - Progress toward molecular biology of DNA polymerase beta. PMID- 3277668 TI - Gene response upon illumination in forming mRNA encoding peroxisomal glycollate oxidase. AB - Glycollate oxidase is a constituent of leaf peroxisomes. Its biosynthesis is, like the biosynthesis of many chloroplastic proteins, controlled by light, via phytochrome. The level of mRNA coding for glycollate oxidase was determined at different stages of greening of etiolated plant cells. The appearance of glycollate oxidase mRNA in the cytoplasm was measured by hybridization with cDNA containing part of the coding sequence for glycollate oxidase. cDNA was prepared from enriched mRNA, inserted into the Pst I site of pBR 322, and cloned in Escherichia coli DH-1. By differential colony hybridization and hybrid selection, a clone containing a 670 bp sequence complementary to mRNA encoding glycollate oxidase was selected and identified. Northern blot hybridization was used to investigate mRNA levels induced by light. It was found that continuous light affected the formation of glycollate oxidase mRNA. When a large population of microbodies was present in the cells being induced, the immediate mRNA increase was very pronounced, and was detectable as little as 20 min after the beginning of the light treatment. In contrast, a lag period in the mRNA increase was observed when the induction was performed with etiolated leaves which are characterized by the occurrence of a rather small population of microbodies. For comparison, we measured the time-course of formation of mRNA coding for a light induced chloroplastic protein, i.e., a protein of the light-harvesting complex. The time-courses of levels of the two mRNAs indicate that the program of gene expression differs between the two particular proteins destined either for chloroplasts or for peroxisomes. The formation of glycollate oxidase mRNA could also be stimulated by a short pulse of light, a treatment of 15 s being a sufficient trigger. PMID- 3277669 TI - Preparation of raf-oncogene-specific antiserum with raf protein produced in E. coli. AB - In this report we describe the expression of v-raf protein in E. coli using a tryptophan-promoter-driven expression vector and its immunological characterization by anti-peptide sera. The purified recombinant protein was used to produce raf-specific antibodies which are suitable for studying v-raf and c raf proteins in vitro and in vivo in a variety of species ranging from mouse to man. PMID- 3277670 TI - Differently bound copper(I) in yeast Cu8-thionein. AB - The reactivity of yeast Cu-thionein in the presence of the Cu(I)-chelators, bathocuproinesulphonate and cuproine, was examined to distinguish between possible differently coordinated Cu(I). Electronic absorption measurements revealed that two out of eight coppers of the protein reacted within seconds with the chelator. At the same time, the shape and magnitude of the characteristic Cotton bands attributable to the Cu(I)-thiolate chromophores remained constant. Due to the successful removal of circular dichroic silent copper, all specific theta Cu values rose by 53% of the original value. Thus, it is strongly suggested that two or more distinct types of Cu(I) ought to be present in Cu8-thionein. In the light of the many different Cu/cysteine ratios of Cu-thioneins from vertebrate and microbial origin, possible interconversion reactions of the Cu(I) thiolate centres seem to be likely. PMID- 3277671 TI - Molecular forms of cathepsin B in rat thyroid cells (FRTL5): comparison with molecular forms in liver (Hep G2) and insulin-secreting cells (HIT T15). AB - A radiolabelled peptide chloromethyl ketone (125I-tyrosyl-L-alanyl-L-lysyl-L arginine chloromethyl ketone) was used to affinity-label proteinases in rat thyroid cells (FRTL5). Two major proteins of 34 kDa and 32 kDa were affinity labelled. Inhibitor competition studies demonstrated that both proteins were cysteine proteinases. Over the range pH 5-8, they exhibited maximum activity against the affinity probe at pH 5. They were soluble rather than membrane-bound and were both glycosylated. The 32 kDa proteinase but not the 34 kDa proteinase was immunoprecipitated using an anti-rat liver cathepsin B antibody. The data suggested that these proteinases were molecular forms of cathepsin B. The affinity-labelled proteins in the thyroid were compared with those in an insulin secreting cell line (HIT T15) and a liver cell line (Hep G2). Two molecular forms of cathepsin B of Mr 39,000 and 33,000 were identified in the insulin-secreting cell line and a single form of Mr 34,000 in the liver cell line. These molecular forms of cathepsin B may reflect the different functions and compartmentation of cathepsin B in these cells. PMID- 3277672 TI - Studies on the expression of Cu,Zn superoxide dismutase in human tissues during development. AB - The developmental expression of Cu,Zn superoxide dismutase in human lung and erythrocytes has been studied using activity measurements, immunoblotting and immunohistochemistry. Enzyme activity in erythrocytes increased significantly during gestation but no developmental trend was seen in lung. Immunoblotting identified a single enzyme form that was present in a variety of tissues and immunohistochemistry showed the enzyme to have widespread distribution in lung tissue. These data indicate that Cu,Zn superoxide dismutase is consistently expressed during human development and that, unlike in other species, no late fetal surge in expression occurs. PMID- 3277673 TI - Development of insulin and epidermal growth factor receptors during the differentiation of rat preadipocytes in primary culture. AB - An homogeneous cell population isolated from the inguinal tissue of 3-day-old rats is able to proliferate in primary culture. In the presence of a physiological concentration of insulin (1.5 nM) it converts into cells exhibiting the morphology and the biochemical characteristics of adipocytes. Insulin and epidermal growth factor (EGF) receptors were studied during both the exponential growth and the adipose conversion phases of these cells. Binding experiments with 125I-labelled peptides were performed directly in the culture dishes. The number of high affinity insulin binding sites increased, during the entire culture period studied, reaching 18 days after plating the value of 10,600 x 2360. Control cells (cultured in the presence of anti-insulin antibody) exhibited an increase of the concentration of insulin binding sites from no more than 500 sites/cell to 6880 +/- 1710 sites/cell between dat 0 and 9 (corresponding to the exponential growth phase); this increase was followed by a rapid reduction in insulin receptors during the stationary phase. The density of EGF binding sites increased between day 0 and 4 (one cell cycle), whether the cells were maintained or not with insulin, and plateaued thereafter. Mature adipocytes freshly isolated from the inguinal tissue of 3-day-old rats had no detectable EGF binding sites, but their content in high affinity binding sites for insulin was similar to that of cells after complete adipocyte conversion in primary culture. PMID- 3277674 TI - Mobilization of cellular Ca2+ by lysophospholipids in rat islets of Langerhans. AB - To determine whether lysophospholipids mobilize cellular Ca2+, intact rat islets were prelabelled with 45Ca2+ and subjected to three maneuvers designed to simulate the physiologic accumulation of lysophospholipids: (1) exogenous provision; (2) addition of porcine pancreatic phospholipase A2; and (3) provision of p-hydroxymercuribenzoic acid, which impedes both the reacylation and hydrolysis of endogenous lysophospholipids, leading to their accumulation in islets. Each maneuver provoked 45Ca2+ efflux at concentrations nearly identical to those previously reported to induce insulin release in the absence of toxic effects on the islets. Lysophosphatidylcholine (lysoPC) and lysophosphatidylinositol were active, whereas the ethanolamine and serine derivatives, and lysophosphatidic acid, were much less effective. The effects of lysoPC were reversible; they also were reduced by lanthanum or gentamicin (which are probes of superficial, plasma membrane-bound stores of Ca2+) or by prior depletion of membrane-bound cellular Ca2+ stores using ionomycin, but not by removal of extracellular Ca2+ or Na+. The effects of lysoPC, phospholipase A2 and p-hydroxymercuribenzoic acid were largely independent of any hydrolysis to, or accumulation of, free fatty acids as assessed by resistance to dantrolene or trifluoperazine (which selectively reduce arachidonic acid-induced 45Ca2+ efflux and insulin release). Thus, lysophospholipids are a newly recognized class of lipid mediators which may promote insulin release at least in part via mobilization of a pool(s) of Ca2+ ('trigger Ca2+') bound in the plasma membrane and possibly in other cellular membranes. PMID- 3277675 TI - Effect of desipramine treatment on 3H-imipramine binding in the blood platelets of depressed patients. AB - Platelet imipramine binding (IB) was studied in depressed patients before and after treatment with desipramine for 17-28 days. Administration of desipramine was associated with a significant increase in Bmax. There was a trend for an increase in Kd, but it did not reach statistical significance. The net result of the changes in Bmax and Kd was an increase in IB. There were significant correlations between the change in depression ratings and pretreatment Kd, as well as the change in Kd during treatment. These results suggest that decreased IB is not a trait-dependent marker, but a state-dependent marker for depression. PMID- 3277676 TI - Melatonin and psychiatry. AB - The pineal methoxyindole melatonin remains the most widely studied of the "pineal principles," and in subhuman species, the neuroendocrine status of this hormone is now generally acknowledged. In humans, however, no definitive functional activity for melatonin has yet been convincingly demonstrated, despite the description in recent years of marked changes in the metabolism of this hormone in several clinical categories. Currently, much interest is focused on the role that melatonin may play in various psychiatric disorders, and pineal research now represents one of the active areas of current psychiatry research. Investigators in this field have encountered many technical and practical difficulties, but the advent of the impressively sensitive and specific assay systems for melatonin has done much to facilitate the progress of research. Present ideas suggest a positive involvement of melatonin in affective disorders, possible involvement in the schizophrenic psychosis, and potential involvement of this hormone in other psychiatric categories. The present review discusses the etiological significance, diagnostic potential, and clinical utility of melatonin in psychiatry. PMID- 3277677 TI - The source of energy for bacteriophage DNA packaging: an osmotic pump explains the data. PMID- 3277678 TI - Abnormalities of hematopoiesis in the acquired immunodeficiency syndrome. PMID- 3277680 TI - Randomized study on the treatment of chronic myeloid leukemia (CML) in chronic phase with busulfan versus hydroxyurea versus interferon-alpha. AB - For palliative therapy during the chronic phase of CML busulfan has proved to be the drug of choice. During the past years hydroxyurea and also interferon-alpha have gained increasing significance since they might prolong the duration of the chronic phase. In a multicenter study it is being determined, whether the use of hydroxyurea or of interferon-alpha instead of busulfan prolongs the duration of the chronic phase of Philadelphia positive CML. Additional goals are the examination of whether the types of disease evolution and the terminal phases differ between the treatment groups, and the prospective recognition of prognostic criteria for the duration of the chronic phase of CML. By December 31, 1987, 326 CML-patients had been randomized, 150 for busulfan, 150 for hydroxyurea and 26 for interferon-alpha. The average age is 50 years. 59 patients reached the end of the chronic phase, 55 died. The mean observation time of all patients is 1.34 years. At present no significant difference in survival is recognizable between the busulfan and hydroxyurea groups. Fewer adverse effects have been observed in the hydroxyurea group. Philadelphia chromosome negative patients show a higher average age and tend to have lower white blood cell and platelet counts. The number of patients having received interferon-alpha is still too small to allow evaluation. This report intends to document organization and progress of this study which to our knowledge is, at present, the largest ongoing prospective multicenter study on the therapy of CML. PMID- 3277681 TI - Setting the scene and posing the questions. AB - Rheumatoid arthritis (RA) is a common disabling disease. We are only just developing the necessary skills to assess the outcome of RA in both the short and long term. We can measure outcome in terms of radiological change, functional capacity and death. Patterns of disease onset and process measures, such as ESR and CRP, help to predict outcome. Without satisfactory methods of documenting the natural history of RA we cannot hope to be able to identify effective therapies or to develop sensible policies for their use. PMID- 3277679 TI - Intravenous immunoglobulin (i.v. IgG) for previously treated acute or for chronic idiopathic thrombocytopenic purpura (ITP) in childhood: a prospective multicenter study. AB - In a prospective multicenter study 42 thrombocytopenic (less than 30 X 10(9) platelets/l) children with chronic idiopathic thrombocytopenic purpura (ITP) or with acute ITP, dependent on or refractory to corticosteroids, were given 0.4 g i.v. IgG/kg body weight/day on 5 consecutive days and thereafter once a week if the platelet count fell to less than 20 X 10(9)/l or if the patient bled. After the initial 5 days of i.v. IgG the platelets rose within a mean of 7-8 days to greater than 30 X 10(9)/l in all and to greater than 150 X 10(9)/l in 33 of 42 patients (79%). After a mean observation time of 26.6 months 26 of 42 patients (62%) showed a satisfactory long-term effect, i.e. no need for treatment for at least 6 months without bleeding and with no platelet counts below 20 X 10(9)/l. No difference in response rate was found between children with chronic and those with previously treated acute ITP. These results indicate that i.v. IgG could be used to control emergency situations, e.g. to stop bleeding or to prepare a patient for surgery. I.v. IgG also represents a good alternative to treatment modalities, such as splenectomy and/or the administration of cytostatic immunosuppressants with potentially serious side effects. In addition to the expected transient rise in serum IgG levels, i.v. IgG induced a more prolonged elevation of serum IgM. Platelet associated IgG, elevated before therapy, was correlated with the clinical long-term outcome. PMID- 3277682 TI - Clinical and laboratory assessment of outcome in rheumatoid arthritis. AB - The management of rheumatoid arthritis would be assisted by an ability to assess prognosis in the individual patient. A number of studies have investigated the role of various clinical and laboratory measurements as predictors of prognosis, but all are hindered by the lack of adequate measures of outcome. Age, sex, initial radiograph and functional grades, the presence of rheumatoid factor or nodules may all be useful indicators. Mode of onset may have a bearing on outcome. The relationship between these variables and the clinical and biochemical assessment of disease activity is discussed in relation to prognosis. PMID- 3277683 TI - Radiological assessment of outcome in rheumatoid arthritis. AB - Radiographs are an accepted method of assessing disease severity and progression in rheumatoid arthritis. The advantages of using radiological damage as an outcome measure are that it reflects the history of the joint pathology, it can be objectively scored, radiographs provide a permanent record necessary for sequential studies and they do relate to other measures of disease outcome. However, measurement of radiological damage is fraught with methodological problems and studies to define what is the best approach have only recently been performed. There is also the problem of differentiating between radiological progression which is unavoidable due to mechanical derangement and that which is due to currently active disease. The effect of treatment on radiological damage remains controversial. A better understanding of how to use this important outcome measure should now provide rheumatologists with a more critical assessment of new therapies as well as providing a better knowledge of the disease process. PMID- 3277684 TI - Mortality in rheumatoid arthritis. AB - Rheumatoid arthritis (RA) is often regarded as a non-fatal disease. Yet patients with RA have a substantially reduced life expectancy. Increased mortality in RA is associated with a long disease duration, with severe disabling arthritis and with systemic involvement. Patients with chronic RA are particularly at risk of death from bacterial infection and renal disease. The influence of treatment on mortality remains unclear. In patients with mild RA, the treatments may be more toxic than the disease. PMID- 3277685 TI - Epidemiological aspects of studying outcome in rheumatoid arthritis. AB - Knowledge of the outcome of rheumatoid arthritis (RA) is important both to the patient and to the rheumatologist. However, little data exist on the long-term outcome and effects of treatment on the disease. Consideration is given to the problems that arise in the choice of methods and measures to be used in an outcome study. Patient selection is an underestimated factor, which often produces biases and problems of comparability. Useful lessons can be learnt from examining outcome studies in other chronic diseases. PMID- 3277686 TI - Can 'disease modifying' drugs influence outcome in rheumatoid arthritis? AB - The treatment of rheumatoid arthritis with disease modifying drugs is based on the hypothesis that they exert a more profound effect on the disease process than non-steroidal anti-inflammatory drugs. Short-term studies of disease modifying drugs show significant clinical and laboratory improvements in comparison to placebo. Longer-term studies suggest that this improvement is not maintained. Attempts to assess the effect of disease modifying and immunosuppressive drugs on radiological progression suggest that they may have a week protective effect, but there is no evidence to suggest that this is maintained in the long term. Studies of corticosteroid therapy indicate that in large doses it possesses disease modifying properties and is capable of retarding radiological progression. The benefit-risk ratio of such doses is unacceptable. Lower doses have not yet been adequately investigated. Rheumatologists should regard existing suppressive agents as moderately effective in the short term. Few patients remain on single drug therapy for prolonged periods and available evidence does not suggest that these drugs are capable of altering the long-term outcome of rheumatoid arthritis. PMID- 3277687 TI - Outcome in juvenile arthritis. AB - Juvenile chronic arthritis has a number of subtypes with only seropositive juvenile rheumatoid arthritis and systemic juvenile chronic arthritis having equivalents in adult life. In 75% of patients the inflammatory disease has subsided by adulthood, leaving some with degenerative and mechanical problems. Systemic, polyarticular and pauciarticular subgroups, based on mode of presentation, have been related to prognosis. Seropositive polyarticular disease behaves as an aggressive form of adult rheumatoid arthritis. Standard methods of assessment are inappropriate in children. Active joint score is most useful. Radiographs are difficult to interpret because of growth and lack of early erosive disease. Growth and social outcome is important. Death occurs in 7% of cases and is due to infection and cardiac involvement during active systemic disease, and due to secondary amyloidosis later. Slow-acting drugs and surgical procedures may alter outcome. The aetiology of these diseases remains unknown and there is a need for diagnostic tests, particularly to identify those children who will do badly. PMID- 3277689 TI - An evaluation of urologist-operated ultrasound and its use in the urological out patient clinic. AB - The value of urologist-operated real time ultrasound scanning was assessed in the urological out-patient clinic. In terms of accuracy, the urologists' ultrasound scans of the genito-urinary tract proved comparable with those of the radiologists. The techniques were quickly learned and scanning added little to the consultation time. Scanning during clinic time was shown to be both time saving and cost-effective by allowing more rapid assessment of the patient and a speedier diagnosis. In economic terms considerable savings could be made by reducing the need for formal ultrasound referrals, since patients scanned at the out-patient clinic would be spared two further trips to hospital, one for the formal examination and another for the out-patient clinic review. Clinic turnover thus becomes more efficient and inconvenience to the patient and transport costs are lessened. PMID- 3277688 TI - Pre-emptive (neo-adjuvant) intravenous chemotherapy for invasive bladder cancer. PMID- 3277690 TI - Development and decision-making in the mammalian cerebral cortex. AB - One of the fundamental tasks of neurobiology is to understand how the precision and specificity of the adult nervous system is achieved during development. This paper reviews the progress that has been made toward this end in studies of the developing mammalian cerebral cortex. Particular attention is focused on the problem of how cortical neurons make decisions during development: the correlation between a neuron's 'birthday' and its final laminar destination and projection patterns has raised the possibility that young neurons may be committed to their adult fates very early on in development, perhaps prior to migration. Indeed, several lines of evidence reviewed here suggest that at least some of the decisions made by cortical neurons are intrinsic properties of the cell itself. These studies include experiments on the reeler mouse mutant, and more recent attempts to manipulate developmental fates by pharmacological interventions and transplantation techniques. It is concluded that early commitment events in the cerebral cortex may specify a neuron's laminar position and restrict the range of potential axonal projections that the cell may form, but that local positional cues direct neurons to select (or maintain) only certain of the possible projections. PMID- 3277691 TI - The cellular neurobiology of neuronal development: the cerebellar granule cell. AB - Cerebellar granule cells in vivo and in vitro have been widely used in the study of the cellular neurobiology of neuronal development. We have described the basic neuroanatomical data on the granule cell in the developing and mature cerebellum. The importance of the cytoskeleton in determining the morphology of the granule cell and in process outgrowth and cell migration has been described. Extensive information is now available on the composition of the granule cell cytoskeleton. Cell surface glycoproteins are thought to be involved in the control of cell adhesion and cellular interactions during development. A number of surface molecules belonging to either the N-CAM or the Ng-CAM groups of glycoproteins have been studied in detail in the cerebellum. The role of these proteins in cell adhesion and in granule cell-astroglial interactions during granule cell migration has been reviewed. The survival and differentiation of neurones is controlled by soluble trophic factors. Several factors have been described which act as trophic factors for granule cells in vitro and may do the same in vivo. The numerous studies that have been carried out on the cerebellar granule cell have allowed us to describe certain aspects of the cellular neurobiology of this class of neurones as an example with general significance for the understanding of neuronal differentiation and function. PMID- 3277693 TI - Lasers in dentistry. "Star wars". Dreaming or a future reality? PMID- 3277692 TI - Cardiovascular and respiratory changes elicited by stimulation of rat superior colliculus. AB - Stimulation of the rat superior colliculus can produce either orienting or defensive movements, which if elicited by natural stimuli would be accompanied by cardiovascular changes. To assess whether cardiovascular changes might also be mediated by the superior colliculus, blood pressure and heart rate were measured in Saffan-anaesthetised rats while the dorsal midbrain was systematically explored with electrical and chemical stimulation. Electrical stimulation (10 sec trains of 0.3 msec 100 Hz cathodal pulses, 50 microA) within the superficial and intermediate layers of the rostral superior colliculus transiently lowered blood pressure without affecting heart rate. In contrast sites within the deep layers, and in adjacent periaqueductal grey and midbrain tegmentum, gave pressor responses accompanied by a variety of heart-rate changes, that usually included a period of bradycardia. A roughly similar distribution was obtained with the cell stimulant bicuculline (200 or 500 nl, 490 microM), though sodium L-glutamate (200 nl, 0.05 or 1.0 M) was ineffective. These results suggest that (a) cardiovascular responses can be produced by stimulation of the rat superior colliculus; (b) their nature depends on the location of the stimulation; and (c) they may be mediated in part by cells differentially sensitive to glutamate and to bicuculline. In addition, in some animals respiratory responses were measured stethographically. Short-latency increases in thoracic girth, often accompanied by increases in respiratory rate and depth, were elicited by electrical stimulation from 61% of the collicular sites examined, and by microinjection of glutamate from 56% of collicular sites. These data suggest that (a) cells within the superior colliculus are capable of influencing respiration; (b) given the widespread distribution of responsive sites within the superior colliculus, the respiratory changes may be preparatory for both approach and defensive movements; (c) the collicular cells that affect respiration may be different from those that influence blood pressure, because the latter are relatively insensitive to microinjection of glutamate. PMID- 3277694 TI - Peripheral ameloblastoma. Report of a case. PMID- 3277695 TI - Lorazepam sublingual for the nervous dental patient. PMID- 3277696 TI - [Various clinical data on the trichodento-osseous syndrome]. PMID- 3277697 TI - CANDI. A knowledge-based system for nursing diagnosis. PMID- 3277698 TI - A profile of the use of computer assisted instruction within baccalaureate nursing education. PMID- 3277699 TI - Computer assisted stereotactic surgery. PMID- 3277700 TI - Heterogeneity among the non-Hodgkin's lymphomas. Implications for autologous bone marrow transplantation with in vitro purging using monoclonal antibodies. AB - To investigate the possible implications of heterogeneity among the non-Hodgkin's lymphomas for bone marrow purging using complement-fixing monoclonal antibodies to lymphoma-associated antigens, a panel of large cell lymphoma cell lines of diverse phenotypes was treated with monoclonal antibodies DLC-48 and LN-1. An association was demonstrated between the percentage of suppression of colony formation by the cell line and both the percentage of cells staining with the antibody and the intensity of its binding. Flow cytometric analysis of cells surviving treatment with antibody and complement demonstrated that the population that escaped lysis showed weak immunofluorescent staining. Similarly, 40% of the clones derived from cells surviving treatment with antibody and complement stained weakly compared with the parent cell line. For a given fluorescence intensity, cells differed in their susceptibility to treatment. Some cells with moderate to strong staining survived incubation with antibody and complement. In five cases, treatment of bone marrow contaminated with malignant lymphoma cells resulted in complete eradication of even cells with weak staining. In two cases, a population of cells that stained dimly survived treatment with either antibody. DNA-content analysis showed that the cell cycle distribution of cells surviving treatment with DLC-48 or LN-1 and complement was similar to that of cells treated with control antibody 46-1G7 and complement. Phenotypic heterogeneity may hinder efforts to purge malignant lymphoma cells from human bone marrow with complement fixing monoclonal antibody reagents. Relative resistance to complement-mediated lysis may underlie differences in the susceptibility of cells to treatment and also limit the effectiveness of this technique. PMID- 3277701 TI - Bilateral adrenal ganglioneuroblastoma with neuromelanin. Clinical and pathologic observations. AB - A case of bilateral adrenal ganglioneuroblastoma in an adolescent boy is described. The clinical evolution was remarkable for its quiescent course, despite unfavorable prognostic indicators that included: intraabdominal primary site, large tumors on both sides of the midline, and "unfavorable" pathologic subtype. There was no family history of neuroblastomas. Production of neuromelanin was manifested by this unusual tumor. A review of published cases of multifocal neuroblastomas suggests that these tumors follow an uncommon natural history, at variance with the expected behavior of the usual unicentric and sporadic type of neuroblastoma. PMID- 3277702 TI - Cerebral germinomas and Klinefelter syndrome. A review. AB - Patients with Klinefelter syndrome appear to be predisposed to the development of extragonadal cerebral germinomas. A case of a pineal region germinoma in a boy 15 years of age with Klinefelter syndrome is documented in this article. In view of three other cases of cerebral germinomas associated with Klinefelter syndrome in the literature, a hypothesis for this predisposition is suggested. PMID- 3277703 TI - Six primary cancers in individuals. Report of four cases. AB - Four patients who had six or more primary cancers are described in this article. Two of the patients had seven cancers each; the most frequent cancer site was the colon. These patients were young at the onset of their first cancer and had a long survival. All the patients had a strong family history of cancer, especially colon cancer. We found that family members of individuals with multiple cancers should be considered to have an increased risk for the development of cancer. PMID- 3277704 TI - Chromosomes in solid tumors and beyond. PMID- 3277705 TI - Pitfalls and practice of Luria-Delbruck fluctuation analysis: a review. AB - Luria-Delbruck fluctuation analysis provides a method to estimate mutation rates in cell populations. Originally designed for bacterial populations, the method now is widely applied in somatic cell genetics and in cancer biology. However, there are fundamental genetic differences between bacteria and somatic cells, and this together with the inherent mathematical complexity of fluctuation analysis can lead to many pitfalls in its application. In addition there is considerable statistical error associated with the method. The use, misuse, and limitations of fluctuation analysis are reviewed here with the hope that such problems may be avoided. PMID- 3277706 TI - Two-dimensional gel electrophoretic analysis of cytoplasmic proteins from Friend erythroleukemia cells chemically induced to undergo terminal erythroid differentiation. AB - The proerythroblastoid Friend erythroleukemia cell (FELC) line, clone TR 19-9, was treated with 4 mM hexamethylene bisacetamide (HMBA) over a 6-day period. Greater than 94% of the FELC reacted positively to the benzidine assay for hemoglobin by Day 4 of treatment. Protein accumulation during the final 4 days of treatment (from Days 2 to 6) was monitored by labeling for 24-h periods with a 14C-labeled amino acid mixture. At the end of each radiolabeling time point, cells were harvested and cytoplasmic proteins were isolated and subjected to two dimensional gel electrophoresis in triplicate. Short-term fluorographic exposures were made in the linear X-ray film response range to monitor those polypeptides which were most rapidly accumulated. Fluorographs were digitized for computer image analysis and gel data comparison rationales were used to combine the polypeptides contained on the replicate fluorographs into a single cytoplasmic polypeptide profile or Master Image for each of the two experimental conditions, control and HMBA-treated FELC. These two images were merged into a single Master Composite Image containing a total of 211 polypeptides so that those polypeptides common to both and/or unique to each of the experimental conditions could be viewed graphically in the same plane. A total of 98 polypeptides in HMBA-treated FELC were shown to have large accumulation rate differences from the control FELC;32 of these polypeptides were present in the HMBA Master Image which were not detected in the Control Master Image and 66 polypeptides were present in the Control Master Image but not detected in the HMBA Master Image. Five polypeptides, found in both Master Images, were shown to vary quantitatively in the HMBA-treated FELC from the corresponding polypeptides in the control. These quantitative data measurements on the rates of accumulation of various common polypeptides offer a mode for simultaneously monitoring the kinetics of induction and repression of many gene products throughout an experimental time course. PMID- 3277707 TI - Progesterone receptor structure and protease activity in primary human endometrial carcinoma. AB - Monoclonal antibodies were used to investigate progesterone receptor structure (isoforms) in 33 primary human endometrial tumors. The monoclonal antibodies recognized on protein blots two progesterone receptor proteins with molecular weights of 116,000 and 81,000. The Mr 116,000 protein appeared as a triplet, while a single band was found for the Mr 81,000 protein. The triplet/singlet structure was found in all progesterone receptor-positive tumors, regardless of the degree of tumor differentiation. Protease activity, which gave rise to a false-negative pattern on protein blots, was found in approximately one-half of the tumors in which it was investigated. Inclusion of a cocktail of protease inhibitors during sample preparation resulted in the maintenance of the triplet/singlet progesterone receptor structure. Mixing experiments using a progesterone receptor-rich human endometrial carcinoma (EnCa 101), which lacks protease activity, and protease-containing primary tumor homogenates indicated that the protease was leupeptin sensitive. Interestingly, while the proteolytic activity reduced or eliminated the triplet/singlet progesterone receptor structure seen on protein blot analysis, it did not affect progesterone receptor concentration measured by Scatchard analysis. Sample preparation in the presence of protease inhibitors is therefore a requisite for structural analysis of the progesterone receptor in endometrial tumors. PMID- 3277708 TI - Treatment of Ph'-positive chronic myelogenous leukemia (CML) with recombinant interferon alfa-2b (Intron A). PMID- 3277709 TI - Recombinant interferon alfa-2b (Intron A) as post-induction therapy for responding multiple myeloma patients. M84 protocol. PMID- 3277710 TI - Clinical studies of alpha-interferons in chronic myelogenous leukemia. PMID- 3277711 TI - Localization of CRF-immunoreactive neurons in the cat medulla oblongata: their presence in the inferior olive. AB - Corticotropin releasing factor (CRF)-immunoreactive (IR) perikarya, visualized by the indirect immunoperoxidase method in colchicine-pretreated cats, were localized in many discrete regions of the medulla oblongata. They were found mainly in the dorsal aspect and midline of the medulla oblongata, and more rostrally in the ventrolateral portion. Our results also demonstrated CRF-IR neurons in the rostrocaudal extent of the inferior olive, probably projecting to the cerebellar cortex via thick axons visualized along the lateral edge of the medulla. CRF-IR olivary cells were also found in the pontine cat from which the forebrain was removed, but neither in hypophysectomized nor adrenalectomized cats. PMID- 3277712 TI - Absorption of intact proteins by the intestinal epithelium of trout, Salmo gairdneri. A luminescence enzyme immunoassay and cytochemical study. AB - In the rainbow trout, a carnivorous species with a stomach, orally administered horseradish peroxidase (HRP) crossed the intestinal epithelium into the circulation. The protein first appeared in the blood 7 to 8 h after intubation, and could be assayed up to 24 h after administration. The method used, which combines ELISA (enzyme-linked immunoabsorbant assay) and chemiluminescence, enabled the transfer to be measured quantitatively. There was a direct correlation between the quantity ingested and the quantity transferred to the plasma within the experimental limits chosen. The clearance was monophasic and exponential (clearance rate: 3% per minute). Up to 6% of the ingested HRP was transferred to the blood. By cytochemistry it was possible to demonstrate that the protein crossed the intestinal cells at the level of the posterior segment, escaping the particularly intense intracellular lysosomal digestion. After entering the intercellular space, HRP was transferred to the interstitial space of the subepithelial lamina propria. During this transfer the HRP was in close contact with infiltrated macrophages and leukocytes resembling lymphoid cells. Thus, the passage of these protein particles could be the first indispensable step in the possible triggering of a local and/or a systemic immune response. PMID- 3277713 TI - Fine-structural localization of neuropeptide tyrosine (NPY)-like immunoreactivity in the neuronal somata of colchicine-pretreated celiac ganglia of rats. AB - In colchicine-pretreated cells of sympathetic ganglia, intensely NPY immunoreactive material was localized within vacuoles and vesicles of the disorganized, widely dispersed Golgi apparatus. Intensely positive large granular vesicles, which are known to be one of major storage sites of various peptides in the autonomic nerve endings, were essentially unobserved in the perikaryal cytoplasm. The present finding provides evidence that one pool of NPY-like immunoreactivity is localized in the Golgi apparatus of colchicine-pretreated as well as normal sympathetic ganglion cells. It is also clear that visualization of NPY-immunoreactive somata by colchicine-pretreatment in the sympathetic ganglia is due to the accumulation of the neuropeptide in the disorganized Golgi stacks instead of increased amount of the large granular vesicles containing NPY. PMID- 3277714 TI - Macroautophagic phenomena in renin granules. AB - The secretory granules of murine epithelioid cells take up and probably degrade mitochondria; they thus appear to have macroautophagic properties. As renin granules also have other properties uncommon for secretory granules, they are suggested to fulfill functions in these cells otherwise reserved for lysosomes. PMID- 3277715 TI - 44-kDal bone phosphoprotein (osteopontin) antigenicity at ectopic sites in newborn rats: kidney and nervous tissues. AB - Previous immunohistochemical data have shown that the 44-kDal bone phosphoprotein (44K BPP, also called sialoprotein I or oestopontin) recently isolated in our laboratory was synthesized by osteoblasts and osteocytes and was expressed early during differentiation of bone-forming cells. We report here the presence of 44K BPP antigenicity at certain ectopic sites, namely, the proximal-convoluted tubule of the kidney, neurons, sensory and secretory cells in the internal ear. To insure specificity and reproducibility, different immunohistochemical methods were used and affinity-purified antibodies against two separate preparations of pure 44K BPP were tested. In the cells of the proximal-convoluted tubule, 44K BPP immunoreactivity was observed within apical endocytotic vacuoles and within lysosomes. This staining thus correlates with the degradation of the 44K BPP epitope which we previously demonstrated to occur in serum. On the other hand, in the neurons of the acoustic ganglion and the sensory cells of the macula, 44K BPP immunoreactivity was associated with the Golgi apparatus indicating synthesis and secretion by these cells. The finding that the 44K BPP (or a structurally related molecule) is synthesized by neurons and neuroepithelial cells deserves further investigation with respect to a possible embryologic relationship between neuroectodermal cells and the precursors of some bone forming-cells of the skull. PMID- 3277716 TI - Localization of avian LHRH-immunoreactive neurons in the hypothalamus of the domestic fowl, Gallus domesticus, and the Japanese quail, Coturnix coturnix. AB - The localization of LHRH-containing perikarya and nerve fibers in the hypothalami of the domestic fowl and Japanese quail was investigated by means of the specific immunoperoxidase ABC method, using antisera against chicken LHRH-I ([Gln8]-LHRH), chicken GnRH-II ([His5-Trp7-Tyr8]-LHRH[2-10]) and mammalian LHRH ([Arg8]-LHRH). Chicken LHRH-I-immunoreactive perikarya were sparsely scattered in the nucleus preopticus periventricularis (POP), nucleus filiformis (FIL) and nucleus septalis medialis (SM), and in bilateral bands extending from these nuclei into the septal area in both species. A few reactive perikarya were also observed in the nucleus accumbens (Ac) and lobus parolfactorius (LPO). Numerous cLHRH-I-immunoreactive fibers were widely scattered in the preoptic, septal and tuberal areas, and were densely concentrated in the external layer of the median eminence and in organum vasculosum of the lamina terminalis (OVLT) in both species. Anti-mammalian LHRH serum cross-reacted weakly with perikarya and fibers immunoreactive to anti-cLHRH I serum in normal chicken and quail. Anti-cGnRH-II[2-10] serum immunoreacted with magnocellular neurons distributed in the rostral end of the mesencephalon along the midline close to the nervus oculomotorius (N III). These perikarya were apparently different from cLHRH-I immunoreactive neurons. No immunoreactive cells and fibers against anti-cGnRH-II[2-10] were observed in the hypothalamus and median eminence of the chicken or quail. Anti-cGnRH-II[2-10] bound specifically with cGnRH-II.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277717 TI - A non-AUG translational initiation in c-myc exon 1 generates an N-terminally distinct protein whose synthesis is disrupted in Burkitt's lymphomas. AB - The c-myc gene comprises three exons with a single large AUG-initiated open reading frame extending from exon 2 through exon 3. Exon 1 lacks any AUG codons. Cells from a wide range of species produce two c-myc proteins that, while highly related, do not appear to arise from posttranslational interconversion. To understand the origin of the two proteins, we mapped them and analyzed the in vitro protein-coding capacity of c-myc cDNAs. Our findings show that the two proteins are derived from alternative translational initiations at the exon 2 AUG and at a non-AUG codon near the 3' end of exon 1, resulting in the production of proteins with distinct N termini. In Burkitt's lymphomas, the removal or specific mutation of exon 1 in c-myc translocations correlates with suppression of synthesis of the larger protein, and thus may contribute to the oncogenic activation of c-myc. PMID- 3277718 TI - Spindle formation and chromatin condensation in cells blocked at interphase by mutation of a negative cell cycle control gene. AB - In Aspergillus nidulans the temperature-sensitive cell cycle mutation bimE7 causes chromosome condensation and pre-anaphase spindle formation to occur at restrictive temperature. By constructing double mutants between bimE7 and S phase or G2 phase mutants and blocking DNA replication with hydroxyurea, we demonstrate that bimE7 can cause chromatin condensation and spindle formation in cells held in S or G2. Thus bimE7 overrides normal control systems that prevent mitosis from prematurely occurring during S or G2. We show that bimE7 is a loss of function mutation and propose that bimE normally functions to negatively control a positive mitotic inducing factor, possibly the cell cycle gene nimA. PMID- 3277719 TI - Protein unfolding and the energetics of protein translocation across biological membranes. PMID- 3277720 TI - Mini-P1 plasmid replication: the autoregulation-sequestration paradox. AB - It has been proposed that the initiator protein RepA is rate limiting for mini-P1 plasmid replication, and that the role of the plasmid copy number control locus is to sequester the initiator and thus reduce replication. This proposal appears inconsistent with the observation that RepA is autoregulated, since the protein lost by sequestration should be replenished. A resolution of this autoregulation sequestration paradox is possible if the sequestered RepA, unavailable for replication, is still available for promoter repression. We demonstrate that RepA binds to the control locus and to the promoter region simultaneously, causing the intervening DNA to loop. DNA looping could provide the requisite mechanism by which RepA bound to the control locus might exert repression. PMID- 3277721 TI - Resolution of model Holliday junctions by yeast endonuclease is dependent upon homologous DNA sequences. AB - Holliday junctions, in which two double-stranded DNA molecules are linked by single-stranded crossovers, are thought to be central intermediates in genetic recombination. We report here the in vitro specificity of a yeast endonuclease for structures analogous to Holliday junctions. Plasmids that extrude inverted repeat sequences into cruciform junctions are cleaved by the introduction of nicks into strands of like polarity, approximately 4-8 nucleotides from the base of the junction. In all cases, cleavage occurs within homologous sequences, and with precise symmetry across the junction. In contrast, a junction containing four arms of unrelated sequence is cleaved asymmetrically. The dependence upon homology for symmetrical cleavage is not found with T4 endonuclease VII, which cleaves branched structures in vitro. Holliday junction resolution appears to occur in a concerted manner by the introduction of nicks into two homologous DNA helices held in alignment. PMID- 3277722 TI - Influence of saccharides and sodium chloride on growth and differentiation of Trypanosoma cruzi. AB - The influence of saccharides, especially glucose and fructose, on the metacyclogenesis and growth of Trypanosoma cruzi has been investigated. In the absence of glucose and fructose in the media, both the percentage of metacyclic forms and the growth increased significantly. Furthermore, the addition of NaCl to the medium without monosaccharides strongly increased the formation of metacyclic forms. Presence of NaCl and absence of monosaccharides showed a synergic effect on differentiation of T. cruzi. PMID- 3277723 TI - The chicken blastoderm: current views on cell biological events guiding intercellular communication. PMID- 3277724 TI - Subperiosteal implants. PMID- 3277725 TI - Implants. Part I. Cylindrical implants. PMID- 3277726 TI - Implants. Part three. An overview. PMID- 3277727 TI - Mandibular ramus frame. PMID- 3277729 TI - Implants. Biomaterials and biomechanics. PMID- 3277728 TI - Implants. Bone and bone substitutes. PMID- 3277730 TI - Blade implants. PMID- 3277731 TI - Cytosolic epoxide hydrolase. AB - Epoxide hydrolase activity is recovered in the high-speed supernatant fraction from the liver of all mammals so far examined, including man. For some as yet unexplained reason, the rat has a very low level of this activity, so that cytosolic epoxide hydrolase is generally studied in mice. This enzyme selectively hydrolyzes trans epoxides, thereby complementing the activity of microsomal epoxide hydrolase, for which cis epoxides are better substrates. Cytosolic epoxide hydrolase has been purified to homogeneity from the livers of mice, rabbits and humans. Certain of the physicochemical and enzymatic properties of the mouse enzyme have been thoroughly characterized. Neither the primary amino acid, cDNA nor gene sequences for this protein are yet known, but such characterization is presently in progress. Unlike microsomal epoxide hydrolase and most other enzymes involved in xenobiotic metabolism, cytosolic epoxide hydrolase is not induced by treatment of rodents with substances such as phenobarbital, 2-acetylaminofluorene, trans-stilbene oxide, or butylated hydroxyanisole. The only xenobiotics presently known to induce cytosolic epoxide hydrolase are substances which also cause peroxisome proliferation, e.g., clofibrate, nafenopin and phthalate esters. These and other observations indicate that this enzyme may actually be localized in peroxisomes in vivo and is recovered in the high-speed supernatant because of fragmentation of these fragile organelles during homogenization, i.e., recovery of this enzyme in the cytosolic fraction is an artefact. The functional significance of cytosolic epoxide hydrolase is still largely unknown. In addition to deactivating xenobiotic epoxides to which the organism is exposed directly or which are produced during xenobiotic metabolism, primarily by the cytochrome P-450 system, this enzyme may be involved in cellular defenses against oxidative stress. PMID- 3277732 TI - Comparative distribution and excretion of carboplatin and cisplatin in mice. AB - The comparative distribution and excretion of Carboplatin (cis-diammine-1,1 cyclobutane dicarboxylate platinum II, CBDCA, JM8) and cisplatin have been investigated in Balb C- mice following i.v. administration of the maximally tolerated doses (MTDs) of the compounds. Although the concentrations of platinum in the plasma and tissues during the alpha-phase were much higher for Carboplatin than for cisplatin, reflecting the difference in the doses used (4 vs 80 mg/kg), the tissue-to-plasma ratios were similar. During the beta-phase (1-10 days), however, both the platinum concentrations and the ratios were found to be similar for most tissues when cisplatin and Carboplatin were compared. The platinum concentrations and the tissue-to-plasma ratios of the spleen, brain, muscle, testes, ovary and bile, on the other hand, were consistently higher (two- to sixfold) after Carboplatin than after cisplatin. The highest ratios (greater than 20) were found in the kidney, liver, spleen (after Carboplatin only) and skin at 6 days after treatment. Comparison of the two compounds showed that the half lives of platinum in the plasma and tissues during both the alpha- and beta phases were similar, except for the spleen, in which a nine-fold greater t1/2 beta was recorded for Carboplatin than for cisplatin. The main route of excretion for the two complexes is via the kidneys, with 52% of cisplatin and 93% of Carboplatin being excreted during the first 3 days. The major part of this, however, is excreted within the 1st day. These results indicate that, although there are quantitative differences, the distribution and excretion profiles are similar for Carboplatin and cisplatin. PMID- 3277733 TI - Comparison of intestinal toxic effects of platinum complexes: cisplatin (CDDP), carboplatin (CBDCA), and iproplatin (CHIP). AB - The biochemical background of the intestinal side effects of cis-diammine-1,1 cyclobutane dicarboxylate platinum (II) (CBDCA) and cis-diisopropylamine-trans dihydroxy-dichloro platinum (IV) (CHIP) was compared with those of cis diamminedichloroplatinum (II) (CDDP). Biochemical investigations were carried out on mucosal cells isolated by a combined chemical-mechanical method from the total length of the small intestine. After treatment with single, equitoxic doses of Pt analogues, the activities of thymidine kinase (TK) EC 2.7.1.21, sucrase (SUC) EC 3.2.1.26, maltase (MAL) EC 3.2.1.20, and protein content showed dose-dependent decreases, whereas the activity of alkaline phosphatase (AP) EC 3.2.1.20 increased slightly. The nadir of enzyme activity changes occurred 24-48 h after treatment. For the regeneration of the mucosa more than 96 h was necessary. Of the platinum analogues studied, CHIP proved to be the most toxic to the small intestine. While the highest doses of CDDP and CBDCA (0.66 x LD50) caused significant but less than 50% decreases in TK, SUC, MAL, and protein content (PROT), the CHIP doses needed for 50% reduction were between 0.44-0.66 x LD50. PMID- 3277734 TI - Pharmacokinetics of carboplatin after intraperitoneal administration. AB - The pharmacokinetics of carboplatin, ultrafilterable platinum, and total platinum after intraperitoneal (i.p.) administration were studied in peritoneal fluid, plasma, red blood cells (RBCs), and urine during a phase-I trial in patients with minimal, residual ovarian cancer. Samples were collected from 7 patients who had received carboplatin (200-500 mg/m2) in 21 dialysis fluid. The fluid was withdrawn after a 4-h dwell. Platinum concentrations were measured by flameless atomic absorption spectrometry, and intact carboplatin was determined by HPLC with electrochemical detection. Peak concentrations of carboplatin in plasma were obtained 2 h after the end of instillation. The mean ratio of peak concentrations of carboplatin in instilled fluid and plasma was 24 +/- 11. The peritoneal clearance of carboplatin was 8 +/- 3 ml/min, which was 12 times less than the plasma clearance (93 +/- 32 ml/min). Due to this clearance ratio, the AUCs for the peritoneal cavity were about 10 times higher than those for plasma. On average, 34% +/- 14% of the dose was still present in the instillation fluid that had been withdrawn after a dwell time of 4 h. In plasma, the mean value of AUC/Dnet (Dnet = Dose - amount recovered from the peritoneal cavity) after i.p. administration was comparable with that of AUC/D after i.v. administration. This means that unrecovered carboplatin (66%) was completely absorbed from the peritoneal cavity. It may be expected from this bioavailability that the maximum tolerated dose (MTD) of i.p.-administered carboplatin with a 4-h dwell is around 1.5 times higher than that after i.v. administration. Overall pharmacokinetic parameters of carboplatin and platinum in plasma were comparable after i.p. and i.v. administration. PMID- 3277735 TI - Systole has little effect on diastolic coronary artery blood flow. AB - The hypothesis that myocardial systolic contraction attenuates diastolic coronary flow was tested by comparing flow during diastole to flow during a prolonged asystole. The circumflex coronary artery was cannulated and perfused at constant pressure in closed-chest, morphine- and alpha-chloralose-anesthetized dogs. The heart was paced at 80, 120, 160, or 200 beats/min after atrioventricular heart block under control, intracoronary adenosine, and intravenous norepinephrine treatment conditions. Cessation of pacing while holding coronary pressure constant at the previous diastolic pressure resulted in asystolic circumflex flow that initially equaled the previous diastolic flow during heart rates of 80, 120, and 160 in all treatment groups. Initial asystolic circumflex flow was approximately 5% higher than the previous diastolic flow at a heart rate of 200 beats/min, but this was probably due to an artifact. It is concluded that systolic contraction does not limit diastolic coronary flow at heart rates less than 160 beats/min and probably does not at higher heart rates. PMID- 3277736 TI - Mortality associated with diastolic hypertension and isolated systolic hypertension among men screened for the Multiple Risk Factor Intervention Trial. AB - The large cohort of white men (317,871) 35 to 57 years old at initial screening for possible enrollment into the Multiple Risk Factor Intervention Trial (MRFIT) was examined with regard to initial blood pressure levels and subsequent coronary heart disease (CHD), stroke, and all-cause mortality. The overall prevalence of isolated systolic hypertension (ISH), defined as systolic blood pressure (SBP) greater than or equal to 160 mm Hg and diastolic blood pressure (DBP) less than 90 mm Hg, was 0.67% among white men screened for MRFIT and increased with age (0.31% among 35- to 39-year-olds to 1.7% among 55- to 57-year-olds). The 6 year CHD and all-cause mortality rates in men over 50 were highest in those with ISH compared with both subjects with diastolic hypertension and those with normal pressure. The relative risk of death from stroke in those with ISH, compared with that in those with SBP less than 160 mm Hg and those with DBP less than 90 mm Hg, was 3.0 (95% confidence interval 1.3 to 6.8). In addition, at any level of DBP, the level of SBP appeared to be the major determinant of all-cause and CHD mortality. The determinants of ISH in individuals under 60 years of age as well as the possible efficacy of its treatment should be evaluated further. PMID- 3277737 TI - Time domain echo pattern evaluations from normal and atherosclerotic arterial walls: a study in vitro. AB - The aim of this study in vitro of human fresh specimens was to quantitatively evaluate the contribution of the aqueous phase-intima interface (the first 400 msec of the reflected signal) in normal and atherosclerotic arterial walls. Seventy-five samples were studied, 15 normal, 15 fatty, 15 fibrofatty, 15 fibrous, and 15 calcific. A broadband transducer (4 to 14 MHz) was used. The aqueous phase-intima reflection (expressed in dB, mean +/- SD) was lowest in the fatty plaques (-35.3 +/- 2.5), differing in a highly significant way from that in all other groups: normal (-13.2 +/- 8.8), fibrofatty (-20.4 +/- 8.3), fibrous ( 13.0 +/- 9.7), calcific (-5.9 +/- 3.4). The echo coming from the intima-media transition was of relatively low amplitude in normal and in fatty samples; typically, strong reflections from the intima-media transitions were present in the other pathologic subsets. In conclusion, the time domain echo pattern of the arterial wall may provide a useful clue to the structure of the plaque. PMID- 3277738 TI - Cardiac transplantation at the Cleveland Clinic Foundation: the first twenty-four months. PMID- 3277739 TI - Results of mechanical ventricular assist in bridging to cardiac transplantation. PMID- 3277740 TI - Solitary pulmonary nodule. PMID- 3277741 TI - Combined surgery for valve and coronary artery disease. PMID- 3277742 TI - HMG-CoA reductase inhibitors. A new approach to the management of hypercholesterolemia. PMID- 3277743 TI - Determination of manganese in biological materials by electrothermal atomic absorption spectrometry: a review. AB - The great diversity of methods for measuring manganese in biological materials (serum, plasma, whole blood, urine, spinal fluid, and hair) reflects the difficulty in measuring extremely small quantities of this element. Detailed examination of these methods demonstrates that the one most used is flameless atomic absorption spectrometry. In this review we report the different instrument settings for wavelength, slit width, protection gases, graphite furnaces, type of background correction, amounts measured, and thermal programs. We give detailed recommendations by various authors for collecting samples. A thorough description of the preliminary steps and the handling of the specimen samples is also included: direct determination with or without dilution, addition of a matrix modifier or determination after ashing, with or without chelation-extraction steps. The preparation of the standards, procedures used, analytical criteria (accuracy, precision, specificity, detection limit, linearity), problems (interferences, matrix effects), and reference values and their physiological variations are also described. We give a consensus of recommendations concerning the choice of a method. PMID- 3277744 TI - Specific 3H radioimmunoassay with a monoclonal antibody for monitoring cyclosporine in blood. AB - A specific radioimmunoassay involving a mouse monoclonal antibody to cyclosporine has been developed for monitoring the parent drug in blood. Pretreatment with methanol removes cyclosporine from the erythrocytes. The limit of detection is about 12 micrograms/L, sample volume is 50 microL of blood, and within- and between-assay CVs are less than 7%. Assay results correlated well with those obtained by "high-performance" liquid chromatography (HPLC) for liver (n = 42), for heart (n = 64), for bone-marrow (n = 36), and for kidney (n = 140). For blood specimens obtained from patients treated with cyclosporine postoperatively for as long as 65 months, the mean RIA/HPLC ratio in all with transplant indications was close to 1. Therefore, the specific radioimmunoassay apparently can be used instead of HPLC to measure the parent drug in blood. PMID- 3277745 TI - "Sandwich"-type immunoassay of carcinoembryonic antigen in patients receiving murine monoclonal antibodies for diagnosis and therapy. AB - Measurements of carcinoembryonic antigen (CEA) in blood increased dramatically in some patients who were receiving injections of monoclonal antibody. CEA titers were measured with a monoclonal antibody-based double-determinant enzyme immunoassay in which untreated plasma specimens were diluted with an equal volume of buffer containing mouse serum. Increasing CEA titers were accompanied by the appearance and coincident increase in titers of human antibody against mouse Ig (HAMA). Adsorption of these sera with solid-phase anti-human IgG or Protein A restored antigen titers to pretreatment values; evidently the serum factor eliciting false-positive CEA titers was most probably HAMA. Neither addition of undiluted mouse serum to the assay mixture nor pretreatment by heating plasma specimens to 70 degrees C effectively abolished HAMA interference. By contrast, protein precipitation with polyethylene glycol (130 g/L) or heating plasma samples to 90 degrees C eliminated false-positive titers caused by HAMA, but did not reduce authentic CEA titers. PMID- 3277746 TI - Effects of reaction variables on nephelometric and turbidimetric responses for the immunochemical reaction of immunoglobulin G. AB - Here we report a kinetic study of the immunoprecipitin reaction involving immunoglobulins G, A, and M. We used stopped-flow mixing adapted for simultaneous monitoring of nephelometric and turbidimetric signals for some studies and centrifugal mixing for others. The variables having the most significant effects on the kinetic responses in the regions of excess antibody and excess antigen are polyethylene glycol concentration, ionic strength, and the ratio of antigen to antibody. We document effects of these variables on maximum velocities and signal changes over a fixed-time interval for both monitoring modes and on the maximum signal change for nephelometry. We use response-surface methodology to help identify interactive effects among these variables (polyethylene glycol, NaCl, and antibody concentrations) and to select the best combination to use to quantify antigen in all regions of the immunoprecipitin curve. We also observe that turbidimetric responses are more reproducible and much simpler than are nephelometric responses. Implications of these results for quantification of the immunoglobulins are discussed. PMID- 3277748 TI - Serum fructosamine in diabetic pregnancy. AB - Serum fructosamine was measured in 275 blood donors, in 559 subjects with a normal pregnancy, in 32 gestational diabetics being treated with insulin and 69 being treated by diet only, and in 53 pregnant subjects with established diabetes. In none of the pregnant subgroups did the mean fructosamine concentration exceed that of the donor group. The concentration in normal pregnant subjects showed a modest but significant decrease with gestational age and an increase with maternal age. Hyperglycemic non-pregnant subjects (n = 24) had significantly increased serum fructosamine concentrations, and 96% of these subjects exceeded the upper 95% confidence limit for fructosamine in the donor group. A highly significant correlation was demonstrated between serum fructosamine and preprandial plasma glucose in the hyperglycemic subjects. A weak, but significant, correlation was shown for the entire population sample of antenatal patients, while this was non-significant within each of the sub-groups comprising established diabetics and gestational diabetics, respectively. PMID- 3277747 TI - Kinetic turbidimetric method for the immunochemical quantification of immunoglobulins, including samples with excess antigen. AB - Here we describe a kinetic approach for quantification of the immunoglobulins (IgG, IgA, IgM) in all regions of the immunoprecipitin curve. We use centrifugal mixing and report results for maximum-velocity, two-point, and multipoint curve fitting methods as well as the use of rate coefficients obtained from the curve fitting process to differentiate among regions of excess antibody, equivalence, and excess antigen. We show that it is possible to quantify each immunoglobulin over a concentration range from a large excess of antibody to moderate excesses of antigen with a single set of measurements made on a single dilution of each sample. Results for standard additions of the immunoglobulins to pooled sera have relative standard deviations (coefficients of variation) in the range of 1% to 3%, with analytical recoveries in the range of 95% to 106%. Correlations among determined and reported values in individual sera are quite good, with slopes ranging from 0.86 to 1.03 and no intercepts differing from zero by more than two standard deviation units. Concentrations quantified in 14 pathological sera by the proposed method correlated well with concentrations quantified by a fluorescence immunoassay method. PMID- 3277749 TI - Preliminary tests for drugs of abuse. AB - A drug-testing program must be designed by the client in consultation with the laboratory. The test procedures selected for the analytes in question depend on the defined "cutoff" concentrations, equipment available, and turnaround time. Preliminary tests are needed to separate the large number of negatives from presumptive positives, which then have to be confirmed. Immunoassays done with random-access analyzers are the procedures of choice. In clinical situations, thin-layer chromatographic procedures may be favored. The attributes and liabilities of the various procedures are presented as guides to the selection of a suitable procedure for a particular client. PMID- 3277750 TI - Theophylline determined by a bedside immunochromatographic method. PMID- 3277751 TI - Stratus fluorometric enzyme immunoassay system evaluated for determination of total thyroxin. PMID- 3277752 TI - Heterotopic brain presenting as a lip lesion. AB - Heterotopic brain tissue in the upper lip of a newborn child is presented and discussed. This rare developmental anomaly is usually present at birth and may simulate hemangioma. Before any surgical procedure can be performed, thorough radiographic and neurosurgical examination is essential to rule out eventual communication of the tumor with intracranial space. PMID- 3277753 TI - Congenital absence of the nasal columella. AB - Three cases of congenital absence of the nasal columella are presented: one male and twin females. The male also had bilateral congenital cataracts. The nose and the septum were otherwise well developed and appeared normal. The missing segment involved the medial crura of the alar cartilages with their tegumental mantle. There was no deformity of the upper lip or alveolus. Two procedures for reconstruction of the columella that were used in these cases are described in detail. The embryonic pathogenesis of this deformity is suggested. PMID- 3277754 TI - Cleft lip: a combined approach. AB - A combination of recognized procedures in the repair of the cleft lip patient is described. The first combination, which is used for the narrow cleft lip, consists of the forked flap, the rotation-advancement flap, and the round nostril technique. The second combination, which is best for the wide cleft, is the same except that the Wynn lateral flap replaces the rotation-advancement flap. It is believed that the results are sufficiently improved to justify the use of each of these combinations in selected cases. The indications, technique, and the short term follow-up are presented. PMID- 3277755 TI - A new chromosomal instability disorder confirmed by complementation studies. AB - Two sisters with a complex clinical pattern, including microcephaly, microgenia, defects of skin pigmentation, anal stenosis/atresia, and combined immunodeficiency together with spontaneous chromosomal instability and cellular hypersensitivity to X-rays and bleomycin are described. Complementation studies on heterokaryons proved that the underlying genetic defect is non-allelic with that of patients with ataxia telangiectasia (complementation groups AB-E) and the Nijmegen breakage syndrome, but identical with the case described by Conley et al. (1986). PMID- 3277756 TI - Partial deletion of 4p in fetal cells not present in chorionic villi. AB - A case of a prenatal diagnosis at the second trimester is presented showing a normal karyotype in 12 metaphases from chorionic villi. In all cultured amniotic cells, however, and also in all fetal fibroblasts analyzed after abortion a structural anomaly (46,XY;del 4(pter----p15.2) was detected. Prenatal diagnosis was performed because of intrauterine growth retardation, cleft lip and esophagus atresia by ultrasound. The fetal stigmata are compatible with the Wolf Hirschhorn syndrome. We conclude that amniocentesis may be indicated notwithstanding a normal CV-diagnosis in those rare pregnancies with a characteristically abnormal ultrasound. PMID- 3277757 TI - Concerning the interrelationship between form and function of the individual parts of the organism. By Julius Wolff, 1900. PMID- 3277758 TI - Malignant transformation of fibrous dysplasia. A case report and review of the literature. AB - A 34-year-old man developed a spindle-cell sarcoma originating in a preexisting lesion of monostotic fibrous dysplasia. A review of the literature reveals 83 cases of a malignant degeneration in fibrous dysplasia; osteosarcoma was the most common type of tumor. The next most common were fibrosarcoma and chondrosarcoma. The malignant tumor usually developed in the third or fourth decade of life. The most frequent anatomic sites were the craniofacial bones, the femur, and the tibia. Twenty-three of the 83 cases were treated with local radiation. In fibrous dysplasia, any abrupt alteration in the clinical course, manifested by pain and swelling, raises the possibility of malignant degeneration. PMID- 3277759 TI - Ultrasonography for urinary tract evaluation in patients with congenital spine anomalies. AB - Outpatient pediatric orthopedic records were reviewed retrospectively in an attempt to identify all patients with congenital spine and urinary tract anomalies. All patients with a positive intravenous pyelogram (IVP) were asked to return for ultrasonographic evaluation. Urinary tract abnormalities were identified in seven (26%) of the 27 patients with documented IVPs. An additional patient was later added to the series, making a total of seven patients who returned for an ultrasonogram, which was then compared with the IVP. Observations and a review of the literature suggest that ultrasonography combined with urinalysis and serum creatinine is the screening protocol of choice in this patient population. PMID- 3277760 TI - Randomized study of six umbilical cord care regimens. Comparing length of attachment, microbial control, and satisfaction. AB - Two hundred and seventy one infants were enrolled in a study to compare six different methods of treating the umbilical cord. Antimicrobial control was equal for all methods. Repeated triple dye application was considered least acceptable by staff and parents and had the longest attachment time. Povidone-iodine was associated with the shortest attachment time and was most liked. If there is no special need to treat a specific nosocomial outbreak, duration of cord attachment and satisfaction of staff and parents can help clinicians decide on a cord care regimen. PMID- 3277761 TI - An unusual presentation of an infected urachal cyst. Review of urachal anomalies. AB - An infected urachal cyst classically presents with a tender lower midline abdominal mass and systemic signs of infection, including fever, malaise, and leukocytosis. At times, the findings may be clinically confused with those of acute appendicitis, Meckel's diverticulitis, or peritonitis. Sonography aids in differentiating these entities by identifying the localized cystic mass containing debris, located anteriorly in the low mid-abdomen, extending from the region of the bladder to the umbilicus. We present an unusual case of an infected urachal cyst in a 6-year-old boy who presented with lower abdominal pain, fever, intermittent diarrhea, polyuria and dysuria, a firm, fixed left lower quadrant tender mass, and an elevated white blood cell count. PMID- 3277762 TI - Alimentary tract duplications in children: case and literature review. AB - This report reviews 11 alimentary tract duplications over a 25-year experience at Children's Hospital Medical Center of Akron, Ohio. The cases are compared and contrasted to the literature with respect to lesion, location, and patient presentation. There were no multiple duplications in this series. Clinical presentations were related to obstruction, abdominal pain, and/or hemorrhage. There were four foregut duplications, five midgut duplications, and two hindgut lesions. All patients were treated by surgical removal and all survived. One case was an incidental finding at appendectomy. Pooled data from five large series of duplications revealed the ileal region to be involved in 41 percent of all duplications, followed by esophageal (21%), gastroduodenal (12%), and jejunal (8%). Diverticular, recanalization, and split notochord theories of pathogenesis are discussed. The curious association between duplications and gastric mucosa is explored. PMID- 3277763 TI - Peritonitis complicating continuous ambulatory peritoneal dialysis. PMID- 3277764 TI - AIDS. AB - AIDS is a syndrome that represents the most severe form of infection with the retrovirus HIV. Opportunistic infections, uncommon malignant neoplasms, and intractable immunologic deficiency are hallmarks of AIDS. To date, the syndrome in the U.S. is seen mainly in epidemiologically restricted populations. It appears to be transmitted in a manner analogous to hepatitis B. There is no available means of reversing the immune deficit. Therapy is restricted to treating the complicating infections and tumors. Those having been diagnosed with P. carinii pneumonia may benefit from therapy with AZT. The spread of HIV and the syndrome can only be reduced by preventive measures until an effective and safe vaccine can be developed. PMID- 3277765 TI - Otitis media. AB - Otitis media is a disease involving the inflammation and infection of the middle ear. Despite modern medical therapy, its widespread incidence in all age groups makes it one of the most common illnesses seen by physicians. The advent of a wide range of antibiotics has helped to decrease the number of complications resulting from the disease. Nevertheless, the large number of missed school and work days and the hearing losses and related problems that accompany otitis media make it a perpetual menace to public health. PMID- 3277766 TI - Diagnosis and management of chronic active hepatitis B. PMID- 3277767 TI - Current thinking on spondarthritides. AB - In this article I have briefly considered current thinking in the field of spondarthritis. Etiopathogenetic aspects include the structure of the HLA-B27 molecule and the population distribution of B27, as well as the significance of bacterial infection in the disease process. Diagnostic aspects have focused on infrared thermography, radionuclide scintigraphy, and computerized tomography. The current therapeutic position involves the traditional combination of NSAID, exercises, and surgery, as well as a new interest in sulfasalazine. PMID- 3277768 TI - Mood disorder following stroke. PMID- 3277769 TI - Kraepelin and the diagnostic concept of paranoia. PMID- 3277770 TI - Physicians' net income grows despite surge in expenses. AMA Center for Health Policy Research. PMID- 3277771 TI - Continuous positive airway pressure with and without high-frequency ventilation: hemodynamics, oxygenation, and endocrine response. AB - After 18 h of mechanical ventilation following open heart surgery, central hemodynamics, systemic oxygen delivery (DO2), and oxygen consumption were assessed in ten consecutive patients receiving continuous positive airway pressure (CPAP) therapy. Plasma vasopressin, norepinephrine, and epinephrine levels were analyzed. While maintaining the mean airway pressure, two CPAP methods were studied: a demand CPAP with continuous flow without (CPAP) and one with high-frequency ventilation (CPAP-HFV). The frequency used during CPAP-HFV was 300 cycle/min. The spontaneous ventilatory rate was found to be equal during CPAP and CPAP-HFV. The cardiac and stroke volume indices were slightly higher (p less than .05) during CPAP-HFV, which accounted for the finding that DO2 was also slightly higher (p less than .05) during CPAP-HFV. The epinephrine and norepinephrine levels did not differ, whereas the vasopressin level was somewhat higher during CPAP-HFV, which might indicate a higher level of vigilance. It is concluded that cardiac output was slightly higher during CPAP-HFV compared to that during CPAP. This may be due to an effect of the oscillations on circulation or to differences in the level of vigilance. PMID- 3277772 TI - Bedside assessment of the work of breathing. AB - The oxygen consumption (VO2) of healthy volunteers and patients recovering from respiratory failure in the ICU was measured by indirect calorimetry during complete mechanical (VO2vent) and spontaneous (VO2wean) ventilation. The work of breathing was calculated as the difference in VO2 between spontaneous and mechanical ventilation and expressed as a percentage of VO2vent (% delta VO2). The average % delta VO2 for eight normal healthy volunteers was 3.7 +/- 1.8%, while it was 7.7 +/- 8.8% with the Bechman and Utah metabolic carts for patients recovering from ventilatory failure who were weaned successfully from respiratory support based on clinical criteria within 24 h of their metabolic study. In patients who were not weaned successfully, the average % delta VO2 measured was 24.7 +/- 12.3%. Indirect calorimetry is a relatively simple, reliable bedside technique for determining the oxygen cost of breathing. In our sample, the oxygen cost of breathing was a reliable predictor of weaning and extubation in patients recovering from respiratory failure. This measurement may be clinically useful in identifying the patient who cannot sustain spontaneous ventilation because of excessive respiratory work. PMID- 3277773 TI - Hemodynamic relationship between renal venous pressure and blood flow regulation during positive end-expiratory pressure. AB - The hemodynamic relationship between renal venous pressure (RVP) and renal blood flow (RBF) during PEEP was investigated using adult mongrel dogs. When continuous mechanical ventilation (CMV) with 10 cm H2O of PEEP was applied to dogs previously on CMV with zero PEEP, RVP increased from 6.6 to 8.7 mm Hg (p less than .01), and left RBF decreased from 66 to 57 ml/min (p less than .05). RBF recovered by 49% of the difference as soon as PEEP was discontinued when the RVP elevation was maintained at the level observed during 10 cm H2O of PEEP. With 20 cm H2O of PEEP, RVP increased further to 10 mm Hg (p less than .01) and left RBF decreased to 48 ml/min (p less than .05). When the left renal vein was occluded and the RVP was maintained at the level seen during 20 cm H2O of PEEP, left RBF recovered only 50% of the difference from the flow during zero PEEP. We conclude that the reduction in RBF with PEEP application is caused by several factors; however, RVP elevation during CMV with PEEP is influential in decreasing RBF. PMID- 3277774 TI - Calibration of respiratory inductive plethysmography in lambs receiving intermittent mandatory mechanical ventilation. AB - Respiratory inductive plethysmography (RIP) is a noninvasive method of assessing breathing pattern. We employed a single-position graphic (SPG) calibration technique for gain factor calculation in 38 studies on five sedated lambs who were receiving intermittent mandatory mechanical ventilation (IMV). The SPG technique uses selection of two breaths from a 20-sec run of breaths with different ribcage/pneumotachograph (PNT) and abdomen/PNT ratios for gain calculation. Validation of gains was performed by comparing volumes obtained simultaneously by RIP and PNT. The mean tidal volume (VT) measured by RIP corresponded well with mean VT measured by PNT with animals receiving 42.2 +/- 13.2 (SD) % of breaths over 1 min by IMV. Time for calibration and validation ranged between 15 and 30 min. The results of this study suggest that the SPG calibration technique provides an accurate method of calibration of RIP in sedated lambs receiving IMV. PMID- 3277775 TI - Blood flow to organs: parameters for function and survival in critical illness. AB - Tissues are usually considered as being supply-dependent (e.g., heart and brain) and supply-independent (e.g., splanchnic area, kidneys, skin, and resting muscle) for oxygen delivery. When cardiovascular function is compromised, circulatory compensations are aimed at maintaining supply-dependent tissues. In the long term, this leads to the possibility of an inadequate blood flow to supply independent tissues. The perfusion maintenance of all organs requires adequate cardiac output, blood volume, and arterial BP. When BP and cardiac output fail, regional perfusion diminishes. Although the human system tolerates anemia well, optimum Hct levels are probably between 30% to 40%. Inadequate perfusion can be supplemented partially by increasing the FIO2 on a temporary basis. Hyperoxic arterial oxygen tensions may cause maldistribution of blood flow within organs. PMID- 3277776 TI - Intravenous fat emulsions and lung function: a review. AB - Numerous studies have reported varying degrees of apparent pulmonary dysfunction when iv fat emulsions (IVFE) are given. These changes have generally not been of sufficient magnitude to carry clinical significance. The lung dysfunction observed has been attributed to an associated hyperlipemia. Recent studies, however, suggest that the associated impairment in lung function is due to alterations in pulmonary vascular tone (which results in ventilation/perfusion inequalities) caused by an IVFE-related increase in prostaglandin (PG) production. The polyunsaturated fatty acids in the IVFE serve as precursors to the PGs. Due to the varied effects of PGs on inflammation and pulmonary vasomotor tone, infusion of IVFE could have profound physiologic and pharmacologic actions aside from the provision of lipid calories. In some circumstances, IVFE may, in fact, be beneficial to the lung via alterations in PMID- 3277777 TI - Adult respiratory distress syndrome and pancreatitis as complications of falciparum malaria. PMID- 3277778 TI - Positive tip cultures and related risk factors associated with intravascular catheterization in pediatric cardiac patients. AB - The incidence and risk factors of positive catheter tip cultures were studied prospectively in 392 consecutive children undergoing cardiac surgery under cover of cephalothin prophylaxis. A total of 1649 catheter tips were cultured and 58 (3.5%) yielded positive cultures. Specifically, the incidence of positive catheter tip cultures for iv, central venous, arterial and pulmonary arterial (PA) catheters was 0.9%, 5.9%, 3.9% and 10.6%, respectively, whereas one of the six surgically placed venous and arterial catheters had a positive tip culture and none of the 279 transthoracic catheters. Staphylococcus epidermidis was isolated from 79% of the positive tip cultures. Ten percent of the children had one or more positive tip cultures but none developed catheter-related septicemia or endocarditis. Stepwise logistic regression analysis revealed that longer in situ time (p less than .001), younger age (p less than .001), and inotropic support (p = .003) were significant independent predictors of risk for children developing positive catheter tip cultures. The safe in situ period for arterial, central venous, and PA catheters is 3 days in infants under 1 yr and 4 and 6 days for arterial and central venous catheters, respectively, in older children, if 0.95 cumulative probability of remaining free of a positive tip culture is accepted. The data generally support the bacteriologic safety of invasive hemodynamic monitoring in infants and children undergoing cardiac surgery. PMID- 3277779 TI - Ranitidine--bolus or infusion prophylaxis for stress ulcer. AB - Stress ulcer is a dangerous complication for the critically ill patient. Prophylaxis with antacids can undoubtedly reduce this risk, if gastric pH is maintained above 3.5. Histamine receptor antagonists may achieve this more conveniently. We have studied the effects of ranitidine, given either as 50-mg boluses every 6 h or as one of two infusion regimes (125 or 250 micrograms/kg.h), in controlling pH in critically ill patients on a ventilator. The percentage of samples with a pH less than 4 fell in all groups during therapy; while there was no significant difference between groups, pH control was achieved more rapidly in the bolus group. Infusion therapy with ranitidine is an attractive concept but a loading dose must be used. The presence of occult blood in the gastric juice did not correlate with pH and was not affected by ranitidine therapy. PMID- 3277780 TI - Nosocomial infections in a pediatric intensive care unit. AB - In a prospective 30-month study of nosocomial infections in a pediatric ICU (PICU), the incidence, sites, and causes of infection were determined. Factors associated with increased risk of infection were investigated. In 1,388 patients who remained in the PICU for a minimum of 72 h, 116 infections occurred (6.1 infections/100 admissions). Primary bacteremias comprised 38% of PICU infections and lower respiratory infections comprised 15%. The remaining infections were divided equally among GI, skin, eye, upper respiratory, postoperative wounds, and other sites. Coagulase-negative staphylococci, Pseudomonas aeruginosa, and Staphylococcus aureus were the most prevalent pathogens. Surgical patients had similar rates of infection to medical patients. Patients in the first 2 yr of life, particularly those between 7 and 30 days of age, had the highest rate of infection. Onset of infection was more common after the first week in the PICU with 11% of patients staying 14 to 20 days, 27% of patients staying 21 to 27 days, 48% of patients staying 28 to 34 days, and 52% of patients staying more than 35 days before the onset of infection. The risk of nosocomial infection increases with arterial and central line use, prolonged intubation, ventilation, intracranial pressure monitoring, and paralysis. PMID- 3277781 TI - Glucagon antagonism of calcium channel blocker-induced myocardial dysfunction. AB - Calcium channel blockers (CCBs) may produce profound myocardial depression. Glucagon antagonized verapamil-induced hypotension and bradycardia in rats; however, glucagon's ability to antagonize other CCBs is unexplored. This study determined: a) if glucagon reverses verapamil-induced depression by a direct cardiac effect, b) if myocardial depression induced by diltiazem and nifedipine (representing different classes of CCBs) is also reversed by glucagon, and c) the glucagon concentration needed to reverse myocardial depression. Isolated rat hearts were perfused at a constant flow rate in a Langendorff preparation. Developed pressure (dP), contractility (+dP/dtmax), relaxation (-dP/dtmax), heart rate, and coronary vascular resistance were recorded. A CCB (n = 6, each blocker) was infused until greater than 50% depression of contractility was achieved. Glucagon was then simultaneously infused (perfusion concentration of 0.6-1.1 x 10(-7) M), and repeat cardiac variables were recorded. In a separate group of 36 hearts, glucagon dose response was determined. After producing a greater than 50% depression in dP/dtmax with 3 mumol of diltiazem, a single concentration of glucagon was infused simultaneously into each heart (perfusion concentrations between 10(-6) and 10(-9) M) and percent recovery of baseline function was determined. Glucagon restored baseline contractility and dP with all three CCBs. Complete reversal of diltiazem-induced myocardial depression occurs at glucagon concentrations greater than or equal to 5 x 10(-7) M. We conclude that a) glucagon directly reverses myocardial depression from three classes of CCBs at concentrations achieved in vivo, and b) glucagon may be useful in the treatment of CCB-induced myocardial toxicity. PMID- 3277782 TI - Computer-controlled positive end-expiratory pressure titration for effective oxygenation without frequent blood gases. AB - We have previously designed a computerized system to automatically deliver PEEP to maintain functional residual capacity (FRC) at a desired value. The purpose of this study was to compare the computerized PEEP titration system with a standard clinical PEEP titration algorithm in the animal adult respiratory distress syndrome (ARDS) model. Thirty mongrel dogs were anesthetized, paralyzed, intubated, and ventilated. An acute pulmonary injury was produced using 0.09 ml/kg of oleic acid. The animals were then given PEEP for 5 h. Arterial and venous blood gases, BP, thermodilution cardiac output, heart rate, body temperature, total respiratory system compliance (Ctr), and end-tidal CO2 were measured every 30 min. FRC was measured using an automated sulfur hexafluoride washout system every 15 min. The animals were allocated randomly to three ten animal groups. The first group had PEEP titrated using a standard clinical protocol; the remaining two groups had PEEP updated at 15-min intervals under computer control to maintain FRC at 1.4 times the postanesthetized, postparalyzed, preinjury value. The second group received fixed 3-cm H2O PEEP steps. The third group had variable size PEEP steps depending on the output of a proportional, integral, and derivative (PID) controller. PaCO2 was maintained at 35.8 +/- 3.4 (SD) torr. There was a significant difference in PEEP delivered between the three groups (p = .0006) and in FRC (p = .005). There was no significant difference in PaO2 (p = .80) or venous admixture (Qva/Qt) (p = .84) between the three groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277783 TI - Experimental closed head injury in rats: mechanical, pathophysiologic, and neurologic properties. AB - A model of closed head injury in rats was developed using a calibrated weight drop device. The development of edema was studied in various brain regions (cerebral hemispheres, brain stem, cerebellum) using a linear specific gravity gradient column. Regional brain tissue density was measured within 1 min, at 15 and 60 min, 18 h, 4 and 10 days after injury to the left cerebral hemisphere, and was compared with values in sham-operated and control rats. Significant edema (i.e., reduced specific gravity) occurred only in the traumatized hemisphere and was maximal at 18 h. A neurologic severity score (NSS) was developed to evaluate the status of the rat after injury. Specific gravity was significantly correlated with NSS at 18 h after injury. The affected hemisphere displayed hemorrhagic lesions as early as one hour post head trauma (HT), which evolved into hemorrhagic necrosis at 18 h. A pathologic score, evaluated 18 h post HT based on size and severity of the lesion, was correlated with the NSS and evaluated for each rat at one hour and 18 h postimpact. This correlation was found to be highly significant. This model of brain injury may be useful in future studies on the effects of therapeutic agents. PMID- 3277784 TI - Incidence of infection related to arterial catheterization in children: a prospective study. AB - The incidence of infection related to arterial catheterization has not been studied in critically ill children, using systematic catheter cultures. We studied prospectively 68 children in whom 70 arterial catheters were inserted. After the aseptic catheterization procedure, no component of the system was changed. The insertion site was inspected daily for signs of inflammation. Upon removal, catheters were cultured using a semiquantitative method. Blood and infusion fluid specimens were also cultured if septicemia was clinically suspected. Mean duration of catheterization was 59 +/- 6 (SE) h. In our series, all catheter and infusion fluid cultures were negative. Local inflammation was not predictive of catheter tip infection and correlated poorly with duration of catheterization (r = 0.2). In our experience, the incidence of infection related to arterial catheterization is low. Routine change of infusion fluid, tubing, dressing and insertion site as well as systematic catheter culture in the absence of fever appears unwarranted. PMID- 3277785 TI - Fifty years of the Institute of General Reanimatology of the USSR Academy of Medical Sciences. PMID- 3277786 TI - Magnesium: a discussion of its role in the treatment of ventricular dysrhythmia. PMID- 3277787 TI - Animal models of appetitive behavior: interaction of nutritional factors and drug seeking behavior. PMID- 3277788 TI - Appetite regulation in bulimia. PMID- 3277789 TI - Neurotransmitters, control of appetite, and obesity. PMID- 3277790 TI - The satiating effect of cholecystokinin. PMID- 3277791 TI - Psychological factors in the control of appetite. PMID- 3277792 TI - The role of food perceptions in food use. PMID- 3277793 TI - Pharmacological modification of appetite. PMID- 3277794 TI - Regulation of food intake during pregnancy and lactation. PMID- 3277795 TI - Non-Q-wave myocardial infarction: diagnosis, prognosis, and management. PMID- 3277796 TI - Pathophysiology and clinical aspects of fibrinolysis and inhibition of coagulation. Experimental and clinical studies with special reference to women on oral contraceptives and selected groups of thrombosis prone patients. AB - The primary aim of the haemostatic mechanism is to protect the vascular system and to keep it intact after injury in order to secure the function of tissues and organs. A second aim is to provide a matrix in wound healing and tissue repair. The regulation of this physiological mechanism is effected by a dynamic haemostatic balance comprising interactions between endothelial cells, thrombocytes, coagulation, and fibrinolysis. This balance determines the amount of fibrin layed down at a site of injury thereby influencing the progress of the reparative processes. Clinical experience has, as described, shown that the concept of a dynamic haemostatic balance, and the increase in knowledge about the mechanisms involved in its regulation, can be applied with success in the elucidation and treatment of cases of impaired haemostasis, or when during a disease instances of thrombosis or embolism arise, which otherwise would have been difficult to explain or to subject to rational treatment. The results obtained and the experiences gained have therefore substantiated the existence of such a balance. Disturbances in the regulation of the balance may cause the formation and deposition of too little fibrin at a site of injury resulting in impaired haemostasis, ultimately manifesting itself as a haemorrhagic disorder. Or, an enhanced formation or delayed resolution of fibrin may cause thrombosis. Therefore, in the acute clinical cases the balance may adequately be described as a thrombohaemorrhagic balance. These observations have in particular underscored the role of an impaired fibrinolysis or decreased inhibition of coagulation in the pathogenesis of thromboembolic disease. They suggest the existence of an antithrombotic potential, which might be reduced due to a decreased inhibition of coagulation and/or a decreased fibrinolysis. The major stages in the mechanisms of blood coagulation and fibrin resolution are now well elucidated. This has increased our understanding of the interplay between the activating and regulating factors by which the organism keeps the formation of fibrin under control. Effects of disturbances in the balance are illustrated by description of cases of haemorrhagic disorders or thrombosis, and the pathophysiological aspects are surveyed. The regulation of coagulation and fibrinolysis follows in both systems the same pattern. The active enzymes (thrombin and plasmin, respectively) are formed by activation of circulating proenzymes, and inhibitors (circulating or localized) exert their modifying influences at various stages of the total process.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3277797 TI - Electron microscopy of nucleic acid. AB - Electron microscopy (EM) of nucleic acids was first described by Kleinschmidt and Zahn 1959 (1). By complexing duplex DNA with basic proteins and spreading the complexed DNA onto the surface of an aquous phase it was possible to obtain well stretched DNA molecules that could be examined by EM. Addition of formamide to DNA spreading solution as well as to hypophase prevented single-stranded DNA and RNA from forming secondary structures thus providing conditions for analysis of these molecules. EM studies have provided information about molecular weight, molecular configuration and homogeneity/heterogeneity of the DNA preparations examined. Furthermore, intramolecular heterogeneity in base sequence could be analyzed by partial denaturation of duplex DNA. By partial denaturation mapping information of the orientation of DNA molecules was obtained. Sequence homology between two DNA molecules were studied by heteroduplex analyses where the two DNAs to be studied were denatured to full strand separation followed by reassociation. This method has been widely used to analyze DNA mutations, and to discover sequence homologies within a DNA molecule or between two DNA molecules. Heteroduplex analyses between DNA and RNA (R-loop formation) provided information about distribution of ribosomal RNA genes and gave the first information of eukaryotic post transcriptional processing of mRNA. Also the various modes for DNA replication and transcription were studied by EM. It is possible to study duplex DNA not complexed by basic proteins by EM. The DNA is then adsorbed to an activated carbon film and rotary shadowed with finely grained metals to enhance the contrast. Using this method it was possible to study binding of proteins to DNA. This method was also used in the study of chromatin structure where it provided information of the size and distribution of nucleosomes as well as packaging of DNA in chromatin fibres. The complicated nature of DNA strand exchange and repair reactions was studied by in-vitro systems where EM analysis was used in the description of the presynoptic filament and structure of the joined molecules. Furthermore, EM provided the first direct evidence for the existence of the paranemic joint, where the DNA strands are joined without Watson Crick base-pairing. PMID- 3277798 TI - Pelvic inflammatory disease following induced first-trimester abortion. Risk groups, prophylaxis and sequelae. PMID- 3277799 TI - Assessment of risks in connection with use of a recombinant E. coli strain for production of human growth hormone. AB - A number of studies were performed with the aim of elucidating possible risks in connection with the use of a recombinant E. coli strain for the production of human growth hormone (hGH). The survival of recombinant E. coli in the gastrointestinal tract in rats was studied. The results showed that the recombinants were only detectable in the faeces one to two days after the administration of 10(11) bacteria. Since the recombinants are resistant to ampicillin, survival in the gastrointestinal tract was improved in rats treated with ampicillin. However, no recombinants could be detected a few days after the discontinuation of ampicillin treatment. Studies of transfer of plasmid DNA from recombinant E. coli to other bacteria strongly indicated that the possibility of transfer of the recombinant plasmid pHD117 used in the production of hGH to enterobacteria in rats is minimal. In vitro experiments have shown that transfer by conjugation, presumably after recombination between a non mobilizable plasmid such as pHD117 and a conjugative plasmid, can be calculated to be 4 X 10(-6). An uptake of free plasmid DNA in bacteria was only observed when the bacteria were treated with CaCl2. The evaluation of risks in connection with inadvertent consumption of the hGH producing bacteria has included studies of the absorption of hGH after peroral administration to rats. Approximately 0.005% was found to be absorbed. A prerequisite for absorption of hGH after consumption of recombinants is a lysis of the bacteria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277800 TI - Seroepidemiological study of Legionella infection in Denmark. A 28-month retrospective survey. AB - An indirect immunofluorescence (IF) test for Legionella antibodies has been used since 1978 at Statens Seruminstitut, Copenhagen. An increasing annual number of blood specimens from all parts of the country has been tested by IF and the number of Legionella antigens in the test was increased from 4 over 10 to 13, resulting in an ever growing number of seropositive patients over the years. We investigated the occurrence of serologically diagnosed Legionella infections from November 1982 through February 1985, a period of 28 months during which the same 13 Legionella antigens were applied in the IF test. We used CDC's criteria for the serological diagnosis of a current Legionella infection: a greater than or equal to 4-fold rise in antibody titre to greater than or equal to 128 in the IF test. In a test of more than 5,000 blood specimens from 3,374 patients, 69 were found to have diagnostic titre rises. When analysed according to serological reactions with three groups of antigens, seroconversion to a L. pneumophila antigen was found to be more frequent in patients 30-59 years old than seroconversion to a non-L. pneumophila Legionella antigen, while in the age group 60-69 this relation was reversed. Thirteen of the 69 patients had acquired their infection abroad. Twelve of these were below the age of 60, and they had all seroconverted to a L. pneumophila antigen. Clinical data were in accordance with the assumption that Legionella may have been the aetiological agent of the disease in our patients selected by serological criteria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277801 TI - The fate of aortic valve homografts 12 to 17 years after implantation. AB - Results of long-term follow-up of an early cohort of patients receiving aortic valve homografts for aortic stenosis and aortic insufficiency are presented. All patients were operated upon by a single surgeon from 1966 to 1971. Eighty-three patients underwent insertion of 85 homograft aortic valves. Homografts were sterilized with either betapropiolactone (39 valves) or gamma irradiation (41 valves) and were inserted following storage in nutrient medium (16 valves) or after cryopreservation (51 valves). All homograft valves were sutured in the subcoronary position using a freehand technique. There was a 55 percent 15-year actuarial patient survival and a 16 percent 15-year actuarial homograft survival in this cohort. Homograft valve failure occurred gradually allowing the patients to be observed until they developed hemodynamic compromise at which time elective valve replacement was performed. PMID- 3277802 TI - Nifedipine and angina pectoris. Short-term changes in quantitative coronary angiography with nifedipine and clinical response to treatment in effort-induced, mixed, and spontaneous angina pectoris. AB - Changes induced by nifedipine (10 mg sublingually) in the residual luminal diameter of significant (greater than 50 percent) coronary lesions were assessed angiographically in 69 patients with effort-induced angina (group 1), in 22 patients with mixed angina (group 2), and in 14 patients with Prinzmetal's angina (group 3). These changes were related to the clinical response to treatment with the same drug, as evaluated through diary records and Holter monitoring in the mixed (spontaneous component) and Prinzmetal forms and through exercise testing in effort-induced and mixed (effort-associated component) angina. In groups 1 and 2, segments of stenotic vessels showed either an increase or decrease or no change in diameter with the calcium antagonist; in group 3, the majority of the lesions had compliant portions which invariably responded with dilatation. Nifedipine failed to improve cases with exertional (20 percent [14/69] unchanged; 19 percent [13/69] worsened) and mixed (41 percent [9/22] exacerbated) forms; 100 percent of the 14 patients with the Prinzmetal form had relief of the anginal episodes. In group 1, the response to exercise tests was dissociated from the short-term vasomotor pattern, and the pressure-rate product failed to explain the clinical results. Forty-five percent (ten) of the patients in group 2 showed significant short-term widening of critical stenoses, as well as obvious improvement; patients who did worse with treatment in this group had reacted to nifedipine with narrowing of critical stenoses. These data suggest that the response to nifedipine of classic effort-induced angina is probably the net result of an interaction of changes in myocardial oxygen consumption and supply; coronary vasomotion has a role in mixed angina, and influences of nifedipine may be either favorable or unfavorable; stenotic lesions in the Prinzmetal form are quite sensitive to the relaxant action of calcium blockade, and this probably represents a background to the highly positive clinical response to treatment. PMID- 3277803 TI - Pressure support compensation for inspiratory work due to endotracheal tubes and demand continuous positive airway pressure. AB - We evaluated the use of pressure support to compensate for the added inspiratory work of breathing due to the resistances of endotracheal tubes and a ventilator demand-valve system for continuous positive airway pressure (CPAP). A mechanical model was used to simulate spontaneous breathing at five respiratory rates through 7-mm, 8-mm, and 9-mm endotracheal tubes with and without a ventilator demand CPAP circuit. Added work was measured as the integral of the product of airway pressure and volume during inspiration. Additional work was a function of the tube's size, and each 1-mm decrease in the tube's diameter resulted in a 67 to 100 percent increase in work. Adding the ventilator CPAP circuit further increased work and was responsible for 30 to 50 percent of the total work resulting from a tube and CPAP circuit together. Pressure support was added to a level at which net work on the airway was zero, and a relationship between mean inspiratory flow (VT/TI) and the optimal level of pressure support was established for each endotracheal tube. The inspiratory work of breathing was then measured in normal subjects breathing with and without each endotracheal tube plus the demand CPAP circuit. Work per liter of minute ventilation due to the endotracheal tube and CPAP circuit was increased from 54 to 240 percent over levels measured while breathing through an open airway. For each endotracheal tube and VT/TI, a level of pressure support (range, 2 to 20 cm H2O) was found which eliminated added work in the spontaneously breathing subject. This level correlated well with that predicted from the data derived using the mechanical model. We conclude that when adjusting for an endotracheal tube's diameter and VT/TI, pressure support can be used to compensate for the added inspiratory work due to artificial airway resistances. PMID- 3277804 TI - Comparison of the effects of nebulized terbutaline with intravenous enprofylline in patients with acute asthma. AB - We compared the bronchodilating effects of intravenously administered enprofylline (2 mg/kg) with nebulized terbutaline (10 mg) in patients presenting to hospital with acute asthma in a multicenter double-blind parallel study. One hundred twenty three patients were randomized into the study, and 69 of these fulfilled the inclusion criteria and a retrospective time to study entry criterion; 34 received enprofylline and 35 received terbutaline. There was no significant difference in maximum increase in forced expired volume in 1 second (FEV1) between the enprofylline group (0.24 +/- 0.33 L) and the terbutaline group (0.25 +/- 0.28 L) (p greater than 0.05), nor for the increase in FEV1 over the 1 hour study period. Tremor was reported more in the group receiving terbutaline, and nausea was reported more in the group receiving enprofylline. Two patients experienced hypotension and one patient had a vasovagal episode with enprofylline treatment. Both agents acted as bronchodilators with similar efficacy in patients with acute asthma in this study. PMID- 3277805 TI - Unilateral diaphragmatic dysfunction in blunt chest trauma. AB - This study was undertaken to evaluate unilateral diaphragmatic dysfunction within ten days after blunt chest trauma. Thirty patients with unilateral chest injury, or predominantly one-sided injuries, were investigated in the supine position, under analgesia. Right and left hemidiaphragm displacement (DD) was measured, using digital subtraction radiography, during quiet and forced breathing. The diaphragmatic contribution to breathing was determined by rib cage and abdominal circumference measurement changes. In both breathing modes, DD of the injured side was lower than DD of the uninjured side (p less than 0.01, p less than 0.001). Six patients had complete diaphragmatic motionlessness. The inspired air volume due to diaphragmatic motion (Vab) was reduced when compared to normal subjects and Vab/VT ratio was always found to be less than 0.65. The degree of diaphragmatic dysfunction appeared related to injury location and is most severe in injuries of the lower chest which implies direct diaphragm muscle injury, although other mechanisms may be implicated. Diaphragmatic dysfunction can contribute to respiratory failure in these patients, and should be considered. PMID- 3277806 TI - Temporary transvenous cardiac pacing in the critical care setting. PMID- 3277807 TI - The elasticity of mammalian lungs. An historic perspective. PMID- 3277808 TI - Persistent pulmonary hypertension in the neonate. AB - Respiratory failure is the leading cause of death in the neonatal period. The anatomic and functional basis for this, particularly in full-term infants, most often is persistent pulmonary hypertension of the neonate (PPHN). This condition is reversible but can cause very severe and unrelenting respiratory failure and ultimate death when uncontrolled. Recent technologic advances have expanded the scope of therapy available for PPHN, resulting in increasing therapeutic success for these critically ill infants. This article reviews the anatomic and functional anomalies of PPHN, as well as the methods of diagnosis and discusses current treatment. PMID- 3277809 TI - Bilateral pyopneumothorax secondary to intravenous drug abuse. AB - An intravenous drug abuser presented with bilateral pyopneumothoraces and bacteremia which is a previously unreported complication of jugular vein self injection. The patient sustained direct pleural trauma and resultant infection by injecting herself with contaminated needles. PMID- 3277810 TI - Early post-pneumonectomy bronchial stump fistula. AB - Bronchial stump fistula occurred on the seventh postoperative day in a 45-year old man who underwent right pneumonectomy for T2N2M0 adenocarcinoma of the lung. It was attributable to ventilator-related barotrauma during treatment of ARDS from multiple pulmonary emboli. A frequently lethal complication, its presentation, management and prevention in the early postoperative period are discussed. PMID- 3277811 TI - Captopril-induced cough. AB - Since the advent of angiotensin-converting enzyme inhibitors (captopril and enalapril), cough has been recognized sporadically as a side effect, but has received little attention in the pulmonary literature. To emphasize that angiotensin-converting enzyme (ACE) inhibitors should be considered among possible etiologies of cough, we report recent experience with two patients and review the available experience with ACE inhibitor-induced cough. PMID- 3277812 TI - Relationship of the pulmonary vascular endothelium to altered pulmonary vascular resistance. State of the art. PMID- 3277813 TI - Eicosanoids in the fetal and transitional pulmonary circulation. PMID- 3277814 TI - Problems of pulmonary hypertension in children with congenital cardiac defects. PMID- 3277815 TI - Pulmonary vascular remodeling in neonatal pulmonary hypertension. State of the art. PMID- 3277816 TI - Chronic primary and secondary thromboembolic pulmonary hypertension. PMID- 3277817 TI - Primary pulmonary hypertension. PMID- 3277818 TI - Current approach to treatment of primary pulmonary hypertension. AB - Based upon our experience with a cohort of 46 patients referred to the UCHSC from April, 1980 to April, 1987 for evaluation and treatment of PPH, we currently assess acute pulmonary vasoreactivity as defined by the patient's response to intravenous PGI2 during the initial diagnostic catheterization. A 3 to 5 day trial of high dose oral diltiazem treatment (720 mg/day maximum) is given while monitoring the patient in the clinical research center to detect significant side effects including arrhythmias, orthostatic systemic hypotension, arterial desaturation, and worsened right ventricular dysfunction. We believe it is necessary to recatheterize each patient to establish the efficacy of calcium antagonist treatment prior to discharge. Those patients who are responsive to diltiazem are discharged and followed in our pulmonary hypertension clinic. Since an occasional patient will deteriorate after several weeks of therapy, repeat right heart catheterization after 8 weeks of treatment is used to determine which patients should be continued on diltiazem for chronic therapy. Approximately 30 percent of our patients with PPH have been improved on diltiazem treatment. Most patients who have a good response to treatment after eight weeks continue to benefit from long-term treatment. It appears that the response to an acute infusion of PGI2 is useful in safely identifying those PPH patients who are likely to benefit from vasodilator therapy. Debilitated patients who are unresponsive to PGI2 and vasodilator therapy are considered potential candidates for cardiopulmonary transplantation. PMID- 3277819 TI - Comparison of acute hemodynamic responses to prostacyclin with standard vasodilators in patients with primary pulmonary hypertension. PMID- 3277820 TI - The normal lung circulation. State of the art. PMID- 3277821 TI - Pulmonary intravascular macrophages. PMID- 3277822 TI - Pulmonary vascular reactivity. AB - The pulmonary vasculature responds to a multitude of constrictor and dilator mediators, but the exact physiologic and pathologic significance of such responsiveness is unknown. Further careful studies with specific mediator receptor blockers and synthesis inhibitors are required to determine if dilators play a role in maintaining the low vascular tone of the normal pulmonary circulation and if constrictors contribute to either the onset or the maintenance of the pulmonary hypertension associated with chronic airway hypoxia, lung injury, and pulmonary microembolism. It would be a mistake to summarily dismiss the possible involvement of vasoconstrictors in chronic pulmonary hypertension, but the apparent difficulty in establishing their importance emphasizes that mediators of vascular cell migration, proliferation, synthesis, and secretion may be at least as important in the etiology of the increased vascular resistance as the mediators of vascular tone. PMID- 3277823 TI - Loglinear analysis of cross-classified ordinal data: applications in developmental research. AB - This article provides an introduction to loglinear analysis of cross classification tables, including tables with nominal and ordinal variables. Loglinear models offer several advantages over the more commonly used chi-square test of independence, including the ability to analyze 3-, 4-, and higher-way interactions, the ability to determine whether the association between variables is linear or nonlinear, and the ability to interpret scale scores assigned to categories of an ordinal variable. After a review of the advantages of loglinear modeling, the chi-square test of independence is compared with the loglinear model of independence. This comparison serves to introduce the notation and terminology of loglinear modeling. The overall strategy of loglinear modeling is introduced next; then special loglinear models for ordinal data are reviewed. Each model discussed in the article is applied to data from the developmental literature. PMID- 3277824 TI - Clinical significance of abnormalities of the gastrointestinal tract detected by abdominal ultrasound. AB - In order to define the clinical significance and the need for further clinical work-up in patients where abnormalities of the stomach or bowel are found by ultrasound, we performed a prospective study on 100 patients with such findings. Of all patients, 35% were found to have a malignant tumor, 73% had a diagnosis as made by reference methods which was probably (18%) or definitively (55%) related to the US finding. Eighteen percent had definitive false positive findings, in 9% no final diagnosis was obtained. Thus, a positive predictive value of 80% was calculated for the US finding of a mass or a target sign related to bowel or stomach in US. The positive predictive value was lowest for target signs related to the bowel (75%) and highest for bowel conglomerates (100%). Patients with target signs of the stomach, bowel conglomerates, or masses were more likely to have malignant disorders (72%) than those with target signs related to the bowel (16%). We conclude from this study that the ultrasound finding of a target sign or a mass related to stomach or bowel has a high clinical relevance and should in any case worked up by appropriate investigations when clinical consequences are possible. PMID- 3277825 TI - Gastrointestinal histoplasmosis. AB - Three cases are reported of gastrointestinal histoplasmosis in patients who came from the Caribbean or South America and had lymphoma, acquired immunodeficiency syndrome, and prior local radiation therapy. The patients had small-bowel obstruction with ileal involvement, mucosal erythema, and friability on colonoscopy with colonic involvement and an exophytic rectal mass with rectal involvement. Review of the 77 reported cases of gastrointestinal histoplasmosis shows that this is a clinical subset of disseminated histoplasmosis. With gastrointestinal involvement, pulmonary symptoms are uncommon and gastrointestinal symptoms predominate. Fever is less common than in other forms of dissemination. The most common lesions are a mass or ulcers, which often mimic inflammatory bowel disease or carcinoma. Terminal ileal involvement predominates in one third. The complement fixation test was positive in about three quarters of cases tested, but the skin test is not diagnostically useful. In one quarter of patients there is other evidence of immunosuppression. In the immunosuppressed, gastrointestinal histoplasmosis must be considered, even in a patient from a nonendemic area, who presents with lesions appearing like carcinoma or inflammatory bowel disease. When feasible, endoscopic examination and biopsy with stains and culture for histoplasmosis is recommended for diagnosis. Medical management is recommended, with surgery reserved for acute emergencies or when mandatory for diagnosis. PMID- 3277826 TI - Chronic hepatitis: pathogenesis and treatment. AB - Current therapies for chronic viral hepatitis, autoimmune "lupoid" chronic active hepatitis, and drug-induced chronic hepatitis are discussed in the context of recent advances in our understanding of the pathophysiology of chronic active liver disease. Accurate diagnosis is the cornerstone of proper treatment; the limitations and pitfalls of conventional techniques are discussed. Current theories of the pathogenesis of chronic hepatitis B are reviewed to provide a framework for the use of antiviral drugs. Data from the early results of therapy with adenine arabinoside, acyclovir, and immunomodulatory agents are reviewed, and the theoretical basis for the use of alpha-interferon as well as preliminary data supporting its efficacy is presented. Strategies for the treatment of chronic delta hepatitis and chronic non-A, non-B viral hepatitis are discussed as well. The immunological changes associated with autoimmune chronic active hepatitis are described to help define those patients with chronic active hepatitis who are likely to respond to immunosuppressive therapy. The recognized hazards of long-term corticosteroid therapy are indicated and guidelines for the management of these patients are suggested. Chronic drug-induced liver disease will usually improve with cessation of the offending agent. An approach to the patient with suspected drug-induced chronic hepatitis is indicated. Finally, the role of liver transplantation is mentioned as the ultimate treatment modality available for endstage liver disease. PMID- 3277827 TI - Effect of two new alpha-glucosidase inhibitors in insulin-dependent diabetic patients. AB - The delay in glucose absorption at the intestinal level obtained with the administration of alpha-glucosidase inhibitors may contribute to an improved metabolic control in diabetic patients. We have examined the effects of two new compounds, BAY m 1099 (short acting) and BAY o 1248 (long acting), on the postprandial glycemic changes, the insulin requirements and the meal-induced hormone responses in nine insulin-dependent diabetics (IDD). The investigation was conducted according to a protocol in which medication and placebo were administered in a double-blind randomized manner. Twelve hours before each experimental day, the patients were connected to the Biostator GCIIS (Ames-Miles) to maintain stabilized normoglycemic levels for the whole period of study. The results showed that: (1) BAY m 1099 decreased the 4-h postprandial glycemic excursions compared to placebo both at dinner and breakfast (P less than 0.05), (2) BAY o 1248 when compared with placebo showed a significant lowering of the peak glycemic levels at breakfast (P less than 0.001) and at lunch (P less than 0.0025), (3) the 2-h and 4-h post-breakfast insulin requirements fell significantly after either drug (P less than 0.02), (4) the plasma levels of contrainsular hormones were not affected by drugs or placebo at any time during the period of study, and (5) no side effects with either drug could be detected. We conclude from our study that both drugs may be useful adjuncts to insulin therapy in insulin-dependent diabetics by reducing postprandial glycemic fluctuations as well as by decreasing insulin requirements with no modification of the meal-induced hormone responses. PMID- 3277828 TI - Relationship of islet cell and islet cell surface antibodies to the presentation and early course of IDDM in childhood. AB - Islet cell (ICA) and islet cell surface (ICSA) antibodies were measured in 30 children (aged 6-17.7 years) with newly diagnosed insulin-dependent diabetes mellitus (IDDM) to determine the relationship of antibody positivity/negativity to a variety of factors both at presentation (e.g., age, severity of onset, residual insulin secretion, insulin autoantibodies) and during the first year thereafter (HbA1c, insulin antibody binding, residual insulin secretion). At diagnosis, 10 of 30 were ICA (+) and 13 ICSA (+): no differences were found between ICA (+) and (-) subjects at onset; however ICSA (+) children had a lower bicarbonate concentration than those (-) for ICSA (P less than 0.01). During the first year after diagnosis the only significant finding was that in ICA (+) patients insulin dose (units/kg) was lower at both 6 and 12 months (mean +/- SD 0.55 +/- 0.14 and 0.67 +/- 0.12 U/kg, respectively) than ICA (-)'s (0.70 +/- 0.22 and 0.96 +/- 0.38, respectively, both P less than 0.05). Those children positive for both ICA and ICSA did not differ in any way at onset or during the subsequent 12 months from those negative for both antibodies. These results suggest that, except for minor differences, the presentation and course during the first year after diagnosis of IDDM do not differ in those children positive or negative for either or both ICA and ICSA. PMID- 3277829 TI - [Improved insulin action by ACE inhibition in type-2 diabetics]. AB - The effect of the angiotensin converting enzyme inhibitor captopril (25 mg by mouth) on glucose metabolism of skeletal muscle and the whole organism was studied in nine normotensive type II (non-insulin dependent) diabetics using a combination of euglycaemic-hyperinsulinaemic glucose-clamp and forearm catheter techniques. The administration of captopril resulted in a significant rise of both the whole-body glucose elimination and utilization rate in the forearm musculature. At the same time the arterial kinin level rose, while the concentrations of insulin, free fatty acids and gluconeogenesis precursors, as well as the number and activity of insulin receptors (measured in an erythrocyte binding study) remained unchanged. The data support the view that, in type II diabetics, ACE inhibition raises the insulin-stimulated glucose uptake of the whole organism, predominantly due to an increased glucose uptake by the skeletal musculature. The demonstration of an increased kinin level points to this effect possibly being caused by the reduced breakdown of locally liberated kinins. PMID- 3277830 TI - [Normalization of perinatal morbidity in gestational diabetes by strict metabolic adjustment]. AB - A prospective study compared the perinatal morbidity of 141 normal pregnancies (group I) with that of 108 pregnancies in whom gestational diabetes had been treated early (group II) and 35 with unsatisfactorily treated gestational diabetes (group III). The therapeutic goal in gestational diabetes was to have a postprandial blood-glucose level of less than 130 mg/100 ml. If this was not achievable through diet alone, insulin was injected once daily. Neonatal macrosomia, dystrophy, acidosis, hyperbilirubinaemia, hypoglycaemia and hypocalcaemia had a normal incidence in group II, but in group III macrosomia was twice as frequent as in group II (P less than 0.02), and acidosis (pH less than 7.20) twice as frequent (P less than 0.05). The results indicate that strict metabolic control in gestational pregnancy will achieve a normal rate of perinatal morbidity. PMID- 3277831 TI - [Pregnancy during cyclosporin medication following a kidney transplant]. AB - A 33-year-old patient became pregnant two years after transplantation of a cadaver kidney and continuous cyclosporine administration. An uncomplicated spontaneous delivery of a healthy boy weighing 3360 g took place in the 40th week. Cyclosporine was demonstrated in umbilical cord and neonatal blood and in the mother's milk, but not in amniotic fluid. Because mother's milk contained one sixth the concentration of cyclosporine in maternal blood, the mother was dissuaded from breast feeding. PMID- 3277832 TI - [Nuclear medicine diagnosis and therapy of distant metastases of pheochromocytoma]. AB - Three foci, suspected of being metastases, were discovered by sonography and computed tomography in a patient twelve years after resection of a phaeochromocytoma and six years after resection of liver metastases. The findings were confirmed by scintigraphy with 131I-metaiodobenzylguanidine (MIBG) and treated with 3700 MBq of MIBG, to be repeated in the near future. PMID- 3277833 TI - [Silent ischemia of the heart]. PMID- 3277834 TI - [The significance of nutritional factors for the occurrence of gastrointestinal tumors]. PMID- 3277835 TI - [Drug monitoring of cyclosporin by using high-performance liquid chromatography]. PMID- 3277837 TI - Insulin stimulates protein synthesis in compacted mouse embryos. AB - Preliminary work suggested that insulin affects preimplantation mouse embryos. We investigated the effects of insulin on incorporation of [3H]-leucine by embryos cultured for long (greater than 24 h) or short (4 h) terms with insulin. Insulin stimulated incorporation by compacted 8-cell embryos, blastocysts and expanded blastocysts. The stimulation in blastocysts had an EC50 of 0.5 pM in the presence of 1 g/L BSA and was blocked by anti-human insulin anti-serum. Inclusion of insulin in the medium elevated the levels of incorporation towards those of embryos developing in vivo. The stimulation was not observed in uncompacted 8 cell embryos. The ontogeny of stimulation at compaction coincides with a switch in energy dependence from lactate and pyruvate to glucose and an increase in protein synthetic activity. PMID- 3277836 TI - Immunolocalization of betagranin: a chromogranin A-related protein of the pancreatic B-cell. AB - The tissue and subcellular distribution of betagranin, a chromogranin A-related, cosecreted protein produced in rat insulinoma tissue, has been investigated using a combination of density gradient centrifugation, immunoblotting, immunofluorescence, and immunoelectron microscopic techniques. Antibodies raised to insulinoma betagranin recognized antigens of the same molecular size (approximately 20,000 daltons) in insulinoma tissue and normal islets. Antigenicity was confined principally to secretory granules, and in insulinoma tissue was colocalized with insulin. Within the islet, all endocrine cells were immunoreactive, although subpopulations of beta- and alpha-cells displayed a more intense immunofluorescence. Adrenal tissue and anterior and posterior pituitaries were also highly immunoreactive, the antigen again being confined principally to the secretory granule. Higher molecular size species of 65,000, 85,000, and 100,000 daltons, which predominated in adrenal, were also present in pituitary along with equivalent amounts of the 20,000-dalton proteins. Isolated cells in the gastric antrum, small intestine, and colon were strongly immunofluorescent, but again, the molecular form differed from those of other tissues. Parallel experiments performed with antichromogranin A antisera suggested that betagranin in pancreatic B-cells is formed from chromogranin A by limited proteolysis within the secretory granule. It would appear that although chromogranin A is confined to tissues of the diffuse neuroendocrine system it can be processed differentially in tissues in this series. Potentially, the biological activity of chromogranin A resides in such derived peptides rather than in the parent molecule. PMID- 3277838 TI - Regulation of extra-renal renin during ontogeny. AB - Previous studies demonstrated that the level of renin in the male submandibular gland (SMG) of mouse strains that contain renin genes [e.g. Cr1:CD-1(1CR)BR] increased dramatically at puberty, but a less pronounced response was seen in the C57BL/10J (a strain that has a single renin gene). However, the expression of renin in kidney and other extrarenal tissues throughout growth and development has not been examined. In this study we characterized developmental changes in renal renin and certain extrarenal renin levels in the male and female CD-1 mouse and male C-57 mouse. Renal renin activity remains relatively constant throughout ontogeny in male and female CD-1 mice and in the C-57 male mouse. In the CD-1 male mouse, SMG renin levels vary during ontogeny, coincident with periods in growth and development that are associated with hormonal shifts. Glandular renin levels are higher in the neonatal period than at 2-3 weeks of age, and then rise dramatically with the onset of puberty. Renin levels in the adrenal and testis of the CD-1 male mouse follow a similar temporal pattern. However, this dramatic increase in gonadal, adrenal, and SMG renin in the CD-1 male mouse at puberty is not seen in the organs from the CD-1 female mouse or those of the C-57 male mouse. Taken together, the present results demonstrated that the expression of extrarenal sources of renin is under genetic and hormonal influences. In addition, our data suggest that control of extrarenal renin expression may differ from that of renal renin. PMID- 3277839 TI - Effect of pulsatile infusion of progesterone on the in vivo activity of the luteinizing hormone-releasing hormone neural apparatus of awake unrestrained female and male rabbits. AB - Eight female and eight male New Zealand White rabbits were outfitted with push pull cannulae aimed at the tuberal region of the hypothalamus and were used in 19 perfusion experiments. Animals were treated under 2 conditions: a control condition in which female (n = 4) and male (n = 4) rabbits were perfused only with artificial medium for 5-9 h, and an experimental condition in which female (n = 4) and male (n = 5) rabbits were subjected to perfusion with artificial medium, followed by 6 pulses of progesterone (P4) (10 min on, 30 min off; 10 ng/ml) during a 240-min period. Two female rabbits were also subjected to perfusion with artificial medium, followed by 6 pulses of cholesterol (10 min on, 30 min off; 10 ng/ml) during a 240-min period. The LHRH concentration in perfusates collected every 10 min was measured by RIA. In the 4 females undergoing 6- to 7-h control push-pull perfusions, spontaneous pulses were observed, with about 1 pulse every 60 min, and a variable amplitude of the LHRH signal, with a mean release of about 0.91 pg/10 min. In the 4 does treated with pulsatile P4 at 10 ng/ml, the mean LHRH release rate increased significantly from 0.91 +/- 0.13 to 1.66 +/- 0.20 pg/10 min (P less than 0.035), primarily due to an increase in the amplitude of the LHRH pulses, which were significantly greater than controls. This response occurred with an apparent mean latency of about 50 min. Cholesterol pulses did not affect the spontaneous activity of the LHRH neural apparatus. In the 4 males undergoing 5- to 9-h control push-pull perfusions, spontaneous LHRH pulses were observed with about 1 pulse every 60 min, and the mean release increased from 1.25 +/- 0.56 to 1.54 +/- 0.55 (P less than 0.035, by Wilcoxon's matched pairs signed rank test) in the late afternoon primarily due to an increase in the amplitude of the pulses. P4 pulses did not affect the spontaneous activity of the LHRH neural apparatus compared to that in the control animals. Overall, these results clearly demonstrate that although spontaneous pulsatile LHRH release from the hypothalamus of awake unrestrained female and male rabbits is similar, pulses of P4 can activate only the female LHRH neural apparatus, with an apparent latency to peak LHRH release of approximately 50 min. In addition, there appears to be an increase in LHRH mean release levels in the late afternoon to early evening in male rabbits. PMID- 3277840 TI - Functional differences in insulin receptors in rat adipocyte and human placenta membranes. AB - Incubation of human placenta membranes with low concentrations (0.1-0.2 mM) of dithiothreitol (DTT) increased insulin binding approximately 1.4-fold, while 10 mM DTT completely inhibited insulin binding. In contrast, treatment of rat adipocyte membranes with 0.5-2.0 mM DTT increased tracer insulin binding 3- to 6 fold, while higher levels of DTT (10 mM) also fully inhibited insulin binding. Scatchard analysis of insulin binding revealed that DTT treatment of adipocyte membranes resulted in an increase in both the high and low affinity dissociation constants. Purification of adipocyte insulin receptors by wheat germ agglutinin Sepharose chromatography, followed by insulin-agarose affinity chromatography, resulted in loss of DTT stimulation of insulin binding. Comparison of insulin receptors purified from rat adipocytes or human placenta membranes revealed no significant differences in the DTT sensitivities of insulin binding or protein kinase activities. These data suggest that the functional properties of the rat adipocyte insulin receptor are modified by its membrane environment compared to those of insulin receptors in placenta membranes or purified insulin receptors in detergent solution. PMID- 3277841 TI - Opiate-induced hypersensitivity to testosterone feedback: pituitary involvement. AB - We have examined the mode of morphine's (M) action to increase the sensitivity of castrated male rats to the inhibitory feedback action of testosterone (T) on LH release. In castrated rats, sc implantation of M pellets or 5-mm long T-filled capsules (T5) failed to suppress LH release, but a combination of M and T5 drastically decreased serum LH levels. Likewise, while treatment with a higher dose of T (30-mm long implant, sc) suppressed LH release, combined treatment with M and T30 produced a further suppression of LH levels. We have now assessed the in vitro release rate of LHRH from the medial basal hypothalamus-preoptic area of castrated rats treated with M and/or T as well as the in vivo pituitary LH response to LHRH challenge in similarly treated rats. Interestingly, the in vitro basal and naloxone-induced LHRH release from the medial basal hypothalamus preoptic area of the six groups of rats was similar, regardless of whether LH levels were in the high castrate or low basal range. On the other hand, M treatment greatly attenuated LH release in vivo in response to LHRH challenge (10pmol-1pmol) [corrected] in T-treated rats. In fact, LH increments in response to 1pmol [corrected] LHRH, seen in control, T5, and T30 groups, were abolished by additional M treatment of T-treated rats. This in vitro assessment of LHRH release suggests that the drastic decrease in LH release in T-plus M-treated rats may not be due to impaired LHRH release, but, rather, be due in part to reduced pituitary responsiveness to intermittent endogenous LHRH signals. The reduced pituitary responsiveness to LHRH in T-plus M-treated rats may be a consequence of either a direct pituitary effect of opiates in conjunction with T or augmented action of hypothalamic neurohumoral agents which may inhibit LH release on their own or antagonize the LH-releasing action of LHRH at the level of pituitary gonadotrophs. PMID- 3277842 TI - A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension: II. Effects on cardiovascular reactivity. AB - In the course of conducting a controlled comparison of progressive muscle relaxation and thermal biofeedback as possible substitutes for second-stage (sympatholytic) antihypertensive medications, we measured reactivity (heart rate, systolic blood pressure, and diastolic blood pressure) to three different stressors (mental arithmetic, cold pressor, and negative mental imagery) before and after treatment and drug withdrawal. Neither treatment was consistently effective in reducing reactivity across a variety of stressors. Relaxation led to more reductions in some aspect of reactivity than did biofeedback. The modest level of reductions in reactivity were seen more for mental arithmetic and systolic blood pressure. PMID- 3277843 TI - Assessment of methods for measuring social support. AB - A rapidly expanding literature documents the effects of social support on physical and psychological well-being. Although definitions vary, most include both tangible components (e.g., financial assistance and physical aid) and intangible components (e.g., encouragement and guidance). Social support has been implicated in the mediation of stressful life events, recovery from illness, and increased program adherence. There are many inconsistent findings in the literature, however, and it is difficult to resolve discrepancies because measures of social support vary widely from study to study. To guide in the selection of measurement methods for research and applied work, 23 techniques for assessing social support are reviewed and evaluated. Criteria for favorable evaluation included reliability coefficients greater than .8 and documentation of validity. Correlations between various social support and criterion measures are simulated in order to demonstrate the consequences of choosing a measure with low reliability. Scale developers reported reliability data for 19 of the reviewed measures. Internal consistency coefficients ranged from .31 to .98. Test-retest coefficients ranged from .22 to .96. At least some validity documentation was available for 13 of the scales. Discriminant validity evidence, however, is almost universally absent. Despite psychometric weaknesses and variability among the scales, researchers have several instruments available to them. PMID- 3277844 TI - Salmonella mutagenicity tests: IV. Results from the testing of 300 chemicals. AB - Three hundred chemicals were tested for mutagenicity, under code, in Salmonella typhimurium, using a preincubation protocol. All tests were performed in the absence of exogenous metabolic activation, and in the presence of liver S-9 from Aroclor-induced male Sprague-Dawley rats and Syrian hamsters. The results and data from these tests are presented. PMID- 3277845 TI - Hormonal and metabolic response to physical exercise, fasting and cold exposure in the rat. Effects on ketogenesis in isolated hepatocytes. AB - Four groups of rats were subjected to the following conditions: (1) 48 h fasting, (2) 48 h of 4 degrees C cold exposure, (3) 5 h treadmill running, (4) 48 h fasting with 4 degrees C cold exposure. The groups were compared to fed control rats in order to study hormonal and metabolic responses in blood and tissue samples. Isolated hepatocytes were used to evaluate the rate of ketogenesis. Decreases in liver glycogen and increases in blood free fatty acids (FFA) confirmed that glycogenolysis and lipolysis occur in these situations of metabolic stress. Increases in the glucagon/insulin plasma ratio were also noted. Plasma catecholamine levels were only enhanced after running and after cold exposure. Production of blood ketone bodies was stimulated more by running and by fasting than by cold exposure. The low ketone body production observed after cold exposure seems to be linked to increases liver glycogen levels and decreased FFA availability. Liver cells isolated after cold exposure exhibited higher ketogenesis than these isolated after running. This difference in ketogenic capacity could result both from the longer hormonal stimulation by high glucagon/insulin plasma ratios and from the metabolic state of the liver. PMID- 3277846 TI - Metabolic effects of glucose, medium chain triglyceride and long chain triglyceride feeding before prolonged exercise in rats. AB - The purpose of this study was to test the hypothesis that oral ingestion of lipids could increase endurance by slowing the rate of glycogen depletion. Trained rats were killed after a 2 h run on a rodent treadmill, following an intragastric infusion of water, glucose, medium chain triglycerides (MCT) or long chain triglycerides (LCT). Glucose and triglycerides were administered in equicaloric concentrations (50 kJ). The results show that oral ingestion of lipids (MCT or LCT) did not reduce glycogen depletion in liver, heart or skeletal muscle after exercise whereas the fat diet increased muscle and heart glycogen stores in resting conditions. In contrast, glucose feeding induced a significant sparing effect on endogenous carbohydrate utilization and reduced physical exercise lipolysis. These data indicated, firstly, that enhanced lipid availability induced by a single lipid meal before exercise was not able to modify the glycogen depletion occurring after exercise and, secondly, that the glucose/fatty acid cycle was not effective in these conditions. The comparison between lipids indicated that the effect on glycogen use of MCT did not differ from that of LCT, and did not seem to be of any particular importance during physical exercise. PMID- 3277847 TI - Lipoprotein lipase activity in skeletal muscle and adipose tissue of marathon runners after simple and complex carbohydrate-rich diets. AB - A comparison of the influence of simple and complex carbohydrate (CHO) consumption on adipose tissue- and skeletal muscle-lipoprotein lipase activity (AT-LPLA, SM-LPLA) was examined. Twenty male marathon runners were divided into two equal dietary groups: simple-CHO and complex-CHO. Half of the subjects in each group consumed either a low-CHO (15% energy [E] intake), or a mixed diet (50% CHO) for 3 days. Immediately following this dietary period, the subjects consumed a CHO-rich diet (70% E intake) predominant in simple-CHO or in complex CHO for an additional 3 days. Thereafter, all subjects returned to a normal mixed diet. Skeletal muscle biopsies, adipose tissue aspirations, and venous blood samples were obtained prior to dietary manipulation (PRE), upon completion of the 6 day diet (POST I), and 2 weeks after returning to a normal diet (POST II). The samples were analysed for AT-LPLA, SM-LPLA, serum insulin, and free fatty acids (FFA), and blood glucose, and lactate. SM-LPLA fell 71% from PRE values of 0.39 +/- 0.30 mu mol.g-1.h-1 to POST I values of 0.11 +/- 0.09 mu mol.g-1.h-1 (means +/- SD) (p less than 0.05), after a complex-CHO diet. However, the simple-CHO diet did not alter SM-LPLA. AT-LPLA similarly decreased (p less than 0.05) after the complex-CHO diet, and no significant decrease was noted after the simple-CHO diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3277848 TI - Percutaneous transuretero-ureterostomy in situ. AB - Endourological techniques allow one to postpone a second, planned intervention- urinary diversion to the intestine--in radical cystectomies with a high surgical risk. PTU consists in introducing one nephrostomy tube percutaneously through one kidney and replacing it by the definitive drainage tube during the surgical procedure after suturing both ureters together. PMID- 3277849 TI - Surgical reinnervation of the transplanted kidney: is it needed? AB - The influence of surgical reinnervation on the organ was experimentally investigated on 175 dogs using the model of in situ denervation and kidney autotransplantation. It was found to ensure: anatomic and physiological conditions for the directed intergrowth of nerve fibres up to the principal structural elements of kidney; normal levels of nervous mediators, and complete kidney efficiency over a long period of time. The expediency of surgical reinnervation in the case of auto- and allotransplantation of the kidney is discussed. PMID- 3277850 TI - Ileal conduit and orthotopic renal transplantation. An alternative in pathology of the nonviable lower urinary tract. AB - The technique of orthotopic renal transplantation with urinary shunt, using the ileal conduit as an alternative in cases of pathologically nonviable lower urinary tract, is described. Various techniques for heterotopic renal transplantation using the ileal conduit have been used. We feel that orthotopic renal transplantation accompanied by the ileal conduit results in a more anatomical and physiological unit than the previously proposed alternatives. PMID- 3277851 TI - Intrathoracic kidneys: report of 6 cases and a review of the literature. AB - Six cases of intrathoracic kidneys are reported: 1 bilateral; 1 on the right and associated with dextrocardia and possible right lung hypoplasia; the other 3 cases being on the left. Only 1 case on the left presented with symptoms that could be attributed to the intrathoracic kidney. The clinical features, associated anomalies, and diagnostic methods are discussed. Our cases include the 3rd case to be diagnosed by computerized tomography, the 4th case of bilateral intrathoracic kidneys and the 2nd case to be associated with dextrocardia. PMID- 3277852 TI - Echograms of prostate cancer: inside echo patterns of localized prostate cancer. AB - Transrectal ultrasonography has been considered useful for the diagnosis of prostate cancer. There have been few reports on localized cancer in the prostate diagnosed by echogram. In this paper, we discuss echograms of the prostate in cases of localized cancer, advanced cancer and well-controlled cancer. Hypoechoic lesions seem to suggest prostate cancer. PMID- 3277853 TI - Immunoelectronmicroscopic investigation of Hodgkin's disease with monoclonal antibodies against histiocytes. AB - 8 cases of Hodgkin's disease (HD nodular sclerosis (n = 3), HD mixed type (n = 2), and nodular paragranuloma (n = 3] were investigated with monoclonal antibodies against histiocytes (Ki-M1, Ki-M3, Ki-M4, Ki-M6, and Ki-M7). Reactivity of H- and SR-cells with the monoclonal antibodies Ki-M3 and Ki-M7 could be shown at the ultrastructural level in cases of HD of nodular sclerosis and mixed type. In nodular paragranuloma no positive H-, SR- nor L & H-cells could be demonstrated. The reaction site of the monoclonal antibodies in H- and SR-cells was comparable to those in histiocytes. PMID- 3277854 TI - Low dosage alpha-interferon treatment in patients with advanced cutaneous T-cell lymphoma. AB - Treatment with high dose (10-50 x 10(6) IU/m2 three times a week) of alpha interferon (alpha-IFN) has been shown to induce remissions in about 50% of patients with cutaneous T-cell lymphoma. The optimal alpha-IFN dose, however, is not known. 4 patients with advanced cutaneous T-cell lymphoma were therefore treated with alpha-IFN in low doses of 2-4 x 10(6) IU/m2 three times a wk. 1 complete, 1 partial and 1 minor remission were observed. Skin biopsies before and during treatment were taken from 2 of the patients and showed improvement. Low doses of alpha-IFN can thus induce remission in patients with cutaneous T-cell lymphoma. PMID- 3277855 TI - Cytogenetic follow-up of 100 patients submitted to bone marrow transplantation for Philadelphia chromosome-positive chronic myeloid leukemia. Cooperative Study Group on Chromosomes in Transplanted Patients. AB - 100 Ph+ CML patients submitted to BMT were studied cytogenetically before grafting and serially after transplantation. The 12 European institutions participating in the study, including transplant units and laboratories of cytogenetics, collected a total of 520 studies. The Ph chromosome was observed after BMT in 22 patients who did not enter relapse during the observation time (10-1400 days--median 420 d) following initial detection of the chromosome. This abnormality was observed in 1 to 30% of the cells analyzed. In 10 patients, abnormal cells were detected only within the first 90 d after BMT, in 5 patients both before and after 90 d and in 7 patients only after 90 d. 44% of these 22 patients had a moderate-to-severe cGVHD. Future studies are needed in order to better evaluate the real incidence of persistent disease and the correlations with the GVHD. PMID- 3277856 TI - The spleen in Felty's syndrome: a histological, morphometrical, and immunohistochemical study. AB - A histological study employing morphometrical and immunohistochemical methods was performed in 3 spleens removed because of Felty's syndrome (FS). A comparison was made with control spleens and with spleens removed from patients with idiopathic thrombocytopenic purpura (ITP) or autoimmune hemolytic anemia (AIHA). In FS, the spleen is enlarged, mainly due to expansion of the red pulp. The sinuses are enlarged, too, and contain many macrophages. 2 of our specimens showed many hyperplastic germinal centers; the 3rd contained no germinal centers. Only in the former cases did splenectomy lead to an increase in the number of circulating granulocytes. Immunohistologically, FS spleens differed from the control, the ITP, and the AIHA spleens. The results have provided further evidence indicating that the pathogenesis of granulocytopenia in FS differs from that of autoimmune hematocytopenias, and have given rise to the hypothesis that, in FS, the spleen is the site of interaction between immune complexes and granulocytes. PMID- 3277857 TI - N-terminal amino acid sequence analysis of the subunits of pea photosystem I. AB - Six 'core' subunits of pea photosystem I have been isolated and their N-terminal amino acid sequences determined by gas-phase or solid-phase sequencing. On average more than thirty residues were determined from the N-terminus of each polypeptide. This sequence analysis has revealed three polypeptides with charged N-terminal regions (21, 17 and 11 kDa subunits), one polypeptide with a predominantly hydrophobic N-terminal region (9 kDa subunit), one polypeptide which is cysteine-rich (8 kDa subunit) and one which is alanine-rich (13 kDa subunit). PMID- 3277858 TI - Limited proteolysis of actin by a specific bacterial protease. AB - A 36 kDa fragment of rabbit skeletal muscle actin resistant to further proteolytic breakdown was obtained with a new bacterial protease. This fragment was the only cleavage product obtained from native actin whereas proteolysis of heat-inactivated actin was unlimited. The 36 kDa fragment failed to polymerize and to inhibit DNase I activity. Binding to DNase I protects actin against proteolysis by protease. The results on actin proteolysis by different proteases are compared. PMID- 3277859 TI - Inhibition of the amplified bombesin-stimulated inositol phosphate response in N ras transformed cells by high density culturing. AB - The bombesin-stimulated inositol phosphate response is only increased in cells transformed by the overexpression of N-ras when they are cultured under sub confluent conditions. The inhibition of the amplified bombesin stimulation can be partially reversed by either, incubation of the cells for 5 h with 1 mM suramin, or by a 30 min preincubation of cells in excess buffer. The inhibitory effects are probably caused by the effects of autocrines and may explain some of the different published observations concerning the effects of ras gene products upon inositol phospholipid metabolism. PMID- 3277860 TI - Cloning, sequencing and expression of a full-length rabbit fast skeletal troponin C cDNA. AB - A full-length cDNA coding for troponin-C isolated from an adult rabbit fast skeletal muscle library has been sequenced and expressed in an E. coli host. The amino acid sequence derived from the coding region agrees with the published protein sequence except that the first two residues are reversed. The expressed protein was found to be identical to purified rabbit skeletal troponin-C based on electrophoretic mobilities in polyacrylamide gels containing either SDS or urea, and on immunoblotting. These results establish that our troponin-C cDNA clone is suitable for site-directed mutagenesis studies on the structure and function of troponin-C. PMID- 3277861 TI - An initiator protein for plasmid R6K DNA replication. Mutations affecting the copy-number control. AB - Two kinds of mutations affecting the copy-number control of plasmid R6K were isolated and identified in an initiator pi protein by DNA sequencing. Firstly, a temperature-sensitive replication mutation, ts22, with decreased copy number results in a substitution of threonine to isoleucine at position 138 of the 305 amino-acid pi protein. Secondly, a high-copy-number (cop21) mutant was isolated from this ts mutant and was identified by an alteration of alanine to serine at position 162. This cop21 mutation suppressed the Ts character and was recessive to the wild-type allele in the copy control. PMID- 3277862 TI - Biological activities of chemically synthesized N-acetylneuraminic acid-(alpha 2- --6)-monosaccharide analogs of lipid A. AB - The mitogenicity and lethal toxicity of chemically synthesized lipid A analogs, in which 2,3-acyloxyacylglucosamine-4-phosphate linked to tetraacetyl-N acetylneuraminic acid (compound A-207) or to N-acetylneuraminic acid (compound A 307), were examined. Although the mitogenic activity of the synthetic compounds was weaker than that of bacterial LPS, doses of 10-50 micrograms/ml of A-207 and 5-10 micrograms/ml of A-307 were capable of increasing incorporation of [3H]thymidine into cultured spleen cells of C57BL/6 mice. Lethal toxicity of A 207 was observed at 10 micrograms/mouse in C57BL/6 mice sensitized with D galactosamine hydrochloride. However, the attachment of tetraacetyl-N acetylneuraminic acid or N-acetylneuraminic acid does not appear to enhance the biological activity of acyloxyacylglucosamine-4-phosphate. PMID- 3277863 TI - Structural differences between oxidized and reduced thioredoxin monitored by two dimensional 1H NMR spectroscopy. AB - Two-dimensional high resolution NMR techniques have been applied to study the structural differences between the oxidized and reduced forms of Escherichia coli thioredoxin in solution. Sequential proton resonance assignments indicate only limited conformational changes; major chemical shift differences are found for a few residues in a beta-strand immediately preceding the active site S-S bridge and the active site itself. Additional resonance shifts are observed for several residues distant in the primary sequence. The X-ray structure of oxidized thioredoxin shows that these residues form a flat hydrophobic surface, close to the active site S-S bridge, which is probably involved in interactions with other protein molecules. PMID- 3277864 TI - Electron microscopy study of Q beta replicase. AB - Purified preparations of Q beta replicase have been studied by electron microscopy using a negative staining technique, and a three-dimensional model of the enzyme molecule has been constructed. The molecule of this four-subunit protein appears to be a compact structure having a size of 100 +/- 10 A; it is subdivided into two unequal bipartite subparticles. The conclusion has been made that all the constituent subunits, including the ribosomal protein Sl, acquire a globular conformation when associated in the replicase complex. PMID- 3277866 TI - Follicular aspiration: a comparison of an ultrasonic endovaginal transducer with fixed needle guide and other retrieval methods. AB - Ultrasonic techniques have been developed as alternatives to conventional laparoscopic aspiration for oocyte retrieval for in vitro fertilization (IVF). Given the advantages (less risk, lower cost, and greater patient acceptance) of these alternative techniques, it is appropriate to assess their efficacy compared with traditional laparoscopic retrieval. This article examines the recovery rate of oocytes and their subsequent fertilization rate with the use of an ultrasonic endovaginal transducer with fixed needle guide and compares these results with other retrieval methods. Comparisons were made between laparoscopic harvesting (n = 71, group I), ultrasonic transabdominal transvesical (n = 21, group II), and ultrasonic vaginal transducer (n = 76, group III). The data demonstrate comparable success using an ultrasonic endovaginal transducer with fixed needle guide. The authors believe this technique to be the procedure of choice for all routine oocyte retrievals during IVF treatment. PMID- 3277865 TI - A randomized trial of human chorionic gonadotropin support following in vitro fertilization and embryo transfer. AB - This article reports on the effects of human chorionic gonadotropin (hCG) on progesterone (P) and estradiol (E2), luteal phase length, and conception in 116 cycles treated by in vitro fertilization and embryo transfer (IVF-ET). In 60 cycles, the luteal phase was supported by hCG, 1500 IU three times at 2-day intervals from the day of ET. The remaining 56 cycles served as controls. hCG significantly increased the P level (93 +/- 53 versus 62 +/- 46 ng/ml), the P/E2 ratio, and the luteal phase length (17.4 +/- 1.3 versus 12.2 +/- 1.7 days). However, the total pregnancy rate did not significantly differ between the two groups, though the pregnancy rate after transfer of two or three embryos was slightly higher in the hCG group (26.9 versus 22% in the control group), as was the rate of implanted embryo per transferred embryo after transfer of two or three embryos (25 versus 15.3%). It was concluded that, while hCG increased the magnitude and duration of the luteal P secretion, it did not clearly improve the pregnancy rate. PMID- 3277867 TI - An analysis of factors influencing the establishment of a clinical pregnancy in an ultrasound-based ambulatory in vitro fertilization program. AB - In the study period (June 1984 to December 1986), 2232 cycles were stimulated in 1294 patients. Ultrasound-directed oocyte recovery (UDOR) was performed as an ambulatory procedure in 1737 (77.8%) cycles, resulting in 1375 embryos transfers (ET). Age, etiology, menstrual cycle length, number of oocytes collected, and number of embryos transferred were important determinants of the outcome. The number of attempts at in vitro fertilization did not affect the clinical pregnancy rate (CPR). In patients receiving four embryos, the CPR appeared to be highest when up to seven embryos were available for transfer. The fertilization rate in an individual cycle had a good prognostic value, the implantation rate being highest when 7 to 9 oocytes were retrieved and greater than 60% of these were fertilized. When 10 or more oocytes were collected, the implantation rate showed a progressive decline, regardless of the fertilization rate. Furthermore, multiple pregnancies failed to occur when greater than 12 oocytes were retrieved or more than eight embryos were available for transfer. These data suggest that, in excessively stimulated cycles, the quality of oocytes and embryos or uterine receptiveness may be suboptimal, and the transfer of more than four embryos is unlikely to increase the success rate. PMID- 3277868 TI - Antibody binding patterns in infertile males and females as detected by immunobead test, gel-agglutination test, and sperm immobilization test. AB - Sera from 214 infertile patients were assayed for antisperm antibodies using the IBT, GAT, and SIT. The new IBT methodology was compared with the more classical tests. Although SIT and GAT did not correlate to any particular antibody class, both were negative if IgA was present alone. The immunoglobulin class presented a preferential sperm region binding site: IgG to the head and tail, IgM to tail tip only, IgA to head and tail. Furthermore, these immunoglobulins from the serum of male patients bound differently to sperm than immunoglobulins from female serum. Finally, we were able to calculate the relative sensitivity, specificity, and predictive values for these tests. PMID- 3277869 TI - Treatment of uterine fibroids with agonist analogs of gonadotropin-releasing hormone. AB - Agonist analogs of GnRH were used to effect a "medical castration" in 14 patients with uterine fibroids, presenting with either an enlarged uterus, recurrent menometrorrhagia, and/or infertility. This study confirms prior reports of a reduction in uterine size and cessation of menometrorrhagia in patients with fibroids following treatment with GnRHa. Of interest, however, was the successful use of GnRHa as either the sole treatment for uterine fibroid-associated infertility, or as a preoperative adjunct in infertility patients scheduled for myomectomy. Three of the five infertility patients in this study achieved intrauterine pregnancies. Further study of the role of GnRHa treatment in infertility patients with uterine fibroids appears warranted. PMID- 3277870 TI - [Blood transfusion: history and daily practice]. PMID- 3277871 TI - The blood flow velocity waveform index in the fetal thoracic aorta and its ability to detect fetal compromise in the small for gestational age fetus. AB - In a prospective longitudinal study of 96 patients, mean values of blood velocity waveform indices of the fetal thoracic aorta are established with a combined linear array real-time and pulsed Doppler transducer. The course of the various blood velocity waveforms is elucidated. The most striking finding is the restricted variability of the pulsatility index (PI), resistance index (RI), A/B ratio, acceleration time (AcT) and acceleration time percentage (AcTP) during the last trimester of pregnancy. In 17 proven and evaluable SGA infants the various blood velocity waveform indices were compared with the established mean values. Fourteen of these 17 (82%) infants were proven to be intrauterine growth-retarded (IUGR). Only 3 of these 14 (21%) showed a significant increase in PI values. PMID- 3277872 TI - Validity of a selective policy for ultrasound examination of fetal congenital anomalies. AB - The validity of the Stage II ultrasound examination for fetal congenital anomalies has been determined. Only pregnancies that fulfilled certain criteria, i.e. obstetric complications (IUGR, polyhydramnios, immature-premature uterus contractions), or women with a history of congenital anomalies qualified. Five hundred and fifteen pregnant women were examined. Follow-up evaluation was available on 481 pregnancies (494 neonates). Of these children 102 (21%) appeared to have one or more structural anomaly following birth. In 88 of them at least one congenital anomaly had been detected antenatally by the Stage II ultrasound examination. The sensitivity of the ultrasound scanning procedure was 86%, the specificity 100%. The validity of the applied selection criteria for the Stage II ultrasound examination was studied in 2059 women who had delivered consecutively in our hospital. One hundred and eighty-one had the Stage II ultrasound examination performed. Thirty-six of these 181 women delivered an infant with a structural anomaly (20.0%). The remaining 1878 did not qualify for the Stage II ultrasound examination. From these pregnancies 24 infants were born with a structural anomaly (1.3%). The sensitivity of the applied selection criteria was 60% and the specificity 93%. The incidence of congenital anomalies was strikingly higher in pregnancies scanned for reasons of obstetric complications than in the pregnancies scanned for a history of congenital anomalies. The necessity of the Stage II ultrasound examination in every pregnancy is questioned on the basis of the results. PMID- 3277874 TI - The accuracy of measurements of ovarian follicular scanning by inexperienced observers using real-time sector scanning. AB - Three inexperienced operators (2 midwives and one obstetric registrar) were given ten sessions of training in ovarian follicular scanning. During each session, five patients were examined jointly. Once the inexperienced observers had received sufficient training the prospective study was started. Twenty measurements by each inexperienced observer were compared to measurements made by an experienced observer. In 17% of measurements the error was greater than 3 mm, the errors being evenly distributed among the three observers. After a further five sessions of instructions, another set of sixty measurements was generated: 93% of these measurements correlated exactly among the inexperienced operators and between the inexperienced and the experienced operator. This study suggests that after a supervised training of 15 sessions, obstetricians and midwives with prior obstetric scanning experience can produce reliable ovarian follicular measurements. PMID- 3277873 TI - Primary abdominal pregnancy: can artificial abortion, endometriosis and IUD be etiological factors? AB - Primary abdominal pregnancy is a very rare condition, accompanied by high rates of perinatal and maternal mortality. The etiology of this condition is not clear; nevertheless several theories have been proposed. We have reported three cases in whom the etiological factors may have been the presence of an IUD, and patches of endometriosis adjacent to the site of the pregnancy in two cases. It is suggested that in cases suspected of ectopic pregnancy, in the presence of IUD or other pelvic pathology, it should first be determined whether it is the dangerous condition of abdominal pregnancy, in view of the high mortality rates. PMID- 3277875 TI - The efficiency of prostaglandin E2 vaginal suppositories versus intracervical prostaglandin gel for induction of labor in patients with unfavorable inducibility prospects. AB - Two different applications of prostaglandin E2 for induction of labor were randomly used in 113 women with an unripe cervix; 57 women were given prostaglandin suppositories each containing 2.5 mg PGE2 in a basis of Witepsol S55 (Dynamit Nobel), another 56 women were treated with intracervical gel containing 1 mg PGE2 in 5 g hydroxypropylmethyl cellulose. The treatment was repeated after 4 h if the cervix was still unripe, and the procedure was repeated the following day if the cervix was still unfavorable. Cesarean sections was performed within 48 h after the start of induction and before the second stage of labor in 8 women in the suppository group and 7 women in the intracervical gel group. Of the remaining 98 women, 73% (34/48 women) in the suppository group and 36% (18/50 women) in the cervical gel group had delivered within 24 h (p less than 0.01). After 48 h, 88% (42/48 women) in the suppository group and 74% of the women (37/50 women) in the cervical gel group had delivered (p greater than 0.05). The induction-delivery interval in the suppository group was half that found in the cervical gel group. There was no significant difference between the two groups in the use of instrumental vaginal deliveries and cesarean sections nor was there any difference with regard to fetal distress. The post-delivery condition of the newborn was similar in the two groups. No side-effects were reported in either of the two groups. PMID- 3277876 TI - Feasibility of self-administration analgesia by the intramuscular route in labour. AB - The feasibility of patient-controlled on-demand analgesia by the intramuscular route during labour was tested on 10 primigravid mothers. Pethidine 50 mg or meptazinol 75 mg was available double-blind at minimum intervals of 20 min. The mean dose demanded was 190 (SD 96.2) mg of pethidine and 285 (SD 97.8) mg of meptazinol. The dose of pethidine is similar to that demanded by the intravenous route. Pain evaluations were not significantly different, but one mother who had meptazinol opted for epidural analgesia, and 2 wished they had done so. The system could be easily managed by all the mothers and there were not technical difficulties. Self-administered intramuscular analgesia could be instituted by a midwife with a dosage scheme similar to current practice. A field trial by midwives of self-administered intramuscular analgesia with pethidine is indicated. PMID- 3277877 TI - Lactose intolerance. PMID- 3277878 TI - Effects of adenosine deaminase on the sensitivity of glucose transport, glycolysis and glycogen synthesis to insulin in muscles of the rat. AB - 1. Soleus, extensor digitorum longus (EDL) or hemi-diaphragm muscles of the rat were incubated in the presence of insulin and rates of the processes of glycolysis and glycogen synthesis were measured. 2. The concentrations of insulin required to cause half-maximal stimulation of glycolysis in both soleus and EDL preparations were significantly decreased by the presence of adenosine deaminase in the medium. 3. Adenosine deaminase increased the sensitivity of the process of hexose transport to insulin (in an identical manner to the change in sensitivity of glycolysis) in the EDL preparation. 4. None of the adenosine mediated effects on insulin-stimulated rates of glycolysis were observed in the hemi-diaphragm preparation or on the rates of glycogen synthesis in any of the three muscle preparations. 5. Therefore, changes in the adenosine system in skeletal muscle influence insulin sensitivity regardless of fibre type composition of the muscle. PMID- 3277879 TI - Spectroscopic studies of lipids and biological membranes. Twenty-first Colworth medal lecture. PMID- 3277880 TI - Shedding light on lysosomes--applications of fluorescence techniques to cell biology and diagnosis of lysosomal disorders. Seventh BDH medal lecture. PMID- 3277881 TI - Spectrin and calmodulin in spreading mouse blastomeres. AB - The role of spectrin and its association with calmodulin in spreading mouse blastomeres was investigated. Embryonic spectrin binds 125I-calmodulin in a calcium-dependent fashion in the blot overlay technique. Double-labeling experiments show coordinate redistribution of spectrin and calmodulin in blastomeres preparing to undergo active spreading movement. At this stage cortical spectrin staining is lost from the region of cell-substrate contact and spectrin and calmodulin become concentrated in two structures closely associated with the contacted region: a group of spherical bodies located on the cytoplasmic side of the cortical layer and a subcortical ring that marks the perimeter of the contacted region. The localization pattern of spectrin and calmodulin is also coordinated with that of actin and myosin. The results suggest that spectrin plays a role in the spreading of blastomeres and that this function may involve linkage of spectrin, calmodulin, and the cortical contractile apparatus. PMID- 3277882 TI - Intrinsic and extrinsic controls of the hypertrophic program of chondrocytes in the avian columella. AB - Immunohistochemical studies of the chick columella have shown that the extracellular matrix of this ossicular cartilage template is composed largely of type II collagen. As development proceeds, synthesis of type X collagen, a hypertrophic cartilage-specific molecule, is initiated by endochondral chondrocytes within the zone of cartilage cell hypertrophy. Subsequently, these cells and their surrounding extracellular matrix are removed, resulting in marrow cavity formation. We have examined which of these processes are programmed within the columella chondrocytes themselves, and which require involvement of exogenous factors. Prehypertrophic columella from 12-day chick embryos were grown either in organ culture on Nuclepore filters or as explants on the chorioallantoic membrane of host embryos. Chondrocytes from the same source were grown in monolayer cell cultures. In both organ culture and cell culture, chondrocytes developed to the stage at which some of them entered the hypertrophic program and initiated the production of type X collagen as determined by immunofluorescence histochemistry with a monoclonal antibody specific for that collagen type. The organ cultures, however, did not progress to the next stage, in which detectable removal of the type X collagen-containing matrix occurs. When identical columella were grown on the chorioallantoic membrane of host chicks, the type X collagen-containing matrix which formed was rapidly removed, resulting in the formation of a marrow cavity. Thus, progression of endochondral chondrocytes to the deposition of type X collagen-containing matrix seems to be programmed within the cells themselves. Subsequent removal of this matrix requires the involvement of exogenous factors. PMID- 3277883 TI - The effects of stress and social support on health: a research challenge for family medicine. AB - Family physicians frequently encounter patients who have recently experienced stressful life changes and who have weak social supports. Since an accumulation of evidence indicates that these psychosocial profiles are associated with health impairment, further investigation of these factors is of importance to family medicine. This paper reviews conceptual and methodologic issues involved in the assessment of the health effects of stress and social support and identifies particular questions and directions appropriate for family medicine research. The ultimate goal of research inquiry in this area is to develop effective clinical and public health strategies that prevent or minimize adverse health consequences. PMID- 3277884 TI - Biology of interleukin 1. AB - Interleukin 1 (IL 1) is a polypeptide that is produced after infection, injury, or antigenic challenge. Although the macrophage is a primary source of IL 1, epidermal, epithelial, lymphoid, and vascular tissues synthesize IL 1. When IL 1 gains access to the circulation, it acts like a hormone and induces a broad spectrum of systemic changes in neurological, metabolic, hematologic, and endocrinologic systems. Some of the IL 1 that is synthesized remains associated with the plasma membrane and induces changes in local tissues without producing systemic responses. IL 1 affects mesenchymal tissue remodeling where it contributes to both destructive and repair processes. IL 1 activates lymphocytes and plays an important role in the initiation of the immune response. Receptors for IL 1 have been identified, but receptors are scarce and their affinities often do not match the potency of the biological response. The most consistent property of IL 1 is up-regulation of cellular metabolism and increased expression of several genes coding for biologically active molecules. IL 1 is a highly inflammatory molecule and stimulates the production of arachidonic acid metabolites. IL 1 also acts synergistically with other cytokines, particularly tumor necrosis factor. The multitude of biological responses to IL 1 is an example of the rapid adaptive changes that take place to increase the host's defensive mechanisms. PMID- 3277885 TI - Hemostatic properties of normal and perturbed vascular cells. AB - Vascular endothelial and smooth muscle cells actively maintain vessel wall thromboresistance by expressing several antithrombotic properties. With perturbation or injury, vascular cells express thrombogenic properties. Loss of vessel wall thromboresistance may be associated with thrombosis and vascular disease. PMID- 3277886 TI - Molecular basis of bacterial resistance to organomercurial and inorganic mercuric salts. AB - Bacteria mediate resistance to organomercurial and inorganic mercuric salts by metabolic conversion to nontoxic elemental mercury, Hg(0). The genes responsible for mercury resistance are organized in the mer operon, and such operons are often found in plasmids that also bear drug resistance determinants. We have subcloned three of these mer genes, merR, merB, and merA, and have studied their protein products via protein overproduction and purification, and structural and functional characterization. MeR is a metalloregulatory DNA-binding protein that acts as a repressor of both its own and structural gene transcription in the absence of Hg(II); in addition it acts as a positive effector of structural gene transcription when Hg(II) is present. MerB, organomercury lyase, catalyzes the protonolytic fragmentation of organomercurials to the parent hydrocarbon and Hg(II) by an apparent SE2 mechanism. MerA, mercuric ion reductase, is an FAD containing and redox-active disulfide-containing enzyme with homology to glutathione reductase. It has evolved the unique catalytic capacity to reduce Hg(II) to Hg(0) and thereby complete the detoxification scheme. PMID- 3277887 TI - Potential mechanisms mediating postprandial renal hyperemia and hyperfiltration. AB - Although the existence of postprandial renal hyperemia and hyperfiltration has been established, the precise mechanism governing protein-mediated increases in renal hemodynamics is not, as yet, clearly defined. Investigative effort over the past decade has provided at least two plausible mechanisms playing an important role in renal hyperemia and hyperfiltration associated with ingestion of a protein-rich meal: 1) blood-borne vasoactive agents (e.g., pancreatic glucagon and/or hepatic glomerulopressin); and 2) intrarenal mechanisms (e.g., the tubuloglomerular feedback system). Data supporting each of these two candidate mechanisms are reviewed as are data supporting the importance of other factors such as renal prostanoids, the renin-angiotensin system, and renal cyclic nucleotides. It is anticipated that future investigative effort will be stimulated by our present knowledge of postprandial renal hemodynamics so that one day we not only will know the precise mechanisms governing postprandial renal hyperemia and hyperfiltration but, in addition, may gain valuable insight into the pathogenesis of chronic renal disease. PMID- 3277888 TI - Control strategies in physiological systems. AB - In this paper, written for a general audience, I review and contrast various strategies that the body uses to control homeostasis and movement. Messages, signals, communication channels, and control systems are dealt with from both a cellular and an integrative perspective. The major global control strategies are feedback, feedforward, and adaptive control, and examples of each are presented to highlight advantageous and disadvantageous features. Many physiological systems use these three strategies in combination. PMID- 3277889 TI - Aging and the kidney: adjusting treatment to physiologic change. AB - Changes in renal physiology and function with aging--eg, morphologic changes, decreased renal blood flow, altered glomerular filtration rate, and blunted tubule response--put the elderly patient at higher risk for adverse effects of drug therapy and for undertreatment. A thorough understanding of the many age related alterations in kidney function will lead to the selection of appropriate therapy for elderly patients and, thus, the prevention of common problems such as volume depletion, infection, hyponatremia, metabolic acidosis, and excessive dosing. PMID- 3277890 TI - Differential diagnosis of pseudodementia in the elderly. AB - When depression occurs in the elderly, it may mimic dementia. The identification of depressive pseudodementia is important because this syndrome, unlike true dementia, often responds to antidepressant treatment. In this paper, the authors present strategies for differentiating pseudodementia, dementia, and coexisting depression and dementia. The treatment of depression in the elderly is also discussed. PMID- 3277891 TI - Vasculitis in older patients: presentations and significance. AB - Vasculitis is commonly considered in the differential diagnosis of systemic disease in the elderly. Because the spectrum of vasculitis is so variable, it is useful to utilize a classification system that limits the diagnostic options. Classification systems based on potential pathologic mechanisms or specific histologic findings are of limited usefulness in the initial assessment of an elderly patient. A classification system based on the clinical features exhibited will be discussed in the context of vasculitic syndromes which may present in the elderly. While this approach is by no means comprehensive, it should allow the correct diagnosis of vasculitis in the majority of cases. Common and unique presentations of vasculitis in the elderly will also be discussed. PMID- 3277892 TI - Diagnosing vitamin B12 deficiency, a common geriatric disorder. AB - Vitamin B12 deficiency in the elderly is a common disorder associated with an increased morbidity if it goes undetected, as often happens. Its diagnosis can be enhanced if the clinician recognizes the associated clinical features of nonspecific symptoms, glossitis, and dermatologic and neuropsychiatric abnormalities, and realizes the limitations of various tests (serum B12 assay, parietal cell and intrinsic factor antibody, mean corpuscular volume, and Schilling tests). Available data indicate it is sufficient to prescribe replacement B12 injections three or four times a year. PMID- 3277893 TI - Involvement of fibronectin in in vitro regeneration of retinal pigment epithelium. AB - Argon laser photocoagulation was placed on the confluent monolayer of cultured chick retinal pigment epithelial cells as a model of the regeneration process of retinal pigment epithelium after laser burn. The intense fibrillar net immunofluorescent pattern of fibronectin appeared on the burnt area from 2 h after the laser application, before the beginning of tissue reconstruction. Fibronectin was observed for several days, then became undetectable before the complete regeneration of retinal pigment epithelial cells. This indicates that fibronectin is involved in the early regeneration process of retinal pigment epithelium. PMID- 3277894 TI - Ophthalmoscopic findings in spontaneous carotid cavernous fistula: an analysis of 20 patients. AB - The pathophysiological influence of spontaneous carotid cavernous fistula (CCF) on retinal/orbital circulation is discussed. Of 20 patients, 1 case of papilloedema, 4 of choroidal detachment (CD), 2 of exudative retinal detachment (ERD) and 3 cases of central venous thrombosis (CVT) were seen, associations that on rarely reported in the literature. An elevation in the episcleral venous pressure was measured that was more than twice the normal, which explains the ophthalmoscopic findings. PMID- 3277895 TI - Routine collection of medication side effect data using computer terminals located in a senior center. PMID- 3277896 TI - The 1985 Robert W. Kleemeier award lecture. Neural and endocrine approaches to the resolution of time as a dependent variable in the aging processes of mammals. PMID- 3277897 TI - The changing structure of elderly service delivery systems. PMID- 3277898 TI - Leukocytes, oxygen radicals, and myocardial injury due to ischemia and reperfusion. AB - Ischemic myocardium generates stimuli for neutrophil chemotaxis before the final extent of irreversible ischemic injury is attained. Reperfusion accelerates the infiltration of ischemic myocardium by neutrophils. Oxygen radicals released by the activated neutrophils may exacerbate the tissue damage caused by ischemia. Neutrophil depletion by antiserum was shown to limit infarct size in dogs undergoing coronary occlusion for 90 minutes followed by reperfusion for 6 or 72 hours, but not in dogs undergoing occlusion for 4 hours. Prostacyclin, which inhibits the generation of superoxide anions by neutrophils, also limited canine myocardial injury despite no effect on collateral blood flow. Iloprost, an analogue of prostacyclin that inhibits neutrophils also reduced infarct size, while SC39902, an analogue that does not inhibit neutrophils, did not alter infarct size. The results suggest that oxygen radicals released by activated neutrophils play a role in the pathophysiology of myocardial injury due to ischemia followed by reperfusion. PMID- 3277899 TI - Oxygen-derived free radicals and 'stunned myocardium'. AB - A brief, transient period of coronary artery occlusion (less than 20 minutes in duration) followed by reperfusion does not result in irreversible myocyte injury or death, yet the regional contractile function and high energy phosphate content of the previously ischemic tissue remains depressed or 'stunned' for hours to days following reperfusion. It has been suggested that this prolonged postischemic dysfunction of viable, previously ischemic myocardium may be a consequence of oxygen-derived free radicals generated during occlusion or at the time of reperfusion. Recent evidence demonstrates that free radical scavenging agents such as superoxide dismutase (SOD) + catalase, N-2 mercaptopropionylglycine, and allopurinol, administered prior to coronary artery occlusion, significantly enhance recovery of regional contractile function of the stunned, previously ischemic tissue. This improved contractile function was not, however, accompanied by improvements in high energy phosphate metabolism: infusion of SOD + catalase did not preserve ATP stores in the previously ischemic tissue. These data support the hypothesis that oxygen-derived free radicals contribute, at least in part, to the phenomenon of the stunned myocardium. The source or mechanisms of free radical production in the setting of brief, transient ischemia, however, remains to be elucidated. PMID- 3277900 TI - Oxygen radicals in cardiac surgery. AB - Most cardiac surgical procedures require the use of prolonged induced myocardial ischemia. Experimental models of global myocardial ischemia which mimic cardiac surgical techniques have been developed to investigate the possibility of oxygen free radical development during prolonged myocardial ischemia or upon reperfusion. In such experiments, various free radical scavenging agents, including superoxide dismutase, catalase, and mannitol, have been shown to improve the tolerance of the heart to protracted global ischemia. Use of these agents has improved cardiac functional recovery and has attenuated the biochemical and structural changes which occur due to prolonged ischemia and reflow. In a recently developed porcine experimental model, the effects of preexisting regional myocardial ischemia with superimposed global ischemia and reperfusion have been studied, with free radical scavenging agents administered in an attempt to reduce myocardial infarction and improve regional functional recovery. In most such studies completed to date, free radical scavenging agents have resulted in better myocardial preservation, suggesting, at least indirectly, that there may be an oxygen free radical-mediated component of the ischemia reperfusion injury seen in such models. Techniques for directly measuring myocardial oxygen free radical levels may allow for early clarification of the development of such toxic species in the clinical cardiac surgical setting. PMID- 3277901 TI - Neurophysiological assessment of the pelvic floor. PMID- 3277902 TI - Ultrasonographic identification and measurement of the human fetal adrenal gland in utero: clinical application. AB - The size of the fetal adrenal gland was determined using ultrasonography in 346 fetuses with no complications at 28-40 weeks of gestation and in 12 fetuses of abnormal pregnancies (8 intrauterine growth retardations, 2 anencephalies, 1 intrauterine fetal death and 1 fetus of a mother who had been on steroids for treatment of systemic lupus erythematosus). The fetal adrenal gland area (FAGA), circumference (FAGC) and length (FAGL) were calculated. In 12 abnormal fetuses, FAGA values always fell below the mean +/- 2 SD. Deviations from the normal values were seen in 9 out of 12 cases (75%) in FAGC and in 4 out of 12 cases (33.3%) in FAGL. Of these pregnancies, 4 (33.3%) resulted in intrauterine fetal or neonatal death, and 2 neonates (16.6%) had to be admitted to the neonatal intensive care unit. Measurement of the fetal adrenal gland, especially of the FAGA, should be a pertinent diagnostic tool for perinatologists to manage and control high-risk pregnancies. PMID- 3277903 TI - Tamoxifen and natural progesterone as supplements to low-dose postmenopausal estrogen therapy. AB - Postmenopausal women received 1 mg estrone sulfate a day for 3 weeks in 12 sequences separated by a 7-day interval without medication and every second time by a 10-day treatment with natural progesterone, 100 mg 2 times daily (n = 16), or tamoxifen, 10 mg 2 times daily (n = 17). Both treatments alleviated climacteric symptoms, maturated the vaginal epithelium, and decreased follicle stimulating hormone, luteinizing hormone, and prolactin concentrations while lipid metabolism remained unaltered. In the estrogen-progesterone group 4 women (25%) were persistently amenorrheic, 12 (75%) experienced 1-5 bleedings per year, and 4 women had proliferative endometrium after treatments. In the estrogen tamoxifen group 11 women (65%) were amenorrheic, 6 (35%) had 1-4 bleedings per year, and 5 had proliferative endometrium. With the present treatment schedules, tamoxifen was more effective than natural progesterone in inhibiting estrogen stimulation of postmenopausal endometrium. PMID- 3277904 TI - Treatment of early chronic lymphocytic leukemia: intermittent chlorambucil versus observation. AB - The effect of early therapy on the course of chronic lymphocytic leukemia (CLL) has not been established. Fifty-nine patients with indolent Rai stage I and II CLL were randomized to receive intermittent chlorambucil once a month or to receive no treatment. The two groups were comparable in entry characteristics. At 5 years from randomization there was no significant difference in survival between the two groups although the proportion of patients exhibiting active disease 5 years after randomization is 70 per cent in the untreated group and 55 per cent in the treated group. In this study, early treatment of CLL with intermittent chlorambucil did not result in a survival advantage for patients with indolent stage I and II CLL. PMID- 3277905 TI - Immunohistochemical localization of cytochrome P-450C21 in human adrenal cortex and its relation to endocrine function. AB - Cytochrome P-450C21 was successfully demonstrated in the human adrenal glands by a peroxidase-antiperoxidase method. All three cortical layers were stained in the normal adrenal glands, particularly the zonae glomerulosa and reticularis. Well stained and faintly stained cells were intermingled in the zona fasciculata, suggestive of intrazonal variations. The immunoreactivity was particularly intense at the site of ACTH action, i.e., cells in micronodules and cells around myelolipomatous lesions in adrenocortical hyperplasia of Cushing's disease and sites of regeneration in the normal adrenal glands. In adrenocortical adenomas with Cushing's syndrome and primary aldosteronism, cells with large nuclei were generally stained well. In the adrenocortical tissue adjacent to a functioning adenoma, the immunoreactivity was observed only in the zona glomerulosa, especially in cases of primary aldosteronism. This finding is consistent with morphologic observations. PMID- 3277906 TI - Cell- and tissue-specific expression of a 34,000-molecular-weight peptide growth factor in humans. AB - A 34,000-dalton peptide growth factor that we originally identified in human placental trophoblasts and in certain carcinomas was shown to be expressed in several normal human tissues. A highly specific antibody to the trophoblast derived growth factor was used in an immunoperoxidase staining technique to identify the immunoreactive peptide in tissue sections. Immunoreactivity was seen in the adrenal cortex, Leydig cells of the testes, and follicular cells of the thyroid. In addition, strong staining was seen in the ducts and terminal ductules of the pancreas, in glandular epithelium of the prostate, in the chief cells of the stomach, and in the columnar epithelium of the trachea and bronchus of the lung. Certain tissues were negative for the peptide, including the adrenal medulla, liver, esophagus, small intestine, colon, bladder, lymph node, spleen, bone marrow, and thymus. Thus, the expression of the peptide depends on cell lineage and the state of differentiation; tissues of hematopoietic lineage are devoid of the 34,000-dalton peptide, whereas some of the major hormone-secreting tissues that are under pituitary control show the highest immunoreactivity. PMID- 3277907 TI - Mucin production in metastatic papillary carcinoma of the thyroid. AB - Although textbooks often state that demonstration of mucin in a metastatic carcinoma excludes the possibility of a thyroidal primary tumor, mucin recently has been reported in various types of thyroid carcinoma, particularly medullary carcinoma. The presence of mucin in papillary carcinoma has not been extensively studied, even though this tumor not uncommonly presents with lymph node metastasis. We stained 40 lymph nodes containing metastatic papillary carcinoma of the thyroid for mucin. Mucin was demonstrable by mucicarmine stain in the colloid, luminal borders, and cytoplasm in 18 (45%), 9 (22.5%), and 7 (17.5%) cases respectively; 17 cases (42.5%) were completely negative. With alcian blue staining, mucin was seen in 9 (22.5%), 9 (22.5%), and 7 (17.5%) cases; 25 cases (62.5%) were negative. Most of the cytoplasmic vacuoles were target-like, with a peripheral rim of sulfated acid mucin and a central core of neutral mucin. The psammoma bodies stained consistently with mucicarmine, alcian blue, and periodic acid-Schiff. We conclude that papillary carcinoma of the thyroid should be included in the differential diagnoses for a mucin-producing metastatic carcinoma. PMID- 3277908 TI - Immunohistochemical study of cerebral amyloid angiopathy: use of an antiserum to a synthetic 28-amino-acid peptide fragment of the Alzheimer's disease amyloid precursor. AB - A polyclonal antibody to a synthetic peptide representing a 28-amino-acid sequence of the previously isolated and described Alzheimer's disease amyloid precursor was raised in rabbits. The antibody was used in conjunction with an avidin-biotin-peroxidase technique to stain cerebral microvessels involved by amyloid angiopathy and senile "neuritic" plaque amyloid cores. The staining method has significant advantages over standard histologic techniques used to demonstrate brain amyloid and might have important practical applications in the study of microvascular lesions associated with cerebral amyloid angiopathy, as well as in studies on the pathogenesis of Alzheimer's disease or senile dementia of Alzheimer type. PMID- 3277909 TI - Index of titles and authors 1969-1987. PMID- 3277910 TI - Serotoninergic mechanisms in hypertension. Focus on the effects of ketanserin. AB - Aggregating platelets release serotonin, which induces contraction of most vascular smooth muscle by activation of S2-serotoninergic receptors. Serotonin released in the circulation may contribute to the increase in peripheral resistance of hypertension as the responsiveness of blood vessels from hypertensive animals and humans to the vasoconstrictor action of the monoamine is augmented. The data obtained with the new antihypertensive agent ketanserin may favor that interpretation. Ketanserin is a selective S2-serotoninergic antagonist with additional alpha 1-adrenergic blocking properties. In humans, it has a terminal half-life of 12 to 25 hours and is eliminated predominantly by the liver. The hemodynamic profile of ketanserin is that of a vasodilator drug with actions on both resistance and capacitance vessels. On short-term intravenous administration, it lowers blood pressure in hypertensive patients with minimal reflex changes in cardiovascular function. When given orally long term to hypertensive patients, ketanserin causes a sustained reduction in arterial blood pressure, comparable to that obtained with either beta-adrenergic blockers or diuretics. Several studies have shown a greater efficacy in older (greater than 60 years of age) than in younger patients independent of starting pressure. Side effects mainly consist of dizziness, somnolence, and dry mouth, but they are usually not severe. The mechanism underlying the antihypertensive effect of ketanserin is unclear. It cannot be attributed to either S2-serotoninergic or alpha 1-adrenergic blockade alone, but an interaction between the two effects appears to be required. PMID- 3277911 TI - Role of thromboxane A2 in the hypotensive effect of captopril in essential hypertension. AB - We have previously reported that captopril stimulates thromboxane A2 synthesis in patients with essential hypertension. In the present study, the hypotensive effects of captopril and OKY-046, a selective inhibitor of thromboxane A2 synthetase, were studied in nine patients with essential hypertension to determine whether thromboxane A2 is involved in the regulation of blood pressure. A single oral dose of OKY-046 (400 mg) decreased urinary thromboxane B2 (a stable metabolite of thromboxane A2) excretion significantly (from 113 +/- 19.0 to 51.0 +/- 6.1 pg/min; p less than 0.01) and increased urinary sodium excretion significantly (from 73.0 +/- 15.3 to 113.0 +/- 14.4 microEq/min; p less than 0.01), but no change was observed in mean arterial pressure. The administration of OKY-046 (600 mg/day) for 3 days induced a significant and sustained decrease in urinary thromboxane B2 excretion, but it did not affect the mean arterial pressure. Although captopril (50 mg) alone induced a significant increase in urinary thromboxane B2 excretion (from 91.4 +/- 11.0 to 297.3 +/- 30.8 pg/min; p less than 0.001) and a significant decrease in mean arterial pressure (from 97.0 +/- 4.7 to 88.1 +/- 5.1 mm Hg; p less than 0.01), captopril in combination with OKY-046 induced a decrease both in urinary thromboxane B2 excretion (from 70.8 +/ 12.3 to 54.2 +/- 14.7 pg/min; p less than 0.01) and in mean arterial pressure (from 105.1 +/- 3.8 to 84.2 +/- 3.6 mm Hg; p less than 0.01). Thus, the hypotensive effect of captopril was potentiated by OKY-046. OKY-046 did not affect the changes in plasma renin activity and plasma aldosterone concentration and blunted urinary prostaglandin E2 and 6-keto-prostaglandin F1 alpha excretion in response to captopril. These results indicate that thromboxane A2 counteracts the hypotensive effect of captopril in patients with essential hypertension. PMID- 3277912 TI - Crossover design to test antihypertensive drugs with self-recorded blood pressure. AB - In a double-blind, within-patient study, blood pressure was measured at regular intervals at the clinic by the physician and each day at home by the patient. Both methods of blood pressure measurement demonstrated an antihypertensive effect of the diuretics chlorthalidone (25 mg) and triamterene (50 mg) and the beta-blocker oxprenolol (160 mg) and the greater efficacy of the combination of the two therapies. During placebo, as well as during active treatment, blood pressure values were higher at the clinic than at home, except when the patients were taking the beta-blocker, which minimized the arousal response during blood pressure measurements in the clinic. With 2-week treatment periods, separated by 2 weeks of placebo administration, blood pressure returned toward its initial level after each of the three treatments and none of the carryover effects was significant at the 5% level. This methodology was intended to make it possible to demonstrate in 27 patients at the clinic and in 20 patients with measurements made at home, at the usual statistical risks (alpha = 5%, beta = 10%), a fall of 5 mm Hg in diastolic blood pressure in comparison with a placebo. Moreover, at the end of this 3-month follow-up, each patient could continue to receive the treatment that was the most effective and the best tolerated. In conclusion, the use of a within-patient trial design, with a 15-day washout period between active treatments and careful recording of blood pressure values, can minimize the number of patients included in hypertension trials and offer to each patient the possibility of individualization of treatment. PMID- 3277913 TI - Purinergic receptors in the brainstem mediate hypotension and bradycardia. AB - Adenosine acts at many sites to modulate neuronal activity. The purpose of this study was to investigate a possible role for adenosine as a neuromodulator of brainstem cardiovascular control. Microinjections of adenosine (0-2.3 nmol) were made stereotaxically into various brainstem sites. Injection of adenosine into the nucleus tractus solitarii (NTS) produced dose-related decreases in heart rate and systolic and diastolic blood pressures. Maximal changes occurred 90 seconds after injection. Injection into the area postrema also produced decreased heart rate and systolic and diastolic blood pressures. No significant effect occurred following injection into the C1 area. Adenosine 5'-triphosphate and its analogue, beta, gamma-methylene adenosine 5'-triphosphate also produced dose-related and potent vasodepressor and bradycardia effects in the NTS. Injection of 1,3 dipropyl-8-p-sulfophenylxanthine (0.92 nmol), a potent adenosine receptor antagonist, produced no effect itself, but abolished for 45 minutes the actions of further injections of adenosine and adenosine 5'-triphosphate (but not L glutamate) in both the NTS and area postrema. Thus, NTS and area postrema injections of adenosine decrease blood pressure and heart rate in anesthetized normotensive rats through adenosine receptors located in these areas. These findings support a role for endogenous adenosine as a central modulator in cardiovascular control. PMID- 3277914 TI - Interactions between human natural killer (NK) lymphocytes and yeast cells: human NK cells do not kill Candida albicans, although C. albicans blocks NK lysis of K562 cells. AB - Rodent natural killer (NK) lymphocytes are cytotoxic to certain fungi. We investigated whether human NK cells are cytotoxic to the yeast Candida albicans. We found that human peripheral blood lymphocytes possessing NK cell activity had little or no effect on the viability of the yeast. Unopsonized C. albicans, however, were able to block NK cell-mediated cytotoxicity at a ratio of 100 yeast to one K562 erythroleukemia cell. C. albicans was not toxic to the lymphocytes nor did it take up isotope released by the K562 cells. Furthermore, C. albicans that was pretreated with human serum blocked NK cell activity more than did untreated C. albicans. Binding of the yeasts to NK cells could account for the blocking effect of serum-treated yeasts, but not for that of the untreated yeasts. Flow cytometry indicated that there was preferential binding of C. albicans to NK lymphocytes but not to T cells when the yeasts were pretreated with human serum. In this report we affirm the results of the study by Vecchiarelli et al. (A. Vecchiarelli, F. Bistoni, E. Cenci, S. Perito, and A. Cassone, Sabouraudia 23:377-387, 1985), that the first report of rodent NK cell activity against the yeast Cryptococcus neoformans (J. W. Murphy and D. O. McDaniel, J. Immunol. 128:1577-1583, 1982) cannot be extrapolated to a general phenomenon of unprimed lymphocyte-mediated destruction of all species of yeast. Our data extend the observations to humans and also suggest that in vivo interactions between NK lymphocytes and opportunistic fungal pathogens may affect NK cell function. PMID- 3277915 TI - Antigenic differences in the surface mannoproteins of Candida albicans as revealed by monoclonal antibodies. AB - Monoclonal antibodies to Candida albicans were prepared with blastoconidia bearing germ tubes used as the immunogen. Four antibodies reacted by immunofluorescence with surfaces of C. albicans as well as Candida stellatoidea, Candida tropicalis, and several strains of C. albicans, but not with Torulopsis glabrata. One antibody reacted with Saccharomyces cerevisiae. In addition, the monoclonal antibodies precipitated material of approximately 200 kilodaltons when tested against metabolically labeled blastoconidia digests. The monoclonal antibodies exhibited heterogeneous staining of C. albicans surfaces, as shown by immunofluorescence. None of the monoclonal antibodies were specific to germ tubes. More importantly, however, two of the monoclonal antibodies reacted with the mannoprotein precipitin arc of C. albicans that was produced by reference rabbit polyclonal antisera by crossed immunoelectrophoresis, thus linking the heterogeneity seen by immunofluorescence to the heterogeneity in mannoproteins. Finally, three of the monoclonal antibodies reacted with a glycan fraction of cell digests, indicating their reactivity with the carbohydrate portion of the mannoprotein. PMID- 3277916 TI - Expression of extracellular acid proteinase by proteolytic Candida spp. during experimental infection of oral mucosa. AB - We traced an acid proteinase from Candida spp. in the initial stages of the pathogenesis of the mycosis. On infection of human buccal mucosa, proteinase antigens were detected by immuno-scanning electron microscopy on the surface of adhering blastoconidia and invading filamentous cells of C. albicans serotype A. Proteinase antigens were also present on blastoconidia of C. albicans serotype B, but were missing on filamentous cells of this serotype. Proteolytic isolates of C. tropicalis behaved like C. albicans serotype A. An isolate of C. parapsilosis did not express the proteinase antigen under conditions of this study. After infection of mucosa, culture medium of C. albicans or C. tropicalis showed a time dependent accumulation of acid proteolytic activity, indicating that the visualized antigens represent active proteinase. No such activity was detected in the medium of C. parapsilosis. Preliminary experiments with the proteinase inhibitor pepstatin A revealed an 89% reduction of mucosal adherence of C. albicans (serotype A). These results suggest that Candida proteinase is involved in fungal attachment. The pattern of adherence reflects the differential expression of secretory proteinase by different candidal strains. PMID- 3277917 TI - Recombinant interleukin-2 limits the replication of Mycobacterium lepraemurium and Mycobacterium bovis BCG in mice. AB - BALB/c mice were infected with Mycobacterium lepraemurium in the footpad or with Mycobacterium bovis BCG intravenously with 5 x 10(7) bacilli. Recombinant interleukin-2 (IL-2) was injected intraperitoneally as a single dose (20,000 U), as a single course of five injections (400 U each), or as a 6-month course starting 3 days after the M. lepraemurium infection. BCG-infected mice received a single dose (1,000 U) or five daily injections of 100 or 1,000 U each. IL-2 significantly reduced the total bacterial counts in the footpad, lymph nodes, and liver of M. lepraemurium-infected mice (50 to 85%) by 6 months and viable counts in the spleen (30 to 50%) by 60 days after BCG infection. The courses of IL-2 started at 60 days were more effective than those started at 3 days after M. lepraemurium infection (P less than 0.05 to 0.001), and for BCG, 100 U of IL-2 was better than 1,000 U (P less than 0.05 to 0.01). These results indicate that IL-2 limits mycobacterial infections in mice and raise the question of its possible use in humans. PMID- 3277919 TI - Autoantibodies to the mitotic spindle apparatus in Mycoplasma pneumoniae disease. AB - Antibodies to the mitotic spindle apparatus (MS) have been detected in only a very few patient sera studied for antinuclear antibodies by routine screening (G. A. McCarty, D. W. Velencia, and M. J. Fritzler, J. Rheumatol. 11:213-218, 1984). We found anti-MS antibodies to be quite common in sera from patients with Mycoplasma pneumoniae, especially in those who developed cold agglutinins (71%). Absorption experiments indicated that the formation of anti-MS antibodies is not triggered by epitopes on the M. pneumoniae surface. These antibodies were distinct from cold agglutinins, antibrain antibodies, and smooth-muscle antibodies. All patients previously reported to harbor anti-MS had clinical features compatible with a diagnosis of systemic lupus erythematosus, rheumatoid arthritis, or an evolving connective-tissue disorder. Such systemic disorders might develop in a small proportion of patients who have had M. pneumoniae illness. PMID- 3277918 TI - Liposomes, lipid A, and aluminum hydroxide enhance the immune response to a synthetic malaria sporozoite antigen. AB - A liposome-encapsulated cloned protein (R32tet32) containing sequences from the tetrapeptide repeat region of the circumsporozoite protein of Plasmodium falciparum sporozoites was examined for immunogenicity with rabbits and monkeys. Effects of adjuvants were tested by encapsulation of the antigen in liposomes either lacking or containing lipid A and adsorption with aluminum hydroxide (ALUM). When rabbits were immunized with R32tet32 alone, a primary antibody response was not seen and a secondary response did not appear until 32 to 36 weeks after boosting. Immunization with ALUM-adsorbed R32tet32 resulted in a minimal primary antibody response. A moderate secondary antibody response was detected within 2 weeks after boosting, but antibody levels decreased to preimmunization levels 8 weeks after boosting. When R32tet32 was encapsulated in liposomes containing lipid A, strong primary and secondary antibody responses were observed. Strong primary and secondary responses also were obtained when R32tet32 was encapsulated in liposomes either containing or lacking lipid A and the liposomes were adsorbed with ALUM. The strongest antibody response was obtained by immunization with ALUM-adsorbed liposomes containing lipid A and R32tet32, suggesting that the adjuvant effects of liposomes, lipid A, and ALUM were additive or synergistic. PMID- 3277920 TI - Acute myocardial infarction: pathogenesis and implications for treatment. Where do we go now? PMID- 3277921 TI - Effect of combined administration of a prostacyclin analogue and adriamycin against the artificial metastasis of Meth A cell. AB - Antimetastatic effect of a stable prostacyclin analogue (PGI2-TEI8153) in combination use with adriamycin (ADM) was investigated. Meth A cell, which had membrane protein of 18,000 daltons specifically bound to platelets, induced platelet aggregation dose-dependently. This platelet aggregation was totally suppressed by PGI2-TEI8153. PGI2-TEI8153 also suppressed the pulmonary arrest as well as pulmonary metastasis of Meth A cells. Combined use of PGI2-TEI8153 and ADM exerted much less antimetastatic effect than that with PGI2-TEI8153 alone, indicating the counteracting effect of ADM against the PGI2-TEI8153. However, this combination use brought about additive antimetastatic effects with 2-fold reduction of pulmonary nodules compared to that of ADM alone. Consequently, even the anticancer drug itself has a negative influence on metastasis, the combined use of PGI2-TEI8153 with it is promising for the prevention of metastasis. PMID- 3277922 TI - Periarticular calcification in immunosuppressed cardiac transplant patients. AB - A retrospective study was performed to determine whether the likelihood of developing periarticular calcification in the hands is increased significantly in cardiac transplant patients. Two groups of patients were identified: those whose transplant occurred before the routine use of Cyclosporine as an immunosuppressive agent and those who received Cyclosporine at the time of transplantation. Seven of nine patients in the former group demonstrated periarticular calcification at multiple sites in the hands, but no patient in the post-Cyclosporine group had calcification at more than one site. Cardiac transplant patients on high dose systemic steroids for an extended period of time are likely to develop periarticular calcification. This appears to be related to steroid dose and duration of treatment and also may be influenced by other immunosuppressive agents. PMID- 3277923 TI - Interventional radiology 1988. PMID- 3277924 TI - Quantitative digital subtraction coronary angiography using videodensitometry. An in vivo analysis. AB - A videodensitometric method for measuring absolute cross-sectional area and diameter has been tested in living dogs with coronary artery stenoses created surgically by placement of small Silastic cuffs. Coronary arteriograms were performed using a circular tomographic unit to provide multiple views of each lesion, and measurements were made from logarithmically subtracted digital images. Dimensions of 13 stenoses of cross section 1 to 5 mm2 and adjacent reference segments (2 to 9 mm2) were determined by histologic sectioning of the segments after injection with a rapidly hardening plastic fixative under physiologic pressure. Two different methods were tested for calculating cross sectional area. On 238 measurements, 102 of normal vessel segments and 135 of stenoses, both methods showed good correlation with histologic measurements, with slopes of 0.929 + (SD) 0.037 (r = 0.8563) and 0.948 + (SD) 0.037 (r = 0.8554). Multiple measurements of each segment produced values within 30% of the true absolute cross sectional area in most cases. The method shows promise as a means for quantitating absolute dimensions of vessels in clinical arteriography. PMID- 3277925 TI - The effect of aspartame on migraine headache. PMID- 3277927 TI - Health care requirements planning: a conceptual framework. AB - A clearly defined closed-loop operations management system comparable to the Manufacturing Resource Planning System (MRP-II) does not exist in the health care industry. Therefore, a study was conducted to evaluate the basic modules of MRP II in terms of their applicability for developing a workable health care requirements planning system. PMID- 3277926 TI - Metoprolol in the prophylaxis of migraine: parallel-groups comparison with placebo and dose-ranging follow-up. PMID- 3277928 TI - Controlling disenrollment in health maintenance organizations. AB - With increasing competition, health maintenance organizations (HMOs) are struggling to maintain their enrollment levels. As a result, growing interest has emerged in studies of disenrollment, including factors associated with disenrollment and its implications for the HMO manager, as well as approaches for measuring and monitoring disenrollment. PMID- 3277929 TI - Strategy formulation in hospitals. AB - By acknowledging the inherent antagonism between strategic planning and the structure and function of hospitals, and explicitly integrating and adapting existing models, hospital administrators can develop a strategy formulation process into an operational tool. PMID- 3277930 TI - Acquired immune deficiency syndrome: an overview. PMID- 3277931 TI - Improved survival of poor prognosis diffuse histiocytic (large cell) lymphoma managed with sequential induction chemotherapy, "boost" radiation therapy, and autologous bone marrow transplantation. AB - From 1981 to 1985, 33 patients with the diagnosis of diffuse histiocytic (large cell) lymphoma (DHL) with a poor prognosis received induction multi-drug chemotherapy followed by autologous marrow cryopreservation. Thirty patients who had residual disease after chemotherapy were given "boost" irradiation to these sites, followed immediately by hyperfractionated total body irradiation, 1320 to 1375 cGy in 11 fractions over 4 days, then cyclophosphamide (60 mg/kg/d) for 2 days. All patients received an autologous bone marrow transplant (ABMT), with 15 patients receiving marrow purged with 4-hydroperoxycyclophosphamide. Patients were transplanted either as part of a planned induction-transplant approach (Group I), or as salvage after relapse on the same induction regimen (Group II), or other conventional chemotherapy regimens (Group III). In the entire group, 16 of 33 patients (48%) are alive free of lymphoma with a median follow-up of 32 months (11 to 53 mo). Actuarial (Kaplan-Meier) survival is 51% at 2 years and 46% at 3 years, with only 1 patient dying after 2 years out of 11 at risk. Eight patients (24%) succumbed to early treatment related complications. Nine patients (27%) died from relapse. Patients receiving ABMT as planned sequential therapy post-induction (Group I) did significantly better than patients given ABMT as salvage therapy after relapse on prior chemotherapy (Groups II and III) and better than the historical group of patients treated with chemotherapy alone. At 2 years, the survival in Group I is 79% versus 0% for Group II versus 48% for Group III. Historically, this group of high risk patients had a 2-year disease free survival of 20% or less with chemotherapy alone. PMID- 3277932 TI - Dose-limiting complications from upper half body irradiation in C3H mice. AB - This investigation evaluates the usefulness of an experimental technique in mice that has been used to study lung tolerance as a major dose-limiting tissue in clinical radiotherapy. The pathological sequalae of upper half body irradiation using a range of single and fractionated (2 Gy per fraction once or twice daily) doses was characterized in C3H/HeJ mice. Four phases of potentially lethal syndromes were revealed starting with the very acute effects of oral inflammation within 1 month. Incisor damage occurred between 1 and 3 months when the supplying of powdered food appeared to prevent lethality from starvation. Single radiation doses then produced a predictable incidence of pneumonitis (3 to 6 months) followed by pleural effusions (6 to 12 months). These later two syndromes were absent in mice that survived the acute effects of fractionated UHBI. In accordance with other rapidly proliferating tissues, the estimated alpha/beta ratios for oral epithelial and incisor damage were notably larger than that previously reported for lung. This denotes the smaller capacity of the acute responding target cells to repair sublethal damage. The consequent predominance of acute reactions in the fractionated courses therefore confined the maximal tolerated dose to that which produced an unmeasurable level of pulmonary injury. Our discussion of these results warn against the simple extrapolation of fractionated or low dose rate UHBI lethality data from mouse to man without due consideration of extrapulmonary radiation effects. PMID- 3277933 TI - Modification of radiation-induced damage to bone marrow stem cells by dose rate, dose fractionation, and prior exposure to cytoxan as judged by the survival of CFUs: application to bone marrow transplantation (BMT). AB - The relative importance of the effects of dose rate, dose fractionation, and prior exposure to Cytoxan on the recovery of cells in the bone marrow, following conditioning for BMT, remains controversial. Traditionally, bone marrow stem cells and leukemic cells have been considered as having a limited ability to repair radiation-induced damage following total body irradiation (TBI) compared to cells of the lung (the dose-limiting tissue for TBI). We examined the survival response of the bone marrow stem cells of mice (CFUs) at three TBI dose rates (0.47, 0.25 and 0.08 Gy/min). The radiation response of CFUs (compilation Do = 0.75 Gy) was independent of dose rate. One TBI dose fractionation was chosen: two fractions per day, separated by 6 hours, for 3 days. The radiation survival curve of CFUs showed a compilation Do of 1.09 Gy, compared to 0.75 Gy for the one fraction case. The recovery of CFUs following 2 days of Cytoxan demonstrated an "overshoot," whereas recovery of CFUs was incomplete, even by day 23, following the initiation of the complete conditioning regimen of Cytoxan plus TBI. These data demonstrate no significant effect of dose rate, at least in the range 0.08 to 0.48 Gy/min, on the survival of CFUs following either single or six fractionated TBI doses. However, the statistically significant difference in the Do of CFUs in going from one to six fractions has direct application to bone marrow transplantation techniques. Moreover, Cytoxan, at least at 200 mg/kg for 2 days, prior to TBI, appears to have only a marginal modifying effect on the eventual recovery of CFUs. PMID- 3277934 TI - Research workers I have known. PMID- 3277935 TI - Applications of ultrasonography in the diagnosis of parenchymal kidney disease in cats: 24 cases (1981-1986). AB - Renal sonograms from 24 cats with confirmed parenchymal kidney disease and from 1 cat with radiographic and palpable evidence of renal enlargement (but without identifiable histologic abnormalities) were evaluated to describe the ultrasonographic appearance of feline renal diseases and to determine the role of ultrasonographic examination in the clinical evaluation of these cases. In all cats with radiographic evidence of abnormal renal size or contour and when poor intraabdominal radiographic contrast precluded visualization of the kidneys, ultrasonography provided complementary information pertaining to location (cortical/medullary), extent, and distribution (focal/multifocal/diffuse) of disease. Ultrasonography also characterized these lesions as cystic (cavitating) or solid. The echo patterns were most specific for renal cysts. Infiltrative diseases did not have consistent patterns. Multifocal hypoechoic nodules, diffuse cortical hyper-echogenicity, and normal-appearing parenchyma were identified. In these instances, however, ultrasonography did define the extent of disease and narrowed the spectrum of differential considerations. PMID- 3277936 TI - Perceiving mitosis in eukaryotic cells. AB - A sensitive method has been developed for visualizing eukaryotic cells in mitosis (M) phase. It employs Zenker's fixative, which makes the plasma membrane but not the nuclear envelope permeable to immunoglobulins. Zenker's-fixed cells are exposed to an antibody which recognizes a major constituent of chromatin. In this case the antibody is a monoclonal (MC 21) which recognizes histone H2b. Because cells in M phase do not have an intact nuclear envelope, the antibody has access to and interacts with their chromatin. The presence of a nuclear envelope in Zenker's-fixed interphase cells precludes access of the antibody to the nuclear chromatin. Consequently, this indirect immunofluorescence procedure selectively labels M-phase cells. At high enough magnification some details of the chromatin figures are revealed. MC 21 recognizes the chromatin of cells of many different species. With appropriate fixation it can be used effectively on cells in culture. With some procedural modifications it can also be used with more complex tissue systems. Detailed mitotic patterns for chick embryos up to Day 3 of development have been obtained by this method. PMID- 3277937 TI - Membrane antigens of human bronchial epithelial cells identified by monoclonal antibodies. AB - Subpopulations of normal bronchial epithelial cells were identified using a series of murine monoclonal antibodies. These antibodies were used to stain intact bronchial epithelial cells in culture by indirect immunofluorescence. LAM 2 reacted with 80%, LAM 6 with 75%, LAM 7 with 60%, and LAM 8 with 5% of these cells. Sections of human bronchial epithelium were also stained with these antibodies by immunoperoxidase methods. LAM 2 was found to bind with 80%, LAM 6 with 65%, LAM 7 with 50%, and LAM 8 with less than 1% of bronchial epithelial cells. LAM 2 stained both columnar epithelial cells and basal cells; LAM 6 stained mainly basal cells and only a small proportion of columnar cells; LAM 7 showed specificity for basal cells; LAM 8 distinctly stained single cells in the basal cell layer. These antibodies were previously shown to react with the surface membrane of human lung carcinomas, ranging from the broad reactivity of LAM 2 with small cell and non-small cell lung cancers to the highly restricted reactivity of LAM 8 with small cell carcinomas of the lung. Thus, membrane antigens have been identified in bronchial epithelial cells by monoclonal antibodies which exhibit a similar range of cellular reactivity in vitro as in vivo. Inasmuch as these antibodies recognize subsets of cells which could not be easily distinguished by morphologic characteristics, these reagents may be useful in classifying bronchial epithelial cells. PMID- 3277938 TI - Liver epithelial cell migration induced by epidermal growth factor or transforming growth factor alpha is associated with changes in the gene expression of secreted proteins. AB - Rat liver epithelial cells are induced to migrate by epidermal growth factor (EGF) or transforming growth factor alpha (TGF-alpha) in serum-free medium supplemented with insulin. Immunohistological staining of the migration tracks containing laminin and fibronectin has allowed a quantitative analysis of the process. The growth factor-induced migration is relatively slow, but very efficient. Between 24 and 48 h after exposure to EGF (or TGF-alpha), 50 to 70% of the cells have migrated away from their site of initial attachment and spreading. This delayed effect of the interaction of the receptor with its ligands is associated with changes in gene expression, but is not associated with a stimulation of cell proliferation. In serum-free medium supplemented with insulin, the cells secrete six major proteins, as revealed by SDS-polyacrylamide gel electrophoresis. The media of cultures supplemented with insulin plus EGF (or TGF-alpha) contain in addition two new proteins and an increased amount of fibronectin. One secreted protein is synthesized in significantly reduced amounts. The most conspicuously EGF-induced protein (EIP-1; Mr 47,000) is detected within 2 h, depends on the continued presence of the growth factor, and has not been detected as bound to the substratum. The stringent regulation of EIP 1 suggests that this gene product might participate in the modulation of the changes induced by the growth factor. The system is being used for the further analysis of the regulation of gene expression by EGF and of the migration of normal and neoplastically transformed epithelial cells. PMID- 3277939 TI - In vitro cytodifferentiation of perinatal rat islet cells within a tridimensional matrix of collagen. AB - Cell suspensions prepared by collagenase digestion of pancreases obtained from rat fetuses (21.5 d old) and newborns (2.5 d old) were mixed with a collagen solution and inoculated on a collagen base layer. At the onset of the culture, most acinar cells became necrotic, whereas other epithelial cells proliferated. Most of the cell clusters arranged themselves into simple polarized structures composed of epithelial cells forming hollow spheres, and from these budded neoformed endocrine islets. Scarce fibroblasts were located close to these structures. Immunocytochemical localization of insulin and glucagon, as well as ultrastructural characteristics of the cell types revealed an intrainsular distribution similar to the in vivo localization. Tridimensional matrix of collagen offers, to perinatal pancreatic cells in culture, an environment close to the in vivo conditions: cells reorganize themselves in tissuelike structures and cell interactions concerned in the cytodifferentiation of pancreatic islets occur. This system allows for the study of undifferentiated epithelial cells--the presumed stem cells--differentiating and differentiated endocrine cells in the same preparation. PMID- 3277940 TI - Child and adolescent psychiatry come of age: a fifty year perspective. PMID- 3277941 TI - Extrafamilial information sources in the study of childhood depression. PMID- 3277942 TI - Genetic analysis of an Escherichia coli urease locus: evidence of DNA rearrangement. AB - Ureolytic Escherichia coli strains are uncommon clinical isolates. The urease phenotype in a large percentage of these isolates is unstable and lost upon storage. We examined two urease-positive uropathogenic E. coli isolates that give off urease-negative segregants and determined that the urease phenotype was chromosomally encoded. The urease phenotype was cloned from E. coli 1021 and found to be encoded on a 9.4-kilobase HindIII restriction fragment. Transposon mutagenesis indicated that at least 3.2 kilobases of this fragment were necessary for production of urease. The urease recombinant plasmid pURE coded for at least four insert-specific polypeptides as determined by maxicell analysis. Disruption of the region encoding two of these polypeptides (67 and 27 kilodaltons) abolished urease activity. Analysis by Southern hybridization of urease-positive E. coli 1021 and seven independently isolated urease-negative segregants showed that a DNA rearrangement was associated with the urease-negative phenotype. PMID- 3277943 TI - Bacillus sporulation gene spo0H codes for sigma 30 (sigma H). AB - The DNA sequences of the spo0H genes from Bacillus licheniformis and B. subtilis are described, and the predicted open reading frames code for proteins of 26,097 and 25,447 daltons, respectively. The two spo0H gene products are 91% identical to one another and about 25% identical to most of the procaryotic sigma factors. The predicted proteins have a conserved 14-amino-acid sequence at their amino terminal end, typical of sigma factors. Antibodies raised against the spo0H gene product of B. licheniformis specifically react with RNA polymerase sigma factor protein, sigma 30, purified from B. subtilis. We conclude that the spo0H genes of B. licheniformis and B. subtilis code for sigma 30, now known as sigma H. PMID- 3277944 TI - Control of bacterial alkaline phosphatase synthesis and variation in an Escherichia coli K-12 phoR mutant by adenyl cyclase, the cyclic AMP receptor protein, and the phoM operon. AB - Mutant phoR cells show a clonal variation phenotype with respect to bacterial alkaline phosphatase (BAP) synthesis. BAP clonal variation is characterized by an alternation between a Bap+ and Bap- phenotype. The switching is regulated by the phoM operon and the presence of glucose; the pho-510 mutant form of the phoM operon abolishes both BAP clonal variation and the effect of glucose (B.L. Wanner, J. Bacteriol. 169:900-903, 1987). In this paper we show that a mutation of the adenyl cyclase (cya) and the cyclic AMP receptor protein (crp) gene also abolish BAP clonal variation; either simultaneously reduces the amount of BAP made in phoR mutants. Also, the pho-510 mutation is epistatic; it increases BAP synthesis in delta cya phoR and delta crp phoR mutants. These data are consistent with the wild-type phoM operon having a negative, as well as a positive, regulatory role in gene expression. Furthermore, the data suggest that adenyl cyclase and Crp indirectly regulate BAP synthesis in a phoR mutant via an interaction with the phoM operon or its gene products. However, phoM operon expression was unaffected when tested with phoM operon lacZ transcriptional fusions. In addition, the switching Bap phenotype was not associated with an alternation in phoM operon expression. PMID- 3277946 TI - Effect of growth stage on mycolic acid structure in cell walls of Nocardia asteroides GUH-2. AB - Mycolic acids were extracted from the cell walls of Nocardia asteroides GUH-2 during different phases of growth at 37 degrees C. These were subjected to structural analysis by combining thin-layer chromatography and gas-liquid chromatography with UV and infrared spectrophotometry and mass spectroscopy of both methyl esters and trimethyl silyl derivatives. By analyzing the fragmentation patterns of these derivatives by three different methods of mass spectroscopy combined with gas-liquid chromatographic separation, the different structural subclasses of mycolic acids were quantitated. Significant qualitative and quantitative modifications of specific mycolic acid subclasses occurred in the cell walls of N. asteroides GUH-2 that were growth stage dependent. The mycolic acids that were predominant in the log phase were polyunsaturated (greater than 2 double bonds per molecule), with long chain lengths and even carbon atom numbers (i.e., C54, C56). In contrast, those that were prominent in the stationary phase were more saturated (few or no double bonds) and of shorter overall carbon chain length (less than or equal to C52). Furthermore, stationary phase cells had significantly increased amounts of mycolic acids with odd numbered carbon chain lengths (i.e., C49, C51, C53). PMID- 3277945 TI - Physiological and structural analysis of light-harvesting mutants of Rhodobacter sphaeroides. AB - Two mutants of Rhodobacter sphaeroides defective in formation of light-harvesting spectral complexes were examined in detail. Mutant RS103 lacked the B875 spectral complex despite the fact that substantial levels of the B875-alpha polypeptide (and presumably the beta polypeptide) were present. The B800-850 spectral complex was derepressed in RS103, even at high light intensities, and the growth rate was near normal at high light intensity but decreased relative to the wild type as the light intensity used for growth decreased. Mutant RS104 lacked colored carotenoids and the B800-850 spectral complex, as well as the cognate apoproteins. This strain grew normally at high light intensity and, as with RS103, the growth rate decreased as the light intensity used for growth decreased. At very low light intensities, however, RS104 would grow, whereas RS103 would not. Structural analysis of these mutants as well as others revealed that the morphology of the intracytoplasmic membrane invaginations is associated with the presence or absence of the B800-850 complex as well as of carotenoids. A low-molecular-weight intracytoplasmic membrane polypeptide, which may play a role in B800-850 complex formation, is described, as is a 62,000-dalton polypeptide whose abundance is directly related to light intensity as well as the absence of either of the light-harvesting spectral complexes. These data, obtained from studies of mutant strains and the wild type, are discussed in light of photosynthetic membrane formation and the abundance of spectral complexes per unit area of membrane. Finally, a method for the bulk preparation of the B875 complex from wild-type strain 2.4.1 is reported. PMID- 3277948 TI - Partial characterization of an electrophoretically labile hydrogenase activity of Escherichia coli K-12. AB - A mutant of Escherichia coli K-12 is described that is specifically impaired in only one hydrogenase isoenzyme. By means of Tn5-mediated insertional mutagenesis, a class of mutants was isolated (class I) that had retained 20% of the overall hydrogenase activity. As determined by neutral polyacrylamide gel electrophoresis, the mutant contained normal amounts of the hydrogenase isoenzymes 1 and 2. Therefore, the hydrogenase activity affected seemed to be electrophoretically labile and was called hydrogenase L. The presence of such an activity was recently suggested in various papers and was called isoenzyme 3. Hydrogenase L might be identical or part of the latter isoenzyme. By DEAE ion exchange chromatography it could be separated from hydrogenases 1 and 2. Hydrogenase activity in the parent strain HB101, determined manometrically with cell-free preparations and methylviologen as the electron acceptor, immediately showed maximal activity. However, class I mutants showed a lag phase which was dependent on the protein concentration utilized in the assay. This suggested that the fast initial activity of HB101 was due to hydrogenase L. The enzyme or enzyme complex showed an Mr around 300,000 and a pH optimum between 7 and 8. Strong indications about its physiological role were provided by the finding that in class I mutants H2 production by the formate-hydrogen lyase pathway was unimpaired, whereas fumarate-dependent H2 uptake was essentially zero. Complementation with F-prime factor F'116 but not with F'143 and coconjugation and cotransduction experiments localized the mutation (hydL) close to metC at approximately 64.8 min. PMID- 3277947 TI - Nucleotide sequence of an Rts1 fragment causing temperature-dependent instability. AB - Rts1 is a multiphenotypic drug resistance plasmid which is eliminated from host bacteria at 42 degrees C but not at 32 degrees C. This phenotype has been called temperature-dependent instability (Tdi). We determined the nucleotide sequence of the Rts1 DNA b' segment which causes this phenotype. Within this 786-base-pair segment, several open reading frames (ORFs) were found, including one which encodes a protein with a molecular weight of 16,000. A protein approximately corresponding to this protein is expressed in Escherichia coli minicells harboring plasmids containing the b' segment. In addition, we found the chi sequence at 112 bases proximal to this ORF. Temperature-dependent elimination due to this segment was not observed in the RecA strain of E. coli, but the RecB protein was not required for expression of this phenotype. We constructed various deletion derivatives and found that three portions, the region containing the chi (nucleotides 1 to 24), ORF (nucleotides 25 to 546), and tail (nucleotides 631 to 786) sequences are necessary for Tdi activity. Site-directed mutagenesis studies indicated that ORF I is required for Tdi expression. PMID- 3277949 TI - Loss of the spacer loop sequence from the rrnB operon in the Escherichia coli K 12 subline that bears the relA1 mutation. AB - A polymorphism affecting the spacer region of the rrnB rRNA operon is described. Strains from a major Escherichia coli K-12 subbranch are missing a 106-nucleotide portion of the rrnB 16S-to-23S spacer, and a 20-nucleotide sequence is found in its place. We have called this mutant operon rrnB2. The rrnB2 spacer was most probably derived from either rrnC or rrnE. This alteration of rrnB may have occurred by a recombinational exchange or by gene conversion. In the genealogy of E. coli K-12 strains, the appearance of rrnB2 is associated with the spontaneous occurrence of the first relaxed mutation, but attempts to show a selective relationship between the two mutational events have had negative results. The sequences of the rrnG and rrnC 16S-to-23S spacers have also been determined and their comparisons to the other rrn operons encoding tRNAGlu2 are presented. PMID- 3277951 TI - Importance of the C terminus of plasmid Rts1 RepA protein for replication and incompatibility of the plasmid. AB - RepA protein, essential for replication of plasmid Rts1, was found to bind in vivo immediately upstream of the repA promoter in studies with mini-Rts1 derivatives with deletions in the upstream region of repA. We constructed another series of repA mutants that would encode RepA derivatives containing oligopeptide substitutions in place of the carboxyl-terminal six amino acids. These modified RepA proteins could not activate ori (Rts1) at all and showed various degrees of incompatibility, or no incompatibility, toward a mini-Rts1 plasmid. These results suggest that the carboxyl-terminal six (or fewer) amino acids of RepA are important for exerting replication and incompatibility functions. One of the RepA derivatives, which showed an evident incompatibility without initiating replication, was examined for its ability to repress the repA gene. PMID- 3277950 TI - ompT encodes the Escherichia coli outer membrane protease that cleaves T7 RNA polymerase during purification. AB - Bacteriophage T7 RNA polymerase is stable in Escherichia coli but very susceptible to cleavage by at least one endoprotease after cell lysis. The major source of this endoprotease activity was found to be localized to the outer membrane of the cell. A rapid whole-cell assay was developed to screen different strains for the presence of this proteolytic activity. Using this assay, we identified some common laboratory strains that totally lack the protease. Genetic and Southern analyses of these null strains allowed us to conclude that the protease that cleaves T7 RNA polymerase is OmpT (formerly termed protein a), a known outer membrane endoprotease, and that the null phenotype results from deletion of the OmpT structural gene. A recombinant plasmid carrying the ompT gene enables these deletion strains to synthesize OmpT and converts them to a protease-positive phenotype. The plasmid led to overproduction of OmpT protein and protease activity in the E. coli K-12 and B strains we used, but only weak expression in the E. coli C strain, C1757. This strain-dependent difference in ompT expression was investigated with respect to the known influence of envZ on OmpT synthesis. A small deletion in the ompT region of the plasmid greatly diminishes the amount of OmpT protein and plasmid-encoded protease present in outer membranes. Use of ompT deletion strains for production of T7 RNA polymerase from the cloned gene has made purification of intact T7 RNA polymerase routine. Such strains may be useful for purification of other proteins expressed in E. coli. PMID- 3277952 TI - First committed step of lipid A biosynthesis in Escherichia coli: sequence of the lpxA gene. AB - The min 4 region of the Escherichia coli genome contains genes (lpxA and lpxB) that encode proteins involved in lipid A biosynthesis. We have determined the sequence of 1,350 base pairs of DNA upstream of the lpxB gene. This fragment of DNA contains the complete coding sequence for the 28.0-kilodalton lpxA gene product and an upstream open reading frame capable of encoding a 17-kilodalton protein (ORF17). In addition there appears to be an additional open reading frame (ORF?) immediately upstream of ORF17. The initiation codon for lpxA is a GUG codon, and the start codon for ORF17 is apparently a UUG codon. The start and stop codons overlap between ORF? and ORF17, ORF17 and lpxA, and lpxA and lpxB. This overlap is suggestive of translational coupling and argues that the genes are cotranscribed. Crowell et al. (D.N. Crowell, W.S. Reznikoff, and C.R.H. Raetz, J. Bacteriol. 169:5727-5734, 1987) and Tomasiewicz and McHenry (H.G. Tomasiewicz and C.S. McHenry, J. Bacteriol. 169:5735-5744, 1987) have demonstrated that there are three similarly overlapping coding regions downstream of lpxB including dnaE, suggesting the existence of a complex operon of at least seven genes: 5'-ORF?-ORF17-lpxA-lpxB-ORF23-dnaE-ORF37-3 '. PMID- 3277953 TI - Genetic analyses of the mannitol permease of Escherichia coli: isolation and characterization of a transport-deficient mutant which retains phosphorylation activity. AB - Three positive selection procedures were developed for the isolation of plasmid encoded mutants which were defective in the mannitol enzyme II (IIMtl) of the phosphotransferase system (mtlA mutants). The mutants were characterized with respect to the following properties: (i) fermentation, (ii) transport, (iii) phosphoenolpyruvate(PEP)-dependent phosphorylation, and (iv) mannitol-1-phosphate dependent transphosphorylation of mannitol. Cell lysis in response to indole acrylic acid, which causes the lethal overexpression of the plasmid-encoded mtlA gene, was also scored. No correlation was noted between residual IIMtl activity in the mutants and sensitivity to the toxic effect of indole acrylic acid. Plasmid-encoded mutants were isolated with (i) total or partial loss of all activities assayed, (ii) nearly normal rates of transphosphorylation but reduced rates of PEP-dependent phosphorylation, (iii) nearly normal rates of PEP dependent phosphorylation but reduced rates of transphosphorylation, and (iv) total loss of transport activity but substantial retention of both phosphorylation activities in vitro. A mutant of this fourth class was extensively characterized. The mutant IIMtl was shown to be more thermolabile than the wild-type enzyme, it exhibited altered kinetic behavior, and it was shown to arise by a single nucleotide substitution (G-895----A) in the mtlA gene, causing a single amino acyl substitution (Gly-253----Glu) in the permease. The results show that a single amino acyl substitution can abolish transport function without abolishing phosphorylation activity. This work serves to identify a site which is crucial to the transport function of the enzyme. PMID- 3277954 TI - Replication patterns of multiple plasmids coexisting in Escherichia coli. AB - The replication patterns of several plasmids were measured simultaneously during the cell division cycle of Escherichia coli B/r. F plasmids harboring oriS, both oriS and oriV, pSC101, and pBR322 were found to replicate at all stages of the cell division cycle with kinetics which were indistinguishable from one another and clearly different from the periodic synthesis of the minichromosomes pAL49 and pAL70. PMID- 3277955 TI - Roles of the Escherichia coli heat shock sigma factor 32 in early and late gene expression of bacteriophage T4. AB - We have analyzed early and late T4 gene expression at the levels of transcription and translation in rpoH+ (sigma 32+) and rpoH mutant cells infected under heat shock conditions. We found, as expected, that Escherichia coli cells must be adapted before infection to high temperature by the heat shock response to allow early T4 transcription, subsequent late gene expression, and progeny production at 42 degrees C. Unexpectedly, we found in addition that when rpoH mutant (sigma 32 mutant) cells were shifted from 30 to 42 degrees C 10 min after infection, late T4 genes were not expressed, even though DNA synthesis appeared to be normal. PMID- 3277956 TI - New locus for exopolysaccharide overproduction in Escherichia coli K-12. AB - A new locus for exopolysaccharide overproduction in Escherichia coli K-12 was mapped by insertion mutagenesis. A 66% linkage to serA, which is located at 62 min on the E. coli K-12 linkage map, was shown by P1 transduction. The polysaccharide produced by the mutant was isolated and was shown to be similar to colanic acid. PMID- 3277957 TI - Cloning of the recB, recC, and recD genes from Proteus mirabilis in Escherichia coli: in vivo formation of active hybrid enzymes. AB - We cloned chromosomal DNA fragments from Proteus mirabilis which complement recBCD deletion mutants of Escherichia coli by restoring (i) recombination proficiency in conjugation, (ii) normal resistance to UV irradiation, and (iii) ATP-dependent exonuclease activity for duplex DNA. The data indicate that the order of the genes thyA, recC, recB, recD, and argA is similar in both P. mirabilis and E. coli. Hybrid enzymes formed in vivo were active in repair and recombination. PMID- 3277958 TI - Uridine diphosphate galactose 4-epimerase. pH dependence of the reduction of NAD+ by a substrate analog. AB - Neutron activation analysis of UDP-galactose 4-epimerase from Escherichia coli for 53 metals shows that the enzyme does not contain any of these metals at significant levels. The substrate analog P1-5'-uridine-P2-glucose-6-yl pyrophosphate (UGP), a structural isomer of UDP-glucose with the sugar linked to UDP through the C-6 hydroxyl group, is an inactivator that irreversibly reduces epimerase.NAD+ to epimerase.NADH. The pH dependence of kobs reveals the essential involvement of an acidic group, kinetically measured pKa = 5.48 +/- 0.08, in unprotonated form and two weakly acidic or basic groups, apparent pKa values of 10.03 +/- 0.43, in protonated forms. Measurements of kobs as a function of [UGP] show that it is given by kobs = k[UGP]/(K + [UGP]) at a given pH, where K = 0.19 +/- 0.04 mM throughout the pH range 4.8-10.4. The pH-dependent first order rate constants range from 0.28 to 1.94 s-1, with the maximum value at pH 7.6 and decreasing at acidic and basic pH values. Reaction of [glucose-1-2H]UGP proceeds with kinetic isotope effects of 5.0, 2.1, 2.0, 1.9, and 3.5 at pH values 5.0, 6.2, 7.6, 9.0, and 10.0, respectively. Therefore, hydride transfer becomes rate limiting at pH extremes but is not limiting at neutral pH, although deuteride transfer is significantly limiting at all pH values. The isotope effects facilitated correction of the kinetic pK values to the thermodynamic values 6.1 6.2 on the acid side and 9.0-9.6 on the alkaline side. We postulate that the group with pK1 = 5.5 (6.1-6.2 corrected) functions as an enzymic general base that abstracts the glucosyl C-1 hydroxyl proton in concert with transfer of the C 1 hydrogen and two electrons to NAD+. The pH dependence on the alkaline side may be related to the uridine nucleotide-dependent conformational transition that is an essential step in the reduction of epimerase.NAD+ to epimerase.NADH by sugars. PMID- 3277959 TI - Enhancement of the inositol 1,4,5-trisphosphate-releasable Ca2+ pool by GTP in permeabilized hepatocytes. AB - Permeabilized rat hepatocytes were used to study the effects of inositol 1,4,5 trisphosphate (Ins(1,4,5)P3) and GTP on Ca2+ uptake and release by ATP-dependent intracellular Ca2+ storage pools. Under conditions where these Ca2+ pools were completely filled, maximal doses of Ins(1,4,5)P3 released only 25-30% of the sequestered Ca2+. The residual Ca2+ was freely releasable with the Ca2+ ionophore ionomycin. Addition of GTP in the absence of Ins(1,4,5)P3 did not cause Ca2+ release and had no effect on the steady-state level of Ca2+ accumulation by intracellular storage pools. However, after a 3-4-min treatment with GTP the size of the Ins(1,4,5)P3-releasable Ca2+ pool was increased by about 2-fold, with a proportional decrease in the residual Ca2+ available for release by ionomycin. In contrast to the situation with freshly permeabilized cells, permeabilized hepatocytes from which cytosolic components had been washed out exhibited direct Ca2+ release in response to GTP addition. The potentiation of Ins(1,4,5)P3 induced Ca2+ release by GTP in permeabilized hepatocytes was concentration dependent with half-maximal effects at about 5 microM GTP. The dose response to Ins(1,4,5)P3 was not shifted by GTP; instead GTP increased the amount of Ca2+ released at all Ins(1,4,5)P3 concentrations. The effects of GTP were not mimicked by other nucleotides or nonhydrolyzable GTP analogues. In fact, guanosine 5'-O-(3 thiotriphosphate) (GTP gamma S) inhibited the actions of GTP. However, this inhibition only occurred when GTP gamma S was added prior to GTP, suggesting that the GTP effect is not readily reversible once the cells have been permeabilized. Experiments using vanadate to inhibit the ATP-dependent Ca2+ uptake pump showed that Ins(1,4,5)P3 releases all of the Ca2+ within the Ins(1,4,5)P3-sensitive Ca2+ pool even in the absence of GTP. The increase of Ins(1,4,5)P3-induced Ca2+ release brought about by GTP was also unaffected by vanadate. It is concluded that GTP increases the proportion of the sequestered Ca2+ which is available for release by Ins(1,4,5)P3, either by unmasking latent Ins(1,4,5)P3-sensitive Ca2+ release sites or by allowing direct Ca2+ movement between Ins(1,4,5)P3-sensitive and Ins(1,4,5)P3-insensitive Ca2+ storage pools. PMID- 3277960 TI - The primary structure of the mitochondrial energy-linked nicotinamide nucleotide transhydrogenase deduced from the sequence of cDNA clones. AB - The amino acid sequence of the bovine mitochondrial nicotinamide nucleotide transhydrogenase, which catalyzes hydride ion transfer between NAD(H) and NADP(H) coupled to proton translocation across the mitochondrial inner membrane, has been deduced from the corresponding cDNA. Two clones were isolated by screening a bovine lambda gt10 cDNA library, using two synthetic oligonucleotides and a cDNA restriction fragment as probes. The inserts together covered 3,105 base pairs of coding sequence, corresponding to 1.035 amino acid residues. However, the reading frame at the 5' end was still open. N-terminal sequence analysis of the isolated enzyme indicated the presence of 8 additional residues. Thus, the mature transhydrogenase appeared to have 1,043 amino acid residues and a calculated molecular weight of 109,212. The deduced amino acid sequence of the transhydrogenase contained the sequences of four tryptic peptides that had been isolated from the enzyme. Two of these were the peptides that had been used for construction of the oligonucleotide probes. The other two were tryptic peptides isolated after labeling the NAD-binding site of the transhydrogenase once with [3H]p-fluorosulfonylbenzoyl-5'-adenosine (FSBA), and another time with [14C]N,N' dicyclohexylcarbodiimide. The FSBA-labeled peptide was found to be located immediately upstream of the [14C]N,N'-dicyclohexylcarbodiimide-labeled peptide, about 230 residues from the N terminus. One of the tryptic peptides used for oligonucleotide probe construction was the same as that labeled with [3H]FSBA when the NAD-binding site was protected from FSBA attack. This peptide, which might be at the NADP-binding site of the transhydrogenase, was located very near the C terminus of the enzyme. The central region of the transhydrogenase (residues 420-850) is highly hydrophobic and appears to comprise about 14 membrane-spanning segments. By comparison, the N- and the C-terminal regions of the enzyme, which contain the NAD- and the putative NADP-binding sites, respectively, are relatively hydrophilic and are probably located outside the mitochondrial inner membrane on the matrix side. There is considerable homology between the bovine enzyme and the Escherichia coli transhydrogenase (two subunits, alpha with Mr = 54,000 and beta with Mr = 48,700), whose amino acid sequence has been determined from the genes (Clarke, D.M., Loo, T.W., Gillam, S., and Bragg, P.D. (1986) Eur. J. Biochem. 158, 647-653). PMID- 3277961 TI - Electron microscopic studies of free and proteinase-bound duck ovostatins (ovomacroglobulins). Model of ovostatin structure and its transformation upon proteolysis. AB - Conformational changes of duck ovostatin (ovomacroglobulin) upon complexing with thermolysin have been studied by electron microscopy. Both free and thermolysin bound ovostatin preparations were negatively stained with uranyl acetate, a series of three pictures were taken at 10 degrees specimen tilt intervals (+10 degrees, 0 degrees, and -10 degrees), and images of the inhibitor molecules were observed in three dimensions. Four approximately cylindrical subunits were observed in free ovostatin. Two subunits associated approximately midway from both ends to form a dimer of four arms. Two dimers associated with each other at the midpoint to form a tetramer. The proteinase susceptible "bait" regions were located near the center of the molecule. Eight arms of the tetramer take various configurations. The orthogonal extent of free tetrameric ovostatin in a two dimensional micrograph averages 26.0 +/- 4.7 x 34.0 +/- 5.0 nm. Upon complexing with thermolysin, all eight arms curl toward the center of the molecule, having four arms upward and the other four downward. Thus, proteinase-bound ovostatin has a uniform structure with a 2-fold axis of symmetry. The overall structure of the complex is more compact with average dimensions of 16.9 +/- 0.6 x 16.9 +/- 0.6 x 19.9 +/- 0.4 nm. From these electron microscopic studies we propose that a proteinase reaches to the center of the free ovostatin molecule and attacks the bait region. Subsequent to proteolysis the subunit arms curl and entrap the enzyme within the ovostatin molecule. The results support the unique mechanism of inhibition of proteinases by alpha 2-macroglobulin and ovostatin postulated from biochemical observations (Barrett, A. J., and Starkey, P. M. (1973) Biochem. J. 133, 709-724; Nagase, H., and Harris, E. D., Jr. (1983) J. Biol. Chem. 258, 7490 7498). PMID- 3277962 TI - The primary structure of rat ribosomal protein S6. AB - The amino acid sequence of rat ribosomal protein S6, the major phosphoprotein in the organelle, was deduced from the sequence of nucleotides in two recombinant cDNAs and confirmed from the sequence of amino acids in portions of the protein. Ribosomal protein S6 contains 249 amino acids and has a molecular weight of 28,683. The protein has 15 seryl residues; 7 are located in the carboxyl-terminal sequence of 15 amino acids and probably include most if not all of the residues that are phosphorylated. There are related repeated sequences of 10 amino acids each that occur at four separate positions in S6 and that are very basic. Rat S6 is homologous to Saccharomyces cerevisiae S10 (the extent of the identity is 75%) and most likely also to Schizosaccharomyces pombe S6. PMID- 3277963 TI - Identification and subcellular localization of the polypeptide for chick DNA primase with a specific monoclonal antibody. AB - Polypeptides responsible for activities of chick embryo DNA primase and DNA polymerase alpha were identified using monoclonal antibodies specific to these two enzymes. The 4-8H antibody neutralized DNA polymerase alpha activity measured on activated DNA template and also ribonucleoside triphosphate-dependent DNA synthesis on single-stranded DNA template (DNA primase-DNA polymerase alpha combined activity) to a partial extent (about 30%), but did not affect DNA primase activity. The 4-2D antibody, although it did not affect DNA polymerase alpha activity, did neutralize both DNA primase activity and DNA primase-DNA polymerase alpha combined activity extensively (up to 70%). Immunoblotting analysis of the DNA primase-DNA polymerase alpha complex showed that 4-2D and 4 8H antibodies recognize 60-kDa and 160-180-kDa polypeptides, respectively. An immunoaffinity column made of either of these antibodies retained DNA primase-DNA polymerase alpha complex. When the enzyme was eluted from the 4-8H column with alkaline solution, DNA primase was eluted prior to DNA polymerase alpha. In the case of 4-2D antibody column chromatography, the elution order of two enzymes was reversed. Results indicate that two enzymes in the complex which was retained in the antibody column were dissociated by lower alkaline pH than that dissociated the antigenic enzymes from the corresponding antibodies. In both cases, the fractions with DNA primase activity contained exclusively 60-kDa polypeptide, while those with DNA polymerase alpha contained 160-180-kDa polypeptides. Thus, DNA primase resided in 60-kDa polypeptide and was recognized by 4-2D antibody while DNA polymerase alpha resided in 160-180-kDa polypeptides and was recognized by 4-8H antibody. Immunofluorescence made with the DNA primase-specific 4-2D antibody as well as with 4-8H antibody appeared in granular structures which were tightly bound to the nuclear matrix. These nuclear fluorescences were much reduced in quiescent cells. Furthermore, since the fluorescence made by these antibodies was induced by adding serum to the quiescent cells in serum-deprived cultures, the expression of DNA primase and its organization in the structures on the nuclear matrix are regulated in correlation to the proliferating stage of cells, as observed with DNA polymerase alpha. PMID- 3277964 TI - A monoclonal antibody against the type II isotype of beta-tubulin. Preparation of isotypically altered tubulin. AB - Mammalian brain tubulin consists of several isotypes of alpha and beta subunits that separate on polyacrylamide gels into three electrophoretic classes, designated alpha, beta 1, and beta 2. It has not been possible hitherto to resolve the different isotypes in a functional form. To this end, we have now isolated a monoclonal antibody, using as an immunogen a chemically synthesized peptide corresponding to the carboxyl-terminal sequence of the major tubulin isotype (type II) found in the beta 1-tubulin electrophoretic fraction. The antibody binds to beta 1 but not to alpha or beta 2. When pure tubulin from bovine brain is passed through an immunoaffinity column made from the anti-type II antibody, the tubulin that elutes in the unbound fraction is enriched greatly for the beta 2 electrophoretic variant. The tubulin that binds to the column appears to contain only alpha and beta 1, not beta 2. When these tubulin fractions are characterized by immunoblotting using the anti-type II antibody, the antibody binds only to the beta 1 band in the bound fraction, not to the beta 1 band in the unbound fraction. Using polyclonal antibodies generated against the carboxyl-termini of types I, III, and IV, we demonstrate that the beta 1 electrophoretic species is comprised of isotypes I, II, and IV, whereas the beta 2 variant is comprised exclusively of type III beta-tubulin. Further, we calculate that beta-tubulin in purified bovine brain tubulin is comprised of 3% type I, 58% type II, 25% type III, and 13% type IV tubulins. PMID- 3277965 TI - Inositol phosphates: synthesis and degradation. PMID- 3277967 TI - Enzymatic catalysis in nonaqueous solvents. AB - Subtilisin and alpha-chymotrypsin vigorously act as catalysts in a variety of dry organic solvents. Enzymatic transesterifications in organic solvents follow Michaelis-Menten kinetics, and the values of V/Km roughly correlate with solvent's hydrophobicity. The amount of water required by chymotrypsin and subtilisin for catalysis in organic solvents is much less than needed to form a monolayer on its surface. The vastly different catalytic activities of chymotrypsin in various organic solvents are partly due to stripping of the essential water from the enzyme by more hydrophilic solvents and partly due to the solvent directly affecting the enzymatic process. The rate enhancements afforded by chymotrypsin and subtilisin in the transesterification reaction in octane are of the order of 100 billion-fold; covalent modification of the active center of the enzymes by a site-specific reagent renders them catalytically inactive in organic solvents. Upon replacement of water with octane as the reaction medium, the specificity of chymotrypsin toward competitive inhibitors reverses. Both thermal and storage stabilities of chymotrypsin are greatly enhanced in nonaqueous solvents compared to water. The phenomenon of enzymatic catalysis in organic solvents appears to be due to the structural rigidity of proteins in organic solvents resulting in high kinetic barriers that prevent the native-like conformation from unfolding. PMID- 3277966 TI - Structure and function of the yeast tRNA ligase gene. AB - We report here the DNA sequence of the entire coding region of the Saccharomyces cerevisiae tRNA ligase gene. tRNA ligase is one of two enzymes required for tRNA splicing in yeast, and the enzyme is likely a single polypeptide with multiple activities. We find that tRNA ligase is a basic protein of 827 amino acids corresponding to a molecular weight of approximately 95,400. The inferred amino acid sequence for tRNA ligase is not significantly homologous to that of other known proteins of similar activity. In addition to the tRNA ligase reading frame and several other unidentified open reading frames, we have found two open reading frames, ORF1 and ORF2, near the 5'-end of the ligase structural gene. One of these, ORF2, produces a divergent transcript which initiates only 125 nucleotides upstream of the tRNA ligase transcript, and is present in approximately the same relative abundance as the transcript for tRNA ligase. PMID- 3277968 TI - The complete amino acid sequence of the catalytic domain of rat brain hexokinase, deduced from the cloned cDNA. AB - The complete amino acid sequence of the catalytic domain of rat brain hexokinase (ATP:D-hexose 6-phosphotransferase, EC 2.7.1.1) has been deduced from the nucleotide sequence of cloned cDNA. Extensive similarity in sequence, taken to indicate similarity in secondary and tertiary structure, is seen between the mammalian enzyme and yeast hexokinase isozymes A and B. All residues critical for binding glucose to the yeast enzyme are conserved in brain hexokinase. A location for the substrate ATP binding site is proposed based on relation of structural features in the yeast enzyme to characteristics commonly observed in other nucleotide binding enzymes; sequences in regions proposed to be important for binding of ATP to the yeast enzyme are highly conserved in brain hexokinase. PMID- 3277969 TI - Sterol-dependent repression of low density lipoprotein receptor promoter mediated by 16-base pair sequence adjacent to binding site for transcription factor Sp1. AB - A 42-base pair sequence from the 5' flanking region of the low density lipoprotein receptor gene was shown previously to confer sensitivity to sterol mediated repression when inserted into the herpes simplex virus thymidine kinase promoter. This sequence contains two contiguous 16-base pair repeats, designated repeats 2 and 3, which differ from each other at four positions. In the current study we have analyzed separately the functions of repeats 2 and 3 by altering their sequences, inserting them into the -60 position of the thymidine kinase promoter, and introducing the hybrid promoters into hamster cells by transfection. These studies show that repeat 3 is a constitutive positive transcriptional element that acts in the absence or presence of sterols. Repeat 2 confers strong repression upon repeat 3 when sterols are present. In vitro DNase footprinting and gel retardation assays show that repeat 3, but not repeat 2, binds purified Sp1, a positive transcription factor. Mutants of repeat 3 that abolish transcriptional activity in vivo abolish Sp1 binding in vitro. We suggest that the low density lipoprotein receptor is regulated by a push-pull mechanism in which sterol-regulated binding of a protein to repeat 2 silences the activity of the adjacent Sp1-binding site in repeat 3. PMID- 3277970 TI - Type C Niemann-Pick disease. Lysosomal accumulation and defective intracellular mobilization of low density lipoprotein cholesterol. AB - The intracellular accumulation of unesterified cholesterol was examined during 24 h of low density lipoprotein (LDL) uptake in normal and Niemann-Pick C fibroblasts by fluorescence microscopy with filipin staining and immunocytochemistry. Perinuclear fluorescence derived from filipin-sterol complexes was observed in both normal and mutant cells by 2 h. This perinuclear cholesterol staining reached its peak in normal cells at 6 h. Subsequent development of fluorescence during the remaining 18 h of LDL incubation was primarily limited to the plasma membrane region of normal cells. In contrast, mutant cells developed a much more intense perinuclear fluorescence throughout the entire 24 h of LDL uptake with little enhancement of cholesterol fluorescence staining in the plasma membranes. Direct mass measurements confirmed that internalized LDL cholesterol more readily replenishes the plasma membrane cholesterol of normal than of mutant fibroblasts. Perinuclear filipin-cholesterol fluorescence of both normal and mutant cells was colocalized with lysosomes by indirect immunocytochemical staining of lysosomal membrane protein. Abnormal sequestration of LDL cholesterol in mutant cells within a metabolically latent pool is supported by the finding that in vitro esterification of cellular cholesterol could be stimulated in mutant but not in normal cell homogenates by extensive disruption of the intracellular membranous structures of cells previously cultured with LDL. Deficient translocation of exogenously derived cholesterol from lysosomes to other intracellular membrane sites may be responsible for the delayed homeostatic responses associated with LDL uptake by mutant Niemann-Pick Type C fibroblasts. PMID- 3277971 TI - Evidence for intracellular association of the glucocorticoid receptor with the 90 kDa heat shock protein. AB - We have investigated the association of the glucocorticoid receptor in S49 mouse lymphoma cells with the 90-kDa heat shock protein, HSP 90. Proteins were synthetically labeled by culturing cells with [35S]methionine and immunoadsorbed to protein A-Sepharose using monoclonal antireceptor antibody (BuGR-2). HSP 90 coimmunoadsorbed with the receptor when cytosol was incubated with antireceptor antibody for 1 h in the absence of molybdate, indicating that molybdate is not required for either formation or recovery of HSP 90-receptor complexes. Molybdate stabilized HSP 90-receptor complexes during prolonged incubation in vitro and rendered the complexes resistant to dissociation by 500 mM NaCl. In pulse-chase experiments, cells were incubated with [35S]methionine for 30 min (pulse label) and then cultured with excess unlabeled methionine (chase). At different times in the chase, cytosol was prepared from cells, and labeled proteins were immunoadsorbed by antireceptor antibody. The amount of labeled receptor recovered from cytosol decreased during the chase with a half-life of about 4 h. Labeled HSP 90 coimmunoadsorbed with the receptor at 4 h into the chase but not at the beginning of the chase or at 2 h into the chase, indicating that newly synthesized HSP 90 associated with the receptor in a time-dependent manner during the chase. Labeled HSP 90 did not associate with the receptor when dexamethasone was added to cells at the beginning of the chase. These findings support the hypothesis that HSP 90 associates with the glucocorticoid receptor in intact cells rather than in cytosol and indicates that dexamethasone promotes dissociation of HSP 90-receptor complexes in vivo. PMID- 3277972 TI - Limb salvage for osteosarcoma. PMID- 3277973 TI - Distal interphalangeal joint injuries. AB - Pain-free stability in the DIP joint is essential for effective stable pinch. Distal interphalangeal joint injuries usually achieve this function when treated as described. Stiffness in the DIP joint is not ideal, but its presence after treatment is not a major functional limitation if the joint is painless and aligned in the proper position. Mallet fingers are common injuries that usually are treated in extension splinting. Profundus injuries are uncommon injuries that require a high degree of clinical suspicion and are complex to repair. Due to its close proximity, the PIP joint can suffer from coexistent, unrecognized injury. Furthermore, the uninjured PIP joint can become stiff from unnecessary splinting. Therefore, it is essential that the PIP joint be carefully assessed and treated, if necessary, so that full motion can be maintained in the PIP joint. As with any hand injury, treatment and rehabilitation of the DIP joint should be designed to be effective, yet should not compromise overall hand function. It is logical that the more traumatic the injury, the stiffer the joint will become. It is equally logical that more involved surgical repairs also have a high yield of postoperative stiffness. The treating physician is encouraged to share this knowledge with the patient prior to initiating treatment, as this will decrease patient dissatisfaction. PMID- 3277974 TI - Dislocations and fracture-dislocations at the carpometacarpal joints of the fingers. AB - A variety of injuries can occur to the medial four CMC joints. Chronic problems are best avoided by a combination of attentive diagnostic evaluation, appreciation of unstable injury patterns, and prompt fixation either by percutaneous pinning or open reduction and internal fixation. PMID- 3277975 TI - Epiphyseal injuries in the small joints of the hand. AB - The principles followed in treatment of epiphyseal injuries of the hand are essentially the same as those used in treating epiphyseal injuries elsewhere in the child. Special patience is required in treating the patients, and methods of immobilization must be modified appropriately for the active child. A knowledge of the mechanism of injury and potential effects on the growth potential of the digit are important in determining treatment and counseling parents on possible growth disturbance and later deformity. The epiphyses of the proximal phalanges of the fingers and the thumb metacarpal are the most frequently injured. Salter Type I and II fractures frequently demonstrate remarkable remodeling potential, whereas intra-articular Salter III and IV fractures often require surgical repair and may be more frequently associated with later problems of growth and post traumatic arthritis. The physician should establish a trusting relationship with the child and his or her parents in order to provide comforting reassurance, facilitate treatment and compliance, and promote an understanding of the possible outcomes associated with injuries of the vulnerable growth plate. When these principles are followed appropriately, the long-term follow-up of these children provides for a very satisfying and rewarding experience for the physician and family. PMID- 3277976 TI - Dorsal fracture dislocations of the proximal interphalangeal joint. AB - Dorsal fracture dislocations of the proximal interphalangeal joint with or without subsequent instability require a careful initial clinical examination followed by appropriate operative or nonoperative treatment. Attention to detail is crucial in achieving a successful outcome, regardless of the treatment selected. This article outlines the various classification systems available for dorsal fracture dislocation of the proximal interphalangeal joint and the appropriate treatment. It further describes management of cases that present late and require secondary reconstructive procedures. PMID- 3277977 TI - Extensor tendon injuries at the proximal interphalangeal joint. AB - From the prior discussion, it should be apparent that the multitude of operative procedures reflects the complexity inherent in the extensor mechanism and the often unpredictable outcome of operative intervention. Large studies with detailed analysis of data are few. Despite this, several themes are apparent and need to be respected. The chronic boutonniere deformity reflects long-term derangement with secondary compensation of the extensor mechanism. The surgeons rendering treatment must have a thorough appreciation of normal anatomy as well as an understanding of the evolving pathomechanics. Both physician and patient must be committed to the need for long-term treatment of this disability. The literature leaves no doubt that surgical intervention is best initiated after the attainment of full passive PIP extension. Finally, even in the chronic situation, long-term splinting and exercises may be successful and both obviate surgery and result in a superior outcome. PMID- 3277978 TI - Metacarpophalangeal dislocations. AB - Although MCP joint dislocations are much less common than PIP dislocations, they present a unique set of problems. MCP dislocations usually require open reduction. The obstructions to reduction include the volar plate, interposed ligaments, and the finger-trap effect of intrinsics and flexor tendons. The key to management of such injuries is proper identification of the dislocation type, use of open reduction where necessary, and an aggressive postinjury rehabilitation program. Complications of these injuries do occur, and they must be identified and managed properly. PMID- 3277979 TI - Dislocations and fracture dislocations of the metacarpophalangeal joint of the thumb. AB - Due to its exposed position, the MCP joint of the thumb is particularly vulnerable to dislocations and fracture dislocations. Depending on the direction of the injuring force, injuries to the ulnar, radial, and volar aspect of the joint can occur. If high-grade lesions are not identified and treated appropriately during their acute phase, marked instability with associated long term disability due to weakness and pain in pinch and grip can result. In the absence of a reliable method for diagnosing the Stener lesion, surgical repair of acute, third-degree lesions on the ulnar side of the joint remains the treatment of choice. In the presence of chronic instability, a variety of effective soft tissue reconstructive measures are available. The fact that both acute and chronic injuries enjoy a favorable prognosis with operative repair is due to the fact that operative intervention reliably restores stability to the joint. Mild to moderate loss of motion at the joint is well tolerated functionally. For this reason, arthrodesis remains an exceptionally satisfactory salvage for failed soft tissue reconstructions. PMID- 3277980 TI - Proximal interphalangeal joint dislocations without fractures. AB - Injuries to the proximal interphalangeal joint are extremely common. An understanding of the complex anatomy of this joint is essential for diagnosis and treatment of proximal interphalangeal joint sprains and dislocations. Lateral injuries are among the commonest injuries in the hand. These are often stable after reduction, requiring only closed treatment. Occasionally, however, the collateral ligament can be trapped in the joint and require open reduction. Dorsal dislocations represent the most common dislocation in the hand. These, too, are usually stable after reduction and can be treated by closed methods. On occasion, however, these dislocations will be open or irreducible by closed means, requiring surgical intervention and repair of damaged structures. Complex rotary dislocations are exactly that: complex. An exact understanding of the damaged structures and causes of irreducibility frequently makes this an injury often requiring open reduction and selective repair of damaged soft tissue structures. Fortunately, prompt diagnosis, reduction, and institution of appropriate treatment can usually afford the patient good function after these injuries. It must be noted that stiffness is more common than instability, and active range-of-motion exercises instituted at the proper time are essential. These joints will often remain permanently thicker after injury in spite of optimal care, and tenderness and soreness with use may persist for 6 to 12 months. PMID- 3277981 TI - Intra-articular fractures of the metacarpophalangeal and proximal interphalangeal joints. AB - When displaced or unstable, intra-articular fractures of the metacarpophalangeal and proximal interphalangeal joints represent difficult management problems. The best results can be achieved only with near-anatomic restoration of the joint surfaces and early active motion exercises. These principles dictate the use of rigid internal fixation by means that are not compromised by the exercise program. Not all of these serious injuries, regardless of how they are treated, will do well. Salvage procedures represent considerable functional compromise. Therefore, the most reliable techniques must be used in the initial treatment of these uncommon injuries. PMID- 3277982 TI - Fractures at the base of the thumb. AB - The details of the basal joint anatomic complex must be understood if fractures in this area are to be classified and treated properly. The specifics have been reviewed and treatment principles emphasized. Most injuries respond to closed reduction and external immobilization, often with supplemental percutaneous internal fixation. Occasionally, for specific indications, open reduction will be necessary. Fortunately with carefully selected treatment, results from fractures in this area are usually favorable. PMID- 3277983 TI - Developmentally regulated expression of cell surface carbohydrates during mouse embryogenesis. AB - Cell surface carbohydrates undergo marked alterations during mouse embryogenesis. In preimplantation embryos, many carbohydrate markers show stage-specific expression in diverse ways. In early postimplantation embryos, certain carbohydrate markers are localized in defined regions in the embryo. Important carriers of stage-specific carbohydrates are the lactoseries structure (Gal beta 1----4GlcNAc) and the globoseries structure (Gal alpha 1----4Gal). Notably, the glycoprotein-bound large carbohydrate of poly-N-acetyllactosamine-type ([Gal beta 1----4GlcNAc beta 1----3]n) carries a number of markers preferentially expressed in early embryonic cells. These markers are of practical value in analyzing embryogenesis and cell differentiation. For example, in order to monitor in vitro differentiation of multipotential embryonal carcinoma cells, stage-specific embryonic antigen-1 (SSEA-1) and the Lotus agglutinin receptor have been used as markers of the undifferentiated cells, and the Dolichos agglutinin receptor has been used as a marker of extraembryonic endoderm cells. Developmental control of cell surface carbohydrates is attained by controlled expression of activities of key glycosyltransferases; for example, the activity of N-acetylglucosaminide alpha 1----3 fucosyltransferase is lost during in vitro differentiation of embryonal carcinoma cells to parietal endoderm cells, in parallel to the disappearance of SSEA-1. Accumulating evidence suggests that poly-N acetyllactosamine-type glycans that are abundant in early embryonic cells are involved in cell surface recognition of these cells. PMID- 3277984 TI - Structure-function studies on Acanthamoeba myosins IA, IB, and II. AB - Myosins IA and IB are globular proteins with only a single, short (for myosins) heavy chain (140,000 and 125,000 daltons for IA and IB, respectively) and are unable to form bipolar filaments. The amino acid sequence of IB heavy chain shows 55% similarity to muscle myosins in the N-terminal 670 residues, which contain the active sites, and a unique 500-residue C-terminus highly enriched in proline, glycine, and alanine. The C-terminal region contains a second actin-binding site which allows myosins IA and IB to cross-link actin filaments and support contractile activity. Myosins IA and IB are regulated solely by phosphorylation of one serine on the heavy chain positioned between the catalytic site and the actin-binding site that activates ATPase. Myosin II is a more conventional myosin in composition (two heavy chains and two pairs of light chains), heavy chain sequence (globular head 45% identical to muscle myosins and a coiled-coil helical tail), and structure (bipolar filaments). The tail of myosin II is much shorter than that of other conventional myosins, and it contains a 25 amino acid sequence in which helical structure is predicted to be weak or absent. The position of this sequence corresponds to the position of a bend in the monomer. Myosin II heavy chains also have a 29-residue nonhelical tailpiece which contains three regulatory, phosphorylatable serines. Phosphorylation at the tip of the tail regulates ATPase activity in the globular head apparently through an effect on filament structure. PMID- 3277985 TI - Lipid polarity and sorting in epithelial cells. AB - Apical and basolateral membrane domains of epithelial cell plasma membranes possess unique lipid compositions. The tight junction, the structure separating the two domains, forms a diffusion barrier for membrane components and thereby prevents intermixing of the two sets of lipids. The barrier apparently resides in the outer, exoplasmic leaflet of the plasma membrane bilayer. First data are now available on the generation of these differences in Madin-Darby canine kidney (MDCK) cells, grown on filter supports. Experiments in which fluorescent precursors of apical lipids were introduced into the cell have demonstrated that upon biosynthesis apical lipids are sorted from basolateral lipids in an intracellular compartment. In this paper we present a model for the sorting process, the central point of which is that the two sets of lipids laterally segregate into microdomains that bud to form vesicles delivering the lipids to the apical and the basolateral plasma membrane domains, respectively. PMID- 3277986 TI - Transport of proteins into yeast mitochondria. AB - The amino-terminal sequences of several imported mitochondrial precursor proteins have been shown to contain all the information required for transport to and sorting within mitochondria. Proteins transported into the matrix contain a matrix-targeting sequence. Proteins destined for other submitochondrial compartments contain, in addition, an intramitochondrial sorting sequence. The sorting sequence in the cytochrome c1 presequence is a stop-transport sequence for the inner mitochondrial membrane. Proteins containing cleavable presequences can reach the intermembrane space by either of two pathways: (1) Part of the presequence is transported into the matrix; the attached protein, however, is transported across the outer but not the inner membrane (eg, the cytochrome c1 presequence). (2) The precursor is first transported into the matrix; part of the presequence is then removed, and the protein is reexported across the inner membrane (eg, the precursor of the iron-sulphur protein of the cytochrome bc1 complex). Matrix-targeting sequences lack primary amino acid sequence homology, but they share structural characteristics. Many DNA sequences in a genome can potentially encode a matrix-targeting sequence. These sequences become active if positioned upstream of a protein coding sequence. Artificial matrix-targeting sequences include synthetic presequences consisting of only a few different amino acids, a known amphiphilic helix found inside a cytosolic protein, and the presequence of an imported chloroplast protein. Transport of proteins across mitochrondrial membranes requires a membrane potential, ATP, and a 45-kd protein of the mitochondrial outer membrane. The ATP requirement for import is correlated with a stable structure in the imported precursor molecule. We suggest that transmembrane transport of a stably folded precursor requires an ATP-dependent unfolding of the precursor protein. PMID- 3277987 TI - Role of receptor occupancy in the transition from responsive to unresponsive states in cultured breast tumor cells. AB - Progression from a steroid sensitive to insensitive state is characteristic of breast tumors, but little is known about the molecular mechanisms involved. Changes in steroid receptor can be associated with the progression. This paper reviews the cell culture data pertaining to loss of response and concludes that loss of receptor is a consequence rather than a cause of insensitivity. This view is based on evidence that loss of all response parameters occurs despite the presence of fully functional receptors as determined by transfection experiments. The postreceptor defect appears to be at the level of the hormone response element of the responsive genes and may involve DNA methylation. The implications of the model for human breast cancer biology are discussed. PMID- 3277989 TI - Comparison of API ZYM system with API AN-Ident, API 20A, Minitek Anaerobe II, and RapID-ANA systems for identification of Clostridium difficile. AB - The API ZYM system was compared with four anaerobe identification systems for the definitive identification of Clostridium difficile by using 88 cultures of C. difficile grown on Mueller-Hinton blood agar medium. The API ZYM system yielded a distinct and consistent enzyme profile for all test strains, whereas the sensitivities of the other systems in identifying C. difficile ranged from 78 to 96% (AN-Ident, 77.9%; RapID-ANA, 88.6%; Minitek Anaerobe II, 90.9%; and API 20A, 95.5%). The API ZYM system is highly reliable in identifying C. difficile accurately, is rapid, and is relatively simple to use. PMID- 3277988 TI - Comparison of Western blot (immunoblot) based on recombinant-derived p41 with conventional tests for serodiagnosis of human immunodeficiency virus infections. AB - To evaluate the performance of a serological test for human immunodeficiency virus type 1 (HIV-1) infections based on the use of a recombinant envelope gene derived protein as the antigen, we caused expression of a 1.4-kilobase fragment of HIV.DNA that codes for the complete gp41 transmembrane protein in an Escherichia coli expression vector and used Western blots (WB; immunoblots) prepared with recombinant material (pEX-41) to detect antibodies to HIV-1. This test detected all 339 sera which were positive by a combination of conventional serodiagnostic assays and produced no false-positive results with 311 negative samples. Also no false-positive results were obtained with 20 sera from systemic lupus erythematosus patients which had high titers of cross-reactive autoantibodies. In six cases, the pEX-41 WB proved to be more sensitive than individual assays applied on their own, and in five cases it was even more sensitive than a combination of conventional assays. We tested 221 sera in both our pEX-41 WB and a commercially available recombinant enzyme immunoassay (EIA [Abbott]). The results were identical in 188 cases. A total of 27 sera containing antibodies to gp41 as demonstrated in the pEX-41 WB, as well as the Abbott recombinant EIA, had no antibodies to the recombinant core antigen as measured in the Abbott EIA. However, 25 of these sera did stain the 24-kilodalton band on a WB with purified virus. Six sera that were positive in all of the conventional confirmatory assays and reacted strongly with the pEX-41 WB did not recognize the surface antigen used in the Abbott recombinant EIA. We conclude that the use of WB prepared with recombinant-derived p41 offers a very sensitive and specific method to detect antibodies to HIV. PMID- 3277990 TI - Predominance of the ac variant in K88-positive Escherichia coli isolates from swine. AB - Monoclonal antibodies to K88ac and K88ab were used in enzyme-linked immunosorbent assays on Escherichia coli cultures known to produce K88 pili. A total of 415 K88 positive E. coli isolates from nine states were all found to be the K88ac variant. The cultures tested were isolated during the years 1976 to 1985. PMID- 3277992 TI - Conventional and revised isolator tubes. PMID- 3277991 TI - RAPIDEC UR, a 2-h miniaturized system for pinpointing uropathogens. AB - A miniaturized 2-h system (RAPIDEC UR; API System, la Balme-les-Grottes, Montalieu-Vercieu, France) that uses nine enzymatic tests for the diagnosis of most uropathogens was challenged with 330 strains. With few exceptions (Citrobacter, Enterobacter, and Providencia spp., Morganella morganii, and staphylococci other than Staphylococcus saprophyticus), there were distinct patterns that allowed at least a preliminary species diagnosis. PMID- 3277993 TI - Alkaline phosphatase-conjugated oligonucleotide probes for enterotoxigenic Escherichia coli in travelers to South America and West Africa. AB - Several studies have demonstrated the usefulness of 32P-labeled recombinant DNA probes for identifying enterotoxigenic Escherichia coli (ETEC). The use of radioisotopes and X-ray development, however, severely handicaps the utility of DNA probes in most clinical laboratories. In this study, enzyme-labeled oligonucleotide probes for ETEC LT (heat-labile toxin) and ST (heat-stable toxin) genes were compared with the standard Y1 adrenal cell and suckling mouse assays for their ability to identify ETEC in a population of American adults experiencing acute episodes of diarrhea in South America and West Africa. The LT probe hybridized with 12% (64 of 529) of the E. coli colonies tested, whereas 11% (57 of 529) were positive by Y1 adrenal cell assay. DNA from 9% (47 of 529) of the E. coli colonies tested hybridized with the ST probe, whereas only 5% (28 of 529) produced ST as measured by the suckling mouse bioassay. For the patient samples tested, correlation between probe and bioassay for LT was 97%, or three discrepancies in 111 patients tested. Overall concordance of the ST probe and bioassay was 95%, or five discrepancies in 111 patients. Enzyme-labeled oligonucleotide probes represent a major advance in the diagnosis of ETEC associated diarrheal disease and may be used in laboratories with minimal equipment. PMID- 3277994 TI - Multicenter comparative evaluation of two rapid microscopic methods and culture for detection of Chlamydia trachomatis in patient specimens. AB - Four hundred and seventy-three men and women at high risk for sexually transmitted disease were tested for the presence of Chlamydia trachomatis in the urethra or the endocervix. Four groups were involved in this multicenter study of two direct fluorescent-antibody microscopy tests, Kallestad Pathfinder and Syva Microtrak, compared with culture techniques. Results from the test sites indicated that there was no significant difference overall in the sensitivity and specificity of the two test kits. However, there was some interlaboratory variation seen in the sensitivity of the microscopy, but little difference in the specificity. Either kit could be an effective screening method for C. trachomatis in high-risk populations. PMID- 3277995 TI - Morphologic appearance of inclusion bodies and their association with the antigenic composition of naturally occurring rabies viruses. AB - A total of 112 rabies virus-infected skunk brain samples from naturally occurring cases (64 from Missouri, 48 from Kentucky) were code labeled and grouped into two morphologic categories according to the appearance and size of the discrete particles observed by immunofluorescent-antibody staining. The reactivity of the blind-labeled samples was then determined using a panel of 23 antinucleocapsid monoclonal antibodies to test whether morphologic appearance was associated with antigenicity. Two categories were defined and designated; they were morphologic type I (MO-I) and morphologic type II (MO-II). MO-I viruses produced granular type fluorescing aggregates with no evidence of inclusions compatible in appearance with Negri bodies. MO-II viruses produced at least one and usually many large, round, or oval fluorescing inclusion bodies. No viruses categorized as MO-I reacted with antinucleocapsid monoclonal antibodies 103-7, 239-10, and 120-2; all MO-II viruses reacted positively to these three antibodies, with one exception involving antinucleocapsid monoclonal antibody 239-10. The results indicate a strong association between the reactivity of these antibodies and the morphologic appearance of the aggregates of antigen. PMID- 3277996 TI - Human coproantibody secretory immunoglobulin A response to Yersinia species. AB - A semiquantitative indirect immunofluorescence assay to detect coproantibody secretory IgA (SIgA) was established to investigate the human intestinal immune response to Yersinia species. This assay was based on microagglutination of SIgA in fecal specimens with the patient's homologous organism. Two populations of patients were defined, those who produced an agglutinating (2+) SIgA response and those who did not. A comparison between SIgA production and standard in vitro virulence-related characteristics of infecting organisms, including autoagglutination, calcium dependence, plasmid carriage, and absorption of Congo red, mouse virulence, and clinical presentation, was performed. A positive (2+) SIgA result was associated with acute enteric illness (positive predictive value, 78.6%) and mouse virulence (positive predictive value, 85.7%). When patients with active inflammatory bowel disease were excluded, the positive predictive value of SIgA for mouse virulence and acute enteric disease became 100%. In addition to strains of Yersinia enterocolitica 4,O:3, strains generally characterized as nonpathogenic, including Yersinia frederiksenii, were found to be associated with acute disease, mouse virulence, and stimulation of SIgA. The indirect immunofluorescence assay for detection of SIgA response appears to be a useful indicator of pathogenic strains of yersiniae recovered from enteric specimens. PMID- 3277997 TI - Commercial identification systems often fail to identify Providencia stuartii. AB - We tested 145 clinical isolates in an attempt to evaluate some of the most widely used commercial identification systems in Europe in terms of their ability to identify Providencia strains. Two manual miniaturized systems (API 20E and Enterotube II) and three mechanized-automated systems (Cobas-Bact, Sceptor System, and Titertek-Enterobac-Rapid Automated System) were evaluated. Providencia alcalifaciens and Providencia rettgeri strains were correctly identified by all systems in all cases, and in most cases identification was achieved without the aid of supplementary tube tests. By contrast, Providencia stuartii was identified without the aid of supplementary tube tests for only 42.5% (API 20E), 37.5% (Enterotube), 68.7% (Sceptor), and 71.2% (Cobas-Bact) of the isolates. The overall misidentification rates were 16.3, 11.3, 11.3, and 10%, respectively. The Titertek-Enterobac-Rapid Automated System failed to identify only 1 of 80 strains (1.3%) and required supplementary tests in 2 other cases (2.5%). Since four of the multitest systems examined often failed to correctly identify P. stuartii, we conclude that supplementary conventional tube tests should always be used to distinguish this species from the other taxa of the Proteeae tribe. PMID- 3277998 TI - Nosocomial urinary tract infection with a slowly growing, fastidious Escherichia coli. AB - Escherichia coli recovered from a nosocomially acquired urinary tract infection required 48 h of incubation on blood agar and did not grow on other routine clinical laboratory media. This bacterium dissociated readily into three colony types, all of which were confirmed as E. coli by DNA hybridization studies. Preliminary studies indicate a prolonged lag phase that could not be corrected by the addition of a variety of peptones and yeast extracts. Better growth was achieved by the addition of 10% horse serum. PMID- 3278000 TI - First isolation of Legionella gormanii from human disease. AB - Legionella gormanii, previously isolated only from the environment, was grown from the bronchial brush specimen of a patient with pneumonia. The organism was characterized by serologic, biochemical, and DNA hybridization studies. PMID- 3277999 TI - Comparison of three enzyme-linked immunosorbent assays and a direct fluorescent antibody test for detection of respiratory syncytial virus antigen. AB - We prospectively evaluated three enzyme immunoassays (EIAs) and a direct fluorescent-antibody (DFA) test for respiratory syncytial virus detection. Of 90 specimens, 79% gave the same results in all four tests (30 positive and 41 negative) and 97% were in agreement in three of the four assays. The agreement between the direct fluorescent-antibody test and each enzyme immunoassay was greater than or equal to 86%. PMID- 3278001 TI - DNA probes for K-antigen (capsule) typing of Escherichia coli. AB - DNA restriction fragments derived from the polysaccharide biosynthesis regions of cloned Escherichia coli K1, K5, and K12 capsular antigen genes hybridized only with DNA of strains determined by conventional methods to be of the same K serotype. A probe derived from the common transport region hybridized to all encapsulated E. coli strains. PMID- 3278002 TI - Sorbitol, osmoregulation, and the complications of diabetes. PMID- 3278003 TI - Regional adipocyte precursors in the female rat. Influence of ovarian factors. AB - A flow cytometric immunofluorescence procedure utilizing a specific antibody to rat adipose tissue lipoprotein lipase (LPL) was developed to quantify differentiated and undifferentiated preadipocytes present in the adipose tissue vascular stroma. This method is highly sensitive and specific for cells capable of synthesizing LPL in significant quantities. Pubescence in female rats was associated with an increase in differentiated preadipocytes and in fat cell number with enlargement of the fat depots in the perirenal, parametrial, and the subcutaneous dorsal and femoral regions. A concomitant decline in the percentage of undifferentiated preadipocytes occurred in all but the femoral depot. Ovariectomy reduced pubertal adipose growth in the femoral and parametrial but not the dorsal or perirenal regions. Furthermore, the femoral undifferentiated preadipocyte pool was not preserved in the ovariectomized animals. Thus, ovarian factors influence the pubescence-associated regional preadipocyte differentiation and conversion to adipocytes. The femoral depot contains an ovarian-dependent infinite pool of fat cell precursors. These features could account for the association between ovarian hormones and body fat topography. PMID- 3278005 TI - Epidermolysis bullosa acquisita antigen is the globular carboxyl terminus of type VII procollagen. AB - Epidermolysis bullosa acquisita (EBA) is a severe, chronic blistering disease of the skin. EBA patients have circulating and tissue-bound autoantibodies to a large (Mr = 290,000) macromolecule that is localized within the basement membrane zone between the epidermis and dermis of skin, the site of blister formation. The "EBA antigen" is known to be distinct from laminin, heparan sulfate proteoglycan, fibronectin, the bullous pemphigoid antigen, elastin, and collagen types I, II, III, IV, and V. Sera from patients with EBA, two monoclonal antibodies to the EBA antigen, and a monoclonal antibody to the carboxyl terminus of type VII procollagen identically label human amnion and skin by immunofluorescent and immunoelectron microscopy. Western immunoblots of the EBA antigen extracted from skin and of type VII procollagen labeled with the above sera and antibodies are identical. None of the sera or antibodies labels Western blots of pepsinized type VII collagen which is missing the globular amino and carboxyl terminal domains. These data show that the EBA antigen is the carboxyl terminus of type VII procollagen. PMID- 3278004 TI - Increased surface expression of CD11b/CD18 (Mac-1) is not required for stimulated neutrophil adherence to cultured endothelium. AB - The mechanism whereby the human neutrophil membrane heterodimer, CD11b/CD18 (Mac 1, Mo1), mediates neutrophil adherence is not known. We studied the role of CD11b/CD18 surface expression in the promotion of neutrophil adhesiveness. We found that phorbol myristate acetate (PMA), calcium ionophore (A23187), and FMLP caused a three- to sevenfold increase in surface expression of both CD11b (alpha M) and CD18 (beta) as assayed by binding of MAbs 60.1 (anti-CD11b) and 60.3 (anti CD18). Increased binding of MAbs was temporally associated with the promotion of neutrophil aggregation and adherence to cultured endothelial monolayers. Pretreatment of neutrophils with the anion channel-blocking agent, DIDS (4,4' diisothiocyanostilbene-2,2'-disulfonic acid), inhibited the increased surface expression of CD11b and CD18 after stimulation by PMA, A23187, or FMLP and resulted in nearly complete inhibition of neutrophil aggregation. However, pretreatment with DIDS did not diminish either PMA-, A23187-, or FMLP-stimulated neutrophil adherence to endothelial monolayers. We also observed that stimulation of granule-depleted neutrophil cytoplasts by PMA, A23187, or FMLP induced aggregation and adherence to endothelial monolayers without increasing surface expression of CD11b or CD18. We conclude that the increased surface expression of CD11b/CD18 that occurs after stimulation is neither sufficient nor necessary for enhanced adherence to endothelium. Moreover, though both are CD11b/CD18 dependent, the mechanisms involved in neutrophil aggregation are different from those involved in neutrophil adherence to endothelium. PMID- 3278008 TI - Day care and its effect on children: an overview for pediatric health professionals. PMID- 3278009 TI - An alternative procedure for repositioning the anteriorly displaced TMJ disk. PMID- 3278006 TI - Acetylated lipoproteins impair erythroid growth factor release from endothelial cells. AB - Endothelial cells are a known source of hematopoietic growth-enhancing factors, including platelet-derived growth factor (PDGF). In addition, endothelium interacts directly with plasma lipoproteins which have been shown to modulate hematopoiesis. To determine the relationship of these properties, we measured the release of an erythroid growth-enhancing factor from bovine endothelial cells under lipid-loaded and control conditions. Human bone marrow cells cultured under serum-free conditions form more erythroid, granulocyte/macrophage, and mixed hematopoietic colonies when supplemented with endothelial cell-conditioned medium (ECCM) than do controls (P less than 0.05). The activity is expressed over a wide range of erythropoietin, lymphocyte-conditioned medium (LCM), recombinant human interleukin-3, and colony-stimulating factor (CSF) concentrations, and is related to ECCM dose. In contrast, enhancing activity in ECCM prepared with 0-400 micrograms/ml acetylated low density lipoproteins (AcLDL) or native LDL is diminished to 0% in a dose-dependent fashion (relative to ECCM from unexposed cells or from cells incubated with very low density lipoproteins, P less than 0.05). Upon dilution, medium prepared from cells incubated with LDL shows a rightward shift in the dose-response curve for erythroid colony formation, while that prepared from AcLDL loaded cells demonstrates a downward shift, indicating that the inhibitory activities are kinetically distinct. Delipidation of ECCM prior to addition to marrow culture removes the inhibitory action of native LDL (P less than 0.05) but not that of AcLDL (P greater than 0.10). Immunochemical analysis suggests that the erythropoietic activity in ECCM is unrelated to that of PDGF, recombinant human CSF, and erythroid burst-promoting activity (BPA) present in LCM. This conclusion is supported by Northern blot analysis of endothelial cells using a cDNA probe for the v-sis homologue of the PDGF beta chain and by immunoprecipitation of metabolically labeled PDGF. The relative amounts of c-sis transcripts and of secreted PDGF were similar in endothelial cells incubated with or without AcLDL. We conclude that AcLDL impair the synthesis or release of an erythropoietic growth-enhancing factor(s) which is biologically distinct from PDGF and BPA present in LCM. PMID- 3278007 TI - A monoclonal antibody to the adherence-promoting leukocyte glycoprotein, CD18, reduces organ injury and improves survival from hemorrhagic shock and resuscitation in rabbits. AB - Leukocytes have been shown to play an important role in the development of isolated organ injury after experimental ischemia and reperfusion. To examine the role of leukocytes in generalized ischemia-reperfusion injury we used the MAb 60.3 (directed to the human leukocyte adherence glycoprotein, CD18) to block leukocyte adherence functions in a rabbit model of hemorrhagic shock and resuscitation. In control animals subjected to 1 h of shock (mean blood pressure 45 torr and mean cardiac output 30% of baseline) followed by resuscitation, only 29% survived 5 d. All had gross and histologic evidence of injury to lungs, liver, and gastrointestinal mucosa. In contrast, 100% of the MAb 60.3-treated animals survived 5 d (P less than 0.01) and organ injury was absent or markedly attenuated. The control animals also had a persistent acidosis, lost more weight, and had evidence of continued gastrointestinal bleeding in contrast to MAb 60.3 treated animals. We conclude that increased leukocyte adhesiveness plays an important role in the development of multiple organ injury and death after generalized ischemia-reperfusion and that this injury may be significantly reduced by blocking leukocyte adherence functions with the MAb 60.3. PMID- 3278010 TI - Factors influencing joint mobility in general and in particular respect of the craniomandibular articulation: a literature review. PMID- 3278011 TI - The long-term effects of early parent death: a review. AB - A review of the literature indicates some evidence for an association between early death of the mother and severe forms of depression in adulthood. The relationship of early parent death with later alcoholism, other forms of depression, and milder effects within the general population also is suggested. A number of factors that may mitigate the long-term effects of the loss are discussed. The experience of early parent death is conceptualized as an exceptionally visible representation of the capacity of the child to cope adaptively with developmental crisis. PMID- 3278012 TI - Gerard Slavin: editor, Journal of Clinical Pathology, 1978-1988. PMID- 3278013 TI - Immunoblot fingerprinting of coagulase negative staphylococci. PMID- 3278014 TI - Effect of inoculum size on detection and recovery of Clostridium difficile in selective broth cultures. PMID- 3278015 TI - Enzyme immunoassay for detecting genital tract Chlamydia trachomatis. PMID- 3278016 TI - Haemorrhagic colitis: detection of verotoxin producing Escherichia coli O157 in a clinical microbiology laboratory. AB - Faeces (n = 1319) were examined over three months for the presence of non sorbitol fermenting, verotoxin producing Escherichia coli (serotype O157). Seven isolates were found, four from patients with bloodstained diarrhoea and three from patients with no evidence of blood in the faeces. Screening of all faecal samples with specific O157 antiserum for non-sorbitol fermenting organisms and agglutination was an important adjunct to clinical and microscopic findings and helped detect cases of verotoxin producing E coli which might otherwise have been missed. PMID- 3278017 TI - Comparison between cell culture and serology for detecting Chlamydia trachomatis in women seeking abortion. AB - The efficiency of an immunoperoxidase serological assay and culture of Chlamydia trachomatis were compared in 127 women seeking first trimester abortion. Serum IgG and IgA antibodies specific for C trachomatis were detected by a single serovar (L2) inclusion immunoperoxidase assay (IPA). Eighty (63%) women were seropositive for chlamydial IgG and 31 (24%) for IgA antibodies. C trachomatis was isolated from 21 of 127 (17%) women. Twenty of the 80 women (25%) seropositive for specific IgG antibodies and one of 47 (2%) patients without these antibodies were culture positive (p less than 0.001). Compared with isolation, chlamydial antibodies at a titre of greater than or equal to 16 showed high sensitivity and negative predictive value (95% and 98%, respectively), but low specificity and efficiency (43% and 52%, respectively). Chlamydial IgA antibodies at a titre of greater than or equal to 8 showed low sensitivity (52%), but a higher specificity, negative predictive value, and efficiency of 81%, 90%, and 76%, respectively. C trachomatis IgG antibodies at a titre of 16 as determined by IPA can be used as an efficient negative exclusion marker for active chlamydial infection in screening women seeking abortion. PMID- 3278018 TI - Immunohistochemical localization of serotonin and choline acetyltransferase in sensory neurones of the locust. AB - Sensory neuronal cell bodies in the leg of locust, Schistocerca gregaria, were visualized with antibodies to locust choline acetyltransferase and with antibodies to serotonin by the avidin-biotin peroxidase technique. Two groups of sensory cells react with the antibody to choline acetyltransferase: One group is associated with external mechanoreceptors (i.e., hair-plate hairs and campaniform sensilla) and the other with internal proprioceptors (i.e., chordotonal organs and multiterminal receptors). Sensory cells which react with the antibody to serotonin are associated only with internal proprioceptors being found in both chordotonal organs and multiterminal receptors. In the metathoracic femoral chordotonal organ indirect evidence suggests that some sensory cells are reactive to both antibodies. Some multiterminal receptors react with anti-choline acetyltransferase, while others react with antiserotonin. These results support the conclusion that most insect sensory neurones are cholinergic but some are serotoninergic. PMID- 3278019 TI - Angioendotheliomatosis. AB - "Angioendotheliomatosis" is a diagnostic term used in histopathology to describe the proliferation of dilated vessels filled with mononuclear cells that have varying degrees of atypia. Either benign or malignant angioendotheliomatosis may exhibit this histologic pattern, and depending on the clinical course, cases are classified as either reactive angioendotheliomatosis or neoplastic angioendotheliomatosis. A case of neoplastic angioendotheliomatosis is presented and the literature reviewed with special attention to the pathogenesis of this condition. PMID- 3278020 TI - Linear IgM dermatosis of pregnancy. AB - An intensely pruritic dermatosis that occurred in a woman during the third trimester of pregnancy is described. The clinical manifestations included red follicular papules symmetrically distributed on the skin of the forearms, abdomen, thighs, and legs. The histopathologic findings were not specific. However, immunopathologic examination revealed dense linear deposition of IgM in the dermoepidermal junction. The eruption and the immunopathologic findings disappeared at the end of the puerperium. This dermatosis differs from previously described specific dermatoses of pregnancy because of the clinical appearance and the immunopathologic findings. Thus we propose the term linear IgM dermatosis of pregnancy. PMID- 3278021 TI - Multiple minute digitate hyperkeratosis. AB - We report a case of multiple minute digitate hyperkeratosis. The patient had hundreds of keratotic lesions--some tiny and spiked, others larger, flat papules- localized on the trunk and arms. Histologic sections showed focal areas of compact hyperorthokeratosis with few dermal changes. Ultrastructurally, keratohyalin granules were smaller than normal. The keratin pattern was one of a normal variant. Odland bodies present. Various family members of the patient, in different generations, were affected. PMID- 3278022 TI - Lateral nose and perinasal defects: options in management following Mohs micrographic surgery for cutaneous carcinoma. AB - Primary and recurrent cutaneous carcinomas of the nose and the adjacent perinasal tissues often invade more deeply than cutaneous carcinomas in other areas. The operative defect may be large. The physician who has to close these defects is faced with a challenging problem that requires an appreciation of facial anatomy and function. There is often more than one option in the repair of these defects. Important concepts in the management of lateral nose and perinasal surgical defects are discussed. PMID- 3278024 TI - Acute renal failure in the intensive care unit. Part 1. PMID- 3278023 TI - A review of the mechanisms and methods of humidification of inspired gases. PMID- 3278026 TI - The presidents. Carl A. Laughlin 1971-1972. PMID- 3278025 TI - ARDS after accidental inhalation of zinc chloride smoke. AB - Five soldiers were injured by inhalation of hexite smoke (ZnCl2) during military training. Two soldiers, not wearing gas masks breathed hexite for 1 or 2 min, they slowly developed severe adult respiratory distress syndrome (ARDS) over the ensuing 2 weeks. This slow, progressive clinical course has not been previously described. In both patients, an increased plasma zinc concentration was measured 3 weeks after the incident. Intravenous and nebulized acetylcysteine increased the urinary excretion of zinc, and briefly decreased the plasma levels. In an attempt to arrest collagen deposition in the lungs, L-3,4 dehydroproline was administered. Both patients died of severe respiratory failure (25 and 32 days after inhalation). At autopsy diffuse microvascular obliteration, widespread occlusion of the pulmonary arteries and extensive interstitial and intra-alveolar fibrosis was observed. Three soldiers wearing ill fitting gas masks, immediately developed severe coughing and dyspnea. They improved, and 12 months after exposure their lung function tests were nearly normal, but they still had slight dyspnea on exercise. PMID- 3278027 TI - Nonsurgical antibacterial approaches to periodontal treatment. PMID- 3278028 TI - Hypertensive response to levonordefrin in a patient receiving propranolol: report of case. AB - Propranolol is a commonly used drug; of new and refilled prescriptions, it ranked no. 1 in 1984 and no. 2 in 1985. Medical conditions for its use include angina pectoris, myocardial infarction, hypertension, cardiac dysrhythmias, hypertrophic subaortic stenosis, migraine headache, hyperthyroidism, and pheochromocytoma. Almost all dental practitioners will treat a patient receiving propranolol for one of these conditions. The following recommendations seem appropriate at this time: The patient should continue to receive propranolol during dental treatment. Sudden withdrawal of the beta-blocker will cost the patient the benefit of propranolol therapy and may lead to acute myocardial ischemia. Acute stress should be minimized, as hypertensive responses may also be caused by endogenously released epinephrine. Short appointments scheduled in the morning, possibly with conscious sedation, should be considered. The dosage of adrenergic vasoconstrictors should be limited and gingival retraction cord containing epinephrine avoided entirely. The blood pressure should be taken approximately 5 minutes after local anesthesia is administered to determine if a systemic response has occurred. In the unlikely event of a hypertensive emergency, a rapidly acting, short-duration antihypertensive drug, such as the alpha-blocker phentolamine (Regitine, 5 mg intravenously) should be administered. Sublingual nitroglycerin (Nitrostat, 0.4 mg) may be useful as a nonparenteral alternative. These recommendations apply to other nonselective beta-blockers, including nadolol (Corgard) and timolol (Blocadren). They may also apply to labetalol (Normodyne, Trandate), a nonselective beta-antagonist with some alpha-blocking activity and to pindolol (Visken), a beta-blocker with some intrinsic beta 2 agonistic activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278029 TI - Use of an unerupted third molar for a prosthetic abutment. PMID- 3278030 TI - The presidents. Louis A. Saporito 1972-1973. PMID- 3278031 TI - Neurotransmitter modulator (TENS) for control of dental operative pain. AB - A pain control study of 600 dental procedures was undertaken during a 1-year period. The procedures varied from vigorous subgingival scaling to endodontic procedures. Most procedures involved the placement of two- and three-surface anterior and posterior restorations. Results were evaluated for pain control related to procedure type, patients' level of relaxation, sensitivity to pain, and patients' skepticism about the success of the reduction in pain during the procedure. Electrical analgesia with neurotransmitter modulator (TENS) was a valuable adjunctive tool for scaling, prophylaxis, and restorative procedures. PMID- 3278032 TI - Prognostic significance of location and type of myocardial infarction: independent adverse outcome associated with anterior location. AB - To determine the relative prognostic significance of location (anterior or inferior) and type (Q wave or non-Q wave) of infarction, the hospital course and follow-up outcome (mean duration 30.8 months) of 471 patients with a first infarction were analyzed. Analyses were performed grouping the patients according to infarct location (anterior, n = 253; inferior, n = 218), infarct type (Q wave, n = 323; non-Q wave, n = 148), and both location and type (inferior non-Q wave, n = 85; inferior Q wave, n = 133; anterior non-Q wave, n = 63; and anterior Q wave, n = 190). Patients with anterior infarction had a substantially worse in-hospital and follow-up clinical course compared with those with inferior infarction, evidenced by a larger infarct size (21.2 versus 14.9 g Eq/m2 creatine kinase, MB fraction [MB CK], p less than 0.001), lower admission left ventricular ejection fraction (38.1 versus 55.3%, p less than 0.001) and higher incidence of heart failure (40.7 versus 14.7%, p less than 0.001), serious ventricular ectopic activity (70.2 versus 58.9%, p less than 0.05), in-hospital death (11.9 versus 2.8%, p less than 0.001) and total cumulative cardiac mortality (27 versus 11%, p less than 0.001). Patients with Q wave infarction similarly experienced a worse in-hospital course compared with patients with non-Q wave infarction, evidenced by a larger infarct size (20.7 versus 12.7 MB CK g Eq/m2, p less than 0.001), lower admission left ventricular ejection fraction (43.7 versus 50.6%, p less than 0.001), and a higher incidence of heart failure (31.9 versus 21.6%, p less than 0.05) and in-hospital death (9.3 versus 4.1% p less than 0.05). However, there was no increased rate of reinfarction or mortality in hospital survivors with non-Q wave infarction compared with those with Q wave infarction, and total cardiac mortality was similar (16 versus 21%, p = NS). To evaluate the role of infarct location and type independent of infarct size, patients were grouped according to quartile of infarct size, and outcome was reanalyzed within each group. Patients with anterior infarction demonstrated a lower left ventricular ejection fraction on admission and after 10 days than did patients with inferior infarction, even after adjustment for infarct size, as well as a higher incidence of congestive heart failure and cumulative cardiac mortality.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3278034 TI - Coronary flow and resistance reserve in patients with chronic aortic regurgitation, angina pectoris and normal coronary arteries. AB - Left ventricular hypertrophy has been found to be associated with a reduction of coronary vascular reserve, which could be responsible for episodes of myocardial ischemia. To evaluate coronary flow and resistance reserve in patients with chronic aortic regurgitation, coronary sinus blood flow and coronary resistance were measured before and after an intravenous dipyridamole infusion (0.14 mg/kg per min X 4 min) in eight control subjects and eight patients with aortic regurgitation, exertional angina pectoris and normal coronary arteriograms. Coronary flow reserve, evaluated by the dipyridamole/basal coronary sinus blood flow ratio, and coronary resistance reserve, evaluated by the basal/dipyridamole coronary resistance ratio, were both significantly reduced in patients with aortic regurgitation (1.67 +/- 0.40 versus 4.03 +/- 0.52 in control subjects, p less than 0.001 and 1.71 +/- 0.50 versus 4.38 +/- 0.88 in control subjects, p less than 0.001, respectively). In patients with aortic regurgitation, basal coronary sinus blood flow was higher than in control subjects (276 +/- 81 versus 105 +/- 24 ml/min, respectively, p less than 0.001) and basal coronary resistance was lower (0.31 +/- 0.13 versus 0.95 +/- 0.17 mm Hg/ml per min, respectively, p less than 0.001), but coronary blood flow and resistance after dipyridamole were not significantly different in the two groups (461 +/- 159 versus 418 +/- 98 ml/min in control subjects, 0.19 +/- 0.11 versus 0.22 +/- 0.04 mm Hg/ml per min in control subjects, respectively). These data demonstrate that coronary reserve is severely reduced in patients with chronic aortic regurgitation and exertional angina.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278033 TI - Myocardial infarction and normal coronary arteriography: a 10 year clinical and risk analysis of 74 patients. AB - Myocardial infarction with normal coronary arteries was identified in 74 patients with a mean age of 43 years (range 19 to 66). A mean follow-up period of 10.5 years after documented myocardial infarction and 8.6 years after cardiac catheterization was obtained. The survival rate was 85% (n = 63). There were no statistical differences in age or clinical risk factor prevalence between survivors and nonsurvivors. Moderate (55%) to severe (27%) left ventricular impairment was more common in nonsurvivors. Nine of 11 deaths were cardiovascular, 6 were sudden and 8 occurred in patients with moderate to severe global left ventricular impairment. Seventy-six percent of survivors were asymptomatic and 86% were fully active at follow-up. Two survivors and three nonsurvivors experienced a second myocardial infarction. The clinical risk factors of the study group (Group I) were compared by age, sex and year of catheterization with risk factors in two matched groups. Group II consisted of 74 patients with coronary occlusive disease and myocardial infarction and Group III consisted of 148 patients with normal arteriograms. Group I differed from Group II in having fewer clinical risk factors (p = 0.01 to less than 0.0001). Cigarette smoking did not differ significantly between Group I (72%) and Group II (69%) but was less common in Group III (45%) (p less than 0.001). Hormone therapy or the peripartum state was more common in women in Group I (34%) than in women in Group III (14%) (p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278035 TI - Initiation of lethal arrhythmias: use of experimental methods to study clinical observations. PMID- 3278036 TI - Effect of verapamil on postischemic "stunned" myocardium: importance of the timing of treatment. AB - Timely administration of verapamil has been shown to reduce indexes of ischemic injury in experimental models of prolonged coronary artery occlusion, yet its effect on contractile function of reversibly injured (that is, "stunned") myocardium remains unknown. The objective of the present study was to determine whether verapamil--administered either 30 min before coronary artery occlusion, at the time of reperfusion or 30 min after reperfusion--could attenuate the regional contractile dysfunction and alterations in high energy phosphate metabolism produced by 15 min of transient coronary artery occlusion in anesthetized, open chest dogs. All treatment groups exhibited passive systolic bulging during occlusion. In the control dogs receiving saline solution, segment shortening in the previously ischemic tissue averaged only 31 +/- 8% of normal baseline values after 3 h of reperfusion. In addition, endocardial adenosine triphosphate (ATP) stores were depleted by -8.7 +/- 0.8 nmol/mg cardiac protein to 26.5 +/- 1.1 nmol/mg protein, and endocardial creatine phosphate content increased by 9.6 +/- 4.3 nmol/mg cardiac protein over normal values. Pretreatment with verapamil essentially ablated the phenomenon of postischemic stunning: segment shortening was restored to 115 +/- 8% of normal after 3 h of reflow (p less than 0.01 versus control), endocardial ATP stores were partially preserved (30.6 +/- 1.2 nmol/mg protein; p less than 0.05 versus control) and creatine phosphate overshoot was blunted (endocardial creatine phosphate content decreased by -5.6 +/- 2.9 nmol/mg protein; p less than 0.05 versus control). Verapamil administered at or after reperfusion also attenuated postischemic contractile dysfunction: segment shortening for both groups recovered to 65 +/- 9% of baseline at 3 h after reperfusion (p less than 0.05 versus control). Verapamil given at or after reperfusion had no beneficial effect, however, on high energy phosphate stores. Thus, even when treatment was "delayed," that is, initiated at or after reperfusion, administration of verapamil significantly increased contractile function of the postischemic stunned myocardium. PMID- 3278038 TI - Magnesium therapy in premature neonates with apnea neonatorum. PMID- 3278037 TI - Pathology of the cardiac conduction system in myotonic dystrophy: a study of 12 cases. AB - In 12 autopsy cases of myotonic dystrophy, the most frequently observed histopathologic lesions of the cardiac conduction system were fibrosis, fatty infiltration and atrophy. Fibrosis involved the sinus node in 6 cases, atrioventricular (AV) node in 7, AV bundle in 8, bundle branches in 10 and ventricular myocardium in 11. Fatty infiltration was observed in the sinus node in two cases, AV node in two, AV bundle in six, bundle branches in one and ventricular myocardium in nine. Atrophy was prominent in the AV bundle in five and bundle branches in eight. Lymphocytes infiltrated the conduction system in three cases and were associated with myotonic dystrophy in two and varicella myocarditis in one. Ventricular myocytes were hypertrophied in seven cases, vacuolated in three and exhibited disarray in two. The distribution and extent of conduction system lesions tended to correspond to antemortem electrocardiographic abnormalities, including prolonged PR interval in six cases, intraventricular conduction delay in six and bundle branch block in four. Cardiac involvement by myotonic dystrophy may have contributed to sudden death in four cases. PMID- 3278039 TI - Sodium sensitivity: a determinant of essential hypertension. AB - The epidemiologic correlation of chronic dietary salt intake among populations with the prevalence of hypertension has resulted in the concept that sodium plays an etiologic role in the development of essential hypertension (EH). However, the association of sodium intake with blood pressure in individuals within populations has been difficult to demonstrate. The differing human responses to sodium intake are dependent upon the individual level of sodium sensitivity or sodium resistance. Factors associated with sodium sensitivity are race, age, and other dietary factors. More recent investigations have pursued the interaction of sodium intake with other physiologic parameters including neurogenic activity, vascular structure, renal function, and other cations such as potassium and calcium. The observations that some humans demonstrate very little increase in blood pressure despite high levels of sodium intake supports the concept that a high sodium intake alone is not a single causal factor in hypertension. Sodium intake appears to interact with renal excretory capacity and vascular compliance. These varying physiologic functions must be delineated to characterize sodium sensitivity. PMID- 3278040 TI - Serum zinc response in thermal injury. AB - Zinc is an essential trace element required for RNA and DNA synthesis and the function of over 200 zinc metalloenzymes. After surgery or trauma, the serum zinc concentration usually decreases. The magnitude and duration of this hypozincemia after thermal injury are unclear, as are mechanisms for this hypozincemia. In this study we evaluated, over the duration of their hospital course, serum zinc concentrations in 23 thermal injury patients. The initial mean serum zinc concentration was significantly depressed (42 +/- micrograms/dl; normal 66-110 micrograms/dl). By the second week of hospitalization, serum zinc concentrations gradually increased into the normal range in the majority of patients. Mechanisms for this hypozincemia were evaluated. Decreases in the serum zinc concentration did not correlate with increased urinary zinc excretion; thus increased urinary zinc excretion was an unlikely mechanism for the observed hypozincemia. Values for albumin, the major zinc binding protein in serum, generally were inversely correlated with the serum zinc concentration. Thus, hypoalbuminemia could not explain the decreased serum zinc concentration. Certain cytokines such as interleukin-1 are known to cause a decrease in the serum zinc concentration as part of the acute phase response. Therefore, we measured serum C reactive protein concentrations as an indicator of the acute phase response. Thermally injured patients initially had markedly elevated C-reactive protein levels which gradually decreased during hospitalization. We suggest that the initial hypozincemia observed in thermally injured patients may be a reflection of interleukin-1 mediated acute phase response. Whether one should vigorously attempt to correct this initial marked hypozincemia requires further investigation. PMID- 3278041 TI - Acquired immune deficiency syndrome: implications for optometry and the public health. AB - Recognized in 1981, acquired immune deficiency syndrome or AIDS has become a worldwide epidemic. HIV virus is believed to be the causative agent and acts primarily upon T-helper lymphocytes and nerve tissue, damaging the body's immune system. Ocular and systemic opportunistic infections result. Transmission is primarily by intimate contact with infected blood or semen. The virus has been found in eye tissues and raises questions about safety during eye care delivery, as well as optometry's role as a primary eye care profession. PMID- 3278042 TI - Health care cost, competition, and the quality of care in third party vision plans. AB - Spiralling costs have created new ways to deliver and pay for health care services. Competition and the desire of payors for the least expensive health plan have raised concern about the quality of services in third party plans. This paper reviews the issues surrounding quality of health care and offers guidelines to promoting quality eye and vision care plans. PMID- 3278043 TI - National trends in lens extraction: 1965-1984. AB - This paper describes the impact of modern technology on extraction of lens procedures. National estimates are presented on inpatient hospital utilization based on data collected through the National Hospital Discharge Survey. Trend data are shown for numbers, rates and average lengths of stay for patients with the procedure for 1965-1984. The trend data demonstrate changes in the procedure brought about by the effect of brought about by the effect of the introduction of Medicare and the introduction of the intraocular lens implant. Data on insertion of intraocular lens prosthesis are also presented for 1979-1984. PMID- 3278045 TI - Ocular manifestations of pregnancy. AB - Pregnancy results in hormonal changes that produce ocular effects. Normal pregnancies and pregnancies associated with underlying systemic pathology are considered here in a review of the recent literature. With current advances made in all areas of prenatal care, the optometrist can become an important link in the chain of primary health care delivery to his or her pregnant patients. This may be achieved by patient management and education or by referral and consultation/co-management with the appropriate specialist(s). PMID- 3278044 TI - Relationship of glare to uncorrected visual acuity and cycloplegic refraction 1 year after radial keratotomy in the prospective evaluation of radial keratotomy (PERK) study. AB - This study examines the relationship of subjective glare to refraction and visual acuity, respectively, 1 year after surgery in 435 patients who underwent radial keratotomy for nearsightedness in the Prospective Evaluation of Radial Keratotomy (PERK) study. Patients were asked if they experienced glare in bright light. Of the 425 responding, 200 patients responded "no" and 225 patients responded "yes." We found no statistically significant difference in the mean value of the cycloplegic refraction 1 year after surgery in these two patient groups. (Mean cycloplegic refraction: no = -.48, yes = -.52, p = .73). We also found no difference between these groups with respect to the percent of patients with uncorrected visual acuity of 20/40 or better 1 year after surgery (no = 79%, yes = 76%, p = .46). PMID- 3278046 TI - Optometric services and private health insurance. AB - This article provides an overview of the private health insurance system and its relevance to optometric practice. The extent of private health coverage in the U.S. and the projected decline of fee-for-service income mandates a working knowledge of the insurance system by optometrists and their staff members. The coverage of eye examinations and related services is dependent upon the diagnosis. Using a well-designed fee slip will expedite claims processing for patients and reduce insurance paperwork for the practitioner. Fee slip design and implementation are discussed in detail and illustrated with clinical examples. PMID- 3278047 TI - Streptococcal outbreak. PMID- 3278048 TI - Anterior cervical epidural abscess with pneumococcus in an infant. AB - Spinal epidural abscess is a rare infection in childhood. We report the first documented case of pneumococcal epidural abscess in an infant and review the literature regarding this entity. In children, the signs and symptoms of spinal epidural abscess may not be as helpful as those in older patients. Furthermore, the offending organism may not be the usual Staphylococcus seen in adults. Infants may recover neurologic function even after prolonged cord compression; however, a high index of suspicion is needed to make the diagnosis in a timely fashion. PMID- 3278049 TI - The management of children with spinal dysraphism. AB - Improvements in technology have dramatically increased the survival of children with spinal dysraphism. Because this complex condition affects multiple organ systems as well as the psychosocial functioning of the child and family, these children require care from a host of specialists in order to achieve optimum functioning. This article reviews the pathophysiology and discusses the current management of the medical and psychosocial effects of spinal dysraphism. It also briefly discusses strategies for intervention, long-term outcomes, and some controversies regarding care and screening. PMID- 3278051 TI - Computers in hospital epidemiology practice. PMID- 3278050 TI - Computerized real-time neuromuscular sonography: a new application, techniques and methods. AB - Diagnostic ultrasound has been extensively used for neurologic evaluation of cranial, vascular and spinal diseases. This study presents the techniques, methodology, and procedures for a new diagnostic application of ultrasound for evaluation of the neuromuscular system. In order to determine the optimum sonographic characterization of neuromuscular disease, normal anatomy has to be studied with ultrasound to develop a reproducible standardized methodology for routine use of ultrasound in neuromuscular imaging. To fulfill this objective, 30 subjects between the ages of 1 day and 59 years were studied with computerized real-time sonography. The results of this study are presented with illustration of the sonographic images of transverse and longitudinal planes of the upper and lower limbs. Computerization of optimum sonographic techniques, gradation of normal sonographic muscle anatomy by age, and elimination of operator variability were goals that were accomplished, thereby setting the stage for reliable, reproducible muscle imaging by ultrasound. PMID- 3278052 TI - Nosocomial Achromobacter xylosoxidans infections. AB - A xylosoxidans is being recognized as an important nosocomial pathogen. As more patients are rendered immunosuppressed by chemotherapy, this organism's increasing role in hospital-acquired infections will be assured. Achromobacter is a water-borne organism, highly resistant to most antibiotics, and even to some disinfectant solutions, and easily establishes itself in the hospital aquatic environment. Achromobacter infections and outbreaks should be recognized and approached as serious problems requiring the institution of appropriate infection control measures. A xylosoxidans infections should be empirically treated with a combination of a third generation cephalosporin and TMP-SMX pending susceptibility testing. PMID- 3278053 TI - Polymyalgia rheumatica and giant cell arteritis. PMID- 3278054 TI - Medical museum notes. PMID- 3278055 TI - Immunocytochemical localization of aldolase in normal, denervated, and dystrophic chicken muscles. AB - To investigate whether immunocytochemical localization of muscle-specific aldolase can be used for fiber phenotype determination, we produced specific antibodies against the enzyme and studied its distribution in adult chicken skeletal muscles by indirect immunofluorescence microscopy. Monoclonal antibodies against the myosin heavy chains of fast-twitch (MF-14) and slow-tonic (ALD-58) muscle fibers were also used to correlate aldolase levels with the fiber phenotype. The goat anti-aldolase antibody was found to be specific for the A form of aldolase, as evidenced by sodium dodecyl sulfate gel electrophoresis, immunotitration experiments, and immunoblot analysis. The antibody reacted strongly with the fast-twitch myofibers of normal pectoralis and posterior latissimus dorsi muscles; the phenotype of these muscle fibers was confirmed by a positive immunofluorescent reaction after incubation with MF-14 antibody. By contrast, the slow-tonic myofibers of normal anterior latissimus dorsi, which react positively with ALD-58 antibody, reacted weakly with anti-aldolase antibodies. In denervated chicken muscles, reaction to anti-aldolase antibodies was markedly reduced in fast-twitch fibers, although reaction to MF-14 was not diminished. By contrast, in dystrophic muscle, fast-twitch fibers showed reduced reactivity to anti-aldolase and marked to moderate reduction in MF-14 reactivity. Our results show that: (a) in normal muscles, reactivity to anti-aldolase matches the phenotype obtained by using anti-fast or anti-slow myosin heavy chain antibodies, and therefore can serve to identify mature fibers as fast or slow; and (b) in denervated or dystrophic muscles, the intracellular expressions of aldolase and fast-twitch myosin heavy chains are regulated independently. PMID- 3278056 TI - Differential inhibition of indirect immunofluorescence in rat liver sections incubated with antibodies against microsomal cytochromes P-450a, b, and c and epoxide hydrolase. AB - Rat liver sections were incubated with antibodies (100-1000 micrograms IgG/ml) against microsomal cytochromes P-450a, P-450b, and P-450c, and epoxide hydrolase. Inhibition of indirect immunofluorescence, which progressed with higher concentrations of primary antibody, corresponded with antigen-enriched tissue in frozen liver sections from male and female rats. It was found in liver sections from phenobarbital-treated rats incubated with anti-P-450b and anti-epoxide hydrolase and from 3-methylcholanthrene-treated rats incubated with anti-P-450c. No inhibition was found in sections from untreated rats or rats receiving treatments that did not induce the specific antigen. No inhibition was found in sections incubated with anti-P-450a. Inhibition of immunofluorescence was abolished in frozen sections subjected to dehydration-rehydration protocols known to extract antigens, and was prevented by certain solvents and detergent-wash. Inhibition of immunofluorescence provides a unique method for confirming the antigen-rich regions of the liver lobules specific for microsomal expoxide hydrolase and the cytochrome P-450s. PMID- 3278057 TI - A comparison of three immunoperoxidase techniques for antigen detection in colorectal carcinoma tissues. AB - We compared the streptavidin-peroxidase conjugate (SP) method of immunoperoxidase histochemistry to the unlabeled antibody (PAP) and avidin-biotin-peroxidase complex (ABC) techniques in human colorectal carcinoma tissues stained with a monoclonal antibody for expression of carcinoembryonic antigen. Compared to the ABC and PAP method, the SP method produced stronger staining intensity and very low background staining. This was true when other antibody isotypes, other antibody species, other organs, and another tumor-associated antigen were used. Moreover, the SP procedure time could be reduced to one third that of the ABC or PAP methods without compromising accuracy, and the SP reagent is stable for several months. The chemical nature of the streptavidin molecule accounts, in large part, for the advantages of the SP method. PMID- 3278058 TI - Light microscopic localization of alkaline phosphatase in fetal bovine bone using immunoperoxidase and immunogold-silver staining procedures. AB - We localized alkaline phosphatase in the metaphyses of fetal bovine tibial bone by use of avidin-biotin-immunoperoxidase and immunogold-silver staining procedures. Low melting-point, paraffin-embedded sections of periodate lysine paraformaldehyde-fixed undecalcified bone were used for immunostaining. We suggest that the combination of intact embryonic bone with this fixative and the immunohistochemical procedures used in this study may have helped to preserve antigenicity and thus to improve the efficiency of immunolabeling. Similar patterns of alkaline phosphatase localization were produced by the immunoperoxidase and immunogold-silver staining methods. The latter, although free of immunoreagents such as diaminobenzidine, must be monitored closely to avoid nonspecific staining during the silver enhancement procedure. Both methods revealed a concentration of the enzyme in osteoblasts and in areas of osteoid that lined the bone trabeculae. The results support the findings of earlier enzyme cytochemical studies in which osteoblasts were shown to have significant alkaline phosphatase activity. PMID- 3278059 TI - Evidence for an intracellular pool of a migration inhibitory factor-associated, activation antigen of human mononuclear phagocytes, Mo3e. AB - Mo3e is a protease-sensitive Ag (p75,50) selectively expressed by human monocytic cells stimulated in vitro by exposure to various activating factors including PMA. Here, we report the existence of a large intracellular pool of Mo3e Ag in addition to that expressed on the surface of activated U-937 cells. As detected by quantitative immunofluorescence analysis, permeabilization of unstimulated and PMA-stimulated U-937 cells revealed a latent pool of Mo3e Ag that was 75-fold and 9-fold greater, respectively, than the magnitude of Mo3e Ag expressed on the surface. PMA stimulation not only induced an increase in the relative proportion of Mo3e antigen expressed on the surface membrane, but also stimulated a 1.8-fold increase in "total" Mo3e detectable in permeabilized cells. Trypsin treatment of intact PMA-stimulated U-937 cells eliminated surface Mo3e expression but had little measureable effect on the total Mo3e pool. Permeabilization also uncovered a sequestered compartment of Mo3e Ag in I-937 cells, a variant of U-937 that is surface Mo3e negative. Although the PMA-induced surface Mo3e expression of U-937 was abrogated by cycloheximide, the total pool of Mo3e detectable in permeabilized PMA-stimulated cells was only partially reduced; cycloheximide treatment caused no reduction in the intracellular Mo3e compartment of unstimulated U-937 cells. Detergent lysates of PMA-stimulated U-937 cells exhibited undiminished quantities (relative to untrypsinized cells) of p75 and p50 proteins immunoreactive with anti-Mo3e mAb as detected by Western blotting. This trypsin-sequestered intracellular Mo3e Ag may serve as a reservoir for the up-regulated surface expression of Mo3e that occurs as a result of mononuclear phagocyte activation. PMID- 3278060 TI - E pluribus unum. PMID- 3278061 TI - Cachectin: a hormone that triggers acute shock and chronic cachexia. AB - Septic shock and invasive infection are diseases caused by humoral mediators of both exogenous and endogenous origin. The search for and identification of these factors has led to the discovery and molecular cloning of cachectin. This pyrogenic cytokine is identical to tumor necrosis factor (TNF) and, when released into the circulation, causes profound shock and multiple organ injury. Cachectin antibodies protect against the lethal effects of mice given endotoxin and baboons given E. coli, a result suggesting that this mediator is both necessary and sufficient to provoke septic shock. Cachectin is produced in humans after endotoxin infusion; the infusion of small doses of TNF is associated with fever, rigors, headache, and hypotension. Septicemic patients also produce cachectin, and during meningococcal infection, patients with the highest serum levels of cachectin die. Chronic cachectin production causes a potentially lethal syndrome of cachexia, anemia, and protein and lipid wasting. Future investigation is being directed toward the development of cachectin antibodies for use in treating the humorally mediated systemic complications of infectious disease. PMID- 3278063 TI - AIDS commentary. Azidothymidine. PMID- 3278062 TI - Host-parasite interaction in the urinary tract. PMID- 3278064 TI - Angiotensin converting enzyme inhibition in the management of congestive heart failure. PMID- 3278065 TI - Delirium in the elderly: acute organic mental disturbance. PMID- 3278066 TI - Middle ear effusion--a theoretical neuro mechanical hypotheses. PMID- 3278067 TI - Thirty years of stapes surgery. AB - The modern stapedectomy with prosthesis insertion and living oval window seal, like the modern cataract extraction with lens replacement, is now performed, very much the same, throughout the world. I have reviewed the evolution of stapes surgery during these last thirty years and tried to gain some agreement for several important facts about otosclerosis and several basic principals of stapes surgery. While a well-performed stapedectomy can eliminate the conductive component, the sensorineural hearing loss continues and, in about one-third, will progress till the patient, after age 65, must return to a hearing aid. A piston prosthesis gives the best hearing results: 0.6 mm diameter, when half the footplate is removed and a living oval window seal interposed, and 0.6 mm diameter when a small opening is made in the footplate obliterated by otosclerosis. I prefer a teflon prosthesis to stainless steel because it can be altered by the surgeon at operation, and vein as an oval window seal. I have presented a rare group of patients who develop facial palsy 5-1/2 days after uncomplicated stapedectomy, of whom all recover quickly and completely. I am confident that progress will continue to be made in the understanding of otosclerosis, and the performance of stapes surgery, but in these last thirty years we have made a good beginning. PMID- 3278068 TI - Relief of pain and trismus in patients treated with naproxen or acetylsalicylic acid after tonsillectomy. AB - The pain-relieving efficacy of naproxen and acetylsalicylic acid (ASA) in tonsillectomized patients was compared in a double blind parallel clinical trial comprising 83 patients, among whom 42 were treated with naproxen and 41 with ASA. The patients were treated post-operatively for two days with either naproxen suppositories 500 mg. twice, or ASA effervescent tablets 1000 mg. three times, daily. The therapeutic gain was evaluated by recording the intensity of pain, reduced ability to open the mouth (trismus), consumption of supplementary analgesic (parcetamol), and pain-related sleep disturbances. The statistical analysis of the results revealed no differences in pain intensity, consumption of additional analgesics or pain-related sleep disturbances in the two treatment groups. A considerable degree of trismus was demonstrated in most of the tonsillectomized patients. This reduced ability to open the mouth was gradually overcome in the naproxen group while it remained unchanged in the ASA group, however, no statistical significant difference could be demonstrated. Additionally, no significant positive correlation between pain intensity and trismus was proven. The pain-relieving effect, however, was unsatisfactory in both the naproxen and the ASA group, and clinical controlled trial studies of alternative analgetics in tonsillectomized patients are still to be encouraged. PMID- 3278069 TI - Hypopharyngeal carcinomatosis, large bowel obstruction and a gastrobronchial fistula. A case report with a review of the literature. PMID- 3278070 TI - Swallowed radiolucent dental prostheses: risk of extraluminal oesophageal perforation. PMID- 3278071 TI - Ectopic thyroid malignancy in the midline of the neck (a case report and literature review). AB - A 71-year-old female presented with a midline neck mass. The clinical impression was that of a thyroglossal cyst but preoperative assessment suggested a solid lesion, possibly malignant. The mass was removed surgically using the Sistrunk technique and shown pathologically to be a mixed papillary-follicular carcinoma of the thyroid with no cystic elements. Clinically and radiologically the thyroid was normal and thyroidectomy was not performed. This management is discussed along with a brief review of the relevant literature on the pathology and treatment of similar lesions. PMID- 3278072 TI - Accelerated recovery of hematopoiesis following sub-lethal whole body irradiation with recombinant murine interleukin-1 (IL-1). AB - This communication reports the results of studies designed to investigate the ability of recombinant murine interleukin-1 (rIL-1) to enhance the recovery of hematopoiesis following administration of sub-lethal whole body irradiation (2 Gy). Mice were administered rIL-1 (100 and 500 units) i.p. Twenty-four hours later these mice were administered 2 Gy radiation. Irradiated control mice were given only phosphate buffered saline (PBS). Animals were then serially sacrificed (on days 1, 2, 4, 7, 9, and 12 following irradiation) and their peripheral blood was analyzed for indices (packed red cell volume, WBC, platelets, and differential). Femoral bone marrow was harvested and assayed for their stem cell content--erythroid (CFU-E, BFU-E), granulocyte-macrophage (CFU-GM), and megakaryocyte (CFU-MEG). Irradiated mice pretreated with rIL-1 demonstrated accelerated hematopoietic recovery as measured by higher WBC, platelets and femoral stem cell content than PBS-treated irradiated controls. These results indicate IL-1 may be an effective radioprotective agent against the hematotoxicity induced by ionizing radiation. PMID- 3278073 TI - Outcome in anorexia nervosa and bulimia nervosa. A review of the literature. AB - Forty follow-up studies of anorexia nervosa and bulimia nervosa are reviewed. Data on recovery, relapse, and crossover are presented in addition to data on mortality, weight, eating behavior, menses, psychological functioning, and psychosexual functioning. Predictors of these outcomes are discussed. Guidelines for future research are suggested to decrease the variability that is created by differences in research methodologies and study designs. PMID- 3278074 TI - Nerve-cell grafting in Parkinson's disease. AB - The successful utilization of fetal nerve-cell grafts as therapeutic tools in animal models of neurodegenerative disease has prompted the first clinical attempts in parkinsonian patients in at least three countries. The extensive scientific data in rodents coupled with the first successful fetal neural grafts in monkeys with experimental parkinsonism suggest that consideration might now be given to clinical applications. Attention is also directed to the various types of donor cells that might be utilized in clinical trials for the treatment of parkinsonism, including potential benefits, risks, and limitations associated with each type of donor material. This review highlights major developments in this field as they relate to basic principles of neural grafting and discusses potential applications in humans. PMID- 3278075 TI - Comparison of bromodeoxyuridine labeling indices obtained from tissue sections and flow cytometry of brain tumors. AB - Sixteen patients with brain tumors were given a 30- to 60-minute intravenous infusion of bromodeoxyuridine (BUdR), 200 mg/sq m. Grossly viable fragments were taken from the biopsied tumor specimens and divided into two portions. One portion was dissociated into single cells, stained both with fluorescein isothiocyanate (FITC) using anti-BUdR monoclonal antibody as the first antibody and with propidium iodide (for deoxyribonucleic acid), and analyzed by flow cytometry (FCM). The labeling index (LI) was calculated as the number of FITC labeled cells expressed as a percentage of the total number of cells analyzed. The other portion was fixed in 70% ethanol, embedded in paraffin, sectioned, and stained with immunoperoxidase using anti-BUdR monoclonal antibody as the first antibody. The LI of these tissue sections was calculated in two ways: from selected areas in which the labeled cells were evenly distributed and from the entire tissue section. The LI's obtained by FCM correlated closely with those from the entire tissue sections (r = 0.99, p less than 0.000001) and were usually lower than LI's from selected areas of tissue sections. The LI's determined by FCM also correlated well with the LI's from selected areas of tissue sections (r = 0.82, p less than 0.00012), despite the difference in values between them. Thus, the FCM-derived LI and the tissue LI can both provide useful information for predicting the biological malignancy of individual tumors and for designing treatment regimens for individual patients with brain tumors; however, different standards should be used to interpret the LI's obtained by these two methods. PMID- 3278076 TI - The International Society for Heart Transplantation: eighth annual meeting and scientific sessions. April 20-22, 1988, Los Angeles, California. Abstracts. PMID- 3278077 TI - Lectin-binding histochemistry of intracellular and extracellular glycoconjugates of the reserve cell zone of growth plate cartilage. AB - The distribution of intracellular and extracellular lectin-binding glycoconjugates of the reserve cell zone of growth plate cartilage was studied in the distal radial growth plate of 4-week-old Yucatan swine using a postembedment method on Epon-embedded sections. Direct comparisons were made to articular, tracheal, and auricular cartilages not involved in endochondral ossification. All patterns of lectin binding that in the growth plate were restricted to the reserve cell zone were also patterns characteristic of tracheal, articular, and auricular cartilages. These included: (a) pericellular binding with peanut agglutinin (PNA) without prior digestion with neuraminidase; (b) pericellular binding with wheat germ agglutinin (WGA) at 24 h; (c) intracellular cytoplasmic binding to concanavalin A (CON-A), Lens culinaris agglutinin (LCA), and Lotus tetragonobolus agglutinin (LTA) after periodic acid oxidation; and (d) a lack of pericellular binding with CON-A and ricin agglutinin 1 (RCA-1) after periodic acid oxidation. We conclude that reserve zone chondrocytes lack specific phenotypic markers as defined by lectin-binding affinity that are found in the cellular zones of the growth plate that undergo calcification and vascularization. The reserve zone has identical lectin-binding affinities to the three structural cartilages used as controls. One interpretation of these results is that the reserve zone may not be involved directly in endochondral ossification, but may have a structural function in growth plate cartilage. PMID- 3278078 TI - Effect of purified human interleukin-1 on cartilage degradation. AB - The effects of highly purified human monocyte-derived interleukin-1 (IL-1) on bovine nasal cartilage breakdown were investigated. Cartilage degradation was determined by quantifying the fraction of total proteoglycan released from cartilage during 8 days of culture. The response appeared to be chondrocyte dependent, for IL-1 stimulated proteoglycan (PG) release from living but not from dead (frozen-thawed) cartilage. IL-1 action on living cartilage was heat labile and concentration dependent, with significant effect at 5 U/ml and maximal effect at 10-20 U/ml. Kinetic studies showed significant stimulation of PG release by 3 days of incubation with 10 U/ml IL-1. Studies in which IL-1 was removed on day 1 or day 4 showed that the cartilage-degrading effect of this monokine was reversible. Although IL-1 caused little change in the Sepharose CL-2B chromatographic profile of released PGs using an associative elution buffer, a significant shift to lower mol wt was observed under dissociative conditions. To probe the mechanism of IL-1 action, cartilage samples were incubated with IL-1 in the presence of the protein synthesis inhibitor, cycloheximide, or the lysosomal membrane-stabilizing steroid, hydrocortisone. Cycloheximide at 5-10 micrograms/ml completely blocked IL-1-induced breakdown. One the other hand, 3 x 10(-7) M hydrocortisone had little or no effect on IL-1 action. IL-1 was also shown to stimulate the degradation of human articular cartilage. PMID- 3278079 TI - Moderate running exercise augments glycosaminoglycans and thickness of articular cartilage in the knee joint of young beagle dogs. AB - The local influences of physical exercise on thickness and glycosaminoglycan (GAG) content of canine articular cartilage were measured by microspectrophotometry of Safranin O- and periodic acid-Schiff (PAS)-stained tissue sections. Female Beagle dogs were housed in individual cages (bottom 0.9 x 1.2 m) and divided into runner (n = 6) and control (n = 8) groups. The training program started at the age of 15 weeks. During the subsequent 10 weeks, the dogs were accustomed to running on a treadmill inclined 15 degrees uphill. Thereafter, the dogs ran 1 h daily, 5 days a week, at a speed of 4 km/h for 15 weeks. At the age of 40 weeks, the dogs were killed, and the samples for histology were taken from 11 different anatomical locations of the right knee (stifle) joint. The thickness of the uncalcified cartilage increased 19-23% on the lateral condyle and patellar surface of the femur, whereas the enhancement was smaller in other parts of the trained cartilage. The calcified cartilage did not show thickness alterations. Total GAGs were augmented by 28% in the summits on the femoral condyles, more on the medial than lateral side. The increased GAGs appeared to be predominantly chondroitin sulphates and were localized in the intermediate, deep, and even in the calcified zones, whereas the superficial zone did not show changes. There was a concomitant increase of non-GAG oligosaccharides in the intermediate and deep zones, but not in the calcified cartilage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278080 TI - Model analysis of factors influencing the prediction of muscle forces at the knee. AB - A three-dimensional stochastic mathematical muscle model of the knee joint has been developed and applied to a study in which the influence of both mechanical and physiological factors were examined in relation to the prediction of muscular forces about the joint. The model includes a representation of the proximal portion of the tibia and distal portion of the femur along with a mathematical expression of the patellar mechanism and 13 muscles crossing the knee joint. The model accounts for the rolling and gliding movement of the tibial-femoral articulation. The computational technique involves equilibrating three components of external moments at the knee joint to the internal moments generated by muscular forces and soft tissue. The variables contained in the moment equilibrium equation are randomly chosen based on the choice of the tibial femoral contact point. The randomness of the variables, reflected in the final solution, defines a stochastic process in the context of the present model. Studies with the model indicated that a very important mechanical aspect of the model was the capability to simulate the moving contact point between the tibia and femur. The moving contact point increased the mechanical advantage of the quadriceps muscles by 50%, which corresponded to in vivo EMG measurements. Muscle force predictions during normal gait have shown the capability of the model to determine the presence of synergistic and antagonistic muscle action. PMID- 3278082 TI - Angiomatous malformation of the retrolaminar optic nerve. AB - A vascular abnormality of the optic nerve was found incidentally in two infants whose eyes were enucleated because of the clinical suspicion of retinoblastoma. The lesion consisted of numerous thin-walled vascular channels within pial septa of the retrolaminar optic nerve. Although it is unclear if this angiomatous malformation could disturb vision, the lesion may be more common than can be inferred from the small number of reported cases. PMID- 3278081 TI - Comparative evaluation of the diffusion of tobramycin and cefotaxime out of antibiotic-impregnated polymethylmethacrylate beads. AB - Both tobramycin and cefotaxime diffuse from antibiotic-impregnated polymethylmethacrylate (PMMA) beads in quantities sufficient to inhibit the growth of bacteria on agar lawns or in broth cultures over a 28-day period. Extraction of antibiotic from tobramycin or cefotaxime-impregnated PMMA beads revealed that substantial amounts of both antibiotics remained within the beads despite 28 days of diffusion. Diffusion of antibiotic from the PMMA beads during the initial 3-5 days is much greater than occurs for the remainder of the 4-week period. The results of the study suggest that perhaps tobramycin of cefotaxime impregnated PMMA beads would produce local levels of antibiotic high enough to sterilize a given dead space for a period of 28 days. PMID- 3278083 TI - Metastatic Serratia marcescens endophthalmitis. AB - Metastatic endophthalmitis in a ten-day-old baby who underwent colostomy for an unperforated anus and developed septicemia to Serratia marcescens is described. Although rapid isolation of the agent enabled efficacious specific antibiotic treatment and systemic eradication of the infective agent, the ocular condition continued to deteriorate. Because of the total loss of visual functions and the fear of possible development of sympathetic ophthalmia, enucleation rather than vitrectomy or evisceration was performed. Histopathologic examination of the globe revealed massive infiltrates within the choroid and optic nerve with total destruction of the retinal architecture. The child recovered immediately after surgery and was discharged a week later. PMID- 3278084 TI - Kasabach-Merritt syndrome. AB - Eight infants with hemangiomata associated with severe consumption coagulopathy are reviewed; three died. The presentations and method of management are discussed. The varied response to different modalities of therapy initiated this report and led to a search of the world literature in an attempt to identify the pattern of response, if any, to particular therapy. From our own experience with two cases and from the review of the literature, it appears that radiotherapy alone or in combination with steroids gives a superior overall treatment in terms of reducing the death rate. PMID- 3278085 TI - Frantz's tumor: a papillary and cystic tumor of the pancreas in girls. AB - Four girls with Frantz's tumor, a papillary and cystic tumor of the pancreas, are studied and discussed in comparison with 112 cases in the literature, including 58 Japanese cases. The neoplasms occur predominantly in girls and young women. Up to recently, the tumors have possibly been misclassified as nonfunctioning islet cell tumor or carcinoma, acinar cell carcinoma, papillary cystadenocarcinoma, or pancreatoblastoma according to microscopic findings and frequently have been managed with aggressive surgery such as pancreatoduodenectomy. The tumors are well encapsulated and the cut surfaces show characteristically solid and hemorrhagic-necrotic patterns. Ultrasonography and CT scan are the most useful tools for the diagnosis. The neoplasms usually behave like a very low-grade malignancy, so that complete removal is the treatment of choice for the tumor arising anywhere in the pancreas. Immunochemical and electron microscopic studies can differentiate Frantz's tumor from other neoplasms and also suggest that the tumors originate from primordial cells or multipotential stem cells capable of differentiating into both exocrine and endocrine lines. PMID- 3278086 TI - Preventing accidental decannulations following tracheostomy. AB - Tracheostomy in infants and children is associated with a high rate of accidental decannulation in the early postoperative period. Eighty-eight patients underwent tracheostomy from 1980 to 1985, and 22 were sutured in place. Accidental decannulation occurred in 31.8% of the nonsutured and 4.5% of the sutured tracheostomies. We advocate suturing tracheostomy tubes in place in infants and children and describe a simple suture technique for this purpose. PMID- 3278087 TI - Ureteropelvic junction obstructions: prenatal diagnosis and neonatal surgery in 47 cases. AB - In a series of 150 patients with congenital urologic disorders diagnosed in utero and managed in the neonatal period from 1980 to 1985, 48 cases were ureteropelvic junction obstructions. One was a false positive, and 47 were documented pyelocaliceal distension and retention; 12 of them were bilateral. Five cases had a spontaneous resolution. Three had a nephrectomy performed (destroyed kidney). Fifty kidneys have been operated on (Anderson-Hynes dysmembered pyeloplasty). Ninety percent of the cases are reported as clinically, biologically, and radiologically fair. Six percent postoperative complications are reported. The authors pointed out the great interest in neonatal repair of this condition, using microsurgical techniques without stent or nephrostomy. A comparison is made of the overall results with an identical series of older patients operated on during the same period. PMID- 3278088 TI - Acute scrotum due to Haemophilus influenzae type b. AB - The acute scrotum in infants and children is generally due to torsion of the spermatic cord, torsion of the appendix testis, or acute epididymitis. An infant is presented who was found to have epididymitis and a scrotal abscess due to Haemophilus influenzae type b at the time of surgical exploration for suspected torsion of the spermatic cord. PMID- 3278089 TI - Idiopathic perforation of the biliary tract in infancy and childhood. AB - The case of a 25-day-old Saudi boy with spontaneous perforation of the biliary tract is reported. The mode of presentation and treatment are described and the literature on the subject reviewed. PMID- 3278090 TI - Macrodystrophia lipomatosa of the foot. AB - This study deals with a case of macrodystrophia lipomatosa, the literature is reviewed, the surgical correction is described and attention is drawn to the differential diagnosis. PMID- 3278091 TI - Virginia Ohlson: ambassador to postwar Japan. PMID- 3278092 TI - Malignant melanoma. Case study and review of the literature. PMID- 3278093 TI - Use of tissue expansion in podiatric surgery. A literature review and case report. PMID- 3278094 TI - Metal-reinforced glass ionomers: their flexural and bond strengths to tooth substrates. AB - This study compared the flexural strengths and bond strengths to dentin and enamel of two brands of silver-reinforced glass ionomers with their respective unfilled glass-ionomer cements for luting. The results led to the following conclusions. 1. No significant differences in bond strengths to tooth substrates were recorded between silver-reinforced and unfilled glass ionomers. 2. Although the mean bond-strength values of enamel were higher than those of dentin, no statistically significant differences were observed. 3. No significant differences in bond strengths to tooth substrates were observed between the two brands of glass ionomers studied. 4. No differences in flexural strengths were recorded between the silver-reinforced glass ionomer and glass ionomer of a similar brand for luting. 5. Ketac-Silver and Ketac-Cem cements had significantly higher flexural strength than Fuji II Lumi Alloy and Fuji I cements. PMID- 3278095 TI - Effect of preparation cleaning procedures on crown retention. PMID- 3278096 TI - The effect of finishing resin-bonded fixed partial dentures on postcementation tensile strength. PMID- 3278097 TI - Gold-plating etched-metal surfaces of resin-bonded retainers. PMID- 3278098 TI - A gingival guard for crown preparation. AB - A device for subgingival margin preparation is presented. The gingival guard consists of a clamp attached to the high-speed handpiece supporting a stainless steel shank terminating in a sphere. The guard permits nontraumatic subgingival margin preparation. PMID- 3278100 TI - Tensile and peel bond strengths of tray adhesives. PMID- 3278099 TI - Evaluation of resin-bonded retainers with the scanning electron microscope. AB - The data confirmed that etching produced a stronger bond than air abrasion of the metal. PMID- 3278101 TI - Wear characteristics of high-strength denture teeth. PMID- 3278102 TI - Tissue-integrated prostheses for edentulous patients with normal and abnormal jaw relationships. AB - Diagnosis and treatment planning are keys to successful prosthodontic rehabilitation. The increasing interest in the use of the tissue-integrated prosthesis to resolve the problems of edentulous patients indicates caution in the selection of patients for this procedure. Even if patients are identified who could potentially benefit, application of the concept must meet the needs of the patient. The treatment planning phase must include all professionals participating in patient management and must consider the best placement of fixtures to improve patient findings to an optimal degree. Although many patient factors must be considered in treatment planning, this article discussed application of the tissue-integrated prosthesis concept as it relates to jaw relationship. The tissue-integrated prosthesis must not compound or create retention and stability problems found with complete dentures. This article suggests treatment considerations in planning the tissue-integrated prosthesis for normal and abnormal jaw relationships. PMID- 3278103 TI - The dentist and AIDS. PMID- 3278104 TI - A reverse buildup technique using light-cured composite. PMID- 3278105 TI - Therapeutic considerations in postpartum endometritis. AB - The physiologic changes of pregnancy and the puerperium and their effect on antibiotic therapy have not received widespread attention. Pregnancy is accompanied by multiple physiologic changes, including increased uterine weight, blood volume, extracellular fluid, endometrial blood flow and renal function changes. Those changes affect therapy for endometritis since it may take several weeks for a return to the pregravid state. Preeclampsia is associated with reductions in intravascular space, increased extravascular space from edema and impaired renal function. Postpartum uterine changes may also complicate drug therapy because of poor antibiotic perfusion. The ideal antibiotic for postpartum endometritis would achieve optimal uterine tissue levels, be administered infrequently, and have adequate activity against anaerobes and minimal toxicity. PMID- 3278106 TI - Prevention of sexually transmitted diseases in women. AB - The frequency and severity of sexually transmitted diseases (STDs) and their sequelae, including sterility, numerous perinatal infections, genital tract neoplasia and possibly death (from ectopic pregnancy, ruptured tuboovarian abscess, human immunodeficiency virus-1 and hepatitis B virus infection), should be acknowledged by all sexually active individuals. Aspects of sexuality that place individuals at risk of STDs must be reexamined. Health care providers must effectively inform patients and the public of these often-ill-appreciated risks in a straightforward fashion, free of judgmental and punitive attitudes. New, more-effective means of prevention, diagnosis and treatment are being sought using research techniques in microbiology, immunology and behavioral science. In the meantime, medical screening, treatment and contact tracing should be carried out for patients and their sexual partners. Sexually active individuals must be empowered with knowledge and emboldened to protect themselves and their established or potential families from these common infections. Existing means of screening and treating must be utilized fully. PMID- 3278107 TI - Acute pelvic inflammatory disease. Etiologic and therapeutic considerations. AB - Acute pelvic inflammatory disease (PID) is a community-acquired bacterial infection presumed to be initiated by sexual activity. The therapeutic goals in its treatment are to treat the symptoms, preserve fertility when desired and prevent the development of sequelae. PID should be diagnosed early and accurately, and appropriate antimicrobial therapy should be initiated immediately. Cost-effective parenteral therapy should include antibiotics that can be administered in as few daily doses as possible without sacrificing efficacy. PMID- 3278108 TI - Microbiologic considerations in the treatment of serious pelvic infections in women. AB - Antibiotic therapy in the woman with suspected pelvic inflammatory disease (PID) may often be empiric. Thus, an understanding of the microbiology of the female genital tract is important in the informed selection of therapy for PID. Chlamydia trachomatis plays an important role in PID, and tetracycline and erythromycins are the agents most active against those infections. Neisseria gonorrhoeae is also an important pathogen in PID, particularly in a lower socioeconomic, urban setting. The treatment regimens currently recommended for penicillinase-producing N gonorrhoeae are spectinomycin and a broad-spectrum cephalosporin. Other bacterial flora of the female genital tract, including the facultative enteric bacilli, gram-positive aerobes and anaerobes, play an important pathogenic role in PID. Among the broad-spectrum cephalosporins, ceftizoxime has been shown to possess greater activity against isolates of the Bacteroides fragilis group and enteric bacilli than do the related agents, cefoxitin and cefotetan. PMID- 3278109 TI - Preservation of fertility in women with pelvic inflammatory disease. AB - The epidemic of sexually transmitted diseases has placed young, sexually active women at risk of infertility from tubal and pelvic factors. Salvaging reproductive function in women desiring fertility depends upon an accurate diagnosis and early, aggressive therapy for all cases of salpingitis. Conservative surgical management of tubal pregnancy in such women is now standard practice. Less-aggressive surgical approaches to chronic pelvic inflammatory disease and even tuboovarian abscess, when possible, can preserve some part of the pelvic anatomy in these women, who may then undergo reconstructive pelvic surgery or in vitro fertilization. Due to the recent technological revolution in infertility therapy, preservation of a women's uterus alone is all that is necessary to sustain the hope for a pregnancy. PMID- 3278110 TI - Pelvic inflammatory disease. Decision making in the pharmacy and therapeutics committee. AB - In today's environment of cost containment, the pharmacy and therapeutics committee plays an increasingly important role in determining the availability of antibiotics for the treatment of specific diseases. However, if the drug is not optimal for treatment and sequelae of a disease process develop, no true savings are gained. The goal of treating pelvic inflammatory disease should not be just reduction of morbidity but preservation of fertility and reduction of surgery after therapy. Multiple factors must be considered when choosing antibiotic therapy for pelvic inflammatory disease, including the spectrum of pathogenic organisms involved, the efficacy of the antibiotic chosen, the safety profile of the antibiotic, the pattern of resistance to the antibiotic in both the hospital and the community, the cost of administering the antibiotic and management of its side effects. This paper reviews the concepts used at the Chicago Lying-in Hospital, University of Chicago, in choosing the primary antibiotic, ceftizoxime, for the treatment of pelvic inflammatory disease. This antibiotic offers a broad spectrum of antimicrobial activity with little resistance, few side effects, evidence of penetration into the infected tissues and prolonged dosing intervals, which allow substantial cost savings as well as efficacious treatment of acute pelvic inflammatory disease. PMID- 3278111 TI - Prevention of infections after obstetric and gynecologic surgery. AB - The need for antimicrobial prophylaxis in patients undergoing vaginal hysterectomy is well recognized, and the benefits of prophylaxis in cesarean section are relatively clear-cut. In contrast, only those patients at risk of serious complications from postoperative infection are considered candidates for prophylaxis after abdominal hysterectomy. This paper addresses the following questions: Does the patient need prophylaxis? If so, how should the most suitable antibiotic be selected? PMID- 3278112 TI - Surgical approaches to pelvic infections in women. AB - Pelvic abscess is a complication of gynecologic disease or obstetric surgery. Tuboovarian complex is differentiated from abscesses because of the absence of a true abscess wall; treatment of a tuboovarian complex is conservative. The diagnosis of tuboovarian complex is made by history, pelvic examination and ultrasonography. Tuboovarian abscesses (TOAs) are sequelae of surgical procedures. Both conventional and novel surgical techniques can be used to manage them. Pelvic thrombophlebitis and ovarian vein thrombosis are late complications of pelvic infections that may be associated with significant morbidity and mortality. PMID- 3278113 TI - Microorganisms and premature labor. AB - A number of organisms, including Mycoplasma, group B Streptococcus, Bacteroides, Neisseria gonorrhoeae and Chlamydia trachomatis, have been isolated more frequently from patients in premature labor than from controls. Prophylactic antibiotic treatment in some studies lowered the incidence of prematurity. Silent chorioamnionitis has been noted in 15% of patients in premature labor. Untreated pyelonephritis is clearly associated with premature labor; however, the association of asymptomatic bacteriuria, appropriately treated pyelonephritis and premature labor is less clear. Some microorganisms have been demonstrated to produce phospholipase A2 and possibly prostaglandins, which might be the mechanism for some of the associations between premature labor and bacteria. PMID- 3278114 TI - Postpartum endometritis. Pathophysiology and prevention. AB - Postpartum endometritis (PPE) continues to be a leading cause of morbidity in the puerperium. The patient's endogenous cervicovaginal flora remains the source of the polymicrobial character of this infection. Patients in labor with ruptured membranes for more than three hours who undergo delivery by cesarean section have an increased risk of developing PPE. PMID- 3278115 TI - Use of ultrasound localization to improve results of fine needle aspiration cytology of breast masses. AB - A prospective randomized controlled trial of 116 patients with breast masses was conducted to compare the accuracy of 'blind' aspiration cytology performed in the clinic with aspiration cytology using ultrasound localization. The unsatisfactory aspiration cytology rate was significantly reduced by ultrasound localization (P = 0.028). This was mainly due to an improvement in the unsatisfactory rate for tumours less than 3 cm in diameter (P = 0.036). The results were influenced by the number of needle manoeuvres performed, less than 10 needle manoeuvres being associated with a 54% unsatisfactory aspiration rate compared with 25% when greater than 10 manoeuvres were performed (P = less than 0.02). One experienced aspirator in the clinic had results comparable to those achieved with ultrasound localization. It is concluded that experience and technique are the most important factors in obtaining a satisfactory aspirate from breast masses. Routine ultrasound localization prior to aspiration confers some benefit. Consideration should be given to the use of the ultrasound-assisted technique following a previous unsatisfactory aspiration, particularly if the tumour is less than 3 cm in diameter. PMID- 3278116 TI - The dexamethasone suppression test as a variable in clinical diagnosis and research: a review. PMID- 3278118 TI - Surgery at Waterloo. PMID- 3278117 TI - Familial dysalbuminaemic hyperthyroxinaemia: a review. PMID- 3278119 TI - Master John of Arderne--surgeon of Newark. PMID- 3278120 TI - Leprosy and the Bible. PMID- 3278121 TI - Regulated expression of the human mutant ras gene after transfection of BALB/c mouse embryo fibroblast cells. AB - Four continuous cell lines constructed by transfecting BALB/c mouse fibroblast cells with an expression system that has the mutant c-Ha-ras gene under control of a truncated version of the mouse metallothionein-1 (mt-1) promoter were characterized for zinc-induced phenotype switching. These cells were selected for transformation in the presence of zinc, a known inducer of the mt-1 promoter. When the transfected cells were grown in medium depleted of zinc, there was a dramatic reduction in their soft agar cloning efficiency. Adding zinc back to the medium restored the transformed phenotype in a dose-dependent manner. Analysis of the intracellular p21 levels of induced and uninduced cells showed that zinc was modulating the expression of the transfected ras gene. In vivo studies done with syngeneic mice showed that zinc-induced cells were tumorigenic and formed metastatic lesions in the lungs of the inoculated animals. PMID- 3278123 TI - Arterial drug infusion: pharmacokinetic problems and pitfalls. AB - The pharmacokinetic theory of intra-arterial drug administration has been clearly articulated. It provides a useful guide to the development and interpretation of preclinical studies and clinical trials. Despite the clarity and usefulness of the theory, there are misunderstandings of its implications and technical problems associated with its implementation. Few studies have been properly designed to validate the theory experimentally. Independence of steady-state pharmacokinetic advantage on intraregion blood flow differences predicted for a nonextracted drug is counterintuitive. Extrapolation from laboratory animals to humans raises some important questions of allometry, particularly for the brain, which does not follow the scaling rules applicable to other organs. Finally, drug streaming from the site of infusion has been observed in vitro and in vivo. The extent of the resulting clinical problem has not been adequately characterized, but it may be severe under some circumstances. PMID- 3278122 TI - Phase I and pharmacokinetic trial of carboplatin in refractory adult leukemia. AB - Sixteen patients [13 acute nonlymphocytic leukemia (ANLL), 2 acute lymphocytic leukemia, 1 chronic myelogenous leukemia in a blast crisis; median age, 40 yr; range, 25-78 yr; 9 male, 7 female] received 23 courses of carboplatin given as a bolus on a daily X 5 schedule. Six patients were given 7 courses of carboplatin at 200 mg/m2/day; 3 patients received 5 courses at 250 mg/m2; 9 patients received 11 courses at 300 mg/m2; 2 patients initially treated at 200 mg/m2 were given their 2nd course at 300 mg/m2. Significant hearing loss documented by audiometry occurred in five patients, including three of nine treated at 300 mg/m2. All five had prior or recent exposure to aminoglycoside antibiotics. Three patients developed cancer and acute leukemia group B grade 3 or 4 mucositis, and 18 of 23 courses were complicated by nausea and vomiting. Marrows were hypocellular or aplastic in all patients treated at the highest dose. No complete responses occurred, although two patients with ANLL treated at 300 mg/m2 achieved partial responses lasting 71 and 138 days. The t1/2 alpha [half-life (t1/2)], t1/2 beta, and total body clearance of ultrafilterable platinum were comparable to those previously described by us in patients receiving bolus doses of carboplatin of 22 77 mg/m2/day X 5. Carboplatin has activity in ANLL. PMID- 3278124 TI - Post-tonsillectomy and adenoidectomy hemorrhage. AB - This is a retrospective review of 6842 tonsillectomies and adenoidectomies performed over a seven-year period at the Montreal Children's Hospital. The total incidence of postoperative bleeding was 2.5%. The incidence of primary post tonsillectomy hemorrhage was 1.0%, with 78% of these children having developed bleeding within 12 hours of surgery. The overall incidence of secondary post tonsillectomy hemorrhage was 1.2%. Twenty-nine percent of children with primary hemorrhage required a second general anesthetic, and 40% required blood component transfusion. Eight percent of children with secondary hemorrhage required a second general anesthetic and 24% received transfusions. Based on these findings, primary and secondary hemorrhage can be classified further into major and minor. The criteria for a major post-tonsillectomy hemorrhage are: requirements of a general anesthetic to control and repair the bleeding, or blood loss that is sufficient to require blood component transfusion therapy. The relevance of these findings with regard to outpatient adenotonsillectomies is discussed. PMID- 3278125 TI - Hemostatic suture for septoplasty: how we do it. AB - One of the disadvantages of the septoplasty procedure is patient discomfort, mainly from nasal packing, usually necessitating hospital stay. In an attempt to overcome some of this problem, a method was sought to replace the purpose of packing; namely hemostasis, prevention of hematoma and displacement of the retained cartilage. A continuous septal suturing technique was conceived some years ago by one of the authors (LV) and since then used extensively and perfected by both. Using this method in more than 800 cases (both septoplasties and septorhinoplasties) has proved to considerably reduce patient discomfort by eliminating nasal packs, and allowed the septoplasty procedure to be carried out in most cases on a day-surgery basis, also reducing the hospital stay of the septorhinoplasties. The final postoperative appearance of the septum also seems better than previously. We conclude that the use of the continuous hemostatic stabilizing septal suturing technique is a useful modification of the standard procedure, with only minor increase in operating time. PMID- 3278126 TI - Sexual dysfunction and electroejaculation in men with spinal cord injury: review. PMID- 3278127 TI - Cadaveric renal transplantation: surgical results and expectations in the cyclosporine era. AB - During a 36-month period 100 patients received 104 cadaveric renal transplants with cyclosporine-based immunosuppression. Of the patients 26 required 31 additional operations. Of the 19 secondary operations performed 1 month after transplantation 18 were emergency in nature, whereas beyond this period the majority of the procedures were elective. Both deaths in this series were related to the operation. Only 1 graft loss was directly attributed to a secondary operation. The patient undergoing cadaveric renal transplantation is at significant risk (25 per cent) of requiring at least 1 additional operation. However, despite this high probability of reoperation, graft loss and patient death after such procedures should be rare. PMID- 3278128 TI - Ultrasonically determined kidney transplant hypertrophy. AB - Increased renal transplant size is a criterion of acute rejection. Statistically significant increases in ultrasonically measured kidney graft dimensions were demonstrated in 8 recipients of living related donor kidneys who never had rejection crises. After an average followup of 4.9 +/- 3.8 months (range 2 to 12 months), anteroposterior, cross-sectional and pole-to-pole measurements were increased by 0.75, 1.9 and 0.58 cm., respectively. Some increase in kidney graft size is normal and should not be confused with acute rejection. PMID- 3278129 TI - Extravesical ureteroneocystostomy in renal transplantation. AB - From October 1970 to January 1986, 808 patients underwent renal transplant ureteroneocystostomy by an extravesical technique. Complications related to the anastomosis and/or ureter were reviewed. There were 23 total complications, for an over-all urological complication rate of 2.8 per cent. Of these complications 17 were related to the ureteroneocystostomy, for an anastomotic complication rate of 2.1 per cent. Complications were almost universally repaired by another operation. Two patients died and 1 lost the allograft because of urological complications. PMID- 3278130 TI - Colonic complications of renal transplantation. AB - Colonic complications of renal transplantation occur in 1.9 per cent of the cases. In our series of 587 consecutive renal transplants recipients 3 (0.51 per cent) had colonic complications, including 2 with ischemic colitis and 1 with pseudomembranous colitis. A review of 8 large series describing 2,539 additional renal transplant patients revealed 55 with significant colonic complications. The most common complication was ischemic colitis, which occurred in 29 patients, followed by diverticulitis in 17, pseudomembranous colitis in 5, appendicitis in 3, hemorrhagic proctitis in 1, a disrupted appendiceal stump in 1 and fecal impaction in 1. Etiological factors that may be important in the development of these colonic complications are uremia, blood volume redistribution, immunosuppressive therapy, antibiotic therapy, irradiation and previous retroperitoneal surgery. PMID- 3278131 TI - Surgical treatment of localized renal cell carcinoma in von Hippel-Lindau's disease. AB - From 1981 to 1986, 10 patients with von Hippel-Lindau's disease underwent an operation for bilateral nonmetastatic renal cell carcinoma. Of the patients 9 underwent unilateral partial nephrectomy and contralateral radical nephrectomy, and 1 underwent bilateral nephrectomy with subsequent hemodialysis and cadaver renal transplantation. Pathologically, the tumor was stage I in 9 patients and stage III in 1. Currently, 8 patients are alive after partial nephrectomy (5 to 56 months) with good renal function (mean serum creatinine 2.0 mg. per dl.) and no evidence of malignancy; 1 of these patients underwent excision of a cerebral metastasis 2 years after partial nephrectomy. One patient is alive on dialysis after removal of the renal remnant for local tumor recurrence. The patient who underwent transplantation is free of tumor with a well functioning allograft. The distinctive features of renal cell carcinoma in von Hippel-Lindau's disease that influence the management of these patients are reviewed. PMID- 3278132 TI - Vena caval extension of right renal vein for cadaveric renal transplants. AB - A short right renal vein can create technical problems during cadaveric renal transplants. A method is described of right renal vein extension. The technique incorporates the proximal vena cava into the right renal vein, using the cephalad vena caval opening as the new renal vein ostium. The potential advantages of this method are discussed. PMID- 3278133 TI - Pelvic lymphocele after pediatric renal transplantation: a successful technique for prevention. AB - Pelvic lymph accumulation (lymphocele) is a recognized complication of renal transplantation. During a 12-year period 166 renal transplants were performed in 143 children at our institution. From 1973 to 1979, 5 lymphoceles were treated in 64 children. From 1979 until the present a technique of peritoneal fenestration has been performed in 69 children, in whom 1 lymphocele developed. Lymphoceles required surgical treatment in 5 of the remaining 10 cases that were not fenestrated. Our experience with peritoneal fenestration as a method of lymphocele prevention has been excellent, and we recommend it as a prophylactic addition to renal transplant surgery. PMID- 3278134 TI - Post-rejection ureteral obstruction owing to ureteral adherence to graft inferior pole. AB - We describe 2 renal transplant patients with increasing plasma creatinine levels after resolution of acute rejection episodes. Antegrade pyelography demonstrated adherence of the ureter to the inferior pole of the kidney with partial obstruction in both cases, which was confirmed at operation. PMID- 3278135 TI - The integration of clinical renal transplantation into urology residency training. PMID- 3278137 TI - Renal transplantation in a patient with an artificial urinary sphincter device. AB - Use of the artificial urinary sphincter device has become widespread. We describe the successful transplantation of a renal allograft into a recipient with an artificial urinary sphincter. Pretransplant placement of a sphincter, intraoperative avoidance of the prosthetic device and proper urinary drainage perioperatively make the artificial urinary sphincter device a feasible means to provide continence in a renal transplant recipient. PMID- 3278136 TI - Transplantation of a horseshoe kidney en bloc: report of a case. AB - Transplantation of a horseshoe kidney rarely has been reported. We report a case of successful en bloc transplantation of a horseshoe kidney. The kidney could not be divided because of a complex vascular situation in the isthmus region. The recipient was discharged from our hospital with normal kidney function 12 days postoperatively. We recommend the use of kidneys with anatomical malformations for transplantation. PMID- 3278138 TI - Combination extracorporeal shock wave lithotripsy and percutaneous extraction of calculi in a renal allograft. AB - Renal calculi are a well documented although uncommon complication of kidney transplantation and may be associated with significant morbidity in this immunosuppressed population with a single functioning kidney. We describe a patient who presented with 2 episodes of staphylococcal bacteremia associated with a ureteral structure and struvite calculi involving the calices, renal pelvis and proximal ureter of a cadaveric renal allograft. The patient was treated successfully with a combination of extracorporeal shock wave lithotripsy, percutaneous extraction and balloon dilation of the ureteral stricture. Renal transplant function was not altered postoperatively. In selected cases shock wave lithotripsy can be used as effective adjunctive therapy in a renal allograft harboring stones. PMID- 3278139 TI - Decompensated ureteropelvic junction obstruction in renal allograft. AB - We report a case of complete obstruction at the ureteropelvic junction in a renal allograft 6 months after related kidney transplantation. Surgical treatment consisted of a Foley nondismembered Y-V pyeloplasty. Although the donor harbored undetected bilateral, mild, ureteropelvic junction stenosis, as established by review of the excretory urogram that was performed before nephrectomy, the remaining kidney functioned well, as confirmed by renal function and morphological appearance on a repeat excretory urogram. The possible mechanisms of ureteropelvic junction decompensation, the most crucial of which appears to be autonomic denervation of the allograft, are discussed. PMID- 3278140 TI - Long-term survival and late development of bladder cancer in renal transplant patient with progressive multifocal leukoencephalopathy. AB - We describe a renal transplant recipient in whom progressive multifocal leukoencephalopathy and transitional cell carcinoma of the bladder developed. Despite these potentially fatal sequelae of chronic immunosuppression the patient remains free of recurrent disease. PMID- 3278141 TI - Intraoperative sonography: application in renal cell carcinoma. AB - Our ability to detect and potentially to treat renal tumors earlier has increased exponentially during recent years, in part owing to the introduction of more sophisticated imaging modalities. We report 2 cases in which intraoperative sonography was used to localize tumors not palpable at operation. In both cases surgery was performed on solitary kidneys for renal cell carcinoma in otherwise healthy patients. PMID- 3278142 TI - The pathological, ultrasonographic and computerized tomographic characteristics of chronic hematocele. AB - We report a case of a chronic hematocele and describe its characteristics. The specific pathological lesion of a chronic hematocele consists of several neovascular formations covered by layers of fibrin. These lesions give characteristic ultrasonic and computerized tomographic images, consisting of several sharply circumscribed small spherical areas of soft tissue. When correctly interpreted before the initiation of surgical treatment, these images will obviate an orchiectomy, which is not always necessary. PMID- 3278143 TI - Urinary stone matrix. PMID- 3278144 TI - Monitoring quality of care. PMID- 3278145 TI - When did artificial heart implants begin? PMID- 3278146 TI - Aminophylline treatment in severe, acute asthma. A meta-analysis. AB - Aminophylline is routinely recommended as a basic part of the emergency treatment of asthma. A comprehensive search found 13 reports of controlled trials of intravenous aminophylline therapy in severe, acute asthma. These studies compared aminophylline therapy with treatment with either albuterol (salbutamol), epinephrine, or other bronchodilators. The 13 reports did not agree. Seven reported no difference in spirometric values between aminophylline treatment and the control regimens. Three found aminophylline treatment superior. Three favored the control regimen. The results of the 13 trials were reanalyzed and pooled. Overall, there was no difference between the aminophylline-treated groups and the control groups. Sensitivity analysis suggests that aminophylline therapy is ineffective alone but may be more effective than single-drug therapy when combined with an injected beta-agonist. Despite widespread practice, available trials do not provide adequate evidence to support or reject the use of aminophylline in the treatment of severe, acute asthma. PMID- 3278147 TI - Meta-analysis. A quantitative approach to research integration. AB - Meta-analysis is being used with increasing frequency in clinical medicine as an attempt to improve on traditional methods of narrative review by systematically aggregating information and quantifying its impact. Combining data from several studies using meta-analysis can increase statistical power, provide insight into the nature of relationships among variables, and increase generalizability of results more rigorously than less quantitative review methods. Like all review methods, meta-analysis can be limited by sampling bias, inadequate data, and biased outcome interpretation. Still, the advantages noted above make meta analysis a methodology that warrants testing and empirical evaluation. PMID- 3278148 TI - Progress and objectives in cancer control. AB - This article reviews progress in cancer control and objectives for achieving further control. In particular, rather than relying on a single composite statistic such as the age-adjusted mortality rate, this review stresses trends in cancer mortality in the United States using a cohort analysis. That method reveals a decline in cancer mortality beginning with young children in the 1950s and proceeding up the age scale in subsequent decades to those persons who were approximately 50 years of age in the mid-1980s. From age 55 years upward, the continuing increase in cancer mortality is due to epidemic lung cancer. The principal cause of that disease and what must be done to control it are well understood. The objectives for cancer control by the year 2000 set by the National Cancer Institute and the feasibility of reducing cancer mortality by as much as 25% to 50% are also considered. Increased cancer prevention research is needed. PMID- 3278149 TI - How to evaluate a diagnostic marker test. Lessons from the rise and fall of dexamethasone suppression test. AB - To understand why the dexamethasone suppression test (DST) for the diagnosis of depression became widely accepted and later rejected, we reviewed the sequence of publications in the DST literature. To evaluate the events, we developed and applied concepts of a five-phase process that can be used to assess the clinical utility of diagnostic marker tests. The review showed that when the DST was introduced into the clinical arena, the initial and final two phases of testing (I, IV, and V) had not been adequately conducted. When these phases of testing were suitably checked many years later, the Phase I studies (exploring basic mechanics of test procedures) showed that dexamethasone had variable bioavailability and that the cortisol assay procedure was unreliable. The Phase IV and V studies (examining test results in groups with suitably broad spectrums of cases and controls) showed that the test did not differentiate depression from most pertinent comorbid conditions. Beyond application to the specific problems of the DST, the proposed five phases of development and evaluation for diagnostic marker tests can be used to plan suitable research and avoid similar problems in the future. PMID- 3278151 TI - Nation's first '21st-century' morgue opens with veteran chief medical examiner in charge. PMID- 3278150 TI - Drug abuse in athletes. Anabolic steroids and human growth hormone. Council on Scientific Affairs. AB - This report, the first in a three-part series on drug abuse by athletes, responds to adopted Resolution 4 (1984 Annual Meeting) and to Resolution 57 (1986 Annual Meeting), "Human Growth Hormone," which was referred to the Board of Trustees for action. Subsequent reports will cover other classes of abused drugs. PMID- 3278152 TI - From the Health Care Financing Administration. PMID- 3278153 TI - Leads from the MMWR. Acute rheumatic fever at a Navy training center--San Diego, California. PMID- 3278154 TI - Lithium treatment of manic-depressive illness. Past, present, and perspectives. PMID- 3278155 TI - Biotechnology and medicine of the future. AB - The practice of biology and medicine has been revolutionized during the past ten years by the advent of three biotechnologies--recombinant DNA techniques, the monoclonal antibody technology, and the development of microchemical instrumentation, machines that permit the rapid and effective synthesis and sequence analysis of proteins and genes. In this article, these powerful biotechnologies will be discussed, with particular emphasis on microchemical instrumentation, a major focus of my efforts for the past 15 years. I will also discuss two fundamental problems in modern medicine that are being explored in my laboratory using these techniques--genetic engineering of the nervous system and the mapping and sequencing of the human genome. PMID- 3278156 TI - Antibody and T-cell receptors. PMID- 3278157 TI - Cyclotrons and radiopharmaceuticals in positron emission tomography. Council on Scientific Affairs. Report of the Positron Emission Tomography Panel. AB - Positron emission tomography (PET) can probe biochemical pathways in vivo and can provide quantitative data; for that purpose, tracers labeled with positron emitting radioisotopes are essential. This report describes the tracers that are being used or that may have future use, their production by cyclotrons, and other needed resources for PET imaging. Current routine and automated methods for convenient production of labeled compounds, coupled with simple computer controlled accelerators, can support the creation of clinical PET centers in any large medical institution, obviating the need for in-depth research teams. An alternate approach involves the development of regional centers that provide in house service and that supply fluorine 18- and carbon 11-labeled compounds to nearby hospitals with PET machines. PMID- 3278158 TI - Effect of nucleotide restriction and supplementation on resistance to experimental murine candidiasis. AB - The influence of dietary nucleotides on susceptibility to candidiasis in mice was studied using two criteria: animal survival and recovery of viable Candida albicans organisms from the kidney and spleen. One-month-old mice were placed on one of five diets with varying nucleotide content. The results show that mice maintained on a nucleotide-free diet (NF) exhibit a significantly decreased mean survival time and a significantly increased viable organism recovery in the spleen following intravenous injection of graded inocula of C. albicans compared to mice fed diets containing RNA or uracil as a nucleotide source. PMID- 3278159 TI - Management of catheter-related infections in pediatric patients. AB - Broviac catheters are commonly used to provide parenteral nutrition and access for infusion of blood products and drugs to pediatric patients. Sepsis is the most common serious complication of continued catheter use. Although removal of the catheter is generally recommended when it becomes contaminated, it may not be feasible to do so without compromising patient care. We evaluated the management of catheter-related infections in pediatric patients with and without removal of catheter. Seventy-seven episodes of catheter sepsis were evaluated in 61 pediatric patients; 24 were neonates and 37 were older children. The catheters were used for multiple purposes in 75% of cases. The most common microorganisms isolated were Staphylococcus epidermidis in 26%, Klebsiella pneumoniae in 9%, and Streptococcus viridans in 8% of cases; other pathogens included group D Enterococcus, Staphylococcus aureus, and Escherichia coli. Pseudomonas aeruginosa was isolated in four older children. Thirty-five patients were treated with antibiotics without catheter removal. Thirty patients received appropriate antibiotic therapy based on the susceptibility data. Twenty-six of these 30 patients responded within 5 days of therapy whereas the others required 15-39 days of treatment. Lack of response was mainly associated with the presence of abscess, immunocompromised status, and organisms P. aeruginosa and Candida albicans. Based on the sensitivity and minimum inhibitory concentration data, a combined regimen of gentamicin and vancomycin would be an effective initial therapy. These findings suggest that (1) catheter sepsis can be managed with appropriate antibiotics, and (2) when continued use of Broviac catheter is desired, a trial of antibiotic therapy should be attempted before catheter removal. PMID- 3278161 TI - [80-year anniversary of infant welfare in Berne. From infant welfare to counseling for mothers. From aides to nurse counselors]. PMID- 3278160 TI - Noninvasive diagnosis of renal allograft rejections--application of an information-theoretical model. AB - This paper describes an information-theoretical model developed for detection of renal allograft rejection on the basis of various laboratory data. In this report the mathematical background of the model is described in detail and the rationale of its use is discussed. An example is given for the practical application of the model in kidney grafted patients. In the 30 patients of the test collective, seven rejection episodes were diagnosed by the clinicians and verified histologically. All seven rejection episodes were detected by the model, in the mean 2.4 days (median; 3 days) before the clinical diagnosis. PMID- 3278162 TI - An optimal morphometric method for quantitating wound epithelization. AB - A new, inexpensive method for quantitative evaluation of reepithelization of shallow split thickness wounds in piglets is described. Wounds, 2.2 X 2.2 cm and 0.4 mm depth are inflicted by an electro-keratome knife in domestic piglets. At a specific time after wounding, the wound area is excised and processed for histology. A computer simulation, based on a randomized systematic sectioning of an entire wound, was used to conclude that only eight sections from the 2.2 X 2.2 cm wound are needed for the final evaluation. The results showed that the above method allows for determination of the epithelization magnitude within +/- 5% at a 95% confidence limit. It was found that in 15 kg piglets 50% epithelization of the above wounds was achieved in 65 hr; however, there exists a great interindividual variability. The rate of epithelization is age dependent and significantly faster in 7 kg body weight piglets than in those weighing 40 kg. The epithelization rate was the same at both the wound edge and the center of the wound, stressing the importance of hair follicles as a source of epithelization. PMID- 3278163 TI - Experimental methods in the pathogenesis of limb ischemia. AB - Ischemia of extremities is responsible for considerable morbidity and mortality and the pathophysiology of this condition warrants further study. The purpose of this review is to discuss techniques used in the evaluation of limb ischemia and reperfusion. It is of critical importance to study limb blood flow distribution to the microcirculation where nutritive exchange occurs. Skeletal muscle ischemia progresses to infarction when critical deficits of cellular metabolites develop, which mandates that studies be focused at the cellular level. It is clear that the adverse effects of ischemia can be exacerbated by a reperfusion injury to the endothelium of the microvasculature. Investigators wishing to study limb ischemia have a wide spectrum of methodology and established models available to use in improving the understanding of the complex events of ischemic injury. PMID- 3278164 TI - Neurologic manifestations of non-ketotic hyperglycemia. PMID- 3278165 TI - That's life. PMID- 3278166 TI - Surgical implications of hepatic venocclusive disease following bone marrow transplantation. AB - Hepatic venocclusive disease occurs with a spectrum of severity in an estimated 21% of bone marrow transplant patients. Clinical features include severe right upper quadrant pain, ascites, weight gain and initially minimal derangement of liver function. In contrast to hepatic graft versus host disease, venocclusive disease usually occurs within the first three weeks of engraftment and in autologous grafts. Urgent surgical consultation is requested when these features are prominent enough to mimic common acute processes requiring laparotomy. This condition must be included in the differential diagnosis in order to avoid an unnecessary laparotomy in this select group of patients who are usually severely thrombocytopenic and leukopenic. Clinical diagnosis alone is very reliable. PMID- 3278167 TI - Tumor markers carcinoembryonic antigen, tissue polypeptide antigen, and carbohydrate antigen 19/9 in liver diseases. AB - The tumor markers carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), and carbohydrate antigen 19/9 (CA19/9) have been compared with regard to their sensitivity to liver diseases. All three markers have been found to be sensitive to liver diseases, but to a different degree: TPA rises the most; CEA the least. The sensitivities of TPA and CA19/9 are higher in a group of liver diseases than, for comparison, in a group of colorectal carcinomas. PMID- 3278168 TI - Oxygen-derived free radical scavengers for amelioration of reperfusion damage in heart transplantation. AB - In this study we tried to define the possible benefits of the oxygen-derived free radical scavengers after 3 hours of cold myocardial global ischemia, as required in the setting of cardiac transplantation. Twenty-one pig hearts were harvested after preservation with a cold cardioplegic solution (St. Thomas' Hospital solution) and topical cooling. Normothermic reperfusion with blood was achieved with a special heart-lung machine preparation, which allows the heart to beat in a working or nonworking mode. Twelve hearts served as control hearts (group I), and nine (group II) were subjected to superoxide dismutase and catalase. Superoxide dismutase was applied at a dose of 40 U/ml of cardioplegic solution and 1500 U/kg body weight with the start of reperfusion. Catalase was added to the cardioplegic solution in a dose of 100 U/kg and 3500 U/kg body weight with the start of reperfusion. After 15 minutes of retrograde reperfusion, both left ventricular developed pressure and its first derivative were significantly higher in group II (137 +/- 7.6 mm Hg, 2467 +/- 162 mm Hg/sec) than in group I (105 +/- 6 mm Hg, 1676 +/- 231 mm Hg/sec, p less than 0.05 for each). In addition, a considerably higher coronary blood flow was observed in group II throughout the 180-minute period of reperfusion (p = 0.047). We therefore conclude that the combined administration of superoxide dismutase and catalase during the initial period of cardioplegic arrest and during early reperfusion of donor hearts submitted to 3 hours of cold ischemia has a beneficial effect on myocardial performance. PMID- 3278169 TI - Prevention of free radical-induced myocardial injury by allopurinol. Experimental study in cardiac preservation and transplantation. AB - To determine the role of free radical-induced injury during heart preservation and transplantation, we harvested hearts from 28 mongrel dogs (12.5 to 16.5 kg), divided them into four groups, and orthotopically transplanted them. A group of seven hearts were orthotopically transplanted immediately after excision (group A). A second group of seven animals received allopurinol pretreatment (50 mg/kg/day) for 72 hours, and the hearts were orthotopically transplanted immediately after excision (group B). A third group of seven hearts were transplanted after continuous perfusion with oxygenated modified Collins solutions at 4 degrees C, pH 7.4, and a pressure of 20 mm Hg for 18 hours (group C). A fourth group of seven animals received allopurinol pretreatment (50 mg/kg/day) for 72 hours, and the hearts were orthotopically transplanted after perfusion with modified Collins solutions in the same manner as group C hearts (group D). The generation of free radicals, estimated by measurement of thiobarbituric acid reactive substances (malondialdehyde) in the coronary effluent, stayed at low levels during perfusion in groups C and D and also remained at low levels during operational ischemia in group A and B. During reperfusion, their levels abruptly and significantly increased and were associated with a corresponding increase in creatinine kinase MB isoenzyme (malondialdehyde levels at 30 minutes' reperfusion: A, 2.25 +/- 0.43; B, 1.55 +/- 0.25 nmol/ml/100 gm wet weight [p less than 0.05 versus group A]; C, 2.67 +/- 0.28; D, 1.77 +/- 0.27 nmol/ml/100 gm wet weight [p less than 0.05 versus group C]). In the allopurinol pretreatment groups, allopurinol significantly slowed the appearance of malondialdehyde and the release of creatinine kinase MB isoenzyme during reperfusion. Furthermore, cardiac functions during reperfusion, expressed as percent of control (mean +/- standard deviation), were significantly better in the allopurinol pretreatment groups than in the untreated groups: maximum first derivative of left ventricular pressure: A, 76.4 +/- 9.5; B, 99.7 +/- 14.3 [p less than 0.05 versus group A]; C, 25.2 +/- 2.6; D, 42.7 +/- 7.9 [p less than 0.05 versus group C]). These results indicate that (1) the generation of oxygen free radical is not significant during perfusion with modified Collins solutions nor during operational ischemia, but only during reperfusion, and (2) allopurinol reduces free radical-induced injury during reperfusion. Allopurinol has potential application in the prevention of reperfusion injury during heart transplantation. PMID- 3278171 TI - Speculations on the cause of childhood acute lymphoblastic leukemia. PMID- 3278170 TI - The role of epsilon-aminocaproic acid in reducing bleeding after cardiac operation: a double-blind randomized study. AB - Sixty patients scheduled for elective coronary artery bypass graft operations were randomly assigned to receive epsilon-aminocaproic acid or placebo to test whether antifibrinolytic therapy would decrease postoperative bleeding. A small but significant decrease in bleeding was observed in the treated group without complications resulting from treatment with epsilon-aminocaproic acid. PMID- 3278172 TI - 12th codon mutation resulting in c-N-ras activation in acute myelogenous leukemia. AB - Activation of the cellular oncogene c-N-ras has been frequently observed in DNA from leukemic cells in acute myeloid leukemia (AML). Ras gene activation sufficient to mediate in vitro transformation and rodent tumorigenesis usually results from point mutations and amino acid substitutions in the 12th or 61st codons. In AML and the related myelodysplastic syndromes, amino acid substitution at the 13th codon has been observed. An activated c-N-ras gene from a 45-year-old patient with AML was isolated by transfection analysis and subjected to molecular cloning and sequence analysis. A point mutation of the 12th codon (GGT to GAT) resulting in aspartic acid substitution for glycine was observed. In other neoplasms such as colon cancer, specific ras mutations occur predominantly (e.g., K-ras, codon 12). This predominance has been of demonstrable value in analyzing large cohorts for ras activation with techniques that are rapid and economical, such as oligonucleotide hybridization. It had previously been thought that such a predominance for activation of c-N-ras at codon 13 existed in AML; however, this study in concert with others underscores the importance of 12th codon c-N-ras mutations, along with 13th and 61st codon mutations in the molecular pathogenesis of AML. Guanylate to adenylate transition mutations are commonly observed in AML and may provide insight into potential environmental leukemogens. Addressing all commonly prevalent ras activating mutations bears impact in the future design of molecular surveys of the role of ras activation in leukemogenesis. PMID- 3278173 TI - Anniversary of Dr. William Worrall Mayo's arrival in Rochester. PMID- 3278174 TI - Cyclosporine nephrotoxicity is minimized by adjusting dosage on the basis of drug concentration in blood. AB - Two immunosuppressive regimens-cyclosporine plus prednisone and azathioprine plus prednisone-were compared in 78 renal transplantation patients (39 in each treatment group) who were successfully managed for more than 15 months. In patients who received cyclosporine, the dosage was adjusted to achieve trough whole blood concentrations of 100 to 250 ng/ml measured by liquid chromatography. A greater number of haplotypes matched in the azathioprine-treated group than in the cyclosporine-treated group (P less than 0.026). Graft survival was similar in patients who received azathioprine (95%) and those given cyclosporine (94%). The azathioprine group had a higher mortality (7%) than the cyclosporine group (2%). In a comparison of the two treatment groups, no statistically significant difference was found in posttransplant renal function, based on either serum creatinine or iothalamate clearance. We conclude that renal toxicity due to cyclosporine can be minimized to statistical nonsignificance by using cyclosporine dosages that provide trough whole blood concentrations in the range of 150 to 250 ng/ml during the first 4 months of therapy and 80 to 200 ng/ml thereafter. PMID- 3278175 TI - Oral glucose tolerance test: indications and limitations. AB - The oral glucose tolerance test has been used in many clinical situations. From a practical standpoint, however, it has limited applicability. The test should never be done to evaluate reactive hypoglycemia. It can be used in the patient whose fasting plasma glucose level is less than 140 mg/dl but who manifests symptoms compatible with complications of diabetes. Finally, all pregnant patients should undergo testing for gestational diabetes with a 50-g glucose screen at 24 to 28 weeks of pregnancy, and a subsequent glucose tolerance test should be performed if the result of that test is abnormal. PMID- 3278176 TI - Chronic aortic regurgitation: indications for operation--1988. AB - Timing of operation in a patient with severe aortic regurgitation is a difficult and controversial decision, especially when the patient is asymptomatic or minimally symptomatic. A rational decision can be made when the pathophysiologic features of aortic regurgitation and the natural history of medically treated patients are understood and the benefits and risks associated with aortic valve replacement are known. Proper interpretation of the literature involving echocardiography and nuclear cardiology is essential, as is consideration of the constantly changing surgical techniques and results. Aortic valve replacement should be recommended for those patients with chronic aortic regurgitation who are severely symptomatic (New York Heart Association Functional Class III or IV), in order to ameliorate symptoms and increase longevity. In asymptomatic or minimally symptomatic patients, close continued serial follow-up is necessary in order to detect the onset of resting left ventricular dysfunction and to recommend the optimal timing for surgical intervention. PMID- 3278177 TI - Recent advances in the management of venous thromboembolism. AB - Deep venous thrombosis and pulmonary embolism are frequently diagnosed in patients encountered in a primary-care practice. In the past 10 years, many important advances have been made regarding the management of these disorders. Risk factors have been better defined than in the past. Several new prophylactic measures--such as external pneumatic compression of the lower extremities, dihydroergotamine in combination with heparin, adjusted-dose heparin, and two step warfarin therapy--can be used to help prevent deep venous thrombosis in surgical patients. The use of serial impedance plethysmography has expanded options for noninvasive diagnosis of deep venous thrombosis. Correlations between pulmonary embolism and ventilation-perfusion lung scan patterns have been clarified. Although much has been learned about heparin and warfarin that affect common management decisions, the indications for thrombolytic therapy for venous thromboembolism remain controversial. Finally, studies have shown that calf vein thrombi that are not detectable by impedance plethysmography and that show no evidence of proximal propagation by serial impedance plethysmography do not require treatment. PMID- 3278178 TI - Magnetism used for "cure" in early medicine. PMID- 3278179 TI - Conformational analysis and computer graphics in drug research. PMID- 3278180 TI - GABA synaptic mechanisms: stereochemical and conformational requirements. PMID- 3278181 TI - Applications of NMR spectroscopy to biological systems. PMID- 3278182 TI - Colchicine and its analogues: recent findings. PMID- 3278183 TI - The chemistry of methotrexate and its analogues. PMID- 3278184 TI - Management of obstructive sleep apnea: comparison of various treatment modalities. AB - From July, 1982 through March, 1986, 253 patients with moderate to severe sleep apnea (OSA) were treated and had polysomnographic assessment of treatment. The treatment modalities were: 1. uvulopalatopharyngoplasty (UPP), 2. nasal continuous positive airway pressure (CPAP), 3. tracheostomy, 4. medication (tricyclic antidepressants), 5. tongue retaining device (TRD), and 6. orthodontic device. Uvulopalatopharyngoplasty was performed in 98 patients. The patients were categorized according to post-treatment improvement in the apnea/hypopnea index (A+HI) and severity index (SI) into good, moderate, and poor responders. There were 37 (37.7%) good, 33 (33.6%) moderate, and 28 (28.5%) poor responders in this group. Twenty-four patients underwent tracheostomy. Eighteen (75%) patients continue to have their tracheostomies without complications (mean follow-up time 32 months). One hundred thirty-eight patients were evaluated with CPAP. Of the 100 patients who began home CPAP use, 53 continue to use CPAP successfully at 18 months. Medical treatment (tricyclic antidepressants) was used in 35 patients. The response to this modality was generally poor. Six patients were fitted with TRD. The compliance to this device was poor, although two have had significant improvement in their apnea. An orthodontic appliance was used in two patients with one responding successfully. PMID- 3278185 TI - Evaluation of malignant invasion of the carotid artery by CT scan and ultrasound. AB - Carcinoma adherent to the carotid artery may be present in advanced head and neck cancers. Angiography, ultrasound, computerized tomography (CT), and magnetic resonance imaging (MRI) are available for the preoperative evaluation of the carotid artery. This study demonstrates that CT is not accurate in demonstrating malignant invasion of the carotid artery. Ultrasonography appears to be the best modality for assessing carotid artery invasion. Magnetic resonance imaging may prove helpful in this determination. PMID- 3278186 TI - Interferon alfa-n1 (Wellferon) in juvenile onset recurrent respiratory papillomatosis: results of a randomized study in twelve collaborative institutions. AB - Sixty-six patients with clinically severe juvenile-onset recurrent respiratory papillomatosis (RRP) were entered into a 12-month randomized crossover study to evaluate interferon alpha-n1 Wellferon (WFN) as an adjuvant to CO2 laser surgical excision. Eligibility required disease onset to be before age 16, and an endoscopic excision requirement of at least three operations in the 6 months immediately prior to entry. Patients were randomized to Observation versus WFN at a dose of 5 MU/m2 daily for 28 days and three times weekly for 5 months. The patient groups were comparable in extent of disease at entry. Total extent of disease was determined by a composite score derived from the number of diseased anatomic sites and extent of surface area and lumen encroachment present at each site. Standard endoscopic excisions were performed every 2 months and clinical courses compared on a basis of composite scores determined at each endoscopy. Statistically significant improvement occurred in the patient group which received WFN. We conclude that interferon alpha n-1 is an effective adjuvant to surgery in RRP management. PMID- 3278187 TI - Gonadotropin-releasing hormone (GnRH) pharmacokinetics: peptide hormone pharmacokinetics needs clarification. AB - The plasma level curves of the peptide hormone gonadotropin-releasing hormone (GnRH) after its intravenous, intramuscular, and intraperitoneal administration into rats were fitted according to a two- (i.v.) and one-compartment model (i.m., i.p.), respectively. From the pharmacokinetic parameters it is concluded that urinary excretion and proteolytic degradation by kidney and liver are not sufficient to fully account for the clearance of the hormone and that, therefore, proteolytic degradation by tissues may play a role for the elimination of GnRH. This may be generally true with other short peptide hormones. The GnRH pharmacokinetics is shown as an example to underline that there presently exist problems of interpreting pharmacokinetic data of peptide hormones and that there is a need for a close interplay between biochemical and pharmacokinetic studies on peptide hormones for their pharmacokinetic behaviour to be understood. PMID- 3278188 TI - [Analysis of receiver operating characteristic curves in radiodiagnosis]. PMID- 3278189 TI - Time course of the response of carbohydrate metabolism to unloading of the soleus. AB - The time course of the response of carbohydrate metabolism to unloading was studied in the soleus muscle of rats subjected to tail-cast suspension. In the fresh soleus, just 12 hours of unloading led to higher concentrations of glycogen and lower activity ratios of both glycogen synthase and glycogen phosphorylase. These changes were still evident on day 3. This initial accumulation of glycogen was likely due to its decreased degradation in response to muscle disuse. Thereafter, the increased glycogen concentration apparently diminished the activity ratio of glycogen synthase, leading to a subsequent fall in the total glycogen content after day 1. After 24 hours of unloading, when no significant atrophy was detectable, there was no differential response to insulin for in vitro glucose metabolism. As reported for day 6 (reference 6), on day 3 the soleus atrophied significantly and displayed a greater sensitivity to insulin for most of these parameters compared to the weight-bearing control muscle. However, insulin sensitivity for glycogen synthesis was unchanged. These results showed that the increased sensitivity to insulin of the unloaded soleus is associated with the degree of muscle atrophy, likely due to an increased insulin binding capacity relative to muscle mass. This study also showed that insulin regulation of glucose uptake and of glycogen synthesis is affected differentially in the unloaded soleus muscle. PMID- 3278190 TI - Hypertriglyceridemia and hyperuricemia: effects of two fibric acid derivatives (bezafibrate and fenofibrate) in a double-blind, placebo-controlled trial. AB - The effects of bezafibrate and fenofibrate on serum lipoproteins and serum urinary uric acid were compared. In a double-blind, placebo-controlled, cross over study, each drug was administered in random order for 6 weeks followed by a 3-week drug-free phase to ten men with primary hypertriglyceridemia. Serum triglyceride and cholesterol concentrations decreased significantly with both fenofibrate and bezafibrate, although no significant change in serum apolipoprotein B, serum low density lipoprotein (LDL) cholesterol or serum high density lipoprotein (HDL) cholesterol concentrations was apparent. Serum uric acid levels, which were elevated on placebo and bezafibrate, were significantly reduced by 20% by fenofibrate. This was associated with an increase in renal uric acid clearance of 30% during fenofibrate therapy. Because it seems likely that hypertriglyceridemia and hyperuricemia are linked by a common carbohydrate inducibility, we studied the acute hyperuricemic response to orally administered fructose. Fructose (50 g) caused the anticipated rise in serum urate reaching a peak between 60 and 90 minutes, which was quantitatively greater in the men with hypertriglyceridemia than in healthy controls. The serum uric response to fructose was unaffected by bezafibrate, but was converted to normal by fenofibrate. The hyperuricemic action of fenofibrate is of sufficient magnitude to be of therapeutic value in the management of patients whose hypertriglyceridemia is associated with gout. PMID- 3278191 TI - Serum carnitine levels and carnitine esters of patients after kidney transplantation: role of immunosuppression. AB - Serum levels of carnitine and carnitine esters were measured in different groups of patients after cadaveric renal transplantation and compared with those of healthy subjects as well as azotemic and uremic patients. In all groups of patients serum levels of total carnitine (TC), free carnitine (FC), short-chain acylcarnitine (SCC), and long-chain acylcarnitine (LCC) increased with reduction of kidney function. However, cyclosporin- and prednisone-treated transplant patients with impaired kidney function displayed significantly higher TC, FC, and SCC compared with transplant patients under immunosuppression with azathioprine and prednisone. This group of cyclosporin-treated patients showed also significantly elevated serum cholesterol suggesting that carnitine deficiency is not responsible for the observed abnormalities in lipid metabolism after renal transplantation. Urinary excretion of TC, FC, SCC, and LCC decreased with reduction of kidney function without differences between cyclosporin- and azathioprine-treated patients. Single dose L-carnitine administration (10 mg/kg body weight IV) resulted in significantly higher TC, FC, SCC, and LCC values of azotemic patients with and without immunosuppression than in healthy subjects. Acylation of the administered carnitine was comparable in healthy controls and azotemic patients. Increased values of short-chain and long-chain acylcarnitine, therefore, seem to depend on the excretion of the diseased kidney(s). Our data demonstrate abnormalities in carnitine metabolism in patients with impaired kidney function. These alterations are further influenced by immunosuppressive drugs. PMID- 3278192 TI - Ciglitazone, a hypoglycemic agent: early effects on the pancreatic islets of ob/ob mice. AB - Chronic administration of ciglitazone (5-4[1-methyl-cyclohexylmethoxy)-benzyl] thiazolidine-2,4 dione) decreased both plasma glucose and insulin concentrations in ob/ob mice. When given as an admixture to the feed, blood glucose levels were reduced as early as 12 hours after initiation of treatment. Concomitant with the decrease in circulating insulin, there was an increased hormone content in the beta-cells as judged by RIA and aldehyde-fuchsin staining. Acute oral dosing with ciglitazone produced a 41% reduction in circulating insulin at a time when glucose concentrations were as yet unaffected. Ciglitazone also inhibited glucose stimulated insulin secretion in vitro. The results suggest that the hypoglycemic agent, ciglitazone, may reduce plasma glucose and insulin concentrations at least partially as the result of independent mechanisms. PMID- 3278193 TI - Fat distribution, endocrine and metabolic profile in obese women with and without hirsutism. AB - The relationship between adipose tissue distribution, androgen levels, and metabolic complications of obesity was studied in 20 hirsute and 20 nonhirsute obese premenopausal women. The group of hirsute women showed preferentially an upper body type of obesity as assessed by the waist-to-hip ratio (0.902 + 0.017 v 0.778 +/- 0.015, P less than .01). They had higher serum concentrations of total testosterone (100.4 + 11.7 v 48.8 +/- 4.5 ng/dL, P less than .01) and lower levels of serum sex-hormone-binding globulin (28.1 +/- 3.6 v 44.0 + 4.2 nmol/L, P less than .05) exhibiting an increased androgenic activity as compared to the nonhirsute women. Serum glucose and insulin levels after an oral glucose load were significantly higher in the hirsute women. In addition, the group of hirsute females has significantly higher fasting concentrations of total cholesterol (5.82 +/- 0.28 v 4.75 +/- 0.14 mmol/L, P less than .05) and triglycerides (2.51 +/- 0.38 v 1.14 +/- 0.10 mmol/L, P less than .01). The hirsute group also showed higher systolic (166.7 +/- 5.1 v 142.1 +/- 4.5 mm Hg, P less than .01) and diastolic (100.9 +/- 3.6 v 85.2 +/- 2.5 mm Hg, P less than .01) blood pressure values than the nonhirsute women. Analysis of correlation revealed that an increasing waist-to-hip ratio was accompanied by increasing testosterone levels (r = .39, P less than .05) and by decreasing sex-hormone-binding globulin levels (r = .37, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278194 TI - The theoretical bases of indirect calorimetry: a review. AB - Indirect calorimetry is the method by which the type and rate of substrate utilization, and energy metabolism are estimated in vivo starting from gas exchange measurements. This technique provides unique information, is noninvasive, and can be advantageously combined with other experimental methods to investigate numerous aspects of nutrient assimilation, thermogenesis, the energetics of physical exercise, and the pathogenesis of metabolic diseases. Since its use as a research tool in metabolism is growing, the theoretical bases of indirect calorimetry are here reviewed in a detailed and orderly fashion. Special cases, such as the occurrence of net lipid synthesis or gluconeogenesis, are formally considered with derivation of explicit stoichiometric equations. The limitations of indirect calorimetry, both theoretical and technical, are discussed in the context of circumstances of clinical interest in metabolism. PMID- 3278195 TI - Regulation of the TRP4 gene of Saccharomyces cerevisiae at the transcriptional level and functional analysis of its promotor. AB - The TRP4 gene of Saccharomyces cerevisiae, which encodes anthranilate phosphoribosyl transferase (E.C. 2.4.2.18), is subject to the general control of amino acid biosynthesis. The regulation takes place at the transcriptional level by increasing the amount of initiation and not by changing the stability of mRNA. We have observed a change in the utilization of TRP4 mRNA start sites, depending on whether cells were grown under repressing or derepressing conditions. The function of promoter elements has been tested by deletion analysis with a plasmid encoded TRP4 gene. A routinely practicable method was used for copy-number calibration of plasmids based on 2 micron DNA. Promoter structures and spacing problems in the TRP4 promoter region are discussed. PMID- 3278197 TI - A role for prostaglandins in estrogen growth regulation. AB - Several lines of evidence support the theory that estrogen increases prostaglandin F2 alpha (PGF2 alpha) receptor number and amplifies the intracellular response to the uterine mitogen, PGF2 alpha, in primary cultures of rabbit endometrium. It is proposed here that estrogen induction of growth in target tissues may be mediated through prostaglandins. Determination of prostaglandin receptor status and prostaglandin levels in estrogen dependent tumors could be of importance as diagnostic tools. The use of prostaglandin synthesis inhibitors and/or antagonists in the therapy of these tumors should be considered. PMID- 3278198 TI - Has selenium a beneficial role in human exposure to inorganic mercury? AB - Laboratory experiments have indicated that selenium acts as a powerful antagonist to mercury intoxication. The literature is reviewed and from this it is concluded that mercury and selenium react in various ways. 1) The mercuric ion binds to selenium to form a biologically inert complex leading to increased body burden of both elements. This reaction seems to take place only when a threshold of mercury exposure is exceeded. 2) Selenium influences the oxidation rate of elemental mercury and as such the distribution pattern. This reaction is influenced by the nature of the antioxidative system. In species with low glutathione peroxidase activity, mercury oxidation seems decreased which can lead to an increased brain uptake. In this process there is no threshold. 3) Selenium can, as part of the antioxidative defence system, counteract mercury induced lipid peroxidation. Other antioxidants e.g. vitamin E might be just as effective. Based upon the literature it is hypothesised that to man selenium is of no benefit in cases of exposure to mercury either as mercuric mercury or as vapours. The only protection against mercury will still be a low exposure level. PMID- 3278196 TI - Enhancement of copper resistance and CupI amplification in carcinogen-treated yeast cells. AB - Carcinogen-induced amplification at the CupI locus, coding for a metallothionein protein, was studied in the yeast Saccharomyces cerevisiae. Exposure of cells from three different haploid strains, 4939, DBY746 and 320, to chemical carcinogens such as N-methyl-N'-nitro-N-nitroso-guanidine (MNNG), ethylmethanesulfonate (EMS) and 4-nitroquinoline-N-oxide (4NQO) enhanced the frequency of copper-resistant colonies up to several hundred fold. Copper resistant clones obtained from strains DBY746 and 320, which contain more than one copy of the CupI locus, displayed a four- to eightfold amplification of the CupI sequences. In these clones the amplified CupI sequences were organized in a tandem array. Carcinogen treatment of strain 4939 in which only one copy of the CupI gene is present produced resistant colonies without CupI amplification. The possible use of the yeast system to study gene duplication and amplification is discussed. PMID- 3278199 TI - The reliability and validity of provocative food testing: a critical review. AB - Clinical reports have advocated intradermal and sublingual provocative food testing as effective methods of identifying food sensitivities. However, studies assessing their reliability and/or validity have generally reached negative conclusions. These studies commonly have serious flaws in design and analysis. These include: (1) the administration of food antigens to subjects without verifying sensitivity to them, and then comparing responses to antigens and placebos, (2) the failure to implement double-blind procedures with placebo controls, (3) the failure to analyse results statistically, and (4) improper statistical analysis. In some cases, re-analysis of the data provided seriously affects the conclusions of the study. Overall, the evidence suggests that both intradermal and sublingual provocative food tests are capable of provoking reactions above placebo levels, but whether they are sufficiently reliable and valid to be clinically useful is questionable. PMID- 3278200 TI - Aspects of the psychological management of breast cancer. AB - Psychological factors influence the survival of patients with breast cancer through the early detection of the cancer and through compliance with the treatment. There is now evidence that psychological factors also influence the immune factors which control micrometastases. In particular, stoical acceptance of cancer is associated with a shorter survival of the patient, while the expression of hostility towards the cancer is associated with a longer survival of the patient. Unrecognized psychological morbidity can impair the quality of a patient's life for years. Such psychological morbidity may be reduced by more open communication with the patient, by encouragement of the expression of feelings (especially anger), by preoperative diagnosis of the cancer by biopsy and by a greater time allowance before a mastectomy is performed. Morbidity may also be reduced by the encouragement of patients to take an active part in their treatment decisions, by the avoidance of a mastectomy, by immediate breast reconstruction surgery, and by appropriate psychological support which includes self-help techniques, such as meditation. Breast cancer can be a positive turning point in a person's life. PMID- 3278201 TI - Mozart's left ear. PMID- 3278202 TI - Congenital radial aplasia. Results of 10 cases and review. PMID- 3278203 TI - Inverse correlation between combined mutagenicity in Salmonella typhimurium and strength of coordinate bond in mixtures of cobalt(II) chloride and 4-substituted pyridines. AB - Cobalt(II) chloride (CoCl2), non-mutagenic by itself, has been tested for mutagenic activity in the presence of 4-substituted pyridines in the test strains of Salmonella typhimurium. CoCl2 was found to be mutagenic in strains TA1537 and TA2637, when combined pyridine, with methyl isonicotinate, 4-methyl-pyridine, 4 ethylpyridine, 4-chloropyridine or 4-bromopyridine. Mixtures of CoCl2 and isonicotinic acid, 4-cyanopyridine, 4-aminopyridine, or 4-dimethylaminopyridine exhibited no mutagenicity. Judging from the spectral observations, such combined mutagenicity may be due to the formation of moderate to weak complexes between these compounds and the Co(II) cation. PMID- 3278204 TI - Mutagenicity of methyl isocyanate in the modified test conditions of Ames Salmonella/microsome liquid-preincubation procedure. AB - Methyl isocyanate (MIC) was tested for mutagenicity using the Ames Salmonella/microsome liquid-preincubation procedure with slight modification of test conditions. In the modification the preincubation mixture was incubated at 10 degrees C for 60 min. MIC was assayed both in the presence and absence of Aroclor-1254-induced S9, using 5 tester strains of Salmonella typhimurium, TA97a, TA98, TA100, TA102 and TA104. MIC induced mutagenic response in two base-pair substitution strains, TA100 and TA104, in the presence and absence of S9. However, mutagenic response in the presence of S9 was low as compared to that in the absence of S9. In the comparative mutagenic activity at 3 different preincubation test conditions (37 degrees C for 20 min, 20 degrees C for 40 min and 10 degrees C for 60 min), optimum mutagenic response was observed at 10 degrees C for the 60-min test condition. However, no mutagenic response was observed at 37 degrees C for the 20-min test condition. PMID- 3278205 TI - Evaluation of the genotoxic activity of 2-nitroanthrafurans. AB - We measured the genotoxic activities in two bacterial tests, the Salmonella/histidine assay (a reverse mutation assay) and the SOS chromotest (an assay for SOS induction in E. coli), of three 2-nitroanthrafurans: 2 nitroanthra[1,2-b]furan (R-7688), the isomeric compound 2-nitroanthra[2,1-b]furan (R-7686) and its 8-methoxylated derivative (R-7707). Their genotoxic activities were compared to that of 7-methoxy-2-nitronaphtho[2,1-b]furan (R-7000) which has been studied in previous works (Arnaise et al., 1986). We found that: (1) for all three 2-nitroanthrafurans, as generally observed for other 2-nitrofuran derivatives, the responses were correlated in the 2 tests and were decreased in the presence of an 'activating mixture' and in nitroreductase-deficient strains; (2) in contrast to what is usually observed with other 2-nitrofuran derivatives for which methoxylation increases genotoxic activity, the genotoxic activity of the methoxylated 2-nitroanthrafuran (R-7707) was comparable and may be even lower than that of the unsubstituted 2-nitroanthrafuran (R-7686); (3) the addition of a third ring that leads from 2-nitronaphthofurans to 2-nitroanthrafurans increased slightly the genotoxic activity of these compounds; (4) compounds with the oxygen heteroatom outside the 'bay region', R-7686 and R-7707, gave higher responses than their isomers with the oxygen heteroatom within the 'bay region', R-7688. PMID- 3278206 TI - Genotoxicity of 6 oxime compounds in the salmonella/mammalian-microsome assay and mouse lymphoma TK +/- assay. AB - To aid in the selection of chemical candidates for in vivo tests, the mutagenicity of 6 oxime compounds was evaluated in the Salmonella plate incorporation assay and mouse lymphoma L5178Y TK +/- assay. All of the oximes were mutagenic in the mouse lymphoma assay in the absence of exogenous metabolic activation. Acetaldehyde oxime was also mutagenic in the presence of S9 activation. In contrast to these results, a positive response was noted only for 2-(hydroxyimino)-N-phenyl-acetamide oxime in strain TA1535 in the absence of activation in the Salmonella/microsome test. PMID- 3278207 TI - Testing for mutagens in an aluminium plant. The results of Salmonella typhimurium tests on urine from exposed workers. AB - Urine concentrates from workers in a Soderberg potroom and an anode paste plant were tested for mutagenicity by the Salmonella reversion assay. The study is aimed at group exposure as an indicator of the effect of the work atmosphere. Urine from exposed smokers showed mutagenic activity, whereas urine from exposed non-smokers did not. The mutagenicity of exposed smokers' urine was not significantly different from the urine from non-exposed smokers. Significant mutagenicity of smokers' urine was evident only in the presence of a rat-liver metabolic system. Since an earlier expectorate analysis has shown that mutagens from the work atmosphere are deposited in the workers' respiration system and the urine analysis does not show any effect of occupational exposure, it is likely that the mutagens are eliminated from the body via other routes than renal excretion. PMID- 3278208 TI - Genotoxicity and PAC analysis of particulate and vapour phases of environmental tobacco smoke. AB - Samples of indoor air were collected from an office room (88 m3) both before smoking and during experimental smoking of 96 cigarettes by 10 persons within 6 h. The particulates were collected on glass-fibre filters and the vapour-phase compounds on XAD-2 resin. The samples were extracted with acetone and analysed quantitatively for polycyclic aromatic compounds and qualitatively with GC-MS. The extracts of filters and XAD-2 resins were fractionated into neutral/acidic and 2 basic (strong and weak bases) fractions; all these fractions were tested with the sister-chromatid exchange (SCE) assay in Chinese hamster ovary (CHO) cells and with the Salmonella/microsome test (strain TA98). Total concentrations of PAC were 205 ng/m3 in the background sample and 1207 ng/m3 after contamination by cigarette smoking. The total PAC concentrations were 4-6 times higher in the vapour phase than in the particulate phase. The fractions of the particulate samples collected before smoking showed mainly marginal genotoxic activity, whereas after smoking their genotoxicity increased dramatically. The fractions of the vapour phase samples were not genotoxic before smoking, but after smoking the neutral/acidic and strong basic fractions induced responses in both assays. The SCE assay was more sensitive towards the vapour-phase mutagens of environmental tobacco smoke (ETS). The relative responses of the two basic fractions, whereas the fraction containing neutral and acidic compounds was the most potent in the SCE assay. In the Salmonella test, the mutagenic activity was mainly detected with metabolic activation, while the induction of SCE in CHO cells was also seen without an exogenous metabolic activation system. PMID- 3278209 TI - Activation of the food-derived mutagen 2-amino-3-methylimidazo[4, 5-f]quinoline by human-liver microsomes. AB - The ability of human-liver microsomes to metabolically activate the food-derived heterocyclic amine, 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), and the model mutagen, 2-aminofluorene (AF), has been investigated using Salmonella typhimurium TA98. In 6 subjects tested the number of revertants produced by 0.1 micrograms IQ per mg microsomal protein varied from 11, 830 +/- 320 to 42, 830 +/- 290 (mean +/ SD). With the same livers and a dose of 10 micrograms AF per plate the number of revertants varied from 15,770 +/- 1600 to 29,380 +/- 810 per mg microsomal protein. Metyrapone and alpha-naphthoflavone caused differential inhibition of the mutagenesis of both IQ and AF indicating the involvement of different forms of cytochrome P450 in the metabolic activation of these amines in human-liver microsomes. In presence of human-liver microsomes IQ produced no detectable increase in mutations at the hypoxanthine phosphoribosyl transferase locus in lymphocytes and caused no increase in micronuclei formation at realistic exposure levels. PMID- 3278210 TI - 1-Hydroxypyrene as an indicator of the mutagenicity of coal tar after activation with human liver preparations. AB - Liver S9 fractions were prepared from male Wistar rats, either non-induced or induced with Aroclor 1254 and from 5 human kidney transplant donors. The preparations were compared for their ability to metabolize the premutagens present in coal tar to mutagenic metabolites in the Salmonella mutagenicity assay towards strain TA98. Low levels of mutagenicity of coal tar were seen with human S9 preparations. The differences between the S9 mix of the 5 donors in capacity to activate premutagens were approximately 6-fold. The activation of coal tar by rat liver S9 preparations was higher than by the human S9 preparations. The metabolic conversion of pyrene in coal tar to 1-hydroxypyrene by the same human S9 preparations was determined in a parallel assay. 3 human preparations showed a high correlation between the formation of 1-hydroxypyrene and bioactivation of coal tar to mutagenic metabolites. The slope values of the individual regression lines were equal, suggesting that 1-hydroxypyrene is a good indicator for the activation of premutagens present in coal tar. PMID- 3278211 TI - Mutagenicity of bi-, tri- and tetra-cyclic aromatic hydrocarbons in the "taped plate assay" and in the conventional salmonella mutagenicity assay. AB - Aromatic hydrocarbons in the range of 1-4 nuclear rings were examined for mutagenicity in the so-called "taped-plate assay". This modification of the Ames assay is particularly equipped for the detection of volatile mutagens. Of the many compounds tested only phenanthrene, pyrene, benzo[c]phenanthrene and benzoacenaphthylene were positive in this assay. The present data underline the exceptional behaviour of fluoranthene by being a rather potent bacterial mutagen with a volatile nature (as found in a previous study). PMID- 3278212 TI - Comparison of the mutagenicity of amsacrine with that of a new clinical analogue, CI-921. AB - The mutagenicity of CI-921, the 4-methyl-5-(N-methyl)carboxamide derivative of the clinical antileukaemia agent, amsacrine, has been assessed using both bacterial and mammalian cells. CI-921 is distinguished from amsacrine in its high activity against some experimental tumours and is currently undergoing phase I clinical trial. Like 9-aminoacridine and amsacrine, CI-921 is mutagenic to the Salmonella typhimurium frameshift tester strain TA1537, but shows no sign of inducing base pair changes in strain TA100. In Chinese hamster cell culture, however, it differs from 9-aminoacridine in causing extensive chromosomal aberrations and an increase in mutations at the hypoxanthine-guanine phosphoribosyltransferase locus. It induces the formation of tightly packed and multilayered colonies in treated cultures of C3H/10T1/2 cells, but its action differs from that of benzo[a]pyrene, which induces type III fibroblastic multilayered colonies. Side-by-side comparison of the mutagenic properties of CI 921 and amsacrine showed no substantial differences at similar toxicity, suggesting that the increased lipophilicity and DNA-binding affinity of CI-921, which are thought to contribute to its increased antitumour activity, do not concomitantly increase the efficiency of in vitro mutagenesis or cell transformation. PMID- 3278213 TI - Mutagenic activity of some coffee flavor ingredients. AB - The mutagenicity of 4 coffee flavor ingredients (chlorogenic acid, caffeic acid, pyrazine, and trigonelline) was evaluated in the Salmonella plate incorporation assay and mouse lymphoma L5178Y TK +/- assay. Two of the compounds, pyrazine and trigonelline, were negative in both assays. The other two compounds, caffeic acid and chlorogenic acid, were positive in the mouse lymphoma assay but negative in the Salmonella assay. PMID- 3278214 TI - Antimutagenic activity of extracts from anticancer drugs in Chinese medicine. AB - The antimutagenic activities of extracts of 36 commonly used anticancer crude drugs from Chinese herbs were studied by using the Salmonella/microsomal system in the presence of picrolonic acid or benzo[a]pyrene to test whether they contain direct or indirect antimutagens. Each crude drug was extracted with boiling water for 2 h, the method which is commonly used by Chinese people to prepare the drug for oral intake. The extracts of Pteris multifida P. showed the highest antimutagenic activity against picrolonic acid-induced mutation. The extracts of 6 other different kinds of Chinese herbs were shown to have a moderate antimutagenic activity against picrolonic acid-induced mutation, and they are: Actinidia chinensis P., Artemisia lavendulaefolia DC. and Crotalaria sessiflora L., Prunella vulgaris L., Paris polyphylla S. and Ampelopsis brevipedunculata T. The extracts of Smilax china L., Prunella vulgaris L. and Actinidia chinensis P. were demonstrated to inhibit the mutagenicity of benzo[a]pyrene completely. The 12 other kinds of extracts of Chinese herbs which had a moderate antimutagenic activity against benzo[a]pyrene were: Pteris polyphylla S., Ampelopsis brevipedunculata T., Duchesnea indica F., Gossypium herbaceum L., Lithospermum erythrorrhizon SZ., Artemisia lavendulaefolia DC., Selaginella doederleinii H., Dianthus superbus L., Centipeda minima ABA., Curcuma zedoaria R., Marsdenia tenacissima WA. and Kalopanax septemlobus K. Among them, there were 5 kinds of crude drugs, Actinidia chinensis P., Artemisia lavendulaefolia DC., Prunella vulgaris L., Paris polyphylla S. and Ampelopsis brevipedunculata T., containing antimutagenic factors against both picrolonic acid- and benzo[a]pyrene-induced mutation. PMID- 3278215 TI - Absence of genotoxic activity of refined smoke flavor (RSF) in two bacterial short-term tests. AB - The genotoxic activities of refined smoke flavor (RSF) produced in Poland and used in food processing were investigated in 2 bacterial short-term tests. Its mutagenic activity was examined in the Salmonella/histidine plate assay and its SOS-inducing capacity in the SOS Chromotest both without and with 'activation' by a rat liver homogenate. No genotoxic activity was detected using these 2 bacterial tests. PMID- 3278216 TI - Mitotic crossing-over by anticancer drugs in Saccharomyces cerevisiae strain D5. AB - Treatment with an anticancer drug causing mitotic crossing-over could lead to expression of recessive genes, previously masked in a heterozygote. Used clinically, such drugs might cause an increased risk of cancer in cases of familial tumours, such as Wilm's tumour or retinoblastoma. Potentially, novel forms of drug resistance could also be unmasked by such a recombinogenic event. We have estimated the extent of this potential problem in current clinical drugs by comparing a range of antitumour agents for ability to cause mitotic crossing over in Saccharomyces cerevisiae strain D5. We have compared these data with ability to cause an increase in total aberrant colonies in the same experiments. Although many of the agents known to cause point mutation also have some ability for mitotic crossing-over, there are also point mutagens which have little recombinogenic potential. Conversely, some effective recombinogens appear to be either very specific or rather ineffective point mutagens. Although the most generally effective agents in the present experiments were alkylating agents, several other types of drug including DNA-cutting agents, topoisomerase inhibitors, other DNA-binding drugs and antimetabolites may stimulate mitotic crossing-over. None of the mitotic inhibitors or the DNA minor groove binding drugs tested caused recombinogenic events. It would seem that the ability to induce mitotic crossing-over is an important endpoint in its own right. Assays for this event might provide an important complement to other assays commonly required for registration of new pharmaceuticals. PMID- 3278217 TI - Sperm shape abnormality and urine mutagenicity in mice treated with niclosamide. AB - Niclosamide, a widely used anthelmintic drug in underdeveloped countries, is known to be mutagenic in the Salmonella typhimurium microsomal test system. The urine obtained from mice treated with niclosamide is mutagenic in the TA98 and TA1538 strains. Its effects on mouse-sperm morphology were evaluated in CD1 and (BALB/cJ x DBA/2J) F1 mice after 5 daily oral niclosamide doses of either 60, 80, 100 or 120 mg/kg. A statistically significant increase in abnormal sperm morphology was detected in both CD1 and (BALB/cJ x DBA/2J) F1 mice. No drug related effects on testis weight nor on sperm count were observed in either genotype. Urine samples obtained from niclosamide-treated F1 mice were assayed with the Salmonella typhimurium strain TA1538 both in the absence and presence of beta-glucuronidase. In the absence of glucuronidase, urine mutagenicity increased with increasing dose and the highest doses were toxic. In the presence of glucuronidase, urine mutagenicity and toxicity also increased. Only at the highest dose (120 mg/kg), however, was there a positive correlation between the urine mutagenic activity and an increase in the number of abnormal sperm. The results of this study suggest that the increase in abnormal sperm depends on the systemic presence of non-conjugated niclosamide metabolites. PMID- 3278219 TI - Response to total body irradiation in dermatomyositis. AB - There were two patients with severe dermatomyositis refractory to immunosuppressive therapy treated with 150 rad of total body irradiation given over a period of 5 weeks. Both patients responded promptly with minimal side effects and remain in partial remission 42 and 18 months after completion of the treatment. Total body irradiation is effective in some patients with dermatomyositis who are refractory to standard therapy. PMID- 3278218 TI - Mutagenic and clastogenic activity of direct-acting components from air pollutants of the Silesian industrial region. AB - Sequential elution solvent chromatography (SESC) developed by Farcasiu for characterization of coal liquids was used for the fractionation of benzene extracts of airborne particulate pollutants. Mutagenic and clastogenic activity of SESC fractions was determined by the Salmonella/microsome test and the assay for V79 cell chromosomal aberrations (CAs), respectively. Five out of 8 obtained fractions showed differentiated, direct and indirect mutagenic activity. Selected 'direct' fractions, examined by the rodent cell chromosome aberration test, also gave a clastogenic response that increased with prolonged treatment time. The SESC system combined with 2 biological assays, the Ames test and the CAs test, seems to be a useful method for examination of genotoxic components of environmental pollutants. PMID- 3278220 TI - Acidic phosphoproteins associated with the host erythrocyte membrane of erythrocytes infected with Plasmodium berghei and P. chabaudi. AB - New phosphoproteins appear on the host erythrocyte membrane during Plasmodium berghei and P. chabaudi infection. Distinct proteins having similar properties and all distinguished by isoelectric points of less than 4.0 are identified. Associated with the erythrocyte membranes of P. berghei infected erythrocytes are two proteins with molecular masses of 65 and 46 kDa, whereas 93, 90 and 76 kDa proteins are observed during P. chabaudi infection. These new erythrocyte membrane associated proteins are all of parasite origin as indicated by metabolic labeling with proline and are synthesized during the ring stage of the asexual replicative cycle. Three of these proteins, the 93 kDa P. chabaudi protein and both P. berghei proteins, have been purified and the amino acid composition determined. All three are characterized by a relatively high proportion of aspartate and glutamate residues. Mono-and polyclonal antibodies were also raised against the same three purified proteins. No cross reactivity between these three proteins is observed, but one monoclonal antibody against the 65 kDa P. berghei crossreacts with a 27 kDa mouse erythrocyte protein. Immunofluorescence using the antibodies in combination with subcellular fractionation studies clearly shows that these phosphoproteins are associated with the host erythrocyte membrane and not the parasite. PMID- 3278221 TI - Codon usage in Plasmodium falciparum. AB - The codon frequencies used in 7874 codons from 17 sequences of Plasmodium falciparum have been examined. The frequency distribution is markedly biased. A and C occur with similar frequency in all positions but G is predominantly in the first base and T is predominantly in the last position. This information can be used to predict the coding strand and reading frame of P. falciparum genes. PMID- 3278222 TI - Acid protease activity of a major surface membrane glycoprotein (gp63) from Leishmania mexicana promastigotes. AB - A unique protease with activity optimal at pH 4.0 and trailing toward the alkaline pH spectrum was detected with intact glutaraldehyde-fixed promastigotes of Leishmania mexicana amazonensis, indicating surface localisation of the enzyme. That this surface protease may be a virulence factor is suggested by its apparent roles in multiple steps during leishmanial infections of macrophages. Indeed, its specific activity was 2-2.5 fold higher on virulent cells than on avirulent cells. Several lines of evidence indicate that this acid protease activity is expressed by the major surface glycoprotein (gp63) of L. m. amazonensis. Monoclonal antibody affinity purified gp63 degraded serum albumin, hemoglobin, complement C3, immunoglobulin G and purified rat liver lysosomal proteins in their native forms. The specific activity is about 20-fold higher at pH 4.0 than at pH 7.5 and is about four-fold higher at the body temperature of the mammalian host (37 degrees C) than at that of the insect host (27 degrees C). The protease activity is sodium dodecyl sulphate-sensitive. Among various protease inhibitors tested, only heavy metal ions (1 mM), 1,10 orthophenanthroline (1 mM) and bestatin (100 ng ml-1) significantly inhibited gp63 acid protease activity by up to 80%. N-linked oligosaccharides of gp63 appear to be important for the stability of this molecule, possibly by preventing its autodegradation. Purified gp63 effected limited proteolysis of human complement C3 molecules at the physiological serum pH of 7.5 in a manner, which supports the idea of its participation in complement-receptor mediated endocytosis of promastigotes by macrophages. PMID- 3278223 TI - Characterization of a 225 kilodalton rhoptry protein of Plasmodium falciparum. AB - A monoclonal antibody (24C6 4F12) raised against Plasmodium falciparum culture supernatant antigens gave a multiple dot picture on schizonts when assayed by immunofluorescence on P. falciparum erythrocytic stages. The corresponding antigen was localized in the peduncle of rhoptries by immunoelectronmicroscopy. On Western blots of P. falciparum schizonts, a major antigen of 225 kDa and a minor one of 240 kDa were recognized by this McAb. Pulse chase analysis of [35S]methionine biosynthetic labeling of P. falciparum culture demonstrated that the 240 kDa molecule was the precursor of the 225 kDa and that its processing occurred between 0 and 4 h after synthesis. Biosynthesis of the 240-225 kDa antigen occurred only during schizogony. PMID- 3278224 TI - Stage-specific alteration of nucleoside membrane permeability and nitrobenzylthioinosine insensitivity in Plasmodium falciparum infected erythrocytes. AB - In human erythrocytes, the intracellular presence of malarial parasites (Plasmodium falciparum) markedly changed the permeation characteristics of the nucleosides, adenosine and tubercidin, an adenosine analogue. We report parasite induced changes in the kinetics of cellular uptake of the nucleosides and in the appearance in infected cells of a nucleoside permeation route of low sensitivity to the classical inhibitor of erythrocytic nucleoside transport, nitrobenzylthioinosine (NBMPR). These changes and a diminution in NBMPR effectiveness during parasite maturation to the trophozoite or schizont stage, suggest the presence in the infected cells of an altered or new nucleoside permeation mechanism of low sensitivity to NBMPR. The incorporation of adenosine into polynucleotides was also of low sensitivity to 10 microM NBMPR. Binding studies of [3H]NBMPR with both normal erythrocytes and those harbouring parasites at each morphological stage indicated that fewer high affinity NBMPR binding sites were present on cells containing mature parasites than on the uninfected cells. The apparent low sensitivity to NBMPR of nucleoside permeation in erythrocytes containing P. falciparum forms may enable therapeutic measures with cytotoxic nucleosides to be directed with selectivity toward parasite-containing cells. PMID- 3278225 TI - The S-antigen of Plasmodium falciparum Palo Alto represents a new S-antigen serotype. AB - The S-antigen from the Palo Alto isolate of Plasmodium falciparum has been characterized. The partial sequence for the gene coding for this antigen (clone 281) reveals the presence of tandem repeats of eight amino acids which defines a new S-antigen serotype. Antibodies raised against the 281 recombinant clone reacted with a 140 kDa antigen by immunoblotting with parasite extracts and culture supernatants. The 140 kDa peptide was also identified by immunoprecipitation of metabolic labelled parasites. The 281 mouse antiserum was used to localize the antigen on parasite smears by indirect immunofluorescence assay and more precisely by immunoelectron microscopy. The S-antigen is localized within the parasitophorous vacuole. Furthermore, different isolates were examined for the presence of the Palo Alto S-antigen specificity. PMID- 3278226 TI - A site of intrinsic bending in a highly repeated element of Plasmodium berghei genome. AB - The basic element of the 2.3 kb repetitive family, present in approximately 300 copies in the Plasmodium berghei genome, contains a bent DNA region. Indications of this given by anomalies in electrophoretic behaviour were confirmed by computational analysis of sequence data. PMID- 3278227 TI - Two approximately 300 kilodalton Plasmodium falciparum proteins at the surface membrane of infected erythrocytes. AB - Two very large Plasmodium falciparum proteins are identified as constituents of the infected erythrocyte membrane. Sera were obtained from Aotus monkeys that had been repeatedly infected with asexual P. falciparum from one of four strains. The capacity of these sera to block in vitro cytoadherence of infected erythrocytes and agglutinate intact infected cells was determined. The sera were also used to immunoprecipitate protein antigens from detergent extracts of 125I-surface labeled or biosynthetically radiolabeled infected erythrocytes. For each serum/antigen combination, precipitation of only one protein correlated with the ability of the serum to interfere with cytoadherence and agglutinate infected cells. This malarial protein, denoted Pf EMP 1 (P. falciparum-erythrocyte membrane-protein 1) bore strain-specific epitope(s) on the cell surface and displayed size heterogeneity (Mr approximately 220,000-350,000). Pf EMP 1 was strongly labeled by cell-surface radioiodination but was a quantitatively very minor malarial protein. Pf EMP 1 was distinguished by its size, surface accessibility and antigenic properties from a more predominant malarial protein in the same size range (Pf EMP 2) that is under the infected erythrocyte membrane at knobs. Monoclonal antibodies and rabbit antisera raised against Pf EMP 2 were used to show that this size heterogeneous antigen was indistinguishable from the previously described MESA (mature parasite infected erythrocyte surface antigen), identified by precipitation with rabbit antisera raised against the MESA hexapeptide repeats. Antibodies raised against Pf EMP 2/MESA did not precipitate Pf EMP 1. We conclude that Pf EMP 1 is either directly responsible for the cytoadherence phenomenon, or is very closely associated with another as yet unidentified functional molecule. Pf EMP 2/MESA must have a structural property/function that is important under the host cell membrane. PMID- 3278228 TI - Expression of an enzymatically active parasite molecule in Escherichia coli: Schistosoma japonicum glutathione S-transferase. AB - The NH2-terminal amino acid sequence of the Mr 26 000 glutathione S-transferase (EC 2.5.1.18) of Schistosoma japonicum (Sj26) has been deduced by RNA and protein sequence analysis. Using this information, a bacterial plasmid has been constructed that directs the synthesis of the entire Sj26 molecule in Escherichia coli. Recombinant Sj26 exhibits glutathione S-transferase activity and can be readily purified from bacteria in a one-step procedure under non-denaturing conditions. The availability of recombinant Sj26 in essentially unlimited quantities will aid its assessment as a candidate vaccine molecule in schistosomiasis and could eventually lead to the rational design of a drug targetted on schistosome glutathione S-transferases. PMID- 3278229 TI - The three 5S rRNA genes from the human malaria parasite Plasmodium falciparum are linked. AB - 5S rRNA and rDNA from Plasmodium falciparum have been characterized. The 5S rRNA transcripts isolated from erythrocytic stage parasites are composed of three distinct subclasses, 117-119 nucleotides in length, which are identical in sequence with the exception of one or two additional uridine residues at the 3' terminus. Southern blot analysis of genomic DNA identified three 5S rRNA gene classes which are clustered within 1.5 kb of DNA. Cloning and sequence analyses of the 5S rDNA revealed identical coding regions surrounded by divergent extremely A+T rich flanking sequences (greater than 90%). Typical PolIII termination signals (6-8) T residues abut each coding region. Copy number analysis indicates that P. falciparum contains only three 5S rRNA genes, the lowest number reported for any organism. PMID- 3278230 TI - Molecular cloning and partial characterization of ribosomal RNA genes from Trypanosoma cruzi. AB - To further analyze the organization of the nuclear rDNA locus in Trypanosoma cruzi, genomic recombinant plasmid clones were constructed and isolated after hybridization with rRNA molecules as hybridization probes. Approximately 11 kilobase pairs from the cistron were cloned in three recombinant plasmids carrying adjacent genomic fragments. Restriction mapping and Southern hybridization experiments performed on these clones indicate the following relative arrangement of the mature rRNA coding sequences: 18S (2.46 kb), S3 (197 b), 24S alpha (2.02 kb), S1 (261 b), 24 beta (1.66 kb), S2 (217 b) and S6 (90 b). Neither S4 (141 b) nor S5 (110 b) sequences were found within these genomic clones. Nevertheless genomic Southerns suggest a linkage of S4 towards the 3' end of this genetic system. PMID- 3278231 TI - Nucleotide sequence and deduced amino acid sequence of a Plasmodium falciparum actin gene. AB - The nucleotide sequence of a Plasmodium falciparum actin gene has been established. The gene codes for a protein of 376 amino acids and is not interrupted by introns. The nucleotide sequence reveals an extreme bias in codon usage. Not less than 85% of the codons possess an A or T at the third position. As has been found for the actins in other unicellular eukaryotes, P. falciparum actin is related both to vertebrate cytoplasmic and vertebrate muscle specific actins. However, the malarial actin is one of the most alpha-like actins hitherto found in lower eukaryotes. PMID- 3278232 TI - Methotrexate in the treatment of corticosteroid-dependent asthma. A double-blind crossover study. AB - To test our previous observation that methotrexate reduces corticosteroid requirements of patients with severe asthma, we studied 14 patients with corticosteroid-dependent bronchial asthma in a 24-week randomized double-blind crossover trial comparing a low dosage of methotrexate (15 mg per week) with placebo. At base line the mean dosage of prednisone was 173.5 mg per week (range, 70 to 420). On the average, 36.5 percent less prednisone was required when patients received methotrexate than when they received placebo (P = 0.01). Measurement of forced vital capacity and forced expiratory volume in one second showed that there was no deterioration in the condition of patients in whom the dosage of prednisone was reduced. The patients' subjective assessment of breathing ability indicated significant improvement (P = 0.01). The adverse effects of methotrexate were limited to transient nausea in three patients and an evanescent rash in one patient. Nine patients are still receiving methotrexate 3 to 10 months after the study's conclusion. The dosages of steroids have been further reduced in each of these patients, and prednisone has been discontinued in four. We conclude from this preliminary study that the use of methotrexate allows a significant reduction in the use of corticosteroids in patients with severe asthma without deterioration of pulmonary function. PMID- 3278233 TI - Oncogenes and tumor-suppressing genes. PMID- 3278234 TI - Prophylaxis of gonococcal and chlamydial ophthalmia neonatorum. A comparison of silver nitrate and tetracycline. AB - We evaluated the use of silver nitrate drops and tetracycline ointment for the prophylaxis of ophthalmia neonatorum in a controlled trial involving 2732 newborns in Nairobi, Kenya. The overall rates of prevalence of intrapartum maternal gonococcal and chlamydial infection were 6.4 and 8.9 percent, respectively. After prophylaxis with silver nitrate, the incidence rates of gonococcal, chlamydial, and nongonococcal, nonchlamydial ophthalmia neonatorum were 0.4, 0.7, and 6.2 percent, respectively, whereas after prophylaxis with tetracycline, the rates were 0.1, 0.5, and 4.5 percent. The attack rates of gonococcal ophthalmia neonatorum in newborns exposed to Neisseria gonorrhoeae at birth were 7.0 percent in those receiving silver nitrate and 3.0 percent in those receiving tetracycline (95 percent confidence interval for the difference in rates, -3.4 to 11.4 percent). As compared with historical controls, the incidence of gonococcal ophthalmia neonatorum decreased 83 percent among infants treated with silver nitrate and 93 percent among those treated with tetracycline. Failure of prophylaxis was associated with postpartum maternal endometritis (P = 0.05). Among newborns exposed to maternal infection with Chlamydia trachomatis, chlamydial conjunctivitis developed in 10.1 percent given silver nitrate and in 7.2 percent given tetracycline (95 percent confidence interval for the difference in rates, -4.7 to 10.5 percent), yielding reductions in the incidence of chlamydial ophthalmia of 68 and 77 percent, respectively, as compared with the historical controls. We conclude that tetracycline is as effective as silver nitrate in preventing gonococcal ophthalmia neonatorum. PMID- 3278236 TI - Hospitals and Medicare's prospective payment system. PMID- 3278235 TI - Severe graft-versus-host disease in a liver-transplant recipient. PMID- 3278237 TI - Disseminated cutaneous and peritoneal hyalohyphomycosis caused by Fusarium species: three cases and review of the literature. AB - Three recent cases of hyalohyphomycosis caused by Fusarium sp. illustrate differing aspects of infections produced by these organisms. One patient was undergoing continuous ambulatory peritoneal dialysis when peritonitis developed caused by Fusarium moniliforme. Removal of the catheter and amphotericin B were used in successful management. In a neutropenic patient on therapy for leukemia, multiple persistent infections occurred including JK diptheroids, and Candida albicans sepsis. Finally, numerous florid skin lesions caused by Fusarium oxysporum developed even while the patient was receiving amphotericin B and he died. In a second neutropenic patient on treatment for leukemia, sinus and cutaneous lesions developed due to Fusarium. These resolved on amphotericin B therapy following the return of circulating neutrophils. The literature on Fusarium infections and aspects of the biology of the organism are reviewed. PMID- 3278238 TI - Induction of germ-tube formation by Candida albicans in amino acid liquid synthetic medium at 25 degrees C. AB - Candida albicans (3153A) was found to exhibit extensive germ-tube and mycelial development at 25 degrees C when transferred from amino acid synthetic medium at pH 6 to medium of pH 7. Significant germ-tube formation was detectable after approximately 8 h and in all experimental treatments, the peaks of maximal germination occurred at approximately 40-44 h. Such a transition was not only dependent on the initial pH of the medium but also on the glucose concentration and inoculum size. The optimum initial glucose concentration and inoculum size for maximal germ-tube development was 1.25% and 2 X 10(6) cells ml-1 respectively and above or below these values the extent of germ-tube formation was greatly reduced. PMID- 3278239 TI - Prototheca zopfii: natural, transient, occurrence in pigs and rats. AB - Domestic swine faeces and fresh faeces from trapped barnyard rats were heavily contaminated with Prototheca zopfii, a cause of dairy cow mastitis. When the pigs and rats were maintained on Prototheca-free diets, the transient intestinal population of P. zopfii decreased precipitously and disappeared. When combined with the information that other farm animals excrete P. zopfii, it was concluded that contaminated animal feed may be the source of large numbers of P. zopfii in the farm environment. We found P. zopfii in wet spoiled feed. Rats are logical vectors for contamination of feed. PMID- 3278240 TI - Tuberculosis: new facets of an old disease. PMID- 3278241 TI - The management of clinically localized prostate cancer. A summary of the Consensus Statement of the National Institutes of Health. PMID- 3278242 TI - The Osler tradition at Duke. PMID- 3278243 TI - Different handling of beta 2-microglobulin during hemodialysis and hemofiltration. AB - Very recently it was reported that the amyloid associated with chronic hemodialysis contains, as a major component, a new form of amyloid fibril protein which is homologous to beta 2-microglobulin. As beta 2-microglobulin has a molecular weight of 11,600 daltons, investigations were carried out to see whether or not this protein would be handled differently by hemodialysis and hemofiltration, because the latter method especially is capable of eliminating solutes with such a high molecular weight. The results clearly indicate that hemofiltration removes substantial amounts of beta 2-microglobulin (about 190 mg per treatment, which represents 80% of daily production). It remains to be clarified whether or not hemofiltration is therefore superior to hemodialysis with regard to amyloid deposit formation. PMID- 3278244 TI - Competition between albumin and beta-2-microglobulin for renal tubular uptake: brush border and/or lysosomes? PMID- 3278245 TI - Posttransplant Kaposi sarcoma: staging as a guide to therapy and prognosis. PMID- 3278246 TI - Renal cystic disease. Insights from recent experimental investigations. PMID- 3278247 TI - Uremic exocrine pancreopathy. PMID- 3278248 TI - N-tosyl-L-phenylalanine chloromethyl ketone inhibits LHRH-degrading activity and increases in vitro LHRH release from the immature rat median eminence. AB - Median eminence (ME) luteinizing-hormone-releasing hormone (LHRH)-degrading activity (LHRH-DA) may play a role in regulating the availability of releasable LHRH. Incubation of LHRH with ME tissue supernatant yields LHRH(1-5) and LHRH(6 10) degradation fragments, as detected by high-performance liquid chromatography (HPLC) analysis, suggesting a 5-6 cleavage of the decapeptide. Since these fragments are also present after incubation of LHRH with alpha-chymotrypsin (alpha-CH), we examined the possibility that the irreversible inhibitor of alpha CH, N-tosyl-L-phenylalanine chloromethyl ketone (TPCK), might inhibit LHRH-DA and affect LHRH release. Irreversible inhibitors of trypsin-like proteases [N-alpha-p tosyl-L-lysine chloromethyl ketone (TLCK), and phenylmethylsulfonylfluoride (PMSF)] were used as controls. LHRH-DA was determined by HPLC estimation of the loss of synthetic LHRH incurred when the peptide was incubated with aliquots of ME supernatant in the presence or absence of the inhibitors. LHRH release from ME fragments was assessed by radioimmunoassay after incubating the tissue with the inhibitors in Krebs-Ringer bicarbonate buffer. The LHRH-DA in both the incubation medium and the ME tissue was determined at the end of the incubation. TPCK (0.5 100 microM) added to ME tissue supernatant inhibited LHRH-DA in a dose-dependent manner. In contrast, when TPCK was added to medium in which intact ME were being incubated to assess LHRH release, the LHRH-DA of these ME was inhibited only at the 25-, 50- and 100-microM doses of TPCK, suggesting a relative inability of the inhibitor to reach endopeptidase pools in intact tissue. These same doses of TPCK increased LHRH release from the incubated ME.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278249 TI - Thoracic outlet syndrome. AB - Much controversy exists regarding the pathogenesis, diagnosis, and management of thoracic outlet syndrome. The authors review the embryology of several fibroosseous anomalies at the superior thoracic aperture and relate normal and morbid anatomy of this region and the putative roles of anthropomorphic, postural, and dynamic factors to the genesis of neurovascular symptoms. The salient clinical features of this syndrome are described, with emphasis on the peculiar pattern of motor weakness and the physiology of painful symptoms. Diagnostic methods are critiqued. The various surgical approaches for this syndrome are evaluated according to their facility for wide exposure, their potential morbidity, and their beneficial results. PMID- 3278250 TI - Clinical and radiological aspects of dysplastic gangliocytoma (Lhermitte-Duclos disease): a report of two cases with review of the literature. AB - Two cases of Lhermitte-Duclos disease confirmed by biopsy are reported. Review of the 58 published cases shows that the disease can manifest itself only by signs of increased intracranial pressure. Cerebellar symptoms are not constant. Computed tomographic (CT) scans suggest the diagnosis by showing a posterior fossa lesion, iso- and hypodense, partially calcified, and not enhanced by contrast medium. Magnetic resonance imaging (MRI) seems to define limits of the lesion better than CT scanning and could improve the surgical approach. Surgical excision of the lesion is the only satisfactory treatment. The postoperative prognosis is usually favorable. PMID- 3278251 TI - Effects of vasospasm on levels of prostacyclin and thromboxane A2 in cerebral arteries of the monkey. AB - To determine whether cerebral arteries in spasm have an altered capacity to synthesize the vasoactive substances prostacyclin and thromboxane A2, we measured levels of these arachidonic acid metabolites using a primate model of vasospasm. Twenty-four cynomolgus monkeys were assigned at random to one of three groups designated sham, clot, or clot-removal. All animals underwent base line cerebral angiography and bilateral dissection of the major cerebral arteries from the arachnoid. The clot and clot-removal groups had autologous hematomas placed around the vessels to simulate subarachnoid hemorrhages. The sham group had a similar volume of saline instilled into the subarachnoid space. Twenty-four hours later, the clot-removal group underwent a second craniotomy to remove the hematomas. Seven days after the initial operation, angiography was repeated on all animals. The animals were then killed, and the cerebral arteries were removed. Basal levels of prostacyclin and thromboxane in the cerebral vessels were measured after incubation in vitro by radioimmunoassay. No detectable leukotriene C4 release by these arteries was measurable using radioimmunoassay. Angiography revealed severe cerebral vasospasm in the clot group, but not in the clot-removal or sham groups. There were no statistical differences among the groups in thromboxane release, but prostacyclin levels were significantly lower in the clot group than in the clot-removal group (P less than 0.05). It thus seems that, if an imbalance in constrictor and dilator eicosanoids occurs in association with vasospasm, this is more likely to arise from a relative lack of the vasodilator component prostacyclin than from a surplus of the vasoconstrictor thromboxane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278252 TI - Results of computed tomography-based computer-assisted stereotactic resection of metastatic intracranial tumors. AB - Forty-four patients underwent 45 computer-assisted stereotactic resections of intracranial metastases from various centrally located and deep-seated regions using methods described in this report and elsewhere. Gross total removal was achieved in all cases. There was no postoperative mortality (within 30 days). Postoperative neurological examinations revealed that: (a) of 26 who presented with preoperative neurological deficits, 13 were normal postoperatively, 7 were improved, 3 were unchanged, and 3 were worse; (b) 5 of 5 patients who had increased intracranial pressure preoperatively were normal postoperatively; and (c) 3 of 3 patients who had increased intracranial pressure and neurological deficit preoperatively were neurologically normal postoperatively. Nine of 10 patients who were neurologically normal preoperatively were normal postoperatively, and the other had transient upper extremity weakness after resection of a lesion in the contralateral motor strip. The 1-year survival in this group of patients was 62.5%. No local recurrence was noted in any patient. Computer-assisted stereotactic resection permits accurate localization of metastatic lesions and gross total resection from difficult locations with acceptable levels of morbidity. PMID- 3278253 TI - Drug screening in the workplace--scientific and legal issues. AB - Urine drug testing is gaining acceptance with employers nationwide as a method of assuring a drug-free work environment. This article explains and discusses the currently used urine drug screening tests (EMIT, TLC, RIA and GCMS). Practical considerations involving specimen collection and proper chain of custody procedures are outlined. The legality of such tests and the legal and ethical issues of drug testing in the workplace are explored by reviewing precedent setting court decisions. Labor's position on drug testing is summarized. The nurse practitioner responsible for establishing and/or administering company testing policy will benefit by a review of the scientific and legal issues involved in testing workers for drug use. PMID- 3278254 TI - Massive hemorrhage and gastric rupture from an ulcer eroding the splenic artery. PMID- 3278255 TI - Neonatal craniopharyngioma. PMID- 3278256 TI - Increasing rate of Salmonella enteritidis infections associated with consumption of raw and undercooked eggs. PMID- 3278257 TI - The immunoarchitecture of the normal human lacrimal gland. Relevancy for understanding pathologic conditions. AB - To delineate the immunoarchitecture of the normal human lacrimal gland, monoclonal antibodies that detect B- and T-lymphocyte, macrophage, and dendritic cell lineage, subset, and differentiation-associated antigens were used in combination with highly sensitive tissue-section immunoperoxidase techniques. Plasma cells, identified with monoclonal antibody OKT10, represented the predominant mononuclear cell population, accounting for 53.9% of all mononuclear cells present. A qualitative study of plasma cell cytoplasmic immunoglobulin heavy-chain expression in deparaffinized, formalin-fixed tissue sections showed that the vast majority of these plasma cells contained IgA. Rare plasma cells contained IgG, IgM, or IgD. T-cells, identified with monoclonal antibody OKT3, represented the second most common cell type in the normal human lacrimal gland, accounting for 40.3% of all mononuclear cells present. T cells were located predominantly in lymphocytic foci and singly in the interstitium. T8 antigen positive (suppressor/cytotoxic) T cells predominated over T4 antigen-positive (helper) T cells, averaging 25.2 and 14.7%, respectively. The overall mean T4/T8 ratio was 0.56. T8 antigen-positive T cells were the most numerous cell population outside aggregates and follicles, being distributed almost equally between the acini and the ducts (49%) and the interstitium (51%). Only 16% of T4 antigen-positive cells preferred glands or ducts to the interstitium. B cells, identified with monoclonal antibody BL9, represented only 5.7% of all mononuclear cells present. B cells were exclusively found in the centers of primary and secondary follicles. The majority of the surface immunoglobulin-positive B cells expressed IgM, fewer expressed IgD, and still fewer expressed IgG or IgA. Rare LeuM1+ OKM1+ macrophages were present in the center of B-cell follicles, where rare OKT6+ dendritic cells and activated T cells (IL-2+) were also discovered. These results support the concept that the lacrimal gland belongs to the mucosa associated lymphoid system. PMID- 3278258 TI - Fistula excision and peripheral grafts in the treatment of persistent limbal wound leaks. AB - Most small scleral wound leaks at the limbus are treated successfully with suturing, patching, bandage lenses, or cyanoacrylate adhesive, but occasionally a wound leak may continue and a fistula may develop. Although rare, most such fistulas are usually associated with cataract surgery or trauma. Failure of a scleral fistula to close may be due to epithelialization or chronic necrosis of the lumen. In three cases, persistent fistulas of the limbal sclera were excised with a trephine, and a peripheral graft using corneal donor tissue was used to seal the circular defect. This resulted in permanent wound closure and provided a tissue diagnosis of epithelial downgrowth (2 cases) and chronic scleral necrosis (1 case). PMID- 3278259 TI - Clinically atypical granular corneal dystrophy with pathologic features of lattice-like amyloid deposits. A study of these families. AB - Four patients from families in Pennsylvania, Massachusetts, and Argentina were diagnosed clinically as having granular dystrophy. Results of pathologic examination of the corneal buttons from each patient after penetrating keratoplasty confirmed granular deposits in the anterior third of the stroma. Amyloid was demonstrated within some of these granular deposits by Congo red staining with birefringence and dichroism and by electron microscopy. In addition to the morphologically granular deposits, numerous fusiform deposits identified as amyloid by histochemistry and electron microscopy and morphologically identical to those seen in lattice corneal dystrophy were detected deep to the granular deposits. It was further shown that the histochemical pattern of staining of the granular material by a series of lectins was similar to that present in corneas with lattice dystrophy. Although a relationship between these patients cannot be definitively proven, each family traces its origins to the Italian province of Avellino. PMID- 3278260 TI - Corneal amyloidosis associated with keratoconus. AB - Nodular, gray-white, central corneal opacities which extended from the subepithelial zone through the anterior four fifths of the stroma developed in a 50-year-old man with a longstanding history of hard contact lens wear for keratoconus. Results of histopathologic analysis of the corneal button obtained at the time of penetrating keratoplasty disclosed that the opacities were composed of amyloid. Corneal amyloidosis is rarely found in association with keratoconus. Although there were some similarities in the pattern of amyloid deposition to that seen in primary familial amyloidosis of the cornea, the authors believe that their patient is more likely to have had a secondary amyloidosis. Corneal amyloidosis should be considered in keratoconus patients with development of unusual forms of central corneal opacification. PMID- 3278261 TI - Prospective evaluation of a regression-determined formula for use in triple procedure surgery. AB - A surgeon-specific regression equation was applied prospectively to determine the intraocular lens (IOL) power for use in 52 consecutive patients undergoing triple procedure surgery. At their final refraction, 85% (44/52) of these patients could see 20/40 or better. Upon comparing the preoperatively determined refractive goal with that actually obtained, an "ideal" IOL power which would have resulted in the refractive goal was determined. The IOL power selected by the regression formula was within 2 diopters (D) of the ideal IOL power in 67% (35/52) of the cases. For comparison, the power which would have been selected if the Sanders Retzlaff-Kraff (SRK) or Binkhorst formula was used would have been within 2 D of the ideal IOL power in 62% (SRK, 32/52) and 58% (Binkhorst, 30/52) of the cases. Deviations from the ideal IOL power were predominantly in the undercorrected category for all three formulas evaluated. The authors conclude that even though a surgeon-specific regression formula relying on preoperative axial length performed fully as well as either the SRK or Binkhorst formulas, the choice of which formula to apply remains in the surgeon's hands. PMID- 3278262 TI - Benign mixed tumor of the palpebral lobe of the lacrimal gland. Clinical diagnosis and appropriate surgical management. AB - The treatment of suspected benign mixed tumor (pleomorphic adenoma) of the lacrimal gland consists of wide local surgical excision of the tumor and its capsule in their entirety. The tumor should be approached routinely via a lateral orbitotomy to provide maximal exposure and allow complete removal of the lesion. However, if clinical and radiographic evidence indicates a far anterior location implying an origin in the more superficial palpebral lobe, an anterior transcutaneous approach is advantageous and preferred. The authors report an adult case of an anteriorly located benign mixed tumor of the palpebral lobe of the lacrimal gland. The authors reviewed the characteristic clinical, echographic, and computed tomographic (CT) features, offered a differential diagnosis, and described surgical removal using a cryoprobe via an anterior lid approach. An awareness of the distinctive clinical and diagnostic features of benign mixed tumor of the palpebral lobe should help to avoid the complications that ensue from an incisional biopsy or piecemeal resection through the lid, and also to avoid the need for more extensive surgery for removal of residual or recurrent tumor. PMID- 3278263 TI - Hemophilic arthropathy of the temporomandibular joint: review of the literature, a case report, and discussion. AB - Hemarthrosis of extremity joints in patients with hemophilia has been well documented. However, hemarthrosis of the temporomandibular joint in patients with coagulopathies appears to be rare. Consequently, management of a temporomandibular joint hemarthrosis is difficult because of the lack of treatment guidelines. The purpose of this article is to review the pathophysiology of hemophilic arthropathy and its management. A case of temporomandibular joint hemophilic arthropathy in a patient with a factor XI deficiency will be presented. A brief review of factor XI deficiency and a hypothetical pathophysiological mechanism for internal derangement induced by myofascial pain dysfunction are included. PMID- 3278264 TI - Orbital floor repair with lyophilized porcine dermis. AB - Various implants have been used to repair defects in orbital walls. Few are fully biocompatible. The indications for repair of a defect of the orbital floor are reviewed, and the suitability in selected cases of placement of lyophilized porcine dermis (xenograft) is discussed. PMID- 3278265 TI - Consent for dental therapy in severely ill patients. AB - Delirium, dementia, or depression is frequently seen in association with severe medical illness. Usually transient, it is precipitated by the stress of systemic illness and the medications used to treat the underlying disease. Unrecognized, it may invalidate the informed consent required for the provision of emergency dental care services. PMID- 3278266 TI - An evaluation of reported cases of median mandibular cysts. AB - All English-language reports of median mandibular cysts and one German article were carefully studied. All but three of 20 such cases were readily interpreted as being various forms of odontogenic cysts. Tissue sections of two of the three others were obtained, and it was eventually concluded that all three probably also represented odontogenic cysts. The median mandibular cyst does not appear to exist as an entity. All cysts reported as such are probably odontogenic. In previous reports on median mandibular cysts, undue emphasis has been placed on the "vitality" of adjacent teeth, as determined by thermal or electrical pulp testing. These tests are not completely reliable. Mucous cells and cilia can be found in odontogenic cysts, and consequently their presence in lesions reported as median mandibular cysts does not preclude these cysts from being odontogenic. PMID- 3278267 TI - Osteopetrosis: a case report including gross and microscopic findings in the mandible at autopsy. AB - A case of juvenile osteopetrosis in a 10-year-old girl, including the skeletal, hematologic, and neurologic features, is described. Ankylosis of cementum to bone was evident in histologic sections, providing a possible explanation for the delayed or impaired eruption of teeth. A summary of the literature on the pathogenesis of osteopetrosis is presented. PMID- 3278269 TI - [Current status of heart transplantation]. PMID- 3278268 TI - Autonomic innervation of the nasal mucosa. AB - The nasal passages play a crucial role in the protection and functioning of the lower airways. Consequently the nerve supply of the nasal mucosa is extensive, which is related to an immediate and adequate reaction upon a variety of external and internal stimuli. A brief review of the present knowledge on nasal autonomic innervation and pharmacology will be given. There is special attention to more advanced methods, such as radioligand receptor binding techniques, which might augment our insight in the significance of the nervous system in nasal (patho)physiology. Furthermore data on the secretory activity of the nasal glands in the rat and its neural regulation will be accentuated. PMID- 3278270 TI - [Psychology of tourism and its effect on mental health--in the view of Sandor Ferenczi]. PMID- 3278271 TI - [Remembering Maximilian Nitze]. PMID- 3278272 TI - [This radiology is not that radiology any more]. PMID- 3278273 TI - [Retrospective psychiatric evaluation of suicides in Budapest]. PMID- 3278274 TI - [Bi-centenary of higher education in veterinary medicine in Hungary]. PMID- 3278275 TI - [The "other" Forbath]. PMID- 3278276 TI - [Additional brush-strokes on the portrait of Bela Entz]. PMID- 3278277 TI - AIDS update: new developments, current issues. PMID- 3278278 TI - Motor vehicle injuries during adolescence. PMID- 3278279 TI - The epidemiology of injuries in adolescents. AB - Injuries are the major health problem of adolescents. Injuries are the leading cause of death in the adolescent age group and the leading cause of potentially productive years of life lost in the nation. Nonfatal injuries are also very common, generating frequent physician visits, hospital admission, and high medical care costs. The road is the most dangerous environment for teens where motor vehicle occupants, motorcyclists, pedestrians, and bicyclists all sustain frequent injuries. Alcohol and other drugs are often contributing factors to these injuries. Head and spinal cord injury result in many permanent disabilities. At school, children usually sustain nonfatal injuries in sports activities. Injuries at home are less common among adolescents than among younger children. The farm environment is an understudied, but dangerous environment. There is a need for standardization of data sets and age grouping within data sets to better understand the epidemiology of injuries in adolescents. PMID- 3278280 TI - Feeding the premature and compromised infant: gastrointestinal considerations. AB - We have presented the current concepts of gastrointestinal ontogeny--the various factors governing the ontogeny of the gastrointestinal tract and the interaction and intricate relationship between different determinants. It is only through a better understanding of the development of the gut and the various factors affecting it that pediatric gastroenterologists are able to design nutritional support strategies for managing very young and compromised neonates. PMID- 3278281 TI - Disorders of carbohydrate digestion and absorption. AB - The carbohydrate malabsorptive syndromes are frequently seen by pediatricians. The congenital deficiency states are quite rare, but adult type hypolactasia and lactose intolerance following rotavirus infection are recognized with increasing frequency by primary care physicians. Therapy for these disorders involves identification of the offending carbohydrate, removal of the carbohydrate from the diet, and exclusion of other entities that may result in carbohydrate malabsorption but not respond to its removal from the diet. Prognosis for both the primary and secondary carbohydrate malabsorption syndromes is excellent. Compliance with diets for those pediatric patients who will require lifelong therapy remains problematic. PMID- 3278282 TI - Encopresis and constipation in children. AB - Chronic retentive constipation in children is common, often undertreated, and frequently resistant to standard treatment. A new understanding of abnormal defecation dynamics has evolved to complement the established medical behavior model of this condition. The primary care pediatrician is in an excellent position to facilitate prevention through counseling on normal bowel habits and early intervention. A comprehensive medical behavior intervention program can be supervised effectively by the pediatrician providing benefit to most patients. Those who are compliant with treatment and are resistant to intervention may benefit by extensive evaluation of anorectal dynamics and use of such teaching as biofeedback training. PMID- 3278283 TI - Evaluation of the gastrointestinal tract in the child: CT, MRI, and isotopic studies. AB - The gastrointestinal radiologist no longer has to rely on indirect signs of extraluminal and solid organ pathology. With the use of the newer imaging modalities, including computed tomography, magnetic resonance imaging, and isotopic techniques, the entire abdomen and its contents can be directly visualized. Pathology, its extent and its effect on adjacent structures, can be readily appreciated. PMID- 3278284 TI - Gastrointestinal motility disorders in children. AB - The present state of knowledge regarding human gastrointestinal motility is summarized in this article. Areas that are of particular interest in childhood are highlighted. The relationship of this knowledge to disease states is discussed and areas where it might practically be applied indicated. PMID- 3278285 TI - Endoscopic examination of the colon in infancy and childhood. AB - Flexible fiberoptic colonoscopy is a safe and effective diagnostic procedure in infants and children. It is a sensitive and practical procedure that has made substantial contributions to the diagnosis and treatment of colonic disorders in infants and children. With further refinements in technique, future applications of its use are likely to occur. PMID- 3278286 TI - Cholestatic disorders of infancy. AB - We no longer view the infant with persistent cholestasis with a "wait and see" strategy. Identification of the cause of "neonatal hepatitis" may allow specific treatment. Improved surgical techniques for portoenterostomy have provided early hope for patients with biliary atresia. Rapidly advancing nutritional strategies allow many portoenterostomy failures an additional further option, that is, hepatic transplantation. I express my thanks to the many investigators who have contributed and are continuing to advance the progress recounted in this review. Perusal of the references cited in this review makes clear the identity of these investigators. PMID- 3278287 TI - A pediatric perspective on liver transplantation. AB - Liver transplantation has revolutionized the field of pediatric hepatology. The present status of this therapy is reviewed in this article from a nonsurgical perspective. PMID- 3278288 TI - Noninvasive determination of respiratory mechanics during mechanical ventilation of neonates: a review of current and future techniques. AB - Study of the mechanical properties of the respiratory system is needed to help provide a better understanding of the pathogenesis of diseases causing respiratory failure. The nature of neonatal intensive care requires that any technique for monitoring respiratory mechanics be simple, noninvasive, and allow continued free access to the neonate. The peak airway pressure developed during volume cycled ventilation reflects the mechanical properties of the respiratory system but cannot distinguish between changes in the flow-resistive or elastic properties. Similarly, dynamic compliance combines both the flow-resistive and elastic components of the respiratory system in a single number and flow-volume loops also reflect both elements. Extracting a single time-constant from the expiratory limb of the latter assumes a single-compartment model for the respiratory system and, as such, does not provide sufficient information to describe frequency dependence of resistance and compliance. Furthermore, flow volume loops are markedly distorted by the presence of an endotracheal tube, which must be corrected for, before calculating values of resistance and compliance. To provide the information to understand better the physiologic processes and adaptive mechanisms in diseased states causing acute respiratory failure, it is necessary to use a method that is based on a more detailed and realistic model of the respiratory system. Two such techniques that appear to warrant further investigation in ventilated infants are the interrupter technique and the forced-oscillation technique. PMID- 3278289 TI - Current techniques for assessing pulmonary function in the newborn and infant: advantages and limitations. AB - One of the major problems in pediatric pulmonology has been the shortage of tools to assess objectively the mechanical status of the lung and the effects of therapy. In the last few years this has changed; there are now a large number of methodologies to choose from. One method has rarely been tested against another, and as there does not appear to be a gold standard, the situation is becoming confused. Choice of the technique to be applied must be based on the characteristics of the patient to be studied. With the recent introduction of commercially available devices for performing some of these techniques, it is essential that those using them have a clear understanding of what they are measuring, the limitations of the measurements, and their interpretation. PMID- 3278290 TI - Long-term continuous positive airway pressure in a child with asphyxiating thoracic dystrophy. PMID- 3278291 TI - Hemolytic-uremic syndrome associated with a variant Shiga-like cytotoxin of Escherichia coli O111. PMID- 3278292 TI - Meningococcal brain abscess and meningitis in a neonate. PMID- 3278293 TI - Advantages and disadvantages of antimicrobial prophylaxis in chronic granulomatous disease of childhood. PMID- 3278294 TI - Correlates of high grade and low grade Haemophilus influenzae bacteremia. AB - Routine use of the Isolator 1.5 Microbial Tube lysis direct plating blood culture system at our institution since November, 1983, provided a unique opportunity to study bacteremia in children from a quantitative perspective. In a 3-year period, 90 episodes of Haemophilus influenzae bacteremia occurred in immunocompetent outpatients; 83 of these met the criteria for study. Patients with high grade bacteremia (greater than 100 colony-forming units/ml) were more likely to have meningitis than those with low grade bacteremia (less than or equal to 100 colony forming units/ml); conversely low grade bacteremia patients were more likely to have cellulitis or arthritis. Of 38 meningitis patients those with high grade bacteremia (n = 25) had a significantly shorter duration of illness before presentation than those with low grade bacteremia (median, 1 vs. 3 days; P less than or equal to 0.006). In addition high grade bacteremia patients had significantly lower white blood cell counts (median, 11.4 vs. 17.3 X 10(3)/mm3; P less than or equal to 0.007) and absolute neutrophil counts (5.5 vs. 11.1 X 10(3)/mm3; P less than or equal to 0.01). Only 1 of 8 meningitis patients who were pretreated with appropriate antibiotics had high colony counts compared to 7 of 8 matched controls (P = 0.04). PMID- 3278295 TI - Renal injury in sick newborn infants: a prospective evaluation using urinary beta 2-microglobulin concentrations. AB - Urinary concentrations of beta 2-microglobulin and creatinine were measured serially in 140 sick infants, of whom 109 were asphyxiated, and in 35 healthy preterm and term infants. First voided urines and samples from days 3 and 7 postpartum were studied. Urinary beta 2-microglobulin concentrations in healthy infants averaged 1.34 +/- 1.34 mg/L (mean +/- SD) in first voided specimens and 1.32 +/- 0.98 mg/L in day 3 samples; the calculated upper limit of normal (95% confidence limit) was 4.00 mg/L. Elevated values (those exceeding the 95% confidence limit) occurred most often in the sick asphyxiated patients (56%); the first voided sample value in these patients was 10.0 +/- 10.4 mg/L. The equivalent value in the sick nonasphyxiated infants was 8.32 +/- 7.27 mg/L. Values were significantly and persistently elevated in the sick infants on days 3 and 7. Factoring beta 2-microglobulin levels by urinary creatinine concentration did not affect the significance of the findings. The increased urinary beta 2 microglobulin levels were not (1) related to gestational age; low beta 2 microglobulin values occurred at all gestational ages for both healthy and sick infants; (2) a consequence of urine flow rate; urinary beta 2-microglobulin did not correlate with urinary creatinine concentration or with urine to plasma creatinine ratio; and (3) a consequence of increased production of beta 2 microglobulin; urinary and serum beta 2-microglobulin values did not correlate (r = .03). Thus, we propose that the elevated levels of urinary beta 2-microglobulin in the sick infants were the consequence of tubular injury. This was associated with hematuria but not with a high incidence of azotemia or oliguria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278296 TI - Merozoite surface protein sequence from the Camp strain of the human malaria parasite Plasmodium falciparum. PMID- 3278297 TI - Complete nucleotide sequence and deduced amino acid sequence of the ompT gene of Escherichia coli K-12. PMID- 3278298 TI - Sequence polymorphisms in the yeast gene encoding aspartyl tRNA synthase. PMID- 3278299 TI - RNA-protein cross-linking in Escherichia coli 50S ribosomal subunits; determination of sites on 23S RNA that are cross-linked to proteins L2, L4, L24 and L27 by treatment with 2-iminothiolane. AB - RNA-protein cross-links were introduced into E. coli 50S ribosomal subunits by treatment with 2-iminothiolane followed by mild ultraviolet irradiation. After partial digestion of the RNA, the cross-linked RNA-protein complexes were separated by our recently published three-step procedure. In cases where this separation was inadequate, a further purification step was introduced, involving affinity chromatography with antibodies to the ribosomal 50S proteins. Analysis of the isolated complexes enabled four new cross-link sites on the 23S RNA to be identified, as well as re-confirming several previously established sites. The new sites are as follows: Protein L2 is cross-linked within an oligonucleotide at positions 1818-1823 in the 23S RNA, protein L4 within positions 320-325, protein L24 within positions 99-107, and protein L27 within positions 2320-2323. PMID- 3278300 TI - Mutational analysis of the tobacco mosaic virus 5'-leader for altered ability to enhance translation. AB - Mutational analysis of the 5'-untranslated leader sequence (omega) of tobacco mosaic virus (TMV) was carried out to determine those sequences necessary for the translational enhancement associated with omega. Five deletion mutants, a single base substitution, and a 25 base replacement mutant were tested for alterations in omega's ability to enhance expression of beta-glucuronidase (GUS) mRNA in tobacco mesophyll protoplasts and Escherichia coli or chloramphenicol acetyltransferase (CAT) mRNA in Xenopus laevis oocytes. Alteration of an eight base subsequence required for the binding of a second ribosome resulted in the loss of translational enhancement in X. laevis oocytes but not in protoplasts. Substantial increases in enhancement were observed for several of the mutants in E. coli. PMID- 3278301 TI - Coordinate N-ras mRNA up-regulation with mutational activation in tumorigenic guinea pig cells. AB - Tumorigenic guinea pig cell lines with mutationally activated N-ras alleles also exhibited up-regulated N-ras mRNA. Mutational activation and mRNA up-regulation were limited to tumorigenic cells; preneoplastic progenitors were unaffected. Therefore, up-regulation occurred at a late stage of carcinogenesis closely associated with acquisition of tumorigenicity. cDNA and S1 protection analysis demonstrated that polyadenylation site of the short N-ras message and the mRNA start sites were different from that reported for human. The promoter region contained no canonical TATA or CCAAT boxes, but exhibited GGGCGG and CCGCCC SPl binding motifs characteristic of growth control genes. Moreover, both mutant and wild-type alleles were up-regulated in a guinea pig line heterozygous for N-ras codon 61. Coordinate N-ras mutational activation and up-regulation in five independent tumorigenic lines with unique chromosome constitutions suggests that both events are required for expression of the neoplastic phenotype. PMID- 3278302 TI - The war of the weed. PMID- 3278303 TI - Late effects of cancer therapy: chemotherapy-related malignancies. PMID- 3278304 TI - Survey of graduate programs in cancer nursing. PMID- 3278305 TI - Endoscopy for peptic ulcer hemorrhage. Its expanding role into therapy. PMID- 3278306 TI - Artificial instillation of amniotic fluid as a new technique for the diagnostic evaluation of cases of oligohydramnios. AB - In cases of severe oligohydramnios, sonographic diagnosis is hampered by poor visibility and by increased fetal flexion. Therefore, 74 artificial instillations of amniotic fluid were performed in 50 pregnancies by sonographic guidance. Fetal diseases included Potter's syndrome, obstructive uropathy, cystic kidneys (20 cases); Meckel's syndrome, C. de Lange syndrome, cytomegaly fetopathy (1 case each); VATER association (2 cases); triploidy (5 cases); severe intrauterine growth retardation (8 cases); and premature rupture of membranes (12 cases). By improved sonographic visibility and the observation of fetal behaviour (drinking, filling of stomach and bladder, voiding of bladder after artificial instillation of amniotic fluid), the fetal anatomy could be studied more accurately, malformations could be identified or excluded, and bladder function could be examined. Thus, differentiation between fetuses without functioning kidneys and those with severe intrauterine growth retardation becomes possible. Further, re aspiration on the day following instillation permitted determination of the karyotype. Finally, the artificial instillation of amniotic fluid is a hazardous intervention (rupture of membranes, labour) and should be reserved only for a small number of selected cases with diagnostically unclear oligohydramnios. For these cases, it seems to be the method of choice permitting a variety of diagnostic information to be obtained. PMID- 3278307 TI - Transabdominal chorionic villus sampling for fetal genetic diagnosis. Technical and obstetrical evaluation of 100 cases. AB - First trimester fetal diagnosis was established in 100 pregnancies at risk by transabdominal chorionic villus sampling (TA-CVS). Forty-eight per cent of the women were 35 years or more at the time of sampling. Using the double needle technique, both the aspiration and the diagnostic success rate were 100 per cent. The mean amount of villi aspirated was 28.2 mg (10-50 mg). The mean needle time was 3 min. Vaginal spotting appeared in 2 per cent of the women. Four women had therapeutic abortion due to abnormal findings and one for social reasons. Three fetuses with normal karyotypes were lost. Excluding the therapeutic abortions, the fetal loss rate was 3.2 per cent. The fetal loss rate in the amniocentesis control group (n = 200) was 3.6 per cent. The cytogenetic diagnosis was carried out by the direct preparation technique as well as by chorion villus cultivation. All karyotypes were confirmed by lymphocyte cultures from umbilical cord blood or heel blood from the newborn or from aborted fetal tissue. Transabdominal CVS is deemed a safe and easy tool for achieving chorionic villi in the first trimester. PMID- 3278308 TI - Prenatal sonographic diagnosis of endocardial fibroelastosis secondary to aortic stenosis. AB - Endocardial fibroelastosis is characterized by a diffuse thickening of the left ventricular endocardium with or without other cardiac anomalies. This entity had been diagnosed prenatally previously (Bovicelli et al., 1984) at a gestational age of 36 weeks. A case of endocardial fibroelastosis due to aortic stenosis accompanied by pericardial effusion, ascites, and hydramnion, diagnosed ultrasonographically and confirmed pathologically at 21 weeks of gestation, is presented. PMID- 3278309 TI - Prenatal ultrasound diagnosis of macroglossia in the Wiedemann-Beckwith syndrome. AB - We report the ultrasound prenatal diagnosis at the 30th week of macroglossia in two sibs with the Wiedemann-Beckwith syndrome; the syndrome was also present in their mother. A study of high resolution chromosomes did not show any anomaly. PMID- 3278310 TI - Yeast RNase P: catalytic activity and substrate binding are separate functions. AB - During tRNA biosynthesis the 5'-leader sequences in precursor tRNAs are removed by the ribonucleoprotein RNase P, an enzyme whose RNA moiety is required for activity. To clarify some aspects of the enzyme mechanism, we examined substrate binding and product formation with mutant precursor tRNAs. Mutations G-1----A or U-2----C in the Schizosaccharomyces pombe sup3-e tRNASer, which cause mispairing at or near the top of the acceptor stem, prevent the removal of the 5'-leader sequences by Saccharomyces cerevisiae RNase P. Equilibrium binding studies involving specific gel retardation of RNase P-precursor tRNA complexes showed that complexes with wild-type and A-1 and C-2 mutant precursor tRNAs had very similar dissociation constants (average Kd for sup3 = 1.5 +/- 0.2 nM). Thus, the 5'-terminal nucleotides of mature tRNA, on the 3' proximal side of the RNase P cleavage site, affect the enzyme's catalytic function but not substrate binding. The catalytic integrity of the RNA component of RNase P is not essential for binding of tRNA precursors, as demonstrated by gel retardation of micrococcal nuclease-inactivated enzyme. This suggests a possible role for the protein component of the enzyme in substrate binding. Upon restoration of base pairing to the acceptor stem in the A-1 or C-2 mutants, we found that, in addition to a requirement for pairing at these positions, conservation of the wild-type first and second nucleotides of the tRNA was necessary to obtain maximal cleavage by RNase P. This indicates a distinct sequence preference of this enzyme. PMID- 3278311 TI - CheA protein, a central regulator of bacterial chemotaxis, belongs to a family of proteins that control gene expression in response to changing environmental conditions. AB - During bacterial chemotaxis, the binding of stimulatory ligands to chemoreceptors at the cell periphery leads to a response at the flagellar motor. Three proteins appear to be required for receptor-mediated control of swimming behavior, the products of the cheA, cheW, and cheY genes. Here we present the complete nucleotide sequence of the Salmonella typhimurium cheA gene together with the purification and characterization of its protein product. The protein is a 73,000 Mr cytoplasmic constituent. Amino acid-sequence comparisons indicate that it belongs to a family of bacterial regulatory proteins including the products of the cpxA, dctB, envZ, ntrB, phoR, phoM, and virA genes. Each member of this family has a conserved domain of approximately equal to 200 residues within its C terminus. We have previously shown that another chemotaxis protein, CheY, represents a domain of protein structure that has been conserved within a second large family of bacterial regulatory proteins. Each protein of the CheA family seems to function as a regulator of a different CheY homologue. Although each pair of proteins appears to produce a specialized response to a distinct type of stimulus, the relationships in primary structure suggest that a similar molecular mechanism may be involved. PMID- 3278313 TI - A Candida albicans dispersed, repeated gene family and its epidemiologic applications. AB - Candida albicans causes a wide variety of infections but can readily be isolated from the skin and mucosa of healthy individuals. To enable high-resolution epidemiologic studies on this common pathogen, a species-specific DNA probe has been isolated from its genome. There are approximately equal to 10 copies of the sequence dispersed among the chromosome-sized DNA molecules resolved by pulsed field electrophoresis. New DNA polymorphisms in this gene family arise at high rates. As a consequence, this probe will readily distinguish strains from different patients in the same hospital and from various sites in individual patients. The DNA polymorphisms detected by using this probe are largely due to internal changes in members of the family rather than movement to new genomic locations. This suggests recombination or gene conversion rather than transposition as the mechanism producing the observed variation. PMID- 3278312 TI - Cloning and cDNA sequence of the dihydrolipoamide dehydrogenase component human alpha-ketoacid dehydrogenase complexes. AB - cDNA clones comprising the entire coding region for human dihydrolipoamide dehydrogenase (dihydrolipoamide:NAD+ oxidoreductase, EC 1.8.1.4) have been isolated from a human liver cDNA library. The cDNA sequence of the largest clone consisted of 2082 base pairs and contained a 1527-base open reading frame that encodes a precursor dihydrolipoamide dehydrogenase of 509 amino acid residues. The first 35-amino acid residues of the open reading frame probably correspond to a typical mitochondrial import leader sequence. The predicted amino acid sequence of the mature protein, starting at the residue number 36 of the open reading frame, is almost identical (greater than 98% homology) with the known partial amino acid sequence of the pig heart dihydrolipoamide dehydrogenase. The cDNA clone also contains a 3' untranslated region of 505 bases with an unusual polyadenylylation signal (TATAAA) and a short poly(A) track. By blot hybridization analysis with the cDNA as probe, two mRNAs, 2.2 and 2.4 kilobases in size, have been detected in human tissues and fibroblasts, whereas only one mRNA (2.4 kilobases) was detected in rat tissues. PMID- 3278314 TI - lac permease of Escherichia coli containing a single histidine residue is fully functional. AB - Arg-302, His-322, and Glu-325, neighboring residues in putative helices IX and X of the lac permease (lacY gene product) of Escherichia coli, play an important role in lactose/H+ symport, possibly as components of a catalytic triad similar to that postulated for the serine proteases [Kaback, H. R. (1987) Biochemistry 26, 2071-2076]. By using restriction fragments of lacY genes harboring specific site-directed mutations, a fusion gene has been constructed that encodes a permease in which His-35 and His-39 are replaced with arginine, and His-205 with glutamine (RQHE permease). The resultant molecule contains a single histidine residue at position 322 and exhibits all of the properties of the wild-type permease. In addition, an analogous single-histidine permease was engineered with alanine at position 325 in place of glutamic acid (RQHA permease). This construct is defective in active transport but catalyzes exchange and counterflow normally. RQHA permease, like the single-histidine permease with Glu-325, also shows normal behavior with respect to N-ethylmaleimide inactivation, substrate protection, and binding. In addition to providing strong support for previous experiments, the engineered permease molecules should be useful for determining the apparent pK of His-322 under various conditions. PMID- 3278315 TI - Functional role of cysteine-146 in Escherichia coli thymidylate synthase. AB - Analysis of mutant Escherichia coli thymidylate synthases (EC 2.1.1.45) with various amino acids substituted for cysteine at position 146 revealed the cysteine to be involved in the binding of 2'-deoxyuridylate as well as initiating the catalytic process. The substitution of a serine or alanine residue at position 146 did not appreciably alter the binding affinity for 2'-deoxyuridylate but the serine mutant enzyme was less active by a factor of 5000, whereas the alanine mutant enzyme was catalytically inactive. In contrast, the substitution of a glycine or threonine at position 146 created inactive enzymes with higher 2' deoxyuridylate dissociation constants. The dissociation constant values for 2' deoxyuridylate were used to estimate the overall contribution of the side chain of the amino acid at position 146 to substrate binding. The results suggested that the side chains of cysteine, alanine, and serine make nonspecific but effective van der Waals contacts with 2'-deoxyuridylate, thereby contributing about 0.82 kcal.mol-1 (1 cal = 4.184 J) to the apparent binding energy of the substrate. PMID- 3278316 TI - Expression and developmental control of platelet-derived growth factor A-chain and B-chain/Sis genes in rat aortic smooth muscle cells. AB - Cultured arterial smooth muscle cells (SMC) can produce platelet-derived growth factor (PDGF)-like molecules. This property raises the possibility that SMC derived PDGFs function as autocrine/paracrine regulators in the formation and maintenance of the artery wall. In this study we have asked if levels of mRNAs directing synthesis of PDGF are modulated in aortic SMC during postnatal development. We report here that genes encoding PDGF A- and B-chain precursors are expressed at similar low levels in intact aortas from newborn and adult rats. Marked differences in regulation of transcript abundance of these genes were revealed when aortic SMC were grown in cell culture. PDGF B-chain transcripts accumulated in passaged newborn rat SMC but not adult rat SMC, whereas PDGF A chain RNA was found in comparable amounts in SMC from both age groups. Similarly, SMC from newborn rats secreted at least 60-fold more PDGF-like activity into conditioned medium than did adult rat SMC. PDGF B-chain transcripts in newborn rat aortic SMC are short-lived and increased 5-fold by 3 hr after treatment with cycloheximide. In contrast, PDGF A-chain transcripts are more stable, and their constitutive levels were generally unaffected by cycloheximide. These results show that PDGF A- and B-chain genes are transcribed in the normal rat aorta and provide evidence for age-related change in the control of PDGF B-chain gene expression in aortic SMC. Independent regulation of transcript levels in cultured SMC leaves open the possibility that PDGFs of different composition (AA, AB, BB) play different roles in normal function of the artery wall. PMID- 3278317 TI - Isolation and characterization of the apical surface of polarized Madin-Darby canine kidney epithelial cells. AB - We have developed a fast and efficient method to isolate the apical surface of Madin-Darby canine kidney epithelial cells. After confluent cell monolayers were coated with alternate layers of cationized colloidal silica and a polyanion, 60% of the apical surface was recovered as large membrane sheets through the application of a polylysine-coated glass surface. Scanning electron microscopy of the cytoplasmic aspect of the apical surface revealed a honeycomb pattern given by the cell borders fractured at or above the level of the tight junctions. By transmission electron microscopy, the apical preparation appeared to be composed of plasma membrane and a thin layer of cytoplasm. Enzyme assays and immunoblots demonstrated a 6- to 7-fold enrichment of an apical marker and a low level of contamination by cytoplasmic and basolateral markers. After removal of cytosolic contaminants and peripheral membrane proteins by alkaline extraction, apical integral membrane proteins were characterized by sodium dodecyl sulfate/polyacrylamide gel electrophoresis (NaDodSO4/PAGE). Lectin blotting and [3H]glucosamine labeling identified two major sialoglycoproteins of apparent Mr 200,000 and 100,000. The apical membrane sheets here described provide a useful model for systematic characterization of the molecular components of the membrane, for reconstitution of lipid and protein transport in cell-free systems, and for study of the interactions of submembranous cytoskeletal proteins with the apical plasma membrane domain. PMID- 3278318 TI - Merosin, a protein specific for basement membranes of Schwann cells, striated muscle, and trophoblast, is expressed late in nerve and muscle development. AB - We have identified a tissue-specific basement membrane-associated protein by using monoclonal antibodies prepared against a protein fraction of human placenta. In immunofluorescence, the monoclonal antibodies stained basement membranes of Schwann cells, striated muscle, and trophoblast, whereas no reaction was seen with any other basement membrane or tissue structure. In antibody affinity chromatography of proteolytic digests of human placenta, a 65-kDa polypeptide was bound by these monoclonal antibodies. Rabbit antisera and monoclonal antibodies raised against the isolated 65-kDa polypeptide stained human and monkey tissues identically to the original monoclonal antibodies and reacted with an 80-kDa polypeptide in tissue extracts prepared without proteolysis. The 65-kDa and 80-kDa polypeptides were shown to be immunologically distinct from laminin, type IV collagen, fibronectin, and major serum proteins. They presumably represent a novel basement membrane-associated protein, which we have named merosin. No merosin immunoreactivity could be detected in cultures of any of 28 established cell lines. In developing mouse tissues, merosin staining first appeared at the newborn stage. The restricted tissue distribution and late developmental appearance of merosin suggest that the protein has a tissue specific function associated with a high level of differentiation. PMID- 3278319 TI - An Escherichia coli mutation preventing degradation of abnormal periplasmic proteins. AB - A fusion between tsr (encoding the inner membrane protein Tsr) and phoA (encoding the periplasmic protein alkaline phosphatase, AP) generates a membrane-bound hybrid protein (Tsr-AP 2) with AP enzymatic activity. The hybrid protein is proteolytically unstable and is broken down to yield a smaller, soluble species with AP activity. We devised a genetic screen to distinguish between cells containing only membrane-bound AP and those containing soluble AP. The screen depends on diffusion of soluble AP away from cells with a leaky outer membrane to produce a halo of AP activity around colonies on solid growth medium. Several mutants lacking this halo show reduced degradation of Tsr-AP 2. One mutant is also defective in breakdown of five other abnormal periplasmic proteins but not of two cytoplasmic proteins. The mutation in this strain, degP4::Tn5, defines a locus distinct from previously identified loci that affect protein stability or protease activities. This strain may be useful for preventing the breakdown of unstable foreign proteins in Escherichia coli. PMID- 3278320 TI - Targeted mutations induced by a single acetylaminofluorene DNA adduct in mammalian cells and bacteria. AB - Mutagenic specificity of 2-acetylaminofluorene (AAF) has been established in mammalian cells and several strains of bacteria by using a shuttle plasmid vector containing a single N-(deoxyguanosin-8-yl)acetylaminofluorene (C8-dG-AAF) adduct. The nucleotide sequence of the gene conferring tetracycline resistance was modified by conservative codon replacement so as to accommodate the sequence d(CCTTCGCTAC) flanked by two restriction sites, Bsm I and Xho I. The corresponding synthetic oligodeoxynucleotide underwent reaction with 2-(N-acetoxy N-acetylamino)-fluorene (AAAF), forming a single dG-AAF adduct. This modified oligodeoxynucleotide was hybridized to its complementary strand and ligated between the Bsm I and Xho I sites of the vector. Plasmids containing the C8-dG AAF adduct were used to transfect simian virus 40-transformed simian kidney (COS 1) cells and to transform several AB strains of Escherichia coli. Colonies containing mutant plasmids were detected by hybridization to 32P-labeled oligodeoxynucleotides. Presence of the single DNA adduct increased the mutation frequency by 8-fold in both COS cells and E. coli. Over 80% of mutations detected in both systems were targeted and represented G.C----C.G or G.C----T.A transversions or single nucleotide deletions. We conclude that modification of a deoxyguanosine residue with AAF preferentially induces mutations targeted at this site when a plasmid containing a single C8-dG-AAF adduct is introduced into mammalian cells or bacteria. PMID- 3278321 TI - Identification of a 24-kDa cytokine that is required for development of cytolytic T lymphocytes. AB - It is known that the production of cytolytic T lymphocytes requires growth factors such as interleukins 2 and 4 (IL-2 and IL-4). Elsewhere we have described bioassays that detect a cytokine that operates in concert with growth factor to generate cytolytic T lymphocytes. The factor that is termed cytolytic T lymphocyte differentiation factor (CDF), together with IL-2 and lectin, mediates the formation of CD8+ killer cells in 2 days from thymocyte or peripheral lymphoid precursors. CDF is not mimicked by natural or recombinant sources of interferons, colony-stimulating factors, and IL-1 to IL-4. Here we use these bioassays to isolate and further characterize a single 24-kDa CDF protein from the conditioned medium of stimulated human blood mononuclear cells. CDF is first enriched by three successive chromatographic procedures that utilize anion exchange, hydroxyapatite, and phenyl-Superose. A single 24-kDa band with CDF activity is then isolated on 12% NaDodSO4/PAGE and clearly distinguished from the 17-kDa band of IL-2. The apparent molecular mass is similar under reducing and nonreducing conditions. After elution from NaDodSO4/PAGE the cytokine is maximally active at 0.25 nM in the CDF assay and has no growth factor activity for T lymphoblasts. To generate cytolytic CD8+, CD4- cells from spleen and lymph node T lymphocytes, IL-2 and small numbers of accessory dendritic cells must be applied together with CDF. PMID- 3278322 TI - Analysis of RAS gene mutations in acute myeloid leukemia by polymerase chain reaction and oligonucleotide probes. AB - In vitro DNA amplification followed by oligonucleotide dot blot analysis were used to study RAS gene mutations in acute myeloid leukemia (AML). Fifty-two presentation AML DNAs were screened for mutations in codons 12, 13, and 61 of NRAS and in codons 12 and 61 of KRAS and HRAS. Fourteen (27%) contained mutations -all in NRAS and predominantly in codon 12. The most common amino acid substitution identified was of glycine by aspartic acid at codon 12 (7/18), with a G----A transition being the most common base change (11/18). No particular correlation was observed between disease subtype and the incidence or type of NRAS mutation. In DNA samples from four patients, 2 NRAS mutations were found to coexist. NIH 3T3 focus-formation assays revealed that in each case the mutations were present in different NRAS alleles. We also report the absence of a mutated RAS gene in relapse DNAs of four patients in which a RAS oncogene had been detected at presentation. These observations suggest that RAS mutations arise as part of the evolution of neoplastic transformation. PMID- 3278323 TI - Highly potent antagonists of luteinizing hormone-releasing hormone free of edematogenic effects. AB - To eliminate the undesirable edematogenic effect of the luteinizing hormone releasing hormone (LH-RH) antagonists containing basic D amino acids at position 6, exemplified by [Ac-D-Phe(pCl)1,2,D-Trp3,D-Arg6,D-Ala10]LH-RH [Phe(pCl) indicates 4-chlorophenylalanine], analogs with D-ureidoalkyl amino acids such as D-citrulline (D-Cit) or D-homocitrulline (D-Hci) at position 6 were synthesized and tested in several systems in vitro and in vivo. HPLC analysis revealed that the overall hydrophobicity of the D-Cit/D-Hci6 analogs was similar to that of the basic D-Arg6 antagonists. In vitro, most of the analogs completely inhibited LH RH-mediated luteinizing hormone release in perfused rat pituitary cell systems at an antagonist to LH-RH molar ratio of 5:1. In vivo, the most active peptides, [Ac D-Nal(2)1,D-Phe(pCl)2,D-Trp3,D-Cit6,D-Ala10]LH-RH [Nal(2) indicates 3-(2 naphthyl)alanine] and its D-Hci6 analog, caused 100% inhibition of ovulation in cycling rats in doses of 3 micrograms and suppressed the luteinizing hormone level in ovariectomized female rats for 47 hr when administered at doses of 25 micrograms. Characteristically, these peptides did not exert any edematogenic effects even at 1.5 mg/kg. These properties of the D-Cit/D-Hci6 antagonists may make them useful clinically. PMID- 3278325 TI - The nature of electromagnetic stimuli. PMID- 3278324 TI - Distribution of precursor amyloid-beta-protein messenger RNA in human cerebral cortex: relationship to neurofibrillary tangles and neuritic plaques. AB - Neurofibrillary tangles (NFT) and neuritic plaques (NP), two neuropathological markers of Alzheimer disease, may both contain peptide fragments derived from the human amyloid beta protein. However, the nature of the relationship between NFT and NP and the source of the amyloid beta proteins found in each have remained unclear. We used in situ hybridization techniques to map the anatomical distribution of precursor amyloid-beta-protein mRNA in the neocortex of brains from three subjects with no known neurologic disease and from five patients with Alzheimer disease. In brains from control subjects, positively hybridizing neurons were present in cortical regions and layers that contain a high density of neuropathological markers in Alzheimer disease, as well as in those loci that contain NP but few NFT. Quantitative analyses of in situ hybridization patterns within layers III and V of the superior frontal cortex revealed that the presence of high numbers of NFT in Alzheimer-diseased brains was associated with a decrease in the number of positively hybridizing neurons compared to controls and Alzheimer-diseased brains with few NFT. In contrast, no correlation was found between the densities of NP and neurons containing precursor amyloid-beta-protein mRNA transcripts. These findings suggest that the expression of precursor amyloid beta-protein mRNA may be a necessary but is clearly not a sufficient prerequisite for NFT formation. In addition, these results may indicate that the amyloid beta protein, present in NP in a given region or layer of cortex, is not derived from the resident neuronal cell bodies that express the mRNA for the precursor protein. PMID- 3278326 TI - Microwave challenges to the thermoregulatory system. AB - The results of several kinds of experiments have been introduced as evidence in support of the thesis that the thermoregulatory system of endotherms functions no differently in the presence of microwaves than it does in the presence of conventional sources of thermal energy. The thermoregulatory profile, unique for each species, provides the framework for the argument. The results of our experiments have demonstrated the equivalence between T and microwave intensity as they influence individual responses of heat production and heat loss. This equivalence, in turn, allows the prediction of specific alterations in thermoregulatory responses when microwaves are present. Predictions of this kind are possible because the hierarchy of autonomic responses available to any given species is always the same. This fact should provide some comfort to those who profess concern abut the uniqueness of absorbed radiofrequency energy and its fate within the body. Additional comfort can be derived from the demonstration that changes in thermoregulatory responses in the presence of microwaves depend upon the integral of energy absorption by the whole body, not upon energy deposited in some restricted locus such as the PO/AH. It is clear that the circulatory system plays a major role in the distribution of energy deposited during such exposures, a fact already emphasized by others (Burr and Krupp, 1980; Way, et al., 1981; Stolwijk, 1983; Krupp, 1983). This fact does not negate the presence of electrical hotspots as predicted on theoretical grounds (e.g, Kritikos and Schwan, 1979) or as demonstrated dosimetrically (e.g., Guy, 1971), but it does deemphasize their importance as potential deterrents to the efficient mobilization of thermoregulatory responses. The utility of the thermoregulatory profile in research of the kind described here cannot be overemphasized. Accurate profiles have been determined for most of the commonly-used laboratory animals as well as for human beings. In the broader sense, such profiles should serve as fundamental data to the design of any experiment in which microwaves may be present. For example, the normal "room temperature" for clothed human beings lies well below the LCT of most laboratory species and such a Ta may exert a substantial influence over diverse behavioral responses, drug effects, etc. as well as basic thermoregulatory responses (Adair, et al., 1983). This paper has demonstrated that by considering the thermoregulatory profile, microwave challenges to the thermoregulatory system assume their proper position within the fundamental science of thermal physiology. PMID- 3278327 TI - Electromagnetic orientation: a relativistic approach. PMID- 3278328 TI - Microwave and infrared radiations as sensory, motivational, and reinforcing stimuli. PMID- 3278329 TI - Recent studies in the behavioral toxicology of ELF electric and magnetic fields. AB - Behavioral responses to ELF electric and magnetic fields are reviewed starting with the simple sensory awareness or detection by an animal and moving on through more-complicated behavioral responses such as behavior that averts exposure. The literature selected in this review is taken primarily from the area of behavioral toxicology. As such, it does not review work on specialized response systems to ELF fields. The most notable of these omitted specialized response systems are electroreception, (see Kalmijn, this volume), which occurs in a number of fish species, and homing/navigation and communication of the location of food that occurs in several species of birds and in honeybees, respectively. The toxicologic orientation of most researches that evaluate the effects of exposure to ELF electric and magnetic fields has been influenced primarily by the "missions" of DOE and the power industry programs to determine the health effects of power frequency (50- and 60-Hz) electric and magnetic fields. Because of these large programmatic efforts, most of the recent research has in fact been done at 50 or 60 Hz. In the context of the above limitations, remarkably few robust behavioral effects have been reported. Those that have been reported probably relate to an animal's perception of the electric field, although there are some exceptions to this generalization. The apparent lack of deleterious effects in animals is consistent with recent studies on humans that have been conducted in the UK. With this in mind, it is tempting to conclude that exposure to an ELF field is a rather innocuous event and, other than possible mini-shocks, is without hazard. However, if this is the case, then what sense are we to make of reports of altered neural function (other than behavior) that result from exposure to ELF fields (e.g., suppressed melatonin and SNAT activity in the rat pineal; efflux of calcium ions from brain cortices; histological change in the cerebellum and hippocampus following perinatal exposure, etc.)? Are these neural effects no more than "noise" to the behaving organism? Possible reasons form the disparity between cell biology, neurochemistry, and behavior have been presented in this chapter, and based on the hypothesized reasons for the existing disparity, a number of experiments were suggested. PMID- 3278330 TI - The cellular microenvironment and signaling through cell membranes. AB - The structural and functional aspects of communication between cells have been reviewed, with emphasis on the cell membrane in detection and transductive coupling of oscillating electromagnetic fields in the pericellular environment. Imposed fields are powerful and highly specific tools in manipulation of the sequence of events in membrane transductive coupling. They have revealed nonlinear and nonequilibrium aspects of these interactions. In cerebral tissue, extracellular fields orders of magnitude weaker than the membrane potential can modulate cell firing patterns, entrain EEG rhythms, alter neurotransmitter release and modulate behavioral states. These sensitivities have also been widely detected in non-neural tissues. It is therefore proposed that an intrinsic communication system between cells based on these weak electromagnetic influences may be a general biological property. A three-step model of transductive coupling is presented. First, a highly cooperative modification of calcium binding occurs in the plane of the membrane surface following a focal event at a receptor site. This "amplifying" stage releases substantially more energy than in the initial events. Cerebral extracellular conductance changes accompanying physiological responses may arise in perineuronal fluid with a substantial macromolecular content and calcium ions may modulate perineuronal conductivity. In the second stage, coupling occurs along transmembrane helical proteins and may be mediated by solitons. The third stage couples transmembrane signals to the cytoskeleton and to intracellular enzyme systems, including membrane-bound adenylate cyclase and the protein kinase system of intracellular messengers. Activation of these intracellular systems is calcium-dependent. PMID- 3278331 TI - The phototoxicity of phenylheptatriyne: oxygen-dependent hemolysis of human erythrocytes and inactivation of Escherichia coli. PMID- 3278332 TI - Production of photoreactiveable lesion in the yeast S. cerevisiae by irradiation with 193 nm excimer laser light. PMID- 3278333 TI - Base-specific damage induced by 4-thiouridine photosensitization with 334-nm radiation in M13 phage DNA. PMID- 3278334 TI - [Genetic effects of the decay of radionuclide products of nuclear fission in Saccharomyces cerevisiae cells. Lethal effects of the decay of 89Sr incorporated in cells of different ploidies and radiosensitivity]. AB - Decay of 89Sr incorporated in yeast cells produces a pronounced inactivating effect. The transmutation mainly contributes (about 80%) to cell inactivation. Haploid cells are more sensitive to 89Sr disintegration than diploid and tetraploid ones. A radiosensitive mutant XRS2, that is particularly sensitive to the transmutation effect of radionuclides, has proved to be sensitive to 89Sr transmutation as well. At the same time, another radiosensitive mutant, rad 54, does not virtually differ from the wild-type strain by its sensitivity to 89Sr decay. PMID- 3278336 TI - [Ureterocele in childhood. Clinical and radiologic picture]. AB - This is a retrospective analysis of the clinical and radiological data recorded in 45 children with ectopic and 5 children with orthotopic ureteroceles diagnosed from 1965 to 1982. As shown in this article, it is mandatory to perform an ultrasonic examination of kidney and bladder whenever there are signs of urinary tract infection or any abnormalities of voiding. Ureterocele is diagnosed by i.v. urogram in more than 90% of cases; before treatment it is obligatory to perform a voiding cystourethrogram in addition. PMID- 3278335 TI - [Quantitative analysis of survival during syngeneic and semisyngeneic bone marrow transplantation: relation of the protective effect and the ability to induce secondary disease as affected by differences in the major histocompatibility locus]. AB - The protective effect of bone marrow (BM) with both syngeneic and semisyngeneic transplantation is an exponential function of the number of transplanted cells. The regression coefficient in the logarithmic equation represents a fraction of hemopoiesis repair units (HRU). The quantitative analysis of the remote death of recipients of the parents' BM shows that the secondary disease (SD) is caused by other than HRU cells which is in agreement with the data obtained by other methods. The fraction of BM cells that induces SD is lower than the fraction of HRU. This helps to find an optimum BM dose range within which the risk of the SD induced death is minimized. PMID- 3278337 TI - Dopamine release from sympathetic nerve terminals. PMID- 3278338 TI - Recent advances in inner ear cytochemistry--microanalytical and immunomorphological investigations. PMID- 3278339 TI - The sick motoneurone hypothesis of muscular dystrophy. PMID- 3278340 TI - The search for therapeutic gain in the combination of radiotherapy and chemotherapy. AB - The literature on combined treatment with radiation and cytotoxic drugs in experimental tumours and normal tissues of laboratory animals is reviewed in the context of the four previously proposed mechanisms whereby a therapeutic advantage might be gained. There is evidence for strong time-dependent processes occurring in some normal tissues. In tumours, the evidence for this is much weaker and there is considerable disparity among experimental tumours in optimum timing. This review leads to the conclusion that the clinical use of drug radiation combinations should not be based on an anticipated beneficial interaction; gain will most probably come from the best radiotherapy and the best chemotherapy given as far as possible independently. Deleterious interactions can be reduced by allowing a gap of some weeks between chemotherapy and radiotherapy and by avoiding drugs that are known to enhance radiation damage to the normal tissues that are irradiated. PMID- 3278341 TI - Bone marrow transplantation. PMID- 3278342 TI - The critically ill bone marrow transplant patient. PMID- 3278343 TI - An overview of bone marrow transplantation. PMID- 3278344 TI - Bone marrow transplant in children. PMID- 3278345 TI - Ambulatory care of the bone marrow transplant patient. PMID- 3278346 TI - Psychosocial aspects of bone marrow transplantation. PMID- 3278347 TI - Nursing management of a marrow transplant unit: a framework for practice. PMID- 3278348 TI - Innovations in psychosocial staff support: a model program for the marrow transplant nurse. PMID- 3278349 TI - The future of marrow transplantation. PMID- 3278350 TI - [Pulmonary actinomycosis. Clinical case and review of the literature]. PMID- 3278351 TI - [Interstitial curietherapy with iridium-192 in the conservative treatment of the breast]. PMID- 3278352 TI - [Reye's syndrome and aspirin]. PMID- 3278353 TI - Meniscal repair in athletes. PMID- 3278354 TI - Techniques of measurement of body composition. Part I. AB - The measurement of lean body and fat mass has developed with the increase in sports participation and the prescription of exercise. Quantification of body fat is also related to the treatment of obesity and to assess nutritional status. Different levels of evaluation have been proposed depending on expertise and need. Body density estimation from skinfold measurements has the advantage of simplicity, low cost and reasonable validity with predictions to within 3 to 4% for 70% of the population. The choice of prediction equation will depend on whether a generalised equation or a population-specific equation is appropriate. In all cases tester reliability and standard error of estimation should be established. There is strong evidence that a quadratic equation should be applied and that measures of the lower limb should be included with circumference and diameter measures to strengthen the prediction. Methodological errors need to be reduced by careful training of experimenters. Crossvalidation of regression equation will strengthen their validity, particularly when fat loss is to be quantified. The popularity of skinfold assessment of body fat is enhanced by the use of nomograms to predict body fat, although some accuracy will be lost. Skinfold estimation of body fat will continue to be a useful guide to adiposity for epidemiological studies and for popular usage. The hydrostatic weighing procedure to estimate body density is considered by many to be the criterion method. Under carefully controlled conditions with maximum subject compliance, it is highly reliable, particularly if residual volume can be determined accurately. The conversion of body density to percentage body fat is based on a number of assumptions which need to be considered with respect to the population being studied. Simple methods for adiposity include various weight for height indices, for example, the body mass index of weight (kg) divided by height2 (m) which is often used to define obesity, frame size for the prediction of ideal weight and visual estimation for predicting body fat. Differences in the literature concerning fat cell size and number have their origins in variations of methodology. The choice of site for removal of tissue will influence the size of adipocytes, those obtained from deep sites are generally smaller than subcutaneous fat cells. If total cell number is determined from cell size, there will also be variability of cell number. The correlation between different methods of sizing cells is high for most techniques, but as the validity of the criterion method is not based on statistical evidence, the validity of the other methods cannot be readily accepted.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3278355 TI - Applied physiology of diving. AB - Recreational diving is a popular sport, although human ability to stay in and under water is severely limited physiologically. An understanding of these limitations enhances safety and enjoyment of sports diving. Breath-hold diving involves head-out water immersion, apnoea and submersion, exercise, cold stress, and pressure exposure. Each of these components, by itself, elicits prominent and specific physiological effects. Combination of these factors produces a unique and interesting physiological response generally known as diving reflex. Humans display weak diving responses, but exhibit no oxygen conservation function. Nevertheless, application of diving-induced physiological changes is now finding its way into clinical practice. Apnoea, face immersion, and head-out water immersion all show promise of clinical application. There are several spin-offs from diving research worth noting. Diuresis, enhancement of cardiac performance, and redistribution of blood flow, all produced by head-out water immersion, have been shown to be clinically useful, besides providing physiological data useful to space travel. Results from investigations on apnoea have been shown to be relevant to the following: treating some forms of cardiac arrhythmias; understanding drowning, sudden infant death syndrome and sleep apnoea; and confirming hyperventilation as the major cause of drowning. In comparison to marine mammals, humans are poor divers because of severe physiological constraints which limit their breath-hold time, diving depth, and ability to conserve body heat. Although under special circumstances humans can achieve unusually long breath-hold time and reach exceptional depth with a single breath, the sustainable working time and depth are only about 1 minute and 5 metres, respectively. Hypothermia inevitably results in divers working in the ocean. Without thermal protection, the intolerable limit of 35 degrees C is reached within 30 minutes in winter (10 degrees C) water and within 60 to 90 minutes in summer. Nevertheless, effective harvest work can be performed by humans in the ocean, and recreational benefits enhanced when these physiological limitations are respected. An unusual circulatory state exists during head-out water immersion in that there is a sustained increase of stroke volume. This results in 30% increase in cardiac output when the subject is resting in thermal neutral water, indicating a substantial overperfusion for the oxygen requirement. Furthermore, animal experiments showed that the elevated blood flow is preferentially channeled to the liver, fat, and the organs in the splanchnic region.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3278356 TI - Practical considerations in the testing of VO2max in runners. AB - Maximal oxygen intake (VO2max) may be the most physiologically significant and, therefore, the most commonly measured parameter in the physiological assessment of well trained runners. To insure valid and reliable VO2max values, there are a number of practical concerns that must be addressed. An exercise modality must be selected that activates the specific muscle mass and duplicates the motion utilised in the runners' training programme. Motorized treadmill running has been shown to allow the most efficient, valid and reproducible VO2max values in a controlled testing environment. A testing protocol must be used that is easily administered, comfortable for the runner, allows test completion within 10 minutes, uses grade increments at a constant speed, and is reproducible. Speeds should be selected that approximate the runner's training pace. The criterion for the attainment of VO2max include the levelling off of VO2 with an increase in work stage, the onset of extreme exhaustion, the respiratory exchange ratio exceeding 1.1, blood lactate levels approaching or exceeding 10 mmol/L, and ratings of perceived exertion of 19 or 20. Quality control in terms of standardisation of procedures and calibration and maintenance of equipment is essential for the minimisation of technological error. Measurement equipment must be affordable, dependable, easily calibrated, yield reproducible data, and be within the technical skill levels of the operating personnel. PMID- 3278357 TI - Rebounding exercise. Are the training effects sufficient for cardiorespiratory fitness? AB - Additional research is needed in order to document the effects of rebound training. Efforts should focus on the factors that are necessary for standardising the intensity of exercise such as step height and frequency. In addition, attention may be given to alternative methods of increasing exercise intensity while rebounding. One such method may be to increase the total muscle mass involved by adding the pumping of handheld weights to the rebounding exercise. Data from our laboratory (Bishop et al. 1986) has demonstrated that the addition of pumping 1-, 2- and 3-pound (0.45, 0.91 and 1.36 kg) handheld weights, at 2- and 3-foot (30 and 45 cm) heights, to rebounding exercise will increase the oxygen requirement from 26 to 60%. Assessing these effects in a training study would necessitate testing for adaptation in the upper extremities. This type of training highlights the need for activity specific tests. More specifically, additional research is needed to: 1. Determine the energy cost of activities other than jogging/bouncing that may be possible on a mini-trampoline, such as those described by White (1984). 2. Determine the training response of subjects in studies in which the controllable factors affecting intensity are standardised. 3. Examine the effects of longer periods of rebound training. Because rebounding exercise is novel to most subjects, it would appear that the length of training should allow subjects to maintain a reasonable frequency, intensity, and duration of exercise above that needed for familiarization with the new activity. 4. Determine if the prolonged use of other training aids (limb weights) with rebounding is feasible and effective in long term training.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278358 TI - [Liver metastases in colorectal carcinoma. A preoperative and postoperative sonographic study]. PMID- 3278359 TI - [Interleukin 1 (IL-1). A mediator in inflammation]. PMID- 3278360 TI - [A surgeon politicizes: the Sauerbruch scandal of 1915]. PMID- 3278361 TI - [The oncogenes]. PMID- 3278362 TI - Alternatives to the acid-oriented approach to ulcer disease: does 'cytoprotection' exist in man? A new classification of antiulcer agents. AB - This review summarizes the historical contradictions and inconsistencies that form the labile arguments advocating neutralization or inhibition of secretion of gastric acid for the prevention or treatment of gastroduodenal ulcers. Re evaluation of old concepts is needed in the wake of recognition that even the most potent antisecretory agents do not change the natural history of ulcer disease; that is, the recurrence is high after termination of treatment. New biochemical, functional, and structural targets are listed for pharmacologic intervention in ulcer disease. As a supplement or alternative to the antisecretory agents, we should now consider prosecretory agents (for example, for bicarbonate and mucus secretion) and antioxidants (for example, free radical scavengers). Gastroduodenal motility, smooth muscle, the vascular endothelial cell, and the basement membrane seem to represent additional pharmacologic targets toward which new gastroprotective drugs can be directed even though the biochemical mechanism of action of these new agents may not be fully understood. New results suggest that these elements have a role in the pathogenesis of ulcer disease, and their modulations seem to exert a beneficial effect without inhibiting gastric secretion in rodents. In man, the acid antisecretory and cytoprotective doses seem to overlap, but arguments are presented to shift defining gastric 'cytoprotection' by the dose of drugs to the characterization of the phenomenon (for example, events such as the ethanol-induced hemorrhagic erosions which cannot be decreased by antisecretory agents). Furthermore, non prostaglandin and non-H2-receptor antagonist drugs are available that exert acid independent gastroprotection both in animals and humans. The future is thus bright for the development of new antiulcer agents. PMID- 3278363 TI - Hepatic ultrasonography in the terminally ill patient. AB - In 53 patients comparison was made between findings at autopsy and findings at ultrasound (US) examination performed shortly before death as the only morphologic diagnostic procedure of the liver during the patient's last year. US was found to be highly accurate. The non-invasiveness and the possibility of examining the patient in bed make US examination in experienced hands the ideal initial diagnostic procedure, especially in terminally ill patients. PMID- 3278364 TI - Production of peptides inducing chemotaxis and lysosomal enzyme release in human neutrophils by intestinal bacteria in vitro and in vivo. AB - Low molecular weight (Mr 200-1500) N-formylated peptides that stimulate many leucocyte functions, including chemotaxis and lysosomal enzyme release, have previously been isolated from Escherichia coli cultures. We have used high performance liquid chromatography and bioassay techniques to study production of such peptides by intestinal bacteria in vitro and their activity in intestinal luminal contents, obtained by in vivo dialysis methods. Bioactivity was detected in culture supernatants of all 11 species of bacteria so far investigated, was resistant to digestion with aminopeptidase, but was destroyed by carboxypeptidase, confirming that bioactive moieties were amino-terminal-blocked peptides. By similar isolation procedures, pronase-sensitive bioactive factors have been demonstrated in human rectal dialysates from normal subjects and patients with Crohn's disease. In the patients, bioactivity in dialysates was not observed after treatment with broad-spectrum poorly absorbed antibiotics. The gut may be a reservoir or source of bacterial peptides that could promote an inflammatory response should they cross the 'mucosal barrier'. PMID- 3278365 TI - Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis. AB - The diagnostic power of combined cholescintigraphy and ultrasonography was tested in 67 patients suspected of having acute cholecystitis; of these, 42 (63%) had acute cholecystitis. The predictive value of a positive scintigraphy (PVpos) was 95% and that of a negative (PVneg) was 91% (n = 67). The PVpos and PVneg of ultrasonography were 89% and 75%, respectively (n = 54), and these values did not achieve statistical significance when compared with those for scintigraphy. Inconclusive tests were 10% and 11%, respectively, but in no patient were both scintigraphy and ultrasonography inconclusive. PVpos and PVneg of combined scintigraphy and ultrasonography were 100% when the two test results were identical (n = 34). In patients with one test inconclusive or discrepancy between scintigraphy and ultrasonography, PVpos and PVneg were 79% and 67%, respectively (n = 20). The results suggest that in patients suspected of having acute cholecystitis cholescintigraphy should be the first diagnostic procedure performed. If the scintigraphy is positive, additional ultrasonographic detection of gallstones makes the diagnosis almost certain. If one diagnostic modality is inconclusive, the other makes a fair basis for diagnostic and therapeutic decision. In case of discrepancy between ultrasonography and scintigraphy the diagnosis should be reevaluated. PMID- 3278366 TI - Treatment with cimetidine, antacid, or placebo in patients with dyspepsia of unknown origin. AB - Patients with dyspepsia of unknown origin were randomly allocated to a controlled double-blind study to examine the symptomatic effect of cimetidine and antacid especially on the relief of pain, nausea, and bloating. Two hundred and twenty two patients with no previous history of peptic ulcer disease and no evidence of other organic causes of dyspepsia were treated for 6 weeks with placebo, cimetidine, or antacid. The results showed that cimetidine was superior to both placebo and antacid in relieving pain and nausea but not bloating. Certain background factors, such as epigastric pain and symptoms relieved by solid food, had a significant positive influence on the outcome of treatment. When the impact of background factors was taken into account, cimetidine was found to be more effective than both placebo and antacid also with regard to the number of patients who improved in general well-being. PMID- 3278367 TI - Dietary supplementation with pectin in the maintenance treatment of duodenal ulcer. A controlled study. AB - Patients with recently healed duodenal ulcers diagnosed by endoscopy were randomly allocated to receive 10 g apple pectin USP powder twice daily, 150 mg ranitidine at night, or one tablet matching ranitidine placebo at night for 6 months. Repeat endoscopy was performed at 6 months or if symptoms recurred. Eighty-three patients completed the study. Recurrences occurred in 23 of 27 (85%) patients taking pectin, 6 of 28 (21%) patients taking ranitidine, and 20 of 28 (71%) patients taking placebo. (Pectin versus placebo, NS; ranitidine versus pectin, p less than 0.00001; ranitidine versus placebo, p less than 0.0005). The average amount of pectin taken was 12.7 g/day in patients who relapsed and 12.4 g/day in those who did not. At the doses taken, therefore, dietary supplementation with pectin did not reduce the incidence of duodenal ulcer relapse. PMID- 3278368 TI - [Reactivation of Staphylococcus aureus osteomyelitis after 49 years]. AB - The treatment of chronic osteomyelitis is laborious and ill defined. We report the case of a 57-year-old woman admitted to hospital with Staphylococcus aureus septicemia due to relapse of osteomyelitis after an interval of 49 years. By surgical debridement, suction drainage and 8 months of high-dose antibiotic treatment we were able to control the infection in terms of clinical symptoms and laboratory parameters. PMID- 3278369 TI - [Malignant neuroleptic syndrome. Literature review and case report]. AB - The neuroleptic malignant syndrome, first described by Delay and Deniker in 1968, is a rare but severe complication of neuroleptic treatment. According to the literature the syndrome particularly affects young men undergoing rapidly intensified neuroleptic treatment ("rapid neuroleptization"). The diagnosis is based on the triad of hyperthermia, extrapyramidal signs, and autonomic dysfunction, once infectious disease has been ruled out. The clinical features, course and therapy of the syndrome are described on the basis of a case report. PMID- 3278370 TI - [Are cephalosporins more active than penicillin G in poisoning with the deadly Amanita?]. AB - High dose penicillin-G has been found empirically to be effective against liver cell damage in amanita mushroom poisoning. We have recently found that betalactam antibiotics inhibit eukaryotic DNA polymerase-alpha, penicillins being more active than cephalosporins, and this may explain the antagonistic effect of penicillin-G against amanitin toxicity. Preliminary experiments in liver cell cultures and in mice are summarized, as well as first clinical experience pointing to the possibility that cephalosporins may be more effective against amanita mushroom toxicity than penicillin-G. PMID- 3278371 TI - [Kaposi's sarcoma following kidney transplantation: remission following reduction of immunosuppression and consequent HIV infection]. AB - Kaposi's sarcoma (KS) in renal allograft recipients is a rare though serious complication of immunosuppressive treatment. Therapeutic procedures such as surgical excision and local irradiation are inappropriate, since the endothelial originated tumor is often multicentric. However, systemic treatment such as chemotherapy entails further immunosuppression. We observed a patient with renal allograft who developed disseminated KS of legs and trunk while receiving azathioprine, cyclosporin and prednisone after intensive rejection therapy with high dose corticosteroids, antithymocyte globulin and transplant irradiation. At that time the immunological status was similar to that of an AIDS patient, though HIV serology was negative. Azathioprine was withdrawn while cyclosporin and prednisone were continued. KS disappeared shortly after without a decrease in allograft function, and immunological parameters tended to normalize. When KS had disappeared almost completely the patient became infected with HIV. Complete remission was not hampered, nor was there recurrence of KS. The late appearance of HIV-antigenemia with seroconversion in the course of the tumor makes HIV unlikely as a causative factor. The predisposing factors for KS after renal transplantation are discussed: 1. Amplification of immunosuppression due to rejection therapy, 2. Genetic predisposition such as HLA DR5 antigen, 3. Cytomegalovirus infections. For therapy of iatrogenic KS we propose reduction of immunosuppressive therapy before additional chemotherapy is initiated. PMID- 3278372 TI - [Current role of biopsy in the diagnosis of hepatic disease]. AB - The criteria for the use of liver biopsy as a diagnostic tool were retrospectively analyzed over a ten-year period in 390 consecutive patients. The four principal conditions in which this procedure was employed were alcoholism (33%), hepatitis (18%), abnormal hepatic tests (16%) and tumors (10%). The development of new, "non-invasive", investigative methods such as echography and tomodensitometry has led to an decrease in the number of liver biopsies performed annually, but no change in the relative frequency of the various indications. In this paper, evidence is presented which demonstrates that hepatic biopsy confirmed the clinical diagnosis in 62.4% of the cases reviewed and fundamentally modified the diagnosis in 20.2%. Based upon these findings, it can be concluded that liver biopsy remains an indispensable diagnostic procedure in the field of hepatology, since it can result in modification of the clinician's diagnosis in one out of five cases. PMID- 3278373 TI - [Treatment of carotid atherosclerosis. Possibilities and limitations]. AB - Many kinds of treatment have been advocated for stroke prevention, but little is known on what should be the best management of carotid atherosclerosis. The effect of drugs, such as antiaggregants and anticoagulants, on carotid plaques is poorly known, but may be of importance in long-term prophylactic treatment. In this review, the advantages and the limitations of available treatments are discussed. PMID- 3278374 TI - [Continuous nasal positive pressure respiration (nCPAP) as a therapeutic possibility in the sleep apnea syndrome]. AB - Sleep apnea syndrome (SAS) is a rare disorder which is being diagnosed more often with increasing knowledge among physicians and patients. SAS presents with daytime hypersomnolence, intellectual deterioration and personality changes, chiefly in obese men, and is caused by intermittent upper airway obstruction during sleep at the level of the mesopharynx. Consecutive repetitive apneas of more than 10 seconds' duration are immediately abolished by pneumatic splinting with continuous positive pressure of 5 to 15 cm H2O with a nasal mask (nCPAP). A case report on a 31-year-old man with obesity and hypercapnia demonstrates that, although nCPAP by itself does not lead to weight reduction, it is more acceptable than surgical therapy (tracheostomy or uvulopalatopharyngoplasty). PMID- 3278375 TI - [Lack of effect of ACE inhibition on severe proteinuria in diabetic nephropathy- a 6-month-long study]. AB - The effect of angiotensin converting enzyme inhibition with captopril therapy (3 x 12.5 mg/d) on heavy proteinuria and kidney function was investigated in 10 insulin-treated diabetic patients over a period of 6 months. Urinary protein excretion increased from 3706 mg/day (SD 1491) to 5405 (SD 2699) after 6 months of treatment (p = 0.05); serum creatinine rose from 248 mumol/l (SD 163) to 283 (SD 186) (p less than 0.01), whereas there was no significant difference in blood pressure before (150/80 mm Hg--SD 23/6) and after therapy (150/90 mm Hg--SD 23/10). HbA1c as a marker of metabolic long-term control decreased from 8.3% (SD 1.0) to 7.3% (SD 1.0) (p less than 0.05). No beneficial effects of low dose angiotensin converting enzyme inhibition on heavy proteinuria could be demonstrated in this group of patients with advanced diabetic nephropathy. In particular, progressive deterioration of kidney function was not influenced by the captopril treatment. In diabetic patients with incipient diabetic nephropathy presenting with microalbuminuria, further studies concerning a possible therapeutic effect are necessary. PMID- 3278376 TI - Stress fracture of the ulnar diaphysis in athletes: a case report and a review of the literature. PMID- 3278377 TI - Molecular cloning of the zeta chain of the T cell antigen receptor. AB - The T cell antigen receptor is a multi-subunit receptor complex present on the surface of all mature and many developing T cells. It consists of clonotypic heterodimers noncovalently linked to five invariant chains that are encoded by four genes and referred to as the CD3 complex. The CD3 gamma, delta, and epsilon chains have been molecularly characterized. In this report the molecular cloning of a complementary DNA encoding the zeta chain of the murine T cell antigen receptor is described. The predicted protein sequence of the zeta chain suggests a structure distinct from those of any of the previously described receptor subunits. PMID- 3278378 TI - Modulation of folding pathways of exported proteins by the leader sequence. AB - Leader peptides that function to direct export of proteins through membranes have some common features but exhibit a remarkable sequence diversity. Thus there is some question whether leader peptides exert their function through conventional stereospecific protein-protein interaction. Here it is shown that the leader peptides retarded the folding of precursor maltose-binding protein and ribose binding protein from Escherichia coli. This kinetic effect may be crucial in allowing precursors to enter the export pathway. PMID- 3278380 TI - FDA queries Alzheimer's trial results. PMID- 3278379 TI - Donor-derived cells in the central nervous system of twitcher mice after bone marrow transplantation. AB - The twitcher mouse is an animal model of galactosylceramidase deficiency, comparable to Krabbe's disease, a lysosomal storage disease in humans. As in most lysosomal storage diseases, neurological deterioration is a prominent feature of the disease in these mice. Transplantation of enzymatically normal congenic bone marrow was earlier found to result in prolonged survival and increased levels of galactosylceramidase in the visceral organs of twitcher mice. It is now reported that bone marrow transplantation results in increased galactosylceramidase levels in the central nervous system (CNS). Concomitantly, the levels of psychosine, a highly toxic lipid that progressively accumulates in the CNS of untreated twitcher mice, stabilized at much lower levels in the CNS of treated twitcher mice. Histologically, a gradual disappearance of globoid cells, the histological hallmark of Krabbe's disease, and the appearance of foamy macrophages capable of metabolizing the storage product were seen in the CNS. By immunohistochemical labeling it was demonstrated that these foamy macrophages were of donor origin. The infiltration of enzymatically competent, donor-derived macrophages was accompanied by extensive remyelination in the CNS. It is concluded that after bone marrow transplantation, donor-derived macrophages infiltrate the affected brain tissue and are capable of inducing a partial reversal of the enzyme deficiency. PMID- 3278381 TI - Radon in homes: determining risks and preventing exposures. AB - Knowledge about the effects of radon disintegration products and their levels in the nation's homes indicates that in a small proportion of homes these radioactive substances are increasing the inhabitants' risks of lung cancer. Testing for the problem and reducing its magnitude are the homeowner's responsibility. While practical methods for testing are known, they may not be easily available in all regions. Present understanding of the techniques of prevention and remediation is less satisfactory. PMID- 3278382 TI - Chernobyl retrospective. AB - On April 28, 1986 heavy radioactive fallout from an unknown source was reported from Sweden. Later, it was discovered that two days earlier, a nuclear power reactor at Chernobyl, in the Soviet Union, had exploded releasing an enormous cloud of effluent containing 40 million Ci of 131I, 3 million Ci of 137Cs, and 50 million Ci of xenon radioisotopes. This far exceeded the 15 Ci of 131I escape in the notorious Three Mile Island accident. Chernobyl reactor IV, of an antiquated design, was a graphite-moderated reactor which suffered a steam explosion when the operating staff attempted an experiment involving preservation of safety functions during a planned shutdown. Following the explosion, a fire started in the graphite core which required ten days to control. Thirty-one persons died, two in the initial explosion and 29 of various combinations of thermal and radiation burns, and gamma irradiation. Existing emergency plans were invoked involving treatment on the scene and evacuation of seriously injured patients to a special hospital in Moscow, as well as to nearby Kiev. Later, 135,000 residents of the immediate neighborhood were surveyed and evacuated after fallout radiation levels began to rise. Fallout patterns around Europe and the northern hemisphere were closely tracked. Consequences of the accident in human and monetary terms will require years of evaluation. Although the United States has no power reactors of the Chernobyl type, the country does have a radiation disaster management plan, often rehearsed at the state level. As a consequence of Chernobyl certain international agreements dealing with radiation disaster information and management have been forged. PMID- 3278383 TI - The nuclear power industry in the United States: status and projections. AB - One sixth of the electricity in the United States is now being generated in nuclear power plants, a remarkable achievement for a technology whose basic nuclear reaction was not even known 50 years ago. On the other hand, many of the nation's electric utilities are experiencing great difficulties completing the construction of their nuclear plants; 41 partially constructed plants have been abandoned. Those abandoned plants plus about 110 in operation and 15 still to be completed comprise the first generation of nuclear power plants in the United States. When, and even if, there will be a second generation is much in doubt. Data are presented to show that the absence of a second generation of nuclear plants will place large demands on the fossil fuels, with attendant high energy prices and high environmental costs the expected outcome. It appears that the future will bring large economic forces to start new orders for nuclear plants. On the other hand, the opposing institutional forces appear equally strong. Among the problems creating these institutional forces are the difficulty the United States is having in finding a politically acceptable approach to nuclear waste disposal and the vulnerability of power plant builders and operators to litigation and high financial risk. At present, the issue of a second generation of nuclear plants is stalemated. PMID- 3278384 TI - Origin and health risks of indoor radon. AB - Radon has always been a component of ground and air and it has been present in increased concentrations from the moment humans first sought shelter inside dwellings. Recent improvements in the energy efficiency of dwellings have led to increased concentrations of radon and to increased risks of lung cancer. To quantify the magnitude of this risk, well-designed epidemiological studies, including surveys of representative dwellings, are needed, and several are being implemented. In the meantime, the EPA and other agencies have offered guidance on monitoring procedures and remedial measures appropriate for the problem on indoor radon. Recent disclosures of relatively high concentrations of radon and radon decay products in homes in several parts of the country have increased public concern about the problem. More information and education are needed about the health risks of radon, the desirability of implementing monitoring procedures for radon, and about remediation measures when detected levels are above average. Educational resources are needed in communities to address local issues when they arise. These resources should include knowledgeable individuals who can work with state and county health officials to put public concerns into perspective within the local context. Physicians, other health professionals, and medical scientists have the knowledge and credentials to be these individuals. To provide health professionals with knowledge and skills to communicate with the public about the health risks of radon, the American Medical Association has prepared an authoritative report and initiated a series of regional seminars on the origin and health risks of radon.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278385 TI - Preservation of food products by irradiation. AB - The use of irradiation to preserve food has the potential to significantly enhance our capacity to maximize the quality and quantity of the food we consume. In a world in which distribution of food occurs across continents and in which malnourished populations are in dire need of basic food products, any safe, effective, and efficient means of preserving food is more than welcome. Irradiation, as a method for food preservation, has been studied for more than 30 years. This discussion focuses on this most recent method for the preservation of food with particular emphasis on its effects on the safety, nutritive, and aesthetic values of the food preserved by irradiation. The use of ionizing radiation as a method to preserve foods is one that has been demonstrated to be effective for a variety of food classes. Irradiation offers a means to decontaminate, disinfest, and retard the spoilage of the food supply. At the same time, it appears that the wholesomeness of these food products is maintained. Nutritive value can be sustained by use of effective doses of radiation. Concerns over the safety of irradiated food are rooted in questions regarding the potential induction of radioactivity, harmful radiolytic products, and pathogenic radiation-resistant or mutant strains of microorganisms. Research findings have allayed concerns over safety. However, more research is necessary to conclusively resolve these safety issues. Food irradiation is a promising technology that has and will contribute to our ability to feed the people of this world. This technology is but one of many available ways to preserve our greatest natural resource, the food supply. Enhancement of the ability to preserve food by irradiation will facilitate the distribution of food from fertile developed regions to the malnourished peoples of underdeveloped countries. It is in diminishing the problem of malnourishment and starvation that irradiation as a means to preserve food may find the greatest acceptance. PMID- 3278386 TI - Radioactive artifacts: historical sources of modern radium contamination. AB - Radium has been distributed in a wide variety of devices during the early part of this century. Antique objects containing significant amounts of radium turn up at flea markets, antique shows, and antique dealers, in a variety of locations. These objects include radium in devices which were used by legitimate medical practitioners for legitimate medical purposes such as therapy, as well as a wide variety of "quack cures." These devices may contain anywhere from a few nanocuries to as much as several hundred microcuries of radium. In addition to medical sources, a large variety of scientific instruments utilize radium in luminous dials. These instruments include compasses, azimuth indicators, and virtually any object which might require some form of calibration. In addition, the consumer market utilized a large amount of radium in the production of wrist watches, pocket watches, and clocks with luminous dials. Some of these watches contained as much as 4.5 microCi of radium, and between 1913 and 1920 about 70 gm was produced for the manufacture of luminous compounds. In addition to the large amount of radium produced for scientific and consumer utilization, there were a number of materials produced which were claimed to contain radium but in fact did not, further adding to the confusion in this area. The wide availability of radium is a result of the public's great fascination with radioactivity during the early part of this century and a belief in its curative properties. A number of objects were produced in order to trap the emanations of radium in water for persons to drink in order to benefit from their healing effects. Since the late 20s and early 30s the public's attitude towards radiation has shifted 180 degrees and it is now considered an extremely dangerous and harmful material. However, even as late as the 1950s, there were still some items produced containing radioactivity which today would be unthinkable. The "Buck Rogers Mystery Ring" of the 1950s was activated with polonium. With the shift in public attitudes towards radioactivity, and increasing problems in disposal of radioactive materials, the disposal of radium presents a particularly perplexing problem. The radium which was produced in the early part of the century is still around in various forms and is extremely difficult to dispose of. All objects discovered claiming to contain radium should be taken seriously and should be properly surveyed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3278387 TI - The surgical pathology of head and neck cancer. PMID- 3278388 TI - Epidemiology of head and neck cancer. PMID- 3278389 TI - Surgical management of head and neck cancer. AB - The management of advanced carcinoma of the head and neck excluding thyroid carcinoma requires a combination of operation and radiation therapy to give the patient the best chance of cure. It is not appropriate to try to extirpate advanced squamous cell carcinoma by operation alone. There is evidence that postoperative radiation therapy is more effective in local regional control at least in certain sites than preoperative radiation therapy and there is better patient acceptance of the treatment plan in which the radiation therapy is administered after the operation. PMID- 3278391 TI - Head and neck cancer: chemotherapy concepts. PMID- 3278392 TI - Prosthodontic rehabilitation of the head and neck cancer patient. PMID- 3278390 TI - Radiation Therapy Oncology Group (RTOG) studies in head and neck cancer. AB - Since its foundation in 1971, the RTOG has conducted a successful clinical research program in head and neck mucosal squamous cell carcinoma with 22 treatment protocols and one registry study which combined have accumulated data on over 5,500 patients. The RTOG was the first multicenter group to evaluate neoadjuvant chemotherapy before definitive radiation with its methotrexate study. Although the study was negative, RTOG has since conducted five pilot or phase II studies of neoinduction or concurrent chemotherapy with radiation therapy in patients with inoperable tumors. The last study showed that radiation concurrent with cisplatinum was tolerable with a suggestion of increased antitumor effect. In patients with potentially resectable tumors, RTOG has completed a pilot study of combination chemotherapy administered either before or after the surgery with radiotherapy. Based upon its findings, the treatment sequence, surgery chemotherapy-radiotherapy, was chosen as the experimental arm for a new phase III study. This study was subsequently adopted by the head and neck intergroup mechanism as its study (INT 0034/RTOG 8503). RTOG has investigated the optimal timing of radiotherapy with surgery. The 7303 study established that postoperative radiotherapy achieved significantly better locoregional control but not improved absolute survival. Approximately 30% of the patients on each arm failed to complete both modalities. Even when comparison is restricted to patients who completed both modalities, postoperative radiotherapy still produced the better locoregional control. Efforts to overcome the limitations imposed by tumor hypoxia through use of carbogen (95% O2 and 5% CO2) breathing or the radiosensitizer misonidazole during radiotherapy have been unsuccessful. In a phase I study, RTOG showed that 15 to 18 sessions of sensitized radiation can be safely delivered with the new radiosensitizer SR 2508 in contrast to only six such sessions with misonidazole. This promising radiosensitizer is now being tested in a phase III trial. RTOG has also investigated variations in fraction size, fraction number, and total radiation dose. In the 7102 study, split-course irradiation achieved equivalent antitumor results as compared to continuous daily irradiation but with less social alteration and cost to the patient. In the hyperfraction pilot study 7703, twice a day irradiation with 120 cGys up to 6,000 cGys proved to be tolerable.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3278393 TI - [Bulk-containing diet in preparation for double-contrast examination of the colon in practice]. PMID- 3278394 TI - [Conventional tomographic versus computed tomographic diagnosis of the superior mediastinum]. PMID- 3278395 TI - A new instrument for hepatic resection. AB - A new instrument for hepatic resection was designed and developed. Use of the hepatic comb during hepatic resection is described. It is very simple in shape, easy to handle and inexpensive. Using the instrument has made mandatory rapid hepatectomy in poor risk patients possible. The hemostatic effect of the procedure with this instrument is excellent, which is an important consideration in surgical treatment of the liver. PMID- 3278396 TI - Delayed type hypersensitivity testing in surgical patients. AB - DTH skin reactions can identify a population of surgical patients at increased risk for sepsis and related mortality. The usefulness of the technique is increased by repeating the test during the hospital course and by calculating a DTH score, which is the sum of the diameter of induration of all five or six tests expressed in millimeters. Regression analysis of factors that could possibly indicate development of sepsis and death after surgical treatment reveals that the most powerful predictors are serum albumin, DTH score and age of the patient. The population of patients who are anergic are more frequently malnourished than reactive patients, but the DTH response cannot be used to determine the malnourished state in individual patients. The lack of a DTH reaction (anergy) identifies an immune defect characterized by a failure of release of lymphokines in vivo. Lymphokines from normal individuals can restore to normal the absent response of anergic patients to specific antigens. In experimental animals made anergic by a heat injury, the mortality rate from bacterial peritonitis can be significantly lowered by lymphokines. Immunomodulation of demonstrated defects in host resistance is an exciting prospect for the future of surgical patients. PMID- 3278397 TI - Joseph L. Ransohoff. PMID- 3278398 TI - Group B streptococcal infections of the central nervous system in infants with myelomeningocele. AB - Three cases of group B streptococcal infection of the central nervous system (CNS) occurred among 147 neonates treated for myelomeningocele at The Children's Hospital in Boston from 1970 to 1985. This pathogen was responsible for one third of the nine CNS infections noted in these patients over the 15-year study period. All three children with group B streptococcal CNS infections subsequently required multiple CNS shunting procedures and prolonged hospitalizations. Two children suffered major neurological sequelae. In neonates with myelomeningocele, group B streptococci have direct access to the CNS, perhaps explaining the high incidence of serious meningitis and ventriculitis in this population. Antibiotic prophylaxis for early myelomeningocele repair should be adjusted accordingly. PMID- 3278399 TI - World Federation of Neurological Societies. PMID- 3278400 TI - Rotational total skin electron beam therapy. AB - Our technique for dual-field rotational total skin electron beam therapy (TSEBT) is described in detail. The need for boost to different sites due to self shielding or artificial shielding is also described in detail. PMID- 3278401 TI - Coumarin necrosis--a review of the literature. AB - Skin and soft tissue necrosis is a rare complication of anticoagulation therapy. Two patients who exhibited the spectrum of this disorder are described. The clinical features, etiology, pathophysiology, and treatment of coumarin skin necrosis are outlined, and the English-language literature is reviewed. PMID- 3278402 TI - Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection. Registry of Hepatic Metastases. AB - In an investigation of the indications for hepatic resection in the treatment of colorectal carcinoma metastases, the records of 859 patients who had undergone this procedure were reviewed. This patient group, from 24 institutions, was found to have a 5-year actuarial survival of 33% and a 5-year actuarial disease-free survival of 21%. The only factors that might by themselves be considered contraindications to hepatic resection are the presence of positive hepatic nodes, the presence of resectable extrahepatic metastases, or the presence of four or more metastases. Other factors that had a negative effect on long-term survival were margins of resection on the liver metastases less than or equal to 1 cm (S [5-year actuarial survival] = 23%), the presence of positive mesenteric nodes in the primary tumor specimen (S = 23%), and a disease-free interval of less than 1 year (S = 24%). The effect of any one of these factors was not great enough to contraindicate resection. However, combinations of prognostic factors must be considered before resection is recommended. The overall 5-year survival rate for this large series has been very satisfying. Decision making in the future must take into account such factors as number of metastases, extrahepatic involvement, and stage of the primary tumor. PMID- 3278403 TI - Upper gastrointestinal endoscopy after cardiac transplantation. AB - Three hundred four patients have undergone cardiac transplantation at the University of Pittsburgh since 1980. Twenty patients have required 27 upper gastrointestinal (GI) endoscopic procedures. After heart transplantation the primary indications for endoscopy were epigastric pain (six patients with gastritis, one with multiple shallow gastric ulcers, and one with normal test results), mild upper GI bleeding (four patients with esophagitis, two with gastritis, and two with multiple shallow gastric ulcers), dysphagia and odynophagia (two patients with esophagitis), persistent nausea and vomiting (one with normal test results), lower GI bleeding (one with normal test results), and routine follow-up (one with normal test results). After heart-lung transplantation the primary indications for the endoscopy were massive upper GI bleeding (three patients with actively bleeding duodenal ulcers), dysphagia and odynophagia (one patient with esophagitis), mild upper GI bleeding (one patient with gastritis), and routine follow-up (one patient with normal test results). No complications resulted from endoscopy. The procedures were performed in the GI suite without cardiac monitoring. Prophylactic antibiotics were not routinely administered. No patient had a fungal infection of the upper GI tract--a finding attributed to the prophylactic use of nystatin in all patients. Opportunistic viral infections were identified histologically in six patients, including two patients with actively bleeding duodenal ulcers. The possibility of opportunistic viral infections in this immunosuppressed group required aggressive diagnostic techniques, including endoscopy and biopsy, which can be safely performed after cardiac transplantation. PMID- 3278404 TI - A new microvascular model for noninvasive nuclear magnetic resonance spectroscopy of the transplanted kidney. AB - The cellular biology of graft rejection is not well understood. Phosphorus-31 nuclear magnetic resonance (31P NMR) spectroscopy is a new noninvasive technique for the measurement of intracellular pH and relative amounts of phosphorus containing compounds, such as adenosine triphosphate (ATP), inorganic phosphate, phosphocreatine, and sugar phosphates, in any tissue from which a clear signal can be obtained. Biochemical analysis of such precision, without the need for tissue destruction, represents an unusual opportunity for analysis of in vivo cellular metabolism under varying conditions, including graft rejection. 31P NMR study of intra-abdominal viscera has not been feasible in most laboratories without laparotomy because of signal interference from abdominal wall muscle. In this study, to eliminate this interference, a rat kidney was transplanted to the groin, where it could be serially studied without overlying skeletal muscle. This new vascular technique was successful in 11 of 11 attempts and maintained normal serum creatinines in 10 chronic survivors after removal of both native kidneys. The 31P NMR spectroscopic signal from the groin kidney is clear and highly reproducible. This new microvascular model will make it possible to carry out noninvasive long-term spectroscopic studies that could potentially identify a reliable marker for allograft rejection. PMID- 3278405 TI - Impact of endoscopic ultrasonography on diagnosis and treatment of primary gastric lymphoma. AB - Endoscopic ultrasonography (EUS) allows a visualization in vivo of the gastric wall. Five ultrasonic layers of different echogenicities are displayed; each corresponds to a precise anatomic structure. In gastric diseases this layering evidently changes. In 10 patients with suspected primary gastric lymphoma, EUS showed a characteristic thickening of the second, the second and third layers, or a diffuse, transmural thickening of the entire wall. A precise correlation between the longitudinal and depth infiltration observed at EUS and the surgical finding was seen in all patients. In three cases in which the preoperative bioptic diagnosis was erroneous (two gastritis and one carcinoma) EUS showed a characteristic echographic pattern for lymphoma, which was confirmed at surgery. There was agreement also, in EUS and surgical findings in all patients, about involvement of neighbor organs. It seems possible that in the future EUS could play an important role in detecting, staging, and planning treatment of lymphoma and other gastric tumors. PMID- 3278406 TI - Wandering intravascular missiles: report of five cases from the Lebanon war. AB - From 1980 to 1986, during the Lebanon war, five patients with missile embolization were seen at the American University of Beirut Medical Center. Three had entry in the heart or thoracic aorta with peripheral embolization, and two had entry in the internal carotid artery and inferior vena cava with embolization to the middle cerebral artery and heart, respectively. Embolization was suspected when, in the absence of an exit, routine x-ray films showed the missile in a distant location. Angiography and echocardiography confirmed the diagnosis. Peripheral arterial emboli were extracted while cerebral and venous emboli were kept, as they caused transient symptoms and remained silent. PMID- 3278407 TI - Pelvic cellulitis: a life-threatening complication of hemorrhoidal banding. AB - Rubber band ligation is a commonly employed office procedure for the eradication of symptomatic internal hemorrhoids. Since 1980 increasingly frequent reports of an often fatal complication--"pelvic cellulitis"--have appeared. Death has been avoided for some of these patients by early recognition and treatment. One such survivor is reported here, in a case report that illustrates the value of early recognition of symptoms and appropriate diagnostic and therapeutic intervention. PMID- 3278408 TI - [EDP--results reached only by thinking in units]. PMID- 3278409 TI - [EDP--tell your TV screen what will happen with patients]. PMID- 3278410 TI - [Student nurses must learn about EDP as soon as possible]. PMID- 3278411 TI - Rural hospitals: changing with the times. PMID- 3278413 TI - Bilateral hypoglossal nerve injury after bilateral carotid endarterectomy. AB - A case of severe bilateral injury to the hypoglossal nerves after two-stage carotid endarterectomy is described. Injury to the hypoglossal nerve occurs in up to 20% of patients undergoing carotid endarterectomy and may result in mild or unnoticed deficits. These injuries must be carefully searched for in patients who will undergo a similar procedure on the opposite side since a bilateral deficit of the hypoglossal nerve is poorly tolerated, causing potentially serious impairment of speech and risk of aspiration. PMID- 3278412 TI - Treatment of acute cerebral infarction with a choline precursor in a multicenter double-blind placebo-controlled study. AB - A multicenter double-blind placebo-controlled study of cytidine 5' diphosphocholine (CDP-choline) was conducted to evaluate possible clinical benefits of the drug in patients with acute, moderate to severe cerebral infarction. The patients included also suffered from moderate to mild disturbances of consciousness, and all were admitted within 14 days of the ictus. Patients were allocated randomly to treatment with either CDP-choline (1,000 mg/day i.v. once daily for 14 days) or with placebo (physiological saline). One hundred thirty-three patients received CDP-choline treatment, and 139 received placebo. The group treated with CDP-choline showed significant improvements in level of consciousness compared with the placebo-treated group, and CDP-choline was an entirely safe treatment. PMID- 3278414 TI - The entry of the prothymocyte into the thymus after lethal irradiation and bone marrow transplantation. I. Seeding of bone marrow cells into the thymus. AB - Bone marrow (BM) cells arrive in the thymus of lethally irradiated mice as early as three hours after bone marrow transplantation (BMT). They can be recognized by labeling of the injected cells with Hoechst 33342 (direct homing assay). In order to relate the immigrated BM cells to thymocyte precursor cells, direct homing and thymus repopulation experiments were compared. It was shown that homing of BM cells depends on the time between lethal irradiation and BMT, while it was previously shown that thymus repopulation does not. In addition, thymic immigrants were smaller than precursor cells committed to the T cell limeage (prothymocytes) and their progenitors. A cell population obtained from normal BM cells and enriched in stem cells (purified stem cells) was previously shown to repopulate the thymus similarly as BM cells from mice pretreated in vivo with 5 fluorouracil (FUBM). Both cell suspension showed a delayed thymus repopulation when compared to normal BM. This is indicative for a depletion of prothymocytes in these cell suspensions. In the direct homing assay, however, it was found that relatively many cells from FUBM seeded into the thymus, while purified stem cells did not. These results indicate that most if not all donor cells that are present in the thymus at three hours after BMT are not thymocyte precursor cells. PMID- 3278415 TI - The entry of the prothymocyte into the thymus after lethal irradiation and bone marrow transplantation. II. Time of entry. AB - The time of entry of prothymocytes into the thymus after lethal irradiation and bone marrow transplantation (BMT) was determined by exposing the thymus only or the whole body with the thymus shielded to a second irradiation after different intervals. The repopulation of the thymus by donor type cells was determined by a thymus repopulation assay using donor specific markers. Reirradiation of the thymus kills the prothymocytes that have entered the thymus during the interval. It was found that reirradiation of the thymus from 48 hours after BMT onwards increasingly delayed thymus regeneration. This shows that donor prothymocytes do not enter the thymus until about 2 days after BMT and that they continue to do so during at least three subsequent days. In the second reirradiation protocol thymus regeneration occurred earlier in the shielded thymus than in thymuses of whole body irradiated mice. Earlier thymus regeneration was not seen in mice that were reirradiated at 24 hours after BMT, but occurred only when irradiation took place at 48 hours and later. These data are consistent with those obtained in the first protocol. The results are in contradiction with results of direct homing experiments, which showed entrance of donor cells within 3 hours after BMT. Our functional assay demonstrated that the early appearing cells cannot be prothymocytes. In retransplantation experiments it was shown that the bone marrow (BM) may indeed be the initial homing site of prothymocytes. PMID- 3278416 TI - Ablation of free radical-mediated reperfusion injury for the salvage of kidneys taken from non-heartbeating donors. A quantitative evaluation of the proportion of injury caused by reperfusion following periods of warm, cold, and combined warm and cold ischemia. AB - Postischemic renal failure is a severe problem following cadaveric renal transplantation, especially if the kidney has been harvested from a non heartbeating donor, and thereby subjected to periods of both warm and cold ischemia. It is well established that a substantial component of postischemic injury is produced by oxygen-derived free radicals generated from xanthine oxidase at reperfusion. However, the clinical potential of free radical ablative therapy is dependent upon the proportion of the total injury caused by this reperfusion mechanism, compared with the proportion resulting from ischemic injury per se. Therefore, we quantitatively evaluated these proportions in porcine kidneys subjected to various periods of warm (renal artery occlusion in situ), cold (harvest, cold preservation, and allotransplantation), and combined warm and cold ischemia. Experiments were paired, one kidney treated with either superoxide dismutase (SOD) or allopurinol for free radical ablation, the contralateral kidney serving as a control. Creatinine clearance (Ccr) was measured separately for each kidney 48 hr after reperfusion. After 1 and 2 hr of warm ischemia, Ccr dropped to 50% and 36% of normal, respectively. This was improved to 110% and 55% when SOD was given into the renal artery at reperfusion. Similarly, after 24 and 48 hr of cold ischemia, kidney function was significantly improved from 30% and 18% to 72% and 47% of normal, respectively, when allopurinol was added to the preservation solution. SOD used at harvest and again at reperfusion was particularly effective following combined warm and cold ischemia, in a situation mimicking the harvest of cadaver kidneys from a non heartbeating donor. These findings suggest that the ablation of free radical mediated reperfusion injury may improve posttransplant renal function sufficiently to allow expansion of the cadaveric donor pool to include non heartbeating donors. PMID- 3278417 TI - Effect of ultraviolet-B-irradiated donor-specific blood transfusions and peritransplant immunosuppression with cyclosporine on rat cardiac allograft survival. AB - We have previously demonstrated that pretreatment of ACI recipients with ultraviolet-irradiated donor-specific blood transfusion (UV-DST) leads to permanent cardiac allograft survival without further host immunosuppression (ACI rats are weak responders to Lewis lymphocytes in mixed-lymphocyte reaction). This study examines the effect of UV-DST and the timing of transfusions on ACI cardiac allograft survival in Lewis recipients with and without the addition of peritransplant cyclosporine (CsA) (20 mg/kg i.m.) given on days 0, +1, and +2 in relation to the time of transplantation. The mean survival time (MST) of ACI cardiac allografts in Lewis recipients was significantly increased to 33.6 +/- 5.7 days (P less than 0.001) by CsA treatment alone as compared to 6.5 +/- 0.5 days survival in control. When DST was given on day -3 combined with CsA, graft survival was increased to 42.0 +/- 9.3 days (P less than 0.01), as compared to 5.8 +/- 1.3 days when DST alone was used. When DST was irradiated with ultraviolet B (UV-DST) and administered on day -3 combined with peritransplant CsA, the MST was increased to 68.83 +/- 16.1 days as compared to an MST of 10.0 +/- 1.0 days in controls treated with UV-DST alone. When UV-DST was given on day 7 and combined with peritransplant CsA immunosuppression, the results were similar. However, when UV-DST was peritransplant CsA course, 4 of 6 recipients maintained their ACI heart allografts indefinitely (greater than 300 days) in contrast to the effect of UV-DST alone (MST of 13.5 days). Third-party (W/F) UV irradiated blood transfusions were ineffective in prolonging ACI cardiac allografts in Lewis rats, regardless of whether the transfusions were given alone or in combination with peritransplant immunosuppression with CsA. In conclusion, these results demonstrate that UV-DST combined with a brief peritransplant immunosuppression with CsA induces prolonged heart allograft survival in a histoincompatible, strong responder host, and that such effect is donor specific. The use of UV-DST combined with peritransplant CsA immunosuppression offers a promising approach to achieving organ transplant unresponsiveness, and decreased sensitization to the donor blood elements, which eventually may have important clinical implications. PMID- 3278418 TI - Low-dose cyclosporine maintenance therapy after immunosuppressive induction in a rat cardiac transplant model. AB - An immuno-reduction-suppression protocol using spleen cell infusion followed by cyclophosphamide (CP) or azathioprine (AZ) to reduce the immunocompetent cells and maintenance suppression with low-dose cyclosporine (CsA) was highly effective in a rat cardiac transplant model. Following one or two spleen cell infusions, AZ or CP treatment was given before transplantation. After transplantation the animals were maintained with low-dose CsA. Among those treated with AZ, five of eight survived greater than 100 days, and among those treated with CP, six of eight survived greater than 100. These two protocols were far superior to 28 other permutations of treatment consisting of 164 transplants, such as infusions plus AZ without CsA and infusions without AZ but with CsA. We conclude that CsA can most effectively be used in low dose as a maintenance drug and that immunoreduction therapy is optimized by prestimulation and expansion of reactive cells. Another important feature of this proposal is that the immunoreductive risk phase, performed before transplantation, can be separated from the operative risk period. This avoids the conventional superimposition of the two risks. PMID- 3278419 TI - The repopulation capacity of bone marrow grafts following pretreatment with monoclonal antibodies against T lymphocytes in rhesus monkeys. AB - Complement-mediated lysis of (subsets of) T lymphocytes in bone marrow grafts is increasingly used to prevent acute graft-versus-host disease in human bone marrow transplant recipients, especially in case of major immunogenetic disparity between donor and recipient. Since T lymphocyte depletion has resulted in an increased frequency of allogeneic engraftment failures, its effect on hemopoietic reconstitution was measured in rhesus monkeys. The reactivity patterns of commonly used types of antihuman T lymphocyte monoclonal antibodies (MCAs) with rhesus monkey lymphocytes was analyzed using a double-label cytofluorometry technique and found to be very similar to those with human lymphocytes. The antibodies investigated included CAMPATH-1 (recognizing an antigen present on virtually all lymphocytes and monocytes), OKT4 + 4a (CD4, helper/inducer T lymphocytes), B9 (CD8, suppressor/cytotoxic T lymphocytes), WT-1 (CD7, pan-T), and anti-DR MCAs as stem cell toxic controls. Their possible toxicity to hemopoietic stem cells was studied by using a semiquantitative autologous regeneration assay. Cytotoxic lysis of cells in the bone marrow grafts reacting with the T lymphocyte purging MCAs did not result in delayed regeneration compared to untreated autologous grafts. It is concluded that T lymphocyte depletion using anti-T-lymphocyte MCAs does not influence the repopulating capacity of an autologous bone marrow graft. PMID- 3278420 TI - Improvement of renal preservation by verapamil with 24-hour cold perfusion in the isolated rat kidney. AB - There is substantial evidence that increased cellular calcium may activate processes that lead to cellular injury and death, and calcium entry blockers (CEB) have been shown to protect against renal ischemic injury. This approach has been used experimentally to enhance kidney preservation during both warm and cold ischemia. In the present study, the effect of the CEB verapamil on kidney function after 24 hr of hypothermic (4-7 degrees C) perfusion was examined and compared with simple cold storage with Eurocollins' solution (4 hr), 4 or 24 hr cold perfusion, without the addition of verapamil. The cold perfusion media consisted of 3% albumin in phosphate-free Krebs-Henseleit saline supplemented with 5 mM glucose. Cold perfusion was performed at 40 mmHg perfusion pressure with either 0 (C) or 5 microM verapamil (V) added to the cold perfusion media. Renal functional parameters of plasma flow (RPF), inulin clearance (Cin), fractional (FRNa+) and net sodium reabsorption (TNa+) were assessed during 60 min of reperfusion at 37 degrees C using 6.7% albumin in Krebs-Henseleit saline supplemented with glucose, inulin, and 20 amino acids. There was no increase in RPF with V (33 +/- 1 vs. 32 +/- 2 ml/min/g,NS) but Cin was significantly higher (271 +/- 30 vs. 168 +/- 20 microliter/min/g P less than 0.01) with V. Preservation of tubular function by V was demonstrated by an increase in FRNa+ (84 +/- 5 vs. 57 +/- 8%, P less than .01), TNa+ (32 +/- 6 vs. 15 +/- 3 mumol/min/g, P less than .01) and renal adenosine triphosphate (ATP) concentration (8.0 +/- 5 vs. 4.7 +/- 1.0 mumol/g dry tissue, P less than .01). Thus, V appears not only to enhance kidney preservation with warm and cold ischemia but also improves renal function, as assessed by glomerular filtration rate (GFR) tubular function, and tissue ATP concentration with 24-hr cold perfusion. PMID- 3278421 TI - Successful transplantation of blood group A2 kidneys into non-A recipients. AB - The ABO subgroup A2 has been reported to be less reactive with the anti-A1 antibody naturally occurring in the serum of group O and B recipients and to occur in approximately 20% of group A individuals. Between March 1986 and February 1987, the Midwest Organ Bank (MOB) in Kansas City, screened all group A renal donors for the A2 subgroup. A total of 190 cadaverdonor kidneys were retrieved during this time, of which 68 were subgroup A1 and 16 were subgroup A2 (incidence of A2 = 19% of As and 8.5% of all donors). Of the subgroup A2 kidneys, 13 were transplanted into 9 group O and 4 group B recipients. One group O recipient received an HLA-identical A2 living-related graft. Recipients were not preselected or modified by splenectomy, plasmapheresis, or other means, and were treated with cyclosporine, steroids--and, in most cases, azathioprine, after transplantation. There was one hyperacute rejection and there were 5 acute cellular rejection episodes, 3 of which were reversed. One additional patient died at 2.5 months with a functioning graft. Including the successful living related graft, 10 of 14 patients (71%) have functioning grafts, with a follow-up of 5 to 14 months, and a mean creatinine of 1.7 mg/dl. We find that the A2 subgroup represents a small but important minority of A donors, and that transplantation into non-A recipients can generally, but not universally, be safely accomplished. We recommend the screening of A donors for the A2 subgroup in both the cadaver-donor and living-related groups, and suggest that the utilization of A2 donors in non-A patients may contribute to the transplantation of group O and highly sensitized patients--and, in some cases, improve the degree of HLA matching. PMID- 3278422 TI - Low-dose cyclosporine for cadaveric renal transplantation. AB - Low-dose cyclosporine (CsA) plus prednisone for induction and maintenance immunosuppression were used in 106 consecutive cadaveric renal transplants. Previous reports of lower initial CsA have described its use in combination with other forms of immunosuppression. An oral CsA dose of 3 mg/kg was given 2-4 hr before operation, and maintenance CsA was started 12 hr post-operatively at 1 or 1.5 mg/kg i.v. every 12 hr for non-functioning and functioning kidneys, respectively. Oral CsA was given at 3 times the i.v. dose and started 2-3 days postoperatively. The CsA dose was adjusted to maintain plasma trough levels, as measured by radio-immunoassay, of 150-200 ng/ml for the first two weeks, 125-175 ng/ml 2-4 weeks posttransplant, and 100-150 ng/ml for the second month after transplant. Between two and six months, the CsA dose was gradually reduced by 33%. Maintenance prednisone was rapidly reduced 5 mg/month to a maintenance dose of 10 mg/day. Graft survivals for low and high-risk patients at one year were 91% and 81%, respectively. Patient survivals for low-and high-risk patients at one year were 97% and 90%, respectively. Patient death was caused by: aspiration (1), suicide (1), cardiac failure (1), Mediterranean fever with colon perforation (1), and traumatic renal artery disruption (1). Except for death, grafts were lost to primary nonfunction (2), accelerated rejection at +/- 12 hr (3), medical noncompliance (1), renal artery thrombosis (1), and vascular rejection (1). Of 106 patients, 26 (25% were treated for rejection with 3.5 g of i.v. methylprednisolone over 10 days; 25/26 (96%) rejections were reversed with methylprednisolone alone. OKT-3 failed to reverse the remaining vascular rejection. All 9 conversions from CsA to azathioprine for toxicity were successful. Our definition of toxicity was rising serum creatinine, normal CsA level, and no response to 7-10 days of i.v. methylprednisolone and no change in biopsy. We were not able to distinguish CsA toxicity and rejection in most biopsies. Average serum creatinines at 1, 6, and 12 months were 1.6 mg/dl, 1.55 mg/dl and 1.65 mg/dl, respectively. We conclude that low-dose CsA plus prednisone can be successfully used for all cadaveric renal transplants without other forms of immunosuppression. Steroid-resistant rejection is extremely rare if adequate time is given for i.v. methylprednisolone treatment. Almost all "steroid resistant rejections" were found to be CsA toxicity, and they were reversed after conversion to azathioprine. PMID- 3278423 TI - Withdrawal of steroid immunosuppression in renal transplant recipients. AB - The complications of long-term steroid immunosuppression are well known. During a 12-month period, 52 living-donor renal transplant recipients were entered into a protocol of intentional early steroid withdrawal. Selection criteria were primary living-related renal transplants in HLA-identical (12) or one-haplotype match (40) patients. The study population consisted of 25 diabetics (48.1%) with a mean age of 32.4 years. All patients received preoperative blood transfusions (3 donor specific in haplotype-matched, 3 random in HLA-identical recipients). Immunosuppression consisted of cyclosporine, azathioprine, and corticosteroids, with deliberate steroid withdrawal after two weeks. Forty-six patients (88.5%) were successfully tapered off steroids, while the six protocol failures (11.5%) were due to early rejection or leukopenia that prevented steroid withdrawal. Twenty-three patients (50%) subsequently were returned to steroid therapy for rejection (21) or leukopenia (2). Inadequate immunosuppression precipitated six rejection episodes and were preventable, while the remaining 15 were true breakthrough crises. The overall rejection rate was 50%, with 92.3% of initial rejection episodes occurring within five weeks of steroid withdrawal. Rejection episodes were responsive to steroid therapy alone in 73.2% of cases. No graft loss from rejection has occurred after a mean follow-up interval of 8.5 months. At present, 33 patients (63.5%) are off steroids. In HLA-identical recipients, all but one successfully completed the protocol and 75% are currently steroid free. In haplotype-matched patients, 87.5% completed the protocol and 60% are steroid-independent. Comparison with well-matched control groups on steroids failed to reveal any difference in graft or patient survival, rejection, infection, or mean serum creatinine level. No discriminating risk factors could be identified that were predictive of steroid withdrawal success or failure. In select patients, early steroid withdrawal can be accomplished without jeopardizing graft function. Long-term follow-up is required to assess the risk benefit ratio of steroid withdrawal upon immunosuppressive morbidity. PMID- 3278424 TI - Late results of renal transplantation. AB - A total of 315 (64%) of 491 primary cadaver and living-related donor transplants performed from 1975 through 1984 were still functioning at 24 months. These selected patients were examined further to assess the impact of several risk factors on late graft and patient survival. Black recipients, patients with underlying diabetes mellitus or hypertension, patients with poor renal function at 24 months, and recipients of cadaver grafts had significantly poorer long-term graft survival. Age greater than or equal to 40, diabetes or hypertension, poor 24-month function, and cadaver donor transplantation were associated with poorer long-term patient survival. Considerable improvement in graft survival at 24 months was seen in 1980-1984 compared with the earlier period, coincident with our adoption of routine pretransplant random donor blood transfusion. In contrast, long-term graft survival in patients with functioning graft at two years did not improve significantly over the same period. Although living-related donor transplants showed greater graft and patient survival than cadaver donor grafts by univariate analysis, no such advantage was demonstrated by multivariate analysis. PMID- 3278425 TI - The impact of HLA A, B, and DR blood transfusions and immune responder status on cardiac allograft recipients treated with cyclosporine. AB - From July 1982 to August 1986, 137 patients received heart allografts at our transplant (Tx) center. Recipients were treated postoperatively with cyclosporine (CsA) and prednisone (Pred), with a minority of patients receiving CsA, Pred, and azathioprine (Aza) as immunosuppression. The impact of pre-Tx immune factors on survival was evaluated, including HLA A, B, and DR mismatches (MM), blood transfusions (BT), immune responder status, crossmatch results, and donor and recipient AIDS-virus (human immunodeficiency virus, HIV-1) status. The overall patient survivals were 75%, 68%, and 62% at one, two, and three years respectively. Pre-Tx, 15/137 (11%) recipient sera and 5/137 (3.6%) donor sera were HIV-1 reactive in both enzyme immunoassay (EIA) and Western blot antibody assays. Two of the 5 recipients of HIV-1 (+) donor allografts are alive 11 and 29 months post-Tx, whereas the other 3 recipients died at 1, 31, and 36 months post Tx from diseases unrelated to AIDS. All 5 were pre-Tx HIV-1 nonreactive. The survivals for the 15 recipients who tested pre-Tx HIV-1 (+) were 87%, 87%, and 69% at 1, 2, and 3 years, respectively, comparable to the overall group survivals. Pre-Tx strong and weak immune responders had comparable 12-month survivals of 73% and 80%, respectively. Six patients displayed a positive pre-Tx donor crossmatch, two were attributed to autoantibody, and 4 were attributed to donor T cell reactivity. Five of the six patients presently survive 14, 16, 30, 36, and 44 months post-Tx. Recipients treated pre-Tx with 1-4 BTs displayed significantly better 12-month survival (81% vs. 69%, P less than 0.05) and fewer rejections (1.3 +/- 0.9 vs. 1.9 +/- 1.0, P less than 0.05) than untransfused recipients. Recipients of a 0-1 vs. 2 DR donor antigen-mismatch experienced fewer rejections (1.3 +/- 1.0 vs. 1.8 +/- 1.1, P less than 0.05). Evaluation of the combined influence of HLA DR as well as pre-Tx BTs suggested a significantly improved survival (80% vs. 61%, P less than 0.05) and fewer rejection episodes (1.4 +/- 0.9 vs. 2.0 +/- 1.1, P less than 0.05) for 29 well-matched, transfused (0-1 DR MM and 1-4 BT) compared with 43 poorly matched, untransfused (2 DR MM and 0-BT) heart allograft recipients. Moreover, the benefit of DR matching was only observed in untransfused, but not transfused, cardiac recipients. PMID- 3278426 TI - Successful transplantation of highly sensitized patients without regard to HLA matching. PMID- 3278427 TI - Significance of delayed graft function in cyclosporine-treated recipients of cadaver kidney transplants. AB - Many transplant teams are reluctant to initiate cyclosporine immunosuppression in recipients of cadaver kidney grafts with delayed graft function (DGF). The renal function of cadaver kidney grafts in cyclosporine-treated recipients was compared in 47 recipients with DGF and 57 without DGF. Regardless of initial renal function, all recipients received prednisone, azathioprine, and oral cyclosporine 5 mg/kg/day or its intravenous equivalent. All kidneys were flushed with ice-cold intracellular electrolyte solution and cold-stored for 15-54 hr (mean of 31 hr) prior to transplantation at our hospital between April 10, 1985 and November 30, 1986. Rejection crises were treated with high-dose steroids or OKT3. Cyclosporine was discontinued during courses of OKT3. Recipients with DGF had significantly higher one-month serum creatinine nadirs (2.6 +/- 1.8 mg/dl vs. 1.5 +/- 0.5 mg/dl). Actuarial graft survivals were not significantly different at one year (82.2 +/- 5.5% vs. 82.6 +/- 6.4%, all graft losses included). Mean serum creatinine levels at six months and twelve months after grafting were not significantly different (1.7 +/- 0.4 mg/dl vs. 1.8 +/- 1.2 mg/dl and 2.0 +/- 0.5 vs. 1.7 +/- 0.7 mg/dl, respectively). Delayed graft function following cadaver kidney transplantation does not adversely affect intermediate term function of kidney grafts flushed with intracellular electrolyte solution and cold-stored until transplantation when a low-dose cyclosporine induction protocol is used and cyclosporine is discontinued during OKT3 administration. PMID- 3278428 TI - Reexposure to OKT3 in renal allograft recipients. AB - Between 40% and 80% of patients treated with the monoclonal antibody OKT3 develop blocking antibody against its idiotypic region. Thus a major concern with the use of OKT3 as part of a baseline immunosuppressive regimen is that formation of blocking antibodies might preclude its subsequent use. Between 7/86 and 2/87, 32 patients received prophylactic OKT3 in addition to low-dose prednisone, azathioprine, and cyclosporine. Prophylactic OKT3 did not prevent rejection, as 21 of 32 patients studied developed rejection. Retreatment of 13 patients with OKT3 successfully reversed 12 rejections and lowered the number of T3-positive cells in spite of a low level of blocking antibody in two patients in this group. Of the patients analyzed, 38% developed blocking antibody on initial exposure to OKT3, but OKT3 reuse was denied only 4 patients due to the presence of these antibodies. Three of these had rejections reversed with steroids alone; the other patient lost the allograft. A high frequency of infectious complications occurred in the retreatment group, with viral infections predominating. Only one patient in the retreated group developed antibodies after the second use. Appearance of blocking antibodies after use of OKT3 as part of a base-line prophylactic immunosuppressive regimen did not significantly compromise access to OKT3 for treatment of subsequent rejection episodes, but multiple exposures to OKT3 did increase the frequency of infectious complications. PMID- 3278429 TI - Short-term and long-term function of cadaveric kidneys from pediatric donors in recipients treated with cyclosporine. AB - Short and long-term renal function of 67 cyclosporine-prednisone (CsA-Pred) treated recipients of pediatric cadaveric donor kidneys followed for up to 68 months (mean 16 months) were compared with 67 recipients of adult kidneys (group 3), who were demographically matched for recipient age, sex, race, cause of disease, HLA compatibility, ABO blood type, and retransplant status. Thirty-seven of the pediatric kidneys came from donors less than or equal to 10 years old (group 1) and 30 from donors 11-16 years old (group 2). Group 1 displayed impaired short-term graft function: a significantly higher mean value of the nadir serum creatinine (SCr; 2.35 versus 1.63 mg/dl), a lower maximal creatinine clearance during the first 30 days (50.3 versus 65.7 ng/dl/1.73 m2), and a longer time to achieve the nadir creatinine (22.1 versus 17.2 days). Group 1 transplants also had a higher mean nadir creatinine at 3 months and a lower mean creatinine clearance (CCl) at 3 and 6 months. By 12 months the values in the group 1 pediatric kidneys were similar to those using the group 3 adult grafts. Therefore, CsA therapy did not preclude compensatory graft function. Group 2 grafts showed intermediate short-term function relative to groups 1 and 3. Mean SCr and CCl showed progressive improvement over time, significantly better than adult kidneys at two years. Graft loss was significantly greater at two years in pediatric compared with adult grafts, but significantly better than our historical controls using azathioprine-prednisone immunosuppression. PMID- 3278430 TI - Influence of positive lymphocyte crossmatch and HLA mismatching on vanishing bile duct syndrome in human liver allografts. AB - Among the first 52 recipients of primary liver allografts with follow-up of 2 weeks or greater, 6 patients had biopsy-confirmed vanishing bile duct syndrome (VBDS) and required retransplantation. Five of these six patients had positive lymphocyte crossmatches. Of the 46 remaining liver transplant recipients, 11 had positive crossmatches. Thus, the incidence of VBDS was 5/16 in recipients with a positive crossmatch and 1/36 in recipients with a negative crossmatch. The positive-crossmatch group was significantly more likely to develop VBDS than the negative-crossmatch group (P less than 0.004, log rank test). Additional HLA studies comparing degree of donor-recipient mismatch at the various HLA loci showed no significant difference between the groups for class I disparity. However, class II mismatch was of borderline significance (P less than 0.056). When evaluated individually, the DQ mismatch (P less than 0.04) appeared to be more important than the DR mismatch (P = NS). Our data suggest that a positive lymphocyte crossmatch and a class II mismatch, in particular HLA DQ disparity, may play an important role in the pathogenesis of VBDS. PMID- 3278431 TI - A randomized trial comparing cyclosporine with antilymphoblast-globulin azathioprine for renal allograft recipients. Results at 2 1/2-6 years. AB - Between September 1980 and June 1984, 246 splenectomized, transfused renal allograft recipients were stratified according to presence of diabetes and donor source, and randomized to treatment with either cyclosporine (CsA)-prednisone (pred) or antilymphoblast-globulin (ALG--azathioprine (AZA)--prednisone. As of August 1986, mean follow-up is 47 months. Over all, actuarial patient survival is 84% and 83%, respectively at 4 years. Corresponding graft survival is 70% and 63% for CsA-treated and ALG-AZA-treated patients (NS). Within the subgroup of diabetic recipients of cadaver grafts, graft survival is 70% for CsA-treated and 53% for ALG-AZA-treated recipients (P = .035). In the CsA group, 71% required either a significant reduction in CsA dosage with the addition of azathioprine or a complete switch to azathioprine, mainly because of CsA-associated nephrotoxicity. Of those CsA patients switched at a mean time of 21.3 +/- 16.4 months posttransplant with mean serum creatinine of 2.40 +/- .67, current serum creatinine is 1.79 +/- .63. Current mean serum creatinine values are significantly greater for patients randomized to CsA-pred (1.73 +/- .60) vs. ALG AZA-pred (1.49 +/- .59), P = .014, even though most CsA-treated patients were eventually switched. The causes of graft loss are not different between CsA and ALG-AZA randomized patients. In nondiabetics, rejection is the most common cause of graft loss (17/33), whereas in diabetics loss due to complications from overimmunosuppression or death from cardiovascular events is significantly more common (27/44) than corresponding losses in nondiabetics (6/33, P less than .05). Switching does not seem to influence the incidence or cause of graft loss. Since most patients started on CsA-prednisone are ultimately switched to triple drug therapy, the latter is now the preferred initial treatment modality. PMID- 3278432 TI - Splenic artery aneurysms in liver transplant patients. AB - We found splenic artery aneurysms in 6 of 71 consecutive patients who underwent orthotopic liver transplantation at the Mayo Clinic. The incidence of splenic artery aneurysms in cirrhotic patients with portal hypertension was 10%. Five of the aneurysms were found in patients suffering from chronic active hepatitis, whereas no aneurysms were encountered in patients with primary sclerosing cholangitis or primary biliary cirrhosis. One patient ruptured a splenic artery aneurysm shortly after liver transplantation, and 1 patient developed an aneurysm 3 months after transplantation. We recommend coeliac angiography to be performed prior to liver transplantation, and if splenic artery aneurysms are found, ligation of the splenic artery should be performed at the time of transplantation to prevent possible rupture. PMID- 3278433 TI - Cyclosporine plasma levels six hours after oral administration. A useful tool for monitoring therapy. AB - Clinical evolution and cyclosporine (CsA) monitoring of 65 transplanted patients (55 kidneys, and 10 kidneys and pancreases) treated with CsA were analyzed retrospectively (45 patients) and prospectively (34 patients). Our results showed the following: (1) nephrotoxicity is not uncommon even with low trough plasma levels of CsA; (2) the T6 value of a CsA pharmacokinetic plasma curve (6 hr after oral drug administration) is a valid expression of a full pharmacokinetic study; (3) when T6 was used prospectively as a monitoring tool and dose adjustments made disregarding concomitant serum creatinine levels, the latter decreased when CsA dose adjustments were made to correct toxic (greater than 350 ng/ml) or subtherapeutic (less than 100 ng/ml) T6, P less than 0.01. At present, serum creatinine for all our patients is 180.2 +/- 8 mumol/L, and no patient has needed to be switched to conventional treatment. The validity of trough plasma levels in patients under CsA oral administration once or twice a day seems questionable, and T6 proved to be more useful. Thus nephrotoxicity and CsA undertreatment may be avoided. This new monitoring tool (T6) will allow the utilization of lower doses of CsA and thus contribute to improved long-term graft function. PMID- 3278434 TI - Individualization of immediate posttransplant immunosuppression. The value of antilymphocyte globulin in patients with delayed graft function. AB - In patients with delayed graft function (DGF), the use of cyclosporine (CsA) has been reported to prolong DGF, increase the number of required dialyses, increase the duration of hospitalization, and be associated with decreased graft survival. Routine postoperative antilymphocyte globulin (ALG) use has been advocated, but ALG is associated with increased viral infection. We studied outcome of individualization of immunosuppression. Between 11/84 and 8/86, first-cadaver transplant recipients whose serum creatinine (Cr) fell greater than or equal to 30% in the first 24 hr (immediate function) were started on CsA and prednisone (P) (group 1, n = 26). The remainder were randomized to P and azathioprine (group 2, n = 32) or P and ALG (group 3, n = 26), and switched to CsA when serum Cr fell greater than 30% (minimum 5 days ALG for the ALG group). P taper was the same in all groups. Patients with DGF (groups 2 and 3) had longer preservation time and higher peak PRA (P less than .05) than group 1. Groups were otherwise equivalent. One and 2-year patient survival was 96% (3 cardiovascular deaths; all with functioning grafts). One-year graft survival was 87% for group 1, 87% for group 2, and 82% for group 3(NS). In patients requiring dialysis, mean day off dialysis was 12 +/- 3 in both groups 2 and 3. Mean hospital stay was 12.5 +/- 1.3 days for group 1, 21.6 +/- 2.1 days for group 2 (P less than .05 vs. 1 & 3), and 14.5 +/- 1.2 days for group 3 (NS vs. 1). The increased hospital stay for group 2 patients was mainly due to increased in-hospital rejections: 75% for group 2, (P less than .05 vs. group 1 [35%], and group 3 [11.5%]). In addition, more group 2 in hospital 1st rejections were steroid resistant as compared to group 1; 46% group 1 patients have remained rejection free as compared to 0% group 2 (P less than .05 vs. 1 and 3) and 35% of group 3 (P less than .05 vs. 1 and 2). Mean serum creatinine at 6-12 months remained higher in patients with DGF (group 1 P less than .05 vs. 2 and 3). Rejection was the major cause of graft loss in all groups.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3278435 TI - Dominant effect of histocompatibility on ten-year kidney transplant survival. AB - Using actuarial methods, factors influencing long-term graft survival were examined in 33,594 recent (since 1974) kidney transplants reported to the University of California, Los Angeles, Transplant Registry. One- and 10-year graft-survival rates as well as late (from 3 through 10 years) graft-loss rates (half-lives) were determined. The donor-recipient relationship had the greatest influence on long-term graft survival. Transplants between HLA-identical siblings had graft-survival rates of 89% at 1 year and 68% at 10 years, compared with 76% and 43% for parental donors, and 58% and 26% for cadaver donor transplants, respectively. These differences were also evident from the graft half-lives, which were 22 years for HLA-identical sibling, 12 years for parental, and 8 years for cadaver donor allografts. In cadaver donor transplants, matching for HLA-A,B antigens had the greatest influence on long-term graft survival, with a 15% 10 year graft survival (39% vs. 24%) and 7-year half-life (14 vs. 7 years) advantage seen with the best (zero HLA-A,B mismatches) compared with the worst (4 HLA-A,B) cases, respectively. Some of the factors studied, such as transplant number and pretransplant transfusions, tended to influence the short- rather than long-term graft-survival rates. Others, including HLA-A,B matching, early graft function and the recipient's original disease, influenced both early and late graft survival. Over all, histocompatibility between donor and recipient had by far the greatest influence on the long-term success of renal allografts. PMID- 3278436 TI - Quality of life after kidney transplantation. A prospective, randomized comparison of cyclosporine and conventional immunosuppressive therapy. AB - The aim of this research is to compare the quality of life after kidney transplantation for patients treated with cyclosporine versus conventional immunosuppressive therapy. This evaluation assumes particular importance given the high cost of cyclosporine, the resistance of the government to cover these costs, and the absence in some series (including this one) of significant differences in patient and kidney survival. This study is based on a randomized, stratified, prospective trial and concentrates on nondiabetic patients from ages 19 to 56 at 1-year posttransplant. Patients on cyclosporine show significant advantages in physical, emotional, and social well-being. Differences for 5 out of 10 indicators of quality of life were significant at the P less than or equal to .05 level. Significant differences are found on health satisfaction, happiness measures, indices of overall life satisfaction and well-being, perceived adjustment of the family, and female (not male) vocational rehabilitation. The fewer number of episodes of rejection and infection are, in part, responsible for these advantages in quality of life for cyclosporine patients. PMID- 3278437 TI - Cyclophosphamide in renal transplantation. AB - Success in renal transplantation is now largely dependent on safe and effective immunosuppression. Nonspecific immunosuppression by chemical agents continues to be the mainstay of clinical immunosuppression. Azathioprine and prednisolone have remained the two main drugs used in combination in standard immunosuppressive therapy in renal transplantation for many years. Although cyclophosphamide (CP) was tried in the early years of transplantation, enthusiasm for its use was dampened by the advent of newer agents. We have analyzed our experience with 29 recipients of living-related donor (LRD) renal allotransplantation on cyclophosphamide therapy. Cyclophosphamide is a safe and effective alternative to azathioprine in clinical renal allotransplantation. Due to its easy availability and the fact that it is a cheaper alternative to azathioprine and cyclosporine, it is more significant for developing countries. PMID- 3278438 TI - Antibody immunotherapy of gram-negative bacterial sepsis in an immunosuppressed animal model. AB - Leukopenic, immunosuppressed recipients of solid organ allografts are at high risk for gram-negative bacterial sepsis, and mortality remains unacceptably high (greater than 30%). The purpose of this study was to determine whether murine monoclonal antibody (MAb) directed against lipopolysaccharide (LPS, endotoxin) would reduce lethality caused by a septic insult in immunosuppressed mice, and to determine if a specific antibody class would prove more efficacious in this setting. Two MAbs (3-H9, IgG3; 7-B5, IgM) were selected that reacted by ELISA, immunodot blot, and Western blot analysis against the O antigen polysaccharide portion of Escherichia coli 0111:B4 LPS. The 3-H9 MAb, 7B-5 MAb, or sterile saline was administered i.v. to normal or neutropenic Swiss-Webster mice immediately prior to an E coli 0111:B4 bacterial (i.v. or i.p. plus hemoglobin) or LPS (i.v.) challenge. In normal mice, administration of 3-H9 MAb or 7-B5 MAb i.v. immediately prior to a bacterial or endotoxin challenge resulted in a significant increase in the LD50. Neutropenia lowered the LD50 by nearly one log10 in both the bacteremia and peritonitis models. Both MAbs provided similar protection, raising the LD50 one log10 in neutropenic mice. Thus neutropenic animals receiving either MAb had a mortality nearly identical to that of normal animals receiving saline. No significant difference between the protective capacity of these MAbs was noted in any of the three models. These studies demonstrate that MAbs directed against LPS exert protection during gram-negative bacterial sepsis in either normal or neutropenic animals. In addition, the particular IgG and IgM MAbs examined provided similar protective capacity. Antibody directed against LPS may provide an additive form of therapy that may serve to decrease lethality during clinical gram-negative sepsis in immunosuppressed patients. PMID- 3278439 TI - Characteristics of rejection of orthotopic corneal allografts in the rat. AB - We have employed a rat model of orthotopic corneal transplantation to study the characteristics of rejection and development of systemic immunity in the host. Lewis (LEW) rats underwent a true penetrating keratoplasty using Wistar-Furth (WF) donor corneas. A rejection incidence of 55% with a mean survival time (MST) of 17.1 days was observed using these untreated allogeneic corneas. Animals undergoing rejection of these allografts developed cytotoxic T lymphocytes (CTL) capable of lysing WF lymphoblasts in a standard 51-chromium release assay. These same rats did not have delayed-type hypersensitivity (DTH) responses when compared to skin grafted controls. Rats with clear allografts had no demonstrable CTL or DTH activity. As expected, LEW rats that were preimmunized with WF skin grafts and subsequently received WF orthotopic corneal grafts rejected 100% of these corneas at an accelerated rate (MST = 9.7 days, P less than .02). We then employed a previously described technique of using latex beads to induce migration of Langerhans cells into the central cornea of the donor graft prior to transplantation. The presence of Langerhans cells in the donor cornea resulted in a higher incidence of rejection (96%) and an accelerated rate (MST = 11.8 days, P less than .02) when compared to untreated allografts. These rats also had a higher level of CTL activity and marked DTH responses. These data show that rejection of orthotopic allogeneic corneas is accompanied by the development of systemic alloimmunity as measured by CTL activity. However, these fully allogeneic corneas can be rejected in the absence of DTH responses. Langerhans cells have a dramatic effect on graft survival and are necessary for induction of DTH responsiveness in the host. PMID- 3278441 TI - Effector mechanism in rejection of allografts expressing an isolated minor histocompatibility disparity. Importance of cytotoxic T lymphocytes in the rejection of H-43a allografts by H-43b mice. AB - To explore effector mechanisms in allograft rejection, we transplanted skin grafts (SG) across a single minor histocompatibility locus (H-43) using mouse strains carrying the H-43b allele as SG recipients and those carrying the H-43a allele as SG donors. Recipients' spleen cells (SC) were assayed at various intervals for 200 days for anti-H-43a cytotoxic T lymphocyte (CTL) responsiveness, as well as delayed-type hypersensitivity (DTH) responsiveness. When H-43a SG from C3H.SW mice were transplanted to H-43b CWB mice, two thirds of the recipients rejected the SG, and recipients' SC showed marked self-H-2Kb restricted anti-H-43a CTL responsiveness until the end of the observation period. In contrast,H-43aSG transplanted to H-43b (B10.BRxCWB)F1 (BWF1) mice survived in almost all of the BWF1 recipients. The anti-H-43a CTL responsiveness of the recipients' SC was evident until day 40 but thereafter started to wane and eventually disappeared. Notably, BWF1 mice whose self-H-2Kb-restricted anti-H-43a CTL precursors had been primed by prior injection with H-43a SC rejected H-2Kb bearing H-43a CSW SG but not H-2k, H-43a C3H/HeN SG. In contrast, an anti-H-43a DTH response was not induced in any of the CWB and BWF1 recipients, including CWB recipients who rejected the H-43a SG. Since it has been well documented that anti H-43a CTL are restricted solely by self-H-2Kb, the results in this study indicate that self-H-2Kb-restricted anti-H-43a CTL are responsible for rejection of H-43a allografts by H-43b recipient mice. PMID- 3278440 TI - Failure to alter neonatal transplantation tolerance by the injection of interleukin 2. AB - It has been postulated that the establishment of acquired, neonatal immunologic tolerance is due to a "deficit" in interleukin 2 (IL-2). To test this hypothesis, chickens were made immunologically tolerant to both major and minor histocompatibility antigens by transplantation of skin grafts onto newly hatched recipients. In this study, we injected various doses of IL-2 and concanavalin A simultaneously with transplantation and in some cases, several days posttransplantation, and we failed to enhance graft rejection. These results may have practical importance in respect to the clinical use of recombinant IL-2. Injection of IL-2 in and around surviving skin grafts also failed to alter skin graft survival. PMID- 3278443 TI - Preliminary results with combined hepatorenal allografting. PMID- 3278442 TI - Relationship between the liver and lymphocytotoxic alloantibodies in inbred rats. Specific absorption by nonparenchymal liver cells. AB - Liver allografts have a privileged status with regard to hyperacute rejection. In this experimental study, we have used extracorporeal liver hemoperfusion in sensitized rats in order to analyze reactions between lymphocytotoxic antibodies and the liver. In sensitized BN rats, a donor-specific (Lewis) extracorporeal liver hemoperfusion can delay hyperacute rejection of heart allografts and reduce the level of lymphocytotoxic antibodies. The decrease in the level of antibodies could be due to massive absorption of antibodies by the liver or to release of major histocompatibility complex antigens in a soluble form. Immunofluorescent examination of the hemoperfused liver revealed important deposits of C3 on Kupffer cells and of IgG on sinusoidal cells. On the contrary, in control rats in which a third-party (DA) liver hemoperfusion was performed, heart allograft survival was less prolonged, the decrease in the level of lymphocytotoxic antibodies was not significant, and the deposits of IgG and C3 were much less evident. The level of circulating immune complexes was unchanged after a donor specific or a third-party liver hemoperfusion. These results support the hypothesis that resistance of the liver to hyperacute rejection might be due to a massive and nontoxic absorption of lymphocytotoxic antibodies on nonparenchymal liver cells. PMID- 3278444 TI - The growth of transplanted liver cells within the pancreas. PMID- 3278445 TI - Effect of verapamil on posttransplant acute renal failure in the canine kidney. PMID- 3278446 TI - Failure of anti-Ia monoclonal antibody to abrogate transfusion-induced sensitization and prevent marrow graft rejection in DLA-identical canine littermates. PMID- 3278447 TI - The use of percutaneous nephroscopic techniques in renal allografts. PMID- 3278448 TI - Continuous postoperative peritoneal lavage for the management of intra-abdominal sepsis in renal allograft recipients. PMID- 3278449 TI - Late development of intractable lymphocele after renal transplantation. AB - A case of lymphocele occurring 7 years after kidney transplantation and leading to intractable ascites and recurrent pleural effusion is presented. Ultrasound was used extensively for diagnosis, diagnostic sampling, and monitoring of resolution and recurrence. Invasive approaches to definitive therapy, including internal drainage and ligation of lower extremity lymphatics, alleviated the local problem of a lymphocele but led to recurrent ascites and symptomatic pleural effusions. A Denver shunt,reportedly helpful in cirrhotic and oncologic patients, was successfully employed to decompress the ascites and effusion of this patient. The pathophysiology and treatment of lymphoceles and the management of peritoneovenous shunts is discussed. PMID- 3278450 TI - Cessation of steroids in renal allograft recipients on combined cyclosporine A, azathioprine, and prednisolone. PMID- 3278451 TI - Comparison of serum neopterin levels and spontaneous blastogenesis in monitoring of kidney graft recipients. PMID- 3278452 TI - Cyclosporine neurotoxicity in liver transplant recipients: report of three cases. PMID- 3278453 TI - Renal artery thrombosis associated with elevated cyclosporine levels: a case report and review of the literature. PMID- 3278454 TI - Pharmacologic alteration of the donor specific transfusion effect. PMID- 3278455 TI - Wound infections presenting several years after successful renal transplantation. PMID- 3278456 TI - Equitable allocation of extrarenal organs: with special reference to the liver. AB - A national plan is proposed for the equitable allocation of extrarenal organs, with particular reference to the liver. The principles of the plan include preferential use of the organs in the local and regional area of procurement, with national listing of the organs left over after the original cut. At each of the local, regional, and national levels, the allocation is based on total points awarded for medical urgency, time waiting, blood group conformity, and physical location of both donor and recipient. The plan, which should be applicable as well for allocation of hearts, is compatible with international sharing with nearby countries such as Canada. PMID- 3278458 TI - Monocyte alloantigens recognized by dialysis and transplant sera. PMID- 3278457 TI - Early glomerular rejection in sensitized patients: treatment with plasma exchange and antithymocyte globulin. PMID- 3278459 TI - Transplantation versus dialysis: a study of quality of life. PMID- 3278460 TI - The effect of food and cholestyramine on the absorption of cyclosporine in cardiac transplant recipients. PMID- 3278461 TI - Australian National Pilot Liver Transplantation Program: the first year's report. PMID- 3278463 TI - T cell depletion for matched marrow transplants. PMID- 3278462 TI - Improved results after liver transplantation: Queensland liver transplant program. PMID- 3278464 TI - The effect of multiple organ donation on subsequent renal function and survival. PMID- 3278465 TI - Triple low-dose immunosuppression with cessation of steroids in pediatric renal transplantation. PMID- 3278466 TI - Whole pancreas grafting with exocrine drainage into the bladder: method of choice for clinical transplantation? PMID- 3278467 TI - The clinical effects of lysosomal enzyme replacement by bone marrow transplantation after total lymphoid irradiation on neurologic disease in fucosidase deficient dogs. PMID- 3278468 TI - De novo malignancies after liver transplantation. PMID- 3278469 TI - Inadvertent transplantation of choriocarcinoma into four recipients. PMID- 3278470 TI - Ultrasonic wave fluctuations through tissue: an experimental pilot study. AB - The fundamental role of the assumption of plane wave ultrasonic propagation in attenuation and scattering measurements on soft tissues is discussed. The evidence for and against the validity of the assumption is shown to be inconclusive. An experimental procedure for direct assessment, by measurement of the ultrasonic amplitude and phase fluctuations occurring after an interrogating plane wave has passed through a tissue specimen, is described. The phase measurements impose significant demands on the mechanical precision, temperature stability and electronic timing capabilities of the measurement system. Measurements are reported on two specimens of fresh beef liver. One exhibited significant fluctuations of amplitude and phase which were reduced by 50% when the effects of thickness variations in the specimen were removed. The other specimen exhibited relatively small fluctuations. The feasibility of making such measurements has been demonstrated and the detailed features of the experimental procedure-which requires considerable care-have been outlined. Although more measurements are needed for definitive conclusions, these will require the development of a reliable technique for determining the presence of gaseous microbubbles in tissue in vitro. The preliminary conclusion that some samples of liver may exhibit low levels of wavefront disruption is consistent with recent evidence in the literature. PMID- 3278471 TI - Hemodynamics of penile erection. AB - In the flaccid state, the smooth muscles of the cavernous arterioles and trabeculae are contracted, and minimal blood flow enters the sinusoids. Relaxation of these smooth muscles incites arterial dilation, venous compression, and sinusoidal relaxation and results in penile erection. PMID- 3278472 TI - Venous arterialization for erectile impotence. AB - Revascularization of the corporal bodies in arteriogenic impotence can be accomplished by means of a venous arterialization procedure as described by Ronald Virag. This surgical approach and early results are detailed in this article. PMID- 3278473 TI - Drug-induced male sexual dysfunction. AB - Many commonly used drugs can interfere with male sexual function, either by decreasing libido, interfering with erectile function, or causing absent seminal emission or retrograde ejaculation. Although drug-related effects on sexual function may be difficult to distinguish from the effects of organic disease, anxiety, or depression, it is important for the physician to be aware of the drugs most commonly associated with sexual dysfunction. This article considers these drugs and the potential mechanism by which they exert their adverse effects. PMID- 3278474 TI - Iatrogenic causes of erectile dysfunction. AB - Normal penile erection is a complex event dependent upon the proper sequential function of the endocrine, nervous, and vascular systems. Medical or surgical therapy can influence those systems and so cause erectile dysfunction. Physicians must understand these iatrogenic causes of erectile dysfunction in order to prevent or reverse them. PMID- 3278475 TI - Psychologic factors in the multidisciplinary evaluation and treatment of erectile dysfunction. AB - The members of a multidisciplinary team treating sexual dysfunction must work together from different perspectives and training to determine an accurate diagnosis, choose an appropriate treatment, and evaluate those treatments systematically. Integrating data from both physical and psychologic evaluations is essential. Anxiety, depression, or other reactions to stress are seen as cognitive interferences that inhibit sexual arousal by distracting attention from erotic stimuli. The goals of sex therapy are to enhance attentional focus on sexual cues and to lessen distractions in the form of anxiety, conflict, or other stresses. Although there continue to be methodologic problems in outcome evaluation research of multidisciplinary treatment of sexual dysfunction, follow up studies generally indicate improvements in sexual functioning, satisfaction, and self-esteem. PMID- 3278476 TI - Endocrine evaluation and therapy of erectile dysfunction. AB - Recent innovative laboratory and clinical investigations have implicated an organic cause for as many as 30 to 50 per cent of cases of impotence. Understanding the clinical subtleties of hypogonadism and the reproductive hormonal axis in the male is critical to the evaluation and treatment of impotence of endocrinologic origin. Gonadotropin assays are essential for detecting elevations of FSH and LH, which will help to distinguish primary from secondary testicular failure. The goal of androgen replacement is the maintenance of physiologic testosterone levels without the potential hepatotoxic effects. PMID- 3278477 TI - Evaluation of vasculogenic impotence. AB - Penodynamics, the functional evaluation of erection after intracavernous injection of vasoactive drugs, is a simple screening test that excludes significant vascular problems if full erection occurs within a reasonable period of time. Although it is more invasive than the penile brachial index (PBI), it is well tolerated and easy to perform. There is good evidence that studies on the flaccid penis are less accurate and do not correlate well with the results of functional papaverine testing. To evaluate arteriogenic impotence, sonography and pulsed Doppler analysis combined with papaverine injections provide objective and reproducible measurements of diameter increase and blood flow of each penile artery and have the advantage of being a functional study. Although this equipment is expensive, it is available in many centers where noninvasive vascular flow studies are performed. With training, the technique can be mastered by anyone. The arterial response to papaverine and the resulting erection allow indirect judgment about the venous system. Therefore, the whole penile vasculature can be evaluated with this technique. Currently, many drugs or drug combinations are used to induce artificial erection, not only for diagnosis but also as a therapeutic alternative to penile prostheses. The only physiologic agent is prostaglandin E1, a substance that seems to be as effective as papaverine but can be metabolized within the cavernous tissue and reportedly results in fewer incidences of prolonged erection and priapism. The use of vasoactive drugs is also very helpful for angiographic studies by improving flow and diameter of the penile vessels, which will result in better images of the arterial lesions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278478 TI - Local control of penile erection. Nerves, smooth muscle, and endothelium. AB - This article reviews the state of knowledge on the neurologic and non-neurologic mechanisms that control the tone of the corpus cavernosum trabecular smooth muscle and the smooth muscles of penile arteries and veins. It includes discussion of the role of the adrenergic, the cholinergic, and the nonadrenergic noncholinergic neuroeffector systems as well as the potential role of the vascular endothelium and prostaglandins in the control of penile erection. PMID- 3278480 TI - Treatment of bladder cancer with hematoporphyrin derivatives and laser light. PMID- 3278479 TI - Failure to prolong rat renal allograft survival time by photochemical donor kidney pretreatment during hypothermic pulsatile kidney preservation. AB - Systemic photochemical pretreatment of a rat kidney donor with the photosensitizer 8-methoxypsoralen (8-MOP; 0.06 mg/kg intravenously, 10 min before graft removal) plus ex vivo longwave ultraviolet (UVA) irradiation of the kidney graft during simple hypothermic storage significantly prolonged survival time in allogeneic recipients. In contrast to these results, the present use of UVA irradiation during hypothermic pulsatile kidney perfusion using Euro-Collins solution containing 8-MOP (0.06 mg/ml) did not prolong graft survival compared with untreated controls. Systemic application of 8-MOP to the kidney donor may be necessary for effective action of the combined photochemical treatment as a method of immunoalteration. The extended UVA irradiation time and the local use of 8-MOP in the preservation fluid had no effect on graft survival possibly because of inadequate tissue distribution of 8-MOP during both hypothermia and perfusion. PMID- 3278481 TI - Intraoperative electron-beam therapy and other bladder-sparing approaches to bladder carcinoma. PMID- 3278482 TI - Infection in patients with advanced bladder cancer. PMID- 3278483 TI - Toward the rational management of bladder cancer: an overview. PMID- 3278484 TI - Neoadjuvant chemotherapy in bladder cancer. PMID- 3278485 TI - Gastroenteritis of basenji dogs. AB - Intestinal digestive and absorptive function and the gross and histologic appearance of the gastrointestinal tract were evaluated in Basenji dogs with chronic diarrhea, asymptomatic Basenji dogs, and healthy control dogs. Gastric rugal hypertrophy, lymphocytic gastritis, and gastric mucosal atrophy occurred in asymptomatic and affected Basenji dogs. All affected dogs had moderate or severe intestinal lesions characterized by villous clubbing and fusion, increased tortuosity of intestinal crypts, and diffuse infiltration of mononuclear inflammatory cells. Intestinal lesions in asymptomatic Basenji dogs invariably were less severe than those in affected dogs, but the small intestinal lamina propria of asymptomatic Basenji dogs consistently contained greater numbers of mononuclear inflammatory cells than did that of control dogs. The proportion of cells containing each immunoglobulin isotype (IgG, IgM, IgA) was similar among affected Basenji dogs, asymptomatic Basenji dogs, and control dogs. As compared to healthy beagle controls, intestinal function was abnormal in both affected and asymptomatic Basenji dogs evaluated by combined N-benzoyl-L-tyrosyl-p aminobenzoic acid and d-xylose test, but malabsorption and maldigestion were most pronounced in affected Basenji dogs. PMID- 3278486 TI - [Water intoxication--a little known complication in the course of mental diseases]. AB - Acute or chronic psychogenic polydipsia is a not uncommon finding in psychiatric patients. Water intoxication either results from the intake of large amounts of fluid within a short period of time and/or from a reduction of the renal "free water clearance". The latter can be caused iatrogenically by the administration of certain drugs or by the "Syndrome of Inadequate Secretion of ADH" (SIADH). Water intoxication results in cerebral oedema and may ultimately lead to death. A case is reported of iatrogenically-induced water intoxication in a patient with chronic psychogenic polydipsia. PMID- 3278487 TI - [Multiple transplantation of the kidney as a risk factor]. AB - The influence of match, immunological therapy, age of the recipient and sex has been analysed by graft survival in 91 patients receiving a second kidney graft. Effects of these risk factors in first kidney grafts are not demonstrable in second grafts with the exception of cyclosporin which also produces better second graft survival. The main active risk factor for second transplants is endurance of function of the first graft. Function of the first graft over a period exceeding 1 year gives a significantly better second graft survival rate than function lasting less than one year. PMID- 3278488 TI - Randomized controlled trials on the effectiveness of preoperative biliary decompression. PMID- 3278489 TI - Malignant cellular blue nevus: unusual case of a rare tumor. PMID- 3278490 TI - Significance of pharmacokinetic variables in reproductive and developmental toxicity. AB - 1. As in other fields of toxicology, pharmacokinetic variables are of considerable significance for the assessment of reproductive or developmental toxicity. 2. When assessing the possibility of an adverse effect of a chemical on male or female fertility, in the majority of the cases no information on the concentration at the target is available. This may cause problems in the case of a 'negative' finding. 3. Prenatal toxicity takes place within a complex 'two compartment' system (mother: conceptus); pharmacokinetic variables in both systems determine the concentration at the target (the conceptus). These variables may be expected to vary greatly during the different stages of development. While the contribution of maternal pharmacokinetics can easily be assessed, the pharmacokinetics within the embryo/foetus will remain largely unknown in man. 4. While it is quite feasible in animal experiments to study the transfer of a given chemical to the conceptus in vivo at various stages of pregnancy it is almost impossible to obtain such information for most developmental stages in man, except at the perinatal period (by sampling cord blood). For this reason during most risk assessments exposure of the embryo or fetus can only be roughly assumed from maternal plasma concentrations. 5. A significant capacity of foetal tissues (including liver) for metabolic transformation of many chemicals (e.g. via cytochrome-P-450-dependent monooxygenases) develops only perinatally in the usual rodent animal species. But in primates (including man) the activity of several such monooxygenases is substantial in liver already at early foetal stages. Much less information is available on the metabolic capacity for xenobiotics in extrahepatic tissues of primate embryos and foetuses. 6. Since pharmacokinetic variables (e.g. half-life) often differ considerably in laboratory rodents and in man a risk assessment for man on the basis of doses is often greatly misleading. It seems more justified to predict toxic effects on the basis of plasma levels. This aspect is of great significance and must be taken into consideration since the results of many routine studies are not suitable for risk assessments because pharmacokinetic variables were not considered when planning experimental studies. 7. Factors affecting the transfer of chemicals via mothers milk to the neonate are largely known today. But solid data on the pharmacokinetics of xenobiotics with respect to transfer to the milk and ensuing concentrations in the neonate are still lacking for the majority of relevant chemicals.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3278491 TI - The role of metabolism and disposition studies in the safety assessment of pharmaceuticals. PMID- 3278492 TI - [Now Astrid is Doctor. Interview by Jan Thomasson]. PMID- 3278494 TI - Randomized, prospective, double-blind clinical trial of butorphanol and diazepam in patients undergoing upper gastrointestinal endoscopy. AB - Premedication that provides sedation and analgesia is commonly used for patients undergoing endoscopic procedures. We studied the efficacy and safety of butorphanol and diazepam as preprocedure medications for patients having upper gastrointestinal endoscopy. To achieve an adequate level of sedation, patients receiving diazepam required a mean (+/- SEM) dose of 12.0 +/- 1.0 mg, whereas those receiving butorphanol required a mean dose of 4.8 +/- 0.4 mg. There were no differences between treatment groups in the overall assessment of sedation, the ease of performance of the endoscopic procedure, or vital signs during or following the procedure. Fifty-four percent of butorphanol patients and 48% of diazepam patients experienced at least one minor adverse event. Butorphanol in small doses can produce satisfactory sedation and analgesia for patients undergoing gastrointestinal endoscopic procedures. PMID- 3278495 TI - Clinical pharmacology of antagonists of narcotic-induced respiratory depression. A brief review. AB - A variety of drugs have been used to antagonize the respiratory depression caused by narcotics. Some of these drugs, such as nalorphine, naloxone, butorphanol, and nalbuphine, are opiates, which interact directly with opiate receptors. Others, such as physostigmine, doxapram, and aminophylline, probably act indirectly by stimulating neuronal pathways involved in the regulation of ventilation. None of these drugs is ideal, and all have adverse side effects. Cardiovascular instability and eradication of analgesia have been troublesome, especially with the use of naloxone. The newer mixed agonist-antagonist agents, butorphanol and nalbuphine, may have significant advantages compared with naloxone. The purpose of this review is to summarize the pharmacology of the common narcotic antagonists, with an emphasis on obtaining acceptable results while avoiding adverse side effects. PMID- 3278493 TI - Epidural and intrathecal administration of opioids in obstetrics. AB - Intraspinal epidural or intrathecal injection of opiates can provide outstanding analgesia in obstetric patients. Epidural and intrathecal opiates may afford more prolonged analgesia without interference of neuromuscular function or depression of the sympathetic nervous system that can occur with other anesthetic regimens. However, certain precautions are recommended to minimize potential side effects. PMID- 3278496 TI - Cerebral blood flow and oxygen consumption during isoflurane and halothane anesthesia in man. AB - In 13 patients, the effects on cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) of isoflurane and halothane administered in a clinically relevant situation were studied. Measurements were performed during fentanyl/nitrous oxide (65%) anesthesia together with moderate hyperventilation (PaCO2 approx 4.5 kPa), and repeated after addition of 0.65 MAC of isoflurane (n = 6) or halothane (n = 7). CBF was measured after intravenous administration of 133xenon and CMRO2 was calculated from the arterial venous differences of oxygen content (AVDO2) determined in arterial and jugular venous bulb blood. CBF and CMRO2 (means +/- s.e. mean) determined prior to administration of volatile agents were 28 +/- 5 ml x 100(-1) x min-1 and 2.0 +/- 0.3 ml x 100 g-1 x min-1, respectively, in the isoflurane group. In the halothane group, CBF was 25 +/- 0.4 ml x 100 g-1 x min-1 and CMRO2 was 2.0 +/- 0.4 ml x 100 g-1 x ml-1. There were no significant intergroup differences. Isoflurane did not change CBF, whereas halothane produced an increase of 36% (P less than 0.05) compared to values obtained during fentanyl/N2O anesthesia. In addition, isoflurane caused a further decrease in CMRO2 of 12% (P less than 0.01) as compared to a 20% increase (P less than 0.05) with halothane. The cerebral metabolic depression caused by the short acting anesthetic induction agents would be expected to decrease with time, and could partly explain the observed increase in CMRO2 produced by halothane. The study suggests that the cerebrovascular and metabolic properties of isoflurane differ from those of halothane, also in man. PMID- 3278498 TI - Intravenous indomethacin prevents venipuncture inflammatory sequelae. AB - One hundred general or orthopaedic surgery patients (ASA I-II) were randomly given either indomethacin (25-50 mg bolus plus infusion, 5-7.5 mg h-1) in lactated Ringer solution intravenously in one hand and only lactated Ringer solution into a corresponding vein of the other hand (50 patients) or only lactated Ringer solution intravenously in both hands (50 patients), starting before anaesthesia induction and ending at 7 a.m. the following morning. All anaesthetic drugs were given equally divided into both drips. The need for additional analgesia as well as venipuncture and infusion sequelae were registered on the postoperative morning in a double-blind fashion. The mean +/- s.d. oxycodone dose in the postoperative observation period was lower in the indomethacin group (18 +/- 16 mg) than in the control group (27 +/- 20 mg) (n.s.). There was a lower number of patients requiring oxycodone more than once in the indomethacin group than in the control group (P less than 0.05). Fewer patients in the indomethacin group (22%) had inflammatory changes at the venipuncture site than in the control group (46%) (P less than 0.05). There was no difference between hands; i.e. in patients given indomethacin inflammatory changes were equally common in both hands. No thrombophlebitic complications developed, which was confirmed by a mailed questionnaire (response 96/100) 2 weeks after surgery. PMID- 3278497 TI - The effect of droperidol on fentanyl-influenced gastric emptying in man. AB - The effect of droperidol on gastric emptying was determined from the rate of paracetamol absorption in seven healthy adult volunteers who received fentanyl, each acting as his/her own control. On each occasion the subjects were given droperidol 2.5 mg or normal saline (placebo) i.v. in double-blind fashion. On both occasions, 20 and 50 min later a dose of 0.0015 mg kg-1 fentanyl was given. Ten minutes after the first fentanyl dose, the subjects ingested 20 mg kg-1 paracetamol with 200 ml of water. Our findings demonstrate that droperidol was not able to accelerate gastric emptying in subjects receiving subsequent small doses of fentanyl. Furthermore, the delayed absorption pattern of paracetamol on both occasions suggests that gastric emptying is retarded with or without droperidol. PMID- 3278499 TI - Monitoring of cardiac output and cardiac work during anaesthesia by means of pulsed ultrasound Doppler. AB - During anaesthesia haemodynamic measurements were performed with pulsed ultrasound Doppler in six patients with a Swan-Ganz catheter. Cardiac output (CO), heart rate (HR), arterial blood pressure (AP), systemic vascular resistance (SVR) and left cardiac work (LCW) were measured simultaneously with the velocity measurements of the bloodstream in the ascending aorta. Six to fourteen (median 9) simultaneous measurements were done in each patient. Sixty-two measurements were made. The velocity (V) and the product of velocity and heart rate (VHR) were compared with CO in order to establish a non-invasive index of the cardiac output. The product of velocity, the heart rate and the arterial blood pressure (VHRAP) was compared with LCW, showing a good correlation between VHR and CO (V = maximum velocity) (rho = median 0.85), as was the case between VHRAP and LCW (rho = 0.88). Furthermore, a negative correlation between V and SVR was found, illustrating that the velocity of the bloodstream in the aorta obviously depends on the afterload. It is concluded that pulsed ultrasound Doppler in combination with HR and AP can measure relative changes in CO and LCW. PMID- 3278500 TI - Epidural versus combined spinal epidural block for cesarean section. AB - In a controlled study a single segment combined spinal epidural (CSE) block was compared with epidural block for cesarean section. Thirty healthy parturients were randomly divided into two groups. In both groups a T4 block was aimed at. Bupivacaine was used to provide analgesia in both groups. All patients receiving CSE block had good to excellent analgesia, while 11 patients (74%) receiving epidural block had similar pain relief. This was reflected in the requirement for additional analgesics, sedatives or N2O anesthesia. The muscular relaxation was also better following CSE block. The total dose of bupivacaine for a T4 block was three times larger in patients receiving only epidural block. The maternal and fetal blood bupivacaine levels were correspondingly about three times higher in the epidural group. Additionally, the incidence of maternal hypotension was higher in patients receiving epidural block. Apgar scores, blood gases and neurobehavioural evaluation did not show any differences between the two groups of neonates. No postspinal headache was noted. CSE block appears to combine the reliability of spinal block and the flexibility of epidural block while minimizing their drawbacks. PMID- 3278501 TI - Endoscopic neurosurgery. AB - This paper describes an ultrasound-guided, laser-assisted, and TV-controlled endoscopic technique which has been used so far in 133 patients for a variety of intracranial lesions. Following CT or MRI image reconstruction, and a decision on the placement of a 1 cm or a 2 cm burrhole, a 1 cm 5.0 mHz or 7.5 mHz intraoperative ultrasound probe is used to direct the endoscope from the burrhole to the target area. A 22.5 cm long rigid endoscope tube with an outer diameter of 6 mm with an inbuilt suction irrigation system, Neodymium Yag laser with 600 micron Quartz glass-fibre and an inlet for various microinstruments is then introduced. The attachment of a TV camera to the ocular lens allows the operator to control further surgical steps in the target area via the TV screen and thus warrants sterility in the operating field. The technique has been used for evacuation of 77 spontaneous intracerebral haematomas (lobar, putaminal, thalamic), 8 traumatic intracerebral haematomas, 13 ventricular haematomas, 8 cerebellar haematomas and 1 brainstem haematoma. Total or subtotal evacuation was achieved in 33% of intracerebral haematomas, removal of more than 50% of the clot in 55%. Twenty-four brain tumours (12 ventricular, 12 cystic cerebral or cerebellar tumours) were operated on for biopsy, evacuation of cyst, resection or removal of the cyst wall and/or laser irradiation of solid tumour or the inner cyst wall of cystic tumours. The complication rate probably related to surgery was 1.6%, morbidity 1.6%, mortality 0%. This high-tec endoscopic technique with its minimal surgical trauma and short operation time can be recommended as a low risk alternative to conventional neurosurgical techniques. PMID- 3278502 TI - B-lymphoid neoplasms: immunoglobulin genes as molecular determinants of clonality, lineage, differentiation, and translocation. AB - The basic rules of Ig gene recombination that were learned from examining clonal proliferations of B cells have paid enormous dividends in improving our understanding of B-cell malignancy. The DNA rearrangements of Ig genes creates a tumor-specific marker capable of establishing the clonality, cellular lineage, and stage of development of a lymphoid tumor. Most importantly, the Ig genes have proved to be the sites of interchromosomal translocations that contribute directly to the malignant phenotype. These genetic tools hold the promise of improving our classification schemes, providing sensitive and specific approaches to following the clinical course, and providing insights into pathogenesis that will prompt improved therapies. PMID- 3278503 TI - When to treat hyperlipidemia. PMID- 3278505 TI - The diagnostic dilemmas of hyperthyroxinemia and hypothyroxinemia. AB - It should be apparent that the diagnosis of thyrotoxicosis and hypothyroidism can be correctly made in the majority of ambulatory patients. However, the clinician needs to be extremely careful in reaching such a definitive diagnosis on the hospitalized patient. Both the clinical features and the standard thyroid function tests need careful evaluation and reanalysis before the diagnosis of thyroid dysfunction can be made with confidence. PMID- 3278504 TI - Cytotoxic T-lymphocytes. AB - Cytotoxic T-lymphocytes have received intensive scrutiny in the past decade, and have been implicated as important effector cells in diverse clinical settings. A variety of technological advances--the establishment of T cell clones, the production of MAb, the production of pure lymphokines through gene cloning, the modification of target cells by gene transfer and synthetic peptides--has led to tremendous strides in our understanding of CTL function and their role in the pathophysiology of a variety of disease states. It is likely that future efforts will generate important applications of such understanding, such as the pharmacologic modulation of CTL activity and proliferation, novel vaccines, and the introduction of adoptive transfer of cloned CTL as a clinically practical therapy. PMID- 3278506 TI - Mechanisms for prevention, development, and reversal of hypoglycemia. PMID- 3278507 TI - Non-Q-wave infarction: diagnosis, prognosis, and treatment. AB - The patient with a non-Q-wave myocardial infarction should be considered as having an uncompleted myocardial infarction. The ultimate prognosis in this patient depends upon the amount of viable myocardium still at risk. These patients have a higher incidence of reinfarction than those who had a Q-wave infarction. There is evidence that diltiazem after a non-Q-wave infarction can prevent early reinfarction. It is evident that those patients who continue to have myocardial ischemia, manifested by continued angina, ischemia, ST depression, or thallium 201 perfusion defects on exercise, especially if they already have reduced ventricular function, are at the greatest risk. These are the patients who should be considered for angiography and revascularization. PMID- 3278508 TI - Right ventricular infarction: clinical and pathophysiologic considerations. PMID- 3278509 TI - Esophageal disease as a cause of noncardiac chest pain. PMID- 3278510 TI - Nutritional approaches to preserving renal function. PMID- 3278511 TI - Diagnosis and treatment of delayed gastric emptying. PMID- 3278512 TI - Gastroduodenal bicarbonate production. PMID- 3278513 TI - Dissolving gallstones. PMID- 3278515 TI - Displacement bone marrow transplantation and immunoprophylaxis for genetic diseases. PMID- 3278514 TI - The health consequences of cigarette smoking and the internist's role in smoking cessation. PMID- 3278516 TI - Residual motor functions in spinal cord injury. AB - After acute spinal cord injury, only 10% of the patients experience significant functional recovery. The remaining 90% reveal numerous varieties of spinal cord dysfunctions with different degrees of incomplete and unsatisfactory recovery of functional usage. In such cases of partial recovery of spinal cord functions, a certain degree of restitution of functions can be achieved. By studying these patients and their neurocontrol, we can learn that there are minimal requirements for the restitution of brain influence on segmental mechanisms and that different degrees of control can exist and contribute to the control of steps. These cases exemplify that upper motor neuron paresis is not only a weaker control owing to the loss of a certain percentage of functional fibers: it is an alternative in neurocontrol resulting from suprasegmental and segmental mechanisms within residual structures and their functional performance. On the basis of our observations we conclude that in addition to the model of the "transected spinal cord injury" and the model of the partially injured spinal cord, there is a third model with "discomplete lesion," indicating that it is necessary to revise the conventional concept of "released segmental functions" in patients with transected spinal cord lesion. PMID- 3278517 TI - Clinical course and electrophysiology of multiple sclerosis. PMID- 3278518 TI - Remyelination in the central nervous system and the peripheral nervous system. AB - Remyelination in the PNS is efficient, quick, and consistently found in all demyelinating diseases. Schwann cell proliferation in response to demyelination is rapid and prolific, and the numbers of Schwann cells generated are in excess of those required for adequate remyelination. This cell poses no limit to regenerative potential, and it can divide and remyelinate following numerous repetitive episodes. The Schwann cell generally has easy access to the denuded axons. The limiting factor to remyelination is the persistence of the demyelinating agent, be it directed at the myelin or secondarily through axonal disease. CNS remyelination differs in some respects. Although it has now become clear that it may occur in a variety of clinical and experimental situations, it is slower and often less complete than in the PNS. The limiting factors here include the nature of the demyelinating process, the regenerative potential of the oligodendrocyte, and the accessibility of the latter to the demyelinated axon. It is apparent that the oligodendrocyte is capable of some proliferation, but the time frame in which this can occur is more constrained than for the Schwann cell. Nevertheless the demonstration that the process occurs leads to increasing hope that clinically useful remyelination may be encouraged in the future either by more carefully controlling the extent of demyelination or by finding ways of stimulating oligodendrocyte proliferation and access to the axon. PMID- 3278519 TI - Clinical observations on recovery from stroke. AB - Recovery from stroke occurs in a similar pattern in most patients, but the final functional status is difficult to predict. This recovery is most rapid in the first few months, but it may continue for years. The factors facilitating prolonged and more complete recovery are unclear and multiple. The neurophysiologic mechanisms of synaptic sprouting, unmasking, and redevelopment of inhibition may underlie recovery and provide the basis for developing therapeutic interventions in an attempt to promote return of function. Although the impact of current rehabilitation strategies on stroke recovery is uncertain, review suggests that it is beneficial in selected groups of patients. Further research is needed to answer the many questions surrounding recovery from stroke (a) to address the mechanisms of stroke recovery in human subjects with imaging or pathologic correlation, (b) to design therapeutic techniques based on neurophysiology and assess their effectiveness in groups of patients, (c) to determine if intensive rehabilitation reduces functional dependency resulting in decreased long-term social and economic costs, (d) to determine when rehabilitation should begin, where rehabilitation should take place, and how rehabilitation programs should be organized, and (e) to enable selection of patients most likely to succeed in rehabilitation programs. Although difficult to design, studies addressing these areas will provide much useful information that will further the development and delivery of rehabilitation services, resulting in improved patient care and reduced costs. PMID- 3278520 TI - Membrane organization and myelin remodeling in regenerating axons. PMID- 3278521 TI - Synaptic plasticity and functional stabilization in the hippocampal formation: possible role in Alzheimer's disease. AB - In this chapter we have explored the hypothesis that reactive synaptogenesis is an adaptive mechanism that can compensate for loss of a fraction of a defined neuronal population. Partial cell loss occurs during the course of aging, neurodegenerative diseases, and minor traumatic brain injuries. As cells are lost or as their function severely declines, new connections made by healthy neurons from within the population can assume parallel functions (homotypic sprouting), or fibers from converging pathways (heterotypic sprouting) can act to boost weakened signals and maintain functional stability. When cell death (or disease) progresses to the point where the pathway is broken, sprouting can no longer maintain information flow along the circuit and thus is unable to preserve function, unless new circuits can also be compensatory as, for example, after unilateral injury. We have analyzed the consequences of cell loss on the nature of circuit regrowth within the primary hippocampal circuits--i.e., the entorhinal dentate gyrus-CA3-CA1 pathways. Reactive synaptogenesis can occur throughout the system after loss of each major cell population. Homotypic sprouting predominates in several pathways (e.g., dentate gyrus after CA4 loss, CA1 field after CA3 loss), and heterotypic sprouting appears prominent in the dentate gyrus after entorhinal cell loss. Each reactive network as a result of the regrowth can, in principle, still function, if cell loss is partial. The observation that sprouting also occurs in Alzheimer's disease illustrates that a slow and fractional loss of a neuronal assembly can trigger reactive growth in humans even along with a severe neurodegenerative disease. Axon sprouting was predicted in the dentate gyrus after entorhinal cell loss from rodent studies and has now been demonstrated in the brain of Alzheimer's victims. Cholinergic septal inputs, if present, can sprout, thereby enhancing cholinergic function and transmission by entorhinal perforant path fibers. CA4 fibers also sprout, thereby increasing positive feedback on granule neurons. At present, however, the functional significance of these mechanisms has yet to be established in clinical studies. Alzheimer's disease has a prolonged course with progressive symptoms. We would propose that axon sprouting or reactive synapse formation provides additional stability beyond the decline predicted from cell loss alone (Fig. 8). Thus, the clinical threshold where functions disappear is postponed for longer periods of time. Some reports in the literature are consistent with rapid behavioral decline followed by intervening periods of stability.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3278522 TI - Physiological aspects of synaptic plasticity: the Ia/motoneuron connection as a model. AB - Damage to peripheral nerves results in substantial changes in the function of spinal synapses that mediate the monosynaptic reflex. These alterations consist independently of those caused by axotomy of the postsynaptic neuron and those produced by axotomy of the presynaptic neuron. Synaptic transmission is depressed following interruption of either limb of the segmental reflex loop. These reductions in EPSP amplitude are largely reversed following reinnervation of the peripheral tissue by the cut fibers, whether or not the regenerating fiber finds the correct muscle. Alterations in synaptic transmission following damage to the spinal cord itself are more variable than those noted after peripheral nerve damage. Although segmental EPSPs are generally enhanced following spinal injury (if in fact changes do occur), these increases are superimposed on motoneuron hyperpolarization, making the net changes in reflex transmission unpredictable. Furthermore, the extent of motoneuron depolarization is also influenced by the amount of temporal summation of EPSPs during the high-frequency activation of group Ia fibers known to occur, for example, during normal walking. Because EPSP amplitude is not constant during such activation and is modulated differently at connections on different motoneurons, changes in effective levels of synaptic transmission after such lesions are very difficult to predict. Thus it is not surprising that it is not possible to make close correlations between changes in amplitude of EPSPs and reflex behavior following injury (but see chapter by M.E. Goldberger and M. Murray, this volume). These alterations in synaptic transmission can occur at a considerable physical distance from the site of injury, peripheral or central. They illustrate the interdependence in elements of the nervous system, which can also be seen as changes in properties of motoneurons themselves (e.g., input resistance, after-hyperpolarization, rheobase) following many of these injuries. Altered cell properties complicate the functional interpretation of synaptic changes obtained after injury but must be considered in evaluating the sequelae of lesions in the peripheral and central nervous system. PMID- 3278523 TI - Patterns of sprouting and implications for recovery of function. PMID- 3278524 TI - Spasticity as an adaptation to pyramidal tract injury. PMID- 3278525 TI - Control of locomotion in vertebrates: spinal and supraspinal mechanisms. PMID- 3278526 TI - Neuronal replacement by intracerebral neural implants in animal models of neurodegenerative disease. PMID- 3278527 TI - Growth factors. PMID- 3278528 TI - Voltage gradients and ionic currents in injured and regenerating axons. AB - When an axon is damaged, a strong, persistent, injury current enters the damaged area, driven by the ionic pumps of the healthy portion of the cell. This current is associated with an electrical field, existing within the damaged axon and in the extracellular space around it. Such currents and fields are a common feature of neuronal damage and probably play a role in Ca2+-mediated degenerative events soon after transection, retrograde die-back, a structuring of the axonal terminus into zones, and perhaps organelle movement within damaged fibers. The long-term persistent currents may be a common feature of growing axons and might play a role in development and regeneration. Altogether, electrical effects of injury provide an alternative to conjecture concerning the physiological basis for immediate cellular responses to axonal injury. They also provide a possible basis for modulating the responses of neurons to injury by applied electric fields. PMID- 3278529 TI - Gangliosides as a possible treatment affecting neuronal repair processes. PMID- 3278530 TI - Stimulation of neuronal regeneration and development by steady electrical fields. PMID- 3278531 TI - Prospects for a cognitive orthosis. PMID- 3278532 TI - Regeneration of pyramidal tract axons. PMID- 3278533 TI - The glial scar: its bearing on axonal elongation and transplantation approaches to CNS repair. PMID- 3278534 TI - Cranial-cervical dyskinesias: an overview. PMID- 3278535 TI - Etiology and differential diagnosis of blepharospasm and oromandibular dystonia. PMID- 3278536 TI - Blepharospasm: a form of focal dystonia. PMID- 3278537 TI - Spasmodic torticollis. PMID- 3278538 TI - Anatomy of the orbicularis oculi and other facial muscles. PMID- 3278539 TI - Hemifacial spasm: differential diagnosis, mechanism, and treatment. PMID- 3278540 TI - Idiopathic oral-facial dyskinesia. PMID- 3278541 TI - Tardive dystonia: clinical aspects and treatment. PMID- 3278542 TI - Facial synkinesis and aberrant regeneration of facial nerve. PMID- 3278543 TI - Head, facial, and voice tremor. PMID- 3278544 TI - Epileptic facial automatisms and head movements. PMID- 3278545 TI - Dysarthrias of movement disorders. AB - Following the seminal works of Canter (152) and Darley, et al. (1) concerning differential diagnosis and classification of dysarthria, considerable strides have been made with regard to characterizing the features of speech that occur with disorders of movement. Research should continue to address the neurophysiologic substrates of the dysarthrias of movement disorders, and most importantly, efficacious means of treating these impairments of speech. PMID- 3278546 TI - Nocturnal bruxism and temporomandibular disorders. AB - This chapter has discussed the important aspects of nocturnal bruxism and its relation to disorders of the masticatory system and headaches. Bruxism is believed to be a stress-related sleep disorder, occurring in both men and women, in children, and in adults. In most patients, bruxism results only in minor tooth wear; however, it can become extremely severe with damage occurring in essentially every part of the masticatory apparatus. Nocturnal bruxism should not be overlooked as an etiologic factor in muscular headaches. Short-term acute therapy may involve physical therapy, nocturnal electromyographic biofeedback, and medication to relieve anxiety and improve sleep. Long-term management usually includes some form of stress reduction, change in lifestyle, and an occlusal splint or nightguard to protect the teeth and masticatory system. PMID- 3278547 TI - Orofacial and other self-mutilations. PMID- 3278548 TI - Sporadic facial stereotypies in patients with schizophrenia and compulsive disorders. PMID- 3278549 TI - Brain stem pathology in cranial dystonia. PMID- 3278550 TI - Neurologic disorders of gastroesophageal function. PMID- 3278551 TI - Cholinergic pharmacology of blepharospasm with oromandibular dystonia (Meige's syndrome). PMID- 3278552 TI - Botulinum A toxin in the treatment of blepharospasm. PMID- 3278553 TI - Local side effects of botulinum toxin injections. PMID- 3278554 TI - Surgical management of blepharospasm. PMID- 3278555 TI - Blepharospasm-oromandibular dystonia syndrome (Meige's syndrome): clinical aspects. AB - Meige's syndrome is a form of cranial dystonia characterized by the presence of bilateral dystonic spasms of the facial muscles and frequently of other cranial muscles as well. Its most common and disabling manifestation is blepharospasm which can render the patient functionally blind. Several types of orbicularis oculi spasms occur in Meige's syndrome: brief clonic spasms, prolonged dystonic spasms, constant tonic contraction, and "apraxia" of lid opening. In the completed form of the syndrome, blepharospasm is typically associated with lower facial or oromandibular dystonia. Spasms of the neck and limb muscles, generally mild, and action tremor not uncommonly accompany the cranial dystonia. In most patients the cause of the spasms is unknown. This so-called idiopathic or primary form of Meige's syndrome is considered an adult form of adult onset dystonia. Secondary Meige's syndrome can be encountered in the context of several neurodegenerative disorders, chronic administration of neuroleptics, levodopa, or other drugs, and in patients with focal brain lesions. These secondary cases of Meige's syndrome suggest that a dysfunction of the basal ganglia or of the mesencephalic/diencephalic region plays an important role in the pathophysiology of this dystonic syndrome. Recent neurophysiologic studies and postmortem findings in some patients also support the notion that disease of the brain stem contributes to the pathophysiology of orofacial dystonia. PMID- 3278556 TI - So-called apraxias of lid movement. PMID- 3278557 TI - Ophthalmologic causes of blepharospasm. PMID- 3278558 TI - Cat scratch disease. PMID- 3278559 TI - Fever in children. AB - True fever occurs when there is an upward displacement of the thermostatic mechanism of the anterior hypothalamus in response to exogenous pyrogens. Fever may increase immune system activity, but it also induces an array of discomforts. In children under three months of age, fever is often an indication of serious illness, and aggressive evaluation is indicated. Febrile children aged three months to two years frequently do not manifest the classic signs and symptoms of specific diseases. PMID- 3278561 TI - Shinsplints. AB - Shinsplints is not a specific diagnosis; it is a general term encompassing several conditions that result in chronic leg pain. Some recent advances, particularly the use of bone scan, have improved the diagnosis of shinsplints. Physicians dealing with these problems should refer to specific anatomic and etiologic conditions rather than use the term shinsplints. This will not only improve communication but also permit more accurate direction of therapy. PMID- 3278560 TI - Post-traumatic stress disorder in Vietnam veterans. AB - Post-traumatic stress disorder evolved from the concepts of shell shock and traumatic war neurosis. In Vietnam veterans, the disorder is associated with unemployment, marital discord, alcoholism and increased autonomic system response to perceived symbols of war trauma. A combination of psychotherapy and pharmacotherapy is the recommended treatment. PMID- 3278562 TI - Leiomyomas in pregnancy. AB - Although the growth of uterine leiomyomas is influenced by estrogens, growth during pregnancy has been documented in only a small fraction of cases. Degeneration or torsion of a pedunculated leiomyoma can cause pain. The cesarean section rate is not increased. Pregnant patients with leiomyomas should be followed with serial ultrasound to document the location, size and growth of the tumors, as well as fetal growth. The majority of pregnancies in women with leiomyomas have good outcomes. PMID- 3278563 TI - Rubeola. AB - Although immunization practices have dramatically reduced the incidence of measles, several populations remain at risk of the disease. Modified measles may occur in those who received immune globulin in childhood. Atypical measles, often confused with Rocky Mountain spotted fever, may develop in those who received inactivated measles virus vaccine and were subsequently exposed to the natural disease. The diagnosis of measles requires a high index of suspicion and a careful immunization history. PMID- 3278564 TI - Herpes simplex encephalitis. AB - Herpes simplex encephalitis is a rapidly progressive disease in neonates and adults. Mortality is high, and there are severe neurologic sequelae in survivors. The reasons for centripetal transfer of virus to the brain are not fully understood. Prompt diagnosis followed by antiviral therapy with acyclovir significantly improves the prognosis. Controversy surrounds the need for brain biopsy before antiviral therapy is started. PMID- 3278565 TI - Soft tissue infections due to noncholera vibrios. AB - Noncholera vibrios can cause soft tissue infections as well as diarrheal disease. A history of exposure to marine water or shellfish aids in the presumptive diagnosis of these atypical infections. The treatment of choice for Vibrio wound infections is tetracycline, since these organisms often are resistant to penicillins, cephalosporins and some aminoglycosides. PMID- 3278566 TI - Aging skin. AB - Environmentally induced (extrinsic) changes in aging skin are often difficult to distinguish from physiologic (intrinsic) changes due to longevity. Structural alterations include dermoepidermal junction flattening, epidermal basal cell heterogeneity, depletion of Langerhans' cells and melanocytes, dermal and subcutaneous atrophy, appendageal deterioration and a decline in special sensory end organs. In addition to cosmetically compromising changes in the skin, hair and nails, clinical manifestations include a propensity to blister formation, cutaneous injury, epidermal neoplastic transformation, infection, xerosis and thermoregulatory perturbations. PMID- 3278567 TI - Varicoceles and male infertility. AB - Approximately 15 percent of the postpubertal male population develops varicoceles, and one-third of men seen in fertility clinics have this lesion. Semen samples commonly show diminished sperm counts, decreased motility and immature cellular morphology. Treatment is usually surgical, although percutaneous methods are now available. Early diagnosis and treatment may prevent the testicular insult. PMID- 3278568 TI - Amblyopia. AB - Amblyopia, commonly known as "lazy eye," is a frequent but preventable cause of decreased vision. An anatomically normal eye, free from organic disease, has reduced vision compared with the other eye. Ptosis of the eyelids, strabismus, certain refractive disorders and other abnormalities may precede amblyopia. If discovered early enough, usually before the age of five, amblyopia can often be reversed. PMID- 3278569 TI - Infected diabetic foot ulcers. AB - Infections of diabetic foot ulcers are a common, longstanding complication of poorly controlled diabetes. They result from the interplay of peripheral neuropathy and peripheral vascular disease. In most cases, diabetic foot infections are polymicrobial, and deep tissue culture after debridement is essential for identifying the true pathogens. Treatment includes bed rest, empiric and specific antibiotic therapy, and good control of diabetes. PMID- 3278570 TI - Neuroleptic malignant syndrome. AB - Neuroleptic malignant syndrome may occur in patients taking neuroleptics and other psychotropic drugs. The syndrome is characterized by hyperthermia, muscular rigidity, altered consciousness and autonomic instability. Cerebrospinal fluid examination is normal. Treatment includes intensive supportive measures and the use of dantrolene or bromocriptine, or both. PMID- 3278572 TI - Assessing and treating communication disorders. AB - Communication disorders are defined as difficulties involving speech, language or hearing. Speech problems may involve disorders of articulation, fluency or voice. Language disorders include problems of receptive, expressive and pragmatic language. The most common communication disorder is hearing loss. The role of the family physician is to recognize the problem, supervise the evaluation, coordinate the therapy, and support the patient and family. PMID- 3278571 TI - Cardiac tumors. AB - Cardiac tumors are great imitators in cardiovascular disease. Common clinical presentations include arrhythmias, congestive heart failure, pericardial effusion, pulmonary or systemic embolic disease, valvular dysfunction and constitutional symptoms, such as fever, malaise and weight loss. M-mode and two dimensional echocardiography have simplified diagnosis, but the physician must have a high index of suspicion. PMID- 3278573 TI - Common fractures from a fall on an outstretched hand. PMID- 3278574 TI - Combination of calcium channel blocker and thrombolytic therapy in acute myocardial infarction. AB - To evaluate the protective effect of nifedipine on ischemic myocardium, in addition to thrombolytic therapy, a total of 149 patients with acute myocardial infarction were included in a double-blind controlled study in which they received 20 mg sublingual nifedipine (74 patients in group 1) or placebo (75 patients in group 2) in the emergency ward, either intracoronary nifedipine, 0.2 mg before and 0.2 mg after reperfusion of the infarct-related vessel and 20 mg three times/day during the hospital stay, or placebo. Combined intravenous and intracoronary thrombolytic therapy was initiated by means of mechanical recanalization in nonreperfused vessels. There were no differences between group 1 and 2 with regard to age, sex, body weight, or location of infarct. Evolution of CK-MB release and cumulative CK-MB was higher in group 1 than in group 2. Changes with regard to regional and global left ventricular function and coronary anatomy were not significantly different (NS) between the two groups. Reocclusion occurred in 15 of 74 (20%) and 10 of 75 (13%) patients in groups 1 and 2, respectively. During the reperfusion period, second- and third-degree atrioventricular block occurred in 5.4% and 6.7% (NS), ventricular couplets in 17.6% and 24% (NS), ventricular tachycardia in 2.7% and 9.3%, and ventricular fibrillation in 2.7% and 8% of the patients, respectively. Mortality rates were 13% and 8%. The study demonstrates that even very early administration of nifedipine combined with intracoronary administration does not enhance the salvage of ischemic myocardium achieved by reperfusion. PMID- 3278575 TI - Early natural history of regional left ventricular dysfunction after experimental myocardial infarction. AB - Existing studies provide conflicting information concerning the natural history of regional dysfunction after subacute myocardial infarction. The purpose of this study was to use quantitative computer-assisted two-dimensional echocardiography to define the natural history of abnormal wall motion in a subacute canine infarct model within individual short-axis echocardiographic planes, and in the entire ventricle as well. Serial short-axis echocardiograms were obtained from 10 closed-chest dogs before occlusion and at 0.5, 6, 24, 48, and 72 hours after ligation of the circumflex (six dogs) or left anterior descending (four dogs) coronary artery. The circumferential extent of abnormal wall motion was quantified by two different computer-assisted methods: the first, a derived correlation method, examined wall motion throughout the systolic contraction sequence; the second method examined the fractional radial change in endocardial ray length from end-diastole to end-systole. The study shows that for individual planes there is a slight but not statistically significant increase in the circumferential extent of abnormal wall motion from 0.5 to 72 hours after coronary artery occlusion; however, when the total extent of left ventricular asynergy was used to define a global functional infarct size, we observed a small (3.6% to 5.4%) but significant increase in the circumferential extent of abnormal wall motion. PMID- 3278576 TI - Antifibrillatory action of the narcotic agonist fentanyl. AB - Morphine, an opiate alkaloid with mixed mu- and delta-agonist properties, raises the ventricular fibrillation threshold in anesthetized dogs by altering autonomic tone. To elucidate further underlying structure-activity relationships, the effect of fentanyl, a nonalkaloid, mu-selective agonist in wide clinical use, was studied. Fentanyl (30 micrograms/kg) was given intravenously to 27 chloralose anesthetized dogs, and ventricular fibrillation threshold was measured by means of the single-stimulus technique. In the baseline state fentanyl raised the ventricular fibrillation threshold by 14%. When the dogs were subjected to hemorrhagic stress, this effect was amplified to 29% (p less than 0.0001). Bilateral cervical vagotomy abolished fentanyl's antifibrillatory effect, but neither atropine sulfate (0.4 mg/kg/hr) nor atropine methylnitrate (0.5 mg/kg/hr) did so. Fentanyl's influence on the fibrillation threshold during hemorrhage was significantly reduced by bilateral stellate ganglionectomy (p less than 0.005). It is concluded that fentanyl raises the ventricular fibrillation threshold by its known sympathoinhibitory action rather than by its vagal efferent activating effect. The facts that an intact vagus is required and that hemorrhage amplifies the effect suggest that the antifibrillatory effect of fentanyl is mediated through the afferent component of the baroreflex arc. PMID- 3278577 TI - Doppler echocardiographic assessment of the effect of varying atrioventricular delay and pacemaker mode on left ventricular filling. AB - Pulsed Doppler echocardiography was used to study the timing and dynamics of left ventricular filling in 14 patients with permanent dual-chamber programmable pacemakers. Pacemakers were programmed to atrial sensed (VDD) mode and atrial ventricular sequential paced mode at low (DVI-L) and high (DVI-H) heart rates, and pulsed Doppler recordings of transmitral flow were analyzed at atrioventricular delays of 50 to 300 msec in each mode. There was a significant decrease in the one-third filling fraction in both VDD and DVI-L modes and a significant increase in DVI-H modes with increasing atrioventricular delay. The ratio of early filling area to atrial filling area was significantly lower at longer atrioventricular delays in both VDD and DVI-L modes. The time from pacemaker spike to mitral valve closure was highly significantly correlated with atrioventricular delay in VDD, DVI-L, and DVI-H modes (r = -0.92, p = 0.0001; r = -0.90, p = 0.0001; and r = -0.85, p = 0.0001, respectively) as was the diastolic filling time to a lesser extent (r = -0.73, p = 0.0001; r = -0.69, p = 0.0001; r = -0.61, p = 0.0001, respectively). Events reflecting atrial systole occurred at a later time in the cardiac cycle in the atrial paced vs the atrial sensed mode. Thus changes in atrioventricular delay and pacemaker mode in this group of patients are a strong determinant of the timing and dynamics of left ventricular filling. PMID- 3278578 TI - The effects of antihypertensive drugs on glucose intolerance in hypertensive nondiabetics and diabetics. PMID- 3278579 TI - Myocardial injury associated with polysubstance abuse. PMID- 3278580 TI - Therapeutic trials and large arteries in hypertension. PMID- 3278582 TI - Usefulness of aspirin for coronary artery disease. PMID- 3278583 TI - Similarities and dissimilarities in hypnotic and nonhypnotic procedures for headache control: a review. PMID- 3278581 TI - Influence of long-term metoprolol treatment on early and late exercise test performance after acute myocardial infarction. AB - The effect of therapy on exercise performance during a 3-year follow-up after acute myocardial infarction (AMI) was evaluated in a double-blind randomized comparison between 154 patients given metoprolol (100 mg twice daily) and 147 patients given placebo. Exercise tests were performed 1.5, 6, 12, 24 and 36 months after AMI. Maximal accomplished workloads were similar in the 2 groups throughout follow-up. Maximal heart rate was significantly higher in the placebo treated group throughout the study (p less than 0.001). At the 6-week test more patients in the placebo group terminated exercise due to angina pectoris (40 vs 25%, p less than 0.05) and showed exercise-induced ST-depressions (38 vs 27%, p = 0.05) compared with the metoprolol group. Exercise-induced ventricular arrhythmias were significantly more common in the placebo group during the initial 6 months. Death, another AMI or both were significantly reduced by metoprolol treatment in patients with exercise-induced ST depression greater than or equal to 1 mm at the 6-week test. In a multiple logistic regression analysis maximal accomplished workload at 6 weeks (p less than 0.026), male sex (relative risk [rr] = 3.57, p = 0.016), previous AMI (rr = 3.07, p = 0.001), therapy with placebo (rr = 2.14, p = 0.007) and left ventricular failure (rr = 2.04, p = 0.023) were shown to carry independent prognostic information as well as exercise induced ST-depression (greater than or equal to 1 mm) in placebo-treated patients (rr = 2.70, p = 0.01). PMID- 3278584 TI - Early uses of hypnosis as surgical anesthesia. PMID- 3278585 TI - The "third eye": a psychoendocrine model of hypnotizability. PMID- 3278586 TI - Re: Effect of timing on long-term clinical success of alveolar bone grafts. PMID- 3278587 TI - Lead poisoning: a report from Saudi Arabia. PMID- 3278588 TI - Prediction of nonsurvival in critically ill infants with respiratory failure. Which patients are candidates for extracorporeal membrane oxygenation? PMID- 3278589 TI - Hypoxic vs septic pulmonary hypertension. Selective role of thromboxane mediation. AB - Pulmonary hypertension was generated in 11 newborn piglets, via either infusion of group B beta-hemolytic streptococci (n = 5) or induction of isocapnic hypoxia (n = 6), to study the contributions of thromboxane metabolite thromboxane B2 levels to different types of pulmonary hypertension. After 30 minutes of stable pulmonary hypertension, mean (+/- SD) pulmonary artery pressure increased similarly from 16 +/- 4 to 33 +/- 5 mm Hg (hypoxic), and from 14 +/- 2 to 34 +/- 6 mm Hg (septic). All other measured hemodynamic variables were similar. Despite these hemodynamic similarities, there were significant differences in thromboxane B2 levels. After 60 minutes of pulmonary hypertension, thromboxane B2 levels were 760 +/- 253 pg/mL (hypoxic), and 3103 +/- 1083 pg/mL (septic). These data demonstrate that, while thromboxane appears to be crucial in mediating septic pulmonary hypertension in the piglet, it is not associated with hypoxic pulmonary hypertension, implying that different types of pulmonary hypertension are probably mediated by different biochemical agents. PMID- 3278590 TI - Pharmacokinetics and pharmacodynamics of treatments for peptic ulcer disease in the elderly. PMID- 3278591 TI - Selected rheumatologic and dermatologic manifestations of inflammatory bowel disease. AB - This review focuses on the behavior and pathogenesis of selected dermatologic and rheumatologic manifestations of inflammatory bowel disease. Erythema nodosum, the most common skin lesion, correlates with activity of the bowel disease but not with its duration or extent. Resolution occurs with therapy of inflammatory bowel disease. Pyoderma gangrenosum, the most severe skin lesion, bears little relationship to the activity or extent of the colitis. Therapy is usually supportive, but dapsone and steroids appear promising. Immune and vasculitic mechanisms have been postulated for both skin lesions. Peripheral arthritis usually has its onset with or after the development of colitic symptoms. It worsens with exacerbation of bowel inflammation and responds to treatment of the bowel disease. Immune mechanisms are likely. Spondyloarthropathy usually occurs before the onset of overt intestinal disease. Its course is unrelated to the bowel inflammation, it does not respond to treatment of bowel disease, and it is associated with HLA B27. PMID- 3278592 TI - 1987 Henry Baker lecture. Nutrition, alcohol, and the liver. AB - Alcohol is hepatotoxic in both established alcoholics and normal volunteers. Good nutrition does not protect against this effect. Those who are admitted to the hospital with evidence of alcoholic liver disease are uniformly malnourished. The malnourished sick, including those with alcoholic liver disease, do not fare as well with their disease as do the well-nourished sick. The data are compatible with the concept that malnutrition is a complication of alcoholism and interferes with rapid repair of alcoholic liver injury. Only in this important sense does poor protein intake contribute to the hepatic injury of alcohol abuse. Correction of kwashiorkor allows the inherent repair mechanisms to operate in reversing the reversible. Therefore, for the sicker alcoholics who have a reversible component to their liver disease, but who cannot consume adequate diets, enteral or parenteral caloric supplements are indicated. This is, after all, not so different from other diseases. 'Tis better to have one ailment at a time. If one wishes to alter the overall impression or picture of the play, remove one of the significant actors. PMID- 3278593 TI - Role of endothelial cell injury in the spectrum of azathioprine-induced liver disease after renal transplant: light microscopy and ultrastructural observations. AB - Three cases of azathioprine-induced complex of liver diseases are described, and their light microscopy and ultrastructural findings are detailed. It was found that the drug produces a spectrum of pathological changes that include veno occlusive disease, peliosis hepatis, perisinusoidal (Disse space) fibrosis, and nodular regenerative hyperplasia. It is suggested that the explanation for this spectrum is the variable degree of damage to the endothelial cells lining the sinusoids and the terminal hepatic venules. This spectrum is seen almost exclusively in male patients with renal transplant. PMID- 3278594 TI - Extrahepatic obstructive jaundice due to colorectal cancer. AB - A prospective registry of patients with obstructive jaundice referred for percutaneous bile duct drainage found six patients with extrahepatic obstruction due to colorectal cancer in a 21-month period. This cause of jaundice in patients with colorectal cancer is not uncommon, and deserves routine diagnostic consideration, even in the presence of intrahepatic metastases. Percutaneous biliary drainage was beneficial for four of the six patients. PMID- 3278595 TI - A prospectively randomized trial of heat probe thermocoagulation versus pure alcohol injection in nonvariceal peptic ulcer hemorrhage. AB - We conducted a prospectively randomized trial of 78 patients with peptic ulcer hemorrhage to evaluate the hemostatic effects of heat probe thermocoagulation and pure alcohol injection. The initial and ultimate success rates of heat probe thermocoagulation were better than those of pure alcohol injection (p less than 0.05). Rebleeding rates and success rates of retreatment in the two groups were not significantly different. In the case of a spurter or a bleeder located over the lesser curvature side of the stomach or superior wall of the duodenal bulb, heat probe thermocoagulation was better than pure alcohol injection in achieving hemostasis. We conclude that heat probe thermocoagulation is better than pure alcohol injection in arresting peptic ulcer hemorrhage. If the bleeder is a spurter or is located over the lesser curvature side of the stomach or superior wall of the duodenal bulb, heat probe thermocoagulation is the treatment of choice. PMID- 3278596 TI - Screening colonoscopy: has the time come? PMID- 3278597 TI - Symptomatic sclerosing cholangitis in patients with a normal alkaline phosphatase: two case reports and a review of the literature. AB - The diagnosis of sclerosing cholangitis is usually not considered in the absence of an elevation of serum alkaline phosphatase. The purpose of this paper is to report two symptomatic cases of primary sclerosing cholangitis (PSC) which presented with a normal alkaline phosphatase, and to review the literature regarding alkaline phosphatase in PSC. A total of 172 patients with PSC were identified in the literature; six of these patients (3%) presented with a normal alkaline phosphatase. Patients with diseases known to be associated with primary sclerosing cholangitis and having a compatible clinical presentation should be considered for evaluation with endoscopic retrograde cholangiography, even in the presence of a normal level of serum alkaline phosphatase. PMID- 3278598 TI - Herpes simplex esophagitis in a renal transplant patient: the need for antiviral therapy. PMID- 3278599 TI - Recombinant human erythropoietin: implications for nephrology. AB - The pathophysiology of the anemia of chronic renal failure (CRF), erythropoietin physiology, the characteristics of recombinant human erythropoietin, and the results of nearly 2 years of therapy with this product in hemodialysis patients are detailed in this review. This anemia is primarily an endocrine deficiency state corrected by the hormone erythropoietin. Correction of the anemia eliminates transfusions and their associated risks, improves physical endurance, and results in healthier patients beginning dialysis. Adequate support services will be necessary to maximize patient rehabilitation and employment potential. Further research is needed to better understand erythropoietin physiology and metabolism, and the impact of uremia on end organ function in the absence of anemia. PMID- 3278600 TI - The influence of donor age on renal function in transplant recipients. AB - To the extent that age-related declines in kidney function are caused by intrarenal alterations, donor age should affect glomerular filtration rate (GFR) after renal transplantation. Although some investigations have suggested that transplantation of aging kidneys may cause an increased incidence of primary allograft failure, the effects of donor age on GFR are unknown. In the present study, 201 patients who had allografts that survived for at least 24 months were investigated. The age range of the donors was 7 to 61 years. Multivariate regression analysis demonstrated that both donor and recipient age had significant, independent effects on creatinine clearance at 1 year, and at last follow-up, 5.0 +/- 1.9 years (mean +/- SD) after transplantation. The effect of donor age on renal function could not be attributed to differences in the number of rejection episodes, the frequency or duration of posttransplant acute tubular necrosis, age of the recipient, or other factors. Donor age had no effect on allograft survival, and did not affect the rate of decline in creatinine clearance between 1 year and last follow-up. Thus, these results suggest that donor age is associated with intrarenal alterations that lead to reductions in renal function after transplantation, but donor age may not affect long-term prognosis or allograft survival in the late posttransplant period. PMID- 3278601 TI - Hypogammaglobulinemia in a renal transplant recipient with antiglomerular basement membrane disease. AB - A thirty-six-year-old woman developed antiglomerular basement membrane disease, necessitating bilateral nephrectomies. Subsequent to cadaveric renal transplant and 8 years of immunosuppressive treatment with prednisone and azathioprine, the patient developed multiple life-threatening infections. Quantitative immunoglobulins revealed IgG = 9, IgA less than 6.7, and IgM = 33. Lymphocyte population studies revealed absence of B-lymphocytes. It is suspected that prednisone or azathioprine may have caused a defect in B cell differentiation. In patients who are taking immunosuppressive medications and develop multiple infections, it is indicated to evaluate immunoglobulin and/or B lymphocyte status. PMID- 3278602 TI - Recurrent nephrotic syndrome in renal allografts. AB - We describe the clinicopathologic course of two patients with recurrent focal segmental glomerular sclerosis (FSGS). In both patients, FSGS was initially demonstrated during the evaluation of proteinuria. After progressing to end-stage renal disease, each patient received a living-related renal transplant. Shortly after transplantation, proteinuria recurred in both patients, progressing to the nephrotic syndrome. Serial renal biopsies were obtained from each patient. These initially demonstrated focal segmental epithelial proliferation (the "cellular lesion"), but focal segmental scars were observed in subsequent biopsies. None of the biopsies demonstrated immunoglobulin, complement deposition, or diffuse epithelial cell foot process fusion. These findings suggest that the scarring lesion in recurrent FSGS may be the result of a primary process involving damage to a limited number of visceral epithelial cells. PMID- 3278603 TI - Biologic interactions between smoking and occupational exposures. AB - Cigarette smoking is a major cause of cancer and lung disease in the U.S. population. The biological processes that underlie the response of the lung to cigarette smoke are important considerations for designing analyses of the effects of occupational exposures. Interactions between cigarette smoking and occupational exposures may occur through a combined effect on the mechanism of disease production, through an effect on the dose of the toxic substances that reach the target issue, or through an effect on the response of the lung to the toxic agents. Disease due to occupational exposures can occur in a similar pattern in both smokers and nonsmokers; however, as more complex interactions are examined, different responses to the same occupational exposure may be identified for smokers and nonsmokers. It is only through the successful intermingling of biologic information with epidemiologic data that these interactions can be fully examined. PMID- 3278604 TI - Current policies regarding smoking in the workplace. AB - This paper briefly reviews the evolution of worksite smoking policies and programs, beginning with the goals and objectives from which they have sprung. Workplace smoking deterrents are shown to involve three different types of strategies: 1) legalistic approaches use policies and rules to restrict or foreclose smoking on the job; 2) economic strategies create incentives and disincentives, often through the employee health benefit plan; and 3) educational programs seek to motivate smokers to quit and to supply them with information and skill that may facilitate that process. The three types of intervention are combined in a broad public health approach that some companies are now developing. Research is needed on the efficacy of a range of possible approaches and attention should be paid to the ethical and policy issues of tensions and contradictions between health goals and cost containment. PMID- 3278605 TI - Direct methods of obtaining information on cigarette smoking in occupational studies. AB - Many occupational epidemiology studies require complete and accurate information on tobacco use to control for confounding by smoking and to assess interactions of smoking with workplace exposures. This paper reviews and evaluates the availability, reliability, validity, and efficiency of the various data sources and techniques for obtaining individual smoking data, including existing records, biological markers, and surveys. Emphasis is placed on the highly problematic issue of obtaining retrospective smoking histories. In general, the survey technique is currently deemed the most feasible approach for obtaining lifetime smoking histories. Both theoretical and practical aspects of smoking surveys are discussed in detail and are illustrated with a review of the recent literature and with data from two recent retrospective cohort studies conducted at the University of Pittsburgh. Several recommendations involving both the use of smoking data and areas for future methodologic research are presented. These include (1) justification for collecting smoking data in occupational studies based primarily on the potential for smoking to act as an effect modifier rather than solely as a confounder, (2) checks for reliability and validity in all studies which involve the collection of smoking data, (3) more methodologic research to better understand the impact that missing, unreliable, and invalid smoking data may have on the ability to detect and quantify important smoking exposure interactions, and (4) an assessment of the correlation between biological markers and cigarette carcinogen exposure. PMID- 3278606 TI - Blunted kaliuresis after an acute oral potassium load in diabetes mellitus. AB - It is unknown whether diabetic patients without renal failure or aldosterone deficiency respond normally to potassium administration. Acute oral potassium loading was carried out in eight diabetic patients with modestly reduced creatinine clearance (Ccr) and in 11 diabetic patients and 13 controls with normal clearances. Only one diabetic patient manifested an inappropriately low upright plasma aldosterone level (6 ng/dL). The percentage of potassium excreted in 4 hour by both groups of diabetic patients was significantly less than that of the controls (decreased Ccr:21% +/- 6%, normal Ccr:36% +/- 5%, controls:54% +/- 5%; p less than 0.01 and 0.05 respectively). On the other hand, the estimated amount of potassium translocated intracellularly tended to be greater in the diabetic patients (18 +/- 3 mmol; 11 +/- 3 mmol) than controls(7 +/- 2 mmol; p less than 0.005 and 0.1 respectively), and the ratio of the increase in plasma (K) to the amount of potassium retained, was lower in diabetic patients, probably indicating enhanced intracellular potassium translocation. The authors conclude that diabetic patients with normal or only slightly reduced renal function (and no aldosterone deficiency) may have a reduced capacity to excrete an acute potassium load but an enhanced capacity to transfer potassium intracellularly. PMID- 3278607 TI - Subclinical hypothyroidism in the elderly: to treat or not to treat? AB - Patients with subclinical hypothyroidism (SCH) have normal concentrations of thyroid hormone and elevated thyrotropin (TSH) levels. These individuals may experience mild symptoms of hypothyroidism. Such symptoms are nonspecific and also can be associated with aging or nonthyroidal illness. SCH is not uncommon in the elderly, particularly in females with positive thyroid antibodies and in those who have undergone partial thyroidectomy or I131 treatment for Graves' disease. Patients with SCH with markedly increased TSH levels or high-titer thyroid antibodies are at higher risk of progressing to overt hypothyroidism. Management options include observation only, with long-term follow up, or substitution with thyroid hormone. Replacement will prevent the development of overt hypothyroidism when reliable follow-up cannot be assured and may improve subtle, nonspecific symptoms of thyroid hormone deficiency. If a decision in favor of replacement therapy has been made, the dose of thyroid hormone should be increased gradually with the objective of returning the TSH level to normal without inappropriately elevating the serum thyroxine concentration. The patient should be carefully observed to see if hypothyroid symptoms, mental status or cardiac function improve with therapy. Continued administration of thyroid hormone would serve prophylactic purposes even if improvement did not occur. PMID- 3278608 TI - Yersinia pseudotuberculosis sepsis presenting as multiple liver abscesses. AB - A 50-year-old man with diabetes was found to have sepsis with multiple small hepatic abscesses secondary to Yersinia pseudotuberculosis which were detected by computed tomography (CT) scan. Sepsis with Y. pseudotuberculosis is uncommon but usually seen in patients with underlying liver disease. Those patients with liver abscesses invariably have multiple small abscesses. Widespread use of CT scanning is likely to uncover more cases of hepatic microabscesses; in the appropriate clinical setting, Y. pseudotuberculosis should be considered as a possible cause. PMID- 3278609 TI - Combined Escherichia coli and Staphylococcus aureus thyroid abscess in an asymptomatic man. AB - Patients with acute suppurative thyroiditis usually have pain or tenderness in the anterior part of the neck associated with erythema and dysphagia. An elderly man with none of these symptoms presented with fever and a urinary tract infection. When his systemic infection failed to respond to antibiotics, a search for an occult abscess was undertaken. An 111Indium leukocyte scan indicated a localized abscess in the right lobe of his thyroid from which Escherichia coli and Staphylococcus aureus coagulase positive were isolated. This case demonstrates that a thyroid abscess can occur in a completely asymptomatic patient without a clinically enlarged thyroid. PMID- 3278610 TI - Paget's disease of bone. AB - Paget's disease is a relatively common bone disease. This review aims to present reasonable treatment recommendations with enough background to understand them. To accomplish this end, some aspects of basic bone cell biology, biochemistry, and pathology are presented, as are speculations about possible causes of this disease. Treatment of Paget's disease will be considered in three sections. The first two sections will review treatment with calcitonin and diphosphonates, respectively. These sections briefly will consider the mechanism of action of the drugs, review in detail clinical studies of drug effectiveness, and summarize the advantages and disadvantages of each drug. The third section details specific treatment recommendations for each of the six clinical settings in which treatment of Paget's disease is justified. PMID- 3278611 TI - Genitourinary anomalies are a component manifestation in the ectodermal dysplasia, ectrodactyly, cleft lip/palate (EEC) syndrome. AB - Here we report on 13 individuals with the EEC syndrome from a single craniofacial clinic population. Eight of 13 underwent genitourinary (GU) evaluation; all had abnormal findings. Seven had anomalies of the urinary tract, and 3 had genital anomalies. To our knowledge, this is the first report of GU evaluation of the majority of EEC patients from a single clinic population. Results support the suggestion that GU anomalies are a major component of the EEC syndrome. Genitourinary evaluation of all EEC patients and their first degree relatives seems indicated. The abnormal findings observed to date suggest variable expression of an autosomal dominant gene. PMID- 3278613 TI - Paracentric inversion of Xq and ovarian dysfunction. AB - We report on a paracentric inversion X(q13 q24) in a 20-year-old woman with ovarian dysfunction. The findings add evidence on the role of breakpoints in Xq13 and Xq24 in causing ovarian dysfunction. A review of the published data on paracentric inversion of chromosome X is included. PMID- 3278612 TI - Two patients with ring chromosome 15 syndrome. AB - We report on 2 patients (3 1/2 year-old-male and 6-year-old female) with the ring 15 chromosome syndrome and speech delays and review 25 cases from the literature. The main characteristics of this syndrome include growth retardation (100%), variable mental retardation (95%), microcephaly (88%), hypertelorism (46%), and triangular facies (42%). Other frequent findings include delayed bone age (75%), brachydactyly (44%), speech delay (39%), frontal bossing (36%), anomalous ears (30%), cafe-au-lait spots (30%), cryptorchidism (30%), and cardiac abnormalities (30%). The average age at diagnosis was 8.1 years. The average maternal and paternal age at the time of birth was 28 and 31 years, respectively. PMID- 3278614 TI - Prenatal sonographic diagnosis of Pena-Shokeir syndrome type I, or fetal akinesia deformation sequence. AB - We report on a familial case of Pena-Shokeir syndrome type I (fetal akinesia deformation sequence) born to healthy parents. The antenatal ultrasound diagnosis was based on hydramnios, restricted limb movements, decreased fetal chest movements, small chest, arthrogryposis, clubfoot, fixed extension of knees, fixed flexion of elbows, camptodactyly, kyphosis of thoracic spine, cryptorchidism, and small muscle bulk. Thymic hyperplasia was noted at autopsy. PMID- 3278615 TI - Use of split-thickness dermal graft in the surgical treatment of corneal and scleral defects. AB - We used split-thickness dermal grafts for the surgical treatment of corneal and scleral perforations in two patients and obtained excellent results. Patient 1 had severe lye burns and bilateral corneal perforations and Patient 2 had scleromalacia perforans. The dermal graft self-epithelializes and, thus, does not need to be covered by conjunctiva; is supple, without the bulkiness of other materials, particularly cartilage and periosteum; is hearty and flourishes on avascular surfaces such as cornea and sclera; has good tensile strength; and is autogenous. PMID- 3278616 TI - Predictors of scleral rupture and the role of vitrectomy in severe blunt ocular trauma. AB - We reviewed retrospectively 40 eyes that had received blunt trauma and had been explored for scleral rupture. Twenty-nine eyes had scleral rupture. Of these 29, ten had ruptures seen preoperatively. Nineteen had occult ruptures. The preoperative findings predictive of scleral rupture were a visual acuity of light perception or no light perception, an intraocular pressure of less than 10 mm Hg, hyphema, and chemosis. Of the 29 ruptures, 27 involved the superior hemisphere and 25 involved the anterior hemisphere of the globe. Ten of 29 eyes (34%) with scleral rupture and eight of 11 eyes (73%) without rupture achieved a final visual acuity of 5/200 or better over an average follow-up period of 6.7 months. Factors prognostic of ambulatory vision for eyes with ruptured and intact globes included an initial visual acuity of 5/200 or better, absence of scleral rupture, and a rupture length of less than 11 mm in eyes with ruptures. The vitrectomized eyes also had a better result, suggesting that early pars plana vitrectomy is of benefit in selected rupture cases. PMID- 3278617 TI - Clear graft two years after keratoplasty in nephropathic cystinosis. PMID- 3278618 TI - Leukemic corneal infiltrates. PMID- 3278619 TI - Multiple indicators of success in residential youth care and treatment. AB - Based on a large, ongoing empirical research effort to determine factors associated with the successful community adjustment of troubled adolescents leaving residential treatment, this paper focuses on multiple indicators of success measured at multiple points of time in the treatment process. Implications for research and clinical practice are discussed. PMID- 3278620 TI - Child care and attachment: a new frontier the second time around. AB - A review of the research reveals that older studies show no group differences in mother-child attachment between children cared for at home by their mothers and children in substitute child care, and that newer studies do report differences. Along with other methodological limitations, most fail to consider interaction of family and child care systems. An ecological model is considered with suggestions for future research. PMID- 3278621 TI - Preventing childhood injury: developmental and mental health issues. AB - Injuries have replaced illness as the major source of death and disability for children in the United States. Conceptual issues underlying child safety programs are reviewed, and a framework is presented within which such efforts can be evaluated and the relationship between "accidental" and "inflicted" injuries assessed. The framework is applied in a proposal for the training and support of professionals as community child safety specialists. PMID- 3278622 TI - Rapprochement in the psychic development of the toddler: a transactional perspective. AB - The concept of rapprochement, central to separation-individuation theory, is examined and reinterpreted from a transactional perspective. A range of naturally occurring confrontations and conflicts between toddlers and their caregivers is addressed to advance the idea that rapprochement is a continuing rather than phase-specific process of early development. PMID- 3278623 TI - Teenage pregnancy from the father's perspective. AB - Teenage pregnancy is examined from the perspective of a number of studies conducted with teenage fathers. Five commonly held myths about teenage fathers are contradicted by the research. Data on sexual knowledge and behavior, attitudes toward marriage and child rearing, psychological variables, and consequences of fatherhood are presented and implications for mental health practitioners are discussed. PMID- 3278624 TI - Fasting in king penguin. I. Hormonal and metabolic changes during breeding. AB - During long-term fasting in birds and mammals, protein utilization initially decreases (phase I), is thereafter maintained at a low value (phase II), and then further increases (phase III). To delineate hormonal and biochemical changes responsible for these modifications, the effect of food deprivation for 50 days was studied in 6 male king penguins captured at the beginning of their natural breeding fast. During phase II, both rate of mass loss and plasma uric acid concentration remained at low levels, whereas plasma beta-hydroxybutyrate concentration increased. In phase III there was by contrast a 2.5-fold increase in the rate of mass loss, an eightfold increase in plasma uric acid, and an 80% drop in plasma beta-hydroxybutyrate. Plasma corticosterone was low and steady in phase II and increased three times in phase III. During the overall fast, there were no significant variations in plasma insulin, but there was a fourfold increase in plasma glucagon and a decrease in plasma thyroxine and triiodothyronine. These findings suggest that protein sparing (phase II) requires low levels of corticosterone, insulin, and thyroid hormones, whereas the further increase in protein utilization (phase III) is due to an increase in plasma corticosterone. The high plasma glucagon concentration in phase III is presumably responsible for a transient increase in plasma glucose observed at this stage; such increase in glucagon could enhance gluconeogenesis from amino acids. PMID- 3278625 TI - Fasting in king penguin. II. Hormonal and metabolic changes during molt. AB - The coincidence of fast and molt in penguins is an interesting condition for investigating the factors controlling protein metabolism; avian molt involves the utilization of amino acids for synthesis of new feathers, whereas a major factor for adaptation to fasting in birds, as for mammals, is reduction in net protein breakdown. Hormonal and biochemical changes were studied in seven molting king penguins. Their initial body mass was 18 kg. It decreased by 58% over 41 days of fasting. Feather synthesis lasted for the first 3 wk of the fast. It was marked by plasma concentrations of alanine and uric acid 1.5 to 2 times those for nonmolting fast, and plasma thyroxine was increased five times. At the completion of molt all these values returned to levels comparable to those in nonmolting fast. As indicated by high plasma levels of beta-hydroxybutyrate, lipid stores were mobilized readily during molting. The fast ended by a phase of enhancement in protein utilization that was characterized by a fivefold increase in uricacidemia and coincided with an 80% drop in plasma beta-hydroxybutyrate and a fourfold increase in plasma corticosterone. These data suggest that two different hormones control the two successive periods marked by an increased protein mobilization during the molting fast, i.e., thyroxine during feather growth and corticosterone toward the end of the fast, when the molt is completed. PMID- 3278626 TI - Ventricular receptors stimulate vasopressin release during hemorrhage. AB - These experiments were designed to investigate whether a reflex arising from ventricular receptors is capable of stimulating vasopressin secretion during hemorrhage. Three groups of conscious dogs (sham operated, cardiac denervated, and ventricular denervated) were hemorrhaged slowly until 30 ml blood/kg body wt had been removed. Hemorrhage produced comparable decreases in stroke volume, central venous pressure, and left atrial pressure in each group of dogs but produced a different pattern of heart rate response in each group. Plasma vasopressin concentrations before hemorrhage did not differ in the three groups of dogs. In sham-operated dogs plasma vasopressin increased from a control level of 2.4 +/- 0.3 to 6.2 +/- 1.7, 200.0 +/- 65.4, and 991.3 +/- 220.9 pg/ml after 10, 20, and 30 ml/kg of blood had been removed, respectively. In contrast, plasma vasopressin did not increase in either cardiac-denervated or ventricular denervated dogs after 10 ml/kg of blood had been removed, and the increases in circulating vasopressin after 20 and 30 ml/kg hemorrhage were markedly attenuated by cardiac denervation and by ventricular denervation. The magnitude of the increase in plasma vasopressin in the cardiac-denervated and ventricular denervated dogs did not differ significantly at comparable levels of hemorrhage. The results are consistent with the possibility that a reflex initiated by ventricular receptors is primarily responsible for stimulating the secretion of vasopressin during hemorrhage in conscious dogs. PMID- 3278627 TI - Reflex effects of prolonged cardiopulmonary baroreceptor unloading in humans. AB - Most studies of the reflex responses to cardiopulmonary baroreceptor unloading with lower body negative pressure (LBNP) have assessed responses during the first few minutes of LBNP. It is unknown if these early changes are representative of the steady state. Thus we determined the response of heart rate, arterial pressure, forearm vascular resistance (FVR), and plasma norepinephrine (NE), renin (PRA), and aldosterone to prolonged (20 min) LBNP in nine normal subjects. All measurements were obtained at base line and after 3, 10, and 20 min of LBNP ( 10, -20, and -40 mmHg). A 20-min recovery period was interposed between each period of LBNP. The heart rate and mean arterial pressure responses to LBNP during all levels of suction were not significantly different at 3, 10, and 20 min of continuous suction. Changes in FVR at 3, 10, and 20 min, respectively, were 18.4 +/- 3.2, 26.3 +/- 4.2, and 19.6 +/- 4.2 U during LBNP -10 mmHg; 33 +/- 7, 30.5 +/- 7.6, and 30 +/- 5.2 U during LBNP -20 mmHg; and 53.6 +/- 11.7, 57 +/- 8.8, and 49.4 +/- 12 during LBNP -40 mmHg, thus indicating a near maximal vasoconstrictor response at 3 min that was sustained throughout the 20 min during all levels of LBNP. Plasma NE rose to near peak level by 3 min. However, PRA and aldosterone changed significantly only after 20 min during LBNP at -10 and -20 mmHg. These data indicate that LBNP activates the sympathetic nervous system early, whereas activation of the renin-angiotensin-aldosterone axis is delayed. Our data should be taken into consideration in the design of future investigations of reflex neurohumoral responses to LBNP. PMID- 3278628 TI - Electrical stimulation of paraventricular nucleus increases plasma renin activity. AB - Studies employing direct electrical stimulation of the renal nerves have shown that, depending on the frequency used, selective effects on renal function can be evoked. With low frequencies, an increase in renin secretion can be elicited without affecting glomerular filtration rate, sodium excretion, or renal blood flow. In the present investigation the possibility was addressed that the central nervous system (CNS) is also organized to evoke selective changes in renal function. The paraventricular nucleus (PVN) of the hypothalamus was electrically stimulated in conscious rats with 150 microA and frequencies of 2.5, 5, 10, and 15 Hz. Blood samples for determination of plasma renin activity (PRA) were collected before and at the end of each 5-min stimulation period. The lower frequencies had no effect on PRA, but stimulation with 10 and 15 Hz produced a significant increase. This effect on PRA was not accompanied by changes in arterial pressure or renal blood flow. In a separate group of animals, stimulation of the PVN with 15 Hz produced a marked decrease in urine volume, but sodium excretion did not change. These data raise the possibility that the CNS is organized to evoke selective increases in sympathetic outflow to the kidney and to produce separate changes in renal functions. PMID- 3278629 TI - Neurohumoral interactions in conscious dehydrated rabbit. AB - The purpose of this study was to examine the role of angiotensin II (ANG II), arginine vasopressin (AVP), and neurogenic mechanisms in maintaining arterial pressure (MAP) in conscious water-deprived rabbits. Water deprivation produced marked increases in plasma renin activity and the concentration of AVP; however, plasma catecholamine concentrations were unchanged. Arterial baroreflex control of renal sympathetic nerve activity (RSNA) and heart rate (HR) was similar in water-replete and dehydrated animals. Administration of an ANG II receptor antagonist (ANG IIX) to water-deprived animals produced a small decrease in MAP but no significant changes in HR or mesenteric and hindquarters vascular resistances. Similarly, there was no significant effect on MAP, HR, or regional hemodynamics when dehydrated animals received an AVP-V1 antagonist (AVPX). RSNA increased by maximums of 61 and 43% in response to ANG IIX and AVPX, respectively. Combined administration of ANG IIX and AVPX produced significant decreases in MAP (-9 mmHg) and hindquarters resistance (-24%) and 117% and 23 beat/min increases in RSNA and HR, respectively. The effect on mesenteric resistance was variable; however, the response was generally a decrease. We conclude that ANG II and AVP pressor mechanisms are activated to sustain MAP in the dehydrated state. In contrast, the basal level and baroreflex control of sympathetic nervous system activity are unchanged from the water-replete state. However, activation of sympathetic nerve activity may become important in maintaining peripheral resistance when ANG II and AVP receptors are blocked in water-deprived animals. PMID- 3278630 TI - DSM-III axis IV revisited. AB - Clinicians have traditionally inquired about stressful life events preceding the onset of a psychiatric disorder. Axis IV of DSM-III attempted to improve on this by suggesting that a wide range of events be considered and that the information obtained be integrated into a global rating of severity. After reviewing recent evidence, the authors suggest that this process might result in ratings with lower reliability than expected. They also discuss some of the methodological difficulties in this field and explore directions for further research. PMID- 3278632 TI - Clonidine and clomipramine in obsessive-compulsive disorder. PMID- 3278631 TI - Phenelzine versus imipramine in the treatment of probable atypical depression: defining syndrome boundaries of selective MAOI responders. AB - Sixty patients with probable atypical depression--defined as meeting Research Diagnostic Criteria for depressive illness, having reactive mood, and having one of four associated symptoms (hyperphagia, hypersomnolence, leaden feeling, and sensitivity to rejection)--took part in a study contrasting phenelzine, imipramine, and placebo. Phenelzine was found to be superior to imipramine and placebo. These results were compared to results from a sample of 120 patients with identical characteristics, except that they had more than one associated atypical symptom (full atypical syndrome). The size of the drug effect was comparable in patients with full atypical and partial atypical syndromes. PMID- 3278633 TI - Peripheral tears of the meniscus. The effect of open versus arthroscopic repair on intraarticular contact stresses in the human knee. AB - The mechanical properties of the repaired meniscus may affect its ability to heal and to protect the articular surface against degenerative changes. We compared the immediate biomechanical consequences of open versus arthroscopic repair in the human cadaver knee. Additionally, having measured postoperative stresses at various degrees of knee flexion, we have addressed the effect of tethering of the meniscus, a question relevant to both meniscus repair and replacement. Peak stresses were measured by the Pressensor system. Fresh human cadaver knees were subjected to loading in an Instron unit, on an unconstrained base. Instantaneous loads were applied with the knee in 0 degree, 30 degrees, or 60 degrees of flexion, and stress distributions were measured after repair of a 2 cm peripheral tear, by an open or arthroscopic approach. The results of loading experiments on five knees revealed no statistically significant differences between stresses after the two repairs. Similarly, there was no statistically significant difference between the normal and repaired menisci. In our model, this suggests that the immediate biomechanical consequences of open and arthroscopic repair are equivalent and that the "tethered" meniscus distributes loads as well as the normal meniscus. PMID- 3278634 TI - Anterior cruciate ligament injuries in the young athlete with open physes. AB - From 1980 to 1985, 40 patients under the age of 14 with open physes were treated for midsubstance tears of the ACL at the Methodist Sports Medicine Center. In this series, 16 were treated conservatively with rehabilitation, bracing, and counseling on activity modification. The remaining 24 patients underwent arthroscopic examination and either an extraarticular or intraarticular reconstruction based on growth potential. The average followup was 27 months for the conservative group and 26 months for the surgical group. In the conservative group, six patients underwent arthroscopy for meniscal tears, four medial and two lateral. Only seven patients returned to sports, all experiencing recurrent episodes of giving way, effusions, and pain. In the surgical group, 12 medial and 6 lateral meniscal tears were found at arthroscopy. There were 10 extraarticular reconstructions and 14 intraarticular reconstructions. All 24 returned to sports activity, and 22 of the 24 are still competing. The two remaining patients both suffered reinjury 3 years after their surgery. We recommend arthroscopy and examination under anesthesia for the young patient with ACL tears. Based on the amount of instability, presence or absence of meniscal tears, and athletic desires of the patient and his or her family, a treatment plan can be undertaken. PMID- 3278635 TI - Effect of viscoelastic shoe insoles on vertical impact forces in heel-toe running. AB - The purposes of this study were: 1) to compare the impact forces in running using running shoes with conventional insoles to the impact forces using running shoes with four different viscoelastic insoles, 2) to discuss possible effects of the viscoelastic insoles on lower leg kinematics, and 3) to explain the force and kinematic results using a mechanical model. Kinetic and kinematic data were collected for 14 subjects running heel-toe at an average speed of 4 m/s. The results showed that the four tested viscoelastic insoles did not differ in variables describing the vertical impact forces (vertical force peak, time of occurrence of vertical force peak, maximum vertical loading rate) compared to the conventional insoles furnished in running shoes. Furthermore, the viscoelastic insoles did not influence kinematic variables of the lower extremities in a systematic way. PMID- 3278636 TI - Pulmonary histology for the surgical pathologist. AB - This is a review of the variety of pulmonary histologic artifacts and incidental findings that may come to the attention of the surgical pathologist. In some cases, these may lead to an erroneous diagnosis; in others, they may obscure the diagnosis. The following groups of lesions are discussed: artifacts seen in biopsy and resection material, site-specific changes commonly encountered, incidental findings and structures seen in biopsy and resection material, and age related changes. A short review of normal histology is included for perspective and a discussion of the abnormal biopsy that appears normal on first review is presented. PMID- 3278637 TI - Follicular thyroid carcinoma with clear cell change showing unusual ultrastructural features. AB - We report a case of follicular thyroid carcinoma with clear cell change displaying unusual ultrastructural features. Light microscopy revealed a metastatic neoplasm in the 12th thoracic vertebra that was composed of nests consisting mainly of clear cells. The tumor was interpreted as a metastasis of a clear cell type of thyroid carcinoma, based on positive immunohistochemical staining for thyroglobulin. However, unlike the metastatic bone lesions, the primary tumor in the thyroid consisted mainly of neoplastic follicular cells with lightly eosinophilic cytoplasm. A distinct follicular formation was noted throughout the tumor. In a portion of the tumor, a solid or stratified disposition of the cells was also observed. The primary tumor contained only a few clear cells similar to those seen in the metastatic bone lesions. In addition, we noted a transition between the follicular cells and the clear cells. Thus, this neoplasm was diagnosed as a follicular thyroid carcinoma with clear cell change, but not a specific type of thyroid neoplasm. Electron-microscopic examination revealed that the cells corresponding to clear cells under light microscopy had abundant cytoplasm characterized by varying degrees of dilation of rough endoplasmic reticulum (RER), which might reflect increased synthesis, storage of secretory products, or both. PMID- 3278638 TI - A prospective, randomized clinical investigation of cholecystoenterostomy and choledochoenterostomy. AB - A prospective, randomized clinical trial was conducted to assess the efficacy of bilioenteric bypass in noncalculous distal biliary obstruction. Thirty-one patients required bypass for either malignant obstruction or chronic pancreatitis and were randomized into two groups: cholecystoenterostomy or choledochoenterostomy with cholecystectomy. Nine bypasses failed after cholecystoenterostomy and two after choledochoenterostomy (p less than 0.04). Eight of the 9 failures occurred in the subgroup of 22 patients with malignant biliary obstruction. In this subgroup, five bypasses failed within 90 days of operation, all after cholecystoenterostomy (p = 0.03 compared with choledochoenterostomy). The results indicate that choledochoenterostomy is the superior operation for malignant distal biliary obstruction. Additional studies will be necessary to identify the procedure of choice for benign noncalculous obstructions. PMID- 3278639 TI - Alexis Carrel: Jules Verne of cardiovascular surgery. AB - There is in every field one individual who stands apart as a great thinker, leader, or teacher. In the field of cardiovascular surgery, Alexis Carrel was each of these. Proof of this lies in the fact that daily, the modern cardiovascular surgeon is likely to use a concept or technique first developed by Carrel. During the 75th anniversary year of Carrel's receipt of the Nobel Prize, the life and work of this great innovator should be remembered. PMID- 3278640 TI - Plasma expanders. An update. AB - This review of the literature has revealed that isotonic fluids, such as 0.9 percent sodium chloride and Ringer's lactate, are effective plasma volume expanders. Despite the continued use of a variety of colloid solutions in resuscitation, there is no good evidence to document a benefit of these solutions over the crystalloid solutions. The additional cost of colloid compared with crystalloid is another argument against colloid use. The most interesting solution currently being assessed is hypertonic saline solution. Its major benefit is that a small volume of fluid can achieve effective resuscitation. The smaller weight gain and lower incidence of peripheral edema may also prove to be significant benefits. Further evaluations are needed to verify the efficacy of this therapy. Finally, a recent National Institute of Health consensus panel identified the appropriate indications for fresh frozen plasma. They concluded that there is no indication for the use of fresh frozen plasma as a volume expander. PMID- 3278642 TI - Soft tissue sarcomas. PMID- 3278641 TI - Growth factors and intestinal neoplasms. AB - Signals that control normal and neoplastic epithelial proliferation are not completely understood. We have reviewed the importance of the possible roles of the following control mechanisms: polyamine biosynthesis, intraluminal nutrients, gastrointestinal hormones and growth factors, bowel resection, carcinogens, and oncogenes. The mechanisms by which these agents act and the precise roles they play in normal and abnormal proliferation of intestinal mucosa have not yet been clearly defined. Peptide hormones and growth factors exert their mitogenic effects by first interacting with specific receptors in the cell membrane. Oncogenes induce production of growth factors or replace growth factors and, by themselves, stimulate growth. We believe that no single agent is likely to be responsible; rather, multiple agents are involved in stimulation of growth of normal and neoplastic intestinal epithelial cells. A clear understanding of the factors responsible for regulation of normal and abnormal intestinal cell growth will greatly facilitate the development of therapeutic strategies for the prevention and treatment of gastrointestinal cancers. PMID- 3278643 TI - Iron overload diseases. PMID- 3278644 TI - Pulmonary embolism. Part II. Management. PMID- 3278645 TI - Current trends in liver transplantation. PMID- 3278646 TI - Campylobacter pylori. Infectious cause of ulcers. PMID- 3278647 TI - Termination of treatment. A legal update. PMID- 3278648 TI - The evolution from "the male hormone" to anabolic- androgenic steroids. PMID- 3278649 TI - Mushroom allergy. AB - The overall extent of mushroom allergy is not known. It may be very slight (1%) from eating, but could, alternatively, be as prevalent as pollen and mould allergy (10-30% of an allergic population). Aerospora of mushrooms and other woodland fungi, mostly basidiospores, occur in temperature zones in June to November, reaching maximum in August and September in quantities comparable to pollen and mould spores. There are large local and annual variations in species and spore concentrations in different milieus. In SPT and BPT studies about two dozen of these species have been associated with inhalant type I allergy. All species studied so far have yielded positive results. Mushroom allergens have been explored in only two studies. These show that mushrooms are antigenically rich and that a species can have more than one allergen. The difficulties of mushroom allergen research are very substantial because one usually has to rely on naturally growing mushrooms, where allergenic contamination by other allergen sources is frequent. Choice and recognition of species is also difficult. Virtually all known allergenic mushrooms and fungi are universal, growing equally well in Europe and North America. The genus Chlorophyllum occurs only in North America, but its close relatives of the genus Macrolepiota are common also in Europe. Podaxis grows only in desert regions near the equator and is not found in Europe. The majority of the large and more common universal mushroom families has not yet been investigated. The allergenicity of families Cortinariaceae, Russulaceae, Lactariaceae and Boletaceae is totally obscure even though they produce large quantities of spores in the air, particularly in northern Europe. PMID- 3278650 TI - Effects of adenosine-induced hypotension on myocardial hemodynamics and metabolism during cerebral aneurysm surgery. AB - The effects of adenosine-induced hypotension on central as well as myocardial hemodynamics and metabolism were studied in five neurolept-anesthetized patients without known heart or lung diseases, who were undergoing cerebral aneurysm surgery. Adenosine (217 +/- 32 micrograms.kg-1.min-1) decreased mean arterial pressure 30% from 77 +/- 5 to 54 +/- 3 mm Hg. Cardiac filling pressures and heart rate remained unchanged during hypotension. Adenosine decreased systemic vascular resistance 50 +/- 5% while cardiac index increased 39 +/- 10%. Coronary sinus blood flow increased by 73 +/- 13% from 128 +/- 18 to 224 +/- 36 ml/min with a concomitant decrease in calculated coronary vascular resistance (66 +/- 4%). Both systemic and myocardial arteriovenous oxygen content differences decreased, and myocardial oxygen consumption decreased 42 +/- 9%. There were no alterations in myocardial fractional lactate extraction. Arterial plasma renin activity and arterial catecholamine levels were unaffected by hypotension. It is concluded that adenosine hypotension in this group of patients produced a hyperkinetic circulation in the systemic as well as in the myocardial vascular bed. Cardiac output and coronary sinus blood flow increased at the same time as myocardial oxygen consumption decreased. PMID- 3278651 TI - Placement of nasogastric tubes and esophageal stethoscopes in patients with documented esophageal varices. PMID- 3278652 TI - The possible immunosuppressive effects of perioperative blood transfusion in cancer patients. PMID- 3278653 TI - Epidural narcotic and patient-controlled analgesia for post-cesarean section pain relief. PMID- 3278654 TI - Atypical serum cholinesterase eliminated by orthotopic liver transplantation. PMID- 3278655 TI - Antimicrobial properties of topical anesthetic liquids containing lidocaine or benzocaine. AB - Six species of microorganisms commonly found within the oral cavity were exposed for either one minute or two hours to 5% lidocaine liquid topical anesthetic and benzocaine liquid topical anesthetic. Mixtures of microorganisms and anesthetics were diluted and plated onto a brain heart infusion medium. Reduction in cell viability was 73-100% after exposure to the anesthetic agents when compared with the saline/buffer controls. A significant reduction (p < .005) in cell growth by Streptococcus mutans, S. sanguis, S. mitis, S. salivarius, Actinomyces viscosus, and Candida albicans was associated with a one-minute and two-hour exposure to lidocaine, benzocaine, 5% lidocaine, and the benzocaine vehicle control. Five percent lidocaine reduced growth of the test orgainisms more than benzocaine in one-minute exposures to S. mutans, A. viscosus and S. salivarius and with a two hour exposure to S. salivarius.Five percent lidocaine was bacteriocidal or fungicidal to all microorganisms for both time periods whereas, benzocaine liquid topical anesthetic was predominately bacteriostatic or fungistatic after one minute exposures and bacteriocidal or fungicidal after two hours.The results indicated that two dental liquid topical anesthetics containing lidocaine or benzocaine possessed considerable antimicrobial activity to selected oral microorganisms. The exclusive use of a topical liquid anesthetic may be an adequate means to render the oral mucosa aseptic before injection of a local anesthetic. PMID- 3278656 TI - Valvular heart disease: clinical approach to acute decompensation of left-sided lesions. AB - Acute valvular heart disease is often life-threatening. The diagnosis of acute valvular decompensation is made by attention to the physical assessment and appropriate use of diagnostic techniques. Recent advances in valvular heart disease have centered around noninvasive diagnostics. Doppler echocardiography can accurately diagnose and quantify stenotic and regurgitant lesions; its use with M-mode and two-dimensional echocardiography makes these the noninvasive diagnostic procedures of choice. Acute decompensation is often related to preexisting critical aortic or mitral stenosis, or more commonly, acute severe regurgitation. Although of different etiologies, acute mitral and aortic regurgitation are associated with similar diagnostic and therapeutic modalities. Emergency treatment consists of vasodilator and, possibly, inotropic therapy. However, definitive therapy generally requires surgical intervention. PMID- 3278657 TI - Pulmonary embolism. AB - The incidence and mortality of acute pulmonary embolism (PE) remain ill defined, particularly in the setting of the emergency department. However, high-risk groups can be identified based on medical conditions known to predispose patients to venous thrombosis. Recent research into the physiologic regulation of coagulation and thrombolysis reveals that recurrent venous thrombosis and PE may be caused by heritable deficiencies and abnormalities of plasma proteins. To decide among options for evaluation and treatment of patients suspected of PE, physicians combine clinical assessment with patterns observed on radionuclide ventilation-perfusion (V/Q) scans. However, the prevalence of PE among patients with "low probability" V/Q scans suggests that current physician behavior may be imprudent. Heparin anticoagulation continues to be standard therapy for acute PE, but newer clot-specific thrombolytic drugs may offer superior benefits with acceptable complication rates in carefully selected patients. PMID- 3278658 TI - Pericarditis. AB - Pericarditis is a common but frequently subclinical entity. There are a number of causes, including infection, systemic illness, cardiac disease, trauma, and neoplasm. Iatrogenic causes include surgery, cardiac instrumentation, irradiation, and medications. The clinical presentation varies, depending on the cause. Chest pain and dyspnea are characteristic complaints. A typical progression of ECG changes occurs during the course of acute pericarditis. These changes occasionally require differentiation from those of acute myocardial infarction or normal variant ST segment elevation. Echocardiography is the most sensitive technique for detecting the presence of pericardial effusion. In addition, a number of echocardiographic findings are characteristic of larger effusions and cardiac tamponade. Any form of pericarditis may lead to the development of cardiac tamponade. Malignant effusion is probably the most common single cause. PMID- 3278659 TI - Oxygen enrichment of bag-valve-mask units during positive-pressure ventilation: a comparison of various techniques. AB - Bag-mask devices are used frequently to provide patients with positive-pressure assisted ventilation. To increase the percentage of oxygen delivered (FDO2) from the bag, supplemental oxygen must be provided by way of an oxygen inlet nipple attached to the unit. Using ten medical volunteers and a test lung with oxygen analyzer, we studied the effect of several variables on the FDO2 and determined the most effective reservoir that would provide the highest consistent FDO2 from the ventilating port of the bag. An FDO2 of 1.00 was consistently provided by the 2.5-L bag reservoir and a demand-valve set-up attached to the reservoir port of the ventilating bag. Bag refill time significantly affected the FDO2 when no reservoir or corrugated tube reservoirs were used. Corrugated tube reservoirs were found to be more sensitive to all variations in ventilatory technique and to oxygen flow rates. From our findings we recommend that corrugated tube reservoirs not be used for oxygen supplementation, as they are sensitive to variations in ventilatory technique and cannot alert clinicians to problems with oxygen flow. While both the 2.5-L bag reservoir and demand-valve provide a consistent FDO2 of 1.00, the demand valve has the advantage of audible filling of the ventilating bag as well as being compact and independent of ventilatory technique. PMID- 3278661 TI - A technique for parallel lacerations. PMID- 3278660 TI - Toxic shock syndrome: a review. AB - TSS is a recently described acute febrile illness characterized by hypotension, rash, desquamation, and multisystemic involvement. While most common in menstruating women, TSS also occurs in men and non-menstruating women. It is now known that the disease is caused by one or more toxins produced by the S aureus organism. Treatment of TSS consists primarily of fluid resuscitation and supportive care. Anti-staphylococcal antibiotics are indicated primarily to reduce the rate of recurrence in menstrually related cases. In wound-related TSS, antibiotics are necessary to treat the primary wound infection and to prevent recurrent disease. Currently, the case fatality rate is stable at less than 3% and the major long-term complication of survivors is the risk of recurrence. PMID- 3278662 TI - Synergism between inflammatory mediators in vivo. Induction of airway hyperresponsiveness to C3a in the guinea pig. AB - The complement anaphylatoxin C3a causes acute bronchoconstriction after intravenous infusion in guinea pigs. At doses of 6 to 600 micrograms/kg, the peptide causes significant and dose-dependent increases in resistance (RL) and decreases in dynamic compliance (Cdyn). Inhibition of serum carboxypeptidase N, the enzyme thought to be responsible for control of C3a activity in blood, by pretreating animals with DL-2-mercaptomethyl-3-guanidinoethylthiopropanoic acid (MGPA), resulted in a 4-fold potentiation of the response to 200 micrograms/kg C3a. Responses to lower C3a doses were not significantly affected. Pretreating animals intravenously with histamine prior to administration of C3a resulted in potentiation of C3a-induced bronchoconstriction at all doses tested, decreasing the amount of C3a required to double RL by 15-fold, from 110 to 7 micrograms/kg. The effect appears to be relatively specific for C3a since histamine pretreatment did not alter airway responsiveness to methacholine. Similarly, pretreatment with methacholine at a dose that caused an increase in RL comparable to histamine did not alter subsequent responses to C3a. Administration of capsaicin, under conditions that elicit acute release of endogenous substance P, also resulted in potentiation of C3a responses, to an extent similar to that observed for histamine. These data are consistent with an increase in pulmonary vascular permeability facilitating accessibility of C3a for its receptor to cause bronchoconstriction before it is inactivated by serum carboxypeptidase N. Further, when C3a is generated in the presence of histamine-and/or substance-P releasing agents, it may be responsible for a greater fraction of altered pulmonary mechanics than has previously been appreciated. PMID- 3278663 TI - A longitudinal study of the occurrence of bronchial hyperresponsiveness in western red cedar workers. AB - Two hundred twenty-seven workers in a western red cedar sawmill underwent methacholine bronchoprovocation testing at least 2 times during 3 surveys over a 2-yr period. At the first survey, workers completed a respiratory and occupational questionnaire, performed spirometry, gave serum for measurement of plicatic acid-specific IgE antibodies by radioallergosorbent testing, and had skin prick tests to detect atopy. Bronchial hyperresponsiveness was present initially in 18% of the workers. Approximately 15% of those with initially no hyperresponsiveness developed hyperresponsiveness during the follow-up period; 15% of those with initial hyperresponsiveness also lost it during follow-up. Development of hyperresponsiveness tended to coincide with a decrease in level of pulmonary function, whereas loss of hyperresponsiveness was associated with improvement in pulmonary function. Workers with either persistent bronchial hyperresponsiveness or with varying responsiveness had a higher prevalence of plicatic acid IgE antibodies and lower levels of initial pulmonary function than did workers with persistent nonresponsiveness. Workers with persistent hyperresponsiveness had higher initial estimated total airborne dust exposure than did other workers. Age, duration of sawmill employment, atopy, race, and cigarette smoking did not influence the occurrence of hyperresponsiveness. Levels of plicatic-acid-specific IgE antibodies did not change substantially over the 2 yr. These results indicate that immunologic sensitivity to plicatic acid and change in airway caliber are associated with the occurrence of bronchial hyperresponsiveness in cedar workers. PMID- 3278664 TI - Mechanical ventilation after marrow transplantation. Risk factors and clinical outcome. AB - The risk factors for and the outcome of mechanical ventilatory support after marrow transplantation were analyzed in 1,089 consecutive marrow recipients. Of 232 patients receiving ventilatory support at this center, 63 (27%) survived an initial episode of ventilatory support. In contrast, 74% of nonventilated patients survived at least 6 months after transplantation. Among patients with malignant disease (n = 992), a multivariate regression model revealed 3 pretransplant factors that were associated with ventilatory support: age greater than or equal to 21 yr (RR = 1.6, 95% confidence intervals [Cl] = 1.3, 2.0), hematologic malignancy in relapse (RR = 2.1, 95% Cl = 1.7, 2.4), and HLA nonidentical donor-recipient pair (nonidentical graft) (RR = 1.7, 95% Cl = 1.4, 2.1). Survival after ventilatory support was not found to be associated with any pretransplant or post-transplant factors examined. We conclude that although the risk factors for mechanical ventilatory support after marrow transplantation can be defined, we are unable to identify characteristics predictive of survival after such support. The implications of these findings in relation to patient selection and future research activities are discussed. PMID- 3278666 TI - The propulsion of mucus by cilia. AB - The presence of cilia on epithelia of the respiratory tract was reported more than 150 yr ago, and the two-layer model of mucus transport was put forward more than 50 yr ago. However, it is only in the last 10 yr or so that the motion of mucus-propelling cilia of the mammalian respiratory system has been adequately described, and fluid dynamic studies have developed far enough to allow descriptions of the mechanisms by which ciliary movement is coupled to mucus transport. In this review, scientific developments on the study of cilia and mucus, and interactions between them, are drawn together to further understanding of mucociliary clearance mechanisms of the respiratory tract. The study of the cilia incorporates a discussion of the internal mechanics and biochemistry of the ciliary axoneme, the physical principles of the beat pattern, and the (weak) metachronal coordination of cilia in the lung. Mucus rheology plays a central role in mucociliary transport with the rheologic properties of the mucus determining the effective functioning of this clearance mechanism. Theoretical models provide information on the mechanical principles of the beat pattern as well as providing reliable estimates of the transport rates. Although airflow is not thought to contribute to mucus transport in the normal state, high frequency ventilation and coughing may make significant contributions. PMID- 3278665 TI - Role of prostacyclin and thromboxane in the circulatory changes of acute bacteremic Pseudomonas pneumonia in dogs. AB - We investigated the role of prostacyclin (PGI2) and thromboxane A2 (TxA2), as evidenced by changes in their stable metabolites, 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) and thromboxane B2 (TxB2), in the pathophysiology of acute bacteremic gram-negative pneumonia. Three groups of dogs were inoculated endotracheally: Group I (n = 5) with sterile broth, and Groups II (n = 5) and III (n = 10) with Pseudomonas aeruginosa. Gas exchange, hemodynamics, and plasma prostaglandins were measured before inoculation and hourly thereafter for 5 h in Groups I and II but only once in Group III, 5 h after inoculation. All animals were then killed, and the extent of pneumonia was assessed by lung wet weight and measurement of the percentage of cardiac output (CO) perfusing pneumonic lung using radionuclide-labeled microspheres. None of these measurements changed significantly in Group I, but all dogs in Groups II and III developed severe pneumonia. In Group II, mean arterial oxygen tension fell from 575 +/- 17 to 237 +/- 59 mm Hg (FIO2 = 1.0), with an increase in pulmonary shunt from 6 +/- 2% to 24 +/- 6%. Although TxB2 levels did not change, plasma 6-keto-PGF1 alpha rose progressively as pneumonia developed from baseline levels (less than 100 pg/ml) to a peak level of 890 +/- 114 pg/ml 5 h after inoculation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278667 TI - [Idiopathic mitral valve prolapse and prolapse leakage. Study using Doppler ultrasound in 51 cases]. AB - This study concerns 51 cases of mitral valve prolapse demonstrated on bidimensional 4 cavities sonography according to Gilbert's criteria and aims to determine the frequency of the associated valvular involvement, anatomically with sonography and functionally with the Doppler test. Sonography demonstrates a tricuspid valve prolapse in 79 p. cent of the cases and an aortic valve prolapse in 10 p. cent. The Doppler test demonstrates a tricuspid leakage in 52 p. cent of the cases, a pulmonary leakage in 62 p. cent, and an aortic leakage in 18 p. cent. The myxoid degeneration found in 60 p. cent of the cases is a major factor in the occurrence of complications, especially progressive cardiac insufficiency (A). The myxoid degeneration defines therefore the "isolated prolapse disease" as opposed to "the prolapse without myxoid degeneration" which is a pure sonographic entity and probably a variation of the normal (A). This cardiac insufficiency occurs late during the 6th or 7th decade and is due to mechanical factors: prolapse, chords rupture and annular dilatation. PMID- 3278668 TI - [Surgical treatment of arrhythmia]. AB - The surgical treatment of rhythm disorders began with interruption of the atrio ventricular conduction by surgical section of the His bundle, then of the accessory path (Kent bundle) in the Wolff-Parkinson-White syndrome. Later on, surgery was extended to the treatment of chronic ventricular tachycardias. At a time when surgery seems to be progressively replaced by ablation methods using physical agents, electric shock or radio-frequency current, applied through endoluminal probes, it seemed justified to evaluate the established surgical procedures in the treatment of rhythm disorders. Therefore, this study proposes to review the current place of these methods which, in the last few years, have been modified in order to improve the quality of the results, decrease the mortality and specify their indications. PMID- 3278669 TI - [Current role of partial interruption of the inferior vena cava. Apropos of 100 cases]. AB - In reference to a personal series of 100 partial interruptions of the inferior vena cava (74 clips, 11 Mobin-Uddin umbrellas, 15 Greenfiled's filters), the authors analyze the criteria of choice in various procedures where the mortality, morbidity and sequellae remain low. In light of these results, the current place of surgery in the prevention of pulmonary embolism is discussed, in cases where anticoagulant therapy is contraindicated, inadequate or has failed. PMID- 3278670 TI - [Functional non-invasive cardio-respiratory evaluation a month and a year after orthotopic heart transplantation]. AB - Cardio-respiratory stress tests of 14 patients, performed one month and one year after orthotopic heart transplant, are compared in order to demonstrate the functional and metabolic improvements of their adaptation to stress. At maximal stress, we note a 33 p. cent increase of the oxygen consumption (p 0.001), an 11 p. cent increase of the heart rate (p 0.025) and an 18 p. cent increase of the systolic arterial pressure (p 0.005). Respiratory quotients and respiratory equivalent for oxygen are significantly lower (p 0.008) while there was no significant variation of ventilation/minute, respiratory rate, and the normal capacity. At the sub-maximal level, the only significant differences observed are the decrease of the respiratory quotient (p 0.01), the ventilation/minute (p 0.025), the respiratory equivalent for oxygen (p 0.005) and the respiratory rate (p 0.03). The improvement of the physical condition observed in heart transplants seems related to a better peripheral adaptation to stress (lower respiratory quotients, reflection of the decreased demand on anaerobic metabolism) permitting a lesser demand on the ventilatory response to stress. PMID- 3278671 TI - Axonal transport in neurological disease. AB - The axonal transport systems have a wide variety of primary roles and secondary responses in neurological disease processes. Recent advances in understanding these roles have built on the increasingly detailed insights into the cell biology of the axon and its supporting cells. Fast transport is a microtubule based system of bidirectional movement of membranous organelles; the mechanism of translocation of these organelles involves novel proteins, including the recently described protein of fast anterograde transport, kinesin. Slow transport conveys the major cytoskeletal elements, microtubules, and neurofilaments. Several types of structural changes in diseased nerve fibers are understood in terms of underlying transport abnormalities. Altered slow transport of neurofilaments produces changes in axonal caliber (swelling or atrophy) and is involved in some types of perikaryal neurofibrillary abnormality. Secondary changes in slow axonal transport--for example, the reordered synthesis and delivery of cytoskeletal proteins after axotomy--also can produce changes in axonal caliber. Secondary demyelination can be a prominent late consequence of a sustained alteration of neurofilament transport. Impaired fast transport is found in experimental models of distal axonal degeneration (dying back). Retrograde axonal transport provides access to the central nervous system for agents such as polio virus and tetanus toxin, as well as access for known and hypothetical trophic factors. Correlative studies of axonal transport, axonal morphometry, cytoskeletal ultrastructure, and molecular biology of cytoskeletal proteins are providing extremely detailed reconstructions of the pathogenesis of experimental models of neurological disorders. A major challenge lies in the extension of these approaches to clinical studies. PMID- 3278672 TI - Cyclosporine versus azathioprine in the long-term treatment of multiple sclerosis -results of the German multicenter study. AB - In a double-blind controlled trial of 194 patients with clinically definite active multiple sclerosis, 98 were randomized to treatment with cyclosporine (CyA, 5 mg/kg/day), and 96 to treatment with azathioprine (Aza, 2.5 mg/kg/day). Eighty-five patients in the CyA group and 82 in the Aza group completed a treatment period of 24 to 32 months in accordance with the study protocol. No significant differences could be detected between the two treatment groups at the end of the trial. Assessment was done by serial quantitative neurological examinations and Kurtzke's Expanded Disability Status Scale. Frequency of relapse and patient self-evaluation also failed to show significant differences. Overall deterioration observed in both groups during the trial was only minor. The incidence of side effects in the CyA group was more than two times that in the Aza group. We conclude that CyA as a single agent cannot be the drug of final choice in long-term immunosuppressive treatment of relapsing-remitting and relapsing-progressive multiple sclerosis. PMID- 3278673 TI - Expression of immunoreactive major histocompatibility complex products in human skeletal muscles. AB - Immunoreactive class 1 and class 2 major histocompatibility complex gene products (MHCP) and beta 2 microglobulin (beta 2 MG) were demonstrated by microscopic immunocytochemistry in cryostat sections of skeletal muscle biopsies of 67 patients with various neuromuscular diseases. Diagnoses included normal muscle, chronic partial denervation, Duchenne dystrophy, polymyositis, dermatomyositis, inclusion body myositis, and miscellaneous neuromuscular diseases. Normal mature muscle fibers did not express MHCP, but blood vessels showed both class 1 and 2 MHCP and beta 2 MG. Regenerating muscle fibers showed consistent sarcolemmal class 1 MHCP expression irrespective of the disease. In polymyositis, the majority of extrafusal muscle fibers of most patients showed strong sarcolemmal class 1 MHCP expression. In dermatomyositis, muscle fibers situated either in perifascicular or in randomly clustered distribution revealed strong class 1 MHCP reactivity. In inclusion body myositis, scattered small clusters of muscle fibers were positive for class 1 MHCP. In polymyositis and inclusion body myositis, particularly strong class 1 MHCP expression was invariably seen in nonnecrotic muscle fibers partially invaded by lymphocytes whose cytotoxic effects are believed to be class 1 MHCP restricted. Factors or agents that trigger class 1 MHCP expression are presumed also to sensitize lymphocytes to muscle fibers in these diseases, but their identity remains obscure at this time. In dermatomyositis, the expression of MHCP in perifascicular muscle fibers and in areas of capillary loss may represent the triggering of MHCP expression by a nonspecific cellular stress reaction, in this case probably low-grade ischemia. PMID- 3278674 TI - Human behavior genetics. PMID- 3278675 TI - Psychophysical scaling. PMID- 3278676 TI - Addictive behaviors: etiology and treatment. PMID- 3278677 TI - Juvenile delinquency. PMID- 3278678 TI - The family and psychopathology. PMID- 3278679 TI - Systems of family treatment: substance or semantics? PMID- 3278680 TI - Perceptual development. AB - Our selective review of perceptual development has attempted to highlight three different structural levels: sensory primitives, perceptual representations, and higher-order operations. Each of these levels appears to undergo considerable development. Moreover, both within- and between-level developments appear to influence the emergence and form of perceptual abilities. The distinction between levels is often elusive, defined more by task than by logic. As a result, some distinctions seem clearer than others. First, the emergence of sensory primitives, particularly in the visual modality, may severely constrain the quality of perceptual representations. Despite these constraints, however, there is strong support for the hypothesis that distal stimulation is primary at the level of perceptual representation. Second, perceptual representations, particularly in the domain of speech sounds, appear to undergo considerable reorganization that cannot be attributed to the emergence of sensory primitives. Although some of this development in perceptual representations can be attributed to representational changes per se, much of this reorganization at the level of perceptual representations appears to be mediated by emerging cognitive operations and linguistic processes. Unfortunately, an evaluation of reorganizational factors (e.g. familiarity) that are potentially independent of higher-order cognitive and language influences is confounded by the co-occurrence of postnatal experience with the emergence of more mature cognitive and language abilities. Obviously, to disentangle the effects of experience from the effects of higher-order processes on perceptual development, it would be necessary either to eliminate these higher-order processes or to accelerate their potential influence. Controlled experiments of this sort are difficult or impossible to conduct with humans, although suitable animal models of some aspects of perceptual development may be possible. Current and future research on perceptual development appears to be directed toward three general goals. First, the ecological and psychophysical perspectives appear headed for a marriage that will enhance both the richness and the utility of these two approaches. Second, computational techniques appear to offer a new level of sophistication that should force developmentalists to sharpen their hypotheses and to make point predictions rather than simple directional predictions. Third, the search will continue for methods to assess the role of higher-order processes. PMID- 3278681 TI - Adolescent development. PMID- 3278682 TI - Interpersonal processes in close relationships. PMID- 3278683 TI - Color vision. PMID- 3278685 TI - Intracellular ethanol accumulation in Saccharomyces cerevisiae during fermentation. AB - An intracellular accumulation of ethanol in Saccharomyces cerevisiae was observed during the early stages of fermentation (3 h). However, after 12 h of fermentation, the intracellular and extracellular ethanol concentrations were similar. Increasing the osmotic pressure of the medium caused an increase in the ratio of intracellular to extracellular ethanol concentrations at 3 h of fermentation. As in the previous case, the intracellular and extracellular ethanol concentrations were similar after 12 h of fermentation. Increasing the osmotic pressure also caused a decrease in yeast cell growth and fermentation activities. However, nutrient supplementation of the medium increased the extent of growth and fermentation, resulting in complete glucose utilization, even though intracellular ethanol concentrations were unaltered. These results suggest that nutrient limitation is a major factor responsible for the decreased growth and fermentation activities observed in yeast cells at higher osmotic pressures. PMID- 3278684 TI - In situ survival of Vibrio cholerae and Escherichia coli in tropical coral reefs. AB - Vibrio cholerae and Escherichia coli were inoculated into membrane diffusion chambers and placed around two small coral reef islands in Puerto Rico and monitored for 5 days. Several chambers were also buried in the sands of one of the reefs. Both E. coli and V. cholerae densities declined by 2 orders of magnitude, as measured by direct particle counts with a Coulter Counter (Coulter Electronics, Inc., Hialeah, Fla.). However, the density of neither bacteria changed dramatically when the same samples were analyzed by epifluorescent direct counts. Differences in the two direct count methods were accounted for by changes in cell morphology that occurred in both bacteria after exposure to seawater. Morphological changes occurred more rapidly in E. coli compared with those in V. cholerae. Bacteria in chambers exposed to sediment did not show significant changes in morphology and had only a slight decline in density. Physiological activity declined by more than 40% for both bacteria within 24 h. The decline in activity was less severe in the sediments. Tropical coral reef sands and turtle grass beds were shown to be less stressful environments for V. cholerae and E. coli than would have been predicted from temperature and microcosm studies. V. cholerae can survive the in situ conditions of a tropical coral reef and could become a source of bacterial contamination for fish and shellfish in this environment. The simultaneous monitoring of E. coli levels established that this bacteria can not be used as an indicator of V. cholerae or other fecal-borne pathogens in coral reef environments because of the greater stress these environments put on E. coli. Both bacteria could be of greater public health importance in tropical marine areas than previously imagined. PMID- 3278686 TI - Enzyme immunoassay for the macrocyclic trichothecene roridin A: production, properties, and use of rabbit antibodies. AB - Antisera against roridin A were prepared by using a roridin A-hemisuccinate derivative coupled to human serum albumin as the immunogen. Antibodies could be detected in the sera of the immunized rabbits as early as 4 weeks after the initial exposure. After one booster injection at week 14, high antibody titers were measured over a period of 21 weeks. The specificity and sensitivity of the antibodies were tested by using roridin A-hemisuccinate coupled to horseradish peroxidase as an enzyme-linked toxin in a competitive assay with a double antibody solid phase. The assay was most specific for the tested macrocyclic trichothecenes, and the relative cross-reactivities with roridin A, roridin J, verrucarin A, satratoxin H, and satratoxin G were 1, 0.41, 0.15, 0.15, and 0.07, respectively. When 16 nonmacrocyclic trichothecenes were tested, only diacetylverrucarol (0.0015) and verrucarol (0.0005) showed minor cross reactivity. The sensitivity of the enzyme immunoassay for the detection of roridin A was in the range of 5 to 50 ng/ml (0.16 to 1.6 ng per assay). PMID- 3278687 TI - Nucleotide sequence of the cell wall proteinase gene of Streptococcus cremoris Wg2. AB - A 6.5-kilobase HindIII fragment that specifies the proteolytic activity of Streptococcus cremoris Wg2 was sequenced entirely. The nucleotide sequence revealed two open reading frames (ORFs), a small ORF1 with 295 codons and a large ORF2 containing 1,772 codons. For both ORFs, there was no stop codon on the HindIII fragment. A partially overlapping PstI fragment was used to locate the translation stop of the large ORF2. The entire ORF2 contained 1,902 coding triplets, followed by an apparently rho-independent terminator sequence. The inferred amino acid sequence would result in a protein of 200 kilodaltons. Both ORFs have their putative transcription and translation signals in a 345-base-pair ClaI fragment. ORF2 is preceded by a promoter region containing a 15-base-pair complementary direct repeat. Both the truncated 33- and the 200-kilodalton proteins have a signal peptide-like N-terminal amino acid sequence. The protein specified by ORF2 contained regions of extensive homology with serine proteases of the subtilisin family. Specifically, amino acid sequences involved in the formation of the active site (viz., Asp-32, His-64, and Ser-221 of the subtilisins) are well conserved in the S. cremoris Wg2 proteinase. The homologous sequences are separated by nonhomologous regions which contain several inserts, most notably a sequence of approximately 200 amino acids between the His and Ser residues of the active site. PMID- 3278688 TI - Deletion analysis of the proteinase gene of Streptococcus cremoris Wg2. AB - The Streptococcus cremoris Wg2 proteinase gene, cloned in S. lactis, specified a proteinase which exhibited the same specificity toward casein as did the proteinase isolated from the original host. Although the cloned gene lacked the last 130 codons, the proteinase still specifically degraded beta-casein. Deletion of the C-terminal 343 amino acids from the proteinase did not influence this specificity. Cell-free transcription-translation studies of plasmids carrying deletion derivatives of the proteinase gene showed that the 100-kilodalton C terminally truncated proteinase still exhibited proteolytic activity. Crossed immunoelectrophoresis revealed that proteins A and B identified in the proteolytic system of S. cremoris Wg2 are both encoded by the proteinase gene. A working model based on integration of available genetic, immunological, and biochemical data is presented to explain this result. PMID- 3278689 TI - Nucleotide sequence and expression of the Enterobacter aerogenes alpha acetolactate decarboxylase gene in brewer's yeast. AB - The nucleotide sequence of a 1.4-kilobase DNA fragment containing the alpha acetolactate decarboxylase gene of Enterobacter aerogenes was determined. The sequence contains an entire protein-coding region of 780 nucleotides which encodes an alpha-acetolactate decarboxylase of 260 amino acids. The DNA sequence coding for alpha-acetolactate decarboxylase was placed under the control of the alcohol dehydrogenase I promoter of the yeast Saccharomyces cerevisiae in a plasmid capable of autonomous replication in both S. cerevisiae and Escherichia coli. Brewer's yeast cells transformed by this plasmid showed alpha-acetolactate decarboxylase activity and were used in laboratory-scale fermentation experiments. These experiments revealed that the diacetyl concentration in wort fermented by the plasmid-containing yeast strain was significantly lower than that in wort fermented by the parental strain. These results indicated that the alpha-acetolactate decarboxylase activity produced by brewer's yeast cells degraded alpha-acetolactate and that this degradation caused a decrease in diacetyl production. PMID- 3278690 TI - Characterization of bacteriophage nucleic acids obtained from Clostridium botulinum types C and D. AB - Nontoxigenic strains of Clostridium botulinum types C and D are converted to toxigenic strains by infection with specific Tox+ bacteriophages. The nucleic acids were extracted from five converting phages, c-st, c-468, c-203, c-d6f, and d-1873, and one nonconverting phage, c-n71, and treated with nucleases. The nucleic acids isolated were not digested by RNase A, but were digested by DNase I and exonuclease III, indicating that they were double-stranded DNA. On the basis of the restriction endonuclease digestion patterns on 0.8% agarose gel electrophoresis, the length of c-st, c-n71, c-468, and c-d6f phage DNAs was estimated to be about 110 kilobase pairs and that of c-203 and d-1873 was about 150 kilobase pairs. The digestion patterns of c-st, c-468, and c-n71 phage DNAs by PstI and HindIII were very similar. High homology was observed in the dot hybridization test. For other phages and nucleases, a good similarity was not observed. Only a little similarity was observed between c-203 and c-d6f phages. The existence of the structural genes for the toxin in both c-st and c-n71 phages was confirmed by the hybridization test with these phage DNAs and the oligonucleotide probe which represented the DNA sequence predicted for the N terminal amino acids (2 to 17) of C. botulinum type C toxin. The loss of the converting ability of c-n71 phage may be caused not by the deletion of the tox+ gene but rather by the base mutation in c-st phage DNA. PMID- 3278692 TI - Dinitrochlorobenzene is inherently mutagenic in the presence of trace mutagenic contaminants. AB - 2,4-Dinitrochlorobenzene (DNCB) is used for immunotherapy of alopecia areata and verruca vulgaris. We initially postulated that the presence of mutagenic contaminants in commercially available DNCB might account for part of its mutagenicity. We have now characterized changes in the dose-mutagenic response curve of 99% DNCB modified by adding 1% concentrations of known contaminants: 1 chloro-2-nitrobenzene; 1,3-dinitrobenzene; and 2,4-dichloronitrobenzene. Dose response curves were generated using Salmonella typhimurium tester strains TA-98 and TA-100 at concentrations of 0, 1, 5, 10, 25, 50, and 100 micrograms per plate in a modified Ames assay. We observed a linear dose-response relationship with a slight, but nonsignificant, shift to the right when contaminants were added. We conclude that DNCB is itself mutagenic, and that contaminants play a minor role in its observed mutagenicity. PMID- 3278691 TI - Intracellular accumulation of AMP as a cause for the decline in rate of ethanol production by Saccharomyces cerevisiae during batch fermentation. AB - A general hypothesis is presented for the decline in the rate of ethanol production (per unit of cell protein) during batch fermentation. Inhibition of ethanol production is proposed to result from the intracellular accumulation of AMP during the transition from growth to the stationary phase. AMP acts as a competitive inhibitor of hexokinase with respect to ATP. When assayed in vitro in the presence of ATP and AMP concentrations equivalent to those within cells at different stages of fermentation, hexokinase activity declined in parallel with the in vivo decline in the rate of ethanol production. The coupling of glycolytic flux and fermentation to cell growth via degradation products of RNA may be of evolutionary advantage for Saccharomyces cerevisiae. Such a coupling would reduce the exposure of nongrowing cells to potentially harmful concentrations of waste products from metabolism and would conserve nutrients for future growth under more favorable conditions. PMID- 3278693 TI - Conditioned medium from stimulated mononuclear leucocytes potentiates the ability of human neutrophils to damage human articular cartilage. AB - Human neutrophils were able to degrade proteoglycan and inhibit its synthesis when incubated with human articular cartilage coated with heat aggregated immunoglobulin G. These effects were potentiated when culture medium conditioned by mononuclear leucocytes stimulated with killed Staphylococcus aureus was also present during the incubations. Neutrophils preincubated with this conditioned medium and washed before incubation with cartilage also showed an increased ability to degrade proteoglycan and inhibit its synthesis. The percentage of neutrophils binding to cartilage was significantly increased in the presence of this conditioned medium. PMID- 3278694 TI - Pulse steroid therapy in rheumatoid arthritis: can equivalent doses of oral prednisolone give similar clinical results to intravenous methylprednisolone? AB - Pulse methylprednisolone therapy has dramatic effects on clinical and immunological parameters of disease activity in patients with rheumatoid arthritis. Previous studies of this treatment have all used the intravenous route and methylprednisolone succinate. This study addresses the question of whether oral prednisolone in equivalent doses can substitute for intravenous methylprednisolone in pulse therapy in a double blind parallel study. It is shown that oral prednisolone has clinical and immunological effects equivalent to those of intravenous methylprednisolone, making it possible to administer pulse therapy to patients with rheumatoid arthritis as outpatients without the inconvenience and inherent dangers of intravenous administration. PMID- 3278695 TI - Synovial fluid neutrophils of patients with rheumatoid arthritis have membrane antigen changes that reflect activation. AB - The level of expression of surface antigens was studied on neutrophils from paired samples of blood and synovial fluid of patients with rheumatoid arthritis (RA). By measuring the immunofluorescence of labelled monoclonal antibodies it was shown that on joint neutrophils there was an increase in expression of complement receptor 3 (CR3) and granulocyte functional antigens 1 and 2 compared with blood neutrophils, whereas the expression of GpIIb-IIIa was reduced. The pattern of expression was the same as that seen with in vitro activation and strongly suggest that activation is occurring within the joint. PMID- 3278697 TI - Did Galen describe rheumatoid arthritis? PMID- 3278696 TI - Effect of dietary restrictions on disease activity in rheumatoid arthritis. AB - Additions in five steps were made, as a possible therapeutic measure, to the diet of 27 patients with rheumatoid arthritis (RA) after a period of two weeks of a basal isocaloric diet free from pulses, cereals, milk, and non-vegetarian protein foods. Fourteen patients finally took part in the trial, 10 (71%) of whom showed significant clinical improvement. Only three patients (11%) adhered to the diet for a period of 10 months. The others discontinued the diet and were then treated with conventional disease modifying drugs. The study indicates that dietary factors may influence inflammatory response in RA. PMID- 3278698 TI - The limitations of diagnosis of carotid occlusion by Doppler ultrasound. AB - Duplex scanning has been advocated as an acceptable alternative to angiography in the preoperative evaluation of carotid artery stenosis. To evaluate the accuracy of carotid Doppler in differentiating severe carotid stenosis from occlusion, we compared the results of angiography with duplex scanning in 124 carotid arteries (62 patients) and with continuous-wave Doppler in 662 carotid arteries (331 patients). The specificity was 95-99%, sensitivity was 86-96%, and accuracy was 95-98%. Duplex scanning wrongly identified occlusion in four arteries and failed to detect occlusion in one artery. In making decisions prior to carotid endarterectomy, even infrequent errors are unacceptable. We recommend angiography of all surgical candidates with apparent severe stenosis when the internal carotid artery cannot be clearly identified on duplex, or to distinguish apparent occlusion from undetectably low blood flow. PMID- 3278699 TI - The pathology and etiology of cocaine-induced heart disease. AB - During the last two years, reports have appeared linking cocaine use to virtually every type of heart disease. Ischemic events have been reported regularly, and there appears to be a strong relationship between cocaine use, contraction bands, and sudden arrhythmic death. The evidence concerning cocaine-induced myocarditis, cardiomyopathy, and valvular heart disease is less clear. In this article, we review the currently known morphological changes induced by cocaine and discuss the possible mechanisms of action leading to these changes. PMID- 3278700 TI - Conjugated hyperbilirubinemia and renal function in bone marrow transplant recipients. AB - Although it has long been recognized that hyperbilirubinemia is enhanced in patients with impaired renal function, a clear correlation between the levels of bilirubin and creatinine in serum has never been established. We have studied this relationship in 13 bone marrow transplant recipients who had episodes of combined conjugated hyperbilirubinemia and renal impairment. Most of the patients had graft-vs-host disease and various degrees of hepatic cholestasis as evidenced by histologic examination results and abnormal liver function tests. Serial serum specimens obtained during this period showed a good correlation between the two analytes, with a mean (+/- SD) correlation coefficient of .86 +/- .10. The slopes of the regression lines, represented as bilirubin-creatinine ratios, varied widely (0.2 to 3.6), reflecting the wide variation in the degree of hyperbilirubinemia attributable to renal impairment. PMID- 3278701 TI - Massive bone allografts in large skeletal defects after tumor surgery: a clinical and microradiographic evaluation. AB - Massive deep-frozen bone allografts were implanted in 13 patients after en bloc tumor resection. Patients were followed up for 14 months to 17 years. Most of the reconstructive procedures included a segmental bone allograft with knee or ankle fusion. Graft infections were the most critical complications in regard to the end results, finally requiring amputation in two cases. There were three stress fractures; two of which were successfully treated without further complication. Graft incorporation was assessed by bone scintimetry in four cases. Isotope uptake by the center of the graft was found to be superior to control bone segments at only 15 years after surgery. Two recovered allograft specimens were available for a microradiographic study. Creeping substitution was a very slow process, initiated at the outer surface of the graft and characterized at 2-3 years after implantation by large, incompletely filled osteons. The present investigation demonstrates that massive bone allografts are very slowly revascularized and are intimately anchored by the host bone. Provided that tumor control is effective and graft infection is avoided, reconstructive surgery with massive bone allografts represents a successful alternative to prosthetic implants in young adult with a long life expectancy. PMID- 3278702 TI - Anterior interosseous nerve palsy following closed fracture of the proximal ulna. A case report and review of the literature. AB - Complete paralysis of the anterior interosseous nerve was seen in 32-year-old army officer 5 weeks after he sustained a minimally displaced fracture of the proximal ulna. The fracture was immobilized in an arm cast. Thirteen weeks after injury, the cast was removed following evidence of bone union. Complete recovery of the flexor pollicis longus was noted 17 weeks after the injury, while recovery of the flexor profundus to the index finger to grade four lasted 10 months. To the best of our knowledge, this is the first case reported in the English language literature in which anterior interosseous nerve palsy follows isolated fracture of the proximal ulna. PMID- 3278703 TI - Melanoma arising de novo over a 16-month period. AB - Choroidal melanoma is widely regarded as a slow-growing tumor. We report herein the first documented case, to our knowledge, of a choroidal melanoma present in an eye in which examination 16 months earlier disclosed no tumor. On gross examination following enucleation, the largest tumor diameter at the base was 19 mm and the height was 11 mm. The implications as to the growth rate and the precursor lesions of choroidal melanomas are discussed. PMID- 3278705 TI - Orbital neurilemoma. PMID- 3278704 TI - Iris inflammatory cells, fibronectin, fibrinogen, and immunoglobulin in various ocular diseases. AB - Using immunohistochemical techniques, we analyzed the inflammatory cell subpopulation and the presence of fibronectin and immunoglobulin in iridectomy specimens from 50 patients with cataracts, glaucoma, and uveitis, and from ten normal eyes. The irises from patients with uveitis showed the highest numbers of T-lymphocytic infiltration compared with all other groups. Concentrations of fibronectin, fibrinogen, and immunoglobulins were significantly higher in the uveitic group compared with other diseases and normal controls. The irises from patients with glaucoma showed fewer infiltrating cells and less fibronectin and fibrinogen. Enhancement of major histocompatibility complex class II antigen HLA DR expression was observed in all disease groups compared with controls. These findings suggest that in patients with uveitis and acute glaucoma the infiltrating T lymphocytes and the presence of fibronectin, fibrinogen, and immunoglobulins may contribute to the greater risk of postsurgical inflammation, leading to such problems as closure of the iridectomy. The enhancement of HLA-DR antigen expression in the iris may indicate abnormalities of iris resident cells seen in various diseases. PMID- 3278706 TI - Implantation of posterior chamber lens in the absence of capsular and zonular support. AB - We have developed surgical techniques for implanting a posterior chamber lens in the absence of capsular and zonular support by securing both haptics of the posterior chamber lens to the sclera at the ciliary sulcus with 10-0 prolene suture. These techniques have been successfully performed and have produced good visual results in six monocularly aphakic patients who had contact lens intolerance and/or contraindications to anterior chamber lens implantations. In consideration of the high incidence and the great variety of complications associated with anterior chamber lenses, these newly developed surgical techniques will be a useful alternative to anterior chamber lenses, even in patients who do not have definite contraindications to anterior chamber lens implantations. PMID- 3278707 TI - Doctors and dependency. PMID- 3278708 TI - Autologous red blood cell reinfusion: effects on stress and fluid regulatory hormones during exercise in the heat. AB - This study assessed the effects of induced erythrocythemia on stress and fluid regulatory hormones during walking exercise in the heat. Six unacclimated male subjects received approximately 600 ml of a sterile saline solution containing 50% volume-to-volume of autologous erythrocytes. Three heat stress tests (HSTs) were attempted: one approximately 2 weeks prior to the reinfusion procedure, a second 48 h after the reinfusion procedure, and a third 1 week later, corresponding to 9 d subsequent to reinfusion. Each HST comprised three consecutive 45-min exercise and 15-min rest intervals (VO2 approximately 2.0 L.min-1, 1.56 m.s-1, 6% incline, 35 degrees C, 45% rh). Blood was withdrawn before the HST and 30 min into each exercise (EX) bout. In all three HST's plasma cortisol (PC) levels were significantly (p less than 0.01) reduced during the first EX bout compared to preexercise levels, and then progressively increased during the second and third EX intervals during HST 1. During HST 2 (48 h postinfusion), however, PC levels were significantly (p less than 0.05) reduced in two blood samples (EX 2, 3) compared to the same blood samples from HST-1 (preinfusion). Plasma renin activity (PRA) and aldosterone (ALD) were significantly (p less than 0.01) increased by the exercise/heat stress, but were unaffected by erythrocythemia either 48 h or 9 d subsequent to reinfusion. PRA and ALD were correlated (r = 0.84, p less than 0.001) under all conditions. We concluded from this study that acutely induced erythrocythemia reduced the stress response to consecutive exercise/heat intervals as manifested in PC responses during HST 2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278709 TI - Prophylactic corticosteroid suppresses endotoxemia in heat-stressed primates. AB - We previously found that lipopolysaccharides (LPS) leak from the gut lumen into the hepatic portal vein during heat stroke. Furthermore, we found that prophylactic corticosteroid administration could prevent a rise in plasma LPS concentration in superior mesenteric artery occlusion shock. In this study, we found that treatment prior to heat-stress with corticosteroids could prevent any rise in plasma LPS concentration in heat-stressed primates. Two groups of primates, one of which received a prophylactic dose of methylprednisolone sodium succinate (MPSS) (n = 4) were subjected to heat-stress (41 +/- 0.3 degrees C). Their arterial blood pressure, heart rate and rectal temperature (Tr) were continuously recorded. In the untreated control group (n = 8), the plasma LPS concentration tended to increase slowly at a Tr of 41.5 degrees C from an initial 0.06 +/- 0.013 ng.ml-1. Above a Tr of 43 degrees C, the plasma LPS level rose rapidly until at a Tr of 44.4 +/- 0.1 degrees C, the mean LPS level was 0.315 +/- 0.03 ng.ml-1 (p less than 0.001). Prophylactic treatment with MPSS suppressed the increase in plasma LPS levels to 0.066 +/- 0.01 ng.ml-1 before heat-stress and 0.03 +/- 0.01 ng.ml-1 at Tr 44.4 degrees C just before primate demise. The mean arterial pressure of the control group was lower than the treated group for any given Tr; between Tr 42-43 degrees this difference was significant (p less than 0.05). Moreover, the cardiovascular parameters began to deteriorate at a lower Tr in the control group. PMID- 3278710 TI - Effect of longitudinal physical training and water immersion on orthostatic tolerance in men. AB - To test the hypothesis that moderately intense physical training has no effect on orthostasis, orthostatic and fluid-electrolyte-endocrine responses to 60 degrees head-up tilt were compared before and after 6 h of water immersion (34.5 +/- 0.1 degrees C) up to the neck following 6 months of exercise training. During the tilt test the five male subjects (27-42 years) each wore a lower-body positive pressure suit (MAST-111A antishock trousers). The tilt procedure consisted of a 40-min supine control period (suit deflated), followed by a maximum 90-min tilt period (suit inflated to 50 +/- 5 mm Hg for 30 min, then deflated for 60 min or until presyncope). The mean +/- S.E. pretraining cycle ergometer peak VO2 was 3.20 +/- 0.14 L.min-1 (39 +/- 2 ml.min-1.kg-1), 3.36 +/- 0.27 L.min-1 (42 +/- 4 ml.min-1.kg-1) after 3 months (N.S.), and increased by 18% to 3.78 +/- 0.36 L.min 1 (48 +/- 5 ml.min-1.kg-1, +22%, p less than 0.05) posttraining. During pretraining, water immersion tilt tolerance decreased from 74 +/- 16 min before to 34 +/- 9 min (delta = 40 min, p less than 0.05) after immersion. During posttraining, water immersion tilt tolerance decreased similarly from 74 +/- 16 min preimmersion to 44 +/- 13 min (delta = 30 min, p less than 0.05) postimmersion (74 vs. 74 min, N.S.; 34 vs. 44 min, N.S.).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278711 TI - Quantitative structure-activity relationships in amphotericin B derivatives. AB - The quantitative structure-activity relationships studies of amphotericin B and its 16 semisynthetic derivatives obtained by modification at carboxyl and amino groups have been done. The results of five biological tests were subjected to principal component analysis, a numerical method useful in the investigation of large sets of data. For some compounds, also, interaction with lipidic vesicles was investigated by spectroscopic methods. The results obtained indicate that: (i) The presence of positively charged nitrogen atom (protonable or bearing fixed charge) is indispensable for biological activity and antibiotic-sterol interaction; (ii) The lack of free carboxyl group in the molecule favours the differentiation between cholesterol and ergosterol containing cells. PMID- 3278712 TI - Glutathione reductase inhibitors as potential antimalarial drugs. Effects of nitrosoureas on Plasmodium falciparum in vitro. AB - Malarial parasites are believed to be more susceptible to oxidative stress than their hosts. BCNU(1,3-bis(2-chloroethyl)-1-nitrosourea) and HeCNU(1-(2 chloroethyl)-3-(2-hydroxythyl)-1-nitrosourea), inhibitors of the antioxidant enzyme glutathione reductase, were found to prevent the growth of Plasmodium falciparum in all intraerythrocytic stages. When exposing infected red blood cells to 38 microM BCNU or 62 microM HeCNU for one life cycle of synchronously growing parasites, the parasitemia decreased by 90%. During the formation of new ring forms, the parasites are even more susceptible to these drugs. The treatment with BCNU or HeCNU produced a rapid depletion of GSH in the parasites and their host cells; in addition, protection against lipid peroxidation was impaired in these cells. Possible mechanisms for the antimalarial action of the inhibitors are discussed. Our results suggest that erythrocyte glutathione reductase, an enzyme of known structure, might be considered as a target for the design of antimalarial drugs. PMID- 3278713 TI - Glutathione reductase-deficient erythrocytes as host cells of malarial parasites. AB - BCNU [1,3-bis(2-chloroethyl)-1-nitrosourea] and its less toxic derivative HeCNU [1-(2-chloroethyl)-3-(2-hydroxyethyl)-1-nitrosourea] are clinically-used antitumour drugs. In erythrocytes BCNU is a highly specific inhibitor of the enzyme glutathione reductase [H. Frischer and T. Ahmad, J. Lab. clin. Med. 89, 1080 (1977)]. When treating erythrocytes in vitro, 50% enzyme inhibition was obtained with 1 microM BCNU or 3 microM HeCNU within 2 hr. The two drugs were used for preparing red cell populations with various levels of glutathione reductase activity; complete inhibition (greater than or equal to 98%) was only achieved when the medium contained glucose as a source of reducing equivalents. The erythrocytes were then tested in drug-free media as host cells for the malaria parasite Plasmodium falciparum. In the range of 0-300 mU/ml cells, there was a correlation between glutathione reductase activity and parasite growth; erythrocytes with an activity of less than 20 mU/ml did not serve as host cells for P. falciparum at all although these erythrocytes were viable. When the culture medium was supplemented with 20 mM glutathione (GSH), parasite growth was normal irrespective of the glutathione reductase level in the erythrocytes. This is consistent with the finding that poisoning glutathione reductase led to a 10 fold decrease of the cytosolic GSH level. Our results corroborate the concept that intraerythrocytic inhibition of glutathione reductase mimicks the biochemistry of drug-sensitive glucose-6-phosphate dehydrogenase deficiency (favism), an inherited condition which confers protection from malaria. PMID- 3278714 TI - Selective inhibition by minoxidil of prostacyclin production by cells in culture. AB - The effect of minoxidil on arachidonic acid metabolism by cells in culture was studied. In bovine aorta endothelial cells, treatment with minoxidil in the presence of various stimulators of arachidonic acid metabolism was accompanied by a dose-dependent inhibition of prostacyclin production (measured as 6-keto prostaglandin F1 alpha). Synthesis of the other cyclooxygenase products (prostaglandins E2, F2 alpha and thromboxane) was not inhibited. When the bovine aorta endothelial cells were stimulated by the Ca2+ ionophore A-23187, the inhibition was seen as early as 2 min. Minoxidil also inhibited prostacyclin production by a second cell line of bovine aorta endothelial cells (the established CPAE cell line), bovine aorta smooth muscle cells, porcine aorta endothelial cells, and rat liver cells (the C-9 cell line)--the latter, less effectively. Again, formation of all the other cyclooxygenase products studied was not inhibited. Minoxidil did not affect significantly prostaglandin E2 and F2 alpha production by newborn rat keratinocytes (the NBR cell line)--a cell that does not produce PGI2. The clinical, biochemical, and pharmacologic implications are discussed. PMID- 3278715 TI - Arthritis in idiopathic hypereosinophilic syndrome. AB - A 54-year-old man was admitted for tenosynovitis of the wrists, olecranon bursitis, stiffness, progressive flexion of the fingers, subcutaneous nodules, and persistent blood eosinophilia. A high eosinophil count was detected in his synovial fluid. We review the literature on idiopathic hypereosinophilic syndrome. This case provides evidence that nonerosive polyarthritis with periarticular involvement and nodules can be manifestations of this syndrome. PMID- 3278716 TI - Inside the National Office. Business Management Department. PMID- 3278718 TI - Creating confusion. PMID- 3278717 TI - Public school speech-language pathologists needed in Arizona, Colorado, New Mexico, and Utah. PMID- 3278719 TI - Heart transplantation in Norway. Morphological monitoring of cardiac allograft rejection. A 3-year follow-up. AB - A brief description is given of the most important morphological changes in endomyocardial biopsy specimens taken from cyclosporin A (CyA)-treated cardiac allograft recipients. The National Hospital of Norway was, in 1983, the first Scandinavian hospital to perform a heart transplantation, an event facilitated by the new immunosuppressive drug CyA. Up to now (February 1987), 38 allogeneic orthotopic transplants have been carried out on a total of 37 patients, of whom 32 are alive and clinically well. There was no operative mortality, but 5 patients died of other causes: Two early rejections, one arrhythmia due to moderate rejection, one Toxoplasma myocarditis and one early graft failure due to donor heart coronary artery disease. The observation time ranges from six weeks to 39 months. The first 9 patients received CyA and prednisolone; all subsequent recipients were treated with Azathioprine additionally. Thirty six grafts were controlled by 557 sequential biopsy procedures which yielded 2783 endomyocardial specimens for histopathological examination. A histological diagnosis of rejection was made 99 times in 32 grafts (mean 2,6). Twenty four biopsies were obtained on clinical indication in 15 patients, and rejection was diagnosed in 11 biopsies. Evaluation of endomyocardial biopsies is important in monitoring cardiac recipients and provides a morphological index of acute rejection. Serial biopsies with adequate endomyocardial sampling from different areas of the right ventricle make it possible to diagnose acute cellular rejection at an early stage and are essential to control immunosuppressive treatment. Endomyocardial biopsy is a safe and reliable procedure and plays an important role in the management of cardiac allograft rejection. PMID- 3278720 TI - DNA flow cytometric values in bladder carcinoma biopsies obtained from fresh and paraffin-embedded material. AB - DNA-histograms were obtained by flow cytometry (FCM) of nuclei prepared from fresh bladder carcinoma biopsies and from 100 micron sections of paraffin embedded material from the same biopsies. Linear regression analysis of ploidy values from fresh material versus those from paraffin blocks showed excellent correlation (R2 = 0.957). Owing to the high background, the paraffin-embedded material was less suited for analysis of S-phase fraction. It is concluded that DNA FCM of nuclei obtained from paraffin-embedded bladder carcinoma biopsies yields reliable results concerning ploidy, but does not permit evaluation of the S-phase fraction. PMID- 3278721 TI - The potential intermediate role of lysosomes in oxygen free radical pathology. Review article. AB - The term "free radical" refers to atoms or groups of atoms containing a single unpaired electron occupying an outer orbital. This unpaired electron lends the molecule distinct chemical and physical properties such as its high reactivity and magnetic moment, respectively. Some relevant advances in medical research have encompassed O2 radicals and other toxic derivatives of O2. These reactive O2 species were shown to play a significant role in a wide spectrum of pathological states (see Halliwell & Gutteridge, 1985; Flohe 1986; Kensler & Taffe, 1986; McCord, 1986), though the measurement of free radical activity in clinically accesible material has been unsatisfactory (Dormandy, 1986). This overview provides only a framework of information to assist the reader on some relevant topics on free radical pathology, which by no means can cover the multiple aspects of the medical literature in this context. The reader is referred to several articles which cover particular features of free radical biology and medicine (Chance et al., 1979; Pryor, 1976-1984; Fridovich, 1983; Jamieson et al., 1986; Kensler & Taffe, 1986; McCord, 1986; Weiss, 1986). PMID- 3278722 TI - The E. coli immunosorbent as used in serodiagnosis of Legionella infections studied by crossed immunoelectrophoresis. AB - In this study we investigated an immunosorbent, E. coli blocking fluid (BF), proposed for use in the Legionella Indirect Fluorescent Antibody Test (IFA). With crossed immunoelectrophoresis (CIE) of clinically relevant Legionella species, only one heat-stable antigen (no. 1) cross-reacted with the BF preparation. Patients' sera with elevated Legionella IFA titres did not react with this antigen in CIE. Out of 23 IFA positive patients' sera, six had titres lowered significantly to negative, when BF was applied as serum diluent for the titration (IFA BF negative sera). All six sera were negative in the micro agglutination test (MA). None of the IFA BF negative sera contained any Legionella precipitins in CIE, whereas nine out of the remaining 17 IFA BF positive sera unchanged by BF contained one or more precipitins. CIE results could not explain the effect of BF in Legionella IFA, and further studies are needed to sufficiently define the use of immunosorbents in diagnostic Legionella serology. PMID- 3278723 TI - Lipopolysaccharide as a tool to reveal autoreactive B cells. AB - It has been found in several different test systems that LPS is competent to induce autoantibodies of different specificities. As a rule only IgM autoantibodies have been found. The presence of autoreactive B cells in healthy individuals indicate that autoreactive B cells have not been not eliminated by the induction of immunological tolerance. This result is to expected according to the concept of the one non-specific signal hypothesis for B cell activation, which only ascribes a passive focussing role to the immunoglobulin receptors, whereas activation and tolerogenic signals are delivered via non-clonally distributed receptors for polyclonal B cell activators and T cell interleukins. The induction of autoantibodies by LPS in mice does not result in detectable disease or symptoms. Therefore, the ability of LPS to induce IgM autoantibodies does not constitute a model for induction of autoimmune diseases. The main importance of these findings is that the self-non-self distinction is not carried out by B cells. Presumably T cells alone are responsible for the self-non-self distinction. PMID- 3278725 TI - Badges of the dental profession. Birmingham Medical Institute Odontological Section. PMID- 3278724 TI - The foundation of the Lindsay Club. PMID- 3278726 TI - Posture and post-spinal headache. A controlled trial in 80 obstetric patients. AB - Eighty obstetric patients receiving subarachnoid anaesthesia for second and third stage procedures, excluding Caesarean section, were studied. They were randomly allocated postpartum to either 24 h bed rest or early (6 h post spinal) mobilization. Patients were followed up at 48 h post-partum and the incidence and severity of post-spinal headache noted. There was a significantly greater incidence of severe spinal headaches in the "bed-rest" group and three patients in this group required blood patch treatment for their headache. Early mobilization is, therefore, the recommended management after spinal anaesthesia for these types of obstetric procedure. PMID- 3278727 TI - Effects of altered patterns of ventilation and of increased cardiac output on blood flow to a collapsed lung in anaesthetized, closed-chest dogs. AB - Right-to-left shunt (Qs/Qt) was measured by the SF6 and oxygen methods in 13 anaesthetized closed-chest dogs intubated with a double-lumen endobronchial tube. Collapse of the left lung increased Qs/Qt from 10% to 23%, suggesting that blood flow to the left lung had been reduced by about 60%. Increasing right lung mean airway pressure by the alteration of the inspiratory:expiratory time ratio or the application of PEEP produced a small but non-significant increase in Qs/Qt with significant increases in arterial and mixed venous carbon dioxide tensions, and arterial to right lung end-tidal carbon dioxide tension difference. Fluid loading during collapse increased cardiac output and pulmonary vascular pressures, but Qs/Qt did not differ significantly from the normovolaemic collapsed state. Increasing the right mean airway pressure in this condition had no effect on Qs/Qt or carbon dioxide tensions. PMID- 3278729 TI - The Haloscale "Infanta" Wright respirometer. An in vitro and in vivo assessment. AB - The performance of the Haloscale "Infanta" respirometer has been assessed in vitro using ISO test compliances and resistances, and in vivo by comparison with pneumotachograph volumes in 13 spontaneously breathing children and 13 children during intermittent positive pressure ventilation. The Infanta was shown to be capable of registering volumes between 15 and 200 ml with an accuracy of +/- 5%. The registered volume decreased rapidly below 15 ml, whilst above 200 ml over registration developed. PMID- 3278728 TI - Monoamine oxidase inhibitors and anaesthesia. A review. AB - There has been a recent renewal of interest in the use of monoamine oxidase inhibitors in psychiatry. The concurrent administration of anaesthetic agents, particularly narcotic analgesics, is often a cause for concern. Although many monoamine oxidase inhibitor-drug interactions have been reported, in practice it is only the interaction with pethidine which has led to fatalities. What is not appreciated is that the monoamine oxidase inhibitor-pethidine interaction has two distinct forms-"excitatory" and "depressive". It is this lack of appreciation that has led to much confusion when dealing with patients taking monoamine oxidase inhibitors. PMID- 3278730 TI - Recent developments on Mediterranean G6PD. PMID- 3278731 TI - Inability to detect transferrin receptors on P. falciparum parasitized red cells. AB - The mechanism by which P. falciparum takes up iron from transferrin has been explored. Binding of 125I labelled transferrin to parasitized red cells at 37 degrees C is two-fold greater than to control cells; at 0 degrees C there is no significant difference. The binding is non-specific as judged from the following: it is not saturable; it is not limited to transferrin as lactoferrin (which has iron binding domains) and bovine serum albumin (which does not) also bind in excess to parasitized red cells. A transferrin receptor complex could not be demonstrated when parasitized red cells, to which 125I transferrin was bound, were solubilized in Triton X100. Previous observation showed that uptake of transferrin iron by parasitized red cells is not accompanied by equimolar uptake of transferrin protein. We therefore suggest that nonspecifically bound transferrin is endocytosed, that the protein is degraded and the iron selectively retained. PMID- 3278732 TI - Effects of cis-diamminedichloroplatinum (II) upon haemopoietic progenitors and the haemopoietic microenvironment in mice. AB - We studied the short- and long-term effects of a fractionated injection of cis diamminedichloroplatinum (II) (CDDP) upon the haemopoietic stroma and the haemopoietic precursor cell compartment of young and adult mice. The integrity of the stromal microenvironment was investigated using three different assays including quantification of (a) the fibroblastoid progenitor cell compartment, (b) the regenerative capacity after subcutaneous implantation of spleen and femur, and (c) the growth of normal bone marrow progenitors in lethally irradiated CDDP-treated mice. CDDP treatment induced a slight anaemia which lasted for the observation period of 1 year, and could not be restored by infusion of normal bone marrow cells. The population size of haemopoietic progenitors was severely decreased immediately after CDDP treatment and the CFU-S recovery in the bone marrow was slow and temporary. Stromal function was significantly decreased and normalization occurred within approximately 40 d, depending on the stromal parameter measured. Subsequently, the regenerative capacity of the stroma showed a second decrease which was still detected at 1 year. This pattern of stromal damage has not been reported for any other cystostatic agent. Since the other two assays did not detect a second decrement in stromal integrity it is implied that the three stromal assays used detect different stromal functions. We conclude that CDDP treatment of both young and adult mice results in severe short-term damage and a late occurring secondary regenerative defect of the haemopoietic organ stroma. PMID- 3278734 TI - Squamous cell carcinoma arising in an odontogenic keratocyst. AB - A case of squamous cell carcinoma arising in an odontogenic keratocyst is described. A review of the literature revealed only one other adequately documented case. PMID- 3278733 TI - Characterization of a monoclonal antibody ITI-Pl 1 directed against human platelet membrane glycoprotein IIb using extracts of whole platelets and platelet surface and intracellular membranes. AB - A monoclonal antibody (mAb) termed ITI-Pl 1 has been prepared by the hybridoma procedure. Using immuno-absorption and crossed immunoelectrophoresis of Triton X 100 extracts of untreated and EDTA-treated human platelets it was shown to be directed against the surface membrane glycoprotein IIb (GP IIb). This mAb binds to whole platelets independently of ADP-stimulation and the presence of Ca2+ ions. It saturates at around 870 ng/10(8) cells corresponding to approximately 35,800 molecules/platelet. ITI-Pl 1 did not significantly inhibit GP IIb-IIIa dependent functions such as platelet aggregation or fibrinogen binding. Immunofluorescence could be demonstrated using ITI-Pl 1 and intact normal platelets, but not with platelets from a Glanzmann's thrombasthenia patient. Crossed immuno-electrophoresis with platelet extracts from four different thrombasthenic patients gave a line precipitate in the intermediate gel with 125I labelled ITI-Pl 1 and autoradiography indicating trace amounts of free GP IIb or the GP IIb-IIIa complex. The epitope on GP IIb detected by ITI-Pl 1 is not destroyed by neuraminidase treatment. Thus the mAb also interacts with neuraminidase-treated GP IIb-IIIa complex in highly purified platelet surface membrane fractions as well as with GP IIb-IIIa from untreated internal membranes isolated by continuous flow electrophoresis. PMID- 3278736 TI - Somatic cell genetics and the study of cholesterol metabolism. AB - The regulation of cholesterol biosynthesis by extracellular cholesterol occurs both in whole animal tissue and in permanent somatic cell lines in culture. Permanent mammalian cells lines, under optimized growth conditions, are easily manipulated both biochemically and genetically. The Chinese hamster ovary cell line (CHO-K1) is the most widely used cell line for genetic studies. CHO-K1 is a pseudo-diploid mammalian cell exhibiting a short doubling time and a relatively high plating efficiency. Somatic cell mutants can be generated through mutagenesis and also by drug adaptation. Following mutagenesis, auxotrophs may be isolated either by selection or by screening. Most selection procedures for mutants of cholesterol metabolism must be done in serum depleted of cholesterol which requires the endogenous biosynthetic pathway to be intact. Mutants failing to produce cholesterol do not replicate their DNA and exhibit reduced concentrations of cholesterol in their membranes. BUdR and polyene antibiotics have both been used to select against the wild-type cells which incorporate these compounds and are killed, allowing the survival of the mutant cells. Both mevalonate and cholesterol auxotrophs have been isolated with the BUdR technique and have proven useful for elucidation of the early steps in cholesterol biosynthesis, particularly for the ratelimiting enzyme HMG-CoA reductase. Somatic cell fusion of a mutant and wild-type cell followed by chromosomal segregation, routinely used to map human genes, has also been used to map the human gene for HMG-CoA synthase. Such hybrids also provide valuable information on the dominance or recessivity of a specific lesion. DNA-mediated gene transfer into somatic cell mutants allows the selection of DNA sequences which complement the mutation, and is also useful for analysis of regions of regulatory significance. Mutants, resistant to the regulatory effects of oxygenated sterols, can be isolated following mutagenesis. Mutants of this type vary the lipid content of their membranes in response to cholesterol concentration in the medium. All such mutants tested exhibit a pleiotropic regulatory effect on more than one enzyme in the cholesterol biosynthetic pathway. Adaptation to drugs such as compactin and mevinolin, which inhibit HMG-CoA reductase, have been used to produce mutants which overexpress enzymes in the pathway. These amplified cells are useful sources of specific mRNAs for construction of cDNA libraries and gene isolation. Structure-function relationships of membrane sterols can be studied in cholesterol auxotrophs where changes in acyl-chain ordering can be manipulated by exogenous sterols in the medium. PMID- 3278735 TI - Nutrient composition is a poor determinant of the glycaemic response. AB - 1. The glycaemic response of healthy males to potato, bread, rice and green gram (Phaseolus aureus Roxb.) was compared with that to meals equivalent to these foods in terms of carbohydrate, protein, fat and fibre content, but made up of maize flour, casein, maize oil and ispaghula husk. 2. Natural foods led to a higher postprandial glycaemia than their respective equivalents, but the difference was significant only in the case of potato at 0.5 h (P less than 0.05). 3. The insulin response, studied only in the case of rice and green gram, followed a trend similar to the glycaemic response but the differences between natural foods and equivalents were even more marked. 4. A food is more than the sum of its major nutrients. Several poorly understood factors may contribute to the glycaemic response to a food. In addition to the quantity of nutrients, the response may be the result of the specific type of nutrients, non-nutrient chemicals and anti-nutrients composing the food, and their unique physical arrangement within the food. PMID- 3278737 TI - Epidermal amino acid transport in marine invertebrates. PMID- 3278738 TI - Structure and properties of model membranes: new knowledge from high-pressure vibrational spectroscopy. PMID- 3278739 TI - Amino acid transport in developing animal oocytes and early conceptuses. PMID- 3278740 TI - Reverse micelles as hosts for proteins and small molecules. PMID- 3278741 TI - Phagocytosis of bacteria and phospholipid degradation. PMID- 3278742 TI - Membrane glycoprotein abnormalities in pathological platelets. PMID- 3278743 TI - The transport of bile acids in liver cells. PMID- 3278744 TI - Inhibition of sterol biosynthesis in Saccharomyces cerevisiae by N,N diethylazasqualene and derivatives. AB - The ability of some azasqualene derivatives to inhibit yeast cell growth was compared with their inhibition activity on squalene-2,3-oxide cyclase (EC 5.4.99.7) both in living cells and in microsome preparations. Among the compounds tested, N,N-diethylazasqualene showed the best correlation between the activity on squalene-2,3-oxide cyclase and its inhibition of yeast growth. The N-oxide derivative, N,N-diethylazasqualene N-oxide, which was as active as the amine in microsomes, was much less active in living cells, probably because it could not easily penetrate the cell wall. Kinetic analysis of the inhibitory activity of compounds on squalene-2,3-oxide cyclase revealed a sharp difference between N,N diethylazasqualene and its N-oxide; the former showed a non-competitive-type inhibition, whereas the latter behaved as a competitive inhibitor. PMID- 3278745 TI - Cell contact induces the synthesis of a lysosomal enzyme precursor in lymphocytes and its direct transfer to fibroblasts. AB - The activity of a lysosomal enzyme, alpha-D-mannosidase (EC 3.2.1.24), increased markedly in normal lymphocytes when they were cultured together with fibroblasts from a patient with an inherited deficiency of this enzyme. Cell-to-cell contact was obligatory for this increase in activity, which also required new protein synthesis. The enzyme induced in the co-cultured lymphocytes was a high molecular weight form of alpha-D-mannosidase that was not detected in lymphocytes cultured alone, which had only the low molecular weight mature enzyme. It was this precursor form alone that was directly transferred to the mannosidosis fibroblasts, where it was present initially in organelles of low density. When the culture period was extended the lymphocyte precursor enzyme was transported to the heavy lysosomes in the recipient cells, and correctly processed to the functionally effective mature enzyme. PMID- 3278746 TI - In vitro glucose and 2-aminoisobutyric acid uptake by rat interscapular brown adipose tissue. AB - The dependence upon substrate and insulin concentrations, as well as on sodium and potassium concentrations in the medium of the uptake of glucose and 2 aminoisobutyric acid, was determined for fragments of brown and white adipose tissues incubated in vitro. Brown adipose tissue showed a high capacity for glucose uptake at high glucose concentrations, this uptake being dependent on both glucose and insulin concentration. White adipose tissue showed much more limited uptake capabilities. The presence of Na+ and K+ had little effect on the uptake. The uptake of 2-aminoisobutyric acid was similar in both adipose tissues, being enhanced by physiological levels of insulin and depressed by ouabain. This amino acid transport was dependent on Na+ and K+ concentrations, and the overall transporting capability was two to three orders of magnitude lower than that for glucose. It was concluded that amino acids could not play a significant role as bulk thermogenic substrates for brown adipose tissue, as their transporters lack the plasticity of response to high substrate and insulin concentrations which characterize brown adipose tissue uptake of glucose. PMID- 3278748 TI - Synergistic effect of granulocyte-macrophage colony-stimulating factor and 1,25 dihydroxyvitamin D3 on the differentiation of the human monocytic cell line U937. AB - The human monoblastlike cell line U937 can be induced to differentiate by a variety of agents including gamma-interferon, phorbol esters, retinoic acid, and 1,25-dihydroxyvitamin D3 (VD3). Incubation of U937 with 1 to 1,000 units of recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) did not induce macrophage differentiation. A synergistic effect on macrophage differentiation was observed, however, when U937 was cocultured with 10(-8) mol/L VD3 plus 50 U/mL GM-CSF. GM-CSF-plus VD3-treated cells demonstrated significant increases in OKM1 antigen expression, increased chemokinesis and chemotaxis, and increased Fc receptor-mediated erythrophagocytosis. Human peripheral blood monocyte cultures also demonstrated increased OKM1 antigen expression and chemotaxis when incubated with 50 to 500 U/mL of GM-CSF for 48 to 72 hours. VD3, however, was not necessary for the increases in effector function observed for GM CSF-stimulated monocyte cultures. In distinction to the synergistic effect of GM CSF on VD3-induced differentiation of U937, recombinant human granulocyte colony stimulating factor (G-CSF) at comparable concentrations had no augmenting effect over that observed for VD3 alone. These results suggest that GM-CSF, in the presence of other physiological stimuli, can induce significant phenotypic changes in GM-CSF-nonresponsive cells of the monocytic lineage and can increase the effector functions of GM-CSF-responsive peripheral blood monocyte cultures. PMID- 3278747 TI - Cytoplasmic expression of the CD3 antigen as a diagnostic marker for immature T cell malignancies. AB - The expression of cytoplasmic CD3 (CyCD3) was analyzed in 45 leukemias, five thymus cell samples, five peripheral blood (PB) samples, and ten cell lines. All T cell acute lymphoblastic leukemias (T-ALL) that did not express surface membrane CD3 (SmCD3) appeared to express CyCD3. Furthermore, the majority of SmCD3+ T-ALL also expressed CyCD3. Analogous results were obtained with thymus cell samples in that about 95% of the thymocytes expressed CyCD3 whereas 60% to 75% of the thymocytes also expressed SmCD3. In normal peripheral blood only prominent SmCD3 expression was found. These data indicate that immature T cells express CyCD3 only, that the combined expression of CyCD3 and SmCD3 is characteristic for intermediate differentiation stages, and that mature T cells express prominent SmCD3. All (precursor) B cell leukemias, acute myeloid leukemias, and non-T cell lines tested did not express CyCD3. On the basis of these data, we conclude that CyCD3 expression is restricted to the T cell lineage and can be used as a diagnostic marker for immature SmCD3- T cell malignancies. Therefore, we evaluated which fixative is optimal for CyCD3 staining, and we determined by immunofluorescence staining and Western blotting which anti-CD3 monoclonal antibody (MoAb) can be used for the detection of CyCD3. In our opinion, acid ethanol was the best fixative for the cytocentrifuge preparations. Furthermore, we demonstrated that CyCD3 can be easily detected by use of MoAbs raised against denaturated CD3 chains such as those of the SP series (SP-6, SP 10, SP-64, and SP-78). In addition we tested 22 anti-CD3 MoAbs of the Oxford CD3 panel that were raised against native SmCD3, and it appeared that only four (UCHT1, VIT-3b, G19-41 and SK7/Leu-4) of them were able to detect CyCD3. In Western blot analysis all four MoAbs recognized the CD3-epsilon chain only. PMID- 3278749 TI - Sickling-induced binding of immunoglobulin to sickle erythrocytes. AB - Previously we demonstrated that sickle erythrocytes sedimenting at high densities after gradient centrifugation contain higher levels of surface immunoglobulin bound in vivo in comparison to low-density erythrocytes from the same patient. The present study examines the possibility that binding of autologous IgG to sickle erythrocytes may be associated with the sickling phenomenon. In the present study we subjected low-density erythrocytes to prolonged sickling under nitrogen in the presence of platelet-poor autologous plasma with added glucose for 24 hours (37 degrees C). After reoxygenation IgG bound in vitro was quantified by a nonequilibrium 125iodinated protein A-binding assay and by flow cytometry. Results show that sickle erythrocytes incubated under nitrogen bound significantly (P less than .001) more IgG, 439 +/- 41, molecules of IgG per cell (mean +/- SD) compared with sickle cells incubated under oxygenation (227 +/- 12 molecules of IgG per red cell) or compared with 196 +/- 26 molecules IgG per cell for untreated sickle cells. In contrast, normal erythrocytes incubated in autologous plasma exhibited no detectable IgG binding in vitro under either oxygenation or deoxygenation. Flow cytometry shows that deoxygenation of sickle cells generated a two-to-sixfold increase in the subpopulation of brightly fluorescent IgG-positive cells in comparison to oxygenated sickle cells and a 13.5% +/- 3.1% (mean +/- SD) increase in median fluorescence intensity for fluorescein isothiocyanate-labeled deoxygenated sickled cells compared with labeled oxygenated sickle cells. Our studies demonstrate that prolonged sickling will induce in vitro binding of autologous IgG to sickle erythrocytes. These findings indicate that sickle erythrocytes may be unique when compared with erythrocytes from other nonimmunologic hemolytic anemias or senescent red cells in that the primary events producing surface antigens recognized by autoantibody may include the sickling process. These findings also suggest that sickling in vivo may generate membrane alterations in sickle erythrocytes that lead to cumulative binding of autoantibody in vivo. PMID- 3278750 TI - Enhancement of neutrophil function by granulocyte-macrophage colony-stimulating factor involves recruitment of a less responsive subpopulation. AB - Human granulocyte-macrophage colony-stimulating factor (GM-CSF) enhances numerous functions of mature neutrophils (PMN) including phagocytosis, superoxide responses to chemotaxins, antibody-dependent cellular cytotoxicity, and expression of complement receptors. A central question concerns whether the mechanism of enhancement involves quantitative increases in the response of all cells v subpopulation recruitment. The effects of GM-CSF on individual cell light scatter changes, membrane potential, and oxidant responses induced by the chemoattractant N-formyl-methionyl-leucyl-phenylalanine (FMLP) were assessed by flow cytometry and by scoring individual cells for nitroblue tetrazolium dye (NBT) reduction. GM-CSF produced a dose- and time-dependent shift in forward light scatter that was very similar in character to that seen with FMLP or leukotriene B4 stimulation. Although not capable of depolarizing the cells directly, GM-CSF primed PMNs for enhanced membrane potential responses to FMLP by significantly increasing the proportion of depolarizing cells when compared with diluent-treated controls after a 60-minute incubation at 37 degrees C (79.4% +/- 3.4% v 29.5% +/- 4.7% GM-CSF v diluent, mean +/- SE, P less than .005, n = 11). Subpopulation recruitment by GM-CSF treatment was also demonstrated by the FMLP elicited NBT test. Taken together, these results indicate that GM-CSF can modulate the function of mature PMN by enhancing the proportion of responsive cells. PMID- 3278751 TI - Syngeneic leukocytes together with suramin failed to improve immunodeficiency in a case of transfusion-associated AIDS after syngeneic bone marrow transplantation. AB - A 22-year-old man who underwent syngeneic bone marrow transplantation (BMT) for acute lymphoblastic leukemia acquired a human immunodeficiency virus (HIV) infection by transfusion of blood products from a donor at risk. The manifestations were acute encephalopathy together with immune thrombocytopenia in the early posttransplant period, and acquired immunodeficiency syndrome (AIDS) developed 20 months after BMT. Because he had a syngeneic donor, the possibility of reconstituting the immune system was investigated by repeated transfer of healthy syngeneic lymphocytes and by combining repeated transfer of syngeneic lymphocytes with the antiviral agent suramin to protect the infused leukocytes from being attacked by HIV. No improvement was observed clinically or in the patient's immune functions by these efforts. PMID- 3278752 TI - Human granulocyte-monocyte colony-stimulating factor and interleukin 3 stimulate monocyte cytotoxicity through a tumor necrosis factor-dependent mechanism. AB - Human colony-stimulating factors (CSF) exert multiple effects on the proliferation, differentiation, and function of myeloid lineage cells. In this study, the effects of three recombinant human CSFs (granulocyte-monocyte CSF [GM CSF], interleukin 3 [IL-3], and granulocyte CSF [G-CSF]) on antibody-independent monocyte tumoricidal activity were investigated by using WEHI 164 fibrosarcoma cells as monocyte-sensitive targets. None of the CSFs directly induced monocyte cytotoxicity, although both GM-CSF and IL-3 were found to significantly enhance monocyte killing in response to a second stimulatory event (endotoxin). No effect was seen with G-CSF. Antitumor necrosis factor antibody completely abolished CSF enhanced monocyte cytotoxicity, which suggests that this effect was mediated through increased release of tumor necrosis factor (TNF). As previously shown for GM-CSF, IL-3 was found to induce cytoplasmic accumulation of TNF messenger RNA (mRNA) after 18 hours of exposure. These results suggest that GM-CSF and IL-3 may stimulate monocyte killing indirectly by enhancing expression of TNF mRNA, thereby leading to augmented TNF protein secretion in response to a second activation signal. PMID- 3278753 TI - Production of granulocyte-macrophage colony-stimulating factor by primary cultures of unstimulated rat microvascular endothelial cells. AB - Small vessel (microvascular) endothelial cells are in close contact with hematopoietic progenitor cells in the bone marrow and therefore may have an important role in hematopoiesis. Although other studies have shown that endothelial cells produce various colony-stimulating factors (CSFs), these studies examined large vessel endothelial cells, which are different in many respects from microvascular endothelial cells and which do not contact cells in the bone marrow. We show in this study that primary cultures of unstimulated rat fat capillary endothelial cells grown in serum-free medium produce a substantial amount of granulocyte-macrophage CSF (GM-CSF). The medium conditioned by these cells stimulated proliferation of two different lines of GM-CSF-responsive cells- PT-18 mast cells and FDC-P1 cells--and supported the growth of cells of the granulocyte and macrophage lines in cultures of rat bone marrow cells. The factor responsible for this activity had physical properties consistent with those of GM CSF, namely, a similar apparent mol wt by gel filtration, resistance to repeated freeze-thaws, resistance to boiling for ten minutes but not for 30 minutes, and resistance to heating to 56 degrees C for one hour. The factor causing target cell stimulation was not B cell-stimulating factor-1 (BSF-1, or IL 4), since it failed to stimulate a BSF-1-responsive cell line HT2-JH, and target cells (PT-18) did not respond appreciably to recombinant BSF-1. Northern blot analysis of mRNA from rat fat capillary endothelial cells showed high levels of expression of GM CSF, confirming that this factor is produced by microvascular endothelial cells. This is the first report of CSF production by unstimulated microvascular endothelial cells, demonstrating that these ubiquitous cells are capable of producing sizable amounts of at least one growth factor for hematopoietic progenitor cells. PMID- 3278754 TI - Randomized study of 13-cis retinoic acid v placebo in the myelodysplastic disorders. AB - A double-blind, placebo-controlled randomized trial of 13-cis retinoic acid was performed to determine if the drug has a therapeutic effect in patients with myelodysplastic syndromes (MDS). Sixty-eight evaluable patients with MDS were randomized to receive a single, daily oral dose of either 13-cis retinoic acid (13-CRA, 100 mg/m2) or matching placebo. Treatment was continued, when possible, for a period of 6 months. Determination of response to treatment was based on clinical course, repeat bone marrow biopsies, and aspirates and blood counts (CBC) with WBC differential, platelet, and reticulocyte numbers at specified intervals. No significant difference was noted between the two treatment groups in response to test drug (P = .66). One patient (3%) in the 13-CRA group and two patients (6%) in the placebo group had a minor response. Approximately 30% of patients in both groups had progression of their disease, and progression-free survival was nearly identical. Greater than 90% of the patients receiving 13-CRA developed mild or moderate skin toxicity that was reversible with decreasing or discontinuing the drug. Our study did not find that 13-CRA exerts a beneficial therapeutic effect in patients with MDS. PMID- 3278755 TI - Canine model for gene therapy: inefficient gene expression in dogs reconstituted with autologous marrow infected with retroviral vectors. AB - Successful retroviral gene transfer into murine hematopoietic stem cells indicates the potential for somatic gene therapy in the treatment of certain human hereditary diseases. We developed a canine model to test the applicability of these techniques to a preclinical model of human marrow transplantation. Previously we reported that canine CFU-GM could be infected with retroviral vectors carrying either the gene for a mutant dihydrofolate reductase (DHFR) or neomycin phosphotransferase (NEO). This study reports six lethally irradiated dogs transplanted with autologous marrow cocultivated with retroviral vector producing cells. This procedure conferred drug resistance to 3% to 13% of the CFU GM. Three dogs infected with either the NEO or DHFR virus engrafted, but we detected no drug-resistant CFU-GM. Three dogs were given marrow infected with a DHFR virus and received methotrexate (MTX) as in vivo selection; all three had evidence of engraftment. In the surviving dog, we detected 0.03% to 0.1% MTX resistant CFU-GM at 3 to 5 weeks posttransplant during in vivo selection. These results indicate that we can reconstitute lethally irradiated dogs with autologous marrow exposed to retroviral vectors and suggest that gene transfer into hematopoietic cells is feasible on a large scale. However, the low-level transient gene expression indicates that considerable obstacles remain before human gene therapy can be considered. PMID- 3278756 TI - Fractionation of subsets of BFU-E from normal human bone marrow: responsiveness to erythropoietin, human placental-conditioned medium, or granulocyte-macrophage colony-stimulating factor. AB - Normal human bone marrow mononuclear cells were fractionated by differential adherence, immunomagnetic separation, and fluorescence-activated cell sorting (FACS). The resultant fractionated cells were cultured in semisolid medium to monitor the presence of BFU-E, Mix-CFC, and nonerythroid CFC. Two populations of cells were recovered on the basis of binding by the monoclonal antibody (MoAb) RFB-1. One of these populations contained BFU-E that were stimulated only by erythropoietin (Epo), whereas the second population contained BFU-E responsive to Epo, Epo and recombinant human granulocyte-macrophage colony-stimulating factor (rHGM-CSF), or Epo and human placental-conditioned medium (HPCM). Prior enrichment of clonogenic cells by removal of adherent and Leu-M3+ve, Leu-4+ve, Leu-7+ve, B1+ve, WEMG1+ve, and Glycophorin A+ve cells, followed by FACS fractionation on the basis of RFB-1 binding, consistently resulted in recoveries of BFU-E, Mix-CFC, and nonerythroid CFC of greater than 100% (up to 800%). These procedures also resulted in enrichment of up to 200-fold and frequencies of 1:6 for BFU-E, 1:5 for CFC, and 1:130 for Mix-CFC. PMID- 3278757 TI - Successful transplantation of Friend virus-induced preleukemia into stem cell deficient fetal mice. AB - The leukemias induced by the Friend polycythemia virus and other leukemogenic retroviruses have previously not been transplantable until weeks or months after virus inoculation. Because tumor-specific immune mechanisms persist in both irradiated and nude mice, it has not been possible to determine if this result is due to rejection of cells already immortalized by retrovirus infection, or reflects an inherent limitation in the proliferative capacity and malignancy of these "preleukemic" cells. To clarify these issues, we have transplanted virus infected bone marrow into mouse fetuses that are immunologically immature and thus incapable of graft rejection. We report here that within days of virus inoculation, transplantable cells capable of disease progression in certain fetal hosts can be detected with this technique. These results demonstrate that cells with the capacity for extensive leukemic proliferation arise very early in Friend virus-induced disease. However, successful transplantation was seen only in genetically anemic recipients (Wx/Wv), which are deficient in hematopoietic stem cells, and not in their normal littermates. Thus, in accord with recent in vitro observations, this in vivo data suggests that normal hematopoietic cells, independent of immune mechanisms, can suppress the malignant progression of transformed cells. PMID- 3278758 TI - Biochemical and histological effects of diclofop-methyl in mice and voles under laboratory conditions. PMID- 3278759 TI - Comparison of antibiotic production from four ecotypes of the marine alga, Dunaliella. PMID- 3278760 TI - Dose-response studies using ethylene dibromide (EDB) in Hydra oligactis. PMID- 3278761 TI - The movies and the wettening of American: the media as amplifiers of cultural change. PMID- 3278763 TI - Conversation with Mustapha Soueif. PMID- 3278762 TI - Drinking sensibly. Defining the historical context. PMID- 3278764 TI - A double-blind, cross-over trial of O-(beta-hydroxyethyl)-rutosides (benzo pyrones) in the treatment of lymphoedema of the arms and legs. AB - A randomised, double-blind, cross-over trial was performed on 26 patients with postmastectomy lymphoedema of the arm, and 14 with lymphoedema of the leg. For 6 months, patients took 0-(beta-hydroxyethyl)-rutosides (oxerutin; "Paroven", "Venoruton", Zyma) in doses of 3 g/day, or the placebos; then they took the reverse. Measurements (volume, circumferences, tonometry and skin temperature) were made monthly. The active drug reduced the volumes of the limbs (p less than 0.05 to 0.01) and their circumferences (p less than 0.05 to 0.001). It increased the softness of the limbs, as shown by the increases in the tonometry values (p less than 0.01 to 0.001). There was a lowering of the elevated skin temperatures (p less than 0.05 to 0.001). Patients reported increased comfort and freedom of movement, a lessening of their bursting pains, heaviness and tension (p less than 0.05 to 0.01), and an increased mobility of their limbs (p less than 0.0001). Most patients (70%) preferred the active drug (p less than 0.0001). An increase in general well-being was reported by 97% of patients when taking the active drug compared with 4% for placebo (p less than 0.0001). PMID- 3278765 TI - The bolus tie-over "pressure" dressing in the management of full thickness skin grafts. Is it necessary? AB - It has been taught that the bolus tie-over "pressure" dressing is essential for the successful "take" of full thickness skin grafts. This was tested in a prospective randomised trial in which 40 full thickness grafts were either managed with the conventional bolus dressing, or alternatively with quilting sutures and no dressing. Whether under local or general anaesthesia there was only one total graft failure from haematoma (tie-over bolus group) and one partial graft failure from haematoma (quilted group). Sixty-five per cent. of all grafts were performed by junior surgical trainees. The bolus tie-over "pressure" dressing does not appear essential for full thickness skin graft survival in the areas of the head and neck studied. PMID- 3278766 TI - Three great guys (Sir Astley Paston Cooper, Thomas Bryant, Thomas Graham Humby). PMID- 3278767 TI - The history, antecedents and progress of the Mount Vernon Centre for Plastic Surgery and Jaw Injuries, Northwood, Middlesex 1939-1983. PMID- 3278768 TI - Improved suture tying technique in microsurgery. AB - A technique is presented that maintains control of the short suture end in microsurgical suture tying. This technique significantly shortens the time taken to tie a microsurgical knot. It reduces the number of manoeuvres required to complete the knot and by maintaining control of the short suture end, prevents adherence to soft tissue. PMID- 3278769 TI - The aesthetic surgeon, BAAPS, and the case of Serge Lifar. PMID- 3278770 TI - The medical implications of canine obesity and their relevance to anaesthesia. PMID- 3278772 TI - Electrical and metabolic activity of suprachiasmatic nucleus neurons in hamster hypothalamic slices. AB - Single unit neuronal activity and glucose utilization were studied in the suprachiasmatic nucleus (SCN) in hypothalamic slices from the golden hamster brain in vitro. An apparent circadian rhythm was observed both in SCN single unit activity and in glucose utilization. These observations indicate that the brain slice method is useful for the analysis of pacemaker function in hamster SCN. PMID- 3278771 TI - Some nutritional implications of leg problems with poultry. PMID- 3278773 TI - Impaction of the first permanent molar. Two case reports. PMID- 3278775 TI - Understanding computer hardware. PMID- 3278774 TI - Treatment of the edentulous maxillary arch using osseointegrated implants supporting a fixed-removable prosthesis. PMID- 3278776 TI - Dental management system software. PMID- 3278777 TI - Lymphocytic adenohypophysitis. AB - Lymphocytic adenohypophysitis (LAH) is an uncommon disorder in the spectrum of pituitary disease. Twenty-three cases proven by biopsy or at autopsy have been reported since 1962. We report 2 further cases and review the etiology, immunology and pathology of the disease. The diagnosis should be considered in a female patient who presents during the post-partum period with the clinical picture of a non-functional or prolactin cell pituitary adenoma and evidence of hypopituitarism. PMID- 3278778 TI - Harrington rod instrumentation: a cause of Brown-Sequard syndrome. AB - We describe a child with Brown-Sequard syndrome beginning at C8-T1, immediately following Harrington rod instrumentation for idiopathic scoliosis. We believe this is most likely related to either a common variation of the branches of the anterior spinal artery to one side or due to rupture of the ipsilateral spinal vein. This possible complication should be considered in patients undergoing Harrington rod instrumentation. PMID- 3278780 TI - Current status of artificial vision by electrocortical stimulation. AB - The history of the provision of artificial vision by electrocortical stimulation has its origin in observations over 50 years ago. However, the realistic modern stimulation of human visual cortex is only 20-years-old. No useful device has been devised as yet and it therefore remains purely experimental. The primary objective of such a prosthetic device is that of independent mobility. This would require the appreciation of half-tone pictures, the detection of depth and discontinuities in outlines, and a significant quality of resolution. Some of the problems which threaten resolution in such a device and the factors which must be overcome in order to achieve a useful visual prosthesis are discussed. PMID- 3278779 TI - Deafferentation pain in man and animals as it relates to the DREZ operation. PMID- 3278781 TI - Management of chronic ventilatory insufficiency with electrical diaphragm pacing. AB - We have had experience with diaphragm pacing in 24 patients at the Toronto Western Hospital. Fourteen patients have undergone bilateral implants to treat chronic ventilatory insufficiency (CVI) caused by traumatic tetraplegia at the C1/2 level (eight patients), neurogenic apnea (five) and one case of neonatal apnea. Unilateral stimulators for nocturnal pacing have been implanted in five patients with central alveolar hypoventilation (sleep apnea) and five patients who suffered CVI resulting from various etiologies. Of the patients who were ventilatory dependent, 80% were successfully weaned and in the entire series, 58% of the patients are living. Diaphragm pacing was successful in 67%, partially successful in 8% and ineffective in 25%. The major complications were: death by pneumonia, failure of the radio receivers, and infection. Diaphragm pacing is the treatment of choice for patients who are ventilator dependent and tetraplegic from upper cervical trauma or in some cases of neurogenic apnea; it may be life saving for patients who suffer central alveolar hypoventilation. PMID- 3278782 TI - Should nonionic radiographic contrast media be given to all patients? PMID- 3278783 TI - Chronic obstructive pulmonary disease. AB - Outpatient management of chronic obstructive pulmonary disease (COPD) is reviewed in this paper. Smoking cessation is probably important, although its benefit in established COPD is unproven. Bronchodilator therapy may be of more than symptomatic benefit and is indicated in virtually all patients. Specific beta 2 agonists are the most widely used agents and can be given in substantially larger doses than are usually recommended. Ipratropium bromide, an anticholinergic drug, is about as effective as a beta 2-agonist, but in large doses the two drugs do not seem to have additive effects, unlike theophylline and beta 2-agonists. Systemic corticosteroids decrease airway obstruction substantially in a small number of patients with COPD; these agents should be reserved for these patients and used sparingly. Inhaled steroids are of little benefit, as are respiratory stimulants and depressants. Broad-spectrum antibiotic therapy helps to relieve symptomatic exacerbations of COPD, particularly those characterized by increased dyspnea, sputum volume and sputum purulence. Cor pulmonale is best managed by diuretics and oxygen, with digoxin reserved for left ventricular failure and supraventricular arrhythmias. Continuous oxygen therapy at home is indicated for the patients who have chronic arterial hypoxemia. PMID- 3278784 TI - Loxoscelism in Canada. PMID- 3278785 TI - Approach to the management of coronary artery disease in the elderly. AB - Atherosclerotic coronary artery disease is an important problem in the elderly and is the leading cause of death. It is a diagnosis that is often difficult to make; signs and symptoms of angina pectoris and myocardial infarction can be atypical in the elderly patient for a variety of reasons. The chest radiograph, electrocardiogram, and echocardiogram can provide diagnostic clues as to the presence of coronary artery disease. Exercise testing is foremost among the noninvasive diagnostic modalities, but it has significant limitations particular to the elderly patient. These include a decreased ability to exercise in the elderly, difficulty in interpretation because of an abnormal resting electrocardiogram, and the nature of an imperfect test that provides a statement of probability rather than an unequivocal diagnosis. Cardiac catheterization can be performed with minimal risk in selected, particularly unstable patients, in whom a surgical alternative is contemplated. The elderly patient can benefit as much from coronary artery bypass graft surgery as younger counterparts, albeit with a modestly increased risk. The medical therapy of coronary artery disease, stable and unstable angina, and myocardial infarction is not substantially different in the older patient. Nitrates, beta blockers, and calcium antagonists provide relief of anginal symptoms. The older patient stands to derive the same benefits from CCU monitoring as does the younger patient. An increased awareness of adverse drug reactions is necessary, however, and as for patients of any age, the particular goals of therapy may differ substantially and require an individualized approach. PMID- 3278786 TI - Pharmacodynamic basis for altered drug action in the elderly. AB - The elderly have the highest incidence of medical and psychiatric disorders. These conditions frequently occur simultaneously and are often chronic, lasting the lifetime of the individual. Consequently, the elderly require more medications than do younger patients. Consumption of over-the-counter drugs is considerable among the aged. There is considerable evidence that the elderly patient in most cases responds differently to drugs than do young adults. Many factors contribute to these differences. Among them are reduced protein binding, reduced biotransformation, diminished renal elimination, changes in receptor density or affinity, or both, diminished receptor adaptability, changes in the coupling between receptors and effector systems, impairment of responding organs resulting from the pathologic state, reduction in the reactivity of homeostatic mechanisms, and the aging process itself. These components may have different weight, depending on the drug and the individual considered. Because of the physiologic age-related changes in the distribution and elimination of drugs and in the sensitivity to medications, adverse side effects develop frequently in the elderly. Accordingly, dosages and dosage intervals must be adjusted carefully. In addition, since the elderly often take multiple medications, they frequently experience ADRs. Psychotropic drugs are often involved in such interactions and cause twice the incidence of side effects in elderly patients as they do in younger patients. Drug-nutrient and drug-drug interactions, programs to enhance patient compliance, and sociogenic factors should be taken into account in any well-designed dose regimen for the elderly. Physician awareness of problems that exist in the elderly population's use of drugs is essential if rational drug therapy for the aged is to evolve. The proper use of drugs in the elderly largely depends on taking into account both the pharmacokinetic and the pharmacodynamic properties of the drug and how these parameters are altered with age; such information can be obtained only by investigating drug action in older people. PMID- 3278787 TI - The physician's role with the terminally ill patient. AB - The physician encounters many issues and problems when working with the terminally ill. It is important to remember that the most important aspect of care for the dying is to maintain open and honest communication among the doctor, the patient, and the family. In brief, the physician should play a major role in helping the dying patient. Open communication and support must be continually provided by the physician, both to the dying patient and to the family. All it takes, basically, is common sense and human compassion. No matter how often the physician treats dying patients, he or she should never be casual or matter-of fact about death. Death should always command respect and awe, but it need never terrorize us or cause us to turn away from providing help to the dying patient. Those who care for the terminally ill may find, to their surprise, that great satisfaction can be derived from this work. One becomes enriched by observing the courage of many dying patients. Therein lies the challenge and the reward. PMID- 3278788 TI - Thyroid function in the elderly. AB - Many differences in thyroid function exist between elderly and younger populations. Although serum T4 levels probably do not change with age, serum T3 levels appear to decline. Hyperthyroidism in the geriatric population may be atypical and is characterized by anorexia and constipation. The pulse rate is often slower than in younger patients. Apathetic hyperthyroidism mainly occurs in older patients. The cause of hyperthyroidism is usually toxic multinodular goiter. Isolated T3 or T4 elevations may be seen. RAIU is often normal. Hypothyroidism is common in the elderly. TSH is a reliable indicator, but the significance of mild elevations (less than 20 microU/ml) is unclear. Serum antithyroid antibodies are unreliable in the definitive diagnosis of hypothyroidism. Acute and chronic illnesses occur frequently in older patients and have varied and important effects on thyroid function tests. Low T3 and both low T4 and low T3 are seen. High T4 syndrome may be more common in older patients than in younger patients. It is also seen in psychiatric populations. TSH levels are usually normal but may be mildly elevated. PMID- 3278789 TI - What is a complete work-up for dementia? AB - As the elderly population grows proportionately larger, the clinician may anticipate seeing more hapless souls present with intellectual decline. It should be remembered that not all of these individuals in fact demonstrate dementia and that not all the cases of dementia are irreversible. Through a detailed history, neurologic examination, and the use of appropriate studies, the clinician may be able to establish the diagnosis, offer a prognosis, and exclude those diseases that are potentially remediable. PMID- 3278790 TI - Benefits of exercise in old age. AB - Although exercise capacity declines with age, the decline appears to be slight when measured in healthy, physically active subjects. There is growing evidence that exercise has a positive influence on increasing healthy function and decreasing the impact of diseases common in the elderly. While the dose-response relationship between physical activity and health benefits continues to be studied, there is some evidence that even low- and moderate-intensity exercise programs in older people result in tangible improvements in many physical and psychologic parameters. PMID- 3278791 TI - Dietary guidance for the elderly. AB - General recommendations about nutritional adequacy and diets for health promotion must be adapted to the individual needs of elderly patients. Medical and nutritional status, food practices, and social and economic factors must be considered in providing nutritional care. PMID- 3278792 TI - Use of antidepressants in the frail elderly. When, why, and how. AB - Sir Martin Roth has stated, "where there is depression, there is hope," to emphasize the fact that depression can be a treatable source of excess disability, even when it is superimposed upon irreversible chronic medical illness. Both the potential benefits and the risks of antidepressant medications are increased in the frail elderly. This article presents an approach toward defining who should be treated and for ensuring that elderly patients receive adequate treatment. PMID- 3278793 TI - Appropriate prevention and detection of gastrointestinal neoplasms in the elderly. AB - The incidence of colorectal carcinoma and gastric cancer is related to environmental factors and lifestyle. Long-term exposure to multiple mutagens is believed to initiate the carcinogenesis of colorectal and gastric cancer. Even though patients older than 65 years of age have developed particular modes of cooking and dietary preferences, these habits can be changed with instruction, patient-doctor rapport, and suggestions of alternative foodstuffs that are palatable to them. Elderly patients can be persuaded to avoid fatty foods; smoked, pickled, and salted fish; and red meat. They should be encouraged to eat chicken, fish, fresh fruit, and vegetables (especially cruciferous vegetables), to ingest vitamin C, and to avoid overcooking, frying, and excessive broiling of meat and fish. Surveillance examinations must be practiced in the elderly to avoid malignant conversion of adenomatous polyps. All patients who have undergone gastric resections for peptic ulcer disease need to be watched carefully, with identification of high-risk individuals who must undergo periodic endoscopy. PMID- 3278794 TI - Approach to mild anemia in the elderly. AB - There is evidence that indicates a physiologic decrease in bone marrow function as a part of aging, perhaps as an adjustment to a decrease in metabolic demand and tissue requirement for oxygen. In general, aging is associated with a decline in activity and an increase in chronic inflammatory as well as cardiovascular disorders. These alter not only red blood cell production but also plasma volume, leading to an increased frequency of a lower hemoglobin concentration and hematocrit level. However, there is resistance to using new geriatric norms for these hematologic parameters to define anemia, since the majority of patients without disease fall within the usual established ranges. Yet surveys have shown that there is no increase in iron deficiency with age, and the majority of elderly patients with mild anemia show no demonstrable cause and are unresponsive to therapy. The statement that anemia is often a presenting sign of a serious underlying illness and that patients with anemia must undergo a complete work-up should be reconsidered in the elderly, and the criteria for anemia should be redefined to prevent unnecessary studies for individuals who fall in the lower limits of normalcy because of age. This statement is supported by the results of long-term follow-up of patients in a geriatric care institution. A group of patients with mild anemia, without any apparent cause, who were often not examined thoroughly because of the relative mildness of symptoms and lack of progression, lived a satisfactory life and seem to be well adjusted to low hemoglobin levels. Asymptomatic elderly patients with mild anemia may not be anemic if we adjust the expected levels for the elderly. We can save 95 per cent of these patients from undergoing unnecessary testing. PMID- 3278795 TI - Asymptomatic bacteriuria in the elderly. AB - Bacteriuria in the elderly is common and usually asymptomatic. In the absence of symptoms or obstructive uropathy (which is rare in women), bacteriuria in the elderly appears to be a benign disease, and therefore antimicrobial therapy is probably not warranted. PMID- 3278796 TI - What is normal sleep in the elderly? AB - Changes in the sleep and daytime alertness of the elderly are common and are secondary to a variety of causes. These changes cannot be attributed solely to the aging process. The role of occult sleep disorders in producing these changes in significant, and severe sleep disruption in the healthy elderly is almost always secondary to a sleep disorder such as sleep apnea. A number of precautions must be kept in mind when interpreting studies of sleep in the elderly. PMID- 3278797 TI - Diagnosis and treatment of cardiac rhythm disorders in the elderly. AB - The elderly patient is susceptible to a variety of cardiac rhythm disturbances that may or may not cause symptoms. It is incumbent on the physician who cares for geriatric patients to have a familiarity with the diagnostic criteria for each of these arrhythmias and with the drugs and devices that are used to treat them. This includes the potential adverse effects of therapy and methods to counter them. Even more important is a sense of when to intervene, which is based, in large measure, on a knowledge of "normal variation" in the aged. PMID- 3278799 TI - Systemic polyclonal immunoblastic proliferations. AB - This report describes the clinical and pathologic features of four patients with a florid, systemic immunoblastic proliferation. The blood of these patients exhibited a mild to marked leukocytosis with a high percentage of immunoblasts and plasma cells. The bone marrow also was infiltrated extensively by immunoblasts. Lymph node biopsy specimens from two patients showed near total effacement of the nodal architecture by a diffuse infiltration of immunoblasts and plasma cells. The proliferative process was determined to be polyclonal with immunohistochemical techniques. Cytogenetic studies of bone marrow from two patients showed a pseudodiploid abnormal clone, with a translocation involving a break in band 14q32 in each case. The pathogenesis of these proliferative disorders in unclear, although three patients had some evidence of an acute immune disorder. One of these patients was treated with steroids, vincristine, and cyclophosphamide. Another patient was treated with steroids only, and one patient was treated with steroids and cyclophosphamide. All had rapid regression of the disease process. Two patients are alive and apparently free of disease 31 and 48 months after diagnosis. One died of sepsis. The fourth patient had acquired immune deficiency syndrome (AIDS) and died without therapy. The biology of the immunoblastic proliferation of these patients is uncertain. The immunohistochemical results suggest a reactive, polyclonal proliferation, but the cytogenetic abnormalities in two patients indicate the possibility of a cryptic neoplastic clone. PMID- 3278798 TI - Comparison of intermittent or continuous methotrexate plus 6-mercaptopurine in regimens for standard-risk acute lymphoblastic leukemia in childhood (JCCLSG S811). The Japanese Children's Cancer and Leukemia Study Group. AB - From 1981 to 1983, 131 previously untreated patients with acute lymphoblastic leukemia (ALL) standard-risk group were entered to the protocol JCCLSG-S811. Of 119 eligible patients, 115 (96.6%) attained complete remission by treatment with prednisone (PRD) plus vincristine (VCR) or vindesine (VDS). After preventive central nervous system (CNS) therapy including 18 Gy cranial irradiation and three doses of intrathecal methotrexate (MTX), the patients were assigned randomly to the two maintenance chemotherapies, Regimen A and Regimen B. Regimen A (intermittent regimen) consisted of PRD (120 mg/m2/day by mouth for 5 days) plus 6-mercaptopurine (6MP) (175 mg/m2/day by mouth for 5 days) plus VCR (2.0 mg/m2 intravenously) alternating biweekly with MTX (225 mg/m2 intravenously). Regimen B (continuous regimen) consisted of 6MP (50 mg/m2/day by mouth) plus MTX (20 mg/m2/week by mouth) combined with pulses of PRD and VCR (the same dosages as Regimen A) every 4 weeks. As the late intensification therapy (LIT), five courses of high-dose MTX (2000 mg/m2 per dose per week intravenously for three doses every 12 weeks) with leucovorin rescue were administered to all patients who were in continuous complete remission (CCR) for more than 2 years. Sixty and 55 patients, respectively, were registered in Regimen A and B. The CCR rates in Regimen A and B were 75.1% +/- 5.8% (mean +/- 1 SE) and 49.7% +/- 7.3% (P less than 0.01) at 4 years, and 72.1% +/- 6.3% and 49.7% +/- 7.3% (P less than 0.05) at 5 years, respectively. In Regimen B, CNS and testicular relapses increased after 3 years of CCR. In addition, the patients in Regimen B had a much higher incidence of infections than Regimen A. The LIT did not seem to have important effects on the duration of CCR. From these data we conclude that the intermittent cyclic regimen of 6MP and MTX may be more effective as compared to the continuous administration of these drugs in the maintenance chemotherapy. PMID- 3278800 TI - Recurrent meningioma. AB - Single meningiomas are histologically classified as benign tumors, but clearly malignant types have been encountered. The standard mode of management is total macroscopic removal with excision of the dural attachment and abnormal bone, if there is any. Despite this aggressive surgery, recurrence rates of approximately 9% have been reported with the removal of benign tumors, and the rate is much higher with the removal of malignant meningiomas. Recurrence most frequently occurs at the original tumor site and is most often explained by incomplete removal, which, in turn, is a function of the anatomic location of the tumor. Less common are regional recurrences, which may be explained on the basis of the multicentric origin of meningiomas. This theory may also explain the rare entity, "multiple meningioma." This article documents an unexpected regional recurrence of meningioma. The pertinent literature is reviewed. PMID- 3278801 TI - Changing concepts in cancer prevention: limitations and implications for future research in environmental carcinogenesis. AB - While the cause and nature of certain human cancers are known, definitive preventative guidelines still cannot be offered for many types of tumors. This is partly due to the inherent biostatistical and epidemiological limitations involved in the identification and interpretation of complex carcinogenic risk factors and potential low-risk hazards. Two divergent control strategies have emerged: (a) regulatory programs designed to control or eliminate minute quantities of pollutants in the ambient environment, based on fairly rigid quantitative risk assessment; (b) a biological research effort to understand the fundamental biological mechanisms with the objective of eventually manipulating or intervening in carcinogenesis through chemoprevention or therapy. Apart from more intensified effort on certain already recognized causal factors, current research indicates that the eliminatory approach will have little impact on the cancer burden and that the mechanistic approach, although difficult and slow, represents the most logical alternative. This will require long-term major investments in fundamental research and manpower. This biological approach, however, is largely ignored by the public and legislative bodies concerned with cancer control strategies, partly due to lack of formal input to appropriate national bodies by experts in chemical carcinogenesis. Informed scientists have an important role in ensuring that the public and legislative bodies are aware of current scientific views on carcinogenesis and the need to establish priorities in research. PMID- 3278802 TI - Correlation between classification of human urothelial cell lines and HLA-A,B,C expression. AB - Quantitative changes in major histocompatibility class I antigen expression in tumour cells are believed to affect the host immune response against the tumour. In tumourigenic (TGrIII) human urothelial cell lines the apparent loss of polymorphic HLA-A,B epitopes has previously been demonstrated. In the present study, 3 non-tumourigenic (TGrII) and 6 tumourigenic (TGrIII) human urothelial cell lines have been investigated for their quantitative expression of monomorphic HLA-A,B,C and B2-microglobulin. Evidence is provided that an inverse correlation exists between tumourigenicity and HLA-A,B,C and B2-microglobulin expression. Furthermore, treatment of the cells with neuraminidase partly restored the expression of monomorphic HLA-A,B,C suggesting that at least some of the observed quantitative differences could be due to masking of the membrane bound HLA antigens by sialic acid-containing glycoconjugates. PMID- 3278803 TI - Forced eruption, Part I: Periodontal and orthodontic considerations for the treatment of an isolated periodontal angular infrabony defect. PMID- 3278804 TI - Microleakage of posterior composite restorations after rebonding. PMID- 3278805 TI - The antibacterial action of eugenol, thyme oil, and related essential oils used in dentistry. PMID- 3278806 TI - Fluoride intake of infants and young children and the effect of supplemental and nondietary sources of fluoride. PMID- 3278807 TI - The immunologic implications and clinical management of the endodontic flare-up. PMID- 3278808 TI - Forced eruption, Part II: Esthetic treatment of nonrestorable teeth. PMID- 3278809 TI - Oxalate dentin bonding. PMID- 3278810 TI - Cellular ras activity and phospholipid metabolism. AB - Cellular ras activity has been neutralized in 3T3 cells by microinjection of a specific anti-ras monoclonal antibody. The injected antibody efficiently inhibited proliferation in cells treated with a phorbol ester and a calcium ionophore, or with prostaglandin F2 alpha. These treatments were designed to imitate the action of phospholipase C or of phospholipase A2. In addition, the highly efficient mitogenic potential of phosphatidic acid was inhibited by the injected antibody even more efficiently than was serum-induced proliferation. The close reliance of phospholipid-induced mitogenesis upon ras activity suggests that ras proteins are unlikely to function to control the action of a phospholipase. PMID- 3278811 TI - Failure to synthesize the T cell CD3-zeta chain: structure and function of a partial T cell receptor complex. AB - The T cell antigen receptor is composed of two variable chains (alpha and beta, termed Ti), which confer ligand specificity, and five constant chains (gamma, delta, epsilon, zeta, and p21, collectively termed CD3) whose functions are poorly understood. To explore the roles of the individual CD3 components, an antigen-specific murine T cell hybridoma was chemically mutagenized and antigen induced growth inhibition was used to select CD3/Ti expression variants. One variant produced all CD3/Ti components except CD3-zeta and was able to express small amounts of surface CD3/Ti. This variant failed to respond normally to either antigen or a mitogenic anti-Thy-1 antibody. Surprisingly, in the absence of CD3-zeta, direct cross-linking of the partial receptor induced both phosphatidylinositol hydrolysis and interleukin 2 production. These data indicate that CD3-zeta determines the normal intracellular fate of the T cell antigen receptor and is likely to play an important role in physiologically relevant transmembrane signaling. PMID- 3278812 TI - Transcriptional elements as components of eukaryotic origins of DNA replication. PMID- 3278813 TI - The role of membrane gangliosides in murine alveolar macrophage-mediated suppression of the immune response. AB - Generation of aldehydes on cell membranes of viable alveolar macrophages (AM) by mild oxidation with sodium periodate was previously shown to result in total abrogation of AM-mediated suppression of the plaque-forming cell (PFC) response of spleen cells previously primed with sheep erythrocytes (SRBC). These results suggested a possible role for macrophage sialoglycoconjugates, such as gangliosides and sialoglycoproteins, in suppression. In the present report, it is shown that a purified mixture of gangliosides suppressed the PFC response of SRBC primed spleen cells in a dose-dependent manner. Addition of rabbit anti-mouse brain antiserum (RAMB), which reacts with the gangliosides, reversed both ganglioside- and AM-mediated suppression of the PFC response. Pretreatment of AM but not spleen cells with RAMB also resulted in the reversal of AM-mediated suppression. The expression of gangliosides on the membrane of AM was detected with RAMB in an enzyme-linked immunosorbent assay (ELISA). The results suggest that membrane gangliosides may play an important role in the AM-mediated suppression of the PFC response. Since paraformaldehyde-fixed AM were not suppressive, it is speculated that AM release the suppressive gangliosides into the culture medium and rabbit anti-mouse brain antibody either prevents their release and/or neutralizes the suppressive function of released gangliosides. PMID- 3278815 TI - Changes in tissue levels of carnitine during E. coli sepsis in the rat. AB - Carnitine metabolism was studied in rats that were injected i.v. with 8 X 10(7) live colonies of E. coli per 100 g body weight or physiological saline. All rats were fasted after injection to equalize differences in food intake. Twenty-two hours following E. coli injection serum total carnitine, free carnitine, and acyl carnitine of septic rats increased by 53%, 74%, and 40% respectively, compared with the levels of the control rats. The elevated serum carnitine does not appear to be due to increased mobilization from the skeletal muscle as there were no changes in the total carnitine content of the gastrocnemius muscle during sepsis. Urinary excretion of total carnitine decreased by 62% in the septic rats compared with their controls which may account, in part, for the high serum levels of carnitine in the septic rat. There were no significant differences in the carnitine content of the livers from the septic and control rats. The acid soluble and acid-insoluble carnitine content of the hearts from the septic rats decreased by 35% and 27%, respectively compared with the hearts from the control rats. The reduced myocardial carnitine occurs in spite of the elevated levels of serum carnitine which suggests that the rates of carnitine transport may be altered in the hearts from septic rats. PMID- 3278814 TI - Bacterial cysteine conjugate beta-lyase and the metabolism of cysteine S conjugates: structural requirements for the cleavage of S-conjugates and the formation of reactive intermediates. AB - The cysteine conjugate beta-lyase mediated metabolism and the mutagenicity of the synthetic cysteine conjugates S-(2-chloroethyl)-L-cysteine (CEC), S-(2 chlorovinyl)-L-cysteine (CVC), S-(1,2,3,3,3-pentachloroprop-1-enyl)-L-cysteine (PCPC), S-(pentachlorophenyl)-L-cysteine (PCPhC), S-(chloro-1,2,2-trifluoroethyl) L-cysteine (CTFEC), S-benzyl-L-cysteine (SBC) and S-methyl-L-cysteine (SMC) were investigated in Salmonella typhimurium strains TA100, TA2638, TA102 and TA98 to establish structure/activity relationships. Bacterial 100,000 X g supernatants cleaved CTFEC, PCPC, CVC, PCPhC and SBC to pyruvate; pyruvate formation was inhibited by the beta-lyase inhibitor aminooxyacetic acid (AOAA) in all cases. Of the compounds tested, CEC, PCPC and CVC were mutagenic in the Ames-test. CTFEC, PCPhC and SBC failed to increase the number of revertants above control levels. The mutagenicity of PCPC and CVC could be inhibited by AOAA. CEC exerted a potent mutagenic effect in the Ames-test which was not affected by AOAA; CEC was not transformed to pyruvate by bacterial beta-lyase. Neither pyruvate formation nor mutagenicity were observed with SMC. These results indicate that the structure of the substituent on the sulfur atom is an important determinant for the biological activity of cysteine S-conjugates. Electronegative and/or unsaturated substituents are required for beta-lyase catalysed beta-elimination reactions. The formation of chemically unstable thiols, which may be converted to thioacylating intermediates, seems to be a prerequisite for beta-lyase dependent mutagenicity of S-conjugates. PMID- 3278816 TI - Ibuprofen in experimental group B streptococcal shock. AB - A rabbit model was used to characterize the effects of high (Group II, 100 mg/kg) and low (Group III, 10 mg/kg) dose ibuprofen in modulating the hemodynamic and hematologic manifestations of group B streptococcal shock. Short-term survival was significantly increased with ibuprofen pretreatment. Ibuprofen failed to prevent GBS-induced shock, although shock was favorably modified in a dose dependent manner. Likewise, GBS-induced increases in 6KPGF1a and TxB2 were not prevented but were modified in Group II at 120 min. However, neutropenia, thrombocytopenia, and acidosis were not prevented by pretreatment with ibuprofen and may have been exacerbated. Thus, ibuprofen modifies but does not prevent GBS induced hemodynamic and hematologic manifestation. PMID- 3278817 TI - Intraaortic balloon tamponade during hemorrhagic shock in sheep. AB - Two groups (n = 10 in each) of adult sheep were exposed to hemorrhagic shock resulting in mean arterial pressure (MAP) below 25 mmHg for 10 min. Following that, group A received crystalloids (8% of body wt) during one hr together with supraceliac intraaortic balloon tamponade during the first 30 min, while group B (controls) received crystalloids only. The central circulation was rapidly restored in group A, as indicated by increased MAP and increased systemic vascular resistance (SVR). After deflation of the balloon MAP dropped to the same value as in the control group, while cardiac index increased gradually with volume replacement and was significantly higher at the end of the resuscitation period (60 min) than in the control group (P less than 0.05). Despite a more rapid restoration of central hemodynamics in group A, lactic acidosis was more severe, acute renal failure and neurological complications more frequent, and mortality higher than in the control group. It was concluded that continuous supraceliac aortic occlusion for 30 min had deleterious effects on organs dependent on aortic blood flow distal to the aortic tamponade and may contribute to the development of multiple organ failure after resuscitation from hemorrhagic shock. Further studies are needed to evaluate the effects of intermittent intraaortic balloon tamponade in hemorrhagic shock. PMID- 3278818 TI - Relationship between urine beta-2-microglobulin and platinum levels during cisplatin treatment. AB - We evaluated whether urine beta 2-microglobulin (beta 2M) excretion as a function of nephrotoxicity correlated with plasma and urine platinum levels in patients receiving cisplatin. Thirty-one patients had urine platinum measurements in urine samples collected at 0 to 6 and 6 to 24 h after cisplatin administration, 25 of these patients had serial plasma platinum measurements. Sixteen of the 31 patients had an increase in urine beta 2M. A significant correlation was obtained between urine platinum and beta 2M in the 6- to 24-h samples (r = 0.61, p less than 0.02). The mean plasma platinum levels were higher (12.6 +/- 6.1 mumol/L) in the patients with an increase in urine beta 2M compared to those patients with no change in beta 2M (6.8 +/- 4.1 mumol/L) (p less than 0.02). Our study indicates that tubular damage occurs within 24 h after cisplatin administration and that the damage correlates with urine platinum levels. PMID- 3278819 TI - James V. Warren: a tribute. PMID- 3278820 TI - Prediction of rupture in acute myocardial infarction. AB - In two patient series including 809 and 327 patients, respectively, with acute myocardial infarction we have compared those who died in myocardial rupture (verified at autopsy, Group A) with those who died without rupture (autopsied, Group B), and those who survived hospitalization (Group C) with regard to previous history and clinical course in hospital. Rupture among autopsied patients was observed in 45% and 40% of the cases in the respective studies. Previous infarction was observed in each study as 0% and 0% in Group A compared with 25% and 31% in Group B, and 20% and 34% in Group C. Previous angina pectoris was observed in 26% and 22% in Group A compared with 50% and 54% in Group B and 52% and 54% in Group C. Maximum serum enzyme activity in Group A did not differ from Group B, but was higher than in Group C (p less than 0.001). Group A patients tended to have a higher initial pain score and a higher requirement of analgesics compared with other groups, whereas initial heart rate or systolic blood pressure did not differ in these patients compared to others. We thus conclude that patients with myocardial rupture have a very low occurrence of previous myocardial infarction and angina pectoris, and that their pain course appears to be particularly severe in the acute phase. PMID- 3278822 TI - New drug development in the United States, 1963 through 1984. AB - This study is the fifth in a series that documents changes in the status of drug development in the United States based on a survey of the pharmaceutical industry. For example, the study shows that, although there has been a recent increase in the number of new chemical entities being tested by US firms, an increasing proportion are acquired from outside the firm. Moreover, a growing number of acquired new chemical entities are coming from sources outside the United States, particularly Japan. These and other trends suggest an overall decline in research activity in the United States. At the same time, foreign firms are becoming more active, foretelling greater competition in the United States for both market share and research resources. The analyses also show a continued increase in synthesis-to-approval time, surpassing 13 years in the early 1980s, and rising success rates, reaching about 12% by the late 1970s. PMID- 3278821 TI - Effects of guanfacine monotherapy on blood pressure, heart rate, plasma renin activity, aldosterone, and catecholamines in hypertensive patients with chronic glomerulonephritis. AB - Effects of guanfacine, a centrally acting antihypertensive, on blood pressure, heart rate, plasma renin activity, serum aldosterone, plasma norepinephrine, and renal function were evaluated in 16 patients with hypertension with biopsy-proved chronic glomerulonephritis. Guanfacine monotherapy with a daily dose of 1 to 2.5 mg at bedtime for 6 months brought about a significant reduction in blood pressure (171 +/- 2/110 +/- 2 to 144 +/- 2/89 +/- 1 mm Hg; P less than 0.01), with concurrent decreases in heart rate (78 +/- 2 to 70 +/- 2 bpm; P less than 0.01), plasma renin activity (1.96 +/- 0.12 to 1.21 +/- 0.19 ng/ml/hr; P less than 0.05), aldosterone (14.6 +/- 1.5 to 9.7 +/- 0.9 ng/dl; P less than 0.05), plasma norepinephrine (220.5 +/- 24.2 to 132.8 +/- 27.7 pg/ml; P less than 0.05). There was no change in serum creatinine, beta 2-microglobulin, or endogenous creatinine clearance during guanfacine monotherapy. Our data suggest that guanfacine exerts its antihypertensive effect via the inhibition of sympathetic outflow and in part the suppression of the reninangiotensin-aldosterone system and that guanfacine is suitable for the effective treatment of hypertension associated with chronic glomerulonephritis. PMID- 3278824 TI - The chin. AB - The aesthetic aspects of the chin necessitate its evaluation in the context of the nose, mouth, and, to a lesser extent, the neck. Functional consideration must be given to the dental occlusion and the perioral muscular sphincter, and planning should acknowledge the sociologic implications of a strong versus a weak chin. After thorough skeletal and soft-tissue examination, the appropriate type of surgical intervention can be selected. Among the various procedures, chin implant remains the most commonly used, but the osteotomy offers the greatest flexibility, reliability, and potential for significant modification of chin form. PMID- 3278823 TI - Gemfibrozil decreases platelet reactivity in patients with hypercholesterolemia during physical stress. AB - The effects of the lipid-lowering drug gemfibrozil on platelet reactivity at rest and during submaximal exercise were investigated in 10 patients with serum cholesterol levels greater than 270 mg/dl. No significant changes were observed in platelet reactivity at rest after gemfibrozil treatment. However, a marked decrease in platelet reactivity was seen in almost all patients treated with gemfibrozil during exercise. The adrenaline concentration necessary to induce secondary aggregation increased in eight patients during exercise after gemfibrozil and in two after placebo treatment. When adenosine diphosphatase (2 to 4 mumol/L) was used to induce aggregation, 5-hydroxytryptamine (serotonin) and thromboxane B2 secretion by platelets decreased by 35% and 67%, respectively, during exercise in patients treated with gemfibrozil. The area under the aggregation curve decreased by 28% during exercise after gemfibrozil. No significant changes occurred in these variables during exercise after placebo. Thus, gemfibrozil seems to have antiplatelet effects that might have importance in the prevention of acute complications of atherosclerosis in patients with hypercholesterolemia. PMID- 3278825 TI - Basic primary rhinoplasty. AB - This article presents the guest editor's views on basic primary rhinoplasty at this time, and explains changes in techniques during the past 30 years of his practice. PMID- 3278826 TI - Aesthetic aspects of nasal reconstruction. AB - Reconstructive nasal surgery aims not just to rebuild a nose or part of a nose, but to blend and tailor the new and old tissues in such a way as to create a nearly ideal shape that is likely to be an improvement on the original. The challenge of the reconstruction is enhanced by the complexity of the defect. Differences in color, texture, and thickness between the nasal remnants and the sources of skin available for the reconstruction impose aesthetic limits that are often difficult to overcome. PMID- 3278827 TI - Rehabilitation for the post-cleft nasolabial stigma. AB - The post-cleft central facial stigma is a psychologically crippling deformity that challenges the reconstructive surgeon's imagination. Rewarding improvements can be achieved through a combination of an "elephant trunk" open approach and restoration of existing structural elements with addition of a central cartilage or bony columellar strut capped by cartilage to provide nasal tip projection. The entire deformity must be considered and, if needed, maxillary or lip revisional surgery must be done to obtain optimal results. PMID- 3278828 TI - Saddle nasal deformity. AB - Correction of the saddle nasal deformity requires generous elevation and mobilization of the overlying soft tissue, the restoration of skeletal support, and the provision of nasal mucosa lining ("the forgotten link"). For moderate to severe saddle deformities, calvarial bone grafts serve well to reconstruct the disrupted skeletal framework. PMID- 3278829 TI - Open rhinoplasty. AB - Open rhinoplasty provides visualization, which for many is essential for the best sculpturing. The indications for its use include every primary and secondary rhinoplasty candidate unless tip grafts are going to be under tension or if the deformity is minor. The technique of opening the nose has been described. Emphasis is placed on (1) suturing the medial crura together, (2) suturing the medial crura to the septum, (3) resecting a portion of the lateral crus, and (4) leaving as much cartilage in the supratip and cephalic parts of the lateral crus as possible. The result is (1) greater tip projection with fewer tip grafts, (2) improved correction of tip convexity, (3) fewer supratip deformities, and (4) fewer Weir excisions. The columella scar is usually inconspicuous and has not been a significant problem in any case. PMID- 3278830 TI - Bone disease in rheumatoid arthritis. PMID- 3278832 TI - Lovastatin: a new cholesterol-lowering agent. AB - The chemistry, pharmacology, pharmacokinetics, clinical efficacy, dosage and administration, and adverse effects of lovastatin are reviewed. Lovastatin is the first agent marketed in a new class of pharmacologic compounds called the 3 hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors. By competitively inhibiting HMG CoA reductase, the drug disrupts the biosynthesis of cholesterol in hepatic and peripheral cells. This increases the synthesis of low density-lipoprotein (LDL) receptors and thereby increases the uptake of LDL cholesterol from the plasma. In doses of 20 to 80 mg daily, lovastatin decreases total and LDL cholesterol concentrations 25 to 45%. It also substantially reduces concentrations of triglycerides, very-low-density-lipoprotein (VLDL) cholesterol, and apolipoprotein B and slightly increases high-density-lipoprotein (HDL) cholesterol concentrations. Lovastatin is effective in patients with heterozygous familial and nonfamilial (polygenic) hypercholesterolemia but is ineffective in patients with homozygous familial hypercholesterolemia. It is also effective in combination with bile acid sequestrants, nicotinic acid, and gemfibrozil. Administration of lovastatin once daily in the evening (to enhance compliance) or twice daily is recommended to maximize the drug's cholesterol-lowering effects. Headache and gastrointestinal complaints are the most common adverse effects. Treatment has been withdrawn from 1.9% of patients receiving the drug because of elevated aminotransferase concentrations. The relationship of lovastatin to the development of lens opacities requires further evaluation. Lovastatin is highly effective in the treatment of primary hypercholesterolemia and represents an important therapeutic advance. Safety with long-term use and effect on coronary heart disease remain to be established. PMID- 3278831 TI - Effects of heroin addiction on the responses of glucose, C-peptide and insulin to a standard meal. AB - 1. The aim of the study was to examine the responses of plasma glucose, C-peptide immunoreactivity (CPR) and total immunoreactive insulin (IRI) to a standard meal in heroin addicts, since the presence of immunoreactive beta-endorphin has been demonstrated in human endocrine pancreas. 2. Ten heroin addicts and 10 control subjects participated in the study. The addicts had been taking heroin (from 0.5 to 2 g/day) for at least 2 months and they had no detectable diseases. 3. After a 12 h fast, each subject received a standard meal; blood samples were taken at 15, 0, 15, 30, 60 and 120 min to determine glucose, CPR and IRI. Calculation of the CPR/IRI molar ratio was used as a semiquantitative estimation of the hepatic extraction of insulin. 4. No difference in plasma glucose was observed between the groups. Addicts had lower CPR than normals at 15, 30 and 120 min (P less than 0.01). On the contrary, IRI was higher in addicts than in normals (P less than 0.05 at -15 and 0 min, P less than 0.01 at 15, 30 and 60 min), except at 120 min. The CPR/IRI molar ratio was lower in addicts (P less than 0.01). 5. Heroin addiction seems to produce a beta-cell failure and contemporaneously a state of hyperinsulinaemia; blood glucose remains in the normal range. 6. We conclude that chronic heroin addiction may produce a change in the rate of hepatic extraction of insulin. PMID- 3278833 TI - Sulbactam: a beta-lactamase inhibitor. AB - The chemistry, pharmacology, microbiology, pharmacokinetics, clinical efficacy, and adverse effects of sulbactam are reviewed. Sulbactam is a competitive, irreversible beta-lactamase inhibitor. Its binding to penicillin-binding proteins imparts weak intrinsic antibacterial activity. Synergy of sulbactam with beta lactam antibiotics is most marked in bacterial species in which beta lactamase is a major mechanism of resistance. Sulbactam sodium is available in combination with ampicillin sodium for injection in a 1:2 ratio of sulbactam to ampicillin. Sultamicillin, an oral prodrug that is hydrolyzed to equimolar amounts of ampicillin and sulbactam, is in clinical trials. Ampicillin and sulbactam have similar pharmacokinetic properties. Sulbactam-ampicillin appears to be most useful for the treatment of polymicrobial aerobic or anaerobic infections and uncomplicated gonorrhea. Persistence, relapse, and superinfections have been reported after sulbactam-ampicillin treatment of urinary-tract and respiratory tract infections. The combination is not effective against pseudomonal infections. Sulbactam-ampicillin is generally well tolerated. By restoring or expanding the activity of older, well-established beta-lactam antibiotics, sulbactam offers a new approach to the management of bacterial infections; the minimal toxicity of sulbactam-ampicillin makes the combination appealing for the treatment of gram-negative nonpseudomonal and anaerobic infections. PMID- 3278834 TI - Effects of alcohol abuse on bone. AB - The relationship between bone disease and alcohol abuse is well established. A large percentage of individuals whose drinking habits have caused them to seek medical help can be diagnosed, with routine X-rays, as having bone disease. The degree to which bone disease is present in the overall drinking population remains uncertain. The predominant form of bone disease is osteoporosis, and it seems likely that most osteoporosis in the middle-aged man can be attributed to alcohol abuse. The reason alcohol abuse leads to osteoporosis remains unclear. Vitamin D deficiency, hyperparathyroidism, and decreased intestinal calcium absorption may play a role, but a direct inhibitory effect of alcohol on bone remodeling seems a more likely explanation. No effective form of treatment has yet been established. Bone lost may not be regained. The best approach is to stop the alcohol abuse before the bone disease becomes manifest. PMID- 3278835 TI - Patellofemoral stress syndrome: a common but complex problem. PMID- 3278836 TI - Causes and management of shoulder arthritis. AB - We recommend that physicians distinguish shoulder arthritis from periarticular disorders. A specific diagnosis should be made in the former, if possible. A number of arthritides have frequent shoulder involvement, and they should be kept in mind. Septic arthritis should always be suspected when there is acute pain and swelling. Joint fluid aspiration should almost always be performed when fluid is present. The diagnosis of gout or CPPD deposition disease usually requires crystal identification from joint fluid for diagnosis. Treatment of shoulder arthritis with oral anti-inflammatory medication is usually indicated; appropriate treatment of the underlying disorder, e.g., rheumatoid arthritis, is necessary. Physical therapy started early, often combined with IA corticosteroids, helps to maintain or improve shoulder motion. PMID- 3278837 TI - Cytoprotection in NSAID gastropathy. PMID- 3278838 TI - Radiographic evaluation of prosthetic joints. PMID- 3278839 TI - A new look at osteoporosis and estrogen replacement therapy. PMID- 3278840 TI - Current therapeutic practices in spondyloarthropathies. AB - Spondyloarthropathies are comprised of a number of diseases that have the following features in common: involvement of the spine with sacroiliitis, peripheral arthritis that is frequently asymmetric, absence of rheumatoid nodule, negative rheumatoid factor, and association with HLA-B27. The most important aspect of spondylitis management is a program of regular exercises, aided by nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy. Indomethacin and phenylbutazone are most effective in AS and RS, although the latter drug should be used with care and only after a trial of other NSAIDs. The mainstay of peripheral arthritis management is the use of NSAIDs and intra-articular corticosteroids, but several delayed-acting drugs (gold, cytotoxic drugs) are beneficial in difficult cases, depending on the type and severity of the disease. PMID- 3278841 TI - Diffuse idiopathic skeletal hyperostosis. AB - The ubiquitous nature of spinal ligamentous calcification in the paleontologic record provides additional support for the suggestion that DISH is a protective phenomenon rather than a musculoskeletal disease, and perhaps represents a normal variant. Clinical assessment of contemporary DISH suggests a protective mechanical effect, paradoxically associated with increased risk of hypertension and cerebrovascular accident. DISH should probably not be considered a satisfactory explanation for back pain, but the presence of spinal ligamentous calcification requires that the patient be assessed for hypertension and that aggressive therapy be instituted for any found. PMID- 3278842 TI - Relationship of running to osteoarthritis and bone density. PMID- 3278844 TI - Semantic relationships and medical bibliographic retrieval: a preliminary assessment. AB - This paper describes a project exploring whether semantic relationships between bibliographic terms may effectively partition the clinical literature. To address this question, a set of semantic relationships was identified between pairs of bibliographic terms taken from four categories: (1) diseases, (2) treatments, (3) tests, and (4) patient characteristics. The MEDLINE system of the National Library of Medicine was used to generate lists of abstracts relating to pairs of clinical terms. Each list of abstracts was examined to identify the semantic relationships, if any, which applied to the two terms in each paper. The study suggests that semantic relationships may play a potentially valuable role in assisting computer-based medical bibliographic retrieval. The degree to which relationships partition the literature is strongly dependent on the underlying semantics of the particular bibliographic terms involved. PMID- 3278845 TI - Sanctions don't measure "success". PMID- 3278843 TI - Decline of fibroblast chemotaxis with age of donor and cell passage number. AB - Human dermal fibroblasts have a limited life span in culture, which is manifested by a progressive decline of their proliferative activity. Here we show by the Boyden Chamber assay that the chemotactic response of human fibroblasts to fibroblast-conditioned medium and fibronectin declines during cellular aging in vitro and in vivo. The chemotactic response of human embryonic fibroblasts (HEF) declined progressively after the 25th passage. Virtually no chemotactic activity could be observed after the 40th passage in culture. Fibroblasts cultures from donors aged between 70-90 years had lost chemotactic activity by the 15th passage. Cells from patients suffering from progeroid syndromes of premature aging showed, even in early passages, a very low chemotactic response (20% of the HEF) and lost their chemotactic activity after a few subcultures. The response to the chemoattractant fibronectin also decreased with aging. Immunofluorescence studies indicated that the decline in chemotactic activity was accompanied by the formation of a thicker fibronectin network in the extracellular matrix of senescent human fibroblasts and progeroid cells than that observed in early passage embryonic cultures. Since fibroblast chemotaxis and synthesis of connective tissue components probably play an important role in tissue repair, our results could contribute to an understanding of age-related differences in the healing of skin wounds. PMID- 3278847 TI - Consensus development summaries: geriatric assessment methods for clinical decision making. National Institutes of Health. PMID- 3278846 TI - Malpractice, informed consent, and the use of low osmolality contrast media. PMID- 3278848 TI - Drug information update: Hartford Hospital. Lovastatin. PMID- 3278849 TI - Animal models to induce renal failure: a historical survey. PMID- 3278850 TI - Pharmacological and dietary intervention in experimental models of chronic renal disease. PMID- 3278851 TI - Progression of kidney damage in subtotally nephrectomized rats: influence of dietary manipulations. PMID- 3278852 TI - Protein intake and deterioration of renal function in rats: experimental data and hypothetical mechanism. PMID- 3278853 TI - Nutritional effects of ketoacid-supplemented diets in rats. PMID- 3278855 TI - Growth and appetite in chronic renal failure. Role of different protein diets. PMID- 3278854 TI - Small intestine function in experimental uremia. Studies on enzyme levels and absorptive capacity. PMID- 3278856 TI - Methods for the measurement of blood pressure in conscious rats. PMID- 3278857 TI - Blood pressure and uremic cardiomyopathy. PMID- 3278858 TI - Limitations and problems of animal experiments in uremia. PMID- 3278859 TI - Uremic rat model: experience with young rats. PMID- 3278860 TI - Focal glomerular hyalinosis and sclerosis in aminonucleoside and adriamycin nephrosis: pathogenetic and therapeutic considerations. PMID- 3278861 TI - Application of puromycin aminonucleoside and adriamycin to induce chronic renal failure in the rat. PMID- 3278862 TI - Development of diabetic nephropathy in the rat: morphological, functional, and pathophysiological aspects. PMID- 3278864 TI - Wound pH as a predictor of skin graft survival. PMID- 3278863 TI - Bites and stings in the pediatric patient. PMID- 3278865 TI - Induction of long-term rat cardiac allograft survival in rats with multiple donor specific transfusions and cyclosporine. PMID- 3278866 TI - Blistering distal dactylitis in an adult. AB - Streptococci are responsible for a diverse spectrum of cutaneous infections like erysipelas, impetigo, and cellulitis. Blistering distal dactylitis is an infrequent, superficial infection of the anterior fat pad of the distal portion of the finger described classically in children. We report a case of blistering distal dactylitis in an adult caused by group A beta-hemolytic streptococci that was cured with oral phenoxymethyl penicillin. Familiarity with blistering distal dactylitis should permit the dermatologist and internist to diagnose this new entity in adults. PMID- 3278867 TI - Eugene Frederick Traub, MD 1894-1987. PMID- 3278868 TI - Neuroendocrine modulation of the immune system. Possible implications for inflammatory bowel disease. AB - Evidence for neuroendocrine regulation of the immune system is reviewed. This includes human clinical studies of the influence of psychological stress on immune function, direct experimentation in animals, including classical Pavlovian conditioning of the immune response, modulation of immune function in vitro by chemical messengers such as neuropeptides, the finding of receptors for neuropeptides on immunocytes, and the demonstration that lymphoid tissue is directly innervated. Secretory products of the immune system, which include interleukins and neuropeptides, may also influence the neuroendocrine system. Communication between the two systems is therefore bidirectional. The potential importance of the neuropeptide-immunocyte interaction within the intestinal mucosal immune system is emphasized, and its possible relevance in inflammatory disorders is discussed. This aspect of the "gut-brain" interaction deserves further study. PMID- 3278870 TI - New enema treatments for inflammatory bowel disease. AB - Two new preparations are under clinical trial for use in the treatment of ulcerative proctitis and left-sided colitis. One is 5-aminosalicylate, a component of sulfasalazine. This substance has virtually no immunomodulating capabilities. Evidence for efficacy equal to that of sulfasalazine in acute colitis has been obtained but its role in preventing recurrences is unknown. The other substance is tixocortol, a rapidly metabolized steroid, which has local antiinflammatory activity. Specific procedures of preparation and dosage remain to be established. Both preparations are administered as enemas. PMID- 3278869 TI - Chemotactic peptides. Mechanisms, functions, and possible role in inflammatory bowel disease. AB - An important component of host defenses is the ability of inflammatory cells to detect and respond to minute concentrations of chemoattractant substances. Chemotactic peptides elaborated by both bacteria and leukocytes are the focus of this review. These peptides induce directed migration of inflammatory cells towards their targets, and stimulate biological functions including degranulation, release of oxygen radicals, phagocytosis, and eicosanoid production. Among the released eicosanoids, leukotriene B4 potentiates the leukocyte response. As with other chemotactic factors, these functions are regulated partially through differential coupling to high- and low-affinity receptors and via calcium as the second messenger. Some chemotactic peptides are elaborated by normal colonic luminal bacteria. Recent evidence demonstrates that these peptides can produce mucosal inflammation in vivo. A possible mechanism for this effect involves abnormal colonic permeability in susceptible individuals that allows bacterial chemotactic peptides access to the mucosa where they may induce inflammation. Remaining questions include the mechanism by which the mucosal barrier is breached and the role of leukotrienes in the potentiation of colonic inflammation. PMID- 3278871 TI - Regulation of glucose metabolism by sympathochromaffin catecholamines. PMID- 3278872 TI - Effects of glucocorticoids on carbohydrate metabolism. PMID- 3278873 TI - Somogyi and dawn phenomena: mechanisms. PMID- 3278874 TI - Gluconeogenesis and hypoglycemia. PMID- 3278875 TI - Hypoglycemia and glucose counterregulation in normal and insulin-dependent diabetic subjects. PMID- 3278876 TI - [Therapy of endemic goiter with levothyroxine and iodide. A multicenter study]. AB - 74 patients suffering from diffuse endemic goitre and with peripheric euthyrotic metabolism were treated for 6 months either with 150 micrograms levothyroxine (T4) daily (group I, n = 35), or with a combination of 100 micrograms levothyroxine and 130.8 micrograms potassium iodide (corresponding to 100 micrograms iodide) daily (group II, n = 39). This was followed in each case by a 3-month prophylactic administration of 100 micrograms iodide daily. After 3, 6 and 9 months the reduction of the goitre volumes--measured by sonography--was significantly different from the initial value in both groups. The reduction in goitre size was more marked in group II (-30.3%) than in group I (-25.2%), in each case after 6 months' treatment, but this difference was not significant. Suppression of the basal TSH levels in the serum coincided almost completely in both groups with an equidirectional increase after the subsequent iodide administration of 3 months' duration. Whereas in group I there was a renewed tendency towards thyroid enlargement under iodide prophylaxis, the diminution effect obtained in group II remained unchanged. PMID- 3278877 TI - [Riedel's struma and fibrous mediastinitis. Their relation to multifocal fibrosis]. PMID- 3278878 TI - Bitolterol. A preliminary review of its pharmacological properties and therapeutic efficacy in reversible obstructive airways disease. AB - Bitolterol is a beta-adrenoceptor agonist which is hydrolysed to colterol by tissue esterases present at high concentrations in the lung. Animal studies indicate that bitolterol has significant beta 2-selectivity. In initial clinical trials transient cardiovascular effects have occurred in about 5% of patients. The spectrum of other adverse reactions with bitolterol is similar to that found with other beta-adrenoceptor agonists. Preliminary therapeutic trials of bitolterol administered by aerosol or nebuliser in adult patients with asthma have shown variable but significant improvements in forced expiratory volume in 1 second (FEV1) and a duration of action of up to 8 hours in some patients. Bitolterol has been shown to provide similar maximum increases in FEV1 to isoprenaline (isoproterenol) and to be significantly longer acting in long term comparative trials. Either alone or in combination with oral theophylline, bitolterol aerosol produces greater and more prolonged bronchodilation than oral theophylline alone but more consistently in non-steroid-dependent patients. Duration of bronchodilation with bitolterol in patients receiving steroids is less than in those who are not steroid dependent, perhaps due to more severe disease in the former group. More long term trials in larger groups of patients are clearly needed to assess the efficacy and safety of bitolterol in comparison with other long acting beta-adrenoceptor agents, and to define the role of bitolterol in the combination regimens of antiasthmatic agents which are becoming increasingly popular. Nevertheless, bitolterol appears to be a well tolerated and relatively long acting alternative to other beta-adrenoceptor agonists in the treatment of reversible obstructive airways disease. PMID- 3278881 TI - The emergence of fetal behaviour. III. Individual differences and consistencies. AB - Intra- and inter-fetal consistencies and differences in motor activity were studied in 12 healthy nulliparous women during the first half of gestation. Real time ultrasound observations, lasting 60 min, were performed weekly from 7 to 15 weeks of gestation and at 17 and 19 weeks. The various types of movements were categorized according to a previously developed classification system. Data on general movements during the second half of gestation were carried out on the same group of women and these results are also included in this study. Intra individually there appeared to be a relative week-to-week consistency in the amount of total motor activity, i.e. the sum of all the movement patterns. There was a slight tendency of intra-fetal consistency when the incidence of general movements during the first half of gestation was compared to that during the second half. The other movement patterns did not show these consistencies, namely, each fetus showed large fluctuations in the week-to-week incidences. Inter-individually there were large differences in the amount of the different types of movements at the various ages, which resulted in wide ranges. The sum of the rank orders which for total activity and general movements, were found weekly, were compared to those which could be expected to occur in a homogeneous population. Two fetuses appeared to be significantly different from the others on mathematical grounds. One consistently showed a high and one a low motor output. Week-to-week stability in the rank orders of the various movement patterns was studied by adding up a sum score of all the weekly changes in ranks. Three fetuses were found to be stable and three showed large fluctuations. The others were in between these extremes. The ranks of the movements from high to low frequency, appeared to be strictly age dependent, whereby all the fetuses followed the same developmental trend. There were no differences between female and male fetuses in any of the movement patterns. PMID- 3278880 TI - Alopecia and hirsuties. Current concepts in pathogenesis and management. AB - Hirsuties and androgenic alopecia are the patterns of hair growth in women which develop in a similar manner to that normally seen in men. This process is mediated by androgens. It may be due to increased hormone production or increased target organ sensitivity. The majority of patients with hirsuties may be adequately managed with a careful explanation of their condition and advice about depilatory techniques. Some will benefit from a course of systemic antiandrogen therapy, but hair growth will resume on cessation of therapy. There have been few objective studies to evaluate the benefits of antiandrogen therapy in female baldness and none with minoxidil. PMID- 3278879 TI - GnRH agonists and antagonists. Current clinical status. AB - Gonadotrophin-releasing hormone (GnRH) analogues offer a novel approach for the non-steroidal manipulation of the reproductive endocrine axis. GnRH agonists are now effectively employed in the management of precocious puberty, prostate and breast cancer, endometriosis, uterine leiomyoma, polycystic ovarian disease, and various other disorders. Unfortunately, contraceptive applications of GnRH agonists have been disappointing. The availability of slow release depot formulations of GnRH agonists, and the development of GnRH antagonists may further optimise and extend the clinical application of these compounds. PMID- 3278882 TI - Neuro-ophthalmologic emergencies. AB - This article is designed to provide the emergency physician with the knowledge necessary for the diagnosis and management of the more common neuro ophthalmologic emergencies. Emphasis is placed on the recognition and initial evaluation of neuro-ophthalmologic disease. PMID- 3278883 TI - Penetrating ocular injuries. AB - Penetrating ocular and orbital trauma present the emergency medicine physician with ongoing challenges. A suspicion of their occurrence with understanding and prompt recognition of presenting signs ultimately will give the patient the best possible visual outcome. PMID- 3278884 TI - Blunt ocular trauma. AB - The emergency medicine physician is encouraged to perform a brief eye history and examination on patients presenting with not only ocular but also multisystem trauma. Obviously, life-threatening conditions take precedence, but it is important to give attention to the ocular area once the patient is stabilized. The minor injuries can be treated initially in the emergency room and referred to an ophthalmologist for follow-up care. If, however, the emergency medicine physician has any doubts as to the nature or severity of the injury, appropriate ophthalmologic consultation should be sought. It is hoped that by taking a rational approach to blunt ocular trauma, as outlined in this article, the emergency medicine physician can provide emergency eye care in a confident and thorough manner. PMID- 3278885 TI - The acute painful eye. AB - A number of ocular and nonocular conditions may produce an acutely painful eye or orbit. A careful history and physical examination with special attention to the cornea, sclera, fundus, and cranial nerves will usually delineate the etiology of the pain. In particular, certain life- or vision-threatening conditions such as leaking internal carotid aneurysm, cavernous sinus thrombosis, orbital cellulitis, acute narrow-angle glaucoma, and temporal arteritis must be kept in mind. PMID- 3278886 TI - The red eye. AB - The patient with a red eye constitutes a very common clinical problem encountered in the Emergency Department setting. Conjunctivitis, the most common cause of the red eye, generally is not associated with disturbance of vision or associated ocular pain. If either of these symptoms is present, a more serious disorder must be suspected. Treatment of infectious conjunctivitis is guided by interpretation of a Gram's stain and subsequent culture of any exudate present. Initial treatment of most cases includes use of topical antibiotic and local comfort measures. Complications of infectious conjunctivitis include more invasive disease such as keratitis or abscess formation, with potential corneal perforation and destruction. All patients should be referred for ophthalmologic followup, both to assess adequacy of treatment and to treat unexpected complications. Remember that allergic conjunctivitis is a common condition that responds to antihistamine decongestant medications given orally or topically. Occasionally these conditions are caused by self-prescribed use of ocular medication, and discontinuation of all eye medication is required. Corticosteroid eye drops are rarely indicated and should be used only at the direction of an ophthalmologist. When the diagnosis is uncertain, treatment is best withheld, as "shotgun" therapy is seldom beneficial. PMID- 3278888 TI - Corneal injuries. AB - The article on corneal injuries illustrates the means by which mechanical, chemical, and radiant energies interrupt the normal anatomy and physiology of the cornea. Methods of diagnosis and management of such problems, including those caused by contact lenses, are presented. PMID- 3278887 TI - Acute visual loss. AB - Acute visual loss is not an infrequent presenting complaint to the Emergency Department. The history of visual loss, physical examination of the eye, and indicated laboratory evaluation are keys to making the diagnosis. The etiology of nontraumatic visual loss is diverse, involving vascular, anatomic, infectious, autoimmune, toxicologic, and psychogenic causes. Appropriate treatment, as well as the need for timeliness of ophthalmologic consultation, is described. PMID- 3278889 TI - The eye and systemic disease. AB - This article describes various ocular manifestations of certain systemic diseases. The most common are given herein, but in addition several less common conditions are detailed because of the life-threatening nature of the underlying cause. Emergency physicians need to be aware of these conditions in order to be prepared for possible presentations in the Emergency Department. PMID- 3278890 TI - Stimulation by D-glucose of protein biosynthesis in tumoral insulin-producing cells (RINm5F line). AB - Tumoral insulin-producing cells of the RINm5F line display a poor secretory response to D-glucose. Relative to basal insulin output, which corresponds to a fractional release of stored hormone close to 25%/90 min, the glucose-induced increment in insulin release does not exceed 28 +/- 7%. The low efficiency of D glucose as an insulin secretagogue contrasts with a marked stimulant action of the hexose on peptide biosynthesis. Thus, D-glucose increases in a rapid, sustained, and dose-related manner the incorporation of [3H]leucine or [3H]phenylalanine into trichloroacetic acid-precipitable material; there is a 7 fold difference between basal and glucose-stimulated protein biosynthesis. Although the low proinsulin and insulin content of the tumoral cells, relative to their total protein content, hampers the quantification of newly synthesized hormonal products, the ratio of immunoreactive proinsulin to insulin exceeded the value in normal islet cells; this difference was more marked in secreted than stored material. It is concluded that despite their poor secretory response to D glucose, the tumoral cells are, in fact, quite sensitive to this hexose, as documented by its effect on biosynthetic activity. Although RINm5F cells are known to display an acute secretory response to nonnutrient secretagogues, the apparent discrepancy between the biosynthetic and secretory responses to D glucose may be accounted for in part by a severe perturbation in the capacity of the tumoral cells to store proinsulin and insulin. PMID- 3278891 TI - A correlation between the ligand specificity for 67copper uptake and for copper prostaglandin E2 stimulation of the release of gonadotropin-releasing hormone from median eminence explants. AB - We have previously shown that copper (Cu) leads to a 3- to 4-fold amplification of prostaglandin E2 (PGE2) stimulation of LHRH release from explants of the median eminence area (MEA), that this amplification is a saturable function of [Cu], and that complexed Cu but not ionic Cu is the active form of the metal. This implicates a ligand-specific site in Cu action. In this study we address the following questions. Is there a ligand specificity for Cu amplification of PGE2 stimulation of LHRH release, and if so, does it correlate with the ligand specificity for Cu uptake? MEAs of 1-month-old female rats were incubated for 5 min with 150 microM Cu solution and then for 15 min with 10 microM PGE2 (Cu/PGE2); LHRH released into the medium was evaluated by RIA. To assess Cu uptake, MEAs were incubated with 100 microM67 Cu solution for 15 min, and 67Cu accumulation by the MEA was evaluated. The Cu was complexed to one of the following ligands: histamine, His, Cys, Thr, Gly, glutathione, Gly-His-Lys, or albumin. There was a high degree of correlation (r = 0.943) between the ligand specificity for Cu/PGE2 stimulation of LHRH release (Cu action) and 67Cu uptake. Complexation of ionic Cu with His facilitated Cu action and 67Cu uptake 3-fold each, and this was completely prevented by the inclusion of His in a 100-fold excess over the concentration of the Cu/His complex. Histamine, the amino acids, and the peptides facilitated Cu action and 67Cu uptake, whereas albumin did not do so. Of these facilitatory ligands, histamine and His were the most effective and Gly-His-Lys was the least effective. In summary, both 67Cu uptake and Cu action are ligand-dependent and ligand-specific; the Cu interactive sites have a common recognition for the Cu-ligand complex and for the ligand itself; and the ligand specificity for 67Cu uptake and for Cu action are highly correlated. These results are consistent with the ligand specificity for Cu uptake being the primary determinant of the ligand specificity for Cu/PGE2 stimulation of LHRH release. PMID- 3278892 TI - Somatomedin-C/insulin-like growth factor I as an enhancer of androgen biosynthesis by cultured rat ovarian cells. AB - The ovarian granulosa cell has recently been shown to be a site of somatomedin C/insulin-like growth factor I (Sm-C/IGF-I) production, reception, and action. These observations have generally been interpreted to suggest the existence of an autocrine loop concerned with granulosa cell physiology. It is the objective of the in vitro studies reported herein to extend these observations by evaluating the interaction of Sm-C/IGF-I with the adjacent thecal-interstitial cell. Treatment of collagenase-processed whole ovarian dispersates or highly enriched (greater than 90%) thecal-interstitial cells from immature rats with Sm-C/IGF-I (50 ng/ml) or hCG (1 ng/ml), resulted in 2.1- and 4.0-fold increments in the accumulation of androsterone (3 alpha-hydroxy-5 alpha-androstane-17-one), the main androgenic steroid identified in culture media. However, combined treatment with both agents unmasked a synergistic interaction producing a 3.3-fold increase in the hCG-stimulated accumulation of androsterone, an effect consequent to enhanced androgen biosynthesis rather than diminished degradation. Unaccounted for by an increase in viable ovarian cell numbers and independent of the hCG dose (0.1-10 ng/ml) used, the Sm-C/IGF-I effect proved time and dose dependent, with a projected minimal effective dose of 3 ng/ml and a minimal time requirement of 72 h. [125I]Iodo-Sm-C/IGF-I binding to untreated highly enriched thecal-interstitial cells proved saturable, with a single class (Hill coefficient = 0.98 +/- 0.01) of high affinity (Kd = 3.0 nM), low capacity (maximum binding = 10,840 +/- 2,108 sites/cell) binding sites. Limited specificity studies using related peptides produced a rank order of competitive potency of: Sm-C/IGF-I greater than multiplication stimulating activity greater than insulin, a pattern compatible with the presence of type I IGF receptors. Other related peptides, such as porcine proinsulin and porcine desoctapeptide insulin, proved weakly effective in inhibiting Sm-C/IGF-I binding to its receptor; unrelated peptides such as porcine relaxin and erythropoietin were without effect. Taken together, these findings suggest that 1) the thecal-interstitial cell, like the granulosa cell, may be a site of Sm-C/IGF-I reception and action, and 2) the ability of high dose insulin to stimulate ovarian androgen biosynthesis may be due to its capacity to act as a Sm-C/IGF-I surrogate, its high dose requirements reflecting cross-interaction with the type I receptor.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3278893 TI - The in vitro synthesis and release of proteins by the human oviduct. AB - The purpose of this study was to identify major proteins synthesized by the human oviduct and to determine if the ability of the human oviduct to synthesize these proteins was correlated with a specific stage(s) of the menstrual cycle. Oviducts, obtained from normal menstrual and immediately postpartum women, were minced and cultured in the presence of labeled precursors. The culture medium was analyzed for newly synthesized proteins by electrophoresis, followed by fluorography. One-dimensional gel electrophoretic analysis of culture medium of oviducts obtained at midcycle revealed a major diffuse band in the 120,000 130,000 mol wt (Mr) region which was greatly diminished in intensity or nondetectable in the media of oviducts obtained at all other stages of the cycle. Two-dimensional gel electrophoresis resolved the 120,000-130,000 Mr region into two major proteins, one basic and one acidic. Both proteins were intensely labeled with glucosamine, and the basic protein also incorporated leucine and methionine. Western blots of culture media incubated with antibodies against human placental proteins (PP) demonstrated that PP4 and PP7 were released throughout the cycle, while PP14 was present only at the late luteal stage of the cycle. This study demonstrates that human oviducts continue to synthesize and release macromolecules during organ culture. Additionally, the synthesis of some of these proteins appeared to be stage specific. The Mr 120,000-130,000 glycoproteins are of particular interest since they were observed in medium from midcycle oviducts, a period when the oviduct participates in gamete transport and embryo development. PMID- 3278894 TI - Identification and characterization of an abundant ovarian interstitial gland protein associated with sexual maturity in rabbits. AB - An abundant ovarian protein with a relative mol wt (Mr) of 37K and an apparent pI of 8, associated with the onset of sexual maturity in the rabbit, has been identified. Ovaries from sexually mature (greater than 6 months old) rabbits contain large quantities of this 37K protein, while none can be detected in ovaries of immature (1 and 2 months) animals. Analysis of polyacrylamide gel electrophoresis (PAGE) gels of mature ovarian homogenates demonstrates that this protein is more abundant than actin in these preparations. It appears to be tissue specific, since it was not detected in 16 other rabbit tissues tested. Autoradiographic analysis of proteins labeled with 35S in ovarian organ culture demonstrates that a protein of identical Mr and charge to the 37K protein is synthesized in this tissue. Polyclonal sheep antiserum has been produced to the two-dimensional PAGE-purified protein. Immunoblotting of two-dimensional PAGE gels shows specific recognition of this protein and two slightly more acidic proteins of the same Mr by this antiserum. These three protein species also stain identical colors with a silver-based color stain, further suggesting that these are charge variants of the same protein. This protein is not present in corpora lutea isolated form sexually mature ovaries and is present in interstitial cell enriched ovaries of rabbits which have been actively immunized with zona pellucida proteins. Immunocytochemical localization studies further demonstrate that this protein is localized in the interstitial gland cells. These findings suggest that this 37K protein is not associated with either follicular or luteal cells, but, rather, is linked with the 20 alpha-hydroxyprogesterone-secreting interstitial gland cell population. PMID- 3278896 TI - Comparative mutagenicity of nine brands of coffee to Salmonella typhimurium TA100, TA102, and TA104. AB - Nine coffee preparations, four caffeinated instant brands, three caffeinated drip coffees, and two decaffeinated coffees, one of which was an instant brand, were evaluated for mutagenicity by the Ames assay using Salmonella typhimurium TA100, TA102, and TA104. All the coffees contained direct-acting mutagens, which reverted the three strains. The inclusion of a rat microsomal enzyme preparation reduced the mutagenic response of the three strains in the presence of some of the coffee samples. Both glyoxal and methylglyoxal, 1,2-dicarbonyls found in the coffees were mutagenic. The concentration of glyoxal, methyglyoxal, diacetyl, and guiacol were measured by gas chromatography/mass spectrometry. Caffeine, furfural, and 5-methylfurfural concentrations were determined by high performance liquid chromatography. Although lower concentrations of methyglyoxal were found in the drip caffeinated coffees, the mutagenic potency of these preparations was higher than the instant coffees on a weight basis especially when TA104 was the indicator organism. Our findings agree with those of other workers who have shown that carbonyl compounds, which were present in all the brands tested, are partially responsible for the mutagenic response of coffee but that additional mutagens are also present. PMID- 3278895 TI - Gonadotropin-releasing hormone desensitization preferentially inhibits expression of the luteinizing hormone beta-subunit gene in vivo. AB - In this study we investigated changes in steady state cytoplasmic mRNA levels for LH subunits in pituitaries of male rats desensitized by continuous infusion of GnRH in vivo. Seven days of GnRH infusion (340 micrograms/day) reduced (P less than 0.01) LH beta mRNA levels in intact adult male rats and prevented the LH beta mRNA rise observed after castration. In contrast, common alpha mRNA doubled (P less than 0.05) in intact rats, and the elevated alpha mRNA after 7 days castration was unchanged. Serum and pituitary LH levels were suppressed below values of intact controls. Fourteen days of GnRH infusion (290 micrograms/day) further reduced LH beta mRNA levels in both intact and castrated male rat pituitaries. alpha mRNA levels in intact rat pituitaries were unchanged by 14 days of GnRH infusion, while in castrated rats there was a 23% (P less than 0.05) decrease, though values were still twice those of intact controls. As at 7 days, serum and pituitary LH were suppressed. Infusion of a superagonist analog (Buserelin) at a dose of 14 micrograms/day for 28 days reduced LH beta mRNA to 15% of intact control values in both castrated and intact rats. Common alpha mRNA was significantly (P less than 0.05) increased in intact rats and reduced by 13% (P less than 0.05) in castrates by superagonist infusion. These results were similar to those produced by 20- to 30-fold higher doses of native GnRH. GnRH and agonist analog effects were specific since no changes were observed in other mRNA species (GH, PRL, actin). These results indicate that in GnRH-desensitized gonadotropes LH beta gene expression is inhibited, and this may largely explain the reduced LH biosynthesis. However, there is a differential effect of continuous GnRH or agonist analog treatment on LH subunit gene expression, with a time-dependent stimulation of common alpha gene expression in intact rats. This may be caused by a stimulatory interaction between GnRH and progestagens at the level of the gonadotrope. Thus, common alpha gene expression is less tightly coupled than that of LH beta to GnRH action. PMID- 3278897 TI - Mutagenic potency of chlorofuranones and related compounds in Salmonella. AB - One of the mutagenic byproducts associated with chlorinated humic waters and kraft pulp bleaching effluents was recently identified as 3-chloro-4 (dichloromethyl)-5-hydroxy-2(5H)-furanone. This compound and several related chlorofuranones and precursors were synthesized and evaluated for direct-acting mutagenicity in Salmonella typhimurium tester strain TA100. Mutagenicity was greatest for 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone, its 5-methoxy derivative, and the precursor in their synthesis, 3-(dichloromethyl)-2,4,4 trichloro-2-butenoic acid. Several of the compounds were tested in the presence of added rat liver homogenate S9 fraction, and in all cases mutagenicity was substantially reduced. An important structural feature which may govern the mutagenic response in these instances appears to be the cis arrangement of CHCl2 and Cl substituents on a carbon-carbon double bond. These compounds may also be transformed in vitro to the same acyclic chlorine substituted alpha, beta unsaturated aldehyde derivative, which is proposed to be the agent responsible for the observed mutagenicity. PMID- 3278898 TI - Adaptive response of Escherichia coli to alkylation damage. AB - Treatment of cells with low levels of alkylating agents for extended periods of time causes them to become resistant to the lethal and mutagenic effects of subsequent high-level challenge treatments with alkylating agents. This increased resistance has been called the adaptive response to alkylation damage and results from the induction of an alkylation-specific DNA repair response. The adaptive response is most efficiently induced by methylating agents and is most effective against the lethal and mutagenic effects of methylation damage to DNA. Four genes have been identified as components of this response, ada, alkA, alkB and aidB. The functions of two of these genes are known. AlkA protein functions as a glycosylase that repairs N3-meA, N3-meG, O2-meT, and O2-meC residues in DNA, and Ada protein functions as an alkyltransferase that removes alkyl groups from O6 meG, O4-meT residues as well as methylphosphotriesters. After it interacts with methylated DNA, Ada protein functions as a positive regulatory element that controls the expression of the adaptive response by stimulating the expression of the ada-alkB operon, and the alkA and aidB genes. PMID- 3278899 TI - Redox and acid-base characterization of cytochrome b-559 in photosystem II particles. AB - The redox and acid/base states and midpoint potentials of cytochrome b-559 have been determined in oxygen-evolving photosystem II (PS II) particles at room temperature in the pH range from 6.5 to 8.5. At pH 7.5 the fresh PS II particles present about 2/3 of their cytochrome b-559 in its reduced and protonated (non auto-oxidizable) high-potential form and about 1/3 in its oxidized and non protonated low-potential form. Potentiometric reductive titration shows that the protonated high-potential couple is pH-independent (E'0, + 380 mV), whereas the low-potential couple is non-protonated and pH-independent above pH 7.6 (E'0, pH greater than 7.6, + 140 mV), but becomes pH-dependent below this pH, with a slope of -72 mV/pH unit. Moreover, evidence is presented that in PS II particles cytochrome b-559 can cycle, according to its established redox and acid/base properties, as an energy transducer at two alternate midpoint potentials and at two alternate pKa values. Red light absorbed by PS II induces reduction of cytochrome b-559 in these particles at room temperature, the reaction being completely blocked by dichlorophenyldimethylurea. PMID- 3278900 TI - Production in Escherichia coli and one-step purification of bifunctional hybrid proteins which bind maltose. Export of the Klenow polymerase into the periplasmic space. AB - Two enzymes, the secreted Staphylococcus aureus nuclease A and the Klenow fragment of the cytoplasmic Escherichia coli DNA polymerase I, were fused, at the genetic level, to MalE, the periplasmic maltose-binding protein of E. coli, or to a signal-sequence mutant. The hybrid proteins were synthesized in large amounts by E. coli under control of promoter malEp. The synthesis was repressed with glucose and could be totally switched off in a malT mutant strain. The hybrid between MalE and the nuclease was exported into the periplasmic space. Several criteria demonstrated that a fraction of the hybrid chains with the Klenow polymerase was exported to the periplasm in a signal-sequence-specific manner and ruled out the possibility of a membrane leakage. The hybrid with the Klenow polymerase was not exported and remained in the cytoplasm when carrying a tight signal-sequence mutation in its MalE portion. The hybrid proteins were purified in one step by affinity chromatography on cross-linked amylose. Most of the hybrid chains in the periplasm but only a fraction of those in the other cell compartments had their MalE portion correctly folded. The nuclease and the Klenow polymerase had their full specific activities in the purified hybrids. The potential of MalE as a vector for the production, export and purification of desirable proteins in E. coli is discussed. PMID- 3278901 TI - T-kinin release from T-kininogen by rat-submaxillary-gland endopeptidase K. AB - Submaxillary gland extracts have been fractionated to characterize the enzyme responsible for the T-kininogenase activity previously reported in this tissue [Damas, J. & Adam, A. (1985) Mol. Physiol 8, 307-316] and to know whether this activity could be of physiological relevance, since no enzyme reacting in catalytic amounts has been described so far to be able to release a vasoactive peptide from T-kininogen. The purified enzyme, provisionally called endopeptidase K, has an apparent Mr of 27,000 when not reduced prior to analysis but 21,000 after reduction and an acidic pI of 4.3 +/- 0.1. Antigenically, it is not related to tissue kallikrein. Upon incubation with purified T-kininogen it may induce a complete liberation of T-kinin from the precursor provided it is added in stoichiometric amounts. However, in parallel with the liberation of immunoreactive kinin, a proteolysis of T-kininogen is observed which is not restricted to the site of insertion of T-kinin as would be expected using a specific kininogenase. In agreement with these results, no change of the mean blood pressure was observed upon injection of endopeptidase K into the circulation of normal rats even if the amount of injected enzyme was up to ten times that required for tissue kallikrein to induce a significant fall in blood pressure. However, in spite of the large proteolysis induced by incubation with stoichiometric amounts of endopeptidase K, the total papain inhibiting capacity of T-kininogen as well as the value of the apparent inhibition constant, Ki, with this proteinase remained unchanged. Proteolytic fragments which retain cysteine proteinase-inhibiting activity may therefore be released from T-kininogen by endopeptidase K more easily than immunoreactive kinin, thus emphasizing a prominent function of proteinase inhibitor or of proteinase inhibitor precursor for this molecule. PMID- 3278902 TI - Sialylated lactosylceramides. Possible inducers of non-specific immunosuppression and atherosclerotic lesions. PMID- 3278903 TI - The heat-shock response in Trypanosoma cruzi. AB - When Trypanosoma cruzi epimastigotes are exposed to temperatures of 37-41 degrees C there is a drastic decline in total protein synthesis. Analysis of the proteins synthesized at 41 degrees C by one-dimensional gel electrophoresis showed three major bands of Mr 83,000, 70,000 and 60,000. A similar pattern of heat-shock proteins was found in two different strains of T. cruzi (Tulahuen and GM strains) and in exponentially growing or in stationary epimastigotes. Actinomycin D prevented the appearance of these polypeptide bands, suggesting that the heat shock proteins in T. cruzi epimastigotes are induced at the level of transcription. Analysis of the proteins synthesized by metacyclic forms at different temperatures suggests that heat-shock proteins in these cells are already synthesized at 27 degrees C. Elevation of temperature above 37 degrees C blocks the synthesis of most proteins in metacyclic forms except for major bands of Mr 83,000, 70,000, 60,000 and 55,000. More detailed analyses by high resolution two-dimensional gel electrophoresis of the proteins synthesized at 27 degrees C or 37 degrees C by epimastigotes indicates that the heat-shock protein pattern is more complex than that demonstrated by one dimension, and at least ten new polypeptides are identified in two-dimensional gels. A similar analysis of metacyclic forms shows that most if not all the proteins present at 39 degrees C are also present at 27 degrees C. This result led us to the suggestion that the differentiation of T. cruzi to metacyclic forms involves the induction of heat shock proteins, which prepares the parasite to infect the mammalian host. PMID- 3278904 TI - Excision of apurinic and/or apyrimidinic sites from DNA by nucleolytical enzymes from rat brain. AB - Apurinic and/or apyrimidinic (AP) sites were excised from PM2 phage DNA by two enzymes: an AP endodeoxyribonuclease isolated from rat neocortex chromatin and a rat brain exodeoxyribonuclease, DNase B III. The resulting gap was filled with DNA polymerase beta prepared from rat liver and finally ligated by Escherichia coli DNA ligase. PMID- 3278905 TI - Highly sensitive peptide-4-methylcoumaryl-7-amide substrates for blood-clotting proteases and trypsin. AB - Seventy-four peptide amides of 7-amino-4-methylcoumarin (Mec) of the type Boc-Xaa Yaa-Arg-NH-Mec were newly synthesized and tested to find specific substrates for blood-clotting proteases and trypsin. The Xaa and Yaa residues of these substrates have been replaced by 12 and 15 different amino acids, respectively. Among these peptides, the followings were found to be most sensitive substrates for individual enzymes: Boc-Asp(OBzl)-Pro-Arg-NH-Mec (kcat = 160 s-1, Km = 11 microM, kcat/Km = 15,000,000 M-1 s-1) for human alpha-thrombin, Z-less than Glu Gly-Arg-NH-Mec (kcat = 19 s-1, Km = 59 microM, kcat/Km = 320,000 M-1 s-1) for bovine factor Xa, Boc-Gln-Gly-Arg-NH-Mec (kcat = 5.8 s-1, Km = 140 microM, kcat/Km = 42,000) for bovine factor XIIa, Boc-Asp(OBzl)-Ala-Arg-NH-Mec (kcat = 9.2 s-1, Km = 120 microM, kcat/Km = 77,000 M-1 s-1) for bovine activated protein C, and Boc-Gly-Phe-Arg-NH-Mec (kcat = 29 s-1, Km = 230 microM, kcat/Km = 130,000 M-1 s-1) for bovine plasma kallikrein. Moreover, Boc-Glu(OBzl)-Ala-Arg-NH-Mec (kcat = 46 s-1, Km = 370 microM, kcat/Km = 120,000 M-1 s-1) was newly found as a good substrate for human factor XIa. Bovine trypsin effectively hydrolyzed peptide-NH-Mec substrates containing Ala and Pro at the P2 site. The most reactive substrate was Boc-Gln-Ala-Arg-NH-Mec (kcat = 120 s-1, Km = 6.0 microM, kcat/Km = 20,000,000 M-1 s-1). PMID- 3278906 TI - Modifications of oxidative phosphorylations in mitochondria isolated from a mutant of Saccharomyces cerevisiae. Possible alterations of the phosphate transport. AB - Mutants of Saccharomyces cerevisiae were isolated which supported two unlinked nuclear mutations conferring thermosensitivity and cold sensitivity respectively, and a mitochondrial one conferring paromomycin sensitivity. Mitochondria isolated from such a mutant exhibited modifications of several phosphate-requiring functions: (a) kinetic parameters of the phosphate dependence of ATP synthesis were modified; (b) in the absence of phosphate the inner mitochondrial membrane exhibited a high proton leakage; (c) mutant mitochondria always exhibited a poor respiratory control and required tenfold more phosphate to reach a maximal state 3 of respiration; (d) phosphate transport, as measured by swelling experiments, was mersalyl-insensitive and, consequently, state 3 of the respiration and ATP synthesis remained less mersalyl-sensitive than in wild-type mitochondria. Analysis of the mitochondrial metabolism of diploid and segregant strains indicates that these modifications are related to the cryosensitive phenotype; however, at present, a cooperative effect of the mitochondrial mutation cannot be eliminated. It is proposed that the phosphate carrier itself or a regulatory element was modified. PMID- 3278907 TI - Thrombin-like inhibitory action of trypsin and trypsin-like proteases on human platelet adenylate cyclase. AB - The effects of trypsin, acrosin and a recently described trypsin-like protease from bovine sperm were studied on adenylate cyclase activity in membranes of human platelets. These proteases caused an immediate decrease in adenylate cyclase activity, which was independent of the platelet membrane concentration used and which was constant for up to 20 min of incubation at 25 degrees C. When the incubation was prolonged, the proteases eliminated their own inhibitory action as well as that of the inhibitory hormone epinephrine. The adenylate cyclase inhibition caused by the proteases was strictly dependent on the presence of GTP (EC50 approximately 0.1 microM), whereas in the absence of GTP only minor changes in enzyme activity were observed at the conditions and protease concentrations used. Maximal inhibition caused by the proteases was between 40% and 60%. Half-maximal inhibition by the purified proteases trypsin and acrosin was observed at about 30 ng/ml and 2 micrograms/ml respectively. Inhibition of platelet adenylate cyclase by the proteases was partially additive with that caused by epinephrine, while with thrombin no additivity was observed. The serine protease inhibitor leupeptin blocked the actions of the proteases when added simultaneously with the enzymes, but was ineffective when added later on. Treatment of platelet membranes with the alkylating N-ethylmaleimide at low concentrations and Mn2+ ions (greater than or equal to 1 mM), both agents known to abolish inhibition of adenylate cyclase via the inhibitory guanine-nucleotide binding protein Gi, eliminated the inhibitory action of the proteases. The data indicate that trypsin and trypsin-like proteases have two opposite effects on the platelet adenylate cyclase system, the well-documented elimination of Gi action and, as shown here, an immediate activation of Gi with subsequent adenylate cyclase inhibition. The data are consistent with the hypothesis that the activation of Gi caused by the proteases is due to an interaction of the proteases with specific cell-surface receptor sites in a manner similar to thrombin. PMID- 3278909 TI - Determination of left ventricular wall thickness and muscle mass by intravenous digital subtraction angiocardiography: validation of the method. AB - Left ventricular (LV) wall thickness and muscle mass are important measures of LV hypertrophy. In 24 patients LV end-diastolic wall thickness and muscle mass were determined (two observers) by digital subtraction angiocardiography (DSA) and conventional LV angiocardiography (LVA). Wall thickness was determined over the anterolateral wall of the left ventricle according to the technique of Rackley (method 1) or by planimetry (method 2). Seventeen patients were studied at rest and seven during dynamic exercise. Wall thickness correlated well between LVA and DSA; the best correlations were obtained by a combined subtraction mode using either method 1 or 2 (method 1, r greater than or equal to 0.80; method 2, r greater than or equal to 0.75). The standard error of estimate of the mean (SEE) was slightly lower for method 2 (less than or equal to 10%) than for method 1 (less than or equal to 13%). DSA significantly overestimated wall thickness by 5 7% with method 1 and underestimated by 12-14% with method 2. Muscle mass correlated well between LVA and DSA; the SEE was less than or equal to 15% for method 1 and less than or equal to 12% for method 2. Overestimation of muscle mass by DSA was 7-11% with method 1 and underestimation was 13-15% with method 2. It is concluded that LV wall thickness can be determined accurately by DSA with an SEE ranging between 10 and 13%. Determination of LV muscle mass is slightly less accurate and the SEE is slightly larger ranging between 13 to 17%. With method 1, wall thickness and muscle mass were overestimated and with method 2 underestimated. PMID- 3278908 TI - Rat liver alcohol dehydrogenase of class III. Primary structure, functional consequences and relationships to other alcohol dehydrogenases. AB - The amino acid sequence of alcohol dehydrogenase of class III from rat liver (the enzyme ADH-2) has been determined. This type of structure is quite different from those of both the class I and the class II alcohol dehydrogenases. The rat class III structure differs from the rat and human class I structures by 133-138 residues (exact value depending on species and isozyme type); and from that of human class II by 132 residues. In contrast, the rat/human species difference within the class III enzymes is only 21 residues. The protein was carboxymethylated with iodo[2(14)C]acetate, and cleaved with CNBr and proteolytic enzymes. Peptides purified by exclusion chromatography and reverse-phase high performance liquid chromatography were analyzed by degradation with a gas-phase sequencer and with the manual 4-N,N-dimethylaminoazobenzene-4'-isothiocyanate double-coupling method. The protein chain has 373 residues with a blocked N terminus. No evidence was obtained for heterogeneity. The rat ADH-2 enzyme of class III contains an insertion of Cys at position 60 in relation to the class I enzymes, while the latter alcohol dehydrogenase in rat (ADH-3) has another Cys insertion (at position 111) relative to ADH-2. The structure deduced explains the characteristic differences of the class III alcohol dehydrogenase in relation to the other classes of alcohol dehydrogenase, including a high absorbance, an anodic electrophoretic mobility and special kinetic properties. The main amino acid substitutions are found in the catalytic domain and in the subunit interacting segments of the coenzyme-binding domain, the latter explaining the lack of hybrid dimers between subunits of different classes. Several substitutions provide an enlarged and more hydrophilic substrate-binding pocket, which appears compatible with a higher water content in the pocket and hence could possibly explain the higher Km for all substrates as compared with the corresponding values for the class I enzymes. Finally the class III structure supports evolutionary relationships suggesting that the three classes constitute clearly separate enzymes within the group of mammalian zinc-containing alcohol dehydrogenases. PMID- 3278910 TI - In memory of G. N. Papanicolaou in the centennial of his birth. AB - The author recalls the most important events in the life of George N. Papanicolaou, "the father of modern cytology", underlining the social message arising out of his scientific achievement and moral personality. PMID- 3278911 TI - Screening for endometrial adenocarcinoma. AB - A careful evaluation of endometrial adenocarcinoma risk factors has allowed the AA. to suggest an integrated screening program, including cytology, hysteroscopy and guided biopsy. First results of this program are then described. PMID- 3278912 TI - CD5 and CD21 molecules are a functional unit in the cell/substrate adhesion of B chronic lymphocytic leukemia cells. AB - The modulation of surface molecules on B-chronic lymphocytic leukemia (B-CLL) cells was studied in vitro by incubation with CD19, CD20, CD21, CD5 and anti-IgM antibodies. The cytoplasmic changes were evaluated by analyzing the organization of cytoskeletal F-actin and the adhesive properties of stimulated B-CLL cells. The following observations were made: (a) CD5 antigen is capped on the surface of B-CLL cells (but not on normal CD5+ B and T lymphocytes). (b) On B-CLL cells, CD5 and CD21, the receptors for the C3d fraction of complement, co-cap and co modulate while surface IgM as well as CD19 and CD20 do not cap. (c) B-CLL cells, after capping of CD5 or CD21 surface molecules, fail to organize F-actin into podosomes. (d) The pre-incubation of B-CLL cells with either CD5 or CD21 antibodies prevents their binding to purified C3d protein used to coat coverslips. These data indicate that an intimate spatial relationship exists between CD5 and CD21 molecules on the B-CLL surface. The CD5-CD21 complex is involved in the redistribution of cytoskeletal proteins which may control the adhesive properties of these malignant B cells. PMID- 3278913 TI - The distribution of two hnRNP-associated proteins defined by a monoclonal antibody is altered in heat-shocked HeLa cells. AB - A monoclonal antibody obtained after mice were immunized with hnRNP purified from HeLa cells recognizes two polypeptides of Mr 35,000 and 37,000. By immunocytofluorescence, these antigens can be visualized only in cells previously heat shocked at 45 degrees C for 5 or 10 min, although they are present at the same level in unstressed and stressed cells. The signal, which is mostly concentrated in the interchromatin space, where hnRNP fibrils are located, does not accumulate with time and disappears 4 to 5 h after heat shock. Discrimination between the two types of hnRNP substructures, the 30-50 S monoparticles and the nuclear matrix fibrils, based on differential sensitivity to salt or ribonuclease treatment, showed that in unstressed cells the antigens behave as monoparticle proteins. In contrast, in heat-shocked cells, most 35-37K antigens behave as nuclear matrix proteins. Thus, heat shock seems to induce a rapid and reversible switch of these two antigens from hnRNP monoparticles to the nuclear matrix. The data demonstrate that heat shock, which was previously shown not to alter the overall RNA: protein packaging ratio of hnRNP, induces subtle modifications of their substructure. Such modifications might be of importance since heat shock is known for instance to affect pre-mRNA processing. PMID- 3278914 TI - Monoclonal antibodies induce the translocation, patching, and shedding of surface antigens of sea urchin spermatozoa. AB - Monoclonal antibodies reacting with external domains of plasma membrane proteins of sea urchin spermatozoa cause the reversible aggregation of sperm. The rate of disaggregation is temperature dependent indicating the involvement of membrane fluidity. Immunofluorescence shows that disaggregation is temporally correlated with the movement of surface-bound antibody into large aggregates which are then shed from the cell surface. Electrophoretic analysis of the shed antigens shows that they resemble the total complement of proteins of isolated sperm membranes. The translocation and shedding of surface-bound ligands may be a common property of eukaryotic flagellar membranes. PMID- 3278915 TI - Protein kinase C is differentially regulated by thrombin, insulin, and epidermal growth factor in human mammary tumor cells. AB - The exposure of serum-deprived mammary tumor cells MCF-7 and T-47D to insulin, thrombin, and epidermal growth factor (EGF) resulted in dramatic modifications in the activity and in the translocation capacity of protein kinase C from cytosol to membrane fractions. Insulin induces a 600% activation of the enzyme after 5 h of exposure to the hormone in MCF-7 cells; thrombin either activates (200% in MCF 7) or down-regulates (in T-47D), and EGF exerts only a moderate effect. Thus, the growth factors studied modulate differentially the protein kinase C activity in human mammary tumor cells. The physiological significance of the results obtained are discussed in terms of the growth response elicited by insulin, thrombin, and EGF. PMID- 3278916 TI - Peripheral nerve grafts lacking viable Schwann cells fail to support central nervous system axonal regeneration. AB - Peripheral nerve grafts were implanted bilaterally into the diencephalon of adult hamsters. One graft segment contained both viable Schwann cells and their basal lamina tubes. The Schwann cell population in the second graft segment was killed by freezing prior to implantation. Seven weeks after graft implantations, the extracranial end of each graft segment was exposed, transected and labelled with a fluorescent tracer substance. One week after the labelling procedure each animal was perfused and the diencephalon and midbrain were examined. Ultrastructural analyses of both types of graft demonstrated the persistence of the Schwann cell-derived basal lamina tubes. Retrogradely labelled neurons were found in all cases in which an intact graft remained in place for two months, but were seen in only one case with a frozen graft. Large numbers of myelinated and unmyelinated axons were seen within the intact grafts, but no axons were found in the previously frozen grafts. These results indicate that lesioned CNS axons are able to regenerate vigorously when provided with an environment which includes viable Schwann cells. But, CNS axons regenerate less well, if at all, when Schwann cells are absent. Further, it appears that Schwann cell-derived basal lamina tubes, when isolated from their parent cells, are insufficient to initiate or sustain CNS axonal regeneration. PMID- 3278917 TI - Platelets, endothelium and blood vessel wall. AB - Aggregating platelets cause contraction of vascular smooth muscle, because they release serotonin and thromboxane A2. If the platelets aggregate in a blood vessel with intact intima, the platelet-products cause endothelium-dependent relaxation of the underlying smooth muscle. Hence, the presence of an intact intima considerably reduces the vasospastic response to platelet-aggregation. The major platelet products which trigger endothelium-dependent relaxations are the adenine nucleotides and serotonin. The ability of the endothelium to prevent platelet-induced vasospasm is augmented after chronic intake of cod liver oil, but is reduced after previous intimal injury. PMID- 3278918 TI - Platelets, platelet-derived growth factor and arteriosclerosis. AB - Platelets participate in the pathogenesis of arteriosclerosis and in the progression of atherosclerosis by adhering to the damaged arteries and subsequently forming mural thrombi which are either swept away and embolize or are endothelialized and thus become part of the vessel wall. Rheologic considerations predict and blood perfusion experiments using flow chambers with exposed vessel wall components demonstrate that platelet participation increases with the wall shear rate and is thus particularly important in stenosed arteries (acute thrombosis) and the microvasculature (hemostasis). In addition to their involvement in thrombosis, activated platelets release growth factors, most notably a platelet-derived growth factor (PDGF) which may be the principal mediator of smooth muscle cell migration from the media into the intima and of smooth muscle cell proliferation in the intima as well as of vasoconstriction. The recent discovery that PDGF can be produced by additional cells involved in the pathogenesis of arteriosclerosis (endothelial cells, monocytes/macrophages, smooth muscle cells themselves) and that they may play a role in tumorigenesis has tremendously increased the interest in this growth factor and in potential antagonists. PMID- 3278919 TI - Platelets and neurobiological research. PMID- 3278921 TI - Regulation of ribosomal protein S6 kinase in human mammary tumor cells: effect of estrogen, growth factors and phorbol ester. AB - Growth of human mammary tumor cells ZR-75-1 is stimulated by estradiol (E2), epidermal growth factor (EGF) and insulin-like growth factor I (IGF-I). In these cells ribosomal protein S6 kinase is activated by EGF, IGF-I, insulin and phorbol 12-myristate 13-acetate (TPA) but not by E2. The human mammary tumor cell line MDA-MB 231, which is E2-receptor negative, has receptors for EGF, IGF-I and insulin but is unresponsive to these factors in terms of growth and S6 kinase activation. The role of protein kinase C (PKC) in the activation of S6 kinase by growth factors and TPA was investigated in ZR-75-1 cells. Down regulation of PKC activity by treatment with TPA for 48-h blocks the stimulation of S6 kinase by TPA but leaves the activation by EGF, IGF-I and insulin unaffected. In intact ZR 75-1 cells staurosporine blocks activation of S6 kinase by EGF and TPA, however with different IC50. The results show that S6 kinase is not activated by estradiol, that its activation by EGF, IGE-I and insulin does not depend on the presence of PKC activity and that its activation by TPA is mediated by a different (PKC-dependent) pathway. PMID- 3278922 TI - Abundant macrophage growth in culture from patients with chronic myelogenous leukemia: a risk factor for graft-versus-host disease after bone marrow transplantation. AB - Peripheral blood cultures of hemopoietic precursor cells from 30 patients with chronic myelogenous leukemia showed different growth patterns before bone marrow transplantation. A strong increase of free and clustered macrophages was seen in 11/30. Of these 11 patients, 10 developed Graft-versus-Host Disease (GvHD). Of 19 patients without the macrophage pattern, 4 developed GvHD (p = 0.004). Of 14 patients with GvHD, 10 had shown the macrophage pattern before bone marrow transplantation, compared to 1/19 without GvHD (p = 0.004). We postulate that excess macrophages in the bone marrow recipient trigger GvHD by enhancing presentation of recipient antigens to donor T-lymphocytes, and that their presence is predictive of GvHD in CML. PMID- 3278920 TI - Platelet monoamine oxidase B: use and misuse. AB - The human platelet in addition to having serotonin (5-HT) receptors, uptake carriers (receptor) and transmitter storage vesicles, primarily possesses mitochondrial monoamine oxidase (MAO) type B. Similar to the major form of MAO in the human brain, this enzyme actively oxidizes A-B and B substrates (tyramine, dopamine, phenylethylamine) as well as the novel secondary amine anticonvulsant, milacemide and dopaminergic neurotoxin, MPTP. 5-HT oxidation is hardly affected by the platelet enzyme and MAO inhibitors have no net effect on its accumulation. MAO-B is selectively inhibited by 1-deprenyl and thus the platelet enzyme may be useful to monitor the anti-Parkinson activity of such drugs, as related to their ability to inhibit brain MAO-B. The oxidation of the anticonvulsant, milacemide, to glycine in vitro and in vivo by MAO-B, may herald new prospects for the development of inert prodrugs capable of being metabolized to neuroactive substances by MAO-B. The plasma levels of their metabolites may be an index of MAO-B activity found in the platelet and brain. PMID- 3278923 TI - Thymine dimer repair in fibroblasts of patients with dysplastic naevus syndrome (DNS). AB - Dysplastic naevus syndrome (DNS) is frequently observed in association with familial melanoma and xeroderma pigmentosum (XP), but the role of UV-light in the development of DNS has not been elucidated. Previous work has shown that UV induced unscheduled DNA synthesis is associated with the early loss of antigenicity observed in immunoassays using a monoclonal antibody specific for thymine-thymine dimers. We now show that the rate of loss of antigenicity, which reflects the relative amount of bound antibody, observed during the first 60 min following 10 Jm-2 UVC irradiation is significantly reduced (p = 0.02) in cultures of fibroblasts from 7 out of 8 DNS patients compared with the results from cells of a group of 30 healthy volunteers. This observation suggests an early event in excision repair is altered in the majority of DNS patients. PMID- 3278924 TI - The platelet in pathophysiological research. Celebrating the 70th birthday of Professor Alfred Pletscher and the first ten years of the Department of Research of the University Hospital of Basel. PMID- 3278925 TI - Alfred Pletscher. PMID- 3278927 TI - Effect of androgens on the response to antithymocyte globulin in patients with aplastic anaemia. AB - 30 patients with aplastic anaemia (18/30 with severe aplastic anaemia) were prospectively randomized to be treated with 100 mg/kg ATG with or without the oral androgen Methenolone (3 mg/kg). 15 of 30 patients responded. Among the 15 patients receiving ATG plus androgen, 11 patients (73%) responded, including 8 complete and 3 partial responses. 4 of the 15 patients (31%) receiving ATG only responded, including 2 complete and 2 partial responses. The difference in response rate was statistically significant (p = 0.01). The survival rate in the total population of 30 patients was 64%. The survival rate in the group receiving ATG plus androgen was 87%; in the group receiving ATG only it was 43%. The difference in survival rates between both groups did not reach statistical significance (p = 0.15). Toxicity of ATG and androgens was considerable but manageable. These data support the result of the recent European reevaluation of a large pool of patients by the EBMT (39), that androgens in addition to ATG increase survival in patients with aplastic anaemia. They are, however, in contradiction to a controlled American study showing no benefit of a combined treatment with androgens as compared to ATG only. Further controlled studies on a larger number of patients are indicated to determine the therapeutic efficacy of androgens in addition to immunosuppression in aplastic anaemia. PMID- 3278926 TI - Cytosolic calcium in platelet activation. AB - Experiments with permeabilised platelets, and with intact platelets loaded with fluorescent Ca2+-indicators, over the past several years have greatly extended our knowledge and understanding of cytosolic Ca2+ as a platelet activator and its interactions with other cytosolic regulators. This article outlines insights, gained from the use of the fluorescent dyes, into maintenance and restoration of basal [Ca2+]i, mechanisms of receptor-mediated Ca2+-mobilisation and quantitation of [Ca2+]i/response relations in intact human platelets. PMID- 3278928 TI - Kinetics of hemopoietic stem cells in a hypoxic culture. AB - The influence of low oxygen tension on the clonal growth of hemopoietic stem cells in vitro was examined. The numbers of colonies of neutrophil, macrophage, and eosinophil progenitors (CFU-C), derived from human bone marrow, increased at a rate 1.7 times higher in low oxygen tension (7% O2) than in a gas phase that contained air (19% O2). The erythroid (BFU-E) and multipotential (CFU-mix) progenitors increased about 2.4 times in 7% O2, and the increase in the composed cell type of mixed colonies showed no rate difference in either gas phase. Under atmospheric conditions, a mouse mast cell progenitor (CFU-mast) formed colonies, with the addition of 2-mercaptoethanol (2-ME). Under low oxygen tension, the CFU mast formed colonies without 2-ME, but a further enhancement was observed with the addition of 2-ME. Blood gas analysis of human bone marrow showed a pO2 of 51.8 +/- 14.5 mmHg, which was closed to O2 tension in a gas phase culture media containing 7% O2. This data shows that the physiological O2 tension enhances hemopoietic stem cell proliferation in vitro, and that a part of the enhancing effect by 2-ME is due to a prevention of O2 toxicity at 19% O2. PMID- 3278929 TI - Ultrasonic characterization of splenic tissue in myelofibrosis: further evidence for reversal of fibrosis with chemotherapy. AB - Fibrosis in patients with myelofibrosis (MF) is seen not only in the bone marrow but also around the metaplastic foci in the spleen and liver. Following our observation of reversal of bone marrow fibrosis in MF patients treated with chemotherapy, we undertook ultrasonic splenic tissue characterization studies using sound speed measurements to assess the effect of such therapy on the splenic fibrosis. Single studies in 19 patients showed overlapping ranges among the three sub-groups classified according to the grade of bone marrow fibrosis, but the mean values in these sub-groups showed a trend towards decreasing sound speed with increasing marrow fibrosis. Sequential studies in 9 of these patients showed increased splenic sound speed with decreasing marrow fibrosis in 8 patients following treatment, with a reversal of this pattern seen in 1 patient 1 2 years post-treatment. These results suggest simultaneous reversal of fibrosis in the bone marrow and the spleen in MF patients receiving effective chemotherapy. PMID- 3278930 TI - Gene probe analysis demonstrates independent clonal evolution of co-existent chronic myeloid and chronic lymphocytic leukaemia. AB - We describe a case of Philadelphia-positive chronic myeloid leukaemia occurring simultaneously with B-cell chronic lymphocytic leukaemia in a 69-yr-old male. Gene probe analysis of DNA from both peripheral blood and bone marrow provided evidence for the independent evolution of 2 clones in this case, with a predominant population showing immunoglobulin heavy chain gene rearrangement and a smaller population showing a rearrangement within the breakpoint cluster region of chromosome 22. PMID- 3278931 TI - The fluorescence intensity of the lipophilic probe N-phenyl-1-naphthylamine responds to the oxidation-reduction state of purified Escherichia coli cytochrome o incorporated into phospholipid vesicles. AB - N-Phenyl-1-naphthylamine (NPN), a reagent which has been used previously to probe the fluidity or microviscosity of the membrane lipids of intact cells of Escherichia coli, was found to respond to the redox state of purified cytochrome o incorporated into lipid vesicles formed from purified or E. coli phospholipids. NPN was bound to the proteoliposomes to produce a steady-state level of fluorescence intensity. Addition of the substrate ascorbate, in the presence of phenazine methosulfate as an electron donor, did not alter the fluorescence. However, following complete removal of oxygen from the medium by oxidation of the substrate by molecular oxygen catalyzed by cytochrome o, there was an increase in the fluorescence of NPN. This coincided with the reduction of cytochrome o. Reoxidation of the cytochrome by addition of oxygen decreased the fluorescence to steady-state levels until the oxidant had been completely reduced. The fluorescence changes were dependent on the incorporation of cytochrome o into phospholipid vesicles but were insensitive to the state of energization of the vesicle membrane. PMID- 3278932 TI - Calcium-dependent KEX2-like protease found in hepatic secretory vesicles converts proalbumin to albumin. AB - The yeast KEX2 protease is the only enzyme that has a proven role in the activation of polypeptide hormones through cleavage at pairs of basic residues. The enzyme that fulfils this role in higher eukaryotes has yet to be unequivocally identified. In this investigation, a KEX2-like calcium-dependent protease has been identified in rat hepatic microsomes. The enzyme is membrane bound, has a pH optimum of 5-6 and converts proalbumin to albumin. More importantly, like the KEX2 protease, it meets two other exacting criteria defined by specific mutations in humans. Namely, it does not process proalbumin Christchurch (-1 Arg----Gln) which lacks one of the requisite basic residues and, whilst not itself a serine protease, it is inhibited by the reactive center variant, alpha 1-antitrypsin Pittsburgh (358 Met----Arg) but not by normal alpha 1-antitrypsin. PMID- 3278933 TI - A new strategy for primary structure determination of proteins: application to bovine beta-casein. AB - A new approach has been developed for sequencing proteins. A radioactive label is attached specifically to the C-terminus of the protein. The labelled molecule is subjected to varying proteolysis conditions. From the electrophoretic patterns (SDS-PAGE) of the hydrolysates, appropriate cleavage conditions are selected, giving labelled peptides of different lengths which are purified. The labelled peptides are sequenced in order of increasing size (from 1 to n), peptide (i) being sequenced until the N-terminal sequence of peptide (i-1) is encountered. This approach allows the determination of a complete protein sequence with a minimal number of Edman cycles. The method was successfully applied to bovine beta-casein (209 residues) which was completely resequenced with only 239 Edman cycles. PMID- 3278934 TI - Expression of human leukotriene A4 hydrolase cDNA in Escherichia coli. AB - The cDNA clone encoding human leukotriene A4 hydrolase was inserted into a vector pUC9 and expressed in Escherichia coli as a fusion protein containing the first 10 amino acid residues derived from a vector. The leukotriene A4 hydrolase activity was recovered in the soluble fraction of the transformants. The purified enzyme showed kinetic properties similar to the native enzyme, including inactivation by the substrate and sulfhydryl-modifying reagents. The results demonstrate that a protein with an Mr of 70,000 was expressed in Escherichia coli with a full enzyme activity and structural fidelity. Acquisition of the expression system makes it feasible to elucidate the reaction mechanism of the enzyme. PMID- 3278935 TI - Ectoenzymes of the kidney microvillar membrane. Aminopeptidase P is anchored by a glycosyl-phosphatidylinositol moiety. AB - The mode of membrane anchorage of three kidney microvillar membrane ectoenzymes has been examined. The release of aminopeptidase P (EC 3.4.11.9) from kidney membranes by bacterial phosphatidylinositol-specific phospholipase C (PI-PLC) and the pattern of detergent solubilization of this ectoenzyme implies that it is anchored to the membrane via a covalently attached glycosyl-phosphatidylinositol moiety. As deduced by phase separation in Triton X-114, octyl-glucoside solubilized the amphipathic form of aminopeptidase P, whereas the PI-PLC-released form displayed hydrophilic properties. In contrast, the pattern of detergent solubilization of two microvillar carboxypeptidases and their resistance to release from the membrane by bacterial PI-PLC suggest that these two ectoenzymes are not anchored via phosphatidylinositol. PMID- 3278936 TI - Monoclonal antibodies in immunodiagnosis and immunotherapy of human cancer. PMID- 3278937 TI - Urinary excretion of beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase in advanced neuroblastoma patients receiving cis-diamminedichloroplatinum(II). AB - Urinary excretion of beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase (NAG) were determined in eight patients with advanced neuroblastoma receiving cis diamminedichloroplatinum(II) (CDDP). Urinary excretion of beta 2-microglobulin was increased within 3 days after CDDP treatment and returned to its pretreatment level within the first week. Increased urinary excretion of NAG was observed until the end of the second week after CDDP administration. But the measured values on the third day after CDDP administration were not significantly correlated with the accumulated dose of CDDP administered. These results indicate that beta 2-microglobulin excretion and NAG enzymuria after CDDP treatment are sensitive parameters of acute renal tubular damage, but the long-term latent nephrotoxicity of CDDP cannot be predicted from these parameters. PMID- 3278938 TI - Allogeneic bone marrow transplantation: current status. PMID- 3278939 TI - Otitis media: an overview of current treatment. PMID- 3278940 TI - Women doctors from Johns Hopkins. PMID- 3278941 TI - Immunolocalization of laminin in normal rat liver and biosynthesis of laminin by hepatic lipocytes in primary culture. AB - Laminin, a glycoprotein with a molecular weight of approximately 850,000 daltons, is a major constituent of most epithelial basement membranes. Its presence in the extracellular matrix of normal liver, however, is debated. Using two affinity purified antibodies directed against laminin, we have localized the glycoprotein within normal rat liver and identified its cellular source. Immunofluorescent staining of rat liver sections revealed laminin in a continuous distribution around hepatic sinusoids, adjacent to hepatocytes and sinusoidal lining cells. To determine the cellular origin of laminin, three perisinusoidal cell populations (hepatocytes, sinusoidal endothelial cells, and lipocytes) were purified from enzymatically dispersed rat liver and were established in primary culture. By immunofluorescence, laminin was associated almost exclusively with lipocytes. Synthesis of laminin was demonstrated by immunoprecipitation of the protein from lipocyte culture medium pulse-labeled with radioactive methionine. These results show that in adult liver, laminin is present in the perisinusoidal matrix and is produced by hepatic lipocytes. Lipocytes, which have the capacity to produce collagen as well as laminin, may be the principal source of extracellular matrix proteins in the perisinusoidal space, and may contribute to subendothelial fibrosis resulting from liver injury. PMID- 3278943 TI - The sensory-efferent function of capsaicin-sensitive sensory neurons. AB - Capsaicin-sensitive sensory neurons convey to the central nervous system signals (chemical and physical) arising from viscera and the skin which activate a variety of visceromotor and neuroendocrine reflexes integrated at various levels (intramurally in peripheral organs, at level of prevertebral ganglia, spinal and supraspinal level). Much evidence is now available that peripheral terminals of certain sensory neurons, widely distributed in skin and viscera have the ability to release, upon adequate stimulation, their transmitter content. In addition to the well-known "axon reflex" arrangement, the capsaicin-sensitive sensory neurons have the ability to release the stored transmitter also from the same terminal which is excited by the environmental stimulus. The efferent function of these sensory neurons is realized through the direct and indirect (i.e. mediated by activation of other cells) effects of released mediators. The action of released transmitters on postjunctional elements covers a wide range of effects which may have a physiological or pathological relevance. Development of drugs capable of controlling the sensory-efferent functions of the capsaicin-sensitive sensory neurons represent a new and very promising area of research for pharmacological treatment of various human diseases. PMID- 3278942 TI - 5-Aminosalicylic acid enemas: effective agent in maintaining remission in left sided ulcerative colitis. AB - The efficacy of 5-aminosalicylic acid enemas in maintaining remission in left sided ulcerative colitis was studied. Twenty-five patients in remission for at least 2 mo were randomized to receive either 1-g 5-aminosalicylic acid or placebo enemas daily and were followed up for 1 yr. Eleven of 13 patients randomized to placebo relapsed after a mean of 16 wk. Nine of 12 patients randomized to 5 aminosalicylic acid remained in remission for 1 yr, 2 others in remission withdrew by request, and 1 relapsed at 10 wk. The difference between relapse rate on 1-g 5-aminosalicylic acid versus placebo was significant (p less than 0.005). Seven patients entered the blinded trial a second time. Three of 4 patients randomized to 5-aminosalicylic acid remained in remission and 1 relapsed. Three randomized to placebo relapsed at a mean of 14 wk. One-gram 5-aminosalicylic acid enemas are safe and effective in maintaining remission in patients with left sided ulcerative colitis. PMID- 3278944 TI - Metabolic side effects induced by diuretic therapy: problems and possible solutions. PMID- 3278945 TI - Pharmacological profile of droxicam. AB - In Studies of anti-inflammatory activity, droxicam has shown itself to be as active as piroxicam and much more active than phenylbutazone, isoxicam and suprofen, both in acute studies such as carrageenin oedema, nystatin oedema and ultraviolet erythema, and in longer-term tests such as that of the cotton pellet. In the studies of anti-arthritic activity, which require long-term treatment, droxicam was as effective as piroxicam, both on primary and on secondary lesions. The study of analgaesic activity, conducted by means of the tests of protective activity against writhing induced by phenylbenzoquinone and acetylcholine bromide in the mouse and by acetic acid in the rat, droxicam activity was superior to that of acetylsalicylic acid, dipyrone, isoxicam and phenylbutazone. Droxicam also showed antipyretic activity in the rat, greater than that of acetylsalicylic acid, dipyrone and 4-aminoantipyrine, in the brewer's yeast and Salmonella typhi tests. Droxicam also acts as an ex vivo platelet aggregation inhibitor in the dog. In the study of inhibition of peritoneal capillary permeability in the mouse, droxicam was considerably more potent than isoxicam or phenylbutazone. Studies of general pharmacology have demonstrated that droxicam, at high doses, has no cardiovascular or respiratory effects, and that neither does it modify behaviour in rats and mice, determined by the Irwin test. Gastrointestinal tolerance of droxicam has been compared with that of piroxicam, and it has been found that droxicam is far better tolerated. The study of induction of gastrointestinal lesions in the rat demonstrated that the gastrolesive potential of droxicam is 10 times inferior to that of piroxicam.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278946 TI - Therapeutic potential of selective D-1 dopamine receptor agonists and antagonists in psychiatry and neurology. PMID- 3278947 TI - Evaluation and treatment of sleep disorders in the medical setting. AB - Sleep disturbances may complicate the clinical presentation of medically ill patients. The assessment and management of sleep disorders in this population requires direct attention to the nature of the relationships between medical illness and sleep disorder. In this paper we present a systematic description of these relationships, which include sleep disturbances secondary to symptoms of a medical illness, sleep disturbances secondary to medical treatment, sleep disorders sharing a similar pathophysiology with medical symptoms, and sleep disturbances and medical symptoms secondary to a psychiatric disorder. PMID- 3278948 TI - Neurology and psychiatry. AB - There has been a long historical relationship between neurology and psychiatry. This relationship has been nurtured by the common interest in the central nervous system and disturbed behavior associated with dysfunctions of the nervous system. This paper reviews the formal relationships between neurology and psychiatry and particularly looks at the behavioral aspects of neurological disease. For the past 10 years, both from a clinical and a theoretical viewpoint, the importance of understanding central nervous system functioning and dysfunctioning has become increasingly apparent to psychiatrists. PMID- 3278949 TI - Care provision through the ages: Part 1. Primeval and mediaeval times. PMID- 3278950 TI - Vascular effects of oxygen-derived free radicals. AB - This review attempts to summarize the available data regarding the vascular actions of free oxygen radicals. Studies on blood vessels in situ and in vitro demonstrate that free oxygen radicals can evoke both vasodilation and vasoconstriction. Free oxygen radicals can modulate the tone of vascular smooth muscle by acting directly on the smooth muscle cells, and also via indirect mechanisms by changes in the production or biological activity of vasoactive mediators. The individual oxygen radicals may have different (sometimes opposite) vascular effects. Superoxide anion inactivates endothelium-derived relaxing factor and the adrenergic neurotransmitter norepinephrine. Hydrogen peroxide and the hydroxyl radical evoke vasodilation by acting directly on vascular smooth muscle and also by stimulating the synthesis/release of endothelium-derived relaxing factor. In acute arterial hypertension or experimental brain injury oxygen radicals are important mediators of vascular damage. Production of oxygen derived free radicals by activated neutrophils may be responsible for vasodilation and increased permeability of capillary membrane during the acute inflammatory process. Free oxygen radicals also play an important role in reperfusion injury of various organs, and vascular actions of the free radicals may contribute to the damage of parenchymal tissues. PMID- 3278951 TI - The effect of oxidant gases on membrane fluidity and function in pulmonary endothelial cells. AB - Free radicals and oxidant gases, such as oxygen (O2) and nitrogen dioxide (NO2), are injurious to mammalian lung cells. One of the postulated mechanisms for the cellular injury associated with these gases and free radicals involves peroxidative cleavage of membrane lipids. We have hypothesized that oxidant related alterations in membrane lipids may result in disordering of the plasma membrane lipid bilayer, leading to derangements in membrane-dependent functions. To test this hypothesis, we examined the effect of exposure to high partial pressures of O2 or NO2 on the physical state and function of pulmonary endothelial cell plasma membranes. Both hyperoxia (95% O2 at 1 ATA) and NO2 exposure (5 ppm) caused early and significant decreases in fluidity in the hydrophobic interior of the plasma membrane lipid bilayer and subsequent depressions in plasma membrane-dependent transport of 5-hydroxytryptamine. Lipid domains at the surface of pulmonary endothelial cell plasma membranes are more susceptible to NO2-induced injury than to hyperoxic injury. Alterations in the fluidity of these more superficial domains are associated with derangements in surface dependent functions, such as receptor-ligand interaction. These results support our hypothesis and advance our understanding of how the chemical events of free radical injury associated with high O2 and NO2 tensions are translated into functional manifestations of O2 and NO2-induced cellular injury. PMID- 3278952 TI - Lipid peroxidation and endothelial cell injury: implications in atherosclerosis. AB - Vascular endothelial cells, which play an active role in the physiological processes of vessel tone regulation and vascular permeability, form a border separating deeper layers of the blood vessel wall and cellular interstitial space from the blood and circulating cells. Damage or dysfunction of endothelial cells may reduce the effectiveness of the endothelium to act as a selectively permeable barrier to plasma components, including cholesterol-rich lipoprotein remnants. This may be involved in the etiology of atherosclerosis. Experimental evidence indicates that free radical-mediated lipid peroxidation can induce endothelial cell injury/dysfunction. Reactive oxygen species, including peroxidized lipids capable of initiating cell injury, may be generated within endothelial cells, be present in plasma components, or be derived from neutrophils or other blood-borne cells. Lipid peroxidation could initiate or promote the process of atherosclerotic lesion formation by directly damaging endothelial cells, and by enhancing the adhesion and activation of neutrophils and the susceptibility of platelets to aggregate. Endothelial cell injury by lipid hydroperoxides also could increase the uptake of LDL into the vessel wall. These events and other cellular dysfunctions may individually or collectively initiate and/or help to sustain the development of atherosclerosis. PMID- 3278953 TI - Non-surgical treatment of gall stones: many contenders but who will win the crown? PMID- 3278955 TI - Effect of omeprazole and cimetidine on prepyloric gastric ulcer: double blind comparative trial. AB - We conducted a six week double blind randomised study of 176 patients with prepyloric gastric ulcer to determine whether the proton pump inhibitor, omeprazole 30 mg daily would accelerate healing and pain relief, as compared with cimetidine 1 g daily. At two, four, and six weeks after entry ulcers healed in a larger percentage of patients treated with omeprazole (54, 81, and 86%) than of those treated with cimetidine (39, 73, and 78%) ('intention to treat' cohort; p less than 0.05 at two weeks). A higher proportion of patients on omeprazole became free of pain during the first week of treatment (p less than 0.05). No major clinical or biochemical side effects were noted. Omeprazole is an efficient treatment for patients with prepyloric gastric ulcers. PMID- 3278956 TI - Sarcoma botryoides of the uterine cervix in young women: a clinicopathological study of 13 cases. AB - Although the clinical and pathological features of sarcoma botryoides of the vagina in infancy are well documented in the literature, only occasional cases of a histologically similar tumor of the uterine cervix have been described, mostly as individual case reports. We have reviewed 13 cases of sarcoma botryoides of the cervix. The patients range in age from 12 to 26 years, with a mean of 18 years. All presented with vaginal bleeding, "something" protruding from the introitus, or both. On gross examination the tumors were polypoid, smooth, glistening, and focally hemorrhagic. Microscopic examination revealed the presence of a cambium layer and cells showing the features of rhabdomyoblasts in all the cases. Six of the 13 tumors (45%) contained foci of mature cartilage. All the patients were alive and well 1 to 8 years (average 3.5 years) postoperatively except for one who died of the tumor after 1 year. Although most of the patients had a radical operation, sometimes followed by chemotherapy, three had excellent results after polypectomy or cervicectomy. The findings indicate that, unlike its counterpart in the vagina, which has a poor prognosis, sarcoma botryoides of the cervix in young women has a favorable outlook. PMID- 3278954 TI - Effect of calcitonin and calcitonin gene-related peptide on pancreatic functions in man. AB - Calcitonin gene-related peptide (CGRP) has recently been identified in central and peripheral nerve fibres, including those of blood vessels supplying the exocrine pancreas, and in pancreatic islet cells. Moreover, receptors have been characterised in the same tissue. The present study examined the effects of human CGRP and of calcitonin on exocrine pancreatic secretion and on islet cell function in nine healthy volunteers. CGRP (300 ng/kg/h) caused, respectively, a 25% and 31% inhibition of caerulein stimulated trypsin and amylase output which was similar to that seen with calcitonin (300 ng/kg/h). Arginine stimulated insulin and glucagon release was unaffected by either CGRP, or calcitonin. Calcitonin gene-related peptide caused cutaneous flushing, but did not affect the pulse rate or arterial blood pressure in the doses tested. Calcitonin gene related peptide inhibits exocrine pancreatic secretion in vivo in man, but does not affect islet cell hormone release. PMID- 3278957 TI - Home care for ventilator-dependent persons: a cost-effective, humane public policy. AB - The study measured cost-effectiveness of home care for severely disabled persons. Findings support home care as more cost-effective than other alternatives for ventilator-dependent persons. Home care-related policy reform in Medicaid, Medicare, Supplemental Security Income, and subsidized housing, coupled with a coordinated service delivery system, could save millions of public dollars. To accomplish this, policies must accommodate and encourage independent community living for the disabled and the integrity of their families. PMID- 3278958 TI - Chemical and biological properties of indole glucosinolates (glucobrassicins): a review. AB - Glucosinolates are a group of secondary products commonly, but not exclusively, found in plants of the family Cruciferae. They give rise, upon enzymic hydrolysis, to a range of volatile, pungent and physiologically active compounds. Recently, particular attention has been focused upon those that are trytophan derived--the indole glucosinolates (glucobrassicins). When chemically or enzymically hydrolysed these compounds give rise to a range of involatile indole compounds which have been implicated in the anti-carcinogenic and mixed-function oxidase stimulatory activities of brassica vegetables. This review details the chemical and physiological properties of indole glucosinolates and their products and suggests possible areas for future research. PMID- 3278959 TI - [Modern lung function measurements for general practice]. PMID- 3278961 TI - An overview of psychiatric treatment approaches to three offender groups. AB - The chances for successful management of three groups of mentally ill offenders- insanity acquittees, sexual offenders, and offenders with alcohol problems--can be maximized by using specific diagnostic and therapeutic techniques for each group. The recommended model for treatment of insanity acquittees is based on a single administrative organization to oversee treatment programs, which include clearly defined inpatient and outpatient components and careful monitoring of conditional release to the community. Techniques for the diagnosis of sexual offenders include bioimpedance and physiological measures of sex hormone levels and penile tumescence. Medication with antiandrogens and cognitive behavioral treatment using covert sensitization and operant aversion are among the appropriate therapeutic modalities. Treatment of persons charged with alcohol related crimes should be matched to the severity of the alcohol problem. Legal intervention supplemented by brief treatment programs may be effective for offenders with lesser degrees of alcohol abuse. For offenders with more serious alcohol problems, longer group treatment or detoxification may be necessary. Treatment of alcoholic criminals may be most effective in peer groups in institutional settings, where legal coercion can be used to encourage compliance. PMID- 3278962 TI - Communication can prevent med staff conflict. PMID- 3278960 TI - [Dihydroergotamine and flunarizine in the prevention of migraine. A comparative double-blind study]. PMID- 3278963 TI - HHS seeks 2.34-3.34% PPS increase in FY 1989. PMID- 3278964 TI - Struggles ahead for high Medicare hospitals. PMID- 3278965 TI - U.S. District Court restores Medicaid cuts in Louisiana. PMID- 3278966 TI - Establishing, promoting audiology services. PMID- 3278967 TI - Monoclonal antibodies reactive with normal and neoplastic T cells in paraffin sections. AB - Without fresh or frozen tissue, it previously has been impossible to confirm the T-cell nature of reactive or neoplastic lymphoid cells. The availability of antibodies reactive with T cells in paraffin sections now allows retrospective analysis of a large number of cases. Two commercially available monoclonal antibodies, MT1 and MT2, were tested for their reactivities with T cells in a wide range of formalin-fixed, paraffin-embedded tissues, including 130 cases of immunologically characterized lymphoma. In reactive lymph nodes, MT1 stained the T-cell areas, whereas MT2 stained both the T-cell areas and mantle-zone B lymphocytes. MT1 stained 38 of 55 T-cell lymphomas (69.1%; 94.7% of cases from one hospital that used a shorter fixation time, and 55.6% of cases from another hospital that used a longer fixation time). MT2 stained only 6 (10.9%) of the T cell lymphomas. Among the 74 cases of B-cell lymphoma, 3 (4.0%) were stained by MT1 and 30 (40.5%) by MT2.MT1 was also reactive with 3 of 4 cases of granulocytic sarcoma, as expected from its reactivity with normal granulocytes. Neither MT1 nor MT2 stained Reed-Sternberg cells or their variants in HodgKin's disease. We conclude that MT1 is a valuable marker for T cells, particularly when used with a panel of antibodies reactive with B cells in paraffin sections. MT2 is of limited value because of its cross-reactivity with many B-cell lymphomas. PMID- 3278968 TI - Primary squamous cell carcinoma of the colon arising in a villous adenoma. AB - The first case of pure squamous cell carcinoma arising in a villous adenoma of the cecum is reported, and the literature of squamous cell carcinoma of the colon is reviewed. The possible origin of this neoplasm in adenomas of the colon, similar to that of adenocarcinoma, is discussed, and the site distributions of adenocarcinoma and squamous cell carcinoma are compared. The distribution of primary colonic squamous cell carcinoma is found to be predominantly right-sided in comparison to adenocarcinoma (p less than 0.05). Although this result does not preclude adenomas as the origin of most squamous cell carcinomas, it suggests the influence of as yet unknown site-asymmetric factors that are different from those for adenocarcinoma. PMID- 3278969 TI - The enigma of non-gonococcal urethritis: role for Bacteroides ureolyticus. AB - Although up to about half the cases of acute non-gonococcal urethritis (NGU) are caused by Chlamydia trachomatis organisms (chlamydiae) and a smaller, ill defined, proportion probably by Ureaplasma urealyticum organisms (ureaplasmas), the aetiology of all cases is not understood. Clarification of the role of the anaerobe, Bacteroides ureolyticus, was sought in the current study. Seventy five chlamydia negative patients with NGU were treated on a double blind placebo controlled basis with metronidazole. After seven days more of the 35 patients given this drug tended to improve clinically than the 40 given the placebo, but the difference was not significant. Of 23 chlamydia negative but anaerobe positive men, however, 78% (7/9) receiving metronidazole responded clinically, but only 7% (1/14) receiving placebo responded (p less than 0.001). Furthermore, whereas 78% of the anaerobe positive men given metronidazole recovered, only 23% (6/26) of the anaerobe negative men did so (p less than 0.02). No further evidence for the role of ureaplasmas in the aetiology of NGU was obtained, but the data suggest that B ureolyticus organisms, and perhaps other anaerobes, have an important role in a small proportion of cases and that the beneficial effects of metronidazole given on an empirical basis will be confined to anaerobe positive urethritis. PMID- 3278970 TI - Ciprofloxacin treatment of chlamydial infections of urogenital tracts of women. AB - Ciprofloxacin was evaluated in chlamydial infections of the urogenital tracts of women treated with a dosage regimen of 500 mg orally twice a day for seven days. Of the 40 women evaluated, 30 were infected with Chlamydia trachomatis only, two were infected with Neisseria gonorrhoeae only, and a further eight had combined gonococcal and chlamydial infections. Ten were found to be harbouring Chlamydia trachomatis in the urethra as well as the cervix. Neisseria gonorrhoeae was eradicated from all patients with or without concomitant chlamydial infection. The overall chlamydial reisolation rates were 14% (5/35) four weeks after treatment and 23% (6/26) 11 weeks after treatment. The organism was not reisolated from the urethra of any of the patients after treatment. Ciprofloxacin was effective against Mycoplasma hominis, but almost completely ineffective against Ureaplasma urealyticum. PMID- 3278971 TI - Managing trichomonal vaginitis refractory to conventional treatment with metronidazole. AB - Three patients with vulvovaginitis caused by Trichomonas vaginalis, which was refractory to conventional treatment with metronidazole are described. The T vaginalis strain isolated from one patient was resistant to metronidazole (minimum inhibitory concentration (MIC) more than 100 mg/l) under aerobic conditions, although under anaerobic conditions it was as susceptible as a normal reference strain. The effect of the concomitant use of other medication and the influence of other vaginal pathogens on the efficacy of metronidazole are highlighted. PMID- 3278973 TI - Free radicals and antioxidant protection: mechanisms and significance in toxicology and disease. PMID- 3278972 TI - Paraquat poisoning by skin absorption: a review. AB - All reported cases of paraquat poisoning by absorption through the skin are briefly reviewed. It is concluded that, while paraquat cannot be absorbed significantly through intact human skin, damage to the skin, either by paraquat itself or by other means, will permit greater systemic absorption and possibly poisoning. The lowest known concentration of paraquat to result in fatal poisoning through the skin is 5 g/l. Animal experiments with paraquat are also reviewed. The fact that the reported lethal dermal dose of paraquat in rats is slightly less than the oral dose is probably due to the lack of head restraint on the rats in the dermal dosing experiments. In vivo and in vitro tests on human skin at concentrations of 9 g/l and 5 g/l did not result in significant absorption of paraquat through the skin but in these experiments the skin was intact. PMID- 3278974 TI - Diabetes mellitus and hypertension. State of the art lecture. AB - In rats with streptozotocin-induced diabetes an increase in arterial blood pressure was observed as early as the first week after the drug was injected. Blood pressure reached maximal values around the fourth week and remained stable for a long period of follow-up. The responsiveness of these rats to the three major vasopressor hormones, angiotensin II, norepinephrine, and vasopressin, was decreased in the early phase of diabetes and returned to normal in the late phase. Acute treatment at the third, sixth, and twelfth weeks with blockers of these vasopressor hormones resulted in a significant fall in blood pressure at the third week with captopril and at the twelfth week with propranolol plus phentolamine. No significant fall was observed when a specific vasopressin inhibitor was administered. Good control of the blood pressure was obtained when these rats were treated chronically with captopril or prazosin, and partial control was achieved when they were fed a low salt diet. An attenuation in arterial blood pressure levels was observed in rats with two-kidney, one clip hypertension when diabetes was induced by streptozotocin. Plasma creatine levels in diabetic rats were significantly higher than those in control rats only in the sixth and twelfth weeks. Electron microscopy revealed some minor glomerular lesions only at the twelfth week. PMID- 3278976 TI - Labetalol blunts morning pressor surge in systolic hypertension. AB - Twenty-four-hour ambulatory blood pressure, including the acceleration phase, and left ventricular mass were evaluated in 16 patients with isolated systolic hypertension (standing blood pressure greater than or equal to 160 mm Hg systolic and less than or equal to 95 mm Hg diastolic). After a 4-week, single-blind, placebo period, each patient underwent 24-hour ambulatory blood pressure monitoring and echocardiography. Labetalol therapy was then initiated at 100 mg twice a day in a single-blind manner and increased weekly by 100 mg twice a day until blood pressure control was obtained or a maximum dosage of 400 mg twice a day was reached. Blood pressure control was achieved at a mean daily dose of 363 +/- 46 mg of labetalol. Measurements were repeated at the end of an 8-week maintenance phase. Labetalol therapy significantly reduced the mean 24-hour systolic ambulatory blood pressure from 154 +/- 8 (mean +/- SEM) mm Hg at baseline to 142 +/- 6 mm Hg (p greater than 0.01) and controlled the early morning surge in systolic ambulatory blood pressure. Minor reductions in diastolic blood pressure and heart rate were statistically but not clinically significant. Left ventricular mass was not changed. Labetalol monotherapy provides effective 24-hour control of systolic blood pressure, including the acceleration phase, in patients with isolated systolic hypertension. PMID- 3278975 TI - Long-term captopril treatment. Angiotensin II receptors and responses. AB - The purpose of this study was to elucidate the mechanism of the antihypertensive effect of the angiotensin I (Ang I) converting enzyme inhibitor captopril in spontaneously hypertensive rats (SHR). Drinking responses, peripheral vascular reactivity, and angiotensin II (Ang II) receptor binding in both the brain and vascular smooth muscle were examined in control and captopril-treated SHR. Pregnant and nursing dams were treated with oral captopril (100 mg/kg). After weaning, offspring were maintained on captopril (50 mg/kg). The average systolic pressures after 21 weeks of captopril treatment were 122 +/- 3 mm Hg (male) and 118 +/- 4 mm Hg (female) as compared with 169 +/- 4 mm Hg (male) and 162 +/- 2 mm Hg (female) in age-matched controls. Drinking responses to intracerebroventricular (10 ng) and subcutaneous (100 micrograms/kg) administration of Ang I and II were attenuated in captopril-treated SHR in comparison to control SHR. Ang II receptor binding in the hypothalamus, thalamus, and septum of captopril-treated SHR was also significantly reduced. In contrast to a depressed angiotensinergic system in the brain, peripheral vascular reactivity to Ang II, as determined in isolated, artificially perfused kidneys, was elevated. Threshold and ED50 values for Ang II were significantly lower in captopril-treated SHR than in controls. Ang II receptor binding in aortic smooth muscle cells prepared from captopril-treated SHR was also significantly greater than in cells from controls. Thus, lifetime treatment with captopril induced alterations in the renin angiotensin systems in the periphery and brain that were manifested by changes in receptor binding and responsiveness to Ang II.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3278977 TI - Clinical pharmacology of calcium antagonists. Satellite symposium on calcium antagonists. AB - A new class of agents has been made available for the treatment of hypertension. These calcium antagonists have rapid bioavailability and dramatic antihypertensive effects through reduction of total peripheral resistance and the vascular resistance of the major target organs of the body. These changes are usually associated with unchanged cardiac output, preserved organ blood flows, maintained organ function, and preserved reflex responses without fluid retention in long-term treatment. These drugs do not stimulate plasma renin activity and aldosterone levels. Thus they fulfill many of the major criteria for an ideal antihypertensive agent. PMID- 3278978 TI - The C1 area of the brainstem in tonic and reflex control of blood pressure. State of the art lecture. AB - Recent studies have demonstrated that the neurons of the lower brainstem that are responsible for maintaining normal levels of arterial pressure reside in a specific area of the rostral ventrolateral medulla. In rat, the critical zone corresponds to a small region containing a subpopulation of the adrenergic C1 group, defined immunocytochemically by the presence of the epinephrine synthesizing enzyme phenylethanolamine N-methyltransferase. Neurons of this region (the C1 area), possibly including the adrenergic neurons, directly innervate preganglionic neurons in the spinal cord, and are tonically active and sympathoexcitatory. The excitatory transmitter released into the spinal cord is unknown. The discharge of C1 area neurons is locked to the cardiac cycle and, in turn, leads to firing of sympathetic preganglionic neurons. The C1 area neurons are inhibited by baroceptor input and mediate the vascular component of baroceptor reflexes. They also mediate somato-sympathetic pressor responses from skin and muscle and participate in reflex responses to hypoxia. The neurons are directly innervated by local neurons containing gamma-aminobutyric acid, acetylcholine, enkephalin, and substance P, all of which modulate arterial pressure. The C1 area is the site of the hypotensive actions of clonidine. Clonidine appears to act on imidazole receptors in the C1 area to lower arterial pressure. The natural ligand for these receptors may be a newly defined substance in brain, clonidine-displacing substance. Neurons of the C1 area appear to be the critical neuronal group governing the normal resting and reflex control of arterial pressure. They may play a critical role in the maintenance of elevated arterial pressure in hypertension and as a site of action of antihypertensive drugs. PMID- 3278979 TI - Antibodies to the ring-infected erythrocyte surface antigen of Plasmodium falciparum elicited by infection with Plasmodium malariae. AB - The ring-infected erythrocyte surface antigen (RESA) of Plasmodium falciparum (RESA-P), found in the membrane of erythrocytes infected with young asexual stages of P. falciparum, is a promising vaccine candidate. Antibodies to RESA-P were inducible by infection with another human malaria species, P. malariae. Of 298 serum samples from inhabitants of three isolated localities in Peru where P. vivax and P. malariae were endemic and P. falciparum had never been reported, 26% had anti-RESA-P antibodies as evidenced by a modified immunofluorescent-antibody assay and confirmed by Western blot (immunoblot) analysis. These seroepidemiologic observations were corroborated by the fact that of six chimpanzees infected with P. malariae, three developed anti-RESA-P antibodies after infection. The modified immunofluorescent-antibody-reactive antibodies, purified by adsorption and elution on monolayers of glutaraldehyde-fixed and air dried P. falciparum-infected erythrocytes, reacted in an immunofluorescent antibody assay with both parasite structures and erythrocyte membrane in P. falciparum antigen preparations, but only with parasite structures in P. malariae antigen preparations. This serologic cross-reactivity between P. falciparum and P. malariae is of interest in view of the importance of RESA-P as a vaccine candidate and because the two species are coendemic in many areas. PMID- 3278980 TI - Attaching and effacing adherence of Vero cytotoxin-producing Escherichia coli to rabbit intestinal epithelium in vivo. AB - Vero cytotoxin-producing Escherichia coli (VTEC) strains have been associated with sporadic cases and outbreaks of hemorrhagic colitis and with the hemolytic uremic syndrome in humans. Since adherence of enteric pathogens to epithelial surfaces is often a prerequisite for the subsequent delivery of bacterial enterotoxins and mucosal invasion, we evaluated intestinal adherence by 18 VTEC strains, which were of human origin and belonged to 10 distinct serotypes, 7 days after enteral challenge of rabbits. A total of 23 postweaning rabbits (body weight, 1 kg) were each fed 2 X 10(8) VTEC, and 5 rabbits were challenged with an equal number of fecal commensal E. coli strains as controls. Each rabbit was monitored daily for the development of diarrhea. At 7 days after infection the proximal jejunum, distal ileum, cecum, and proximal colon were removed from each rabbit and examined for the presence of adherent organisms under light microscopy, after Giemsa staining of Formalin-fixed secretions, and by transmission electron microscopy. Nonbloody diarrhea developed in 16 of 23 VTEC infected rabbits in contrast to 0 of 5 infected with commensal E. coli strains (P less than 0.02). Organisms were adherent to surface epithelial cells in the ceca (20 of 23 rabbits), proximal colons (9 of 23), and distal ilea (6 of 23) of VTEC infected rabbits. Intimate attaching and effacing binding of bacteria to intestinal epithelial cells, in regions where the normal microvillous membrane architecture had been disrupted, was observed under electron microscopy for VTEC of multiple serotypes. In contrast, no organisms were adherent to the jejuni. Adherence of organisms was not seen in any portion of the intestines of rabbits that were challenged with commensals. These findings indicate that multiple serotypes of VTEC demonstrate intimate attaching and effacing binding to rabbit enterocytes and colonocytes in vivo. In addition to bacterial binding in the ceca and colons, VTEC adhere to enterocytes in the distal small intestines of per orally infected postweaning rabbits. PMID- 3278981 TI - Lipid X protects mice against fatal Escherichia coli infection. AB - Lipid X, the major monosaccharide precursor of lipid A, is nontoxic and has previously been shown to protect mice and sheep from the harmful effects of endotoxin. To test the hypothesis that lipid X could be therapeutic against infections with gram-negative organisms, neutropenic ICR mice were infected by intramuscular inoculation of Escherichia coli and subsequently treated with lipid X alone or in combination with the antibiotic ticarcillin. Lipid X slightly prolonged survival; treated mice had a significantly improved rate of survival 18 h after intramuscular inoculation as compared with controls (P less than 0.025). By 24 h, however, this difference disappeared. When lipid X was combined with ticarcillin, survival differences were both significant and prolonged. Treatment of mice with one to two doses of lipid X for a total dose of 1 mg intravenously and with 1,200 mg of ticarcillin per kg every 6 h improved survival over a 48-h treatment period from 5 to 23% (P less than 0.0025). Treatment with lipid X and ticarcillin over a broad range of antibiotic dosages in 362 mice demonstrated improved survival of two- to fourfold (P less than 0.0001 at 24 h after inoculation, P less than or equal to 0.0005 at 48 h, and P less than or equal to 0.0001 at 5 days). Lipid X enabled the dose of ticarcillin necessary to protect 50% of mice from death to be reduced by two- to fivefold. Pretreatment with lipid X was not necessary to improve survival: 16 of 17 (94%) infected and visibly ill animals that received lipid X and ticarcillin 6 h after thigh inoculation survived versus 30 of 44 (68%) control animals treated with ticarcillin alone (P less than 0.0001). Lipid X had no antimicrobial activity in vitro. Lipid X is a novel agent that enhances survival in an animal model of severe infection with gram-negative organisms. PMID- 3278982 TI - Factors influencing the interaction of Candida albicans with fibroblast cell cultures. AB - The interaction of Candida albicans clinical isolates with primary and established fibroblast cultures was studied. The intent was to determine whether yeast adherence and invasion of nonendothelial cell monolayer cultures could be quantitated reproducibly and whether this system could be used for future studies on yeast pathogenesis. Our results demonstrated that specific interactions between the yeast cells and fibroblasts only occurred at 37 degrees C and correlated with the germination process. Fluorescent-antibody staining indicated that invasion or tight associations between the germinating yeast cells and mammalian cells occurred after less than 3 h of incubation. Yeast adherence was estimated radiometrically and trypsin-resistant interaction with individual mammalian cells (infection) was measured microscopically after inoculated monolayer cells were detached with trypsin. We demonstrated that both types of association were time dependent at 37 degrees C; neither was affected by the concentration of glucose used to grow the yeast cells. Primary and established fibroblast cell lines were equally susceptible to infection, but primary cells appeared to have more yeast-binding sites. Fibroblasts maintained in confluent culture for an extended period of time also appeared to have more binding sites, and while not quantitatively more susceptible to infection, the older cells were more susceptible to infection-related cell death. An established kidney epithelial cell line (MDCK) was not susceptible to either type of yeast interaction, indicating that the yeast-fibroblast associations were specific. PMID- 3278983 TI - A basic replicon of virulence-associated plasmids of Shigella spp. and enteroinvasive Escherichia coli is homologous with a basic replicon in plasmids of IncF groups. AB - Shigella species and enteroinvasive Escherichia coli strains carry a large (120- to 140-megadalton) plasmid called pINV, which contains genes essential for the invasiveness of these pathogens. Hybridization with specific probes derived from the RepFIC and RepFIB replicons of the IncF1 Ent plasmid P307 showed that pINVs present in 35 clinical isolates are homologous with RepFIC but not RepFIB, regardless of the serogroup of the Shigella or E. coli strain. RepFIC of P307, in turn, is very similar to RepFIIA replicons of IncFII R plasmids. These and other related replicons constitute the RepFIIA family. With one pINV, pWR110, a plasmid of Shigella flexneri 5, we demonstrated the existence of a functional replicon, RepINV, with a restriction map similar to that of RepFIIA of plasmid R1. We isolated the putative inc RNA coding region of RepINV, which is a major determinant of incompatibility. The nucleotide sequence of the RepINV-inc RNA coding region was determined and compared with the corresponding sequences of RepFIC and RepFIIA. The differences were small, but apparently were sufficient to affect the target specificity of the inc RNAs, thus rendering the replicons compatible with each other. We conclude that pINVs present in Shigella spp. and enteroinvasive E. coli constitute a homogeneous group, containing one basic replicon that belongs to the RepFIIA family of replicons. PMID- 3278984 TI - Inhibitory monoclonal antibody against a (myristylated) small-molecular-weight antigen from Plasmodium falciparum associated with the parasitophorous vacuole membrane. AB - A small-molecular-weight antigen that occurs in asexual blood stages in synchronized cultures of Plasmodium falciparum was detected by a monoclonal antibody which inhibits parasite growth in vitro. This antigen, QF116, showed a molecular weight of 15,000 in parasite strain FCR-3K+ from The Gambia and 19,000 in strain FCQ-27 from Papua New Guinea. The protein did not show significant glycosylation by galactose or glucosamine labeling but was found to be acylated by myristic acid. By using immunogold labeling and electron microscopy, the location of the antigen could be attributed to the parasitophorous vacuole membrane and to inclusions and vesicles residing within the cytoplasm of the erythrocyte host cell. PMID- 3278985 TI - Combined parenteral and oral immunization results in an enhanced mucosal immunoglobulin A response to Shigella flexneri. AB - Achieving a vigorous secretory immunoglobulin A (IgA) response in intestinal secretions usually requires multiple doses of antigen given orally, while systemic immunity is more easily attained by parenteral immunization. This study examines the role of combined parenteral and oral immunizations to enhance the early mucosal immune response to an enteropathogen. We have used a chronically isolated intestinal-loop model in rabbits as a probe to monitor kinetically the initial (primary) local immune response to shigella lipopolysaccharide (LPS) following combinations of parenteral immunization intramuscularly (i.m.) and oral stimulation with shigellae. Predictably, effective stimulation of systemic immunity was elicited when heat-killed preparations of Shigella sp. strain X16 were given i.m., as shown by strong serum IgG and weak intestinal IgA activity to shigella LPS. A single oral dose of live Shigella sp. strain X16 given to unprimed rabbits elicited only a typical weak IgA response in intestinal secretions. However, when an i.m. dose of heat-killed shigellae was followed 1 day later by an oral dose of live Shigella sp. strain X16, a hyperstimulation of the early secretory IgA response was elicited, and the response reached levels found previously only after multiple oral administrations of live shigellae. This stimulation did not require the use of an adjuvant. At the same time, the animals receiving this combined oral and i.m. regimen had a lower IgG antishigella LPS activity in serum compared with their response after receiving parenteral antigen in adjuvant alone. These findings indicate that while a dichotomy exists between the systemic and mucosal immune responses, careful orchestration of the stimulatory events can promote a vigorous early local IgA response. PMID- 3278989 TI - Toward a transformation of health and aging policy. AB - Millions of Americans are plagued by serious problems of inadequate health care benefits, limiting their access to services and creating hardship. For those under 65 years of age, the problem is the lack of insurance for many working poor and others. For the elderly, the problem is one of underinsurance in terms of both cost and coverage, particularly for long-term care. Policies of cost containment and cost shifting to consumers have exacerbated these problems, and current health policy proposals offer little respite. Arguments are made for a program of public national health care. Health policy interventions are considered at four levels: incrementalism, modification, alteration, and transformation. A proposal is presented for universal health benefits that are organized and operated to eliminate for-profit medical care and to promote social and preventive care. PMID- 3278986 TI - Cloning of a species-specific antigen of Mycobacterium bovis. AB - A DNA library from a virulent strain of Mycobacterium bovis was constructed in the expression vector lambda gt11, and the library was probed with antisera to M. bovis. Clones expressing M. bovis antigens were isolated and characterized by using M. bovis-specific monoclonal antibodies that recognize a 22,000-molecular weight protein (MPB70). MPB70 is a major protein antigen of the vaccine strain of M. bovis BCG and of virulent M. bovis, the causative agent of bovine tuberculosis. Of 32 clones selected by using polyclonal affinity-purified anti-M. bovis sera, 5 were recognized by the anti-MPB-70 monoclonal antibodies, and one monoclonal antibody, SB10, recognized all 5 clones. Characterization of these clones showed that one clone containing a 253-base-pair insert expressed a polypeptide bound by all of the MPB70-specific monoclonal antibodies. Western blots (immunoblots) showed that this cloned protein was recognized by sera from M. bovis-infected cattle, although not all cattle with bovine tuberculosis produced antibodies reactive to this clone. DNA sequencing of the clone showed that it coded for 84 amino acids from positions 17 to 114 of the 161-amino-acid protein, with a 16-peptide deletion between positions 79 and 94. Apart from this deletion, there were seven other variations between the cloned sequence and that deduced from M. bovis BCG MPB70. PMID- 3278988 TI - "Your time or mine?" An anthropological view of the tragic temporal contradictions of biomedical practice. AB - The symbolic construction and use of time in health care is examined both in relation to social control of patients and to the power/powers accorded to and claimed by physicians. After reviewing classical medical sociology approaches of Zerubavel and Roth, it is suggested that an anthropological approach using concepts of disease, illness, and sickness and especially the last make it possible to produce a more adequate analysis. The cultural performance of sickness is seen in a framework of power, space, and time, and comparisons drawn between preindustrial and industrial patterns of healing (including Hahn's detailed ethnographic account of the practice of an internist in the United States). It is argued that medicine as it is at present practiced in industrial society inevitably requires health workers and especially physicians to distance themselves in time from the experience of their patients by taking the present tense account of perceived illness (the history), which they initially share, and translating it into timeless, almost disembodied, disease. The physicians' special position in relation to time makes symbolically possible their control not only over patients' access to space and use of time but also over patients' autonomy in controlling the body and its boundaries. Finally, it is proposed that, although the contradiction arises from the theory and practice of biomedicine itself, the ability of health workers to overcome it is related to the extent to which the exercise of power within medicine reinforces (or is reinforced by) the ideology of the society in which it operates. PMID- 3278987 TI - Genetic control in the susceptibility of germfree inbred mice to infection by Escherichia coli O115a,c:K(B). AB - We studied the susceptibility of five germfree inbred strains of mice to oral infection by murine pathogenic Escherichia coli O115a,c:K(B) (MPEC), the causative agent of mouse megaenteron. Although MPEC colonized all strains of mice at 10(9)/g of feces, the mouse strains could be divided into three groups according to their intestinal lesions. In CF1 and C3H/He mice, intestinal lesions were produced in the cecum and colon with hyperplasia of epithelial cells accompanied by severe inflammatory reactions and erosion. The lesions in NC and C57BL/6 mice were restricted to the tip of the cecum, and hyperplasia of epithelial cells was more severe in these mice than in CF1 or C3H/He mice. BALB/c mice had no lesions. Analysis of F1 hybrids of CF1, NC, and BALB/c mice and offsprings from backcrosses of F1 mice to parental strains showed that susceptibility to MPEC seemed to be controlled genetically by a single locus which may be related to the receptors on epithelial cells for MPEC adherence. However, the differences in lesions between CF1 and NC mice suggest that a combination of this locus and another locus to which it may be related regulates the hyperplasia of intestinal epithelial cells. PMID- 3278990 TI - IgA dermatosis in an adult Chinese population. A 10-year study of linear IgA and dermatitis herpetiformis in Singapore. AB - During a 10-year period (1976-1985), eight Chinese patients from a population of 2.5 million fulfilled the criteria for dermatitis herpetiformis and linear IgA bullous dermatosis (LABD). These rare diseases among Asians presented during the third decade of life with homogenous linear IgA deposits along the dermoepidermal junction in four of the eight cases. Three had classic granular deposits in the papillary dermis, while one was negative. There has been a remission in two of the patients. Dermatitis herpetiformis among the Chinese differs from experience elsewhere in that there was no associated gluten-sensitive enteropathy. The response to a very low-dose dapsone was excellent in most cases. PMID- 3278992 TI - Inoculation leprosy. Current status. PMID- 3278991 TI - Clobetasol propionate ointment once daily versus fluocinonide ointment three times daily in psoriasis. PMID- 3278993 TI - Radioprotection by glutathione esters and cysteamine in normal and glutathione depleted mammalian cells. AB - Monoethyl (MEE) and diethyl (DEE) esters of glutathione (GSH) had the capacity to provide some protection of normal and buthionine sulfoximine (BSO) pretreated cells against X-irradiation. Both compounds appeared to be transported through the cell membrane into the cells. MEE was intracellularly partly hydrolysed to GSH and caused a limited rise of intracellular GSH. DEE was intracellularly mainly converted into MEE and partly into GSH. DEE caused a larger rise of the intracellular GSH content than MEE; it also provided a better radioprotection. Radioprotection by the GSH esters may be explained by an increase of intracellular GSH as well as by the presence of the esters themselves. Cysteamine caused no rise of the intracellular GSH content, thus its radioprotection could not be mediated by an increase of intracellular GSH. When the radiosensitivity of GSH-depleted cells protected by cysteamine was compared with the radiosensitivity of non-GSH-depleted cells similarly protected by cysteamine, it appeared that the GSH-depleted cells remained more sensitive to irradiation. Thus, it seems that in this respect cysteamine cannot fully substitute for endogenous GSH. PMID- 3278994 TI - Effects of monoenergetic X-rays with resonance energy of bromine K-absorption edge on bromouracil-labelled E. coli cells. AB - In order to examine enhanced killing that might be induced by Auger cascades in the incorporated atoms in cells, bromouracil(BrU)-labelled E. coli cells were irradiated with monoenergetic X-rays at 13.49 and 12.40keV, just above and below the K-absorption edge of bromine. In both cases BrU-labelled cells were more sensitive for killing than were normal cells. However, when the degree of BrU sensitization was compared between the two energies of X-rays, the enhanced killing at 13.49 keV was only small, 2 +/- 8 per cent based on the D0 value in saline. By the addition of DMSO, which is believed to suppress radical-mediated effects, killing of BrU-labelled cells was enhanced at 13.49 keV by 8 +/- 4 per cent as compared with 12.40 keV, based on D0. These results have been examined in terms of absorbed energy in BrU-labelled cells and in terms of the number of induced Auger events. PMID- 3278995 TI - Dithiothreitol pretreatment and inducible repair in UV-irradiated Escherichia coli K12 cells. AB - The UV radiation survival of several Escherichia coli K12 strains was measured after pretreatment of the cells with dithiothreitol (DTT). In DNA repair competent cells (AB1157), UV survival was enhanced (ER = 1.2) after pretreating cells for 1.0 h using 10 mmol dm-3 DTT and then incubating the cells for 1.5 h in buffer before UV irradiation. Similar experiments using the excision repair mutant, AB1886uvrA6, or the recombination repair and SOS-deficient mutant, AB2462recA, strains did not show enhanced UV survival. None of the E. coli strains tested were protected against UV killing by simultaneous treatment with DTT (10 mmol dm-3). These results, and the fact that incubation in chloramphenicol removed the wild-type response in DTT-pretreated, UV-irradiated cells, suggest that the observed UV radioprotection was a result of inducible enzymatic repair processes such as recA-dependent repair. The proposed stimulus for inducible repair in these cells is DNA damage caused by intracellular hydroxyl radicals arising from thiol oxidation. The involvement of oxygen radicals in the induction pathway is supported by results that showed superoxide dismutase and catalase could inhibit a portion (one-third) of the inducible repair. PMID- 3278996 TI - The level of induced DNA double-strand breaks does not correlate with cell killing in X-irradiated mitotic and G1-phase CHO cells. AB - The neutral (pH 9.6) filter elution technique was used to evaluate DNA damage induced in CHO cells irradiated at mitosis or in G1-phase under various incubation and postirradiation treatment conditions. Mitotic and G1/S border cells were more sensitive to radiation than G1 cells with respect to cell killing, but showed similar (G1/S) or lower (M) DNA elution dose--response curves. Similar cell survival and DNA/elution dose--response curves were obtained with plateau-phase cultures containing mainly G1-cells, as well as with G1 cells obtained after division of mitotic cells in either fresh or conditioned medium. However, survival of plateau-phase cells could be modified substantially by delayed-plating or postirradiation treatment with araA. These results, together with previously published observations, indicate that induction of DNA dsb cannot be invoked as an explanation for the variations in radiosensitivity observed through the cycle, or as an explanation for the formation of the survival curve shoulder. It is proposed that repair and fixation of radiation-induced DNA damage, expressed at the cell survival level as repair and fixation of alpha-PLD, are responsible for these effects. PMID- 3278997 TI - Synergistic killing of Escherichia coli K-12 by UV (254 nm) and H2O2. AB - Prior UV irradiation strongly increased the sensitivity to H2O2 of wild-type E. coli K-12 cells. This synergistic lethal interaction was also observed to a reduced extent in a polA mutant but was absent in uvrA, uvrArecA and xthA mutants. In a recA mutant an antagonist effect was observed. Prior H2O2 treatment did not sensitize the wild-type cells to UV irradiation. Alkaline and neutral sucrose gradient analysis, as well as DNA degradation studies, demonstrated that the synergism is due to the production of DNA double-strand breaks and a block of their repair. The possible mechanism of induction of such lesions is discussed. PMID- 3278998 TI - Factors influencing the uptake of iron and plutonium into cells. AB - Uptake of 59Fe as well as 125I-labelled Fe-transferrin into HeLa cells points to the existence of a limited number of specific binding sites. This is in contrast to hepatocytes and hepatoma cells (Hep G2) where metal uptake from transferrin is very low, not saturable and cannot be prevented by an excess of the protein. Iron uptake into these cells is much higher from the citrate complex. The same is true for plutonium uptake into rat hepatocytes, while the uptake of this metal into Hep G2 cells is very small regardless of the ligand. In contrast to iron, plutonium presented as citrate is taken up into HeLa cells much better than plutonium presented as transferrin. The uptake of both metals from the citrate complex requires a high activation energy and can be prevented only by inhibition of oxidative phosphorylation. Other processes such as endocytosis, intactness of microtubuli, assembly of microfilaments or pH of the lysosomes do not seem to be of importance. Metal uptake from the citrate complex can be prevented only by the presence of other chelating agents and/or by transferrin. It can be assumed, therefore, that the metals react directly with constituents of the cell membrane, a process in which chelating agents can successfully compete if they form strong enough complexes with the metals. PMID- 3278999 TI - Corneal surgery I. PMID- 3279000 TI - Corneal surgery I. PMID- 3279001 TI - Penetrating keratoplasty techniques. PMID- 3279002 TI - Techniques of lamellar keratoplasty. PMID- 3279004 TI - Prevention of astigmatism in corneal transplant surgery. PMID- 3279003 TI - Corneal graft reaction. PMID- 3279005 TI - Vitrectomy during penetrating keratoplasty. PMID- 3279006 TI - Indications for corneal transplant surgery. PMID- 3279007 TI - Anterior segment reconstruction following ocular trauma. PMID- 3279008 TI - Repair of corneal lacerations and perforations. PMID- 3279009 TI - Corneal surgery following alkali burns. PMID- 3279010 TI - Therapy with nifedipine in asthma: a randomized double-blind crossover trial. AB - A randomized double-blind crossover trial with nifedipine (10 mg orally four times a day for 2 weeks) was carried out in 11 asthmatic patients. The analysis of the differences between the periods of running-in, placebo and nifedipine administration showed a mild improvement in symptom scores during the nifedipine period (2.8 +/- 1.5, 2.8 +/- 1.8 and 2.1 +/- 1.6, respectively; P less than 0.05). Drug intake and peak expiratory flow rates remained unchanged. This suggests that the drug did not influence the baseline bronchial tone, but might have attenuated some superimposed exacerbations due to unavoidable exposure to cold, effort or allergens. We conclude that the benefit of orally administered nifedipine in low doses has little value in the treatment of asthma. PMID- 3279011 TI - Glucose, insulin and glucagon response to intravenous glucose load in patients on chronic hemodialysis. AB - We examined the theory that patients with chronic renal failure exhibit glucose intolerance that is not completely corrected by dialysis. I.v. glucose tolerance tests (IVGTT) were performed in 11 uremic patients who were on chronic intermittent hemodialysis therapy for a mean of 33 months, before and 24 h after dialysis. The glucose disappearance constants (K-glucose) were normal in all subjects and were not affected by dialysis. Insulin response was within normal limits, with minimal changes by dialysis. Serum glucagon was higher than normal. The early, middle and late insulin levels were the same as in the normal population. These results indicate that chronic hemodialysis therapy, together with continuous effective control of biochemical impairment, can achieve normal glucose tolerance in uremic patients. PMID- 3279012 TI - Pew Memorial Trust policy synthesis: 5. State coverage for organ transplantation: a framework for decision making. AB - Transplantation of hearts and livers for both adults and children is increasingly viewed as therapeutic and lifesaving, but access to these procedures is impeded by their high cost as well as by a limited supply of organs. In the absence of comprehensive federal coverage, pressure is being brought to bear on states to provide broader access to these procedures. This synthesis provides a framework for the consideration of coverage decisions at the state level. While there are no "right" answers about whether a state should support such coverage, the analytic tools of cost analysis, demand estimation, and assessment of capacity described in this synthesis can better inform the decision-making process. PMID- 3279014 TI - Role of the cephalosporinase gene in the resistance of the clinically isolated cephem-resistant Escherichia coli. AB - A small number of highly cephem-resistant strains was found in extensive susceptibility testing of clinical isolates of Escherichia coli to the new cephalosporin derivatives. The cephem-resistance of these clinical isolates appeared to be due to the increased cephalosporinase activities. To clarify the mechanism of the resistance, we cloned the cephalosporinase genes from two typical cephem-resistant clinical isolates as well as from an E. coli K-12 strain. The following two lines of evidence indicated that the cephem-resistance resulted from hyper production of the cephalosporinase due to the up-mutation of the regulatory sequence of the cephalosporinase gene. 1) Reciprocal exchange of the regulatory sequence including a short segment of N-terminal coding sequence and the rest of the coding sequence between the cephalosporinase genes from E. coli K-12 and the cephem-resistant clinical isolate showed that the higher cephalosporinase activity was accompanied by the regulatory sequence of the cephalosporinase gene from the clinical isolate. 2) The promoter activities of the cephalosporinase genes were determined by cloning the regulatory sequences into a promoter analysis vector. The promoter activities of the cephalosporinase genes from the clinical isolates were 23-33-fold higher than that of the cephalosporinase gene from E. coli K-12. PMID- 3279013 TI - Localization and synthesis of type III collagen and fibronectin in human reparative dentine. Immunoperoxidase and immunogold staining. AB - The injury of dental pulp tissue, following caries, is accompanied by the deposit of a typical hard scar tissue known as reparative dentine which should be regarded as the mineralization of a new organic matrix. Highly purified antibodies were used in combination with immunoperoxidase or immunogold technique at the ultrastructural level to reveal the distribution and synthesis of types I and III collagen and fibronectin elaborated by typical matrix-forming cells in the new tissue. Specific immunoperoxidase labelling, on demineralized teeth, clearly demonstrated that type I collagen represents the main type of collagen (88%). It is associated with bundles of fine striated fibrils of type III collagen and in close vicinity with fibronectin and constituted, at least, the new organic matrix of reparative dentine. Immunogold staining gave precise localization mainly over Golgi apparatus for the 3 components, thus suggesting that the cells concerned should not be considered as new odontoblasts but rather as pulpal cells in the process of differentiation participating in the formation of new dentine. Moreover, these events are very similar to those observed during wound healing in other tissues. PMID- 3279015 TI - Cephalosporinase interactions and antimicrobial activity of BMY-28142, ceftazidime and cefotaxime. AB - Cephalosporinases of Enterobacter cloacae and Citrobacter freundii were responsible for resistance to newer cephalosporins such as cefotaxime and ceftazidime but not BMY-28142. Interaction of these cephalosporins including hydrolysis, binding, inhibition, and inactivation with cephalosporinases from E. cloacae GN7471 and C. freundii GN7391 were studied. BMY-28142 was much more stable against the both enzymes than cephalothin, but more hydrolyzable than cefotaxime and ceftazidime at higher concentration such as 100 microM. Because of low affinity for the enzymes, i.e. large Km and Ki, the calculated hydrolysis rate of BMY-28142 at 0.1 microM was smaller than those of cefotaxime and ceftazidime, that explained the difference in activity against cephalosporinase producing strains between BMY-28142 and cefotaxime or ceftazidime. The effects of cephalosporinase production on susceptibility of Escherichia coli omp mutants were examined using a plasmid having cephalosporinase gene of C. freundii GN346. Decrease in susceptibility of E. coli by cephalosporinase production was larger in the strain lacking outer membrane proteins (Omp) F and C, and smaller in the strain producing OmpF constitutively. PMID- 3279016 TI - Evaluation of the patient with a possible phagocytic disorder. AB - This article presents an outline of a rational approach to the patient with recurrent infections. The different categories of phagocytic defects are reviewed, and a brief discussion of the various tests of phagocyte function is presented. PMID- 3279017 TI - The CD11/CD18 leukocyte glycoprotein deficiency. AB - CD11/CD18 leukocyte glycoprotein deficiency is a rare, inherited disorder of leukocyte function, manifested by recurrent severe bacterial infections. A deficiency in the expression of a family of leukocyte membrane glycoproteins (the CD11/CD18 glycoproteins) represents the molecular basis for this disease. PMID- 3279018 TI - Oxygen-independent bactericidal systems. Mechanisms and disorders. AB - Neutrophils contain microbicidal proteins packaged in numerous cytoplasmic granules. During phagocytosis, granules fuse to phagolysosomes where the granule contents contribute to the destruction and dissolution of ingested bacteria. The properties of the microbicidal proteins cathepsin G, BPI, and defensins are described and contrasted. PMID- 3279019 TI - Pathologic states associated with activation of eosinophils and with eosinophilia. AB - Eosinophils are involved in cytotoxicity against helminths and tumor cells and effect both tissue damage and tissue protection in hypersensitivity reactions. Their migratory patterns and oxidative mechanisms are most similar to those of neutrophils, but their tissue longevity and functional variation are more similar to those of monocytes and macrophages. Their enzyme components and behaviors are only now beginning to be defined, and their biologic functions in pathologic states remain a topic of considerable discussion. PMID- 3279021 TI - Chemotactic disorders. AB - Clinical disorders of phagocyte chemotaxis have heterogeneous etiologies. The physiologic defect can involve adherence, the cytoskeleton, deformability, granule dysfunction, regulation of receptors, or a variety of soluble mediators. At present, successful clinical management depends on early and compulsive attention to infectious complications. A host of new immunomodulators (GM-CSF, gamma interferon, tumor necrosis factor, etc.), made available through recombinant gene technology, are now under study and may provide new and more effective means of treatment for these life-threatening disorders. PMID- 3279020 TI - The chemotactic peptide receptor. A model for future understanding of chemotactic disorders. AB - Chemotaxis by human phagocytes enables these cells to find sites of injury or inflammation in the host. This function is a complex orchestration of biochemical and morphologic events that begins with the occupancy of specific surface receptors for chemotactic agents. The response is propagated and amplified by a biochemical cascade of transduction reactions. This cascade is mediated by receptor interactions with guanyl nucleotide binding proteins, subsequent activation of phospholipase C, and a resulting increase in phospholipid turnover. These events are spatially and temporarily integrated as elevations in the concentrations of intracellular Ca++ and diacylglycerol combine to activate protein kinase C. At the macromolecular and subcellular level, integration of these functions with as yet undiscovered pathways results in stimulation of actin polymerization, shape change, degranulation, and membrane flow. Final integration of these events results in the morphologic process of directed migration of the cell along concentration gradients of chemotaxins. During this process, chemotactic receptors are continuously regulated and feed back information to the response system that adjusts the biochemistry and morphology accordingly. This article has briefly considered some of the relationships between these transduction events and the control of a specific chemotactic receptor system employing the N-formylated chemotactic peptides. It is hoped that knowledge of this regulation will aid the physician in understanding the origin of chemotactic disorders derived from defects in chemotactic receptor systems of the phagocytic cells. PMID- 3279022 TI - Clinical and immunologic aspects of the hyperimmunoglobulin E syndrome. AB - The HIE syndrome is a rare disorder characterized by extremely high serum IgE levels; recurrent serious infections, primarily involving the skin and sinopulmonary tract; and chronic eczematoid dermatitis dating from early infancy. The most common organisms that infect these patients are S. aureus and C. albicans. In addition, they have increased susceptibility to infection with H. influenzae, S. pneumoniae, enteric gram-negative rods, herpesviruses, and a variety of fungal organisms. The infections are frequently deep-seated, with abscess formation in the case of skin infection and pneumatocele formation in the case of pneumonias. Osteomyelitis, septic arthritis, and visceral abscesses are also seen but less frequently. Associated features of this syndrome are coarse facies, growth retardation, osteoporosis, keratoconjunctivitis, and eosinophilia. The immunologic basis of the HIE syndrome is still speculative. It is believed that the elevated IgE levels reflect a T-cell imbalance characterized by T-cell activation and a deficiency of suppressor T cells to inhibit IgE production. The propensity for recurrent infection may be related to a unique abnormality in the humoral immune system: excessive production of IgE directed to S. aureus and other infectious organisms with a concurrent deficit in their ability to synthesize protective IgG antibody against the same organisms. The fluctuating neutrophil chemotactic abnormality found in these patients may be secondary to the underlying T-cell defect with secretion of chemotactic inhibitor substances from mononuclear cells. Alternatively, the interaction of infectious agents with IgE on the surface of Fc epsilon R-bearing immune effector cells results in the release of inflammatory mediators that impair local host immune response. Activation of the immune system may also contribute to the associated features in this syndrome via the secretion of mediators that regulate connective tissue production and bone mineralization. Further studies will be needed before we completely understand the pathogenesis of HIE syndrome. Therapy primarily involves use of prophylactic anti-S. aureus antibiotics and the use of intravenous antibiotics, antifungal agents, or antiviral agents during acute infections. Surgical drainage or resection of deep-seated infections are frequently indicated. In patients who do not respond to conservative management, there may be a role for intravenous gammaglobulin and/or plasmapheresis. PMID- 3279023 TI - Plasma levels and therapeutic response with trimipramine treatment of endogenous depression. AB - In a 6-week, double-blind study involving 34 endogenously depressed patients, plasma trimipramine levels of two dosage groups, 75-mg/day and 150-mg/day, were compared with regard to clinical efficacy as determined by scores on the Hamilton Rating Scale for Depression, the Clinical Global Impressions scale, and the Zung Self-Rating Depression Scale. Both dosage levels of trimipramine produced prompt, consistent, and progressive antidepressant effects. No correlation between plasma levels and clinical efficacy was found. PMID- 3279025 TI - Lysis induction of Escherichia coli by the cloned lysis protein of the phage MS2 depends on the presence of osmoregulatory membrane-derived oligosaccharides. AB - Expression of the cloned lysis protein of phage MS2, which is sufficient to lyse wild type Escherichia coli, does not cause lysis of mutants lacking the osmoregulatory membrane-derived oligosaccharides (MDO). The lysis gene product normally found in the membrane fraction was not stably inserted into the membranes of a mdoA mutant; rather degradation and release from the membrane occurred. Gentle plasmolysis of the MDO-lacking mutant clearly showed an increased periplasmic space as compared to wild type cells. It is concluded that the MDOs play an important role in maintaining a proper arrangement of inner and outer membrane, a prerequisite for a functional insertion of the MS2 lysis protein. PMID- 3279024 TI - Structure and mechanism of bacterial periplasmic transport systems. AB - Bacterial periplasmic transport systems are complex, multicomponent permeases, present in Gram-negative bacteria. Many such permeases have been analyzed to various levels of detail. A generalized picture has emerged indicating that their overall structure consists of four proteins, one of which is a soluble periplasmic protein that binds the substrate and the other three are membrane bound. The liganded periplasmic protein interacts with the membrane components, which presumably form a complex, and which by a series of conformational changes allow the formation of an entry pathway for the substrate. The two extreme alternatives for such pathway involve either the formation of a nonspecific hydrophilic pore or the development of a ligand-binding site(s) on the membrane bound complex. One of the membrane-bound components from each system constitutes a family of highly homologous proteins containing sequence domains characteristic of nucleotide-binding sites. Indeed, in several cases, they have been shown to bind ATP, which is thus postulated to be involved in the energy-coupling mechanism. Interestingly, eukaryotic proteins homologous to this family of proteins have been identified (mammalian mdr genes and Drosophila white locus), thus indicating that they perform a universal function, presumably related to energy coupling in membrane-related processes. The mechanism of energy coupling in periplasmic permeases is discussed. PMID- 3279026 TI - Hematopoietic growth factor glycosylation. Multiple forms of chicken myelomonocytic growth factor. AB - The production of chicken myelomonocytic growth factor (cMGF) can be rapidly induced by bacterial lipopolysaccharide from the macrophage cell line HD11. Immunoprecipitation analysis of lipopolysaccharide-induced HD11 cells labeled with various radioactive precursors showed the secretion of a variety of cMGF forms. The precursor-product relationships of the different cMGF forms were studied by pulse-chase experiments, by long-term metabolic labeling in the presence or absence of glycosylation- and oligosaccharide-processing inhibitors, as well as by glycosidase treatment of immunoprecipitates. Our results show that the half-time for intracellular processing/secretion is less than 10 min, making cMGF one of the most rapidly processed proteins. The different forms of the factor are generated from a 24-kDa polypeptide precursor by co- and post translational acquisition of one or two N-linked oligosaccharides and by O-linked glycosylation. In addition, a fraction of cMGF is modified by long chain, chondroitinase-sensitive, sulfated glycans. This modification is tunicamycin sensitive, suggesting that the sulfated glycans are attached to N-linked rather than to O-linked oligosaccharides. PMID- 3279028 TI - Ferredoxin requirement for electron transport from the carbon monoxide dehydrogenase complex to a membrane-bound hydrogenase in acetate-grown Methanosarcina thermophila. AB - Cell extracts from acetate-grown Methanosarcina thermophila contained CO oxidizing:H2-evolving activity 16-fold greater than extracts from methanol-grown cells. Following fractionation of cell extracts into soluble and membrane components, CO-dependent H2 evolution and CO-dependent methyl-coenzyme M methylreductase activities were only present in the soluble fraction, but addition of the membrane fraction enhanced both activities. A b-type cytochrome(s), present in the membrane fraction, was linked to a membrane-bound hydrogenase. CO-oxidizing:H2-evolving activity was reconstituted with: (i) CO dehydrogenase complex, (ii) a ferredoxin, and (iii) purified membranes with associated hydrogenase. The ferredoxin was a direct electron acceptor for the CO dehydrogenase complex. The ferredoxin also coupled CO oxidation by CO dehydrogenase complex to metronidazole reduction. PMID- 3279027 TI - Functional and structural similarities between protease nexin I and C1 inhibitor. AB - Protease nexin I is a proteinase inhibitor that is secreted by human fibroblasts and forms stable complexes with certain serine proteinases; the complexes then bind to the fibroblasts and are rapidly internalized and degraded. In this report, we show that this inhibitor, which is present in very low concentrations in plasma, has functional and structural similarities to C1 inhibitor, an abundant proteinase inhibitor in plasma. Both inhibitors complex and inactivate certain proteinases that previously were known to rapidly react only with C1 inhibitor. Kinetic inhibition studies show that protease nexin I inhibits Factor XIIa and plasma kallikrein with second-order rate constants of 2.3 x 10(3) and 2.5 x 10(5) M-1 s-1, respectively, which are similar to the rate constants for inhibition of these proteinases by C1 inhibitor. Protease nexin I inhibits C1s about one-tenth as rapidly as does C1 inhibitor. Alignment of the amino acid sequences of protease nexin I and C1 inhibitor shows that these proteins have similarity at their reactive centers (from sites P7 to P1). The remaining regions of the two proteins share much less similarity. In contrast to protease nexin I, C1 inhibitor is not secreted by human fibroblasts. Although 125I-C1s-protease nexin I complexes readily bind to human fibroblasts, binding of 125I-C1s-C1 inhibitor complexes or other 125I-proteinase-C1-inhibitor complexes to these cells is not detectable. Thus, protease nexin I and C1 inhibitor may control some common regulatory proteinases in the extravascular and vascular compartments, respectively. PMID- 3279029 TI - The primary structure of the human ribosomal protein S6 derived from a cloned cDNA. AB - Polyclonal antibodies directed against a synthetic octapeptide of the cAMP dependent phosphorylation site of the ribosomal protein S6 of rat liver were used to screen a lambda gt11 cDNA expression library of human lymphoblasts. An S6 specific clone was isolated. It consists of the complete coding sequence of 747 base pairs and the 3' noncoding region of 40 base pairs. The sequence of 249 amino acids was deduced from the nucleotide sequence. The amino- and carboxyl terminal regions are almost identical to the reported partial peptide sequences of rat liver S6. The yeast protein S10 is homologous to the human S6 with the exception of 3 amino acid insertions and a carboxyl-terminal extension of 10 amino acids within the human S6. The only two phosphorylation sites at the carboxyl terminus of yeast S10 are homologous to the two cAMP-dependent sites in human S6. Since there are additional phosphorylation sites in mammalian S6, one can assume that they are located in the cluster of 5 serines within the carboxyl terminal extension. The sequence comparison of these two ribosomal proteins from evolutionarily distant eucaryotes, such as man and yeast, indicates that the structure and probably the function of the phosphoprotein S6 of the small ribosomal subunit has been highly conserved. The expression of the S6 gene has been investigated in proliferating lymphocytes stimulated by concanavalin A. During all stages of lymphoblast development the level of S6 mRNA appeared to be similar. Southern blot analysis of human genomic DNA suggests that multiple genes exist for the S6 protein. PMID- 3279030 TI - Effectors of Escherichia coli aspartate transcarbamoylase differentially perturb aspartate binding rather than the T-R transition. AB - New systematic methods developed for equilibrium isotope exchange kinetics have been used to analyze the effects of activator ATP and inhibitor CTP with Escherichia coli aspartate transcarbamoylase. This indepth approach requires (a) variation of [modifier] with fixed subsaturating levels of substrates, and (b) variation of at least three combinations of reactant-product pairs in constant ratio at equilibrium: [A,B,P,Q], [A,P], and [B,Q] with the co-substrates held constant, in the presence and absence of added modifier. Both ATP and CTP had much stronger effects on the [14C]Asp in equilibrium C-Asp exchange rate than on [32P]C-P in equilibrium Pi. The bisubstrate analog N-phosphonacetyl-L-aspartate activated, then inhibited, Asp in equilibrium C-Asp more strongly than C-P in equilibrium Pi. N-Phosphonacetyl-L-aspartate gave complete (100%) inhibition, whereas CTP inhibition of either exchange was only partial. Substrate saturation curves in the presence and absence of effectors indicate that ATP and CTP perturb the observed values of Rmax and S0.5 in different fashions without appreciably changing the observed Hill number. Computer simulations indicate that the primary site of ATP and CTP action is the association rate for Asp, not the allosteric T R transition. This finding is substantiated by previous studies in which modified aspartate transcarbamoylase had lost cooperative Asp binding without loss of sensitivity to effectors, or in which sensitivity to one effector could be deleted selectively. The present results, with newly devised computer simulation and analysis methods, illustrate the usefulness of equilibrium isotope exchange kinetic probes for providing unique insights to enzyme regulatory mechanisms, to define exactly which steps are altered in a given kinetic mechanism. PMID- 3279031 TI - Kinetics of promoter search by Escherichia coli RNA polymerase. Effects of monovalent and divalent cations and temperature. AB - The rapid mixing/photocross-linking technique developed in our laboratory has been employed in the study of the mechanism of promoter binding by Escherichia coli RNA polymerase (RPase). We have previously reported on the quantitation of the one-dimensional diffusion coefficient (D1) for RPase along the DNA template (Singer, P. T., and Wu, C.-W. (1987) J. Biol. Chem. 262, 14178-14189). In this paper, we describe the effect of salt concentration and temperature on the kinetics of promoter search by RPase using plasmid pAR1319 DNA, which contains the A2 early promoter from bacteriophage T7, as template. Over a range of KCl concentrations from 25 to 200 mM, the apparent bimolecular rate constant (ka) for the association of RPase with the A2 promoter on this DNA template varied approximately 2-fold, achieving a maximal value between 100 and 125 mM KCl. More significantly, the transient distribution of RPase among nonspecific DNA binding sites changed markedly as a function of salt concentration, indicative of gross changes in the average number of base pairs covered by sliding during a nonspecific lifetime. Using the mathematical treatment outlined in our earlier report, the nonspecific dissociation rate constant (koff) was calculated from the binding curves for the nonspecific as well as promoter-containing DNA. The observed variations in ka as a function of monovalent cation concentration ([M+]) were due primarily to changes in koff, as D1 was found to be essentially independent of [M+]. Interestingly, D1 decreased by one-third as the concentration of magnesium was lowered from 10 to 1 mM. In addition, the dependence of koff (and consequently the nonspecific equilibrium association constant, keq) on [M+] agreed qualitatively with the results of deHaseth et al. (deHaseth, P.L., Lohman, T. M., Burgess, R. R., and Record, M. T., Jr. (1977) Biochemistry 17, 1612-1622), though we consistently measure a weaker Keq. The association rate constant was also measured between 4 and 37 degrees C, and was found to vary approximately 2-fold over that range. An activation energy for the bimolecular association of RPase to the A2 promoter was calculated to be 2.2 +/- 0.4 kcal/mol, while the activation energy for one-dimensional diffusion was 4.7 +/- 0.8 kcal/mol. PMID- 3279032 TI - The role of redox in the regulation of manganese-containing superoxide dismutase biosynthesis in Escherichia coli. AB - The manganese-containing superoxide dismutase in Escherichia coli is an inducible enzyme that protects cells against oxygen toxicity. The manganese-enzyme is induced by oxygen, nitrate, redox active compounds that react with oxygen to generate superoxide radicals, as well as iron chelators. In order to test the hypothesis that the redox state of the cell is involved in regulating manganese superoxide dismutase biosynthesis, we studied the effects of several oxidants on growth and superoxide dismutase biosynthesis. The data showed, that under anaerobic conditions, the active manganese-enzyme is induced in the presence of potassium ferricyanide, copper-cyanide complex, ammonium persulfate, and hydrogen peroxide. Western blot analysis revealed that the induction of manganese superoxide dismutase by the oxidants is associated with de novo protein biosynthesis. Potassium ferricyanide and hydrogen peroxide induced the enzyme under aerobic conditions as well. It is concluded that the redox state of the cell possibly influences the biosynthesis and/or activity of an iron-containing repressor protein that serves to negatively regulate manganese-superoxide dismutase biosynthesis. PMID- 3279034 TI - Identification of a cross-link in the Escherichia coli ribosomal protein pair S13 S19 at the amino acid level. AB - Escherichia coli 30 S ribosomal subunits and 70 S ribosomes were treated with the bifunctional reagent diepoxybutane, acting as a cross-linker. One major cross linked protein pair in the 30 S subunit was generated in relatively high yields. This cross-link was shown to consist of ribosomal proteins S13 and S19. Purification of this complex was achieved by a series of conventional and/or high pressure liquid chromatography techniques allowing its isolation in milligram quantities. To reveal the exact position of the two amino acids involved in the cross-link formation, the purified protein pair S13-S19 was subjected to several enzymatic fragmentations, and the resulting peptides were characterized by sequence analysis, amino acid analysis, and fast atom bombardment mass spectrometry. After isolation of the cross-linked peptides, Cys84 in protein S13 and His68 in S19 could be unequivocally identified as the amino acids cross linked by the bifunctional reagent. This result demonstrates that, despite neutron scattering data which place the centers of mass of S13 and S19 85 A apart, at least these regions of the two proteins are located within a 4-A distance in the ribosomal particle. PMID- 3279033 TI - Inductions of superoxide dismutases in Escherichia coli under anaerobic conditions. Accumulation of an inactive form of the manganese enzyme. AB - Escherichia coli growing anaerobically respond to NO3- with a 3-fold induction of the iron-containing superoxide dismutase. Mutants lacking nitrate reductase do not show this response. Anaerobically grown cells also contain an inactive form of the manganese-containing superoxide dismutase (MnSOD) which can be activated by addition of Mn(II) salts in the presence of acidic guanidinium chloride, followed by dialysis against neutral buffer. Direct addition of Mn(II) to a neutral solution of the inactive MnSOD does not impart activity. This inactive MnSOD thus behaves as would the apoenzyme or the enzyme bearing a metal other than Mn(II) at its active sites. Terminal electron acceptors, such as NO3- or trimethylamine N-oxide, increase the amount of inactive MnSOD produced by anaerobic E. coli. Paraquat, which is itself ineffective in this regard, markedly augments the effect of these terminal electron acceptors. It appears that flow of electrons to sinks such as NO3- or trimethylamine N-oxide, facilitated by paraquat, is sufficient to elicit biosynthesis of the MnSOD protein and that O2- is not needed for this process. Yet, oxygenation and concomitant O2- production do appear important for the insertion of manganese into the growing MnSOD polypeptide, possibly because O-2 oxidizes Mn(II) to Mn(III), and the latter is the valence state most effective in combining with the apoenzyme. PMID- 3279035 TI - Purification and characterization of recombinant spinach acyl carrier protein I expressed in Escherichia coli. AB - Expression of plant acyl carrier protein (ACP) in Escherichia coli at levels above that of constitutive E. coli ACP does not appear to substantially alter bacterial growth or fatty acid metabolism. The plant ACP expressed in E. coli contains pantetheine and approximately 50% is present in vivo as acyl-ACP. We have purified and characterized the recombinant spinach ACP-I. NH2-terminal amino acid sequencing indicated identity to authentic spinach ACP-I, and there was no evidence for terminal methionine or formylmethionine. Recombinant ACP-I was found to completely cross-react immunologically with polyclonal antibody raised to spinach ACP-I. Recombinant ACP-I was a poor substrate for E. coli fatty acid synthesis. In contrast, Brassica napus fatty acid synthetase gave similar reaction rates with both recombinant and E. coli ACP. Similarly, malonyl-coenzyme A:acyl carrier protein transacylase isolated from E. coli was only poorly able to utilize the recombinant ACP-I while the same enzyme from B. napus reacted equally well with either E. coli ACP or recombinant ACP-I. E. coli acyl-ACP synthetase showed a higher reaction rate for recombinant ACP-I than for E. coli ACP. Expression of spinach ACP-I in E. coli provides, for the first time, plant ACP in large quantities and should aid in both structural analysis of this protein and in investigations of the many ACP-dependent reactions of plant lipid metabolism. PMID- 3279036 TI - The mechanisms of ornithine decarboxylase deregulation in c-Ha-ras oncogene transformed NIH 3T3 cells. AB - NIH 3T3 cells transformed with the human c-Ha-rasVal-12 oncogene showed markedly enhanced activity of ornithine decarboxylase (ODC), the key enzyme of polyamine biosynthesis, as compared with their nontransformed counterparts. While in normal and in c-Ha-ras proto-oncogene-transfected cells stimulation with serum caused a transient induction of ODC, in cells transfected with the mutant c-Ha-ras oncogene the activity of ODC persisted at high levels for greatly extended periods of time. The amounts of immunoreactive ODC protein roughly paralleled the changes in the enzyme activity. The augmentation of ODC content by transformation could be largely, but not solely, accounted for by an enhanced accumulation of ODC mRNA. Nuclear run-off transcription assays demonstrated that in transformed cells the rate of transcription of the ODC gene was increased but to a much lower extent than the increase in the level of ODC mRNA. The turnover of ODC mRNA, as measured after actinomycin D treatment, was negligible in transformed cells for up to 8 h, whereas in normal cells the messenger content was initially decreased, by 40% within 4 h, and then remained constant. In normal cells, however, actinomycin D depressed the expression of ODC by more than 80%, while in transformed cells the activity of ODC was slightly superinduced, corresponding to the changes of ODC mRNA. These findings suggest that labile proteins may be involved in the regulation of both the stability and translatability of the ODC mRNA. Transformation led also to about 3-fold stabilization of ODC as determined by an exposure of the cells to cycloheximide. The results thus suggest ODC deregulation at multiple levels in the ras-oncogene-transformed cells. PMID- 3279037 TI - Metallic wear in failed titanium-alloy total hip replacements. A histological and quantitative analysis. AB - We conducted extensive histological examination of the tissues that were adjacent to the prosthesis in nine hips that had a failed total arthroplasty. The prostheses were composed of titanium alloy (Ti-6Al-4V) and ultra-high molecular weight polyethylene. The average time that the prosthesis had been in place in the tissue was 33.5 months (range, eleven to fifty-seven months). Seven arthroplasties were revised because of aseptic loosening and two, for infection. In eight hips cement had been used and in one (that had a porous-coated implant for fifty-two months) no cement had been utilized. Intense histiocytic and plasma cell reaction was noted in the pseudocapsular tissue. There was copious metallic staining of the lining cells. Polyethylene debris and particles of cement with concomitant giant-cell reaction were present in five hips. Atomic absorption spectrophotometry revealed values for titanium of fifty-sic to 3700 micrograms per gram of dry tissue (average, 1047 micrograms per gram; normal, zero microgram per gram), for aluminum of 2.1 to 396 micrograms per gram (average, 115 micrograms per gram; normal, zero micrograms per gram), and for vanadium of 2.9 to 220 micrograms per gram (average, sixty-seven micrograms per gram; normal, 1.2 micrograms per gram). The highest values were found in the hip in which surgical revision was performed at fifty-seven months. The concentrations of the three elements in the soft tissues were similar to those in the metal of the prostheses. The factors to which failure was attributed were: vertical orientation of the acetabular component (five hips), poor cementing technique on the femoral side (three hips), infection (two hips), and separation of a sintered pad made of pure titanium (one hip). A femoral component that is made of titanium alloy can undergo severe wear of the surface and on the stem, where it is loose, with liberation of potentially toxic local concentrations of metal debris into the surrounding tissues. It may contribute to infection and loosening. PMID- 3279038 TI - Infection in bone allografts. Incidence, nature, and treatment. AB - Of 283 patients who had a massive allograft of bone, an infection developed in thirty-three (11.7 per cent). To assess the frequency and identify the co-morbid and predisposing factors of this devastating complication, we compared demographic data for the infected and non-infected patients. Comparison of mean age, type of graft, anatomical site of the procedure, and stage of the tumor yielded no significant differences. Multiple-regression analysis of a subgroup of eighty-two patients who had a distal femoral graft showed a correlation between infection and factors that are associated with more extensive surgery (more loss of bone, soft tissue, or skin) or with multiple operations. Approximately 30 per cent of the patients who had an infected allograft had no co-morbid or predisposing factors that could be statistically correlated with an increased risk for infection. Gram-positive organisms were the most common cause of infection, with twelve infections (36 per cent) being due to Staphylococcus epidermidis. Six patients had a single gram-negative organism and nine had mixed flora. The final result in the thirty-three patients who had an infected allograft was poor compared with that of the over-all series and of the uninfected patients. Twenty-seven infected allografts (82 per cent) were considered to be failures of treatment because amputation of the limb or resection of the graft was required to control the infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279039 TI - Treatment of infected non-unions and segmental defects of the tibia with staged microvascular muscle transplantation and bone-grafting. AB - Fourteen patients who had an infected non-union or segmental defect of the tibia were treated with debridement and microvascular transplantation of muscle. Successful free muscle transplantation and control of the infection were achieved in all patients. The prognosis was, in general, related to the severity of the underlying osseous problems, which were categorized into types A (a tibial defect and non-union without significant segmental loss), B (a tibial defect that is more than three centimeters long and an intact fibula), and C (a tibial defect that is more than three centimeters long, involving both the tibia and the fibula). All of the six type-A patients healed without needing bone-grafting. Of the four type-B patients, all of whom had subsequent bone-grafting, reactivation of the infection occurred in two, and both ultimately had a below-the-knee amputation; the third patient had a non-union between the fibular graft and the tibia; and the fourth patient was fully weight-bearing. All of the four type-C patients also required subsequent bone-grafting; all finally healed and were able to walk with a brace. The results in the present series indicate that, in patients who have an infected tibial defect or non-union, including those that are so severe that an amputation might be considered, this method of treatment is a valid option for salvage of the limb. PMID- 3279040 TI - Osteonecrosis of the knee. PMID- 3279041 TI - Capsular distension and intracapsular pressure in subcapital fractures of the femur. AB - It has been shown that raised intracapsular pressure causes avascular necrosis of the femoral head in experimental animals, but the relevance of this to clinical fractures of the femoral neck is controversial. We have studied 19 patients with intracapsular fractures of the femoral neck by pressure measurement and by ultrasonography to demonstrate capsular distension. The intra-articular pressure in Garden Grade I and II fractures averaged 66.4 mmHg with a maximum of 145 mmHg. In 10 Garden Grade III and IV fractures the average pressure was 28 mmHg with a maximum of 65 mmHg. Most of the recorded intracapsular pressures were high enough to have caused possible vascular embarrassment, and it is suggested that early decompression of the haemarthrosis should be considered. PMID- 3279042 TI - Triple arthrodesis of the foot in spina bifida patients. AB - The feet of 13 spina bifida patients who had undergone triple arthrodesis in adolescence were reviewed at an average of 10 years after operation. Fifteen of 18 feet were considered satisfactory (83%); of the remaining three, two had recurrent planovalgus deformities and one a painful pseudarthrosis. Three feet had required revision of the triple arthrodesis, and there was one postoperative infection. No patient had lost ambulatory status as a result of foot problems and eight of the 10 patients who previously needed calipers were able to discard them or to use lighter ones. PMID- 3279043 TI - The migration of a Kirschner wire from shoulder to spleen: brief report. PMID- 3279044 TI - A view of acidic intracellular compartments. PMID- 3279045 TI - A 5S rRNA/L5 complex is a precursor to ribosome assembly in mammalian cells. AB - A novel 5S RNA-protein (RNP) complex in human and mouse cells has been analyzed using patient autoantibodies. The RNP is small (approximately 7S) and contains most of the nonribosome-associated 5S RNA molecules in HeLa cells. The 5S RNA in the particle is matured at its 3' end, consistent with the results of in vivo pulse-chase experiments which indicate that this RNP represents a later step in 5S biogenesis than a previously described 5S*/La protein complex. The protein moiety of the 5S RNP has been identified as ribosomal protein L5, which is known to be released from ribosomes in a complex with 5S after various treatments of the 60S subunit. Indirect immunofluorescence indicates that the L5/5S complex is concentrated in the nucleolus. L5 may therefore play a role in delivering 5S rRNA to the nucleolus for assembly into ribosomes. PMID- 3279046 TI - Histone H3 and H4 gene deletions in Saccharomyces cerevisiae. AB - The genome of haploid Saccharomyces cerevisiae contains two nonallelic sets of histone H3 and H4 genes. Strains with deletions of each of these loci were constructed by gene replacement techniques. Mutants containing deletions of either gene set were viable, however meiotic segregants lacking both histone H3 and H4 gene loci were inviable. In haploid cells no phenotypic expression of the histone gene deletions was observed; deletion mutants had wild-type growth rates, were not temperature sensitive for growth, and mated normally. However, diploids homozygous for the H3-H4 gene deletions were slightly defective in their growth and cell cycle progression. The generation times of the diploid mutants were longer than wild-type cells, the size distributions of cells from exponentially growing cultures were skewed towards larger cell volumes, and the G1 period of the mutant cells was longer than that of the wild-type diploid. The homozygous deletion of the copy-II set of H3-H4 genes in diploids also increased the frequency of mitotic chromosome loss as measured using a circular plasmid minichromosome assay. PMID- 3279047 TI - Comparative analysis of the biogenesis of photosystem II in the wild-type and Y-1 mutant of Chlamydomonas reinhardtii. AB - Expression of the genes of the photosystem II (PSII) core polypeptides D1 and D2, of three proteins of the oxygen evolving complex of PSII and of the light harvesting chlorophyll a/b binding proteins (LHCP) has been compared in wild-type (wt) and in the y-1 mutant of Chlamydomonas reinhardtii. Since wt, but not y-1 cells produce a fully developed photosynthetic system in the dark, comparison of the two has allowed us to distinguish the direct effect of light from the influence of plastid development on gene expression. The PSII core polypeptides and LHCP are nearly undetectable in dark-grown y-1 cells but they accumulate progressively during light induced greening. The levels of these proteins in wt are the same in the light and the dark. The amounts of the proteins of the oxygen evolving complex do not change appreciably in the light or in the dark for both wt and y-1. Steady state levels of chloroplast mRNA encoding the core PSII polypeptides remain nearly constant in the light or the dark and are not affected by the developmental stage of the plastid. Levels of nuclear encoded mRNAs for the oxygen evolving proteins and of LHCP increase during light growth in wt and y 1. In contrast to wt, synthesis of LHCP proteins is not detectable in y-1 cells in the dark but starts immediately after transfer to light, indicating that LHCP synthesis is controlled by a light-induced factor or process. While the rates of synthesis of D1 and D2 are immediately enhanced by light in wt, this increase occurs only after a lag in y-1 and thus must be dependent on an early light induced event in the plastid. These results show that the biosynthesis of PSII is affected by light directly, by the stage of plastid development, and by the interaction of light and events associated with plastid development. PMID- 3279049 TI - Pericellular proteolysis by neutrophils in the presence of proteinase inhibitors: effects of substrate opsonization. AB - Inflammatory cells are capable of degrading extracellular matrix macromolecules in vivo in the presence of proteinase inhibitors. We and others have hypothesized that such proteolysis is permitted in large part by mechanisms operative in the immediate pericellular environment, especially at zones of contact between inflammatory cells and insoluble matrix components. To further test this hypothesis in vitro, we have used a model system in which viable polymorphonuclear neutrophils (PMN) are allowed to contact a surface coated with proteinase-sensitive substrate, and in which PMN interaction with the surface can be modulated. We have evaluated proteolysis of the surface-bound protein in the presence and absence of proteinase inhibitors. Our results were: (a) In the presence (but not in the absence) of proteinase inhibitors, proteolysis was confined to sharply marginated zones subjacent to the cells; (b) opsonization of the surface enhanced spreading of the PMN, (c) opsonization diminished the effectiveness of alpha-1-proteinase inhibitor (alpha-1-PI) and alpha-2 macroglobulin as inhibitors of proteolysis of surface-bound protein; (d) anti oxidants did not alter the effectiveness of alpha-1-PI in inhibiting proteolysis of opsonized substrate by PMN; and (e) PMN could restrict entry of alpha-1-PI into zones of contact with opsonized surfaces. We conclude that: (a) In the presence of proteinase inhibitors, PMN can express sharply marginated and exclusively pericellular proteolytic activity; (b) locally high proteinase concentrations and/or exclusion of proteinase inhibitors from pericellular microenvironments may be important mechanisms for pericellular matrix degradation by PMN; and (c) these observations may have general relevance to extracellular matrix remodeling by a variety of inflammatory and other cell types. PMID- 3279048 TI - Posttranslational oligomerization and cooperative acid activation of mixed influenza hemagglutinin trimers. AB - The influenza virus hemagglutinin (HA) is a well-characterized integral membrane glycoprotein composed of three identical subunits. We have analyzed the formation of mixed trimers in cells expressing two different HA gene products. The results show efficient and essentially random assembly of functional hybrid trimers provided that the HAs are from the same HA subtype. Trimerization is thus a posttranslational event, and subunits are recruited randomly from a common pool of monomers in the endoplasmic reticulum. Mixed trimers were not observed between HAs derived from different subtypes, indicating that the trimerization event is sequence specific. Mixed trimers containing mutant subunits were, moreover, used to establish that the acid-induced conformational change involved in the membrane fusion activity of HA is a highly cooperative event. PMID- 3279050 TI - Kinetics of desmosome assembly in Madin-Darby canine kidney epithelial cells: temporal and spatial regulation of desmoplakin organization and stabilization upon cell-cell contact. II. Morphological analysis. AB - Biochemical analysis of the kinetics of assembly of two cytoplasmic plaque proteins of the desmosome, desmoplakins I (250,000 Mr) and II (215,000 Mr), in Madin-Darby canine kidney (MDCK) epithelial cells, demonstrated that these proteins exist in a soluble and insoluble pool, as defined by their extract ability in a Triton X-100 high salt buffer (CSK buffer). Upon cell-cell contact, there is a rapid increase in the capacity of the insoluble pool at the expense of the soluble pool; subsequently, the insoluble pool is stabilized, while proteins remaining in the soluble pool continue to be degraded rapidly (Pasdar, M., and W. J. Nelson. 1988. J. Cell Biol. 106:677-685). In this paper, we have sought to determine the spatial distribution of the soluble and insoluble pools of desmoplakins I and II, and their organization in the absence and presence of cell cell contact by using differential extraction procedures and indirect immunofluorescence microscopy. In the absence of cell-cell contact, two morphologically and spatially distinct patterns of staining of desmoplakins I and II were observed: a pattern of discrete spots in the cytoplasm and perinuclear region, which is insoluble in CSK buffer; and a pattern of diffuse perinuclear staining, which is soluble in CSK buffer, but which is preserved when cells are fixed in 100% methanol at -20 degrees C. Upon cell-cell contact, in the absence or presence of protein synthesis, the punctate staining pattern of desmoplakins I and II is cleared rapidly and efficiently from the cytoplasm to the plasma membrane in areas of cell-cell contact (less than 180 min). The distribution of the diffuse perinuclear staining pattern remains relatively unchanged and becomes the principal form of desmoplakins I and II in the cytoplasm 180 min after induction of cell-cell contact. Thereafter, the relative intensity of staining of the diffuse pattern gradually diminishes and is completely absent 2-3 d after induction of cell-cell contact. Significantly, double immunofluorescence shows that during desmosome assembly on the plasma membrane both staining patterns coincide with a subpopulation of cytokeratin intermediate filaments. Taken together with the preceding biochemical analysis, we suggest that the assembly of desmoplakins I and II in MDCK epithelial cells is regulated at three discrete stages during the formation of desmosomes. PMID- 3279051 TI - Relation between the organization of spectrin and of membrane lipids in lymphocytes. AB - In lymphocytes, the cytoskeletal protein spectrin exhibits two organizational states. Because the plasma membrane lipids of lymphocytes also display two organizational states, it was asked whether there is a relation between the organization of spectrin and of membrane lipids. When mouse thymocytes were stained with merocyanine 540 (MC540), a fluorescent lipophilic probe that binds preferentially to loosely packed, disorganized lipid bilayers, some cells fluoresced brightly and some only dimly or not at all. When the same population was stained for spectrin by indirect immunofluorescence, the spectrin in some cells was uniformly distributed, while in others it was concentrated in a unipolar aggregate. Techniques enriching for mature thymocytes selected for cells displaying low MC540 fluorescence and aggregated spectrin, the same characteristics found in peripheral blood lymphocytes. Flow cytometric sorting of thymocytes based on MC540 phenotype simultaneously sorted them by spectrin phenotype. Finally, treatment with agents that alter the distribution of spectrin caused mature lymphocytes to display high MC540 fluorescence and uniform spectrin. Thus, a relation exists between the organizational states of spectrin and of membrane lipids in lymphocytes: aggregated spectrin is found in cells with tightly organized membrane lipids, uniform spectrin in those with loosely organized lipids. Spectrin may thus be involved in modulating membrane lipid organization in lymphocytes as it is in erythrocytes. Since loosely organized lipids may promote adhesion of blood cells to reticuloendothelial cells, spectrin may thereby be involved in transducing an internally generated adhesion signal to the lymphocyte surface. PMID- 3279052 TI - Expression of the gene for main intrinsic polypeptide (MIP): separate spatial distributions of MIP and beta-crystallin gene transcripts in rat lens development. AB - The main intrinsic polypeptide (MIP) is the major protein present in the lens fiber cell membrane and is the product of a gene which, as far as is known, is expressed only in the lens. We have used in situ hybridization and immunofluorescence microscopy to characterize the expression of this gene during the course of development in the rat. At progressive stages of lens morphogenesis, we find that synthesis of the protein is closely tied to the accumulation of MIP mRNA in cells that are committed to terminal differentiation, first in the elongating presumptive primary lens fibers and later in the secondary fibers as they differentiate from the anterior epithelial cells. The transcripts accumulate in the basal cytoplasm of the primary fibers and in the cytoplasm which surrounds the cell nucleus in the secondary fibers. We have compared this pattern of expression with that of a gene for a cytoplasmic protein, beta-crystallin beta-A1/A3. In sharp contrast to the localized concentrations seen for the MIP mRNA, beta-A1/A3 transcripts are relatively uniformly distributed throughout the cytoplasm. Neither MIP nor crystallin gene appears to be transcriptionally active in the undifferentiated epithelial cell, but transcripts from the beta-A1/A3 gene appear earlier in fiber cell differentiation than do those from the gene for MIP. PMID- 3279053 TI - Nuclear migration in a nud mutant of Aspergillus nidulans is inhibited in the presence of a quantitatively normal population of cytoplasmic microtubules. AB - Nuclear migration was studied in germinating conidia of a temperature-sensitive mutant of the fungus Aspergillus nidulans. At the restrictive temperature motility was demonstrably impaired because significantly fewer nuclei migrated into the germ tube relative to a population of similarly sized germlings grown at the permissive temperature. Further comparison of these populations showed that the mutant was leaky in that an increasing number of nuclei migrated as the total nuclear content increased in each germling. The restrictive temperature also induced elevated mitotic asynchrony and increased numbers of nuclei per germling. Serial section-based reconstruction of the microtubules in a freeze-substituted germling showed that they were not attached to the nucleus-associated organelles, were approximately parallel to the long axis of the germ tube, and seemed to be randomly distributed between the central and peripheral cytoplasm. Five germlings from each temperature were selected for quantitative analysis of cytoplasmic microtubules. All 10 germlings had typical nuclear migration phenotypes. No significant temperature-related difference in microtubule density was found. We conclude that inhibition of nuclear migration in the mutant is the effect of some defect other than the failure of cytoplasmic microtubules to assemble to their normal population density. We also suggest that nuclear motility is not dependent on mitosis-related microtubules. PMID- 3279054 TI - Epidermal growth factor controls smooth muscle alpha-isoactin expression in BC3H1 cells. AB - We have examined the effects of epidermal growth factor (EGF), platelet-derived growth factor, and insulin on the differentiation of a mouse vascular smooth muscle-like cell line, the BC3H1 cells. On the basis of cell morphology and smooth muscle alpha-isoactin synthesis, we demonstrate that EGF at physiological concentrations prevents the differentiation of these cells, whereas platelet derived growth factor has no apparent effect. The induction of alpha-isoactin synthesis by serum deprivation is inhibited by EGF in a dose-dependent manner with a half-maximal effect at 3-5 ng/ml and a maximal inhibition at approximately 30 ng/ml. Northern analysis also shows that EGF blocks the accumulation of alpha isoactin mRNA normally observed during cell differentiation. Addition of EGF to differentiated cells results in a repression of alpha-isoactin synthesis, a stimulation of beta- and gamma-isoactin synthesis, and the stabilization of the nonmuscle isoactins. The synthesis of creatine phosphokinase, a muscle-specific noncontractile protein, is also regulated by EGF in a similar fashion. Modulation by EGF of alpha-isoactin expression is not affected by aphidicolin and is therefore independent of its mitogenic effect on these cells. Insulin is not required for observation of the EGF-dependent effects but instead seems to promote differentiation. Our results show that EGF can replace serum in controlling the differentiation of BC3H1 cells. PMID- 3279057 TI - Localization of protease nexin-1 on the fibroblast extracellular matrix. AB - Protease nexin-1 (PN-1) is a protease inhibitor that is secreted by fibroblasts and several other cultured cells. PN-1 forms complexes with certain serine proteases in the extracellular environment including thrombin, urokinase, and plasmin. The complexes then bind to the cells and are rapidly internalized and degraded. This report demonstrates that PN-1 is present on the surface of fibroblasts, bound to the extracellular matrix. Immunofluorescent studies showed that PN-1 colocalized with fibronectin on both intact cells and in preparations of extracellular matrix made from these cells. In contrast, PN-1 did not colocalize with the epidermal growth factor receptor, a plasma membrane marker. An enzyme-lined immunosorbent assay was developed which showed that the extracellular matrix contained at least 60-80% of the cellular immunoreactive PN 1. Extraction of the matrix with 2 M NaCl removed PN-1 in a form which reacted with 125I-thrombin to form complexes which were immunoprecipitated by anti-PN-1 IgG and were of identical size as complexes made from soluble PN-1 and 125I thrombin. These data indicate that in addition to its role as a soluble protease inhibitor, PN-1 is also a component of the extracellular matrix and might control its proteolysis. PMID- 3279056 TI - Joint oxygen-glucose deprivation as the cause of necrosis in a tumor analog. AB - The sandwich system was recently developed as an in vitro tumor analog. Like spheroids, sandwiches are organized, multicellular systems in which the interplay between diffusion and consumption leads to the formation of spatial gradients; a necrotic center and a viable cell border subsequently develop. Using sandwiches of the 9L and V79 cell lines, the effects of oxygen and glucose deprivation on the onset and formation of necrosis were investigated. The data indicate that in sandwiches necrosis is a result of a shortage of both substances. Complementary cell monolayer experiments to determine a number of consumption parameters were performed. On the basis of the data, we propose a joint oxygen-glucose deprivation model for V79 cell necrosis. It is assumed a cell dies when oxygen deprivation in conjunction with glucose deprivation lowers the cell's ATP production rate below a critical value. Interactions of the concentrations and consumptions of oxygen and glucose are analyzed theoretically; concentration profiles are obtained by numerically solving coupled non-linear integral equations arising from the diffusion equation. The predicted viable border widths are in good agreement with the observed values. PMID- 3279055 TI - Effects of heat shock on the expression of thrombospondin by endothelial cells in culture. AB - Heat-shock proteins from confluent primary cultures of bovine aortic endothelial cells were analyzed by SDS-polyacrylamide gels. In addition to the increased synthesis of the classical heat-shock proteins, there is an increase of a 180,000 mol wt polypeptide in the growth media of heat-shocked cells. Immunoprecipitation with specific antiserum indicates that the 180,000-mol wt polypeptide is thrombospondin. Assay of mRNA levels coding for thrombospondin after brief hyperthermic treatment (45 degrees C, 10 min), followed by a recovery of 2 h at 37 degrees C, results in a twofold increase in mRNA abundance. In contrast, the activation level of the 71,000-mol wt heat-shock protein mRNA occurs at an earlier time than for thrombospondin mRNA. Immunofluorescence microscopy was used to study the intracellular and extracellular distribution of thrombospondin. Thrombospondin is localized to a prominent pattern of granules of intracellular fluorescence in a perinuclear distribution in cells not exposed to heat. Upon heat treatment, the pattern of granules of intracellular fluorescence appears more pronounced, and the fluorescence appears to be clustered more about the nucleus. There are at least three pools of extracellular forms of thrombospondin: (a) the fine fibrillar extracellular matrix thrombospondin; (b) the punctate granular thrombospondin; and (c) the thrombospondin found in the conditioned medium not associated with the extracellular matrix. When bovine aortic endothelial cells are exposed to heat, the extracellular matrix staining of a fibrillar nature is noticeably decreased, with an increase in the number and degree of fluorescence of focal areas where the punctate granule thrombospondin structures are highly localized. No gross morphological changes in extracellular matrix staining of fibronectin was noted. However, the intermediate filament network was very sensitive and collapsed around the nucleus after heat shock. We conclude that the expression of thrombospondin is heat-shock stimulated. PMID- 3279058 TI - The role of transmembrane cationic gradients in immune complex stimulation of human polymorphonuclear leukocytes. AB - The role of monovalent cationic gradients in human polymorphonuclear leukocyte (PMNL) stimulation was investigated by monitoring immune complex-stimulated transmembrane depolarization and superoxide production, events which accompany- and have been used as indicators of --PMNL activation. Abolishing only the Na+ gradient by substitution of choline for extracellular Na+ did not affect the resting membrane potential but reduced the rate of stimulus-induced transmembrane depolarization to 50% of control. In contrast, collapsing both Na+ and K+ gradients by suspension in K+ buffer (high K-PRK) depolarized the cells and reduced the stimulus-induced rate of depolarization to 11% of control. Pretreatment of cells suspended in Na+ buffers with 5-(N,N-dimethyl)amiloride hydrochloride (DMA) or with valinomycin reduced by one-half the rate of immune complex induced membrane depolarization. Conversely, in the absence of either or of both Na+ or K+ gradients, or in the presence of valinomycin, immune complex elicited an enhanced rate of superoxide production. However, PMNL prepared via NH4Cl (NH4Cl-PMNL) instead of H2O (H2O-PMNL) lysis of residual red blood cells exhibited an absolute requirement for an intact Na+ gradient in cell stimulation. The present results thus demonstrate that: 1) both Na+ and K+ gradients participate equally in the membrane depolarization elicited by immune complex; 2) neither a Na+ or a K+ gradient is required for immune complex activation, or for activity of the respiratory burst; and 3) an artifactual requirement for an intact Na+ gradient occurs in neutrophils prepared by the NH4Cl lysis technique. PMID- 3279059 TI - Thrombin-induced adherence of neutrophils to cultured endothelial monolayers: increased endothelial adhesiveness. AB - We examined the effects of alpha-thrombin on the adherence of neutrophils to endothelial cell monolayers. Endothelial cells derived from the ovine pulmonary artery and ovine neutrophils were used. Thrombin (10(-8) M) resulted in a time dependent increase in neutrophil adherence to the endothelium. The response was concentration-dependent with a maximal response at 10(-8) M. Thrombin did not induce neutrophil adherence either to plastic or to endothelial cell-derived matrix. The adherence response was inhibited in the presence of alpha-thrombin that had been inactivated with anti-thrombin III (1U:1U) or with hirudin (1 U/ml). However, the addition of either anti-thrombin III or hirudin simultaneously with alpha-thrombin to the cultured endothelial monolayers did not prevent neutrophil adherence. The monoclonal antibody MoAb 60.3, which precipitates a complex of four neutrophil surface glycoproteins (CDw18) was used to further characterize the reaction. MoAb 60.3 decreased the thrombin-induced adherence of neutrophils to the endothelial monolayer. Addition of 10(-8) M thrombin to the endothelial monolayer for 60 min, followed by washing the endothelium with fresh medium, caused resting neutrophils to adhere to the endothelial monolayers. MoAb 60.3 decreased neutrophil adherence to the washed endothelium. The factor(s) responsible for adherence was partially transferable. Medium obtained from incubating endothelial monolayers with thrombin (10(-8) M) for 60 min, adding hirudin to the medium to inactivate thrombin, and transferring it to untreated endothelial monolayers, elicited neutrophil adherence. The response was less than that obtained with thrombin alone (22.9 +/- 2.3% vs. 12.9 +/- 3.3%). The results indicate that the catalytic site of the thrombin molecule is responsible for the adherent activity. Thrombin elicits a rapid activation of endothelial cells with a response that involves the expression of endothelial adhesion sites and sites that interact with the neutrophil CDw18 adhesive glycoprotein complex. In addition, soluble transferable factor(s) which are generated by the endothelium also contribute to thrombin-induced neutrophil adherence. PMID- 3279060 TI - Phosgene as a derivatizing reagent prior to gas and liquid chromatography. AB - The use of phosgene as a derivatizing agent for bifunctional compounds prior to gas and liquid chromatographic analysis is reviewed. Applications include gas chromatographic determinations of metoprolol and its metabolites in biological fluids, enantiomeric separations of beta-blocking drugs and sympathomimetic agents on a chiral stationary phase and liquid chromatographic enantiomer separations. PMID- 3279061 TI - The renal vasodilating effect of dopamine is mediated by calcium flux and prostacyclin release in man. AB - A low dose of dopamine (DA; 1 microgram/kg.min for 3 h) was infused into 10 normal subjects to determine whether vasodilator prostaglandins might be involved in the vascular action of this vasoactive hormone. Although this DA dose did not alter blood pressure, pulse, or cardiac index, it significantly increased renal blood flow (RBF), as estimated by para-amino-hippurate clearance [1.40 +/- 0.10 (+/- SE) to 1.93 +/- 0.18 L/min.1.73 m2; P less than 0.02]. This increase was due to DA receptor action since it was blocked by metoclopramide, a DA antagonist, and was not altered by prazosin, an alpha-adrenergic antagonist. DA simultaneously increased the urinary excretion rate of 6-keto-PGF1 alpha, a stable metabolite of prostacyclin [PGI2; 79 +/- 16 to 154 +/- 32 ng/g creatinine (2 +/- 0.40 to 3.88 +/- 0.78 pmol/mumol creatinine); P less than 0.02], but there was no change in PGE2 excretion. This dose of DA increased urinary Na+ and K+ excretion and slightly increased creatinine clearance from 0.12 +/- 0.01 to 0.16 +/- 0.02 L/min.1.73 m2 (P less than 0.05). Metoclopramide also blocked the increase in PGI2 excretion, indicating that this increase was due to DA. The relationship between RBF and PGI2 was supported by studies in which either indomethacin or ibuprofen, both cyclooxygenase inhibitors, blocked the increase in both RBF and PGI2 excretion rate. Since some DA actions may be mediated through calcium flux, we also administered nifedipine, a calcium channel-blocking drug, and found that the DA effect on RBF and PGI2 was significantly reduced. These studies suggest that the DA effect on RBF is mediated by calcium flux, which probably activates renal vascular phospholipase, leading to release of arachidonic acid and synthesis of PGI2, a potent vasodilator. PMID- 3279062 TI - Postnatal decrease in insulin binding to erythrocytes in infants of diabetic mothers. AB - To clarify the role of insulin receptors in the macrosomia and the tendency to hypoglycemia in infants of mothers with insulin-treated diabetes mellitus (IDM) we studied insulin binding in erythrocytes from mixed umbilical blood and from peripheral venous blood collected when the infants were 3-14 days old. Normal infants were matched for gestational and postnatal age. The IDM infants were macrosomic, with significantly higher birth weights relative to gestational age than the control infants. Plasma free insulin concentrations in cord blood were 15-fold higher in the IDM than in the normal infants and more than 3-fold higher in the peripheral venous blood at the median age of 4 days. Hypoglycemia occurred in 12 of the 17 IDM and in none of the normal infants. In umbilical blood insulin binding to erythrocytes was similar in the IDM and normal infants. In both groups insulin binding decreased during the first postnatal weeks, but the decrease was significantly greater in the IDM than in the normal infants. The decrease in insulin binding to erythrocytes was a consequence of decreased receptor affinity as well as decreased receptor concentration in the IDM infants, but was mainly due to decreased receptor concentration in the normal infants. We conclude that insulin binding to its erythrocyte receptor in cord blood in IDM infants is similar to that in normal infants in spite of the simultaneous gross hyperinsulinemia in the IDM infants. The resulting increase in insulin action would then contribute to the tendency toward hypoglycemia and may be partly responsible for the macrosomia in IDM infants. The marked postnatal decrease in insulin binding in IDM infants is a possible explanation for their diminishing risk of hypoglycemia after the first few days of life in spite of persisting hyperinsulinemia. PMID- 3279063 TI - Urinary growth hormone levels measured by ultrasensitive enzyme immunoassay in patients with renal insufficiency. AB - An ultrasensitive enzyme immunoassay was used to measure urinary GH levels in patients with renal insufficiency and normal subjects. Urinary GH excretion varied widely, but was significantly higher (P less than 0.01) in patients with renal insufficiency (median, 339; range, 2-17,000 ng/day) than in normal subjects (5.4; 1.2-15 ng/day). Urinary GH excretion correlated positively with urinary beta 2-microglobulin excretion (r = 0.79; P less than 0.001) and negatively with creatinine clearance (r = -0.83; P less than 0.001). Gel chromatography of urine from patients with renal insufficiency revealed a major peak of urinary GH corresponding to a mol wt of 22K, that of pituitary GH. These findings suggest that the kidneys play an important role in the catabolism of GH and that urinary GH may reflect, at least in part, renal function as well as hypothalamo-pituitary function. PMID- 3279064 TI - Prospective studies of insulin sensitivity in normal women receiving oral contraceptive agents. AB - Seven normal premenopausal women were studied before (control) and after 3 and 6 months of oral contraceptive agent (OCA) administration (30 micrograms ethinyl estradiol plus 150 micrograms levonorgestrel). The plasma glucose responses during 75-g oral glucose tolerance tests were not altered by the OCA, but the 3- and 6-month plasma insulin responses significantly exceeded control values (P less than 0.05). On a separate morning a constant iv infusion of [3H]3-glucose was given throughout a 2-h basal period and during two successive 2-h euglycemic clamp procedures at iv insulin delivery rates of 10 and 40 mU/m2.min, respectively. Endogenous glucose production rates (milligrams per kg/min) were not altered after 3 or 6 months of OCA administration. Peripheral glucose utilization rates were expressed as M (milligrams per kg/min) or the ratio of M over the prevailing plasma insulin concentration (M/I). One or both parameters were significantly reduced below control values at both insulin infusion rates after 3 months (P less than 0.05), but returned toward control values after 6 months. Serum androgen concentrations were reduced or not altered by OCA administration. We conclude that insulin resistance induced by OCA administration is manifested by reduced peripheral tissue insulin sensitivity and may ameliorate with time. This effect does not relate consistently to total plasma insulin responses during oral glucose tolerance tests or to elevated serum androgen concentrations. PMID- 3279066 TI - The dentist as a plastic surgeon (Hugo Ganzer 1879-1960). AB - In a short biography, the life and achievements in plastic surgery of the German dentist Hugo Ganzer are described. This pioneer made real contributions in developing tubed pedicle flaps, naso-labial flaps, nasal reconstruction, periorbital reconstruction, jaw reconstruction and cleft palate surgery. His professional career was tragically influenced by his decision not to strive for a medical qualification, being convinced that dentistry alone was a sufficiently sound basis for the performance of facial plastic surgery. Although he found broad recognition, this point of view made it impossible for the formal foundation of the specialty to be attributed to him. PMID- 3279065 TI - Failure of gonadotropin therapy secondary to chorionic gonadotropin-induced antibodies. AB - Seventeen years after first receiving treatment with hCG (at age 8 yr), a man with hypogonadotropic hypogonadism no longer responded to gonadotropin therapy. He had received hCG for 6 months when he was 8 yr old, from age 18-21 yr and from age 21-25 yr, when the resistance developed. Anti-hCG antibodies were found in his serum. Three sequential treatment regimens were tried to obviate the effect of these antibodies. 1) hCG treatment (2000 IU, three times per week) concomitant with weekly plasmapheresis (since the patient's response to an hCG challenge test was improved after a reduction of antibody titer by plasmapheresis) resulted in only a temporary increase in testosterone production. 2) Treatment with human (h) LH (400 IU/week) and hFSH (25 IU/week) was used because of the low cross-reaction of the antibodies with hLH and a response to a hLH-challenge test. This treatment maintained serum testosterone levels within the normal range for long periods, but had to be discontinued when the supply of hLH was exhausted. 3) Pulsatile LHRH administration (25 ng/kg, sc, every 2 h) for 2 months did not induce the release of pituitary gonadotropins. These results indicated that 1) conventional hCG treatment was impaired by antibody-induced changes in the kinetics of hCG after its im administration; 2) hLH was an effective substitute for hCG, and the combined hLH-hFSH administration initiated a moderate amount of spermatogenesis; and 3) the patient differs from most individuals with hypogonadotropin hypogonadism in that he did not have normal responses to repetitive LHRH administration. PMID- 3279068 TI - Rhinocerebral mucormycosis. Presentation of two cases and review of the literature. AB - Mucormycosis is a serious infection with a fulminating course caused by opportunistic fungi. The territory most frequently affected is the maxillofacial region. The disease develops in patients with severe metabolic and immunological disorders. We present two cases that illustrate its severity and the need for early diagnosis and aggressive treatment. PMID- 3279067 TI - Medial orbital wall fracture with enophthalmos. AB - An isolated blow-out fracture of the medial orbital wall is uncommon, whereas the incidence in conjunction with an orbital floor fracture is high. The most striking features of an isolated medial wall fracture are diplopia on medial and lateral gaze and/or enophthalmos. The cases of two patients with a fracture of the medial orbital wall with enophthalmos are presented. One patient had an isolated medial wall fracture, whereas the other had a combined medial and inferior orbital wall fracture. Treatment of the enophthalmos consisted of exposure of the medial wall fracture site using a bicoronal flap, freeing of the herniated soft tissues and reconstruction of the defect with an autogenous medial iliac bone graft. The incidence, aetiology, pathogenesis, signs and symptoms and surgical treatment of the isolated orbital medial blow-out fracture are discussed. PMID- 3279069 TI - Development of a tooth germ within an autogenous clavicular graft. AB - The left side of the mandible distal to the second primary molar of a 3 years old Southern Chinese boy was resected as a result of osteomyelitis. A diaphyseal clavicular graft pedicled on the sternomastoid muscle was selected for the reconstruction of the mandible. By the age of 6 years, the mandible although stunted in size did exhibit appropriate remodelling. In addition a tooth germ in the region of the second permanent molar was found developing in the autogenous bone graft of the mandible. PMID- 3279070 TI - Microbial succession in recolonizing deep periodontal pockets after a single course of supra- and subgingival debridement. AB - In the present study, the effect of supra and subgingival plaque debridement on the dynamics of the subgingival microflora in deep pockets was investigated. 8 adult periodontitis patients participated in the study. In each patient, 4 clinically diseased sites were investigated microbiologically by phase contrast microscopy for the determination of both the %s as well as the total numbers of spirochetes and motile rods and by anaerobic cultivation for the determination of the different black-pigmented Bacteroides species. After base-line examination, patients were treated by mechanical removal of supra- and subgingival plaque deposits. 2 and 8 weeks after treatment, clinical and microbiological parameters were re-evaluated. During the experimental period, no oral hygiene procedures were performed in order to achieve fast recolonization of the pockets. Treatment resulted in a significant reduction in probing pocket depth and gain of probing attachment. 2 weeks after treatment, no further improvements could be observed. A positive correlation was found between the reduction in probing pocket depth and decrease in Bacteroides gingivalis (P less than 0.009) and between gain in probing attachment and reduction in the % of B. gingivalis (P less than 0.009). No correlation between these clinical parameters and B. intermedius, spirochetes or motile rods was apparent. An inverse relationship between B. gingivalis and B. intermedius was observed. We found that changes in %s of spirochetes and motile rods are not correlated with changes in total numbers of these bacterial groups. It was concluded that monitoring of %s of micro-organisms may not supply rational information on the microbiological conditions of the subgingival area. PMID- 3279071 TI - Observations on the initial stages of healing following human experimental gingivitis. A clinical and morphometric study. AB - The aim of the present study was to investigate stereologically the histologic alterations occurring during gingival healing after experimental gingivitis and to compare clinical parameters with histological findings. 8 dental students volunteered for the investigation. After a prophylaxis, they performed optimal oral hygiene to reach mean plaque and gingival indices approaching zero. They then abolished all oral hygiene procedures for a period of 21 days. After this experimental gingivitis phase, they again performed optimal oral hygiene for 8 days to restore gingival health. At days 0, 1, 2, 4 and 8 after experimental gingivitis, the plaque index (PlI), the gingival index (GI) and the gingival exudate flow rate (GEFR) were assessed and their buccal gingiva was biopsied. Point counting procedures were performed at 2 different levels of magnification on light microscopic sections to estimate the volume fractions of epithelium, infiltrated and non-infiltrated connective tissue, and collagen. The relative numbers of fibroblasts, polymorphonuclear neutrophils, lymphocytes, plasma cells and macrophages were estimated by counting the number of profiles of these cells in a specific connective tissue area adjacent to the apical end of the junctional epithelium. A rapid drop in the PlI was noted with increasing time after oral hygiene, followed by a slower decrease in the GI and GEFR scores. The histological picture during the entire experiment was that of an initial gingival lesion. At day 0, no chronic inflammation of the gingiva characterized by a predominance of plasma cells was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279072 TI - A perspective on periodontal disease activity measurements. AB - Studies utilizing serial standardized periapical radiographs for measurements of alveolar bone height and for digital subtraction and changes in clinical probing attachment level have suggested that adult periodontitis may exhibit periods of exacerbation and remission at specific sites. The use of such serial examinations for the determination of disease activity must be interpreted with caution since the different methods for the assessment of disease activity have different levels of sensitivity and specificity and because such sequential methods integrate disease activity and do not provide an instantaneous measure of activity. An ideal test for disease activity would approach an instantaneous measure of disease activity and would not integrate activity over time. PMID- 3279073 TI - Bacteroides gingivalis, Bacteroides intermedius and Actinobacillus actinomycetemcomitans in human periodontal diseases. AB - Bacteroides gingivalis, Bacteroides intermedius and Actinobacillus actinomycetemcomitans seem to be major pathogens in advancing periodontitis in man. First, these organisms are recovered in higher prevalence and proportions from progressive periodontitis lesions than from quiescent periodontal sites. Second, antibody levels against B. gingivalis and A. actinomycetemcomitans are markedly elevated in serum and gingival crevice fluid of periodontitis patients compared to normal controls. Third, B. gingivalis and B. intermedius elaborate potent proteases and A. actinomycetemcomitans various noxious substances which have the potential to perturb important host defenses and to disintegrate key constituents of the periodontal tissues. Monitoring these bacteria in advanced periodontal lesions may greatly assist the assessment of treatment efficacy and risk of further periodontal breakdown. PMID- 3279074 TI - Surgical versus non-surgical treatment and recurrent periodontal disease in beagle dogs. AB - The present study was designed to compare clinical, microbiologic and histometric parameters of recurrent periodontal disease in areas which had been treated either surgically (SU) or nonsurgically (NS). Periodontal disease was induced for 6 months in 3 quadrants in each of 6 beagle dogs. 2 of the 3 diseased quadrants were treated by definitive surgical or nonsurgical therapy followed by plaque control for 4 months. 2 dogs were then sacrificed to provide histometric data. Periodontal disease was reinduced in the remaining 4 dogs by allowing plaque accumulation for 6 months after which the dogs were sacrificed for histometric analysis. Clinical parameters were recorded and darkfield microscopic analysis of subgingival plaque samples was performed at regular intervals. Following 6 months of plaque accumulation during disease reinduction, there were significant changes (p less than 0.05) in the pocket depths, bleeding scores and attachment levels in both the SU and NS areas. These changes were accompanied by significant increases (p less than 0.05) in the proportions of spirochetes and motile rods and decreases in the proportions of coccoid cells in both the SU and NS areas. There were, however, no significant differences between the SU and NS areas when clinical and microbiologic parameters were compared. At the end of disease reinduction phase, the length of inflammatory cell infiltrate and % inflamed connective tissue had increased significantly in both the SU and NS areas.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279075 TI - Histopathological classification of malignant lymphomas in slaughtered swine. AB - A histological classification of 36 cases of malignant lymphoma in slaughtered swine is reported. All the lymphomas observed were diagnosed as diffuse types and were further classified into four types by their histological characteristics based on the classification of the Japanese Lymphoma Study Group (Suchi et al., 1979). The cases consisted of 16 of the Burkitt type, 2 of the immunoblastic type, 3 of the medium-sized cell type and 15 of the mixed cell type. The histological appearances of these lymphomas were compared with those of human lymphomas. All tumours closely resembled non-Hodgkin's diffuse type of B cell lymphoma and differed from tumours in other sites such as the liver and kidneys. PMID- 3279076 TI - John McFadyean and the Journal of Comparative Pathology and Therapeutics. PMID- 3279077 TI - Amyloid and amyloidosis. AB - Cutaneous lesions are present in up to 40% of patients with primary and myeloma associated systemic amyloidosis and occur as a result of tissue deposition of immunoglobulin light chain material derived from a circulating paraprotein. The occurrence of waxy, purpuric mucocutaneous lesions provides a crucial early pointer to underlying occult plasma cell dyscrasia; the combination of the symptoms of the carpal tunnel syndrome, macroglossia, and specific mucocutaneous lesions is highly characteristic. Although secondary systemic (reactive) amyloidosis rarely gives rise to clinically evident cutaneous lesions, it may be etiologically related to a number of chronic dermatoses. Lesions of nodular primary localized cutaneous amyloidosis are indistinguishable from those of primary and myeloma-associated systemic amyloidosis, and they result from local plasma cell infiltration. Macular and papular (lichen amyloidosus) variants of primary localized cutaneous amyloidosis may have a familial or racial basis and are characterized by a tendency for keratinocytes to undergo filamentous degeneration and apoptosis. The prognosis of patients with plasma cell dyscrasia related systemic amyloidosis remains poor, since there is little response to therapy with cytotoxic agents, colchicine, or dimethylsulfoxide. Colchicine is the drug of choice in the prevention and treatment of the renal amyloidosis associated with familial Mediterranean fever, and dimethylsulfoxide may be useful in the management of patients with secondary systemic amyloidosis. Macular amyloid and lichen amyloidosus generally follow a chronic course with intractable pruritus; there have been isolated reports of the beneficial effect of dermabrasion, topical dimethylsulfoxide, and therapy with the aromatic retinoid, etretinate. PMID- 3279078 TI - Relaxation therapies in the treatment of psoriasis and possible pathophysiologic mechanisms. AB - Psychologic factors play a role in many dermatologic disorders, giving rise to the possible use of psychotherapeutic modalities in treatment. Regarding psoriasis, emotional factors have a strong correlation with onset and flare-ups. The psychophysiologic mechanisms involved are not known; however, stress and its effect on the autonomic nervous system and the immune system may play a significant role in the onset and course of psoriasis. Relaxation and mere suggestion also affect the autonomic nervous system and the immune system and therefore may affect the course of the skin disorder. A few case studies have documented successful treatment of psoriasis with hypnosis and biofeedback. Further study of this process is needed, and the role of stress in dermatologic diseases must always be given consideration. PMID- 3279079 TI - Wells' syndrome is a distinctive disease entity and not a histologic diagnosis. AB - Wells' syndrome is a distinctive dermatosis clinically resembling acute cellulitis with solid edema; it resolves spontaneously after weeks or months without residues. Recurrences over many years are common. Light microscopy is characteristic for the disease, with diffuse tissue eosinophilia and marked edema, fibrinoid "flame figures," and palisading microgranuloma. Vasculitis is never found. Eosinophilia of the peripheral blood is a frequent feature. Etiology and pathogenesis are unknown, but the disease has been found to be associated with hematologic disorders in several cases, and recurrences can often be related to infections, arthropod bites, drug administration, or surgery. The diagnosis of Wells' syndrome should be based on the typical clinical picture and the course of the disease with its recurrences and histopathology. Flame figures in histologic sections are an important diagnostic feature but not diagnostic per se for the disease because they represent a reaction pattern that can occur in other conditions. A dilution of Wells' syndrome by making flame figures the central criterion of diagnosis and by lumping all flame figure-positive skin reactions together is therefore unjustified. PMID- 3279080 TI - Nonmelanoma skin cancer. PMID- 3279081 TI - The Koebner phenomenon and the microbial basis of psoriasis. PMID- 3279082 TI - Primary cutaneous amyloidosis of the auricular concha. AB - Several patterns of primary cutaneous amyloidosis are recognized; in this report of four cases, we define a new pattern in which the lesions are composed of small papules grouped on the concha of the ear. The lesions typically are not pruritic but slightly friable. They may be present on both ears. The patients do not have lesions of amyloidosis on other parts of the body and no known insult precedes the appearance of lesions. This entity appears to have been described previously as collagenous papules of the ear. Histochemical and electron microscopic methods allow us to confirm the amyloid nature of the substance. We believe this condition to be a variant of primary cutaneous amyloidosis, particularly because monoclonal antikeratin antibody EKH4, which has been positive in lichenoid, macular, and skin epithelial tumor-associated amyloidoses, was positive in our cases. PMID- 3279083 TI - Naftifine cream 1% versus econazole cream 1% in the treatment of tinea cruris and tinea corporis. AB - Data from 104 subjects with tinea cruris or tinea corporis were evaluated in this double-blind, randomized study. The subjects applied naftifine cream 1% or econazole nitrate cream 1% to affected areas twice daily for 4 weeks. After 1 week of treatment naftifine had an overall cure rate of 19% compared with 4% for econazole (p = 0.03). A difference in favor of naftifine, although not statistically significant after the first week, persisted throughout treatment. Two weeks after the end of treatment both medications had overall cure rates of approximately 80%. Three percent of the naftifine-treated subjects had side effects compared with 13% of the econazole-treated subjects. In two subjects using econazole, the side effects were severe enough to warrant discontinuation of treatment. PMID- 3279084 TI - Vesiculobullous systemic lupus erythematosus. A report of four cases. AB - A vesiculobullous eruption is now recognized as a specific but rare cutaneous complication of systemic lupus erythematosus. Four additional cases are reported in whom the five previously proposed criteria were met. Increased activity of systemic lupus erythematosus affecting other organ systems was documented in three of four cases. All four patients demonstrated a positive lupus band, and three of four showed granular deposits of IgA along the basement membrane zone (BMZ). Evidence of glomerulonephritis was obtained in three of four cases, which resulted in death in one. The higher than expected incidence of IgA deposits in skin and renal disease in patients with vesiculobullous eruption of systemic lupus erythematosus is again confirmed. The eruption cleared in all four cases with either dapsone, 50 mg daily, or high doses of corticosteroids and immunosuppressive agents. PMID- 3279085 TI - What's new in pediatric dermatology. AB - This report discusses some of the newly described diseases in pediatric dermatology and recent developments in other diseases that are pertinent to this field. PMID- 3279086 TI - Iontophoretic study of skin vessel reactivity in atopic dermatitis and its correlation to serum IgE levels. AB - Skin vessel reactivity was studied by means of an iontophoretic technique in 19 adult patients with atopic dermatitis. Fifteen patients were available for reinvestigation some 6 months later in winter. Compared with a control group, we found a significantly increased sensitivity in summer of dermal skin vessels toward the alpha 1-agonist phenylephrine. Patients with elevated serum IgE levels seemed to be more sensitive to phenylephrine. However, the difference was not significant. Isoproterenol, the beta-adrenoceptor agonist, induced blanching (as opposed to erythema) in 7 of 19 (37%) atopic dermatitis patients in summer and in 9 of 15 (60%) in winter compared with 1 of 36 in the control groups. This blanching was antagonized by the alpha-blocker phentolamine. From the results we concluded that there may be an increased alpha-adrenoceptor reactivity and/or a decreased beta-adrenoceptor reactivity in atopic dermatitis patients, which might be a primary defect. PMID- 3279087 TI - Group psychotherapy as an aid in the medical treatment of eczema. AB - The ongoing management of severe adult eczema is often difficult and problematic for both patient and doctor. A group of ten adult eczema patients were given group psychotherapy as a supplement to their regular medical regimen. Five target symptoms were rated on a biweekly basis first to establish individual baselines of disease course and later to measure treatment effect. The psychologic treatment combined behavioral and cognitive interventions with relaxation training. Patients used multiple self-rating sheets to provide feedback with the goal of increasing their skills in the management of scratching behaviors. At the end of treatment all ten patients showed significant reduction in targeted symptoms. PMID- 3279088 TI - Clinical, pathologic, and immunopathologic manifestations of the toxic oil syndrome. Analysis of fourteen cases. AB - The clinical, pathologic, and immunopathologic findings of 14 patients with the toxic oil syndrome are presented. The toxic oil syndrome occurred in Madrid, Spain, as a consequence of ingestion of an industrial oil sold as olive oil. The syndrome occurred in two phases. In the acute phase patients developed an interstitial pneumonitis, fever, and exanthem, and some died of respiratory insufficiency. Of those who survived, some developed a chronic phase with a neuromyopathic and scleroderma-like illness that had many features of a collagen vascular disease. Histologic examination of lung in the acute phase showed an endovasculitis and features of adult respiratory distress syndrome. In the chronic phase the skin showed various degrees of sclerodermoid changes and vessel injury. Immunofluorescence with antiprocollagen and antifibronectin antibodies revealed abundant perivascular fluorescence suggestive of vascular injury. Electron microscopy corroborated this by the presence of endothelial swelling and basal lamina reduplication. Similar findings have been described in systemic sclerosis, and this provides an important model for study of connective tissue disease, including scleroderma. PMID- 3279089 TI - 5-Methoxypsoralen (Bergapten) for photochemotherapy. Bioavailability, phototoxicity, and clinical efficacy in psoriasis of a new drug preparation. AB - In a previous study we evaluated a microcrystalline preparation of 5 methoxypsoralen (5-MOP; Bergapten) for its photochemotherapeutic properties. Preliminary data indicated that the clinical efficacy of 5-MOP is comparable to that of 8-methoxypsoralen. 5-MOP appeared as a promising alternative photosensitizer for the management of psoriasis because of the almost complete lack of phototoxic and drug intolerance reactions that are frequently encountered in patients undergoing 8-MOP photochemotherapy. With a new liquid preparation of 5-MOP we have now extended our earlier investigation on a larger clinical scale and have correlated the clinical response with the bioavailability of the drug. Serum level determinations showed an absorption rate of only approximately 25% that of 8-MOP. When administered in the same dosage as 8-MOP, 5-MOP turned out to be significantly less effective; however, by doubling the oral dosage, comparable results in terms of clearing of psoriasis were obtained. Also with this high-dose 5-MOP regimen, no drug intolerance was noted and other side effects, such as severe erythema, pruritus, and nausea, occurred only rarely. We propose 5-MOP as a valuable alternative for photochemotherapy (PUVA) of PUVA-responsive diseases. PMID- 3279090 TI - Kathon CG: a review. AB - Kathon CG, a cosmetics preservative containing, as active ingredients, 5-chloro-2 methyl-4-isothiazolin-3-one and 2-methyl-4-isothiazolin-3-one, appears to be a frequent cause of contact dermatitis in Europe. In the United States, where Kathon CG was introduced some 5 years later, the use of this preservative system for cosmetics and toiletries is rapidly increasing. Undoubtedly cases of contact sensitization will soon emerge in this country. Most cases of contact allergy are caused by the use of moisturizing creams on (slightly) damaged skin. Sensitization by the use of cosmetic products on previously healthy skin, especially the face, does occur but appears to be less frequent. Rinse-off products do not seem to have a substantial potential for the induction and elicitation of contact allergic reactions to Kathon CG because of dilution of the product and the allergen with water as well as a short contact time with the skin. This review provides a synopsis of current knowledge on the preservative system Kathon CG, with emphasis on the risk of sensitization and diagnostic procedures. PMID- 3279091 TI - Psychosocial treatment for recurrent genital herpes. PMID- 3279092 TI - Micrograft dilators: in pursuit of the undetectable hairline. AB - The process of single-hair transplanting, though providing obvious cosmetic advantages in hairline refinement, has long been considered too tedious and time consuming to be incorporated into standard transplant sessions. Micrograft dilators provide dilatation, organization, and hemostasis, while permitting large numbers of micrografts to be placed quickly and effortlessly below the standard transplanted hairline. PMID- 3279093 TI - Aids to scalp reduction surgery. AB - Utilizing certain surgical techniques during scalp reduction surgery will assist the surgeon in achieving a carefully planned and more efficient result. Measurement of scalp depth will assist in predicting the amount of skin to be excised. A simple method of safe identification of the periosteum is described along with the description of an elevator which assists in rapid, safe, and extensive undermining in the galeal-periosteal plane. An accessory supra auricular scalp incision can be employed to allow for extensive scalp undermining. A transverse incision into the skin flap to be advanced, allows the surgeon to safely approximate the amount of skin to be excised. When skin closure becomes impossible due to overzealous excision of bald skin, galeotomies can provide closure. A special order suture is described which allows for easier galeal closure. Surgical skin staples are recommended to provide a faster skin closure. PMID- 3279094 TI - IgE-mediated food intolerance. PMID- 3279095 TI - Efficacy and safety of ketotifen in young children with asthma. AB - Thirty children (aged 1 to 3 years) with mild to moderate asthma were entered into a 28-week double-blind, crossover study comparing the prophylactic effect of ketotifen and placebo. A patient daily diary card was used to document symptoms and concomitant medications taken during a 2-week baseline and subsequent 12-week drug/placebo period. This was followed by a 2-week washout and 12 more weeks of drug/placebo in a crossover design. Physician assessment was performed at the beginning, at the end of each period, and at 4-week intervals throughout the drug study. No significant difference was observed between ketotifen treatment and placebo treatment in any of the study parameters that were tested. A decrease in concomitant medication usage during the first treatment period with ketotifen was observed. The principle side effect of ketotifen therapy observed in this age group was weight gain. In contrast to studies in adults, no sedation was noted. PMID- 3279097 TI - Using a nutrition services directory as a promotional tool: a National Nutrition Month project. PMID- 3279096 TI - Partial characterization of a rapidly released antigenic/allergenic component (Ag 5) of Aspergillus fumigatus. AB - An antigenic component of Aspergillus fumigatus, which was responsible for inducing an initial early antibody response in rabbits immunized with A. fumigatus germlings, has been identified and partially characterized. By immunofluorescent antibody and ELISA techniques, this antigen was demonstrated to be present on the germling surface, although it was also detected in supernatants of conidia/germlings within 1 hour and was present in all shake and stationary culture-filtrate extracts. By incorporation of a monospecific antiserum to this component in an intermediate gel of the reference self-crossed radioimmunoelectrophoresis pattern for allergic bronchopulmonary aspergillosis sera, it was recognized as Ag 5 and was also demonstrated to bind specific IgE. Further immunochemical analyses have revealed that Ag 5 is relatively heat labile, does not bind to concanavalin A, and has a molecular weight of approximately 35 kd. This rapidly released antigenic/allergenic component may play an important role in the initiation of immunologic responses in patients with allergic bronchopulmonary aspergillosis. PMID- 3279098 TI - Copper nutriture, bioavailability, and the influence of dietary factors. AB - Copper is known to be an essential nutrient for human beings, but a Recommended Dietary Allowance has not yet been established. A safe and adequate range of intake was established in 1980 for copper and five other trace elements. The range for copper, 2 to 3 mg/day, is higher than the usual dietary copper intake of many individuals in this country. On the basis of balance studies, a requirement of 1.3 mg/day has been suggested. Recent data on copper intake and bioavailability should aid in reevaluating the dietary copper requirement. Copper deficiency symptoms have seldom been observed in human beings. When copper deficiency has been recognized, it has been under unusual conditions, such as in patients receiving parenteral nutrition. Interactions between copper and other dietary components may alter copper status, but the impact of those interactions is not yet well understood. Dietary factors that may affect the bioavailability of copper include the levels of copper, zinc, and molybdenum in the diet; iron deficiency; ascorbic acid intake; intake of carbohydrates, including fructose, glucose, and starch; and fiber and phytate intakes. Some drugs may also affect copper bioavailability. PMID- 3279099 TI - Lactation outcome in insulin-dependent diabetic women. AB - To document the incidence and management of breast feeding among women with insulin-dependent diabetes mellitus (IDDM), 30 IDDM mothers and 30 controls were followed from birth of their infants to 6 weeks postpartum. The researchers interviewed the mothers in the hospital and by telephone at 1, 2, and 6 weeks postpartum. Fifty-three percent of the IDDM women and 57% of the general hospital population intended to breast feed. Because of the need for neonatal observation for hypoglycemia, most IDDM mothers were separated from their infants for the first 2 days. After 1 week, as many IDDM mothers as controls nursed. Initially, no differences in breast-feeding problems were found between the groups, but between 2 and 6 weeks postpartum, two IDDM nursing mothers but none of the controls experienced clinically diagnosed mastitis. A daily diet prescription of 31 kcal per kilogram of maternal body weight was associated with IDDM mothers' ability to sustain lactation, in contrast with 25 kcal per kilogram of maternal weight for IDDM mothers who stopped nursing. Six-week postpartum fasting plasma glucose levels of IDDM mothers who exclusively breast fed were significantly lower (4.6 +/- 2.2 mmol/L [82 +/- 40 mg/dl]) than the glucose levels of the women who stopped nursing (8.1 +/- 2.1 mmol/L [145 +/- 37 mg/dl]) or the glucose levels of the IDDM mothers who chose to bottle feed (6.7 +/- 1.7 mmol/L [120 +/- 30 mg/dl]). It appears that adequate maternal calories, blood sugar control, early breast stimulation, and mastitis monitoring are necessary for optimal lactation outcome in insulin-dependent diabetic women. PMID- 3279100 TI - Modified food starch--an update. AB - In 1970, the National Academy of Sciences reviewed the safety and suitability of modified food starch for use in baby foods. Their report concluded that modified food starches were safe and appropriate for use. A second review, in 1978, by the Committee on Nutrition of the American Academy of Pediatrics, reaffirmed this conclusion. This update provides new information on modified starch utilization and reaffirms its value for use in baby foods. PMID- 3279101 TI - Short-term effects of an intravenous infusion of a nutrient solution containing amino acids, glucose and insulin on leucine turnover and amino acid metabolism in patients with liver failure. AB - Tolerance to an intravenous nutrient infusion containing amino acids, glucose and insulin was assessed in 12 adult patients with clinical and biochemical evidence of liver failure. In six individuals, fasting plasma amino acid patterns and turnover rates were measured by a constant intravenous infusion of [1-14C]leucine tracer. In the remaining patients the same measurements were made after a 10 h intravenous infusion of a 'standard' commercial mixture of amino acids (3.4 g/h), dextrose (20 g/h) and insulin (1.6 units/h). On the second day, conditions were crossed over and measurements were repeated. With the exception of glycine, the infusion of the amino acid-containing solution failed to significantly increase plasma amino acid content. Plasma leucine flux measurements indicated that the explanation involved a reduction in input of amino acids derived from the breakdown of body proteins rather than an increased uptake of amino acids into protein; i.e., the rate of liberation of leucine from protein decreased by an average of 2.4 mmol/h (P less than 0.05) whilst intake only added 1.6 mmol/h. No consistent changes in encephalopathy were observed. In conclusion, the infusion of the amino acid solution together with glucose and insulin resulted in improved nutritional intake and had no deleterious short-term effects on encephalopathy. However, judging from the plasma amino acid concentrations, the composition of the commercial mixture could be improved by reducing the glycine content. PMID- 3279102 TI - The genetics of haemochromatosis. PMID- 3279103 TI - Reactive oxygen intermediates and liver injury. PMID- 3279104 TI - Rat hepatic sinusoidal endothelial cells in monolayer culture. Biochemical and ultrastructural characteristics. AB - Sinusoidal endothelial cells were isolated by collagenase-pronase digestion of rat livers followed by centrifugal elutriation. The main endothelial cell fraction consisted of more than 85% endothelial cells as shown by electron microscopy and enzyme histochemistry. Contamination by Kupffer cells was less than 5%. The endothelial cells formed a coherent stable monolayer on dishes coated with collagen type IV in the presence of an RPMI 1640 medium supplemented with 4% Ultroser. Fc receptors were undetectable immediately after elutriation but reappeared after 12 h in culture. Von Willebrand factor (formerly factor VIII related antigen) could not be detected unequivocally by immunofluorescence. Unchallenged endothelial cells did not produce eicosanoids. In the presence of free arachidonate, however, prostaglandins D2 and E2 as well as thromboxane B2 and 6-keto-prostaglandin F1 alpha were detected by radioimmunoassay and by high performance liquid chromatography analysis of [3H]arachidonate-exposed cells. Cells treated with the Ca2+ ionophore A23187 produced the same spectrum of immunologically measured prostanoids. In contrast to Kupffer cells in primary culture, eicosanoid formation by endothelial cells was neither triggered by phagocytotic stimuli nor suppressed by pretreatment with dexamethasone. PMID- 3279105 TI - Isolation and culture of Kupffer cells from human liver. Ultrastructure, endocytosis and prostaglandin synthesis. AB - Kupffer cells and other sinusoidal cells were isolated after perfusion and incubation with pronase and collagenase of pieces of liver tissue obtained from organ donors. The resulting cell preparations contained endothelial cells, Kupffer cells and fat-storing cells as well as considerable numbers of leucocytes. Attempts to purify the different sinusoidal cell types by density centrifugation and centrifugal elutriation were successful only for Kupffer cells. Kupffer cells, in contrast to endothelial cells and fat-storing cells, could be kept in maintenance culture for at least 5 days. Cultured Kupffer cells were active in the endocytosis of foreign substances, such as colloidal carbon, latex beads, horseradish peroxidase and bacterial endotoxin. The cultured Kupffer cells synthesized and secreted considerable amounts of prostaglandins PGE2, PGF2 alpha, 6-keto-PGF1 alpha and thromboxane B2. The production of prostaglandins was influenced by the presence of Escherichia coli endotoxin. PMID- 3279106 TI - Renin-angiotensin system in dogs following chronic bile-duct ligation. Relation to vascular reactivity. AB - The pressor response to angiotensin II, blood volume, angiotensin II in arterial blood, renin substrate, renin concentration, renin activity and aldosterone in venous blood, liver function tests, kidney function tests, glucose, sodium, potassium, plasma osmolality and complete blood count were examined before and 1, 2, 3 and 5 weeks after ligation of bile ducts in nine conscious trained dogs. The pressor response to angiotensin II was markedly suppressed after bile-duct ligation, especially at 1-3 weeks postoperation. A maximal decrease in plasma renin substrate, and maximal increases in plasma renin concentration, plasma renin activity and aldosterone were noted at 1 week postoperatively. Plasma angiotensin II levels were elevated at 1 and 5 weeks postoperatively but were near normal 2 weeks postoperatively despite suppression of the angiotensin II pressor response. Endogenous levels did not correlate with suppression of the pressor response to exogenous angiotensin II. PMID- 3279107 TI - Blood group antigens in the intrahepatic biliary tree. I. Distribution in the normal liver. AB - The distribution of six blood group-related antigens, A, B, H, Lea, Leb and sialylated Lea antigens, in the intrahepatic biliary tree was studied. These carbohydrate antigens in fixed normal liver tissues were immunostained with the use of highly specific monoclonal antibodies in an avidin-biotin-peroxidase complex method. Bile ducts expressed both ABH and Lewis blood group antigens. However, only Lewis blood group antigens could be detected in the bile ductules. Canaliculo-ductular junctions could be clearly delineated with the anti-Lewis blood group antibodies, especially with anti-Lea antibody. Small Lewis antigen positive cells were scattered intralobularly. They were adjacent to parenchymal liver cells, mainly in Rappaport zone 1, and apparently in continuity with the portal biliary tree. Sialylated Lea antigen was found in some septal bile ducts. No blood group antigen could be detected in the bile canaliculi. These results indicate that (1) biliary tract of a given size has its own pattern of blood group antigen expression, and (2) biliary epithelial cells are not identical with regard to the phenotypic expression of their structural carbohydrates. In future, it will be possible to classify biliary epithelial cells by their blood group antigen expression. PMID- 3279108 TI - Low C3 in cirrhotic ascites predisposes to spontaneous bacterial peritonitis. AB - The risk of developing spontaneous bacterial peritonitis (SBP) in relation to the concentration of C3 in ascitic fluid (AF) has been studied prospectively in 33 patients with cirrhosis of the liver, seven of whom had one or more episodes of SBP during hospitalization. C3 concentrations in the AF of patients who developed infection (9.0 +/- 2.67 mg/dl) were significantly lower than in those who did not (18.26 +/- 8.11 mg/dl) (P less than 0.01). C4 concentrations were similar in both groups. A direct correlation was found between AF C3 and total protein concentrations (P less than 0.001). We conclude that a low C3 concentration in AF may predispose to SBP. PMID- 3279109 TI - Bone disease after orthotopic liver transplantation. AB - After orthotopic liver transplantation (OLT), not infrequently a deterioration of bone disease leading to compression fractures of vertebrae is seen. In a consecutive series of 36 adult OLT patients, we studied, clinically and radiologically, the incidence and degree of bone disease before and after OLT; we also studied whether clinical, radiological and laboratory findings were related to the event of postoperative vertebral collapse. Before OLT, radiological signs of mostly slight osteoporosis were seen in a minority of patients. After OLT, 38% of patients developed vertebral collapse, mainly in the second trimester. Collapse occurred in both previously normal and abnormal vertebrae. Of the preoperative parameters sex, age, menopause, intake of prednisolone, duration and diagnosis of liver disease, duration and degree of cholestasis, bone radiology and urinary calcium, only a low urinary calcium was related to postoperative collapse. Of the postoperative parameters duration of cholestasis, urinary calcium, duration of hospital stay, prednisolone dose and outcome in terms of life and death, none was related to collapse. We conclude that vertebral collapse after OLT occurs frequently and is not easily predicted. Early prevention of bone disease in patients with chronic liver disease before OLT and a low steroid containing immunosuppressive regimen after OLT are advocated. PMID- 3279110 TI - Preparation and characterization of a colloidal gold-insulin complex with binding and biological activities identical to native insulin. AB - We studied the binding and biological activities of gold-insulin complexes to develop a complex with properties identical to native insulin. Stabilizing amounts of insulin absorbed to 5-, 10-, or 15-nm gold particles resulted in complexes with 40-327 insulin molecules per gold particle and 4-111 times the biological activity of unlabeled insulin, based on the molar concentration of gold complex. These data suggested that these complexes behaved as multivalent ligands. Gold-insulin complexes were prepared with 5% of the stabilizing insulin concentration and were stabilized with bovine serum albumin. This resulted in a complex with 5-7 insulin molecules per 10-nm gold particle, which stimulated glucose oxidation in rat adipocytes and competed with [125I]-insulin for binding to the insulin receptor identically to unlabeled insulin on an equimolar basis. The organization and distribution of insulin receptors occupied by this monovalent-behaving gold-insulin complex were virtually identical to previous observations using monomeric ferritin-insulin. Since multivalent ligands may affect receptor binding, re-distribution, and intracellular processing, the use of electron-dense probes that resemble the unlabeled ligand in biological and binding properties is appropriate when studying receptor dynamics of in vivo or in vitro biological systems. The gold-insulin complex developed in this study should serve this function. PMID- 3279111 TI - Immunoperoxidase localization of GCDFP-15 with mouse monoclonal antibodies versus rabbit antiserum. AB - Five monoclonal antibodies (Mabs) raised against separate determinants on a breast gross cystic disease fluid protein of 15 KD (GCDFP-15) were compared to one another and to a rabbit antiserum (Rb) against GCDFP-15 by radioimmunoassay (RIA) and by immunoperoxidase localization in paraffin-embedded tissues. All five Mabs and the Rb were equivalent in recognition of GCDFP-15 in solution, as determined by RIA. However, two of the Mabs (A5, B15) showed only minimal binding to GCDFP-15 in paraffin-embedded tissues, whereas the other three Mabs (B1, B4, D6) were equivalent to the Rb in staining intensity. These latter three Mabs and the Rb were evaluated by the immunoperoxidase technique on a variety of benign and malignant neoplasms as well as normal tissues (150 specimens) for staining specificity. Immunoperoxidase staining by the three Mabs vs the Rb was equivalent in apocrine glands, metaplastic apocrine epithelium of breast, and breast carcinomas with apocrine features. No staining of the Mabs or Rb was seen in the other tissue specimens. PMID- 3279112 TI - Changes in distribution of extracellular matrix proteins during wound repair in corneal endothelium. AB - The distribution of fibronectin (FN) and laminin (LM) in non-injured and injured rat corneal endothelium in vivo was investigated by light microscopy using immunoperoxidase cytochemistry. In non-injured tissues, both FN and LM have distinct pericellular staining patterns and exhibit some diffuse cytoplasmic staining. After a circular freeze injury, cells migrating into the wound area at 24 hr lack the characteristic pericellular staining observed in non-injured cells but show cytoplasmic staining for both extracellular matrix glycoproteins. Endothelial cells on the periphery of such preparations do not partake in wound repair and retain their pericellular staining patterns. Forty-eight hours after injury, cells have filled in the wound area but are disorganized. They display intracellular FN and LM staining but do not demonstrate any pericellular staining. When observed 10 days after injury, a uniform monolayer has formed but neither FN nor LM is detected pericellularly. By 14 days post injury, endothelial cells in the wound area display pericellular FN patterns but not LM patterns. This may reflect differences in the function of each glycoprotein in maintaining the attachment of the endothelium to Descemet's membrane. PMID- 3279113 TI - A pre-embedding immunolabeling technique for basal lamina and extracellular matrix molecules. AB - We have developed a pre-embedding immunolabeling technique to identify basal lamina and extracellular matrix molecules in embryos at various stages of development. The technique works for both fluorescence optical microscopy (1-2.5 micron sections) and for transmission electron microscopy, and enables straigthforward correlation between the two. An additional advantage is the easy preparation of well-oriented serial sections, facilitating detailed studies of development. PMID- 3279114 TI - Synergistic effect of colony-stimulating factors and IL-2 on prothymocyte proliferation linked to the maturation of macrophage/dendritic cells within L3T4 Lyt-2-Ia-Mac- cells. AB - Bone marrow-derived precursors colonize the thymus, where they constitute the minor L3T4-Lyt2- subset which can give rise to all thymocyte subpopulations. We show in the present paper that L3T4-Lyt2- population depleted of Ia+, Mac-1+ cells contain pluripotent hemopoietic stem cells (CFU-S) and granulocyte macrophage colony-forming cells (GM-CFC). Addition of GM-CSF to the culture medium leads to the production of adherent and nonadherent cells of the macrophage-monocyte lineage. L3T4-Lyt2- cells poorly respond to IL-2 in vitro, but the addition of either rIL-3 or rGM-CSF allows the IL-2 response of L3T4-Lyt2 cells. This response is at least partly mediated by maturation of double negative cells for L3T4 and Lyt-2 Ag into cells able to produce IL-1. PMID- 3279115 TI - Studies on the adhesive interaction between purified human eosinophils and cultured vascular endothelial cells. AB - Many recent studies have established the eosinophil as a primary effector cell in the pathology of allergic diseases. However, relatively little is known about the mechanisms by which eosinophils accumulate and are activated at local sites of tissue inflammation in allergic or other eosinophil-dependent pathologic states. Because the adherence of leukocytes to vascular endothelial cells (VEC) is a critical initial event in eosinophil infiltration, we have studied the interaction of purified human eosinophils with cultured human umbilical vein endothelial cells. Treatment of VEC with stimuli known to activate endothelial cells, including purified human IL-1, rTNF-alpha, bacterial endotoxin LPS, and the tumor-promoting phorbol diester 12-O-tetradecanoylphorbol-13-acetate resulted in time- and dose-dependent increases (from two- to fourfold) in adhesiveness for eosinophils. Adherence induced by optimal concentrations of IL-1 (2 U/ml), TNF (1 micrograms/ml), and LPS (1 microgram/ml) is dependent upon the CD18 leukocyte cell surface adherence glycoproteins, because a mAb (60.3) directed against the common beta-subunit of the complex inhibits adherence induced by these stimuli. Several agents directly activated eosinophils to display increased adhesiveness to both VEC and gelatinized plates. The bacterial chemotactic peptide formyl methionyl-leucyl-phenylalanine (10(-8) to 10(-6) M), TNF (1 to 1000 ng/ml), and 12-O-tetradecanoyl-phorbol-13-acetate (0.3 to 3 ng/ml) all increased eosinophil binding to VEC by two to fivefold. Platelet-activating factor (PAF; 10(-8) to 10( 6) M), but not lyso-PAF, caused approximately a twofold increase in eosinophil binding to both VEC and gelatinized tissue culture plates, suggesting that activation of eosinophils may be responsible for the known ability of PAF to induce eosinophilic responses. These results suggest that the initiation of an eosinophilic infiltrate in vivo can result from activation of endothelial cells, activation of eosinophils, or activation of both cell types. PMID- 3279116 TI - Separation and comparison of two monokines with lymphocyte-activating factor activity: IL-1 beta and hybridoma growth factor (HGF). Identification of leukocyte-derived HGF as IL-6. AB - Supernatants of mitogen-stimulated human leukocytes contain two biologically related cytokines, IL-1 and hybridoma growth factor (HGF). IL-1 beta is a potent inducer of HGF in fibroblasts but has little stimulating effect on monocytes that spontaneously produce HGF. Leukocyte-derived HGF and IL-1 were separated by the use of affinity chromatography on specific antibodies and discriminating assay systems for both cytokines. They had different Mr upon gel filtration and SDS PAGE. In contrast to IL-1 beta, HGF showed heterogeneity on a cation-exchange column. IL-1 beta and HGF were purified to homogeneity by a sequence of four and five purification steps, respectively. Leukocyte-derived HGF was characterized by analysis of its NH2-terminal amino acid sequence. This revealed complete homology with fibroblast-derived HGF, 26-kDa protein, IFN-beta 2, and B cell stimulatory factor 2, molecules which have collectively been designated as IL-6. IL-1 beta exerted an antiviral and growth-promoting effect of fibroblasts, whereas HGF/IL-6 did not. Both IL-1 and IL-6 possessed lymphocyte-activating factor activity, which could be neutralized only by an anti-serum against the corresponding cytokine. PMID- 3279117 TI - Modulation of phenotypic and functional properties of human peripheral blood monocytes by IL-4. AB - Highly purified peripheral blood monocytes were cultured in the presence of rIL 4. Major changes in the morphology of the monocytes were observed. After day 5 of culturing the cells acquired a macrophage-like appearance, with increased cell size and extensive processes, suggesting that IL-4 may induce monocyte-macrophage differentiation. This notion is supported by the observed increased expression of MHC class II Ag, which is thought to be associated with monocyte differentiation. Exposure of monocytes to IL-4 resulted in a dose-dependent increase of the expression of MHC class II Ag, which became apparent after only 20 h of incubation. Maximal expression was obtained after incubation for 6 days, and persisted throughout the whole culture period. Similarly, IL-4 increased the expression of R for C3bi and p150.95 Ag, two members of the leukocyte function associated Ag 1 family, whereas the expression of the third member, leukocyte function-associated Ag 1, remained unchanged during culture. Furthermore, it was shown that IL-4 inhibited the secretion of cytostatic and chemotactic compounds. Supernatants of monocytes cultured with IL-4 were, in contrast to control cultures, much less effective in inhibiting the growth of A375 melanoma cells. In addition, these supernatants failed to direct the migration of freshly isolated monocytes in a chemotaxis assay. Further analysis revealed that these supernatants exhibited reduced IL-1 activity, as measured in a mouse thymocyte proliferation assay, which might explain the low cytostatic and chemotactic activity. Taken together these results show that IL-4 modulates monocyte phenotype and function and may induce monocyte-macrophage differentiation in vitro. PMID- 3279118 TI - Antiviral action of tumor necrosis factor in human fibroblasts is not mediated by B cell stimulatory factor 2/IFN-beta 2, and is inhibited by specific antibodies to IFN-beta. AB - A protein termed IFN-beta 2, originally described on the basis of antiviral activity and antigenic cross-reactivity with the classical IFN-beta, is now known to be identical with the independently isolated B cell stimulatory factor (BSF 2). Earlier it was suggested that IFN-beta 2 (i.e., BSF-2) mediates the antiviral action of TNF in human fibroblasts. We examined Escherichia coli-derived recombinant preparations of human IFN-beta and BSF-2 for antiviral activity and plasmacytoma growth factor (PCT-GF) activity. IFN-beta had antiviral activity but showed no PCT-GF activity. BSF-2 showed potent PCT-GF activity but lacked antiviral activity. Antiviral activity of IFN-beta was neutralized by polyclonal antibodies and mAb to IFN-beta, but not by antibody to rBSF-2. PCT-GF activity of BSF-2 was neutralized by antibody to rBSF-2, but not by antibodies neutralizing the antiviral action of IFN-beta. Five mAb and a polyclonal antibody to human IFN beta failed to react with BSF-2 in a solid phase RIA and antibody to BSF-2 did not react with IFN-beta. PCT-GF activity in supernatants of human FS-4 fibroblasts stimulated with TNF, IL-1 or poly(I).poly(C) was neutralized by antibody to rBSF-2, but not by antibodies neutralizing the antiviral activity of IFN-beta. Finally, the antiviral activity of TNF in FS-4 cultures was neutralized by antibodies to IFN-beta but not by antibodies to BSF-2. Taken together, these results support the view that the antiviral action of TNF in human fibroblasts is mediated by IFN-beta, and not by BSF-2/IFN-beta 2 that apparently lacks significant antiviral activity. PMID- 3279119 TI - A 34-amino acid peptide of the third component of complement mediates properdin binding. AB - In this study, a peptide of 34 amino acids from the Mr 40,000 C terminus alpha chain fragment of C3 was found to mediate properdin (P) binding. Treatment of the Mr 40,000 fragment with CNBr generated one major Mr 17,000 fragment that was capable of binding P. Amino acid sequence data placed the Mr 17,000 fragment within residues 1385 to 1540 of the C3 sequence. After analyzing this sequence for highly conserved segments within the C3 from other species (which bind P) and segments of low similarity within human C4, mouse C5, and alpha 2-macroglobulin (which do not bind P), a 34-amino acid (1402 to 1435) peptide was synthesized. This synthetic peptide bound to P and inhibited its binding to C3b. In addition, it exhibited negative regulatory activity on the alternative pathway as it inhibited the lysis of rabbit erythrocytes by normal human serum. These results show that the P-binding site is located within the residues 1402 to 1435 of the C3 sequence. PMID- 3279120 TI - Induction of activated macrophages in C3H/HeJ mice by avirulent Salmonella. AB - A single injection of viable Salmonella typhimurium SL3235, an avirulent organism blocked in the aromatic pathway, induced the generation of activated peritoneal macrophages in three different C3H mouse strains, including macrophage-defective C3H/HeJ mice. Macrophages obtained from immunized mice were cytotoxic for B16 melanoma cells, P815 mastocytoma cells, and TU-5 fibrosarcoma cells and microbicidal in vitro for the obligate, intracellular, protozoan parasite Leishmania major. The capacity of live SL3235 to activate C3H/HeJ macrophages contrasts with the failure of live Bacillus Calmette-Guerin to induce activated macrophages in this mouse strain. Although viable SL3235 were capable of fully activating cells of both normal and defective mice, a dose-dependent difference was observed in the number of organisms necessary for induction of tumoricidal macrophages in C3HeB/FeJ (normal) and C3H/HeJ (defective) animals. As few as 80 viable SL3235 were capable of activating C3HeB/FeJ macrophages whereas 5 X 10(4) organisms were required to activate C3H/HeJ macrophages. Maximal macrophage activation occurred 7 to 10 days after SL3235 inoculation in C3H/HeJ and C3HeB/FeJ mice. Acetone-killed cells of SL3235 had some but not all of the activity of the living Salmonella. A single in vivo injection of the nonviable preparation resulted in the induction of tumoricidal macrophages in C3HeB/FeJ but not in C3H/HeJ mice, even when tested over a wide dosage range. Injection of acetone-killed cells of SL3235 did, however, result in a population of primed macrophages in C3H/HeJ mice, as explanted cells could be induced to express activated macrophage effector activities after additional treatment in vitro with either LPS or IFN-gamma. Thus, in vivo administration of viable SL3235 is, by itself, capable of eliciting the full series of steps required for activation of C3H/HeJ macrophages, whereas killed SL3235 only provides signals sufficient to prime these defective macrophages for further activation in vitro. AI 15613 PMID- 3279121 TI - Parasite polymorphism present within minimal T cell epitopes of Plasmodium falciparum circumsporozoite protein. AB - Identification of T cell antigenic sites is critical for antisporozoite malarial vaccine design. Here, we present data that define two minimal functional T cell sites present in an immunogenic domain of the circumsporozoite protein of Plasmodium falciparum. These two sites overlap one another and correlate with polymorphic regions of the molecule. This suggests that these polymorphisms may be a result of pressure from immune T cells. PMID- 3279122 TI - T cells, T sites, and malaria immunity--further optimism for vaccine development. PMID- 3279123 TI - Evidence that leukocyte function-associated antigen-1 is involved in recirculation and homing of human lymphocytes via high endothelial venules. AB - We report the results of mAb inhibition studies of human lymphocyte-high endothelial venule interaction in vitro. These studies in which T cells from both normal donors and from a LFA-1-deficient patient were used indicate that in addition to a system of organ-specific 90-kDa "homing" receptors on lymphocytes, LFA-1 is also involved in lymphocyte recirculation and homing. PMID- 3279124 TI - Endothelial activation during interleukin 2 immunotherapy. A possible mechanism for the vascular leak syndrome. AB - A major sequela of immunotherapy with interleukin 2 (IL-2) is development of a vascular leak syndrome. The pathogenesis of this toxic effect is not known. We have examined pre- and post-treatment skin biopsies from 14 patients undergoing systemic administration of IL-2 for evidence of endothelial cell activation. Specifically, we have used the immunoperoxidase technique to detect the expression of three different activation antigens: endothelial-leukocyte adhesion molecule 1, detected with monoclonal antibody H4/18; intercellular adhesion molecule 1, detected with antibody RR1/1; and histocompatibility leukocyte antigen-DQ, detected with antibody Leu 10. Each of these antigens may be induced on cultured endothelial cells by various cytokines (although not by IL-2) and is expressed during endothelial cell activation in vivo at sites of delayed hypersensitivity and other immune responses. Pretreatment biopsies from each patient showed no endothelial expression of endothelial-leukocyte adhesion molecule 1 and only weak to moderate expression of intercellular adhesion molecule 1 and histocompatibility leukocyte antigen-DQ (except for one specimen unreactive with Leu 10). After 5 days of treatment, every patient showed marked endothelial expression of all three antigens (except for the same patient who remained unreactive with Leu 10). Endothelial-leukocyte adhesion molecule-1 expression was confined to postcapillary venular endothelium whereas intercellular adhesion molecule-1 and Leu 10 also were expressed on stromal cells and mononuclear cells. Thus, we conclude that i.v. administration of IL-2 leads to endothelial cell activation. Because IL-2 fails to induce the same antigens on cultured endothelial cells, we infer that IL-2 acts in vivo by inducing the production of other cytokines (e.g., interleukin 1, tumor necrosis factor, lymphotoxin, and interferon-gamma). Finally, since endothelial cell activation at sites of cell-mediated immune responses is well known to result in vascular leakiness to macromolecules, we propose that the vascular leak syndrome accompanying IL-2 therapy may arise from widespread inappropriate endothelial cell activation. PMID- 3279125 TI - Response of resident murine peritoneal macrophages to in vivo administration of granulocyte-macrophage colony-stimulating factor. AB - The effect of s.c. inoculation of purified recombinant derived granulocyte macrophage (GM)-CSF on resident murine peritoneal macrophages was assessed in this study. From 18 to 24 h after s.c. administration of GM-CSF to normal mice, the resident peritoneal macrophages were harvested and the levels of membrane bound IL-1, FcR, Mac-1 cell-surface Ag, and class II MHC expression were assessed. Peritoneal cells from GM-CSF-inoculated mice had significantly greater levels of membrane-bound IL-1 than did control mice. In addition when resident peritoneal macrophages from normal mice were purified by adherence and grown in the presence of GM-CSF, they produced greater levels of both membrane-bound and secreted IL-1. The peritoneal cells from GM-CSF-inoculated mice did not differ from controls in the expression of class II MHC-encoded Ag. This observation was confirmed by the finding that GM-CSF was unable to induce class II MHC expression on P388D1 cells, whereas a secondary mixed leukocyte culture supernatant was. Peritoneal cells from GM-CSF-inoculated mice also exhibited greater levels of expression of FcR and the Mac-1 cell-surface Ag. This resulted in an increase in their ability to phagocytose opsonized SRBC in vitro. PMID- 3279126 TI - Nutritionally variant streptococcal serotype I antigen. Characterization as a lipid-substituted poly(ribitol phosphate). AB - Initial characterization of the nutritionally variant streptococcal serotype I amphipathic polymer indicated an estimated m.w. of 360,000 for the aggregated form of the molecule, whereas the dissociated form had an estimated m.w. of 38,000 based on dextran m.w. standards. In addition, SDS-PAGE indicated an amphiphile with a stepladder appearance made up of several components with m.w. larger than the major electrophoresis components of LPS or lipoteichoic acid. Chemically, the serotype I amphiphile appeared to be a lipid-substituted poly(ribitol phosphate) with galactose and alanine substitution on the ribitol phosphate backbone. This report represents the first characterization of a bacterial amphiphile with a chemical composition and structure as proposed here. As is the case with other bacterial amphiphiles, the nutritionally variant streptococcal serotype I amphiphile was found both intra- and extracellularly. Finally, immunofluorescence studies demonstrated that the amphiphile was expressed on the cell surface. PMID- 3279127 TI - Target cell directed NK inactivation. Concomitant loss of NK and antibody dependent cellular cytotoxicity activities. AB - We investigated the inactivation of human NK cells, a population of large granular lymphocytes (LGL), with K562, an NK-sensitive target cell (TC) and KLCL, an NK-resistant TC, but which can be lysed by NK cells via antibody (Ab) dependent cellular cytotoxicity. NK-enriched effector cells (ECc) were first treated with either K562 or Ab-coated KLCL (Ab-KLCL). After incubation, ECc were separated from their TC then examined for residual NK and ADCC activities, phenotypic changes, and changes in LGL morphology. K562-treated ECc and Ab-KLCL treated ECc, when retested against the inactivating TC, respectively, lost greater than 90% of their lytic activities. However, K562-treated ECc lost 60 to 70% of their activity against Ab-KLCL, whereas Ab-KLCL-treated ECc lost less than 10% of their activity against K562. In contrast to what we observed with K562 treated ECc, we detected significant reductions in plasma membrane expression of Leu-11a and Leu-11b on Ab-KLCL-treated ECc. Although the proportion of OKM1+ cells remained unchanged after the inactivation process, the density of OKM1 on both K562-treated ECc and Ab-KLCL-treated ECc increased significantly. Morphologic analysis revealed no apparent differences in the percentages of LGL before and after treatment with K562 or Ab-KLCL. Finally, IL-2 restored lytic potential to both K562-treated ECc and Ab-KLCL-treated ECc and, in addition, IL-2 induced enhancement of Ab-KLCL-treated ECc was accompanied by a partial reexpression of Leu-11a. These data support the hypothesis that NK-cell-mediated cytotoxicity and antibody-dependent cellular cytotoxicity may result from a common lytic mechanism, although the initiation steps and regulation of the pathway are distinct. PMID- 3279128 TI - Modification and application of a simple, surface hydrophobicity detection method to immune cells. AB - A simple method to assess fungal cell surface hydrophobicity involves enumeration of cell-attached, polystyrene latex microspheres. Modifications and conditions of this method for application to immune cell populations were investigated. The media used for suspending cells and microspheres appeared to influence microsphere attachment. Several tissue culture media supported high levels of microsphere attachment, but serum inhibited attachment. The concentration of microspheres also influenced the apparent level of detectable cell surface hydrophobicity. Under conditions which allow different levels of apparent cell surface hydrophobicity to be discriminated, the assay revealed that surface hydrophobicity of YAC-1 cells, which are used as standard targets in murine natural killer cell assays, varied depending on the time of harvest during growth and that phagocytic populations differed in cell surface hydrophobicity. Trypsinization experiments indicated that one hydrophobic constituent of the cell surface includes protein. These results indicate that the microsphere assay is a useful method for assessing cell surface hydrophobicity. The possibility that the assay could be used to determine quantitatively the surface free energies of immune cells and cell targets is discussed. PMID- 3279129 TI - A new microsphere-based immunofluorescence assay for antibodies to membrane associated antigens. AB - The screening of panels of hybridoma supernatants for specific secreted monoclonal antibodies is often achieved by cellular immunofluorescent staining and flow cytometric analysis. In some circumstances such assays are difficult because the required antigen-bearing cell population is not suitable for use in flow cytometry, has limited cell cycle expression or poor in vitro growth. A method is presented here that provides a solution to these difficulties. A system was developed, using polyacrylamide microspheres coupled with cell membranes, which permitted the production of an easily stored, standardised antigen source which could be used in subsequent flow cytometric assays. Studies comparing the binding of antibodies to whole cells and cell membrane-coupled microspheres indicate a strong qualitative and quantitative correlation in the expression of surface antigens. It is shown here that membrane antigens can be stored coupled to microspheres for months and still retain good reactivity with the appropriate antibodies. This same technique could be used in studies of antigens other than those of the mammalian cell membrane - for example, membrane antigens of sub cellular organelles such as the mitochondrion and endoplasmic reticulum, plant or bacterial membrane antigens, or antigens not associated with membranes such as viral proteins. PMID- 3279130 TI - Electrotransfer of proteins following polyacrylamide gel electrophoresis. Nitrocellulose versus nylon membranes. AB - We found that some plasma proteins such as haptoglobin (Mr 200,000) and alpha 1 acid glycoprotein (Mr 40,000) do not bind at all to nitrocellulose membranes in classical transfer conditions. In contrast, these proteins can be clearly identified when a charged nylon membrane is disposed on the anodal side of the nitrocellulose membrane. Several factors which are important in modifying the adherence between proteins and the blotting membrane have been studied. They are not directly related to the molecular weight of the protein considered but also include the presence of organic solvents in the buffer systems, the pore size of the membrane and the degree of reduction and/or glycosylation of the protein. The eventuality of decreased or absent identification of some antigens on nitrocellulose membranes stresses the importance of controls using nylon membranes. PMID- 3279131 TI - Enzyme-labeled type III bacterial Fc receptors. A versatile tracer for immunoassay. AB - The type III bacterial Fc receptor isolated form a group C streptococcus has been conjugated to alkaline phosphatase and used as a tracer in a variety of direct and indirect immunoassays. These immunoassays have utilized specific antibodies prepared in species whose immunoglobulins are poorly reactive with the type I Fc receptor, staphylococcal protein A. The value of the type III Fc receptor as a tracer for immunoassays utilizing antibodies produced in sheep and goats is documented. PMID- 3279132 TI - Chondroitin-6-sulfate-containing proteoglycan: a new component of human skin dermoepidermal junction. AB - A murine monoclonal antibody (3B3) has been produced with specificity for chondroitin-6-sulfate (C-6-S) and proven binding to rodent basement membranes, presumably detecting a population of C-6-S-containing proteoglycans. Utilizing this antibody, we sought to determine whether a basement membrane chondroitin sulfate proteoglycan is present in adult, neonatal, and/or fetal skin, and if present, its ultrastructural localization. Indirect immunofluorescence was performed on human adult, neonatal, and fetal skin. To detect the antigen, specimens were pretreated with chondroitinase ABC; absence of enzyme treatment served as negative control. Chondroitin sulfate proteoglycan was detectable in linear homogeneous array along the dermoepidermal junction and within vascular (and when present, adnexal) basement membranes in both adult and neonatal skin. In fetal skin, basement membrane staining was noted as early as 54 gestational days. Indirect immunoelectron microscopy and NaCl-split skin studies were performed to ultrastructurally localize the antigen; immune deposits were detectable within the lamina densa in chondroitinase-treated skin. These findings demonstrate that chondroitin sulfate proteoglycan is present within all skin basement membranes; that it is present in the region of the lamina densa; and that similar to some other ubiquitous basement membrane antigens, it is present early in the developing fetus. PMID- 3279133 TI - Epidermal interleukin-1 is increased in cutaneous T-cell lymphoma. AB - Interleukin-1 (IL-1) is a monocyte-derived polypeptide with immunoregulatory and proinflammatory functions. Although monocytes are the principle source of IL-1, other cells, such as keratinocytes, endothelial cells, renal mesangial cells, and neutrophils, produce a factor with IL-1 activity. The IL-1-like polypeptide produced by keratinocytes, epidermal-derived thymocyte-activating factor (ETAF), is similar on biological, biochemical, and molecular levels to monocyte-derived IL-1. Studies of IL-1 or ETAF have for the most part been undertaken using cell culture supernatants or cell lysates, and in situ localization of ETAF has not been demonstrated. Previous studies have suggested that ETAF is involved in the pathogenesis of cutaneous T-cell lymphoma (CTCL). To gain insights into the role of these cytokines in disease states, we investigated whether IL-1 could be localized in tissue sections using a direct immunofluorescence technique with a monoclonal antibody directed against IL-1. This monoclonal antibody partially inhibited ETAF activity and totally inhibited IL-1 activity in the co-stimulator assay and so could be used to detect IL-1 or ETAF. We studied skin biopsies from 10 healthy individuals, 10 patients with CTCL, and 11 patients with various inflammatory dermatoses. Intense epidermal fluorescence was demonstrated in all cases of CTCL, whereas minimal reactivity was visible in normal biopsies and the inflammatory dermatoses. Most patients with CTCL showed an intercellular pattern, while none of the normal controls or those with inflammatory dermatoses showed this pattern. An irrelevant IgM monoclonal antibody, used as a negative control, did not demonstrate epidermal staining. To further demonstrate specificity, we incubated the anti-IL-1 antibody with recombinant beta IL-1:Epidermal reactivity was completely blocked. In a separate experiment, COLO 16 cells, a squamous cell carcinoma cell line that constitutively produces ETAF, stained positively for the IL-1 antibody. We conclude that epidermal IL-1 is elevated in CTCL. PMID- 3279134 TI - Quantitation of surface antigens on cultured murine epidermal Langerhans cells: rapid and selective increase in the level of surface MHC products. AB - It was recently discovered that murine epidermal Langerhans cells (LC) changed significantly in function and phenotype when maintained in culture. Notably, accessory cell function for primary immune responses increased while cytologic markers like ATPase, nonspecific esterase, and Birbeck granules were lost. To further analyze LC differentiation, we used flow cytometry and a panel of 22 monoclonal antibodies to quantitate changes in surface antigens at the single cell level. A striking change was a fivefold increase in the amount of Ia antigens (which are expressed on class II MHC products) during the first day of culture. The increase was evident within 3 h and reached a plateau at 15-24 h. Both I-A and I-E products behaved similarly. The increase in Ia was blocked by 1 microgram/ml cycloheximide. Expression of other surface antigens was then monitored on Ia+ LC by two-color flow cytometry. Low levels of class I (H-2D and H-2K) MHC products were detected on freshly isolated LC, and these antigens also increased severalfold during the first day of culture. Fc receptors (identified with the 2.4G2 mAb) and the F4/80 macrophage antigen decreased, as reported previously. Three antigens that were detected in fresh suspensions were expressed at constant levels in culture. These were the C3bi receptor and the pan leukocyte and interdigitating cell antigens. Several leukocyte antigens that were not found initially on LCs did not appear, including B220 anti-B cell, 33D1 anti-dendritic cell, and CD4, CD5, CD8 T-cell specificities. We conclude that the surface of cultured LCs undergoes selective changes in culture. As a result, the cells are rich in Ia and H-2 and have detectable C3bi receptors, but have little or no LFA 1, Ti, CD4, 5, and 8, 33D1, 2.4G2, F4/80, and B220 antigens. PMID- 3279135 TI - Cryptococcal meningitis in patients with AIDS. AB - The Cryptococcus has become a major cause of meningitis in patients infected with the human immunodeficiency virus (HIV), and the expression of cryptococcal infection in this population of patients is quite unique. Often the infection is devoid of inflammatory response and is associated with very high antigen and fungal titers. Response to amphotericin therapy is erratic, and relapse is common. We have asked Dr. William E. Dismukes, principal investigator of the NIAID Mycoses Study Group, to discuss the following clinical questions: When and how does cryptococcal infection in HIV-infected patients present? How does it differ in HIV-infected and non-HIV-infected individuals? How is the diagnosis established? What is the sensitivity of the CSF cryptococcal antigen test? Is the serum antigen test of any value? What is the best way to treat patients--the recommended drugs, dosages, and duration of therapy? Is maintenance therapy necessary, and finally, what drugs are available for it? [Please note that an AIDS training program is now available for members of the Infectious Diseases Society of America and that details of this program appear in the Notices section of this Journal issue (pages 859-60).] PMID- 3279136 TI - Effect of ethanol on functions required for the delivery of neutrophils to sites of inflammation. AB - Acute ethanol intoxication inhibits neutrophil delivery to sites of inflammation and, concomitantly, reduces the adhesion of neutrophils to surfaces. The effect of ethanol on several other neutrophil functions required for normal delivery are examined herein. Serum-free neutrophil suspensions showed normal resting adherence to endothelial monolayers in ethanol concentrations up to 1000 mg/dL, but when neutrophils were stimulated by 10(-6)M N-formyl-L-methionyl-L-leucyl-L phenylalanine (fMLP) to induce hyperadherence, ethanol induced a dose-dependent inhibition that was significant at concentrations greater than or equal to 500 mg/dL. Pretreating the endothelium with ethanol had no effect. Similarly, resting surface expression of the adhesive glycoprotein Mac-1 was unaffected by ethanol, but its up-regulation induced by fMLP was inhibited by 25.5% at 250 mg of ethanol/dL and by 52.3% at 1000 mg/dL. Release of both primary and secondary granule contents after activation showed dose-dependent inhibition, whereas resting granule content and spontaneous release were unaffected. Passive neutrophil deformability was significantly enhanced in 500 mg of ethanol/dL. Thus, ethanol affects several neutrophil delivery functions normally activated by inflammatory stimuli. PMID- 3279137 TI - Analysis of C3 deposition and degradation on bacterial surfaces after opsonization. AB - C3b and iC3b, opsonic fragments of C3, interact with specific receptors on phagocytic cells. After bacterial opsonization, C3 fragments were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, western blotting, and immunodetection. For bacteria opsonized in 50% pooled human serum (PHS), C3 deposition and cleavage to iC3b occurred rapidly. C3b, iC3b, and C3d made up 17%, 64%, and 19%, respectively, of the C3 on Staphylococcus aureus and 53%, 44%, and 2% respectively, on Escherichia coli. Residual C3b was refractory to factor I cleavage, an occurrence enabling alternative pathway activation to continue. C3 deposited was quantitated by enzyme-linked immunosorbent assay; with 50% PHS, greater than 50% and 90% of total C3 deposition occurred within 5 and 10 min, respectively. With a lower percentage of PHS, maximal deposition required up to 60 min and was not achieved in less than 10% PHS. Ester-bound fragments represented 34% and 82% of covalently bound C3 on S. aureus and E. coli, respectively. PMID- 3279138 TI - Isolation and characterization of a capsular polysaccharide adhesin from Staphylococcus epidermidis. AB - We isolated a polysaccharide adhesin from Staphylococcus epidermidis strain RP 62A. The adhesin was composed of a complex mix of monosaccharides (with galactose and glucosamine predominating), bound well to silastic catheter tubing, inhibited adherence of strain RP-62A to catheters, and elicited antibodies that both blocked adherence and stabilized an extracellular structure (visualized by transmission electron microscopy) that appeared to be a capsule. Two of three heterologous, highly adherent strains of coagulase-negative staphylococci also produced this adhesin, and their adherence to catheters was inhibited by both purified adhesin and antibody to adhesin. In contrast, the adherence of one highly adherent and two poorly adherent heterologous strains was unaffected by the RP-62A purified adhesin or antibody, a result suggesting the expression of alternate adhesins by these strains. We conclude that the capsular polysaccharide of some strains of coagulase-negative staphylococci is an important factor in adherence to catheter tubing. PMID- 3279139 TI - Phenotypic selection of small-colony variant forms of Staphylococcus epidermidis in the rat model of endocarditis. AB - Four pathogenic strains of Staphylococcus epidermidis (sensu strictu)-EC, RP62A, LW, and HBSN--exhibited a mixed population of colony phenotypes when plated onto a high-salt, low-glucose agar ("Memphis agar"). When compared with challenge inocula, significant shifts in colony populations to the small-colony variant forms occurred for all four strains for isolates recovered from infected vegetations of rats with catheter-induced endocarditis. Various colony phenotypes of the HBSN strain were compared in virulence studies by using the rat model of endocarditis. The infectivity rate of the small-colony variant forms was significantly less than that of either the normal parent form (P less than .05) or the mixed phenotypic inoculum (P less than .05). These data indicate that the small-colony variant forms may be selected for, once endocardial infections are established, and that the small-colony variant forms alone are much less able to initiate and/or sustain intracardiac infections in experimental endocarditis. PMID- 3279140 TI - Comparison of immunoblotting and indirect enzyme-linked immunosorbent assay using different antigen preparations for diagnosing early Lyme disease. AB - We compared immunoblotting and indirect enzyme-linked immunosorbent assay (ELISA) using different antigen preparations to test for antibody to Borrelia burgdorferi in patients with early Lyme disease. With immunoblotting, 16 (53%) of 30 patients had positive tests in acute-phase sera and 25 (83%) had them in convalescent phase sera. Among 64 controls, false-positive results were obtained in only three individuals with syphilis and in one hospitalized patient with renal allograft rejection. Among the patients with Lyme disease, both IgM and IgG antibodies most commonly bound to the 41-kilodalton (kDa) flagellar antigen, but many patients had binding to other components, particularly those of 25, 55, 58, or 66 kDa, and the order of their appearance was variable. Compared with indirect ELISA (using sonicated whole spirochetes or a flagellin-enriched fraction as the antigen preparation), more patients with Lyme disease had positive tests by immunoblotting, and fewer control subjects had false-positive results. Our results indicate that immunoblotting is superior to indirect ELISA for diagnosing early Lyme disease. PMID- 3279141 TI - Splenomegaly in asymptomatic hepatitis B surface antigen carriers. PMID- 3279144 TI - Plasma cell granuloma of the larynx (case report and review of the literature). AB - A case is reported of Plasma Cell Granuloma of the larynx treated successfully with steroids and antibiotics. PMID- 3279143 TI - Budesonide nasal spray as prophylactic treatment after polypectomy (a double blind clinical trial). AB - This double-blind parallel-group study compared the effect of budesonide with placebo, in the prophylaxis of nasal polyp recurrence after evulsion. Seventy three patients with first time or recurrent polypectomy were enrolled. At revisits 3 and 6 months after evulsion, the budesonide-treated patients had significantly lower polyp scores than the placebo-treated patients. Only patients with recurrent nasal polyposis benefited from the budesonide treatment, whereas no effect was evident in patients with first time evulsion. PMID- 3279142 TI - Clinical evaluation of hyperthermia equipment: the University of Arizona Institutional Report for the NCI Hyperthermia Equipment Evaluation Contract. AB - Two-hundred and fifteen independent sites in 203 patients were treated with hyperthermia at the University of Arizona from 10/81 through 3/86 under the auspices of this contract. In the head and neck, a site dominated by superficial tumors, air-coupled and water-coupled microwave applicators yielded the best results. Similarly in the thorax, also dominated by superficial tumors, water coupled microwave applicators were best. In the abdomen and pelvis, sites dominated by deep tumors, only interstitial radiofrequency (RF) heating, an invasive technique useful only in selected cases, was capable of consistently producing therapeutic temperatures. Toxicity appeared to be site-related, and treatment discomfort was especially common in abdominal and pelvic sites. In conclusion, while superficial sites were readily heated using propagative electromagnetic devices, these devices were ineffective and poorly tolerated at deeper sites. Effective deep hyperthermia was best produced with interstitial techniques, and further development of these techniques using RF electrodes, implantable microwave antennas and thermoregulating ferromagnetic seeds, as well as scanned, focussed-ultrasound techniques, holds promise for effective heating of deep visceral sites. PMID- 3279146 TI - [The use of clinical assessment in the diagnosis of deep venous thrombosis. Practical application of Bayes theorem]. PMID- 3279145 TI - Long-term presence of a denture fragment in the airway (a report of two cases). AB - Two cases are reported in which a denture fragment was lodged in the bronchus for a period of six years. Bronchial asthma which did not worsen immediately after inhalation and other misleading factors made the diagnosis more difficult in the first case, whilst the respiratory symptoms in the second case appeared only 4 years after inhalation. Haemoptysis 2 years later led to a bronchoscopy and the removal of the foreign body. PMID- 3279147 TI - [Doppler ultrasonic evaluation of the embolism-causing potential of carotid artery plaques. Apropos of 113 macroscopic findings]. AB - Comparison was made between precise descriptions of gross pathology of 113 carotid artery atheromatous plaques (69 symptomatic, 44 asymptomatic) operated upon by thromboendarterectomy and results of ultrasound-Doppler examinations, to determine possible specific ultrasound criteria for precise anatomical lesions. Echographic criteria studied were: ultrasonic structure of plaques; relation of plaque to wall; existence or absence of a solution of continuity; regular or irregular nature of endoluminal border of plaque; and finally the notion of discordance between degree of stenosis as shown by Doppler (D) and ultrasound (E) imaging (E much less than D). Principal results were as follows. Images of the regular, homogeneous highly echogenic plaques (36 cases) corresponded in 69.4% of cases to simple fibrous or calcified plaques with regular endoluminal borders. Irregular heterogeneous plaques (31 cases) were suggestive of irregular, friable and/or ulcerated material in 64.4% of cases. Weakly echogenic plaques (9 cases) suggested mainly thrombus (44.4%) or soft, friable plaques (33.3%). Plaques with solution of continuity do not correspond to a precise lesion but, in contrast, are specific (with weakly echogenic plaques) of the emboligenic character of the plaques (100%). The criterion ultrasound "Doppler was specific for thrombus in 75% of cases. In contrast, the thrombus can also demonstrate very different ultrasound images. Finally, in this study ultrasound-Doppler findings produced 3 false negatives (2.6%). Combined ultrasound-Doppler imaging allows quantitative evaluation and particularly qualitative assessment of carotid artery atheromatous lesions, with sufficiently reliable criteria to detect lesions of high emboligenic potential. PMID- 3279148 TI - [Scanner and carotid artery surgery]. AB - The utility of CT scan imaging in patients with hemispheric cerebrovascular accidents suspected of being of carotid artery origin was investigated by analysis of case reports of 57 patients treated recently. A low density image was found in 38.5% of cases, superficial and deep localizations being of equal number. A silent infarct was detected in 13.6% of the patients and a meningioma was able to be diagnosed by the scanner. CT scan imaging is indispensable for care of these patients: --dissuasive in case of cerebral tumor, severe infarction or extensive cerebral destruction; --persuasive in case of major carotid artery lesions and/or those threatening with normal scanner image. Carotid artery surgery can then protect cerebral capital; --directive in case of "watershed" infarct, of enhancement, of silent infarct or an occurring accident. In all such cases, it appears indispensable. PMID- 3279149 TI - [Ultrasonic tomography in the study of supra-aortic trunks]. AB - Real time mode B echotomography completes ultrasound exploration of supra-aortic trunks. Continuous Doppler recording is essential for detection of vessels and identification of significant lesions. However, it cannot detect arterial wall lesions that have no effect on arterial blood flow but can be at the origin of migrating emboli. The latter can be visualized by echotomography, which localizes the lesion and allows evaluation of its morphologic and anatomic characteristics. The methodology of the examination and normal anatomic findings are summarized and the different types of lesion occurring in the supra-aortic trunks described. The limitations of echotomography are discussed and a description given of a semiology of vascular ultrasonic structures of emboligenic potential. PMID- 3279150 TI - The linear system theory's account of behavior maintained by variable-ratio schedules. AB - The mathematical theory of linear systems, which has been used successfully to describe behavior maintained by variable-interval schedules, is extended to describe behavior maintained by variable-ratio schedules. The result of the analysis is a pair of equations, one of which expresses response rate on a variable-ratio schedule as a function of the mean ratio requirement (n) that the schedule arranges. The other equation expresses response rate on a variable-ratio schedule as a function of reinforcement rate. Both equations accurately describe existing data from variable-ratio schedules. The theory accounts for two additional characteristics of behavior maintained by variable-ratio schedules; namely, the appearance of strained, two-valued (i.e., zero or very rapid) responding at large ns, and the abrupt cessation of responding at a boundary n. The theory also accounts for differences between behavior on variable-interval and variable-ratio schedules, including (a) the occurrence of strained responding on variable-ratio but not on variable-interval schedules, (b) the abrupt cessation of responding on occurrence of higher response rates on variable-ratio than on variable-interval schedules. Furthermore, given data from a series of variable-interval schedules and from a series of concurrent variable-ratio variable-interval schedules, the theory permits quantitative prediction of many properties of behavior on single-alternative variable-ratio schedules. The linear system theory's combined account of behavior on variable-interval and variable ratio schedules is superior to existing versions of six other mathematical theories of variable-interval and variable-ratio responding. PMID- 3279151 TI - Rescue of Daudi cell HLA expression by transfection of the mouse beta 2 microglobulin gene. AB - The Daudi cell line is a B-lymphoblastoid line derived from a Burkitt lymphoma. Daudi cells lack cell surface expression of class I HLA molecules despite the presence of intracellular class I heavy chains. They have a defect in the gene encoding beta 2-microglobulin (beta 2m), resulting in lack of translatable mRNA for this protein. It has been thought that this deficiency is responsible for the lack of cell surface class I expression. However, data have recently been presented demonstrating that at least one mouse class I heavy chain can be expressed on the cell surface in the absence of beta 2m. These results raised the questions of whether the lack of beta 2m is the only defect in Daudi and whether transfer of this single gene could restore surface class I expression. We found that transfection of the mouse beta 2m gene into Daudi indeed rescued cell surface expression of class I HLA molecules, and that these molecules could be recognized both by monomorphic and allospecific mAbs. CTL clones specific for HLA B17 or a determinant shared by HLA-B17 and HLA-A2 killed the Daudi cells transfected with the beta 2m gene, but not untransfected Daudi or Daudi transfected with vector alone. Mouse beta 2m on the transfected Daudi cells could exchange with human beta 2m when the cells were incubated in human serum. This exchange did not alter the ability of the cells to be killed by the specific CTLs. These results demonstrate that the lack of beta 2m is the sole reason for lack of surface class I molecules in Daudi cells, and that beta 2m is required for cell surface expression of the specific class I heavy chains of Daudi. PMID- 3279152 TI - Developmentally regulated, phospholipase C-mediated release of the major surface glycoprotein of amastigotes of Trypanosoma cruzi. AB - The surface of amastigotes of Trypanosoma cruzi is covered by Ssp-4, a major stage-specific glycoprotein. Ssp-4 is anchored to the cell membrane by GPI. It can be metabolically labeled with [3H]myristic acid, and is converted into a hydrophilic form by treatment with the glycan-specific phospholipase C of T. brucei, or after lysis of the parasites in non-ionic detergents. The hydrophilic form of Ssp-4 is recognized by antibodies to the cross-reactive determinant of the variant surface glycoprotein of African trypanosomes. Ssp-4 is progressively shed during the intra- or extracellular development of amastigotes preceding their transformation into epi- and trypomastigotes. We show here that T. cruzi contains a phospholipase C and that most shed Ssp-4 is hydrophilic, does not contain myristic acid, and reacts with anti-CRD. These observations provide strong evidence that phospholipase C mediates the release of this glycosyl phosphatidylinositol-anchored protein under physiological conditions, as the parasite undergoes differentiation. PMID- 3279153 TI - Interleukin 1 beta is localized in the cytoplasmic ground substance but is largely absent from the Golgi apparatus and plasma membranes of stimulated human monocytes. AB - The subcellular location of IL-1 beta was determined using a postsectioning immunoelectron microscopic method on ultrathin frozen sections of human monocytes stimulated with LPS. This methodology permits access of antibody probes to all sectioned intracellular compartments, and their visualization at high resolution. Staining was performed with a rabbit antibody that specifically recognized amino acids 197-215 in the 33-kD IL-1 beta precursor molecule, followed by affinity purified goat anti-rabbit IgG conjugated to 10 nm colloidal gold particles. Approximately 90% of the IL-1 beta antigens were localized in the ground substance of the cytoplasm at 4 or 20 h after activation, when both intracellular and extracellular accumulation of IL-1 beta was well underway. No significant IL 1 beta staining was observed on the outer cell membrane, nor within the lumens of the endoplasmic reticulum (ER), the Golgi apparatus, or secretory vesicles. In contrast, lysozyme was localized in the ER and dense secretory granules using these methods. Our results suggest that IL-1 beta is not anchored on the plasma membrane, and that its secretion occurs by a novel mechanism that does not use a secretory leader sequence, nor the classical secretory pathway involving the ER and Golgi apparatus. PMID- 3279154 TI - Macrophages secrete a novel heparin-binding protein with inflammatory and neutrophil chemokinetic properties. AB - We report the identification and purification of a new inflammatory monokine synthesized by the macrophage tumor cell line RAW 264.7 in response to endotoxin. This monokine, which we term "macrophage inflammatory protein" (MIP), is a doublet with an apparent molecular mass of approximately 8,000 daltons on SDS PAGE but forms aggregates of greater than 2 x 10(6) daltons as assessed by gel filtration. Partial NH2-terminal amino acid sequence data reveal no significant homology with any previously described protein. Although the monokine is anionic under physiological conditions, it is one of two major macrophage-secreted proteins that bind to heparin at high salt concentrations. At 100 ng/ml or greater, MIP is chemokinetic for human polymorphonuclear cells and triggers hydrogen peroxide production. Subcutaneous injection of 10 ng or greater of MIP into footpads of C3H/HeJ mice elicits an inflammatory response, characterized by neutrophil infiltration. These findings suggest that MIP is an endogenous mediator that may play a role in the host responses that occur during endotoxemia and other inflammatory events. PMID- 3279155 TI - Detection of transforming growth factor alpha in normal, malignant, and hyperproliferative human keratinocytes. AB - Transforming growth factor alpha (TGF-alpha) is a 50-amino acid peptide, previously demonstrated only in transformed cell lines and human tumors, which is structurally homologous to epidermal growth factor (EGF). TGF-alpha expression in keratinocytes from normal individuals, patients with psoriasis, and patients with malignant skin diseases was investigated using an mAb raised against synthetic human TGF-alpha. mAb A1.5 reacted with TGF-alpha, but not EGF, in a sensitive ELISA. Keratinocytes in eight nodular basal cell carcinomas, one morpheic basal cell carcinoma, and one squamous cell carcinoma demonstrated intense membranous immunoperoxidase staining with mAb A1.5. Of even greater interest was the observation that the overlying normal epidermis, as well as the epidermis from five normal skin specimens, were stained by the mAb. Keratinocytes in plaques from 18 psoriasis patients were more intensely stained than those from normal skin. Cultured normal keratinocytes demonstrated membranous staining with mAb A1.5. Absorption of mAb A1.5 with synthetic human TGF-alpha completely removed the reactivity of mAb A1.5 with both basal cell tumors and normal epidermis. The demonstration of TGF-alpha in normal keratinocytes suggests that it plays a role in normal keratinocyte growth, wound healing, and in the pathogenesis of acanthosis. PMID- 3279157 TI - Balint work in England: lessons for American family medicine. AB - The work of Michael and Enid Balint in developing case discussion seminars for general practitioners in England has important implications for the teaching of family medicine in the United States. Focusing on the physician-patient relationship, their seminars evolved from an emphasis on a psychiatric history taken by the physician to a more pragmatic concern with the process of the everyday brief consultation. The leaders of traditional Balint groups guide group members toward open discussion of case material by modeling listening, curiosity, and tolerance for group members. Seminar goals include increasing general practitioners' sensitivity to their patients' emotional problems and expanding the practitioners' repertoire of interventions in the medical interview. With modifications, Balint-type seminars have been incorporated into some general practice and family medicine training settings both in England and in the United States. The unique features of Balint seminars within the context of medical education are their nondidactic, participatory nature, their goals of an emotional change within the physician, and their focus on the physician-patient relationship. PMID- 3279156 TI - Granulocyte/macrophage colony-stimulating factor and interleukin 1 mediate the maturation of murine epidermal Langerhans cells into potent immunostimulatory dendritic cells. AB - Freshly isolated, murine epidermal Langerhans cells (LC) are weak accessory cells for primary T cell-dependent immune responses, but increase their stimulatory capacity at least 20-fold progressively over a 3-d culture with keratinocytes. We have studied the mediators of LC maturation. LC enriched from 12-h epidermal cultures by negative selection do not survive when cultured for 60 h in standard medium. LC survive and show increased stimulatory capacity for oxidative mitogenesis and the primary MLR when 30% keratinocyte-conditioned medium is included. Of the three cytokines that are known to be produced by keratinocytes, only granulocyte/macrophage CSF (GM-CSF) maintains viability and increases stimulatory capacity. IL-1 alone does not keep LC alive, but further enhances the stimulatory activity when combined with GM-CSF. IL-3 has no effect. The increase in LC stimulatory capacity is not due to increased Ia antigen expression, which does not change between 12 and 60 h. Function is not simply due to improved viability, as GM-CSF does not enhance the function of 12-h LC when added to the short-term oxidative mitogenesis assay. By generating LC with strong stimulating activity for resting T cells, GM-CSF and IL-1 may be critical in the sensitization phase of T cell-mediated immunity. PMID- 3279158 TI - Erectile impotence: evaluation and management. AB - Dramatic progress in the understanding and treatment of erectile impotence has occurred over the past decade. Most cases have an organic cause that is related to vascular (arterial or venous) supply, innervation, or the hormonal milieu of the penis. Multifactorial causes of organic impotence are common and include diabetes mellitus, alcoholism, renal failure, and liver failure. Medications may cause impotence by a variety of mechanisms. The history and physical examination, along with simple laboratory tests, are the mainstay of evaluation and may be performed appropriately by family physicians. Successful new forms of nonsurgical treatment include penile self-injection with papaverine (sometimes with phentolamine) and penile-suction devices. Penile prostheses have been improved greatly in recent years. The patient may select among semirigid, multicomponent inflatable, and self-contained inflatable devices. New surgical treatments include penile arterial revascularization (for atherosclerosis) and ligation of the dorsal vein of the penis (for venous leak). PMID- 3279159 TI - Estrogen receptors in breast cancer. PMID- 3279160 TI - Occupational health in the wood pulp and paper industry: a review with implications for Florida practitioners. PMID- 3279162 TI - The increasing third-party menace. PMID- 3279161 TI - Physician participation in the Florida Medicaid System: a reassessment. PMID- 3279163 TI - [3H]imipramine binding of protein nature in human platelets: inhibition by 5 hydroxytryptamine and 5-hydroxytryptamine uptake inhibitors. AB - The nature of [3H]imipramine binding to human platelets was investigated. Desipramine and 5-hydroxytryptamine (5-HT) displaced the same amount of binding and the binding was sensitive to protease treatment. The nature of pharmacological inhibition of [3H]imipramine binding was investigated in saturation experiments. Increases in KD without changes in Bmax were noted with the addition of 5-HT, desipramine, norzimeldine, or 5-methoxytryptoline. Reductions in Bmax without alterations in KD were obtained when citalopram or clomipramine was added. It is concluded that the [3H]imipramine binding site in human platelets is of protein nature and that this binding site contains the substrate recognition site for 5-HT uptake. In addition, [3H]imipramine and other 5-HT uptake inhibitors have bonds to other parts of the 5-HT uptake carrier or to the surrounding lipid membrane. This additional binding outside the substrate recognition site is not one single site but most likely represents sites that are specific for the chemical structure of each uptake inhibitor, respectively. PMID- 3279164 TI - Localization of the novel neuropolypeptide h3 in subsets of tissues from different species. AB - Recently we reported the isolation and partial biochemical characterization of a novel polypeptide, h3, from the human brain and liver. Thin-layer isoelectric focusing showed that the polypeptide was ubiquitously distributed throughout the human brain. Immunophosphatase transfer electrophoresis showed that this protein was localized in several mammalian species and different tissues. In addition, h3 or h3-like protein was demonstrated in subsets of tissues from one avian species. Protein h3 was present in epithelial and muscular tissue, as well as in nervous tissue; however, for all species investigated, it was most abundant in CNS and muscle. PMID- 3279165 TI - A double-blind controlled trial of high dose methyl prednisolone in multiple sclerosis. PMID- 3279166 TI - Ultrastructural identification of type 1 fibres in human skeletal muscle. Immunogold labelling of thin cryosections with a monoclonal antibody against slow myosin. AB - Existing methods for the ultrastructural identification of fibre types in human skeletal muscle are fallible. This has prompted us to develop a reliable immunoelectron microscopic approach for the identification of human skeletal muscle fibre types. Here we report the unambiguous electron microscopic identification of human type 1 muscle fibres, achieved by combining cryoultramicrotomy with colloidal gold immunocytochemical labelling, using a monoclonal antibody (N0Q7.5.4D) which is specific for the heavy chain of the slow myosin isoform of human skeletal muscle. This method for the identification of muscle fibre types and determination of myosin isoform distributions may have important applications in the ultrastructural study of pathological muscle and in the analysis of myofibrillar assembly during myogenesis. PMID- 3279167 TI - Estimation of extracellular fluid volume from plasma clearance on technetium-99m DTPA by a single-injection, two-sample method. AB - A simple method is presented for estimating extracellular fluid volume from the plasma clearance of [99mTc])DTPA or [169Yb]DTPA. Two plasma samples are required, at 1 and 3 hr, following a single intravenous injection. (The same plasma samples can be used for measurement of glomerular filtration rate.) Using the complete plasma clearance curve as a reference (eight samples at 10 to 240 min), the error of the two-sample method in 40 patients was 1.5 I for [99mTc]DTPA, 2.1 I for [169Yb]DTPA (residual standard deviation). PMID- 3279168 TI - Scintigraphic demonstration of accessory hepatic duct leak following liver transplantation. AB - Few noninvasive methods are available to diagnose complications following liver transplantation. Hepatobiliary scintigraphy can differentiate rejection from primary biliary complications such as obstruction or extravasation in patients with nonspecific clinical findings such as fever and rising liver function studies. In the following case report, an unexpected biliary leak from a recipient accessory hepatic duct was demonstrated by [99mTc] DISIDA scintigraphy following liver transplantation. PMID- 3279169 TI - Early description of "bull's-eye" plot for emission cardiac tomography. PMID- 3279170 TI - Absorbed radiation dose in adults from iodine-131 and iodine-123 orthoiodohippurate and technetium-99m DTPA renography. AB - A mathematic model for evaluation of absorbed dose in radionuclide renography has been developed and programmed for automatic calculation in the computer. Input data to the model are readily available from the results of the renography and, hence, the method described is suitable for individual dose determinations in adults. Apart from the situation with very considerable outflow obstructions [131I]OIH single probe renography involves a 15-20 times smaller dose to radiation sensitive organs than [123I]OIH gamma camera renography. Further, the latter examination results in a 2-10 times smaller dose than [99mTc]DTPA gamma camera renography under normal outflow conditions. Absorbed renal dose is large, approximately 70 mGy, in the three renographies in the borderline case with total outflow obstructions. For comparison, i.v. pyelography, which is the x-ray examination often used instead of radionuclide renography, involves an absorbed dose to ovaries 10-1000 times larger than in radionuclide renography. PMID- 3279171 TI - Glass ionomer cement: 10 years of clinical use. AB - Glass ionomer cements have been commercially available for 10 years. Research has led to the production of improved formulations and the material is now advocated for use in a number of clinical situations. The aim of this review is to bring together the findings of published studies that provide information on the clinical uses and performance of this material. The opening section looks at the biocompatibility of the glass ionomer cements. Their clinical handling and techniques for use are then discussed. Finally, specific clinical uses are considered in the light of published clinical data. The glass ionomer cements appear to offer the profession many benefits and they are proving to be successful in a variety of clinical situations. Improvements in strength, abrasion resistance and colour matching will widen the scope of their application still further. PMID- 3279172 TI - The plastic cap--an improved technique for impression taking. AB - An improved impression technique is described using a plastic, transparent, flexible cap in combination with silicone impression materials. The technique can easily be applied at the chairside by the clinician and provides a solution to some of the present problems in impression with minimal trauma to the surrounding tissues. PMID- 3279173 TI - Follow-up study of patients with bridge constructions performed by private dental surgeons and at a university clinic, 8 years following insertion. AB - Patients treated in private practice and patients treated at the Department of Prosthetic Dentistry of the Faculty of Odontology in Gothenburg with fixed bridgework were questioned about their experience of their bridges. The interview was carried out with questionnaires and in some cases by telephone. The results were similar in both groups, and the patients were satisfied with the treatment. PMID- 3279174 TI - Adult respiratory distress syndrome in pediatric patients. II. Management. AB - Adult respiratory distress syndrome, a clinical syndrome of respiratory failure that follows many kinds of insults, often in patients with no previous pulmonary disease, occurs in pediatric patients. This group of disorders has a typical clinical, pathologic, and pathophysiologic course, the hallmark of which is injury to the alveolar-capillary membrane with increased permeability of the pulmonary vasculature and pulmonary edema. Resolution may occur at any stage, but most patients die and many develop chronic lung disease requiring respiratory support for weeks or months. Multiple organ system failure, secondary infection, and irreversible respiratory dysfunction are responsible for the poor outcome. The underlying mechanisms that relate injury to the development of pulmonary disease are unclear. In some cases there may be direct injury to the lung, but in others, such as septic shock, there are mediators that link the initial insult to the subsequent lung injury. The leukocyte may have a central role in this process, although this is uncertain. Therapeutic measures needed to support the patient, especially increased inspired oxygen, are additional factors in the progression of lung disease. Current therapy, as summarized in Table II, is primarily supportive. Efforts to treat ARDS after it is clinically apparent have been disappointing. The pathogenic mechanisms that lead to ARDS are probably well advanced by the time the syndrome is diagnosed on the basis of the usual clinical signs. Therefore an emphasis on understanding the mechanisms of lung injury so that specific markers can be used to predict which patients will develop ARDS, allowing intervention in the early stages of the process, may prove rewarding. PMID- 3279175 TI - Bacterial virulence and inflammatory response in infants with febrile urinary tract infection or screening bacteriuria. AB - Two populations were analyzed prospectively after a first episode of urinary tract infection. Asymptomatic infants were screened at 2 weeks and at 3 and 10 months of age, and bacteriuria was confirmed by bladder puncture. Infants with febrile urinary tract infection were enrolled during the same study period. The inflammatory response was characterized by the presence of fever, serum C reactive protein, microsedimentation rate, urinary leukocyte excretion, and width of the ureters. The bacteria were defined for O:K:H serotype, hemolysin production, resistance to the bactericidal effect of serum, attachment to uroepithelial cells, and specificity for the globoseries of glycolipid receptors. In agreement with previous studies, the frequency of increased inflammatory signs and of attaching Escherichia coli was significantly higher in infants with febrile urinary tract infection than in the screening group. Within both patient groups, however, children infected with attaching E. coli strains had significantly more inflammatory signs. The results suggest that adherence facilitates the presentation of bacterial components capable of causing inflammation in the tissues in the urinary tract. PMID- 3279176 TI - Role of autoimmunity in insulinopenia and carbohydrate derangements associated with cystic fibrosis. PMID- 3279177 TI - Ontogeny of glucose homeostasis in low birth weight infants. AB - Suppression of the endogenous glucose production rate (Ra) is the adult response to glucose infusion. Persistent Ra (greater than or equal to 1 mg.kg-1min-1 or less than 80% decrease in basal Ra) in response to glucose infusion is evidence of a transitional homeostatic state in the neonate during the first days after birth. To determine whether postnatal development produces an adultlike response, Ra was measured in 11 infants (birth weight 1716 +/- 48 g, gestational age 33 +/- 0.3 weeks) at 2 to 5 weeks of age. In these paired studies, 4 micrograms.kg-1min 1 D-(U-13C)glucose tracer was infused by prime constant infusion to determine Ra, during infusion of either saline solution or glucose, the latter at a rate of 5.3 +/- 0.2 mg.kg-1min-1 (mean +/- SEM). When the results of the saline infusion turnover period were compared with those of the glucose infusion turnover period, plasma glucose concentration increased significantly, from 88 +/- 3 mg/dL to 101 +/- 4 mg/dL (P less than 0.001). Plasma insulin concentration remained unchanged (12 +/- 5 microU/mL vs 8 +/- 3 microU/mL). Ra was heterogenous during glucose infusion, and persistent Ra was present in six of 11 infants. Of the five infants who had decreased Ra during glucose infusion, three received glucose at a rate exceeding basal Ra. Of the remaining six infants who evidenced persistent Ra during glucose infusion, three received glucose at a rate equal to or in excess of basal Ra. We conclude that glucose homeostasis in low birth weight infants is transitional throughout the neonatal period. PMID- 3279178 TI - Root curettage and gingival repair in periodontitis. AB - Twelve patients, aged 35 to 60, having adult periodontitis were treated with scaling and root planning performed with ultrasonic and hand scalers. Biopsies were taken, gingival crevicular fluid and clinical parameters were analyzed at different times, and the healing process was monitored. Findings showed a clear correlation between the amount of crevicular fluid and the histological inflammatory pattern, whereas no relationship between crevicular fluid and gingival pocket depth was apparent. In this study, no differences were found in the histological features of the repair process triggered by either type of scaler. PMID- 3279179 TI - Neutral endopeptidase and angiotensin converting enzyme inhibitors potentiate kinin-induced contraction of ferret trachea. AB - Neutral endopeptidase (NEP) (enkephalinase, EC 3.4.24.11) and angiotensin converting enzyme (ACE) are two peptidases that can cleave the C-terminal dipeptide bradykinin(8-9) from bradykinin. To determine whether these peptidases play roles in modulating kinin-induced contractions in the airways, we studied the effects of captopril, an ACE inhibitor, and of leucine-thiorphan and phosphoramidon, two NEP inhibitors, on the contractile responses to bradykinin and lysyl-bradykinin in isolated segments of ferret trachea. Bradykinin and lysyl bradykinin-induced contractions in a concentration-dependent fashion (P less than .001), with a threshold of 10(-7) M and 5 x 10(-7) M, respectively. In contrast, the bradykinin(8-9) and the N-terminal heptapeptide bradykinin(1-7), the major fragments of hydrolysis of bradykinin by NEP and ACE, had a very weak or no effect on tracheal contraction in concentrations as great as 10(-5) M. Captopril, leucine-thiorphan and phosphoramidon (each inhibitor at 10(-5) M, 15 min) shifted the concentration-response curves to lower concentrations by approximately 1 to 1.5 log U (P less than .05). Both NEP inhibitors and the ACE inhibitor potentiated the response to bradykinin in a concentration-dependent fashion (P = .0001), and the combination of phosphoramidon and captopril resulted in an additive potentiation of bradykinin-induced contraction (P less than .02). [D Pro2-D-Trp7,9]-substance P, a substance P antagonist, did not modify the potentiation of bradykinin-induced contraction by NEP inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279180 TI - Photoelastic stress analysis of supporting alveolar bone as modified by nonrigid connectors. AB - A two-dimensional photoelastic model was constructed to represent the mandible with a missing first premolar and first molar. The model contained a canine, second premolar, and second molar as abutment teeth supported by simulated periodontal ligament and photoelastic bone. Six FPDs were constructed, one of rigid design and five of nonrigid design with varying location and orientation of the nonrigid connector. Each of the six prostheses was subjected to six different loading conditions. Patterns of stress for each loading condition were recorded photographically and evaluated. This study indicated that the rigid FPD distributed stresses vertically and evenly. The nonrigid D of canine and nonrigid M of molar designs distributed stresses almost as well as the rigid FPD. They also resisted rotational movements and resultant horizontal stress better than other nonrigid designs. Compared with the other designs, prostheses with nonrigid connectors at the pier exhibited greater apical and horizontal stress particularly with one-point loading on the pier. Considering the limitations of this study, the following conclusions were drawn: 1. The pattern of stress is dependent on incorporation and location of a nonrigid connector. 2. The pattern of stress reflected the condition of loading. 3. The pattern of stress is independent of the orientation of the nonrigid connector at the distal aspect of the pier abutment. 4. The placement of a nonrigid connector at the mesial surface of the pier is least desirable. PMID- 3279181 TI - A new visible light-cured composite for modification of fixed partial dentures. PMID- 3279182 TI - Controlled tooth and mouth preparation for fixed and removable prostheses. PMID- 3279183 TI - Quantitative determination of taper adequate to provide resistance form: concept of limiting taper. PMID- 3279184 TI - Accuracy of impression materials for complete-arch fixed partial dentures. AB - The accuracy of 12 impression materials of six different types were studied by using complete-arch FPD impressions. Sixty impressions were made of a Columbia dentoform maxillary model with complete cast crown abutment preparations on the canines and the second molars. A one-piece casting was constructed by connecting the four individual castings made for the four abutment teeth. The master prosthesis was seated on the stone casts produced from the impressions. The marginal adaptation on the four abutments was then evaluated with a travelling microscope. The individual marginal adaptation of the four castings on the abutments was also examined after sectioning the four joints. The following conclusions were drawn. 1. The polyethers produced the most accurate complete arch replicas. The second most accurate were the vinyl polysiloxanes, followed by the polysulfides and the irreversible-reversible hydrocolloids. The least accurate were the reversible hydrocolloids and the irreversible hydrocolloids. 2. The polyether impression materials exhibited the most consistent accuracy for a master cast to fabricate a complete-arch FPD. PMID- 3279185 TI - Evaluation of the fit and strength of an all-ceramic fixed partial denture. AB - A laboratory investigation of the fit and strength of three-unit all-ceramic FPDs was performed with a metal-ceramic FPD control. The conclusions were: 1. No difference was found between the marginal seal of the metal-ceramic and all ceramic FPDs. 2. The all-ceramic FPDs had a more uniform cement space and their occlusal seat was significantly (99.9%) better than the metal-ceramic restorations. 3. The metal-ceramic FPDs were significantly stronger than the all ceramic FPDs. 4. Load calculations suggest that short-span all-ceramic FPDs may be strong enough to resist normal masticatory forces for selected patients. However, generalized usage will probably result in an unacceptable failure rate. PMID- 3279186 TI - The dimensional accuracy of improved dental stone, silverplated, and epoxy resin die materials. PMID- 3279187 TI - Effects of cooling methods on silver-palladium castings. AB - Cast metal specimens for three ceramic metals were subjected to two different types of cooling procedures after casting. One method involved the rapid cooling of the casting as soon as the red glow of the button disappeared. The other method allowed the castings to bench cool to room temperature. Hardness, bond strength, and microstructural determinations lead to the following conclusions. 1. Vickers hardness values for W-1 and Rx-91 alloys for each cooling regimen were not significantly different. Statistically higher hardness values were obtained for the quenched specimens of JP-5 alloys compared with the bench-cooled specimens. 2. Cooling of W-1 and JP-5 alloy specimens by quenching resulted in higher bond strengths than for specimens that were bench-cooled to room temperature. However, bench-cooling Rx-91 alloy lead to higher bond strengths than did quenching. 3. For all of the alloys examined, quenching produced a smaller grain structure than did bench-cooling. 4. From the standpoint of the parameters tested and the saving of processing time, quenching of the silver palladium ceramic alloys examined is the cooling procedure of choice for W-1 and JP-5 alloys. PMID- 3279188 TI - Accuracy and comparative stability of three removable die systems. AB - A study was performed to evaluate three removable die systems: the Accu-Trac, the Pindex, and the conventional brass dowel pin technique. The stability of the dies in the mesiodistal, bucco-lingual, and gingivoocclusal directions was compared. Under the conditions of this investigation, the following conclusions were drawn. 1. No significant difference was found in the shift of the removable die in a horizontal direction between any of the three systems. 2. No significant difference was found in the displacement of the removable die in the vertical direction with the Pindex system and the conventional dowel pin techniques. The slight displacement that did occur was in an upward direction. 3. A significant vertical displacement of the removable die in a downward direction was found with the Accu-Trac system compared with the other two systems. PMID- 3279189 TI - Retention of cast endodontic posts: comparison of cementing agents. AB - Zinc phosphate, glass-ionomer, and polycarboxylate cements were compared with a composite for ability to retain cast gold posts in prepared root canals of extracted teeth. Zinc phosphate and glass-ionomer cements were found to be more retentive than polycarboxylate cement and composite. PMID- 3279190 TI - Determination of occlusal vertical dimension: a literature review. AB - The vertical dimension of occlusion refers to the length of the face as determined by the amount of separation of the jaws. Its determination is important for fabrication of all restorations. Many techniques have been used for measurement of the vertical dimension of occlusion in dentulous and edentulous patients. These range from using preextraction records to the use of swallowing, functionally acquired jaw positions associated with phonetics, and cephalometric radiographs and evaluation of radiopaque paste in the vestibular fornix. There is no universally accepted or completely accurate method of determining the vertical dimension of occlusion in edentulous patients. There seem to be no significant advantages of one technique other than those of cost, time, and equipment requirements. It is the end result that matters. It should be satisfactory to the dentist and the patient from an esthetic point of view and not induce degenerative changes from a functional standpoint. Regardless of the technique, the vertical dimension of occlusion must be determined carefully by the dentist for a successful prosthesis. PMID- 3279191 TI - Limited mandibular movement: causes and treatment. AB - Limited mandibular movement is a challenging clinical problem. A variety of treatment modalities have been described to permit planning of an individual course of treatment for each patient. PMID- 3279192 TI - Resin-bonded components for maxillofacial prosthesis construction: a clinical trial. PMID- 3279193 TI - Physical therapy techniques in the treatment of the head and neck patient. AB - Limited jaw openings, which may develop following surgery and radiation therapy is a significant clinical problem. Some patients develop restricted oral opening because of extensive fibrosis and scarring of the affected tissues. The aid of the physical therapist is invaluable in the treatment of these patients. PMID- 3279194 TI - An etched metal splint to prevent the supereruption of unopposed teeth. PMID- 3279195 TI - A simple aid to stabilize the mandibular complete denture during recording of centric relation. PMID- 3279196 TI - An altered-cast impression technique that eliminates conventional cast dissecting and impression boxing. PMID- 3279197 TI - Pain and the heart: discussion paper. PMID- 3279198 TI - Optic neuropathy and chronic cyanide intoxication: a review. PMID- 3279199 TI - Royal Earlswood Hospital: a historical sketch. PMID- 3279200 TI - Salutary lessons for a diabetic patient. PMID- 3279201 TI - Psychiatry and its historians. PMID- 3279202 TI - Insanity in the 18th and 19th centuries. John Conolly: a reconsideration. PMID- 3279203 TI - The Victorian controversy about the insanity defence. PMID- 3279204 TI - Criminal insanity in 19th century asylums. PMID- 3279205 TI - Puerperal insanity in the 19th century. PMID- 3279206 TI - New inhibitors of human renin that contain novel Leu-Val replacements. Examination of the P1 site. AB - Stereoselective syntheses of several nonpeptide sulfidoethanol fragments that function as Leu10-Val11 (P1-P1') scissile bond replacements in human angiotensinogen are presented. These fragments are prepared from a variety of amino acids with formal P1 side chains varying in size and lipophilicity by converting them to their corresponding N-protected aminoalkyl epoxide 5 followed by ring opening with isopropyl mercaptan. The coupling of these fragments to either Boc-Phe-Ala-OH or Boc-Phe-His-OH produces inhibitors of human renin, 6 and 7, respectively, which are compared to a series of dipeptide-aldehyde inhibitors, 4, by molecular modeling and biochemical methods. Qualitatively, histidine containing (P2) inhibitors 7 possess greater inhibitory potency than their corresponding alanine (P2) analogues 6, which are more potent than the corresponding aldehydic inhibitors from series 4. Within a given series, inhibitors with the cyclohexylmethyl P1 side chain are more potent than the benzyl analogues, which in turn are more potent than cyclohexyl or isobutyl derivatives. Inhibitors with parger P1 side chains (e.g. adamantylmethyl and benzhydryl) are much less active. The inhibitory potency of these compounds against human renin is discussed in terms of specific interactions with the enzyme. PMID- 3279207 TI - Clofazimine analogues active against a clofazimine-resistant organism. AB - Clofazimine analogues active against a strain of Mycobacterium smegmatis 607 made resistant to the antileprosy agent have been synthesized. Activity (i.e., less than or equal to 2 micrograms/mL causing complete inhibition of growth) requires that there be a basic nitrogen in the "rimino" side chain and that the spacer distance between this nitrogen and the imino nitrogen be at least three carbon atoms. The nitrogen may be primary, secondary, or tertiary and may be part of an open chain or enclosed in a ring compound. Provided that the criteria of basicity and spacer distance are satisfied, all are active in vitro against both the sensitive and resistant strains. Substitution elsewhere in the molecule had little effect on the activity. The compounds have been shown to have growth inhibitory activity against human-derived Mycobacterium leprae in murine macrophages in culture. PMID- 3279208 TI - Arteether, a new antimalarial drug: synthesis and antimalarial properties. AB - Arteether (6) has been prepared from dihydroquinghaosu (3) by etherification with ethanol in the presence of Lewis acid and separated from its chromatographically slower moving alpha-dihydroqinghaosu ethyl ether (7). The absolute stereochemistry at C-12 has been determined by 1H NMR data (J11,12, NOESY). Ethyl ethers 6 and 7 showed potent in vitro inhibition of Plasmodium falciparum, and both compounds were highly potent antimalarials in mice infected with a drug sensitive strain of Plasmodium berghei. Crystalline arteether (6) and its oily epimer 7 were 2-3 times more potent schizontocides than quinghaosu (1), but deoxy compounds 8, 9, and 11 were 100-300 times less potent in vitro than their corresponding peroxy precursors. Pharmacological studies have shown arteether(6) to have antimalarial activity in animals comparable to artesunate (2) and artemether (4), both of which are fast-acting blood schizontocides in humans. Arteether (6) has now been chosen for a clinical evaluation in high-risk malaria patients. PMID- 3279209 TI - Synthesis and anticandidal properties of polyoxin L analogues containing alpha amino fatty acids. AB - Analogues of polyoxin L containing amino acids with saturated fatty acid like side chains were synthesized from the benzyloxycarbonyl-protected alpha-amino fatty acid p-nitrophenyl ester and uracil polyoxin C. Transfer hydrogenolysis using palladium black and formic acid gave diastereomeric, dipeptidyl polyoxin L analogues containing alpha-aminooctanoic acid (3), alpha-aminododecanoic acid (4), or alpha-aminohexadecanoic acid (5) as the amine terminal residue in 40-60% yield. Diastereomers of 3 and 5 were resolved by using high-performance liquid chromatography on a reversed-phase column and designated as 3a, 3b and 5a, 5b. Analogues 3-5 were excellent inhibitors of chitin synthetase from Candida albicans; 4, the best inhibitor, had an ID50 of 0.5 microM. The L,L diastereomers of 3 and 5 were 1-2 orders of magnitude more potent chitin synthetase inhibitors than their D,L homologues. None of the synthetic polyoxin L analogues inhibited transport of trimethionine, but 3a, 4, and 5b caused decreases of 71%, 87%, and 83%, respectively, in the initial rate of uptake of dileucine. Compounds 3-5 were significantly more stable to peptidase degradation than polyoxin L analogues containing naturally occurring alpha-amino acids. Compound 4 inhibited growth of C. albicans in culture at 40-80 micrograms/mL. All other analogues were less potent antifungals. The results suggest that synthetic polyoxins can be designed to have increased affinity for a peptide transport system and to have increased stability against intracellular degradation in C. albicans. PMID- 3279210 TI - Renin inhibitors containing psi[CH2O] pseudopeptide inserts. AB - Renin inhibitors 2-4 with the D-Lys renin inhibitory peptide (RIP) sequence, but containing Leu psi[CH2O]Ala (2), Leu psi[CH2O]Val (3), and Leu psi[CH2O]Leu (4) at the P1-P1' site, were of a comparable potency to RIP. N-Terminal Boc-protected inhibitors containing Pro psi[CH2O]Phe in positions P4-P3 were potent inhibitors of renin, with Boc-Phe-Pro psi[CH2O]Phe-His-Leu psi[CH(OH)CH2]Val-Ile-(2 aminomethyl) pyridine (17) having an IC50 of 1.6 X 10(-9) M. PMID- 3279211 TI - Design of potent cyclic gonadotropin releasing hormone antagonists. AB - In order to improve the biological potency of cyclic gonadotropin releasing hormone (GnRH) antagonists, we have synthesized analogues, the conformations of which were restrained through internal side chain/side chain amide bridges linking aspartic acid or glutamic acid and L-2,3-diaminopropionic acid or L ornithine. A disulfide bridge linking L-cysteine residues was also introduced. Residues belonging to the bridge spanned from position 4 to positions 9 or 10. Two series of analogues were synthesized and are characterized by residues at positions 1 [Ac-D-3-(2'-naphthyl)alanine], 2 [D-(4-chlorophenyl)alanine or D-(4 fluorophenyl)alanine], 3 [D-3-(3'-pyridyl)alanine or D-tryptophan], 5 (arginine or tyrosine), and 6 [D-3-(3'-pyridyl)alanine or D-arginine], respectively. These substitutions were selected in an effort to optimize high biopotency for inhibition of luteinizing hormone secretion, minimization of histamine release activity, and high (relative) hydrophilicity. The most potent analogues in the antiovulatory assay were cyclo(4-10) [Ac-DNal1,DCpa2,DPal3,(Asp4 or Glu4),Arg5,DPal]6,Dpr10]GnRH (compounds 5 and 7), which were fully active at ca. 12.5 micrograms/rat in the first series, and cyclo(4-10)[Ac DNal1,DFpa2,DTrp3,Asp4,DArg6++ +,Dpr10]GnRH (compound 12), which was fully active at 2.5 micrograms/rat in the second. PMID- 3279212 TI - A combinatorial method for grouping cases with multiple malformations. AB - A combinatorial method is described for grouping cases with multiple malformations for the purpose of identifying previously undescribed syndromes. This method includes ways of carrying out 'tight' or 'loose' grouping, of allowing for variability of reporting of physical features by different observers, and of minimising the number of 'spurious' groups. Evaluation using a test data set of known dysmorphic syndromes showed that the method provides a feasible and useful means of grouping undiagnosed cases. PMID- 3279213 TI - Bacillus species of medical and veterinary importance. PMID- 3279214 TI - Measurement of hypoxanthine incorporation in purified suspensions of Mycobacterium leprae: a suitable method to screen for anti-leprosy agents in vitro. AB - The rate of incorporation of hypoxanthine was measured in suspensions of Mycobacterium leprae, with and without added anti-leprosy agents. Dapsone, clofazamine and brodimoprim, as well as other benzylpryimidines, inhibited hypoxanthine incorporation, and their minimum inhibitory concentrations for incorporation with intact M. leprae were near the minimum inhibitory concentrations at which the agents have antibacterial effects. At sub-inhibitory concentrations for hypoxanthine incorporation, some combinations of benzylpyrimidines and dapsone were inhibitory, suggesting that synergic effects of anti-leprosy agents might also be detected by the inhibition of hypoxanthine incorporation. Thus, demonstration of inhibition of hypoxanthine incorporation in M. leprae could be a rapid method for screening anti-leprosy agents and especially for preliminary testing of new, potential anti-leprosy agents. The rate of hypoxanthine incorporation was generally lower in suspensions of M. leprae with lower viability, but it was not proportional to viability so the technique would not be suitable for accurate determination of viability. PMID- 3279215 TI - Lipopolysaccharide-induced non-specific resistance to systemic Escherichia coli infection in mice. AB - A high degree of non-specific resistance to a lethal systemic Escherichia coli infection was induced in mice by pretreatment with a small dose (less than 5 micrograms/mouse) of the homologous lipopolysaccharide (LPS) or with heterologous rough-type LPS from E. coli K-12. The route of LPS administration, intraperitoneally or subcutaneously, did not influence the development of resistance, suggesting that a systemic cell activation was responsible for the effect. The enhanced elimination of bacteria was similar to that in mice recovering from a sublethal E. coli infection. In the LPS-treated mice, elimination of the challenge bacteria from the peritoneal cavity and the blood started 3-4 h after challenge whereas, in controls, the bacterial numbers continued to increase until the mice died. The detoxified LPS derivative, monophosphoryl lipid A (MPL), also increased the survival of mice infected with E. coli O18:K1. However, the dose of MPL required for optimal infection resistance was 100-fold greater than that of native, E. coli K-12 LPS, corresponding to the 100-fold reduced toxicity of MPL for mice and rabbits in lethality and pyrogenicity assays. PMID- 3279216 TI - Abortive phage-infection and UV-protection markers on Col I plasmids from epidemic strains of Salmonella. AB - Cultures of Escherichia coli carrying ColI plasmids received in conjugation from strains of Salmonella typhimurium and S. agona were examined for abortive infection (Abi) of phage BF23 and for enhanced resistance to the lethal action of UV-irradiation (Uvr). The Abi character of stored cultures of E. coli was also compared with the reaction of the same stock culture tested 5 years before. Seven of the eight potential types differentiated by three characters were represented among 160 ColI plasmids: ColIa Abi+ Uvr+ (3 plasmids), ColIa Abi- Uvr+ (1), ColIa Abi- Uvr- (2), ColIb Abi+ Uvr+ (85), ColIb Abi+ Uvr- (5), ColIb Abi- Uvr+ (4), ColIb abi- Uvr- (60). Recognition that different plasmid types could be carried by strains of a clone proved useful in the interpretation of the epidemic spread of strains of S. typhimurium of phage type/biotype 141/9f in Scotland and in tracing the ancestry of a recently emerged rhamnose non-fermenting mutant strain of S. agona. PMID- 3279217 TI - Purging tumor cells from bone marrow by use of antibody and complement: a critical appraisal. AB - This review highlighted several problems associated with the use of antibody and complement in the elimination of tumor cells from bone marrow that was to be used for transplantation, and it discussed some of the difficulties encountered in developing this approach in model systems. These problems should be seriously considered by any clinician contemplating this method for bone marrow purging. PMID- 3279218 TI - Intensive single-agent mitoxantrone for metastatic breast cancer. AB - Twenty-seven women with metastatic breast cancer were treated with mitoxantrone as a single agent, with the use of an intensive dose-escalating schedule. Doses were given at 0.5 mg/m2/day as an iv injection for 3 consecutive days and then were escalated each month by 2.5 mg/m2/day until maximal tolerance was reached on the basis of hematologic or cardiac toxicity. No complete responses were demonstrated. Six patients (22%) had partial responses of 5.5 months' median duration. Four of 12 patients who had not received prior doxorubicin responded (33%), whereas two of 15 patients with previous doxorubicin exposure responded (13%). Cardiotoxicity, determined by serial radionuclide ventriculography, occurred in 10 patients (37%) at a mean total mitoxantrone dose of 83.0 mg/m2. Three of these 10 patients had no predisposing risk factors, four had received thoracic radiotherapy that might have involved the heart, and three had received prior doxorubicin without clinical toxicity. The failure of dose intensification to augment the response rate when compared to the response rates reported for less myelotoxic doses of the drug, in addition to the extent of cardiotoxicity noted, calls into question the value of dose intensification of mitoxantrone in the treatment of metastatic breast cancer. PMID- 3279220 TI - Surgical treatment of burns in elderly patients. AB - This study evaluates our experience with surgical treatment of burns in the elderly. Forty-two patients more than 59 years old were treated from 1982 to 1986. The mean age was 73, and the mean TBSA burned was 29%. The patients were divided into three groups. Group I had 22 patients with less than 20% TBSA burn (mean of 11%, with a mean of 6% full-thickness burns). Their survival rate was 91%. Group II had 11 patients with 21-40% TBSA burns (mean of 32%, with a mean of 17% full-thickness burns). Their survival rate was 82%. Group III had nine patients with burns greater than 40% TBSA (mean, 71%). None of these patients survived. Twenty of 29 (68%) survivors required a total of 36 operations. The mean area grafted per procedure was 8%. Each procedure required a mean of 2U packed red blood cells, and a mean of 2 1/4 hours. The complication rate was 33%, with partial graft loss (14%) being the most frequent. The average hospital stay was 27 days in Group I and 45 days in Group II. Only 25% of the patients required nursing home assistance at discharge. PMID- 3279219 TI - Eradication of Candida burn wound septicemia in massively burned patients. AB - The increased incidence of Candida burn wound infection and septicemia in massively burned patients is well known. One thousand thirty six patients were admitted from January 1982 through December 1986. Nystatin prophylaxis, both oral and topical, was initiated in October 1984 and 472 patients were treated. The control group was comprised of the 564 patients treated January 1982 through September 1984. There was a significant difference (p less than 0.005) between the groups in the number of Candida colonized patients, the numbers of Candida burn wound infections, the incidence of multi-organ system involvement/failure, and the occurrence of Candida sepsis. There has not been a Candida burn wound infection in this institution since June 1985. Nystatin, given orally as a 'swish and swallow' or mixed 1:1 with either silver sulfadiazine or polymyxin B/bacitracin, has eradicated Candida burn wound infections and septicemia from this institution and thus obviated the need for systemic antifungals such as amphotericin B. PMID- 3279221 TI - Enhanced allograft survival in H-2 compatible cyclosporine-treated mice. AB - Skin allograft survival time has been prolonged in a variety of animal and human studies. Burn injury, histocompatibility matching, and cyclosporine administration each independently have been shown to increase skin allograft survival times. A mouse model was developed to study these relationships. Histocompatibility matching of mouse H-2 I showed a trend toward skin allograft prolongation when comparing nonburned and burned animals. When there was complete histocompatibility of mouse H-2 and H-4 allograft survival time was significantly prolonged. Cyclosporine administration to the optimally matched donor/recipient combination further enhanced allograft survival. This study demonstrated that histocompatibility matching for the entire H-2 locus correlated with prolonged allograft survival. Optimal histocompatibility and cyclosporine administration further enhanced skin allograft survival in burned mice. PMID- 3279223 TI - A truly wandering spleen. PMID- 3279222 TI - In-vivo sensitivity of Plasmodium falciparum to chloroquine in Zaria, Nigeria. AB - In 33 children with confirmed Plasmodium falciparum malaria, the WHO Extended Field Test was employed to test the sensitivity of the parasite to chloroquine in Zaria urban area. No evidence of resistance to the drug was found. In 82% of the patients parasitaemia had disappeared within 3 days, while the remaining 18% were parasite negative on day 4 or 5. The mean parasite clearance time was calculated as 3.45 +/- 1.23 days. The results suggest that chloroquine sensitivity of P. falciparum may be decreased in this part of Nigeria. PMID- 3279224 TI - Sonographic diagnosis of diastematomyelia. PMID- 3279226 TI - The Dandy-Walker malformation prenatal sonographic diagnosis and its clinical significance. AB - To determine the usual sonographic findings and clinical significance of the Dandy-Walker malformation (DWM) identified in utero, we reviewed seven proven cases diagnosed by prenatal ultrasound during a 6-year period. All patients demonstrated complete or partial absence of the cerebellar vermis and a posterior fossa cyst. Other central nervous system (CNS) findings included hydrocephalus (five cases) and agenesis of the corpus callosum (one case). Extra-CNS abnormalities were prospectively identified in 3 of 4 fetuses with multiple anomalies. Chromosomal analysis was performed on all four fetuses with multiple extra-CNS anomalies, yielding 2 abnormal karyotypes (trisomy 18 and mosaic trisomy 13). Fetal mortality was directly dependent on the presence of extra-CNS anomalies. Five fetuses ultimately died, including all four with multiple extra CNS anomalies. The remaining two patients are alive at 1.5 and 6 years of age. We conclude that DWM has a distinctive sonographic appearance that can be identified by prenatal ultrasound and that identification of DWM should initiate a careful search for concurrent anomalies as well as consideration of chromosomal analysis. PMID- 3279225 TI - A comparison between ultrasound and gynecologic examination for detection of enlarged ovaries in a group of women at risk for ovarian carcinoma. AB - In order to evaluate the quality of ultrasound and gynecologic examination of the ovaries in women at risk for ovarian carcinoma, a group of 115 women all relatives to women with ovarian carcinoma, were examined. Although this small group of women was considered a risk group, no carcinoma was found. In premenopausal women 92% of the ovaries could be identified and measured using ultrasound. In postmenopausal women this figure was 87%, while only 30% could be identified at the gynecologic examination. This indicates that ultrasound examination of the ovaries is a much more reliable method for examining the ovary than gynecologic palpation. PMID- 3279227 TI - The identification of ulcerative plaque with high resolution duplex carotid scanning. AB - A retrospective study evaluated 50 patients who had pathologically proven intraplaque hemorrhage. The patients were pathologically divided into two groups by the presence or absence of intimal ulcerations. These two groups were then sonographically compared with regard to surface characteristics of the plaque, plaque size, size of the sonolucent area within the plaque, and location of the sonolucent area relative to the intimal surface. No defined sonographic characteristics could be used to separate these two groups of patients with heterogeneous plaques into those who had or did not have ulcerations. Most importantly, merely sonographically evaluating the surface of the plaque to determine if it was smooth or irregular could not be used as a successful means to identify which patients were at risk for ulceration. PMID- 3279228 TI - High frequency breast ultrasound. Hand-held versus automated units; examination for palpable mass versus screening. AB - Four hundred forty-five patients had one or more breast ultrasound examinations with equipment from six manufacturers, operating at 5, 7.5, or 10 MHz. Two hundred seven patients were examined by both automated and hand-held units. In revealing cysts and solid masses, the automated and hand-held units performed nearly identically. Of 198 patients who had screening mammograms, ultrasound evaluation revealed that 85 (43%) had cysts, while 32 (16%) had solid masses. Of the 207 patients who had diagnostic mammograms for a palpable mass, 63 (30.4%) had cysts, while an equal number had solid masses. Of 45 solid masses from both groups that were imaged and biopsied, all 15 that were malignant were palpable. No nonpalpable malignancies were found by ultrasound alone. PMID- 3279229 TI - Renal transitional cell carcinoma mimicking stone echoes. PMID- 3279230 TI - Prenatal diagnosis of an intrapericardial teratoma. A cause for nonimmune hydrops. PMID- 3279231 TI - Prenatal diagnosis of a bronchogenic cyst. PMID- 3279232 TI - Sonographic diagnosis of omphalocele in the first trimester of fetal gestation. PMID- 3279233 TI - A deletion mutant of L-A double-stranded RNA replicates like M1 double-stranded RNA. AB - X double-stranded RNA (dsRNA) is a 0.52-kilobase dsRNA molecule that arose spontaneously in a nonkiller strain of Saccharomyces cerevisiae originally containing L-A and L-BC dsRNAs (L-BC is the same size as L-A but shares no homology with it). X hybridized with L-A, and direct RNA sequencing of X showed that the first 5' 25 base pairs (of the X positive strand) and at least the last 110 base pairs of the 3' end were identical to the ends of L-A dsRNA. X showed cytoplasmic inheritance and, like M1, was dependent on L-A for its maintenance. X was encapsidated in viruslike particles whose major coat protein was provided by L-A (as is true for M1), and X was found in viruslike particles with one to eight X molecules per particle. This finding confirms our "head-full replication" model originally proposed for M1 and M2. Like M1 or M2, X lowers the copy number of L A, especially in a ski host. Surprisingly, X requires many chromosomal MAK genes that are necessary for M1 but not for L-A. PMID- 3279234 TI - Brachial artery aneurysm in an infant: case report and review of the literature. AB - A case is reported of a congenital aneurysm of the brachial artery in a 9-month old boy. The lesion was excised and the artery reconstructed with an end-to-end anastomosis. Review of the English language literature showed that brachial artery aneurysms in children usually occur in association with arteritis, connective tissue disorder, or a syndrome of multiple aneurysms of unknown origin. PMID- 3279235 TI - A prospective, randomized trial of Unna's boots versus hydroactive dressing in the treatment of venous stasis ulcers. AB - In many centers the standard treatment for venous stasis ulcers consists of UB dressings. A new dressing, DuoDERM hydroactive dressing (HD), has recently been used extensively for the treatment of venous stasis ulcers. Because of this trend, a prospective, randomized trial of these two dressings was undertaken. Sixty-nine ulcers (39 HD and 30 UB) were randomized. End points were complete healing and development of complications necessitating cessation of treatment. Time to healing, cost of treatment, and patient convenience were also evaluated. Twenty-one of 30 ulcers (70%) healed with UB therapy compared with 15 of 39 ulcers (38%) treated with HD (p less than 0.01, CST). Life-table healing rates at 15 weeks were 64% for UB compared with 35% for HD (p = 0.01, log rank test). Ten of 39 patients (26%) receiving HD had complications compared with no complications in the UB group (p = 0.004, FET). For those patients whose ulcers healed, there was no significant difference (p = 0.51, STT) in the mean time required for healing or the average weekly cost of dressing materials between the HD group (7.0 weeks at +11.50 per week) and the UB group (8.4 weeks at +12.60 per week). Those patients treated with HD reported a significantly greater level of convenience than those patients with UB (p = 0.004, STT). Although treatment with HD led to better patient acceptance, those patients receiving UB therapy had a significantly greater rate of healing and a significantly lesser incidence of complications than those patients treated with HD. PMID- 3279236 TI - Cellular oxygen metabolism during sepsis and shock. The relationship of oxygen consumption to oxygen delivery. PMID- 3279237 TI - Report on medical licensure. Council on Medical Education. PMID- 3279238 TI - Rhododendrons, mountain laurel, and mad honey. PMID- 3279239 TI - Pertussis vaccines: trials (and tribulations) PMID- 3279240 TI - The emergence of grade A eggs as a major source of Salmonella enteritidis infections. New implications for the control of salmonellosis. AB - From 1976 to 1986, reported Salmonella enteritidis infections increased more than sixfold in the northeastern United States. From January 1985 to May 1987, sixty five foodborne outbreaks of S enteritidis were reported in the Northeast that were associated with 2119 cases and 11 deaths. Twenty-seven (77%) of the 35 outbreaks with identified food vehicles were caused by Grade A shell eggs or foods that contained such eggs. National data from 1973 to 1984 showed that S enteritidis outbreaks (44%) were more frequently associated with egg-containing foods than were outbreaks of other Salmonella serotypes (15%). Reflecting the geographic distribution of human illness, cultures of bulk raw eggs from pasteurization plants in the Northeast more frequently yielded S enteritidis (10%) than did eggs from other regions of the United States (0%). The epidemic rise in S enteritidis infections due to Grade A shell eggs is unlike past problems of salmonellosis associated with cracked or soiled eggs and raises the possibility of trans-ovarian contamination of eggs with S enteritidis. New techniques may therefore be needed to control resurgent egg-associated salmonellosis in the United States. PMID- 3279242 TI - Consensus conference. Magnetic resonance imaging. PMID- 3279241 TI - Positron emission tomography in oncology. Council on Scientific Affairs. AB - This report describes the current and potential uses of positron emission tomography in clinical medicine and research related to oncology. Assessment will be possible of metabolism and physiology of tumors and their effects on adjacent tissues. Specific probes are likely to be developed for target sites on tumors, including monoclonal antibodies and specific growth factors that recognize tumors. To date, most oncological applications of positron emission tomography tracers have been qualitative; in the future, quantitative metabolic measurements should aid in the evaluation of tumor biology and response to treatment. PMID- 3279243 TI - The Monterey California papal visit: an emergency services point of view. PMID- 3279244 TI - One hospital's experience with guidelines for improved collaboration between emergency medical technicians, nurses, and physicians. PMID- 3279246 TI - Role of the registered nurse in the prehospital environment. PMID- 3279245 TI - Sheltering and response to evacuation during Hurricane Elena. PMID- 3279247 TI - New law requires emergency staff members to offer option of organ donation to families. Interview by Linda Johnson McGaw. PMID- 3279248 TI - Improving compliance with referrals from the emergency department. PMID- 3279249 TI - Reporting child abuse: duties and dangers. PMID- 3279250 TI - Standardized care plans. Suspected abuse and neglect of children. PMID- 3279251 TI - Triage decisions. An unusual case of syncope. PMID- 3279252 TI - Cardiopulmonary arrest after cold water immersion and hypothermia. PMID- 3279254 TI - Acute burn care: an update. PMID- 3279253 TI - Then I close my eyes. PMID- 3279256 TI - [Recent developments in fibrinolysis]. AB - Since streptokinase and urokinase became available for clinical use, numerous attempts have been made to improve these useful thrombolytic agents. In order to decrease its antigenicity, streptokinase has been fragmented or coupled to human plasminogen or polyethylene glycols. With a plasmin B-chain-streptokinase complex a more potent agent was obtained. To prolong their half-life, streptokinase and urokinase were immobilized with water-soluble carriers. Coupling urokinase or tissue-type plasminogen activator with fibrin-specific antibodies increases its thrombolytic efficiency, at least in vitro. The only thrombolytic agents with a relative fibrin-selectivity presently available for clinical purposes are tissue type plasminogen activator and single chain urokinase-type plasminogen activator. Structural manipulation allows to design and produce mutant proteins with specific deletions, additions or substitutions of non-protease domains. Also chimaeric molecules combining fragments of tissue-type plasminogen activator and single chain urokinase-type plasminogen activator have already been constructed. These modifications of natural molecules may further improve their fibrin specificity and therapeutic potential. PMID- 3279257 TI - [Results and limits of fibrin-unspecific thrombolysis in acute myocardial infarct]. AB - Acute myocardial infarction is caused by thrombotic occlusion of a coronary vessel. Mortality and quality of life are both determined by the extent of infarction. It is possible to interrupt the development of necrosis by early fibrinolytic therapy. If reperfusion is initiated within three to six hours, a significant reduction in mortality is likely. Currently available fibrin unspecific plasminogen activators such as streptokinase and urokinase are effective thrombolytic agents but do not fulfill all the criteria of an ideal plasminogen activator. Recanalisation rates are relatively low after intravenous administration, since the agents are not fibrin-specific and because the effect is delayed. Serious hemorrhagic complications may occur, since therapeutically effective dosage results in a hemostatic defect. The possible advantages of reduction in blood viscosity for collateral circulation in the ischemic region and a possible antithrombotic effect have not been defined. A complex strategy is necessary for optimal treatment of acute myocardial infarction. Early intervention is decisive in regard to recanalisation rate, infarct size, left ventricular function and mortality, while delayed interventions serve to maintain the advantages of early recanalisation by limiting angina pectoris and preventing reinfarction. Therefore, a combination of early intravenous administration of a fibrinolytic agent with subsequent invasive intervention appears reasonable and advantageous. Progress in the treatment of acute myocardial infarction will depend on development of effective plasminogen activators capable of achieving rapid and complete recanalisation without major side effects after intravenous administration. PMID- 3279255 TI - Atherosclerosis of the carotid arteries in young patients with familial hypercholesterolemia. AB - Patients with heterozygous and homozygous Familial Hypercholesterolemia exhibit a high incidence of premature coronary heart disease, presumably due to atheromatous plaque-formation in the coronary arteries. Clinical symptoms develop when the disease has progressed to more severe stages of atherosclerosis. Aim of our study was to visualize and document early atheromatous lesions in the carotid arteries of asymptomatic patients with familial hypercholesterolemia under 30 years of age by Duplex-scan. Of 44 patients, 70% had detectable carotid plaques, while only 12% of the controls were affected. All patients with severe carotid disease had serum cholesterol levels above 350 mg/dl. In the age group 2-20 years, 66% of the patients exhibited plaques. Only 6% of the FH patients 21-30 years had normal carotid arteries. We conclude that the process of atheromatous plaque formation in patients with FH starts early in life, severity of atherosclerosis being a function of both extent and duration of hypercholesterolemia. Duplex-scan examination of the carotid arteries is efficient and precise non-invasive method suitable to visualize this process and, by measuring regression, monitor the efficacy of therapeutic measures. PMID- 3279258 TI - Basement membrane gene expression in polycystic kidney disease. PMID- 3279259 TI - The pathogenesis of atherosclerosis: atherogenesis and inflammation. AB - Current concepts of the pathogenesis of atherosclerosis have been reviewed, emphasizing some of the similarities of the mechanisms and events involved to those in inflammation. Figure 2 is a schematic summary of these events. Hyperlipidemia, or some component of hyperlipidemic serum, as well as other risk factors, are thought to cause endothelial injury, resulting in adhesion of platelets and/or monocytes and release of PDGF (and other growth factors), which leads to smooth muscle migration and proliferation. It is clear that endothelial injury need not be denuding, and in fact may consist of altered endothelial function (dysfunction); adhesion of monocytes, increased permeability of endothelium, and disturbances in growth control can occur without morphologically obvious endothelial injury. Hyperlipidemia, hypertension, smoking, immune injury, and other risk factors may contribute to this endothelial dysfunction in different ways and sometimes in combination. Smooth muscle cells produce large amounts of collagen, elastin, and proteoglycans and these form part of the atheromatous plaque. Hyperlipidemia contributes in a number of ways (as discussed earlier), and indeed, in the severely hypercholesterolemic patient, such as one with familial hypercholesterolemia, is alone sufficient to cause atherosclerosis in the absence of other risk factors. Foam cells of atheromatous plaques are derived both from macrophages and from smooth muscle cells; from macrophages via the beta-VLDL receptor and also possibly by way of LDL modification, recognized by the acetyl-LDL receptor (such as oxidized LDL); and from smooth muscle cells by less certain mechanisms. Extracellular lipid is derived from insudation from the lumen, particularly in the presence of hypercholesterolemia, and also from degenerating foam cells. Cholesterol accumulation in the plaque should be viewed as reflecting imbalance between influx and efflux, and it is possible that high density lipoprotein is the molecule which helps clear the cholesterol from these accumulations (134). The diagram (right) also depicts the possibility that smooth muscle proliferation may occur without endothelial injury at all. There are several postulated mechanisms for such an occurrence: loss of growth control, direct smooth muscle injury (such as by LDL), and autonomous proliferation by the mechanisms suggested by Benditt. The theoretical scheme presented is based largely on in vitro work, only partly substantiated by experimental and human studies, and does not explain the precise mechanisms by which all risk factors increase the susceptibility to atherosclerosis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3279260 TI - Altered mRNA expression of basement membrane components in a murine model of polycystic kidney disease. AB - Basement membranes surround the renal tubules and have been shown to limit their distension in vitro. Therefore, it has been postulated that a defect in a basement membrane component(s) underlies the pathogenesis of polycystic kidney disease. Here we have studied a murine model of congenital polycystic kidney disease and found by immunohistology, that the components of the peri-cyst basement membrane appeared to diminish with time. We also measured mRNA levels for collagen IV and laminin, and found a different pattern than in the normal mouse kidney. In normal kidneys, mRNA levels for the B1 and B2 chains of laminin were maximal at birth, and at 1 week for the alpha 1(IV) chain of collagen IV. With all three chains, the levels then rapidly declined. In contrast, mRNA for the alpha 1(IV) chain in congenital polycystic kidneys was half normal 1 week after birth and then increased. Laminin B1 and B2 chain mRNA's were 80% of normal at 1 week but were maintained at that level. As a control, beta-actin mRNA was examined and found to remain constant in both normal and diseased kidneys. In situ hybridization of cRNA probes for the alpha 1(IV) chain confirmed that cells associated with cysts were the principal source of expression of these basement membrane mRNAs. Thus, there exists an abnormal regulation of basement membrane gene expression in congenital polycystic kidney disease. The first stage is characterized by reduced levels of expression. In the second stage, the levels are abnormally high, perhaps representing a compensatory synthesis of basement membrane as cysts enlarge. PMID- 3279261 TI - Antibodies to purified renal tubular epithelial antigens contain activity against laminin, fibronectin, and type IV collagen. AB - Antibodies directed against tubular brush border antigens (RTE) are used to induce heterologous immune-complex nephritis. Among these antigens a glycoprotein with a molecular weight of 330 kilodaltons (gp330) has been shown to be of pathogenetic significance. We investigated whether antibodies other than those directed against gp330 are present in anti-RTE and whether they play a pathogenetic role. By using enzyme-linked immunosorbent assay techniques and Western blotting, we investigated polyclonal antibodies directed not only against crude RTE but also against RTEgp, a purified glycoprotein fraction of RTE, with respect to activity against glomerular basement membrane (GBM) components laminin, fibronectin, and type IV collagen. Both antibody preparations showed reactivity predominantly to the 220 kilodaltons subunit of laminin. Lower but nevertheless distinct reactivity to fibronectin and type IV collagen was also found. The antibody fraction directed against components of the GBM, which was isolated from anti-RTE IgG by affinity chromatography, showed linear binding to the GBM in indirect immunofluorescence studies. Injection of these antibodies into the renal artery also led to linear binding to the GBM with linear deposition of complement factors 3 and 9 and induced a weak and transient proteinuria. Immunoelectron microscopy revealed binding of the antibodies to glomerular epithelial and endothelial cell surfaces adjacent to the GBM. Injection of anti-RTE antibody absorbed to GBM components resulted in binding of antibodies and complement factors 3 and 9 in a fine granular pattern along the GBM, whereas injection of unabsorbed anti-RTE led to a course granular pattern. We conclude that the presence of antibodies (cross-)reacting with laminin, fibronectin, and type IV collagen in anti-RTE antibody has pathogenetic effects and could explain differences in pathogenicity between monospecific anti-gp330 antibody and polyclonal anti-RTE antibody. PMID- 3279263 TI - Demonstration of estrogen receptors by monoclonal antibody in formalin-fixed breast tumors. AB - An immunohistochemical technique using a commercially available monoclonal antibody to the estrogen receptor in formalin-fixed breast tumors is described. The author's technique is compared to three other recently published techniques in 27 case studies. The authors' method using pronase enzyme pretreatment and alkaline phosphatase as the third antibody yielded the best results. Comparison with the standard dextran-coated charcoal cytosolic assay results from the cases selected yielded a 100% sensitivity and 89% specificity for the authors' technique. The advantages of the immunohistochemical method over the biochemical assay are discussed and clinical implications are suggested. A step-by-step procedure for the authors' technique follows the text. PMID- 3279262 TI - The twitcher mouse. Central nervous system pathology after bone marrow transplantation. AB - Effects of bone marrow transplantation (BMT) on the pathology of the central nervous system were evaluated, at light and electron microscope levels, in the homozygous twitcher mouse (twi/twi), an authentic murine model of globoid cell leukodystrophy (GLD, Krabbe disease) in humans. In the twitcher mice with BMT examined at ages 44 and 71 days (transplanted at the day 9 to 12), degeneration of oligodendrocytes and myelin was still present. In these mice, oligodendrocytes and macrophages containing typical tubular and crystalloid inclusions of GLD were observed in the white matter, in particular that of the cerebellum, brainstem, and spinal cord. However, significant morphologic improvement was observed in the central nervous system of the twitcher with BMT which survived more than 100 days. In the cerebellum, brainstem, and spinal cord of these mice, myelin degeneration and infiltration of macrophages containing typical GLD inclusions were either absent or only rarely observed. Instead, many foamy macrophages, either scattered or clustered around blood vessels, were conspicuous. Many nerve fibers with thin myelin sheaths indicative of remyelination were present in the white matter. GLD inclusions were, however, still found in the cytoplasm of apparently remyelinating oligodendrocytes. These results suggest that the foamy macrophages are of donor origin, since they are able to digest degraded myelin components completely, because of a sufficient galactosylceramidase activity, and are contributing to the improvement of the central nervous system pathology in the twitcher mouse following BMT, by supplying the deficient enzyme, galactosylceramidase. However, the presence of inclusions in oligodendrocytes in the twitcher with BMT, even after 100 days of age indicates that the basic enzymatic defect involving oligodendrocytes could not be completely corrected with BMT. PMID- 3279264 TI - Thrombotic microangiopathies: a review. PMID- 3279265 TI - Hemicorporectomy: the contribution of Frederick E. Kredel. PMID- 3279266 TI - Eulogy written in a country churchyard. PMID- 3279267 TI - Theodore Gaillard Croft, M.D., July 10, 1845-March 10, 1915. PMID- 3279269 TI - A hypothesis on the mechanism of trauma of lung tissue subjected to impact load. AB - When a compressive impact load is applied on the chest, as in automobile crash or bomb explosion, the lung may be injured and show evidences of edema and hemorrhage. Since soft tissues have good strength in compression, why does a compression wave cause edema? Our hypothesis is that tensile and shear stresses are induced in the alveolar wall on rebound from compression, and that the maximum principal stress (tensile) may exceed critical values for increased permeability of the epithelium to small solutes, or even fracture. Furthermore, small airways may collapse and trap gas in alveoli at a critical strain, causing traumatic atelectasis. The collapsed airways reopen at a higher strain after the wave passes, during which the expansion of the trapped gas will induce additional tension in the alveolar wall. To test this hypothesis, we made three new experiments: (1), measuring the effect of transient overstretch of the alveolar membrane on the rate of lung weight increase; (2) determining the critical pressure for reopening collapsed airways of rabbit lung subjected to cyclic compression and expansion; (3) cyclic compression of lung with trachea closed. We found that in isolated rabbit lung overstretching increases the rate of edema fluid formation, that the critical strain for airway reopening is higher than that for closing, and that these critical strains are strain-rate dependent, but independent of the state of the trachea, whether it is open or closed. Furthermore, a theoretical analysis is presented to show that the maximum principal (tensile) stress is of the same order of magnitude as the maximum initial compressive stress at certain localities of the lung.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279268 TI - Analysis of ultrafiltration and mass transfer in a bioartificial pancreas. AB - A bioartificial pancreas is an implantable device which contains insulin secreting cells (Langerhans islets), separated from the circulating blood by a semi-permeable membrane to avoid rejection. This paper describes the operation of such a device and evaluates the respective contributions of diffusion and ultrafiltration to the glucose and insulin mass transfer. It is shown that the pressure drop along the blood channel produces across the first half of the channel an ultrafiltration flux toward the islet compartment followed in the second half by an equal flux in reverse direction from islets to blood. The mass transfer analysis is carried out for an optimal geometry in which a U-shaped blood channel surrounds closely a very thin islet compartment formed by a folded flat membrane. A complete model of insulin release by this device is developed and is compared with in vitro data obtained with rats islets. Satisfactory kinetics is achieved with a polyacrylonitrile membrane used in hemodialysis. But the model shows that the membrane hydraulic permeability should be increased by a factor of 10 to significantly improve the performance. PMID- 3279270 TI - Regulation of milk protein synthesis by progesterone in cultured mouse mammary gland. AB - The effect of progesterone on the synthesis of milk proteins, casein and alpha lactalbumin was investigated by culturing mammary explants from mid-pregnant mice in serum-free medium. The addition of progesterone at concentrations above 10 ng/ml inhibited both the casein and alpha-lactalbumin accumulation that were induced by the synergistic actions of insulin, prolactin and cortisol. The maximal inhibition was attained at a progesterone concentration of 100 ng/ml. The maximal level of inhibition of the alpha-lactalbumin accumulation was about 90% in the presence of insulin and prolactin or insulin, prolactin and 0.01 microgram/ml of cortisol. The inhibition of the casein accumulation by progesterone was about 80% in the presence of insulin and prolactin, and about 40% in the presence of insulin, prolactin and 1 microgram/ml of cortisol, indicating that cortisol partially antagonized the action of progesterone on the casein synthesis. When the inhibitory effect of progesterone on the accumulation of both alpha-lactalbumin and casein was examined in cultured mammary tissues from virgin, early pregnant, mid-pregnant and late pregnant mice, the degree of inhibition was markedly reduced in tissue from late pregnant mice. This indicates that the susceptibility of mammary gland to the inhibitory action of progesterone varies with the developmental stage of the tissue. PMID- 3279271 TI - Generation of corticosteroid binder IB from binder II by a sulfhydryl dependent renal cytosolic factor. AB - It has long been debated whether binder IB represents a unique form of the glucocorticoid receptor or is derived from the larger molecular weight form, binder II, by limited proteolysis. Transformed glucocorticoid receptors in kidney, liver and mixed kidney/liver cytosols were examined using anion exchange and gel filtration chromatography. The transformed receptor in liver cytosols chromatographs as binder II on DEAE-Sephadex A-50 anion exchange columns and has a Stokes radius of approx 6.0 nm. The transformed receptor in kidney cytosols chromatographs as binder IB on DEAE-Sephadex A-50 anion exchange columns and has a Stokes radius of 3.0-4.0 nm (3.2 nm on agarose; 3.0-4.0 nm on Sephadex G-100). Using cytosols prepared from mixed homogenates (2 g kidney plus 8 g liver tissue), our experiments show that binder II is converted to a lower molecular weight form (Rs = 3.2 nm on agarose; Rx = 3.9 nm on Sephadex G-100) that is identical to binder IB in its elution position from DEAE-Sephadex anion exchange resin. Identical results are obtained using kidney/liver/cytosols mixed in vitro in which only the hepatic receptor, binder II, is labelled with [3H]TA. These results support the hypothesis that the renal receptor, binder IB, is a proteolytic fragment of binder II and does not represent a polymorphic form of the glucocorticoid receptor. The renal converting activity is dependent on free SH for full activity but is insensitive to the protease inhibitors leupeptin, antipain, and PMSF. The conversion of hepatic binder II to binder IB in in vitro mixing experiments can be prevented if kidney cytosol is gel filtered on Sephadex G-25 and the eluted macromolecular fraction is adjusted to 10 mM EGTA (or EDTA) prior to mixing with the [3H]TA labelled hepatic cytosol. PMID- 3279272 TI - A possible role for progesterone in the preovulatory gonadotropin surge through modulation of LHRH degrading activity. AB - The preovulatory surge of gonadotropins is triggered by estradiol and enhanced to its full magnitude by progesterone. Progesterone may exert this effect through several mechanisms. One of the mechanisms is through the ability of progesterone to induce an increase in the hypothalamic content and release of LHRH. The purpose of this study was to determine if progesterone might not act through yet another mechanism and facilitate LHRH release of the proestrous gonadotropin surge through modulation of luteinizing hormone releasing hormone (LHRH) degrading activity. Sixty-day-old Sprague-Dawley rats were ovariectomized; 14 days later, the estradiol-progesterone milieu of proestrous was mimicked in these animals through the use of estradiol containing silastic implants and subcutaneous progesterone injections. The LHRH degrading activity of the hypothalamus, pituitary and serum were monitored subsequently at preselected time points. In the hypothalamus, estradiol alone was capable of inducing significant increase in degrading activity; progesterone alone had no effect; however, progesterone subsequent to estradiol priming suppressed the increase induced by estradiol alone. In the pituitary, neither estradiol alone nor progesterone alone nor progesterone subsequent to estradiol priming had any significant effect on degrading activity. In the serum, estradiol induced a rapid and significant increase in activity; progesterone alone suppressed activity; progesterone subsequent to estradiol priming induced a similar but more rapid suppression. Therefore, the overall tendency was for estradiol to stimulate and progesterone to suppress LHRH degrading activity in the tissues studied. The results of this study indicate that progesterone has the capacity to suppress LHRH degrading activity and may be one of the mechanisms capable of increasing the availability of LHRH to the anterior pituitary gland thereby facilitating the preovulatory gonadotropin surges. PMID- 3279273 TI - Mathematical means to allow computer calculation of stereotaxic settings. AB - Stereotaxic instruments have wide use in neuroscience research. In certain of these machines the electrode can be introduced at an angle as well as perpendicularly. Computation of instrument settings to place the electrode in the desired location is the problem this paper addresses. Mathematical formulae are presented that allow a computer to calculate instrument settings given coordinates and angles read from a stereotaxic atlas. PMID- 3279274 TI - Bone marrow transplantation for chronic myelogenous leukemia: some thoughts about future prospects. PMID- 3279275 TI - [The role of dopamine in the gastrointestinal tract and its relation to intestinal peptides]. PMID- 3279276 TI - [A 37-year-old woman with cough and bilateral nodular picture on a chest x-ray (clinico-pathological conference)]. PMID- 3279277 TI - [Primary empyema caused by Aspergillus]. PMID- 3279278 TI - [Captopril in the treatment of essential hypertension in old age]. PMID- 3279279 TI - [Diabetic nephropathy]. PMID- 3279280 TI - [New directions in the pharmacologic treatment of arterial hypertension in the elderly]. PMID- 3279282 TI - [Captopril and hypertensive crisis]. PMID- 3279281 TI - [Psychiatric disorders caused by corticoids]. PMID- 3279283 TI - Newer antiarrhythmic drugs. AB - The effective management of cardiac arrhythmias remains a major challenge in cardiovascular therapeutics. The management of arrhythmias encompasses a wide spectrum of supraventricular and ventricular tachyarrhythmias occurring in patients with various cardiac diagnoses and different degrees of myocardial dysfunction. A number of the newer antiarrhythmic drugs that have either recently been released or appear promising are reviewed in this article. Drugs are described with respect to their basic pharmacology, electrophysiologic actions, pharmacokinetics and metabolism, hemodynamics, antiarrhythmic effects, side effects, interactions, indications, and dosage. PMID- 3279284 TI - Amiodarone in the management of cardiac arrhythmias: current concepts. AB - This article reviews current information on the clinical pharmacology, therapeutic utility, and adverse reactions of amiodarone, with emphasis on guidelines for its rational use. PMID- 3279285 TI - Recent issues in antihypertensive drug therapy. AB - Results of recent large scale treatment trials have demonstrated that aggressive management of high blood pressure prevents progression of mild hypertension to the accelerated or malignant phase and reduces incidence of stroke, congestive heart failure, and left ventricular hypertrophy. These trials mostly have utilized a diuretic-based, stepped-care approach to drug therapy, however, and have not shown a consistent beneficial effect of treatment on coronary heart mortality. In addition, the results of studies such as MRFIT have raised questions about serious risks of diuretic treatment in selected patients. These concerns have led to increased use of nonpharmacologic approaches to lowering blood pressure in patients with mild hypertension, but most patients ultimately require drug therapy. Alternative agents to diuretics now being employed as monotherapy in mild hypertension include beta-blockers, calcium channel blockers, ACE inhibitors, alpha-blockers, alpha- and beta-blockers, and, to a lesser extent, centrally-acting sympatholytics and peripheral adrenergic antagonists. Rational use of these agents primarily is based on a careful evaluation of concomitant medical conditions (see Table 3), as well as their mode of action, relative side effects, ease of administration, and cost. Age and race recently have been found to be important determinants of antihypertensive response to agents such as diuretics, beta-blockers, calcium channel blockers, and ACE inhibitors (see Table 3) and appreciation of these relative differences may affect drug selection. When these factors are taken into account, an effective and well tolerated regimen can be tailored to the individual patient. It is hoped that aggressive treatment of hypertension in the future will cause a further decline in cardiovascular mortality in the United States. PMID- 3279287 TI - Calcium channel blockers in systemic hypertension. AB - Alterations in transmembrane flux of calcium ions may be playing a role in the pathophysiology of systemic hypertension. Calcium channel blockers have been shown to be effective antihypertensive drugs with excellent safety profiles. They are efficacious in the long term treatment of systemic hypertension in all population subgroups, and have special applicability for treating patients with hypertensive urgencies and individuals with concomitant diseases such as angina pectoris and arrhythmias. PMID- 3279286 TI - Angiotensin-converting enzyme inhibitors. AB - There is convincing evidence that ACE inhibitors, alone or in combination with a diuretic, effectively lower blood pressure in patients with all grades of essential or renovascular hypertension and that they are of particular benefit as adjunctive therapy in patients with congestive heart failure. The hemodynamic, hormonal and clinical effects of the presently available ACE inhibitors, captopril and enalapril, are comparable and their side effect profiles are extremely favorable. One important difference between the two oral ACE inhibitors, however, is their pharmacokinetics; enalapril's action is slower to begin and is of longer duration. Compared with other agents, ACE inhibitors offer important advantages, among them an improved feeling of well being. It is, therefore, expected that ACE inhibitors will gain greater acceptance by patients and physicians in the future. PMID- 3279288 TI - Serotonin antagonism in the treatment of systemic hypertension: the role of ketanserin. AB - Serotonin has various hemodynamic effects, and may play a role in systemic hypertension. Ketanserin is a specific S2 serotonergic receptor blocker with possible adrenergic blocking activities that has clinical utility in the treatment of hypertension. The drug may have particular advantages for various patient populations. PMID- 3279289 TI - Isolated systolic hypertension in the elderly: pathophysiology and treatment. AB - Isolated systolic hypertension (ISH) is a common clinical finding in the elderly population and appears to be a risk factor for cardiovascular morbidity and mortality. It appears feasible and safe to treat patients with various antihypertensive drugs; however, the morbidity and mortality benefits still need to be determined. PMID- 3279290 TI - [Microsurgically revascularized transplants for covering defects in the midface area]. AB - Radical or palliative resection of tumours in the region of the midface often require a combined approach by maxillary-facial surgeons, as well as by oto-rhino laryngologists. This holds true not only for the excision of the tumour, but also for adequate reconstructive measures. These are necessary to alleviate as much disfiguration as possible, and to ensure correct physiological and mechanical function, i.e. nasal patency and chewing ability. We are aware of the increasingly important role of microsurgically transplanted myocutaneous and osteomyocutaneous flaps. In this paper we demonstrate our operative technique by means of several selected cases, primarily in the use of the following pegged vascularized flaps: 1. free myocutaneous latissimus dorsi flaps, 2. iliac osteomyocutaneous flaps and 3. modified rectus abdominis flaps. PMID- 3279291 TI - A knowledge representation concept facilitating construction and maintenance of large knowledge bases. PMID- 3279292 TI - A reappraisal of co-trimoxazole. PMID- 3279293 TI - Measurement of cytosolic calcium: ion selective microelectrodes. AB - Since the Ca2+-selective neutral carrier was introduced in 1972, Ca2+-selective microelectrodes have been made and used for measurement of Ca2+ activity (effective Ca2+ concentration) in the cytoplasm. Over the last several years, application of the technique has provided valuable information about resting levels and changes of cytosolic Ca2+ activity. This article reviews technical aspects of the electrodes, including their construction, calibration, and determination of cytosolic Ca2+ activity. The Ca2+-selective microelectrodes successfully prepared show the voltage responses of about 20 mV between 10(-6) and 10(-7) M Ca2+, and about 10 mV between 10(-7) and 10(-8) M Ca2+ so that they could be used to monitor changes in cytosolic free Ca2+. However, the techniques of the electrodes are still difficult as compared with those of other ion selective microelectrodes. Some advantages and disadvantages of the techniques are discussed. PMID- 3279294 TI - The effects of calcium on water transport. AB - Some critical level of calcium appears to be necessary for maximum expression of the hydroosmotic effect of vasopressin: both maneuvers which elevate cell calcium or activate calcium-dependent enzymes and maneuvers which diminish cell calcium or inhibit its effect diminish vasopressin-stimulated water flow. It would thus appear that cell calcium might well be maintained at some optimum level for mediating vasopressin-stimulated water flow across epithelia. At the same time, there is considerable evidence supporting vasopressin-elicited alterations in cell calcium and phospholipid metabolism; however, the linkage between these alterations and any eventual effects on water permeability has not yet been established with confidence. PMID- 3279295 TI - Potential role of cytoplasmic calcium ions in the regulation of sodium transport in renal tubules. AB - Experimental maneuvers that increase intracellular calcium ion levels inhibit sodium transport by renal tubules. In the isolated perfused renal tubule, intracellular calcium ion activity (aiCa) changes in response to alterations in the magnitude of the electrochemical potential gradient for sodium ions across the basolateral cell membrane. However, a potassium-induced depolarization of this cell boundary does not cause a rise but rather a fall in intracellular calcium ion levels. Ionomycin raises aiCa without causing intracellular acidification. This observation does not support the view that high cytosolic calcium produces intracellular acidification. At least in the case of ionomycin, the inhibition of sodium transport appears to be due to ionophore-induced increases in aiCa. The changes in intracellular calcium ion concentration found in the different experimental conditions studied were consistent with the notion that cytosolic calcium ions may mediate a feedback mechanism that links the luminal entry to the peritubular extrusion of sodium ions. The mechanisms by which cytosolic calcium alters entry is not yet clear but recent experiments suggest an indirect effect on sodium channel activity. PMID- 3279296 TI - Hormonal modulation of cytoplasmic calcium concentration in renal tubular epithelium. AB - Recent advent in techniques to measure cytosolic calcium concentration significantly stimulated research of signal transduction. The results of the studies of a messenger role of calcium in renal tubular epithelial cells as well as some difficulties encountered in these efforts are briefly summarized below. PMID- 3279297 TI - Measurement of cytosolic calcium: fluorescent calcium indicators. AB - The invention of intracellularly trappable fluorescent indicators of [Ca2+i] has provided an important new way to answer many key questions about the role of Ca2+ and of other messengers in cell activation. Perhaps equally important, the results of these investigations have thrown up many interesting new questions. The suitability of this, or any other method of measuring [Ca2+]i, naturally depends on the tissue, the experimenter, the facilities available and the particular question to be asked. For simply measuring [Ca2+]i, fura-2 and indo-1 are likely to be preferable to quin2, although right now more is known about quin2, its behaviour and its calibration in cells. Anecdotal evidence suggests that indo-1 may have advantages over fura-2 although many more people are presently using fura-2. For manipulating [Ca2+]i by deliberately adding Ca2+ buffering power, quin2 may have advantages and is certainly the tried and tested method. For epithelial cell work, where the relation of the cells to the rest of the tissue and their polarity are critical, suspensions and even monolayer measurements will seldom be adequate. Calcium microelectrodes or single-cell fluorescence techniques will surely be required and rewarding. PMID- 3279299 TI - Parkinson's disease, Alzheimer's disease and the aging brain. Celebrating Professor Melvin D. Yahr on the occasion of his 70th birthday. PMID- 3279298 TI - Role of calcium in chloride-secreting epithelia. AB - There are a number of well-characterized chloride-secreting epithelia. The role of cyclic AMP in mediating chloride secretion in these tissues is well established. The role of calcium is less well established, although a substantial body of evidence points to a significant mediator role of calcium in the modulation of chloride secretion. In some of these tissues, a rise in cytosolic calcium activity in response to secretagogues may potentiate cyclic AMP effects on chloride conductance by the activation of serosally located potassium channels. In addition, in many instances, the effect of a rise in cytosolic calcium may itself be mediated by stimulation of cyclooxygenase products that themselves are known to be chloride secretagogues. Sustained chloride secretion may reflect a synergism between cyclic AMP, calcium, and prostaglandins although such a mechanism is apparent in only some but not all chloride-secreting epithelia. It is hoped that with the application of newer techniques to measure cytosolic calcium concentration and to monitor individual channel activities, we will better understand the exact role of calcium in modulating chloride transport. PMID- 3279300 TI - Parkinson's disease, Alzheimer's disease, and the aging brain. Introduction. PMID- 3279301 TI - Neurochemical pathology and the etiology of Parkinson's disease: basic facts and hypothetical possibilities. PMID- 3279302 TI - Biochemical fundamentals of Parkinson's disease. PMID- 3279304 TI - Lessons from stereotaxic surgery using microelectrode techniques in understanding parkinsonism. PMID- 3279303 TI - Role of the nigrostriatal dopaminergic neurons in mediating the effect of exogenous L-dopa in Parkinson's disease. PMID- 3279305 TI - Options for the etiology of Parkinson's disease: the association with dementia. PMID- 3279306 TI - Speculations on the control of mental and motor functions by dopamine-modulated cortico-striato-thalamo-cortical feedback loops. PMID- 3279307 TI - Mild senile dementia of the Alzheimer's type: diagnostic criteria and natural history. PMID- 3279308 TI - Iron in the brain: implications for Parkinson's and Alzheimer's diseases. PMID- 3279309 TI - Use of a dodecadeoxynucleotide to study repair of the O4-methylthymine lesion. AB - A dodecadeoxynucleotide of defined sequence containing O4-methylthymine was labeled at the 5' end with [32P] by the reaction with (gamma-32P]ATP and polynucleotide kinase. Extracts prepared from bacterial and mammalian sources such as the human cell lines, HeLa and HT29, and rat liver were incubated with the labeled, methylated dodecamer to determine the extent of repair of the lesion. The labeled, demethylated dodecamer was separated from the labeled methylated dodecamer on a reverse-phase column using a shallow methanol gradient. There was complete repair of O4-methylthymine by the E. coli alkyltransferase upon incubation for 4 h at 37 degrees C. There was no detectable amount of demethylated product formed upon incubation with HeLa or HT29 cell extract for the same incubation period. There was also no repair of the O4-methylthymine lesion in the presence of crude rat-liver extract. However, the rat-liver extract alone degraded the methylated substrate completely, and the assay had to be conducted in the presence of NaF, AMP and unlabeled, nonmethylated dodecamer to prevent this. The results obtained from this assay, which is at least an order of magnitude more sensitive than previous methods, are in agreement with previous results that the mammalian alkyltransferase is specific for O6-alkylguanine repair. PMID- 3279311 TI - Mutation cytogenetics: past, present and future. PMID- 3279310 TI - UV mutagenesis in E. coli with excision repair initiated by uvrABC or denV gene products. AB - Mutation frequency responses produced by ultraviolet light are compared in 4 closely related strains of E. coli B/r having the same tyr(Oc) allele and different excision-repair capabilities: uvr+ (excision repair initiated by wild type UvrABC activity), uvrA (excision repair defective), uvrA/pdenV-7 (excision repair initiated by endonuclease V of bacteriophage T4, DenV activity), and uvr+/pdenV-7 (excision repair initiated by UvrABC and DenV activities). The production of Tyr+ prototrophic mutants is classified into back-mutations and de novo or converted glutamine tRNA suppressor mutations to indicate different mutation events. Cells transformed with the plasmid pdenV-7 require larger exposures than the parent strains to produce comparable mutation frequency responses, indicating that DenV activity can repair mutagenic photoproducts. When damage reduction by UvrABC or DenV is compared for each of the specific categories of mutation, the results are consistent with the idea that pyrimidine dimers infrequently or never target back-mutations of this allele, frequently target the de novo suppressor mutations, and extensively or exclusively target the converted suppressor mutations. This analysis is based on the distinction that UvrABC-initiated excision repair recognizes dimer and non-dimer (pyrimidine (6-4) pyrimidone) photoproducts but that DenV-initiated repair recognizes only pyrimidine dimers. PMID- 3279312 TI - Comparison of techniques for monitoring human exposure to genotoxic chemicals. PMID- 3279313 TI - The appropriateness of carotid endarterectomy. AB - Carotid endarterectomy is a commonly performed but controversial procedure. We developed from the literature a list of 864 possible reasons for performing carotid endarterectomy, and asked a panel of nationally known experts to rate the appropriateness of each indication using a modified Delphi technique. On the basis of the panel's ratings, we determined the appropriateness of carotid endarterectomy in a random sample of 1302 Medicare patients in three geographic areas who had had the procedure in 1981. Thirty-five percent of the patients in our sample had carotid endarterectomy for appropriate reasons, 32 percent for equivocal reasons, and 32 percent for inappropriate reasons. Of the patients having inappropriate surgery, 48 percent had less than 50 percent stenosis of the carotid artery that was operated on. Fifty-four percent of all the procedures were performed in patients without transient ischemic attacks in the carotid distribution. Of these procedures, 18 percent were judged appropriate, as compared with 55 percent judged appropriate in patients with transient ischemic attacks in the carotid distribution. After carotid endarterectomy, 9.8 percent of patients had a major complication (stroke with residual deficit at the time of hospital discharge or death within 30 days of surgery). We conclude that carotid endarterectomy was substantially overused in the three geographic areas we studied. Furthermore, in situations in which the complication rate is equal to or above the study's aggregate rate, carotid endarterectomy would not be warranted, even in cases with an appropriate indication, because the risks would almost certainly outweigh the benefits. PMID- 3279314 TI - Current concepts: immunology. Monocytes and macrophages. PMID- 3279315 TI - Edmund Brisco Ford (1902-1988). PMID- 3279316 TI - French medics to go on-line. PMID- 3279317 TI - Malaria. Effective vaccine for humans? PMID- 3279319 TI - DNA repair. Views of unity and diversity. PMID- 3279318 TI - Immunological unresponsiveness induced by recipient cells transfected with donor MHC genes. AB - Immunological unresponsiveness to allografts can be achieved by pretreating recipients with cells (whole blood, erythrocytes, lymphocytes) expressing donor specific histocompatibility antigens. Attempts to determine the relative contribution of class I or class II major histocompatibility antigens and/or minor histocompatibility (miH) antigens towards the induction of an unresponsive state have yielded conflicting results. We have addressed this issue using DNA mediated gene transfer to introduce murine class I or class II major histocompatibility complex (MHC) genes from the organ donor into cells of recipient origin. This allowed murine recipients of cardiac allografts to be pretreated with either donor cells sharing only an isolated class I or class II MHC locus product with the donor organ. We show that pretreatment with either donor class I or class II antigens prolongs survival of cardiac allografts, and that the capacity of a particular donor MHC antigen to induce unresponsiveness is the product of its intrinsic immunogenicity and the antigen load delivered during pretreatment. These results explain discrepancies in earlier studies of antigen induced unresponsiveness and suggest a novel approach to specific immunosuppression in clinical transplantation. PMID- 3279320 TI - Possible demographic consequences of AIDS in developing countries. AB - Simple mathematical models of the transmission dynamics of HIV that incorporate demographic and epidemiological processes to assess the potential impact of AIDS on human population growth and structure in developing countries suggest that AIDS is capable of changing population growth rates from positive to negative values over timescales of a few decades. The disease is predicted to have little if any impact on the dependency ratio of a population, defined as the number of children below age 15 years and elderly people over 64 years, divided by the number of adults between 15 to 64 years. PMID- 3279322 TI - [The greater omentum, a much-used organ]. PMID- 3279321 TI - Nursing shortage and insurance problems: the long-term focus of DHHS' Otis Bowen. Interview by Karen Mitchell. PMID- 3279323 TI - [Metastases seen with the ophthalmoscope; diagnosis and therapy of choroid metastases]. PMID- 3279324 TI - [2 families with malignant atrophic papulosis (Degos disease)]. PMID- 3279326 TI - [Sunlight and melanoma]. PMID- 3279325 TI - [Chemonucleolysis for lumbar nucleus pulposus hernia; efficacy and side effects]. PMID- 3279328 TI - [Dementia in Parkinson disease]. PMID- 3279327 TI - [The Dutch TIA study of the preventive action of very low doses of acetylsalicylic acid and atenolol]. PMID- 3279329 TI - [Diagnosis of uncomplicated urinary tract infections: complicated?]. PMID- 3279330 TI - [A rapid and reliable method for the demonstration of Chlamydia infections]. PMID- 3279331 TI - [Prenatal diagnosis in a primigravida of the short rib-polydactyly syndrome using echography]. PMID- 3279332 TI - The computer screen: a window on the world of biomedical information. PMID- 3279333 TI - Acquired amegakaryocytic thrombocytopenic purpura. Treatment with high-dose dexamethasone pulse therapy and review of the literature. PMID- 3279335 TI - Replacement therapy in hypothyroidism. PMID- 3279334 TI - Medical information--online. A critical review on computer access to medical information. PMID- 3279336 TI - Gastric emptying in man: physiology and effects of medical and surgical therapy. An update. PMID- 3279337 TI - Tetrabenazine therapy of dystonia, chorea, tics, and other dyskinesias. AB - Dopamine receptor blocking drugs, commonly used in the treatment of involuntary movements, may cause potentially serious adverse effects, including tardive dyskinesia. Tardive dyskinesia has not been reported with tetrabenazine, a dopamine-depleting drug. We report a follow-up in 217 patients treated with tetrabenazine for about 18 months (range, 1 to 80). The response was rated on a scale of 0 to 5 (1 = marked improvement, 4 = no response, 5 = worsening). The mean effect from tetrabenazine was rated as follows: 2.3 in 44 patients with tardive dyskinesia, 2.6 in 15 with tardive dystonia, 2.6 in 10 with Huntington's disease, 2.7 in 17 with Gilles de la Tourette's syndrome, 2.8 in 19 with generalized dystonia, 2.8 in 57 with Meige's syndrome, and 3.4 in 25 with other focal dystonias. Twenty-two patients with a variety of unusual movement disorders had a mean effect of 2.9. Parkinsonism occurred as a side effect in 53 patients, sedation in 28, depression in 23, anxiety in 16, insomnia in 11, and akathisia in 10. The choreatic movement disorders are most amenable to tetrabenazine therapy, but tardive and idiopathic dystonia may also be responsive. Tetrabenazine is an effective and relatively safe drug for a variety of hyperkinetic movement disorders. PMID- 3279338 TI - Barbiturate anesthesia in the treatment of status epilepticus: clinical experience with 14 patients. AB - We report our experience using barbiturate anesthesia for the treatment of refractory status epilepticus. Following a retrospective review of eight patients treated with a variety of barbiturates and dosing regimens, we established a specific protocol employing pentobarbital and evaluated it prospectively in six patients. Among the 14 patients, intravenous barbiturates, when administered with a loading dose followed by continuous infusion, were uniformly effective in aborting seizures and producing a burst-suppression EEG pattern. Other than the pupillary light reflex, most patients lost all brainstem reflexes and motor responses during therapy. Barbiturate-induced hypotension was observed in 9 of the 14 patients, and required treatment with pressors in seven cases. Three patients died early as a consequence of their underlying illness, while three others died late for reasons unrelated to the status itself or to anticonvulsant therapy. The time to recovery of function following anesthesia varied highly, spanning hours to days for return of motor function and days to weeks for cognition. Of the eight survivors, four were left with mild cognitive deficits, one returned to his baseline dementia, and three had residual encephalopathies (severe in two). We conclude that barbiturate anesthesia is an extremely effective therapy for refractory seizures. However, its use necessitates recognition of untoward cardiovascular responses and prolonged intensive care. PMID- 3279339 TI - Phantom limbs as reported by S. Weir Mitchell. PMID- 3279340 TI - Localization of kappa-opioid binding sites in the guinea pig cerebellum. AB - The cellular location of kappa-opioid binding sites in the guinea pig cerebellum has been investigated. kappa-Opioid sites were labelled using [3H]ethylketocyclazocine in the presence of mu- and delta-blocking ligands. In vitro autoradiography demonstrated that this kappa-opioid binding was localized predominantly in the molecular layer. Stereotaxic injection of the neurotoxin kainic acid into the guinea pig cerebellum produced a complete abolition of [3H]ethylketocyclazocine binding. These observations indicate that the kappa opioid binding sites within the molecular layer of the guinea pig cerebellum are located on neuronal elements and not cerebellar astrocytes. These conclusions are in contrast with our previous observations regarding the cellular location of kappa-opioid sites in the neural lobe of the rat pituitary. PMID- 3279341 TI - NJ State Commission on Smoking or Health. PMID- 3279342 TI - The aging process: lessons from observations in man. PMID- 3279343 TI - Body composition and aging. PMID- 3279344 TI - Diet, exercise, and chronic disease patterns in older adults. PMID- 3279345 TI - Nutrition, immunity, aging, and cancer. PMID- 3279346 TI - Nutrition and the occurrence and prevention of cardiovascular disease in the elderly. PMID- 3279347 TI - Practical nutrition for the elderly. PMID- 3279348 TI - More hospitals likely to swing beds. PMID- 3279349 TI - In one year and out the other. PMID- 3279350 TI - Bromocriptine in polycystic ovarian disease: a controlled clinical trial. AB - Bromocriptine and placebo were given to a group of 20 polycystic ovarian disease patients on a double-blind, cross-over basis. Patients were studied for three cycles: a baseline cycle without any medication, a placebo-treated cycle, and a bromocriptine-treated cycle with multiple plasma samples taken during the different phases of the menstrual cycle. The clinical response to bromocriptine was compared with that of a placebo for the following hormones: prolactin (PRL), luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio, testosterone, androstenedione, estradiol-17 beta (E2), estrone (E1), and progesterone. Patients were divided into two subgroups: hyperprolactinemic (basal PRL greater than 20 ng/mL) and normoprolactinemic (basal PRL less than 20 ng/mL), and the response of both subgroups to bromocriptine was compared. Prolactin, LH/FSH ratio, testosterone, and E1 showed a significant drop with bromocriptine, whereas E2 significantly increased. Two out of nine amenorrheic polycystic ovarian disease patients menstruated during bromocriptine treatment, and three patients showed evidence of ovulation. PMID- 3279353 TI - Computerized analysis of resting fetal heart rate tracings. AB - Previous attempts to computerize the analysis of fetal heart rate (FHR) using mainframe or minicomputers were not accepted in routine clinical practice because of their complexity, cost, and lack of validation. We describe the first practical, inexpensive system integrated into a clinical protocol that analyzes and documents FHR baseline, long-term variability, and episodic events using a standard microcomputer. A comparison of computerized and manual analyses of 284 nonstress tests (NSTs) of high-risk patients revealed no significant differences in determining the number of acceleration and deceleration events and mean FHR baseline. Long-term variability and other reported data could not be compared for lack of manual techniques. The combination of standardized analysis and quantified data may improve the predictive value of the computerized NST compared with the visually analyzed NST. Other benefits include computerized archiving, data transmission by telephone, and linkage to a perinatal data base. PMID- 3279352 TI - A modified biophysical profile for antenatal fetal surveillance. AB - Three hundred thirty-seven high-risk pregnancies were screened using a modified biophysical profile consisting of nonstress testing (NST) and ultrasound evaluation of amniotic fluid volume. Ultrasound assessment of fetal breathing and body movements was performed only to evaluate the nonreactive NST. Decreased amniotic fluid volume and spontaneous fetal heart rate (FHR) decelerations were considered abnormal findings during antenatal testing, and served as indications for delivery regardless of FHR reactivity. Despite intervention, decreased amniotic fluid volume and spontaneous decelerations were associated with an increased incidence of meconium staining, decelerations during labor, cesarean section for fetal distress, and small for gestational age infants. Perinatal morbidity also occurred in patients with spontaneous decelerations and normal amniotic fluid volume. The search for spontaneous FHR decelerations by electronic fetal monitoring should continue during antepartum testing because FHR decelerations cannot be identified by conventional ultrasound assessment. The modified profile seems practical for routine assessment of fetal well-being in high-risk pregnancy, and affords insights unavailable with ultrasound surveillance alone. PMID- 3279351 TI - Prevention of puerperal lactation by a single oral administration of the new prolactin-inhibiting drug, cabergoline. AB - To evaluate the efficacy of a single oral administration of the new ergot derivative Cabergoline in the prevention of post-partum lactation, we compared the effects of three different doses of the drug with those of placebo in 32 puerperal women. In a controlled, double-blind trial, the subjects were randomly allocated to four treatment groups receiving either placebo or 400, 600, or 800 micrograms Cabergoline (N = 8 in each group) within 24 hours after delivery. Treatment efficacy was assessed clinically by physical examination before (day 0) and at one, two, three, four, and 14 days after treatment. Plasma prolactin (PRL) concentrations were measured in blood samples collected before and at one, two, three, and four days after treatment. Lactation was prevented in four of the eight subjects (50%) who received 400 micrograms Cabergoline and in all subjects who received 600 or 800 micrograms Cabergoline. By contrast, only one of the eight subjects (12.5%) receiving placebo showed no signs of spontaneous lactation within the 14 days after delivery. No effects of placebo administration on plasma PRL levels were observed. Plasma PRL concentrations were significantly reduced starting from one day after Cabergoline administration, however, and the amount of inhibition of PRL secretion induced by different doses of the drug was not statistically different. These preliminary data demonstrate that Cabergoline has a dose-related effect in the prevention of postpartum lactation, and milk secretion can be prevented completely by a single oral administration of 600 or 800 micrograms of the drug. PMID- 3279354 TI - A comparison of culture, direct fluorescent antibody test, and a quantitative indirect immunoperoxidase assay for detection of Chlamydia trachomatis in pregnant women. AB - An indirect immunoperoxidase assay that quantitates antichlamydial immunoglobulin G (IgG) and IgA antibodies in serum was compared with endocervical culture and direct fluorescent antibody (MicroTrak) for detection of Chlamydia trachomatis in asymptomatic pregnant women. Of the 64 women tested by the three methods, 22 (34%) had antichlamydial IgG and IgA in their serum. The culture was positive in nine patients (14%) and the MicroTrak was positive in eight (12.5%). All positive cultures were immunoperoxidase-positive. One positive MicroTrak was immunoperoxidase- and culture-negative. Thirteen patients had IgG and IgA antichlamydial antibodies with no organisms detected in the endocervix by culture or by direct fluorescent antibody screen. PMID- 3279357 TI - Placenta percreta: ultrasound diagnosis and conservative surgical management. AB - Placenta percreta is a rare yet serious complication of pregnancy. Only an occasional case has been managed conservatively without hysterectomy. We report a case of placenta percreta managed conservatively at 16 weeks' gestation by oversewing the uterine defect created by the protruding placenta and continuing the pregnancy for an additional eight weeks. The diagnosis of placenta percreta was made again at 26 weeks' gestation by ultrasonography, and a placenta increta to within 1 mm of the serosa was confirmed histologically. This case is added to the five cases of placenta percreta managed by conservative operative therapy. PMID- 3279355 TI - Detection of human ovarian tumor-associated antigens by sandwich enzyme immunoassay. AB - Immunoglobulin G (IgG) complexes were isolated from the ascitic fluids of patients with serous cystadenocarcinoma of the ovaries, and antiserum against the IgG complexes was raised in rabbits. The antibodies reacting with the tumor associated antigens were purified after the rabbit antihuman IgG was removed by affinity chromatography on IgG coupled to agarose. The purified antibodies recognized antigens on two human ovarian cell lines and several fresh ovarian tumor specimens, but did not react with nongynecologic tumors. The purified antibodies (IgG) were labeled with alkaline phosphatase, and a noncompetitive enzyme immunoassay was developed to detect the tumor-associated antigens in the sera of patients with ovarian cancer. The levels of tumor-associated antigens detected by this assay were found to be two to four times higher in patients with ovarian cancer than in controls. Levels of tumor-associated antigens were higher in patients with high levels of CA 125, although a direct correlation was not observed with the levels of CA 125 in these patients. PMID- 3279358 TI - Asymptomatic uterine retroversion at 36 weeks' gestation. AB - Approximately 11-19% of pregnancies begin in a retroverted uterus. If spontaneous displacement does not occur, fundal impaction may be manifest by 14-16 weeks. We present a report of persistent retroversion discovered at 36 weeks' gestation. A "pelvic mass" was misdiagnosed as posterior sacculation of the uterine wall. We include a review of the literature with regard to incidence, complications, and management of this sometimes confusing condition. PMID- 3279359 TI - Treatment of cervical pregnancy with methotrexate. AB - A case of cervical pregnancy was treated successfully with methotrexate. We used serial beta-human chorionic gonadotropin levels, magnetic resonance imaging, and sonography to diagnose the pregnancy and monitor therapy. Hysterectomy was avoided, and the patient's reproductive capability was preserved. Toxicity was limited to transient elevation of liver transaminases. PMID- 3279356 TI - Malignancy arising in endometriosis associated with unopposed estrogen replacement. AB - Malignant transformation of endometriosis is a well documented phenomenon. Although it occurs most commonly in the ovaries, there have been approximately 50 reported cases of extraovarian malignant transformation of endometriosis. This paper presents two cases of malignancy arising from a dormant focus of endometriosis after total abdominal hysterectomy, bilateral salpingo oophorectomy, and exogenous estrogen replacement therapy. These malignancies are often well differentiated and may behave similarly to estrogen-induced endometrial carcinomas. After surgical castration of a premenopausal woman with endometriosis, the use of progestins in replacement therapy may reduce the risk of malignancy arising in endometriosis. PMID- 3279360 TI - Endometriosis of the sciatic nerve: a report of two cases and a review of the literature. AB - Endometriosis of the sciatic nerve is rare but must be included in the differential diagnosis of sciatic pain. Patients present with typical signs and symptoms of sciatica, which are cyclic in nature. Electromyography and computed tomographic scanning are useful in diagnosis. At laparoscopy or laparotomy, a characteristic "pocket sign" is frequently seen, and may be the only clue to the presence of endometriosis. The patient often requires definitive surgery with total abdominal hysterectomy and bilateral salpingo-oophorectomy. However, conservative surgery with excision of the endometriosis from the nerve can be successful in selected patients who wish to preserve reproductive function. PMID- 3279361 TI - Pregnancy and liver transplantation. AB - A pregnancy after an orthotopic liver transplantation was associated with abruptio placentae and preterm delivery at 27.5 weeks. The mother's immediate postpartum period was complicated by a midgut volvulus through a mesenteric defect in the Roux-en-Y loop. Both mother and infant survived after prolonged hospitalization. PMID- 3279362 TI - Acute focal pyelonephritis (lobar nephronia) complicating pregnancy. AB - Lobar nephronia, although initially indistinguishable from acute pyelonephritis, is characterized by a prolonged febrile course. The diagnosis is established radiographically using computed tomography. Treatment involves continuation of antimicrobials until the patient has been afebrile for 48 hours. Lobar nephronia has not been previously reported with pregnancy. PMID- 3279364 TI - Inferior limbal traction suture. PMID- 3279363 TI - Medicare premiums are rising; physicians should not be blamed. PMID- 3279365 TI - The triple procedure--results in cataract patients with corneal opacity. AB - Beginning in May 1984, we performed penetrating keratoplasties in combination with extracapsular cataract extractions and implantations of posterior chamber lenses in 21 patients. In addition to cataracts, 15 of these elderly patients presented Fuchs' dystrophy and 6 had corneal scars due to infectious or inflammatory corneal diseases. In 2 of the 21 eyes, keratoplasty was a repeat operation because of graft rejection or graft dystrophy. With a mean follow-up of 22 months, visual rehabilitation was satisfactory: 15 patients (71%) achieved a postoperative corrected visual acuity of 6/12 or better. Postoperative deviation from preoperatively calculated refractive lens power--the only major problem- remained within +/- 2 dptr in 95% (20 eyes), with an error of + 4 dptr in 1 eye (5%). In all 21 eyes, clear corneal grafts were obtained. Thus we consider the triple procedure to be the treatment of choice in cataract patients with corneas opacities. PMID- 3279367 TI - [Intra-aortic diastolic counterpulsation in intensive cardiologic practice]. PMID- 3279366 TI - Effect of changing medication regimens in glaucoma patients. AB - When glaucoma medication fails to adequately control intraocular pressure (IOP), a second medication is frequently added. Before adding a second drug to patients whose IOP was no longer controlled by 0.5% timolol, we tested the effect of switching to another beta blocker, levobunolol (0.5 or 1%). We also evaluated the effect of study participation on compliance in the control group continuing to receive 0.5% timolol. In each treatment group, the IOP of approximately 30-40% of the patients was successfully controlled for the 3-month study period. The remaining patients did not exhibit significant pressure reductions and were dropped from the study within 2 weeks. We concluded that (1) the results of 'switch' studies without a control group must be interpreted carefully, and (2) the initiation of a 'new regimen' with an equieffective beta blocker may be sufficient to increase compliance and thereby control IOP. PMID- 3279368 TI - [Multiple tumors]. PMID- 3279369 TI - [Lajos Kossuth and health]. PMID- 3279370 TI - [Data on the history of smallpox vaccination in Hungary]. PMID- 3279371 TI - [Hungarian physicians graduating in Halle]. PMID- 3279372 TI - [Aseptic femur neck necrosis (Perthes disease) in childhood and the current status of its management]. PMID- 3279373 TI - [Experience with the treatment of Hodgkin's disease (1975-1986)]. PMID- 3279374 TI - [Emotional disorders in adolescence]. PMID- 3279375 TI - [Parlodel: a new therapeutic possibility in the management of Parkinson disease]. PMID- 3279376 TI - [Pathographies on Istvan Szechenyi]. PMID- 3279378 TI - Jane Delano: a nursing pioneer remembered. PMID- 3279377 TI - [Commemoration of a famous family of physicians on medals]. PMID- 3279379 TI - [Use of cultured epidermis of human origin for demonstrating the acantholytic action of staphylococcal exfoliatin A]. AB - Cultured human epithelia obtained from epidermal cells in vitro were used to assay the activity of staphylococcal epidermolytic toxin and develop an in vitro experimental model for the staphylococcal scalded skin syndrome. Human epidermal cells were grown from single epidermal cell suspensions obtained through trypsinization of adult normal skin into multilayered epithelia (with a basal cell layer, several intermediate and one or two upper layers) on mouse 3T3 feeder cells. First passage cultures were incubated with exfoliative toxin A from phage Group II staphylococci at various concentrations in DMEM. They were examined at various time intervals by direct microscopic and histological examination of respectively the culture plates or the epidermal sheets after their detachment from the plates with dispase grad II. A total exfoliation could be obtained at 24 hour at concentrations of Img and 500 micrograms/ml, only local areas of epidermolysis noted at 100 micrograms/ml. The intraepithelial separation was noted to occur between the basal layer and the lowest intermediate layer. No exfoliation could be observed at lower concentrations. Up to 4-5 hours few changes were evident, but at this time small areas of epidermolysis developed. With exfoliatin 100 micrograms/ml, intraepidermal blisters were clearly visible, occurring either between the basal cells and the lowest intermediate layer or between the first two intermediate cell layers. At the ultrastructural level, desmosomes were sparse and altered, with enlargement of the intercellular spaces and condensation of tonofilaments. These data indicate that human epidermal cell cultures, although their differentiation in culture only mimics what occurs in vivo, can be used as an in vitro model of the staphylococcal TEN to further investigate the site of action of such a toxin and the cellular mechanism responsible for the syndrome. PMID- 3279381 TI - [In vitro sensitivity of Aspergillus to terbinafine: comparative study on amphotericin B, 5-fluorocytosine and ketoconazole]. AB - Terbinafine, a new antifungal agent derived from allylamine, effective by oral route, was tested against 32 different strains of Aspergilli to determine its in vitro efficiency compared with amphotericin B, 5-fluorocytosine and ketoconazole. Antifungal sensitivity was determine by the MIC method in liquid and solid mediums (Sabouraud, Casitone, YMA, YMB, YNB): with MIC between 0.005 and 5 micrograms/ml, whatever the species and the techniques, terbinafine is more efficient than amphotericin B, ketoconazole (0.5 to 100 micrograms/ml) and 5-FC (1-greater than 100 micrograms/ml). PMID- 3279380 TI - [Correlation between the IgG oligoclonal pattern and the benign nature of monoclonal abnormalities in the aged subject]. AB - The presence of an IgG oligoclonal pattern was investigated by isoelectric focusing and immuno detection in 151 individuals over 60 years of age. One hundred are individuals with no detectable monoclonal anomaly and among them, 22 exhibit an oligoclonal pattern. The others are 27 patients with a benign and 24 with a malign monoclonal dysglobulinemia, including respectively 9 and 2 oligoclonal patterns. In all groups the oligoclonal pattern is always found among the oldest individuals. The small association found between this special distribution of the IgG and the benign monoclonal dysglobulinemia seems to be most probably in favour of aging. The IgG oligoclonal distribution associated to a monoclonal component would not be a discriminating argument for malignant or benign monoclonal proliferation diagnosis. PMID- 3279382 TI - [Effects of weightlessness on phospho-calcium metabolism and its hormonal regulation in man during the 51 G Franco-American space flight]. AB - During the 51 G franco-american mission in weightlessness, calcium metabolism and hormonal regulation were analyzed in two astronauts (a male, a female) before (30,7 and 4 days) and after (0,2 and 5 days) the 7-day spaceflight. Calcium, phosphate, alkaline phosphatase, GLA protein, 25 hydro-vitamin D, 1-25 dihydroxyvitamin D, parathyroid hormone, 24 h urinary calcium, total, dialysable and nondialysable hydroxyproline and glycosaminoglycans (GAG) were measured in blood and urine. Only urinary parameters are increased after space flight. Blood parameters, in particular hormone measurements, are unchanged. The data indicate stimulation of resorptive activity which could result in bone matrix atrophy and demineralisation. On the contrary, no bone formation impairment is noted since alkaline phosphatase and GLA protein are unchanged. These changes are not dependent on hormonal variations. They could only reflect the mechanical bone adaptation to weightlessness. PMID- 3279383 TI - [Comparative study of two methods of determining plasma and salivary theophylline]. AB - A new method for theophylline assay (Aris method), uses an immuno enzyme assay on a solid-phase (strips). We compared it to a HPLC method for 33 plasma samples and 85 saliva samples in children and adults. The correlation-coefficient between the two methods is highly significant (r = 0.976 for plasma samples and r = 0.99 for saliva samples) although we found a significant difference: the average difference is 0.789 microgram/ml for plasmatic levels and 0.55 microgram/ml for saliva levels. The values are rather low and remain widely satisfactory for posology adaptations. The reproducibility of the Aris method is similar to the HPLC method. Its sensitivity is quite satisfactory and can be improved. Yet the good correlations we obtained for plasma as well as for saliva, the rapidity, simplicity, specificity and low cost of this new technique should make the theophylline estimation easier in hospitals and laboratories. PMID- 3279385 TI - [Elimination of various virulence plasmids by antibiotics]. AB - The pathogenicity of some enterobacteria is due to a plasmid encoding for outer membrane proteins or for toxins. The elimination of the plasmid gives a non virulent strain. We have tried to eliminate plasmids encoding for the thermostable toxin of Escherichia coli (plasmid pCSltl) or for the enteroinvasive property of Shigella (plasmids pWR24, pHW401, pWR110), of Salmonella (plasmid pSD6) and of Yersinia (plasmids pYL4 and P4). The loss of plasmid was confirmed by agarose gel electrophoresis of a crude lysate. Fourteen antibiotics belonging to different chemical families were used at subinhibitory concentration. A control experiment without antibiotic was carried out to detect spontaneous loss of plasmids. No antibiotic was able to eliminate plasmids pCSltl, pHW401, pSD6, pYL4. Novobiocin eliminated pWR24 and pWR110, rifampicin eliminated pWR110 and P4. Three other antibiotics gave a cure of bacteria harbouring plasmids pWR110 and P4 but the percentage of cure was too low for a therapeutical interest. PMID- 3279384 TI - [Influence of fever on cefotaxime pharmacokinetics]. AB - The role of fever on cefotaxime disposition was studied in ten hyperthermic patients. Each subject received intravenously 1 g of cefotaxime on two separated occasions, first when the body temperature was more than 39 degrees C then during a basal state (37 degrees C). Blood samples were taken over 12 hours and urine was collected for 24 hours after injection. After dosing cefotaxime and its metabolite by high performance liquid chromatography, the pharmacokinetic parameters were calculated, especially: plasma and renal clearance, volume of distribution at steady state, area under the curve, and elimination half-life. There is no significant difference in cefotaxime and desacetylcefotaxime disposition between these two states. Hyperthermia has no influence on pharmacokinetics of this cephalosporin. PMID- 3279386 TI - [In vitro bacteriostatic and bactericidal effect of ciprofloxacin and others quinolone derivatives on Campylobacter jejuni]. AB - The in vitro bacteriostatic (MIC) and bactericidal (MBC) activities of ciprofloxacin and seven other quinolone derivatives on Campylobacter jejuni from human origin were determined. Ciprofloxacin, pefloxacin and rosoxacin exhibited the best bacteriostatic and bactericidal activities. For the three compounds the MIC90 was less than or equal to 0.33 microgram/ml while the MBC90 was resp. 0.36, 0.56 and 0.56 microgram/ml. The MBC values were always significantly higher than the MIC values (P less than 0.001). An attempt was made to select strains with an induced resistance against the quinolone derivatives. PMID- 3279387 TI - [Acid lipases and acid cholesterol esterases: Wolman's disease and cholesteryl ester storage disease]. AB - In the first part of the review are reported the properties of mammalian acid lipases and cholesterol esterases. Lysosomal acid lipase differs from the other acid or neutral lipases by its subcellular localization and a large substrate specificity on natural lipids, triglycerides and cholesteryl esters and on semi synthetic or synthetic coloured or fluorescent substrates; the enzymatic activity of acid lipase depends on the presence of detergents and phospholipids and the structural properties are well known. In vivo, lysosomal acid lipase hydrolyses neutral lipids from exogenous origin (lipoprotein). The second part is an updated review on the diseases caused by hereditary acid lipase deficiency: Wolman's disease occurring in the first months of life and fatal before the age of one year and Cholesteryl Ester Storage Disease, a more benign form with normal lifespan. Both diseases are characterized by massive storage of neutral lipids. Molecular and metabolic pathways, new diagnostic tools used for the diagnosis and experimental cellular model systems are reviewed and discussed. PMID- 3279388 TI - [Virus and insulin-dependent diabetes mellitus. Etiopathogenic perspectives]. AB - Epidemiologic studies suggest an association between insulin dependent diabetes mellitus and viral infections. Several candidates like cytomegalovirus, Coxsackie virus and hepatitis virus have a selective tropism for beta cells. Progress in the understanding of the pathogenic importance of such viruses has been facilitated by animal models with virus induced diabetes and infections of human pancreatic beta cells maintained in culture. Immunological studies of type I diabetes after viral infections suggest that virus may trigger pancreatic autoimmunity. Molecular mimicry between viral and tissue antigens may represent a possible mechanism. Loss of immune tolerance toward beta cells would only appear in genetically predisposed individuals. The better understanding of the pathogenesis of type I diabetes mellitus brings out new approaches to treatment. PMID- 3279389 TI - Identification of Pseudomonas, Flavobacterium, and Alcaligenes with the API 20 NE system. AB - The API 20 NE system is designed for the rapid identification of Gram negative rods other than Enterobacteriaceae. It has been compared to conventional methods in the characterization of 404 strains representative of 23 species belonging to 3 genera: Pseudomonas (236 strains), Flavobacterium (133 strains) and Alcaligenes (35 strains). The system consists of 9 enzymatic tests and 12 carbohydrate assimilation tests. A 7-digit numerical profile is obtained by an octal coding of the test results. The strains are identified by comparing the numerical profile to those of species listed in a profile index. The API 20 NE tests showed 99-100% correlation with corresponding conventional methods except in indole production (96.5%) for which we observed 14 false negative reactions in testing F. meningosepticum and CDC groups IIb and IIf. The API 20 NE system presented 94.1% identification to the species level and 96.3% to the genus level in agreement with conventional biochemical methods. Among the correctly identified strains, 7.4% (30) gave an erroneous or unlisted numerical profile in the first version of the Profile Index and required the use of the computer. Among the misidentified strains 2%, (8) were assigned to the right genus but wrong species, 0.7% (3) were placed in the wrong genus and 1% (4) gave a doubtful profile with one or more tests compared to the profiles listed. PMID- 3279390 TI - Protein binding sites on Escherichia coli 16S ribosomal RNA; RNA regions that are protected by proteins S7, S9 and S19, and by proteins S8, S15 and S17. AB - Selected groups of isolated 14C-labelled proteins from E. coli 30S ribosomal subunits were reconstituted with 32P-labelled 16S RNA, and the reconstituted complexes were partially digested with ribonuclease A. RNA fragments protected by the proteins were separated by gel electrophoresis and subjected to sequence analysis. Complexes containing proteins S7 and S19 protected an RNA region comprising helices 29 to 32, part of helix 41, and helices 42 and 43 of the 16S RNA secondary structure. Addition of protein S9 had no effect. When compared with previous data for proteins S7, S9, S14 and S19, these results suggest that S14 interacts with helix 33, and that S9 and S14 together interact with the loop-end of helix 41. Complexes containing proteins S8, S15 and S17 protected helices 7 to 10 as well as the "S8-S15 binding site" (helices 20, 22 and parts of helices 21 and 23). When protein S15 was omitted, S8 and S18 showed protection of part of helix 44 in addition to the latter regions. The results are discussed in terms of our model for the detailed arrangement of proteins and RNA in the 30S subunit. PMID- 3279391 TI - A heat shock element in the phosphoglycerate kinase gene promoter of yeast. AB - The phosphoglycerate kinase (PGK) promoter is often employed in yeast expression vectors due to its very high efficiency. Its activity in unstressed cells has been shown to be due to an upstream activator site (UASPGK) at -402 to -479. Since levels of PGK mRNA can sometimes be elevated by heat shock of yeast cultures this investigation determined how specific deletions of PGK promoter sequences effect levels of PGK mRNA both before and after heat shock. A series of PGK promoter deletions was inserted on a high copy plasmid into cells having a TRP1 gene disruption of the solitary chromosomal PGK locus. This enabled PGK transcripts of plasmid and chromosomal origin to be distinguished by virtue of their different sizes. Certain deletions lacking UASPGK displayed activities that were very low in unstressed cells, but which increased fifty to one-hundred fold after heat shock. With UASPGK present heat shock had only a relatively small or negligible effect on PGK mRNA levels. Heat shock activation was abolished when the -256 to -377 region with homology to the heat shock element consensus of eukaryotes was deleted in addition to UASPGK, but was unaffected by the deletion of regions further downstream containing TATA- and CAAT- sequence motifs. This is the first demonstration of a heat shock element, an activator site normally found upstream of eukaryotic heat shock protein genes, as a natural constituent of a high efficiency glycolytic promoter. It is proposed that PGK may be one member of a small subset of yeast genes that are highly expressed in unstressed cells yet possess a heat shock element to ensure their continued transcription after heat shock. PMID- 3279392 TI - The protein factor which binds to the upstream activating sequence of Saccharomyces cerevisiae ENO1 gene. AB - Using a gel retardation assay it was shown that the 87 bp DNA fragment (UAS87) containing the upstream activating sequence (UAS) of S. cerevisiae EN01 gene and a nuclear extract gave rise to three migration-retarded species specific to UAS87. Heat- or proteinase-treatment of the nuclear extract revealed that these species were protein-DNA complexes. The precise binding region of the protein identified by DNaseI protection analysis was found to include a CCAAACA sequence which forms a dyad-symmetrical structure. The amount of one of the three migration-retarded species significantly increased when cells were grown in medium containing a gluconeogenic carbon source. The introduction of pGCR8, a multicopy plasmid containing GCR1 gene, a regulatory gene controlling the expression of several glycolytic enzymes, showed no effect on the amount of three migration-retarded species. PMID- 3279393 TI - Sigma elements are position-specific for many different yeast tRNA genes. AB - We determined the DNA sequence of seventeen sigma elements and flanking regions in order to investigate the extent of the association between the yeast repetitive element, sigma, and tRNA genes. Fifteen of seventeen sigma elements analyzed begin at position -19 to -16 with respect to the 5' end of a tRNA-coding sequence. This region is close to the initiation point of tRNA gene transcription and contains a sequence which is modestly conserved for a number of tRNA genes. Two pairs of identical sigma elements occur as the long terminal repeats of a sequence which, together with flanking sigma elements, has the structural properties of a retrotransposon; this element has been named Ty3 (manuscript submitted). Hybridization analysis of yeast chromosomal DNA separated by orthogonal field alternation gel electrophoresis (OFAGE) showed that Ty3 and isolated sigma elements are distributed over many chromosomes in the yeast genome. PMID- 3279394 TI - Nucleotide sequencing of the ruv region of Escherichia coli K-12 reveals a LexA regulated operon encoding two genes. AB - The nucleotide sequence of a 2505 bp region of the Escherichia coli chromosome containing the LexA regulated ruv gene has been determined. A sequence of 1631 bp encoding two non-overlapping open reading frames that constitute a single operon and which specify polypeptides with predicted molecular weights of 22172 daltons and 37177 daltons respectively, was identified as the most probable sequence for ruv. Each of the two open reading frames, designated ruvA and ruvB, is preceded by a reasonable Shine-Dalgarno sequence. Two 16 bp sequences (SOS boxes) that match the consensus sequence for binding LexA protein are located 5' to ruvA in a region that provides a possible single promoter for expression of both ruvA and ruvB, with the second SOS box overlapping the putative -35 region. A possible transcriptional terminator is located 137 bp downstream of ruvB. The amino acid sequence predicted for RuvB contains a region that matches a highly conserved sequence found in several DNA repair and recombination proteins that bind ATP. PMID- 3279397 TI - Nucleotide sequences of the penicillin-binding protein 5 and 6 genes of Escherichia coli. PMID- 3279395 TI - Accurate in vitro cleavage by RNase III of phosphorothioate-substituted RNA processing signals in bacteriophage T7 early mRNA. AB - To test the ability of an RNA processing enzyme to cleave chemically-modified RNA substrates, RNA transcripts containing RNase III cleavage sites were enzymatically synthesized in vitro to contain specific phosphorothioate diester internucleotide linkages. One transcript (R1.1 RNA) was generated using phage T7 RNA polymerase and a cloned segment of phage T7 DNA containing the R1.1 RNase III processing site. The second transcript was the phage T7 polycistronic early mRNA precursor, which was synthesized using E. coli RNA polymerase and T7 genomic DNA. The RNA transcripts contained phosphorothioate diester groups at positions including the scissile bonds. The modified RNAs were stable to incubation in Mg2+ containing buffer, and were specifically cleaved by RNase III. RNA oligonucleotide sequence analysis showed that the modified R1.1 RNA processing site was the same as the canonical site and contained a phosphorothioate bond. Furthermore, RNase III cleaved the phosphorothioate internucleotide bond with 5' polarity. RNase III cleavage of phosphorothioate substituted T7 polycistronic early mRNA precursor produced the same gel electrophoretic pattern as that obtained with the control transcript. Thus, RNase III cleavage specificity is not altered by phosphorothioate internucleotide linkages. PMID- 3279398 TI - 'One minute' transformation of competent E. coli by plasmid DNA. PMID- 3279396 TI - Identification of defined sequences in domain V of E. coli 23S rRNA in the 50S subunit accessible for hybridization with complementary oligodeoxyribonucleotides. AB - The accessibility of specific sequences in domain V of E. coli 23s rRNA in the 50S subunit to complementary oligodeoxyribonucleotides (cDNA) has been investigated. The apparent percentage of subunits engaged in complex formation was determined by incubation of radiolabeled cDNA probe with 50S subunits, followed by nitrocellulose membrane filtration of the reaction mixtures and measurement of the bound radiolabeled cDNA probes by liquid scintillation counting of the filters. The site(s) of hybridization were determined by digestion of the RNA in the RNA/DNA heteroduplex by RNase H. The results of this study indicated that single-stranded sequences, 2058-2062, 2448-2454, 2467-2483, and 2497-2505 were available for hybridization to cDNA probes. Bases 2489-2496, which have been postulated to be base paired with 2455-2461 were also accessible for hybridization. PMID- 3279400 TI - Selected list of nursing books and journals. PMID- 3279399 TI - Insights from life in the trenches. PMID- 3279401 TI - Microcomputer-based bibliographic searching. PMID- 3279402 TI - The prime of Miss A. Lethbridge. PMID- 3279403 TI - Alzheimer's disease. Involving nursing in the development and implementation of health care for patients and families. AB - This article focuses on integrating nurses into the development, implementation, and evaluation of clinical, inpatient, community-based, and in-home services for patients with Alzheimer's disease and for their families. PMID- 3279404 TI - Pathophysiology and etiology of Alzheimer's disease. AB - Morphologic, neurochemical, and physiologic alterations in the brain constitute the biologic correlates of aging and of progressive, irreversible deterioration in mental function and personality characteristics of Alzheimer's disease. PMID- 3279405 TI - Nursing assessment of the incontinent geriatric outpatient population. AB - The key to effective management of urinary incontinence is a comprehensive evaluation that accurately characterizes the type of incontinence and, if possible, identifies the underlying etiology. The nurse has a vital role in the initial assessment of the incontinent elderly individual in the outpatient setting. By obtaining a thorough history and physical examination, a voiding diary, and simple laboratory tests, the nurse can make a preliminary diagnosis of the type of incontinence. In simple, uncomplicated cases, the nurse might initiate a trial of behavioral treatment prior to further evaluation. In complex cases, referral for further gynecologic or urologic evaluation may be initiated. PMID- 3279406 TI - Sources of stress among families caring for relatives with Alzheimer's disease. AB - We have described the different sources of stress and burden that are imposed by caring for a family member with AD. We have provided an approach to assessing each of these possible sources of stress and burden and have indicated how such assessments must take a family-based approach and consider the broader social roles and family dynamics that may color the way in which family members view and carry out their caregiving roles. PMID- 3279407 TI - Nursing interventions for patients with Alzheimer's disease. AB - Common nursing concerns and patient needs within the physical, emotional, cognitive, and social dimensions are addressed. Nursing interventions that help the patients maintain the maximum level of independence for as long as possible are suggested. PMID- 3279408 TI - Group B streptococcal endocarditis in a neonate. AB - This is a case of bacterial endocarditis and dissecting aneurysm of the ascending aorta secondary to group B streptococcal (GBS) septicemia in a one-mouth-old infant girl who presented with meningitis. A large aortic vegetation and a large dissecting aneurysm of the root of the aorta were detected by two-dimensional (2D) echocardiography. Apparently the infant did not have any preexisting cardiac anomaly. She received intravenous ampicillin for six weeks. She also underwent successful surgery for the replacement of the ascending aorta with an aortic homograft. This occurrence reemphasizes the value of 2D echocardiography in detecting vegetations for endocarditis. PMID- 3279409 TI - Plasma levels of hydroxy-flutamide in patients with prostatic cancer receiving the combined hormonal therapy: an LHRH agonist and flutamide. AB - The present study describes a method for the measurement of the plasma levels of hydroxy-flutamide (Flu-OH), the biologically active and main circulating metabolite of flutamide. We have observed that two to four hours after oral administration of 250 mg of flutamide to healthy young men, as well as to patients with prostate cancer, the plasma concentration of Flu-OH reaches a peak at approximately 1.7 microM. The plasma concentration of Flu-OH measured at months 6, 12, and 18 of treatment shows a minimal basal level of 3.4 microM with a maximal increase at 6.8 to 8.5 microM at 2 to 4 hours. Since the serum levels of testosterone in these patients are approximately 1 nM, the levels of the active antiandrogen are at a 5000- to 10000-fold excess. However, due to the low affinity of the antiandrogen for the androgen receptor, it is extremely important to maintain this concentration of the antiandrogen in plasma constant. PMID- 3279410 TI - Smoking, catecholamines, and the ischemic myocardium. AB - Catecholamine stimulation increases the heart rate and the force of cardiac contraction. Cardiac output then increases, with a decrease occurring in total peripheral resistance due to smooth muscle dilation in the vascular beds of the muscle and heart, though there is constriction of the skin and viscera; this leads to a net decrease in total peripheral resistance. Consequently, systolic pressure rises and diastolic pressure falls. The net effect is to increase myocardial oxygen demand. Smoking stimulates catecholamine secretion and may therefore be expected to have detrimental effects in patients with angina. In a double-blind study of ten patients with stable angina pectoris treated with nifedipine, propranolol, and atenolol, smoking was found to have direct and adverse effects on the heart and to interfere with the efficacy of all three antianginal drugs, but with that of nifedipine the most. Differences between the two beta blockers may be related, at least in part, to the known different metabolic pathways of these drugs. PMID- 3279411 TI - Quality of life during antihypertensive treatment. Refining its measurement to individualize drug selection. AB - Three questions relating to assessment of quality of life during antihypertensive therapy are discussed here. 1. Can the quality of life be measured? The two approaches thus far explored have used external parameters, such as counting days of work lost or changes in sexual function, and subjective assessment by patients, through completion of a questionnaire. The latter presents problems of reliability and sensitivity of the instrument as well as comparability of results across various studies. 2. Should quality of life be measured? If morbidity due to hypertension is reduced but quality of life is also reduced without an associated improvement in longevity, it is important to know exactly how and to what extent quality of life is impaired. Also, measurement of quality of life should make possible improved compliance with antihypertensive therapy. 3. How can quality of life be measured? Results of the studies evaluating quality of life associated with antihypertensive therapy leave much to be desired. A study protocol is proposed that would use the voluntary drop-out rate as the point of comparison. Research would then unravel the behavioral factors specifically affected by a given treatment. Through such studies, the effects of drugs on quality of life could become a criterion in individualization of treatment. PMID- 3279412 TI - [Winkler's chondrodermatitis nodularis chronica helicis]. PMID- 3279413 TI - [Malignant diffuse mesothelioma of the tunica vaginalis testis. Report of a case with immunohistochemical assessment]. PMID- 3279414 TI - [The 150th birthday of Moriz Kaposi (1837-1902)]. PMID- 3279415 TI - Three binding sites for AraC protein are required for autoregulation of araC in Escherichia coli. AB - Three binding sites for AraC protein were shown to be required for the autoregulation of araC: araI1, araO1, and araO2. Selective inactivation of AraC binding sites on the DNA demonstrated that araO1 and araO2 are required in vivo to produce repression of araC in the presence of arabinose, whereas araI1 and araO2 are required in its absence. We found that the low-affinity site araO2 is essential for araC autoregulation; araO1 and araI1 provide high-affinity AraC binding sites, which allow cooperative binding at araO2. Profound effects on the araBAD promoter and the araC promoter are produced by ligand-induced changes in AraC occupancy of functional sites on the DNA. We suggest that AraC exerts its multiplicity of controls through two alternative states of cooperative interactions with DNA and we illustrate this with a model. This model presents our interpretations of activation and repression of the araBAD operon and the autoregulation of the araC gene. PMID- 3279416 TI - Molecular cloning and nucleotide sequence for the complete coding region of human UMP synthase. AB - The last two steps in the de novo biosynthesis of UMP are catalyzed by orotate phosphoribosyltransferase (OPRT; orotidine-5'-phosphate:pyrophosphate phosphoribosyltransferase; EC 2.4.2.10) and orotidine-5'-monophosphate decarboxylase (orotidine-5'-phosphate carboxy-lyase; EC 4.1.1.23). In mammals these two activities are found in a single, bifunctional protein called UMP synthase. A human T-lymphoblastic cell cDNA library constructed in lambda gt10 was screened with a UMP synthase-specific rat cDNA probe. Human UMP synthase cDNAs were isolated and then used to select UMP synthase gene fragments. The complete coding sequence of the mRNA for UMP synthase was determined by analysis of overlapping cDNA and genomic fragments. One of the cDNAs appears to have been synthesized from an incompletely or alternatively processed form of the UMP synthase mRNA. This cDNA lacks a poly(A) tail and has an extended 3' nontranslated region that hybridizes with larger forms of the UMP synthase mRNA. The UMP synthase protein is composed of 480 amino acids with a molecular weight of 52,199. The two activities of UMP synthase reside in distinct domains encoded by the 3' and 5' halves of the mRNA. The COOH-terminal 258 amino acids of the human UMP synthase protein contain the orotidine-5'-monophosphate decarboxylase catalytic domain. This region is highly homologous to the mouse orotidine-5' monophosphate decarboxylase sequence. The NH2-terminal 214 amino acids contain the OPRT domain. There is amino acid homology between this protein domain and specific regions of the Escherichia coli OPRT. The human OPRT domain also contains the putative catalytic site common to other human phosphoribosyltransferases. PMID- 3279419 TI - Nucleotide sequence for yeast dihydrolipoamide dehydrogenase. AB - Rabbit antiserum to the dihydrolipoamide dehydrogenase (dihydrolipoamide:NAD+ oxidoreductase, EC 1.8.1.4) component of the pyruvate dehydrogenase complex from bakers' yeast was used to screen plaques produced by a lambda gt11 yeast cDNA library. A 2.1-kilobase insert was isolated that also hybridized to a 17-base mixed oligonucleotide probe corresponding to the amino-terminal sequence of the yeast dihydrolipoamide dehydrogenase. The cDNA has a coding sequence of 499 amino acids that corresponds to a 21-residue signal peptide and a 478-residue mature protein (Mr = 51,558). Computer analysis shows that yeast dihydrolipoamide dehydrogenase has about 41% amino acid identity with Escherichia coli dihydrolipoamide dehydrogenase. Particularly striking is the conservation of sequence in the active site region of the dihydrolipoamide dehydrogenases from E. coli, yeast, and pig heart. PMID- 3279418 TI - RecA-mediated cleavage activates UmuD for mutagenesis: mechanistic relationship between transcriptional derepression and posttranslational activation. AB - The products of the SOS-regulated umuDC operon are required for most UV and chemical mutagenesis in Escherichia coli. It has been shown that the UmuD protein shares homology with LexA, the repressor of the SOS genes. In this paper we describe a series of genetic experiments that indicate that the purpose of RecA mediated cleavage of UmuD at its bond between Cys-24 and Gly-25 is to activate UmuD for its role in mutagenesis and that the COOH-terminal fragment of UmuD is necessary and sufficient for the role of UmuD in UV mutagenesis. Other genetic experiments are presented that (i) support the hypothesis that the primary role of Ser-60 in UmuD function is to act as a nucleophile in the RecA-mediated cleavage reaction and (ii) raise the possibility that RecA has a third role in UV mutagenesis besides mediating the cleavage of LexA and UmuD. PMID- 3279417 TI - UmuD mutagenesis protein of Escherichia coli: overproduction, purification, and cleavage by RecA. AB - The mutation rate of Escherichia coli increases approximately 100-fold after treatment with replication-inhibiting agents such as UV light. This enhanced mutation rate requires the action of the UmuD and UmuC proteins, which are induced as part of the SOS response to DNA damage. To initiate a biochemical characterization of the role of these proteins, we have developed a plasmid system that gives efficient expression of the umuD and umuC genes. The umuD and umuC genes were placed under the control of a regulated phage lambda PL promoter and a synthetic ribosome-binding site, and the distance to the UmuD start was adjusted to maximize gene expression. Starting from this overproduction system, we have purified the UmuD protein and studied its interaction with RecA. The SOS response is turned on by the capacity of RecA protein to mediate cleavage of the LexA repressor for SOS-controlled operons. Others have shown that UmuD exhibits sequence homology to LexA around the cleavage site, suggesting a possible cleavage reaction for UmuD. We show that RecA mediates cleavage of UmuD, probably at this site. As with LexA, UmuD also undergoes a self-cleavage reaction. We infer that RecA-mediated cleavage of UmuD is another role for RecA in SOS mutagenesis, probably activating UmuD for its mutagenic function. PMID- 3279421 TI - Transforming genes in chronic myelogenous leukemia. AB - Chronic myelogenous leukemia (CML) is a hematopoietic malignancy characterized by an indolent chronic phase that invariably leads to a "blast crisis" indistinguishable from acute leukemia. Using a sensitive assay based on gene transfer and tumorigenesis, we sought evidence that damage to protooncogenes might figure in the progression from the chronic to the blast phase of CML. Seven of the 12 patients with CML examined in this manner harbored transforming genes. Mutations in RAS protooncogenes were detected in the leukemic cells from 1 of 6 chronic-phase patients, and 3 of 6 blast-crisis patients. In addition, a presently unidentified transforming gene (neither RAS nor RAF) was detected in 1 patient with chronic phase and 1 with blast crisis. Our data indicate that mutations in RAS genes may play diverse roles in the pathogenesis of CML. PMID- 3279420 TI - Immunological significance of Mycobacterium leprae cell walls. AB - Cell walls of Mycobacterium leprae, prepared by differential solvent extraction, were shown to contain arabinogalactan, mycolates, and peptidoglycan. In addition, amino acid analysis revealed the unexpected presence of large amounts of protein that retained potent immunological reactivity. Purified cell walls stimulated proliferation of T cells from tuberculoid, but not from lepromatous leprosy, patients and elicited delayed-type hypersensitivity skin reactions in guinea pigs and patients sensitized to M. leprae. Analysis of the precursor frequency of antigen-reactive human peripheral T cells revealed that as many cells (approximately equal to 1/6000) proliferate to antigen contained in cell walls as to intact M. leprae. Sequential removal of mycolates and arabinogalactan resulted in a large peptidoglycan-protein complex that retained all the immunological activity. This immunological reactivity and the inherent protein were destroyed by proteolysis. Thus, cell wall protein is a major contributor to cell-mediated immune reactivity to this pathogenic mycobacterium. PMID- 3279422 TI - Human ovarian theca cells are a source of renin. AB - Human ovarian follicular fluid contains renin-like activity. In normal women, circulating levels of prorenin, the biosynthetic precursor of renin (EC 3.4.23.15), change in parallel with changes in progesterone during the menstrual cycle. Therefore, the ovary has been implicated as a source of plasma prorenin. In the present studies, we report the finding of high concentrations of prorenin in human ovarian follicular fluid (3000 ng.ml-1.hr-1 vs. 10-40 ng.ml-1.hr-1 in normal human plasma) obtained from follicles of women prepared for in vitro fertilization. The inactive renin-like enzyme was identified as prorenin by its activation characteristics, its molecular weight of 47,000, which is the same as that for recombinant prorenin, and its cross-reactivity with human renal renin antibodies. Culture of isolated human theca cells and isolated granulosa cells indicated that prorenin is secreted by theca cells but not by granulosa cells. Prorenin production by theca cells peaked during the first 10 days of culture and gradually decreased by 17 days. Active renin levels were 10% or less of the prorenin levels. Prorenin was barely detectable in medium from granulosa cells cultured for 24 days. Immunohistochemical staining of human ovaries (n = 5) with anti-human renin antibody demonstrated the presence of renin primarily in theca cells. These studies suggest that the theca cell is the source of the large quantities of prorenin in human ovarian follicular fluid. PMID- 3279424 TI - The control of intracellular membrane traffic: implications for Ca++ and phosphate transport. PMID- 3279425 TI - The mitochondrial phosphate transport protein and the kidney and intestine sodium/phosphate cotransporters--recent progress and a comparison. PMID- 3279426 TI - Fura-2 measurements of intracellular [Ca2+] in Escherichia coli. PMID- 3279423 TI - Early cross-striation formation in twitching Xenopus myocytes in culture. AB - Spontaneous release of neurotransmitter has been demonstrated in various types of synapses. Its physiological significance, however, is still unknown. In nerve muscle cultures of embryonic Xenopus laevis, we observed that acetylcholine, which is released spontaneously at the synaptic terminal, caused frequent twitches of muscle cells. These muscle cells developed cross-striations earlier than neighboring non-twitching cells. This effect of innervation was unaffected by tetrodotoxin but was blocked by alpha-bungarotoxin. Repeated iontophoretic application of acetylcholine or KCl to muscle cells caused twitches and also accelerated the formation of cross-striations. Thus twitching apparently promotes lateral alignment of myofibrils. It is also known that myosin synthesis is higher in twitching muscle cells. Therefore, successfully innervated twitching muscle cells may have an advantage for faster differentiation over neighboring non twitching muscle cells. We suggest that spontaneously released transmitter may serve as a mediator for trophic interaction at forming synapses. PMID- 3279427 TI - Alterations of calcium and phosphate transport in disease. PMID- 3279428 TI - Biophysical analysis of a novel transport pathway induced in red blood cell membranes by the malaria parasite. PMID- 3279429 TI - [Biological actions of flavonoids]. PMID- 3279430 TI - The central neuropharmacology of psychotropic cannabinoids. PMID- 3279431 TI - Metabolism of natural and synthetic steroids used in cancer treatment. PMID- 3279432 TI - Developmental pharmacology and toxicology: principles of study design and problems of methodology. AB - Pharmacologic investigations in the fetus, neonate and child are difficult for the various reasons outlined above, ranging from ethical constraints to difficulties with microanalytic techniques. Attempts to circumvent these difficulties through animal studies, retrospective analyses, and prospective surveys have provided only partial answers. These studies have often helped to guide subsequent similar studies in humans. Results of developmental pharmacologic studies applied to the human must be conducted in humans. The alternatives to randomized, controlled trials presented above may help with these studies, but these innovative study designs must be applied carefully to avoid biasing the results. Although difficult, definitive studies in developmental pharmacology are possible with investigators willing to work within the ethical constraints outlined above, to sensitively consider the needs of perinatal and pediatric patients, and to adhere to the strictest standards of study design. PMID- 3279433 TI - Pharmacology of ethanol. PMID- 3279434 TI - Thoreau's natural pollinometers. PMID- 3279435 TI - Field testing of the movement assessment of infants. AB - The purpose of this study was to compare the test results of normal 4-month-old infants on the Movement Assessment of Infants with the published Movement Assessment of Infants a priori profile. We tested 50 healthy 4-month-old infants (24 white, 20 black, 6 other races) on 65 Movement Assessment of Infants items, encompassing the categories of muscle tone, primitive reflexes, automatic reactions, and volitional movements. The total-risk score was a sum of categorical risk scores. A between-group analysis of variance showed that the total-risk scores did not differ significantly by sex or race. Thirty percent of the infants we tested had total-risk scores greater than 7, which differed significantly from the 15% in the original Movement Assessment of Infants data. On 18 of the 65 Movement Assessment of Infants items, more than 15% of our study sample had risk scores that differed from Movement Assessment of Infants profile normative scores. The results of our study suggest that the current Movement Assessment of Infants profile may not accurately reflect the normal motor behavior of a 4-month-old infant. Suggestions for revising the Movement Assessment of Infants are made that could improve the reliability and validity of the test. PMID- 3279436 TI - Augmenting voluntary torque of healthy muscle by optimization of electrical stimulation. AB - The purpose of this study was to evaluate the ability of electrical stimulation (2,500-Hz sine waves, interrupted for 50 pulsed bursts per second) to improve muscle torque using low-dosage training characteristics. Fifteen healthy subjects (9 men, 6 women), 20 to 32 years of age, participated in the experiment. All subjects received electrical stimulation of the right anterior thigh musculature while their left leg served as the control. Electrical stimulation was repeated eight times per session, each stimulation producing isometric torque equal to 50% of the subject's maximum voluntary isometric contraction. The sessions were repeated twice a week over a period of five weeks. Results showed that electrical stimulation, when used with the specified low-dosage training characteristics of this study, will augment quadriceps femoris muscle torque of men. PMID- 3279437 TI - Effects of soft tissue mobilization (Rolfing pelvic lift) on parasympathetic tone in two age groups. AB - The effects of a soft tissue mobilization procedure, the Rolfing pelvic lift, on parasympathetic tone was studied in healthy adult men. Parasympathetic tone was assessed 1) by quantifying the amplitude of the respiratory sinus arrhythmia from the heart rate pattern and 2) by measuring heart rate. Heart rate patterns were assessed during the pelvic lift and during the durational touch and baseline control conditions. Two groups of healthy subjects were tested: Group 1 contained 20 subjects aged 26 to 41 years, and Group 2 contained 10 subjects aged 55 to 68 years. In Group 1, the pelvic lift elicited a somatovisceral-parasympathetic reflex characterized by a significant increase in parasympathetic tone relative to durational touch and baseline conditions. Group 2 did not exhibit a parasympathetic change during the pelvic lift. The results of this study contribute to our understanding of pelvic mobilization techniques and may help to explain why these techniques have been clinically successful in treating myofascial pain syndromes and other musculoskeletal dysfunctions characterized by reduced parasympathetic tone and excessive sympathetic activity. PMID- 3279438 TI - Geriatrics emphasis in physical therapy. A historical survey. AB - The number of elderly individuals and the health care needs of elderly persons are rapidly growing. Are physical therapists interested and involved in meeting the needs of this geriatric group? One measure of physical therapists' interest is the quantity of geriatrics-related articles that appear in our profession's journal. The purpose of this study was to conduct a historical review of the number of geriatrics-related articles published in Physical Therapy. All articles indexed under "geriatrics" between January 1921 and June 1987 were identified and categorized in five-year time intervals to assess trends over time. Geriatrics indexed articles generally appeared infrequently in the Journal, averaging one article every two years. All Physical Therapy articles published between January 1980 and June 1987 were read to determine whether they exhibited a geriatrics orientation. An average of six geriatrically oriented articles appeared in the Journal annually (about 5% of all articles annually). An increased number of geriatrics articles appeared in the Journal between 1980 and 1987. An imbalance clearly exists when an age group that comprises 25% of our patient population receives attention in only 5% of the Journal articles. As a profession, we must examine our attitudes toward and perceptions about elderly persons if we are to address their needs responsibly. PMID- 3279439 TI - Osteoarthritis. Effects on synovial joint tissues. AB - The purposes of this article are 1) to provide an updated summary of some aspects of research into osteoarthritis and 2) to stimulate physical therapy inquiry on its causes, effects, and treatments. The current literature concerning the pathological changes associated with osteoarthritis is reviewed in the context of specific joint tissues (ie, articular cartilage, bone, synovial membrane, capsule and capsular ligaments, muscle, and nerve). Correlations are drawn between the pathological effects of osteoarthritis on these tissues and commonly observed clinical changes. Gaps in the current research literature are discussed, and areas needing further research are highlighted. PMID- 3279440 TI - Mandatory continuing education--a survey of current activity. A special communication. AB - The purposes of this article are 1) to present a review of the literature addressing issues related to mandatory continuing education (MCE) and 2) to report the responses from three surveys conducted by the Task Force on Mandatory Continuing Education of the Florida Physical Therapy Association, Inc. Questionnaires were sent to appropriate representatives in 1) American Physical Therapy Association chapters of all states with MCE required for relicensure, 2) APTA chapters of all states without MCE required for relicensure, and 3) state headquarters of nine other health-related associations with MCE required for relicensure in Florida. Feedback from respondents is presented concerning state requirements for MCE, the process of MCE, and overall sentiment of the membership concerning this requirement. In general, states with MCE required for relicensure and selected associations in Florida with this requirement responded positively toward MCE, whereas states without the MCE requirement responded negatively. All three groups expressed a growing concern for a system to ensure practitioner currency. PMID- 3279441 TI - Relationship between academic achievement and clinical performance in a physical therapy education program. AB - This study was performed to ascertain whether a relationship exists between physical therapy students' preprofessional academic achievement and their academic or clinical performance while attending professional school. A comparison was also made between professional academic achievement and clinical performance. The records of three classes of graduates (N = 65) were examined in relation to preprofessional grade point average, professional grade point average, and clinical performance. Pearson product-moment correlations showed no significant relationship between preprofessional and professional academic achievement or preprofessional academic achievement and clinical performance. The correlation between professional academic achievement and clinical performance was higher, but did not reach statistical significance. This study did find that preprofessional and professional grade point averages were related. The authors urge further study of current admission criteria and their relationship to clinical performance. PMID- 3279442 TI - Perforator-based flaps for low posterior midline defects. AB - A new type of flap is described based on unnamed perforators located near the midline of the lower back region. Such flaps combine the superior blood supply of the myocutaneous flap with the lack of donor-site morbidity of a skin flap. Five clinical cases are presented, showing how such perforators can augment skin flaps or create custom-designed island flaps. The dissection of the flap is described, and further possibilities for its use are suggested. PMID- 3279443 TI - Reconstruction of Achilles tendon and calcaneus defects with skin-aponeurosis bone composite free tissue from the groin region. AB - Eight patients had reconstructive surgery for soft-tissue, associated Achilles tendon, and calcaneus defects on the posterior aspect of the ankle. In group A, those patients with skin, soft-tissue, and Achilles tendon loss were treated with free groin flaps that included sheets of the external oblique aponeurosis based on the superficial circumflex iliac vessel. The groin flap provided skin coverage, and the aponeurosis was rolled to form a tendon-like structure to replace the Achilles tendon. In group B, those patients with an additional calcaneus bone loss were treated with free iliac osteocutaneous flaps, together with the external oblique aponeurosis based on the deep circumflex iliac vessel. The iliac bone was then utilized to reconstruct the calcaneus defect. All composite free tissue transfers were successful, except in two group B patients who suffered partial skin loss. The advantages of this technique are (1) a single, one-stage procedure, (2) faster wound healing with fewer adhesions of the reconstructed Achilles tendon, and (3) good cosmesis and minimal morbidity at the donor site. PMID- 3279444 TI - The history of plastic surgery in Hungary. PMID- 3279445 TI - Induced movement in the visual modality: an overview. PMID- 3279446 TI - Motor illusions: what do they reveal about proprioception? PMID- 3279447 TI - Subjective insomnia without objective findings: a pseudo diagnostic classification? PMID- 3279448 TI - Ethanol ingestion and the development of post-exercise ketosis in non-alcoholic human subjects. AB - Alcoholic ketosis occurs in alcoholics, who have been shown also to be more predisposed than normal to post-exercise ketosis (Chalmers, Sulaiman & Johnson, 1977). We therefore studied post-exercise ketosis in ten normal people who drank 1.6 mol ethanol at 18.00-21.00 h, and then did a 12 km walk at 07.00 h the next morning. (The timing of the alcohol ingestion was prompted by the finding that alcoholic ketosis usually develops after the blood ethanol concentrations have fallen to zero.) Ten subjects who had not drunk alcohol for 60 h, acted as controls. All subjects were observed till 16.00 h. The blood 3-hydroxybutyrate level rose from 0.034 +/- 0.006 to 0.336 +/- 0.073 mmol/l (P less than 0.001) during the 9 h observation period in the controls, and from 0.038 +/- 0.009 to 0.352 +/- 0.127 mmol/l (P less than 0.001) in the test subjects. The differences between the two groups are not significant. Plasma free fatty acid concentrations, and insulin/glucagon ratios of the two exercise groups did not differ significantly from each other, or from those of a sedentary group (n = 16). Acute ethanol ingestion (1.6 mol/person) therefore does not predispose normal, non-alcoholic subjects to ketosis, even when ketogenesis is further stimulated by exercise. PMID- 3279449 TI - Activation of Ca2+-dependent processes during heat shock: role in cell thermoresistance. AB - In this brief review, it is proposed that some Ca2+-dependent processes are induced upon subjecting cells to hyperthermic temperature, and play an essential role in the final cell responses. The triggering signal does not involve external Ca2+. Instead, it is most likely to be generated by a redistribution of Ca2+ between the internal pools. A role for heat-induced Ca2+-dependent processes is supported by findings that Ca2+-active agents such as chelators, ionophores, or anticalmodulin drugs modify the cytotoxic action of hyperthermia and that some heat shock proteins are calmodulin-binding proteins. Furthermore, within minutes at hyperthermic temperature, changes are observed in the pattern of phosphoproteins suggesting that heat shock activates kinase or phosphatase activities, processes which are often mediated by Ca2+. Suggestive evidence that these phosphorylation events are determinants of cell thermoresistance is provided by the fact that one of these proteins whose phosphorylation changes rapidly upon hyperthermia is a heat shock protein (HSP28) and that the content of HSP28 is elevated not only in thermotolerant cells but also in a family of thermoresistant variants isolated after mutagenesis of Chinese hamster cells. PMID- 3279450 TI - Growth factors and hyperthermia. II. Viability of Chinese hamster ovary HA-1 cells during serum starvation and hyperthermia. AB - We tested the possibility that hyperthermia kills HA-1 cells in a manner analogous to growth factor deprivation. HA-1 cells were inactivated by serum starvation when incubated in Eagle's MEM at a density of 40 cells/cm2 or less. Cells became resistant to the absence of serum when the cell density was greater than 400 cells/cm2 or when lethally irradiated HA-1 feeder cells were present. The feeder cells exerted their effect through a diffusible factor. In addition, a 1:1 mixture of Eagle's MEM and Ham's F-12 enabled HA-1 cells to remain viable without serum. Ten days growth in Eagle's MEM + Ham's F-12 without serum resulted in the formation of microcolonies of cells. This indicated that growth factor deprivation was not lethal to HA-1 cells, and it suggested that they may have been partially transformed. The presence of the growth factors insulin, transferrin, and fibroblast growth factor (FGF) reduced cell killing by a small amount during conditions of serum starvation. After hyperthermia, the presence of growth factors again diminished cell killing by a modest amount (approximately twofold). Feeder cells also improved cell survival after hyperthermia. The effect of feeder cells was greatest when cells were trypsinized immediately after hyperthermia. When cells were not trypsinized after heating, feeder cells increased survival less than twofold. In summary, the absence of growth factors was not lethal to HA-1 cells, and therefore the cytotoxic effects of hyperthermia could not be explained fully by the failure to bind growth factors. HA-1 feeder cells secreted undefined, growth-promoting substances, but feeder cells exerted only a small positive effect on cell survival after hyperthermia when cells were not trypsinized after heating. PMID- 3279451 TI - The present status of the radiologic examination of the colon. PMID- 3279452 TI - Fetal gallstones. AB - Routine obstetric ultrasound (US) examinations in a 33-year-old woman revealed a normal fetal gallbladder at 24 menstrual weeks but multiple structures in the gallbladder with findings typical of gallstones at 37 menstrual weeks. No other abnormalities were present. Three days after a term delivery, an abdominal US examination again demonstrated multiple gallstones. When the infant was 6 weeks old, a follow-up abdominal US study showed no evidence of gallstones. This case, as well as one previously reported, demonstrates that findings typical of gallstones may be seen in the fetus, and that these structures may spontaneously resolve. PMID- 3279453 TI - Peripheral nerves of the extremities: imaging with US. AB - High-resolution real-time ultrasonography (US) was used to evaluate peripheral nerves of the extremities in healthy subjects and in 11 patients with a mass developed from a peripheral nerve. The normal median and ulnar nerves in the upper extremity and the normal sciatic and external popliteal nerves in the lower extremity were seen, all having an echogenic fibrillar echotexture. Pathologic findings included nine cases of benign tumor (four schwannomas, three neurofibromas, two traumatic neuromas), one of neurilemmitis, and one of tuberculoid leprosy. All lesions were hypoechoic. Three of the four schwannomas had well-defined contours, and two were associated with a typical distal sound enhancement. Neurofibromas and traumatic neuromas were less sharply delineated. Inflammatory conditions were characterized by a hypoechoic, thickened nerve. US was effective in imaging nerve masses in the extremities, and large normal nerves can now be demonstrated with high-resolution US. PMID- 3279454 TI - Central nervous system lymphoma: histologic types and CT appearance. AB - The distribution of histologic types of lymphoma according to the proposed working formulation was determined for 55 patients with primary central nervous system (CNS) non-Hodgkin lymphoma. Fifty-five percent of these patients had diffuse large-cell histologic features. When the relationship between histologic type and computed tomographic (CT) appearance was analyzed, the following trends were noted: A greater percentage of mixed cell tumors were multiple when compared with other types; noncleaved small-cell tumors were more commonly located in the central gray matter or corpus callosum than were other types; all immunoblastic tumors were enhanced homogeneously, unlike other types; and smaller tumors appeared to be associated with an increased histologic grade. Eleven patients had CT confirmation of a CNS recurrence; in eight patients, the recurrent tumor was in a different location than the original lesion. Eleven patients had associated intraocular lymphoma, and four were immunosuppressed. PMID- 3279456 TI - Renal calculi: sensitivity for detection with US. AB - The sensitivity of sonography in the detection of renal calculi was tested in a three-phase study in 100 patients. In phase 1, ultrasonographic (US) scanning was performed after review of abdominal radiographs and renal tomograms in 30 patients who had undergone extracorporeal shock wave lithotripsy (ESWL). In this group the sensitivity of US for detecting stones was 98%. In phase 2, scanning was performed in 30 post-ESWL patients without prior review of radiographs or tomograms. The sensitivity of US for stone detection in this group was 95%. In phase 3, sonography was performed in a blinded fashion on a random mix of post ESWL patients and patients who had undergone urography for reasons unrelated to nephrolithiasis. The sensitivity of US for stone detection in this group of 40 patients was 91%. The overall sensitivity in all three groups was 96%, which was superior to the performance of abdominal radiography and slightly inferior to the combination of abdominal radiography and renal tomography. The ability to detect kidney stones with US depended on stone size but was independent of stone location or patient size. The study findings suggest that US is an effective means for detecting kidney stones in patients with suspected nephrolithiasis. PMID- 3279455 TI - Cyclic endometrial changes: US assessment with histologic correlation. AB - The ultrasonographic (US) appearance of the endometrium was evaluated in 80 patients, and the US diagnosis of endometrial stage was compared with that from same-day endometrial biopsy specimens. The US signs of proliferative endometrium included triple-line sign, hypoechoic function layer, and minimal or absent posterior acoustic enhancement. The signs of secretory endometrium included absent triple-line sign, hyperechoic functional layer, and strong posterior acoustic enhancement. When all of these US signs were clearly depicted in combination, the accuracy of diagnosis was 93% (30 patients). The accuracy of diagnosis for all patients in the study was 76% (73 patients). The relative distributions of each US sign in proliferative and secretory endometrium were compared. Despite complicating extrinsic factors such as uterine leiomyomas and intrinsic factors such as the transition period between endometrial phases, US staging of the endometrium is a useful diagnostic technique that allows serial examinations of the endometrium. PMID- 3279457 TI - Evaluation of azotemic patients: diagnostic yield of initial US examination. AB - To determine whether renal ultrasound (US) is necessary in all patients with azotemia, the authors retrospectively evaluated renal US examinations in 394 azotemic patients. The patients included 119 patients considered clinically to be at high risk for postrenal urinary obstruction and 275 patients considered to be at low risk. In the high-risk population, 35 patients were found to have hydronephrosis (29%). In the low-risk population, three patients were found to have hydronephrosis (1%). In two of these patients surgical intervention resulted in reversal of the azotemia. The authors recommend that renal US be performed in all high-risk patients and in low-risk patients only if temporization and standard medical treatment do not resolve the azotemia. PMID- 3279458 TI - Can the newer interventional procedures replace cholecystectomy for cholecystolithiasis? The potential role of percutaneous cystic duct ablation. PMID- 3279459 TI - Assessing stenosis severity: coronary flow reserve, collateral function, quantitative coronary arteriography, positron imaging, and digital subtraction angiography. A review and analysis. PMID- 3279460 TI - Myocardial infarction and risk region relationships: evaluation by direct and noninvasive methods. AB - Optimal quantitation of myocardial infarction requires resolution of the three dimensional geometry of the ischemic region at a time that progression of tissue necrosis has been completed and can be sharply delineated from noninfarcted myocardium but before significant remodeling of the ventricular chamber. Although this can be achieved at two to three days after coronary occlusion by histologic techniques, a variety of technologies including two-dimensional echo, CTT, SPECT, PET, and NMR have demonstrated potential for providing noninvasive quantitative measurements of the extent of myocardial infarction. Additional studies are needed to clarify the utility of these technologies for resolving the highly variable transmural distribution of infarction that is present in the clinical setting. Assessment of the region at risk for infarction, the ischemic zone, requires quantitative measurements of the degree of ischemia as well as the size of the ischemic region. Although the above technologies may provide quantitative measurements of the dimensions of the ischemic zone, the utility for resolving the highly variable transmural distribution of regional myocardial blood flow using clinically applicable methodologies has not been convincingly established at present. It is possible that cine CT, new generation PET, and NMR technologies may eventually provide noninvasive quantitative measurements of regional myocardial blood flow. PMID- 3279461 TI - Endothelial modulation of coronary tone. PMID- 3279462 TI - [Vienna, Freud and psychoanalysis]. PMID- 3279463 TI - [History of the "secret committee." Psychoanalysis in the institutionalization process]. PMID- 3279465 TI - [Review of the main diseases transmitted by insects in Panama]. PMID- 3279464 TI - Effectiveness of teaching breast self examination during office visits. AB - In a randomized clinical trial a comparison was made of two BSE teaching interventions delivered by primary providers during office visits in a group nursing faculty practice. Patients who reported no regular BSE (n = 121) received either individualized teaching focused on reducing perceived barriers and reinforcing benefits of BSE, or routine teaching limited to usual instruction in BSE technique. Patients reporting frequent/monthly BSE during the past year were comparison subjects (n = 81). Self-reported data on BSE behavior were obtained in questionnaires administered before the interventions and via telephone interviews three months after the visit. Analysis using chi square showed that, contrary to expectation, individualized and routine teaching were equally effective: 61.4% of the individually taught and 63.5% of the routinely taught reported frequent or monthly practice at followup. Both groups were significantly more confident in technique and ability to detect change in the breast. The previously non practicing women remained significantly less likely than comparison subjects to be performing BSE monthly at followup. The perceived benefit of BSE giving peace of mind predicted non-practicers most likely to change. PMID- 3279466 TI - [Aneurysm of the hepatic artery. An occasional echographic finding]. PMID- 3279467 TI - [Echotomographic finding of radiotransparent surgical materials retained in the soft tissues of the legs]. PMID- 3279468 TI - [Urothelial carcinoma in bladder diverticulum. Case contribution]. PMID- 3279469 TI - [Use of echography in the diagnosis of congenital dysplasia of the hip]. PMID- 3279470 TI - [Enthesopathies. Radiography and xeroradiography compared]. AB - The term "enthesis" designates the sites of tendon, ligament and articular capsule insertion to bone. Entheses are fundamental to the cybernetic regulation and correlation of postural and motion functions in the body. They also hold a key position in the locomotor system diseases. "Enthesopathy" is a disease occurring at these sites (primary enthesopathy), which can occur alone or together with different disorders, including inflammatory, degenerative, metabolic and traumatic conditions (secondary enthesopathy). Enthesopathy may lead to articular and non-articular manifestations: common sites of involvement include the spine and pelvis, femoral trochanter, humeral tuberosity, patella, olecranon and calcaneus. In acute enthesopathy, all the signs of acute inflammation may be present. In subacute or chronic forms, pain and tenderness localized in the entheses are found. Radiographic patterns include bone erosion, hyperostosis (enthesophytes), bone fragmentation and crystal deposits. PMID- 3279471 TI - [Aneurysms of the spleno-portal axis and the superior mesenteric vein. Observation of 4 cases]. AB - Four asymptomatic cases are reported of aneurysms of the spleno-portal and mesenteric veins. These ectasias, whose etiology is most probably congenital, are very rare (about 20 cases in world literature), especially if compared with aneurysms of the splenic arteries, and they are mainly occasional findings. Complications may occur in the biliary tract and duodenal loop, often associated with portal hypertension. US and CT are sometimes very valuable in characterizing them, but an angiographic map is needed for the patients who will undergo surgery. Angiographic procedure is also mandatory for interventional approach in case of porto-caval fistulas. Doppler US scanning seems to be the best technique for the follow-up. PMID- 3279472 TI - [Echographic anatomy of the greater peritoneal cavity and its recesses]. AB - The peritoneum of the great abdominal cavity and its recesses are a blind radiographical area which can however be easily outlined by US when it contains fluid. The anatomical study of these usually virtual cavities represents the purpose of this paper. The natural contrast of the peritoneal fluid as amplified by the mechanical effect produced by an adequate amount of fluid, allows a clear visualization of the anatomy of various peritoneal structures in either upper (subphrenic, subhepatic, lesser sac, etc.) or lower (pelvic) areas. The sovramesocolic and the infracolic compartments are in communication through the two external paracolic gutters which are the main passageways for the fluids between upper and lower compartments. In fact, peritoneal fluids are in constant movement due to different factors, such as gravity, statics, which causes the peritoneal fluids to flow into the lowest part of the peritoneal cavity, and hydrostatic pressure. Pressure differences are thought to convey fluids from various sites of the abdomen into different areas. In the lower abdomen, pressure is 3 times as much as in the upper abdomen, which causes the fluids to move into the subhepatic and subphrenic regions. The redistribution of fluids can be influenced by particular anatomical causes. The phrenicocolic ligament, eg, is a barrier to the advancing of fluids along the left paracolic gutter, which makes the right paracolic gutter the main passageway for the fluids. This pattern explains why abscesses are more frequent in the right than in the upper left abdominal regions. Another example is the tiny Winslow opening, which does not allow inflammatory material to pass into the lesser sac in case of inflammatory processes of the great peritoneal cavity and vice versa. Moreover, pointing out fluid collections and abscesses is important, since an early diagnosis and a topographic map are essential in order to plan treatment. PMID- 3279473 TI - [Urography with non-ionic contrast media. Multicenter experience on the optimization of the technic]. AB - The authors report the results of a multicentric experience based on 1200 urograms performed with nonionic contrast medium. The global diagnostic reliability is evaluated, together with the specific reliability for kidneys, ureters, and bladder, according to the various pathologies. The eventual need of radiographs of completion is showed. In searching for an optimization of the technique for nonionic contrast medium, a panoramic radiograph performed 10' after the end of the injection is pointed out as the key-moment of the test, being extremely rich in information, so as to help defining the most appropriate technique to continue the examination. For its excellent tolerability and high reliability, the nonionic contrast medium is recommended also in routine IVP, not only in risk patients. PMID- 3279474 TI - [Magnetic resonance in renal transplants]. AB - The authors report their experience in the study of renal transplant recipients by MR, in order to determine its clinical potentials. The main purpose of this work is to focus on MR patterns in relation to clinical findings of rejected or normally functioning kidney. Twenty-four patients were examined with a 0.5 T superconductive magnet, body coil, spin-echo pulse sequence (SE) and inversion recovery (IR). MRI patterns could be seen in normally functioning kidneys and transplant rejections, while variable MRI findings were observed in transplants with acute tubular necrosis (ATN). In the normally functioning transplanted kidney there is a clear corticomedullary differentiation (CMD), and the extent of vascular penetration into the renal parenchyma is clearly seen. In transplant rejection, CMD is either diminished or absent, and there is no vascular penetration into the parenchyma; to differentiate acute from chronic rejections, the increase/decrease in renal size and the change in renal shape (spherical shape in acute transplant rejection) respectively must be observed. MRI proves thus to be useful in the study of renal transplants, even in case of questionable clinical findings, and in patients in whom renal biopsy is contraindicated. PMID- 3279476 TI - [Duplex sonography--an improvement in the diagnosis of mesenterial circulatory disorders]. PMID- 3279475 TI - [Interstitial pulmonary diseases. Clinico-radiologic setting]. PMID- 3279478 TI - [Endoscopic sonography of the upper gastrointestinal system with special reference to esophageal diseases]. PMID- 3279477 TI - [Missed gallstones in endoscopic retrograde cholangiopancreatography (ERCP). Case reports]. PMID- 3279479 TI - [Iscador--mistletoe extract for cancer treatment. Documentation No. 10]. PMID- 3279480 TI - [Neurological syndromes of the upper limb with acroparesthesia and pain]. PMID- 3279481 TI - [Painful plexopathies of the upper limb]. PMID- 3279482 TI - [What medicine for medical computer technology?]. PMID- 3279483 TI - [Leukoencephalopathy, leukoaraiosis and cerebral infarction]. AB - The terms Binswanger's disease and arteriosclerotic subcortical encephalopathy are often applied to elderly patients with dementia and a diffuse hypodensity of the white matter on CT scan (or increased signal on MRI). Recently, similar white matter abnormalities have been reported in non-hypertensive patients with Alzheimer's disease and in elderly healthy people, casting doubt upon Binswanger's disease as an entity. These findings also suggest that the descriptive term leukoaraiosis meaning rarefied white matter is more appropriate than the term leucoencephalopathy. Nevertheless, within the group of patients with an ischemic stroke, several data suggest that leukoaraiosis is not a fortuitous finding and does not simply reflect ageing. Actually, these patients have a particular clinical profile, with intellectual deterioration, chronic hypertension, usually patent carotid arteries, and a deep location of the presenting infarct. Moreover hypertension seems to be still more strongly associated with leukoaraiosis than with a deep location of the infarct (lacunar infarction). PMID- 3279485 TI - [French Society of Neurology. Membership directory (1988)]. PMID- 3279484 TI - [Dissecting aneurysm of the intracranial vertebral artery. An anatomo-clinical case]. AB - A 64 year old patient with a cardiac prosthesis and receiving antivitamin K therapy presented with a right bulbar syndrome. Based on absence of meningeal signs and hemorrhage on CT scan heparin therapy was instituted. Fatal coma developed two and a half days later. Autopsy findings included a right lateral bulbar infarct and meningeal hemorrhage, predominant around a fusiform dilatation of the end of the right vertebral artery. Serial sections showed a large dissecting aneurysm between media and adventitia communicating with an intimal tear. Among intracranial dissecting aneurysms those of vertebrobasilar localization have the peculiarity of being subadventitial in some cases, with a subsequent enhanced risk of hemorrhagic complications. The use of anticoagulants appears contraindicated in these cases, even if their clinical expression is suggestive of an infarct. Their etiology is often unknown. PMID- 3279487 TI - Use of animal models in evaluation of the quinolones. AB - Discriminative animal models of infection are important in helping to define the role of new antibacterial drugs in the treatment of human diseases. Several animal models have been used to compare the efficacies of quinolones with those of standard therapies against selected bacterial pathogens. In animal models of endocarditis, pefloxacin, enoxacin, and ciprofloxacin have been shown to be equivalent to standard therapies against methicillin-sensitive Staphylococcus aureus and as effective as vancomycin against methicillin-resistant strains. Difloxacillin has been shown to be equivalent to vancomycin in a model of osteomyelitis due to S. aureus. Ciprofloxacin is as effective as the combination of ceftazidime and tobramycin in a model of pseudomonal meningitis, although the levels of ciprofloxacin (6 mg/L) in serum required to produce a bactericidal effect in the cerebrospinal fluid are higher than those usually obtained in humans. Ciprofloxacin and other quinolones are also effective therapy for pseudomonal infections in neutropenic animals with pneumonia, peritonitis, osteomyelitis, and endocarditis. Data obtained from these animal studies suggest that the quinolones may have an important role in the treatment of endocarditis, meningitis, osteomyelitis, and other serious infections in humans caused by S. aureus and Pseudomonas aeruginosa. PMID- 3279486 TI - New quinolones: pharmacology, pharmacokinetics, and dosing in patients with renal insufficiency. AB - Despite similarities in their chemical structures, the new fluoroquinolones differ greatly in the extent to which renal clearance contributes to their elimination. On the opposite ends of this spectrum are ofloxacin, which is almost entirely eliminated by the kidney as unmodified drug, and pefloxacin, which undergoes extensive biotransformation. Dosage adjustments in patients with renal insufficiency therefore are recommended for ofloxacin, but, on the basis of currently available data, adjustments do not appear to be required for pefloxacin. Both renal clearance of unmodified drug and metabolic transformation contribute substantially to the elimination of norfloxacin and ciprofloxacin. Because of the great antimicrobial potency of the new fluoroquinolones, it should be possible to employ them in the treatment of urinary tract infections caused by highly susceptible bacteria even in patients with marked impairment of renal function. PMID- 3279488 TI - Drug interactions with quinolones. AB - The mechanisms involved in drug interactions may be either pharmacokinetic or pharmacodynamic. Pharmacokinetic interactions are the leading events and are caused by alterations in absorption, distribution, metabolism, and elimination of one drug by another. The reported interactions of new quinolones are due to a decrease in antimicrobial activity at low pH, a Mg++-dependent reduction in efficacy, and a probenecid-induced decrease in tubular secretion of ciprofloxacin. The reduction of theophylline clearance by those quinolones that are metabolized primarily in the liver (enoxacin and ciprofloxacin) is of clinical relevance; also, the interactions of quinolones with Mg++-containing antacids, which result in tremendous loss of bioavailability, are of therapeutic importance. PMID- 3279489 TI - Specific toxicologic aspects of the quinolones. AB - Possible targets of quinolone toxicity include the juvenile joint, the kidney, the central nervous system (CNS), the eye, and the cardiovascular system. In immature animals all quinolones studied cause arthropathies of the major diarthrodial joints. Arthropathies have also developed in adult dogs after 12 months of pefloxacin treatment. At high doses the quinolones exert effects on renal function that are related to a foreign-body reaction caused by crystals; nephropathologic changes seem not to occur without crystalluria. In humans quinolones can have various CNS effects. The subcellular "substrate" for these effects is unknown. Further understanding of severe CNS reactions (confusion, hallucination, anxiety, agitation, nightmares, convulsive seizures, and depression) is needed. Pefloxacin causes cataracts in dogs after treatment for 8 12 months. Low-dose quinolones (administered as an intravenous bolus) cause pronounced but transient systolic hypotension in dogs and cats; cardiovascular effects may be mediated by histamine release. Quinolones inhibit the bacterial enzyme DNA gyrase. To exclude the possibility of damage to mammalian DNA, mutagenicity studies have been performed. Since all but two tests (which may give false-positive results) have been negative, quinolones appear to be nonmutagenic. Photosensitivity has occurred in humans given quinolones. Drug interactions can be clinically important. PMID- 3279490 TI - Comparative studies of fluoroquinolones in the treatment of urinary tract infections. AB - The results of comparative trials of fluoroquinolones for the treatment of uncomplicated and complicated urinary tract infections (UTI) were reviewed. Several randomized, comparative trials showed that in uncomplicated UTI norfloxacin, ciprofloxacin, and ofloxacin were at least as effective as trimethoprim-sulfamethoxazole (TMP-SMZ) and amoxicillin and usually more effective than nalidixic acid, pipemidic acid, and nitrofurantoin. Comparative trials of single-dose regimens have, however, been limited. A few randomized, comparative trials have shown that in complicated UTI norfloxacin, ciprofloxacin, and ofloxacin were at least as effective as amoxicillin and TMP-SMZ and usually more effective than pipemidic acid. Moreover, preliminary results indicate that fluoroquinolones might be effective for the oral treatment of complicated UTI that are difficult to treat, especially those due to Pseudomonas aeruginosa. Comparative trials are needed to establish the value of fluoroquinolones for chronic bacterial prostatitis. There are no conclusive data on fluoroquinolone treatment of UTI in patients with renal failure. Emergence of resistant pathogens during therapy with fluoroquinolones has been infrequent but might be more frequent in complicated UTI caused by P. aeruginosa. PMID- 3279491 TI - New quinolones in the treatment of joint and bone infections. AB - New quinolones are promising agents for use in the treatment of bone and joint infections because of their broad spectrum of activity against staphylococcal strains as well as gram-negative bacteria. Their pharmacologic properties and their availability for oral administration make them the drugs of choice in the treatment of such chronic infections. Pefloxacin and ciprofloxacin are the principal quinolones that have been evaluated with respect to the treatment of bone and joint infections. In the literature cited the mean rates of bacteriologic and clinical response among patients treated with pefloxacin and ciprofloxacin were 87.6% and 73%, respectively, whereas failure of therapy were due to the persistence of the causative organisms (5% and 15% of the cases, respectively) or to the emergence of resistant mutant strains (15% and 12% of the cases, respectively). Development of resistance to the quinolones--especially in staphylococci, Pseudomonas aeruginosa, Serratia, Enterobacter species, and Klebsiella pneumoniae--is a problem that can be reduced by the intelligent use of these potent agents in spite of the ease of their administration. Therapy that combines new quinolones with other antibiotics should prevent the emergence of resistant mutants, but this hypothesis has to be assessed in large studies. PMID- 3279492 TI - Effect of new quinolones on the human gastrointestinal microflora. AB - During the last years, the effect of new quinolones--ciprofloxacin, norfloxacin, ofloxacin, and pefloxacin--on the human microflora has been studied. This review article summarizes the published data concerning these studies. The results show that the oropharyngeal flora is only slightly or not at all affected by the quinolones. All new quinolones have a similar effect on the normal intestinal flora. The gram-negative aerobic flora is strongly suppressed during administration of quinolones, while the gram-positive flora is only slightly affected. The anaerobic microflora is almost not at all affected by the administration. The emergence of resistant bacterial strains is uncommon, although one investigation showed increased MIC values for anaerobes during ciprofloxacin administration. Replacement by yeasts or other inherently resistant microorganisms does not often seem to be a problem. High concentrations of the new quinolones are reached in feces; values between 100 and 2,200 mg/kg are reported. Since the new quinolones do not cause marked ecologic disturbances in the intestinal microflora, they may be suitable for selective decontamination in immunocompromised patients and for treatment of bacterial intestinal infections. PMID- 3279493 TI - Antimicrobial therapy for enteric infections and typhoid fever: state of the art. AB - Increasing antimicrobial resistance of enteric pathogens represents a significant barrier to therapy for bacterial enteritis and, to a lesser extent, typhoid fever. Poor study design limits the value of many of the clinical trials that suggest drug efficacy. Studies are often not placebo-controlled, randomized, or blind comparative trials; clinical criteria for response are frequently not stated; and the numbers of subjects are small. Among the known therapeutic principles for choosing drugs for enteric infections is that the agent be active in vitro against the isolate, that for treating infections due to invasive pathogens both lumenal and tissue levels be adequate, that drugs with good enterohepatic circulation may be especially well suited for the treatment of infections due to noninvasive pathogens, and that drugs active intracellularly may have particular value in therapy for typhoid, especially in reducing the relapse rate. The new 4-quinolones are not only highly active in vitro against a broad range of enteric pathogens but generally also exhibit most of the other properties desirable for the treatment of these infections. Although further clinical trials are necessary to assess the comparative efficacy of the quinolones, the present clinical data already indicate that they will be of great utility, and particularly important in the treatment of drug-resistant shigellosis, which is currently a major problem in many developing nations in Asia and Africa. PMID- 3279494 TI - Aspects of chemistry in the development of the 4-quinolone antibacterial agents. AB - The evolutionary route followed in the development of the new generations of 4 quinolone antibacterial agents, from the precursor of nalidixic acid to ciprofloxacin and ofloxacin (and beyond), is characterized by a paramount role for serendipity. All of the high-technology features such as fluorination, the presence of a piperazine ring at position 7, and the stereoisomerism of the molecule, represent only the combination of characteristics incorporated in earlier generations of nalidixic acid analogues. Although almost unprecedented levels of potency per mole have been attained along with effective broad-spectrum antibacterial activity and acceptable pharmacokinetic properties, all developments have been made and are being made in the absence of a proper knowledge of how these agents work against susceptible bacteria. The absence of this knowledge, along with our almost total ignorance of how the antibacterial activity relates to possible effects in Homo sapiens, is at present a barrier to the rational development of truly optimized 4-quinolones. PMID- 3279495 TI - Quinolones in the treatment of bronchopulmonary infections. AB - The role of the new fluoroquinolones in the treatment of lower respiratory tract infections is still difficult to assess. These compounds can be successfully used in the treatment of acute exacerbations of chronic bronchitis but do not seem superior to older drugs; moreover, bacteriologic persistence and even treatment failures in infections due to Streptococcus pneumoniae can be a problem. Because of the poor activity of fluoroquinolones against S. pneumoniae, these compounds do not appear to be the first choice in the empiric treatment of community acquired pneumonia. Ciprofloxacin is apparently valuable for the treatment of pseudomonas infections in patients with cystic fibrosis: clinical results seem comparable to those obtained with conventional intravenous treatments. More clinical experience is needed to compare the role of fluoroquinolones with that of beta-lactam and aminoglycoside antibiotics in the treatment of nosocomial gram negative pneumonia. PMID- 3279496 TI - Quinolones in the treatment of serious infections. AB - The new 4-quinolones have excellent broad-spectrum antibacterial activity. Pharmacokinetic studies show that they are reliably absorbed when given orally and reach high tissue levels. They are effective in animal models of systemic infections, with activity comparable to that of current antimicrobial regimens. Their use to date in systemic infections in humans has not been extensive, but results in the treatment of severe infections, including bacteremia, osteomyelitis, and pneumonia have been encouraging. The few comparative studies that have been undertaken confirm the efficacy of these agents. The limited experience with these drugs in the treatment of infection in the immunosuppressed host is largely favorable. Emergence of resistance, although demonstrable in vitro, does not appear to pose a clinical problem, although addition of a second agent may be advantageous. These drugs appear to be well tolerated, with gastrointestinal disturbance being the most commonly reported adverse effect. PMID- 3279497 TI - Pharmacokinetics and efficacy of the new quinolones in infections of the eye, ear, nose, and throat. AB - A review of published data indicates that the new quinolones readily penetrate the tissues and secretions of the upper respiratory tract. The concentrations of ciprofloxacin and ofloxacin in tonsillar tissue and the concentrations of ofloxacin in the mucosa of the paranasal sinuses generally exceeded the peak concentrations of these agents in serum after oral administration of the drugs. Good penetration was noted for ciprofloxacin into nasal secretions, ofloxacin into tears, and various quinolones into saliva. Penetration into ocular humors appears to be moderate. Reports in English concerning clinical trials of the new fluoroquinolones in the treatment of infections of the eyes, ears, nose, and throat are sparse, but a number of studies of ofloxacin have been published in Japanese. The data suggest that the new quinolones may be useful for the treatment of acute sinusitis and chronic suppurative otitis media. However, studies comparing these agents with more established drugs and using carefully defined criteria for diagnosis and for evaluation of the response to treatment are needed. PMID- 3279498 TI - 4-Quinolones in the treatment of infections of the central nervous system. AB - The literature concerning the penetration of new 4-quinolones into the cerebrospinal fluid (CSF) and brain tissue is reviewed as well as the few reports on clinical use of these antibiotics in the treatment of infections of the central nervous system (CNS). Pefloxacin has been found to penetrate well into the CSF of patients with normal or inflamed meninges as well as into brain tissue. Ciprofloxacin also penetrates into CSF, although not as well as pefloxacin. Two patients with meningitis due to Pseudomonas aeruginosa have been reported to have recovered after treatment with ciprofloxacin. Because of the spectrum limitations of quinolones, especially with regard to anaerobes and gram positive aerobic cocci, these agents should not be considered for empiric use in CNS infections. They may, however, become alternatives in the rare cases of CNS infection caused by organisms resistant to other antibiotics. PMID- 3279499 TI - Adverse effects of the fluoroquinolones. AB - Data on adverse reactions due to the quinolone antibacterial agents- ciprofloxacin, ofloxacin, pefloxacin, norfloxacin, and enoxacin--observed in a patient sample of approximately 30,000 are reviewed. Overall rates of adverse reactions were 4.0%-8.0%, and adverse reactions necessitated discontinuation of therapy in 1.0%-2.6% of patients. Patterns of organ-system involvement and of signs and symptoms were quite similar, with gastrointestinal effects predominating (nausea, vomiting, diarrhea, or abdominal pain in 1.0%-5.0% of the patients), followed by effects on the central nervous system (dizziness, headache, and/or insomnia in 0.1%-0.3% of the patients) and skin (0.5%-2.2% of the patients). Elevation in levels of hepatic enzymes occurred in 1.8%-2.5% of the patients, azotemia in 0.2%-1.3%, and eosinophilia in 0.2%-2.0%. These adverse effects were reversible after drug withdrawal and were generally not dose dependent. Within the constraints of the relatively small number of well documented patients and the unique mechanism of action of these antimicrobial agents, the safety profile of these drugs seems to make them acceptable for use when their administration is well directed and specific. In addition, close surveillance for new phenomena should be maintained. PMID- 3279501 TI - Comparative activity of the 4-quinolones. AB - Minimal inhibitory concentrations (MICs) of the 4-quinolones ciprofloxacin, enoxacin, norfloxacin, ofloxacin, pefloxacin, difloxacin, A-56620, and CI-934 are consistent world-wide, with allowances for differences in acquired resistance. MICs of these drugs for Enterobacteriaceae correlate with those of nalidixic acid, but resistance to the quinolones is rare if a breakpoint of greater than 2 mg/L is accepted. Most intestinal pathogens are sensitive. Acinetobacter, Pseudomonas aeruginosa, and other Pseudomonas species except Pseudomonas maltophilia are usually sensitive. Ciprofloxacin is generally the most active of the 4-quinolones against these organisms. All of the new agents have antistaphylococcal activity, but that of norfloxacin and ofloxacin is borderline. Against streptococci, including enterococci and pneumococci, the drugs' activity is moderate or poor. Haemophilus influenzae and Branhamella catarrhalis are very sensitive. Gonococci and meningococci are also highly sensitive to the new agents, but activity against Chlamydia trachomatis and the mycoplasmas is borderline. The organisms associated with nonspecific vaginal infection are not very sensitive. Anaerobes except Bacteroides ureolyticus and Clostridium perfringens are mostly resistant. PMID- 3279500 TI - Bacterial resistance to fluoroquinolones. AB - Fluoroquinolones inhibit bacteria by interacting with the A subunit of DNA gyrase. Resistance to older agents such as nalidixic acid was due to mutations in the gyrA gene. Resistance to the new fluoroquinolones (e.g., norfloxacin, enoxacin, ofloxacin, pefloxacin, and ciprofloxacin) as a consequence of spontaneous single-step mutation occurs at a low frequency, less than 10(-9), and generally results in a 300-fold lower level of resistance than does the mutation to nalidixic acid resistance. High-level resistance to quinolones can be produced by serial exposure of bacteria to subinhibitory concentrations. Cross-resistance to all quinolones usually occurs. High-level resistance appears to be due to alterations in the A subunit of DNA gyrase and in a simultaneous alteration in permeability that probably is related to a loss of outer-membrane proteins. Organisms resistant to the new quinolones may also be resistant to other antibiotic classes, including beta-lactams. Clinical resistance to the new quinolones has been uncommon and has occurred most often among respiratory pathogens, particularly Pseudomonas aeruginosa from patients with cystic fibrosis and, less frequently, among strains of Serratia marcescens, P. aeruginosa, and Staphylococcus aureus from wound infections. Resistance of urinary or diarrheal isolates has been rare. So far, overall resistance of bacteria to quinolones has not emerged as a major problem, but--like resistance to all other antimicrobial classes--does occur in certain clinical settings. PMID- 3279503 TI - [Organogenesis of hearing. Development of the ear]. AB - From a review of the literature, the authors describe the development of the auditory organ, from embryogenesis to function, explaining the hearing abilities of the newborn as well as the possibilities of hearing in utero. PMID- 3279502 TI - [Oligo-amnios]. AB - The amniotic fluid shares closely in the well-being of the future child and volume abnormalities represent a valuable factor in the screening of fetal pathology. Many publications have recently reminded of the importance of oligo amnios as a prognosis factor in prenatal monitoring. Through an incomplete review of the literature, the author reminds of the physiology of amniotic fluid, diagnosis methods of oligo-amnios (essentially sonography), its causes and consequences, and finally its practical use as a monitoring parameter. A few possibilities of treatment are also discussed. PMID- 3279504 TI - [Organogenesis of hearing. Ontogenesis of the auditory pathways]. AB - A general review of the bibliography concerning the embryonic development of the auditory receptor provides a better knowledge of this topic, and anatomical basis of prenatal hearing, the existence of which has recently been demonstrated. The auditory receptor appears to be functional from the second trimester of pregnancy, but hearing seems mainly possible after 35 weeks. PMID- 3279505 TI - [Dysgerminoma of the ovary. Current diagnosis and therapy]. AB - From a review of the literature, the authors present some new facts on the diagnosis of ovarian dysgerminoma, as well as a therapeutic protocol for the treatment of extended forms, as well as the conservative treatment of localized forms in women wishing to become pregnant. PMID- 3279506 TI - [Acute respiratory infections in children]. PMID- 3279507 TI - [Asthma in infants and children]. PMID- 3279508 TI - [Treatment of asthma in infants and children]. PMID- 3279509 TI - Brain imaging: applications in psychiatry. AB - Various brain imaging techniques have become available in the past decade. These include techniques to evaluate brain structure, such as computed tomography and magnetic resonance imaging, and techniques to assess functional activity, such as measurement of regional cerebral blood flow, single photon emission computed tomography, and positron emission tomography. These techniques can be used to map brain structure and function in normal human beings, and they have enlarged our knowledge of the pathophysiology of mental illnesses by demonstrating structural, metabolic, and neurochemical abnormalities in a wide range of mental disorders. PMID- 3279510 TI - Performance assessment of radioactive waste repositories. AB - The current plans for permanent disposal of radioactive waste call for its emplacement in deep underground repositories mined from geologically stable rock formations. The U.S. Nuclear Regulatory Commission and U.S. Environmental Protection Agency have established regulations setting repository performance standards for periods of up to 10,000 years after disposal. Compliance with these regulations will be based on a performance assessment that includes (i) identification and evaluation of the likelihood of all significant processes and events that could affect a repository, (ii) examination of the effects of these processes and events on the performance of a repository, and (iii) estimation of the releases of radionuclides, including the associated uncertainties, caused by these processes and events. These estimates are incorporated into a probability distribution function showing the likelihood of exceeding radionuclide release limits specified by regulations. PMID- 3279511 TI - [Improved objectivity of the Lachman test by arthrosonography]. PMID- 3279512 TI - Biology of chronic myelogenous leukemia: is discordant maturation the primary defect? PMID- 3279513 TI - Cytogenetics of chronic myelogenous leukemia. AB - The fundamental pathogenetic significance of the Ph chromosome abnormality in CML has been clarified by molecular studies. However, this balanced reciprocal t(9;22) is probably not the primary event in the pathogenesis of this disease, at least at a cytogenetic level. The cause of Ph variants in +/- 5% of patients is still unknown. Improvements in cytogenetic techniques and molecular studies in a limited number of cases indicate that simple variants do not exist: Region 9q34 appears to be involved in all types of Ph variants. There is tentative evidence that these variants may in fact represent a clonal evolution from a standard t(9;22). The types of additional secondary abnormalities found in Ph variants are the same as those commonly found in standard cases. Ph negative CML represents a heterogeneous group of myeloproliferative/myelodysplastic disorders. The various mechanisms that could lead to Ph negativity are discussed. Some karyotypically normal cases and those showing a chromosome abnormality other than the Ph during the chronic phase have shown the same molecular changes as found in Ph positive CML. The types of clonal changes accompanying transformation to an acute phase are similar to those seen in myeloid disorders as a whole. The prognostic karyotypic factors in predicting imminent metamorphosis to the acute stage and during the acute phase are discussed. The extent of clonal evolution, the type of secondary abnormalities, and their relationship to the hematopoietic lineage of blast cells should be assessed. The nonrandom clonal changes found in 80% of cases are +Ph, +8, i(17q), +19, and loss of the Y. The significance of +Ph is possibly related to amplification of the bcr/abl fusion gene product, but the reason for the other persistent nonrandom changes is still speculative. Recent cytogenetic data indicate that the specific changes observed in various types of ANLL may be seen in corresponding types of MT, such as t(15;17) in promyelocytic transformations and abnormalities of 3q21-3q26 in megakaryoblastic transformations. Patients with LT usually have an early precursor B phenotype associated with a better prognosis. They tend to have either normal or hypodiploid karyotypes. An i(17q) is never seen and +8 and +19 are absent in most series. Duplication of the Ph and loss of the Y are common to both MT and LT. Data relating 14q+ abnormalities to LT are presently ambiguous.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3279515 TI - Staging and prognosis in chronic myelogenous leukemia. PMID- 3279514 TI - Molecular biology of chronic myelogenous leukemia. AB - In this review we have described molecular consequences of the t(9;22) translocation typical of CML and some cases of ALL. This data indicates an important role for abl and bcr and suggest some common mechanisms of activation of c-abl related tyrosine kinase activity. This data also provides insight into the relationship between Ph1 positive, Ph1 negative CML and Ph1 positive ALL. Although this data answers some questions, they raise others; eg, what is the molecular basis of the t(9;22) translocation? How does increased abl related kinase activity eventuate in CML? Finally, this data reviewed suggests that factors other than abl and bcr must play a role in CML. Definition of these factors will be important in the future. PMID- 3279516 TI - Bone marrow transplantation in chronic myelogenous leukemia. PMID- 3279517 TI - Stress research: its present status and issues for future developments. AB - In this article the contribution of nine approaches to stress research is discussed. These approaches are: (1) the biological approach; (2) the (classic) psychosomatic approach; (3) the life event approach; (4) interactionistic or transactional approaches; (5) life style and behavior; (6) group differences; (7) sociocultural (macro-)factors; (8) work and organizational psychology; and (9) intervention and prevention. It is concluded that, more and more, exchanges take place between different approaches and that the willingness to collaborate increases. Not only do we observe collaboration between different disciplines, there also are examples of an integration of laboratory research and field research. In addition, interest of animal workers for human research and vice versa seems to increase. Although it is realized that stress research has its own inherent characteristic problems (e.g. ethics), the authors feel that the future still can bring important progress. PMID- 3279518 TI - Stress, salt and hypertension. AB - Reasons are given why calcium, obesity and genetics cannot be considered primary factors in the etiology of essential hypertension. This leaves the major protagonists as salt and neuroendocrine responses to the emotions aroused by the social environment. Most essential hypertension is renin dependent and associated with the physiological changes induced by arousal of the defence response. The psychosocial stimulation associated with this arousal induces an increase in salt appetite. This makes the salt consumption of society a measure of the social stress to which it is exposed. Primitive people whose blood pressure remains normal throughout their lives may lack modern societies' physically protective achievements but their religiously prescribed social solidarity may protect them from psychosocial stress. Our chronic suppression of awareness of emotional arousal together with loss of the ritualized support of affiliative behavior may result in repressed emotional responses which find somatic expression in diseases such as essential hypertension. Hypertensiologist George Pickering proposed that the primitive's ritual and taboo (the equivalent in our society might be the Alcoholic's Anonymous belief in a 'Higher Power') protect them from much anger and despair. He gave this precedence over salt as the primary factor in essential hypertension. New evidence supports this. Despite a high salt diet the blood pressure of socially adjusted rodents remains normal throughout their lifespan. On the other hand, the hypertension that develops when they are psychosocially stimulated is not abated by a low salt diet. In humans, the blood pressure of cloistered, secluded Italian nuns on a high salt diet has remained normal for 20 years while that of nearby village women has risen at a startling 2 mmHg/annum during the same period. On the other hand, in rapidly changing Malawi mature adult, rural and urban blood pressures are rising fast despite a low salt intake. Thus the evidence today argues that the most important factor in the etiology of essential hypertension is not salt but psychosocial stimulation. PMID- 3279519 TI - Aerobic fitness and the physiological stress response: a critical evaluation. AB - Aerobically fit persons need less sympathetic activation to perform the same absolute workload than less fit persons. This led to the idea that aerobic fitness might reduce the physiological activation during psychological stress as well. Several experiments showed inconsistent results with regard to this supposed effect of fitness. The comparability of the results is hampered by the differences in operationalization of aerobic fitness and by the confusion of the terms aerobic fitness, training and habitual physical exercise. The expectancy of an effect of fitness on the physiological stress response is based on the assumption that this response resembles the response to exercise. The tenability of this assumption was examined for cardiac, vascular and hormonal responses respectively. It was concluded that the two types of responses only superficially have similarity. So a simple analogy between the stress and the exercise response does not allow a reliable prediction concerning the effect of fitness on the stress response. There are however other reasons to expect an effect. Especially the effect of fitness on adrenoceptor sensitivity suggests that the most important effect of fitness might be found in the vascular part of the stress response. It is argued that the measurement of complete response patterns, instead of isolated parameters, is a prerequisite for progress in this field. Future studies should address the question what the relative contribution of psychological and physiological factors is to the effect of fitness on the physiological stress response. PMID- 3279520 TI - The relationship between coping and emotion: implications for theory and research. AB - Historically, coping has been viewed as a response to emotion. Our purpose here is to evaluate this idea and offer a broader view based on cognitive and relational principles concerning the emotion process. We will explore the ways emotion and coping influence each other in what must ultimately be seen as a dynamic, mutually reciprocal relationship. PMID- 3279522 TI - Chronic stress and sympathetic-adrenal medullary responsiveness. AB - Acute exposure of animals to stressful stimulation is attended by a significant activation of the sympathetic-adrenal medullary system. If animals are exposed to the same stressful stimulus each day for several weeks, a number of adaptive changes occur in the sympathetic-adrenal medullary system, including increased synthesis and storage of catecholamines, increased basal levels of circulating catecholamines, and decreased release of catecholamines into the circulation following exposure to the identical (homotypic) stressful stimulus. If chronically stressed animals are exposed to a novel (heterotypic) stressful stimulus, there is an exaggerated response of the sympathetic-adrenal medullary system compared to animals exposed to the same stressful stimulus for the first time. Other neuroendocrine systems share some characteristics with the sympathetic-adrenal medullary system in its pattern of adaptation to chronic stress. Several variables appear to influence this pattern of neuroendocrine adaptation to stressful stimulation, including predictability of the stressor, the intensity and duration of the stressor, the interval between each episode of stress, and the number of presentations of the stressor. The pattern of neuroendocrine adaptation to chronic intermittent stressful stimulation resembles in some respects the processes of habituation and sensitization. PMID- 3279521 TI - Disclosure of traumas and psychosomatic processes. AB - Results from a series of studies are summarized in support of a general theory of inhibition and psychosomatics. According to this view, to inhibit thoughts, feelings, or behaviors is associated with physiological work. In the short term, inhibition results in increased autonomic nervous system activity. Over time, inhibition serves as a cumulative stressor that increases the probability of psychosomatic disease. Actively avoiding thoughts and feelings surrounding a trauma and/or not discussing a trauma is a particularly insidious form of inhibition. The results from recent surveys and experiments indicate: (a) childhood traumatic experiences, particularly those never discussed, are highly correlated with current health problems; (b) recent traumas that are not discussed are linked with increased health problems and ruminations about the traumas; (c) requiring individuals to confront earlier traumas in writing improves health and immune system functioning; (d) actively talking about upsetting experiences is associated with immediate reductions in selected autonomic activity. Implications of these findings for our understanding of disclosure, trauma, and disease are discussed. PMID- 3279523 TI - Stress-coping in migraine. AB - During a total of six months weekly measurements of coping with every-day life stresses were obtained from 29 migraine patients. Four issues were investigated: (1) the relation between daily stresses and the occurrence of migraine attacks; (2) the associations between ways of stress-coping and attack occurrence; (3) the effects on stress-coping of two behavior therapeutic methods, relaxation training and stress-coping training; (4) the clinical utility of pre-training measurement of stress-coping. the results yield evidence that both threat as a form of every day stress and 'depressive reaction' as a way to cope with threat are significantly related to the occurrence of migraine attacks. In general the effects of training on stress-coping appeared to be rather small. Three coping strategies changed as a result of both regimens taken together: 'tackling the problem actively' increased, while 'avoidance' and (quite tenuous) 'depressive reaction' decreased. Although relaxation training contributed most to these outcomes, no significant between-group differences were found. Divergent baseline per-subject patterns of stress-coping suggest that individual differences must be acknowledged. A sensible clinical usage of stress-coping data in our view requires that inferences are based on individual rather than group outcomes. Also, one cannot afford to neglect the actual and often idiosyncratic context of stress-coping. PMID- 3279524 TI - On the nature of social stress: production of a modern mythology. AB - In recent decades there has been increasing interest in the subject of stress and a proliferation of research into the contribution of stress as a cause of illness. This association has been widely popularized and now has an established position within the body of popular ideas about health and illness. Nevertheless, very little has been confidently established about the relationship between stress and illness. The precise nature of stress itself eludes definition and there is no consensus as to what it encompasses. There has been a confusion of the models of stress developed in the laboratory and those applied to society. Early laboratory research was modelled on 'mechanical' images of stress taken from contemporary physics and engineering. Since then the stress theory has been heavily psychologised, although it still relies for its validation on the physiological models with which it is fundamentally non-comparable. It is argued that stress is not something naturally occurring in the world, but a manufactured concept which has by now become a 'social fact'. As such it has direct implications for the ways in which people perceive their world and act within it. Stress has increasingly come to be regarded as an integral part of everyday experience. Although much of the attractiveness of the stress theory derives from its seeming to reduce the arbitrariness of suffering, it also carries with it a significant ideological component. This can serve as a means of organising and expressing a variety of ideas about the social order relating, for example, to issues of individual autonomy and responsibility, or to the ways in which society might be perceived as dangerous, repressive or pathogenic. PMID- 3279525 TI - Diagnostic peritoneal lavage in blunt trauma. AB - We reviewed the records of 274 trauma patients who had 275 diagnostic peritoneal lavages from Feb 1, 1983 through Jan 31, 1986. Lavage was done in 271 of 560 (48%) cases of blunt trauma and three of 245 (1%) penetrating injuries (gunshot wounds to the chest). The open lavage technique was used, and results were considered grossly positive if there was 10 ml of gross blood. Results were considered microscopically positive if there were more than 100,000 RBCs or 500 WBCs/cu mm, an elevated amylase or bilirubin value, or bacteria or vegetable fibers. Lavage was negative in 193 cases, including false-negative results (1%), and positive in 78, with three false-positive results (3.8%). Open peritoneal lavage is safe, rapid, readily available, and accurate in the evaluation of blunt abdominal trauma. PMID- 3279527 TI - Cecal diverticulitis: changing trends in management. AB - Diagnosis of cecal diverticulitis remains a dilemma. Preoperatively it can mimic appendicitis, and intraoperatively the surgeon is confronted with an inflammatory mass that may masquerade as a neoplasm. We reviewed 18 cases of pathologically documented cecal diverticulitis and one case of solitary diverticulitis of the ascending colon. Ileocolonic resection was done in 16 patients, and three patients had local resection. Patients having local resection had greater morbidity and a significantly longer hospital stay. There were no deaths. We have found ileocolonic resection to be safe and effective, and we recommend it as the procedure of choice for cecal diverticulitis. PMID- 3279526 TI - Phlegmasia cerulea dolens: therapeutic considerations. AB - Phlegmasia cerulea dolens (PCD) is a rare venous disorder that continues to be a major therapeutic challenge. We reviewed 16 cases of PCD treated during the past 15 years; 11 of the patients were male, and the average age of all the patients was 59 years. Malignant disease was the most common underlying condition (seven patients). Venous gangrene (VG) was present in seven extremities. Three treatment methods were used alone or in combination--intravenous heparin, venous thrombectomy, and thrombolytic therapy. Heparin was used initially in 13 patients; it yielded a successful result in seven (53%) patients, none of whom had VG. Venous thrombectomy was done in six patients; in three it was the primary procedure, in two it followed failure of heparin, and in one it followed failure of both heparin and thrombolytic therapy. Venous thrombectomy was successful in three (50%) patients, one of whom had early VG. Thrombolytic therapy was used on one occasion in conjunction with both heparin and venous thrombectomy, without benefit. Five patients died, all with VG, three after heparin only, one after heparin and venous thrombectomy, and one after all three treatment methods. Review of the 38 cases reported in the recent literature shows comparable results. These data suggest that nongangrenous forms of PCD respond well to systemic anticoagulation. Combination therapy using venous thrombectomy and heparin is indicated for severe ischemia, early VG, or failure of PCD to improve after six to 12 hours of heparin therapy. Phlegmasia cerulea dolens with VG is the lethal form of the entity and responds poorly to established therapy. Future therapeutic trials need to consider aggressive use of thrombolysis with or without thrombectomy. PMID- 3279528 TI - Pediatric lateral ventral (spigelian) hernias. AB - Lateral ventral (spigelian) hernias may not be recognized if the physician is unaware that they can occur in pediatric patients. Diagnosis depends on finding a protrusion in the spigelian fascia lateral to the rectus sheath at the junction of the arcuate and semilunar lines, below the umbilicus. We report nine such cases, to bring the total number of recorded pediatric cases to 18. Surgical repair involves a layered overlapping closure using interrupted nonabsorbable sutures. Since the rim of the defect is extremely difficult to outline once the child is asleep and relaxed, it must be outlined in indelible ink while the child is awake and straining. PMID- 3279529 TI - Bilateral renal agenesis: clinical implications. AB - Bilateral renal agenesis is a common congenital defect, with an incidence of 1 per 3,000 births. Though prenatal diagnosis is possible with ultrasound examination, sonographic findings may be equivocal, making the management of such pregnancies difficult. I report three cases that represent the diversity of the condition, and discuss implications of management. PMID- 3279530 TI - Prevalence of non-group-A beta-hemolytic streptococci in childhood pharyngitis. AB - We studied the prevalence of non-group-A beta-hemolytic streptococci (NGAS) in the pharyngeal cultures of symptomatic and asymptomatic children. Throat cultures were obtained by house officers in the Emergency Department at Children's Hospital of Pittsburgh to aid in the evaluation of children with symptoms or signs of pharyngitis, or both. A total of 929 throat cultures were read in four discrete periods between July 1982 and February 1984. A control group was composed of 414 asymptomatic children, recruited contemporaneously with study subjects. beta-Hemolytic colonies were evaluated for bacitracin susceptibility and grouped by the Streptex method. The prevalences of NGAS in symptomatic and control children were 6.5% (60/929) and 1.0% (4/414), respectively (P less than .01). Seasonal variation in the recovery of NGAS from symptomatic children was suggested by higher relative and absolute recovery rates of NGAS during warm weather. This study demonstrates an association between NGAS and sporadic pharyngitis in school children but does not establish causality. PMID- 3279531 TI - Bacteriology of middle ear effusions. AB - We studied fluid obtained from middle ear effusions (MEEs) during 908 myringotomy and tube insertion procedures on 495 children aged 4 months to 12 years. Under general anesthesia the external auditory canal was sterilized with povidone iodine (Betadine) and alcohol, and myringotomy was done. Fluid was aspirated into a Luki tube and sent for culture and sensitivity determination. The median age of patients was 3 years 5 months; 1-year-old children comprised the largest single group. Two thirds of the children were male. Effusion was present in three fourths of the ears; in about 20% of these, culture grew bacteria. Haemophilus influenzae made up almost 50% of the pathogens, with the percentage decreasing with age. Almost 90% of the H influenzae organisms were sensitive to erythromycin, and about three fourths to ampicillin and cephalosporin. PMID- 3279532 TI - Cardiovascular risk in parents of children with extreme lipoprotein cholesterol levels: the Bogalusa Heart Study. AB - Fasting serum lipids, lipoprotein cholesterol, and other cardiovascular disease risk factors were examined in 321 natural parents of children with low and/or high levels of beta- and pre-beta-lipoprotein cholesterol. Parents of children from low pre-beta-lipoprotein groups had elevated alpha- and lower pre-beta lipoprotein cholesterol levels. Parents whose children had high beta-lipoprotein cholesterol levels also had high serum total and beta-lipoprotein cholesterol levels. Parents of children with high levels of both beta- and pre-beta lipoprotein cholesterol had a high prevalence of both abnormal risk factor levels, as well as clinical evidence of early coronary artery disease (before age 50 years). These observations show that parents of children with high beta- and/or pre-beta-lipoprotein cholesterol levels have greatly enhanced risk for cardiovascular disease, and children mirror their parents' lipoprotein cholesterol levels. These observations emphasize the need for cardiovascular risk evaluation early in life, especially in high-risk families. PMID- 3279533 TI - Automated hematology: where we stand. AB - Rapid, accurate, and relevant laboratory testing is essential in an era of cost effective medicine. The routine manual complete blood count (CBC) is a labor intensive test that lacks reproducibility. The new automated instruments such as the Coulter S+ series offer "state of the art" precision and accuracy in counting more than 10,000 cells per blood sample. The nonoptical electronic impedance method yields RBC, WBC, and platelet data, as well as histograms that characterize hematologic data. Analysis of more than 3,500 cases yielded a false negative rate of less than 4% and a false-positive rate of 30%, indicating the instrument's accuracy in recognizing and flagging abnormalities. All normal screened CBCs were free of significant abnormalities. The Coulter S+ series provides innovative parameters and histograms that aid in establishing differential diagnoses. We review the advantages and the limitations of automation. Morphologic examination of abnormal blood smears remains the cornerstone of diagnosis in both the new and the old hematology. PMID- 3279534 TI - Nodular sclerosing Hodgkin's disease with giant Reed-Sternberg cells. AB - A 70-year-old woman with multiple symptoms and extensive lymphadenopathy had a lymph node biopsy specimen that contained highly pleomorphic, giant Reed Sternberg cells that resembled cells from other malignant giant cell neoplasms. The cells were strongly positive for Leu-M1, alpha 1-antitrypsin, S-100 protein, kappa light chain, and lambda light chain. With five courses of chemotherapy for pathologic stage IV-B Hodgkin's disease, the patient achieved a complete remission, and remains free of disease 85 months after diagnosis. PMID- 3279536 TI - The big chill: intraoperative diagnosis and treatment of unsuspected preoperative hypothermia. PMID- 3279535 TI - Intracerebral and intracerebellar neurilemoma. AB - Neurilemomas (schwannomas) within the brain substance and not associated with a peripheral nerve are rare. We have presented two such cases, one with a prominent angiomatous component. Neither patient had neurofibromatosis. Both patients had headache and focal neurologic signs, and surgical excision was curative in both cases. PMID- 3279537 TI - Idiopathic hypereosinophilic syndrome with polymyositis. AB - We have reported a case of idiopathic hypereosinophilic syndrome (HES) with polymyositis, in which there was marked eosinophilic leukocytic infiltration of the myocardium and striated skeletal muscles, particularly of the diaphragm, with foci of necrosis and areas of fibrosis. We believe this to be the first detailed report of the involvement of the diaphragm in HES. PMID- 3279538 TI - Dukes' classification of rectal cancer. PMID- 3279539 TI - Cure of brain abscess caused by Nocardia asteroides resistant to multiple antibiotics. AB - A 29-year-old man with pulmonary infiltrates due to pulmonary alveolar proteinosis had Nocardia asteroides pneumonia and brain abscess. The nocardial infections persisted after therapy with sulfonamides, minocycline, and cefotaxime. Based on the susceptibility studies and serum antibiotic concentrations, he was treated with minocycline, 400 to 600 mg daily, cefotaxime, 12 to 30 gm daily, and probenecid for 15 months. Proteinuria observed near the completion of therapy was transient. Three years after therapy, the infections appear to have been cured. PMID- 3279540 TI - Suppurative pylephlebitis caused by toothpick perforation. AB - We have reported a case of suppurative pylephlebitis in an elderly, debilitated patient. The infection was caused by toothpick perforation of and migration from the gastrointestinal tract. The patient had risk factors for foreign body ingestion, including poor dentition, aphasia caused by a previous cerebrovascular accident, and alcohol abuse. Investigation for the otherwise obscure cause of suppurative hepatic disease should take into account the possible, yet difficult to define, source related to an ingested foreign body. PMID- 3279541 TI - In situ localization of murine c-Ki-ras-2 oncogene: preliminary evidence for conservation of telomeric territory of oncogenes? AB - The use of a human cDNA probe and a Robertsonian translocation marker allowed us to localize the murine c-Ki-ras-2 oncogene to 6F-G at the telomere. Our finding provides support for the hypothesis that oncogenes have a preferred telomeric territory that is evolutionarily conserved. Given our physical mapping of c-Ki ras-2 to 6F-G, the role of this oncogene in the genesis and/or maintenance of granulocytic leukemias can now be explored by correlating the oncogenic site to that of the structural rearrangement of chromosome 6 seen in the tumors. PMID- 3279543 TI - Genuine septation of the gallbladder. A case report. AB - Septation of the gallbladder is rarely of any consequence except in differentiating it from a disease of the organ. To date all radiographically demonstrated septa have been considered simple foldings of the wall. A case of genuine septation of the gallbladder after cholecystojejunostomy is presented. PMID- 3279542 TI - The pineal organ in man. An endocrine gland awaiting recognition. AB - Information on pineal gland function in man is briefly reviewed. The evidence presented suggests that in man the pineal gland: (i) is involved in control of certain types of behaviour, such as sleep and sleepiness; (ii) is associated with direction orientation; (iii) is in some way related to the phenomenon known as jet lag; (iv) affects sexual maturation; and (v) may affect sperm motility. On the basis of available evidence it is concluded that in man the pineal gland must be regarded as an endocrine gland participating in the close synchronization of a variety of functions. PMID- 3279544 TI - Computed tomography and magnetic resonance imaging of the acute abdomen. AB - CT is a noninvasive investigation that in many instances is more sensitive in elucidating intra-abdominal and retroperitoneal disease than is conventional radiography. With modern scanners, the procedure is rapid and efficient and suitable for the most severely ill and infirm. The scans are easily interpretable, and the anatomic and morphologic depiction of disease is readily understood by those with surgical training. Information regarding the state of the bowel wall, mesentery, and intraperitoneal and retroperitoneal structures is displayed in greater detail than by any other diagnostic imaging modality. The use of intravenous contrast medium is rarely essential. The concentration of iodinated contrast needed for opacification of the bowel is no greater than 2 per cent to 5 per cent and will not complicate bowel surgery, as would standard upper gastrointestinal or barium enema studies. Abscess, free air, calcium, and intraperitoneal fluid are very sensitively detected. CT is extremely useful in aiding surgical decision making in the acute abdomen and is complementary to or has replaced conventional studies. PMID- 3279546 TI - Acute cholecystitis. AB - Acute cholecystitis is a common cause of the acute abdomen. The diagnosis has been distinctly improved with the development of ultrasonography and hepatobiliary scanning over the past 20 years. The treatment is cholecystectomy, with early as opposed to delayed operation gaining increasing popularity nationwide. Acute acalculous cholecystitis and emphysematous cholecystitis are special features of acute cholecystitis occurring in more complicated cases and requiring diligence in diagnosis and great care in treatment. PMID- 3279545 TI - CT scanning in acute abdominal injuries. AB - Computed tomography has become an important adjunct in the evaluation of the patient with blunt abdominal trauma. It provides quantitative information about hemoperitoneum as well as qualitative information about the source of hemoperitoneum. CT scanning also evaluates the retroperitoneal organs and retroperitoneal hematoma more accurately than any other available imaging technique. Like any other diagnostic tool, the CT scan must not be overused or abused. This technique should be applied only to stable patients and only in institutions with up-to-date equipment, a committed radiology and surgery staff, and appropriate monitoring equipment in the CT suite. If proper technique is used, then high-quality scans can be obtained which, if interpreted by experienced personnel in the light of the clinical findings, can improve our management of selected trauma patients. PMID- 3279547 TI - Acute pancreatitis. AB - In order to recognize acute pancreatitis in the setting of the acute abdomen, the surgeon must be thoroughly familiar with the numerous etiologies of the disease. No specific test is available to diagnose acute pancreatitis. CT scanning is arguably the most useful single tool, but surgical judgment is critical. Most cases of acute pancreatitis resolve spontaneously without sequelae, but the spectrum of the disease also includes highly lethal forms associated with a variety of systemic complications. Operative intervention is indicated when other, more rapidly fatal, abdominal processes cannot be reliably excluded and when local complications develop. PMID- 3279548 TI - Acute colonic diverticulitis. AB - Colonic diverticulosis is truly a disease of the 20th century. A direct correlation is thought to exist between the incidence of diverticular disease and the amount of dietary fiber. Acute colonic diverticulitis occurs in approximately 25 per cent of the patients with diverticula, and 20 per cent of the patients with diverticulitis will ultimately require surgical intervention. Because of the often virulent nature of the disease in younger patients and the prevalence in the geriatric population, an aggressive approach is advocated. Primary resection of the involved segment of colon is advocated in all cases requiring operation. A primary anastomosis can be constructed in stage I and some cases of stage II disease. This results in lower morbidity and mortality rates as well as fewer days of hospitalization and disability. Newer techniques such as diagnostic CT scanning, percutaneous drainage of diverticular abscess, and greater application of surgical stapling devices have done much to improve the ultimate outcome of colonic diverticulitis. PMID- 3279549 TI - Perforated peptic ulcer. AB - Peptic ulcer disease has declined significantly since 1950 in industrialized nations. However, the number of patients with perforated and bleeding ulcers has been constant or has declined only slightly, except for older patients, in whom the frequency has increased. In patients with perforated ulcers, operative management is preferable to non-operative treatment. The operative choices are simple closure of the perforation or definitive surgery. Patients who have significant risk factors should undergo simple closure. Closure of the ulcer with parietal cell vagotomy is the author's first choice for definitive operative treatment when this procedure can be performed. PMID- 3279550 TI - Mesenteric ischemia. AB - Mesenteric ischemia secondary to vascular disease remains a significant problem in patients presenting with acute abdominal conditions, especially if they are elderly. Although rare, it is nevertheless an important and perhaps increasing cause of death or significant morbidity. Occasionally, it may be a mode of dying, but more often, it is the reason for death. Individual cases can manifest an almost overwhelming spectrum from chronic to acute, mild to catastrophic, arterial to venous, occlusive to hemodynamic, extensive to limited, or precisely diagnosed to accidentally found. Treatment principles are well defined, but continued refinement of supportive therapies of several types is occurring. In contrast, improved screening tests that can lead to early specific etiologic diagnosis remain at the experimental stage. Thus, good "clinical suspicion" is foremost and essential. PMID- 3279551 TI - Obstruction of the large and small intestine. AB - This article provides an overview of mechanical small and large bowel obstruction with emphasis on newer diagnostic and therapeutic surgical techniques. Small and large intestinal pseudo-obstruction is discussed with reference to its diagnosis and appropriate treatment. PMID- 3279552 TI - Management of ruptured or symptomatic abdominal aortic aneurysms. AB - During the past 15 years, the operative mortality for elective repair of abdominal aortic aneurysms has declined; this favorable trend has very likely resulted from simplified operative technique and improved perioperative management. Unfortunately, however, there has been no comparable decline in the mortality associated with repair of ruptured abdominal aortic aneurysms. The management of these patients remains a challenge to even the most skilled and experienced vascular surgeon. PMID- 3279553 TI - Gynecologic causes of the acute abdomen. AB - Acute surgical emergencies of gynecologic origin occur for the most part in women of reproductive age but occasionally in newborn and adolescent patients and rarely in the postmenopausal patient. The most common and most important conditions to be considered include pelvic inflammatory disease (PID) with abscess, ectopic pregnancy, hemorrhage from a functional ovarian cyst, and adnexal or ovarian torsion. PMID- 3279554 TI - Urologic causes of the acute abdomen. AB - This article reviews renal and perirenal infections, obstructing conditions of the renal pelvis and ureter, and acute intrascrotal events. Each subject is reviewed with regard to patterns of presentation, means of diagnosis, and treatment options. Emphasis is placed on new modalities in the evaluation and treatment of these conditions. PMID- 3279555 TI - Acute abdominal conditions in children and adolescents. AB - Evaluation and management of the acute abdomen in childhood require a thorough familiarity with the numerous disorders that may cause abdominal emergencies. Many of these entities are rarely seen in adults or have clinical features that are very different from those observed in adults. Diagnosis is often confounded by difficulties in obtaining an accurate history and physical examination. In infants and young children, complications of various congenital abnormalities are more common causes of abdominal pain, whereas acquired disorders are observed more frequently in older children and adolescents. PMID- 3279556 TI - The biology of peritonitis and implications for treatment. AB - Peritonitis continues to be one of the major infectious problems confronting surgeons. Despite the many advances in antimicrobial agents and supportive care, mortality from diffuse suppurative peritonitis remains unacceptably high. The authors review the anatomy and defense capabilities of the peritoneal cavity and then focus on the polymicrobial nature of peritonitis and how, through microbial interactions with host defenses, there is either resolution or persistent infection. They also consider possible infection-potentiating agents in the peritoneal cavity and experimental modes of therapy. PMID- 3279557 TI - Early postoperative acute abdominal complications. AB - The detection and management of acute postoperative conditions of the abdomen present a challenge to the surgeon. Many of these conditions threaten life because of their association with disorders of oxygenation, circulatory stability, and infection leading to multiple organ failure. This discussion highlights features of rapid diagnosis and focuses on problems relating to the decision to reoperate for diagnosis and therapy. PMID- 3279558 TI - The pregnant woman's eye. AB - The effects of pregnancy on the eye fall into three categories. Nonpathological physiologic changes in pressures, corneal sensitivity and thickness, and visual function can occur. Pathologic conditions reported to develop during pregnancy include central serous chorioretinopathy, hypertensive and vascular disorders, and uveal melanoma. Pregnancy also can affect pre-existing ocular conditions, such as diabetic retinopathy, tumors, and a variety of immunological disorders and can have beneficial effects on such pre-existing conditions as glaucoma. This review covers ocular disorders in these three categories, and summarizes the systemic changes of pregnancy and the effects of ocular medications on the fetus. PMID- 3279559 TI - Epidemiologic aspects of uveal melanoma. AB - Although the underlying cause or causes of uveal melanoma have yet to be elucidated, important insights may be gained by examining the epidemiologic features of the disease. Uveal melanoma is an uncommon cancer with an incidence of only six cases per million population per year. It is most often diagnosed in the sixth decade and is somewhat more common in males. Apart from sporadic reports of family clusters, uveal melanoma is not considered an inherited disease. Whether some environmental exposure triggers the development of uveal melanoma remains an open question. Sunlight has been proposed as an environmental risk factor because sunlight is known to cause melanoma of the skin and both diseases are rare in nonwhite races. Unlike cutaneous melanoma, however, rates have not been increasing over time and do not vary by latitude. This paper evaluates the available evidence for sunlight and other potential risk factors for uveal melanoma, highlighting areas requiring further research. PMID- 3279560 TI - Solar radiation and age-related macular degeneration. AB - Age-related macular degeneration (AMD) involves a progressive impairment of the outer layers in the center of the retina. Experimental studies have demonstrated that bright light preferentially damages precisely the region that degenerates in AMD. The evidence that solar radiation is responsible for some of the deteriorative changes that lead to AMD is examined in this review. In the primate eye, the high-energy portion of the solar spectrum is most hazardous to retinal molecules, with damaging effects increasing as photon energy rises. This action spectrum is explicable by the quantum laws which describe the interaction of radiation with matter. High-energy visible and ultraviolet photons can produce molecular damage by a photochemical mechanism. The lesion is exacerbated by oxygen, which initiates free-radical chain reactions (photodynamic effects). Melanin exerts a protective effect against damage from sunlight. In the human retina, documented lesions from solar radiation range from the acute effects of sun-gazing to injuries resulting from prolonged periods of exposure in brightly illuminated environments. The damage occurs in the same region that degenerates in AMD. A cataractous lens and ocular melanin both protect the retina against AMD, as predicted by the radiation hypothesis. Identification of an environmental factor that evidently plays a role in the etiology of AMD provides the basis for a program of preventive medicine. PMID- 3279561 TI - Pneumatic retinopexy. AB - Pneumatic retinopexy, a term introduced by Hilton in 1985, describes a recently revised and modified operation used for primary rhegmatogenous retinal reattachment. A gas bubble is injected into the vitreous cavity and the patient positioned so that the bubble closes the retinal break, permitting resorption of subretinal fluid. A chorioretinal adhesion formed around the break secures the retina in place. The history of pneumatic retinopexy is presented as well as recent studies on the subject. Characteristics of intraocular gases are reviewed. A protocol is described for pneumatic repair of complex retinal detachments. Patient selection and surgical techniques are recommended. Pneumatic retinopexy is compared to other retinal reattachment techniques and controversial issues are discussed. PMID- 3279562 TI - Acardiac fetus in a triplet pregnancy. AB - The acardiac monster represents one of the most severe but rare congenital anomalies. It occurs only in multiple gestations associated with vascular anastomoses between the affected fetus and its co-twin. The prenatal diagnosis of an acardiac fetus must be suspected in any multiple gestation in which cardiac activity cannot be documented sonographically in a growing fetus. We report an acardiac fetus occurring in a spontaneously conceived triplet pregnancy. A review of the literature, including pathogenetic theories and sonographic reports, is discussed. PMID- 3279563 TI - Teratogen update: anesthetic agents. AB - Although many pregnant women undergo anesthesia and many others are occupationally exposed to anesthetics every year, assessment of the teratogenic risk of anesthetic agents in humans must currently be made on the basis of very limited data. Available studies suggest that administration of an anesthetic to a pregnant woman will usually not have a deleterious effect on embryonic or fetal development. The risk of congenital anomalies does not appear to be substantially increased among children of women who have chronic occupational exposure to anesthetic gases during pregnancy, either, but miscarriages may occur more frequently than expected among such women. There is an urgent need for publication of good human epidemiologic and experimental animal studies on the teratogenicity of anesthetics. PMID- 3279564 TI - [Chorea, athetosis, ballism: clinical aspects, causes and treatment]. PMID- 3279565 TI - [The current place of stereotaxic neurosurgery in the treatment of involuntary movements]. PMID- 3279566 TI - Rotraut Gollwitzer (20.7.1925 - 11.9.1986). PMID- 3279567 TI - [The New Dutch Kidney Test. I. Description of the method]. AB - The New Netherlands Kidney test is designed for the detection of antibacterial residues in slaughtered animals. It is a single-plate system in which the culture medium used is composed of Standard II nutrient agar, supplemented with 1 per cent of NaCl, 1 per cent of dextrose, 0.2 per cent of KH2PO4 and 0.28 per cent of Na2HPO4.12H2O. After autoclaving, this medium is cooled to 55 degrees C, which is followed by the addition of trimethoprim (0.12 microgram/ml of agar) and spores of Bacillus subtilis BGA (10(4) ml of agar). The pH should be adjusted to 7.00 +/ 0.05, the prepared medium then being poured out into plates specially designed for this purpose, in such a manner that the thickness of the layer of agar is 2.2 mm throughout. The following method is used in examining slaughtered animals for the presence of residues showing antibacterial activity. Four paper discs are placed in the renal pelvis for a minimum period of thirty minutes; two discs impregnated with fluid from the renal pelvis are frozen at -20 degrees C for possible re-inspection and the other two are laid diagonally on a test plate. 25 microliter of a trimethoprim solution (containing 2 micrograms of TMP per ml of a 10 per cent NaCl solution) are dropped on each of the two last-named discs. The test plates are incubated at 37 degrees C for a period ranging from thirteen to eighteen hours.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279568 TI - [The New Dutch Kidney Test. II. Sensitivity of the test system]. AB - When the in vitro sensitivity of the New Netherlands Kidney Test (NNKT) is compared with that of the test plates of the current Netherlands Kidney Test (NKT) and the EEC four-plate system (ECT), this shows that it occupies a middle position with regard to aminoglycosides, macrolides and tetracyclines. The test plate of the NNKT is more sensitive to sulphonamides. Experimental qualitative and quantitative studies in slaughtered pigs showed that the New Netherlands Kidney Test was equally sensitive or more so in detecting residues of sulphonamides, chloramphenicol, tetracyclines, aminoglycosides and penicillin derivatives than the ECT system for meat. In addition to the simplicity of the current Netherlands Kidney Test, the New Netherlands Kidney Test also shows the broad-spectrum sensitivity of the ECT system. When tolerance standard of nitrofurans or chloramphenicol respectively is 1 or 10 ppb, the New Netherlands Kidney Test will fail. PMID- 3279569 TI - [The New Dutch Kidney Test. III. Practical evaluation]. AB - The New Netherlands Kidney Test (NNKT) is a method used to detect residues of antibacterial agents in slaughtered animals. This test will shortly be substituted for the current Netherlands Kidney Test (NKT). The new method was tested for its suitability in meat inspection in the field by four district laboratories, comparative studies with the current Netherlands Kidney test being done at the same time. These investigations showed that, when the new test (NNKT) was used, 5.3 per cent of the category of diseased animals and, using the current Netherlands Kidney Test, 2.2 per cent of these animals were positive. When control discs were used, it was shown that reproducibility of the new test (NNKT) within and between the participating laboratories was satisfactory. A method was developed to obtain similar results on re-examination with the NNKT as those obtained in the first inspection. By freezing the duplicate discs at the time of performance of the test and using these discs for re-inspection, reproducible results were obtained with the NNKT. The substance inhibiting the growth of bacteria was identified in a number of specimens diagnosed as positive when the NNKT was used. False-positive results were not recorded in the NNKT. PMID- 3279570 TI - Staphylococcal alpha toxin--recent advances. AB - The elucidation of the amino acid sequence of alpha toxin in 1984 has greatly promoted our understanding of the basic biochemistry and interaction of this toxin with membranes. These aspects are discussed and the concept of alpha toxin as a channel forming protein is critically evaluated. The lethal action of alpha toxin has not yet been clarified, but the previously postulated action as a neurotoxin is not supported by recent observations. PMID- 3279571 TI - Large-scale production of fetal porcine pancreatic isletlike cell clusters. An experimental tool for studies of islet cell differentiation and xenotransplantation. AB - A recently described method for the preparation of isletlike cell clusters (ICC) from human fetal pancreas has been applied to the fetal pig with the ultimate aim of large-scale production of ICC. Fetuses ranging in age from 51 to 77 days were used, and after a brief collagenase-incubation the pancreatic digest was plated into culture dishes containing medium RPMI 1640 supplemented with either 10% fetal calf serum (FCS) or human serum (HS). HS seemed to increase the number of ICC formed as compared to that obtained with FCS. A total of more than 100,000 ICC were produced from each of 3 litters, ages 67-77 days, after culture in the presence of HS. The DNA content of such ICC was reduced by about 50% as compared to those maintained with FCS supplementation. Immunocytochemical staining revealed insulin- and glucagon-positive cells scattered among a majority of nonstained cells within the cell clusters. ICC maintained in either FCS or HS displayed significant rates of (pro)insulin biosynthesis in vitro and an increased insulin release when exposed to 16.7 mM glucose plus 5 mM theophylline. Four weeks after implantation, ICC grafted under the kidney capsule of nondiabetic nude mice contained frequent insulin- and glucagon-positive cells. In 2 nude mice transplanted with ICC, the functional capacity of the graft was tested by perfusing the graft-bearing kidney. When the perfusion fluid was changed from one containing 2.8 mM glucose to one containing 16.7 mM glucose +/- 5 mM theophylline, the secretion of insulin increased within a few min. It is concluded that the fetal porcine pancreas can be used for large-scale production of ICC, which have a very consistent, but immature functional capacity. Because of their inherent growth and differentiation properties, fetal porcine ICC constitute a potential source of xenogenic islet grafts intended for human diabetics. PMID- 3279572 TI - Discordant heart xenografts in the rat. Additional effect of plasma exchange and cyclosporine, cyclophosphamide, or splenectomy in delaying hyperacute rejection. AB - Natural antidonor antibodies are known to play a prominent role in hyperacute xenograft rejection. The aim of this work was to devise an experimental protocol to prolong the survival time of guinea pig heart xenografts transplanted into rats. A technique of continuous plasma exchange adapted to small animals was used to remove the natural cytotoxic antibodies from the recipient prior to the transplantation. In some experiments, cyclosporine (CsA), cyclophosphamide (CY), or splenectomy were associated with the plasma exchange. In this highly discordant xenogenic donor-recipient combination, the mean graft survival time in nontreated rats was 16 min. When an exchange of 1.5 plasma volume was performed 24 hr before the transplantation, no prolongation of the graft survival time was observed. When CsA, CY, or splenectomy were associated with the plasma exchange, the graft survival time was significantly increased by more than 2500% (up to 418 min with CsA). When used isolately, none of these 3 immunosuppressive methods was able to prolong the graft survival time. Natural cytotoxic antibodies were monitored by a complement-mediated cytotoxicity assay. After a plasma exchange, the titers decreased from 1:16-1:32 to 1:1-1:2. When no immunosuppressive method was associated with the plasma exchange, the antibodies returned to their initial level within the 24 hr that preceded the transplantation, and the graft was rejected as in nontreated animals. When an immunosuppressive method was associated with the plasma exchange, and particularly in the case of CsA, the titers remained low, and the hyperacute rejection was delayed. Therefore, it can be concluded that plasma exchanges, associated with CsA, are an efficient experimental protocol in the rat to increase the survival time of guinea pig heart xenografts. The effect of the treatment is correlated with the decrease in natural cytotoxic antidonor antibodies. PMID- 3279573 TI - Liver transplantation with reduced-size donor organs. AB - Orthotopic liver transplantation (OLT) of the pediatric patient is often limited by the availability of a size-matched donor organ. Use of reduced liver transplantation (RLT) can increase the proportion of candidates transplanted and may reduce overall mortality. We report herein the initial clinical application of RLT in the United States. Indications for RLT included fulminant hepatic failure (n = 2), acute hepatic artery thrombosis (n = 3), and chronic liver disease unresponsive to inpatient support and more than 30 days on transplant list (n = 4). Donor hepatectomy was performed using standard techniques. Formal hepatic resection was performed ex-vivo to create a size-matched graft, from the larger donor organ, which was implanted in the orthotopic position. Between 11/84 and 4/87, 70 pediatric patients were evaluated for OLT, and 33 of these were transplanted. During this period only 5 patients (7%) died awaiting OLT. Of 33 patients treated at the University of Chicago, 5 received RLT. Donor: recipient weight ratios ranged from 2:1 to 8.1:1. For RLT median operative blood loss was 1.7 blood volumes (range 0.5-11.7) with an operative time of 9.3 + 3.5 hr. Acceptable early graft function was observed in five patients, all of whom were discharged from the hospital. Four of these five patients are alive between 2 and 48 months after transplantation. Marginal graft function with cholestasis and coagulopathy was associated with acute intracranial hemorrhage and neurologic death in one case. One patient died intraoperatively with non-function caused by the use of a liver from a donor with steatosis and a poor size match. Another patient died on day 5 with primary nonfunction and persistent hemorrhage. Systemic cytomegalovirus infection was the cause of death in the other two cases. RLT can provide life-sustaining liver function in urgent clinical settings. The graft can serve as a temporary or permanent liver replacement. With evolution of the technique RLT could eventually be offered to more elective candidates and increase the utilization of available donors by reducing size limitations in OLT. PMID- 3279574 TI - Immunopathologic features of de novo membranous nephropathy in renal allografts. AB - De novo membranous nephropathy (MN) is now one of the most common forms of posttransplant glomerular disease, second only to allograft glomerulopathy. We investigated several immunopathologic and physicochemical properties of the immune complex (IC) or IC components displayed in the sera of patients with de novo MN. The parameters studied included detection of small (9S) preformed IC by monoclonal rheumatoid factor, determination of IC isoelectric point by chromatofocusing, detection of cationic IgG spectrotypes (pI 8.0-9.2), and demonstration of brush border or tubular epithelial/interstitial antibodies in the sera by indirect immunofluorescence. Of 7 de novo MN sera, 5 demonstrated the presence of each of these four immunopathologic features, whereas normal transplant patients, transplant recipients with recurrent focal sclerosis (FSGN), and those with chronic rejection did not display such features. Sera of patients with untreated idiopathic MN revealed immunochemical properties of IC that were similar to those seen in circulating IC of de novo MN. These studies suggest that a strongly nephritogenic internal milieu exists in transplant recipients with de novo MN. Our data indicate that unique immunochemical properties of IC or their components may predispose to subepithelial immune deposit formation and should provide new insights into the pathogenesis of idiopathic human MN. PMID- 3279576 TI - The importance of eosinophil cells in kidney allograft rejection. AB - The composition of the intragraft cellular infiltrate was studied in 83 renal allograft recipients with the technique of fine-needle aspiration cytology in the first four weeks following kidney transplantation. We found a significantly (P less than 0.05) higher mean tissue eosinophil percentage in patients who had irreversible rejections with transplant loss than in those who had reversible rejections (12.54 +/- 2.31 versus 3.79 +/- 1.14, mean +/- SEM). Patients who had serious, dialysis-requiring rejections also showed a significantly (P less than 0.05) higher mean tissue eosinophil percentage than those who had reversible rejections (21.40 +/- 5.98 versus 3.79 +/- 1.14, mean +/- SEM). The frequency of the HLA B8 antigen was 46.2% in patients who had excessive tissue eosinophilia, whereas its frequency in all the studied patients was 18.3%. Based on our observations, the presence of more than 4% eosinophils in the tissue inflammatory exudate is a specific (91%) and fairly sensitive (78%) indicator of irreversible and severe acute rejections. PMID- 3279575 TI - Immunohematologic consequences of major ABO-mismatched bone marrow transplantation. AB - Twelve of 58 (21%) evaluable patients of blood group 0 who received a bone marrow transplant (BMT) from an HLA-matched sibling of a donor of group A or B developed significant immunohematologic problems in the posttransplant period. Anti-A or anti-B isohemagglutinins persisted for longer than 120 days post-BMT in nine patients and are still present in three patients at days +162 to +605. Red cell production as indicated by a reticulocyte count of greater than 0.5% was delayed to 40 days or more in nine patients, and in five of these was markedly delayed to 170 days or longer. One patient does not as yet have red cell production on day +605 in spite of having had 13 plasma exchanges performed to reduce the anti-B titer. Five patients experienced overt hemolysis, manifested by a sudden drop in hemoglobin of 1.5 to 4 gm/dl (median = 2.5 mg/dl), starting on day +37 to +105 (median = +65), persisting for 10 to 94 days (median = 36 days). Hemolysis and a delay in the onset of erythropoiesis beyond 170 days were more frequent in 30 patients treated with cyclosporine/prednisone than in 28 patients treated with methotrexate/prednisone for graft-versus-host disease prophylaxis. Our data indicate that ABO major mismatched BMT can be associated with significant immunohematologic consequences, some of which occur more frequently in association with cyclosporine administration. PMID- 3279577 TI - Clinical and immunological studies of cadaveric renal transplant recipients given total-lymphoid irradiation and maintained on low-dose prednisone. AB - Twenty-five recipients of cadaveric renal transplants were given total lymphoid irradiation (TLI), perioperative antithymocyte globulin, and low-dose prednisone as the sole maintenance immunosuppressive drug. Nine patients were diabetic, and follow-up was between 19 and 37 months. One-year graft and patient survival was 76% and 87%, respectively, Serious complications included four deaths from cardiovascular disorders, and two deaths from viral infections. Studies of peripheral blood T cell subsets showed a prolonged reduction in the absolute number of helper (Leu-3+) cells, and a rapid recovery of cytotoxic/suppressor (Leu-2+) cells. Analysis of the latter subset, using the monoclonal antibody 9.3, showed that the ratio of suppressor/cytotoxic cells was approximately 10:1. The normal ratio is 1:1. The mean mixed leukocyte reaction remained below 30% of the pre-TLI value for 6 months, and approached 80% at two years. Similar kinetics were observed in the proliferative response to mitogens. The results show that maintenance immunosuppressive drug therapy can be reduced after TLI as compared with conventional drug regimens that use prednisone in combination with cyclosporine and/or azathioprine. PMID- 3279578 TI - One-month prophylactic use of OKT3 in cadaver kidney transplant recipients. AB - Fifty-five recipients of first cadaveric renal allografts were randomly assigned to three treatment groups in order to compare the safety and efficacy of a mouse antihuman T cell monoclonal antibody (OKT3) given prophylactically for a one month period. This long period of administration was made possible by concomitant administration of azathioprine. The immune response against the foreign immunoglobulin was thus delayed and decreased in both intensity and severity, and OKT3 treatment could be given during almost the entire month in the majority of patients. The 18 patients who were enrolled in this treatment group had significantly (P less than 0.01) fewer rejection episodes during the first month posttransplantation than the 19 patients allocated to the high-dose (HD) steroid control group or the 18 patients allocated to the low-dose (LD) control group. Actual 2-year as well as actuarial 4-year graft survival rates were 89% in the OKT3 group, whereas they were 70% and 67% respectively in the steroid control groups. Four-year serum creatinine levels were normal and doses of steroids and other immunosuppressive agents were lower in the OKT3 group as compared with the control groups. Tolerance to OKT3 was good, and while viral infections were more frequently observed in OKT3 treated patients, the total number and the severity of infectious episodes were similar in all groups. The combination of one-month OKT3 plus azathioprine prophylaxis followed by conventional azathioprine plus low dose steroid maintenance produced very satisfactory long-term results comparable to the best results now being obtained with cyclosporine regimens. PMID- 3279579 TI - Late mortality and morbidity five to eighteen years after kidney transplantation. AB - The experience with 102 kidney transplants (86 from cadaver donors) functioning more than 5 years in 99 patients followed in one center is reviewed. With the 100% survival point set at 5 years, patient and graft survivals were 92% and 73% at 10 years, and 70% and 56% at 15 years, respectively. Of those 102 recipients, 58 are presently alive with a functioning graft and 18 died with a functioning graft; 26 patients rejected their graft after a mean interval of 8.3 years posttransplant, 11 of them died within 4-45 months following readmission to dialysis. For the whole group, 29 patients died after a mean period of 10 years following transplantation. Main causes of death were vascular catastrophes (48%), malignancies (21%), sepsis (17%), and liver failure (14%). Because vascular accidents, hepatic failure, and sepsis predominated in male patients, the overall late mortality was higher in male (37%) than in female (25%) patients. The high incidence of late complications--including chronic and acute graft rejections--in long-term kidney recipients constitutes a strong argument for maintaining constant supervision of those patients by a medical team with extensive experience with transplantation. PMID- 3279580 TI - The relationship between flow cytometer crossmatch results and subsequent rejection episodes in cadaver renal allograft recipients. AB - Flow cytometry (FC) T and B cell crossmatches were done retrospectively for 38 cadaver renal transplant recipients (29 first and 9 retransplants--minimum follow up 12 months) using both current pretransplant serum and peak-reactive sera. An increase in median fluorescence intensity (channel shift) and/or an increase in the number of donor T and/or B cells binding antibody in test sera occurred in 23 cases. These 23 patients experienced a greater number of reversible rejection episodes as compared with patients with negative FC crossmatches (65% vs. 33%), P = 0.031. Graft outcome, however, was not different in the two groups. Thus, a positive FC crossmatch allows for the detection of subliminal levels of donor presensitization and is associated with a greater number of rejection episodes. A positive FC crossmatch is not predictive of ultimate graft loss. PMID- 3279581 TI - A comparative trial of posttransplant immunosuppression in patients transplanted for thalassemia. Cyclosporine alone versus cyclosporine, cyclophosphamide, and methotrexate. AB - This study compares the efficacy of 2 posttransplant immunosuppressive regimens for prevention of graft-versus-host disease (GVHD). Forty-four patients, ages 8 15 years, with homozygous beta thalassemia received marrow allografts from HLA identical siblings following an ablative regimen of busulfan and cyclophosphamide. Twenty-two patients received cyclosporine (CsA) alone and 22 received cyclosporine, cyclophosphamide, and methotrexate for prophylaxis against GVHD. Two who received CsA alone have died (1 of graft rejection and 1 of acute GVHD) as did 4 patients who received 3 drugs (1 of rejection, 1 of acute GVHD, 1 of infection and cardiac failure before engraftment, and 1 of acute respiratory failure before engraftment). One patient in each group rejected the transplant and survives with thalassemia. The probability of developing acute GVHD was 41% for the CsA group and 15% for the 3-drug group (P = less than 0.05). Patients receiving CsA alone had a probability of event-free survival of 86% compared to 77% in the group receiving 3 drugs (P = 0.40) with a followup of 209-706 days. Although the study showed a decrease in the incidence of GVHD in recipients of the more intensive prophylactic regimen, this study was terminated since it was apparent that even if larger numbers of patients were studied it would be difficult to demonstrate a significant survival advantage with the use of this drug regimen. PMID- 3279582 TI - Selective bowel decontamination to decrease gram-negative aerobic bacterial and Candida colonization and prevent infection after orthotopic liver transplantation. AB - Gram-negative bacterial and fungal infections are a major cause of morbidity and mortality following liver transplantation. We therefore used selective bowel decontamination (SBD) to eliminate the endogenous source of gram-negative aerobic bacteria and Candida pathogens in an attempt to reduce the high incidence of infection related to these organisms. Thirty consecutive patients undergoing liver transplantation were treated with SBD starting 3 days prior to donor search and continuing for 21 days postliver transplantation. Selective bowel decontamination consisted of administering nonabsorbable antibiotics (Polymixin E, gentamicin, Nystatin) and a low bacterial diet. Surveillance cultures of the throat and rectum were obtained to monitor efficacy of selective bowel decontamination. In addition, in the posttransplant period, tracheal, wound, blood, and bile cultures were obtained to screen for gram-negative bacterial and Candida colonization and infection. Our baseline surveillance culture revealed that 29/30 (97%) of recipients were colonized with gram-negative aerobic bacteria and 16/30 (53%) with Candida. Three days after selective bowel decontamination was started, 26/30 (87%) were free of gram-negative bacteria, and 100% were free of Candida colonization of the gastrointestinal tract. There was a similar reduction in the oropharyngeal gram-negative aerobic bacteria and Candida colonization. In the first 30 days following liver transplantation, gram-negative infections were not diagnosed in any of our patients. Following discontinuation of SBD, recolonization of the gastrointestinal tract with gram-negative aerobic bacteria and Candida occurred within 5 days in 26/28 (90%) and 11/28 (35%), respectively. Our study suggests that prophylactive administration of nonabsorbable antibiotics will markedly reduce gram-negative aerobic bacterial and Candida colonization and appears to reduce the high incidence of infection related to these organisms in the early posttransplant period. PMID- 3279583 TI - An analysis of cyclosporine efficacy and toxicity after liver transplantation. AB - The use of cyclosporine long term after orthotopic liver transplantation has been analyzed in 73 adults with particular reference to the dose of drug used, either alone or in combination with other immunosuppressive agents, and the side effects observed. The first 22 patients were given cyclosporine 10 mg/kg/day for up to 2 years, but thereafter in these, and in all the other patients, the drug dose was regulated by whole blood trough levels. The proportion of patients maintained on cyclosporine alone increased from 11% at 3 months to 54.9% and 55.6% at 3 and 4 years, respectively. The dose of prednisolone used in combination with cyclosporine was lower than that used with azathioprine (P less than 0.05) up to 12 months after transplantation, but thereafter no significant difference was found. Acute cellular rejection was seen in 5 patients and in all instances was related to cessation of cyclosporine, while 10 patients developed chronic graft rejection manifested by the vanishing bile duct syndrome. At 12 months and onward, 54.5-73.3% of patients had normal serum bilirubin levels, and 47.6-80.0% had aspartate aminotransferase levels in the normal range. Cyclosporine was discontinued in 12 patients, in 8 cases because of impairment of renal function or hypertension. A trend toward rising serum creatinine levels was seen, and after 4 years on cyclosporine none of 12 patients had normal levels, and these exceeded 200 mumol/L in 5. The rise in creatinine levels was probably in part related to the higher doses used early in the study period. The incidence of hypertension progressively increased from 15.3% at 3 months to 63.6% at 4 years in patients maintained on cyclosporine. PMID- 3279585 TI - The cytokinetic behavior of donor hepatocytes after syngenic hepatocyte transplantation into the spleen. AB - The cytokinetic behavior of isolated hepatocytes transplanted into the spleen of syngenic normal Wistar rats was studied. Hepatocyte transplantation (HTX) was performed by the intrasplenic injection of 10(7) isolated hepatocytes. The proliferation index (PI) of intrasplenic donor hepatocytes was assessed by immunocytochemical visualization of DNA-synthesizing cells after pulse-labeling with bromodeoxyuridine (BrdU), a thymidine analogue. A method for determination of intrasplenic liver mass based on tissue glutamate dehydrogenase content was developed. The spontaneous PI of donor hepatocytes at 12 and at 20 weeks post-HTX amounted to around 3%. A significant increase of intrasplenic liver mass was demonstrated between the 12th and 20th week post-HTX (from 8.1 +/- 0.8% to 10.8 +/- 0.8% of spleen weight, P less than 0.05). After partial hepatectomy (PH) at 12 weeks post-HTX, the PI of liver cells in the spleen showed a transient increase up to about 10%, which rapidly declined to the "spontaneous" level of 3%. However, PH did not cause an additional increase in intrasplenic liver mass. This study shows that continuous mitotic activity of intrasplenic hepatocytes results in an actual increase of liver mass in spleen. Although a short-lived increase of proliferative activity of ectopically grafted hepatocytes was shown to occur after PH in the HTX-treated rat, this procedure did not result in an additional increase of intrasplenic liver tissue. PMID- 3279584 TI - High frequency of graft-versus-host-like syndromes following syngeneic bone marrow transplantation. AB - Occurrence of acute graft-versus-host reactivity-like (GvHR) syndromes has been shown in at least 3 and possibly in 4 further cases of 9 patients with bone marrow transplants from identical twin donors. The diagnosis of GvHR-like syndromes is based on clinical, immunologic, and histologic features indistinguishable from those observed in graft-versus-host disease (GvHD) grades I-III of patients receiving allogeneic major histocompatibility complex (MHC) matched bone marrow transplants. Induction of GvHR-like symptoms appeared to be correlated with reactivated viral infections after bone marrow transplantation (BMT) or, like in animal models, was due to specific conditioning therapy with cyclophosphamide. The high incidence of acute GvHR-like syndromes in the first months after syngeneic BMT suggests inability of the immune system to discriminate appropriately self from nonself antigens during a normal tolerance induction period after grafting. PMID- 3279587 TI - Life-threatening thrombocytopenia complicating antithymocyte globulin therapy for acute kidney transplant rejection. Evidence of in situ immune complex formation on the platelet surface. PMID- 3279586 TI - Delayed rejection of heart allografts after extracorporeal donor-specific liver hemoperfusion. Role of Kupffer cells. AB - Liver allografts have a privileged status in regard to acute rejection. In this experimental study, we have analyzed the immunosuppressive effects of an extracorporeal liver hemoperfusion. In the LEW-to-BN combination of inbred rats, donor-specific liver hemoperfusion can significantly delay acute rejection of heart allografts. Analysis of the immunological status of these animals revealed a significant decrease in donor-specific lymphocytotoxic antibodies and in cytotoxic T lympholysis. Reactivity in mixed lymphocyte culture was normal. After third-party (DA) liver hemoperfusion or after donor-specific (LEW) splenic hemoperfusion, prolongation of heart allograft survival was moderate. Previous blockade of Kupffer cells suppressed the effects of donor-specific liver hemoperfusion. These results suggest that the sequestration by Kupffer cells of a clone of cytotoxic T cells and/or lymphocytotoxic antibodies may explain the immunosuppressive effects of donor-specific liver hemoperfusion. PMID- 3279588 TI - Effect of obesity on cyclosporine disposition. PMID- 3279589 TI - Successful engraftment of high-risk corneal allografts with short-term immunosuppression with cyclosporine. PMID- 3279590 TI - The effect of cyclosporine on the pharmacokinetics of prednisolone in renal transplant patients. PMID- 3279591 TI - Successful pregnancy in a cyclosporine-treated renal transplant recipient with sickle cell disease. PMID- 3279592 TI - Liver transplantation in a patient with abdominal situs inversus. PMID- 3279593 TI - Changes in circulating eosinophil counts induced by skin allograft in the rat. PMID- 3279594 TI - The importance of specificity in the transfusion effect. PMID- 3279595 TI - Effect of carbodiimide donor-specific blood transfusion on cardiac allografts in rats. PMID- 3279596 TI - Thyroid function in human cardiac allograft donors. PMID- 3279597 TI - International Organ Transplant Forum honoring Thomas E. Starzl for his 25 years of contribution to the field of organ transplantation. September 8-11, 1987, Pittsburgh, Pennsylvania, USA. PMID- 3279598 TI - Tissue transplantation: allocation and related issues. PMID- 3279600 TI - Federal financing of transplantation. PMID- 3279599 TI - Allocation of cadaver kidneys for transplantation. PMID- 3279601 TI - Three ethical revolutions: ancient assumptions remodeled under pressure of transplantation. PMID- 3279602 TI - Immunologic analysis of cellular infiltrates during human renal allograft dysfunction. PMID- 3279603 TI - Synergistic immunosuppressive strategies for the induction of allogeneic unresponsiveness in the adult host. PMID- 3279604 TI - Total lymphoid irradiation in transplantation. PMID- 3279605 TI - In a small Iowa town. PMID- 3279606 TI - The use of donor-specific antigen for the induction of immunologic unresponsiveness to experimental and clinical allografts. PMID- 3279607 TI - Attempts to induce tolerance with cyclophosphamide after renal transplantation in swine. PMID- 3279608 TI - Prevention of cyclosporine-associated nephrotoxicity by K-MAP. PMID- 3279609 TI - Effect of a stable analogue of prostacyclin on cyclosporine A-induced nephrotoxicity: morphological qualitative and quantitative studies. PMID- 3279610 TI - Allogeneic small bowel transplantation with cyclosporine and donor whole-body irradiation. PMID- 3279611 TI - The second histocompatibility locus in humans. AB - Even when HLA is completely matched in sibling donor transplants, as many as one third of the transplants are lost in 10 years. This means that a second or third histocompatibility locus plays some role in rejection of kidney grafts. We postulate that the second locus is Lewis. First, because among 18 second cadaver donor transplant patients having Lewis antibodies, the 1-year graft survival rate was 32% compared to 61% in 37 patients without Lewis antibodies (P = .02). The Lewis antibodies presumably were produced in the course of rejection of the first graft and had an effect on the success of the second graft. As indirect evidence, Lewis mismatching would be expected to occur more frequently in black patients than white, and correspondingly, a lower graft survival rate was noted in black patients receiving sibling, parent, and cadaver donor grafts. PMID- 3279612 TI - Histocompatibility. PMID- 3279613 TI - 15-Deoxyspergualin as an immunosuppressive agent in dogs. PMID- 3279614 TI - Effect of 15-deoxyspergualin on experimental organ transplantation. AB - DSPG had a definite but relatively feeble immunosuppressive effect in rats undergoing heterotopic heart transplantation and in dogs after renal transplantation. The drug was toxic in both species, although less so in rats. In dogs, synergistic interactions with cyclosporine and steroids were not evident. PMID- 3279615 TI - OKT3-treated kidney transplant patients: monitoring of effects on peripheral blood mononuclear cells by using two-color flow cytometry. PMID- 3279616 TI - The use of OKT3 rescue therapy after orthotopic liver transplantation--the University of Nebraska Medical Center experience. PMID- 3279617 TI - Cancers after cyclosporine therapy. PMID- 3279618 TI - Using ABO-incompatible blood in massive transfusion in orthotopic liver transplantation. AB - With massive plasma exchange, transfusion with major ABO-incompatible blood was possible. Herein we reported the experience of two cases of liver transplantation without serious adverse effects. However, further refinement of the procedure is warranted before it can be used as routine treatment. PMID- 3279620 TI - Xenotransplantation. PMID- 3279619 TI - A new method of immunosuppression by selective destruction of cytotoxic T cells with photodynamic effect. PMID- 3279622 TI - Kidney transplantation. The past, present, and future. PMID- 3279621 TI - Renal transplantation before Starzl. PMID- 3279623 TI - Renal transplantation--the Starzl influence. AB - In summary, I have attempted to review with you some of Dr Starzl's numerous clinical and scientific contributions that have cut across the spectrum of the field of renal transplantation. It is thus not surprising that Dr Starzl was elected the first President of the American Society of Transplant Surgeons, singular recognition from his own peers for the many contributions and leadership that he has provided during the formative and developmental years of organ transplantation. In addition, Dr Starzl has been recognized with a number of other prestigious awards, among which was the David M. Hume Memorial Award, the highest honor bestowed by the National Kidney Foundation. Careful analysis of Dr Starzl's work therefore clearly indicates that many of his contributions since 1960 have been uniquely innovative, have provided many firsts, and have reflected the science and technology of transplantation as it is today, in 1987. Thus, it can be truly said that Dr Starzl, the surgeon-scientist, was not only a pioneer but also a leader and subsequently a giant in the field of clinical renal transplantation. He has left a lasting and indelible impact on the field, the Starzl influence, for which all of us, both patient and physician, are extremely grateful. Thank you very much, Dr Starzl. PMID- 3279625 TI - The optimal use of pediatric donors for renal transplantation. PMID- 3279624 TI - Living donor kidney transplantation. PMID- 3279626 TI - Intraperitoneal placement of renal transplants. PMID- 3279627 TI - TIMY--a center-oriented transplant information management system. PMID- 3279628 TI - The intake of initially high doses of cyclosporine A in cadaveric kidney transplantation is not justified. Results of a prospective study. PMID- 3279629 TI - Two immunosuppressive drug regimens after renal transplantation: low dosage of cyclosporine adjusted on the basis of high-performance liquid chromatography whole blood levels and prednisone. PMID- 3279630 TI - A clinical study of renal transplant patients receiving triple-drug therapy- cyclosporine A, mizoribine, and prednisolone. PMID- 3279631 TI - Differential effect of CGS 13080, a thromboxane synthase inhibitor, in suppressing serum and urine immunoreactive thromboxane B2 in kidney transplant patients. PMID- 3279632 TI - Quebec Metro-Transplantation Multicenter Study on delayed graft function in kidney transplantation. PMID- 3279633 TI - Kidney transplantation: complications. PMID- 3279634 TI - Metabolic problems in renal transplant patients. Persistent hyperparathyroidism and hypophosphatemia: effects of intravenous calcium infusion. PMID- 3279635 TI - New insights into the mechanisms of post-transplant erythrocytosis. PMID- 3279636 TI - Kidney transplantation: the hyperimmunized recipient. PMID- 3279639 TI - Liver transplantation: clinical studies. PMID- 3279638 TI - Kidney transplantation: infection. PMID- 3279637 TI - Hyperacute rejection of the kidney in patients with a negative crossmatch. PMID- 3279640 TI - Liver transplantation: the Paul Brousse experience. PMID- 3279641 TI - Liver transplantation: the promise of the past and the future. PMID- 3279644 TI - The technique of liver size reduction in orthotopic liver transplantation. PMID- 3279642 TI - Regulation of liver size and regeneration: importance in liver transplantation. PMID- 3279643 TI - Experience in 1,000 liver transplants under cyclosporine-steroid therapy: a survival report. PMID- 3279645 TI - The activity of the Liver Transplant Center of Milan, Italy. PMID- 3279646 TI - Quadruple immunosuppressive therapy for liver transplantation. PMID- 3279647 TI - Orthotopic liver transplantation of liver grafts previously resected in situ. PMID- 3279648 TI - Total hepatectomy as temporary approach to acute hepatic or primary graft failure. PMID- 3279649 TI - B hepatitis and liver transplantation. PMID- 3279650 TI - Comparison of combined portal-arterial versus portal perfusion during liver procurement. AB - PAP of harvested livers is routinely used to minimize parenchymal anoxia during storage. PP is compared with PAP to evaluate the relative reliability of PAP. Sixty female Landrace pigs were used for 30 OLTs. Group 1 livers underwent PP, whereas group 2 livers were treated with PAP. The cold ischemic time was less than 120 minutes for both groups, with no warm ischemia. Intraoperative and 24 hour postoperative biochemical, coagulation, and histocytological data were analyzed. Morphological studies of cellular damage were based on the percentage of CVD and KP and classified as light, moderate, and severe damage. Data, at closing, were compared by using Fisher's test (group 1 v group 2,P = 0.003 for light damage and P = .04 for severe damage; first postoperative day for group 1 v group 2, P = .133 for light damage and P = .25 for severe damage. Blood samples at closing and 24 hours postoperatively showed significant differences between groups 1 and 2: At closing for groups 1 and 2, respectively: AST, 968.9 +/- 742.7 and 327.4 +/- 174.7 IU/L (P less than .001); ALT, 63.1 +/- 40.3 and 20.3 +/- 5.3 IU/L (P less than .001); AP, 292.2 +/- 107.1 and 139.5 +/- 45.3 IU/L (P less than .001); and 24 hours postoperatively for groups 1 and 2, respectively: AST, 1,664.9 +/- 917.8 and 419.3 +/- 230.9 IU/L (P less than .001): ALT. 180.4 +/- 28.9 and 66.4 +/- 17.5 IU/L (P less than .001); AP, 602.1 +/- 153.3 and 255.7 +/- 116.3 IU/L (P less than .01). Comprehensively, the results reflect a better perfusate distribution of the PAP livers compared with PP ones: uniform organ preservation, faster metabolic recovery, and reduced postoperative mortality. PMID- 3279652 TI - Liver transplantation: complications. PMID- 3279651 TI - The quality of survival after liver transplantation. PMID- 3279653 TI - Human orthotopic liver transplantation: surgical aspects in 393 consecutive grafts. PMID- 3279654 TI - Thrombocytopenia after liver transplantation. AB - Thrombocytopenia occurs in postoperative liver transplant patients, with platelet counts reaching a nadir on the third postoperative day. Significant bleeding episodes are not uncommon during the first five days postoperatively when platelet counts are low. This thrombocytopenia may be the result of platelet sequestration in the newly grafted liver. The sequestration phenomenon does not appear to be on the basis of antiplatelet antibody activity. Further work defining the time course of this organ sequestration and evaluating the possible release of previously sequestered platelets back into the circulation need to be done. Also, it may be productive to study medications known to inhibit platelet activation (ie, cyclooxygenase inhibitors, prostacyclin, and calcium channel blockers) with the intent of interrupting platelet adhesiveness-sequestration at the time of recirculation of the newly grafted liver. PMID- 3279655 TI - Pulmonary complications and disease severity in adult liver transplant recipients. PMID- 3279657 TI - Liver transplantation: diagnosis of rejection. PMID- 3279658 TI - Expression of monomorphic and polymorphic major histocompatibility complex determinants in human heart grafts. PMID- 3279656 TI - Acute rejection in liver transplants. PMID- 3279659 TI - Percutaneous transhepatic cholangiography rather than ultrasound as a screening test for postoperative biliary complications in liver transplant patients. PMID- 3279660 TI - The importance of percutaneous liver biopsy in the management of the liver transplant recipient. PMID- 3279661 TI - Liver transplantation: experimental studies. PMID- 3279662 TI - Role of HLA in intragraft cellular immunity in human liver transplantation. PMID- 3279663 TI - Prolonged survival of hepatic xenografts in the hamster to rat combination: efficacy of cyclosporine in combination with splenectomy. PMID- 3279664 TI - Heart transplantation at the University of Pittsburgh: 1980 to 1987. PMID- 3279665 TI - Late follow-up of children after heart transplantation. AB - The majority of late recipients of heart transplantation have returned to age appropriate activities and are showing normal linear growth. The only child who has significant symptoms is an 11-year-old heart-lung transplant recipient who developed airway rejection with restrictive pulmonary function 14 months after transplantation. Rejection continues to be a major threat to these children more than a year removed from their transplantation procedure. Until a satisfactory noninvasive method is developed to monitor graft rejection, endomyocardial biopsies will continue to be performed at 6-month intervals. Cyclosporine nephrotoxicity and systemic hypertension remain important and unresolved problems that could limit the initial success of transplantation. We believe that heart transplantation is an acceptable option for children with end-stage heart and heart-lung disease who have a grim outlook. Future improvements in immune suppression, and the development of improved methods of assessing rejection, will allow for improved survival. PMID- 3279666 TI - The role of surveillance bronchoscopy and bronchoalveolar lavage prior to heart transplantation. AB - All patients had an elevated bronchitis score over that of normal controls. The cause of this bronchitis is likely multifactorial and was not uniformly predicted by bronchial neutrophil counts, current smoking history, or PFT abnormality. All patients had, in addition to high bronchitis score, evidence of increased bronchial neutrophils and/or PFT abnormality or cancer. These findings lead to a change in management prior to heart transplantation. PMID- 3279667 TI - Prolonged amrinone therapy prior to orthotopic cardiac transplantation in patients with pulmonary hypertension. PMID- 3279669 TI - Crossmatching and immunological monitoring. PMID- 3279668 TI - Patient selection and results of cardiac transplantation in patients with cardiomyopathy. PMID- 3279670 TI - Dynamics of bronchoalveolar lavage in the canine lung transplant. PMID- 3279671 TI - Hyperacute rejection after portacaval shunt in the rat. PMID- 3279672 TI - Pancreatic transplantation for diabetes mellitus: the Stockholm experience. PMID- 3279673 TI - Combined liver-kidney transplantation: analysis of patients with preformed lymphocytotoxic antibodies. PMID- 3279674 TI - Thermographic study of the canine pancreaticoduodenal graft. PMID- 3279675 TI - Organ procurement and preservation: the kidney, liver, heart and pancreas. PMID- 3279676 TI - Successful 72-hour cold storage kidney preservation with UW solution. PMID- 3279677 TI - Superoxide dismutase improves organ preservation in liver transplantation. PMID- 3279679 TI - Fluorometric study for the noninvasive determination of cellular viability in perfused rat livers. PMID- 3279678 TI - Amelioration of normothermic canine liver ischemia with prostacyclin. AB - A model of hepatic ischemia was developed in dogs using a pump-driven splanchnic to-jugular vein bypass during crossclamping of the portal triad. An LD50 was established with three hours of ischemia. PGI2 given for one hour before the ischemic insult ameliorated the ischemic injury and increased survival. PMID- 3279680 TI - Development of an ectopic liver by transplantation of cryopreserved hepatocytes. PMID- 3279681 TI - The influence of donor organ stability and ischemia time on subsequent cardiac recipient survival. PMID- 3279682 TI - Combined liver and pancreas harvesting from cadaveric donors. PMID- 3279683 TI - Efficacy of echo-Doppler examination for the evaluation of renovascular disease. AB - The accuracy of the diagnosis of renal artery stenosis using noninvasive echo Doppler velocimetry was compared with that of angiography in 40 renal arteries. The duplex-Doppler signals were detected through the muscle of the back (the translumbar approach). Renal artery stenosis was diagnosed by three objectively defined Doppler parameters, the acceleration index (AI), the acceleration time (AT), and the acceleration time ratio (ATR). The normal range obtained on 11 control subjects was defined as AI greater than or equal to 3.78, AT less than or equal to 0.07 s, and ATR less than or equal to 1.35. High technological success (98%) was obtained using the translumbar approach. In comparison with angiography (cases of significant stenosis), the accuracy of the echo-Doppler method using the criteria of the AI was 95%, the sensitivity was 100%, and the specificity was 93%. This noninvasive method may be one of the most accurate screening methods for diagnosing significant renal artery stenosis. PMID- 3279685 TI - Flow dynamics in a stenosed carotid bifurcation model--Part I: Basic velocity measurements. AB - A model of the human carotid artery bifurcation has been constructed and tested under mean physiologic flow conditions (fluid viscosity = 0.035 poise; mean Re inlet = 400; unconstricted flow split = 70:30, internal carotid artery:external carotid artery). Smooth, axisymmetric constrictor plugs with 0, 20, 40, 60, and 80% diameter reduction are placed in the simulated proximal internal carotid artery to provide a range of flow conditions similar to those found clinically. Axial velocity measurements are made at sites +/- 0.625 radius within the lumen of the tube at distances of 0, 1, 3, 5 and 10 diameters downstream of the constrictor throat using H2 bubble markers and a 7.5 MHz ultrasound pulse Doppler. Measurement of mean, mode -3 dB down high and low and -9 dB down high and low velocities are made from selected fast-Fourier transform (FFT) spectra. The flow field downstream of the 0% diameter reduction is entirely laminar, exhibiting a peak skewed toward the flow divider along the entire 10 diameters downstream and having a consistently narrow bandwidth. Obstruction of the flow channel produces increased axial velocity at the constrictor (20%), an oscillatory jet extending approximately 5 diameters downstream (40%), a transitional jet extending approximately 5 diameters downstream (60%) and a turbulent jet extending approximately 3 diameters downstream (80%). Velocity bandwidth (both -3 dB and -9 dB) increases with degree of constriction and low velocity flow patterns exist between the center line and both tube walls. Presence of constriction produces characteristic downstream flow patterns which are distinctive for each degree of diameter reduction. PMID- 3279684 TI - Potential hazards of the dental ultrasonic descaler. AB - The use of a dental ultrasonic descaler may be associated with biological hazards to structures within the oral cavity. Thermal hazards may result from either frictional contact between the oscillating probe and tooth or from absorption of acoustic energy within the tooth. Transmission of ultrasound along the tooth may result in thrombogenic damage to nearby blood vessels. The vibrating probe tip may produce scratching of the tooth surface, and incorporation of oral bacteria within the aerosol generated by the instrument which may result in transmission of infected material. Damage to the ear may arise from the coupling of ultrasound to the bones of the skull via the tooth. Furthermore the electro-magnetic field produced by these devices may interfere with cardiac pacemakers. It is the patient receiving treatment who is mainly exposed to these potential hazards. However, the clinician and his supporting staff may also be at risk. PMID- 3279687 TI - Bibliography of biomedical ultrasound. No. 71. PMID- 3279686 TI - Flow dynamics in a stenosed carotid bifurcation model--Part II: Derived indices. AB - Basic velocity measurements from the previous study in this issue of modelled carotid artery bifurcation disease are post-processed to derive indices potentially useful for clinical diagnosis. Selected parameters are based upon ultrasound pulse Doppler velocity measurements made at sites +/- 0.625 radius at axial distances of 0, 1, 3, 5, and 10 diameters downstream of smooth, axially symmetric constrictions of 0, 20, 40, 60, and 80% diameter reduction. Indices based on single point velocity measurements include: (a) the center-line velocity index (CVI) at the throat of the constrictor which is sensitive to all degrees of constriction (p less than 0.05), and (b) various measures of velocity disturbance (VDI1-VD14) which show greatest sensitivity when measured at one-fourth diameter from the tube wall. Cross-sectional indices include: (a) the maximum slope index (MSI) which separates constrictions of less than 60% diameter reduction from those having greater than or equal to 60% diameter reduction (p less than 0.05), and (b) the cross-sectional profile index (CPI) which separates constrictions of less than or equal to 20% diameter reduction from those having greater than 20% diameter reduction (p less than 0.05). A field profile index (FPI) utilizes data from all available sites up to 5 diameters downstream and is able to separate all constrictor groups (p less than 0.05). Presence of constrictions produces characteristic flow patterns which can be quantified using indices based on the downstream velocity spectra. Specifically, locally increased velocity is very sensitive to degree of constriction and is best detected along the center line. Disturbance effects, while less pronounced, are complementary to changes in velocity magnitude and are first seen off-axis. Multiple point profile measures (cross sectional and full field) are also sensitive to degree of constriction and are best evaluated at 1 diameter and over 5 diameters, respectively, downstream of the constriction. All of the nondimensional indices offer the advantages of reduced probe and angle dependence and particular approaches may be implemented according to the data collection capability of the instrument used. PMID- 3279688 TI - Applications of ultrasound in dentistry. AB - An ultrasonic descaler working at kHz frequencies is used in dentistry to remove attached deposits from the teeth. Such devices offer many advantages over conventional hand instruments by reducing both the work and time involved in the clinical descaling process. Although it is a recognised clinical instrument, there has been little attempt to standardise its acoustic power output. A parameter which may characterise adequately the acoustic emission from these instruments is the displacement amplitude of the probe tip. Modification of the ultrasonic descaler generator has led to the further use of the instrument in other dental areas. Diagnostic applications of MHz ultrasound is limited by the structure and arrangement of the dental tissues. Therapeutic ultrasound has been used to treat a variety of dentally related ailments, and ultrasonic cleaning baths are used to clean both dental instruments and materials. PMID- 3279690 TI - Investigation of Doppler waveforms in porcine renal allografts: Doppler pathologic correlation. AB - A porcine model was devised to investigate Doppler waveforms in dysfunctional renal allografts. NIH miniature pigs served as allografts donors and recipients. Renal transplantation was effected into the recipient pelvis while the left normotopic kidney was subjected to warm ischemia in order to induce acute tubular necrosis (ATN). Doppler demonstration of allograft arterial occlusion in six animals was confirmed at surgery. Increased pulsatility of intrarenal arterial signals constituted evidence of vascular rejection in two animals. Biopsies confirmed the diagnosis in both cases. Histologic changes of ATN were identified in two native kidneys subjected to ischemia. No waveform or pulsatility alterations were observed in these animals. The porcine model provides for the investigation of allograft Doppler waveforms in a controlled setting with free access to biopsy and operative pathologic correlation. PMID- 3279689 TI - Resistance index, blood flow velocity, and resistance-area product in the cerebral arteries of very low birth weight infants during the first week of life. AB - Cerebral artery Doppler ultrasound recordings, and intra-arterial pressure measurements have been made from 27 very low birth weight infants during the first week of life. These data were used to calculate Pourcelot's resistance index (RI), mean blood flow velocity, and resistance-area product (RAP), in both the anterior and middle cerebral arteries. There was a good degree of correlation between recordings from different sites on the same occasion, but absolute values were site dependent. Over the first three days of life there was a significant increase in blood flow velocity in each of the vessels, and a significant fall in RI and RAP. PMID- 3279692 TI - Bibliography of biomedical ultrasound. No. 72. PMID- 3279691 TI - In-vivo measurements of ultrasound attenuation in normal or diseased liver. AB - Ultrasonic attenuation coefficients of liver have been derived from echoes received by a modified commercial B-scan imaging instrument. Values have been measured from selected regions within liver scans of 59 individuals, of which 15 cases were presumed normal (based on medical histories), and the remainder were involved with diffuse liver disease such as alcoholic cirrhosis, chemotherapy toxicity, chronic hepatitis, and liver metastases. Medical histories on most individuals include the results of serum liver function enzymes, conventional B scan examinations, and exposure to drugs and alcohol. The results of CT abdominal scans (N = 13) and/or liver biopsy (N = 12) were also available. The results show that normal attenuation values for human liver are 0.054 +/- 0.009 Np/cm-MHz (0.47 dB/cm-MHz) with a frequency dependence of fn, where n = 1.05 +/- 0.25, in agreement with in vitro studies of mammalian liver. In diffuse liver disease, no relationship was found between the attenuation coefficient and the results of CT or conventional ultrasonic examination. A trend towards higher attenuation with increased fibrosis and fat, as graded from liver biopsies, was noted, but the results were generally not statistically significant. However, a significant correlation was found between high values of attenuation and abnormal liver function tests. High attenuation is also found with ingestion of alcohol, chemotherapeutic agents, and steroids, all of which may affect liver composition. PMID- 3279693 TI - Ultrasound in Medicine and Biology Clinical Prize. PMID- 3279694 TI - Epidemiology of human exposure to ultrasound: a critical review. AB - Epidemiologic studies and surveys and widespread clinical usage over 25 years have yielded no evidence of any adverse effect from diagnostic ultrasound. Nonetheless, the inability to find convincing proof of an effect, either from epidemiology or from physicians' experience, does not preclude the possibility of it happening. Statistical reasoning shows that even with large population studies, it is difficult to identify a small increase in the rate of a commonly occurring event. Subtle effects, long-term delayed effects, and certain genetic effects, could easily escape detection. PMID- 3279696 TI - Splenosis mimicking a renal mass. AB - Regenerated splenic tissue is commonly found after splenectomy. This tissue has been shown to have a desirable effect on postsplenectomy sepsis. Complications because of splenosis have been reported but are rare. The main significance of this tissue is to differentiate it from solid tumors which can be done most efficiently in a noninvasive fashion. PMID- 3279695 TI - Wave space interpretation of scattered ultrasound. AB - Wave space is described nonmathematically for design and interpretation of ultrasound scattering experiments. By considering ultrasound scattering from a variety of targets and geometries, the wave space approach is shown to describe target characteristics in terms of spatial frequencies and their amplitudes. Experimental limitations for determining effective spacing of scattering structures and scattering medium anisotropy are discussed. PMID- 3279697 TI - Urethral suture guide for radical prostatectomy. PMID- 3279699 TI - Serologic response of Babesia equi-infected horses as measured by complement fixation and indirect fluorescent antibody tests. AB - Both the complement-fixation test (CFT) and the indirect fluorescent antibody test (IFAT) were conducted on weekly serum samples from nine Arab geldings for 28 days before and 256 days after their exposure to Babesia equi of European origin. On an average the IFAT became positive 8 days before the CFT and showed higher relative serum titer increases. Both test procedures successfully detected infection and neither showed an appreciable drop in titer during this time frame, with the exception of the CFT, which showed a transient drop immediately following treatment with imidocarb. A test conducted 540 days after infection showed four of the eight surviving, and presumably infected, horses to be negative on CFT, where as all eight were still positive on IFAT. Comparisons made with the IFAT, on horse sera from B. equi infection of both European and North American origin, utilizing homologous and heterologous antigens, showed significantly higher titers with homologous antigens. PMID- 3279698 TI - BCG (RIVM) versus mitomycin intravesical therapy in superficial bladder cancer. First results of randomized prospective trial. AB - This study presents the preliminary results of a randomized prospective two-arm study in which bacillus Calmette-Guerin (BCG) RIVM, a Dutch BCG preparation, is compared with mitomycin C (MMC) in patients with primary or recurrent superficial bladder tumors, including carcinoma in situ (CIS). Therapeutic regimens were as follows: after complete transurethral resection of all visible tumors, BCG RIVM (1 x 10(9) bacilli in 50 mL saline) was instilled once a week for six consecutive weeks, and mitomycin C (30 mg in 50 mL saline) was administered once a week for one month (weeks 1 to 4) and thereafter once a month for a total of six months. Reported are the incidence of side effects in 165 patients and the recurrence rate of tumors in 308 patients after a follow-up period of twelve months. Drug induced, or chemical cystitis was observed in 13 (16.7%) of 78 BCG-treated patients and in 12 (13.8%) of 87 MMC-treated patients. In the same groups bacterial cystitis occurred in 17 (21.8%) patients and in 16 (18.4%) patients, respectively. In the BCG-treated group (N = 148), 44 (29.8%) had recurrent tumors, while in the MMC-treated group (N = 160), 40 (25.0%) had a recurrence. The recurrence rate for BCG-treated patients was 0.33; the recurrence rate for MMC-treated patients was 0.29 (P = 0.560, not significant). These preliminary data demonstrated no statistically significant difference between the two arms with regard to toxicity and recurrence of tumors. PMID- 3279700 TI - The genes encoding the DNA binding protein and the 23K protease of adenovirus types 40 and 41. AB - The adenovirus (Ad) single-stranded DNA binding protein (DBP) is a multifunctional protein. It is thought to consist of two domains, the amino terminal domain involved in host-range determination and the carboxyl-terminal domain functioning in DNA replication and DNA binding. We have determined the nucleotide sequences of the DBP genes of Ad40 and Ad41, two human adenoviral serotypes that differ significantly from other adenoviruses. Regions of structural and functional importance in the corresponding proteins could be identified by comparison of the amino acid sequences with those of other known DBPs. In addition, the nucleotide sequences of the DBP early promoters, of the 23K protease genes, and of parts of the hexon and 100K protein genes have been determined. It can be deduced from the nucleotide sequences, that the Ad40 and Ad41 DBPs are relatively small (473 and 474 amino acids (a.a.), respectively, versus 529 a.a. for the Ad5 DBP). This is caused by the presence of very small amino-terminal domains of 119 a.a. (Ad40) and 120 a.a. (Ad41), as compared to 173 a.a. for the corresponding Ad5 domain. Only a few amino acids in this domain have been conserved in all known DBPs. The carboxyl-terminal domains show a higher degree of sequence conservation. In this domain, four strongly conserved regions can be identified, one of which might form a metal-binding site. The 23K proteases of both Ad40 and Ad41 show a strong homology to the Ad2 and Ad5 proteins, with the exception of the carboxyl-terminal end of the proteins. The 23K protease gene of Ad41 has an open reading frame that extends beyond the polyadenylation signal, in contrast to the Ad40 gene that ends well in front of the signal. PMID- 3279702 TI - A phosphorylated 34-kDa protein and a subpopulation of polyhedrin are thiol linked to the carbohydrate layer surrounding a baculovirus occlusion body. AB - Surrounding baculovirus occlusion bodies is an electron-dense layer reported to be composed of carbohydrate which we term calyx. Incubation of Autographa californica nuclear polyhedrosis virus occlusion bodies (AcMNPV OBs) with dilute alkaline saline (DAS) followed by centrifugation at 12,000 g resulted in the sedimentation of calyx material which contained pp34, residual polyhedrin (p32), and entrapped occluded virions (DAS P-12 fraction). Incubation of the DAS P-12 fraction with sodium dodecyl sulfate (SDS) resulted in solubilization of the entrapped virions and the majority of p32, while calyx material, pp34, and some p32 remained sedimentable at 12,000 g. Immunofluorescence microscopy of DAS solubilized OBs using monoclonal antibody to pp34 and p32 revealed that both pp34 and p32 are closely associated with the calyx. When DAS P-12 fractions were resuspended in SDS and reducing agent, not only were the entrapped virions solubilized, but pp34 and the remaining p32 were also liberated, indicating that pp34 and a subpopulation of p32 are associated with the calyx via thiol linkages. Immunoblot analysis and peptide mapping demonstrated that pp34 is neither immunologically nor structurally related to p32. The kinetics of pp34 synthesis were also examined by immunoprecipitation of infected cell polypeptides using pp34-specific monoclonal antibody. pp34 was detected initially 15 hr postinfection (p.i.) and continued to be phosphorylated until 60-70 hr p.i. This study demonstrates that the AcMNPV calyx has a proteinaceous component and we propose that other occluded baculoviruses may also have a calyx-associated protein analogous to pp34. PMID- 3279701 TI - Infectious positive- and negative-strand transcript RNAs from bacteriophage Q beta cDNA clones. AB - Plasmids containing full-length cDNA copies of the Q beta RNA phage genome and flanking T7 promoters were constructed. Positive-strand Q beta RNA, generated by in vitro transcription of these plasmids with T7 RNA polymerase, was infectious to Escherichia coli spheroplasts. The Q beta replicase gene from the cloned DNA was subcloned and expressed in E. coli cells by means of a thermoinducible plasmid. Full-length, negative-strand Q beta transcripts were infectious when transfected into spheroplasts containing the induced replicase gene. PMID- 3279703 TI - [Approaches to cancer control in Canada]. PMID- 3279704 TI - [The lymphokine-activated killer cell system]. PMID- 3279705 TI - Recombinant EIA for anti-HIV testing is more specific than conventional EIA. PMID- 3279706 TI - Kawasaki disease: an update. PMID- 3279707 TI - The role of percutaneous lung biopsy in the workup of a solitary pulmonary nodule. AB - As the technique of percutaneous lung biopsy continues to evolve, it offers an increasingly accurate method of establishing the malignancy or benignity of a solitary pulmonary nodule. There are relatively few contraindications to the procedure, and the complications-primarily pneumothorax and hemoptysis-generally resolve without therapy. Transthoracic needle aspiration has an important role in the workup for a "coin lesion." Other elements of the diagnostic workup particularly the history, a chest roentgenogram, computed tomography, sputum cytology, and transbronchial brush biopsy-may either add to or substitute for a transthoracic needle aspiration biopsy. An algorithm can be used to guide the diagnostic approach to a solitary pulmonary nodule. PMID- 3279709 TI - Enzyme immunoassay of immunoreactive trypsin in serum and blood spots. AB - An enzyme immunoassay method for the assay of serum immunoreactive trypsin (IRT) is described. The method is a two site binding assay carried out on microtitre plates as the solid phase. Wells were coated with affinity purified anti-human trypsin and biotinylated anti-trypsin and avidin-beta-galactosidase were used as the second antibody and detection system respectively. The assay was sensitive enough to determine IRT concentrations in either serum or dried blood spots. A good correlation was obtained when the method was compared with the Hoechst radioimmunoassay method. PMID- 3279710 TI - Immunosuppression for cardiac transplantation at the University of Wisconsin Madison. PMID- 3279708 TI - Adolescent idiopathic scoliosis. AB - Adolescent idiopathic scoliosis is the single most common form of spinal deformity seen in orthopedic practice. Our knowledge about the epidemiology, etiology, natural history, and treatment has recently increased dramatically. The incidence of small curves is rather high (2% of the population), whereas severe curves are much less common (<0.1%), but we cannot always predict which curve will progress. Abnormalities of the neuromuscular system and of calcium metabolism, and certain growth, genetic, and mechanical factors may all play roles in the pathogenesis of the disorder. The physiologic secondary effects of severe scoliosis relate to restrictive lung disease, but most patients do not have a deformity great enough to affect their cardiorespiratory function. The psychological and social effects of scoliosis are significant for patients but difficult to quantitate. For most patients with moderate scoliosis-that is, more than 25 to 30 degrees-treatment with an underarm brace or electrical stimulation is adequate to "control" progression of the curve. Surgical fusion allows actual correction of the curve but is indicated in only a small percentage of patients usually those with more than 50 degrees of deformity. PMID- 3279711 TI - Head trauma and epilepsy. PMID- 3279712 TI - The value of the immunoperoxidase slide assay in the diagnosis of malignant pleural effusions in breast cancer. AB - Whether immunocytochemical studies of malignant pleural effusions due to breast cancer would increase the diagnostic yield as compared with conventional effusion cytology was examined in 30 cases with biopsy-proven metastatic spread to the pleura. Conventional cytology was performed on air-dried smears as well as on cytocentrifuge preparations stained with the May-Grunwald-Giemsa stain. Immunocytochemistry was performed with monoclonal antibodies against carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA) and human leukocyte antigen (HLA) and the peroxidase-antiperoxidase technique on glass slides after Ficoll-Hypaque centrifugation. By conventional cytology, 13 cases (43%) were positive for malignant cells, 6 cases (20%) were suspicious, and 11 cases (37%) were negative. In marked contrast, all 30 cases were immunocytologically positive for malignancy. Tumor cells in all cases demonstrated a positive reaction for EMA. Some mesothelial cells were also positive for EMA, but their reaction pattern was clearly distinguishable from that of the tumor cells. Twenty-one cases (70%) also showed CEA-positive tumor cells; mesothelial cells never reacted with CEA. Some tumor cells showed a loss of HLA expression. In conclusion, this immunocytologic method can be recommended as a routine procedure for greatly increasing the diagnostic yield of cytology in pleural effusions due to breast cancer. PMID- 3279713 TI - Cardiac tamponade as a presentation of malignant thymoma. AB - Morphologic, cytochemical and immunocytochemical studies of pericardial fluid from a 30-year-old man presenting with cardiac tamponade are described. Based on the results of the immunocytochemical studies and the histologic examination of excised pericardium, a diagnosis of malignant thymoma was made. This is the first documented case in which malignant cells were found in the pericardial effusion in a patient with invasive thymoma. The significance of using a multidisciplinary approach to the study of body fluids is discussed. PMID- 3279714 TI - Cytologic diagnosis of bancroftian filariasis in a nonendemic area. AB - Parasitic infections are common in the developing countries, but the cytologic diagnosis of such infections is infrequent or rare. This paper presents four cases of filariasis caused by Wuchereria bancrofti diagnosed by cytologic examination and discusses some unusual observations. The finding of microfilariae in pleural fluid in the absence of the classic symptoms and signs of tropical pulmonary eosinophilia is highlighted. In two patients, nocturnal microfilaremia could not be demonstrated despite Nuclepore filtration, thus suggesting the possible merits of cytology in the primary diagnosis of a filarial infection. Even the diethylcarbamazine provocative test failed to elicit a peripheral microfilaremia in one patient, further emphasizing the importance of cytology as a diagnostic method in amicrofilaremic infections. Attention is drawn to the need for a high index of suspicion on the part of the cytologist in the identification of parasitic organisms in material from high-risk groups to achieve an early diagnosis of such infections and the prompt institution of appropriate chemotherapy. This may obviate the more serious pathologic changes of advanced disease, especially the disfigurement of chronic and late filariasis. PMID- 3279716 TI - "Closing volume" during high-frequency ventilation in anesthetized dogs. AB - Airway closure, mean airway pressure, gas exchange and different modes of artificial ventilation were investigated in anesthetized and paralyzed dogs with clinically healthy lungs. The animals were ventilated with either intermittent positive pressure ventilation (IPPV), continuous positive pressure ventilation (GPPV, positive end-expiratory pressure (PEEP) = 0.49 kPa) or high-frequency jet ventilation (HFJV, open system) of 2 and 30 Hz with an inspiratory to expiratory (I/E) - ratio of 30/70 and 60/40. Closing volume (CV) was determined by a modified technique, submitting the lung to constant subatmospheric pressure after an inspiratory vital capacity of oxygen. Two different tests for CV were used: the foreign gas bolus (FGB) with helium as nonresident gas and the single breath nitrogen dilution technique (SBO2). During conventional mechanical ventilation, CV decreased significantly (P less than 0.05) after establishing a PEEP of 0.49 kPa. During HFJV, CV increased significantly (P less than 0.01). This effect was predominantly dependent on I/E duration time ratio and to a lesser extent on ventilatory frequency. There were significant differences between CV obtained by the FGB-method (CV(helium] and CV derived from the SBO2-test (CV(SBO2], although both tests revealed the same proportional changes of CV during the different modes of ventilation. The elevated CV was associated with a decreasing Pao2 and increasing Aa-Do2 and Paco2, indicating substantial hypoventilation and mismatching of ventilation and perfusion. Mean airway pressure increased with both CPPV and HFJV, revealing a dissociation between airway pressure and regional FRC distribution during HFJV. It is concluded that certain modes of high frequency ventilation lead to impaired distribution of inspired gas to dependent lung regions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279715 TI - Immunocytochemical detection of chlamydial antigen in both the urethral scraping and prostatic aspirate in a case of abacterial prostatitis. PMID- 3279717 TI - Pharmacokinetic implications for the clinical use of atropine, scopolamine and glycopyrrolate. AB - Several specific and sensitive new methods for determining atropine and its metabolites in biological fluids have increased the possibility to characterise the pharmacokinetic properties of this antimuscarinic agent. Following i.v. injection, atropine disappears very quickly from the circulation, resembling its fast onset of action. Age, but not sex, appears to have a clear effect on its kinetics, explaining at least partly the higher sensitivity of very young and very old patients to this anticholinergic agent. Following i.m. or oral atropine administration, typical anticholinergic effects coincide quite well with the absorption rate of the drug, indicating that the premedication should be given about 1 and 2 h before induction of anaesthesia. A sufficient absorption after rectal administration offers an alternative treatment, especially in children. Differing from its placental transfer, atropine has a delayed and incomplete lumbar cerebrospinal fluid penetration, indicating a fundamental difference between these two biological membranes. Oropharyngeally administered atropine has a very variable absorption, but inhaled or intratracheally given drug has produced interesting new results, e.g. pulmonary atropine administration appears to have clinical significance in special situations, such as cardiac arrest and organophosphate poisoning (military personnel). Depending on the method used, different data on the metabolism and excretion for atropine have been reported and therefore further studies are needed in this respect. The pharmacokinetics of scopolamine and glycopyrrolate and their relation to clinical response are poorly understood. PMID- 3279719 TI - Pseudologia fantastica. AB - Pseudologia fantastica has not been reviewed in the English literature in over 50 years, but the term is still used, for example, among the diagnostic criteria for the Munchausen syndrome. Based upon a review of 72 cases of pseudologia fantastica collected from 26 reports since its initial description in 1891, pseudologia is distinguished from other types of lying. Pseudologia fantastica is typified by these characteristics: (1) the stories are not entirely improbable and are often built upon a matrix of truth; (2) the stories are enduring; (3) the stories are not told for personal profit per se and have a self-aggrandizing quality; and (4) they are distinct from delusions in that the person when confronted with facts can acknowledge these falsehoods. The authors compile phenomenological data about "the pseudolouge", who is represented equally males and females. Intelligence varies, but at least 40% have evidence of central nervous system dysfunction. The authors suggest that disease simulation, peregrination, and imposture are secondary behavioral manifestations of pseudologia, which is deserving of additional study. PMID- 3279718 TI - Immunolocalization of cathepsins B, H and L in skeletal muscle of X-linked muscular dystrophy (mdx) mouse. AB - The amounts of non-collagen proteins (muscle structural proteins) and the activity of creatine kinase were significantly decreased in muscles of 28-day-old mdx mice. The activities of lysosomal thiol proteases such as cathepsins B and L were increased in muscles of mdx mice at as early as 10 days of age. Endogenous thiol proteinase inhibitor and various lysosomal hydrolases also showed increased activities. The localization of cathepsins B, H and L, and endogenous thiol proteinase inhibitor was investigated using the respective specific antibodies. While only invading macrophages were stained strongly with anticathepsin B and H, and anti-thiol proteinase inhibitor antibodies, cathepsin L was localized in muscle cells as well as in invading macrophages. Cathepsin L in muscle cells itself may initially degrade muscle structural proteins, before lysosomal thiol proteases, mainly derived from macrophages, degrade them in skeletal muscles of mdx mice. PMID- 3279721 TI - Treatment of depression with clonazepam. AB - The antidepressive effect of an anticonvulsant clonazepam was studied with maximum daily dose of 1.5 to 6.0 mg (mean 3.4 mg) in 27 patients with major depression (n = 18) or bipolar disorder (n = 9). Two of them dropped out at an early stage of the treatment, and the antidepressive effect of clonazepam was evaluated for the remaining 25 patients. A marked to moderate improvement was obtained for 21 patients (84%), and the onset of the antidepressive effect of clonazepam appeared within 1 week in most of the cases who responded to the therapy. The total scores on the Hamilton Depression Rating Scale and the Beck Self-Rating Scale were significantly reduced after the clonazepam treatment. Side effects occurred in 14 patients, but most of them were not severe. From these results, it is thought that clonazepam might be useful as an antidepressant for patients in whom conventional antidepressant treatment are contraindicated. PMID- 3279720 TI - Reliability and validity of a Chinese computerized diagnostic instrument. AB - This paper reports on the development and testing of a new Chinese diagnostic instrument--the Adult Diagnostic Interview Schedule-Present (ADIS-P). This instrument uses a selection of items adapted from DIS and SADS. It is administered within approximately 25 min by a trained clinician using a small portable computer that provides an immediate diagnosis. The instrument was tested on 1,331 patients from six large mental hospitals across the country. The concurrent validity was good: compared to the concensus diagnosis of two senior clinicians (who were blinded to the ADIS-P result), the overall diagnostic accuracy was 83% and the weighted Kappa value was 0.60. The 1 month test-retest reliability was satisfactory (weighted Kappa = 0.55). We conclude that ADIS-P is a convenient, reliable and valid diagnostic instrument. PMID- 3279722 TI - Effect of very early intravenous streptokinase infusion in patients with evolving myocardial infarction. AB - The effect of very early infusion of 1.5 X 10(6) U of streptokinase intravenously was studied in 29 patients with nitroglycerin-resistant chest pain and ST-segment elevation. Infarct size was estimated from maximal LD1 isoenzyme levels, and the diagnosis confirmed by CK-MB determination. Thrombolytic therapy was started within 1 hour of pain onset in 11 patients (group A), between 1 and 2 hours in 10 (group B), and later than 2 hours in eight patients (group C). Marked differences appeared between the groups. Thus, three patients in group A and one patient in group B did not develop infarction, all had critical LAD stenoses. Three patients in group C died in shock without bleeding. Further, the average maximal LD1 values in the 22 patients who survived their infarction differed significantly between the groups, and were 12.6, 19.1 and 36.2 mu kat/l in groups A, B and C, respectively. In conclusion, very early intravenous streptokinase infusion probably reduces myocardial necrosis, and possible prevents infarction in some patients. PMID- 3279724 TI - Effects of the calcium antagonist felodipine on the sympathetic and renin angiotensin-aldosterone systems in essential hypertension. AB - Studies were performed in 10 male patients with untreated essential hypertension, WHO grade I-II, aged 25-62 years, to explore the acute (single dose) and long term (8 weeks) effects of felodipine on sympathetic activity--evaluated by plasma and urinary catecholamines--as related to blood pressure, heart rate and the activity in the renin-angiotensin-aldosterone system. The patients were hospitalized for 8 (acute) and 6 (long-term) days and were maintained on a standardized daily intake of sodium (150 mmol), potassium (75 mmol) and water (2,500 ml). Acute felodipine administration (10 mg) significantly reduced blood pressure and increased heart rate. Plasma and urinary noradrenaline, plasma renin activity and angiotensin II increased, whereas plasma and urinary adrenaline, dopamine, aldosterone and plasma vasopressin were unaltered. Long-term felodipine treatment, 10 mg twice daily, reduced blood pressure to a similar extent as acute felodipine administration, but heart rate was not significantly changed. Plasma noradrenaline 3 and 12 hours after the last dose and urinary noradrenaline were increased, whereas plasma and urinary adrenaline and dopamine were unchanged. Plasma renin activity and angiotensin II were increased 3 hours, but unchanged 12 hours after the last dose. Plasma aldosterone was unchanged but urinary aldosterone increased. Plasma vasopressin was unchanged. The changes in plasma noradrenaline as related to blood pressure, heart rate, plasma renin activity and angiotensin II during long-term felodipine treatment may reflect decreased cardiac and renal beta-adrenoceptor-mediated responses. Increased renal clearance of aldosterone could partly explain the unaltered plasma aldosterone level in spite of increased plasma angiotensin II following long-term felodipine treatment. PMID- 3279723 TI - Stopping insulin treatment in middle-aged diabetic patients with high postglucagon plasma C-peptide. Effect on glycaemic control, serum lipids and lipoproteins. AB - We studied the successfulness of stopping insulin treatment in middle-aged diabetic patients aged 45-64 with a high postglucagon C-peptide level and the effects of this change on glycaemic control, serum lipids and lipoproteins. Insulin treatment was successfully stopped in 15 of our 22 patients who satisfied the inclusion criteria for the study and were selected on the basis of a computer file including practically all diabetic patients treated with insulin in the Kuopio University Central Hospital region (population base 250,000 inhabitants). Insulin therapy was restarted in seven patients during the first 3 months after discharge. During the following 9 months insulin therapy was restarted in another three patients so that after a 1-year follow-up period half of the diabetic patients whose insulin therapy was stopped had been switched back to insulin. Insulin therapy was seldom successfully stopped if the postglucagon C-peptide value was under the limit of 1.0 nmol/l. Glycaemic control did not change during the follow-up, although there was a significant weight loss in diabetic patients. No changes were observed in serum lipids or lipoproteins with the exception of LDL cholesterol, which showed a significant reduction during the 3-month follow up. In conclusion, insulin therapy can often be successfully stopped in patients with postglucagon C-peptide over the limit of 1.0 nmol/l without worsening of glycaemic control and without unfavourable changes in serum lipid and lipoprotein levels. PMID- 3279725 TI - Additive effects of moderate dietary salt reduction and captopril in hypertension. AB - In a randomized, cross-over study 27 patients had diastolic blood pressure of greater than or equal to 96 mmHg during four visits without treatment. Following captopril 25 mg b.i.d. nine patients' blood pressure was less than or equal to 90 mmHg. The remaining 18 were randomized into two treatment modalities, captopril and moderate dietary salt reduction, and captopril and hydrochlorothiazide 25 mg daily. Following a wash-out period the groups crossed over to the alternative treatment. At the end of the control period the average blood pressure was 151/100 +/- 12/6 mmHg recumbent and 140/91 +/- 11/7 standing, following captopril 144/94 +/- 13/5 and 132/92 +/- 12/6, respectively, with low salt diet added to captopril 140/91 +/- 12/6 and 128/89 +/- 11/6 and with hydrochlorothiazide and captopril 133/86 +/- 12/7 and 120/84 +/- 11/7 mmHg supine and erect, respectively. It is concluded that moderate dietary salt reduction, which is easily advised, will significantly potentiate the blood pressure fall following captopril treatment in moderate arterial hypertension. PMID- 3279727 TI - Necrotic bullous erysipelas. AB - During the last few years streptococcal infections have been reported in connection with various cutaneous manifestations with severe or fatal outcome. A 62-year-old female with chronic interstitial nephritis was admitted with progression of confluent bullous lesions on her right leg. She had contracted a superficial scratch on her right foot 2 days prior to admission. Within 16 hours she deteriorated rapidly with symptoms on sepsis. Blood cultures and cutaneous swabs disclosed growth of beta-haemolytic streptococci group A. In spite of correct penicillin treatment she died 28 hours after admission. Skin biopsies from her right leg showed severe necrosis. This report is a reminder that new, cutaneous manifestations of streptococcal disease are still emerging. PMID- 3279726 TI - Thromboxane A2 and prostacyclin release in bleeding time blood during primary haemostasis in healthy individuals. AB - It is generally believed that prostacyclin (PGI2) generation is greatly stimulated when blood vessels are injured, even by minor trauma, such as venepuncture. The Simplate technique for measuring skin bleeding time was adapted to quantify by radioimmunoassay PGI2 and thromboxane A2 (TXA2) in the emerging blood, as the stable degradation products 6-keto-prostaglandin F1 alpha (6-keto PGF1 alpha) and thromboxane B2 (TXB2), both of which were measured in venous plasma as well as in serum (clotted at 37 degrees C for 1 h). During bleeding, when platelets aggregate to occlude the injured vessels, the median TXB2 level in the emerging bleeding time blood was 1.7 ng/ml. The median TXB2 level in plasma was less than 1 ng/ml and in serum 275 ng/ml. The levels of immunoreactive 6-keto PGF1 alpha were always below determination limit in bleeding time blood (0.2 ng/ml) and in plasma (0.1 ng/ml), whereas in serum the levels ranged between 0.26 and 0.47 ng/ml. The fact that enhanced PGI2 production in primary haemostasis in skin incisions could not be demonstrated calls for further investigations of possible PGI2 production with more sensitive assays or in injured large vessels. PMID- 3279728 TI - The direct method of diagnosis of duodenal ulcer by means of the roentgen ray. PMID- 3279729 TI - Magnetism: a primer and review. PMID- 3279730 TI - The role of radiology in fatality investigations. PMID- 3279731 TI - Determining the cause of pulmonary atelectasis: a comparison of plain radiography and CT. AB - In a retrospective analysis of 50 patients with segmental or lobar atelectasis of the lung, chest radiographs and CT studies were compared for their abilities to distinguish whether a centrally obstructing tumor was the cause. This was done to help define the role of CT in evaluating patients with atelectasis. Atelectasis was caused by an obstructing tumor in 27 cases and a variety of other conditions in 23. The chest radiograph correctly identified an obstructing tumor as the cause of atelectasis in 24 of 27 patients on the basis of the presence of a central hilar mass or obvious bronchial abnormality; there was 89% sensitivity and 96% specificity with a 12% false-negative rate and a 4% false-positive rate. CT correctly identified all 27 obstructing carcinomas on the basis of the presence of either a central bronchial abnormality or a central hilar mass; there was 100% sensitivity and 87% specificity with a 0% false-negative rate and a 10% false-positive rate. Absence of air bronchograms or the presence of mucus-filled bronchi within the atelectatic lung were secondary CT findings that also favored the presence of an obstructing tumor. Although the chest radiograph was more specific than CT for tumor as the cause of atelectasis (96% vs 87%, respectively), it was less sensitive than CT for tumor (89% vs 100%, respectively) resulting in missed tumor diagnoses. CT identified all cases caused by obstructing tumor and successfully excluded obstructing tumor in most of the remaining cases, with an acceptable number of false-positive tumor diagnoses (10%). CT should be performed when the cause of segmental or lobar atelectasis cannot be established with certainty on the basis of the chest radiograph. PMID- 3279733 TI - Migration of breast biopsy localization wire. PMID- 3279732 TI - Color-flow Doppler sonography in Graves disease: "thyroid inferno". AB - Graves disease is a common diffuse abnormality of the thyroid gland usually characterized by thyrotoxicosis. We performed color-flow Doppler sonography in 16 patients with Graves disease and compared the results with those in 15 normal volunteers and 14 patients with other thyroid diseases (eight with multinodular goiter, four with focal masses, and two with papillary thyroid carcinoma). All 16 Graves disease patients exhibited a pulsatile pattern we call "thyroid inferno." This pattern consists of multiple small areas of intrathyroidal flow seen diffusely throughout the gland in both systole and diastole. In systole, both high-velocity flow (color coded white) and lower velocity flow (color coded red and blue) were noted. In diastole, fewer areas of flow and lower velocity flow were noted. Patients with Graves disease also exhibited color flow around the periphery of the gland. The inferno pattern did not occur in normal subjects or in patients with other thyroid diseases. On occasion, focal areas of intrathyroidal flow were detected in patients with multinodular goiter and focal thyroid masses. High-resolution gray-scale images did not show the small vascular channels from which the flow signal originated. Color-flow Doppler sonography shows promise as a cost-effective, noninvasive technique for diagnosing Graves disease. PMID- 3279735 TI - MR imaging of focal splenic tumors. AB - This study was undertaken to define the MR appearance of splenic tumors in 16 cancer patients with focal splenic lesions; 50 volunteers and liver cancer patients without splenic abnormalities served as controls. In 14 patients with focal splenic lesions, differences between splenic and lesion signal intensities permitted detection of splenic lesions on MR images, either because of cystic or necrotic areas lengthening T2 within the tumor, because of T1 shortening from tumor-associated hemorrhage, or because of T2 shortening of surrounding spleen in two cases of suspected transfusional iron overload. In one spleen, a lesion appeared isointense on both T1- and T2-weighted pulse sequences and was detected only by gross splenic deformity. In one other case, CT defined splenic metastases not visible on MR images. Measurements of signal intensity of normal spleens and tumor are so similar that spin-echo MR imaging can underestimate the size and extent of focal splenic disease or may miss lesions entirely. We conclude that MR imaging is a less sensitive technique for detecting focal lesions of the spleen than for detecting focal hepatic lesions. PMID- 3279734 TI - Radionuclide surveillance of the allografted pancreas. AB - To determine the value of scintigraphy to detect posttransplantation complications of the allografted pancreas, we retrospectively reviewed 209 scintigrams obtained with 99mTc-sulfur colloid (99mTc-SC) and 99mTc glucoheptonate (99mTc-GH). The scintigraphic studies were performed in 37 recipients of simultaneous renal and pancreatic allografts harvested from the same donor. 99mTc-SC was used as an indicator of thrombotic vasculitis; pancreatic perfusion and blood-pool parameters were monitored with 99mTc-GH. In 11 of the 37 recipients, scintigraphic abnormalities suggested posttransplantation infarction. Recurrent episodes of acute rejection of the pancreatic allograft, which always coincided with acute rejection of the renal allograft, were monitored in 24 recipients. Rejection-induced ischemic pancreatitis was suggested in 12 of the 24 recipients and persisted in 10 recipients for several weeks after improvement of renal allograft rejection. Pancreatic atrophy was suggested scintigraphically in 16 of the 24 recipients with recurrent episodes of rejection. Spontaneous pancreatic-duct obstruction and obstructive pancreatitis were associated with a scintigraphic pattern similar to that of rejection-induced ischemic pancreatitis. We concluded that the specific radionuclides used in this series are useful for the surveillance and assessment of posttransplantation pancreatic infarction, acute rejection, pancreatitis, and atrophy. PMID- 3279737 TI - Sonography of cerebral infarction in infancy. AB - Six infants with cerebral infarcts were examined prospectively with real-time sonography to determine the sonographic characteristics of infarcts and their evolution. Patients' ages ranged from 1 day to 7 months, and serial sonographic and/or CT scans were obtained over a period of 2 weeks to 14 months in the survivors. Among our patients the most characteristic sonographic findings of infarction were absence of gyral definition, absence of vascular pulsations, altered parenchymal echogenicity, and territorial distribution. Mass effect, reflected in ventricular size and shift of midline structures, may also be seen and largely parallels the extent of the infarction. Evolution of infarcts was seen sonographically as gradual return of arterial pulsations and concurrent development of cystic spaces. Sonography was found to be a valuable tool in the diagnosis of infarction in infancy and in monitoring its evolution, although CT was necessary for adequate initial evaluation in older infants. PMID- 3279736 TI - Imaging of renal transplants. PMID- 3279738 TI - Sonographic diagnosis of foreign bodies of the distal extremities. PMID- 3279739 TI - Postpartum hemorrhage. AB - Postpartum hemorrhage is usually unexpected, and blood loss can be massive. Excessive bleeding after delivery may result from uterine atony, disruption of the genital tract, placental abnormalities, coagulation disorders and miscellaneous obstetric complications. Prompt treatment is imperative. Treatment options include oxytocics, prostaglandins, uterine exploration, uterine packing and, occasionally, surgery. PMID- 3279741 TI - Unproven cancer therapies. PMID- 3279740 TI - The acute scrotum. AB - Testicular torsion is characterized by the sudden onset of testicular pain associated with abdominal pain, nausea and vomiting. Fever is unusual and urinalysis is often normal. Fever, pyuria, dysuria and urethral discharge are characteristic of epididymitis. Radionuclide scanning and Doppler ultrasound are helpful in establishing the diagnosis. If the diagnosis is uncertain, the patient should be considered to have testicular torsion until it is proved otherwise. Undiagnosed torsion leads to testicular necrosis. PMID- 3279742 TI - Advances in the diagnosis and management of depression. Part II. PMID- 3279743 TI - Nitrates and calcium antagonists for silent myocardial ischemia. AB - Continuous Holter monitoring of patients with coronary heart disease can show transient ischemic episodes occurring spontaneously with or without angina throughout the day. A controlled double-blind trial was conducted comparing the effects of isosorbide-5-mononitrate (IS-5-MN) and nifedipine in patients with documented transient ischemic episodes. Seventy-five percent of the ischemic episodes were not accompanied by pain. Twenty patients with documented coronary heart disease were included; 15 finished the 4-week study (1 patient had headaches, 1 thyrotoxicosis, 1 hypertensive crisis and 2 unstable angina). On a dual-channel FM-recorded electrocardiogram, ischemic episodes were counted when ST deviation was greater than 1 mm for greater than 1 minute. Patients received IS-5-MN (20 mg 3 times a day or 50 mg in a sustained-release tablet) or nifedipine (20 mg in a sustained-release tablet 3 times a day) in random order over four 1-week periods. At the end of each week, Holter monitoring was repeated and showed reductions of episodes by 67% and 67% after weeks of IS-5-MN therapy and 56% and 58% after weeks of nifedipine therapy (all p less than 0.05). Painful and painless episodes were reduced to a similar extent. Individual responses showed great variability, and in all treatment periods not more than half of the patients were completely free of ischemic episodes. One of the 12 patients did not respond to either way of treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279744 TI - Maturation antigen of the mouse sperm flagellum. I. Analysis of its secretion, association with sperm, and function. AB - We report here recent findings on the sperm maturation antigen SMA4, which is secreted by holocrine cells of the distal caput epididymis and binds to the flagellar surface of mouse sperm during epididymal transit. Washed sperm from the caput and corpus epididymides of mice were examined by immunofluorescence and SDS PAGE using wheat germ agglutinin, which binds specifically to SMA4 as a primary probe. Results indicate that sperm first exhibit WGA reactivity on their flagellae in the region of the distal caput, and that the appearance of WGA receptors is due to the binding of a 54-Kd glycoprotein (SMA4) to the cell surface. Extracts of epididymis containing SMA4 were tested for their ability to bind to the surfaces of caput and corpus sperm. Caput sperm surfaces bound SMA4 in a temperature-independent manner, and binding occurred in the presence of enzyme inhibitors, suggesting a nonenzymatic process. Biochemical studies revealed that SMA4 contains disulfide bonds which stabilize it on the sperm surface and restrict its mobility. Terminal carbohydrate residues of the molecule are sialic acids. The addition of SMA4 to caput sperm flagellae prevented tail-to tail agglutination, normally seen when caput sperm are diluted into saline; and SMA4 was able to disperse clumps of agglutinated caput sperm. The data suggest that a primary function of SMA4 is to prevent tail-to-tail agglutination of sperm during storage in the epididymis. PMID- 3279746 TI - Effect of starch structure on glucose and insulin responses in adults. AB - Twelve women and 13 men were given meals containing cornstarch with 70% of the starch in the form of amylopectin or amylose to determine if differences in glycemic response result from different chemical structure. Blood was drawn before and 30, 60, 120, and 180 min after each meal. The meals consisted of starch crackers fed at the rate of 1 g carbohydrate from starch per kilogram body weight. The amylose meal resulted in a significantly lower glucose peak at 30 min than did the amylopectin meal. Plasma insulin response was significantly lower 30 and 60 min after amylose than after the amylopectin meal. Summed insulin above fasting was significantly lower after amylose while summed glucose was not significantly different between the two meals. The sustained plasma glucose levels after the amylose meal with reduced insulin requirement suggest amylose starch may be of potential benefit to carbohydrate-sensitive or diabetic individuals. PMID- 3279745 TI - Effect of a milk-based food supplement on maternal nutritional status and fetal growth in underweight Chilean women. AB - The effects on pregnancy outcome and maternal iron status of powdered milk (PUR) and a milk-based fortified product (V-N) were compared in a group of underweight gravidas. These take-home products were distributed during regular prenatal visits. Women in the V-N group had greater weight gain (12.29 vs 11.31 kg, p less than 0.05) and mean birth weights (3178 vs 3105 g, p less than 0.05) than those in the PUR group. Values for various indicators of maternal Fe status were also higher in the V-N group. Compared with self-selected noncompliers, similar in all control variables to compliers, children of women who consumed powdered milk or the milk-based fortified product had mean birth weights that were higher by 258 and 335 g, respectively. Data indicate a beneficial effect of the fortified product on both maternal nutritional status and fetal growth. PMID- 3279747 TI - Serotonin precursor influenced by type of carbohydrate meal in healthy adults. AB - We compared the effects on the ratio of plasma tryptophan to large neutral amino acids (trp:LNAA) of two different carbohydrate meals (sucrose or starch, 120 g) and a contrasting meal of fat + protein given at breakfast to 10 healthy adults. Plasma glucose and insulin were also measured. The trp:LNAA ratio rose after both carbohydrate meals (p less than 0.001). Glucose and insulin peaks were higher after sucrose than starch, and trp:LNAA rose correspondingly higher (sucrose +34% and starch +20%, p less than 0.05). The ratio declined 45% after the fat + protein meal. At 180 min, absolute ratio values were twofold higher after carbohydrate (sucrose 0.133 and starch 0.127) than after fat + protein (0.057). Similar results were found with the same meals given in the evening. Our results suggest that high-carbohydrate meals have an influence on serotonin synthesis. We predict that carbohydrates with a high glycemic index would have a greater serotoninergic effect than carbohydrates with a low glycemic index. PMID- 3279748 TI - Zinc concentration in plasma and erythrocytes of subjects receiving folic acid supplementation. AB - It has been suggested that oral supplements of folic acid interfere with the intestinal absorption of zinc and may have toxic side effects. The concentrations of Zn and folate in blood were monitored in a group of women with cervical dysplasia randomly assigned to receive 10 mg/d of either folic acid (pteroylglutamic acid) or ascorbate. Fifty subjects were evaluated after 2 mo; 21 of the same subjects were evaluated again after 4 mo. No untoward clinical effects were observed. Significant elevation of erythrocyte folate above the baseline value was observed in the supplemented group but not in the placebo group (p less than 0.001). The concentration of Zn in plasma and erythrocytes did not change significantly in either the folate-treated or placebo groups after 2 and 4 mo. It is concluded that carefully controlled clinical intervention trials of this type do not impose a risk of depleting the concentration of Zn in erythrocytes and plasma. PMID- 3279750 TI - Nevus cell aggregates in the placenta. A histochemical and electron microscopic study. AB - This is a report of the histochemical and ultrastructural analysis of nevus cell aggregates in the placenta from a neonate with a giant pigmented nevus. Although the distinction between aberrant migration of neural crest elements and blood borne metastasis from the giant pigmented nevus is not readily resolved, the authors favor the former as an explanation of this unusual placental lesion. PMID- 3279749 TI - Immunoelectronmicroscopic demonstration of S-100 protein in hairy cell leukemia cells. AB - Hairy cell leukemia (HCL) is generally considered a neoplastic proliferation of B cell lineage. Among immunocompetent cells, however, S-100 protein is also demonstrated in "dendritic" cells (i.e., interdigitating reticulum cells, Langerhans cells, follicular dendritic cells) and in a small percentage of T8 cells. This study reports the surprising detection of S-100 protein in peripheral blood HCL cells of B-cell type, using immunofluorescence and immunoelectronmicroscopy. However, negative results for S-100 protein staining were obtained in paraffin splenic sections of HCL cases. This report stresses the need for caution in the interpretation of immunocytochemical methods and results, and emphasizes the diagnostic ambiguity of the S-100 protein. PMID- 3279752 TI - In memoriam James W. Reagan, M.D. (1918-1987). PMID- 3279751 TI - Myelodysplastic syndrome with acquired hemoglobin H disease. Evolution through megakaryoblastic transformation into myelofibrosis. AB - A 64-year-old man was found to have a hemolytic anemia with a hematocrit of 0.28 (28%) during a routine evaluation. One month before this his hematocrit had been normal. Further studies revealed a myelodysplastic syndrome and acquired hemoglobin H disease. Eighteen months later this transformed into acute megakaryoblastic leukemia with disappearance of hemoglobin H, and shortly thereafter he had myelofibrosis develop. Acquired hemoglobin H disease, which is an alpha-thalassemia-like syndrome, results in the formation of an unstable hemoglobin composed of beta chain tetramers. This condition has been associated with preleukemia, sickle cell anemia, and hematologic malignancies. Although idiopathic myelofibrosis also has been described as a setting in which this thalassemic syndrome occurs, the present case is unusual in that the myelofibrosis was preceded by refractory anemia with leukemic transformation. PMID- 3279753 TI - Flocculation and precipitation of insulin. PMID- 3279754 TI - Follow-up of infants with bilateral renal disease detected in utero. Growth and renal function. AB - We studied 69 infants who had urinary tract abnormalities detected by antenatal ultrasound examination. There were 21 intrauterine or immediate neonatal deaths; in all 21 infants, severe bilateral renal disease incompatible with life was found at autopsy. Six of the live-born infants with abnormal results of antenatal ultrasound examinations had a normal urinary tract after birth. Of the remaining 42 infants, the prenatal diagnosis was confirmed with renal ultrasound and other studies during the first week of life. Twenty-one of 42 infants had bilateral renal disease. We obtained follow-up data on 19 of 21 of these infants. Twelve of 19 had obstructive uropathy that was treated surgically. After one to 51 (mean, 18) months of follow-up, renal function varied. Ten of 19 patients had a calculated glomerular filtration rate greater than or equal to 79 mL/min/1.73 m2. One infant required long-term ambulatory peritoneal dialysis. Renal function (glomerular filtration rate, 74 +/- 5 mL/min/1.73 m2) and growth (height percentile, 41 +/- 8) were unexpectedly good considering the severity of the urinary tract abnormalities. Prenatal detection of bilateral renal disease followed by careful medical and surgical management results in a favorable outcome with good growth and renal function. PMID- 3279755 TI - Diagnosis and treatment of protozoan diarrheas. PMID- 3279756 TI - Early evening ranitidine administration promotes faster duodenal ulcer healing. AB - In a prospective double-blind clinical trial, 141 patients with endoscopically diagnosed duodenal ulcer were randomly assigned to treatment with ranitidine 300 mg, taken either at 6 PM or at 10 PM. After 2 wk of treatment, 52 of 70 patients (74%) in the 6 PM treatment group had healed, compared with 32 of 64 patients (50%) taking ranitidine at 10 PM (p less than 0.01). After 4 wk, the cumulative healing rates were 100% and 94%, respectively, for the 6 PM and 10 PM treatment regimens. These results suggest that ranitidine, taken as a single daily 300-mg dose at 6 PM after dinner, provides more rapid duodenal ulcer healing than the same dose of the drug taken at 10 PM. PMID- 3279757 TI - Campylobacter pylori-associated gastritis: a double-blind placebo-controlled trial with amoxycillin. AB - We randomly assigned 45 adult patients with Campylobacter pylori-confirmed antral gastritis to 8 days of treatment with 1 g amoxycillin suspension twice a day, or placebo, according to a double-blind study design. At the end of therapy, 91% of patients treated with amoxycillin demonstrated clearance of the organism from the antrum, compared with 16% in the placebo group (p less than 0.001). Active antral gastritis resolved in 68% of patients in the amoxycillin group versus only 9% in the placebo group (p less than 0.001). No significant difference was observed when looking at the evolution of chronic only gastritis. No significant improvement was observed in the assessment of clinical symptoms and endoscopic appearance. Reappearance of C. pylori and significant worsening of the histological score of active gastritis was observed after 2 wk in all patients. In a second study phase, 18 patients initially not cleared of their bacteria received amoxycillin single blind for 14 days. Clearance of bacteria associated with improvement or resolution of active gastritis was observed in 72% of the cases. In this subgroup, all patients investigated after 1 month were recolonized with C. pylori and, again, had histological active gastritis. We conclude that amoxycillin is effective in treating active antral gastritis associated with C. pylori, but not in preventing relapses, which occur in all cases within 1 month after therapy. PMID- 3279758 TI - Effects of the pathway of bile flow on the digestion of fat and the release of gastrointestinal hormones. AB - The effects of an altered pathway of bile flow upon fat metabolism and gastrointestinal hormone release were investigated in patients undergoing biliary reconstruction procedures or external biliary drainage. After ingestion of a fat enriched meal, patients with jejunal interposition hepaticoduodenostomy showed the same patterns as controls, with similar levels of plasma triglyceride and gastrointestinal hormones. On the other hand, patients with Roux-Y hepaticojejunostomy or external biliary drainage revealed the impairment of fat metabolism, although the response patterns were different. As for the changes in gastrointestinal hormones in the two groups, both gastric inhibitory polypeptide (GIP) and insulin levels were reduced, whereas glucagon-like immunoreactivity (GLI) levels rose, especially in the external biliary drainage group. It is considered that the disturbance of fat metabolism, in cases of internal or external biliary diversion, is closely related to change in GIP, insulin, and GLI release, in addition to the impairment of mixed micelle formation by bile and of hydrolysis by pancreatic enzymes. PMID- 3279760 TI - Neonatal hemochromatosis: a case and review of the literature. AB - Hemochromatosis is a disease in which the inappropriate absorption of iron over 30-40 yr results in tissue iron overload and the development of cirrhosis of the liver, diabetes, hypogonadism, arthropathy, and skin pigmentation. We present an infant who died at 2 days of age, and who was found to have massive iron overload in the liver. This case is consistent with a rare condition that has been called neonatal hemochromatosis. This disease is discussed in the context of an overview of iron metabolism and adult hemochromatosis. PMID- 3279759 TI - Portal hemodynamic responses after oral intake of glucose in patients with cirrhosis. AB - Changes of portal, superior mesenteric, and splenic venous flows, and portohepatic gradient (portal vein pressure minus free hepatic vein pressure) after a meal were studied in patients with cirrhosis using the duplex ultrasonic Doppler flowmeter, and portal and hepatic vein catheterizations after ingestion of 227 ml of 33% glucose solution (300 kcal). As a control, changes of portal venous flow and portohepatic gradient after drinking 227 ml of water, were studied. Portal and superior mesenteric venous flows increased significantly at 30 min after glucose intake, and they returned gradually to the basal values, whereas no significant postprandial change occurred in splenic venous flow. The sum of superior mesenteric and splenic venous flows was greater than the estimated portal venous flow before glucose intake, and the difference widened during post-prandial mesenteric hyperemia, indicating an increase of blood flow into the portal-systemic shunts. After glucose intake, portohepatic gradient elevated immediately, in parallel with an increase of portal venous flow, and these changes persisted for the 30 min studied; however, no significant change occurred in these parameters after drinking water. IN CONCLUSION: 1) In patients with cirrhosis, hyperemia occurs in the intestine but not in the spleen after glucose intake, and 2) postprandial mesenteric hyperemia causes an increase of portal venous inflow, portal-systemic collateral flow, portal venous flow, and an elevation of portohepatic gradient. PMID- 3279761 TI - Squamous cell cancer of the liver arising from a solitary benign nonparasitic hepatic cyst. AB - A case of squamous cell carcinoma arising from a solitary benign nonparasitic hepatic cyst (SBNHC) causing bile duct obstruction is presented. A review of the literature regarding SBNHC suggests that, although these lesions may appear benign, they may also undergo metaplastic and subsequent malignant transformation. This appears to be particularly true when the SBNHC is lined with squamous epithelium. Once squamous cell carcinoma arises from one of these lesions, the prognosis is extremely grave, despite all forms of surgical and medical management. PMID- 3279762 TI - Possible cytogenetic distinction between lymphoid and myeloid blast crisis in chronic granulocytic leukemia. AB - This study consists of 25 patients with chronic granulocytic leukemia in blast crisis (BC) or with acute leukemia who had a Ph1 chromosome and one or more other chromosome abnormalities and who were investigated by cytochemistry and immunocytochemistry techniques to determine whether the predominant blasts were myeloid or lymphoid. The disorder was myeloid in 15 patients, lymphoid in 8, and mixed in 2. Among the 15 patients with myeloid disorders, 13 (86.6%) had an additional Ph1 chromosome, i(17q), +8, +19, or some combination of these abnormalities. None of the eight patients with a lymphoid disorder had +8, +19, or i(17q), but one had an additional Ph1 chromosome. Among the eight patients with lymphoid disorders, two had structural abnormalities of chromosome 7 and two were monosomy 7. None of the patients with myeloid disease had a structurally abnormal chromosome 7, but one was monosomy 7. Our findings suggest that the number of chromosomes in an abnormal clone may be unreliable for distinguishing between lymphoid and myeloid BC. Most patients with myeloid disease had only abnormal metaphases, whereas many patients with lymphoid disorders had both normal and abnormal metaphases. This finding may partially explain why many patients with lymphoid BC respond better to treatment than do those with myeloid BC. PMID- 3279763 TI - Statistical methodology in the analysis of relationships between DNA polymorphisms and disease: putative association of Ha-ras-I hypervariable alleles and cancer. PMID- 3279764 TI - AIDS facts for pharmacists. PMID- 3279765 TI - Pharmacists in motion pictures. PMID- 3279766 TI - Overview of gastroduodenal mucosal protection. AB - The ability of the gastric mucosa to resist autodigestion has been recognized for over 200 years. Since these early observations, several components of gastroduodenal defense against injury from damaging luminal contents have been identified. The first line of defense is the thick layer of mucus gel into which bicarbonate is secreted by the underlying epithelial cells. The "mucus bicarbonate" barrier sustains a pH gradient between the lumen and cell surface such that epithelial cells are maintained at pH 7 to 8, despite the presence of intraluminal acid. The epithelial cells form a second line of defense; since the pH gradient may be overwhelmed by physiologic concentrations of intraluminal acid, this mechanism may be important in maintaining mucosal integrity. The physical properties of the apical cell membrane and intercellular junctions and the presence of surface-active phospholipids on the membrane may be responsible for preventing hydrogen ions (H+) from diffusing into the mucosa by providing a physical barrier to their movement. Furthermore, epithelial cells are capable of rapid turnover and migration and may breach a defect in the epithelium within hours. The aftermath of mucosal damage may generate a further defense mechanism: a thick layer of mucus containing sloughed epithelial cells together with passive movement of bicarbonate-rich fluid from the damaged mucosa. This may prevent exposure of undamaged cell nests to acid and thus aid re-epithelialization. Finally, mucosal blood flow plays a vital role in maintaining epithelial integrity. Studies have shown that increasing or decreasing mucosal blood flow will, respectively, reduce or enhance susceptibility to damage. Although the precise physiologic control mechanisms for mucosal protection have not been defined, there is evidence that local endogenous prostaglandin metabolism may play an important role [4]. The release of neurotransmitters and hormones may also contribute to or modulate the defense mechanisms. PMID- 3279767 TI - Clinical spectrum of the upper gastrointestinal effects of nonsteroidal anti inflammatory drugs. Natural history, symptomatology, and significance. AB - Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve rheumatic pain and are in extensive use. Symptomatic complications of NSAIDs requiring the discontinuation of their use occur in 2 to 10 percent of patients with rheumatic diseases in sharp contrast to the common asymptomatic problems of gastroduodenal erosions, ulcerations, and bleeding, with resulting anemia in more than 40 percent of these patients. Opinions concerning the clinical significance of these complications are not uniform. The natural history of the effects of NSAIDs on the gastroduodenal mucosa reveals a sequence of initial subepithelial hemorrhage over a 24-hour period followed by gastroduodenal erosions and ulcerations in the next two weeks. From one week to three months, gastroduodenal erosions and ulcerations disappear in about half of the patients as an adaptation to continuing NSAID ingestion occurs. Hemorrhage may occur at any time in most patients and in a small minority (1 percent) it is massive. Non-aspirin NSAIDs (NANSAIDs) exhibit significantly fewer complications than do aspirin. These complications, however, demand considerable clinical attention and are ordered in a constant hierarchy, suggesting variable risks of complications among agents. NSAIDs are a blessing for those who have chronic pain, but that blessing does not prevent significant asymptomatic complications in the same patients. Prophylaxis for high-risk groups, such as women over the age of 65 years, should be subjected to study. PMID- 3279768 TI - In memoriam. Dr. Arthur J. Antenucci. 1905-1987. PMID- 3279770 TI - The enigma of insulin resistance and hypertension. Insulin resistance, blood pressure, and the circulation. AB - The epidemiologic link between obesity and hypertension is more clearly emerging to be one between insulin resistance and hypertension. Relative insulin resistance occurs not only in obese hypertensive patients but also in non-obese lean essential hypertensive patients. Although insulin has complex actions on the circulation, plausible mechanisms by which insulin might raise blood pressure include renal sodium retention and stimulation of the sympathetic nervous system. However, the evidence that insulin can actually raise blood pressure in the long term is lacking. Since hypertension does not develop in all obese or insulin resistant subjects, the relationship must be modulated by other genetic or environmental factors. Obesity, diminished physical conditioning, aging, and diabetes are ubiquitous contributors to relative insulin resistance and all are associated with a tendency for blood pressure to rise. Conditions and agents associated with acquired insulin resistance and secondary forms of hypertension include pregnancy, oral contraceptives, acromegaly, and glucocorticoids. Although type 2 non-insulin-dependent diabetes is a state of increased insulin resistance, hypertension is partly sustained by secondary renal mechanisms. Future research should identify the genetic and environmental determinants of insulin resistance in hypertension and utilize these in therapy. PMID- 3279769 TI - Calcitriol in the treatment of postmenopausal osteoporosis. AB - Calcitriol was compared with placebo in the treatment of postmenopausal osteoporosis in a double-blind, randomized, parallel clinical trial of 24 months' duration. Adjustment was made in dietary calcium to maximize the dose of calcitriol. The study was completed by 15 patients who received placebo and 12 patients who received calcitriol. The calcitriol group had positive slopes (compared with negative slopes for the placebo group) for total body calcium, bone mineral content of the radius, bone mineral density of the lumbar spine, and radiographic absorptiometry of the middle phalanges. The difference between the two groups was statistically significant for each of these measurements. The fracture rate in the treatment group was 250 per 1,000 patient-years as compared with 333 for the placebo group. The mean dose of calcitriol was 0.8 micrograms per day. Hypercalcemia, hypercalciuria, and perhaps nephrolithiasis were observed as complications of treatment. Calcitriol increased bone mineral density by decreasing bone resorption, but not by increasing bone formation. Future studies should concentrate on treatment with oral calcitriol in lower doses. It would also be of interest to examine parenteral administration of calcitriol. It is possible that bone formation can be increased by achieving higher serum levels of the drug, whereas complications may be avoided by using a non-oral route of administration. PMID- 3279771 TI - Pseudohypertension masquerading as malignant hypertension. Case report and review of the literature. AB - An elderly man with chronic renal failure and radiologic evidence of vascular calcification was found to have severe pseudohypertension mimicking hypertensive crisis. Pathologic examination of his artery revealed severe medical calcification. The syndrome of pseudohypertension is reviewed. PMID- 3279772 TI - Treatment of epidural cord compressions from Hodgkin's disease with chemotherapy. A report of two cases and a review of the literature. AB - Epidural cord compressions are a frequent and serious problem for patients with cancer. Standard treatment for these lesions includes local irradiation with or without surgery. Herein are reported two cases of epidural cord compression from Hodgkin's disease that responded dramatically to systemic chemotherapy. A review of the literature reveals reports of successful chemotherapy in the treatment of seven patients with epidural metastases secondary to lymphomas and 15 secondary to a variety of other tumors. The use of systemic chemotherapy is an increasingly important therapeutic option for treatment of epidural cord compressions in carefully selected patients. PMID- 3279773 TI - Changing patterns of infectious diseases. AB - In the 20 years that have passed since I received my medical degree, some of the most evident, striking, and interesting changes in patterns of diseases have occurred among those due to transmissible agents. Among other changes are the recognition of new diseases, new clinical manifestations for old diseases, new ecologic niches for traditional pathogens, and new modes of disease transmission. Implicated causes for these changes include alterations in lifestyle such as sexual behaviour, leisure activity, and dietary trends, along with the impact of immigration and the effects of medical progress. A review of these changing patterns demonstrates the dynamic nature of medicine and suggests lessons for medical education. PMID- 3279774 TI - Randomized trial of beta-lactam regimens in febrile neutropenic cancer patients. AB - A three-arm prospective randomized trial was designed to compare the efficacies of piperacillin plus vancomycin, ceftazidime plus vancomycin, or all three drugs as initial therapy for fever in neutropenic cancer patients. The objectives were to determine whether a broad-spectrum penicillin was as effective as a broad spectrum cephalosporin and whether two beta-lactam antibiotics were more effective than one. Four hundred and seventy of the 519 febrile episodes entered in the study could be evaluated for response. Ceftazidime plus vancomycin was significantly more effective than piperacillin plus vancomycin, considering all febrile episodes (79 percent versus 61 percent, p = 0.001), documented infections (79 percent versus 57 percent, p = 0.004), gram-negative infections (88 percent versus 47 percent, p = 0.001), and bacteremias (81 percent versus 51 percent, p = 0.01). The addition of piperacillin to ceftazidime (piperacillin plus ceftazidime and vancomycin versus ceftazidime plus vancomycin) did not improve the response rate and was associated with a significantly higher incidence of skin rash. Vancomycin plus ceftazidime provides adequate antibiotic coverage for initial treatment of fever in neutropenic patients. This combination was equally effective, less expensive, and less toxic than the double beta-lactam combination used in this study. PMID- 3279776 TI - Escherichia coli emphysematous endophthalmitis and pyelonephritis. Case report and review of the literature. AB - Emphysematous escherichia coli endophthalmitis occurred in a 72-year-old patient as a complication of E. coli septicemia secondary to emphysematous pyelonephritis and endocarditis. This is the first reported case of endogenous emphysematous endophthalmitis secondary to E. coli septicemia. PMID- 3279775 TI - Ketoconazole therapy of progressive coccidioidomycosis. Comparison of 400- and 800-mg doses and observations at higher doses. AB - One hundred and twelve patients with progressive pulmonary, skeletal, or soft tissue infections caused by Coccidioides immitis were randomly assigned to treatment with 400 or 800 mg per day dosages of ketoconazole. During therapy, if response was unsatisfactory, the protocol provided for treatment with higher doses. With 400 mg, ketoconazole resulted in 23.2 percent successes, which was similar to 32.1 percent successes with 800-mg treatments (p = 0.29). An additional six of 23 patients in whom initial therapy failed and who later received 1,200 or 1,600 mg per day of ketoconazole also showed improvement. However, among patients completing successful courses of therapy, relapses were more frequent in those requiring higher than 400-mg dosages for their success. From these studies, it is concluded that ketoconazole in doses above those currently recommended offer little or no benefit for most patients with non meningeal forms of coccidioidomycosis. PMID- 3279777 TI - Which child gets the transplant? PMID- 3279778 TI - Harvest Moon. Portrait of a nursing home. PMID- 3279779 TI - Why not launch a new Cadet Nurse Corps? PMID- 3279780 TI - NIH-sponsored clinical trials begin for antiviral drug AL721. PMID- 3279781 TI - Preventing home care denials is not a simple matter. PMID- 3279783 TI - 1988 directory of nursing organizations. PMID- 3279782 TI - Changes in Medicare home care forms. PMID- 3279784 TI - Conservative management of a severely alloimmunized pregnancy: case report. AB - A pregnancy complicated by severe alloimmunization because of anti-E antibodies was evaluated with fetal movement counts, nonstress tests, and serial ultrasonography-amniocentesis. The successful outcome of this case suggests that such treatment may be an acceptable alternative to intrauterine transfusions for very select cases of severe alloimmunization. PMID- 3279785 TI - Congenital atresia and stenosis of the duodenum: the impact of a prenatal diagnosis. AB - This review was undertaken to determine the effects of prenatal diagnosis, on the basis of ultrasonographic evidence, of a duodenal obstruction on the care and morbidity of the newborn infant. The records of 46 cases of either atresia or stenosis of the small bowel in infants treated during the last six years in a tertiary perinatal center were reviewed retrospectively. A prenatal fetal diagnosis of obstruction was made in 13 patients (12 obstructions located in the duodenum and one in the jejunum). The mean gestational age at prenatal diagnosis was 33.7 weeks (range 27 to 37 weeks). The course of those infants with the prenatal diagnosis made by ultrasound was compared with that of those infants in whom the diagnosis was established after the onset of symptoms of obstruction appeared. Such a prenatal diagnosis resulted in earlier surgical intervention (1.8 versus 3.9 days). Metabolic complications secondary to repeated vomiting were found to be less frequent. The expectant mother in whom such a fetal prenatal diagnosis has been made can be transported to a tertiary level perinatal center where neonatal and specialized surgical expertise are available. After birth, the infant can undergo immediate operation without being separated from its mother. PMID- 3279786 TI - Serum-specific antibodies for Chlamydia trachomatis in premature contractions. AB - A case-control study was undertaken to examine the possible morbidity associated with Chlamydia trachomatis in 28 pregnant women having idiopathic premature contractions, in 35 healthy preterm pregnant women, and in 43 healthy pregnant women at term. Serum C. trachomatis IgG- and IgA-specific antibodies were determined by the single serovar inclusion immunoperoxidase assay. There were no significant differences in the prevalence rate of elevated C. trachomatis IgG specific antibodies (titer greater than or equal to 1:128) between pregnant women suffering from idiopathic premature contractions as compared with healthy preterm and term pregnant women (11%, 28%, and 26%, respectively). The known prevalence rate in a normal healthy population is 23%. The prevalence rate of elevated C. trachomatis IgA-specific antibodies (titer greater than or equal to 1:16) was significantly lower in the pregnant women with idiopathic premature contractions as compared with the healthy preterm and term pregnant women (0%, 20%, and 17%, respectively; p less than 0.002 and p less than 0.012). These findings do not support the assumption that C. trachomatis has a role in premature contractions. PMID- 3279787 TI - Successful pregnancy and vaginal delivery after heart transplantation. AB - Successful pregnancy and delivery in women with serious cardiovascular diseases have been reported. We describe here a patient with a transplanted heart, treated with cyclosporine and prednisone, who underwent pregnancy and vaginal delivery with good outcomes for mother and infant. PMID- 3279788 TI - Ovarian dysgerminoma: report of seven cases and review of the literature. AB - Seven cases of ovarian dysgerminoma are presented and the recent literature reviewed. The majority of the cases reviewed had tumor confined to one ovary at the time of diagnosis, and nearly 50% occurred in women less than 20 years of age. The 5-year survival rate was 91% for 211 patients with stage I disease and 65% for 60 patients with stage II to IV dysgerminoma. The addition of contralateral adnexectomy, abdominal hysterectomy, and radiation therapy was not beneficial when disease was confined to one ovary. The survival of patients with advanced disease treated with chemotherapy was comparable with that of patients who received radiation. Analysis of the present data suggests that the use of unilateral oophorectomy should be limited to those patients with disease confined to one ovary and no histologic evidence of lymph node metastasis. Abdominal hysterectomy, bilateral adnexectomy, and adjuvant radiation is currently the treatment of choice for patients with more advanced dysgerminoma. PMID- 3279789 TI - High levels of circulating prorenin in pregnancy. PMID- 3279790 TI - Three-contrasts method: an ultrasound technique for monitoring transcervical operations. PMID- 3279791 TI - Fibrinogen influx and accumulation of cross-linked fibrin in healing wounds and in tumor stroma. AB - Fibrinogen enters wounds and solid tumors, where it is clotted to fibrin that may subsequently be replaced by collagenous stroma. If, as has been suggested, the pathogenesis of wound healing and tumor stroma generation is similar and dependent on fibrin deposition, then the types and amounts of fibrin deposited in wounds and tumors might also be expected to be similar. To test this hypothesis, the authors injected homologous tracer fibrinogen (125I-GPF) intravenously into guinea pigs and measured its influx and accumulation in skin wounds and syngeneic carcinomas. In support of their hypothesis, the urea-insoluble product deposited in both wounds and tumors was identified as cross-linked fibrin by gel electrophoresis. Accumulation of both total and urea-insoluble 125I-GPF was quantitatively similar in wounds and tumors. However, influx and initial clotting of 125I-GPF in tumors exceeded that in wounds; given equivalent accumulation, these data suggest that fibrin turnover is more rapid in tumors than in wounds. Fibrinogen influx and fibrin accumulation declined toward normal a few days after wounding but remained consistently elevated in tumors. Thus, the magnitude and the persistence of microvascular hyperpermeability, as well as fibrin turnover, are major points of difference that distinguish tumors from healing wounds. PMID- 3279792 TI - Basement membrane antigens in renal polycystic disease. AB - Status of basement membrane antigens in renal polycystic disease was investigated. Antibodies directed against various components of basement membrane, including anti-heparan sulfate proteoglycan, Type IV collagen, laminin, and fibronectin, were employed. Their reactivities with basement membranes of normal and cystic segments of the renal tubules were ascertained by indirect immunofluorescence. The tissues were obtained either from kidneys of patients with adult (autosomal dominant) polycystic disease or from rats with renal cystic change induced by administration of 2-amino-4,5-diphenylthiazole HCl. The human and rat tissues that had undergone cystic change exhibited essentially similar results. A loss of reactivity to anti-heparan sulfate proteoglycan antibodies was observed. The reactivity toward anti-Type IV collagen and laminin either remained unchanged or was focally increased. The reactivity toward fibronectin, normally absent, increased dramatically in the peritubular regions and interstitium. The results indicate that there is an imbalance in various antigenic components associated with renal tubular cystic disease in rat and man, which may have a fundamental role in the pathogenesis of this disorder. PMID- 3279793 TI - Phenotypic and genotypic analysis of a human medulloblastoma cell line and transplantable xenograft (D341 Med) demonstrating amplification of c-myc. AB - D341 Med is a new continuous cell line and transplantable xenograft derived from a cerebellar medulloblastoma. This line grew in vitro in suspension culture with spontaneous macroscopic spheroid formation and demonstrated 20-fold amplification of c-myc. Cultured D341 Med cells injected subcutaneously into athymic mice grew as markedly cellular, highly invasive undifferentiated neoplasms. Intracranial tumors grew as markedly cellular mitotically active neoplasms largely located within the subarachnoid space or lining the ventricular system. Immunocytochemical analysis of the cell line and SQ tumors revealed the high (NFP H) and middle (NFP-M) molecular weight (Mr) neurofilament proteins (NFPs). Immunoblots demonstrated the presence of molecular species that co-migrated with authentic human NFP-H and NFP-M. This cell line and transplantable xenograft may allow, in conjunction with the authors' other models of human medulloblastoma, analysis of the heterogeneous biologic properties and therapeutic sensitivity of this tumor. PMID- 3279795 TI - Murine chronic graft-versus-host disease as a model for lupus nephritis. PMID- 3279796 TI - Smooth muscle intracellular pH: measurement, regulation, and function. AB - Smooth muscle performs many functions that are essential for the normal working of the human body. Changes in pH are thought to affect many aspects of smooth muscle. Despite this, until recently little was known about either intracellular pH (pHi) values or pHi regulation in smooth muscle. Recent work measuring pHi with either microelectrodes or nuclear magnetic resonance spectroscopy is now providing some of this much needed information for smooth muscles. From these studies, it can be concluded tentatively that pHi is the same in different smooth muscles, approximately 7.06 (37 degrees C). This value is very close to those obtained in cardiac and skeletal muscle. It is clear that H+ is not in equilibrium across the smooth muscle membrane; i.e., pHi is regulated. Preliminary results in smooth muscle suggest that certain aspects of this regulation are different from that described for other muscle types. Changes in pHi have been found to produce marked effects on contraction in smooth muscle. Of particular interest is the fact that, unlike striated muscles, some smooth muscles can product more force during an intracellular acidification. PMID- 3279794 TI - Intermediate filament proteins and actin isoforms as markers for soft tissue tumor differentiation and origin. II. Rhabdomyosarcomas. AB - A series of 15 rhabdomyosarcomas was examined by light microscopy, transmission electron microscopy, two-dimensional gel electrophoresis (2D-GE) and indirect immunofluorescence, the latter using monoclonal or affinity-purified polyclonal antibodies to desmin, vimentin, alpha-smooth muscle and alpha-sarcomeric (alpha sr) actins. By light microscopy, the authors diagnosed 1 botrioid, 1 alveolar, and 7 embryonal rhabdomyosarcomas, 4 pleomorphic spindle cell sarcomas, and 2 spindle cell sarcomas, one nondistinct, the other with a hemangiopericytomatous pattern. By transmission electron microscopy, 13 neoplasms disclosed rhabdomyoblastic differentiation; the remaining 2, myogenic differentiation. By immunofluorescence microscopy, all neoplasms expressed vimentin and alpha-sr actin, 12 expressed, in addition, desmin, and 1 expressed alpha-smooth muscle actin. Among the 11 neoplasms studied by means of 2D-GE, 7 demonstrated an alpha actin spot, while 4 showed only beta and gamma spots. One tumor disclosed, in addition to alpha, beta, and gamma spots, a spot with a molecular weight corresponding to actin, but more acidic than alpha-actins. This study demonstrates that alpha-sr actin antibody represents a valuable marker for the diagnosis of rhabdomyosarcoma, because it was present in all neoplasms, including the one negative for desmin. This antibody further allowed the recognition of pleomorphic variants and morphologically atypical forms of rhabdomyosarcomas. The presence of alpha-smooth muscle actin in 1 case of rhabdomyosarcoma suggests that this actin isoform may be expressed during skeletal muscle differentiation. PMID- 3279797 TI - Effect of seeding density and time in culture on vascular smooth muscle cell proteins. AB - The purpose of this work was to determine the effect of seeding density and time in culture on quantitative and qualitative characteristics of myosin in primary cultures of vascular smooth muscle cells (VSMCs). Enzymatically dispersed VSMCs from femoral arteries and saphenous veins of adult dogs were seeded at a density of 10(3)-10(5) cells/cm2 and assayed after 7 days or at 10(5) cells/cm2 and assayed between 1 and 10 days. Myosin, actin, and total protein contents as well as electrophoretic and immunoreactive characteristics of myosin heavy chains (MHCs) were determined. Total and contractile protein contents were independent of seeding density and increased with time in culture. Freshly dispersed cells exhibited two MHCs (MHC-1 and MHC-2) but, within 24 h after culturing, only cells attached to the dish expressed a third protein band (MHC-3), which had electrophoretic mobility and immunoreactivity similar to purified platelet MHC. MHC-3 appeared before onset of cell division and, by 4 days in culture when cells were proliferating, became the dominant MHC form. Loss of MHC-1 and MHC-2 could be prevented by growing cells in a serum-free, defined media that prevented proliferation. These data indicate that seeding density does not affect myosin content, but that with time in culture expression of a MHC with characteristics similar to nonmuscle myosin occurs. Expression of MHC-3 is associated with cell attachment, whereas loss of MHC-1 and MHC-2 requires proliferation. PMID- 3279798 TI - Regulation of Ca2+ homeostasis by islet endoplasmic reticulum and its role in insulin secretion. AB - Changes in intracellular Ca2+ concentrations have a major role in the regulation of insulin secretion by islet beta-cells. It has recently become apparent that the endoplasmic reticulum plays a prominent role in the regulation of intracellular Ca2+ concentrations under basal conditions and during insulin secretion. This review describes biochemical properties of the endoplasmic reticulum that contribute to intracellular Ca2+ homeostasis including 1) an ATP dependent Ca2+ uptake pump associated with a Ca2+-ATPase located in the endoplasmic reticulum; 2) Ca2+ release from the endoplasmic reticulum induced by the second messengers inositol trisphosphate and arachidonic acid as well as the guanine nucleotide GTP; and 3) a Ca2+ sequestration mechanism localized to the endoplasmic reticulum that is regulated by glucose 6-phosphate and glucose-6 phosphatase. The hypothesis is developed that these biochemical mechanisms participate in the regulation of intracellular Ca2+ concentrations and represent central intracellular events involved in the first phase of glucose-induced insulin secretion. PMID- 3279799 TI - Relationship of substrate level to turnover rate in fasted adult and newborn dogs. AB - Glucose turnover, clearance and response to insulin were determined in fasted newborn and adult dogs. Fasting levels of glucose and insulin and rates of glucose turnover and clearance were not different between the two groups. Blood glucose correlated with basal glucose turnover in newborn pups but not in adult dogs. Glucose turnover was not related to fasting plasma insulin levels. Glucose clearance was an inverse function of blood glucose levels among newborn but not adult dogs. Glucose clearance and blood glucose levels were not related to insulin concentrations. In response to euglycemic hyperinsulinemia, glucose metabolism increased 4-fold among adults but only 1.7-fold in pups. Hyperglycemic hyperinsulinemia increased glucose metabolism in both groups but to a much greater extent in the pups. Euglycemic hyperinsulinemia increased the metabolic clearance rate of glucose 4.2-fold among adults but only 1.8-fold in newborn dogs. In response to hyperglycemic hyperinsulinemia glucose clearance rates were now similar. Despite euglycemic hyperinsulinemia, the newborn dog had an attenuated response to insulin, demonstrating lower rates of glucose metabolism and glucose clearance. The response to the hyperglycemic stimuli suggests that maximal glucose uptake was not achieved during hyperinsulinemia alone. This response supports the concept of glucose-mediated regulation of glucose disposal in newborn animals. PMID- 3279800 TI - Acute effects of ethanol and acetate on glucose kinetics in normal subjects. AB - We compared the effects of two ethanol doses on glucose kinetics and assessed the role of acetate as a mediator of ethanol-induced insulin resistance. Ten normal males were studied on four occasions, during which either a low (blood ethanol 4 +/- 1 mmol/l) or moderate (14 +/- 1 mmol/l) ethanol, acetate, or saline dose was administered. Both ethanol doses similarly inhibited (0.4-0.5 mg.kg-1.min-1, P less than 0.01) basal glucose production. The decrease in Ra was matched by a comparable decrease in glucose utilization (Rd), resulting in maintenance of normoglycemia. During hyperinsulinemia (approximately 70 microU/ml), glucose disposal was lower (1.2-1.7 mg.kg-1.min-1, P less than 0.01) in the moderate than the low-dose ethanol or saline studies. During acetate infusion, the blood acetate level was comparable with those in the ethanol studies. Acetate had no effect on glucose kinetics. In conclusion, 1) in overnight fasted subjects, ethanol does not cause hypoglycemia because its inhibitory effect on Ra is counterbalanced by equal inhibition of Rd;2) basal Ra and Rd are maximally inhibited already by small ethanol doses, whereas inhibition of insulin stimulated glucose disposal requires a moderate ethanol dose; and 3) acetate is not the mediator of ethanol-induced insulin resistance. PMID- 3279801 TI - Dissociation between plasma renin and plasma aldosterone induced by dietary glycine hydrochloride. AB - We evaluated the effects of selective dietary chloride loading (without sodium) on plasma renin activity (PRA) and plasma aldosterone in the sodium-deprived Sprague-Dawley rat. Three groups of animals were fed one of the following diets for 13 days: 1) low NaCl; 2) high NaCl; or 3) low sodium, high chloride, provided as glycine hydrochloride. Compared with NaCl-deprived animals, PRA and plasma aldosterone were lower (P less than 0.01) in animals fed low sodium high chloride, whereas aldosterone in animals fed glycine hydrochloride was higher (P less than 0.01) than that of NaCl-deprived animals. In contrast, plasma concentrations of corticosterone and 18-hydroxycorticosterone were not increased by selective chloride loading. Glycine chloride-fed animals were acidotic and had elevated plasma concentrations of potassium and ionized calcium. Thus stimulation of aldosterone by selective chloride loading is not related to PRA or ACTH but may be due to a direct effect of acidosis or an indirect effect of acidosis on potassium and/or calcium. Additionally, selective chloride loading appears to stimulate the conversion of 18-hydroxycorticosterone to aldosterone. PMID- 3279802 TI - Normalization of carbohydrate-induced thermogenesis by fructose in insulin resistant states. AB - To examine whether defects in carbohydrate oxidation and thermogenesis in aging, obesity, and diabetes are secondary to impaired insulin action or to a primary defect in intracellular metabolism, we compared substrate oxidation and energy expenditure in 9 younger, 9 older, 9 obese, and 10 non-insulin-dependent diabetic subjects after the ingestion of 75 g of glucose or fructose (a monosaccharide whose transport into the cell and subsequent metabolism are independent of insulin). In young control subjects fructose produced a significantly greater increase in carbohydrate oxidation and energy expenditure than glucose despite significantly lower plasma glucose and insulin levels. In aged, obese, and diabetic individuals the increments in carbohydrate oxidation and energy expenditure after glucose ingestion were significantly imparied versus the younger controls. After fructose ingestion the increase in carbohydrate oxidation in the three insulin-resistant groups remained below that observed in the younger volunteers, whereas carbohydrate-induced thermogenesis was enhanced to levels that were comparable with those seen in the younger group. These data suggest that 1) the stimulation of thermogenesis after fructose ingestion is related to an augmentation of intracellular metabolism rather than an increase in the plasma insulin concentration per se, 2) the insulin resistance of aging, obesity, and diabetes is associated with a defect in intracellular carbohydrate oxidation, and 3) the cellular mechanisms involved in carbohydrate-induced thermogenesis are not primarily impaired in insulin-resistant states. PMID- 3279803 TI - Leucine incorporation into mixed skeletal muscle protein in humans. AB - Fractional mixed skeletal muscle protein synthesis (FMPS) was estimated in 10 postabsorptive healthy men by determining the increment in the abundance of [13C] leucine in quadriceps muscle protein during an intravenous infusion of L-[1 13C]leucine. FMPS in our subjects was 0.046 +/- 0.003%/h. Whole-body muscle protein synthesis (MPS) was calculated based on the estimation of muscle mass from creatinine excretion and compared with whole-body protein synthesis (WBPS) calculated from the nonoxidative portion of leucine flux. A significant correlation (r2 = 0.73, P less than 0.05) was found between MPS (44.7 +/- 3.4 mg.kg-1.h-1) and WBPS (167.8 +/- 8.5 mg.kg-1.h-1). The contribution of MPS to WBPS was 27 +/- 1%, which is comparable to the reports in other species. Morphometric analyses of adjacent muscle samples in eight subjects demonstrated that the biopsy specimens consisted of 86.5 +/- 2% muscular as opposed to other tissues. Because fiber type composition varies between biopsies, we examined the relationship between proportions of each fiber type and FMPS. Variation in the composition of biopsies and in fiber-type proportion did not affect the estimation of muscle protein synthesis rate. We conclude that stable isotope techniques using serial needle biopsies permit the direct measurement of FMPS in humans and that this estimation is correlated with an indirect estimation of WBPS. PMID- 3279804 TI - Insulin response of components of whole-body and muscle carbohydrate metabolism in humans. AB - We measured total body insulin-mediated glucose uptake, carbohydrate oxidation, storage (nonoxidative disposal), muscle glycogen synthase activity, and muscle glucose 6-phosphate (G-6-P) content in response to five levels of insulinemia (means 16, 52, 152, 573, and 5,550 microU/ml) in 16 male glucose-tolerant volunteers. Insulin dissociation constants (KDs) for disposal, storage, and synthase activity (but not for oxidation) are coincident, suggesting that storage via glycogen synthesis could be a major determinant of glucose disposal. Increases in glucose disposal were associated with decreases in muscle G-6-P concentration. These data suggest that the principal control over carbohydrate disposal is exerted after G-6-P. The coincidence of insulin sensitivities for disposal, storage, and synthase activity suggest that storage via glycogen synthesis could be a major determinant of glucose disposal. PMID- 3279806 TI - Neonatal and maternal prostaglandin in the ontogenic response of rat gastric mucosa to H+. AB - We have previously demonstrated that neonatal rat stomach is less susceptible to luminal H+ when compared with the adult. In the present study we investigate the role of endogenous prostaglandins (PG) in the ontogeny of gastric permeability responses to H+. Responses to luminal instillation of 250 mN HCl were measured in rats at 10, 15, 20, and 25 days after birth. Mucosal responses were measured in terms of loss of H+ and appearance of Na+, K+, and protein in the luminal instillate. Indomethacin (IM; 8 mg/kg sc) administration to rat pups reduced mucosal levels of prostaglandin E2 (PGE2) and 6-ketoprostaglandin F1 alpha (6 keto-PGF1 alpha). In response to intraluminal HCl, the reduction of mucosal PG did not significantly affect transmucosal fluxes of ions and protein when compared with control pups. IM was also given to lactating dams on days just prior to the pups being 10, 15, 20, and 25 days old. IM treatment significantly reduced the content of PGE2 and 6-keto-PGF1 alpha in maternal milk. Permeability responses in pups from IM-treated dams were increased over pups from control dams. This effect was not observed in 25-day-old rats. Treatment of pups from IM injected dams with PGE2 but not PGI2 partially restored the permeability responses to luminal H+ to levels observed in pups from control dams.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279805 TI - Compliance in microcomputer-assisted conventional insulin therapy: computer simulation study results. AB - Compliance in diabetes self-management is a complex issue. It involves the interdependent daily actions of self-measurement of blood glucose and adherence to a prescribed schedule of daily activities. This impacts strongly on lifestyle because it necessitates precise meal timing as well as control of size and carbohydrate content. We sought to identify how strongly relaxing the lifestyle constraints per se would impact the ability to achieve improved metabolic control. To isolate these effects from those that result from poor measurement compliance, we used a computer simulator called OMNI et al. Furthermore, to standardize the "clinical" therapy, a second microprocessor device called an "Insulin Dosage Computer" was used to adjust insulin doses based on the usual clinical practice of four times a day precibal blood glucose measurements. Ten type 1 diabetic patients were stimulated and each followed for 120 simulated days. In each such subject, the simulation was repeated three times to include three different levels of lifestyle compliance ranging from excellent to poor. In all three protocols, starting from a level of poor control of diabetes, mean blood glucose values were significantly improved without significant differences after 120 days of computer-simulated treatment. Only the standard deviations, expressing the fluctuations of blood glucose and hence its stability, increased with decreasing lifestyle compliance. This computer simulation predicts that consistent self-monitoring of four blood glucose values per day is the cornerstone of diabetic self-control and that the use of these data according to a standardized therapeutic algorithm for insulin adjustment may successfully stabilize even patients with poor lifestyle compliance. Clinical studies must follow. PMID- 3279807 TI - Molecular events in synaptogenesis: nerve-muscle adhesion and postsynaptic differentiation. AB - The clustering of acetylcholine receptors (AChR) in the postsynaptic membrane of newly innervated muscle fibers is one of the earliest events in the development of the vertebrate neuromuscular junction. Here, we describe two hypotheses that can account for AChR clustering in response to innervation. The "trophic factor" hypothesis proposes that the neuron releases a soluble factor that interacts with the muscle cell in a specific manner and that this interaction results in the local accumulation of AChR. The "contact and adhesion" hypothesis proposes that the binding of the nerve to the muscle cell surface is itself sufficient to induce AChR clustering, without the participation of soluble factors. We present a model for the molecular assembly of AChR clusters based on the contact and adhesion hypothesis. The model involves the sequential assembly of three distinct membrane domains. The first domain to form serves to attach microfilaments to the cytoplasmic surface of the muscle cell membrane at sites of muscle-nerve adhesion. The second domain to form is clathrin-coated membrane; it serves as a site of insertion of additional membrane elements, including AChR. Upon insertion of AChR into the cell surface, a membrane skeleton assembles by anchoring itself to the AChR. The skeleton, composed in part of actin and spectrin, binds and immobilizes significant numbers of AChR, thereby forming the third membrane domain of the AChR cluster. We make several predictions that should distinguish this model of AChR clustering from one that invokes soluble, trophic factors. PMID- 3279808 TI - Receptors for and effects of insulin and IGF-I in rat glomerular mesangial cells. AB - Receptors for and biological effects of insulin and insulin-like growth factor I (IGF-I) were studied in cultured rat renal mesangial cells. Specific binding of 125I-IGF was over 200-fold greater (5.8%/0.2 mg cell protein) than the specific binding of 125I-insulin (0.2%/2 mg cell protein). Fifty percent inhibition of 125I-insulin binding was obtained with 8 x 10(-9) M unlabeled insulin. For 125I IGF-I, 50% inhibition required 1.8 x 10(-9) M unlabeled IGF-I. 125I-IGF-I was also displaced by IGF-II and insulin but at 10-and 100-fold lower potencies, respectively, than IGF-I. Cross-linking of 125I-insulin and 125I-IGF-I to their receptors, using disuccinimidyl suberate (DSS), and identification of the receptor with sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography showed a band with a molecular mass of 135 kDa, probably corresponding to the alpha-subunit of the insulin receptor and a major band with a molecular mass of 145 kDa for the alpha-subunit of the IGF-I receptor. Both insulin and IGF-I stimulated the incorporation of [3H]thymidine into DNA. A half maximal effect was obtained at 1.6 x 10(-8) M for insulin and 1.2 x 10(-9) M for IGF-I. No additive effect on DNA synthesis was observed. Insulin at 8 x 10(-10) M increased the accumulation of [14C]glucose in mesangial cells, whereas IGF-I was 10-fold less potent. PMID- 3279809 TI - Dynamic NMR measurement of volume regulatory changes in Amphiuma RBC Na+ content. AB - 23Na nuclear magnetic resonance (NMR) and conventional chemical methods were employed to measure Na+ fluxes in Amphiuma red blood cells (RBC) during volume regulation. Paramagnetic shift reagents [dysprosium triethylenetetraminehexaacetic acid (DyTTHA) and dysprosium tripolyphosphate (Dy(TPP)2)] were used to alter extracellular Na+ magnetic resonance. Data are presented describing 23Na resonance dependence on shift reagent, sodium and calcium concentration. We confirmed that the shift reagents neither enter the cells nor alter intracellular Na+, K+, and Cl-concentrations under control conditions when extracellular calcium was maintained greater than 0.5 mM. We also confirmed that the shift reagent complexes chelate calcium [Dy(TPP)2 much more so than DyTTHA] and that their toxic effects could be alleviated by adjusting calcium in the cell's suspension medium to control levels. In parallel experiments, where volume-activated Na+ fluxes ranged from 0.3 to 3 mmol Na+/kg dry cell solid (DCS) x minute in cells containing from 30 to 150 mmol Na+/kg DCS, changes in intracellular sodium measured by 32Na NMR were within 4% of those measured by conventional destructive methods. Finally, we present data that are consistent with the interpretation that 6 mmol Na+/kg DCS plus 16% of intracellular Na+ is NMR invisible. PMID- 3279810 TI - Epinephrine-induced renin secretion is not initiated by cardiac adrenoceptors. AB - Experiments were designed to test the hypothesis that epinephrine may act directly on cardiac or pulmonary adrenoceptors to alter the release of a humoral substance that in turn influences renin secretion. Accordingly, anesthetized dogs were prepared with catheters for infusion of epinephrine at three sites: 1) into the aorta just distal to the left subclavian artery, 2) into the left ventricle, and 3) near the right atrium. Left renal renin secretion rates were determined before, during, and after 30-min infusions of epinephrine at each site in each animal; the order of the infusions was randomized. At epinephrine infusion rates of 15 and 75 ng.kg-1.min-1, epinephrine-induced changes in renin secretion rates were dose dependent but were independent of the site of infusion. These data do not support the hypotheses that either pulmonary or cardiac adrenoceptors are involved in the initiation of epinephrine-induced renin secretion. In additional experiments, an isolated canine heart was perfused with femoral arterial blood from an experimental dog, and the coronary venous effluent was returned to the experimental dog via the femoral vein. Intravenous epinephrine infusion at 50 ng.kg-1.min-1 increased plasma renin activity nearly 1.5-fold. In contrast, plasma renin activity did not increase during infusion of epinephrine at 5 ng.kg 1.min-1 directly into the coronary perfusate of the isolated heart. Coronary perfusate epinephrine concentration was 699 +/- 71 pg/ml (mean +/- SE) during intravenous infusion and was 851 +/- 121 pg/ml during direct infusion of epinephrine into the coronary perfusate. We conclude that cardiac adrenoceptors do not participate in the initiation of epinephrine-induced renin secretion. PMID- 3279812 TI - Relationships between cell surface insulin binding and endocytosis in adipocytes. AB - Chymotrypsin substrate analogues, such as N-acetyl-Tyr ethyl ester, have recently been demonstrated to inhibit the endocytic uptake of insulin in isolated rat adipocytes. In this study, the effects of N-acetyl-Tyr ethyl ester on cell surface insulin binding and dissociation were examined. Surface-bound 125I insulin was distinguished from intracellular 125I-insulin by the sensitivity of the former to rapid dissociation with an acidic buffer (pH 3.0). Plateau levels of surface-bound insulin at 37 degrees C were increased 70% by inhibiting the internalization pathway. This increase was temperature and insulin concentration dependent. Thus differences in surface binding were small at 12 degrees C and also at high (100-200 ng/ml) insulin concentrations. Inhibition of internalization with N-acetyl-Tyr ethyl ester markedly slowed the loss of surface bound insulin observed during dissociation studies. After 20-30 min of dissociation, the remaining levels of surface-bound insulin were three- to fourfold higher in treated adipocytes compared with control adipocytes. Added unlabeled insulin retained its ability to accelerate the dissociation of insulin in N-acetyl-Tyr ethyl ester-treated cells. These observations indicate that the internalization pathway is a quantitatively important factor in determining levels of surface binding at 37 degrees C and in determining the rate of deactivation of insulin binding. PMID- 3279811 TI - Dose-dependent effects of oral and intravenous glucose on insulin secretion and clearance in normal humans. AB - Insulin secretion and clearance were studied in 2 groups of 7 normal subjects who each received 25, 50, and 100 g of glucose either orally or intravenously (iv) on separate occasions. Insulin secretion rates were calculated during a 1-h base line and for 5 h after glucose administration from a two-compartmental analysis of peripheral C-peptide concentrations using individual kinetic parameters derived after iv bolus injections of biosynthetic human C-peptide. Incremental glucose areas after oral or iv glucose increased as a function of the glucose dose (P = 0.0001). Incremental insulin secretion increased with increasing doses of both oral and iv glucose (P = 0.0001). The metabolic clearance rate (MCR) of endogenous insulin was calculated as the ratio of the total area under the insulin secretion rate curve and the simultaneous peripheral insulin concentration curve. The basal MCR was 1,879.5 +/- 110.5 ml/min (mean +/- SE). The poststimulatory MCR decreased with increasing doses of both oral and iv glucose concomitant with the greater insulin secretory response (P = 0.0014). This decrease in insulin clearance was not significantly different between oral and iv administration of glucose (P = 0.495). In conclusion diminished insulin clearance may be seen after marked stimulation of insulin secretion with larger doses of oral and iv glucose. PMID- 3279813 TI - Effect of hyperglucagonemia on whole-body leucine metabolism in immature pigs before and during a meal. AB - Leucine metabolism was measured isotopically in 12 immature female pigs to assess the effect of acute hyperglucagonemia on leucine kinetics in both the fed and fasting states. After an overnight fast, immature pigs were infused with alpha [3H]ketoisocaproate and [14C]leucine. After a 2-h equilibration period, an infusion of either saline or 7 pg.kg-1.min-1 of glucagon was begun, which increased plasma glucagon from approximately 140 to approximately 640 pg/ml and doubled the insulin concentrations. Two hours later, pigs were fed small meals to which [5,5,5-2H3]leucine was added to trace absorption. By subtracting absorption from total leucine flux, an estimate of endogenous proteolysis during the meal was made. In the fasting state, glucagon increased proteolysis, relative to controls, by approximately 20% (P less than 0.05) and increased oxidation by approximately 50% (P less than 0.05). No significant glucagon-related changes in any other flux parameters occurred in the fasting state. Ingestion of the meals caused oxidation to increase 41% in control animals, whereas in glucagon-infused animals, oxidation increased 84% (P less than 0.05 control vs. glucagon response to meal). Additionally, animals infused with glucagon suppressed endogenous proteolysis 43% after the meal compared with a 55% decrease in control animals (P less than 0.05 basal period vs. fed period). These data indicate that glucagon stimulates whole-body proteolysis in both the fasting and fed states. PMID- 3279814 TI - Episodic release of insulin by rat pancreas: effects of CNS and state of satiety. AB - This study reports that insulin is secreted in an episodic manner in rats and that the characteristics of its release can be modified by the central nervous system (CNS) and state of satiety. The pancreata of male Sprague-Dawley rats were perfused using the in situ brain-pancreas technique under urethan anesthesia. Episodic insulin release under non-fasted conditions was not altered by the presence or absence of CNS innervation to the pancreas. Under these conditions the interpeak period was 5.9 and 6 min, respectively, and cycle length was 3.7 and 4 min. However, perfusions that were performed following an overnight fast demonstrated that the CNS is capable of modulating episodic insulin release. After fasting, when comparing CNS-ablated with -intact preparations, the period was shortened from 5.2 to 4.1 min (P less than 0.05), and the number of episodes per 90-min perfusion increased from 16.0 to 19.0 (P less than 0.05) when the pancreas was innervated by the CNS. Additionally, the effect of fasting on denervated pancreata resulted in a shortening of the cycle length, which was prevented when the CNS was functional. These results demonstrate that episodic insulin release can be modified by metabolic conditions and are subject to mediation by the CNS. PMID- 3279815 TI - Reduced mucosal prostaglandin synthesis after massive small bowel resection. AB - Exogenous 16,16-di-methyl-prostaglandin (PG) E2 administration augments mucosal hyperplasia after massive small bowel resection in the rat. We, therefore, evaluated the ability of aspirin to inhibit mucosal PG synthesis in the small intestine and further evaluated the effects of reduced PG synthesis on mucosal adaptation after a 70% jejunoileal resection in male Sprague-Dawley rats. Sixteen of 27 resected and 8 of 16 sham-operated rats were given aspirin 20 mg/kg body wt subcutaneously every 8 h for 12 days; the remainder were given vehicle only. Although mucosal PGE2, PGF2 alpha, and thromboxane B2 synthesis were all reduced by aspirin administration to 20-40% of the control values, mucosal adaptation in resected animals as measured by mucosal weight, DNA, protein, and maltase levels was only inhibited in the distal ileum. Aspirin did not affect these values in the duodenum, the upper jejunum, and the midileum. This study provides evidence for some involvement of endogenous PGs in regulation of the mucosal adaptation process in the distal ileum after massive small bowel resection in the rat. However, lack of inhibition more proximally suggests that factors other than PGs are more important. PMID- 3279816 TI - Functional coupling of tight junctions and microfilaments in T84 monolayers. AB - The actin-binding agent cytochalasin D (CD) in intact intestinal epithelium appears to elicit segmentation and contraction of a perijunctional ring of actomyosin and, consequently, to diminish tight junction resistance. We determined if an intestinal epithelial model composed of T84 cells also displayed such a perijunctional cytoskeletal specialization and, if so, whether exposure to CD also affected the tight junction barrier. We find T84 cells display a prominent perijunctional microfilament ring that is actin rich. CD elicits large decreases in transepithelial resistance due specifically to perturbed tight junction permeability as determined with dual Na+-mannitol flux analysis. Transepithelial mannitol and insulin fluxes also increase after CD exposure, but these molecules remain differentially restricted in accordance with their sizes, indicating that gross disruption of the monolayer has not occurred. Structurally, CD elicits segmentation and condensation of the perijunctional ring into actin rich plaques. These features have similarity to those seen in native intestinal epithelia. This system may represent a simple model for studies of cytoskeletal tight junction relationships. PMID- 3279817 TI - Modeling the proximal tubule: complications of the paracellular pathway. AB - When the proximal tubule epithelium is represented as cellular and lateral intercellular (LIS) compartments, the presence of a paracellular pathway can render the overall phenomenologic equations quite an indirect representation of intraepithelial transport processes. 1) Active sodium transport into the LIS may create a hypertonic region that drives water movement from lumen to peritubular blood, i.e., a term for active water transport may appear in the overall transport equations. The correlate of this uphill water flux is a solute polarization effect, such that the measured epithelial water permeability is less than that of the cell membranes. 2) Basolateral uptake of potassium by the cell may lower the LIS concentration and promote diffusive entry of K across the tight junction. Even without cellular uptake of K from the lumen, the epithelial transport equations may contain a term for active K reabsorption. The solute polarization correlate is a low epithelial reflection coefficient that does not represent a convective flux of K through a specific channel. 3) When there is convective flux of Na and Cl through the tight junction but none through the cell, then a fluid circuit around junction and cell may be present, even when net epithelial volume flux is absent. In this case, part of the net epithelial Cl flux must be represented in the overall transport equations as electroneutral Na Cl cotransport. PMID- 3279818 TI - Transport of tetraethylammonium by a kidney epithelial cell line (LLC-PK1). AB - We investigated whether the LLC-PK1 epithelial cell line (which shows many characteristics of proximal tubular cells) also is capable of transporting an organic ion. Suspended LLC-PK1 cells accumulated tetraethylammonium (TEA). The uptake showed characteristics of a facilitated mechanism; TEA uptake was saturable and temperature-dependent and was inhibited by other organic cations. Quinine and mepiperphenidol were the most potent inhibitors, whereas N1 methylnicotinamide and morphine inhibited the transport system only slightly at doses of 10(-3) M. Basolateral-to-apical TEA flux through LLC-PK1 monolayers was five to six times larger than that of mannitol, a nontransported compound, whereas apical-to-basolateral TEA and mannitol fluxes were equal. Only the basolateral-to-apical TEA flux was inhibited by quinine. Under similar experimental conditions, no transport of p-aminohippuric acid was observed. It is concluded that LLC-PK1 cells are able to transport TEA, as do cells of the proximal tubule. PMID- 3279819 TI - Angiotensin II and prostaglandins in control of vasa recta blood flow. AB - Angiotensin II has been implicated in the regulation of medullary blood flow and is known to interact with prostaglandins at sites within the kidney. Therefore the role of angiotensin in control of vasa recta blood flow was studied in antidiuretic, Munich-Wistar rats. We also tested the hypothesis that prostaglandins act to modulate the effect of angiotensin. Total renal blood flow was measured by an electromagnetic flow probe, vasa recta blood flow by a dual slit method. Captopril was used to confirm that angiotensin blockade increased renal blood flow (by 15 +/- 4%). Captopril and saralasin were used to show that angiotensin blockade increased vasa recta blood flow (by 23 +/- 9 and 14 +/- 7%, respectively). The results demonstrate a tonic constrictor effect of angiotensin in the renal medulla. Exogenous angiotensin II, delivered intravenously, failed to mimic the effect of endogenous angiotensin. Indomethacin did not alter blood pressure or renal blood flow but did reduce vasa recta blood flow by 20 +/- 3%, suggesting that prostaglandins act preferentially on the medullary circulation. Nor did it alter the response of blood pressure, of renal blood flow, or of vasa recta blood flow to captopril. Moreover, prior angiotensin blockade with either captopril or saralasin enhanced the medullary vasoconstrictor effect of indomethacin (P less than 0.05). These results are not consistent with the hypothesis that prostaglandins act primarily as angiotensin modulators. They suggest that the medullary interaction between angiotensin and prostaglandins differs from that in the cortex. PMID- 3279820 TI - Functional differences of six forms of renin in rats. AB - Six forms of renin with different isoelectric points (pIs) have been described in rats. This study was designed to determine if any of the renin forms have different biological activities. Each form of rat renin was semipurified and injected intravenously or intraventricularly in Sprague-Dawley rats anesthetized with pentobarbital sodium or Inactin. Changes in blood pressure (BP), renal function, sodium, and water excretion were observed, before and following equipressor doses; the peak response of BP was similar for all forms. However, the half-lives were significantly different. Form 4 (pI = 5.2) caused a significant increase in urine flow, Na, and K excretion, and urinary osmolality when given intravenously. The other forms were without significant effect. Infusion of converting enzyme inhibitor not only completely blocked the BP response, but also prevented the natriuresis and diuresis. This was observed in rats anesthetized with pentobarbital sodium or Inactin. Intraventricular infusions resulted in a diuresis and natriuresis when form 6 (pI = 4.8) was infused, but not with other forms. BP remained unchanged throughout. This study presents evidence that functional differences exist between renin forms. PMID- 3279821 TI - Specific albumin binding to microvascular endothelium in culture. AB - The specific binding of rat serum albumin (RSA) to confluent microvascular endothelial cells in culture derived from the vasculature of the rat epididymal fat pad was studied at 4 degrees C by radioassay and immunocytochemistry. Radioiodinated RSA (125I-RSA) binding to the cells reached equilibrium at approximately 20 min incubation. Albumin binding was a slowly saturating function over concentrations ranging from 0.01 to 50 mg/ml. Specific RSA binding with a moderate apparent affinity constant of 1.0 mg/ml and with a maximum binding concentration of 90 ng/cm2 was immunolocalized with anti-RSA antibody to the outer (free) side of the endothelium. Scatchard analysis of the binding yielded a nonlinear binding curve with a concave-upward shape. Dissociation rate analysis supports negative cooperativity of albumin binding, but multiple binding sites may also be present. Albumin binding fulfilled many requirements for ligand specificity including saturability, reversibility, competibility, and dependence on both cell type and cell number. The results are discussed in terms of past in situ investigations on the localization of albumin binding to vascular endothelium and its effect on transendothelial molecular transport. PMID- 3279822 TI - Cardiovascular performance with E. coli challenges in a canine model of human sepsis. AB - We investigated cardiovascular dysfunction by injecting lethal and nonlethal bacterial challenges into conscious dogs. E. coli bacteria of varying numbers were placed in a peritoneal clot. Cardiovascular function was studied with simultaneous radionuclide scans and thermodilution cardiac outputs. In surviving animals, the number of bacteria in the clot increased as the corresponding systolic cardiac function decreased (P = 0.01). Cardiac function was measured by left ventricular (LV) ejection fraction (EF) and LV function curves [LV stroke work index (LVSWI) vs. end-diastolic volume index (EDVI), and peak systolic pressure vs. end-systolic volume index]. Furthermore, the diastolic volume pressure relationship of survivors shifted progressively to the right [i.e., increasing EDVI (P less than 0.02) with minimal change (P = NS) in LV filling pressure]. This increase in LV size was associated with maintenance of measures of cardiac performance [stroke volume index (SVI) and stroke work index (SWI)] at similar levels. Death occurred only in the group with the highest bacterial dose. Compared with survivors receiving the same number of bacteria, nonsurvivors had a decrease in (P less than 0.05) LV size, a leftward shift (P less than 0.01) in LV diastolic volume-pressure relationship, and a decrease in both LVSWI and SVI (possibly related to volume and/or LV functional status). Data from survivors suggest that increasing the number of bacteria produces changes in myocardial compliance and contractility. These changes increase LV size (preload), a major determinant of cardiac performance that possibly enhances survival. PMID- 3279823 TI - Myocardial serotonin exchange: negligible uptake by capillary endothelium. AB - The extraction of serotonin from the blood during transorgan passage through the heart was studied using Langendorff-perfused rabbit hearts. Outflow dilution curves of 131I- or 125I-labeled albumin, [14C]sucrose, and [3H]serotonin injected simultaneously into the inflow were fitted with an axially distributed blood tissue exchange model to examine the extraction process. The model fits of the albumin and sucrose outflow dilution curves were used to define flow heterogeneity, intravascular dispersion, capillary permeability, and the volume of the interstitial space, which reduced the degrees of freedom in fitting the model to the serotonin curves. Serotonin extractions, measured against albumin, during single transcapillary passage, ranged from 24 to 64%. The ratio of the capillary permeability-surface area products for serotonin and sucrose, based on the maximum instantaneous extraction, was 1.37 +/- 0.2 (n = 18), very close to the predicted value of 1.39, the ratio of free diffusion coefficients calculated from the molecular weights. This result shows that the observed uptake of serotonin can be accounted for solely on the basis of diffusion between endothelial cells into the interstitial space. Thus it appears that the permeability of the luminal surface of the endothelial cell is negligible in comparison to diffusion through the clefts between endothelial cells. In 18 sets of dilution curves, with and without receptor and transport blockers or competitors (ketanserin, desipramine, imipramine, serotonin), the extractions and estimates of the capillary permeability-surface area product were not reduced, nor were the volumes of distribution. The apparent absence of transporters and receptors in rabbit myocardial capillary endothelium contrasts with their known abundance in the pulmonary vasculature. PMID- 3279824 TI - Response of hypertensive rats to acute and chronic conditions of static exercise. AB - To determine whether chronic static exercise would alter resting caudal artery systolic blood pressure (RSBP) in stroke-prone hypertensive rats (SP-SHR), a 20- to 21-wk experimental study was initiated with 24 male and 16 female rats. In addition, eight rats were cannulated for heart rate and blood pressure measurements and implemented with Doppler flow probes (mesenteric and iliac arteries) for determination of the acute responses. The rats were trained to perform static exercise by forelimb hanging over an electrical grid (3-5 mA) activated with a high-frequency sound (2.5-10kHz) of 60 dB. Acute forelimb hanging by nontrained rats caused a 70-mmHg elevation in mean blood pressure, 115 beat/min increase in heart rate, and 71% decrease in mesenteric blood flow. The procedure for chronic forelimb hanging included increasing the number of sets per session from one to three, maintaining the number of repetitions between 6 and 10 and the hang time within 7-10 s/hang, while increasing the amount of weight supported per set from 0 to 12% of body weights for males and 30% for females. Two performance tests, one for endurance (no weights) and one for "strength" (weights), demonstrated that the hanging animals increased their endurance ability by 103% and their strength by 115%. RSBP was not significantly increased in either the male or female trained populations when evaluated by analysis of variance or trend-analysis procedures. Food and water consumption, sodium and potassium excretion, and blood volume measurements exhibited no group differences that had statistical significance. Five animals had evidence for previous strokes, with four being associated with the nonhanging animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279826 TI - Further evidence implicating prostaglandin E2 in the genesis of pyrogen fever. AB - Conscious cats were used to study the effects of endotoxin and interleukin 1 (IL 1) on levels of prostaglandin (PG) E2 and thromboxane (TX) B2 (the stable TXA2 byproduct) in cerebrospinal fluid (CSF) from the third ventricle. Pyrogens were given intravenously or intraventricularly and prostanoids were measured by radioimmunoassay. PGE2 was normally less abundant than TXB2 (mean, 37 vs. 528 pg/ml), and its level increased severalfold during the sustained fever following intravenous endotoxin (bolus) or IL 1 (bolus plus infusion). PGE2 elevation preceded the fever and was maintained thereafter. Likewise, intraventricular pyrogens promoted PGE2 formation, and their effect was also manifest during the latent period of the fever. The PGE2 metabolite, 13,14-dihydro-15-keto-PGE2, was not measurable in CSF from either afebrile or febrile animals. Basal content of PGE2, on the other hand, was higher in animals pretreated with probenecid (30 mg/kg ip or iv; 50 or 100 micrograms ivt), confirming the importance of transport processes in removing prostanoids from brain. Unlike PGE2, TXB2 levels did not change during the fever to intravenous endotoxin. TXB2 rose instead in response to intraventricular endotoxin, although the elevation did not extend beyond fever uprise. Furthermore, a TXA2 analog (ONO-11113;2 or 4 micrograms ivt) had inconsistent effects on body temperature, while a TXA2 antagonist (ONO-11120;2 micrograms ivt) did not interfere with endotoxin fever. These findings strongly support a causative role for PGE2 in the onset and progression of pyrogen fever. No evidence of a similar role was obtained for TXA2. PMID- 3279825 TI - PGI2 attenuates baroreflex control of renal nerve activity by a vagal mechanism. AB - The present study was undertaken to determine whether left circumflex coronary artery (ic) administration of prostacyclin (PGI2) caused an inhibition of the baroreflex control of renal sympathetic nerve activity (RSNA). RSNA was recorded in 12 dogs. Baroreflex sensitivity of RSNA was assessed by infusion of either sodium nitroprusside or phenylephrine and by determining the slope of the mean arterial pressure-RSNA relationship. During nitroprusside infusion, intracoronary PGI2 depressed the baroreflex sensitivity by nearly 90% compared with intracoronary tris(hydroxymethyl)aminomethane (Tris) (P less than 0.002). In addition, the peak increase in RSNA during nitroprusside infusion was significantly inhibited during intracoronary PGI2 (57.9 +/- 6.4 vs. 21.2 +/- 3.0 spikes/s, P less than 0.05). There was no significant difference in the inhibition of RSNA during phenylephrine infusion when intracoronary PGI2 was compared with Tris. Both bilateral vagotomy and pericoronary lidocaine blocked the inhibitory effects of PGI2 on the baroreflex increase in RSNA. It is concluded from these data that exogenously administered PGI2 stimulates or sensitizes afferent endings within the supply of the left circumflex coronary artery to inhibit the baroreflex control of RSNA during evoked hypotension. These afferents traverse vagal pathways via the pericoronary nerves. The role of endogenous prostaglandins in modulation of baroreflex function via a cardiac reflex remains to be elucidated. PMID- 3279827 TI - Plasma catecholamines during E. coli bacteremia in conscious rats. AB - Fasted, conscious male rats, prepared with arterial and venous cannulas, were given doses (10(10)-10(11) organisms/kg) of live Escherichia coli bacteria. Heart rate and blood pressure were recorded, and arterial plasma samples were taken preinjection and at 30, 180, and 360 min after bacterial administration. Plasma was analyzed for lactate, glucose, norepinephrine (NE), and epinephrine (E). Rats given E. coli were normotensive but with significant tachycardia (P less than 0.05 vs. saline). Plasma NE and E levels increased severalfold during bacteremia (P less than 0.05 for all comparisons). Rats were euglycemic but had a sixfold increase in lactate 6 h (P less than 0.05) after E. coli treatment. Additional rats were subjected to the same protocol but had been made tolerant to bacterial endotoxin by multiple injections over the course of several days. Endotoxin tolerant rats were also tolerant to live E. coli administration (P less than 0.05, 24 h survival) and had significantly reduced levels of E and NE at 6 h compared with nontolerant bacteremic rats (P less than 0.05). Increases in heart rate and plasma lactate were not significant in endotoxin-tolerant rats. These results suggest profound sympathetic activation during acute bacteremia with attenuated activation in endotoxin-tolerant rats. Tolerance appears to reduce the afferent stimuli that are presumably activated during the course of bacteremia. PMID- 3279828 TI - Effect of feeding on renin-angiotensin-aldosterone system of the horse. AB - The effect of feeding frequency and associated meal size on the renin-angiotensin aldosterone system (RAAS) in seven horses was examined. A daily maintenance ration of hay-grain pellets was provided either as a multiple feeding regimen (MF), in which the ration was divided into six equal portions fed at 4-h intervals, or as a single large feeding (SF) given from 9 A.M. until 11 A.M. Plasma renin activity (PRA), aldosterone (PAC), cortisol (PCC), protein concentration (TP), packed cell volume (PCV), and serum sodium and potassium were measured serially. To prevent significant RAAS stimulation due to strenuous exercise or by assuming orthostatism after a period of recumbency, the horses were trained to stand in 1 X 4-m tie stalls during the experiments. Changes in Na intake were prevented by disallowing nonration salt sources. A 12:12 light-dark interval was maintained. During the MF experiment, only serum Na changed diurnally, with concentrations lowest in early morning and highest before midday. In contrast, during the SF experiment, PRA was increased at 0.5, 1.0, and 3.0 h and PAC was increased at 3.0, 5.0, and 7.0 h after onset of feeding (P less than 0.005). Increased TP and PCV suggested transient hypovolemia was responsible for renin release. Significant increases in Na and decreases in K occurred while eating; however, K increased postprandially to be coincident with aldosterone. Except for a transient increase during feeding in SF, PCC demonstrated a similar circadian rhythm in both experiments. It was concluded that 1) episodic feeding (SF) causes significant diurnal variation of the RAAS in the horse, and 2) spontaneous circadian activity of the RAAS cannot be demonstrated in this species during a steady-state feeding regimen (MF). PMID- 3279829 TI - The right to refuse treatment with antipsychotic medications: retrospect and prospect. AB - The right to refuse antipsychotic medication is now more than a decade old. Its evolution has taken divergent forms, driven either by the needs of patients' treatment or the mandate of patients' rights. Regardless of the model employed, refusal is not uncommon, but refusing patients appear almost always to receive treatment in the end. These findings point up the essential illogic of allowing committed persons to refuse treatment that would permit their freedom to be restored. The future evolution of the right may proceed differently in federal and state courts, but whether at the level of legal theory or actual practice, some accommodation will restore the equivalence between the power to commit and the power to treat. PMID- 3279830 TI - Affective and psychotic symptoms associated with anabolic steroid use. AB - To assess the frequency of affective and psychotic symptoms in athletes taking anabolic steroids, the authors performed structured interviews of 41 body builders and football players who had used steroids. According to DSM-III-R, nine subjects (22%) displayed a full affective syndrome, and five (12%) displayed psychotic symptoms in association with steroid use. These findings suggest that major psychiatric symptoms may be a common adverse effect of these drugs. PMID- 3279831 TI - Weaning and depression: another postpartum complication. AB - The dramatic endocrinologic changes that occur after childbirth and the coincident affective disturbances that range from "maternity blues" to major depression have stimulated much theorizing and some study. The role of breast feeding and weaning has received remarkably little attention both in the more biologically oriented studies and in epidemiologic work. This paper reviews endocrinologic data which support the thesis that postpartum psychiatric disorders have a hormonal basis and discusses the possible psychiatric effects of breast-feeding and weaning. The cases of four patients who developed major depressions in close temporal association with weaning are presented and discussed. PMID- 3279832 TI - Animal rights and research. PMID- 3279833 TI - AIDS and public health. PMID- 3279835 TI - Venereal disease control by health departments in the past: lessons for the present. PMID- 3279834 TI - AIDS in historical perspective: four lessons from the history of sexually transmitted diseases. PMID- 3279836 TI - Prevention of AIDS and HIV infection: needs and priorities for epidemiologic research. AB - By the end of 1987, almost 50,000 cases of acquired immunodeficiency syndrome (AIDS) will have been reported in the United States. Although the primary epidemiology of the disease has been described, much work remains to be done to complete our understanding of the dynamics of transmission and infection with the causative virus, human immunodeficiency virus (HIV). At the state and local level, the highest priorities for epidemiologic research are to understand better the precise populations at risk of prevalent and incident HIV infection, and to use this information to direct and monitor specific prevention programs that are likely to be effective for the populations at risk. These parallel efforts sophisticated investigative epidemiologic research and applied epidemiologic and serosurveillance studies-must be expanded rapidly and continued for the forseeable future if we are to accomplish the goal of preventing further spread of HIV. PMID- 3279840 TI - Drinking patterns and problems associated with injury status in emergency room admissions. AB - A study of emergency room admissions at San Francisco General Hospital was undertaken to analyze the association of drinking patterns and problems with injury status. A 20% probability sample of patients admitted to the emergency room around-the-clock over a 60-day period was interviewed. Interviews were completed on 75% of those sampled (N = 1896). Of these, 29% (N = 555) were admitted to the emergency room for injuries, with drinkers more likely than abstainers to be admitted for injuries. Differences were found in the quantity and frequency of usual drinking and frequency of drunkenness for type and cause of injury and for prior alcohol-related accidents. Little differences was found between the injured and noninjured on social consequences of drinking or experiences associated with alcohol dependence and loss of control over drinking. Both injured and noninjured in this population reported much higher rates of frequent heavy drinking and alcohol-related problems than that found in the general population which may have masked additional associations of drinking patterns and problems with injury status. PMID- 3279839 TI - State Medicaid coverage of AZT and AIDS-related policies. AB - Medicaid programs are paying for 23 per cent of the health care costs of AIDS patients nationally, and approximately 40 per cent of all AIDS patients will become dependent on Medicaid to pay for their health care. The state Medicaid programs were surveyed by mail for this research in mid 1987 to determine if the states covered AZT (Retrovir), if limits apply to this coverage, if the states have or are developing AIDS-related policies, and if hospice care is a benefit. Forty-four states cover AZT (two additional states cover AZT only during inpatient hospital care), with most Medicaid programs placing some limit on coverage or reimbursement. Most states do not have special Medicaid coverage for AIDS care nor are they developing proposals or policies for this care. However, a number of states are developing or implementing AIDS-related policies through their Medicaid programs. These policies can become models for other Medicaid programs to follow if the incidence of AIDS increases in their states. PMID- 3279838 TI - Prostitutes and AIDS: a health department priority? AB - With increasing competition for resources, health departments are faced with the question of whether to target female prostitutes as a high priority component of AIDS prevention strategy. Prostitutes are considered to be a reservoir for transmission of certain sexually transmitted diseases (STDs). However, a variety of studies suggest that human immunodeficiency virus (HIV) infection in prostitutes follows a different pattern than that for STDs: HIV infection in non drug using prostitutes tends to be low or absent, implying that sexual activity alone does not place them at high risk, while prostitutes who use intravenous drugs are far more likely to be infected with HIV. Emerging data from heterosexual groups similarly suggest a low rate of heterosexual transmission, particularly from women to men. Prostitutes who do not use intravenous drugs probably face their highest risk from steady partners who may be infected with HIV and other STDs and with whom barrier protection is generally not used. Nevertheless, there are good reasons for health departments to place high priority on prevention efforts directed to prostitutes: 1) prostitutes often have other risky behaviors such as drug use; and 2) prostitutes are reachable, being a group which is already in the health care system administered by health departments. PMID- 3279837 TI - AIDS and behavioral change to reduce risk: a review. AB - Published reports describing behavioral changes in response to the threat of AIDS (acquired immunodeficiency syndrome) are reviewed. These studies demonstrate rapid, profound, but expectably incomplete alterations in the behavior of both homosexual/bisexual males and intravenous drug users. This is true in the highest risk metropolitan areas such as New York City and in areas with lower AIDS incidence. Risk reduction is occurring more frequently through the modification of sexual or drug-use behavior than through its elimination. In contrast to aggregate data, longitudinal descriptions of individual behavior demonstrate considerable instability or recidivism. Behavioral change in the potentially vulnerable heterosexual adolescent and young adult populations is less common, as is risk reduction among urban minorities. Reports of AIDS-related knowledge and attitudes generally parallel the pattern of behavioral changes. Nonetheless, few studies investigate the relationship of knowledge and attitudes to risk reduction. Future studies should provide much-needed information about the determinants as well as the magnitude of behavioral changes required to reduce the further spread of AIDS. PMID- 3279841 TI - Ethanol inhibits some of the early effects of epidermal growth factor in vivo. AB - Charles River male Wistar rats (200-300 g) were meal fed for 9-10 days, injected with either saline, epidermal growth factor (EGF), ethanol, or ethanol combined with EGF and their livers were freeze clamped 5 min after intraperitoneal injection of EGF. Metabolites were measured and the redox state and phosphorylation potential were calculated. Epidermal growth factor alone elevated hepatic content of glucose 1-P, glucose 6-P, fructose 6-P, and 3-phosphoglycerate 1.2-1.3-fold when compared to saline treatment. Ethanol alone decreased hepatic content of 3-phosphoglycerate and phosphoenolpyruvate 3.2-3.7-fold below saline treated levels. Ethanol, in combination with EGF, decreased hepatic values for 3 phosphoglycerate and phosphoenolpyruvate 2.0-2.3-fold from saline treatment but elevated the content of phosphoenolpyruvate 1.6-fold over ethanol treatment alone. Epidermal growth factor inhibited pyruvate kinase activity 1.3-fold when compared to saline controls but ethanol in the presence of EGF facilitated the recovery of activity of this enzyme. PMID- 3279842 TI - Motor performance in detoxified alcoholics. AB - Detoxified male and female alcoholics (aged 20-49 years) and age-matched controls performed a series of 15-sec target-tapping tasks in which they alternatively marked two target strips with a felt marker as rapidly and as accurately as possible. Consistent with "Fitts' Law" (Fitts PM: J Exp Psych 47:381-391, 1954), a highly linear relationship between movement time and task difficulty was observed in all four groups. Overall, the alcoholics were slower and made more errors than the controls, although the pattern of deficit differed for males and females. Accuracy, but not speed, was impaired in male alcoholics. The production of undershoot errors was increased more in alcoholics than nonalcoholics in targets of narrower width, whereas the production of overshoot errors was increased more in alcoholics as target separation decreased. Female alcoholics displayed impairment in speed of movement, but not accuracy. However, both alcoholic groups displayed elevated error rates for the more difficult targets. It is thus possible that detoxified alcoholics might mimic the speed functions of nonalcoholic individuals at the occasional cost of an erroneous response at a difficult target. PMID- 3279843 TI - Early motor development and cerebral cortical morphology in rats exposed perinatally to alcohol. AB - Specific tests of early motor development and cerebral cortical morphology were studied in rats born from alcohol-fed mothers, pair-fed mothers, and ad libitum controls (either liquid or pellet diets). Liquid Bio-Serv diets were used. Alcohol feeding began on day 5 of pregnancy and ended on day 10 postpartum. The weight gain of the pups after birth was drastically reduced compared with pair fed and other control groups; however, removal of the alcohol on day 10 postpartum resulted in an upswing of the growth curve that paralleled control groups. Between days 2 and 21 (postnatal) three behavioral tests of motor function were performed. Righting reflex (time for an animal to return to all four feet after being placed on its dorsum) was slightly delayed but the delay was not significant. Negative geotaxis (time for an animal to rotate 180 degrees from a head-down position on an inclined plane), and reflex suspension (time an animal maintained its grip on a crossbar) were significantly delayed (approximately 2 days) in offspring from alcohol-fed mothers. In the frontal cortex the offspring of alcohol-treated mothers, a marked decrease (approximately 25%) in thickness of Lamina VI was found while the other Lamina (I-V) were less altered. These results indicate that the effect of alcohol on the frontal cortex is related to a significant delay in motor development of reflex suspension and negative geotaxis since both of these require frontal integration. PMID- 3279844 TI - Temporal pattern of alcohol consumption in the United States. AB - Alcohol is a major risk factor for many causes of injuries. A preliminary assessment of alcohol's involvement in specific causes of injuries must take into account when people are drinking. This study quantified the weekly and diurnal rhythm of alcohol consumption for the general U.S. population using data collected in a national survey. The data showed a strong temporal pattern consisting of more drinking on weekends with daily peaks in the early evening and troughs in the early morning. The national temporal drinking pattern was positively correlated (0.22 to 0.56) with national temporal patterns of motor vehicle accidents, a cause of injury commonly associated with drinking. PMID- 3279846 TI - Alcohol intolerance in the hypereosinophilic syndrome. AB - Alcohol intolerance presented as an initial symptom in two patients with hypereosinophilic syndrome. In patient 1 alcohol intolerance persisted during the whole course of disease, while in patient 2 all symptoms including alcohol intolerance disappeared after treatment with prednisolone and vincristine. Alcohol intolerance seems to be influenced by hypereosinophilia and may be of clinical value in the evaluation of the activity of the malignant disorder. PMID- 3279845 TI - Detection and localization of immunoreactive alcohol dehydrogenase protein in the rat testis. AB - Alcohol dehydrogenase in the testis metabolizes ethanol and a variety of physiological substrates such as dihydrotestosterone and vitamin A. Studies of the localization of enzyme activity in the testis have revealed its presence in either interstitial cells or seminiferous tubules alone or in both places. The purpose of this study was to detect and localize immunoreactive alcohol dehydrogenase in the testis. The testis enzyme had similar antigenicity than the liver enzyme as demonstrated by double immunodiffusion and inhibition titration using antibody to the liver enzyme. The concentration of immunoreactive enzyme protein was 1.7 +/- 0.1 micrograms/mg of cytosol protein in the testis as compared with 9.3 +/- 0.3 micrograms/mg of cytosol protein in the liver. Isoelectric focusing revealed eight isoenzyme bands. Only the three bands with the highest isoelectric points precipitated with antibody to liver alcohol dehydrogenase. By immunohistochemistry using this antibody, the enzyme was localized principally to the Leydig cells which are also the site of steroidogenesis. The presence in the seminiferous tubules of isoenzymes of lower isoelectric point, which do not react with the antibody to the liver enzyme, can not be excluded. PMID- 3279847 TI - Effect of ethanol dose on low density lipoproteins and high density lipoprotein subfractions. AB - Male squirrel monkeys were fed increasing caloric percentages (0, 12, 24, and 36%) of ethanol (ETOH) substituted isocalorically for carbohydrate as part of a chemically defined liquid diet to assess how alcohol dose modifies plasma lipoproteins and liver function. A separate group of primates was used to define the dose at which elevations in plasma apolipoprotein B first occurred and to measure plasma alcohol levels. ETOH caused a dose-related, linear increase in high density lipoprotein (HDL) cholesterol which was primarily the result of increments in coronary protective HDL2 cholesterol. HDL2 total mass (lipid + protein) followed the pattern of HDL2 cholesterol. Animals fed the 12% regimen had plasma ETOH levels of approximately 49 mg/dl, the lowest low density lipoprotein (LDL) cholesterol, and the highest HDL2/HDL3 cholesterol ratio. Significant elevations in apolipoprotein B first appeared at 18% ETOH while higher doses (24 and 36%) caused increases in LDL cholesterol and HDL3, reduced HDL2/HDL3 ratios, and plasma alcohol levels of 142 and 202 mg/dl, respectively. Liver function tests were normal for all animals. Our results indicate that while a moderate ETOH caloric intake (12%) produces an antiatherogenic lipoprotein profile (decreases LDL/HDL, increases HDL2/HDL3), any coronary protection afforded by continued increases in HDL2 at higher doses may be attenuated by concurrent atherogenic alterations (increases LDL cholesterol, increases apolipoprotein B). PMID- 3279848 TI - Imparied lymphocyte proliferative response to mitogen in alcoholic patients. Absence of a relation to liver disease activity. AB - Concanavalin A-induced lymphocyte proliferation was studied in 25 patients with alcoholic hepatitis or compensated alcoholic cirrhosis. Nine alcoholics without evidence of liver disease were also evaluated. A nonlinear correlation equation, which was natural logarithmic, was applied to individual dose-response proliferation curves and permitted comparisons between patient groups and controls. The proliferative response in all patient groups was significantly lower when compared to healthy controls and was independent of the presence or absence of liver disease. This suggests that some changes in immune function observed in alcoholics may be linked to the direct effects of alcohol on the immune system rather than to the associated liver disease. PMID- 3279849 TI - Chronic alcohol treatment results in disturbed vitamin D metabolism and skeletal abnormalities in rats. AB - The effect of chronic alcohol consumption on the skeleton was investigated in rats. The treated group received ethanol administered as 38% of caloric intake in a liquid diet (Sustacal) for 10 months. The control rats were pair weighted to the ethanol-treated animals throughout the study; the growth curves of the two groups were the same. The controls were given the same liquid diet except that dextrin:maltose (3:1) was substituted isocalorically for ethanol. Ethanol-treated rats did not differ from the pair-weighted controls in mean serum calcium, phosphorous, or creatinine. In contrast, serum magnesium was reduced (p less than 0.02) in alcohol-treated rats. Ethanol treatment also resulted in changes in the serum concentrations of vitamin D metabolites; serum 25-hydroxyvitamin D3 was increased (p less than 0.001), while serum 1,25-dihydroxyvitamin D3 was decreased (p less than 0.01). Tibial length was reduced in ethanol-treated rats (p less than 0.05) but there was no change in femoral length. Medullary area was increased in tibial diaphyses from alcohol-treated rats compared to weight matched control animals (p less than 0.01), indicating a net increase in resorption. The cross-sectional area of the tibial diaphysis of ethanol-treated rats was the same as the matched controls. Trabecular bone was decreased in the tibial metaphysis of ethanol-treated rats compared to the matched controls (p less than 0.05) indicating a net loss of trabecular bone. Ethanol treatment did not have an effect on the organic weight of the femur but the ash weight was reduced (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279851 TI - Accuracy of death certificates in the diagnosis of alcoholic liver cirrhosis. AB - In 108 patients with alcoholic liver disease who died during a 10-year follow-up, the diagnoses from the liver biopsies were compared with that from the Death Certificates. Data show that the currently used ICD-9 category of cirrhosis with or without mention of alcohol has a 47.2% chance of missing the diagnosis of cirrhosis. On the other hand when the mention of liver disease in the Death Certificate is used for the diagnosis of cirrhosis, the percentage of undiagnosed cirrhosis decreases to 19.4% (p less than 0.0001). PMID- 3279850 TI - Increase in tryptophan oxygenase activity in alcoholic patients. AB - This study was conducted in order to assess whether chronic excessive alcohol consumption affects the activity of the liver enzyme tryptophan oxygenase which is rate limiting along the most important pathway of tryptophan catabolism. Five alcoholics were studied twice, once shortly after admission to an inpatient unit and the second time 1 month later. On each study day patients were given a tryptophan load of 50 mg/kg. Kynurenine in the urines (which reflects tryptophan oxygenase activity) was measured for a period of 6 hr following the load and showed a significantly enhanced activity of the enzyme shortly after cessation of drinking. This increased activity could explain the lowered tryptophan levels we have previously reported in alcoholics. The increase in enzyme activity may have been mediated by a rise in glucocorticoid hormones. In all instances, plasma cortisol measured hourly for 6 hr after the start of the experiment, was higher shortly after cessation of drinking than 1 month later. PMID- 3279853 TI - American Medical Society on Alcoholism and Other Drug Dependencies, Inc. 19th annual medical-scientfic conference. April 21-14, 1988, Arlington, Virginia. Abstracts. PMID- 3279852 TI - Observer variation in assessment of liver biopsies of alcoholic patients. AB - The aim was to construct a questionnaire analyzing pathological features possibly present in alcoholic liver disease, to assess its interobserver variation and to determine the influence of technical data on this variation. A total of 764 inpatients drinking 90 g (median) of pure alcohol per day for 25 years was observed; 402 patients were excluded because of associated nonalcoholic disease, refusal or contraindication to biopsy, leaving 362 patients included. Two pathologists independently analyzed each biopsy and completed a questionnaire including 41 items. Coefficient of concordance between observers was evaluated with the kappa statistic (k). The prevalence of 14 lesions was low, equal to or under 10%, leading to a nonsignificant concordance. For the 27 remaining features, two had an almost perfect degree of concordance (k greater than 0.81): presence of hepatocellular carcinoma and cirrhosis. Three had a substantial coefficient of concordance (k greater than 0.61): fibrous septa, size of cirrhotic nodules, and liver cell regeneration. Nine had a moderate (k greater than 0.41), 11 a fair (k greater than 0.21), and two a slight (k less than 0.21) coefficient of concordance. In terms of final diagnosis of alcoholic liver disease the concordance was substantial for cirrhosis with acute alcoholic hepatitis (k = 0.77), cirrhosis without alcoholic hepatitis (k = 0.75), acute alcoholic hepatitis without cirrhosis (k = 0.65) and normal liver (k = 0.64). Concordance was moderate for steatosis (k = 0.47) and slight for fibrosis alone (k = 0.16).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279854 TI - Alcoholics committed to treatment: a prospective long-term study of behavioral characteristics, mortality, and social adjustment. AB - Three hundred eighty-three alcoholics, who had at least once been ordered supervision or compulsory treatment at an institution for alcoholics by the Temperance Board, were compared with 383 other alcoholics matched for age and sex. All the alcoholics were first admitted to the Department of Psychiatry, University Hospital, Lund, during the years 1949 to 1969 and followed up until January 1, 1981. They were systematically rated concerning symptoms and etiological factors at first admission. According to a stepwise logistic regression analysis, the following initial symptoms were positively associated with later compulsory treatment: slight cerebral dysfunction/personality change, antisociality/criminality, and impaired social and work performance. Social pressure/responsibility/conflict, slight depression, and continuous drinking were positively associated with the controls. There were 168 deaths in the compulsory treatment group and 124 in the control group (p less than 0.01). The excess deaths in the compulsory treatment group were mainly caused by accidents, poisoning, and violence (21 cases) and sudden cardiac death (10 cases), while there were no differences concerning alcohol-related neoplasms and liver cirrhosis. The compulsory treatment group had a worse long-term social adjustment. The findings indicate that compulsory treatment was related to behavioral patterns showing a stability over time, supporting the validity of subclassification of alcoholics using social data. PMID- 3279855 TI - Toxicity of ethanol and other components of alcoholic beverages. PMID- 3279856 TI - The hangover hypothesis and the influence of moderate social drinking on mental ability. AB - The "hangover" hypothesis proposes that there is some residual effect of low to moderate alcohol intake on the nervous system after the blood alcohol level has returned to zero. This notion has been invoked to explain the putative effects of moderate alcohol consumption on mental ability. We evaluated the hangover hypothesis by attempting to predict cognitive performance from self-reports of alcohol consumed during the week prior to testing. We found no meaningful evidence to support the notion that moderate alcohol ingestion produces a measurable toxic effect on brain function after the period of acute intoxication. PMID- 3279857 TI - Psychophysiological effects of oral ethanol in alcoholics and social drinkers. AB - The acute and extended effects of ethanol ingestion were examined in five alcoholic subjects, and five "social" drinkers. Six physiological and four subjective report measures were taken before, during and up to 90 min after the ingestion of ethanol in three doses and placebo. Findings showed that alcohol exerted significant dose-related physiological effects in the initial minutes of ingestion, and in extended analyses of physiological and subjective measures in both groups of drinkers. Alcoholics and social drinkers generally did not differ in their physiological responses to alcohol doses and placebo, while some evidence for tolerance to reported euphoric effects of alcohol in the alcoholic subjects was found. The possibility is raised that early physiological responses observed during ethanol ingestion may arise not only from pharmacological effects of the drink, but may also be evidence for conditional predrink responses. PMID- 3279858 TI - Genetically determined response of hepatic aldehyde dehydrogenase activity to ethanol exposures may be associated with alcohol sensitivity in mouse genotypes. AB - Mice (Mus musculus) from four genetic strains (BALB/c, C57BL/6J, 129/ReJ, and SW) and their F1 hybrids (SWxBALB/c, C57BL/6JxBALB/c, and C57BL/6Jx129/ReJ) were used to evaluate the effect of ethanol on the activity of the two primary enzymes, alcohol dehydrogenase (ADH; E.C.1.1.1.1) and aldehyde dehydrogenase (ALDH; E.C. 1.2.1.3), of alcohol metabolism. Three week-old male mice (12-16 g) were placed on liquid diet (5% ethanol) while a weight-matched littermate control was fed isocaloric maltose-dextrin in place of ethanol. Animals were sacrificed after 3 weeks and the liver and stomach were excised for biochemical analysis. Although the ethanol feeding did not influence the stomach ADH and ALDH activity levels, these enzymes in the liver were affected. The liver ADH activity was depressed to varying degrees in all mouse genotypes studied. Also, the ethanol feeding altered the liver-ALDH activity, which was highly variable and genotype specific. The mice of C57BL/6J and F1 C57BL/6JxBALB/c, both relatively resistant genotypes, exhibited significant increase in liver ALDH-(cytosolic and whole liver homogenate) activity. The response in the other genotypes were not significantly different from their matched controls. The relative resistance of the C57BL/6J strain may be associated with the increase in liver ALDH activity which is expected to facilitate the elimination of acetaldehyde, the toxic metabolite. The results from the selected F1 crosses indicate a multigene system regulating the inducibility of the liver ALDH. The relative sensitivity of different genotypes may be attributed to inducibility components regulating the liver enzyme activity, particularly liver ALDH following challenges with ethanol. These observations may offer a new approach in explaining extensive variability in response to alcohols in most populations. PMID- 3279859 TI - Prediction of posttreatment drinking outcome in a 2-year out-patient alcoholic treatment program. A follow-up study. AB - Fifty alcoholics who attended a 2-year out-patient treatment program with standardized evaluations every third month were followed-up 2 years after completion of the program. One patient refused to be followed-up and four were dead. Corroboration was available in 78% of the cases. The number of abuse days from the second half-year of therapy and forward was strongly related to the number of abuse days during the follow-up period as were ratings both of drinking goal fulfillment and fulfillment of other treatment goals at termination of the treatment period. On the contrary initial characteristics and background data as well as the number of abuse days during the first half-year were not related to number of abuse days during the follow-up period. Our findings indicate that improvement during long term out-patient treatment for alcoholism is stable during the following 2 years with a socially stable sample. PMID- 3279860 TI - Acute cardiovascular and metabolic effects of acetate in men. AB - We studied the potential contribution of acetate to the cardiovascular effects of ethanol in 12 healthy male volunteers. Sodium acetate, or sodium chloride in control experiments, was infused i.v. at the rate of 0.033 mEq/kg/min for 60 min. Left ventricular function was examined by M-mode echocardiography and systolic time intervals during infusion and for 60 min thereafter. Blood acetate rose during infusion from 0.19 +/- 0.02 (mean +/- SEM) to a maximum of 0.99 +/- 0.08 mmol/liter. Changes in serum free fatty acids, glycerol, and ketone bodies indicate that acetate inhibited peripheral lipolysis. The volume of urine excreted during the acetate experiment (305 +/- 37 ml) was significantly larger (p less than 0.01) than during the chloride experiment (181 +/- 21 ml). Left ventricular function did not differ between the experiments during the infusions even though at 45 min heart rate was increased by acetate (7%; p less than 0.01, between infusions). After the infusion period, at 75 min the treatment by acetate increased cardiac output from the baseline by 17% (p less than 0.05, between infusions), and decreased peripheral arterial resistance (19%, p less than 0.05), and diastolic blood pressure (10%, p less than 0.01). Circumferential fiber shortening velocity was increased during the acetate experiment maximally by 7% (p less than 0.01) from the baseline at 120 min. These data indicate that acetate is an arterial vasodilator and a mild diuretic and may slightly improve myocardial performance in the concentrations encountered during ethanol metabolism in men. PMID- 3279862 TI - Association between alcoholism and increased hepatic iron stores. AB - Although alcoholic liver disease is often associated with some increase in hepatic iron stores, it is now established that when gross iron overload is present, this is due to genetic hemochromatosis. Furthermore, there appears to be a critical iron concentration necessary for the induction of hepatic fibrosis. Lipid peroxidation induced by ethanol and/or iron would appear to play a major role in hepatic damage in both humans and experimental animals. Although the exact mechanism(s) of induction of lipid peroxidation by ethanol and iron remains to be elucidated, both toxins can exert a synergistic effect upon hepatic lipid peroxidation. Iron overload has also been shown to stimulate directly hepatocyte and hepatic procollagen mRNA expression, which is further stimulated by ethanol. The observed synergism between iron and alcohol with respect to both hepatic lipid peroxidation and collagen biosynthesis offers a possible explanation of the apparent early onset of fibrosis and cirrhosis in patients with iron overload who have an excessive alcohol intake. PMID- 3279861 TI - Effects of prenatal alcohol exposure on the sexually dimorphic nucleus of the preoptic area of the hypothalamus in male and female rats. AB - Prenatal alcohol exposure can produce a variety of behavioral and physiological alterations, including changes in sexually dimorphic behaviors. It has been proposed that alcohol alters these behaviors by altering prenatal androgen and/or other steroid levels. This study was designed to examine the effects of prenatal alcohol exposure on a sexually dimorphic neuroanatomical structure, namely, the sexually dimorphic nucleus of the preoptic area of the hypothalamus (SDN-POA). This nucleus is larger in males than females and is sensitive to perinatal sex steroid exposure. The SDN-POA was examined in 70-80-day-old male and female rats whose mothers received on days 6-20 of pregnancy either a liquid diet containing 35% ethanol-derived calories (EDC) or a 0% EDC isocaloric pair-fed liquid diet. An ad libitum lab chow control group was also included (LC). Both volume and average cell size of the SDN-POA were markedly smaller in alcohol-exposed males relative to 0% EDC and LC controls. In contrast, prenatal alcohol exposure did not appear to affect SDN-POA volume or cell size in females. Prenatal alcohol exposure did not significantly alter the volume of a nearby nucleus, the nucleus of the anterior commissure, in either sex. These findings support the hypothesis that prenatal alcohol exposure alters sexual differentiation in males, perhaps by altering some aspect of the prenatal androgen environment. The absence of any effect in 35% EDC females suggests that males and females may be differentially sensitive to alcohol's effects on this nucleus. PMID- 3279863 TI - Pharmacokinetics of ethanol in the guinea pig. AB - Chronic consumption of ethanol by pregnant and nonpregnant guinea pigs for 8 weeks at doses of 1.2 or 1.6 g/kg body weight twice daily affected pregnancy outcome and changed the pharmacokinetics of ethanol elimination. Ethanol treatment as compared to that of isocaloric sucrose decreased maternal weight, and decreased both the litter size and the number of liveborn offspring. Total litter weight was significantly decreased with the low ethanol dose (12% alcohol derived energy). During pregnancy, low and high doses produced peak blood ethanol concentrations (BEC) of 89 +/- 8 mg/dl (mean +/- SE) and 125 +/- 6 mg/dl, respectively. At the high dose, peak BEC decreased dramatically (about 30%) in both pregnant and nonpregnant animals from treatment weeks 0 to 4; thereafter peak BEC remained depressed up to 8 weeks of treatment, which occurred with a concomitant increased volume of ethanol distribution. With both doses, rates of ethanol elimination and Michaelis-Menten's Vm values were significantly lower among pregnant as compared with nonpregnant guinea pigs during 8 weeks of treatment. These data suggest that the guinea pigs can be a valuable animal model to study the effects of low ethanol doses on fetal growth, the adaptation of peak BEC with duration of treatment and the lower rate of ethanol elimination in pregnancy. PMID- 3279864 TI - Brain CT changes in alcoholics: effects of age and alcohol consumption. AB - A computerized tomographic (CT) brain scan and assessments of lifetime alcohol consumption, body size, and cognitive performance were performed in 37 male alcoholics, aged 26-62 years. Hematocrit and mean corpuscular volume (MCV) were also measured. CT data were analyzed using a semiautomated scoring system yielding measures of percentage of fluid at the ventricles and cortical sulci. Normative brain CT data from 57 community controls spanning the adult age range allowed Z-score assessment of deviation from age norms for each alcoholic. Across the entire group, alcoholics had significantly enlarged ventricles and sulci for their age. Enlargement at both sites correlated significantly with lifetime alcohol consumption. Sulcal enlargement in alcoholics was found across all ages. In contrast, ventricular enlargement was apparent only in older alcoholics and became increasingly exaggerated with age. Measures of body size, hematocrit, and MCV correlated with ventricular but not sulcal enlargement, suggesting that nutritional factors play a role in ventricular enlargement. Associations between neuropsychological performance and CT changes or alcohol consumption were less pronounced and at times counterintuitive. The findings support a modest dose effect relationship between ethanol exposure and changes in brain morphology, and suggest that ventricles and sulci show a different time course of response. The role of nutritional status needs to be more closely investigated. PMID- 3279865 TI - Neuropsychological performance and treatment outcome in male alcoholics. AB - Commonly used neuropsychological tests were administered to 91 detoxified alcoholics at the beginning of treatment. Statistically significant relationships were observed between test scores and post-treatment consumption determined 8 months after completing treatment for 72 patients. The results varied depending upon the particular measure of posttreatment consumption evaluated and the type of statistical analysis used. The most consistent relationships were often counter to the notion that increased neuropsychological performance is correlated with a more favorable treatment outcome. Neuropsychological evaluation is of limited clinical utility in predicting posttreatment alcohol consumption. PMID- 3279866 TI - Multivariate diallel analysis of ethanol withdrawal symptoms in mice. AB - Mice from five highly inbred strains were crossed in a complete diallel design. Five hundred and fifty-five offspring were given a liquid diet containing ethanol as their sole food source for 9 days in an attempt to induce dependence. At 6 hr postwithdrawal on day 10, the mice were given a battery of physiological and behavioral measures designed to assess the symptoms of withdrawal. Littermate data were aggregated separately by sex and the aggregate litter mean data was employed in a multivariate extension of Hayman's diallel analysis. Hypothesis sums of squares and cross-products were tested against pooled-within-cell sums of squares and cross-products using Wilk's lambda as a criterion. For each sex, a highly significant additive effect was found, with some evidence for dominance effects as well, suggesting the raw materials are present for successful genetic selection. There was some evidence for dominance effects as well, but no evidence for maternal and other reciprocal effects was found for the set of seven measures. Composites derived from the additive and general dominance hypotheses correlation matrices and error correlation matrix were compared with a composite index currently being used in a multivariate selection study of ethanol dependence. Total ethanol consumption during the exposure period was positively correlated with low dependence between strains, and negatively correlated with measures of low dependence within cells. PMID- 3279867 TI - Effects of actinomycin D on the lysosomes of newborn rat hepatocytes. AB - The effects of actinomycin D on newborn rat liver were studied by using biochemical assays, electron microscopy, and quantitative morphometry. Actinomycin prevented the normal postnatal rise in acid a 1,4 glucosidase (maltase) activity and the breakdown of lysosomal glycogen. The results suggest that the postnasal increase in acid glucosidase activity is protein synthesis dependent. This enzyme is critical for the catabolism of the lysosomal glycogen in newborn rat hepatocytes. PMID- 3279869 TI - Nasal provocation challenge--strategies for experimental design. PMID- 3279868 TI - Topography and behavior of Sertoli cells in sparse culture during the transitional remodeling phase. AB - We report observations on the behavior of Sertoli cells in sparse culture during the period from the time of plating to the time of initial confluence (the transitional remodeling phase). Changes in shape, structure, and polarity of cells, as well as changes in migration patterns and cell-cell association patterns, have been followed during the transitional remodeling phase with the aid of topographical markers. These markers are based upon differences between ultrastructural features of the basolateral and apicolateral surfaces. The basolateral surface is characterized by plasmalemmal blebs, whereas the apicolateral surface is characterized by filopodial extensions. Structural differences observed in situ remain evident in Sertoli cells isolated by sequential enzymatic treatments that are described. Another marker is provided by laminin-binding sites, which are detected exclusively on the blebbed, basolateral surfaces of freshly prepared Sertoli cell aggregates. The orientation described is sustained during the initial radial migration of Sertoli cells explanted on uncoated glass coverslips. Under these conditions, blebs are detected only on the dorsal surfaces, and filopodial extensions are evident only on the ventral surfaces. In contrast, Sertoli cells sparsely plated on a reconstituted basement membrane (air-dried Matrigel) migrate rapidly, display an extraordinary capacity to form elaborate cytoplasmic extensions for cell-cell and cell-substratum contacts, and readily retract blebs and filopodial extensions. These cells do not form mosaic borders, whereas cells plated on uncoated glass do form a monolayer with mosaic-like borders. Cells sparsely seeded on gelated Matrigel migrate preferentially at gaps between adjacent cell explants, and develop a compact cell cell association pattern. These cells display few, if any, cytoplasmic extensions. We compare the behavior of Sertoli cells sparsely plated on Matrigel with the behavior of Sertoli cells in situ during different stages of development. PMID- 3279870 TI - [Physiological mechanisms of venous admixture during general anesthesia]. PMID- 3279871 TI - Comparison of phagocytosis and chemiluminescence by blood and mammary gland neutrophils from multiparous and nulliparous cows. AB - Neutrophils were isolated from the blood and mammary gland of 3 multiparous lactating cows and 3 nulliparous heifers. Neutrophil function was evaluated by phagocytosis and luminol-dependent chemiluminescence. Peroxidase activity was detected by use of transmission electron microscopy. Compared with that for blood neutrophils, percentage of phagocytosis was 9.6% lower for neutrophils isolated from the mammary gland of lactating cows, but this difference was not observed between neutrophils isolated from the mammary gland and from the blood heifers. Similarly, after subtraction of chemiluminescence values in the absence of zymosan, phagocytosing neutrophils from the mammary gland of lactating cows had lower chemiluminescence than did those from the blood of such cows. For heifers, however, chemiluminescent activity by phagocytosing neutrophils obtained from the mammary gland was similar to that of blood neutrophils. Chemiluminescent activity of resting neutrophils from the mammary gland of lactating cows pretreated with cytochalasin B was not inhibited, compared with that of nontreated resting neutrophils (controls). This was attributed to xanthine oxidase activity. Transmission electron microscopy of mammary gland neutrophils from lactating cows revealed peroxidase-positive material associated with milk-fat globule membranes and with phagosomes containing zymosan. Results indicated that ingestion of fat and casein by neutrophils isolated from milk caused a decrease in phagocytic and chemiluminescent activity. Also, luminol-dependent chemiluminescence was not a reliable measure of milk neutrophil function, because of interference by xanthine oxidase. PMID- 3279873 TI - Yohimbine increases plasma insulin concentrations and reverses xylazine-induced hypoinsulinemia in dogs. AB - Xylazine (1.1 mg/kg of body weight, IV), an alpha 2-adrenoreceptor agonist, suppressed the increase in plasma insulin concentration induced by glucose (0.6 g/kg, IV) in dogs. Yohimbine (0.11 mg/kg, IV), an alpha 2-adrenoreceptor antagonist, given 5 minutes after xylazine, reversed effects of xylazine, whereas yohimbine alone increased plasma insulin and decreased plasma glucose concentrations. Seemingly, alpha 2-adrenoreceptors exert a negative control of insulin release. PMID- 3279872 TI - Effects of source and washing of erythrocytes on growth of bacterial pathogens from the bovine mammary gland. AB - Effects of source and washing of RBC on quantitative growth and hemolytic zone sizes of common bacterial pathogens of the bovine mammary gland were evaluated. Blood samples used to prepare the blood agar media were obtained from 10 adult dairy cows, 10 dairy calves, and 10 sheep. Hemolytic zone sizes produced by Staphylococcus aureus were significantly (P less than 0.01) larger on blood agar prepared with washed RBC than on blood agar prepared with nonwashed RBC, regardless of RBC source. With the exception of Corynebacterium bovis, growth of all bacteria was equivalent or significantly higher on medium prepared with washed RBC, compared with that on medium prepared with nonwashed RBC, regardless of RBC source. Significantly higher numbers of C bovis (P less than 0.01) and Streptococcus agalactiae (P less than 0.01) were isolated on medium prepared with washed cow RBC. Significantly higher numbers of Str uberis (P less than 0.01) and S aureus (P less than 0.05) were isolated on medium prepared with washed sheep RBC and washed calf RBC, respectively. Growth of Escherichia coli was not affected by the RBC source. Seemingly, RBC used in the preparation of medium should be washed. The source of RBC, as well as inter-animal variation, also should be considered in the quality control of medium. PMID- 3279874 TI - Presidential address. The type A behavior pattern and coronary artery disease. Quest for the active ingredients and the elusive mechanism. PMID- 3279875 TI - Profiting from controversy. Lessons from the person-situation debate. PMID- 3279876 TI - Fantasy proneness. Hypnosis, developmental antecedents, and psychopathology. PMID- 3279877 TI - The identity and idiodynamics of the multiple personality "Sally Beauchamp". A confirmatory supplement. PMID- 3279878 TI - Thoracic outlet syndrome: a comprehensive evaluation. AB - Using various modalities, 480 patients were evaluated for thoracic outlet compression syndrome. Of this group, 300 patients were eventually diagnosed as having thoracic outlet syndrome after extensive evaluation. Ninety of these patients underwent a total of 103 operative procedures for thoracic outlet decompression. Nerve conduction velocities and directional Doppler studies were the most useful adjuncts in making the diagnosis. Surgical therapy after proper selection yielded an 80.6 per cent long-term "good" operative result and an additional 6.9 per cent long-term "fair" operative result in follow-up to 12 years. PMID- 3279880 TI - Relationship between postsurgical fibrinolytic parameters and deep vein thrombosis in surgical patients treated with compression devices. AB - This study consisted of 52 patients admitted for orthopedic surgery and 28 patients admitted for general surgery, who were treated with Sequential Compression Devices (SCD) and Thromboembolic Deterrent Stockings (TEDS) and monitored for the development of deep vein thrombosis (DVT). Coagulation and fibrinolytic profiles were carried out on these patients preoperatively, and on days one, three, and six postoperatively. All patients were followed by I-125 Fibrinogen scanning, Venous Doppler, and Impedance Plethysmography studies for clot detection. In the orthopedic surgery group, six (11.5%) developed DVT, and in the general surgery group, one (3.6%) developed DVT. No patients developed pulmonary embolism. The combined incidence of DVT was 8.8 per cent. A variety of parameters was measured in order to determine whether compression devices prevent a fibrinolytic shut-down commonly seen in the postsurgical patient. A combination of three assays was found to be significant in demonstrating a fibrinolytic response. These parameters were a post-surgical decrease in the plasminogen level, an increase in the level of free protease activity postoperatively, and an increase in the level of tissue plasminogen activator after surgery. 56.3 per cent of all patients treated with SCD and TEDS showed a fibrinolytic response on postoperative day one by a combination of all three of these parameters. In the group of patients that developed DVT none showed an increase in free protease activity, and five of seven showed no significant decrease in plasminogen and no increase in tissue plasminogen activator. Patients who developed thrombosis had measurable differences in their fibrinolytic system compared to those without postoperative thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3279879 TI - Pulmonary artery disruption from blunt thoracic trauma. AB - Blunt chest trauma occurs in up to 50 per cent of all fatal motor vehicle accidents and is the primary cause of death in 12-25 per cent; yet only 15 per cent of patients with chest trauma arriving alive to the emergency department require early thoracotomy. Pulmonary artery disruption from blunt trauma is extremely rare. Two patients both women, older and obese with multiple rib fractures and little pulmonary parenchymal damage are reported. Neither had injury to the aorta, heart or intra-abdominal organs. One patient survived after lateral repair of the left main pulmonary artery and the other exsanguinated from a laceration of the right main pulmonary artery. Intrapericardial exposure of the proximal pulmonary arteries may be necessary for control of hemorrhage. Trauma surgeons should be familiar with this technique. Indications for immediate thoracotomy should include: massive hemothorax (greater than 1000 ml), continued bleeding greater than 300 ml in the first hour, bleeding greater than 200 ml/hr for 5 hours, or increasing hemothorax in spite of tube thoracostomy. Close adherence to these guidelines would have allowed both patients to be explored earlier. PMID- 3279881 TI - [Infectious mononucleosis in children]. AB - 50 cases of infectious mononucleosis by Epstein-Barr virus were studied in patients over and under 4 years age. Clinical evolution did not show any statistical differences between both age groups, except for splenomegalia which was more common in children under 4. Serology was divided into 3 groups: children under 4 year, between 4 and 5 and those over 5 years of age. First group exhibited a positive Davinsonh test in 15.3% of cases; second group in 33.3% and third in 80%. IgG antibodies against virus capsid were positive in 86% of cases with an equal distribution according to age groups. IgM antibodies were positive in 66%, not exhibiting any disparity in age groups. PMID- 3279882 TI - [Rapid diagnosis of streptococcal pharyngo-tonsillitis in a primary care unit]. AB - One of the main consulting motives in ambulatory pediatric practice is acute pharyngotonsillitis. This work values the efficacy of a test to confirm rapid diagnosis (30 minutes) of streptococcal pharyngitis. Authors selected 100 children in a office of primary health care whose ages were between two and seven years, from February to July in 1986. They have considered classical clinical symptoms of pharyngitis and have applied a throat culture and rapid test in all. After comparing test results and culture results, obtained sensibility and specificity have been 80% and 95% (p less than 0.01) respectively. According to these results, they believe on the necessity of a test that permits a rapid diagnosis and which enables to treat acute pharyngitis in a more suitable way in ambulatory pediatrics. PMID- 3279884 TI - [Diagnosis of genetic diseases by DNA analysis]. PMID- 3279883 TI - [Identification of Streptococcus group A in children with pharyngitis, in ambulatory care, through pharyngeal culture]. AB - 574 cases of pharyngitis (patients 0.3-14 years aged) were studied. Throat swabs were obtained from all the children, inoculated into blood-agar plates and incubated aerobically at 37 degrees C, in the office, using the bacitracin test for identification of group A streptococci. The 25% of the cultures were positives (80% in the first 24 hours, and the rest in 48 hours). We did not find reliable clinical findings that enable us to diagnose streptococcal pharyngitis accurately. So that we conclude that demonstration of group A streptococcus in patients throat is essential and we find that throat culture is a practical and advisable method for the office practice. PMID- 3279885 TI - [Value of muscular echography in the detection of carriers of progressive muscular dystrophy]. AB - Progressive muscular dystrophy is an hereditary disease with a sex-linked recessive transmission. It is remarkable that in a 33% of the patients the disease is due to a spontaneous mutation. The great deal of methods described for the detection of carriers, reflects their poor reliability. The gemellus muscles of 11 women belonging to 3 different families with children affected by progressive muscular dystrophy were explored by means of ultrasounds. Comparison was made with healthy controls. Since our findings are in concordance with those of the literature, we recommend the use of muscular ultrasounds in the detection of Duchenne muscular dystrophy carriers, specially considering the accessibility, innocuousness and quickness of this method. PMID- 3279886 TI - [Non-immune hydrops fetalis. Review of 11 cases]. AB - Eleven cases of non-immune hydrops fetalis (NIHF) are presented. Incidence was 1.8 out of 10,000 births. NIHF became more common than immune hydrops fetalis (1.4/10,000 births). Mortality was of 81% and complications were frequent. NIHF is associated with prematurity, neonatal anoxia, polyhydramnios, hypoalbuminemia and hypoproteinemia. Considerable emphasis must be placed on antenatal diagnosis to achieve a precocious treatment and so improve the present poor prognosis. PMID- 3279887 TI - [Argininosuccinic aciduria. Comparative studies and detection of carriers in 3 affected families]. AB - Three patients with argininosuccinic aciduria are described. One of them is a neonatal form, with typical acute course and severe hyperammonemia who died on the sixth day of life. Postmortem analysis showed a marked plasmatic accumulation of argininosuccinic acid. Later on, red blood cell ASA-lyase levels demonstrated the heterozygosity of her parents and sisters. The two other patients are late onset forms and were diagnosed after detection of ASA and its anhydrides in plasma and urine. Levels of these metabolites did not correlate with levels of residual ASA-lyase in erythrocytes. Treatment with a hypoproteic diet supplemented with arginine has improved their clinical state. Carriers have been detected in both families. Importance of rapid diagnosis and treatment of hyperammonemic patients in order to prevent neurologic damage is emphasised. PMID- 3279889 TI - [Vertebral arteriovenous fistula and neonatal cardiac insufficiency: diagnosis using duplex Doppler echography]. AB - An extracranial arteriovenous fistula case, placed in vertebral artery territory that dealt with congestive heart failure and which developed advantageously without a surgical treatment is shown. Authors emphasize the fact of being a rarity the so premature beginning of the signs in a arteriovenous communication at that level, results in Doppler duplex echography and the need to have in count this entity previous to congestive heart failure with a deep origin in neonatal period. PMID- 3279888 TI - [Orofaciodigital syndrome type I in a mother and daughter]. AB - Two patients, a mother and her daughter, who manifested the clinical features of the oro-facial-digital syndrome (OFD I) are reported. The mother have polycystic disease of the kidneys. Clinical data and genetic aspects are commented in relation with these new cases. PMID- 3279890 TI - [Childhood scabies: a different entity]. AB - Epidemiological, clinical, diagnostic and therapeutic aspects that make scabies a clinical entity with a special personality in the pediatric field, are reviewed. On the epidemiological aspects, a special mention of its unsuspected frequency in this age is made. Scabies is an endemic disease in our country among the more deprived people. On the clinical aspects, the great importance of clinical history and distribution of skin lesions for the early diagnosis is pointed out. Some "alert pointers" are described for this early diagnosis. On the therapeutic field, the importance of the primary care prevention is discussed, and the drug approach for its relieve is commented. PMID- 3279891 TI - [Fetal bilateral hydronephrosis. Diagnostic problems in duodenal atresia]. PMID- 3279892 TI - [Ileal obstruction caused by a plug of meconium as a complication of the treatment of ductus arteriosus]. PMID- 3279893 TI - Pityrosporum folliculitis after bone marrow transplantation. Clinical observations in five patients. AB - A skin rash in marrow graft recipients often poses difficult diagnostic problems because multiple causes may be implicated, and clinical and histopathologic findings may be nonspecific. Five recipients of allogeneic bone marrow transplants had pityrosporum folliculitis diagnosed by skin biopsy in the early weeks (less than 18 days) after transplantation. In all cases, patients were febrile and leukopenic (granulocyte count, less than 500 cells/mm3), and were receiving broad-spectrum antibiotics at onset of the skin rash. Erythematous macules and papules were distributed primarily over the chest, shoulders, and upper back, and pustules and crusts developed in some cases. Granulocyte counts of more than 500 cells/mm3 were associated with resolution of the rash. Pityrosporum infection should be considered in the differential diagnosis of skin rashes in marrow graft recipients. PMID- 3279894 TI - Advanced breast cancer: high-dose chemotherapy and bone marrow autotransplants. AB - The response of human breast cancer to drugs and radiation is dose-dependent, with higher doses producing increased response rates. However, dose escalation of several agents active against breast cancer is limited by bone marrow toxicity. This limitation can be overcome in some instances by transplantation of bone marrow cells. We evaluated 27 trials of bone marrow autotransplants in 172 patients who received single or multiple drug chemotherapy, radiation, or both. The overall response rate was 58%. Response rates were highest in trials involving multiple alkylating agents (76%) or previously untreated patients (81%). These data suggest that high-dose therapy and bone marrow autotransplants can produce remissions in patients with advanced breast cancer unresponsive to conventional therapy. A critical evaluation of this approach will require controlled trials in high-risk persons. PMID- 3279895 TI - NIH conference. Angioimmunoblastic lymphadenopathy with dysproteinemia. AB - Angioimmunoblastic lymphadenopathy with dysproteinemia is a disorder characterized by a sudden onset of constitutional symptoms and lymphadenopathy. Patients often have hypergammaglobulinemia, autoantibodies, rashes, thrombocytopenia, or hemolytic anemia. Diagnosis requires a lymph node biopsy that shows architectural effacement, absence of germinal centers, arborization of postcapillary venules, and a polymorphous infiltrate that includes immunoblasts. Early in the disease, activated T cells in blood and lymph nodes stimulate B cells to proliferate and produce antibody. However, late in the disease, immune suppression may result from increased suppressor function. Clonal rearrangements, which are seen in all patients with regard to either the T-cell receptor beta chain gene or immunoglobulin genes, have been followed by malignant transformation and frank lymphoma in some patients. Thus, this disorder stands partway between benign lymphoid proliferation and clonal lymphoid transformation. The prognosis of this disorder is poor; 75% of patients die within 2 years or develop a lymphoid malignancy. The rest usually go into a sustained remission. Current treatment with corticosteroid and immunosuppressive agents is unsatisfactory, especially because of late immunosuppression and predisposition to infections. PMID- 3279896 TI - Postischemic myocardial "stunning": a clinically relevant phenomenon. PMID- 3279897 TI - Renal salt wasting and carboplatinum. PMID- 3279898 TI - Heterogeneity of long-distance migration in studies of genetic structure. AB - One of the assumptions of migration matrix methods of population structure is that long-distance migrants are all sampled from a genetically homogeneous 'outside world'. This assumption has not often been tested. This paper examines migration and surname data from four towns in historical Massachusetts in order to examine this assumption and potential genetic effects of heterogeneous long distance migration. Analysis of migration data shows that the rate of long distance migration is significantly different for the four towns. The distributions of source populations for long-distance migrants into each town are significantly different. Surname analysis shows that in spite of the violation of the assumption of long-distance migrant homogeneity, there is little effect on the degree and pattern of within-group and among-group variation for these towns. This lack of effect seems related to genetic homogeneity of the long distance migrants. PMID- 3279900 TI - Sir Peter Medawar 1915-1987. PMID- 3279899 TI - Secondary sexual development of 'Cape Coloured' girls following kwashiorkor. AB - This report describes the secondary sexual development of 45 'Cape Coloured' female ex-kwashiorkor patients and 43 female controls. All patients were originally seen between five months and four years four months of age, treated and then followed up for 15 years after discharge. Age at menarche was available on 42 ex-patients and 33 controls, and age at peak height velocity (PHV) was available for 30 ex-patients and 15 controls. Maximum likelihood estimates of the mean age at entry to each pubertal stage were made, age at menarche was obtained directly from the subject records and age at PHV was obtained by fitting a non linear growth function to the data for each subject. All subjects passed through the sequence of pubertal events in the normal order, i.e., no reversals were observed. Ex-patients were generally delayed in relation to controls but there were no significant differences for ages at entry to any of the pubertal stages. The subjects were combined for comparison to equivalent data on British girls. The South African girls were significantly delayed in the development of pubic hair and menarche but showed no significant differences for age at entry or duration of breast development and PHV. It is suggested that lack of delay in breast development may have selective advantages to females living in situations of chronic malnutrition. PMID- 3279901 TI - Antibody to human and simian retrovirus, HTLV-I, HTLV-II, HIV, STLV-III, and SRV I not increased in patients with multiple sclerosis. AB - We have tested sera from patients with multiple sclerosis, matched controls, and those with other neurological diseases, as well as sera from patients with the acquired immunodeficiency syndrome and controls and patients with tropical spastic paraparesis (TSP) and controls for antibody to human T-lymphotropic virus type I (HTLV-I), HTLV-II, human immunodeficiency virus (HIV), simian T lymphotropic virus type III, or simian retrovirus type I by immunofluorescent activity test, and for HTLV-I and HIV by the ELISA method. Sera from patients with multiple sclerosis and matched controls, and from patients with optic neuritis and Parkinson's or other neuromuscular diseases did not have antibody to any of the retroviruses tested. Specimens from TSP patients and some controls contained HTLV-I antibody. We conclude from our study that only TSP patients had serological evidence of infection with one of the retroviruses studied. PMID- 3279902 TI - Neurological and neuropathological features of human immunodeficiency virus infection in children. AB - A progressive encephalopathy occurs in 30 to 50% of infants and children infected with the human immunodeficiency virus (HIV). The expression of HIV antigen in the cerebrospinal fluid appears to correlate with the clinical occurrence of progressive encephalopathy. The signs of progressive encephalopathy in children with HIV infection, including loss of developmental milestones, impaired brain growth, and progressive motor dysfunction, indicate a poor prognosis and almost invariably a fatal outcome. Neuropathological findings in these children, including virus-laden macrophages and multinucleated giant cells are unique to this condition. Opportunistic or reactivated latent infections and neoplasms of brain occur in children with HIV infection but are uncommon. These findings support the hypothesis that the progressive encephalopathy observed in HIV infected children is caused by primary infection of the brain with this virus. Epidemiological data predict increasing numbers of HIV-infected women and children. Research aimed at an understanding of the mechanism(s) of mother-to infant transmission of HIV infection is urgently needed so that strategies for the prevention and treatment of such infection in children may be planned. PMID- 3279903 TI - Neurotropic retroviruses of wild mice and macaques. AB - A neurotropic retrovirus causes a naturally occurring lower-limb paralysis in wild mice, characterized by a noninflammatory spongiform change located primarily in the lower spinal cord. The causative agent is an ecotropic murine leukemia virus, unique to certain wild mice in southern California. The disease is readily transmitted to newborn susceptible laboratory mice. The paralytogenic property is attributed to direct viral injury to motor neurons and glial cells and is associated with unique amino acids in the murine leukemia virus envelope gp70. This murine model may have relevance to both human T-lymphotropic virus type I, and human immunodeficiency virus infection of human brain. It presents a practical model for testing antiviral agents aimed at retrovirus infection of the mammalian central nervous system. Simian acquired immunodeficiency syndrome type D retrovirus causes a silent infection of the brain in infected macaques. Viral nucleic acids are detected in the brain parenchyma in the absence of viral antigen, neurological symptoms, and neuropathology. Infected choroid plexus epithelial cells are the source of cell-free virus in the cerebrospinal fluid of viremic monkeys. This model adds yet another example of retroviral infection of the central nervous system and points to the choroid plexus as a potential source of infectious virus. PMID- 3279904 TI - Review of central nervous system pathology in human immunodeficiency virus infection. AB - Aseptic meningitis, subacute encephalitis, and vacuolar myelopathy are the three diseases of the central nervous system that are specifically related to or associated with human immunodeficiency virus (HIV) infection. HIV encephalitis initially is associated with myelin pallor and gliosis of the centrum semiovale, which is found in more than 90% of brains from patients dying with the acquired immunodeficiency syndrome. With increased severity of disease, multiple glial nodules with the multinucleated cells characteristic of HIV encephalitis are present throughout the cerebral white matter, basal ganglia, and cerebral cortex, and also may be found in cerebellum, brainstem, and spinal cord. HIV has been demonstrated in monocytes and multinucleated cells by electron microscopy, immunohistochemical techniques, and in situ hybridization. Vacuolar myelopathy occurs in approximately 30% of patients and is characterized by vacuolation of the white matter of the spinal cord that is most prominent in the posterior and lateral columns at thoracic levels. The severity of the pathological lesions correlates not only with symptoms and signs of spinal cord disease but also with dementia. Although the incidence of vacuolar myelopathy is increased in patients with HIV encephalitis, its etiology is not yet established. PMID- 3279905 TI - Increase in permeability of Escherichia coli outer membrane by local anesthetics and penetration of antibiotics. AB - The MICs of several antibiotics (both hydrophobic and hydrophilic) which penetrate very poorly into intact Escherichia coli cells were found to be 2- to 10-fold decreased in the presence of low doses of various local anesthetics (procaine, dibucaine, tetracaine, chlorpromazine, and quinine). The concentrations of anesthetics necessary for this effect have no adverse effect on cell growth and are markedly lower than those concentrations used clinically. PMID- 3279906 TI - Tigemonam, an oral monobactam. AB - Tigemonam is an orally administered monobactam. At less than or equal to 1 microgram/ml it inhibited the majority of strains of Escherichia coli, Klebsiella spp., Enterobacter aerogenes, Citrobacter diversus, Proteus spp., Providencia spp., Aeromonas hydrophila, Salmonella spp., Shigella spp., Serratia marcescens, and Yersinia enterocolitica. At less than or equal to 0.25 microgram/ml it inhibited Haemophilus spp., Neisseria spp., and Branhamella catarrhalis. It did not inhibit Pseudomonas spp. or Acinetobacter spp. Tigemonam was more active than cephalexin and amoxicillin-clavulanate and inhibited many members of the family Enterobacteriaceae resistant to trimethoprim-sulfamethoxazole and gentamicin. Some Enterobacter cloacae and Citrobacter freundii strains resistant to aminothiazole iminomethoxy cephalosporins and aztreonam were resistant to tigemonam. The MIC for 90% of hemolytic streptococci of groups A, B, and C and for Streptococcus pneumoniae was 16 micrograms/ml, but the MIC for 90% of enterococci, Listeria spp., Bacteroides spp., and viridans group streptococci was greater than 64 micrograms/ml. Tigemonam was not hydrolyzed by the common plasmid beta-lactamases such as TEM-1 and SHV-1 or by the chromosomal beta-lactamases of Enterobacter, Morganella, Pseudomonas, and Bacteroides spp. Tigemonam inhibited beta-lactamases of E. cloacae and Pseudomonas aeruginosa but did not induce beta lactamases. The growth medium had a minimal effect on the in vitro activity of tigemonam, and there was a close agreement between the MICs and MBCs. PMID- 3279908 TI - Polysulfone hip prosthesis. A prosthesis being investigated. PMID- 3279907 TI - Pharmacokinetics and serum bactericidal activity of vancomycin alone and in combination with ceftazidime in healthy volunteers. AB - The pharmacokinetics and serum bactericidal activity of vancomycin alone and in combination with ceftazidime were investigated in 10 healthy volunteers. The pharmacokinetic parameters showed no significant differences (P less than 0.05) between single and combined administration. No antagonistic effects were observed in serum bactericidal activity with the combination against 20 gram-positive and 20 gram-negative locally isolated bacteria. A titer of greater than or equal to 1:8 was generated by the combination against all test strains except enterococci. Seven of ten volunteers developed a typical "red man's syndrome" during the administration of 1.0 g of vancomycin. PMID- 3279909 TI - [The structure and antitumor activity of antitumor antibiotics--recent progress]. AB - Effort looking for new antitumor antibiotics useful for the treatment of curing cancer resulted to the discovery of a number of new compounds with newer action mechanism as well as newer structural feature. The antibiotics which have been discovered since 1984 are discussed under classifications of action mechanism and structural feature, as well. The first group, which belong to a novel class of antibiotics containing a bicyclodiynene carbon skeleton in the molecules exhibited the most strong anti-tumor activity comparing with the antitumor antibiotics so far discovered. The action mechanism of this was explained by the diradical formation of diynene-cyclization, which led to the scission of double strand DNA. Amongst, esperamicin A seems of great interest in view of the therapeutic development. Moreover, elsamicin A, a member of chatarin antibiotics, and FR-900482 compound, an antibiotic having a polycyclic alkalodal skeleton are under development for the new chemotherapeutic agents. Rhizoxin, the metabolite of Rhizopus chinensis is also a promising candidate as anticancer agent. Its action mechanism was classified as an inhibitor of mitosis by binding to the microtibline proteins. Rhizoxin A shows no cross resistance with vincristine. MX2 (KRN 8602), the morpholino derivative of 13-deoxo-10-hydroxy-carminomycin, shows anticancer activity against tumor cells resistant to P388/ADM as well as low cardial toxicity. Miscellaneous compounds whose action mechanism are unknown are described. PMID- 3279910 TI - [Potentiation of the antitumor activity of 5-fluorouracil by biochemical modulators]. AB - About 30 kinds of biochemical modulators of 5-fluorouracil (5-FU) are described. They modify the metabolism and cytotoxic action of 5-FU through an alteration in (1) intracellular concentration of 5-FU or its metabolites, (2) intracellular pool of co-substrates essential for 5-FU metabolism, and (3) intracellular pool of normal substrates which compete with 5-FU metabolism. As a result, they affect either its inhibitory effect on thymidylate synthase or incorporation into RNA, or both. Thus, some of these modulators can improve antitumor activity of 5-FU by potentiating its tumor-selective toxicity or reducing its host toxicity selectively. From such various points of view, a variety of biochemical modulators of 5-FU are reviewed. PMID- 3279911 TI - [Biochemical modulation of 5-fluorouracil by high-dose leucovorin]. AB - The biochemical modulation of 5-fluorouracil (FU) by using it in combination with leucovorin (LV) is reviewed. One of the mechanisms of action of FU is inhibition of thymidylate synthase (TS), a critical enzyme in the de novo synthesis of thymidylate required for DNA repair and synthesis. In the presence of 5, 10 methylene tetrahydrofolate, 5-fluoro-deoxyuridine monophosphate (FdUMP), which is an active nucleotide of FU, forms a ternary complex with TS, resulting in enzyme inhibition. The rationale for the use of LV with FU is to increase of formation and stability of catalytically inactive ternary complexes. In clinical trials, the dose schedules of 500 mg/m2 iv bolus or 500 mg/m2 continuously iv infusion is frequently used in order to obtain an ideal plasma concentration of active LV metabolites. Preliminary clinical trials using the combination of FU and LV appear to be capable of increasing of the clinical activity of FU for colorectal and breast cancers. Several randomized studies have supported the increase in response rates seen in the uncontrolled trials but additional studies are required to demonstrate a positive impact on the survival of treated patients. PMID- 3279913 TI - [Enhancement of antitumor effects by the combination of cytotoxic agents and cytokines]. AB - The characteristics and feasibility of combination therapy of cytotoxic agents and cytokines were discussed from the theoretical as well as experimental basis. The content was divided into two parts depending upon requirements and elements for tumor cells to proliferate. One was concerning the in vitro conditions in which tumor cells were supplied all of them sufficiently. The other was concerning the host conditions in which cells were not necessarily supplied all of them freely and sufficiently. On the basis of characteristic tumor cell and host modifications achieved through receptor binding of cytokines, the combination of cytotoxic agents with cytokines, particularly with interferons, would produced the therapeutic effects that are distinct from those produced by the combination among cytotoxic agents. The clinical and experimental findings were reviewed and summarized along with this proposal. PMID- 3279912 TI - [Current studies of sequential methotrexate and 5-fluorouracil treatment in cancer chemotherapy]. AB - This paper reviews the data on the clinical studies of sequential methotrexate and 5-fluorouracil in advanced colorectal, gastric, head and neck, and breast cancer. To date, a lot of phase II studies have been conducted, but there are many distance in each clinical data concerning response rate and side effect by the difference between their clinical methods with respect to the interval between methotrexate and 5-fluorouracil, or the dosage of each drugs. There are several reports with high response rate in those phase II studies, but randomized controlled studies recently reported have not yet confirmed the sequential effect of MTX-5-FU treatment. Therefore, it is concluded that the randomized controlled studies with the most available methods must be performed to evaluate the true efficacy of sequential methotrexate and 5-fluorouracil treatment. PMID- 3279914 TI - [An anticancer drug--carboquone]. AB - Carboquone (CQ) is an anticancer alkylating agent synthesized and developed by Arakawa et al. (Sankyo Co, Ltd.) in 1970, having chemical structure, 2,5-bis-(1 aziridinyl)-3-(2-carbamoyloxy-1-methoxyethyl)-6-methyl- 1,4- benzoquinone. The antitumor efficacies of CQ were reported as excellent, however, the side effects are considerably strong. For the purpose to increase the effectiveness and to eliminate the side effect, various treatment regimen with CQ have been reported. Combination chemotherapies including CQ and cis-Platinum etc. have been reported to increase the antineoplastic activity and CQ combined with immunopotentiator or prednisone have been reported to diminish the side effects. The regimens of PPQ therapy in our department is as follows. CQ is given 7 mg/m2 iv on day 1; cis Platinum 20 mg/body, drip infusion on day 1-5. Prednisone 3.0 mg p.o. on day 1-5. The response rate found in this regimen was about 30% so far. Antitumor spectrum of this drug has been reported to become broad. PMID- 3279915 TI - Is neonatal cerebral ultrasound just for the voyeur? PMID- 3279916 TI - Surfactant treatment and incidence of intraventricular haemorrhage in severe respiratory distress syndrome. AB - As part of a multicentre study of porcine surfactant administration in respiratory distress syndrome, 29 babies weighing 2000 g or less were studied in the neonatal intensive care unit of the Royal Maternity Hospital, Belfast. Fourteen babies of a mean gestational age of 28.1 weeks were randomly allocated to the treatment group (200 mg/kg phospholipid given intratracheally) and 15 babies of a mean gestational age of 28.7 weeks formed the control group. All babies had severe respiratory distress syndrome (oxygen requirement over 60%, mechanical ventilation, and age 15 hours or less). Almost immediate improvement in oxygenation was seen in the treated group so that oxygen concentrations could be reduced and remained significantly lower than those of control babies for the first seven days of life. Alveolar-arterial oxygen gradients were also significantly different for the first five days after treatment. More babies in the treatment group survived (79% v 40%) but the difference was not significant. The incidence of pneumothorax and of intraventricular haemorrhage, however, was significantly lower in treated babies compared with controls. For babies weighing less than 1200 g the risk of developing or extending intraventricular haemorrhage after entry to the study was also reduced in the treatment group (29% v 100%). PMID- 3279917 TI - Infective endocarditis in neonates. AB - Five patients with neonatal infective endocarditis were reviewed, two of whom survived. Infection was caused by Staphylococcus aureus in four and by Candida albicans in one. All cases of bacterial endocarditis had clinical signs of septicaemia, positive blood cultures, thrombocytopenia, microscopic haematuria, and heart murmurs. Three developed skin abscesses early in their illnesses. Three patients had two dimensional echocardiographic studies that showed bacterial vegetations. One of these studies was done before the heart murmur could be heard. We suggest that echocardiography in conjunction with the clinical picture described may help in making an early diagnosis of endocarditis in neonates. PMID- 3279918 TI - Patient triggered ventilation in premature neonates. AB - Patient triggered ventilation using oesophageal pressure changes was assessed in eight premature neonates. Respiratory activity was reliably recorded and positive pressure inflation occurred synchronously with inspiration. Peristalsis resulted in only minimal interference. During patient triggered ventilation, inflating volume and oxygenation increased significantly compared with periods of conventional ventilation. PMID- 3279919 TI - Ultrasound diagnosis of nephrocalcinosis in preterm infants. AB - The incidence of nephrocalcinosis in very low birthweight (less than 1500 g) premature infants was assessed by ultrasound scan and analysis of urine. Three of 36 infants had nephrocalcinosis. All had been receiving long term frusemide for bronchopulmonary dysplasia with simultaneous fluid restriction. Urinary investigations showed no consistent findings in babies with nephrocalcinosis. PMID- 3279920 TI - Maternal depression and impact on children's development. PMID- 3279921 TI - Immunisation for the immunosuppressed child. PMID- 3279922 TI - The highly talented child. PMID- 3279923 TI - End stage renal failure: 14 years' experience of dialysis and renal transplantation. AB - One hundred and thirteen children (59 boys and 54 girls aged from 2 to 16 years) with end stage renal failure entered the renal dialysis and transplantation programme between 1972 and 1983. They were followed up until December 1985. Ninety eight children were initially treated by haemodialysis in hospital and 15 by renal transplantation. The average wait on dialysis was seven months (range 0.1-43 months). One hundred and six children were given 129 renal transplants, 32 of which were from living related donors. At the end of 1985 94 of the 113 patients (83%) were alive, 81 (72%) with functioning grafts, 11 (10%) were receiving haemodialysis in hospital, two (1%) were being treated by continuous ambulatory peritoneal dialysis, and three had been lost to follow up. The 14 years actuarial survival was 81%. Four patients receiving dialysis and 12 who had received transplants died, a mortality of 14%. The main complications of treatment were retardation of growth in 49 (43%), hypertension in 75 (66%), and osteopathy in 36 (32%). Retardation of growth could not be reversed by successful renal transplantation. Seventy two patients (88%) assessed their health as good to excellent, and 9 (12%) as poor. Patients with a functioning graft did much better than those receiving dialysis. Treatment of end stage renal failure led to full rehabilitation in most patients, and renal transplantation was more effective than dialysis. PMID- 3279925 TI - Improved diabetic control in a district general hospital clinic. AB - A clinic for diabetic children was established in 1983 in a district general hospital to coordinate the changeover to a standard 100 unit insulin regimen. The children's progress was monitored for the next three years. Glycated haemoglobin A1 (HbA1c), measured at the same time each year, fell from a mean (SD) of 15.8 (4.7)% to 9.9 (2.6)% over the three years. A similar degree of improvement was seen when newly diagnosed patients were excluded from the analysis. This improvement was associated with a rise in mean (SD) insulin dosage from 0.89 (0.29) U/kg/day to 1.17 (0.35) U/kg/day. Good control was achieved more easily in children who had been diabetic for less than two years and in those who were prepubertal (particularly boys). A combination of isophane and soluble insulin appeared to be more effective than zinc and soluble insulin in maintaining good control. Ten complications of diabetes were noted in eight patients from 5.2 to 12.4 years after diagnosis. These results show that setting up a diabetic clinic for children in a district general hospital had a beneficial effect on the quality of diabetic control and such improvement may help to reduce the incidence of diabetic complications. PMID- 3279924 TI - Observation of spontaneous respiratory interaction with artificial ventilation. AB - To compare the accuracy of clinical observation and detailed respiratory recordings in identifying infants at high risk of developing pneumothoraces 10 infants, with idiopathic respiratory distress syndrome, were studied at three different ventilator rates. All infants with synchronous respiration at fast rates were correctly identified by clinical observation. The clinical signs used to identify 'high risk' interactions--that is, active expiration and asynchronous breathing--were obvious respiratory efforts and a failure of improvement in oxygenation at increased rates. These criteria enabled correct identification of 'high risk' respiratory patterns on 15 (88%) of the 17 study occasions. These clinical criteria were then used as criteria for selective paralysis; no infant developed a pneumothorax during ventilation. PMID- 3279926 TI - Dry lung syndrome after oligohydramnios. AB - We studied four infants whose mothers had had leaks of amniotic fluid for varying periods before birth. Three were associated with compression deformities. Oxygenation was achieved only by overriding the pressure limit safety devices on the resuscitation apparatus and ventilating after birth with high inflation pressures. In all cases the ventilation pressures had to be further increased for 12 hours but rapid improvement followed on the second day so that all four were spontaneously breathing air after a few days. It is postulated that collapse of the airways resulted from oligohydramnios, and that the resulting 'dry lungs' would only respond to high inflation pressures. PMID- 3279927 TI - Severe combined immunodeficiency syndrome, tissue transplant, leukaemia, and Q fever. AB - A child born with severe combined immunodeficiency, who was immunoreconstituted by a fetal liver and thymus transplant, developed acute lymphoblastic leukaemia in the donor cell line. During remission she contracted acute Q fever, which gave rise to unexpected complications. Early treatment of the Q fever might have altered the subsequent events and prevented her death. PMID- 3279928 TI - Conductive education. PMID- 3279930 TI - Hidden foreign body as a cause of recurrent hemoptysis in a teenage girl. AB - Hemoptysis in a teenage girl caused by a foreign body located in the posterior segment of the left lower lobe is described. The patient was seen four years after the initial inhalation. The importance of taking a meticulous history and the use of computed tomography in the localization of the lesion are emphasized, and the use of the fiberoptic bronchoscope in peripheral lesions and in the investigation of hemoptysis is discussed. PMID- 3279929 TI - Chondrosarcoma metastatic to the heart. AB - This review summarizes the clinical manifestations and results of treatment of chondrosarcoma metastatic to the heart. Including the patient in the present report, a total of 18 patients have been reported. The most common site of cardiac metastasis was the right atrium. Dyspnea and pleuritic chest pain were the most common symptoms associated with cardiac metastases. The median time from the initial diagnosis of primary chondrosarcoma to death was 36 months, and the median time from the initiation of cardiac symptoms to death was 2 months. Treatment of primary chondrosarcoma included local radical resection in 14 patients. Treatment of cardiac metastases consisted of palliative support in 13 patients and surgical resection in 5 patients. Median survival following the development of cardiac symptoms was 2 months for patients treated nonsurgically and 18 months for those who underwent resection of cardiac metastases. The longest survival (24 and 28 months) was obtained in 2 patients with metastases confined to the heart that were successfully resected soon after development of cardiac symptoms. These results suggest that surgical resection of cardiac metastases in patients without widespread other metastases can result in substantial prolongation of life. PMID- 3279931 TI - Reexpansion pulmonary edema. AB - Unilateral reexpansion pulmonary edema (RPE) is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. Although RPE generally is believed to occur only when a chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid, in this review 15 of 47 cases of RPE available for assessment occurred when the pulmonary collapse was of short duration or when the lung was reexpanded without suction. The pathogenesis of RPE is unknown and is probably multifactorial. Implicated in the etiological process of RPE are chronicity of collapse, technique of reexpansion, increased pulmonary vascular permeability, airway obstruction, loss of surfactant, and pulmonary artery pressure changes. Since the outcome of RPE was fatal in 11 of 53 cases reviewed (20%), physicians treating lung collapse must be aware of the possible causes and endeavor to prevent the occurrence of this complication. PMID- 3279932 TI - Diagnosis and correction of anomalous pulmonary venous return. PMID- 3279934 TI - The 20th Walter J. Zeiter lecture. Trends in delivery and funding of postacute care. PMID- 3279933 TI - Vena cava filter and renal transplant. PMID- 3279935 TI - Myofascial pain syndromes: where are we? Where are we going? AB - In recent years, research activity related to myofascial pain syndromes due to trigger points (TrPs) has blossomed. This paper introduces and relates the presentations made in a symposium entitled "Myofascial Pain Syndromes: Where are we? Where are we going?" at the 47th Annual Assembly of the American Academy of Physical Medicine and Rehabilitation in Kansas City October 2, 1985. It summarizes a number of recent research advances and key research issues related to myofascial pain syndromes: 1. Thermography appears valuable for imaging the reflex thermal tracks of previously identified TrPs. 2. Three new devices are reported to measure reliably the pressure threshold for pain of TrPs and tender points (TePs). 3. Fibrositis/fibromyalgia and myofascial pain syndromes may or may not be separate entities. The question needs to be resolved. 4. New evidence strongly supports previous indications that a TrP is a region of increased energy consumption with an inadequate oxygen supply. 5. A foundation has been established for investigating the sensitizing agent(s) responsible for the increased sensitivity of TrPs and muscular TePs. 6. At least four mechanisms can account for the pain referred by TrPs in muscles. The convergence-projection mechanism appears to be consistently present in visceral pain pathways and to be likely in mammalian muscle nociceptive pathways. PMID- 3279936 TI - Effects of muramyl dipeptide and core body temperature on peritoneal bacterial clearance. AB - To examine the interaction between muramyl dipeptide (MDP) and core body temperature in murine peritonitis, 120 Sprague-Dawley rats were randomized to receive either 0, 1, or 4 micrograms/g body weight of MDP. Twenty-four hours later a sublethal intraperitoneal inoculation of Escherichia coli was given after core body temperature regulation at 32 degrees C to 40 degrees C, which was maintained for 30 minutes. Killing of the rats at 1, 3, or 6 hours later allowed evaluation of peritoneal white blood cell and bacterial counts. Results demonstrated that MDP (independent of core body temperature) caused an increased peritoneal white blood cell response at one and six hours and an increased peritoneal bacterial clearance at three hours. Increasing core body temperature adversely affected peritoneal bacterial clearance. High-dose MDP was clearly significant in acceleration of peritoneal bacterial clearance. No interaction between MDP and core body temperature was seen. PMID- 3279937 TI - Use of ultrasonographic risk score in the timing of operative intervention for acute cholecystitis. AB - Timing of operative intervention for acute cholecystitis has long been a subject of debate. However, actual or impending perforation constitutes an absolute indication for prompt operative intervention. To discriminate these cases from those undergoing observation with conservative treatment, clinical and ultrasonographic findings were reviewed and analyzed in 17 patients with acute cholecystitis. Specificity, sensitivity, and accuracy of ultrasonography in discriminating cases of acute cholecystitis, in terms of timing of operative intervention, were calculated retrospectively based on the operative findings. The risk score for each ultrasonographic finding was determined, and the total risk score was calculated for each patient. The calculated total risk score was found to be well correlated with the macroscopic appearance of the gallbladder at operation in cases of acute cholecystitis. Therefore, this score should be useful in determining the timing of operative intervention for acute cholecystitis. However, the usefulness of the variables should further be established prospectively in other patient populations. PMID- 3279938 TI - A comparative immunofluorescent study of fixed decalcified tissue and frozen non decalcified tissue from the guinea pig cochlea. AB - The immunofluorescence test (IF) is an important diagnostic laboratory tool for detecting immune-mediated sensorineural hearing loss (SNHL). The results of applying the IF to ethanol-fixed, paraffin-embedded, decalcified sections of guinea pig cochlea as compared with frozen non-decalcified preparations are presented. Sera from ten patients with SNHL were tested in addition to antibody positive and negative human serum controls. Despite fixation and prolonged decalcification, deparaffinized cochlear sections showed a strong positive reaction with most of the positive serum controls. Anti-endothelial antibodies were detected in the serum of one patient and anti-nuclear antibodies in another. The fine cochlear structure was clearly delineated. However, the decalcified specimens failed to react with one serum model, which revealed a positive fluorescence when incubated with the frozen non-decalcified cochlear preparations. These latter findings denote possible leaching of the antigenic material from the sections. This study further shows that frozen nondecalcified cochlear tissue is a reliable tissue source for the interpretation of the results obtained with IF. PMID- 3279939 TI - The effect of an orally administered proteolytic enzyme on the elasticity and viscosity of nasal mucus. AB - We have evaluated the effect of serratiopeptidase (SER), a proteolytic enzyme, on the elasticity and viscosity of the nasal mucus in adult patients with chronic sinusitis. SER was administered in a dose of 30 mg/day orally for 4 weeks. Nasal mucus was collected from the nasal cavities of each patient before (week 0) and 4 weeks after the start of the medication (week 4). The storage modulus (G') and the dynamic viscosity (eta') of each specimen of nasal mucus were determined by an oscillating sphere magnetic rheometer at frequencies of 0.5, 1, 5, 10 and 20 Hz at a constant temperature of 25 degrees C. The dynamic viscosity (eta') of the mucus at week 4 was significantly lower than that at week 0 (at frequencies of 5, 10 and 20 Hz). No significant differences were observed in the storage modulus (G') between the mucus at week 0 and week 4. SER reduced the viscosity but not the elasticity of the nasal mucus. These findings are discussed in relation to mucociliary clearance. PMID- 3279940 TI - The epidemiology of malignant neoplasms of the nasal cavities, the paranasal sinuses and the middle ear in Canada. AB - Canadian patterns of morbidity and mortality from malignancies of the nasal cavities, the paranasal sinuses and the middle ear for the periods 1970-1980 and 1970-1984 have been examined. Age-standardized morbidity rates have not changed significantly during 1970-1980 for either males (P = 0.65) or females (P = 0.96). Analysis of age-specific morbidity rates revealed that rates of change for male rates have also remained stable during this period for all age groups studied (P greater than 0.29). For females, rates of change for seven of eight age groups examined also failed to achieve statistical significance (P greater than 0.30). However, rates for females aged 45-54 have shown an increase of 0.35 additional new cases per 1,000,000 population per year. This finding is of borderline significance (P = 0.051). In contrast, age-standardized mortality rates have declined significantly during 1970-1984 by, on average, 0.08 and 0.07 fewer deaths per 1,000,000 population per year in males and females respectively. Analysis of age-specific mortality rates reveals that the declines in mortality are attributable to significant reductions in age-specific rates for males aged 65-74 and 85+ and females aged 0-24, 55-64, and 85+. In these groups rates have declined by as much as 4.1 fewer deaths per 1,000,000 population per year (P less than 0.045). PMID- 3279941 TI - Insulin therapy induces antiatherogenic changes of serum lipoproteins in noninsulin-dependent diabetes. AB - To study the effects of rigorous insulin therapy on serum lipoproteins in patients with noninsulin-dependent diabetes not controlled with oral agents only, we measured serum lipoproteins, apoproteins, lipolytic enzymes, and glucose disposal using an insulin clamp technique before and after 4 weeks of insulin therapy. Lipoproteins were isolated by ultracentrifugation and high density lipoprotein (HDL) subfractions, by rate-zonal density gradient ultracentrifugation. The group included 11 women and eight men (age 58 +/- 1 years and RBW 125 +/- 4%). Body weight, glycosylated hemoglobin, mean diurnal glucose, plasma free insulin, and glucose uptake (M-value) were 75 vs. 76 kg; 11.9 vs. 8.9%; 234 vs. 124 mg/dl; 12 vs. 27 microU/ml; and 5.0 +/- 0.4 vs. 7.1 +/ 0.6 mg/kg/min before and after insulin therapy, respectively. After insulin therapy there was a decrease of very low density lipoprotein (VLDL) triglyceride (-60%, p less than 0.001) but an increase of HDL2 cholesterol (+21%, p less than 0.001); HDL2 phospholipids (+38%, p less than 0.001); HDL2 proteins (+23%, p less than 0.01); and HDL2 mass (127 +/- 11 vs. 158 +/- 12 mg/dl, p less than 0.001). There was a decrease of HDL3 cholesterol (-13%, p less than 0.05); HDL3 phospholipids (-16%, p less than 0.05); HDL3 proteins (-18%, p less than 0.001); and HDL3 mass (179 +/- 6 vs. 146 +/- 6, p less than 0.01). Zonal profiles showed a redistribution of particles from HDL3 to HDL2. Serum apo A-I increased (p less than 0.05), apo A-II remained constant, but apo B decreased (-29%, p less than 0.001). The most marked change during insulin therapy was a 2.3-fold increase in adipose tissue lipoprotein lipase (LPL) activity (p less than 0.001). The changes of VLDL and HDL subfractions were not explained by respective changes of the blood glucose, free insulin, or M-value. The data indicate that intensive insulin therapy induces antiatherogenic changes in serum lipids and lipoproteins and suggest that the induction of LPL by insulin is the major factor responsible for redistribution of HDL particles from HDL3 to HDL2. PMID- 3279942 TI - Adapted formulae: an up-to-date revision of ESPGAN recommendations. European Society for Pediatric Gastroenterology and Nutrition. PMID- 3279943 TI - Requirements of carbohydrates, lipids and minerals in low-birth-weight infants. PMID- 3279944 TI - Requirement and role of essential fatty acids during brain development. PMID- 3279945 TI - Evaluation of nutritional health. PMID- 3279946 TI - Iron nutrition in infancy. PMID- 3279947 TI - Nutritional problems related to diagnostic and therapeutic elimination diets. PMID- 3279948 TI - Fine mapping of an Alzheimer disease-associated gene encoding beta-amyloid protein. AB - We have sublocalized an Alzheimer Disease-associated gene, which encodes for cerebrovascular beta-amyloid protein, to the region from the centromere through the proximal half of band 21q21 using both somatic cell and in situ mapping techniques. In addition we found repeatedly significant but weaker hybridization of the beta-amyloid protein probe to the short arm of chromosome 20. 794 cells were analyzed from whole blood, lymphoblastoid and skin cultures. The latter two types of cultures had parts of the 21st chromosome translocated to other chromosomes facilitating sublocalization. PMID- 3279950 TI - Stimulation of aromatase activity in immature porcine Leydig cells by fibroblast growth factor (FGF). AB - The effects of fibroblast growth factor (FGF) on testicular aromatase activity has been studied using primary cultures of porcine Leydig cells. After culture for 3 days in the absence or presence of FGF, the ability of the cells to produce estrogen was examined in a 4h-test period in which either (a) hCG (10(-9) M) or (b) androstenedione (3 x 10(-6) M) was added to the medium. FGF produced a 3- to 20-fold increase in estrogen formation from endogenous or exogenous substrate during the test period, in spite of a marked decrease (approximately equal to 60%) in [125I]-hCG binding and no significant change in testosterone concentration. Stimulation of estrogen secretion by FGF was dose-(ED50 approximately equal to 2 ng/ml) and time-dependent, the first and maximal effects were observed after 12h and 48h, respectively. Preliminary tests with several other factors (insulin, EGF, TGF-beta, FSH and hCG) showed that hCG alone directly stimulated aromatase activity. From these findings a role is suggested for FGF as a paracrine/autocrine agent in the control of estrogen secretion by Leydig cells. PMID- 3279949 TI - Heterogeneity of human liver, muscle, and adipose tissue insulin receptor. AB - We have studied the structure and function of the human insulin receptor in liver, skeletal muscle and adipose tissue. The alpha-subunit of the insulin receptor for liver, muscle and adipose tissue migrated on SDS-PAGE with Mrs 137632 +/- 216, 134034 +/- 1080, and 133575 +/- 165, respectively (p less than 0.05). Treatment of these receptors with neuraminidase decreased their molecule sizes and eliminated the relative size differences between the receptors. Three monoclonal antibodies (5A1, 10D9, and 20H3), directed towards different epitopes of the human insulin receptor alpha-subunit were used to probe immunological differences among the receptors. Antibodies 5A1 and 20H3 recognized all the receptors, whereas 10D9 recognized muscle and adipose tissue receptors but not liver receptors. The mobility of insulin receptor beta-subunit in the absence of insulin was the same in all tissues with a similar phosphorylation-induced decrease in mobility in SDS-PAGE in the presence of insulin. However, insulin stimulated autophosphorylation per receptor was different being greatest (p less than 0.05) in muscle (334 +/- 104 32P cpm) and similar in adipose tissue (114 +/- 10) and liver (183 +/- 68). These studies indicate, therefore, that the human insulin receptor is heterogeneous among the major target tissues for insulin, and raise the possibility that this heterogeneity may account for tissues' specific differences in insulin's biological messages. PMID- 3279951 TI - Biosynthesis of biopterin. Studies on the mechanism of 6 pyruvoyltetrahydropteridine synthase. AB - [1'-3H]- and [2'-3H]dihydroneopterin triphosphate (NH2TP) were prepared enzymatically from [4-3H]- and [5-3H]glucose and converted to tetrahydrobiopterin (BH4) by an extract from bovine adrenal medulla. The formation of BH4 from both [1'-3H]- and [2'-3H]-NH2TP proceeds with virtually complete loss of the respective tritium label. The breaking of the CH-bond at C-1' is characterized by a kinetic isotope effect of 2.6 +/- 0.5. A smaller kinetic isotope effect of 1.5 +/- 0.2 was found for the breaking of the CH-bond at C-2'. PMID- 3279952 TI - Inhibition of cathepsin L-induced degradation of epidermal growth factor receptors by c-Ha-ras gene products. AB - The inhibitory activities of c-Ha-ras gene products (p21s) toward several cysteine proteinases have been investigated. The activity of cathepsin L was inhibited by p21s most effectively while those of cathepsin B and papain were slightly inhibited by p21s. p21s did not show any inhibitory activity toward cathepsin H. In order to connect the protease-inhibitor activity of p21s with cell growth, the degradation of epidermal growth factor receptors (EGF-receptors) was investigated. EGF-receptors were preferentially cleaved by cathepsin L but not by cathepsin B or H. The cleavage of EGF-receptors by cathepsin L was inhibited by p21s dose-dependently. These results raise the possibility that p21s can suppress the degradation of growth-related proteins such as EGF-receptors and thereby affect cell growth. PMID- 3279953 TI - Viruslike particles containing knob-associated histidine-rich protein are secreted into the culture medium of Plasmodium falciparum in vitro cultures. AB - This report describes the isolation of a viruslike particle from in vitro cultures of the human malaria parasite P. falciparum. Electronmicroscopic observations suggest that the particles are liberated into the culture medium by budding from the erythrocyte membrane. The density of the free particles is 1.16, they contain nucleic acid and two distinct molecular species of the knob associated Histidine-rich protein. Proteins of the particles are recognized by sera from malaria patients. The previously described knobs may correspond to viral coats inserted in the membrane. PMID- 3279954 TI - Electric field effects on the virus M13, detected by electro-optical measurements. AB - We have carried out transient electric birefringence experiments with M13 in aqueous solution. A normal effect with a negative sign is superimposed by anomalous positive effects. These prevail more and more upon raising the field strength. They apparently reflect electrically induced structural transitions. The threshold field strength decreases when buffer and/or electrolyte is removed. PMID- 3279955 TI - T-2 toxin inhibits mitochondrial function in yeast. AB - T-2 toxin inhibits oxygen consumption of whole cells and purified mitochondria of Saccharomyces cerevisiae. Inhibition of mitochondrial respiration is not relieved by 2, 4-dinitrophenol, indicating that T-2 toxin inhibits mitochondrial function at the level of the electron transport chain. T-2 toxin inhibition of state 3 respiration (with succinate) is overcome by N, N, N', N'-tetramethyl-p phenylenediamine, indicating inhibition of site II of the electron transport chain. T-2 toxin inhibits mitochondrial succinate dehydrogenase activity and increases mitochondrial NADH dehydrogenase activity. PMID- 3279956 TI - Development of immunoreagents to ciliary zonules that react with protein components of elastic fiber microfibrils and with elastin-producing cells. AB - We describe the generation of a monoclonal antibody library to ocular zonule components and the characterization of three monoclonal antibodies: 1) one specific for microfibrillar associated glycoprotein (MAGP), a component of both ocular zonules and microfibrils of elastin fibers, 2) an antibody to an as yet unidentified 70,000 dalton antigen that is present in abundance in the extracellular matrix (ECM) of elastin-producing cells, and 3) an antibody reacting with the 67000 dalton subunit of the elastin receptor. The presence of antigenic determinants common to the ocular zonule and elastic fiber microfibrils suggests that zonules, which can be obtained in relatively pure form, can provide a valuable resource for characterizing proteins common to both microfibrillar structures. PMID- 3279957 TI - Structure determination of a human lymphocyte derived neutrophil activating peptide (LYNAP). AB - Phytohemagglutinin or Concanavalin A-stimulated human T-lymphocytes produce a factor (LYNAP) with potent chemotactic and enzyme degranulating activity in peripheral human neutrophils. Sequence analysis of LYNAP established an apparently novel 72 residue polypeptide structure. Examination of protein data bases showed that LYNAP had about 30% sequence homology with recently characterised connective tissue activating proteins produced by platelets. Furthermore, it was subsequently found that the amino acid sequence is largely the same as that predicted from a cDNA clone derived from mRNA elevated in peripheral human leukocytes stimulated by mitogens. PMID- 3279958 TI - Sensory transduction in bacterial chemotaxis involves phosphotransfer between Che proteins. AB - The CheA protein of the Salmonella typhimurium chemotaxis system is phosphorylated by ATP. Phospho-CheA transfers its phosphoryl group to a second chemotaxis protein, CheY. Unlike phospho-CheA, phospho-CheY is relatively unstable, rapidly decaying to phosphate and CheY. We propose that phosphorylation of CheY may play a role in its function as a tumble regulator to control motor behavior in response to attractant and repellent stimuli. PMID- 3279960 TI - Effect of arginine and glucagon on perifused purified beta cells. AB - The secretory response of purified beta cells was studied employing a newly developed microperifusion technique. In control experiments, initial high insulin release up to 50 minutes followed by a steady state basal level was observed up to five hours. The changes in hydrodynamic pressure of perifusion produced small, statistically non-significant fluctuations in the insulin release in succeeding two samples of effluent. Pulse stimulation of the purified beta cells with arginine 10 mM and 20 mM produced a biphasic secretory response. The total insulin secretion with arginine (1, 5, 10, or 20 mM) was concentration dependent. Glucagon (1, 5, 10, or 20 nM) produced concentration dependent stimulation of insulin secretion. The results of these studies indicate that the secretory responses of the purified beta cells could be studied employing the microperifusion technique described in this report. The purified beta cells respond to arginine and glucagon with increased insulin secretion as observed in microperifusion and static incubation studies (1, 2). PMID- 3279959 TI - Transthyretin is synthesized in the mammalian eye. AB - Transthyretin (TTR, prealbumin) is a 55 kDa protein which plays an important role in the plasma transport of thyroxine and retinol. Although the liver and choroid plexus are the two major known sites of TTR synthesis, several lines of evidence suggest the possibility of a separate ocular source of TTR. We report the presence of TTR mRNA in rat and bovine eye and of TTR in rat eye. Preliminary immunohistochemical data indicate that the retinal pigment epithelium is a major site of TTR immunoreactivity in the rat. While the functional significance of ocular TTR synthesis is unclear, TTR may be involved in the ocular translocation and processing of retinol. The finding of TTR synthesis in the eye may explain ocular involvement in the familial amyloidotic polyneuropathies. PMID- 3279961 TI - Erythrocyte complement receptor type 1, immune complexes, and the rheumatic diseases. PMID- 3279962 TI - Long-term prospective trial of low-dose methotrexate in rheumatoid arthritis. AB - Twenty-six patients with severe rheumatoid arthritis who had completed a randomized crossover trial of methotrexate elected to continue to receive the drug in a long-term prospective study. At 36 months, 16 patients remained in the study. Over this period of time, significant improvement was noted in the number of painful and swollen joints, physician and patient global assessments, erythrocyte sedimentation rate, and prednisone dose. Adverse reactions occurred in 16 patients (62%), including nausea, alopecia, headache, stomatitis, herpes zoster, and diarrhea. Mild leukopenia (3 patients), thrombocytopenia (3 patients), and elevated transaminase levels (8 patients) resolved with temporary drug discontinuation. No patient withdrew due to drug toxicity. Liver biopsy specimens in 17 patients after 24 months of treatment showed no evidence of fibrosis or cirrhosis. A significant increase in the percentage of T3 and T4 blood cells and increases in lymphocyte proliferation to concanavalin A and purified protein derivative of tuberculin were found after 2 years of therapy. Our findings indicate that methotrexate has remained effective over 36 months of therapy, with acceptable toxicity levels and no evidence of systemic immunosuppression. PMID- 3279964 TI - Evidence that a humoral immune response to autologous cartilage proteoglycan can participate in the induction of cartilage pathology. AB - We examined antiproteoglycan antibodies as an autoimmune response for induction of synovitis. This hypothesis was studied by monitoring humoral antiproteoglycan antibody following IgG induction of experimental immune synovitis, localization in the articular cartilage of an autologous immune response, and loss of proteoglycan from cartilage following intravenous administration of antiproteoglycan monoclonal antibodies. The data support the hypothesis that autoimmunity to cartilage macromolecules may play a role in the etiopathogenesis of arthritis. PMID- 3279963 TI - The AI/RHEUM knowledge-based computer consultant system in rheumatology. Performance in the diagnosis of 59 connective tissue disease patients from Japan. AB - AI/RHEUM is a knowledge-based computer consultant system for the diagnosis of rheumatic diseases. Its diagnostic accuracy was evaluated using information that was supplied by Japanese rheumatologists on 59 patients with connective tissue diseases. The diagnoses of the AI/RHEUM model were in full or partial agreement with those of the Japanese rheumatologists in 54 of 59 cases (92%). Preliminary evaluation of the criteria tissue disease showed a sensitivity of 90% and a specificity of 96%. PMID- 3279965 TI - Degenerative spondylolisthesis, synovial cyst of the zygapophyseal joints, and sciatic syndrome: report of two cases and review of the literature. AB - Two cases of sciatica secondary to nerve root compression by a "synovial cyst" of a zygapophyseal joint are described. In light of these 2 cases and on reviewing the literature, it appears that zygapophyseal joint osteoarthritis with degenerative (or articular) spondylolisthesis can be a predisposing factor to the formation of such synovial expansions and, consequently, the cause of nerve root compression. The coexistence of a lumbar degenerative spondylolisthesis with a radicular syndrome should therefore encourage early investigation by computed tomography scan, so that conservative treatment would not be unnecessarily prolonged. PMID- 3279966 TI - Simvastatin (MK-733): a potent cholesterol synthesis inhibitor in heterozygous familial hypercholesterolaemia. AB - Simvastatin (MK-733), a new inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, was administered to 38 patients with heterozygous familial hypercholesterolaemia for 24 weeks. A dose of 40 mg per day produced a mean reduction in low density lipoprotein cholesterol of 43-45% and in triglycerides of 21-31%. Mean high density lipoprotein cholesterol increased significantly by 10-13%. There were no major differences in response whether the drug was taken in one or two doses. MK-733 was tolerated well. Adverse effects were infrequent and limited to slight increases of alanine aminotransferase, creatine phosphokinase and bilirubin. This drug appears to be a potent inhibitor of cholesterol synthesis and has produced the largest therapeutic response as monotherapy in patients with familial hypercholesterolaemia. PMID- 3279967 TI - Variations in lipoproteins, hormones and blood glucose during the early acute phase of myocardial infarction. AB - This study reports on 22 patients (18 men, 4 women), 45-83-year-old admitted to hospital less than 24 h after the first clinical signs of myocardial infarction. Lipids, lipoproteins, serum insulin and growth hormone, urinary cortisol and vanillylmandelic acid and blood glucose were analysed on the day of admission (day 1) and on days 2, 4 and 8 of the acute phase. Results for lipoproteins generally confirm those of earlier studies: lowered total cholesterol (day 1-8), LDL-cholesterol (day 1-2), HDL-cholesterol (day 2-8), LDL apo B (day 1-2) and apo A-1 (day 1-8). There was no significant correlation between stress hormone and plasma lipoprotein alterations. Blood glucose decreased progressively (P less than 0.05) between day 1 and day 8. Glucose value at day 1 correlated significantly with nonesterified fatty acids, total cholesterol and LDL constituents, but not with HDL-cholesterol and apo A-1. Metabolic disturbances modifying blood glucose thus might be involved in LDL changes, whereas other processes govern HDL changes. PMID- 3279969 TI - Decrease in LDL and increase in HDL concentrations in type II hyperlipoproteinaemic patients on low-dose combination therapy of cholestyramine and Complamin. AB - A low-dose combination of Complamin retard (1 g t.i.d.) and cholestyramine (4 g b.i.d.) was compared with each agent alone in 2 serial open trials without dietary restriction using type IIa and IIb hyperlipoproteinaemic patients. Complamin alone produced decreases in LDL and VLDL cholesterol concentrations (up to 20%) whereas cholestyramine alone produced only a modest reduction in LDL (up to 15%). The combination produced marked, progressive reductions in total cholesterol (up to 35%) and LDL (up to 40%); reductions in VLDL (up to 45%), total triglyceride (up to 60%) and free fatty acids (up to 60%) were found only in type IIb patients. The average increase in HDL-cholesterol from the 2 studies for combination therapy was 35%. No side-effects were reported or measured and compliance was excellent. The results demonstrate the potential of a method of achieving beneficial actions on lipoprotein levels with a well-tolerated therapy. PMID- 3279968 TI - Effects of acipimox on serum lipids, lipoproteins and lipolytic enzymes in hypertriglyceridemia. AB - Two separate studies were carried out with acipimox, a new antilipolytic agent with long-lasting activity. First, in a randomized, double-blind, cross-over study a dose of 750 mg/day of acipimox versus placebo was employed for 60 days in 11 patients with type IV hyperlipoproteinemia. Mean plasma triglyceride levels were reduced after acipimox compared to placebo (434 +/- 60 vs 777 +/- 224 mg/dl, P less than 0.01). Serum total cholesterol fell also significantly after acipimox compared to placebo. No significant alteration was observed in the HDL2/HDL3 ratio or in the concentration or composition of the HDL subfractions. Six patients with severe hypertriglyceridemia (2 type IV and 4 type V) and low lipoprotein lipase (LPL) activity took part in a second, open study, lasting for 9 months. Acipimox was given at a dose of 750 mg/day for the first 6 months and 1200 mg/day for the last period. The response of serum total and VLDL triglycerides was inconsistent. HDL cholesterol was significantly raised (+33.3%) after 9 months of treatment due to changes of HDL2 and HDL3 cholesterol, phospholipid and protein concentrations. LPL activity was markedly reduced in adipose tissue at 9 months. No significant changes occurred in postheparin plasma LPL activity. In contrast, hepatic lipase activity showed a reduction of about 25% from 6 months of treatment onwards. PMID- 3279970 TI - A century of practice: occupational health nursing. PMID- 3279971 TI - Antenatal sonographic findings of agenesis of corpus callosum. AB - Agenesis of the corpus callosum is a central nervous system anomaly that may be associated with other intracranial abnormalities. It is easily diagnosed in the postnatal period by computed tomographic scan and ultrasound. However, its prenatal sonographic diagnosis remains a challenge. This report will evaluate three cases of fetal agenesis of the corpus callosum, review the antenatal sonographic findings and postnatal outcomes, and provide criteria for the antenatal diagnosis. PMID- 3279972 TI - Antenatal ultrasound findings in a case of Uhl's anomaly. AB - A case of severe congenital Uhl's anomaly is described. Uhl's anomaly is a rare disorder characterized by near total absence of the right ventricular myocardium. Antenatal ultrasound and echocardiographic findings are presented and the differential diagnosis is discussed. PMID- 3279973 TI - Exercise-induced changes in uterine artery blood flow, as measured by Doppler ultrasound, in pregnant subjects. PMID- 3279974 TI - Exercise-induced changes in uterine artery blood flow, as measured by Doppler ultrasound, in pregnant subjects. AB - Eleven healthy women with singleton pregnancies between 16 and 28 weeks gestation were continuously exercised, in a graded fashion, by stationary bicycle to a predetermined target heart rate. Before and within 3 minutes after exercise, uterine artery waveforms were identified from a semirecumbent position using a 3.5 MHz continuous-wave Doppler transducer coupled to an Angioscan spectrum analyzer. The ratio of peak systolic to end-diastolic frequency (A/B ratio) was utilized to assess qualitative differences in flow before and after exercise. No statistically significant changes in A/B ratios were noted. This study suggests that nonexhaustive maternal exercise does not compromise uterine artery blood flow in healthy, low-risk pregnant subjects. PMID- 3279975 TI - [The symbol and emblem of the medical profession]. PMID- 3279976 TI - Active and inactive forms of hemolysin (HlyA) from Escherichia coli. AB - The HlyA protein (Mr 110 kDa) which is the gene product of the hlyA gene encoded by the hemolysin determinant of Escherichia coli (Goebel, W. & Hedgpeth, J. (1982) J. Bacteriol. 151, 1290-1298) was observed to accumulate in the culture supernatant (in the presence of the three other Hly proteins HlyC, B and D) throughout the active growth cycle. However, the amount of extracellular HlyA protein did not correlate with the external hemolytic activity, which declined when the cells entered the stationary phase. External hemolytic activity was highly sensitive to phospholipase C and to ultrasonication. The size of the HlyA protein on SDS-PAGE was not changed by these treatments although the hemolytic activity was entirely abolished. On a polyacrylamide gel containing 2M urea but only 0.1% SDS hemolytically active HlyA migrated slightly ahead of the inactive HlyA suggesting that HlyA is more negatively charged than HlyA. Active hemolysin from unconcentrated hemolytic supernatants migrated on Sephacryl S-400 and on glycerol gradients as large complexes. Analysis of the hemolytically active fractions on SDS-PAGE yielded in both cases only HlyA (110 kDA) as major protein. An internal hemolytic activity appeared in most Escherichia coli K-12 strains in the stationary phase which was independent of the presence of HlyA or any other Hly gene product. This hemolytic activity which reached in some strains about 10% of the level determined by the hly genes was sensitive to proteinase K and disappeared upon shift of the cells to the logarithmic phase. PMID- 3279977 TI - [Alcohol-sobering drugs--soberly evaluated]. PMID- 3279978 TI - The pathogenesis of acute post-streptococcal glomerulonephritis in new lights. Review article. PMID- 3279979 TI - [Duchenne muscular dystrophy (DMD) in a female with an X-autosome translocation]. PMID- 3279980 TI - [An atypical case of adrenoleukodystrophy (ALD) with frontal lobe syndrome and slow progression]. PMID- 3279981 TI - A survey of patients referred to restorative dentistry clinics. PMID- 3279982 TI - Denture base poly(methyl methacrylate) reinforced with ultra-thin modulus polyethylene fibers. PMID- 3279983 TI - Kubangwa. PMID- 3279984 TI - Computerised teaching of temporomandibular joint dysfunction. PMID- 3279985 TI - Aetiology of malignant hyperthermia. PMID- 3279986 TI - Clinical presentation of malignant hyperthermia. PMID- 3279987 TI - Malignant hyperthermia: biochemical aspects of the acute episode. PMID- 3279988 TI - Malignant hyperthermia. Dantrolene--dynamics and kinetics. PMID- 3279989 TI - Diagnosis of susceptibility to malignant hyperthermia in man. PMID- 3279990 TI - Malignant hyperthermia: relationship to other diseases. PMID- 3279991 TI - Malignant hyperthermia myopathy--a critical review. PMID- 3279992 TI - Malignant hyperthermia. Preoperative assessment of risk factors. PMID- 3279993 TI - Haematogenous dissemination of cells from human renal adenocarcinomas. AB - Estimates were made of the rates at which cancer cells were released directly into the renal vein in patients undergoing radical nephrectomy for primary renal cancer. Cancer cells were counted in blood samples taken from the renal vein using a density gradient centrifugation procedure, and identified using immunocytochemical techniques, on the basis of their cytoskeletal intermediate filament proteins. Cancer cells were released as single cells and multicell emboli in 8/10 patients, in numbers varying widely between 14-7509 emboli ml-1 of blood. Despite a calculated median input into the metastatic process of 3.7 x 10(7) cancer cells per day for at least 180 days, only 3/10 patients had extraperitoneal metastases prior to surgery and only 1 of the remaining disease free patients subsequently developed distant metastases over a maximum 35 month period. These results are discussed in terms of primary tumour kinetics and metastatic inefficiency. PMID- 3279994 TI - Reactivity of monoclonal antibodies to oncoproteins with normal rat liver, carcinogen-induced tumours, and premalignant liver lesions. AB - Monoclonal antibodies to proteins encoded by the ras, myb, myc, erb-B, src and PDGF-2 genes were tested for reactivity with normal rat liver, livers from rats fed with 0.06% 2-acetylaminofluorene (AAF), and premalignant lesions and primary liver tumours from rats given AAF alone or a combined treatment with diethylnitrosamine and AAF. Radioimmunoassays were performed with plasma membrane fractions and total soluble subcellular extracts of the tissues, and immunoperoxidase staining was carried out on frozen tissue sections. All of the antibodies were positive in radioimmunoassays, some more strongly than others, and each antibody bound equally to extracts of different kinds of tissue. Immunohistology revealed significant staining of normal liver by 5 of the 6 antibodies, and only minor qualitative differences of the staining pattern in some tumours and hyperplastic nodules. It was concluded that these antibodies were not able to discriminate sufficiently well between normal, premalignant and malignant rat liver to be of value in identifying the precursor cells of malignant tumours. PMID- 3279997 TI - A randomized trial of maintenance versus no maintenance melphalan and prednisone in responding multiple myeloma patients. AB - In order to assess the role of maintenance melphalan and prednisone (MP) in responding multiple myeloma patients, 185 eligible patients who responded to initial MP with stabilization for at least 4 months were randomized to either stop treatment and resume therapy at relapse or to continue MP until relapse. Time to first relapse was significantly shorter in the no maintenance group (P = 0.0011), however 57% of the no maintenance patients had a second response when MP was restarted and others had minor improvement. The time to final progression on MP, which reflects the duration of disease control by MP, was therefore longer for the no maintenance group (median = 39 months) compared to the maintenance group (median = 31 months) although the observed difference was not statistically significant (P = 0.086). Median survival from start of MP in the maintenance group (46 months) was also not significantly different than the no maintenance group (51 months) (P = 0.587). Multifactor analysis of the randomized patients demonstrated shorter total remission duration and shorter survival in patients who had an initially rapid response to therapy or a lesser reduction in serum M protein concentration. PMID- 3279996 TI - Antitumour effects of streptococcal lipoteichoic acids on Meth A fibrosarcoma. AB - The antitumour effects of lipoteichoic acids (LTA) extracted from Streptococcus pyogenes were studied in comparison with other streptococcal cellular components. LTA suppressed the tumour growth of both solid- and ascites-type Meth A fibrosarcoma as did the whole cells of S. pyogenes (OK-432). No other cellular components, such as cell wall peptidoglycan, group-specific C-carbohydrate or type-specific M protein, suppressed the growth of Meth A. LTA, but not the other cellular components, induced tumour necrosis factor (TNF) in Propionibacterium acnes-primed mice. LTA had no direct killing effects on Meth A cells. These results indicate that LTA may be an important antitumour component of OK-432 and that one of the antitumour mechanisms by this streptococcal preparation is the induction of TNF. PMID- 3279998 TI - The pathomechanisms of psoriasis; the skin immune system and cyclosporin. PMID- 3279999 TI - Cantharide acantholysis: endogenous protease activation leading to desmosomal plaque dissolution. AB - Using a method which allowed us to study the morphological consequences of the expression and the inhibition of proteases in living tissues, we demonstrated that the primary detectable cellular event in cantharide acantholysis is the dissolution of the dense plaque, leading to the detachment of tonofilaments from desmosomes. This process is inhibited by neutral serine protease inhibitors. This suggests that the desmosome-tonofilament complex, more precisely the desmosomal dense plaque, is the primary target of activated proteases during cantharide acantholysis, and can be disrupted by a specific epidermal protease-anti protease system. Cantharide acantholysis may be useful model for studying desmosomal turnover. PMID- 3280000 TI - Low-dose cyclosporin A in severe psoriasis. A double-blind study. AB - Twenty patients with severe plaque psoriasis were selected to receive either low dose cyclosporin A (CyA) or placebo (CyA vehicle) in a double-blind randomized trial at two centres. Within 4 weeks the mean reduction in the Psoriasis Area and Severity Index (PASI) in 10 patients receiving CyA (mean dose 5.5 mg/kg/day) differed significantly from the mean reduction in 10 patients receiving placebo. In eight patients given placebo a switch to CyA therapy resulted within 4 weeks in a mean reduction in PASI of 90%. In a total 15 out of 18 patients given CyA (83%) (mean dose 5.6 mg/kg/day) there was an improvement of greater than or equal to 75% in PASI within 4 weeks. In a 2-month tapering off phase a lower mean CyA dose (3 mg/kg/day) was effective in maintaining the reduced PASI scores in seven of nine patients. Four out of five CyA treated patients who entered a post treatment observation phase had a relapse (PASI score greater than or equal to 50% of score at baseline) after a mean interval of 6.5 weeks. The most important side-effects were mild reversible hypertension in 5 of 18 patients (28%), and reversible elevated serum creatinine levels in 7 of 18 patients (39%). We consider that further studies are justified in severe chronic psoriasis to establish suitable regimens for maintenance of remission in psoriasis with low doses of CyA or a combination of CyA with other anti-psoriatic agents. PMID- 3279995 TI - Ionizing radiation-induced mutagenesis. PMID- 3280002 TI - Adhesive properties of haemopoietic stem cells. PMID- 3280001 TI - Immunofluorescent studies in ocular cicatricial pemphigoid. AB - Twenty nine patients with cicatrizing conjunctivitis were studied; 17 with a clinical diagnosis of cicatricial pemphigoid, five with a clinical diagnosis of pseudopemphigoid caused by long-term application of topical medication and seven who had a cicatrizing conjunctivitis from other causes. Biopsies from clinically uninvolved bulbar conjunctiva were taken for direct immunofluorescence and blood was taken for indirect immunofluorescence using normal human conjunctiva, oral mucosa and skin as substrates. On direct immunofluorescence, in vivo bound immunoglobulins were found along the basement membrane in 10 of the 17 patients with cicatricial pemphigoid, one of the five with pseudopemphigoid and two of the seven with a cicatrizing conjunctivitis associated with other diseases. Circulating anti-basement membrane zone antibodies were found only when conjunctiva was used as a substrate. These were present in seven of the patients with cicatricial pemphigoid, three of those with pseudopemphigoid and two of those with a cicatrizing conjunctivitis caused by other diseases. These results indicate that direct immunofluorescence is a useful, but not absolute diagnostic marker for ocular cicatricial pemphigoid. The results in the pseudopemphigoid group argue that this is an immunologically mediated disorder indistinguishable from spontaneous cicatricial pemphigoid and probably triggered by the drugs. The presence of circulating antibodies should allow for precise identification of the antigen involved in cicatricial pemphigoid using SDS electrophoresis and Western blot analysis. PMID- 3280003 TI - Enrichment of haemopoietic progenitor cells from the marrow of patients with myelodysplasia. AB - Myeloid and erythroid progenitors from myelodysplastic marrows have been separated from accessory cell populations likely to influence their in-vitro growth. Myeloid colony-forming cells were enriched 23-fold and erythroid progenitors 5-7-fold but, in both cases, retained their abnormal growth characteristics. After enrichment and removal of lymphocytes and monocytes, erythroid burst formation became markedly more dependent on the addition of 5637 bladder carcinoma conditioned medium as an exogenous source of haemopoietic growth factors. This suggests that lymphocytes and monocytes usually support erythropoiesis in cultures of myelodysplastic marrow and demonstrates that erythroid burst-forming progenitor cells from myelodysplastic patients can respond to these populations in vitro. Haemopoietic failure in myelodysplasia appears to result from a defect within the preleukaemic clonogenic cell, rather than from an aberration in exogenous factors. The procedure outlined here can be used as a first step towards the isolation of these abnormal progenitors. PMID- 3280004 TI - Dendritic reticulum cell pattern as a microenvironmental indicator for a distinct origin of lymphoma of follicular mantle cells. AB - Follicular dendritic reticulum cells (DRCs) are known to be normally present in primary follicles and both follicular centres and mantle zones of secondary follicles of peripheral lymphoid tissue. Involved frozen biopsy tissue specimens from eight cases of intermediate lymphocytic lymphoma/mantle zone lymphoma (ILL/MZL); eight cases of follicular centre cell lymphomas (FCCL) of the centroblastic/centrocytic type; and seven cases of well-differentiated lymphocytic lymphoma (WDLL) consistent with chronic lymphocytic leukaemia (CLL) were analysed immunohistologically with R4/23 (DRC-1) monoclonal antibody reactive with 'bystander' DRCs. As opposed to FCCL and most WDLL/CLL cases, the DRCs consistently formed a loose, ill-defined meshwork with a radiating or blurred outline in all MZL cases and one ILL. On the basis of the observed findings as well as from those reported in literature, the hypothesis is proposed that ILL/MZL originates from the follicular mantle zone and represents a distinct lymphoma entity owing to its peculiar immunostaining pattern of DRCs that allows it to be separated from both FCCL and WDLL/CLL. Moreover, the absence of DRCs in the microenvironment of other B-cell malignancies such as prolymphocytic leukaemia and hairy cell leukaemia, analogously with most CLL cases, would speak in favour of their different--possibly extrafollicular--compartment of origin within lymphoid tissue. PMID- 3280005 TI - Allogeneic bone marrow transplantation versus intensification chemotherapy for acute myelogenous leukaemia in first remission: a prospective controlled trial. AB - In 1982 we began a prospective controlled trial to assess the effectiveness of allogeneic bone marrow transplantation and intensive post-remission chemotherapy for patients with acute myelogenous leukaemia in first complete remission. Fourteen patients, 3-45 years of age, who had an HLA-identical sibling donor, received bone marrow transplantation. Twenty-five patients who either lacked an HLA-identical sibling or were over 45 years of age received intensive consolidation chemotherapy including high-dose cytosine arabinoside with or without adriamycin. The actuarial rate of continued complete remission (CCR) at 3 years was significantly higher in the transplantation group than in the chemotherapy group: 70% (95% confidence interval 35-91%) compared with 10% (95% confidence interval 2-30%); P = 0.01. However, the actuarial rate of CCR was not significantly different between the transplantation group and patients under 45 years in the chemotherapy group: 70% (95% confidence interval 35-91%) compared with 17% (95% confidence interval 4-45%), 0.1 greater than P greater than 0.05. The actuarial probability of leukaemia relapse was significantly lower in the transplantation group than in the chemotherapy group: 10% (95% confidence interval 4-21%) compared with 88% (95% confidence interval 70-96%), 0.005 greater than P greater than 0.001. There was no significant difference between both groups if we compare only the patients who died of non-leukaemic causes: 22% (95% confidence interval 9-42%) versus 25% (95% confidence interval 7-59%), P = NS. In summary, this study shows that allogeneic bone marrow transplantation is a better anti-leukaemic treatment than is intensive consolidation chemotherapy in patients with AML in first complete remission. PMID- 3280006 TI - Abnormal membrane phospholipid organization in Plasmodium falciparum-infected human erythrocytes. AB - The membrane phospholipid organization in Plasmodium falciparum-infected human erythrocytes was analysed by employing phospholipase A2 and Merocyanine 540 as external membrane probes. Both bee venom and pancreatic phospholipases A2 failed to hydrolyse phosphatidylserine in uninfected human red cells isolated from in vitro P. falciparum cultures. However, these enzymes under identical conditions readily degraded this aminophospholipid in P. falciparum-infected erythrocytes. Phosphatidylethanolamine hydrolysis also increased in parasitized cells. The degree to which these aminophospholipids were cleaved by the enzymes in intact infected cells depended on the developmental stage of the intracellular parasite, and was maximum at the schizont stage. This was consistent with the finding that the 'fluid-sensing' fluorescent dye, Merocyanine 540, readily labelled both the schizont and trophozoite-infected cells but not the fresh, uninfected or ring infected erythrocytes. These results demonstrate that P. falciparum produces stage-dependent changes in the membrane phospholipid organization of its host erythrocyte. PMID- 3280007 TI - Comparison of pregnancy-specific beta 1-glycoprotein (SP1) and ultrasound in predicting the date of delivery. AB - The accuracy of ultrasound measurements (crown-rump length and gestational sac diameter) and the serum concentration of pregnancy-specific beta 1-glycoprotein (SP1) in the prediction of the date of birth was analysed in a study population of 94 patients. When measured before 8 weeks after the last menstrual period (LMP) the serum concentration of SP1 was found to be a good predictor of the expected date of delivery and a good alternative to ultrasound, but it was of limited use when determined at a later gestation. PMID- 3280008 TI - Does mother know best? Maternal assessment of relative fetal size in utero. AB - The accuracy of pregnant womens' impressions of the size of their babies in utero relative to their previous babies has been assessed in 140 parous women. The women who thought their babies would be bigger gave birth to babies weighing a mean of 0.30 kg more than their previous babies (P less than 0.01) and the women who thought their babies would be smaller were delivered of babies weighing a mean of 0.22 kg less than their previous babies (P less than 0.01). PMID- 3280009 TI - Decrease in pulsatile flow in the internal carotid artery in fetal hydrocephalus. AB - The effect of ventriculomegaly on pulsatile flow in the internal carotid arteries has been studied by Doppler ultrasound in four hydrocephalic fetuses. The pulsatility index showed progressive elevation proportional to the developing ventriculomegaly and thus may be a valuable index for the study of the mechanism of brain injury and for the determination of optimal timing of intervention. PMID- 3280010 TI - Treatment of menstrually induced acute intermittent porphyria by a long-acting gonadotrophin-releasing hormone agonist (D Trp6-Pro9 N ethylamide) LHRH. Case report. PMID- 3280011 TI - Fetal brain death. Two case reports. PMID- 3280012 TI - Progress in uveitis. PMID- 3280013 TI - NMR sequential assignment of Escherichia coli thioredoxin utilizing random fractional deuteriation. AB - All non-proline residues except for the N-terminal dipeptide have been assigned in the 108-residue protein Escherichia coli thioredoxin. Central to these experiments has been the use of protein samples in which all carbon-bound hydrogen positions are substituted to 75% with deuterium by bacterial growth on partially deuteriated carbon sources and media. The dilution of the local proton density gives rise to narrower line widths with little loss in sensitivity. In addition, passive or secondary coupling to protons not directly involved in the coherence transfer process of correlation experiments is largely suppressed, thus significantly improving the resolution for side-chain couplings. Simultaneous multiresidue-type assignments have been obtained by incorporation of several amino acids with differing selective alpha- and/or beta-deuteriation into a fractionally deuteriated background. Combined with several single residue type labeling experiments, these selective labelings have yielded direct residue type assignments for two-thirds of the protein. In addition to improved resolution, the amide to carbon-bound proton NOESY spectra offered equivalent sensitivity while the amide to amide NOESY spectra offered superior sensitivity to that observed for natural abundance samples. The resultant sequential assignment has an average number of nearest-neighbor NOE connectivities of 2.35 out of the possible 3 alpha-amide, beta-amide, and amide-amide connectivities. PMID- 3280014 TI - Primary structure of mammalian ribosomal protein S6. AB - Ribosomal protein S6 was isolated from rat liver ribosomes by reversed-phase high performance liquid chromatography (HPLC) and subjected to cyanogen bromide and proteolytic cleavages. The cleavage fragments were resolved by HPLC and sequenced by automated Edman degradation. The overall amino acid sequence of S6 (249 residues) was determined by alignment of the overlapping sequences of selected cyanogen bromide, chymotryptic, tryptic, and clostripain cleavage fragments. The only protein found to exhibit close homology with the S6 sequence is yeast ribosomal protein S10 (61% sequence identity). Previously, characterized phosphopeptide derivatives of S6 containing phosphorylation sites for adenosine 3',5'-cyclic phosphate dependent and protease-activated protein kinases originate from the carboxy-terminal region of S6 encompassing residues 233-249. PMID- 3280015 TI - Inhibition of phosphatase and sulfatase by transition-state analogues. AB - The inhibition constants for vanadate, chromate, molybdate, and tungstate have been determined with Escherichia coli alkaline phosphatase, potato acid phosphatase, and Helix pomatia aryl sulfatase. Vanadate was a potent inhibitor of all three enzymes. Inhibition of both phosphatases followed the order WO4(2-) greater than MoO4(2-) greater than CrO4(2-). The Ki values for potato acid phosphatase were about 3 orders of magnitude lower than those for alkaline phosphatase. Aryl sulfatase followed the reverse order of inhibition by group VI oxyanions. Phenol enhanced inhibition of alkaline phosphatase by vanadate and chromate but did not affect inhibition of acid phosphatase. Phenol enhanced inhibition of aryl sulfatase by metal oxyanions in all cases following the order H2VO4- greater than CrO4(2-) greater than MoO4(2-) greater than WO4(2-), and N acetyltyrosine ethyl ester enhanced inhibition of aryl sulfatase by H2VO4- and CrO4(2-) more strongly than did phenol. It is apparent that the effectiveness of metal oxyanions as inhibitors of phosphatases and sulfatases can be selectively enhanced in the presence of other solutes. The relevance of these observations to the effects of transition metal oxyanions on protein phosphatases in vivo is discussed. PMID- 3280016 TI - Isotope partitioning for NAD-malic enzyme from Ascaris suum confirms a steady state random kinetic mechanism. AB - Isotope partitioning studies beginning with E.[14C]NAD, E.[14C]malate, E.[14C]NAD.Mg2+, and E.Mg.[14C]malate suggest a steady-state random mechanism for the NAD-malic enzyme. Isotope trapping beginning with E.[14C]NAD and with varying concentrations of Mg2+ and malate in the chase solution indicates that Mg2+ is added in rapid equilibrium and must be added prior to malate for productive ternary complex formation. Equal percentage trapping from E.[14C]NAD.Mg and E.Mg.[14C]malate indicates the mechanism is steady-state random with equal off rates for NAD and malate from E.NAD.Mg.malate. The off-rates for both do not change significantly in the ternary E.Mg.malate and E.NAD.Mg complexes, nor does the off-rate change for NAD from E.NAD. No trapping of malate was obtained from E.[14C]malate, suggesting that this complex is nonproductive. A quantitative analysis of the data allows an estimation of values for a number of the rate constants along the reaction pathway. PMID- 3280017 TI - DNA binding domain of Escherichia coli DNA polymerase I: identification of arginine-841 as an essential residue. AB - To identify the DNA binding site(s) in Escherichia coli DNA polymerase I (pol I) (Klenow fragment), we have used an active-site-directed reagent, phenylglyoxal (PG), which specifically reacts with arginine residues. Preincubation of DNA pol I with PG resulted in the loss of polymerase, 3'-5'-exonuclease, and DNA binding functions. Furthermore, the presence of DNA but not deoxynucleoside triphosphates protected the enzyme from inactivation. Labeling studies with [7-14C]PG indicated that two arginine residues were modified per mole of enzyme. In order to locate the site of PG modification, we digested the PG-treated enzyme with trypsin and V 8 protease. The resulting peptides from each digest were then resolved on reverse phase hydrophobic columns. An appearance of a new peptide peak was observed in both tryptic and V-8 protease digests. Since inclusion of template-primer during PG modification of enzyme blocks the appearance of these peaks, these peptides were concluded to represent the template-primer binding domain of pol I. Indeed, the extent of inactivation of enzyme by PG treatment correlated very well with the quantitative increase in the new tryptic peptide peak. Amino acid composition analysis of both tryptic peptide and V-8 peptide revealed that the two peptides were derived from the same general region; tryptic peptide spanned between residues 837 and 857 while V-8 peptide spanned between residues 841 and 870 in the primary sequence of pol I. Sequence analysis of tryptic peptide further identified arginine-841 as the site of PG modification, which implicates this residue in the DNA binding function of pol I. PMID- 3280018 TI - Relationship between domain closure and binding, catalysis, and regulation in Escherichia coli aspartate transcarbamylase. AB - Previous evidence, from both crystallographic and biochemical studies, has indicated that profound tertiary and quaternary changes in the structure of Escherichia coli aspartate transcarbamylase occur upon the binding of the bisubstrate analogue N-(phosphonoacetyl)-L-aspartate (PALA). In particular, within a single catalytic polypeptide chain, the aspartate binding domain relocates closer to the carbamyl phosphate binding domain, thereby resulting in a major reorganization of the interface between the two domains. Among the new interactions, salt bridges between Glu-50 and both Arg-167 and Arg-234 are formed. In the present study, site-directed mutagenesis is used to replace Glu-50 by glutamine in the catalytic chain. The Michaelis constant for aspartate of the mutant catalytic subunit is about 10-fold higher and the turnover number 10-fold lower than their respective counterparts in the wild-type catalytic subunit, whereas the dissociation constant for carbamyl phosphate is almost unchanged. For the holoenzyme, this substitution results in an 8-fold decrease in the specific activity, a 20-fold increase in the aspartate concentration that gives half of the maximal velocity, and a loss of cooperativity for both substrates. However, the mutant enzyme is not "frozen" in a low-affinity-low-activity conformation since PALA stimulates the activity severalfold and induces an increase in the sulfhydryl reactivity analogous to that of the wild-type enzyme. Together these results indicate that the stabilization of the aspartate binding domain near the carbamyl phosphate binding domain, through specific interdomain bridging interactions, is necessary for the high-affinity-high-activity configuration of the active site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280019 TI - A possible model for the concerted allosteric transition in Escherichia coli aspartate transcarbamylase as deduced from site-directed mutagenesis studies. AB - Aspartate transcarbamylase is stabilized in a low-affinity-low-activity state exhibiting no cooperativity by selective perturbation of the Glu-50-Arg-167 and Glu-50-Arg-234 interdomain salt bridges. Similarly, a high-affinity-high-activity state of the enzyme, retaining a significant amount of cooperativity, is obtained by perturbation of the interaction between Tyr-240 and Asp-271. In this work, we show that the rupture of the link between Tyr-240 and Asp-271 in the enzyme already lacking the interdomain salt bridges regenerates the homotropic cooperative interactions between the catalytic sites and substantially increases the activity and affinity of the enzyme for aspartate. These results suggest a possible relationship between these two sets of interactions for the establishment of the cooperative behavior of the enzyme. Another mutation, Glu 239 to Gln, introduced to perturb the Glu-239-Lys-164 and Glu-239-Tyr-165 interactions between the two catalytic subunits, is sufficient to "lock" the enzyme in the R state. These observations emphasize the importance of the interactions at the interface between the catalytic trimers in maintaining the T state of the enzyme and shed light on the role played by this pathway in the communication of homotropic cooperativity between the different sites. A model including all these findings, as well as the interactions stabilizing the T state or the R state in the presence of the natural substrates, is proposed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280020 TI - Site-directed mutagenesis and 1H NMR spectroscopy of an interdomain segment in the pyruvate dehydrogenase multienzyme complex of Escherichia coli. AB - Deletion of two of the three homologous lipoyl domains that form the N-terminal half of each dihydrolipoamide acetyltransferase (E2p) polypeptide chain of the Escherichia coli pyruvate dehydrogenase complex can be achieved by in vitro deletion in the structural gene aceF. A site-directed mutagenesis of this shortened aceF gene was carried out to replace the glutamine residue at position 291 (wild-type numbering) with a histidine residue. Residue 291 is near the middle of a long segment (about 30 amino acid residues) of polypeptide chain, rich in alanine, proline, and charged amino acids, that links the remaining lipoyl domain to the dihydrolipoamide dehydrogenase (E3) binding domain in the E2p chain. A fully active enzyme complex was still assembled, and despite the enormous size of the particle (Mr approximately 4 x 10(6)), sharp resonances attributable to the single new histidine residue per E2p chain could be detected in the 400-MHz 1H NMR spectrum of the complex. The sharpness of these resonances, their chemical shifts (7.94 and 7.05 ppm), and the apparent pKa (6.4) of the side chain were all consistent with this histidine residue being exposed to solvent in a conformationally flexible region of the E2p polypeptide chain. These experiments provide direct proof for the conformational flexibility of this region of polypeptide chain, which is thought to play an important part in the movement of the lipoyl domain required for active site coupling in the enzyme complex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280021 TI - Equilibrium binding of Escherichia coli single-strand binding protein to single stranded nucleic acids in the (SSB)65 binding mode. Cation and anion effects and polynucleotide specificity. AB - The Escherichia coli single-strand binding (SSB) protein binds single-stranded (ss) nucleic acids in at least four distinct binding modes depending on the salt conditions [Lohman, T. M., & Overman, L. B. (1985) J. Biol. Chem. 260, 3594; Bujalowski, W., & Lohman, T. M. (1986) Biochemistry 25, 7799]. Equilibrium binding constants for the interaction of the E. coli SSB protein with poly(A), poly(U), poly(dA), and poly(dT) have been measured over a range of monovalent salt concentrations and types under conditions which favor only the high site size, (SSB)65 binding mode, which covers 65 nucleotides per SSB tetramer. The binding isotherms are analyzed by using a statistical thermodynamic model ("tetramer/octamer" model) that assumes cooperative binding of SSB is limited to the formation of octamers [Bujalowski, W., & Lohman, T. M. (1987) J. Mol. Biol. 195, 897] rather than the indefinite clustering of tetramers. The dependence of the intrinsic association equilibrium constant, Kobsd, and cooperativity parameter, omegoT/O, on salt concentration has been determined by titrations which monitor the fluorescence quenching of the SSB protein upon complex formation. In the (SSB)65 binding mode, SSB binds with only moderate cooperativity to ss nucleic acids [Lohman, T. M., Overman, L. B., & Datta, S. (1986) J. Mol. Biol. 187, 603]. The cooperativity parameter derived from the tetramer/octamer model, which represents the equilibrium constant for formation of a nucleic acid bound SSB octamer from two nucleic acid bound tetramers, has a value of omegaT/O = 410 +/- 120 and is independent of salt concentration and type for poly(dA), poly(U), and poly(A) (25 degrees C, pH 8.1). However, Kobsd decreases steeply with increasing salt concentration, such that alpha log Kobsd/alpha log [NaCl] = -7.4 +/- 0.5 for poly(U), -6.1 +/- 0.6 for poly(dA), and -6.2 +/- 0.3 for poly(A) (25.0 degrees C, pH 8.1). The SSB-poly(dT) affinity is too high to measure in buffers containing even 5 M NaCl; however, in 1.8-2.5 M NaBr, we measure alpha log Kobsd/alpha log [NaBr] = -5.7 +/- 0.7, with a lower value of omega T/O = 130 +/- 70. The polynucleotide specificity of the (SSB)65 binding mode (0.20 M NaCl, 25.0 degrees C, pH 8.1) is Kobsd(dT) greater than Kobsd(dC) much greater than Kobsd(ss M13 DNA) greater than Kobsd(I) greater than Kobsd(U) = 8Kobsd(dA) = 87Kobsd(A) much greater than Kobsd(C).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3280022 TI - Partial assignment of resonances in the 19F nuclear magnetic resonance spectra of 5-fluorouracil-substituted transfer RNAs. AB - Features of the 19F nuclear magnetic resonance (NMR) spectra of three purified 5 fluorouracil-(FUra-) substituted Escherichia coli tRNAs, tRNA(1Val), tRNA(mMet), and tRNA(fMet), are compared. Each of the tRNA species can be resolved into two isoaccepting forms, A and B, whose 19F NMR spectra differ in the shift of one peak from the 4.5 to 4.8 parts per million (ppm) range (FUra = O) in the spectrum of isoacceptor B upfield to ca. -15 ppm in that of isoacceptor A. Because the sequences of the two isoacceptors of each tRNA differ only at one position in the D loop, that normally occupied by a dihydrouridine residue, we assign the 4.5 ppm peak in the spectrum of fluorine-labeled tRNA(1Val) to FUra17 and the resonance at 4.6 ppm in the spectrum of fluorouracil-substituted tRNA(mMet) to FUra20. A reciprocal 19F[19F] nuclear Overhauser effect is observed between the downfield peaks A and B in the 19F NMR spectrum of 19F-labeled tRNA(1Val). Assuming that fluorine-labeled tRNA(1Val) has a structure similar to that of yeast tRNA(Phe), only FUra54 and -55 are close enough (4-5 A) to give an appreciable 19F homonuclear Overhauser effect. Peaks A and B have therefore been assigned to FUra54 and -55. As the temperature is raised from 30 to 45 degrees C, the intensity of peak B (6.6 ppm) in the spectrum of 19F-labeled tRNA(1Val) gradually shifts upfield to 6.4 ppm (Tm = 36 degrees C), indicating a temperature-dependent slow exchange of the corresponding 5-fluorouracil residue between two magnetically distinct environments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280023 TI - Analysis of biochemical reactions with molecular specificity using fast atom bombardment mass spectrometry. PMID- 3280024 TI - Mechanisms of error discrimination by Escherichia coli DNA polymerase I. AB - The mechanism of base selection by DNA polymerase I of Escherichia coli has been investigated by kinetic analysis. The apparent KM for the insertion of the complementary nucleotide dATP into the hook polymer poly(dT)-oligo(dA) was found to be 6-fold lower than that for the noncomplementary nucleotide dGTP, whereas the Vmax for insertion of dATP was 1600-fold higher than that for dGTP. The ratio of Kcat/KM values for complementary and mismatched nucleotides of 10(4) demonstrates the extremely high specificity of base selection by DNA polymerase I and is in agreement with results obtained with a different template-primer, poly(dC)-oligo(dG) [El-Deiry, W. S., Downey, K. M., & So, A. G. (1984) Proc. Natl. Acad. Sci. U.S.A. 81, 7378]. Studies on the effects of phosphate ion on the polymerase and 3'- to 5'-exonuclease activities of DNA polymerase I showed that, whereas the polymerase activity was somewhat stimulated by phosphate, the exonuclease activity was markedly inhibited, being 50% inhibited at 25 mM phosphate and greater than 90% inhibited at 80 mM phosphate. Selective inhibition of the exonuclease activity by phosphate also resulted in inhibition of template dependent conversion of a noncomplementary dNTP to dNMP and, consequently, markedly affected the kinetic constants for insertion of noncomplementary nucleotides. The mutagenic metal ion Mn2+ was found to affect error discrimination by both the polymerase and 3'- and 5'-exonuclease activities of DNA polymerase I.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280025 TI - Raman spectroscopy of mercury (II) binding to two filamentous viruses: Ff (fd, M13, f1) and Pf1. AB - Ff and Pf1 are filamentous bacteriophages. Each contains, in a central core region surrounded by protein, a circular single-stranded DNA molecule, and it is known that the DNA bases are sites of Hg(II) binding. In the present study, Raman spectra were obtained for the two viruses in the presence of increasing amounts of Hg(II), with ratios (m) of Hg(II) added per nucleotide residue in the range 0 less than m less than 2.0. Hg(II) binding to the viruses induces Raman intensity changes in previously assigned Raman lines of viral DNA, demonstrating metal binding to the DNA bases, but also in many lines assigned to protein. The overall structures of the viruses do not change with Hg(II) binding, and the Raman spectra indicate little, if any, change in protein secondary structure. Changes in certain protein Raman lines induced by Hg(II) binding to the DNA for low values of m are attributed to altered interactions between solvent and protein side chains, aliphatic groups being the most affected. The nature of such changes for both viruses suggests DNA-protein linkage. In Pf1, lines assigned to ring vibrations of all four bases are perturbed upon initial addition of Hg(II) to m = 0.25. In Ff, however, lines assigned to base ring vibrations are not perturbed until m greater than or equal to 0.5. The results provide additional evidence for fundamentally different DNA structures in Ff and Pf1. PMID- 3280026 TI - Characterization of recombinant human epidermal growth factor produced in yeast. AB - Four different forms of human epidermal growth factor (h-EGF) are found in the culture medium of a recombinant strain of Saccharomyces cerevisiae. These forms were characterized after purification using reverse-phase high-performance liquid chromatography. The most abundant form of secreted recombinant h-EGF has leucine at the carboxyl terminus and is identical with gamma-urogastrone. A second species is identical with the most abundant form except that it lacks the carboxyl-terminal leucine. This form appears to be the product of a carboxypeptidase found in the growth medium. The other two forms of recombinant h EGF are the respective oxidation products of the above where the single methionine residue has been converted to methionine sulfoxide. These four forms of recombinant h-EGF are fully active; they bind to the EGF receptor of A431 cells as well as stimulate mitotic activity of human foreskin fibroblasts with equal specific activity. The location of the disulfide bonds in the predominant form of recombinant h-EGF was determined following digestion with thermolysin. The amino acid compositions of the resulting peptides showed that the placement of disulfide bonds in recombinant h-EGF is identical with that in murine EGF. PMID- 3280027 TI - Folding of homologous proteins: conservation of the folding mechanism of the alpha subunit of tryptophan synthase from Escherichia coli, Salmonella typhimurium, and five interspecies hybrids. AB - The equilibrium and kinetic properties for the urea-induced unfolding of the alpha subunit of tryptophan synthase from Escherichia coli, Salmonella typhimurium, and five interspecies hybrids were compared to determine the role of protein folding in evolution. The parent proteins differ at 40 positions in the sequence of 268 amino acids, and the hybrids differ by up to 15 amino acids from the Escherichia coli alpha subunit. The results show that all the proteins follow the same folding mechanism and are consistent with a previously proposed hypothesis [Hollecker, M., & Creighton, T. E. (1983) J. Mol. Biol. 168, 409; Krebs, H., Schmid, F. X., & Jaenicke, R. (1983) J. Mol. Biol. 169, 619] that the folding mechanisms are conserved in homologous proteins. Analysis of the kinetic data suggests that the 15 positions at which the parent proteins differ in the amino folding unit, residues 1-188, do not play a role in a rate-limiting step in folding that has been previously identified as the association of the amino and carboxyl folding units [Beasty, A. M., Hurle, M. R., Manz, J. T., Stackhouse, T. S., Onuffer, J. J., & Matthews, C. R. (1986) Biochemistry 25, 2965]. One or more of the 25 positions at which the parent proteins differ in the carboxyl folding unit, residues 189-268, do appear to play a role in this same rate-limiting step. PMID- 3280029 TI - Energetic consequences of two mutations in Escherichia coli K+ uptake systems for growth under potassium-limited conditions in the chemostat. AB - The energetics of growth of two Escherichia coli strains (TK 2240 and TK 2242) differing in Km of the high-affinity potassium uptake system and lacking the low affinity system were studied in the chemostat under potassium-limited conditions. The results were compared with the results obtained previously (Mulder, M.M., Teixeira de Mattos, M.J., Postma, P.W. and Van Dam, K. (1986) Biochim. Biophys. Acta 851, 223-228) with the wild-type FRAG-1, having two potassium uptake systems, and FRAG-5, a mutant which lacks the high-affinity potassium uptake system. We postulated that the high-affinity potassium uptake system was able to generate such a steep gradient across the membrane that the low-affinity system would act in reverse, thus creating a futile cycle of potassium ions at the cost of energy. As a result, FRAG-1 would show a higher ATP turnover at all growth rates tested than the mutant FRAG-5, in which strain the proposed futile cycle is interrupted because of the lack of the high-affinity system. It is shown here that the results obtained with TK 2240 and TK 2242 are in line with our hypothesis of futile potassium cycling. Under our experimental conditions, the yield on potassium was not dependent on the kinetic parameters of the uptake systems. The (thermodynamic) energy demand of the uptake systems determined the carbon substrate conversion required to achieve this yield. PMID- 3280028 TI - Relationships between membrane-bound cytochrome o from Vitreoscilla and that of Escherichia coli. AB - The cytochrome o terminal oxidases from the bacteria Vitreoscilla and Escherichia coli are structurally and functionally related. They have similar optical spectra, both exhibit ubiquinol-1 oxidase activity and are inhibited similarly. Both enzymes contain four subunits by SDS-polyacrylamide gel electrophoresis analysis and contain protoheme IX and Cu2+ prosthetic groups. Antibodies raised against the oxidase purified from E. coli crossreact with the Vitreoscilla oxidase. PMID- 3280030 TI - Identification of cyclophilin as the erythrocyte ciclosporin-binding protein. AB - Previous studies on the distribution of circulating ciclosporin have shown that the majority of the drug is associated with erythrocytes. In order to investigate the nature of ciclosporin-erythrocyte binding, binding studies were performed on isolated erythrocytes. At therapeutic concentrations (approx. 0.5 microgram/ml in whole blood) greater than 90% of the erythrocyte associated ciclosporin was found in the cytosol. The cytosolic binding capacity was approximately (2-2.5).10(5) molecules of ciclosporin per cell. A lower affinity binding of the drug to the plasma membrane occurred only at higher ciclosporin concentrations. The ciclosporin-binding species was purified from erythrocyte cytosol using ciclosporin-Affigel affinity chromatography. This revealed a 16 kDa protein, similar in size to the ciclosporin-binding protein, cyclophilin, previously identified in lymphocyte cytosol. Immunochemical analysis using rabbit anti bovine spleen cyclophilin antisera revealed that the erythrocyte ciclosporin binding protein was either cyclophilin or a closely related protein. It is concluded that intracellular ciclosporin-binding within erythrocytes is mostly attributable to the presence of a single protein or protein family represented by cyclophilin. The presence of (2-2.5).10(5) copies of this binding protein within each erythrocyte is responsible for the ciclosporin found associated with erythrocytes. PMID- 3280031 TI - DNA transfection of Escherichia coli by electroporation. AB - Electroporation was applied to transfection and transformation of Escherichia coli. Efficient transfer of DNA was achieved by a single voltage pulse at 2.5 kV (initial electric field strength = 6.25 kV/cm), with a 25 microF capacitor. As the recipient for transfecting DNA in the electroporation, spheroplasts, EDTA treated cells and osmotically shocked bacteria were inferior to intact E. coli. Various parameters affecting the transfection efficiency were defined including growth phase of recipient cells, concentrations of DNA and cells, temperature and additions. In most strains tested, electroporation was far more efficient than Ca2+-dependent transfection (transformation). Various aspects of the electroporation-mediated DNA uptake are discussed. PMID- 3280032 TI - Evidence by NMR for mobility of the cytochrome domain within flavocytochrome b2. AB - According to a model proposed by Gervais, M, Groudinsky, O., Risler, Y. and Labeyrie, F. ((1977) Biochem. Biophys. Res. Commun. 77, 1543-1551) flavocytochrome b2 is composed of a central flavodehydrogenase entity of 4 X 45 kDa to which are attached four cytochrome b2 globules of approx. 11 kDa that are released after proteolysis of the connective loops. A possible inherent mobility of the latter with functional significance was suspected. Proton NMR spectra at 400 MHz of the isolated and of the flavodehydrogenase-bound ferricytochrome b2 units have been compared. In the ranges downfield of +12 ppm and upfield from -4 ppm, where hyperfine-shifted heme proton resonances reside, the chemical shifts are identical for the two forms, but the linewidths are markedly broader for flavocytochrome b2. The linewidths of three heme resonances, a methyl at +19 ppm, two single protons at -6 and -8 ppm (most probably from one vinyl) and an unassigned line at -2.4 ppm, all increase by a factor of about 4. Since, in the present case, linewidths are controlled mainly by proton/proton dipolar relaxations which are caused by molecular tumbling, a change in linewidths of about 15 would be expected if the cytochrome b2 globule had no free motion relative to the flavodehydrogenase domain. The present results thus support the previous hypothesis that such a relative mobility, of unknown correlation time and amplitude, actually exists. PMID- 3280033 TI - Molecular cloning of a phospholipid-cholesterol acyltransferase from Aeromonas hydrophila. Sequence homologies with lecithin-cholesterol acyltransferase and other lipases. AB - We have determined the nucleotide sequence of a gene encoding Aeromonas hydrophila phospholipid-cholesterol acyltransferase, an enzyme which shares many properties with mammalian lecithin:cholesterol acyltransferase. The derived amino acid sequence of the protein contains two regions which are homologous to the proposed active sites and binding sites of the plasma acyltransferase and to similar sequences in other interfacially acting lipolytic enzymes. The amino terminus is preceded by a typical 18 amino acid signal sequence. The protein, which is released into the culture supernatant by Aeromonas hydrophila, is confined to the periplasm of Escherichia coli. PMID- 3280034 TI - Identification of an epididymal immunorelated protein family: sequential appearance under testosterone stimulation. AB - The lizard has a seasonal sexual cycle, during which the epididymis produces large amounts of proteins that mix with spermatozoa during the reproductive period. Through one-dimensional electrophoresis we identified among these proteins a band of major soluble Mr 19,000 proteins. In two-dimensional electrophoresis the Mr 19,000 protein molecules separated into four pHi groups ranging from 3.7 to 8.7. An immunoserum prepared against the most acidic fraction recognized all four protein groups. Immuno-electrophoresis confirmed that these proteins have similar immunological characteristics. The androgen dependence of each group was demonstrated in vitro with testosterone stimulation of tissue from castrated animals. The groups appear sequentially as a function of culture growth time. PMID- 3280035 TI - Human placental chorionic renin: production, purification and characterization. AB - Native human renin, produced from the culture of human chorionic trophoblasts, has been purified to homogeneity on a milligram scale using a five-step purification scheme. The chorion cells secrete 50-200 milliGoldblatt Units of trypsin-activatable prorenin per ml into the medium. The pro-enzyme is partially purified by ammonium sulfate fractionation and chromatographies on QAE-Sephadex and cibracon blue-agarose. Following conversion of prorenin to the active enzyme by porcine trypsin, the renin is purified to homogeneity by affinity chromatography and gel filtration. Chorionic prorenin has a molecular weight of 43,000; the active enzyme 40,000. Both proteins exist as a single polypeptide chain as determined by SDS-polyacrylamide gel electrophoresis under reducing conditions. The average specific activity of six different preparations was found to be 1072 Goldblatt Units/mg. The amino acid composition and N-terminal sequence of the active enzyme has been determined and is identical to the human kidney enzyme. Microheterogeneity of chorionic renin was demonstrated by isoelectrofocusing analysis. The physical characterization of chorionic renin is compared with that reported for the human kidney enzyme. PMID- 3280036 TI - Casein kinase II accumulation in the nucleolus and its role in nucleolar phosphorylation. AB - A rabbit antiserum against highly purified casein kinase II from mouse tumor cells was used for immunolocalization of the enzyme in fixed, permeabilized mouse cells. Casein kinase II was highly accumulated in nucleoli compared to the extra nucleolar space of the nucleus or to the cytoplasma. Casein kinase II samples highly purified from the cytoplasma, from the extra-nucleolar fraction of the nucleus or from nucleoli exhibited no differences with respect to structure and function. All samples originally had an alpha 2 beta 2 structure (alpha, 42 kDa; beta, 24 kDa) showing formation of the alpha'-chain (36 kDa) only in the late steps of purification. The isoelectric point of the alpha-chain of all three samples was pH 7.7 and that of the beta-chain was pH 6.4-6.6. Using ATP or GTP, all three casein kinase II samples gave the same results of maximum phosphorylation of purified nucleolar marker phosphoproteins pp105/C23, pp135 and B23, yielding pp135 as one of the most highly phosphorylated proteins with an incorporation of about 75 phosphate groups per molecule pp135. Studies on optimum conditions of phosphorylation of nucleolar phosphoproteins by casein kinase II revealed that each of the protein substrates individually responded to alterations of assay parameters such as pH, magnesium ion and sodium chloride concentrations indicating that predominantly individual structural criteria were responsible for optimum phosphorylation. The determination of the apparent Km of casein kinase II for purified nucleolar phosphoproteins yielded values of 0.15 microM (pp105/C23), 0.1 microM (pp135) and 1.0 microM (B23) identifying them as high-affinity substrates of casein kinase II. PMID- 3280037 TI - Polymeric microspheres as drug carriers. AB - The use of polymeric microsphere systems (including polypeptides) as vehicles for delivering drugs by a variety of routes is considered with particular reference to parenteral administration. Microsphere formulation is discussed with emphasis on the role of surface properties and how these can determine the fate of administered particles. Studies on the use of adsorbed block copolymers that can alter processes of protein uptake onto particle surfaces (opsonization) as well as the interaction of particles with macrophages (cell-particle adhesion) are described. Data are presented which show that by the selection of the appropriate coating material it is possible to direct particles within the body to sites such as the lung, liver, bone marrow, or to retain materials within the systemic circulation. PMID- 3280039 TI - In vitro and in vivo interactions of cells with biomaterials. AB - The biocompatibility of materials at an implant site involves a complex interaction of cells and tissues with the biomaterial. This cell-cell and cell polymer interaction evokes the release of mediators such as chemotactic and growth factors that elicit and sustain inflammatory responses at the implant site. In this review, we summarize the interaction of cells with biomaterials in vitro and in vivo. PMID- 3280038 TI - Activation of the complement system at the interface between blood and artificial surfaces. AB - The interaction between blood and the artificial devices used in haemodialysis results in the activation of the immune system. Complement activation is known to play a key role in the production of inflammatory mediators. This article describes the complement system and the way in which it is triggered in the patient undergoing haemodialysis. It highlights those factors thought to be of particular importance in the pathogenesis of adverse reactions and targets them as obstacles to be overcome in the future design of biocompatible materials. PMID- 3280040 TI - Optical and electrochemical detection of DNA. AB - There is a growing demand for the production of a DNA biosensor with applications in medicine, the food industry, agriculture, veterinary science and environmental science. In this paper we describe methods for the optical and electrochemical detection of DNA using the enzyme horseradish peroxidase (EC 1.11.1.7) and glucose oxidase (EC 1.1.3.4). We have used bis-methylacridinium nitrate and luminol for the optical detection of DNA using a purpose built, inexpensive luminometer. Using this system detection limits of 10(-11) g of plasmid DNA have been observed. Electrochemical detection of DNA was carried out by the use of a fluoride ion selective electrode and stripping voltammetry. DNA was detected down to 10(-9)-10(-10) g of DNA by the enzymatic release of halogen ions from organohalogen compounds. PMID- 3280041 TI - On-line sensors for coagulation proteins: concept and progress report. AB - The assessment of blood damage and of the activation of the coagulation, complement and/or inflammatory systems by cardiovascular and extracorporeal devices is difficult at best. Immunoassay methods are now available for the measurement of many of the proteins, enzymes and peptides involved in coagulation, thrombosis, complement and inflammation. We present a long-range project and plan to develop an array of remote, on-line, semicontinuous immunosensors for selected coagulation proteins, based on fluoroimmunoassay principles. The free/bound separation step is performed optically. Excitation of fluorescence is performed via an evanescent wave produced by total internal reflection and waveguide optics. Fluorescence emission is collected only in the near field. Means to deliver fluorescently-labelled reagent and to modify the antigen-antibody binding constant are presented and discussed. The results of non specific binding, plasma-blood fluorescence, and blood compatibility are also discussed. PMID- 3280042 TI - [The nitroblue tetrazolium reduction test in evaluating the function of the circulating leukocytes in mice with experimental malaria]. AB - NBT-test for circulating neutrophils and monocytes in the blood of mice inoculated with Plasmodium berghei, strain N or LNK-65, have been performed. Within the first 24 h of the infection, before the onset of the recordable parasitemia or in the course of the subsequent six days (depending of the strain used for inoculation) a 50-100% reduction in NBT-positive cells was observed. This demonstrates the ability of malaria parasite to suppress the oxygen dependent enzyme system in circulating phagocytes, neutrophils and monocytes of the host blood. The results of NBT-test could be utilized for the investigation of immunological disorders and also for the differential diagnosis of malarial infection. PMID- 3280043 TI - [Lysosome proteinases and protein turnover in the liver, spleen and thymus of rats undergoing antigenic stimulation and fasting]. AB - Antigenic stimulation (AS) inhibited cathepsin A and D activation in the liver induced by fasting. AS after short-term fasting (4 days) induced the activation increase in the most of lysosomal proteinases by 20-80% in the spleen and thymus, while AS of animals, upon 6- and 8-day fasting depressed the activation of all the investigated lysosomal hydrolases (cathepsin A, B, C, D and arylsulphatases A and B) and decreased the total protein half-life. The revealed peculiarities in the lysosomal proteolytic system function and intensified protein turnover in lymphoid organs may reflect the general reaction of the organism, directed towards the maintenance of immunological homeostasis and, in particular, towards antibody production. PMID- 3280044 TI - [Functional characteristics of the antioxidative system in mycobacteria grown on perfluorodecalin-modified media]. AB - The growth of mycobacteria on perfluorodecalin-modified media was shown to be accompanied by distinct alterations in the activity of the antioxidant enzyme system in M. bovis BCG and M. lufu. In M. bovis BCG the levels of glutathione transferase and glutathione peroxidase-hydrogen peroxidase activity are decreased by 45.47% and 100.88%, respectively. In M. lufu, on the contrary, the level of superoxide dismutase is increased by 42.23%, with no changes observed in the levels of glutathione transferase and glutathione peroxidases. The data obtained suggest physiological heterogeneity of mycobacteria and, thus, open prospects for the differential approaches to the problem of increasing the efficacy of in vitro cultivation of various mycobacterial species, including M. leprae. PMID- 3280045 TI - [Implantation of embryonic pancreas into the anterior chamber of healthy and diabetic rats]. AB - The possibility of pancreatic-islet embryonic implantation into the frontal chamber of the eye in Wistar rats has been demonstrated. The implantation was followed by the induction of alloxan diabetes. Clinical diabetic compensation has been shown in a number of experimental animals (maximum time of experiments--45 days). The formation of islet-like structures in the frontal chamber of the eye was confirmed microscopically. The structures contained B cells in their cytoplasm. Cellular differentiation leading to the appearance of functionally active endocrine cells has been noted in the implants. PMID- 3280046 TI - [Effect of insulin on cartilage differentiation in vitro]. AB - A consistent chondrogenesis takes place in high-density microcultures derived from bud mesenchymal cells of 4-day-old chicken embryos in a serum-supplemented medium. In serum-free medium DNA level and uronic acid content in the cultures were low, as well as the 35SO4 uptake and release, and only a small mass of cartilage was formed. With the addition of 0.025-10 micrograms/ml insulin to serum-free medium the uronic acid and DNA content in the cultures increased considerably in a dose-dependent way. The intensity of 35SO4 uptake and release exceeded the values measured in serum-containing medium, more cartilage tissue was formed in them also in a dose-dependent manner. With the use of 20-80 micrograms/ml insulin, the increment in DNA content proved to decrease, and with the use of 80 micrograms/ml insulin the uronic acid content and the cartilage mass decreased to a greater extent than in the case of lover doses. PMID- 3280047 TI - [Method of creating a model for assessing the effectiveness of preparing the wound surface for autodermoplasty in an experiment]. AB - Twenty rabbits and fourty male rats were used for the development of the autodermoplasty model: two symmetrical semilunar skin incisions, turned to one another, with 1 cm space between the ends of the arches, were made on the back of the animal. The skin with subcutaneous fat was exfoliated from above the muscular tissue in the area between the incisions. Elastic arched net-shaped fluoroplastic plate, matching to the size of the exfoliated skin graft and raising it 1.5 cm above the wound surface was introduced into the cavity emerged. As soon as any method of wound surface purification was used, the plate was removed and the the skin graft above (conditional autodermograft) was applied and fixed to the edges of the wound with 4 interrupted sutures. It was stated that the model used for testing various methods of preparing the wound surface for autodermoplasty not only decreased the duration of experiment and the number of animals employed but cut their keeping and dressing expenditures. PMID- 3280048 TI - [Effect of opioid peptides on the lymphatic drainage of the pancreas in the rat and dog]. AB - The effect of dalargin and some other ligands of the opioid receptors on drainage function of the pancreatic lymphatic system was studied in rats and dogs. In rats, dalargin (30-1000 micrograms/kg, subcutaneously) accelerated the elimination of Evans blue from beneath the pancreatic capsule in a dose-related manner. The effect of dalargin was attenuated by naloxone. Specific agonists of mu-, delta- and sigma-opioid receptors had no dalargin-like activity. In dogs, dalargin (60-80 micrograms/kg, subcutaneously) after the administration of Evans blue into the pancreas increased its concentration in the truncus lymphaticus and slowed down its penetration into the blood. Thus, dalargin accelerates the elimination of Evans blue from the pancreas due to the intensification of lymphatic drainage. The effect of dalargin was mediated by subpopulation of opioid receptors with which their certain selective ligands have but slight interaction. PMID- 3280049 TI - [Effect of acute hypoxia on the renin and erythropoietin activities of the blood serum in rats]. AB - A comparative study of renin and erythropoietin content in the blood serum of rats with "endocrine" kidneys and changes in their activity following the action of specific erythropoietic stimulus (4-hour hypoxia) has been conducted. The presence of "endocrine" kidneys increased renin and erythropoietin activity in such animals. Acute hypoxia produced further increase in erythropoietin titre in the blood serum, with renin remaining at the same level. Possible differences in the mechanisms of renin and erythropoietin biogenesis in the kidneys are considered. PMID- 3280051 TI - [Formation of a heterotopic hemopoiesis focus from the administration of a cryptococcal heteropolysaccharide to bone marrow donors and recipients]. AB - The effect of Cryptococcus luteolus (strain 228) heteropolysaccharide on heterotopic bone marrow organ formation was studied. Heteropolysaccharide (Hp) injections were initiated on the next day after bone marrow transplantation and were performed weekly for 30 days. This resulted in the increase in both the cellularity and the weight of the ossicle. The injections performed twice weekly produced the decrease of cellularity while ossicle weight did not change. Higher dose of Hp produced no changes in heterotopic bone marrow organ. Hp injections to donor mice did not result in any changes in heterotopic organ in bone marrow recipients. Thus, this kind of Hp was capable both of stimulating and inhibiting heterotopic bone marrow organ formation in relation to the dose and scheme of administration. PMID- 3280050 TI - [Model systems of carcinogenesis in vitro: the interaction of the ras oncogene with immortalized cells]. AB - Gene transfer experiments have shown that ras effector functions are sufficient to transform cells from a variety of established lines (e. g., mouse NIH3T3 cells). In contrast, primary cells and early passage rodent cells can be transformed by ras oncogenes only at low frequencies, unless cotransfected with collaborating genes such as adenovirus early region IA (EIA) or myc retroviral oncogene homologue. Primary rat embryo fibroblasts (REF) were chosen as a model for the analysis of multistep cellular transformation. Transfection of REF, immortalized by early region of simian adenovirus SA7 with c-Ha-ras oncogene cannot induce their morphological transformation. This phenomenon is observed only after second transfection with the same oncogene. These different cell lines can be used for further analysis of the mechanisms of carcinogenesis. PMID- 3280053 TI - [Register of the Academy and program of conferences]. PMID- 3280054 TI - Venous skin flaps: an experimental study and report of two clinical distal island flaps. AB - An experimental study of saphenous flaps in 26 dogs is reported, which confirmed the work of Baek et al. (1985) that venous flaps can survive. In addition, it showed that venous island flaps could survive after division of the venous pedicle proximally or distally, or as free flaps, providing through flow was re established by venous anastomoses. In this study no flaps survived on a single venous pedicle without through flow. Two successful clinical cases of venous flaps are also reported, in which through flow was re-established by a simple venous anastomosis. One of these flaps threatened to become necrotic until the thrombosed anastomosis was successfully redone. PMID- 3280052 TI - [Ultrastructural changes in the microcirculatory bed of the lungs in endotoxin shock]. AB - The electron microscopic study of the lungs during the initial and intermediate stages of endotoxin shock has revealed the manifestations of thrombo-hemorrhagic syndrome. Three days later interstitial fibrosis developed. Ultrastructural alterations of microcirculation become the basis for the formation of acute pulmonary failure. PMID- 3280055 TI - Reconstruction of the hard palate using free iliac bone covered with a jejunal flap. AB - In this paper we report the reconstruction of a large defect of the hard palate by covering free iliac bone with a jejunal flap. The new palate is moist and tough but not bulky. This new method brings with it the useful concept that the jejunum might nourish the free bone through its serosa. PMID- 3280056 TI - The effect of mechanical stress on soft and hard tissue repair; a review. AB - The influence of mechanical forces on intact tissue is well established. A growing body of evidence demonstrates that healing wounds also respond to the functional demands of their mechanical environment. At the present time, an understanding of the fundamental mechanism by which mechanical stress affects tissues and wounds remains elusive. PMID- 3280057 TI - The evolution of plastic surgery in Dr Steevens' Hospital, Dublin. PMID- 3280058 TI - History of the establishment and development of the plastic surgical service in the City of Cork and surrounding province of Munster. PMID- 3280059 TI - Forerunners of mesh grafting machines. From cupping glasses and scarificators to modern mesh graft instruments. AB - Lanz described mesh grafting in 1907. A similar device was used earlier by Pare and Heister for different applications. Historical analysis reveals a definite link between old scarificators and mesh graft machines. PMID- 3280062 TI - Evaluation of the processing functions of a digital subtraction angiography image processor. AB - A large number of imaging systems for digital subtraction angiography (DSA) are now commercially available. Numerous evaluations of the performance of these systems have been reported in the literature. However systematic evaluations of the processing functions of DSA image processors have not been widely reported. Such an evaluation for one commercial system is presented in this paper. Functions evaluated include linear transformation, logarithmic transformation, integration, subtraction and temporal filtration. The observations indicate that image processing results are frequently achieved by indirect routes which compromise the fidelity of the image data. PMID- 3280061 TI - Hypertrophic pyloric stenosis: determination of muscle dimensions by ultrasound. AB - To evaluate the usefulness of ultrasound in hypertrophic pyloric stenosis (HPS) and to analyse the correlation between the dimensions of the pyloric muscle and the age and the weight of the child, 34 children with suspected HPS and 34 controls were examined. An overlap between the dimensions of the pyloric muscle in the HPS group and in the controls stresses the need to assess the muscle length, the muscle diameter, and the muscle wall thickness in establishing the sonographic diagnosis of HPS. We found the following criteria useful: muscle length greater than or equal to 19 mm, muscle diameter greater than or equal to 10 mm, and muscle wall thickness greater than or equal to 4 mm. The results did not confirm previous reports of increasing dimensions of the pyloric muscle with age and weight. PMID- 3280063 TI - Case of the month. Blindingly obvious. PMID- 3280060 TI - Highly potent and stereoselective effects of the benzoic acid derivative AZ-DF 265 on pancreatic beta-cells. AB - 1. Mouse islets were used to define the characteristics and study the mechanisms of the stimulation of insulin release by compound AZ-DF 265, 4-[[N-(alpha-phenyl 2-piperidino-benzyl) carbamoyl]methyl] benzoic acid, a substituted benzoic acid with an asymmetric carbon atom. 2. At a non-stimulatory concentration of glucose (3 mM), (-)-AZ-DF 265 reversibly inhibited 86Rb efflux from islet cells, depolarized the beta-cell membrane, induced electrical activity, stimulated 45Ca efflux, and triggered insulin release. Maximum inhibition of 86Rb efflux occurred at 0.03 microM (-)-AZ-DF 265, whereas the threshold concentration for stimulation of release was 0.1 microM. Omission of extracellular Ca2+ abolished all effects of the drug but the inhibition of 86Rb efflux. 3. At a stimulatory concentration of glucose (10 mM), (-)-AZ-DF 265 reversibly increased 86Rb efflux, potentiated electrical activity, augmented 45Ca efflux, and increased insulin release. Maximum stimulation of 86Rb efflux and insulin release was obtained with 0.03 microM (-)-AZ-DF 265. Omission of extracellular Ca2+ abolished all effects of the drug. 4. The potency of (-)-AZ-DF 265 was similar to that of glibenclamide, whereas the (+)-enantiomer was about 10 times less potent on 86Rb efflux and insulin release. 5. It is concluded that, like sulphonylureas, compound AZ-DF 265 decreases K+ permeability of the beta-cell membrane and thereby causes depolarization. This activates voltage-dependent Ca channels, permits Ca2+ influx and eventually stimulates insulin release. Its stereoselectivity may help to elucidate the mechanisms of K channel blockade and, hence, lead to the design of more potent and specific insulinotropic drugs. PMID- 3280065 TI - Low dose total-body irradiation. PMID- 3280064 TI - Iotrolan versus iopamidol for radiculography: a randomized double-blind study. PMID- 3280066 TI - Stress changes of the wrist in adolescent gymnasts. AB - The radiographic appearances are reported of chronic stress to the wrist joints of eight adolescent males, seven gymnasts and one roller skater. These consist of bilateral, asymmetrical widening and irregularity of the distal radial growth plates with an ill-defined cystic appearance, sclerosis and flaring of the metaphyses in all eight cases. Similar but less marked changes were present in the distal ulnar growth plates in five cases. The aetiology is thought to be that of a Salter Type I stress fracture of the growth plate due to chronic repetitive shear forces applied to the hyperextended wrist joint. Rapid healing of the stress fracture will occur with cessation of the sporting activity but continued strenuous use of the wrists will result in further widening and irregularity of the growth plate. The differential diagnosis of the radiographic appearances and previous literature are discussed. PMID- 3280067 TI - Magnetic resonance imaging of renal transplants: initial experience. AB - Magnetic resonance imaging (MRI) was used in 45 renal transplant investigations (38 patients) using a Picker 0.15 T resistive system and a localized surface coil. An attempt was made to define optimal sequences in the evaluation of both normal and pathological transplants. Three sequences were found to be of value; a T1 weighted sequence (IR2180/700/40) to assess corticomedullary differentiation and its loss in acute rejection and acute tubular necrosis, a T2 weighted sequence (SE2000/80) for assessment of renal vessels and disturbances in blood supply, and a STIR (short tau inversion recovery) sequence (IR800/100/40) to define further the distended collecting system in obstruction and the presence of any perirenal collection. Encouraging results have been obtained, particularly in cases of acute rejection. It is suggested that the MRI scan is a useful screening test in cases of clinical doubt and may even obviate biopsy in some cases. PMID- 3280068 TI - Ultrasonographically defined parenchymal patterns of the breast: relationship to mammographic patterns and other risk factors for breast cancer. AB - We have used ultrasound of the breast to define four parenchymal patterns in which increasing proportions of the breast are replaced by densely echogenic tissue. A series of 452 symptomatic women examined by both ultrasound and conventional X-ray mammography was reviewed to determine whether these ultrasonographic images could predict the breast parenchymal pattern defined mammographically. A very strong correlation was demonstrated between the breast pattern on ultrasound and the volume of the breast replaced by either dysplasia (Kendall's tau-b = 0.731 +/- 0.026, p less than 0.0001) or ductal prominence (Kendall's tau-b = 0.641 +/- 0.049, p less than 0.0001). This was seen both on initial reporting and on a blind re-reading of a random sample of 100 cases. The strength of correlation was similar for subgroups defined by family history of breast cancer, age, menopausal status, and history of benign breast disease, and the breast parenchymal pattern assessed by mammography or ultrasound showed similar associations with these variables. Ultrasonographic parenchymal patterns of the breast can predict the tissue patterns defined mammographically and may therefore be useful as a marker of breast cancer risk. PMID- 3280070 TI - The acute scrotum: a complication of cardiac catheterization. PMID- 3280069 TI - Possible dose rate dependence of recovery kinetics as deduced from a preliminary analysis of the effects of fractionated irradiations at varying dose rates. AB - Data relating to jejunal crypt survival following fractionated total body irradiation of C3H mice have been subjected to a preliminary analysis using the linear-quadratic formalism. Because the regimes considered involved fairly closely-spaced fractions, delivered at dose rates in the range 1.2-72 Gy h-1, it was necessary to further develop previously established forms of the model in order to carry out the evaluation. The magnitude of the recovery half-life has been deduced for each of the regimes and found to be in the approximate range 0.1 0.6 h. For any given fraction number, the half-life appears to be markedly dependent on dose rate, increasing with dose rate up to approximately 25 Gy h-1, falling off thereafter. Tentative reasons for this behaviour are given, together with an assessment of the possible shortcomings of the analytical method. PMID- 3280072 TI - Case of the month. An opportunity not to be missed. PMID- 3280071 TI - Pelvic hydatid disease presenting as acute urinary retention. PMID- 3280073 TI - Ultrasonographic diagnosis of clinically non-palpable primary colonic neoplasms. AB - Over a 2-year period, more than 1700 abdominal ultrasound scans were performed which included a search for bowel disease in the scanning routine. Features consistent with a primary colonic neoplasm were reported in 35 patients. In 14 patients, ultrasound indicated the possibility of a colonic neoplasm in the absence of a clinically palpable mass. An intraabdominal mass was confirmed in 12 patients (86%), and was a primary colonic neoplasm in 11 patients (79%). In one patient a metastatic malignant mass had been misinterpreted as arising from the colon. In two patients no lesion could be demonstrated to account for the ultrasonographic abnormality. In a further 21 patients in which an abdominal mass had been evident on clinical examination, ultrasound was performed for further elucidation and indicated the mass to be arising from the colon. In this group, a primary colonic neoplasm was the cause in 11 patients (52%), while other primary or metastatic malignancy was found in six patients (29%) and benign disease in four patients (19%). We conclude that ultrasound is a useful primary diagnostic technique for colonic neoplasms, with a predictive value of 79% in detecting clinically non-palpable lesions. In our experience, false positive results due to scanning artefacts are rare. We consider that examination of the bowel is a worthwhile addition to the routine scan in patients with non-specific abdominal complaints. PMID- 3280074 TI - Renal artery stenosis: the use of duplex ultrasound as a screening technique. AB - Over an 18-month period, 44 patients with hypertension were referred for evaluation of the renal arteries by duplex Doppler ultrasound. Those patients referred were pre-selected in that they were either young, or suffering from accelerated hypertension. Eleven patients (12 arteries) were considered to have characteristics suggesting renal artery stenosis. Of the 11 patients, nine have submitted themselves for further evaluation by angiography and radionuclide renography. These further investigations have identified seven true positive and three false positive results. Criteria for duplex diagnosis of renal artery stenosis are presented and a possible role for duplex Doppler ultrasound as a screening tool for renal vascular hypertension is discussed. PMID- 3280075 TI - Ocular lens dose in cerebral vascular imaging. AB - Ocular lens dose was considered with respect to cerebral vascular imaging, using both digital subtraction angiography (DSA) and conventional angiography. A dose measurement study is described in which doses were found to be minimal (0.327 cGy) in DSA, but high (60 cGy) using conventional techniques. The use of an undercouch tube in DSA and an increased focus-lens distance, when compared with the conventional angiographic approach were considered the major factors contributing to the difference in lens dose. The implications for selection of technique are discussed. PMID- 3280076 TI - Infants presenting with respiratory distress due to anterior mediastinal teratomas: a report of three cases and a review of the literature. PMID- 3280077 TI - Ultrasonographic appearances of glomus vagale tumour. PMID- 3280078 TI - Urographic visualization of the native kidneys following renal transplantation: a demonstration of the intact nephron hypothesis. PMID- 3280079 TI - Detrusor behaviour following implantation of the Brantley Scott artificial urinary sphincter for neuropathic incontinence. AB - During a 3-year period, 102 Brantley Scott artificial urinary sphincters were implanted to control urinary incontinence. Nineteen patients underwent endoscopic sphincterotomy and artificial sphincter implantation for the control of sphincter weakness incontinence due to congenital neuropathic bladder dysfunction. None had previous augmentation or substitution procedures. Nine patients (47%) subsequently showed a deterioration in detrusor function, resulting in either recurrent incontinence or upper tract dilatation. Eight of these (89%) had previously been shown to have an intermediate pattern of neuropathic bladder abnormality. All patients implanted with an AUS require long-term surveillance including videourodynamic studies, and patients with intermediate neuropathic bladders should be considered for augmentation or substitution at the time of implantation. PMID- 3280080 TI - Flutamide versus stilboestrol in the management of advanced prostatic cancer. A controlled prospective study. AB - In a prospective randomised study the effect of flutamide 750 mg daily was compared with that of stilboestrol 3 mg daily in the treatment of 40 previously untreated patients with advanced prostatic cancer. There was a good subjective response to both treatments. After 12 months, a response was demonstrated in 13 of 20 patients treated with flutamide and 8 of 20 patients treated with stilboestrol. The difference was not statistically significant. Treatment with stilboestrol caused more frequent, and more severe, side effects than flutamide. PMID- 3280082 TI - Salmonella prostatic abscess. PMID- 3280081 TI - Diagnosis and treatment of venous leakage: a curable cause of impotence. AB - Sixteen of 149 patients complaining of impotence of a non-neurogenic or endocrine aetiology and with a penile brachial index of greater than 0.7 failed to achieve an erection following intracavernosal injection of 30 mg papaverine and 1 mg phentolamine. All 16 were shown to have a significant venous leak using digital subtraction cavernosography. Nine of the 13 so far operated upon have had a full return of potency. Repeat cavernosography in three failures showed persistent leakage into crural veins in two and non-ligated superficial veins in one. Impotent men with a normal penile brachial index who fail to respond to papaverine and phentolamine have a venous leak, a curable cause of impotence. Surgical access should allow ligation of all identified leaking veins. PMID- 3280083 TI - re Reduction of post-operative bleeding after transurethral resection of the prostate by local instillation of fibrin adhesive (Beriplast) PMID- 3280085 TI - Tightening the loose arterial suture. PMID- 3280084 TI - Sir Eric Riches. PMID- 3280086 TI - Prediction of choledocholithiasis using a pocket microcomputer. AB - A computerized method, using a small pocket computer, has been used to predict the presence of choledocholithiasis in a prospective series of 239 patients undergoing cholecystectomy. From an initial data base of 424 patients 36 factors were evaluated and the most important 2 of these were determined by multivariate analysis for use in the prospective analysis. Satisfactory operative cholangiograms were a prerequisite to evaluation of the statistical method and were obtained in 90.4 per cent of cases. Using the computerized method a common bile duct stone would have been overlooked in only 1 patient but 17 unnecessary explorations would have been carried out. The overall accuracy of the computerized method was 92.5 per cent. When the method was applied to a further study of 97 patients from a separate centre the overall accuracy was 85.6 per cent. If the method was used to aid selective use of operative cholangiography, cholangiograms would be performed in 20 per cent and stones would be overlooked in less than 1 per cent. PMID- 3280087 TI - Pancreatitis and hyperparathyroidism. AB - Hypercalcaemia is considered to be a rare cause of pancreatitis but the true cause-and-effect relationship between hyperparathyroidism and pancreatic inflammatory disease remains controversial. Over 100 patients have been reported in whom both processes have occurred concurrently, but doubts have been expressed as to whether or not this association is due to chance. We report 10 new cases of hypercalcaemic hyperparathyroidism associated with different types of pancreatitis. Seven patients had primary hyperparathyroidism and three had hyperparathyroidism after renal transplantation. Two experienced acute pancreatitis after parathyroidectomy. Of the remaining eight patients, five had hypercalcaemia equal to or above 120 mg/l. The prevalence of pancreatitis in our series of 86 cases of primary hyperparathyroidism is 8 per cent. Acute and chronic calcifying types of pancreatitis were observed. Three patients died of the disease, two of them after renal transplantation. It is suggested that pancreatitis may complicate the clinical course of hyperparathyroidism, particularly when hypercalcaemia is moderate to severe and/or there are other risk factors such as treatment with steroids and azathioprine after renal transplantation. PMID- 3280089 TI - 'Button hole' incisional hernia. PMID- 3280088 TI - Effect of splenectomy on gram-negative bacterial clearance in the presence and absence of sepsis. AB - Severe sepsis leads to depression of the reticulo-endothelial system (RES) with delayed bloodstream clearance of particulate matter and bacteria. Splenectomy results in increased susceptibility to infection with encapsulated organisms but its effect on the resistance to postoperative Gram-negative infection has been little studied. We have investigated the effect of splenectomy on RES function by measurement of plasma fibronectin concentrations and bacterial clearance in the presence and absence of sepsis. In experiment 1, rabbits underwent splenectomy (n = 8) or laparotomy only (n = 8) 4 weeks before a second laparotomy. In experiment 2, animals had either splenectomy (n = 8) or laparotomy only (n = 8) followed 4 weeks later by devascularization of the appendix (sepsis). Plasma fibronectin concentrations and the blood clearance and organ distribution of an intravenous injection of 75Se-labelled viable Escherichia coli (2-3 X 10(8) colony forming units (c.f.u.] were measured 24 h after the second operation. Splenectomy resulted in: (1) a persistent reduction in plasma fibronectin concentration in the presence and absence of sepsis, and (2) a delay in the bloodstream clearance with reduced hepatic (Kupffer cell) uptake of E. coli which was exaggerated in the septic splenectomized animal. It is concluded that the spleen may be important for Gram-negative bacterial clearance, possibly related to its influence on plasma fibronectin concentration and Kupffer cell function. PMID- 3280090 TI - Diagnosis of pancreatic necrosis. PMID- 3280091 TI - Choice of treatment in carcinoma of the oesophagus. PMID- 3280092 TI - Contact laser or conventional cholecystectomy: a controlled trial. AB - There have been claims that the use of lasers in surgery is associated with reduced operative blood loss, trauma, postoperative pain and improved postoperative mobility. With the development of sapphire probes capable of transmitting neodymium yttrium aluminium garnet (Nd: YAG) laser light, it is now feasible to perform direct-contact low-power laser surgery. In a small randomized controlled trial, we have compared cholecystectomy performed by conventional methods (n = 11) with the same operation performed by contact laser (n = 10). Operative time, blood loss, operative stability, analgesic requirement, mobility and response to the trauma of surgery were compared. The only differences between the two groups were a significantly increased wound infection rate (P = 0.051) in the laser surgery group and a significantly increased length of operating time (P = 0.001). Thus, the laser did not confer any advantage over conventional surgery. PMID- 3280093 TI - Blunt injuries of the diaphragm. AB - Rupture of the diaphragm is a potentially serious complication of blunt trauma which can easily be overlooked at the time of presentation. This review examines the incidence and pathogenesis of the injury and discusses diagnosis and management. PMID- 3280096 TI - Ultrasound mammography in the management of breast cancer. AB - In this centre, ultrasound mammography has been shown to be more accurate in elucidating the nature of palpable breast lesions than X-ray mammography. A prospective study was devised to determine whether this accuracy could be translated into improved management of patients with breast carcinoma. A total of 223 patients with palpable breast masses were assessed by clinical examination, imaging (X-ray and ultrasound mammography) and aspiration cytology. Each was scored on a five-point scale and treatment was planned according to the total score. According to the protocol, an adequate total score would permit definitive surgery avoiding frozen section. By using sonography rather than radiology, the number of correct diagnoses could be improved by 25 per cent. This was because the greater sensitivity of ultrasound (92.8 per cent) compared to X-ray mammography (82.5 per cent) was reflected in a higher total score, which was sufficient to allow definitive surgical treatment without prior histological confirmation of diagnosis. PMID- 3280094 TI - Doppler ultrasonography in the diagnosis of acute scrotal pain. AB - Pre-operative Doppler ultrasonography was performed on 41 patients who underwent an emergency scrotal exploration because of the clinical suspicion of a testicular torsion. The final diagnoses were testicular torsion in 18 patients, epididymitis in 15 patients and torsion of a testicular appendage in 8 patients. An unequivocal indication as to the presence or absence of a testicular torsion was obtained in 31 patients (76 per cent), an equivocal result was obtained in 5 patients and in 5 patients the examination was unsatisfactory. The sensitivity and specificity of the investigation for the diagnosis of testicular torsion were 67 per cent and 83 per cent respectively, and the predictive value of either a positive or negative result was 100 per cent. Our results suggest that the use of Doppler ultrasonography could reduce the incidence of unnecessary operations without incurring the risk of reduced testicular salvage. PMID- 3280095 TI - High prevalence of abdominal aortic aneurysm in men with peripheral vascular disease: screening by ultrasonography. AB - A study was carried out to see if an ultrasonic examination of the abdominal aorta was indicated in every patient who attended an outpatient clinic with peripheral vascular disease (PVD). One hundred consecutive patients were studied and compared with a control group. The incidence of abdominal aortic aneurysm (AAA) in the control group was 2 per cent. In the study group, the male patients had an incidence of 20 per cent of aneurysm and ectasia, while the female patients had an incidence of 12 per cent. Of all the abnormal aortas found by ultrasound, only 31 per cent were palpable clinically. Two aneurysms that required operation were found, while the remainder are to be followed by regular ultrasound assessment. Further studies are necessary to conclude if screening of a high risk group, such as patients with PVD, is worthwhile. PMID- 3280097 TI - Relative merits of ultrasound and intravenous urography in the investigation of the urinary tract. AB - Three hundred and fifty adult patients referred for intravenous urography were entered into a prospective double blind trial comparing intravenous urography with real time ultrasound. The study was performed to clarify the relative merits of the two techniques. Our results show that ultrasound and a plain abdominal radiograph should be the examination of first choice in most circumstances. This is particularly so in vague abdominal pain and in recurrent urinary tract infections where intravenous urography can usually be omitted or used only as a secondary investigation for further evaluation of abnormal ultrasound findings. In acute renal colic, intravenous urography should be the primary investigation. In macroscopic haematuria, initial examination by ultrasound would reliably diagnose mass lesions, show whether the lesion is cystic or solid and assess possible spread. Normal ultrasound does not exclude haematuria due to ureteric lesions or bladder lesions and intravenous urography is recommended. PMID- 3280098 TI - Transvaginal compared with transvesical ultrasonography for recovery of oocytes for in vitro fertilisation. PMID- 3280100 TI - Cumulative author and subject indexes. Volumes 325-361 (1985). PMID- 3280099 TI - Brain/body relations among myomorph rodents. AB - The observed increase in brain size (E) with body size (P) 'from mouse to elephant' may be described by a power relation E = kPb, where b is near 2/3 or 3/4. That this reflects a single, strong interaction between brain and body evolution is challenged by two observations: (1) different species with the same body size may have markedly different brain sizes, and (2) the value of b at the species level is usually nearer 1/3 than 2/3. Furthermore, the idea that a bigger brain means greater versatility on the part of its owner makes a strong statement about such animals. We examined these notions by measuring cranial volumes of 1,480 skulls from 62 subspecies of cricetid and murid rodents. Values of k and b were obtained by computing a reduced major axis on E and P across all specimens (b = 0.693), and when specimens were partitioned by genus (b = 0.456) and subspecies level (b = 0.338). Thus, the overall slope of 7/10 is not a simple extension of the developmental rules at the subspecies level (b near 1/3) nor even at the genus level (b near 4/9). Rather, it may reflect the most likely path for an interbreeding population subjected to varying selective pressures on one or more correlated traits. Furthermore, among the rodents studied, folivorous subspecies averaged about 2/3 as much brain as granivorous, insectivorous or generalist subspecies of the same body weight. Also, Old World rats, which may be more versatile than wood rats, gained their competitive advantage despite having relatively smaller brains. PMID- 3280101 TI - [Anesthesia in resections and anastomoses of the trachea]. AB - Resections and end-to-end anastomosis have been effective in correcting localized tracheal strictures. Important clinical considerations are the precise preoperative assessment of the lesion, careful planning of anesthetic management and choice of the appropriate decision. Surgical procedures involving sharing of the air way between the anaesthetist and the surgeon impose special problems on the anaesthetist. On the one hand, the surgeon requires unrestricted access to the operating site and on the other, the anaesthetist must ensure adequate anaesthesia, oxygenation and carbon dioxide elimination, preferably without contamination of the lung fields. The more commonly employed technique is the use of a tracheal tube so that anaesthesia can be maintained using conventional IPPV. In our experience, the majority of strictures in adults can be managed as well, or better, by using a conventional endotracheal tube. PMID- 3280103 TI - [Prevention of infections in operating rooms]. PMID- 3280104 TI - AIDS and donor eyes. PMID- 3280102 TI - [Precurarization by atracurium before suxamethonium]. PMID- 3280105 TI - Uveal melanoma with opaque media: absence of definitive diagnosis before enucleation. AB - It is often difficult to make a correct diagnosis of a uveal melanoma in an eye with opaque media. A patient with a blind, painful eye and opaque media was evaluated clinically and with computed axial tomography and ultrasonography. We were unable to establish the definitive diagnosis of a uveal melanoma until the eye was examined histologically. Necrotic melanomas usually present with inflammatory signs, may produce opaque media and can be difficult to diagnose with clinical and imaging studies. PMID- 3280106 TI - Louis Riel: a case of insanity. PMID- 3280107 TI - Thoracic outlet syndrome with congenital pseudarthrosis of the clavicle: treatment by brachial plexus decompression, plate fixation and bone grafting. AB - Although a number of cases of congenital pseudarthrosis of the clavicle have been described in the literature, they provide little direction for the treatment of this condition when it is associated with thoracic outlet syndrome. The authors describe their experience with such a case in a 20-year-old woman. Symptoms of pain in the ulnar distribution of the right forearm and discoloration of the hand with abduction of the extremity had developed over 3 years. The radial pulse was obliterated by abduction of the arm. Exploration of the brachial plexus revealed a constricting band arising from the distal fragment of the clavicle running to the first rib which, together with the mass of the pseudarthrosis, comprised the thoracic outlet. The patient was successfully treated by division of the fibrous band, reduction of the clavicle, internal fixation with a plate and iliac crest bone grafting. At follow-up the patient had a full range of motion in the shoulder and was asymptomatic. PMID- 3280110 TI - Clinical nurse specialization: an annotated bibliography--implementation and utilization. PMID- 3280108 TI - Experimental peste des petits ruminants (goat plague) in goats and sheep. AB - In order to study the pathomorphology and immunohistochemistry of peste des petits ruminants, four goats and two sheep were inoculated intranasally with the Malig-Yemen strain of peste des petits ruminants virus. The animals developed fever, nasal discharge, oral erosions, cough and diarrhea. One goat and one sheep died and one moribund goat was killed. Three animals survived the infection. At necropsy, erosive stomatitis, pneumonia and gastroenteritis were found. Histopathologically the pneumonocytes and epithelial cells of the ileum had eosinophilic cytoplasmic and nuclear inclusions. By an indirect immunoperoxidase method, the nuclei and cytoplasm of the ileal epithelial cells of one goat contained positively (brown) stained antigen, which corresponded to viral nucleocapsids by electron microscopy. Virus appeared to be released through the microvilli of the epithelial cells. We also confirmed the formation of giant cells due to peste des petits ruminants virus. PMID- 3280109 TI - Studies of ERA/BHK-21 rabies vaccine in skunks and mice. AB - ERA rabies vaccine virus grown in BHK-21 13S cells (ERA/BHK-21) and street rabies virus were titrated in mice by intracerebral, intranasal and intramuscular inoculation. Mice were also given undiluted ERA/BHK-21 in baits. Skunks were given undiluted ERA/BHK-21 in baits and by intramuscular, intranasal and intestinal inoculation. Virus neutralizing antibody titers against rabies virus were measured over a three month observation period. The surviving skunks were challenged by intramuscular inoculation with rabies street virus from a skunk salivary gland suspension. When titrated in mice, ERA/BHK-21 had titers of 10(7.0), 10(5.2) and 10(3.9) median lethal doses per mL by the intracerebral, intranasal and intramuscular routes, respectively. All skunks (8/8) inoculated intranasally developed paralytic rabies by 12 days after exposure to ERA/BHK-21 virus. None of the skunks that developed vaccine-induced rabies had infectious virus in the submandibular salivary glands. Vaccine-induced rabies also occurred in 1/8 skunks in the intramuscularly inoculated group and in 1/8 in the intestinally inoculated group. The survival rates of challenged skunks in the various groups were as follows: intramuscular, 7/7; intestinal, 2/7; bait, 0/8; and control, 0/8. These results indicate that ERA/BHK-21 virus has a significant residual pathogenicity in mice and in skunks by some routes of inoculation. Skunks given vaccine intramuscularly were protected against challenge, while those skunks given the vaccine in baits were not. PMID- 3280111 TI - Clinical nurse specialization: an annotated bibliography--educational preparation. PMID- 3280113 TI - High activity iodine 125 endocurietherapy for recurrent skull base tumors. AB - Experience with endocurietherapy of skull base tumors is reviewed. We present our cases of recurrent pituitary hemangiopericytoma, radiation-induced recurrent meningioma, recurrent clival chordoma, recurrent nasopharyngeal cancer involving the cavernous sinus, and recurrent parotid carcinoma of the skull base which were all successfully retreated with high-activity 125iodine (I-125) permanent implantation. PMID- 3280112 TI - Combination antiemetics for cisplatin chemotherapy. AB - Nausea and vomiting occur in a majority of patients receiving cisplatin chemotherapy despite prophylactic single agent antiemetic therapy. Three potent antiemetics, metoclopramide, droperidol and dexamethasone, and diphenhydramine to prevent potential extrapyramidal reactions, were combined in prophylaxis of 67 patients receiving cisplatin chemotherapy. Of the patients studied, 76.1% experienced complete protection from both nausea and vomiting in their first course and 62.7% in all their courses of treatment. In 73.3% of 161 evaluable courses, there was neither nausea nor vomiting. Vomiting did not occur in 79.5% of courses. There was no evidence to suggest tachyphylaxis. The efficacy in preventing nausea and vomiting was independent of primary disease site, age, sex, performance status, prior chemotherapy, and prior vomiting. Toxicities were mild and infrequent. Reversible transient extrapyramidal reactions, sweating or twitches occurred in 5.6% of courses. The combination of metoclopramide, diphenhydramine, droperidol and dexamethasone was highly efficacious in preventing nausea and vomiting in moderate or high-dose cisplatin chemotherapy with little toxicity. PMID- 3280114 TI - A randomized, double-blind, placebo-controlled trial of transfer factor as adjuvant therapy for malignant melanoma. AB - One hundred and sixty-eight evaluable patients participated in a randomized, double-blind study of transfer factor (TF) versus placebo as surgical adjuvant therapy of Stage I and Stage II malignant melanoma. Eighty-five patients received TF prepared from the leukocytes of healthy volunteer donors; eighty-three participants received placebo. Therapy was initiated within 90 days of resection of all evident tumor and continued until 2 years of disease-free survival or the occurrence of unresectable dissemination of melanoma. Known prognostic variables were similarly distributed in the treatment and control groups, documenting the randomization efficacy. Three endpoints were analyzed: disease-free interval, time to Stage III metastasis, and survival. After a median follow-up period of 24.75 months, there was a trend in favor of the placebo group with regard to all three endpoints and this was significant (P less than or equal to 0.05) for time to Stage III metastasis. These findings indicate that TF is not effective as surgical adjuvant therapy of malignant melanoma. PMID- 3280115 TI - Clinical, ultrastructural immunohistochemical and DNA content analysis of lymphomas having features of interdigitating reticulum cells. AB - Interdigitating reticulum cells (IRC) are dendritic, nonphagocytic histiocytes found in thymus-dependent areas of lymphoid tissues. We report two cases of large cell lymphoma having features of IRC in patients 13 and 17 years old. In each case the diagnosis was suggested by light and electron microscopic features, positive immunoperoxidase staining for S-100 protein, and additional immunoperoxidase findings. Both patients presented with aggressive lymphomas and were treated with intensive combination chemotherapy. Each patient achieved a complete clinical remission, then rapidly relapsed and died with disseminated disease 3 and 9 months after presentation. Novel findings included strong staining of specimens with an antibody to epithelial membrane antigen, staining of one specimen with peanut agglutinin in the pattern previously described in normal IRC, and a DNA content analysis that showed aneuploid stem cell lines in both patients. PMID- 3280116 TI - Primary Kaposi's sarcoma of the lymph node in children. AB - A case of primary Kaposi's sarcoma of the lymph node (single node involvement) is reported on here. It occurred in a white, Italian boy 10 years of age. An extensive review of the literature showed that this was only the second childhood case of the disease among non-acquired immune deficiency syndrome (AIDS)-related people of the Western world. PMID- 3280118 TI - A will to live. PMID- 3280117 TI - Learning by computer. PMID- 3280119 TI - Evolution of cancer genes as a mutation-driven process. AB - Cancer is primarily a somatic genetic disease resulting from the accumulation of several precancerous mutations in a cell lineage. The evolution of highly oncogenic retroviruses has been used as a model for the evolution of a cancer cell. The properties of intermediates between one set of replication-competent retrovirus and protooncogene progenitors and the homologous highly oncogenic retrovirus were analyzed to differentiate between selection-driven and mutation driven models of this evolution. In this case and in some other cases where sufficient data are available, it appears that the intermediates in the evolution of highly oncogenic retroviruses are not transforming, indicating that they were not formed in a purely selection-driven process. Furthermore, analysis of retrovirus mutation rates indicates that there is a high rate of mutation in retrovirus replication such that the evolution of highly oncogenic retroviruses could be mutation-driven. Other evidence is mentioned suggesting that oncogenesis in general is at least partially mutation-driven, although mutational mechanisms are involved that are different from those involved in the evolution of highly oncogenic retroviruses. PMID- 3280121 TI - Point mutation of the ras protooncogenes and chromosome aberrations in acute nonlymphocytic leukemia and preleukemia related to therapy with alkylating agents. AB - Nine cases of overt acute nonlymphocytic leukemia and four cases of preleukemia or a myelodysplastic syndrome, all related to intensive treatment with alkylating agents, were studied cytogenetically and investigated using a rapid and sensitive dot blot screening procedure for point mutations in the Ha-ras, Ki-ras, and N-ras protooncogenes within codons 12, 13, and 61. The technique involves a selective amplification of genomic DNA sequences containing the codon sequence of interest, in combination with oligonucleotide hybridization. Examining fractionated mononuclear cells from bone marrow or peripheral blood, an N-ras mutation at position 13 was observed in one patient with overt leukemia, resulting in a base change from GGT to TGT thus converting glycine to cysteine. The other cases exhibited no ras gene mutations. It is surprising that c-ras mutations are only occasionally observed in overt acute nonlymphocytic leukemia related to treatment with alkylating agents, as such abnormalities have often been observed in acute nonlymphocytic leukemia de novo, and as many alkylating agents are known to produce DNA adducts leading to point mutations and substitution of single amino acids. The fact that deletions of varying parts of the long arms of chromosomes 5 and 7 are observed in most cases of therapy-related acute nonlymphocytic leukemia and preleukemia, as confirmed by our own series of 71 patients, suggests that loss of heterozygosity for specific alleles on the two chromosomes, rather than activation of a protooncogene, could be an important step in leukemogenesis. PMID- 3280122 TI - Heterogeneity of progesterone receptor distribution in human endometrial adenocarcinoma. AB - The clinical response of advanced endometrial adenocarcinoma to progestin therapy does not correlate perfectly with biochemically assayed progesterone receptor status of the tumor. We have previously suggested that heterogeneity of progesterone receptor at the cellular, tumor, and tissue levels, not detectable by the biochemical assay, might contribute to this discrepancy. A monoclonal antibody, hPRa-1, generated against human progesterone receptor, was used in the present study to immunohistologically define the heterogeneity of progesterone receptor distribution in primary endometrial carcinomas. Twenty-four hysterectomy specimens removed for the treatment of endometrial adenocarcinoma were examined by biochemical assay of progesterone receptor and immunohistochemistry. In two cases, in which tumor occupied almost all of the endometrial lining, more extensive sampling was performed with removal of four noncontiguous sites. Each site was subdivided for immunohistochemistry and biochemical assay of progesterone receptor. When present, progesterone receptor localization was confined to the nuclei of target cells. Variability in the distribution and intensity of staining was consistently observed within the tumors. Of 24 tumors 15 were determined to be progesterone receptor positive by biochemical assay, while 12 of 24 tumors displayed immunolocalization for progesterone receptor. The correlation of the results by the two methods was high (20 of 24 cases, 83%), and the discrepancies in three cases appeared to reflect tissue and tumor heterogeneity. Immunolocalization has demonstrated that heterogeneity is present at the tumor, tissue, and cellular level within endometrial carcinomas, and the failure of some progesterone receptor-positive (by biochemical assay) tumors to respond to progestin therapy may reflect false positive results due to contamination of progesterone receptor-negative tumors by adjacent benign endometrium or myometrium. PMID- 3280120 TI - Potential intracellular target proteins of the anticarcinogenic Bowman Birk protease inhibitor identified by affinity chromatography. AB - The soybean-derived Bowman Birk inhibitor (BBI) has been shown to inhibit carcinogenesis in both in vitro and in vivo model systems. In the present study, we have utilized a BBI affinity column to determine whether cellular enzymes, present in C3H/10T1/2 cells, specifically interact with this inhibitor. Using this technique, we have identified three proteins with masses of about 70, 60, and 50 kilodaltons. Cell fractionation experiments demonstrate that the 60- and 50-kilodalton proteins are present in the 10,000 x g pellet (lysosomal/golgi fraction) of C3H/10T1/2 cell homogenates. We have also identified two proteins with masses of 60 and 50 kilodaltons which bind to the BBI affinity column in fibroblasts from patients having Bloom syndrome. BBI as well as several other protease inhibitors has been shown previously to reduce the frequency of spontaneous chromosomal aberrations in these cells. Our results indicate that the 50- and 60-kilodalton proteins we have identified by affinity chromatography are present in both mouse and human cells and further suggest that these proteins are potential intracellular targets of the BBI in these cells. PMID- 3280123 TI - Fibrinogen influx and accumulation of cross-linked fibrin in mouse carcinomas. AB - 125I-radiolabeled guinea pig fibrinogen was used to measure the influx (20 min) and accumulation (18 h) of fibrinogen/fibrin in three transplantable carcinomas (Lewis lung, TA3/St mammary, and MOT ovarian) growing in the subcutaneous space of syngeneic mice. Fibrinogen influx and, to an even greater extent, fibrin accumulation were substantially increased in all three tumors, as compared with normal control tissues. A significantly larger fraction of tumor-associated than control tissue radioactivity was insoluble in 3 M urea, a property of cross linked fibrin. Positive identification of cross-linked fibrin was made by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography of tumor extracts. Tumor fibrin deposits were localized by immunoperoxidase staining of tissue sections. Fibrin accumulation was also significantly increased in premalignant hyperplastic alveolar nodules that had been transplanted to cleared mammary fat pads, as compared with normal mammary tissue, and was further increased in primary mammary carcinomas that arose from hyperplastic alveolar nodules. These findings generalize to the mouse the principles that tumor vessels are hyperpermeable to plasma proteins and that fibrin accumulates in transplantable and primary tumors. Further, they demonstrate that tumor fibrin is cross-linked and therefore analogous to the fibrin deposited in thrombi, wounds, and cellular immunity. PMID- 3280124 TI - Modulation of Mr 53,000 protein with induction of differentiation of human neuroblastoma cells. AB - LA-N-5 human neuroblastoma cells were found to express high levels of an Mr 53,000 cellular tumor antigen (p53), a protein that has been implicated as playing a fundamental role in the control of cell division and differentiation processes in a variety of tumor systems. When LA-N-5 cells are treated with retinoic acid, they undergo growth and morphological, biochemical, and electrophysiological changes that are characteristic of neuronal maturation and a reduction of the malignant phenotype. We find that these retinoic acid-induced changes are accompanied by a marked decrease in the levels of p53 and p53 mRNA. In our study, p53 levels decreased in concert with both morphological differentiation and with inhibition of cellular proliferation in vitro. These results suggest that p53 levels are intimately related to an undifferentiated phenotype in neuroblastoma cells and support studies which relate p53 levels to the malignant phenotype in other tumor systems. PMID- 3280125 TI - Blood, retinol and zinc riboflavin status in relation to precancerous lesions of the esophagus: findings from a vitamin intervention trial in the People's Republic of China. AB - Data from a double-blind intervention trial in China are reanalyzed to explore auxiliary information. The trial had shown that in a high-risk area for esophageal cancer the dietary supplementation of apparently healthy individuals with a combination of retinol, riboflavin, and zinc did not lead to a different prevalence of precancerous lesions of the esophagus among those receiving the active treatment compared to a placebo group. However, improvement of blood retinol and zinc levels were also observed in the placebo group. The logistic regression analysis presented in this paper illustrates that those individuals who showed large increases in retinol, riboflavin, and zinc blood levels were more likely to have a histologically normal esophagus at the end of the trial. This effect is clearer for retinol than for riboflavin and zinc and it is independent of whether the change was caused by the active treatment or occurred otherwise. PMID- 3280126 TI - Recent advances in drug delivery technology for neurology. PMID- 3280127 TI - Glutamatergic abnormalities in Alzheimer's disease and a rationale for clinical trials with L-glutamate. PMID- 3280128 TI - Pharmacological study in Meige's syndrome with predominant blepharospasm. AB - Objective quantification of the symptoms of Meige's syndrome is difficult and has not been performed in the majority of pharmacological studies of Meige's syndrome published so far. The aim of the present study was to reexamine the therapeutic potential of biperiden, clonazepam, haloperidol, and lisuride using an objective method of quantification of the symptoms. Eleven patients received daily i.v. injections of biperiden, 5.0 mg; clonazepam, 1.0 mg; haloperidol, 2.5 mg; lisuride, 0.05 mg; and placebo in randomized order. The symptoms of the patients [idiopathic blepharospasm (IB), in 11 patients, oromandibular dystonia (OMD) in four patients] were quantified by a blind observer counting the frequencies and recording the cumulative duration of sustained spasms of IB and OMD over periods of 4 min before, and 15, 30, 60, 90, and 120 min after the i.v. challenges. Baseline quantification of IB and OMD was performed at identical intervals on randomized days of the trial. Significant improvement of the IB scores was found in response to biperiden and clonazepam and a trend toward improvement in response to lisuride (Wilcoxon test). Evaluation of the individual IB scores of each patient following the various drug challenges failed to predict the therapeutic potential of these drugs for subsequent oral treatment. PMID- 3280129 TI - Brain grafting may reverse loss of responsiveness to levodopa therapy in Parkinson's disease. AB - Loss of efficacy and response fluctuations develop in many patients with Parkinson's disease after long-term levodopa therapy. This may be due in part to near-total degeneration of the surviving nigrostriatal dopaminergic neurons during disease progression, with massive decreases in the capacity of the striatum to form and store dopamine from exogenous levodopa. It was recently suggested that intracerebral grafting of fetal nigral or adrenal chromaffin cells may be beneficial in advanced Parkinson's disease by reestablishing spontaneous dopaminergic neurotransmission or by secretion of trophic factors that promote sprouting of residual dopaminergic nerve-terminals. It is now hypothesized that intrastriatal transplantation of such cellular elements that contain the enzyme dopa decarboxylase and dopamine storage sites may significantly increase synthesis, storage, and release of dopamine from exogenous levodopa. It may therefore reverse loss of responsiveness and restore the initial smooth and stable beneficial effect of levodopa therapy. PMID- 3280130 TI - Structure determination of Cryptococcus neoformans serotype A-variant glucuronoxylomannan by 13C-n.m.r. spectroscopy. AB - A series of polysaccharides was derived by physical and chemical methods from an antigenic, O-acetyl-containing, glucuronoxylomannan (GXM), isolated from the growth medium of Cryptococcus neoformans (CDC B2550) serotype A-variant having composition ratios of Man:Xyl:GlcA:OAc = 10:4:3:6. 13C-N.m.r. spectra of derivatives provided new structural evidence for GXM. Treatment of GXM with Li in ethylenediamine gave a xylomannan (XM, with Man:Xyl = 5:2). Smith degradation of XM gave a mannan (M). Ultrasonic treatment of GXM gave GXM-sonicated (GXMS). Treatment of GXM with 3-(3-dimethylaminopropyl)-1-ethylcarbodiimide.HCl and then with NaBH4 gave reduced GXMS (RGXMS), or with aq. trifluoroacetic acid gave partially acid-hydrolyzed GXMS. Periodate oxidation of GXM and NaBH4 reduction of the product gave a polyalcohol-mannan (PM). Treatment of GXMS, RGXMS, and PM with NH4OH at pH 11 gave the respective O-deacetylated analogs. Comparison among the 13C-n.m.r. spectra of GXM, the various derivatives, and reference monosaccharides allowed the following conclusions: M is (1----3)-alpha-D-mannopyranan; XM consists of the M backbone with 91% of the Xyl on nonadjacent Man residues as 2-O beta-D-Xylp substituents and with 9% as 4-O-D-Xylp substituents on other Man residues. GXM consists of the XM structure, but with non-D-xylosylated Man residues substituted with 2-O-beta-D-GlcpA substituents and with 6-O-acetyl groups distributed approximately equally on Man residues that have other substituents and those that have none. The molecular mechanics program MM2 was used to estimate the relative energies of anomeric orientations of the typical glycosidic linkage in M. The results suggest that 6'-OH----O-2 H-bonding is significant in the minimal-energy orientation of M, with phi = -36 degrees and psi = 51 degrees, and that two other glycosidic orientations may be important in the 2-O- or 6-O-substituted derivatives of M. PMID- 3280133 TI - [Old Prague hospitals. IV. Hospitals in the New Town section of Prague in the post-Hussite period (to 1518)]. PMID- 3280131 TI - Etching behaviour of bovine enamel after the formation of precipitates adhering to the surface. PMID- 3280132 TI - [Hippuran does not interfere with glucose metabolism and proximal tubule function in persons with normal renal function]. PMID- 3280135 TI - Molecular analysis of dorsal-ventral polarity in Drosophila. PMID- 3280134 TI - [Old Prague hospitals. V. Preliminary results of archeological research in the area of the former Hradcany Hospital]. PMID- 3280136 TI - IME1, a positive regulator gene of meiosis in S. cerevisiae. AB - IME1 (Inducer of MEiosis) was cloned due to its high copy number effect: it enabled MAT insufficient strains to undergo meiosis. Disruption of IME1 results in a recessive Spo- phenotype. Diploids homozygous for the two mutations ime1-0, rme1-1 are also meiosis deficient. We conclude that IME1 is a positive regulator of meiosis that normally is repressed by RME1. RME1 is repressed by a complex of MATa1 and MAT alpha 2 gene products. IME1 is also regulated by the environment: no transcripts could be detected in glucose growing cells, in contrast to acetate growing cells. Starvation for nitrogen further induced (6- to 8-fold) transcription of IME1, but, as expected, the induction was found only in MATa/MAT alpha or rme1-1/rme1-1 diploids. Furthermore, the IME1 multicopy plasmids promoted sporulation in rich media. PMID- 3280137 TI - A yeast centromere acts in cis to inhibit meiotic gene conversion of adjacent sequences. AB - The centromere of chromosome III (CEN3) of yeast has been examined for its ability to inhibit meiotic recombination in adjacent sequences. The effect of the centromere was investigated when it was adjacent to both of the recombining sequences (homozygous) or adjacent to only one of the two recombining DNA segments (hemizygous). When homozygous, CEN3 exerts a bidirectional repression of crossing over and a strong inhibition of gene conversion. This suggests that CEN3 reduces the frequency of crossing over by interfering with the initiation of proximal recombination events. When hemizygous, CEN3 impairs the ability of adjacent sequences to act as the recipient of genetic information during gene conversion. These results support the idea that the initiating event in yeast meiotic recombination involves the recipient molecule. PMID- 3280140 TI - Protein phosphorylation in bacterial chemotaxis. PMID- 3280138 TI - Site-specific endonucleolytic cleavages and the regulation of stability of E. coli ompA mRNA. AB - The stability of ompA mRNA is growth-rate dependent. We show that the 5' noncoding region of this mRNA provides a target for site-specific endonucleases. The rate of degradation of ompA mRNA parallels the rate of these endonucleolytic cleavages, implying that endonucleolytic rather than exonucleolytic attack is the initial step in ompA mRNA degradation. Thus the 5' noncoding region appears to be a determinant of mRNA stability, and endonucleolytic cleavages in the 5' noncoding region may well regulate expression of the ompA gene. PMID- 3280139 TI - Mutant phenotypes support a trans-splicing mechanism for the expression of the tripartite psaA gene in the C. reinhardtii chloroplast. AB - The chloroplast psaA gene of the green unicellular alga Chlamydomonas reinhardtii consists of three exons that are transcribed from different strands. Analysis of numerous nuclear and chloroplast mutants that are deficient in photosystem I activity reveals that roughly one-quarter of them are specifically affected in psaA mRNA maturation. These mutants can be grouped into three phenotypic classes, based on their inability to perform either one or both splicing reactions. The data indicate that the three exons are transcribed independently as precursors which are normally assembled in trans and that the splicing reactions can occur in either order. While some chloroplast mutations could act in cis, the nuclear mutations that fall into several complementation groups probably affect factors specifically required for assembling psaA mRNA. PMID- 3280141 TI - A yeast and a human CCAAT-binding protein have heterologous subunits that are functionally interchangeable. AB - The S. cerevisiae HAP2 and HAP3 gene products have been shown to recognize CCAAT containing transcription elements as a HAP2/HAP3 multisubunit heterologous complex, or heteromer. Recently, we have demonstrated that the human sequence specific DNA-binding protein, CP1, also recognizes CCAAT-containing transcription elements as a heteromer. Mammalian cells contain at least three distinct CCAAT binding proteins, all of which appear to be multisubunit complexes composed of heterologous subunits. One of these proteins, CP1, has DNA-binding properties that are virtually identical to the yeast HAP2/HAP3 complex. These two proteins bind to the same target sequences, make the same DNA contacts, and are affected in a similar manner by mutations in the CCAAT element. Most surprisingly, the subunits of CP1 and HAP2/HAP3 are functionally interchangeable. That is, the yeast/human hybrid complexes that are formed retain the ability to specifically recognize CCAAT elements. PMID- 3280142 TI - DNA methylation and gene activity. AB - The above experiments support a relatively simple model to explain the role of DNA methylation in vivo. Most tissue-specific genes are methylated. The methyl groups may generate a local chromatin configuration that renders the genes inaccessible, and thus transcriptionally inactive. This would provide a general mechanism for transcriptional repression which may operate independent of the requirement for interactions between cis-acting regulatory elements and tissue specific factors. In contrast, house-keeping genes may not be affected by this inhibitory mechanism, and are thus available for constitutive expression in all cell types. Activation of tissue-specific genes from their generalized state of repression must first involve recognition of the genes while they are still methylated and this event initiates the process of transcription and concomitant demethylation. In their demethylated state these genes would be stably maintained in an active structure that is generally accessible to the transcriptional machinery of the cell. PMID- 3280144 TI - [Complications after initial BCG vaccination in a 5-year-period in the East Bohemia Region]. PMID- 3280145 TI - [The early activities of Prof. Treger at the Comenius University Medical School in Bratislava]. PMID- 3280143 TI - Phosphorylation of three proteins in the signaling pathway of bacterial chemotaxis. AB - Six cytoplasmic che gene products are required for signal transduction in bacterial chemotaxis, but the nature of their biochemical interactions is not known. We show that in vitro the CheA protein becomes autophosphorylated in the presence of ATP. In addition, the phosphate group on CheA can be rapidly transferred to CheB, a protein involved in adaptation to stimuli, or to CheY, a protein involved in the excitation response. The phosphorylation of CheB and CheY is transient; they readily dephosphorylate. We have also found that CheZ, a protein that appears to antagonize CheY function in vivo, accelerates the hydrolysis of the phosphate on CheY. These results suggest that signal transduction in bacterial chemotaxis may involve the flow of phosphate through a cascade of phosphorylated protein intermediates. PMID- 3280146 TI - Immune hemolytic anemia in children. PMID- 3280147 TI - Second-look surgery in ovarian carcinoma. PMID- 3280148 TI - Postoperative vomiting following strabismus surgery in paediatric outpatients: spontaneous versus controlled ventilation. AB - The study was designed to compare the frequency and severity of postoperative vomiting in paediatric out-patients receiving controlled ventilation (IPPV) or breathing spontaneously (SV) during anaesthesia for strabismus repair. One hundred and twenty unpremedicated children (ages 2-12 years) were studied in a randomized fashion. After intravenous induction of anaesthesia and tracheal intubation, patients breathed halothane 1-1.5 per cent inspired and N2O 66 per cent in O2 spontaneously (n = 60), or received IPPV, halothane 0.5-1 per cent, N2O 66 per cent, and pancuronium 0.05 mg.kg-1, which was reversed with neostigmine and atropine (n = 60). The incidence of vomiting with SV was 50 per cent (95 per cent confidence limits: 34.5-65.5 per cent) compared with 40 per cent (24.5-55.5 per cent) with IPPV (p greater than 0.25). Patients in the SV group experiencing emesis had longer operations than those not vomiting (mean +/- SEM = 1.5 +/- 0.1 vs 1.2 +/- 0.1 hours, p less than 0.005). This was not the case with IPPV. There was no correlation between age, sex, duration of surgery, or number of extraocular muscles repaired, and frequency or severity of vomiting or time to discharge. No significant advantage was afforded by IPPV over SV in the present study. PMID- 3280149 TI - Sherlock Holmes and anaesthesia. AB - Sir Arthur Conan Doyle's first Sherlock Holmes adventure, A Study in Scarlet, was published 100 years ago. Between 1887 and 1927 he wrote 56 short stories and four novels about his fictional detective. Episodes in the adventures which relate to anaesthetic drugs are described. Use of the drugs was criminal in the case of chloroform, opium, and curare; therapeutic in the case of morphine; and recreational when Holmes himself used cocaine. PMID- 3280150 TI - Use of a Doppler ultrasound stethoscope for intercostal nerve block. AB - Two cases with rib injuries are reported where intercostal nerve block without rib palpation was safely and successfully performed on six separate occasions using a Doppler blood-flow detector ultrasound stethoscope. A third case studied by a radiologist using a pulsed Doppler flowmeter, determined the source of the Doppler signals as originating from the intercostal artery. The significance of these findings is discussed. PMID- 3280151 TI - Laryngospasm in paediatric anaesthesia. PMID- 3280153 TI - Effects of cisplatin on different measures of glomerular function in the human kidney with special emphasis on high-dose. AB - To investigate the effect of high-dose cisplatin (40 mg/m2 daily for 5 days), 51Cr-EDTA clearance was used as a measure of glomerular filtration rate (GFR). 51Cr-EDTA clearance decreased significantly from 109 +/- 3 ml/min * 1.73 m2 to 68 +/- 3 ml/min * 1.73 m2 after three cycles of cisplatin and remained at this decreased level during the observation period (24 months). To determine the reliability of creatinine as a measure of GFR, we compared the simultaneous clearance of creatinine to that of 51Cr-EDTA. A good correlation between 51Cr EDTA clearance and creatinine clearance was observed before and 3 months after termination of treatment, but no correlation was found during treatment. S creatinine decreased significantly during treatment, probably due to muscle wasting. We conclude that s-creatinine and creatinine clearance are unsuitable measures of glomerular function during high-dose cisplatin treatment. All patients developed proteinuria during treatment. The changes in clearance ratios of beta-2-microglobulin/albumin and IgG/albumin show that the proteinuria observed during cisplatin infusion is predominantly of tubular origin, whereas the proteinuria between the treatment periods is mainly of glomerular origin. PMID- 3280152 TI - Combination chemotherapy for advanced adenocarcinoma of the lung. A review. AB - Combination chemotherapy has been used widely in the treatment of inoperable adenocarcinoma of the lung (ACL), but without uniform success. This review summarizes current knowledge of combination chemotherapy in ACL, with the aim of establishing critical background material for future studies. Not all the numerous combinations applied in non-randomized studies have produced response rates above 20% when evaluated in randomized trials. This holds true for the following regimens: cyclophosphamide + lomustine + methotrexate (response rates 14%-38%), hexamethylmelamine + doxorubicin + methotrexate (13%-32%), methotrexate + doxorubicin + cyclophosphamide + lomustine (13%-24%), cyclophosphamide + doxorubicin + cisplatin (0-36%), cyclophosphamide + bleomycin + cisplatin (20%), mitomycin C + vinblastine + cisplatin (26%-33%), cyclophosphamide + doxorubicin + etoposide + cisplatin (29%) and vindesine + cisplatin (33%). None of these combinations has been shown to be clearly superior to single-agent treatment. Nor has any specific regimen been shown to have clear advantages over other active combination chemotherapy regimens or over the sequential administration of either single agents or combined treatments. The prognosis for patients with inoperable ACL remains dismal. None of the studies considered in this review revealed median survival times exceeding 47 weeks. High priority should therefore be given to the identification of new compounds with significant activity against ACL. PMID- 3280155 TI - Angiotensin II induces hypertrophy, not hyperplasia, of cultured rat aortic smooth muscle cells. AB - We have explored the hypothesis that contractile agonists are important regulators of smooth muscle cell growth by examining the effects of one potent contractile agonist, angiotensin II (AII), on both cell proliferation and cellular hypertrophy. AII neither stimulated proliferation of cells made quiescent in a defined serum-free media nor augmented cell proliferation induced by serum or platelet-derived growth factor. However, AII did induce cellular hypertrophy of postconfluent quiescent cultures following 4 days of treatment, increasing smooth muscle cell protein content by 20% as compared with vehicle treated controls. AII-induced hypertrophy was maximal at 1 microM, had an ED50 of 5 nM, and was blocked by the specific AII receptor antagonist Sar1,Ile8 AII. The cellular hypertrophy was due to an increase in protein synthesis, which was elevated within 6-9 hours following AII treatment, while no changes in protein degradation were apparent. AII was even more effective in inducing hypertrophy of subconfluent cultures, causing a 38% increase in protein content after 4 days of treatment (1 microM) and showing a maximal response at concentrations as low as 0.1 nM. Interestingly, in subconfluent cultures, AII treatment (1 microM, 4 days) was associated with a 50% increase in the fraction of cells with 4C DNA content with the virtual absence of cells in S-phase of the cell cycle, consistent with either arrest of cells in the G2 phase of the cell cycle or development of tetraploidy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280154 TI - Single-agent chemotherapy for advanced adenocarcinoma of the lung. A review. AB - Systemic therapy with cytostatic agents has been widely used in the management of inoperable adenocarcinoma of the lung (ACL). However, chemotherapy for this tumor type remains experimental, and the prognosis is still poor. Thus, the literature on single-agent chemotherapy was reviewed in order to establish critical background material for the planning and evaluation of future studies. Only vindesine, dibromodulcitol, doxorubicin and hexamethylmelamine have displayed overall response rates exceeding 10% in randomized studies. Several of the most promising agents with response rates above 20% in non-randomized studies, i.e., 5 fluorouracil, mitomycin C, vinblastine and ifosfamide, have not been adequately evaluated in randomized trials in ACL. There is no published evidence to suggest the superiority of single-agent chemotherapy over the best supportive treatment, with respect either to survival or to quality of life. There are considerable methodological problems in designing, executing, analyzing and reporting these studies. Some of the problems could be solved by use of the internationally accepted guidelines for reporting results of cancer treatment, which might make more rapid progress possible. PMID- 3280156 TI - Neurohormonal interactions and adaptations in congestive heart failure. PMID- 3280158 TI - Diltiazem, nifedipine, and their combination in patients with stable angina pectoris: effects on angina, exercise tolerance, and the ambulatory electrocardiographic ST segment. AB - The efficacy and safety of oral nifedipine and diltiazem were compared in 20 patients with stable angina pectoris with use of a placebo run-in, randomized, double-blind titration to maximal effect crossover protocol. The effects of treatment withdrawal were also analyzed. All patients received placebo for 2 weeks and were then randomly assigned to receive either diltiazem or nifedipine. A 2 week drug titration phase in which patients received either diltiazem (180 to 360 mg/day) or nifedipine (30 to 120 mg/day) in three divided doses was followed by a 1 week maintenance phase. Patients then received placebo for 1 to 2 weeks, followed by crossover to the other treatment regimen and a second placebo washout period of 1 week. Patients (n = 13) who remained symptomatic on both diltiazem and nifedipine during the monotherapy periods entered a 3 week combination treatment phase, followed by a final 1 week placebo washout period. Frequency of angina, nitroglycerin consumption, exercise tolerance (Naughton protocol), and frequency of daily episodes of ST segment deviations on the electrocardiogram (1 mm of ST segment depression persisting for at least 1 min with and without chest pain) on an ambulatory electrocardiographic monitor were assessed during the baseline placebo, active monotherapy, placebo withdrawal, and combination treatment phases. Plasma drug levels were also measured. Compared with initial placebo values, the frequency of angina and the amount of nitroglycerin treatment were reduced by both diltiazem (p less than .001) and nifedipine (p less than .02). Diltiazem was more effective than nifedipine in reducing angina (p less than .02). Exercise duration increased with both drugs (p less than .0001). Diltiazem was significantly better than nifedipine in reducing the episodes of ST segment depression on the ambulatory monitor (p less than .01). Diltiazem reduced the resting heart rate (p less than .01); both drugs reduced the resting blood pressure and rate-pressure product. Overall, combination therapy was more effective in patients who did not maximally respond to diltiazem or nifedipine alone with respect to anginal and exercise variables and in reducing blood pressure at rest and during exercise. Plasma drug levels could not predict an individual patient's treatment response. Diltiazem may increase nifedipine drug levels when the drugs are combined. Fewer side effects were observed with diltiazem than nifedipine; the most side effects were seen with combination treatment. There were no apparent withdrawal effects observed with either treatment regimen.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3280157 TI - Increases in walking distance in patients with peripheral vascular disease treated with L-carnitine: a double-blind, cross-over study. AB - A double-blind, cross-over study was designed to evaluate the effects of L carnitine in patients with peripheral vascular disease. After drug washout, 20 patients were randomly assigned to receive placebo or L-carnitine (2 g bid, orally) for a period of 3 weeks and were then crossed over to the other treatment for an additional 3 weeks. The effect on walking distance at the end of each treatment period was measured by treadmill test. Absolute walking distance rose from 174 +/- 63 m with placebo to 306 +/- 122 m (p less than .01) with carnitine. Biopsy of the ischemic muscle, carried out before and after 15 days of L carnitine administration in four additional patients, showed that treatment significantly increased total carnitine levels. An additional goal of this study was to ascertain the effects of L-carnitine on the metabolic changes induced by exercise in the affected limb. In six patients under control conditions, arterial and popliteal venous lactate and pyruvate concentrations were determined at rest, when the maximal walking distance was reached, and 5 min after the walking test. Twenty-four hours later, L-carnitine was administered intravenously (3 g as a bolus followed by an infusion of 2 mg/kg/min for 30 min) and metabolic assessments were repeated. Five minutes after the walking test, popliteal venous lactate concentration increased by 107 +/- 16% before treatment and by only 54 +/ 32% (p less than .01) after carnitine. Furthermore, carnitine induced a more rapid recovery to the resting value of the lactate/pyruvate ratio.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280160 TI - Ocular allergy. PMID- 3280161 TI - Analytical and technical aspects of testing for drug abuse: confirmatory procedures. AB - Many laboratories are now performing urine drug testing for employers, governmental agencies, and other institutions. It is now recognized that presumptive positive screening results have to be confirmed by an analytical procedure based on a different chemical technique with greater than or equal sensitivity to the screening test. Thin-layer chromatography has been widely used for this; however, it is relatively insensitive for certain drugs, and it cannot satisfy the accuracy and precision requirements needed to determine threshold concentrations reliably. Gas chromatography-mass spectrometry is able to satisfy these threshold requirements and has become the method of choice for confirming initial immunoassay results. PMID- 3280159 TI - Clinical implications of internal mammary artery bypass grafts: the Coronary Artery Surgery Study experience. AB - From the Coronary Artery Surgery Study Registry, all patients undergoing initial bypass surgery procedures with independent vein grafts were identified. The 950 patients receiving an internal mammary artery bypass graft were compared with the 6027 patients receiving vein graft alone. Improved survival rates with internal mammary artery grafts were noted at hospitals in which these grafts were performed infrequently as well as those in which the internal mammary artery graft was used frequently. The improved survival was noted in patients with normal (p = .004) as well as impaired (p = .004) ventricular function, in men (p = .0001) as well as women (p = .005), in patients over age 65 (p = .01) as well as younger patients (p less than .0001), and in those with (p = .05) or without (p less than .0001) critical stenosis of the left main coronary artery. The internal mammary artery bypass graft was an independent predictor of survival (p = .0004) and reduced the risk of dying by a factor of 0.64. It was concluded that the internal mammary artery graft is the bypass vessel of choice and should not be denied any subgroup. PMID- 3280162 TI - Trace elements in human clinical specimens: evaluation of literature data to identify reference values. AB - Reference values are proposed for the concentrations of As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Mo, Pb, Se, and Zn in whole blood, blood serum, urine, milk, liver, and hair from adult human subjects. For F, I, and Ni, it was not possible to evaluate reference intervals for all the specimens mentioned above. For several elements, including Al, B, Br, Cs, Li, Rb, U, and V, the present status of the literature does not provide an adequate basis for formulating baseline concentrations; therefore, results from selected investigations are listed for information only. For elements such as Cu, Fe, and Zn, which are known to be homeostatically controlled, the concentrations in whole blood and blood serum follow a gaussian like frequency distribution, and we could consider both median and mean values for evaluation. On the other hand, elements whose concentrations in tissues and body fluids are influenced by dietary availability (e.g., As and Se) or environmental factors (e.g., Cd, Hg, and Pb) show wide scatter. In these cases, the median appeared to be a better indicator of the central tendency than the mean, when different populations are involved. These points are illustrated. PMID- 3280163 TI - Preparation of monoclonal antibodies reactive with beta-1,2-linked oligomannosyl residues in the phosphomannan-protein complex of Candida albicans NIH B-792 strain. AB - Hybridomas obtained by fusing the spleen cells of BALB/c female mice hyperimmunized with heat-killed yeast-form cells of Candida albicans NIH B-792 strain and a mouse myeloma cell line, P3X63Ag8.653, produced antibodies to beta 1,2-linked oligomannosyl residues in the phosphomannan-protein complex of the parent cells. Most of these monoclonal antibodies were IgM, but about 10% of the hybridomas produced IgG1 immunoglobulins. Ascites fluid from BALB/c mice inoculated with an IgG1-producing hybridoma showed different precipitability with the phosphomannan-protein complexes of three representative C. albicans strains, with NIH B-792 (serotype B) greater than NIH A-207 (serotype A) greater than J 1012 (serotype A, formerly serotype C). In contrast, a rabbit polyclonal antiserum to C. albicans NIH B-792 cells was unable to distinguish these same complexes. This ascites fluid agglutinated the heat-killed cells of three Candida strains, but not those of three others or of Torulopsis glabrata IFO 0622. The other ascites fluids, containing antibodies of the IgM class, agglutinated cells from three C. albicans strains and also C. tropicalis IFO 0587 cells. PMID- 3280165 TI - Immunoprecipitation method for CK-MB analysis re-evaluated: influence of CK-BB and macro-CK on blank activities. AB - We evaluated the analytical performance of the immunoprecipitation technique for quantification of creatine kinase (CK; EC 2.7.3.2) isoenzyme MB, focusing on specimens with increased blank activities. The samples we studied had blank values that were equal to or greater than either 15 U/L or the uncorrected CK-MB value. Of 134 specimens selected, 16 and 21 contained macro CK type 1 and CK-BB, respectively. All samples containing macro CK type 1 gave negative CK-MB values, even though four contained significant quantities of CK-MB. Correcting the blank value for the fluid displacement of the second antibody suspension eliminated all but three of the negative results. However, 45 specimens, negative for CK-MB by electrophoresis, gave CK-MB values ranging from 1 to 21 U/L. Furthermore, 11 of the specimens containing macro-CK type 1 were in this group. Thus, the presence of macro-CK type 1 definitely interferes with the immunoprecipitation technique. Our results indicate the need to re-evaluate the diagnostic accuracy of the immunoprecipitation technique, especially when the un-adjusted blank activities are increased. PMID- 3280166 TI - Critical issues in urinalysis of abused substances: report of the Substance-Abuse Testing Committee. PMID- 3280164 TI - Anodic stripping voltammetry procedure modified for improved accuracy of blood lead analysis. AB - In evaluating the accuracy and reliability of blood lead (PbB) measurements with the Environmental Science Associates Model 3010A Trace Metal Analyzer, intralaboratory comparison demonstrated that use of the operating conditions recommended by the manufacturer resulted in consistently underestimated PbB concentrations less than 400 micrograms/L and overestimated PbB values greater than 400 micrograms/L. At PbB concentrations less than 50 micrograms/L, measured concentrations were often registered as negative results. However, these negative values could be replicated to within +/- 10 micrograms/L, indicating good precision of the method, but obviously not good accuracy. In addition, lower-than expected lead (Pb) values were measured in samples containing increased concentrations of copper (Cu), such as may occur in pregnant women. We modified the procedure to eliminate these inaccuracies by substituting manual peak-height measurements for reliance on the integrator and digital display of the instrument. We established the accuracy of the modified procedure by using calibration standards previously quantified by isotope dilution-mass spectroscopy. A quality-control program for monitoring PbB analysis is also described. PMID- 3280167 TI - Legal issues related to drug testing in the clinical laboratory. AB - As has been reported many times by the lay press, urine drug testing may pose some unique challenges. The clinical laboratory interested in industrial drug testing (typically known as employee drug testing) should be aware of the many challenges that may be brought on by the fact that the result may be contested in an adversarial proceeding. This is what makes the urine drug test a forensic test. It may be one piece of evidence or the only piece of evidence used in an adversarial proceeding that may decide on punitive or rehabilitative action against an employee. As a result, unique standards for governmental contract laboratories have been proposed from the National Institute on Drug Abuse, and special proficiency testing and accreditation procedures have been promoted by professional societies. These standards illustrate the sensitive nature of the results. Because the results are subject to adversarial proceedings, all parties concerned in the testing process should be aware of the legal issues surrounding urine drug testing. There are constitutional and statutory issues as well as tort issues such as negligence, defamation, invasion of privacy, battery, infliction of emotional distress, and others. Laboratories should be especially aware of these issues, since they may be brought in as a third-party defendant to a suit or brought in as a participant in gathering the evidence. The laboratory should also be aware of other legal ramifications such as chain of custody, expert testimony, and the acceptability of scientific evidence. PMID- 3280168 TI - Organ specific properties for human urinary alkaline phosphatases. AB - We have re-evaluated the isolation and characteristics of human urinary alkaline phosphatases (ALPs). From the results of physicochemical properties and immunological identification, the urinary ALPs from healthy subjects and patients with hepatoma were found to be similar in nature to liver and/or bone-like ALP. In patients with chronic or acute nephritis, the ALPs contained a major band of kidney-like ALP with a minor band of bone and intestinal ALPs. However, the ALPs in pregnant women had not only liver and bone ALPs but also placental-like ALP. It is interesting that only bone-like ALP was detected in psychiatric patients administered chlorpromazine. In the conditions we investigated, the molecular sizes of the urinary ALPs were similar as those of original ALPs, except for the enzyme from renal failure. Moreover, the total activity of urinary ALP was closely related to the level of serum ALP, being in a ratio of 1/40. In general, urinary ALP may be derived from serum ALP by minor modification, suggesting that the identification of excreted ALP in urine is a good marker for disturbed organs in respective diseases. PMID- 3280169 TI - Effect of renal insufficiency on the concentration of free retinol-binding protein in urine and serum. AB - The concentration of retinol-binding protein (RBP) in urine was determined in 20 healthy individuals and 119 patients with various renal diseases involving tubular or glomerular dysfunction. The sera from 4 healthy individuals and 33 patients were chromatographed on Sephadex G-75 to measure the concentration of free (i.e. not prealbumin-bound) RBP. In healthy individuals, the mean concentration of free RBP in serum was 5.8 mg/l and represented 14% of total RBP; the renal clearance and the fractional tubular uptake of free RBP averaged 0.032 ml/min and 99.97%, respectively. In patients, the concentration of free RBP and the percentage of free RBP in serum were on logarithmic scales inversely correlated with the endogenous creatinine clearance (r = -0.80 and -0.76) and increased in parallel with the serum creatinine (r = 0.67 and 0.66) and beta 2 microglobulin concentrations (beta 2-m, r = 0.76 and 0.89). The semi-logarithmic plot of urine versus serum concentration of free RBP suggests a renal threshold for the tubular reabsorption of this protein at a concentration of about 25 mg/l in serum. The existence of this threshold is confirmed by the relationship between urinary RBP and serum beta 2-m showing that urinary excretion of RBP is invariably high when the serum level of beta 2-m exceeds 5 mg/l. The latter value corresponds precisely to the renal threshold for the tubular reabsorption of beta 2-m. The corresponding value for free RBP derived from the relationship between both proteins is 24 mg/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280170 TI - The central effects of the renin-angiotensin system. AB - The acute administration of ANG II into the brain of experimental animals produces transient pressor effects, a marked increase in drinking, release of the antidiuretic hormone, increase in total peripheral resistance, a diuretic and natriuretic effect and an increase in sympathetic outflow. The chronic administration of ANG II into a cerebrolateral ventricle produces sustained pressor effects only if 0.9% sodium chloride solution is used as the drinking fluid. The hypertension is due to an increase in total peripheral resistance which appears to be due to an increase in intrinsic tone of vascular smooth muscle. In addition there was enhanced responsiveness of the vasculature to norepinephrine and ANG II and a decrease in reflex vasodilatation of the hind limb of ANG II treated dogs. The chronic elevation of ANG II in the CSF plus an increase in NaCl intake produces a low renin, sodium dependent, expanded volume hypertension. Data are presented suggesting that this model of hypertension is induced by the central release of an inhibitor of the Na+,K+-Pump. PMID- 3280172 TI - Mechanisms of colonic electrolyte absorption and secretion. PMID- 3280173 TI - Laxative abuse. AB - Two types of laxative abuse are described, namely habitual abuse and surreptitious abuse. Phenolphthalein and the anthraquinone derivatives have been most abused in this respect. Long-term anthraquinone use may lead to melanosis coli and cathartic colon, with typical histological and radiological features. Surreptitious abuse presents as a factitious illness with diarrhoea, hypokalaemia, abdominal pain and thirst, as well as melanosis coli. Over 90% of cases occur in women, many of whom work in a paramedical situation. Wider recognition of the range of normal bowel habit and a cultural change with rejection of Victorian mores and concepts of 'intestinal auto-intoxication' have led to a decrease in inappropriate laxative consumption. However, they are still widely prescribed and bought. Although it was as long ago as 1937 that Witts [108] drew attention to the dangers associated with the use of laxatives, his lesion still needs to be preached today. PMID- 3280171 TI - Regulation of the brain angiotensin system: a thesis of multicellular involvement. AB - Many potential sites of regulation may be envisioned for the brain angiotensin system. However, new findings indicate that regulatory mechanisms may be more complex and detailed then previously recognized. These results, summarized below, include the recent findings of probable glial involvement in the brain angiotensin system, the potential for neuronal-glial interaction and the role of peptidases in either the activation of the relevant angiotensin peptide or in the termination of action of angiotensin II. A hypothesis is presented which proposes that a subpopulation of glia function to convert angiotensin II to angiotensin III so as to facilitate the rapid inactivation of the octapeptide. This could be a mechanism both for terminating action of the peptide at a neuronal receptor as well as for shielding receptors from exogenous angiotensins. Glia may also scavenge angiotensinogen from extracellular fluids, thereby limiting the lifetime of the prohormone. Thus, cross-talk between glia and neurons is proposed as one element of regulation of the brain angiotensin system. PMID- 3280174 TI - Hepatic resection for liver metastases. PMID- 3280176 TI - Murine monoclonal antibody to mitochondria reacts with the 72 kD antigen of primary biliary cirrhosis. AB - BALB/c mice were immunized with canine gastric mucosal cells enriched to 70% for parietal cells, to produce monoclonal antibodies (MoAb). Three MoAb, FMM-4C5, FMM 4C9 and FMM-2B2, were obtained which reacted by indirect immunofluorescence with gastric parietal cells and kidney tubules, predominantly distal kidney tubules, with a pattern similar to that of the M2 autoantibodies of primary biliary cirrhosis (PBC). The antibodies also reacted with tissues from rabbit, rat, pig, human and with rod-shaped structures in acetone-fixed monolayer cultures of human fibroblasts and HEp 2 cells. FMM-4C9 and FMM-2B2 reacted with tissues from BALB/c mice but FMM-4C5 did not. Immunoblots of FMM-4C5 with mitochondrial fractions showed that the antibody recognized a 63 kD antigen from dog stomach, rat kidney and rat liver, and a 72 kD antigen from human placenta; mouse preparations were not reactive. The antigen co-migrated with that recognized by serum from cases of PBC and some cases of progressive systemic sclerosis. Absorption of the mitochondrial fraction with PBC sera removed reactivity by immunoblotting with the murine autoantibody and vice versa. Two dimension immunoblots showed that the murine and human antibodies recognized an identical series of paired 'spots'. FMM 4C5 also reacted by immunoblotting with a rat recombinant mitochondrial polypeptide which has disease-specific reactivity with PBC sera. Absorption with recombinant polypeptide removed anti-mitochondrial activity by immunoblotting and immunofluorescence. These observations suggest that the MoAb FMM-4C5 recognizes part of the same 72 kD molecule recognized by human PBC sera. The murine monoclonal antibodies should be useful probes for further studies of the structure, function and possible pathogenicity of the 72 kD autoantigen. PMID- 3280175 TI - Cellular immunology of HIV-infection. PMID- 3280177 TI - Rat heterotopic heart transplantation: quantification and analysis of cell mediated cytotoxicity. AB - Limiting dilution analysis was used to measure the frequency of PVG-reactive cytotoxic T lymphocytes (CTL) within the peripheral blood mononuclear cell population of Lewis rats before heterotopic transplantation of PVG rat derived cardiac tissue, and in both the blood and graft-infiltrating cell populations at daily time points afterwards. Before surgery, the frequency of PVG-reactive cells within the blood was between 1/31,700 and 1/50,300; however, this value increased rapidly on day 4 after transplantation to reach values of up to 1/1,100 by day 7. The frequency of these cells was first measurable in the graft-infiltrate on day 2 and also showed a rapid increase 4 days after surgery; peak values up to 1/4,800 were recorded on day 5. This time corresponded with that of functional cardiac rejection and maximum infiltration of the graft by mononuclear cells. The similar kinetic changes and absolute values recorded for the frequency of donor reactive CTL within the blood and graft-derived cell populations was indicative of a rapid bi-directional passage of cells between these pools and provided no evidence for specific sequestration of CTL by the graft. Cells purified from the graft on post-operative day 5 mediated an immediate specific cytotoxicity towards PVG target cells (44% lysis during a 4 h assay at an effector:target ratio of 100:1) which was of a higher activity than would be predicted on the basis of an effector population containing only 1/4,800 PVG-reactive CTL. This finding implies that other mononuclear cell types than CTL present within the graft infiltrating population were capable of mediating target cells lysis. PMID- 3280178 TI - Immunohistological analysis of experimental gingivitis in humans. AB - Immunohistological analysis of experimental gingivitis in humans was carried out to provide a baseline for the study of immunoregulatory mechanisms in chronic inflammatory periodontal disease. Using a panel of monoclonal antibodies in an avidin biotin immunoperoxidase technique, T cell subsets were identified and the pattern of Class II major histocompatibility complex (MHC) antigens determined. Twenty third-year dental students took part in the study. Following the cessation of oral hygiene procedures, gingival biopsies were taken from each of five students at days 0, 4, 8 and 21 during the development of the inflammatory lesion. Each student had one biopsy which healed uneventfully. The T4:T8 ratio showed only slight variation over the time course of the lesion varying from 2.18:1 at day 0 to 2.48:1 at day 4. At all stages the T cells displayed both HLA DR and HLA-DQ antigens, but less than 10% had detectable IL-2 receptors. The predominant macrophage population was acid phosphatase + ve, adenosine triphosphatase -ve, HLA-DR+ and HLA-DQ+ antigens suggesting an activated phagocytic population. During the development of the lesion, the number of intraepithelial Langerhans cells (T6+) increased but there appeared to be a discrepancy between HLA-DR and HLA-DQ expression on these cells. Similarly, the keratinocytes expressed HLA-DR but failed to express HLA-DQ at any stage. These results suggest that the developing gingival lesion is a well controlled lesion and follows a similar pattern to a controlled delayed type hypersensitivity (DTH) response. PMID- 3280179 TI - Immunohistochemical demonstration of migration inhibitory factor (MIF) in experimental allergic contact dermatitis. AB - The kinetics of appearance of MIF+ cells was investigated in experimental contact dermatitis using a monoclonal antibody (7D10) against murine MIF which was reacted with cryostat sections of tissues and detected by the indirect immunoperoxidase test. Four groups of BALB/c mice were investigated: (1) sensitized with 2,4-dinitrofluorobenzene (DNFB); (2) unsensitized controls; (3) tolerized; (4) unsensitized. A challenge dose of DNFB was applied to the ear of animals of groups 1-3 and of croton oil to those of group 4. Three phases could be distinguished in group 1: (a) an initial vascular and exudative reaction; (b) an early cellular phase; and (c) a late cellular phase. At zero time rarely any T lymphocytes (Lyt 1+; Lyt 2+) were seen in all four groups. Within less than 30 min venous endothelial cells became strongly MIF+. This was followed by an influx of monocytes/macrophages reaching a maximum of 72 h in group 1 and a slight peak at 12 h in groups 2 and 3. At 16-24 h in all groups the endothelial reaction weakened while many 7D10+ macrophages appeared in group 1. By double-labelling it was shown that lymphocytes were 7D10-. The influx of lymphocytes, part of which carried the T cell receptor, began at 12 h, reaching a maximum at 72 h in group 1. In groups 2 and 3 only a weak lymphocytic infiltrate developed which declined at 24 h. Group 4 developed an inflammatory reaction after the initial phase with similar kinetics as in group 1. The data suggest that an immune inflammatory reaction is preceded by a nonspecific reaction of the vascular endothelium and the mononuclear phagocytic system and that MIF is playing a central role in these events. PMID- 3280180 TI - Interactions of Mycobacterium lepraemurium with resident peritoneal macrophages; phagocytosis and stimulation of the oxidative burst. AB - Live Mycobacterium lepraemurium or 60Co-gamma-irradiated organisms stimulated a very weak oxidative burst compared with similar numbers of heat-killed organisms or with live M. microti. This was found to reflect the poor uptake of the living organisms rather than an absolute failure to stimulate an oxidative burst. It is possible, however, that phagocytosis of fewer than 3-4 bacteria may not trigger the respiratory burst. Pre-incubating live M. lepraemurium with sera from infected mice, but not with fresh normal mouse sera, resulted in enhanced phagocytosis with a concomitant increase in the oxidative burst. The level of opsonic activity correlated with the M. lepraemurium specific antibody titres. The opsonic activity appeared to be mediated by antigen-antibody activation of the classical complement pathway as heat-inactivation destroyed the activity. PMID- 3280181 TI - Insulin receptor antibodies in diabetes mellitus. AB - Sera from 80 subjects with IDDM and NIDDM, together with sera from 20 patients with miscellaneous autoimmune conditions and 20 healthy adult subjects were tested for insulin receptor antibodies by (1) inhibition of 125I-insulin binding to EBV-transformed lymphoid cells, and by (2) immunoprecipitation of solubilized insulin receptors in the presence of an excess of mono-specific anti-human IgG or IgM; this test allowed the assessment of the class of antibody activity. Anti insulin antibodies in the sera were also measured using a double antibody technique. Anti-insulin receptor antibodies were found in 13 of 33 subjects with IDDM and six of 47 with NIDDM. These were principally in the IgM class, and in both groups of diabetics there was a good correlation between % inhibition of insulin binding to intact cells, and % of antibody precipitated by IgM (P less than 0.001), but not by IgG (P greater than 0.1). There was also a good correlation between the % inhibition of insulin binding to intact cells and the daily dose of insulin used in treatment (P less than 0.001). Insulin antibodies were found in seven of 33 subjects with IDDM and six of 12 with NIDDM, all of whom were on insulin treatment. These six subjects were the only ones with NIDDM who also had anti-insulin receptor antibody activity, suggesting that such antibodies may represent auto-anti-idiotype activity. This study shows that autoimmunity in insulin dependent (Type I) diabetes is not limited to islet cells and that such patients also develop antibodies to the insulin receptor. While three out of five patients with relative insulin resistance (requirement greater than 90 u/day) also showed evidence of insulin receptor antibody activity, the clinical significance of these antibodies has yet to be determined. PMID- 3280182 TI - Insulin responses and lymphocyte subclasses in children with newly diagnosed insulin-dependent diabetes. AB - Children with newly diagnosed insulin-dependent diabetes mellitus (IDDM) had increased numbers of CD25 positive lymphocytes in peripheral blood and peripheral blood mononuclear cells responded to insulin antigens by proliferation. The CD25 positivity and insulin proliferation were associated to the duration of symptoms before the diagnosis of IDDM. Thus increased numbers of CD25 positive cells were found in 89% and insulin induced proliferation in 100% of patients with symptoms of diabetes of less than 1 week's duration before diagnosis, while CD25 positivity and insulin-induced proliferation were observed in 36% and 29% of children who had had symptoms for 4 weeks or more before diagnosis. Children with IDDM also had increased numbers of CD4 positive T cells in peripheral blood. The frequency of HLA-DR4 and HLA-DR3/4 in diabetic children was higher and that of HLA-DR2 lower than in the normal population. Insulin, islet cell, gastric parietal cell, thyroid and antinuclear antibodies did not correlate to the duration of symptoms before diagnosis. PMID- 3280183 TI - Biological properties of human C5a: selected in vitro and in vivo studies. PMID- 3280184 TI - Measles virus infection of unstimulated blood mononuclear cells in vitro: antigen expression and virus production preferentially in monocytes. AB - Synthesis of measles virus antigens occurred only in a small percentage of peripheral blood mononuclear cells infected in vitro with measles virus without mitogenic stimulation. The infection cycle was restricted as only low amounts of infectious virus were released but all the major structural viral proteins were present as shown by immunofluorescence with monoclonal antibodies. Cells with viral antigen synthesis were characterized by double labelling and by infecting selectively depleted subpopulations. In 3-day cultures, up to 80% of the cells with measles virus antigen were shown to be monocytes by specific staining with anti-MMA and anti-Leu M3 monoclonal antibodies and up to 40% of the monocytes were infected. Less than 10% of the cells expressing virus antigens carried the lymphocyte marker OKT3, the majority of these cells belonging to the Leu3a (helper) population. Anti-alpha-interferon treatment increased the number of measles-positive cells and the release of infectious virus in preparations enriched for monocytes, but had no significant effect on infection of lymphocytes. PMID- 3280185 TI - Lymphatic filariasis: detection of circulating and urinary antigen and differences in antibody isotypes complexed with circulating antigen between symptomatic and asymptomatic subjects. AB - A two-site immunoradiometric assay using a monoclonal antibody (MoAb) against Brugia malayi microfilariae allowed the detection of parasite molecules both in the serum and the urine of patients from Sri Lanka infected with Wuchereria bancrofti. Whereas 50% of patients had no antigen in their serum, all of them excreted detectable amounts of antigen in their urine, the levels being higher in symptomatic than in asymptomatic patients. The poor detection in serum appeared to be related to the presence of circulating immune complexes. It was shown that the isotype of the antibodies complexed with the circulating antigen was IgM in the asymptomatic group, while it was mainly IgG in the symptomatic patients (swelling and lymphoedema or elephantiasis). These results suggest the existence of regulatory immune mechanisms affecting the clinical expression of lymphatic filariasis. PMID- 3280186 TI - Mercury induced antinuclear antibodies in mice: characterization and correlation with renal immune complex deposits. AB - Female SJL and Balb/c mice were given subcutaneous injections of 1.6 mg HgCl2/kg body weight every third day for 2, 4, 8, or 12 weeks. Indirect immunofluorescence using HEp-2 cells as substrate showed that SJL mice developed antinuclear antibodies (ANA) with a predominantly nucleolar and a weaker, homogeneous nuclear pattern after 4 weeks treatment. The nucleolar antigen was sensitive to treatment with trypsin and RNAse, but the antibody was not absorbed by calf liver RNA. The antigen responsible for the homogeneous nuclear pattern was sensitive to treatment with trypsin, DNAse, and acid solution, but reconstitution with histones on acid treated substrate did not restore the fluorescence. The corresponding antibody was not absorbed by double-stranded or single-stranded DNA, and the Crithidia luciliae assay was negative. This suggests that the antigen responsible for the homogeneous ANA pattern is a non-histone chromatin protein. No autoantibodies were found in Balb/c mice. Electron dense immune deposits containing IgG and C3 in a mesangial-vascular pattern developed after 4 weeks mercury treatment in SJL and Balb/c mice. Acid eluate from kidneys of SJL mice with immune deposits contained tissue-bound ANA with a strictly anti nucleolar pattern, showing that such antibodies make up part of the renal immune deposits. No autoantibodies were found in the eluate from Balb/c mice. The findings demonstrate that mercury induces a polyclonal autoantibody response in SJL mice, and suggests a restricted antibody response with unknown specificity in Balb/c mice, in both cases leading to immune complex deposits in the kidneys. PMID- 3280188 TI - The initiation and early development of autoimmune diseases. AB - Our understanding of autoimmunity has changed considerably over the past years as a consequence of the demonstration that self-reactive B cells and T cells are not necessarily deleted from the immunological vocabulary. The critical event in initiating (or avoiding) autoimmune responses is presentation to T cells of the self-peptide-MHC antigen complex. Based on the premise that quantitative aspects are of paramount importance, we suggest that T-cell activity, MHC expression, and self-peptide binding determine the initiation of autoimmune responses. PMID- 3280187 TI - Interleukin 6 (IL-6) in serum and urine of renal transplant recipients. AB - Hybridoma growth factor (HGF) is a 20-25 kD protein, supporting the growth of hybridoma cells in vitro and capable of replacing feeder cells. It was shown to be produced by human monocytes and a number of cultured cell lines. Recently, HGF was found to be identical to interferon-beta 2 or 26 kD protein and BSF-2, and was renamed interleukin 6 (IL-6). Using a sensitive bio-assay we were able to measure IL-6 activity in the serum and urine of healthy volunteers and renal transplant recipients. Low levels of IL-6 were present in the serum but not in the urine of healthy individuals. In contrast, both serum and urine of renal transplant recipients contained high levels of IL-6 directly after transplantation and during acute rejection episodes. On the basis of kinetic studies of the IL-6 response, it is concluded that serial measurement of IL-6, especially in urine, may be of value in monitoring renal transplant recipients. Moreover, the sensitivity of the bioassay will allow for detailed studies as to the biological significance of IL-6 in health and disease. PMID- 3280189 TI - Synthesis of interleukin-1-like activity by normal rat chondrocytes in culture. AB - Chondrocytes prepared from the articular cartilage of young rats synthesize and secrete an interleukin-1-like activity into the medium. The physical and biochemical properties of this IL-1-like activity are similar to macrophage derived IL-1. Immunological studies suggest that this activity is related to IL-1 alpha. Isolated chondrocytes and those grown in culture can express Ia. PMID- 3280192 TI - Hemodynamic effects of metoprolol and nifedipine in angina pectoris measured by isotope technique. AB - In order to evaluate the therapeutic effects of metoprolol, nifedipine, and their combination, 11 patients with secondary angina pectoris and with thallium tomographic findings indicating coronary artery disease were studied before and after these three treatment regimes in a single-blind cross-over study. The therapeutic effect was measured by standardized working test and isotope angiocardiography, which enabled evaluation of left ventricular ejection fraction, stroke volume, and phase analysis of left ventricular contraction. Treatment with metoprolol and combination therapy increased work performance. Ejection fraction did not differentiate the treatment regimes, whereas stroke volume was significantly lower at work and heart rate higher at rest and at work during nifedipine treatment compared to either metoprolol or combination treatment (p less than 0.05). Cardiac output was significantly reduced during nifedipine and metoprolol treatment during work (p less than 0.05). Phase improved after all therapeutic regimes, but reached significance only during the metoprolol treatment period at rest (p less than 0.05). PMID- 3280190 TI - Antinuclear antibodies (ANAs): diagnostically specific immune markers and clues toward the understanding of systemic autoimmunity. AB - The convergence of studies in the clinical and basic sciences has resulted in the definitive identification of many intracellular antigens which are the targets of autoantibodies in patients with systemic lupus erythematosus, scleroderma, dermatomyositis/polymyositis, Sjogren's syndrome, mixed connective tissue disease, and drug-induced autoimmunity. Some of this new knowledge includes the identification of the Sm and RNP antigens as ribonucleoprotein particles involved in splicing of precursor messenger RNA, Scl-70 as DNA topoisomerase I, proliferating cell nuclear antigen as auxiliary protein of DNA polymerase delta, and certain antigens in myositis as aminoacyl transfer RNA synthetases. This information confirms, at a molecular level, the presence of specific profiles of autoimmune responses so that autoantibodies can be used in clinical medicine as diagnostically useful immune markers. In addition the data give compelling reasons to consider that certain autoimmune diseases are antigen-driven. Many auto-antibodies have the interesting feature of recognizing epitopes on the antigens which are active or functional sites of the molecule. It is suggested that the data provide clues to the nature of the intracellular particle initiating the immune response and may help to elucidate some of the early mechanisms of the autoimmune process. PMID- 3280191 TI - Exercise stress test in young hypertensive patients. Response to vasodilators (prazosin) vs. beta-blocker (atenolol) agents. AB - Dynamic response of arterial blood pressure during exercise has been studied in 40 normotensive young subjects and 20 mild hypertensive young patients (20-40 years of age). Hypertensive patients were treated with atenolol (beta blocker) and prazosin (vasodilator). Both groups underwent maximal exercise stress test. A double-blind nonrandomized study was practiced in hypertensive patients with placebo, prazosin (3 mg/12 h), and atenolol (100 mg/24 h). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and exercise duration (ED) were analyzed. All parameters remained stable in both groups. The hypertensive patients showed an increase in maximum SBP more than 230 mmHg during the placebo phase. This same group showed a significant increase in HR at rest two hours after administration of prazosin. Atenolol produced a significant reduction in HR both during rest and exercise. Both drugs produced a significant decrease in SBP and DBP (at rest and exercise). We conclude that exercise test is a noninvasive procedure that could distinguish mild arterial hypertension. The dynamic changes of arterial blood pressure can be controlled with prazosin (3 mg/12 h) or 1 daily intake of 100 mg atenolol. PMID- 3280193 TI - George C. Griffith. PMID- 3280195 TI - Current theories on the etiology of idiopathic scoliosis. AB - Review of the literature shows that the cause of idiopathic scoliosis remains unknown, although research has possibly eliminated some hypothetical causes. Abnormalities of disc, bone, muscle, and collagen do not appear to be etiological factors but, rather, reflect the effects of scoliosis on normal tissues. Although most patients with idiopathic scoliosis are thought of as tall and slender, it has not yet been proven that growth in this condition differs from normal. It is possible that idiopathic scoliosis is caused by multiple factors rather than a single factor. Perhaps there are different factors for curve initiation and curve progression. It appears that a brain stem or equilibrium abnormality does exist in patients with idiopathic scoliosis, although more research is needed to confirm and define the problem. There also may be a genetic basis for idiopathic scoliosis, as it does seem to occur within patients' families more frequently than in the general population. Whether these two factors form the basis for a multifactorial etiology of idiopathic scoliosis remains to be proven. PMID- 3280196 TI - Spinal cord monitoring during posterior spinal instrumentation and fusion. AB - Two hundred seventy-five consecutive patients who were treated by posterior spinal instrumentation and fusion with iliac crest bone graft were intraoperatively monitored using cortical somatosensory-evoked potentials without a planned wake-up test. The monitoring was performed using a TECA TE-4 system that included an electromyograph, a nerve stimulator, and a digital averager. Intraoperatively, six patients (2%) demonstrated significant changes in evoked potentials, consisting of either marked increase in latency or a loss of wave form during instrumentation of the spine. The instrumentation was removed immediately and the evoked potentials returned to base-line tracing within 15-30 minutes in all six cases. Five patients who had instruments refitted to maintain a lesser amount of correction had no subsequent change in the evoked potentials. One patient had spinal fusion without instrumentation. Postoperatively, all patients are neurologically normal. PMID- 3280194 TI - Oncogene expression in related cancer lines differing in metastatic capacity. AB - Various murine tumor cell lines with different metastatic capacities were tested in vitro for oncogene expression, especially of the p21-Ha-ras protein. Small differences were seen in the expression of several distinct oncogenes in the case of a high metastatic lymphoma variant (ESb) and its low metastatic parental line (Eb). In one instance we observed a 30-fold Ha-ras gene amplification in a metastasis-derived cell line from a spontaneous mouse mammary carcinoma. In spite of this amplification we did not find an increased p21 expression in these cells. PMID- 3280197 TI - Late infections of total joint prostheses. A review and recommendations for prevention. AB - The incidence of late infection of total joint prostheses is 0.6%. Because this incidence has increased from 0.08% in 1978, the authors reviewed their experience and the literature in search of pathogenetic and preventative measures. The most common pathogen responsible for late prosthetic joint infections was staphylococcus (54%; both Staphylococcus aureus and Staphylococcus epidermidis), even when infection was of dental origin. The three most common origins of infection were skin and soft tissue (46%), dental (15%), and urinary (13%). Escherichia coli was the most common pathogen when the source was the urinary tract. Mortality and cost calculations indicate that chemoprophylaxis is justified for dental procedures and probably also for other surgical procedures in organs containing microflora. Prophylaxis must include antistaphylococcal drugs. The first generation cephalosporin antibiotics are recommended. PMID- 3280199 TI - Autolyzed antigen-extracted allogeneic bone for bridging segmented diaphyseal bone defects in rabbits. AB - The autolyzed antigen-extracted allogeneic (AAA) bone implant was placed into a 17-mm long diaphyseal periosteum-free defect in the radius in 27 rabbits. The animals were observed physically and roentgenologically every week. The continuity of the radius was evaluated macroscopically and histologically. Maximum length of the follow-up period was 114 days. The AAA implants were progressively resorbed and replaced by the recipient's bone growing from fragments of radius, restoring the continuity of diaphysis. Osteoinductive activity of the implant was transferred across a tube of a polyamide vascular prosthesis. There were no appreciable histologic signs or immune of foreign-body reaction. PMID- 3280198 TI - The natural history of idiopathic scoliosis. AB - A clear understanding of the natural history of idiopathic scoliosis is essential for developing effective treatment. The current information on its natural history indicates that a large number of patients have minor degrees of curvature (approximately 100 per 1000 individuals), although only about two per 1000 individuals warrant treatment because of curve progression. A large number of these curves do not increase even without treatment. Prognostic indicators such as growth, menarch, Risser sign, age at diagnosis, and sex are useful for predicting curve progression but are not always precise. Nonpredictive factors include family history, thoracic kyphosis, lumbar lordosis, lumbosacral transitional anomalies, and trunk balance. Future growth potential and curve severity remain the most reliable considerations in predicting the course of the disorder and in devising suitable approaches to treatment. PMID- 3280200 TI - Regional differences in matrix formation in the healing flexor tendon. AB - In 20 white leghorn chickens, the effect of proximity (proximal vs. distal) to the repair site and the effect of sheath excision versus sheath repair on biochemical matrix formation in the healing zone 2 flexor tendon were studied. In 14 animals, the profundus tendon of the long toe on both feet was lacerated and repaired in zone 2. In the right foot, the sheath was repaired, and on the left foot, the sheath was excised. Segments proximal and distal to the laceration site were studied at six weeks postrepair compared to control segments. Sheath excision versus sheath repair had no effect on the net matrix formation of the healing flexor tendon. A higher DNA content and lower hydroxyproline and hexosamine contents were present in the healing tendons, indicating the healing process was not complete at six weeks. Sheath excision versus sheath repair had no effect on net matrix formation in the healing tendon. There is no difference in DNA content or glycosaminoglycan content in the proximal versus distal segments. There was a significantly greater net hydroxyproline content in the proximal segment versus the distal segment of the healing tendon, which was not present in similar control segments. These results support the concept that the zone 2 flexor tendon does not respond to injury as a homogeneous structure. PMID- 3280202 TI - A report of fifty-nine cases of scoliosis treated by the fusion operation. By Russell A. Hibbs, 1924. PMID- 3280201 TI - Brace treatment in adolescent idiopathic scoliosis. An update on concepts and technique. AB - Correct guidelines for the initiation and evaluation of brace treatment in adolescent idiopathic scoliosis are dependent on a thorough knowledge of the condition's natural history. Recently acquired data from school children screening programs and long-term follow-up studies of idiopathic scoliosis have added new insight to the natural history of the condition. This new information has raised questions concerning the validity of previous treatment guidelines and has led to changes concerning patient selection and indications for brace initiation, type of spinal orthotic used, duration of brace treatment, brace-wear programs, and anticipated results from bracing. Proper application of this new knowledge allows the physician to avoid overdiagnosis and overtreatment and to become more efficient in the use of spinal orthoses. PMID- 3280203 TI - Wisconsin and other instrumentation for posterior spinal fusion. AB - In idiopathic scoliosis, the Wisconsin system is as safe as a Harrington rod and nearly as strong as a Luque construct. The installation is relatively easy. Sagittal curves can be preserved while correcting the scoliosis by contouring the rods and fixing them to the spine in a segmental fashion. The Wisconsin system is currently the instrumentation of choice at the authors' clinic for routine idiopathic scoliosis. The quest for the ideal spinal instrumentation system will probably never end. Further improvements on the current systems will inevitably appear, and new concepts will be developed. Spine surgeons will continue to be faced with the need to compare the advantages and disadvantages of different systems. PMID- 3280205 TI - Control of blood loss during scoliosis surgery. AB - By combining surgical and anesthetic techniques that minimize blood loss with the use of autotransfusion, it should now be possible to complete a routine posterior spinal fusion without using allogeneic blood transfusions. Surgical efforts should include careful preoperative planning, positioning with the abdomen hanging free, use of topical hemostatic agents, and decortication late in the procedure. Preoperatively donated autogeneic blood or reclaimed red cells from suction can take the place of allogeneic transfusions. Blood loss during scoliosis surgery correlates closely with left ventricular stroke work index (LVSWI), a measure of blood flow calculated from systemic vascular resistance, cardiac output, and heart rate. All of these parameters are under the anesthesiologist's control, making him the primary determinant of blood loss in scoliosis surgery. Induced hypotensive anesthesia may be ineffective in controlling blood loss if the cardiac output or heart rate is high. Halothane, a commonly used hypotensive agent, is not very useful for scoliosis surgery because spinal cord monitoring and wake-up testing are not possible. Rebound hypertension has been noted with the use of sodium nitroprusside. Trimethaphan works well clinically but experimentally it reduces spinal cord blood flow, which may increase the risk of spinal cord injury. PMID- 3280206 TI - Use of cortical cancellous allograft for posterior spinal fusion. AB - Fifty consecutive patients had posterior spinal fusion using only graft from bone banks. They were studied retrospectively in order to determine the pseudarthrosis rate, the quality of fusion mass obtained, the rate of infection, volume of blood lost, and operative time. The results showed that it is likely that the graft material used is not as important as the fusion technique. Strict adherence to facet obliteration, posterior element decortication, thorough removal of all soft tissue, and stable, well-planned instrumentation are probably the most important factors in preventing pseudarthrosis. With the complications associated with iliac crest graft and the potential benefits of reduced operative time and blood loss, use of allogeneic bone appears justified. PMID- 3280204 TI - The Galveston experience with L-rod instrumentation for adolescent idiopathic scoliosis. AB - Eighty patients were treated with L-rod instrumentation (LRI) for adolescent idiopathic scoliosis at the authors' institution from 1978 through 1985. The percentage correction of Cobb angle, the fusion rate, and the neurologic injury rate were similar to that reported for Harrington instrumentation. Avoidance of postoperative casting or bracing, maintenance of secondary spinal contours, secure pelvic fixation when needed, and anterior thoracoplasty in a majority of patients were achievable goals with LRI. PMID- 3280207 TI - Technetium-99m DTPA uptake in uterine leiomyoma. PMID- 3280208 TI - Technetium-99m HM-PAO images (planar and SPECT) of the human brain. AB - Tc-99m HM-PAO has a great potential in the assessment of regional brain perfusion in various neurologic disorders. An atlas of planar and SPECT images of the normal and abnormal human brain has been generated using Tc-99m HM-PAO as the tracer. PMID- 3280209 TI - Use of Tc-99m DTPA aerosol in the scintigraphic evaluation of pulmonary embolism. PMID- 3280210 TI - Use of ultrasonography to eliminate hemiagenesis of a thyroid lobe in the differential diagnosis of a toxic adenoma (Plummer's disease) PMID- 3280213 TI - A protocol of plain radiographs, hip ultrasound, and triple phase bone scans in the evaluation of the painful pediatric hip. AB - A useful protocol for the evaluation of hip pain in the pediatric patient, using a combination of plain radiographs, hip ultrasound (US), and triple phase radionuclide bone scans is presented. Patients with hip pain were initially evaluated by plain radiographs of the pelvis and hips. If no diagnosis was reached, the hips were studied for effusions by real-time hip ultrasonography. If an effusion was present, the joint was aspirated for diagnosis. If no effusion was present by US or if no diagnosis was reached by aspiration, triple phase radionuclide bone scans were performed. Fifty patients were evaluated by this prospective protocol, and the diagnosis was reached in 48 of the 50 cases (10 by plain radiographs, 16 by US, and aspiration of the joint, and 22 by triple phase bone scans). Hip effusions were found in 20 patients by US, with no false positives or false negatives. Previous studies for detecting effusions by US have emphasized absolute measurements of the capsular width, but we report a typical appearance of the hip capsule when fluid is present (a bulging convex capsule). When no effusion is present, the capsule is concave and parallels the long axis of the femoral neck. PMID- 3280217 TI - Rocky Mountain spotted fever. AB - The epidemiology, pathogenesis, clinical features, and treatment of Rocky Mountain spotted fever are reviewed. Rocky Mountain spotted fever is a severe infection caused by Rickettsia rickettsii transmitted to man by various species of ticks. High-incidence areas exist in the southeast and south central United States. Only 60-70% of patients with the disease report a history of tick bite or exposure to tick-infested areas. The disease is initially characterized by fever, headache, gastrointestinal complaints, myalgia, and a generalized rash. In several days generalized vasculitis may lead to periorbital edema and nonpitting edema of the face and extremities. Central nervous system involvement is common. Because signs and symptoms associated with the disease are nonspecific, the diagnosis is often delayed or missed. Traditionally diagnostic confirmation relied on serologic testing, but an indirect fluorescent antibody assay will soon be commercially available. Rocky Mountain spotted fever is usually treated with the rickettsiostatic agents chloramphenicol or tetracycline, but few comparative data on these agents in patients with the disease are available. For patients who cannot tolerate oral medications, intravenous chloramphenicol sodium succinate is the preferred treatment; chloramphenicol is also the drug of choice for children less than eight years of age. Otherwise, oral tetracycline hydrochloride is the drug of choice. Antibiotic therapy should be continued for 7-10 days or until the patient is afebrile for two to five days. All cases of Rocky Mountain spotted fever must be reported to the Centers for Disease Control. The best ways to decrease the morbidity and mortality of the disease are to increase awareness of its signs and symptoms and to prevent exposure to ticks. PMID- 3280214 TI - The evaluation and management of the patient with ptosis. AB - This article deals with fundamentals in evaluation and correction of ptosis, with some references to special situations. Ptosis defies a cookbook approach if one wishes predictable results. In a certain percentage of patients, the result will remain unpredictable and the surgeon must be prepared to perform revisional surgery. PMID- 3280218 TI - Pathophysiology and treatment of the anemia of renal failure. AB - The pathophysiology of anemia associated with renal failure and the major pharmacologic agents used in the treatment of this anemia are reviewed. Patients with renal failure are often anemic primarily because of diminished circulating erythropoietin and suppressed erythropoiesis in the bone marrow. The anemia may cause malaise, fatiguability, aggravated angina, and decreased exercise tolerance. Many patients require frequent red blood cell transfusions. Therapy has included anabolic androgen administration, iron and vitamin supplementation, and the administration of red blood cells. These approaches generally have not resulted in sustained improvement of the anemia. The recent development of recombinant human erythropoietin may represent a major therapeutic advance for the treatment of anemia associated with renal failure. Previously, erythropoietin therapy was not possible because of lack of sufficient quantities of the purified hormone. Clinical trials indicate, however, that recombinant human erythropoietin may improve erythropoiesis in most patients. Adverse effects have generally been mild and easily managed; however, increases in blood pressure and arteriovenous fistula clotting have been reported. Although initial reports are encouraging, larger and longer clinical trials are needed to determine proper dosing and to understand more completely the potential adverse effects of recombinant human erythropoietin. Previous pharmacologic attempts to improve the anemia associated with renal failure have been largely unsatisfactory; initial reports on the use of recombinant human erythropoietin are promising. PMID- 3280215 TI - Treatment of post-traumatic orbital deformities. AB - Correction of post-traumatic orbital deformities requires adequate exposure, often through coronal and intraoral approaches; adequate dissection, at times circumferential and to within 1 cm of the optic foramen; repositioning of displaced bone segments; refabrication of an orbital framework with autogenous materials; and reattachment of soft-tissue adnexae--all of which are basic maneuvers in craniofacial surgery. PMID- 3280212 TI - Clinical pharmacokinetics of amantadine hydrochloride. AB - Amantadine is a drug with diverse uses ranging from prevention of influenza A illness to the treatment of patients with Parkinson's disease. It is available only in oral formulations from which it is well absorbed and widely distributed, little drug being present in the circulation. Apparent volume of distribution is inversely related to dose over the therapeutic range and accounts in part for a noteworthy logarithmic increase in plasma concentration as a function of dose. Elimination is primarily by renal clearance by both glomerular filtration and tubular secretion. Amantadine accumulates in patients with renal dysfunction. Hence, doses must be reduced in such patients to avoid toxicity. Interactions with other drugs appear uncommon. Relationships have been demonstrated between amantadine therapeutic effects and plasma concentrations in different study cohorts, but not in individual patients. Dose schedules have been suggested for individuals in whom amantadine kinetics are different from healthy subjects. However, these schedules are controversial in their choice of target concentrations and in being untested as to predictive value. PMID- 3280211 TI - Clinical pharmacokinetics of ketoconazole. AB - Ketoconazole, a synthetic imidazole antifungal, is effective for superficial fungal infections, genital candidosis and chronic mucocutaneous candidosis, and has been used in immunocompromised patients and advanced prostatic carcinoma. Absorption of ketoconazole is variable after oral administration, with large variability in peak serum concentrations. Antacids reduce, and food or dilute hydrochloric acid increase, absorption. Renal failure and bone marrow transplantation are associated with reduced absorption. Ketoconazole is not absorbed systemically after topical administration, and minimally absorbed from the vagina. Distribution of ketoconazole varies according to the tissue sampled, the underlying disease and the dose and duration of treatment. Ketoconazole does not cross the intact blood-brain barrier, and crosses to only a limited extent in fungal meningitis. Urinary concentrations of ketoconazole are usually low, but vaginal and vaginal tissue concentrations correlate with those in serum. Seminal fluid concentrations are inadequate for treatment of epididymitis. Ketoconazole is 83.7% plasma protein (mainly albumin) bound, and 15.3% is erythrocyte bound, resulting in only 1% of free drug. Animal studies indicate strong binding to the cytochrome P-450 mono-oxygenase complex. Extensive metabolism to inactive metabolites occurs, the products being mainly excreted in the faeces. Saturable hepatic first-pass metabolism is probable. The half-life of ketoconazole is dose dependent, increases during long term treatment, suggesting auto-inhibition of metabolism. The kinetics after oral administration fit a 2-compartment model. Drug interactions of theoretical, if not practical, significance include warfarin, chlordiazepoxide, methylprednisolone, cyclosporin and drugs known to induce microsomal enzymes. In each case, some dosage adjustment for ketoconazole, or the interacting drug, may be required. PMID- 3280216 TI - Early and late complications of orbital fractures. AB - Complications, unfortunately, arise as a result of traumatic or iatrogenic injuries. The sequelae can range from the most insignificant to the most debilitating. The most common complications noted in the diagnosis and treatment of orbital fractures are outlined as well as discussed as appropriate to their appearance during the healing process. With better understanding and better management, complications can be prevented. PMID- 3280219 TI - Management of hypophosphatemia. AB - The etiology, clinical presentation, and management of hypophosphatemia are reviewed. Phosphorus is a major intracellular anion and plays an important role in many biochemical pathways relating to normal physiologic functions. Approximately 60 to 90% of the 1 to 1.5 g of daily dietary phosphorus intake is absorbed, and of that amount, about two thirds is excreted in the urine. The overall incidence of hypophosphatemia is about 2 to 3% of all hospitalized patients. Factors associated with hypophosphatemia include phosphate-binding antacid therapy, nasogastric suction, liver disease, sepsis, alcoholism, and acidosis associated with diabetic ketoacidosis. Patients receiving parenteral nutrient solutions were also at higher risk for hypophosphatemia before the routine supplementation of these formulations with phosphate. Patients with hypophosphatemia may be asymptomatic or may experience weakness, malaise, anorexia, bone pain, and respiratory arrest. The major systems involved include the neuromuscular, hematologic, and skeletal systems. Phosphorus-containing products used to treat hypophosphatemia are a combination of monobasic and dibasic phosphate salts. Therefore, it is essential to calculate doses in millimoles rather than milligrams or milliequivalents to more accurately reflect the phosphorus concentration and to avoid potentially serious dosage errors. Normal daily requirements are readily maintained by dietary sources of phosphorus such as milk products or may be supplemented by phosphate-containing products administered orally or intravenously. Since phosphorus is a key factor in many organ systems, it is essential to monitor serum phosphorus concentrations in patients at risk for hypophosphatemia. PMID- 3280220 TI - Comparison of equal-weight oral dosages of verapamil hydrochloride and diltiazem hydrochloride in patients with mild to moderate hypertension. AB - The clinical efficacy, safety, and tolerability of oral verapamil and diltiazem, at total daily dosages of equal weight, were evaluated in a placebo-controlled, double-blind crossover study. Thirty-six ambulatory patients with chronic, stable, mild to moderate hypertension (supine diastolic blood pressure of 94-116 mm Hg) received a dosage of either verapamil or diltiazem 80 mg t.i.d. as the hydrochloride salt for one week after an antihypertensive-drug washout period. Each then received 120 mg of the same drug t.i.d. for one week. After another two week washout period, the patients were crossed over to the other drug. Each patient had a 12-lead electrocardiogram and measurement of supine and standing blood pressure weekly. In the 32 patients completing the study, low-dose verapamil reduced supine diastolic blood pressure (DBP) from a mean of 101.5 +/- 5.2 to 95.3 +/- 9.5 mm Hg; high dose verapamil reduced DBP to 90.9 +/- 7.4 mm Hg. Standing DBP was reduced to a similar degree. Diltiazem showed an almost identical effect: Supine DBP was reduced from a mean of 101.7 +/- 5.3 to 94.0 +/- 10.1 mm Hg with the low dose and to 91.0 +/- 8.6 mm Hg with the high dose, with similar effects on standing DBP. The high dose of both drugs significantly increased the QTc interval, and both doses of diltiazem significantly increased the PR interval compared with baseline. Both drugs exhibited consistent efficacy with minimal adverse effects. The electrophysiologic safety profile of verapamil was superior to that of diltiazem. PMID- 3280221 TI - Effect of temperature on in vitro measurement of quinidine free fraction. PMID- 3280224 TI - The physiology of spontaneous and mechanical ventilation. AB - This article provides both an overview of normal ventilation and gas exchange during spontaneous breathing and a review of the alterations of pulmonary physiology that occur with the institution of mechanical ventilation. PMID- 3280223 TI - The modern evolution of mechanical ventilation. AB - Continuous mechanical ventilation used for life support is accepted as standard practice in nearly every hospital in the United States today. The history of the evolution of techniques that we take virtually for granted today is fascinating. This article recounts some of the highlights in the development of modern-day mechanical ventilators, with emphasis on the past 25 years. PMID- 3280222 TI - Nicardipine, nitrendipine, and bepridil: new calcium antagonists for cardiovascular disorders. AB - The chemistry, pharmacology, pharmacokinetics, clinical uses, and adverse effects of nicardipine, nitrendipine, and bepridil are reviewed. Nicardipine, nitrendipine, and bepridil are calcium antagonists under investigation for the treatment of cardiovascular disorders. Nicardipine and nitrendipine share a common dihydropyridine nucleus with the calcium antagonist nifedipine; bepridil is unrelated to other known calcium antagonists. Like nifedipine, nicardipine and nitrendipine produce peripheral vasodilation as their predominant in vivo effect. Bepridil has vascular, sinoatrial and atrioventricular nodal, and myocardial effects qualitatively similar to those of the calcium antagonist verapamil; it also interferes with the fast sodium channel and prolongs refractoriness in atrial and ventricular tissue. Nicardipine and nitrendipine undergo extensive first-pass hepatic extraction after oral administration; oral bioavailability of bepridil is about 60%. All three drugs are highly protein bound and have been reported to increase plasma digoxin concentrations. Both nicardipine and nitrendipine are effective antihypertensive agents used alone or combined with diuretics, beta blockers, or angiotensin-converting enzyme inhibitors. Nicardipine and bepridil effectively control angina, and preliminary studies indicate that nitrendipine has antianginal properties. Bepridil may be useful in the treatment of various cardiac arrhythmias; however, its tendency to cause or worsen cardiac arrhythmias and its association with torsade de pointes may limit its usefulness. Nicardipine and nitrendipine have similar adverse effect profiles, with vasodilation-related complaints being most common. Since nicardipine, nitrendipine, and nifedipine are similar in efficacy and safety, the eventual availability of sustained-release dosage forms may determine how these drugs are ultimately used. Bepridil is an effective antianginal drug, but, because of its proarrhythmic potential, it should probably not be used as a first line agent. PMID- 3280226 TI - Complications in the ventilated patient. AB - The use of mechanical ventilation may subject patients to a variety of complications and adverse effects. Certain complications may be a direct result of mechanical ventilation, whereas others seen in association with this modality of therapy appear to be related to concurrent conditions and the severity of underlying disease. The incidence, evaluation, and management of major complications associated with mechanical ventilation are reviewed. PMID- 3280225 TI - Discontinuation of mechanical ventilation. AB - The vast majority of patients who undergo mechanical ventilation are able to discontinue ventilatory assistance within a few days. Typically, patients who require only short-term mechanical ventilation do not have severe underlying lung disease, and the problem for which they require ventilatory support is most commonly rapidly reversible. In these patients on short-term ventilatory support, parameters of spontaneous ventilatory requirements and respiratory muscle strength, including minute ventilation, maximal voluntary ventilation, vital capacity, and maximal inspiratory pressure, are useful in predicting the success of discontinuation of mechanical ventilation. Ventilatory support can generally be discontinued by a variety of techniques in these patients without the need for weaning from the ventilator per se. The smaller group of patients in whom it is not possible to discontinue mechanical ventilation within less than 7 days comprises individuals who frequently have severe acute or chronic lung disease, multisystem extrapulmonary disease, or neuromuscular disease. After a period of prolonged mechanical ventilatory support, these complicated patients require a process of progressive weaning in which they gradually become able to support spontaneous ventilation. Spontaneous ventilatory parameters do not correlate well with weaning ability in patients on long-term ventilatory support. A systematic and comprehensive approach in which attention is focused on optimizing pulmonary and nonpulmonary factors that affect the weaning process provides the best chance for successful withdrawal of ventilatory support after long-term mechanical ventilation. Inadequate ventilatory drive, respiratory muscle weakness and fatigue, increased work of breathing, excessive CO2 production, and cardiac failure are potential mechanisms that may play a role in inhibiting successful weaning. Adverse factors relevant to each of these mechanisms must be addressed and corrected to whatever extent possible. Studies have not demonstrated the superiority of either classic T-piece weaning or IMV weaning methods in difficult to-wean patients on long-term ventilatory support. Both techniques may be used successfully as long as all patient variables that may adversely affect weaning ability are corrected or optimized and close care and attention to the details of the weaning process itself are provided.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3280227 TI - Oxygen toxicity. AB - Ventilating patients with elevated oxygen tensions alters normal respiratory physiology and may damage lung tissue, depending on coexisting host and iatrogenic factors. Pulmonary oxygen toxicity begins at a cellular level when the generation of reduced oxygen intermediates exceeds local defenses. The mainstay of therapy is prevention. Supplemental oxygen should be prescribed at the lowest concentration possible that will still allow adequate tissue oxygenation. Presently, no specific therapeutic interventions are approved for use in humans to treat pulmonary oxygen toxicity. New agents that act as free radical scavengers or reduce free radical formation may prove useful in future clinical trials based on many of the scientific studies summarized in this review. PMID- 3280229 TI - Tracheal intubation in mechanically ventilated patients. AB - Airway management is an important skill in the care of patients undergoing mechanical ventilation. This article reviews the available techniques of tracheal cannulation and describes common complications, preferred routes of intubation, and approaches to weaning. PMID- 3280228 TI - Intermittent mechanical ventilation. AB - More than 150 years have passed since the birth of the idea of intermittent mechanical ventilation. Many types of ventilatory disorders can result in excessive loading of the respiratory muscles, thus causing them to fail. We now have several types of ventilatory assist devices to choose from so that we can select a system that fulfills the physical, physiologic, and psychological needs of patients and return them to a more satisfactory level of living in the home. This is successful when the care team and the patient and family set realistic goals and maintain close clinical supervision. Much more study is needed to determine the optimal times for respiratory muscle rest. Future technologic designs for ventilatory systems should aim to decrease cost and increase efficiency, ease of use, and durability. PMID- 3280230 TI - Conventional mechanical ventilation. AB - Mechanical ventilation has become a very common and well-accepted practice in modern intensive care units. The use of the mechanical ventilator has progressed from being a support system during surgery and for acutely ill patients to being used in both moderate and long-term life support in patients with inadequate ventilation. The sophistication of modern ventilators and the ability of trained respiratory therapists and nursing personnel have permitted this technology to explode. This is occurring at a time when there are still many controversies about the relative benefits and modes of action of conventional ventilation. As newer techniques are developed, it is mandatory that the application of these techniques be tempered with controlled clinical trials, documenting their effectiveness. The beneficial effects of new modalities must be documented as mechanical ventilation expands from use in the intensive care unit to use in standard medical wards and the patient's home. In these latter two settings, the vigilance of an intensive care unit is absent and the simplest method will be preferable. The requirement to demonstrate efficacy of new techniques with adequate studies is especially necessary now as the economics of health delivery have come under increasing scrutiny. Even more important than new technologies may be the efficacy of prolonged mechanical ventilation. A recent study by Spicher and White evaluated the outcome in 250 patients ventilated for 10 days or more at the Hershey Medical Center (Pennsylvania State University). The mortality, morbidity, and disability in patients in this study population requiring prolonged ventilation were extremely high. As these studies have pointed out, further evaluations of predictors of meaningful survival are necessary to avoid unnecessary human suffering and to best use limited resources. PMID- 3280231 TI - New forms of mechanical ventilation in the adult. AB - Although mechanical ventilatory support in the 1980s clearly provides adequate gas exchange with minimal side effects, there remains a need for ventilation and oxygenation in those with severe gas exchange abnormalities, for reduced airway pressure effects in those at risk for barotrauma, for a better muscle reconditioning approach in those with muscle dysfunction, and for better ventilator-patient interactions (synchrony) in many patients receiving mechanical ventilatory support. The new approaches outlined previously address these issues. However, research and development for new and better techniques are needed. Specific areas that require better understanding include the effects of intrathoracic pressure on the lungs and the circulation, the matching of ventilation and perfusion under different support modes, the function of the respiratory muscles during fatigue and recovery, and the ventilatory reflexes operational during mechanical ventilation. Only with this information can we design the optimal ventilatory support system. PMID- 3280232 TI - Effects of mechanical ventilation on right and left ventricular function. AB - We have discussed the complex hemodynamic changes that occur throughout the respiratory cycle during mechanical ventilation and have reviewed the physiologic changes associated with spontaneous respiration. In patients, many cumulative factors account for the total hemodynamic burden of mechanical inspiration and expiration. Thus, the change in pleural pressure, respiratory rate, mode of ventilation, amount of spontaneous ventilation, underlying lung and cardiac disease, and intravascular volume status all affect cardiocirculatory equilibrium during the respiratory cycle. Knowledge of the effects presented in this article will aid the physician in choosing the therapeutic options in instrumented, mechanically ventilated patients. PMID- 3280233 TI - The George K. Smelser Award. PMID- 3280234 TI - Recent advances in corneal stromal dystrophies. AB - Newer biochemical, immunohistochemical, and cell culture techniques have been used to investigate metabolic abnormalities in corneal stromal dystrophies. Organ cultures of macular corneal dystrophy (MCD) have shown a defect in the synthesis of keratan sulphate proteoglycan. Alterations in corneal stromal glycoconjugates have also been detected using biotinylated lectins. An absence of normal keratan sulphate proteoglycan has been shown in the blood of patients with MCD. Granular corneal dystrophy (GCD) is associated with increased phospholipid, as shown by biochemical analysis and staining with Luxol-fast blue. Immunohistochemical stains revealed reactivity with antibodies against microfibrillar protein at the edges of the deposits. Clinically, recently described early features of lattice corneal dystrophy (LCD) include discrete ovoid subepithelial opacities, a diffuse central anterior stromal haze, and anterior stromal dots and filamentary lines. Early clinical recognition of these corneal genetic disorders, with appropriate studies to define their nature and possible pathogenetic mechanisms, are important in expanding our knowledge of this disease spectrum. PMID- 3280235 TI - Fuchs' dystrophy. AB - Fuchs' dystrophy is an inherited disorder of unknown etiology in which the corneal endothelial cells develop morphologic and functional abnormalities. Clinically, the disease progresses slowly over a period of 20 or more years from asymptomatic cornea guttata to corneal edema with decreased vision and pain. Pathologic studies suggest abnormalities in endothelial function occurring early in life, although symptoms usually do not appear until middle age. The definitive treatment for Fuchs' dystrophy is penetrating keratoplasty. Recent findings regarding the pathophysiology of the disease have increased our understanding of it and have suggested areas for future research. PMID- 3280236 TI - Application of immunologic technology to the diagnosis of viral infections of the ocular surface. AB - Recent advances in immunologic technology are making the rapid diagnosis of viral infections of the ocular surface possible. The prompt use of these diagnostic techniques can directly influence therapeutic decision making, such as the use of antiviral drugs and steroids. In this article, existing methods of sampling the ocular surface are discussed, and the yield of infectious virus and viral antigens from various sites on the ocular surface is reviewed. The immunologic principles underlying radio-immunoassays, enzyme immunoassays, and a variety of immunocytologic methods are outlined, along with the advantages and disadvantages of each immunologic technique. In addition to reviewing the methods for detecting viral antigens on the ocular surface, the value of assessing antiviral antibodies in the tear film, as well as prospects for future diagnostic techniques, are discussed. PMID- 3280237 TI - Ring stromal opacity in lens-corneal adhesion. AB - Severe congenital corneal clouding may be associated with abnormal anterior segment development (dysgenesis). Often, congenital corneal opacities preclude visualization of intraocular anatomy. In this report, five eyes of four patients with congenital corneal clouding and lens-corneal adhesion (LCA) are described. All had a ring- or doughnut-shaped haze within the stroma surrounding a central clear corneal zone delineating the adhesion. Recognition of LCA is pivotal in planning surgical therapy for eyes with congenital corneal clouding. As a clue to recognition of this anomaly, the ring-shaped stromal opacity may aid in diagnosis of this phenomenon and in avoidance of surgical complications. PMID- 3280238 TI - Glaucoma in keratoplasty. AB - This paper reports intraocular pressure findings in 676 eyes that received penetrating keratoplasties. There were four groups: 1. keratoconus without preoperative glaucoma (75 cases); 2. Fuchs' dystrophy and cataract (triple procedure) without glaucoma (260 cases); 3. aphakic eyes with or without intraocular lenses (204 cases); and 4. pseudophakic eyes with or without intraocular lens removal (137 cases). The last two groups had a significant number of glaucoma cases. All were controlled before surgery. There were no early or late glaucoma cases in the first group. A few cases with triple procedures had mild early intraocular pressure elevation. Thirty percent of aphakic eyes and 52% of pseudophakic eyes had early glaucoma. Twenty percent and 25% of these two groups had persistent glaucoma. Preoperative glaucoma eyes were included in these long-standing glaucoma cases. PMID- 3280239 TI - Impression cytology. AB - Impression cytology refers to the application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. Impression cytology has been found to be useful in assessing the ocular surface in various dry eye disorders, such as keratoconjunctivitis sicca (KCS), cicatricial ocular pemphigoid, and vitamin A deficiency. The technique is noninvasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squamous metaplasia assessed. A specific criteria based on the appearance of the epithelial cells and the density of the goblet cells can be used to assign a grade (0-3) to the ocular surface. The grade of the ocular surface is related to the degree of squamous metaplasia and usually parallels the severity of clinical disease. Impression cytology can also be used to differentiate between various dry eye disorders. Disorders that are extrinsic or environmental (such as KCS) often affect the exposed interpalpebral ocular surface before the more protected inferior palpebral ocular surface. Intrinsic surface disorders (such as ocular pemphigoid) affect the palpebral, as well as the bulbar ocular surfaces, early in the disease. PMID- 3280240 TI - Eye banking activity--1986. PMID- 3280242 TI - Regulation of H-2 class I gene expression in virally transformed and infected cells. AB - Early studies of the resistance and susceptibility of mouse strains to radiation induced leukemia virus have demonstrated the important role of altered histocompatibility (H-2) antigen expression in the effectiveness of the immune response of the host to virus-infected and transformed cells. Changes in H-2 gene expression have now been correlated with disease resistance in a variety of viral systems. The experiments discussed indicate that viruses may directly or indirectly affect H-2 antigen expression at various levels of gene expression. These investigations generate a framework for approaching a molecular understanding of viral-induced changes in H-2 gene expression. PMID- 3280241 TI - Autoantibodies to DNA. AB - Naturally occurring antibodies directed against the principal component of the gene are conceptually remarkable as well as of great interest to both basic and applied immunologists. In this article, some of the important literature concerning these antibodies are reviewed, concentrating on studies performed during the last 5 years. One of the major recent advances has been the generation of monoclonal anti-DNA antibodies, studies of which have shed light on the ligand binding characteristics, idiotypic properties, and genetic origin of anti-DNA and other autoantibodies. The major current hypotheses for the origin of autoantibodies and, in particular, present evidence that anti-DNA antibodies are part of the normal immune repertoire are also discussed. Finally, the evidence that certain subgroups of anti-DNA antibodies may be pathogenic is examined. PMID- 3280243 TI - Cardiovascular and renal effects of dopamine and dobutamine in healthy, conscious piglets. AB - The pharmacologic effects of dopamine and dobutamine (2 to 32 micrograms/kg.min) were evaluated in 12 1 to 2-month-old piglets. Dopamine increased cardiac output at 16 to 32 micrograms/kg.min (p less than .05) and increased heart rate (HR) at 4 to 32 micrograms/kg.min (p less than .05). Dobutamine produced an increased cardiac output at doses of 16 to 32 micrograms/kg.min (p less than .05), and increased HR at 32 micrograms/kg.min (p less than .05), decreased systemic arterial pressure and systemic vascular resistance at 16 to 32 micrograms/kg.min (p less than .05), decreased renal vascular resistance at 16 to 32 micrograms/kg.min, and increased renal blood flow at 4.8 and 32 micrograms/kg.min (p less than .05). We conclude that dopamine and dobutamine increase cardiac output in healthy, conscious piglets primarily by increasing HR. Neither agent was effective in increasing stroke volume, although a positive inotropic effect obscured by tachycardia cannot be ruled out. Dobutamine was the superior agent for renal vasodilation, whereas neither agent produced significant pulmonary vasodilation. PMID- 3280244 TI - Giant prostate carcinoma: computed tomography findings and review of previous reports. AB - Two patients with massive prostate adenocarcinoma were evaluated by several imaging modalities. Computed tomography provided excellent anatomic delineation of the tumors. In one patient, computed tomography demonstrated significant tumor regression following orchiectomy. Giant prostate carcinoma should be considered in the differential diagnosis of a large, inhomogeneous pelvic mass. PMID- 3280246 TI - Skin preservation at 4 degrees C: a species comparison. AB - There are numerous experimental studies in the literature regarding skin storage and preservation. These studies are difficult to interpret due to the variety of storage techniques utilized and the number of different animal species used as skin donors. This study utilized a single cold storage protocol to test the effect of species variation on skin graft viability. Donor skin was obtained from five animal species and human surgical panniculectomy specimens. The skin was stored in modified Roswell Park Memorial Institute (RPMI) 1640 tissue culture media at 4 degrees C. Stored skin was transplanted to surgically created defects on athymic (nude) mice after specific storage intervals. Ten days after transplantation, the grafts were examined by gross and microscopic techniques. The viability of mouse, rat, and dog skin was significantly different from human skin, while stored rabbit and pig skin were similar to human skin. These results demonstrate the difficulty of applying the data of skin storage studies from nonhuman species to clinical practice. The data indicate that rabbit and pig skin may be used in laboratory studies of skin preservation at 4 degrees C with a strong likelihood that the results may be of clinical relevance in predicting the behavior of human skin under similar storage conditions. PMID- 3280245 TI - Function of lymphocytes and macrophages after cryopreservation by procedures for pancreatic islets: potential for reducing tissue immunogenicity. AB - The survival of tissue allografts can be extended by pretreating the tissue to remove the stimulatory leucocytes that populate the graft; with this in mind, we have recently begun to explore a cryobiological approach to modulating tissue immunogenicity by using the differential susceptibility of different cells to freezing injury. The sensitivity of leucocytes to fast cooling rates, which were used in procedures that have been reported to yield viable pancreatic islets of Langerhans, was examined. The loss of both cell numbers and the ability of peripheral blood lymphocytes to undergo blastogenic transformation in response to the mitogen concanavalin A after freezing and thawing was determined over a range of cell concentrations using the "curve-shift" method. Lymphocytes frozen at 1 degree C/min by a control procedure that was designed to yield maximum survival of lymphocytes showed that although there was a decrease in the number of responding cells, there was no reduction in the ability of the recovered cells to undergo blastogenesis when compared with the response of nonfrozen cells. However, cooling at 1 degree C/min in the experimental procedures resulted in both the loss of cells as well as a marked reduction in the ability of recovered cells to incorporate 125I-deoxyuridine into nucleic acid. Cells cooled at either 20 or 75 degrees C/min by any of the procedures showed total inability to respond to stimulation. Lysozyme is produced continuously by all types of macrophages in culture. The large net increase in total lysozyme content of macrophage cultures is therefore a useful measure of the viability of these accessory cells. Cooling at 1 degree C/min by a control, optimized procedure yielded 91% survival of viable peritoneal exudate cells. Cooling at either 1 or 20 degrees C/min in the experimental procedures resulted in 72-75% survival of cells frozen by one method and 33% survival when frozen by an alternative procedure. Negligible recovery of viable cells was obtained after cooling at 75 degree C/min. The preservation protocols employed in this study differ significantly in the variables known to influence the survival of the cells; these include the concentration of cryoprotectant (CPA), the length and temperature of exposure to CPA, the dilution regimen, and the optimum cooling rate for survival of pancreatic islets. This study therefore defines clearly those conditions most likely to effect a depletion of "passenger" lymphoid cells by freezing during the cryopreservation of islets of Langerhans. PMID- 3280247 TI - Cheese industry development and research in Argentina. AB - Research and development projects concerning cheese industry in Argentina are described in this study. Regional strains of lactic acid bacteria were isolated from different ecological pockets and their taxonomic profiles were determined. Proteolytic and acid activity as well as diacetyl production were analyzed. Results obtained depended on the species and strains under consideration. The cell permeabilization using 20 to 40% ethanol improved the acid production by lactic acid bacteria. Freeze-drying was used for culture preservation. The optimal conditions for obtaining the highest survival rate were determined. Best results were obtained by using 0.75 M adonitol as a cryoprotectant. The rehydration conditions to be used depended on the bacterial species. Freeze-dried cultures showed good viability and activity up to 1 year of storage at 4 degrees C. PMID- 3280248 TI - Pleurotus mushrooms. Part IB. Pathology, in vitro and in vivo growth requirements, and world status. AB - Part IB of this review discusses growth abnormalities and diseases of the fruit bodies, as well as containments in the substrates that affect the quality and yield of the fruit bodies. The means and methods to overcome these problems during culturing of Pleurotus on commercial scales are described. In vitro growth requirements and prospects of producing mycelium on organic wastes in liquid culture are discussed. The effects of changes in the nutrients of growth substrate on the yield and quality of fruit bodies in vivo are brought out. Status of culturing Pleurotus in different parts of the world is evaluated. Finally, a critical consideration of the scope and problems of Pleurotus cultivation technology is given. PMID- 3280251 TI - Complications of invasive hemodynamic monitoring in the intensive care unit. PMID- 3280249 TI - Radiation preservation of foods of plant origin. Part VI. Mushrooms, tomatoes, minor fruits and vegetables, dried fruits, and nuts. AB - In this concluding article in the series on the technological feasibility of ionizing radiation treatment for shelf life improvement of fruits and vegetables, the present status of research on several commodities that have not been dealt with earlier is discussed. The commodities include mushrooms, tomatoes, pineapples, lychees, longans, rambutans, mangostenes, guavas, sapotas, loquats, ber, soursops, passion fruits, persimmons, figs, melons, cucumbers, aubergines, globe artichokes, endives, lettuce, ginger, carrots, beet roots, turnips, olives, dates, chestnuts, almonds, pistachios, and other dried fruits and nuts. Changes induced by irradiation on metabolism, chemical constituents, and organoleptic qualities are considered while evaluating the shelf life. The commodities have been grouped into those showing potential benefits and those not showing any clear advantages from radiation treatment. Shelf life improvement of mushrooms and insect disinfestation in dried fruits, nuts, and certain fresh fruits appears to have immediate potential for commercial application. PMID- 3280250 TI - The chemistry of lysozyme and its use as a food preservative and a pharmaceutical. AB - The chemistry and use of lysozyme as a food preservative and a pharmaceutical are reviewed. Lysozyme inhibits the growth of deleterious organisms, thus prolonging shelf life. Chemicals used to improve the preservative effect of lysozyme and those that inhibit the enzyme are discussed, along with the stability of lysozyme in various chemical environments. Lysozyme has been used to preserve fresh fruits and vegetables, tofu bean curd, seafoods, meats and sausages, potato salad, cooked burdock with soy sauce, and varieties of semihard cheeses such as Edam, Gouda, and some Italian cheeses. Lysozyme added to infant-feeding formulas makes them more closely resemble human milk. Lysozyme has been used clinically in the treatment of periodontitis, administered in chewing gum, and implemented to prevent tooth decay. It has also been administered to patients suffering from cancer for its analgesic effect and has been used as a potentiating agent in antibiotic therapy. PMID- 3280252 TI - Neonatal alloimmune thrombocytopenia: a clinical perspective. PMID- 3280256 TI - Target antigens for platelet autoantibodies. PMID- 3280254 TI - Percutaneous umbilical blood sampling. PMID- 3280255 TI - Glycoprotein IIb-IIIa as an immunologic target. PMID- 3280253 TI - The importance of the platelet membrane in transfusion medicine. PMID- 3280257 TI - Infection following coronary artery surgery. Comparison of two antibiotic prophylaxis regimens. AB - A prospective randomized study was conducted in 200 patients undergoing coronary artery bypass surgery. All patients received intravenous (IV) cephalothin prophylaxis for 48 hours beginning with anesthetic induction. Group A (99 eligible patients) received cephalexin 500 mg po, qid for three extra days. Group B (94 eligible patients) received no oral therapy. The overall infection rate was 9.3 percent (18 patients). Six patients had multiple sites of involvement. There was no difference between group A (9.0 percent, nine patients) vs B (9.5 percent, nine patients) (p greater than 0.5). The median sternotomy infection rate, superficial or deep, was 2.6% (five patients). The surgical wound infection rate was 4.7 percent (nine patients). The overall infection rate compares favorably with that of high risk groups for clean surgical procedures defined in SENIC study. There was no advantage to prolonged oral cephalexin prophylaxis following coronary artery bypass (CAB) surgery. PMID- 3280259 TI - Pulmonary function in long-term survivors of hyaline membrane disease. AB - In order to determine the long-term pulmonary consequences of hyaline membrane disease (HMD), we measured pulmonary function and airway responsiveness to methacholine in 22 survivors of HMD aged 18 to 22 years. Nineteen age-matched control subjects without a history of lung disease or asthma were also studied. There was no statistically significant difference between the mean pulmonary function test results of the control vs the HMD group. The mean N2 delta of the five HMD patients who required assisted ventilation was significantly different from that of the control group. Airway responsiveness to methacholine, as estimated by the dose of methacholine aerosol necessary to provoke a 35 percent fall in SGaw did not differ between the control and HMD groups. In the absence of prematurity, low birth weight (less than 1,500 g), and requirement for positive pressure ventilation, HMD is not associated with an increase in nonspecific airway reactivity or abnormal pulmonary function in adulthood. PMID- 3280258 TI - A home monitoring system for nasal CPAP. AB - A compact portable sensing system (PSS) was developed for home monitoring of patients with obstructive sleep apnea treated with nasal continuous positive airway pressure (CPAP). The system consisted of a solid-state pressure sensor connected with plastic tubing to the side port of the nasal CPAP mask, a power supply, and a strip chart recorder. The device was validated against standard polysomnography in ten patients with obstructive sleep apnea undergoing overnight nasal CPAP trials. A total of 397 apneas and hypopneas were observed in the ten patients. The PSS device detected 386 events (sensitivity, 97.2 percent). In addition, there were 29 false positive events noted by the device (positive predictive value, 93 percent). The device was then tested at home in 23 patients on nasal CPAP. Eight of these patients had persistent apneas requiring adjustment of their CPAP pressure. The PSS device allowed for accurate reevaluation of nasal CPAP settings in the patient's home without necessitating expensive, time consuming in-hospital laboratory polysomnographic studies. PMID- 3280260 TI - Effects of expiratory flow resistance on inspiratory work of breathing. AB - To minimize work of breathing, airway pressure should not fluctuate during spontaneous breathing with continuous positive airway pressure (CPAP). However, flow resistance in the inspiratory limb of the breathing circuit and an inadequate continuous gas flow rate result in airway pressure fluctuation and increased work of breathing. Flow resistance of the expiratory pressure/exhalation valve also directly affects the level of airway pressure during spontaneous inhalation with CPAP (the greater the resistance of the valve, the greater the decrease in airway pressure and work of breathing). We compared this effect with three types of expiratory pressure valves: a threshold resistor with low resistance to flow, an inflatable balloon (mushroom) valve with moderate resistance to flow, and a variable-orifice flow resistor with a high resistance to flow. Work increased up to threefold with the balloon valve and more than tenfold with the flow resistor compared with the threshold resistor. To apply CPAP, expiratory pressure valves with low resistance to flow should be used to minimize fluctuations in airway pressure and, thus, in the work of spontaneous breathing. PMID- 3280261 TI - Concepts and applications of cardiopulmonary exercise testing. PMID- 3280265 TI - Primary pulmonary hypertension. PMID- 3280262 TI - Treatment of histoplasmosis and blastomycosis. AB - Prior to the development of ketoconazole, the treatment of systemic histoplasmosis and blastomycosis was limited to AMB. The convenience of oral dosing, combined with avoidance of the significant toxicities associated with AMB, make ketoconazole an attractive alternative for the treatment of selected forms of histoplasmosis and blastomycosis. Although high-dose (800 mg/day) ketoconazole is generally more effective than low-dose (400 mg/day), therapy should be initiated at the lower dose due to significantly more adverse effects at higher doses; the daily dose should be increased in patients with progressive disease. Caution should be exercised when ketoconazole is used to treat patients with GU tract disease and in patients with naturally occurring or pharmacologically induced achlorhydria. Thus, AMB remains the drug of choice for difficult to treat cases of histoplasmosis and blastomycosis; however, recent studies have established ketoconazole as the drug of choice in immunocompetent patients with non-life-threatening, non-meningeal H capsulatum and B dermatitidis disease. PMID- 3280263 TI - Massive air embolism in an adult following positive pressure ventilation. AB - A 95-year-old woman presented in cardiac arrest. She had been intubated and positive pressure ventilation had been administered by paramedics. Air was aspirated during cannulation of the subclavian vein and the femoral artery. Chest roentgenogram revealed the heart and great vessels filled with air. Massive air embolism caused by positive pressure ventilation is a well described complication in premature infants, but has not, to our knowledge, been previously reported in an adult. PMID- 3280264 TI - Bilateral otorrhagia associated with continuous positive airway pressure. AB - A patient had bilateral tympanic membrane rupture and otorrhagia, an unusual complication of continuous positive airway pressure (CPAP). CPAP, applied by a bag/mask system using disposable spring valves, was used to treat acute pulmonary edema during volume resuscitation and vasopressin therapy for bleeding from esophageal varices. PMID- 3280266 TI - Penetration of cefuroxime and ceftazidime into human lungs. AB - We have studied the penetration of cefuroxime and ceftazidime into lung tissue of 40 patients subjected to pulmonary surgery. Samples of blood and lung tissue were taken 1 and 2 h after antibiotic administration. Patients were randomly assigned to four dosage schedule groups: group A received a single intravenous injection of 750 mg cefuroxime; the lung tissue levels at 1 and 2 h were 9.6 +/- 3.1 and 4.54 +/- 2.64 micrograms/g of cefuroxime; the percentage penetration from serum into the lung tissue was 33.7 and 34.6%, respectively. Group B patients received three doses of 750 mg cefuroxime; lung tissue levels were 17.1 +/- 7.7 and 14.7 +/- 5.4 micrograms/g, the percentage of penetration being 89.1 and 102.8% at 1 and 2 h. Group C received a single intravenous injection of 1 g ceftazidime; the lung tissue levels were 16.3 +/- 10.1 and 10 +/- 5.04 micrograms/g; the percentage of penetration from serum was 38.3 and 35.3%. Group D received three doses of 1 g ceftazidime; the lung tissue concentrations were 11.98 +/- 7.5 and 8.5 +/- 7.3 micrograms/g and the percentage of penetration 35.1 and 32.2% at 1 and 2 h after last dose. PMID- 3280267 TI - [Wound healing of the pelvis following abdominoperineal rectum extirpation. A comparison of 2 drainage procedures in a prospective randomized study]. AB - In a prospectively randomized study we used two different ways of drainage of the sacral space after an abdomino-perineal-resection of the rectum. One group with 25 patients had a drainage anteriorly through the abdominal wall, the other 25 patients got a drainage posteriorly through the buttocks. In each case we used two closed silicone-drainage-systems without active suction. In 60% of the anterior and in 50% of the posterior drained cases we saw an unaffected primary healing of the sacral wound. There was no significant difference. The patients felt the anterior way of drainage to be more convenient. Contamination of the sacral space by disrupture of the rectum during the operation was followed by a sacral abscess in 50%. PMID- 3280270 TI - The single-layer continuous polypropylene colon anastomosis. A prospective assessment using water-soluble contrast enemas. AB - Fifty consecutive unselected patients with anastomoses to the left side of the colon were studied. Each patient had an anastomosis constructed with a single layer of continuous 4-0 polypropylene. On the seventh postoperative day, or sooner, a water-soluble contrast enema was obtained to evaluate the integrity of the anastomosis. Two patients developed radiographic and clinical evidence of anastomotic leakage, and one patient developed a late pelvic abscess and colocutaneous fistula. The documented leak rate of 6 percent attests to the safety of this method of colonic anastomosis. PMID- 3280271 TI - Experimental ileal J-pouch construction. A comparison of three techniques. AB - Endorectal ileal pouch-anal anastomosis has become the surgical alternative of choice for patients requiring colectomy for ulcerative colitis or familial polyposis coli. The optimal method of ileal pouch construction has not been determined. In this study, a canine preparation was used to compare the immediate results of three different techniques of ileal J-pouch construction. The three methods studied were two-layer hand-suturing (HS), stapling through enterotomies placed laterally on the ileal limbs (LS), and stapling via an apically placed enterotomy (AS). All three techniques resulted in watertight reservoirs. Ease of construction was scored significantly differently among the pouch variations (AS greater than LS greater than HS). Construction time was significantly less for both of the stapled reservoirs than for the HS pouch. Capacity of the AS pouch was significantly greater than the HS reservoir. This study suggests that stapling the ileal J-pouch through a single apical enterotomy should be the preferred technique during colectomy, mucosal proctectomy, and ileal pouch-anal anastomosis. PMID- 3280272 TI - Squamous-cell carcinoma of the colon. Experience at the University of Chicago, review of the literature, report of two cases. AB - Primary squamous-cell and adenosquamous-cell carcinoma of the colon are uncommon and their characteristics not well known. This paper reports the clinical features and pathologic findings of two colonic adenosquamous carcinomas and reviews other reports of adenosquamous and squamous carcinoma of the colon from the English medical literature. Including these two cases, 63 cases have been reported since 1927. Of these, six occurred in patients with ulcerative colitis, three occurred at the colonic opening of chronic colocutaneous fistulas, and concomitant schistosomiasis was present in two patients. Synchronous squamous cell carcinoma of the colon was present in 3.2 percent of cases and 10 percent had either antecedent, synchronous, or metachronous adenocarcinoma of the colon. These lesions appeared to be distributed uniformly throughout the colon. The five year survival after resective therapy for primary squamous-cell and adenosquamous cell carcinoma of the colon calculated with life table analysis is 50 percent for Dukes' B lesions, 33 percent for Dukes' C lesions, and 0 percent for Dukes' D lesions. PMID- 3280268 TI - [Postaggression metabolism following laparotomy and thoracotomy]. AB - The purpose of this investigation was to collect data concerning changes in carbohydrate and amino acid metabolism following different surgical operations (thoracotomies, laparotomies). Blood of 20 metabolically healthy adult surgical patients, who had to undergo elective surgery (lobectomies, pneumonectomies, colon resections) was examined preoperatively, immediately postoperatively and from 1.-4.postoperative day. The experimental data during the perioperative phase showed a similar pattern in both groups of patients: We found a significant elevation in the blood glucose level and there was also a rise in plasma cortisol and plasma free fatty acids levels. We found no significant changes of blood lactate, plasma insulin and branched chain amino acids. Simultaneously we found a drop in plasma albumin, pre-albumin and some glucoplastic amino acids (ALA, GLN, THR, PRO). It is concluded that major abdominal and thoracic surgery give rise to a nonspecific stress situation reflected in carbohydrate and amino acid metabolism with the following metabolic symptoms: Raised lipolysis and gluconeogenesis, disturbance of glucose utilisation and obvious peripheral insulin resistance. These perioperative metabolic effects show some similarities to the metabolic situation in diabetes mellitus type 2. PMID- 3280269 TI - Chromosome 9 of Ellobius lutescens is the X chromosome. AB - Ellobius lutescens carries an apparently identical karyotype (2n = 17) in both sexes. On the basis of indirect evidence the unpaired chromosome 9 has been considered to represent the X chromosome of this species. We have obtained data to substantiate this view by four different techniques. After fusion of HPRT- RAG cells with E. lutescens fibroblasts we demonstrated that the enzymes HPRT and G6PD are localized on the presumptive X chromosome. By analysis of pachytene figures after silver staining we showed by electron microscopy that the single chromosome exhibits the typical features of an X chromosome in male meiosis. Hybridization of (GATA)4 and (GACA)4 oligonucleotide probes to E. lutescens DNA revealed several distinct bands in the high molecular weight range some of which appeared to be specific for the individual but not for the sex of the animal. Hybridization in situ of the (GATA)4 probe on metaphase spreads of E. lutescens did not highlight any particular chromosome segment but showed a significant deficit of these sequences in chromosome 9. These observations are discussed with respect to their bearing on X chromosome determination. Finally it is concluded that E. lutescens should be an ideal tool for testing candidate genes assumed to be involved in primary sex determination. PMID- 3280273 TI - Efficacy of balloon tamponade in treatment of bleeding gastric and esophageal varices. Results in 151 consecutive episodes. AB - The efficacy and complications of esophageal tamponade as the first procedure in the routine management of acute variceal hemorrhage were evaluated in 151 consecutive bleeding episodes treated at a specialized unit. The Sengstaken Blakemore tube was employed in the 118 cases in which emergency endoscopy demonstrated bleeding esophageal varices, and the Linton-Nachlas balloon in the 33 cases with bleeding from gastric varices. Hemostasis lasting at least 24 hr was obtained in 91.5% of cases treated with the Sengstaken-Blakemore balloon and in 88% of those treated with the Linton-Nachlas balloon. Permanent hemostasis was obtained in 47.7% of all cases. The only severe complication noted in these 151 episodes of bleeding treated by tamponade was pulmonary aspiration, which was detected in 10% of cases. This complication was related to the presence and degree of encephalopathy (P less than 0.001) and was prevented by orotracheal intubation prior to tamponade. These results indicate that balloon tamponade continues to be a reliable and valuable method to arrest bleeding from esophagogastric varices. PMID- 3280274 TI - Is hepatic ultrasonography a valid alternative tool to liver biopsy? Report on 507 cases studied with both techniques. AB - In order to evaluate the diagnostic potential of liver ultrasonography (US), the charts of 23 cases with normal liver, 424 patients with chronic widespread, and 60 patients with focal hepatic diseases, who had undergone both US and liver biopsy, were reviewed. The positive predictive value of US was good in all hepatic disorders (range 86.9-96.5%), while its negative predictive value was very low (range 14.1-42.5%) in the various forms of widespread liver disease and suitable for screening purposes (74%) in focal lesions. Of the 507 cases, 39 with an ultrasonically suspected liver mass also underwent an echo-guided fine-needle aspiration, which showed a high sensitivity (85%) in the 27 biopsy-proved malignant lesions and excluded tumor cells in the remaining 12 cirrhotic cases. As regards US tissue diagnosis, hepatic tumors, fatty infiltration, and fibrosis were detected in 88%, 60%, and 49% of cases, respectively. Fat and fibrous content on biopsy were similarly and significantly correlated with both echo pattern and sound attenuation. Overall results suggest that in the group of widespread hepatic disorders the usefulness of US is greatly reduced by the fact that the patient's actual condition is not likely to be negative if US examination is normal and by the impossibility of differentiating fat from fibrosis. In focal lesions, the diagnostic value of US appears high and the method may frequently provide conclusive proof of the tumor if a positive cytodiagnosis on echo-guided aspirated material is done. PMID- 3280276 TI - Primary adenocarcinoma of the ileostomy after colectomy for ulcerative colitis. AB - A fifth case of adenocarcinoma arising at an ileostomy site many years after total colectomy for ulcerative colitis is reported with a review of the literature. The patient is a 79-year-old white man who presented with a bleeding, locally invasive exophytic mass at his ileostomy site 36 years after total colectomy for ulcerative colitis; he is the oldest patient, with the longest interval from creation of his ileostomy to diagnosis of adenocarcinoma. Careful gross and histopathologic examination of any mass arising at an ileostomy site is recommended. Early detection of such a slowly growing malignancy arising in a long-standing ileostomy may result in cure. PMID- 3280275 TI - Subepithelial hemorrhages and erosions of human stomach. AB - Subepithelial hemorrhages and erosions of the stomach are being studied extensively in experimental animal models but have not been well-characterized in humans. The definitions of these hemorrhagic and erosive lesions are not uniform and are often further confused by being labeled with the blanket term "gastritis." We define these lesions from an endoscopic perspective, describe the clinical settings in which they occur, and provide endoscopic-histologic correlations, where available. PMID- 3280277 TI - Pleural effusions: pathophysiology and management with intrapleural tetracycline. AB - Chronic or recurrent pleural effusions are a consequence of a variety of disease states and may produce significant pain or discomfort in a patient. Both surgical and pharmacological attempts to control pleural effusions have been tried, with moderate success. This article reviews the pathophysiology of pleural effusion and the role of intrapleural tetracycline in its management. Irritating chemicals, when instilled into the pleural space, are known to produce adhesion of the pleural membranes. Tetracycline has been shown in both animal and human studies to be effective in preventing the recurrence of a pleural effusion while producing only minor side effects, such as fever and pleuritic pain. Studies involving tetracycline in treating pleural effusions are reviewed, and guidelines for the preparation and administration of intrapleural tetracycline are presented. Because of its efficacy, low toxicity, ease of preparation, ready availability, and low cost, tetracycline deserves strong consideration as a first line agent in the management of recurrent pleural effusions. PMID- 3280278 TI - Single-dose versus traditional therapy for uncomplicated urinary tract infections. AB - In the treatment of uncomplicated urinary tract infection, single-dose therapy has appeared to be as efficacious as traditional 7-14 day therapy in women with cystitis without renal involvement. Current localizing techniques to differentiate between lower- and upper-tract disease are inadequate for routine clinical practice. As a result we have proposed that failure of cure with single dose treatment may be the most specific test available to diagnose renal infection. Most of the published data on single-dose therapy involves treatment with either amoxicillin or trimethoprim-sulfamethoxazole. Single-dose therapy offers advantages over traditional therapy, including improved compliance, reduced adverse effects, and decreased cost. Appropriate patient selection is critical if the outcome of single-dose therapy is to be effective. PMID- 3280280 TI - Postmarketing surveillance methodologies. AB - This article describes and discusses the strengths and limitations of the major pharmacoepidemologic methodologies employed in postmarketing drug surveillance and describes the current status of the U.S. surveillance system. The main methodologies employed in postmarketing drug surveillance include controlled clinical trials, observational epidemiologic studies (cohort, case-control, cross sectional), demographic methods, drug utilization surveys, spontaneous reports, and automated databases linking medications and disease. Examples of pharmacoepidemiologic studies using each of these methodologies are presented. When a question arises about the efficacy and/or safety of a marketed drug, typically a mixture of these study methodologies is employed. The article concludes with a brief discussion of the role of the Food and Drug Administration, pharmaceutical manufactures, and academic institutions in initiating and conducting postmarketing drug studies. PMID- 3280279 TI - Pentamidine therapy in renal failure: case report and literature review. AB - The literature lacks adequate dosing guidelines for modifying pentamidine therapy in renal failure. This report describes a patient in renal failure undergoing intermittent peritoneal dialysis who is treated with pentamidine for Pneumocystis carinii pneumonia. Data on pentamidine's disposition are reviewed. PMID- 3280281 TI - Detection and prevention of deep venous thrombosis. AB - Deep venous thrombosis (DVT) is a significant problem in the postoperative course of high-risk patients. Risk factors that further predispose patients to DVT include obesity, age over 40 years, smoking, dehydration, and a prior history of thromboembolism. Diagnosis of DVT by physical examination and medical history is difficult; objective diagnostic techniques are often required. Considerable emphasis has been placed on the cost-effectiveness of implementing prophylactic measures in patients who are at high risk for developing DVT. Physical maneuvers attempt to reduce stasis and enhance venous return and pharmacologic approaches alter blood coagulability. The drug therapy used in preventing DVT consists of dextran, low-dose heparin, a combination of low-dose heparin and dihydroergotamine, and warfarin. Effective prophylactic regimens differ according to the type of patients at risk. Prophylactic therapy should be tailored according to the patient's disease and degree of risk. PMID- 3280282 TI - Issues with antihypertensive therapy: safety perspectives. AB - The benefits of treating hypertension have been documented by several long-term studies that have shown a decreased incidence of morbidity and mortality associated with stroke, left ventricular failure, and renal insufficiency. With the large number of antihypertensive drugs currently available, several safety factors need to be considered when initially choosing a regimen so as not to adversely influence the potential benefits of blood pressure control. Antihypertensive agents should be chosen based on their hemodynamic profile, the absence of adverse metabolic effects and subjective side effects, and the presence of beneficial effects on the patients' quality of life. Thiazide diuretics and beta-blocking agents have often been recommended as initial therapy in patients with mild to moderate hypertension. However, thiazide diuretics may be less desirable in certain patients because of their effects on lipids, potassium, and glucose tolerance; beta-blocking agents are not ideal for some patients because of their effects on lipids, exercise tolerance, and overall quality of life. The angiotensin-converting enzyme inhibitors, selective alpha 1 blocking agents, and calcium channel blocking agents may be more appropriate for initial therapy of hypertension in many patients. PMID- 3280285 TI - [Sonography in shoulder wounds and diseases. The value, potentials and limits of the method]. PMID- 3280283 TI - [Substitution therapy with alpha-1-Pi in patients with alpha-1-Pi deficiency and progressive pulmonary edema]. AB - In a multi-centre study 20 patients with severe congenital alpha-1-Pi deficiency and progressive pulmonary emphysema received infusions of alpha-1-Pi concentrate from human plasma once weekly for six months, at an initial dosage of 60 mg/kg body-weight, in some instances slightly increased to achieve a minimum serum level above 70 mg/100 ml. The immunologically measured serum level of alpha-1-Pi rose 30 min after start of the infusion by a mean of 130% of normal, at an initial level of 13%. An exponential fall followed this rise. The lowest level occurred at the end of the first week, immediately before the next infusion, to 35% of normal, a serum level which is assumed still to provide an effective protection against elastases in the lung. There was also a definite increase of free inhibitors against both trypsin and leucocyte-elastase in serum of all patients, with a minimal level which for both was many times that of the initial value. There were no side-effects in more than 500 infusions and no dose reduction was necessary. During the entire course there were no significant changes in haematological, coagulation and biochemical test results, and lung function means remained constant. No antibodies against alpha-1-Pi were demonstrated, nor transmission of hepatitis B. PMID- 3280284 TI - [Selective pregnancy termination by minor section in the 24th week in a discordant twin pregnancy and the spontaneous birth of a healthy child at term]. AB - In a twin pregnancy of a 25-year-old woman one fetus was a normal male, while the other had hydrocephalus (6 mm thick pallium in the 23rd week) and a neural-tube defect in the thoracic-lumbar region. The abnormal fetus was removed by minor section in the 24th week, after which the normal one developed without complication. A healthy boy, weighing 3050 g and 52 cm long, was delivered spontaneously in the 39th week. Palpation of the uterus revealed a dehiscence, covered by muscle, in the region of the uterotomy scar, but it required no revision. PMID- 3280286 TI - [Anticytoplasmic antibodies as serological markers and activity parameters of Wegener's granulomatosis. A prospective study]. AB - Sera from 105 patients with Wegener's granulomatosis (WG) and 1,500 control subjects (with, among other diseases, primary or secondary vasculitis, collagen disease, glomerulonephritis or various granulomas) were examined with respect to sensitivity, specificity and importance of anticytoplasmic antibodies (ACPA) as markers of disease activity. The antibodies were demonstrated in 77 of the 105 patients (73%) with WG and six of the controls (less than 1%). They were always present in active WG (57 patients). In a prospective study of 21 closely followed patients with WG there was a close correlation between ACPA titre and the disease activity as measured by clinical and biochemical criteria. After induction of remission there was in all instances a clear fall in titre, while the titre rose again on exacerbation but remained unchanged during superinfection. Thus anticytoplasmic antibodies are useful both in primary diagnosis and in estimating disease activity of WG. PMID- 3280287 TI - [Extra- and intracranial Doppler ultrasound. Evaluation of patients with surgical anastomosis of the arteria temporalis superficialis superficialis and arteria cerebri media]. AB - During a mean postoperative period of 16 months, 51 patients who had received an extracranial-intracranial (EC-IC) arterial bypass were examined by means of transcranial and extracranial Doppler ultrasound, with the following results: the flow velocities of the middle cerebral artery (MCA) are postoperatively significantly lower than in normal control subjects. No differences were seen if the MCA was supplied via the EC-IC bypass or via any "natural" collateral vessels. In 32 cases, blood supply of the MCA artery was provided via the EC-IC bypass. In another 13 cases the MCA was supplied via the contralateral carotid artery and in six further cases via other collateral vessels. In the extracranial area, an internalisation of the flow pattern of the superficial temporal artery was found if the bloodstream from the anastomosis passed through the MCA. Similar changes at the external carotid artery were mainly due to the changed haemodynamics resulting from the extracranial occlusion of the internal carotid artery. No correlation was found between the clinical neurological course and haemodynamic data. The only indication for the EC-IC bypass, as we see it at the moment, is prophylactic surgery, such as, for example, treatment of giant aneurysms and definitely insufficient crossflow. All other indications that have been suggested after the publication of the results of the EC-IC Bypass Study Group will have to be confirmed by further study. PMID- 3280289 TI - [Supplying vitamin K to the newborn infant]. PMID- 3280290 TI - [Chronic subdural hematoma]. PMID- 3280292 TI - [Mechanisms of cytostatic and cytolytic action of glucocorticoids on lymphoma cells]. PMID- 3280288 TI - [Ultrasonic diagnosis of hip dysplasia and hip luxation]. PMID- 3280293 TI - [Acute appendicitis and ultrasonic diagnosis]. PMID- 3280294 TI - [Ultrasonics in acute appendicitis. A prospective study]. AB - In a prospective study 404 unselected patients suspected of having acute appendicitis were examined by ultrasound, the results being compared with the initial clinical findings. Acute appendicitis was established in 27.2%, confirmed by histology. The overall accuracy of ultrasonography in relation to the diagnosis of appendicitis was 95.5%, 95.1% when positive, 95.7% when negative. An acutely inflamed appendix could not be demonstrated by ultrasound in 13 patients (sensitivity 88.2%), while in five there was a false-positive ultrasound result (specificity 98.3%). Complicated appendicitis with perforation occurred in 22 patients (20%): ultrasound sensitivity in this situation was 91%. Especially when the clinical picture was unclear (34.5% of all cases of appendicitis) a definitive diagnosis of acute appendicitis was made both earlier and more certainly by ultrasonography. Further-more, in many instances ultrasound was able to demonstrate other serious disease in the differential diagnosis from acute appendicitis. Negative laparotomy rate was lowered from 21.9% to 11.4% by taking into account ultrasonographic findings. Thus ultrasonography proved to be an important method as an imaging technique and in the differential diagnosis of acute appendicitis. PMID- 3280291 TI - [Clinical features of analgesic-induced headache]. PMID- 3280295 TI - [Interaction of cyclosporin and ethambutol-isoniazid]. AB - A 34-year-old patient prophylactically received tuberculostatic treatment with ethambutol and isoniazide after having had an allogenic renal transplant and immunosuppression with methylprednisolone and cyclosporine. The tuberculostatic treatment was discontinued 165 days after the transplantation. The cyclosporine blood level, which was measured daily thereafter, gradually rose from 250 ng/ml to 400 ng/ml. It is possible that enzyme induction due by the tuberculostatic drugs was responsible for the increased breakdown of cyclosporine. PMID- 3280296 TI - [Maintenance of continence after proctocolectomy]. PMID- 3280297 TI - Dysphagia from benign mucocutaneous pemphigoid. PMID- 3280298 TI - Use of steroids in otolaryngology. PMID- 3280299 TI - Hypertension in the emergency department. AB - Hypertensive emergencies are now rare and are recognized by the deleterious effect on end-organs. Prompt, efficacious treatment is critical, and the current drug of choice for most episodes is sodium nitroprusside. Hypertensive urgencies are more common than are emergencies, and are distinguished by diastolic pressures greater than 115 mm Hg without end-organ dysfunction. Although there are many efficacious agents, one excellent choice is nifedipine. PMID- 3280300 TI - Defibrillation. AB - Defibrillation has emerged as the single most effective intervention for resuscitation of patients from cardiac arrest. This article reviews the electrophysiologic basis of defibrillation, and ways to increase the effectiveness of counter-shocks, particularly for refractory ventricular fibrillation. Automatic implantable and automatic external defibrillators have been developed and are being used in many locations. In future years they will be used increasingly in the homes of high-risk patients, in community settings with limited access to emergency care, and by minimally trained pre-hospital emergency personnel. PMID- 3280301 TI - Pulmonary embolism. AB - Pulmonary embolism remains a challenging problem in diagnosis and management for the emergency physician. Although its clinical presentation is protean and often ambiguous, risk stratification can be accomplished based on the predictive power of a limited number of physical and historical characteristics. Ventilation perfusion lung scanning occupies a central position in the work-up of suspected PE; however, evidence exists that it may be misused by many physicians. A low probability V-Q scan does not exclude the diagnosis of PE. Patients with other than normal- or high-probability patterns of pulmonary ventilation and perfusion on lung scanning require further investigation. Noninvasive venous studies are useful when indicative of proximal deep venous thrombosis, but are normal in many patients with acute PE. Heparin remains the standard of treatment for most patients with PE. Vena cava filters effectively reduce the incidence of recurrent PE in patients with contraindications to anticoagulation. Thrombolytic therapy offers potential advantages in the treatment of patients with shock due to their PE. Case reports of PE treated with tissue-type plasminogen activator, a new thrombus-specific fibrinolytic agent, are encouraging but preliminary. PMID- 3280302 TI - Update on the emergent treatment of arrhythmias. AB - The interpretation and treatment of arrhythmias presents a continuing challenge to the emergency physician. Better understanding of the mechanisms involved and development of additional drugs will provide the physician with an enhanced ability to treat these patients effectively in the Emergency Department. PMID- 3280303 TI - Detection of myocardial ischemia/infarction in the emergency department patient with chest discomfort. AB - Detailed review of the literature for chest discomfort evaluation in the Emergency Department leaves the clinician without a precise guideline as to whom to admit or send home. It is clear that the seasoned physician's instinct (the sum total of the history, physician examination, and ancillary laboratory tests) is as good an indicator as existing statistical decision models. Current decision rules appear most helpful as teaching aids for physicians-in-training and for providing reassurance to seasoned physicians. Although ancillary tests such as echocardiography and rapid myoglobin analysis may play more important roles in the future, emergency physicians must now rely primarily upon their clinical impression to guide admission decisions. Vigorous attempts to minimize the admission of patients without ischemia to the CCU will increase the incidence of infarction patients released from the Emergency Department. The liberal use of intermediate care unit beds may represent one future disposition alternative. Nonetheless, each physician must establish his or her own threshold for admission. Several studies have found a 5 per cent unintentional release of infarction patients from the Emergency Department. Decreasing the admission threshold may lower this rate substantially. Patients with chest discomfort who are released from the Emergency Department require close followup. At urban teaching hospitals, where private physician referral is often limited, the institution may need to establish a clinic specifically for this purpose. Unrecognized myocardial ischemia is one rationale for close followup; however, the pursuit of alternative diagnoses including gastrointestinal and psychiatric (e.g., panic disorders) etiologies may minimize subsequent morbidity in the released population. PMID- 3280304 TI - If a well-stabilized epileptic patient has a subtherapeutic antiepileptic drug level, should the dose be increased? A randomized prospective study. AB - In an attempt to determine whether the dose of an antiepileptic drug should be increased in epileptic patients who were seizure-free and had subtherapeutic serum levels, 79 patients with idiopathic generalized tonic-clonic seizures treated with monotherapy [phenytoin (PHT) or phenobarbital (PB)] and with a subtherapeutic serum level were prospectively studied. Their last seizure was at least 3 months prior to entry, and no patient had any clinical evidence of toxicity. They were randomized to study arm A (keeping the level in the subtherapeutic range) or study arm B (increasing the dose until the level reached and stayed at the therapeutic range). Over a mean follow-up period of 24 months, there was no significant difference between the two study arms in the occurrence of seizures, but arm B patients had an increased incidence of neurotoxic side effects from the dose increment. These results confirm the clinical impression that it is unnecessary to increase the dose of the antiepileptic drug despite a subtherapeutic serum concentration in a relatively well-stabilized patient, thus minimizing the frequency of dose adjustment and the need for expensive therapeutic drug monitoring. PMID- 3280305 TI - Hepatotoxic reactions associated with carbamazepine therapy. AB - Hepatotoxic reactions in patients receiving carbamazepine (CBZ) therapy have been reported, and some have been considered fatal. We present two patients with hepatic dysfunction secondary to CBZ therapy. Liver biopsies were compatible with hepatotoxic damage, and the symptoms were reversible with medication withdrawal. Our patients are representative of those in the literature, most of whom have granulomatous hepatitis and sometimes have associated cholangitis. The patients with fatal reactions differed clinically and pathologically from the others, and may represent a different entity. The clinical syndrome resembles a viral hepatitis. Elderly patients seem to be particularly susceptible and their hepatic function should be monitored closely when CBZ therapy is initiated. PMID- 3280306 TI - Effects of a behavioral intervention on epileptic seizure behavior and paroxysmal activity: a systematic replication of three cases of children with intractable epilepsy. AB - Three children with very frequent refractory epileptic seizures underwent a behavioral intervention consisting of symptom discrimination, countermeasures, contingent relaxation, and positive reinforcement for correct responses in a systematic replication series. The studies involved a 6-h nonintervention base rate, a 6-h treatment phase, and a 6-h nonintervention follow-up under laboratory conditions for each child. Neurophysiologic and behavioral measures of the effects of treatment were made using electroencephalogram (EEG)-video equipment. Effects of treatment were assessed by using a random sample of EEG-video sequences in base rate and follow-up. Results showed that no significant reduction of either seizure behavior or paroxysmal EEG activity was found subsequent to training in discrimination of early paroxysmal activity and/or sensations preceding seizures. Both seizure behavior and paroxysmal activity were significantly reduced in all three cases following intervention with an adapted countermeasure technique. No additional effects could be noted subsequent to the application of either contingent relaxation or positive reinforcement for correct responses. Paroxysmal EEG changes and seizure behavior were highly correlated. Reduction of the clinical manifestation or seizure response by behavioral manipulation was accompanied by a reduction of the total amount of paroxysmal activity as measured by the EEG. PMID- 3280307 TI - Direct and indirect electron transfer between electrodes and redox proteins. AB - The direct electrochemistry of redox proteins has been achieved at a variety of electrodes, including modified gold, pyrolytic graphite and metal oxides. Careful design of electrode surfaces and electrolyte conditions are required for the attainment of rapid and reversible protein-electrode interaction. The electron transfer reactions of more complex systems, such as redox enzymes, are now being examined. The 'well-behaved' electrochemistry of redox proteins can be usefully exploited by coupling the electrode reaction to enzymes for which the redox proteins act as cofactors. In systems where direct electron transfer is very slow, small electron carriers, or mediators, may be employed to enhance the rate of electron exchange with the electrode. The organometallic compound ferrocene and its derivatives have proved particularly effective in this role. A new generation of electrochemical biosensors employs ferrocene derivatives as mediators. PMID- 3280309 TI - Hydrodynamic properties of colicin A. Existence of a high-affinity lipid-binding site and oligomerization at acid pH. AB - The hydrodynamic properties of colicin A have been studied. The molecular mass of colicin A was determined from sedimentation equilibrium centrifugation to be 63 +/- 1.2 kDa, in agreement with that determined from the primary amino acid sequence [Morlon et al. (1983) J. Mol. Biol. 110, 271-289]. The sedimentation coefficient has been analyzed over a wide range of ionic strength (NaCl 0.06-0.56 M) and pH (8-4) and was found to remain almost constant. However, below pH 5 an oligomerization of colicin A to tetramers occurred. The frictional coefficient value indicated that the shape of the colicin A monomer was very asymmetric. Analysis of the pH dependence of circular dichroism of colicin A and of its COOH terminal domain indicated that a sharp transition occurred between pH 4 and 3. This transition was very much reduced for the COOH-terminal domain in the presence of a non-ionic detergent. The presence of a lipid-binding site in colicin A at neutral pH was demonstrated both by hydrodynamic studies with micelles of n-hexadecanoyl and n-octadecanoylphosphocholine and by differential sensitivity to a proteolytic enzyme in the presence or absence of detergent micelles. About 75 molecules of lipid were bound under these conditions suggesting that colicin A was bound to lipid micelles. In contrast, at acid pH, in the presence of an excess of lipid the tetramer was dissociated into monomers complexed to 20-30 lipid molecules, indicating the exposure of a high-affinity lipid-binding site. PMID- 3280308 TI - Amino acid sequence determination and three-dimensional modelling of thioredoxin from the photosynthetic bacterium Rhodobacter sphaeroides Y. AB - The complete primary structure of thioredoxin from Rhodobacter sphaeroides Y has been determined by analysis of peptides after cleavage with cyanogen bromide, chymotrypsin and trypsin. Peptides were separated by HPLC and analyzed by liquid phase and gas-phase sequencer degradations. The protein consists of 105 residues (Mr = 11,180); its amino acid sequence shows a clear homology to the five known thioredoxins from plant or bacterial sources, with 40-56% residue identity when the proteins are aligned at the active-site disulfide. Not only the active-site regions are conserved, but also residues which belong to the hydrophobic surface suggested to be important for binding of procaryote thioredoxins in redox interactions with other proteins (residues 75-76; 91-93 in Escherichia coli). A three-dimensional model of Rb. sphaeroides thioredoxin has been derived from the E. coli crystallographic structure with computer graphics. This model indicates that the overall structures as well as the active sites are closely similar; however, the residue substitutions allow both proteins to adopt different local folding as shown in the hydrophobic core. PMID- 3280310 TI - 18th Sir Hans Krebs lecture. Knowledge-based protein modelling and design. AB - A systematic technique for protein modelling that is applicable to the design of drugs, peptide vaccines and novel proteins is described. Our approach is knowledge-based, depending on the structures of homologous or analogous proteins and more generally on a relational data base of protein three-dimensional structures. The procedure simultaneously aligns the known tertiary structures, selects fragments from the structurally conserved regions on the basis of sequence homology, aligns these with the 'average structure' or 'framework', builds on the loops selected from homologous proteins or a wider database, substitutes sidechains and energy minimises the resultant model. Applications to modelling an homologous structure, tissue plasminogen activator on the basis of another serine proteinase, and to modelling an analogous protein, HIV viral proteinase on the basis of aspartic proteinases, are described. The converse problem of ab initio design is also addressed: this involves the selection of an amino acid sequence to give a particular tertiary structure, in this case a symmetrical domain of two Greek-key motifs. PMID- 3280311 TI - Structural studies on the core and lipid A region of a 4-amino-L-arabinose lacking Rc-type mutant of Proteus mirabilis. AB - The structure of the 4-amino-L-arabinose-lacking lipopolysaccharide of the Proteus mirabilis Rc-type mutant R4, derived from wild-type O28, was elucidated. The lipopolysaccharide core structure has previously been partially characterized. The linkage between heptose and deoxyoctulosonic acid(dOclA) is now reported, as well as the structure of the lipid A moiety of this mutant strain. Besides the tentative identification of an alpha-linked glucosamine disaccharide in the lipid A backbone accompanying the usual beta 1----6-linked glucosamine-disaccharide, the only significant structural variation to previous studies was the lack of substitution of the C-4' phosphate by 4-amino-L arabinose. In addition, the substitution at C-8 of one dOclA unit by 4-amino-L arabinose, previously reported for the R45 mutant of P. mirabilis 1959, is lacking in this R mutant. Also in addition to previous findings, the terminal unit of heptose was found to be substituted at C-7 with phosphorylethanolamine (PEtN) and not only with phosphate, although this substitution is not complete as demonstrated by the relevant signals in 31P-NMR. Additional studies with the wild type strain P. mirabilis O28 revealed the presence of 4-amino-L-arabinose in both the core and the lipid A regions suggesting that the R4 mutant is defective in the biosynthesis of this amino sugar rather than in its transfer. Otherwise the lipid A regions of the mutant and the wild-type strain show no structural differences. The following formula is proposed for the lipopolysaccharide of 4 amino-L-arabinose-lacking mutant R4/O28 P. mirabilis: (Formula; see text) PMID- 3280313 TI - Purification and characterization of two oxidoreductases involved in the enantioselective reduction of 3-oxo, 4-oxo and 5-oxo esters in baker's yeast. AB - Two NADPH-dependent oxidoreductases catalyzing the enantioselective reduction of 3-oxo esters to (S)- and (R)-3-hydroxy acid esters, [hereafter called (S)- and (R)-enzymes] have been purified 121- and 332-fold, respectively, from cell extracts of Saccharomyces cerevisiae by means of streptomycin sulfate treatment, Sephadex G-25 filtration, DEAE-Sepharose CL-6B chromatography, Sephadex G-150 filtration, Sepharose 6B filtration and hydroxyapatite chromatography. The relative molecular mass Mr, of the (S)-enzyme was estimated to be 48,000-50,000 on Sephadex G-150 column chromatography and 48,000 on sodium dodecyl sulfate/polyacrylamide gel electrophoresis. The enzyme was most active at pH 6.9 and reduced 3-oxo esters, 4-oxo and 5-oxo acids and esters enantioselectively to (S)- hydroxy compounds in the presence of NADPH. The Km values for ethyl 3 oxobutyrate, ethyl 3-oxohexanoate, 4-oxopentanoic and 5-oxohexanoic acid were determined as 0.9 mM, 5.3 mM, 17.1 mM and 13.1 mM, respectively. The Mr of the (R)-enzyme, estimated by means of column chromatography on Sepharose 6B, was 800,000. Under dissociating conditions of SDS/polyacrylamide gel electrophoresis the enzyme resolved into subunits of Mr 200,000 and 210,000, respectively. The enzyme is optimally active at pH 6.1, catalyzing specifically the reduction of 3 oxo esters to (R)-hydroxy esters, using NADPH for coenzyme. Km values for ethyl 3 oxobutyrate and ethyl 3-oxohexanoate were determined as 17.0 mM and 2.0 mM, respectively. Investigations with purified fatty acid synthase of baker's yeast revealed that the (R)-enzyme was identical with a subunit of this multifunctional complex; intact fatty acid synthase (Mr 2.4 X 10(6)) showed no activity in catalyzing the reduction of 3-oxo esters. PMID- 3280312 TI - Characterisation of two differently processed forms of human recombinant factor IX synthesised in CHO cells transformed with a polycistronic vector. AB - A stable transformed cell line constitutively expressing human factor IX has been established. Wild-type Chinese hamster ovary cells (CHO cells) were transformed using a polycistronic expression vector carrying a previously isolated factor IX cDNA and a selection gene encoding the Escherichia coli xanthine-guanine phosphoribosyl transferase. One clone, CHO 622.4, contains a high number of genomically integrated plasmids and secretes 1-3 mg factor IX l-1 day-1 into the culture medium with a biological activity ranging from 25% to 40%. The recombinant molecule was purified either by conventional chromatography or by immunoaffinity chromatography using antibodies specific to a calcium-induced factor IX conformer. The purified recombinant protein migrates as a single band with the same mobility as that of natural factor IX on SDS/polyacrylamide gels. N terminal sequencing shows tow differently processed forms of recombinant factor IX: whereas the majority of the zymogen is correctly processed, approximately 20% of the purified recombinant molecule contains an 18-amino-acid NH2-extension corresponding to the precursor form of factor IX. Analysis of the 4 carboxyglutamic acid content indicates a high but incomplete carboxylation (70%) of the recombinant molecule as compared to natural factor IX. The carbohydrate composition of both the natural and recombinant molecules has been determined. Both molecules have a N-glycan structure of similar complexity, indicating that factor IX contains all the information to direct the same glycosylation pattern in human liver cells and in an unrelated cell line such as CHO-K1. PMID- 3280315 TI - Haemodynamic effects of high or low doses of furosemide in acute myocardial infarction. AB - The haemodynamic effects of high or low doses of furosemide used to prevent overt left heart failure (LHF) in acute myocardial infarction (AMI) were studied. Fifteen consecutive AMI patients without overt LHF and with a cardiac index (CI) of 2.6 +/- 0.5 l min-1 m-2, a right atrial mean pressure (RAMP) of 7 +/- 3 mmHg and a pulmonary arterial diastolic pressure (PADP) of 14 +/- 4 mmHg were investigated during 24 h. A high dose group (HDG) received 40 mg furosemide t.i.d. and a low dose group (LDG) 20 mg once daily. Following the first 40 mg of furosemide (HDG), the stroke volume index (SVI), CI, RAMP and PADP decreased. The heart rate and systemic vascular resistance index (SVRI) increased. Following the first 20 mg of furosemide (LDG), the only significant change was a decrease in PADP. After 24 h, the heart rate in the HDG was further increased; the SVI, RAMP and PADP were further reduced, whereas CI was similar to that before. In the LDG, the heart rate, SVI and CI remained unchanged. All pressures tended to decline and the SVRI was lower than in the HDG. Thus, repeated injections of 40 mg of furosemide induced a sustained preload reduction in AMI patients without overt LHF, but this was associated with potentially disadvantageous haemodynamic findings. PMID- 3280314 TI - Improper expression of insulin receptors on fibroblasts from a leprechaun patient. AB - Leprechaunism is an inherited human disorder characterized by severe insulin resistance. We have examined the properties of the insulin receptor in fibroblasts from a leprechaun patient. In vitro, severe insulin resistance is reflected by a low level of insulin binding to the patients fibroblasts and impaired insulin-mediated uptake of 2-deoxyglucose. Quantification of the receptor in detergent-solubilized total glycoprotein indicates a normal receptor number, in agreement with the observed normal level of insulin receptor mRNA on northern blots. The insulin-stimulated autophosphorylation of the patient's receptor shows a normal profile. The insulin receptor is present on the plasma membrane as indicated by cell-surface iodination experiments. No abnormalities in the molecular masses of the receptor's alpha and beta chains were observed. The results indicate that an apparently normal receptor is synthesized in sufficient amounts but functional expression of the receptor on the plasma membrane is impaired. PMID- 3280316 TI - A randomized hemodynamic comparison of intravenous amiodarone with and without Tween 80. AB - In 20 patients undergoing coronary arteriography, the hemodynamic effects of an experimental preparation of i.v. amiodarone 5 mg kg-1 without Tween 80 (N) (10 patients) were compared with those of the commercial form with Tween 80 (A) (10 patients). Analysis of variance demonstrated differences during the 3 min of injection and for 3 min afterwards: left ventricular systolic pressure decreased from 110 + 11 to 86 +/- 11 mmHg (P = 0.001) after A and from 114 +/- 22 to 106 +/ 19 (P = 0.05) after N (comparison P = 0.01) while related tachycardia was also more pronounced after A (comparison P = 0.001). Left ventricular end diastolic pressure transiently decreased after A while continuously increasing after N (P = 0.05). During the following 30 min both A and N caused similar bradycardia, increase in ventricular filling pressure, vascular resistance and decrease in cardiac and contractility indexes. Amiodarone blood levels were similar after A or N. These data document a significant initial short duration vasoplegia, mainly related to Tween 80, after A, when amiodarone itself after producing a similar very slight effect causes bradycardia, and a moderate and progressive negative inotropic effect. It was concluded that while the experimental form would be of interest, the risk of severe hypotension after i.v. Cordarone can be largely avoided by using a slower rate of infusion, especially in patients with hypovolemic status. PMID- 3280317 TI - Comparison of the antianginal efficacy of isosorbide dinitrate (ISDN) 40 mg and verapamil 120 mg three times daily in the acute trial and following two-week treatment. AB - Fourteen male patients with exertion-related angina pectoris and reproducible ST segment depression on stress testing were each treated with isosorbide dinitrate (ISDN) 40 mg three times daily, verapamil 120 mg three times daily and placebo three times daily for two weeks according to a double-blind cross-over protocol. The mean improvement of exercise-induced ST-segment depression amounted to 73% on the first day of ISDN treatment (P less than 0.001) and to 54% following acute administration of verapamil (P less than 0.001). On the last day of continuous treatment, the antianginal efficacy of ISDN was somewhat mitigated (reduction of ST-segment depression: 54%; P less than 0.001), while the effect of verapamil remained unchanged (55%, P less than 0.001). The double product (heart rate x systolic blood pressure) at the end of stress testing decreased most pronouncedly on day 1 of ISDN treatment (-21%; P less than 0.01). On chronic testing, both drugs similarly influenced this parameter: 10-11% (P less than 0.05). The mean global ejection fraction (EF) assessed by gated blood pool scintigraphy on day 13 showed a stress-induced fall from 49 to 44% (P less than 0.05) after the administration of placebo. The respective values with ISDN were 53% at rest and 52% on exercise (n.s.), and after giving verapamil 50% and 47% (n.s.). Thus, ISDN 40 mg and verapamil 120 mg displayed beneficial anti-ischaemic effects in patients with stable exertion-related angina pectoris after acute and chronic administration. The efficacy of ISDN declined somewhat in the course of the two week treatment, whereas that of verapamil remained unchanged. Beneficial effects of both drugs were also demonstrated with regard to the rate-pressure product. Isosorbide dinitrate 40 mg and verapamil 120 mg administered three times daily can be recommended for the acute and chronic therapy of patients with stable angina. PMID- 3280318 TI - Programmed electrical stimulation in hypertrophic cardiomyopathy. Results in patients with and without cardiac arrest or syncope. AB - Programmed electrical stimulation was performed in 54 consecutive patients with hypertrophic cardiomyopathy. There were 11 'symptomatic' patients: three had a history of cardiac arrest due to ventricular tachyarrhythmias (group A), and eight had a history of syncope of unknown origin (group B); 43 patients were 'asymptomatic', i.e. they had no documented or suspected symptomatic ventricular arrhythmias (group C). There were no differences among the groups with respect to electrocardiographic, echocardiographic or hemodynamic data. Ventricular arrhythmias were induced by atrial and right and left ventricular stimulation with a maximum of two extrastimuli in 18 patients. Induced arrhythmias were repetitive ventricular response in six patients, nonsustained ventricular tachycardia in four, sustained ventricular tachycardia in five, and ventricular fibrillation in three patients. With one exception, ventricular tachycardia was always rapid (cycle lengths ranged from 180 to 250 ms); it was polymorphic in six patients and monomorphic in three. Atrial stimulation induced rapid monomorphic ventricular tachycardia in one group A patient. The type and incidence of induced ventricular arrhythmias did not differ among the three groups. It is concluded that programmed electrical stimulation induces the same type of ventricular arrhythmia (rapid polymorphic ventricular tachycardia or ventricular fibrillation) in 'symptomatic' and 'asymptomatic' patients with hypertrophic cardiomyopathy, the incidence in the latter group being 19%. Induction by atrial stimulation of a rapid ventricular tachycardia may be a specific finding to identify patients with hypertrophic cardiomyopathy at risk for exercise-induced ventricular fibrillation. PMID- 3280319 TI - Mortality in various intervention trials in elderly hypertensive patients: a review. AB - Results on total and cause-specific mortality from various randomized intervention trials on antihypertensive drug treatment in elderly hypertensives are reviewed, compared and pooled. Mortality from all causes tended to decrease in all trials, but this decrease was not statistically significant in any of the trials separately, nor when all results were pooled. When the results of all the trials were combined, there was a significant overall decrease in cardiovascular mortality of 28%. This decrease in cardiovascular mortality was mainly related to a significant reduction in cerebrovascular mortality of 41%. Mortality from coronary heart disease also tended to decrease by 28%, but statistical significance was not reached. PMID- 3280321 TI - Late sequelae of foreign body inhalation. A multicentric scintigraphic study. AB - A multicentre European study on foreign body inhalation has been organized by the Pediatric Task Force covering both the SNME and the ENMS. Among the 100 cases which could be collected in a 2 year period, about 40% of scintigraphic abnormalities were found 6 months after relief of the foreign body. The frequency of these defects was clearly related to the time interval between aspiration and removal. Factors like the localization of the foreign body and the site of the early scintigraphic defects could be related to the further scintigraphic outcome, but this could not be proven statistically. Similarly, the absence of bronchial tree inspection after removal of the foreign body seemed to be associated with more permanent scintigraphic lesions. Finally, it is obvious that a large number of patients demonstrated scintigraphic alterations 6 months or more after removal of the foreign body, although the chest X-rays were considered normal. PMID- 3280323 TI - Selective decontamination of the digestive tract: general principles. PMID- 3280322 TI - Immunoscintigraphic localization of inflammatory lesions: pharmacokinetics and estimated absorbed radiation dose in man. AB - Five patients with inflammatory lesions received anti-granulocytes murine monoclonal antibody (Mabgc) infused over 5 to 15 min at doses between 3.4 and 5.4 mCi 123I (120 micrograms antibody). Clearance of 123I from blood pool closely fits a biexponential mathematical model with the two effective half-lives 0.73 h and 9.3 h. The spontaneous release of 123I was found to be relatively low in the blood pool. The cumulative urinary excretion of the 123I label over 120 h was in the range of 63% of the totally administered dose and is assumed to represent only a low molecular compound or 123I alone as iodide. Analysis of the label in spleen, liver and red marrow showed that the concentration of label in these tissues remains more or less constant over a period of 20 h after infusion. With data of liver, spleen, red marrow and whole body activity over a period of 24 h, an estimated radiation dose was calculated. Compared with 111In labelled leucocytes, especially in spleen, the absorbed dose is lower by a factor of ten per examination. PMID- 3280320 TI - ECG gated thallium 201 myocardial images: value in detecting multivessel disease in patients on anti anginal therapy 1-3 months after myocardial infarction. AB - ECG gated 201Tl scintigraphy was compared to non gated images for detecting 2-3 vessel disease 1-3 months after a first uncomplicated myocardial infarction. In all, 111 patients on anti anginal treatment underwent coronary arteriography and stress thallium imaging; 39 showed single vessel disease (SVD), and 72 multivessel disease (MVD). Sensitivity of black and white analog images was 82% for SVD and 8% for MVD. Sensitivity of computerized colored static images was 87% for SVD and 33% for MVD. For gated images, sensitivity was 100% and 92% in patients with SVD and MVD respectively. Specificity for detecting MVD was 95% for black and white images, 77% for computerized colored static images, and 69% for ECG gated images. Thus, ECG gated exercise 201TL scintigraphy is useful for predicting the extent of coronary artery disease 1-3 months after myocardial infarction in patients on anti anginal therapy. PMID- 3280324 TI - Norfloxacin in the eradication of enteric infections in AIDS patients. AB - Recurrent episodes of salmonellosis, including recurrent life-threatening bacteremias, have been well-described in patients with AIDS. Because of the need to avoid sensitization to trimethoprim-sulfamethoxazole (TMP-SFX) in AIDS patients and the high frequency of ampicillin resistance of Salmonella isolates, alternative therapies must be sought. We report the treatment of nine AIDS patients, who had recurrent salmonellosis, with norfloxacin, a new oral fluoroquinolone which has excellent in vivo activity against Salmonella sp. Each patient had two to three prior distinct clinical episodes of salmonellosis which had failed to be eradicated with standard courses of ampicillin, TMP-SFX, ceftriaxone or cefotaxime. Microbiologic relapse had occurred in each patient within 2-4 weeks. Each of the enteric pathogens was susceptible in vitro to norfloxacin. Patients were treated with norfloxacin 400 mg bid orally for 30 days. Stool cultures were negative at 1 week in all patients. Nausea and headache were the only adverse reactions to norfloxacin noted. One patient had a clinical and microbiologic relapse of Salmonella 1 week after norfloxacin was stopped but responded to retreatment with norfloxacin. Norfloxacin appears effective in the treatment of enteric infections in AIDS patients and may be more useful than standard agents in eradicating the organism and preventing clinical and microbiologic relapse. Oral administration and twice daily dosing are significant advantages. PMID- 3280325 TI - The tolerability profile of prophylactic norfloxacin in neutropenic patients. AB - Norfloxacin has been compared to placebo (136 patients), sulfamethoxazole plus trimethoprim (SXT, 72 patients) and oral vancomycin plus colistin (V/C, 61 patients) for the prevention of alimentary tract-associated infections during and after induction chemotherapy. These patients were evaluated for the safety and tolerability of each regimen by clinical and laboratory means. Most neutropenics involved, regardless of the regimen, experienced at least one adverse experience. The majority were felt to be unrelated to prophylactic study drug therapy. Of 139 patients who received norfloxacin, only two had drug-related adverse experiences, compared to two of 35 receiving SXT, five of 28 for VC, and none of 67 receiving placebo. In evaluating adverse experiences considered possibly drug related, 19 occurred on norfloxacin compared to 13 for placebo. Among neurologic adverse experiences, only one possibly related to norfloxacin occurred (confusion), while three occurred on placebo (confusion, decreased auditory acuity and hallucinations). Generally, no significant differences were seen between any of the regimens except for a higher frequency of diarrhea in those receiving V/C. PMID- 3280327 TI - Bacterial resistance to norfloxacin and other newer quinolones: pattern and prospects. PMID- 3280326 TI - Empiric antimicrobial therapy for febrile granulocytopenic cancer patients: lessons from four EORTC trials. AB - The results of the four EORTC trials conducted over the past 15 years suggest: (1) early empiric therapy with broad spectrum antibiotics directed against gram negative bacterial bacteremia (GNBB) is a reasonable approach in febrile granulocytopenic patients (GCP); (2) the level and dynamics of the granulocyte count are extremely important in determining the outcome of bacteremia; severely and/or persistently neutropenic patients are the true tests of antibiotic efficacy and they benefit from antimicrobial synergism; (3) mortality from GNBB in GCP is not related directly to a given empiric antimicrobial regimen which may 'buy time' and allow appropriate therapeutic alterations; (4) only microbiologically documented infections and especially bacteremias are useful to compare responses to antimicrobial regimens; (5) the response rate of GNBB is clearly influenced by the susceptibility of the causative pathogen to the beta lactam component of the empiric regimen and emergence of resistance to some antibiotics (cephalothin, carbenicillin, ticarcillin, azlocillin) has rendered some combinations less effective. The combination of an anti-Pseudomonas beta lactam plus an aminoglycoside is recommended as the 'standard' for empiric therapy in febrile GCP; (6) gram-positive pathogens have become a common cause of bacteremia in GCP and although the response rate to empiric regimens may be marginal, the associated mortality is low. A general conclusion from these trials is that studies of the management of infection in GCP should include sufficient numbers of eligible patients to allow for evaluation of bacteremic patients at highest risk of death. The need for large collaborative studies stems directly from these considerations. PMID- 3280328 TI - The effect of synthetic peptides corresponding to Fc sequences in human IgG1 on various steps in the B cell activation pathway. AB - The influence of synthetic peptides comprising sequences in the exposed positions of the Fc region of human IgG 1 was tested on B lymphocyte activation. CH 2 domain peptides having an inhibitory effect on antibody-dependent cellular cytotoxicity, as well as the whole Fc fragment, induced the appearance of the early signs of activation on resting B lymphocytes such as increase in cell volume and HLA-DR antigen expression or leukocyte migration inhibitory factor production. The peptides did not induce proliferation of resting B cells even when B cell growth factor (BCGF)-containing supernatants were added. Exposure to Fc fragment, however, induced a weak proliferation which was significantly enhanced by BCGF. On the other hand, both the Fc fragment and the CH 2 or CH 3 domain peptides enhanced the IgM synthesis of human blood mononuclear cells when a suboptimal dose of pokeweed mitogen was present. This effect was lost when Fc fragment or the peptides were added on the third day of culture. These results suggest that the early steps of B cell activation can be induced by Fc fragment and by small molecular weight Fc peptides, which are potential ligands of Fc receptors. The Fc fragment activates B cells to the state where they respond to BCGF, but the peptides do not possess this activity. Furthermore, both Fc fragment and Fc peptides are able to enhance the IgM synthesis, when accessory cells and the appropriate differentiating factors are present. PMID- 3280329 TI - Comparison of the effects of MK-801 and phencyclidine on catecholamine uptake and NMDA-induced norepinephrine release. AB - MK-801 was found to be more potent than phencyclidine (PCP) as an inhibitor of N methyl-D-aspartate-induced [3H]norepinephrine (NE) release and [3H]TCP binding in the hippocampus. On the other hand, MK-801 was slightly less potent than PCP to enhance kainate-stimulated [3H]NE release and to inhibit hippocampal [3H]NE uptake. Further, MK-801 was strikingly less potent than PCP as an inhibitor of striatal synaptosomal [3H]dopamine uptake. These data are discussed with reference to the therapeutic potential of MK-801. PMID- 3280330 TI - Effect of chronic treatment with SCH 23390 and haloperidol on spontaneous activity of dopamine neurones in substantia nigra pars compacta (SNC) and ventral tegmental area (VTA) in rats. AB - The effect of chronic treatment (21 days s.c.) with SCH 23390 and haloperidol on spontaneously active DA neurones in substantia nigra pars compacta (SNC) and ventral tegmental area (VTA) was studied in rats by means of single unit recording techniques. The specific DA D-1 receptor antagonist SCH 23390 was injected twice daily in one of the following doses: 0.06, 0.23, 0.46 or 0.90 mumol/kg. SCH 23390 decreased the number of spontaneously active neurones in SNC and VTA to the same extent. The DA D-2 receptor antagonist haloperidol was injected once daily in one of the following doses: 0.05, 0.21 or 1.7 mumol/kg and induced a decrease in the number of spontaneously active DA neurones in SNC and VTA. These results suggest that SCH 23390 has a profile similar to that of haloperidol and that SCH 23390 has clinical antipsychotic activity but also induces extrapyramidal side-effects. PMID- 3280331 TI - Phencyclidine-like discriminative stimulus properties of MK-801 in rats. AB - The discriminative stimulus properties of the N-methyl-D-aspartate (NMDA) antagonist MK-801 ((+)-5-methyl-10,11-dihydro-5H-dibenzo(a,d)cyclohepten-5,10 imine) were investigated in rats trained to discriminate phencyclidine (PCP; 1.25 mg/kg i.p.) from saline on a standard two-lever fixed ratio 32 schedule of food reinforcement. MK-801 was generalized from PCP in a dose-dependent manner, with an ED50 of 0.10 mg/kg i.p. The ED50 for PCP was 0.7 mg/kg io.p. MK-801 is, therefore, a very potent PCP-like drug which may share cellular mechanisms and other effects with PCP, including the antagonism of NMDA. PMID- 3280332 TI - Characterization of a highly purified membrane proteinase from bovine lens. AB - A highly purified bovine lens membrane proteinase has been obtained. The purification was accomplished by solubilization of the proteinase from the membrane with 2% sodium deoxycholate followed by gel-filtration chromatography. The purified proteinase showed a major protein band having molecular weight of 17,000 on sodium dodecyl sulfate-polyacrylamide-gel electrophoresis (SDS-PAGE) and an active band on a non-denaturing acrylamide gel. The proteinase existed as a tetramer having a molecular weight of 68,000 as determined by gel-filtration chromatography. The proteinase had a pH optimum of 7.8 and was unstable above 40 degrees C. It lacked any requirement for metal ions for activity and was inhibited by all serine proteinase inhibitors tested. The proteinase hydrolysed mostly arginine amide and ester bonds. Based on its properties, the newly isolated membrane proteinase seems to be distinct from any mammalian lens proteinase isolated so far. PMID- 3280334 TI - Plasmodium falciparum: the behavior of clinical isolates in an in vitro model of infected red blood cell sequestration. AB - An in vitro model of Plasmodium falciparum-infected red blood cell sequestration which uses C32 amelanotic melanoma cells as targets has been used to examine the binding capacity of infected red blood cells from subjects with naturally acquired P. falciparum infections of varying severity. The binding of infected red blood cells (IRBCs) to melanoma cells was specific to cells containing mature parasites. Variations in target cell density and in conditions of growth had significant effects on binding. Binding was pH dependent, being maximum at a pH of 6.9. Using standardized conditions the binding capacity of individual isolates of P. falciparum could be measured with a high degree of reproducibility. Binding capacity of IRBCs from 51 subjects between the ages of 6 months and 15 years varied between 12 and 1254 IRBCs per 100 melanoma cells when RBC suspensions at a 1% parasitemia and 4% hematocrit were used. Variation in binding was not related to the level of peripheral parasitemia of the isolate or to differences in adaptation to culture conditions. The binding capacity of parasitized cells from subjects with cerebral malaria did not differ from that of IRBCs from subjects with less serious clinical manifestations. PMID- 3280333 TI - Trypanosoma cruzi: origin of metacyclic trypomastigotes in the urine of the vector Triatoma infestans. AB - Population density and percentage of the different stages of an established infection of Trypanosoma cruzi were determined for two parts of the excretory system and for the rectum of fifth instars of Triatoma infestans unfed and 4 hr after feeding. These data were also evaluated for feces and urine of the fed bugs. In the first unfed group only small populations of the flagellate occurred in the Malpighian tubules and ampullae and not in all bugs. The three rectal populations (rectal lumen and anterior and posterior rectal wall) consisted of approximately equal numbers. About 10% were spheromastigotes and about 10% were stages intermediate to epimastigotes. Significantly fewer epimastigotes and more trypomastigotes were present on the rectal wall than in the lumen. Two intermediate forms leading to the trypomastigote stage occurred in similar numbers. In nearly all bugs the initial excretion (feces) contained the highest number of flagellates as compared to the following drops of urine. More flagellates were excreted through the urine than were contained in the excretory system of unfed bugs. The population in the feces reflected the percentage of forms present in the rectal lumen of unfed bugs, but in the urine the percentage of trypomastigotes increased up to 100%. Four hours after blood uptake, dissection of bugs still showed parasites in the Malpighian tubules and ampullae; the total number of parasites in the rectum was reduced by more than 50%. This reduction was more pronounced in the rectal lumen and on the posterior rectal wall. In stained smears from all three rectal populations there were rarely spheromastigotes but high percentages of epimastigotes. The intermediate stages leading to trypomastigotes mainly originated from short epimastigotes. Comparison of the T. cruzi populations before and after feeding demonstrates that the trypomastigotes in the urine should originate from the rectal wall, especially from the posterior part. PMID- 3280337 TI - Heterochromatin associated with active versus inactive centromeres of mouse replicates at different times. AB - A subline of mouse L-cells carries a dicentric chromosome in which one centromere always separates prematurely. This centromere is not involved in the dynamics of chromosome migration and is considered inactive. By use of anti-BRdU antibody binding to BRdU-treated chromosomes it is shown that the pericentric constitutive heterochromatin associated with the prematurely separating centromere replicates earlier than its counterpart associated with the active centromere and even before several euchromatic regions in the genome. These results point to a possible mechanism by which dicentric chromosomes segregate equationally. PMID- 3280336 TI - The binding of FITC-insulin to ANAE-positive cells in rat thymus. AB - To determine if thymic macrophages have insulin receptors, alternate sections of rat thymus were stained with FITC-insulin and examined for nonspecific esterase (ANAE) activity. Cells showing a diffuse ANAE staining pattern also bound FITC insulin. These cells were concentrated in the cortico-medullary border and increased in number following administration of cortisol. Thymic macrophages may be insulin-dependent and therefore could be malfunctional in diabetes. PMID- 3280335 TI - Effect of protein kinase C activation and depletion on insulin stimulation of glycogen synthesis in cultured hepatoma cells. AB - Insulin stimulation of glycogen synthesis was nearly abolished in hepatoma cells shortly treated with 4 beta-phorbol 12 beta-myristate, 13 alpha-acetate (protein kinase C activation) but remained unmodified in cells chronically treated with the phorbol ester (protein kinase C depletion). Thus, although exogenous activation of protein kinase C results in an inhibition of insulin action, protein kinase C depletion has no influence on this process. The results suggest that, in hepatoma cells, no endogenous activation of protein kinase C may occur in response to the signal triggered by insulin. PMID- 3280338 TI - Casein, a prohormone with an immunomodulating role for the newborn? AB - Maternal colostrum and milk, the earliest food of the newborn, should not only be considered as supplying nutrients, but also as agents providing protection against aggressions from the new environment. Indeed by enzymatic digestion of the main milk proteins, the caseins, biologically active peptides are released; they may be implicated in the stimulation of the newborn's immune system. From this point of view a 'strategic active zone' has been characterized in beta casein. A possible role of casein as a 'prohormone' for the newborn is suggested. PMID- 3280339 TI - Preliminary observations on the co-existence of regulatory peptides in cells of the baboon endocrine pancreas. AB - Immunocytochemical procedures at ultrastructural and light microscopy level revealed, in the Chacma baboon endocrine pancreas, cells which were immunoreactive for glucagon and pancreatic polypeptide (PP). Some D cells were observed to contain secretory granules with both the appearance and immunoreactivity of A cell secretory granules. PMID- 3280342 TI - Effects of lipid peroxides on prostacyclin and thromboxane generation in hypercholesterolemic rabbits. AB - Rabbits fed an atherogenic diet for 60 days resulted in high levels of plasma lipid peroxides as well as extreme hypercholesterolemia. Both levels stayed high until 35 days after the atherogenic diet stopped. At the same time, plasma PGI2 level was remarkably decreased while TXA2 and platelet aggregability were increased. Atherosclerotic aortas contain high levels of lipid peroxides associated with decreased PGI2 and increased TXA2 generation. Atherosclerotic plaques had the highest level of lipid peroxides and TXA2 while PGI2 production was the least, as compared with nonplaque tissue of the same artery and the normal arteries. The condition of normal arteries was just the reverse. There was a negative correlation between lipid peroxides and prostacyclin production, and a positive correlation between lipid peroxides and TXA2, in both plasma and aorta of rabbits. These results suggest that there is a close correlation between atherosclerosis, elevated lipid peroxides, and disturbances in PGI2/TXA2 balances. PMID- 3280340 TI - Effects of anti-EGF serum on newborn mice. AB - Administration of anti-EGF serum to newborn mice led to delay of eyelid opening and incisor tooth eruption, acceleration of hair growth and delay of weight gain. These results indicate that in the first week after birth EGF still has a physiological function, which can be abrogated by anti-EGF serum. PMID- 3280341 TI - Ultrasonic vocalizations by adult prairie voles, Microtus ochrogaster. AB - Male and female Microtus ochrogaster were presented with anesthetized and awake conspecifics while ultrasonic vocalizations (USVs) were monitored. Males produced significantly more USVs than females during 5-min testing sessions. Males tended to produce more USVs to unfamiliar females than to familiar female siblings. Sexual experience led to increased USV scores by males. These results suggest that USVs by male prairie voles communicate to females the male's gender and his availability for reproductive behavior. PMID- 3280345 TI - Renin inhibitors. Improvements in the stability and biological activity of small peptides containing novel Leu-Val replacements. AB - We have designed a novel class of potent (0.3-7 nM) renin inhibitors which contain a dihydroxyethylene replacement for what is formally the Leu10-Val11 amide bond. Good potency (0.6 nM), water solubility (greater than 10 mg/ml at 37 degrees C), stability toward degradation by chymotrypsin (t1/2 = 820 min), and in vivo activity in a primate model (15% drop in mean arterial pressure in association with complete inhibition of plasma renin activity) are properties which have been incorporated into compound 10, an interesting new agent to be used in the study of hypertension. PMID- 3280344 TI - Functional characterization of Asp-317 mutant of human renin expressed in COS cells. AB - Renin is an unique aspartyl (acid) protease with optimal activity at neutral pH. It has been suggested that Ala-317 of human renin contributes to neutral optimum pH of the enzyme [(1984) FEBS Lett. 174, 102-111]. The hypothesis was verified by the characterization of mutant renin in which Ala-317 was replaced with Asp by a site-directed mutagenesis. Wild-type and mutant renins, which were expressed in COS cells, exhibited different pH-activity profiles and optimum pH of the mutant enzyme was lower than that of the wild-type enzyme. This result suggests that Ala 317 of human renin plays an important role in the determination of optimum pH of the enzyme. PMID- 3280343 TI - The effects of prostacyclin on early ultrastructural changes in the neuron nuclei of the motor cortex in rabbits after complete 20-min cerebral ischemia. AB - Twelve rabbits underwent 20-min of complete cerebral ischemia. They were given PGI2 for 3 min before and during ischemia and for 15 min after ischemia. Control animals with complete cerebral ischemia over the same period of time were not given PGI2 medication. The animals treated with PGI2 were found to have recovered bioelectric activity of the cerebral cortex in half the time that it took the control group. A positive effect of PGI2 on some parameters of the peripheral blood system after ischemia was observed. Under the conditions of this experiment PGI2 did not effect the ultrastructural changes in motor cortex neuron nuclei. The changes were manifested in numerous vesicular structures and nuclear inclusions. The inclusions took the forms of clusters, rodlets, and lattices constructed of filaments and/or tubules. The number of vesicular structures and inclusions grew with the lapse in time after ischemia. PMID- 3280347 TI - Antibodies against the human cellular 3,3',5-triiodo-L-thyronine-binding protein (p 58). AB - High-titer antibodies against a cellular thyroid hormone-binding protein (Mr 58,000, p58) were developed by a special immunization method. To enhance immune responses, this method uses a boosting protocol in which repeated injections of small amounts of antigen are administered at 2-day intervals. Antibodies were detected 1 week after the last injection of antigen by ELISA, Western dot blotting and immunoprecipitation. The anti-p58 antibodies recognized p58 which is bound to the thyroid hormone. With the availability of anti-p58 antibodies, it has become possible to study cellular localization and function. PMID- 3280346 TI - Determination of intermediates, products and cleavage site in the reaction between plasminogen activator inhibitor type-2 and urokinases. AB - Several specific inhibitors for plasminogen activators have been isolated from various organs and cell lines, those from human placenta and the human monocyte like cell line U-937 being virtually identical. The reaction between this type of inhibitor, designated as type-2, and high-Mr and low-Mr urokinase-type plasminogen activators was followed by reversed-phase high-performance liquid chromatography and gel electrophoresis. The components, their stable complexes and their dissociation and cleavage products could be clearly identified in both systems. The amino acid sequence of the inhibitor at the cleavage site was determined to be -Met-Thr-Gly-Arg decreases Thr-Gly-His-Gly-. A 35-residue carboxy-terminal fragment was found to be released. PMID- 3280348 TI - The challenge of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in women and children. PMID- 3280349 TI - Gamete intrafallopian transfer (GIFT) complicated by bilateral ectopic pregnancy. AB - A case of bilateral tubal ectopic pregnancies following GIFT is reported. Subsequent pathology revealed follicular salpingitis in both salpingectomy specimens. The need for evaluation of potential risk factors for ectopic gestation following GIFT is discussed. PMID- 3280351 TI - Memoire sur la fermentation appelee lactique (Louis Pasteur). PMID- 3280352 TI - The death of Benjamin Rush. PMID- 3280353 TI - Umbilical and uteroplacental blood flow velocity waveforms in pregnancies with fetal growth retardation. AB - A 2 MHZ pulsed Doppler ultrasound was used to record blood flow velocity waveforms (FVW) in the umbilical and arcuate arteries of 129 singleton pregnancies where intra-uterine growth retardation (IUGR) was suspected at routine ultrasound screening in the 32nd week of gestation. All patients were examined once a fortnight, between 32nd week and delivery, the results presented being from the final examination before delivery. The FVW were characterized by the pulsatility index (PI). Sixty-six of the 129 newborns were growth-retarded at delivery (birthweight less than or equal to mean--2SD of the general population). Of the IUGR cases, 56% had an abnormal PI (greater than or equal to mean + 2SD of normals) in the umbilical artery and 47% in the arcuate artery. Significant relationships were found between abnormal umbilical artery PI and both IUGR (p less than 0.001) and operative delivery for fetal distress (ODFD) (p less than 0.001). No such relationship was found between abnormal PI in the arcuate artery and either IUGR or ODFD. Four placenta waveform classes (PWC), reflecting the FVW on either side of the placenta, are presented and compared with the outcome of pregnancy. The data show the umbilical artery FVW to be a good predictor of IUGR and intra-uterine fetal distress, whereas the arcuate artery FVW appears to have low predictive value for the above conditions. PMID- 3280350 TI - Should patients with myocardial infarction receive caffeinated coffee? PMID- 3280356 TI - Rupture of pregnant noncommunicating uterine horn with fetal salvage. AB - A case is presented of pregnancy in an uncommunicating rudimentary uterine horn. The pregnancy proceeded to 31 gestational weeks, when the rudimentary horn ruptured. At laparotomy the surviving fetus was lying free in the peritoneal cavity, was delivered breech and subsequently did well. This is the fifth case reported of rupture of a pregnant rudimentary horn with neonatal and maternal survival. PMID- 3280357 TI - Chemoprevention of cancer: selenium. AB - 1. Selenium intake (in the form of selenite, selenate, selenomethionine, etc.) protects the organism against the action of some kinds of carcinogens. 2. People and animals having less Se in their blood are at a higher risk of acquiring cancer than those whose blood contains more of this element. 3. This chemopreventive action is probably due to antioxidant properties of Se, its involvements in the enzyme glutathione peroxidase as well as in the inhibition of enzymes converting carcinogens to their ultimate forms in the cell. 4. An intake of 150-300 micrograms of Se daily is considered to be adequate to protect the human organism without exhibiting the toxic properties of this element. PMID- 3280355 TI - Hydronephrosis during pregnancy: a literature survey. AB - The occurrence of hydronephrosis and hydroureters during pregnancy has been termed physiological, inasmuch as it is seen in more than 80%, most frequently and most pronounced in primigravida. The dilatation develops during the second trimester, and becomes more prominent on the right side, is only seen above the linea terminalis and disappears within a few weeks after birth. The condition is not seen in women whose ureters do not cross the pelvic brim. The extent of the dilatation can be reduced by placing the woman on the side least affected or in the knee-elbow position. After a survey of the literature, the conclusion is reached that today there is every probability that hydronephrosis during pregnancy develops as a result of compression of the ureters between the pregnant uterus and the linea terminalis. It has not been demonstrated that the change in hormonal balance during pregnancy is of importance. The clinical significance of hydronephrosis lies in the association between ureteral obstruction and the high frequency of ascending urinary tract infection during pregnancy and in the understanding of the importance--in the treatment of infection--of improving drainage by means of a change in position. Isotope renographic studies seem to show a possible relationship between bilateral ureteral obstruction and the development of pre-eclampsia. Similarly, it appears that acute hydronephrosis or worsening of an existing hydronephrosis has been somewhat overlooked as a possible cause of uncertain abdominal pain during pregnancy. These conditions should be examined by means of ultrasonography, and an attempt at treatment by a change in position should be made. In cases of continued pain or affected renal function, treatment should consist of the insertion of a ureteral catheter. PMID- 3280358 TI - Folic acid. PMID- 3280354 TI - Hydronephrosis during pregnancy: four cases of hydronephrosis causing symptoms during pregnancy. AB - Hydronephrosis during pregnancy is a physiological phenomenon in the majority of pregnant women after the 20th week of pregnancy; normally it gives rise to no symptoms. Four cases of hydronephrosis causing symptoms during pregnancy are described, where ureteral colic has been the reason for hospitalization. An evaluation is given of the indications and the methods of treatment, including the employment of an indwelling ureteral catheter. PMID- 3280359 TI - Regulation of pyruvate kinase in Reuber H35 hepatoma cells by insulin and fructose. AB - 1. Kinetic and immunological studies as well as electrophoretic behaviour indicated that pyruvate kinase in Reuber H35 hepatoma cells is of the M2-type. 2. Addition of 0.1 microM insulin or 2 mM fructose to the incubation medium for 72 hr increased the activity of the M2-type pyruvate kinase in Reuber H35 hepatoma cells by 103 and 25% respectively. 3. Incorporation studies with [3H]leucine followed by immunoprecipitation showed that the apparent rate of synthesis of the M2-type pyruvate kinase was increased by both insulin and fructose. 4. Degradation studies indicated that the addition of insulin and fructose to the incubation medium increased the half-life of the M2-type pyruvate kinase from 4.8 to 8.6 and 6.8 hr respectively. PMID- 3280360 TI - Glycosidase and phosphatase activities in U-937 and some clones and sublines. AB - 1. The activities of nine glycosidases, lysozyme and acid and alkaline phosphatases were compared in the histiocytic lymphoma cell line U-937 and a set of clones and sublines derived from this line. 2. The patterns of the different enzyme activities and selected enzyme ratios have been used as a method to distinguish between different clones and sublines. 3. Sublines with high lysozyme levels were rich in most cell-bound glycosidases. 4. During long-term growth distinct enzyme patterns of individual lines were preserved. 5. The enzyme pattern during a cell culture growth cycle was basically stable. PMID- 3280361 TI - Guide to therapy with theophylline for the treatment of obstructive lung disease. AB - During the last 10-15 years, therapy with theophylline for the treatment of obstructive lung disease has been rationalized because of increased investigation into drug pharmacokinetics and metabolism and the introduction of new techniques for measuring drug concentration in plasma. Orally administered sustained-release preparations of theophylline have recently been introduced as therapy following the development of new technology. Such preparations allow more effective use of theophylline through increased patient compliance and the maintenance of more stable plasma theophylline concentrations. PMID- 3280362 TI - The role of prenylamine in the prevention of adriamycin-induced cardiotoxicity. A review of experimental and clinical findings. AB - Experimental and clinical trials to determine the potential of prenylamine in the prevention of adriamycin-related cardiotoxicity are reviewed. In mice given 4 mg/kg body weight adriamycin, the incidence of myocardial damage after 19 days' treatment was lower than in those given adriamycin and placebo. Rabbits were given adriamycin (total dose 10.8 mg/kg body weight), adriamycin plus prenylamine (1.5 mg/kg body weight), and adriamycin plus vitamins A (250 IU) and E (40 mg) for 9-11 weeks. Adriamycin-induced electrocardiogram changes were observed to a lesser extent in animals also receiving prenylamine. Heart homogenates from adriamycin-treated animals showed enhanced hydroperoxide-initiated chemiluminescence which was not affected by the simultaneous administration of prenylamine. The extent of adriamycin-induced myocytolysis and the degree of alterations observed on electron microscopy were markedly reduced by prenylamine. In a double-blind clinical trial with 26 oncological patients, no cardiomyopathy, arrhythmia or adverse reactions were observed in the group given adriamycin plus prenylamine. In those given adriamycin plus placebo, two patients developed congestive cardiopathy and another showed severe supraventricular arrhythmias together with hypotension and dyspnoea. The mechanisms of adriamycin-related cardiotoxicity, the effects of prenylamine and the benefit from combined treatment are discussed. PMID- 3280363 TI - Domiodol treatment for bronchopulmonary diseases in the paediatric age group: a double-blind controlled clinical trial versus placebo. AB - Thirty children (25 males, five females), mean age 9.33 +/- 2.57 years, with acute infectious pulmonary diseases or acute flare-ups of chronic bronchitis, were randomly treated with either domiodol or placebo. The study was conducted between November 1986 and February 1987. Domiodol was administered orally for 14 days in doses of 0.5 mg/kg three times daily. Subjective symptoms (cough, sputum viscosity, difficulty in raising sputum and sputum characteristics) were assessed semi-quantitatively. They were all reduced significantly in the group treated with domiodol compared to those given placebo. Spirometric measures of vital capacity and peak expiratory flow rate were also improved in patients given domiodol compared with placebo. Conversely, no differences were noted in forced expiratory volume in 1 s, Tiffenau index, or mid-expiratory flow. There were no clinical side-effects and no changes in any other parameters measured; in particular, levels of thyroid hormone and thyroid stimulating hormone were unchanged. Thus, domiodol proved effective in reducing the symptoms of infection of the lower respiratory tract and in improving the consistency of mucus in children. PMID- 3280364 TI - Proteoglycan synthesis in flat cell-free cultures of chick embryo retinal neurons and photoreceptors. AB - Extracellular matrix and cell surface proteoglycans are thought to play important roles in neural development and regeneration. Central nervous system proteoglycans have been isolated and characterized from rat and sheep brain and from chick neural retina. An experimental advantage offered by the latter tissue is that it is avascular and can be isolated free of connective tissue and pigment epithelium. Therefore, proteoglycans synthesized by this tissue are derived exclusively from neural cells. However, it has not yet been determined whether neurons and photoreceptors contribute to proteoglycan synthesis or whether these molecules are largely glial in origin. In the present study we have addressed this question using cultures of chick neural retinal cells free of flat, glial like cells. Proteoglycans synthesized by cultures of retinal neurons, photoreceptors, and undifferentiated, process-free round cells from 8-day embryonic chick neural retina were metabolically labeled in vitro using [35S]sulfate and [3H]glucosamine as precursors. Radiolabeled proteoglycans accumulated in the medium, and could also be extracted from the cell layer by sequential treatments with Triton X-100 and with guanidine HCl. The proteoglycans were isolated by ion-exchange chromatography, and characterized by gel filtration chromatography and by susceptibility to degradation by enzymatic and chemical treatments. Overall, heparan sulfate proteoglycans were the predominant type of proteoglycan synthesized in vitro by the cultured neural retinal cells at this developmental stage. The medium and the Triton extract contained different proportions of both chondroitin sulfate and heparan sulfate proteoglycans, while heparan sulfate was the only proteoglycan recovered from the guanidine extract. These studies demonstrate that heparan sulfate and chondroitin sulfate proteoglycans are actively synthesized by cultures of neural retinal cells free of flat, glial-like cells. PMID- 3280365 TI - Temporal and spatial analysis of cartilage proteoglycan core protein gene expression during limb development by in situ hybridization. AB - As limb mesenchymal cells differentiate into chondrocytes they initiate the synthesis of a cartilage-specific sulfated proteoglycan, cartilage-characteristic type II collagen, and other cartilage-specific proteins. In the present study, in situ hybridization with a 32P-labeled cloned cDNA probe complementary to mRNA encoding the core protein of cartilage proteoglycan has been used to visualize and localize the accumulation of cartilage proteoglycan core protein mRNA sequences during development of the chick limb bud in vivo. When the probe was hybridized to sections through 7-day (stage 32) limbs, an intense hybridization signal was observed over the well-differentiated cartilage rudiments of the limb, while no signal above background was observed over nonchondrogenic tissues including muscle, loose connective tissue, and epidermis. At early stages of limb development, an accumulation of silver grains representing hybridizable core protein mRNA first became detectable in the proximal central core of the limb where the prechondrogenic condensation of mesenchymal cells that characterizes the onset of cartilage differentiation was occurring. In fact, the pattern of silver grain accumulation closely followed the pattern of mesenchymal cell condensation, and no hybridizable core protein mRNA sequences were detectable in the limb bud prior to condensation. Cartilage-characteristic type II collagen mRNA was colocalized with core protein mRNA in the condensing central core of the limb suggesting that the genes for these two major constituents of cartilage matrix are coordinately regulated at the onset of chondrogenesis. Furthermore, the appearance of hybridizable core protein mRNA was closely followed by the appearance of the protein for which it codes as detected by immunohistochemical staining with monospecific antibody. These observations support the hypothesis that at the initial stages of limb chondrogenesis core protein gene expression is controlled primarily at the transcriptional level. PMID- 3280366 TI - Effect of insulin on ketone body clearance studied by a ketone body "clamp" technique in normal man. AB - The effect of elevated plasma insulin concentration (55 +/- 2 mU/l) on peripheral clearance and production of total ketone bodies was determined using 3-14C acetoacetate tracer infusions. Nine normal subjects were studied twice, once during insulin infusion (20 mU.m-2.min-1), once during basal plasma insulin concentrations (controls). Blood total ketone body concentrations (sum of acetone, acetoacetate and beta-hydroxybutyrate) were maintained in both studies at 2 mmol/l by feedback-controlled sodium acetoacetate infusions. The coefficient of variation of total ketone body concentrations during the two clamp studies was 10 and 11% respectively. The sodium acetoacetate infusion rate required during the clamp was 55 +/- 4% higher during hyperinsulinaemia than in controls (p less than 0.005). This was due to increased total ketone body clearance (8.4 +/- 0.7 vs 6.7 +/- 0.4 ml.kg-1.min-1, p less than 0.015), and to enhanced suppression of ketone body production (p less than 0.01). Hyperketonaemia alone decreased ketone body production by 42% and diminished ketone body clearance by 46%, the former being enhanced, the latter being in part antagonised by insulin. Since the plasma insulin concentrations were within those observed in patients treated for diabetic ketoacidosis, the data suggest that the antiketotic effect of insulin therapy results in part from an increase in peripheral ketone body disposal. PMID- 3280368 TI - The metabolic and hormonal effects of continuous subcutaneous insulin infusion therapy in diabetic children. AB - To find out whether the concurrent metabolic and hormonal abnormalities are corrected when normoglycaemia is achieved, two groups of diabetic children (newly diagnosed and chronically-treated) were treated with insulin pumps. Fasting levels of metabolites, lipids and hormones were measured before and after 8 to 10 days of pump treatment and the immediate postprandial hormonal and metabolic changes after a test-meal were also measured. Restoration of normoglycaemia was accompanied by correction of multiple metabolic abnormalities including the normalisation of fasting plasma free insulin, growth hormone, free fatty acid, triglyceride and total cholesterol levels. Plasma glucagon, however, decreased below normal, and significant hypoketonaemia developed in newly-diagnosed diabetic children. The fall in (VLDL + LDL)-cholesterol levels was accompanied by a substantial increase in HDL2-cholesterol concentration in newly-diagnosed diabetic children, whereas pump-treatment resulted in a decrease of the HDL3 cholesterol subfraction in chronically-treated diabetic children. The postprandial blood glucose and free insulin profiles were similar to that of control subjects, but there was an "abnormal" postmeal fall in plasma glucagon and free fatty acid levels. These changes together with the fasting hypoglucagonaemia and hypoketonaemia indirectly suggest that optimal glycaemic control is only achievable at the expense of "increased insulin action" despite the failure to detect peripheral hyperinsulinaemia. Furthermore, the restoration of normoglycaemia and the simultaneous normalisation of the metabolic and endocrine milieu is not entirely possible with this mode of therapy. PMID- 3280369 TI - The adjustment of diet and insulin dose during long-term endurance exercise in type 1 (insulin-dependent) diabetic men. AB - We examined in 2 consecutive years the effect of a 75-km (greater than 7 h) cross country skiing on dietary and insulin requirements and glycaemic control in 9 Type 1 (insulin-dependent) diabetic patients. In the first year, the patients were hyperglycaemic (20.9 +/- 1.8 mmol/l) before the race due to excessive carbohydrate loading (65 g) and reduction (by 58%) of short-acting insulin for breakfast. In the second year, breakfast included less carbohydrate (40 g) and more protein, and the morning short-acting insulin was reduced by 35%. With this adjustment of therapy the pre-exercise hyperglycaemia was less (p less than 0.05). The morning intermediate-acting insulin was reduced by 28 and 38% in consecutive years. During both races carbohydrate intake approximated 40 g/h, and blood glucose was maintained at near normal levels after 33 km of skiing. Hypoglycaemia did not occur during exercise, but one patient had symptomatic hypoglycaemia after finishing the second race. The day after exercise insulin sensitivity was increased in all four patients studied. Insulin treated patients can perform strenuous long-term exercise and maintain near normoglycaemia with a proper adjustment of therapy. Augmented insulin sensitivity may contribute to post-exercise hypoglycaemia. PMID- 3280367 TI - Opioid peptides and metabolic regulation. PMID- 3280370 TI - In vitro kinetics of insulin release by microencapsulated rat islets: effect of the size of the microcapsules. AB - Microencapsulation has been proposed to protect islets of Langerhans against immune rejection in xenogenic transplantation. However, to achieve glucose homeostasis in human diabetic patients, insulin release by microencapsulated islets must increase in response to a glucose load. We microencapsulated isolated rat islets using the alginate-polylysine procedure. Capsule size was found to range from 300 to 800 micron, and microencapsulated islets were separated according to their size. Groups of 10 microencapsulated islets, either small (350 micron) or large (650 micron) were placed in plastic microwells, in minimal Eagle's culture medium containing either 5.5 mol/l glucose (basal) or 16.5 mol/l glucose and 5.5 mol/l theophylline (stimulatory medium). The increase in insulin concentration in the surrounding medium was then serially determined over 30 min: (1) With the small capsules, insulin concentration rose from 199 +/- 20 to 297 +/ 58 microU/ml in basal medium, and from 236 +/- 23 to 510 +/- 121 microU/ml in stimulatory medium (n = 10 preparations), the difference between the data obtained with the basal or the stimulatory medium being significant (p less than 0.01) from the 5th min onwards. (2) With large capsules, insulin concentration increased from 182 +/- 9 to 266 +/- 44 microU/ml, and from 216 +/- 19 to 297 +/- 34 microU/ml in basal and stimulatory medium, respectively, with no apparent significant difference. The magnitude of insulin secretion in response to glucose by unencapsulated islets was, under similar conditions, seven-fold greater. We conclude therefore that the size of the microcapsules is an essential parameter which has to be considered for the optimisation of the microencapsulation procedure. PMID- 3280371 TI - Effects of the diuretic furosemide on the sensitivity of glycolysis and glycogen synthesis to insulin in the soleus muscle of the rat. AB - The diuretic furosemide (0.5 mmol/l) impaired glucose uptake in the soleus muscle of the rat by decreasing the sensitivity of glycolysis to insulin. In addition, at higher concentrations (1.0 mmol/l) the drug inhibited the basal rate of glycolysis. It did not, however, inhibit the rate of glycogen synthesis except at a concentration of 6.0 mmol/l. Since furosemide has some structural similarities to adenosine, the above effects on insulin sensitivity may be due to its ability to act as an adenosine receptor agonist in muscle. These effects of furosemide in skeletal muscle may contribute to the glucose intolerance following therapy with this and similar agents in man. PMID- 3280372 TI - Dietary prevention of diabetes in the non-obese diabetic mouse. AB - Diabetes prone NOD female mice were fed diets containing different proteins from just before weaning. Only mice receiving meat meal or casein as the protein source developed diabetes at the rate expected from this colony. Lactalbumin and gluten did not precipitate diabetes except in a small number. Casein hydrolysate in lieu of protein protects against overt diabetes, but only if introduced early. The animals which did not show overt diabetes nevertheless had intermittent trace glycosuria and the majority showed mild degrees of periinsular lymphocytic infiltration. PMID- 3280373 TI - Insulin release by glucose anomers in a rat model of non-insulin-dependent diabetes. AB - The effects of the alpha and beta anomers of D-glucose on insulin release were studied in a rat model of non-insulin-dependent diabetes, which was induced by streptozotocin injection at 2 days of age. Glucose tolerance of the streptozotocin-treated rats at 8-10 weeks of age was mildly diabetic. Insulin release from the isolated perfused pancreas of the diabetic rats in response to 10 mmol/l alpha-D-glucose was markedly impaired, while insulin response to 10 mmol/l beta-D-glucose in the diabetic pancreas was only slightly reduced as compared to that in the control pancreas. PMID- 3280375 TI - RNA splicing in the T-even bacteriophage. AB - Group 1 introns, first demonstrated in the nuclear large rRNA of Tetrahymena thermophila and subsequently in many yeast, fungal mitochondrial, and chloroplast precursor RNAs, are capable of intron excision and exon ligation in vitro, although this process occurs much more rapidly in vivo. The discovery and characterization of a similar intron in the T4 phage thymidylate synthase gene (td) led to the finding of additional group 1 introns in other T4 genes and in genes of the related T2 and T6 phages. Because protein factors are not required in the splicing of group 1 introns in vitro, it has been postulated that the precursor RNA can assume a critical conformation enabling it to undergo site specific autocatalytic cleavage and ligation (self-splicing). By means of site directed mutation, it has been shown unequivocally that several sequence elements in the Tetrahymena rRNA intron are involved in the formation of base-paired stem structures that are essential for the self-splicing process. These sequence elements have been demonstrated in other eukaryotic group 1 introns, as well as in the td intron. In this brief review we shall describe the biochemical and structural properties of the td intron in relation to other newly found phage introns. The interesting implications arising from these revelations will also be discussed. PMID- 3280374 TI - Development of a testing battery to assess chemical-induced immunotoxicity: National Toxicology Program's guidelines for immunotoxicity evaluation in mice. PMID- 3280377 TI - Michael Heidelberger--active at 100. PMID- 3280376 TI - The vitamin D story: a collaborative effort of basic science and clinical medicine. AB - The discovery in 1919-1924 of vitamin D and its production in skin and foods by UV irradiation led to the elimination of rickets as a major medical problem. The identification and chemical preparation of vitamin D in the next decade provided large quantities of vitamin D to the physician for the treatment of a variety of metabolic bone diseases. Early in the 1960s, little was known about the function of vitamin D in causing mineralization of the skeleton, and hence in preventing the disease rickets in children and osteomalacia in adults. With the application of modern tools of biochemistry came the discovery that vitamin D must first be modified by 25-hydroxylation in the liver followed by 1 alpha-hydroxylation in the kidney to produce the vitamin D hormone 1 alpha,25-dihydroxyvitamin D3 [1,25 (OH)2D3]. This process is strongly feedback-regulated and is one of the major endocrine systems regulating plasma calcium and phosphorus concentrations. Furthermore, it is a major endocrine system regulating bone mass and state. With the chemical synthesis of 1,25-(OH)2D3 and many of its analogs has come the possibility of treating a number of metabolic bone diseases not previously managed adequately, such as vitamin D-resistant rickets, hypoparathyroidism, renal osteodystrophy, and osteoporosis. By using 1,25-(OH)2D3, considerable work has been carried out to understand how this hormone facilitates calcium transport across the intestinal membrane. Modern work is described on the molecular mechanism of action of the vitamin D hormone in eliciting the cellular responses that result in mineral homeostasis. The possible use of the vitamin D analogs to bring about differentiation of myelocytic-type leukemias and in the treatment of psoriasis has been an important new development. This paper will thus be a blend of basic science of the vitamin D system and the application of that information to the treatment of disease. PMID- 3280378 TI - Age-related nephropathy in laboratory rats. AB - Chronic progressive nephropathy is a spontaneous disease common among aging laboratory rats, often making it difficult to distinguish age-related from drug related effects in chronic toxicity studies. Morphological changes of the kidney that occur with age include thickening of glomerular and proximal tubular basement membranes, mesangial proliferation, fusion of foot processes, and, ultimately, glomerular sclerosis. Proteinuria (specifically, albuminuria) is the most striking characteristic change in renal function of aging rats and, generally, correlates well with the severity of age-related glomerular pathology. Changes in tubular functions also may occur with aging but have not been investigated sufficiently. The pathogenesis of chronic progressive nephropathy is not known; however, hemodynamic adaptations after ad libitum consumption of protein-rich diets may be a contributing factor. High-protein diets increase glomerular pressures and flows, perhaps facilitating excretion of metabolic end products. These hemodynamic adaptations may impair the permselective properties of the glomerulus, leading to: enhanced accumulation of macromolecules in the mesangium, progressive mesangial expansion, and, ultimately, glomerular sclerosis. Indeed, decreasing total food or protein intake retards or prevents the progression of age-related nephropathy. Inasmuch as chronic toxicity studies are complicated by a high incidence of spontaneous nephropathy, implementation of a restricted dietary regimen may improve detection of drug-induced toxicity. PMID- 3280379 TI - A homologue of platelet-derived growth factor produced by rat alveolar macrophages. AB - Rat alveolar macrophages secrete a growth factor that renders rat lung fibroblasts competent to initiate DNA synthesis in vitro in the presence of platelet-poor plasma. This biological activity resembles that of platelet-derived growth factor (PDGF). After separation from putative associated binding proteins by chromatography under acidic conditions, the macrophage-derived factor exhibited a relative molecular weight similar to that of highly purified human PDGF. The factor bound to a monospecific antibody to human PDGF and thus could be quantitated in an enzyme immunoassay for PDGF. It competed with radiolabeled human PDGF for receptor sites for PDGF on rat lung fibroblasts, and binding to these receptor sites could be specifically inhibited by anti-PDGF. These data strongly support the view that the factor derived from rat alveolar macrophages is homologous to human PDGF and is similar to human macrophage-derived PDGF-like growth factor. Furthermore, we have demonstrated that the lung contains both an effector cell (pulmonary macrophage) and a potential target cell (interstitial fibroblast) for this cytokine. Therefore the rat appears to be an appropriate animal model in which to study macrophage-derived PDGF-like growth factors as mediators of proliferation in pulmonary fibrogenesis. PMID- 3280380 TI - [Are epidemiologically linked cancers risk antecedents for rectocolonic cancer?]. PMID- 3280381 TI - [Extrahepatic digestive surgery in cirrhotic patients: mortality, morbidity and preoperative prognostic factors]. AB - The purpose of this work was to study postoperative mortality and morbidity with respect to preoperative prognostic factors in 67 patients with alcoholic or posthepatitis cirrhosis. Surgical procedures involved the biliary tract (n = 20), stomach (n = 16), colon or rectum (n = 12), and hernia (n = 7). Thirteen preoperative clinical and biological variables were subjected to mono- and multivariate statistical analysis. The mortality rate was 23 p. 100. There was no statistical difference between the three main surgical procedures. No patients died after herniorrhaphy. The rate of morbidity was 37 p. 100. The most common complications were sepsis, organ failure, and ascites. Three preoperative variables were found to be different between survivors and non survivors: ascites, prothrombin time and the Child-Pugh score. Multidimensional analysis demonstrated that the only variable to have an independent unfavorable prognostic value was albuminemia. These results suggest that postoperative mortality following extrahepatic abdominal surgery in cirrhotic patients is: 1) especially high after digestive procedures, 2) increased by ascites, low prothrombin time and high Child-Pugh score. Only hypoalbuminemia had a significant independent explanatory value regarding prognosis. PMID- 3280382 TI - [A case of esophageal papillomatosis in adults]. AB - The authors report the case of a 60 year-old woman patient with esophageal papillomatosis, revealed by slowly progressive dysphagia and digestive hemorrhage. Multiple warty tumors were found at endoscopy, starting at approximately 23 cm from the dental ridge, increasing in size into the lower esophagus where they were responsible for stenosis. Pathological examination demonstrated epithelial proliferation with lengthened papillae, hyperkeratosis, hyperacanthosis and severe dysplasia. No extra-esophageal papillomata were discovered. Subtotal esophagectomy was performed and pathological examination with immune markers suggested a human papilloma virus (HPV) infection. However, search for HPV DNA was negative. To our knowledge, this constitutes the fifth case reported in the literature. The principal problem posed by this rare disease is the possible association with and/or progression to carcinoma, the diagnosis of which may be difficult, and particularly, with verrucous carcinoma. With this diagnostic uncertainty in mind, the authors suggest total surgical removal of the esophagus in this situation. PMID- 3280383 TI - [Linear IgA bullous dermatosis associated with Crohn's disease]. PMID- 3280384 TI - Bile duct measurements after ceruletide as an aid to the ultrasound diagnosis of choledocholithiasis. AB - Despite good results in gallbladder imaging, ultrasound (US) diagnosis of choledocholithiasis remains a challenge. The value of US before and after a provocative injection of the decapeptide ceruletide was examined in 25 patients with suspected common duct stones immediately prior to diagnostic retrograde cholangiography. An abnormal response (increase in US duct diameter) was seen in 4 of 6 patients with an obstructed duct, giving a sensitivity of 67% and predictive value of 80% for the procedure. There was a normal response (decrease in US diameter of a dilated duct or decrease/no change in a normal duct) in 14 of 19 with an unobstructed duct (specificity 79%, predictive value 93%) and an equivocal response (no change in diameter of a dilated duct) in 5 patients. In 1 patient a calculus not seen on the initial US became visible as the duct distended by ceruletide administration. Symptoms after ceruletide were few and not discriminatory. Although it added to the time and difficulty of performing biliary US, ceruletide administration proved a useful adjunct to the diagnosis of choledocholithiasis. PMID- 3280385 TI - Hepatitis tuberculosis presenting as tumoral disease on ultrasonography. AB - Macronodular involvement of the liver is a rare manifestation of hepatitis tuberculosis. Two cases of this pseudotumoral form are reported on ultrasonography, demonstrating multiple hypoechoic nodules distributed throughout the liver. The authors state the difficulty in differentiating this form in its atypical presentation from lymphomatous or secondary malignancies. They stress the importance of the bacteriological and/or histological diagnosis which can be performed with fine-needle percutaneous biopsy under ultrasound guidance and which allows effective therapy. PMID- 3280386 TI - Effect of aging on immunological memory in gastrointestinal tract induced by sheep red blood cells in mice. AB - Tolerance induction by oral administration of sheep red blood cells (SRBC) was investigated in young and aged mice. Two-month old C3H/He mice receiving oral administration of 8 X 10(9) SRBC a day for two weeks became tolerant to a subsequent SRBC challenge in the systemic immune system. In contrast, older C3H/He mice aged about 1 year old receiving the same treatment did not become tolerant but resisted tolerance induction and produced a prominent IgG memory in the systemic immune system. Autoimmune-prone NZB mice showed a similar resistance to tolerance induction even at 3 months of age. To investigate a possible role of the liver in the oral tolerance induction, young (2-month old) C3H/He mice received an injection of 1 X 10(8) SRBC via portal vein. The mice thus treated, were not tolerized at all but immunized. The results suggest that gut-associated local immune system play a key role in the induction of the oral tolerance and that the tolerance inducing function of the local immune system declines with aging. Antigens in the gut including denatured self antigens may immunize the systemic immune system of aged animals. PMID- 3280387 TI - Pancreatic pseudocyst involving the spleen. AB - Pancreatic pseudocyst involving the spleen in a 52-year-old man is reported, with review of the literature. Physical examination and laboratory data revealed no specific abnormalities. A CT scan demonstrated multiple calcifications throughout the pancreas, with a cystic mass in the tail of the pancreas involving the spleen. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a dilated main pancreatic duct with a direct communication to the cyst. Distal pancreatectomy with splenectomy was performed on a diagnosis of pancreatic pseudocyst. The 10 x 9.5 x 7 cm in size cyst had no epithelial lining on its wall. The amylase level in the cystic fluid was 23424 IU/l. The literature reveals that hemorrhagic complications are common and often serious. Timely surgical intervention is advocated to reduce mortality and morbidity from complications. PMID- 3280388 TI - Controlled trials of charcoal hemoperfusion and prognostic factors in fulminant hepatic failure. AB - One hundred thirty-seven patients with fulminant hepatic failure were entered into two controlled trials of charcoal hemoperfusion carried out concurrently. In trial A, 75 patients with grade 3 encephalopathy were randomized to receive 5 or 10 h of hemoperfusion daily. Overall survival rates for the two groups were similar (51.3% vs. 50.0%) as was the frequency of major complications including cerebral edema and renal failure. In trial B, in which 62 patients with established grade 4 encephalopathy on admission were randomized to a no-perfusion group or to have 10 h of hemoperfusion daily, overall survival rates for the two groups were again similar (39.3% and 34.5%, respectively). There was in both trials a significant relationship between survival and etiology quite independent of the use or duration of hemoperfusion. Thus, percentage survival for the acetaminophen-overdose cases was 52.9%, for hepatitis A 66.7%, for hepatitis B 38.9%, for presumed non-A, non-B hepatitis 20%, and for halothane or drug reaction 12.5%. Within the etiologic subgroups survival was also influenced by the three major complications that developed, being inversely related to their frequency and combination, except in the non-A, non-B hepatitis and halothane or drug reaction subgroups, which had a high mortality throughout. In the latter cases particularly, orthotopic liver transplantation merits early consideration and in the group with better "intrinsic" survival (acetaminophen, hepatitis A and B) intensive management of complications (rather than charcoal hemoperfusion) would appear to be of major importance. PMID- 3280389 TI - Transplantation for primary biliary cirrhosis. AB - Primary biliary cirrhosis is a frequent indication for liver transplantation. The purpose of this report is to present our experience with liver transplantation for primary biliary cirrhosis. Attention is given to the causes of hepatic dysfunction seen in allografts. In addition, we review the postoperative problems encountered and the quality of life at time of last follow-up in patients with transplants for primary biliary cirrhosis. A total of 97 orthotopic liver transplant procedures were performed in 76 patients with advanced primary biliary cirrhosis at the University of Pittsburgh from March 1980 through September 1985. The transplant operation was relatively easy to perform. The most common technical complications experienced were fragmentation and intramural dissection of the recipient hepatic artery, which required an arterial graft in 20% of the cases. Most of the postoperative mortality occurred in the first 6 mo after transplantation, with an essentially flat actuarial life survival curve from that time point to a projected 5-yr survival of 66%. Common causes of death included rejection and primary graft nonfunction. Thirteen of the 76 patients had some hepatic dysfunction at the time of the last follow-up, although none were jaundiced. Recurrence of primary biliary cirrhosis could not be demonstrated in any of the patients. Antimitochondrial antibody was detected in the serum of almost all of the patients studied postoperatively for it. Most important, almost all of the 52 surviving patients have been rehabilitated socially and vocationally. PMID- 3280391 TI - Doppler flowmetry and portal hypertension. PMID- 3280390 TI - Hepatic subcapsular biloma. An unusual complication of endoscopic retrograde cholangiopancreatography. AB - Development of an intraabdominal bile collection (biloma) usually occurs secondary to traumatic or iatrogenic injury including abdominal surgery, percutaneous catheter drainage, and transhepatic cholangiogram. We present a case of hepatic subcapsular biloma following endoscopic retrograde cholangiography and identified by ultrasound and computed tomodensitometry examinations. A percutaneous drainage procedure allowed a subsequent endoscopic retrograde cholangiopancreatography to be performed that documented the location and extent of the bile leak and led to resolution of the biloma. PMID- 3280392 TI - The diagnosis of pancreatic cancer by endoscopic ultrasonography. AB - Endoscopic ultrasonography was evaluated for detection of tumors of the pancreas. The technique was performed in 42 patients with cancer of the pancreas and 8 patients with nodular fibrosis of chronic pancreatitis. The lesions were clearly identified in all 50 patients, even when the size of the tumor was less than 20 mm in diameter. A tumor of the pancreas was usually visualized as a hypoechoic mass that had a characteristic image depending on the size. Ultrasonographic differentiation of malignant from benign tumors of the pancreas was possible in tumors larger than 30 mm in size but difficult in tumors less than 20 mm in size. Compared with conventional ultrasonography, endoscopic retrograde pancreatography, computed tomography, and angiography, endoscopic ultrasonography had the highest detection rate of tumors of the pancreas, especially in cases of small tumors under 20 mm in size. In cancer of the pancreas, endoscopic ultrasonography also proved to be valuable for the detection of vascular invasion. PMID- 3280393 TI - The role of bacteria in the blockage of biliary stents. AB - Recurrent jaundice and cholangitis due to stent occlusion by biliary sludge is a major complication of endoscopic stenting for malignant obstructive jaundice. Scanning electron microscopy study of the blocked stents revealed the sludge to consist of a mixture of bacteria and amorphous material. In vitro study using scanning electron microscopy demonstrated the attachment of bacteria to a segment of stent perfused with infected bile containing live bacteria. Associated with the microcolonies of bacteria was a collection of amorphous material forming a dense concretion on the surface of the stent. This phenomenon was not observed in experiments using sterile bile or with infected bile sterilized by formalin treatment or autoclaving. It was concluded that live bacteria are necessary for the initiation of biliary sludge formation which leads to subsequent stent blockage. PMID- 3280394 TI - Is there an ultrasonographic endoscope in your future? PMID- 3280395 TI - [Maternal morbidity following cesarean section. Comparison of isthmo-corpus longitudinal section and isthmian transverse section in premature labor]. AB - In an increasing number of cases of the Caesarean delivery of small premature babies (length of gestation less than 32 weeks or an estimated weight of less than 1501 g) between April 1983 and March 1987, the uterus was opened by an isthmo-corporeal longitudinal section if the lower uterine segment appeared too narrow for a gentle delivery via an isthmian transverse incision. A comparison of 67 Caesarean deliveries of this type with 116 Caesarean deliveries of the same small premature babies using an isthmian transverse incision did not reveal any difference with regard to postoperative infections, feverish standard morbidity, or other noninfectious complications. In comparison with Caesarean deliveries of older babies, the Caesarean deliveries of small premature babies had significantly more infectious and noninfectious complications, such as cases of phlebitis of the arm owing to intravenous application (2.7% as against 1.0%), posthemorrhaging and hematomas (3.8% as against 0.8%), and blood transfusions (3.3% as against 0.8%). The number of infectious complications was significantly reduced by a perioperative antibiotics prophylaxis. The question of late complications as a result of the isthmo-corporeal longitudinal section, especially the danger of rupture of the uterine scar in the event of a subsequent vaginal delivery, has not yet been resolved. PMID- 3280396 TI - Multifactorial modeling, drug interactions, liver damage and aging. AB - A well designed physiological flow model can be used not only to describe and analyze the basic elimination of a drug but also it can form the basis for multifactorial analysis in situations of multiple organ dysfunction and drug therapy. Physiological flow models use existent knowledge of anatomical structure and physiological processes along with the biochemical basis of drug elimination to calculate concentration-vs-time profiles of drugs in various organs and tissue regions. A tissue region or organ must be included in the model if it is an important site of storage, toxicity, elimination, or other significant pharmacological action. Such models can be a powerful tool in medicine providing a rational basis for multiple drug therapy in high risk patients with altered organ function--especially for drugs with a narrow margin of safety. For some specific types of drug systems, physiological flow model models exist which can accurately describe drug concentration profiles in tissues for a variety of situations. A definitive general model is theoretically possible; but, in practice, has not yet been developed. Future research could provide the necessary information to make multifactorial analysis a clinically useful tool in rational drug therapy. PMID- 3280397 TI - Pharmacology of oxazolidinones in rat decerebrate rigidity, with reference to their glutamate blocking action. PMID- 3280398 TI - Models of thrombosis. AB - A critical review is presented on animal models of thrombosis. After a glance at the pathogenesis of clinical thrombosis and its multifactorial character, the classification, aims and a suggested rational design of thrombosis models are advanced and illustrated by some examples of an attempted solution of this complex problem. PMID- 3280399 TI - Interrelationship between the kallikrein-kinin system and hypertension: a review. AB - The evidence presented here suggests strongly that the kallikreins-kininogens kinins-kininase II system has most significant role in regulation of systemic BP. This system is involved in mediation and modulation of renin-angiotensin aldosterone, PGS and vasopressin in the regulation of sodium water balance, renal hemodynamic and BP. Therefore, reduction in the kinin-formation due to high production of kininase II, and lower formation of tissue kallikrein might result in an increased release of vasoconstrictor angiotensin II on one side, and on the other side much reduced production of PGE, vasodilator. These changes might lead to deranged vascular smooth muscle structures and cell membrane functions, retention of sodium and water, increased plasma volume, and renovascular constriction. These physiological defects might result in the development of essential hypertension (Fig. 4). Although, it is possible now to treat hypertensive conditions with tissue kallikrein and kininase II inhibitors. These discoveries have opened up new vistas to research on the pharmacological applications of kallikreins-kininogens-kinins-kininases in human diseases. PMID- 3280400 TI - The effect of aminopyridines on the activity recorded in the dorsal roots of an isolated hamster spinal cord preparation. AB - 1. The aminopyridines (AP) increase the activity recorded on the dorsal roots of an isolated hamster spinal cord preparation. 2. The threshold for 4-AP was 4 X 10(-6) M and the maximum effect was 3 X 10(-5) M. The threshold for 2AP and 3AP was 3 X 10(-5) M and the maximum effect was at 10(-3) M. 3. It took longer for the preparation to recover on washing from treatment with 4-AP than from 2-AP or 3-AP. Washing often showed a transient increase in activity. 4. Treatment with AP changed the pattern of firing so that the activity after treatment and prolonged washing showed a bursting pattern. 5. The activity recorded in the dorsal roots is generated within the spinal cord and may be related to activity of central pattern generators. PMID- 3280401 TI - Review of medical emergencies in dentistry: staff training and prevention. Part 1. PMID- 3280402 TI - Microleakage at the etched-amalgam/composite resin interface of etched-metal resin-bonded retainers. PMID- 3280403 TI - A review of blood transfusion. PMID- 3280404 TI - Freeze-dried skin allograft. PMID- 3280405 TI - The story of elderly care: Elizabethan times and the Poor Laws. PMID- 3280406 TI - Aging-related skin changes: development and clinical meaning. AB - The medical literature is replete with articles that discuss the spectrum of sun induced changes in human skin. These extrinsic, actinically induced changes, more prevalent in the elderly, include wrinkling and loss of elasticity; dyspigmentation; vascular ectasias and hemorrhage; atrophy; and benign and malignant neoplasms. This article, however, focuses on the intrinsic changes behind geriatric skin problems, providing a non-specialist's illustrated guide to recognizing structural and functional changes due to normal, chronological aging and how they manifest clinically in elderly patients. PMID- 3280407 TI - Some changes in concepts of dose fractionation over 20 years. PMID- 3280408 TI - Therapeutic ratio and fractionation in cancer of the lung. PMID- 3280409 TI - Irradiation of adenocarcinomas of the gastrointestinal tract malignancies. PMID- 3280410 TI - Time, dose, and fractionation in radiation therapy: an historical perspective. PMID- 3280411 TI - European Organization for Research on Treatment of Cancer trials using radiotherapy with multiple fractions per day. A 1978-1987 survey. PMID- 3280412 TI - Low-dose rate irradiation. AB - There are a number of rather obvious conclusions from these experimental data that have implications in clinical radiotherapy: (1) Survival curves for cells of human origin, in general, have a smaller initial shoulder and exhibit greater sensitivity to ionizing radiation than cells of rodent origin. (2) Nevertheless, the response of human cells to gamma-rays, in a fractionated or low-dose schedule, is dominated by repair. (3) Radiosensitivity, as well as the repair of sublethal damage as evidenced by the dose rate effect, is very similar for a range of normal human cells, including skin and lung fibroblasts, as well as endothelial cells from umbilical cord veins. (4) Human tumor cells are much more variable than normal cells in radiosensitivity, and in the repair of sublethal damage, evident in the dose rate effect. Some show a smaller, and some show a larger dose rate effect than normal cells. (5) Consequently, the use of a large number of fractions, as for example in hyperfractionation regimens, is contraindicated in those tumors that show repair factors larger than for normal tissues; though of course it is a substantial advantage in other cases. PMID- 3280413 TI - Reoxygenation and repopulation in irradiated tumors. PMID- 3280414 TI - Skin: the basic model for relating dose, time, and fractionation. PMID- 3280415 TI - Radiotherapy in the management of cutaneous melanoma: effect of time, dose, and fractionation. PMID- 3280416 TI - [The relevance of the works of A. A. Letavet at today's stage of scientific and technical progress]. PMID- 3280417 TI - [Research development and the results of cooperation on soil hygiene in the socialist countries 1981-1985]. PMID- 3280418 TI - [Gas embolism in operations with artificial circulation]. PMID- 3280419 TI - [Viktor Sergeevich Savel'ev (on his 60th birthday)]. PMID- 3280420 TI - [Surgical treatment of dissecting aneurysms of the ascending aorta]. PMID- 3280421 TI - Purification of plasma protein. AB - The purification of coagulation proteins from plasma milieu is a complex and sometimes difficult task. Most clotting factors are present in plasma in trace amounts. They are sensitive to proteolytic degradation and adsorption to surfaces. Thus for most coagulation proteins it was not until the seventies that highly purified preparations were available. Nowadays, most coagulation proteins are isolated from plasma using combinations of ion exchange, molecular sieve and affinity chromatographies. Sometimes, e.g. for Vitamin K dependent factors, specific adsorption properties are utilized. During affinity chromatography, proteins may be bound to specific immobilized receptors, antibodies, substrates, or inhibitors. An example for the latter is the use of bezamidine-Sepharose for the purification of thrombin. Immunoadsorption to immobilized monoclonal antibodies allowed the isolation of highly purified factor VIII:C. For factor XI and prekallikrein the binding of these proteins to the immobilized cofactor high molecular weight kininogen is utilized for an effective separation of contaminations. Antithrombin III can be isolated by linkage to its cofactor, heparin, on heparin-Sepharose. Using affinity chromatography on lysine-Sepharose it is possible to isolate plasminogen from plasma, serum or urine in a one step procedure with high yield and quality. This, of course, is an ideal situation, where the goal of a purification, namely the separation of a highly purified, biologically active product with high yield can be accomplished in a simple, fast procedure. PMID- 3280422 TI - Review of studies with plasminogen concentrates and proposals for further therapeutic strategies with plasminogen concentrates. AB - Since the introduction of thrombolytic treatment based on the activation of plasminogen (PLG) by streptokinase (SK) and urokinase (UK) the search for new and improved methods has been continuing. The pivotal issue is how to achieve clot specific fibrinolysis without producing systemic fibrinogenolysis. One out of various approaches to enhance lysis rates has been the use of PLG either alone or in combination with UK or SK in the light of the fact that fibrinolytic treatment, particularly using SK, is associated with a consumption of PLG, and that thrombi contain relatively small amounts of native PLG, however, are capable of incorporating added PLG in vitro. PLG-concentrates from various manufactures have been administered intravenously for treatment of deep venous thrombosis, mainly in combination with SK, and of pulmonary embolism in combination with UK. Local intracoronary and intraarterial administration in combination with UK has been reported in patients with myocardial infarction, and peripheral arterial occlusions, respectively. Lysis rates obtained in these studies were in most cases superior to results obtained with SK or UK alone, without increasing the incidence of bleeding complications. In addition, excellent results in larger group of patients with cerebral thrombosis were obtained with PLG alone. The encouraging results of these studies may be explained by the fact that all of the preparations used contained partially activated forms of PLG (commonly designated lys-PLG) to a greater or lesser extent. Lys-PLG has a higher affinity for fibrin than the native glu-PLG and is activated by UK or SK by a manyfold faster. These properties allow for a rapid formation of plasmin which--bound to fibrin--is also protected from the attack of neutralizing antiplasmin. The design and results of previous studies with lys-PLG concentrates will be reviewed and approaches to further improve fibrinolytic regimens with lys-PLG-concentrates discussed. PMID- 3280423 TI - Physiology of plasminogen: with special reference to activation and degradation. AB - Plasminogen is said to be synthesized in many organs, but the major source of its production is considered to be the liver. The production of plasminogen is observed in fetal life, but its plasma level is low in new born infants, rising rapidly to attain adult levels in about 13 weeks. The plasma levels do not change much with age. Although the fibrinolytic enzyme system is influenced by many factors such as hormones, exercise, emotion, age, sex, nutritional states etc., the plasma levels of plasminogen are relatively stable. In this presentation we would like to discuss three important subjects related to the physiology of plasminogen. The first subject is the activation pathway of the native form of plasminogen (Glu-plg) by various activators in the plasma or clotted plasma. Glu plg was not easily activated by activators such as urokinase (UK) or tissue plasminogen activator (t-PA), but activated very easily in the presence of fibrin clot. In the presence of purified clot, Glu-plg was partly activated by activators to Glu-plasmin, but also converted to Lys-plg by preformed plasmin, subsequently being activated to plasmin. Glu-plg I (containing two carbohydrate chains) changed conformation more easily upon interaction with fibrin than Glu plg II (containing one carbohydrate chain) and Glu-plg I was also more easily activated by activators than Glu-plg II. Although Glu-plg was hardly activated by activators in the plasma, Glu-plg was activated easily in the presence of plasma clot. Results of immunoblotting experiments indicated that Glu-plg was mainly activated by activators directly to plasmin, not via Lys-plg in contrast to purified systems. The second subject is the degradation of plasminogen by elastase. Plasminogen may be degraded by proteolytic enzymes such as cathepsin or elastase. The degradation of plasminogen by elastase is shown to give rise to K1 to K3, K4, and mini-plg (containing K5). We have shown that the degradation rate to Glu-plg by elastase increased in the presence of tranexamic acid, indicating that the conformational change of Glu-plg in the presence of tranexamic acid resulted in the exposure of the hydrophobic regions connecting K3, K4 and K5, thus making them accessible to elastase. Consequently, Lys-plg or conformationally altered Glu-plg (possibly bound to fibrin or FDP) is more easily degraded in vivo. The last subject is relationship between plasma plasminogen levels and fibrinolytic activity in various ages. Although plasma plasminogen levels do not change with age, the fibrinolytic activity lowers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3280424 TI - Basics and practice in evaluating plasminogen. AB - There exist different ways of assays of plasminogen which give information about different properties of this proenzyme. The concentration of plasminogen can be determined by its antigenicity. Since the normal concentration of plasminogen in plasma is between 15 and 25 mg/dl the test can be carried out by simple methods such as radial immunodiffusion on Partigen plates. The possibility of errors is small and there is no need of special apparatus. The disadvantages are the lapse of 24 h until the result is available and the fact that the knowledge of the concentration does not give any information about the activity. The activity can be measured by different coagulation tests. A typical assay would involve activation of plasminogen to plasmin, addition of plasminogen-free thrombin and measuring of the lysis time. The result is however, dependent on more than one variable. Plasmin is rapidly inhibited by alpha-2-antiplasmin (APL) and there is also a dependence of the lysis time on the amount of clottable fibrinogen in the test system. Better results can be obtained by the use of diluted test plasma and addition of a constant amount of plasminogen-free fibrinogen. A different way would be the use of the euglobulin fraction instead of plasma. This has however, the possible disadvantage of incomplete precipitation of plasminogen. Instead of coagulation tests the activity can also be determined when diluted activated plasma is placed on plasminogen-free fibrin plates and the amount of lysis in the plate is recorded. All assays of this group also depend on the method of activation of plasminogen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280425 TI - Standardization of plasminogen assays. AB - Like a number of the components of the fibrinolytic and coagulation systems, plasminogen (plgn) is a multifunctional molecule. As a proenzyme, a number of its activities such as its binding to fibrin, histidine-rich glycoprotein (HRGP) and alpha 2-antiplasmin (AP) are expressed while its major enzymatic activity remains unexpressed. This latter activity has been used as a yardstick of plasminogen potency, despite the fact that no such activity resides in the native plasminogen molecule. Assay procedures usually involve the activation of the plasminogen to plasmin using an activator such as streptokinase (SK) or urokinase (UK) and a major problem involves the establishment of a properly-timed plasminogen activator ratio to fully express the plasminogen as the active enzyme plasmin (Gaffney, P.J. et al. Activation of plasminogen as a feature of its assay. Haemostasis 1977, 6, 72-78). Substrates such as casein, fibrinogen and fibrin have been used to assess the plasmin activity developed while more recently the tripeptide chromogenic substrate S-2251 has been successfully used. These assays have been standardised using a reference preparation of the active enzyme, plasmin, and both a 1st and 2nd International Reference Preparation (IRP) have been established. These IRP's differed in that the fibrin binding kringle structures were missing in the 1st IRP yielding differing fibrinolytic and chromogenic activities (Philo, R.D. and Gaffney, P.J. Plasmin potency estimates. Influence of substrate used in assay. Thrombosis and Haemostasis 1981, 45, 107 109). Activation procedures of plasminogen and subsequent assays of plasmin using a variety of substrates have been recently superseded by an assay which involves the formation of a plgn-SK complex which complex has an active site which hydrolyses the chromogenic substrate S-2251. This avoids the problems highlighted above involved in measuring plasminogen activity at the optimum stage during activation. While plasmin standards have been suitable for the standardisation of plasminogen when it is measured by activation-based procedures, a British Standard for glutamic acid-plasminogen has now been established in order to standardise the plgn-SK assay (Gaffney, P.J. and Curtis, A.D. The establishment of a standard for plasminogen (glu-type). Thrombosis and Haemostasis 1984, 51, 376-378). The calibration of this standard using the 2nd IRP for plasmin and the value of this standard in the measurement of plasminogen in plasma is discussed. PMID- 3280426 TI - Plasminogen: a brief introduction into its biochemistry and function. AB - Human plasminogen is a beta-globulin (2% carbohydrate, molecular weight 90 KD), which in its native form has NH2-terminal glutamic acid (Glu-plasminogen) whose primary structure is known (31, 37, 38). From human plasma plasminogen can easily be isolated by affinity chromatography techniques (10, 25, and Table 1). Plasminogen is synthesized in many organs. The production site of the zymogen may be the liver (21), the eosinophiles (3) or the kidney (15). The plasma plasminogen level is low in newborns (22) and even lower in the premature infant (2). In healthy adults it is found in plasma or serum in a concentration of 200 mg/l (= 2 microM, 22, 39). The half-life of the native (Glu-) plasminogen is 2.24 +/- 0.29 days (6). Two types of Glu-plasminogen occur in human plasma, which differ in their carbohydrate composition as well as in their content of sialic acid. Genetic variants (see Mayr, 3.1.); of plasminogen have been reported (16) after isoelectric focusing of human plasma in polyacrylamide gels. Three patterns were found, two completely different and the third most likely a mixture of the other two. Characteristical functional properties of plasminogen are related to its molecular structure, e.g. its in vivo specificity for fibrin in contrast to the fairly unspecific in vitro activity of plasmin. Glu-plasminogen is easily converted by limited plasmic digestion to modified forms with NH2-terminal lysine, valine or methionine, which are commonly designated "Lys-plasminogen" displaying a plasma half-life time of 0.8 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280427 TI - Characterizing hereditary and acquired defects of plasminogen. AB - Since plasminogen is the proenzyme of plasmin most acquired defects of plasminogen are associated with situations with an increased fibrinolytic activity. Congenital defects also have been described both such associated with thrombotic disease and such that are not. An increased fibrinolytic activity leading to an acquired plasminogen defect is seen 1) in situations complicated with a free proteolytic activity most often involving both the fibrinolytic and the coagulation systems, 2) as a result of locally increased fibrinolytic activity (angiomas), 3) during thrombolytic therapy using plasminogen activators (SK, UK, tPA). A congenital plasminogen defect characterized by 1) a low protein level as well as one with 2) a normal plasminogen protein level in plasma but a defect activation pattern has been reported. Plasminogen can be determined immunochemically, a method which does not differentiate between functionally active plasminogen/plasmin and complexes between these proteins and inhibitors. Plasminogen activity is measured in a chromogenic method using the chromogenic substrate S2251 (Kabi Diagnostica, Stockholm). In this latter method SK is used as a plasminogen activator and the total plasmin formed is measured amidolytically. Using both the immunochemical and the amidolytical methods it has been possible to identify congenital plasminogen defects characterized by a defective activation of plasminogen into plasmin, a defect that has been associated with thromboembolic disease. Another congenital plasminogen defect seems to be caused by a decreased synthesis of a normal plasminogen molecule. Such a defect may not be associated with thrombotic disease. In situations complicated with an increased fibrinolytic activity, decreased plasminogen levels (in both types of assay) are of diagnostic help. Values down to below 50% or even lower may be seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280428 TI - [Education and training in microsurgery without experiments on live animals]. AB - A theoretical concept of a training programme for microsurgery is presented. This programme--as an alternative to the presently existing types of microsurgical education using the living laboratory animal--pursues the training of microsurgical skills exclusively on non-living objects. This paper describes the training laboratory as well as four training procedures, each using separate objects with an increasing degree of difficulty and educational benefit: surgical glove; silastic tube; sciatic nerve of a chicken; perfused coronary arteries of a pig's heart. Completion of this programme conveyed to the trainee the same basic abilities as training on a living laboratory animal. PMID- 3280429 TI - [Free fascial and septo-fascial flap-plasty]. AB - Free fascial and septo-fascial flaps may be used to reconstruct gliding structures for nerves and tendons in combination with skin grafts to cover exposed bones, joints, tendons and nerves, and as filling material for contour correction. The advantages are the minimal disfigurement of the donor site, the very thin soft tissue cover created, and the possibility of avoiding adhesions. Possibilities of the use for reconstruction of gliding structures are shown. In a special case the superiority compared to simple tenolysis is demonstrated. Such flaps include the gliding tissue between latissimus dorsi and serratus anterior based on the thoracodorsal artery, the galea flap on the superficial temporal and the forearm septo-fascial flap on the radial. PMID- 3280430 TI - [Rare lesion of the median nerve caused by elbow dislocation with avulsion of the epicondylus humeri medialis in childhood]. AB - A case of posterior dislocation of the elbow complicated by intraarticular entrapment of the median nerve is reported. Sixteen cases have previously been described in the literature. The mechanism of the injury is discussed. Early exploration of the nerve is advised when signs of median nerve deficit persist following reduction of the dislocated elbow. PMID- 3280431 TI - [Anti-idiotypic antibodies vaccines]. PMID- 3280432 TI - [Approaches for reconstruction after mastectomy]. PMID- 3280433 TI - [Vacuum or forceps?]. PMID- 3280434 TI - [Fulminant hepatitis in Wilson's disease--diagnostic and therapeutic problems]. PMID- 3280435 TI - [Problems and potential solution associated with use of sodium nitroprusside for hypotension in anesthesia]. PMID- 3280436 TI - [Atypical rickettsial disease]. PMID- 3280437 TI - [New strategies in the treatment of osteogenic sarcoma]. PMID- 3280438 TI - [New drugs for deliberate hypotension in anesthesia]. PMID- 3280439 TI - [Genetic factors in schizophrenia]. PMID- 3280440 TI - [Guillain-Barre syndrome: neurological and rehabilitational aspects]. PMID- 3280441 TI - [Neisseria infections in hereditary complement deficiency]. PMID- 3280442 TI - [Nonimmune fetal hydrops]. PMID- 3280444 TI - [AIDS and the gastrointestinal tract]. PMID- 3280443 TI - [Clinical significance of antibodies to SM and RNP]. PMID- 3280445 TI - Atraumatic avascular necrosis of the head of the talus: a case report. AB - Avascular necrosis of the talus has frequently been reported following trauma. The incidence of avascular necrosis has been reported to be as high as 50% for Hawkins Type II talar fractures and to range from 75-100% for Type III fracture dislocations. The resultant avascular necrosis has been reported to occur primarily in the body and dome of the talus with apparent sparing of the head of the talus. The close association of trauma to avascular necrosis of the talus has been alluded to by Cobey and others. Reports of avascular necrosis of the talus, without an antecedent history of trauma, have been rare. This paper presents a case of atraumatic avascular necrosis of the talar head. PMID- 3280446 TI - Giant cell tumor of the metatarsal. AB - The following is a report of a giant cell tumor of a metatarsal, description of treatment, and review of the literature. Giant cell tumors comprise approximately 5-8% of the primary bone tumors. Metatarsal bones are a very rare primary site of involvement. Clinically aggressive or benign behavior cannot be predicted histologically. Treatment should be aggressive, as in this case where en bloc resection and bone graft were performed. Results were excellent with 4 yr follow up. PMID- 3280447 TI - 'Stranger' child-murder: issues relating to causes and controls. AB - Most industrialised countries are concerned with a perceived increase in the killing of children and adolescents by strangers. Though reliable statistics are lacking, the growth of serial murder suggests that more young persons may be at risk than ever before. Explanations, either of a psychological or sociological kind, of child murder by strangers are inadequately developed. Despite the tendency to see such killers as psychiatrically ill a number of studies suggest that the majority of offenders do not differ significantly, at least in psychological traits, from non-offenders. Subcultural and other sociological perspectives stressing "social disadvantage" have low levels of exploratory power and do not assist greatly in understanding child killings. Despite sketchy and contradictory evidence on the effects of the media on sexual and violent crime case study material supports the view that pornography, including popular music, may increase the propensity of individuals to commit atrocities. Counter-measures to control stranger child killing lie in more sophisticated law enforcement (profiling and computer links between police forces) long periods of incarceration of the offender and more sophisticated analyses of the crimes. PMID- 3280448 TI - Vitamin D binding protein (Gc) subtypes by isoelectric focusing and immunoblotting. AB - The polymorphism of the human vitamin D binding protein (Gc system) was investigated in a total of 149 sera from unrelated healthy Egyptians residing in Tanta City, Gharbiya Governorate, Nile Delta of Egypt, using isoelectric focusing (IEF) in thin-layer polyacrylamide gel followed by immunoblotting. The estimated gene frequencies were Gc1s = 0.540, Gc1f = 0.242 and Gc2 = 0.218. PMID- 3280449 TI - [Therapy of rheumatic disease of the future. A critical review of trends and new developments]. PMID- 3280450 TI - [Antimycotic sensitivity of yeasts from the intestinal tract. Comparative studies with the serial dilution test and disk diffusion test]. PMID- 3280451 TI - [Silent myocardial ischemia]. PMID- 3280452 TI - Hospitals fail to post productivity gains. PMID- 3280453 TI - Trouble ahead: PPS outpatient radiology limits. PMID- 3280454 TI - Business plan key to selecting an alliance. PMID- 3280455 TI - Gain public support for adequate payment. PMID- 3280456 TI - More Medicare audits planned for FY 1989. PMID- 3280457 TI - Medicare PPO demonstration plans detailed. PMID- 3280458 TI - Hospitals fight PPS rates with financial data. PMID- 3280459 TI - Medicare losses lower margins: HFMA study. PMID- 3280460 TI - New gallstone treatment intrigues hospitals. PMID- 3280461 TI - External data can improve strategic planning. PMID- 3280462 TI - A robot with improved absolute positioning accuracy for CT guided stereotactic brain surgery. PMID- 3280463 TI - Microcomputer-aided insulin dose determination in intensified conventional insulin therapy. PMID- 3280464 TI - Artificial sensing skin mimicking mechanoelectrical conversion properties of human dermis. PMID- 3280465 TI - Mental health effects of women's multiple roles. PMID- 3280466 TI - Occupational health hazards for nurses: infection. PMID- 3280467 TI - Genetic and environmental regulation of the cytolytic T lymphocyte receptor repertoire specific for alloantigen. PMID- 3280468 TI - T cell selection in the thymus. PMID- 3280469 TI - The participation of B cells and antibodies in the selection and maintenance of T cell repertoires. PMID- 3280470 TI - The T-cell receptor for antigen in T-cell development and repertoire selection. PMID- 3280471 TI - T-cell specificity and repertoire. PMID- 3280472 TI - Role of recombinant interleukin-1 compared to recombinant T-cell replacing factor/interleukin-5 in B-cell differentiation. AB - The B-cell differentiation-inducing activity of interleukin-1 (IL-1) was compared with that of T-cell replacing factor (TRF)/interleukin-5 (IL-5), which was originally described as a late-acting B-cell differentiation-inducing factor. Human recombinant IL-1 and murine recombinant TRF/IL-5 were used in this study. Purified B cells from non-primed or antigen-primed mice, LPS-stimulated B-cell blasts, and chronic B-cell leukaemia (BCL1) cells were used as the responding B cell population. Addition of IL-1 to the culture of normal B-cells and sheep red blood cells (SRBC) induced a dose-dependent anti-SRBC IgM response, with maximal response at 100 U/ml, whereas the response induced by TRF/IL-5 was less than that induced by IL-1 and did not reach the maximum even at 100 U/ml. Addition of anti IL-1 antibody, but not anti-TRF/IL-5 antibody or anti-IL-2 receptor antibody, inhibited IL-1-induced anti-SRBC responses. Depletion of cells adherent to Sephadex beads from splenic B cells showed no significant effect on the magnitude of the total responses. IL-1 could induce little, if any, differentiation in antigen-primed B cells, LPS-stimulated B-cell blasts, or BCL1 cells into antibody secreting cells, whereas differentiation could be induced by low doses of TRF/IL 5 (1-2 U/ml). Of great interest is that suboptimal doses of IL-1 (10 U/ml) could synergize with TRF in the primary anti-SRBC PFC responses. Kinetic studies revealed that IL-1 acts on B cells for the first 2 days and TRF/IL-5 for the last 3 days in 5-day cultures of B cells. These results suggest that IL-1 acts primarily on resting B cells as a differentiation-inducing factor in the presence of antigen, and also acts as a 'priming' factor for TRF/IL-5. PMID- 3280473 TI - Lung transplantation in the rat: a model for study of the cellular mechanisms of allograft rejection. AB - Single-lung transplantation in the rat has been shown to provide an effective model for the study of cellular events associated with allograft rejection. It is possible to recover sufficient viable immune cells for functional immunological studies by lavage of the broncho-alveolar space of the grafts with tissue-culture medium. These cells are representative of the population within the parenchymal infiltrate, but are not exposed to harsh, potentially damaging, physical and chemical conditions during their extraction. Lavage-derived cells from non immunosuppressed recipients showed donor-specific cytotoxicity, were clonable by limiting dilution culture, and proliferated in response to 24-hr stimulation with recombinant IL-2. Administration of Cyclosporin A (CsA) prevented pulmonary rejection and was also shown to block the formation of specific cytotoxic effector cells and the development of responsiveness to IL-2. PMID- 3280474 TI - The influence of Peyer's patches on the organ-specific distribution of IgA plasma cells. AB - After the surgical removal of Peyer's patches (PP) in rats, the IgA-containing cells in the thoracic duct, mesenteric lymph nodes and lamina propria of the small intestine are decreased, as shown by immunohistology. The analysis of the immunoglobulin secretion in agar of single-cell suspensions confirmed these results. Using lipopolysaccharide (LPS) 055B5 as antigen, it could be demonstrated that this reduction may be the result of an inadequate presentation of antigen and/or impaired migration of locally primed antigen (AG)-specific cells. The oral application of heat-inactivated Escherichia coli 055B5 to PP deprived rats resulted almost exclusively in anti-LPS-secreting cells in the mesenteric lymph nodes and spleen, whereas in control animals these cells were distributed along the intestine. Therefore, in rats PP have an important function in the regulation of the intestinal immune responses. PMID- 3280475 TI - Absence of any male-specific antigen recognized by T lymphocytes in X/XSxr' male mice. AB - Previous work has established that whereas X/X mice carrying the sex-reversing chromosomal fragment Sxr are positive for the male-specific transplantation antigen, H-Y, X/X mice carrying the variant Sxr', although they too develop as phenotypic males, are H-Y negative. In this paper we show that X/XSxr' male mice do not express any male-specific antigen that can induce skin-graft rejection. PMID- 3280477 TI - Monoclonal antibodies produced by in vitro immunization with sera of human xenotransplant-bearing mice. AB - In vitro immunization procedures, using sera of athymic mice bearing human WOC ovarian tumors or CM III mammary tumors as immunizing antigen, induced a highly efficient formation of mABs (44% of antibody-producing clones) reacting with human ovarian and/or mammary tumor cells. More than half of these mABs showed cross-reactivity with mouse cell lines. Immunogenicity of normal mouse components in the sera from tumor bearers can be excluded since control immunization with sera of normal athymic mice yielded no mABs reacting with mouse or human cell lines. Furthermore, immunization with sera from tumor bearers did not induce mABs only reacting with mouse cells since 20% of the antibody-producing clones showed an exclusive specificity for the human tumor cells. On the basis of these results we concluded that the human-mouse cross-reacting mABs were induced by circulating human TAA with epitopes shared by mouse cellular components. PMID- 3280476 TI - Non-co-ordinate expression of HLA-DR antigens and invariant chain. AB - The expression of HLA-DR and MHC class II antigen-associated invariant chain (Ii) was studied in normal colorectal mucosa, adenomas and carcinomas using monoclonal antibodies and a sensitive immunoperoxidase technique on frozen sections. In six of 15 specimens of normal mucosa, epithelial cells expressed Ii, but were unreactive for HLA-DR antigens. In 15/20 adenomas and 51/70 carcinomas, Ii positive tumour cells clearly outnumbered HLA-DR-positive tumour cells. Expression of Ii in non-neoplastic epithelium adjacent to carcinoma was much stronger than expression of HLA-DR. The results indicate that in certain tissues expression of these two antigens is not closely associated. PMID- 3280478 TI - Effector lymphocyte response to homologous tumor antigens in various stages of malignant disease as monitored by leukocyte adherence inhibition--cell mediated immunity (LAI-CMI). AB - Leukocyte adherence inhibition-cell mediated immunity (LAI-CMI) studies were performed on leukocytes obtained from patients with various stages of breast cancer, colon carcinoma and lung cancer in order to monitor cell mediated immunity during tumor progression. In the presence of autologous serum, all patients with localized tumors showed positive LAI-CMI indexes (greater than 20%), while significant reduction of homologous tumor antigen recognition as measured by the LAI-CMI responses was observed in nearly all patients with Stage IV breast cancer, Duke C colon cancer and Stage III lung cancer. On substituting autologous serum with normal AB serum, leukocytes from patients with large tumor burdens responded to homologous tumor antigens. These results indicate the existence of organ-specific serum factor(s) which may mask the receptor sites on effector cells for tumor recognition. Patients with such serum blocking factor(s) showed significant increase of IgG immune complexes IgM, IgA and alpha-2 macroglobulins. Application of a protein A affinity column purification resulted in a major reduction of IgG and other immune globulins but not of alpha-2 macroglobulin. The blocking effects of autologous serum, however, were not completely abrogated by filtration on the protein A column, thus suggesting that SBF may be heterogeneous in nature and may occur in other serum protein fractions beside the immune globulins. PMID- 3280480 TI - Mechanism of inhibition of human renin by monoclonal antibodies. AB - The mechanism by which monoclonal antibodies directed against human renin (R3-36 16 and R3-47-10) inhibit renin activity was investigated using various substrates. Both antibodies acted as potent inhibitors of human renin activity when human angiotensinogen was used as a substrate. However, their effects differed clearly in the presence of synthetic tetradecapeptide. When low concentrations of tetradecapeptide were used as substrate, renin activity was only partially inhibited by R3-47-10, whereas it was stimulated by R3-36-16. At higher synthetic substrate concentrations, both antibodies stimulated angiotensin I production. This effect was independent of the pH. Both antibodies exerted their effects in the presence of CGP 29287, a peptidic transition-state competitive renin inhibitor, indicating that their binding sites differed from that of CGP 29287. In combination, the stimulatory effect of R3-36-16 was not blocked by R3-47-10, but the inhibition produced by R3-47-10 was reversed by R3 36-16. Both antibodies may prevent the large natural substrate angiotensinogen from entering the enzymatic cleft by steric hindrance. At a low substrate concentration, R3-47-10 may also partially hinder the access of synthetic tetradecapeptide into the active cleft by steric hindrance. In contrast, the stimulating effect of both antibodies may be due to a conformational change in the renin molecule, allowing an increased access of tetradecapeptide or a more rapid release of the product from the enzymatic cleft. PMID- 3280479 TI - Antibodies to diethylcarbamazine cross-react with microfilariae of Wuchereria bancrofti. AB - Antibodies directed against the microfilarial sheath have been instrumental in the immune elimination of circulating microfilariae in human lymphatic filariasis. We report here that antibodies to diethylcarbamazine (DEC, the most commonly used anti-filarial drug) cross-react with the sheath of Wuchereria bancrofti microfilariae. Antibodies with reactivity to DEC were raised in rabbits by immunization with a conjugate of methylpiperazine carboxylic acid (MPCA, an acid hydrolysis product of DEC) coupled to bovine serum albumin. The reactivity of these antibodies with microfilarial sheath of W. bancrofti was demonstrated by indirect immunofluorescent assay and indirect immunoperoxidase assay. This reactivity could be effectively inhibited by pre-incubation of the antisera with different haptens such as DEC, MPCA or piperazine citrate. PMID- 3280481 TI - The effect of captopril on renal blood flow in renal artery stenosis assessed by positron tomography with rubidium-82. AB - The sequence and magnitude of acute changes in renal blood flow following administration of captopril were determined in a canine model of acute unilateral renal artery stenosis using rubidium-82 and positron emission tomography. Data were recorded in each of nine dogs under three conditions: 1) during a baseline control interval, 2) during renal artery stenosis, and 3) during stenosis with intravenous injection of captopril (1.2 mg/kg). Mean arterial blood pressure was 108 +/- 12 mm Hg at control, increased significantly to 125 +/- 13 mm Hg (p less than 0.01) during stenosis, and decreased to 98 +/- 13 mm/Hg (p less than 0.01) after captopril infusion. Mean renal blood flow was calculated using a steady state single compartment model from the images produced by positron emission tomography. The estimated flow to the affected kidney was 3.37 +/- 1.48 ml/min/g at control, 0.86 +/- 0.62 ml/min/g during stenosis (p less than 0.01), and 0.64 +/- 0.57 ml/min/g after captopril administration (p = NS compared with precaptopril value). The estimated flow to the contralateral kidney was minimally reduced from a baseline of 3.84 +/- 0.95 to 3.24 +/- 1.13 ml/min/g (p = NS) during stenosis and increased after captopril infusion (4.08 +/- 0.94 ml/min/g; p = 0.01). These data suggest that repetitive imaging with positron emission tomography can be used to delineate acute changes in renal perfusion following captopril administration. PMID- 3280482 TI - Local generation and release of angiotensin II in peripheral vascular tissue. AB - Isolated rat hindlegs were perfused with Krebs-Ringer solution, and immunoreactive angiotensin II (irAng II) released into the perfusate was directly determined using a Sep-Pak C18 cartridge connected to the perfusion system. High performance liquid chromatography clearly demonstrated the presence of angiotensin I (Ang I), angiotensin II (Ang II), and a small amount of angiotensin III. The spontaneous release of irAng II was as high as about 600 pg/30 min, which was stable up to 3 hours. Captopril added to the perfusion medium (10(-9) to 10(-6) M) suppressed irAng II release in a dose-dependent manner (p less than 0.001), and it (10(-6)M) caused a reciprocal increase of irAng I release (p less than 0.05). Oral pretreatment of captopril (50 mg/kg/day) for 1 week suppressed the irAng II release by 31% (p less than 0.02). The same treatment with SA 446, a highly lipophilic angiotensin converting enzyme inhibitor, inhibited the irAng II release by 63% (p less than 0.001). On the other hand, the two inhibitors suppressed the plasma irAng II to very similar extents. Pretreatment with SA 446 plus nephrectomy did not cause any further change in irAng II release as compared with that with SA 446 alone. These results provide direct proof for local generation and subsequent secretion of Ang II by peripheral vascular tissue. PMID- 3280483 TI - Effect of a low fat diet on carbohydrate metabolism in patients with hypertension. AB - Plasma glucose and insulin responses to both a 75-g oral glucose challenge and to conventional meals were determined in eight patients with hypertension and compared with values of a control population. The results indicated that patients with hypertension had significantly higher than normal plasma glucose and insulin concentrations in both situations. Furthermore, when dietary carbohydrate was increased by 16% of total calories (with a reciprocal reduction in dietary fat), the hyperglycemia and hyperinsulinemia present in patients with hypertension were accentuated. Since low fat-high carbohydrate diets are usually recommended for patients with hypertension, these data suggest that abnormalities of glucose and insulin metabolism associated with hypertension would be increased if patients with high blood pressure followed conventional dietary advice. Since hyperglycemia and hyperinsulinemia have been shown to be associated with an increased risk of developing coronary artery disease, it may be appropriate to reevaluate the clinical utility of low fat-high carbohydrate diets in the treatment of hypertension. PMID- 3280485 TI - Drug interactions in hypertension. AB - Interactions between drugs and antihypertensive agents can result in either increased or decreased antihypertensive effects. These interactions may be pharmacokinetic or pharmacodynamic in type, resulting in either altered plasma drug concentrations or altered drug effects at similar plasma concentrations. Drugs may limit the absorption of antihypertensive agents, alter their metabolism through either enzyme inhibition or induction, or change renal excretion. In addition, by altering cardiovascular and volume homeostasis, changes in antihypertensive response may be produced. PMID- 3280484 TI - A comparison of the random-zero and standard mercury sphygmomanometers. AB - Both the standard mercury sphygmomanometer and the random-zero sphygmomanometer have been used in epidemiological studies and clinical trials. Problems arise in comparing studies since, in addition to other methodological differences, the readings obtained with the random-zero sphygmomanometer have been found to be lower than those obtained with the standard mercury sphygmomanometer. In the present study, blood pressures were measured in 66 subjects to examine the comparability of findings with the two instruments. Trained observers measured blood pressures simultaneously using a double-headed stethoscope and one cuff connected to the two sphygmomanometers. Use of instrument was randomly assigned for each blood pressure measurement; each observer was unaware of the other's blood pressure reading. Readings were lower with the random-zero sphygmomanometer; mean difference ranged from 2.5 to 3.3 mm Hg for systolic pressure and 1.9 to 2.7 mm Hg for diastolic pressure. Digit distributions recorded by the two observers for the standard mercury sphygmomanometer and the random-zero sphygmomanometer were not significantly different for either systolic or diastolic blood pressure. Intraindividual variation was greater with the random-zero sphygmomanometer than with the standard mercury sphygmomanometer. These data do not indicate that one instrument is clearly superior to the other, although in studies where the observer seeks to reduce the bias of multiple readings per person, the random-zero sphygmomanometer may be the more appropriate instrument. Critical to the use of either instrument are careful training, standardization, certification, and periodic recertification of observers. PMID- 3280486 TI - Oral contraceptives and hypertension. AB - Oral contraceptives result in a mild elevation of blood pressure in most women and overt hypertension in about 5%. Both estrogen and progestogen are responsible for the blood pressure effect, but the mechanism is as yet unknown. The risk of cardiovascular complications is found primarily in women over 35 years of age and in those who smoke. Preparations with an estrogen content of 30 g and a progestogen content of 1 mg or less appear to be safe. PMID- 3280487 TI - Diuretics and their side effects. Dilemma in the treatment of hypertension. AB - Diuretics have traditionally been the keystone of antihypertensive therapy. A variety of clinical trials, designed to examine the benefit of blood pressure reduction in decreasing morbidity and mortality from hypertension-related cardiovascular disease, have surprisingly failed to show a decrease in coronary artery disease death rate, although other forms of vascular disease were impressively reduced. These trials have consistently used diuretics as the initial therapeutic choice. Such observations have stimulated a reevaluation of the "stepped-care" approach and a critical appraisal of diuretic effects. This review examines the efficacy of diuretics in reducing blood pressure and attempts to identify individuals most likely to respond to these agents. The side effects of diuretic therapy are reviewed in hemodynamic, cardiac, metabolic, and symptomatic terms, but because some of these aspects of diuretic or antihypertensive therapy are detailed elsewhere in this monograph, the present discussion focuses on cardiac, metabolic, hemodynamic, and symptomatic effects. Finally, alternative therapeutic options and guidelines for therapy are outlined. PMID- 3280488 TI - Side effects of sympatholytic antihypertensive drugs. AB - Antihypertensive drugs with pharmacological action due to sympatholytic activity have been second only to diuretics in their use and efficacy in normalizing blood pressure. Their pharmacological actions have resulted in the notable absence of chemical toxicity, but because of symptomatic side effects, their use has been limited relative to some of the newer antihypertensive agents. Most prominent among undesirable side effects are the central nervous system findings of sedation, altered thought process, depression, and orthostatic or exercise hypotension. Sexual problems, especially in men, are also prominent. Special toxicity is discussed with reference to methyldopa, clonidine, monoamine oxidase inhibitors, and metyrosine. PMID- 3280489 TI - Side effects of vasodilator therapy. AB - Vasodilating antihypertensive drugs have in common the capacity to activate the peripheral sympathetic nervous system through the carotid sinus baroreceptor reflex mechanism, thereby increasing heart rate, renin release, and sodium and water retention. They differ in their tendencies to augment cardiac output and to relieve or precipitate cardiac failure and arrhythmias. Vasodilating antihypertensive drugs can produce an array of side effects and toxicity including headache, facial changes, hair growth, varying degrees of sodium and water retention, and rarely systemic lupus erythematosus and allergic reactions. Detailed knowledge of these effects is a prerequisite to skillful individualization of antihypertensive regimens. PMID- 3280490 TI - Angiotensin converting enzyme inhibitors. Properties and side effects. AB - The purpose of this brief review is to separate the characteristic properties and side effects attributable to the pharmacology of the whole class of angiotensin converting enzyme (ACE) inhibitors from those attributable to the chemical structure and kinetics of each particular ACE inhibitor. The former would be predictable and probably similar for all agents and, therefore, would be expected to recur with each agent, whereas the latter are likely to be characteristic of individual compounds and may be avoidable by changing to another compound with similar pharmacology but different molecular structure. PMID- 3280492 TI - Side effects of calcium channel blockers. AB - Calcium channel blocking drugs are a chemically heterogenous group, so it might be expected that their effects on vascular smooth muscle, cardiac contractility, and conduction tissue may differ. However, the majority of adverse reactions are predictable from their pharmacological actions and may be conveniently grouped in the following categories: 1) vasodilatation, 2) negative inotropic effects, 3) conduction disturbances, 4) gastrointestinal effects, 5) metabolic effects, and 6) drug interactions. Vasodilatory symptoms, namely, dizziness, headaches, flushing sensation, and palpitation, are more likely with nifedipine. Peripheral edema is also common with nifedipine, but the mechanism is uncertain. For a given degree of vasodilation, the greatest negative inotropic effect is seen with verapamil first, diltiazem second, and nifedipine last. Calcium channel blocking drugs are contraindicated in hypertensive patients with second and third degree heart block, sick sinus syndrome, and severe heart failure. Verapamil and diltiazem have a significant effect on cardiac conduction, whereas nifedipine, in therapeutic doses, does not. Local gastrointestinal symptoms, such as nausea and constipation, are common with verapamil. None of the calcium channel blocking drugs have been reported to adversely affect lipid or protein metabolism. However, nifedipine, verapamil, and diltiazem in high doses may inhibit liberation of insulin. The significance of this finding needs to be explored further in hypertensive diabetics. Serum digoxin levels have been shown to increase after administration of verapamil and nifedipine, but there is no evidence that this change has any clinical relevance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280491 TI - Antagonism of antihypertensive drug therapy by nonsteroidal anti-inflammatory drugs. AB - Certain nonsteroidal anti-inflammatory drugs antagonize the action of antihypertensive therapy. Indomethacin has been shown to abrogate the antihypertensive effect of beta-adrenergic receptor blockers, diuretics, converting enzyme inhibitors, and several antihypertensive drug combinations, and the accumulated evidence on piroxicam indicates that it also raises arterial pressure in treated patients. In contrast, sulindac and aspirin do not reverse the effects of antihypertensive drugs, and currently available data indicate that they are the safest cyclooxygenase inhibitors for use in hypertensive patients. In the absence of definitive information on the array of other nonsteroidal anti inflammatory drugs, they should be considered to pose a risk similar to indomethacin until proved otherwise. The magnitude of the elevation in blood pressure varies between patients, ranging from no effect to dangerous hypertensive responses. Generalized inhibition of the cyclooxygenase enzyme has opposing effects on arterial pressure, lowering renin on one hand and causing sodium retention on the other. Some evidence suggests that cyclooxygenase inhibition causes the greater increments in pressure in patients who initially have low plasma renin activity (often the elderly). The potential for cerebral vascular catastrophes attends these drug interactions in which platelet function also is suppressed by cyclooxygenase inhibition. PMID- 3280493 TI - Hypertension, antihypertensive treatment, and sudden coronary death. The Framingham Study. AB - During 30 years of follow-up, there were 183 sudden deaths in men and 77 in women ages 35 to 94 years who participated in the Framingham Study. Risk of sudden death was increased threefold in hypertensive persons but only if there was no previously diagnosed coronary heart disease. Men receiving antihypertensive treatment had more than twice the risk of sudden death compared with those who were untreated, whether or not they had prior manifestations of coronary heart disease. More than twice as many men who died suddenly were receiving antihypertensive therapy compared with those in the population at risk of the same age. In those with overt coronary heart disease, 34% of those dying suddenly were on antihypertensive treatment compared with 18% of those of the same age in the general population. Multivariate analysis taking into account the level of blood pressure, electrocardiographic abnormalities, and previously diagnosed coronary heart disease and cardiac failure, all of which are predisposing factors for sudden death, indicated a persistent increased risk of sudden death in association with antihypertensive treatment. Tests of interaction indicate that the excess sudden death risk was not confined to those with electrocardiographic abnormalities. In women, it may be associated with diabetes. These data suggest that some feature of antihypertensive treatment as practiced in the general population may contribute to sudden death incidence in an ill-defined subgroup of hypertensive persons. PMID- 3280494 TI - Compliance and chronic disease. AB - The shifting demographics of the population and increasing skill in treatment of chronic disease in this country have combined to make compliance a topic of greater salience than ever before. General issues of compliance are a necessary background to specific issues of compliance with regimens for single diseases such as hypertension. The definition of compliance continues to be modified, and examination of past work reveals certain consistencies in studies of compliance. Non-compliance is higher in chronic conditions, in activities requiring change in life-style, and in clinician-initiated visits. Noncomprehension of instructions is held to be the most frequent cause of noncompliance. Noncompliance is a threat to the course of treatment, increases unnecessary diagnostic procedures, and confounds evaluation of effectiveness. Factors related to compliance have been identified with regard to certain patient and disease characteristics, amount of support in the immediate environment, and the nature of the doctor-patient relationship. Older patients are often at greater risk in understanding regimens because clinicians educate this group less often, because symptoms are misunderstood by both patient and provider, and because of greater complexity in both conditions that are being treated and number of drugs and other aspects of treatment required. Methods of improving the doctor-patient relationship have been urged most recently as a means through which compliance can be increased. PMID- 3280495 TI - Compliance and blood pressure control. AB - Compliance with medical therapy in general is often low, and compliance with blood pressure treatment is no better. Numerous studies have shown that patients frequently drop out of treatment for hypertension. Furthermore, even when patients stay in treatment, they often take their medications in a way quite dissimilar from that prescribed. Identifying noncompliant patients is important but not always easy to accomplish. Pill counts, the "gold standard," are seldom practical in routine clinical practice. Assessing compliance by its biological effect is compromised by physiological diversity among patients. Assessing compliance from patient self-reports is limited in its accuracy but is more useful than many researchers and clinicians appreciate. Compliance behavior is affected by many factors. Complexity of medical regimen has some effect; the presence of drug side effects has surprisingly little. Contrary to what many clinicians think, increased age is often accompanied by increased medication compliance. Features of the doctor-patient relationship likely have an important effect on patient compliance, though our knowledge of these factors is still limited. PMID- 3280496 TI - Classification of resistant hypertension. AB - Resistant hypertension has become a less frequently encountered clinical problem. It may be defined as failure to control pressure below levels of 160/100 mm Hg despite adequate nonpharmacological intervention and pharmacotherapy. Adequate therapy is defined as the use of three antihypertensive agents, which includes a diuretic plus two other compounds. Resistant hypertension may be classified as physician resistant, patient resistant, and hypertension resistant. Each of these categories is described, and resolution of the problem of resistance can usually be achieved by improved patient education and adherence to therapy, reevaluation of diagnosis, and consideration of alternative therapeutic programs. PMID- 3280497 TI - Phenylpropanolamine and other over-the-counter vasoactive compounds. AB - Phenylpropanolamine is a sympathomimetic amine that shares structural similarities with amphetamine and ephedrine. It increases blood pressure primarily by increasing peripheral vascular resistance. This effect is the result of alpha-adrenergic agonist activity largely from both direct stimulation of adrenergic receptors and release of neuronal norepinephrine. As such, it has the potential to interact with other drugs to produce toxic reactions, especially in treated hypertensive patients. Complications have occurred with single oral doses that suggest some normal subjects may be more sensitive to the drug than others. The incidence of serious complications in the general population is small but could be much higher in susceptible individuals (e.g., cardiomyopathic and hypertensive patients). The availability of high-dose phenylpropanolamine containing preparations without medical supervision is potentially dangerous, and certain restrictions should be imposed on such preparations. PMID- 3280498 TI - The patient with resistant hypertension. Cations, volume, and renal factors. AB - Hypertension that is truly resistant to modern antihypertensive therapy is uncommon. In the majority of cases, apparent resistance is more likely associated with poor patient adherence, interacting drugs, drug interactions, and inappropriate drug dosages. Sodium and fluid volume play a major role in resistant hypertension. There is considerable evidence to support the role of dietary sodium restriction in successful nonpharmacological treatment of hypertension. Salt sensitivity in humans appears to represent at least one factor determining individual susceptibility to variable salt intakes. Sodium and water retention may lead to refractoriness to many antihypertensive agents, and there is evidence to suggest that extracellular fluid volume expansion also plays a role in many hypertensive patients. While retention of sodium and water is well established early in patients with renal parenchymal disease, hypertension associated with progression of renal parenchymal disease is complicated by other factors that include interactions between hemodynamic and humoral factors, functional changes in adrenergic responses, and structural vascular disease. The role of other cations such as potassium, calcium, and magnesium in resistant hypertension has yet to be established. PMID- 3280499 TI - Factors that contribute to resistant forms of hypertension. Pharmacological considerations. AB - Treatment failure may be caused by induction of compensatory mechanisms that compromise effectiveness of the antihypertensive regimen. Antihypertensive agents have been classified according to mechanism of action, and compensatory mechanisms usually evoked by each class of drugs have been reviewed. Host factors may be responsible for the inability to control blood pressure or may predict special sensitivity or contraindication to a particular class of antihypertensive agents. Recommendations have been made for modification of stepped-care regimens and selection of initial antihypertensive agents based on host factors. Experimental evidence suggests the ability to target antihypertensive therapy in a manner that will prevent or reverse specific end-organ damage. Clinical studies are needed to define the long-term benefit derived from aggressive target organ protection. PMID- 3280500 TI - Blood pressure monitoring outside the office for the evaluation of patients with resistant hypertension. AB - Although severe hypertension is associated with a poor prognosis, there exists a substantial number of patients who have persistently elevated blood pressures, but no signs of target organ damage, and nearly normal life expectancy. In such cases, measurement of blood pressure outside the clinic may give readings that are as much as 30 mm Hg lower than the clinic readings. The first step recommended in the identification of such patients is to use home blood pressure monitoring. If home blood pressures are low, 24-hour ambulatory blood pressure recording is indicated. If this also gives low readings, it is appropriate to treat patients according to their level of home blood pressure. Because of the unreliability of clinic pressures, ambulatory and home blood pressure monitoring may also be of value in assessing the response to treatment. PMID- 3280501 TI - Beneficial effect of captopril on systemic lupus erythematosus-like disease in MRL lpr/lpr mice. AB - MRL lpr/lpr (MRL/l) mice exhibit a disease similar to systemic lupus erythematosus (SLE) in humans. To investigate the influence of antihypertensive treatment on this disease, four groups of MRL/l mice were treated with the angiotensin-converting enzyme inhibitor captopril (n = 25), with the sympathetic blocker bretylium (n = 15), and with cyclophosphamide (n = 10). Thirty-five mice did not receive any treatment and served as controls. Survival rate, blood pressure, incidence of proteinuria and hematuria, renal pathology, lymphoid hyperplasia and dermatitis were studied. The survival at the age of 36 weeks was significantly improved by captopril as compared to controls (60 vs. 25%, p = 0.035). The cyclophosphamide group showed no mortality at that time and the bretylium group did not differ from the control group. Captopril and bretylium reduced systolic blood pressure significantly while cyclophosphamide was without effect. Captopril and cyclophosphamide diminished significantly the glomerular damage with less proliferative changes and a decreased incidence of proteinuria. The bretylium-treated animals also exhibited an improved renal pathology index but they did not differ from the controls with respect to proteinuria and hematuria. Lymphoid hyperplasia and dermatitis were decreased only by captopril and cyclophosphamide. It is concluded that captopril improves survival in SLE disease of MRL/l mice, counteracting lymphoid hyperplasia, renal disease, dermatitis and decreasing arterial blood pressure. PMID- 3280502 TI - Antibody-dependent cell-mediated cytotoxicity against Tamm-Horsfall protein in acute pyelonephritis. AB - The cytotoxic activity of leukocytes from humans and rats with pyelonephritis were examined in an antibody-dependent cell-mediated cytotoxicity assay (ADCC) with CrCl3-treated erythrocytes coated with Tamm-Horsfall (TH) as target cells. The specificity of the ADCC was confirmed by absorption with TH urinary glycoprotein and inhibition of the ADCC activity seen with polyclonal rabbit anti TH antisera by monoclonal mouse antibodies. The ADCC activity detected in children with acute pyelonephritis was low in the initial phase of the disease, but increased significantly 9 days after the start of antibacterial treatment. In rats with experimental pyelonephritis, ADCC activity decreased significantly with increased duration of infection. Depletion of cells adhering to carbonyl iron led to higher ADCC activity. During the course of the infection the difference in ADCC activity between effector cell preparations depleted using carbonyl iron and those not depleted decreased. The decreased ADCC activity demonstrated during acute pyelonephritis may point to mechanisms operating to diminish the risk of tissue damage. PMID- 3280503 TI - Antibodies reactive with streptococcal peptidoglycan-polysaccharide complexes in rheumatic fever, subacute bacterial endocarditis and tuberculosis. AB - Serum antibodies reactive with streptococcal peptidoglycan-polysaccharide complexes (PG-PS) have been estimated by enzyme-linked immunosorbent assay in patients with acute rheumatic fever (ARF), tuberculosis (TB) and subacute bacterial endocarditis (SBE) compared with normal age- and sex-matched controls. IgG2 and IgG3 were the predominant subclasses of antibodies in TB and SBE, whereas in ARF IgG1, IgG2 and IgG3 antibodies were detected. IgG4 antibodies were detected only infrequently. Antibodies of the IgG subclasses were detected in a greater proportion of sera when the PG-PS antigen was further purified by extraction with sodium dodecyl sulphate. PMID- 3280504 TI - Studies on the formation of a unique cellular intermediate (EAC14256) from EAC142 and C56. AB - The binding reaction of C56 to EAC142 was studied. The following was observed: (1) C56 can bind to EAC142, without participation of C3 or C7, to form EAC14256; (2) the efficiency of EAC14256 formation from EAC142 and C56 depends highly on the ionic strength of the buffer; (3) EAC14256, generated from EAC142 and C56, decays spontaneously by elution of C56 into the medium and thus the reaction between C56 and EAC142 is reversible; (4) the receptor on EAC142 for C56 is C2 or C42 on the cell surface, and (5) the binding of C56 to C2 or C42 on cells is independent of the usual (C3-dependent) complement cascade activation. These observations, together with the results of our previous report, indicate that the binding of C56, generated from the activation of C5 by C42 (without C3), to EAC142 may be the initial step of membrane attack complex formation in C3 independent immune hemolysis. PMID- 3280505 TI - Comparative outcome in time-limited individual and group psychotherapy. PMID- 3280507 TI - Lymphocyte targeting with 111In-labelled monoclonal antibodies. AB - In vitro tests were conducted using human T and B cell lines, as well as whole blood, to establish the usefulness of 2 murine monoclonal antibodies (MAbs), an anti-CD5 (Pan T) and a Pan B, for potential radioimmunolocalization and therapy. Both MAbs showed specificity for the cell line in question as tested by indirect immunofluorescence and radioimmunoassay. Assays carried out on whole blood showed 40-70% of the added activity of 111In-labelled Pan B antibody binding to B cells and 20-24% of 111In-Pan T antibody binding to T cells. The amount of internalised 111In-labelled Pan B was 6% of total amount at 24 hr indicating a slow internalisation process. These results should allow for in vivo targeting of normal and neoplastic B and T cells. PMID- 3280506 TI - Gd-25 DTPA-MAb, a potential NMR contrast agent for MRI in the xenografted nude mouse: preliminary studies. AB - Monoclonal antibodies (MAbs) 19-9 and 73-3 specific for human colon adenocarcinoma were labelled with a high number of gadolinium atoms. Twenty five DTPA were chelated per MAb, with only slight loss of immunoreactivity. The NMR contrast agent Gd-25 DTPA-MAb 19-9 or 73-3 ([Gd] 17 mumole/kg, [MAb] 60 microM) was injected into nude mice bearing human colon adenocarcinoma (SW948). Tumours were removed 24 hr after injection and T1 was measured in vitro. T1 relaxation time varied according to MAb specificity against tumour targets; T1 decreased 20% for MAb 19-9 and MAb 73-3 with SW948 tumour. Imaging was performed with this model. Very good contrast was obtained 24 hr after Gd-25 DTPA-MAb injection. PMID- 3280508 TI - Radiation-induced potentially lethal damage: DNA lesions susceptible to fixation. AB - The various postirradiation incubation conditions reported to uncover potentially lethal damage (PLD) induced by ionizing radiation are outlined and critically discussed. The process of damage fixation is the most characteristic determinant in distinguishing between PLD and other forms of damage (lethal or non-lethal). The results compiled indicate the induction of two forms of PLD (termed alpha- and beta-PLD). Evidence is presented that repair and fixation of alpha-PLD may underlie the variation in radiosensitivity observed through the cycle. Beta-PLD appears to be sensitive only to postirradiation treatment in anisotonic sale solutions. Results obtained at the DNA and chromosome level, under conditions allowing repair or causing fixation of PLD, are reviewed and combined together to devise a qualitative model that outlines a possible sequence of events from damage fixation at the DNA level, to damage fixation at the chromosome level and, ultimately, to cell death. It is suggested that damage uncovered at the cellular level as potentially lethal, comprises DNA dsb (single, pairs or groups) and that fixation is mediated by forces transmitted to the double helix through alteration (local or general) in chromatin conformation. Changes in chromatin conformation are caused either as a result of the cell's progression through the cycle or in response to a postirradiation treatment. The fixation process leads to the induction of chromosome aberrations. The validity of the concept of PLD in in vivo systems is shown, and the possible importance of PLD repair in radiation therapy is reviewed. The concept of PLD is compared to the concept of sublethal damage, and the possibility that similar molecular lesions underlie both types of damage is discussed. PMID- 3280509 TI - Laser Doppler flowmetry during hyperaemic reactions in the skin. AB - Laser Doppler flowmetry (LDF) was used to study skin blood flow in the finger tip and on the dorsum of the hand in healthy volunteers. Vasodilatation in the finger tip was induced by immersing the arm in water at 42 degrees C, and vasodilatation in the dorsum of the hand by intracutaneous injection of dihydralazine. Simultaneous measurements were performed using venous occlusion plethysmography (finger tip) and 133Xe clearance (dorsum of hand). Three output signals from the laser Doppler flowmeter were recorded. The LDFPf-1 value is linearly related to the blood flow, provided the concentration of blood cells in the scattering volume is low. The LDFPf-2 value is generated by a signal processor designed to give linearity even at higher concentrations of moving blood cells (CMBC), the latter quantity being reflected by the CMBC value. During vasodilatation by immersion, all laser Doppler values from the finger tip increased but less than the total finger blood flow as measured using venous occlusion plethysmography. Intracutaneous injection of dihydralazine in the dorsum of the hand caused markedly increased CMBC values and the increase in LDFPf-2 was significantly greater than that of LDFPf-1. The increase in 133Xe clearance was less pronounced. The results indicate that capillary blood flow as well as blood flow in vessels below the capillary level contribute to the Doppler signal. However, flow through the arteriovenous shunts in the finger tip seems to be only partially registered by the laser Doppler technique. The higher the CMBC value, the more obvious is the difference between LDFPf-1 and LDFPf-2 values. When using laser Doppler flowmetry, the addition of CMBC value registration may be helpful in clarifying changes in microvascular blood flow. PMID- 3280510 TI - [Posibilities for using high-resolution nuclear magnetic resonance spectroscopy and histotomography in tumors and metastases]. PMID- 3280511 TI - [Macroprolactinoma in a 16-year-old patient]. PMID- 3280512 TI - [Bone marrow necrosis in acute leukemias]. PMID- 3280513 TI - [Persistent diarrhea as a complication of gallstone disease]. PMID- 3280514 TI - [Thromboembolism complications and coumarin necrosis in a patient with congenital antithrombin III deficiency]. PMID- 3280515 TI - [A 27-year-old patient with fever, diarrhea and Plasmodium-negative hemolysis following a sojourn in Africa]. PMID- 3280516 TI - Osteoporosis detection. PMID- 3280517 TI - Energy expenditure in normal and diabetic man: the role of brown adipose tissue. PMID- 3280518 TI - Vertical distribution of soil removed by four species of burrowing rodents in disturbed and undisturbed soils. AB - Burrow volumes were determined in disturbed and undisturbed soils for four species of rodents in southeastern Idaho. Comparisons were made between soil types for the average volume and the proportion of the total volume of soil excavated from 10-cm increments for each species, and the relative number of burrows and proportion of total soil removed from beneath the minimum thickness of soil covers over buried low-level radioactive wastes. Burrows of montane voles (Microtus montanus) and deer mice (Peromyscus maniculatus) rarely extended below 50 cm and neither volumes nor depths were influenced by soil disturbance. Townsend's ground squirrels (Spermophilus townsendii) had the deepest and most voluminous burrows that, along with Ord's kangaroo rat (Dipodomys ordii) burrows, were more prevalent beneath 50 cm in disturbed soils. PMID- 3280519 TI - Sterility and efficiency of two methods of cardiac output determination: closed loop and capped syringe methods. AB - A prospective randomized study was done to compare the fluid contamination rates of two methods used to determine cardiac output by thermodilution under in-use conditions. Fifty patients were randomly assigned to have cardiac output measured by the capped syringe or closed loop method, and were followed with quantitative cultures of fluid and catheter. The two treatment groups (n = 25 each) were comparable in terms of age, sex, intensive care unit location, underlying diagnosis, and mean number of cardiac output determinations performed in the first 24 hours after placement of the catheter line. No differences in the rates of fluid contamination were seen at any time between the two groups. The overall fluid contamination rate was 2/124 cultures (1.8% with 95% confidence interval +/ 4.1%) with one colony of Staphylococcus epidermidis from a closed loop sample and one colony of Pseudomonas maltophilia in a capped syringe sample. Although no difference in contamination rates was documented, the closed loop system required less nursing time and effort. PMID- 3280520 TI - Acute orthostatic hypotension. AB - Acute orthostatic hypotension is a common occurrence during a patient's first experiences out of bed after surgery or a period of immobility. It is imperative that acute care nurses understand the dynamics of this phenomenon to provide effective preventive and supportive care for these patients. In this article are outlined recommendations for this care. Preventing acute orthostatic hypotension entails careful assessment of the status of the patient's sympathetic reflexes and assisting these reflexes to gain maximal control over peripheral vasoconstriction before the patient leaves bed. Supportive care during the patient's early experiences out of bed involves measures to reduce the likelihood of acute orthostatic hypotension, careful assessment of parameters that signal impending syncope, and immediate assistance for the patient who does experience it. On the patient's return to bed, evaluation of the patient's tolerance level assists in planning the patient's next venture out of bed. PMID- 3280521 TI - Asymptomatic coronary artery disease. AB - Asymptomatic coronary artery disease (ACAD) is a significant diagnosis that is documented in the current cardiology literature. This syndrome is characterized by myocardial ischemia without the typical anginal pain. Diagnosis must be specific, with the use of objective evidence of ischemic changes provided by ambulatory monitoring or exercise stress testing. It is the purpose of this article to review the current literature for the prognosis, the population at risk, and the recommended therapies for these patients. ACAD appears to occur in three different types of individuals. A type 1 person is totally asymptomatic, has no history of angina, myocardial infarction, or congestive heart failure, and demonstrates myocardial ischemia. The type 2 patient with ACAD is in the postmyocardial infarction period and demonstrates asymptomatic myocardial ischemia. The type 3 patient with ACAD is one who experiences myocardial ischemia both with and without pain. Nursing needs to provide support and guidance for the ACAD patient and family. Common nursing diagnoses have been outlined to assist in planning the care of this patient population. PMID- 3280522 TI - Gd-DTPA: an i.v. contrast agent for clinical MRI. PMID- 3280523 TI - Fundamental considerations in the design of fluorine-18 labeled progestins and androgens as imaging agents for receptor-positive tumors of the breast and prostate. PMID- 3280524 TI - [Laryngotracheoplasty in early childhood]. AB - Because of increased risk of surgery in infancy and because surgery at this age may affect laryngotracheal growth it is preferable to postpone open surgical correction of congenital or acquired laryngotracheal stenoses until pre-school or even school age. However, early intervention by one of the surgical methods available today appears to be justified if a child with a tracheostomy has unsatisfactory home surroundings, if the tracheostomy impedes a rehabilitation programme or if the laryngeal stenosis does not allow voice production. Of 42 children with congenital (14) or acquired (28) laryngotracheal stenosis, 13 were operated between the ages of 3 months and 6 years. The following surgical methods were used, depending on the type and degree of stenosis: (1) submucosal scar resection (5 cases); (2) "stepped incision" as described by Evans and Todd (2 cases); (3) widening of the anterior wall by an autogenous cartilage graft as described by Cotton (2 cases); (4) laminotomy with interposition of an autogenous cartilage graft as described by Rethi (3 cases); (5) multiple-staged laryngotracheal reconstruction with regional skin flaps and repeated cartilage grafting (1 case). The soft silicon Montgomery T tube was preferred in all cases for stenting the reconstructed laryngotracheal lumen, because it seems to be the most convenient and safest method. The importance of painstaking postoperative intensive care is emphasized. Up to now 11 patients have been extubated, but 4 of them show a mild restenosis. The history of one child who has not yet been decannulated is reported in detail to demonstrate the limits of laryngotracheoplasty in early childhood. PMID- 3280525 TI - [Experiences with B scan sonography as a diagnostic imaging procedure in the specialty of ENT]. AB - Our experiences with more than 1200 cases submitted to high resolution ultrasound examination during a one year period are described. The findings on B-scan sonography are compared to those for radiology. The reliability of both methods was checked by reference to histological findings and the course of the disease. The indications, capabilities and limits of high resolution ultrasound are discussed. PMID- 3280526 TI - [Significance of computerized tomography and sonography in the staging (TNM classification) of cancers of the tongue and floor of the mouth]. AB - Computerized tomography and sonography were used for pretherapeutic staging of 40 patients with cancer of the tongue. The size of the tumors and invasion of cervical lymph nodes were assessed, and both methods were compared in relation to the stage of the tumor. Clinical findings were amended by diagnostic imaging in 25% of the cases. There was a distinct preponderance of advanced stages. Ultrasonography proved superior to CT for T1 and T2 tumors. Full assessment of T4 tumors was feasible by CT only. We were able to develop a selective protocol for the use of CT and ultrasound scan based on the TNM classification. PMID- 3280527 TI - Comparison of five latex agglutination kits for detecting group A streptococcal antigen. PMID- 3280528 TI - Dermatofibroma protuberans: report of a case. PMID- 3280529 TI - Percutaneous cholecystostomy: case report and literature review. PMID- 3280530 TI - Dedication to Gilbert H. Fletcher, M.D. PMID- 3280531 TI - Radiotherapy alone in carcinoma of the intact uterine cervix according to G. H. Fletcher guidelines: a French cooperative study of 1383 cases. AB - A French Cooperative study of 1383 cases with invasive carcinoma of the intact uterine cervix treated with radiation therapy alone, using the guidelines provided by G. H. Fletcher led to the following conclusions: The techniques of treatment were easily reproducible in 9 French centers, working in a prospective cooperative study; Results similar to those of the original study were achieved in Stages I and IIA (MDAH substaging) with a locoregional failure rate of 7%; In Stage IIB, the locoregional failure rate of 16% is also comparable in both studies; Locoregional failures in Stage III are slightly lower than those reported in Houston, probably reflecting differences in patient's prognostic factors in France and Texas; The 5-year survival rate obtained in advanced Stages (UICC FIGO staging) are among the highest in the literature (76% in Stage IIb, 62% in Stage IIIa and 50% in Stage IIIb); The rate of severe complications remains acceptable and decreased throughout the study thanks to a better use of computer dosimetry. PMID- 3280533 TI - Is there a role for post-operative adjuvant radiation in breast cancer? Beautiful hypothesis versus ugly facts: 1987 Gilbert H. Fletcher lecture. PMID- 3280532 TI - The adjuvant role of two cycles of MOPP and low-dose lung irradiation in stage IA through IIB Hodgkin's disease: preliminary results. AB - Fifty-eight laparotomy-staged I and II patients with upper torso presentations of Hodgkin's disease and 8 patients with lymphangiogram-staged lower torso disease were treated with radiotherapy alone or with 2 cycles of MOPP and radiotherapy. Patients with upper torso disease with either no mediastinal or only small mediastinal disease without hilar involvement and with no "B" symptoms were treated with mantle radiotherapy alone. Patients with large mediastinal masses or hilar disease were treated with 2 cycles of MOPP followed by definitive mantle irradiation and low dose lung irradiation. Those for whom "B" symptoms were the only adverse prognostic feature received 2 cycles of MOPP and mantle radiotherapy. Patients with lower torso disease were treated with radiotherapy alone if the disease was limited to the pelvis. Those with more extensive disease received 2 cycles of MOPP prior to radiotherapy. The 4-year survival for all 66 patients was 97%. The corresponding disease-free and freedom from second relapse figures were 77% and 92%. Survival for the patients with unfavorable presentations who received 2 cycles of MOPP and radiotherapy was 100%. It was 92% for the group with favorable presentations who were treated with radiotherapy only. PMID- 3280534 TI - Planned preoperative irradiation in the management of clinical stage B2-C (T3) bladder carcinoma. AB - In recent years the role of planned preoperative irradiation in the management of clinical Stage B2-C (T3) bladder cancer has been questioned by a number of investigators. Much of the confusion regarding the efficacy of combined therapy results from studies that compare the results of treatment of pathological Stage B2-C patients treated by cystectomy alone versus clinical Stage B2-C patients treated by preoperative irradiation plus cystectomy. Such comparisons are biased because of (1) the exclusion of a large number of Stage D patients from cystectomy-alone series and their inclusion in preoperative irradiation plus cystectomy series and (2) the inclusion in the cystectomy-alone series of patients whose clinical stages were less than or equal to T2. The purpose of this paper is to compare the results of treatment in patients with clinical Stage B2-C bladder carcinoma following radical cystectomy alone versus preoperative irradiation plus cystectomy. This article reviews the rationale for administering preoperative irradiation, the effect of preoperative irradiation on the pathological specimen (including down-staging, the effect on regional lymph nodes, and radioresponsiveness according to tumor configuration, i.e., papillary vs. solid), the impact of preoperative irradiation on pelvic recurrence and 5 year survival, and the effect of preoperative irradiation on operative and postoperative complications. This paper cites all known literature on the subject in the English language. Data comparing 5-year survival results between radical cystectomy alone versus preoperative irradiation plus cystectomy are analyzed in three different ways: (a) retrospective comparisons of historical results, (b) review of the results of 6 randomized trials, and (c) comparison of concomitantly treated "modern-day" (1960-1980) series treated by either radical cystectomy alone versus preoperative irradiation plus cystectomy in 1185 patients. Preoperative results are also analyzed according to dose level (2000 rad versus 4000 rad versus 4500-5000 rad). The data presented indicate that the addition of preoperative irradiation to cystectomy for clinical Stage B2-C (T3) bladder cancer adds approximately 15 to 20 percentage points to the 5-year survival, leading to a survival figure that is approximately half-again that achieved by cystectomy alone. PMID- 3280535 TI - Gray-scale ultrasonography in the diagnosis of adrenal neoplasia in dogs: six cases (1981-1986). AB - In addition to survey abdominal radiography, 2-dimensional gray-scale ultrasonography was utilized as a non-invasive imaging mode in 6 dogs with adrenal neoplasia. Ultrasonography was a safe method of obtaining information about the organ of involvement, extra-adrenal extent of disease, vascular invasion or compression, and internal architecture of abdominal masses in the area of the adrenal gland. The data obtained ultrasonographically was determined to be useful in diagnosing adrenal neoplasia. PMID- 3280536 TI - Toward responsible use of the proper dosage of veterinary drugs. PMID- 3280537 TI - Administration of pharmaceutical preparations by extra-label routes: special considerations and potential pitfalls. PMID- 3280538 TI - Dynamics of preparation of parenteral and other drugs by veterinary practitioners. PMID- 3280539 TI - Whither now. PMID- 3280540 TI - The 1987 Mary E. Switzer lecture: The tapestry of rehabilitation, its weavers and threads. PMID- 3280541 TI - Rapid selective enumeration of bacteria in foods using a microcolony epifluorescence microscopy technique. AB - The growth patterns of microcolonies of 59 different pure cultures were studied on eight selective solid media. A method of growing microcolonies on the surface of polycarbonate membrane filters, placed on the selective agar media, followed by staining and examination by epifluorescent microscopy was developed. The patterns of growth of the pure cultures as microcolonies were studied on the eight selective media. Only four media proved to be reliable for this purpose and the relationship between the microcolony count and plate count was studied on these media together with nutrient agar. Microcolony counts using three of these media (enriched lauryl sulphate aniline blue, pseudomonas selective agar (C-F-C) and Baird-Parker medium) were capable of giving reliable estimates of coliforms (r = 0.89), pseudomonads (r = 0.93) and staphylococci (r = 0.92) after incubation at 30 degrees C for 3 or 6 h (staphylococci) at contamination levels of above 10(3) bacteria/g in a variety of foods. The results are available within a working day and should allow the more efficient management of food supplies. PMID- 3280542 TI - Evaluation of the Anderson Baird-Parker direct plating method for enumerating Escherichia coli in water. AB - The direct plating (DP) method for enumerating Escherichia coli in food was adapted for water analysis by membrane filtration and a standardized protocol was described. The DP method was found to give equal or better recoveries of E. coli than a membrane filtration method using 0.1% sodium lauryl sulphate agar; the repeatability of the DP method was markedly better. The necessity to transfer membranes from the non-selective medium tryptone soy agar (TSA) to the selective medium tryptone bile agar (TBA) after pre-incubation for 4 h was considered disadvantageous for practical purposes. A double-layer method, where the membrane filter is placed on a layer of TSA poured over TBA, with incubation in an incubator that automatically switches from 37 degrees to 44 degrees C after 4 h, was found to be an acceptable alternative. Recovery of E. coli and inhibition of competitive flora were equal or only slightly less than for the standard DP method. PMID- 3280543 TI - A method for the quantitative analysis of nerve growth in vitro. AB - A method is described for the quantitative analysis of the nerve-growth-promoting activity of biological molecules in tissue culture. The criteria used for the evaluation of this activity is based on the neurite length as well as the total number of neurites produced by the explant of whole dorsal root ganglia from 12-d old chick embryos. A nerve growth index (NGI) is given to each ganglion during each of a 5-d culture period. The NGI is defined as the product of average neurite length in millimeters and the total number of neurites. We report that with increasing concentrations of fetal bovine serum, there was a proportional increase in NGI due to increased neurite density while the neurite length was not greatly affected. The NGI of several proteins with known nerve growth promoting activity, namely nerve growth factor, insulin, transferrin, and fibronectin were investigated for their activity and compared with that of fetal bovine serum. PMID- 3280544 TI - In vivo test system for tumor production by cell lines derived from lower vertebrates. AB - The immune suppressed lizard, Anolis carolinensis, can be used to test for in vivo tumor production by cell lines derived from a variety of ectothermic vertebrates. Cell lines tested for tumor production were also assessed for loss of attachment-dependent proliferation and contact inhibition of cell overlap. The results demonstrate that the criteria standardly used to assess transformation and neoplastic change in cultured mammalian cells apply equally well to cultured cells from ectotherms. PMID- 3280545 TI - A rapid fluorometric DNA assay for the measurement of cell density and proliferation in vitro. AB - Many research efforts require the accurate determination of cell density in vitro. However, physical cell counting is inaccurate, time-intensive and requires removal of the cells from their growth environment, thereby introducing a host of potential artifacts. The current studies document a very simple method of determining cell density in microtiter wells via DNA-enhanced fluorescence. Fixed cells are stained with the A-T intercalating DNA stains DAPI or Hoechst 33342 and then fluorescence is quantified in a plate fluorometer. Fluorescence is shown to be linearly related to cell density as determined by two physical counting methods. The validity of the method is established in determining serum stimulated growth of smooth muscle cells and in mitogen-induced growth of endothelial cells. The fixed cells can be stored for prolonged periods, thus allowing time-course proliferation assays without interassay variations. The fixed cells are also suitable for determinations of antigens of interest by ELISA. This method is potentially valuable in many in vitro systems where the quantification of cell density and proliferation is necessary. PMID- 3280546 TI - Purification and properties of Escherichia coli dimethyl sulfoxide reductase, an iron-sulfur molybdoenzyme with broad substrate specificity. AB - Dimethyl sulfoxide reductase, a terminal electron transfer enzyme, was purified from anaerobically grown Escherichia coli harboring a plasmid which codes for dimethyl sulfoxide reductase. The enzyme was purified to greater than 90% homogeneity from cell envelopes by a three-step purification procedure involving extraction with the detergent Triton X-100, chromatofocusing, and DEAE ion exchange chromatography. The purified enzyme was composed of three subunits with molecular weights of 82,600, 23,600, and 22,700 as identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The native molecular weight was determined by gel electrophoresis to be 155,000. The purified enzyme contained 7.5 atoms of iron and 0.34 atom of molybdenum per mol of enzyme. The presence of molybdopterin cofactor in dimethyl sulfoxide reductase was identified by reconstitution of cofactor-deficient NADPH nitrate reductase activity from Neurospora crassa nit-I mutant and by UV absorption and fluorescence emission spectra. The enzyme displayed a very broad substrate specificity, reducing various N-oxide and sulfoxide compounds as well as chlorate and hydroxylamine. PMID- 3280548 TI - Construction and characterization of mutations in hupB, the gene encoding HU-beta (HU-1) in Escherichia coli K-12. AB - Plasmid pJMC21 contains Escherichia coli chromosomal DNA encoding Lon protease, HU-beta (HU-1), and an unidentified 67,000-dalton protein. A kanamycin resistance cassette was used in the construction of insertion and deletion mutations in hupB, the gene encoding HU-beta on plasmid pJMC21. The reconstructed plasmids were linearized and used to introduce hupB chromosomal mutations into JC7623 (recBC sbcBC). These mutations, as expected, mapped in the 9.8-min region of the E. coli chromosome by P1 transduction (16% linkage to proC+). Southern blot hybridization of chromosomal fragments verified that hupB+ was replaced by the mutant allele, with no indication of gene duplication. All the mutant strains had growth rates identical to that of wild-type E. coli, were resistant to UV irradiation and nitrofurantoin, and supported the in vivo transposition replication of bacteriophage Mu, Mu lysogenization, Tn10 transposition from lambda 1098, and lambda replication-lysogenization. The only observable phenotypic variation was a reduced Mu plaque size on the hupB mutant strains; however, the yield of bacteriophage Mu in liquid lysates prepared from the mutant strains was indistinguishable from the yield for the wild type. PMID- 3280547 TI - Division behavior and shape changes in isogenic ftsZ, ftsQ, ftsA, pbpB, and ftsE cell division mutants of Escherichia coli during temperature shift experiments. AB - Isogenic ftsZ, ftsQ, ftsA, pbpB, and ftsE cell division mutants of Escherichia coli were compared with their parent strain in temperature shift experiments. To improve detection of phenotypic differences in division behavior and cell shape, the strains were grown in glucose-minimal medium with a decreased osmolality (about 100 mosM). Already at the premissive temperature, all mutants, particularly the pbpB and ftsQ mutants, showed an increased average cell length and cell mass. The pbpB and ftsQ mutants also exhibited a prolonged duration of the constriction period. All strains, except ftsZ, continued to initiate new constrictions at 42 degrees C, suggesting the involvement of FtsZ in an early step of the constriction process. The new constrictions were blunt in ftsQ and more pronounced in ftsA and pbpB filaments, which also had elongated median constrictions. Whereas the latter strains showed a slow recovery of cell division after a shift back to the permissive temperature, ftsZ and ftsQ filaments recovered quickly. Recovery of filaments occurred in all strains by the separation of newborn cells with an average length of two times LO, the length of newborn cells at the permissive temperature. The increased size of the newborn cells could indicate that the cell division machinery recovers too slowly to create normal-sized cells. Our results indicate a phenotypic resemblance between ftsA and pbpB mutants and suggest that the cell division gene products function in the order FtsZ-FtsQ-FtsA, PBP3. The ftsE mutant continued to constrict and divide at 42 degrees C, forming short filaments, which recovered quickly after a shift back to the permissive temperature. After prolonged growth at 42 degree C, chains of cells, which eventually swelled up, were formed. Although the ftsE mutant produced filaments in broth medium at the restrictive temperature, it cannot be considered a cell division mutant under the presently applied conditions. PMID- 3280549 TI - Abnormal induction of heat shock proteins in an Escherichia coli mutant deficient in adenosylmethionine synthetase activity. AB - Most prototrophic strains of Escherichia coli become restricted for methionine at 44 degrees C. A mutant strain (RG62 metK) in which the level of S adenosylmethionine synthetase activity is only 10 to 20% of normal shows constitutive expression of one of the heat shock proteins, the lysU gene product, lysyl-tRNA synthetase form II, at 37 degrees C. These findings suggested a possible linkage between methionine metabolism and heat shock. We examined the induction of heat shock polypeptides in strain RG62 (metK) and in its parent, RG (metK+), from which it was derived by spontaneous mutation. Exponential-phase cultures of the two strains were pulse-labeled with [3H]leucine shortly after a shift from 37 to 44 degrees C, and the total cellular polypeptides were examined by two-dimensional electrophoresis. The results confirmed the constitutive production of the lysU gene product previously reported for strain RG62, but also revealed that the induction of 2 of the 17 heat shock polypeptides, C14.7 and G13.5, was markedly depressed. Otherwise the heat shock induction pattern was similar in timing and magnitude in the two strains. Transformation of the mutant strain with a plasmid, pK8, containing the metK coding sequence and promoter region as a 1.8-kilobase insert into pBR322 restored normal induction of C14.7 and G13.5, but did not prevent constitutive expression of the lysU gene product in the medium required for growth of this strain. The three heat shock polypeptides abnormally controlled in strain RG62 are the three polypeptides which are not induced when rapid synthesis of the htpR gene product is induced by isopropyl-beta-D-thiogalactopyranoside at 28 degree C (R. A. VanBogelen, M. A. Acton, and F. C. Neidhardt, Genes Dev. 1:525-531, 1987). We postulate that induction of these three polypeptides involves metabolic signals in addition to the synthesis of the htpR gene product and that strain RG62 (metK) fails to produce the signals involved in induction of C14.7 and G13.5 on a shift-up in temperature and produces the signal related to lysU induction even at 37 degree C. PMID- 3280551 TI - Absence of autolytic activity (peptidoglycan nicking) in penicillin-induced nonlytic death in a group A streptococcus. AB - The extent of sublytic autolysin activity (peptidoglycan [PG] nicking) after exposure of exponentially growing cultures of a group A streptococcus (GAS) to benzylpenicillin (PenG) was studied by determining changes in the glycan chain length of PG polymers. The average PG chain length in isolated cell walls was estimated by calculating the ratio of the total hexosamine content (Morgan-Elson reactive material) to reducing-end group content established via quantitation of [3H]borohydride reduction products. Comparison of the average PG chain length obtained from untreated control cultures of GAS with those obtained after exposure to a saturating dose of PenG revealed no decrease over a time interval equivalent to four mass doublings of the control cultures. Exposure to this concentration of PenG for a time equivalent to only two mass doublings resulted in approximately 90% loss of viability. In contrast, exposure of the lytic bacterium, Streptococcus faecium ATCC 9790, to a 50% growth inhibitory dose of PenG produced a 20% reduction in the average PG chain length concomitant with only a 65% loss of viability. Preliminary characterization of the autolytic system of GAS indicated that this streptococcus has a hexosaminidase-type autolysin. The results presented indicate the lack of autolytic activity in PenG induced nonlytic death. PMID- 3280550 TI - Evidence that TET protein functions as a multimer in the inner membrane of Escherichia coli. AB - The inner membrane TET (TetA) protein, which is involved in Tn10-mediated microbial tetracycline resistance, consists of two domains, alpha and beta, both of which are needed for tetracycline resistance and efflux (M.S. Curiale, L.M. McMurry, and S.B. Levy, J. Bacteriol. 157:211-217, 1984). Since tetracycline sensitive mutants in one domain can partially complement sensitive mutants in the other domain and since some sensitive mutants show dominance over the wild type, a multimeric structure for TET in the membrane had been suggested. We have studied this possibility by using tetA-phoA gene fusions. We fused all but the last 40 base pairs of the tetA gene with the carboxy terminus of the phoA gene for alkaline phosphatase (PhoA), whose activity requires its dimerization in the periplasm. The tetA-phoA fusion protein was under control of the tetracycline inducible regulatory system for the tetA gene. Induction led to the synthesis of a 78,000-dalton inner membrane protein. Tetracycline resistance was expressed at reduced levels, consistent with the terminal beta domain deletion. Alkaline phosphatase activity was also present, but at low levels, suggesting that some, but not all, of the fusion proteins had their carboxy-terminal ends in the periplasm. When wild-type or mutant TET proteins were present in the same cell with the fusion protein, the tetracycline resistance level was affected (raised or lowered); however, phosphatase activity was reduced only when TET proteins with intact or near-intact beta domains were present. These findings suggest that TET functions as a multimer and that intact beta domains, on TET molecules in the heterologous multimer, either allow fewer PhoA moieties to project into the periplasm or sterically hinder PhoA moieties from dimerizing. PMID- 3280552 TI - Roles of bacteriochlorophyll and carotenoid synthesis in formation of intracytoplasmic membrane systems and pigment-protein complexes in an aerobic photosynthetic bacterium, Erythrobacter sp. strain OCh114. AB - Synthesis of bacteriochlorophyll and carotenoids was inhibited in an aerobic photosynthetic bacterium, Erythrobacter sp. strain OCh114, by alpha, alpha' dipyridyl and diphenylamine. Formation of two pigment-protein complexes, reaction center-B870 (RC-B870) and B806, and development of the intracytoplasmic membranes of the cells were studied by spectral analysis and electron microscopy. Inhibition of bacteriochlorophyll synthesis by alpha, alpha'-dipyridyl, which was accompanied by a decrease in carotenoid synthesis, suppressed formation of intracytoplasmic membranes in the cells. Growth under illumination had a similar effect on formation of pigments and membranes. On the other hand, inhibition of carotenoid synthesis by diphenylamine did not suppress either development of the membrane system or bacteriochlorophyll synthesis. Formation of RC-B870 and B806 complexes, however, was differentially affected by blockage of carotenoid synthesis. In the presence of diphenylamine, the B806 complex was formed in a much smaller amount than the RC-B870 complex. These results suggest that, in Erythrobacter sp. strain OCh114, bacteriochlorophyll plays an essential role in intracytoplasmic membrane development, and carotenoids are important for assembly of pigment-protein complexes. PMID- 3280553 TI - Inducer expulsion in Streptococcus pyogenes: properties and mechanism of the efflux reaction. AB - Expulsion of preaccumulated methyl-beta-D-thiogalactoside-phosphate (TMG-P) from Streptococcus pyogenes is a two-step process comprising intracellular dephosphorylation of TMG-P followed by rapid efflux of the intracellularly formed free galactoside (J. Reizer, M.J. Novotny, C. Panos, and M.H. Saier, Jr., J. Bacteriol. 156:354-361, 1983). The present study identifies the mechanism and the order and characterizes the temperature dependency of the efflux step. Unidirectional efflux of the intracellularly formed [14C]TMG was only slightly affected when measured in the presence of unlabeled TMG (25 to 400 mM) in the extracellular medium. In contrast, pronounced inhibition of net efflux was observed in the presence of relatively low concentrations (1 to 16 mM) of extracellular [14C]TMG. Since net efflux was nearly arrested when the external concentration of [14C]TMG approached the intracellular concentration of this sugar, we propose that a facilitated diffusion mechanism is responsible for efflux and equilibration of TMG between the intracellular and extracellular milieus. The exit reaction was markedly dependent upon temperature, exhibited a high energy of activation (23 kcal [ca. 96 kJ] per mol), and followed first-order kinetics, indicating that the permease mediating this efflux was not saturated under the conditions of expulsion employed. PMID- 3280555 TI - A progenitor of the outer membrane LamB trimer. AB - During its localization to the outer membrane, LamB possesses distinctive biochemical properties as it passes through the cytoplasmic membrane. Because LamB entered this dynamic state with an attached signal sequence and leaves after cleavage, we call this export-related form of LamB the early-translocation form (et-LamB). PMID- 3280554 TI - Isolation and characterization of Saccharomyces cerevisiae mutants resistant to Calcofluor white. AB - Calcofluor is a fluorochrome that exhibits antifungal activity and a high affinity for yeast cell wall chitin. We isolated Saccharomyces cerevisiae mutants resistant to Calcofluor. The resistance segregated in a Mendelian fashion and behaved as a recessive character in all the mutants analyzed. Five loci were defined by complementation analysis. The abnormally thick septa between mother and daughter cells caused by Calcofluor in wild-type cells were absent in the mutants. The Calcofluor-binding capacity, observed by fluorescence microscopy, in a S. cerevisiae wild-type cells during alpha-factor treatment was also absent in some mutants and reduced in others. Staining of cell walls with wheat germ agglutinin-fluorescein complex indicated that the chitin uniformly distributed over the whole cell wall in vegetative or in alpha-factor-treated cells was almost absent in three of the mutants and reduced in the two others. Cell wall analysis evidenced a five- to ninefold reduction in the amount of chitin in mutants compared with that in the wild-type strain. The total amounts of cell wall mannan and beta-glucan in wild-type and mutant strains were similar; however, the percentage of beta-glucan that remained insoluble after alkali extraction was considerably reduced in mutant cells. The susceptibilities of the mutants and the wild-type strains to a cell wall enzymic lytic complex were rather similar. The in vitro levels of chitin synthase 2 detected in all mutants were similar to that in the wild type. The significance of these results is discussed in connection with the mechanism of chitin synthesis and cell wall morphogenesis in S. cerevisiae. PMID- 3280556 TI - Hydrogen-mediated enhancement of hydrogenase expression in Azotobacter vinelandii. AB - Azotobacter vinelandii cultures express more H2 uptake hydrogenase activity when fixing N2 than when provided with fixed N. Hydrogen, a product of the nitrogenase reaction, is at least partly responsible for this increase. The addition of H2 to NH4+-grown wild-type cultures caused increased whole-cell H2 uptake activity, methylene blue-dependent H2 uptake activity of membranes, and accumulation of hydrogenase protein (large subunit as detected immunologically) in membranes. Both rifampin and chloramphenicol inhibited the H2-mediated enhancement of hydrogenase synthesis. Nif- A. vinelandii mutants with deletions or insertions in the nif genes responded to added H2 by increasing the amount of both whole-cell and membrane-bound hydrogenase activities. Nif- mutant strain CA11 contained fourfold more hydrogenase protein when incubated in N-free medium with H2 than when incubated in the same medium containing Ar. N2-fixing wild-type cultures that produce H2 did not increase hydrogenase protein levels in response to added H2. PMID- 3280557 TI - The clinical use of carbamazepine in affective disorders. AB - Carbamazepine, although not widely used in the treatment of affective disorders until the mid-1970s, is now considered an integral part of the pharmacological treatment of affective disorders. The author reviews much of the currently available data on the clinical effects of carbamazepine for both the acute and prophylactic treatment of affectively ill patients. Because of theoretical implications for the use of carbamazepine in affectively ill patients and reports of early success in uncontrolled trials, the first double-blind, placebo controlled trial of carbamazepine in affective illness was undertaken at the National Institute of Mental Health in 1976. The results of this trial and other controlled and uncontrolled trials form the basis of this review. PMID- 3280558 TI - Carbamazepine in nonresponsive psychosis. AB - Nonresponsive psychosis encompasses heterogeneous psychotics who are symptomatic despite adequate trials of neuroleptic medication. A proportion of those patients are schizophrenic. A second subgroup are symptomatic in that they have specific target features. The use of carbamazepine is discussed in the context of searching for active target symptoms and features that may imply its appropriate application as adjunctive medication in nonaffective, nonepileptic psychotics. Despite a dearth of studies in the literature, two studies, those of Neppe and of Klein, appear to be of theoretical relevance and are used as starting points to compare the other blind and nonblind literature available. It appears that carbamazepine is worthwhile in patients with some aggression and interpersonal difficulties who are refractory to neuroleptics alone and who exhibit instability and agitation. The role of temporal-lobe symptomatology and temporal-lobe foci is unclear, and the mechanism of action of carbamazepine is apparently not directly antipsychotic and may relate to an antikindling-like mechanism. The role of psychodynamics should not, however, be ignored. A great deal more research is required. PMID- 3280559 TI - Effects of antiepileptic drugs on abilities. AB - The selection of antiepileptic drugs depends not just on efficacy considerations but on psychological side effects, including their effects on abilities. In general, investigations show that antiepileptic drugs have slight to mild adverse effects on abilities. Of the major agents, carbamazepine is frequently associated with fewer of these effects. There are, however, a number of confounding factors which complicate the interpretation of these studies. These include procedures pertaining to subject selection, statistical analysis, seizures, co-medication, test selection, and the use of the active agent versus placebo study design. The importance of each of these factors is briefly discussed, with emphasis on their relevance to interpretation of existing studies. PMID- 3280560 TI - Time course of clinical effects of carbamazepine: implications for mechanisms of action. AB - The onset of therapeutic effectiveness of carbamazepine is generally very rapid in the treatment of seizure and paroxysmal pain disorders, shows some lag in the treatment of mania, and exhibits the longest lag in depression. These time course variations may indicate that different mechanisms underlie the efficacy of carbamazepine in the differential neuropsychiatric syndromes. Biochemical and pharmacological data suggest that the anticonvulsant effects of carbamazepine are related to "peripheral-type" benzodiazepine and alpha 2-noradrenergic receptor systems and to its ability to stabilize sodium channels. GABAB (baclofen-like) actions appear to be involved in antinociceptive, but not anticonvulsant, effects. The relatively acute time course of antimanic efficacy may be related to the above-mentioned mechanisms or to other effects related to systems postulated to be altered in the manic syndrome. These effects might include carbamazepine's ability to increase acetylcholine in the striatum, decrease probenecid-induced levels of CSF homovanillic acid (HVA) in man and dopamine turnover in animals, decrease CSF norepinephrine in manic patients, inhibit adenylate cyclase activity (in response to norepinephrine, dopamine, adenosine, or ouabain), decrease GABA turnover, or act as a vasopressin agonist. Efficacy in depression may be related to actions in man that take time or chronic drug administration to develop, such as increases in plasma tryptophan, decreases in CSF somatostatin, decreases in thyroid indices, and increases in urinary free cortisol excretion and, in animals, increases in substance P sensitivity and increases in brain adenosine receptors. The ability of carbamazepine to block the development of lidocaine- and cocaine-induced seizures also requires chronic administration, suggesting that these seizure models may provide a unique perspective for understanding mechanisms of time-dependent effects. PMID- 3280561 TI - Fundamentals of carbamazepine use in neuropsychiatry. AB - Carbamazepine, mainly used as an anticonvulsant but also used for trigeminal neuralgias and other neuralgic pains, is now being used experimentally for affective disorders, nonresponsive psychoses, and dyscontrol. However, carbamazepine dosage must be carefully monitored because low initial doses are equivalent to higher later doses, and the drug's addition to a regimen of other drugs may increase carbamazepine's serum levels. Given alone to a pharmacologically naive inpatient, initial dosage of carbamazepine 200 mg/day can be increased by 100 mg every day or every second day; an outpatient can have the dosage increased by 100 mg every third day. Serum levels and side effects should be monitored. White cell counts usually decrease about 25%, but the decrease is not clinically related to the very rare occurrence of agranulocytosis. A side effect of concern is hepatic toxicity, but few such cases have been reported. The most common side effect is allergic rash, which occurs in about 5% of all patients receiving carbamazepine; antihistamines sometimes bring about a remission of the rash. Generic carbamazepine may cause more problems than Tegretol. PMID- 3280562 TI - Psychiatric aspects of epilepsy. AB - The frequency of severe psychiatric disorders in patients with epilepsy depends first and foremost on what populations of patients are studied. In random surveys seeking prevalence of epilepsy in the community, the prevalence of associated psychiatric disorder is low. In specialty referral clinics for epilepsy, particularly those serving indigent populations, the prevalence is 25% to 50%. Among epileptics in mental hospitals or psychiatric clinics, the prevalence is, naturally, 100%. This discussion is focused on the evidence for a causal or physiological relationship between epilepsy and psychosis, depression, aggression, and sexual disturbances, and treatment of these disorders. Particular attention is given to possible relationships between temporal lobe (limbic) epilepsy and schizophrenic disorders. PMID- 3280563 TI - Clinical pharmacokinetics of carbamazepine. AB - The relationship between daily dose and plasma levels of carbamazepine is poor. The slope of that relationship varies with the patient population. Children require twice as much of the drug as adults do to achieve a given level. Also, dosage requirements increase in the presence of other drugs that are enzyme inducers. Recent reports suggest that the 10,11-epoxide metabolite of carbamazepine can contribute to the neurotoxicity attributed to carbamazepine. Carbamazepine is a broad-spectrum enzyme inducer. Three reports in the past 2 years show that haloperidol levels are reduced by approximately 50% when carbamazepine is introduced. Those interactions may complicate the interpretation of clinical trials of carbamazepine. PMID- 3280564 TI - Carbamazepine and mood: evidence from patients with seizure disorders. AB - The author reviews the use of carbamazepine in the treatment of epilepsy. The so called psychotropic effects of carbamazepine were first described after the introduction of the drug to clinical practice in the mid-1960s, and since, several investigators have found relationships between carbamazepine and mood variables in seizure disorder patients. Results of investigations at the National Hospitals, London, suggest that carbamazepine influences behavior disorders, anxiety, and depression in patients with epilepsy. Mechanisms of these psychotropic effects are discussed, including the influence of carbamazepine on limbic-kindled seizures and metabolic effects of the drug. Differences between carbamazepine and other anticonvulsants with regard to effects on mood and behavior are presented. PMID- 3280565 TI - Cell type-specific expression of protein kinase C isozymes in the rabbit cerebellum. AB - Monoclonal antibodies raised against rabbit brain protein kinase C were classified into at least three types, MC-1a, MC-2a, and MC-3a, which selectively interact with hydroxyapatite column chromatographically resolved isozymes type I, II, and III of protein kinase C, respectively, determined on the basis of immunoblotting experiments. Immunoprecipitating analysis revealed that MC-1a, 2a, and -3a interacted with protein kinase C expressed in the brain and MC-2a and -3a, but MC-1a immunoprecipitated the protein kinase from rabbit spleen. Immunocytochemical localization of the protein kinase isozymes in the rabbit cerebellum and spleen was studied using these monoclonal antibodies. Staining with MC-1a was restricted to Purkinje cells of the rabbit cerebellum, and there was no reaction product in the Purkinje cells with either MC-2a or MC-3a. Cells in the granular layer of the cerebellum were labeled with MC-2a, and oligodendroglia in the white matter of the cerebellum was stained with MC-3a. The rabbit spleen contained no product reacting with MC-1a, but MC-2a and MC-3a reacted with lymphocytes in the mantle zone and the periarterial lymphatic sheath of the white pulp, respectively. These results suggest that expression of the protein kinase C isozyme in the rabbit cerebellum may depend on the cell type. PMID- 3280566 TI - Binding mode transitions of Escherichia coli single strand binding protein-single stranded DNA complexes. Cation, anion, pH, and binding density effects. AB - We have extended our investigations of the multiple binding modes that form between the Escherichia coli single strand binding (SSB) protein and single stranded DNA (Lohman, T. M. & Overman, L. B. (1985) J. Biol. Chem. 260, 3594 3603; Bujalowski, W. & Lohman, T. M. (1986) Biochemistry 25, 7799-7802) by examining the effects of anions, pH, BaCl2, and protein binding density on the transitions among these binding modes. "Reverse" titrations that monitor the quenching of the intrinsic tryptophan fluorescence of the SSB protein upon addition of poly(dT) have been used to measure the apparent site size of the complex at 25 degrees C in pH 8.1 and 6.9 as a function of NaF, NaCl, NaBr, and MgCl2 concentrations. Under all conditions in which "reverse" titrations were performed, we observe three distinct binding modes with site sizes of 35 +/- 2, 56 +/- 3, and 65 +/- 3 nucleotides/SSB tetramer; however, the transitions among the three binding modes are strongly dependent upon both the cation and anion valence, type, and concentration as well as the pH. A net uptake of both cations and anions accompanies the transitions from the (SSB)35 to the (SSB)56 binding mode at pH 6.9, whereas at pH 8.1 this transition is anion-independent, and only a net uptake of cations occurs. The transition from the (SSB)56 to the (SSB)65 binding mode is dependent upon both cations and anions at both pH 6.9 and 8.1 (25 degrees C), and a net uptake of both cations and anions accompanies this transition. We have also examined the transitions by monitoring the change in the sedimentation coefficient of the SSB protein-poly(dT) complex as a function of MgCl2 concentration (20 degrees C, pH 8.1) and observe an increase in s20,w, which coincides with the increase in apparent site size of the complex, as measured by fluorescence titrations. The frictional coefficient of the complex decreases by a factor of two in progressing from the (SSB)35 to the (SSB)65 binding mode, indicating a progressive compaction of the complex throughout the transition. The transition between the (SSB)35 and the (SSB)56 complex is dependent on the protein binding density, with the lower site size (SSB)35 complex favored at higher binding density. These results indicate that the transitions among the various SSB protein-single-stranded DNA binding modes are complex processes that depend on a number of solution variables that are thermodynamically linked.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3280567 TI - Incorporation of single dinitrophenyl-modified proteins into the 30 S subunit of Escherichia coli ribosomes by total reconstitution. AB - In this first of two consecutive papers, the main objective of which is to present a new approach to the systematic localization of individual proteins located in the Escherichia coli ribosome by immunoelectron microscopy, we describe the derivatization of several purified 30 S proteins (S12, S21, S14, S19, S18, S17) with 2,4-[3,5-3H]dinitrofluorobenzene at pH 7.4 and 8.4 and the uptake of each dinitrophenylated protein in place of the corresponding unmodified protein into totally reconstituted 30 S subunits. Reverse-phase high performance liquid chromatography is used to purify the proteins, to separate and characterize the products of 2,4-[3,5-3H]dinitrofluorobenzene modification, and to analyze the protein composition of the reconstituted subunits. The extent of dinitrophenyl (DNP) modification is estimated by both radioactivity and integrated peak areas, using dual wavelength monitoring at 214 and 360 nm. DNP derivatives of each of the six proteins are efficiently incorporated into reconstituting 30 S subunits. Incorporation of any of the six DNP-modified proteins does not interfere with binding of Phe-tRNA(Phe) in a poly(U)-dependent manner. This result, as well as data showing that unmodified protein competes with DNP-protein for uptake during reconstitution, provide evidence that each DNP protein occupies the same position in 30 S subunit as does unmodified protein. In general, for a given protein, unmodified and/or less modified forms are incorporated in preference to more modified forms. Modification of protein S19 at pH 7.4 proceeds with selective formation of one derivative in high yield. Reverse phase high performance liquid chromatography analysis of acid hydrolysates of a purified sample of this derivative, as well as of peptides derived from it by digestion with Staphylococcus aureus protease, show the N-terminal proline to be the predominant site of DNP-derivatization. PMID- 3280568 TI - Immune electron microscopic localization of dinitrophenyl-modified ribosomal protein S19 in reconstituted Escherichia coli 30 S subunits using antibodies to dinitrophenol. AB - Escherichia coli small ribosomal subunits have been reconstituted from RNA and high performance liquid chromatography-purified proteins including protein S19 that had been modified at its amino-terminal proline residue with 1-fluoro-2,4 dinitrobenzene. As detailed in the accompanying paper (Olah, T. V., Olson, H. M., Glitz, D. G., and Cooperman, B. S. (1988) J. Biol. Chem. 263, 4795-4800), dinitrophenyl (DNP)-S19 was efficiently incorporated into the site ordinarily occupied by S19. Antibodies to DNP bound effectively to the reconstituted subunits and did not cause dissociation of the modified protein from the subunit. Electron microscopy of the immune complexes was used to localize the modified protein on the subunit surface. More than 95% of the antibody binding sites seen were consistent with a single location of protein S19 on the upper portion or head of the subunit, on the surface that faces the 50 S particle in a 70 S ribosome, and in an area relatively distant from the subunit platform. The S19 site is close to the region in which 30 S subunits are photoaffinity labeled with puromycin. Protein S19 is thus near protein S14 in the small subunit and in proximity to the peptidyl transferase center of the 70 S ribosome. PMID- 3280569 TI - Expression of soluble and fully functional ricin A chain in Escherichia coli is temperature-sensitive. AB - Linkage of ricin A chain (RA) to a cell surface binding antibody or other ligand can result in a potent cytotoxic agent. We expressed the primary sequence for RA in Escherichia coli to facilitate production and to obtain protein free of naturally occurring contaminants, i.e. ricin B chain. Differences in the level of expression and in the characteristics of the expressed protein were noted when several different host/vector systems were tested. Recombinant RA (rRA) was expressed directly under control of the phage lambda major leftward promoter (PL) and the E. coli trp promoter. It was also expressed fused to E. coli alkaline phosphatase sequences, both in the same reading frame for secretion and out-of reading frame for expression in a cistron-like arrangement. Expression in the PL promoter system, which is temperature-regulated, was achieved at 37 degrees C as well as at 42 degrees C. The protein expressed at these different temperatures had grossly different properties. Whereas rRA expressed at 37 degrees C was soluble and fully active, that produced at 42 degrees C was aggregated, insoluble, and reduced in activity. Soluble rRA could be converted to the insoluble form by incubation at 42 degrees C in vivo, but not in vitro. Hence, this difference in properties does not simply reflect an inherent thermal instability of the protein. Conditions present in vivo, including the possible association with other proteins, are apparently required for this effect on rRA. PMID- 3280570 TI - Structure of the glycoprotein Ib.IX complex from platelet membranes. AB - The glycoprotein Ib.IX complex is a major component of the platelet membrane. It mediates the adhesion of platelets to exposed subendothelium and provides an attachment site for the membrane skeleton on the plasma membrane. The present study was designed to characterize the structure of the glycoprotein Ib.IX complex. Electron microscopy of purified glycoprotein Ib.IX complex in detergent showed that each complex existed as a flexible rod with a globular domain on either end. The overall length of the complex was approximately 59.5 nm. The smaller globular domain had a diameter of approximately 8.9 nm; the larger, a diameter of approximately 15.9 nm. In the absence of detergent, the glycoprotein Ib.IX complexes tended to self-associate through the larger globular domain, suggesting that this domain contained the hydrophobic region that inserts into the membrane. Proteases known to cleave glycoprotein Ib alpha close to its membrane-insertion site released the larger globular domain. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that this domain was composed of glycoprotein Ib beta, glycoprotein IX, and a Mr = 25,000 fragment of glycoprotein Ib alpha. Proteolysis at the external end of glycoprotein Ib alpha reduced the size of the smaller globular domain. This study shows that the glycoprotein Ib.IX complex has an elongated shape, with a globular domain on the end that inserts into the membrane and a smaller globular domain on the end of glycoprotein Ib alpha that is oriented external to the plasma membrane. PMID- 3280571 TI - A novel Candida albicans skin test antigen: efficacy and safety in man. AB - Yeast phase Candida albicans (ATCC No. 10231) was grown in a nonantigenic medium, harvested and lyophilized. Ammonium sulfate fractions of an aqueous extract of the lyophilized cells were evaluated and the fraction yielding the highest specific delayed cutaneous reactivity in sensitized guinea-pigs was used to prepare a C. albicans skin test antigen (CASTA). The safety of the antigen was evaluated by measuring immediate and delayed (0.25, 6, 24, 48 and 72 h) cutaneous reactions in atopic and nonatopic human subjects. The outcome of three repetitive monthly Mantoux skin tests with 0.01-1 microgram antigen doses was used to test for booster effects in 14 subjects and to estimate a safe initial test antigen dose. The utility of a single skin test as a measure of cell-mediated immunity was evaluated in 40 healthy subjects. Reactor rates (greater than or equal to 2 mm, 48 h) of 40% and 85% were detected, respectively, with doses of 0.0316 and 1 microgram. Using a skin test reaction diameter greater than or equal to 5 mm at 48 h, the reactor rate was 50% for the 1-microgram dose. The only adverse reaction (45 mm, 0.25 h) was detected with the 1-microgram dose in an atopic subject who also exhibited exquisite scratch test reaginic hypersensitivity to C. albicans allergen. The prevalence of other adverse reactions to this antigen compared favorably with that to other antigens used for recall antigen testing. These studies suggest the 1-microgram CASTA dose can be used for effective, safe recall antigen skin tests. PMID- 3280572 TI - Additives to biological substances. IV--Lyophilization conditions in the preparation of international standards: an analysis by high-performance liquid chromatography of the effects of secondary desiccation. AB - Many International Standards, Reference Preparations and Reference Reagents are routinely prepared by lyophilization in the presence of 'inert' carriers followed by an extensive period of secondary desiccation. In this study we have used high performance liquid chromatography (HPLC) to analyse the effects of lyophilization and secondary desiccation on initial degradation and subsequent stability of a model protein, insulin. Secondary desiccation was found to promote a reaction of the insulin with a carrier consisting of non-volatile buffer salts and a sugar. Secondary desiccation did not improve the stability of the insulin as determined by accelerated thermal degradation and analysis using the Arrhenius equation. We conclude that careful consideration needs to be given, on a case-by-case basis, to the selection of the procedures for the preparation of International Standards, particularly those ampouled in the absence of carrier proteins and intended for physicochemical analysis such as HPLC. PMID- 3280574 TI - [The role of surgery in primary gastric non-Hodgkin's malignant lymphoma]. AB - A total of 15 cases of primary gastric non-Hodgkin's malignant lymphoma (PGML) seen between 1974 and 1985 were reviewed, and data obtained combined with reports in the literature, to define the place of surgery in this affection becoming the monopoly of chemotherapists. The indication for surgery is indisputable when the diagnosis is in doubt, and justified for ulcerated and preperforating forms and in extirpable tumoral forms of loco malignancy. It should be avoided in high grade PGML unless the operation does not delay chemotherapy. Total gastrectomy should not be performed by principle but by necessity. Abdominal exploration should include lymph node and liver biopsies. An effective total care of these patients requires close cooperation between medical and surgical teams. PMID- 3280573 TI - Renal dysfunction following high-dose carboplatin treatment. AB - A case history is reported or renal failure during and after treatment with carboplatin for 3 days, total dose 750 mg/m2, in a conditioning regimen prior to autologous bone marrow transplantation. Pretreatment renal function was compromised after nephrectomy and chemotherapy with cisplatin. A decrease in glomerular filtration rate concurred with a decrease in excretion of platinum in the urine and an increase in urinary beta 2 microglobulin. Treatment with high dose carboplatin in patients with impaired renal function and previous treatment with cisplatin may lead to further loss of renal function. PMID- 3280575 TI - [Pancreatic transplantation: technics--results]. AB - Renewed interest is occurring in organ transplantation due to improvement of results. Pancreatic transplantation, carried out in more than 60 centers worldwide, has evolved since the first transplant in Minneapolis in 1966. Until 1978 an average of 6 operations per year were performed with a 1-year graft survival of 3%. The initial technic used was mainly duodenopancreatic transplantation with digestive by pass of external pancreatic secretions. Serious surgical complications led to progressive abandon of this procedure. Segmental transplantation, particularly after the appearance of methods of obliteration of wirsung's duct in 1978, has simplified the surgical act and stimulated renewed interest in pancreatic transplantation. The improvement in the technic, selection of donors and recipients and protocols of immunosuppression can hopefully allow a 1-year survival of graft of 55%. The current tendency is also to restore use of duodenopancreatic or total pancreatic transplants with intestinal or bladder drainage of secretions, providing improved survival of the graft in technically successful transplantations. PMID- 3280576 TI - [Technic of suturing a peripheral nerve]. AB - Essential practical rules for suture of a peripheral nerve are detailed in the order of the different stages involved: instrumentation, moment of reconstruction, approach route, preparation of nerve extremities, absence of tension, type of suture and postoperative immobilization. Preference is given to epi-perineural sutures. PMID- 3280577 TI - Refining transcriptions: the significance of transcriber 'errors'. PMID- 3280578 TI - The ISU/ChiLDS database--a bibliogrpahic addition to ChiLDES. PMID- 3280579 TI - On the early learning of formal grammatical systems: evidence from studies of the acquisition of gender and countability. PMID- 3280580 TI - Fenfluramine treatment of autism. PMID- 3280581 TI - Urbanism and child mental health. PMID- 3280582 TI - Thin-layer chromatography of endotoxins, their derivatives and contaminants. AB - Thin-layer chromatographic (TLC) separation techniques were used to analyze the heterogeneity of various preparations which included smooth and rough endotoxins (ET), Lipid A precipitates and synthetic Lipid A samples and a novel cytotoxic bacterial lipid. Furthermore, carbohydrate-rich split products (PS) of ET were also separated on commercial silica-coated plates. Satisfactory results were obtained by two-dimensional TLC or by the combination of chromatography followed by high-voltage electrophoresis in the separation of PS of ET cleaved by mild acetic hydrolysis. Several spray reagents were found which were eminently suitable to detect carbohydrate containing compounds. Less specific but generally useful spray reagents were also developed which gave strong color reactions with lipids, proteinaceous and carbohydrate containing split products of the ET preparations. Improved chromatographic resolution has also revealed substantial heterogeneity in both rough and smooth ET samples. Three biological activities of the separated components could be determined. These were antigenicity detected by reactivity with monoclonal antibodies on the TLC plates, endotoxicity, determined by the Limulus amoebocyte lysate (LAL) test and direct cytotoxicity of P815 cells in vitro. Considerable amounts of non-endotoxic and non-antigenic contaminants could be detected in all preparations tested. Significant amounts of free Lipid A were also found in smooth ETs. Thus a new level of complexity is recognized by TLC within these preparations. PMID- 3280583 TI - Concentration and purification of plant pathogenic viruses by field step electrophoresis. AB - Concentration and purification of plant pathogenic viruses by field step electrophoresis comprises a new and rapid preparative method with high throughput and short separation time. With this technique and combinations of field step and zone electrophoresis it is possible to purify plant pathogenic viruses from several contaminants in one separation step. Another application of field step electrophoresis allows the separation of viruses from each other. PMID- 3280584 TI - Detection and purification of a recombinant human B lymphotropic virus (HHV-6) in the baculovirus expression system by limiting dilution and DNA dot-blot hybridization. AB - A recombinant virus Ac373-HB was detected and purified from the transfection mixture of wild type and recombinant virus in the baculovirus expression system using a combination of limiting dilution and DNA dot-blot hybridization. This method allows for a quick and convenient way of detection and purification of recombinant virus without the need to use a plaque purification step. It is generally applicable to other expression systems besides the baculovirus system described here. PMID- 3280585 TI - Detection of human immunodeficiency virus (HIV) in serum and body fluids by sequential competition ELISA. AB - A micro-ELISA based on competition with the biotin-labeled 25 kDa gag (p25gag) recombinant protein of the human immunodeficiency virus (HIV) was compared to commercial antigen capture ELISAs for the detection of viral antigens in a variety of body fluids including serum, cerebro-spinal fluid (CSF), sputum, saliva, milk, semen, vaginal and bronchial fluids, as well as earwash fluid. Two thirds (24/30) of these specimens contained IgG and/or IgA antibodies to HIV. The results were correlated with the recovery of infectious HIV in culture. The competition ELISA detected the presence of HIV antigen in 4 out of 8 sera, 5 out of 6 CSF and 6 out of 15 other body fluids that were found to contain infectious virus. Comparatively, 5 of the 8 sera, 3 of the 6 CSF, and 2 of the 15 body fluids tested positive for HIV antigen by capture ELISA. The data suggest that the competition test is more effective than the capture method in detecting antigen in CSF and body secretions, which might be due to the presence of immune complexes. However, both ELISA methods showed similar susceptibility to antibody interference in spiked specimens. The results confirm that antigenemia status can be of value in assessing HIV infection when used in combination with other clinical and laboratory data. PMID- 3280586 TI - Antibodies to nuclear antigens in Graves' disease. AB - A recent publication reported a high prevalence of double-stranded DNA antibodies quantitated by RIA in patients with Graves' disease. We, therefore, measured antibodies to a variety of nuclear antigens in 20 patients with Graves' disease, most of whom where hyperthyroid. Fluorescent antinuclear antibody tests using HEp 2 cells as substrate were positive in serum of 15 of the 20 patients but in only 2 of 20 normal subjects. DNA binding, determined by RIA, was increased in 12 of 18 patients with Graves' disease. However, a more specific indirect immunofluorescence assay for antibodies to double-stranded DNA using Crithidia luciliae was negative in all 20 patients. Furthermore, antibodies to single stranded DNA, measured by counterimmunoelectrophoresis, and ribonucleoprotein and Sm antigens, measured by double diffusion in agar, were undetectable in all patients tested. These results demonstrate a high frequency of antinuclear antibody in patients with Graves' disease. The presence of antibodies to double stranded DNA was not confirmed when assayed by the highly specific and sensitive Crithidia luciliae method, suggesting nonantibody DNA binding in the DNA RIA. PMID- 3280587 TI - Comparisons among methods of measuring bone mass and relationship to severity of vertebral fractures in osteoporosis. AB - Several techniques are now available for quantitation of bone mass, including total body calcium by neutron activation analysis (TBC), single and dual photon absorptiometry at the radius and spine, respectively (SPA and DPA), quantitative computed tomography of the spine (QCT), and cancellous bone volume from iliac crest bone biopsies. The aims of this study were to assess the correlation among these techniques and to determine if bone mass correlated with height loss or the severity of vertebral fractures in osteoporotic women. These measurements were performed in the same group of women (n = 122) with postmenopausal osteoporosis. TBC, SPA, DPA, and QCT correlated significantly with each other (r = 0.33-0.76). The correlation between QCT and DPA improved significantly (r = 0.33-0.57; P = 0.02) when integral QCT was used instead of the usual QCT of the central vertebra. The correlation was not improved by expressing DPA in different dimensions, but was improved by including normal women. Multiple linear regression analysis showed that TBC was predicted better using SPA, DPA, and QCT than by any single variable. Cancellous bone volume correlated weakly (r = 0.10 0.26) to the other measurements. Height loss and fracture index correlated significantly with each other (r = 0.66; P less than 0.001), but the correlations with bone mass measurements were weak (r = -0.09 to -0.47). For each patient, a bone mass index was defined using z scores from the SPA, DPA, QCT, and TBC measurements; this index correlated inversely with the fracture index (r = -0.29; P = 0.009). This correlation was not significant when controlled for age. Thus, bone mass measurements correlate moderately well with each other, but poorly with severity of fracture. Other factors in addition to low bone mass may be important in determining whether bone will fracture. PMID- 3280588 TI - Peripheral and hepatic insulin antagonism in hyperthyroidism. AB - Eight hyperthyroid and eight normal subjects underwent 2-h oral glucose tolerance tests (OGTT) and euglycemic clamp studies to assess the presence of peripheral and hepatic insulin antagonism in hyperthyroidism. Although the mean total glucose area during the OGTT was similar in the hyperthyroid patients and normal subjects [16.4 +/- 0.8 (+/- SE) vs. 15.8 +/- 0.7 mmol/L.h], the mean insulin area was significantly elevated in the hyperthyroid group (1413 +/- 136 vs. 1004 +/- 122 pmol/L.h; P less than 0.05). Basal hepatic glucose production was measured during the second hour of a primed [3-3H]glucose infusion. A two-insulin dose euglycemic clamp study with [3-3H]glucose and somatostatin (500 micrograms/h) was carried out during the next 6 h. The insulin infusion rate was 0.05 mU/kg.min during the third, fourth, and fifth hours and 0.60 mU/kg.min during the sixth, seventh, and eighth hours. Hepatic glucose production and glucose utilization were measured during the final 0.5 h of each clamp period. Serum C-peptide concentrations were measured in the initial sample and in the last sample of each clamp period. The mean equilibrium serum insulin concentrations were similar in both groups during the final 0.5 h of the low (90 +/- 8 vs. 79 +/- 6 pmol/L) and high (367 +/- 11 vs. 367 +/- 15 pmol/L) insulin infusion rates. Basal serum C peptide levels were significantly increased in the hyperthyroid patients (596 +/- 17 vs. 487 +/- 43 pmol/L; P less than 0.05) but were suppressed equally in both groups at the end of both clamp periods. The MCRs of insulin were similar in the hyperthyroid and normal subjects during the low (6.7 +/- 1.1 vs. 5.6 +/- 0.5 mL/kg.min) and high (11.9 +/- 0.4 vs. 12.1 +/- 0.5 mL/kg.mm) insulin infusion rates. Glucose production was significantly increased in the hyperthyroid patients during the basal state (17.6 +/- 0.9 vs. 11.5 +/- 0.5 mumol/kg.min; P less than 0.001) and remained elevated during the final 0.5 h of the low (12.1 +/ 1.1 vs. 5.9 +/- 1.7; P less than 0.01) and high (3.2 +/- 1.2 vs. 0.5 +/- 0.3; P less than 0.05) insulin infusion rates. Peripheral insulin action, assessed by Bergman's sensitivity index, was significantly decreased in the hyperthyroid patients (7.4 +/- 2.2 vs. 15.6 +/- 2.1 L/kg min-1/pmol/L; P less than 0.02). In conclusion, hyperthyroidism is characterized by 1) hyperinsulinemia after oral glucose loading, 2) increased basal hepatic glucose production, 3) impairment of insulin-mediated suppression of hepatic glucose production, and 4) antagonism to insulin-stimulated peripheral glucose utilization. PMID- 3280589 TI - Endogenous dopamine (DA) and DA2 receptors: a mechanism limiting excessive sympathetic-adrenal discharge in humans. AB - We studied the effects of presynaptic dopamine (DA) 2 receptor blockade on the sympathetic-adrenal response to graded exercise in seven normal men. DA2 receptor blockade was achieved by means of domperidone (DMP) administration. The exercise consisted of progressive cycling activity, from 30-80% of the predetermined maximal oxygen consumption for each man. Systolic, diastolic, and mean arterial pressures; heart rate; and plasma norepinephrine (NE), epinephrine (E), PRL, glucose, lactate, FFA, sodium, potassium, cortisol, and PRA were measured at rest, during exercise, and during recovery after placebo or DMP administration. Graded exercise caused significant increases in systolic and mean arterial pressures and plasma NE, E, lactate, sodium, potassium, FFA, cortisol, and PRA. DMP administration before exercise caused a significant increase in plasma PRL (P = 0.0009), a greater increase in plasma NE at the end of the exercise (P = 0.002), and an overall increase in plasma E (P = 0.02) and FFA (P = 0.02) concentrations. These results strongly suggest that endogenous DA limits catecholamine release during sympathetic-adrenal stimulation by activating DA2 receptors. PMID- 3280590 TI - In memoriam: Edward H. Rynearson, M.D. PMID- 3280591 TI - Primary and working memory functioning in Alzheimer-type dementia. AB - This paper reviews recent neuropsychological studies of primary-memory functioning in early Alzheimer-type dementia (AD) with specific reference to recent research on working memory. The deficits in primary memory follow a fairly distinct pattern with a comparatively unimpaired recency effect in free recall, a moderate impairment in memory span, and a more substantial impairment in short term retention following distraction. The nature of these deficits is considered in relation to the Working Memory Model (Baddeley & Hitch, 1974). It is suggested that the Articulatory Loop System is functioning normally but that there is an impairment in the control processes of working memory. PMID- 3280592 TI - Kiril Bratanov's endeavour in laying the foundations of reproductive immunology. PMID- 3280593 TI - The hypothalamic gonadotrophic hormone releasing hormone (GnRH) pulse generator in the rhesus monkey and its neuroendocrine control. PMID- 3280594 TI - Ovarian stimulation for in-vitro fertilization. AB - In-vitro fertilization (IVF) and embryo transfer has become an accepted clinical method for the treatment of sterility. Different types of ovarian stimulation have been used successfully. The therapeutic principles behind the stimulation treatment in an IVF programme are the same as those applied in the treatment of normal and hypogonadotrophic ovarian insufficiency. These include clomiphene therapy with subsequent HCG administration, combined clomiphene/HMG administration and stimulation with HMG alone, followed by HCG. A new approach to the stimulation of follicular development and oocyte maturation is the use of pure FSH and GnRH analogues. The principal indications, results, advantages and disadvantages of these different schemes of ovarian stimulation for oocyte retrieval are discussed. PMID- 3280595 TI - Clinical applications of gonadotrophin-releasing hormone and its analogues. AB - The clinical applications of GnRH and its analogues are discussed. GnRH can be used diagnostically to assess the releasable pool of LH and the status of gonadotrophin secretion. Clinically it can be used to induce follicle growth and ovulation in patients with hypogonadotrophic amenorrhoea, especially when given in pulsatile form, and there are reports that it might also stimulate spermatogenesis in men with hypogonadotrophic hypogonadism. Analogues are proving valuable in the treatment of precocious puberty, but are not yet practical for contraception. They are more valuable in the treatment of endometriosis, hormone dependent cancers, the polycystic ovary and for the induction of ovulation for in vitro fertilization. PMID- 3280596 TI - Antibodies against steroids. AB - Since the first reports in the early 1960s on the successful production of antibodies against steroids, a large body of evidence has accumulated demonstrating the practical usefulness of steroid antibodies in both clinical and laboratory settings. As to the latter, the development of immunoassays for measuring steroids in blood and other body fluids, as well as the localization of the steroid hormones and their receptors in cells and tissues in vitro are of considerable value. The possible clinical application of steroid immunity with respect to reproductive endocrinology and fertility is reviewed. The role of antibodies against steroids in autoimmune gonadal failure is also discussed. At present, immunization with steroid antibodies is not without limitations, which should be borne in mind, particularly in studying endocrine regulation. PMID- 3280597 TI - Gage's sign--revisited! AB - This article describes the use of the eponym "Gage's sign," one of the "at-risk" signs in Legg-Calve-Perthes disease, described by Catterall in 1971. Catterall's description of this radiographic finding differs from the radiographic finding described by Gage in 1933. Thus, what we have come to call Gage's sign would be more appropriately called "Catterall's sign." PMID- 3280598 TI - Role of adhesive proteins in platelet tumor interaction in vitro and metastasis formation in vivo. AB - Platelet-adhesive protein-tumor cell interaction was studied in vitro and in vivo. Monoclonal antibody 10E5, which inhibits binding of fibronectin and von Willebrand factor to the platelet membrane glycoprotein GPIIb-GPIIIa complex, inhibited the binding of mouse CT26 and human HCT8 colon carcinoma cells to platelets by 63-65%, whereas an irrelevant monoclonal antibody, 3B2, had no effect. Monoclonal antibody 6D1, which inhibits binding of von Willebrand factor to GPIb, also had no effect. RGDS, a tetrapeptide that represents the adhesive domain of fibronectin and von Willebrand factor inhibited binding of the tumors to platelets by 64-69%. Monospecific polyclonal antifibronectin antibody inhibited binding by 60-82%; anti-von Willebrand factor antibody inhibited binding by 75-81%. In vivo, polyclonal monospecific anti-mouse von Willebrand factor antibody inhibited pulmonary metastases induced by CT26 tumor cells by 53 64%, B16a amelanotic melanoma cells by 45% and T241 Lewis bladder cells by 46% without induction of thrombocytopenia. Pulmonary metastases with CT26 cells could be inhibited by induction of thrombocytopenia, and reconstituted by infusion of either murine or human platelets. Reconstitution of pulmonary metastases with human platelets could be inhibited 77% by preincubation of human platelets with monoclonal antibody 10E5 before infusion of platelets into mice. Thus, platelets appear to contribute to metastases by their adhesive interaction with tumor cells via the adhesive proteins fibronectin and von Willebrand factor. PMID- 3280599 TI - Attenuated release of biologically active luteinizing hormone in healthy aging men. AB - To examine the biological quality and physiologically pulsatile mode of endogenous luteinizing hormone release in active, healthy aging men, we used the rat interstitial-cell testosterone in vitro bioassay to probe LH bioactivity in response to (a) endogenous gonadotropin-releasing hormone (GnRH) action (basal pulsatile bioactive LH secretion); (b) exogenous GnRH stimulation (10 micrograms IV pulses); and (c) inhibition of endogenous estrogen negative feedback (treatment with a nonsteroidal antiestrogen, tamoxifen). Basally, some healthy older men exhibited evidence of neuroendocrine dysfunction, reflected by irregular bursts of bioactive LH release followed by transiently low plasma bio:immuno (B:I) LH ratios. However, mean basal plasma bioactive LH concentrations, B:I ratios, and spontaneous LH pulse properties (peak frequency, amplitude, duration, and enhanced B:I ratios within LH peaks) were not altered in older men. On the other hand, augmentation of bioactive LH secretion and enhancement of plasma B:I ratios by pulsed injections of exogenous GnRH were either significantly reduced or absent in older men. In addition, although tamoxifen increased bioactive LH pulse frequency in both age groups and facilitated exogenous GnRH action in some subjects, older men increased their 12 h mean bioactive LH concentrations, B:I ratios, and bioactive LH peak amplitudes to a significantly lesser degree than young men. In summary, young and older healthy men exhibit similar mean basal plasma bioactive LH concentrations and spontaneous LH pulse properties. However, pituitary bioactive LH reserve is markedly attenuated in older men challenged with either exogenous GnRH or antiestrogen. Accordingly, we conclude that healthy aging men manifest an impaired secretory reserve for biologically active LH release. PMID- 3280600 TI - Specific amino acid (L-arginine) requirement for the microbiostatic activity of murine macrophages. AB - The microbiostatic action of macrophages was studied in vitro employing peritoneal cytotoxic macrophages (CM) from mice acting against Cryptococcus neoformans cultured in Dulbecco's medium with 10% dialyzed fetal bovine serum. Fungistasis was measured using electronic particle counting after lysis of macrophages with detergent. Macrophage fungistasis failed in medium lacking only L-arginine. Complete fungistasis was restored by L-arginine; restoration was concentration dependent, maximal at 200 microM. Deletion of all other essential amino acids did not abrogate fungistasis provided that L-arginine was present. Of twenty guanido compounds, including D-arginine, only three (L-arginine, L homoarginine, and L-arginine methylester) supported fungistasis. Known activators or mediators of macrophage cytotoxicity (endotoxin, interferon gamma, tumor necrosis factor) did not replace L-arginine for CM-mediated fungistasis. The guanido analogue NG-monomethyl-L-arginine was a potent competitive inhibitor of CM-mediated fungistasis giving 50% inhibition at an inhibitor/L-arginine ratio of 1:27. Although CM completely blocked fungal reproduction via an L-arginine dependent mechanism, the majority of the dormant fungi remained viable. Thus, this mechanism is viewed as a microbiostatic process similar or identical to the tumoristatic effect of macrophages. This suggests the production of a broad spectrum biostatic metabolite(s) upon consumption of L-arginine by cytotoxic macrophages. PMID- 3280602 TI - Characterization of the thyroid microsomal antigen, and its relationship to thyroid peroxidase, using monoclonal antibodies. AB - MAb directed to the thyroid microsomal antigen have been developed. All bound to 101- and 107-kD bands in Western blot analysis using thyroid microsomal fraction as antigen. The MAb also bound to microsomal proteins immunoprecipitated by serum from patients having a high titer of anti-microsomal antibody but no antibodies to thyroglobulin or thyrotropin-stimulating hormone receptor. The pattern of binding was related to the amount of reducing agent. The 101- and 107-kD bands were increased by addition of dithiothreitol whereas, in its absence, numerous bands of higher molecular weight were present, suggesting a multimeric protein structure. Despite the inability to immunoprecipitate thyroid peroxidase (TPO) enzymatic activity, the MAb bound intensively in Western blot to denatured purified hog TPO and to denatured immunopurified human TPO. Trypsin digestion of the 101-107-kD antigen produced a doublet of 84-88 kD that was still immunoreactive with MAb. One of five polyclonal sera tested (with a microsomal antibody titer greater than 1/20,480 measured by the tanned red cell hemagglutination technique) also recognized the 84-88 kD trypsin fragments. Addition of V8 protease led to a disappearance of the 107-kD protein, but not the 101-kD protein, proving that this antigen is formed by two different polypeptides. The MAb bound strongly to thyroid epithelium, whereas binding to papillary carcinoma was absent or low and moderate for follicular and Hurthle cell carcinoma. This study indicates that the thyroid microsomal antigen and TPO are identical and are constituted of two different polypeptides. On SDS-PAGE the antigen appears as two contiguous bands which share common epitopes but are not identical, as proven by their size and difference in susceptibility to proteolytic digestion. The immunoreactivity of the molecule is highly dependent on a trypsin-sensitive site, which appears important in the recognition of the antigen by polyclonal sera and may have biological importance. The expression of microsomal antigenicity is variable among various thyroid carcinomas. PMID- 3280601 TI - Ethanol causes acute inhibition of carbohydrate, fat, and protein oxidation and insulin resistance. AB - To study the mechanism of the diabetogenic action of ethanol, ethanol (0.75 g/kg over 30 min) and then glucose (0.5 g/kg over 5 min) were infused intravenously into six normal males. During the 4-h study, 21.8 +/- 2.1 g of ethanol was metabolized and oxidized to CO2 and H2O. Ethanol decreased total body fat oxidation by 79% and protein oxidation by 39%, and almost completely abolished the 249% rise in carbohydrate (CHO) oxidation seen in controls after glucose infusion. Ethanol decreased the basal rate of glucose appearance (GRa) by 30% and the basal rate of glucose disappearance (GRd) by 38%, potentiated glucose stimulated insulin release by 54%, and had no effect on glucose tolerance. In hyperinsulinemic-euglycemic clamp studies, ethanol caused a 36% decrease in glucose disposal. We conclude that ethanol was a preferred fuel preventing fat, and to lesser degrees, CHO and protein, from being oxidized. It also caused acute insulin resistance which was compensated for by hypersecretion of insulin. PMID- 3280603 TI - Vascular transport of insulin to rat cardiac muscle. Central role of the capillary endothelium. AB - Using intact, beating hearts, we have assessed the interaction of insulin with capillary endothelium and the subsequent appearance of insulin in cardiac muscle. Rat hearts were perfused with 125I-insulin (10(-10) M) alone or in combination with unlabeled insulin (10(-9)-10(-5) M). 125I grains (shown to represent greater than 90% intact insulin) over both capillary endothelium and cardiac muscle decreased in a dose-dependent manner when hearts were co-perfused with labeled insulin and increasing concentrations of unlabeled insulin. Perfusion of 125I desoctapeptide (DOP) insulin, a low affinity insulin analogue, with unlabeled insulin (10(-9)-10(-5) M) had no effect on the appearance of 125I-DOP insulin over microvessel endothelium and muscle. When capillary receptors were first destroyed by trypsin treatment or blocked by anti-receptor antibodies, the appearance of 125I-insulin in cardiac muscle decreased proportional to the inhibition of insulin binding to the capillary receptors. We conclude that insulin binding to capillary endothelial receptors is a central step in the transport of intravascular insulin to rat cardiac muscle. PMID- 3280605 TI - Histological features of skin and rectal biopsy specimens after autologous and allogeneic bone marrow transplantation. AB - The histological appearances of skin and rectal biopsy specimens were studied in 31 bone marrow transplant recipients (13 autologous, 18 allogeneic) before transplant, at 28 days, at six months, and as soon as graft versus host disease (GVHD) was clinically suspected. Grades I and II skin changes were commonly seen in patients before transplant and in the autologous group after transplant, as well as in most of the allogeneic recipients with suspected GVHD. Epidermal lymphocytic infiltration was seen only in allogeneic recipients, with clinical GVHD following transplant, but this was not a consistent finding and no other histological features were seen which would distinguish early GVHD from changes caused by cytotoxic agents. Rectal biopsy specimens, however, were normal in patients before transplant and in autologous recipients at 28 days; single cell necrosis of crypt cells was seen only in six of 13 allogeneic recipients studied after transplant with clinical skin GVHD but no gastrointestinal symptoms. Skin changes greater than I and II are required for the histological diagnosis of GVHD. Rectal changes are more specific and may be present despite a lack of intestinal symptoms. PMID- 3280604 TI - Regulation of gene expression by thyroid hormone. PMID- 3280606 TI - An unusual interpodocyte cell junction and its appearance in a transplant graft kidney. AB - In a case of focal and segmental glomerulonephritis unusual cell junctions were discovered between podocytes. These most closely resembled lesions described in aminonucleoside induced nephrosis in rats and were unlike anything previously seen in our experience. Shortly after renal transplantation nephrotic syndrome recurred and biopsy specimens showed recurrent focal and segmental glomerulonephritis, with the appearance of these unusual interpodocyte junctions in the graft kidney. This may be related to circulating factors in the blood of the patient. PMID- 3280607 TI - Osteoarticular amyloidosis associated with haemodialysis: an immunoultrastructural study. AB - Osteoarticular amyloidosis occurred in a patient receiving long term haemodialysis. Histological examination showed that the amyloid deposit was surrounded by inflammatory cells and macrophages filled with haemosiderin. Electron microscopy showed that the amyloid fibrils were in close contact with cytoplasmic expansions, or located in intracytoplasmic pockets of the infiltrating cells. Immunohistological and immunoultrastructural observations confirmed that beta 2-microglobulin was a major constituent of amyloidosis associated with dialysis. Amyloid P component was also detected within the amyloid deposits. These findings suggest that amyloid P component, iron overload, or macrophage derived factors could have a role in the polymerisation of beta 2 microglobulin into amyloid deposit. PMID- 3280608 TI - Routine and rapid enzyme linked immunosorbent assays for circulating anti glomerular basement membrane antibodies. AB - Microtitre plate modifications of the original tube enzyme linked immunosorbent assay (ELISA) of Wheeler and Sussman were used for the routine and rapid assays of anti-glomerular basement membrane antibodies in human sera. In a prospective study of 238 sera from 200 patients, the routine assay (about 24 hours) detected circulating antibodies in seven sera from three patients with active anti glomerular basement membrane disease. The remaining sera, from patients with a variety of other glomerulonephropathies, were negative by the assay. The rapid assays took less than four hours, and in a retrospective study, detected anti glomerular basement membrane antibodies in a range of 15 positive sera, with a level of discrimination similar to that observed in the routine assay and with no false positive/negative results. PMID- 3280609 TI - Prevention of nitroimidazole resistance in Campylobacter pylori by coadministration of colloidal bismuth subcitrate: clinical and in vitro studies. AB - One hundred patients with duodenal ulceration and Campylobacter pylori in their stomach were entered into a double blind placebo controlled prospective study. Treatment schedules were cimetidine and placebo, or cimetidine and tinidazole, or colloidal bismuth subcitrate (CBS) and placebo, or CBS and tinidazole. Seventeen per cent of isolates of C pylori obtained at the first endoscopy were resistant to tinidazole and 70% of the second isolates from patients given cimetidine and tinidazole became tinidazole resistant. Suspensions of nitroimidazole sensitive cultures of C pylori showed that three of 22 isolates had a nitroimidazole resistant subpopulation. In patients who healed and remained free of C pylori after treatment ulcers recurred less often than in patients who healed but retained C pylori (23% v 73% over 12 months, p less than 0.001). PMID- 3280610 TI - Immunoturbidimetric assay for rheumatoid factor using an enzyme immunoassay microplate reader. PMID- 3280611 TI - The role of black-pigmented Bacteroides in human oral infections. AB - Today, 10 black-pigmented Bacteroides (BPB) species are recognized. The majority of these species can be isolated from the oral cavity. BPB species are involved in anaerobic infections of oral and non-oral sites. In the oral cavity, BPB species are associated with gingivitis, periodontitis, endodontal infections and odontogenic abscesses. Cultural studies suggest a specific role of the various BPB species in the different types of infection. Bacteroides gingivalis is closely correlated with destructive periodontitis in adults as well as in juveniles. Bacteroides intermedius seems to be less specific since it is found in gingivitis, periodontitis, endodontal infections and odontogenic abscesses. The recently described Bacteroides endodontalis is closely associated with endodontal infections and odontogenic abscesses of endodontal origin. There are indications that these periodontopathic BPB species are only present in the oral cavity of subjects suffering from periodontal breakdown, being absent on the mucosal surfaces of subjects without periodontal breakdown. BPB species associated with healthy oral conditions are Bacteroides melaninogenicus, Bacteroides denticola and Bacteroides loescheii. There are indications that these BPB species are part of the normal indigenous oral microflora. Many studies in the past have documented the pathogenic potential and virulence of BPB species. This virulence can be explained by the large numbers of virulence factors demonstrated in this group of micro-organisms. Among others, the proteolytic activity seems to be one of the most important features. Several artificial substrates as well as numerous biological proteins are degraded. These include anti-inflammatory proteins such as alpha-2-macroglobulin, alpha-1-antitrypsin, C3 and C5 complement factors and immunoglobulins. B. gingivalis is by far the most proteolytic species, followed by B. endodontalis. Like other bacteria, the lipopolysaccharide of B. gingivalis has shown to be active in bone resorption in vitro and is capable in stimulating interleukin-1 production in human peripheral monocytes. Based on the well documented association with periodontal disease and the possession of relevant virulence factors, BPB species must be considered as important micro-organisms in the etiology of oral infections. B. gingivalis seems to be the most pathogenic and virulent species. PMID- 3280612 TI - Detectability of artificial marginal bone lesions as a function of lesion depth. A comparison between subtraction radiography and conventional radiographic technique. AB - Subtraction of serially obtained standardized radiographs of the marginal periodontal bone offers possibilities for an increased detectability of small bony changes compared to conventional radiography. In this study, the depth of artificially induced bone lesions in the alveolar crest was assessed by means of 125I absorptiometry. The results served as reference values when a series of radiographs containing lesions of various depths was interpreted by 10 examiners. Both conventional radiographs and subtraction images made from the conventional radiographs after digitization were interpreted. The ROC-curve technique was used to evaluate the two techniques. A close to perfect accuracy was found at a lesion depth corresponding to 0.49 mm of compact bone using the subtraction technique. A similar degree of accuracy was not reached for the conventional technique until the lesions were approximately 3 times deeper. PMID- 3280613 TI - System approaches in pharmacokinetics: I. Basic concepts. AB - System approaches mathematically describe a general property of a pharmacokinetic system without modeling in specific terms the kinetic processes responsible for the general property considered. Definitions, basic concepts, kinetic basis, and rationale for system approaches as well as advantages and disadvantages of system approaches are presented and discussed. It appears that the system approaches may offer certain advantages over more traditional methods for many practical applications. PMID- 3280614 TI - Intravenous dilazep reduces blood pressure and peripheral vascular resistance in humans. AB - Dilazep, a coronary vasodilating drug with adenosine-mediated activity, was tested (acute double-blind study versus placebo) for its antihypertensive activity in 12 patients who had mild to moderate hypertension. Dilazep (0.2 mg/kg body weight by IV infusion for ten minutes) significantly reduced systolic and diastolic blood pressure (random-zero sphygmomanometer) on average by 13.3 and 10.6 mm Hg respectively. The antihypertensive effect started rapidly, reached its maximum 20 minutes after administration, and lasted for 90 minutes. Heart rate significantly increased between 10 and 30 minutes. The antihypertensive effect of dilazep was associated with a relevant vasodilating effect as demonstrated by the changes in upper limb blood flow (strain-gauge plethysmography, +32%; P less than .001) and vascular resistance (-29%, P less than .001). The maximal reduction of vascular resistance was directly correlated to its baseline value. For these characteristics of action, at least in acute administration, dilazep would be useful agent for the treatment of high blood pressure in mild to moderately hypertensive patients. PMID- 3280615 TI - Comparison of lorazepam and flurazepam as hypnotic agents in chronic insomniacs. AB - Hypnotic efficacy and safety of 3 weeks of daily doses of 2 mg lorazepam or 30 mg flurazepam were compared in a double-blind cross-over study in eight chronic insomniacs between the ages of 29 and 60 years. Subjects were monitored in the sleep laboratory twice weekly for a total of 25 nights. Also, subjective estimates of sleep, vigilance tests, and adverse effects were recorded throughout the study. Findings indicated lorazepam performed better than flurazepam in most sleep parameters. With lorazepam there was improvement from baseline in percentage of sleep time (P less than .05); in total wake time after sleep onset (P less than .01) and in last third of night (P less than .05); in percentage of stage 2 (P less than .05) (weeks 1, 2, 3) and in percentage of night in stage 4 (weeks 2 and 3). Only total wake time from baseline improved (P less than .05) with flurazepam (week 2). Objective and subjective sleep parameters did not correlate well for either drug. Neither drug impaired REM sleep or vigilance test performance. Side effects (grogginess, lethargy; flurazepam only) were few and none was unexpected; neither rebound insomnia nor early morning insomnia occurred with either drug. In summary, both lorazepam 2 mg at bedtime and flurazepam 30 mg at bedtime were found to be effective and safe for treating chronic insomnia, as measured by parameters of sleep and daytime functioning. Lorazepam had more favorable effects on sleep than did flurazepam. PMID- 3280616 TI - Antimuscarinic agents as substances of abuse: a review. AB - Centrally active antimuscarinic agents are generally used in psychiatry to treat the extrapyramidal side effects of antipsychotic medications. However, these agents may have antidepressant and mood-elevating properties, and the literature suggests they are liable to abuse. The author reviews this literature and discusses its implication. PMID- 3280617 TI - A comparison of thiothixene with chlorpromazine in the treatment of mania. AB - High potency neuroleptics have been advocated for acute mania because their side effect profile may allow for a more rapid dose escalation and symptom resolution. Low potency neuroleptics have also been advocated because their sedative properties might better calm the acutely agitated manic patient. The authors tested these hypotheses using a double-blind design comparing thiothixene with chlorpromazine in 29 manic patients on a standard dose of lithium. They found that thiothixene and chlorpromazine produced identical rates and degree of improvement, that side effect profiles differed for each drug but did not affect overall clinical response, and that most patients had a good response on much lower than expected doses. The implications for less aggressive use of neuroleptics to treat mania are discussed. PMID- 3280618 TI - Acetazolamide and thiamine (A+T): a preliminary report of an ancillary therapy for chronic mental illness. PMID- 3280619 TI - Systemic scleroderma. Clinical and pathophysiologic aspects. AB - Systemic scleroderma is a generalized disease of connective tissue involving mainly the skin, the gastrointestinal tract, the lungs, the heart, and the kidneys. It can be present in different forms, of which acroscleroderma, with limited cutaneous and extracutaneous involvement, and diffuse scleroderma within a more rapid progression are most characteristic. Circulating antibodies against antinucleolar antigens are present in most patients with systemic scleroderma. They are helpful for establishing a classification and for determining the prognosis of the disease; their involvement in the pathogenesis, however, is still unclear. Alterations of the blood vessels and induction of fibroblasts by potent mediators are thought to play an important role in the early phase of scleroderma. Therefore early diagnosis is required, which then can initiate vasoactive therapy. In patients with systemic scleroderma, who also suffer from additional myositis, interstitial lung diseases, or arthritis, anti-inflammatory treatment with prednisolone and azathioprine is suggested. Development and progression of fibrosis cannot yet be influenced sufficiently. Only D penicillamine affecting cross-linking of collagen has been widely used in scleroderma and has some beneficial effect. PMID- 3280620 TI - Clinical response and tissue effects of etretinate treatment of patients with solar keratoses and basal cell carcinoma. AB - Patients with basal cell carcinoma and solar keratoses were treated with etretinate. Substantial and prolonged clinical improvement was seen. All patients with solar keratoses showed a decrease in the mean area and number of lesions and eight patients demonstrated complete healing clinically. Two patients experienced recurrence at 9 months after completion of treatment. Histometric and cell kinetic measurements on the epidermis of skin samples from these patients were performed. They revealed epidermal thickening and increased deoxyribonucleic acid (DNA) synthesis both in lesions and in clinically uninvolved skin following treatment. Assessments were also made of enzyme activities in lesions and uninvolved skin with the use of established quantitative cytochemical techniques. Significant reduction in levels of succinic dehydrogenase activity following etretinate treatment was detected in solar keratoses and in basal cell carcinomas. This was also the case for uninvolved skin of patients with solar keratoses. Glucose-6-phosphate dehydrogenase (G6PD) activity was significantly reduced following etretinate treatment in solar keratoses and in basal cell carcinomas, but uninvolved skin did not exhibit significant changes. These changes are in contrast to those previously reported in normal subjects, where the activity increased, but are similar to those observed in patients with ichthyotic disorders. The alterations in the cytochemical profile following administration of etretinate in the lesions of patients reported here are consistent with the view that the drug promotes a more normal pattern of epidermal differentiation. We favor the view that etretinate's antineoplastic action is exerted by preferentially allowing differentiation of normal epidermal cells and inhibiting dysplastic cells. PMID- 3280621 TI - Atrophoderma vermiculatum. Case reports and review. AB - Two patients, a father and a daughter, with atrophoderma vermiculatum are presented. The chief characteristics of this rare, benign condition that usually begins in childhood are a symmetric worm-eaten or reticular atrophy of the cheeks that may extend to the ears or forehead. An autosomal dominant mode of inheritance is present in this family. The prominent characteristics, cause, histologic findings, and rare associated medical conditions are reviewed. The prognosis is good, with many instances of spontaneous regression. Primarily a cosmetic problem, therapy for this condition is aimed at reassurance, genetic counseling, and dermabrasion where appropriate. PMID- 3280623 TI - Pyoderma gangrenosum: a review. AB - Pyoderma gangrenosum is a poorly understood disease characterized by exacerbations and remissions of morphologically unique skin ulcers. It frequently is thought to be the cutaneous manifestation of an underlying systemic disease. In this review of pyoderma gangrenosum, the characteristics of the disease are described and a differential diagnosis is formulated. Associations with systemic diseases are made through a review of the literature. The pathophysiology of pyoderma gangrenosum and probable causes are considered, and special consideration is given to the immunologic mechanisms that may be operative in the disease. Finally the currently available therapeutic alternatives are reviewed. PMID- 3280622 TI - Adverse reactions to isotretinoin. A report from the Adverse Drug Reaction Reporting System. AB - Between October 1982 and June 1985 the Adverse Drug Reaction Reporting System received reports of 104 suspected adverse reactions occurring in 93 patients who took isotretinoin. Adverse reactions involving the skin and mucous membranes (29 reports), central nervous system (23), musculoskeletal system (12), pregnancy (11), and eyes (8) were most commonly reported. Severe headache was the most frequently reported adverse reaction (15 reports). In four cases headaches were attributed to pseudotumor cerebri. Some of the reported reactions, for example, a disulfiram (Antabuse)-like reaction and oculogyric crisis, have not been described previously in the literature. Other reports, such as congenital malformations, serve to emphasize some of the serious reactions that are known to occur. These spontaneous reports of adverse reactions associated with isotretinoin use, together with the literature we review, may help alert physicians to the diverse spectrum of adverse reactions that may develop in patients taking isotretinoin. PMID- 3280624 TI - Perianal streptococcal cellulitis. PMID- 3280625 TI - Do corticosteroids prevent postherpetic neuralgia? A review of the evidence. AB - A short course of corticosteroids is frequently used in herpes zoster to prevent postherpetic neuralgia. To clarify the evidence behind this routine practice, we reviewed the three randomized controlled trials on this subject. Although in all three similar dosages of corticosteroids (40 mg to 60 mg prednisone daily for 2 to 4 weeks) were used, deficiencies in reported clinical characteristics of study subjects, the potential for bias in the ascertainment of pain duration, and the inability to exclude type II error make it impossible to determine whether or not this practice is effective. More research on this subject is needed, with greater attention to good study methodology. PMID- 3280626 TI - CT demonstration of portal vein aneurysm. AB - We report a case of portal vein aneurysm showing characteristic enhancement on dynamic CT. PMID- 3280627 TI - Pleomorphic xanthoastrocytoma: CT appearance. PMID- 3280628 TI - MR subtraction angiography with a matched filter. AB - The technique of matched filtering (MF) has been used in the past with X-ray digital subtraction angiography as a method of improving signal-to-noise ratio (SNR) in subtraction angiographic images. In this work we describe how MF can be applied to a series of images produced by cinematographic magnetic resonance (cine MR) to produce angiographic images. Likewise, a simple subtraction image can be formed by subtracting an image in which flow is not well visualized from an image at the same location but with flow visualization. Theory predicts that a subtraction image resulting from the MF technique will yield typical SNR improvements of 60% over results from simple subtraction. Twenty-one studies of the human popliteal, canine aorta, and canine carotid artery were undertaken in which MF was compared with simple subtraction. It was determined that cine MR can be used to produce subtraction angiographic images and that MF can produce a modest improvement in SNR over simple subtraction. PMID- 3280629 TI - Carcinosarcoma of the skin. AB - A 91-year-old patient with an extraskeletal osteosarcoma (characterized by atypical mesenchymal cells with ossification) of the forehead associated with a basal cell carcinoma is reported. Both osteoid and basal cell carcinoma nests were found embedded in a stroma containing markedly atypical cells. The 2 previously reported carcinosarcomas of the skin are reviewed. PMID- 3280630 TI - Porokeratotic eccrine ostial and dermal duct nevus. AB - We report 2 cases of congenital porokeratotic eccrine nevus in a 5-year-old girl and a 7-year-old boy. The clinical manifestations were those of nevus comedonicus palmaris. The histologic picture consisted of comedo-like dilatations and cornoid lamellae involving the eccrine ostia and ducts. One of the cases showed anomalies in the dermal eccrine ducts. We believe that these lesions are eccrine hamartomas unrelated to porokeratosis. We review similar cases from the literature and discuss the differential diagnosis. PMID- 3280632 TI - The retention of fissure sealants using twenty-second etching time: three-year follow-up. AB - The retention of a self-polymerized fissure sealant applied after twenty seconds etching time was evaluated after three years. From the original 100 molars that were sealed, seventy-one teeth with 105 sites were available. The sealants were totally retained in 91 percent of the cases, after three years. The findings demonstrate that the retention rates of fissure sealants using twenty seconds etching time are comparable to those reported with the more conventional sixty seconds. PMID- 3280631 TI - Treatment of unilateral posterior crossbite: comparison of the quad-helix and removable plate. AB - The aim of this retrospective study was to compare the quad-helix and removable plate with respect to effect and cost of treatment in the mixed dentition with unilateral forced crossbite. In the quad-helix group (25 children), expansion was accomplished with a prefabricated .036'' quad-helix soldered to bands on the maxillary molars. In the plate group (25 children), the removable plates had a midline screw and four Adams clasps. The screw was opened by one quarter-turn each week. The crossbite was eliminated in all cases in the two groups. The respective results in the quad-helix group and in the plate group (in brackets) were: intermolar arch width increased 3.6 mm (3.7 mm); the total period of appliance therapy averaged 3.8 months (21.6 months), ranging from 2 to 6 months (12-30 months); the number of visits averaged 4.6 (16.0), ranging from 3 to 6 (11 22); number of appliances needed averaged 1 (1.7), and the costs of the appliances averaged $58 ($174). In the plate group, the average values of the laboratory costs were 3-fold, the number of visits 3.5-fold, and the expansion and retention time 5.7-fold more than the quad-helix group. The present treatment rationale with the quad-helix appliance is easy, effective, cost-efficient, and can be learned by every pedodontitis for correction of unilateral crossbites in the mixed dentition. PMID- 3280633 TI - The suicidal adolescent. AB - It is the author's opinion that by educating dentists on the warning signs of suicide and the protocol for managing suspected cases, the tragic deaths of many adolescents may be prevented. Educational material should be presented in the undergraduate dental curriculum and periodically reinforced in the dental literature and continuing education courses. Dentists and their staffs must be constantly alert to warning signs of this ever-increasing problem. Suspected cases should be thoroughly investigated and followed up. PMID- 3280634 TI - Risk factors for the development of malignant melanoma--I: Review of case-control studies. AB - Data concerning risk factors for the development of cutaneous malignant melanoma (MM) were abstracted from published case-control studies. Relative risks (more appropriately "odds ratios") and 95% confidence intervals were quoted or calculated for each risk factor in each study. Those risk factors that were reported to be significant in over half of the studies include: phenotypic factors (blue eyes, blond or red hair, light complexion, freckles, sun sensitivity, and inability to tan); personal history of non-melanoma cutaneous cancer or precancer; higher socioeconomic status; increased numbers of nevocytic nevi; and bursts of sun exposure. Further study is needed on family history and personal history of MM; these were not found to be significant risk factors in over half the reviewed case-control studies. This review leaves out other undoubtedly important risk factors such as dysplastic nervus syndrome and race, which need investigation by the case-control method. Determination of risk factors allows the identification of that subset of the population most at risk for the development of MM. Given the continued increase in the incidence of MM, these data can help to focus preventive measures on the more susceptible subgroups of the population. PMID- 3280635 TI - Dr. Abner Kurtin, father of ambulatory dermabrasion. PMID- 3280636 TI - The (mis)measurement of restraint: an analysis of conceptual and psychometric issues. PMID- 3280637 TI - Biological effects of the hand-arm vibration syndrome: historical perspective and current research. AB - The objective of this paper is to highlight gaps of information regarding mechanisms of vascular, neurological, and musculo-skeletal damage caused by vibration. Also addressed is evidence that high noise level may act synergistically to the development of vibration syndrome of the hand and arm. Areas of research currently active in psychophysical and neurophysiological investigations to increase our understanding of tactile and spatial discrimination are discussed. Although the importance of sensory loss or "fine touch" is understood, there is neither a proven objective scientific test with which the syndrome can be diagnosed nor is there a scale of damage assessment. Determining the exact role of the central nervous system in assessing damage from vibration is difficult in view of nonspecific symptoms reported from eastern Europe and from Japan. To complicate matters still further, there is the possibility that repeated, rapid mechanical movements of the hand and arm associated with handling heavy tools produce carpal tunnel syndrome but that the injury is not directly attributed to vibration. Therefore, it follows that there could exist an element of carpal tunnel syndrome in many vibration syndrome cases. PMID- 3280638 TI - The presidents. Carlton H. Williams, 1973-1974. PMID- 3280639 TI - Orthodontic treatment of the primary dentition. AB - Five patients were treated for corrections of problems in the primary dentition. Anterior and posterior crossbite, deep overbite malocclusion, and overbite malocclusion were treated with simple removable orthodontic appliances. Early orthodontic treatment for these patients helped resolve any functional problems that could interfere with later growth and development, such as health and function of the TMJ complex. PMID- 3280640 TI - Ventricular function and infarct size: the Western Washington Intravenous Streptokinase in Myocardial Infarction Trial. AB - The Western Washington Intravenous Streptokinase in Acute Myocardial Infarction Trial randomized 368 patients with symptoms and signs of acute myocardial infarction of less than 6 h duration to either conventional care or 1.5 million units of intravenous streptokinase. The mean time to randomization was 209 min and 52% of patients were randomized within 3 h of symptom onset. Quantitative, tomographic thallium-201 infarct size and radionuclide ejection fraction were measured at 8.2 +/- 7.5 weeks in 207 survivors who lived within a 100 mile radius of a centralized laboratory. Overall, infarct size as a percent of the left ventricle was 19 +/- 13% for control subjects and 15 +/- 13% for treatment patients (p = 0.03). For anterior infarction in patients entered within 3 h of symptom onset, infarct size was 28 +/- 13% in the control group versus 19 +/- 15% for the treatment group (p = 0.09). Left ventricular ejection fraction was 47 +/- 15% in the control versus 51 +/- 15% in the treatment group (p = 0.08). For anterior infarction of less than 3 h duration, the ejection fraction was 38 +/- 16% in the control versus 48 +/- 20% in the treatment group (p = 0.13). By statistical analysis incorporating the nonsurvivors, p values for all of these variables were less than or equal to 0.08. There was no benefit for patients with inferior infarction or for anterior infarction of greater than 3 h duration. It is concluded that intravenous streptokinase, when given within 3 h of symptom onset to patients with anterior infarction, reduces infarct size and improves ventricular function. PMID- 3280642 TI - Visual estimates of percent diameter coronary stenosis: "a battered gold standard". PMID- 3280641 TI - Demonstration of restrictive ventricular physiology by Doppler echocardiography. AB - In patients with restriction of cardiac filling of various origins, cardiac catheterization has been traditionally used as part of the diagnostic evaluation to verify the presence of restrictive/constrictive hemodynamics. In an attempt to determine whether this "restrictive" physiology could be demonstrated noninvasively, 14 patients who had a history, physical examination, two dimensional echocardiogram and catheterization data compatible with a restrictive myocardial process were studied with pulsed wave Doppler ultrasound. Forty normal subjects served as a control group. The Doppler ultrasound evaluation included measurement of peak mitral and tricuspid flow velocities and flow velocity integrals, mitral and tricuspid deceleration times and central venous flow patterns during apnea and inspiration. The flow velocity recordings across the mitral and tricuspid valves in patients manifesting restriction were markedly different from those in normal subjects, showing shortened deceleration times across both valves, which indicated both an abrupt premature cessation of ventricular filling and the presence of a diastolic dip-plateau contour in ventricular pressure recordings. In addition, abnormal central venous flow velocity reversals with inspiration and diastolic mitral and tricuspid regurgitation were frequently observed, also suggesting the reduced myocardial compliance characteristic of a restrictive myocardial process. PMID- 3280644 TI - Insulin sensitivity and beta-cell responsivity are not decreased in elderly subjects with normal OGTT. AB - Glucose intolerance has been observed often in elderly subjects, but it is not yet clear whether this impaired metabolic state is due to the aging process itself or is secondary to the appearance of other age-related variables. This study attempts to elucidate the effect of age in itself on factors controlling glucose tolerance. Several metabolic parameters were measured in 10 young male controls (23-29 yr) and 17 nonhospitalized, healthy, nonobese, old (60-80 yr) male subjects. Insulin binding to circulating cells was performed along with the intravenous glucose tolerance test, and the data were analyzed by the minimal model method. This approach yields the following measures: tissue insulin sensitivity (SI), fractional glucose disappearance at basal insulin (glucose effectiveness, SG), and first (phi 1) and second (phi 2) phase beta-cell responsiveness to glucose. Insulin-binding capacity to monocytes and erythrocytes was respectively 6.03% +/- 0.57% and 5.96% +/- 0.53% (elderly), 5.97% +/- 0.39% and 5.36% +/- 0.57% (young); SI was 6.20 +/- 0.59 X 10(4) min-1/(microU/mL) (elderly) and 6.35 +/- 0.30 (young); SG was 0.016 +/- 0.002 min-1 (elderly) and 0.019 +/- 0.003 (young); phi 1 was 1.84 +/- 0.29 min-1 (microU/mL)/(mg/dL) (elderly) and 3.37 +/- 0.84 (young); phi 2 was 13.80 +/- 1.78 X 10(4) min-2 (microU/mL)/(mg/dL) (elderly) and 9.59 +/- 2.65 (young). These results show no change with aging of tissue insulin sensitivity and an intact beta-cell activity, suggesting that age per se does not contribute to the deterioration of glucose tolerance when the effect of other age-related variables, eg, obesity and physical inactivity, is precluded. PMID- 3280643 TI - Metabolic changes in Alzheimer's disease. AB - Patients with Alzheimer's disease (AD) and matched controls fasted for 24 hours, and serial glucose, pyruvate, lactate, beta-hydroxybutyrate, acetoacetate, insulin, and glucagon levels were measured. Patients with AD showed a glucose insulin correlation pattern over the 24 hours that differed from the control group. These differences may be secondary to weight loss or to other metabolic or nutritional factors affecting the AD patients. PMID- 3280645 TI - Evaluation of excessive daytime sleepiness in the elderly. PMID- 3280646 TI - Thrombotic thrombocytopenic purpura in older patients. PMID- 3280647 TI - Evaluation of Chemstrip LN in a male geriatric population. AB - A dipstick method for bacteriologic screening of urine using a combination of leukocyte esterase and nitrite indicators, Chemstrip LN, was evaluated in a male inpatient geriatric population. Three hundred seventy-five urine samples from 198 symptomatic patients (age range, 45 to 98 years; mean, 69.6) were tested by LN and cultured using standard methods. LN showed 169 negatives, but in 7 of these cases, the culture was positive (greater than or equal to 5 X 10(4) col/mL). Organisms recovered from these cultures were Candida (not albicans), Group B Streptococcus, Staphylococcus aureus, and in four cases, Pseudomonas aeruginosa. In the four cases of missed Pseudomonas the patients were receiving aminoglycoside therapy for 2 to 6 days and/or drugs that dye the urine. Despite the fact that many patients were on medications known to interfere with the test strips, the negative predictive value was still 96.0% showing that the strips may be suitable for use with this population given the understanding that certain antibiotics and/or substances that dye the urine may give false negative results. PMID- 3280648 TI - National Institutes of Health Consensus Development Conference Statement: geriatric assessment methods for clinical decision-making. PMID- 3280649 TI - The geriatrician and the homebound patient. PMID- 3280651 TI - [Value and dangers of indomethacin used in pregnancy. Apropos of 304 treated patients]. AB - When Indomethacin in a dosage of 175 mg/day was used to treat threatened premature labour more than 70% of cases carried on until 37 weeks. This treatment therefore is an interesting alternative treatment to beta-mimetics whose the maternal side effects can be serious. As far as the cardiovascular systems of the fetus and neonate are concerned the effects in the dosage used are negligible. On the other hand there may be renal failure which is transitory at birth when delivery has taken place while treatment was going on. The treatment should not be prolonged for more than three weeks because Indomethacin causes oligohydramnios and this can cause in its place malpositions and maldevelopment of the lungs. Finally, it is not certain whether this treatment has any effect on fetal growth causing diminished growth, possibly. PMID- 3280650 TI - Microbiologic characteristics of unpreserved saline. AB - This study was designed to assess the microbiological risk associated with using unpreserved saline buffered with either borate or phosphate salts. The results indicate that borate buffer has measurable antimicrobial activity and can control some microbiological contamination. However, phosphate-buffered saline can become easily contaminated and usually promotes growth or maintains viability of adventitious contaminants. PMID- 3280652 TI - [Nuclear magnetic resonance imaging in gynecology. An evaluation of its current applications]. AB - The authors present a research carried out by the Universities of Essen, Tubingen (RFA) and Grenoble, France, on the use of magnetic resonance imaging (M.R.I.) in gynaecology. After clarifying our knowledge of the normal anatomy of the pelvis and of the tissular characteristics of MRI the principal indications are discussed and set out. The investigation is shown to be particularly valuable in working out the aetiology, the volume and the spread of a pelvic mass whether it is benign or malignant when it is important to be exact in finding the origin of the tumour. This research has been illustrated by analysing 35 case histories including 28 malignant tumours. A second study was carried out on 30 cases of cancer of the cervix. In this field MRI is the only test that can be carried out before therapy to give a tridimensional assessment of the size of the tumour and whether it has spread into the parametrium. The visual impressions obtained by MRI illustrate each chapter: of the gynaecological anatomy, of the pathology, in cancers of the cervix, in pelvic masses and particularly in ovarian tumours. PMID- 3280653 TI - [Ultrasonics and fetal growth in Gabon]. AB - The authors have worked out growth curves for the 3 classical parameters (BPD, HED and Femur) for the Gabonese by studying 870 ultrasound sets of measurements carried out between the 15th and the 40th week of amenorrhoea in normal pregnancies. Comparisons between these curves that have been worked out with those in Europe and the U.S.A. show that there is no difference between them that could be explained by the ecological conditions or the eating habits among other factors. PMID- 3280654 TI - [Electrophoresis of cholinesterases of the amniotic fluid in the prenatal diagnosis of closure defects of the neural tube]. AB - The value of acetylcholinesterases (AChE) qualitative analysis as a tool for the diagnosis of fetal neural tube defect has been investigated in a series of 2,815 amniotic fluid samples. This test successfully identified all the 84 cases of open neural tube defects, 16 of which had been missed by ultra-sonography. AChE electrophoresis made it possible to exclude one false positive ultrasound diagnosis of neural tube defect, and to differentiate meningocele from myelomeningocele. Our experience suggests that AChE electrophoresis should be carried out in place of amniotic fluid alpha-fetoprotein estimations, in all cases of fetal abnormality detected by ultrasound scanning especially in fetal hydrocephaly, and in all pregnant women with an history of a previous pregnancy with a neural tube defect. PMID- 3280655 TI - [Ultrasonic control immediately after voluntary interruption of pregnancy. Apropos of 144 cases]. AB - This study has led to two conclusions: the first is that ultrasound examinations of the pelvis are often asked for immediately after termination of pregnancy because clinicians suspect there may be complications. On the other hand these ultrasound pictures are difficult to interpret and so often, therefore, curettage is carried out which in fact is not necessary. The authors describe a prospective study carried out on 144 cases of termination of pregnancy for which pelvic ultrasound was routinely carried out following termination of pregnancy. The results of this study show that there are several types of ultrasound pictures found immediately after termination of pregnancy; these contain some that can be considered to be reassuring and others that are doubtful. The conclusion depends on the answer to several questions: is it correct to carry out routine ultrasound immediately after termination of pregnancy and has it a real practical purpose? From this can one say that it is necessary to do an ultrasound after every termination of pregnancy? If not, are there special indications for the procedure? PMID- 3280656 TI - [Anorexia nervosa and pregnancy]. AB - We report the case of a pregnancy associated with severe anorexia nervosa. The patient weighed 33 kg for 1 m 51 at conception. The pregnancy was obtained during a spontaneous cycle. Despite nutritional and psychological case, the patient continued to lose weight and weighed only 28 kgs at 33 weeks of amenorrhea, when she gave birth to a hypotrophic child of 1130 gr after artificial starting. The case provides discussion of the relation ship between anorexia nervosa and pregnancy. PMID- 3280657 TI - [Heterotopic twin pregnancies. Review of the literature after a case where the 2 children survived]. AB - A combination of an extra-uterine and an intra-uterine pregnancy is defined as heterotopic twin pregnancy. A case is reported where the 2 infants were born alive and have had a normal psychomotor development at 3 years of age. It is a case where the first observation taken by ultrasound made the diagnosis possible at 27 weeks of the pregnancy and therefore gave rise to the crucial problem of how to manage the case. Because of this case history we have discussed the frequency (one in every 30,000 pregnancies), the aetiological factors, the clinical factors, the prognostic factors and what is to be done. The discussion takes note of the modern ways of diagnosing it (ultrasound), of monitoring it and of handling in a specialised unit this exceptional kind of "high risk" pregnancy. PMID- 3280658 TI - [First heterotopic ovarian autotransplantation in the female]. AB - Treatment of subdiaphragmatic Hodgkin's disease with combined radio and chemotherapy results in castration of more than 80% women treated, despite oophorepexy. Several types of oophorepexy (lateral and medial transposition), have been described in the literature. None warranted sufficient schelter to avoid frequent alteration of ovarian function and fertility. We suggest a news technique of subcutaneous ovarian grafting which provides full protection against irradiation. To be successful, this technique requires the creation, prior to grafting, of a receptive cavity, two surgical teams working together, and the use of an operative microscope during transplantation. A mature oocyte was collected by puncture of the ovary containing cavity one year after the operation. Two years later, ovarian cycles remain regular, and follicle growth occurs normally each second of third cycle on the transplanted ovary. PMID- 3280659 TI - Adrenomedullary catecholamine release in the fetus and newborn: secretory mechanisms and their role in stress and survival. AB - Catecholamines released by the adrenal medulla during birth play a key role in the adaptation of the newborn to extrauterine life. Respiratory, metabolic and cardiovascular adaptations to the hypoxia and other stresses associated with delivery are dependent upon a profound surge of adrenomedullary activity which occurs despite the immaturity of connections between the central nervous system and the adrenal. The "non-neurogenic" response seen in the fetus and neonate is thus essential to survival, and any interference either with catecholamine release or with catecholamine actions at adrenergic targets results in loss of the ability to survive hypoxia or other stressors. The immature secretory mechanism disappears as a result of development of neural connections, and factors which accelerate ontogeny of neural competence thus lead to premature loss of non-neurogenic secretory capabilities and a consequent increase in vulnerability. The fetus and neonate also have unusual proportions of adrenergic receptor subtypes in many tissues; these confer reactivity to specific stimuli associated with birth and with periods in which tissue differentiation may be under adrenergic control. Again, the ontogenetic switchover of receptor-mediated mechanisms appears to be a function of the development of neuronal competence, but in this case an important role may be played by a secondary surge in sympathetic tone occurring during the postnatal period. Through specialized mechanisms mediating catecholamine secretion and adrenergic responses, the adrenal medulla thus appears to provide both physiological and trophic signals to the fetus and neonate. PMID- 3280660 TI - Flexor tendon rupture associated with an anomalous muscle. AB - A rupture occurred in the substance of an apparently normal flexor digitorum profundus tendon of a left small finger. It was associated with a previously undescribed anomalous flexor digitorum superficialis of the brevis type to the same finger. Clinical reports of 20 anomalous flexor digitorum superficialis muscles were found in the literature; all but one were on the right side or bilateral and occurred predominantly in females. Three cases were of the brevis type and all involved the index finger. Although the precise reason for rupture is not known we have speculated that the anomalous superficialis may have given rise to a deficient vinculum longus to the profundus predisposing it to failure. PMID- 3280661 TI - Only a good man (or woman) can be a great physician. PMID- 3280662 TI - Trispiral tomography for the evaluation of wrist problems. AB - Trispiral tomography is an x-ray technique that is essential in the diagnosis and management of a wide variety of problems involving the carpal bones and their joints. It facilitates the visualization of acute fractures, particularly those of the scaphoid and hook of the hamate, as well as cysts, sclerosis, and erosive lesions. It is useful in differentiating between acute and chronic changes, and it is often indispensable in evaluating healing after acute fractures or bone grafts to treat nonunions. PMID- 3280664 TI - Use of an H-graft in the treatment of a Delta phalanx. PMID- 3280663 TI - A case study of pyoderma gangrenosum. AB - Pyoderma gangrenosum is a rare neutrophilic dermatosis seen initially as painful pustules or bullae on the skin that rapidly ulcerate and have a characteristic raised, purplish areola surrounding them. It is often associated with inflammatory bowel disease and less commonly with other systemic diseases, such as myelofibrosis, rheumatoid arthritis, and chronic active hepatitis. Pyoderma gangrenosum involving the hand is a rare entity, with only two previous cases reported in the literature. This article describes a patient with myelofibrosis in whom pyoderma gangrenosum of the hand developed after she underwent splenectomy. PMID- 3280665 TI - Butoconazole nitrate. PMID- 3280667 TI - Indiana Medical College School of Medicine Purdue University 1906-1908. PMID- 3280666 TI - Medical museum notes (Drs Thomas H. Harrison and William B. Fletcher). PMID- 3280668 TI - Evaluation and treatment of hepatic metastasis from colorectal cancer. PMID- 3280669 TI - Cumulative bibliography of the current world literature in hypertension. PMID- 3280670 TI - Hypertension 1988: present challenges and future strategies. PMID- 3280671 TI - Reno-submandibular axis controls release of extrarenal inactive renin. AB - The mechanisms causing the release of plasma inactive renin (PIR) area still unclear. We have investigated the role of the kidney in the release of trypsin activable PIR from extrarenal sources in the rat, with special reference to the submandibular gland. The activation of PIR was performed by incubation with 20 mg/ml trypsin at 4 degrees C for up to 10 min; the reaction was then terminated by addition of 20 mg/ml of soybean trypsin inhibitor. Bilateral nephrectomy resulted in a gradual, marked, sex-independent increase in PIR concentration, reaching levels 4.5 times higher than basal in 24 h (time 0: 14.8 +/- 1.0 ng/ml per h; 24 h: 66.8 +/- 3.4 ng/ml per h, mean +/- s.d., P less than 0.001). This increase was not altered by the concomitant intravenous infusion of pressor doses of either angiotensin (Ang) II (30 ng/min) or pure mouse submandibular renin (a 20-ng intravenous bolus followed by intravenous infusion at the rate of 50 ng/h) for 4 h, but was completely prevented by prior removal of the submandibular glands, in which no activity of active renin and no inactive renin was detected. These results suggest that the post-nephrectomy increase of PIR is not dependent on feedback mechanisms of the suppressed renin-angiotensin system, but is controlled by the presence of submandibular glands in the rat. PMID- 3280672 TI - Effects of trypsin on the measurement of inactive renin in rat plasma by radio immunoassay: decrease in inactive renin following nephrectomy. AB - We have examined the effect of trypsin treatment of rat plasma on the rate of angiotensin (Ang) I generation and measurement of this peptide by radio immunoassay. Trypsin increased the renin incubation blank but did not alter the kinetics of the renin reaction with exogenous renin. The quantity of immunoreactive material detected in trypsin-treated plasma was not proportional to the volume of plasma assayed. Consequently, the level of inactive renin was dependent upon the volume of plasma subjected to the assay. This discrepancy occurred with two independent radio-immunoassay systems. The rate of Ang I generation was linear and significantly elevated following the addition of renin substrate to trypsin-treated plasma. However, if trypsin degradation of endogenous renin substrate was extensive and additional renin substrate was not provided, non-linear rates of Ang I generation occurred. Multiple additions of trypsin were necessary to activate maximally inactive rat plasma renin. Inactive renin accounted for 79 +/- 2% of the total enzyme activity in normal rats. Although active renin declined following bilateral nephrectomy, the ratio of active to inactive renin did not change. The data suggest that the kidney is the primary source of inactive renin in the normal rat. PMID- 3280673 TI - Bibliography of the current world literature in hypertension. PMID- 3280674 TI - The use of ambulatory blood pressure monitoring to improve the accuracy and reduce the numbers of subjects in clinical trials of antihypertensive agents. AB - A low-cost ambulatory blood pressure measuring device has been developed from a commercially available stationary apparatus. The device, which has been compared for accuracy with a mercury manometer, has functioned satisfactorily as an ambulatory monitor for 4 years. To minimize errors, blood pressure readings were made in the sitting position at half-hourly intervals over the waking day. The utility of the device in clinical trials has been investigated. On repeated readings no placebo effect on blood pressure was detectable and the mean difference between two readings in 42 subjects was 1.9/-0.33 mmHg. The standard deviation of the difference were 8.1/5.6 mmHg. This should make it possible to detect differences of 8/5 mmHg between two treatments in about 16 subjects. There was no detectable tendency for blood pressure to change during the day but the variability between readings was substantially increased if the observation periods were reduced to 4 h. PMID- 3280675 TI - Medial prefrontal cortical lesions and baroreceptor heart rate reflex sensitivity in the spontaneously hypertensive rat. AB - Previous investigations have shown that an excitotoxic lesion of the medial prefrontal cortex (MPFC) in normotensive Sprague-Dawley rats results in a reduction in the sensitivity of the baroreceptor heart rate reflex. The aim of this study was to examine the importance of the MPFC in regulation of the heart rate reflex in conscious, unrestrained spontaneously hypertensive rats (SHR). The MPFC was lesioned by bilateral microinfusions of the excitotoxin N-methyl-D aspartic acid (NMDA). Baroreceptor heart rate reflex testing was performed by measuring reflex heart rate changes in response to blood pressure alterations induced by nitroprusside and phenylephrine with subsequent computerized sigmoidal curve-fitting of the data. Lesion of the MPFC did not significantly alter resting, systolic and diastolic blood pressure, heart rate or baro-reflex parameters (gain, thresholds, range or plateaus). These observations suggest that the putative descending facilitatory influence from the MPFC to brainstem areas, involved in baroreceptor reflex regulation observed in normotensive rats, may be defective in SHR. PMID- 3280676 TI - Evidence for a predominant renal secretion and clearance of inactive plasma renin, studied by in vivo inhibition of protein synthesis. AB - The aim was to investigate the contribution of the kidneys and the extrarenal tissues to the concentration of inactive renin in the circulation. Renin was determined in plasma from normal, conscious, male mice in strains with low (BALB/c) and high (Theiller) renin content in the submandibular glands. In untreated, conscious males, inactive and active renin concentration in plasma was 24.9 GU/l (range 13.6-40.1 GU/l) and 4.2 GU/l (0.6-8.8 GU/l), respectively in the BALB/c strain (n = 28). These values were not significantly different from the concentrations of inactive (29.2 GU/l, range 15.6-88.3 GU/l) and active (5.1 GU/l, range 1.9-10.4 GU/l) renin in Theiller's strain (n = 10). Thus, inactive renin comprised 80-90% of the total renin in plasma from normal, conscious, male mice of both strains. The percentage of inactive renin was similar to that found in humans. Following sialo-adenectomy and bilateral nephrectomy, the plasma concentration of inactive renin was unchanged. The effect of in vivo inhibition of the protein synthesis by intraperitoneal injection of emetine was also investigated. After 6 h of inhibition, inactive renin in plasma declined from 21.0 to 9.9 GU/l in normal mice. In contrast, inactive renin was unchanged in sialo-adenectomized and nephrectomized mice (29.1 versus 28.6 GU/l). Our findings suggest that the kidneys are the main source of inactive renin in the circulation. The data also indicate that the kidneys simultaneously secrete and remove inactive renin from the blood at approximately the same rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280677 TI - Psychosocial stress induces high blood pressure in a population of mammals on a low-salt diet. AB - The relative importance of salt intake and psychosocial stimulation in the development of high blood pressure has been studied in colonies of CBA/USC mice. Approximately 50 males were observed for 3-4 months in five population cages which successfully induced chronic psychosocial interaction, resulting in chronic hypertension. Under these conditions, progressive arteriosclerosis develops together with myocardial hypertrophy, increased catecholamine synthesis and increased angiotensin sensitivity. Previous work indicates that this condition shows the characteristics of renin dependent human hypertension. A special grain based diet was used which included 0.014% sodium. This resulted in the ingestion of the equivalent of 40 mmol/l sodium or 3.0 g NaCl in a 70-kg man. This, and an even more stringent synthetic diet containing less than 0.01% NaCl, i.e. less than 2 g NaCl per day in man, were contrasted with the standard chow which contains 0.4% sodium. Over 4 months of social interaction the psychosocial stimulation proved to be the critical factor and, despite the low-salt intake, blood pressure rose to the same levels as those of control groups on a normal diet containing 1% salt. Hypertension occurs in the absence of kidney failure as assessed by blood urea. Plasma renin levels on the low-salt grain based diet were double those on standard chow, showing that the diet was sufficiently low in salt to activate the renin-angiotensin system. PMID- 3280678 TI - The fifth Sir George Pickering memorial lecture. Epitaph to essential hypertension--a preventable disorder of known aetiology? PMID- 3280679 TI - A monoclonal antibody detects macrophage maturation antigen which appears independently of class II antigen expression. Reactivity of monoclonal EBM11 with bovine macrophages. AB - A mAb EBM11, raised against human macrophages [M phi] was found to detect a bovine M phi diameter-subpopulation. The Ag was strictly intracellular and was expressed in M phi only at a certain state of maturation. Its expression was regulated independently of the activation state of the cells, as revealed by treating M phi in vitro with bovine rIFN-alpha I1, IFN-gamma, or TNF-alpha, all potent M luminal diameter activators. Such treatment had no apparent effect on Ag expression. The Ag was present in 1 to 5% of peripheral blood leukocytes, i.e., up to 20% of circulating blood monocytes, in both normal noninfected cattle and in cattle persistently infected with bovine viral diarrhoea virus. Blood monocytes of the latter group were activated in vivo, but apparently did not reach a more mature state than found in noninfected animals. After an acute infection with bovine herpes virus type 1, the frequency and total number of EBM11+ cells decreased dramatically in inverse relationship to an equally significant increase in frequency and total number of circulating monocytes. In cryostat sections of normal tissues, the EBM11 mAb reacted with sinus M phi and M phi in germinal centers of lymphoid tissues, with alveolar M phi and liver Kupffer cells. In skin it reacted with few scattered M phi in the dermis, but not with epidermal Langerhans cells. This latter feature distinguishes the bovine system from the human. In virus-induced inflammatory processes in skin and keratinized epithelia EBM11+ cells constituted a subpopulation of the infiltrating M phi. The data obtained suggest that EBM11 mAb could be useful both for the elucidation of differentiation/maturation pathways of cells of the monocyte-macrophage lineage as well as for studies of M phi-virus interactions in virus infections. In either aspect cattle could provide a useful comparative model. PMID- 3280680 TI - Transforming growth factor-beta 1 (TGF-beta 1) and recombinant human tumor necrosis factor-alpha reciprocally regulate the generation of lymphokine activated killer cell activity. Comparison between natural porcine platelet derived TGF-beta 1 and TGF-beta 2, and recombinant human TGF-beta 1. AB - We have investigated the ability of porcine-platelet-derived transforming growth factor-beta 1 (TGF-beta 1) to inhibit the generation of lymphokine-activated killer (LAK) cells by human rIL-2. The results demonstrate that TGF-beta 1, in a dose-related manner, significantly inhibits rIL-2-induced LAK cell activity against Daudi and COLO target cells and, to a lesser degree, against K-562 cells. Maximal inhibition was obtained by the addition of TGF-beta 1 at the time of culture initiation and, to a lesser degree, on day 1. Only minimal inhibition was obtained when TGF-beta 1 addition was delayed until day 2 of culture or when added directly into the LAK cell assay. Additional studies demonstrated that porcine platelet-derived TGF-beta 2 and human rTGF-beta 1 inhibited LAK cell generation similar to that obtained with TGF-beta 1. The inhibition of LAK cell activity by TGF-beta 1 was reversed by the addition of human rTNF-alpha at the initiation of culture. In addition, rTNF-alpha synergized with suboptimal levels of rIL-2 in the generation of LAK activity. After stimulation with rIL-2, LAK cells produced significant levels of IFN-gamma, TNF-alpha, and TNF-beta. TGF-beta 1 inhibited the production of these cytokines in a dose-related manner. The results extend the previous known activities for human rTNF-alpha and TGF-beta 1 and further demonstrate the reciprocal relationship between these two molecules in the regulation of certain immune functions. PMID- 3280681 TI - Mast cell-dependent amplification of an immunologically nonspecific inflammatory response. Mast cells are required for the full expression of cutaneous acute inflammation induced by phorbol 12-myristate 13-acetate. AB - Mast cells clearly are critical for the expression of some IgE-dependent responses, but their roles in other forms of inflammation are uncertain. We previously described a new model system for defining the unique contribution of mast cells to biologic responses in vivo, genetically mast cell-deficient WBB6F1 W/Wv mice that have undergone selective local repair of their mast cell deficiency by the injection of IL-3-dependent cultured mast cells derived from the congenic normal (WBB6F1-+/+) mice. Using this approach, we analyzed the contribution of mast cells to the acute inflammation induced by the epicutaneous application of PMA. Even though PMA can activate a wide variety of cell types that may contribute to acute inflammation, we found that mast cells were required for the full expression of the tissue swelling and leukocyte infiltration associated with the response to the agent in vivo. Thus, in WBB6F1-W/Wv mice selectively reconstituted with dermal mast cells by intradermal injection of cultured WBB6F1-+/+ mast cells into the left ear only, PMA induced approximately twice the tissue swelling and neutrophil infiltration in the mast cell reconstituted left ears as in the contralateral control ears. This represents the first use of W/Wv mice locally reconstituted with mast cells to confirm the hypothesis that mast cells can represent an important amplification mechanism in acute inflammatory responses of nonimmunologic origin. It also defines a model system that may be generally useful for investigating mast cell-dependent and independent aspects of acute inflammatory responses. PMID- 3280682 TI - Defective T lymphocytes in old mice. Diminished production of mature c-myc RNA after mitogen exposure not attributable to alterations in transcription or RNA stability. AB - To gain further insight into the mechanism of age-associated loss of T cell proliferative responses to mitogenic lectins, we measured c-myc specific mRNA accumulation in Con A-stimulated cultures of spleen cells from old and young mice using Northern blot and S1 nuclease protection analyses. Aging led to a consistent decline (an average of approximately 60%) in the level of c-myc mRNA in stimulated cells. The time course for c-myc RNA accumulation was similar for old and young mice. Nuclear runoff experiments showed that mitogen stimulation leads to an equivalent increase in transcription of the c-myc gene in T cells from old and young mice. Furthermore, in the presence of 5,6 dichlorobenzimidazole riboside, a selective inhibitor of RNA polymerase II, c-myc mRNA decayed with equal kinetics in cells from mice of different ages. These results show that lymphocytes from aged mice exhibit defects in gene expression very early in the activation process and suggest that these deficits may involve, at least for some genes, alterations in post-transcriptional processing. PMID- 3280683 TI - Measurement of chemotaxis of polymorphonuclear leukocytes in vitro. The problems of the control of gradients of chemotactic factors, of the control of the cells and of the separation of chemotaxis from chemokinesis. PMID- 3280684 TI - An enzyme immunoassay for the flow cytometer (FEIA). AB - This report describes the use of a fluorescent activated cell sorter (FACS) in combination with an enzyme immunosorbent assay (EIA). This combination of techniques expands the versatility of the flow cytometer. It introduces a new set of fluorescent enzyme products for antigen detection. These highly substantive fluorescent compounds permit the flow cytometer to quantify cell-EIA reactions and also to delineate subpopulations of cells with different quantities of surface antigens. Because the FEIA product is colored, as well as fluorescent, a simple light microscope may also be used to define the distribution of the label on the cell surface. These techniques have been applied to the examination of antigens on human erythrocytes, human T cell lymphoma cells (H9), and to surface markers on the tissue culture cell line K562. PMID- 3280685 TI - Assessment of total immunoreactive lactoferrin in hematopoietic cells using flow cytometry. AB - Cell-associated lactoferrin (Lf) was analyzed using a new method involving cell permeabilization, indirect immunofluorescence staining, and flow cytometry. Statistical techniques to evaluate the results for percentage of positive cells, relative fluorescence and homogeneity of Lf distribution were also devised. Most normal adult neutrophils (97.1 +/- 0.3% (SEM), range 92.7-99.6%, n = 41) had brilliant fluorescence homogeneously distributed among the cells. There was significantly greater homogeneity of neutrophil Lf distribution in post menopausal than pre-menopausal females. In chronic myelogenous leukemia (n = 13) and cord blood (n = 7), fractions of Lf-positive neutrophils were decreased (77.3 +/- 7.5%, range 13.3-96.3%; 71.4 +/- 9.3, range 32.0-95.6%, respectively). Normal monocyte-rich isolates had moderate fluorescence (28.7 +/- 3.6%, range 9.3-76.8%, n = 22). Among blood lymphocyte-rich preparations, 13.1 +/- 1.3% of cells had weak positivity (range 4.9-26.6%, n = 19); monoclonal B and T lymphocytes had similar parameters. No other cells had detectable Lf. Our results were significantly correlated with those obtained manually (r = 0.98, P less than 0.001), and are consistent with Lf quantity and distribution determined using other methods. PMID- 3280686 TI - An amplification technology for improving sensitivity when measuring components in biological samples. AB - A new technology for improving the sensitivity in measuring components in biological samples is described. The method is based on the use of spherical microbeads (detection beads) which contain a large amount of immobilized enzyme and a reagent with biospecific affinity for the component to be detected. These microbeads have been used in a 'sandwich reaction' for visualization of P fimbriated Escherichia coli which has a known receptor structure (Gal(alpha 1 4)Gal(beta)). In the initial step the bacteria were enriched on a solid support (e.g., a plastic film or beads (greater than 150 microns)) to which the receptor structure had been covalently bound. In the next step detection beads coupled with enzyme and receptor structure were added and finally a chromogenic substrate for the enzyme was used for visualization. A sensitivity of 10(5) bacteria/ml was reached. The detection beads are of general utility and might be useful for the detection of lectins on other pathogens. PMID- 3280687 TI - Immune carrier properties of acid-treated Salmonella minnesota R595 bacteria. The immune response to TNP-bacterial conjugates in rabbits and mice. AB - Salmonella minnesota R595 bacteria from which the core region of the lipopolysaccharide on the cell wall had previously been removed by mild acid treatment were trinitrophenylated. Differing amounts of these trinitrophenyl naked bacterial conjugates (TNP-NB), covering a range of epitope densities, were used for immunising mice and rabbits via the intraperitoneal or intravenous routes without adjuvants. It was found that such acid-treated, naked bacteria were effective carriers for the covalently linked hapten, TNP, with an optimum epitope density of 15 micrograms TNP/mg NB. Significant immune responses were obtained with dose levels as low as 50 ng TNP. The possible applications of acid treated, naked bacteria as universal carriers having inherent adjuvant activity are discussed. PMID- 3280688 TI - Direct detection of Chlamydia trachomatis in clinical specimens by a dot immunobinding technique using monoclonal antibody. AB - A dot-immunobinding technique (DIBT) has been developed to permit detection of Chlamydia trachomatis organisms or antigen in clinical specimens. This method was evaluated for the rapid diagnosis of chlamydia infections using monoclonal antibody. The membrane antigen extracted from reticulate bodies was used for the production of species-specific monoclonal antibodies by an in vitro immunization procedure. The DIBT involved spotting clinical specimen directly onto a nitrocellulose membrane followed by reaction with monoclonal antibody and a biotin-avidin-peroxidase indicator system. Specimens were tested for the presence of chlamydia by the cell culture method. Of these, 361 positives and 317 negatives were selected for detection of antigen using the DIBT method. Of 678 clinical specimens that were evaluated by DIBT, 654 (96.7%) gave identical results to the cell culture method, whereas 24 (3.5%) were positive by the DIBT but culture negative. The overall sensitivity was 100% with a specificity of 92.4%. The test could detect as little as 75 pg of chlamydial antigen. PMID- 3280689 TI - Evaluation of an enzyme immunoassay for total IgE on a semi-automated analyser. A multicentre study. AB - Total serum IgE was measured by a semi-automated enzyme immunoassay on sera from normal and disease groups. Data from this investigation was analyzed in respect of precision, linearity, sensitivity and correlation with other test methods. Using human serum pools having values between 7 and 480 IU/ml, the intra-assay coefficient of variation ranged from 3.3 to 14.6% with an arithmetic mean of 6%. The inter-assay coefficient of variation on commercially supplied control sera ranged from 4.4 to 14.2%. In addition, tests were carried out on serially diluted samples to assess the linearity of the method, and on sera with IgE levels of less than 5 IU/ml in order to assess its sensitivity. It was shown that the technique being assessed was unaffected by the presence of lipid or haemoglobin or by the addition of bilirubin or any one of 46 commonly prescribed drugs each at double its toxic dose. There was good correlation between the semi-automated enzyme immunoassay technique and four other methods used during this study. This technique exhibits excellent specificity, reproducibility and a sensitivity well within clinical demands. PMID- 3280690 TI - Toxoplasmosis and the acquired immune deficiency syndrome. AB - The literature on toxoplasmosis in the acquired immune deficiency syndrome is reviewed with reference to more than 140 cases from various centres. The incidence, pathogenesis, clinical features, diagnosis, treatment and prognosis are considered. PMID- 3280691 TI - Group G streptococcal endocarditis: two case reports, a review of the literature and recommendations for treatment. AB - Two cases of endocarditis caused by a group G streptococcus are reported and the literature on group G streptococcal endocarditis is reviewed. The onset of illness is usually acute and the portal of entry for the organism through the skin. The left side of the heart is mainly involved and in about 50% cases the endocarditis arises on a normal valve. Most patients develop complications, both embolic and cardiac, and the mortality is high (36%). We suggest that patients with proven group G streptococcal endocarditis should be treated with large doses of benzyl penicillin and with an aminoglycoside for not less than 4 weeks. Patients with complications should be referred to a cardiothoracic centre. We should be glad to know details of complications, treatment and outcome in other cases of group G streptococcal endocarditis. PMID- 3280692 TI - Thyroid abscess caused by Eikenella corrodens. AB - To our knowledge, this is only the fourth case recorded of thyroid abscess due to Eikenella corrodens and the first in which the causative organism has been isolated in pure culture from the site of infection. E. corrodens may be the cause of apparently sterile thyroid abscesses encountered in head and neck surgery and should be considered in their differential aetiology. PMID- 3280693 TI - Streptococcus pyogenes and dysentery. PMID- 3280694 TI - Studies on the cellular immune responses of insects toward the insect pathogen Trypanosoma rangeli. PMID- 3280695 TI - DNA-cytophotometry of lymph node touch imprints in cutaneous T-cell lymphoma. AB - Scanning DNA-cytophotometry was performed on touch imprints of 26 lymph nodes (LN) obtained from 25 patients with cutaneous T-cell lymphoma (CTCL), stained by the Feulgen technique, and interpreted without knowledge of histopathologic diagnosis. Four patterns of DNA distribution were identified, but only histograms that demonstrated cells containing nuclei with more than 4C DNA content (hypertetraploidy) reliably distinguished LN involved with CTCL from LN with reactive changes; for example, dermatopathic lymphadenitis. An abnormal DNA histogram with evidence of hypertetraploidy was demonstrated in 9 of 12 LN showing histopathologic evidence of involvement compared with no abnormal histograms in 14 LN without histopathologic involvement. One LN that was diffusely involved with CTCL had a DNA distribution characteristic of a relatively high level of cell proliferation, but without definite hypertetraploidy. Cytogenetic studies on the blood of this patient, who had Sezary syndrome, demonstrated a clone of lymphocytes with a pseudodiploid karyotype without a related polyploid subline. The remaining two histopathologically involved LN had normal DNA histograms; these LN were only focally involved with CTCL. These observations indicate that DNA-cytophotometry correlates well with the histopathologic findings in LN diffusely involved with CTCL, but may be normal in LN with focal involvement or in those that contain cytogenetically abnormal cells with a near-diploid DNA content. PMID- 3280696 TI - The phenotypic spectrum of histiocytosis X cells. AB - Proliferating cells in histiocytosis X (histiocytosis X cells) share many structural and immunophenotypic features with Langerhans cells, leading to the assumption that histiocytosis X represents a proliferative disorder of Langerhans cells. Because, depending on their state of activation and/or differentiation, Langerhans cells exhibit a varying immunophenotype, we investigated whether histiocytosis X cells display a similar phenotypic heterogeneity and, if so, whether the heterogenous biological behavior of histiocytosis X is reflected by differences in the immunophenotype of the proliferating cells. In 21 patients suffering from different clinical manifestations of histiocytosis X, proliferating cells uniformly expressed class I and II alloantigens, T200, CD1, CD4, and S100 protein. In 12 of 21 cases, histiocytosis X cells additionally exhibited immunocytochemically detectable amounts of C3b and C3bi receptors and certain monocyte/macrophage antigens (CDw14, Ki-M1, Ki-M6). This immunophenotypic heterogeneity of histiocytosis X cells could not be correlated with clinical course, prognosis, and final outcome of the disease in a given patient. The capacity of histiocytosis X cells to immunophenotypically mimic various states of Langerhans cell activation and/or differentiation, however, underscores the concept of histiocytosis X as a proliferative disorder of Langerhans cell origin. PMID- 3280697 TI - Monoclonal antibody (AFH1) immunoreactive on morphologically abnormal basal melanocytes within dysplastic nevi, nevocellular nevus nests, and melanoma. AB - The mouse monoclonal antibody AFH1 was produced using formalin-fixed, sham paraffin-embedded human melanoma cell culture line A375 as immunogen. Reactivity of this antibody was assessed by immunohistochemical techniques against formalin- or acid alcohol-fixed paraffin-embedded tissue as well as formalin- or acid alcohol-fixed unembedded lesions. Ninety-seven nevomelanocytic lesions, neurofibromas, epithelial lesions, and a plasmacellular infiltrate were evaluated. AFH1 was immunoreactive on 54 of 55 nevocytic lesions (98.2%), 15 of 16 primary melanomas (93.7%), a lentigo maligna, and nests in 21 of 21 dysplastic nevi (100%). Of 100 consecutive basal melanocytes of intraepidermal melanoma cells counted in each lesion, mean AFH1 immunoreactivity for nonnested basal melanocytes in nevocellular nevi was 3.8%; for dysplastic nevi, 13.8%; and for intraepidermal melanoma cells, 78.0%. When nonnested basal melanocytes were subdivided into cytologically normal and abnormal cell groups, AFH1 immunoreactivity was 9.4% and 72.6%, respectively. AFH1 recognition of the lentiginous portion of dysplastic nevi corresponds statistically to the appearance of abnormal melanocyte cytology, nest formation, or both. Using 50% immunoreactive nonnested melanocytes as the criterion, AFH1 seems to distinguish primary melanoma from dysplastic nevi with a sensitivity of 93.8% and a specificity of 95.8%. PMID- 3280698 TI - Differentiation antigens of melanocytes and melanoma: analysis of melanosome and cell surface markers of human pigmented cells with monoclonal antibodies. AB - Three mouse monoclonal antibodies (mAbs) recognizing antigens of human melanocytic cells were used to study a large panel of cultured normal and tumor cells and fresh tissues. Two of the monoclonal antibodies (designated TA99 and CF21) detect melanosomal antigens, whereas mAbC350 recognizes a cell surface antigen. Among cultured cells the three mAbs reacted exclusively with normal melanocytes and pigmented melanomas, but not with nonpigmented melanomas or cells of other lineage. Immunohistochemical assays using mAbTA99 and mAbCF21 on fresh frozen sections from a large panel of normal tissues revealed a characteristic pattern of reactivity restricted to pigmented cells. mAbC350 did not react with any normal tissues. All nevi and primary melanoma specimens and 93% of metastatic melanomas were reactive with at least one of these three monoclonal antibodies. No reactivity was found with 62 nonmelanoma tumors. An inverse correlation was observed between TA99 expression and stage of tumor progression. These markers are useful for studies of melanocyte differentiation and malignant transformation, subsetting of melanocytic lesions, and identification of tumors of melanocytic origin. PMID- 3280699 TI - Absence of specific histologic changes in guinea pig skin treated with bullous pemphigoid antibodies. AB - Previous studies have reported that intradermal injections of bullous pemphigoid antibodies into guinea pigs can reproduce the histologic and immunohistologic features of bullous pemphigoid lesions. In this study we examined this model to determine its reproducibility and suitability for testing other types of anti-BMZ antibodies. Twenty guinea pigs were injected intradermally with 0.1, 0.3, or 0.5 ml of either bullous pemphigoid serum or IgG fraction containing high-titer complement-binding anti-BMZ antibodies or an equivalent volume of normal human serum or IgG fraction as control. Sites were biopsied at intervals after injection and were examined by routine histology and direct immunofluorescence. The results showed (a) no difference in the incidence of dermal epidermal separation or type of inflammation in experimental and control sites; (b) no evidence of an eosinophil-rich inflammatory reaction typical of bullous pemphigoid; (c) an absence of linear BMZ deposits of IgG and complement in the majority of sites injected with bullous pemphigoid antibodies; and (d) no correlation between dermal-epidermal separation and deposition of immune reactants at the BMZ. These results suggest the histologic changes seen in guinea pigs that are administered intradermal injections of bullous pemphigoid antibodies are nonspecific and that the model is not suitable for testing the pathogenicity of anti-BMZ antibodies in sera or IgG fractions. PMID- 3280700 TI - Digital subtraction angiography: the intravenous approach. AB - With further improvement of digital subtraction angiography (DSA) equipment, and the development of sophisticated soft-ware programs, the intravenous approach again has become an promising diagnostic alternative in certain clinical settings, if the patient's cardiac output is not severely diminished. In many cases an additional arterial study is not necessary. The diagnostic results, advantages and limitations of the intravenous approach in imaging the brachiocephalic, renal and peripheral vessels are discussed. PMID- 3280701 TI - Left ventricular imaging by digital subtraction angiography. AB - Digital radiography is a rapidly developing new approach to cardiovascular imaging that converts radiographic and fluoroscopic video images into digital format for subsequent image enhancement analysis, and storage. Left ventriculography can be performed by this method using either intravenous or low dose intraventricular contrast administration. Advantages over standard radiography include reduced radiation and contrast medium burden, visualization of very low contrast medium concentrations, and an image format that can be directly analyzed by quantitative techniques. As these cardiac applications are developed and improved archiving is implemented, it is likely that the digital left ventriculography will replace standard cardiac angiography. PMID- 3280702 TI - Assessment of regional coronary flow reserve by digital angiography in patients with coronary artery disease. AB - Digital angiography provides a convenient means to quantify the progression of a contrast medium bolus injected into a coronary artery throughout the myocardium, which in turn yields information on myocardial perfusion. Sixteen patients presenting a single critical proximal stenosis (estimated diameter reduction greater than 80%) on either the left anterior descending coronary artery (LAD) or the left circumflex coronary artery (LCX) were studied. First, 12 consecutive end diastolic images of an ECG-triggered intracoronary injection of 4 ml of iopamidol were acquired on 60 degree left anterior oblique projection under basal conditions. This was repeated 30 s after intracoronary injection of 12 mg of papaverine. For each image sequence, a densogram was computed in each pixel by fitting a curve through its 12 consecutive intensity values. The 'time of maximal pixel opacification' (TMAX) and the 'mean ascending time' (TMAT), expressed in cardiac cycles, were determined from each curve. Two myocardial regions of interest (ROI) were defined for each patient, one in the perfusion bed of the LAD, the other in the bed of the LCX. The mean values of TMAX and TMAT in each ROI were computed, at rest and during hyperemia. At rest, the mean values of TMAX and TMAT obtained from the ROI associated to the stenosis artery were not significantly different from the values obtained in the ROI associated with the intact artery. During hyperemia, a significant decrease of the mean TMAX and TMAT was observed in the normally perfused regions (p less than 0.001). The rest to hyperemia ratios of both TMAX and TMAT mean values were considered to be indices of coronary flow reserve.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280703 TI - Laboratory tests in the diagnosis of the chronic pancreatic diseases. Part 4. Tests involving the measurement of pancreatic enzymes in body fluid. PMID- 3280704 TI - Dynamics of insulin release by perifused insulin-producing tumoral cells: effects of glucose, forskolin, leucine, barium and theophylline. AB - Perifused tumoral insulin-producing cells, of the RINm5F line, display a high basal insulin output relative to their hormonal content. D-Glucose (2.8 or 16.7 mmol/l) causes a modest and monophasic increase in insulin output. The secretory response to D-glucose (1.4 to 16.7 mmol/l) is enhanced by forskolin, which exerts little effect in the absence of exogenous nutrient. L-Leucine (10.0 mmol/l) also stimulates insulin release from the perifused cells. The secretory response to these nutrient secretagogues in much less marked, however, than that evoked, in the absence of Ca2+, by the association of Ba2+ and theophylline. It is concluded that the dynamics of insulin release by the tumoral cells, when compared to that of normal islet cells, are characterized by several anomalies, including a high basal ratio between secretion and content, a low threshold (less than or equal to 1.4 mmol/l) in the secretory response to D-glucose, and a lesser responsiveness to nutrient than nonnutrient secretagogues. PMID- 3280705 TI - Amplification of c-Ki-ras-2 oncogene sequences in human carcinoma of pancreas. AB - c-Ki-ras-2 sequences were visualized in paraffin embedded sections from normal adult human pancreases and 24 carcinomas of pancreas by an in situ hybridization technique. A biotinylated 1 kbp EcoRI fragment of pHiHi3 DNA was used as probe and the oncogene was visualized as one or two large grains of reaction products produced in more than 9% of normal pancreas nuclei by streptavidin-peroxidase complex and diaminobenzidine tetrachloride. Its amplification in pancreatic carcinomas was detected as one or more large grains in 54% of the nuclei. In addition, tumor cells showed small nuclear and cytoplasmic grains scarcely seen in normal pancreatic cells. The differential transcriptional activity of this oncogene in cancer cells and the adjacent normal pancreatic cells on the same section was evident in sections from 5 cases where normal pancreas was present. PMID- 3280706 TI - [Hypothalamic hypogonadism--repetitive administration of gonadotropin-releasing hormone differentiates hypothalamic from pituitary hypogonadism]. PMID- 3280707 TI - [Response of ovarian steroid secretion to the intrinsic gonadotropin release caused by the administration of a synthetic luteinizing hormone-releasing hormone -the difference between the follicular and luteal phases]. AB - During gynecologic laparotomy both ovarian and peripheral venous blood specimens were collected simultaneously, and follicle-stimulating hormone (FSH), luteinizing hormone (LH), pregnenolone (P5), 17 alpha-hydroxypregnenolone (17 alpha-OH-P5), dehydroepiandrosterone (DHA), progesterone (P4), 17 alpha hydroxyprogesterone (17 alpha-OH-P4), delta 4-androstenedione (delta 4-A), estradiol (E2) and 20 alpha-dihydroprogesterone (20 alpha-OH-P4) were measured in each sample by means of the radioimmunoassay technique before and after the administration of synthetic LH-releasing hormone (LH-RH). Significantly higher concentrations of P5, 17 alpha-OH-P4 and E2 during the follicular phase and that of P5, DHA, P4, 17 alpha-OH-P4 and E2 during luteal phase were observed in the ovarian than in the peripheral venous blood. During the follicular phase, P5, DHA and E2 concentrations in ovarian vein blood increased significantly following LH RH administration. It was observed that the delta 4-steroids and E2 concentrations during the luteal phase were higher than those during the follicular phase. During the luteal phase P4, 17 alpha-OH-P4, and E2 increased after LH-RH administration. Enzymes involved in the formation of these steroids may be stimulated by the intrinsic gonadotropin caused by LH-RH administration. The difference in steroidal profiles in ovarian vein blood and response to LH-RH in follicular and luteal phase were demonstrated. PMID- 3280708 TI - [Immunohistochemical studies on epidermal growth factor receptor and the myc oncogene product in squamous cell carcinoma of the uterine cervix]. AB - Recent studies have demonstrated that the amount of epidermal growth factor receptor (EGF-R) is increased in squamous cell carcinoma cells and that the amino acid sequence of EGF-R shows great homology with the v-erb B transforming protein. In this study, we examined the tissue localization of EGF-R and myc oncogene product in normal squamous epithelium, dysplasia, carcinoma in situ, invasive squamous cell carcinoma of the uterine cervix and in metastatic lymph nodes by means of the avidin/biotin immunoperoxidase technique. Normal squamous epithelium was negative for EGF-R and myc product. The lesions of dysplasia and carcinoma in situ had a positive staining for EGF-R, but were still negative for myc product. There were differences in the staining intensity of EGF-R and myc product among the types of invasive carcinoma. Staining for EGF-R and myc product was negative in small cell non-keratinizing carcinoma, whereas strong staining for both EGF-R and myc product was observed in large cell non-keratinizing and keratinizing carcinoma. The intensity of positive staining for EGF-R and myc product declined in the lesions of cancer pearl. Metastatic lymph nodes were remarkably stained for EGF-R and myc product, while non-metastatic lymph nodes were negative for EGF-R and myc product. Our observations suggest that the amplified expression of EGF-R and myc product may accompany the malignant transformation of squamous epithelium of the uterine cervix, together with the metastasis. PMID- 3280709 TI - [Evaluation of female intrapelvic blood vessels and their hemodynamics with real time two-dimensional Doppler ultrasound]. AB - Real-time two-dimensional and pulsed Doppler ultrasound examinations were performed on 5 healthy Japanese with a history of normal menses and 27 pregnant subjects with regular menstrual cycles and no complications. The objective of the study was to visualize blood flow and record blood flow velocity waveforms from the pelvic vessels. This approach led to an accurate estimation of blood flow in a non-invasive manner. No particular technical skill or training is required. The resistance index of the arcuate artery was high in non-pregnant subjects and in those in early pregnancy. By 15 weeks the index became low and there was little change thereafter. We propose that real-time two-dimensional and pulsed Doppler ultrasound will prove to be good diagnostic tools for the detection of various pathologies encountered in the field of obstetrics and gynecology. PMID- 3280710 TI - [Detection of perinatal Chlamydia trachomatis infection by an enzyme immunoassay method]. AB - During the one year period from February 1986 to January 1987, 839 pregnant women were screened for Chlamydia trachomatis infection of the uterine cervical canal by the enzyme immunoassay (EIA, Chlamydiazyme) method. Out of 768 normal pregnant women positive results were obtained in 21 women for a positive rate of 2.7%. In none of 64 women with spontaneous abortion or 7 women with stillbirth were positive results obtained. In 20 of EIA positive women labor was controlled. Extraordinary maternal abnormalities were not seen through labor and puerperium. Out of 21 babies born to these 20 pregnant women, chlamydial pneumonitis developed in 2 babies (10%) and chlamydial conjunctivitis in 1 baby (5%) and these babies were treated. Urethral samples were taken from 16 husbands of EIA positive women, and they were all EIA negative. As to the correlation between EIA and the culture method using HeLa 229 cells, the consistency rate was 78% (n = 18) for positive results and 100% (n = 66) for negative results. Chlamydial IgG antibodies were assayed in 19 out of 21 cases, and all of them yielded positive results. From these results, the importance of screening for Chlamydia trachomatis infection in our country was affirmed. PMID- 3280711 TI - Are we about to enter the golden era of clinical investigation? PMID- 3280712 TI - Platelet transfusion therapy: platelet concentrate preparation and storage. PMID- 3280713 TI - Inferior meatal antrostomy. Fundamental considerations of design and function. AB - The operation of inferior meatal antrostomy has emerged as the most popular surgical technique in the management of maxillary sinusitis though the surgical anatomy and natural history of the procedure are poorly understood. The anatomy of the inferior meatus determines surgical limitations and a retrospective study of 108 patients who have undergone antrostomy provides a basis for a prospective study in which the size of the antrostomy has been assessed in 65 patients pre- and post-operatively using direct measurement and serial photography. After initial circumferential healing within the first few weeks, the majority remain unchanged unless infection supervenes when complete closure may result. The closure is a combination of fibrous tissue and bone in the majority of cases. A critical size is apparent below which complete closure can be anticipated whereas if too large an antrostomy is fashioned, related anatomy is jeopardized and therefore the dimensions must be carefully judged if long-term patency is desired. The effect of patency on the mucus-secreting elements of sinus mucosa is examined in a second prospective group of 19 patients. Assessment of subjective clinical success determines overall benefit from the operation in most patients though mucous discharge is least improved and this is directly related to the level of increase in goblet cells. The role of the inferior meatal antrostomy is dependent upon an understanding of the pathophysiology of sinusitis and thereby determining those patients who have potentially reversible mucosal damage and are therefore most likely to benefit from the procedure. PMID- 3280714 TI - Antecedent knowledge and intelligent computer assisted instruction. PMID- 3280715 TI - Nomenclatures of anatomical distortions of the spine: a comparison. AB - A review of the major chiropractic, osteopathic and medical nomenclatures for describing anatomical distortions of the spine is presented. A survey of the institutions demonstrates 10 separate nomenclatures currently being employed by the three professions to describe similar anatomical distortions of the spine. This wide variety of nomenclature can only be seen as creating barriers to communication both inter- and intraprofessionally. Because there are two differing conceptual principles for the definition of an anatomical distortion of the spine, an argument is presented for the adoption of two universal nomenclatures. PMID- 3280716 TI - The chiropractic wars. PMID- 3280717 TI - Does the human corpus luteum synthesize neurohypophysial hormones? PMID- 3280718 TI - Oxytocin and parturition--new complications. PMID- 3280719 TI - Analysis of release of porcine relaxin by reverse haemolytic plaque assay: evidence for autoregulation. AB - Relaxin release from monodispersed luteal cells derived from pregnant pigs (days 100-110 of gestation; n = 3) was detected by a reverse haemolytic plaque assay. In this technique, luteal cells were co-cultured in monolayers with ovine erythrocytes coupled to protein-A. In the presence of porcine relaxin antiserum and complement, a zone of haemolysis--a plaque--developed around relaxin releasing luteal cells. Luteal cells were preincubated with porcine relaxin (up to 1000 ng/ml) or progesterone (up to 0.5 micrograms/ml) for 18 h before the plaque assay. Relaxin (but not progesterone) pretreatment inhibited subsequent relaxin release. The inhibitory effect of relaxin on its own release (autoregulation) has the potential to be a significant part of the local mechanisms which contribute to the overall control of ovarian secretion of protein hormones. PMID- 3280720 TI - An evaluation of hormonal changes at puberty in man. AB - The pulsatile nature of the secretion of gonadotrophins, sex steroids and growth hormone are important in both the onset and maintenance of sexual maturation. The night-time is intimately related to the endocrine events which result in puberty, such that hormone measurements during the daytime have little meaning. This relationship between the night-time and gonadal function is not restricted to puberty but continues in adult life; the onset of the preovulatory LH surge occurs in the early hours of the morning. Girls seem more sensitive to small changes in GnRH concentrations than boys, which is why the physical signs of puberty appear slightly earlier in them. Low levels of oestradiol appear to assist growth hormone secretion, whereas higher levels of testosterone are required for the same effect. This probably explains the sex differences in the timing of the pubertal growth spurts. PMID- 3280721 TI - Endocrine manipulation of constitutional delay in growth and puberty. PMID- 3280722 TI - Evidence that angiotensin II is a paracrine agent mediating gonadotrophin releasing hormone-stimulated inositol phosphate production and prolactin secretion in the rat. AB - Gonadotrophin-releasing hormone (GnRH) stimulated the accumulation of inositol phosphates and prolactin secretion in anterior pituitary cells from young male rats. Saralasin [( Sar1, Ala8]-angiotensin II; a competitive antagonist of angiotensin II) inhibited the increase in both inositol phosphates and prolactin in a dose-dependent manner. Since angiotensin II has been shown to be a potent stimulus for inositol phosphate accumulation and prolactin secretion in the lactotroph, these findings suggest that angiotensin II acts as a paracrine agent, being released from the gonadotroph in response to GnRH and causing the lactotroph to release prolactin through an effect on phosphoinositide metabolism. The ability of GnRH to promote prolactin release was lost in pituitaries from older rats, and the increase in total inositol phosphate accumulation was less. These findings provide evidence of a physiological role for the presence of the renin-angiotensin system within the pituitary gland. PMID- 3280723 TI - Effects of physical endurance training on the plasma renin-angiotensin aldosterone system in normal man. AB - The effect of physical endurance training on the plasma renin-angiotensin aldosterone system was studied in 27 normal sedentary volunteers aged between 20 and 55 years, using a randomized two-period cross-over study design. After 4 months of training (2.5 h/week), peak oxygen uptake and physical working capacity at a heart rate of 130 beats/min were increased by 16% (P less than 0.01) and 29% (P less than 0.001) respectively, whereas resting heart rate was decreased by 15% (P less than 0.001). The plasma noradrenaline concentration and haematocrit were both decreased (P less than 0.01) after training. For the total group of subjects, the small decreases in plasma renin activity (PRA) and in the plasma concentrations of angiotensin-I, angiotensin-II and aldosterone were not statistically significant. However, the change in PRA during the training period was negatively correlated with the increase in physical working capacity (r = 0.49, P less than 0.01), suggesting that PRA decreased only in those subjects with the greatest increase in exercise capacity. Also, the change in plasma aldosterone during training was negatively related to the rise in physical working capacity (r = -0.57, P less than 0.01). Furthermore, the changes in plasma angiotensin-I (r = 0.75), angiotensin-II (r = 0.49) and aldosterone (r = 0.43) during the training period correlated positively with the change in PRA. It is concluded that physical endurance training, leading to a substantial gain of physical working capacity, suppresses the plasma renin-angiotensin-aldosterone system in normal man. PMID- 3280724 TI - Evidence of functional lymphocytes in some (leaky) scid mice. AB - Although the majority of severe combined immune deficiency (scid) mice lack functional lymphocytes, some (2-23%) appear to develop a limited number of B and T cells between 3 and 9 mo old. Most of these leaky scid mice were shown to contain very few clones (less than or equal to 3) of Ig-producing plasmacytes. Clonal progeny were distributed unevenly in the lymphatic tissues and appeared as discrete plasmacytic foci. In many cases, individual clones persisted for several months and produced abnormally high concentrations of Ig that included multiple isotypes. Functional T cells were inferred from the ability of leaky mice to reject allogeneic skin grafts, a T cell-dependent reaction. Interestingly, approximately 40% of leaky mice developed thymic lymphomas. In other respects, leaky mice resembled regular scid mice; e.g., their splenic cells failed to express common lymphocyte antigens (Ly-5[B220], Ly-1) and to proliferate in response to lymphocyte mitogens. Histologically, their lymphoid tissues retained the same general pattern of severe lymphocytic deficiency as scid mice. PMID- 3280725 TI - A high proportion of T lymphocytes that infiltrate H-2-incompatible heart allografts in vivo express genes encoding cytotoxic cell-specific serine proteases, but do not express the MEL-14-defined lymph node homing receptor. AB - The role of cytotoxic cells in in vivo immune functions such as allograft rejection is unknown. To begin to assess the function of cytolytic cells in vivo we have begun with cytolytic cell-specific functional molecules: we have isolated and characterized cytolytic cell-specific cDNA clones from cytolytic T cell clones, both encoding distinct serine esterases. The HF gene encodes a trypsin like enzyme while the C11 gene encodes an enzyme with likely specificity for acidic residues. Here we demonstrate, using in situ hybridization with RNA probe, that both genes are expressed selectively in a subset of T lymphocytes that have infiltrated cardiac allografts. The phenotype of these cells is consistent with the most frequent phenotype of active CTL raised in vitro: they are predominantly CD4-, CD8+, MEL-14- T cell blasts. Thus the expression of these genes, each of which encodes serine esterase found in killer cell granules in vitro, is a valid marker for these cells in vivo as well. The kinetics of their accumulation is consistent with, but not proof of, a putative role in allograft rejection. It is likely that HF and C11 gene expression will be of diagnostic value. PMID- 3280726 TI - p53 in chronic myelogenous leukemia. Study of mechanisms of differential expression. AB - The p53 is a nuclear protein that is associated with normal cellular proliferation and can cooperate with Ha-ras in causing cellular transformation in vitro. Lineage association is known to exist between p53 expression and normal lymphopoiesis, but not myelopoiesis. We studied the expression of p53 using chronic myelogenous leukemia (CML) cell lines, somatic hybrids of these cells, and leukemic cells from CML patients. Lymphoid CML lines expressed both p53 mRNA and protein. We also analyzed p53 synthesis by two B-lymphoid lines from the same CML patient; cells of one line were derived from the neoplastic clone, cells of the other were derived from the normal clone. Both synthesized equal amounts of a phosphorylated p53 protein. None of the myeloid CML lines expressed detectable p53 protein and two of four expressed negligible p53 mRNA. Two other myeloid CML lines and myeloid cells from three of four patients expressed p53 mRNA. These findings suggest that expression of the gene is not regulated normally in CML. Several approaches were pursued to explore the differential expression of p53. Southern blot analyses showed no gross alterations in the p53 gene from cells of either the expressing or the nonexpressing lines. No difference in the pattern of demethylated CpG sites was noted in the region of the p53 gene in cells from K562 (myeloid p53 nonexpressor) and in BV173 (lymphoid p53 expressor). The sites of demethylation clustered in and around the p53 promoter in both cell lines. Somatic hybrids formed between a p53 mRNA nonexpressor myeloid line (K562) and the parental p53 expressor lymphoid lines (Daudi, PUT) produced p53 mRNA and protein, suggesting that p53 is a dominantly expressed protein and that lack of expression in myeloid cells is not mediated by a trans-acting negative regulatory protein. DNA transfection experiments performed using the indicator gene chloramphenicol acetyltransferase attached to promoter sequences of p53 showed that these constructs were equally activated in BV173 (p53 expressor) and K562 (p53 mRNA nonexpressor). The mechanism of p53 regulation in CML remains unclear. PMID- 3280727 TI - Complement binding by two developmental stages of Leishmania major promastigotes varying in expression of a surface lipophosphoglycan. AB - The binding of complement by two developmentally distinct stages of Leishmania major has been studied. Noninfective log phase growth (LOG) promastigotes (serum sensitive) activate complement with deposition of covalently bound C3b onto the surface of the parasite. Infective, peanut agglutinin (PNA-) metacyclic stage promastigotes (serum resistant) also bear mainly C3b after incubation in serum, but a major portion of deposited C3 is present as a 110 X 10(3) mol wt C3 fragment. Whereas deposition of C3b on LOG promastigotes is mediated through the alternative pathway. PNA- parasites are unable to activate the alternative pathway in nonimmune serum. C3 is released from the parasite surface by proteolytic cleavage, at a rate which is nearly threefold greater for LOG than for PNA- promastigotes. Immunoprecipitation experiments show that the developmentally regulated lipophosphoglycan is a major C3 acceptor on both LOG and PNA- parasites. These experiments, which are the first to compare the form and processing of complement on infective and noninfective promastigotes of Leishmania, provide a framework for further definition of the differential C3 receptor-dependent uptake and survival of these parasites within mononuclear phagocytes. PMID- 3280730 TI - The use of histomorphology to estimate age. AB - The purpose of this paper is to discuss some of the major factors that can affect age-at-death predictions when using histomorphological methods. Although evidence suggests that some of the currently available methods are more reliable and accurate, and there are a number of factors other than chronological age that can affect bone remodeling, histomorphological methods, when properly applied, are valuable tools for anthropology and forensic medicine. It is suggested that both accuracy and reliability are maximized when the histomorphometrics of as many anatomical sampling sites as possible are sampled and the resultant ages are averaged. PMID- 3280728 TI - In vivo incisional wound healing augmented by platelet-derived growth factor and recombinant c-sis gene homodimeric proteins. AB - Human platelet-derived growth factor (hPDGF) is likely to be important in stimulating tissue repair, based upon its in vivo chemotactic and stimulatory activities for inflammatory cells and fibroblasts and upon the presence of PDGF and related proteins in platelets, macrophages, and activated fibroblasts, cell types that make up the milieu of the healing wound. Recombinant human c-sis (rPDGF-B), homodimers of the B chain of PDGF, were compared with hPDGF in vitro. rPDGF-B was immunologically similar to hPDGF and, at identical concentrations, similar to hPDGF in stimulating fibroblast mitogenesis and chemotaxis of polymorphonuclear leukocytes, monocytes, and fibroblasts. Purified hPDGF and rPDGF-B were also tested in vivo for potency in a model of tissue repair using a linear incision wound through rat dermis. A single application of hPDGF or rPDGF B (2-20 micrograms/wound) in a slow release vehicle at the time of wounding resulted in a dose-dependent, statistically highly significant increase of breaking strength of treated wounds. Wound healing in animals treated with rPDGF B was 170% stronger and accelerated by 2 d during the first week over control wounds and by 4-6 d over the next 2 wk. Histologic evaluation of growth factor treated wounds correlated the in vitro chemotactic activity and the accelerated healing of wounds with a striking inflammatory cell infiltrate early after wounding, markedly increased formation of granulation tissue by 4-d, and increased fibrosis by 14 d in comparison to control wounds. The results thus demonstrate that rPDGF-B is fully active in in vitro tests of mitogenesis and chemotaxis and, for the first time, demonstrate directly that PDGF significantly advances wound healing in incisional wounds of experimental animals. PMID- 3280729 TI - Development of golden hamster embryos through the two-cell block in chemically defined medium. AB - The effect of increasing the embryo:medium volume ratio on overcoming the hamster two-cell block was examined. Two-cell golden hamster embryos from each superovulated female were cultured in microdrops (estimated at 0.75 microliter) or 100 microliter macrodrops of chemically defined medium (modified Tyrode's solution [TLP] plus glutamine, isoleucine, methionine, phenylalanine, and taurine). In 11 trials (i.e., with embryos from 11 donors), 28.6% of 269 embryos developed to the four-cell stage in microdrops, whereas only 2 (0.7%) embryos developed in the macrodrops. When two microdrops were used to culture the two cell embryos from each donor (n = 8), 17.8% of 304 embryos developed to four cells. Increasing the embryo:medium volume ratio further by culturing all of the embryos from each donor (n = 10) in single microdrops resulted in 53.1% of 397 embryos developing to four cells. Conditioning of the culture medium by these embryos could not be demonstrated. Increasing the embryo:medium volume ratio may protect against loss of some intracellular component essential for growth of early-stage hamster embryos. Alternatively, increasing this ratio may permit embryos to reduce the concentration of a substance detrimental to their growth. This work represents the first report of cleavage of hamster two-cell embryos in vitro. These findings are a significant step towards our goal of obtaining complete preimplantation developmental of hamster embryos in vitro and may be helpful for solving the in vitro developmental blocks in embryos from other species. PMID- 3280731 TI - Childhood identification and prophylaxis of antisocial personality disorder. AB - Physiological and psychological characteristics show considerable similarity between children with attention deficit disorder with hyperactivity (ADDH) and adults with antisocial personality disorder (ASPD). Prospective studies of ADDH children, with or without conduct disorder (CD), show a high outcome of ASPD. Recently, other forms of treatment have been added to the traditional psychopharmacological agents used for ADDH. If medication and new treatment modalities are administered for a period of three years, a recent controlled study indicates that the mean number of arrests for felony offenses and the mean number of institutionalizations are reduced at a p less than 0.0001 level (1.32 versus 0.19 and 0.49 versus 0.00, respectively). PMID- 3280732 TI - Morphology and development of Rift Valley fever virus in Vero cell cultures. AB - Rift Valley fever virus (RVFV) grown in vero cell cultures has a completed replication cycle within 13 hours. The first signs are the appearance of intranuclear fibrillar rods, followed by aggregations of precursor viral material in host cell cytoplasm and viral nucleocapsids budding into vacuoles associated with the Golgi apparati. Mature particles, liberated by the disintegration of vero cells, contained ribosomelike structures within the nucleocapsid, which was surrounded by a typical unit membrane through which were inserted some 350-375 surface spikes whose inner ends were incorporated into the nucleocapsid structure. In the negatively stained material, the overall diameter of the virion was 90-110 nm; the spikes were 10-18 nm in length and 5 nm in diameter. PMID- 3280733 TI - In memoriam: Werner Henle 1910-1987. The Children's Hospital of Philadelphia. PMID- 3280734 TI - Gastrin responses in patients with adrenergic insufficiency. AB - High basal gastrin levels in pure autonomic failure could result from peripheral vagus nerve involvement, whereas the increased response during hypoglycaemia may reflect adrenergic supersensitivity. A reduced gastrin increment in multiple system atrophy was found following insulin-hypoglycaemia and is consistent with decreased gastrin release secondary to diminished central sympathetic nervous system activation in the absence of peripheral denervation supersensitivity. PMID- 3280736 TI - Major nursing diagnoses following cardiac transplantation. PMID- 3280737 TI - Quality of life for heart transplant recipients. PMID- 3280735 TI - Seizure disorder in the men of a Veterans Administration nursing home. AB - This study examined the descriptive epidemiology of seizure disorder in 129 male residents of a Veterans Administration Nursing Home. Eighty-seven of the residents were institutionalized because of nonpsychiatric disorders (60 for chronic neurologic diseases, and 27 for other medical conditions). Forty-two were institutionalized because of a chronic psychosis (39 for schizophrenia, three for affective disorders). We determined for each resident an extensive clinical data base of 54 items including measures of hematologic, nutritional, metabolic and endocrine status, as well as continuing medications. In the nonpsychiatric group, 16 of the 87 men had a seizure disorder. In the psychiatric group, this proportion was only three of 42. The prevalence of epilepsy in the nonpsychiatric group was 20-40 times greater than in the aged-matched general population of men. In the nonpsychiatric group, the onset of seizures followed the onset of organic brain disease. Forty-five percent of seizure disorders occurred in men who had experienced a cerebrovascular accident, and 23% in men with other types of chronic brain disease. The seizures of the nonpsychiatric men had been observed to be generalized clonic-tonic in 45%, and partial complex in 22%. Ninety-four percent of the nonpsychiatric men with epilepsy received anticonvulsants, and none had experienced more than one seizure during the preceding year. Univariate statistical analysis of the 54 item data base showed that the occurrence of seizure disorder correlated inversely with age, blood urea nitrogen, serum creatinine and serum bilirubin, and directly with plasma testosterone, hemoglobin, use of anticonvulsants, and use of psychotherapeutic agents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280738 TI - Ethical issues in cardiac transplantation. PMID- 3280739 TI - Cardiac transplantation: issues of donor procurement and management. PMID- 3280740 TI - Heart transplantation: a case study. PMID- 3280741 TI - A randomized trial of fluorouracil and folinic acid in patients with metastatic colorectal carcinoma. AB - We determined the therapeutic effect of fluorouracil (5-FU) in combination with folinic acid (FA) in patients with measurable recurrent or metastatic carcinoma of the colon or rectum by comparing it to standard 5-FU therapy in a prospective randomized controlled trial. Patients were randomized to receive either FA, 200 mg/m2/d for five consecutive days, or nothing. All patients received 5-FU, 370 mg/m2/d for five days on the first course, with subsequent dose modifications to maintain equal toxicity in the two arms. One hundred thirty patients were entered on trial and only five were excluded from the analysis because they did not meet the eligibility criteria or they refused therapy after randomization. The two treatment arms were balanced for 11 clinical characteristics. Patients were evaluated for response at the end of every two treatment courses and toxicity after every course of therapy. Median follow-up was 1.45 years. Dose-limiting toxicity was mucositis and diarrhea on this treatment schedule, although neutropenia was apparent. The response rate was 33% (21 of 63 patients) in the 5 FU and FA arm and was 7% (four of 61 patients) in the 5-FU arm (P less than .0005). Time to disease progression was significantly different in the combination arm as compared with the single-agent arm (P = .023). Overall survival was significantly longer for patients treated with 5-FU and FA as compared with those receiving 5-FU alone (P = .05). The median survival was 12.6 months for patients receiving the combination, and 9.6 months for those receiving 5-FU alone. Our results indicate that the combination of 5-FU and FA is effective treatment for patients with metastatic or recurrent carcinoma of the rectum and colon who have not received prior chemotherapy. PMID- 3280742 TI - Alpha-interferon in superficial bladder cancer: a Northern California Oncology Group Study. AB - Thirty-five patients with superficial transitional carcinoma of the bladder were treated intravesically with escalating doses of recombinant alpha-2-interferon administered weekly for 8 weeks. Of the 19 patients with high-grade intraepithelial neoplasia (17 carcinoma in situ [CIS], two severe dysplasia, all cytology positive), six (32%) had complete resolution of all histologic and cytologic evidence of disease (complete response). An additional three patients (16%) had complete resolution of CIS, but the interval appearance of a low-grade transitional cell neoplasm. Five (26%) had a partial response (complete resolution of all evidence of CIS on multiple bladder biopsies but persistently positive cytologic preparations). Sixteen patients with recurrent papillary tumors and extensive prior therapy were also treated. Four (25%) had a complete response. Twenty-three of the 35 patients had prior intravesical therapy. Seven of the 23 (30%) patients with prior intravesical chemotherapy or immunotherapy had a complete or partial response to interferon, while eight of the 12 patients (67%) without prior intravesical treatment responded. These responses were achieved with minimal local and systemic toxicity. Of the ten complete responders, five remain in continuous unmaintained remission for 18+ to 37+ months. Intracavitary alpha-2-interferon is an effective new treatment for some patients with bladder cancer. PMID- 3280744 TI - Glucocorticoid treatment for brain metastases and epidural spinal cord compression: a review. PMID- 3280743 TI - Preliminary results of treatment of Ewing's sarcoma of bone in children and young adults: six months of intensive combined modality therapy without maintenance. AB - Thirty-one previously untreated patients with Ewing's sarcoma were treated with an intensive chemotherapy program of vincristine, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and cyclosphosphamide (VADRIAC) in combination with radiation therapy to the primary site (greater than 50 Gy) and bone metastases (45 to 50 Gy). An intensified regimen with one further cycle of chemotherapy (VADRIAC), total body irradiation (TBI), and autologous bone marrow transplantation was given to patients with primary tumors of the pelvis, humerus, femur, and chest wall without metastases and to all patients with metastases at diagnosis. Patients with primary tumors of the distal extremity and other sites without metastases at diagnosis were treated on a less intensive chemotherapy regimen of VADRIAC without the intensification. Therapy was completed within 6 to 7 months in all patients. Thirteen patients had metastatic disease at diagnosis; only two of these had the lung as the sole site of metastatic disease. Eighteen patients had no evidence of metastatic disease at diagnosis: ten of these patients had tumors that arose in central axis and proximal extremity sites, and eight had tumors that arose in distal extremity and other sites. Thirty of the 31 patients achieved a complete remission, although two patients underwent amputation: one before chemotherapy and radiation and one after chemotherapy and radiation because of persistent local disease. Seventeen remain in their first complete remission at a median time on study of 30 months and a median time after completion of therapy of 24 months. Fourteen patients have relapsed (13) or progressed (1): ten in metastatic sites and four in the primary site. One patient had persistent local disease after radiation requiring amputation. Nine of the 13 patients with metastatic disease at diagnosis have relapsed compared with five of the 18 patients without metastatic disease. For the entire group, the actuarial survival is 78% (65% to 87%) at 30 months, and the actuarial disease-free survival is 58% (46% to 69%) at 30 months. PMID- 3280745 TI - Guidelines for reporting outcomes of lymphoma trials. PMID- 3280746 TI - Nimodipine treatment in poor-grade aneurysm patients. Results of a multicenter double-blind placebo-controlled trial. AB - A multicenter, randomized placebo-controlled double-blind trial of nimodipine in poor-grade aneurysm patients was carried out in 17 Canadian hospitals. Of 188 patients enrolled in the trial, 32 were excluded for protocol violations and two were excluded due to statistical considerations, leaving 154 patients for valid outcome analysis. Nimodipine treatment was associated with a significantly better outcome (p less than 0.001): 21 (29.2%) of 72 nimodipine-treated patients had a good outcome at 3 months after subarachnoid hemorrhage (SAH) compared to eight (9.8%) of 82 placebo-treated patients. Delayed ischemic deficits from vasospasm alone were significantly less frequent in the nimodipine group (p less than 0.05) with permanent deficits occurring in five nimodipine-treated patients (6.9%) and in 22 placebo-treated patients (26.8%). Improvement in the good outcome rate and reduction in delayed ischemic deficits from vasospasm alone occurred in both Grade 3 and 4 patients, with no difference between nimodipine- and placebo treated patients being found in Grade 5 patients. Repeat angiography after Day 4 was carried out in 124 patients. There was no significant difference in the incidence of moderate or severe diffuse spasm, which was seen in 64.3% of nimodipine-treated patients and 66.2% of placebo-treated patients. The authors conclude that nimodipine treatment in poor-grade patients with SAH results in an increase in the number of good outcomes and a reduction in the incidence of delayed neurological deterioration due to vasospasm. This effect occurs by a mechanism other than prevention of large-vessel spasm as visualized on angiography. PMID- 3280747 TI - Clinical, radiological, and pathological spectrum of angiographically occult intracranial vascular malformations. Analysis of 21 cases and review of the literature. AB - The clinical, radiological, and histopathological features of 21 cases of angiographically occult intracranial vascular malformations (AOIVM's) are analyzed, and a review of 241 additional appropriately documented, histologically verified cases collected from the literature is presented. In all, there were 115 (43.8%) arteriovenous malformations, 82 (31.2%) cavernous angiomas, 26 (9.9%) venous angiomas, 10 (3.8%) cases of capillary telangiectasis, and 29 (11%) mixed or unclassified angiomas. The result of the analysis shows that there are no essential differences in the patterns of clinical presentation, the computerized tomography (CT) appearance, or the surgical prognosis among these pathological types of vascular malformations. Certain histological features common to all AOIVM's (such as the small caliber, the more or less complete thrombosis of the malformed vessels, and the changes induced in the surrounding brain tissue by repeated microhemorrhages) seem to determine the biological behavior of the anomaly rather than the predominant type of vessel involved. Thus, subdivision of AOIVM's into the four classical pathological types has little practical value. Most AOIVM's are visualized by the CT scan and show a rather typical appearance. Surgical removal, which prevents rebleeding and ameliorates or suppresses seizure activity, is usually easy to perform and represents the treatment of choice for patients with clinically symptomatic AOIVM's. PMID- 3280748 TI - Intradural arachnoid cysts of the spinal canal associated with intramedullary cysts. AB - Five patients had intradural arachnoid cysts of the thoracic spinal canal associated with syringomyelia or posttraumatic intramedullary spinal cord cysts. Three cases were diagnosed 6 to 18 years after spinal surgery and two 14 to 17 years after spinal cord trauma. In each case, delayed progression of symptoms led to the identification of the lesions. The diagnosis was assisted by the use of myelography and delayed computerized tomography scanning in two cases and by magnetic resonance imaging in all five. In each case, the arachnoid cyst appeared to compress the spinal cord or nerve roots; in three cases, the syrinx cavities appeared to exert a significant mass effect. In the two trauma-related cases, the intramedullary cysts were small and may have represented areas of cystic myelomalacia. In four cases, intraoperative real-time ultrasonography helped to localize the arachnoid and intramedullary cavities. All five patients were treated by fenestration of the arachnoid cyst; additional peritoneal shunting of the cyst was performed in one case and of the intramedullary cavity in three. In one patient, the two lesions appeared to have a balancing effect; after drainage of the arachnoid cyst, the syrinx cavity expanded and had to be treated separately. The neurological deficits were reduced in four patients and stabilized in one. Intradural arachnoid cysts and intramedullary cysts may occur together as a late complication of spinal surgery or spinal cord trauma, and either or both lesions may cause delayed neurological deterioration. PMID- 3280749 TI - Intraoperative color-flow Doppler imaging of AVM's and aneurysms. AB - The use of intraoperative color-flow Doppler sonography to image cerebral and spinal arteriovenous malformations (AVM's) and a giant aneurysm is reported in 10 patients. The technique is a useful adjunct in localizing vascular lesions, identifying feeding or draining vessels, and confirming intraoperative surgical excision of AVM's or ligation of giant aneurysms. Imaging of lesions deeper than 4 to 5 cm is, however, limited with the equipment design now commercially available. PMID- 3280750 TI - Donner Laboratory: fifty years of nuclear medicine innovation. PMID- 3280751 TI - Comparison of different radioactive agents for the detection of renovascular hypertension with captopril in a rat model. AB - In Goldblatt hypertension in rats produced by implanting a silver clip on the left renal artery, captopril induces a greater difference in the 1-min uptake of diethylenetriaminepentaacetic acid (DTPA) between the two kidneys than in baseline uptakes, similar to the experiences in unilateral renovascular hypertension in man. The combination of captopril and furosemide induces an even greater difference in renal uptakes than with captopril alone in this rat model. In paired experiments, DTPA complexes were used as a standard to compare the differences in renal uptake between the two kidneys after captopril-furosemide with other existing and potential renal radiodiagnostic agents. No statistically significant difference was found between DTPA, glucoheptonate, dimercaptosuccinic acid, aminated dextran, or lysozyme. However, the differences in renal uptake were significantly less with hippuran than with DTPA. Furosemide and captopril caused delayed renal retention of hippuran after one minute. This response appeared to be due to non-specific volume depletion because it occurred in both clipped and unclipped kidneys. PMID- 3280752 TI - Captopril renography in Goldblatt hypertension. PMID- 3280753 TI - Strategic planning: the practical vision. AB - During the first planning year, 29 tactics were identified in a 5-year plan. Two 90-day victory calendars in that year resulted in 17 of 29 tactics being successfully implemented. During this time, strong momentum and eagerness to have successful change was evidenced. The second planning year resulted in 30 revised and/or new tactics. Midway into the second year, 6 of 30 tactics have been completed. the overall number of completed tactics was dependent upon factors such as complexity of the tactic, degree of management turnover, and operational priorities. The overall numbers of completed tactics are not as significant as the process itself, which provides mechanisms to quantify and identify quality nursing care. As a result, the nursing environment is perceived, both internally and externally, to demonstrate a nursing environment of excellence. Currently, a third annual strategic planning conference is being developed. We are confident that a planning process is in place that provides for a strong future as we continue to strive for achievement of our vision. PMID- 3280755 TI - Food restriction, circadian disorder and longevity of rats and mice. AB - Evidence that food restriction alters circadian rhythms as it prolongs the healthful life of rats and mice is reviewed. Because rhythms in different variables are changed in different ways, the circadian organization that is characteristic of freely feeding animals is disrupted. In the case of daily food restriction (meal feeding), the extent of disruption depends on the timing of the meal in relation to the daily light-dark schedule. Recent studies indicate that the extension of life span by a given level of food restriction is similar regardless of mealtime, whether fixed or shifted at weekly intervals throughout life. Such results suggest that the effects of food restriction on circadian organization are not involved in the effect on survival. On the other hand, changes in any given rhythm (such as an increased amplitude and a decreased overall average of body temperature) could point to the mechanism by which longevity is increased. PMID- 3280754 TI - Andre Gerard van Veen (1903-1986). PMID- 3280756 TI - Asbestos exposure and laryngeal cancer: an analysis of the epidemiologic evidence. AB - We conducted a critical analysis of the available epidemiologic investigations on the causal relationship between asbestos exposure and laryngeal cancer. A review of nine case-control studies indicates that the estimated risk (odds ratio) attributable to asbestos exposure alone is negligible when smoking and ethanol intake are appropriately controlled for. Six of the 12 cohort studies demonstrated no significant increase in the standardized mortality ratio due to asbestos exposure. The remaining six longitudinal studies showed an increased standardized mortality ratio from 1.91 to 5.41 but no adjustment was made for the confounding effects of smoking and ethanol consumption. In conclusion, the available epidemiologic evidence does not support a causal association between asbestos exposure and laryngeal cancer. PMID- 3280757 TI - Smoking and pulmonary fibrosis. AB - A review of the relevant literature provides evidence that cigarette smoking causes microscopic diffuse interstitial pulmonary fibrosis in humans at autopsy. The association shows a dose-response relationship and the fibrosis is often severe. Experimental animal studies have confirmed these observations when the exposure to inhaled smoke was prolonged or heavy. Six published and one unpublished cross-sectional chest x-ray surveys of adults have shown low profusion of small irregular opacities related to smoking with a dose-response relationship when this has been studied. Although information on radiographic pathologic correlation is deficient, these studies support the hypothesis that smoking causes diffuse interstitial pulmonary fibrosis which is radiologically visible with low profusion in low prevalence. The x-ray manifestations may be confused with early pneumoconiosis such as asbestosis. PMID- 3280758 TI - Costochondral grafting in condylar replacement and mandibular reconstruction. AB - Thirty costochondral grafts in 22 patients were retrospectively studied with a mean follow-up of five (range, 2 to 11) years. The functional results, esthetics, and incidence of complications in these patients were determined. A discussion of these findings as well as the surgical technique is included. The results confirm previous studies and indicate that free costochondral grafting is a successful and physiologically sound method for reconstruction of portions of the mandible and its temporal articulation. PMID- 3280759 TI - Morbidity from bone harvest in major jaw reconstruction: a randomized trial comparing the lateral anterior and posterior approaches to the ilium. AB - A randomized prospective study was done to compare bone harvest morbidity in the lateral anterior versus the lateral posterior approach to the ilium. One hundred consecutive patients, requiring at least 60 ml of bone for continuity defects of the mandible, were randomly placed in equal groups in these two categories. Assessment of morbidity vectors included pain, ambulation, seroma, and blood loss. Results, in part, identified the posterior ilium harvest to have decreased morbidity in all variables. The reduced morbidity encountered, and the greater quantity of available bone, are both related to the anatomic differences between the anterior and posterior ilium. Accepted disadvantages were increased operating time and the need to turn the patient. PMID- 3280760 TI - Use of a latissimus dorsi myocutaneous flap for closure of an orocutaneous fistula of the cheek. AB - The latissimus dorsi myocutaneous flap can be used successfully for external cover in the cheek region when the nature of the defect precludes the use of other local or regional flaps. It is exceedingly useful when a large amount of well-vascularized tissue is needed. The flap is extremely reliable and versatile as a one-stage reconstruction. Its major drawbacks are its bulkiness and the necessity to reposition the patient intraoperatively. PMID- 3280761 TI - Chondromyxoid fibroma of the maxilla. AB - A case of chondromyxoid fibroma of the anterior maxilla arising in a 38-year-old Japanese woman is presented. Review of the literature reveals 16 cases of CMF of the jaws, of which only 3 were in the maxilla. Curettage and subsequent 5 year followup showed no evidence of recurrence. PMID- 3280762 TI - Rapid condylar degeneration after glenoid fossa prosthesis insertion: report of three cases. AB - Three cases of temporomandibular joint disc replacement with a polymer glenoid fossa prosthesis, followed by rapid condylar degeneration, are reported. The relationship between this degeneration and a consistent foreign body reaction to fragments caused by implant wear is postulated. PMID- 3280763 TI - Percutaneous catheters and totally implantable access systems: a review of reported infection rates. PMID- 3280764 TI - Chronic gastritis--a pathogenetic approach. PMID- 3280765 TI - An immunocytochemical study of lymphocyte and macrophage populations in the bone marrow of patients with non-Hodgkin's lymphoma. AB - Pairs of bone marrow trephine samples from 67 patients with known or suspected non-Hodgkin's lymphoma (NHL) were collected. One sample was processed for morphological examination, the other for frozen section immunohistology, using a panel of monoclonal antibodies (MAB) reacting with lymphocyte and macrophage determinants, detected by the immuno-alkaline-phosphatase (APAAP) method. Forty one cases showed definite (36) or suspected (5) involvement of the marrow by NHL. Most were examples of lymphocytic or centroblastic/centrocytic NHL. The pattern of immunostaining confirmed the presence of NHL in these cases: the phenotype of the neoplastic cells was broadly consistent with nodal histology, where available. In ten cases, the marrow showed no evidence of involvement by NHL, and in 15, the eventual diagnosis was an abnormality of the myeloid series. These two groups of marrows not involved by NHL both showed a 'reactive' pattern of immunostaining, comprising polyclonal B-cells, T-helper and suppressor/cytotoxic cells and macrophages. We conclude that immunohistological examination of the bone marrow is useful in cases where the specimen shows morphological evidence of NHL, including those that are only 'suspect', but does not detect lymphoma where there is no morphological evidence of involvement. PMID- 3280766 TI - Correlation between DNA flow cytometric and nucleolar organizer region data in non-Hodgkin's lymphomas. AB - The argyrophilic staining (AgNOR) technique, novel in histopathology, was applied to a series of 20 non-Hodgkin's lymphomas (NHL) of established Kiel subtype. The method demonstrates nucleolar organizer regions (NORs) by virtue of sulphydryl groups on their associated proteins and the enumeration of AgNOR foci has been previously shown to discriminate between NHL of low- and high-grade histological types. This finding was confirmed and the results were compared with those obtained by means of DNA flow cytometry performed on paraffin wax-embedded tissue from the same lymphomas. There was a very good linear correlation between the mean numbers of AgNOR sites per nucleus and the percentage of S-phase cells for each case, both values being high in high-grade NHL and low in low-grade lesions. Conversely there was no significant correlation between the DNA index, representing DNA aneuploidy, and AgNOR counts. It is suggested that the numbers of AgNORs in a lymphoma may be related to the dividing fraction of cells rather than, as might be expected, to ploidy alone. It is also proposed that the AgNOR technique, which is rapid, simple, and inexpensive, may provide, at least, an adjunct to DNA flow cytometry in the assessment of neoplasm in histopathology. PMID- 3280767 TI - The glomerular tip lesion: a distinct entity or not? AB - Howie and Brewer recently described a novel glomerulopathy: the glomerular tip lesion (GTL). The characteristic feature of this entity is a collection of intracapillary foam cells and marked vacuolization of the epithelial cells of the glomerular segment adjacent to the origin of the proximal tubule. Although this lesion resembles focal segmental glomerulosclerosis (FSGS), Howie and Brewer suggested that it constitutes a distinct entity, differing also clinically from FSGS, in that it would have a better response to steroid treatment. We treated five patients fulfilling the criteria of Howie and Brewer. However, neither corticosteroids (1.5 mg/kg/day for 1 month in five patients) nor cyclosporin-A (5 mg/kg/day for three months in four patients) caused a decrease in proteinuria to below 4 g/day. In two patients, renal function deteriorated and in one of them, recurrence of classical FSGS was found in the renal transplant. A sixth patient was observed in whose biopsy a combination of GTL with membranous glomerulopathy was present. We conclude that GTL is not a distinct entity and that in the clinical course and response to treatment it does not differ from FSGS. PMID- 3280768 TI - Point mutations in human neoplasia. PMID- 3280769 TI - Colorectoral excision specimens and prognosis. PMID- 3280770 TI - Activation and differentiation antigen expression in B-cell non-Hodgkin's lymphoma. AB - In an attempt to establish whether extended immuno-phenotyping allows more accurate definition of subgroups of B-cell non-Hodgkin's lymphoma (NHL) we have stained a series of 145 cases with a large panel of monoclonal antibodies that recognize B-cell differentiation and activation antigens. No antigen was expressed by all cases. The B-cell histogenesis in many cases could be confirmed only by using a panel of immunoglobulin and pan B-cell markers. There was marked phenotypic heterogeneity within and between major groups of B-cell NHL as delineated by the Kiel classification although the differentiation antigens CD5 (lymphocytic and centrocytic NHL) and OKT10 (plasma cell tumours) were more often expressed by certain morphological groups. The activation antigens 4F2 and transferrin receptor were expressed more strongly and more often by high grade NHL but other activation antigens (CD23 and CD25) were not more frequently associated with these tumours. Extended phenotyping may be of value in improving the understanding of biological abnormalities and processes involved in B-cell NHL, but we conclude that a limited panel of markers (CD3, CD5, CD22, CD45, IgM, kappa, and lambda) should be sufficient for routine diagnosis and classification of most cases. PMID- 3280771 TI - Clinical perspectives on penicillin tolerance. PMID- 3280772 TI - Bronchial provocation tests in young children using tracheal auscultation. PMID- 3280773 TI - Prophylactic furosemide in severe respiratory distress syndrome: blinded prospective study. AB - To further characterize the place for furosemide in the treatment of newborn infants with respiratory distress syndrome requiring mechanical ventilation, we conducted a blinded, prospective study comparing early prophylactic use (1 mg/kg every 12 hours for four doses beginning at 24 hours of age) with prn use of this drug. Prophylactic administration of furosemide produced no beneficial effect on any measure of pulmonary function compared with use of this drug as needed (prn). However, patients receiving the prophylactic furosemide regimen were found to have more rapid postnatal weight loss, higher pulse rate, and greater sympathomimetic drug requirement during the period of diuretic administration. Patients in the prophylactic group did not demonstrate the moderate expansion in plasma volume between 48 and 96 hours of age seen in the control group. These data suggest that the prophylactic regimen produced an undesirable degree of volume depletion. Further studies should be conducted to develop objective criteria for the selection of the subgroup of patients with respiratory distress syndrome who may benefit from furosemide. PMID- 3280774 TI - Diaphragmatic movement in newborn infants. AB - Axial movement of the right hemidiaphragm during tidal breathing was recorded using real-time ultrasonography in 46 healthy term infants. Displacement was 2.6 +/- 0.1, 3.6 +/- 0.2, and 4.5 +/- 0.2 mm (mean +/- SEM) for the anterior, middle, and posterior thirds, respectively. Diaphragmatic movement was significantly greater in the middle and posterior segments than in the anterior segment (P less than 0.0001). Excursion of the diaphragm was similar in sleeping and awake infants, and during quiet and active sleep, as identified by behavioral criteria. Diaphragmatic movement was also assessed in nine infants who required mechanical ventilation and pharmacologic paralysis because of respiratory disease. In these infants, axial movement of the right hemidiaphragm was less in the middle and posterior thirds (P less than 0.05 and P less than 0.01, respectively) than in spontaneously breathing infants, and posterior movement was not predominant. Normative data for axial diaphragmatic movement may be of clinical value in the assessment of defects of the diaphragm, rib cage, or abdomen in newborn infants and may allow further understanding of the direct effects of therapeutic interventions on the respiratory system in infancy. PMID- 3280775 TI - Liver transplantation therapy for children: Part 1. PMID- 3280776 TI - Graft-versus-host disease: gastrointestinal involvement with a rectovaginal fistula. AB - Bone marrow transplantation is an accepted form of treatment for aplastic anemia and end-stage hematological malignancies. Despite a satisfactory outcome in selected patients, more than one-half develop acute graft-versus-host disease (GVHD), characterized typically by involvement of the skin, liver, and gastrointestinal tract. We describe an unusual case in which a 10-year-old girl developed gastrointestinal symptoms as the only manifestation of GVHD. The patient presented with a rectovaginal fistula and had clinical, radiological, and histological features of gastrointestinal GVHD without evidence of liver or skin involvement. PMID- 3280777 TI - Anorectal malformations: evaluation of associated spinal dysraphic syndromes. AB - The early recognition and treatment of correctable lesions of the terminal spinal cord in patients with anorectal malformations may preserve important neurologic function. Tethered cord and intraspinal masses are detectable with the use of high-resolution ultrasonography in the neonate. Fourteen infants and children with anorectal malformations and associated spinal dysraphism have been identified in our institution over the past 7 years. Six patients had cloacal exstrophy, and eight had imperforate anus (four high and four low lesions). The spinal lesions caused symptoms in only seven children; progressive neurologic deficit in five, and urinary incontinence or retention in two others. Five asymptomatic patients with cutaneous abnormalities on the back were studied and two were discovered during scoliosis evaluation. Imaging techniques included high resolution ultrasonography, computed tomography with and without metrizamide myelography, and magnetic resonance imaging. Spinal sonography was highly accurate in the neonatal period. The application of ultrasonography can be of great advantage in early screening of patients with anorectal malformations and, in some cases, may eliminate the need for invasive imaging techniques. PMID- 3280778 TI - Bruxism in children: review of the literature. PMID- 3280779 TI - Penetration of fissure sealants into contraction gaps of bulk packed auto-cured composite resin. PMID- 3280780 TI - Retention of composites on alumina-blasted stainless steel crowns. PMID- 3280781 TI - Stimulation of anterior maxillary growth in a unilateral alveolar cleft patient. PMID- 3280783 TI - Experimental intraocular lens implantation in the rabbit eye and in the mouse peritoneal space. Part II: Morphological stages of the macrophage on the implanted lens surface. AB - Macrophages appearing on implanted intraocular lenses (IOLs) in the rabbit eye and in the mouse peritoneal space were observed using Wolter's implant cytology staining and scanning and transmission electron microscopy. In response to the implanted IOL, macrophages in the mouse peritoneal space displayed an activated form with marked ruffles on the surface. They were attached to the IOL with a broad base (sessile macrophage). The macrophages metamorphosed gradually to the flat shape of so-called epithelioid cells with many processes. They showed a tendency to fuse together or become more flat by extending the cytoplasmic lamellipodia and finally disappeared, leaving a thin membrane or a fibrous matrix. Phagocytic activity of macrophages and related cells was also observed. However, those observed on the IOL implanted in the rabbit eye showed less surface structure and appeared to adhere weakly to the IOL. PMID- 3280782 TI - Experimental intraocular lens implantation in the rabbit eye and in the mouse peritoneal space. Part I: Cellular components observed on the implanted lens surface. AB - Polymethylmethacrylate and silicone intraocular lenses (IOLs) were implanted in the rabbit eye and in the mouse peritoneal space to study cellular response to the implanted IOL. Animals were sacrificed at various times after implantation. The removed IOLs were properly fixed and stained using Wolter's implant cytology technique. Scanning and transmission electron microscopic studies were performed. Macrophages, lymphocytes, and fibroblast-like cells were the major components identified. Occasional formations of foreign-body giant cells were seen. The responses observed on IOLs implanted in the rabbit eye were generally milder than those observed on IOLs implanted in the mouse peritoneal space. PMID- 3280784 TI - Arginine vasopressin in primigravid human pregnancy. A prospective study. AB - The relationship between plasma osmolality (Posm) and plasma arginine vasopressin (Pavp) was determined in: (1) 62 normal primigravidas (P) at various stages of gestation and 35 nonpregnant, healthy volunteers (NP) under conditions of normal hydration or water deprivation, and (2) a separate group of 29 normotensive primigravidas during both the second and third trimesters under normal hydration. Pavp was similar in the P and NP groups, and Posm and Pavp were correlated significantly in both groups, but the osmotic threshold was lowered by 11 mosm/kg in primigravidas. In the prospective study, Pavp and Posm were correlated significantly at both stages. Pavp rose between trimesters, as did plasma volume and plasma renin activity, but urine volume and osmolality and Posm did not change significantly. These data confirm that resetting of the osmostat is operative in primigravid pregnancy and extend these observations by demonstrating that this phenomenon is established at least as early as mid-pregnancy. Furthermore, the osmoregulatory system does not appear to be altered by changes in plasma volume or plasma renin as pregnancy progresses. PMID- 3280785 TI - Antenatal management of a large placental chorioangioma. A case report. AB - Chorioangiomas of the placenta are found in approximately 1% of all pregnancies. In most cases the lesion is identified only on histologic examination of the placenta after delivery. Prenatal diagnosis of large lesions is possible with ultrasound. The occurrence of a large chorioangioma during pregnancy may lead to serious maternal and fetal complications. A case of a large chorioangioma was associated with polyhydramnios and diagnosed antenatally with ultrasound. Fetal compromise from pressure necrosis of the tumor on the normal placental tissue necessitated preterm delivery. PMID- 3280786 TI - Conservative management of placenta accreta. A case report. AB - Placenta accreta is a rare complication of pregnancy. Traditional therapy has centered upon total abdominal hysterectomy to prevent serious hemorrhagic and infectious sequelae. Conservative management, however, may preserve reproductive function without jeopardizing maternal welfare. PMID- 3280788 TI - Ultrasonographic criteria for the conservative management of antenatally diagnosed fetal ovarian cysts. AB - Routine antenatal ultrasonography at regular intervals will detect fetal ovarian cysts. Before the era of ultrasound, the attending physician was unaware of the presence of these cysts. It is therefore imperative that a protocol for the management of asymptomatic, antenatally diagnosed ovarian cysts be developed. The vast majority of these cysts are benign and functional; laparotomy during the neonatal period is not only unnecessary but may be harmful. In a prospective study undertaken at Tygerberg Hospital, Parowvallei, South Africa, six ultrasound criteria were drawn up for the safe, conservative management of these neonates. Adherence to these criteria enabled us to manage five of seven neonates conservatively. Laparotomy in one neonate showed a benign functional ovarian cyst. Retrospectively, this case should have been managed conservatively. In the remaining neonate a laparotomy for an acute abdomen demonstrated torsion of an ovarian cyst, emphasizing the necessity for adequate follow-up. PMID- 3280787 TI - Caffeine consumption and the risk of reproductive hazards. AB - Recent reports on the relationship between caffeine consumption by pregnant women and their infants' risk of miscarriage, low birth weight, preterm delivery and congenital malformations were reviewed. The evidence continues to support the view that moderate consumption of caffeine by pregnant women does not adversely affect their fetuses. PMID- 3280789 TI - Invasive adenocarcinoma of the ovary diagnosed after cardiac transplantation. A case report. AB - After cardiac transplantation, a woman was maintained on cyclosporine A and prednisone and shortly thereafter was diagnosed as having stage IV ovarian cancer. This is the first such reported case. Comprehensive preoperative gynecologic evaluation and diligent postoperative surveillance of such patients are recommended. PMID- 3280790 TI - Severe reversible interstitial pneumonitis induced by low dose methotrexate: report of a case and review of the literature. AB - A patient treated with 7.5 mg methotrexate/week (MTX) for rheumatoid arthritis (total dose 300 mg) developed high fever, dry cough and progressive dyspnea and hypoxemia due to a severe interstitial pneumonitis. MTX was discontinued and an infectious etiology was ruled out by cultures, serology and lung biopsy. Corticosteroids administered intravenously in high dose led to a dramatic improvement and a complete amelioration of all symptoms and signs. Pulmonary toxicity is a rare adverse effect of low dose MTX therapy and a review of the literature reveals 6 additional cases. Since MTX induced pneumonitis is a potentially fatal, yet completely reversible, disease, attention should be paid to even mild early respiratory symptoms in patients treated with low dose MTX and patient monitoring should include pulmonary function tests. PMID- 3280791 TI - Relapse of systemic lupus erythematosus in a patient receiving cyclosporine A. AB - Cyclosporine A (CyA) is being increasingly used as an immunosuppressive agent to treat various autoimmune diseases. A patient with systemic lupus erythematosus (SLE) receiving CyA after renal transplantation suffered a disease relapse associated with high serum CyA levels. Lowering of the CyA dose and the start of steroids resulted in a rapid improvement in her condition. Trials evaluating CyA for SLE should proceed with caution since under certain circumstances this drug may exacerbate disease activity. PMID- 3280792 TI - Nocardia bursitis. AB - Nocardia asteroides was recovered from the olecranon bursa in a healthy young man with no predisposing illness. Diagnosis was made on bursal fluid culture. Clinical features and bursal fluid analysis were misleading. Our patient responded to sulfonamide therapy. PMID- 3280793 TI - Aortic valve insufficiency and coronary artery narrowing in a child with polyarticular juvenile rheumatoid arthritis. AB - Involvement of the cardiac valves in juvenile rheumatoid arthritis (JRA) is a rare but life threatening complication. We report a 9 1/2-year-old girl with rheumatoid factor positive polyarticular JRA who developed aortic insufficiency that required valve replacement. Six months later she developed angina due to narrowing of the left coronary artery, probably secondary to aortitis. PMID- 3280794 TI - Comparison of ANA testing in JRA using immunofluorescent and immunoenzyme assays on HEp-2 cells. PMID- 3280795 TI - Dose response studies and longterm evaluation of auranofin in rheumatoid arthritis. AB - Fifty-eight patients with rheumatoid arthritis (RA) entered a double blind trial of auranofin (AF) designed to assess dose response relationships and longterm outcome. Multivariate analysis of repeated measures with trend analysis and discriminant function analysis of standard measures of RA activity were applied to a randomized double blind trial of AF at daily doses of 4, 6 and 8 mg over 6 months. Improvement occurred in each group. There was a highly significant (p less than 0.001) linear trend in the 6 mg group, 73% of whom showed linear improvement. A significant correlation (p less than 0.05) was found between response of individual patients and AF dose (mg/kg/day), but there was no significant correlation between dosage and mean steady state serum gold concentration. No significant correlation was seen between outcome and pretreatment demographic and disease variables. In a subsequent 6 month phase of dosage adjustment, aiming for optimal dosage, no advantage resulted from increasing the dose above 6 mg/day. Patients apparently benefiting from treatment continued an open long-term trial of AF. By 45 months, 33.5% had stopped treatment due to lack of efficacy and 14.5% due to toxicity, mainly rash and diarrhea. PMID- 3280797 TI - 1,2,4-Trioxanes as potential antimalarial agents. AB - A number of 1,2,4-trioxanes were prepared and tested for antimalarial activity in search of a simplified analogue of the naturally occurring antimalarial qinghaosu. The compounds were assayed in an in vitro system for antimalarial activity against chloroquine-susceptible and chloroquine-resistant strains of Plasmodium falciparum. The most active compounds were methyl 2-(2,4a-epidioxy 4a,5,6,7,8,8a-hexahydro-5,5,8a-trimethyl-2H-1-benzop yra n-2-yl) acetate (3b), which showed IC20's of 96 and 39 ng/mL, respectively, and 2,4a-epidioxy 3,4,4a,5,6,7,8,8a-octahydro-2-[2-(benzoyloxy)propyl]-5,5,8 a- trimethyl-2H-1 benzopyran (12), which showed IC50's of 24 and 99 ng/mL, respectively. For comparison, qinghaosu exhibits an IC50 of 1 ng/mL for both strains. PMID- 3280796 TI - Measurement of synovial fluid volume using albumin dilution upon intraarticular saline injection. AB - A simple method for measuring synovial fluid (SF) volume is described. The degree of dilution of SF albumin after intraarticular injection of a defined volume of saline was used to calculate residual SF volume. Good correlation between calculated and aspirated SF volume was found for knee joint exudates. The method is simple, requires no radioactive tracer and should be useful in quantitative studies involving SF pathophysiology. Interestingly, the major portion of the SF could be directly aspirated, since residual volumes were small in comparison. PMID- 3280798 TI - Peptide derivatives of primaquine as potential antimalarial agents. AB - Three peptide derivatives of primaquine were synthesized. The compounds were tested for radical curative antimalarial activity against Plasmodium cynomolgi in rhesus monkeys and blood schizonticidal antimalarial activity against Plasmodium berghei in mice. All three peptide derivatives showed activity against P. cynomolgi greater than that expected for the primaquine content of each prodrug. The toxicity of one of the peptide derivatives was less than that of primaquine in mice. PMID- 3280799 TI - Comparison of DNA-probe and isoenzyme methods for differentiating Anopheles gambiae and Anopheles arabiensis (Diptera: Culicidae). PMID- 3280800 TI - The premature breech: caesarean section or trial of labour? AB - Obstetricians face difficult decisions when the interests of fetus and mother conflict. An example is the problem of choosing the delivery method when labour begins prematurely and the fetus is breech. Vaginal delivery involves risks for the breech fetus of brain damage or death caused by umbilical cord compression and head entrapment. Caesarean section might avoid these dangers but involves risks for the mother, including infection, haemorrhage and even death in a small percentage of cases. If a caesarean section is performed the infant might die anyway, due to complications of prematurity. Thus, decisions about delivery method involve balancing the risks to mother and fetus. Uncertainty about the frequency of fetal injuries in vaginal breech deliveries adds to the difficulty of these decisions. PMID- 3280801 TI - Medical genetics in Hungary. PMID- 3280802 TI - Rapid initial cleavage of nascent pre-rRNA transcripts in yeast. AB - In yeast cells, as in many other eukaryotes, the initial step in the processing of the pre-rRNA primary transcript is removal of external transcribed spacer (ETS) sequences from the 5' end of the transcript. We show here, both by Northern analysis and by quantitative hybridization procedures using cloned yeast ETS sequences, that in cells growing exponentially at 23 degrees C most nascent pre rRNA transcripts no longer contain ETS sequences. Moreover, quantitative hybridization shows that uncleaved pre-rRNA molecules that still contain ETS sequences have a half-life of only 0.5 minute, a value that supports the finding that ETS removal usually takes place before pre-rRNA transcription is complete. Under these same conditions, the half-life of ETS sequences is shown to be only 1.0 minute. PMID- 3280803 TI - Transcriptional activation of bacteriophage T4 middle promoters by the motA protein. AB - Transcriptional activation of middle genes in bacteriophage T4 requires the phage encoded motA protein. Many middle genes are involved in deoxyribonucleotide biosynthesis and phage DNA replication. In the absence of motA, the gene products that are required for DNA synthesis are transcribed from other, upstream promoters. Using primer extension sequencing on RNA templates isolated from T4 motA+ and motA- infected cells, we have characterized 14 motA-dependent transcripts. The T4 middle promoters have a consensus sequence of nine base pairs, (a/t)(a/t)TGCTT(t/c)A, spaced 11 to 13 nucleotides away from the Escherichia coli--10 consensus sequence, TAnnnT. The motA protein also can act as a transcriptional repressor for at least one early gene. Furthermore, the phage encoded motA protein can activate in trans a middle promoter resident on a plasmid. PMID- 3280804 TI - Interaction of Escherichia coli RNA polymerase with DNA in an elongation complex arrested at a specific psoralen crosslink site. AB - We have probed the interaction of Escherichia coli RNA polymerase with DNA in an elongation complex arrested by a site-specifically placed psoralen crosslink using DNase I footprinting techniques. The psoralen derivative 4'-hydroxymethyl 4,5',8-trimethylpsoralen was first placed at a specific site in the middle of a chemically synthesized double-stranded DNA fragment containing an E. coli RNA polymerase promoter at one end. The psoralen molecule was photochemically attached to two adjacent thymidine residues on opposite strands as a diadduct. Using this crosslinked DNA as the template for transcription, we found that the E. coli RNA polymerase was blocked at the psoralen diadduct, yielding a transcript 29 nucleotides long. The arrested elongation complex inhibited DNase I digestion of both the coding strand and the non-coding strand from about 22 nucleotides upstream to 15 nucleotides downstream from the diadduct. These results, which suggest that the unwindase and the catalytic sites of the polymerase are very close to each other, have been incorporated into a model of the transcription elongation complex. PMID- 3280805 TI - Nucleotide and deduced amino acid sequence of stp: the bacteriophage T4 anticodon nuclease gene. AB - Pre-existing host tRNAs are reprocessed during bacteriophage T4 infection of certain Escherichia coli strains. In this pathway, tRNALys is cleaved 5' to the wobble base by anticodon nuclease and is later restored in polynucleotide kinase and RNA ligase reactions. Anticodon nuclease depends on prr, a locus found only in host strains that restrict T4 mutants lacking polynucleotide kinase and RNA ligase; and on stp, the T4 suppressor of prr restriction. stp was cloned and the nucleotide sequences of its wild-type and mutant alleles determined. Their comparison defined an stp open reading frame of 29 codons at 162.8 to 9 kb of T4 DNA (1 kb = 10(3) base-pairs). We suggest that stp encodes a subunit of anticodon nuclease, perhaps one that harbors the catalytic site; while additional subunits, such as a putative prr gene product, impart protein folding environment and tRNA substrate recognition. PMID- 3280806 TI - Analysis in vivo of the bacteriophage P22 headful nuclease. AB - Bacteriophage P22 packages its double-stranded DNA chromosomes from concatemeric replicating DNA in a processive, sequential fashion. According to this model, during the initial packaging event in such a series the packaging apparatus recognizes a nucleotide sequence, called pac, on the DNA, and then condenses DNA within the coat protein shell unidirectionally (rightward) from that point. DNA ends are generated near the pac site before or during the condensation reaction. The right end of the mature chromosome is created by a cut made in the DNA by the "headful nuclease" after a complete chromosome is condensed within the phage head. Subsequent packaging events on that concatemeric DNA begin at the end generated by the headful cut of the previous event and proceed in the same direction as the previous event. We report here accurate measurements of the P22 chromosome length (43,400( +/- 750) base-pairs, where the uncertainty is the range in observed lengths), genome length (41,830( +/- 315) base-pairs, where the uncertainty represents the accuracy with which the length is known), the terminal redundancy (1600( +/- 750) base-pairs or 3.8( +/- 1.8)%, where the uncertainty is the observed range) and the imprecision in the headful measuring device ( +/- 750 base-pairs or +/- 1.7%). In addition, we present evidence for a weak nucleotide sequence specificity in the headful nuclease. These findings lend further support to, and extend our understanding of, the sequential series model of P22 DNA packaging. PMID- 3280807 TI - SUF12 suppressor protein of yeast. A fusion protein related to the EF-1 family of elongation factors. AB - Mutations at the suf12 locus were isolated in Saccharomyces cerevisiae as extragenic suppressors of +1 frameshift mutations in glycine (GGX) and proline (CCX) codons, as well as UGA and UAG nonsense mutations. To identify the SUF12 function in translation and to understand the relationship between suf12-mediated misreading and translational frameshifting, we have isolated an SUF12+ clone from a centromeric plasmid library by complementation. SUF12+ is an essential, single copy gene that is identical with the omnipotent suppressor gene SUP35+. The 2.3 x 10(3) base SUF12+ transcript contains an open reading frame sufficient to encode a 88 x 10(3) Mr protein. The pattern of codon usage and transcript abundance suggests that SUF12+ is not a highly expressed gene. The linear SUF12 amino acid sequence suggests that SUF12 has evolved as a fusion protein of unique N-terminal domains fused to domains that exhibit essentially co-linear homology to the EF-1 family of elongation factors. Beginning internally at amino acid 254, homology is more extensive between the SUF12 protein and EF-1 alpha of yeast (36% identity; 65% with conservative substitutions) than between EF-1 alpha of yeast and EF-Tu of Escherichia coli. The most extensive regions of SUF12/EF-1 alpha homology are those regions that have been conserved in the EF-1 family, including domains involved in GTP and tRNA binding. It is clear that SUF12 and EF-1 alpha are not functionally equivalent, since both are essential in vivo. The N-terminal domains of SUF12 are unique and may reflect, in part, the functional distinction between these proteins. These domains exhibit unusual amino acid composition and extensive repeated structure. The behavior of suf12-null/SUF12+ heterozygotes indicates that suf12 is co-dominantly expressed and suggests that suf12 allele specific suppression may result from functionally distinct mutant proteins rather than variation in residual wild-type SUF12+ activity. We propose a model of suf12 mediated frameshift and nonsense suppression that is based on a primary defect in the normal process of codon recognition. PMID- 3280808 TI - Hjalmer August Schiotz, 1850-1927. PMID- 3280809 TI - Clinical aspects of postirradiation sarcomas. AB - The number of cancer patients who live longer and are cured of their disease is increasing. Many of them have received radiotherapy as part of their treatment. Postirradiation sarcoma (PIS), while still uncommon, is a complication which is appearing more frequently as the number of long-term survivors increases. Studies of the clinical characteristics of PIS, such as stage of disease, grade, survival, and prognosis, are therefore of increasing importance, and may lead to different strategies for early detection and prevention. In a literature review of PIS, we identified 344 cases with sufficient data for analysis of these clinical characteristics. In these selected cases, we found that: (a) PIS was most often diagnosed at an advanced stage and high grade; (b) most of the tumors were located in areas where radical surgery could not be performed; (c) the response rate to chemotherapy was almost always poor; and (d) most patients with PIS died from locally advanced and/or metastatic disease within a few months after diagnosis. PIS is a serious, usually fatal, late complication of radiotherapy and it should be weighed in the decision to use this modality of therapy. In the follow-up of cancer patients, a low threshold of suspicion for PIS is recommended in order to detect it early for possible resection. Because of the poor prognosis, more aggressive and investigative chemotherapeutic regimens are warranted. PMID- 3280810 TI - Progressive loss of phenotypic proteins in mature granulocytes before the onset of blast crisis in human chronic myelogenous leukemia. AB - A combined high-performance liquid chromatography-sodium dodecyl sulfate-gel electrophoresis method for the study of the phenotypic protein patterns of mature blood granulocytes was previously described. With the use of this method in the present study, the progression of human chronic myelogenous leukemia (CML) from the stable to the blast crisis stage was shown to be accompanied by a progressive decrease in the amounts of cell membrane and granule phenotypic proteins in mature granulocytes. Survival time from the initial diagnosis was significantly shorter for CML patients whose levels of granulocyte phenotypic proteins were below the normal range compared with survival time for those patients whose levels were normal or higher than normal. The data suggest that these changes in mature granulocytes serve as useful diagnostic indicators of an impending blast crisis in CML patients. PMID- 3280811 TI - Phase II evaluation of carboplatin in advanced endometrial carcinoma. AB - Carboplatin was administered by iv bolus every 28 days to 26 patients who had extensive metastatic or recurrent endometrial adenocarcinoma and no prior chemotherapy exposure. The dose level was 400 mg/m2 in 5 patients with and 4 patients without prior irradiation and 300 mg/m2 in 16 patients with prior pelvic irradiation. Partial disease regressions were seen in 28% of patients (95% confidence interval, 12%-50%), with a median response duration of 129 days. Median survival of all patients was 215 days; median time to disease progression for all patients was 117 days. We conclude that carboplatin is an active agent in advanced endometrial carcinoma and is worthy of further investigation in single agent and combination chemotherapy. PMID- 3280812 TI - Treatment of hypertension in black patients with angiotensin-converting enzyme inhibitors. AB - The prevalence of hypertension and the incidence of complications from uncontrolled elevated blood pressure in blacks is much greater than in the white population. In general, blacks have underlying differences in the factors relating to blood pressure level, including low plasma renin, and, in certain instances, a decreased ability to excrete sodium. The stepped-care approach in the management of the black hypertensive patient is similar to that taken with white patients, but racial differences in response to antihypertensive drugs exist that require careful consideration when choosing a treatment regimen. Thiazide diuretics are effective in blacks and are often used as initial therapy. Blacks tend to respond less well to beta-blockers, but when combined with a diuretic, they are also effective. Encouraging data are available on the use of calcium channel blockers in blacks. When combined with a diuretic, the angiotensin-converting enzyme (ACE) inhibitors also provide an alternative to therapy for black patients. The use of low doses of ACE inhibitors has reduced the high incidence of adverse effects associated with this group of drugs in earlier studies. PMID- 3280813 TI - Update in cancer chemotherapy: genitourinary tract cancer, Part 3: Cancer of the prostate. AB - An update of the state of the art of cancer chemotherapeutic treatment of genitourinary tract cancer is described in this multi-part series: included are cancers of the kidney, bladder, prostate, testicle, ovary, uterus, vulva, and gestational trophoblastic neoplasms. Part 3 is a review of treatments for cancer of the prostate.The role of cancer chemotherapeutics as adjuvant therapy and in combination modalities in the treatment of prostatic carcinoma has yet to be determined. No single agent or combination can be considered standard therapy. The role of chemotherapy in prostatic carcinoma needs further definition. Only through randomized trials will better guides to better treatment be established. PMID- 3280814 TI - Health and health care in post-apartheid South Africa: a future vision. AB - This paper accepts the idea that patterns and distribution of health care and resources are determined by "realpolitik," and that South Africa is at present in the throes of a political revolution, the outcome of which is bound to reflect a considerable degree of "self-determination" of the majority black (African, Asian, and mixed-race) people. It is postulated that the health services-and other pre-determinants of the health of the black people-will be shaped by a mixed socialist-capitalist economy and a socialized or nationalized form of health care service. This is because all the leading players in the revolutionary stakes, especially the exiled African National Congress of South Africa (ANC) and the above-ground United Democratic Front (UDF) and its affiliate, the National Alternative Medical and Dental Association (NAMDA), who are the front-runners, advocate these kind of changes for the future of South Africa, as exemplified in the ANC's Freedom Charter of 1955.Powerful political forces, both inside South Africa and in the Western World, are resisting this outcome, despite it clearly being the democratic will of the people, as shown by all the polls. These reactionary strategies would leave the health of most blacks in South Africa and Namibia little improved over its present status. PMID- 3280815 TI - Aspartate-induced neuronal necrosis in infant mice: protective effect of carbohydrate and insulin. AB - Infant mice given large doses of glutamate or aspartate develop hypothalamic neuronal necrosis. Studies by others demonstrated that simultaneous administration of carbohydrate or prior injection with insulin markedly decreased glutamate-induced neuronal damage. We investigated whether carbohydrate and insulin exert a similar protective effect against aspartate-induced neuronal necrosis. Eight-day-old mice administered aspartate at 750 and 1000 mg/kg body weight developed neuronal necrosis (45.9 +/- 7.2 and 80.8 +/- 17.3 necrotic neurons/section, respectively). When carbohydrate (1 g/kg body weight) was administered simultaneously no lesions were detected in mice administered 750 mg/kg body weight aspartate, while 30.1 +/- 14.2 necrotic neurons/section were noted at 1000 mg aspartate/kg body weight. Mice administered 1000 mg/kg body weight aspartate with prior injection of insulin had 28.4 +/- 12.6 necrotic neurons/section, while 4.2 +/- 1.4 necrotic neurons/section were noted in insulin treated mice given 750 mg aspartate/kg body weight. Carbohydrate and insulin treatments has only minimal effects on plasma aspartate concentrations. PMID- 3280816 TI - Role of muscle microvasculature during hyperdynamic and hypodynamic phases of endotoxin shock in decerebrate rats. AB - Microcirculatory derangements in skeletal muscle could act to change cardiac output during endotoxemia. To explore this idea, we measured arteriole and venule responses to low-dose and high-dose endotoxemia in the rat cremaster muscle by direct in vivo videomicroscopy. Our data indicate that cardiac output increased in the low-dose group and decreased in the high-dose group. In both animal groups, a differential arteriolar response occurred to give small arteriole dilation and large arteriole constriction while venous diameters did not change. We conclude that: 1) changes in cardiac output during endotoxemia are not related to microvascular responses in skeletal muscle, and 2) the microvascular responses in skeletal muscle could be responsible for the decreased systemic vascular resistance during high cardiac output endotoxemia, but not for the elevated systemic vascular resistance during low cardiac output endotoxemia. PMID- 3280817 TI - Detection of foreign bodies in soft tissues: experimental comparison of ultrasonography and xeroradiography. AB - The value of xeroradiography and of high-resolution ultrasonography was compared on minute samples of foreign bodies of various radiographic density (wood, plastic, metallic wires and needles, glass, fish bones). The samples were introduced into pieces of veal meat at different angles with respect to the surface. Xeroradiographic images were taken at 60 kVp, with 32 mAs, and were developed in both positive and negative mode. The echographic examinations were performed using a real-time sector 10 MHz probe placed directly over the specimen, with constant gain rates. The results confirm the value of xeroradiography and demonstrate the effectiveness of high-resolution ultrasonography for the detection of minute foreign bodies. Some materials showed a peculiar echographic pattern, like sand, that corresponded to a frank acoustic shadow, or like metal and glass, showing a comet tail of reverberation artifacts. Wood and fish bones were well outlined, while plastic was less effectively represented. High-resolution ultrasonography is considered to be a first-line technique in searching for many kinds of minute foreign bodies, to be used in combination with xeroradiography in routine clinical examination. PMID- 3280818 TI - Shotgun 'birdshot' wounds to the neck. PMID- 3280819 TI - Afghan war wounded: experience with 200 cases. AB - The injuries seen in 200 Afghan war wounded in the International Committee of the Red Cross (ICRC) hospital in Quetta are reported. Evacuation took several days and no proper initial first aid was available. Therefore few of those reaching us had serious multiple injuries. The anatomic distribution of wounds was remarkably similar to that seen in other conflicts: 38% of the injuries were caused by bullets, 50% by fragmentation weapons, and 10% by mines. Two thirds of the patients had limb injuries. Of all wounded, patients with fractures of long bones needed the greatest number of repeated operations and the longest hospitalization time. Twenty-five patients had abdominal or perineal wounds and 12 needed laparotomy. Of 25 with head injuries 14 had penetrating brain trauma. Thoracic, vascular, and burn injuries were rare. The eight patients with spinal cord injury could fortunately be referred to the ICRC rehabilitation center in Peshawar within a week. Wound sepsis was the major problem due to the extraordinarly long delay in the initiation of treatment. In spite of the often grossly infected wounds, radical debridement usually led to good recovery for most patients, with a hospital mortality rate of only 2.5%. PMID- 3280820 TI - Thromboembolism as a complication of myocardial contusion: a new capricious syndrome. AB - Myocardial contusion is becoming more frequently recognized as a concomitant of blunt chest and abdominal trauma. Thromboembolism is an infrequent, but serious, complication of myocardial contusion and management is controversial. We report a case and review the literature of thromboembolism complicating blunt heart injury, and suggest a protocol to prevent this complication. PMID- 3280821 TI - Doppler ultrasound of twin transfusion syndrome. AB - Doppler sonography of umbilical arteries was used to evaluate eight cases of twin transfusion syndrome (TTS). Data were collected regarding the Doppler and real time sonographic evaluation, clinical course, and outcome. In addition, the literature was reviewed. An abnormal peak systolic velocity (A) to end diastolic velocity (B) ratio, as defined by Giles et al, was seen in at least one twin in five cases. A difference in the A/B ratios between the two twins was greater than 0.4 in all eight cases. Doppler studies were able to suggest which fetus was encountering greater placental resistance, however they could not differentiate donor from recipient or provide prognostic data regarding outcome. Doppler evaluation was helpful when there was uncertainty as to whether growth discrepancy in a twin pregnancy was significant enough to suggest a pathologic state. In the future, Doppler sonography may be helpful in evaluating the effectiveness of therapy in TTS. Variable Doppler findings confirm that TTS is an extremely complex dynamic physiologic state. PMID- 3280822 TI - Sonographic features of urinary bladder involvement in regional enteritis. AB - Three cases of regional enteritis (Crohn disease) with secondary involvement of the urinary bladder diagnosed by ultrasound are presented. The ability of ultrasound to simultaneously and noninvasively demonstrate the changes in bladder and adjacent bowel, unlike other radiologic or urologic investigations, is emphasized. PMID- 3280823 TI - Value of the yolk sac in evaluating early pregnancies. AB - To determine the potential value in identifying a yolk sac in women with suspected ectopic pregnancies, 211 consecutive women who were referred to pelvic sonography with this clinical indication were prospectively studied. Of the 211 patients examined, 104 proved to have a normal intrauterine pregnancy (IUP), 59 had an abnormal (nonviable) IUP, and 48 had a surgically-proven ectopic pregnancy. Considering only intrauterine "sacs" that lacked a visible embryo, a yolk sack was identified in 16 of 26 (62%) normal IUPs, and 3 of 19 (16%) abnormal IUPs, but was not seen in any of six pseudo-gestational sacs in women with ectopic pregnancies. In comparison, a double decidual sac (DDS) finding was thought to be present in 24 of 26 (92%) normal gestational sacs, 12 of 19 (63%) abnormal gestational sacs, and 2 of 6 (33%) pseudogestational sacs. We conclude that in women in whom a living embryo is not identified, demonstration of a yolk sac is reliable evidence for early IUP, and virtually excludes the possibility of an ectopic gestation. Although a yolk sac is less frequently observed than a DDS finding, it is also more specific evidence for an IUP. Careful attention to the yolk sac should permit earlier, more reliable diagnoses of IUP than previously possible. PMID- 3280824 TI - Sonographic diagnosis of a subdural hematoma as the initial manifestation of hemophilia in a newborn. PMID- 3280825 TI - Intrauterine growth retardation in the first trimester associated with triploidy. PMID- 3280826 TI - The sonographic appearance of blood in the fetal stomach and its association with placental abruption. PMID- 3280827 TI - Sonography of Nager acrofacial dysostosis syndrome in utero. PMID- 3280828 TI - Sonography of the Zellweger syndrome. PMID- 3280829 TI - Chlorthalidone reduces calcium oxalate calculous recurrence but magnesium hydroxide does not. AB - We examined the effectiveness of chlorthalidone or magnesium hydroxide in the prevention of recurrent calcium oxalate kidney calculi. In a double-blind random allocation design daily dosages of 25 or 50 mg. chlorthalidone, 650 or 1,300 mg. magnesium hydroxide, or an identical placebo were administered. All groups showed significantly decreased calculous events compared to the pretreatment rates. During the trial 56.1 per cent fewer calculi than predicted developed in the placebo group (p less than 0.01), whereas the groups receiving low and high dosage magnesium hydroxide showed 73.9 and 62.3 per cent fewer calculi, respectively (p less than 0.001 and less than 0.01, respectively). Chlorthalidone treatment resulted in a 90.1 per cent decrease from predicted rates and both dosages yielded similar results. When the treatments were compared chlorthalidone was significantly better than the placebo or magnesium hydroxide (p less than 0.01). The large decreases in calculous events seen when placebo or ineffective therapy was given underscore the positive treatment bias that occurs when historical controls are used and they demonstrate the need for proper experimental design. PMID- 3280830 TI - Piezoelectric extracorporeal lithotripsy by ultrashort waves with the EDAP LT 01 device. AB - A total of 433 extracorporeal lithotripsy procedures was performed for renal, ureteral and bladder stones by means of a system of ultrasonographic detection and piezoelectric destruction in 386 patients. The stones were detected easily in 87 per cent of the patients, difficult to detect in 10 per cent and impossible to detect in 3 per cent. Mean duration of treatment was 35 minutes. Mean number of piezoelectric waves was 2,700 at 1.25 per second. With a frequency of 1.25 to 5 per second, extracorporeal lithotripsy was performed without any local, regional or general anesthesia, and without premedication in 210 patients. Of the 217 patients with a renal stone reviewed at 3 months 161 (74 per cent) had successful results and 56 (26 per cent) failed therapy. Thirty patients (14 per cent) underwent 2 or 3 sessions. The morbidity was low: 2 per cent of the patients suffered ureteral obstruction, 1.5 per cent had subcapsular hematoma and 4 per cent had fever. No significant modifications of laboratory tests were necessary and no patient suffered renal failure. Of the stones 31 in the lumbar ureter, 15 in the pelvic ureter and 8 in the bladder were treated, with success rates of 87, 46 and 50 per cent, respectively. A total of 103 patients was treated on an outpatient basis. This outpatient treatment, together with the low cost and minimal maintenance of the apparatus, and the absence of anesthesia constitute a new progress in the treatment of renal stones. PMID- 3280831 TI - Painless piezoelectric extracorporeal lithotripsy. AB - A total of 693 stones in 438 renoureteral units from 426 patients 4 months to 84 years old was treated with a mobile piezoelectric lithotriptor using ultrasound stone localization. Of the units 37 per cent had solitary stones smaller than 1.5 cm. in diameter, (group 1), 32 per cent had multiple stones up to this size (group 2), 21 per cent had stones 1.6 to 2.5 cm. in diameter (group 3) and 10 per cent had calculi larger than 2.5 cm. in diameter (group 4). No sedation or analgesics were necessary in 96.2 per cent of the treatments. Of all stones 97.2 per cent were disintegrated, with 39 per cent of the units requiring repeat treatments usually on an outpatient basis. Of the patients 82 per cent had transient hematuria, 6 per cent had fever and 28 per cent temporarily took some type of analgesics within the first 3 months after treatment. Nine per cent of the patients required postoperative ancillary interventions. After 3 months 92 per cent of the renoureteral units in group 1, 73 per cent in group 2, 74 per cent in group 3 and 50 per cent in group 4 were free of stones. Piezoelectric extracorporeal lithotripsy proved to be as efficient as spark-gap lithotripsy, yet it was essentially painless. Ultrasound localization permits treatment of all renal stones but it restricts lithotripsy of ureteral stones to the most proximal and distal fourths of the ureter. PMID- 3280832 TI - A modified perineal approach to reconstruction of membranous urethra for stricture. AB - Difficulty in obtaining perineal exposure of the membranous urethra in cases of traumatic stricture led to the development of the combined perineosuprapubic and transpubic approaches. Use of the standard perineal incision for perineal prostatectomy with division of the urogenital diaphragm in the midline from behind up to and encircling the urethra, and temporary suturing of the flaps of the urogenital diaphragm that are created to the lateral edges of the skin incision provides good exposure of the membranous and proximal bulbous urethra, thus, making reconstruction easier. This approach should minimize the need for the transpubic or perineosuprapubic approaches. It has been used for urethroplasty in 12 patients with traumatic membranous strictures, 5 with traumatic bulbomembranous strictures, 7 with post-gonococcal strictures involving the proximal bulbous and distal membranous urethra, and 1 with a bulbomembranous urethral rupture. PMID- 3280833 TI - Malignant melanoma of the penis and male urethra: 4 case reports and literature review. AB - Malignant melanomas of the penis and male urethra are uncommon lesions. We report 3 new cases of male urethral melanoma and 1 case of penile melanoma, bringing the total numbers of reported cases to 26 and 57, respectively. The literature is reviewed, and biological, histopathological and therapeutic considerations are analyzed. PMID- 3280834 TI - Acute and chronic bacterial infection in the rat urinary tract: immunofluorescent localization of immunoglobulins. AB - To study the relative concentrations and appearance of immunoglobulin in the bladder and kidneys of rats with acute and chronic urinary tract infections, three groups of female Sprague-Dawley rats were studied. Group I underwent weekly intraurethral inoculation with Escherichia coli 07. Group II received inoculation of 0.2 ml of PBS alone. Group III were unmanipulated controls. Bladder and kidney washings were obtained for bacterial colony counts and organism identification. Bladder and kidney tissue was prepared for immunofluorescent examination using goat or rabbit antirat IgA, IgM, or IgG layered with fluorescent-labeled rabbit antigoat or goat antirabbit serum. Negative immunofluorescent controls substituted PBS for antirat serum. No significant difference was noted between bladder and kidney cultures in groups I and II. Comparison of immunofluorescent intensity between groups I and III demonstrated that IgM intensity was greatest between weeks one and three in bladders and kidneys, then decreased to non significant levels. Bladder IgG intensity peaked at week four and remained elevated throughout the remainder of the study while renal IgG intensity was significant throughout the study period. Renal and bladder IgA was noted only sporadically. Comparison of culture positive animals to culture negative animals (groups II and III) demonstrated a lower immunofluorescent intensity score for culture negative animals. Discrete cellular immunofluorescence was evident in 19.1% of bladders and compared to 0.6% of kidneys. This study suggests that the immunologic response in the rat to intraurethral inoculation and infection is biphasic (IgM followed by IgG) and that a local cellular immunologic response may exist in the bladder. PMID- 3280835 TI - Thromboxane release after reperfusion of chronically ischemic limbs in patients. AB - We hypothesized that chronic ischemia of peripheral vascular disease would lead to increased thromboxane A2 (TxA2) and decreased prostacyclin (PGI2) production and surgical correction of the ischemia would stabilize TxA2 and PGI2 at normal levels. TxA2 and PGI2 concentrations were determined in 22 patients before, during, and after arterial reconstruction for limb salvage and in 10 control subjects. Control samples and preoperative patient samples had no detectable TxA2 or PGI2 (less than 26 pg/ml). Five minutes after reperfusion TxA2 increased (TxA2 = 76.27 +/- 48.9 pg/ml, mean +/- SEM) and persisted at 1 day (TxA2 = 190.1 +/- 80.1 pg/ml), 2 days (TxA2 = 224.7 +/- 131.7 pg/ml), 5 days (TxA2 = 334.8 +/- 272.8 pg/ml), and 7 days postoperatively (TxA2 = 256.6 +/- 149.0 pg/ml). Elevated TxA2 production was not associated with chronic ischemia of peripheral vascular disease. Reperfusion of the severely ischemic limb caused significant TxA2 release. PMID- 3280836 TI - Endothelial cell seeding of expanded polytetrafluoroethylene vena cava conduits: effects on luminal production of prostacyclin, platelet adherence, and fibrinogen accumulation. AB - The blood-surface interface of 12 mm ID x 5 cm ePTFE vena cava conduits, unseeded (n = 8) and seeded (n = 8) with enzymatically derived autologous endothelial cells, was studied in a canine model at 4 and 12 weeks after graft implantation. Acetylsalicylic acid (325 mg each day) and Coumadin (prothrombin time 1.4 to 1.7 times the control value) were administered preoperatively and continued 4 weeks postoperatively. Platelets labeled with 111In and 125I-labeled fibrinogen were administered 24 hours before graft removal. Luminal platelet adherence, expressed as 10(6) platelets/cm2 of graft surface, was 8.9 +/- 5.6 vs. 56.4 +/- 8.0 (p less than 0.008) and 4.0 +/- 0.9 vs. 12.4 +/- 2.3 (p less than 0.005) in seeded vs. unseeded grafts at 4 and 12 weeks, respectively. Luminal fibrinogen deposition, expressed in micrograms per square centimeter of graft surface, was 11.8 +/- 2.2 vs. 32.0 +/- 2.0 (p less than 0.06) and 6.1 +/- 2.4 vs. 12.4 +/- 6.3 (p less than 0.005) in seeded vs. unseeded grafts at 4 and 12 weeks, respectively. Cumulative 4- and 12-week luminal production of 6-keto-PGF1 alpha from seeded and unseeded grafts represented 11% and 5%, respectively, of that produced from the native iliac vein. Luminal endothelial cell coverage was 71% +/- 22% vs. 33% +/- 9% and 79% +/- 8% vs. 55% +/- 8% (p less than 0.05) in seeded and unseeded grafts at 4 and 12 weeks, respectively. Although endothelialization was not complete in seeded vena cava grafts, it is clear that seeded prostheses exhibited improved thromboresistance compared with unseeded conduits. PMID- 3280837 TI - Spirochetes in mammals and ticks (Acari: Ixodidae) from a focus of Lyme borreliosis in California. AB - In northern California, antibodies to Borrelia burgdorferi were detected in 58 of 73 (79%), and spirochetemias in one of 26 (4%) black-tailed jackrabbits (Lepus californicus californicus), by indirect and direct immunofluorescence, respectively. Five species of ticks (Dermacentor occidentalis, D. parumapertus, Ixodes neotomae, I. pacificus, and Haemaphysalis leporispalustris) were collected from rabbits. Two of these species of ticks were found to contain spirochetes; two of 10 (20%) I. neotomae and two of 174 (1%) H. leporispalustris. A strain of B. burgdorferi was recovered from I. neotomae. One infected H. leporispalustris female passed spirochetes via eggs to about 67% of her progeny. The widespread distribution of the black-tailed jackrabbit, its infestation by at least four ticks (D. occidentalis, D. parumapertus, I. neotomae, and I. pacificus) known to be infected naturally with B. burgdorferi, and the high prevalence of spirochetal antibody in this lagomorph suggest that it might be useful as a sentinel for surveillance of Lyme borreliosis. Spirochetes were detected in 15% of 40 Columbian black-tailed deer (Odocoileus hemionus columbianus) by direct immunofluorescence bound with a Borrelia-specific monoclonal antibody (H9724), but not with a monoclonal antibody (H5332) specific for B. burgdorferi. The geographical overlap of different borreliae in ticks that bite wildlife such as deer may confound spirochetal serosurveys, and underscores the need for more specific serologic tests than those currently available. PMID- 3280838 TI - Comparison of serum and lung extracts for surveys of wild animals for antibodies to Francisella tularensis biovar palaearctica. AB - A comparative study of the antibody titer against Francisella tularensis biovar palaearctica in serum and lung extract was made using different immunoassays. Samples were taken from experimentally-infected goshawks (Accipiter gentilis) and European beavers (Castor fiber), and in a field survey of wild beavers. Good accordance between the antibody titer in serum and in lung extract was found in the experimental studies. However, the antibody titer was generally one- to three fold lower in lung extract than was the titer of serum. Results in the field survey were less reliable. Estimating antibody titer in lung extract is a practical method for surveys for antibody levels, and an alternative to serological surveys, despite lower sensitivity as compared to serum. PMID- 3280839 TI - Experimental infection of five species of raptors and of hooded crows with Francisella tularensis biovar palaearctica. AB - Sixteen raptors and three hooded crows were infected experimentally with Francisella tularensis biovar palaearctica. The birds were infected parenterally or per os. One goshawk, one sparrow hawk and one hooded crow died during the experimental period, and the remaining 16 birds were killed 14-77 days after the first infection. Francisella tularensis was not isolated from any bird. Antibody levels against F. tularensis measured in nine birds varied from 0 to 1:1,280. In one goshawk with a titer of 1:1,280, positive fluorescent antibody reactions against F. tularensis were seen in the liver and spleen. These results are similar to those found by other authors indicating that raptors and corvids are normally resistant to infections with F. tularensis. PMID- 3280841 TI - Experience with single-lung transplantation for pulmonary fibrosis. The Toronto Lung Transplant Group. AB - Repeated success has now been obtained with single-lung transplantation for end stage pulmonary fibrosis. Potential candidates for this procedure are individuals who are less than 60 years of age and who have progressive pulmonary deterioration with limited life expectancy. Since November 1983, eleven such transplantations have been performed; nine patients achieved discharge from the hospital and eight patients have remained alive up to 44 months after surgery. All of these recipients have good oxygenation on room air and good exercise tolerance and are capable of performing routine activities, including a return to previous employment. From our experience, it appears likely that single-lung transplantation can achieve the same success rates as other major organ transplantations. PMID- 3280840 TI - Fatal shigellosis in a chimpanzee (Pan troglodytes) in the Jos Zoo, Nigeria. AB - Shigellosis due to Shigella dysenteriae was diagnosed in an adult male captive chimpanzee (Pan troglodytes) which died suddenly after a brief recovery from illness lasting at least 3 wk. Confirmatory diagnosis was based on postmortem examination and cultural isolation of Shigella dysenteriae from the intestine, liver, lung, spleen and heart blood. PMID- 3280842 TI - The FDA's new procedures for the use of investigational drugs in treatment. AB - The Food and Drug Administration has established new procedures to make promising investigational drugs available for treatment of patients with immediately life threatening or serious diseases as early in the drug development process as possible and well before general marketing begins. The purpose of this article is to inform the medical community about these new procedures and to facilitate their implementation. Examples of immediately life-threatening and serious diseases are given and the procedures that physicians should use to obtain a drug under the new regulations are described. The treatment use of zidovudine (Retrovir), while still in the investigational phase, is described as a case study. The article also summarizes the Food and Drug Administration's new procedures under which drug sponsors can charge for investigational drugs. PMID- 3280844 TI - Lung transplantation. PMID- 3280843 TI - Occupational solvent exposure and glomerulonephritis. A case report and review of the literature. AB - We describe a patient who presented with renal failure after a one-year period of unprotected heavy occupational exposure to organic solvents. Renal biopsy results and serological findings were diagnostic of anti-glomerular basement membrane antibody-mediated glomerulonephritis. An analytic review of the literature revealed substantial evidence linking solvent exposure to the development of glomerulonephritis (GN), with seven of nine case-control studies demonstrating a statistically significant association. Odds ratios were reported by or could be calculated for six of these studies, and the five positive studies detected a 2.8 to 8.9-fold increased risk for GN among solvent-exposed individuals. The findings in several of these studies of dose-response relationships, the reports of variations in disease severity in relation to exposure intensity, and the absence of alternative explanations for the association provide additional supportive evidence for a solvent effect. In the majority of cases of anti glomerular basement membrane antibody-mediated GN and other types of GN, there is no remarkable preceding exposure to organic solvents. However, we conclude that in the case presented herein and in cases of GN with similar exposure histories, solvent exposure may play a significant contributing role in the development of GN. PMID- 3280845 TI - The common anemias. PMID- 3280846 TI - Application of positron emission tomography in the heart. Council on Scientific Affairs. Report of the Positron Emission Tomography Panel. AB - This report discusses experimental and clinical applications of positron emission tomography to the heart, including measurements of blood flow to the myocardium and studies of metabolism and experimental injury. Most initial clinical studies have concentrated on ischemic heart disease, but the technique also has potential for investigation of cardiomyopathies, studying the neural control of the heart, and evaluating the effects of drugs on cardiac tissues. PMID- 3280847 TI - Geriatric assessment: methods for clinical decision making. PMID- 3280848 TI - A piece of my mind. Check kiting: lessons from a master. PMID- 3280849 TI - A case of early cancer in the gallbladder: immunohistological analysis with monoclonal antibodies. AB - A case of early cancer in the gallbladder is reported. The tumor was disclosed as an echogenic nodular lesion with irregular margin by ultrasonography and endoscopic retrograde cholangiography. Among several tumor markers, CA19-9 showed a slightly higher level (51 U/ml). An operation was carried out because of the tumor size (over 10 mm) and the coexistence of a gallstone. The tumor was a well differentiated tubular adenocarcinoma. In the carcinoma tissue, CA19-9 and YH206 antigens showed different staining patterns, the latter antigen being detected by the monoclonal antibody, YH206, established in our laboratory. Although CA19-9 was strongly positive in the non-cancerous gallbladder epithelial cells, the YH206 antigen was negative. A slight elevation of the CA19-9 level in the patient's serum was probably caused by a diffusion of the CA19-9 antigen from the gallbladder epithelial cells to the serum, due to inflammation. On the other hand, it is interesting to note that the YH206 antigen was not demonstrated in the non-cancerous gallbladder epithelial cells but was in the cancer tissue. PMID- 3280850 TI - Medical management in head injury. PMID- 3280851 TI - Intravascular platelet activation in the hemolytic uremic syndrome. AB - We studied intravascular platelet activation in patients with typical (epidemic) and atypical (sporadic) HUS and found defective aggregation, decreased platelet and increased plasma serotonin in both groups. The findings were present not only on admission during the thrombocytopenic stage of the disease, but persisted for several weeks after recovery of the platelet count. Reduced endothelial PGI2 production was significantly more common in plasma from atypical than typical cases. Plasma from both typical and atypical HUS patients induced aggregation of normal platelets, but this phenomenon was unrelated to both the presence of thrombocytopenia or the stage of the disease. Serum platelet aggregating activity was higher in the atypical HUS patients, and was not associated with immune complexes detectable by polyethylene glycol precipitation. The data indicate that intravascular platelet activation is a feature of both forms of HUS, and may be initiated by different mechanisms in the two subgroups. While abnormal PGI2 synthesis appears to be important in the atypical cases, neither defective PGI2 production nor platelet aggregation by plasma factors adequately accounts for platelet activation in the majority of typical cases. PMID- 3280852 TI - Preventing the progression of human renal disease: have rational therapeutic principles emerged? PMID- 3280853 TI - Detection of endotoxin-like interleukin-1-inducing activity during in vitro dialysis. AB - In order to study the integrity of dialysis membranes to pyrogens, the dialysate side of a closed loop hemodialysis (HD) circuit was challenged with E. coli microfiltrate containing 500 ng/ml endotoxin. Three solutions, a) tissue culture medium/saline, b) 5% human serum albumin, and c) 10% fresh human plasma, were circulated in the blood loop for five hours. Samples drawn from the blood side were assayed for interleukin-1 (IL-1)-inducing activity on human mononuclear cells (MNC) in vitro. No IL-1-inducing substances were detected when saline or culture medium was circulated in the blood loop. Circulating 5% human serum albumin revealed IL-1-inducing activity in the samples drawn only after five hours of HD. However, the addition of 10% fresh human plasma to the blood side resulted in the appearance of an IL-1-inducing substance(s) after 15 minutes of HD. After 30 minutes, maximum IL-1-inducing activity was observed (control stimulation index, 3.30 +/- 0.67 SEM vs. 7.59 +/- 1.50, P less than 0.02). The IL 1-inducing activity of the samples was completely inhibited by polymyxin B, a cationic antibiotic which blocks the IL-1-inducing activity of endotoxin. Additional experiments demonstrated that in vitro MNC IL-1-production induced by the same E. coli microfiltrate is enhanced in the presence of 10% plasma. These studies demonstrate that: (a) in the presence of plasma, IL-1-inducing factors pass into the blood compartment of a dialysis system challenged with bacterial pyrogen; and (b) MNC production of IL-1 is enhanced in the presence of plasma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280854 TI - Peritoneal dialysate volume determined by indicator dilution measurements. AB - Dialysate volume was simultaneously determined by two different indicator dilution technique as a function of dwell time in a rabbit model of peritoneal dialysis using isotonic, hypertonic and hypotonic solutions. After a single injection of a large molecular weight index solute (SIIS) to the dialysis solution at a known concentration, the first indicator dilution technique determined dialysate volume by the change in the index solute concentration. In the second technique, dialysate volume was determined after multiple injections of a different index solute (MIIS) by measuring the change in concentration of the index solute two minutes after its injection into the dialysis solution. The volumes determined by SIIS were similar during isotonic, but larger during both hypertonic and hypotonic exchanges, than those determined by MIIS. Drained volume was dependent upon the peritoneal catheter used, was not different from that determined by MIIS, but was significantly smaller than that determined by SIIS. The present results suggest that systematic errors in volume measurements when using indicator dilution result from the loss of the index solute from the peritoneal cavity and are greater for SIIS than for MIIS. A model for fluid transfer during peritoneal dialysis showed that dialysate volumes determined by SIIS were useful, however, when estimating the rate of fluid movement across the peritoneal membrane. PMID- 3280855 TI - Calcium citrate, a nonaluminum-containing phosphate-binding agent for treatment of CRF. AB - Calcium citrate was evaluated as a dietary phosphate binder in 81 patients with end-stage renal disease. These patients were grouped as follows: Group 1, 43 patients who were treated with calcium citrate; and Group 2 (the control group), 38 patients who were treated with aluminum-containing compounds. Blood chemistries were measured monthly and medications adjusted to maintain the following levels: serum calcium, greater than 9 mg/dl; serum phosphorus, less than 5.5 mg/dl; and total CO2 content, greater than 22 mmol/liter. At the end of the treatment period, the following serum values were obtained in Groups 1 and 2, respectively: calcium, 9.6 +/- 1.2 mg/dl (mean +/- SD) versus 8.9 +/- 0.8 mg/dl (P less than 0.001); phosphorus 5.5 +/- 1.9 mg/dl versus 7.0 +/- 2.3 mg/dl (P less than 0.005); and calcium-phosphate product, 52 +/- 18 versus 61 +/- 21 (P less than 0.05). Differences in alkaline phosphatase, total CO2 content, and C terminal parathyroid hormone (C-PTH) values were not statistically significant between the two groups. Fifteen patients in Group 1 were then switched to aluminum-containing compounds and chemistries were compared one month later. During calcium citrate therapy, serum calcium was significantly higher, while C PTH and serum alkaline phosphatase were significantly reduced. No difference was noted in serum phosphorous and total CO2 content. A questionnaire completed by 17 patients in Group 1 documented excellent patient tolerance to calcium citrate. Hypercalcemia (greater than 10.5 mg/dl) was the only significant complication, but only one patient became symptomatic. We conclude that, as a phosphate binder, calcium citrate is at least as effective as aluminum-containing compounds. PMID- 3280856 TI - [Antibacterial therapy in diseases of the liver and biliary tract (a review of the literature)]. PMID- 3280857 TI - [Ultrasonics in the diagnosis and treatment of patients with mechanical jaundice]. PMID- 3280858 TI - [Diagnosis and treatment of combined calculi of the kidneys and gallbladder]. PMID- 3280859 TI - [Hepaticojejunal anastomoses]. PMID- 3280860 TI - [Anastomoses of the pancreatic duct transplanted in an experiment]. PMID- 3280861 TI - [Determination of the risk of kidney allograft rejection in patients]. PMID- 3280862 TI - [Liver transplantation in the clinic (a review of the foreign literature since 1982)]. PMID- 3280863 TI - [Historical aspects of the postcholecystectomy syndrome (a review of the literature)]. PMID- 3280864 TI - [Entropion of the upper eyelid--surgical aspects]. AB - At the end of the 19th century several surgical procedures for the treatment of upper eyelid entropion were described. At that time this type of entropion was much more common than it is today. The goal of treatment is to evert the lashes away from the lid margin. This can be accomplished by tightening the anterior lamella combined with a tarsal wedge resection, or by an upward transposition of the lid skin after splitting the upper lid apparatus. The resulting free anterior tarsal surface must be covered by a free graft to prevent tarsal shrinking. The latter would soon cause a recurrence. After upward transposition of the anterior lamella, the excised skin is very suitable for covering the free tarsal surface. A fibrin sealing method is used to fix the graft on the tarsus, thus making sutures unnecessary. Good results, primarily with regard to function, can be achieved with these methods. PMID- 3280865 TI - [Moth fragments as intraocular foreign bodies]. AB - The authors describe an accident leading to penetration of the eye of an 11-year old boy by an unusual foreign body, and the subsequent diagnosis and treatment. Persistent ocular irritation following a corneal perforation wound, in spite of appropriate treatment, led to the presence of an intraocular foreign body being suspected. The results of radiologic examination, including CT (Siemens Somatom 2), were negative. Only A-scan sonography (Kretztechnik 7002) called attention to the possibility of a foreign body in the vitreous behind the traumatic cataract. Extracapsular extraction was immediately followed by careful removal of very small foreign-body particles from the vitreous. Once the corneal sutures had been removed the irritation decreased. The scanning electron microscope (Cambridge) images of the largest particle showed the foreign bodies to be fragments of a moth (order Noctuideae). PMID- 3280866 TI - [Bacterial flora of the eyelids following preoperative disinfection]. AB - After careful preoperative disinfection of the periorbita, the eye, and the lids, cultures were taken from the upper and lower lash bases of 100 patients waiting for intraocular operations. Despite the careful disinfection 36% of the cultures from the upper and 48% of those from the lower lash bases were positive. A method of covering the lids adequately with adhesive material is recommended as a means of avoiding this potential source of infection. PMID- 3280867 TI - [Pioneer through 125 years of ophthalmologic science and practice. Theodor Axenfeld (1867-1930)]. PMID- 3280868 TI - [Hematologic or hemostaseologic "paraneoplastic syndromes" as prognostic factors?]. AB - Paraneoplastic syndromes are early but seldom appearing remote effects of tumors. In contrast, hematological or hemostaseological tumor signs can be demonstrated nearly in every tumor patient, mostly, however, after prolonged disease. The signs result from interaction between tumor and host, they depend upon the monocyte-macrophage system and are mediated by interleukin-1. Therefore, strictly speaking, they are no paraneoplasias. By genetic instability and increasing heterogeneity, the tumor cell gradually overcomes this defence line and the clinical pictures of different metastatic diseases equalize slowly. Finally, main causes of death are equally occurring infectious and hemostaseological complications. They demonstrate the final breakdown of this defence system. PMID- 3280869 TI - Expression of viral hemagglutinin on the surface of E. coli. AB - Expression of a foreign protein molecule on the E. coli bacterial surface has been achieved through hybrid plasmid construction of fusion proteins using outer membrane protein ompA as a carrier system. Influenza virus hemagglutinin fusion proteins of this character have been shown to become integrated into the bacterial outer membrane and to expose their hemagglutinin moiety at the exterior surface in a conformation which is at least similar to the authentic viral antigen structure. PMID- 3280870 TI - Alloxan-induced diabetes mellitus in pregnant sheep and chronic fetal catheterization. AB - 25 female sheep of the Texel breed were made hyperglycaemic by administration of alloxan monohydrate (ALX) in early pregnancy and 15 ewes served as controls. Average venous glucose levels (mean +/- standard deviation) increased from 3.5 +/ 0.2 to 14.0 +/- 1.8 mmol/l. All hyperglycaemic sheep were treated with long acting insulin in doses adjusted individually (0.2-1.0 U/kg per day) to keep glucose levels above 8 mmol/l. After a temporary significant increase, maternal venous concentrations of urea and creatinine returned to normal levels. One sheep died on day 6 after administration of ALX. Another hyperglycaemic sheep died at induction of anaesthesia. Eight hyperglycaemic ewes aborted between days 90 and 128 of gestation. Between days 103 and 135 of gestation the remaining hyperglycaemic (n = 15) and control (n = 15) ewes were operated upon and the fetuses were provided with EEG, nuchal EMG and ECG electrodes and catheters in the trachea, amniotic fluid, jugular vein and carotid artery. Use of the chronic sheep preparation for the study of diabetes mellitus and fetal reactions was successful in 10 out of 25 cases, as in the diabetic group postoperative intra uterine fetal survival varied between 2 and 19 days and in 10 cases was at least 5 days. Postoperative intrauterine fetal survival in the controls was significantly longer and varied between 4 and 28 days, and in 13 cases was at least 5 days. A highly significant correlation (P less than 10-6) between maternal and fetal blood glucose levels was seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3280871 TI - A process to register and certify professional health educators in Florida. PMID- 3280872 TI - Imagery and the school nurse. PMID- 3280873 TI - Specificity of the cannabinoid metabolite and phencyclidine EMIT d.a.u. assays. AB - An investigation to determine the specificity of the EMIT d.a.u. assays was conducted. Samples of drug-free urine from healthy volunteers were spiked individually with one of 162 drugs to a concentration of 1000 mg/L. These samples were analyzed with the EMIT d.a.u. assays for phencyclidine and cannabinoids. Although some of the assays yielded positive results at this concentration, negative results were obtained in all samples diluted to 100, 10, and 1 mg/L. PMID- 3280875 TI - Swallowing-induced tachycardia. PMID- 3280874 TI - Speech compensation for prosthodontically created palatal asymmetries. AB - Symmetry of alveolar and palatal contour was altered prosthodontically for five subjects. There was palatographic evidence, for both /s/ and /l/, that the prosthodontic changes were not always compensated for in one week of adaptation. Compensation was more pervasive for /s/ and took the form of preservation of the general orientation of the air channel in spite of the palatal asymmetries present. PMID- 3280876 TI - Pilomatrix carcinoma. AB - Pilomatrixomas are uncommon tumors of hair matrix origin. They are characteristically benign, calcifying lesions. Eleven cases of aggressively invasive pilomatrixomas have been reported, and this variant has been termed pilomatrix carcinoma. This report presents the first known case of a cervical pilomatrix carcinoma. Modified radical neck dissection was necessary for tumor extirpation. Pilomatrix carcinoma behaves similarly to an aggressive basal cell carcinoma. These lesions require definitive, anatomic resection, careful histological examination of margins, and systematic follow-up examinations. PMID- 3280877 TI - Endocrine function after hetero- and ortho-topic segmental pancreatic transplantation in primates. AB - This study assessed the early postoperative pancreatic endocrine function after intraperitoneal segmental hetero- and ortho-topic pancreatic allotransplantation in hemipancreatectomized, nonimmunesuppressed chacma baboons. Hemipancreatectomized animals remained normoglycaemic but rendered significantly reduced K values and insulin release during IVGTT, findings consistent with major pancreatic resection. Segmental hetero- or ortho-topic pancreatic transplantation did not improve reduced K values and hypoinsulinaemia following hemipancreatectomy although orthotopically sited grafts rendered the best glucose tolerance test curves. Glucagon output during IVGTT remained the same in both transplant models. It is concluded that the postoperative hormonal response was similar in both orthotopic and heterotopic transplant recipients, which indicates that drainage of graft venous effluent into the portal circulation has no advantage over systemic insulin drainage as reflected in this "diabetic" model. PMID- 3280878 TI - Effect of cyclosporine and irradiation on experimental pancreatic allografts in the primate. AB - The present study assessed the effectiveness of cyclosporine (CSA) and subtotal marrow irradiation (TL1) alone, and CSA in combination with TL1 in a primate segmental pancreatic allotransplantation model. Continuous administration of CSA 25 mg/kg/day and 50 mg/kg/day resulted in mean graft survival of 21.5 days and 24.5 days, respectively. Administration of fractionated TL1 800 rad (8 Gy) and 1,000 rad (10 Gy) alone resulted in mean graft survival of 13.3 days and 14.5 days, respectively. Of 20 animals that received TL1 1,000 rad (10 Gy) and CSA 25 mg/kg/day orally for 5 days then 10 mg/kg/day intramuscularly indefinitely, 3 had graft survival of greater than 100 days. Likewise, of a group of 15 animals that received TL1 800 rad (8 Gy) and combined indefinite administration of CSA, 6 had graft survival of greater than 100 days. Although CSA and TL1 administration alone produced modest pancreatic allograft survival, a combination of IL1 (800 or 1,000 rad) and CSA resulted in highly significant segmental pancreatic allograft survival in the primate. PMID- 3280879 TI - 17th annual UCLA symposium. Abstracts: Bone marrow transplantation: current controversies. PMID- 3280880 TI - A review of medicinal plants showing anticonvulsant activity. AB - The term epilepsy is collectively designated for a group of chronic central nervous system disorders characterized by spontaneous occurrence of seizures generally associated with the loss of consciousness and body movements (convulsions). The disease has its origin from an early age. Anticonvulsant drugs are used to control the convulsions by inhibiting the discharge and then producing hypnosis. Various synthetic drugs, viz. sodium diphenyl hydantoin (Dialtin) barbiturates, pyrimidon, succinamides, diazepines etc. are used for the treatment. In this paper various medicinal plants and plant components, which are being used as anticonvulsant and antiepileptic, are discussed. PMID- 3280881 TI - Surgical anatomy of the atrioventricular conduction bundle in tetralogy of Fallot. New findings relevant to the position of the sutures. AB - To avoid three of the causes of right ventricular end-diastolic pressure elevation, complete heart block, residual leakage, and fixing of tricuspid septal leaflet, we studied detailed anatomy of the posteroinferior corner of the ventricular septal defect of tetralogy of Fallot in 81 specimens. A new stitching method was applied in 79 patients with tetralogy of Fallot. Sixty-eight specimens (84%) had perimembranous outlet ventricular septal defect with a membranous flap 4.5 +/- 2.6 mm long. Thirteen (16%) had a muscle bar separating the defect from the central fibrous body area. The width was 5.8 +/- 1.7 mm. Microscopic study revealed that the membranous flap is a safe structure for suturing because of the thick posterior extension of the trabecular septomarginalis. In the clinical application of a new stitching method that uses the membranous flap, all patients showed sinus rhythm and no patient had complete heart block. We conclude that a membranous flap can be used safely as a suture line to avoid conduction tissue damage without using the tricuspid septal leaflet. PMID- 3280882 TI - Esophagovisceral anastomotic leak. A prospective statistical study of predisposing factors. AB - An esophagovisceral anastomotic leak is a life-threatening postoperative complication, especially in the mediastinum. Of the 242 patients who underwent intrathoracic esophagogastric anastomosis for esophageal carcinoma (182 patients) and adenocarcinoma of the cardia (60 patients) between January 1980 and June 1985, 14 (5.8%) had esophageal anastomotic leakage and two died (0.8%). Various clinical and biologic parameters and aspects of operative technique were studied prospectively and analyzed statistically to identify possible factors responsible for leaks. Both bivariate and multivariate statistical analysis with logistic regression showed that the following clinical and biologic factors do not influence anastomotic leakage: tumor stage, the curative or palliative purpose of resection, neoplastic permeation of anastomotic margins, total protein concentration below 5 gm/dl, albumin concentration below 3 gm/dl, patient's age, diabetes, high blood pressure, cirrhosis of the liver, and cardiac, respiratory, or renal diseases. Technical factors, on the contrary, were statistically significant and of great clinical importance: manual as opposed to mechanical suturing (chi 2 = 8.8, p = 0.013) and single-layer as opposed to double-layer suturing (chi 2 = 9.9, p = 0.043). The level of the anastomosis was found to be a further statistically significant factor: The incidence of leakage was greater when the anastomosis was located between the azygos vein and the lower pulmonary vein (chi 2 = 15.5, p = 0.004) than above the azygos vein or below the lower pulmonary vein. PMID- 3280883 TI - Pericardial fat necrosis. AB - Pericardial fat necrosis has a highly characteristic clinical picture that enables a preoperative diagnosis to be made on clinical grounds. Surgical therapy, which remains the treatment of choice for this curable entity, confirms the diagnosis. This report reviews the literature and adds a thirteenth documented case to the previously reported 12 cases. PMID- 3280884 TI - Heparin-induced thrombocytopenia and thrombosis in ischemic stroke. AB - We reviewed the records of all patients who underwent carotid endarterectomy at our institution during the period from January 1970 through December 1986 to determine the frequency of postoperative occlusions and the role of heparin induced thrombosis in patients with such occlusions. After 2,527 carotid endarterectomies, a total of 19 occlusions occurred in 18 patients. Of these 18 patients, 6 had an associated heparin-induced coagulation disorder, 3 of whom are described in detail. Although heparin is a useful anticoagulant, it may precipitate occlusion of vessels after an endarterectomy procedure, either at the endarterectomy site or elsewhere. Physicians should be aware of the potentially increased risk for embolic or thrombotic cerebrovascular events in patients who receive heparin therapy. PMID- 3280885 TI - Free radicals in medicine. II. Involvement in human disease. AB - This review explores evidence that free radicals might be involved in various human disease processes. Such involvement is difficult to prove because direct evidence is often lacking and is based on animal models of the disease process. Evidence for free radical involvement includes demonstrating abnormal free radical production in the disease, finding that deliberately applying free radical-producing systems into the cellular locus responsible for the disease reproduces its manifestations, and showing that free radical scavengers control facets of the disease process. Confirmation of free radical involvement in a particular disease may have clinical relevance, inasmuch as clinically applicable techniques are currently being developed to remove free radicals from cellular sites where they are injurious and, in other situations such as chemotherapy, techniques or drugs that produce free radicals are available to destroy harmful cells. PMID- 3280886 TI - Jaime Ferran y Clua: bacteriologist. PMID- 3280887 TI - Maternal and child health services for medically indigent children and pregnant women. AB - Millions of low-income children and women of childbearing age are completely uninsured. Medicaid, the nation's largest public health financing program for the poor, is an inadequate resource for uninsured families with children. By 1984, the program served only 46% of the poor and near-poor, down from 65% in 1976. To assess the availability of maternity and pediatric services for low income uninsured women and children, a survey of 51 Title V Maternal and Child Health agency officials was conducted in 1986. While nearly all states (48) offer some prenatal care programs for indigent women, restrictive eligibility requirements and limited distribution meant that these programs reached only a small proportion of those in need. Only one state, Massachusetts, offered a truly statewide program to all uninsured pregnant women with incomes under 185% of the poverty level. Twenty-three states reported the existence of inpatient maternity programs for indigent women. Yet these, too, were extremely limited. Sixteen programs restricted funds either to women who participated in certain designated maternity programs or else only to those who were identified as high risk prior to the labor and delivery period. Fifteen state agencies reported that hospitals were denying admission to women about to deliver. Another 13 reported that hospitals were denying admission to women not yet in "active" labor. Six additional states were aware of patient dumping but did not identify the specific populations that were affected. Forty-six states reported the existence of pediatric outpatient programs. However, the majority (30) offered only "well child" care. Seven states maintained pediatric programs limited to only certain ages of children; three of these imposed an age requirement as low as 2 years or younger. Only two states reported the availability of any pediatric inpatient programs financed or administered by Title V agencies other than those for children with special health care needs. PMID- 3280888 TI - [Vasodilators and cardiac insufficiency]. PMID- 3280889 TI - [Measles in 1987]. PMID- 3280891 TI - [Quality of clinical information (II): Statistical significance]. PMID- 3280890 TI - [Disseminated invasive aspergillosis with cutaneous involvement in a patient with acute myeloblastic leukemia]. PMID- 3280892 TI - [Nutrition of the Spanish population from the postwar period to the 80's: a critical review of nutrition surveys]. PMID- 3280893 TI - [Hypertensive crisis, hypertensive emergencies and severe arterial hypertension]. PMID- 3280894 TI - [Systolic intervals in dilated heart insufficiency. Influence of vasodilator treatment]. PMID- 3280895 TI - [Acute pharyngitis: the predictive value of clinical data in the diagnosis of streptococcal etiology]. PMID- 3280896 TI - [A new method for the determination of blood theophylline]. PMID- 3280897 TI - [The administration of sex hormones during pregnancy]. PMID- 3280898 TI - [Idiopathic juvenile osteoporosis: 2 case reports and a review of the literature]. PMID- 3280899 TI - [Analysis of the synovial fluid]. PMID- 3280900 TI - [Captopril-induced agranulocytosis]. PMID- 3280901 TI - [Captopril-induced cough: a not unusual adverse effect]. PMID- 3280902 TI - [Salmonella enteritidis bacteremia preceding the onset of acquired immunodeficiency syndrome]. PMID- 3280903 TI - [Sublingual captopril in hypertensive crises]. PMID- 3280904 TI - [AIDS: the population at risk?]. PMID- 3280905 TI - [Lumbosacral plexopathy of syphilitic origin]. PMID- 3280906 TI - Aztreonam: the first monobactam. AB - There are several areas in which the use of aztreonam seems logical. Infections caused by organisms sensitive to aztreonam that are known to be multiresistant to other agents can be treated directly with aztreonam in single, directed therapy, thus making the use of more toxic agents unnecessary. In types of infection in which both gram positive and gram negative bacteria are present, aztreonam can replace the usual aminoglycoside component of the therapeutic regimen. In settings of mixed infections suspected of being caused by drug-resistant strains of Enterobacteriaceae and/or P. aeruginosa, aztreonam can be combined with an agent active against gram positive organisms or with one active against anaerobes. Aztreonam has proven to be effective, safe therapy for serious and life-threatening infections caused by multiresistant aerobic gram negative bacteria. It should be used in combination with drugs that inhibit gram positive species if the etiology of the infection is not known, particularly in the immunocompromised, neutropenic patient. Doses of 1 g every 8 to 12 hours will be adequate for treatment of infections caused by most Enterobacteriaceae. Whether 2 g doses every 8 hours would be preferred for treatment of systemic Pseudomonas infections remains to be determined. Urinary infections caused by gram negative bacteria can be treated with 500 mg administered IM once or twice daily. The dosage of aztreonam should be adjusted in patients with renal failure. Clearly, aztreonam is a useful addition to the antimicrobial agents available to the physician. PMID- 3280907 TI - Imipenem: a new carbapenem antibiotic. AB - Imipenem is a new carbapenem antibiotic that has an extremely broad spectrum of antibacterial activity. It has been used to treat a variety of serious infections and an increasing volume of literature documents its value in infections due to multiresistant bacteria. This article reviews the antibacterial activity, pharmacology, and clinical uses of imipenem. PMID- 3280909 TI - Metronidazole. AB - Metronidazole is a highly effective therapy for anaerobic infections and a variety of protozoal and parasitic diseases. Its pharmacokinetics, toxicities, and unique mode of action are reviewed in detail. Indications for use and respective dosages are suggested. PMID- 3280908 TI - Aminoglycoside antibiotics in clinical use. AB - Aminoglycosides are among the most used antibiotics despite competitive pressure from newer beta-lactam agents. The activity profile, pharmacology, toxicity potential, and methods of toxicity prevention of aminoglycosides are well appreciated after three decades. Nephrotoxicity, ototoxicity, and the added costs of drug level monitoring limit wider usage, but great activity against highly antibiotic resistant gram negative bacteria often outweigh these disadvantages and will likely keep aminoglycosides available for the foreseeable future. PMID- 3280910 TI - Quinolones: a new class of antimicrobial agents with wide potential uses. AB - Quinolone antibiotics provide potentially important therapy for many infections that heretofore required extensive hospitalization. Improper use of these agents rapidly can lead to resistance and thereby remove them from the physician's arsenal of antimicrobial compounds. It also is possible that with more extensive use, these drugs will demonstrate adverse reactions that to date are unknown. Attention to how the agents are used can simultaneously avoid the problems of resistance and toxicity. PMID- 3280911 TI - Topical and systemic antifungal agents. AB - Superficial fungal infections are frequent and can cause considerable morbidity. Many topical agents are available that are effective against most of these infections. Systemic fungal infections are increasing in frequency, especially among immunocompromised hosts. Amphotericin B remains the most important therapeutic agents but is associated with significant acute and chronic toxicities. PMID- 3280912 TI - Antituberculosis agents. AB - Tuberculosis, once considered a problem solved, is now dramatically on the rise. New approaches to chemotherapy will hopefully help to control this again serious problem. This article reviews the current status of tuberculosis chemotherapy, including the management of drug-resistant cases. PMID- 3280913 TI - Parasitic infections: therapeutic considerations. AB - Parasitic infections are a problem even in developed countries. Since the agents used to treat these infections are infrequently used, most physicians are unfamiliar with antiparasitic compounds. The activity, mode of action, and use of antiparasitic agents is reviewed. PMID- 3280914 TI - Antiviral agents. AB - Potent effective antiviral drugs recently have been licensed for several viral diseases, ushering in a new era in the treatment of viral diseases. Several unique features in the process of a viral infection have been identified as target points for inhibition. The unique steps and the interfering compounds are the subject of this review. PMID- 3280915 TI - Topical antimicrobial agents and antibiotics for the eye. AB - Antibiotics for eye infection can be given topically, by subconjunctival or intravitreous injection, or systemically. The bacteria responsible are reviewed and pharmacokinetics influencing topical concentration are discussed. An approach to treatment by the primary care specialist is suggested. PMID- 3280916 TI - [Surgical treatment of heart arrhythmias]. PMID- 3280917 TI - [100 years of Swedish neurology--milestone and future prospects]. PMID- 3280918 TI - [Can ultrasound replace urography in the examination and check-up of children with urinary tract infections?]. PMID- 3280919 TI - [The Oterdahlska house in Gothenburg--a corner stone in Gothenburg's hospital history]. PMID- 3280920 TI - [A case of prenatal meconium peritonitis difficult to diagnose]. PMID- 3280921 TI - [Veterinary medicine--a contributing factor in the improvement of public health]. PMID- 3280922 TI - [Chronic compartment syndrome of the lower leg]. PMID- 3280923 TI - [The man behind the syndrome: Harvey Cushing. The neurosurgeon who operated every day but still had time left to initiate research]. PMID- 3280924 TI - [The human immunodeficiency virus (HIV)--an explosion of knowledge in virology]. PMID- 3280925 TI - [The man behind the "tube": his dissertation on intratracheal anesthesia was rejected because of insignificant practical use]. PMID- 3280926 TI - [Expected effects of tonsillitis therapy. Personal treatment helps toward a more rapid recovery]. PMID- 3280927 TI - [LHRH analogs--a new treatment in hormone-dependent tumors]. PMID- 3280928 TI - [Bone marrow transplantation--rapid development towards new indications]. PMID- 3280929 TI - Long-term observations on ceramic ossicular replacement prosthesis (CORP). AB - Long-term observations on the ceramic ossicular replacement prosthesis (CORP) were performed. Extrusion rates were 8.3% for CORP-P and 5.2% for CORP-T, with most extrusions occurring within 2 years. Hearing results were satisfactory. Air bone gaps at 1 year were within 10 dB in 44.8% with CORP-P and 31.2% with CORP-T. At 3 to 5 years, air-bone gaps were within 10 dB in 42.2% and 33.3%, respectively. It was found that the short-term results were maintained even for the long period. Unsatisfactory hearing gains were caused mainly by the displacement or extrusion of CORP which could be prevented by fixation with the cartilage plate, deepening of the base of CORP-P, fixing of the base of CORP-T with the fascia, and additional fixing with the malleus handle and chorda tympani nerve. PMID- 3280930 TI - Spectroscopic characterization of cardiovascular tissue. AB - We present results of a series of laser spectroscopic measurements on in vitro samples of cardiovascular tissue. These include laser Raman scattering, Fourier transform infrared, plasma emission and fluorescence, and electron paramagnetic resonance spectroscopy. The results of these spectroscopic measurements are discussed in terms of their implications for the field of laser angioplasty. PMID- 3280931 TI - [Microbiology of Campylobacter pylori]. AB - Campylobacter pylori is a hitherto unknown spiral bacterium. It is implicated in the pathogenesis of chronic antral type B gastritis and also of duodenal and gastric ulcer disease. However, its causal role has not yet been unequivocally established. Taxonomically, C.pylori appears to belong to a genus different from genuine campylobacters, but a precise classification is likewise lacking. The in vitro sensitivity analyses of various antibiotics are complicated by a number of technical difficulties. This is one of the reasons, that results of in vivo eradication trials have to be interpreted with considerable caution. PMID- 3280932 TI - [Therapy of Campylobacter pylori infection]. AB - A simple and efficient therapy eradicating C. pylori with high reliability from gastroduodenal mucosae is presently unknown. In regard to such a "puristic" approach, antibiotics given as monotherapy are presently as ineffective as bismuth salts, which may temporarily reduce the bacterial density, but yield a low complete bacterial eradication rate of not more than 10% to 30% of all patients. Pilot studies are being performed in many centers to identify more efficacious drugs or combinations. Alternative modalities, such as manipulation of mucus, active vaccination, or clearing of bacterial sources in the environment, presently represent nothing but hypothetical models. Bismuth salts might play an important future role in a more "pragmatic" approach, which investigates any potential clinical benefit derived from a mere suppression of bacterial growth, possibly resulting in a temporary restoration of the mucosal integrity. However, this approach will probably fail to modify the long-term natural history of C. pylori-associated chronic gastritis and its sequelae. PMID- 3280933 TI - [Dietary modification of bile lipids]. AB - The average incidence of gallstones in european countries is about 25%. Excessive secretion of cholesterol into the bile can predispose to saturation and gallstone formation. Obesity, overnutrition, diets rich in refined carbohydrates, diets high in cholesterol intake and poor in dietary fibre, lipid lowering drugs, age and female sex hormones are recognized causing increased cholesterol secretion into the bile. These metabolic consequences may predispose to a higher incidence of cholesterol gallstone than in normal persons. Taking all the results of the literature together patients with gallstones should be encouraged to take a low cholesterol, low calorie, low refined carbohydrate and high polyunsaturated fat diet rich in bran und vegetable fibre. Obese patients should reduce their body weight. These dietary recommendations should be given for patients with gallstones during bile acid therapy and after successful dissolution in order to prevent gallstone recurrence. PMID- 3280934 TI - [Campylobacter pylori-associated chronic gastritis: a new entity in gastroduodenal diseases?]. AB - Clinical, morphological and immunological data in addition to animal studies clearly support the conclusion, that Campylobacter pylori infection is a direct cause (sufficient condition) for chronic type B gastritic in man. C. pylori gastritis is primarily a histologic entity defined by the presence of a gastric mucosal cellular infiltrate and the histologic demonstration of typical curved bacilli. Preliminary findings indicate, that this infection is not associated with a specific combination of symptoms. Also, it is not exclusively confined to human beings, since this or similar infections appear to represent a rather common phenomenon of mammalian stomachs. The emergence of C. pylori gastritis as a distinct entity may give rise to a new classification of dyspeptic disorders based on etiologic considerations. However, the clinical impact of C. pylori will in all likelihood depend primarily on the as yet unestablished therapeutic potential to effectively eradicate the organisms. PMID- 3280935 TI - The contribution of bromobenzene to our current understanding of chemically induced toxicities. AB - The metabolism and toxicity of bromobenzene has been investigated for well over one hundred years. The urinary excretion of mercapturic acids was first reported in 1879, in animals treated with bromobenzene. Bromobenzene has since proven to be a valuable tool in efforts to unravel the complexities involved in chemical- induced toxicities. For example, the importance of metabolic activation via the cytochrome(s) P-450; the role of glutathione in the detoxification of reactive metabolites; and the toxicological significance of covalent binding, enzyme inactivation and lipid peroxidation have all been illustrated in studies with bromobenzene. Thus, many of the principles involved in chemical-induced toxicity have been exemplified in studies with bromobenzene. These studies have provided substantial insight into the role of chemically reactive metabolites in the genesis of xenobiotic-mediated cytotoxicity. PMID- 3280936 TI - Biotin supplementation improves glucose and insulin tolerances in genetically diabetic KK mice. AB - Because biotin treatment may lower blood glucose in insulin-dependent diabetes, we chose to study such an effect in non-insulin dependent diabetes. Twenty-six diabetic KK mice, moderately hyperglycemic and insulin resistant, were treated for 10 weeks: 9 animals with 2 mg of biotin/Kg, 8 with 4 mg of biotin/Kg, and 9 with saline (controls). Blood glucose levels, oral glucose tolerance, insulin response to oral glucose, and blood glucose decrease in response to insulin were quantitated. Compared to controls, biotin treatment lowered post-prandial glucose levels, and improved tolerance to glucose and insulin resistance. Serum immunoreactive insulin levels in biotin-treated mice were like the controls. PMID- 3280937 TI - Adenosine uptake site heterogeneity in the mammalian CNS? Uptake inhibitors as probes and potential neuropharmaceuticals. AB - Inhibitors of adenosine uptake or transport have been used clinically for some time in certain cardiovascular diseases. More recently, some of them have also been investigated for possible clinical use in combination with antimetabolites based on the observed heterogeneity of nucleoside transport in mammalian tumor cells. Such a heterogeneity of adenosine uptake and uptake sites has now also been suggested in the mammalian CNS. The aim of this article is, therefore, to review the present status of our knowledge of adenosine uptake in the mammalian CNS, compare it with our far more advanced knowledge of nucleoside transport in other mammalian cells and suggest direction of future research. The possible implications for the development of adenosine uptake inhibitors as adenosinergic neuropharmaceuticals will be discussed based on our knowledge of the physiological function of adenosine in the CNS. PMID- 3280938 TI - Reduction of rapid eye movement (REM) sleep by glucose alone or glucose and insulin in rats. AB - Administration of a high dose of glucose (2.5 g/kg, i.p.) that is known to produce severe hyperglycemia in euglycemic rats suppressed rapid eye movement (REM) sleep time significantly during the first three hours of 8 hr total electroencephalogram (EEG) recording period. Co-administration of glucose (2.5 g/kg, i.p.) and a non-convulsive dose of insulin (1.0 I.U./kg, i.p.) produced a significant reduction in REM sleep time during 1st through 5th hour and an increase in slow-wave sleep (NREM) time in the 3rd and 4th hour of 8 hr total EEG recording period. However, awake, NREM and REM sleep time in the 8 hr total EEG recording period were unaffected by either glucose alone or glucose plus insulin treatments. These results strongly suggest that the insulin's effects on the sleep-awake cycle i.e. reduction in REM and a slight increase in NREM sleep times of rats is not due to indirect effects of insulin on the central nervous system via hypoglycemia as reported by us previously, but could possibly be due to its direct effects on brain chemistry of neurotransmitters such as serotonin, catecholamines and acetylcholine which are believed to modulate the sleep-awake cycle pattern in rats. PMID- 3280939 TI - Serum inhibitors of interleukin-2. AB - Interleukin-2 (IL-2) is an important modulator of cell-mediated immunity. Its activity is suppressed by various serum inhibitors generated under normal and pathological conditions. It is believed that an inhibitor which occurs in normal serum is a T-cell derived heat labile protein (or protein-glycolipid complex), and it acts in a homeostatic mechanism to restrict IL-2 action to the vicinity of the activated T cells. Changes in inhibitory activity have been found in various physiological and pathological states, e.g. during ontogeny, in systemic lupus erythematosus, in rheumatoid arthritis, and with some systemic infections. There are also suggestions that some tumor cells generate IL-2 inhibitors which diminish killer cell activity against the tumor. It is possible that a better understanding of IL-2 inhibitors would help elucidate some pathological mechanisms connected with disturbed cellular immune responses. PMID- 3280940 TI - Magnetically responsive microspheres for the pulsed delivery of insulin. AB - This paper describes a new formulation for triggered delivery of insulin which consisted of magnetic particles dispersed in alginate spheres. When magnetic field was applied to that system, the release rate of insulin was about 50 times higher than in the absence of magnetic field. The influence of oscillating magnetic field was tested, in the same experimental conditions, on polyethylenimine cross-linked alginate spheres. In that case, the pulsed delivery of insulin occurred not immediately but during the period just after applying the magnetic field. The proposed magnetically responsive alginate spheres open new perspectives for the rhythmically delivery of peptides. PMID- 3280942 TI - Pseudocoarctation of the aorta. AB - We report a case of a 50-year-old man with pseudocoarctation of the aorta that we examined with magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). The MR images demonstrated the characteristic "kink" of the aorta and the absence of true coarctation. These appearances were confirmed by DSA, but we believe MRI to be the better method for examining the aorta because it is non-invasive and has the ability to display the mediastinal anatomy in the sagittal plane, in addition to the axial and coronal planes. PMID- 3280943 TI - [Antiemetics in the radiation therapy of tumors]. PMID- 3280941 TI - Regulation of squalene epoxidase activity by membrane fatty acid composition in yeast. AB - Depriving Saccharomyces cerevisiae strain GL7 of exogenous unsaturated fatty acid supplements causes this sterol biosynthetic mutant to accumulate squalene at the expense of squalene epoxide and squalene diepoxide. To further characterize the apparent relationship between squalene epoxidase activity and membrane fatty acid composition, a variety of unsaturated fatty acids differing in their chain lengths and in the positions and orientation (cis or trans) of their double bonds were tested for their ability to promote turnover of endogenous squalene in cells previously deprived of olefinic supplements. All of the unsaturated fatty acids tested were found to restore squalene epoxidase activity but there were marked differences in their efficacies that best were correlated with the extent to which they reduced the medium chain (C-10 + C-12) saturated fatty acid content of cellular phospholipids. Additional studies demonstrated that de novo protein synthesis was required for the restoration of squalene epoxidase activity in unsaturated fatty acid-deprived cells. PMID- 3280945 TI - A mutant in a major heat shock protein of Escherichia coli continues to show inducible thermotolerance. AB - Escherichia coli cells carrying the dnaK756 mutation, were inactivated at 52 degrees C faster than control cells. This suggests that the intact dnaK gene product plays a role in protecting the cell from lethal damage at 52 degrees C. The effect of the dnaK mutation on induced thermotolerance was examined. Prior heat shock at 42 degrees C greatly lowered the subsequent inactivation rate in both mutant and control cells. This result suggests that, although produced in large amounts in response to thermal stress, mutation in the DnaK protein has little or no effect on induced thermotolerance. PMID- 3280944 TI - Infections after liver transplantation. An analysis of 101 consecutive cases. AB - We studied infections in 101 consecutive patients who underwent liver transplantation between July 1984 and September 1985. The mean length of follow up was 394 days. Eighty-three percent of population had 1 or more episodes of infection and 67% of the population had severe infections. The overall mortality was 26/101 (26%) and 23 of 26 deaths (88%) were associated with infection. Seventy percent of severe infections occurred in the first 2 months after transplantation. The most frequent severe infections were abdominal abscess, bacterial pneumonia, invasive candidiasis, Pneumocystis pneumonia, and symptomatic cytomegalovirus infection. Patients with more than 12 hours of cumulative surgical time had a higher rate of severe infections (P less than 0.001), particularly fungal (P less than 0.001) and bacterial (P less than 0.01) infections. Also, the use of choledocho-jejunostomy was associated with a higher rate of infection in patients who had more than 1 transplant operation (P less than 0.02). No increase in infection was found in patients who received azathioprine, or more than the median number of steroid boluses or "recycles"; but patients who received OKT3 therapy had a higher rate of protozoal infections (P less than 0.05). A result similar to that of our previous studies was a strong relation between the number of severe fungal infections and prolonged courses of antibiotics after transplant operation (P less than 0.001). Pretransplant manifestations of severe liver disease such as ascites, encephalopathy, and gastrointestinal bleeding were not associated with higher rates of infection after transplantation, but high serum levels of ALT were. Patients with lower ratios of T-helper to T-suppressor lymphocytes had more severe viral (P less than 0.02) and fungal (P less than 0.01) infections after transplantation. PMID- 3280946 TI - The immunity and lysis genes of ColN plasmid pCHAP4. AB - Nucleotide sequencing of part of the plasmid pCHAP4, which encodes the ca. 42,000 Da putative poreforming colicin N, confirmed previous results indicating that the colicin N immunity gene (cni) and the colicin release or lysis gene (cnl) are located immediately downstream from the colicin N structural gene (cna) in the order cna-cni-cnl. The cni gene is transcribed in the opposite direction to cna and probably encodes an Mr 15239 Da protein. The putative immunity protein was detected among the [35S]methionine-labelled proteins produced by minicells carrying cni cloned under lac promoter control, and when the gene was subcloned into expression vectors under the control of a bacteriophage T7 promoter. Deletion of the region immediately upstream from cni completely abolished colicin N immunity, presumably because the natural promoter had been deleted. cnl is in the same operon as cna, and encodes a typical Col plasmid pro-lysis protein comprising a signal peptide and a 34 residue mature polypeptide with high homology to all but one of the other known Col lysis proteins, including the fatty acylated amino-terminal cysteine residue which was specifically labelled with 3H-palmitate. Cell fractionation studies indicated that the cnl gene product was located predominantly in the outer membrane. PMID- 3280948 TI - Kinetics of phagocytosis and killing of E. coli by murine macrophages in presence of different serum preparations. AB - In this study we evaluated the kinetics of phagocytosis and killing of E. coli by thioglycollate-elicited murine peritoneal macrophages and the role of specific antibodies and complement present in different serum preparations in modulating these processes. In our system phagocytosis of E. coli by macrophage monolayer was exponential for 180 min. The killing activity was high in the first 30-60 min and then virtually ceased. The least phagocytosis and killing occurred in presence of heat-inactivated fetal calf serum (HFCS). These activities were 2 fold increased in presence of normal mouse serum (NMS) or heat-inactivated newborn calf serum (HNCS) and were highly stimulated in presence of immune mouse serum (IMS). IMS without complement was less efficient in enhancing phagocytosis and killing by macrophages. However when IMS or HNCS were deprived of specific antibodies their activity was remarkably reduced. When macrophages containing phagocytized bacteria were reincubated with different sera, multiplication of intracellular E. coli occurred with HFCS, NMS or antibody-deprived IMS or HNCS. In contrast, a significant decrease in the survival of intracellular bacteria was seen in presence of IMS, HNCS or complement-deprived IMS. The results indicated that specific bacterial antibodies play a major role in the phagocytic process and in the activation of killing mechanisms. However optimal macrophage activity resulted from the presence of both specific antibodies and complement. PMID- 3280949 TI - Protection of Escherichia coli K12 structural integrity by Ca2+ and Mg2+ in bactericidal and bacteriolytic tests. AB - Escherichia coli K12 suspended in different media showed a loss of phospholipids. Mg2+ and Ca2+ 0.01 M prevented phospholipid loss and stabilized Escherichia coli K12 for bactericidal and bacteriolytic assays. PMID- 3280947 TI - Function of cloned T4 recombination genes, uvsX and uvsY, in cells of Escherichia coli. AB - Genes uvsX and uvsY of bacteriophage T4 both control genetic recombination and repair of damaged DNA, and their mutant phenotypes bear a striking resemblance to each other. It has been shown recently that the uvsX gene product is analogous to the recA gene product of Escherichia coli (Yonesaki et al. 1985; Yonesaki and Minagawa 1985; Formosa and Alberts 1986), but the function of the uvsY gene is unknown. To obtain further insight into the function of these genes we introduced plasmidborne copies of the two genes separately or together into E. coli. The uvsX gene rendered recA- cells more resistant to UV and raised the recombination frequency of lambda phage and E. coli, but hampered induction of the lambda prophage and the SOS function of E. coli. The uvsY gene had no detectable function when introduced alone into E. coli but significantly enhanced the function of the uvsX gene when the two plasmid-borne genes were introduced together. PMID- 3280950 TI - Unusual behaviour of Klebsiella rhinoscleromatis strains on API 20E strips. AB - Seven Klebsiella rhinoscleromatis standard cultures and two wild isolates were examined for their responses to Api 20E (API System, S.A.) strips. Several strains yield incostant results for arabinose fermentation test in Api strips and, when positive, they were not identified. The arabinose positive test indeed, led to the numerical profiles 0004773 (not mentioned in the analytical catalogue), or 0004553 (two strains) corresponding to a Klebsiella ozaenae identification. The mathematical analysis of the biochemical results confirmed the identity of the strains as K. rhinoscleromatis. PMID- 3280952 TI - [Tumor therapy]. PMID- 3280951 TI - Comparison between enzyme-linked immunosorbent and I.F. assays in the serological diagnosis of HIV infections. AB - A rapid, sensitive indirect immunofluorescence assay based on the use of acetone fixed virus producing MOLT T4/LAV cells was adapted for the detection of anti-HIV antibodies. At the same time, 1486 serum samples, collected by the AIDS Surveillance and Study Centre of Modena, were tested by ELISA and IFA: the percentage of agreement of both assays was of 99.66%. Such datum suggested that IFA could be used as a serological assay for screening and confirmatory purposes. PMID- 3280954 TI - [Developments in allergology]. PMID- 3280953 TI - [Progress in clinical cardiology. 1. Coronary angiography]. PMID- 3280955 TI - [Adverse reactions to narcotics. Developments and trends]. PMID- 3280956 TI - [New infectious diseases and their treatment. Important developments in the last decade]. PMID- 3280958 TI - [Therapy of acute lung edema with piretanide]. PMID- 3280957 TI - [Comparison of 2 antacids with different acid binding capacity in low dosage in the treatment of duodenal ulcer]. PMID- 3280959 TI - [Clinical aspects, morphology and origin of Kaposi sarcoma]. PMID- 3280960 TI - [Alcohol drinking and arterial hypertension]. PMID- 3280961 TI - [Current therapy of advanced prostatic cancer]. PMID- 3280963 TI - Thionucleosides in transfer ribonucleic acid: diversity, structure, biosynthesis, and function. PMID- 3280964 TI - Biology of Naegleria spp. PMID- 3280962 TI - Homologous recombination in procaryotes. PMID- 3280968 TI - Insulin usage in the neonate. PMID- 3280966 TI - Molecular genetics of photosynthetic membrane biosynthesis in Rhodobacter sphaeroides. PMID- 3280965 TI - Biology of asaccharolytic black-pigmented Bacteroides species. PMID- 3280969 TI - Yeast STE7, STE11, and STE12 genes are required for expression of cell-type specific genes. AB - Cell type specialization in yeast haploids involves the mutually exclusive expression of one of two sets of genes, the a-specific and alpha-specific genes. We demonstrated that the products of the STE7, STE11, and STE12 genes were required for the expression of both gene sets. RNA levels transcribed from these gene sets were significantly decreased but not abolished in haploids containing a null mutation in the STE7, STE11, or STE12 gene. Transcript levels from the a- and alpha-specific gene sets were not further reduced in strains harboring mutations in all three STE genes, suggesting that STE7, STE11, and STE12 are required for the same aspect of transcription. We further showed that the requirement for these products was not the same for each member of a particular gene set. However, for any given a- or alpha-specific gene, the effect on RNA levels of any of the three ste mutations was similar. PMID- 3280971 TI - The SPS100 gene of Saccharomyces cerevisiae is activated late in the sporulation process and contributes to spore wall maturation. AB - We previously described the use of a differential hybridization screen of a genomic DNA library of Saccharomyces cerevisiae to identify sporulation-specific (SPS) genes (A. Percival-Smith and J. Segall, Mol. Cell. Biol. 4:142-150, 1984). This initial screen identified 14 SPS genes that are first expressed 6 to 8 h after transfer of cells to sporulation medium. Accumulation of transcripts corresponding to these genes becomes maximal at 8 to 12 h of sporulation, the time at which meiotic events are nearing completion, and by 15 h of sporulation, transcript levels are beginning to decrease. In the present study two additional SPS genes, first expressed at 12 h of sporulation, were isolated. The steady state level of transcripts corresponding to these two genes, termed SPS100 and SPS101, remains unchanged from 15 to 35 h, a time coincident with spore wall maturation. The nature of the putative 34.2-kilodalton protein encoded by the SPS100 gene is consistent with its being a component of the glycoprotein matrix of the spore wall; the protein contains a potential signal sequence and cleavage site and numerous sites for potential glycosylation. A MATa sps100/MAT alpha sps100 strain was found to be indistinguishable from the wild-type strain when assessed for efficiency of ascus formation and spore viability. However, a more detailed analysis of the mutant strain revealed that the SPS100 gene product serves a protective role during the early stages of spore wall formation. The time at which resistance to ether could first be detected in developing spores was delayed by 5 h in the mutant strain relative to the wild-type strain. This phenotype is presumably a reflection of a defect in spore wall maturation. This study has confirmed that temporally distinct classes of sporulation-specific genes are sequentially activated during the process of meiosis and spore formation and has shown that the SPS100 gene, identified on the basis of its developmental-specific expression pattern, contributes to spore development. PMID- 3280970 TI - ATR1, a Saccharomyces cerevisiae gene encoding a transmembrane protein required for aminotriazole resistance. AB - In Saccharomyces cerevisiae, 3-amino-1,2,4-triazole (aminotriazole) competitively inhibits the activity of imidazoleglycerolphosphate dehydratase, the product of the HIS3 gene. Wild-type strains are able to grow in the presence of 10 mM aminotriazole because they induce the level of imidazoleglycerolphosphate dehydratase. However, strains containing gcn4 mutations are unable to grow in medium containing aminotriazole because they lack the GCN4 transcriptional activator protein necessary for the coordinate induction of HIS3 and other amino acid biosynthetic genes. Here, we isolated a new gene, designated ATR1, which when present in multiple copies per cell allowed gcn4 mutant strains to grow in the presence of aminotriazole. In wild-type strains, multiple copies of ATR1 permitted growth at extremely high concentrations of aminotriazole (80 mM), whereas a chromosomal deletion of ATR1 caused growth inhibition at very low concentrations (5 mM). When radioactive aminotriazole was added exogenously, cells with multiple copies of ATR1 accumulated less aminotriazole than wild-type cells, whereas cells with the atr1 deletion mutation retained more aminotriazole. Unlike the mammalian mdr or yeast PDR genes that confer resistance to many drugs, ATR1 appears to confer resistance only to aminotriazole. Genetic analysis, mRNA mapping, and DNA sequencing revealed that (i) the primary translation product of ATR1 contains 547 amino acids, (ii) ATR1 transcription is induced by aminotriazole, and (iii) the ATR1 promoter region contains a binding site for the GCN4 activator protein. The deduced amino acid sequence suggests that ATR1 protein is very hydrophobic with many membrane-spanning regions, has several potential glycosylation sites, and may contain an ATP-binding site. We suggest that ATR1 encodes a membrane-associated component of the machinery responsible for pumping aminotriazole (and possibly other toxic compounds) out of the cell. PMID- 3280972 TI - Suppression of chromosomal mutations affecting M1 virus replication in Saccharomyces cerevisiae by a variant of a viral RNA segment (L-A) that encodes coat protein. AB - For the maintenance of "killer" M1 double-stranded RNA in Saccharomyces cerevisiae, more than 30 chromosomal genes are required. The requirement for some of these genes can be completely suppressed by a cytoplasmic element, [B] (for bypass). We have isolated a mutant unable to maintain [B] (mab) and found that it is allelic to MAK10, one of the three chromosomal MAK genes required for the maintenance of L-A. The heat curing of [B] always coincided with the loss of L-A. To confirm that [B] is located on L-A, we purified viral particles containing either L-A or M1 from strains with or without [B] activity and transfected these purified particles into a strain which did not have either L-A or M1. The transfectants harboring L-A and M1 from a [B] strain showed the [B] phenotype, but the transfectants with L-A and M1 from a [B-o] strain did not show the [B] phenotype. Furthermore, the transfectants having L-A from a [B] strain and M1 from a [B-o] strain also showed the [B] phenotype. Therefore, we concluded that [B] is a property of a variant of L-A. In the transfection experiment, we also proved that the superkiller phenotype of the [B] strain is a property of L-A and that L-A with [B] activity can maintain a higher copy number of M1 regardless of the source of M1 viruslike particles. These data suggest that MAK genes whose mutations are suppressed by [B] are concerned with the protection of M1 (+) single-stranded RNA or the formation of M1 viruslike particles and that an L-A with more efficient production of M1 viruslike particles can completely dispense with the requirement for those MAK genes. PMID- 3280973 TI - Comparison of the structure and cell cycle expression of mRNAs encoded by two histone H3-H4 loci in Saccharomyces cerevisiae. AB - The haploid genome of Saccharomyces cerevisiae contains two nonallelic sets of histone H3 and H4 gene pairs, termed the copy I and copy II loci. The structures of the mRNA transcripts from each of these four genes were examined by nuclease protection and primer extension mapping. For each gene, several species of mRNAs were identified that differed in the lengths of their 5' and 3' untranslated regions. The cell cycle accumulation pattern of the H3 and H4 mRNAs was determined in cells from early-exponential-growth cultures fractionated by centrifugal elutriation. The RNA transcripts from all four genes were regulated with the cell division cycle, and transcripts from the nonallelic gene copies showed tight temporal coordination. Cell cycle regulation did not depend on selection of a particular histone mRNA transcript since the ratio of the multiple species from each gene remained the same across the division cycle. Quantitative measurements showed significant differences in the amounts of mRNA expressed from the two nonallelic gene sets. The mRNAs from the copy II H3 and H4 genes were five to seven times more abundant than the mRNAs from the copy I genes. There was no dosage compensation in the steady-state levels of mRNA when either set of genes was deleted. In particular, there was no increase in the amount of copy I H3 or H4 transcripts in cells in which the high-abundance copy II genes were deleted. PMID- 3280967 TI - Deoxyribonucleic acid repair in the yeast Saccharomyces cerevisiae. PMID- 3280974 TI - Gene conversion associated with site-specific recombination in yeast plasmid pSR1. AB - A circular DNA plasmid, pSR1, isolated from Zygosaccharomyces rouxii has a pair of inverted repeats consisting of completely homologous 959-base pair (bp) sequences. Intramolecular recombination occurs frequently at the inverted repeats in cells of Saccharomyces cerevisiae, as well as in Z. rouxii, and is catalyzed by a protein encoded by the R gene of its own genome. The recombination is, however, independent of the RAD52 gene of the host genome. A site for initiation of the intramolecular recombination in the S. cerevisiae host was delimited into, at most, a 58-bp region in the inverted repeats by using mutant plasmids created by linker insertion. The 58-bp region contains a pair with 14-bp dyad symmetry separated by a 3-bp spacer sequence. The recombination initiated at this site was accompanied by a high frequency of gene conversion (3 to 50% of the plasmid clones examined). Heterogeneity created by the linker insertion or by a deletion (at most 153 bp so far tested) at any place on the inverted repeats was converted to a homologous combination by the gene conversion, even in the rad52-1 mutant host. A mechanism implying branch migration coupled with DNA replication is discussed. PMID- 3280976 TI - DNA sequence analysis of spontaneous mutations in the SUP4-o gene of Saccharomyces cerevisiae. AB - A collection of 196 spontaneous mutations in the SUP4-o gene of the yeast Saccharomyces cerevisiae was analyzed by DNA sequencing. The classes of mutation identified included all possible types of base-pair substitution, deletions of various lengths, complex alterations involving multiple changes, and insertions of transposable elements. Our findings demonstrate that at least several different mechanisms are responsible for spontaneous mutagenesis in S. cerevisiae. PMID- 3280977 TI - [Exact description of non-glomerular and glomerular erythrocyte forms in pediatric hematuria]. AB - We examined 70 urinary sediments of 35 children with non-glomerular hematuria (NGH) and 65 urinary sediments of 17 children with glomerular hematuria (GH) by phase-contrast microscopy at 1,000 X magnification. In each urinary sediment 200 erythrocytes were classified into 18 types of "non-glomerular erythrocytes" and 15 types of "glomerular erythrocytes". According to the percentage of greatly altered erythrocytes the urinary finding was termed isomorphic, mixed or dysmorphic. In 91% of the urinary sediments of patients with NGH the erythrocyte pattern was isomorphic, and in 91% of the urinary sediments of children with GH it was dysmorphic. 9 types of non-glomerular erythrocytes and 10 types of glomerular erythrocytes constituted 94.5% of all 26,809 erythrocytes examined. Torocytes (doughnut-like cells) can be considered characteristic for GH. This study demonstrates a high specificity of this method in discriminating NGH from GH. The exact morphological description of urinary erythrocytes allows the method to be reproducible. For future use examiners can concentrate on the 19 commonest erythrocyte types. PMID- 3280978 TI - [Acquired--accepted--adopted? On the status of neonatology in West Germany]. AB - The worldwide reduction in infant mortality and low birthweight lethality has also been observed in the Federal Republic of Germany during the past two decades. In many countries, neonatology has emerged as a scientifically active subspecialty of pediatrics. Its main characteristic is an understanding of partially mature function and perinatal adaptation. In West Germany, however, education programs for neonatologists have not been inaugurated and neonatology has been identified with pediatric intensive care. Sophisticated neonatal transport systems, expensive special care units, and highly aggressive therapeutic approaches have resulted. Neither perinatal centers for high-risk deliveries nor regionalization programs for intrauterine transport to the neonatal special care unit have been created. Neonatology may drift towards obstetrics if established pediatrics continues to ignore educational, organizational and manpower needs of neonatal care. PMID- 3280979 TI - [The use of a light microscopy immuno-gold-silver method and sensitive immunoperoxidase technic on routine pathological matter]. PMID- 3280975 TI - An oligomer complementary to c-myc mRNA inhibits proliferation of HL-60 promyelocytic cells and induces differentiation. AB - To study the role of a nuclear proto-oncogene in the regulation of cell growth and differentiation, we inhibited HL-60 c-myc expression with a complementary antisense oligomer. This oligomer was stable in culture and entered cells, forming an intracellular duplex. Incubation of cells with the anti-myc oligomer decreased the steady-state levels of c-myc protein by 50 to 80%, whereas a control oligomer did not significantly affect the c-myc protein concentration. Direct inhibition of c-myc expression with the anti-myc oligomer was associated with a decreased cell growth rate and an induction of myeloid differentiation. Related antisense oligomers with 2- to 12-base-pair mismatches with c-myc mRNA did not influence HL-60 cells. Thus, the effects of the antisense oligomer exhibited sequence specificity, and furthermore, these effects could be reversed by hybridization competition with another complementary oligomer. Antisense inhibition of a nuclear proto-oncogene apparently bypasses cell surface events in affecting cell proliferation and differentiation. PMID- 3280980 TI - DNA binding and mutagenicity of ethyl methanesulfonate in wild-type and uvrB cells of Salmonella typhimurium. AB - The extent of DNA ethylation and the influence of excision repair on ethyl methanesulfonate (EMS) mutagenesis of Salmonella typhimurium were examined. The relationship between the dose to DNA and the exposure concentration of EMS was linear. EMS induction of his+ revertants followed exponential kinetics and did not parallel the increase in total DNA ethylation. Mutant induction was influenced by the cells' nucleotide excision repair ability. Although mutagenized to a larger extent than the wild-type (uvr+) strain at high doses, the uvrB strain was more resistant to the mutagenic effect of low doses of EMS. PMID- 3280981 TI - Organ-specific, carcinogenic dibenzo[c,g]carbazole derivatives: discriminative response in S. typhimurium TA100 mutagenesis modulated by subcellular fractions of mouse liver. AB - 7H-Dibenzo[c,g]carbazole (DBC) has carcinogenic effects on mouse subcutaneous fibroblasts and liver; the N-methyl derivative (N-MeDBC) induces only sarcomas; 3 methyl- and 5,9-dimethyldibenzo[c,g]carbazole (3-MeDBC and 5,9-DMeDBC) are specific, potent hepatocarcinogens in mice. The mutagenicity in S. typhimurium TA100 of these 4 compounds was evaluated in relation to the concentration of mouse liver 9000 X g supernatant (S9) and to the proportions of microsomes and cytosol in the medium. Optimal mutagenicity of N-MeDBC was seen with a low concentration of S9 or microsomes; a 5-10 times higher concentration of the subcellular fraction was necessary to induce optimal mutagenicity of the hepatocarcinogens 3-MeDBC and 5,9-DMeDBC. Intermediate quantities were needed in the case of DBC, which is carcinogenic in both cell types. Whereas the presence of cytosol had an inhibitory effect on the mutagenicity of the sarcomagenic N MeDBC, the cytosolic fraction was essential for optimal mutagenic expression by the 2 hepatocarcinogenic derivatives. The activating cytosolic fraction is not inducible. These experiments show that programmed modulation of the metabolic activation system in the Ames test can be used to study organ-specific chemical carcinogenesis. The results suggest that differences in the enzymatic composition of target tissues are a determining factor in the organ specificity of carcinogens such as DBC. PMID- 3280982 TI - Influence of divalent metal activator on the specificity of misincorporation during DNA synthesis catalyzed by DNA polymerase I of Escherichia coli. AB - To test whether the identity of divalent metal activator affects the specificity of misincorporation during polymerization catalyzed by E. coli DNA polymerase I, we carried out the following procedure. A series of oligonucleotide primers, annealed at different positions along the lacZ region of bacteriophage M13mp9 DNA, were elongated in the presence of 3 of the 4 deoxynucleoside 5' triphosphates (dNTPs) until one or a few misincorporations occurred in each elongated primer. The elongated primers (containing deoxynucleotide residues that had been misincorporated in the presence of either Mg2+ or Mn2+) were then isolated and sequenced by the 'dideoxy' chain termination method to determine the identity of deoxynucleoside monophosphates (dNMPs) that had been misincorporated at different template positions during the original 'minus' reactions, activated by Mg2+ or Mn2+. The results obtained by this approach revealed that both the type of misincorporation and the effect of substituting Mn2+ for Mg2+ depended on the nucleotide sequence of the template. At 40% of the template positions at which misincorporation was compared with both metal ions (8 out of 20), the identity of mispairs differed significantly for synthesis activated by Mn2+ versus Mg2+. Of these 8 sites, 4 exhibited increased transversions in the presence of Mn2+, while 4 exhibited decreased transversions with Mn2+. PMID- 3280983 TI - Methyl-directed DNA mismatch repair in Escherichia coli. AB - Some of the molecular aspects of methyl-directed mismatch repair in E. coli have been characterized. These include: mismatch recognition by mutS protein in which different mispairs are bound with different affinities; the direct involvement of d(GATC) sites; and strand scission by mutH protein at d(GATC) sequences with strand selection based on methylation of the DNA at those sites. In addition, communication over a distance between a mismatch and d(GATC) sites has been implicated. Analysis of mismatch correction in a defined system (Lahue et al., unpublished) should provide a direct means to further molecular aspects of this process. PMID- 3280985 TI - A comparative study of the cytotoxic and genotoxic effects of cisplatin and its analogue, TNO-6, in yeast. AB - The antitumour drug cisplatin and its analogue, TNO-6, were studied for their cytotoxic, mutagenic and recombinagenic effects in a diploid strain (D7) of the yeast, Saccharomyces cerevisiae. It was observed that the structural change in TNO-6 resulted in reduced cytotoxicity and recombinagenicity (mitotic gene conversion) but increased mutagenic activity compared to the effects of cisplatin at equimolar concentrations. These results indicated that the mechanism through which TNO-6 damages cellular DNA is different from that of cisplatin. PMID- 3280984 TI - Induction of the SOS function sfiA in E. coli by systems which generate triplet ketones. AB - Generation of triplet ketones, either chemically through thermal decomposition of 3-hydroxymethyl-3,4,4-trimethyl-1,2-dioxetane and 3-[N-(pyridino)carbamoyl]methyl 3,4,4-trimethyl-1,2-dioxetane++ + or enzymatically via the aerobic oxidation of isobutyraldehyde trimethylsilyl enol ether catalyzed by horse-radish peroxidase, triggers the SOS function sfiA in E. coli. Although the observed effects are relatively weak and the triplet ketone scavenger tryptophan was ineffective in this system, our results provide evidence for the involvement of triplet ketones in this type of DNA damage. Possible mechanisms are discussed. PMID- 3280986 TI - Mechanisms in metal genotoxicity: the significance of in vitro approaches. AB - A survey of the literature published on the ability of metal salts to produce, in vitro, gene mutations, structural chromosome aberrations, sister-chromatid exchanges, to interfere with the chromosome distribution or to induce mammalian cell transformation demonstrates that the carcinogenicity of inorganic compounds is clearly associated with their genotoxicity. The induction of structural aberrations, SCEs and forward gene mutations represents the most sensitive and specific assay to assess the carcinogenic potential of metal salts. PMID- 3280987 TI - Radiation-induced translocations in spermatogonial stem cells of Macaca fascicularis and Macaca mulatta. AB - 3 adult monkeys, one Macaca fascicularis and two Macaca mulatta, were whole-body irradiated with 1 Gy gamma-rays (60 Co). Reciprocal translocations induced in spermatogonial stem cells were scored as translocation multivalents in primary spermatocytes from 7.5 to 27.5 months after exposure. The translocation yields ranged from 4.1% at the earliest to 1.8% at the latest sampling interval. No significant differences were observed in the responses of the individual animals. A decline in the translocation frequencies with time after treatment was found in all 3 animals. The present data are different from those reported for testicular X-irradiation of the rhesus monkey Macaca mulatta (van Buul, 1980; Lyon et al., 1976) in that the translocation yields are higher. They are consistent with the results reported for testicular gamma-irradiation of the crab-eating monkey Macaca fascicularis (Matsuda et al., 1984, 1985). In view of the present results it appears unlikely that a species difference exists within the genus Macaca in the sensitivity of spermatogonial stem cells to the induction of translocations by ionizing radiation. PMID- 3280988 TI - Mutagenic DNA repair in Escherichia coli. XVI. Mutagenesis by ultraviolet light plus delayed photoreversal in recA strains. AB - Mutagenesis was demonstrable after delayed photoreversal of UV-irradiated strains carrying a recA deletion indicating that RecA protein is not essential for the misincorporation process that is revealed by delayed photoreversal. Moreover, the data suggest that RecA protein actually depresses misincorporation to varying extents depending on the recA allele. No delayed photoreversal was demonstrable in reA1 or recA56 bacteria unless the lexA102(ind-) allele was also present. It is suggested that the level of these RecA proteins may be lower in the lexA102(ind-) strains thus minimising their depressive effect. Delayed photoreversal mutagenesis in strains carrying the recA441 allele was not affected by either adenine or guanosine plus cytidine, substances which affect the proteolytic activity of RecA441 protein. PMID- 3280989 TI - Evaluation of the SOS chromotest. AB - In the present investigation, the SOS chromotest with E. coli PQ37 was evaluated. The potential to identify different kinds of bacterial mutagens was examined. 124 chemicals of different chemical classes were tested. Their responses in the SOS chromotests were compared to reported test results obtained with the Ames test. PMID- 3280990 TI - In vitro and in vivo mutagenicity studies with airborne particulate extracts. AB - The contribution of nitro compounds to airborne particulate mutagenicity was studied with Salmonella typhimurium strains TA98, TA98NR, TA98/1,8DNP6. The results obtained indicate that nitropyrenes play a minor role in air particulate mutagenicity. Seasonal variations indicate a relatively greater contribution of nitro compounds to the mutagenicity of spring and summer samples. Fractionation of extracts into acidic, neutral and basic components shows that neutral compounds account for about two-thirds of the total mutagenic activity. Attempts to extract mutagens adsorbed onto particulate matter with aqueous media were almost completely negative. No significant mutagenicity was detected in urine and faecal extracts and in plasma samples of Sprague-Dawley rats treated with air particulate extracts at 80 mg/kg either per os or by i.p. injection. Negative results were obtained in the micronucleus test with Swiss mice treated at 200 and 400 mg/kg (twice by i.p. injection). A significant decrease in liver aminopyrine N-demethylase was observed in Swiss mice injected with air particulate extracts or its basic and neutral fractions. In vitro experiments suggest a direct interaction of test materials with microsomal cytochrome P-450. PMID- 3280992 TI - Screening for genotoxic activity of amitraz with short-term bacterial assays. AB - Genotoxic effects of both amitraz and its metabolites made by S9 fraction were reevaluated in short-term bacterial assays. Neither amitraz nor its metabolites induced frameshift mutation or caused base-pair substitution as detected by the Ames test. They also did not introduce any damages into DNA recognized by correndonuclease II as shown by the repair test. Metabolites of amitraz (but not amitraz itself) induced the SOS-repair system in E. coli strain PQ 243 tagA, alkA which was deficient in N-glycosylases. It is concluded that neither amitraz nor its metabolites have mutagenic activity. In contrast to amitraz, its metabolites alkylate DNA in the N3-position of adenine. PMID- 3280991 TI - Activation of anti-Trypanosoma cruzi drugs to genotoxic metabolites promoted by mammalian microsomal enzymes. AB - Salmonella typhimurium TA100 and its nitroreductase-deficient derivative, TA100 NR, were used to reevaluate the mutagenic activities of benznidazole and nifurtimox. Mutagenicity and toxicity of nifurtimox were abolished in the TA100 NR tester strain under aerobic or anaerobic conditions and addition of rat liver extracts did not alter the results. However, benznidazole showed a significant mutagenicity and toxicity to the nitroreductase-deficient strain TA100 NR under hypoxic conditions. Addition of rat liver extracts enhanced the observed mutagenicity and toxicity of benznidazole even more. In the presence of O2 the genotoxic activities of benznidazole to the TA100 NR tester strain were eliminated. These results lead us to conclude that bacterial enzymes were responsible for the previously observed genotoxic effects of nifurtimox and benznidazole on S. typhimurium TA100. Moreover, under anaerobic conditions, only benznidazole could be metabolized by mammalian nitroreductases into a mutagenic derivative. PMID- 3280993 TI - Assessment of mutagenic activity of repeatedly used deep-frying fats. AB - Mutagenic activity of repeatedly used deep-frying fats was evaluated in relation to chemical characteristics. Deep-frying fat samples were collected from local restaurants and snack bars after sensory indication of abuse. A total of 20 deep frying fat samples and 2 unused control fat samples was tested. Fat samples were fractionated into non-polar and polar compounds by column chromatography. Amounts of polar compounds obtained ranged from 2% (by weight) for unused fat to 44% for used deep-frying fat. Levels of di- and polymeric triglycerides (DPTG) were determined using gel-permeation chromatography. DPTG concentrations of 13 used deep-frying fat samples exceeded the threshold level of 10% above which fats are rejected for use. In addition thiobarbituric acid-reactive substances (TBA-RS) were measured. Amounts of TBA-RS were just above detection levels for most fat samples. Five used fat samples, however, contained relatively high concentrations of TBA-RS, ranging from 82 to 177 nmoles malondialdehyde/g. Non-polar and polar fractions were screened for mutagenic activity using the Ames mutagenicity assay. Mutagenic activity was found predominantly in polar fractions at doses higher than 1 mg/plate in strains TA97, TA100 and TA104, variously with and without metabolic activation. The highest number of mutagenic samples was detected by strain TA97, which appeared to be most sensitive. Some samples exhibited toxic effects. Chromatography blanks, consisting of solvents processed according to the same procedures as used for fat samples, were not mutagenic. Mutagenic activity was also detected in polar material obtained from unused frying fat. Non-polar fractions of unused frying fats showed no mutagenicity. A frying experiment carried out under laboratory conditions indicated that during repeated and prolonged use of deep-frying fat mutagenic polar substances were formed. Fat samples taken after 20 and 40 h of frying contained increasing amounts of polar compounds. Mutagenic activity was highest after 20 h of frying but was slightly decreased after 40 h of frying. At this stage, however, mutagens also appeared in the non-polar fraction. Mutagenic activity of polar fractions of used deep-frying fats in strain TA97 was positively correlated with levels of TBA-RS, which may indicate the involvement of lipid oxidation products in mutagenicity of used deep frying fats. No significant correlations were found with other chemical characteristics. In the process of deep-fat frying numerous degradation products are formed, which may include mutagenic heterocyclic amines and other pyrolysates.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3280994 TI - Genotoxicity of selenite in diploid yeast. AB - Selenite, a chemical of industrial importance and also an antimutagenic/anticarcinogenic agent, was tested for mutagenic and recombinogenic effects in 2 diploid yeast strains, Saccharomyces cerevisiae BZ 34 and D7. Selenite induced gene conversion and toxicity in BZ 34 and a variety of genetic events, viz. back-mutation, gene conversion, mitotic crossing-over, aberrant colony formation and also toxicity in the D7 strain. In both strains, the genetic effects of selenite showed a peak and a decline during 5 h of treatment while its toxicity increased marginally during 1-5 h. In the BZ 34 strain, the presence of glutathione (GSH) during selenite treatment greatly enhanced the convertogenic and toxic effects of selenite. PMID- 3280995 TI - On the mutagenic and recombinogenic activity of certain herbicides in Salmonella typhimurium and in Aspergillus nidulans. AB - The plant growth-regulating hormones indole-3-acetic acid (IAA) and indole-3 butyric acid (IBA), both strong recombinogens in Aspergillus nidulans, were tested in Salmonella typhimurium strains for his revertants at a range of concentrations from 1 to 2000 micrograms/plate with and without metabolic activation and were found negative. Also 3 herbicides of the chlorophenoxy group, 2,4-(dichlorophenoxy)acetic acid (2,4-D), 2,4-(dichlorophenoxy)butyric acid (2,4 DB) and 4-chloro-2-methylphenoxyacetic acid (MCPA), which show a plant growth hormone-like activity, and 2 of the triazine group, 2-ethylamino-4-chloro-6 isopropylamino-1,3,5-triazine (atrazine) and 2,4-bis(isopropylamino)6-chloro 1,3,5-triazine (propazine) were tested in S. typhimurium for point mutations and in A. nidulans for mitotic recombination. 2,4-D and MCPA were found to be weakly mutagenic at concentrations between 250 and 750 micrograms/plate in strain TA97a and only after metabolic activation and were recombinogens by inducing mainly mitotic crossing-over in A. nidulans at concentrations of 4-48 microM and 1500 3000 microM, respectively. 2,4-DB, atrazine and propazine were negative in both the Ames and the Aspergillus tests. PMID- 3280996 TI - Assessment of the mutagenic potential of a fungicide Bavistin using multiple assays. AB - The fungicide Bavistin was assessed for mutagenic potential by various assays. Bavistin was found to be unable to induce gene mutation in Salmonella typhimurium, but it was able to induce transfection inhibition in Mycobacterium smegmatis. Bavistin was able to induce immediate genotoxic effects in plants but these were not carried through in development as in the long term no genotoxic effects were observed by the progeny test. Bavistin did induce micronuclei formation and did cause an increase in the ratio of normochromatic to polychromatic erythrocytes in mice. It was able to induce a very low frequency of sister-chromatid exchange in human lymphocytes and in addition, it was observed that the chemical affected the mitotic index but did not affect the cell cycle duration. Present studies indicate that the pesticide shows a positive response in 4 out of 5 different test systems (Table 8) and most of the observations support that Bavistin is genotoxic. PMID- 3280997 TI - Muscle imaging in neuromuscular disease using computerized real-time sonography. AB - The results of a study utilizing computerized real-time sonography (CRS) to image muscles in patients with neuromuscular disease are presented for 67 patients, 37 with neuromuscular disease and 4 with upper motor neuron disease, and 26 age matched healthy controls between the ages of 2 days and 59 years. CRS is a safe, noninvasive, atraumatic method for evaluating a broad range of neuromuscular diseases. It is capable of differentiating myopathies or dystrophies from neurogenic atrophies and floppy infants with "central" hypotonia from those with neuromuscular diseases. PMID- 3280998 TI - A computer protocol to predict myocardial infarction in emergency department patients with chest pain. AB - To achieve more appropriate triage to the coronary care unit of patients presenting with acute chest pain, we used clinical data on 1379 patients at two hospitals to construct a simple computer protocol to predict the presence of myocardial infarction. When we tested this protocol prospectively in 4770 patients at two university hospitals and four community hospitals, the computer derived protocol had a significantly higher specificity (74 vs. 71 percent) in predicting the absence of infarction than physicians deciding whether to admit patients to the coronary care unit, and it had a similar sensitivity in detecting the presence of infarction (88.0 vs. 87.8 percent). Decisions based solely on the computer protocol would have reduced the admission of patients without infarction to the coronary care unit by 11.5 percent without adversely affecting the admission of patients in whom emergent complications developed that required intensive care. Although this protocol should not be used to override careful clinical judgment in individual cases, the computer protocol for the most part yields accurate estimates of the probability of myocardial infarction. Decisions about admission to the coronary care unit based on the protocol would have been as effective as those actually made by the unaided physicians who cared for the patients, and less costly. Whether physicians who are aided by the protocol perform better than unaided physicians cannot be determined without further study. PMID- 3280999 TI - The effects of physical therapy on cerebral palsy. A controlled trial in infants with spastic diplegia. AB - Legislatively mandated programs for early intervention on behalf of handicapped infants often stipulate the inclusion of physical therapy as a major component of treatment for cerebral palsy. To evaluate the effects of physical therapy, we randomly assigned 48 infants (12 to 19 months of age) with mild to severe spastic diplegia to receive either 12 months of physical therapy (Group A) or 6 months of physical therapy preceded by 6 months of infant stimulation (Group B). The infant stimulation program included motor, sensory, language, and cognitive activities of increasing complexity. Masked outcome assessment was performed after both 6 and 12 months of therapy to evaluate motor quotient, motor ability, and mental quotient. After six months, the infants in Group A had a lower mean motor quotient than those in Group B (49.1 vs. 58.1, P = 0.02) and were less likely to walk (12 vs. 35 percent, P = 0.07). These differences persisted after 12 months of therapy (47.9 vs. 63.3, P less than 0.01, and 36 vs. 73 percent, P = 0.01, respectively). We noted no significant differences between the groups in the incidence of contractures or the need for bracing or orthopedic surgery. Group A also had a lower mean mental quotient than Group B after six months of therapy (65.6 vs. 75.5, P = 0.05). The routine use of physical therapy in infants with spastic diplegia offered no short-term advantage over infant stimulation. Because of the limited scope of the trial, our conclusions favoring infant stimulation are preliminary. The results suggest that further study of the effects of both physical therapy and infant stimulation is indicated. PMID- 3281000 TI - Insulin resistance and hyperinsulinemia in patients with thalassemia major treated by hypertransfusion. AB - Diabetes mellitus in patients receiving hypertransfusion for thalassemia major is usually attributed to damage to beta cells. To determine whether iron overload leads to insulin resistance before the development of insulin deficiency, insulin was infused (by euglycemic insulin-clamp technique) into 12 children with thalassemia (4 of whom were prepubertal, and 8 pubertal) who had normal or only moderately impaired glucose tolerance and who were receiving chelation therapy. Although insulin-stimulated glucose metabolism in the prepubertal children with thalassemia was similar to that in controls (normal prepubertal children) (319 +/ 23 vs. 314 +/- 41 mg per square meter of body-surface area per minute, P not significant), the response to insulin was markedly impaired in the pubertal children with thalassemia (155 +/- 18 vs. 224 +/- 15 mg per square meter per minute in normal pubertal controls, P less than 0.01). Plasma insulin levels rose excessively after oral glucose administration in the pubertal subjects with thalassemia, but not in the prepubertal patients (P less than 0.001). Furthermore, in response to a standard hyperglycemic stimulus, insulin levels in the pubertal patients rose to two to three times greater than normal and C peptide levels became significantly elevated. Our data suggest that insulin resistance and increased insulin secretion develop in older children with thalassemia treated with long-term hypertransfusion therapy before the development of diabetes. PMID- 3281001 TI - Prophylactic sclerotherapy of large esophageal varices. AB - We randomly assigned 95 patients with large esophageal varices (Grade 3 or 4) who had not previously had upper gastrointestinal tract bleeding to two groups: 49 received intravariceal sclerotherapy, and 46 were followed as controls. Over a mean follow-up of 13 months there was no difference between the sclerotherapy group and the control group in mortality (24.4 percent) or any significant difference in average hospital stay per month (3.0 vs. 2.6 days). Sclerotherapy was associated with significantly more episodes of upper gastrointestinal bleeding (26 vs. 10 episodes, P less than 0.05); 75 percent of deaths in the sclerotherapy group were related to bleeding, as compared with 18 percent in the control group. An additional 54 patients with cirrhosis who did not qualify for the study were also followed--20 with small varices and 34 with none. Mortality was 20 and 15 percent, respectively; no deaths were due to bleeding. We conclude that prophylactic sclerotherapy does not provide clinical benefit to patients with large esophageal varices. PMID- 3281002 TI - Local and systemic factors in the pathogenesis of osteoporosis. PMID- 3281003 TI - A new era in reproductive technology. In vitro fertilization, gamete intrafallopian transfer, and donated gametes and embryos. PMID- 3281004 TI - Creutzfeldt-Jakob disease in histopathology technicians. PMID- 3281005 TI - Effects of prostacyclin on oxygen delivery and uptake in critically ill patients. PMID- 3281006 TI - Splenic function, malaria, and history. PMID- 3281008 TI - Hematopoietic growth factors: biologic complexity and clinical promise. PMID- 3281007 TI - Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation. AB - Recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF) has been reported to increase the leukocyte count in subhuman primates subjected to total-body irradiation and in patients with the acquired immunodeficiency syndrome. We administered this substance to 19 patients with breast cancer or melanoma treated with high-dose combination chemotherapy and autologous bone marrow support. Groups of three or four patients were treated with 2.0, 4.0, 8.0, 16.0, or 32.0 micrograms per kilogram of body weight per day of glycosylated rHuGM-CSF by continuous intravenous infusion for 14 days, beginning three hours after bone marrow infusion. Total leukocyte and granulocyte recovery was accelerated in these patients as compared with 24 historical controls matched for age, diagnosis, and treatment. Leukocyte counts (mean +/- SD) obtained 14 days after transplantation were 1511 +/- 1003 per microliter in patients given 2 to 8 micrograms per kilogram per day, 2575 +/- 2304 in those given 16 micrograms, and 3120 +/- 1744 in those given 32 micrograms, as compared with 863 +/- 645 per microliter in the controls. No consistent effect on platelet counts was noted. Toxic effects were generally mild and not clearly dose-related in patients given 2 to 16 micrograms per kilogram per day. Edema, weight gain, or myalgias occurred in all patients given 32 micrograms per kilogram; marked weight gain, generalized edema, pleural effusions, and hypotension developed in two patients, one of whom also had acute renal failure. Our results indicate that rHuGM-CSF can accelerate myeloid recovery after high-dose chemotherapy and autologous bone marrow transplantation, over a range of doses that can be tolerated. In this setting the ability to increase the dose is limited by the development of myalgias and fluid retention. PMID- 3281009 TI - Knee injuries in sports. AB - Many knee injuries that previously caused disability can now be diagnosed accurately and treated successfully. Arthroscopy has been instrumental in this progress. The anterior cruciate ligament, which is an important stabilizer of the knee, is commonly injured. Disruption of the restraint provided by the ligament results in an unstable knee that can give way during pivoting motions. Early reconstruction is usually effective in restoring stability and improving function. Considerable progress has been made in knee bracing. However, prophylactic bracing has not been demonstrated to be effective in preventing knee injuries. PMID- 3281010 TI - Proto-oncogene activation in lung cancer. PMID- 3281011 TI - Autoantibodies to glutamic acid decarboxylase in a patient with stiff-man syndrome, epilepsy, and type I diabetes mellitus. AB - Stiff-man syndrome is a rare disorder of the central nervous system consisting of progressive, fluctuating muscle rigidity with painful spasms. It is occasionally associated with endocrine disorders, including insulin-dependent diabetes, and with epilepsy. We investigated the possible existence of autoimmunity against the nervous system in a patient with stiff-man syndrome associated with epilepsy and Type I diabetes mellitus. Levels of IgG, which had an oligoclonal pattern, were elevated in the cerebrospinal fluid. The serum and the cerebrospinal fluid produced an identical, intense staining of all gray-matter regions when used to stain brain sections according to an indirect light-microscopical immunocytochemical procedure. The staining patterns were identical to those produced by antibodies to glutamic acid decarboxylase (the enzyme responsible for the synthesis of gamma-aminobutyric acid). A band comigrating with glutamic acid decarboxylase in sodium dodecyl sulfate-polyacrylamide gels appeared to be the only nervous-tissue antigen recognized by cerebrospinal fluid antibodies, and the predominant antigen recognized by serum antibodies. These findings support the idea that an impairment of neuronal pathways that operate through gamma aminobutyric acid is involved in the pathogenesis of stiff-man syndrome, and they raise the possibility of an autoimmune pathogenesis. PMID- 3281012 TI - Myocardial ischemia--silent or symptomatic. PMID- 3281013 TI - Ultrasonography and appendicitis. PMID- 3281014 TI - A randomized controlled trial of hospital discharge three days after myocardial infarction in the era of reperfusion. AB - To evaluate the feasibility and cost savings of hospital discharge three days after acute myocardial infarction, we screened 507 consecutive patients prospectively for clinical complications and exercise-test performance. Of 179 patients whose condition was classified as uncomplicated (no angina, heart failure, or arrhythmia 72 hours after admission), 126 underwent early exercise testing and 90 had no provocable myocardial ischemia. Eighty of these patients were randomly assigned to early (day 3) or conventional (days 7 to 10) hospital discharge. Seventy-six of them had received coronary reperfusion therapy (thrombolysis, angioplasty, or both). At six months of follow-up, there were no deaths or new ventricular aneurysms, and the early-discharge and conventional discharge groups had similar numbers of hospital readmissions (6 and 10), reinfarctions (none and 5), and patients with angina (3 and 8). In the early discharge group, 25 of 29 previously employed patients returned to work 40.7 +/- 21.9 days (mean +/- SD) after admission, as compared with 25 of 27 patients in the conventional-discharge group, who returned to work after a mean of 56.9 +/- 30.3 days (P = 0.054). The mean cumulative hospital and professional charges were $12,546 +/- 3,034 in the early-discharge group, as compared with $17,868 +/- 3,688 in the conventional-discharge group (P less than 0.0001). In carefully selected patients with uncomplicated myocardial infarction, hospital discharge after three days is feasible and leads to a substantial reduction in hospital charges. Before this strategy can be widely recommended, however, its safety must be confirmed in larger prospective clinical trials. PMID- 3281015 TI - High incidence of poor sulfoxidation in patients with primary biliary cirrhosis. AB - An impaired sulfoxidation pathway has been implicated in the pathogenesis of chlorpromazine-induced hepatotoxicity. Since some patients with chronic chlorpromazine-induced cholestasis may have features of primary biliary cirrhosis, we studied the ability to sulfoxidate the amino acid analogue S carboxymethyl-cysteine in 44 patients with primary biliary cirrhosis and in two control groups--one without liver disease and one with a variety of liver diseases other than primary biliary cirrhosis. Poor sulfoxidation was observed in 84 percent of the patients with primary biliary cirrhosis, as compared with 24 percent of patients with other liver diseases and 22 percent of normal controls (P less than 0.0005 for both comparisons). Poor sulfoxidation did not correlate with the degree of hyperbilirubinemia or histologic severity of liver disease in any of the groups studied. There was an inverse correlation with age only in the patients with primary biliary cirrhosis (r = -0.44, P less than 0.001). Liver transplantation was performed in six of the patients and improved sulfoxidation in five; in the four with primary biliary cirrhosis, sulfoxidation improved from poor to good or intermediate. We conclude that poor sulfoxidation is closely associated with primary biliary cirrhosis but not with the other liver diseases we studied. PMID- 3281016 TI - Modification of risk factors for coronary heart disease. Five-year results of a school-based intervention trial. AB - We conducted a study of the effectiveness of an educational intervention designed to modify risk factors associated with coronary heart disease among 3388 children in 37 schools in two demographically dissimilar areas (the Bronx and Westchester County) in and around New York City. Schools within each area were randomly assigned to either intervention or nonintervention groups. In schools targeted for intervention, children in the fourth through eighth grades were taught a teacher-delivered curriculum focusing on diet, physical activity, and cigarette smoking. Risk-factor levels were measured in all schools at base line and at four follow-up points. A total of 1769 of the children qualified for analysis of the intervention effect. After five years, the net mean change in plasma levels of total cholesterol was -1.7 mg per deciliter per year (-0.04 mmol per liter) (95 percent confidence interval, -2.7 to -0.7 mg per deciliter [-0.07 to -0.02 mmol per liter]) in the Westchester County schools, or -8.5 mg per deciliter (-0.22 mmol per liter) (5.1 percent) over a period of five years. In the schools in the Bronx, the net mean change was -1.0 mg per deciliter per year (-0.03 mmol per liter) (95 percent confidence interval, -2.3 to +0.3 mg per deciliter [-0.06 to +0.01 mmol per -2.3 to +0.3 mg per deciliter [-0.06 to +0.01 mmol per liter]), or -5.0 mg per deciliter (-0.13 mmol per liter) (2.9 percent) over a period of five years. Favorable trends in dietary intake and health knowledge were also observed, whereas the other targeted risk factors were not significantly altered. If these findings can be replicated, this will suggest that educational programs to modify coronary risk factors are feasible and may have a favorable (albeit small) effect on blood levels of cholesterol in children. PMID- 3281017 TI - Shorter hospital stay for myocardial infarction. PMID- 3281018 TI - Diagnosis of rejection of lung allografts. PMID- 3281019 TI - Food additives and plant components control growth and aflatoxin production by toxigenic aspergilli: a review. AB - Growth and aflatoxin production by toxigenic aspergilli are partially or completely inhibited by the undissociated form of acetic, benzoic, citric, lactic, propionic and sorbic acids. Salts such as sodium chloride, potassium chloride and sodium nitrate, at low concentrations, can enhance aflatoxin production. At higher concentrations they become inhibitory, but marked inhibition requires amounts of the salts greater than are commonly used in foods. Phenolic antioxidants, sometimes added to foods to prevent oxidative deterioration, also are inhibitory to toxigenic aspergilli. Other inhibitory agents include certain insecticides, methylxanthines (caffeine and theophyllin), and components of some herbs, spices and other plants. PMID- 3281021 TI - Archaeology. Triple Czech burial. PMID- 3281020 TI - Development of amphotericin B liposomes bearing antibody specific to Candida albicans. AB - Liposomes expressing external antibody specific for Candida albicans and encapsulating amphotericin B were developed and characterized in this study. Antibody was first modified by the covalent attachment of palmitic acid residues. Liposomes were produced by reverse-phase evaporation and modified antibody was incorporated into these liposomes via the hydrophobic interaction between the palmitic acid and the phospholipids composing the liposomes. The liposomes were characterized as to the amount of amphotericin B by spectroscopy and for the presence of antibody by protein analysis and secondary immunolabeling by fluorescent and electron microscopic methods. Immunogold labeling showed that the antibody was being expressed externally on the liposomes in the electron microscopic studies and the specificity of these liposomes for C. albicans was observed by secondary immunofluorescence. PMID- 3281022 TI - Szent-Gyorgyi and vitamin C. PMID- 3281023 TI - Vascular biology. Put out to contract. PMID- 3281024 TI - Charles Glen King (1896-1988) PMID- 3281025 TI - Induction of the proteolytic activity of a membrane protein in Plasmodium falciparum by phosphatidyl inositol-specific phospholipase C. AB - Membrane anchoring of proteins by a covalently attached glycosyl phosphatidylinositol moiety has been reported in many different eukaryotic cells including parasite protozoa. The diversity of proteins in which this phospholipid attachment is found suggests that it is functionally important and perhaps also functionally pleiotropic. Studies on the Thy-1 antigen of murine lymphocytes indicate that it can facilitate the lateral mobility of membrane proteins. It can also permit the rapid and specific release of the anchored proteins from the membrane following cleavage by a phosphatidylinositol-specific phospholipase C (PI-PLC). Here we show that this type of anchoring may be involved in the regulation of an enzymatic activity. PI-PLC releases a Plasmodium falciparum membrane protein of relative molecular mass (Mr) 76K (p76) from intact merozoites or isolated schizont membranes and induces a proteolytic activity associated with its soluble form. Endogenous activation of the proteolytic activity of p76 appears to occur at the end of the schizogony and could initiate a cascade of biochemical events associated with merozoite maturation. PMID- 3281026 TI - Quantitative infectivity assay for HIV-1 and-2. PMID- 3281027 TI - Plasma and tumor concentrations of cisplatin following intraperitoneal infusion or bolus injection with or without continuous low-dose-rate irradiation. AB - Our purpose of this study was to determine whether whole-body, continuous low dose-rate irradiation (CLDRI) alters the plasma and/or tumor platinum pharmacokinetics after ip bolus injection or ip infusion as a possible mechanism of interaction between CLDRI and cisplatin. The C3Hf/Sed mice bearing SCCVII/SF tumors were given 6 mg cisplatin/kg ip by bolus injection or an ip infusion of 0.25 mg cisplatin.kg-1.hour-1 for 48 hours with and without CLDRI at 0.56 Gy/hr for 24 or 48 hours. Plasma and tumor platinum concentrations were determined with an atomic absorption spectrophotometer at appropriate intervals during infusion and up to 48 hours after drug administration. Both total and ultrafilterable plasma platinum followed a biphasic elimination after ip bolus injection, whereas only a prolonged single-phase elimination was seen after ip infusion. Tumor uptake of platinum appeared to follow a passive diffusion pattern with a prolonged cellular retention of platinum. Whole-body CLDRI had no apparent effect on the pharmacokinetics of plasma and tumor platinum administered by ip bolus injection or prolonged continuous infusion. PMID- 3281028 TI - Platinum levels in murine tumor following intraperitoneal administration of cisplatin or paraplatin. AB - To design protocols for exploitation of the potential for interaction among the platinum (Pt) chemotherapeutic agents cisplatin and paraplatin and radiation therapy, we measured levels of total platinum in a transplantable murine mammary adenocarcinoma (MTG-B) at different times after ip injection of platinum drugs and in various regimens. Cisplatin (20 mg/kg body weight) or paraplatin (60 or 120 mg/kg body weight) were injected ip in female C3H/HeJ mice bearing MTG-B of about 1 cm diameter. At various times after injection, tumors were removed and processed for acid digestion and total platinum analysis by atomic absorption spectrometry with a graphite furnace. The results of these experiments indicate that intratumoral Pt levels 15 minutes postinjection are higher than at 5 or 30 minutes. At 30 minutes, the Pt concentrations are of the magnitudes of 30 and 50 microM for cisplatin and paraplatin, respectively, that, when added to cells in vitro in combination with radiation therapy, produce the potentiation of cell killing. In addition, for paraplatin, intratumoral Pt levels at 30 minutes following an ip injection are approximately doubled if the tumors receive localized radiotherapy of 20 Gy immediately prior to injection of the drug. This apparent modification of paraplatin pharmacokinetics by radiotherapy might account for some of the supra-additive therapeutic potentiation in MTG-B reported for paraplatin added after irradiation. PMID- 3281029 TI - Combined modality treatment for primary tumor. AB - The combination of radiotherapy and chemotherapy is aimed at improving local control and eradicating distant metastases by using cytostatic drugs as radiosensitizing or independent cell-killing agents. This approach has been successful in some areas but has failed in a large number of trials. The failure can be attributed to biologic and clinical factors; the low drug uptake in the tumor is one of the most limiting factors. New approaches should therefore include the improvement of drug targeting and the use of predictive assays; these efforts should proceed with the performance of pharmacokinetic studies and experiments testing the effects of combined treatment on tumors and normal tissues. Pharmacokinetic studies should include measurement of the intracellular drug uptake, preferably at the target. This is now possible for cisplatin; DNA adducts induced by this drug can now be measured with an immunocytochemical technique. The experimental animal studies should include testing of the effects of fractionated irradiation with drugs on tumors and on early- and late responding normal tissues. PMID- 3281030 TI - An organized multi-institutional interdisciplinary evaluation of role of radiation therapy alone or combined with chemotherapy in treatment of adenocarcinoma of the gastrointestinal tract. AB - Adenocarcinomas of the gastrointestinal tract have generally been considered to be radioresistant. In 1974-1975, following an early lead from the Mayo Clinic (Rochester, MN), the Gastrointestinal Tumor Study Group initiated a series of clinical trials of radiation therapy and chemotherapy as surgical adjuvant programs for patients with pancreatic and rectal cancer and for the treatment of locally unresectable gastric and pancreatic adenocarcinomas. The first protocols for pancreatic cancer included a controlled trial of radiation therapy and chemotherapy following pancreatoduodenectomy or total pancreatectomy and also a randomized trial of high-dose radiation therapy, with or without chemotherapy, compared to a lower dose of radiation therapy combined with chemotherapy for patients with locally unresectable tumors. In the treatment of locally incurable gastric cancer, radiation therapy plus chemotherapy was compared to chemotherapy alone, while the rectal trial was a randomized comparison of radiation therapy; chemotherapy; the combination of radiation therapy and chemotherapy; and no further treatment following surgical extirpation. In all cases, the agent used during the course of radiation was 5-fluorouracil. Subsequent trials in pancreatic cancer compared radiation combined with either 5-fluorouracil or doxorubicin and included a pilot study of hyperfractionated radiation therapy combined with 5-fluorouracil. Confirmatory trials were undertaken and are still under analysis in gastric cancer and in rectal cancer. A follow-up trial in pancreatic cancer was developed to establish the importance of the radiation therapy component of combined modality therapy in the treatment of patients with locally unresectable disease. A final study examined the potential for radiation therapy of the liver and systemic chemotherapy in the prevention of metastatic adenocarcinoma of the colon.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281031 TI - Combined modality approach to treatment of malignant gliomas--re-evaluation of RTOG 7401/ECOG 1374 with long-term follow-up: a joint study of the Radiation Therapy Oncology Group and the Eastern Cooperative Oncology Group. AB - The Radiation Therapy Oncology Group (RTOG) and the Eastern Cooperative Oncology Group (ECOG) conducted a phase III trial in patients with malignant gliomas to evaluate 4 treatment arms: 1) 60 Gy to the whole brain; 2) 60 Gy plus 10-Gy boost; 3) 60 Gy plus carmustine (BCNU); and 4) 60 Gy plus semustine plus dacarbazine. Between September 1974 and March 1979, 626 patients with malignant gliomas were treated on protocol RTOG 7401/ECOG 1374. Each institution chose a subset of the treatments to which the patients would be randomized. Patients were stratified according to subset and randomized to the 4 treatment arms. There were no differences in survival among treatment arms. For patients greater than 60 years of age, the addition of chemotherapy to radiation therapy did not improve survival. For patients aged 40-60 years, there was a statistically significant increase in overall survival when BCNU was added to 60 Gy (P less than .01), with an increase in 2-year survival from 8% to 23%. This beneficial effect of BCNU is apparent in both histological groups (astrocytoma with atypical or anaplastic foci and glioblastoma multiforme). Although few confirmatory autopsies are available, long-term survival in patients with astrocytomas with atypical and anaplastic foci who were treated with 60 Gy plus BCNU (5-yr survival, 22%) suggests no significant late CNS toxicity, compared to 60 Gy alone (5-yr survival, 15%). This is confirmed by comparable neurological function in long term survivors. PMID- 3281032 TI - Effect of total-body irradiation with bone marrow transplantation on toxicity of cisplatin. AB - In defined-flora, barrier-maintained rats (WAG/RijMCW males), radiation nephritis is the principal late toxicity seen after high-dose-rate, total-body irradiation (TBI) when hematologic toxicity is prevented by bone marrow transplantation. Pneumonitis develops only if rats are exposed to a conventional environment during and after bone marrow transplantation. Low-dose-rate TBI gives similar toxicity at doses twice as large. Rats surviving for 9 months after TBI show decreased tolerance for cisplatin. This decreased tolerance is related to dose and dose rate and is seen for radiation doses that show little or no renal toxicity. Evidence suggests that the decrease in renal tolerance is due to decreased renal platinum clearance in the irradiated kidneys. PMID- 3281034 TI - George J. Baylin, M.D. A tribute. PMID- 3281033 TI - DNA damage and repair in patients receiving high-dose cyclophosphamide and radiation. AB - DNA damage and repair were assessed by alkaline sucrose gradients in the nonstimulated circulating mononuclear cells of 7 patients receiving high-dose cyclophosphamide (HDCy) and fractionated whole-body irradiation. Measurable damage produced by HDCy appeared to be repaired in about 60 hours. Damage from a radiation dose of 2 Gy was not completely repaired within 24 hours because DNA molecular weight was found to be decreased by an average of 22%. We attempted to assess the impact of HDCy on radiation damage repair by comparing blood irradiated and incubated in vitro before therapy with in vivo incubation following HDCy administration. Two hours after a radiation dose, repair appeared increased following HDCy. These results suggest the possibility that significant interaction at the DNA level may occur when HDCy and irradiation are administered together. PMID- 3281035 TI - Considered approaches to physician payment in the '90s. PMID- 3281036 TI - [Resistance to genetic counseling]. PMID- 3281037 TI - [Agenesis of the corpus callosum in newborn infants diagnosed by echography via the fontanelle]. PMID- 3281038 TI - Who pays? PMID- 3281039 TI - Evolution of the sex offender statutes in the State of Nebraska. PMID- 3281040 TI - [Landry-Guillain-Barre polyradiculitis]. PMID- 3281041 TI - [Risks and complications of manual therapy of the spine from the neuropathologic viewpoint]. PMID- 3281042 TI - [Knowledge about Meige syndrome]. PMID- 3281043 TI - Fibronectin and the kidney. PMID- 3281045 TI - Acute renal failure due to focal necrotizing glomerulonephritis in a patient with non-Hodgkin's lymphoma. Resolution with treatment of lymphoma. AB - Renal disease in association with lymphoma is more prevalent than generally recognized. Glomerulonephritis may occur as a paraneoplastic phenomenon. We report a patient who presented with acute renal failure due to focal necrotizing glomerulonephritis in association with non-Hodgkin's lymphoma in whom the acute renal failure and glomerulonephritis resolved on clinical, biochemical and histological grounds with treatment of the lymphoma. Focal necrotizing glomerulonephritis is extremely uncommon in association with lymphoma and, to our knowledge, this association with follow-up and histological resolution of glomerulonephritis has not previously been reported. PMID- 3281044 TI - Parameters of the kallikrein-kinin, coagulation and fibrinolytic systems as early indicators of kidney transplant rejection. AB - In order to find early indicators of kidney transplant rejection before clinical symptoms were noticed, parameters of the coagulation, fibrinolytic and kallikrein kinin systems were measured. Nineteen patients were followed before and daily after kidney transplantation during the first week and every second day in the following weeks. All patients received immunosuppressive therapy with cyclosporin and corticoids. Ten patients suffered from transplant rejection. The first rejection occurred on the 7th day after transplantation. Of all the parameters measured, kallikrein inhibition, beta-FXIIa inhibition, plasminogen and antithrombin III were early indicators of kidney transplant rejections. A rise in these parameters could be demonstrated 2-3 days before clinical signs were noticed. In the other 9 patients no significant rises in antithrombin III, plasminogen, kallikrein inhibition and beta-FXIIa inhibition could be found. PMID- 3281046 TI - High prevalence of microproteinuria, an early index of renal impairment, in patients with diffuse psoriasis. AB - Heavy reversible proteinuria induced by antihypertensive treatment with low doses of captopril has recently been reported by our group in psoriatic patients. To ascertain whether an increased permeability of the glomerular basal membrane of psoriatics can lead to an enhanced urinary excretion of albumin independently from the presence or absence of coexisting diabetes or hypertension, the latter parameter was measured in 39 patients affected by diffuse psoriasis. A high prevalence of microalbuminuria was observed in diabetic and hypertensive psoriatics. Moreover, a direct correlation was found between the diastolic blood pressure (BP) values and the urinary excretion of albumin in the entire group of psoriatics, thus suggesting systemic hypertension as one of the factors responsible for proteinuria in these patients. However, more than 50% of normotensive psoriatics showed an enhanced excretion of albumin. Since microalbuminuria has been indicated as a reliable index to predict the development of renal impairment, the finding of an enhanced albumin loss in psoriatics represents a further risk factor in these patients, who are particularly susceptible to experience cardiovascular complications. PMID- 3281048 TI - Non-typhoid salmonellosis in renal transplant patients. Report of a case with colonization of a vascular prosthesis. PMID- 3281047 TI - Atypical membranous glomerulonephritis with fibrillar subepithelial deposits in a patient with malignant lymphoma. AB - A 61-year-old male treated for a malignant lymphoma developed a nephrotic syndrome. Renal biopsy revealed an atypical form of membranous glomerulonephritis whereby the epimembranous deposits were of fibrillar configuration. Immunoglobulin, kappa light chains and complement were demonstrated in a granular pattern. It is suggested that the fibrillar deposits represent an abnormal structural configuration of immune complex deposits. PMID- 3281049 TI - Hyporeninemic hypoaldosteronism presenting with hypokalemia. PMID- 3281050 TI - Clinical and histological sequence of recurrent focal segmental glomerulosclerosis. PMID- 3281051 TI - Thrombocytosis and a renal abscess. PMID- 3281052 TI - Antegrade pyelography in renal allografts. PMID- 3281053 TI - The influence of helium pressure on the reduction induced in field potentials by various amino acids and on the GABA-mediated inhibition in the CA1 region of hippocampal slices in the rat. AB - In a previous study, it was shown that helium pressure depressed excitatory synaptic transmission mediated by the Schaffer-commissural afferents and increased the intrinsic excitability of pyramidal cells, in the CA1 region of hippocampal slices in the rat. In the present study, the neurochemical bases of these changes was investigated. Various excitatory amino acids were studied under normal and up to 80 atm of helium. At normal pressure, the amino acids tested induced a decrease in the field excitatory postsynaptic potential (EPSP) and antidromic field potential of CA1 pyramidal cells. These changes probably resulted from the well known depolarizing effect of the compounds. Quisqualate is supposed to activate the synaptic receptors of the pathway tested. Since the effect of this amino acid and other agonists were not significantly affected by helium pressure, it is suggested that the depressed hippocampal synaptic potentials under pressure did not result from reduced sensitivity of synaptic receptors. On the other hand, helium pressure enhanced the action of N-methyl-D aspartate (NMDA) and depressed the GABA-mediated inhibition of CA1 pyramidal cells. Given that the excitability of these neurones is modulated by NMDA-related events and GABA inhibition, these results indicate that both neurochemical systems were probably involved in the helium pressure-induced hyperexcitability of the cells studied. PMID- 3281054 TI - Traumatic intracranial aneurysms in childhood: two cases and a review of the literature. AB - Traumatic intracranial aneurysms in childhood are rare. To date, 67 well documented cases in children have been reported. We present 2 additional cases and review the literature. Traumatic aneurysms can best be categorized based on mechanism of injury and location. Aneurysms secondary to penetrating trauma occur most commonly in teenage boys suffering gunshot wounds. Aneurysms secondary to nonpenetrating trauma occur at the skull base or in the periphery, with motor vehicle accidents and falls as the most common modes of injury. Skull base traumatic aneurysms most commonly involve the petrous, cavernous, or supraclinoid carotid artery and also show a predominance in teenage boys. Peripheral traumatic aneurysms can further be divided into distal anterior cerebral artery aneurysms secondary to trauma against the falcine edge and distal cortical artery aneurysms associated with an overlying skull fracture. Peripheral traumatic aneurysms tend to occur in younger patients with a less marked male predominance. Two-thirds of the patients suffered symptomatic aneurysmal hemorrhage, with an associated mortality rate of 31%. The clinical presentation, diagnosis, and treatment of traumatic intracranial aneurysms are discussed. PMID- 3281055 TI - Stereotactic aspiration of putaminal hemorrhage using a double track aspiration technique. AB - Double track aspiration was used to remove the hematoma between 6 and 24 hours from onset in nine cases of putaminal hemorrhage. This technique was used in cases where an approach along the long axis of the hematoma was not feasible. With this method, aspiration is done at two target points lying anterior and posterior of the somewhat harder central region, at which aspiration is not attempted. This technique allows aspiration of most of the serum components, which are depicted as low density areas in computed tomographic (CT) scans, and some 53 to 85% of the main mass of the hematoma, which is seen on CT as high density areas. There was no rebleeding among these nine patients, and the remaining hematoma in all cases was located between two target points--a fact that is thought to indicate that the central portion of the hematoma is in fact somewhat harder than the peripheral portions. Although the double track aspiration technique has the disadvantage of producing two tracks, it is thought to be an effective method in such cases because it allows safe and thorough hematoma aspiration. PMID- 3281056 TI - The role of anticoagulation in cavernous sinus thrombosis. AB - Prior to the antibiotic (AB) era, cavernous sinus thrombosis (CST) was almost uniformly fatal. AB therapy has significantly reduced mortality, but additional treatment with anticoagulants (AC) has remained controversial. We reviewed our experience with seven cases, as well as the literature since Lyons' 1941 introduction of AC treatment, to determine effectiveness, complications, and morbidity among survivors. We divided the cases into (1) those treated with AB alone, and (2) those treated with a combination of AB and AC. We found no conclusive evidence for reduction of mortality when AC was used in combination with AB. However, early AC therapy reduced morbidity (blindness, stroke, ophthalmoplegia, hypopituitarism, focal seizures, and vascular steal syndrome), whereas delayed or inadequate use provided no apparent benefit above AB therapy alone. Complications of AC therapy were rare; cerebral venous thrombosis occurred frequently, but in association with dural sinus thrombosis as a direct result of the disease. We conclude that AC therapy is indicated early in the treatment of CST to reduce morbidity among survivors. PMID- 3281057 TI - No response to high-dose muscarinic agonist therapy in Alzheimer's disease. AB - Cholinergic deficiency is the most consistent transmitter system abnormality in Alzheimer's disease. To test the acute therapeutic efficacy of cholinergic replacement, seven patients with presenile onset of Alzheimer's type dementia received maximum tolerated doses (10 mg/d) of the selective muscarinic agonist, RS-86, in combination with a peripherally active anticholinergic glycopyrrolate (6 mg/d), in a double-blind placebo-controlled design. No consistent, clinically significant cognitive improvement could be discerned in these mild to moderately demented patients, despite attainment of central RS-86 levels approximating those that affect behavior in the experimental animal. Muscarinic agonist monotherapy may thus be inadequate to benefit Alzheimer's type dementia. PMID- 3281059 TI - Richard Bright, pioneer epileptologist. PMID- 3281058 TI - Effect of chronic treatment with the calcium antagonist diltiazem in Duchenne muscular dystrophy. AB - We conducted a double-blind trial with the calcium antagonist, diltiazem (8 mg/kg/d), for 24 to 32 months in 22 boys with Duchenne muscular dystrophy, who were paired by functional activity and age. No adverse clinical or ECG effects of diltiazem were detected. In eight matched pairs, completing 28 months, manual muscle testing scores fell somewhat less in the diltiazem group (from 5.5 to 4.6) than in the placebo group (from 5.3 to 4.2), although the difference between groups was not significant (p = 0.06). The 95% confidence interval for the difference in slopes of regression lines obtained from trimonthly manual muscle tests on all subjects was markedly asymmetric in favor of the diltiazem group, but this difference was also not significant. There was less deterioration of functional activity of lower extremities in the diltiazem-treated group, when beginning and end values were analyzed (p = 0.03). However, the difference in slopes of regression lines obtained from trimonthly determinations was nonsignificant. Similarly, the beginning versus end comparisons of systolic and diastolic blood pressure showed a significantly (p less than 0.05) smaller elevation of blood pressure in the diltiazem-treated group, but no difference was observed when the slopes of all values were analyzed. All other clinical and laboratory variables were unaffected by diltiazem treatment. The findings in manual muscle tests and functional activity suggest a beneficial trend with chronic diltiazem treatment in DMD. PMID- 3281060 TI - Alizapride in prevention of postoperative nausea and vomiting. AB - A series of 90 ASA class 1 or 2 young adult female out-patients, randomly assigned to four groups, were treated with placebo (saline solution), alizapride 50 mg, alizapride 100 mg or alizapride 200 mg. The incidence of postoperative nausea and vomiting has been estimated. The incidence of nausea and vomiting was lower with the alizapride-treated patients, while, contrary to the experience with other antiemetics, prolonged recovery was not observed. The incidence of vomiting in the placebo-group was twice as high as in the alizapride-groups. Of the placebo-treated patients, 20 percent requested further antiemetic medication within four hours while none of the alizapride-treated patients needed this. Alizapride 100 to 200 mg intravenously is efficacious in the prevention of postoperative nausea and vomiting. PMID- 3281061 TI - [Leukosis in HIV infections]. AB - Leukosis during HIV infection is extremely rare and up to now in Italy only 3 LLA, 1 LMA and 1 LMC have been described. Personal experience is reported and the pathogenesis of these neoplasias during AIDS and related syndromes is discussed. PMID- 3281062 TI - [Improvement of glucose tolerance in diabetics under nicardipine therapy]. AB - Present study was carried out in order to control if glucose tolerance and insulin secretion changed during nicardipine treatment in healthy or in non insulin dependent diabetics. In the 8th day of therapy with nicardipine (40 mg/day), glucose tolerance and insulin secretion were unmodified in a group of 20 non-diabetic patients. At the same time glucose tolerance was found improved in the group of 14 non-insulin dependent diabetic without a contemporary variation of insulin secretion. Such a result, note-worthy for a drug frequently administered to diabetics, could be due to inhibited glucagon secretion, or to increased glucose uptake by hepatocytes. PMID- 3281063 TI - [Steinert's myotonic dystrophy. Attempts at therapy]. AB - Myotonic dystrophy or Steinert's disease is an autosomal dominant hereditary disease affecting the entire system. Apart from the myotonic phenomenon it involves muscular atrophy, endocrine disorders, baldness, cardiac arrhythmias, hyperglycaemia, cataracts. Over the years a number of drugs have been tried with results on the myotonia that are still debated. They include quinine, corticosteroids, L-DOPA, potassium-binding resins, procainamide, phenytoin, diphenylhydantoin, N-propylajmaline, dantrolene sodium, carbamazepine, imipramine, baclofen, mexiletine. It is emphasised that only the identification of the biochemical defect involved in the disease will permit any efficient treatment of its symptoms or causes. PMID- 3281065 TI - [Liszt's last years]. PMID- 3281064 TI - [Ultrasonics of the liver (and bile ducts). The most significant experiences collected at a district hospital (clinical cases)]. AB - The undoubted advantages deriving from the use of abdominal ultrasonography both in diagnosis and medical or surgical treatment are reported. In particular ultrasonography has proved very helpful in the study of pathologies of the liver and biliary tract, especially in a Rural Hospital, where it is not possible to have recourse to more refined diagnostic techniques. PMID- 3281066 TI - Practical nursing programs accredited by the NLN 1988. PMID- 3281067 TI - Treating sleep apnea with nasal C.P.A.P. PMID- 3281068 TI - An explication of the philosophical assumptions of the Roy adaptation model. PMID- 3281069 TI - Human insulin. PMID- 3281070 TI - Efficient and effective immediate removable partial dentures. PMID- 3281071 TI - The relationship of birth weight and intrauterine diagnostic ultrasound exposure. AB - Imaging with ultrasound is common in obstetric practice. Several laboratory animal studies have shown retardation in fetal growth after experimental ultrasound exposure. This investigation was conducted to determine whether human fetuses exposed to diagnostic ultrasound (sonography) have a greater risk of growth retardation than fetuses not so exposed. This retrospective cohort study compares the birth weights of 1598 exposed and 944 unexposed single live births at the Johns Hopkins Hospital in Baltimore, Maryland during calendar year 1981. Confounding variables, defined as those associated with both exposure status and birth weight outcome, were included in multivariable analysis. Both exposure to more than one ultrasound procedure and first exposure during the third trimester were associated with a reduction in birth weight. However, the most consistent effect associated with birth weight appeared to be the indication for an ultrasound examination. The relationship of ultrasound exposure and reduced birth weight appeared to be due to shared common risk factors, which lead to both exposure and a reduction in birth weight. PMID- 3281072 TI - Routine ultrasound screening for early detection of small for gestational age fetuses. AB - A real-time ultrasound screening examination was performed in 3208 unselected singleton pregnancies at 18 and 34 weeks to detect small for gestational age (SGA) fetuses below the tenth percentile weight for age. Such cases accounted for 4.9% of this population. Biparietal diameter (BPD) was used at the first examination to confirm the true gestational age. The growth was measured at 34 weeks with a combination of BPD and transverse abdominal diameter. With a cutoff level of -1.5 standard deviations (SD), the sensitivity of a single measurement was 62.2%, the specificity was 93.2%, and the positive predictive value was 32.4%. With a cutoff level of -1 SD, the values were 76.3, 84.8, and 20.4%, respectively. The positive predictive value approached 48.7% before birth in the group that was rescanned before delivery. The simple method of a combined measurement of BPD and transverse abdominal diameter provided efficient antenatal screening for diagnosis of SGA fetuses in the general population. A somewhat low positive predictive value indicates a control examination of fetuses suspected of being SGA. Nonlinear methods, such as the measurement of abdominal circumference, appear suitable for ruling out false-positive cases. PMID- 3281073 TI - Sonography at the time of genetic amniocentesis to screen for fetal malformations. AB - Obstetric ultrasound performed in conjunction with genetic amniocentesis at 14-18 weeks' gestation identified 16 fetuses with structural malformations among 4781 examinations. The outcomes for these 16 fetuses included 12 terminations, two fetal deaths, one related death six months after birth, and one transient abnormality with no apparent significant sequelae. The ultrasound examination failed to detect at least nine other fetuses with structural malformations. The relatively small size and early stage of development of the fetuses at the time of genetic amniocentesis appears to have contributed to the failure of ultrasound to detect these malformations. A brief search for fetal malformations during obstetric ultrasound performed at early genetic amniocentesis appears productive enough to be worthwhile. However, if there is a special indication to search for fetal malformations, the ultrasound examination should probably be repeated later. PMID- 3281074 TI - Open spina bifida: does cesarean section delivery improve prognosis? AB - Records were reviewed retrospectively on 72 infants with open spina bifida followed from birth through one year of age. Thirty-two infants were born by cesarean section and 40 vaginally. The following variables were compared between the two groups: 1) mortality in the nursery and between nursery discharge and one year of age, 2) incidence of meningitis in the neonatal period, 3) length of initial hospital stay, and 4) neurologic and developmental status at one year. No significant differences were noted between the two groups. Although it has been suggested that cesarean section may improve the prognosis for infants with open spina bifida, our data do not support that conclusion. PMID- 3281075 TI - Abdominal pregnancy: current concepts of management. AB - Nine cases of early and six cases of advanced abdominal pregnancy managed at the University of Mississippi Medical Center over a 20-year period are reviewed. An incidence of one abdominal pregnancy in 4857 deliveries occurred in this series. A perinatal mortality rate of 83% and no maternal mortality were noted, in contrast to published rates of 40-95% and 0.5-18%, respectively. Important current concepts of management include difficulty in diagnosis, predisposing risk factors, suggestive signs and symptoms, the diagnostic role of ultrasound, and the appropriate surgical management of parturients with this ominous pregnancy complication. PMID- 3281076 TI - Ovarian remnant syndrome: diagnostic dilemma and surgical challenge. AB - The ovarian remnant syndrome, an unusual complication of bilateral oophorectomy, usually presents with pelvic pain with or without a mass. From 1980-1985, 31 patients were seen with this diagnosis, which was confirmed by excision of ovarian tissue. Various adhesion-producing conditions leading to retention of ovarian tissue, such as endometriosis, pelvic inflammatory disease, or inflammatory bowel disease, were present at the original procedure. The increase in diagnosis of this condition during the past five years may represent a greater awareness of the potential condition, combined with wider use of ultrasonography and computed tomography scanning. Twenty of the 31 patients were found to have a tender palpable mass of thickening. In 11 patients, a mass was found only on ultrasonography. Surgical correction required dissection and mobilization of the ureter throughout its entire pelvic course to facilitate resection of the specimen. The complications were minor, and symptoms were relieved. PMID- 3281077 TI - The efficacy of every-other-day administration of gonadotropin-releasing hormone in women with hypothalamic amenorrhea: gonadotropin-releasing hormone treatment can induce clomiphene responsiveness. AB - The efficacy of every-other-day gonadotropin-releasing hormone administration was investigated in clomiphene-human chorionic gonadotropin (hCG) resistant, anovulatory women with hypogonadotropism or normogonadotropism. One hundred micrograms of gonadotropin-releasing hormone was injected intramuscularly three times a week for four weeks (one course). Ten of 11 hypogonadotropic patients responded to clomiphene or clomiphene-hCG after one to three courses of gonadotropin-releasing hormone treatment. Once the patients were converted to clomiphene responsiveness, ovulatory response continued without additional treatment, and all four patients who desired pregnancy conceived. Among eight normogonadotropic women, four with amenorrhea of one year or less became clomiphene-hCG responders after one or two courses of gonadotropin-releasing hormone treatment. They were subsequently treated with gonadotropin-releasing hormone after every one or two ovulatory cycles. One of the four women who desired to be pregnant conceived. We conclude that intramuscular gonadotropin releasing hormone treatment is effective in inducing responsiveness to clomiphene, especially in hypogonadotropic anovulatory women. In normogonadotropic women, gonadotropin-releasing hormone treatment may be useful in those who have been amenorrheic for less than a year. PMID- 3281079 TI - Medicare costs and expenditures. PMID- 3281078 TI - Childhood sexual abuse and the consequences in adult women. AB - This paper reviews the literature on childhood sexual abuse and its implications for women. It is estimated that at least 15-38% of adults have been sexually abused as children, with figures higher for women than for men. Failure to report abuse is common, and only 20-50% of incidents may come to the attention of authorities. Although childhood sexual abuse is present in all socioeconomic groups, more severe forms of abuse appear to be associated with lower socioeconomic status. After the age of ten, a sharp increase is observed in vaginal intercourse, sexual assaults accompanied by physical violence, and abuse committed by strangers. Although fathers are frequently cited as the primary perpetrators, not all studies support this finding. Other relatives have been reported to account for 20-70% of the sexual abuse occurring within the family. A history of childhood abuse may contribute to sexual problems or multiple chronic complaints in the adult woman. Moreover, some of these women may experience depression, anxiety, and low self-esteem. The gynecologist should use empathetic questioning with all patients regarding abuse, and integrate the patient's history of abuse with current health care. Physicians who are uncomfortable with this topic or who observe ongoing distress in their patients should refer these women to a mental health practitioner who is familiar with the issues common to women who have experienced childhood sexual abuse. PMID- 3281080 TI - Reproduction technology. A guide to what's available in Ohio. PMID- 3281081 TI - Reproduction technology: cataloging the criticisms. An ethical view. PMID- 3281082 TI - Reproduction technology: cataloging the criticisms. A legal view. PMID- 3281083 TI - The indirect fluorescent antibody technique for the rapid identification of streptococcosis of rainbow trout (Salmo gairdneri). AB - The indirect fluorescent antibody technique has been used successfully for the rapid serological identification of the Streptococcus sp. responsible for streptococcosis of rainbow trout. This technique has been used to identify the Streptococcus sp. in pure cultures and smears made from experimentally infected and diseased fish. PMID- 3281084 TI - Issues in dental and surgical management of the pregnant patient. AB - The "echo boom" of the 1980s has increased the incidence of pregnancy in our patient population. When a gravid patient has an urgent or emergent problem, knowledge of the unique aspects of pregnancy is necessary for optimal patient care. Maternal health is protected by an appreciation of the physiologic changes and demands of pregnancy. Fetal well-being is protected by avoidance of teratogens, fetal anoxia, and premature labor. Attention to these factors allows the clinician to provide treatment with minimal maternal or fetal risk. PMID- 3281085 TI - Actinic prurigo of the lower lip. Review of the literature and report of five cases. AB - Actinic prurigo (AP) is a chronic, familial, photodermatitis that primarily affects American Indians. It is more prevalent in young females and may be evident clinically as a pruritic lower lip cheilitis that typically does not respond to conventional therapy. Other clinical features associated with AP include conjunctivitis, alopecia of the eyebrows, and formation of pterygia. The histologic features of AP have been described as nonspecific. We are presenting five cases of AP in which the major clinical manifestation was a pruritic, unsightly lower lip cheilitis. All of our patients were American Indians. Three patients were from the same family. The youngest patient was 10 years old and the oldest was 69 years old. All five cases were characterized histologically by numerous germinal centers within the lamina propria and a dense perivascular plasma cell infiltrate. In four of the five cases, there was a moderate to dense infiltrate of eosinophils. All five patients had been generally unresponsive to conventional therapy. With the exception of the youngest patient, all had had the disease for at least several years. One patient, now deceased, had the lower lip lesion surgically removed for cosmetic reasons. To our knowledge, this is the first report in the dental literature that describes the clinical and histologic features of AP of lower lip. PMID- 3281086 TI - [A new antithrombin III variant: antithrombin III Budapest 2]. PMID- 3281088 TI - [At the threshold of the fifth decade of a new beginning]. PMID- 3281087 TI - [Electrolyte disorders caused by drugs]. PMID- 3281089 TI - [Feedback mechanism in the regulation of gonadotropin secretion of the pituitary gland]. PMID- 3281090 TI - [The significance of varicella zoster infections today]. PMID- 3281091 TI - [Plasmapheresis in the treatment of neurologic disorders]. PMID- 3281092 TI - Constitutive c-myc expression enhances the response of murine mast cells to IL-3, but does not eliminate their requirement for growth factors. AB - An interleukin-3 (IL-3) dependent mast cell line (MC) was infected with a recombinant retrovirus expressing the proto-oncogene c-myc and the drug selectable marker neo. Cells containing the transcriptionally activated c-myc gene displayed an increased growth rate in liquid culture and a higher cloning efficiency in soft agar when compared to control virus infected cells. All infected cells remained absolutely dependent on IL-3 for growth and were not tumorigenic in nude mice. Similar results were obtained with two additional IL-3 dependent cell lines, the mast cell 32D and the pre-B-cell Ea3. Thus, while constitutive expression of c-myc potentiates the response of mast cells to IL-3, it is not sufficient to eliminate their requirement for growth factors. PMID- 3281093 TI - v-fps protein-tyrosine kinase coordinately enhances the malignancy and growth factor responsiveness of pre-neoplastic lung fibroblasts. AB - The v-fps oncoprotein was expressed in a pre-neoplastic, growth factor-dependent Chinese hamster lung fibroblast line (CCL39) to study its effect on growth controls and on the induction of malignancy. Two transfectants were characterized which expressed low (39FPS-8) or high (51FPS-6) levels of P130gag-f ps protein tyrosine kinase activity. 39FPS-8 cells still arrested in quiescence when deprived of growth factors, but developed an increased sensitivity to the mitogenic actions of epidermal growth factor (20-fold) and alpha-thrombin (50 fold), although not to insulin. In contrast, 51FPS-6 cells completely escaped growth controls, divided in serum-free medium, and were insensitive to further growth factor stimulation. Both transfectants produced rapidly growing tumors in nude mice that formed pulmonary metastases from a subcutaneous site, unlike the parental cells which are non-metastatic. 51FPS-6 cells were comparatively more efficient than 39FPS-8 cells in colonizing the lungs after intravenous inoculation. The v-fps tyrosine kinase therefore induces a partial to complete relaxation of growth factor-mediated controls on the CCL39 cell cycle, with the extent of factor independence reflecting the amount of P130gag-f ps synthesized. This reduction in growth factor requirements correlates with the capacity of v fps to confer the attributes of metastatic tumors upon preneoplastic CCL39 fibroblasts. We speculate that increased sensitivity to growth factor stimulation represents a common mechanism by which tumor cells acquire metastatic properties. PMID- 3281094 TI - A transcriptional arrest mechanism involved in controlling constitutive levels of mouse c-myb mRNA. AB - The control of c-myb mRNA abundance was examined in three representative cell lines, (the erythroleukaemia F4-12B2, the myeloma MOPC-31C and the fibroblast NIH3T3), which display abundant, low and undetectable levels of this transcript, respectively. We observed a small difference in half-life between F4-12B2 and MOPC-31C c-myb mRNA (175 min and 105 min, respectively) insufficient to account for the approximately 20-fold lower levels of this transcript in myelomas. Using the run-on transcription assay we found that c-myb transcripts were initiated at similar rates in all three cell types and were elongated at this relatively high rate to a site approximately 2 kilobases into the first intron. NIH3T3 c-myb transcripts did not proceed detectably beyond this pause/attenuation site, while in F4-12B2 cells transcription of regions 3' of this site occurred at a rate approximately 12-fold greater than in MOPC-31C. We have concluded that this transcriptional arrest mechanism, together with small differences in RNA turnover, were sufficient to account for the spectrum of c-myb mRNA abundance observed. Despite evidence of transcript initiation, we were unable to detect c myb mRNA in fibroblasts, even under conditions (e.g. serum stimulation) which induced high c-myc mRNA levels. However, a novel 3.0 kilobase transcript with homology to c-myb was detected in cycloheximide-treated NIH3T3 cells. PMID- 3281095 TI - Genetic alterations of the c-erbB-2 oncogene occur frequently in tubular adenocarcinoma of the stomach and are often accompanied by amplification of the v erbA homologue. AB - We analyzed for alterations of the c-erbB-2 oncogene in 35 human stomach cancers and 8 cell lines derived from human stomach cancer. Amplification of c-erbB-2 was found in approximately 40% (5/13) of the tubular adenocarcinomas of the stomach examined, including 4 of 10 fresh tumors and one of 3 cell lines, but not in other histological types of stomach cancer examined (0/30), including 25 fresh tumors and 5 cell lines. This result strongly suggests that amplification of c erbB-2 occurs frequently in tubular carcinomas in stomach cancer. Rearrangement of c-erbB-2 was also detected in one tubular adenocarcinoma. The rearranged fragment carried the 3' half, but not the 5' sequence, of the c-erbB-2 gene. Furthermore, one of the cellular homologues of v-erbA was amplified in 3 of 4 fresh tumors carrying the amplified c-erbB-2 gene. Both c-erbB-2 and the v-erbA homologue were expressed in all the stomach cancer cell lines tested. PMID- 3281096 TI - N-myc proto-oncogene expression can induce DNA replication in Balb/c 3T3 fibroblasts. AB - N-myc and c-myc are structurally and functionally related proto-oncogenes. C-myc expression plays an essential role towards the induction of DNA replication following mitogen stimulation of quiescent cells. We have examined whether N-myc expression can stimulate cellular DNA synthesis. When growth factor-deprived quiescent Balb/c 3T3 fibroblasts harboring a glucocorticoid-inducible N-myc gene were stimulated with dexamethasone, the resultant N-myc expression induced S phase DNA synthesis. Hence, functional homology between N-myc and c-myc extends to their joint ability to stimulate DNA replication. PMID- 3281098 TI - Does computer assisted instruction work? PMID- 3281097 TI - Alternative splicing results in a truncated N-ras protein. PMID- 3281099 TI - Intermittent catheterisation versus percutaneous suprapubic cystostomy in the early management of traumatic spinal cord lesions. AB - Spinal injury patients initially treated by intermittent catheterisation (IUC) and those who received a fine-bore suprapubic catheter (SPC) have been reviewed. The results show that fine-bore suprapubic catheterisation seems to be superior to intermittent catheterisation because the rate of urinary tract infections is significantly lower in the SPC-group (50%) than in the IUC-patients (71.9%), and the first infecting organisms in the SPC-group differ from those in the IUC-group and are much more easily treated by antibiotic therapy. PMID- 3281100 TI - Development of fatal bilateral xanthogranulomatous pyelonephritis in a paraplegic patient: case report. AB - The first case of a bilateral xanthogranulomatous pyelonephritis (XGPN) is reported in a paraplegic patient who did not practise intermittent catheterisation after discharge from the hospital but resorted to the Crede manoeuvre which predisposed to a fatal urinary tract infection and development of XGPN over a period of 5 weeks. The advantages of clean, unsterile, intermittent self catheterisation over the Crede manoeuvre in patients with a neuropathic bladder are discussed especially in preventing infective complications of the upper urinary tract which may prove life threatening as occurred in this patient. PMID- 3281101 TI - The biotin-streptavidin system in a two-site ELISA for the detection of plasmodial sporozoite antigen in mosquitoes. AB - A two-site ELISA has been designed for the detection of sporozoite antigen in mosquitoes. Biotin-labelled monoclonal antibodies against sporozoites and a streptavidin-biotin-peroxidase complex were used to visualize the antigen. Evaluation of the sensitivity and specificity of the procedure was carried out and background levels of reactivity on the basis of negative mosquitoes were calculated. The test has been deliberately kept as simple as possible for use in the tropics and was designed using Anopheles stephensi infected with in vitro cultivated Plasmodium falciparum gametocytes. A minimum of about 100-350 sporozoites could be detected in mature salivary gland infections; in addition sporozoite antigen was detected in mosquitoes several days before the entry of sporozoites into the salivary glands. No reaction was demonstrable either with bloodstage or ookinete antigens of P. falciparum, or with mosquitoes carrying sporozoites of other plasmodial species. The number of sporozoites in positive mosquitoes and the generating capacity of a single oocyst could be assessed by the use of a calibration curve based on dilution data of a known sporozoite suspension. It was found that a single oocyst can produce about 10,000 sporozoite equivalents. PMID- 3281103 TI - Childhood acute lymphoblastic leukemia. AB - Acute lymphoblastic leukemia accounts for 80% of leukemia in children. The exact cause is unknown, but some genetic, immunologic, viral, and environmental factors have been implicated. Symptoms at the time of diagnosis frequently include fever, bleeding, fatigue, and irritability. Initial white blood cell count and patient age at diagnosis are the most reliable indicators of prognosis. Acute lymphoblastic leukemia is a heterogenous disease. Lymphoblast morphology, immunologic markers, enzyme abnormalities, cytogenetic findings, and staining characteristics in conjunction with clinical characteristics allow classification into risk groups. Appropriate therapy for each risk group is based on these parameters. Combination chemotherapy administered alone or with additional chemotherapy or radiotherapy to sanctuary sites is the principal modality for treatment of ALL. Optimal therapy for relapse has not yet been determined, but for patients with appropriate donors, allogeneic bone marrow transplant is promising. Common complications of chemotherapy include tumor lysis syndrome, myelosuppression, and other problems such as gastrointestinal toxicity, neurotoxicity and cardiac toxicity. Significant late effects of chemotherapy include neurological impairment ranging from learning problems to leukoencephalopathy and a possible increased risk of second malignancy. Complete remission is achieved in 95% of children with acute lymphoblastic leukemia, and more than 55% will continue to be in complete remission at five years. Optimal CNS prophylaxis, effective treatment of relapse, and adjustment of therapy to minimize acute and late adverse effects are a continuing challenge. With improved understanding of biologic factors, and development of more specific therapy for each subgroup, children with acute lymphoblastic leukemia should enjoy a better long term outcome. PMID- 3281102 TI - Evidence for a neutrophil-mediated protective response in malaria. AB - Zymosan-activated and non-activated human polymorphonuclear neutrophils (PMN) were added to in-vitro cultures of the human malaria parasite Plasmodium falciparum in microtitre wells. Microscopic counting of parasites in Giemsa stained smears showed that at a PMN:RBC ratio of 1:150, the same as occurs in human malaria, parasites in wells with zymosan-activated neutrophils were suppressed 65%. Determination of parasite nucleic acid synthesis by 3H hypoxanthine incorporation showed that in wells with PMN:RBC ratio of 1:150 parasite viability was only 22% of control. Various oxygen scavengers were tested for ability to reverse the effects of activated neutrophils on parasite development. Superoxide dismutase (20 mg/ml) and catalase (50 mg/ml) had no effect; tryptophan protected the parasites to a moderate degree while histidine alleviated suppression of parasite development to the greatest extent. This suggests that singlet oxygen is the most effective neutrophil product in killing or suppressing the growth of parasites. We also observed that non-activated neutrophils were activated by parasites and/or their products resulting in killing of newly-released parasites. PMID- 3281104 TI - Biology and therapy of childhood acute nonlymphocytic leukemia. AB - Childhood nonlymphocytic leukemia comprises a minority (25%) of pediatric leukemia cases, yet contributes a significant proportion of overall leukemia mortality. Improvements in supportive care (antibiotics, antifungals, nutrition, and blood products) along with aggressive induction therapies have significantly improved remission induction rates over the past two decades. Ideal treatment to completely eliminate residual disease following remission is not yet known. In most series, only one out of three patients are long-term survivors of this disease. Recent advances in allogeneic bone marrow transplantation and improved techniques for autologous engraftment leave promise for significant improvements in postinduction disease control. Biologic studies of surface immunophenotype have contributed to our understanding of the heterogeneity of this family of disorders and allowed identification and characterization of leukemias of mixed myeloid/lymphoid lineage. Karyotype studies have identified important subsets of ANLL with distinctive clinical and biologic properties, for which tailored therapies someday may be developed. In addition, studies of oncogenes provide insight into regulation of leukemic hematopoiesis with potential of identifying future methods to regulate proliferation of the leukemic clone. PMID- 3281105 TI - Non-Hodgkin's lymphomas. AB - The non-Hodgkin's lymphomas are a group of diseases for which substantial progress has been made in understanding tumor biology and effectiveness of treatment during the last few years. These advances may provide insight into the development of neoplasms because of recognized association of lymphomas with viral infections and immunodeficiency. The prognosis for patients with non Hodgkin's lymphomas continues to improve. As a result, current studies on treatment of lymphomas in certain favorable stages have concentrated on reducing the intensity of therapy. For patients with advanced disease, further improvements in treatment are being sought. PMID- 3281106 TI - Hodgkin's disease. PMID- 3281107 TI - Pediatric spinal sonography. Part II: Malformations and mass lesions. AB - The most important spinal disorders in childhood are malformations and mass lesions. The sonographic appearance of the various kinds of dysraphism and their differentiation, of malformations at the cranio-cervical junction, and of mass lesions is demonstrated and illustrated. Based on our preliminary experience, spinal sonography appears to be useful as the first imaging device for the differentiation of complex malformations and as a screening method for occult dysraphism. In mass lesions spinal sonography is useful to diagnose and follow-up disease, with additional imaging procedures currently needed for confirmation of diagnosis. PMID- 3281108 TI - Ultrasonographic findings (CNS, thorax, abdomen) in infants undergoing extracorporeal oxygenation therapy. AB - Extracorporeal membrane oxygenation (ECMO) has been performed on 45 neonates at the Children's Hospital of Michigan in a 39-month period. Ultrasound evaluation of these patients prior to and during ECMO therapy has demonstrated abnormalities in the central nervous system including intracranial hemorrhage (21), extra-axial fluid collections (5), and ventricular enlargement (2). Ultrasonic evaluation of the thoracic cavity in 12 infants revealed pleural fluid in 8. There were seven children with varying types of peritoneal fluid. Two children had visceral abnormalities - 1 with liver hemorrhage and 1 with hydronephrosis found prior to ECMO. Most of these findings could not have been diagnosed without ultrasound and may lead directly to alterations in clinical management. Ultrasound is an extension of physical examination which is important in hour-by-hour clinical care of patients on ECMO. PMID- 3281109 TI - Pulmonary fungal infections after bone marrow transplantation. AB - Of 319 pediatric patients treated with bone marrow transplantation (BMT) during a 10-year period, 27 developed pulmonary fungal infections (PFI). Only 2 patients (7%) survived. Twenty-three patients (85%) had been treated with systemic antifungal therapy immediately before or at the time of diagnosis. Nineteen patients (70%) were neutropenic, and 4 of the 8 patients who were not neutropenic were being treated with systemic steroids for graft vs. host disease (GVHD). Seven patients (26%) died within 7 days of diagnosis. The diagnosis was made ante mortem in 9 patients (33%). Radiographic abnormalities were variable. At the onset of chest X-ray (CXR) change, the pulmonary infiltrates were unilateral in 14 patients (52%) and, at diagnosis, bilateral in 18 (66%). At diagnosis the infiltrates were interstitial in 3 patients (11%), alveolar in 20 (74%) and mixed in 4 (15%). Six patients (22%) developed cavitary lesions. The infecting agents were Aspergillus in 21 patients (78%), Candida in 7 (26%), Mucormycosis in 3 (11%), and Fusarium in 1 (4%). Five patients (19%) had mixed fungal infections and 7 (26%) had concurrent cytomegalovirus (CMV) pulmonary infections. Although the radiographic changes are often nonspecific in PFI, alveolar or nodular infiltrates in neutropenic patients or in those being treated for GVHD should strongly suggest a fungal etiology. PMID- 3281110 TI - The emergence of hepatic fibrosis and portal hypertension in infants and children with autosomal recessive polycystic kidney disease. Initial and follow-up sonographic and radiographic findings. AB - Long-term imaging and clinical findings are reported in six children whose polycystic kidney disease was detected in infancy or early childhood. Over time (2 years to 20 years) all patients developed portal hypertension from hepatic fibrosis, a problem primarily noted in recessive pattern polycystic kidney disease. Mild renal failure (two patients) was accompanied by serious systemic hypertension in the same patients. In one family, one of the babies also showed dilated right hepatic ducts. Imaging studies included urography and CT although recently ultrasonography was the method of choice. The relative renal and hepatic manifestations in these patients so changed with time that it would seem fallacious to attempt to use rigid classifications based on findings at initial diagnosis. PMID- 3281112 TI - US demonstration of pyelitis and ureteritis in children. AB - The authors report a new ultrasonic sign of urinary tract infection in children: thickening of the renal pelvis and/or ureteral wall. This thickening as encountered in 10 children, (10 months to 12 years) all with urinary tract infection, appears to result from inflammatory changes and to correspond to a sonographic sign of pyelitis and ureteritis. These alterations of the walls are similar to striations and folds described in this pathology on intravenous pyelograms. The thickening was the only sign of abnormality of the urinary tract in two cases; it was observed without reflux in four cases. The demonstration of this pattern should lead to further uroradiological investigations and to appropriate treatment. PMID- 3281111 TI - Enterolithiasis with imperforate anus. Report of two cases with sonographic demonstration and occurrence in a female. AB - Enterolithiasis has been previously described as a plain film finding of rectovesical or rectourethral fistula in patients with anorectal malformation. Two cases of enterolithiasis with anorectal malformation are described in which the intraluminal nature of the calcifications was identified using ultrasound. The use of ultrasound for this purpose has not been previously reported to our knowledge. This simple, noninvasive technique permits antenatal differentiation between enterolithiasis and meconium peritonitis in some patients and can suggest the prenatal diagnosis of rectourinary communication when enterolithiasis is present. In addition, one of our cases occurred in a female. The entity of enterolithiasis with imperforate anus in a female has not been previously reported. PMID- 3281113 TI - Reversibility of cortical hyperostosis following long-term prostaglandin E1 therapy in infants with ductus-dependent congenital heart disease. AB - Two neonates with complex cyanotic congenital heart disease, receiving long-term prostaglandin E1 infusion, for 59 and 78 days respectively, demonstrated significant radiographic changes of symmetric cortical hyperostosis of the long bones. Bone biopsies from one of the patients elucidated the histological changes and serial X-rays revealed regression of the hyperostosis. Long-term follow-up after 13 months did not reveal any late bony changes or growth disturbance. PMID- 3281115 TI - Ultrasound and CT diagnosis of intramural duodenal hematoma. AB - An 8-year-old boy with traumatic duodenal hematoma is reported. Diagnosis is easy if one is familiar with its typical findings in modern imaging modalities. PMID- 3281116 TI - Sonographic guidance for infant hip reduction under anesthesia. AB - An initial attempt to reduce a hip dislocation in a 15-month-old by palpation under general anesthesia led to the subsequent discovery of a posterior subluxation by CT. During the second attempt, sonographic guidance in the operating room was used to show concentric reduction both before and after the application of a spica cast. Successful reduction was later confirmed by CT. Imaging by real-time sonography can be useful in monitoring infant hip reduction. PMID- 3281114 TI - Massive jugular and dural sinus reflux associated with cerebral death. AB - Radionuclide cerebral angiograms demonstrated massive jugular venous reflux in two children with clinical and electroencephalographic evidence of cerebral death. With an antecubital injection, the tracer flowed up the jugular vein, through the transverse dural sinus, and down the contralateral jugular vein. No arterial flow was seen. We hypothesize that this unusual pattern reflects the absence of normal antegrade flow through the venous system. The appearance of jugular reflux is distinct from arterial flow and should not be confused with it. These cases illustrate communication between the systemic venous system and the dural sinuses. Although this pattern in not diagnostic of cerebral death, the appearance of radiotracer in the dural sinuses does not establish the presence of cerebral perfusion. PMID- 3281117 TI - Double-sided psoas abscess in a young infant: sonographic and radiographic findings. AB - Psoas abscess is rare in children and is exceptional in the neonatal period. A sonographically and radiographically well-documented case of double-sided primary psoas abscess in a few-week-old infant is presented. To our knowledge this is the first description of a case of double-sided psoas abscess in a neonate. PMID- 3281119 TI - Hypoxanthine as an indicator of hypoxia: its role in health and disease through free radical production. PMID- 3281118 TI - Metaphyseal chondrodysplasia, Schmid type. Clinical and radiographic delineation with a review of the literature. AB - Analysis of 20 cases of metaphyseal chondrodysplasia, Schmid type as well as a review of the world literature reveals a specific autosomal dominant disorder that was often over-diagnosed in the past, sometimes resulting in incorrect genetic counselling. Significant radiologic features include an enlarged capital femoral epiphysis in early childhood, coxa vara, greater involvement of the distal femoral metaphysis than the proximal, anterior rib changes and a normal spine. Chondroosseous morphology is not specific. Presentation in nonfamilial cases is no earlier than the second year of life. PMID- 3281120 TI - Renal hemodynamic responses to hypoxemia during development: relationships to circulating vasoactive substances. AB - Chronically catheterized fetal lambs (n = 11, gestational age 111-139 days) and neonatal lambs (n = 20, postnatal age 4-30 days) were studied to explore during development the relationship of renal hemodynamic responses during hypoxemia to plasma epinephrine concentration (E), plasma norepinephrine concentration (NE), plasma arginine vasopressin concentration (AVP), and plasma renin activity (PRA). A low oxygen gas mixture (11.1 +/- 0.1% O2) was administered for 30 min to the pregnant ewe or neonatal lamb to induce hypoxemia with maintenance of normal arterial pCO2 and pH. Arterial blood pressure was recorded continuously and renal blood flow (RBF) was determined by the radiolabeled microsphere technique. Moderate hypoxemia (pO2 16 +/- 2 torr and 33 +/- 6 torr in fetus and neonate, respectively) induced increases in E, NE (measured by radioenzymatic assay), and AVP (measured by radioimmunoassay) in both fetus and neonate. PRA (measured by radioimmunoassay) also increased in response to hypoxemia in neonatal lambs. The change in mean arterial pressure with hypoxemia (delta MAP) was significant in fetuses (delta MAP 8 +/- 14%, p less than 0.05) but not in lambs (delta MAP 1 +/- 10%, p greater than 0.5). Similarly, the change in renal blood flow with hypoxemia (delta RBF) was significant (delta RBF -51 +/- 24%, p less than 0.001) in fetuses but not in neonatal lambs (delta RBF -9 +/- 38%, p greater than 0.1). These results reflected a change in renal vascular resistance with hypoxemia (delta RVR) that was significant in fetal lambs (delta RVR 169 +/- 168%, p less than 0.01) but not in neonatal lambs (delta RVR 51 +/- 180%, p greater than 0.2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281121 TI - Premature appearance of gluconeogenesis and fatty acid oxidation in the liver of the postterm rabbit fetus. AB - The metabolic consequences of a prolonged gestation (35 vs 32 days) have been studied in the rabbit fetus. Gestation was prolonged by daily subcutaneous injections of progesterone (1.5 mg.kg-1) from day 28 to 34. In control animals, progesterone was injected from day 25 or 28 to day 31 of gestation. When the capacities for gluconeogenesis and fatty acid oxidation, measured on isolated hepatocytes, are normally low in the term control fetus and increase only within the first 24 h after birth, these capacities appear high in the postmature fetus. The rate of glucose production from lactate is 4-fold higher in the postmature fetus than in the normal term fetus. The rate of ketone body production from oleate is also 5-fold higher in the postmature fetus, which results from a switch on of the partition of oleate into esterification and oxidation: 8% of [1 14C]oleate is oxidized in term fetus hepatocytes, but 34% in postmature fetus hepatocytes. As a similar rate of lipogenesis takes place in both stages, this metabolic change could be explained by a 5-fold lower sensitivity of carnitine palmitoyltransferase I to the inhibition by malonyl-coenzyme A. Postmaturity decreases plasma insulin concentrations by 45% and increases plasma glucagon concentrations by 50% which, in turn, induces a 3-fold decrease in the plasma insulin:glucagon molar ratio. As previously shown in fasted or diabetic adult rat, this hormonal change might be a likely candidate for an enhancement of gluconeogenic and ketogenic capacity in the liver of the postterm rabbit fetus. PMID- 3281122 TI - Enhanced enzyme activity after incubation with zinc can be used to distinguish heterozygotes of Pompe's disease. AB - In an attempt to identify heterozygotes for Pompe's disease, the acid alpha-D glucosidase activity at pH 4 in phytohemagglutinin-stimulated lymphocytes was measured. In the standard assay an overlap in the enzyme activity between normal controls and obligate heterozygotes was demonstrated. When the assay was modified by adding zinc chloride into the incubation mixture, the enzyme activity of the lymphocyte homogenates did not change. However, the enzyme activity increased dramatically after intact lymphocytes were preincubated with zinc chloride. There was no more overlap in the acid alpha-D-glucosidase activity between normal controls and obligate heterozygotes when lymphocytes were incubated 1 h with 10( 4) mol/liter zinc chloride or 2 h with 10(-3) or 10(-4) mol/liter zinc chloride. This modified enzyme activity should facilitate improved heterozygote detection. PMID- 3281124 TI - The Society for Pediatric Research membership list, 1987-1988. PMID- 3281125 TI - European Society for Paediatric Research membership list, 1987-1988. PMID- 3281123 TI - The American Pediatric Society membership list 1987-1988. PMID- 3281126 TI - The Latin American Society for Pediatric Research membership list, 1987-1988. PMID- 3281128 TI - Attempted suicide by insulin overdose in insulin-dependent diabetic adolescents. AB - Two cases of attempted suicide by insulin overdose in adolescent girls with insulin-dependent diabetes mellitus were observed. It is possible that suicidal insulin overdose in adolescents is more common than reports suggest and that it may often be unrecognized. PMID- 3281129 TI - Fetal ear length. AB - A prenatal standard for ear length was developed from ultrasonic images of 180 normal subjects. Length increased from about 6 mm at 15 weeks to 33 mm at term and was well fit by linear regression (r2 = .96). Short ears (greater than or equal to 1.5 SD below gestational age average) were associated strongly, and specifically, with chromosomal disorders. PMID- 3281127 TI - Sn-protoporphyrin use in the management of hyperbilirubinemia in term newborns with direct Coombs-positive ABO incompatibility. AB - In two separate studies, in which two different treatment regimens of Sn protoporphyrin were used, a total of 69 control and 53 treated infants were studied to determine whether this potent inhibitor of the enzyme, heme oxygenase, could ameliorate the severity of the hyperbilirubinemia which develops in term babies with direct Coombs-positive ABO incompatibility. The results indicate that Sn-protoporphyrin can, in appropriate doses, moderate the postnatal rate of increase of plasma bilirubin levels and diminish the intensity of hyperbilirubinemia in treated babies. In addition, a decreased use of phototherapy in Sn-protoporphyrin-treated infants was observed. No rebound hyperbilirubinemia was detected during the six- to eight-day period after Sn protoporphyrin administration. The plasma clearance (t1/2) of Sn-protoporphyrin was much faster in newborns than in adults (approximately 1.6 hours v 3.5 hours, respectively). The incidence of clinical side effects in the 53 Sn-protoporphyrin treated infants was limited to the development of transient erythema during the use of concurrent phototherapy in two babies. In both infants this reaction subsided completely without sequelae. The use of Sn-protoporphyrin or related synthetic heme analogues to diminish the severity of hyperbilirubinemia in newborn infants merits further study because inhibition of the rate-limiting enzyme in the catabolism of heme to bilirubin may prove to be a useful therapeutic approach in the clinical management of neonatal hyperbilirubinemia, especially in settings in which, for social or economic reasons, other treatment modalities are not available. PMID- 3281131 TI - Major dietary changes in nineteenth-century Europe. PMID- 3281130 TI - Science and medicine in the spotlight: Alzheimer's disease as an example. PMID- 3281133 TI - Fire walking and the persistence of charlatans. PMID- 3281132 TI - Selective dimensions of personality: psychiatry and sociobiology in collision. PMID- 3281134 TI - Chromatographic separation of enantiomers. AB - In this paper a review is presented on the chromatographic analysis of enantiomers with special attention to high pressure liquid chromatography. Also, some examples of resolution of racemates by thin layer chromatography and gas chromatography are given. The various procedures in the surveyed literature have been divided into three main classes: procedures with formation of diastereomeric compounds prior to the chromatographic separation, procedures in which a chiral mobile phase is used, and procedures with the use of a chiral stationary phase. These methods are subdivided and some examples of their application to drugs and related compounds are presented. PMID- 3281135 TI - Information sources for nursing, a guide. PMID- 3281136 TI - Introduction to information sources in nursing. PMID- 3281137 TI - The library as an information resource. PMID- 3281139 TI - Planning an information search. PMID- 3281138 TI - Information sources for nursing. PMID- 3281140 TI - On-line database searching. PMID- 3281141 TI - Mapping from GenBank to MEDLINE. AB - GenBank has been based largely on literature that provides nucleic acid sequences. To find additional literature that is relevant to a given sequence, a search of MEDLINE can prove helpful. This paper documents some of the similarities between GenBank and MEDLINE that facilitate retrieval of documents from MEDLINE. In particular, techniques and examples are presented which take GenBank information and lead to MEDLINE information that supplements the GenBank information. PMID- 3281142 TI - A backtranslation method based on codon usage strategy. AB - This study describes a method for the backtranslation of an aminoacidic sequence, an extremely useful tool for various experimental approaches. It involves two computer programs CLUSTER and BACKTR written in Fortran 77 running on a VAX/VMS computer. CLUSTER generates a reliable codon usage table through a cluster analysis, based on a chi 2-like distance between the sequences. BACKTR produces backtranslated sequences according to different options when use is made of the codon usage table obtained in addition to selecting the least ambiguous potential oligonucleotide probes within an aminoacidic sequence. The method was tested by applying it to 158 yeast genes. PMID- 3281143 TI - Kill or cure. PMID- 3281144 TI - An innovation in stoma care. PMID- 3281145 TI - Malignant neoplasms of the stomach and the quality of drinking water. AB - This paper evaluates the influence of the quality of drinking water on the incidence of malignant stomach cancer. Both the author's own data and the data collected from published papers are used in this evaluation. The conclusion is that the quality of drinking water can have some influence on the frequency of stomach cancer incidence, especially among the population of autochthons (who have been using such water for a long time). However, taking into consideration all papers quoted here, it seems that there are also various other factors which can influence the incidence of stomach cancer. PMID- 3281147 TI - Actinic damage in the skin of patients on haemodialysis for chronic renal failure. AB - Seventy-nine patients on long-term haemodialysis for chronic renal failure were interviewed and examined as to ethnic origin, actinic habits and the occurrence of blisters, skin fragility and slow healing of the skin of the dorsal part of the hands. On clinical examination, the 6 patients (7.5%) with blisters of the dorsal part of the hands had more damaged skin at that site than would be expected for their age. They also tended to be predominantly of English descent with blue eyes, poorer skin tanning ability and increased net exposure to sunlight. A skin imprint method for the grading of actinic damage showed a statistically significantly increased degree of actinic damage in the haemodialysis patients compared to a control group of healthy individuals matched for age and sex, the difference being more pronounced in the 35-64 year age group. Plasma and erythrocyte porphyrin levels were not related to the degree of actinic damage. It is suggested that reduction of the actinic load on the dermis by avoiding excessive exposure to sunlight might minimize the extent of skin changes in haemodialysis patients. PMID- 3281146 TI - Distribution of thymine dimers induced in mouse skin by ultraviolet radiation. AB - The cellular and tissue distributions of thymine dimers induced in mouse skin by UV radiation were compared in 3 haired mouse strains: Sencar, BALB/c, and C3H. These strains differ markedly in their overall susceptibility to photocarcinogenesis, and they develop UV-induced skin tumors of different histological types and in different anatomical locations. The purpose of this study was to determine whether the differences in strain and site susceptibility are due to inequalities in the distribution of UV radiation-induced DNA damage in the target tissues. An indirect immuno-fluorescence assay was used to examine the location of thymine dimers induced by 254-nm UV radiation (UVC) or 280-400 nm UV radiation (UVAB) in ears and dorsal skin. No differences in the distribution of dimers in skin cells or tissues were found among mouse strains or between anatomical sites (ear vs. dorsum). Thus, these results do not support the hypothesis that differences in the optical properties of skin, which govern penetration and absorption of UV radiation, contribute to site or strain susceptibility in photocarcinogenesis. However, two distinct differences in the cellular and tissue distribution of dimers were found when UVC and UVAB-treated tissues were compared: a) UVAB produced dimers in both dermal and epidermal cells, whereas UVC induced a detectable number of dimers only in epidermal cells; b) UVAB-induced dimers were observed in both the nuclei and cytoplasm of affected cells, whereas dimers induced by UVC were confined to nuclei. PMID- 3281149 TI - Posterior shoulder instability. PMID- 3281148 TI - Biochemical observations in UV-induced pigmentation. AB - The biochemical events in the melanocytes resulting from stimulation of pigmentation by exposure to ultraviolet (UV) irradiation are correlated to changes in specific metabolites in the plasma and in the urine. A compound produced in the melanocyte by nucleophilic addition of cysteine to dopaquinone, 5 S-cysteinyldopa, is present in increased quantities in the plasma and in the urine after different types of pigment-producing UV exposure. Similarly, a methylated indolic metabolite, 6-hydroxy-5-methoxyindole-2-carboxylic acid, appears in increased amounts in the urine after UV exposure of the skin. UVA does not produce inflammation or pigmentation in skin that is anoxic at the time of irradiation. In contrast, inflammation and pigment response to UVB and PUVA are not dependent on oxygenation of the skin at the time of exposure. PMID- 3281150 TI - Multidirectional shoulder instability. AB - Multi-directional shoulder instability is a difficult problem to both diagnose and treat. Knowledge of shoulder anatomy and its pathological states has expanded dramatically in recent years. Aiding diagnostic acumen are new tools including CT arthrograms, glenohumeral arthroscopy, and evaluation under anesthesia. MDI of the shoulder is increasingly recognized as a clinical entity. Diagnosing this problem demands great skill in correlating the history with the physical examination and radiographic procedures. Conservative treatment is the initial treatment of choice. Surgical treatment is exacting both in its preoperative assessment and surgical technique. PMID- 3281151 TI - Total shoulder replacement. AB - It appears that total shoulder replacement can be performed with a high degree of patient satisfaction, with few complications, and with long-term results which certainly appear to rival the success of other arthroplasties. However, the technique is extremely demanding and requires an experienced shoulder surgeon, who must successfully resolve numerous intraoperative variables and problems, must be able to deal with factors which may affect the stability and strength of the implant, and must individualize the postoperative rehabilitation according to quality of bone and soft tissue, as well as the specific needs and desires of the patient. However, when performed technically satisfactorily with proper patient selection, with meticulous attention to the details of the soft tissue surrounding the implant, and with attention to the postoperative rehabilitation, the results have been impressive. Total shoulder replacement has successfully taken its place in the armamentarium of other total joint replacements which have dramatically altered the quality of life in the arthritic patient. PMID- 3281152 TI - Adhesive capsulitis of the shoulder: current concepts and treatment. AB - Primary adhesive capsulitis of the shoulder is a common cause of a painful shoulder in clinical practice. The pathogenesis remains unclear. Many patients continue to have significant long-term restrictions in their range of motion although few are functionally restricted. Prevention is the ideal treatment. Patients respond to treatment plans directed at pain relief and improving the range of motion, however, ongoing controlled therapeutic trials are necessary to better refine the selection of treatment for individual patients. PMID- 3281153 TI - The future of shoulder surgery. PMID- 3281154 TI - Shoulder arthroscopy: current indications and techniques. AB - The role of arthroscopy in the diagnosis and treatment of shoulder disorders is evolving. Arthroscopic subacromial decompression is an alternative to open anterior acromioplasty in the treatment of chronic stage II impingement syndromes prior to the development of full thickness rotator cuff tear. Patients with massive and otherwise unrepairable cuff tears have achieved significant pain relief from arthroscopic decompression and debridement of the floppy and irregular cuff margins. Routine repairable full thickness cuff tears are best treated by open reconstruction. The arthroscope is an adjunct in confirming the diagnosis and direction of shoulder instability. Arthroscopic stabilization is most feasible when the anterior glenohumeral ligament/labral complex is detached. The introduction of a metal staple is controversial, however, reported complications are diminishing with experience. Alternate methods of stabilization are being investigated. Effective arthroscopic techniques have been established for the removal of loose bodies, the treatment of calcific tendinitis, septic arthritis, and other disorders. Shoulder arthroscopy will undoubtedly achieve an appropriate place in the armamentarium of the orthopedic surgeon. PMID- 3281155 TI - Noninvasive imaging of the rotator cuff. PMID- 3281156 TI - Rotator cuff tear: evaluation and treatment. PMID- 3281157 TI - Anterior glenohumeral instability. AB - The understanding of and approach to anterior shoulder instability has changed and improved dramatically in recent years. It is now accepted that a shoulder can subluxate as well as dislocate and that chronic instability may or may not be caused by an initial traumatic event. An anteriorly unstable shoulder also can be unstable inferiorly and/or posteriorly (multi-directional instability). The author's diagnostic acumen has increased with the addition of glenohumeral axillary arthrotomography, glenohumeral CT arthrography, glenohumeral arthroscopy, and other studies. Surgical treatment has moved away from "repair of choice" to an "anatomic reconstruction." The current preferred treatment is to identify and repair only the pathology while preserving normal anatomy, hoping to restore shoulder stability, while preserving normal mobility and strength. Areas of controversy exist. 1) How long should acute dislocations be immobilized, if at all, and is physiotherapy helpful in preventing chronic instability? 2) How long should the surgically repaired shoulder be immobilized, if at all? 3) Is there a place for therapeutic arthroscopy in this area? Also controversial is the concept of "functional instability" or shoulder internal derangement. These patients are felt to have shoulder slipping and catching due to the intermittent interposition of a fragment of tissue (a torn labrum, a loose body, etc) between the articulating surfaces. Arthroscopic debridement of the pathology would be ideally suited for such a clinical entity. Undoubtedly, improvements and controversy will continue until orthopedists are able to accurately diagnose and correct shoulder instability, while preserving range of motion and strength at minimal inconvenience to the patient. PMID- 3281158 TI - Interactions between calcium channel blockers and non-cardiovascular drugs: interactions with drugs acting at the neuromuscular or the CNS level. PMID- 3281159 TI - The predicted DBL oncogene product defines a distinct class of transforming proteins. AB - The DBL transforming gene was originally identified by transfection of NIH 3T3 cells with DNA from a human B-cell lymphoma. This gene was found to have arisen as a result of recombination of the 3' portion of the DBL protooncogene coding sequences with an unrelated segment of human DNA. It encodes a cytoplasmic protein that is equally distributed between cytosol and crude membrane fractions. To further characterize this transforming gene, a biologically active cDNA clone of the DBL transforming gene mRNA was isolated. Analysis of the sequence of the DBL oncogene cDNA revealed a long open reading frame that encodes a hybrid protein whose first 50 amino acids (at least) derive from a complete exon of a different locus. No significant homology with known oncogenes or any known protein sequences was demonstrated. The computer analysis of the predicted DBL protein indicated it is highly hydrophilic with no hydrophobic domains characteristic of a membrane-spanning region or signal peptide. Thus, the DBL oncoprotein is distinct among known transforming gene products. PMID- 3281161 TI - CDC7-dependent protein kinase activity in yeast replicative-complex preparations. AB - A protein kinase activity was identified in preparations of DNA-replicative complex from the budding yeast Saccharomyces cerevisiae. The activity phosphorylated only a few of the endogenous proteins in the replicative fraction, and it displayed a marked preference for a 48-kDa polypeptide. Despite this relative specificity, the protein kinase activity was capable of utilizing exogenously added histone as substrate. The 48-kDa polypeptide was phosphorylated on serine residue(s) exclusively by the endogenous activity in the replicative complex preparation. The activity was not stimulated by cAMP, cGMP, Ca2+/phosphatidylserine/diacylglycerol, or Ca2+/calmodulin. It did not utilize Ca2+ or Zn2+ in the place of Mg2+, and Mn2+ was only 22% as effective in fulfilling the divalent-cation requirement. Most importantly, the protein kinase activity was heat-sensitive in replicative fractions from the cell division cycle 7 (cdc7) mutant, which arrests at or close to the G1/S boundary of the cell cycle at restrictive temperature. Thus, the activity is CDC7-dependent. An effect of heat treatment on replicating activity in the replicative fraction from cdc7 cells was also found. This result and the finding that the protein kinase activity copurified with replicating activity in the preparations suggest that the CDC7 gene product and the protein kinase activity, whether or not they are the same entity, interact with yeast replicative complex. All of these results raise the possibility that phosphorylation of components of the replication machinery may play a role in the control of initiation of DNA replication during the cell cycle. It is possible that the phosphorylation observed is part of a protein kinase cascade that regulates progress through the G1 phase of the cell cycle. PMID- 3281160 TI - Cytosine methylation does not affect binding of transcription factor Sp1. AB - DNA methylation may be a component of a multilevel control mechanism that regulates eukaryotic gene expression. We used synthetic oligonucleotides to investigate the effect of cytosine methylation on the binding of the transcription factor Sp1 to its target sequence (a G + C-rich sequence known as a "GC box"). Concatemers of double-stranded 14-mers containing a GC box successfully competed with the human metallothionein IIA promoter for binding to Sp1 in DNase I protection experiments. The presence of 5-methylcytosine in the CpG sequence of the GC box did not influence Sp1 binding. The result was confirmed using double-stranded 20-mers containing 16 base pairs of complementary sequence. Electrophoretic gel retardation analysis of annealed 28-mers containing a GC box incubated with an Sp1-containing HeLa cell nuclear extract demonstrated the formation of DNA-protein complexes; formation of these complexes was not inhibited when an oligomer without a GC box was used as a competitor. Once again, the presence of a 5-methylcytosine residue in the GC box did not influence the binding of the protein to DNA. The results therefore preclude a direct effect of cytosine methylation on Sp1-DNA interactions. PMID- 3281162 TI - Purification of a yeast protein that binds to origins of DNA replication and a transcriptional silencer. AB - Two factors that interact specifically with the chromosomal replicator, autonomously replicating sequence 1 (ARS1), were identified in whole-cell yeast extracts. One of these proteins, ARS binding factor I (ABF-I), was purified to homogeneity as a polypeptide of 135 kDa. ABF-I binds within a region previously shown to be essential for the function of ARS1 when yeast are grown under certain nutritional conditions, and deletion analysis presented here suggests that the ARS1 domain containing the ABF-I-binding site, domain B, is a complex element composed of at least two subdomains. ABF-I also binds within an ARS at the HMR silent mating locus. This ARS functions as a cis-acting transcriptional silencer, and the ABF-I-binding site within this ARS is important for both ARS and silencer function. PMID- 3281163 TI - The yeast SNF3 gene encodes a glucose transporter homologous to the mammalian protein. AB - The SNF3 gene is required for high-affinity glucose transport in the yeast Saccharomyces cerevisiae and has also been implicated in control of gene expression by glucose repression. We report here the nucleotide sequence of the cloned SNF3 gene. The predicted amino acid sequence shows that SNF3 encodes a 97 kilodalton protein that is homologous to mammalian glucose transporters and has 12 putative membrane-spanning regions. We also show that a functional SNF3-lacZ gene-fusion product cofractionates with membrane proteins and is localized to the cell surface, as judged by indirect immunofluorescence microscopy. Expression of the fusion protein is regulated by glucose repression. PMID- 3281164 TI - Marrow transplantation from tolerant donors to treat and prevent autoimmune diseases in BXSB mice. AB - Autoimmune-prone BXSB male mice were supralethally irradiated and transplanted with CBA/H bone marrow cells. A complete and long-term chimerism was established when donor mice had been induced to develop tolerance of BXSB male antigens by combined treatment with BXSB male spleen cells and cyclophosphamide. Such chimeras did not express autoimmune phenomena or develop lethal autoimmune manifestations. Nor did the recipient mice develop the wasting syndrome or evidence of persistent immunodeficiencies that have been seen in other strains of autoimmune-resistant mice that had been transplanted with bone marrow cells across major histocompatibility complex barriers following an initial purging of the bone marrow of Thy-1+ cells using anti-Thy-1+C. PMID- 3281165 TI - Enzymatically controlled drug delivery. AB - An approach for providing feedback control for polypeptide drugs in a polymeric controlled-release system uses a trigger molecule and a polymer-bound enzyme that, in the presence of that trigger molecule, will cause an acid or a base to form. When the pH inside the polymer system changes, the solubility of the drug shifts dramatically, which changes the diffusion or dissolution driving force, and hence the release rate changes correspondingly. This concept was tested using a controlled-release system of ethylene/vinyl acetate copolymer containing insulin and immobilized glucose oxidase. The enzymatic reaction of glucose to gluconic acid reduces the pH in the polymer microenvironment. Since insulin solubility increases with decreasing pH (at physiologic pH, this is true for an insulin with an isoelectric point of 7.4 or higher), the release of insulin increases in response to glucose concentration. The feasibility of this concept has been shown using trilysyl insulin with an isoelectric point of 7.4. Multiple exposures to buffered glucose solutions over several weeks caused insulin release to reversibly increase during each exposure. Polymer-implanted diabetic rats infused with glucose solutions showed a significant increase in insulin concentration in 30 min-an effect not observed in three different sets of control rats. PMID- 3281167 TI - Cytotoxic mediators of inflammation and host defense. Volume dedicated to Manfred Mayer. PMID- 3281166 TI - Enhanced production of monokines by canine alveolar macrophages in response to endotoxin-induced shock. AB - The enhanced production of soluble mediators by alveolar macrophages may be responsible for promoting lung injury in canines administered endotoxin. One of the most prominent monokines, interleukin 1 (IL-1), has the potential to significantly influence the responses of host tissues. In this study we analyzed alveolar macrophages from canines that were experimentally administered endotoxin (AMEC) for their ability to produce IL-1. When concentrated AMEC supernatants from in vitro cultures were incubated with fresh C3H/HEJ thymocytes, a threefold greater incorporation of [3H]thymidine resulted as compared to the response produced by controls. Heat treatment of the experimental preparations ablated this difference. Conversely, the activity of AMEC intracellular lysates did not significantly differ from the controls. Silver-staining the preparations separated by SDS-PAGE revealed a low-molecular-weight species (17 kD) in the AMEC supernatant lane while a similar molecular distribution was absent in all of the control preparations examined. Moreover, using the L929 cell line in a cytolytic bioassay we found that these same AMEC supernatants also contained significantly elevated levels of tumor necrosis factor. Collectively, this study suggests that during endotoxin-induced canine lung injury, the alveolar macrophages generate soluble species that can substantially regulate the hosts cellular response. This activity in the canine lung may play a critical role in the development and/or maintenance of the pathology associated with exposure to endotoxin. PMID- 3281168 TI - Macrophage-mediated tumoricidal activity: mechanisms of activation and cytotoxicity. PMID- 3281169 TI - The role of lymphotoxin in inflammation. PMID- 3281170 TI - The cytotoxic action of neutrophils on mammalian cells in vitro. PMID- 3281172 TI - The role of cytoplasmic granules in lymphocyte cytotoxicity. PMID- 3281171 TI - Cytotoxic action and other metabolic consequences of terminal complement proteins. PMID- 3281173 TI - Effect of fenfluramine on insulin/growth hormone ratio in obese subjects. AB - Obesity is characterized by increased levels of insulin and by subnormal growth hormone (GH) release. Insulin/GH ratio is significantly higher in obese than in lean individuals. Fenfluramine, an anorectic drug, may have some effects on hypothalamic-pituitary function and on insulin secretion, possibly through a serotonergic stimulation. The aim of this work was to study the effects of fenfluramine on the insulin/GH ratio after arginine in obese subjects. Ten volunteer obese females were studied; 10 volunteer women were the normal weight controls. All subjects were given placebo and fenfluramine (60 mg p.o.) in a randomized order and after 120 min underwent arginine infusion (25 g i.v. for 30 min). Blood samples were taken every 30 min until 270 min for GH and insulin radioimmunoassay. In the obese group the GH response to arginine was significantly lower than in controls. Fenfluramine administration restored the subnormal GH response to arginine in obese subjects. Arginine infusion provoked a greater insulin secretion in obese subjects than in lean individuals. Fenfluramine administration diminished the insulin response to arginine. Fenfluramine did not modify the insulin/GH ratio in controls while it significantly lowered the insulin/GH ratio in obese subjects. Because insulin promotes fat and carbohydrate storage while GH stimulates lipolysis, the combination of high insulin and low GH concentrations may worsen the obese condition. A lower insulin/GH ratio can be useful in the treatment of obesity. PMID- 3281174 TI - Cervical spine management in patients with rheumatoid arthritis. Review of the literature. AB - Rheumatoid arthritis of the cervical spine is a well-recognized source of neck pain. Discussion of the potential effects of various treatment interventions on the tissues of patients with rheumatoid arthritis of the cervical spine, however, has been scarce in the physical therapy literature. Physical therapists should understand the implications of this type of inflammatory arthritis when treating patients with rheumatoid arthritis. The end-stage results of the inflammatory process and the mechanical forces on the cervical spine can cause atlantoaxial subluxation, atlantoaxial impaction, and subaxial subluxation. The purpose of this article is to review the literature on several aspects of rheumatoid arthritis of the cervical spine: 1) pathological anatomy, 2) clinical findings, 3) surgical management, 4) management with cervical orthoses, and 5) physical therapy management. PMID- 3281175 TI - Mental imagery and its potential for physical therapy. AB - The purposes of this article are 1) to review the sports and motor-learning literature regarding the effects of mental imagery and mental practice on physical skills and 2) to explore the feasibility of using them as adjunctive techniques in physical therapy. In the area of sports, evidence exists that mental practice can improve motor skills. Research that supports a mind-body relationship is cited, in addition to research using mental imagery from the areas of medicine, biofeedback, psychoneuroimmunology, and physical therapy. Variables that influence the outcome of mental practice such as vividness, kinesthetic imagery, and combining physical and mental practice are examined, and two major variables associated with ineffective results are identified. The advantages and disadvantages of using mental imagery for physical therapy patients are discussed with the conclusion that mental imagery has the potential to be a viable technique for physical therapists. PMID- 3281176 TI - [Magical thinking in suicidal acts]. AB - This paper declines the anthropological and philosophical background for understanding the less understandable: suicide. Though 'understanding' (in terms of the one who wants to understand) implies the rules of its own (i.e. rationalistic) casted beyond the reefs of knowing the author tries to find traces to make up a new perspective of the horizon. With examples from his therapeutical work, and quoting mythology, and historically famous cases thinking within the terms of suicide is delined, and consequences hereof are stated. PMID- 3281177 TI - Recognition of disoriented shapes. PMID- 3281178 TI - An ecological theory of orientation and the vestibular system. PMID- 3281179 TI - Neural dynamics of planned arm movements: emergent invariants and speed-accuracy properties during trajectory formation. PMID- 3281180 TI - In memoriam Paul A. Obrist (1931-1987). PMID- 3281181 TI - Facts and artifacts in cardiac cycle time analysis: a simple model of vagal control. PMID- 3281182 TI - Electric linear dichroism and birefringence of biological polyelectrolytes. PMID- 3281183 TI - Analysis of the domain structure of membranes by fragmentation and separation in aqueous polymer two-phase systems. PMID- 3281184 TI - The establishment of frequency dependent limits for electric and magnetic fields and evaluation of indirect effects. AB - The biophysical model described in this paper has been used as basis for the preparation of the German standards which determine and define limits of exposure to electric or magnetic fields below several MHz, including 50/60 Hz. The electric field strength within the tissue is considered decisive for the biological effect in the low frequency range. Threshold values of field strengths and current densities including biological effects are compared. It is possible to establish "safe", "dangerous" and "hazardous" current density curves as a function of frequency. To define exposure limits, the field strength or current density causing injury should be reduced by a factor exceeding 100 in order to avoid well established biological effects. The electric and magnetic field strengths in the human environment are correlated with the corresponding electric current density induced in the human body. This enables "safe", "dangerous" and "hazardous" levels of current density in the human body to be correlated with the external electric or magnetic field strength. Additionally to the direct field effects indirect effects must be considered. In the second part of this paper data on touch voltages and currents are summarized and evaluated with regard to their health risk. Furthermore, as an example for indirect effects the interference of electric and magnetic fields with pacemakers is considered. PMID- 3281185 TI - Exponential or shouldered survival curves result from repair of DNA double-strand breaks depending on postirradiation conditions. AB - The yeast mutant rad54-3 is temperature conditional for the rejoining of DNA double-strand breaks, but cells do proliferate at both the restrictive and permissive temperatures. Thus, after irradiation with 30 MeV electrons, survival curves can be obtained which may or may not involve double-strand break rejoining under certain experimental conditions. Because of this special property of rad54 3 cells, it was possible to demonstrate that rejoining of radiation-induced double-strand breaks under nongrowth conditions yields exponential survival curves the slopes of which decrease as a function of the rejoining time. These survival data suggest that, under nongrowth conditions, the rejoining of double strand breaks is an unsaturated process and lacks binary misrepair. In contrast, whenever rejoining of double-strand breaks occurs under growth conditions, shouldered survival curves are observed. This is true for immediate plating as well as for delayed plating survival curves. It is proposed that it is the unsaturated rejoining of double-strand breaks under nongrowth conditions, lacking binary misrepair, which is responsible for potentially lethal damage repair. PMID- 3281186 TI - Is prophylactic para-aortic irradiation worthwhile in the treatment of advanced cervical carcinoma? Results of a controlled clinical trial of the EORTC radiotherapy group. AB - From November 1977 to July 1981, 441 patients with cervical carcinoma were randomized between pelvic irradiation and pelvic and para-aortic irradiation. Included were patients with stage I and IIB with proximal vaginal and/or parametrial involvement with positive pelvic lymph nodes either on lymphangiogram or at surgery, and stage IIB with distal vaginal and/or parametrial involvement and III regardless of pelvic node status on lymphangiogram. Patients with clinically or surgically involved para-aortic nodes were not included. The external beam dose to the para-aortic area was fixed at 45 Gy. There was no statistically significant difference between the two treatment arms in terms of local control, overall distant metastases and survival with no evidence of disease (NED), although the incidence of para-aortic metastases and distant metastases without tumor at pelvic sites was significantly higher in patients receiving pelvic irradiation alone (pelvic group). The 4-year NED survival rate was 51%. The incidence of severe digestive complications was significantly higher in patients receiving para-aortic irradiation (para-aortic group). Routine para aortic irradiation for all high risk patients with cervical carcinoma is of limited value, but patients with a high probability of local control can benefit from extended field irradiation, despite an increase in severe digestive complications. PMID- 3281187 TI - Hyperfractionated total body irradiation for T-depleted HLA identical bone marrow transplants. AB - Twenty patients suffering from malignant hemopathies (mean age 31.7 years) were given hyperfractionated total body irradiation (TBI) (120 cGy/3 fractions per day: total dose = 1440 cGy/4 days) as conditioning for T-depleted HLA identical allogeneic bone marrow transplantation. At an average of 12 months (range of 4.5 22 months) follow-up there were two cases of early death and two cases (11%) of rejection. There were no cases of acute or chronic graft versus host disease (GVHD) nor cases of interstitial pneumonitis. The average time for durable engraftment was 22 days. Disease-free survival at 12 months was 65%. To improve the results and further reduce the percent of rejection, the authors propose intensifying the immunosuppressive conditioning by increasing the cyclophosphamide dose and that of TBI so that a total dose of 1560 cGy is reached. PMID- 3281188 TI - Strategies for systemic radiotherapy of micrometastases using antibody-targeted 131I. AB - A simple analysis is developed to evaluate the likely effectiveness of treatment of micrometastases by antibody-targeted 131I. Account is taken of the low levels of tumour uptake of antibody-conjugated 131I presently achievable and of the "energy wastage" in targeting microscopic tumours with a radionuclide whose disintegration energy is widely dissipated. The analysis shows that only modest doses can be delivered to micrometastases when total body dose is restricted to levels which allow recovery of bone marrow. Much higher doses could be delivered to micrometastases when bone marrow rescue is used. A rationale is presented for targeted systemic radiotherapy used in combination with external beam total body irradiation (TBI) and bone marrow rescue. This has some practical advantages. The effect of the targeted component is to impose a biological non-uniformity on the total body dose distribution with regions of high tumour cell density receiving higher doses. Where targeting results in high doses to particular normal organs (e.g. liver, kidney) the total dose to these organs could be kept within tolerable limits by appropriate shielding of the external beam radiation component of the treatment. Greater levels of tumour cell kill should be achievable by the combination regime without any increase in normal tissue damage over that inflicted by conventional TBI. The predicted superiority of the combination regime is especially marked for tumours just below the threshold for detectability (e.g. approximately 1 mm-1 cm diameter). This approach has the advantage that targeted radiotherapy provides only a proportion of the total body dose, most of which is given by a familiar technique. The proportion of dose given by the targeted component could be increased as experience is gained. The predicted superiority of the combination strategy should be experimentally testable using laboratory animals. Clinical applications should be cautiously approached, with due regard to the limitations of the theoretical analysis. PMID- 3281189 TI - Effect of calcitonin gene-related peptide on glucose and gastric inhibitory polypeptide-stimulated insulin release from cultured newborn and adult rat islet cells. AB - Calcitonin gene-related peptide (CGRP) is a 37-amino acid peptide that is present in peripheral cells of islets and in nerves around and within islets. CGRP can inhibit insulin secretion in vitro and in vivo. Whether the inhibitory action of CGRP is mediated by somatostatin or by nerve terminals is, however, not known. The objective of this study was to examine the effect of CGRP on insulin secretion, using cultured newborn and adult rat islet cells which did not contain nerve terminals. In adult rat islet cells, CGRP (10(-10) to 10(-8) M) significantly inhibited glucose-stimulated and gastric inhibitory polypeptide (GIP)-potentiated insulin secretion, but in newborn rat islet cells, CGRP did not inhibit glucose-stimulated insulin secretion. Inhibition of glucose-stimulated and GIP-potentiated insulin release was dependent on the glucose concentration during the prestimulation period. CGRP did not stimulate release of somatostatin. These findings suggest that rat CGRP can act directly on beta-cells through a specific receptor that is absent in newborn rat beta-cells. PMID- 3281190 TI - Is helodermin produced by medullary thyroid carcinoma cells and normal C-cells? Immunocytochemical evidence. AB - Helodermin is a VIP/secretin-like 35-amino acid peptide originally isolated from the venom of the lizard Gila monster. Recently, helodermin-immunoreactive material was demonstrated in mammalian salivary glands, brain and gut. In the present study 8 human medullary thyroid carcinomas as well as 4 normal thyroid glands were examined immunocytochemically for the presence of helodermin using an antiserum raised against helodermin-(5-35) that does not cross-react with VIP or secretin. Cells displaying helodermin-like immunoreactivity were found in all tumours examined except one. On the whole the helodermin-immunoreactive cells had the same distribution as those storing calcitonin, suggesting coexistence of the two peptides in most of the tumour cells. Also normal human C-cells displayed helodermin immunoreactivity. The results suggest that a peptide chemically related to helodermin is a constituent of human medullary thyroid carcinoma cells as well as of normal C-cells. PMID- 3281191 TI - Sonography of congenital midline brain malformations. AB - The authors present an excellent overview of the anatomic and sonographic findings in the neonate which are associated with the presence of congenital midline malformations of the brain. PMID- 3281192 TI - Current concepts in sonographic diagnosis of fetal renal disease. AB - The fetal kidneys and bladder are usually visible by 15 weeks' gestation on sonograms. The authors present their experience with the diagnosis of renal abnormalities in the fetus. PMID- 3281193 TI - General case of the day. Traumatic arteriovenous fistula between the right superficial femoral artery and the deep femoral vein with a large external iliac venous aneurysm. PMID- 3281194 TI - [Ischemic cardiopathy (I). The epidemiology and primary prevention of ischemic cardiopathy]. PMID- 3281195 TI - [Findings on intermediate metabolism in ruminants]. AB - In ruminants, the digestive tract and liver metabolism represents a substantial part of the energy requirements. There is almost no net glucose absorption by the gut although it is an energy fuel for the enterocytes. There is a permanent gluconeogenesis, for which the major substrate is propionate. Propionate plays a major role in glucose synthesis is highly effective and propionate metabolism may affect the utilization of other substrates such as lactate. In addition, amino acid metabolism provides a net supply of carbon for gluconeogenesis. However, there is a maximal sparing of the NH2 group (via glutamate release) by the ruminant liver and the energy cost of the conversion of amino acids into glucose is very high. The actual importance of insulin in the regulation of liver metabolism in the ruminant is not entirely understood but glucagon seems not to be a major factor in the stimulation of gluconeogenesis in the fed ruminant. Propionate has a potent effect on anabolism because of its effects on glycaemia and insulin secretion. When glucose requirements are to be enhanced (pregnancy, lactation), even a minor imbalance in the supply of glucogenic substrates may elicit striking physiological changes such as lipomobilization or ketonaemia. In early lactation, insulin secretion is still small in spite of an enhanced food intake. As a result, glucose, fatty acids and amino acids are increasingly channeled towards udder metabolism. Lipogenesis is depressed whereas lipolysis is stimulated by catecholamines. However, excessive glucose and propionate supply may lead to exagerated anabolism and to a drop in milk fat. Thus, a high milk production requires an optimal supply of the three volatile fatty acids (VFA) and it should be emphasized that an improved nitrogen supply has a stimulatory effect on milk production. PMID- 3281196 TI - [Findings and hormonal coordination of protein metabolism in ruminants]. AB - Protein metabolism roughly exhibits the same characteristics in ruminants and non ruminant species. Changes in whole-body protein mass are the result of the balance between the simultaneous protein synthesis and breakdown. Essential amino acids are either incorporated into protein or degraded. Insulin, growth hormone and glucagon have been shown to regulate those metabolic pathways in ruminants. Alteration of food intake both decreases protein synthesis and protein breakdown. Protein synthesis is affected to a greater extent than protein breakdown. So protein synthesis is the main factor controlling N balance in response to alteration of food intake. The decrease in protein synthesis may be related to an impairment of plasma insulin. Protein synthesis and breakdown both decrease throughout development. Protein deposition decreases throughout development because protein synthesis declines more rapidly than protein breakdown. The hormonal coordination of those changes depends on the age of the animals. For example the decrease in protein synthesis in the postnatal growth period may be due to either the decrease in plasma growth hormone or to the impairment in cellular insulin receptors. Due to milk protein synthesis in the mammary gland, lactating animals exhibit a large increase in whole-body protein synthesis. Surprisingly, protein synthesis decreases in some non-mammary tissues. This represents a mechanism for a greater partitioning of amino acids towards milk at the expense of body proteins. We recently demonstrated that insulin could be involved in that adaptative process. PMID- 3281197 TI - [Roles and mechanisms of action of somatotropin (growth hormone) in lactating ruminants]. AB - In 18 short-term trials from the literature using dairy cows, somatotropin resulted in increased milk yield (+4.0 kg/d), increased fat, lactose and protein secretions, decreased dry matter intake (-0.5 kg/d) and decreased calculated energy balance (-4.2 Mcal/d). Milk composition was also changed (fat, + 1.9 g/kg; protein, - 1.4 g/kg, and lactose, + 0.6 g/kg), due to the fact that treated cows were often in negative energy balance. In 15 long term trials, somatotropin resulted in increased milk yield (+ 5.7 kg/d) and increased dry matter intake (+ 1.2 kg/d), whereas calculated energy balance decreased (- 2.2 Mcal/d). In 4 trials, digestive efficiency did not seem to be altered by somatotropin. In two long-term trials, body lipids (as estimated by deuterium marked water space) were about 40 kg lower in treated cows, probably reflecting a lower lipid deposition, owing to their lowered energy balance. Current hypothesis on mechanisms of action of somatotropin or somatomedins are discussed, concerning mammary tissue (secretory cell number or metabolic activity), as well as teleophoretic adaptations that alter nutrient partitioning between mammary, liver, muscle and adipose tissues, by way of modifications of tissue responsiveness to homeostatic insulin or adrenergic regulations. Somatotropin could indirectly stimulate metabolic activity in mammary cells. Simultaneously, it could decrease adipose tissue lipogenesis and increase fatty acid mobilization and oxidation in other tissues, thus allowing decreased glucose and amino acid oxidations that insure adequate nutrient supply to the mammary gland. PMID- 3281198 TI - Enhancement of carbon tetrachloride-induced liver injury by glucagon and insulin treatment. AB - Rats given a dose of carbon tetrachloride (CCl4) immediately received injections of glucagon and insulin every 4 h. They frequently died after 4 h and showed a significantly higher mortality between 8 h and 28 h as compared to the control rats where such deaths occurred 16 h later. At 8 h, the derangements of SGPT values and prothrombin time were significantly greater in the hormone-treated rats than in the control rats. In these CCl4-intoxicated rats, hepatic reduced glutathione content at 4 h was significantly reduced after hormone treatment. The treatment significantly enhanced CCl4 metabolism, conversion of 14CCl4 into 14CO2 in vitro, by microsomes isolated from the liver, whereas it did not affect the microsomal cytochrome P450 content. These results suggest that glucagon and insulin treatment increased CCl4 hepatotoxicity in rats through activating the cytochrome P450-dependent mono-oxygenase system. This would merit consideration for the clinical application of this treatment. PMID- 3281199 TI - On the origin of intestinal transferrin. AB - The incorporation of 35S-L-methionine (35S-Met) into TCA-precipitable protein is used to measure protein synthesis in isolated non-vascular perfused jejunal segments and in isolated liver cells under steady-state conditions in rats. 10(5) X g supernatants of homogenates from jejunal segments and from liver cells as well as the jejunal absorbate were processed immuno-electrophoretically. Incorporation of 35S-Met radioactivity into precipitin lines with sera against transferrin, IgG and plasma proteins were autoradiographed and compared semiquantitatively with each other. Calculated on a wet-weight basis this system is sensitive enough to detect transferrin synthesis down to a level of 1% of that in the liver. Still, no transferrin synthesis was found in the jejunal mucosa, while 35S-Met incorporation into TCA precipitates and into IgG continued in isolated jejunal segments for over 2 h. A good correlation was found (r = 0.88, P less than 0.01) between mucosal and plasma transferrin in normal as well as in iron deficient rats. A complete immunologic cross-reactivity could be demonstrated between different plasma transferrins and the transferrin in three different preparations of the intestinal mucosa. Immunoblots of electropherograms after isoelectric focussing showed no distinct differences between transferrin in the plasma, bile, and in the mucosal epithelium. PMID- 3281200 TI - Morphologic diagnosis of cyclosporine nephrotoxicity. PMID- 3281202 TI - Glomerular lesions associated with the acute nephritic syndrome and hematuria. PMID- 3281201 TI - Morphologic diagnosis of proteinuria-nephrotic syndrome. PMID- 3281203 TI - Iatrogenic renal disease as revealed by renal biopsy. PMID- 3281204 TI - Complications of renal transplant: a morphologic evaluation. PMID- 3281205 TI - Nalidixic acid plus sodium citrate twice daily in the treatment of acute urinary tract infection. Swedish Collaborative Study Group. AB - Negram-Citrat (0.66 g nalidixic acid plus 4 g sodium citrate, NAC) twice daily for five days was evaluated in 257 women with symptoms of acute lower urinary tract infection and nalidixic acid sensitive bacteriuria. At two days post treatment 85% of the patients were abacteriuric while nalidixic acid resistant Escherichia coli bacteriuria was present in five %. Side effects of NAC were usually mild and transient and resulted in interruption of medication in three % of the patients and visual disturbances were volunteered by 1.6%. At follow-up one month after treatment bacteriuria had recurred in 18% of the patients immediately cured, thus resulting in an overall success rate of 70%. Of the 35 recurring strains three (1 E. coli, 2 Staphylococcus epidermidis) were nalidixic acid resistant. PMID- 3281206 TI - Some general methods for the analysis of categorical data in longitudinal studies. AB - This paper is concerned with the analysis of multivariate categorical data from epidemiologic and clinical studies with longitudinal designs. An expository discussion of pertinent hypotheses for such situations is provided within the context of two relevant data sets. Appropriate large-sample tests of these hypotheses are developed through the application of weighted least squares to generate Wald statistics. These procedures are illustrated with extensive analyses of one of these data sets. In some situations, the resulting cross classification of the response variables leads to extremely sparse frequency data, especially when the number of subjects is not large. For such repeated measurement designs in which a single variable is measured repeatedly over time, this paper considers the use of a generalized Mantel-Haenszel strategy for tests of marginal homogeneity (symmetry). These randomization model methods are illustrated for data in which the repeated measurement variable is reported on an ordinal scale. This paper also focuses on the available computing software to implement these methods within the version 5 release of the SAS system. The randomization model approach can be implemented within the FREQ procedure and a broad range of models and hypotheses can be investigated within the CATMOD procedure. PMID- 3281207 TI - General methods for analysing repeated measures. AB - We present an overview of issues and methods for analysing repeated measures of a continuous random variable. We discuss modelling the mean vector and covariance structure, statistical efficiency, regression diagnostics, and discrepancies between longitudinal and cross-sectional methods. We illustrate key points with examples and discuss areas requiring further development. PMID- 3281208 TI - Analysing changes in the presence of informative right censoring caused by death and withdrawal. AB - Several approaches for estimating and comparing the rates of change of a continuous variable in two treatment groups in the presence of informative right censoring are reviewed and compared. The comparisons are made under different models for the censoring probabilities and various types of treatment effects. Some recommendations are discussed regarding the application of these approaches to the different settings. PMID- 3281210 TI - Physiology of ice hockey. AB - Ice hockey is characterized by high intensity intermittent skating, rapid changes in velocity and duration, and frequent body contact. The typical player performs for 15 to 20 minutes of a 60-minute game. Each shift lasts from 30 to 80 seconds with 4 to 5 minutes of recovery between shifts. The intensity and duration of a particular shift determines the extent of the contribution from aerobic and anaerobic energy systems. The high intensity bursts require the hockey player to develop muscle strength, power, and anaerobic endurance. The length of the game and the need to recover quickly from each shift demands a good aerobic system. Physical characteristics of elite players show that defensemen are taller and heavier than forwards probably due to positional demands. Hockey players are mesomorphic in structure. They are relatively lean since excess mass is detrimental to their skating performance. There is a large interindividual variability in VO2 during skating. Both the aerobic and anaerobic energy systems are important during a hockey game. Peak heart rates during a shift on the ice exceed 90% of HRmax with average on-ice values of about 85% of HRmax. Blood lactate is elevated above resting values confirming the anaerobic nature of the game. Glycogen depletion studies show a preferential utilisation of glycogen from the slow twitch fibres but also significant depletion from the fast twitch fibres. Elite hockey players display a muscle fibre composition similar to untrained individuals. Physiological profiles of elite hockey teams reveal the importance of aerobic endurance, anaerobic power and endurance, muscular strength and skating speed. Training studies have attempted to improve specific components of hockey fitness. Using traditional laboratory tests, a season of hockey play shows gains in anaerobic endurance but no change in aerobic endurance. On-ice tests of hockey fitness have been recommended as an essential part of the hockey player's physiological profile. Existing training procedures may develop chronic muscular fatigue in hockey players. Lactic acidosis is associated with the onset and persistence of muscle fatigue. Muscle force output remains impaired throughout the hockey player's typical cycle of practices and games. A supplementary programme of low-intensity cycling during the competitive phase of training was unsuccessful in altering VO2max. Strength decrements during the hockey season are attributed to a lack of a specifically designed strength maintenance programmes. On-ice and off-ice training programmes should focus on the elevation of aerobic endurance, anaerobic power and endurance, muscular strength and skating speed. PMID- 3281211 TI - Review of the clinical trials activity of the Soft Tissue and Bone Sarcoma Group of the European Organization for Research and Treatment of Cancer. AB - Despite the low incidence of sarcomas, the Soft Tissue and Bone Sarcoma Group has established itself as one of the more active cooperative groups of the European Organization for Research and Treatment of Cancer. Performing over a 10 yr period three phase III protocols (total entry 750 patients), three randomized phase II studies (464 patients), a pilot combination study (185 patients), and 12 phase II studies (406 patients). The new randomized phase III protocol for advanced soft tissue sarcoma will provide an interesting test of the validity of the current membership policy, which has not discouraged the participation of enthusiastic new members. For extremity sarcomas, improved surgical techniques have increased the number of patients retaining functional limbs but have maintained excellent rates of local control. However, systemic metastasis remains a significant problem and presents a challenge for future adjuvant studies. PMID- 3281212 TI - Chemotherapy of advanced soft-tissue sarcomas. AB - The most active single agents in soft-tissue sarcomas are doxorubicin (Adriamycin) and ifosfamide, with response rates of 20-35%. Dacarbazine (DTIC) has a response rate of 16%. A randomized trial of 5 g/m2 of ifosfamide versus 1.5 g/m2 of cyclophosphamide noted a higher response rate for ifosfamide with less myelosuppression. Both randomized studies of doxorubicin with or without DTIC documented an increased response rate for the combination. In contrast, three randomized trials of doxorubicin-based regimens with and without cyclophosphamide have failed to detect an advantage for the addition of cyclophosphamide. Thus, the most active combination for soft-tissue sarcomas is doxorubicin and DTIC. The role of the addition of ifosfamide is currently under evaluation. PMID- 3281213 TI - Adjuvant chemotherapy for soft-tissue sarcoma: a critical appraisal. AB - Adjuvant chemotherapy, established in the treatment of osteogenic sarcoma, Ewing's sarcoma, and rhabdomyosarcoma, currently remains controversial in adult soft-tissue sarcoma. Because the survival of the control arms in randomized studies is significantly better than historical controls, only randomized studies with nontreatment control arms will be analyzed here. None of the 11 reported adjuvant studies showed a significant survival advantage for chemotherapy overall. Although subset analyses are less reliable, the National Cancer Institute reported a significant prolonged survival and disease-free survival for the subset of chemotherapy-treated extremity primaries. The M.D. Anderson and Italian studies observed a significant disease-free survival advantage; however, survival was not significantly different in the former and survival statistics were not provided in the latter study. In the subset of central body lesions none of the studies revealed a significant survival advantage for chemotherapy. Adjuvant chemotherapy should be considered investigational for adult soft-tissue sarcomas. PMID- 3281214 TI - Intraarterial chemotherapy of soft-tissue sarcomas. AB - This review compares the results of preoperative intraarterial chemotherapy delivered by various methods, such as intraarterial injection/infusion, tourniquet infusion, and isolation perfusion, with the results achieved by pre- and postoperative radiotherapy. The histological heterogeneity of soft tissue sarcomas adds to the inherent difficulties of comparing results across studies. There is a clear need for randomized studies to directly compare these treatment modalities in similar patient populations. Patients with these rare tumors would benefit from the expertise of multidisciplinary teams available at the larger centers. Metastatic spread, which even with the highest rates of local control, occurs in approximately 30% of high grade soft tissue sarcomas, represents a continuing challenge, and innovative approaches are needed to control systemic disease. PMID- 3281215 TI - Concepts in limb-sparing treatment of adult soft tissue sarcomas. AB - Pretreatment assessment of patients with soft tissue sarcomas of the extremities requires careful attention to a biopsy approach that will establish the precise diagnosis and will not compromise the subsequent definitive operative procedure. Also, staging procedures are required to evaluate the status of both local and distant sites. Limb-sparing surgery for high grade extremity soft tissue sarcomas is a feasible and appropriate approach in approximately 90% of patients with such lesions. Wide gross surgical margins around the sarcoma are the optimal operative approach. Circumstantial evidence is convincing that local treatment failure can be reduced by adjuvant regional radiation treatment when surgical margins are narrow, and end results appear to be equal to those obtained by more extensive surgical resection alone. Adjuvant radiation following operation with optimal gross surgical margins has not been established as adding benefit. Although some groups treating soft tissue sarcomas do use intraarterial chemotherapy in conjunction with these other modalities, there is, as yet, no convincing evidence that this aspect of the multimodality treatment adds to local and/or systemic disease control. The efficacy of adjuvant systemic chemotherapy for high grade soft tissue sarcomas remains to be established within the context of prospective clinical trials. PMID- 3281216 TI - Kawasaki syndrome. AB - Kawasaki syndrome is an acute self-limited illness of young children that may result in significant cardiovascular sequelae in 20% of patients. The etiology is unknown, but clinical and epidemiologic features strongly suggest an infectious etiology. The incidence of coronary artery abnormalities has been dramatically reduced by administration of intravenous gamma-globulin in the acute phase of illness. This paper reviews the clinical, laboratory, etiologic, epidemiologic, cardiovascular, pathologic, and therapeutic aspects of Kawasaki syndrome. Discovery of the etiology of this disorder will enable more specific diagnostic tests and therapies to be developed. PMID- 3281217 TI - Lessons learned from animal models of osteomyelitis. AB - Because of the marked variability in presentation and management of osteomyelitis in patients, research with animal models that mimic the human disease offers a more controlled approach. Presently available animal models have been used to study pathogenesis, diagnosis, and treatment of osteomyelitis. Each model has advantages and disadvantages. Although it seems improbable that an ideal model of osteomyelitis will be achieved in the near future, further efforts to develop new experimental models and innovative research with present models are clearly needed. PMID- 3281218 TI - Penicillin prophylaxis for streptococcal infections in United States Navy and Marine Corps recruit camps, 1951-1985. AB - Benzathine penicillin G has been used in United States Navy and Marine Corps recruit camps since 1953 to reduce the incidence of streptococcal disease and its nonsuppurative complications-acute rheumatic fever and acute glomerulonephritis. This paper reviews the history of prophylactic penicillin use among U.S. Navy and Marine Corps recruits and discusses the rationale for continuing this practice today. PMID- 3281219 TI - HIV infection and intravenous drug use: critical issues in transmission dynamics, infection outcomes, and prevention. AB - As the second largest group of persons to have been infected with human immunodeficiency virus (HIV), and the most likely to transmit HIV to heterosexual partners in the United States and Europe, iv drug users will play an increasingly important role in the future of the AIDS epidemic. This paper reviews five emerging critical issues regarding HIV infection among iv drug users. In epidemiology, rates of drug injection and anonymous sharing of injection equipment appear related to rapid spread of HIV among iv drug users, while heterosexual transmission from iv drug users appears to have been occurring at a relatively slow but constant rate. Data exist that support a gender-related cofactor and a continuing drug injection cofactor, but mechanisms for these potential cofactors have not been determined. Besides frank AIDS, HIV infection also appears to lead to epidemic-level increases in a variety of fatal infections among iv drug users. Several studies of prevention show active risk reduction among iv drug users, but new methods are urgently needed to increase amount of risk reduction. PMID- 3281220 TI - A tribute to toilet paper. AB - In modern use, toilet paper would seem to play an important role as a barrier to the transmission of enteric infection by the fecal-manual-oral route. A historical review reveals a dearth of information on this topic. The remarkable compliance with the hygienic practice of toilet paper use is in contrast to the more limited compliance with hand-washing policies touted universally as a sound infection-control measure. PMID- 3281221 TI - Immunity in infective diseases. By Il'ia Il'ich Mechnikov, 1905. PMID- 3281222 TI - Group A and group B beta-hemolytic streptococcal bacteremia. PMID- 3281209 TI - Techniques of measurement of body composition. Part II. PMID- 3281223 TI - Lessons for human influenza from pathogenicity studies with ferrets. AB - In research on influenza, little attention has been given to factors that determine the patterns of infection in human adults or infants and the severity of disease. Ferret influenza has been used to elucidate the following facets of pathogenicity that bear on these questions about human disease: the differential infectivity of virus strains for the upper respiratory tract (URT); the reasons for less severe infection of the lower respiratory tract (LRT) than of the URT; why pneumonia is rare; and why strains differ in the production of LRT infection. The origin of fever has been defined; viruses have been shown to differ in fever producing components. Poor spread of virus from the respiratory tract to other susceptible tissues and rarity of fetal infection have been explained. Death in neonatal ferrets due to influenza with either a syndrome akin to cot death or viral pneumonia have been elucidated, and protection of the young by immunized mothers has been demonstrated. PMID- 3281224 TI - Cefoxitin: its role in treatment and prophylaxis of obstetric and gynecologic infections. AB - Cefoxitin has become one of the most used parenteral antibiotics in the United States, perhaps because of a broad spectrum of activity, including activity against Bacteroides fragilis, which makes the drug suitable for prevention and treatment of intraabdominal and pelvic infections. This review focuses on the use of cefoxitin in obstetric and gynecologic infections, with comparisons to older and newer antibiotics. Numerous studies have shown that cefoxitin is clearly effective; in most of these studies, however, either the initial infection rates were low or the sample sizes were small--circumstances making it difficult to establish the superiority of any one agent. Thus, the necessity of using a drug with activity against B. fragilis for prevention and treatment of pelvic infections has not been proven. Several antibiotics without such activity have been equally effective. Cefoxitin may be of particular value when combined with surgical drainage of pelvic abscesses, infections in which control of B. fragilis may be especially important to outcome. PMID- 3281226 TI - [The suprapatellar space of the knee joint in the sonogram]. AB - The findings of the suprapatellar region in sonography are described of 400 patients. The patterns in sonography of effusion, synovialitis, hemoarthros, soft tissue tumour and soft tissue necrosis, free bodies, and artificial ligaments are demonstrated. The investigation is easy and can be effected with ordinary equipment. PMID- 3281227 TI - [The most common types of collateral circulation following occlusion of extracranial vessels--a digital subtraction angiography study]. AB - We studied the collateral circulation of 56 patients with occlusion of the extracranial arteries. The results of this study showed that there is often a dominant collateral circulation, mainly of the anterior communications arteries, which supply the blood from one half of the brain to the other. PMID- 3281225 TI - Applications of computerized microscopic image analysis in infectious diseases. AB - Advances in computerized microscopy have resulted in image analysis systems that rapidly and precisely measure various aspects of cellular morphology and physiology. These systems-composed of a microscope and attached photomultiplier tube or camera, an image processor, and a computer-have been used to measure lysosomal enzymes, pH, and calcium within phagocytes; to detect viral nucleic acids in in situ hybridization preparations; and to quantitate rates of cellular movement. These experiments have shown that (1) the intracellular proliferation of virulent microorganisms is associated with reductions in acid phosphatase, beta-glucuronidase, and lysozyme activity; (2) virulent Toxoplasma gondii, Legionella pneumophila, and Nocardia asteroides inhibit phagosomal acidification; and (3) changes in intracellular calcium movement affect phagocytic function. These methods have also been used to detect the AIDS virus within cultured lymphocytes and to measure cellular chemotaxis and chemokinesis. Further advances in technology should produce improved microscopic image analysis systems with wider applications for the investigation of infectious diseases. PMID- 3281228 TI - [Medical imaging in the exploration of diseases of the liver, bile ducts and pancreas]. PMID- 3281229 TI - [Chemotherapy of digestive cancers]. PMID- 3281230 TI - [Intestinal functional disorders: current clinical and therapeutic aspects]. PMID- 3281231 TI - [Physiology of potassium and magnesium in the human body]. PMID- 3281232 TI - [Muscular manifestations of dyskalemia]. PMID- 3281233 TI - [Muscular manifestations of dyskalemias]. PMID- 3281234 TI - [The heart, potassium and magnesium]. PMID- 3281235 TI - [The kidney and potassium]. PMID- 3281236 TI - [Arterial hypertension with hypokalemia]. PMID- 3281237 TI - [Arterial hypertension]. PMID- 3281238 TI - [Cholesterol and vascular risk]. PMID- 3281239 TI - [Advances in imaging technics]. PMID- 3281240 TI - [Primary lymphedema of the lower limbs]. PMID- 3281241 TI - [Lupus disease with antinuclear antibodies of the nucleolar type. Apropos of a series of 13 cases]. AB - An exclusive or predominant nucleolar location of antinuclear antibodies is rare in the course of lupus disease: less than 1 p. cent of our patients. Thirteen cases of lupus disease with exclusive or predominant antinucleolar antibodies are analyzed: clinically, the only difference from other lupus diseases is the absence of pleurisy (p less than 0.03) and the frequent thrombopenia (p = 0.05). A proliferative glomerular lesion was found 4 times on renal biopsy. No patient presented any indications of overlapping sign with sclerodermia, polymyositis or Gougerot-Sjogren syndrome which are usually associated to a nuclear fluorescence of nucleolar type. 11 out of 13 patients have natural anti-DNA antibodies, including 9 with a very weak titer. Six patients present cytoplasmic anti-organic antibodies. Four patients have antibodies which precipitates on gelose, identifying nuclear or cytoplasmic antibodies: in 1 instance anti-SS-B et SS-A (Ro), in 1 instance anti-ribosomes associated with anti-ADN, in one instance anti DNA. No serum contained anti-histones antibodies. The study of the sensitivity of nucleolar antigens to digestion by various enzymes (DNAse, RNAse and trypsin) showed that antinucleolar sera could be placed into three groups: 8/10 recognize a ribonucleic antigen, 1/10 a ribonucleoproteic antigen and 1/10 an antigen resisting to various enzymatic digestions. Therefore, in spite of its rarity, an exclusively nucleolar fluorescence should not rule out the diagnosis of lupus disease. PMID- 3281242 TI - [Value of the characterization of anti-ribonucleoproteins and anti-Sm antibodies by immunoblotting and immunoprecipitation in connectivitis]. PMID- 3281243 TI - [Bone loss during aging or how one becomes osteoporotic?]. AB - There is currently a better understanding of bony loss secondary to ageing. It involves cancellous bone as well as cortical bone. Since remodelling of cancellous bone is approximately 7 times higher than that of cortical bone, the bony loss will always be more marked in cancellous bone, especially in vertebral bodies which are essentially made of cancellous bone. In women, the total bony loss secondary to ageing is about 50 p. cent for cancellous bone and 35 p. cent for cortical bone; it is approximately 35 and 20 p. cent in men. Increased bony loss is observed in women during the 10 years following menopause. For instance, the trabecular bony loss, especially in the vertebrae, may reach 1 to 2 p. cent per year, even reaching 12 p. cent during the 2 years following ovariectomy. PMID- 3281244 TI - Comparison of bone reactions to coated tricalcium phosphate and pure titanium dental implants in the canine iliac crest. AB - Titanium and TCP-coated implants were compared after insertion in the canine iliac crest. Observation time was 14 wk. Evaluation included pull-out tests, energy dispersive X-ray analysis, and histologic examination of in situ, undemineralized implants. The TCP-coated implants were more firmly attached to bone than were the titanium implants. The calcium/phosphorus ratios around the titanium implants were higher than around the TCP-coated implants. Both types of implants were closely surrounded by bone after a 14-wk implantation. PMID- 3281245 TI - Silicoating: evaluation of a new method of bonding composite resin to metal. AB - Silicoating is a new type of pretreatment of the metal in the resin-bonded bridge technique. The size of bond strength between resin cement and silicoated metal was investigated. Different resin cements, types of metal, and grain sizes of sand used for roughening the metal surface were tested. Furthermore, the effect on the bond strength of contamination with saliva and of thermocycling was measured. There was no difference of importance between the two resin cements tested. Bond strengths obtained with Wirobond were the highest and insensible to changes in resin cement, grain size of sand, and to thermocycling. It was found that sand of the smallest grain size used brought about the highest bond strengths. Contamination with saliva did not significantly reduce the size of the bond strengths. Rinsing the metal surfaces with water or ethanol after contamination restored the bond strengths to their original magnitude. By silicoating, a greater resistance to thermocycling was obtained. Nevertheless, except for Wirobond, a fall in bond strength was measured after thermocycling. Bond strengths of the size of those between etched enamel and composite resin were measured, and the Silicoater method seems a reliable pretreatment of the metal. PMID- 3281246 TI - Role of the endothelial antigen Eag-1 in the rejection of rat kidney allografts. AB - The immunogenicity of the minor histocompatibility antigen Eag-1 of the rat kidney endothelium was studied in renal allografts mismatched for antigens of the major histocompatibility complex (MHC). The rejection rates of BN.1L (RT1(1), Eag 1+), (BN.1LXMAXX)F1 (RT1l/n, Eag-1+), and LEW (RT1l, Eag-1-) kidneys transplanted into unsensitized, bilaterally nephrectomized MAXX (RT1n, Eag-1-) recipients were comparable, indicating that incompatibility for Eag-1 has no effect on the survival of MHC-incompatible kidney grafts. Transplantation of BN (RT1n, Eag-1+) and WKY (RT1k, Eag-1+) kidneys into unilaterally nephrectomized MAXX recipients led to a weak and inconsistent antibody response against Eag-1, indicating that MHC incompatibility does not influence the formation of antibodies against Eag-1. PMID- 3281247 TI - Respiratory health effects from occupational exposure to wood dusts. AB - Occupational exposure to wood dusts has been well established as a cause of nasal cancer, dermatitis, and pneumonites from molds growing in wood chips. With the exception of studies on western red cedar asthma, there is a dearth of information on the respiratory toxicity of wood dust exposure. This paper reviews the clinical and epidemiologic literature and identifies the specific woods (with botanical names) and their respiratory disease correlates, including pulmonary function declines, chronic and acute symptoms, and impaired mucociliary transport. PMID- 3281248 TI - Absence of mutagenic response to radiation from a video display terminal. AB - The standard Ames Salmonella test (TA 100) was used to detect the mutagenicity of radiation from a video display terminal. The Ames test is a sensitive assay that detects the ability of a chemical to damage deoxyribonucleic acid. It has also been employed to detect the mutagenicity of electromagnetic radiation. An extremely short distance (62 mm) from a video display terminal and an extremely high electrostatic field strength (250 kv/m) was employed. No mutagenic response was found in this test system. PMID- 3281249 TI - [Preparation for adhesive dental prostheses]. PMID- 3281250 TI - Behavioral research and AIDS prevention. PMID- 3281251 TI - A rebel without a cause of AIDS. PMID- 3281252 TI - Evolving legal standards for the admissibility of scientific evidence. AB - Ensuring the scientific validity of scientific evidence has always posed problems for judges and lawyers largely untrained in science. As recent cases involving the health effects of chemicals and drugs make clear, however, irrational and inconsistent decisions result when courts do not hold expert witnesses to the standards and criteria of their own disciplines. A trend toward more thorough judicial review of scientific claims has developed, and it should be encouraged. PMID- 3281253 TI - Dynamic pattern generation in behavioral and neural systems. AB - In the search for principles of pattern generation in complex biological systems, an operational approach is presented that embraces both theory and experiment. The central mathematical concepts of self-organization in nonequilibrium systems (including order parameter dynamics, stability, fluctuations, and time scales) are used to show how a large number of empirically observed features of temporal patterns can be mapped onto simple low-dimensional (stochastic, nonlinear) dynamical laws that are derivable from lower levels of description. The theoretical framework provides a language and a strategy, accompanied by new observables, that may afford an understanding of dynamic patterns at several scales of analysis (including behavioral patterns, neural networks, and individual neurons) and the linkage among them. PMID- 3281254 TI - Peroxisomal membrane ghosts in Zellweger syndrome--aberrant organelle assembly. AB - Peroxisomes are apparently missing in Zellweger syndrome; nevertheless, some of the integral membrane proteins of the organelle are present. Their distribution was studied by immunofluorescence microscopy. In control fibroblasts, peroxisomes appeared as small dots. In Zellweger fibroblasts, the peroxisomal membrane proteins were located in unusual empty membrane structures of larger size. These results suggest that the primary defect in this disease may be in the mechanism for import of matrix proteins. PMID- 3281255 TI - Computers in molecular biology: current applications and emerging trends. AB - The rate of generation of molecular sequence data is forcing the use of computers as a central tool in molecular biology. Current use of computers is limited largely to data management and sequence comparisons, but rapid growth in the volume of data is generating pressure for the development of high-speed analytical methods for deciphering the codes connecting nucleotide sequence with protein structure and function. PMID- 3281256 TI - The neural cell adhesion molecule (NCAM) as a regulator of cell-cell interactions. AB - The neural cell adhesion molecule (NCAM) can influence a number of diverse intercellular events, including junctional communication, the association of axons with pathways and targets, and signals that alter levels of neurotransmitter enzymes. These pleiotropic effects appear to reflect the ability of NCAM to regulate membrane-membrane contact required to initiate specific interactions between other molecules. Such regulation can occur through changes in either NCAM expression or the molecule's content of polysialic acid (PSA). When NCAM with a low PSA content is expressed, adhesion is increased and contact dependent events are triggered. In contrast, the large excluded volume of NCAM PSA can inhibit cell-cell interactions through hindrance of overall membrane apposition. PMID- 3281257 TI - The race for the cystic fibrosis gene. PMID- 3281258 TI - 2-Aminopurine selectively inhibits the induction of beta-interferon, c-fos, and c myc gene expression. AB - The protein kinase inhibitor 2-aminopurine (2AP) blocks the induction of the human beta-interferon gene by virus or poly(I)-poly(C) at the level of transcription. This inhibition is specific, since 2AP does not inhibit induction of either the hsp70 heat-shock gene by high temperature or the metallothionein gene by cadmium or dexamethasone. However, 2AP does block the induction of the c fos and c-myc proto-oncogenes by serum growth factors or virus, suggesting that a protein kinase may be involved in the regulation of these genes, as well as of the beta-interferon gene. However, different factors must be required for the induction of these three genes, since they are not coordinately regulated by the same inducers in most of the cell lines examined. PMID- 3281259 TI - Action at a distance along a DNA. AB - A number of ways are known by which an event at one location on a DNA molecule can affect an event at a distant location on the same molecule. Three classes of mechanisms are described for such distal actions: tracking or translocation of a protein along a DNA, the association of two proteins bound at separate sites to form a DNA loop in between, and distal interactions that are affected by the topology of the DNA. The basic characteristics of each type of mechanism are discussed in terms of the known physicochemical properties of DNA. The various modes of action at a distance are often interrelated. Examples include the formation of positively and negatively supercoiled DNA loops by tracking and the strong effects of DNA topology on looping. PMID- 3281260 TI - Oral Salmonella typhimurium vaccine expressing circumsporozoite protein protects against malaria. AB - Immunization with radiation-attenuated malaria sporozoites induces potent cellular immune responses, but the target antigens are unknown and have not previously been elicited by subunit vaccines prepared from the circumsporozoite (CS) protein. A method is described here for inducing protective cell-mediated immunity to sporozoites by immunization with attenuated Salmonella typhimurium transformed with the Plasmodium berghei CS gene. These transformants constitutively express CS antigens and, when used to immunize mice orally, colonize the liver, induce antigen-specific cell-mediated immunity, and protect mice against sporozoite challenge in the absence of antisporozoite antibodies. These data indicate that the CS protein contains T cell epitopes capable of inducing protective cell-mediated immunity, and emphasize the importance of proper antigen presentation in generating this response. Analogous, orally administered vaccines against human malaria might be feasible. PMID- 3281261 TI - Overview of venous thrombogenesis. AB - In the pathogenesis of venous thrombosis, stasis is essentially a permissive factor, allowing the normal defense mechanisms of the body to be circumvented. Although a platelet monolayer is an insufficient stimulus for fibrin formation, even in the presence of stasis, trace amounts of an activated clotting factor are highly thrombogenic in an area of retarded blood flow. The available clinical and experimental data suggest that, if thrombin generation is reduced, the great majority of venous thrombi are prevented. PMID- 3281262 TI - Use of heparin in newborn infants. PMID- 3281263 TI - Mechanisms of pathogenesis of arterial thrombosis: potential sites of inhibition by therapeutic compounds. PMID- 3281264 TI - Clinical studies: evidence for intervention with specific antiplatelet drugs in arterial thromboembolism. AB - There is conclusive evidence that aspirin is beneficial in patients with unstable angina and that a combination of preoperative dipyridamole with post-operative aspirin is beneficial after coronary artery bypass. The evidence for a beneficial effect of aspirin after myocardial infarction is consistent but inconclusive. The evidence for the use of aspirin alone following coronary bypass is inconclusive. There is convincing evidence that aspirin will reduce the rate of recurrent TIA, stroke, and death in patients with TIA. PMID- 3281265 TI - Prevention of thromboembolism induced by prosthetic heart valves. PMID- 3281266 TI - The metastatic cascade: potential approaches for the inhibition of metastasis. PMID- 3281267 TI - Antimetastatic agents. I. Role of cellular procoagulants in the pathogenesis of fibrin deposition in cancer and the use of anticoagulants and/or antiplatelet drugs in cancer treatment. PMID- 3281268 TI - ["Complex therapy" of injuries of the lower cervical spine with involvement of the spinal cord]. PMID- 3281269 TI - Extracardiac complications of cardiac surgery. PMID- 3281270 TI - The chest radiograph after extrathoracic surgery. PMID- 3281271 TI - Monitoring the monitors: the radiology of thoracic catheters, wires, and tubes. PMID- 3281272 TI - Radiology of the chest after thoracic surgery. PMID- 3281273 TI - Regional and welfare perspectives on the public-private hospital dichotomy in New Zealand. AB - Concern with the social welfare implications of dual (public and private) hospital systems has grown over the last decade as national commitments to welfare state ideals have wavered in the continuing atmosphere of fiscal conservatism that has permeated through western democracies. New Zealand provides an excellent example of a health care system in which private hospitals have survived (and recently flourished) alongside those provided by the state. Following a brief survey of the evolution of the New Zealand hospital system, variations in the 'mix' of public and private hospitals are described at the (regional) Hospital Board District level. It is noted that competition for patients and funding between the public and private sectors occurs almost exclusively in the larger, urban hospital districts, and is invariably to the detriment of public hospitals. Districts with a substantial private hospital presence are found to have fewer resources in the public sector (relative to their population) than those which have few or no private hospitals. The welfare implications of this situation are explored. It is proposed that the maintenance of a dual hospital system in New Zealand has provided, in some parts of the country at least, a 'choice' for those able to afford private hospital charges or insurance coverage, but at the expense of those dependent solely upon a (shrinking) public sector. PMID- 3281274 TI - Private property and public health reform in England 1830-70. AB - British cities of the mid-nineteenth century were unsanitary. In many cases lack of street paving, insufficient water, proliferating cesspools and open sewers turned them into cloying, degrading and offensive mires. Many of the urban workers, too poor to pay rent sufficient to meet the costs of these environmental services, were shuffled among damp dingy rooms into which the sun shone feebly and in which their physical odours were confined against any draughts. The relations between landlord and tenant were circumscribed by the indebtedness of the former and the penury of the latter. Water, sewerage and housing standards were left to the sway of the market while the effective demand for them was limited by low real wages. In the largest cities this filth was dangerous as well as offensive and public health reforms became ever more pressing. Yet the form in which this legislation was secured and the manner in which it was implemented were not as straightforward as this sketch of their crying necessity might suggest. PMID- 3281275 TI - Worksite health promotion: the social context. PMID- 3281276 TI - Formal intervention in employee health: comparisons of the nature and structure of employee assistance programs and health promotion programs. AB - Health promotion programs (HPP) and employee assistance programs (EAP) are compared in terms of their structure and process. Two common themes are extracted: a belief that both are beneficial to both employers and employees, and a sense of 'mission'. The technology of HPP and EAP are examined and compared. EAPs' stimulation from Federal funding is contrasted with the more indigenous roots of HPPs. Examination of empirical data comparing organizations with EAPs which have and have not adopted HPPs indicate the former tend to be somewhat more 'caring' toward employees. An examination of program ingredients indicates much greater commonality of structural and processual ingredients within EAPs as compared to HPPs. The extent to which each program type has become more 'populist' in orientation and the implications of these changes for program technology are considered. Finally the paper describes differences in program evaluation stemming from target group definitions in the two types of programs. PMID- 3281277 TI - Toward a sociology of worksite health promotion: a few reactions and reflections. PMID- 3281278 TI - [Insulin (1)]. PMID- 3281279 TI - [Microcomputer-based automated registry of the KASMON system (comprehensive automated system of medical examinations of the population)]. PMID- 3281280 TI - [Leninist national policy and the formation of Soviet public health in the early months of Soviet power]. PMID- 3281281 TI - [Sergei Sergeevich Iudin]. PMID- 3281282 TI - [History of medical societies in the Kuban]. PMID- 3281283 TI - [Physicians and folk healers of Volga Bulgaria in the 9th to 13th centuries]. PMID- 3281284 TI - [Sources of the social aspect in the history of primitive healing]. PMID- 3281285 TI - [Multiple organ collection for transplant]. PMID- 3281286 TI - [Habent sua fata libelli]. PMID- 3281287 TI - Menstrual dysfunction in female athletes. A review for clinicians. AB - A critical review of factors considered to cause menstrual dysfunction is women athletes with no overt organic cause for the abnormality is presented. Evidence suggests that although regular exercise can produce a specific change in hypothalamic-pituitary function, in particular reduced pulsatile luteinising hormone secretion, this is not associated with amenorrhoea or oligomenorrhoea in the majority of female athletes, most of whom continue to menstruate cyclically. Thus additional factors must be operative. It seems probable that severe menstrual dysfunction occurs in a specific predisposed subset of women athletes who have a particular personality type or body build and are attracted to a lifestyle including regular vigorous exercise. The biochemical basis may be related to hypothalamic, pituitary or even ovarian dysfunction possibly due to elevated levels of anti-reproductive hormones, including beta-endorphins, dopamine, prolactin and catechol oestrogens, induced by exercise; dopamine appears the most likely candidate. Chronic hypo-oestrogenic or eu-oestrogenic amenorrhoea or oligomenorrhoea may not be benign and should probably be treated in order to reduce the risk of osteoporosis or endometrial hyperplasia and adenocarcinoma. PMID- 3281288 TI - Solubility changes on mixing short- and long-acting insulin preparations. AB - The loss of solubility of short-acting insulins when mixed in a ratio of 1:1 with intermediate-acting insulins in vitro was determined using high-performance liquid chromatography. Insulin preparations (porcine and human) from three different manufacturers were tested and various times of mixing (0-24 h) were investigated. The loss of solubility with mixtures of human insulins and with mixtures of porcine Velosulin (Nordisk) and Insulatard (Nordisk) was small at all the times used. A mixture of porcine Actrapid MC (Novo) and Monotard MC (Novo) led to a 60-95% loss of the soluble component, depending on the duration of mixing. The greater the time the greater the loss. These in vitro data indicate that short-acting insulins may lose solubility when mixed with long- or intermediate-acting ones. This phenomenon could be clinically relevant when patients are changed from mixtures of monocomponent to human insulins. PMID- 3281289 TI - The successful management of portal vein thrombosis after hepatic transplantation with a splenorenal shunt. AB - Portal vein thrombosis is an infrequent complication after hepatic transplantation, but is quite dramatic when it occurs. It is usually managed by retransplantation with a significant mortality rate. We present a patient in whom portal vein thrombosis after hepatic transplantation was ultimately managed by a splenorenal shunt. The portal vein thrombosis was manifested by bleeding esophageal varices and, yet, normal hepatic function obviated the need for a new graft (one was not readily available). To the best of our knowledge, this is the first presentation of a patient with a transplant of the liver with acute portal vein occlusion and maintained hepatic function who has been successfully managed by a portosystemic shunt. PMID- 3281290 TI - Ultrasound and magnetic resonance imaging of pelvic masses. AB - Magnetic resonance imaging (MRI) is a complementary imaging modality to ultrasound in the evaluation of pelvic masses. Indications for MRI include differentiating a uterine from an adnexal mass when the ultrasound is inconclusive, establishing the presence of blood in a "simple" appearing cyst and demonstrating fat within a mass that is sonographically suspicious of a benign cystic teratoma. PMID- 3281291 TI - Pharyngostomy with double tube and anastomosis in the posterior wall of the stomach as a method of avoiding leakage after esophagectomy. AB - The cervical esophagogastrostomy is a surgical method that has frequent fistula like complications and it increases the morbidity and mortality rate in surgical treatment for carcinoma of the esophagus. One-hundred and thirty-eight instances of carcinoma of the esophagus were treated surgically from 15 October 1968 to 30 April 1986. In the last 15 instances (10.8 per cent), esophageal anastomosis with the posterior wall of the stomach was done. The decompression of anastomosis and enteral nutrition are done by a Kher drain and Levine catheter, respectively, that are exteriorized by a pharyngostomy. With this method, no fistulas occurred after cervical esophagogastrostomy. PMID- 3281292 TI - A technique for donor lung procurement and preservation for transplantation after completion of cardiac donation. AB - The scarcity of donor lungs for transplantation has been caused, in part, by the belief that a single donor cannot provide usable lungs if it serves as a heart donor. However, the appropriate division of the left atrial wall provides sufficient cuffs for individual transplantation of the heart and each lung into three separate recipients. With the described technique, the results of the present studies demonstrate the feasibility of donor lung procurement and preservation for transplantation after cardiac donation. Use of this method will allow the most effective and efficient use of the limited supply of donor organs and thereby permit therapeutic single lung transplantation in selected patients. Cardiac donation should no longer preclude lung donation as it has in the past. PMID- 3281293 TI - The unpublished letters of William Halsted and Harvey Cushing. PMID- 3281294 TI - Cardiopulmonary function in pectus excavatum. AB - The results of recent studies clearly support a cardiopulmonary impairment resulting from pectus excavatum, but resolving the apparent discrepancies between studies is necessary. Several factors must be taken into consideration. The severity of the deformity of the chest wall must be defined, whether by the sternovertebral distance or by various means proposed by others. Without some index of the degree of sternal depression, it is impossible to compare patients or results among studies. No study has enrolled a sufficient number of patients to provide an accurate correlation between the severity of the deformity and the extent of the cardiopulmonary deficit, nor has any defined how severe the deformity must be to result in cardiopulmonary dysfunction. The second factor that is important in evaluating results is what controls were used. Studies in which each patient functioned as his own control after surgical repair are preferable. In the pediatric age group where growth and increased pulmonary parameters would be expected, the follow-up studies should be performed at a defined time after surgical treatment. Studies completed years later cannot assess the effect of surgical repair upon cardiopulmonary function. Studies wherein persons matched for age and height to serve as controls are available from the same laboratory are also needed. The degree of co-operation and effort of patients will vary, particularly in the pediatric age group. Constancy of the experimental protocol and personnel is important. Least reliable are reports of experimental findings compared with standardized normal values. In early studies, measurements of vital capacity and total lung capacity produced variable results when compared with normal persons matched for age. The wide range of "normal values" makes statistical comparison difficult, if not impossible. A wide spectrum of cardiopulmonary function exists among individuals, depending upon prior physical training and body habitus. Sufficient physiologic reserve is generally present, such that extensive impairment must exist before patients become symptomatic at rest. Physiologic reserve during exercise is rapidly consumed and differences can be more readily determined. Exercise studies must go beyond the measurement of intracardiac pressures and pulmonary volumes at rest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281295 TI - Structural and regenerative changes in deafferented and deefferented ulnar nerves. AB - Both brachial plexuses of Wistar rats were deafferented or deefferented by disrupting their dorsal or ventral roots. At the same time, the ulnar nerves were transected and sutured. A sham group and another group in which the upper (C-5) and lower (T-1) spinal nerves were transected on both sides were included as control groups. Clear differences in the ulnar nerve regeneration rate were found between the deafferented and the deefferented animals. Ultrastructural studies disclosed signs of transient axonopathy in the nontransected fibers of the proximal segment of the ulnar nerve. The possible role of bioelectricity in the genesis of these changes is discussed. PMID- 3281296 TI - Transcranial Doppler ultrasound for the assessment of intracranial arterial flow velocity. PMID- 3281297 TI - Parameters affecting the response of experimental tumours to fractionated radiotherapy. AB - A review is given of data published on the response of experimental tumours to fractionated irradiation including ten or more fractions. In addition experiments performed with the R1H rhabdomyosarcoma of the rat including regimens of six to 126 fractions (dose range 0.43 to 12.5 Gy per fraction) with an overall treatment time of six weeks are reported. Tumour response was assessed by: in vitro colony assay, tumour control probability, tumour growth delay, and flow cytometric determination of DNA-index. While a clear reduction of normal tissue damage is observed with increasing number of fractions, the response of the R1H rhabdomyosarcoma is essentially independent of the number of fractions. This result encourages clinical research on the use of hyperfractionation for curative radiotherapy. The results also indicate that proliferation is decelerated during treatment. During irradiation the DNA-index of the highly hyperploid R1H-tumour cells decreases. This reduction is proportional to the total dose applied. Cells that are separated from the tumour and from metastases have defined DNA-indices. Thus, this special tumour system allows to determine the time point of onset of metastatic spread from flow cytometric DNA-index measurements. PMID- 3281298 TI - Gastroduodenal mucosal defense: factors responsible for the ability of the stomach and duodenum to resist injury. PMID- 3281299 TI - Intravagal paraganglioma: report of a case and a discussion of vascular parapharyngeal masses. AB - A case of intravagal paraganglioma that appeared as a parapharyngeal mass 1 year after tonsillectomy is discussed. The diagnosis of this lesion was based on angiographic findings, and subtraction views provided the best detail of the extent and nature of the mass. Excision was made nearly bloodless by initial ligation of the external carotid artery, followed by the application of direct pressure to the mass during dissection. The diagnosis of parapharyngeal vascular masses is discussed, and the pertinent literature is reviewed. PMID- 3281300 TI - Adenosine stimulates glucose uptake in the isolated rat heart. AB - Adenosine (Ado) is a potent coronary vasodilator. Recent studies suggest that Ado may also have an important effect on myocardial carbohydrate metabolism. To determine whether Ado has a direct effect on myocardial glucose uptake, a recirculating, constant-flow, isolated rat-heart preparation was used. The hearts were perfused with Krebs-Henseleit buffer solution with an initial glucose concentration of 11 mmol/L. A control group was compared with hearts treated with Ado infusions (50 and 100 micrograms/min) or insulin (100, 200, and 300 microU/ml). In a separate series of experiments, nitroprusside was used to evaluate the effect of a nonspecific coronary vasodilator. The rate of glucose uptake was calculated as the amount of glucose removed from the perfusate normalized for heart weight and time. Developed pressure (DP) was assessed with an intraventricular balloon, and the coronary perfusion pressure (CPP) was monitored. At the end of 1 hour, the hearts were freeze-clamped and adenine nucleotide content was measured with HPLC. Ado treatment increased glucose uptake by 80% and 140%, respectively, at the two infusion rates (p less than 0.001). Myocardial adenosine triphosphate content was 18% and 26% higher in the Ado treated hearts than in the controls (p less than 0.001). Ado also decreased the mean DP by 30% and 36% (p less than 0.001) and decreased CPP by 10% and 22%, respectively (p less than 0.001). Insulin increased glucose uptake in a similar dose response fashion but had no effect on myocardial nucleotide content, DP, or CPP. Nitroprusside decreased CPP but had no effect on glucose uptake, adenine nucleotide content, or DP. These results suggest that Ado may have a direct effect on glucose uptake independent of its properties as a coronary vasodilator. PMID- 3281301 TI - Malignant recurrent pheochromocytoma during pregnancy: case report and review of the literature. AB - Pheochromocytoma is an uncommon disorder associated with significant morbidity and mortality. When the disorder is discovered during pregnancy the risks are much greater. Malignant lesions represent only 10% of these tumors. Malignancy associated with pregnancy is even more rare. We present the fourth case of malignant pheochromocytoma and pregnancy to be reported in the literature. Surgery remains the mainstay of therapy. If the disorder is diagnosed early in pregnancy, surgical exploration should be considered after rapid medical control. If diagnosis is made later in pregnancy, medical control for the duration of the pregnancy should be attempted. Labor and vaginal delivery should be avoided because of an associated high morbidity and mortality. Cesarean section is recommended, once fetal maturity has been reached. Localization and definitive resection may be performed after delivery if exploration was not performed at the time of cesarean section. Although the prognosis of patients with malignant pheochromocytomas remains poor, there is hope of improving this prognosis in the future with use of new radiopharmaceutical agents and, possibly, new chemotherapy. Currently, aggressive surgical management not only appears to offer excellent palliation but likely prolongs survival of patients with malignant pheochromocytomas in selected cases. PMID- 3281302 TI - Orthotopic liver transplantation for massive hepatic lymphangiomatosis. AB - Lymphangiomatosis is a rare malformation of the lymphatic system that causes severe symptoms secondary to progressive growth into or close to vital structures. A case report of liver failure related to this space-occupying intrahepatic mechanism is taken as a starting point for a discussion of the problems of liver transplantation related to large hepatomegalies. PMID- 3281303 TI - A comparative study of the effects of retinoic acid given during the critical period for inducing spina bifida in mice and hamsters. AB - Spina bifida occurred in the offspring of golden Syrian hamsters treated on day 8 of gestation, and CD-1 mice treated on day 9, with 80 mg/kg of retinoic acid. Light microscopic examination of term fetuses demonstrated that myeloschisis was the characteristic form of the defect in mice, whereas myelocystocele was the predominant type of spina bifida induced in the hamster. To investigate the pathogenesis of these defects, a comparative study was undertaken by light microscopy and scanning electron microscopy of the changes occurring in caudal embryonic tissues during the initial 48 hr following maternal treatment. Within 18 hr of exposure, similar effects were observed in both species. These included distortion of the neural folds at the level of the posterior neuropore, vascular damage and hematoma formation, malformation of the notochord, and abnormalities of secondary neurulation. No differences were observed that we thought could account for the apparent variation in the pattern of malformations seen in the term litters. Rather, the dissimilarity may reflect species differences in the position of the posterior neuropore in the neuraxis and in the extent to which secondary neurulation contributes to the development of the lumbosacral cord segments. PMID- 3281304 TI - Ectopic pregnancy: clinical and pathological review of 150 cases. PMID- 3281305 TI - Thyroid sonography--first choice for diagnosis? PMID- 3281306 TI - Can pulmonary vasodilators improve survival in cor pulmonale due to hypoxic chronic bronchitis and emphysema? PMID- 3281307 TI - Subcutaneous adrenaline versus terbutaline in the treatment of acute severe asthma. AB - Subcutaneous adrenaline and terbutaline have been compared in a double blind study of 20 patients with acute severe asthma presenting to an accident and emergency department. Ten patients received adrenaline 0.5 mg (0.5 ml) and 10 terbutaline 0.5 mg (0.5 ml) subcutaneously. Further treatment with nebulised salbutamol (5 mg), hydrocortisone (200 mg), and aminophylline (0.9 mg/kg/hour) was started 15 minutes later. All patients reported a reduction in chest tightness within three minutes of receiving both adrenaline and terbutaline and reported no adverse effects. Mean baseline values of peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) did not differ significantly between the adrenaline group (130 1 min-1 and 0.83 l) and the terbutaline group (111 1 min-1 and 0.63 l). After administration of adrenaline PEF had increased by 21% and FEV1 by 40% five minutes after the injection, and by 35% and 64% at 15 minutes. Terbutaline caused a 23% increase in PEF and a 37% increase in FEV1 at five minutes, and a 40% and 58% increase at 15 minutes. There was no significant difference in PEF, FEV1, heart rate, blood pressure, or pulsus paradoxus between the two groups at any time. Continuous electrocardiographic recording showed no abnormalities in either group. Thus in this study subcutaneous adrenaline (0.5 mg) and terbutaline (0.5 mg) produced effective rapid bronchodilatation without serious side effects. PMID- 3281308 TI - Postoperative neuralgia in the leg after saphenous vein coronary artery bypass graft: a prospective study. AB - The degree of cutaneous sensory deficit in the leg was assessed after removal of the long saphenous vein in 50 consecutive patients undergoing coronary artery bypass vein grafts randomly assigned subcutaneous sutures or a single layer of sutures. Removal of the vein and repair of the leg incision were done by the same team of surgeons. In group 1 (25 patients) the leg incision was repaired with "00" Dexon subcutaneous and "00" prolene subcuticular sutures while in group 2 (25 patients) closure was effected by a single layer of interrupted "00" nylon sutures. All had crepe pressure bandage from the base of the toes to the groin for the first 24 hours followed by TED stockings for six to eight weeks. Sutures were removed on the eighth postoperative day. Cutaneous sensation in the leg and ankle was assessed 48 hours, seven days, and six to eight weeks after surgery, and a final comparison of the cosmetic effects and sensory perception after one year or more was made in 37 patients. There were no major differences between the groups at 48 hours in sensory abnormalities (anaesthesia, hyperaesthesia, and pain) but sensory recovery was significantly better in group 2 at the second and third assessments. There was some reduction in sensory abnormalities at the final review in group 1. No appreciable difference was noted in the quality of the scar between the two groups. We conclude that cutaneous sensation is better preserved by repairing the leg incision in a single layer. Subcutaneous sutures may produce neuropraxia of the long saphenous nerve by direct pressure as healing progresses. PMID- 3281309 TI - What is pulmonary fibrosis? PMID- 3281310 TI - Apparent pulmonary mycetoma following invasive aspergillosis in neutropenic patients. AB - After the death from massive haemoptysis of two neutropenic patients who had developed apparent pulmonary mycetomas, two subsequent patients underwent successful resection of similar lesions. Histological examination of these lesions confirmed that these so called mycetomas were masses of devitalized lung tissue infiltrated with fungus. The term mycotic lung sequestrum is therefore proposed to distinguish this condition from a fungus ball arising in a previously formed cavity. A review of 34 similar cases reported previously showed that haemoptysis occurred in about half of the cases and was fatal in just over half of these. Medical treatment appears to have little impact on survival and early consideration of surgical intervention is important. PMID- 3281311 TI - Degradation of connective tissue components by lung derived leucocytes in vitro: role of proteases and oxidants. AB - Inflammatory leucocytes are implicated in connective tissue damage during chronic inflammatory lung disease. In an investigation of the role of leucocytes in connective tissue derangements in the lung, inflammatory leucocytes were generated in rat lungs by intratracheal instillation of inflammatory agents and retrieved by bronchoalveolar lavage. The proteolytic activities of control macrophages and of two inflammatory cell populations were compared; iodinated collagen, laminin, and fibronectin matrices were used. The inflammatory cells caused consistently and substantially more degradation of the matrices than the controls on a per cell basis. The oxidant scavengers superoxide dismutase and catalase did not inhibit matrix degradation, but alpha 1 protease inhibitor and alpha 2 macroglobulin were inhibitory. It is concluded that matrix damage in this assay is enhanced by inflammatory cells and is mediated principally by serine protease activity. PMID- 3281313 TI - [Gamete intrafallopian transfer in infertility]. PMID- 3281312 TI - Fish oil in asthma. PMID- 3281314 TI - [Estimation of delivery date after withdrawal of oral contraceptives]. PMID- 3281315 TI - [Management of diabetic patients in relation to surgery]. PMID- 3281316 TI - [Tumor heterogeneity. Basal aspects of significance for therapeutic strategy]. PMID- 3281318 TI - [Reconstruction of bone defects. Use of corticospongious avascular autografts]. PMID- 3281317 TI - [The Dalkon shield. The infamous intrauterine device]. PMID- 3281319 TI - [The narcotic problem from a historical and international point of view]. PMID- 3281320 TI - [Herpes gestationis. A dermatosis with consequences for further pregnancies]. PMID- 3281321 TI - [Diagnostic imaging of acute appendicitis]. PMID- 3281322 TI - [The woman as gynecological patient seen from a historical perspective]. PMID- 3281323 TI - [Hyperkinetic behavior syndrome. An interdisciplinary study of the basis for rational medical treatment]. PMID- 3281324 TI - [At last, an effective treatment of familial hypercholesterolemia?]. PMID- 3281325 TI - [Fever]. PMID- 3281326 TI - [From the history of microscope]. PMID- 3281327 TI - Biochemical evidence that high concentrations of the antidepressant amoxapine may cause inhibition of mitochondrial electron transport. AB - Overdosage with the antidepressant amoxapine causes metabolic acidosis and may lead to brain damage and death. To better understand the metabolic disturbances caused by amoxapine overdose, its effects on three simple systems were studied: growth of Saccharomyces cerevisiae, mitochondrial energy metabolism, and an electron transport system in microsomal membranes. Growth of yeast on all substrates except lactate was inhibited by amoxapine at 50-100 micrograms ml-1. Growth on lactate was observed at 200 micrograms ml-1 of amoxapine. In beef heart mitochondria, amoxapine at 100 micrograms ml-1 inhibited reactions involving large sections of the electron transport chain. Energy-linked reactions in submitochondrial particles were also inhibited. Electron microscopy showed some disruption of the mitochondrial internal structure by amoxapine and a change from orthodox to condensed conformation. Microsomal NADH-cytochrome b5 reductase was inhibited by amoxapine, but at higher amoxapine concentrations than mitochondrial reactions. The results suggest amoxapine disrupts reactions of membrane associated enzyme complexes, and mitochondrial energy conservation may be one of the first systems affected. We speculate that lactic acid accumulation in patients with amoxapine overdose may be caused by loss of electron acceptor activity in tissues. PMID- 3281329 TI - Polyethylene glycol embedment for histological studies of bean seed testa of low moisture content. AB - Light microscopic examination of the structure of seed testa of snap and semihard bean seeds with 6% and 12% moisture contents in paraffin sections was unsuccessful because of poor paraffin infiltration and subsequent separation of subjacent and palisade cell layers. We devised an alternative method using polyethylene glycol (PEG) as the embedding material. Specimens were killed and fixed in the usual manner. They were then run up through a graded series (25, 50, 75, 100%) of PEG 1000 to PEG 1450, and finally embedded in a mixture of PEG 1450 and 4000 (19:1 by weight). Transverse and longitudinal sections retained excellent morphological detail and were suitable for histological study. Sections temporarily stained with 0.025% thionin allowed good quality photomicrographs. PMID- 3281328 TI - A simple method for collecting and mounting ribboned serial sections of epoxy embedded specimens. AB - A simple and rapid method of handling ribboned serial sections of epoxy embedded specimens is described. Ribbons are cut from a block having the leading and trailing sides coated with contact cement. A scoop made from polyethylene tubing is used to remove a ribbon of sections from the boat of a glass or diamond knife and to transfer it to a pool of water on a microscope slide. Many ribbons (comprising hundreds of sections) can be mounted on a single slide. This method requires the construction of only one simple, inexpensive tool, the polyethylene scoop, and otherwise utilizes only items commonly available in the laboratory. PMID- 3281331 TI - Does transcranial Doppler ultrasonography provide information about cerebral microcirculatory flow? PMID- 3281330 TI - Multicenter validation study of real-time ultrasonography, arteriography, and pathology: pathologic evaluation of carotid endarterectomy specimens. AB - The morphologic description and measurements of endarterectomy specimens are usually believed to be accurate and are used as the gold standard against which the findings of diagnostic procedures are judged. Pathology data on 289 endarterectomy specimens from five participating centers and the corresponding angiography and B-mode ultrasonography data provided a basis for scrutinizing the validity of using the morphologic measurements as a standard. Discrepancies of greater than 1 mm between pathology and angiography measurements of minimum residual lumen occurred in 35% of the cases and between pathology and B-mode ultrasonography measurements in 64% of the cases. Discrepancies of greater than 1 mm between pathology- and angiography-measured lesion width occurred in 81% of the cases and between pathology and B-mode ultrasonography measurements in 64% of the cases. The cases representing mismatches of greater than 1 mm at one participating center were subjected to a rigorous review, with remeasurement of all morphologic features, in an attempt to explain the discrepancies. Various types of artifactual distortion of the specimens, the presence of slit-like and occluded lumens that were likely related to loss of perfusion pressure, and an inability to match planes of interrogation used in angiography and B-mode ultrasonography with pathology planes contributed significantly to the existence of mismatches. On the other hand, fixation and decalcification produced minimal and insignificant distortional changes. We conclude that the acquisition of quantitative data from endarterectomy specimens and the acceptance of morphologic data as a standard are limited by a number of problems that can be defined but have been difficult to resolve. PMID- 3281333 TI - Evidence that Wra and Wrb are antithetical. AB - Studies on 24 Wr(a+b+) and 23 Wr(a-b+) blood samples, using anti-Wrb in the enzyme-linked antiglobulin test (ELAT), have shown that Wr(a+b+) red cells bind, on average, a little over half the amount of anti-Wrb bound by Wr(a-b+) red cells. Similarly, ELAT studies using six different anti-Wra and 10 Wr(a+b+) samples, as well as red cells from the original Wr(a+b-) proposita, have shown that Wr(a+b+) red cells bind about half the amount of anti-Wra bound by Wr(a+b-) red cells. Various pitfalls that can arise when the ELAT is used to measure antigen ratios on red cells have been avoided but are described. This conclusive evidence that Wra and Wrb have an antithetical relationship is discussed in light of the knowledge that a ficin-resistant portion of MN sialoglycoprotein (SGP), when carried in liposomes, can inhibit anti-Wrb. It is possible that Wra, Wrb, or both may encode a post-translational change in MN SGP, or production of transferases that glycosylate membrane lipids that affect in situ orientation of MN SGP, or production of protein band 3 that then forms a complex with MN SGP at the red cell membrane surface. PMID- 3281332 TI - Bacterial contamination of bone marrow grafts intended for autologous and allogeneic bone marrow transplantation. Incidence and clinical significance. AB - In a series of 100 bone marrow harvests, the incidence of bacterial contamination of the bone marrow graft was 17 percent. Ex vivo manipulation of some of the grafts prior to infusion may have caused additional bacterial contamination. All isolated bacteria were common skin flora, and no serious sequelae were observed in the patients receiving the culture-positive bone marrow grafts. Samples of harvested bone marrows purposely contaminated with an isolate of Staphylococcus epidermidis demonstrated a bactericidal property that was maximal early after bone marrow collection. Bone marrow collection and ex vivo manipulation may result in considerable bacterial contamination. Procedures must be developed to assure that marrow collection and processing do not result in clinically significant contamination. PMID- 3281334 TI - Hybrid sialoglycoprotein content of St(a+) red cells. AB - St(a+) red cells contain a ficin-resistant hybrid sialoglycoprotein (SGP) consisting of the amino terminus of Ss sialoglycoprotein (Ss SGP) and the carboxyl terminus of MN sialoglycoprotein (MN SGP). Ficin-modified St(a+) but not St(a-) red cells were agglutinated by monoclonal antibodies NN5 (anti-N) and 31 (detecting a sialic acid-dependent determinant on the SGPs). SDS-polyacrylamide gel electrophoresis showed three periodic acid-Schiff-staining protein bands in ficin-modified St(a+) but not St(a-) red cell-membranes; these bands bound monoclonal antibodies NN5 and 31 on Western blots. Using Scatchard analysis of 125I-NN5 IgG binding to M+N- red cells, estimates were obtained of 25,000 Ss SGP molecules per red cell per s allele, 33,000 Ss SGP molecules per red cell per S allele, and 75,000 hybrid SGP molecules per red cell per hybrid allele. These results are consistent with the expression of the hybrid SGP gene at a level intermediate between the MN SGP gene and the Ss SGP gene. Monoclonal antibodies NN5 and 31 may be useful in screening ficin-treated red cells for hybrid SGP variants. PMID- 3281335 TI - Donor-specific transfusions. Donor-recipient HLA compatibility, recipient HLA haplotype, and antibody production. AB - HLA profiles of 25 donor-specific transfusion (DST) kidney donor-recipient pairs were analyzed for HLA antigen compatibility. Serum samples collected during and after DST were tested for cytotoxic antibodies against T and B lymphocytes of the donors and 30 normal individuals. Eleven recipients did not produce cytotoxic antibodies to the antigens of their DST donors, and eight produced cold and/or warm, broadly reactive B-cell antibodies. Six patients (24%) produced HLA-A, B, C, and/or DR antibodies. Three of these individuals produced antibodies after two immunizations, while others required three immunizations. Three of the 11 antibody nonproducers (17%) had not received previous transfusions, as compared to three of the eight antibody producers (43%). Comparison of HLA profiles revealed 22 percent of the HLA-A, B, DR identities between the transfusion donor and recipient in antibody nonproducers as compared to 9 percent of the HLA-A, B, DR identities in antibody producers. The HLA-A2, B40, DR4 haplotype and HLA-DRW6 antigen were more common among antibody producers than among nonproducers, who had an excess of the HLA-B8, DR3 haplotype. These results are consistent with the hypothesis that there may be high- and low-responder HLA haplotypes that control immunologic responsiveness to histocompatibility antigens. PMID- 3281337 TI - Lumpy skin disease--a review. PMID- 3281336 TI - In memoriam. Philip Levine, 1900-1987. PMID- 3281338 TI - Prevalence of anaplasmosis and babesiosis in N'Dama cattle of the Gambia. AB - Sera from 184 N'Dama cattle randomly selected and averaging 2-7 years of age were tested for the presence of specific antibodies to Anaplasma marginale, Babesia bovis and B. bigemina, using one or more serological tests including complement fixation, rapid card agglutination and indirect fluorescent antibody (IFA). Tests for A. marginale and B. bovis were essentially negative. Utilising the IFA test 65% of the sera tested were positive for B. bigemina. Three randomly selected two year-old N'Dama bulls were splenectomised. All three showed an acute recurrence of a B. bigemina parasitaemia. Two died following typical signs of acute babesiosis and a third recovered following diminazene therapy. No evidence of either B. bovis or A. marginale recrudescence was observed in the single surviving bull. Babesia bigemina appears endemic in the N'Dama cattle of The Gambia but no confirmed serological or clinical evidence of B. bovis or A. marginale was observed. PMID- 3281339 TI - Applications of biochemical epidemiology in the study of human carcinogenesis. AB - The measurement of biochemical parameters in epidemiologic studies can contribute to a better understanding of mechanisms of chemical carcinogenesis. Through identification and quantitation of chemicals in tissues or body fluids or through markers of "effective dose" such as DNA adducts, mechanisms of cancer etiology and pathogenesis can be elucidated. Different approaches and the associated methodologic problems are discussed along with examples. As a comprehensive case study, the relationship between aromatic amine exposure and bladder cancer is considered in light of different biochemical aspects which could be the target of epidemiologic studies. PMID- 3281340 TI - Heterogeneity of malignant schwannomas. AB - Six malignant schwannomas were studied by electron microscopy and immunohistochemistry for S-100 protein at the light and electron microscopic levels to clarify the nature of the tumor cells. Three tumors (group A) were composed of poorly differentiated tumor cells and showed no immunoreactivity for S-100 protein. One tumor (group B) was composed of perineurial cells that were S 100 protein-negative. Two tumors (group C) consisted of both Schwann cells and fibroblastic cells like neurofibromas, and only the former were found to contain S-100 protein. Thus, this study showed the heterogeneous nature of the malignant schwannomas and suggested that these tumors might arise from multipotential Schwann cells or different cellular components of peripheral nerve or primitive cells. PMID- 3281341 TI - Comparative ultrastructure of soft-tissue myxoid tumors. AB - This comparative analysis of the characteristic ultrastructural features specific for intramuscular myxoma, myxoid liposarcoma, extraskeletal myxoid chondrosarcoma, myxoid malignant fibrous histiocytoma, myxoid variant of dermatofibrosarcoma protuberans, and myxoid neurilemmoma is based on our own studies of 52 cases. In spite of the histologic resemblance frequently observed, these tumors can be easily distinguished on the basis of cytoplasmic and extracellular features by electron microscopy. The value of electron microscopy in the diagnosis of myxoid tumors of soft tissues lies mainly in its potential to provide additional information concerning the cell types involved in the neoplastic process and their line of differentiation. PMID- 3281343 TI - [Bovine tuberculous meningitis]. PMID- 3281342 TI - [Erythromycin compared with clindamycin in patients with primary suture of subcutaneous abscesses]. PMID- 3281344 TI - [Liver diseases in children in Denmark and the need for liver transplantation]. PMID- 3281345 TI - [Antithrombotic therapy during hemodialysis]. PMID- 3281346 TI - [Acute interstitial nephritis due to drugs]. PMID- 3281347 TI - [Adenocarcinoma of the uterine cervix]. PMID- 3281348 TI - [Subcortical arteriosclerotic encephalopathy (Binswanger's disease)]. PMID- 3281349 TI - [Magnesium and cardiovascular disease. I. Do patients with ischemic heart disease suffer from magnesium deficiency?]. PMID- 3281350 TI - [Magnesium and cardiovascular disease. II. The significance of magnesium deficiency for cardiovascular disease]. PMID- 3281351 TI - [Proliferating trichilemmal cyst. An important differential diagnosis from squamous cell carcinoma]. PMID- 3281353 TI - [A trochanteric syndrome--trochanteric bursitis]. PMID- 3281352 TI - [Serum osteocalcin. A new biochemical marker for bone formation]. PMID- 3281354 TI - Capabilities and limitations of probe methods for the microanalysis of chemical elements in biology: a brief introduction. AB - This article reviews some of the technical problems involved in achieving high resolution artefact-free quantitative microprobe analyses of biological specimens, and points to some of the techniques now available to overcome these problems. PMID- 3281355 TI - Frontiers in electron probe microanalysis: application to cell physiology. AB - The application of electron probe microanalysis techniques, using X-ray and electron energy loss instruments, to problems in cell physiology is reviewed. The details of the special methodological requirements for the analysis of cryosections at high spatial resolution in an analytical electron microscope are discussed together with a comprehensive review of data obtained on major organ systems and cell types. PMID- 3281356 TI - High spatial resolution spectroscopy in the elemental microanalysis and imaging of biological systems. AB - The application of analytical electron microscopy to the high spatial resolution study of biological systems is reviewed. Specimen preparation, quantitative analysis, capabilities and limitations are all discussed, principally in the context of energy-dispersive X-ray analysis. Results are presented using both current techniques and the developing quantitative image analysis. Finally the role of new instrumental approaches, including electron energy loss spectrometry, is discussed. PMID- 3281357 TI - Quantitative X-ray mapping of biological cryosections. AB - The potential for applying X-ray mapping to the elemental microanalysis of biological cryosections is discussed. Methods are described for acquiring and processing data, including use of the top-hat digital filter to remove the average effects of the background contribution. Practical considerations for X ray mapping are discussed in terms of typical counts per pixel and minimum detectability which depends on the number of pixels chosen to integrate the signal. These aspects are illustrated with elemental maps (Na, P, K, Ca and Fe) from freeze-dried cryosections of mouse cerebellar cortex. A calcium sensitivity in the range 0.5 to 2.5 mmol/kg wet weight of tissue is demonstrated. The correction for overlap of potassium K beta and calcium K alpha is demonstrated with X-ray maps from cryosectioned synaptosomes of squid optic lobe. Quantitative results obtained using internal standards to determine wet weight concentrations are in reasonable agreement with expected values. Alternate schemes applicable to X-ray maps for determining the dry mass concentration, such as the peak/continuum (Hall method), are also discussed. PMID- 3281358 TI - Quantitative electron energy loss spectroscopy in biology. AB - The potential for applying electron energy loss spectroscopy (EELS) in biology is assessed. Some recent developments in instrumentation, spectrometer design, parallel detection and elemental mapping are discussed. Quantitation is demonstrated by means of the spectrum from DNA which gives an elemental ratio for N:P close to the expected value. A range of biologically important elements that can be usefully analyzed by EELS is tabulated and some possible applications for each are indicated. Detection limits and the effects of radiation damage are illustrated by spectra from the protein, insulin, and from the fluorinated amino acid, histidine. Calcium detectability under optimum conditions may be as low as 1 mmol/kg dry weight. The application of EELS to analysis of cryosectioned adrenomedullary (chromaffin) cells is described in order to help determine the composition of the secretory granule. Water content can be determined from the amount of inelastic scattering as measured by the low-loss spectrum. The nitrogen/phosphorus ratio can be measured to provide information about the relative concentrations of ATP, chromogranin, and catecholamines. Quantitative EELS elemental maps are obtained in the STEM mode from chromaffin cells in order to measure the distribution of light elements. PMID- 3281359 TI - Biological microanalysis by secondary ion mass spectrometry: status and prospects. AB - Secondary ion mass spectrometric (SIMS) analysis of biological problems is an evolving technique. Lateral resolution of currently available commercial instrumentation estimated from actual samples is 0.5 micron, and subcellular organelles can be distinguished. The interrelationship of lateral resolution, elemental concentration and ionizability are, however, important in controlling the actual lateral resolution achievable. Although depth resolutions of 5 nm have been measured in other systems, no test of depth resolution in biological systems has been done, and this parameter is also concentration and ionization dependent. The development of liquid metal ion sources in combination with scanning ion microprobes has a potential lateral resolution of as little as 20 nm, but initial studies with this instrumentation show that tissue preservation at the submicron level becomes an important issue. The current development of a cold-transfer stage for SIMS instruments may obviate the problem of submicron localization of diffusible elements, and initial studies indicate that much more needs to be understood about the ionization process in hydrated samples. Quantitation of diffusible elements using external standards has been achieved over a 30 micron diameter analyzed area. Strategies for analysis of areas limited to 1 micron or less has been suggested using image processing techniques, which take advantage of the lateral resolution inherent in the ion optical system. Matrix effects in biological tissues have been reported and constitute a serious problem for analysis of biologicals which must be addressed for each question. However, development of laser ionization of sputtered particles may both increase the sensitivity of analysis and decrease the importance of ionizability of elements. Chemical analysis of organic molecules is another use of SIMS, but, at present, at the cost of losing localized information. SIMS analysis of biological samples is being systematically evaluated and requires increased accessibility of this instrumentation to the end-user for full development of its role in physiological problems. PMID- 3281360 TI - Photoelectron imaging and photoelectron labeling. AB - Photoelectron imaging involves the photoejection of low-energy electrons from a specimen surface exposed to UV light. The electrons are then accelerated and focused by an electron-optics system in much the same way fluorescent light is focused in an optical microscope. Thus, photoelectron imaging is the electron optical analog of fluorescence microscopy. In combination with photoemissive labels it serves to extend the range of studies possible by fluorescence, for example in work on cell surfaces and internal structures of cells that have been exposed by detergent extraction of membranes. PMID- 3281361 TI - X-ray fluorescence with synchrotron radiation. AB - The use of synchrotron radiation for X-ray fluorescence has several advantages over the use of other conventional X-ray sources. The principles of synchrotron radiation and methods for applying synchrotron radiation to the X-ray fluorescence measurements of trace elements are discussed. The Brookhaven National Laboratory X-ray microprobe, facilities dedicated to X-ray fluorescence, and related analytical techniques are discussed. Some examples of trace element analyses in biological materials with synchrotron radiation are presented. PMID- 3281362 TI - Frontiers of submicron spectroscopy and biological microanalysis. Contributions to a special biological symposium honoring T. A. Hall. Forty-fourth annual meeting, Electron Microscopy Society of America. Albuquerque, New Mexico, USA, 10 15 August 1986. PMID- 3281363 TI - Superficial bladder cancer treated with intravesical bacillus Calmette-Guerin or adriamycin: follow-up report. AB - We evaluated 139 patients with superficial bladder cancer (Stages Ta, Tl, and TIS) and treated them with either intravesical bacillus Calmette-Guerin, Tice strain (BCG), or doxorubicin hydrochloride (Adriamycin [ADR]) in a nonrandomized, multicenter study. Our follow-up study comprises 135 of these patients. Of these patients, 78 tumors were completely resected, and 61 were incompletely resected. When a proportional-hazards model (Cox) was applied, there was a statistically significant difference between the recurrence rates for the two drugs. On the basis of recurrence rates per 100 patient-months, both BCG (1.2) and ADR (0.9) worked well with completely resected tumors. However, for incomplete resections, the recurrence rate for BCG (0.9) was less than half that for ADR (1.9). The overall recurrence rates were 1.1 and 1.3 for BCG and ADR, respectively. There have been 42 failures of treatment with either BCG or ADR. We defined failure as any recurrence of tumor; progression of the cancer in stage, grade, tumor number or size; or any residual tumor after 18 treatments (14 months of therapy). As to the failures in patients whom we followed up, and whose treatment was either switched from ADR to BCG or continued on further BCG treatment, 53 per cent have achieved complete remission. Complete remission for BCG and ADR were 76 per cent and 52 per cent, respectively. Of the various factors considered in the study, only tumor grade and treatment drug were statistically significant. The cystectomy rate was 1 per cent for BCG-treated patients and 0 for ADR-treated patients. PMID- 3281364 TI - Hypertrophy of labia minora in myelodysplastic women. Labioplasty to ease clean intermittent catheterization. AB - Female myelodysplastic patients are sometimes annoyed by hypertrophy of the labia minora, possibly caused by long-term diaper dermatitis. This condition makes intermittent catheterization difficult and impairs the cleanliness and aesthetic appearance of the external genitalia. We successfully performed labioplasty on 3 myelodysplastic females. PMID- 3281366 TI - Flexible cystoscopy and retrograde catheterization in renal transplant patients. AB - Catheterizing the ureteral orifice of a renal transplant patient can be difficult using traditional rigid instruments. This report describes our experience with 4 patients who underwent cystoscopy and attempted retrograde catheterization of a transplanted ureter. In all cases attempted catheterization using rigid instruments was unsuccessful, while in 3 of the 4 patients, successful cannulation was accomplished using the flexible cystoscope. These results are attributed to the expanded range of motion achieved with the tip of the flexible cystoscope. The increased mobility afforded by this instrument facilitates access to the ureteral orifice, which is often positioned on the distensible portion of the bladder. PMID- 3281365 TI - Comparison of flutamide and Emcyt in hormone-refractory metastatic prostatic cancer. AB - A prospective randomized trial for metastatic prostatic cancer in 220 patients who were refractory to hormone therapy was conducted by the National Prostatic Cancer Project from 1984 to 1985. As of July, 1986, the evaluation of these patients reflected no difference in response to either estramustine phosphate (Emcyt) or flutamide. Toxicities were minimal, and the observed survival and progression-free survival intervals were noteworthy in view of the overall prospects for such patients. Future studies dealing with specific quality of life issues seem to be indicated by our results. PMID- 3281367 TI - Benign retroperitoneal schwannoma. AB - A case of benign retroperitoneal Schwannoma is presented, with special attention to clarification of often confused pathologic nomenclature. The radiologic diagnosis and the literature on this rare tumor are reviewed. PMID- 3281368 TI - Ciprofloxacin in management of urinary tract infection. AB - Ciprofloxacin is a new quinolone derivative which is particularly well adapted for the treatment of bacterial urinary tract infection. Virtually all uropathogens are susceptible, and the development of resistance is uncommon. Its pharmacokinetic characteristics reveal that effective concentrations of the drug are easily achieved with twice a day oral therapy in the blood, urine, kidneys, and prostate--even in advanced renal failure. The drug is well tolerated, even with prolonged courses of therapy. It will be particularly useful in the treatment of antibiotic-resistant, complicated, and/or prostatic infection. PMID- 3281369 TI - [Protegentin phonophoresis as a method of preoperative preparation in the combined treatment of patients with cicatricial stenoses of the larynx and trachea]. PMID- 3281370 TI - [Herman Schwartze--one of the pioneers of otosurgery (on the 150th anniversary of his birth)]. PMID- 3281371 TI - Monoclonal antibodies to canine adenoviruses 1 and 2 that are type-specific by virus neutralization and immunofluorescence. AB - Monoclonal antibodies were produced against the Mirandola strain of canine adenovirus Type 1 (CAV-1) and the Manhattan strain of canine adenovirus Type 2 (CAV-2). The monoclonal antibodies were used in vitro in virus neutralization (VN) assays and in indirect fluorescent antibody (IFA) tests to examine several strains of each virus type. Out of 36 monoclonal antibodies produced against the Mirandola strain, 18 were type-specific for CAV-1 by IFA and 13 of those neutralized the virus in vitro. The other 18 antibodies bound both CAV-1 and CAV 2 by IFA; however, 7 of those specifically neutralized only CAV-1. The 160 monoclonal antibodies made against the Manhattan strain of CAV-2 yielded 77 type specific antibodies by IFA, of which 39 neutralized only CAV-2 in vitro. The remaining 83 antibodies recognized both CAV-1 and CAV-2 by IFA, with 3 of those neutralizing both viral types. The hemagglutination inhibition (HI) test was performed on a selected monoclonal antibody from each specificity group. Although Type 1 CAV could be readily differentiated from Type 2 CAV by using type-specific monoclonal antibodies in the IFA or VN tests, strains within each type could not be differentiated. This is the first report of neutralizing monoclonal antibodies for a mammalian adenovirus. PMID- 3281372 TI - Adhesion of Staphylococcus aureus and Escherichia coli to bovine udder epithelial cells. AB - An assay for the adhesion of tritiated thymidine-labelled Staphylococcus aureus and Escherichia coli to bovine mammary ductular epithelial cell lines was developed. The relative adhesion of 15 strains of S. aureus to these cell lines was examined. Four strains did not adhere and the remaining 11 adhered at variable levels. Adhesion to different cell lines was generally similar. Adhesion to freshly collected bovine mammary epithelial cells was significantly greater than that to cells maintained in tissue culture. The system described was demonstrated to be a suitable model for studying adhesion of mastitis-causing organisms to bovine mammary epithelial cells. PMID- 3281373 TI - Autographa californica MNPV nucleocapsid assembly: inhibition by cytochalasin D. AB - Autographa californica nuclear polyhedrosis virus (AcMNPV) is a large, double stranded DNA virus of lepidopteran insects. It replicates in the nucleus of host cells and produces two different infectious forms. One of them buds from the plasma membrane and is responsible for systemic infection in insects and for the spread of infection in cell culture. Earlier we reported that cytochalasin D (CD) inhibited the production of this form of the virus in infected IPLB-SF-21 cells by a mechanism other than the prevention of budding [L. E. Volkman, P. A. Goldsmith, and R. T. Hess (1987). Virology 156, 32-39]. Herein we present evidence that CD interferes with proper nucleocapsid assembly which indicates that microfilaments are involved in this nuclear process. The observation that phalloidin localizes in the nuclei of 24-hr infected cells in the absence, but not in the presence, of CD supports this hypothesis. Viral DNA replication and synthesis of the major capsid antigen and its transport to the nucleus are not inhibited by CD. PMID- 3281374 TI - In vitro analysis of tobacco vein mottling virus NIa cistron: evidence for a virus-encoded protease. AB - Potential protease functions associated with the NIa nuclear inclusion protein of tobacco vein mottling virus (TVMV) were investigated. In the absence of treatments, in vitro translation of viral RNA produced various polypeptides representing each of the proposed TVMV cistrons--28K-HC-42K-CI-5.5K-NIa-NIb-CP. When viral RNA was first hybridized to DNA probes complementary to the NIa cistron, and then treated with RNase H prior to translation, a 48-kDa processing product, immunologically identified as the NIa protein, was abolished. In its place was observed a series of larger polypeptides, immunologically identified as fusion products of the cylindrical inclusion (CI) and NIa cistrons. The use of probes which permitted translation through as few as 15 nucleotide residues beyond the sequences encoding the proposed carboxyl terminus of NIa resulted in normal processing. None of the DNA probes affected an apparent cleavage between the helper component (HC) and 42K proteins. Cloned cDNA regions representing the NIa cistron and flanking sequences were inserted in transcription vectors. Translation of the in vitro transcript resulted in synthesis, not of a large fusion polyprotein, but, of a mature-sized NIa polypeptide. In vitro transcripts, lacking the 3'-most sequences that were expected to encode the protease active site of the NIa protein, were translated. These generated an apparent fusion polypeptide that reacted with antisera to both CI and NIa. The results indicate that the NIa gene product functions as a protease responsible for some but not all of the cleavage events which lead to the production of the mature forms of TVMV proteins. PMID- 3281376 TI - [What information is provided by the erythrocyte sedimentation test?]. PMID- 3281375 TI - The Vero cell receptor for the hepatitis B virus small S protein is a sialoglycoprotein. AB - The Vero (African green monkey kidney-derived) cell line is capable of binding recombinant hepatitis B surface antigen (rHBsAg) particles containing only the small surface (S) protein of hepatitis B virus (HBV). This binding activity appears to be due to a single major population of receptors (M. E. Peeples et al., Virology 160, 135-142 (1987]. Since infectious HBV particles also contain the small S protein, it is possible that the Vero cell receptor might also function as an HBV receptor. The initial physical characterization of this receptor is reported here. Treatment of Vero cells with each of four proteases reduced their binding activity by 70% or greater, indicating that the receptor is partially protein in nature. Binding activity was also reduced by pretreating cells with neuraminidase or low levels of sodium periodate, indicating that sialic acid also plays a major role in the receptor activity. Consistent with this interpretation, N-acetylneuraminic acid and N-acetylneuraminyl-lactose were able to competitively inhibit rHBsAg particle attachment to Vero cells. The protein nature of the Vero cell receptor was confirmed by the demonstration that chymotrypsin treatment which resulted in 70% loss of binding had little effect on the cell sialic acid content. Therefore, the Vero cell receptor for rHBsAg particles is a sialoglycoprotein. PMID- 3281377 TI - Essentials of insulin pharmacokinetics. AB - Pharmacokinetic methods are a powerful tool for the investigation of the insulin system in health and disease; the underlying formalisms are simple and straight foreward. Following intravenous injection the plasma concentration of insulin declines with at least two exponentials, the rapidly disappearing component (half time 2.4 min) represents elimination from the intravascular space, whereas the most slowly disappearing component (half-time 50-130 min) reflects elimination from the interstitial fluid and the tissues that utilize insulin. Total clearance of insulin, which is the result of metabolic degradation, ranges between 700 and 800 ml/min. The sites of degradation are primarily the liver (hepatic insulin clearance: 320-400 ml/min) and the kidneys (renal insulin clearance: 190-270 ml/min), hence insulin disposal depends on the function of these organs. The apparent volume of distribution for insulin is approximately equal to the extracellular space. Insulin absorption from the subcutaneous tissue is slow (half-times of 0.5-2.7, 6.6-13.8, and 15-48 hours for fast-, intermediate-, and long-acting insulins, respectively). The bioavailability of insulin after subcutaneous administration is variable. Insulin kinetics appear not to be altered in diabetes mellitus, except in cases with insulin antibodies or in insulin-resistant patients, in which insulin removal may be retarded. Optimization of functional insulin replacement requires knowledge of the pharmacokinetic properties of the insulin preparation used. PMID- 3281378 TI - [Aspects of the psychology of the terminal stage of life]. AB - Six person-centered and six social-network-centered constructs are discussed in order to describe aspects of the terminal time of life: age attitude, death concept, surviving motivation, coping style, partner relatedness, experience of dying; degree of connection, bearing power, taking over, life-end-communication, dying accompany, mourning work. A life span theory of change in activity and social functions stands in the background. PMID- 3281379 TI - [The status quo of pharmacotherapy of lipid metabolism disorders in the aged]. AB - The latest findings of arteriosclerosis and lipid metabolism research have shown that application of medicaments in the treatment of hyper- and dyslipoproteinaemias is necessary also at an advanced age, if dietary treatment fails. A consequent lipid normalisation suggests a decrease of arteriosclerotic effects. The expected benefit must be greater than possible side-effects of lipid regulatives. Lipid regulatives commonly used in the GDR are presented. PMID- 3281380 TI - [Carnitine deficiency and carnitine therapy]. AB - The main function of carnitine is the transport of fatty acids across the inner mitochondrial membrane to the side of beta-oxidation. In healthy subjects no carnitine deficiency occurs. There are many inborn errors with carnitine deficiency as a primary genetic defect or secondary to other familial disorders of metabolism. Furthermore some acquired diseases are associated with secondary carnitine deficiency. Myopathic and systemic forms of carnitine deficiency have been described. Most of the carnitine deficiency syndromes leading frequently to sudden death without therapy, are treatable with L-carnitine. A beneficial influence of L-carnitine to certain hyperlipoproteinemias, hyperlipidaemic diabetes mellitus and other diseases has been reported too. PMID- 3281381 TI - [Basic drug therapy of rheumatoid arthritis]. AB - At first the term of basic therapeutic preparations is explained. Then the essential representatives of the basic medicaments are described, in which cases the author particularly pays attention to their therapeutic mechanisms, the clinical efficiency and their dosage. Out of the number of the possible basic drugs preparations with guaranteed efficacy are particularly described. PMID- 3281382 TI - [The problem of degradation and histocompatibility of bioactive ceramics in soft tissues. 1. Studies of the degradation of bioactive ceramics in soft tissues]. AB - Following implantation of bioactive ceramics both into the bone and the subcutis the implantat surface changed to be relative rich in Ca and absolutely poor in P as indicated by means of electron microprobe. The implants located into the subcutis however, resulted in a more distinctive alteration of those surfaces. This process caused by the interaction between bioactive vitrified ceramics and the connective tissue can be prevented by coating the appropriate parts of the implants with Dentalceramics. A 10 micron to 15 micron layer may to be sufficient. PMID- 3281383 TI - [The problem of degradation and histocompatibility of bioactive ceramics in soft tissues. 2. Descriptive and morphometric evaluation of uncoated and coated bioactive ceramics]. AB - After a 180 day lasting period of observation a persistent chronical inflammation occurred in the implants surrounding tissue of rats implanted with simple sintered biovitroceramics, where as the same material, coated with dental ceramic did not result in a comparable tissue reaction. After application of these coated implants we obtained a significant diminished formation of the periimplant connective tissue capsule. Inactivation of surfaces, being into contact with soft tissue, mentioned above, could be an economical, easy handling method. PMID- 3281384 TI - [An improved model of auxiliary heart transplantation in the rat]. AB - Heart transplantation in the rat is a frequently used model to study immunological problems of primary vascularized organs. A less time consuming and highly successful technique is described in detail. The donor heart is transplanted heterotopically into the recipient with the brachiocephalic artery anastomosed to the renal artery with 10 single sutures, and the pulmonary artery to the renal vein with two continuous semicircular sutures which were left untied. Both anastomoses were done end-to-end with 10-0 Ethilon. PMID- 3281385 TI - [Granulocyte function in the aged]. AB - 22 patients (10 female, 12 male) aged between 60 and 76 were tested in vitro with regard to granulocyte function (i.e., leucotaxis, chemotaxis, capability of phagocytosis, intracellular killing of bacteria, and oxidase reaction). Most of the patients showed reduced chemotactic activity of the granulocytes, although the motility of these cells was normal. With regular phagocytosis of candida albicans cells--either active or heat-inactivated the intracellular killing rate of bacteria was clearly decreased in all cases. The intracellular oxidase activity of granulocytes always showed normal function. PMID- 3281386 TI - [Ambulatory external treatment of psoriasis vulgaris: comparison of the effectiveness of a dithranol and a glucocorticoid-containing preparation]. AB - In a comparative study, 20 ambulatory patients suffering from chronic psoriasis vulgaris with plaques were treated with preparations containing either dithranol (0.1/0.2%) plus urea (17%) or desoximetasone (0.25%). In the two groups, 7 and 8 courses, resp., could be evaluated. Both modalities led to significant improvement of the skin lesions. During the course of treatment, there were no significant differences between the two regimens with regard to both the area of skin involvement and the scores of semiquantitative evaluation of infiltration, erythema, and scaling. PMID- 3281388 TI - Prospects for a virus non-structural protein as a subunit vaccine. AB - The design of contemporary vaccines to date has been dependent upon our understanding of the process of stimulation of protective immunity by virion proteins. However, studies with the flaviviruses have demonstrated that protective immunity can be elicited by a non-structural protein, NS1. Surprisingly, immunity to infection is stimulated in the absence of neutralizing antibodies. The information concerning NS1-induced immunity is described and is discussed with relevance to the role of the protein in immunity and vaccine development, against flavivirus diseases. The possibility exists that the phenomenon of non-structural protein induced immunity is applicable to the prophylaxis of other virus diseases. PMID- 3281387 TI - Trial of a new acellular pertussis vaccine in healthy adult volunteers. AB - Immunogenicity and reactogenicity of a new acellular pertussis vaccine were tested in healthy adults. The vaccine contained three constituents of Bordetella pertussis; filamentous haemagglutinin, pertussis toxin (PT) and fimbriae bearing agglutinogens 2 and 3. The constituents were separately purified, treated with formaldehyde and combined with one of two aluminium adjuvants. Subjects received one dose of vaccine or an appropriate adjuvant-only preparation and were monitored for clinical responses for 7 days. Results with the two forms of vaccine were similar. Of 35 vaccinees, none had a temperature higher than 37 degrees C or a severe reaction, one had a moderate reaction (possibly due in part to intercurrent infection) and nine had mild reactions confined to localized discomfort and/or erythema or induration at the injection site. All vaccinees had good serum antibody responses to vaccine antigens measured by ELISA and for PT, by neutralization of its effects on Chinese hamster ovary cells. PMID- 3281389 TI - [Determination of ochratoxin A in human milk]. AB - A method for the determination of ochratoxin A in milk is described. The milk is homogenized in a buffer solution at pH 1.6 to release ochratoxin A from its bond to proteins. Ochratoxin A is extracted with chloroform and the extract cleaned up using a base clean-up step. Analysis is performed by high-pressure liquid chromatography, using a reversed-phase column and fluorescence detection. The detection limit of the method is 0.1 ng/ml and the average recovery rate, tested in the range between 0.5 and 10.0 ng/ml, was found to be 83.1%. Chemical ionization mass spectrometry (direct exposure probe) and an enzyme immunoassay were used as confirmatory tests. Using this method, trace amounts of ochratoxin A were found in 4 of 36 randomly collected human milk samples. PMID- 3281390 TI - [Analysis of gangliosides with special reference to milk]. AB - Gangliosides are sialic acid containing lipid compounds of a very complex nature, which are involved in many physiological processes. Gangliosides are very important constituents of membrane material in animal tissue, where they occur at very low concentrations. Improved analytical procedures are therefore required to study their behaviour, their role in living systems and their isolation for further investigations. In this paper, all analytical methods which may be important in the analysis of gangliosides are summarized and discussed. These include extraction, purification, enrichment and chromatographic procedures. In bovine milk, three gangliosides of known structure are present. Their isolation, structure and analytical importance (buttermilk) are also reported. PMID- 3281392 TI - [Progress in the treatment of inguinal hernia]. AB - Modified Bassini's procedure until recently used to be the optional surgical approach to inguinal hernia at the authors' hospital. A ten-year retrospective study was conducted into 1,687 patients. Contact was actually established with 1,037 of them. Of these 762 returned a questionnaire sent to them, and 345 were available for clinical follow-up checks. These clinical examinations revealed a rate of recurrence of 7.2 per cent, following primary surgery. We have, therefore, changed our approach and have adopted a modified Shouldice procedure. PMID- 3281394 TI - [Regeneration of the liver under the influence of E. coli endotoxin]. AB - Studies were conducted into regeneration of rat liver exposed to the action of E. coli endotoxin, following two-third resection. No accelerated regeneration was found to take place in the wake of two-third hepatectomy and following postoperative intraperitoneal administration of E. coli endotoxin. However, regeneration was accelerated with significance in response to preoperative administration of 0.1 mg/kg body weight of E. coli endotoxin (B 5:55 DIFCO). PMID- 3281393 TI - [Change in the surgery of inguinal hernia by induction of a load-bearing cicatricial plate with a vicryl pad]. PMID- 3281391 TI - [Blunt abdominal trauma]. AB - Serious intraabdominal injury due to intraabdominal hemorrhage, gastro-intestinal laceration with peritonitis or incarceration of abdominal organs. The most important question in the management is to ascertain a laparotomy or the diagnostic of a specific organ injury is needed. The peritoneal lavage is a great help in making this decision. The x-ray examinations of thorax, abdomen and bones are required. Adjunctive diagnostic modalities for subtile examination of organs are ultrasound, computed tomography and angiography. These examinations have a limited application. Exploratory laparotomy should be done if there are signs of peritoneal irritation with an increased tendency. 168 patients with blunt abdominal trauma where treated in Charity-hospital of Berlin. The laparotomy was necessary in 78 patients. In 70 cases we found organ injuries. It was pointed to splenic repair, the management of liver injury especially the packing of the laceration and the treatment of the injuries of gastro-intestinal tract, pancreas and diaphragmatic rupture. PMID- 3281395 TI - [Our surgical heritage. The 1988 surgical historical calender]. PMID- 3281396 TI - [Current problems of blood group incompatibility in pregnancy]. AB - The frequency of hemolytic disease of fetus and newborn has decreased since introduction of Rh-prophylaxis. In spite of that till now hemolytic disease caused by anti-D antibodies occur. It is probably caused by immunization already during pregnancy. Therefore it seems to be useful to give anti-D-Immunoglobulin (200 micrograms = 1000 IE) in 28-30th week of pregnancy in all d-women with D husband. This seems especially necessary in pregnancy complications as hemorrhages in 3rd trimester, multiple pregnancies, trauma, and external version of breech. Rh-prophylaxis post partum is to perform in usual manner. As done before 2 time screening for irregular antibodies in pregnancy is necessary. Amniocentesis is often required in presence of antibodies against D, C, c, E, e, K, Fya, Fyb, S, s, U, Jka, Jkb and Dia. When hemolytic disease is confirmed, intrauterine transfusion or preterm delivery has to be performed. Immunization have increasing importance against erythrocyte factors other than D. It should give attention to it in transfusion practice during pregnancy. PMID- 3281397 TI - [Intrauterine intraperitoneal transfusion controlled by ultrasound. A case report]. AB - Two intrauterine transfusions in one fetus have been performed utilizing continuous ultrasound supervision by Sonolayer SSA-90 A in the 31st and 33rd gestational week. PMID- 3281399 TI - The analgesic effect of indomethacin in the early post-operative period following abdominal surgery. A double-blind controlled study. AB - Patients undergoing major intra-abdominal operations were randomly allocated to receive either 100 mg indomethacin (n = 26) or placebo (n = 20), both given as suppositories, 3 times a day for 3 days. The analgesic effect of indomethacin was measured during the first 5 post-operative days by grading the experience of pain on a closed visual analogue pain scale and further by registration of the amount of narcotics requested. Patients receiving indomethacin had significantly lower pain scores and received significantly fewer doses of narcotics (p less than 0.01). There were only minor side effects which were equally frequent in the 2 groups. These results indicate that indomethacin is an effective analgesic drug in the early post-operative period. PMID- 3281398 TI - [Intrauterine exchange transfusion in Rh immunization]. AB - Intra-uterine exchange transfusion was performed on a patient in the 30th week of gestational age for Morbus haemolyticus fetalis. The indication for intra-uterine intervention resulted from spectrophotometric investigation of amniotic fluid which had revealed Zone III according to Liley as well as incipient hydropic development and development of ascites. The pregnancy had to be terminated for pathological CTG, four days after therapy. Postnatal neonatological intensive therapy included two exchange transfusions, before the child was dismissed in clinically intact condition. PMID- 3281400 TI - Repair of rectal prolapse by rectosacral suture fixation. AB - In 46 patients with complete rectal prolapse a simple method of rectopexy was used, fixing the mobilized rectum to the sacrum with sutures. In 17 cases the rectopexy was supplemented with levator sutures. The patients' age range was 20 87 years and follow-up was 6 months to 17 years. There was no associated mortality and almost no morbidity. Prolapse recurred in two cases, in one of them due to incomplete fixation because of a congenital pelvic deformity. Rectopexy with sutures seemed to give results as good as the Teflon mesh and Ivalon sponge methods in regard to recurrence rate, while avoiding the complication risks associated with insertion of foreign material. PMID- 3281401 TI - Duration of T-tube drainage after exploration of the common bile duct. AB - The optimal duration of T-tube drainage after choledochotomy is not known. In a randomized study, comparison was made between early (postoperative day 4) and late (day 7) removal of the T-tube. The evaluation was made on 62 patients, after exclusion of 20 because of retained stones, technically inadequate postoperative cholangiography, cholangitis or failed T-tube removal. The T-tube was removed on day 4 in 28 cases and on day 7 in 34. There were no clinically significant complications, but two patients with early and two with late removal had transient pyrexia. The mean postoperative stay in hospital was significantly shorter for the patients with early T-tube removal (8.2 vs. 9.8 days). The corresponding figures for the patients younger than 50 years were 7.1 vs. 9.1 days and for those older than 50 they were 8.7 vs. 10.1 days--both differences significant. The results indicated that early removal of choledochal T-tube drain does not increase postoperative morbidity and can significantly shorten the hospital stay. PMID- 3281402 TI - Ultrasonic nonvisualization of the gallbladder in emphysematous cholecystitis. Case report. AB - In a patient with suspected acute cholecystitis, ultrasonography-although repeated-failed to visualize the gallbladder. Corresponding to the gallbladder fossa there was an area of high-density echoes casting a shadow posteriorly, but the examination was considered inconclusive because the gallbladder was not visualized. Plain abdominal radiographs established the diagnosis of acute emphysematous cholecystitis. PMID- 3281403 TI - The Budget Reconciliation Act of 1987. PMID- 3281404 TI - Comparison of oral and intramuscular lorazepam as a surgical premedicant on gastric pH and volume. PMID- 3281405 TI - Strength of implanted carbon fibers. Studies of the lumbar spine in goats. AB - The L3-4 supraspinous and interspinous ligaments in 10 goats were replaced with carbon fibers stabilized with silk-suture seizing. The implants were removed after 3 weeks in 5 animals and after 3 months in the other 5. The maximum traction strength of nonimplanted slings was 157 +/- 9 kg (M +/- SD). After implantation, the strength was reduced to 136 +/- 17 kg, and after 3 months to 107 +/- 9 kg. However, the maximum strength of the spinous processes was 71 +/- 19 kg, which was less than the strength of 3-month implants. We concluded that the carbon fiber sling stabilized with silk sutures could be used for replacement of the interspinous ligament. PMID- 3281406 TI - Chemonucleolysis for sciatica. A critical review. AB - Intradiscal injection of chymopapain for the treatment of sciatica due to disc herniation has been used for more than 25 years, but is still under debate. We review the indications, complications, and clinical results, and discuss the tissue effects of chymopapain. The results following surgical disc removal versus chymopapain injection indicate that surgery with removal of the disc hernia through a small laminotomy remains the documented treatment of choice for patients with proven disc herniation and sciatica in whom conservative treatment has failed. PMID- 3281407 TI - Safer proteinase treatment of sciatica. A biochemical preview of chymopapain inhibitors. PMID- 3281408 TI - Neonatal jaundice. PMID- 3281409 TI - Breast-feeding and its promotion. PMID- 3281410 TI - Neonatal septicemia caused by coagulase negative Staphylococcus with plasmid analysis. PMID- 3281411 TI - Reduction of blood pressure by treatment with alphacalcidol. A double-blind, placebo-controlled study in subjects with impaired glucose tolerance. AB - Disturbances of calcium or vitamin D metabolism have been suggested to be of pathogenetic importance both for hypertension and impaired glucose tolerance, two disorders that are commonly associated. In the present study 65 men, aged 61-65 years, with impaired glucose tolerance were enrolled in a prospective, double blind, placebo-controlled study over 12 weeks evaluating the effects of 0.75 microgram alphacalcidol, a synthetic analog to the active metabolite of vitamin D. In the 26 patients with blood pressure greater than or equal to 150/90 mmHg before treatment a significant reduction (p less than 0.01) of both the systolic (SBP) and diastolic (DBP) blood pressure was found after therapy (from 171/95 to 150/88 mmHg). The effect was additive to concomitant antihypertensive treatment and was correlated (p = 0.03) to a reduction of serum levels of parathyroid hormone. Also in the whole group of patients given alphacalcidol blood pressure was moderately lowered from a mean of 152/87 +/- 22/10 (SD) to 143/84 +/- 17/8 mmHg. There were no relationships between the changes in body weight, blood glucose or insulin parameters and the changes in blood pressure during the trial. The findings are compatible with the concept that calcium metabolism influences blood pressure regulation and suggest that supplementation with a physiologic dose of active vitamin D could be beneficial for patients with high blood pressure. PMID- 3281412 TI - Effects on mortality during five years after early intervention with metoprolol in suspected acute myocardial infarction. AB - This study reports the mortality over a 5-year-period determined a double-blind trial, which evaluated the effect of early intervention with metoprolol in suspected acute myocardial infarction. In all, there were 1,395 randomized patients, 698 and 697 of whom were allocated to metoprolol 200 mg daily and placebo treatments, respectively, for the first 3 months. Thereafter, the two groups were treated in a similar fashion implying beta-blockade to a majority. Within the first 3 months, mortality in the metoprolol group was 5.7% versus 8.9% of the placebo group (p = 0.02). This difference persisted after 2 years (metoprolol 13.2%; placebo 17.2%; p = 0.04). Over a 5-year-period, 24.2% of the patients who originally were allocated to metoprolol had died as compared to 25.7% of those originally allocated to placebo (p greater than 0.2). Among patients in whom treatment started early (less than or equal to 8 hours after onset of pain = the median delay time), enzyme activities in the metoprolol group was lower (p = 0.03) than in the placebo group. Mortality during the first 2 years among these patients treated early was lower in the metoprolol (11.8%) than in the placebo group (17.3%; p = 0.04). Corresponding figures after 5 years were 22.0% and 25.3%, respectively (p greater than 0.2). Among patients in whom treatment started later than 8 hours onset of pain, there was neither any difference in enzyme activity nor in mortality after 2 and 5 years. It can be concluded that early treatment with metoprolol in suspected acute myocardial infarction reduced mortality during the first 3 months compared with placebo. The difference persisted after 2 years. However, 5 years after randomization, no significant difference in mortality was observed between the two treatment groups. PMID- 3281413 TI - Coarctation of the abdominal aorta in elderly patients. Case report and review of the literature. AB - Coarctation of the abdominal aorta as a congenital disease is infrequent, the diagnosis mostly being made at an early age because of renovascular hypertension. Patients who reach the age of 40 more often tend to have the problems located distally to the renal arteries. A 66-year-old female is described, who developed an aortic occlusion, renovascular hypertension and uremia. She was cured with a bifurcation graft and a patch angioplasty of a stenotic renal artery and nephrectomy of the contralateral kidney with an occluded artery without refilling. A literature survey is made of patients older than 40 years. PMID- 3281414 TI - Epidemiology of drug utilization--basic concepts and methodology. PMID- 3281415 TI - Improvement of cerebral blood flow following stereotactic surgery in patients with putaminal haemorrhage. AB - Changes in cerebral blood flow (CBF) after CT guided stereotactic aspiration of putaminal haematoma were investigated in 13 patients with Xe-133 inhalation and single photon emission computed tomography. The interval from onset to operation ranged from 13 to 82 days (mean 30 days). The mean estimated haematoma volume ranged from 20 to 50 ml (mean 31.9 ml). The percentage of haematoma aspirated ranged from 75 to 98% (mean 86.8%). Postoperative CBF in two thirds of the patients was improved even though all cases were operated on in the subacute stage. Both the mean hemispheric and regional CBF in the anterior territory of the middle cerebral artery and in the region of the thalamus and basal ganglia in the affected hemisphere were increased postoperatively. Also in the nonaffected hemisphere, regional CBF in the region of the thalamus and basal ganglia was improved. PMID- 3281416 TI - A unifying model of the thermodynamics of formation of dehydrogenase-ligand complexes. PMID- 3281417 TI - Molecular size determination of enzymes by radiation inactivation. PMID- 3281418 TI - The behavior and significance of slow-binding enzyme inhibitors. PMID- 3281419 TI - Kinetics of substrate reaction during irreversible modification of enzyme activity. PMID- 3281420 TI - Sorbitol dehydrogenase. PMID- 3281421 TI - Preclinical assessment of abuse liability of drugs. AB - Studies that are used in preclinical assessment of the liability of a drug to become an abuse problem are reviewed. These studies examine the capacity of a drug to produce physiological dependence or to function as a reinforcer. Studies that examine physiological dependence by assessing whether a drug reverses signs of withdrawal from a standard drug are rapid, reliable and inexpensive methods for determining if a drug produces dependence of a type similar to the standard. However, these techniques will not determine if the drug produces a unique type of dependence. Studies that examine whether a drug functions as a reinforcer have been predictive of whether a drug will be abused in human populations. Attempts to rank order drugs with respect to their efficacy as reinforcers, however, are not predictive of measures of extent of abuse in human populations. Since abuse of drugs in human populations is a function of societal variables in addition to pharmacological factors, it is unlikely that preclinical assessments will ever yield more than qualitative information on abuse liability of drugs. PMID- 3281422 TI - Playing HCFA's dungeons and dragons. PMID- 3281423 TI - Aaron Lopez, M.D., 1800-1873. PMID- 3281424 TI - Playing God. PMID- 3281425 TI - Echocardiography and digital subtraction angiography in detection of mycotic false aneurysm complicating coarctation of the aorta. PMID- 3281426 TI - Advances in the diagnosis and management of depression. Part I. PMID- 3281427 TI - The 24-hour heart rate behavior in long-term survivors of cardiac transplantation. AB - A detailed computerized analysis of heart rate (HR) behavior during ambulatory monitoring was performed in 19 long-term survivors of cardiac transplantation (12 orthotopic, 7 heterotopic) and in 10 normal volunteers. Compared with normal hearts, the transplanted denervated and the recipient innervated hearts in the heterotopic group showed higher average HRs over the whole 24 hours, the waking and sleeping periods. The rates of the denervated and the recipient hearts did not differ significantly. The maximal HR was similar in all 3 groups, but the minimal HR was lower in the normal hearts than in denervated and recipient hearts. The 24-hour RR interval variability was greatly reduced in the denervated hearts (60 +/- 22 ms) compared with the recipient (89 +/- 26 ms) and normal (151 +/- 38 ms) hearts. During arousal from sleep, the magnitude, time and rate of the HR change were significantly reduced in the denervated hearts compared with the innervated hearts and in the recipient compared with the normal hearts. These findings demonstrate that denervated hearts can show significant variations in HR during the 24-hour period, but to a lesser extent than normal hearts. The widest deviation from normal occurs during sleep, when the denervated heart shows minimal slowing probably due to lack of parasympathetic innervation. In heterotopic transplant recipients, the patients' own HR responses also are significantly blunted. PMID- 3281428 TI - Limits of reproducibility of mitral pulsed Doppler spectra. AB - The total intrinsic variability of pulsed Doppler spectra of mitral blood flow was evaluated in this study. Doppler examinations were performed in 10 normal volunteers (7 men, 3 women), ages 29 to 57 years (mean 41) with an interval period of 3 months. The recordings were made in the apical 4-chamber view, using a 2.25-MHz transducer. The sample was placed approximately 1 cm proximal (left atrium) and 1 cm distal (left ventricle) from the middle of the anulus of the mitral valve at the onset of diastole. Processing of the raw Doppler spectra was done in a way that avoided subjective manipulation by the investigators. Mitral peak velocities, accelerations and spectral widths were measured in early diastole and late diastole. From the parameters under investigation, maximal velocities showed the best reproducibility with a range of coefficients of variation of 9 to 13%. Peak acceleration in early diastole and spectral widths showed rather large coefficients of variation, ranging from 19 to 30 and 14 to 24%, respectively. Mitral pulsed Doppler spectra in the left atrium were more reproducible than in the left ventricle. PMID- 3281429 TI - From irritable heart to mitral valve prolapse: World War I--the U.S. experience and the prevalence of apical systolic murmurs and mitral regurgitation in drafted men compared with present day mitral valve prolapse studies. PMID- 3281430 TI - Lewis A. Conner, MD (1867-1950), and lessons learned from examining four million young men in World War I. PMID- 3281431 TI - Low dose aspirin after early thrombolysis in anterior wall acute myocardial infarction. PMID- 3281432 TI - Long-term follow-up of valvular function after orthotopic cardiac transplantation. PMID- 3281433 TI - Theory and validity of indirect calorimetry during net lipid synthesis. AB - A critical examination is made of the validity of indirect calorimetry when the nonprotein respiratory quotient is greater than 1. The different published stoichiometries for lipogenesis from glucose are excluded as a source of uncertainty in the interpretation of gaseous exchange measurements. The validity of indirect calorimetry is proved independently by an algebraic approach which, in contrast to previous attempts, makes minimal assumptions about stoichiometries. Although equations relating the respiratory quotient to the heat equivalent of oxygen are found valid, there is uncertainty in using these equations to predict accurately carbohydrate utilization and fat oxidized or synthesized. Reference tables interrelating respiratory data, the heat equivalent of oxygen, and net fuel utilization or synthesis for specified fuels are provided. A suggested framework for calculating energy expenditure in terms of ATP gain is given as an appendix. PMID- 3281434 TI - Estimation of energy expenditure, net carbohydrate utilization, and net fat oxidation and synthesis by indirect calorimetry: evaluation of errors with special reference to the detailed composition of fuels. AB - Sources of error in the interpretation of respiratory data are evaluated and reviewed with special reference to the detailed composition of foods. Estimates of fuel utilization or synthesis are 12-fold more sensitive to errors in the nonprotein respiratory quotient than is the heat equivalent of oxygen. Estimates of protein oxidation from nitrogen excretion can be in error from +14 to -39% of the true value. Heat equivalents of oxygen, respiratory quotients, and urinary nitrogen-to-oxygen conversion ratios are considered for 60 artificial and 101 conventional food proteins, 36 artificial and 125 conventional food fats, and the different carbohydrates contained in these foods. It is concluded that there is considerable uncertainty when the mix of fuels utilized is assessed accurately. Accuracy is best within 5% of the true values. This analysis is completed with descriptions of some physiological sources of error in an appendix. PMID- 3281435 TI - Impaired parasite growth and increased susceptibility to phagocytosis of Plasmodium falciparum infected alpha-thalassemia or hemoglobin Constant Spring red blood cells. AB - In vitro multiplication of Plasmodium falciparum in hemoglobin H or hemoglobin Constant Spring red blood cells (from homozygotes or double heterozygotes) was significantly reduced as compared with that in normal erythrocytes. The parasitized genetically abnormal red blood cells showed furthermore a high propensity for being phagocytosed by peripheral blood monocytes. Both impaired parasite growth and increased susceptibility to phagocytosis may be related to mechanisms for protection of the variants from P. falciparum infection. PMID- 3281436 TI - Immunohistochemical localization of hepatitis B surface antigen and hepatitis B core antigen in tissue sections. A source of false positive staining. AB - The occurrence of apparent false positive immunoperoxidase staining for hepatitis B surface antigen (HBsAg) led to the evaluation of several commercial antisera for usefulness in the diagnosis of hepatitis B by immunohistochemistry. One commercial antibody to hepatitis B core antigen (HBcAg) was tested and found to give sensitive and specific staining, with only a few false negatives and no false positives. Of three antibodies to HBsAg, one gave good staining results that were consistent with serologic data; one had many false positive stains due to contaminating antibodies to plasma proteins; and one (a monoclonal antibody) had many false negatives, probably due to its restricted antigenic specificity. Diagnosticians should be aware of the problems with false positive and false negative immunohistochemical stains. False positives in particular can be a significant problem, causing frequent misdiagnosis of hepatitis B. PMID- 3281437 TI - Graft-versus-host disease in the central nervous system. A real entity? AB - Graft-versus-host disease (GVHD) classically involves the skin, intestines, liver, esophagus, and tongue. clinically apparent disease involving the heart, lungs, kidneys, and central nervous system (CNS) is frequently secondary to other complicating factors. This report describes a case of an infant with severe combined immune deficiency (SCID) who developed unusual manifestations of GVHD following a bone marrow transplant (BMT). These were complete heart block and respiratory insufficiency in the absence of significant pulmonary disease. He lived 133 days post-transplantation. At autopsy, the brain showed focal lymphohistiocytic aggregates which may represent a hitherto unreported lesion of GVHD. PMID- 3281438 TI - A comparison between zinc phosphate and glass ionomer cement in orthodontics. AB - In the past orthodontic band cementation has relied heavily on mechanically retentive cements such as zinc phosphate luting agents. The clinical performance of a glass ionomer cement (GIC), a chemically retentive cement, was evaluated against a conventional zinc phosphate cement (ZP). The recementation values for ZP were significantly higher over a 2-year treatment period than those of GIC. Failures between cement and enamel, and cement and stainless steel were noted for the ZP. Glass ionomer cement had significantly better retentive strength to enamel than to band material. Moisture contamination does not appear to be a problem in orthodontic band cementation with glass ionomer cement. PMID- 3281439 TI - The logic of modern retention procedures. PMID- 3281440 TI - Bonding and debonding brackets to porcelain and gold. AB - Today's orthodontic practice includes a larger proportion of adults. Because many of these adults have crown and bridge restorations fabricated from porcelain or gold, the orthodontist must use methods that permit the attachment of orthodontic brackets to porcelain and nonprecious metal or gold. A bracket may be placed on single-unit crowns of porcelain or gold, but banding becomes difficult. Thus bonding the orthodontic bracket to the restoration provides a satisfactory alternative. This clinical report describes several techniques for bonding orthodontic brackets to porcelain or gold surfaces, and some suggestions for removal of bonded brackets. PMID- 3281441 TI - A comparison of shear bond strengths of metal and ceramic brackets. AB - The study measures and compares shear bond strength data obtained from metal, ceramic, and ceramic-filled plastic brackets bonded to human incisor teeth with a heavily filled composite resin. The mean values for groups of different types of brackets were not statistically significant. The site of failure was commonly at the resin/bracket interface except for the ceramic-filled plastic brackets, which frequently showed failure of the bracket itself. One group of ceramic brackets that used no mechanical retention often showed failure to the extent that the bulk of resin remained on the bracket. The findings strongly suggest that ceramic brackets should offer a viable alternative to their metal counterparts because they combine esthetics with a bond strength that is comparable to and as reliable as their metal counterparts. PMID- 3281442 TI - Aortoesophageal fistula and sudden death. A report of two cases and review of the literature. AB - Two cases of aortoesophageal fistula are presented. The etiology, symptoms, and diagnosis of aortoesophageal fistula are reviewed. Signs and symptoms of gastrointestinal hemorrhage followed by sudden collapse hours to days later should prompt consideration of an aortoesophageal fistula. Accidental ingestion of foreign bodies, particularly by children, is a frequent etiology. PMID- 3281443 TI - Traumatic basal subarachnoid hemorrhage. Report of six cases and review of the literature. AB - Basal subarachnoid hemorrhage due to rupture of normal extra- and intracranial arteries, in association with minor trauma to the face and neck and alcohol intoxication, has been well described but often goes unrecognized at autopsy. This results in the incorrect classification of the manner of death as natural. Six cases of subarachnoid hemorrhage due to mild-to-moderate blows to the head or neck are presented. All were men in the age range 28-61 years (mean, 38.8 years). Four had blood alcohol levels of 0.09-0.28 g % at autopsy, and five of six were comatose or dead within 30 min of the initiating trauma. Traumatic ruptures of otherwise normal extra- and intracranial arteries were identified in four cases. The site of rupture was not found in one case, and the final case had rupture of a fibrotic intracranial vertebral artery. Multiple sites of incomplete and complete rupture were found in four cases. Postmortem angiography was used in one case to demonstrate the site of rupture prior to removal of the brain. Postmortem angiography and careful gross and histologic examination of extra- and intracranial cerebral arteries is recommended in all cases of basal subarachnoid hemorrhage where minor trauma to the head or neck has occurred prior to collapse or death, especially if the decedent was intoxicated at the time of the trauma. PMID- 3281444 TI - Sudden infant death syndrome in Japan. AB - Two autopsied cases are presented, one involving a 5-month-old infant, and a 6 month-old infant both of whom died suddenly and unexpectedly. The incidence of sudden infant death syndrome in Japan is 1.2 per 1,000 babies live births. Among all cases autopsied in the departments of legal or forensic medicine in 78 universities or colleges of Japan, the incidence was 15 (0.5%) per 3,329 in 1984 and 20 (0.6%) per 3,150 in 1985. PMID- 3281445 TI - Medicolegal investigation of an eighteenth century homicide. AB - The skeleton of an adult man, recovered from an eighteenth century French fort site in Indiana, exhibited a series of sharp force wounds. The lesions, three cranial and one postcranial, had apparently been made by a heavy metal instrument similar to one of the European ax heads discovered elsewhere at the site. In this paper we describe the wounds, argue that the instrument used to create them was a European ax, and offer the opinion that the manner of death in this case was homicide. PMID- 3281446 TI - Consecutive infanticides in Japan. AB - A 34-year-old housewife who was arrested for patricide confessed that she had also killed six newborn infants between 1975 to 1983. She is the mother of four other children, and her husband frequently works away from home. Her motive seemed to be economic. In addition to this case, 11 other cases of three or more consecutive infanticides are recorded for the 8-year period between 1979 and 1986 in Japan. All of the suspects were the natural mothers of the murdered infants, and most of them were married. The infants were killed immediately after delivery by various methods of asphyxia, such as strangulation, throttling, smothering, or suffocation. PMID- 3281447 TI - A note on the history of the calculation of hospital statistics. PMID- 3281448 TI - Case-control studies using other diseases as controls: problems of excluding exposure-related diseases. AB - Exclusion criteria are examined in case-control studies which include persons with other diseases in the control group. Theoretically, a sample of the study base should not exclude persons who develop exposure-related diseases before, during, or after the time period in which the case occurred. This principle also generally applies when controls are sampled from the subset of persons with other diseases generated by the same study base. In particular, if the incidence rates (assuming completeness of ascertainment) for all other disease combined are similar in the exposed and nonexposed populations, then controls should be sampled from all other diseases, regardless of their relation to exposure. On the other hand, if the composite incidence rate for other diseases is greater (or less) in the exposed population, then it may be necessary to exclude controls with diseases positively (or negatively) associated with exposure. Additionally, considerable care should be taken when sampling controls from persons with specific diseases which are apparently "unrelated" to exposure because confounding may be introduced by exposure-related determinants of the control disease(s). To remove such confounding, it is necessary to control for risk factors for both the study disease and the control disease(s). PMID- 3281449 TI - Response in serum ferritin and haemoglobin to iron therapy in blood donors. AB - Seven hundred seventeen healthy male blood donors regularly donating four or more units a year were surveyed for haemoglobin and serum ferritin levels. One hundred fifty-one (21%) had a haemoglobin less than 13.5 g/dl and were therefore disqualified from further blood donation, having a mean serum ferritin of 28 micrograms/liter. Of the remaining 566 donors with haemoglobin levels equal to or greater than 13.5 g/dl, the mean serum ferritin was 33 micrograms/liter, although in 299 (53%) the value was less than 28 micrograms/liter. To document response to iron therapy 46 donors with haemoglobin levels equal to or greater than 13.5 g/dl were stratified into those with the lowest iron stores (group 1; n = 23), defined as a serum ferritin less than 20 micrograms/liter, and controls (group 2; n = 23), with serum ferritin between 50 and 150 micrograms/liter. Within each stratum donors randomly received ferric polymaltose at a dose of 100 mg elemental iron twice daily for 56 days (groups 1a and 2a) or an identical iron-free placebo tablet administered on the same schedule (groups 1b and 2b). Iron therapy in the iron-deficient group (group 1a:n = 11) resulted in a significant rise in haemoglobin (p = .03) and iron stores reflected in serum ferritin (p = .002) compared to those receiving placebo (group 1b). In the control group iron therapy or placebo was without significant effect. Thus, ferric polymaltose preparation is bioavailable and is notable for the virtual absence of gastrointestinal tract side effects. PMID- 3281450 TI - Genotypic analysis using a Y-chromosome-specific probe following bone marrow transplantation. AB - To monitor successful engraftment after bone marrow transplantation, we performed Southern hybridization analysis or dot blot analysis of DNA in a set of sex mismatched cases using a Y-chromosome-specific DNA probe (pHY10). This method was extremely sensitive and rapid for checking which cells contain the Y-chromosome. Using this probe, analysis of cells from peripheral blood and bone marrow after transplantation demonstrated the usefulness of confirming engraftment of donor cells and of detecting mixed lymphohematopoietic chimerism. PMID- 3281451 TI - Hypereosinophilic syndrome with multiple organ dysfunction treated by allogeneic bone marrow transplantation. AB - A 26-year-old man with hypereosinophilic syndrome who had initial neurologic, cardiac, and pulmonary dysfunction, high eosinophil count, thrombocytopenia, and bone marrow fibrosis had only a transient response to conventional treatment with corticosteroids and hydroxyurea. He therefore received human lymphocyte antigen identical allogeneic bone marrow transplantation (BMT) after conditioning with cytoxan and fractionated total body irradiation. Hematologic recovery was prompt, with normalization of blood counts and bone marrow. The patient died less than 3 months after transplantation from diffuse cytomegalovirus infection. Potential interest of BMT in patients with resistant hypereosinophilic syndrome and features of poor prognosis is discussed. PMID- 3281452 TI - Nonhepatitis B-associated liver disease in a renal transplant population. AB - The spectrum of liver disease in a population of 293 patients receiving 353 renal transplants (1971-1984) was reviewed. This study looked retrospectively at the histological features of liver disease in this population, and prospectively at the clinical and biochemical features of liver disease associated with renal transplantation. In all patients, infection with hepatitis B was excluded. Six deaths, primarily attributable to hepatic failure have occurred: one, acute herpes simplex infection; one, subacute massive hepatic necrosis of uncertain etiology; two, pretransplant liver disease; and two, posttransplantation cirrhosis of uncertain etiology. Review of the hepatic histology of 26 patients with known liver disease following transplantation revealed a wide range of pathologies with few specific correlations with their clinical status or biochemical tests of liver function. The prevalence of hepatic dysfunction following transplantation in our patient population was assessed by prospective biochemical screening of 111 transplant recipients over a 6-month interval. During this time period, 27 patients (24%) displayed biochemical evidence of hepatic dysfunction. Liver disease was known to have predated transplantation in only three of 27. Episodes of abnormal liver function occasionally occurred during an identifiable acute illness (six of 27), although the majority (21 of 27) had chronic hepatic dysfunction. Transplant recipients with abnormal liver function could not be differentiated from a cohort with normal liver function on the basis of age, sex, duration of graft function, or alcohol/drug intake. The possible etiologies of nonhepatitis B liver dysfunction following renal transplantation are discussed, and the high prevalence of biochemical evidence of hepatic dysfunction in this population free of hepatitis B infection is emphasized. PMID- 3281453 TI - Kaposi's sarcoma in cyclosporine-induced gingival hyperplasia. AB - In the cases presented in this report, Kaposi's sarcoma developed in the gingiva of two patients with cyclosporine-induced gingival hyperplasia. The tumor was clinically inapparent, and was diagnosed unexpectedly following biopsy of the hypertrophied gingiva. This unusual presentation has not been reported previously. PMID- 3281454 TI - Carcinogenicity of occupational nickel exposures: an evaluation of the epidemiological evidence. AB - The health effects documented in recent epidemiological studies of nickel-exposed workers relate to past exposures, mostly of unknown magnitude and unknown nickel speciation. Major studies have been carried out at nickel smelters and refineries. Although each study suffers from some deficiencies, as is common in such retrospective studies, the findings in concert strongly indicate that nickel emitted from the calcining and sintering operations is a potent carcinogen resulting in nasal and pulmonary cancers. Some risk appears to be present in other refinery operations, such as Orford furnace, copper and nickel sulfate, and crushing departments, and one study has suggested a risk associated with soluble nickel compounds in the electrolysis department, although this finding has not been confirmed. Only one study demonstrated an exposure-response relationship, which, however, was not statistically significant. Other studies showed a relationship between increased exposure time and augmented cancer risk. In nickel using industries, no excess cancer related to nickel exposures has been demonstrated beyond doubt; concurrent exposures to other potential carcinogens constitute a confounding variable that makes interpretation difficult. However, the studies have not excluded that a cancer hazard may be present outside the nickel-producing facilities. Further, case-referent studies of respiratory cancers suggest that a nickel-related etiology may well exist in the nickel-using industries. As the exact identity of the carcinogenic form or forms of nickel remains unknown, exposure to all nickel compounds should be kept as low as reasonably achievable. PMID- 3281455 TI - Isocyanates and respiratory disease: current status. AB - This paper reviews the known respiratory effects of isocyanates. There is good evidence to indicate that isocyanates: cause chemical bronchitis/pneumonitis; are potent pulmonary sensitizers capable of causing "isocyanate asthma"; cause nonspecific airways disease, including chronic bronchitis; can induce a general asthmatic state; and can cause hypersensitivity pneumonitis. Similar dose response relationships are seen for both acute and chronic effects. There are plants operating in which exposures are well controlled and in which no respiratory effects can be detected. Suggestions are provided for preplacement assessment and periodic surveillance for workers exposed to these compounds. PMID- 3281456 TI - Estimation of the diesel exhaust exposures of railroad workers: II. National and historical exposures. AB - The diesel exhaust exposures of railroad workers in thirteen job groups from four railroads in the United States were used to estimate U.S. national average exposures with a linear statistical model which accounts for the significant variability in exposure caused by climate, the differences among railroads and the uneven distribution of railroad workers across climatic regions. Personal measurements of respirable particulate matter, adjusted to remove the contribution of cigarette smoke particles, were used as a marker for diesel exhaust. The estimated national means of adjusted respirable particulate matter (ARP) averaged 10 micrograms/m3 lower than the simple means for each job group, reflecting the climatic differences between the northern railroads studied and the distribution of railroad workers nationally. Limited historical records, including some industrial hygiene data, were used to evaluate past diesel exhaust exposures, which were estimated to be approximately constant from the 1950's to 1983. PMID- 3281457 TI - Myocardial fuel and energy balance, acute ischemia and diabetes. AB - When glucose-insulin-potassium (GIK) is infused, glucose supplies most of the energy demands of the heart. Fatty acid becomes the major substrate during fasting, pathologically increased work loads or insulin deficiency. Myocardial purine breakdown reflects myocardial energy status and influences coronary tone. Ischemia accelerates breakdown of ATP to AMP, which is further metabolized to adenosine, which causes vasodilatation and a blunted response to catecholamines. If normal circulation is restored, ADP and AMP are rapidly converted to ATP and purine metabolism is changed from degradation to salvage and de novo synthesis of purines. Ischemia impairs mitochondrial function, causing decreased capacity to oxidize fatty acids once aerobic conditions return. Thus, reperfusion with elevated plasma free fatty acids results in acyl-CoA accumulation in the heart. In diabetic animals, phosphorylation of AMP to ATP is defective in the heart, and AMP degradation is increased. Therefore, careful regulation of the blood sugar with concomitant lowering of plasma free fatty acids in diabetics with ischemic heart disease should improve myocardial salvage by preserving and repleting myocardial ATP. Thus, along with reestablishment of coronary flow and reduction in myocardial oxygen demands, may significantly reduce the morbidity of acute ischemia in diabetics. PMID- 3281459 TI - Heterochrony and human malformation. AB - The role of altered developmental timing or heterochrony in morphologic evolution has intrigued classical and modern biologists. Analogous manifestations of developmental asynchrony occur in human dysmorphogenesis where they illustrate the residue and repertoire of phylogenetic change. Certain single malformations such as holoprosencephaly immediately suggest heterochrony by their resemblance to antecedent phylogenetic or embryologic structures. Multiple malformation syndromes of genetic, chromosomal, or teratogenic etiology may have altered developmental timing as an underlying theme. The persisting alpha-fetoprotein synthesis in ataxia-telangiectasia, the morphologic atavisms in Down or trisomy 13 syndromes, and the delayed growth or fetal to adult hemoglobin switch in diabetic embryopathy all exemplify developmental asynchrony. The perspective of heterochrony stresses the molecular history and hierarchy which is recapitulated with each pregnancy, and reconciles apparent discrepancies between the rates of molecular and morphologic evolution. Recognition of heterochrony places isolated anomalies in the context of pattern and suggests monitoring of teratogenesis through altered expression of ontogenetically regulated, phylogenetically relevant molecules. PMID- 3281458 TI - Prenatal diagnosis of chromosome abnormalities in the presence of fetal structural defects. AB - A chromosomal abnormality was found in 42 (10.9%) out of 386 fetuses with a structural defect. Thirty-five of these were diagnosed prenatally, following ultrasonic detection of one or more structural anomalies and associated pathology such as marked intrauterine growth retardation and polyhydramnios. Termination of pregnancy was carried out in 16 fetuses aged less than 26 weeks, intrauterine and neonatal death occurred in 20 cases, the remaining 6 infants were alive at 3 months. The poor outcome in these pregnancies emphasizes the need for prenatal chromosome analysis in the presence of a fetal structural defect. PMID- 3281460 TI - The Tel Hashomer camptodactyly syndrome: report of a new case and review of the literature. AB - We report on a new case of Tel Hashomer camptodactyly syndrome and review the literature. This syndrome is characterized by skeletal dysplasia, muscle hypoplasia, camptodactyly, and abnormal dermatoglyphics. The inheritance is autosomal recessive with probable partial expression in the heterozygote. PMID- 3281461 TI - Results of a randomized, multicenter, comparative trial of a single dose of cefotetan versus multiple doses of cefoxitin as prophylaxis in cesarean section. AB - In a multicenter, open, randomized, comparative trial, 308 women undergoing cesarean section were given a single 1 gm dose of cefotetan or three 2 gm doses of cefoxitin after cord clamping to reduce the incidence of postoperative infectious morbidity. Of the 286 evaluable patients, 195 received cefotetan and 91 received cefoxitin. Most patients were in active labor and one third had ruptured membranes. Microorganisms cultured from the endocervix or intraoperatively from the endometrium or abdominal wall operative sites were comparable for the two groups. In this multicenter study, the difference between the percentage of patients receiving cefotetan who did not develop clinical signs and symptoms of infection (93%) and the percentage of patients receiving cefoxitin (85%) considered clinical successes was statistically significant (p = 0.02, chi 2). The bacteriologic response rate for patients taking cefotetan was also significantly higher than that for patients taking cefoxitin (93% versus 85%, p = 0.03). Isolates recovered from the endocervix, endometrium, or operative site were comparable for the two groups. Both drugs were well tolerated. In this evaluation, cefotetan administered in a single dose of 1 gm was more effective as a prophylactic agent than multiple 2 gm doses of cefoxitin in the reduction of infectious morbidity in this large series of patients undergoing cesarean section. PMID- 3281462 TI - Multicenter comparison of cefotetan and cefoxitin in the treatment of acute obstetric and gynecologic infections. AB - Two hundred eighty-seven women were treated in a multicenter, randomized, comparative study to compare the safety and efficacy of cefotetan every 12 hours with that of cefoxitin every 6 or 8 hours in the treatment of acute obstetric and gynecologic pelvic infections. The most frequent primary diagnoses in both groups were endometritis and pelvic inflammatory disease; 24 of these patients were also bacteremic. The mean duration of treatment was 5.2 and 5.4 days for the cefotetan and cefoxitin groups, respectively, and the total doses administered were 18.1 and 32.1 gm, respectively. The rate of clinical failure for the cefotetan group was 8.5% and 12.2% for the cefoxitin group. Laboratory and clinical adverse reactions were infrequent and none was serious; both antimicrobials were well tolerated. These results suggest the administration of cefotetan provided adequate clinical and bacteriologic effectiveness in the treatment of hospital- and community-acquired, polymicrobial obstetric and gynecologic pelvic infections. PMID- 3281463 TI - Comparative study of cefotetan and cefoxitin in the treatment of intra-abdominal infections. AB - One hundred eighty-eight patients were enrolled in a multicenter, randomized clinical trial to compare the safety and effectiveness of 1 to 2 gm cefotetan every 12 hours with those of 1 to 2 gm cefoxitin every 6 hours in patients with intra-abdominal infections. Most of the infections were community acquired, were associated with gastrointestinal tract perforation, and were caused by both anaerobic and aerobic bacteria. The median duration of therapy was 6 days for each group. The clinical response rate for the 95 evaluable patients in the cefotetan group was 98%, and that for the 43 evaluable patients in the cefoxitin group was 95%. Bacteriologically, 97% of the 58 evaluable patients in the cefotetan group and 89% of the 27 evaluable patients in the cefoxitin group had a satisfactory or presumed satisfactory response; two patients in the cefotetan group and three in the cefoxitin group were considered bacteriologic failures. Cefotetan was as effective as cefoxitin in eradicating Bacteroides fragilis and other species of Bacteroides, Clostridium sp., and gram-negative bacilli. The incidence of treatment-related adverse reactions for cefotetan (27%) was not statistically different from that for cefoxitin (17%). No clinically significant differences were detected between the treatment groups in changes in the results of clinical laboratory tests performed before and after treatment; a decrease in hematocrit among the cefotetan group was statistically greater (p = 0.04) than that for the cefoxitin group, and a decrease in serum creatinine level for the cefoxitin group was greater than that for the cefotetan group (p = 0.02). Cefotetan may represent an effective, safe, and cost-saving alternative to cefoxitin for the prompt treatment of community-acquired intra-abdominal infections. PMID- 3281464 TI - Pediatric occupational therapy in the home. AB - This article discusses the challenges and implications for pediatric practice in the home. Pediatric occupational therapists are moving the treatment setting from the clinic to the home. Working within the home environment requires occupational therapists to adapt their roles, functions, and treatment styles. Intervention frequently involves practical and relevant treatment, using activities and objects from the child's world. Thus, functional goals may be more realistically achieved in the child's living environment. Involvement with family members also offers opportunities to develop collaborative relationships with parents and, therefore, to integrate the intervention program into the child's home life. PMID- 3281465 TI - Redefining professionalism for occupational therapy. PMID- 3281466 TI - AOTA organizational planning: focusing on the future. PMID- 3281467 TI - Anger intervention. AB - This article compares and contrasts psychoanalytic and cognitive-behavioral approaches to anger intervention. Related research is discussed and a cognitive behavioral model of anger intervention is presented. The model views anger as an affective stress reaction consisting of four factors: physiological arousal, antagonistic cognitions, environmental stimuli, and behavioral reactions. The article also examines occupational therapy assessment and treatment goals on the basis of the cognitive-behavioral model and recommends stress management activities and techniques for helping clients control the factors that mediate their anger. PMID- 3281468 TI - Progesterone receptor distribution in the human endometrium. Analysis using monoclonal antibodies to the human progesterone receptor. AB - Two monoclonal antibodies to the human progesterone receptor (PR), JZB39 and KD68, were used in determining the immunohistochemical distribution of PR in the human endometrium throughout the menstrual cycle and after menopause. These antibodies recognized PR, as demonstrated by a downfield shift in the radiolabeled progestin binding peak when KD68 or JZB39 was added to high salt sucrose density gradients. The specificity of both antibodies for PR was confirmed with Western immunoblots and competition studies performed with purified receptor. Progesterone receptor was identified with these antibodies and the peroxidase-antiperoxidase technique in the nuclei of epithelial cells, stromal cells, and myometrial smooth muscle cells. The receptor content of endometrial epithelium and stroma varied with the menstrual cycle. The variation was most marked in the epithelium, which demonstrated very strong PR immunostaining during the proliferative phase and postovulation Days 1-3 of the early secretory phase, but PR immunostaining decreased sharply at postovulation Day 4 and remained relatively weak or absent during the mid and late secretory phase. In contrast, stromal cell nuclei were moderately to strongly immunostained even during the secretory phase. Progesterone receptor was not localized in vascular smooth muscle cells or endothelial cells. Specific cytoplasmic staining for PR was not identified in any of these cases, even prior to ovulation, when circulating levels of progesterone are low, indicating that both the steroid occupied and -unoccupied forms of human progesterone receptor, like rabbit and guinea pig PR, and estrogen receptor, is a nuclear protein. PMID- 3281469 TI - c-myc protein in normal tissue. Effects of fixation on its apparent subcellular distribution. AB - The c-myc protein is thought to be a DNA-associated nuclear protein. However, immunohistochemical studies on normal or tumor tissues have shown conflicting findings on its subcellular distribution. By using various fixation procedures on cytospin preparations of HL60 cells, the authors found the subcellular distribution of the c-myc protein to be dependent on the method of fixation. When studying mouse tissues in frozen sections using a biotinylated monoclonal antibody against the c-myc protein, they found the protein to be widely distributed in various normal adult mouse tissues, in most cases localized to the nucleus. However, when these tissues were studied after formalin fixation and paraffin embedding, a loss of nuclear staining was observed concurrent with the appearance of c-myc protein immunoreactivity in the cytoplasm. It is concluded that immunohistochemical studies on the expression of this oncogene should take into consideration the effects of fixation when its subcellular distribution is being examined. PMID- 3281471 TI - Metabolic fate of a gastric glucose load in unrestrained rats bearing a portal vein catheter. AB - Metabolic and hormonal responses to the administration of a gastric load of glucose (2.4 mg/g body wt) were evaluated after a fast of 6-7 h in unrestrained rats bearing a portal vein catheter. For the purpose of this study, we have designed a new technique for a direct catheterization of the portal vein that allows serial blood sampling in unrestrained Wistar rats. On the 6th postoperative day, food intake, body weight gain, liver function, histology of the liver, pancreas, intestine, and splanchnic blood flows were similar to those of sham-operated control rats. In the basal state glucose turnover was 21.3 +/- 0.9 mg.kg-1.min-1. After glucose ingestion, a portoperipheral gradient of lactate was present, reflecting the production of lactate by the intestine. Insulin secretion was biphasic and peaked at 12 min (344 +/- 46 microU/ml), whereas portal glucagonemia (400-500 pg/ml) remained unchanged. Sixty minutes after gastric glucose administration, 50% of the load was delivered at the periphery, and glucose utilization was increased by 100%. Hepatic glucose production decreased after 20 min and was inhibited by 30% at 60 min. Liver glycogen concentration remained unchanged during the experiment despite a normal capacity for glycogen synthesis. PMID- 3281470 TI - Immunoelectron microscopy of Schuffner's dots in Plasmodium vivax-infected human erythrocytes. AB - Plasmodium vivax induces morphologic alterations in infected host erythrocytes that are visible by light microscopy in Romanovsky-stained blood smears as multiple brick-red dots. These morphologic changes, referred to as Schuffner's dots, are important in the identification of this species of malarial parasite and have been associated by electron microscopy with caveolavesicle complexes along the erythrocyte plasmalemma. We have produced a monoclonal antibody (MAb A 20) that identifies an antigen in Plasmodium vivax-infected erythrocytes that is associated with the caveola-vesicle complexes of the parasitized host cell. This monoclonal antibody reacts with air-dried P vivax-infected erythrocytes to produce a pattern by the indirect immunofluorescence test (IFT) that is evocative of Schuffner's dots. Immunoelectron microscopy of P vivax-infected human erythrocytes using MAb A 20 confirmed the location of this antigen within vesicles of caveola-vesicle complexes. On Western blots MAb A 20 recognized four polypeptides of 54, 64, 72, and 86 kd. MAb A 20 reacted by IFT with 90% of Sri Lankan isolates and with a Brazilian P vivax isolate, which indicates that the epitope identified by this monoclonal is conserved. PMID- 3281472 TI - Measuring brain glucose phosphorylation with labeled glucose. AB - This study tested whether glucose labeled at the C-6 position generates metabolites that leave brain so rapidly that C-6-labeled glucose cannot be used to measure brain glucose phosphorylation (CMRGlc). In pentobarbital-anesthetized rats, the parietal cortex uptake of [14C]glucose labeled in the C-6 position was followed for times ranging from 10 s to 60 min. We subtracted the observed radioactivity from the radioactivity expected with no loss of labeled metabolites from brain by extrapolation of glucose uptake in an initial period when loss was negligible. The observed radioactivity was a monoexponentially declining function of the total radioactivity expected in the absence of metabolite loss. The constant of decline was 0.0077.min-1 for parietal cortex. Metabolites were lost from the beginning of the experiment. However, with correction for the loss of labeled metabolites, it was possible to determine an average CMRGlc between 4 and 60 min of circulation of 64 +/- 4 (SE; n = 49) mumol.hg-1.min-1. PMID- 3281473 TI - Importance of intrahepatic mechanisms to gluconeogenesis from alanine during exercise and recovery. AB - These studies were performed to assess the importance of intrahepatic mechanisms to gluconeogenesis in the dog during 150 min of treadmill exercise and 90 min of recovery. Sampling catheters were implanted in an artery and portal and hepatic veins 16 days before experimentation. Infusions of [U-14C]alanine, [3-3H]glucose, and indocyanine green were used to assess gluconeogenesis. During exercise, a decline in arterial and portal vein plasma alanine and in hepatic blood flow led to a decrease in hepatic alanine delivery. During recovery, hepatic blood flow was restored to basal, causing an increase in hepatic alanine delivery beyond exercise rates but still below resting rates. Hepatic fractional alanine extraction increased from 0.26 +/- 0.02 at rest to 0.64 +/- 0.03 during exercise and remained elevated during recovery. Net hepatic alanine uptake was 2.5 +/- 0.2 mumol.kg-1.min-1 at rest and remained unchanged during exercise but was increased during recovery. The conversion rate of [14C]alanine to glucose had increased by 248 +/- 38% by 150 min of exercise and had increased further during recovery. The efficiency with which alanine was channeled into glucose in the liver was accelerated to a rate of 338 +/- 55% above basal by 150 min of exercise but declined slightly during recovery. In conclusion, 1) gluconeogenesis from alanine is accelerated during exercise, due to an increase in the hepatic fractional extraction of the amino acid and through intrahepatic mechanisms that more efficiently channel it into glucose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281474 TI - Effect of a converting-enzyme inhibitor on vasa recta blood flow in rat kidney. AB - In young anesthetized Munich-Wistar rats, red cell flux (Qrbc) was measured in the vasa recta of the exposed renal papilla by means of fluorescently labeled erythrocytes. To study the vasoreactivity of the juxtamedullary vasculature and its sensitivity to converting-enzyme inhibition, measurements of Qrbc were made before and after continuous intravenous infusion of the angiotensin I converting enzyme inhibitor captopril (3 mg.h-1.kg body wt-1). A time control group that received vehicle alone was studied in parallel. Captopril acts as a vasodilator and reduces systemic arterial pressure. Captopril treatment increased Qrbc by 40 +/- 4% (n = 9, P less than 0.001) and decreased blood pressure by 9% (P less than 0.001). In the time control group no statistically significant change occurred in either Qrbc (+6 +/- 8%, n = 10) or blood pressure (-1%). Urine samples were taken from the papillary tip. In neither of the groups did the urine osmolality show a statistically significant change. In the time control group the values before and after intravenous infusion were 1,006 +/- 61 and 1,091 +/- 70 mosmol/kg H2O, respectively, and in the captopril-treated animals the corresponding values were 1,150 +/- 85 and 1,210 +/- 60 mosmol/kg H2O, respectively. These results confirm the suggestion that there is high vasoreactivity in the juxtamedullary vasculature and that this region is sensitive to inhibition of angiotensin I converting enzyme, the latter sensitivity implying that angiotensin II plays a role in the regulation of juxtamedullary vascular resistance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281475 TI - Renin and angiotensinogen gene expression in maturing rat kidney. AB - To determine whether angiotensinogen (Ao) and renin are synthesized by the immature kidney and to assess the changes in intrarenal renin distribution that occur with maturation, the kidneys from 24 newborn and 12 adult Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) were processed for renin immunocytochemistry using a highly specific anti-rat renin antibody. Kidney renin and Ao relative mRNA levels (mRNA/total RNA) were detected by Northern and dot blot techniques, using full-length rat renin and Ao cDNAs. Renal renin concentration (RRC) was measured by radioimmunoassay of angiotensin I (ANG I) and expressed as ng ANG I.h-1.mg protein-1 in the incubation media. RRC was higher in newborn than in adult SHR (979 +/- 164 vs. 206 +/- 47) and WKY (573 +/- 69 vs. 297 +/- 74) (P less than 0.05). In the newborn kidneys of both rat strains, renin was distributed throughout the entire length of the afferent arterioles and interlobular arteries, whereas in the adult kidneys renin was confined to the classical juxtaglomerular position. With maturation, there was a decrease in the proportion of immunoreactive juxtaglomerular apparatuses and arterial segments that contained renin. Kidney renin mRNA levels were 7.9-fold higher in the newborn than in the adult animal. Ao mRNA was detected in the newborn and adult kidneys of both rat strains. This study demonstrates conclusively that both renin and Ao genes are expressed in the newborn kidney, providing evidence for a local renin-angiotensin system that is subjected to developmental changes. PMID- 3281476 TI - End-systolic pressure-volume relationships in dogs during ventilation with PEEP. AB - Whether left ventricular (LV) contractility changes during ventilation with positive end-expiratory pressure (PEEP) remains controversial. To assess LV inotropic state during PEEP using a load-independent index, we generated end systolic pressure-volume relationships (ESPVRs) in eight closed-chest, chronically instrumented, anesthetized dogs undergoing 0 [zero end-expiratory pressure for the 1st time (ZEEP1)], 5 (PEEP-5), 10 (PEEP-10), and again 0 (ZEEP2) cmH2O PEEP. LV volume was calculated from three orthogonal internal diameters (sonomicrometry), and LV pressure was measured using an implanted transducer. ESPVRs at each level of PEEP were generated by transient inflation of a vena caval occluder. Despite significant decreases in cardiac output with PEEP-5 (1.81 +/- 0.38 l/min, means +/- SE; P less than 0.05) and PEEP-10 (1.70 +/- 0.46; P less than 0.01) with respect to ZEEP1 (2.12 +/- 0.41), no change was found in the slope (ZEEP1: 6.99 +/- 1.03 mmHg/ml; PEEP-5: 7.48 +/- 1.20; PEEP-10: 7.17 +/- 1.02; ZEEP2: 7.38 +/- 1.02), the volume intercept (ZEEP1: 7.4 +/- 3.4 ml; PEEP-5: 6.6 +/- 3.0; PEEP-10: 7.2 +/- 4.0; ZEEP2: 6.6 +/- 3.6), or the new index area beneath the ESPVR (ZEEP1: 304 +/- 98; PEEP-5: 329 +/- 104; PEEP-10: 310 +/- 98; ZEEP2: 343 +/- 114). We conclude that these levels of PEEP do not affect LV contractility as assessed by the ESPVR. PMID- 3281477 TI - Effect of food manipulation on the GnRH-LH-estradiol axis of young female rats. AB - Female rats were prevented from growing and developing reproductively by restricting their food intake from the time they reached 80-85 g (27-29 days of age) until they were 2 mo old. A return to ad libitum feeding then typically yielded the pubertal ovulation during the third or fourth dark period. Ad libitum feeding for 48 h increased the frequency of luteinizing hormone (LH) pulsing in ovariectomized females. This treatment also depressed the level of circulating estradiol in ovariectomized females implanted with Silastic capsules. It had no effect on the rate at which estradiol was cleared from the blood in a 1-h test, however, nor did it affect the pool of assayable gonadotropin-releasing hormone (GnRH) in the hypothalamus, the pool of assayable LH in the pituitary, the response of the pituitary to GnRH, or the rate at which LH was cleared from the blood. In toto, the present results suggest that food restriction inhibits pubertal development by acting rather specifically on GnRH secretion via an ovarian steroid-independent pathway. The presumed supplemental role for enhanced negative-feedback sensitivity could not be evaluated because of the aberrant results with encapsulated estradiol. PMID- 3281478 TI - Basal and insulin-stimulated skeletal muscle sugar transport in endotoxic and bacteremic rats. AB - Membrane glucose transport with and without insulin was studied in soleus muscle from 5-h endotoxic rats (40 mg/kg Salmonella enteritidis lipopolysaccharide), and in soleus and epitrochlearis muscles from 12-h bacteremic (Escherichia coli, 4 X 10(10) CFU/kg) rats. Glucose transport was measured in muscles by evaluating the fractional efflux of 14C-labeled 3-O-methylglucose (14C-3-MG) after "loading" muscles with 14C-3-MG. Basal 3-MG transport was elevated in soleus muscles from endotoxic as well as in soleus and epitrochlearis muscles from bacteremic rats compared with time-matched controls. Low insulin concentrations stimulated 14C-3 MG transport more in bacteremic and endotoxic rat muscles than in controls. However, sugar transport in the presence of high insulin dose was attenuated in soleus and epitrochlearis muscles from bacteremic rats and soleus muscles from endotoxic rats compared with controls. Analysis of the dose-response relationship with ALLFIT revealed that the maximal transport response to insulin was significantly decreased in both models of septic shock. Sensitivity to insulin (EC50) was increased in endotoxic rat muscles, and a somewhat similar tendency was observed in bacteremic rat soleus muscles. Neural and humoral influences and/or changes in cellular metabolic energy may contribute to the increase in basal transport. Shifts in insulin-mediated transport may be due to alterations in insulin-receptor-effector coupling and/or the number of available glucose transporters. PMID- 3281479 TI - Narcissism: its normal evolution and development and the treatment of its disorders. AB - Narcissism has become a construct attracting increasing attention in mental health. Its precise definition, its normal and abnormal developmental features, its assessment, the pathogenesis of its aberrations, and the treatability of its pathological manifestations merit continuing study and clarification. This overview outlines these relevant issues, and summarizes psychoanalytic psychotherapeutic investigations involving the detection and modification of narcissism as well as the limitations of this approach. PMID- 3281480 TI - Toward justice in health care. PMID- 3281481 TI - Primary osteosarcoma of toe phalanx: first documented case. Review of osteosarcoma of short tubular bones. AB - A case of a sclerosing variant of osteosarcoma of a toe phalanx is reported in a 28-year-old man. This represents the first reported case of osteosarcoma of any kind at this site. This is based on a review of 4,214 cases of conventional osteosarcoma. The reason for the extraordinary rarity in toe or hand phalanges is unknown although osteosarcoma is the second most common primary tumor of bone. Since the neoplasm had minimal signs of cytologic anaplasia, it was originally mistaken for and treated as an osteoid osteoma. The lesion recurred and extended into soft tissues. Reevaluation revealed the tumor to be an osteosarcoma, sclerosing variant with "normalization" of nuclei. The lesions that this tumor should be distinguished from are osteoid osteoma and osteoblastoma. PMID- 3281482 TI - Massive hepatomegaly in adult polycystic liver disease. AB - In adult polycystic liver disease, the liver gradually enlarges as it is replaced by cysts. The disease rarely produces symptoms or complications. Liver cysts are thought to arise from aberrant embryonic intrahepatic bile ducts (Von Meyenburg's complexes). We present a case of adult polycystic liver disease with Von Meyenburg's complexes and unusually severe hepatomegaly (7.7 kg, 22,080 cm3). The autopsy prevalence of adult polycystic liver disease at UCLA Medical Center is 0.13%; 93% of these cases had polycystic kidney disease. Adult polycystic kidney disease had associated liver cysts in 45% of cases. PMID- 3281483 TI - Intestinal mucosal immune defense mechanisms. AB - The intestinal mucosal immune defense mechanisms involve both humoral and cellular immunity. The prominence of suppressor/cytotoxic T lymphocytes in the epithelial layer suggests that these interepithelial lymphocytes play a role in defense against infections within this layer. Secretory IgA is overwhelmingly the major humoral immune response along the gastrointestinal tract and along other mucosal surfaces (respiratory tract, mammary glands, salivary glands, and lacrimal glands). While the functions of secretory IgA are incompletely understood, it is clear that it prevents attachment of microorganisms and toxins (cholera toxin, shiga toxin, etc.) to the surface epithelial cells. Furthermore, secretory IgA may collaborate with eosinophils or killer lymphocytes to mediate cytotoxic reactions against enteropathogens. By learning more about the mucosal immune response, we should be able to understand the relationship between the lamina propria plasmacytosis in inflammatory bowel disease and the increased number of interepithelial lymphocytes that we see in gluten-sensitive enteropathy and the underlying pathogenic mechanisms. PMID- 3281484 TI - Aspiration biopsy--a tool in surgical pathology. AB - A historical overview of the origins of the thin needle aspiration biopsy is given. Current applications of this technique to palpable lesions and lesions requiring various forms of imaging techniques are briefly summarized. The principal advantages of this method of diagnosis are its rapidity, versatility, and applicability to patients with palpable lesions as an office procedure. The procedure is nearly painless, hence readily accepted, and often shortens the anxious wait for a diagnosis. In competent hands, given an adequate sample, the diagnosis can be rendered with an accuracy approaching that of a frozen section. In many instances of intrathoracic and intraabdominal space-occupying lesions, exploratory thoracotomies and laparotomies can be avoided, thus reducing significantly the time of hospitalization. The procedure is safe. Seeding of cancer along the needle track has been reported in a few instances, but the risk of this event must be considered extremely low. Thin needle biopsy may offer the patient an opportunity to participate in therapeutic decisions, for example, in women with breast cancer. Finally, the aspirated sample offers a number of research options that may lead to a better assessment of prognostic parameters and response to treatment in cancer. PMID- 3281485 TI - Campylobacter pylori: a newly recognized infectious agent in the gastrointestinal tract. AB - Recent experience with the gastritis-associated organism Campylobacter pylori is reviewed, placing special emphasis on pathologic aspects. C. pylori is a spiral, gram-negative, urease-producing bacillus that has been found to infect the stomach in many people. C. pylori organisms are readily seen overlying the gastric epithelium, often in large numbers. Demonstration in gastric biopsies with silver stains is most vivid, but other faster, simpler stains such as Giemsa, acridine orange, and, at times, hematoxylin-eosin are satisfactory for routine purposes. The frequent occurrence of C. pylori in persons with chronic active gastritis has been confirmed in medical centers around the world. In addition, epidemiological, serological, pathological, and clinical observations suggest that C. pylori infection occurs in stomachs of duodenal ulcer patients with a frequency approaching 100%, and the infection may be relevant to pathogenesis or therapeutic response in duodenal ulcer disease. C. pylori probably also causes an acute infectious gastritis associated with hypochlorhydria. C. pylori still requires extensive investigation to establish its pathogenic role in upper gastrointestinal disorders, but evidence continues to accumulate that such a role exists and that it may be important. PMID- 3281486 TI - Malaria studies and control in Brazil. PMID- 3281487 TI - Malaria prophylaxis with proguanil in children living in a malaria-endemic area. AB - We studied the effects of daily proguanil compared to weekly chloroquine as malaria prophylaxis in 170 children living in a malaria-endemic area along the Thai-Burmese border. Children aged 5-10 years were matched for age, weight, and presence of splenomegaly then randomly assigned to receive either proguanil (equivalent of 200 mg daily adult dose) or chloroquine (equivalent of 300 mg base weekly). All medications were administered by the investigators and malaria smears were performed on a weekly basis. Among 85 children taking proguanil for 524 human-weeks, there were 17 cases of falciparum malaria and 11 cases of vivax. Of 85 children on chloroquine for 537 human-weeks, there were 24 cases of falciparum and 1 case of vivax. There were no statistically significant differences between the two regimens when analyzed either as suppressive or as causal Plasmodium falciparum prophylactics. The data were suggestive that proguanil may have some causal prophylactic effect against falciparum malaria. There were significantly more vivax prophylactic failures (P less than 0.01) in the proguanil group. Side effects were infrequent, mild, and comparable in both groups. PMID- 3281488 TI - Parasitologic and clinical efficacy of 25 and 50 mg/kg of chloroquine for treatment of Plasmodium falciparum malaria in Rwandan children. AB - The standard chloroquine treatment for Plasmodium falciparum malaria is 25 mg (base)/kg (C25) given over 3 days. In Rwanda, 50 mg/kg (C50) administered over 6 days has been recommended by the Faculty of Medicine, Ministry of Health. The present study compared clinical and parasitological efficacy and side effects of C25 and C50 in children less than or equal to 5 years of age. In vitro studies with chloroquine, mefloquine, pyrimethamine, and quinine were also performed. Ninety children were given a 3-day treatment of C25 and 48 a 5-day treatment of C50. Cases were followed for a total of 15 days (D0 to D14). At day 14, 73% of the C25 and 67% of the C50 children were still parasitemic, but the mean geometric parasite density had decreased by at least 96% in both groups. Clinically, 44 C25 and 12 C50 children had fever on day 0; by day 14 only 4 (9%) C25 and 4 (33%) C50 children still had fever. Side effects were found to be minimal. The chloroquine in vitro tests corroborated the in vivo findings. P. falciparum was found to be quite sensitive to mefloquine and quinine, but showed a high (59%) resistance to pyrimethamine. PMID- 3281489 TI - Amodiaquine and sulfadoxine-pyrimethamine as treatment for chloroquine-resistant Plasmodium falciparum in Rwanda. AB - The efficacy of amodiaquine and sulfadoxine-pyrimethamine combination as a second line therapy for chloroquine-resistant Plasmodium falciparum infections was investigated in Rwanda in September 1986. Children less than or equal to 5 years old presenting with a P. falciparum parasitemia 14 days after treatment with chloroquine were administered either amodiaquine (25 mg/kg over 3 days, 64 patients) or sulfadoxine-pyrimethamine (as a single dose with tablets containing 500 mg of sulfadoxine and 25 mg of pyrimethamine: 1/4 tablet for children under 1 year, 1/2 for those 1-3 years old, and 1 tablet for those 4-5 years old; 34 patients) and followed for 7 days. Seven days after starting treatment with amodiaquine, 50 (76%) children were aparasitemic. All the children who had received sulfadoxine-pyrimethamine were aparasitemic 7 days after initiation of therapy. PMID- 3281490 TI - Pathologic activity of Plasmodium berghei prevented but not reversed by dexamethasone. AB - Dexamethasone has recently been shown to block the production of cachectin (implicated in the pathogenesis of cerebral malaria) if administered prior to endotoxin induction of mouse macrophages. Using the hamster cheek pouch-cerebral malaria model, we tested the hypothesis that dexamethasone is effective as a therapeutic agent in severe malaria if given before some yet undefined trigger point in the disease. Infected hamsters were treated with dexamethasone (0.7 mg/kg) daily on days 7-12, 4-12, or 1-12 post-challenge. When treatment was started on day 1, whole body oxygen consumption (used as a measure of erythrocyte transport to sites of diffusion) on day 12 was greater than (P less than 0.05) that of infected control animals, though the degree of anemia was no different in treated and untreated groups. Furthermore, treatment produced a reduction in monocyte accumulation, capillary malfunction, and monocyte/red blood cell aggregate formation observable in the cheek pouch in vivo and a similar reduction in monocyte presence, capillary pathologic change, and multifocal hemorrhage in the brain on postmortem. These data suggest that mediator(s), whose production can be blocked by pretreatment with dexamethasone, are involved in the pathogenesis of disease leading to death of the Plasmodium berghei infected hamster. PMID- 3281491 TI - A sensitive malaria immunoperoxidase assay for the detection of Plasmodium falciparum antibody. AB - A new and rapid malaria immunoperoxidase assay using the enzyme horseradish peroxidase in place of fluorescein isothiocyanate was developed to allow the serological measurement of antimalarial antibody by light microscopy. Acetone fixed thin blood films prepared from cultured Plasmodium falciparum were used as the source of antigen. This malaria immunoperoxidase assay is as sensitive as, and occasionally more sensitive than, the indirect fluorescent antibody assay. It is easy to perform and the antigen used does not show cross-reactivity with sera from nonmalarial diseases. PMID- 3281492 TI - Patterns of antigen expression in asexual blood stages and gametocytes of Plasmodium falciparum. AB - The stage specificity and localization of 12 Plasmodium falciparum antigens were determined by immunofluorescence using acetone-fixed parasites reacted with monospecific antibodies against cloned antigens. Antibodies were prepared by immunization of rabbits with recombinant proteins or by affinity purification of human plasma against cloned antigen adsorbents. Most of the antigens occurred predominantly in mature asexual parasites, two were abundant in ring stages and three were absent in rings. Four of the 12 antigens were detected in asexual stages but not in gametocytes. Grouping of antigens by localization within blood stages was difficult because of the complexity of fluorescence patterns observed. With some antibodies, fluorescence was apparently distributed evenly over the parasites, but in other cases label was concentrated within discrete compartments or organelles. Extraparasitic intraerythrocytic fluorescence was also observed. PMID- 3281493 TI - Immunization trials with the ring-infected erythrocyte surface antigen of Plasmodium falciparum in owl monkeys (Aotus vociferans). AB - A protocol was developed for the testing of blood stage vaccines against Plasmodium falciparum using Peruvian Aotus vociferans and the Indochina I/CDC strain of the parasite. Three different fused polypeptide vaccines containing elements of the ring-infected erythrocyte surface antigen molecule combined with Freund's complete and Freund's incomplete adjuvants were tested to determine their ability to protect against overwhelming infection following challenge with this highly virulent strain of P. falciparum, and to invoke antibody responses as measured by a standard indirect immunofluorescence technique. Nine of 14 immunized animals exhibited some protection. Presented are the test procedures developed for the conduct of such trials with New World monkeys and the analysis of results that led to the identification of variables selected for study in future trials. PMID- 3281494 TI - Monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA) for detection of Plasmodium malariae sporozoites in mosquitoes. AB - A monoclonal antibody specific for a repeated epitope of the circumsporozoite protein of Plasmodium malariae sporozoites has been used to develop a two-site, single antibody-based enzyme-linked immunosorbent assay that can detect P. malariae sporozoites in mosquitoes. The assay uses a purified monoclonal antibody produced against sporozoites of the Uganda I/CDC strain of P. malariae to capture the antigen and the same monoclonal antibody labeled with horseradish peroxidase as the detector. Sporozoites have been detected in laboratory-infected mosquitoes stored at room temperature in the presence of a desiccant for as long as 18 months. The detection limit of the assay is approximately 50 P. malariae sporozoites per test well. Cross-reaction has not been observed with mosquitoes infected with P. falciparum, P. vivax, or P. ovale sporozoites. PMID- 3281496 TI - Heart and kidney transplantation in the rat using a mixed cuff-stent microsurgical technique. AB - A method has been described for heart and kidney transplantation in rats using a mixed cuff-stent microsurgical technique. The advantages of the method include reduction of total ischemia time to an average of 11 minutes for heart grafting and 6 minutes for kidney grafting, provided donor and recipient operations are performed simultaneously; ease of performance and short training period, which allows the method to be employed by transplantation novices and to be extended to laboratories that lack experienced microsurgeons; and the possibility of applying the method to transplantation of other vascularized organs in the rat. PMID- 3281497 TI - Single-layer end-on continuous suture of colonic anastomoses. AB - The single-layer end-on continuous suture technique for intestinal anastomoses on mobile intraperitoneal bowel segments is at least as safe and probably safer than a corresponding single-layer interrupted suture technique. Although the evaluation of this technique included a substantial number of surgeons who were performing their first anastomosis or who contributed only a single one to the series in a teaching university setting, there were no instances of clinical leak among 143 consecutive colonic anastomoses. Furthermore, 27 percent of the operations were performed as emergencies, thus optimal bowel preparation was lacking. The anastomosis time is distinctly shorter than the time needed for an interrupted single-layer technique, and contamination of the operative field is reduced to a minimum. The anastomosis is extremely simple, comfortable to perform, and reliable. PMID- 3281498 TI - Oral contraceptive agents: current status. AB - Oral contraceptives are the most widely prescribed and ingested drug in human history. The difficulty in establishing their clear-cut side effects is compounded by the rarity of these side effects and their occurrence with multiple other factors and cofactors that may be etiologically more important. For the prudent surgeon, suffice it to say that should operation require bedrest postoperatively, oral contraceptives should be stopped at least 2 weeks preoperatively and barrier methods begun. Barrier methods should also be used when drugs that interfere with oral contraceptives are prescribed. Oral contraceptives and anticoagulants should not be given together because of the chemical changes in the blood caused by the steroid content of the contraceptive. As surgeons, we must remember the contraindications noted herein and become familiar with the current literature as new developments unfold in the dynamic field of conception control. PMID- 3281495 TI - Filarial antigen in circulating immune complexes from patients with Wuchereria bancrofti filariasis. AB - Detection of filarial antigen in circulating immune complexes from patient sera was performed by an enzyme immunoassay in which the immune complexes were precipitated in the cold with polyethylene glycol and then dissociated in an acid pH buffer before being added to an ELISA plate. The dissociated antigen bound to the plate where it could be detected by peroxidase-labeled polyclonal rabbit antifilarial antiserum. Control sera used for defining the specificity of the assay included sera with immune complexes not related to parasite infection with and without free parasite antigen added prior to polyethylene glycol precipitation as well as sera from normal individuals. Filarial antigen was detected in the circulating immune complexes from 10 of 28 patients with bancroftian filariasis residing in either the Cook Islands (subperiodic Wuchereria bancrofti) or India (periodic W. bancrofti). By immunoblotting, the most frequently identified filarial antigen in these complexes was an approximately equal to 200 kDa circulating antigen. PMID- 3281499 TI - History of medicine in Alaska. John C. Tower, M.D. PMID- 3281500 TI - [Epidemiology of pharyngo-laryngeal cancer in the province of Salamanca. I. Protocol for data collection]. PMID- 3281502 TI - [Presentation of an experimental ear model for tympanometric tests]. PMID- 3281501 TI - [Pseudosarcoma of the hypopharynx]. PMID- 3281503 TI - [First structure of the olfactory pathway. The olfactory cilium]. PMID- 3281504 TI - The appointment of an anaesthetist. Edinburgh Royal Infirmary 1900-12. AB - This is an historical vignette about a stage in the evolution of specialist anaesthesia in the capital city of Scotland. Ignorant management decisions delayed development in Edinburgh by 25 years. PMID- 3281505 TI - [Monitoring of oxygen transport systems]. AB - The main task of the cardiorespiratory system is to deliver enough oxygen (O2) to meet the metabolic requirements of the body. Of all metabolic substrates, O2 has the highest percentage of extraction at 25%, and O2-reserves are therefore exhausted within a few minutes. Arterial O2-content and cardiac output (CO) are the determinants of O2-delivery (DO2). O2-delivery in intensive care patients and during the perioperative period can be compromised by many factors, especially diminished O2-uptake in the lung, reduced hemoglobin content, and/or altered cardiac performance. The quality of arterial oxygenation can now easily be monitored noninvasively by pulse oximetry and arterial blood gas analysis. To calculate DO2, however, determination of cardiac output, O2-tension, O2 saturation, and hemoglobin is necessary. Routinely measured hemodynamic parameters such as heart rate, systemic arterial pressure, etc. only poorly reflect O2-transport to the tissues. O2-consumption (VO2), the best mirror of the actual metabolic activities of the tissues, can be measured either noninvasively by the difference between inspiratory and expiratory O2-concentrations in connection with minute ventilation or invasively using arterial-venous O2-content difference and CO, which requires pulmonary artery catheterization. VO2 determination by respiratory gas analysis is very difficult at a high or changing FiO2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281506 TI - [Anesthesia and laser surgery of the laryngo-nasal-ear region]. AB - The applications of lasers in surgery is nowadays a widely used and well appreciated technique. Besides convincing advantages (precision in surgical manipulations, excellent hemostasis, minimal postoperative swelling, rapid healing) laser-unique hazards require particular safety considerations to avoid accidental injuries to patients and medical personnel. For damage of the eyes is the greatest risk in laser surgery goggles designed to the respective wavelength of the specific laser must be worn by everyone in the operation theatre. The patient's eyes are best protected by covering them with water moistened gauze pads. To avoid reflection of the laser beam only instruments with dull surfaces should be used. The proper function of the laser itself has been tested by a well trained surgeon before operation. Especially in microlaryngeal surgery carried out under general anaesthesia, severe complications, e.g. pneumothorax, penetration of large vessels or destruction of the surrounding tissues, may be the result of beam reflection or unskilled use. However, the most serious hazard for the patient-and even that one with the highest incidence (0.4 to 1.5%)-arises from the close neighbourhood of endotracheal tube and laser beam while operating in the larynx or the upper airways. In tests it has been demonstrated that the beams of different lasers penetrate tubes of various materials (silicone, semi- or transparent pvc) to a different extent, often igniting the material. High oxygen and nitrous oxide contents support tube ignition. The inhalation of smoke and toxic pyrolysis products either of tube-material or, possibly, of volatile anaesthetics are followed by serious damage of trachea and lung tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281507 TI - Changes in the distribution of microtubules and intermediate filaments in mammalian Sertoli cells during spermatogenesis. AB - We have studied the distribution of microtubules and intermediate filaments in mammalian Sertoli cells during spermatogenesis. The arrangement of microtubules was determined, by indirect immunofluorescence, in ground squirrel testes that were 1) fixed, mechanically fragmented, and attached to polylysine-coated slides, and 2) fixed, embedded in polyethylene glycol, and sectioned. Intermediate filament patterns were determined, also by indirect immunofluorescence, in sections of unfixed rat testis. Results from these studies were confirmed and extended using electron microscopy. Microtubules first become evident in lateral processes that embrace round spermatids. When spermatids elongate and become situated in apical crypts of Sertoli cells, the microtubules become oriented parallel to the long axis of Sertoli cells and surround the crypts. As spermatids mature and acquire a saucer shape, apical microtubules progressively concentrate in Sertoli cell regions adjacent to the acrosome and eventually form discrete C shaped structures that disappear during spermiation. Intermediate filaments in rat Sertoli cells are centered around the nucleus. From perinuclear regions, filaments extend toward desmosome-like junctions with early spermatogenic cells and into the apical cytoplasm where they have a transient association with crypts containing elongate spermatids. Filaments amongst crypts are most evident in early stages of the spermatogenic cycle when apical crypts are situated deep within the epithelium. They become less evident and eventually disappear as spermatids assume a more apical position. Our fluorescence studies and ultrastructural analyses indicate that the association of intermediate filaments with crypts is specific to regions adjacent to the dorsal or convex aspect of spermatid heads. In these regions, approximately 8 to 12 uniformly aligned filaments are intimately associated with actin filaments in ectoplasmic specializations surrounding the crypts. We conclude that, like actin, the distribution of microtubules and intermediate filaments changes in Sertoli cells during spermatogenesis. The distribution of microtubules correlates with the irregular columnar shape of Sertoli cells. We suspect that the apically situated intermediate filaments may play a role in anchoring or positioning Sertoli cell crypts deep within the epithelium during the early stages of the spermatogenic cycle. PMID- 3281508 TI - Effects of continuous arteriovenous hemofiltration on cardiopulmonary abnormalities during anesthesia for orthotopic liver transplantation. AB - Orthotopic liver transplantation (OLT) often involves large blood loss and replacement, as well as administration of large amounts of blood products to correct coagulation defects. Renal free water excretion is often impaired in end stage liver disease and not responsive to routine diuretic therapy, predisposing these patients to accumulation of extravascular lung water. The effects of the intraoperative use of continuous arteriovenous hemofiltration (CAVH) on cardiopulmonary and oxygen transport variables were studied in ten patients during and 24 hours after OLT. CAVH prevented increases in pulmonary shunt fraction while decreasing PEEP and FIO2 requirements. Pulmonary compliance was significantly higher after operation in patients receiving CAVH. Before surgical dissection, hemodynamic effects of CAVH were minimal. Postoperatively, patients having CAVH had lower cardiac filling pressures and more normal systemic vascular resistance than did patients not having CAVH. These data suggest that CAVH may be a useful intraoperative technique for patients with impaired renal function undergoing liver transplantation. PMID- 3281509 TI - Massive pulmonary thromboembolism during liver transplantation. PMID- 3281510 TI - Mechanism of halothane-induced hepatotoxicity: another step on a long path. PMID- 3281511 TI - Prostacyclin mediation of vasodilation following mesenteric traction. AB - Eight untreated patients (group I) and four patients who received ibuprofen preoperatively (group II) scheduled for elective abdominal aortic aneurysm repair were studied. Heart rate (HR); systolic, diastolic, and mean arterial pressure (MAP); systolic and diastolic pulmonary artery pressure; pulmonary capillary wedge pressure (PCWP); cardiac output (CO); and central venous pressure (CVP) were recorded pre-induction, before mesenteric traction, and 5, 15, and 30 min post-mesenteric traction. Plasma samples were obtained at these times for analysis of six-keto-prostaglandin F1 alpha (PGF1 alpha) concentration by radioimmunoassay. Group II patients received ibuprofen 12 mg/kg orally 1 1/2 h before surgery. Plasma samples from six group I patients and all group II patients taken 5 min after mesenteric traction were added to isolated helical strips of cat superior mesenteric arteries precontracted with norepinephrine (200 ng/ml) for analysis of reduction in developed force. In group I, abdominal mesenteric traction resulted in a significant decrease in MAP (P less than 0.03) and SVR (P less than 0.005) with an increase in CO (P less than 0.05) at 5 min post-mesenteric traction, which returned to mean pre-mesenteric traction values by 30 min and a significant increase in PGF1 alpha concentrations. There was a significant positive correlation between PGF1 alpha and CO (P less than 0.001) and a significant negative correlation between PGF1 alpha and SVR (P less than 0.01) at 5 min post-mesenteric traction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281513 TI - Pediatric orthotopic liver transplantation: multifactorial predictions of blood loss. PMID- 3281512 TI - Peripheral mechanisms of somatic pain. AB - In the last two decades, considerable advances have been made in our understanding of the mechanisms of pain. Studies correlating subjective magnitude estimations of pain in man with activity in single nerve fibers in experimental animals, and microneurographic recordings in awake humans, have provided convincing evidence for the role of specific nociceptors and labelled lines for signalling pain sensation in the normal skin. The response properties of the different types of nociceptive afferents, both myelinated and unmyelinated, from skin, muscle, and joints make them ideal candidates for signalling pain sensations. Cutaneous inflammation from any cause results in hyperalgesia. Cutaneous hyperalgesia at the site of an injury, i.e., primary hyperalgesia, can be explained by sensitization of nociceptors. This sensitization is likely due to local release of chemical mediators in the inflamed area. The metabolites of arachidonic acid (eicasonoids) and bradykinin appear to play an important role in the sensitization of nociceptors. Similar inflammation-induced changes in response properties of fine articular afferents might explain the pain of acute arthritis. The neuropeptide substance P released from primary afferents may also play an important role in the pathogenesis of arthritis. The mechanism of hyperalgesia in the region surrounding the injury, i.e., secondary hyperalgesia, is less well understood, and probably results from changes both in the peripheral and central nervous systems. While considerable advances have been made in our understanding of the mechanisms of acute pain, the pathophysiology of most chronic pain states is still unclear. We hope that future studies in experimental animals, and careful psychophysical testing and microneurographic recordings in chronic pain patients, will lead to a better understanding of the pathophysiology of pain. PMID- 3281514 TI - Intravenous lidocaine reduces the incidence of vomiting in children after surgery to correct strabismus. PMID- 3281515 TI - Bronchoscopy through the mask? A renaissance! PMID- 3281516 TI - Effects of naftidrofuryl in patients with intermittent claudication. AB - In a randomized, double-blind, placebo-controlled study in patients with peripheral arterial occlusive disease stage IIb of Fontaine's classification, the efficacy of naftidrofuryl, a vasoactive substance, was investigated. Forty patients--31 men and 9 women with an average age of 62.98 +/- 10.65 years--were admitted to the study. All had a history of claudication for at least six months. The duration of the trial was eighteen weeks. After a washout period of two weeks the patients received either two times 400 mg naftidrofuryl or two identical placebo tablets daily for eight weeks. Subsequently a crossover from verum to placebo and vice versa was carried out and the alternative medication was administered for another eight weeks. Clinical results were evaluated by measuring painfree and maximal walking distance by treadmill test at a speed of 3.2 km/h and an inclination of 12 degrees. Systolic ankle pressure and brachial pressure were measured by Doppler ultrasound, and ankle/arm pressure ratio was calculated. Treadmill test, Doppler ultrasound examination, and laboratory data analysis were performed at the beginning of every study period, every four weeks during and at the end of the study. Results. The patients in both groups showed an initial homogeneity of age, risk factors, concomitant diseases, walking distance, and Doppler indices. After eight weeks naftidrofuryl resulted in a statistically significant increase in painfree (p less than 0.02) and maximal walking distance (p less than 0.05). The placebo-treated group showed only a slight, statistically nonsignificant increase in both painfree and maximal walking distance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281517 TI - Pirmenol: preclinical pharmacology. AB - Pirmenol, a novel pyridinemethanol derivative, is active in a variety of experimental arrhythmic models of diverse etiology. Animal pharmacology studies showed that pirmenol is highly efficacious whether the arrhythmias were atrial or ventricular in origin; chemically, mechanically, or electrically induced; or of the automaticity or reentrant types. The conscious coronary artery-ligated (Harris) dog model best allowed simulation of a variety of clinical situations in which pirmenol could be used either alone or in combination. Pirmenol was highly effective by both the intravenous and oral routes, causing immediate suppression, prevention, or termination of cardiac arrhythmias. Preclinical studies in the dog showed an excellent correlation between the dose of pirmenol, plasma levels, and antiarrhythmic efficacy. Administration of pirmenol in the dog at intentionally accelerated infusion rates suggested a relatively wide margin of safety for pirmenol compared with other class I agents. In vitro electrophysiologic studies in dog Purkinje fibers revealed possibly unique differences of pirmenol from other antiarrhythmic agents. It depresses fast and slow response automaticity and its electrophysiologic effects were less variable than other class I drugs over a spectrum of potassium levels. To test the relevance of the in vitro electrophysiologic results, pirmenol's antiarrhythmic efficacy was assessed in several in vivo dog models in which serum potassium was either increased or decreased. Studies comparing pirmenol and disopyramide clearly showed a relative lack of serum potassium dependence for pirmenol, suggesting a potential clinical advantage over disopyramide and other antiarrhythmics in variable potassium settings. The clinical relevance of these observations will have to be established in patients with variable potassium levels. Overall, pirmenol compared favorably with other reference agents in efficacy and safety in extensive preclinical investigations. PMID- 3281518 TI - Clinical pharmacology and pharmacokinetics of pirmenol. AB - Pirmenol hydrochloride is a promising antiarrhythmic agent with quinidine-like (Class Ia) properties presently undergoing evaluation. It's clinical pharmacology and pharmacokinetics are reviewed. The author outlines the effects of pirmenol on the sinus node, atrial tissue, A-V node, and ventricular tissue and describes its antiarrhythmic efficacy in clinical studies to date, including his own study in 21 patients with a history of sustained ventricular tachycardia. The author summarizes the hemodynamic and pharmacokinetic studies of pirmenol noting that its effects are relatively independent of potassium concentration. The drug's side effects profile is presented, and it is concluded that pirmenol is well tolerated. Hypotension has not been a significant problem with intravenous pirmenol. Precipitation or worsening of clinical heart failure appears to occur only rarely. The favorable pharmacokinetics of pirmenol permit dosage at less frequent intervals than with procainamide, quinidine, disopyramide. Pirmenol has shown efficacy for ventricular arrhythmias even in some patients refractory to Class Ia agents. Antiarrhythmic effects appear to be correlated with plasma levels, and a well-defined therapeutic minimum has been determined. PMID- 3281520 TI - Surgical-orthodontic stability in retrognathic patients. An implant study. AB - An extensive literature review and two-year evaluation of the stability of surgical mandibular advancement, using implants in proximal and distal segments. Regression averaged 27% of the initial correction, with most occurring early. PMID- 3281519 TI - Management of ventricular arrhythmias occurring in patients after myocardial infarction. AB - Some of the problems facing clinicians in the management of patients with ventricular ectopy occurring during the convalescent phase of myocardial infarction (MI) are discussed, and the pertinent literature is surveyed. The outstanding problem is identification of the patient at high risk for developing sustained ventricular tachycardia or fibrillation. Decisions on administration of antiarrhythmic agents to post-MI patients have long been based solely on detection of ventricular ectopy. By now, however, it has become apparent that this approach has not favorably altered the incidence of sudden cardiac death and has exposed many asymptomatic patients needlessly to potentially toxic antiarrhythmic agents. At present, assessment of the benefit/risk ratio favors treating asymptomatic complex ventricular ectopy only in patients with significant left ventricular dysfunction, provided that treatment results in the adequate suppression of complex forms of the ventricular ectopy and does not produce deleterious effects. The benefit/risk ratio does not favor treatment of asymptomatic ventricular ectopy in other groups of post-(MI) patients. Improved methods of identifying patients requiring treatment are needed. Programmed ventricular stimulation and noninvasive interrogation of signal-averaged electrocardiograms are designed to detect the presence of an arrhythmogenic substrate and offer promise for improved identification of patients at risk for sudden cardiac death. PMID- 3281521 TI - Transfusion therapy in emergency medicine. AB - Volume replacement is critical to the resuscitation of the hemorrhaging patient, but this usually can be accomplished quickly and safely with crystalloid and/or colloid solutions. Red cells should be used in addition to asanguinous fluids in the treatment of tissue hypoxia due to anemia. The need for whole blood as opposed to packed red blood cells is controversial. However, plasma should not be used as a volume expander, and its use to supplement coagulation factors during the massive transfusion of red cells should be guided by laboratory tests that document a coagulopathy. Similarly, platelet transfusions are indicated to correct documented thrombocytopenia or platelet dysfunction, and routine prophylaxis after fixed volumes of red cells results is unwarranted. Many anticipated complications of massive transfusions, including hemostatic abnormalities, acid-base imbalances, hyperkalemia, and hypocalcemia, are uncommon or of limited clinical significance. The risks of immune hemolysis and transfusion-transmitted diseases, on the other hand, are significant, and argue for judicious use of blood components. In emergencies in which blood is required immediately before compatibility testing can be completed, O-negative uncrossmatched blood can be requested. Careful blood specimen collection and patient identification prior to transfusion are critical. Practices that emphasize blood conservation, including the use of autologous salvaged blood, are always to the patient's advantage. PMID- 3281522 TI - Morphologic comparison of healing patterns in ethylene oxide-sterilized cortical allografts and untreated cortical autografts in the dog. AB - Full-thickness canine cortical allografts were harvested cleanly, sterilized with ethylene oxide, and stored at 22 degrees C. The sterilized allografts were incorporated into segmental, femoral fracture repairs and evaluated for 6 months. Allografts were compared with untreated cortical autografts, which also were incorporated into segmental, femoral-fracture repairs for 6 months. Sequential fluorochrome labeling at 8, 11, 21, and 24 weeks after surgery made it possible to evaluate retrospectively the time of new bone formation. Morphometric evaluations were made of the numbers of labeled haversian systems, the percentage of labeled bone, and the porosity of the bone. The cortical allografts had bone formation in the proximal and distal portions of the graft, with the greatest activity at 5 to 6 months after surgery. Activity in the center of the allograft was minimal. Cortical autografts had bone formation throughout the graft, with the greatest number of haversian systems labeled at 3 months after surgery. We concluded that cortical allografts heal and remodel more slowly and in a different sequence of events than do cortical autografts. PMID- 3281523 TI - Healing of transverse humeral fractures in pigeons treated with ethylene oxide sterilized, dry-stored, onlay cortical xenografts and allografts. AB - Transverse humeral fractures were created in adult male pigeons (Columbia livia). They were bridged with an allograft or a xenograft, or they were allowed to heal without treatment. Tissues were examined for wound healing, bony union, infection, and sequestration of the graft at 28, 43, 85, 106, and 168 days after surgery. Neither allografts nor xenografts contributed to nor interfered with bone healing. In nontreated pigeons (controls), bony union with marked callus formation developed between misaligned fragment ends. When onlay grafts were used, bone fragments remained aligned, with minor callus formation. There was a significant (P = 0.0001) increase in the number of wounds opening after surgery and infections of the surgical site (xenograft, P = 0.0026; allograft, P = 0.0021) associated with graft use. A significant (P = 0.0001) frequency of graft sequestration was observed, regardless of graft type. A significant (P = 0.0001) frequency of foreign body reaction also was observed. Under these circumstances, the application of a graft should be considered as an alignment device, rather than a stimulus to healing. PMID- 3281524 TI - Effects of topical application of amitraz on plasma glucose and insulin concentrations in dogs. AB - Amitraz, a formamidine insecticide, is used topically in the treatment of demodicosis and other ectoparasitic infestations. When 3.78 L (containing 2.1 g) of amitraz (twice the recommended concentration) was applied to 5 dogs 4 hours before glucose (0.6 g/kg of body weight) was administered IV, plasma glucose concentration increased, but the increase in plasma insulin concentration, which usually follows IV administered glucose, was suppressed. The results suggested that amitraz induced hyperglycemia at least partly by inhibiting insulin release. PMID- 3281525 TI - Lidocaine treatment of dogs with Escherichia coli septicemia. AB - Effects of lidocaine on organ localization of neutrophils and bacteria and on hemodynamic and metabolic variables were determined during septic shock in dogs. Twelve anesthetized dogs were infused with 10(10) Escherichia coli/kg of body weight through a portal vein catheter over a 1-hour period. Six of these 12 dogs were treated with 2 mg of lidocaine HCl/kg (6 mg/kg/h) 15 minutes after the bacterial infusion had begun. Six dogs not given E coli (surgical controls) were given saline solution at the same rate as the bacterial and lidocaine infusions. Over 4 hours, nontreated dogs with septicemia developed systemic hypotension, decreased cardiac output, increased portal pressure, increased serum alanine transaminase activity, increased liver extravascular water, increased liver glycogen depletion, and decreased PaO2, compared with control dogs. Accumulations of polymorphonuclear leukocytes and E coli were found in the liver and lungs of dogs with septicemia. Lidocaine treatment did not alter the hemodynamic measurements and resulted in metabolic acidosis and hypoalbuminemia. Decreased numbers of E coli were recovered from the liver of lidocaine-treated dogs, whereas increased numbers of organisms were recovered from the blood. Neutrophil sequestration was increased in the liver, but not the lungs of lidocaine-treated dogs. PMID- 3281526 TI - Hemodynamics, plasma eicosanoid concentrations, and plasma biochemical changes in calves given multiple injections of Escherichia coli endotoxin. AB - Twelve male neonatal calves (39 to 50 kg) were allotted to 3 groups of 4 calves each. All calves were anesthetized with halothane, and then Escherichia coli endotoxin was given intravenously (3 times) and intraperitoneally (3 times) during a 6-hour period. Group-1 calves were untreated, group-2 calves were pretreated with a low dose of flunixin meglumine (1.1 mg/kg of body weight), and group-3 calves were pretreated with a high dose of flunixin meglumine (4.4 mg/kg). In calves of group 1, the mean systemic arterial blood pressure (MABP) and cardiac output (CO) decreased, but pulmonary arterial pressure increased after the initial intravenous and intraperitoneal injections of endotoxin. In calves of this group, these changes were accompanied by increased plasma thromboxane B2 (TxB2) concentration. During this period, increased plasma TxB2 concentration or hemodynamic changes were not detected in calves of groups 2 and 3. Only calves of group 1 had altered hemodynamics early in the experiment; however, after 6 hours, calves of all 3 groups had similarly decreased CO and MABP. In calves of the untreated group, plasma 6-keto-prostaglandin (PG)F1 alpha concentration increased steadily from the beginning of the experiment until 3 hours later. The CO and MABP were low at the time when serum 6-keto-PGF1 alpha concentration was high; however, these 2 measurements also were low in treated calves who did not have correspondingly high plasma 6-keto-PGF1 alpha concentration. Regional blood flow analysis did not reveal correlations between prostanoid concentrations and altered blood flow to selected tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281527 TI - Hypoxic pulmonary vasoconstriction during and after infusion of group B Streptococcus in neonatal piglets. Vascular pressure-flow analysis. AB - Hypoxic pulmonary vasoconstriction (HPV) is attenuated after endotoxin infusion into adult dogs and sheep. High dose infusions of Group B Streptococcus (GBS), a neonatal pathogen, into newborn animals produce pulmonary hypertension, hypoxemia, and reduced cardiac output similar to high dose endotoxin infusions in adult animals. To avoid the compounding effects of reduced arterial and mixed venous PO2, HPV was studied after low dose endotoxin in adult animals. We hypothesized that HPV would be attenuated in piglets after a low dose GBS infusion. Both PVR and pressure-flow (P/Q) relationships were measured in piglets to characterize the neonatal pulmonary vascular response to alveolar hypoxia before and after GBS infusion. Hemodynamic measurements were made under Zone 3 conditions in 5 piglets breathing room air and 13% FIO2: (1) prior to GBS, (2) 20 min into a 1-h infusion of 3 +/- 1 x 10(8) cfu/kg/h live GBS, (3) 1 h, and (4) 3 h after completion of the GBS infusion. Prior to GBS, alveolar hypoxia increased PVR (14 +/- 1.3 to 33 +/- 3.6 mm Hg/L/min) and P/Q slope (12 +/- 2.3 to 41 +/- 6.8 mm Hg/L/min). During all subsequent exposures to 13% FIO2, the PVR and P/Q slopes were similar to pre-GBS values. When animals breathed room air, the PVR and P/Q slopes were greater than pre-GBS values during but not after the GBS infusion. We conclude that HPV is not altered 1 and 3 h after a 1-h low dose GBS infusion in neonatal piglets. Infusion of GBS and alveolar hypoxia independently increase pulmonary vascular resistance. PMID- 3281528 TI - Pulmonary edema after Escherichia coli peritonitis correlates with thiobarbituric acid-reactive materials in bronchoalveolar lavage fluid. AB - We developed a new model of acute lung injury caused by live Escherichia coli peritonitis in guinea pigs. Arterial blood gas determinations, arterial blood pressure, and white blood cell counts were monitored serially for 12 h after the injection of either 2 x 10(9) E. coli J96 or saline. Lung water, albumin concentration in bronchoalveolar lavage fluid (BALF) and in lung tissue, WBC counts in BALF, and thiobarbituric-acid-reactive materials (TBARM) in plasma, lung tissue, and BALF were examined. Increased TBARM might be associated with pulmonary injury and are produced either by the generation of lipoperoxides secondary to oxygen-free radicals or as metabolic byproducts of prostanoid metabolism. Lung tissue sections were studied by light microscopy. E. coli peritonitis, as compared with control animals, caused significant peripheral neutropenia, histopathologic evidence of lung inflammation, acidosis, and hypotension. The wet-to-dry lung ratio was increased in the peritonitis group when compared with that in the control group (p less than 0.01). Pulmonary edema in the peritonitis group was associated with significantly increased albumin concentrations in BALF and lung tissue. We report the new finding of increased TBARM concentrations in BALF after E. coli peritonitis (p less than 0.01 and p less than 0.05, respectively). In contrast, plasma TBARM concentrations were unchanged. The levels of TBARM in the BALF correlated significantly with both lung water (p less than 0.01) and lung tissue albumin concentration (p less than 0.01). The measurement of elevated TBARM in BALF may allow acute lung injury to be detected. We conclude that this model may be useful for further studies of acute lung injury caused by E. coli peritonitis. PMID- 3281530 TI - Eosinophil recruitment into guinea pig lungs after PAF-acether and allergen administration. Modulation by prostacyclin, platelet depletion, and selective antagonists. AB - Intravenous administration of PAF-acether to the guinea pig induces bronchoconstriction, hypotension, intravascular platelet aggregation, endothelial disruption, and platelet and neutrophil diapedesis. These effects are followed within 1 h by an eosinophilic infiltration into the bronchial walls, which was also noted after the administration of antigen to passively sensitized guinea pigs. Bronchoconstriction and eosinophil infiltration are 2 major features of asthma, and selective bronchial eosinophilia characterizes late asthmatic reactions. We compared the histologic effects of PAF-acether 6 and 24 h after its intravenous injection with those of experimental passive anaphylactic shock, which is used as a model for asthma. Six hours after PAF-acether or antigen (ovalbumin) administration, a marked lung eosinophil infiltration, particularly in the bronchial walls, was noted, together with mucous plugs containing eosinophils in the bronchial lumen. Epithelial desquamation was followed after 24 h by mucous metaplasia of the bronchial epithelium. These effects were not observed when the inactive metabolite lyso-PAF was used. Our results agree fully with the suggestion that the eosinophil mediates the pathophysiology of bronchial asthma and releases materials toxic for the respiratory epithelium. Two PAF acether antagonists (BN 52021 and WEB 2086) prevented the eosinophil infiltration triggered by PAF-acether and by antigen. When PAF-acether or ovalbumin were injected into guinea pigs after antiplatelet serum or prostacyclin, the eosinophil infiltration was significantly reduced, suggesting that platelets or another adenylate cyclase-sensitive cell are important for the subsequent PAF acether-induced eosinophil infiltration. Our results support an essential role for PAF-acether in an experimental model of allergic asthma. PMID- 3281531 TI - Bronchiectasis: update of an orphan disease. PMID- 3281529 TI - Re-examination of the late asthmatic response to exercise. AB - To determine the nature of the delayed response to exercise, we had 20 atopic asthmatics perform cycle ergometry on 2 occasions while breathing either frigid or hot-humid air in a random fashion. The latter served as a sham control. Forced expiratory volume in one second (FEV1) was measured serially for 10 h after each trial. Subjects developing a second wave of obstruction after recovery from the initial asthma attack were rechallenged on a third day with methacholine and followed in an identical fashion. Cold-air exercise produced an immediate 28% fall in FEV1 for the group as a whole, after which 2 distinct patterns of recovery developed. In 13 subjects, the initial obstruction resolved over several hours. Thereafter, lung function remained constant. In the remaining 7 subjects, the early attack was followed by an initial improvement and then progressive deterioration. This pattern occurred at the same times and to the same magnitude both in the hot-humid experiment in which the initial obstruction was absent, and when the obstruction was induced with methacholine. Based on these observations, it appears that the late asthmatic reaction that follows physical exertion in some subjects is a nonspecific epiphenomenon that is neither dependent upon the existence of an early response nor is unique to exercise. PMID- 3281532 TI - Arterial closure during carotid endarterectomy. PMID- 3281533 TI - Prolapse of gastrostomy tube resulting in entero-enteric fistula and intussusception. AB - A case is reported in which a surgical gastrostomy tube migrated into the duodenum and eroded through the jejunal wall into an adjacent loop of jejunum. This resulted in an entero-enteric fistula, small bowel obstruction and intussusception. Since the number of gastrostomy tubes being placed endoscopically and surgically is increasing, gastroenterologists and surgeons should be alerted to these and other potential complications. PMID- 3281534 TI - [Malaria in childhood. Report of 26 cases]. AB - It's known that there has been a resurgence of malaria in the world. Purpose of this article is to point out the increase in number of cases of imported malaria in children in Spain. Authors performed a clinical study and review up to date treatment and prophylaxis of the disease. They communicate cases of three children infected by Plasmodium falciparum resistant to chloroquine, proceeding from areas that up to one year ago were considered to be not resistant. Data published on prevention and selective primary health care of malaria in the world are revised. PMID- 3281535 TI - [Primary vesicoureteral reflux. I: Renal growth in kidneys without pyelonephritis]. AB - We have studied renal growth in 133 children with 195 refluxing ureters (VUR). Average follow-up was 38 (range 12-84) months. Low grade VUR (I-III) were more frequent and left-sided ones predominated among unilateral cases. There was a clear correlation between VUR grade and the presence of reflux nephropathy (RN). Seventy percent of low-grade VUR cured under long-term urine disinfection, whereas surgery was successful in 97.5% of high-grade, often scarred, units. Recurrent urinary infections after cure of VUR were equally frequent in both groups. The growth of the 140 unscarred refluxing kidneys was evaluated by means of renal length, corticorenal index and growth speed measurements. All values remained within ranges considered statistically undistinguishable from those of normal kidneys. Our findings confirm that, in our conditions of treatment, VUR without RN does not impair renal growth for the period of time studied. PMID- 3281536 TI - [Infantile cortical hyperostosis. Apropos of 8 cases]. AB - Retrospective analysis of eight patients suffering from infantile cortical hyperostosis shows clearly autosomic dominant inheritance of the disease, the strong variation in the clinical expressivity, and therefore the need for an in deep work-up of the patient and his relatives in the presence of any suspicious symptom. PMID- 3281537 TI - [Acute transient myositis after influenza]. AB - The clinical picture, biological findings and outcome of acute myositis during recovery from influenza are so characteristic that can clearly cut-off it from other diseases affecting the muscles. Five cases of acute bilateral lower-limb myositis are described. A flu-like illness had begun to wane before the onset of severe leg pain, preventing the children from walking. All had abnormal serum CPK and SGOT levels. Virological studies were performed with negative findings. The pathogenic mechanism is unknown. We though that more aggressive studies are not justified in view of the transient nature of the patient's illness and their complete recovery. We stress the need of recognizing such disease in every child complaining of lower leg pain associated with very painful walking into a epidemiological setting of a "influenza-like" illness. We also have reviewed the published bibliography is considered. PMID- 3281539 TI - [Prenatal echocardiographic diagnosis of congenital cardiopathies]. PMID- 3281538 TI - [Congenital muscular dystrophy. Apropos of 4 cases]. AB - Four cases of congenital muscular dystrophy are reported. Muscular weakness and hypotonia, with different clinical severity, was present from birth in three patients; in the fourth one, it began at two months old. Three cases had joint contractures. One patient died by respiratory infection. Serum CK level was very high in all of them. Muscle biopsies showed pathologic changes consistent with muscular dystrophy with endomysial and perimysial fibrosis and fatty infiltration. Authors analysed this illness emphasizing clinical and biochemical (CK) data so that an early diagnosis can be suspected. PMID- 3281540 TI - Antenatal diagnosis of congenital deafness. AB - Advances in the field of antenatal diagnosis have made possible the detection of profound sensorineural hearing loss prior to birth. Fetal motion in response to sound and auditory evoked potential testing can determine the presence of fetal hearing in the third trimester of pregnancy. Imaging modalities including ultrasound, computed tomography, and magnetic resonance imaging hold promise for the diagnosis of some forms of congenital deafness in the second trimester fetus. The methods by which congenital deafness soon may be diagnosed and the implications for the otologist are discussed. PMID- 3281541 TI - High frequency audiometry in prospective clinical research of ototoxicity due to platinum derivatives. AB - The results of clinical use of routine high frequency audiometry in monitoring the ototoxic side effects of platinum and its derivatives are described in this prospective study. After demonstrating the reproducibility of the technique, we discuss the first results of an analysis of ototoxic side effects in 75 patients (150 ears). Significant differences in the pattern of hearing loss were registered for the different platinum treatment groups (cisplatin 20 mg/m2, cisplatin 50 mg/m2, and carboplatin 350 mg/m2). In the groups receiving cisplatin 50 mg/m2 and carboplatin 350 mg/m2, 42% and 25%, respectively, of the investigated ears proved to be undamaged, versus 9% undamaged in the group receiving cisplatin 20 mg/m2 (p less than .01). Ototoxic hearing loss started mainly (46% to 70%) in the higher frequencies (10,000 to 18,000 Hz) and developed into a broader-range hearing loss (1,000 to 18,000 Hz) during treatment in 13% to 43% (p less than .01). The onset of hearing damage was influenced by the patient's age (p less than .001) and the existence of a troubled otologic history (p less than .05). The study demonstrates the important role of high frequency audiometry in early detection and monitoring of ototoxic damage. PMID- 3281542 TI - Prospective study of the effects of ventilation tubes on hearing after radiotherapy for carcinoma of nasopharynx. AB - In patients with nasopharyngeal carcinoma, deafness sometimes occurs following radiotherapy. It is usually conductive, but may be sensorineural. Tinnitus is present frequently and usually is distressing. The role of ventilation tubes (grommets) in relieving these problems was assessed in a prospective randomized controlled trial of 115 patients. In the group with grommets, there was an improvement in hearing, with a reduction of the averaged air-bone gap (p less than .01). This was not found in the control group without ventilation tubes, who developed a larger conductive loss (p less than .01) and, in addition, a slight deterioration of the averaged bone conduction threshold (p less than .01). Surprisingly, the group with grommets did not develop this sensorineural loss (p less than .01). In addition, tinnitus was improved significantly by the insertion of ventilation tubes (p less than .01). Neither necrosis nor stenosis of the external auditory meatus was found in either group. PMID- 3281543 TI - Effect of anti-inflammatory drugs on collagen-induced autoimmune inner ear disease. AB - Animals that had collagen-induced autoimmune inner ear disease were treated with anti-inflammatory drugs: Solu-Medrol (steroid), sulindac (nonsteroid), or a combination of both. Temporal bones from drug-treated animals were examined for histopathologic and immunohistochemical changes, and sera were examined for levels of circulating antibody to type II collagen. Therapy was beneficial to the animals whether the drugs were administered alone or in combination; however, fewer lesions were observed in animals given either drug alone. Further, animals treated with steroid alone showed the least amount of inner ear damage. Immunohistochemical changes and serum levels of antibodies against type II collagen correlated with the pathologic changes. These findings suggest that both steroidal and nonsteroidal anti-inflammatory drugs may have potential therapeutic value in the treatment of autoimmune ear disease. PMID- 3281544 TI - Effect of ischemic skin flap elevation on tissue and plasma thromboxane A2 and prostacyclin production: modification by thromboxane synthetase inhibition. AB - The circulating prostaglandins have been implicated as mediators of microcirculatory derangements in skin and skin-muscle flaps. The study described here investigated the roles of thromboxane A2 and prostacyclin, measured as thromboxane B2 (TxB2) and prostaglandin 6-keto-F1a (PGF1a), in ischemic skin flaps, and the effects of thromboxane synthetase inhibition on flap blood flow and survival. A canine ventral island flap model was used to measure the appearance of TxB2 and PGF1a in the central arterial and venous plasma, and in the tissue and venous effluent of acutely raised flaps; with and without pretreatment with the specific thromboxane A2 synthetase inhibitor UK38485. Prostaglandin levels change significantly during flap elevation, and can be modified beneficially by thromboxane A2 synthetase inhibition, causing dramatic increases in flap blood flow and survival, as predicted by intravital dye penetration. The results presented in this article suggest that the manipulation of these compounds may provide a method of producing a pharmacological delay phenomenon and perhaps even allow effective intervention in the failing flap. PMID- 3281545 TI - Chronic extensive necrotizing abscess of the scalp. AB - Chronic subgaleal abscesses have been extremely rare since the advent of antimicrobial therapy. The majority of reported cases have occurred as acute infections following traumatic scalp lacerations or needle electrode insertion for fetal monitoring. The rich blood supply of the head makes widespread infection from a scalp surgical wound a very unlikely occurrence. Most acute infections of the scalp result in complete resolution with adequate early treatment. However, extensive purulent fibrosis of the scalp remains a potentially serious surgical complication. We report 2 cases of chronic necrotizing abscess of the scalp associated with a postsurgical scalp ulcer. The inflammatory process caused extensive necrotizing fibrosis (up to 2.5 cm thick) of the entire undersurface of the scalp and involved both the galea aponeurotica and the periosteum. We discuss the unique pathological features of this entity along with recommendations for its operative management and suggestions for flap design. PMID- 3281547 TI - Orbital lipoma. AB - A patient who had a huge orbital lipoma with extension to the muscle cone is described. The lipoma was 42 x 34 x 32 mm in size, and there was no visual disturbance following removal of the tumor and iliac bone grafting. Diagnosis of orbital lipoma is difficult to make. This is particularly true of a lipoma with an obvious capsule, which cannot be easily differentiated from a dermoid cyst. However, computed tomography scanning is useful in ascertaining the location, size, and relationship with orbital contents. A review of the literature concerning orbital lipoma revealed only a few reports, and the features of the orbital lipoma are summarized. In addition, the possible mechanism of orbital enlargement and the approach to the muscle cone are described. PMID- 3281546 TI - Mycoplasma hominis septic arthritis. AB - An unusual case is described of extragenital Mycoplasma hominis infection presenting as a septic arthritis of the hip joint in a young paraplegic girl. The few reported cases of M. hominis septic arthritis are summarized. Based on the current case and these reported cases, the etiology, presentation, diagnosis, and treatment of this infection are discussed. PMID- 3281549 TI - [Preoperative ultrasonography in cancer of the pancreas. Apropos of 23 cases]. PMID- 3281548 TI - Angiokeratoma circumscriptum: successful treatment with the argon laser. AB - This article describes 2 patients with angiokeratoma circumscriptum for whom the argon laser proved to be a highly successful means of treatment. Both patients had no recurrences of the lesions. Also included is an updated and comprehensive review of the various types of angiokeratoma. PMID- 3281550 TI - [The most common errors of ultrasonic diagnosis in obstetrics and gynecology]. PMID- 3281551 TI - [Quantification of chronic aortic insufficiency. Comparison between Doppler ultrasonic diagnosis and the radiocardiogram]. AB - The objective of this study is to quantify aortic insufficiency by comparing pulsated Doppler ultrasonography and radiocardiography used as reference test. Since february 1986, 23 patients were tested with both techniques within 15 days. The Doppler ultrasonography enabled to quantify aortic insufficiency in 4 stages by semi-quantitative mapping of the regurgitation flow of the left ventricle (LV). Radiocardiography (RCG) has enabled the determination of the regurgitation fraction (RF), for each patient. A mean RF was calculated on RCG, for each Doppler stage. The FR difference between each Doppler stage is significant, especially between minimal and severe aortic insufficiency. RCG is the first stage of an isotopic examination, at rest and during stress; it may be followed by Doppler ultrasonography in monitoring patients with aortic insufficiency. PMID- 3281552 TI - [Comparison of 3 methods of calculating valve surface by continuous Doppler in the quantitative evaluation of 42 cases of aortic stenosis in adults]. AB - 42 patients with a tight, symptomatic aortic stenosis, underwent a Doppler test followed, within approximately 5 days, with catheterization. Non-invasive measurement of the maximal aortic gradient is obtained by applying Bernouilli's formula to the maximum speed. Three methods of evaluation of the valvular areas are compared. The first method derives from Gorlin's formula. The second corresponds to the ratio aortic flow/mean velocity. The third method uses the continuity equation. The results compared with haemodynamic data are as follows: the correlation factor regarding the gradients is: r = 0.72 (EA: 22 mmHg), going from r = 0.74 (EA: 0.11 cm2) for the first method, r = 0.76 (EA: 0.15 cm2) for the second method and r = 0.81 (EA: 0.10 cm2) for the third method. In conclusion, the calculation of the maximum gradients is of good predictive value to differentiate minimal and tight aortic stenoses. Regarding moderate or decompensated aortic stenoses, it is advisable to follow the Doppler with the measurement of the valvular areas. The first two methods are characterized by their practicality and easy realization; the third method is preferable when there is an associated mitral valve disease. PMID- 3281553 TI - [Congenital aneurysm of the coronary arteries. Apropos of 2 cases]. AB - Two cases of aneurysm of the coronary arteries were diagnosed by coronary angiography in the course of a myocardial infarction. The first aneurysm was located at the level of the left coronary trunk in a 32 year-old woman; it was complicated with a massive anterior infarction which led to a heart transplant in the following months. The second aneurysm was located on the right coronary artery in an 18 year-old man; the inferior infarction was rudimentary and the subsequent course was quite favorable. Congenital aneurysm of the coronary arteries is a rare anomaly, often localized on the left coronary trunk and almost always diagnosed in young patients following myocardial infarction. PMID- 3281554 TI - [Aneurysm of the interauricular septum]. AB - In reference to three personal cases of interatrial septum aneurysm discovered on ultrasonography performed for the diagnosis of a cerebral embolism, the authors describe the positive diagnosis criteria, in mono- and bi-dimensional mode, of this abnormality, as well as related data obtained from catheterization, angiocardiography, and phonocardiography. This malformation, the frequency and pathogenesis of which still remain, today, difficult to evaluate, may be at the origin of complications, especially embolic migrations, systemic and also pulmonary, supraventricular rhythm disorders, interatrial shunt, reduced ventricular filling. Once established, the diagnosis is the subject of many controversies: if plain monitoring appears logical in asymptomatic forms, the occurrence of a systemic embolism makes it difficult to choose between surgical treatment and long-term anticoagulant therapy. PMID- 3281555 TI - The clinical use and measurement of theophylline. AB - This report reviews the clinical use, metabolism and toxicity of theophylline (Section 1). Current chromatographic and immunoassay methods for theophylline measurement are discussed and practical methods using high-performance liquid chromatography are described (Section 2). Results from the UK National scheme for theophylline quality control and from an experiment to investigate the degree of interference by 1,7-dimethylxanthine in routine assays for theophylline are discussed in Section 3. PMID- 3281556 TI - Burn and trauma associated proteinuria: the role of lipid peroxidation, renin and myoglobin. AB - Ten trauma patients and 13 burns patients were studied intensively for the first 36 h and subsequent 6 days post injury in order to investigate the mechanism of trauma and burn associated proteinuria. Burns patient's initial maximum proteinuria occurred between 4 and 8 h post injury, whilst trauma patients showed greatest proteinuria within 4 h. In both groups coexisting myoglobinuria or marked elevation of serum renin activity was not found during the first 36 h. Following admission serum lipid peroxides rose in burns patients reaching a maximum between 2 and 8 h following injury, after which levels fell rapidly; in contrast trauma patient's values were initially within normal limits, but rose sharply after 12 h with peaks occurring between 16 h and 7 days post injury. Some patients within both groups showed a recurrent protein leak 2 to 5 days post injury. The data suggest that myoglobinuria or raised renin levels do not play an important role in trauma associated proteinuria. PMID- 3281557 TI - An immunoturbidimetric method for the measurement of beta-2 microglobulin in serum and plasma on a centrifugal analyser. AB - A simple immunoturbidimetric method for the measurement of beta-2 microglobulin in serum on a centrifugal analyser is described. The method detects beta-2 microglobulin in the range 0.4-16 mg/L with an estimated within-batch and between batch coefficient of variation of 5-8.5% and 9%, respectively. The method correlated well with two ELISA methods. PMID- 3281558 TI - The effect of storage temperature and physical state on the performance of antisera in radioimmunoassay after long-term storage. AB - The performance in radioimmunoassay of four antisera after storage at temperatures ranging from -40 degrees C to room temperature, in three physical states (frozen, liquid or freeze dried) was investigated over a 3-year period. No deterioration in antiserum performance in terms of precision and accuracy of quality control serum measurement or recovery of ligand was apparent under any of the storage conditions studied. Some lowering of titre became apparent in two of the antisera over the study period. Deterioration was most marked when antiserum was stored lyophilised at room temperature. Storage of antiserum frozen confers no advantage over storage at 4 degrees C provided precautions are taken to minimise bacterial contamination when storing antiserum in liquid form. PMID- 3281559 TI - The toxicology laboratory--perspectives. PMID- 3281560 TI - Toxic effects of drugs on erythrocytes. AB - The erythrocyte abnormality most often associated with the toxic effects of commonly used drugs is premature destruction. The mechanisms of erythrocyte destruction include: denaturation of unstable hemoglobins, oxidation of sulfhydril groups in hemoglobin and the erythrocyte membrane in the presence of glucose-6-phosphate dehydrogenase deficiency, direct effects on enzymes, cholesterol or phospholipids of the erythrocyte membrane, and various autoimmune reactions. Therapy includes stopping the drug and transfusions when anemia is severe. Splenectomy and steroids are rarely needed. A careful medical history and use of drugs only for good indications may avoid many of these reactions. PMID- 3281561 TI - Current status of radioligand antibodies in the treatment of malignancy. AB - Monoclonal anti-tumor antibodies labeled with a radioactive moiety present an exciting new approach to cancer therapy. With the advent of hybridoma technology, monoclonal antibodies can now be produced in quantity. Indeed, antibodies against tumor-related and tumor-specific antigens have been produced, labeled with a radioactive substance, and used therapeutically. The rationale for this therapeutic approach and the results of human clinical trials will be reported herein. PMID- 3281562 TI - Bacterial toxins. AB - Many bacterial toxins are proteins, encoded by the bacterial chromosomal genes, plasmids or phages. Lysogenic phages form part of the chromosome. The toxins are usually liberated from the organism by lysis, but some are shed with outer membrane proteins in outer membrane vesicles. An important non-protein toxin is lipopolysaccharide or endotoxin, which is a constituent of the cell wall of gram negative bacteria. Toxins may damage the eukaryotic cell membrane by combining with some structural component, or otherwise alter its function. Many toxins combine with specific receptors on the surface membrane, frequently glycoproteins or gangliosides, and penetrate the cell to reach their intracellular target. A common mechanism of entry is absorptive endocytosis. Many protein toxins have an A-B structure, B being a polypeptide which binds to the receptor and A being an enzyme. Many toxins are activated, either when produced by the bacterium or when bound to the membrane receptor, by proteases (nicking). An enzymatic process common to many toxins is adenosine diphosphate (ADP)-ribosylation of the adenylate cyclase regulatory proteins, leading to an increase in intracellular cyclic adenosine monophosphate (cAMP). This is the mechanism of action of cholera toxin. Diphtheria toxin catalyzes the transfer of ADP-ribose to elongation factor 2, inhibiting protein synthesis. Most toxins act on the target cells to which they bind, but tetanus toxin, and, to a lesser degree, botulinum toxin, ascend axons and affect more distant structures. Although many toxin effects caused by bacteria have been described, only a few toxins have been identified, characterized, and their mode of action determined at the molecular level. The best known of these are discussed. PMID- 3281563 TI - [Treatment of hemorrhage caused by rupture of esophageal varices in the cirrhotic patient: remote results of a practical controlled study comparing the esophageal clip to conventional medical treatment]. AB - From 1974 to 1979, a prospective controlled study was conducted in 100 patients with cirrhosis and bleeding esophageal varices. The patients were randomly allocated to either portal disconnection of the esophagus with a clip or medical treatment. Randomization and treatment were performed in emergency situation for 50 patients and electively in 50 patients. All survivors had at least 5 years of observation after randomization. Concerning rebleeding, in the group randomized in emergency, 33 p. cent of patients had recurrent bleeding in the surgical group (mean delay: 64.1 +/- 12.4 months) and 84 p. cent among the medically treated patients (mean delay: 10.6 +/- 4.7 months). This difference is statistically significant (p less than 0.001). For the group randomized electively, 25 p. cent of the surgical patients had recurrent bleeding (mean delay: 76.3 +/- 6.4 months) and 92 p. cent of the medically treated patients had recurrent haemorrhage (mean delay: 20 +/- 5.9 months). The difference is statistically significant p less than 0.001). Concerning survival, among the patients randomized in emergency, 20 died in the surgical group (mean survival: 38.9 +/- 9.3 months) and 22 in the medical group (mean survival: 10.8 +/- 4.6 months). Among the patients randomized electively, there were 19 deaths in the surgical group (mean survival: 46.6 +/- 6.8 months) and 21 in the medical group (mean survival: 32.2 +/- 7.6 months). The difference of survival between the medical and the surgical group is not statistically significant. PMID- 3281565 TI - [Pancreas transplantation in 1987]. PMID- 3281564 TI - [Current aspects of digestive actinomycoses. Apropos of a case of hepatic actinomycosis]. AB - A case of hepatic actinomycosis is described in a patient with fascioliasis with Fasciola hepatica. The authors emphasize the abdominal sites of actinomycosis, specially appendix-cecum. Diagnosis, often difficult, is evoked before fistula with yellow granules in the pus. Definitive identification requires anaerobic culture. The treatment with lengthy antibiotic administration is efficient. PMID- 3281566 TI - Yq deletion and failure of spermatogenesis. AB - The spermatogenesis of a sterile male carrying a Y long arm deletion was analyzed by meiotic techniques and by light and electron microscopy on testicular biopsies. R-, Q- and C- banding techniques have shown that the Y long arm deletion included the entire heterochromatin and a part of the euchromatic region, with breakpoint between q11.21 and q11.23. The seminiferous tubules showed a sharp decrease in spermatogonia, degenerative phenomena in their nuclei and a spermatogenic block. Abnormal meiotic aspects were observed: pairing failure with atypical diakinesis configurations. These findings confirm the presence of spermatogenesis controlling factors on the distal euchromatic region of the Y long arm. PMID- 3281567 TI - Chromosomal instability in incontinentia pigmenti: study of four families. AB - Cytogenetic studies in four patients affected by Incontinentia pigmenti and in their relatives did not show a significant increase of chromatid and chromosome gaps and breaks. This seems to negate a correlation between these findings and the disease. We propose that the responsibility for the chromosomal breakages sometimes observed in this syndrome can be due to external factors that disturb the basal percentage of the lesions. PMID- 3281568 TI - Interstitial deletion of 17p11.2: case report and review. AB - A child with mental retardation and multiple congenital abnormalities, including brachycephaly, an unusual facies, brachydactyly, clinodactyly and bilateral talipes valgus, was found to have a small interstitial deletion of the short arm of chromosome 17. The clinical features and cytogenetic observations are compared with those in previously reported cases. PMID- 3281569 TI - Morphological characteristics of monosomy X in spontaneous abortions. AB - From a morphologic and cytogenetic study of 160 spontaneous abortion specimens with 45,X, as well as data from the literature, we conclude that monosomy X has characteristics which can suggest the diagnosis in prenatal life in the absence of a karyotype. Specimens in our study could be classified into four groups: (I) 49% consisted of a chorionic and amniotic sac, usually ruptured, containing a well-defined umbilical cord with a fragment of embryonic tissue at its end. (II) 25% consisted of small macerated embryos of 40-44 days developmental age, with pronounced retrognathia and lack of nasofrontal angle. Two specimens had a neural tube defect, one had cleft lip and palate, and two had an isolated cleft palate. The developmental age of the embryos was 5-6 weeks behind their gestational age. (III) 5% were very macerated second trimester fetuses with cystic hygromata, lymph-edema of the hands and feet, ascites, hydrothorax, and hypoplastic lungs. Four had coarctation of the aorta, three had single umbilical artery, and two had persistent left cardinal vein. Horseshoe kidney, ventricular septal defect, and anomalous subclavian artery were found once. (IV) The remaining 21% consisted only of fragments of ruptured sacs without an umbilical cord insertion site, pieces of fetal membranes or chorionic villi only. The spectrum of anomalies observed suggests that the pathogenetic mechanism for early death in 45,X embryos and fetuses may be related to vascular abnormalities or to abnormal fluid balance, leading to disturbed embryo-placental circulation, and excess fluid volume in the fetus. The 45,X karyotype is compatible with quite normal morphological development up to the fetal stage, and no specimens were found where development had ceased at a very early stage. The usual lethality of monosomy X may be explained by the presence of genes, essential for survival, on the pseudoautosomal segment of the X and Y. Lethality could result from recessive lethal mutations in this region, or from the necessity for two copies of this regions for normal development. PMID- 3281570 TI - Type C brachydactyly transmitted through four generations. AB - We report a type C brachydactyly transmitted through four generations, with incomplete penetrance and feet abnormalities in the proposita. PMID- 3281571 TI - Poor prognosis of acute lymphoblastic leukemia with translocation (1;19) in childhood: potential interest of allogeneic bone marrow transplantation. AB - We report a new case of childhood acute lymphoblastic leukemia with translocation (1;19). At the time of diagnosis, the only adverse prognosis factor was the existence of this translocation. Under conventional chemotherapy, the girl experienced early marrow relapse (duration of first remission was 2 months). She received allogeneic bone marrow transplantation during the second remission and is alive in continuous complete remission 20 months after transplant. Several earlier reports have suggested that children with the (1;19) have a poor prognosis; If this poor response to conventional therapy is confirmed, an allogeneic bone marrow transplantation should be considered during the first remission. PMID- 3281572 TI - A malformed girl with a de novo proximal 6q deletion. AB - An additional case of interstitial deletion of chromosome 6, the first with breakpoints in q12 and q14, is reported. The female infant was the malformed first child of young, healthy parents. A review of proximal 6q deletions is made. PMID- 3281573 TI - The fetal phenotype of the 18p-syndrome. Report of a male fetus at twenty-one weeks. AB - Morphological and cytogenetic findings in a male fetus at 21 weeks gestation after prenatally detected monosomy 18p are reported. The fetus displayed dysmorphic features resembling the 18p-syndrome, such as decreased head circumference, slightly receding forehead, hypertelorism, epicanthus, horizontal palpebral fissures, depressed nasal bridge, long philtrum, carp mouth, irregular crenated maxillar alveolar ridge, retrognathia, lowset dysplastic ears with posterior rotation, edema of neck, hands and feet respectively, fingers with drop shaped tips, short first toes with dysplastic nails, hypoplastic male external genitalia. After termination of the pregnancy, biopsies from different fetal organs as well as from the placenta were taken and set up for long term cell cultures. The metaphases of fetal organs all showed the karyotype 46,XY,18p-. A fetal blood culture failed to grow. Unexpectedly, the metaphases of the placenta showed the mosaic karyotype 46,XY/46,XY,18p-/46,XY,18p+. PMID- 3281574 TI - Constrained and unconstrained fetal growth: associations with some biological and pathological factors. AB - Data are presented on the birthweights of 1092 siblings and 5207 maternal and paternal relatives of 986 probands. Previous analyses had demonstrated the potency of a maternal regulator constraining fetal growth. Different patterns of birthweights were found in families ascertained, respectively, through very large and very small babies (Ounsted, Scott and Ounsted 1986). When the data were reanalyzed in respect of other biological and pathological factors affecting fetal growth rate the following findings emerged: (1) When pathological factors were associated with the proband pregnancy the typical patterns of pedigree birthweights were not so clearly manifest; (2) general associations were found between the mothers' own birthweights and their size as adults; (3) low maternal birthweight was the biological factor showing the highest risk associated with small babies. When the babies were large the risks associated with high maternal adult weight and parity were similar to those associated with high birthweight. Paternal factors also made a contribution to fast fetal growth rate when pathological factors were absent. These findings confirm our hypothesis that at the lower extreme of fetal growth rate maternal constraint is pre-potent. At the upper extreme, relaxation of constraint allows other biological factors to take up more of the variance. PMID- 3281575 TI - Relations between anthropometric characteristics and androgen hormone levels in healthy young men. AB - Inter-individual correlations between androgen hormone levels and anthropometric features were computed using data from a sample of 110 healthy young men. Radioimmunoassays were used to determine the total testosterone and dihydrotestosterone in the serum and the free testosterone in the saliva. The 58 body measures encompassed the head, trunk and extremities in terms of their length, breadth and circumference. In addition, skin-fold thicknesses were also measured. This set of features was also subjected to factor analysis; the correlations of the resulting individual factor scores with the body measurements were also determined. The total testosterone and dihydrotestosterone were found to have a number of significant correlations with the various body measures and factors, while the free testosterone did not yield any significant findings. These correlations indicate in particular that there is a relation between the serum androgens and leptomorphism (especially negative correlations to indicators of the fat development), whereas a connection between the serum androgens and masculinity is only hinted at. PMID- 3281577 TI - Effects of ingesting glucose and some of its polymers on serum glucose and insulin levels in men and women. AB - Twelve men and 10 women were given maltodextrin (DE20) at various dose levels after an overnight fast. Similar studies were carried out with glucose, maltose and another maltodextrin (DE5). It was found that within each sex the serum glucose and insulin responses were not influenced by the physical form of glucose ingested over a 90-min period. However, the serum glucose response to glucose and to its polymers was found to be dose-dependent in the men but not in the women. The serum insulin response was dose-dependent in both sexes. At any glucose dose level the serum insulin response was approximately 40% greater in men compared to women. PMID- 3281576 TI - Serogenetic studies among an urban and two tribal populations of Orissa, India. AB - Phenotype and gene frequencies of blood groups, plasma proteins and red cell enzymes (23 systems) are examined in two tribal and one low social class urban population of Orissa, India. Genetic heterogeneity is suggested not only between the tribal and urban populations but also between the tribal groups. The gene frequencies of tribal populations indicate a genepool with an ancestral component from the populations of north-east India with some mongoloid affinity, but it seems that there has also been some gene flow from them into the urban population. PMID- 3281579 TI - RN first assistant bill fails. PMID- 3281578 TI - RN first assistant bill died an unjust death. PMID- 3281580 TI - Self-care. Part I: The value of self-reflection. PMID- 3281581 TI - Hospital-based outpatient surgery. Planning the facility. PMID- 3281582 TI - Degradation of 1,2-dichlorobenzene by a Pseudomonas sp. AB - A Pseudomonas sp. that was capable of growth on 1,2-dichlorobenzene (o-DCB) or chlorobenzene as a sole source of carbon and energy was isolated by selective enrichment from activated sludge. The initial steps involved in the degradation of o-DCB were investigated by isolation of metabolites, respirometry, and assay of enzymes in cell extracts. Extracts of o-DCB-grown cells converted radiolabeled o-DCB to 3,4-dichloro-cis-1,2-dihydroxycyclohexa-3,5-diene (o-DCB dihydrodiol). 3,4-Dichlorocatechol and o-DCB dihydrodiol accumulated in culture fluids of cells exposed to o-DCB. The results suggest that o-DCB is initially converted by a dioxygenase to a dihydrodiol, which is converted to 3,4-dichlorocatechol by an NAD+-dependent dehydrogenase. Ring cleavage of 3,4-dichlorocatechol is by a catechol 1,2-oxygenase to form 2,3-dichloro-cis,cis-muconate. Preliminary results indicate that chloride is eliminated during subsequent lactonization of the 2,3 dichloro-cis,cis-muconate, followed by hydrolysis to form 5-chloromaleylacetic acid. PMID- 3281583 TI - Isolation of fecal coliforms from pristine sites in a tropical rain forest. AB - Samples collected from water accumulated in leaf axilae of bromeliads (epiphytic flora) in a tropical rain forest were found to harbor fecal coliforms. Random identification of fecal coliform-positive isolates demonstrated the presence of Escherichia coli. This bacterium was also isolated from bromeliad leaf surfaces. These data indicate that E. coli may be part of the phyllosphere microflora and not simply a transient bacterium of this habitat. The isolation of fecal coliforms from these sites was unexpected and raises questions as to the validity of using fecal coliforms as indicators of biological water quality in the tropics. PMID- 3281584 TI - Evaluation of four methods for enumeration of Vibrio parahaemolyticus. AB - Two membrane filter (MF) and two most-probable-number methods for enumerating Vibrio parahaemolyticus were compared. The MF methods used elevated-temperature incubations (41 and 42 degrees C) and were more specific than the most-probable number methods (conducted at 35 degrees C). The MF method with a hydrophobic grid and a repair step was most effective. PMID- 3281585 TI - Effect of various polyamine analogs on in vitro polypeptide synthesis. AB - Various polyamine analogs were examined for their ability to stimulate and to function as sparing agents for the Mg2+ requirement in polypeptide synthesis at various temperatures in Escherichia coli (37 and 47 degrees C) and the extremely thermophilic Thermus thermophilus (60 and 70 degrees C) cell-free systems. The optimal concentration of each polyamine analog increased as the incubation temperature was elevated. At a fixed temperature, the optimal concentration of polyamine analogs was in the order diamines greater than triamines greater than tetraamines greater than pentaamines. All diamines tested stimulated polypeptide synthesis almost equally but lowered the optimal Mg2+ concentration in the order diaminopropane greater than putrescine greater than cadaverine. The degree of diamine stimulation was maximal at 37 degrees C. The effects of three triamines were very similar in the E. coli system but in the T. thermophilus system spermidine was most effective in stimulation of polypeptide synthesis. From the results of experiments using tetraamines and pentaamines, it was deduced that the presence of both aminobutyl and aminopropyl groups in polyamine analogs is important for stimulation of polypeptide synthesis. In the E. coli system, triamines were the most effective polyamines for stimulation of polyphenylalanine synthesis at both 37 and 47 degrees C, while, in the T. thermophilus system, thermospermine, a tetraamine, was most effective at 60 degrees C and 3,4,4,3 pentaamine was most effective at 70 degrees C. PMID- 3281586 TI - How a soluble enzyme can be forced to work as a transport system: description of an experimental design. AB - The cellular transport systems which have been studied up to now have been found to be based on the functioning of specialized proteins anchored asymmetrically in cell membranes. In the present paper we show that a single soluble enzyme inserted at random in a gel slab can drive an uphill transport, provided that asymmetrical boundary conditions force the reversible reaction catalyzed by this enzyme to work forward on one face of the gel slab and backward on the other face. Experimentally, we have used a yeast alcohol dehydrogenase to induce an uphill transport of NADH. It cannot be excluded that comparable structurally symmetrical transport systems also exist in living cells. Such systems would be particularly well suited to preserving cell homeostasis with regard to small solutes. PMID- 3281587 TI - In situ behavior of the pyrimidine pathway enzymes in Saccharomyces cerevisiae. 3. Catalytic and regulatory properties of carbamylphosphate synthetase: channeling of carbamylphosphate to aspartate transcarbamylase. AB - The present work reports direct evidence for the channeling of carbamylphosphate from carbamylphosphate synthetase to aspartate transcarbamylase in the multifunctional protein that catalyzes the two first reactions of the pyrimidine pathway in Saccharomyces cerevisiae. This phenomenon is almost certainly related to the previously reported observation that the apparent in situ catalytic mechanism of aspartate transcarbamylase is altered by the association of this enzyme to carbamylphosphate synthetase. As a prerequisite of this investigation, the in situ catalytic and regulatory properties of carbamylphosphate synthetase were studied in the permeabilized cells of a strain that contains the wild-type multifunctional protein but is devoid of the carbamylphosphate synthetase specific for the arginine pathway. PMID- 3281588 TI - Distinction between glycoprotein IIIa and the 100-kDa membrane protein (aggregin) mediating ADP-induced platelet activation. AB - Previous studies from our laboratories showed that 5'-p-fluorosulfonylbenzoyl adenosine (FSBA) inhibits ADP-induced platelet shape change, aggregation, and exposure of fibrinogen sites while covalently binding to 100-kDa platelet membrane protein (aggregin) on the intact platelet. Chymotrypsin digests aggregin to a fragment of 70 kDa, abolishing the inhibition, and also cleaves platelet glycoprotein IIIa (GPIIIa) (100 kDa) to a 70-kDa fragment containing the P1A1 epitope. We questioned whether these platelet membrane proteins were distinct. Both 5'-p-[3H]sulfonylbenzoyl adenosine (SBA)-labeled aggregin and 125I-GPIIIa were precipitated by polyclonal antibodies to a 100-kDa fraction of platelet membranes, but aggregin was not precipitated by a monospecific antibody to P1A1 which precipitates GPIIIa. Further a monospecific polyclonal antibody to immunopurified GPIIIa coupled to protein A-Sepharose adsorbed GPIIIa but not aggregin. Similarly, both aggregin and GPIIIa were precipitated by a polyclonal antibody to an isolated 70-kDa component of platelet membrane but only GPIIIa was precipitated by the monoclonal antibody to GPIIIa, (SSA6). Two patients with Glanzman's thrombasthenia whose platelet membranes contained less than 5% GPIIIa as assayed by monoclonal antibody binding (A2A6), incorporated [3H]SBA to the same extent as normal individuals. Furthermore, FSBA inhibited ADP-induced shape change with a similar concentration dependence for both thrombasthenic and normal platelets. Finally, mobility of GPIIIa on sodium dodecyl sulfate-polyacrylamide gel electrophoresis was decreased following reduction with dithiothreitol whereas that of [3H]SBA-labeled MP 100 was not altered. We conclude that GPIIIa and aggregin are distinct platelet membrane proteins. PMID- 3281590 TI - [New directions in research on cancer metastases: molecular biological approaches]. AB - Cancer metastasis is a multistep process related to various factors (genes). One objective of research on cancer metastasis is to identify factors responsible for each of these steps and to evaluate the weight of each factor in the entire metastatic process. Molecular biological approaches are increasingly used in the field of research on cancer metastasis to identify and analyze each factor, at the gene level. Oncogenes, such as ras, N-myc, c-myc, sis, erb B, and fos, are reported as candidate genes related to metastasis. Other candidate genes, such as MHC, cadherin, laminin, and actin have already been cloned and sequenced. By reviewing molecular biological approaches to metastasis, present issues and directions of research on metastasis will be discussed. PMID- 3281589 TI - Insulin-stimulated microtubule associated protein kinase is detectable by analytical gel chromatography as a 35-kDa protein in myocytes, adipocytes, and hepatocytes. AB - Insulin stimulates a novel Ser/Thr kinase, which phosphorylates microtubule associated protein-2 (MAP-2) in vitro. MAP kinase was studied in cell models of the principal insulin responsive tissues using analytical fast-protein liquid chromatography for partial purification of the enzyme. Stimulation of MAP kinase (1.3- to 2-fold) by insulin was readily detected in BC3H1 smooth and 23A2 skeletal muscle cells; 3T3-L1 adipocytes; and isolated rat hepatocytes and adipocytes. No phosphatase activity was detectable under the assay conditions used, proving that stimulation of a kinase, not inhibition of a phosphatase, is responsible for the increased incorporation of 32PO4 catalyzed by supernatants from insulin-treated 3T3-L1 cells. In H4 hepatoma cells, stimulation of MAP kinase was much less evident after gel filtration in comparison to the other cell types. The activated enzyme present in supernatants from insulin-treated cells migrated as a single peak of approximately 35 kDa apparent molecular mass (except in the case of isolated hepatocytes in which a shoulder was present). These results suggest that the insulin-stimulatable MAP kinase may be ubiquitous in insulin responsive cells. PMID- 3281591 TI - [Multidisciplinary treatment of thoracic esophagus carcinoma based on preoperative staging]. AB - Recently, with developments in CT scanning and endoscopic ultrasound (EUS), in addition to conventional ultrasound (US), significant advances have been made in the evaluation of preoperative staging. Evaluation of the presence of A3 invasion is made on the basis of X-ray, CT and EUS findings. In superficial cases of ep, mm or sm, EUS with particular reference to the X-ray and endoscopic appearance is very effective, and in our department the diagnostic accuracy in cases of mucosal lesions is 88%, while it is 84% in sm cases. Diagnosis of metastasis to cervical and abdominal lymph nodes is performed by US, while diagnosis of mediastinal lymph node metastasis is performed by EUS. The accuracy of US for detecting cervical and abdominal lymph node metastases, including those approximately 0.5 cm in size, is 95%, while that of EUS in the diagnosis of metastasis to mediastinal nodes is 89%. The 5-year survival of patients with lymph node metastasis significantly affects prognosis. Based on this, since 1985, extended dissection in the cervical, thoracic and abdominal regions has been carried out. Since 1985, some resected cases have been treated with pre- or postoperative adjuvant chemotherapy regimens, centered primarily on CDDP (majority of cases with CDDP + VDS). A significant improvement has been obtained in the 1-2-year survival of C greater than O resected cases treated since 1985, compared with cases in 1980-1984. This improvement is thought to be due to dissection of lymph nodes in the three major regions, based on more accurate preoperative evaluation and the introduction of postoperative adjuvant chemotherapy. PMID- 3281592 TI - [Advances on ACNU in the past 10 years]. PMID- 3281593 TI - Gram's-stained microscopy in the etiological diagnosis of Malassezia (Pityrosporon) folliculitis. PMID- 3281594 TI - Changing clinical and laboratory concepts in inherited epidermolysis bullosa. PMID- 3281595 TI - Etretinate. Appropriate use in severe psoriasis. PMID- 3281596 TI - Congenital sensory neuropathy with anhidrosis. AB - Congenital sensory neuropathy with anhidrosis (CSNA) is a well-defined entity among a group of sensory deficiency syndromes. Children with this genetic disease are insensitive to pain and temperature, do not sweat, and suffer from mental retardation. Self-mutilation may be severe and may lead to insoluble orthopedic problems. We treated a girl with CSNA, who was born to nonconsanguineous Japanese parents. This disease is important in the dermatological field, since the degree of anhidrosis and self-mutilation influence the prognosis of patients with CSNA. PMID- 3281597 TI - Bullous eruption in a woman with lupus erythematosus. Bullous systemic lupus erythematosus (SLE) PMID- 3281599 TI - A decade of insulin infusion pumps. PMID- 3281598 TI - Clinical applications of nuclear medicine. PMID- 3281600 TI - Histologic characteristics of lichen planus transplanted onto nude mice and cultured in vitro. AB - Typical confluent lesions of lichen planus were transplanted onto nude mice and cultured in organ culture. The characteristic histologic appearance of lichen planus disappeared after grafting and became similar to normal skin within 6 weeks on nude mice; the dense lymphocyte infiltrate in dermis disappeared, the basal cell layer normalized, and the colloid bodies disappeared from epidermis, although some of them were found in dermis. The granular layer also normalized, but the stratum corneum remained hyperkeratotic 6 weeks after transplantation. In organ culture, characteristic histologic features of lichen planus disappeared in 3-5 days via a rapid necrosis of the upper part of the epidermis and formation of a new, normal-looking basal epidermis. These results suggest that lesions of lichen planus are primarily dependent on the influence of the host to maintain their typical histologic appearance. PMID- 3281602 TI - On the health effects of environmental tobacco smoke. AB - Possible adverse health effects of breathing environmental tobacco smoke include lung cancer, respiratory illnesses in young children, decreased pulmonary function, decreased lung growth, allergy to tobacco, and exacerbation of angina. These effects are reviewed to aid informed discussion on this health issue. Some of the constituents of tobacco smoke are found in the home, the outdoor environment, and the workplace in permissible concentrations and are considered unlikely to cause ill health. A double standard, one in the workplace and another for the public, may be evolving for acceptable health risks. PMID- 3281601 TI - Detection of circulating antibodies to purified keratinolytic proteinase in sera from guinea pigs infected with Microsporum canis by enzyme-linked immunosorbent assay. AB - A keratinolytic proteinase (KPase) which is regarded as an important factor in the pathogenesis of dermatophytosis was isolated and purified from Microsporum (M.) canis culture filtrates. Enzyme-linked immunosorbent assay (ELISA) was used to determine the occurrence of circulating antibodies to this enzyme in sera samples from guinea pigs with superficial fungal infections caused by M. canis. Of sera samples from guinea pigs infected with M. canis, 75% were reactive within 10 weeks, however, those ELISA values were relatively low compared with those from guinea pigs immunized with KPase. The presence of circulating antibodies was first detected 2 weeks post inoculation with M. canis, corresponding to the period when the lesions were most severe. The titers of the ELISA antibodies reached a peak at 4 weeks; at that time the lesions had disappeared completely. PMID- 3281603 TI - Cyclosporin in rheumatoid arthritis: a double blind, placebo controlled study in 52 patients. AB - The efficacy and safety of cyclosporin A (CyA) for patients with rheumatoid arthritis were assessed in a four month double blind, placebo controlled study using an initial dosage of 5 mg/kg daily. Six patients withdrew from the study (two in the placebo group because of inefficacy of treatment and four in the CyA group because of side effects). These six patients were considered therapeutic failures. At the end of the trial the study treatment was considered as good or very good by 14 out of the 26 CyA group patients and by only two out of the 26 placebo group patients. Moreover, in the CyA group significant improvement was observed in five of the seven clinical assessment criteria. Clinical improvement was correlated with a decrease in C reactive protein, alpha 1 glycoprotein levels, and platelet count but not with erythrocyte sedimentation rate or rheumatoid factor titres. Renal toxicity (13 cases) remained the major problem in the management of these patients. This study shows that CyA is effective in active rheumatoid arthritis but requires close monitoring for toxicity. PMID- 3281604 TI - Salicylate ototoxicity in patients with rheumatoid arthritis: a controlled study. AB - Tinnitus or subjective hearing loss, or both, were reported by 61 of 134 (45%) patients with rheumatoid arthritis (RA) taking regular salicylates and by 73 of 182 (40%) untreated healthy subjects. In the patients with RA mean salicylate levels were not higher in those with tinnitus than in those without tinnitus, but levels were significantly higher in those with subjective hearing loss than in those with no symptoms. Twenty five per cent of the patients with RA had tinnitus or subjective hearing loss with salicylate levels less than 1.42 mmol/l. Audiometric responses in 31 patients correlated poorly with symptoms. Tinnitus and subjective hearing loss may be too non-specific to be reliable as tools for adjusting the salicylate level into the therapeutic range. PMID- 3281605 TI - Analysis of clinical judgment helps to improve agreement in the assessment of rheumatoid arthritis. AB - Experienced rheumatologists differ widely in their assessments of rheumatoid arthritis even after extensive efforts to improve agreement by discussion and consensus. The use of computer feedback to provide an analysis of clinicians' judgment policies in a highly structured investigation has been shown to improve agreement, but this may not apply in normal clinical practice. Here the successful convergence of clinical agreements by three rheumatologists using computer assisted feedback over several months in a National Health Service outpatient department is reported. In the three months without feedback their pooled agreement for assessing the severity of rheumatoid arthritis was r2 = 0.62. During the three months in which feedback was provided agreement rose to r2 = 0.92. The principal component of all three judgment policies at the end of the feedback period was 'articular index'. PMID- 3281606 TI - Behcet's disease associated with amyloidosis in Turkey and in the world. AB - The association of amyloidosis with Behcet's disease has infrequently been reported in published works. Twenty four such cases have been observed in the world, of which 12 are from Turkey, including eight of ours. In all our eight cases renal biopsy showed amyloidosis of type AA. Behcet's disease of male preponderance, long duration, complete type, multiple organ involvement, and positive skin pathergy test were the main characteristics of all 24 cases of Behcet's disease with amyloidosis. We conclude that amyloidosis associated with Behcet's disease is a secondary AA amyloidosis occurring as an intrinsic manifestation of Behcet's disease. PMID- 3281607 TI - Do diets rich in polyunsaturated fatty acids affect disease activity in rheumatoid arthritis? PMID- 3281608 TI - Autoantibody profile in juvenile chronic arthritis. AB - Patients with juvenile chronic arthritis (JCA) may be subdivided into a minority, who carry IgM rheumatoid factor and have erosive polyarthritis resembling adult rheumatoid arthritis, and the majority (90%), who are seronegative by conventional means. Between 30 and 60% of patients with JCA have positive antinuclear antibodies (ANAs) according to the choice of substrate for indirect immunofluorescence. The importance of ANAs is the frequent development of associated asymptomatic chronic iridocyclitis, which may impair vision causing worse handicap than the arthritis, which remains predominantly pauciarticular in two thirds of these young children. ANA positive patients rarely possess antibodies to deoxyribonucleic acid (DNA) or extractable nuclear antigens (ENA), and current studies suggest that several different nuclear antigens, including histones, may be involved. PMID- 3281609 TI - Pulmonary hypertension in primary Sjogren's syndrome. AB - The clinical course of a patient with pulmonary hypertension associated with Sjogren's syndrome is reported. The clinical features and outcome of this case are compared with those of two other reported cases in the Spanish and Japanese published work. Thus far, pulmonary hypertension has not been reported with primary Sjogren's syndrome in English publications. These three cases suggest that the development of pulmonary hypertension in primary Sjogren's syndrome is uncommon but should be included as part of the clinical spectrum. PMID- 3281611 TI - Effect of T cell modulation on the translocation of bacteria from the gut and mesenteric lymph node. AB - Although the ability of the gut-associated lymphoid tissue (GALT) to respond to orally ingested foreign antigens has been studied extensively, its function in preventing or limiting escape of resident gut bacteria has not been assessed. The following studies were performed to examine what role cell-mediated immunity (CMI) plays in this process. The ability of suppression of CMI to induce escape of gut bacteria (translocation) to the mesenteric lymph node (MLN) in immunocompetent mice whose gut flora was unaltered was examined. Administration of cyclosporine or anti-L3T4 antibody failed to induce translocation of indigenous gut bacteria after 7 or 14 days of treatment. Antithymocyte globulin (ATG) also failed to induce translocation after 7 days of treatment, despite depletion of all Thy 1, Lyt 1, L3T4, and Lyt 2 positive cells from the spleen, MLN, and intestine as demonstrated by immunofluorescent microscopy. Finally, cultures of the MLN, spleen, liver, and peritoneum of T cell-deficient BALB/c nude mice and their heterozygous T cell-replete littermates were also sterile, demonstrating that congenital suppression of T CMI also does not lead to translocation of indigenous gut bacteria. The role of CMI in limiting systemic spread of bacteria that were already translocating to the MLN was also examined. Translocation of Escherichia coli C25 to the MLN was induced by gastrointestinal (GI) monoassociation, which leads to translocation of E. coli C25 to the MLN in 80-100% of mice. Treatment with ATG during monoassociation failed to induce spread of E. coli C25 to the spleen, liver, or peritoneum, despite the same degree of T cell depletion achieved with ATG in the previous experiment. Monoassociation of conventional T cell-deficient BALB/c nude and heterozygous mice and germ-free T cell-deficient BALB/c nude and heterozygous mice also did not lead to spread of E. coli C25 beyond the MLN. However, in ATG-treated, conventional nude, and germ-free nude mice, the average number of translocating E. coli C25 per MLN was consistently higher. In separate experiments the ability of stimulation of T cell function to inhibit translocation of E. coli C25 was examined. Recombinant interleukin-2, 25,000 units, was administered intraperitoneally every 8 hours during exposure to E. coli C25. This reduced the incidence of translocation of E. coli C25 from 85% to 51% (p = 0.02). Suppression of CMI, either systemically or within the GALT, has a minimal influence on the mechanisms by which the normal gut flora are translocated to the MLN.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3281612 TI - The relationship between primary hyperparathyroidism and diabetes mellitus. AB - Previous reports have suggested that control of diabetes improves after successful parathyroidectomy for primary hyperparathyroidism. To investigate this proposition further, a review was made of all insulin-requiring diabetics undergoing curative parathyroidectomy at the Mayo Clinic between 1970 and 1984 (36 patients). All contemporary insulin-requiring diabetics undergoing thyroidectomy for benign euthyroid disease served as a control group (34 patients). One patient in each group had type I diabetes mellitus, and the remainder had type II diabetes mellitus. Preoperative insulin requirements, insulin requirements at follow-up, and change in insulin requirements did not differ significantly between the two groups. This study suggests that parathyroidectomy does not lead to a statistically significant reduction in the insulin requirements of diabetic patients with primary hyperparathyroidism and that coexistent type II diabetes mellitus should not be considered a further indication for parathyroidectomy in patients with primary hyperparathyroidism. PMID- 3281610 TI - Current laser applications in general surgery. PMID- 3281614 TI - Prostacyclin production in free versus native IMA grafts. AB - The long-term patency of the internal mammary artery (IMA) in coronary artery surgery has been superior to that of other grafts. We tested the IMAs as free grafts in an experimental study with 8 dogs. The right IMA was dissected free as a naked artery without surrounding tissue, and the left IMA was dissected with surrounding tissue using electrocautery. Both free IMA grafts were anastomosed first to the left IMA one after another and then to the left anterior descending coronary artery. The grafts were harvested 6 months later, and the prostacyclin (PGI2) production of the free IMA grafts and of the intact IMAs was measured. Radioimmunoassay was used to measure 6-keto-prostaglandin F1 alpha, the stable metabolite of PGI2. The PGI2 production of the right free IMA without surrounding tissue was 21.1 +/- 8.5 pg/mg and of the left IMA with surrounding tissue was 17.9 +/- 7.9 pg/mg (expressed in picograms of 6-keto-prostaglandin F1 alpha per milligram of tissue wet weight). The control value of the intact IMA was 18.3 +/- 6.5 pg/mg. Thus, PGI2 production of both free IMAs did not differ significantly from each other and from controls. This study showed that free IMAs were able to produce as much PGI2 as were control IMAs and that the type of dissection did not affect the result. PMID- 3281615 TI - The artificial heart: infection-related morbidity and its effect on transplantation. AB - Between October, 1985, and September, 1987, a total of 195 patients received cardiac allografts and 15 candidates required mechanical support with the Jarvik 7 total artificial heart. Seven of the 15 died within 60 days of total artificial heart implant. There have been no late deaths, and survivors are unrestricted. Six of 7 deaths were related to infection (mediastinitis, 5; pneumonia and sepsis, 1), and the remaining 1 was due to failure of the transplanted heart. Respiratory tract infection occurred in each of the recipients who died with infection, and the same organisms appeared to be related to subsequent mediastinitis in 3 patients (Serratia marcescens, 2; Pseudomonas, 1) and caused fatal sepsis in another (Enterobacter aerogenes, Candida albicans). One patient died with pneumonia and sepsis prior to transplantation, and another succumbed with mediastinal infection known to be present before transplantation. PMID- 3281613 TI - Septic necrosis of the midline wound in postoperative peritonitis. Successful management by debridement, myocutaneous advancement, and primary skin closure. AB - Wound management following laparotomy for postoperative peritonitis and varying degrees of parietal necrosis remains a challenging and controversial problem. Because maintained peritoneal integrity and primary wound closure offer the best opportunity for survival, an original technique involving bilateral incisions to relax skin and rectus fascia is proposed. This technique permits medial myocutaneous advancement and primary tension-free skin closure of midline laparotomy incisions. Sixty-nine patients with severe postoperative peritonitis were treated according from 1980 through 1985. Nine of these patients died of advanced multiple organ failure soon after referral, and eight more died after prolonged treatment. Fourteen patients had one or more reoperations for complications. Only nine wound failures resulted, including five eviscerations and four wound infections followed by progressive dehiscence. The bilateral relaxing incisions healed secondarily without complication. Survivors developed midline wound hernia; ten of the 52 surviving patients have had these repaired. This method of primary closure is safe when performed in conjunction with rigorous surgical care of intraperitoneal infection and may enhance survival. We recommend the technique to surgeons who treat severe postoperative peritonitis and septic necrosis of midline laparotomy wounds. PMID- 3281616 TI - Use of the internal mammary artery in myocardial revascularization. AB - Internal mammary artery-coronary artery anastomosis is currently considered the newest and best technique for surgical revascularization of ischemic myocardium. The origin and evolution of this technique are reviewed. PMID- 3281617 TI - The clinical spectrum of cardiac fibroma with diagnostic and surgical considerations: noninvasive imaging enhances management. AB - A cardiac fibroma was successfully resected from the interventricular septum of a 25-year-old woman. The clinical data were correlated with a review of the data on 144 other patients, thereby providing a clinical profile and management strategy for this type of tumor. Initial manifestations of a fibroma were determined to be congestive heart failure (21%), tachyarrhythmias (13%), and chest pain (3.5%). A majority of patients were asymptomatic (36%) with abnormal physical findings or an abnormal chest roentgenogram. Finding the tumor at autopsy incidentally or on sudden death (23%) indicated the lethal potential. A few (3.5%) of the reports on patients with cardiac fibroma were without clinical data. Noninvasive imaging by echocardiography, computed tomography, and nuclear magnetic resonance improved the diagnosis. Surgical treatment was successful in 53 of the 84 patients for whom it was attempted. PMID- 3281618 TI - The effect of beta-blockers on mental performance on older hypertensive patients. AB - This double-blind, three-way crossover study measured the influence of beta blocker treatment on drowsiness and mental test performance in older hypertensive patients and determined if lipophilicity was a determinant of these effects. Twenty-seven hypertensive patients (mean age, 63 +/- 3 years) were studied. Patients received two weeks each of daily treatment with placebo, 100 mg of atenolol, or 150 mg of metoprolol tartrate and were evaluated on the 14th day of each treatment period, after which their next treatment period began. Mental performance was measured using Trails-A maze testing. Drowsiness was measured subjectively using a visual analogue scale, and objectively using critical fusion frequency threshold testing. Blood pressure control was equivalent and clinically adequate in all subjects. Steady-state levels of metoprolol tartrate (235.7 +/- 46 ng/mL) and atenolol (453.6 +/- 56 ng/nL) achieved were those expected to produce similar beta-blockade. Mental performance as measured by Trials-A testing showed better scores during beta-blocker treatment compared with placebo. Trails A scores improved as patients went from placebo to metoprolol treatment, but did not change as patients went from placebo to atenolol treatment. Critical fusion frequency threshold measurements were lower following administration of both drugs than following that of placebo, but subjectively there was no difference in feelings of lethargy between either beta-blocker and placebo. These data show greater improvement in mental testing performance to be associated with metoprolol treatment, but neither produced more lethargy than placebo in elderly patients. PMID- 3281619 TI - Sexual symptoms in hypertensive patients. A clinical trial of antihypertensive medications. AB - The effects of captopril, methyldopa, and propranolol hydrochloride on reported distress over sexual symptoms over a 24-week treatment period were examined as part of a multicenter, randomized, double-blind clinical trial in which 626 men with mild to moderate hypertension participated. On entry into the clinical trial, 58% of patients taking antihypertensive medications and 44% of men not receiving antihypertensive drugs reported distress over one or more sexual symptoms. Among 304 patients treated with monotherapy who completed the trial, total symptoms distress scores of treatment groups did not differ from each other in change from baseline to week 24, but in particular, problems of maintaining an erection were significantly worsened with propranolol therapy. Among 177 patients treated with monotherapy plus a diuretic, total sexual symptoms distress scores worsened among the groups taking methyldopa or propranolol, with significant worsening in all individual symptoms among patients taking propranolol, and problems in maintaining an erection and in ejaculation among patients receiving methyldopa. Among patients treated with captopril plus a diuretic, no change from baseline appeared in scores for any of the sexual symptoms. The findings underline the importance of taking an adequate sexual history and document that selection of antihypertensive drugs may significantly affect the incidence of sexual symptoms. PMID- 3281620 TI - Diuretics and hypertension in black adults. AB - A randomized controlled, single-blind trial was conducted to compare the effectiveness of a high-dose diuretic with a combination of a diuretic and metoprolol in black adults with hypertension. All subjects were first treated with 50 mg/d of hydrochlorothiazide for four weeks. Only subjects with a diastolic blood pressure of 95 mm Hg or higher at the end of this four-week period entered the randomized trial. We hypothesized that black patients with uncontrolled hypertension and low plasma renin activity on usual-dose hydrochlorothiazide therapy (ie, 50 mg/d) would respond better to higher doses of hydrochlorothiazide (ie, 100 to 150 mg/d) than to a usual-dose diuretic and metoprolol. Diuretic-metoprolol combination therapy was significantly more effective than high-dose diuretic therapy regardless of plasma renin status. PMID- 3281621 TI - Microalbuminuria and increased plasma prorenin. Prevalence in diabetics followed up for four years. AB - When urinary albumin excretion was measured by radioimmunoassay, most diabetics excreted more albumin than nondiabetic subjects. Microalbuminuria was defined as an albumin excretion greater than 30 mg/g of urinary creatinine, more than twice the upper limit of normal. Intermittent microalbuminuria was found in 20% of patients with insulin-dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes mellitus (NIDDM). Continuous microalbuminuria occurred in a similar percentage of patients with NIDDM, but less frequently in patients with IDDM. Rigorous control of glycemia was followed by cessation of microalbuminuria in nearly half of these patients. Microalbuminuria was associated with an increased incidence of other microvascular complications, as well as a distinctly higher plasma prorenin value in IDDM. Hypertension of 160/100 mm Hg or above was accompanied by increased albumin excretion and lower plasma prorenin values than in normotensive diabetics. PMID- 3281622 TI - Hyperthyroidism following hypothyroidism. Data on six cases. AB - Hypothyroidism complicated by spontaneous hyperthyroidism is an interesting but rare occurrence in the spectrum of autoimmune thyroid disorders. We report data on six patients who had hyperthyroidism two to 20 years (mean, eight years) after the diagnosis of hypothyroidism. In three patients, triiodothyronine toxicosis accounted for the hyperthyroid symptoms. The presence of thyroid antibodies and lymphocytic infiltration in the thyroid gland points to an autoimmune mechanism. It is believed that this phenomenon occurs more often than is recognized. PMID- 3281624 TI - What is a case? A 45-year study of psychiatric impairment within a college sample selected for mental health. AB - Six different models for assessing psychiatric impairment were applied to 188 men who had been studied prospectively for half a century. The six models were categorical DSM-III diagnosis by a senior psychiatrist; objective evidence of impairment in working and loving; relative maturity of ego mechanisms of defense; the Health Sickness Rating Scale; the Global Assessment Scale (Axis V of DSM-III R); and a "research" scale designed to provide a consensual definition of "caseness." As a test of predictive validity of our impairment measures, assessments before the age of 50 years were used to predict psychosocial adjustment and physical health assessed 15 years later. All six models were highly intercorrelated and proved equally effective in predicting future impairment. Procedures to establish construct validity suggested that the presence of a DSM-III diagnosis was a valid categorical definition of case, and that Axis V of DSM-III-R was a valid dimensional measure of impairment. PMID- 3281625 TI - The reliability of the family history method for psychiatric diagnoses. AB - We evaluated the test-retest interrater reliability of the Family History Research Diagnostic Criteria (FH-RDC) in 58 depressed patients who described 341 first-degree relatives. Reliability was examined as a function of the threshold to determine caseness. In general, diagnostic reliability was good-excellent for specific FH-RDC disorders, but not for the residual category of other psychiatric disorder. A higher diagnostic threshold was associated with greater reliability, especially for the diagnosis of depression. Patient variance accounted for a greater percentage of the disagreements between the interviewers than did rater variance. PMID- 3281623 TI - Regeneration of the cell wall in protoplasts of Candida albicans. A cytochemical study using wheat germ agglutinin and concanavalin A. AB - To assess the dynamics of synthesis of the wall by regenerating Candida albicans protoplasts deposition of chitin and mannoproteins were investigated ultrastructurally using wheat germ agglutinin conjugated with either horseradish peroxidase or colloidal gold, and Concanavalin A coupled to ferritin respectively. Freshly prepared protoplasts lacked wheat germ agglutinin receptor sites but after 1-2 h of regeneration, they were detected. After 4-5 h of regeneration, the cell wall showed a discrete structure which was only labelled with wheat germ agglutinin in thin sections. At this stage of regeneration the outermost layer of the wall was labelled with clusters of Concanavalin A-ferritin particles. After 8 h regeneration, the cell wall appeared compact, and homogenously marked with wheat germ agglutinin whereas only the surface layers appeared consistently labelled with Concanavalin A-ferritin. From these observations we conclude that C. albicans protoplasts are able to regenerate in liquid medium a cell wall consisting of a network of chitin fibrils and mannoproteins at least (glucan polymers were not determined in the present cytological study). The former are the fundamental component of the inner layers at early stages of regeneration, whereas the latter molecules are predominant in the outer layers of the wall. PMID- 3281626 TI - Outcome and familial psychopathology in schizophrenia. AB - We examine whether the variation in outcome in schizophrenia is associated with differences in familial psychopathology. We begin with a methodologically oriented review of the large number of previous studies that have addressed this question. Although some trends are evident, the findings are variable. Most of the studies have important methodologic limitations. We then examine the relationship between short-term outcome and four dimensions of long-term outcome in 253 DSM-III schizophrenics and psychiatric illness in their 723 first-degree relatives. No relationship is found between any dimension of outcome in schizophrenics and risk in their relatives for schizophrenia, all nonaffective psychoses, bipolar illness, or anxiety disorder. A marital outcome of divorce was strongly associated with a family history of alcoholism. Good long-term marital, residential, and occupational outcomes were positively correlated with the risk for unipolar illness in relatives. These results do not support the hypothesis that poor outcome schizophrenia is the "genetic" form of the disorder. However, they are compatible with the hypothesis that the liability to affective illness may influence outcome in schizophrenia. PMID- 3281627 TI - What is a case? Food for thought for epidemiologists. PMID- 3281629 TI - A survey of the accuracy of chemical analyses in clinical laboratories. By William P. Belk and F. William Sunderman, 1947. PMID- 3281628 TI - Familial aggregation of schizophrenia and schizophrenia spectrum disorders. Evaluation of conflicting results. AB - In this issue, Coryell and Zimmerman report no significant increase in the risk of schizophrenia or "schizophrenia spectrum" personality disorders in relatives of schizophrenics vs never-ill controls. This article attempts to evaluate critically and interpret their findings. Given the modest number of relatives studied, their negative findings regarding schizophrenia could easily be the result of sampling variation. Relatives were assessed using a general personality disorder instrument, and over two thirds were interviewed by telephone; this method may have a low sensitivity to detect key features of the schizophrenia spectrum such as inadequate rapport and suspiciousness. True population differences may, however, exist in the pattern of familial aggregation for schizophrenia and related disorders. The convincing demonstration of this would be of considerable interest and should lead to a constructive search for the source of the interpopulation differences. PMID- 3281631 TI - Documentation of myofascial trigger points. AB - Two basic diagnostic features of myofascial trigger points (TPs), namely, local tenderness and alteration of tissue consistency (such as in taut bands, muscle spasm), can be documented quantitatively by simple hand-held instruments. A pressure threshold meter (algometer) assists in location of TPs and their relative sensitivity. A side-to-side difference exceeding 2kg in comparison with normal values indicates pathologic tenderness. The effect of treatment can be quantified. Pressure tolerance, measured over normal muscles and shin bones, expresses pain sensitivity. Myopathy is suspected if muscle tolerance drops below bone tolerance. Tissue compliance measurement documents objectively and quantitatively alteration in soft tissue consistency. Muscle spasm, tension, spasticity, taut bands, scar tissues, or fibrositic nodules can be documented. The universal clinical dynamometer is used as part of a physical examination to quantify weakness. Thermography (heat imaging) demonstrates discoid shaped hot spots over TPs. Muscle activity, spasm, or contraction is visualized as increased heat emission in the shape of the active muscle. PMID- 3281630 TI - The Medicare and Clinical Laboratories Improvement Act of 1967 proficiency testing requirements and its relationship to the private sector. AB - The Health Care Financing Administration of the US Department of Health and Human Services is the federal agency that has the responsibility for the administration of the Medicare and Clinical Laboratories Improvement Act of 1967 programs, including the promulgation of standards for clinical laboratories. The Health Care Financing Administration has been working with the Centers for Disease Control of the US Public Health Service to develop uniform standards for proficiency testing programs for the two regulatory programs. The current standards were developed on the premise that a combination of factors, including personnel standards, record-keeping, management requirements, quality control standards, and external quality assurance measures such as proficiency testing, could be used to make decisions on reimbursing facilities for tests or to allow a facility to test in interstate commerce. These programs were regulatory in nature and provided punitive actions for failure to comply with the standards established for participation or licensure. The provision of consultation and training was not the primary focus of the program, even if it was a desirable outcome. The private sector organizations and the regulated industry, on the other hand, viewed their programs as designed for educational and self improvement purposes rather than for any regulatory or punitive functions. Therefore, the approaches for the regulatory agencies and the professional community have differed. PMID- 3281632 TI - Cytotoxicity and effects of T2-toxin on plasma proteins involved in coagulation, fibrinolysis and kallikrein-kinin system. AB - The activity of both the coagulation and fibrinolytic systems was markedly depressed 24 h after a sublethal dose of T-2 toxin. T-2 toxin was active as an anticoagulant at low doses, which did not affect the basal state of the animals. The kallikrein-kinin system was also affected by depletion of the prekallikrein, which indicates increased bradykinin levels in plasma. At the same time there was an increased activity of some clinically relevant enzymes in serum, indicating tissue injuries caused by T-2 toxin. All effects observed in this study reached their maximum within 24 h after administration, which corresponds to the time animals usually die when receiving a lethal dose. T-2 toxin does not, however, seem to affect the protease enzymes by reduced protein synthesis, because of early onset of the effects, nor does it act as a trigger itself. The effect of T 2 toxin on plasma protease enzymes is probably secondary to cytotoxic effects in the vascular endothelium. PMID- 3281633 TI - Time-dependent effects of endotoxin on the ultrastructure of aortic endothelium. AB - The aortic endothelium from control and Escherichia coli (E. coli) endotoxin treated rats and rabbits was examined by transmission and scanning electron microscopy. Following the intravenous injection of endotoxin, the animals were sacrificed at intervals ranging from 1 min to 4 hr. As early as 1 min after endotoxin, there was a widening of the subendothelial space (SES) and an increase in tortuosity of the internal elastic lamina (IEL). At 5 min, the tortuosity of the IEL increased to a peak value, and the SES showed an increase in the amount of smooth muscle cells (SMC). Initial endothelial damage occurred 5 min after endotoxin: SEM showed some spindle-shaped endothelial cells starting to peel from the underlying SES, and TEM showed some endothelial cells protruding or arching into the lumen. The new findings in this study are that endotoxin injection a) has a very rapid (less than 15 min) effect on rat and rabbit aortic endothelium, including localized endothelial injuries in the intima, and b) induces ultrastructural alterations also in the SES, IEL and portions of the tunica media. These effects were largely reversed within 1 hr after endotoxin administration, thus indicating that the endothelium and other components of the arterial wall can recover with great speeds. PMID- 3281634 TI - Long-term compatibility of artificial kidneys. PMID- 3281635 TI - Evaluation of beta 2-microglobulin removal with high-performance hemodiafiltration. AB - Several lines of evidence suggest that beta 2-microglobulin (beta 2M) accumulation in long-term hemodialysis (HD) patients results in so-called dialysis-associated amyloidosis (DAA), which is clinically manifested by carpal tunnel syndrome, osteoarthropathy, and the other organ involvements. For the purpose of preventing the beta 2M accumulation, the efficiency of beta 2M removal during (HPM), hemofiltration (HF), HD, and charcoal hemodiafiltration (HDF) with high-performance membranes (HPM), hemofiltration (HF), HD, and charcoal hemoperfusion was evaluated. Among 27 patients treated with these methods, significant beta 2M removal was noted in HDF with HPM and HD with polyacrylonitril (PAN) membrane. However, treatment of HDF with HPM for more than 6 months caused no remarkable improvement in clinical symptoms of patients, and serum beta 2M levels decreased in only two out of 15 patients. These results imply that beta 2M might be most effectively removed by HDF with HPM and HD with PAN membrane, but further long-term studies will be necessary to conclude whether these procedures could become successful therapeutic regimen for DAA. PMID- 3281636 TI - Artificial heart and cardiac transplantation: report on the first European combined procedure. AB - It became necessary to perform a staged procedure by means of total artificial heart followed by cardiac transplantation in a 26-year-old, female patient. The Ellipsoidheart, as an artificial heart, fitted excellently in the chest without compromising the surrounding structures. As soon as the patient recovered with the artificial heart, a consecutive transplantation was performed. This first European clinical experience gained confidence and suggests applying more artificial hearts as a bridge towards transplantation. PMID- 3281637 TI - A double-blind study of the effectiveness of cyclosporine in amyotrophic lateral sclerosis. AB - In a double-blind placebo-controlled trial of cyclosporine in amyotrophic lateral sclerosis, no differences were observed in the monthly rate of progression or the relative risk of progression in comparing 38 patients randomized to the placebo group and 36 patients randomized to the cyclosporine group. In comparing three subgroups of patients, cyclosporine appeared to benefit men who entered the study within 18 months of the onset of first symptoms, whereas it was of no value to women or to men who entered later than 18 months. For the men with recent onset of disease, the relative risk of progression was 0.403; the monthly rate of progression was 5.2 +/- 1.1 points with placebo and 3.5 +/- 0.7 points with cyclosporine. These provocative results support the need for a full study of cyclosporine in men with recent onset of disease. PMID- 3281639 TI - Multicenter trial of cryotherapy for retinopathy of prematurity. PMID- 3281638 TI - The Salpetriere in the wake of Charcot's death. AB - After Charcot died in 1893, the students of his immediate circle did not fare well academically in the French medical system. Fatigue and bitterness toward the authoritarian Charcot may have contributed to the change in the scientific and social ambience of the Salpetriere of Paris in the generation after Charcot died. Clearly, however, the faculty were not invested in energetically overturning the system that Charcot had established, and their choice of Fulgence Raymond as Charcot's successor was an effective means of permitting a passive waning in the Salpetriere's magnetic influence in world neurology. PMID- 3281640 TI - Analysis of the Archives' most frequently cited articles. PMID- 3281641 TI - The effect of removing running sutures on astigmatism after penetrating keratoplasty. AB - To evaluate astigmatic change after removal of the double running sutures used in penetrating keratoplasty, all patients (N = 131) in the Michigan Corneal Transplantation Patient Registry, Ann Arbor, whose eyes were phakic after penetrating keratoplasty were evaluated. The primary reasons for surgery in this group were keratoconus (n = 44, 34%) and Fuchs' corneal dystrophy (n = 19, 15%). The average effect of 10-0 suture removal in 58 eyes with documented keratometry readings was a 0.30-diopter (D) decrease in astigmatism, with 59% showing 2 D or less of astigmatic change. In 83 eyes with keratometry readings before and after 11-0 suture removal, an average increase of 0.37 D of astigmatism was observed, with 81% showing less than 2 D of astigmatic change. In eyes that were highly astigmatic (greater than 6 D) before suture removal, a reduction in astigmatism exceeding 2 D was observed in 39% and 11% after 10-0 and 11-0 suture removal, respectively. PMID- 3281642 TI - Long-term comparison of epikeratoplasty and penetrating keratoplasty for keratoconus. AB - The results of epikeratoplasty for keratoconus in ten patients with long-term follow-up (mean, 25 months; range, 19 to 31 months) vs ten patients with contemporaneous penetrating keratoplasty for keratoconus (mean, 33 months; range, three to 81 months) indicate a similar level of postoperative spectacle visual acuity (20/32 vs 20/27, respectively) and similar refractive and keratometric results. The healing period until achieving best corrected visual acuity averaged 12 months for epikeratoplasty vs three months for penetrating keratoplasty. Compared with penetrating keratoplasty, epikeratoplasty offers the advantages of maintaining an intact globe surgically and postoperatively in a young, active population, while avoiding potential immune rejection. The major disadvantages are a prolonged healing period and undefined limits in the extent of the cone that would define suitable candidates preoperatively. PMID- 3281643 TI - Streptococcal endophthalmitis from contaminated donor corneas after keratoplasty. Clinical and laboratory investigations. AB - We report three cases of Streptococcus viridans endophthalmitis following penetrating keratoplasty in which S viridans was cultured from the recipient eye, McCarey-Kaufman (M-K) media, and corneoscleral rims. As a laboratory correlation, we investigated the ability of S viridans to survive in M-K medium supplemented with gentamicin. After M-K medium was inoculated with S viridans, it was stored overnight at 4 degrees C, after which the temperature was raised to 23 degrees C. Periodic colony counts were performed for up to 24 hours after warming. No killing occurred in the cold. Ten hours passed before there was one log reduction in the bacterial colony count. Organisms could still be cultured at 24 hours. We conclude that gentamicin alone may be inadequate prophlyaxis against S viridans contamination of donor corneas. PMID- 3281644 TI - The role of the veterinarian in the future. PMID- 3281645 TI - G-induced loss of consciousness: definition, history, current status. AB - G-induced loss of consciousness (G-LOC) is defined as "a state of altered perception wherein (one's) awareness of reality is absent as a result of sudden, critical reduction of cerebral blood circulation caused by increased G force." This phenomenon was first identified in Great Britain in World War I (circa 1918 1919) as "fainting in the air." In the United States G-LOC was first encountered in 1922 during the Pulitzer Trophy Air Race. Although recognized during World War II as an operational hazard for fighter aircraft, the invention of the pneumatic anti-G suit reduced concern about G-LOC at that time. A 1984 survey of pilots of high performance aircraft has shown G-LOC to be an operational problem--probably one that has caused aircraft mishaps for several years. The concern of this panel was to focus on various approaches in reducing the G-LOC hazard. PMID- 3281646 TI - Prevention of loss of consciousness with positive pressure breathing and supinating seat. AB - Maintaining vision and consciousness at high sustained +Gz requires a total body effort for most people, and is very fatiguing. Currently, the only pieces of operational G-protective equipment are the anti-G suit and anti-G valve which provide relaxed G-tolerance protection to about 5.5 G. Protection above 5.5 G requires the anti-G straining maneuver (AGSM). Assisted positive pressure breathing (APPB) has been shown to augment sustained +Gz tolerance and reduce the amount of straining necessary to maintain a specific +Gz level. Moreover the supinating seat has been shown to double relaxed G tolerance at a back angle of 75 degrees from the vertical when compared to relaxed tolerance at a 13 degree or 30 degree position. Problems of cockpit engineering, escape, head-rest angle, restricted rear visibility, and pilot acceptance of a high angle supinated seat may preclude the use of a seat with sufficient back angle to provide "no strain" G protection. Thus, the addition of APPB to a limited protective seat may provide adequate and acceptable G tolerance. PMID- 3281647 TI - Potential crashworthiness benefits to general aviation from Indianapolis Motor Speedway technology. AB - General aviation crashworthiness can potentially benefit from certain advances being accomplished by the automobile industry. Progressive improvements in crash protection technology, as documented by a dramatic reduction in crash injuries and fatalities at the Indianapolis Motor Speedway, reflect improved crashworthiness. The speeds of survivable general aviation aircraft impacts are in the range of the Indianapolis Motor Speedway crashes (200-220 mph). This paper relates the declining crash death rates at Indy by decade versus the increase in speeds. The continuous rise in speeds has prompted the development of new crashworthy designs and driver protection equipment. Crashworthiness improvements include crushable surrounding structures, high-grade restraint systems, protective head gear, fire resistant clothing, break-away structural components, and a "protective cocoon" concept. Adaptation of selected advances in crashworthiness design and operations accomplished at the Indianapolis Motor Speedway to the next generation of general aviation aircraft should provide significant dividends in survival of air crashes. PMID- 3281648 TI - Converging research on +Gz-induced loss of consciousness. AB - The G-induced loss of consciousness (G-LOC) hazard can be reduced either by preventing its occurrence or shortening the period of incapacitation. The latter requires an understanding of this period of incapacitation. Two types of G-LOC occur: Type I is short duration and without convulsive type movements; and Type II is longer and with convulsions. Psychological suppression (denial) by pilots that G-LOC had occurred appears to be an important problem in reporting surveys and flying safety. Auditory and visual types of sensory stimuli to reduce the period of incapacitation are discussed. Recognition by the pilot that G-LOC has occurred appears to decrease incapacitation times and should be considered part of G training. Methods of developing an aircraft recovery system after G-LOC has occurred in pilots is considered a viable approach and is examined. Converging on the G-LOC problem by both, reducing its incidence as well as its duration appears to offer an additional dimension in the approach towards solving this important operational problem. PMID- 3281649 TI - Assisted positive pressure breathing for augmentation of acceleration tolerance time. AB - The addition of assisted (chest counterpressure), positive pressure breathing (APPB) at 50 mm Hg (PPB50) and 70 mm Hg (PPB70) was compared to the current operational support of the G-suit and the anti-G straining maneuver (AGSM) without PPB (PPB0), during acceleration exposures of sustained 9 +Gz for 45 s and a 5-9 +Gz simulated aerial combat maneuver (SACM) to exhaustion. We selected 7 highly motivated male centrifuge subjects from a group of 31 volunteers. Positive pressure breathing was applied to the oronasal cavity with a Royal Air Force P/Q mask. Mask pressure was monitored continuously. Counterpressure was applied to the chest with a Canadian counterpressure garment at the same pressure as the mask. Lower body pressure was provided by a standard USAF G-suit inflated with the standard pressure schedule of 1.5 psi/G after 2.0 G. Positive pressure breathing was provided linearly in proportion to the +Gz level beginning at about 1.2 +Gz and reaching a peak of either 50 or 70 mm Hg (6.7 and 9.3 kPa, respectively) at 9 +Gz. Prepressurization (ready pressure) was used for both PPB (2.1 mm Hg) and G-suit (10.3 mm Hg) inflation. All subjects were monitored for heart rate and rhythm, SaO2 with an ear oximeter, inspired air flow, and rectus femoris electromyogram (EMG). Assisted positive pressure breathing provided a significant (p less than 0.01) increase in mean tolerance time at PPB50 (108%) and PPB70 (88%) compared to PPB0 during the 5-9 SACM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281650 TI - [Usefulness of Salmosyst in concentrating salmonellas from animal fecal samples]. PMID- 3281651 TI - The human macrophage system: activity and functional morphology. AB - Macrophages of humans could be extracted in large numbers from the connective tissue using a newly developed, not particularly difficult method. These macrophages were compared with the peritoneal macrophages of mice using light-, scanning and transmission electron-microscopic methods. The sterility of the cell suspension and the high yield of macrophages has allowed the first in vitro study of histiocytes to take place, in contrast to the classic 'microexudate-coated surface method'. The activity of the human in comparison with peritoneal murine macrophages has been evaluated using numerous histochemical and immunological techniques. These methods prove a modulation of the macrophage activity of healthy humans and mice under exemplary conditions of extremely strenuous physical exercising, in accordance with earlier experimental findings on animals alone. The degenerative changes which occur under these experimental conditions in the skeletal muscular system show an invasion of cells of the immune system, which are integrated into an explanation of the increased activity of macrophages. These results find their place in a new theoretical concept supporting the general validity of the co-operation of macrophages and other cells of the immune system in pathological degeneration and regeneration processes in the skeletal muscular system. It has been shown that the increased activity of human and murine macrophages brought about by extreme strenuous physical exercising, insofar as one is able to order them into a progressive scheme of stress happenings, fit very well into the concepts of the 'alarm reaction' phase. The activity of macrophages proves to be sensitive to the mediators of tumours of mesenchymal origin, with respect to the initial stage of phagocytosis, to the further biochemical deterioration, to the cytotoxicity and to the amount of cells; this, however, is not able to halt the rapid growth of sarcoma in a long term experiment. The proof of a weakened migration of macrophages in sarcoma-bearing animals raises the interest in those substances which are able to positively modulate the migration activity. On the one hand the migratory performance of macrophages in sarcoma-bearing animals in a short-term experiment was increased by the introduction of an anabolic steroid hormone. On the other hand, however, a different degree of success was registered for the further parameters of macrophage activity during short- and long-term experimental investigations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3281652 TI - Interactive properties of calmodulin. PMID- 3281654 TI - Glucocorticoids increase insulin binding and the amount of insulin-receptor mRNA in human cultured lymphocytes. AB - The effect of steroid hormones on insulin binding and the amount of insulin receptor mRNA was examined in IM-9 lymphocytes. Cortisol and cortexolone, but not oestrogen, increased both the binding of insulin and the amount of insulin receptor mRNA in a time- and dose-dependent manner. Cortisol was most potent, and induced a 2-fold increase in insulin binding and a 4-fold increase in mRNA. The elevation in binding was due to an increased number of insulin receptors at the cell surface. The increase in mRNA involved all four of the insulin-receptor mRNAs and could not be inhibited by cycloheximide. The cortisol-induced increase in mRNA was associated with a 3-4-fold increase in the synthesis of pro-receptor. The relative potency of the three steroids indicated that these effects were mediated by an interaction with the glucocorticoid receptor. The results of this study suggest that cortisol can increase the number of insulin receptors at the cell surface by increasing the amounts of insulin-receptor mRNA and the synthesis de novo of insulin receptors. PMID- 3281653 TI - Use of a selectively permeabilized isolated rat hepatocyte preparation to study changes in the properties of overt carnitine palmitoyltransferase activity in situ. AB - 1. A permeabilized isolated rat liver cell preparation was developed to achieve selective permeabilization of the cell membrane to metabolites and to allow the assay of mitochondrial overt carnitine palmitoyltransferase (CPT I) activity in situ. By performing the digitonin-induced permeabilization in the presence of fluoride and bivalent-metal-cation sequestrants, it was possible to demonstrate that the activity of other enzymes, which are regulated by reversible phosphorylation, was preserved during the procedure and subsequent washing of cells before assay. 2. CPT activity at a sub-optimal palmitoyl-CoA concentration was almost totally (approximately 90%) inhibited by malonyl-CoA, indicating that mitochondrial CPT I was largely measured in this preparation. 3. The palmitoyl CoA-saturation and malonyl-CoA-inhibition curves for CPT activity in permeabilized cells were very similar to those obtained previously for the enzyme in isolated liver mitochondria. Moreover, starvation and diabetes had the same effects on enzyme activity, affinity for palmitoyl-CoA and malonyl-CoA sensitivity of CPT I in isolated cells as found in isolated mitochondria. These physiologically induced changes persisted through the cell preparation and incubation period. 4. Neither incubation of cells with glucagon or insulin nor incubation with pyruvate and lactate before permeabilization resulted in alterations of these parameters of CPT I in isolated cells. 5. The results are discussed in relation to the temporal relationships of changes in the activity and properties of CPT I in vivo in relation to the effects of insulin and glucagon on fatty acid metabolism in vivo. PMID- 3281655 TI - Effects of a phorbol ester and clomiphene on protein phosphorylation and insulin secretion in rat pancreatic islets. AB - The potentiation of glucose-stimulated insulin release induced by 100 nM-12-O tetradecanoylphorbol 13-acetate (TPA) was inhibited by clomiphene, an inhibitor of protein kinase C (PK C), in a dose-dependent manner. Clomiphene at concentrations up to 50 microM had a modest inhibitory action (27%) on insulin release stimulated by 10 mM-glucose alone, but had no effect on the potentiation of insulin release induced by forskolin. Islet PK C activity, associated with a particulate fraction, was stimulated maximally by 100 nM-TPA. This stimulation was blocked by clomiphene in a dose-dependent manner, with 50% inhibition at 30 microM. Incubation of intact islets with TPA after preincubation with [32P]Pi and 10 mM-glucose to label intracellular ATP resulted primarily in enhanced phosphorylation of a 37 kDa protein (mean value, +/- S.E.M., 36,700 +/- 600 Da; n = 7). This increased phosphorylation was blocked by the simultaneous inclusion of clomiphene. Subcellular fractionation revealed the presence of the 37 kDa phosphoprotein in a 24,000 g particulate fraction of islet homogenates. Neither clomiphene nor TPA affected the rate of glucose oxidation by islets. These results show that the phosphorylation state of a 37 kDa membrane protein parallels the modulation of insulin release induced by TPA and clomiphene and support a role for PK C in the insulin-secretory mechanism. PMID- 3281657 TI - Purification and characterization of a novel NADPH(NADH)-dependent hydroxypyruvate reductase from spinach leaves. Comparison of immunological properties of leaf hydroxypyruvate reductases. AB - A novel hydroxypyruvate reductase preferring NADPH to NADH as a cofactor was purified over 1500-fold from spinach leaf extracts. The enzyme was an oligomer of about 70 kDa, composed of two subunits of 38 kDa each. The Km for hydroxypyruvate (with NADPH) was about 0.8 mM in the pH range 5.5-6.5, and 0.3 mM at pH 8.2. The Vmax. was highest in the pH range 5.5-6.5 and decreased by about 65% at pH 8.2. Above pH 6.0, the enzyme was prone to a strong substrate inhibition by hydroxypyruvate. The reductase could use glyoxylate as an alternative substrate, with rates up to one-quarter of those with hydroxypyruvate. This glyoxylate dependent activity preferred NADPH to NADH as a cofactor. Rabbit antibodies prepared against NADPH(NADH)-hydroxypyruvate reductase were highly specific for this enzyme and did not cross-react with peroxisomal NADH(NADPH)-dependent hydroxypyruvate reductase, as found by Western immunoblots of proteins from leaf extracts of spinach, pea and wheat. Antibodies raised against purified NADH(NADPH)-hydroxypyruvate reductase were also highly specific, recognizing only their own antigen. To our knowledge, this is the first report in the literature of the occurrence of NADPH(NADH)-hydroxypyruvate reductase in leaves, and the first to provide immunological comparison of leaf hydroxypyruvate reductases. Because of the relatively high rates of the novel reductase in leaf extracts (at least 20 mumol/h per mg of chlorophyll), this enzyme might be an important side component of the glycollate pathway (photorespiration), possibly utilizing hydroxypyruvate 'leaked' from peroxisomes, and thus contributing to the glycerate pool derived from glycollate. Because of the glyoxylate-dependent activity, the enzyme may also contribute to glycollate formation in leaves. PMID- 3281656 TI - Phorbol esters imitate in rat fat-cells the full effect of insulin on glucose carrier translocation, but not on 3-O-methylglucose-transport activity. AB - Tumour-promoting phorbol esters have insulin-like effects on glucose transport and lipogenesis in adipocytes and myocytes. It is believed that insulin activates the glucose-transport system through translocation of glucose transporters from subcellular membranes to the plasma membrane. The aim of the present study was to investigate if phorbol esters act through the same mechanism as insulin on glucose-transport activity of rat adipocytes. We compared the effects of the tumour-promoting phorbol ester tetradecanoylphorbol acetate (TPA) and of insulin on 3-O-methylglucose transport and on the distribution of D-glucose-inhibitable cytochalasin-B binding sites in isolated rat adipocytes. Insulin (100 mu units/ml) stimulated 3-O-methylglucose uptake 9-fold, whereas TPA (1 nM) stimulated the uptake only 3-fold (mean values of five experiments, given as percentage of equilibrium reached after 4 s: basal 7 +/- 1.3%, insulin 60 +/- 3.1%, TPA 22 +/- 2.3%). In contrast, both agents stimulated glucose-transporter translocation to the same extent [cytochalasin B-binding sites (pmol/mg of protein; n = 7): plasma membranes, basal 6.2 +/- 1.0, insulin 13.4 +/- 2.0, TPA 12.7 +/- 2.7; low-density membranes, basal 12.8 +/- 2.1, insulin 6.3 +/- 0.9, TPA 8.9 +/- 0.7; high-density membranes, 6.9 +/- 1.1; insulin 12.5 +/- 1.0, TPA 8.1 +/- 0.9]. We conclude from these data: (1) TPA stimulates glucose transport in fat-cells by stimulation of glucose-carrier translocation; (2) insulin and TPA stimulate the carrier translocation to the same extent, whereas the stimulation of glucose uptake is 3-fold higher with insulin, suggesting that the stimulatory effect of insulin on glucose-transport activity involves other mechanisms in addition to carrier translocation. PMID- 3281658 TI - The presence and origin of phosphopeptides in human saliva. AB - The presence of phosphopeptides in whole saliva (saliva expectorated from the mouth) was demonstrated and their origin was evaluated. Whole saliva contained much larger numbers of small phosphopeptides than are found in the glandular secretions. Most of these originated from the acidic proline-rich proteins (PRPs) in the major salivary glands and were formed, after secretion into the oral cavity, as a result of rapid degradation by proteolytic enzymes from extraglandular sources contained in sediment from whole saliva. Some peptides may have been formed by cleavage of basic PRPs, but other phosphoproteins apparently contributed little to the observed phosphopeptides. Most of the enzymes that produced phosphopeptides are serine proteinases. The gel-electrophoretic band patterns of the phosphopeptides obtained from 26 individuals of various acidic PRP phenotypes were remarkably similar, demonstrating that the enzymes responsible were generally present in the population surveyed and that similar cleavages occur regardless of the nature of the acidic PRPs. Many of these peptides were N-terminal proteolytic cleavage products of acidic PRPs. The N terminal phosphorylated region of acidic PRPs contains various biological activities, such as inhibition of hydroxyapatite formation, calcium binding and binding to hydroxyapatite, the major mineral of teeth. The demonstration of these phosphopeptides in the saliva that is in contact with the oral surface may therefore be of biological importance. PMID- 3281659 TI - Purification and regulatory properties of isocitrate lyase from Escherichia coli ML308. AB - Isocitrate lyase was purified to homogeneity from Escherichia coli ML308. Its subunit Mr and native Mr were 44,670 +/- 460 and 17,000-180,000 respectively. The kinetic mechanism of the enzyme was investigated by using product and dead-end inhibitors of the cleavage and condensation reactions. The data indicated a random-order equilibrium mechanism, with formation of a ternary enzyme-isocitrate succinate complex. In an attempt to predict the properties of isocitrate lyase in intact cells, the effects of pH, inorganic anions and potential regulatory metabolites on the enzyme were studied. The Km of the enzyme for isocitrate was 63 microM at physiological pH and in the absence of competing anions. Chloride, phosphate and sulphate ions inhibited competitively with respect to isocitrate. Phosphoenolpyruvate inhibited non-competitively with respect to isocitrate, but the Ki value suggested that this effect was unlikely to be significant in intact cells. 3-Phosphoglycerate was a competitive inhibitor. At the concentration reported to occur in intact cells, this metabolite would have a significant effect on the activity of isocitrate lyase. The available data suggest that the Km of isocitrate lyase for isocitrate is similar to the concentration of isocitrate in E. coli cells growing on acetate, about one order of magnitude higher than the Km determined in vitro in the absence of competing anions. PMID- 3281660 TI - C-terminal peptide identification by fast atom bombardment mass spectrometry. AB - A previously described technique [Rose, Simona, Offord, Prior, Otto & Thatcher (1983) Biochem. J. 215, 273-277] permits the identification of the C-terminal peptide of a protein as the only peptide that does not incorporate any 18O upon partial enzymic hydrolysis in 18O-labelled water. Formation of chemical derivatives followed by combined g.l.c.-m.s. was used in this earlier work. We now describe the isolation from protein digests, by reversed-phase h.p.l.c., of labelled and unlabelled polypeptides and their direct analysis by fast atom bombardment mass spectrometry. Under the conditions used, the 18O label is retained throughout the separation and analysis, thus permitting assignments of C terminal peptides to be made. Enzyme-catalysed exchange of label into the terminal carboxy group was found to occur in some cases without hydrolysis of a peptide bond. This effect, which may be exploited to prepare labelled peptides, does not prevent application of the method (two separate digests must then be used). We have applied our method to the analysis of enzymic partial hydrolysates of glucagon, insulin and of several proteins produced by expression of recombinant DNA. PMID- 3281661 TI - Rapid inhibition by intragastric triolein of the re-activation of glucose utilization and lipogenesis in the mammary gland during the starved-refed transition in lactating rats. Evidence for a direct effect of oral lipid on mammary tissue. AB - 1. Oral administration of triacylglycerol (triolein) to starved/chow-refed lactating rats suppressed the lipogenic switch-on in the mammary gland in vivo. 2. A time-course study revealed that triolein, administered at 30 min after the onset of refeeding, had no influence on lipogenic rate in the mammary gland between 30 and 60 min, but markedly decreased it between 60 and 90 min. Glucose uptake by the mammary gland (arteriovenous difference) increased by 30 min of refeeding, as did lactate production. Between 30 and 90 min glucose uptake remained high in the control animals, but glucose uptake and net C3-unit uptake were decreased in the triolein-loaded animals by 90 min. 3. Triolein increased [glucose 6-phosphate] in the gland and simultaneously decreased [fructose 1,6 bisphosphate], indicative of a decrease in phosphofructokinase activity. This cross-over occurred at 60 min, i.e. immediately before the inhibition of lipogenesis, and by 90 min had reached 'starved' values. 4. Triolein had no effect on plasma [insulin] nor on whole-blood [glucose], [lactate] or [3 hydroxybutyrate]; a small increase in [acetoacetate] was observed. 5. Infusion of the lipoprotein lipase inhibitor, Triton WR1339, abolished the suppression of mammary-gland lipogenesis by triolein and the increase in the [glucose 6 phosphate]/[fructose 1,6-bisphosphate] ratio, suggesting a direct influence of dietary lipid on mammary-gland glucose utilization and phosphofructokinase activity. PMID- 3281662 TI - Effects of insulin on glucose transport and glucose transporters in rat heart. AB - The effect of insulin on glucose transport and glucose transporters was studied in perfused rat heart. Glucose transport was measured by the efflux of labelled 3 O-methylglucose from hearts preloaded with this hexose. Insulin stimulated 3-O methylglucose transport by: (a) doubling the maximal velocity (Vmax); (b) decreasing the Kd from 6.9 to 2.7 mM; (c) increasing the Hill coefficient toward 3-O-methylglucose from 1.9 to 3.1; (d) increasing the efficiency of the transport process (k constant). Glucose transporters in enriched plasma and microsomal membranes from heart were quantified by the [3H]cytochalasin-B-binding assay. When added to normal hearts, insulin produced the following changes in the glucose transporters: (a) it increased the translocation of transporters from an intracellular pool to the plasma membranes; (b) it increased (from 1.6 to 2.7) the Hill coefficient of the transporters translocated into the plasma membranes toward cytochalasin B, suggesting the existence of a positive co-operativity among the transporters appearing in these membranes; (c) it increased the affinity of the transporters (and hence, possibly, of glucose) for cytochalasin B. The data provide evidence that the stimulatory effect of insulin on glucose transport may be due not to the sole translocation of intracellular glucose transporters to the plasma membrane, but to changes in the functional properties thereof. PMID- 3281663 TI - The chemical characterization of the radioactive products derived from [[3H]PheB1]insulin in the circulation of the rat. AB - 1. Gel filtration of rat plasma taken 1 h after subcutaneous injection of [[3H]PheB1]insulin gives three peaks of radioactivity. 2. The material in these peaks was characterized by electrophoresis and chromatography. 3. We conclude that [[3H]PheB1]insulin is rapidly degraded to free tritiated phenylalanine. The phenylalanine is subsequently used for synthesis of plasma proteins de novo. PMID- 3281664 TI - Isolation, amino acid analyses and refolding of subunits of pig heart succinyl CoA synthetase. AB - For the first time, pig heart succinyl-CoA synthetase has been refolded from its isolated subunits after denaturation. Amino acid analyses of pig heart succinyl CoA synthetase and its subunits were performed. Subunits were isolated by gel filtration in neutral 6 M-urea. The amino acid composition of the native enzyme bears a strong resemblance to that of the Escherichia coli enzyme. Application of the various methods for comparing amino acid compositions [Cornish-Bowden (1983) Methods Enzymol. 91, 60-75] shows that the degree of relatedness between the alpha-subunits of the pig heart and E. coli enzymes and between the beta-subunits of the two synthetases is intermediate between 'strong' and 'weak'. As for the E. coli synthetase, it is unlikely that the alpha-subunit arises from the larger beta-subunit by post-translational modification. The pig heart enzyme contains a single tryptophan residue, which is located in the beta-subunit. Excitation of the enzyme at 295 nm resulted in a typical tryptophan emission spectrum. Refolding of enzyme denatured in 6 M-guanidine hydrochloride or of alpha- and beta-subunits isolated in this solvent required the presence of either ethylene glycol or glycerol, optimally at 20-25% (v/v). GTP-Mg2+ did not stimulate reactivation of the enzyme, in contrast with the result obtained with ATP-Mg2+ in the reconstitution of the enzyme from E. coli. Yields of 60% and 40% were obtained in the refolding of denatured enzyme and isolated subunits respectively. The fluorescence spectrum of the refolded protein was essentially the same as that of native enzyme. Unrecovered activity could not be accounted for in the form of protein aggregates. The specific activity of refolded enzyme that had been separated from inactive protein on a Bio-Sil TSK 250 column was the same as that of native enzyme. Km values for GTP of 27 microM and 14 microM were determined for native and refolded enzyme respectively. PMID- 3281665 TI - Properties of guinea-pig kidney 25-hydroxyvitamin D3 1 alpha-hydroxylase assayed by isotope dilution-mass spectrometry. AB - 1. A highly specific and accurate method based on isotope dilution-mass spectrometry was used for characterization of the renal 25-hydroxyvitamin D3 1 alpha-hydroxylase in untreated guinea pigs with a normal vitamin D status. In previous work, the properties of the enzyme had been determined in rachitic animals only. 2. With intact mitochondria, the reaction required the presence of citric acid-cycle intermediates. The uncoupler carbonyl cyanide p trifluoromethoxyphenylhydrazone had an inhibitory effect on the isocitrate supported reaction, indicating that energy-dependent transhydrogenation is of importance. Mitochondrial respiratory-chain inhibitors (cyanide, rotenone, antimycin A) had no effect on the hydroxylation. CO had an inhibitory effect, suggesting participation of a species of cytochrome P-450 in the reaction. A fraction solubilized from mitochondria by cholate became catalytically active in 1 alpha-hydroxylation of 25-hydroxyvitamin D3 after addition of ferredoxin and ferredoxin reductase. The isocitrate-supported reaction catalysed by crude mitochondria had an apparent Km of about 1 microM. 3. An atmosphere containing 50% O2 was found to be necessary for optimal activity. It is thus possible that O2 may be a limiting factor under normal conditions in vivo. 4. The results demonstrate that the mammalian renal 25-hydroxyvitamin D3 1 alpha-hydroxylase is a cytochrome P-450-dependent mixed-function oxidase with properties similar to those previously reported for the same enzyme system in chicken. The present assay and animal system seem to be suitable for further studies on the mechanism of regulation of the mammalian renal 25-hydroxyvitamin D3 1 alpha-hydroxylase under conditions when the vitamin D status is normal. PMID- 3281666 TI - Phosphate modification of fructose-1,6-bisphosphate aldolase in Escherichia coli. AB - When E. coli carrying multicopy plasmids for fructose-1,6-P2 aldolase or phosphoglycerate kinase was grown in the presence of 32Pi, there was label at the position of cognate high level polypeptide after SDS-PAGE. As tested for aldolase, the label was resistant to acetone, RNase, and hot TCA treatments, and was also observed by immunoprecipitation, which was competed for by purified aldolase. Incorporation of label also occurred in the presence of chloramphenicol. Immunoprecipitation revealed apparent aldolase labeling in the wild type strain as well. PMID- 3281667 TI - Role of associated and covalently bound lipids in salivary mucin hydrophobicity: effect of proteolysis and disulfide bridge reduction. AB - The hydrophobic properties of salivary mucus glycoprotein were investigated by fluorescence spectroscopy using bis(8-anilino-1-naphthalene-sulfonate). The mucin, purified from rat submandibular salivary gland, was subjected to removal of associated and covalently bound lipids, degradation with pronase, and reduction with beta-mercaptoethanol, and titrated with the probe. Analyses of fluorescence data revealed the presence of 49 +/- 5 hydrophobic binding sites in the intact mucin molecule, a 69% increase in the number of binding sites occurred following extraction of associated lipids, while the removal of covalently bound fatty acids caused a 25% decrease in the binding sites. Proteolytic destruction of the nonglycosylated regions of the glycoprotein essentially abolished the probe binding, whereas reduction produced glycoprotein subunits whose combined number of hydrophobic binding sites was 2.4 times greater than that of mucus glycoprotein polymer. The results suggest that associated and covalently bound lipids contribute to hydrophobic characteristics of salivary mucin and that the hydrophobic binding sites reside on the nonglycosylated regions of this glycoprotein buried within its core. PMID- 3281668 TI - Anomalous insulin-binding activity in the bovine neural retina: a possible mechanism for regulation of receptor binding specificity. AB - Crude membrane from the bovine neural retina contains one IGF-I and two insulin binding sites. Although both insulin binding sites have a high affinity for insulin (IC50 = 0.1 and 7.0 nM), only one exhibits "classical" specificity and binds insulin with higher affinity than IGF-I. The second insulin binding site is "non-classical" in that it has an equal affinity for IGF-I and insulin. Retinal IGF-I binding exceeds insulin binding by a factor of 10-20. Despite this high level of IGF-I binding it is unlikely that non-classical insulin binding represents insulin binding to an IGF-I receptor because 1) anomalous binding is 30 times greater than that predicted from cross-specificity, 2) low concentrations of unlabeled IGF-I increase IGF-I binding to the IGF-I binding site but do not increase IGF-I binding to the non-classical insulin binding site and 3) the IGF-I receptor's affinity for insulin (and IGF-I) increases greatly during receptor purification. In contrast, the insulin affinity of the non classical insulin binding site is largely unaffected by this process. Although receptor solubilization and purification had no effect on the insulin receptor's affinity for insulin, it did markedly increase this site's affinity for IGF-I. Thus, the major proportion of purified retinal "insulin receptors" have a higher affinity for IGF-I than insulin. The evidence presented here is consistent with the view that the bovine retina contains one IGF-I and two insulin binding sites and that a detergent-sensitive factor regulates IGF-I affinity of both classes of binding sites. PMID- 3281669 TI - Different processing of Alzheimer's beta-protein precursor in the vessel wall of patients with hereditary cerebral hemorrhage with amyloidosis-Dutch type. AB - Hereditary cerebral hemorrhage with amyloidosis in patients of Dutch origin is an autosomal-dominant type of amyloidosis restricted to the small vasculature of the brain and clinically characterized by recurrent strokes. Amyloid fibrils from the leptomeninges of two patients were isolated and the primary structure determined. The complete sequence of the amyloid protein shows homology to the vascular (beta protein) and plaque amyloid (A4-protein) obtained from Alzheimer's Disease. However, it is three residues shorter (39 instead of 42) than that reported for the plaque amyloid. The difference at the carboxy terminal may reflect specific degradation that occurs in the vessel wall and not in the brain parenchyma. PMID- 3281670 TI - A pancreatic-type phospholipase A2 in rat gastric mucosa. AB - A phospholipase A2, which is immuno-crossreactive with the anti-rat pancreatic phospholipase A2 antibody, is present in rat gastric mucosa. The content of the enzyme in the gastric mucosa was comparable to that in the pancreas, but the specific activity in the gastric mucosa homogenate (60.7 +/- 19.5 nmol/min/mg) was higher than that in the pancreas homogenate (3.16 +/- 0.77 nmol/min/mg). A greater proportion of the enzyme was found in the particulate fraction. The gastric enzyme and its proenzyme were purified from the supernatant. The amino acid sequence of the N-terminal 15 residues of the gastric enzyme was determined and found to be identical with that of rat pancreatic phospholipase A2. Like the pancreatic proenzyme, the gastric proenzyme was activated on trypsin treatment. PMID- 3281671 TI - Chronic stimulation of human fetal pancreas with phorbol inhibits insulin secretion. AB - Acute exposure to agents that activate protein kinase C is known to cause insulin release both from the fetal and adult pancreas. These experiments were designed to test the effect of chronic exposure of the human fetal pancreas to such agents. Nine to twelve days after commencement of culture of this tissue, exposed to 0.165-1.3 microM 12-O-tetradecanoylphorbol-13-acetate, insulin secretion was reduced and remained less than that for controls thereafter. Exchange of the test for the control medium resulted in partial recovery of insulin release. Insulin content of the treated explants was also significantly reduced. The insulinogenic response to an acute challenge of either 20 mM glucose or 10 mM theophylline/2.8 mM glucose at the end of the culture was no different from that for controls. PMID- 3281672 TI - Glucose-induced oscillations of cytoplasmic Ca2+ in the pancreatic beta-cell. AB - The cytoplasmic calcium concentration (Ca2+i) was measured in individual mouse pancreatic beta-cells loaded with fura-2 by recording the 340/380 nm fluorescence excitation ratio. An increase of the glucose concentration from 3 to 20 mM, caused initial lowering of Ca2+i followed by a rise with a peak preceding constant elevation at an intermediary level. However, at 11 mM glucose there were large Ca2+i oscillations with a frequency of 1 cycle per 2-6 min. The results indicate that both first and second phase secretion depend on elevated Ca2+i, and that many electrically coupled cells collectively determine the pace of rhythmic depolarization. PMID- 3281673 TI - Accumulation of processing intermediates of the RAS2 protein in strain 112 of Saccharomyces cerevisiae. AB - Strain 112 (RAS1 RAS2) contains a naturally occurring mutation which significantly retards processing of the RAS2 gene product. This mutation, resulting in the accumulation of precursor forms of RAS2 protein, has been assigned by genetic analysis to a single chromosomal locus distinct from the RAS2 locus. In addition to the known precursor molecule of 41000 daltons (p41), 112 cells accumulate within the soluble fraction an intermediate form of RAS2 (p40 1), which migrates, in SDS-polyacrylamide gel, between p41 and the fully processed, membrane-bound 40,000 daltons (p40) product. We propose for RAS2 protein processing the following sequence of events: p41 greater than p40-1 greater than p40 where p40-1 represents a RAS2 intermediate required for the targeting of the protein to the plasma membrane. PMID- 3281674 TI - The infusion of trieicosapentaenoyl-glycerol into humans and the in vivo formation of prostaglandin I3 and thromboxane A3. AB - Thirty ml of an emulsion containing 3 g of trieicosapentaenoyl-glycerol (90% pure, containing 5% arachidonic acid (AA)) was infused intravenously in 2 male healthy volunteers. Urine samples were collected for 24 h before and 48 h after the infusion in 5 periods. Urinary metabolites of prostaglandin (PG) I2/3 and thromboxane (TX) A2/3 (PGI2/3-M and TXB2/3-M, respectively) were extracted from the urinary samples and measured by GC-MS. Excretion of PGI3-M was markedly enhanced right after the infusion. Because PGI3 was produced without involvement of intestinal absorption of eicosapentaenoic acid (EPA), enhanced PGI3 formation was strongly suggested to take place in the vasculature. From the marked increment in TXB2/3-M after the infusion it was calculated that conversion rate of EPA to TXA3 was 8% of that of AA to TXA2 in this in vivo condition. PMID- 3281675 TI - Identification of epidermal growth factor in mouse abdominal effusion. AB - Epidermal growth factor (mEGF)-like immunoreactive material(s) was identified in mouse abdominal effusion (approximately 2.1 ng/mg protein) by our enzyme immunoassay (EIA) for mEGF. This material(s) and mEGF from the submaxillary glands of male mice were virtually equivalent with respect to the molecular weight and the antigenicity. Also, on isoelectric focusing analysis, the mEGF like material(s) identified in abdominal effusion gave a major peak at pH 4.2 and a minor one at pH 4.5. These results demonstrate that the mEGF-like material(s) found in abdominal effusion is a molecule identical to mouse submaxillary gland EGF. Further we found that sialoadenectomy did not cause a marked decrease in the level of mEGF in abdominal effusion, suggesting that the source of mEGF found in abdominal effusion is other than the submaxillary glands. PMID- 3281676 TI - Glucose-induced increase of potassium in pancreatic beta-cells associated with reduced mobilization of the ion. AB - The potassium contents of beta-cell-rich pancreatic islets from ob/ob-mice were measured with an integrating flame photometer. After exposure to 5 mM glucose islet potassium increased by 17 +/- 2%, no additional effect being seen with increase of the sugar to 20 mM. Glucose counteracted the loss of islet potassium obtained on removal of the ion from the incubation medium, halving the initial disappearance rate. Whereas the effect of glucose in suppressing the mobilisation of potassium was mimicked by tolbutamide and quinine, it was antagonized by diazoxide. It is concluded that the glucose interference with the outward transport of K+ is sufficient to raise the beta-cell content of the ion. PMID- 3281677 TI - Differential effects of inflammation models on rat T-kininogen and rat angiotensinogen. AB - The effect of different experimental models of inflammation on plasma concentrations of T-kininogen and angiotensinogen was examined in the rat. T kininogen, a major phase protein which inhibits cysteine proteinase is increased in all cases of induced inflammation: administration of lipopolysaccharide and turpentine, bilateral nephrectomy or sham-operation and intraperitoneal injection of peanut oil. Angiotensinogen, the renin-substrate, is increased by lipopolysaccharide but is decreased by turpentine. Sham-operation or peanut oil injection have no effect on angiotensinogen whereas, bilateral nephrectomy and dexamethasone increase its concentration. Therefore, angiotensinogen is regulated differently than T-kininogen during inflammation. PMID- 3281678 TI - Physiochemical characterization of cardiovascular calcified deposits. I. Isolation, purification and instrumental analysis. AB - Calcified human aortic atherosclerotic deposits and calf ventricular assist device bioprosthetic deposits were isolated and deproteinated by hydrazine treatment. Detailed chemical and instrumental analyses were applied to gain comprehensive physicochemical information which makes possible establishing compositional and structural similarities between the 2 types of pathologic mineral deposits which form on different host surfaces. These microcrystalline deposit materials are morphologically very heterogeneous and can be represented chemically as carbonate substituted apatite which, in some of its properties, significantly differs from hydroxyapatite. It is indicated that the mechanism for the formation of cardiovascular deposits proceeds through hydrolysis of octacalcium phosphate precursor. PMID- 3281679 TI - Plasma lipid lowering activity of acipimox in patients with type II and type IV hyperlipoproteinemia. Results of a multicenter trial. AB - A multicenter study was carried out in 130 out-patients to assess the plasma lipid lowering activity of acipimox in type IIa, IIb and IV hyperlipoproteinemia. The study consisted of two periods, an 8-week randomized, double-blind comparison of active drug versus placebo and a 16-week open follow-up with acipimox (400 mg and 250 mg t.i.d., respectively, in type II and IV patients). During the double blind phase acipimox, compared to placebo, showed a highly significant triglyceride lowering effect in type IV patients (-43% vs. +4%, P less than 0.01), while reducing plasma cholesterol significantly in type II patients (-7% vs. -3%, P less than 0.05). Further reductions in plasma lipids were obtained in both types of hyperlipoproteinemia after the 16-week follow-up. In type II patients, total cholesterol fell by 9% in the former acipimox group and 17% in the former placebo group, whereas a 34% reduction in triglycerides was found in type IV patients previously treated with placebo. Treatment had to be discontinued in 4 patients during the double-blind phase and in 5 patients during follow-up, because of adverse events such as skin reactions and gastric disturbances. Statistical analysis of hematological and biochemical variables expressing safety did not show any significant change during treatment. PMID- 3281680 TI - The central nervous system and atherogenesis: endothelial injury. AB - Although it has been widely acknowledged that endothelial injury is an important contributing factor to the pathogenesis of atherosclerosis, and may even represent an initiating event, morphologic documentation of its occurrence both in humans and animals has been difficult to obtain. However, electrical stimulation of the lateral hypothalamus in conscious, unrestrained animals on normal diets induces severe endothelial damage with cell loss and denudation in both aortas and coronary arteries. Continued stimulation results in intimal lesions with features of atherosclerotic plaques. The mechanism by which stimulation leads to endothelial injury is discussed and involves the induction of vasospasm. These observations are considered in the light of recent clinical and epidemiological studies, in which the role of neuropsychological and behavioral responses to psychosocial stimuli have been considered important risk factors for the development of atherosclerosis. PMID- 3281681 TI - Pulmonary embolization of needle fragments resulting from intravenous drug abuse. AB - We present two case reports of central embolization of needle fragments as a complication of intravenous drug abuse. In both cases the needle embolization occurred from a peripheral venous site to the right distal pulmonary vasculature. No attempts at removal were made. No complications developed as a result of these needle emboli. PMID- 3281682 TI - Cephalic tetanus: a case report and review of the literature. AB - Cephalic tetanus is a rare form of tetanus defined as trismus plus paralysis of one or more cranial nerves. The most frequently involved cranial nerve is the seventh. It accounts for 1 to 3% of the total number of reported cases of tetanus and has a mortality of 15 to 30%. The incubation period is 1 to 14 days, and approximately two thirds of cases progress to generalized tetanus. The mechanism of the paralysis is not completely understood. Treatment involves debridement of wounds, administration of penicillin and tetanus immune-globulin, aggressive supportive care, and initiation of active immunization. PMID- 3281683 TI - Isolated axial volvulus of a Meckel's diverticulum. AB - A 3.5-year-old boy presented twice within 36 hours to an emergency department with worsening abdominal distress. At surgery, an isolated axial volvulus of a Meckel's diverticulum was found. This finding has been reported three times in the last 20 years and has involved only adult patients. Meckel's diverticulum, although uncommon, can be extremely serious. Its presentation and pathophysiology are reviewed. PMID- 3281684 TI - Acute hydrofluoric acid exposure. AB - Significant local and systemic toxicity may occur from hydrofluoric acid by all routes of exposure. Prompt decontamination by removal from the source and copious irrigation of eyes and skin are essential to reduce morbidity and mortality. Ingestion of small amounts of HF can lead to rapid systemic poisoning and death. Calcium gluconate therapy has become the preferred method of detoxifying the fluoride ion, although its efficacy is based mainly on anecdotal reports and poorly controlled clinical studies. Therefore, more basic research is needed to elucidate the pathophysiology of local toxicity and the best therapeutic modalities to limit injury. All significant exposures should be evaluated by health care personnel familiar with the potential toxicity of this compound. PMID- 3281685 TI - Cerebral preservation during cardiac arrest. PMID- 3281686 TI - Meckel's diverticulum. AB - Meckel's diverticulum is a cause of significant morbidity and mortality. Often this is related to the delay in diagnosis. Based on a US population of 200 million people and a 2% incidence, there are 4 million Meckel's diverticula present waiting to cause symptoms. Considering that most Meckel's diverticula are asymptomatic and that many authors have described the condition as a great mimic, the diagnosis is often quite elusive. Therefore, a high index of suspicion is needed to diagnose Meckel's diverticulum correctly and expeditiously as the source of disease in the patient with an often unclear abdominal presentation. The difficulty with diagnosis should be lessened if one considers that Meckel's diverticulum presents largely in the male and younger age groups with the three major symptom complexes of bowel obstruction, gastrointestinal bleeding, and inflammation. Use of 99mTc pertechnetate scintigraphy appears to be the diagnostic study of choice if Meckel's diverticulum is suspected and the patient is clinically stable. When one considers the potential for bad outcome if Meckel's diverticulum is missed in the setting of possible obstruction or hemorrhage (i.e., bowel infarction or exsanguination), a high index of suspicion and diagnostic aggressiveness is warranted. Lastly, if one thought is to be left behind, it should be: "Meckel's is a great mimic that must be considered in all cases of intra-abdominal disease in which the cause is not readily apparent." PMID- 3281687 TI - The mental status evaluation. Application in the emergency department. AB - The mental status evaluation is a useful test in the emergency department. The major purposes of the examination are to determine the presence of neuropsychiatric illness and to determine whether this illness is functional or organic. The most accepted evaluation of mental status is the formal mental status evaluation. This extensive test is rarely necessary in the emergency department; rather a short test of cognitive function, such as the Cognitive Capacity Screening Examination or Mini-Mental Status Examination, may be more appropriate. With frequent repetition in use and the concomitant development of clear standards for interpretation of the examination used, the emergency physician will become more comfortable with bedside mental status testing. PMID- 3281688 TI - Environmental medicine: an annotated bibliography of the recent literature. PMID- 3281690 TI - Sonographic evaluation of the rotator cuff: correlation with arthroscopy. AB - High-resolution real-time sonography has been reported as a non-invasive means of evaluating the integrity of the rotator cuff. Fifty-two patients underwent both sonographic and arthroscopic evaluation of the rotator cuff. There were 42 men and 10 women with an average age of 47 years (range 28-71 years). The duration of shoulder pain averaged 24 months (range 3 months to 9 years). Thirty-five rotator cuff tears were noted arthroscopically. Twenty-seven of the tears were diagnosed by sonography for a sensitivity rate of 77%. Eleven of the 17 intact rotator cuffs were normal by sonography for a specificity rate 65%. The overall accuracy of sonography was 73% and the predictive value of a positive sonogram was 82%. Sonography appears to be a good initial screening examination in evaluating the integrity of the rotator cuff. It is noninvasive and relatively inexpensive. Technical limitations of this technique as well as the experience of the radiologist in performing and interpreting the examination play a major role in the accuracy of this test. As instrumentation improves and as experience in using this technique increases, we expect the accuracy of sonography in detecting tears of the rotator cuff to continue to improve. PMID- 3281689 TI - History of the Arthroscopy Association of North America, its origin and growth: Part II. PMID- 3281691 TI - Applications of multivariate analysis in diagnostic cytology. AB - Three multivariate methods for structure simplification (cluster analysis, principal component analysis and factor analysis) and three multivariate methods for prediction (discriminant analysis, analysis of variance and regression analysis) are discussed and contrasted, along with basic descriptive statistics for multivariate data. These methods are only a subset of the multivariate methods currently in use, but include those that have thus far been applied in diagnostic cytology. Multivariate analyses provide a basis for describing and analyzing large complex data sets and, with the enormous amounts of data becoming available, their applications in many areas of diagnostic cytology must surely increase. PMID- 3281692 TI - Applications of statistical analysis in diagnostic histopathology and cytopathology. AB - Corresponding to the rapid increase in the amount of data available for use in clinical diagnoses, there is an increased need for procedures that can provide the diagnostician with meaningful statistical summaries of data and with statements concerning the statistical significance associated with a diagnostic evaluation. It has been demonstrated that multivariate statistical assessment of clinical material can provide consistent, reliable and highly sensitive diagnostic clues, even in instances in which trained personnel are unable to see any change. Several examples of applications of statistical analyses in diagnostic cytology and histopathology are given in this paper. The examples were chosen to be illustrative of the different types of problems for which statistical analyses have been found useful. These problems differ with respect to the extent of the statistical methods thus far developed and the difficulty involved in developing further analyses. For many problems, appropriate statistical analyses are readily available; other problems require definition of custom-made test statistics and, in some cases, also definition of new statistical distributions. The problems discussed here are only a small sample of the existing problems, but they provide at least an indication of the scope of the role that statistics plays in cytopathologic and histopathologic diagnosis. PMID- 3281693 TI - Double dissociations of the effects of amygdala and insular cortex lesions on conditioned taste aversion, passive avoidance, and neophobia in the rat using the excitotoxin ibotenic acid. AB - The results in this article show that although electrolytic amygdala lesions disrupt learning of a conditioned taste aversion (CTA), ibotenic acid-induced, axon-sparing lesions of the amygdala do not. However, ibotenic acid lesions of the insular cortex do disrupt learning of a CTA. Electrolytic, but not ibotenic acid lesions of the amygdala, interrupt axons running between the insular (gustatory) cortex and the brain stem/hypothalamus. It is the destruction of these projections which appear to underly CTA deficits after amygdala lesions. Other results revealed that ibotenic acid lesions of the insular cortex attenuated the reaction to the novel taste of saccharin in a familiar environment but failed to affect the ingestion of a novel food in a novel environment or passive avoidance learning. Conversely, ibotenic acid lesions of the amygdala did not affect the reaction to novel saccharin in a familiar environment but did impair both the reaction to novel food in a novel environment and passive avoidance learning. We conclude that the insular cortex is involved in reactions to the novelty and associative salience exclusively of taste stimuli, whereas the amygdala is probably more concerned with the reaction to more general aspects of novelty in the environment and in fear-motivated behavior. PMID- 3281694 TI - Effects of superior colliculus lesions on rats' orienting and detection of neglected visual cues. AB - Superior colliculus lesions generally result in a deficit in visual orienting described as sensory neglect. This observation was confirmed in this study: Rats with lesions did not orient to some stimuli that intact rats readily oriented to. However, rats with lesions did orient to stimuli that the intact rats treated as more salient. Also, when the less salient stimuli signaled aversive stimulation, the rats with lesions detected these stimuli. These findings suggest that superior colliculus lesions do not affect the detection of visual stimuli that have been neglected. PMID- 3281695 TI - History of the AAP. PMID- 3281696 TI - Long-term utilization and charges among post-rehabilitation stroke patients. AB - This paper presents longitudinal charge data on 89 former stroke rehabilitation patients discharged from three Boston area rehabilitation facilities. Medical charges are presented on initial acute and rehabilitation inpatient stays and on care received in the 12 months after discharge. In the sample of 89 stroke patients, charges exceeded four million dollars excluding physician fees and out of-pocket expenses. Of this total, 23% was for acute hospital care preceding rehabilitation (mean = 18 days), 52% for inpatient rehabilitation (mean = 55 days), 13% for rehospitalizations in the 12 months after discharge from rehabilitation (mean = 22 days) and 12% for a variety of outpatient services. PMID- 3281697 TI - Necrotizing otitis externa due to Aspergillus in an immunocompetent patient. AB - An 85-year-old, nondiabetic man is described with necrotizing (malignant) otitis externa. The patient developed facial nerve paralysis in the presence of a progressive cellulitis and chondritis of the external auditory meatus. Destruction of the bony meatus and mastoid and obliteration of normal soft-tissue planes at the skull base were documented by computed tomographic scans. Aspergillus fumigatus was isolated from the external meatus and deep tissue specimens. Fungal invasion of bone and soft tissue was confirmed histopathologically. Pseudomonas aeruginosa was never isolated. This case is unusual from both the standpoint of etiology and host susceptibility in that the patient had no apparent underlying disease. Amphotericin B and rifampin therapy following radical mastoidectomy halted the progression of disease. Finally, this case illustrates the pitfalls of empiric antibacterial therapy for necrotizing otitis externa without cultural confirmation of the etiologic agent. PMID- 3281698 TI - Hexose metabolism in pancreatic islets: regulation of mitochondrial hexokinase binding. AB - A major fraction of hexokinase was found to be bound, presumably to mitochondria, in both normal and tumoral rat pancreatic islet cells examined after either mechanical disruption or digitonin treatment. Spermidine enhanced the binding and glucose 6-phosphate caused the release of hexokinase to and from islet mitochondria, in a manner comparable to that seen in parotid or brain homogenates. In hepatocytes, some hexokinase, but no glucokinase, was found in the bound form. In islet cells, however, the pattern of glucokinase binding was similar to that of hexokinase. It is speculated that the preferential location of both hexokinase and glucokinase on mitochondria may favor the maintenance of a high cytosolic ATP content in islet cells. PMID- 3281699 TI - Atrioventricular block complicating acute streptococcal tonsillitis. AB - A 38 year old woman presented with severe weakness, high fever, and sore throat. Physical examination showed follicular tonsillitis and bradycardia caused by a atrioventricular block. Within 24 hours a normal sinus rhythm was regained but slight transient ST-T changes compatible with myocarditis were evident. Throat culture grew Streptococcus haemolyticus group A. PMID- 3281700 TI - Differential effects of neuromuscular blocking agents on suxamethonium-induced fasciculations and myalgia. AB - The effect of pretreatment with suxamethonium, gallamine or pancuronium on suxamethonium-induced fasciculations and myalgia was studied in a controlled, randomized and double-blind clinical trial. Both fasciculations and myalgia were assessed on a four-point rating scale. There was no significant correlation between fasciculations and postoperative muscle pain at 24, 48 or 72 h, and pretreatment with suxamethonium had no significant effect on fasciculations or myalgia. Gallamine had a more marked effect on fasciculations than pancuronium, and the decrease in the fasciculation score was statistically significant. In contrast, pancuronium had a greater effect on myalgia, and decreased postoperative muscle pain significantly at 24 and 48 h. These differences may reflect the differential activity of gallamine and pancuronium at the neuromuscular junction. Pretreatment had little or no effect on plasma potassium concentrations. PMID- 3281701 TI - Clonidine premedication for isoflurane-induced hypotension. Sympathoadrenal responses and a computer-controlled assessment of the vapour requirement. AB - The effect of single-dose clonidine premedication on the vapour requirement for isoflurane-induced hypotension in patients undergoing middle ear or nasal surgery was evaluated in an open, controlled, randomized study. Inspired isoflurane concentration was regulated by a microcomputer-based, self-tuning control program when hypotension was required. Patients given clonidine 0.6 mg by mouth 2 h before operation required a mean inspired isoflurane concentration of 2.0% to induce hypotension (mean intra-arterial pressure 50 mm Hg) compared with 3.01% in the control group (P less than 0.05). Five out of 10 patients in the control group required a supplementary dose of labetalol 5 mg i.v. to achieve satisfactory hypotension, compared with one of 10 patients given clonidine premedication (Fisher's exact probability, 0.07). A mean concentration of 1.4% isoflurane was required to maintain hypotension in the clonidine group, compared with 2.3% in the control group (P less than 0.01). Plasma adrenaline and noradrenaline concentrations did not increase during induced hypotension in each group. PMID- 3281703 TI - The importance of the coal tar bath in the Ingram treatment of psoriasis. Evaluation by evaporimetry and laser Doppler flowmetry. AB - The contribution of the tar component to the efficacy of the Ingram regimen in the treatment of psoriasis was assessed in 11 patients with symmetrical lesions on the upper extremities. One arm was immersed in an oil emulsion bath and the other in a coal tar bath. Whole body ultraviolet irradiation followed, and dithranol paste was applied to all lesions. Healing was assessed clinically at weekly intervals, and was found to parallel the normalization of transepidermal water loss (TEWL) as determined by evaporimetry, and the dermal blood flow as evaluated by laser Doppler flowmetry. Results obtained with coal tar baths were not significantly different from those obtained with oil emulsion. We conclude that coal tar bath additive has no advantage over oil emulsion in the Ingram regimen. PMID- 3281702 TI - Antiemetic efficacy of high-dose dexamethasone: randomized, double-blind, crossover study with a combination of dexamethasone, metoclopramide and diphenhydramine. AB - A double-blind, randomized, crossover study was conducted to compare the efficacy and safety of high-dose dexamethasone (Protocol D) with a combination of dexamethasone, metoclopramide and diphenhydramine (Protocol DMD) in the management of chemotherapy-induced nausea and vomiting in cancer patients. All entered patients had received no prior chemotherapy. During the study chemotherapy was administered on an inpatient basis. The majority of patients (94%) were treated with cytotoxic drugs of significant emetogenic activity and 40% of the study group received cis-platin-containing combinations. Of the 60 evaluable patients, complete antinausea and antivomiting effects of D were observed in 30 (50%) and 34 (57%), respectively and of DMD in 17 (28%) and 26 patients (43%) respectively. The difference was not statistically significant (P = 0.09 and 0.24, respectively). Lack of significant difference between the two regimens was demonstrated irrespective of the administered cytotoxic drugs. The DMD protocol caused more adverse reactions than D. While 27 patients (45%) experienced no side effects from D, only 14 (24%) remained free of complications due to DMD (P = 0.001). Furthermore, DMD produced more sedation, insomnia, headache, diaphoresis, dizziness and diarrhoea than the D regimen. In addition it gave rise to more adverse effects on appetite and activity. Upon direct questioning, 37 patients (62%) expressed a preference for D, 14 (23%) preferred DMD and 9 (15%) found no difference between the two regimens. We conclude that, while the short DMD protocol has an antiemetic activity equivalent in its effectiveness to D, its associated adverse reactions would minimize its usefulness. Therefore, further investigations should be conducted to find a safer and more potent combination of antiemetics suitable for therapy in an outpatient setting. PMID- 3281704 TI - A study of the role of house dust mite in atopic dermatitis. AB - Subjects with positive skin-prick tests to house dust mite (HDM) solution, including those with and without atopic dermatitis, participated in a double blind, controlled study of the role of HDM exposure in the pathogenesis of atopic dermatitis. HDM solution and diluent control were applied daily to mildly eczematous or clinically uninvolved skin of the antecubital or popliteal fossae, without prior abrasion, for 5 days. Responses were assessed by a clinical grading system and by measurement of area of dermatitis; pruritus was recorded on visual analogue scales. The clinical grading system showed that marked or moderate delayed local reactions developed in one third of patients with atopic dermatitis in response to HDM application to both mildly eczematous and clinically uninvolved skin. Relative to control sites, significant increases in area of dermatitis and degree of pruritus were also recorded in response to HDM application to mildly eczematous sites. Application of HDM solution to normal, unabraded skin of prick test positive subjects without a history of dermatitis, produced pruritus and immediate urticarial responses which were not seen at control sites, findings which demonstrate that HDM antigen may be rapidly absorbed in normal skin. Application of vehicle or antigen solution to which subjects were negative on prick testing, produced no significant local reactions. This study provides objective evidence for a role for cutaneous HDM exposure in the pathogenesis of atopic dermatitis. PMID- 3281705 TI - A second bone marrow transplant for acute myeloid leukaemia after transplantation for aplastic anaemia. PMID- 3281707 TI - Congenital divided naevus of the eyelids. AB - A newborn infant presenting with a divided congenital melanocytic naevus of the eyelid is described. Because of the severe disfigurement, risk of later malignant change in the lesion, and the possibility of deprivation amblyopia, early surgical treatment is recommended for all medium and large congenital melanocytic naevi of the eyelid. Surgery in the first few months of life gives the best cosmetic results. PMID- 3281706 TI - Topical silver sulphadiazine--a new drug for ocular keratomycosis. AB - The efficacy of silver sulphadiazine in human keratomycosis has not been evaluated so far. Encouraged by the success of an earlier experimental trial, a prospective, controlled, randomised double masked clinical study was designed to evaluate the efficacy of 1% silver sulphadiazine ophthalmic ointment in 20 eyes of mycotic keratitis. Miconazole 1% was used for comparative evaluation in another 20 eyes. Silver sulphadiazine had a higher success rate (80% vs 55%) than miconazole. It had broad antifungal activity and was found to be effective in fusarium keratitis. Absence of side effects, economy, and its efficacy in deeper and extensive lesions were additional advantages. It is concluded from this study that silver sulphadiazine is a safe and effective broad spectrum antifungal agent which can be used for the treatment of human keratomycosis. PMID- 3281708 TI - Effect of preoperative fusidic acid on the normal eyelid and conjunctival bacterial flora. AB - A randomised trial comparing the topical application of 1% fusidic acid with 0.3% gentamicin solution in the reduction of the normal preoperative lid and conjunctival microbial flora was performed. Forty patients awaiting cataract surgery were randomly divided into two groups consisting of 20 patients each. The first group received a 1% microcrystalline suspension of fusidic acid, the second 0.3% gentamicin to the preoperative eye every two hours between 0600 and 2400 daily for 48 hours preoperatively. Cultures were obtained from both the lid margins and the conjunctival sac of both groups prior to antibiotic therapy and again in the operating theatre before surgery. Microbiological identification and colony counts were performed by standard laboratory methods. Staphylococcus epidermidis was the commonest micro-organism isolated. Statistical analysis revealed no significant differences in the ability of a 1% microcrystalline suspension of fusidic acid and 0.3% gentamicin in eliminating or reducing the normal preoperative conjunctival or lid flora. PMID- 3281709 TI - Blindness from quinine toxicity. AB - We report a case of quinine overdose in a 47-year-old man who presented with blindness. Fundus photography demonstrates the acute and subsequent retinal changes, and his visual recovery to normal acuity with visual field constriction is documented. Pupillary and electrodiagnostic findings are recorded. Stellate ganglion block has been widely advocated as a helpful therapeutic measure, but out patient was treated with a unilateral stellate ganglion block without apparent benefit to that eye. From a review of the literature we believe that quinine produces its effects by toxicity on the retina rather than by vasoconstriction and that stellate ganglion block probably does not alter the natural history of the retinal toxicity. PMID- 3281710 TI - Effectiveness of a decontamination method for donor corneas. AB - A retrospective study was made of the effectiveness of an eye bank decontamination and storage method. A comparison was made between microbial cultures taken from the limbus at enucleation and from scleral remnants recovered after surgery. Organisms were isolated from the limbus of 73% of donor eyes and from 4% of remnants. Standard eye bank procedures were found to eradicate gut and skin organisms, including candida, from donor tissue. PMID- 3281711 TI - Solubilization and reconstitution of proline carrier in Escherichia coli; quantitative analysis and optimal conditions. AB - Proline carrier of Escherichia coli was extracted from the carrier-overproducing membranes with dodecylmaltoside in the presence of phospholipid. The solubilized carrier showed the same proline binding activity as that in normal membranes. As judged from determinations of the binding activity in the micellar state as a marker of active carrier and the radioactivity of N-[ethyl-2-3H]ethylmaleimide labeled carrier as a marker of carrier polypeptide, 80% of the carrier molecules in the membranes were extracted. Optimal conditions for reconstitution of the solubilized carrier were established. By a combination of freeze-thawing, sonication and dilution procedures, 70% of the solubilized carrier molecules were incorporated into proteoliposomes and the restored active transport of proline showed an apparent Kt of 1 microM and turnover number of 0.6 s-1. The transport of proline was driven by a membrane potential in a Na+ (or Li+)-dependent manner. PMID- 3281712 TI - Human muscle glutathione S-transferase (GST-4) shows close homology to human liver GST-1. AB - Human muscle specific glutathione S-transferase (RX: glutathione R-transferase, EC 2.5.1.18) (GST-4) and liver GST-1 have been purified and subjected to N terminal sequence analysis. These two isozymes show close homology and only differ in 3 residues within the first 24. The N-terminal sequences of GST-1 and GST-4 differ significantly from those of GST-2 and GST-3. Although antiserum raised against native GST-1 did not cross-react with GST-4, cross-reactivity was obtained with antiserum raised against denatured GST-1. The homology between GST 1 and GST-4 indicates that they are both members of the mu evolutionary class. PMID- 3281713 TI - Site-directed mutagenesis of citrate synthase; the role of the active-site aspartate in the binding of acetyl-CoA but not oxaloacetate. AB - Asp-362, a potential key catalytic residue of Escherichia coli citrate synthase (citrate oxaloacetate-lyase [pro-3S)-CH2COO- ----acetyl-CoA), EC 4.1.3.7) has been converted to Gly-362 by oligonucleotide-directed mutagenesis. The mutant gene was completely sequenced, using a series of synthetic oligodeoxynucleotides spanning the structural gene to confirm that no additional mutations had occurred during genetic manipulation. The mutant gene was expressed in M13 bacteriophage and produced a protein which migrated in an identical manner to wild-type E. coli citrate synthase on SDS-polyacrylamide gels and which cross-reacted with E. coli citrate synthase antiserum. The mutant gene was subsequently recloned into pBR322 for large scale purification of the protein, and the resulting plasmid, pCS31, used to transform the citrate synthase deletion strain, W620. The mutant enzyme purified in an analogous manner to wild-type E. coli citrate synthase and expressed less than 2% of wild-type enzyme activity. The activity of the partial reactions catalysed by citrate synthase was similarly affected suggesting that this residual activity may be due to contaminating wild-type enzyme activity. The mutant citrate synthase retains a high-affinity NADH-binding site consistent with the protein preserving its overall structural integrity. Oxaloacetate binding to the protein is unaffected by the Asp-362 to Gly-362 mutation. Binding of the acetyl-CoA analogue, carboxymethyl-CoA, could not be detected in the mutant protein indicating that the lack of catalytic competence is due primarily to the inability of the protein to bind the second substrate, acetyl-CoA. PMID- 3281714 TI - Conformation and proteolysis of glucagon and insulin in surfactant and lipid solutions. AB - The effects of micelles of nonionic, zwitterionic, anionic and cationic surfactants and lipids on the conformation of glucagon and insulin have been investigated by circular dichroism and intrinsic protein fluorescence. The influence of these amphipathic compounds on the hydrolysis, monitored by HPLC, of glucagon and insulin by trypsin and chymotrypsin has also been studied. The alpha helix content of glucagon was increased to a similar extent by all the micelles, irrespective of their charge and of whether they were synthetic surfactants or phospholipids. The amphipathic compounds always induced a blue-shift in the wavelength of maximum emission of fluorescence of glucagon of about 9 nm, whereas the fluorescence intensity was increased in some cases and decreased in others. The circular dichroism of insulin was also modified in some cases. Some amphipathic compounds protected glucagon against proteolysis by trypsin and chymotrypsin very markedly, whereas others did not protect at all or only slightly protected the hormone. Two hypotheses have been formulated to explain the different results. Hydrolysis of insulin was generally not influenced by surfactants and lipids. PMID- 3281715 TI - Effects of acute sodium omission on insulin release, ionic flux and membrane potential in mouse pancreatic B-cells. AB - The effects of acute omission of extracellular Na+ on pancreatic B-cell function were studied in mouse islets, using choline and lithium salts as impermeant and permeant substitutes, respectively. In the absence of glucose, choline substitution for Na+ hyperpolarized the B-cell membrane, inhibited 86Rb+ and 45Ca2+ efflux, but did not affect insulin release. In contrast, Li+ substitution for Na+ depolarized the B-cell membrane and caused a Ca2+-independent, transient acceleration of 45Ca2+ efflux and insulin release. Na+ replacement by choline in the presence of 10 mM glucose and 2.5 mM Ca2+ again rapidly hyperpolarized the B cell membrane. This hyperpolarization was then followed by a phase of depolarization with continuous spike activity, before long slow waves of the membrane potential resumed. Under these conditions, 86Rb+ efflux first decreased before accelerating, concomitantly with marked and parallel increases in 45Ca2+ efflux and insulin release. In the absence of Ca2+, 45Ca2+ and 86Rb+ efflux were inhibited and insulin release was unaffected by choline substitution for Na+. Na+ replacement by Li+ in the presence of 10 mM glucose rapidly depolarized the B cell membrane, caused an intense continuous spike activity, and accelerated 45Ca2+ efflux, 86Rb+ efflux and insulin release. In the absence of extracellular Ca2+, Li+ still caused a rapid but transient increase in 45Ca2+ and 86Rb+ efflux and in insulin release. Although not indispensable for insulin release, Na+ plays an important regulatory role in stimulus-secretion coupling by modulating, among others, membrane potential and ionic fluxes in B-cells. PMID- 3281716 TI - Complications of concurrent lithium and electroconvulsive therapy: a review of clinical material and theoretical considerations. AB - Several anecdotal reports and two retrospective chart reviews have examined complications of concurrent lithium and electroconvulsive treatment. Discussions have generally been contradictory or confusing. This article reviews the literature and particularly emphasizes theoretical considerations and mechanisms, concluding (A) that lithium may act synergistically with neuromuscular blockers, but the effect is not clinically significant, and (B) that repeated electroconvulsive seizures may cause a toxic delirium in patients concurrently taking lithium. PMID- 3281717 TI - Topographic maps of brain electrical activity--pitfalls and precautions. AB - Topographic mapping of brain electrical activity is a popular, powerful, and potentially misleading technique. The map lies at the end of a long chain of physiological, technical, electronic, and mathematical processes and is vulnerable to artifact, error, and distortion at many points. Close attention must be paid to data collection parameters, subject cooperation, minimization of artifact, limitations of resolutions, selection, and transformation of parameters for display, and map generation strategy to yield an accurate, physiologically interpretable map. Review of the data at each step of analysis, from the paper electroencephalogram (EEG) to sets of maps on video display, may be necessary for optimum understanding. Development of more sophisticated qualitative and quantitative concepts of "normal" physiology is needed. These improvements in electrophysiological data analysis demand, rather than obviate, sophistication on the part of the user. PMID- 3281718 TI - Treatment of recurrent unipolar major depression with captopril. PMID- 3281720 TI - Expression of ABH and X (Lex) antigens on platelets and lymphocytes. AB - We used a panel of reagents, polyclonal and monoclonal antibodies, and lectins to define the expression of the ABH- and Lewis-related specificities on platelets and lymphocytes. We also determined the expression of the alpha 2- and alpha 3-L fucosyltransferases necessary for their biosynthesis. The antigens that could be detected by immunofluorescence and Western blot analysis were based on type 2 monofucosylated structures. Antibodies directed toward types 1, 3, and 4 ABH-, X- and Lewis-related antigenic determinants were always negative because the small amounts of ABH and Lewis antigens adsorbed from the serum could not be detected by these techniques. The presence of the type 2 ABH antigens on intrinsic glycoproteins was controlled by the H gene. This correlates with the presence of alpha 2-L-fucosyltransferase and the absence of alpha 3-L-fucosyltransferase on platelets. In contrast, ABH antigens were not detected by immunofluorescence on normal peripheral lymphocytes. These cells thus have only the small amounts of antigens adsorbed from the serum, these being under control of the secretor and Lewis genes. This correlates with the absence of alpha 2-L-fucosyltransferase on lymphocytes. When lymphocytes were transformed in vitro by the Epstein-Barr virus (EBV), however, they strongly expressed the X and sialylated X antigens, which are specific markers of normal granulocytes and monocytes, respectively. Treatment of EBV-transformed lymphoblastoid cell lines with 12-O tetradecanoylphorbol-13-O-acetate significantly decreased the expression of X and sialylated X antigens along with that of surface immunoglobulins, whereas it induced a significant expression of the H antigen under control of the H gene. PMID- 3281719 TI - Immunohistochemical characterization of two new monoclonal antibodies (LN-4, LN 5) reactive with human macrophage subsets and derived malignancies in B5-fixed, paraffin-embedded tissues. AB - Two monoclonal antibodies (LN-4, LN-5) reactive to human macrophages in B5 formalin-fixed, paraffin-embedded tissue sections have been produced by using deparaffinized cell extracts of peripheral blood mononuclear cells. Both monoclonal antibodies were initially identified on paraffin-embedded sections of hyperplastic lymph nodes by using the immunoperoxidase staining procedure. Specificity screens on normal human tissues show that LN-4 and LN-5 stain the cytoplasm of macrophages and histiocytes in hematopoietic organs including Kupffer's cells of the liver and Langerhans' cells of the skin. LN-4 also showed strong positivity with acini of the stomach, whereas LN-5 was positive with mantle zone B lymphocytes of the lymph node and spleen, spermatogonia, and chief cells of the stomach. Both antibodies were strongly reactive with cases of true histiocytic lymphoma but, except for infiltrating macrophages, were entirely negative in Hodgkin's disease and non-Hodgkin's lymphomas. In all cases of nodular sclerosis Hodgkin's disease, LN-4 was positive in macrophagelike cells present in the collagen bands surrounding the Hodgkin's lesions. Both monoclonal antibodies were also positive in macrophages and histiocytes present in a variety of benign lymphoid lesions including persistent generalized lymphadenopathy, Gaucher's disease, sinus histiocytosis, and dermatopathic lymphadenopathy. Because of their specificity for human macrophages, and their ability to stain B5 fixed, paraffin-embedded tissues, LN-4 and LN-5 are important new reagents for the diagnosis and classification of malignant and benign histiocytic lesions. PMID- 3281721 TI - Functional dendritic cells are required for transfusion-induced sensitization in canine marrow graft recipients. AB - Untransfused dogs given 9.2 Gy total-body irradiation and hematopoietic grafts from DLA-identical littermate donors uniformly achieve sustained engraftment, whereas dogs given three transfusions (Tx) of whole blood from the intended marrow donor 24, 17 and 10 days pretransplant uniformly reject their graft. Sensitization appears to be mediated by peripheral blood mononuclear cells and can be prevented by prior irradiation of the Tx product with UV light, known to inactivate leukocytes, in particular, cells with accessory function. In the present study we investigated which leukocyte population was responsible for Tx induced sensitization and subsequent marrow graft rejection. Surprisingly, neither monocytes nor macrophages or dendritic cells induced sensitization, and all dogs so treated achieved engraftment; however, all four evaluable dogs transfused with UV-exposed blood to which small numbers of normal dendritic cells (12.5 x 10(3)/kg) were added rejected their marrow graft. Among five dogs given UV-exposed blood and normal monocytes (12.5 x 10(3)/kg) only one rejected its graft, and four achieved sustained engraftment. We conclude that donor dendritic cells are necessary, albeit not sufficient for in vivo sensitization. Sensitization is prevented by elimination or inactivation of dendritic cell. PMID- 3281722 TI - Allogeneic marrow transplantation for children with juvenile chronic myelogenous leukemia. AB - Fourteen children between the ages of 2 and 5 years with juvenile chronic myelogenous leukemia were given cyclophosphamide, total-body irradiation, and marrow transplants. Unmodified marrow was given to six patients who received marrow from HLA-identical siblings and eight patients who received marrow from family members HLA identical for one haplotype but mismatched for one to three loci on the nonshared haplotype. Five patients died of transplant-related complications, and three relapsed at 48, 81, and 1,670 days posttransplant and died of leukemia. Six patients survive in continuous remission from 0.5 to 11.5 years posttransplant. PMID- 3281723 TI - Independent prognostic significance of a nuclear proliferation antigen in diffuse large cell lymphomas as determined by the monoclonal antibody Ki-67. AB - To assess the prognostic significance of the growth fraction in diffuse large cell lymphoma (DLCL), we studied 105 DLCL patients with the monoclonal antibody Ki-67 applied to frozen tissue sections. Ki-67 detects a nuclear antigen associated with cell proliferation not found in resting cells. Ki-67 findings and other clinical prognostic factors were correlated with outcome using univariate and multivariate analyses in the proportional hazards model. High proliferative activity, defined as nuclear Ki-67 expression in greater than 60% of malignant cells (Ki-67 greater than 60), was found to be a strong predictor of poor survival among these patients (P = .003, log-rank). The 19 patients with Ki-67 greater than 60% had a median survival of 8 months compared with a median survival of 39 months for the 86 patients with Ki-67 less than or equal to 60%. Examination of pretreatment clinical variables indicated the patient groups were similar with regard to age, sex, stage, B symptoms, tumor bulk, and lactate dehydrogenase (LDH). Both patient groups received comparable curative intent therapy and showed comparable complete response rate precluding treatment differences as modifying outcome. Multivariate analysis indicated Ki-67 is an independent predictor of survival (multivariate P = .006). Further statistical analysis using only B-cell DLCL patients treated with CHOP (63 patients) indicated that Ki-67 greater than 60 retained strong prediction of poor outcome (P = .002, log-rank) among this homogeneous group. We conclude that high proliferative activity (Ki-67 greater than 60) is an independent factor allowing laboratory prediction of probable poor outcome of DLCL. PMID- 3281724 TI - Efficacy of high-dose methotrexate in childhood acute lymphocytic leukemia: analysis by contemporary risk classifications. AB - High-dose methotrexate (HDMTX) added to a basic regimen of chemotherapy proved superior to cranial irradiation and sequentially administered drug pairs (RTSC) in prolonging complete remissions in children with "standard-risk" acute lymphocytic leukemia. To extend this result to more contemporary risk groups, we reclassified the patients according to methods of the Pediatric Oncology Group (POG), the Childrens Cancer Study Group (CCG), the Rome workshop, and St Jude Total Therapy Study XI. By life table analysis, 70% to 78% of patients with a favorable prognosis would remain in continuous complete remission (CCR) at 4 years if treated with HDMTX. Uniformly lower CCR rates could be expected with RTSC, especially in St Jude better-risk patients. HDMTX also would show greater efficacy than RTSC in the CCG average-risk and POG poor-risk groups, but the results appear inferior to those being achieved with intensified regimens for high-risk leukemia. Although both therapies would provide adequate CNS prophylaxis in favorable-risk groups, RTSC would offer greater protection in patients classified as being in a worse-risk group by St Jude criteria. We conclude that HDMTX-based therapy, as described in this report, would be most effective in patients with a presenting leukocyte count of less than 25 x 10(9)/L, of the white race, aged 2 to 10 years, and having leukemic cell hyperdiploidy without translocations. PMID- 3281725 TI - High-dose cytosine arabinoside and fractionated total-body irradiation: an improved preparative regimen for bone marrow transplantation of children with acute lymphoblastic leukemia in remission. AB - Twenty children with acute lymphoblastic leukemia in second (18 patients) or third (two patients) complete remission after bone marrow relapse received allogeneic bone marrow transplants from histocompatible sibling donors. The preparative regimen for marrow transplantation consisted of 12 doses of 3,000 mg/m2 cytosine arabinoside twice daily for six days followed by 1,200 cGy total body irradiation (six doses of 200 cGy twice daily for three days). The preparative regimen was well tolerated, and all patients showed marrow engraftment promptly. Twelve patients are alive in complete remission 12+ to 79+ months posttransplant; eight patients are over 48 months posttransplant. Six patients died 1 to 9 months posttransplant of nonleukemic causes: (two each of graft-v-host disease, interstitial pneumonitis, and infection). Two patients developed recurrent leukemia at 15 and 30 months posttransplant. Both have died at 19 and 36 months posttransplant. Life table analysis reveals an actuarial survival and event-free survival rate of 58% and a marrow relapse rate of 17%. These results suggest that high-dose cytosine arabinoside and fractionated total body irradiation is a relatively nontoxic and highly effective preparative regimen for allogeneic bone marrow transplantation for acute lymphoblastic leukemia that deserves further evaluation. PMID- 3281726 TI - A soluble activity from adherent marrow cells cooperates with IL 3 in stimulating growth of pluripotential hematopoietic precursors. AB - Marrow cells from 5-fluorouracil (5-FU)-treated mice formed few or no mixed erythroid colonies when plated in semisolid medium with interleukin 3 (IL 3) and erythropoietin (Ep) alone. When conditioned medium (CM) from plastic-adherent marrow or thymus cells was also included, however, growth of mixed erythroid colonies was strongly stimulated. Both IL 3 and the accessory activity (AA) had to be present at the initiation of the cultures for growth to occur. AA was also produced by a cloned immortalized line (95/1.7) of fibroblastoid marrow cells that lacked macrophage-specific cell surface markers. Colony-stimulating factor-1 (CSF-1) was also released, but not granulocyte colony-stimulating activity. When 95/1.7 CM was analyzed by gel filtration, AA eluted with an apparent size of 35 kd and separated completely from the CSF-1. Biologic assays failed to detect IL 1 or IL 3 activity in 95/1.7 CM. Growth of mixed erythroid colonies from 5-FU treated marrow is thus stimulated by adherent marrow cell-derived factors that appear distinct not only from the known CSFs including IL 3, but also from IL 1. PMID- 3281727 TI - Effects of hematopoietin-1 and interleukin 1 activities on early hematopoietic cells of the bone marrow. AB - Hematopoietin-1 (H-1) was purified from the human cell line 5637 and two amino acid sequences were observed in the preparation. One sequence was identical to that of interleukin 1 alpha (IL 1 alpha) and the other to that of IL 1 beta. The action of recombinant IL 1 alpha and other hematopoietic growth factors was studied using (a) a high proliferative potential colony-forming cell assay that uses primitive hematopoietic precursors from bone marrow, and (b) a spleen colony forming unit assay. The results indicate that the IL 1 alpha target cell population is different than the target cell populations of IL 3, granulocyte macrophage colony-stimulating factor; that IL 1 alpha in combination with mononuclear phagocyte colony-stimulating factor provides a proliferative stimulus; and that IL 1 alpha has at least a survival-enhancing and possibly proliferation-inducing effect on primitive hematopoietic stem cells. PMID- 3281728 TI - Monoclonal glucose-oxidase-anti-glucose-oxidase (GAG) immunosandwich assay for the detection of monoclonal antibodies on routine hematological smears. AB - A murine monoclonal antibody specific for aspergillus niger glucose oxidase has been prepared and used in an unlabeled antibody bridge technique for the detection of monoclonal antibodies. This procedure--the monoclonal glucose oxidase anti-glucose oxidase (GAG) immunosandwich assay--provides excellent immunocytochemical labeling of routine hematological films in combination with optimal preservation of cellular details. In contrast to conventional immunofluorescence procedures, routine hematological films can be used, and these can be stored before and after the immunolabeling. Compared with other immunoenzyme techniques such as those using alkaline phosphatase or peroxidase, the GAG assay is as sensitive and has the advantage that no problems with endogenous enzyme activity are encountered. The availability of alcohol-resistant disclosing reagents allows for routine hematological counterstaining which provides a very clear visualization of both the immunoreaction and the individual morphology of the blood cells. PMID- 3281730 TI - Identification and purification of human erythroid progenitor cells by monoclonal antibody to the transferrin receptor (TU 67). AB - Anti-TU 67 is a murine monoclonal antibody that recognizes the transferrin receptor. With respect to hematopoietic cells TU 67 is expressed by human multipotent colony-forming cells (CFU-Mix), erythroid progenitor cells (BFU-E and CFU-E) and a fraction of granulocyte/monocyte colony forming cells, but is not expressed by mature hematopoietic cells including erythrocytes, platelets, lymphocytes, and peripheral blood myeloid cells. The TU 67-positive fraction of normal bone marrow, separated by fluorescence-activated cell sorting (FACS) or immune rosettes, contained 87% of the erythroid progenitor cells. Erythroid progenitor cells were enriched up to 50-fold by using a combination of monoclonal antibodies to deplete mature hematopoietic cells, followed by positive selection of BFU-E and CFU-E by TU 67 antibody. PMID- 3281731 TI - Immunosuppressive treatment of aplastic anemia: a prospective, randomized multicenter trial evaluating antilymphocyte globulin (ALG) versus ALG and cyclosporin A. PMID- 3281729 TI - Clinical application of various plant and endogenous lectins to leukemia. PMID- 3281732 TI - The hopelessness theory of depression: attributional aspects. AB - In this article, we clarify, expand and revise the basic postulates of the hopelessness theory of depression (Abramson, Alloy & Metalsky, 1988a; Abramson, Metalsky & Alloy, 1987, 1988b; previously referred to as the reformulated helplessness theory of depression: Abramson, Seligman & Teasdale, 1978) and place the theory more explicitly in the context of work in descriptive psychiatry about the heterogeneity among the depressive disorders. We suggest that the hopelessness theory hypothesizes the existence in nature of an, as yet, unidentified subtype of depression--'hopelessness depression'--defined, in part, by its cause. We then give a critique of work conducted to test the hopelessness theory and explicate the limitations in research strategy associated with this line of work. Our critique includes a logical analysis that deduces the conceptual and methodological inadequacies of the research strategies used to test the theory. Finally, we suggest more adequate research strategies for testing the hopelessness theory and discuss conceptual and assessment issues that will arise in conducting such tests with special emphasis on attributional styles. PMID- 3281733 TI - Attributions and adjustment to life-threatening illness. AB - An analysis of the role of attribution in major illness and serious injury is presented. Evidence reviewed includes the impact of illness variables on attributions, the association between attributions and adjustment to illness, and the proposed mechanisms of this association. Illness and injury characteristics such as severity and time since diagnosis appear to relate to attributional activity and content, but the association between attributions and psychological or physical adjustment is weak. Overall, it would appear that the attribution construct can describe individuals' reactions to life-threatening illness or injury. However, the utility of attribution in understanding the processes involved in adjustment to illness has not yet been demonstrated. PMID- 3281735 TI - Rational decision-making in health care: Is there hope? PMID- 3281736 TI - Retraction of research findings. International Committee of Medical Journal Editors. PMID- 3281738 TI - Ultrasound screening for clinically occult abdominal aortic aneurysm. AB - In a review of the records of 74 patients who had undergone repair of an abdominal aortic aneurysm at a community hospital between 1977 and 1983 we found that the aneurysm had been undiagnosed before rupture in 35%; these patients had an operative death rate of 50%, whereas elective repair carried a death rate of 4%. The characteristic patient was an obese man over the age of 55 years with hypertension, coronary artery disease, cerebrovascular disease or peripheral vascular disease. Ultrasound examination was performed in 45 patients with these characteristics, and six aneurysms were diagnosed. Either surgery or computed tomography confirmed the diagnosis. The rate of false-negative results was estimated by review of the charts of 100 men over the age of 55 years who had undergone abdominal ultrasonography for other indications: no undetected aneurysms were discovered over 3 years of follow-up. Routine screening in this high-risk group would improve the rate of diagnosis of this potentially fatal condition before rupture and offer the patient the lower mortality rate associated with elective surgery. PMID- 3281739 TI - Polyglandular autoimmune syndrome type II. PMID- 3281737 TI - Polyglandular autoimmune syndrome: current concepts. AB - The polyglandular autoimmune syndrome (PGAS) is characterized by the association of two or more endocrine disorders that are mediated by autoimmune mechanisms and usually lead to a hypofunctional state. In this review we classify the various types of PGAS and discuss their clinical features and the pathophysiologic autoimmune mechanisms that are thought to play an important role. Circulating organ- and cell-specific autoantibodies are frequently detected in patients with the syndrome and may be a marker of future organ failure. PGAS should be considered in patients with one or more of the disorders constituting the syndrome; this should facilitate early diagnosis and perhaps even prevention of other components of the disease. Early recognition and replacement therapy can be life-saving, particularly when there is adrenal or thyroid insufficiency. PMID- 3281741 TI - Observations on laboratory diagnosis of chlamydial infection. PMID- 3281740 TI - Congestive heart failure. AB - Congestive heart failure (CHF) is a condition that is increasing in incidence and is associated with significant morbidity and mortality rates. The main abnormality that underlies CHF is depressed myocardial function. The resulting decrease in cardiac output activates several peripheral compensatory mechanisms, which may further impair ventricular function and worsen the prognosis. Although systolic dysfunction is the traditional descriptor of CHF, diastolic dysfunction is increasingly recognized as a distinct entity. In prescribing therapy the predominant type of ventricular dysfunction and the peripheral components of the heart failure should be identified. The ultimate aim is to alleviate symptoms, minimize complications and prolong survival. Recent data from two multicentre trials have suggested that vasodilators can achieve these goals. Trials are under way to assess the impact of early vasodilator therapy on CHF. PMID- 3281742 TI - Endoscopic intratumoral injection of OK-432 and Langerhans' cells in patients with gastric carcinoma. AB - OK-432, a compound composed of penicillin-G-treated, attenuated Streptococcus pyogenes of human origin, was administered by intratumoral injection (IT) to 15 of 49 patients with Stage III gastric carcinoma, at the time of preoperative endoscopic examination. The 5-year survival rate of patients given IT was 73.3%, whereas the rate was only 36.5% in those not given IT (P less than 0.05). A study of recurrent cases revealed a significantly low incidence of peritoneal recurrence in the group on OK-432 IT (P less than 0.01). In previous work, the authors noted a favorable prognosis of patients with Stage III gastric carcinoma and with a marked infiltration of Langerhans' cells (LC) in the tumor tissues. All of the 49 in the current study were thus examined immunohistochemically, using anti-S-100 protein antibody, the objective being to clarify the relationship between OK-432 IT and the density of LC. The density of LC among those given IT was significantly increased as compared with those not given IT (P less than 0.05). The results of this study suggest that OK-432 IT may lead to augmentation of the density of LC in tumor tissues and hence prevent peritoneal recurrences in patients with Stage III gastric carcinoma. PMID- 3281743 TI - In vitro analysis of the cellular proliferative response to 17-beta-estradiol of human breast cancer. AB - In human breast cancer the proliferating cells appear to differ from those containing estrogen receptors (ER) as shown by studies on isolated cellular subpopulations. In this paper the in vitro effect of 17-beta-estradiol on cell proliferation in 30 primary breast tumors was studied. The effect of several estradiol concentrations was assayed, and the influence of diethylstilbestrol, tamoxifen, and nafoxidine was also tested. The response to these compounds was measured through the thymidine labeling index (TLI). When exposed to 10(-9) mol/l and 10(-8) mol/l estradiol, 14 of 19 ER-positive tumors and six of 11 ER-negative tumors were induced to further proliferate. The TLI increase over the control was 219% (P less than 0.05) at 10(-9) mol/l E2 and 258% (P less than 0.05) at 10(-8) mol/l E2 for ER-positive tumors, and 233% (0.1 less than P less than 0.2) at 10( 9) mol/l E2 and 321% (0.1 less than P less than 0.2) at 10(-8) mol/l E2 for ER negative tumors. The addition of diethylstilbestrol and antiestrogens in vitro inhibited, to varying degrees, the estradiol-induced increase in the TLI irrespective of the ER-status. The response to E2 was correlated with the expression of the ras p21 protein and carcinoembryonic antigen. It was found that the ras p21 protein is preferentially expressed in ER-negative tumors, the opposite being true for carcinoembryonic antigen. The ras p21 protein is preferentially expressed in those ER-positive tumors that do not respond to estradiol with an increase in the TLI. PMID- 3281744 TI - Diagnostic features of primary malignant lymphomas of the thyroid with monoclonal antibodies. AB - Primary malignant lymphomas (ML) of the thyroid are rare and their conclusive morphologic diagnosis is not always possible. The authors report diagnostic features of 11 cases of ML and one case of plasmacytoma of thyroid compared with chronic lymphocytic thyroiditis and undifferentiated carcinomas of thyroid in an immunohistochemical study using monoclonal antibodies (MoAb). The lymphoid nature of tumors could be identified in all cases with three MoAb on paraffin sections. In ML, tumor cells expressed leucocyte common antigen (Dako-LC+) with negativity for epithelial membrane antigen (Dako-EMA-) and cytokeratin (KL1-). Newer MoAb identifying B-cell (LN-1, LN-2, MB2) and T-cell-associated antigens (MT1, UCHL1) not denatured by fixation, revealed B-cell nature of tumor cells in all cases of ML. Among anti-B MoAb, LN-1 and MB2 were most consistent in their reactivity. In cryostat sections of three ML cases, the tumor cells expressed one or more B-cell associated antigens. Plasmacytoma was negative for Dako-LC and KL1 but positive for Dako-EMA and monotypic cytoplasmic Ig. PMID- 3281745 TI - Clinical staging and treatment results in rhabdomyosarcoma of the female genital tract among children and adolescents. AB - From 1972 to 1984, 47 children and adolescents with primary tumors of the female genital tract were treated with eight different Intergroup Rhabdomyosarcoma Study (IRS I-II) protocols. These included patients with vaginal (28), uterine (ten), or vulval (nine) rhabdomyosarcoma or undifferentiated sarcomas. The mean age of patients with primary vaginal tumors was younger than 2 years. All were of the embryonal histologic subtype. The majority of these patients were treated with initial chemotherapy (vincristine, dactinomycin, +/- cyclophosphamide, +/- Adriamycin [(ADR) doxorubicin]) followed by delayed hysterectomy and/or partial vaginectomy. Among 26 patients with localized vaginal tumors, there have been six relapses resulting in one tumor-related death and one therapy-related death. The five patients with nonfatal relapse have been disease-free for from 2.5 to 6.5 years (mean, 4.4 years) since salvage therapy was commenced. The 19 patients without relapse have been continuously disease-free for 1.5 to 12 years (mean, 5.34 years: median, 6 years). No patient that received ADR initially relapsed. Ten patients, with a mean age greater than 13 years, had primary uterine sarcomas and were treated by the same chemotherapy regimens. Six with polypoid localized lesions, removed before chemotherapy, have remained disease-free for 2.5 to 6.5 years. Four, with more extensive local lesions or disseminated disease, treated with chemotherapy only, died 2 to 11 months from diagnosis. Nine patients with rhabdomyosarcomas of the vulva (age, 1-19 years) were managed by the same chemotherapy regimens +/- radiotherapy. Resection was carried out initially or after chemotherapy. Eight of these have been disease-free from 4 to 10 years (mean, 6.4 years); and one is alive with probable disease at 2.5 years. PMID- 3281746 TI - Culturing and robotic harvesting of bone marrow, lymph nodes, peripheral blood, fibroblasts, and solid tumors with in situ techniques. AB - We have modified our in situ method for culturing amniocytes and have successfully used this new procedure to culture cells from bone marrow, lymph nodes, peripheral blood, fibroblasts, and solid tumors. We have been so satisfied with this method that we have used it in our routine practice for the past 2.5 years. A convenient feature of the in situ method is that the cultures can be processed with a commercially available robotic harvesting system (modified Tecan Robotic Sample Processor Model 505). This system also works well for in situ cultures of amniotic fluids. Robotic harvesting of in situ cultures provides a consistent and accurate procedure that saves about 10-15 minutes of technologist time per case. PMID- 3281747 TI - The contribution of medicine to the primary treatment of breast cancer. PMID- 3281748 TI - Increased synthesis of prostacyclin and thromboxane in human ovarian malignancy. AB - To study the production of antiaggregatory prostacyclin (PGI2) and proaggregatory thromboxane (TxA2) by ovarian tumors, we incubated pieces of benign and malignant ovarian tissue in vitro, and measured by radioimmunoassay the release of 6-keto prostaglandin F1 alpha (6-keto-PGF1 alpha) (a hydration product of PGI2) and thromboxane B2 (TxB2) (a hydration product of TxA2). Healthy ovary (n = 10) produced both 6-keto-PGF1 alpha [mean, 8.9; 95% confidence interval (CI) from 5.4 to 15.2 ng/mg protein/min] and TxB2 (mean, 1.9 ng/mg protein/min; 95% CI from 1.0 to 3.7 ng/mg protein/min). The production of 6-keto-PGF1 alpha (mean, 12.2; 95% CI from 7.7 to 19.3 ng/mg protein/min) and that of TxB2 (mean, 4.8; 95% CI from 2.1 to 11.9 ng/mg protein/min) by benign cystic tumors (n = 12) was normal. Ovarian anaplastic cancer and adenocarcinoma (n = 12) produced 6-keto-PGF1 alpha on average 11.6-fold (95% CI from 5.2 to 26.0) 6-keto-PGF1 alpha and TxB2 on average 30.0-fold (95% CI from 13.5 to 66.7) over production by healthy ovaries, and the ratio of 6-keto-PGF1 alpha to TxB2 shifted to the dominance of TxB2. Similarly ovarian metastases of breast cancer, tubal cancer, and colon cancer produced increasingly 6-keto-PGF1 alpha (mean, 20.7 ng/mg protein/min) and TxB2 (5.1 ng/mg protein/min). The dominance of TxA2 in human ovarian cancer may contribute to the aggressing growth and spreading of this tumor. PMID- 3281749 TI - Curative effect of split low dosage total-body irradiation on mice infected with the polycythemia-inducing strain of the Friend virus complex. AB - Split low dose total-body irradiation (TBI) with 150 cGy was assessed for its efficacy in modifying the disease induced in DBA/2 mice by the polycythemia inducing strain of the Friend virus complex (FVC-P, composed of a Friend murine leukemia helper virus and a spleen focus-forming virus). All FVC-P injected mice were dead within 40 days; however, infected mice receiving TBI on days 5 and 12 exhibited long-term survival. FVC-P-injected mice receiving TBI treatment on days 5 and 12 had normal leukocyte counts, normal spleen weights, and no detectable spleen focus-forming virus. Although the FVC-P-infected mice had decreased proportions of L3T4+ cells and increased proportions of Lyt-2+ cells, these were returned to normal following TBI treatment. Apparently the time sequence of TBI treatments is important since one treatment with TBI on day 5, or two treatments with TBI on days 12 and 18, was not as efficacious. The inability of in vitro irradiation doses of up to 1000 cGy to inactivate FVC-P which was subsequently injected into murine hosts suggests that the effectiveness of the TBI treatment in vivo is not due to a direct radiation effect on the virus. These results indicate a possible relationship between L3T4+ and Lyt-2+ numbers or their ratio in the curative efficacy of TBI in FVC-P-infected mice. PMID- 3281750 TI - Incidence and nature of tumors induced in Sprague-Dawley rats by gamma irradiation. AB - In our previous studies carried out on inbred rats of the Sprague-Dawley strain (L. Gross and Y. Dreyfuss, Proc. Natl. Acad. Sci. USA, 76: 5910-5913, 1979), the tumor incidence was increased following irradiation (150 rads, 5 times, at weekly intervals), from 22 to 93% in females and from 5 to 59% in males. Experiments here reported suggest that 2 consecutive total-body gamma-irradiations of 150 rads each are sufficient to induce in rats the development of tumors, some malignant; 18 of 19 females (94.7%) developed tumors at an average age of 11.4 mo, and seven of the 14 males in this group (50%) developed tumors at an average age of 10.4 mo. In the second group, which received 3 consecutive gamma irradiations, 20 of 23 females (86.9%) and 5 of 13 males (38.4%) developed tumors at average ages of 9.1 and 7.5 mo, respectively. In the third group, among rats which received 4 consecutive gamma-irradiations, 17 of 19 females (89.4%) and 4 of 12 males (33.3%) developed tumors at average ages of 9.4 and 10.5 mo, respectively. The etiology of tumors either developing spontaneously or induced by irradiation in rats remains to be clarified. Our attempts to detect virus particles by electron microscopy in such tumors or lymphomas have not been successful. As a working hypothesis, we are tempted to theorize that tumors or lymphomas developing spontaneously or induced by gamma irradiation in rats are caused by latent viral agents which are integrated into the cell genome and are cell associated, i.e., not separable from the rat tumor cells by conventional methods thus far used. PMID- 3281751 TI - Comparison of growth requirements of two human intratumoral colon carcinoma cell lines in monolayer and soft agarose. AB - The human colon, intratumoral subpopulations HCT 116 and HCT 116a were established in chemically defined medium supplemented with transferrin, insulin, epidermal growth factor (EGF), triiodothyronine, hydrocortisone, and sodium selenite. The responsiveness of the adapted cell lines to these growth factors was compared in anchorage-dependent and -independent assays. HCT 116 cells maintained in serum-free conditions were further adapted to growth factor deprivation, and the effects of these polypeptides were determined in anchorage independent assays. In monolayer, HCT 116 cells adapted to grow in serum-free medium responded to transferrin but not to EGF or insulin. Similarly adapted HCT 116a cells were, however, insensitive to transferrin addition but manifested a 300 and 500% increase in growth rates with EGF and insulin, respectively. Optimal growth of HCT 116 cells was seen in the presence of insulin and transferrin, while maximum proliferation of HCT 116a cells depended on combined insulin, transferrin, and EGF. In soft agarose, both HCT 116 and HCT 116a subpopulations showed a stringent requirement for transferrin. No combination of growth factors without transferrin supported colony formation. These data suggest that (a) these colon tumor subpopulations may be subject to separate growth controls, and (b) there may be an important role for transferrin in anchorage-independent growth and possibly in the maintenance of malignant characteristics. PMID- 3281752 TI - Restoration by polyethylene glycol of characteristics of intestinal differentiation in subpopulations of the human colonic adenocarcinoma cell line HT29. AB - The human colonic cancer cell line HT29 is morphologically undifferentiated in standard culture conditions. The cells were incubated for 30 s in polyethylene glycol (27%, v/v), then washed, and refed with standard medium. In these conditions of treatment, polyethylene glycol was unable to induce a significant cell multinucleation. Three wk after the treatment, circular "flat-foci" developed in the culture, which consisted of circular monolayers of polarized cells. These subpopulations were isolated, then grown as independent lines (lines 27, 28, 30, and 31) in standard culture conditions, and characterized. Two types of differentiated cells were present in these lines, namely, enterocytic cells and mucus-secreting goblet cells. These characteristics of intestinal differentiation were found to be stable during the long-term culture of these lines in standard medium. We were able to isolate from line 27 a clonal derivative (C1.27H) exhibiting 2 lineages of differentiation, as assessed by electron microscopy, immunofluorescence, and immunoblot analysis of cell membranes with anti-sucrase-isomaltase antibodies, and enzyme activities. Sucrase isomaltase was present in two forms, namely, the high-molecular-weight precursor and the cleaved subunits. Finally, the C1.27H cells were found to be significantly less tumorigenic than the parental HT29 cells in both in vitro and in vivo tumorigenicity tests. This stably differentiated cell clone could represent the cancer derivative of the normal stem cells of the intestinal crypt. It is therefore a possible model system for the study of intestinal cell differentiation. PMID- 3281753 TI - Determination of the structure of the Escherichia coli K100 capsular polysaccharide, cross-reactive with the capsule from type b Haemophilus influenzae. AB - The structure of the Escherichia coli K100 capsular polysaccharide, cross reactive with that from type b Haemophilus influenzae, was determined by using a combination of chemical and spectroscopic techniques. The structure of the K100 repeating unit was found to be----3)-beta-D-Ribf-(1----2)-D-ribitol-5-(PO4----. The K100 polysaccharide is thus identical in composition to, but different in linkage from, the H. influenzae type b capsular polysaccharide, which has beta-D Ribf-(1----1)-D-ribitol linkages. PMID- 3281754 TI - [Perinatal hypoxia and brain development]. PMID- 3281755 TI - [Old Prague hospitals. III. Convent and monastery hospitals in Prague from the 13th to the beginning of the 15th century]. PMID- 3281756 TI - [Old Prague hospitals. VI. [The Italian Hospital in Mala Strana (1602-1789)]. PMID- 3281758 TI - [50 years of the Czechoslovak Endocrinology Society]. PMID- 3281757 TI - [C-peptide, glucose tolerance and free fatty acids in hypothyroidism]. PMID- 3281759 TI - [Eiselt's contribution to the founding of the Czech Medical Society]. PMID- 3281760 TI - Properties of anti-Lyb-2-mediated B-cell activation and the relationship between Lyb-2 molecules and receptors for B-cell stimulatory factor-1 on murine B lymphocytes. AB - The murine B-cell differentiation antigen Lyb-2 has been shown to be involved in B-lymphocyte activation and has been postulated by some to be related to a receptor for B-cell stimulatory factor I (BSF-1) (H. Yakura et al., J. Immunol. 137, 1475, 1986). Here we have demonstrated that monoclonal antibody (mAB) to Lyb 2 resembles BSF-1 in its ability to activate small resting B cells and enhancement of surface Ia. Anti-Lyb-2 antibodies bound B cells with very high avidity and were able to induce mobilization of cytosolic-free calcium. Anti-Lyb 2 mAB differs from BSF-1 in that BSF-1 but not anti-Lyb-2 is able to synergize with anti-mu in induction of B-cell proliferation. The relation between Lyb-2 molecules and BSF-1 receptors was tested in assays that measure binding of anti Lyb-2 or BSF-1 in B cells and were found not to compete with each other. It appears that the two B-cell agonists anti-Lyb-2 and BSF-1 may exert their effects on B cells through different cell surface moieties as well as different intracellular pathways. PMID- 3281761 TI - Characterization of two molecules at 30,33 kDa as major target antigens of natural thymocytotoxic autoantibodies. AB - We have attempted to characterize, by immunoblotting, the cell surface determinants which are recognized by natural thymocytotoxic autoantibodies (NTA). NTA-positive sera from spontaneously autoimmune mice and from mice rendered autoreactive by neonatal induction of tolerance were used as probes on blots of thymocytes. Fifty percent of the sera screened under these conditions reacted with a doublet of 30,33 kDa molecular weight present on membranes, but not detectable on blots of total cell extracts. Additional bands of various molecular weights were detected by NTA-positive sera at a much lower frequency than the 30,33 kDa determinants. Direct evidence of identity between the antibodies inducing thymocytotoxicity and those detecting the doublet in immunoblotting was provided by immunoadsorption tests. Among a panel of immunoadsorbents prepared with thymocyte membrane proteins of various molecular weights, only the one containing the 30,33 kDa molecules efficiently adsorbed cytotoxic antibodies whereas the other preparations containing some of the bands occasionally detected in immunoblotting had practically no effect. In addition we showed that the 30,33 kDa doublet is also detected on membrane preparations of T and B lymphocytes but not on preparations of a nonlymphoid cell line, and is composed of two independent molecules not covalently linked, in their native configuration, by disulfide bonds. Altogether these results strongly suggest that the 30,33 kDa molecules represent major cell surface determinants for thymocytotoxic autoantibodies. PMID- 3281762 TI - HIV persistence in monocytes leads to pathogenesis and AIDS. AB - An hypothesis of the pathogenic mechanism leading to acquired immunodeficiency syndrome (AIDS) that places special emphasis on the potential for infected monocytes to act as the reservoir of a persistent human immunodeficiency virus (HIV) infection has been developed. Monocytes may mediate directly the infection and ultimate destruction of helper T cells; this establishes a direct relationship between antigen presentation and HIV dissemination, thus accounting for the cytopathogenic effects and immune system debilitation associated commonly with AIDS. The possibility that this mode of virus dissemination can account for the depletion of helper-T-cell subsets based on their antigen specificity is considered and may explain why the cellular immune response to the virus is ineffective. This concept and may also elucidate the role of intercurrent infections in the development of disease and it suggests mechanistic explanations for the conversion from prodromal to fulminant AIDS. PMID- 3281763 TI - The stress response to induced hypotension for cerebral aneurysm surgery: a comparison of two hypotensive techniques. AB - Plasma epinephrine (PE), plasma norepinephrine (PNE), plasma renin activity (PRA), mean arterial pressure (MAP) and heart rate (HR) were measured before, during and after induced hypotension in two groups of patients undergoing cerebral aneurysm surgery. In Group I isoflurane was used to maintain anaesthesia and induce hypotension. Mean PE fell significantly during hypotension and remained reduced after hypotension, mean PNE remained unchanged, while mean PRA rose slightly but not significantly during hypotension, falling again after hypotension. In Group II halothane was used to maintain anaesthesia and sodium nitroprusside to induce hypotension. During anaesthesia and surgical stimulation PNE and PRA were significantly greater compared to Group I. Mean PE, PNE and PRA all rose during hypotension and remained elevated after hypotension. The rise in PNE and PRA was statistically significant. After hypotension the MAP in Group II was significantly higher when compared to Group I. There was no significant change in HR during the study in either group. In conclusion, isoflurane-induced hypotension with isoflurane anaesthesia unlike sodium nitroprusside-induced hypotension with halothane anaesthesia attenuated the stress response. PMID- 3281764 TI - Does prophylactic intravenous infusion of indomethacin improve the management of postoperative pain in children? AB - The efficacy of prophylactic intravenous infusion of indomethacin as a postoperative analgesic was studied in 100 children aged one to 16 years. At the end of surgery a bolus dose of indomethacin 0.35 mg.kg-1 followed by an infusion 0.07 mg.kg-1.hr-1 for 24 hr or placebo was given in double-blind manner. The efficacy of the treatment was measured by the need of additional morphine given 0.1 mg.kg-1 intravenously in the Recovery Room and 0.15 mg.kg-1 intramuscularly on the ward according to clinical needs. The other measure of the efficacy was assessment of pain intensity in the Recovery Room and pain relief on the ward. In the Recovery Room the pain scores differed between the groups in advantage of indomethacin only at 30 minutes (p less than 0.05) but the need of morphine was significantly less (p less than 0.01) in the indomethacin group. On the ward the mean doses of morphine given and the nurses' pain relief scores were not different between the study groups. However, in the indomethacin group the total dose of morphine given during 24 hr was lower (p = 0.02) and the children assessed the pain relief to be significantly better (p less than 0.02). Twenty per cent of the children in both groups had transient nausea and vomiting. No skin reactions or other allergic manifestations were observed. Prophylactic indomethacin infusion diminished the need of morphine and resulted in better postoperative analgesia than morphine p.r.n. alone. PMID- 3281765 TI - Naloxone infusion after prophylactic epidural morphine: effects on incidence of postoperative side-effects and quality of analgesia. AB - There have been conflicting reports of the value of naloxone infusions to prevent the side-effects associated with epidural morphine. In our study, 29 patients undergoing thoracotomies for pulmonary surgery received epidural morphine (0.1 mg.kg-1) shortly after induction of anaesthesia. One hour after arrival in the Recovery Room, one of four naloxone bolus and infusion sequences was administered: saline bolus followed by saline infusion; 0.4 microgram.kg-1 naloxone bolus followed by 0.4 microgram.kg-1.hr-1 naloxone infusion; 2.0 micrograms.kg-1 naloxone bolus followed by 2.0 micrograms.kg-1.hr-1 naloxone infusion; and 4.0 micrograms.kg-1 naloxone bolus followed by 4.0 micrograms.kg 1.hr-1 naloxone infusion. Although with the number of patients studied, there were no statistically significant differences among groups, clinically, there was a trend toward decreased analgesia with all three naloxone infusion doses as determined by analgesic requirements, longest analgesic-free period and visual analogue pain scores. In addition, side-effects occurred in all groups. We conclude that prophylactic naloxone, used in this manner, is not an appropriate technique for the prevention of side-effects associated with epidural morphine used for the prevention of pain after thoracotomy. PMID- 3281767 TI - Potential complications associated with a temperature monitoring adaptor. PMID- 3281768 TI - Unintentional hypothermia in the operating room: a footnote. PMID- 3281769 TI - Response modification creates promotability in multistage carcinogenesis. PMID- 3281766 TI - Large volume gastroesophageal reflux: a rationale for risk reduction in the perioperative period. PMID- 3281771 TI - Directory. The Shock Society. PMID- 3281770 TI - Transforming activity of the human mammary line HBL100 DNA is associated with SV40 large T antigen genetic information integrated in its genome. AB - The HBL100 cell line, established in vitro from milk of an apparently healthy woman, expresses SV40 large T antigen defective in some of its functions. Here we demonstrate that the HBL100 genomic DNA possesses transforming activity in NIH3T3 cells and that this activity is associated with the viral information. PMID- 3281772 TI - Sir James Mackenzie. PMID- 3281773 TI - Therapeutic drug monitoring. PMID- 3281774 TI - Association of pain relief with drug side effects in postherpetic neuralgia: a single-dose study of clonidine, codeine, ibuprofen, and placebo. AB - In a randomized, double-blind crossover study, 40 patients with postherpetic neuralgia were given single oral doses of clonidine, 0.2 mg, codeine, 120 mg, ibuprofen, 800 mg, or inert placebo. Pain relief and side effects were recorded for 6 hours. Patients reported significantly more relief after clonidine than after the other three treatments. Codeine and ibuprofen were ineffective. Sedation, dizziness, and other side effects were more frequent after clonidine (74%) or codeine (69%) than after placebo (36%) or ibuprofen (28%). Reported pain relief was greater during trials in which side effects were present. A single, mild side effect was associated with as much additional pain relief as multiple, severe side effects. Clonidine's superiority to codeine, which had a similar incidence of side effects, argues for a specific analgesic effect. In addition, side effects may have contributed to clonidine analgesia, perhaps by suggesting to patients that they had received a potent drug. PMID- 3281775 TI - Dose-response of inhaled diltiazem on airway reactivity to methacholine and exercise in subjects with mild asthma. AB - Methacholine challenges were performed by 10 asthmatic subjects, 2 hours before and 15 minutes after placebo (diluent alone) and 5, 10, 15, 30, and 60 mg inhaled diltiazem given in a single-blind crossover manner. There was no significant change from placebo in the dose of methacholine required to produce a 20% decrease in forced expiratory volume in the first second (FEV1) (PD20); the fold increase in PD20 from baseline was 1.1 +/- 0.1 after placebo, 1.4 +/- 0.2 after 5 mg, 1.8 +/- 0.3 after 10 mg, 1.4 +/- 0.2 after 15 mg, 1.6 +/- 0.2 after 30 mg, and 1.2 +/- 0.1 after 60 mg. There was a 1% chance that we missed a twofold difference between placebo and the 10 mg dose because of inadequate sample size. Fifteen minutes before a standardized exercise challenge, 10 subjects received placebo, 10 mg, and the highest dose tolerated during the methacholine study (20 to 45 mg) in a randomized double-blind crossover design. The mean +/- SE maximum postexercise decrease in FEV1 was 28.8% +/- 5.7% after placebo, 23.4% +/- 4.6% after 10 mg, and 20.8% +/- 3.0% after high-dose diltiazem (P greater than 0.05). There was a 12% chance that we missed a 15% difference between placebo and the high-dose regimen because of inadequate sample size. We conclude that diltiazem does not attenuate airway reactivity to methacholine or exercise even when high concentrations are delivered to the lungs. PMID- 3281776 TI - Fetal abnormalities diagnosed from early pregnancy. PMID- 3281777 TI - Radiologically-guided percutaneous catheter drainage of empyemas. AB - We describe our experience with the percutaneous drainage of empyemas in 20 patients, using fluoroscopic, computed tomographic or ultrasonic guidance for catheter placement. The patients were seen over a period of 17 months. Sixteen patients were successfully treated, with the empyema drained and the cavity closed. In four patients drainage was unsuccessful and surgery was required. In three of these patients there was a history of illness in excess of 4 weeks preceding treatment and in one a history of trauma. Two or more catheters were used in seven patients and positive microbiological culture of the pus was obtained in 12, although neither factor significantly altered prognosis. There were no complications of the procedure. We believe the percutaneous insertion of catheters using suitable imaging guidance should be the initial method of drainage of empyemas. PMID- 3281778 TI - The accuracy of mammography alone and in combination with clinical examination and cytology in the detection of breast cancer. AB - The accuracy of mammography alone and in combination with clinical examination and aspiration cytology was assessed in 402 patients who attended the Early Diagnostic Unit of the Royal Marsden Hospital, London. The sensitivities of mammography, clinical examination and cytology in identifying breast cancer were 76.9%, 81.7% and 63.5% respectively; the specificities of each test were 90.0%, 87.6% and 99.3%. The calculated sensitivity was increased to 96.2% if one positive test out of the three was regarded as an indication to undertake breast biopsy. If this approach was adopted the number of breast cancers missed would be two out of 104 and the yield of positive biopsies would be approximately one in four (27.6%). The implications of proceeding to breast biopsy on the basis of a single positive test are discussed. PMID- 3281779 TI - Pre-operative and post-operative ultrasound evaluation of Budd Chiari syndrome due to coarctation of the inferior vena cava. AB - Coarctation of the inferior vena cava (IVC) is being increasingly recognised as a congenital and operable cause for chronic Budd Chiari syndrome. It is necessary to distinguish this entity from other causes of Budd Chiari syndrome because of a more favourable outcome after surgery. Early diagnosis would result in surgical intervention before irreversible liver damage and also possibly avoid the onset of hepatocellular carcinoma. Real time ultrasound has proved valuable in pre operative diagnosis in nine patients with coarctation of the IVC. It has also been found useful to confirm patency of dorsal cavo-atrial bypass using polytetrafluoroethylene grafts in five patients and isthmusplasty of the IVC in one patient. Ultrasound is recommended for routine screening of high risk population. PMID- 3281781 TI - Cancer: the consequences of cure. PMID- 3281780 TI - Computed tomography and ultrasound imaging of jumper's knee-patellar tendinitis. AB - We present nine cases of this relatively unreported condition affecting the patellar ligament in athletes. A comparison between ultrasound and computed tomography of this lesion, shows that whilst neither modality gives false positives, ultrasound is capable of greater distinction between the histological abnormalities confirmed at surgery. PMID- 3281783 TI - Fungal liver abscesses in acute leukaemia--a report of two cases. AB - The radiological findings in two cases of hepatic fungal microabscesses (one with concomitant splenic involvement) occurring in children with acute leukaemia are presented, and the previous literature is reviewed. Usually both liver and spleen are involved, though either organ may be affected in isolation. Typical ultrasound features include hepatosplenomegaly with multiple hypoechoic areas throughout the liver and spleen, often with a 'target' configuration. Computed tomography shows these as multiple non-enhancing low attenuation lesions. These findings in a patient with acute leukaemia are strongly suspicious of fungal infection, and percutaneous fine-needle aspiration under ultrasound or computed tomography-guidance is indicated. PMID- 3281782 TI - Hodgkin's disease involving the large bowel. AB - A case is described in which Hodgkin's disease occurred in the descending colon and adjacent mesenteric nodes as the only site of relapse. This rare presentation is discussed, with a review of the available literature. PMID- 3281784 TI - A subclavian line complication: embolisation of an arteriovenous fistula. AB - We report a case illustrating the successful non-surgical management of an arteriovenous fistula resulting from central line placement. After diagnosis by angiography transcatheter embolotherapy of the internal mammary artery provided an alternative to thoracotomy in treating this unusual complication. PMID- 3281785 TI - The biochemical defect in cystic fibrosis. PMID- 3281786 TI - Relative efficacy of oral verapamil and digoxin alone and in combination for the treatment of patients with chronic atrial fibrillation. AB - 1. The efficacy of verapamil alone, or in combination with digoxin, was compared with digoxin alone in eight patients with chronic atrial fibrillation in this double-blind placebo-controlled study. 2. After 2 weeks on each treatment regimen, heart rate at rest and during progressive load treadmill exercise, left ventricular function at rest and nocturnal heart rate were measured. 3. Oral verapamil alone at a dose of 80 mg three times daily, or 40 mg of verapamil three times daily in combination with 0.25 mg of digoxin daily, was superior to digoxin alone in doses associated with high serum digoxin concentrations (mean +/- SEM 1.6 +/- 0.3 micrograms/l). This superiority manifested as greater control of heart rate during work rates equivalent to regular daily activities, and was not associated with deterioration in left ventricular function or worsening nocturnal bradycardia. 4. We conclude that the treatment of choice in patients with chronic atrial fibrillation is either 80 mg of verapamil three times daily or 40 mg of verapamil three times daily in combination with digoxin. PMID- 3281787 TI - Renal transplantation: HLA-linked, non-cytotoxic antibodies develop after blood transfusion. AB - 1. A previously untransfused dialysis patient was given blood from a single donor on three occasions and sera were obtained from the recipient before and after transfusion. 2. The sera were tested against B-lymphocytes from the blood donor and his family in the erythrocyte-antibody rosette inhibition assay to determine whether any Fc-receptor-blocking activity which developed was HLA linked. 3. Antibody activity was noted after the second transfusion and was directed toward B-lymphocytes from the blood donor and his family members sharing the haplotype HLA A11, B12 with him. 4. These antibodies were removed by the absorption of active sera with lymphocytes from the blood donor but not from (a) his sibling who shared no HLA antigens with him or (b) the transfusion recipient. Absorption of the active sera with platelets from the blood donor did not remove activity. 5. These results indicate that Fc-receptor-blocking antibodies developing after blood transfusion are directed to HLA-linked antigens on donor lymphocytes. PMID- 3281788 TI - Guanfacine hydrochloride: a centrally acting antihypertensive agent. AB - The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage of guanfacine hydrochloride are reviewed. Guanfacine lowers blood pressure by activating CNS alpha adrenoreceptors, which results in sympathetic outflow leading to reduced vascular tone. However, initial hypotensive response to guanfacine may be caused by stimulation of peripheral presynaptic receptors that inhibit sympathetic nerve function. Guanfacine is rapidly and completely absorbed from the gastrointestinal tract and apparently undergoes extensive distribution to all tissues. Steady-state plasma concentrations may be reached in four days. About 30% is excreted renally; the rest is metabolized hepatically. Its long duration of action is related to a slow elimination half-life. In the few controlled clinical trials of guanfacine versus placebo, systolic and diastolic blood pressures were reduced in patients treated with guanfacine; daily dosages of guanfacine 1, 2, and 3 mg (as the hydrochloride salt) were comparable in efficacy. Several large open trials of guanfacine showed blood pressure reductions of about 16% after one year; some patients received other antihypertensive therapy concomitantly. Guanfacine and clonidine appear to have comparable effects in reducing both systolic and diastolic blood pressure when given as monotherapy and as step-2 therapy; data on the comparative blood pressure-lowering effects of guanfacine and methyldopa are less consistent. Guanfacine's adverse reactions include dry mouth, sedation, and constipation. Adverse effects and reaction to sudden withdrawal of the drug may be less severe with guanfacine than with clonidine. A daily dose of guanfacine 1 mg (as the hydrochloride salt) at bedtime is recommended; 2 or 3 mg, or divided doses, may be given if needed. Once-daily administration and fewer adverse effects may give guanfacine some advantage over other centrally acting antihypertensive agents. Further study is needed to determine whether it will be adequate as first-line therapy. PMID- 3281789 TI - Drug dosing during continuous arteriovenous hemofiltration. AB - An overview of continuous arteriovenous hemofiltration (CAVH), which is an alternative to hemodialysis and peritoneal dialysis in the management of acute renal failure, is provided, and literature concerning drug clearance via hemofiltration is reviewed. CAVH is a slow, continuous process that removes, by convective mass transport, non-protein-bound solutes smaller than 10,000 daltons from blood diverted through an extracorporeal filter. The system provides a creatinine clearance of approximately 10 mL/min. The sieving coefficient of a particular compound reflects its ability to permeate the filter membrane and is primarily influenced by protein binding. Clearance of a compound depends on its sieving coefficient and the ultrafiltration rate. Methods for estimating drug clearance, the amount of drug removed per time interval, and appropriate drug dosages are discussed. Many drugs commonly used in an intensive-care setting, including aminoglycosides, cephalosporins, acyclovir, vancomycin, phenobarbital, ranitidine, and theophylline, can be expected to have a limited but clinically important clearance during CAVH. CAVH substantially enhances the current treatment of acute renal failure; although limited data for specific drugs are available in the literature, drug dosages may be adjusted based on the methods outlined in this review. PMID- 3281790 TI - The effects of estrogen, insulin and dexamethasone on the synthesis and secretion of egg white proteins in primary cultured oviduct cells of laying Japanese quail (Coturnix coturnix japonica). AB - 1. The effects of estrogen, insulin and dexamethasone on the synthesis of egg white proteins were investigated by employing primary cultured oviduct cells of laying Japanese quails. 2. It was demonstrated that oviduct cells require insulin and dexamethasone, besides estrogen, to synthesize and secrete egg white proteins maximally. PMID- 3281791 TI - The possible existence of a heat-stable alkaline proteinase (HAP) in rat skeletal muscle. AB - 1. A unique caseinolytic activity was found in the crude extract from chicken and rat skeletal muscle. Hardly any activity was detected at physiological assay temperatures at pH 8.0 but did well at around 60 degrees C. 2. The activity partially purified from rat skeletal muscle showed optimum pH at around 8.0 at 60 degrees C. It hardly hydrolyzed casein below 50 degrees C, but in the presence of 5 M urea it showed relatively high activity at 30 degrees C. The activity was completely stable at 50 degrees C for 1 hr. 3. The activity seems to be contained in a high mol. wt (450,000) protein from the elution volume and is due to cysteine proteinase from the effect of inhibitors. 4. The above properties agreed with those of the heat-stable alkaline proteinase (HAP) of fish purified homogeneously by electrophoresis. This seems to suggest that HAP may also exist in rat skeletal muscle. PMID- 3281792 TI - Homology of delta crystallin and argininosuccinate lyase. AB - 1. Delta crystallin, a major lens protein characteristic of birds and reptiles, is homologous to argininosuccinate lyase; 57% of the residues in chicken delta crystallin and human lyase are identical. 2. Even more similar (62% identical residues) to the human lyase is the sequence translated from the presumably inactive delta-2 gene of the delta crystallin locus. 3. As both delta crystallin and lyase are synthesized in birds only during the embryonic and juvenile stages, the persistence of delta crystallin in the adult lens appears to be paedomorphic. 4. Possible correlations of the origins of delta crystallin with other events in sauropsid evolution are proposed. PMID- 3281793 TI - Development of stereological analysis software for the calculation of volume, number and surface density. AB - COSAS, an acronym for COmputerized Stereological Analysis System, is software designed to facilitate the process of quantitative morphological analysis. It is a flexible, reliable, and easy to use software system which provides the biologist with a simple means for performing stereological analysis. It provides for estimation of volume and surface density and allows for direct calculation of diameter information from planimetric data. The latter capability is unique to COSAS and provides the ability to calculate longest and shortest diameters for convex profiles, enabling calculation of number density. Access to all intermediate calculations is possible, so the process of transformation of raw data into the stereological descriptors can be completely exposed. This serves two purposes: (1) it provides a means for tracing results; (2) the intermediate values can be utilized independently. This system was used to analyze peroxisomes in tissues from patients with Zellweger's disease and neonatal-onset adrenoleukodystrophy. The system was also used to facilitate an immunocytochemical analysis of cytochrome P450 topology in the endoplasmic reticulum membrane. PMID- 3281794 TI - The retrieval of randomized clinical trials in liver diseases from the medical literature: manual versus MEDLARS searches. AB - Recently, the usefulness of MEDLARS computer searches in biomedical research was questioned; the conclusion was drawn that to completely capture a specific population of articles, the MEDLARS system was inadequate. This conclusion was based on a comparison of MEDLARS and manual searches for articles on random clinical trials in liver disease for the period 1966-1982. The present study re evaluated the validity of this conclusion. In the initial revised search strategy, the recall of valid articles was not significantly improved, as compared with the original MEDLARS search strategy, but precision of this revised search was significantly increased. The number of valid articles recalled was significantly increased by broadening the MEDLARS search strategy criteria, but not without a simultaneous and significant decrease in precision. A limiting capture rate of about 79% of the population of articles on random clinical trials was reached when all logical expansions of the search strategy were exhausted. Strategies for increasing the efficiency of MEDLARS searches in general are discussed citing limitations specific to the population of random clinical trial articles. PMID- 3281795 TI - A proposal for registering clinical trials. PMID- 3281796 TI - More on MEDLINE searches. PMID- 3281797 TI - Rabbi Yaacov Wazana: a Jewish healer in the Atlas Mountains. AB - Rabbi Yaacov Wazana, a Jewish healer who died more than 30 years ago in the Atlas Mountains, was a "deviant" type within the Jewish Moroccan curing system. Despite his deviant features, or rather because of them, his memory still vividly reverberates among former members of his community living today in Israel. In seeking to construe a meaningful reading of Wazana's life-story, this work takes into account the fact that he is a mediated object of study whose life can only be examined through historically situated texts. Wazana's script is interpreted on two levels. First, an attempt is made to illuminate the possible motivational structures that fuelled his inexhaustible therapeutic energies and shaped his unique life-style. Dwelling on Wazana's special relations with his parents (and their internalized representations), this psychological interpretation should be evaluated with caution as it cuts across two levels of mediation and may reflect on the informants' or the researcher's psychology imposed on Wazana. Second, a symbolic reading of Wazana's calling is suggested centering on his marginality and unique location at the edge of the social order. Being at once human and demon-bound, Jew and Muslim, old and young, holy and impure, he dissolved the boundaries of the major contrasting social categories of his culture and integrated them. This bridging function may have nurtured his image as an omnipotent healer. PMID- 3281798 TI - Intracytoplasmic membrane configurations, vesicles and vesicular inclusions in Candida albicans. AB - Ultrastructural studies of Candida albicans in its invasive form obtained from oral lesions of patients with acute chronic candidosis, candidal infection on chorio-allantoic membrane of chick embryo, and of organisms grown artificially, have demonstrated the presence of an intracytoplasmic membrane system, vesicles and vesicular inclusions, in varying degrees. These variations appear to be attributed to the environment, cultural conditions and the age of the organism. Their origin, structure and distribution are described. PMID- 3281799 TI - Comparative cytogenetics and the determination of primitive karyotypes. PMID- 3281800 TI - Meiotic segregation of human sperm chromosomes in translocation heterozygotes: report of a t(9;10)(q34;q11) and a review of the literature. AB - Meiotic segregation products were studied in sperm from a man who was heterozygous for a reciprocal translocation, t(9;10)(q34;q11). A total of 171 sperm chromosome complements were studied by in vitro fertilization of hamster eggs. All possible 2:2 and 3:1 meiotic segregations were observed with the following frequencies: alternate, 41%; adjacent-1, 48%; adjacent-2, 5%; 3:1, 6%. Within alternate segregations, the number of normal sperm (35) was not significantly different from the number of sperm carrying a balanced form of the translocation (33), as expected. The proportion of sperm with an unbalanced form of the translocation was 60%. There was no evidence for an interchromosomal effect, since the frequencies of numerical (8%) and structural (15%) chromosomal abnormalities (both unrelated to the translocation) were within the normal range of control donors. The literature on a total of 10 translocation heterozygotes studied by sperm chromosome analysis was reviewed. PMID- 3281801 TI - Heterogeneous heterochromatin and size variation in the sex chromosomes of Microtus cabrerae. AB - The sex chromosomes of Microtus cabrerae are characterized by large segments of constitutive heterochromatin in both the X and Y. Alkali treatment, enzymatic digestion (trypsin), and fluorochrome staining reveal considerable heterogeneity within these heterochromatic blocks and allow us to distinguish several regions. In addition, variation in the length of these segments is also present, probably as a result of deletions. A possible explanation for the origin of these heterochromatic blocks is discussed. PMID- 3281802 TI - Chromosome localization of the human oncogene INT1 to 12q13 by in situ hybridization. AB - The human oncogene INT1 has been mapped to chromosome band 12q13 by in situ hybridization. The precise localization of this gene is of particular interest, since the region 12q13----q14 has been reported to be involved in chromosomal rearrangements in lipomas, myxoid liposarcomas, pleomorphic adenomas, and myomas. The involvement of this region in both benign and malignant tumors suggests a common pathogenetic pathway in which changes affecting INT1 may be an important step. PMID- 3281803 TI - Human renin gene assigned to chromosome band 1q42 by in situ hybridization. AB - A gene coding for renin was assigned to human chromosome region 1q42 by in situ hybridization. Many genes in this region belong to multigene families whose members may be located on the same or different chromosomes. Genes located on the long arm of chromosome 1 appear to have been involved in several instances of gene duplication. PMID- 3281804 TI - Is MYB amplified in acute myelogenous leukemia-derived cell lines? AB - Amplification of MYB DNA has been reported in two cell lines, ML-1 and ML-3, derived from a patient with acute myelogenous leukemia. A relationship between amplification and a terminal deletion on one of the homologs of chromosome 6 has been proposed. The present study shows that equivalent copy numbers for MYB DNA are present on each of the homologs of chromosome 6. Further, no evidence for gene amplification could be demonstrated in either cell line. PMID- 3281805 TI - Selecting CAI software. PMID- 3281806 TI - Hypoglycemia, brain metabolism, and brain damage. PMID- 3281807 TI - Diabetic nephropathy: etiology and prevention. PMID- 3281808 TI - Pathogenesis of diabetic glomerulopathy: hemodynamic considerations. AB - Early stages of diabetes mellitus are characterized by glomerular hyperfiltration in humans and experimental animals. In diabetic rats, single nephron hyperfiltration results from elevations in the glomerular capillary plasma flow rate and hydraulic pressure, which are in turn associated with progressive albuminuria and morphologic injury. Interventions that ameliorate these hemodynamic adaptations afford protection against structural injury. Dietary protein restriction, which lowers glomerular filtration, perfusion, and hydraulic pressure, retards glomerular injury and limits capillary basement membrane thickening in both the glomerular and retinal circulatory beds. Alternatively, selective control of glomerular capillary hypertension using angiotensin I converting enzyme inhibitor therapy limits glomerular injury in this model as well. Each of these interventions is effective even in the absence of improved metabolic control, implying that hemodynamic factors per se are important in this pathogenic process. The pathophysiologic mechanisms of diabetic hyperfiltration remain incompletely elucidated. Recent studies invoke a potential role for atrial natriuretic peptide (ANP). Strict metabolic control abolishes the elevations of glomerular filtration rate and of plasma ANP levels in moderately hyperglycemic diabetic rats. Moreover, infusion of a specific ANP antibody reverses hyperfiltration in diabetic rats. Thus, hyperglycemia-induced chronic volume expansion may trigger ANP release, which in turn contributes to diabetic hyperfiltration. Hemodynamic factors may play an important role in the pathogenesis of extrarenal microangiopathy as well. Elevated peripheral capillary blood flows and/or hydraulic pressure may be found in many peripheral capillaries, in association with thickening of the capillary basement membrane. Dietary protein restriction, which lowers blood flow to many organs, limits retinal as well as glomerular basement membrane thickening in diabetic rats, suggesting that hemodynamically mediated structural injury is a diffuse phenomenon in the diabetic state. PMID- 3281809 TI - Prognostic implications of renal hypertrophy in diabetes mellitus. AB - Early in the course of type 1 diabetes mellitus, hypertrophy of the kidney is a consistent finding that is easily diagnosed using current noninvasive methods, especially ultrasonography. Renal functional changes occur in association with hypertrophy, most notably glomerular hyperfiltration. The structural counterpart of this functional change is an early increase in capillary filtration surface area. In most forms of nondiabetic renal hypertrophy, kidney size is closely linked to GFR. In contrast, in diabetes, persistence of hypertrophy after the clinical onset of overt kidney disease (microalbuminuria, hypertension, decreased GFR, etc.) suggests that sustained release of one or more growth factors may continue even after kidney function declines. The fact that growth factors can act in both an autocrine and paracrine fashion raises the possibility that the local effects of such substances may act as local mediators of kidney growth. Failure of renal hypertrophy to reverse following strict glycemic control for a few months may turn out to be an important prognostic indicator of future progression of the renal disease, but this remains to be established. Prospective studies of kidney size in patients with newly diagnosed type 1 diabetes, using accurate noninvasive methods, may be helpful in establishing whether irreversible ("autonomous") hypertrophy of the kidney is indeed a useful prognostic indicator. As therapies are developed that target the different microvascular complications of diabetes (retinopathy, nephropathy, neuropathy), a noninvasive estimation of kidney size may be a cost-effective method of predicting ultimate renal involvement. Since microalbuminuria occurs relatively late in the disease process, early and persistent hypertrophy of the kidney may become a useful prognostic test in the earliest stages of the disease. PMID- 3281810 TI - Overview of counterregulation and its abnormalities in diabetes mellitus and other conditions. PMID- 3281811 TI - [Anterior wall infarct in an angiographically demonstrated muscle bridge of the ramus interventricularis anterior]. AB - Coronary angiography in a 58-year-old man who had sustained an anterior-wall myocardial infarction demonstrated a myocardial bridge over the anterior interventricular branch as the only abnormal finding which, in the absence of any arteriosclerotic changes proximal or at the level of the bridge, suggests a causal relationship. PMID- 3281812 TI - [Diagnosis of the hepatorenal syndrome]. PMID- 3281814 TI - [Fly infestation in agricultural concerns--causes of resistance and methods of control]. PMID- 3281813 TI - [Therapy of the hepatorenal syndrome]. PMID- 3281815 TI - [Biotelemetrically established daily profile of the core body temperature of the female fallow deer (Dama dama L.) following immobilization with the Hellabrunner mixture in various environmental temperatures]. PMID- 3281816 TI - [Resistance of various Salmonella strains against certain antibacterial substances and aspects related to their virulence]. PMID- 3281817 TI - [Calcium and phosphorus levels in fecal water as a possible parameter for calcium and phosphorus intake in dairy cows and fattening bulls]. PMID- 3281818 TI - [The fowl mite as nuisance, pathogen and vector in man and domestic animal]. PMID- 3281820 TI - Transdermal clonidine. A preliminary review of its pharmacodynamic properties and therapeutic efficacy. AB - The clonidine transdermal therapeutic system (TTS) is a cutaneous delivery device which provides therapeutically effective doses of clonidine at a constant rate over 7 days. In clinical trials it reduces blood pressure in patients with mild to moderate hypertension as effectively as oral clonidine but with greater stability of blood pressure control. Most patients find the transdermal system more convenient than oral treatments, and compliance may be improved. The side effects known to occur with orally administered clonidine, dry mouth and sedation in particular, are also produced with transdermal administration, but possibly at a lower incidence than during oral treatment. A proportion of patients experience adverse skin reactions with the transdermal system. At this stage of its development, transdermal clonidine has not been adequately compared with other 'standard' antihypertensive treatments such as diuretics or beta-adrenoceptor blocking drugs. However, despite the lack of such comparative studies, transdermal clonidine represents a worthwhile new approach to antihypertensive therapy, particularly in terms of patient convenience. PMID- 3281819 TI - Brotizolam. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy as an hypnotic. AB - Brotizolam is a new thienotriazolodiazepine derivative with a pharmacological profile similar to that of benzodiazepines. It is indicated for use as an hypnotic in the management of insomnia, although it also has anticonvulsant, antianxiety and muscle relaxant properties in animals. In clinical trials brotizolam 0.125 to 0.5mg improved sleep in insomniacs similarly to nitrazepam 2.5 and 5mg, flunitrazepam 2mg and triazolam 0.25mg, whilst brotizolam 0.5mg was shown to be superior to flurazepam 30mg in some studies. Brotizolam is an effective hypnotic for hospital patients awaiting surgery, in whom it also reduces anxiety. Brotizolam has an elimination half-life of about 5 hours, which is 'intermediate' compared with the shorter-acting hypnotic, triazolam, and longer-acting benzodiazepines. Consequently, it is able to induce sleep without producing early morning rebound insomnia, and can also maintain sleep throughout the night. Brotizolam at dosages below 0.5mg at night usually produced minimal morning drowsiness; no residual impairment of psychomotor performance occurs following dosages within the recommended range of 0.125 to 0.25 mg/kg. No serious side effects have been reported to date and the most frequently observed adverse experiences are drowsiness, headache and dizziness. Mild rebound insomnia may occur in some patients when treatment is stopped. Thus, brotizolam is a useful hypnotic which can be used in patients who have difficulty in falling asleep and also in patients who are troubled by night-time awakenings. Used in the recommended dosage it may be particularly useful for patients in whom daytime impairment of performance is unacceptable. PMID- 3281821 TI - Sulconazole. A review of its antimicrobial activity and therapeutic use in superficial dermatomycoses. AB - Sulconazole is a substituted imidazole antimicrobial agent structurally related to other drugs in this group. It possesses a broad spectrum of activity in vitro against dermatophytes, yeasts and some Gram-positive bacteria. The efficacy and safety of sulconazole 1% cream has been demonstrated in controlled clinical studies in patients with superficial dermatophyte or yeast infections. In these trials, sulconazole generally displayed similar efficacy to clotrimazole, econazole and miconazole, although in a few studies sulconazole produced better and/or quicker improvement than clotrimazole or miconazole in small numbers of patients with tinea pedis. Further studies in larger groups of patients are needed to confirm these encouraging preliminary findings. Thus, sulconazole is an effective and well tolerated alternative to other topical imidazole drugs in the treatment of superficial fungal infections of the skin. PMID- 3281824 TI - Importance of animal experiments in carcinogenesis research. PMID- 3281825 TI - Flavone mutagenicity in Salmonella typhimurium: dependence on the pKM101 plasmid and excision-repair deficiency. AB - Flavones mutagenic in Salmonella typhimurium fall into two distinct classes, characterized by different structural and metabolic activation requirements and by different strain responses. The mutagenic potencies of a prototype agent of each class, quercetin (3,3',4',5,7-hydroxyflavone) and norwogonin (5,7,8 hydroxyflavone), were determined in tester strains differing in excision-repair capability and in the presence or absence of plasmid pKM101. Two series of strains were used, one with the hisD3052 frameshift mutation and one with the hisG46 missense mutation. With both agents and for both series of strains, the mutagenic response was markedly dependent on the absence of excision repair and the presence of the pKM101 plasmid. PMID- 3281823 TI - PAF antagonists. Their potential therapeutic role in asthma. PMID- 3281826 TI - Effect of treatment medium on induction of aneuploidy by nocodazole in Saccharomyces cerevisiae. AB - While studying ways to improve responsiveness of Saccharomyces cerevisiae strain D61.M to agents that induce aneuploidy, we noted that nocodazole, which strongly induces aneuploidy when yeast cells are treated in yeast extract-peptone-dextrose (YEPD) medium, had no effect when a synthetic complete (SC) medium was used. Further study revealed that the presence of peptone was necessary for induction. Other aneuploidy-inducing agents, including ethyl acetate, acetone, and methyl benzimidazole-2-yl-carbamate (MBC), were equally active in either medium. Benomyl, which degrades to MBC, was less active in SC than in YEPD medium. PMID- 3281822 TI - Aspirin in cardiovascular disease. AB - Although other mechanisms may be contributory, the antithrombotic properties of aspirin derive predominantly from its platelet-inhibitory effects. These are mediated via irreversible acetylation of platelet cyclo-oxygenase with subsequent blockade of platelet thromboxane synthesis. Long term administration of doses of aspirin as low as 20mg daily depresses platelet thromboxane formation by more than 90%; however, higher doses appear to be necessary to prevent thromboxane dependent platelet activation in vivo. While there is evidence of biochemical selectivity with low doses of aspirin, significant reduction of the platelet inhibitory eicosenoid, prostacyclin, occurs even at dosages ranging from 20 to 40mg daily. The ability of aspirin to prevent the occurrence or recurrence of vaso-occlusion has been extensively investigated. In the secondary prevention of myocardial infarction 7 placebo-controlled trials involving more than 15,000 patients have been completed. The dose of aspirin varied from 300 to 1500mg daily. Although none of the individual trials produced statistically significant reductions in total or coronary mortality, taken together the results are highly suggestive of a beneficial effect of aspirin. Similarly, 2 recent studies in patients with unstable angina demonstrated a protective effect of aspirin against acute myocardial infarction and death. While each study employed widely different doses of aspirin (324mg and 1250mg daily) similar reductions in mortality were reported. The effects of aspirin on the prevention of coronary artery bypass graft occlusion have been evaluated in 9 trials. Aspirin in doses of 100 to 975mg daily was shown to be of benefit in preventing early (less than 6 months) graft occlusion, particularly when therapy was started within 24 hours of operation. In patients with prosthetic vascular grafts of the lower limbs, aspirin has been shown to reduce platelet deposition, however further controlled trials will be required to establish the patient population most likely to benefit and, as in all these studies, the optimum dose of aspirin to employ. In patients with prosthetic heart valves it is clear that aspirin alone is insufficient to prevent thromboembolic complications and when administered as an adjunct to anticoagulant therapy it is associated with a high incidence of bleeding. In contrast, there is convincing evidence from several studies for the efficacy of aspirin in doses of 990 to 1300mg daily in the prevention of stroke and death in patients with transient ischaemic attacks.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3281827 TI - Recontacting subjects in mutagen-exposure-monitoring studies: II. Results of a questionnaire study of mutagenesis researchers, with review of the pertinent literature. AB - A questionnaire on the attitudes of mutagenesis researchers regarding the health significance of and the use of data from tests of human mutagen exposure or genetic damage was completed by 71 of 312 (23%) individuals who had been participants in meetings or organizations concerned with mutagenesis research. On a point scale of 0 to 10, with 0 indicating strong disagreement, 5 indicating uncertainty, and 10 indicating strong agreement, the average respondent felt (8.31 +/- 2.27) that data indicating a probable health hazard should be shared automatically with the subjects, but was also moderately concerned about psychological distress of subjects learning of study results indicating abnormally high mutagen exposure (6.14 +/- 2.57) or genetic damage (6.94 +/- 2.48). The average respondent felt that follow-up of subjects could improve the quality of mutagen-exposure-monitoring studies (8.33 +/- 1.49), disagreed that subjects whose laboratory data suggested unusually severe exposure or damage should not be asked about possible sources of exposure (1.15 +/- 1.32), and disagreed that it was ethical to follow up but not discuss results with subjects having laboratory evidence of abnormal mutagen exposure (3.78 +/- 3.43) or genetic damage (3.06 +/- 3.17) to see how many developed cancer relative to a control group. Fifteen specific tests for measuring mutagen exposure or genetic damage were rated on a scale of 0 to 10, with 0 being "totally experimental" and 10 being "absolutely diagnostic of degree of exposure or genetic damage." Values ranged from 6.13 +/- 2.67 for karyotyping leukocytes to 3.43 +/- 2.43 for quantifying frequency of rare red cells with mutant protein. This study may help in decision making regarding follow-up of mutagen-exposed subjects. PMID- 3281828 TI - Chromosomal aberrations in the cotton rat, Sigmodon hispidus, exposed to hazardous waste. AB - The study of chromosome damage in rodents living on hazardous-waste sites may provide evidence of important biological consequences of chronic exposure to toxic chemical wastes. This study compared bone-marrow cells of animals (Sigmodon hispidus) taken from two superfund waste-disposal sites with those from an uncontaminated site and demonstrated that both populations exposed to hazardous wastes had significantly more structural and numerical aberrations than the control population. PMID- 3281829 TI - Selenium-mediated reduction in the mutagenicity of cigarette smoke. AB - Cigarette smoke contains carcinogens and mutagens and affects the health of smokers. Recently, increased research has proven the potentially protective activity of selenium (Se) against heavy metal toxicity, cancer, and other health disorders. Accordingly, we have proposed the fortification of tobacco with Se to develop safer cigarettes. As a start in evaluating any biological effects of added Se, we have determined the mutagenicity of inhaled, mainstream (MS) cigarette smoke condensate (CSC), with and without Se, in the preincubation assay of the Ames test. Initially, it was shown that Se, as sodium selenite, was not mutagenic at high concentrations (up to 80 micrograms/plate) with strains TA1538 and TA1978. Subsequently, the effects of different levels of Se, added to MS CSC, were examined with TA98, TA100, and TA1538. On the average, addition of 10 micrograms Se produced mutagenicity reductions of about 50%. Higher levels of added Se yielded further reductions. Cigarette sidestream (SS) smoke, collected between puffs, was also tested. Again, Se added to SS-CSC gave similar reductions, confirming its antimutagenic effect for both mainstream and sidestream smoke. PMID- 3281830 TI - Human mutagens: evidence from paternal exposure? AB - The importance of inherited mutations as a cause of human disease has been established clearly through examples of well-defined genetic anomalies, such as Down syndrome and retinoblastoma. Furthermore, it is suspected that environmental contaminants induce mutations resulting in increased risk for such defects in subsequent generations of persons exposed. The present lack of direct evidence for induced inherited genetic disorders in human beings hampers the development of risk estimation techniques for extrapolation from animal models. The most extensive prospective epidemiologic studies of inherited genetic effects have involved survivors of atomic bomb detonations and patients treated with cancer chemotherapy. In neither case has a significant elevation in inherited genetic effects or cancer been detected in the offspring of exposed individuals. Epidemiologic studies of subjects receiving chronic exposure may be confounded by the effect of maternal exposure during pregnancy. Consideration of only paternal exposure can minimize the confounding influence of teratogenicity, enhancing the resolving power of studies for inherited effects. Using this approach, retrospective (case-control) studies of childhood cancer patients have provided limited but suggestive evidence for inheritance of induced effects. Endpoints, such as congenital malformations and spontaneous abortion following paternal exposure, can also be considered as indicators of heritable mutagenic effects. For example, there is limited evidence suggesting that paternal exposure to anaesthetic gases may cause miscarriage and congenital abnormalities as a result of induced male germ cell mutations. By comparing male-exposure endpoints for which there are human data, as described above, with parallel or similar animal endpoints, such as dominant lethal, inherited cancer and "male teratogenic" effects, it is possible that suitable models for extrapolating to human risk can be developed. In order to establish a clearer relationship between induced mutation and genetic disease, the current surveillance systems should be expanded to include endpoints relevant to genetic study. The relaxation of regulations regarding access to census data could improve the chances of documenting such an association. PMID- 3281831 TI - Expression, renaturation and purification of recombinant human interleukin 4 from Escherichia coli. AB - The lymphokine human interleukin 4 (IL-4) has been expressed from a plasmid in the cytoplasm of Escherichia coli. Advantage has been taken of insolubility of the human IL-4 in E. coli for rapid purification of this protein in only a few steps. We describe extraction and renaturation procedures which solubilize human IL-4 yielding biologically active protein. The protein was purified to homogeneity by one passage over a gel-filtration column. The refolded human IL-4 was characterized by N-terminal sequence analysis, amino acid analysis and bioassays. The refolded E. coli-derived human IL-4 has biological activity on T and B cells and binds to the human IL-4 receptor, comparable to mammalian expressed human IL-4, indicating that the protein is folded correctly. PMID- 3281832 TI - Ornithine cyclodeaminase from Ti plasmid C58: DNA sequence, enzyme properties and regulation of activity by arginine. AB - Nopaline, an abundant opine in plant cells transformed with nopaline-type Ti plasmids, is catabolized in Agrobacterium by three Ti-plasmid-coded steps via arginine and ornithine to proline. The last enzyme, ornithine cyclodeaminase (OCD), converts ornithine directly into proline with release of ammonia. We describe the DNA sequence of the ocd gene from Ti plasmid C58, antiserum against an OCD fusion protein overexpressed in Escherichia coli, induction and identification of the gene product in Agrobacterium and enzymatic properties of the protein. The DNA sequence suggests a soluble protein with a stretch of some homology with ornithine carbamoyltransferases from other bacteria. OCD activity is subject to substrate inhibition, is stimulated by NAD+ (presumably acting as a catalytic cofactor) and is regulated by L-arginine which has pronounced effects on the optima for pH and temperature and on the Km for ornithine. The regulation of OCD activity by L-arginine is discussed as part of the mechanisms which integrate the pathway of Ti-plasmid-coded opine utilization with general metabolism in Agrobacterium. PMID- 3281833 TI - Electrostatic potential of macromolecules measured by pKa shift of a fluorophore. 2. Transfer RNA. AB - The procedures developed earlier (Friedrich and Woolley, preceding paper in this journal) for probing electrostatic potential with the fluorescein label were applied to transfer RNA. By using tRNA species that contain chemically reactive bases we were able to label these bases with fluorescein derivatives and thus to 'map' the electrostatic potential around the molecule. Both the electrostatic potential and the fluorescence emission anisotropy data that were obtained at the same time could be understood in terms of the well-known, paradigmatic crystal structure of tRNA(Phe). However, within the distribution of the various tRNA species, tRNA(Met)f appeared to occupy an extreme position, which suggests a relation between the conformation in solution and the initiation function of this molecule. Comparison with theoretical predictions by others of the electrostatic potential map of tRNA showed agreement in respect of trends, but the values of the potentials measured were orders of magnitude lower than predicted. This we attribute primarily to solvation. PMID- 3281834 TI - Isoleucyl-tRNA synthetase from baker's yeast and from Escherichia coli MRE 600. Discrimination of 20 amino acids in aminoacylation of tRNA(Ile)-C-C-A. AB - For discrimination between isoleucine and 19 other amino acids by isoleucyl-tRNA synthetase from baker's yeast and from Escherichia coli MRE 600, discrimination factors D have been determined from kcat and Km values in amino-acylation of cognate tRNA(Ile)-C-C-A. Factors D are also products of initial discrimination factors I' and proof-reading factors II'; D = I' II'. Factors II' were calculated from AMP formation stoichiometries and factors I' as quotients of D and II'; I' = D/II'. II' is considered as a product of a pre- and post-transfer proof-reading factor (II' = II1II2), I' as a product of initial discrimination factors I1 and I2 which are due to two steps of initial discrimination. With the yeast enzyme the highest accuracy is achieved in discrimination between isoleucine and valine (D = 38,000); other D values in a high range (10,000-20,000) are observed for Gly, Ser, Thr, Leu and Met; the lowest factors D belong to Cys, Asp, Asn and Trp (300-700); the remaining amino acids are discriminated with medium D values (1000 10,000). Discrimination factors D observed for isoleucyl-tRNA synthetase from E. coli are on average 2-3 times higher than for the yeast enzyme. Highest values were found in discrimination against Gly, Ala and Val (60,000-72,000), the lowest values for Cys, Arg and Trp (600-3000); the other amino acids exhibit D values between 20,000 and 50,000. Initial discrimination factors can be related to hydrophobic interaction forces between the substrates and the enzyme; a hypothetical model of the amino acid binding site is discussed. PMID- 3281836 TI - Parametric imaging of blood flow. AB - The calculation of functional images was based on recorded fluoroscopic sequences. The Fourier coefficients of the first harmonic were calculated for each matrix element, and the amplitude and phase values were used for the generation of two synthetic images. The amplitude image demonstrated the maximum change in opacification with high image contrast. Phantom studies showed that a high correlation exists between the inverse phase differences and flow. The clinical application of the Fourier method revealed substantial additional information to conventional angiography in one of ten patients. While the morphological evaluation demonstrated no significant stenosis, the functional images showed a residual stenosis. PMID- 3281835 TI - The conformation and stability of recombinant-derived granulocyte-macrophage colony stimulating factors. AB - The conformation and stability of recombinant-derived human and murine granulocyte-macrophage colony stimulating factors produced in Escherichia coli have been investigated by analytical ultracentrifugation, urea-gradient polyacrylamide gel electrophoresis and several spectroscopic methods. The proteins were demonstrated to be physically homogeneous monomeric proteins with compact globular shapes and shown to have similar secondary structures containing both alpha-helix and beta-sheet structure. The intramolecular disulphide linkages of both proteins were shown to be essential for maintaining native conformation as reduction with dithiothreitol resulted in protein unfolding. Comparison of the human E. coli-derived (non-glycosylated) and mammalian cell culture-derived (glycosylated) proteins by urea-gradient electrophoresis indicated that glycosylation had no major effect on the conformational stability and kinetics of urea induced unfolding and refolding. PMID- 3281837 TI - Sonography of gallstones and biliary dilatation without a visible aetiology: the infrequency of obstructing choledocholithiasis. AB - This paper describes 50 consecutive patients who sonographically had gallbladder stones and dilated bile ducts, but no visible aetiology for the dilatation. We reviewed these cases to determine the frequency of choledocholithiasis in this setting. Common duct stones caused obstruction in only 36% of these patients. Other aetiologies included strictures due to chronic pancreatitis or prior stone passage in 24% of the patients, and malignant obstruction in 16%. In 24% of the patients, no cause was found for biliary dilatation; common duct stones or obstructing tumours were excluded in the group. Since aetiologies other than stones are likely in a majority of cases, further preoperative workup (CT, percutaneous transhepatic cholangiography, ERCP) or intraoperative cholangiography (if the patient requires urgent cholecystectomy) is indicated. The additional studies should provide a diagnosis, help determine whether or not the common duct should be explored, or avoid unnecessary operation in case of incurable malignancy. PMID- 3281838 TI - High dose brain CT with ioxaglate and diatrizoate adverse reactions and effects on urine protein tests. AB - Sodium meglumine ioxaglate (320 or 306 mg I/ml) and meglumine diatrizoate (306 mg I/ml) in an intravenous dose of 2 ml/kg were compared in a randomized double blind test on the brain CT of 209 patients. Side effects were noted in 56% of the ioxaglate group and 90% of the diatrizoate group. Diatrizoate caused a sensation of heat significantly more often and more intensely, but the frequencies of other side effects did not differ significantly. No severe reactions occurred. The quality of the CT scans was equal. Neither ioxaglate nor diatrizoate impaired renal function. False-positive strip tests and falsely elevated protein values measured by the biuretic method were found in particular in the ioxaglate group. The results of urine protein measurements and strip tests are misleading on the day of the examination with both ioxaglate and diatrizoate. PMID- 3281839 TI - The effect on the blood-brain barrier of intracarotid contrast media--iopamidol and diatrizoate. AB - The effect on the blood-brain barrier (BBB) was assessed following intracarotid injection of iopamidol (300 mgI/ml.), meglumine diatrizoate (305 mgI/ml.) and isotonic saline. Four ml/kg of 2% Evans blue solution and 0.1 mCi 99m Technetium DTPA (Tc-DTPA) were used as tracers. No blue staining was observed in the saline group. Three out of 10 animals showed blue staining in the iopamidol group. All ten animals showed blue staining in the diatrizoate group. There were statistical differences between the diatrizoate and the other two groups. Tc-DTPA extravasation was 0.37 +/- 0.13 (mean +/- SD) in the saline group, 1.29 +/- 0.77 in the iopamidol group and 3.88 +/- 1.67 in the diatrizoate group. Statistical differences were observed among three groups. These observations suggest that Tc DTPA is very sensitive in detecting a subtle BBB injury and that iopamidol had a significantly smaller effect on the BBB than did meglumine diatrizoate. PMID- 3281840 TI - Adjuvant chemotherapy for osteogenic sarcoma. PMID- 3281841 TI - Amphotericin B as a potentiation agent to cytotoxic chemotherapy. PMID- 3281842 TI - Iproplatin and carboplatin induced toxicities: overview of phase II clinical trial conducted by the EORTC Early Clinical Trials Cooperative Group (ECTG). AB - Data of five phase II clinical trials on iproplatin and carboplatin, conducted by the ECTG, have been pooled in order to evaluate the extent of toxicities of these compounds. One hundred and seventy patients treated with iproplatin and 65 patients treated with carboplatin were evaluable. Most of them (81%) had been previously treated with chemotherapy. Doses ranged from 180 to 300 mg/m2 every 4 weeks for iproplatin, and from 350 to 450 mg/m2 every 5 weeks for carboplatin, according to the initial status of the patient. WHO criteria were used to grade toxic effects. Weekly blood counts were performed, and lowest observed counts were analysed by non-parametric methods. Censored data were analysed by actuarial methods. Thrombocytopenia was the dose-limiting toxicity and was dose related. Leucopenia was less severe. The risk of thrombocytopenia varied largely amongst patients, and could be predicted from the initial platelet count, the initial creatinine level and prior therapy with alkylating agents. The cumulative risk increased with the total dose, but with a decreasing hazard rate, and without additional delay to platelet recovery. Nausea, vomiting and diarrhoea were the most frequently observed non-haematological side-effects, and were more severe with iproplatin than with carboplatin. Peripheral neuropathy was observed in some cases, but could be due to prior treatments. Renal toxicity did not cause major problems. Our results confirm the findings of the phase I trials: thrombocytopenia is dose-limiting for both drugs, and renal side-effects are negligible. The risk model of thrombocytopenia, consistent with Egorin's model for carboplatin, could serve as a basis for dose adjustment. The feasibility of the scheme could be insufficient for prolonged treatment. PMID- 3281843 TI - Role of gastrin and cholecystokinin in tumours of the gastrointestinal tract. PMID- 3281844 TI - The role of aspiration cytology in the management of thyroid nodules. AB - In the hands of an experienced cytologist aspiration cytology is a safe and hitherto the best diagnostic tool in the evaluation of nodular thyroid lesions. In histologically verified case series 50-90% of confirmed thyroid cancers can be detected by aspiration biopsy, the sensitivity being dependent on sampling errors, microscopic misinterpretation and the variation in attitude towards indeterminate diagnosis in the decision for diagnostic surgery. The number of proven benign cases that are correctly identified as such by biopsy varies accordingly and approx. 75% (specificity). In comparison with imaging procedures, including those giving information of functional activity, the combined sensitivity and specificity rates of aspiration cytology come closest to the ideal discriminatory situation. In combination with case history and careful clinical examination, fine needle aspiration cytology is the best guidance for an optimal selection of patients for therapeutic or diagnostic surgery. Future development of sensitive markers for malignant degeneration will probably increase the selective power of this diagnostic technique. PMID- 3281845 TI - Clinical and radio-diagnostic aspects in the evaluation of thyroid nodules with respect to thyroid cancer. PMID- 3281846 TI - Thyroid cancer: the case for total thyroidectomy. AB - Since there are no prospective studies concerning the treatment of thyroid cancer, there continues to be a considerable disagreement about the 'best' or most appropriate form of surgical treatment for patients with papillary or follicular thyroid cancer. Some surgeons recommend selective treatment depending upon the type of thyroid tumor and stage of the disease. Some advocate thyroid lobectomy and isthmusectomy, some near total thyroidectomy, and some total thyroidectomy for patients with papillary and follicular thyroid cancer. Total thyroidectomy for thyroid cancer would be the treatment of choice for virtually all patients with thyroid cancers if it could be done without complications. We therefore reviewed 160 consecutive patients who had total thyroidectomy for suspected or proven thyroid cancer to determine the complication rate of total thyroidectomy. One hundred and three patients had primary operations, 57 had reoperations with completion of total thyroidectomy and 124 had thyroid cancer. Serious complications (i.e. vocal cord paralysis or hypoparathyroidism) included two cases of transient bilateral recurrent nerve palsy, two patients with presumed transient unilateral vocal cord paralysis, three recurrent laryngeal nerves that were purposely sacrificed because of invasion of the nerve, and one case of permanent hypoparathyroidism. Two other patients developed postoperative wound infections. Only one of the permanent complications, the case of permanent hypoparathyroidism, could have been avoided by a lesser procedure. The experienced surgeon can perform a total thyroidectomy with minimal morbidity, and this procedure has certain theoretical and practical advantages. It should not be done, however, if it will result in a significant complication rate and, in selected patients, it may be preferable to leave a small amount of thyroid tissue to protect the blood supply to the parathyroid glands or recurrent laryngeal nerve. PMID- 3281847 TI - Modified neck dissection in treatment of thyroid cancer: a safe procedure. AB - Differentiated carcinoma of the thyroid metastasizes early and frequently to cervical lymph nodes. Radical neck dissection performed electively or therapeutically results in high cure rates. Modified neck dissection consisting of a single transverse incision, resection of the jugular chain of nodes and those in the posterior triangle of the neck with preservation of the sternomastoid muscle, the spinal accessory nerve and the submandibular salivary gland provides a cosmetic, functional result with minimal morbidity. In a series of 313 neck dissections for thyroid carcinoma, only three patients with papillary or follicular carcinoma, which was resectable, treated by thyroidectomy and modified neck dissection died of disease. PMID- 3281848 TI - Differentiated thyroid cancer: a stage adapted approach to the treatment of regional lymph node metastases. AB - The controversy in the management of regional lymph nodes in patients with differentiated thyroid cancer is discussed on the basis of a review of the literature. Since no prospective studies have yet compared limited dissections ('node picking') with more extensive dissections [(modified) radical neck dissection], a retrospective analysis was performed using two patient groups in which patients were managed differently with regard to the preoperative diagnosis and treatment of regional lymph node metastases. Only patients with proven lymph node metastases were included in the study. Because of selection methods necessary to create comparable patient groups, only 83 patients could be included in the analysis. There was no difference in survival or recurrence rate in either group, although recurrences occurred less frequently in the explored side of the neck after MRND (3.9% vs. 6.3%). More postoperative morbidity was found in the patients who had been subjected to a more extensive search for and treatment of lymph node metastases. Because of the relatively small number of patients only the difference in occurrence of accessory nerve palsies reached statistical significance (P = 0.05). It is advocated that only in the case of papillary carcinoma with limited lymph node involvement node picking is the procedure of choice. In all other cases a modified radical neck dissection should be standard treatment. PMID- 3281849 TI - The use of radioactive iodine in thyroid carcinoma. AB - The use of radioactive iodine (131I) for the treatment of primary carcinoma of the thyroid and as an alternative to a surgical thyroidectomy in the management of patients with metastatic disease is described. The rationale for using 131I to ablate normal thyroid tissue after a surgical thyroidectomy is considered in relation to the natural history of papillary and follicular tumours and in recognition of the results of such a policy in some recently reported series. It is concluded that 131I ablation is indicated in patients with follicular tumours: and in patients with papillary tumours if they are over the age of 40 or if the tumour contains a substantial follicular component. The management of patients undergoing post-operative 131I ablation is outlined and the possible complications of such treatment which include radiation thyroiditis, radiation sialitis, transient hyperthyroidism and oedema of the neck are described. PMID- 3281850 TI - Recombinant human granulocyte-macrophage colony-stimulating factor induces secretion of autoinhibitory monokines by U-937 cells. AB - Colony-stimulating factors are required for survival proliferation, differentiation and functional activation of granulocytes, macrophages and their precursor cells. In the present report, however, we demonstrate antiproliferative activity of recombinant human (rh) granulocyte-macrophage colony-stimulating factor (GM-CSF) on monoblast cell line U-937 and provide evidence for the involvement of tumor necrosis factor alpha TNF-alpha and interleukin 1 beta (IL 1 beta) in its growth inhibitory action. GM-CSF (but not granulocyte CSF, G-CSF or macrophage CSF, M-CSF) suppressed DNA synthesis and self renewal of U-937 cells. Similarly, medium conditioned by U-937 cells in response to GM-CSF (GM-CSF U-937 CM) was able to reduce clonogenicity and [3H]thymidine uptake by U-937 cells. Since neutralization of GM-CSF present in GM-CSF U-937-CM by monoclonal antibody to GM-CSF did not abrogate the autoinhibitory activity present in GM-CSF U-937 CM, we considered the possibility that other soluble molecules are released by U 937 cells upon GM-CSF stimulation. Neutralization by antibodies to IL 1 beta and TNF-alpha suggested that both monokines could be the antiproliferative principle operating in GM-CSF U-937-CM. Moreover, employing IL 1 beta-specific enzyme linked immunosorbent assay, TNF-alpha specific radioimmunoassay, Northern analysis using a cloned TNF-alpha-specific cDNA and an oligonucleotide probe for IL 1 beta, we demonstrate GM-CSF-inducible IL 1 beta and TNF-alpha gene expression by U-937 cells at the mRNA and protein level. Although M-CSF expression was induced under similar conditions, M-CSF failed to inhibit growth of U-937 cells. PMID- 3281851 TI - In human monocytes a strong correlation exists between expression of the M3 antigen, Fc-mediated phagocytic activity and failure to participate in extracellular antibody-dependent cytotoxicity. AB - Human fresh blood monocytes can phagocytize and lyse antibody-coated target cells by contact with membrane Fc receptors. Recently, the monocyte differentiation antigen Leu M3 has been described to be associated with monocyte/macrophage maturation pathway and to be linked to functionally distinct monocyte subsets. In the present study peripheral blood monocytes were separated into M3+ and M3- subsets, and evaluated for their ability to mediate antibody-driven effector functions. A clear cut functional difference could be demonstrated. M3+ monocytes phagocytize antibody-coated sheep red cells but do not carry out contact-mediated extracellular lysis. In contrast, M3- monocytes have exactly the opposite functional features and they mediate cytolysis without exhibiting any phagocytic activity. By using phenotypically defined clones of the U937 histiocytic cell line, the segregation of different lytic abilities and their linkage of the M3 phenotype have been confirmed. PMID- 3281852 TI - Poultry meat as a source of human salmonellosis in England and Wales. Epidemiological overview. PMID- 3281853 TI - Managemental influences on the selective proliferation of two strains of haemolytic Escherichia coli in weaned pigs. AB - In an experimental study on a piggery it was found that haemolytic Escherichia coli of O-serotypes 138 or 139 proliferated in the intestinal tracts of pigs following weaning, with E. coli of the O-138 type also being occasionally recovered from unweaned pigs, and once from a sow. Organisms of the O-138 type produced heat labile enterotoxin and their presence in weaned pigs was associated with the development of severe post-weaning diarrhoea. E. coli of O-139 type produced a vero cell cytotoxin and were associated with a milder diarrhoea in weaned pigs. Under various managemental circumstances the O-138 type E. coli almost invariably proliferated after weaning. The O-139 strain of E. coli did however proliferate rather than the O-138 strain following the movement of weaned pigs to new accommodation, after weaned pigs were returned to their sow and then weaning again 5 days later, and very occasionally in pigs weaned at 5 weeks of age. In all these cases earlier proliferation of the O-138 E. coli had been detected, suggesting that this may be a prerequisite for proliferation of the O 139 strain. PMID- 3281854 TI - A microbial culture system for use in remote field environments. AB - Field studies of human flora carried out in remote environments are often compromised by problems associated with media, equipment or cargo limitations. For the International Biomedical Expedition to Antarctica an anaerobic culture system was developed based on sealed vials, pre-reduced anaerobically sterilized media, antibiotic selective media and compact processing equipment. The system proved simple to use in a harsh environment and gave results comparable with standard plate and roll-tube techniques. No problems with dehydration, contamination or oxidation were encountered. Furthermore, the system preserved viability of primary isolates for up to 6 months of storage. PMID- 3281855 TI - Bacteriocin (klebocin) typing of clinical isolates of Klebsiella pneumoniae. AB - Three-hundred-forty-two clinical isolates of Klebsiella pneumoniae were subjected to bacteriocin (klebocin) typing using six standard klebocin-producer strains (153-158). The overall typability was 72.8 per cent. The predominant klebocin types found were 244 (14.3 per cent), 313 (13.7 per cent) and 113 (7.6 per cent). Klebocin types 314 and 111 each contributed 5.2 per cent to the total number of isolates. No significant correlation was observed between the source of isolation and the klebocin type. PMID- 3281856 TI - Two genes for chloramphenicol resistance common to staphylococci and streptococci. AB - Southern blot hybridization and pneumococcal transformation were used to study the epidemiology at a molecular level of the genes for chloramphenicol resistance (cat) in streptococci and staphylococci. The cat gene of staphylococcal plasmid pC194 showed homology to the cat genes of the chromosomal elements of 5 different strains of Streptococcus pneumoniae and of Streptococcus agalactiae B109. DNA sequence homology was also detected between the cat gene of staphylococcal plasmid pC221 and the cat gene of broad host range conjugative plasmid pIP501, originally isolated from S. agalactiae. Two different cat genes appear to be present in clinical isolates of both streptococci and staphylococci. PMID- 3281857 TI - A case of Creutzfeldt-Jakob disease related to familial retinitis pigmentosa patients. AB - Similarities between serological alterations and retinal degeneration occurring in natural and experimental CJD and in some forms of human retinal degeneration have recently been reported. In the present paper a family from an areal focal accumulation of CJD in Central Slovakia with 1 histopathologically verified case of Creutzfeldt-Jakob disease and 2 case of retinitis pigmentosa is described. Neuropathological and epidemiological data obtained in investigated patients are discussed from the point of view of a possible relationship between the slow virus infections caused by unconventional agents and degenerative disease affecting the ocular system. PMID- 3281858 TI - Biotyping of aerobic actinomycetes by modified killer system. AB - Forty-four yeasts belonging to the genera Pichia, Candida, Saccharomyces and Kluyveromyces were tested for their potential killer effect on 13 aerobic actinomycetes (6 Nocardia asteroides, 1 N. brasiliensis, 1 N. caviae and 5 Actinomadura madurae). Only a few yeast strains did not display any killer activity against the aerobic actinomycetes studied, thus confirming that the killer phenomenon is widespread among microorganisms. For epidemiological purposes, a killer system was developed. According to their susceptibility to the 9 killer yeasts chosen, it was possible to differentiate the Nocardia and Actinomadura isolates into biotypes. Fitting conditions of the killer system to potential sensitive microorganisms with different characteristics of growth are also discussed. PMID- 3281859 TI - Role of pokeweed mitogen spleen conditioned medium in regulating haematopoiesis in long-term human marrow cultures. AB - The modulatory effect of pokeweed mitogen spleen conditioned medium (PWM-SCM) on the growth of myeloid progenitors (CFU-C) and on the composition of the stromal layer in human bone marrow long-term cultures was studied. In the presence of PWM SCM there was enhanced CFU-C growth in the adherent layer throughout 6 weeks of incubation, with 2-fold, 2-fold and 3.4-fold increases during wk 2, 4 and 6 respectively (p less than 0.05). In the non-adherent layer of control cultures, however, there was a rapid decline in haematopoiesis which could not be offset by PWM-SCM. The differentiation pattern of CFU-C (entailing monocyte - macrophage progenitors CFU-M, granulocytic progenitors CFU-G or monocyte - granulocyte progenitors CFU-GM) was not altered by PWM-SCM. Fewer lipid-containing cells developed in the adherent layer of cultures treated with PWM-SCM than in control cultures, but the distribution pattern of monocytes - macrophages or granulocytes was not affected. These results suggest that in long-term cultures of human marrow cells there may be extensive haematopoiesis in the presence of PWM-SCM. Whether this is a direct effect on progenitor cells of stimulating factors, or rather of accessory cells in the adherent layer, remains to be clarified. PMID- 3281861 TI - [Ninetieth anniversary of the birth of Academician P. K. Anokhin]. PMID- 3281860 TI - Diagnosis of meningeal involvement in childhood acute lymphoblastic leukemia: cytomorphology and TdT. AB - Between December, 1984, and May, 1986, 98 CSF samples were sent to a central laboratory by postal express. The samples could be kept in a medium for up to 24 hours after the lumbar puncture. The quality of the cells proved to be good. Excluded were 5 samples delayed in delivery and 13 samples contaminated with blood, defined as the macroscopical presence of blood. The microscopical presence of erythrocytes in the cytocentrifuge preparation can make interpretation of the results difficult. Especially when leukemic blasts are present in the blood, extreme caution is necessary. A total of 71 samples could be studied by cytomorphology as well as by TdT-IF. When cytomorphological leukemic blasts were present, this was confirmed by TdT-IF positivity in all cases. But in 6 of 71 samples, TdT-IF was positive without the presence of cytomorphological leukemic blasts. Follow-up of these patients will show whether the therapeutic regimen has to be changed. PMID- 3281862 TI - [Mechanism of action of dapsone in chronic inflammatory dermatoses. II: Modification of lymphocyte function and mechanisms of inflammation]. PMID- 3281863 TI - [Dynamics of the lupus band test in chronic discoid lupus erythematosus]. PMID- 3281864 TI - Development of brain insulin receptors. PMID- 3281865 TI - Regulation of the first step of the histidine biosynthesis in Escherichia coli. PMID- 3281866 TI - Effect of age and day time on the adenosine modulation of basal and insulin stimulated glucose transport in rat adipocytes. AB - 1. The relationship between the activity of adenosine metabolizing enzymes 5'nucleotidase (5'N), adenosine kinase (A.K.) and adenosine deaminase (A.D.) with basal and insulin-stimulated glucose transport in isolated fat cells from young and old animals was studied at 08:00 and 16:00 hr. 2. In cells from young animals a larger insulin-stimulation of glucose transport was observed at 16:00 hr than at 08:00 hr. Also at 16:00 hr small changes in 5'N, A.K. and A.D. activities suggest a decrease in adenosine formation. 3. In the cells from old animals no effect of insulin was observed at any time, while a 3-5-fold increase in 5'N indicated a predominance of adenosine formation at both times studied. 4. An inverse relationship was observed in the changes of adenosine metabolism and insulin action. PMID- 3281867 TI - Fetal alcohol effects: evidence of developmental impairment in the absence of immunotoxicity. AB - Pregnant CD-1 mice were intubated from Days 5-17 of gestation with an isocaloric solution of ethanol and/or maltose dextrins in 10% Bio-Serv liquid diet, at doses of 0, 6, and 9 g/kg/day. The control females were food-restricted so that their food consumption matched that of the high-dose females. At delivery, the pups were assigned surrogate mothers and litters were culled to a uniform litter size, when possible. Immediately following birth some pups were examined using a battery of behavioral/developmental tests to monitor postnatal development. At 6 8 weeks of age, other pups were evaluated for changes in immune function. Another group of pups was terminated at 12 weeks of age for hematology and clinical chemistry determinations and histological examination of selected organs. Postnatal developmental delays were seen in pinna detachment, surface righting reflex, eye opening, and incisor eruption. There was no characteristic pattern to immune alterations of the plaque forming cell response to a T-dependent antigen sheep red blood cells, delayed hypersensitivity, and T- and B-lymphocyte blastogenesis. Possible kidney pathology was indicated by a reduction in blood urea nitrogen in the offspring of females treated with 9 g/kg/day. No treatment related effects were noted in those tissues which were examined histologically. PMID- 3281868 TI - [Genetic mapping of the ilv7434 mutation providing threonine deaminase resistance to isoleucine inhibition in Escherichia coli]. AB - Location of previously isolated ilv7434 mutation was determined by use of transductional shortening of the F'14 episome. The ilv7434 mutation causes resistance of threonine deaminase (coded for by ilvA gene) to feed-back inhibition by isoleucine. Another phenotype characteristics of the ilv7434 mutant is the ability to feed a lawn of isoleucine auxotrophs in the cross-streak test. The F'14 strain AB1206 carrying ilv7434 mutation was used as a donor for making transductionally shortened episomes in recA recipient. These shortened F'14 episomes containing variable segments of the ilv cluster were then tested for their ability to transfer ilv7434 phenotype by complementation with ilv recA recipients. The data of complementation test suggest that ilv7434 is situated between ilvD and ilvC genes. One of 20 tested shortened episomes carrying, as shown by complementation test, incomplete ilvA gene was found to transfer ilv7434 phenotype by recombination with ilvA527 recA+ recipient. These data allow to conclude that ilv7434 mutation is located within the ilvA gene. PMID- 3281869 TI - [Yeast resistance to polyene antibiotics. VI. Isolation and biochemical analysis of strains of Saccharomyces cerevisiae yeasts with mutations in the 2 nystatin resistance genes]. AB - The comparative analysis of sterol content in the yeast Saccharomyces cerevisiae strains singly or doubly defective in nystatin resistance genes was carried out. The strains with two mutations in NYS genes were shown to accumulate the sterol mixture, similar to that of the parental singly defective mutant. This type of gene interaction allows to define the main biochemical order of reaction in ergosterol synthesis: methylation in C24 (NYS1), delta 8----delta 7 isomerization (NYS2), C5 (6) and C22 (23) desaturation (NYS3 and NYSX). PMID- 3281870 TI - The story of elderly care. End of Victorian times and Poor Laws. PMID- 3281871 TI - Radical formation during the peroxidase catalyzed metabolism of carcinogens and xenobiotics: the reactivity of these radicals with GSH, DNA, and unsaturated lipid. AB - Radicals generated by the peroxidase catalyzed oxidation of a wide variety of substrates oxidize GSH, NADH, or arachidonate with accompanying oxygen activation. Substrates studied include carcinogens, drugs, or xenobiotics. The effectiveness of the various radicals is partly related to their one-electron oxidation potential. High redox potential radicals were particularly effective at oxidizing these biomolecules. Low redox potential radicals did not react with GSH, NADH, or arachidonate, but can directly activate oxygen to form hydroxyl radicals or undergo scission to carbon radicals. The hydroxyl and carbon radicals have a high redox potential and readily oxidize biomolecules. DNA strand breakage also occurs with some high redox potential radicals, but DNA did not react with low redox potential radicals. The extensive binding of xenobiotics to DNA in the peroxidase system was attributed to noncovalent binding by polymeric products or covalent binding by the two electron oxidation product (formed by radical dismutation or oxidation). The latter can cause alkali labile DNA strand breaks. GSH conjugate formation was also attributed to the two electron oxidation product. Radicals have been trapped in intact cells and oxygen activation or lipid peroxidation has been demonstrated but it is still not clear whether the associated GSH oxidation, DNA strand breakage and cytotoxicity is the result of direct action by radicals. Indirect enzymic mechanisms for free radical mediated DNA strand breakage and cytotoxicity are discussed. PMID- 3281872 TI - Treatment of ulcerative reflux oesophagitis with colloidal bismuth subcitrate in combination with cimetidine. AB - Twenty patients took part in a controlled double blind study comparing the efficacy of colloidal bismuth and cimetidine (800 mg at night) with cimetidine alone in the treatment of ulcerative reflux oesophagitis. Colloidal bismuth 120 mg was administered through an intraoesophageal tube four times a day. Cimetidine with colloidal bismuth gives significantly (p less than 0.001) better results than cimetidine alone. Of 10 patients treated with cimetidine and bismuth, seven had no endoscopic signs of oesophagitis after three weeks and three had grade I oesophagitis. Of 10 patients treated with cimetidine alone, one had grade I oesophagitis and three grade II oesophagitis after three weeks. The remaining six still had grade III oesophagitis. This study also shows that in nine of 10 patients reflux oesophagitis was accompanied by infection with campylobacter like organisms (CLO). After treatment the bacteria disappeared promptly in five patients receiving combination therapy and in two of four treated with cimetidine alone. The possible role of CLO in reflux oesophagitis is uncertain. PMID- 3281874 TI - Does your charting reflect your worth? PMID- 3281875 TI - [First pass radionuclide angiography in diagnosis and prognosis of ischemic heart disease]. PMID- 3281876 TI - [Dermatological diseases and manifestations in psychological factors]. PMID- 3281873 TI - Motility of the ileocolonic junction. PMID- 3281878 TI - [The indications for permanent cardiac pacemaker implantation]. PMID- 3281877 TI - [Myocardial perfusion scintigraphy using thallium 201]. PMID- 3281879 TI - [What is new about benign familial leukopenia]. PMID- 3281880 TI - [Acral lentiginous melanoma]. PMID- 3281881 TI - [Glycogen storage disease type Ib]. PMID- 3281882 TI - [Preventive medicine for children of divorced parents]. PMID- 3281883 TI - [Jewish immigrant physicians from Nazi Germany and their contribution to medicine in Israel]. PMID- 3281884 TI - Endotoxin levels measured by a chromogenic assay in portal, hepatic and peripheral venous blood in patients with cirrhosis. AB - Endotoxin concentrations were measured in the portal, hepatic and peripheral venous blood of two groups of patients with cirrhosis using a limulus-based chromogenic assay. The high sensitivity of chromogenic detection allowed measurement of endotoxin as low as 10 to 15 pg per ml, an order of magnitude greater than previously possible by gelation studies. Group 1 consisted of 56 patients with cirrhosis undergoing angiographic evaluation. In this group, there was wide variability in hepatic venous concentration [73 +/- 110 pg per ml (mean +/- S.D.)] and peripheral venous concentration [31 +/- 58 pg per ml]. However, paired t test showed peripheral venous concentration was significantly (p less than 0.001) lower than hepatic venous concentration. Neither hepatic or peripheral venous endotoxin levels correlated significantly with a variety of clinical, biochemical or radiological parameters. Group 2 consisted of 21 patients with cirrhosis undergoing shunt surgery. Endotoxin levels again showed a wide range, with portal venous concentration (142 +/- 167 pg per ml) and simultaneous peripheral venous concentration (82 +/- 150 pg per ml). Paired t test in this group showed a significant (p less than 0.001) portal to peripheral venous gradient. This study showed the feasibility of measuring endotoxin in plasma to low concentrations by a chromogenic assay technique. It supports the concept of relatively high levels of endotoxin in the portal circulation. In the presence of liver disease, systemic endotoxemia occurs, which is augmented by stressful situations. PMID- 3281885 TI - Reduction by prostacyclin of acetaminophen-induced liver toxicity in the mouse. AB - The effect of prostacyclin on acetaminophen-induced liver injury has been investigated in the mouse. Two structurally unrelated thromboxane synthetase inhibitors, OKY 1581 and benzyl imidazole, were also examined in order to investigate the role of the prostacyclin-thromboxane balance in the development of hepatic lesions. Whereas prostacyclin or OKY 1581 given shortly after acetaminophen prevented mortality and reduced liver necrosis, as assessed by serum ALT activity and histology, benzyl imidazole was only effective if given prior to acetaminophen. Acetaminophen overdose resulted in an enhanced prostaglandin and thromboxane generation by liver homogenates. While OKY 1581 inhibited thromboxane production by the liver homogenates, prostacyclin synthesis was increased. Pretreatment with the cyclooxygenase inhibitor indomethacin blocked both the increase in prostacyclin generation and the protective effect of OKY 1581. Benzyl imidazole inhibited the synthesis of thromboxane but did not enhance prostacyclin production. In addition, the protective effect of benzyl imidazole was unaltered by indomethacin pretreatment. Furthermore, whereas benzyl imidazole interfered with hepatic drug metabolism, as assessed by prolongation of the pentobarbitone sleeping time, prostacyclin and OKY 1581 were without activity. Prostacyclin treatment can prevent acetaminophen-induced liver necrosis in mice. Enhanced prostacyclin synthesis by the selective thromboxane synthetase inhibitor OKY 1581 also exerts a protective role in this model. PMID- 3281886 TI - In vitro toxicity of polymorphonuclear neutrophils to rat hepatocytes: evidence for a proteinase-mediated mechanism. AB - Human polymorphonuclear neutrophils, when exposed to soluble or particulate stimuli, can destroy various types of cells. The aim of this study was to investigate their toxicity against hepatocytes. Human polymorphonuclear neutrophils were incubated in basal conditions and after stimulation with 5 mg per ml opsonized zymosan in the presence of rat hepatocytes isolated by collagenase digestion. Cytotoxicity was quantified by the percentage of ALT activity released by hepatocytes in culture medium. Whereas unstimulated neutrophils exhibited only minor effects, opsonized zymosan-stimulated neutrophils induced, after 16 hr incubation, a 24.0 +/- 4.1% (mean +/- 1 S.E.) ALT activity release at a neutrophil/hepatocyte ratio of 5, and a 51.7 +/- 6.8% ALT activity release at a ratio of 20. At this ratio of 20, the ALT activity release was 9.0% at 1 hr and 24.0% at 4 hr. Three proteinase inhibitors (i.e., soybean trypsin inhibitor, alpha 1-proteinase inhibitor and fetal calf serum) decrease cytotoxicity by 78, 76 and 78%, respectively. The protective effect of proteinase inhibitors was not due to a nonspecific effect of proteins, since bovine serum albumin did not decrease the toxicity of stimulated polymorphonuclear cells. The supernatant of stimulated neutrophils was also found to be toxic against hepatocytes, and again, this effect was inhibited by soybean trypsin inhibitor, alpha 1-proteinase inhibitor and fetal calf serum. Finally, the role of proteinases was supported by the demonstration of a cytotoxic effect of two purified proteinases: porcine pancreatic elastase and human neutrophil cathepsin G. The toxicity of these proteinases was also markedly reduced by the specific inhibitors used in the study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281887 TI - Liver disease in children with PiZZ alpha 1-antitrypsin deficiency. AB - We present our experience with 18 pediatric patients with alpha 1-antitrypsin deficiency of the PiZZ phenotype. Fifteen patients (83%) presented with neonatal cholestatic jaundice at a mean age of 2 +/- 0.6 months (+/- S.D.). The male:female ratio was 15:3, indicating a male predominance. All metabolic, infectious and obstructive causes of jaundice were ruled out by appropriate tests in the patients with neonatal cholestasis. Liver biopsy in 14 patients with neonatal cholestasis showed a histological picture of cholestasis in all biopsies; neonatal giant cell hepatitis appeared in seven, increased fibrosis in appeared five and established liver cirrhosis appeared in two biopsies. Patients were followed for a mean of 3.7 +/- 2.4 years (+/- S.D.). Of the 15 patients with neonatal cholestasis, 3 under went liver transplantation because of decompensated liver cirrhosis at 3, 3 1/2 and 7 years. Two patients died at 4 months and 3 years from complications of liver cirrhosis. Of the remaining 10 patients, 3 had histological evidence of liver cirrhosis, and the remaining 7 patients continue to have enlarged liver and spleen with abnormal liver function tests. Of the three patients without history of neonatal cholestasis, only one had enlarged liver and spleen, and the remaining two are healthy with normal liver function tests. Our experience indicates serious liver disease is highly likely to develop in patients with PiZZ alpha 1-antitrypsin deficiency who present with neonatal cholestatic jaundice. Our experience differs from more recent reports on such patients. PMID- 3281888 TI - Serum albumin. AB - The liver manufactures albumin at a massive rate and decreases production in times of environmental, nutritional, toxic and trauma stress. Osmotic pressure is a basic evolutionary regulatory factor, and hormonal control over albumin production has been demonstrated. Where and why new or old albumin is degraded are questions which have not been clarified, although the vascular endothelium may well be the degradative site. Albumin is important as a transport protein, as a measure of evolution and as a model to study secretion following synthesis without the intervening steps of glycosylation. Investigations as to how this protein enters the endoplasmic membrane may well answer some of the questions concerning signal peptide insertion (288). The role of the urea cycle intermediate ornithine and its participation in polyamine synthesis, which has a positive effect on albumin synthesis, is under study. Likewise, the inverse relation between acute-phase protein synthesis and albumin synthesis regulated by interleukin 1 and other cytokines will merit further study. These are a few of the concepts which will be tested in the future. PMID- 3281889 TI - The liver in protoporphyria. PMID- 3281890 TI - Electropermeabilization: getting inside the cell to study autophagy. PMID- 3281891 TI - Postliver biopsy hepatic hematomas: are routine ultrasonograms needed? PMID- 3281892 TI - Intraoperative ultrasound in detecting hepatic metastases. PMID- 3281893 TI - Emergency liver transplantation in fulminant hepatitis. PMID- 3281894 TI - Sclerotherapy vs. distal splenorenal shunt in the elective treatment of variceal hemorrhage. PMID- 3281895 TI - Modern perspectives on epilepsy in relation to psychiatry: classification and evaluation. AB - This paper begins a two-part series on current psychiatric aspects of epilepsy. Part I focuses on the current classification of epileptic seizures; the possible relationships of epilepsy, especially temporal lobe epilepsy, with psychopathology; and the difficulties of evaluating epileptic conditions through electroencephalography. Part II, to be published in the April issue, will cover the management of epilepsy that is accompanied by behavior disturbance. PMID- 3281896 TI - Plasma and urinary catecholamines in salt-sensitive idiopathic hypertension. AB - Nineteen patients with normal renin idiopathic hypertension were arbitrarily classified as salt-sensitive or salt-resistant depending on whether their mean arterial pressure did or did not increase by 8% or more when sodium intake was increased. The responses of the two subsets and of five normal subjects to sodium intakes of 9, 109, and 249 mEq/day given for 7 days were as follows: The salt sensitive subjects retained more sodium than normal and plasma or urinary norepinephrine did not decrease when they were given a high sodium intake; urinary dopamine was normal but did not increase normally when sodium intake was increased. The salt-resistant subjects excreted sodium normally and plasma and urinary norepinephrine was decreased by 30 and 37%, respectively, when they were given a high sodium intake; urinary dopamine was supernormal and did not increase further when sodium intake was increased. Cumulative sodium retention during the high sodium intake was directly related to the percentage of change in plasma norepinephrine in the hypertensive subjects, suggesting that renal adrenergic activity was a factor in the impaired sodium excretion in the salt-sensitive patients. Cumulative sodium retention and the percentage of change in plasma norepinephrine were inversely related to urinary dopamine in the hypertensive subjects, suggesting that increased formation of dopamine in renal and neural tissue in the salt-resistant subjects may have been responsible for the differences between the subsets in renal and adrenergic responses to a high sodium intake.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281897 TI - Vascular and adrenal reninlike activity in chronically diabetic rats. AB - The aim of this work was to investigate, in an experimental model of diabetes mellitus, the levels of renin activity in vascular and adrenal tissues and their relationship to several circulating renin-angiotensin system components. Rats with chronic (12 weeks) streptozocin-induced diabetes showed a significant decrease in plasma renin activity (PRA), plasma renin concentration, and plasma aldosterone. However, plasma trypsin activatable inactive renin concentration was increased (11.65 +/- 1.40 vs 6.73 +/- 0.57 ng angiotensin I/ml/hr; p less than 0.001), as were aortic reninlike activity (p less than 0.001) and adrenal renin, both in the zona glomerulosa (p less than 0.01) and the fascicular-reticular medullary portion (p less than 0.001) with respect to an age-matched control group. After bilateral nephrectomy, plasma renin-angiotensin system components (PRA and plasma active and inactive renin concentrations) as well as aortic and fascicular-reticular-medullary renin activity significantly decreased in both control and diabetic rats. However, glomerular renin activity increased in control nephrectomized rats to the levels observed in diabetic animals but did not change in diabetic nephrectomized rats. The parallel changes of aortic and fascicular-reticular-medullary renin activity and plasma inactive renin concentration in diabetes and nephrectomy suggest an interdependent relationship, whereas the increase of glomerular renin activity in diabetic and nephrectomized animals, both with low levels of PRA, suggests the existence of a local autonomic renin-angiotensin system regulated by plasma feedback. Tissue renin-angiotensin system alterations in diabetes could mean that a pathogenic factor is involved in long-term diabetic complications or that only a compensatory physiological process is at work. PMID- 3281898 TI - Colonization of the streptomycin-treated mouse large intestine by a human fecal Escherichia coli strain: role of growth in mucus. AB - The relative colonizing abilities of Escherichia coli F-18, isolated from the feces of a healthy human, and E. coli F-18col-, a strain derived from it which does not make the E. coli F-18 colicin, were studied. In a previous report, it was shown that when each strain was fed individually to streptomycin-treated mice, at approximately 10(10) CFU per mouse, each colonized the large intestine at between 10(7) and 10(8) CFU/g of feces indefinitely. However, when simultaneously fed to mice, although E. coli F-18 colonized at about 10(8) CFU/g of feces, E. coli F-18col- dropped to a level of 10(3) CFU/g of feces within 3 to 5 days. In the present investigation, we show that when given enough time to establish a state of colonization, E. coli F-18col- persists in feces in high numbers despite subsequent challenge by E. coli F-18. Therefore, a major defect in the ability of E. coli F-18col- to colonize in the presence of E. coli F-18 appears to be in initiating that state. In addition, when mucus was scraped from the cecal wall and, without further treatment, was inoculated with E. coli F-18 or F-18col-, both strains grew well. However, when cecal mucus was inoculated with both strains simultaneously, E. coli F-18 grew far more rapidly than E. coli F-18col-. Moreover, neither strain grew in cecal luminal contents. Together, these data suggest the possibility that both E. coli F-18 and F-18col- must grow in mucus to colonize the streptomycin-treated mouse large intestine, that E. coli F-18col- is eliminated by E. coli F-18 because it does not grow in mucus as well as E. coli F-18, and that E. coli F-18col- can resist elimination by E. coli F-18 if it is allowed enough time to establish itself within the mucus layer. PMID- 3281899 TI - Variation in the expression of cell wall proteins of Staphylococcus aureus grown on solid and liquid media. AB - To evaluate the variation in the expression of cell wall antigens between Staphylococcus aureus grown in liquid medium and solid support, bacteria were harvested from liquid chemically defined medium and chemically defined medium in a 1% agar base. Cell wall proteins were then extracted by lysostaphin in a protoplast-stabilizing medium (30% raffinose). After separation of the cell wall antigens by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blots, they were probed with chicken antiserum to an S. aureus strain grown on a solid support. For each of the 15 clinical strains analyzed, high-molecular-size bands (molecular size range, 120 to 220 kilodaltons) were either enhanced or distinctly present when compared with those from the cell wall extract of the same strain grown in liquid medium. Results of enzymatic treatment of whole staphylococci grown on solid medium suggested the proteinaceous nature and the surface location of these antigens. Limited passage studies demonstrated the ability of the staphylococci to alter these surface proteins when passaged alternately on liquid and solid media. These observations suggested the importance of the microenvironment to the expression of cell wall proteins in S. aureus. Correlations with observations in vivo may help identify the determinants of microbial pathogenicity in S. aureus. PMID- 3281901 TI - Clearance of Serratia marcescens from blood in mice: role of hydrophobic versus mannose-sensitive interactions. AB - In the present study, we examined the potential roles of cell surface hydrophobicity and mannose-sensitive (MS) interactions in blood clearance of Serratia marcescens in mice. Hydrophobic strain RZ, partially hydrophobic mutant 3162, and nonhydrophobic mutant 3164 were coinoculated into BALB/c male mice, and blood samples were plated out at different time intervals; colonies of the three strains were distinguished by their different morphologies. All three strains were cleared from the blood stream at similar rates, despite their large relative differences in cell surface hydrophobicity. Clearance from blood was subsequently studied by coinoculating two clinical isolates which differ in their abilities to adhere via MS interactions. MS+ strain 1785 was cleared much more rapidly than MS strain 3255; moreover, in the presence of D-mannose, clearance of strain 1785 was inhibited to a rate similar to that of MS- strain 3255. When D-glucose was substituted for D-mannose, inhibition was not observed. The results suggest that MS, rather than hydrophobic, interactions are primarily responsible for the rapid clearance of S. marcescens from blood observed. PMID- 3281900 TI - Effect of environmental pH on enzyme activity and growth of Bacteroides gingivalis W50. AB - Since the pH of the gingival crevice increases from below neutrality in health to above pH 8 in disease, we decided to investigate the effect of environmental pH on the growth and enzyme activity of Bacteroides gingivalis W50. Cells were grown in a chemostat under hemin-excess conditions over a range of pH values; stable growth was observed only between pH 6.7 and 8.3, with the maximum yields obtained between pH 7.0 and 8.0. The enzyme profile of cells varied markedly with pH. Enzymes with a specificity for gingival connective tissue (collagenase, hyaluronidase) were produced optimally at or below neutral pH, whereas trypsinlike activity increased with the growth pH and was maximal at pH 8.0. Chymotrypsinlike activity was generally low, although its activity was highest at the extremes of growth pH, i.e., at pH 6.7 and 8.3. Inhibitor studies provided evidence that the breakdown of collagen involved the concerted action of both a collagenase and the trypsinlike enzyme. The ratio of trypsin to collagenolytic activity rose from 1:1 during growth at neutral pH and below to almost 7:1 during growth at pH 8.3. Thus B. gingivalis appears to be uniquely adapted as a periodontopathic organism in that under environmental conditions likely to prevail during the initial stages of pocket development it produces maximally those enzymes with a tissue-damaging potential. Then, as the pH of the pocket rises during the host inflammatory response, the activity of the trypsinlike enzyme increases markedly, which may enable cells to inactivate key components of the host defenses such as immunoglobulins and complement. PMID- 3281902 TI - Identification of monomeric and oligomeric forms of a major Leishmania infantum antigen by using monoclonal antibodies. AB - Ten monoclonal antibodies (MAbs) produced against isolated Leishmania infantum membranes were used as probes of L. infantum membrane antigens. Western blots of L. infantum membranes, sodium dodecyl sulfate solubilized and heated at 100 degrees C before analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, showed that all 10 MAbs recognized a band at 58 kilodaltons (kDa). However, when solubilized membranes were not heated, 2 of the 10 MAbs recognized, in addition to the 58-kDa band, bands of higher molecular weight. Limited digestion of heated or nonheated membranes showed that both groups of MAbs (i.e., not capable or capable of binding to the high-molecular-weight bands) recognized the same proteolytic digests. Hydrophilic forms of the above proteins, possessing proteolytic activity, were detected and isolated by gel filtration. Protein staining of the isolated monomer analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis, under reducing and heating conditions, revealed incomplete reduction of the 58-kDa protein. The reduced form of the 58 kDa protein migrated at 63 to 65 kDa and was not recognized by the MAbs. These results suggest the existence of a monomeric and an oligomeric form of the 58-kDa antigen. The observed inhibition of Leishmania promastigote-macrophage binding caused by MAbs representative of the two groups (capable of oligomeric and/or monomeric antigen recognition) suggest that the 58-kDa monomer and oligomer play an important role in promastigote-macrophage interaction. We suggest that the 58 kDa L. infantum antigen is the major surface Leishmania antigen (p63) identified by others. PMID- 3281903 TI - Effects of the bactericidal/permeability-increasing protein of polymorphonuclear leukocytes on isolated bacterial cytoplasmic membrane vesicles. AB - The bactericidal/permeability-increasing protein (BPI) of polymorphonuclear leukocytes is a potent bactericidal agent specific for gram-negative bacteria. The protein blocks bacterial multiplication without substantially inhibiting the uptake and incorporation of macromolecular precursors, suggesting that the cytoplasmic membrane escapes early injury. Because greater than 90% of bound BPI can be removed from the bacterial surface sites after irreversible loss of viability, it was uncertain whether BPI reaches the cytoplasmic membrane and, if so, affects its functions. This study shows that BPI caused similar dose dependent inhibition of O2 consumption and metabolic energy-dependent amino acid transport by cytoplasmic membrane vesicles of both gram-negative (Escherichia coli) and gram-positive (Bacillus subtilis) bacteria. Near maximal inhibition occurred at BPI doses that caused complete killing of an equivalent number of intact E. coli, with binding of BPI to membrane vesicles that was less than or equal to 10% of binding to intact (BPI-sensitive) bacteria. The effects of BPI and of the membrane-disruptive peptide antibiotic polymyxin B on membrane vesicles were distinctly different, indicating that the two agents affect membrane function by different mechanisms. BPI also rapidly inhibited O2 consumption by intact E. coli, with minimal impairment of bacterial protein synthesis. Thus, BPI is capable of damaging the cytoplasmic membrane of both gram negative and gram-positive bacteria and of inhibiting at least one cytoplasmic membrane-associated function in intact E. coli. The relationship between these effects and the mechanism of bacterial killing by BPI remains to be established. PMID- 3281904 TI - Heterologous expression of the 65-kilodalton antigen of Mycobacterium leprae and murine T-cell responses to the gene product. AB - The gene encoding the immunodominant 65-kilodalton antigen of Mycobacterium leprae was subcloned from a lambda gt11 clone into the high-copy-number plasmid pUC8. Escherichia coli containing these recombinants produced large amounts of the antigen, which was purified by polyacrylamide gel electrophoresis in the presence of urea. The ability of E. coli to recognize the mycobacterial promoter was confirmed by constructing additional clones in which the gene is flanked by transcriptional terminators from phage fd. A similar approach was used to demonstrate the expression of this gene in Streptomyces lividans. Mice immunized with killed M. leprae showed cell-mediated immune reactivity to the purified 65 kilodalton protein which stimulated both in vitro lymphoproliferative and in vivo delayed-type hypersensitivity responses. PMID- 3281905 TI - The cytolytic toxin aerolysin must aggregate to disrupt erythrocytes, and aggregation is stimulated by human glycophorin. AB - The hole-forming toxin aerolysin was shown to aggregate after binding to erythrocytes at 37 degrees C. Although the protein also bound and aggregated at 4 degrees C, hole formation was not observed, indicating that aggregation preceded penetration of the lipid bilayer. Aggregation, but not binding, could be blocked by pretreatment of the toxin with diethyl pyrocarbonate, a histidine-reactive reagent. This resulted in inactivation of the toxin. Incubation of aerolysin with glycophorin purified from human erythrocytes caused aggregation and complete inactivation. Erythrocytes which lacked glycophorin were less sensitive to the toxin. Proaerolysin, the inactive precursor of aerolysin, also bound to erythrocytes; however, it did not aggregate, nor did it aggregate when preincubated with glycophorin. The protoxin could be activated by treatment with trypsin even after it had bound to erythrocytes. Activation could also be achieved by reaction of proaerolysin with a variety of other proteases, each of which brought about a similar reduction in protein molecular weight. The activated protein was resistant to further proteolysis. These results indicate that aggregation is a necessary step in hole formation and that the sites on aerolysin required for binding and for aggregation and hole formation are separate. PMID- 3281906 TI - Experimental Escherichia coli endocarditis in rats: roles of serum bactericidal activity and duration of catheter placement. AB - Studies were undertaken to investigate the relationship of the sensitivity of Escherichia coli to the bactericidal properties of serum and the ability of different strains to induce and sustain endocardial infection in rats. Strains of E. coli demonstrated different degrees of serum sensitivity, as determined by a method which employed concentrations of serum from 10 to 95% and periods of incubation as long as 24 h. The greater the serum sensitivity of the E. coli strain, the less able it was to initiate infection and the more rapidly it was spontaneously eliminated from established infections. Endocardial infection with E. coli was established by intravenous challenge in rats with polyethylene catheters passing through the aortic valve into the left ventricle. An E. coli strain of low serum sensitivity was used; the initiation of infection depended upon the length of time the catheter had been in place and, in addition, whether the catheter was in place at the time of bacterial challenge. Removal of the catheter permitted spontaneous sterilization of the endocardial vegetations. The time necessary for sterilization was in direct proportion to the length of time the catheter remained in place following bacterial challenge. If the catheter was not removed, sterilization of the endocardial vegetations did not take place. These studies suggest that serum bactericidal activity is an important host defense mechanism, acting to prevent the initiation of endocarditis in the case of highly serum-sensitive E. coli and to sterilize experimentally induced endocarditis in the case of less-serum-sensitive bacteria. The catheter used to induce nonbacterial endocardial vegetations favored the colonization of vegetations by E. coli, and it delayed the spontaneous sterilization of infected vegetations which occurred in relation to the susceptibility of the strain to the bactericidal properties of the serum. This effect of the catheter was not attributable to bacteria remaining viable in its lumen, nor was it attributable to inhibition of the bactericidal capacity of the serum as measured in vitro. Whatever the mechanism responsible for the catheter effect, experimental studies of the evolution of infections established with this technique must take into consideration the duration of catheter placement and whether and for how long it was present before or after inoculation with test bacteria. PMID- 3281907 TI - Role of antibodies in the opsonization of Yersinia spp. AB - We have determined the opsonic capacity of specific antibodies in patient sera obtained after Yersinia infection. The results indicate that Yersinia antibodies lead to complement activation through the classical pathway, thus overcoming the inhibition of complement-mediated opsonization in the absence of specific antibodies provided by the virulence plasmid in Yersinia enterocolitica and Yersinia pseudotuberculosis. Further, antibodies against plasmid-encoded structures, the Yersinia outer membrane proteins (YOPs), are not necessary in this effect. This is indicated by two facts. (i) Monoclonal antibodies directed against the O polysaccharide of Y. enterocolitica O:3 are capable of opsonizing the plasmid-containing bacteria through C1q binding. (ii) Rabbit antisera show opsonic activity when obtained by immunization both with plasmid-containing Y. enterocolitica expressing the YOPs and a plasmid-cured variant not expressing these proteins. PMID- 3281908 TI - Reversible inactivation of bladder surface glycosaminoglycan antibacterial activity by protamine sulfate. AB - Prior studies in our laboratory have shown that the bladder surface is lined with glycosaminoglycans which appear to be an important antibacterial defense mechanism that operates by resisting bacterial adherence and infection. The present study further implicates bladder surface glycosaminoglycans as the key antiadherent factor and also suggests a potential model for diseases (such as urinary tract infections) whereby the antiadherent surface of the bladder is inactivated biochemically. Protamine sulfate treatment of bladder tissue was found to significantly increase bacterial adherence to the urinary bladder by approximately 2.3-fold. This effect was reversed by a second treatment of the bladder with pentosanpolysulfate (a polysaccharide known to duplicate the surface antiadherent effect). Protamine sulfate had no effect on bacterial viability or bacterial adherence when bacteria were pretreated with it. PMID- 3281909 TI - Heterogeneity among strains and a high rate of variation within strains of a major surface antigen of Mycoplasma pulmonis. AB - Monoclonal and monospecific antibodies were used to characterize a major Mycoplasma pulmonis surface antigen complex, V-1. Heterogeneity of V-1 was detected among strains and a high frequency of variation was detected within subclones of single strains. Analysis of 18 different strains showed that no two displayed identical electrophoretic immunoblot patterns for V-1. Analysis of 50 filter clones from an individual strain (not previously filter cloned) revealed at least 10 different V-1 patterns. The two most frequently occurring patterns were expressed by 36% and 24%, respectively, of the total population. Serial subcloning (four separate series) of several of these original clones showed that the average rate of V-1 variation was 2 x 10(-3) per cell per generation. Immunoblots with different anti-V-1 monoclonal antibodies demonstrated that there were both structurally and antigenically different forms of this antigen. Also, two-dimensional polyacrylamide gel analyses showed that different forms of V-1 could vary in charge. This potential for variability in a major surface antigen of mycoplasmas could have important implications as to how the organism interacts with its host. PMID- 3281910 TI - Mitogenic activities of synthetic Escherichia coli lipid A and a synthetic partial structure (tripalmitoyl pentapeptide) of E. coli lipoprotein. AB - Synthetic Escherichia coli lipid A and synthetic S-[2,3-bis-(palmitoyloxy)propyl] N-palmitoylpentapeptide (tripalmitoyl pentapeptide [TPP]), representing the mitogenically active principles of bacterial lipopolysaccharide (LPS) and lipoprotein, respectively, were compared for their mitogenic activities on splenocytes of LPS responder (BALB/c) and LPS-low-responder (C3H/HeJ) mice. Whereas lipid A was active only in LPS-responder mice, TPP resulted in mitogenic activation of B lymphocytes from both LPS-responder and LPS-low-responder mice. When the mitogens were added simultaneously, mainly additive effects of both activators were observed. The data suggest that two different B-lymphocyte populations are responding to these two mitogens. PMID- 3281912 TI - Resistance to infection with Eimeria vermiformis in mouse radiation chimeras is determined by donor bone-marrow cells. AB - The course of infection with Eimeria vermiformis was determined in BALB/b, BALB/c, and C57BL/10ScSn (B10) mice and in radiation chimeras prepared from the H 2-compatible BALB/b and B10 mice. The BALB strains, irrespective of H-2 haplotype, were resistant, the B10 mice were susceptible, and in the chimeras infection was characterized by the genotype of the donated bone-marrow cells and not by the phenotype of the recipient. Thus, the genetic control of relative resistance or susceptibility to infection with this parasite is expressed through bone-marrow-derived cells. PMID- 3281911 TI - Comparison of the extracellular proteinase activity produced by a low-virulence mutant of Candida albicans and its wild-type parent. AB - The production of extracellular proteinase by MY1049, a low-virulence mutant of Candida albicans, was compared with that of its wild-type parent, MY1044. Both strains were grown in a medium containing bovine serum albumin as a nitrogen source to induce proteinase production. Under these conditions, the proteinase activity per cell in the MY1049 cultures was the same as or higher than that of MY1044 cultures. However, MY1049 grew much more slowly than MY1044, and the total proteinase activity of the MY1049 culture remained well below that of the MY1044 culture. In a minimal medium with ammonium sulfate as the nitrogen source, MY1049 grew as rapidly as did MY1044. No significant differences were observed in the effects of inhibitors produced by MY1049 and MY1044. Our previous work indicated that MY1049 was able to grow and produce abundant mycelium in the renal calices of infected mice but that the strain was unable to invasively colonize the renal tissue. The decreased ability of MY1049 to grow in a protein-rich environment, despite its ability to produce extracellular proteinase, may enable the host to contain the mutant strain before the fungal cells invade the tissue. PMID- 3281913 TI - Clinical and serological survey of pulmonary aspergillosis in patients with cystic fibrosis. AB - A 5.5-year survey revealed 9 patients with allergic bronchopulmonary aspergillosis (ABPA) and 1 patient with a highly probable diagnosis among 200 Danish patients with cystic fibrosis (CF). The incidence of ABPA was 0.9 (0.4 1.7, 95% confidence limits) per 100 patients per year. All the patients with definite or probable ABPA had serum antibodies to the Aspergillus fumigatus catalase antigen, and in 5 patients the appearance of catalase antibodies during the incipient phase of ABPA was documented. 29 patients without ABPA also had catalase antibodies, but in lower levels than ABPA patients (p = 0.006). The 6 month prevalence rate of A. fumigatus in sputum was 80 and 72% in the 2 groups, respectively. The finding of catalase antibodies in some CF patients without ABPA may indicate the occurrence of a symptom-poor form of pulmonary aspergillosis. PMID- 3281914 TI - Development of neonatal mouse retinal neurons and photoreceptors in low density cell culture. AB - We describe here a culture method which allows the growth of dissociated mouse retinal neurons and photoreceptors in chemically defined medium. Neural retinas from 2-day-old C57/BL mice were dissected from other ocular tissues, including the pigment epithelium, and dissociated into a cell suspension after brief trypsination. Most cells attached as single, unaggregated units to substrata pretreated with polyornithine and the neurite-promoting factor (PNPF). The cells were cultured in serum-free, high pyruvate Dulbecco's modified Eagle's medium containing chemically defined supplements. Under these conditions, onset of cell process development was rapid, giving rise to extensive neurite networks. Three morphologically distinct cell types were apparent during the first week in vitro. Some cells retained a circular outline and failed to produce processes, while 50 60% of the cells developed as multipolar neurons showing a large cell body and several neurites. Approximately 90% of these cells reacted with an amacrine cell specific monoclonal antibody. Some 30% of the cultured cells expressed phenotypic properties characteristic of rod photoreceptors, including a small cell body, an apical cilium, a short neurite with a spherule-like terminal body, and immunoreactivity with antibodies against opsin as well as a rod cell-specific monoclonal antibody. No further signs of outer segment differentiation were observed in these cells. Non-neuronal "flat" cells, which represented less than 0.5% of the total cell number, reacted with an antibody against the glial fibrillary acidic protein. The number of neurons and photoreceptors remained relatively stable during the first 4-7 days in vitro. During the second week in culture, however, there was specific degeneration of greater than 90% of the photoreceptor cells, while less than 20% of the multipolar neurons were similarly affected. Consequently, in addition to providing a system for studying the differentiation of retinal neurons and photoreceptors, the specific degeneration of photoreceptors in these mouse retinal cell cultures makes this system ideal for investigating factors influencing photoreceptor survival. PMID- 3281915 TI - Ultrastructural analyses of enzyme-treated microfibrils in rabbit corneal stroma. AB - Microfibrils have been identified within and between corneal collagen lamellae in a number of vertebrate species in a variety of developmental and pathological conditions, but they are relatively rare in normal adult animals. The present study was undertaken to analyze corneal microfibrils in adult rabbits using enzymatic digestion techniques. Transmission electron microscopy (TEM) showed clusters of 10-15 nm microfibrils arranged in quasi-parallel bundles within or between orthogonally arranged stromal collagen lamellae. When corneas were fixed with tannic acid/glutaraldehyde, the entire stroma showed increased electron density and microfibrillar bundles were heterogeneously stained. Peripheral fibrils were more electron-dense than those located more centrally. Following sequential detergent solubilization of unfixed corneas, all cellular elements were removed and collagen lamellae were distorted. Microfibrillar bundles remained intact, however, and resembled untreated controls. Subsequent treatment with pepsin, trypsin or elastase resulted in swollen corneal tissues in which collagen lamellae were no longer distinguishable but individual collagen fibrils maintained their morphological integrity. In these tissues microfibrillar bundles were rarely identifiable and were reduced to randomly oriented fragments or clusters of filamentous material. Testicular hyaluronidase or chondroitinase ABC did not affect the fibrils. These data indicate that rabbit corneal microfibrils are proteinaceous and that the tannic acid-staining component of the bundles is not glycosaminoglycan. The fibrils are indistinguishable from those identified as oxytalan in cornea and other ocular tissues. Moreover, their sensitivity to elastase and preferential staining with tannic acid/glutaraldehyde strongly suggest they may be related to the elastic system of fibrils. PMID- 3281916 TI - Double blind controlled randomized study on azathioprine efficacy in multiple sclerosis. Preliminary results. AB - The preliminary results of a double blind controlled prospective randomized trial of Azathioprine for therapeutic efficacy in 38 patients with Multiple Sclerosis are reported. Progression of the disease is significantly reduced in Azathioprine treated group in comparison to Placebo-treated patients, but this effect is reached only after 3 years of treatment (P less than 0.025) regardless of the clinical course and without affecting relapse rate. PMID- 3281918 TI - Is selective IgA deficiency associated with morbidity? Review and reevaluation. PMID- 3281917 TI - Pregnancy and Cushing's syndrome: example of endocrine interaction. AB - Pregnancy rarely occurs in women with Cushing's syndrome, and when it does, fetal mortality and morbidity are very high. We describe a 30-year-old woman who was found to have severe Cushing's syndrome in the 22nd week of her first pregnancy, after a year of unsuccessful attempts to conceive. The patient had the majority of the symptoms and signs characteristic of the syndrome. Laboratory examinations revealed hypokalemia of 2.7 mEq/l, serum cortisol 39.5 micrograms/dl without diurnal variation, free urinary cortisol 1,850 to 3,500 micrograms/24 h, 17 hydroxycorticosteroids (OHCS) 52.5 mg/24 h, 17-ketosteroids (KS) 12 mg/24 h, and ACTH 29 pg/ml. No suppression was observed upon dexamethasone administration (2 and 8 mg). Ultrasound examination of the adrenal glands revealed a left adrenal tumor with a diameter of 4.2 cm. An adrenocortical adenoma was successfully excised in the 24th week of pregnancy. During the 37th week of pregnancy, she delivered a normal baby girl. Postoperatively, the patient was put on maintenance therapy. One year after delivery, mother and child are in perfect health. PMID- 3281920 TI - Reflections. PMID- 3281919 TI - [Multicenter skin tumor of the interdigitating dendritic cell]. AB - This report concerns a multicentric skin tumor of dendritic cells. Skin-colored to reddish-brown papules and nodules erupted on the right arm of a 68-year-old man and, during the following years, spread to the upper extremities, shoulders, legs and face. Immunohistochemically the large, histiocyte-like tumor cells are Leu-6 (CD1), Leu-3a (CD4), HLA-DR/DQ and S-100 protein positive, but on thorough ultrastructural investigation were found to lack Birbeck granules. Thus, this disease represents a skin tumor of the interdigitating dendritic cell, an accessory cell which, in this case, was associated with a high content of T lymphocytes within the cutaneous cellular infiltrate. The clinical course is characterized by periodic progression with intermittent, spontaneous regression. During a 7-year follow-up it was not possible to ascertain involvement of either lymph nodes or internal organs. PMID- 3281921 TI - Ultrasonographic studies on the reproductive tract of mares after parturition: effect of involution and uterine fluid on pregnancy rates in mares with normal and delayed first postpartum ovulatory cycles. AB - During breeding of mares, ultrasonographic detection of uterine fluid accumulations in the first postpartum ovulatory period was associated with significantly decreased pregnancy rates, when compared with rates in control mares (P less than 0.005). The previously gravid uterine horn was recognized as the larger horn, when assessed for size by ultrasonography, for a mean of 21 days (range, 15 to 25 days) after parturition. On the basis of similar measurements obtained during 3 ultrasonographic scans (5-day period), uterine involution was determined to be completed in a mean of 23 days (range, 13 to 29 days). Progestin treatment did not affect uterine size, fluid accumulation, or rate of involution after parturition. However, delaying the first postpartum ovulation with 8 days of progestin treatment significantly improved pregnancy rates (P less than 0.05). More (P less than 0.05) mares became pregnant (23 of 28, 82%) when ovulation occurred after day 15 in the first postpartum ovulatory period, compared with those mares that ovulated before day 15 (6 of 12, 50%). We concluded that ultrasonographic detection of uterine fluid and postpartum progestin treatment can be used to manipulate breeding strategies and to improve pregnancy rates in mares bred during the first postpartum ovulatory period. PMID- 3281922 TI - Morphologic assessment of the equine embryo. PMID- 3281923 TI - Incidence and types of clinical mastitis in dairy herds with high and low somatic cell counts. AB - Eighteen dairy herds were studied, 12 with a 12-month Dairy Herd Improvement Association herd mean somatic cell count (SCC) less than or equal to 150,000 cells/ml (low SCC) and 6 with a 12-month mean SCC greater than 700,000 cells/ml (high SCC). At the outset of the study, quarter samples for bacteriologic culture were collected (in duplicate) from all quarters of all lactating cows (whole herd culture). Subsequently, quarter milk samples for culture from all cows with clinical mastitis were collected for a period of 6 months. In the herds with low SCC, results of whole herd culture revealed low prevalence of intramammary infection attributable to all major pathogens (less than 4% of all quarters). Prevalence of infection with Streptococcus agalactiae (22.2% of all quarters) and Staphylococcus aureus (6.6% of all quarters) was significantly (P less than 0.05) higher in the herds with high SCC. Mean incidence of clinical mastitis in the herds with low SCC was 4.23 infections/100 cows/month (range, 0.42 to 10.25 infections). In the herds with high SCC, mean incidence was 2.91 infections/100 cows/month (range, 1.33 to 3.92 infections). In the herds with low SCC, infection type, as mean percentage of total clinically infected quarters sampled for culture/herd, was 0.0%, 2.2%, 12.3%, 43.5%, and 28.6% for Str agalactiae, S aureus, streptococci other than Str agalactiae, coliforms, and organisms not isolated, respectively. Respective percentages for the herds with high SCC were 41.5%, 18.3%, 12.6%, 8.0%, and 8.8%. During the study period (from April through January), incidence of clinical mastitis and clinical mastitis caused by coliform bacteria were highest in July and August for herds with low SCC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281924 TI - Isolation and structure of a new ansamycin antibiotic kanglemycin A from a Nocardia. PMID- 3281925 TI - Pharmacokinetics in liver disease. PMID- 3281926 TI - Effects of water immersion on arginine vasopressin release in humans. AB - Since suppression of arginine vasopressin (AVP) appears to be a determinant of the diuresis of water immersion (WI) in humans, a further understanding of its responsiveness has important implications for normal physiology, pathophysiology, and space physiology. In recent years, discrepant measurements of AVP in plasma during WI have led to conflicting conclusions. In studies in which the subjects ingested water before or during WI, plasma AVP was reported to be unchanged or even increased. In contrast, plasma AVP was suppressed in studies in which the subjects remained hydropenic. A critical review discloses that water intake before and/or during the experiments introduces several new stimuli for AVP release. Furthermore the lower base-line levels of AVP in hydrated subjects complicate detection of small changes in plasma AVP. Although the mechanisms of AVP suppression during WI are incompletely defined, it appears that not only cardiopulmonary mechanoreceptors but also arterial baroreceptors mediate the response. Additional studies are proposed to delineate further the mechanisms governing AVP release during WI. PMID- 3281927 TI - Effect of physical training on the capacity to secrete epinephrine. AB - Epinephrine responses to hypoglycemia and to identical relative work loads have been shown to be higher in endurance-trained athletes than in untrained subjects. To test the hypothesis that training increases the adrenal medullary secretory capacity, we studied the effects of glucagon (1 mg/70 kg iv), acute hypercapnia (inspired O2 fraction = 7%), and acute hypobaric hypoxia (inspired Po2 = 87 Torr), respectively, on the epinephrine concentration in arterialized hand vein blood in eight endurance-trained athletes [T, O2 uptake = 66 (62-70) ml.min-1.kg 1] and seven sedentary males [C, O2 uptake = 46 (41-50)]. In response to identical increments in glucagon concentrations, plasma epinephrine increased more in T than in C subjects [0.87 +/- 0.11 vs. 0.38 +/- 0.14 (SE) nmol/l, P less than 0.05]. In response to hypercapnia [arterial PCO2 = 56 +/- 0.7 Torr (T) and 55 +/- 0.4 (C), P greater than 0.05], the increment in epinephrine was significant in T (0.38 +/- 0.11 nmol/l) but not (P less than 0.1) in C subjects (0.22 +/- 0.11). Hypoxia [arterial PO2 = 42 +/- 2 Torr (T) and 41 +/- 2 (C), P greater than 0.05] increased epinephrine in T (0.22 +/- 0.10 nmol/l, P less than 0.05) but not in C subjects (0.01 +/- 0.07). The plasma norepinephrine concentration never changed, whereas heart rate always increased, the increase being higher (P less than 0.05) in T than in C subjects only during hypercapnia. The results indicate that training increases the capacity to secrete epinephrine. PMID- 3281928 TI - Effect of lung volume on interrupter resistance in cats challenged with methacholine. AB - To examine the effects of changes in lung volume on the magnitude of maximal bronchoconstriction, seven anesthetized, paralyzed, tracheostomized cats were challenged with aerosolized methacholine (MCh) and respiratory system resistance (Rss) was measured at different lung volumes using the interrupter technique. Analysis of the pressure changes following end-inspiratory interruptions allowed us to partition Rss into two quantities with the units of resistance, one (Rinit) corresponding to the resistance of the airways and the other (Rdif) reflecting the viscoelastic properties of the tissues of the respiratory system as well as gas redistribution following interruption of flow. Rinit and Rdif were used to construct concentration-response curves to MCh. Lung volume was increased by the application of 5, 10, and 15 cmH2O of positive end-expiratory pressure. The curve for Rinit reached a plateau in all cats, demonstrating a limit to the degree of MCh-induced bronchoconstriction. The mean value of Rinit (cmH2O.ml-1.s) for the group under control conditions was 0.011 and rose to 0.058 after maximal bronchoconstriction; the volume at which the flow was interrupted was 11.5 +/- 0.5 (SE) ml/kg above functional residual capacity (FRC). It then fell progressively to 0.029 at 21.2 +/- 0.8 ml/kg above FRC, 0.007 at 35.9 +/- 1.3 ml/kg above FRC, and 0.005 at 52.0 +/- 1.8 ml/kg above FRC. Cutting either the sympathetic or parasympathetic branches of the vagi had no significant effect on the lung volume-induced changes in MCh-induced bronchoconstriction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281929 TI - Nasal delivery of a vasopressin antagonist in dogs. AB - The dosage form (drop or spray) and site of administration (dorsal or ventral surface of the nostril) profoundly affect the distribution and clearance of a gamma-emitting 99mTc-labeled diethylenetriamine pentaacetic acid (99mTc-DTPA) solution in dogs. The slowest nasal clearance was observed for dorsally administered drops. Administration of drops to the ventral surface or sprays to either dorsal or ventral surface results in rapid clearance and little deposition in the turbinates. The octapeptide vasopressin antagonist, SKF 101926, was administered intravenously (0.3, 1.0, 3.0, and 10 micrograms/kg) and then on separate occasions intranasally (10, 25, and 50 micrograms/kg as a drop to the ventral surface) to four conscious, trained, female, water-loaded, vasopressin infused dogs. SKF 101926 reversed the antidiuretic response to vasopressin after administration by either the intravenous or intranasal route in a dose-dependent fashion. Peak dilution of urine occurred within 50- to 60-min postdosing by both routes. Estimated doses to reduce vasopressin antidiuresis by 50% were 1.4 micrograms/kg intravenously and 23 micrograms/kg intranasally. After recovery to at least 70% of antidiuretic base line, and then administration of a second dose of SKF 101926 (3 micrograms/kg), subsequent dilution of urine osmolality was inversely related to the magnitude of the previously administered dose. It is concluded that the estimated relative effectiveness of intranasally administered SKF 101926 is 3-21%, compared with intravenous administration. Acute tachyphylaxis to repeated dosing was observed. The mechanism of the apparent tachyphylaxic response was not elucidated. No tachyphylaxis to less frequent (weekly) dosing was observed. PMID- 3281931 TI - Alprazolam as an antidepressant. AB - Alprazolam appears to be an effective antidepressant in the treatment of outpatients who have a diagnosis of major depressive disorder. The authors have reviewed six controlled double-blind studies of alprazolam in the treatment of depression. Four of the six studies included only outpatients and clearly demonstrated a clinical effectiveness comparable to that of the tricyclics but with fewer, less severe side effects and better tolerance. The other two studies involved both inpatients and outpatients, so no conclusions can be drawn regarding the effectiveness of alprazolam in an inpatient population; further controlled studies are needed to answer this question. No satisfactory explanation exists for the mechanism of alprazolam's proposed antidepressant action. PMID- 3281930 TI - Adinazolam mesylate and placebo in depressed outpatients: a 6-week, double-blind comparison. AB - In 72 outpatients with DSM-III major depressive episode, adinazolam was superior to placebo in all measurements. Significantly more adinazolam-treated subjects (N = 36) than placebo subjects (N = 36) completed the study (67% vs. 19%), were rated "much" or "very much" improved (78% vs. 19%), and had a "moderate" or "marked" therapeutic effect of the drug (67% vs. 19%). The total Hamilton Rating Scale for Depression score decreased by 50% or more in 61% of the adinazolam group and in 17% of the placebo group; 72% of the adinazolam group reported that they felt "moderately," "much," or "very much" improved compared with 17% of the placebo group. The adinazolam group reported significantly more drowsiness and lightheadedness, dizziness, or faintness; the severity of these side effects decreased with time. No significant anticholinergic effects were observed. PMID- 3281932 TI - 'Spontaneous' hypertensive episodes with monoamine oxidase inhibitors. AB - Hypertensive reactions occurred without obvious cause in two patients receiving monoamine oxidase inhibitors (MAOIs) while being monitored in a hospital. These patients appear to have experienced "spontaneous" hypertensive episodes temporally related to the ingestion of the MAOIs. Similar occurrences in outpatients reported in the literature are reviewed. PMID- 3281934 TI - Glucose-induced early changes in cytoplasmic calcium of pancreatic beta-cells studied with time-sharing dual-wavelength fluorometry. AB - The cytoplasmic calcium concentration (Ca2+i) was measured in suspensions of fura 2-loaded mouse pancreatic beta-cells by recording the 340:380 nm fluorescence excitation ratio. Exposure to 20 mM glucose resulted in an initial reduction and later increase of Ca2+i irrespective of preincubation in medium containing 0.5 or 1.28 mM Ca2+ and 0 or 3 mM glucose. When elevating the Ca2+ concentration to 5 or 10 mM only 5 min before raising glucose to 20 mM, the sugar-induced reduction of Ca2+i became more pronounced like the subsequent increase. However, when the Ca2+ concentration was increased from 1.28 to 10 mM 2 min after stimulation with glucose, there was a sudden pronounced Ca2+i transient, which was followed by a decrease and a slower secondary rise. After preincubation in 20 mM glucose the glucose-induced initial reduction of Ca2+i was only seen in a Ca2+-deficient medium. Reintroduction of the sugar in the presence of extracellular Ca2+ resulted in an immediate rise of Ca2+i, the rapidity of which depended on the transmembrane Ca2+ gradient. The results emphasize the role of a saturable beta cell pool of Ca2+ in glucose-induced reduction of Ca2+i and indicate that the first phase of insulin release depends on an influx of extracellular Ca2+. PMID- 3281933 TI - Monoclonal antibodies to the Mr 74,000 cholesteryl ester transfer protein neutralize all of the cholesteryl ester and triglyceride transfer activities in human plasma. AB - A cholesteryl ester transfer protein (CETP) of apparent Mr 74,000 has recently been purified from human plasma. Three monoclonal neutralizing antibodies to the CETP were obtained by immunizing mice with purified CETP. The antibodies, each recognizing a similar epitope on CETP, caused parallel and complete immunotitration of plasma cholesteryl ester and triglyceride transfer activities but only partial inhibition of phospholipid transfer activity. Monoclonal immunoaffinity chromatography of plasma or its fractions showed complete removal of cholesteryl ester and triglyceride transfer activities but incomplete removal of phospholipid transfer activity. Sodium dodecyl sulfate gel electrophoresis and immunoblotting of the immunoaffinity-retained fractions showed that only the Mr 74,000 protein was immunoreactive. The results suggest that the previously characterized CETP accounts for all of the cholesteryl ester and triglyceride transfer activity in human plasma but only part of the phospholipid transfer activity. PMID- 3281935 TI - Purification and characterization of the fructose-inducible HPr-like protein, FPr, and the fructose-specific enzyme III of the phosphoenolpyruvate: sugar phosphotransferase system of Salmonella typhimurium. AB - The proteins comprising the fructose-specific phosphoenolpyruvate:sugar phosphotransferase system were investigated using a strain of Salmonella typhimurium which lacks the general phosphotransferase system proteins, HPr and Enzyme I, synthesizes the fructose phosphotransferase system proteins, FPr, Enzyme IIfru, Enzyme IIIfru, and fructose-1-phosphate kinase, constitutively, and expresses the Enzyme I-like protein Enzyme I. Enzyme I activity was found in the cytoplasmic fraction, Enzyme IIfru in the membrane fraction, and FPr and Enzyme IIIfru activities were distributed between the two fractions. Extraction of membranes with butanol and urea led to quantitative release of the membrane associated Enzyme IIIfru and FPr activities, while Enzyme IIfru remained with the membranes. FPr was purified to homogeneity using ion exchange chromatography, gel filtration, and reversed phase high pressure liquid chromatography (HPLC), and its amino acid composition and N-terminal sequence were determined. A complex of FPr and Enzyme IIIfru (Mr 50,000) was also purified to near homogeneity using ion exchange chromatography, gel filtration, and chromatography on hydroxylapatite. When the purified complex was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, it was visualized as two protein bands with mobilities corresponding to molecular weights of about 40,000 (Enzyme IIIfru) and 9,000 (FPr). Neither the FPr and Enzyme IIIfru activities nor the proteins represented by these two bands separated during the above chromatography steps or using any of several other techniques, including reversed phase HPLC, indicating a very tight association. Active Enzyme IIIfru free of FPr was never isolated or observed. The proteins could be separated in denatured form by gel filtration in the presence of guanidine HCl or urea. Free FPr and the FPr-Enzyme IIIfru complex were characterized, and the properties of free and complexed FPr were compared to those of HPr. PMID- 3281936 TI - Solubilization and purification of alpha-mannosidase, a marker enzyme of vacuolar membranes in Saccharomyces cerevisiae. AB - Yeast alpha-mannosidase, a marker enzyme of vacuolar membranes, was solubilized and purified from commercial bakers' yeast. The alpha-mannosidase was solubilized efficiently with 10 mM Na2CO3. A high pH (greater than 8.5) and a sufficient amount of a detergent such as 0.2% (w/v) Triton X-100 were required to keep the enzyme in a soluble state. This suggested that the enzyme is either a peripheral membrane protein or an ecto-type integral membrane protein. After 4,300-fold purification by conventional chromatography, the alpha-mannosidase gave a single band on nondenaturing polyacrylamide gel electrophoresis, but could be fractionated into active isoforms, which consisted of 107-, 73-, and 31-kDa polypeptides, with a Mono Q anion exchange fast protein liquid chromatography system. Apparent molecular weight of the native enzyme was determined as 560,000. It suggested that the composition of isoforms will be described as (107 kDa)n (73 kDa)6-n (31 kDa)6-n, where n is 0-6. The 107- and 73-kDa polypeptides were purified further under denaturing conditions. One-dimensional peptide map analysis and immunological analysis of these polypeptides indicated that they are closely related proteins. Immunoblotting of crude cell lysates revealed that the 107-kDa polypeptide appeared first, and then the 73-kDa polypeptide appeared along growth phase. It suggested that proteolytic conversion of the 107-kDa polypeptide occurs to form the 73- and 31-kDa polypeptides and leads to formation of isoforms of the enzyme. PMID- 3281937 TI - The active form of the cytochrome d terminal oxidase complex of Escherichia coli is a heterodimer containing one copy of each of the two subunits. AB - The cytochrome d complex is a component of the aerobic respiratory system of Escherichia coli. The enzyme functions as a terminal oxidase, oxidizing ubiquinol 8 within the cytoplasmic membrane and reducing oxygen to water. The enzyme is of particular interest because it is a coupling site in the electron transfer chain. The electron transfer reaction catalyzed by this enzyme is coupled to the translocations of protons across the membrane (H+/e-approximately equal to 1). The oxidase contains two subunits by sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis, with molecular weights of 58,000 and 43,000. In this paper, the question of the quaternary structure is addressed. Quantitative N terminal analysis of the isolated enzyme and relative mass quantitation following sodium dodecyl sulfate-polyacrylamide gel electrophoresis indicate the subunits are present in equimolar amounts. Sedimentation velocity and sedimentation equilibrium studies were used to characterize the hydrodynamic properties of the purified enzyme solubilized in Triton X-100, under conditions where the enzyme is active. It is concluded that the active enzyme in Triton X-100 is a heterodimer, containing one copy of each subunit. This is likely the structure of the enzyme in the E. coli membrane. PMID- 3281938 TI - Efficient in vitro translocation into Escherichia coli membrane vesicles of a protein carrying an uncleavable signal peptide. Characterization of the translocation process. AB - The translocation into Escherichia coli cytoplasmic membrane vesicles of a protein containing an uncleavable signal peptide was studied. The signal peptide cleavage site of the ompF-lpp chimeric protein, a model secretory protein, was changed from Ala-Ala to Phe-Pro through oligonucleotide-directed site-specific mutagenesis of the ompF-lpp gene on a plasmid. The mutant protein was no longer processed by the signal peptidase. When proteinase K treatment was adopted as a probe for protein translocation into inverted membrane vesicles, the mutant protein exhibited rapid and almost complete translocation, most likely due to the lack of premature cleavage of the signal peptide before the translocation. This result also indicates that cleavage of the signal peptide is not required for translocation of the mature domain of the protein. The establishment of an efficient system made it possible to perform precise and quantitative analysis of the translocation process. The translocation was time-dependent, vesicle dependent, and required ATP and NADH. Translocation into membrane vesicles was also observed with the uncleavable precursor protein purified by means of immunoaffinity chromatography, although the efficiency was appreciably low. The translocation required only ATP and NADH. Addition of the cytosolic fraction did not enhance the translocation. PMID- 3281939 TI - Purification of a novel growth inhibitory factor for partially differentiated myeloid leukemic cells. AB - A novel factor termed growth inhibitory (GI) factor, which specifically inhibits the growth of mouse monocytic leukemia cells including monocytic cell lines (Mm-A and J774.1) and other partially differentiated myeloid leukemic cells, has been purified from conditioned medium of some clones of mouse myeloblastic leukemia M1 cells. The procedure for purification of the GI factor included ammonium sulfate precipitation, CM-Sepharose CL-6B and Sephadex G-200 chromatographies, reverse phase high-performance liquid chromatography on a C18 hydrophobic support, and high-performance liquid chromatography on a gel filtration column. The purified factor gave a single band of protein with a molecular weight of 25,000 on sodium dodecyl sulfate-polyacrylamide gel. A concentration of 8 X 10(-10) M GI factor was required for 50% inhibition of growth of Mm-A cells. On chromatofocusing, the GI activity was eluted with Polybuffer 96/acetic acid at pH 8.2-8.4. The purified GI factor markedly inhibited growth of mouse bone marrow cells stimulated by macrophage colony-stimulating factor. The GI factor appeared to be a unique cytokine unrelated to known cytokines such as the tumor necrosis factor, interferons, and oncostatin M. PMID- 3281940 TI - Carboxyl groups near the active site zinc contribute to catalysis in yeast alcohol dehydrogenase. AB - The importance of carboxyl groups near the active site zinc for the catalytic function of alcohol dehydrogenase I from Saccharomyces cerevisiae was examined by directed mutagenesis and steady state kinetics. Asp-49 was changed to asparagine and Glu-68 to glutamine (residue numbering as for horse liver enzyme). The catalytic efficiencies (V/Km) for ethanol oxidation and acetaldehyde reduction were decreased by factors of 1000 with the Asn-49 mutant and 100 with the Gln-68 enzyme. For the Asn-49 mutant, dissociation constants for coenzymes increased 7 fold, and Michaelis and inhibition constants for substrates and substrate analogs increased by factors of 20-50. The turnover numbers were reduced 50-fold for ethanol oxidation and 15-fold for acetaldehyde reduction. Product and dead-end inhibition studies and kinetic isotope effects showed that the mechanism with NAD+ and ethanol was rapid equilibrium random, in contrast to the ordered mechanism of wild-type enzyme. Alcohol dehydrogenase I and the Asn-49 mutant had similar CD spectra and 2 zinc atoms/subunit, but slightly different UV absorption and fluorescence spectra. The Gln-68 mutant resembled the wild-type enzyme in most kinetic constants, but the turnover number for ethanol oxidation decreased 35-fold, and Kd for NAD+ and Km for acetaldehyde increased by factors of 4 and 50, respectively. The pK values for V1 and V1/Km for ethanol oxidation were shifted from 7.7 (wild-type) to 6.8 in the Gln-68 and 6.2 in the Asn-49 mutant. The altered electrostatic environment near the active site zinc apparently decreases activities by hindering isomerizations of enzyme-substrate complexes. PMID- 3281941 TI - Endocytosis of N-acetylglucosamine-containing glycoproteins by rat fibroblasts expressing a single species of chicken liver glycoprotein receptor. AB - A cDNA clone for the chicken liver receptor which mediates endocytosis of glycoproteins containing terminal N-acetylglucosamine has been isolated and sequenced, confirming the previously obtained amino acid sequence of this protein (which is also known as the chicken hepatic lectin). This cDNA was introduced into Rat-1 fibroblasts and expressed using the promotor in the long terminal repeat of Moloney murine leukemia virus. Cells expressing chicken receptor were identified by screening with antireceptor antibodies followed by fluorescein conjugated second antibodies. Receptor expressed in these cells was indistinguishable on gel electrophoresis from receptor isolated from liver. Three clonally isolated lines were examined for their ability to bind agalacto-alpha 1 acid glycoproteins at 0 degrees C and to take up and degrade this ligand at 37 degrees C. The receptor number (50,000/cell), affinity for ligand (35 nM), and uptake rate (5 molecules ligand/surface receptor/h) are similar to those previously observed for chicken hepatocytes, and for the uptake of asialoglycoproteins by rat hepatocytes and hepatoma cells. These findings indicate that the chicken receptor correctly traverses the endocytic pathway in a rat cell even though the cytoplasmic domain of this protein shows no primary structural homology with the corresponding portion of the rat liver receptor or with receptors found in fibroblasts. PMID- 3281942 TI - Differential and developmental expression of beta-tubulins in a higher plant. AB - By using two-dimensional gel electrophoresis and immunoblotting, we have analyzed the expression of beta-tubulin isotypes in the higher plant, carrot. We report a complex expression of beta-tubulins that is dependent on the developmental stage of the tissues analyzed. Consequently, each tissue examined can be identified by its unique composition of beta-tubulins. In total, there are six electrophoretically separable beta-tubulins. In no tissue, however, is there less than two or more than five beta-tubulins. Within this framework we have detected a beta-tubulin specific to seedling tissue beta 6, and a beta-tubulin, beta 5, that is found only in the vegetative tissues of the mature plant. Traced from stem to midrib to leaf lamina, the beta 5 isotype becomes progressively dominant relative to beta 1. Another beta-tubulin isotype, beta 4, appears in marked abundance in immature and mature stamens. In isolated mature pollen the beta 4 tubulin overwhelmingly predominates the ubiquitously expressed beta 2-tubulin isotype. The remaining beta-tubulin isotypes also have specific expression programs with beta 1 present in all tissues except pollen and beta 3 absent only from pollen and leafy tissues. PMID- 3281943 TI - Angiotensinogen mRNA. Regulation by cell cycle and growth factors. AB - The components of the renin-angiotensin system have been colocalized in many tissues suggesting that local generation of angiotensin II can regulate blood flow in specific organs or tissues. This in combination with the fact that proliferating tissues require angiogenesis and increased blood flow to develop have led us to study the relationship of angiotensinogen mRNA production to cell cycle regulation. Reuber H35 (H4IIE) cells were growth-arrested by serum deprivation. Cells were then treated with 10% fetal calf serum, depleted serum, or insulin. Insulin and serum were equally potent at increasing beta-actin mRNA levels, depressing angiotensinogen mRNA levels, and in increasing [3H]methyl thymidine incorporation. The half-maximal insulin effect occurred at 5 x 10(-9) M. Insulin-like growth factor I and II had no effect on any of the parameters measured. 12-O-tetradecanoyl phorbol 13-acetate (TPA) also induced beta-actin mRNA, decreased angiotensinogen mRNA, and caused an increase in [3H]methyl thymidine incorporation. The TPA effects were of shorter duration and of lower magnitude than those caused by insulin or serum. Inactivation of protein kinase C by preincubation with TPA did not block the insulin response. TPA has been shown to induce angiogenesis in vitro. Thus, these studies suggest that inhibition of angiotensinogen gene activity may be part of the proliferative or angiogenic process. Our experimental data may provide a model for further experimental dissection of the biochemical steps involved in angiogenesis. PMID- 3281944 TI - Antigenic variation among group A streptococcal M proteins. Nucleotide sequence of the serotype 5 M protein gene and its relationship with genes encoding types 6 and 24 M proteins. AB - The 1479-base pair (bp) nucleotide sequence of the serotype 5 M protein gene (smp5) from Streptococcus pyogenes contains three distinct types of tandemly repeated sequences, designated A, B, and C. Repeat A (21 bp x 6, in the 5'-half of smp5), shares no homology with the types 6 or 24 M protein genes (Hollingshead, S. K., Fischetti, V. A., and Scott, J. R. (1986) J. Biol. Chem. 261, 1677-1686; Mouw, A. R., Beachey, E. H., and Burdett, V. (1988) J. Bacteriol., in press). Repeat B (75 bp x 3.6, in the center of smp5) is also present in the M6, but not in the M24 gene. Repeat C (105 bp x 2.7, just distal to the B repeats) shares homology with repeats in both the M6 and M24 genes. All three genes share extensive homology in their 3'-halves and in 5' sequences encoding the N-terminal signal peptides, but between these two regions there are highly variable sequences that are responsible for antigenic diversity. These relationships suggest that both intergenic and intragenic recombination has occurred during the evolution of distinct M protein serotypes. All three M proteins contain conserved hydrophobic and proline-rich sequences at their C terminal ends, suggestive of a membrane anchor and a peptidoglycan spanning region. PMID- 3281945 TI - Structural identity between the NH2-terminal domain of the rat and human ornithine carbamyltransferase "targeting" sequences. AB - Analysis of the secondary structure of human and rat ornithine carbamyltransferase's targeting sequence revealed the presence of a highly homologous domain with the following key features: an hydrophobic patch opposite to an hydrophilic surface characterized by the disposition of basic residues at potentially strategic positions. The functional role of this domain was established using a synthetic peptide corresponding to amino acids 1-19 of the rat ornithine carbamyltransferase precursor (pOCT 1-19). When added to an in vitro import assay system, pOCT (1-19) blocked the import of pOCT specifically: it did not impede the entry and processing of the precursor to subunit 2 of the F1-ATPase (p beta). This finding suggests that at least two distinct precursor(s) specific pathways are required for the import of mitochondrial inner membrane and matrix proteins. PMID- 3281946 TI - Esterification of retinol in rat liver. Possible participation by cellular retinol-binding protein and cellular retinol-binding protein II. AB - Retinol bound to cellular retinol-binding protein (CRBP) was available for esterification by liver microsomes in the absence of exogenous acyl donors. Moreover, exogenous acyl-CoA gave little or no stimulation of ester production over what was observed with the endogenous acyl donor. In contrast, unbound retinol was esterified in an acyl-CoA-dependent reaction. The presence of two different enzyme activities, acyl-CoA-dependent and -independent, was demonstrated by differential sensitivities to several enzyme inhibitors. The enzyme reaction with retinol-CRBP and endogenous acyl donor produced retinyl esters normally found in vivo in liver. In addition, rates of esterification with this system were sufficient to maintain liver stores. Liver also contains cellular retinol-binding protein, type II (CRBP(II] during the perinatal period. Radioimmunoassay revealed highest levels of CRBP(II) in liver 3-4 days after birth. Examination of retinol esterification by microsomes from the liver of 3 day-old rats revealed a retinyl ester synthase activity with lower Km and higher Vmax than that found in the adult. The activity could use either retinol-CRBP or retinol-CRBP(II) and an endogenous acyl donor. The microsomes from 3-day-old liver had greater esterifying ability than microsomes from adult liver, perhaps due to the presence of two retinyl ester synthase enzymes. PMID- 3281947 TI - Characterization of the virB operon from an Agrobacterium tumefaciens Ti plasmid. AB - The virulence genes of the Agrobacterium tumefaciens Ti plasmid are grouped into six transcription units and direct the transfer of T-DNA into plant cells. We report here the nucleotide sequence of the largest vir operon, virB, from the Ti plasmid pTiA6NC. This operon contains 11 open reading frames, 7 of which show evidence of translational coupling. trpE::virB gene fusions were used to confirm the reading frames of genes virB2, 4, 5, 6, 7, 8, 10, and 11. In addition, the native gene products of virB6 and virB9 were identified using maxicell and in vitro transcription-translation techniques, and the VirB9 protein was found to be proteolytically processed. The codon usage of the predicted virB genes is very similar to the other pTiA6 vir genes and is much less biased than Escherichia coli. Since many of the virB gene products have secretion signals common to exported bacterial proteins, it is likely that they will be membrane-associated. We propose that the VirB proteins are involved in the formation of a transmembrane structure which mediates the passage of the transferred T-DNA molecule through the bacterial and plant cell membranes. PMID- 3281948 TI - The structure of crystalline Escherichia coli-derived rat intestinal fatty acid binding protein at 2.5-A resolution. AB - Rat intestinal fatty acid-binding protein (I-FABP) is an abundant cytoplasmic protein which is synthesized in the small intestinal lining cell where it is thought to participate in the absorption and intracellular metabolism of fatty acids. Each mole of this 132-residue polypeptide binds 1 mol of long chain fatty acid in a noncovalent fashion. Because of its small size and single ligand binding site, I-FABP represents an attractive model for defining the molecular details of long chain fatty acid-protein interactions. The structure of Escherichia coli-derived rat I-FABP has now been solved to 2.5 A resolution using three isomorphous heavy atom derivatives. The protein consists of 10 anti parallel beta-strands present as two orthogonal beta-sheets. Together a "clam shell-like" structure is formed with an opening located between two beta-strands and an interior that is lined with the side chains of nonpolar amino acids. The bound fatty acid ligand is located in the interior of the protein and has a bent conformation, possibly reflecting the presence of several gauche bonds in the hydrocarbon tail. Our present interpretation of the electron density map suggests that the fatty acid is oriented with its carboxylate group facing the guanidinium group of Arg127, whereas the end of its hydrocarbon tail is in close proximity to Val106. The indole side chain of Trp83 forms the molecular framework around which the principal bend of the hydrocarbon chain occurs. PMID- 3281949 TI - A CCAAT DNA binding factor consisting of two different components that are both required for DNA binding. AB - A CCAAT-binding activity present in nuclear extracts of rat liver and NIH 3T3 fibroblasts was purified using, as assay, DNA binding to a segment of the mouse alpha 2(I) collagen promoter. The activity consists of two components, designated factors A and B, which are separated by ion exchange chromatography on either Mono Q or Mono S columns. Factor A is heat-sensitive, whereas factor B is heat resistant. Both factors are required for DNA binding and both are present in the DNA protein complex. The A + B complex was extensively purified by heparin agarose and sequence-specific affinity chromatography. The Mr of factor A is 39,000, whereas the Mr of factor B is 41,000 as determined by renaturation of a highly purified preparation after sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Competition experiments indicate that this CCAAT-binding complex has a DNA sequence specificity that is different from those of other CCAAT binding proteins. PMID- 3281950 TI - Internalized insulin-receptor complexes are unidirectionally translocated to chloroquine-sensitive degradative sites. Dependence on metabolic energy. AB - Insulin receptors on the surface of isolated rat adipocytes were photoaffinity labeled at 12 degrees C with the iodinated photoreactive insulin analogue, 125I B2 (2-nitro-4-azidophenylacetyl)-des-PheB1-insulin, and the pathways in the intracellular processing of the labeled receptors were studied at 37 degrees C. During 37 degrees C incubations, the labeled 440-kDa insulin receptors were continuously internalized (as assessed by trypsin inaccessibility) and degraded such that up to 50% of the initially labeled receptors were lost by 120 min. Metabolic poisons (0.125-0.75 mM 2,4-dinitrophenol (DNP) and 1-10 mM NaF), which led to dose-dependent depletion of adipocyte ATP pools, inhibited receptor loss, and caused up to 3-fold increase in intracellular receptor accumulation. This effect was due to inhibition of intracellular receptor degradation, and there was no apparent effect of the metabolic poisons on initial internalization of the receptors. Following maximal intracellular accumulation of labeled insulin receptors in the presence of NaF or DNP, removal of these agents resulted in a subsequent, time-dependent degradation of the accumulated receptors. However, when the lysosomotropic agent, chloroquine (0.2 mM), was added immediately following removal of the metabolic poisons, further degradation of the intracellularly accumulated receptors was prevented, suggesting that the chloroquine-sensitive degradation of insulin receptors occurs distal to the site of inhibition by NaF or DNP. To confirm this, maximal intracellular accumulation of labeled receptors was first allowed to occur in the presence of chloroquine and the cells were then washed and reincubated in chloroquine-free media in the absence or presence of NaF or DNP. Under these conditions, degradation of the intracellularly accumulated receptors continued to occur, and NaF or DNP failed to block the degradation. In summary, these results indicate that the loss of cell surface insulin receptors in adipocytes involves: 1) initial internalization of the receptors to a nondegradative intracellular compartment by a process that is relatively insensitive to ATP depletion, followed by 2) a highly energy dependent unidirectional translocation of the receptors from this compartment to chloroquine-sensitive site(s) of degradation. PMID- 3281951 TI - Continued change and constancy. PMID- 3281952 TI - Reconstruction for defects of the proximal part of the femur using allograft arthroplasty. AB - One of the most difficult problems in orthopaedic oncology is reconstruction after resection of a tumor of the proximal end of the femur. In order to achieve a wide margin about a primary or secondary malignant neoplasm of bone, it is often necessary to resect not only the hip joint and fifteen or more centimeters of the proximal part of the femur, but also the surrounding envelope of soft tissue. In some patients, little is left but the sciatic and femoral nerves and vessels. Since 1971, we have done reconstructions in forty-four patients, using an allograft and an implant or else an osteoarticular graft alone to replace the proximal end of the femur. Twenty-eight of these reconstructions were performed in patients who had had a malignant tumor and were followed for two to fifteen years postoperatively. Fifteen of the patients had only an osteoarticular graft, and thirteen had an allograft and a prosthesis (nine Austin Moore, two bipolar, and two long-stem total hip replacements). The average length of the femoral segment was 18.4 centimeters; the longest one measured thirty-one centimeters. Using an evaluation system of functional end-results that includes failures as a result of recurrence of the tumor, we recorded approximately 70 per cent excellent and good results for both groups. When the two failures that were due to recurrence of the tumor were omitted from the statistics (in order to evaluate the allograft procedure more fully), the successful results increased to about 80 per cent. In general, the patients who had an osteoarticular reconstruction fared less well than did those who had an allograft and a prosthesis, but the series were not quite comparable. The major complications were metastases in nine patients (five of whom died), infection in five, and fracture of the allograft in six. Restoration of the reconstruction was possible for most of the patients who had a problem that was not related to the tumor, and only one patient required an amputation for recurrent tumor. Despite the many difficulties, we think that an allograft, with or without a prosthetic implant, should be given primary consideration as a means of reconstruction of the limb when resection of a tumor necessitates resection of a long segment of the proximal end of the femur. PMID- 3281953 TI - Osteosarcomas arising on the surfaces of long bones. AB - Malignant bone-forming tumors that arise from the surfaces of long bones are far less common than those that arise from within bone. These surface osteosarcomas are clinically and radiographically similar, yet histologically they are quite distinct. In reviewing the literature, we classified the tumors according to three subgroups: parosteal (juxtacortical) osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. We also studied the clinical, radiographic, and histological findings in eighty patients who had been treated for an osteosarcoma over a forty-four-year period. Adequate follow-up data existed for forty-eight of the eighty patients. The duration of follow-up ranged from two to fifteen years after the initial operation (amputation or resection). Patients who had a parosteal osteosarcoma had the best prognosis; those who had a periosteal osteosarcoma, the next best; and those who had a high-grade surface osteosarcoma, the poorest. Because of these widely varying prognoses, the lesions require different treatment. PMID- 3281954 TI - Successful treatment of infantile malignant osteopetrosis by bone-marrow transplantation. A case report. PMID- 3281955 TI - Computerized information retrieval and medical education for orthopaedists. PMID- 3281956 TI - Effects of body surface thermal injury on apparent renal and cutaneous blood flow in goats. AB - The etiology of postburn circulatory impairment ("burn shock") is multifactorial and incompletely understood. However, systemic vasoconstriction is a consistent observation during this period and occurs in spite of aggressive fluid resuscitation therapy. We studied the degree and time course of systemic vasoconstriction in goats for 24 hours following burns of two sizes (20% and 35% TBSA), in which fluid resuscitation was performed according to a common clinical crystalloid regimen. Cardiac index and urine output (reflecting renal perfusion) fell dramatically at two hours after burn, but returned slowly to preburn levels by 24 hours. The degree of fall and rate of recovery were dependent on burn size. Dermal perfusion was assessed by laser Doppler flowmetry in both burned and unburned skin. Dermal perfusion was negligible in burned skin. Unburned skin blood flow fell with increasing burn size, progressively recovered to preburn levels after the small burn, but at 24 hours remained significantly depressed after the larger burn. The stimulus for this persistent skin vasoconstriction is unclear. PMID- 3281957 TI - Short-term skin preservation at 4 degrees C: skin storage configuration and tissue-to-volume medium ratio. AB - This study was designed to examine the effect of the storage configuration of skin and the ratio of tissue-to-storage medium on the viability of skin stored under refrigeration. Human skin specimens were stored in four physical configurations in RPMI 1640 tissue culture media at 4 degrees C. Skin was transferred to surgically created defects on nude mice after specific storage intervals. Grafts were examined grossly and microscopically after ten days. In the rolled configuration, on storage day 15, the viability of the outside of the roll was significantly better than the inside (P less than 0.01). The graft viability of the outside of the skin rolls was similar for both tissue-to-media ratios as well as for both free-floating configurations (P = 0.27). These findings suggest the optimum cold storage configuration is free floating, and 300 cm2/100 mL is an appropriate skin surface area to volume media ratio. This proportion of tissue to media is in agreement with the minimum ratio currently recommended by the Skin Council of the American Association of Tissue Banks. PMID- 3281958 TI - Effect of graft bed on long-term functional results of extremity skin grafts. AB - The purpose of the current study was to determine whether the long-term functional results of extremity burns grafted on fat were different from those grafted on fascia. Twelve patients (mean burn size, 38% TBSA) who had fascial excision of the majority of one or more extremities were examined a minimum of one year postinjury. Range of motion, motor strength, and sensation of the fascially excised extremities were measured. Twelve comparable patients with extremity burns (mean burn size, 35% TBSA) who had grafts placed on fat were used as positive controls. Patients whose burns were excised to fat had better joint mobility (P = 0.001) and sensory function (P = 0.001) than did patients whose burns were excised to fascia. Both groups had comparable muscle strength. These results indicate that patients with full-thickness burns of the extremities who have grafts placed on fat have significantly better long-term extremity function than do patients who have their skin grafts placed on fascia. PMID- 3281959 TI - Cytogenetic diversity in primary human tumors. AB - Cytogenetic patterns from primary short-term culture of breast cancer, renal carcinoma, and tumors of the central nervous system are presented to illustrate the range of karyotypic diversity of human solid tumors as well as their biologic differences in culture systems that support their growth. These studies have illustrated several major issues. 1) Results vary with the tissue of origin: primary cultures from breast are almost uniformly diploid, while renal tumors are near-diploid, mosaic, and show clonal aberrations; and CNS tumors are heterogeneous: some diploid, some near-diploid and some highly aneuploid. 2) Results after short-term culture are selective, representing subpopulations from the heterogeneous cells that are detected on direct analysis of fresh tumors by cytogenetics or flow cytometry (FCM). It is not yet clear whether prognosis depends on the dominant population of the primary tumor or alternatively should be influenced by detection of small aneuploid subpopulations. 3) Evidence from all three tumor types supports the interpretation that cytogenetically normal diploid cells constitute part of some tumor populations, and may be better adapted to routine growth in culture than aneuploid subpopulations from the same primary tumors. These cells may also compose a major portion of the viable population of tumors in vivo and, therefore, could represent a useful model for studies of tumorigenesis and therapeutic regimens. PMID- 3281960 TI - Heparanases and tumor metastasis. AB - The successful penetration of endothelial basement membranes is an important process in the formation of hematogenous tumor metastases. Heparan sulfate (HS) proteoglycan is a major constituent of endothelial basement membranes, and we have found that HS-degradative activities of metastatic B16 melanoma sublines correlate with their lung-colonizing potentials. The melanoma HS-degrading enzyme is a unique endo-beta-D-glucuronidase (heparanase) that cleaves HS at specific intrachain sites and is detectable in a variety of cultured human malignant melanomas. The treatment of B16 melanoma cells with heparanase inhibitors that have few other biological activities, such as N-acetylated N-desulfated heparin, results in significant reductions in the numbers of experimental lung metastases in syngeneic mice, indicating that heparanase plays an important role in melanoma metastasis. HS-degrading endoglycosidases are not tumor-specific and have been found in several normal tissues and cells. There are at least three types of endo beta-D-glucuronidases based on their substrate specificities. Melanoma heparanase, an Mr approximately 96,000 enzyme with specificity for beta-D glucuronosyl-N-acetylglucosaminyl linkages in HS, is different from platelet and mastocytoma endoglucuronidases. Elevated levels of heparanase have been detected in sera from metastatic tumor-bearing animals and malignant melanoma patients, and a correlation exists between serum heparanase activity and extent of metastases. The results suggest that heparanase is potentially a useful marker for tumor metastasis. PMID- 3281961 TI - Male contraception. AB - To share contraceptive measures between partners is a goal which should be reached in the future. The possibilities on the male side are still limited in comparison with the techniques available for women. During the last 20 years many efforts have been undertaken to study and evaluate possible methods for fertility control in the male, based on interaction with the hormonal axis, sperm maturation and sperm transport. The requirements for such a method in the male are the same as in female: high efficacy, little or almost no side-effects, high practicability and compliance and the possibility for easy reversibility in a high percentage of men. Despite their increasing acceptability worldwide, the existing male methods, condom and vasectomy, do not fully meet these requirements and therefore a search for alternative male methods is warranted. At present, the following medical approaches to male fertility control have been tested or are under consideration: (i) selective inhibition of FSH: antibodies, inhibin; (ii) inhibition of pituitary-gonadal axis: steroids such as testosterone, progestin testosterone combinations, LHRH analogues with and without testosterone substitution; and (iii) selective inhibition of spermatogenesis by gossypol, a phenolic compound from cotton plant. Whether one of these methods will reach the desired goal for male fertility control has yet to be determined. PMID- 3281962 TI - The corpus luteum. AB - Normal corpus luteum function is determined by function in the follicular as well as the luteal phase. In the follicular phase adequate follicle-stimulating hormone (FSH) and oestrogen stimulation are required for granulosa cell mitosis and luteinizing hormone (LH) receptor synthesis. An increase in LH pulse frequency may also be necessary for adequate oestrogen synthesis and preparation of follicular cells for luteinization and secretion of progesterone. The nature of LH release may also influence luteal function and pre-ovulatory progesterone may increase the responsiveness of the follicle to gonadotrophins. The thecal vascular network becomes extensive around pre-ovulatory follicles and may influence access of gonadotrophins and/or the ability of follicular cells to respond to them. Further vascularization is an early feature of luteinization. Angiogenic factors are found in luteal tissue and prostacyclin increases luteal blood flow. The corpus luteum consists of large cells which secrete most of the progesterone and have prostaglandin F2 alpha receptors and small cells which are responsive to LH. In the luteal phase subnormal luteal function has not been associated with a reduction in LH concentration, pulse frequency or amplitude. The number and occupancy of LH receptors and adenylate cyclase activity do not appear to be altered by a reduction in luteal function. Low density lipoprotein provides the substrate and somatomedin C modulates among other hormones' influences, progesterone production. In addition to the cAMP second messenger system phosphatidyl inositol metabolism may also be associated with LH stimulation. Luteolysis is an active process; prostaglandin F2 alpha or lipoxygenase products and possibly an endogenous GnRH-like ovarian hormone may mediate it as also may oxytocin in some species. PMID- 3281963 TI - The defective luteal phase. AB - A defective luteal phase (DLP) results from a relative deficiency in secretion of progesterone by the corpus luteum. Approximately 30% of normal women show on biopsy an occasional DLP, while only 7-14% of infertile patients have a recurrent DLP. Endometrial biopsy remains the classical way to diagnose an inadequate luteal phase. However because of the discomfort and expense associated with endometrial biopsy, attention has turned to direct measurements of plasma progesterone levels as a means to rule out an inadequate luteal phase. A single plasma progesterone level of 10 ng/ml in the luteal phase or a mean concentration of plasma progesterone of 12-13 ng/ml over 4 days at mid-luteal phase seems to exclude an inadequacy of corpus luteum function. Changes in the precise pattern of pulsatile gonadotrophin secretion (due to weight, hyperandrogenism or hyper prolactinaemia) result in derangements of ovulatory function. For the 'essential' defective luteal phase there are as yet no controlled studies that establish either its role in infertility or the value of therapy. PMID- 3281964 TI - Luteal contraception. AB - Progesterone is an important and unique reproductive hormone. It is the main product of the corpus luteum, dominant in the luteal phase of the cycle, and in pregnancy its secretion continues and increases ensuring maintenance of the early conceptus. At any time in these events, the suspension of progesterone action may interfere with successful reproduction. The term 'luteal contraception' was deliberately chosen for the antifertility effect achieved by the elimination of progesterone action through the use of antiprogesterones in the post-ovulatory phase of the cycle, including early pregnancy. Published clinical experience with RU 486 (Mifepristone) as a post-coital contraceptive, implantation inhibitor, once-a-month pill, menstruation regulator and early abortifacient is reviewed. The potentials and limitations of these uses are discussed and the state of art of 'contragestion' by antiprogestagen treatment summarized. PMID- 3281965 TI - Experience with diagnosis and treatment of sterility due to abnormality of the infundibulum of the Fallopian tube. AB - The diagnosis and treatment of sterility due to abnormalities of the infundibulum of the Fallopian tube are reviewed. Knowledge on the physiology of the distal part of the tube explains the mechanisms of sterility when a lesion occurs, although diagnosis is based mainly on hysterosalpingography and laparoscopy. The requisite treatments are either percoelioscopic or surgical, and techniques and results with these treatments are reviewed. Special attention is given to tubal stenosis as a consequence of embryonic cysts of the tube. PMID- 3281966 TI - Uterine surgery of sterility. AB - Based on personal experience and illustrated by selected case reports, the author gives an account of the modern development of surgical techniques used for the treatment of uterine causes of sterility and infertility. Three main groups of pathology of the uterine body are dealt with: uterine myoma, malformations and the Asherman syndrome. Advances in the surgical methods and instrumentation are discussed in the light of improving success rates. PMID- 3281967 TI - The GIFT experience: an evaluation of the outcome of 115 cases. AB - The outcome of a series of 115 patients undergoing GIFT by minilaparotomy is described, their duration of infertility ranging between 3 and 19 years. Ovarian stimulation was carried out using clomiphene from day 3 and HMG from day 6, and HCG was used to induce follicular maturation. A maximum of four oocytes, two per oviduct with 100,000 spermatozoa, were replaced. Thirty-six pregnancies were established. The highest incidence of pregnancy was obtained in cases of unexplained infertility (42%) and endometriosis (28%), and the lowest with male factors (13%). The most mature oocytes gave the best results. There were eleven miscarriages (30.5%) and two ectopic pregnancies (5.5%). Eleven of the 23 deliveries involved multiple births. PMID- 3281968 TI - Eighty consecutive cases of gamete intra-fallopian transfer. AB - Eighty patients with the main problems of unexplained infertility, oligospermia and endometriosis were treated with gamete intra-Fallopian transfer (GIFT). From 80 treatment cycles, 29 women conceived (36.3%). Of these, four were biochemical pregnancies and therefore the clinical pregnancy rate (25/80) was 31.2%. There were six sets of multiple pregnancies, a multiple pregnancy rate of 24%. Three women (12%) miscarried. The pregnancy rates in the patients with unexplained infertility, oligospermia and endometriosis were 33.3, 16.7 and 38.5%, respectively. The transfer of four oocytes appears to increase the pregnancy rate without increasing the risk of multiple pregnancy. The presence of in-vitro fertilization of excess oocytes after GIFT did not correlate with the final outcome of GIFT. PMID- 3281969 TI - Pregnancy and AIDS. AB - Since the first cases of a new acquired immunodeficiency syndrome (AIDS) described by Oleske et al. and Rubinstein et al. in children in 1983, we have witnessed an ever-increasing number of such observations. As serology is not being performed on all pregnant women in many European countries, obstetricians must try to identify those belonging to risk groups: intravenous drug abusers, natives of affected regions or women having travelled to these areas, women having numerous sexual partners, presenting with other sexually transmitted diseases or living with infected individuals, prostitutes, transfused women. If the woman belongs to risk groups, HIV antibody testing is to be done at the beginning of pregnancy. The risks for the mother remain ill-defined, due in part to the difficulties inherent in keeping track of heroin abusers. Aggravation is certain if the mother is affected with AIDS or an associated syndrome called ARC (AIDS-related complex). It is debatable and at least rarer if the mother presents no clinical symptoms. Infant risks are becoming better known. The existence of materno-fetal contamination by transplacental route is undebatable. However, contamination during delivery or during the passage through the maternal genital tract cannot be excluded. The proportion of contaminated infants is approximately 40%. The disease in the infant is highly dangerous. According to these data, the procedure adopted by most obstetricians is the following: abortion is recommended at the first trimester of the pregnancy, a free choice is left open for the woman at the second trimester and at the third trimester delivery is carried out naturally. Caesarean sections are only done when there are obstetrical indications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3281971 TI - Legionella cincinnatiensis sp. nov. isolated from a patient with pneumonia. AB - A Legionella-like organism (strain 72-OH-H [= ATCC 43753]) was isolated from an open-lung biopsy specimen from a hemodialysis patient with end-stage renal disease and bronchopneumonia. Growth characteristics and gas-liquid chromatographic profiles of the isolate were consistent with those for Legionella spp. The isolate was presumptively identified as a Legionella longbeachae serogroup 1 strain by direct immunofluorescence staining. However, the organism was serologically distinct in the slide agglutination test with absorbed antisera. DNA hybridization studies showed that strain 72-OH-H constitutes a new Legionella species, which is named Legionella cincinnatiensis (ATCC 43753). PMID- 3281970 TI - Comparison of antibody, antigen, and metabolite assays in rat models of systemic and gastrointestinal candidiasis. AB - We compared serial measurements of antibodies to mannan and to a cytoplasmic antigen (enzyme-linked immunosorbent assays), detection of mannan and an unidentified candidal antigen (latex agglutination), and assays of mannose and arabinitol (gas chromatographic assay of per-O-acetylated aldonitrile derivatives). In a high-inoculum intravascular-infection model, antimannan assays were consistently positive beginning on day 2 postinoculation, anti-cytoplasmic antigen assays followed the same time course but were less sensitive, mannan was detected in all samples beginning on day 2 postinoculation, and serum mannose concentrations peaked on day 3 postinoculation and were less sensitive than mannan detection. Other assays were not useful. In a lower-inoculum intravascular infection model, the antibody assays became positive after a similar interval and remained positive for 28 days, with antimannan again being the more sensitive. Mannan and mannose tests were positive in week 1 postinoculation only, with mannan detection being the more sensitive. In a gastrointestinal-colonization model, antimannan assays become positive after 2 weeks of colonization, whereas anti-cytoplasmic antigen and mannan tests remained negative. In a model of gastrointestinal colonization followed by invasive infection produced by induction of neutropenia, only mannan detection was diagnostically useful. These data, comparing this panel of modern serodiagnostic techniques in controlled models of clinically relevant syndromes of candidiasis, enhance understanding of previous efforts in serodiagnosis of candidiasis and provide a foundation for further prospective studies in patients. PMID- 3281972 TI - Quality of commercially produced Shigella serogrouping and serotyping antisera. AB - Shigella grouping antisera from five manufacturers and typing antisera from two were purchased and evaluated with homologous and heterologous Shigella strains in the slide agglutination test. Only 31 of 73 (42%) antisera were satisfactory. In many instances, the antisera gave negative, as opposed to weak, reactions when they should have given strong positive reactions. Four reagents cross-reacted with Shigella strains. Of the 19 polyvalent grouping antisera to subgroups Shigella dysenteriae serotypes 1 through 7, S. flexneri serotypes 1 through 6, S. boydii serotypes 1 through 7, and S. sonnei forms I, II, only one S. sonnei reagent and five S. flexneri reagents were satisfactory with greater than or equal to 90% of the homologous strains. The reagent of poorest quality was satisfactory with only 18% of the homologous strains. There were three polyvalent antisera to the higher types of S. dysenteriae and S. boydii, which were available from only one company, that adequately identified 80, 63, and 65% of the homologous strains. Typing antisera were available from only two companies, and 30 of 51 (59%) were satisfactory. Commercially available Shigella antisera are inadequate for the laboratory testing required for planning the development of and evaluating Shigella vaccines. PMID- 3281973 TI - Detection of Bacteroides fragilis, Bacteroides thetaiotaomicron, and Bacteroides ovatus in clinical specimens by immunofluorescence with a monoclonal antibody to B. fragilis lipopolysaccharide. AB - A total of 1,897 clinical specimens (1,019 aspirates and 876 swabs) were studied by indirect immunofluorescence (IF) with a mouse monoclonal antibody (MAb) against a D-galactose oligomer of Bacteroides fragilis lipopolysaccharide. The MAb has been shown to react with 96% of clinical B. fragilis isolates and with about 50% of Bacteroides ovatus and Bacteroides thetaiotaomicron isolates but not with other aerobic or anaerobic organisms tested. The sensitivity of IF in comparison with culturing was 78.9% for all three species. Of the 32 strains originating from culture-positive, IF-negative specimens, 13 lacked the target determinant for the MAb. Sensitivity was highest with specimens taken from the perineal area (87.1%) and lowest with those taken from undefined sites (56.6%). Sensitivity was better with aspirates (86.8%) than with swabs (72.6%). The specificity of IF was 95.6% for all of the material. Positive and negative predictive values were 51.1 and 98.0%, respectively. Neither long transportation times of specimens nor antimicrobial therapy seemed to correlate with the occurrence of IF-positive, culture-negative specimens. This study shows that a single MAb can be used to establish an IF assay that can complement isolation in the detection of these three members of the B. fragilis group. PMID- 3281974 TI - Diagnosis of systemic candidiasis by an enzyme-linked dot immunobinding assay for a circulating immunodominant 47-kilodalton antigen. AB - A dot immunobinding assay based on the detection of the immunodominant 47 kilodalton (kDa) antigen of Candida albicans is described for the serological diagnosis of systemic candidiasis. It was compared with a reverse passive latex agglutination test and a dot immunobinding assay with total unfractionated hyperimmune serum to C. albicans. Use of the 47-kDa antigen-specific probe increased both the sensitivity and specificity of the assay system. Patients with systemic candidiasis were detected earlier in the course of the infection. The rate of detection of systemic C. albicans infections in neutropenic patients was 77% compared with 55% with total antibody in the dot immunobinding assay and 29% with the latex test. All three assay systems were positive in over 73% of infected patients who were not neutropenic. The 47-kDa antigen-specific probe was relatively specific to C. albicans. Antibody probes to the immunodominant antigens of other yeasts might be incorporated in the same dot immunobinding assay to detect systemic candidiasis caused by other species of yeasts. PMID- 3281976 TI - Characterization of monoclonal antibodies to protein antigen of Salmonella typhi. AB - Two monoclonal antibodies were produced against protein antigens of Salmonella typhi. One of the antibodies (STP14) belongs to the immunoglobulin G1K subclass, and the other (STP13) was assigned to the immunoglobulin G2a(kappa) subclass. Both antibodies could recognize the 34.0-kilodalton protein antigen from S. typhi. The specificity of these antibodies was tested by immunoblotting with a panel of crude protein antigens from 12 bacteria causing enteric fever and enteric fever-like illness: S. typhi, S. paratyphi A, S. paratyphi B, S. paratyphi C, S. choleraesuis, S. enteritidis, S. krefeld, S. panama, S. typhimurium, Escherichia coli, Pseudomonas pseudomallei, and Yersinia enterocolitica. In a modified double-antibody sandwich enzyme-linked immunosorbent assay they could detect the protein antigen at ca. 0.6 microgram/ml. These monoclonal antibodies should be of great value in the diagnostic test for detecting S. typhi antigen in samples of bodily fluids isolated from patients with typhoid fever and in studies of the chemical structure and other immunological properties of this 34.0-kilodalton protein. PMID- 3281975 TI - Enzyme-linked immunosorbent assay of antibody to group A Streptococcus-specific C carbohydrate with trypsin-pronase-treated whole cells as antigen. AB - We describe the measurement by enzyme-linked immunosorbent assay of antibody to group A Streptococcus C carbohydrate in immunized rabbits and human sera, with trypsin-pronase-treated group A streptococcal whole cells used as the antigen. The optimal concentration of the enzyme-treated whole cells used to coat the wells was 2 x 10(7) cells per well. Rabbit antiserum diluted to 1:12,800 and human serum diluted to 1:1,000 were found to be the optimal concentrations for antibody measurement. Antibody that reacted with enzyme-treated whole cells in rabbit antiserum was absorbed with group A streptococcal whole cells, purified C carbohydrate, and N-acetylglucosamine only. Enzyme-treated whole cells did not react with anti-lipoteichoic acid antibody, and rabbit antiserum did not react with lipoteichoic acid. There was a highly significant correlation between the anti-C carbohydrate antibody titrated with enzyme-treated whole cells and that with purified C carbohydrate as antigen. The correlation coefficient for the immunoglobulin M (IgM) antibodies was r = 0.75, and for the IgG antibodies it was r = 0.77. When the IgG antibody titers to the enzyme-treated whole cells of the sera of patients with acute poststreptococcal glomerulonephritis and rheumatic fever were compared with those of sera of healthy individuals, the sera of patients with poststreptococcal sequelae had significantly higher titers than did healthy individuals. Although anti-C carbohydrate antibody in human sera mostly belonged to the IgG2 subclass, there was anti-C carbohydrate antibody that belonged to the IgG3 subclass in a certain percentage of patients with rheumatic fever and acute poststreptococcal glomerulonephritis. PMID- 3281977 TI - Virulence factors of lactose-negative Escherichia coli strains isolated from children with diarrhea in Somalia. AB - Lactose-negative Escherichia coli strains were isolated at high frequency from children with diarrhea in Somalia during a 2-year study on diarrheal diseases. Sixty-four of these strains, considered to be a representative sample, were characterized for virulence factors, plasmid profiles, and antibiotic resistance. Of these strains, 5 were recognized as enteroinvasive E. coli (they were serotyped as O135:K-:H-), 6 belonged to classical enteropathogenic E. coli serotypes, 9 were able to adhere to tissue culture cells (of these, 4 showed a pattern of localized adherence and 1 was an enteropathogenic strain), 18 were both adherent and hemolytic, and 8 were simply hemolytic. None hybridized with 32P-labeled heat-labile or heat-stable (a and b) enterotoxin gene probes or produced moderate or high-level cytotoxic effects on HeLa cells. Of the 64 strains examined, 24 produced mannose-resistant hemagglutination with human, chicken, and monkey erythrocytes. One of these was serotyped as O4:K-:H8, and a rabbit O antiserum raised against this strain allowed us to establish that 23 strains had the same O antigen. The 23 O4 strains were hemolytic and were not enterotoxic for rabbit ileal loops, and intact bacteria were able to destroy tissue culture cell monolayers very rapidly. The uniformity of the antibiotic resistance pattern and of the plasmid DNA content, together with the fact that they were isolated in different years and in different children, suggests that the O4 strains must be epidemiologically relevant in Somalia. A possible diarrheagenic role for the adherent-hemolytic E. coli strains is also discussed. PMID- 3281978 TI - Comparative study of colony hybridization with synthetic oligonucleotide probes and enzyme-linked immunosorbent assay for identification of enterotoxigenic Escherichia coli. AB - On the basis of the published nucleotide sequences of the genes that code for the heat-labile toxin LTh and the heat-stable toxins STaI and STaII of human enterotoxigenic Escherichia coli, a 34-mer and two 33-mer oligonucleotide probes were synthesized. To compare their relative efficacies in the detection and differentiation of enterotoxigenic E. coli, a colony hybridization technique using these probes and a GM1 ganglioside enzyme-linked immunosorbent assay using monoclonal anti-LT and anti-ST antibodies were used with 76 strains of E. coli with known enterotoxin profiles. For further evaluation of probe specificity, the enterotoxigenic bacteria Vibrio cholerae O1 and non-O1 and Yersinia enterocolitica were examined with the colony hybridization technique. The sensitivity of colony hybridization compared favorably with that of GM1 ganglioside enzyme-linked immunosorbent assay, and the two assays showed a high level of concordance in specific detection and differentiation of E. coli with various enterotoxin profiles (kappa = 0.906, P less than 0.00001). The probes did not hybridize with DNAs from strains of V. cholerae O1 or non-O1 or Y. enterocolitica. PMID- 3281979 TI - Comparison of six serological assays for human immunodeficiency virus antibody detection in developing countries. AB - Three commercially available assays for the detection of human immunodeficiency virus (HIV) antibodies-Vironostika enzyme immunoassay (EIA), Wellcozyme competitive EIA, and JLC Allaman indirect immunofluorescence assay--were tested on 300 serum samples from African subjects with and without HIV-related conditions. Two experimental assays both rapid and simple to perform (Biotech dip stick and Cambridge Bioscience latex agglutination) were also evaluated on the same serum samples. The results were compared with those of a commercial Western blot (WB) (immunoblot) assay from Biotech, used as the reference technique. All assays were tested in the laboratory of the AIDS Project in Kigali, Rwanda. Calculated specificity ranged from 90.8% (dip stick) to 98.6% (Vironostika EIA, Wellcozyme competitive EIA, and Cambridge Bioscience latex agglutination). Sensitivity ranged from 95.2% (Cambridge Bioscience latex agglutination) to 98.0% (Vironstika EIA) and JLC indirect immunofluorescence assay). However, the sensitivity of the latex agglutination test improved to 98.6% after the prozone effect was controlled for by serial twofold dilution of latex agglutination negative, WB-positive samples. In situations with a high prevalence of HIV infection, any one of these tests can be regarded as an alternative to the more expensive, time-consuming, and difficult WB assay. PMID- 3281980 TI - Detection of dengue virus type 2 in Aedes albopictus by nucleic acid hybridization with strand-specific RNA probes. AB - A molecular hybridization technique with radiolabeled, strand-specific RNA probes was developed to detect dengue virus type 2 RNA in pools of infected Aedes albopictus mosquitoes. One infected mosquito in a pool of 25 could be detected, corresponding to a dengue virus type 2 titer of 2.75 log10 50% tissue culture infectious doses. PMID- 3281981 TI - Detection of respiratory syncytial virus in clinical specimens by viral culture, direct and indirect immunofluorescence, and enzyme immunoassay. AB - We evaluated prospectively the detection of respiratory syncytial virus (RSV) by culture and by direct antigen detection using an indirect immunofluorescence assay (IFA), a direct monoclonal immunofluorescence assay (DFA), and a monoclonal enzyme immunoassay (EIA). Of 221 specimens, 95 (43%) were culture positive for RSV, 4 (1.8%) contained more than one virus, and 17 (7.6%) contained a virus other than RSV. Overall, HEp-2 and Flow 6000 cells grew significantly more RSV isolates (82 and 72%, respectively) than A549 cells, which grew only 29% of the isolates. The mean time for RSV detection with HEp-2 cells was 2.9 days. This was significantly less than the mean time for RSV detection with either Flow 6000 cells (6.1 days) or A549 cells (6.4 days). Of 221 specimens, 129 were tested simultaneously by culture, IFA, and DFA. Of these 129 specimens, 62 (48%) were positive by culture, 69 (53%) were positive by IFA, and 70 (54%) were positive by DFA. For 92 specimens screened simultaneously by culture, IFA, and EIA, positive results were obtained for 33 (36%) of the specimens by both culture and IFA and for 29 (32%) of the specimens by EIA. Of 126 culture-negative specimens, 21 (17%) were positive for RSV when determined by IFA. Conversely, 14 (15%) of 95 RSV culture-positive specimens were negative by IFA, whereas DFA missed 19% of the culture-positive specimens. Compared with culture, the Kallestad EIA kit had a sensitivity and specificity of 73 and 92% respectively, but missed 9 (27%) of 33 culture-positive specimens. These data demonstrate that isolation by culture continues to be important for viral diagnosis of REV infections and that for valid comparative studies between viral isolations and rapid detection methods, both sensitive host cells and appropriate test conditions are required. PMID- 3281983 TI - Cholinergic synaptic input to different parts of spiny striatonigral neurons in the rat. AB - The postsynaptic targets of cholinergic boutons in the rat neostriatum were assessed by examination in the electron microscope of boutons that were immunoreactive for choline acetyltransferase, the synthetic enzyme for acetylcholine. These boutons formed symmetrical synaptic specializations with neostriatal neurons. Of 209 immunoreactive synaptic boutons observed in random searches of the neostriatum, 45% made contact with dendritic shafts, 34% with dendritic spines, and 20% with neuronal perikarya. Many of the postsynaptic structures had ultrastructural characteristics of the most common type of striatal neuron, the medium-size densely spiny neuron. This was confirmed by the examination in the electron microscope of Golgi-impregnated medium-size spiny neurons from sections that had also been immunostained for choline acetyltransferase. Immunoreactive boutons formed symmetrical synaptic specializations with all parts of the neurons examined, i.e., perikarya, proximal and distal dendritic shafts, and dendritic spines. Two of the Golgi-impregnated medium-size spiny neurons that received input from the cholinergic boutons were also retrogradely labelled with horseradish peroxidase that had been injected into the substantia nigra, they were thus further characterized as striatonigral neurons. Similarly, seven retrogradely labelled perikarya of striatonigral neurons were found to receive input from the cholinergic boutons. It is concluded that cholinergic boutons in the neostriatum form synaptic specializations and that one of their major targets is the medium-size densely spiny neuron that projects to the substantia nigra. The topography of the cholinergic afferents of these cells is distinctly different from that of other boutons derived from local neurons and from boutons that form asymmetrical synaptic specializations, but it is similar to that of the dopaminergic boutons originating from neurons in the substantia nigra. PMID- 3281984 TI - Application of decisions analysis to the management of third molars. PMID- 3281982 TI - Achromobacter xylosoxidans (Alcaligenes xylosoxidans subsp. xylosoxidans) bacteremia associated with a well-water source: case report and review of the literature. AB - A case of community-acquired Achromobacter xylosoxidans bacteremia in a patient with metastatic breast carcinoma is described. The patient's home drinking water was identified as the source of her bacteremia. The case represents the first in which a community-acquired infection due to this organism has been attributed to a documented water source. PMID- 3281986 TI - Use of focused ultrasonic receivers for remote measurements in biological tissues. AB - The feasibility of using a focusing ultrasonic transducer as a sound pressure receiver is discussed. It is shown theoretically that, at certain angular apertures of the receiver, its output signal is proportional to the sound pressure in the field point coincident with the receiver center of curvature. The receivers of this type have been demonstrated suitable for remote measurements of field spatial distribution of plane and focused ultrasonic radiators. Data are presented on the experimental testing of focused receivers in measuring acoustic fields in water, air, and certain samples of biological tissues. The instruments are sufficiently universal and allow the measurement not only of acoustic fields, but also of temperature increments in locally heated media, as well as permit one to follow the initiation and development of ultrasonic cavitation and study nonlinear effects. The remote sensing ability and high sensitivity of focused ultrasonic receivers allow their practical use in biomedical acoustics for noninvasive measurements. PMID- 3281985 TI - Ultrasonic propagation properties (@ 100 MHz) in excessively fatty rat liver. AB - The effects on the ultrasonic propagation properties of livers of the addition of 1% orotic acid to rat diets were examined. In rats, dietary orotic acid exerts several effects on lipid metabolism; its overall consequence is that excessively high hepatic fat concentrations are built up over a short period of time, thus making this an ideal model to study the ultrasonic propagation properties as a function of sequential development of fatty liver. Over a 16-day period on the orotic acid diet, the supplemented rat liver lipid concentrations increased from a normal range of 2%-4% to the lower 20's%; hepatic water concentration decreased from a normal value of approximately 70% to approximately 50%; total protein concentration decreased slightly from a normal range of 17%-20% to 11%-16%; and rat liver weight increased from approximately 11 g to around 20 g. Ultrasonic attenuation coefficient and speed were assessed in liver tissue with the scanning laser acoustic microscope at 100 MHz. As hepatic lipid increased, ultrasonic attenuation at 100 MHz increased temporally from a normal range of 12-14 dB/mm to a maximum of 54 dB/mm and ultrasonic speed decreased from a normal range of 1553 1584 m/s to a minimum of 1507 m/s. Multivariant linear regression was used in the analysis of covariance to fit the least-squares estimates to the linear regression model. Strong correlates of ultrasonic speed with both water concentration and fat concentration in the liver were observed. PMID- 3281987 TI - A new index for evaluation of the turbulent noise in pathological voice. AB - The validity of the parameter Br index, which was designed as an indicator of the turbulent noise in breathy voice, was tested. The parameter was determined by the ratio between energy of the second derivative of the high-pass filtered wave and that of the nonderived high-pass filtered wave. The principle of this method is the utilization of the difference in the frequency range between the turbulent noise and other components present. The parameter was found to correlate with the perception of breathiness. Clinical applications of this index suggest the possibility of using it further as a detection tool for diseases that generate turbulent noises. PMID- 3281988 TI - Speech understanding and aging. Working Group on Speech Understanding and Aging. Committee on Hearing, Bioacoustics, and Biomechanics, Commission on Behavioral and Social Sciences and Education, National Research Council. PMID- 3281989 TI - Reconsideration of echocardiographic standards for mitral valve prolapse: lack of association between leaflet displacement isolated to the apical four chamber view and independent echocardiographic evidence of abnormality. AB - Mitral valve prolapse by current echocardiographic criteria can be diagnosed with surprising frequency in the general population, even when preselected normal subjects are examined. In most of these individuals, however, prolapse is present in the apical four chamber view and absent in roughly perpendicular long-axis views. Previous studies have shown that systolic annular nonplanarity can cause apparent prolapse in the four chamber view without actual leaflet displacement above the most superior points of the anulus, and there is evidence for such nonplanarity in vivo. It is then reasonable to ask whether superior leaflet displacement limited to the four chamber view has any pathologic significance or complications. The purpose of this study, therefore, was to address the following hypothesis: that patients with superior leaflet displacement confined to the four chamber view have no higher frequency of associated echocardiographic abnormalities than do patients without displacement in any view. Such abnormalities, which would provide independent evidence of mitral valve pathology or dysfunction, include leaflet thickening, left atrial enlargement and mitral regurgitation. Leaflet displacement was measured in the parasternal long-axis and apical four chamber views in 312 patients who were studied retrospectively and selected for the absence of forms of heart disease other than mitral valve prolapse. Leaflet thickness and left atrial size were measured and mitral regurgitation was graded. Patients with leaflet displacement limited to the four chamber view were no more likely to have associated abnormalities than were patients without displacement in any view (0 to 2% prevalence, p greater than 0.5). In contrast, patients with leaflet displacement in the long-axis view were significantly more likely to have associated abnormalities (12 to 24%, p less than 0.005), the frequency of which increased with the extent of leaflet displacement in that view (p less than 0.0001). These results suggest that displacement limited to the apical four chamber view is, in general, a normal geometric finding unassociated with echocardiographic evidence of pathologic significance. PMID- 3281990 TI - Cardiac tamponade and pericardial effusion: respiratory variation in transvalvular flow velocities studied by Doppler echocardiography. AB - Cardiac tamponade has been associated with an abnormally increased respiratory variation in transvalvular blood flow velocities. To determine whether this finding is consistently present in cardiac tamponade, seven patients were studied prospectively with Doppler echocardiography before and after pericardiocentesis and the results were compared with those found in 20 normal adults and 14 asymptomatic patients with pericardial effusion who did not have definite clinical evidence of tamponade. Doppler ultrasound evaluation included measurement of mitral, tricuspid, aortic, pulmonary and central venous flow velocities, as well as left ventricular ejection and isovolumic relaxation times during inspiration, expiration and apnea. In the patients with severe cardiac tamponade, respiratory variation in transvalvular flow velocities and left ventricular ejection and isovolumic relaxation times were markedly increased compared with values in normal subjects and those obtained after pericardiocentesis. In the 14 asymptomatic patients with pericardial effusion but without overt tamponade, 7 showed respiratory variation in flow velocity similar to that of normal subjects. The other seven patients demonstrated increased respiratory change compared with normal, but less than that in the patients with tamponade. Clinical and hemodynamic data in this latter group suggest that these patients may represent an intermediate stage of pericardial effusion with an element of hemodynamic compromise. PMID- 3281991 TI - Comparison of time domain and frequency domain variables from the signal-averaged electrocardiogram: a multivariable analysis. AB - The relative values of the unprocessed signal-averaged electrocardiogram (ECG) and time domain analysis and frequency domain analysis of the signal-averaged ECG were compared in 36 patients with sustained monomorphic ventricular tachycardia and a remote myocardial infarction, in 29 asymptomatic patients with a remote myocardial infarction and in 23 normal subjects. Area ratios of the energy spectra derived from fast Fourier transform analysis were calculated using six separate 140 ms intervals starting at 0, 40, 50 and 60 ms after QRS onset; 40 and 50 ms before QRS end and a variable length interval starting 40 ms before QRS end and extending to the T wave. Total filtered QRS duration, late potential duration and root mean square voltage of the terminal QRS complex were measured from the filtered vector magnitude signal-averaged ECG. The total QRS duration was also measured from the X, Y, Z leads of the unfiltered signal-averaged ECG. Seven variables were significantly different in univariate tests between myocardial infarction patients with and without ventricular tachycardia: three fast Fourier transform area ratios with the sampling interval starting at 1) QRS onset (p = 0.007), 2) 40 ms after QRS onset (p = 0.02), and 3) 60 ms after QRS onset (p less than 0.0001); and all four time domain variables at 1) total filtered QRS duration (p less than 0.0001), 2) late potential duration (p = 0.0001), 3) root mean square terminal QRS voltage (p = 0.0001), and 4) QRS duration from the unprocessed signal-averaged ECG (p less than 0.0001). Of these seven variables, only the fast Fourier transform area ratio starting at QRS onset was significantly different between patients with myocardial infarction without ventricular tachycardia and normal subjects. In multi-variable analysis, the total filtered vector magnitude QRS duration, a time domain variable that includes the late potential, was the only independent factor that separated patients with myocardial infarction with and without associated ventricular tachycardia. PMID- 3281992 TI - Ventriculocoronary connections in hypoplastic right heart syndrome: autopsy serial section study of six cases. AB - Myocardial sinusoids communicating with the coronary systems occur in pulmonary atresia with intact ventricular septum. To test the hypothesis that the extent of ventriculocoronary connections correlates with the degree of right ventricular outflow obstruction as evidenced by clinical, angiographic and gross anatomic findings, a serial section study of six human autopsy hearts representing a spectrum of hypoplastic right heart was undertaken. Slides were evaluated for the presence and extent of ventriculocoronary connections, associated developmental abnormalities and secondary changes in the ventricular walls. Whereas extensive blind-ended deep sinusoids were a feature of all five cases with unrelieved obstruction, ventriculocoronary connections were identified in three. Changes that suggested ongoing remodeling provide new evidence for the postnatal temporal evolution of these anomalous communications. The regional distribution of myofiber disarray in hypoplastic right heart supports the concept that vascularization parallels myocardial organization in the developing human heart. PMID- 3281993 TI - Appropriate electrophysiologic study and treatment of patients with the Wolff Parkinson-White syndrome. PMID- 3281994 TI - Outlet strut fracture of the Bjork-Shiley 60 degrees Convexo-Concave valve: current information and recommendations for patient care. AB - Mechanical failure of artificial heart valves can be a catastrophic event. The problem of outlet strut fracture of the Bjork-Shiley 60 degrees Convexo-Concave tilting disc prosthesis has received much attention in the medical literature and generated both concern and confusion among patients and physicians. Analysis of current data from the manufacturer, as well as a review of the medical literature, suggests that the overall risk of outlet strut fracture is low and that elective explantation of a well functioning Bjork-Shiley 60 degrees Convexo Concave valve prosthesis is not warranted. Diagnostic features of outlet strut fracture can be seen with overpenetrated chest X-ray films so that diagnosis can be established promptly. Early operation to replace the fractured prosthesis is essential for patient survival. PMID- 3281995 TI - Analysis of morbid events and risk factors for death after cardiac transplantation. AB - Risk factors for death after cardiac transplantation performed at the University of Alabama at Birmingham from January 1981 to July 1985 included (by multivariate analysis) higher calculated preoperative pulmonary vascular resistance (early and constant phases), morphology of cardiomyopathy (versus ischemic heart disease) (constant phase only) and black race (constant phase). Overall actuarial survival was 71% at 1 year and 48% at 3 years (including azathioprine and cyclosporine eras). The hazard function for death was highest immediately after operation and declined rapidly thereafter, merging with a constant phase of risk at about 3 months. The most favorable group for long-term survival was the group of white patients with ischemic heart disease and low pulmonary vascular resistance. When such patients had a pulmonary vascular resistance less than 3 units.m2, the 3 year survival rate exceeded 85%. The most common causes of death were acute rejection (24%) and infection (17%). The risk of infection remained highest during the first several months after any period of augmented immunosuppression. PMID- 3281996 TI - Human retroviruses and the acquired immunodeficiency syndrome. I. Virology update. PMID- 3281997 TI - The effect of ketotifen on bronchial beta-adrenergic tachyphylaxis in normal human volunteers. AB - The effect of ketotifen on bronchial beta-adrenergic tachyphylaxis was studied in healthy volunteers. In a 2-week pilot study, 19 volunteers inhaled 300 micrograms of salbutamol, four times a day. Ten subjects became tachyphylactic to inhaled salbutamol, assessed by a dose-response curve, before and after the 2 weeks of treatment from a metered-dose inhaler. These 10 subjects were then involved in a double-blind, crossover study comparing the effect of ketotifen, 1 mg in the evening during 1 week, and 1 mg, twice daily, during 3 weeks, and placebo on the bronchial beta-adrenergic tachyphylaxis induced by the concomitant administration during the last 2 weeks of each treatment period of 300 micrograms of salbutamol, four times a day, from a metered-dose inhaler. The end of the pilot study preceded the double-blind study by at least 1 month. However, the salbutamol dose response curve at the beginning of the double-blind study was still significantly decreased, compared to the dose-response curve before the pilot study. During placebo treatment, a further decrease in bronchial beta-adrenergic sensitivity was observed. Treatment with ketotifen prevented the induction of further beta adrenergic tachyphylaxis. Each 2 weeks of treatment with inhaled salbutamol increased significantly the baseline specific airway conductance; therefore, based on the present data, it is impossible to determine whether ketotifen also restores the sensitivity of an already desensitized beta-adrenergic system in the airways. PMID- 3281998 TI - Skin eosinophilia in atopic patients. AB - The responses of six atopic and six control patients to the intracutaneous administration of platelet-activating factor (PAF) acether, of the leukocyte secretagogue and chemoattractant f-methionyl-leucyl-phenylalanine (FMLP), and of allergens were studied. Immediate wheal-and-flare skin reactions to allergens and to PAF acether in atopic patients were the same, and when reactions were compared to reactions of nonatopic patients, these reactions to PAF acether and to FMLP were of equivalent intensity. Late-phase reactions were not observed macroscopically with allergen, PAF acether, or FMLP. The cellular responses, assessed by the Rebuck skin window technique, demonstrated a late (24 hours) eosinophilic response to the allergen and to both inflammatory agents, with 33% to 44% of intensively degranulated eosinophils. In comparison, very few, if there were any, eosinophils were observed in the nonatopic patients. Most infiltrated cells were neutrophils. The accumulation of eosinophils in atopic human skin indicates a potent eosinophilotactic activity restricted to the allergic patients. A similar cellular reaction has been observed in lungs from guinea pigs injected with PAF acether or with allergen, and in patients with severe asthma. The chemoattractant activity of FMLP toward eosinophils cannot be accounted for by its histamine-releasing activity and remains to be explained. PMID- 3281999 TI - A pathologic study of allergic bronchopulmonary aspergillosis. AB - A lung biopsy specimen was obtained from a 10-year-old boy with cystic fibrosis and allergic bronchopulmonary aspergillosis. Light microscopy revealed a marked inflammatory process that was largely bronchocentric. Infiltrating cells included lymphocytes, plasma cells, monocytes, and numerous eosinophils. Elastin layers were intact in blood vessels and markedly disrupted in bronchioles. By immunofluorescent, major basic protein was demonstrated in eosinophils, was freely deposited outside of eosinophils, especially in the interlobular septum, and was taken up by macrophages. A number of lymphocytes stained positively for IgE. Through an immunoperoxidase stain, septate hyphae of Aspergillus were clearly observed in the lung parenchyma. A significant increase in interleukin-2 positive-staining T cells was observed with an approximate 2:1 ratio of helper to suppressor cells. The use of newer immunohistologic techniques has enabled us to gain additional insights into the pathogenesis of allergic bronchopulmonary aspergillosis. PMID- 3282000 TI - AMWA--a support system. PMID- 3282001 TI - Toxicology update. Bis (2-ethylhexyl) phthalate. PMID- 3282002 TI - The life and death of Ismar Boas. AB - Dr. Ismar Boas (1858-1938) was the founder of the medical subspecialty of gastroenterology. In 1886, he opened in Berlin the first specialty clinic for the study of digestive diseases. In 1895, he founded the first journal devoted to gastroenterology. During his long and productive career, Boas was a pioneer in nearly all areas of his field. His most lasting scientific accomplishment is his work on occult bleeding, which first introduced the clinical importance of this abnormal finding for the early diagnosis of gastric carcinoma. Fifty years ago, in 1938, Ismar Boas killed himself as the Nazis occupied Vienna. In this article, we honor the memory of a great physician and retrace the circumstances of his death. PMID- 3282003 TI - Pharmacological aspects of therapy in inflammatory bowel diseases: antidiarrheal agents. AB - We review the use of antidiarrheal medications in inflammatory bowel disease, commenting on potential underlying immunologic mechanisms as a background for discussion of the clinical usage of antidiarrheal medications in this disease spectrum. We comment on new directions for the development of more effective therapeutic approaches and discuss the mechanism of action of antidiarrheal drugs, with emphasis on synthetic opiates. PMID- 3282004 TI - A double-blind multi-centre trial of fluoxetine and dothiepin in major depressive illness. South Wales Antidepressant Drug Trial Group. AB - The response of patients with major depressive illness to fluoxetine or dothiepin was compared in a double-blind multi-centre trial. No differences in efficacy were observed, but the profile of side-effects differed with tremor, rash, nausea and headache occurring with fluoxetine, and drowsiness, dizziness and visual disturbance with dothiepin. It is likely that fluoxetine will be marketed with a proposed dose range lower than the one used here. PMID- 3282005 TI - Cellular distribution and amount of chromogranin A in bovine endocrine pancreas. AB - We determined the cellular distribution and the amount of chromogranin A in endocrine cells of bovine pancreas using a polyclonal antibody against bovine adrenomedullary chromogranin A. The relative amounts of chromogranin A in the different cells of the endocrine pancreas were determined by computer-assisted analyses of the optical densities of the immunoreactivities in the stained sections. More than 80% of the immunoreactive chromogranin A was located in the pancreatic B-cells. In immunoblots of acid tissue extracts, only one chromogranin A band (MW 74 KD) was observed. Quantification of the immunoblots revealed that 3 micrograms of chromogranin A and 918 micrograms of insulin were present per gram pancreas (wet weight), equivalent to a molar ratio of 460 mumol chromogranin A per mol insulin. PMID- 3282006 TI - Effects of fixation time and enzymatic digestion on immunohistochemical demonstration of bromodeoxyuridine in formalin-fixed, paraffin-embedded tissue. AB - We studied the effects of fixation time and enzymatic digestion on immunohistochemical staining for bromodeoxyuridine (BUdR) in excised rat and human gastrointestinal tissues and human brain tumors which had been fixed in formalin after intravenous administration of BUdR shortly before biopsy of tissue. In formalin-fixed rat gastrointestinal tissues not treated with proteinase, the reaction products were insufficient to identify BUdR-positive cells. Results similar to those in ethanol-fixed tissue were obtained when formalin-fixed tissue sections were treated with protease, pepsin, or trypsin. The longer the material had been fixed in formalin, the longer the incubation in proteinase required to identify BUdR-labeled nuclei. The BUdR labeling indices of formalin-fixed human brain tumor specimens treated with protease were comparable to those of ethanol-fixed tissues. Sufficient BUdR staining was obtained even in tissues fixed in formalin for prolonged periods. Therefore, the BUdR labeling index can be determined retrospectively in clinical materials stored in formalin. PMID- 3282007 TI - Polyacrylamide gel electrophoresis and immunoblotting of proteins extracted from paraffin-embedded tissue sections. AB - We show in this communication that polyacrylamide gel electrophoresis (PAGE) and immunoblotting of proteins can be performed using one to two 5-7 micron paraffin sections of tissues fixed in non-cross-linking fixatives (acetone, alcohol, or modified Carnoy's solution). Proteins for study were extracted from paraffin sections of mouse foot pad and liver. The presence of unaltered keratin polypeptides in tissues fixed with either acetone or alcohol was demonstrated in gels stained with Coomassie brilliant blue. The preservation of their antigenic determinants was demonstrated with immunoblotting. Furthermore, the immunoreactivity of soluble proteins, such as albumin, remained unaltered in immunoblots obtained from paraffin-embedded mouse liver sections. These data indicate that tissues embedded and stored in paraffin are useful for the above mentioned biochemical and immunological studies and may therefore be an important technique for diagnostic pathology or retrospective studies. PMID- 3282008 TI - Experimentation and thymic selection. PMID- 3282009 TI - Proteolytic cleavage of Ii to p25. AB - The 25,000-Da protein that is seen in immunoprecipitates with antibodies to class II MHC molecules or to Ii was shown to be a C-terminal fragment of Ii. [35S]Methionine pulse-chase labeling of polyclonally activated B lymphocytes or lymphoblastoid cell lines demonstrated maximal appearance of p25 in Percoll separated endosomal fractions at 20- to 40-min chase times (studies in progress). This finding was consistent with the view that proteolysis of Ii to p25 and its release might catalyze the binding of digested foreign peptides to class II molecules and/or govern release of such charged complexes to traffic to the cell surface. We examined the structural relationship of p25 to Ii and the basis for cleavage of a relatively restricted site just external to the transmembranal segment. [35S]Methionine-labeled Ii and associated molecules were immunoprecipitated with a mAb to native Ii and then denatured, resolubilized, and subjected to a second immunoprecipitation with various antibodies. Two antisera to C-terminal peptides of Ii (183 to 193 and 192 to 211), but not antibodies to an N-terminal peptide (12 to 28), did immunoprecipitate p25. The three antibodies to C-terminal and N-terminal peptides all immunoprecipitated denatured Ii proteins. The mAb to Ii immunoprecipitated [35S]methionine-labeled p25 but not [35S]cysteine-labeled p25. This finding was consistent with loss of a portion of Ii containing the only cysteine in Ii, Cys28. Digestion of class II MHC Ag-Ii complexes with various proteases yielded proteins migrating at and near p25 in two-dimensional electrophoretic gels. Upon increasing the duration of protease digestion, the 25,000-Da fragments were relatively resistant to further digestion. This observation was consistent with the presence of secondary structures (domains) leaving a relatively protease-sensitive (Ig hinge-like) region in Ii near its insertion into the membrane. PMID- 3282010 TI - A two-stage culture system for the induction of antibody-forming cell clones in cultures of normal human blood lymphocytes. AB - A two-stage culture method is described for the induction of a specific antibody response to sheep red cells (SRC) in microcultures at limiting dilutions of human peripheral blood lymphocytes (PBL). PBL from normal donors were cultured for 4 days with antigen and EBV using well defined conditions. The cells were then distributed in 10 microliter microcultures at different cell densities in order to estimate the frequency of responding units. The culture wells were tested for the presence of anti-SRC antibody by the spot test. The results show that the expression of antibody-forming cell clones in the second stage microcultures is strictly dependent on the presence of both antigen and EBV during the first stage cultures. The efficiency of the system was improved by the addition of 4% polyethylene glycol (PEG, MW 6000) in the first stage and its removal in the second stage and by the use of human serum (instead of fetal calf) in both stages. This approach permits the separation of different cellular events, occurring when human B cells are stimulated by antigen and represents a useful approach for studying the mechanisms of the specific immune response in man. PMID- 3282011 TI - A safe and efficient method for elimination of cell culture mycoplasmas using ciprofloxacin. AB - The antibacterial activity of ciprofloxacin, a 4-fluoroquinolone antibiotic, in the control of mycoplasma contamination in experimentally infected cell lines has been investigated. Seven mycoplasma species, including M. hyorhinis, M. gallisepticum, M. orale, M. salivarium, M. hominis, M. fermentans, and M. arginini, which had chronically infected the murine plasmocytoma line X63-Ag8 653, were eradicated with 10 micrograms/ml ciprofloxacin. Wild type laboratory infections of two human cell lines, HL-60 and U-937, were eliminated by 12 days of such treatment. Mycoplasma decontamination of cell cultures was monitored by the cultivation method 4 weeks after treatment. No side effects were seen in cell cultures and complex proliferation assays with cells of human and murine origin, using ciprofloxacin in doses up to 2.5 times the usual bactericidal concentration. PMID- 3282012 TI - Dissociation studies of DNA/anti-DNA complexes in relation to anti-DNA avidity. AB - Antibodies to dsDNA differ in their avidity towards the antigen. The electrostatic interaction between DNA and anti-DNA is sensitive to increases in pH and/or ionic strength and therefore, elution studies employing either of these permit discrimination between anti-dsDNA populations that differ in avidity. Another way to determine anti-dsDNA avidity is the calculation of Farr/PEG ratios. These are obtained by division of the amount of anti-DNA measured with the Farr assay (which does not detect low avidity anti-dsDNA) by the amount measured with the PEG assay (which does detect low avidity anti-dsDNA). With these separate approaches, we compared the sera of 17 SLE patients with nephritis with the sera of 17 patients with central nervous system (CNS) involvement. Farr/PEG ratios and sensitivity to high pH elution of anti-dsDNA in the sera of these patients both permitted discrimination between the two groups of patients. The anti-dsDNA of patients with nephritis was found to have a significantly higher avidity towards DNA than anti-dsDNA of patients with cerebral disease. We also observed a significant correlation between Farr/PEG ratios and the salt lability of anti-dsDNA. PMID- 3282013 TI - An enzyme immunoassay for cuprozinc superoxide dismutase using monoclonal antibodies. Application for pharmacokinetic study. AB - We developed an enzyme immunoassay for determining human cuprozinc superoxide dismutase (h-SOD) using two kinds of monoclonal antibodies prepared by immunizing h-SOD to BALB/c mice. This method was sensitive and specific enough to determine exogenous h-SOD injected into rats. When intravenously injected into rats, much of the immunoreactive h-SOD accumulated in the kidney and was rapidly excreted in the urine. We observed both a modified and an unmodified form of exogenous h-SOD in rat urine. PMID- 3282014 TI - Psychiatric diagnosis and chronic pain: DSM-III-R and beyond. PMID- 3282015 TI - The use of corticosteroids in the treatment of symptoms associated with cancer. PMID- 3282016 TI - An improved technique for the study of immunofluorescence using non-decalcified frozen guinea pig cochlea. AB - A technique for producing frozen sections from the non-decalcified guinea pig cochlea is described. The sections can be utilised for various immunofluorescent studies, including the detection of humoral antibodies against different cellular elements in patients with cochleo-vestibular disorders. The technique assures the preservation of the cochlear architecture and the tissue antigenicity, and it avoids damage to the fine cochlear structural details. PMID- 3282017 TI - Enzyme-linked immunosorbent assay for human proapolipoprotein A-I using specific antibodies against synthetic peptide. AB - Apolipoprotein A-I (apoA-I), the major protein component of human high density lipoprotein, appears intracellularly as an intermediate precursor (proapoA-I) with a hexapeptide extension (Arg-His-Phe-Trp-Gln-Gln) at its amino terminus. To investigate the regulation of processes that regulate plasma apoA-I levels, a sensitive and simple assay for proapoA-I is required. We describe a specific enzyme-linked immunosorbent assay (ELISA) for quantification of proapoA-I using monospecific rabbit antibodies raised against the peptide: Arg-His-Phe-Trp-Gln Gln-Asp-Glu-Pro. The monospecificity of antibodies to propeptide has been checked and no cross-reaction with mature apoA-I has been found although three first mature apoA-I amino acids (Asp-Glu-Pro) were included in the immunizing peptide. The assay is a non-competitive sandwich ELISA in which polystyrene microtiter plates were used with antibodies to propeptide adsorbed on the wells. After incubation with plasma samples, the bound proapoA-I was revealed by labeled rabbit polyclonal antibodies directed against mature apoA-I. The working range was 10 to 100 ng/ml, recovery of proapoA-I added to plasma was 94.6 to 106.5%, and the intra- and interassay coefficients of variation were 3.8% and 7.9%, respectively. A delipidation step using diisopropylether-n-butanol was necessary to expose antigen sites of proapoA-I in native lipoproteins. Mean level of proapoA-I in normal subjects was 87 +/- 15 micrograms/ml. It represented 7.1% of total apoA-I while in Tangier serum it represented 29%. PMID- 3282018 TI - Phosphatidylcholine synthesis in yeast. AB - The two pathways for the biosynthesis of phosphatidylcholine, by way of phosphocholine and by methylation of phosphatidylethanolamine, in wild-type yeast (Saccharomyces cerevisiae) and in the yeast mutant GL7 have been compared. The mutant requires for growth a sterol, unsaturated fatty acids, and methionine. The uptake of labeled choline or labeled methionine and their conversion to phosphatidylcholine were determined in both cell types. The activities of the major enzymes for both pathways were assayed in vitro. We find that the methylation pathway is predominant in both wild-type and mutant cells though the overall activity of the choline pathway is lower in the yeast mutant. The methionine analogue ethionine inhibits the growth of the mutant more strongly than growth of wild-type yeast. Ethionine, while a powerful inhibitor of phosphatidylcholine synthesis by methylation, stimulates the choline pathway in both cell types. PMID- 3282019 TI - Endocrinology and osteoporosis. PMID- 3282020 TI - Plasma LH and testosterone responses to gonadotrophin-releasing hormone in adult red deer (Cervus elaphus) stags during the annual antler cycle. AB - Eight adult red deer stags were given an i.v. injection of synthetic gonadotrophin-releasing hormone (GnRH) on seven occasions at various stages of the antler cycle, namely hard antler in late winter, casting, mid-velvet growth, full velvet growth, antler cleaning and hard antler both during the rut and in mid-winter. The stags were allocated at random on each occasion to one of four doses, i.e. 1, 3, 10 or 95 micrograms GnRH. Blood samples were taken before GnRH injection and for up to 2 h after injection. Pituitary and testicular responses were recorded in terms of plasma LH and testosterone concentrations. There was an increase in plasma concentration of LH after the GnRH injection in all stags at all stages of the antler cycle. Dose-dependent responses of LH to GnRH in terms of area under the curve were apparent at all stages of the antler cycle. The lowest responses were recorded at casting, during velvet antler growth and at the rut sampling. The pattern of testosterone response reflected the inter relationship of the antler and sexual cycles with very low testosterone responses occurring at casting and during velvet antler growth. The responses were higher at antler cleaning and then increased to a maximum at the rut before declining to reach their nadir at casting. The results are consistent with a hypothesis that the antler cycle, as a male secondary sexual characteristic, is closely linked to the sexual cycle and its timing is controlled by reproductive hormones. Low plasma concentrations of testosterone, even after LH stimulation, are consistent with the hypothesis that testosterone is unnecessary as an antler growth stimulant during growth. PMID- 3282021 TI - Interaction of endogenous chicken gonadotrophin-releasing hormone-I and -II on chicken pituitary cells. AB - The presence of two endogenous forms of gonadotrophin-releasing hormone (GnRH) in the chicken hypothalamus (chicken GnRH-I ([Gln8]GnRH) and chicken GnRH-II ([His5, Trp7, Tyr8]GnRH)), and the stimulation of gonadotrophins by both forms, suggests the possible existence of GnRH receptor subtypes and gonadotroph subtypes in the chicken pituitary. This question was investigated by assessing the effects of various combinations of the two known forms of chicken hypothalamic GnRH and antagonist analogues of GnRH on LH release from dispersed chicken anterior pituitary cells in both static and perifused systems. The relative inhibition of chicken GnRH-I-stimulated and chicken GnRH-II-stimulated LH release by 12 GnRH antagonists did not differ significantly, suggesting a single GnRH receptor type. Chicken GnRH-II was approximately sixfold more potent than chicken GnRH-I in releasing LH. Release of LH in response to maximal doses of chicken GnRH-I and chicken GnRH-II and to a mixture of both was similar and the two peptides were not additive in their effects, consistent with the presence of a single type of LH gonadotroph and a GnRH receptor which binds both forms of GnRH. Each form of GnRH desensitized cells to subsequent stimulation with the other form, providing additional evidence for a single type of LH gonadotroph. These findings suggest that chicken GnRH-I and -II stimulate gonadotrophin release through a single GnRH receptor type on a single class of LH gonadotroph in the chicken pituitary. PMID- 3282022 TI - Stimulatory effect of insulin-like growth factor-I on [3H]thymidine incorporation, DNA content and insulin biosynthesis and secretion of isolated pancreatic rat islets. AB - The influence of insulin-like growth factor-I (IGF-I) on both the growth and function of isolated pancreatic rat islets was studied. As a measure of islet cell replication, [3H]thymidine incorporation and DNA content was estimated at the same time as parameters for (pro)insulin biosynthesis and secretion as a measure of the functional capacity of B cells. Incorporation of [3H]thymidine was measured after tissue solubilization; DNA was determined fluorometrically. (Pro )insulin biosynthesis was determined by incorporation of [3H]leucine after immunoprecipitation and binding to protein A-Sepharose. There was a significant increase in both [3H]thymidine incorporation and DNA content after the culture of islets with IGF-I. IGF-I resulted also in an increase in insulin biosynthesis and secretion from isolated pancreatic islets. These results demonstrate a role of IGF-I in regulating the growth and function of pancreatic islets. PMID- 3282024 TI - Management of pharyngitis revisited. PMID- 3282023 TI - Tumor necrosis factor alpha/cachectin is a growth factor for thymocytes. Synergistic interactions with other cytokines. AB - Recombinant murine (rm) TNF-alpha but not recombinant human (rh) TNF-alpha induces the proliferation of murine thymocytes in the presence of a comitogenic stimulus. This effect does not appear to be due to the production of significant levels of IL-1, IL-2, or IL-4. although not directly mitogenic (i.e., in the absence of PHA-P) for thymocytes, rmTNF-alpha amplifies the direct mitogenic signals from hIL-1 and rhIL-2 but not rmIL-4. In the presence of PHA-P, thymocytes stimulated with hIL-1, rhIL-2, and rmIL-4 produced significant amounts of TNF-alpha. Although rhTNF-alpha does not induce a proliferative response, it will competitively inhibit the proliferative response of thymocytes to rmTNF alpha. These data suggest a critical role for TNF-alpha in the intrathymic proliferation of developing T cells. PMID- 3282025 TI - Testing for streptococcal pharyngitis. PMID- 3282026 TI - Vaccination of high-risk patients for influenza. A comparison of telephone and mail reminder methods. AB - During the 1984-1985 influenza season two study groups were used to compare telephone and letter reminder methods with a control group that received no reminder to determine which was the most effective strategy to increase influenza vaccination rates among the high-risk patient population of a university-based family practice. Seven hundred eighty-seven high-risk patients were randomly assigned to one of the three study groups: a mailed-reminder group, a telephone reminder group, and a control group. Vaccination rates for both reminder methods were significantly higher than for the control group (P less than .02), and if successfully contacted, the telephone-reminder group had a significantly better vaccination rate than the mailed-reminder group (P less than .05). If successful telephone contact can be made, this reminder method is more effective than a letter reminder to increase influenza vaccination rates among high-risk patients. PMID- 3282027 TI - Exercise stress testing. AB - Exercise stress testing is used widely to evaluate the presence and extent of anatomic disease and the prognosis when significant disease has been defined. Indications for diagnostic testing include elevated blood pressure, palpitations, and chest pain. Functional testing is used to assess progression of cardiac disease, cardiac status following therapy, and physical capacity. Exercise testing must be applied to an appropriately selected group of patients. The indications, contraindications, types, results, and complications of exercise testing are presented. PMID- 3282028 TI - Is drug treatment indicated for mild hypertension with diastolic blood pressure of 90 mmHg to 100 mmHg? An affirmative view. PMID- 3282029 TI - Is drug treatment indicated for mild hypertension with diastolic blood pressure of 90 mmHg to 100 mmHg? An opposing view. PMID- 3282030 TI - Management of carcinogenic air emissions: a case study of a power plant. PMID- 3282031 TI - High-dose cytarabine and total body irradiation with or without cyclophosphamide as a preparative regimen for marrow transplantation for acute leukemia. AB - Twenty-nine patients were conditioned for allogeneic marrow transplant with cytarabine (ara-C) (3 g/m2 every 12 hours for 12 doses) and total body irradiation (TBI) (200 cGy daily for six days) with or without cyclophosphamide (CY) (60 mg/kg) to determine toxicity and efficacy. Four patients had chronic myelogenous leukemia (CML) in accelerated phase or blast crisis, and 25 patients had acute leukemia, 24 at stages later than first remission. Three patients (10%) had fatal regimen-related toxicity and another 10% experienced severe toxicity in at least one organ system. The addition of CY to the ara-C and TBI regimen was not associated with an increase in the frequency of severe toxicity. Twenty-five of 29 patients engrafted eight to 33 days posttransplant: three died early before engraftment, and one patient failed to engraft. Ten of 29 patients are alive without disease, and the actuarial probability of disease-free survival for the entire group at 3 years is 33%. Three of ten patients with acute nonlymphocytic leukemia (ANL), six of 15 with acute lymphocytic leukemia (ALL), and one of four with CML are alive and disease free 25 to 42 months (median, 30 months) after transplant. High-dose ara-C (HDara-C) and TBI with or without CY can be administered with approximately the same toxicity as CY plus TBI. Phase III studies appear warranted to determine if these newer regimens provide improved results compared with currently used regimens. PMID- 3282032 TI - Maintenance chemotherapy prolongs remission duration in adult acute nonlymphocytic leukemia. AB - The value of maintenance therapy after the achievement of complete remission in adult acute nonlymphocytic leukemia (ANLL) has never been clearly established. A randomized Eastern Cooperative Oncology Group (ECOG) study of postremission therapy compared outcomes in patients who received no further therapy to those administered long-term maintenance chemotherapy. Adverse results in the group administered no further therapy led to early termination of this trial after only 51 patients were randomized. Patients receiving no postremission therapy experienced significantly inferior remission durations (P = .002) compared with patients receiving maintenance therapy. All 26 patients in the group administered no postremission therapy have relapsed, with a median duration of remission of 4.1 months. In contrast, four of 25 patients (16%) who received maintenance therapy remain disease free, with a median duration of remission of 8.1 months. PMID- 3282033 TI - A prospective randomized trial of fluorouracil versus fluorouracil plus cisplatin in the treatment of metastatic colorectal cancer: a Hoosier Oncology Group trial. AB - From May 1984 through December 1986, 141 patients with metastatic adenocarcinoma of the colon or rectum were entered on this Hoosier Oncology Group (HOG) trial evaluating the role of cisplatin in systemic therapy. Patients were stratified by the presence or absence of hepatic metastases and by performance status, and were subsequently randomized to receive fluorouracil (5-FU) (15 mg/kg/wk) alone or the same dose of 5-FU plus cisplatin (60 mg/m2 every 3 weeks). The total duration of treatment was six cycles (18 weeks). In 132 fully evaluable patients the objective response rates were 19% for 5-FU and 22% for 5-FU plus cisplatin. Statistically, the median survival times of 40 and 39 weeks were not significantly different (P = .62). However, the median duration of remission (MDR) was superior (P = .05) for 5-FU alone. This study fails to confirm clinically significant synergy of 5-FU plus cisplatin in the treatment of metastatic colorectal cancer. PMID- 3282036 TI - Clinical stage I carcinoma of the testis: a review. AB - Significant advances in the management of disseminated carcinoma of the testis have had a tremendous influence on the management of all stages of disease, including both stage I and stage II. Because the disease is so uniformly curable in advanced forms, strategies have evolved for lower stages of disease to maximize curative potential with minimization of therapeutic intervention and potential long-term side effects. This review addresses issues of diagnosis and initial clinical staging of patients with stage I carcinoma of the testis. The usefulness of biological tumor markers and the accuracy, sensitivity, and specificity of radiographic imaging modalities are emphasized. The traditional treatment of stage I seminomas and nonseminomas includes the role of both radiation therapy and retroperitoneal lymph node dissection (RPLND). Treatment results and complications of each modality are also reviewed. The importance of orchiectomy followed by meticulous surveillance, as well as a critical analysis of prognostic features of subsequent locoregional or systemic relapse in patients with stage I testis cancer, focuses attention on changing concepts of this disease. The rationale underlying improved ability to stage patients meticulously and offer therapeutic intervention when necessary following orchiectomy, constitutes the focus of present and future clinical research. Such strategies are discussed in detail. PMID- 3282035 TI - Chemical modifiers of cancer treatment. AB - Chemical modification is a concept in cancer therapy in which the state of tumor cells or normal tissues is modified such that a therapeutic gain can be achieved using conventional therapeutic modalities. Hypoxic zones targeted as cells within them may be radiation resistant, poorly perfused by chemotherapeutic agents, and possibly drug resistant due to hypoxia-related gene amplification. Nitroimidazoles have gained particular attention as chemical modifiers because they can increase the radiation sensitivity of hypoxic cells, are cytotoxic to hypoxic cells, can increase sensitivity to chemotherapeutic agents, and are useful for imaging hypoxic cells. While both radiosensitization and chemosensitization require hypoxia, the mechanism of the enhancement of each of the modalities is different. The 2-nitroimidazole hypoxic sensitizers SR 2508 and Ro-03-8799, which are less toxic than the prototype misonidazole (Miso), are in clinical trials, and dual function molecules that include a hypoxic sensitizer and alkylating function are being developed. The presence of both acutely and chronically hypoxic cells in animal tumors has been demonstrated by new imaging techniques. Oxygen delivery to tumors is being altered by the use of perfluorocarbons, and agents that alter hemoglobin affinity for oxygen. Compounds that are selectively toxic to hypoxic cells are being developed. Nonhypoxic modifiers are also being investigated. Thiol modification, particularly the alteration of glutathione concentration, has complex effects on the cell's biochemistry, in addition to affecting the competition between oxygen and thiol groups for the restoration and fixation of radiation-induced radicals. WR-2721 is being studied as a means of reducing the normal tissue toxicity of radiation and chemotherapy. Increased thiol concentration may be a mechanism of cross resistance between certain chemotherapeutic agents and radiation. PMID- 3282034 TI - Control of chemotherapy-induced diarrhea with the synthetic enkephalin BW942C: a randomized trial with placebo in patients receiving cisplatin. AB - Diarrhea commonly occurs following the administration of cisplatin. BW942C, a pentapeptide, is a synthetic enkephalin shown to control castor oil-induced and traveler's diarrhea. To assess the safety and efficacy of BW942C in controlling diarrhea caused by cisplatin, 30 adults with lung cancer who had already experienced diarrhea (three or more loose bowel movements) during the 24-hour period following a prior cisplatin administration were randomized to receive either BW942C or placebo during the next cisplatin course. All patients received a concomitant antiemetic regimen including metoclopramide, dexamethasone, and lorazepam during all courses. Patients administered BW942C experienced less diarrhea (27% v 67%, P = .02). Twenty-seven percent of patients given the pentapeptide had loose bowel movements as opposed to 93% who received placebo (P = .0002). There were no significant differences in the incidence and degree of vomiting and other treatment-related side effects observed between the placebo and treatment groups. We conclude that oral BW942C is more effective than placebo in controlling diarrhea following cisplatin chemotherapy. PMID- 3282037 TI - Growth cone configuration and advance: a time-lapse study using video-enhanced differential interference contrast microscopy. AB - We have analyzed the dynamics of growth cone configuration using video-enhanced contrast differential interference contrast microscopy. Regenerating neurites from NGF-treated PC12 cells and sympathetic neurons were observed in real time during their elongation and reviewed by time-lapse video recordings. This technique provided a high-resolution view of motile growth cone elements including filopodia, microspikes, lamellipodia and ruffles. On the basis of our observations, a multistage model for growth cone advance is proposed. Elongation commences with lamellipodial spreading. If the newly extended lamellipodium does not retract or lift off the substrate in the form of a ruffle, a second phase- consolidation--occurs, in which the lamellipodium thickens as it fills with cytoplasm and organelles. The consolidated area then undergoes further transformation into an area of neuritic shaft as new lamellipodia form at the leading and peripheral zones of the distal process. We never observed filopodia or microspikes contracting to propel the growth cone forward. We also noted that elongating tips generally had large varicosities within 20 micron of their leading edges. These may play a role in neurite outgrowth and in the formation of smaller, synaptic vesicle-containing varicosities. The dynamic behavior of the growth cone was under the control of NGF. Withdrawal of NGF resulted in the disappearance of motile structures and cessation of growth, while readdition of NGF triggered the rapid reappearance of these structures and the resumption of growth. The high-resolution video microscopy of living growth cones provides necessary baseline information, as well as a bioassay paradigm, for future studies on the molecular mechanisms of nerve growth. PMID- 3282038 TI - The establishment of polarity by hippocampal neurons in culture. AB - By the end of the first week in culture, hippocampal neurons have established a single axon and several dendrites. These 2 classes of processes differ in their morphology, in their molecular composition, and in their synaptic polarity (Bartlett and Banker, 1984a, b; Caceres et al., 1984). We examined the events during the first week in culture that lead to the establishment of this characteristic form. Hippocampal cells were obtained from 18 d fetal rats, plated onto polylysine-treated coverslips, and maintained in a serum-free medium. The development of individual cells was followed by sequential photography at daily intervals until both axons and dendrites had been established; identification of the processes was confirmed by immunostaining for MAP2, a dendritic marker. Time lapse video recording was used to follow the early stages of process formation. Hippocampal neurons acquired their characteristic form by a stereotyped sequence of developmental events. The cells first established several, apparently identical, short processes. After several hours, one of the short processes began to grow very rapidly; it became the axon. The remaining processes began to elongate a few days later and grew at a much slower rate. They became the cell's dendrites. Neurons that arose following mitosis in culture underwent this same sequence of developmental events. In a few instances, 2 processes from a cell exhibited the rapid growth typical of axons, but only one maintained this growth; the other retracted and became a dendrite. Axons branched primarily by the formation of collaterals, not by bifurcation of growth cones. As judged by light microscopy, processes are not specified as axons or dendrites when they arise. The first manifestation of neuronal polarity is the acquisition of axonal characteristics by one of the initial processes; subsequently the remaining processes become dendrites. PMID- 3282039 TI - Localization of dural fistulas using metrizamide digital subtraction fluoroscopic cisternography. AB - Demonstration of the exact site of dural fistulas in cases of cerebrospinal fluid rhinorrhea is difficult. Previous reports have described the use of metrizamide cisternography combined with either hypocycloidal tomography or computerized tomography; however, direct, dynamic, real-time visualization of the fistula is difficult with instillation of a minimal dose of metrizamide using those methods. A digital video subtraction fluoroscopy system can visualize the actual site of the fistula directly and dynamically using only a small amount of metrizamide. PMID- 3282040 TI - Transcranial Doppler ultrasonography in raised intracranial pressure and in intracranial circulatory arrest. AB - Transcranial Doppler ultrasonography was used to monitor 71 patients suffering from intracranial hypertension with subsequent brain death. Among these, 29 patients were also assessed for systemic arterial pressure and epidural intracranial pressure, so that a correlation between cerebral perfusion pressure and the Doppler ultrasonography waveforms could be established. Four-vessel angiography was also performed in 33 patients after clinical brain death. With increasing intracranial pressure, the transcranial Doppler ultrasonography waveforms exhibited different characteristic high-resistance profiles with first low, then zero, and then reversed diastolic flow velocities, depending on the relationship between intracranial pressure and blood pressure (that is, cerebral perfusion pressure). This study shows that transcranial Doppler ultrasonography may be used to assess the degree of intracranial hypertension. This technique further provides a practicable, noninvasive bedside monitor of therapeutic measures. PMID- 3282041 TI - Metastases of central nervous system neoplasms. Case report. AB - Tumor-to-tumor metastasis is a rare occurrence. Fewer than 100 cases have been reported, many being metastases from carcinomas to benign intracranial neoplasms, most often meningiomas. A case is presented of carcinoma metastatic to a glioma. The patient, who presented for evaluation of bifrontal headache, was found on computerized tomography to have a partially calcified right frontal mass. Craniotomy revealed an oligodendroglioma containing foci of adenocarcinoma. Further work-up disclosed an infiltrative ductal adenocarcinoma of the breast. It has been suggested that tumors of the central nervous system may provide a fertile substrate or an immunological "haven" for metastases. PMID- 3282042 TI - James A. Halsted. PMID- 3282043 TI - High and low inhibitor soybean meals affect human duodenal proteinase activity differently: in vitro comparison of proteinase inhibition. AB - The purpose of the study was to investigate the in vitro inhibition of the proteolytic activity in samples of duodenal juice obtained during instillation of raw soybeans in humans. The results suggested the presence of an inhibitor resistant trypsin. Practically no inhibition was obtained with phenylmethylsulfonyl fluoride, aprotinin, human alpha 1-antitrypsin or lima bean trypsin inhibitor. Specificity against synthetic substrates was different from that obtained in the absence of raw soybeans. Duodenal aspirates containing this new trypsin activity were able to further inhibit tryptic and chymotryptic activity of basal aspirates from the duodenum, demonstrating surplus amounts of inhibitors in the duodenal juice. Further incubation of trypsin-inhibitor complexes at 37 degrees C, in the presence of surplus uninhibited (trypsin and chymotrypsin) duodenal juice, restored tryptic activity. This activity was not inhibitor-resistant. The results obtained for trypsin activity based on esterase assays were confirmed by a proteolytic assay. It is concluded that the increase in tryptic activity in human duodenal juice during raw soybean infusion is due to a previously unidentified inhibitor-resistant trypsin and not due to inactivation of the inhibitors in raw soybeans. PMID- 3282045 TI - Presidential address: William C. Campbell. Introduction of President Campbell. PMID- 3282046 TI - Eimeria maxima (Apicomplexa): a comparison of sporozoite transport in naive and immune chickens. AB - This study compared the early stages of infection in naive and immune chickens infected with Eimeria maxima. An immunoperoxidase stain was developed and used to detect sporozoites and early schizonts in tissue sections of intestinal epithelium. A significantly higher proportion of sporozoites was present in the crypts of naive chickens, 48 hr postinoculation of oocysts, compared to immune chickens. Sporozoites in immune birds tended to remain in the lamina propria rather than migrate to the crypts. Sporozoites were found within intraepithelial lymphocytes (IEL's) in the epithelium, the lamina propria, and the crypts of both naive and immune chickens. Parasites in IEL's of immune birds at the ultrastructural level and there were no apparent morphological abnormalities. Livers and spleens, of both immune and naive chickens that had been inoculated with Eimeria maxima, produced patent infections when fed to susceptible chickens. Infections could be transferred up to 72 hr post-inoculation of the donor birds. Peak oocyst production in the recipient birds occurred 7-8 days after the transfers. This time period approximates the prepatent period in a natural infection and thus implies that the extraintestinal stage was a sporozoite. PMID- 3282048 TI - Introduction of Dr. Bruce Martin Christensen as the Henry Baldwin Ward medalist for 1987. PMID- 3282047 TI - RESA-IFA assay in Plasmodium falciparum malaria, observations on relationship between serum antibody titers, immunity, and antigenic diversity. AB - RESA-IFA assays were conducted using 63 adult sera from 7 different malarious areas against 7 different strains of Plasmodium falciparum, and 28 children's sera against 3 different parasite strains. Generally, where immunity to malaria was high, there was little or no antigenic diversity among the different strains examined. However, where sera were collected from semi-immunes, or from children, some variation in the RESA-IFA endpoint titers was discernible. Correlation between antibody titers determined by RESA-IFA and in vitro parasite invasion inhibition was not complete. Sera having high RESA-IFA titers were predictably inhibitory; however, many sera having low RESA-IFA titers were as inhibitory as sera having high titers, indicating that antibodies with specificities different from the RESA may be as important, or more important, to clinical immunity to blood-stage infections. PMID- 3282044 TI - Somatization in primary care: patients with unexplained and vexing medical complaints. AB - Somatizing patients experience or express emotional discomfort and psychosocial distress as physical symptoms. Somatization occurs in a broad spectrum of illnesses, in association with a wide variety of mental disorders, including depression, anxiety, and the somatoform disorders. Primary care providers must detect and treat these patients. Diagnosis is based on positive criteria. Care rests upon conservative medical management and evaluation; a physician-patient relationship based on acceptance, caring, and trust; reinforcement of positive behaviors and elimination of destructive ones; and the gradual use of the relationship to promote healthy relating in the patient. PMID- 3282049 TI - Antigens of Cryptosporidium sporozoites recognized by immune sera of infected animals and humans. AB - The humoral response of humans, calves, and horses to Cryptosporidium sporozoite antigens was evaluated using a western blot technique. Sera from calves, humans, and horses were obtained at various times following the detection of infection. Sera were reacted with detergent-solubilized, sodium dodecyl sulfate polyacrylamide gel-electrophoresed (SDS-PAGE) sporozoite antigens. The number of antigens recognized by immune sera from humans and animals increased with time postinfection. A 20-kDa antigen appears to be a major sporozoite surface determinant labeled via membrane protein biotinylation and recognized by mouse monoclonal antibodies using indirect immunofluorescence and western blotting. Detectable recognition of the 20-kDa band occurred in 3-wk postinfection (PI) sera from all species tested. Reactivity to the 20-kDa band diminished significantly in sera 5 mo PI or longer from infected humans with no known recurrence of cryptosporidial diarrhea. In contrast, 12-mo PI sera from an individual constantly exposed to oocysts under working conditions was as strongly reactive as the 3-wk convalescent sera. Serum reactivity to the 20-kDa antigen appears to be a good indicator of exposure to Cryptosporidium. PMID- 3282050 TI - Henry Baldwin Ward medal acceptance speech. PMID- 3282051 TI - Intestinal parasites of small mammals from Grand Teton National Park. AB - A study of the prevalence and identity of Giardia spp. in small mammals of Grand Teton National Park was undertaken. All 90 montane voles examined were positive for Giardia, as were 4 pocket gophers, 1 water shrew, 4 water voles, and 2 meadow voles. How and why these findings contrast with the findings of others are discussed. PMID- 3282052 TI - Heather and ice: an excursion in historical parasitology. AB - Of those who have contributed to parasitology, two, A. E. Wilson and E. L. Atkinson, led lives of remarkable adventure and acquired fame beyond the realms of science. The lives of their fellow-adventurers are commemorated in the scientific names of more than a dozen helminth parasites. PMID- 3282053 TI - Nematode transmission patterns. AB - The transmission of nematode parasites of vertebrates is reviewed with special reference to the phenomena of monoxeny, heteroxeny, paratenesis, and precocity. Monoxeny is divided into 2 types. Primary monoxeny assumes that there was never an intermediate host in the transmission. Secondary monoxeny assumes the loss of an intermediate host during the course of evolution and its replacement by a tissue phase in the final host. Heteroxeny, or the use of intermediate hosts, is a common feature of many nematode groups. The Spirurida utilize arthropods, the Metastrongyloidea molluscs, and Ascaridida arthropods and vertebrates. Paratenesis, or the use of transport hosts, is a common feature of the transmission of nematode parasites of carnivores. It is postulated that in some instances paratenic hosts have become intermediate hosts and replaced the original intermediate host. Precocity in the development of nematodes in intermediate hosts (including what may have been paratenic hosts) is defined as growth and/or development beyond the expected. Its occurrence among the nematode parasites of vertebrates is reviewed. It is regarded as a transmission strategy which accelerates gamete production in the final host. Precocity could also provide the mechanism for the transfer of a parasite from a predator final host to a prey final host. PMID- 3282054 TI - Trematode transmission patterns. AB - The primitive transmission pattern in the Trematoda is a 1-host pattern in which an aspidocotylean matures in a mollusc. The progeny from the parent aspidocotylean typically disseminate from the mollusc to establish in others, but the possibility that some progeny remain in the same mollusc as did the parent and produce a sequential generation exists. It is this potential for sequential generations in the mollusc that may be the key to understanding the complex transmission and life cycle patterns in the Digenea. PMID- 3282055 TI - Cestode transmission patterns. AB - The paradox of high prevalence but low probability of having an egg develop to an adult has been resolved by the evolution of 3 major and basic strategies involving transmission: evolution of life cycles interpolated into host biology; presentation of infective stages that increase probability of contact between host and parasite; and increase in reproductive potential. The rarity of direct cycles confirms that cycles in themselves, with at least 2 hosts, are a key element of cestode success because they provide a vehicle for dispersal and transmission of infective stages. Transmission is primarily by passive stages that become incorporated through intermediate hosts or accidentally in the food chain. High host specificity results from efficient transmission pathways but may represent a fragile system for the evolution of the species. Probability of transmission is increased through diversity of intermediate hosts, making eggs more susceptible to ingestion and by behavioral manipulation of hosts by parasite stages. Spatial and temporal aspects of transmission may be increased through paratenesis. Asexual proliferation of immature stages is uncommon and is favored where there is selective predation; such proliferation may be part of a transmission strategy of colonial cestodes that require high infrapopulations in order to survive. Hyperapolysis may be part of a transmission strategy used by the Tetraphyllidea, Trypanorhyncha, and Lecanicephalidea to increase proglottid production. The dynamics of transmission for cestodes of humans and domestic animals require a different perspective than those of wild hosts. All strategies are reviewed within the framework of certain cestode morphological and ecological constraints. A total of 11 figures and 48 references complements the text. PMID- 3282056 TI - First isolation of Trypanosoma cruzi from a wild-caught Triatoma sanguisuga (LeConte) (Hemiptera: Triatominae) in Florida, U.S.A. AB - An adult female Triatoma sanguisuga was found to be naturally infected with Trypanosoma cruzi. This is the first report of a T. cruzi infection in this bug in Florida and suggests that a study of trypanosomiasis in reservoirs and vectors in north Florida is warranted. PMID- 3282058 TI - Bilateral retinal vascular hypoplasia associated with persistence of the primary vitreous: a new clinical entity? AB - Three infant boys with a bilateral congenital retinopathy characterized by retinal vascular hypoplasia and persistence of the primary vitreous are described. The infants were healthy and had no non-ocular physical abnormalities. None had histories of prematurity or low birth weight. Family histories were negative to similar retinopathy, and the fundi of all examined blood relatives were normal. The described congenital retinopathy is compared and contrasted with persistent hyperplastic primary vitreous, Norrie's disease, idiopathic retinal dysplasia, familial exudative vitreoretinopathy, retinopathy of prematurity, and incontinentia pigmenti. PMID- 3282057 TI - Vitreous cyst combined with bilateral juvenile retinoschisis. AB - Vitreous cyst, an uncommon finding, was first described by Tansley in 1899. Since then only a few reports dealing with congenital or acquired vitreous cyst have been reported. We report the case of a 16-year-old girl with a unilateral developmental vitreous cyst combined with bilateral retinoschisis. The pathogenesis and histopathology of these phenomena remain unclear, although a few assumptions about the common pathogenesis are discussed. According to our knowledge, this is the first description of vitreous cyst and retinoschisis in the same eye. PMID- 3282059 TI - Proteus syndrome: ocular complications. AB - Proteus syndrome is a recently recognized hamartoneoplastic malformation syndrome of uncertain etiology and variable expression, whose cardinal manifestations are pigmented nevi, hemihypertrophy, macrodactly, lipomata, and cerebroid-gyriform configuration of the skin on the soles of the feet. The characteristic features may be present at birth but become more apparent with time. In the past this syndrome has been confused with other overgrowth disorders such as neurofibromatosis, Klippel-Trenaunay-Weber syndrome, Maffucci syndrome, and Bannayan syndrome. The ophthalmic features of the proteus syndrome require clarification. We review the ocular findings in 16 previously described cases and describe the findings unique to our patient, in particular, unilateral epibulbar and suspected posterior segment hamartomas. PMID- 3282060 TI - Cholelithiasis in childhood: a follow-up study. AB - Fifteen children with cholelithiasis who were treated at the Royal Hospital for Sick Children, Glasgow between 1973 and 1985 are reviewed. Ten patients had idiopathic gallstones and five had gallstones in association with hereditary spherocytosis. All patients have been followed up for between 4 months and 12 years (mean 4.1 years): ultrasonography has been carried out on 13. Fourteen patients underwent surgery of whom only seven had symptoms from their gallstones. Nine patients had cholecystostomy and removal of gallstones, four patients had cholecystectomy (one had negative exploration of the common bile duct in addition) and one patient with choledocholithiasis underwent choledochotomy with transduodenal sphincterotomy. One patient did not have surgery; she has remained asymptomatic and ultrasound examination confirms that she still has a solitary gallstone in her gallbladder. Clinical review with ultrasonography shows that cholecystostomy with removal of gallstones appears to be an acceptable alternative to cholecystectomy. PMID- 3282061 TI - Pediatric liver transplantation: report on 52 patients with a 2-year survival of 86%. AB - Between March 1984 and March 1987, 59 orthotopic liver transplantations have been performed in 52 children at the Catholic University of Louvain in Brussels. The actuarial survival was 86% +/- 5 up to 3 years of evolution. The most frequent indication has been chronic hepatic insufficiency (43 patients) mainly because of biliary atresia; seven patients were transplanted for acute hepatic insufficiency and only two for liver tumor. Because of important donor/recipient weight discrepancy, a reduced-size liver was used in 20 occasions either for first or second transplant. No difference in the incidence of major complications were seen between whole liver and reduced size liver transplanted children, with the exception of more frequent subhepatic collections in the first and more hepatic artery thrombosis in the second group. Liver tests, clinical rehabilitation, and survival appear to be equal in the two groups. PMID- 3282062 TI - [Muscle metastases: ultrasonic and x-ray computerized tomographic aspects. Apropos of 9 cases]. AB - Clinical, ultrasound and CT scan examinations were carried out in 9 patients with secondary muscle lesions. All muscles can be affected but there was a marked predominance of psoas lesions (6 of the 9 cases). Two contrasting clinical pictures are seen. Secondary muscle tumors can occur during evolution of a known treated cancer (5 of the 9 cases), revealed usually by large, rarely painful, mass. CT scan imaging shows a heterogeneous mass taking up contrast and often partially necrotic, the lesions appearing hypoechogenic or heterogeneous on ultrasound examination. Certain lesions can be totally necrotic. In some cases (4 of the 9 patients) the muscle metastases revealed the presence of a tumor. Symptomatology may be atypical and lead to a delay in diagnosis. Fine needle puncture biopsy can detect the secondary origin of the muscle lesion and also the primary tumor site (4 out of 9 cases), bronchopulmonary and colon cancer predominating. Images are however non-specific and in the absence of NMR imaging the muscle or lymph node metastases can be confused, although this has no practice consequences since treatment is identical. PMID- 3282063 TI - [Posterior reinforcement behind hepatic angiomas. Mirror artefact as a possible source of error]. AB - Posterior enhancement beyond liver hemangiomas was retrospectively assessed on 89 hemangiomas of all size and localization with in the liver. This enhancement is seen only beyond big and complex lesions, containing hypoechoic or anechoic zones. Conversely, it seems to be very rare beyond little hyperechoic lesions. It is necessary to distinguish true enhancement and a mirror artefact beyond lesions of all sizes but localized just near the diaphragma. In the lesions of less than 2 cm, no clear posterior enhancement was discovered, but some of them showed a very clear mirror artifact. PMID- 3282064 TI - Numerical methods for decision-making in clinical care: where to now? PMID- 3282065 TI - Accident and emergency medicine: an administrative convenience or a specialty? PMID- 3282066 TI - Benefit/risk ratio of new drugs: for whom? Discussion paper. PMID- 3282067 TI - The contribution of sociology to psychiatry: a review. PMID- 3282068 TI - Women and the GMC: the struggle for representation. PMID- 3282069 TI - Participation of volunteer faculty members in education research projects. AB - Physicians in private practice who are also volunteer clinical faculty members are a recognized resource for teaching and patient care at teaching hospitals. Clinical faculty members have seldom been included in education research despite the frequent complaint from community practitioners that the results from studies at teaching hospitals are not applicable to community practice. The authors report on a study involving volunteer clinical faculty members in a randomized education trial to improve patients' everyday functioning. Seventy-six clinical faculty physicians in office practice of internal medicine participated. At the end of the study the physician participants were asked to complete an evaluation questionnaire concerning the appropriateness of clinical faculty members' participation in such research projects. Ninety-five percent said the experiment was appropriate, and 88 percent would participate again. PMID- 3282070 TI - A comparison of two computer programs for searching the medical literature. PMID- 3282071 TI - Computer-assisted instruction in pharmacokinetics for second-year students. PMID- 3282072 TI - Vero cytotoxin-producing strains of Escherichia coli from children with haemolytic uraemic syndrome and their detection by specific DNA probes. AB - Faecal specimens from 66 children with haemolytic uraemic syndrome in the United Kingdom were examined for strains of Escherichia coli producing Vero cytotoxin (VT). Initially, conventional bacteriological methods were used to identify colonies of E. coli which were then tested for VT production. Subsequently, specific DNA probes for VT1 and VT2 were used in hybridisation tests to detect VT producing E. coli (VTEC). VTEC strains were isolated from 19 cases and in 15 they belonged to serogroup O157. Fourteen of these O157 strains possessed the flagellar antigen H7 and one was non-motile. The VTEC strains from the remaining four cases belonged to serotypes O26:H11, O104:H2, O153:H25, and O163:H19 together with a rough VT+ strain with flagellar antigen H51. The O157 strains hybridised with either the VT2 probe or both VT1 and VT2 probes. The other VTEC strains hybridised with either the VT1 or VT2 probe. Confirmation of the production of VT1 and VT2 in vivo was obtained by the neutralisation of faecal VT with specific antisera raised against these two cytotoxins. PMID- 3282073 TI - Antigens recognised by the human immune response to infection with Leptospira interrogans serovar hardjo. AB - Serum samples from patients infected with Leptospira interrogans serovar hardjo were tested by the microscopic agglutination test (MAT), enzyme immunoassay (EIA) and immunoblotting. There was no apparent correlation between MAT titre and EIA optical density (OD) for individual serum samples, but sequential serum samples produced similar profiles in both tests during the course of an infection. Immunoblotting of hardjo sonicate with patients' sera revealed reactions with a number of bands, in the mol. wt (10(3] range 14.4-95. However, all serum samples reacted with the major 28 x 10(3)-mol. wt sub-unit of hardjo lipopolysaccharide (LPS) and most reacted with a (34.5-35) x 10(3)-mol. wt flagella doublet. Examination of sequential serum samples obtained over a period of about 3 months after infection revealed little change in the antigens detected after the second to third week of infection. Absorption of patients' sera with whole viable leptospires revealed that antibodies to several exposed antigens, including LPS, were produced. Sera which reacted with hardjo flagella also reacted with bands of similar mol. wts in preparations from other serovars. PMID- 3282074 TI - No evidence for antibodies to mycobacterial A60 antigen in Crohn's disease sera by enzyme-linked immunoabsorbent assay (ELISA). AB - Sera from patients with Crohn's disease were tested with an ELISA system for antibodies to antigen A60 prepared from Mycobacterium bovis (BCG), M. avium and M. paratuberculosis. No evidence was found for significantly high titres of antibody to these antigens. PMID- 3282075 TI - Two cases of Mycobacterium haemophilum infection in a renal-dialysis unit. AB - Two cases of Mycobacterium haemophilum infection in renal-transplant patients occurred in the same hospital department. This raised the possibility that infection may have been acquired in hospital. PMID- 3282076 TI - Graham Selby Wilson 1895-1987. PMID- 3282077 TI - Hypoxia in tumors: a paradigm for the approach to biochemical and physiologic heterogeneity. AB - While the inherent radiosensitivity of tumor cells is likely to affect treatment outcome, the biochemical and physiologic state of the cell may have a major impact. Tumors are likely to be highly heterogeneous for these dynamic properties. Hypoxic cells are radioresistant, requiring two to three times the radiation dose to kill them compared to the same cells in a eu-oxic state. Hypoxia can be of two types: 1) chronic hypoxia, which is diffusion limited, and 2) acute hypoxia, which is perfusion limited. The mechanism of and approaches toward these are different and can serve as a model for other biochemical and physiologic processes that may affect treatment outcome. PMID- 3282078 TI - Randomized study of the duration of treatment with interferon alfa-2B in patients with hairy cell leukemia. AB - Several previous studies have demonstrated that both partially purified and recombinant alpha-interferons (alpha-IFNs) have high response rates in advanced hairy cell leukemia. However, the optimal dose and duration of therapy have not yet been defined. In this study, 90 patients were randomized after 12 months of IFN alfa-2b therapy with a standard dose of 2 X 10(6) U/m2 sc three times weekly to either no further therapy or an additional 6 months of therapy (18 mo total). There was no significant difference in the peripheral blood cell counts between the two groups (when analyzed) dating from the end of IFN therapy rather than from the time of randomization. Eighteen evaluable patients relapsed and were re treated with IFN: 11 in the no-further-therapy group and 7 in the treated group. No patient was resistant to re-treatment with IFN. There was a significantly greater incidence of fatigue in the treated group (44% vs. 21%; P = .02) during the first 6 postrandomization months. We conclude that the duration of IFN therapy does not influence the clinical course after therapy is discontinued, but responses are maintained while patients receive therapy. However, because of a high incidence of fatigue with prolonged therapy and the ability to reinduce a second response, we recommend that IFN therapy be discontinued after 12 months in asymptomatic patients. PMID- 3282079 TI - Genetic basis of resistance to rimantadine emerging during treatment of influenza virus infection. AB - The emergence of influenza A viruses which had acquired resistance to rimantadine during a clinical trial (C. B. Hall, R. Dolin, C. L. Gala, D. M. Markovitz, Y. Q. Zhang, P. H. Madore, F. A. Disney, W. B. Talpey, J. L. Green, A. B. Francis, and M. E. Pichichero, Pediatrics 80:275-282, 1987) provided the opportunity to determine the genetic basis of this phenomenon. Analysis of reassortant viruses generated with a resistant clinical isolate (H3N2) and the susceptible influenza A/Singapore/57 (H2N2) virus indicated that RNA segment 7 coding for matrix and M2 proteins conferred the resistant phenotype. Resistant viruses isolated from seven patients each contained a single change in the nucleotide sequence coding for the M2 protein which resulted in substitutions in amino acid 30 (two viruses) or 31 (five viruses) in the transmembrane domain of the molecule. These changes occurred in locations identified in influenza viruses selected for resistance to amantadine in tissue culture and indicate a common mechanism of action of the two compounds in cell culture and during chemotherapeutic use. PMID- 3282082 TI - The gamma knife. PMID- 3282080 TI - Scrapie-infected murine neuroblastoma cells produce protease-resistant prion proteins. AB - Scrapie and Creutzfeldt-Jakob disease are transmissible, degenerative neurological diseases caused by prions. Considerable evidence argues that prions contain protease-resistant sialoglycoproteins, designated PrPSc, encoded by a cellular gene. The prion protein (PrP) gene also encodes a normal cellular protein designated PrPC. We established clonal cell lines which support the replication of mouse scrapie or Creutzfeldt-Jakob disease prions. Mouse neuroblastoma N2a cells were exposed to mouse scrapie prions and subsequently cloned. After limited proteinase K digestion, three PrP-immunoreactive proteins with apparent molecular masses ranging between 20 and 30 kilodaltons were detected in extracts of scrapie-infected N2a cells by Western (immuno-) blotting. The authenticity of these PrPSc molecules was established by using monospecific antiserum raised against a synthetic peptide corresponding to a portion of the prion protein. Those clones synthesizing PrPSc molecules possessed scrapie prion infectivity as measured by bioassay; clones without PrPSc failed to demonstrate infectivity. Detection of PrPSc molecules in scrapie-infected N2a cells supports the contention that PrPSc is a component of the infectious scrapie particle and opens new approaches to the study of prion diseases. PMID- 3282081 TI - Simian retrovirus-D serotype 1 (SRV-1) envelope glycoproteins gp70 and gp20: expression in yeast cells and identification of specific antibodies in sera from monkeys that recovered from SRV-1 infection. AB - The gp70 and transmembrane gp20 envelope proteins of simian retrovirus-D serotype 1 (SRV-1) were expressed in Saccharomyces cerevisiae as fusion proteins with human superoxide dismutase (SOD). Expression of the SOD-gp70 and SOD-gp20 sequences yielded fusion proteins of 52 and 29 kilodaltons, respectively. The yeast-expressed SRV-1 envelope proteins were used in an enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies in the sera of rhesus macaques that recovered from SRV-1. Sera from 47 of 49 such monkeys tested positive for antibodies to the SOD-gp70 fusion protein, while 45 of 49 reacted positively to SOD-gp20. None of 26 SRV-1-nonexposed monkeys tested positive in either ELISA. Monkeys immunized with the recombinant SRV-1 gp20 and gp70 proteins made good ELISA and Western blot (immunoblot) antibodies to whole SRV-1. This antibody was not neutralizing in vitro, however. PMID- 3282084 TI - Human immunodeficiency virus test evaluation, performance, and use. Proposals to make good tests better. AB - Human immunodeficiency virus (HIV) tests are essential for detecting asymptomatic infection and are helpful in confirming the diagnoses of acquired immunodeficiency syndrome-related complex and acquired immunodeficiency syndrome. Nonetheless, many aspects of their use remain controversial, partly because of concerns about test accuracy. This article reviews the scientific basis for the evaluation, performance, and use of the most commonly employed HIV assays. Current test performance could be improved by better standardization of test procedures and institution of mandatory proficiency testing and licensure of clinical laboratories that perform HIV testing. Test utility could be enhanced by sequencing tests more appropriately and by interpreting test results in conjunction with the clinical purpose for which the test is being used and the characteristics of the population under study. Finally, HIV tests should be evaluated in a manner that minimizes spectrum and referral bias and inadequate reference standard confirmation, problems that have affected the evaluation of current tests. PMID- 3282083 TI - Burn wounds resurfaced by cultured epidermal autografts show abnormal reconstitution of anchoring fibrils. AB - We studied epidermal autografts placed on four severely burned patients. All of the patients experienced skin fragility in the autograft sites, and three of the four patients reported spontaneous blisters. Epidermal-dermal adherence was objectively examined in one patient by comparing suction blistering times in the autograft and in a parallel, control, unburned site. Blisters formed in the autograft at 17 minutes, and the cleavage plane of the blister was below the lamina densa of the basement membrane. In contrast, the normal skin blistered at 65 minutes and had a superficial cleavage plane, above the basal lamina. In all four patients, the reconstituted basement membrane zone beneath the autografts was incomplete and lacked type IV (basement membrane) collagen 7-S sites and anchoring fibrils. We conclude that skin fragility, apparent as late as seven months after transplantation, may result from defective anchoring fibrils. PMID- 3282085 TI - Walking for health and fitness. AB - Recent studies have linked regular physical activity with reduced likelihood of developing coronary heart disease. Even low- and moderate-intensity exercise such as walking, when carried out consistently, is associated with important cardiovascular health benefits. Walking has also been shown to reduce anxiety and tension and aid in weight loss. Regular walking may help improve cholesterol profile, help control hypertension, and slow the process of osteoporosis. Recent physiological studies have demonstrated that brisk walking provides strenuous enough exercise for cardiovascular training in most adults. A recently developed submaximal 1-mile walk test provides a simple and accurate means for estimating aerobic capacity and guiding exercise prescription. These new insights and tools will assist the clinician in the prescription of safe and effective walking programs. PMID- 3282086 TI - The physical and psychological sequelae of torture. Symptomatology and diagnosis. AB - We present a review of the international literature on the medical and psychological effects of torture. Our review reveals that certain tortures and their physical and emotional sequelae are more prevalent than previously appreciated. They include the common occurrence of sexual violence during the torture of women and female adolescents and the high frequency of head injury and associated neuropsychiatric consequences. We recommend the use of standardized diagnostic criteria in the evaluation of patients who have survived torture; this will facilitate patient care and the documentation of human rights violations. PMID- 3282087 TI - Wound ballistics. A review of common misconceptions. AB - Attempts to explain wound ballistics (the study of effects on the body produced by penetrating projectiles) have only succeeded in mystifying it. This review explains the projectile-tissue interaction and presents data showing the location, type, and amount of tissue disruption characteristically produced by various projectiles. Data on tissue disruption are presented graphically as wound profiles. The major misconceptions in the field are listed, analyzed, and disentangled. Failure in adhering to the basic precepts of scientific method is the common denominator in all of the listed misconceptions; the result has been diversion of attention from the element essential to understanding and properly treating the gunshot wound--objective evaluation of the wound itself. PMID- 3282088 TI - Transrectal ultrasonography: is it ready for routine use? PMID- 3282089 TI - Diagnostic and therapeutic technology assessment. Transrectal ultrasonography in prostatic cancer. AB - The DATTA panelists believe that transrectal ultrasound is established as safe for the screening and staging of prostatic cancer. The majority did not believe, however, that the effectiveness of the procedure has been established yet for either screening or staging. The panelists and the literature indicate, however, that transrectal ultrasound may well have a significant role to play in the future treatment of prostatic cancers. PMID- 3282090 TI - [Effects of regimens of total body irradiation on interstitial pneumonitis after bone marrow transplantation]. AB - Data from 224 patients with leukemia who received TBI followed with allogeneic BMT between 1975 and 1985 were retrospectively analyzed to determine the effects of dose-fractionation factors on the incidences of interstitial pneumonitis (IP). Among several factors examined, the fraction size most predominantly correlated with the IP rate. The selection of the optimal dose rate adjusted to the fraction size also contributed to decreasing the rate of the IP. The total lung dose significantly correlated with the IP rate on a single dose, and the fractionated TBI with a high fraction dose. The dose-response curves of idiopathic IP, derived by a multivariate analyses using the three factors mentioned above, have been presented. PMID- 3282091 TI - [Primary mediastinal seminoma--a case report]. AB - Primary mediastinal seminoma is a rare germ cell tumor that is histologically identical to testicular seminoma. Fifty-one cases have been reported in the Japanese literature. This report concerns a new case of this tumor which showed high levels of a serum alkaline phosphatase (ALP) and a serum angiotensin converting enzyme (ACE). The patient is a 27 year old man whose father underwent an orchiectomy with postoperative radiation therapy for testicular tumor. After radiation and chemotherapy, the patient's chest X-ray showed complete regression of the mass, and his ALP and ACE decreased to normal levels. PMID- 3282092 TI - [A case of secretory carcinoma of the breast in an adult]. AB - This report describes a case of secretory carcinoma of the breast in the adult. The patient, a 56-year-old female, had a tumor, 1 cm in size, in the upper outer quadrant of her left breast, and Patey's modified radical mastectomy was performed. No nodal metastases were found. Although secretory carcinoma of the breast has been called "juvenile carcinoma", 27 adult cases have been reported previously in the English and Japanese literature. It is reported to have a good prognosis but surgical therapy with an axillary node dissection is recommended, since axillary metastases have been found in approximately 30% of the recorded cases. PMID- 3282093 TI - [A case of colonic polypoid ganglioneuromatosis--a light microscopy, electron microscopy and immunohistochemical study]. AB - A 68-year-old man with colonic polypoid ganglioneuromatosis is reported. He had manifested no signs and symptoms of von Recklinghausen's disease and/or a multiple endocrine neoplasia syndrome. A single polyp was found by a barium enema and an endoscopic polypectomy was performed. Light microscopy showed the propria mucosa of the polyp was composed of a proliferation of spindle cells with a fibrillar cytoplasma and large cells with a round large nucleus, a prominent nucleolus, and vast cytoplasm. Some crypts were slightly dilated. Random biopsied specimens from the colonic normal mucosa showed focal proliferation of only the spindle cells. Electron microscopically, the spindle cells consisted of Schwann cells forming neurites, and large cells that coincided with the features of ganglion cells. Immunohistochemically, the localization of neuron specific enolase was demonstrated in the cytoplasm of these cells. These findings led to a diagnosis of colonic polypoid ganglioneuromatosis, and the pertinent literature is reviewed. PMID- 3282094 TI - [An autopsy case of rest stomach cancer accompanied by tongue cancer]. AB - A case of rest stomach cancer, accompanied by tongue cancer, in a 57-year-old man is reported. The patient underwent a stomach resection 11 years earlier because of a discovered cancer. Most cases of rest stomach cancer appear after 10 years in cases of a stomach resection because of a stomach cancer. A double cancer, accompanied by tongue cancer, mostly occurs in people over 60 years old, and more than half such cases involve a cancer in the alimentary tract as well. PMID- 3282095 TI - [Retrograde coronary sinus perfusion in aortic valve surgery]. PMID- 3282097 TI - A child with fever and purpura. PMID- 3282096 TI - Simplifying nursing management of pediatric airways and intravenous infusions. PMID- 3282099 TI - The brotherhood of motherhood. PMID- 3282098 TI - After the rescue: ED nurses reflect on Jessica McClure and the miracle in Midland, Texas. PMID- 3282100 TI - Emergency medical services system for children begins implementation in Santa Cruz County. PMID- 3282101 TI - California EMSC project establishes guidelines for rural pediatric emergency care. PMID- 3282102 TI - A message for grown-ups: from the children of Children's Hospital of Pittsburgh, with the help of the Child Life Department. PMID- 3282103 TI - The pediatric liaison nurse: a new specialist in the emergency department. PMID- 3282104 TI - Current trends in ED nursing shortage: ENA survey results. PMID- 3282105 TI - Preparing teachers to deal with emergencies. PMID- 3282106 TI - A fresh look at pediatric emergency nursing. PMID- 3282107 TI - Sharing the excitement and rewards. PMID- 3282108 TI - Our greatest challenge: other people's children. PMID- 3282109 TI - Intraosseous infusion: rapid vascular access for critically ill or injured infants and children. PMID- 3282110 TI - Epiglottitis: ED nursing management. PMID- 3282111 TI - Basic pediatric cardiopulmonary resuscitation (CPR) update [published erratrum appears in J Emergy Nurs 1988 May-Jun;14(3):193]. PMID- 3282112 TI - Physical abuse of children: recognition and reporting. PMID- 3282113 TI - Pediatric immediate care cart. PMID- 3282114 TI - The Los Angeles pediatric emergency care system. PMID- 3282116 TI - [Clinical aspects of treatment optimization in systemic arterial hypertension]. PMID- 3282115 TI - [Correlation of the total activity of blood plasma renin with levels of active and inactive renin, angiotensinogen and angiotensin II under different functional loads in patients with hypertension]. AB - Components of the renin-angiotensin system (plasma renin activity, total and inactive renin, angiotensinogen and angiotensin II) were examined in 90 patients with labile and stable essential hypertension before and after functional and pharmacologic tests. New data have been obtained on intrasystemic regulatory mechanisms of the pressor renin-angiotensin systems. Different patterns of plasma active and inactive renin variations in response to salt loading are demonstrated in patients with different "renin" variants of essential hypertension. Angiotensin II is shown to have a stimulating effect on angiotensinogen synthesis. PMID- 3282117 TI - [Effect of captopril on arterial pressure, systemic hemodynamics and renin activity in the blood plasma of rats with spontaneous hypertension]. AB - An angiotensin-I-converting enzyme, captopril, was administered since birth onward to normotensive (NR) and spontaneously hypertensive rats (SHR). It produced a marked hypotensive effect in SHR only. Cardiac output and circulating blood volume were similar in intact and experimental animals, NR and SHR alike. Captopril considerably increased plasma renin activity in NR and SHR. PMID- 3282118 TI - [Clinical aspects of the use of physical loading in hypertension]. PMID- 3282119 TI - [Theoretical prerequisites and practical experience of combined therapy with anti arrhythmia preparations]. PMID- 3282121 TI - [Patient care for the long-term illnesses. Recent advances in cancer management]. PMID- 3282120 TI - [Intraventricular conduction disorders during tests with measured physical loading in the diagnosis of ischemic heart disease]. PMID- 3282122 TI - Patterns of tumor metastasis: organ selectivity in the spread of cancer cells. AB - More than a century ago, Fuchs recognized that although tumors varied in their propensity for metastasis, there was, as well, discrimination in the different organs of the body, some providing a more fertile soil for growth for specific tumors than others. Paget dramatized this clear distinction between the intrinsic properties of the cancer cell and the properties of the host when he expanded on the analogy between tumors and plants: "When a plant goes to seed, its seeds are carried in all directions; but they can only live and grow if they fall on congenial soil." Paget is almost apologetic as he contrasts the work of those that study the 'seed' to his own work on the 'soil': "The best work in the pathology of cancer is done by those who...are studying the nature of the seed. They are like scientific botanists; and he who turns over the records of cases of cancer is only a ploughman, but his observations of the properties of the soil may also be useful." In a time where the primary emphasis in cancer research is at the level of gene expression, of regulation and of epigenetic modification of the "seed," those individuals, such as Pauli and Lee, who study the properties of the host environment should not be ignored. Not only are the observations of the 'soil' useful, they provide essential information without which we will not be able to understand the nature of the metastatic process. PMID- 3282123 TI - Acute inflammation and microthrombosis induced by endotoxin, interleukin-1, and tumor necrosis factor and their implication in gram-negative infection. PMID- 3282124 TI - Kidney pathology in liver allograft recipients after long-term treatment with cyclosporin A. AB - Organ transplant recipients given immunosuppressive treatment with cyclosporin A are at risk of injury due to nephrotoxicity. Eight liver allografted patients whose renal function became impaired during therapy with cyclosporin A for up to 4.5 years were investigated by renal biopsy. Ischemic changes in glomeruli were found to be greater than in controls, and there was focal tubular atrophy, but an excess of lesions in small arteries could not be demonstrated. In one patient there were glomerular changes suggestive of thrombotic microangiopathy. Interstitial fibrosis and cellular infiltration were slight. The pathogenesis of the ischemia remains to be elucidated, but reasons are advanced for favoring the view that the mechanism of cyclosporin A nephrotoxicity is primarily vasomotor, causing a reduction of renal blood flow and glomerular filtration rate without permanent organic arterial narrowing; nephrons become damaged irreversibly nevertheless. PMID- 3282126 TI - Effect of glucocorticoids on contractile apparatus of rat skeletal muscle. AB - Skeletal muscles which have a high oxidative potential are less sensitive to the catabolic action of dexamethasone. In fast-twitch white muscles, where the oxidative capacity is low, the alkaline proteinase activity as well as the rise in the number of lysosomes was more pronounced. It seems that the glucocorticoid caused myopathy is a result of elevated degradation of contractile proteins. This process of degradation of contractile proteins begins in the myosine filaments and then spreads to the thin filaments and the z-line. PMID- 3282125 TI - Interaction of murine progesterone receptors with specific monoclonal antibodies to the avian progesterone receptor. AB - Monoclonal antibodies raised against purified chicken progesterone receptor (PgR) have been described and characterized recently. In this study we have screened these antibodies for cross-reactivity with murine PgR. Of the six anti-PgR antibodies tested, one (alpha PR6) precipitates murine PgR in an assay using protein A-sepharose as an absorbent for the antibody. The antibody is specific for PgR and does not react with the estrogen receptor or the glucocorticoid receptor in the same cytosol. In immunoblot experiments, both alpha PR6 and alpha PR11 recognize a 115,000 Da protein, however, alpha PR11 gives a weaker signal than alpha PR6. In photoaffinity labeling experiments, a 115,000 Da and an 83,000 Da protein covalently bind tritiated R5020 in a receptor-specific way. We conclude that the alpha PR6 antibody can be used as a tool to study the structure and function of the murine PgR. PMID- 3282128 TI - Oncogenes in chronic lymphocytic leukemia. AB - Oncogenes, in the context of retroviruses, are a common cause of leukemia in animals. Recently, activation of cellular oncogenes has been shown to be associated with leukemia in humans. Relatively few studies of oncogene activation in chronic lymphocytic leukemia (CLL) have been reported. In most instances, rearrangement of oncogenes has not been detected. Exceptions include the bcl-1 oncogene in B-cell prolymphocytic leukemia, the tcl-1 oncogene in T-cell CLL, the Hu-ets-1 and Hu-ets-2 oncogenes in small cell lymphocytic lymphoma and c-myc in a Sezary cell leukemia cell/line. Overall, it appears that oncogene abnormalities are less common in CLL than in other leukemias. The reason for it is uncertain and may relate to the relatively few cases evaluated. Alternatively, novel mechanisms of oncogene involvement or gene other than oncogenes may be important in the etiology or pathogenesis of CLL. PMID- 3282127 TI - CAMAL: a new prognostic marker for remission in acute nonlymphoblastic leukemia. AB - A leukemia-associated antigen, CAMAL, shown to be present in bone marrow (BM) cells from patients with acute nonlymphoblastic leukemia (ANLL) even during remission, has been examined using indirect immunoperoxidase and a monoclonal antibody, CAMAL-1. We are ending the third year of an ongoing blind study designed to monitor the number of BM cells expressing the CAMAL protein (CAMAL BM value) in ANLL patients over the course of their disease. Results thus far have revealed that the CAMAL BM value in individual patients often changed significantly post-chemotherapy. This change appeared to be a useful prognostic marker in many instances. ANLL patients at initial presentation whose CAMAL BM values increased or stayed the same post-chemotherapy had significantly (p less than 0.025) shorter remission lengths (x = 6.8 months, n = 24) than those whose CAMAL BM values decreased (x = 19.2 months, n = 10). There are indications that increasing CAMAL BM values during remission occur prior to clinical relapse. PMID- 3282129 TI - Inhibition, by vinca alkaloids and colchicine, of antigenic modulation induced by anti-CD19 monoclonal antibodies. AB - Several clinical trials have been reported in which monoclonal antibodies (McAb) were used for therapy of lymphoid malignancies. Such trials have shown that infusion of McAb recognizing lymphoid antigens, is well-tolerated, and leads to the coating of tumor cells and tumor regression in some patients. However, the tumoricidal capacity of a McAb is hampered by the presence of circulating free antigen, antigenic modulation, development of human anti-mouse antibodies, emergence of antigen-negative variants of tumor cells and the inadequacy of host effector cell mechanisms. We have studied the antigenic modulation induced by immunoglobulin (Ig) heavy chain switch variants of anti-CD19 McAb. Modulation of CD19 molecules was not related to the IgG subclass of the McAb. Immunofluorescence studies on the Burkitt tumor cell line Daudi showed that CD19 molecules are internalized after incubation by anti-CD19 McAb. Next, the effect of cytoskeleton inhibitors on antigenic modulation was studied. We found that antigenic modulation on Daudi cells and on an Epstein-Barr virus-transformed B cell line was completely inhibited by vinca alkaloids (VA) or by colchicine. Interestingly, antigenic modulation of tumor cells from a VA-resistant patient, was not inhibited by VA or colchicine. These findings provide information for the rational design of more effective clinical trials with McAb. PMID- 3282130 TI - A method for collecting semithin epoxy serial sections for light microscopy and 3 D reconstruction. AB - In the three-dimensional reconstruction of neuronal structure, it is imperative that ribbons of semithin or ultrathin sections be obtained. Resin-embedded semithin sections display better structural details than paraffin-embedded sections. The cutting and collecting of long ribbons of resin-embedded semithin sections using a microtome, requires the use of large troughs on glass knives. A simple plastic trough has been described which facilitates the collection of ribbons directly onto a coverslip. As the ribbons are formed, they are floated on a coverslip. The water in the trough is slowly drained through a tubing which is attached to a syringe. The ribbons settle on the coverslip, which is easily removed and placed on a hotplate to dry the sections. PMID- 3282131 TI - Nursing in the Blitz. PMID- 3282132 TI - The principles of permeation of substances across the skin. PMID- 3282134 TI - [Current roentgenologic and radiologic diagnosis of osteomyelitis]. PMID- 3282133 TI - [Peritoneovenous shunt in the treatment of therapy-refractory ascites]. PMID- 3282135 TI - [Ultrasonic scanning of the thyroid during dispensary care at an industrial plant]. AB - The paper is devoted to the assessment of potentialities of ultrasonic scanning of the thyroid during mass screening at an industrial enterprise. A total of 488 persons were investigated. Ultrasonic and thermographic investigations were performed in all of them to detect pathology of the cardiovascular system, abdominal cavity, breast and thyroid. Quantitative assessment of questionnaire data was performed in 100 persons. A group of persons aged 35 (7.5%) was selected for a further ultrasonic investigation. Among them 19 persons (54.3%) had diffuse enlargement, stage I-II, 13 (37.1%) had nodular changes, and 3 (8.6%) were after strumectomy. A special additional investigation was required for 13 persons, of them 9 had nodular types of the goiter, the rest of them were followed-up. 4 patients underwent surgical intervention. A conclusion was made of the effectiveness of the use of ultrasonic investigations during mass screening for the detection of early and latent pathological processes in the thyroid. PMID- 3282136 TI - [Oxygen-transporting perfluorocarbon emulsions in the radiotherapy and diagnosis of malignant neoplasms]. PMID- 3282137 TI - [Outstanding thinkers on the significance of work in human health]. PMID- 3282138 TI - [History of a medical school]. PMID- 3282139 TI - Recombinant shuttle vectors for the study of mutation in mammalian cells. PMID- 3282140 TI - Different mechanisms of reversion of HPRT-deficient V79 Chinese hamster cells. AB - The revertibility of three spontaneous hypoxanthine phosphoribosyl transferase (HPRT)-deficient V79 cell lines has been determined after exposure to a number of alkylating agents. TG11 and 19 reverted at frequencies ranging from 1 X 10(-5) to 1 X 10(-4) after exposure to doses of ethylmethane sulphonate (EMS) N-methyl-N nitrosourea (MNU) and N-ethyl-N-nitrosourea (ENU) resulting in surviving fractions between 1.0 and 0.1. Reversion frequencies in TG15 ranged from 10(-7) to 5 x 10(-6) over a similar dose range. The relative efficiencies of different monofunctional alkylating agents in causing reversion of TG11 at equitoxic doses were ENU greater than EMS greater than N-ethyl-N-nitroso-guanidine greater than MNU greater than N-methyl-N-nitrosoguanidine greater than methylmethane sulphonate. Revertant frequencies for all three cell lines were maximal immediately after treatment and declined thereafter at a rate inversely proportional to dose. Such kinetics are explicable if reversion is due to miscoding opposite alkylated guanines. Reversion frequencies after N-butyl-N nitrosourea exposure were 100-fold lower than after MNU and kinetics of expression of revertant colonies differed. Frequencies were low immediately after treatment, increased between 0 and 24 h then remained at a plateau. Similar kinetics were observed after chlorozotocin and bis-chloroethylnitrosourea exposure. This difference in expression kinetics suggests that reversion in this case is not the result of direct miscoding but of errors in excision repair. TG11, 15 and 19 had low spontaneous mutant frequencies which were either unaffected or only marginally increased by treatment with 5-azacytidine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282141 TI - A study of the induction of aneuploidy and chromosome aberrations after diazepam, medazepam, midazolam and bromazepam treatment. AB - Low passage-number cultured Chinese hamster cells were used to assess the ability of four benzodiazepines, namely diazepam, medazepam, midazolam and bromazepam, to induce numerical and structural chromosome aberrations. It was observed that diazepam, medazepam and midazolam treatment produced dose-dependent reductions in the number of diploid cells, with medazepam and midazolam inducing significant levels of hyperdiploidy and diazepam inducing low levels of hypodiploidy (at toxic doses). In contrast, bromazepam-treated cultures showed no significant changes in the level of aneuploidy even when exposed to toxic concentrations. All four sedatives were seen to induce low levels of chromosome aberrations, with bromazepam showing the most potent effect (albeit at a single toxic dose). These observations indicate that these structurally related benzodiazepines could be regarded as potentially genotoxic. PMID- 3282142 TI - Species-specific response to the rodent carcinogens 1,2-dimethylhydrazine and 1,2 dibromo-3-chloropropane in rodent bone-marrow micronucleus assays. AB - 1,2-Dimethylhydrazine is confirmed as active in the mouse bone-marrow micronucleus assay when administered as an aqueous solution via oral gavage to three different strains of mice. It is also shown to be inactive in a corresponding rat assay under similar conditions of test. The observations were independently repeated in two laboratories. In contrast, 1,2-dibromo-3 chloropropane showed the reverse profile, being active in the rat bone-marrow assay but inactive in the mouse; the latter observations were also made in two laboratories. The carcinogen procarbazine was active in both species. These findings are discussed within the context of the present GeneTox revision of the standard test protocol of the rodent bone-marrow micronucleus assay. PMID- 3282143 TI - Toxicity and sister-chromatid exchange in cultured preimplantation mouse embryos exposed to serum from cyclophosphamide-treated rats: possible implications for testing maternal serum genotoxicity. AB - We have worked out a simplified method to detect embryotoxicity associated with blood serum. Here we report results for serum from female rats treated with 0, 25, 250 and 500 mg/kg cyclophosphamide (CP) as a control experiment in order to evaluate the feasibility of this protocol. Eight-cell mouse embryos were cultured for 48 h in medium supplemented with 10% rat serum and 10(-6) M 5 bromodeoxyuridine (BrdU). Colchicine (0.2 microM) was added 3 h prior to harvesting the cells for chromosome preparation, and differentially stained sister chromatids were visualized after fluorescence-plus-Giemsa staining. Rats treated with increasing doses of CP yielded serum which had increasing mutagenic [as evaluated by sister-chromatid exchange (SCE)] and toxic effects on mouse embryos during 48-h in vitro cultures. The SCEs/cell (based on 40 chromosomes) ranged from 17.6 +/- 0.31 (mean +/- SE) for serum from control (0 mg/kg CP) rats to 40.4 +/- 0.22 for serum from rats given 250 mg/kg CP. Serum from rats treated with 500 mg/kg CP was essentially lethal on mouse embryos. The percentage embryo survival decreased from 79.8 +/- 0.31% (mean +/- SE) for serum from control rats to 8.4 +/- 0.42% for serum from rats given 500 mg/kg CP. These results indicate that after appropriate testing, this protocol could be used for the possible detection of embryo genotoxicity associated with any human serum. If successful, the evaluation of mouse embryo survival and SCE in the presence of human female sera could become an 'early warning' system for possible reproductive problems (e.g. recurrent abortions, low birth weight and malformations) of unknown aetiologies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282144 TI - Toxic effects of paracetamol and related structures in V79 Chinese hamster cells. AB - Exposure of V79 Chinese hamster cells to non-cytotoxic concentrations of paracetamol (4-hydroxyacetanilide, 4-HAA) increased sister chromatid exchange (SCE) in the absence of an external activation system. Furthermore, a selective inhibition of DNA synthesis was observed at low 4-HAA concentrations. The inhibition could be counteracted by the addition of ascorbate, indicating that the effect is caused by an oxidation product of 4-HAA. In attempt to clarify possible relationships between cytotoxicity, inhibition of DNA synthesis and increased SCE, we studied the effect of 4-HAA and some related structures on these parameters. The relative position of the amino group and the hydroxyl group on the aromatic ring appear to be important for the inhibition of DNA synthesis. Removal of either of the two groups, N-acetylation and/or alkylation of the aromatic ring or phenolic oxygen decreased the effect of the aromatic amine on DNA synthesis. A significant response on SCE was observed with 4-amino-phenol, 4 HAA, 2-HAA, 3,5-dimethyl-4-HAA, 3-HAA and 2,6-dimethyl-4-HAA (none of the other compounds were tested). The increase in SCE frequency caused by 4-HAA and its analogs does not seem to be related to more general cytotoxic effects. The relative potencies of the compounds for SCE induction paralleled, for the most part, their effects on DNA synthesis. However, the induction of SCE and the inhibition of DNA synthesis did not occur at comparable concentrations. Thus, the possibility that 4-HAA increases the frequency of SCE through some other mechanism cannot be excluded. PMID- 3282145 TI - UDS activity in the rat liver of the human carcinogens benzidine and 4 aminobiphenyl, and the rodent carcinogens 3,3'-dichlorobenzidine and direct black 38. AB - The activity of benzidine and three structurally related carcinogens in an in vivo/in vitro rat liver assay for unscheduled DNA synthesis is described. The first three of these chemicals, benzidine, 4-aminobiphenyl (4AB) and Direct Black 38 have been reported as positive in this assay by other investigators, albeit the data reported for 4AB were limited. The fourth compound, 3,3' dichlorobenzidine has not been studied in this assay before. Each compound gave a clear positive response under conditions of routine testing. PMID- 3282146 TI - Evidence of abnormalities of insulin metabolism in rats with spontaneous hypertension. AB - Various aspects of insulin metabolism were compared in rats with spontaneous hypertension (SHR) and a suitable control group of similar sized Kyota Wistar (WKY) rats. The results indicated that the total integrated serum insulin response to an oral glucose challenge was significantly greater in the SHR rats, despite the fact that the total integrated serum glucose responses were similar in the two groups. This indirect evidence of resistance to insulin-stimulated glucose disposal was supported by the observation that the ability of similar serum concentrations of exogenous insulin to stimulate glucose disposal was reduced in SHR rats. In addition, the metabolic clearance rate of insulin was lower in the SHR rats. These data indicate that abnormalities in insulin secretion, action, and catabolism exist in rats with spontaneous hypertension. Whether this defect is unique to SHR rats, or common to all forms of experimental hypertension, is an important issue. Equally important is the relationship between the observed changes in insulin metabolism and the elevated blood pressure. PMID- 3282147 TI - Dynamics of the protein metabolic response to burn injury. AB - The protein metabolic response to burn injury was assessed in 17 children aged 7.1 +/- 1.1 years (mean +/- SEM) and a mean burn size of 65 +/- 7% total body surface area (TBSA) during the acute, flow, convalescent, and recovery phases. Stable isotopes of leucine, valine, lysine, and urea were infused in postabsorptive patients in order to measure protein kinetics. The absolute rate of protein breakdown was assessed from the plasma flux of the essential amino acids (EAA), and the rate of urea production (Ra urea) was used as an index of net protein catabolism. Compared to values obtained in recovered patients, the plasma fluxes of all three EAAs were significantly increased (P less than .05), indicating an increased protein breakdown, during the acute, flow, and convalescent phases of injury. Ra urea, however, was only significantly increased during the flow phase (P less than .01), suggesting that protein breakdown was adequately counteracted in the acute and convalescent phases by elevations in protein synthesis but not in the flow phase. The protein kinetic response did not correlate with changes in the metabolic rate since resting energy expenditure (REE) was significantly increased above predicted levels during the acute and flow phases (by 40% and 50%, respectively), and returned to normal in convalescence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282148 TI - Hyperinsulinemia, upper body adiposity, and cardiovascular risk factors in non diabetics. AB - Previous studies have suggested that hyperinsulinemia and upper body adiposity are each separately associated with elevated BP and triglyceride (TG) levels, and with lower high density lipoprotein (HDL) cholesterol levels. The joint effect of hyperinsulinemia and upper body adiposity on lipids, lipoproteins, and BP, however, has not been previously studied. We hypothesized that the effect of body fat distribution on cardiovascular risk factors might be mediated through hyperinsulinemia. We measured BP, lipids and lipoproteins, HDL subfractions, and insulin and glucose concentrations as part of the San Antonio Heart Study, a population-based study of diabetes and cardiovascular risk factors. Insulinemia and glycemia were assessed as the sum of the fasting, half-hour, one-hour, and two-hour insulin and glucose levels, respectively, measured during a standardized oral glucose tolerance test. Individuals who had diabetes according to National Diabetes Data Group criteria were excluded from the analyses. In univariate analyses, both hyperinsulinemia and waist-to-hip ratio (WHR), a measure of upper body adiposity, were positively associated with TG and negatively associated with total HDL and HDL2 cholesterol levels. However, when the effects of glycemia and insulinemia were controlled for by analysis of variance, WHR was no longer significantly related to TG levels. By contrast, WHR continued to be inversely related to total HDL and HDL2 cholesterol even after adjustment for glycemia and insulinemia. Hyperinsulinemia was only weakly related to HDL cholesterol. These results suggest that insulinemia and glycemia might mediate the effects of upper body adiposity on TG, although not on HDL and HDL2 cholesterol. Hyperinsulinemia was also positively associated with diastolic and systolic BP in men. PMID- 3282149 TI - Glucose and amino acid metabolism in aging man: differential effects of insulin. AB - Insulin is a major regulator of glucose and body protein homeostasis, both of which demonstrate age-related changes. To clarify insulin's role in these age related changes and to compare age-related glucose and protein homeostatic responses, insulin-mediated aspects of glucose and amino acid metabolism were simultaneously examined in healthy postabsorptive young (n = 5, mean age, 25 years) and elderly (n = 5, mean age, 76 years) men. Primed constant infusions of L-[1-13C]leucine and L-[15N]alanine were administered during a basal period (0 to 180 minutes) and during four separate single rate euglycemic insulin infusions (180 to 360 minutes). Steady state insulin concentrations were 16 +/- 1, 29 +/- 3, 75 +/- 5, and 2407 +/- 56 microU/mL in the young and 23 +/- 4, 37 +/- 8, 96 +/ 11 and 3,357 +/- 249 microU/mL in the elderly at the different insulin infusion rates of 6, 10, 30, and 400 mU mU.m-2.min-1, respectively. For the 6 and 10 mU insulin infusion rates, a primed, constant infusion of [6,6 - 2H2]glucose permitted quantitation of hepatic glucose production. Glucose disposal rates adjusted for lean body mass (LBM) were lower in the elderly than in the young at the 6, 10, and 30 mU insulin infusion rates and similar in the two age groups in the 400 mU studies. Insulin dose-dependent reductions occurred in eight of ten plasma amino acids and were not influenced by age. There was an insulin dose dependent reduction in plasma leucine flux which was similar in both age groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282150 TI - Detection and quantitation of biological sulfhydryls. PMID- 3282151 TI - Methods for study of normal and abnormal skeletal muscle mitochondria. PMID- 3282152 TI - Liposomes: preparation, characterization, and preservation. PMID- 3282153 TI - Analysis of processes causing thermal inactivation of enzymes. PMID- 3282154 TI - Computerized diagnosis: implications for clinical education. AB - The advent of the small computer as a basic clinical tool will have a significant impact on clinical practice and medical training. The application of probability theory to clinical diagnosis has led to the development of several practical diagnostic programs which run on small computers. Expert systems--interactive programs which function as 'electronic consultants'--have now been successfully developed for a number of clinical situations. Experience with two of these, INTERNIST/CADUCEUS and MYCIN, has provided insight into problems and prospects for expert systems in medicine. Less complex programs, particularly those employing clinical prediction rules, and expert system shells, seem well suited for clinical environments. Although computerized medical diagnosis holds great promise as an aid to clinicians, its success will largely be determined by the quality of the information that clinicians provide for analysis. A brief review of the status of bedside diagnosis reveals that data-gathering strategies and techniques must be better understood. In order to take full advantage of computer programs for diagnosis, basic diagnostic skills must be more heavily emphasized in clinical training. PMID- 3282155 TI - Evaluation of monoexponential extrapolation of transpulmonary thermal-dye kinetics by use of a new model-free deconvolution algorithm. AB - This study evaluates the routine mathematic approach (monoexponential extrapolation) for analysis of transpulmonary thermal-dye dilution curves and estimates the effects of systemic-indicator recirculation by use of a deconvolution technique. Fifteen dogs anesthetized with N2O-piritramid were studied before and after induction of pulmonary edema by oleic acid. After introduction of central venous indicator (10 ml of a mixture of cold blood and indocyanine green dye), dilution data were recorded from the pulmonary artery and the ascending aorta. The conclusions were: (1) monoexponential extrapolation yields reasonably good estimates of the mean transit times of dye; (2) mean transit times of heat are usually overestimated by monoexponential extrapolation; (3) extravascular lung thermal volume assessed by monoexponential extrapolation is overestimated by 2.03 ml/kg of body mass under baseline conditions; and (4) the prepulmonary volume of distribution of heat exceeds that of dye by 1.4 ml/kg of body mass, thus increasing the overestimation of pulmonary extravascular heat accessible space by the conventional technique. PMID- 3282156 TI - Controversies in the treatment of osteosarcoma. AB - In my opinion, it is clear that improving the initial disease-free survival is the key to improving the cure rates for patients with osteosarcoma. However, until new drugs with marked activity against osteosarcoma are developed, significant improvements in disease-free survival are unlikely. Almost all patients with newly-diagnosed osteosarcoma will receive preoperative chemotherapy which is followed by a definitive surgical (limb-sparing or amputation) procedure and additional postoperative chemotherapy. The impact of limb-sparing surgery on the incidence of pulmonary metastases and long-term disease-free survival must be assessed carefully in continuing and future trials. It is conceivable that limb sparing surgery may be contraindicated in certain situations. The cure rate after the development of metastatic disease must be assessed, although I fear that it will be quite low. Lastly, and possibly most importantly, the assessment of biological variables such as tumour ploidy, enzyme content, and so on, should be undertaken in an effort to promote a better understanding of osteosarcoma. PMID- 3282157 TI - Controversies in the management of primary bone tumours: an Australian perspective. PMID- 3282158 TI - [Identification of mutations in the asporogenic yeast Candida tropicalis using intrageneric fusion of protoplasts]. AB - The possibility of genetic identification of mutations in asporogenic yeast by the technique of intrageneric fusion of yeast protoplasts of Candida tropicals and Saccharomyces cerevisiae has been demonstrated for Candida tropicals strains G5-9 (Ade- Leu-) and G32-4 (Leu-). The mutations to auxotrophy ade- in the strain G5-9 and leu- in G32-4 of Candida tropicals are allelic to ade2 and leu1 mutations in the genes of Saccharomyces cerevisiae yeast. The allelic character of adenine auxotrophy mutation in Candida tropicals and ade2 mutation in Saccharomyces cerevisiae is confirmed by the absence of AIR-carboxylase activity in cellular extract from the strain G5-9. PMID- 3282159 TI - [Recombinations during DNA cloning]. AB - RecA-independent recombinations accompanying the processes of plasmids preparation and cloning into Escherichia coli cells are induced within the short direct and inverted repeats of several types. PMID- 3282160 TI - A preliminary study of an iron porphyrin-iodosylbenzene system for activation of mutagens in the Ames assay. PMID- 3282161 TI - Anthraflavic acid inhibits the mutagenicity of the food mutagen IQ: mechanism of action. AB - The ability of anthraflavic acid to inhibit the mutagenicity of IQ was investigated using the Ames test and employing hepatic activation systems from Aroclor 1254-pretreated rats. Incorporation of anthraflavic acid into the S9 mix caused a concentration-dependent decrease in the mutagenicity of IQ. A similar effect was seen when microsomes only were employed as activation systems. Cytosol, as we have previously demonstrated, potentiated the microsome-mediated mutagenicity of IQ and this potentiation was also inhibited by anthraflavic acid. In contrast, anthraflavic acid had no effect on the mutagenicity of the direct acting microsome-generated metabolites of IQ. It is concluded that anthraflavic acid is a potent inhibitor of IQ mutagenicity by virtue of its ability to inhibit both its microsomal and cytosolic activation pathways. PMID- 3282162 TI - Mutagenic activity in smoke formed during broiling of lean pork at 200, 250 and 300 degrees C. AB - Smoke formed during pan-broiling of lean pork was recovered at 3 different pan temperatures: 200, 250 and 300 degrees C, using an efficient device for collection of aerosol and volatiles. The mutagenicity of the smoke was assayed using the Ames' Salmonella test. A strong temperature dependence of the mutagen concentration in smoke as well as in meat crust and pan residues was shown. The contribution of mutagenic activity from the smoke relative to the total mutagenicity was 3.1, 4.2 and 11.1% at 200, 250 and 300 degrees C, respectively. PMID- 3282163 TI - Mutagenicity of naphthacene, a non-bay-region aromatic hydrocarbon, in Salmonella. AB - Naphthacene (2,3-benzanthracene, tetracene) was tested for mutagenicity towards Salmonella typhimurium strains TA1535, TA1537, TA1538, TA98 and TA100. Mutagenicity was seen in all strains except in TA1535 when liver S9 fraction from rats or mice was present. The increases in the number of revertants induced by naphthacene equalled those by other naturally occurring polycyclic aromatic hydrocarbons, benzo[a]pyrene and dibenz[ac]anthracene, in the strains TA98 and TA100. PMID- 3282165 TI - Molecular and Biochemical Parasitology. Cumulative Author and Subject Index. PMID- 3282166 TI - Wound sepsis. PMID- 3282167 TI - European Community plans to sequence yeast genome. PMID- 3282164 TI - Differential DNA repair effects in E. coli cells inoculated in intestinal organs of mice. Possible involvement of feed components and/or fecal mutagens. PMID- 3282168 TI - Sewall Wright (1889-1988) PMID- 3282169 TI - DNA typing from single hairs. AB - The characterization of genetic variation at the DNA level has generated significant advances in gene and disease mapping, and in the forensic identification of individuals. The most common method of DNA analysis, that of restriction fragment length polymorphism (RFLP), requires microgram amounts of relatively undegraded DNA for multi-locus typing, and hundreds of nanograms for single-locus comparisons. Such DNA frequently cannot be obtained from forensic samples such as single hairs and blood stains, or from anthropological, genetic or zoological samples collected in the field. To detect polymorphic DNA sequences from single human hairs, we have used the polymerase chain reaction (PCR), in which specific short regions of a gene can be greatly amplified in vitro from as little as a single molecule of DNA. We have detected genetically variable mitochondrial and nuclear DNA sequences from the root region of shed, as well as freshly-plucked, single hairs; mitochondrial DNA (mtDNA) sequences have been detected in a sample from a single hair shaft. We have used three different means of DNA typing on these samples: the determination of amplified DNA fragment length differences, hybridization with allele-specific oligonucleotide probes, and direct DNA sequencing. PMID- 3282171 TI - Protein dynamics. Hard facts on soft centres. PMID- 3282170 TI - Dissecting the catalytic triad of a serine protease. AB - Serine proteases are present in virtually all organisms and function both inside and outside the cell; they exist as two families, the 'trypsin-like' and the 'subtilisin-like', that have independently evolved a similar catalytic device characterized by the Ser, His, Asp triad, an oxyanion binding site, and possibly other determinants that stabilize the transition state (Fig. 1). For Bacillus amyloliquefaciens subtilisin, these functional elements impart a total rate enhancement of at least 10(9) to 10(10) times the non-enzymatic hydrolysis of amide bonds. We have examined the catalytic importance and interplay between residues within the catalytic triad by individual or multiple replacement with alanine(s), using site-directed mutagenesis of the cloned B. amyloliquefaciens subtilisin gene. Alanine substitutions were chosen to minimize unfavourable steric contacts and to avoid imposing new charge interactions or hydrogen bonds from the substituted side chains. In contrast to the effect of mutations in residues involved in substrate binding, the mutations in the catalytic triad greatly reduce the turnover number and cause only minor effects on the Michaelis constant. Kinetic analyses of the multiple mutants demonstrate that the residues within the triad interact synergistically to accelerate amide bond hydrolysis by a factor of approximately 2 X 10(6). PMID- 3282173 TI - Liquid-like movements in crystalline insulin. AB - Diffuse X-ray scattering from protein crystals provides information about molecular flexibility and packing irregularities. Here we analyse diffraction patterns from insulin crystals that show two types of scattering related to disorder: very diffuse, liquid-like diffraction, and haloes around the Bragg reflections. The haloes are due to coupled displacements of neighbouring molecules in the lattice, and the very diffuse scattering results from variations in atomic positions that are only locally correlated within each molecule. The measured intensity was digitally separated into three components: the Bragg reflections and associated haloes; the water and Compton scattering; and the scattering attributed to internal protein movements. We extend methods used to analyse disorder in membrane structures to simulate the diffuse scattering from crystalline insulin in terms of (1) the Patterson (autocorrelation) function of the ideal, ordered crystal structure, (2) the root-mean-square (r.m.s.) amplitude of the atomic movements, and (3) the mean distance over which these displacements are coupled. Movements of the atoms within the molecules, with r.m.s. amplitudes of 0.4-0.45 A, appear to be coupled over a range of approximately 6 A, as in a liquid. These locally coupled movements account for most of the disorder in the crystal. Also, the protein molecules, as a whole, jiggle in the lattice with r.m.s. amplitudes of approximately 0.25 A that appear to be significantly correlated only between nearest neighbours. PMID- 3282172 TI - Two-tiered regulation of spatially patterned engrailed gene expression during Drosophila embryogenesis. AB - A regulatory cascade, initiated during the syncytial stage of embryogenesis, culminates in the striped pattern of engrailed gene expression at the cellular blastoderm stage. The early regulatory genes, for example the pair-rule genes, are expressed transiently and as their products decay a distinct regulatory programme involving segment polarity genes takes over. This late programme maintains and perhaps modifies the striped pattern of engrailed expression through interactions that may involve cell communication. PMID- 3282174 TI - Killed HIV treatment in clinical trials. PMID- 3282175 TI - Human trials go-ahead for the AIDS vaccine with a difference. PMID- 3282176 TI - Heat-shock proteins. Coming in from the cold. PMID- 3282177 TI - Who's paying for new drugs? AB - Direct payment by patients for treatment with drugs still in development is the subject of controversy. The matter goes deeper than it might first appear. PMID- 3282178 TI - A subfamily of stress proteins facilitates translocation of secretory and mitochondrial precursor polypeptides. AB - Depletion of a subset of 70K stress proteins in yeast mutants shows that they are involved in the post-translational import of precursor polypeptides into both mitochondria and the lumen of the endoplasmic reticulum. The identification of such a basic function may explain the remarkable evolutionary conservation of the gene family encoding these proteins. PMID- 3282180 TI - Retinal astrocytes are immigrants from the optic nerve. AB - The retina in most mammals contains two types of macroglial cells--Muller cells, which span the entire thickness of the retina, and astrocytes, which are mainly confined to the nerve fibre layer. Whereas Muller cells are diffusely distributed in all vertebrate retinae, the presence and distribution of retinal astrocytes correlate with the presence and distribution of retinal blood vessels: retinae that are avascular contain no astrocytes; those that are diffusely vascularized contain diffusely distributed astrocytes; and those that are vascularized in a restricted region contain astrocytes only in the vascularized region. This striking correlation between vascularization and the presence of astrocytes led Stone and Dreher to postulate that retinal astrocytes are immigrants that enter the retina with its vasculature, although others have suggested that they derive from Muller cells. Here we provide strong evidence that astrocytes in the diffusely vascularized rat retina are immigrants from the optic nerve. PMID- 3282179 TI - 70K heat shock related proteins stimulate protein translocation into microsomes. AB - A yeast cytosol is shown to contain two distinct activities that stimulate protein translocation across microsomal membranes. One activity was purified. It consists of two constitutively expressed 70K heat shock related proteins that increase the rate of translocation. Possible mechanisms of action of these proteins are discussed. PMID- 3282181 TI - [Shunt meningitis: a recognizable clinical picture?]. PMID- 3282182 TI - [Reflux gastritis]. PMID- 3282183 TI - [Consensus follow-up study after polypectomy]. PMID- 3282184 TI - The pathology of encephalic arteriovenous malformations treated by prior embolotherapy. AB - A pathologic study was undertaken of seven encephalic arteriovenous malformations, including five resected from one to seven days after balloon embolization, one resected 10 days after embolization with polyvinyl alcohol foam (PVA), and a large mesencephalic AVM in a patient who died eight weeks after a series of embolization procedures with PVA and silicone spheres. AVM's resected 6 7 days following balloon embolization showed focal mural and adventitial inflammatory infiltrates and parenchymal (i.e. non-vascular) necrosis of a large portion of one AVM. The AVM examined 7 days post-balloon embolization showed an intraluminal thrombus containing refractile particles surrounded by foreign body giant cells (FBGC's). The AVM removed 10 days after PVA embolotherapy showed mural and perivascular necrosis with infiltration by polymorphonuclear leukocytes. The single autopsy case showed FBGC's surrounding residual PVA, refractile particles deep within vascular walls, and marked mural thickening of AVM channel walls, changes that may represent a response to previous angionecrosis and inflammation at the time of embolization. These findings, the pathogenesis of which is discussed in detail, may help to explain some of the rare complications of iatrogenic embolotherapy with these materials, as well as providing evidence for the basis of their efficacy. PMID- 3282186 TI - A plan for implementing computer-assisted instruction. PMID- 3282185 TI - Complications in cerebral angiography with iohexol (Omnipaque) and meglumine metrizoate (Isopaque cerebral). AB - The complications of cerebral angiography have been recorded in 1509 examinations with metrizoate (Isopaque Cerebral) and in 1000 examinations with iohexol (Omnipaque). The frequency of complications was 2.0 percent for metrizoate and 1.3 percent for iohexol. Permanent sequelae were seen in 4 patients, 3 in the metrizoate and one in the iohexol group. One of these patients died, probably from thromboembolism. Blood coagulation parameters were studied during the angiography in 22 patients and only minor, probably clinically insignificant changes were found, with no difference between the two contrast media. PMID- 3282187 TI - Systemic effects of ophthalmic medication in the elderly. PMID- 3282188 TI - A history of the Onondaga Sanatorium for the Treatment of Tuberculosis. PMID- 3282190 TI - New law changes Medicare home health regulatory system. PMID- 3282189 TI - Physician discipline and professional conduct. PMID- 3282191 TI - California North Coast Preterm Birth Prevention project. AB - A demonstration project aimed at reducing the incidence of preterm birth in a rural population of Northern California was conducted using risk assessment, patient education, and education for providers as interventions. We compared 1914 preintervention deliveries with 7382 births during the intervention period. Although the percentage of preterm labor patients eligible for tocolysis was 34% greater during the intervention period than during the preintervention period, and the percentage of preterm labor patients who achieved term gestation was 53% greater in the intervention period, the overall rate of spontaneous preterm delivery in the population did not differ significantly in the two periods. PMID- 3282192 TI - Prenatal diagnosis of duodenal atresia: does it make any difference? AB - The outcome of infants with duodenal atresia diagnosed antenatally is compared with that of infants diagnosed after birth. The incidence of neonatal morbidity was higher and preoperative conditions were poorer in the second group. PMID- 3282194 TI - Combined sonographic-pathologic surveillance in elective first-trimester termination of pregnancy. AB - In this study, we attempted to develop a surveillance protocol for elective first trimester termination to see whether unsuspected ectopic pregnancy could be detected earlier, and to identify those patients with unsuspected second trimester pregnancies that could be terminated more safely in the hospital. Two hundred fifty consecutive patients requesting elective termination were studied prospectively. All were 12 weeks or less by last menstrual period, had positive urinary pregnancy tests, and had no history of vaginal bleeding. All patients had ultrasound screening before curettage. Immediately after curettage, a "modified" gross pathologic examination (3X magnification) was also performed on unstained curettage material. The sonographic, operative, and pathologic findings were all correlated. Such screening identified four patients with unruptured ectopic pregnancies, who were operated on the same day as the curettage. In addition, four patients, who were actually in the second trimester but had inaccurate dates, were identified and referred to hospital for appropriate methods of termination. We conclude that such surveillance may reduce morbidity in elective terminations and more rapidly identify unsuspected ectopic pregnancies. PMID- 3282193 TI - Doppler umbilical velocimetry in the prediction of adverse outcome in pregnancies at risk for intrauterine growth retardation. AB - Perinatal indicators of fetal compromise were assessed according to the results of continuous-wave Doppler umbilical velocimetry for 172 patients at risk for intrauterine growth retardation (IUGR). Forty-three (25%) of the patients delivered an infant with a birth weight below the tenth percentile for gestational age. The last Doppler study before delivery was abnormal in 48.8% of the growth-retarded infants but in only 13.2% of the infants without evidence of IUGR. Furthermore, in the growth-retarded group, early delivery, reduced birth weight, decreased amniotic fluid at birth, admission to the neonatal intensive care unit, neonatal complications associated with IUGR, and a prolonged hospital stay were observed more frequently in those who had an abnormal ratio than in those with a normal ratio. The sensitivity of the systolic/diastolic ratio for an adverse perinatal outcome (operative delivery for fetal distress, neonatal morbidity associated with IUGR, and/or perinatal death) was significantly better for the infants with IUGR (66.7%) than for the infants without IUGR (27.8%; P less than .05). The predictive value of an abnormal ratio was also higher for the pregnancies complicated with IUGR (57.1%) than for those without IUGR (29.4%), but not to a statistically significant degree. These data suggest that Doppler umbilical velocimetry studies are valuable in identifying those growth-retarded fetuses at increased risk for an adverse perinatal outcome. PMID- 3282195 TI - Management of genital herpes infection in pregnancy. PMID- 3282197 TI - Continuity of ambulatory care in an obstetrics and gynecology residency program. AB - Continuity of ambulatory care was instituted four years ago in a large residency training program serving private and clinic patients. Details of the program are described. Seventy-nine percent and 87% continuity of care was achieved for prenatal patients and women with gynecologic problems, respectively. Long-term continuity of care for preventive health maintenance was not attained. House officers and nurses believe that continuity of care fosters more efficient use of laboratory testing and physician time and results in better patient care. PMID- 3282196 TI - A critical appraisal of fetal acoustic stimulation as an antenatal test for fetal well-being. AB - Fetal acoustic stimulation is becoming a common modality for antepartum testing. The purpose of this study was to review the available literature on the subject to establish whether safety and efficacy have been determined. Safety could not be substantiated. The frequency, intensity, duration, and number of stimuli varied greatly among publications. There is no uniform nomenclature to score test results, and even the definition of the fetal acoustic stimulation test is not uniform. Data on the efficacy of the test are limited. Before fetal acoustic stimulation becomes part of standard obstetric care, rigorous clinical testing is required. PMID- 3282198 TI - Natural history and school screening for scoliosis. AB - In light of the questions and controversy regarding school screening for spinal deformities, should the programs be dropped? The natural history is not completely known and the results of nonoperative treatment questioned. The costs are high due to over-referral and numerous physician visits and radiographs. Would it not be best to wait until the epidemiologic questions are answered? The best approach is one in the middle ground. The program needs to be organized and strengthened. With the education of screeners, over-referral can be reduced. The treating physician must confirm the physical finding, take appropriate radiographs, and plan appropriate follow-up. In this way, the costs will be reduced. In addition, with knowledge regarding natural history, only larger curves or progressive curves will be treated. Nonoperative treatment of idiopathic scoliosis is effective. It can control progression and even result in correction of some curves. The overall effectiveness of braces and electrical stimulation needs to be constantly reviewed. How do these forms of nonoperative treatment affect the progressive curve, and do they reduce the need for surgery in idiopathic scoliosis? Only after we have more studies on natural history and on the results of nonoperative treatment can screening for scoliosis be reassessed to determine its role in the overall treatment program of spinal deformities. PMID- 3282199 TI - The role of Harrington instrumentation and posterior spine fusion in the management of adolescent idiopathic scoliosis. AB - The Harrington instrumentation system was the first widely used, internationally accepted internal fixation system for the correction of idiopathic scoliosis when combined with a spinal arthrodesis. It has been generally available to the orthopedic surgeon for more than 25 years, and therefore its capabilities and limitations have been identified through this long experience. Its implantation requires minimal invasion of the spinal canal and is associated with a low (less than 0.5 per cent) incidence of neurologic complications. It provides predictable correction of spinal deformity with little subsequent loss of correction. When compared with other newer, more complex internal fixation systems for spinal deformities, the Harrington system has a shorter, less difficult "learning curve"; requires less operating time and blood loss to insert; implants a smaller mass of metal; and in some cases costs substantially less for the implant system. The Harrington system has an extremely low incidence of hook dislodgment and pseudoarthrosis formation in single thoracic curves, being reported as near zero for these curves in two recently published series. Conversely, there are some disadvantages to the Harrington system when compared with other types of fixation. It has limited ability to provide sagittal plane control. It does not effectively and predictably derotate the spine. A recent study showed that at an average of 4 years postoperatively, nearly two thirds of the patients had an actual increase in their rib prominence. The pseudoarthrosis rate is high, up to 4 per cent, in the thoracolumbar and lumbar spine. Hook dislodgment approaches 3 per cent when used below the thoracic region. Another disadvantage is the necessity for postoperative external support. As a result, the Harrington system remains an excellent means of treating single and double thoracic idiopathic curves in a safe and predictable manner, while admittedly having limited derotation and sagittal plane control. Other systems that are more sophisticated at segmental fixation of the spine appear to be more appropriate for scoliotic deformities requiring fusion of the thoracolumbar or lumbar spine and those associated with significant sagittal plane deformities. PMID- 3282200 TI - Selection of methodology in surgical treatment of adolescent idiopathic scoliosis. AB - Before contemplating any surgical procedure, one has to define the goals of the operative procedure. The patient should be evaluated thoroughly by physical examination and by adequate radiographs, including bending films. The surgeon should be familiar with different types of techniques and their qualities. The goals of surgery should be outlined clearly and understood between the physician and the patient. The patient should be provided with sufficient and easy-to understand information (Table 1), and be encouraged to have an input in the decision-making process. For instance, is the goal of surgery to stop progression? To achieve cosmetic correction? To preserve maximal spinal mobility or to help improve pulmonary function? Is it important for the patient to be cast free postoperatively? Once the goal is defined, and we are aware of the abilities of each technique, then we can arrive at a realistic expectation. Again, it is of utmost importance that the surgeon select the procedure that he or she has adequate experience in performing. PMID- 3282201 TI - Infantile and juvenile idiopathic scoliosis. AB - Infantile and juvenile idiopathic scoliosis have distinct presentations and natural histories when compared with adolescent idiopathic scoliosis. In addition to age at onset, differences exist in associated anomalies, and frequency and rate of deformity progression. Treatment methods differ from adolescent deformities, and deserve separate discussion. PMID- 3282202 TI - Nonoperative treatment of adult scoliosis. AB - The adult with idiopathic or degenerative scoliosis usually seeks treatment for relief of pain. Identifying the source of pain is crucial in formulating a plan of treatment. Nonoperative treatment is best suited to those adults with mild pain or elderly patients for whom surgery is not prudent. Analgesics, nonsteroidal anti-inflammatory drugs, orthoses, and activity modification are the mainstays of treatment. PMID- 3282203 TI - Operative treatment of adult scoliosis with posterior fusion and instrumentation. AB - Adults with idiopathic or senescent scoliosis are a surgical challenge. Complaints of pain should be investigated to ascertain the exact cause in order for appropriate surgery to be performed. Complications associated with surgery in the adult are higher than with the adolescent, but can be minimized by a careful preoperative evaluation and meticulous surgical technique. Segmental spinal fixation using distraction and compression rods, sublaminar wires, and CD instrumentation are currently in use. PMID- 3282204 TI - Combined use of anterior and posterior surgery for adult scoliosis. AB - The two-staged anteroposterior approach is the indicated surgical procedure for many patients with adult spine deformities as described in this article. These surgeries are not easily performed. The surgeon must have excellent knowledge of anatomy as well as expertise in performing these procedures in order to obtain maximum correction, stabilization of the spine, and minimize complications. PMID- 3282205 TI - Treatment of scoliosis in the adult thoracolumbar spine with special reference to fusion to the sacrum. AB - The major indication for operative intervention in adults with lumbar and thoracolumbar curves is pain. A careful analysis of the pain, including a careful history and the use of discography and facet blocks, has greatly enhanced the success rate both in terms of correction and relief of symptoms postoperatively. Zielke instrumentation is the preferred surgical technique for thoracolumbar curves that do not require extension of the fusion to the sacrum. Cotrel Dubousset fixation is particularly advocated in those cases that show evidence of spinal stenosis and require posterior decompression or in cases of rigid kyphoscoliosis following an anterior release. Fusions of the sacrum require a combined anterior and posterior approach. Iatrogenic loss of lumbar lordosis can be prevented by careful attention to detail and posterior instrumentation with preservation of lumbar lordosis, contouring of rods, and hyperextension of spine and hips at the time of surgery. Loss of lumbar lordosis, which may result in marked fatigue and pain as well as a deformity often worse than the initial one, can be corrected, preferably by a combined anterior and posterior approach (Fig. 5). PMID- 3282206 TI - Loss of lumbar lordosis. A complication of spinal fusion for scoliosis. AB - Symptomatic loss of lumbar lordosis is a disabling complication of scoliosis surgery. This so-called "flat-back syndrome" is characterized by an inability to stand erect and by upper back pain. Distraction instrumentation extending into the lower lumbar spine or sacrum is the most frequently identified etiologic factor responsible for loss of lordosis. The more distal the level of instrumentation, the severer the loss of lumbar lordosis. Other factors that may aggravate the loss of lordosis include thoracolumbar kyphosis, fixed thoracic kyphosis, hip flexion contractures, and pseudoarthrosis. Because of the wide range of values for kyphosis and lordosis in normal individuals, there is no absolute value that can be considered "normal." It is the overall sagittal plane balance that is most important. The most useful radiographic measurement to evaluate this sagittal plane balance is the full-length standing lateral radiograph with the knees extended. On this view, the C7-S1 measurement should fall within 2 cm of the anterior aspect of the sacrum. Surgical treatment for symptomatic loss of lumbar lordosis consists of closing wedge osteotomies through the fusion mass. This should generally be preceded by an anterior release and interbody fusion. Correction should be obtained at the site of the deformity with particular attention paid to the thoracolumbar junction. The surgery is difficult and the risk of complication is high. The most important aspect of this postural disorder is prevention. Avoid distraction instrumentation that extends into the lumbar spine if possible. When distraction instrumentation is used, the techniques described will help preserve lumbar lordosis. When performing a fusion to the sacrum, distraction instrumentation should not be used. PMID- 3282207 TI - Spinal cord monitoring. AB - This article serves as a review of the use of spinal cord monitoring in spine surgery, including both the wake-up test and the various approaches to electrophysiologic (evoked-potential) monitoring. Physiologic and technical aspects of evoked-potential monitoring are presented. The different ways of performing evoked potentials are presented, examined, and compared, with a discussion of the pros and cons of each. PMID- 3282208 TI - [Changes in views on the surgical treatment of gastric and duodenal ulcer]. PMID- 3282209 TI - [Clinical spectrum of type 1 diabetes mellitus of autoimmune origin]. PMID- 3282210 TI - [Etiology of enteral infections in infancy and early childhood]. PMID- 3282211 TI - Imaging modalities for the study of the temporal bone. AB - During the past 30 years, rapid and extensive progress has been made in diagnostic imaging of the petrous temporal bone, especially in the techniques of complex motion (pluridirectional) tomography, computed tomography, and magnetic resonance imaging. Because there are a variety of imaging techniques for evaluation of the petrous temporal bone, it is essential to utilize the optimal examinations. Economic factors and the need to reduce unnecessary radiation exposure for the patient are both important considerations. PMID- 3282212 TI - Congenital malformations of the ear. AB - Either CT or pluridirectional tomography is capable of demonstrating bony anomalies of the ear. For a variety of reasons, high-resolution "bone algorithm" CT is used as the first imaging procedure at our institution, and pluridirectional tomography is done only on rare occasion, usually when there is an ambiguity on the CT images. PMID- 3282213 TI - Rheumatism remedies of the past. PMID- 3282214 TI - Ceftazidime with or without vancomycin vs. cephalothin, carbenicillin and gentamicin as the initial therapy of the febrile neutropenic pediatric cancer patient. AB - In a 28-month randomized trial we compared ceftazidime (CAZ), an extended spectrum cephalosporin, with cephalothin, carbenicillin and gentamicin (KCG) as empiric therapy for febrile neutropenic pediatric cancer patients. Because of the occurrence of ceftazidime-resistant Gram-positive primary infections, vancomycin was added to CAZ after the first year of study. Of 206 evaluable episodes 76 (37%) were documented infections including 20 bacteremias; 130 (63%) episodes were caused by fever of unknown origin. The number of complete responses to initial therapy in patients with documented infections did not differ among regimens: 26 of 43 (61%) for KCG, 9 of 16 (56%) for ceftazidime and 8 of 16 (50%) for CAZ + vancomycin (not significant). In patients with fever of unknown origin, response without modification of the initial regimen was 52 of 62 (84%) in the KCG arm, 32 of 40 (80%) on CAZ and 23 of 29 (80%) in patients treated with CAZ + vancomycin (not significant). Modifications of the regimen were similar among all three groups and were due primarily to the use of empiric antifungal or antiviral therapy and to empiric treatment of interstitial pneumonia. Hypokalemia occurred in 25 of 105 patients treated with KCG and in 4 of 101 treated with CAZ or CAZ + vancomycin (P less than 0.001). No differences between the efficacy of KCG, CAZ and CAZ + vancomycin as initial empiric therapy were demonstrated. PMID- 3282215 TI - Enterobacter sakazakii meningitis in neonates. PMID- 3282217 TI - What's new in pediatric surgery. PMID- 3282218 TI - Nephrolithiasis following in utero diuretic exposure: an unusual case. PMID- 3282216 TI - A double-blind, placebo-controlled clinical trial of the effect of chlorpheniramine on the response of the nasal airway, middle ear and eustachian tube to provocative rhinovirus challenge. AB - This paper presents the results of a randomized, double-blind, placebo-controlled study of the efficacy of chlorpheniramine in relieving the symptoms and attenuating the pathophysiologic correlates of a rhinovirus "common cold." Forty healthy, adult, nonatopic subjects were randomly assigned to one of two treatment groups: active drug and placebo. On study Day 0, all subjects were challenged intranasally with rhinovirus type 39 (dose = 100 TCID50). Subjects were cloistered from Day 2 to Day 7, at which time they were treated with either chlorpheniramine or placebo. From 3 days before challenge to study Day 19, subjects had nasal patency assessed by rhinomanometry, eustachian tube function assessed by the 9-step test and sonotubometry, middle ear pressure assessed by tympanometry and nasal clearance assessed by the dyed-saccharin technique. Symptom diaries were maintained throughout the period of follow-up. During cloister, symptoms also were scored by interview, nasal secretions were quantified and nasal washings were performed for viral culture. Results showed that 19 (95%) subjects in the active-treatment group and 18 (90%) subjects in the placebo-treatment group shed virus. Symptomatic colds were observed in 63% of the active-treated and 83% of the placebo-treated subjects. Symptoms increased on Day 1 and peaked at Days 4 to 5. Detrimental changes in other measured functions consistent with those previously reported were observed. During the period of treatment, significant differences in the average symptom scores favoring the active-treatment group were observed for sneezing. Also, weight of expelled secretions was greater and mucociliary clearance rate less on some cloister days for the placebo-treated group. No significant differences between treatment groups in the objective measures of nasal congestion or the response of the middle ear and eustachian tube were documented. PMID- 3282219 TI - Corticosteroids for exacerbations of asthma: current status of the controversy. PMID- 3282220 TI - Child health and the 1987 Nobel Peace Prize. PMID- 3282221 TI - Update on the role of the blood-brain barrier in damage to immature brain. PMID- 3282222 TI - Effect of sino-aortic denervation in comparison to cardiopulmonary deafferentiation on long-term blood pressure in conscious dogs. AB - The isolated and combined influence of cardiopulmonary and sinoaortic denervation on long-term blood pressure (MAP), heart rate (HR), plasma renin activity (PRA) and plasma volume (PV) was studied in 11 conscious, chronically instrumented foxhounds receiving a normal sodium diet. MAP, HR, PV and PRA remained unchanged in the 5 dogs after bilateral thoracic vagal stripping, which eliminates the cardiopulmonary afferents. After sino-aortic denervation in another 5 dogs there was equally little change when compared to the control group. Only total baroreceptor and cardiopulmonary denervation (7 dogs) revealed significantly higher levels of MAP (119.6 +/- 4.6 vs. 100.4 +/- 1.5, P less than 0.01), HR (118.2 +/- 3.7; vs. 84.1 +/- 3.5; P less than 0.0001), and PRA (3.6 +/- 0.9 vs. 0.9 +/- 0.2; P less than 0.05). In conclusion, the function of either arterial baroreceptors or cardiopulmonary receptors is sufficient for normal circulatory control. When both groups of receptor afferents are interrupted, MAP, HR, and PRA rise to significantly higher levels. Thus, both systems interact in a sense of a non-additive attenuation on "cardiovascular centres". This may clarify previous disputes concerning neurogenic hypertension, and supplies information for the role of the renin-angiotensin system in blood pressure control. PMID- 3282225 TI - Two viral proteins involved in the proteolytic processing of the cowpea mosaic virus polyproteins. AB - A series of specific deletion mutants derived from a full-length cDNA clone of cowpea mosaic virus (CPMV) B RNA was constructed with the aim to study the role of viral proteins in the proteolytic processing of the primary translation products. For the same purpose cDNA clones were constructed having sequences derived from both M and B RNA of CPMV. In vitro transcripts prepared from these clones with T7 RNA polymerase, were efficiently translated in rabbit reticulocyte lysates. The translation products obtained were processed in the lysate by specific proteolytic cleavages into smaller products, which made it possible to study subsequently the effect of the various mutations on this process. The results obtained indicate that the B RNA-encoded 24K polypeptide represents a protease responsible for all cleavages in the polyproteins produced by both CPMV B and M RNA. For efficient cleavage of the glutamine-methionine site in the M RNA encoded polyprotein the presence of a second B RNA encoded protein, the 32K polypeptide, is essential, although the 32K polypeptide itself does not have proteolytic activity. A number of cleavage-site mutants were constructed in which the coding sequence for the glutamine-glycine cleavage site between the two capsid proteins was changed. Subsequent in vitro transcription and translation of these cleavage site mutants show that a correct dipeptide sequence is a prerequisite for efficient cleavage but that the folding of the polypeptide chain also plays an important role in the formation of a cleavage site. PMID- 3282224 TI - Estrogens and growth factors induce the mRNA of the 52K-pro-cathepsin-D secreted by breast cancer cells. AB - The estrogen-induced 52K protein secreted by human breast cancer cells is a lysosomal protease recently identified as a pro-cathepsin D by sequencing several cDNA clones isolated from MCF7 cells (Augereau et al., Mol. Endocr.). Using one of these clones, we detected, in MCF7 cells, a 2.2 kb mRNA whose level was rapidly increased 4- to 10-fold by estradiol, but not by other classes of steroids. Other mitogens, such as epidermal growth factor and insulin, also induced the 2.2 kb mRNA in a dose-dependent manner. Induction with epidermal growth factor was as rapid but was 2- to 3-fold lower than with estradiol. Antiestrogens had no effect on the 52K-cathepsin-D mRNA in MCF7 cells, but became estrogen agonists in two antiestrogen-resistant sublines R27 and LY2. The use of transcription and translation inhibitors and nuclear run-on experiments indicate that estradiol enhances transcription of the 52K-cathepsin-D gene in MCF7 cells. PMID- 3282226 TI - Sleeping without drugs. PMID- 3282227 TI - Dress sense. PMID- 3282228 TI - Aeromonas hydrophila gas gangrene: a case report of management with surgery and hyperbaric oxygenation. PMID- 3282223 TI - Compilation of transcription regulating proteins. PMID- 3282229 TI - Drug use in the chemically dependent. How to avoid relapse to addiction. AB - Unsupervised use of intoxicating drugs almost certainly causes relapse to addiction in persons who have been chemically dependent. Other drugs may predispose some persons to failure in their attempt to remain drug-free. Studies have shown that the chemically dependent are addicted to intoxication, not to one particular chemical, so these persons must be guided away from psychoactive drugs that have any risk of producing intoxication. In some cases, such as during hospitalization, relapse-producing agents may be necessary. With close attention from the physician and the patient's acceptance of his or her addiction and active participation in a self-help group, relapse can usually be avoided. Benefits that are gained from counseling are often underrecognized. The physician who takes time to intervene in this way probably has fewer relapses among his or her chemically dependent patients than the physician who orders a prescription. Prescribing any drugs to these patients must be done with caution. In general, all intoxicating substances are contraindicated outside the hospital. The patient's use of any over-the-counter agent to produce weight loss, excitement, or sleep should serve as a warning signal to both the patient and physician. PMID- 3282230 TI - An 11-kDa form of human immunodeficiency virus protease expressed in Escherichia coli is sufficient for enzymatic activity. AB - In order to define the protease domain of human immunodeficiency virus 1, various regions of the pol open reading frame were cloned and expressed in Escherichia coli. Antiserum directed against the conserved retroviral protease active site was used to identify pol precursor and processed species containing the presumed protease domain. The smallest product that accumulates is about 11 kDa as measured by NaDodSO4/PAGE. This size agrees with that predicted from the presence in this region of two Phe-Pro sequences, which is one of the cleavage sites recognized by HIV protease. DNA encoding only the predicted 11-kDa protein was cloned, bypassing the need for autoprocessing, and the protein was expressed to a high level in E. coli. This form is active as demonstrated by its ability to specifically cleave protease-deficient pol protein in vivo in E. coli. Extracts of E. coli containing the 11-kDa protease also process human immunodeficiency virus gag substrates in vitro. These results demonstrate that the 11-kDa protease is sufficient for enzymatic activity and are consistent with a major role for this form in virus maturation. PMID- 3282231 TI - Biogenesis of glycosomes of Trypanosoma brucei: an in vitro model of 3 phosphoglycerate kinase import. AB - Glycosomes are intracellular, membrane-bound microbody organelles of trypanosomes and leishmania. Nine glycolytic enzymes are the major protein components of the glycosomes of Trypanosoma brucei long-slender bloodstream forms. Glycosomal proteins are believed to be synthesized in the cytoplasm and inserted across the glycosomal membrane posttranslationally. We have developed an in vitro protein import assay for the study of glycosomal biogenesis in T. brucei. All nine glycosomal glycolytic enzymes were detectable by immunoprecipitation and gel analysis of radiolabeled products derived from in vitro translation of total mRNA. Radiolabeled translational products were incubated with purified glycosomes isolated from bloodstream forms and digested with protease to remove proteins not imported into glycosomes. Gel analysis of reisolated glycosomes revealed that glyceraldehyde-3-phosphate dehydrogenase (EC 1.2.1.12) and 3-phosphoglycerate kinase (PGK) (EC 2.7.2.3) were apparently imported intact into the glycosome. Specificity of the protein import assay was verified by using translational products derived from cloned genes encoding T. brucei glycosomal PGK and its 95% homologous cytosolic isozyme. Glycosomal PGK was inserted into the glycosome in vitro with a 27.6% efficiency, but no imported cytosolic PGK was detectable. Preliminary data suggest that certain sequences between the N terminus and residue 123 may be important for import of glycosomal PGK. Our assay, combined with the potential use of genetically altered substrate proteins, may provide the opportunity to explore the recognition systems involved in glycosome biogenesis. PMID- 3282233 TI - Evidence for tektins in centrioles and axonemal microtubules. AB - Affinity purified, polyclonal antibodies were prepared against three tektins (tektins A, B, and C) isolated from sea urchin sperm axonemal microtubules. These antibodies (anti-tektins) were used to localize tektins in axonemes, basal bodies, and centrioles. By immunofluorescence microscopy it could be demonstrated that in sperm tails from Lytechinus pictus all three anti-tektins stain all nine axonemal doublet microtubules and A-tubule extensions along their entire length. In addition to staining doublet microtubules, anti-tektin C weakly labeled the central-pair microtubules in sperm tails from Patiria miniata. The anti-tektin staining revealed also a clear cross-reaction with basal bodies of sea urchin sperm and with centrioles of cells from hamsters, humans, and pigs. These data provide evidence of tektin or tektin-like proteins in basal bodies and centrioles and suggest that centriole microtubules are constructed according to the same principles as flagellar microtubules. PMID- 3282232 TI - Isolation of cDNAs encoding desmosomal plaque proteins: evidence that bovine desmoplakins I and II are derived from two mRNAs and a single gene. AB - Desmoplakins (DPs) I and II (approximately equal to 240 and approximately equal to 210 kDa) are major components of the internal portion of the desmosomal cytoplasmic plaque. Desmosomes play a crucial role in cell-cell adhesion and serve as specific attachment sites for cytoplasmic intermediate filaments. Although DP-I and -II are closely related molecules, their structure (i.e., amino acid or DNA sequence) has not been determined. In addition, it is not known whether these proteins are derived from one or more genes or whether they result from posttranscriptional or posttranslational events. This paper describes the isolation and characterization of eight DP cDNA clones from a bovine lambda gt11 expression library. Fusion proteins from six of these clones selected antibodies that reacted with DP-I and -II and two selected antibodies that reacted with DP-I alone. Antibodies made against fusion protein produced by the DP1A clone reacted specifically with DP-I and -II on immunoblots. When used for indirect immunofluorescence on bovine tongue cryostat sections and cultured mouse keratinocytes, these antibodies produced a typical desmosomal staining pattern. RNA blot analysis demonstrated hybridization of three DP-I/II cDNA probes with two messages of approximately equal to 7.5 and approximately equal to 9.5 kilobases in bovine tongue RNA. In contrast, a cDNA clone that affinity-purified antibodies reacting with DP-I only hybridized exclusively with the 9.5-kilobase band. Southern blots of genomic DNA digested with a panel of restriction enzymes were hybridized with one probe derived from a DP-I/II clone and with one from a DP-I clone. Both probes hybridized with single bands of the same size in each digested sample of DNA. Together, these data suggest that DP-I and DP-II are translated from two separate messages in bovine tongue and that these messages may be derived from a single gene. PMID- 3282234 TI - Two rearranged MET alleles in MNNG-HOS cells reveal the orientation of MET on chromosome 7 to other markers tightly linked to the cystic fibrosis locus. AB - We have found that two alleles of the MET locus are rearranged in the human cell line MNNG-HOS. One allele is the previously characterized TPR-MET oncogene and the other is found on a der(7)t(1;7)(q23;q32) marker chromosome. These data and in situ chromosomal hybridization analysis would indicate that MET and, therefore, the cystic fibrosis locus are located at bands q31-q32 on human chromosome 7. Using somatic cell hybrids, we show that the chromosome containing the TPR-MET oncogene is grossly rearranged and contains both the upstream and downstream portions of the MET protooncogene locus. These results demonstrate that the TPR-MET oncogene rearrangement involving chromosomes 1 and 7 is either due to an insertion of TPR sequences into the MET locus or is more complex. We also show that the upstream MET protooncogene locus is deleted on der(7), while the downstream portion is retained. We cannot exclude that this is due to an interstitial chromosomal deletion or to a more complex rearrangement, but if MET maps at the breakpoint in der(7), then the 3' end of the MET transcription unit should be oriented towards the centromere. We also show that other DNA restriction fragment length polymorphism markers tightly linked with the inheritance of cystic fibrosis are deleted on der(7). PMID- 3282235 TI - In vivo double-strand breaks occur at recombinogenic G + C-rich sequences in the yeast mitochondrial genome. AB - An optional 46-base-pair G + C-rich element (GC cluster) in the coding region of the yeast mitochondrial var1 gene inserts preferentially in crosses into recipient alleles that lack the sequence. Unlike a similar gene conversion event involving the insertion of an optional 1143-base-pair intron, the mitochondrial 21S rRNA gene, which requires the action of a protein encoded by a gene within that intron, conversion of the var1 GC cluster does not require any protein product of the mitochondrial genome. We have detected double-strand breaks in the var1 gene in mitochondrial DNA isolated from unmated haploid rho+ and rho- strains at or near the boundaries of the optional GC cluster, as well as at a conserved copy of that sequence 160 base pairs upstream. No double-strand breaks were detected in the recipient var1 DNA molecules in the vicinity of the optional GC cluster target sequence. This contrasts with 21S rRNA-encoding DNA (rDNA) intron conversion where the recipient, but not the donor DNA, is cleaved at the element insertion site. These results suggest that although the 21S rDNA intron and the var1 GC cluster are preferentially inserted into their respective short alleles, these conversions probably occur by different mechanisms. PMID- 3282236 TI - Saturation mutagenesis of a yeast his3 "TATA element": genetic evidence for a specific TATA-binding protein. AB - The yeast his3 promoter region contains two distinct classes of "TATA elements," constitutive (TC) and regulatory (TR), that are defined by their interactions with upstream promoter elements, selectivity of initiation sites, and chromatin structure. TC is localized between positions -83 and -53, and TR is localized between positions -55 and -35, regions in which there are several TATA-like sequences. In this study, we used saturation mutagenesis to examine the structural requirements of the his3 TR element necessary for transcriptional induction. To avoid the complications of redundant elements, the phenotypic analysis was carried out by using a gal-his3 hybrid promoter whose function depends on a short oligonucleotide containing the prospective his3 TR element. In this context, an oligonucleotide containing the sequence TATAAA is sufficient for TR function. However, 17 out of the 18 possible single-base substitutions and 9 out of 10 double mutations of this sequence abolish TR function. This strict sequence requirement for TR function strongly suggests that the TR element is a target site for a sequence-specific DNA-binding protein. Further, as the region encoding TC and promoters of certain other yeast genes do not contain a sequence that is compatible with TR function, we suggest that yeast cells contain multiple proteins with distinct sequence specificities that carry out a related "TATA function" and that yeast promoters can be divided into classes based on their downstream promoter elements. PMID- 3282237 TI - Mitotic sectored colonies: evidence of heteroduplex DNA formation during direct repeat recombination. AB - In yeast meiosis, ascosporal colonies are sometimes sectored for a marker--i.e., half the colony has one allele and half has the other. This is interpreted as replicative resolution of heteroduplex DNA (hDNA) formed as a recombination intermediate. We have looked for similar evidence of hDNA formation during mitotic recombination between two repeated sequences on the same chromosome. The two repeats, an ochre suppressor and a wild-type tRNA gene, are separated by plasmid DNA and the URA3 marker. Recombination between the repeats excises the URA3 gene and one copy of the repeat, leaving either the wild-type tRNA or the suppressor on the chromosome. A red/white color assay is used to distinguish between the two. We find that some colonies that have lost the URA3 gene are sectored for the suppressor. This suggests that hDNA is formed across the anticodon during the recombination event and then resolved by replication. The disruption of either of two genes involved in recombination and repair, RAD1 and RAD52, does not significantly alter the frequency of sectored colony formation during plasmid excision. PMID- 3282238 TI - Granulocyte-macrophage colony-stimulating factor enhances neutrophil function in acquired immunodeficiency syndrome patients. AB - We conducted a clinical trial of human recombinant granulocyte-macrophage colony stimulating factor (rGM-CSF) in leukopenic patients with acquired immunodeficiency syndrome (AIDS) and analyzed neutrophil function before, during, and after in vivo administration of rGM-CSF. Prior to GM-CSF infusion, AIDS patients' neutrophil superoxide generation and neutrophil antibody-dependent cell mediated cytotoxicity were enhanced normally by in vitro exposure to GM-CSF. Neutrophil phagocytosis and intracellular killing of Staphylococcus aureus were also normal in the majority of these patients. Two patients, however, had discrete neutrophil functional defects: one in phagocytosis and one in intracellular killing. During the period of GM-CSF infusion, these abnormalities were corrected. The number of circulating neutrophils increased in all patients treated with GM-CSF in a dose-dependent manner. Neutrophils produced in vivo in response to GM-CSF administration functioned normally and there was evidence for neutrophil priming and activation in vivo. We conclude that GM-CSF treatment of AIDS patients leads to the production of functionally active neutrophils, suggesting therapeutic potential for GM-CSF in the treatment of patients with impaired host defense. PMID- 3282239 TI - Immunohistochemical evidence for the derivation of a peptide ligand from the amyloid beta-protein precursor of Alzheimer disease. AB - A monoclonal antibody to a synthetic peptide consisting of residues 8-17 of the amyloid beta protein of Alzheimer disease was used in immunohistochemical studies to reveal binding sites for this peptide in vesicular elements in the islets of Langerhans of the pancreas and the zona reticularis of the adrenal gland. These binding sites may represent a specific membrane receptor. These results, together with similarities in structural features between the precursors for epidermal growth factor and beta protein, suggest that the beta-protein precursor may be processed to release an active peptide ligand rather than acting as a membrane receptor. In Alzheimer disease, abnormal processing of this active peptide precursor may result in the deposition of beta-protein amyloid fibrils in the brain. PMID- 3282240 TI - Platelet-derived growth factor gene expression in human atherosclerotic plaques and normal artery wall. AB - We previously demonstrated that the B chain of platelet-derived growth factor (PDGF-B) is transcribed in human atherosclerotic plaques, indicating that production of growth factors within plaques could occur during atherogenesis. However, since atherosclerotic plaques are composed of several cell types and three of these--macrophages, endothelial cells, and smooth muscle cells--can express the PDGF genes, the cell type responsible for PDGF gene expression was not clear. In the present study we explore further the expression of PDGF-A and B and identify transcriptionally active cell types. We assayed PDGF-A and -B mRNA levels in dissected fractions of carotid atherosclerotic plaques and normal artery and then sequentially rehybridized these blots with three cDNA probes that recognize cell type-specific markers: fms for macrophages, von Willebrand factor for endothelial cells, and smooth muscle alpha-actin for smooth muscle cells. In plaques, PDGF-A expression correlated with smooth muscle actin; PDGF-B expression correlated strongly with fms. PDGF-A expression correlated with smooth muscle actin. In normal vessel wall, PDGF-A expression was high in the media and again correlated with smooth muscle actin, whereas PDGF-B expression was high in the adventitia. Since transcripts from both PDGF genes are found in normal artery where cell turnover is very low, we suggest that PDGF gene expression does not necessarily function to produce smooth muscle cell proliferation. We propose that these genes may have an important nonmitogenic, maintenance function in normal arterial tissue and in the atherosclerotic plaque. PMID- 3282241 TI - Identification of a chromosomal gene controlling temperature-regulated expression of Shigella virulence. AB - Genes required for the full expression of Shigella virulence are on both the chromosome and a large virulence-associated plasmid. Expression of one or more virulence (vir) genes is temperature-regulated, wild-type strains being virulent (invasive) when grown at 37 degrees C but phenotypically avirulent (noninvasive) at 30 degrees C. A vir::lac operon fusion located on the virulence plasmid, which brings the lac genes under control of a temperature-regulated vir gene promoter, was used to select regulatory mutants constitutive for the Lac+ phenotype at the nonpermissive temperature. A transposon Tn10-induced mutant that was Lac+ at 30 degrees C and 37 degrees C was isolated, and the Tn10 insertion was transduced into a wild-type strain. The transductants all simultaneously became deregulated for virulence and invaded HeLa cells equally well at 30 degrees C and 37 degrees C. Other virulence-associated phenotypes were also deregulated and expressed at 30 degrees C. Southern hybridization with a probe for Tn10 determined the insertion to be on the chromosome. Fine mapping by transduction with phage P1L4 positioned the mutation between the galU and trp genes. A cosmid cloned fragment of Shigella chromosomal DNA containing the region around galU was used in complementation studies and showed that the closely linked regulatory gene was able to complement, in trans, the Tn10-induced mutation. We propose that this mutation defines a regulatory gene, virR, and that insertion of Tn10 into this gene inactivates a repressor that normally blocks expression of vir genes at 30 degrees C. PMID- 3282242 TI - A simple prostaglandin bioassay based on smooth muscle preparations from the human oviduct. AB - A simple bioassay for the detection of PGE2, PGF2 alpha and PGI2 was developed by the use of smooth muscle preparations from the human oviduct. The circular muscle layer showed opposite responses to PGE2 and PGF2 alpha while the tubal artery was expedient to distinguish PGE2 from PGI2. As compared to earlier described PG bioassays the system showed a high sensitivity and the limit for detection of an unknown sample was approx. 1 ng. Also combinations of PGs could be identified when reference samples were administered parallel to the unknown samples. It is suggested that the described PG bioassay when further developed may be advantageous for certain purposes since the tissue material generally can be obtained at routine gynecological operations, thus avoiding the use of laboratory animals. PMID- 3282243 TI - The pulmonary surfactant system: biochemical aspects and functional significance. PMID- 3282244 TI - Regulation of gastrointestinal mucosal growth. PMID- 3282246 TI - Inhibin. AB - Inhibin has been defined as a gonadal hormone that exerts a specific negative feedback action on the secretion of FSH from the gonadotropic cells of the pituitary gland. The existence of inhibin was postulated as early as 1923 (250). However, only after reliable and sensitive bioassay systems for the detection and estimation of inhibin had been developed and an ample source of inhibin was found in the form of ovarian follicular fluid has progress been made in the isolation and characterization of the hormone. It is apparent now that inhibin, which itself consists of a dimer of two different subunits, alpha and beta, is a member of a much larger family of (glyco)protein hormones and growth factors, which also includes Mullerian-inhibiting substance, transforming growth factor-beta, erythroid differentiation factor, an insect protein that plays an important role in differentiation, and the dimer of two inhibin beta-subunits, activin. The latter substance was reported to counteract the effects of inhibin in pituitary cells. Interactions between these regulatory substances will certainly be a field of major interest in the near future. Inhibin molecules, similar to those in the gonads, have been detected in placental tissue as well. The postulate of inhibin in seminal plasma, prostate, and gastric juice is apparently due to detection of substances that differ from gonadal inhibin. Most likely these substances, the amino acid sequences of which have been elucidated, have a biological function that differs from the suppression of peripheral levels of FSH in vivo. Inhibin is produced in the Sertoli cells in the testis and in the granulosa cells in the ovary. The production of inhibin is stimulated by FSH, but presently a lot of controversy exists about other factors that might play a role in the regulation of the production of inhibin. Because of the lack of reliable methods for estimation of peripheral levels of inhibin in humans and experimental animals, almost all evidence for the physiological importance of inhibin in the regulation of reproductive processes is derived from circumstantial evidence. From these indirect results, it appears likely that inhibin plays an important role in the feedback regulation of peripheral concentrations of FSH during the period in which Sertoli cells and granulosa cells, the target cells for FSH, divide, i.e., during puberty in male animals and during the development of ovarian follicles in female animals.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3282247 TI - [Community nursing in the country]. PMID- 3282245 TI - Senescence of red blood cells: progress and problems. PMID- 3282248 TI - [Romana Siwicka-Bielobradek]. PMID- 3282249 TI - Burn wound management: an update. PMID- 3282250 TI - Neonatal brain: color Doppler imaging. Part I. Technique and vascular anatomy. AB - Color Doppler imaging (CDI) can demonstrate the relative direction and velocity of blood flow in color, superimposed on a conventional gray-scale ultrasound image that depicts stationary tissue. Twenty-five infants were studied with portable CDI in the coronal, sagittal, and axial planes. Bilateral antegrade flow was noted in the anterior, middle, and posterior cerebral arteries in all patients. Multiplanar CDI can image flow in the circle of Willis and its tributaries and branches. PMID- 3282251 TI - Neonatal brain: color Doppler imaging. Part II. Altered flow patterns from extracorporeal membrane oxygenation. AB - Extracorporeal membrane oxygenation (ECMO), a lifesaving procedure in neonates with severely impaired lung function, requires ligation of the right common carotid artery. In an investigation of the collateral pathways that maintain perfusion of the brain after right common carotid artery ligation, ten infants were studied with color Doppler imaging during and after ECMO. The circle of Willis was seen in all infants, and in every case there was retrograde flow in the distal internal carotid artery and the proximal (A1) segment of the anterior cerebral artery. Bilateral flow in the middle cerebral arteries and in distal branches of the anterior cerebral arteries was also seen, documenting flow to both cerebral hemispheres. PMID- 3282252 TI - Follow-up studies of multicystic dysplastic kidneys. AB - Thirty cases of multicystic dysplastic kidney (MCDK) were diagnosed over 11 years. Nine patients underwent nephrectomy: three for increasing kidney size (classic MCDK) and six because of an inconclusive diagnosis (hydronephrotic MCDK). Of the remaining 21 patients, 19 were followed up for a mean of 33.5 months (range, 2-101 months). Follow-up ultrasound examinations revealed that 16 kidneys did not change in size, one decreased in size after cyst puncture, and two disappeared (one after cyst puncture). This series included one case of non renin-producing hypertension that was controlled medically, one case of nephroblastomatosis found in the removed dysplastic kidney, and one case of pyelonephritis in the contralateral kidney. When the diagnosis of classic MCDK is made with imaging modalities, the lesion may not have to be removed unless there is growth of the mass during the 1st year of life. Nine percent of these lesions will disappear within the first 3 years of follow-up, and the authors recommend an even longer period of follow-up. PMID- 3282254 TI - Pancreatic neoplasms: how useful is evaluation with US? AB - The usefulness of ultrasonography (US) in the evaluation of pancreatic neoplasms was assessed in 51 patients. Indications for US included jaundice (n = 19), pain (n = 16), weight loss and anorexia (n = 4), clinically palpable mass (n = 3), bleeding in the upper gastrointestinal tract (n = 1), and gastric outlet obstruction (n = 1). Three patients were investigated because of a previous abnormal US examination; in four the mass was an incidental observation. Sonograms were interpreted without knowledge of results from other procedures. Pancreatic masses were detected in 50 patients. Biliary and pancreatic duct obstructions were seen in 29 and 27 patients, respectively. Liver metastases were identified in 16 patients and missed in three that were not detected with either US or computed tomography. Vascular involvement was predicted in 12 patients and missed in four, while lymphadenopathy was seen in 16 and missed in five. Thirty one cases of unresectable disease were correctly predicted with US. Resectability was not as accurately determined; only seven of 19 "resectable" lesions were successfully removed. US is an effective tool in the detection and preoperative evaluation of pancreatic malignancy. PMID- 3282253 TI - Acute appendicitis: sonographic criteria based on 250 cases. AB - Two hundred and fifty consecutive patients with suspected appendicitis were examined with graded compression sonography. The initial diagnostic criterion for appendicitis was visualization of a noncompressible appendix; this was later modified to include the dimensions of the visualized appendix. The appendix was visualized in 91 of 250 patients (36%). Five adult patients with sonographically visible appendixes that were 6 mm or less in maximal diameter had either benign clinical follow-up (three patients) or a histologically normal appendix removed at surgery (two patients). However, two patients with appendixes measuring 6 mm in diameter and multiple appendicoliths had surgically confirmed acute appendicitis. Of 84 patients with visible appendixes measuring greater than 6 mm in maximal diameter, 78 had surgically confirmed acute appendicitis. In the remaining six, symptoms resolved spontaneously, and no surgery was required. In the absence of compelling clinical findings or an appendicolith, adult patients with maximal appendiceal diameters of 6 mm or less should undergo a period of close observation rather than immediate surgery. A diagnosis of appendicitis can be made in adult patients with persistent right lower quadrant pain and a visualized appendix greater than 6 mm in diameter. PMID- 3282255 TI - Biliary complications after liver transplantation in patients with preexisting sclerosing cholangitis. AB - To determine if biliary complications after liver transplantation are more frequent in patients with preexisting sclerosing cholangitis and to clarify the role of interventional procedures in this setting, the authors reviewed all 40 adult cases in which liver transplantation was performed at their institution over a 3 1/2-year period. Biliary complications, particularly strictures at the choledochojejunostomy and debris in the intrahepatic and common ducts, were seen in six of ten liver transplant patients (60%) with preexisting sclerosing cholangitis; this is six times the frequency of biliary complications seen in other adult recipients (10%). Biliary complications were definitively diagnosed and managed with interventional radiologic procedures. Obstruction due to anastomotic strictures required treatment with balloon dilation in all six of the affected patients. Obstructive biliary complications occur in many liver recipients with preexisting sclerosing cholangitis. These complications require aggressive radiologic assessment and intervention but to date have not adversely affected survival. PMID- 3282256 TI - Nonpalpable breast lesions: recommendations for biopsy based on suspicion of carcinoma at mammography. AB - Carcinoma was found in 30% (119 of 400) of biopsy specimens obtained for mammographically suspicious but nonpalpable findings. The authors reviewed the mammograms of these 400 cases without knowledge of the biopsy results and placed each examination into one of four groups based on their suspicion for carcinoma: minimal (n = 82), slight (n = 91), moderate (n = 174), and high (n = 53). In 127 cases, mammograms showed either minimally suspicious calcifications (n = 33) or minimally (n = 49) or slightly (n = 45) suspicious masses. A 4.7% (six of 127) rate of carcinoma was found in these groups; five of the six cancers were in situ. Had follow-up mammography been done rather than biopsy for these 127 less suspicious lesions, it is probable that the delay in diagnosis would not have altered overall prognosis. In the remaining 273 patients, the positive predictive value of mammography for carcinoma would have risen from 30% (119 of 400) to 41% (113 of 273). The authors conclude that in the management of suspicious nonpalpable mammographic findings, the rate of carcinoma for lesions at biopsy can approximate 40%. This is almost double the rate of most published series. PMID- 3282257 TI - Upper lobe lung disease: physiologic correlates. Review. AB - Preferential localization of pathologic conditions in the upper lobes of the lung might seem unexpected, considering that both blood flow and ventilation predominate in the lower lobes. The erect lung is marked by striking regional non uniformity in perfusion, ventilation, lymphatic flow, metabolism, and mechanics. These regional disparities form the foundation for a physiologic approach to the evaluation of diffuse lung disease. The pathologic-physiologic correlations in apical lung disease are examined, and a differential diagnosis is offered. Analysis of diffuse lung disease on the basis of radiologic-physiologic correlation is suggested as an aid in radiographic interpretation. PMID- 3282258 TI - Early diagnosis of nonviable pregnancy with endovaginal US. AB - The mean diameter of the gestation sac and the presence or absence of a yolk sac or embryo and/or cardiac pulsations on endovaginal ultrasound (US) images were correlated with normal and abnormal outcomes of pregnancy. Sixty-two patients who were less than 10 weeks pregnant (menstrual age) underwent endovaginal US. In 59 patients with gestation sacs greater than or equal to 8 mm, the absence of a yolk sac predicted a nonviable pregnancy with a sensitivity of 67% and a specificity of 100%. In 35 patients with gestation sacs greater than or equal to 16 mm, the absence of an embryo predicted a nonviable pregnancy with a sensitivity of 50% and a specificity of 100%. When the absence of cardiac pulsations was added to the latter group of patients, the sensitivity was 100% and the specificity was 100%. The combination of these criteria (gestation sac size; demonstration of yolk sac, embryo and/or cardiac pulsations) enabled the early (less than 10 weeks menstrual age) diagnosis of a nonviable pregnancy with endovaginal US. PMID- 3282260 TI - Ultrasound: the stethoscope of the future, alas. PMID- 3282259 TI - Abnormalities of fetal cranial contour in sonographic detection of spina bifida: evaluation of the "lemon" sign. AB - Previous reports have shown that visualization of the "lemon" sign on fetal cranial sonograms may indicate the presence of spina bifida before 24 weeks. To further characterize this sign and determine whether other factors might be associated with it, the authors retrospectively (n = 31) and prospectively (n = 19) evaluated 50 fetuses with spina bifida. The lemon sign was noted in 32 (64%), including 24 of 27 (89%) fetuses evaluated before 24 weeks. The presence of both ventricular dilatation, found in 41 (82%) of the fetuses, and a lemon sign correctly predicted spina bifida in all but one case. The location of the spinal defect and other anomalies were not associated with the lemon sign. The lemon sign is an important indicator of spina bifida, particularly in high-risk pregnancies, and should improve sonographic detection of spina bifida before 24 weeks. PMID- 3282261 TI - Double-blind study of a new nonionic contrast agent for cardiac angiography. AB - A randomized, double-blind study of a new nonionic contrast agent (ioversol) was performed in 80 patients undergoing routine coronary angiography and left ventriculography. Its hemodynamic and electrocardiographic (ECG) effects were compared with those of a conventional ionic contrast agent (sodium meglumine diatrizoate). There were 40 patients in each group. The radiographic quality and incidence of adverse reactions were comparable for both agents. Following left ventriculography, there was a smaller decrease in systemic and left ventricular systolic blood pressure and a smaller increase in heart rate and pulmonary artery systolic pressure (P less than .05) with ioversol than with meglumine diatrizoate. There was also a slight decrease in cardiac output with ioversol at 1 and 3 minutes after left ventriculography, while meglumine diatrizoate produced a modest increase. In selective coronary angiography, the fall in diastolic blood pressure was also greater (P less than .05). The Q-T interval was more prolonged with meglumine diatrizoate. Ioversol appears to be both safe and efficacious for cardiac angiography, causing fewer and less severe hemodynamic and ECG alterations than meglumine diatrizoate. PMID- 3282262 TI - Pancreatic pseudocysts drained through a percutaneous transgastric approach: further experience. AB - Percutaneous transgastric placement of a drainage catheter under ultrasonographic and fluoroscopic guidance was performed in 12 patients with pancreatic pseudocysts. Complete resolution of the pseudocysts was obtained in eight patients, and the result was indeterminate in one patient due to early death from unrelated causes. Surgical intervention followed in two patients, one with a multiloculated pseudocyst that was incompletely drained and another with a pseudocyst that became infected following drainage. In one patient with metastatic tumor to the head of the pancreas the pseudocyst resolved initially, but a pseudocyst later recurred. There were no pancreaticocutaneous fistulas or other major complications. The transgastric route of pseudocyst drainage is safe and effective, and it offers a low risk of recurrence and fistula formation. PMID- 3282263 TI - Duodenal perforation as a delayed complication of placement of a biliary endoprosthesis. AB - Duodenal perforation may occur at the time of insertion of a biliary endoprosthesis or following endoscopic manipulation of such a stent. The possibility of perforation as a late sequela of stent migration, after percutaneous placement of an endoprosthesis, however, has not been emphasized. In the authors' experience with a 12-F soft-stent endoprosthesis, duodenal perforation occurred in four of 50 patients following initially satisfactory stent placement. One intraperitoneal perforation necessitated immediate surgical intervention. The three retroperitoneal perforations were treated conservatively. PMID- 3282264 TI - Tendon echogenicity: ex vivo study. AB - Recent publications discussing the echogenicity of normal tendon have described it variously as hyperechoic or hypoechoic. Since the echogenicity of tendon has been used to define normality and abnormality, certain knowledge of the normal echogenicity of tendon is crucial. Fresh tendon and muscle from beef hock was scanned with sector- and linear-array-transducer imaging at multiple angles and distances. The echogenicity of tendon was found to be very angle-dependent, a characteristic known as anisotropy. Scanned perpendicular to its long axis with a linear-array transducer, tendon was significantly more echogenic than muscle. With a change in angle, echogenicity of tendon decreased relative to that of muscle (the echogenicity of muscle remained the same), becoming isoechoic at angles of 2 degrees -7 degrees and hypoechoic at greater angles. Tendon studied with a sector transducer exhibited varying echogenicity. If echogenicity is used as a diagnostic criterion, the angle of the interrogating ultrasound beam must be very specifically defined. PMID- 3282265 TI - Fixed intravascular foreign bodies: a new method for removal. AB - Percutaneous removal of centrally located, embolized, intravascular foreign bodies is essential. A technique was developed to shift fixed foreign bodies into a position where they may be grasped and eventually removed with a snare or Dormia basket. It involves insertion by bilateral femoral vein puncture of a curved-end catheter and a second catheter attached to a Dormia basket set. A wire passed through the first catheter is grasped with the Dormia basket, and the foreign body is mobilized by means of traction on both catheter systems. PMID- 3282266 TI - The "lemon" sign: a clinical perspective. PMID- 3282267 TI - Predictive value, sensitivity, and specificity in breast cancer screening. PMID- 3282268 TI - [Functions of heat shock proteins, HSP 70 and HSP 90 in higher eucaryotes]. PMID- 3282269 TI - [Molecular and metabolic aspects of renin]. PMID- 3282270 TI - [Import of mitochondrial proteins--its machinery and their conformational changes]. PMID- 3282271 TI - [Echography in jaundice caused by primary neoplasms of the bile ducts]. AB - A retrospective study is reported, carried out on 45 patients with primary carcinoma of the biliary tree. The purpose of the study was to test the effectiveness of US in accurately demonstrating the kind of jaundice (diagnostic level I), the site (diagnostic level II) and etiology of the biliary obstruction (diagnostic level III). A carcinoma of the gallbladder with common bile duct infiltration was found in 23 patients, while 22 were affected by primary bile duct carcinoma. In the 23 patients with carcinoma of the gallbladder, the kind of jaundice was correctly diagnosed in 100% of cases, while the site and cause of obstruction were detected in 18 (78%) and 10 (43%) cases respectively. In the 22 cases of primary bile duct carcinoma, the kind of jaundice was accurately demonstrated in 21 cases (95%); the site and etiology of the obstruction in 19 (86%) and 11 (50%) patients respectively. Therefore, in a total number of 45 patients examined, success rate was 98% in diagnostic level I, 80% in diagnostic level II, and 47% in diagnostic level III. Ultrasonography proves thus to be almost completely reliable in diagnostic level I, and very reliable in diagnostic level II; so much so that it can, alone, direct the surgeon in case of an emergency. Results are less satisfactory in diagnostic level III. Therefore, if details of the obstructive lesion and of the biliary tree are required for the planning of definitive treatment, either PTC, ERCP, or CT should be performed. PMID- 3282272 TI - [Abnormalities of the female genital tract. Comparison of radiographic and echographic pictures]. AB - An anatomical study of uterine malformations has become quite frequent in obstetrics and gynaecology because of the increasing use of corrective surgery. More than 100 cases were reviewed and the authors discuss some examples in order to present all kinds of uterine malformations which can be detected by ultrasound together with hysterosalpingography. A comparison of the diagnostic data obtained with the two methods shows US to be able to solve several cases. Hysterosalpingography is mandatory in female infertility when there is a need for examining Fallopian tube patency in addition to the morphological characteristics of the uterine cavity. The results obtained with the two methods in the study of uterine malformations allow the formulation of a diagnostic protocol concerning the study of infertile women. First of all, US must be performed, in order to exclude some causes of ovarian infertility and major uterine malformations. Hysterosalpingography should be performed when US does not prove to be totally reliable. PMID- 3282273 TI - [Has echography modified the occurrence of kidney carcinoma? Considerations on 316 cases]. AB - An analysis of 316 renal carcinomas over an 11-year period has shown an increase in the incidence of tumors per year, together with a progressive decrease in the size of the lesions at the time of diagnosis. This effect occurred especially after the introduction of renal ultrasonography in diagnostic practice. The tumor size is an important prognostic factor, because the 5-year survival rate was 80% for tumors less than 5 cm and 30% for tumors greater than 10 cm. Ultrasonography might thus represent a screening method for renal carcinoma in patients over 50 years of age, if it were possible to define risk groups. PMID- 3282274 TI - [Role of computerized tomography and ultrasonic diagnosis in adrenal neoplasms with an adipose matrix]. AB - Ten cases of adrenal lipomatous tumors discovered incidentally with ultrasounds (US) and computed tomography (CT) during examinations for the staging of malignant tumors are reported. Transparietal bioptic approach and surgery revealed three histologic diagnosis: non-functioning adenomas, lipomas and myelolipomas. Those findings confirmed that adrenal tumours with low density are mainly benign; but in neoplastic patients biopsy and surgery are still mandatory. PMID- 3282275 TI - [Ultrasonic evaluation of primary hyperparathyroidism]. AB - The authors evaluated the diagnostic reliability of echotomography in detecting parathyroid masses: 37 patients were studied with primary hyperparathyroidism, in four cases recurrent. They all underwent surgical ablation of the mass, identification of all glands, and biopsy of an apparently normal parathyroid. Echotomography was accurate in 91.4% of cases: it identified 27 out of 39 pathological glands (sensibility 69.2%) and gave no false-positive results (specificity 100%). Since parathyroid is often ectopic, oblique scans are suggested, i.e. of jugulum while the patient is swallowing. Such scans were always used in our study, in order to identify lesions even in case of "difficult" locations, such as the superior mediastinum. PMID- 3282276 TI - [Diagnosis by imaging of the adrenal gland]. PMID- 3282277 TI - [A case of malignant gastro-colonic fistula. Diagnostic contribution of echography]. PMID- 3282278 TI - [Echographic diagnosis of duodenal stenosis caused by the aorto-mesenteric arch]. PMID- 3282279 TI - [Combined intra- and extra-uterine pregnancy. Echographic study of a case]. PMID- 3282280 TI - [Renal extra-bone marrow erythropoiesis. Correlations, echography and computerized tomography in a case]. PMID- 3282281 TI - [Metastatic melanoma of the gallbladder. Preoperative ultrasonographic documentation]. PMID- 3282282 TI - [Jaundice in the young adult. Carcinoma of the colon with hepatic metastasis and obstructive jaundice]. PMID- 3282283 TI - [Organization of the genome of the retroviruses]. PMID- 3282284 TI - [Osteoporosis: a disease pending definition]. PMID- 3282286 TI - Effect of cortical and subcortical stimulation on human language and verbal memory. PMID- 3282287 TI - What is and is not universal in language acquisition. PMID- 3282285 TI - [Pneumonias and plasma osmoregulation]. PMID- 3282288 TI - Language development: a sensory development and signal processing perspective. AB - The relationship between the development of sensory mechanisms and the maturation of language behavior is poorly understood. From the outset it is important to distinguish between what is necessary for the development of any language system versus what is involved in the development of the verbal language system in the unimpaired child. The presence of highly sophisticated language systems among persons who communicate manually reminds us that no single source of sensory information is absolutely required for the development of at least some form of language system. Nevertheless, there persists a general belief that the availability of an accurate representation of the acoustic environment will facilitate at least the normal process of language acquisition. A more tenable question is whether the completeness or accuracy of the sensory representation places limitations on the emergence of language comprehension and production. I think this is unlikely, unless the relatively untested area of the maturation of "nonlinear processing mechanisms" provides information different than that obtained from more traditional linear systems analysis approaches. The relative integrity of the language systems of the hearing impaired, despite very dramatic differences in auditory sensitivity and frequency-resolving power, argues strongly that whatever mechanisms account for language organization are relatively immune to significant alterations in sensory input. Caution must be exercised here, however, since these comments generally refer to the outcome of studies performed on persons with acquired hearing loss. Naturalistic or descriptive studies of patients with congenital hearing loss are always susceptible to the criticism that whatever agent or agents produced the sensory impairment may also have produced concomitant impairment of nonsensory mechanisms. Nevertheless, comparisons of young infants and hearing-impaired adults, with respect to behavioral studies, suggest that there is a sufficiently rich sensory representation of the acoustic environment to permit the development of language skills much earlier than they naturally emerge. Electrophysiologic comparisons of human newborns and adults also suggest that the diminished auditory sensitivity and alterations in the frequency contour of sensitivity are insufficient to explain age differences in language comprehension and production performance. It may well be that the brain mechanisms responsible for the establishment of language behavior are sufficiently flexible to accommodate even a greatly impoverished sensory representation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3282290 TI - Effect of drug administration on experimental renal glomerular thrombosis. AB - Experimental thrombosis which developed exclusively in glomerular capillary walls was induced in rats by the combined injection of nephrotoxic antiserum (0.2 ml of pooled material) as a preparatory agent and 20 micrograms or more of lipopolysaccharide as a provoking agent. Effects of some antiplatelet and anticoagulant drugs on the glomerular lesions were tested in this experimental glomerular thrombosis. With administration of 2000 units/kg or more of heparin at the time of provoking injection, coagulation time was prolonged for over 5 hr, and the glomerular thrombosis was adequately prevented. Prolongation of prothrombin time (PT) for over 60 sec to prevent thrombosis required warfarin, but with this drug there was only a narrow margin between an effective dose and that which produced a fatal hemorrhage. Low levels of fibrinogen (less than 50 mg/dl) induced by batroxobin seemed to protect partially and high doses of urokinase did not seem to protect from glomerular thrombosis. OP-41483, a derivative of prostacyclin which is about five times more active than PGE1 in inhibiting platelet aggregation, and other anti-platelet drugs except for ticlopidine were not effective in preventing glomerular thrombosis. These findings were in accordance with the fact that thrombocytopenia induced by antiplatelet antiserum did not prevent glomerular thrombosis. Ticlopidine may have a unique and valuable therapeutic potential for the control of this condition. PMID- 3282289 TI - Contextual effects in language comprehension: studies using event-related brain potentials. PMID- 3282291 TI - Immunoassay detection of drugs in racing horses. III. Detection of morphine in equine blood and urine by a one step ELISA assay. AB - A one step enzyme-linked immunosorbent assay (ELISA) test for morphine was evaluated as part of a panel of pre- and post-race tests for narcotic analgesics in racing horses. This ELISA test is very sensitive to morphine with an I-50 for morphine of about 400 pg/ml. The test is also rapid, and ten samples, a normal pre-race complement, can be analyzed in about thirty minutes. The test can be read with an inexpensive spectrophotometer, or even by eye. The test readily detects the presence of morphine or its metabolites in equine blood for up to six hours after administration of sub-therapeutic doses. The antibody also cross reacts with hydromorphone, orymorphone, nalorphine, levorphanol, and codeine, and the test either can detect or is likely to detect these drugs in blood or urine shortly after their administration to horses. As such this test is capable of dramatically improving the speed and efficacy of both pre-race and post-race testing for morphine and its congeners in racing horses. On initial introduction into post-race urine screening this test flagged 18 of 166 samples positive for opiates, and 13 of these samples were confirmed positive for opiates by mass spectrometry. PMID- 3282292 TI - [Brain death]. PMID- 3282293 TI - [Intestinal transplantation. Review of the literature]. PMID- 3282294 TI - [Current viewpoints in immunological studies on rheumatic disorders]. PMID- 3282295 TI - The intrinsic organization of the ventroposterolateral nucleus and related reticular thalamic nucleus of the rat: a double-labeling ultrastructural investigation with gamma-aminobutyric acid immunogold staining and lectin conjugated horseradish peroxidase. AB - An electron-microscopic investigation of the synaptic organization of the rat's ventroposterolateral nucleus (VPL) and of a reticular thalamic nucleus (RTN) area related to somatosensory thalamic nucleus was performed. In a group of 11 rats, wheatgerm agglutinin conjugated to horseradish peroxidase (WGA:HRP) was injected either in the first somatosensory area of cortex (SI) or in the dorsal column nuclei (DCN). The retrogradely and/or anterogradely transported enzyme was visualized using paraphenylenediamine-pyrocatechol (PPD-PC) as substrate. In a second series of six experiments, an immunocytochemical procedure using a specific anti-gamma-aminobutyric acid (anti-GABA) was employed. Postembedding localization of GABA was performed for ultrastructural observation by means of the colloidal gold immunostaining procedure. Thin sections of recognized VPL and RTN areas from WGA:HRP-injected animals were further processed for immunocytochemistry in order to localize simultaneously, at the electron microscopic level, the transported enzyme and GABA. The results obtained with this procedure demonstrated that HRP-labeled terminals from DCN contacted the soma and proximal dendrites of VPL neurons, while the terminals labeled after SI cortical injections were predominantly localized to the distal portion of the dendrites. The same cortical injection also determined the presence of labeled synaptic boutons contacting the soma, and both proximal and distal dendrites of RTN neurons. GABA-immunolabeled terminals were observed in VPL in a number larger than those observed with other methods, since not only typical F terminals were labeled but also terminals containing round and/or pleomorphic vesicles. GABA ergic terminals contacted the soma and the proximal and distal dendrites of VPL neurons, while in RTN cells they made synaptic contact mainly with the soma and proximal dendrites. In the double-labeling experiments, terminals containing both HRP and specific immunogold GABA staining were never observed. The present data provide a direct demonstration of the presence of a strong inhibitory input from RTN upon VPL neurons and of the existence of autoinhibition within RTN neurons. PMID- 3282296 TI - Spinal and trigeminal projections to the parabrachial nucleus in the rat: electron-microscopic evidence of a spino-ponto-amygdalian somatosensory pathway. AB - The fine structure of spinal and trigeminal projections to the parabrachial area (PB) of the rat was studied using either the anterograde transport of a lectin peroxidase conjugate or the degeneration technique. Two morphologically different types of terminals were observed. Most labeled terminals contained round vesicles (R type) and formed asymmetrical synapses, usually with large dendrites. Others contained pleomorphic vesicles (P type) and usually made symmetrical contacts with large or medium-size dendrites. A double-labeling strategy was used, combining the retrograde labeling of PB neurons with lectin-peroxidase conjugate from the amygdala and the identification of degenerating terminals after lesions of spinal or trigeminal pathways. These experiments demonstrated that spinal and trigeminal terminals contact PB neurons that project to the central nucleus of the amygdala. The role of this spino(trigemino)-ponto-amygdalian pathway is discussed in relation to some aspects of pain. PMID- 3282297 TI - [Ultrasonically guided percutaneous nephrostomy--indications and technic]. PMID- 3282298 TI - [Thoracobrachial outlet syndrome. Apropos of 21 surgical cases of a neurological form]. AB - The authors review the literature in reference to 21 cases of thoracic outlet syndrome, essentially of neurological nature. The diagnostic means are essentially clinical with various techniques demonstrating vascular and neurological signs. They stress the advantages of electromyography in normal position or in abduction, showing in half of the cases, positive signs. Finally, X-ray examination demonstrates a congenital bony abnormality. In severe forms resisting to neurological treatment, the treatment advocated is surgery. The approach is high supra clavicular, and the brachial plexus is freed, on request, from the bony, musculotendinous and/or fibrous elements compressing it. Long-term results are usually good and the authors have noticed the correlation between the immediate post-operative disappearance of the pain and the final result. PMID- 3282300 TI - [A case of rheumatoid polyarthritis with infection of the knee due to Streptococcus B]. PMID- 3282299 TI - [Spondylodiscitis due to Streptococcus B]. PMID- 3282303 TI - Trace element analysis in biological materials. Dedicated to Professor John Michael Ottaway. Presented at a symposium, Toronto, Canada, 6-9 October 1986. PMID- 3282301 TI - [Chlamydia diagnosis in clinical practice. Chlamydia trachomatis EIA and direct immunofluorescence (MikroTak) in comparison with cell culture]. AB - The correct obtaining of material is decisive for microbiological diagnosis. The new immunologic methods, enzyme immunoassay (Chlamydiazyme) and the direct immunofluorescence with monoclonal antibodies (MikroTrak) for the detection of Chlamydia trachomatis have several advantages over cell culture. In 457 tests of urethral smears from men with all 3 methods, sensitivity and specificity were compared with cell cultures as method of reference. Tests with Chlamydiazyme yielded a concordance of 87.1%, a sensitivity of 81.5% and an specificity of 87.8%. Tests with MikroTrak were almost identical with a concordance of 86.9%, a sensitivity of 81.3% and a specificity of 87.5%. With both methods, the positive predictive value with 43.8% and 43.3% respectively is low. Frequent positive results with the immunological methods, which could not be verified by cell cultures, must be interpreted as failure of the culture method under practice conditions. The correlation of results with the clinical course supports this assumption. PMID- 3282302 TI - [Campylobacter pylori, gastritis and ulcer disease. Microbiological, histological and serological studies]. AB - In a prospective study of 70 patients with epigastric pain, gastroduodenoscopy revealed gastric and/or duodenal ulcers in a total of 41 and no ulceration in the remainder. Biopsies were taken to assess the severity of gastritis and the presence of Campylobacter pylori (CP) by histology and culture. Gastritis was found in 54 patients. CP was detected in 78% of the ulcer patients and 52% of the patients without ulcer (p less than 0.05). CP was demonstrated in 83% of the histologically diagnosed cases of gastritis (all grades) but no CP was detectable in patients with normal gastric mucosa. Among the ulcer patients, CP was more frequent in those with no history of medication with nonsteroidal antiinflammatory drugs (p less than 0.01). Sera from CP-positive ulcer and gastritis patients have significantly higher levels of IgG antibodies to CP than sera from those found to be free of ulcer or gastritis. In 200 blood donors an increasing percentage of elevated CP-antibody titres were found with advancing age (50% over 60 years of age). Quantification of circulating CP antibodies, would thus seem a valuable adjunct in the diagnosis of gastritis and probably also of peptic ulcer. The data presented furnish further evidence of the high rate of association of CP and the gastritis-peptic ulcer complex. PMID- 3282304 TI - Contributions to biological analysis by atomic spectrometry--a summary of the achievements of Professor John Michael Ottaway. AB - John Ottaway was the Head of the Analytical Chemistry Research Group at the University of Strathclyde for almost 20 years and during that period much of the research performed by the Group was devoted to the development of improved analytical procedures for the determination of trace metals in clinical and biological samples. Although this was only one aspect of the Group's activities in analytical chemistry, a number of significant contributions were made in the clinical field and a summary of Professor Ottaway's achievements is given in this brief review. The techniques covered include electrothermal atomisation atomic absorption spectrometry (ETA-AAS), electrothermal atomisation atomic emission spectrometry (ETA-AES), furnace atomic non-thermal excitation spectrometry (FANES), continuum source atomic absorption spectrometry (CSAAS) and atomic fluorescence spectrometry (AFS). PMID- 3282305 TI - Phosphatidylinositol-glycan anchors of membrane proteins: potential precursors of insulin mediators. AB - BC3H1 myocytes release membrane-bound alkaline phosphatase to the incubation medium upon stimulation with insulin, following a time course that is consistent with the generation of dimyristoylglycerol and the appearance of a putative insulin mediator in the extracellular medium. The use of specific blocking agents shows, however, that alkaline phosphatase release and dimyristoylglycerol production are independent processes and that the blockade of either event inhibits the production of insulin mediator. These experiments suggest a new model of insulin action. PMID- 3282306 TI - Evidence from cassette mutagenesis for a structure-function motif in a protein of unknown structure. AB - The three-dimensional structure of most enzymes is unknown; however, many enzymes may have structural motifs similar to those in the known structures of functionally related enzymes. Evidence is presented that an enzyme of unknown structure [Ile-transfer RNA (tRNA) synthetase] may share a functionally important structural motif with an enzyme of related function (Tyr-tRNA synthetase). This approach involves (i) identifying segments of Ile-tRNA synthetase that have been unusually conserved during evolution, (ii) predicting the function of one such segment by assuming a structural relation between Ile-tRNA synthetase and Tyr tRNA synthetase, and (iii) testing the predicted function by mutagenesis and subsequent biochemical analysis. Random mutations were introduced by cassette mutagenesis into a ten-amino-acid segment of Ile-tRNA synthetase that was predicted to be involved in the formation of the binding site for isoleucine. Few amino acid substitutions appear to be tolerated in this region. However, one substitution (independently isolated twice) increased the Michaelis constant Km for isoleucine in the adenylate synthesis reaction by greater than 6000-fold, but had little effect on the Km for adenosine triphosphate, the apparent Km for tRNA, or the rate constant kcat. PMID- 3282307 TI - Independent molecular pathways in initiation and loss of hormone responsiveness of breast carcinomas. AB - These studies were set up to determine whether those oncogenes participating in the initiation of mammary carcinogenesis (for example, ras oncogenes) play a direct role in the outcome of events associated with the late stages of tumor development such as loss of hormone dependency. Mammary carcinomas induced by a single carcinogenic insult in pubescent rats was selected as an in vivo model system with direct relevance to human breast cancer. Acquisition of hormone independent growth in these carcinogen-induced tumors was found to be independent of the activation of ras oncogenes during the early stages of carcinogenesis. In agreement with these observations, introduction of a human ras oncogene into human MCF-7 breast carcinoma cells did not abrogate their hormonal dependency for growth in vivo. These findings suggest that those events responsible for the critical stages of breast cancer development occur independently and in an uncoordinated manner. PMID- 3282308 TI - Dyssegmental dysplasia in siblings: prenatal ultrasonic diagnosis. AB - Two cases of dyssegmental dysplasia (type Silverman-Handmaker) in siblings are presented. The first-born died at the age of 3 months and the second fetus was followed during pregnancy with ultrasound examinations. In the 20th week of gestation marked shortening of the extremities was found; a female infant showing the same radiologic bony malformations as the firstborn was born by cesarean section. These cases support the autosomal recessive inheritance and demonstrate the possibility of prenatal diagnosis in this type of micromelic dwarfism. PMID- 3282310 TI - Case report 460: Synovial chondrosarcoma of left knee. PMID- 3282309 TI - Giant cell tumor of the ischium. A report of two cases and review of the literature. AB - The ischium represents one of the rarest sites of giant cell tumor of bone. Two additional cases are presented here. The unusual site, aggressive appearance and occurrence in older individuals are suggestive of other primary and secondary malignancies. Characteristic features of giant cell tumor and current treatment options are reviewed. PMID- 3282311 TI - Health and the social power of women. AB - The relationship between women's social status and the survival chances of their children is explained and illustrated with examples. When women (and girls) have low status, relatively little social investment is made in them, and this is reflected in girls' and boys' differential mortality rates. Several health related social investment indicators are given, and matched against children's mortality patterns by ecological regions of Africa and Asia. The cultural propensity to invest in girls (nutrition, education, etc.) and their resultant survival chances, are explained by ecology which in past centuries has largely determined agricultural economies that either had a high demand for female labour or did not. In the former, women are more likely to control the wealth they produce and use it for transactions that put others in their social debt, thus growing in social power. Policy implications of planning and implementing primary health care in these different types of societies are explored. PMID- 3282312 TI - Doctors dispensing medications: contemporary India and 19th century England. AB - In developing countries the widespread use of medications in ways that are unsafe and inappropriate is a threat to health and a waste of scarce resources. It is possible that doctors contribute to the problem when, as in rural India, the doctor earns a living by selling medications rather than by charging a consultation fee and writing a prescription; the incentive is to medicate irrespective of the diagnosis. In this article, doctor-patient roles and paying for the doctor's services in a South Indian town are described. Similarities between the town and 19th century England in regard to doctor-patient roles are noted and analyzed. PMID- 3282314 TI - [Insulin (2)]. PMID- 3282313 TI - Adolescent pregnancy in Africa: a programmatic focus. AB - An increasing age of marriage coupled with high rates of premarital sexual activity have caused notable changes in the incidence of out-of-wedlock pregnancies in much of the developing world. In Africa, local policy makers are beginning to perceive the medical implications of these changes as the youth component of illicit abortion, maternal mortality, and sexually transmitted disease becomes more visible. Other social issues, which include school leaving, unemployment, violence and drug abuse, are emerging among the young people of Africa as elsewhere. A successful approach to these problems will require a multi disciplinary perspective of the adolescent with professional contributions from the arenas of health, behavior, education and sociology. This report stresses the thesis that adolescents constitute a unique sub-population whose special needs must be recognized in Africa; strong institutional facilities are required, backed by committed advocates and leadership for the youth sector. Programs initiated in Kenya and Zimbabwe serve as useful models for other African locales. PMID- 3282315 TI - [Independent practice yesterday and today]. PMID- 3282316 TI - Bleeding due to portal hypertension: the role of surgery. AB - Several therapeutic options are available to stop acute variceal bleeding or prevent its recurrence. Sclerotherapy has emerged as the optimal method for stopping acute bleeding, and as primary therapy for preventing recurrence. Surgery is required for the 30% to 40% in whom sclerotherapy fails. Selective variceal decompression has emerged as the best surgical option to balance bleeding control and maintenance of liver function. Survival is significantly improved at five years in nonalcoholic (75%) compared with alcoholic (45%) cirrhotic patients. Recent advances have modified the operative technique to better maintain portal perfusion. Total shunts stop bleeding, and may be used in emergencies. Devascularization procedures have a 20% to 40% rebleeding rate, but do not accelerate liver failure. Liver transplantation, which is increasingly indicated for patients with end-stage liver disease and variceal bleeding, is dictated by the degree of hepatic failure. To provide optimal patient care, a center should be able to offer all of the treatment methods. PMID- 3282318 TI - Coagulase-negative staphylococci. AB - Coagulase-negative staphylococci, long considered to be harmless commensals or contaminants, have emerged as major pathogens as medical technology has advanced. They are a major cause of intravenous-catheter-associated bacteremia, endocarditis, otitis media, and infection of joint prostheses, vascular grafts, cardiac pacemakers, cerebrospinal fluid shunts, postoperative wounds, the urinary tract, and the eye. Therapy includes removal of infected foreign bodies and administration of appropriate antimicrobial agents. PMID- 3282317 TI - Pneumonia due to Aeromonas hydrophila-complex: epidemiologic, clinical, and microbiologic features. AB - Review of published data examining the various types of infections produced by strains of the Aeromonas hydrophila-complex demonstrates a paucity of information on lower respiratory tract infections due to this organism. Although it is rarely cited as a cause of pneumonitis, we have been able to collect epidemiologic, clinical, and microbiologic data on eight patients who have had evidence of Aeromonas pneumonia. Interestingly, seven of the eight patients were male, and the average age for the group was 54.3 years. In contrast to reports showing a prevalence of other types of A hydrophila infections during the summer months, five of the pneumonitis cases occurred during late fall and early winter. Infections were both community-acquired and nosocomial. A proven or suspected history of aspiration was present in six patients. Preexisting medical conditions were noted in all patients, the majority having multiple predisposing factors, which included alcohol abuse and alcoholic liver disease, cardiovascular and cerebrovascular disease, and chronic lung disease. Three patients died of their acute pulmonary infection. Based on in vitro antimicrobial susceptibility testing, aminoglycoside therapy would seem appropriate in the treatment of these infections. PMID- 3282319 TI - Malignancy-induced lactic acidosis. AB - Lactic acidosis, a rare and usually fatal complication of malignancy, is defined as a clinical condition in which the pH is less than or equal to 7.35 and the serum lactate level greater than or equal to 5 mEq/L. We have described the clinical aspects of four cases of lactic acidosis associated with malignancy, and have reviewed all reported cases of lactic acidosis in malignancy meeting the criteria. Rapid recognition of the condition and prompt institution of chemotherapy led to reversal of lactic acidosis in three of our four patients, but long-term survival is related to the responsiveness of the underlying tumor. PMID- 3282321 TI - [Theoretical problems of medical science in the years of the establishment of Soviet rule]. PMID- 3282320 TI - Primary pericardial mesothelioma: diagnostic and therapeutic challenges in management. PMID- 3282322 TI - [The history of the periodical Salud Publica de Mexico]. PMID- 3282323 TI - [Moderate consumption of alcoholic beverages by pregnant women. An epidemiologic controversy]. PMID- 3282325 TI - [The placenta of undernourished mothers]. PMID- 3282324 TI - [Foci of perinatal research]. PMID- 3282326 TI - [Psychosocial support during the perinatal period. Conceptual and bibliographic review]. PMID- 3282327 TI - Smoking and health in South Africa. AB - In 1984 smoking rates among adults in South Africa were highest in coloureds (41.1%), followed by whites (34.9%), Asians (29.0%), and blacks (27.7%). With increased urbanisation, income, and education, black and coloured smoking rates are likely to rise. Current trends suggest that the proportion of smoking-related disease mortality and morbidity among coloureds and blacks will increase. Studies in South Africa and elsewhere have shown that smokers run an increased risk of coronary artery disease, lung, oesophageal, and cervical cancer, respiratory disease, gastrointestinal ulcers, and leukoedema. Non-smokers exposed to 'involuntary smoking' are also at risk, and smokeless tobacco is not a safe alternative to smoking. The evidence for smoking-induced health damage is so compelling that action against smoking is urgently needed. Surveys of smoking habits among specific groups show the importance of peer and role model example, and suggest guidelines for the targeting of health education. PMID- 3282328 TI - Smoking, oncogenes and human lung cancer. A review of recent laboratory evidence linking smoking and lung cancer. AB - Recent molecular genetic experiments conducted in the USA and The Netherlands have isolated specific mutations in human lung cancer cells. These data implicate the activation of the K-ras oncogene in the pathogenesis of adenocarcinoma of the lungs of heavy smokers and the deletion of DNA from the short arm of chromosome 3 in small-cell and non-small-cell carcinoma of the lung. The implications of these results are discussed and explained in the light of current DNA-manipulative technology which is now available in RSA. PMID- 3282330 TI - Computer assisted clinical decision making. PMID- 3282329 TI - [Radial keratotomy in perspective]. AB - Radial keratotomy is a surgical procedure to reduce or eliminate myopia. Advocates of radial keratotomy stress the dependence, inconvenience and restrictions of glasses or contact lenses. However, opponents of this procedure stress that invasive surgery on a healthy eye, regardless of the reason, is unethical. Candidates for radial keratotomy include adults with myopia between 2,00 and -8,00 diopters and who cannot tolerate contact lenses or glasses. The pre-operative evaluation and surgical techniques are briefly discussed. Complications of this procedure include sensitivity to glare, fluctuating vision, perforations, postoperative infections and corneal scarring. Overcorrections and undercorrections may also occur. It is shown that, although radial keratotomy is effective in the low-to-moderate myopia group, its effect in individual eyes is not totally predictable. PMID- 3282331 TI - AIDS and South Africa--towards a comprehensive strategy. Part I. The world-wide experience. AB - In this, the first of a three-part series of articles in which we propose steps towards a comprehensive strategy for the control of HIV infection, we consider briefly the world-wide experience with the HIV epidemic. Our objective is to highlight the problems and controversial issues which are pertinent to strategies for the control of HIV infection. We focus on problems of case-definition, differences between 'African' and 'Western' AIDS and the implications for South Africa, and problems with sensitivity and specificity of tests used at present, particularly in the context of false positivity in a community with a low prevalence of HIV infection. We consider some of the ethical issues, including the need for adequate counselling, the need for informed consent before testing, and the centrality of confidentiality, particularly in the context of possible victimisation and neglect of HIV-positive individuals. Differences between 'notification' and 'reporting' are emphasised. Recommendations are made regarding these problems. PMID- 3282332 TI - AIDS and South Africa--towards a comprehensive strategy. Part II. Screening and control. AB - In this, the second of a three-part series of articles in which we propose steps towards a comprehensive strategy for the control of HIV infection, we consider controversies relating to screening for HIV, the indications for and desirability of mandatory testing of certain groups at risk, and the place of voluntary testing in the control of HIV transmission and infection. Key recommendations are that mandatory testing of donors of blood and other vital tissues, patients on haemodialysis and haemodialysis unit staff is justified, and that children put up for adoption may require testing. We make further recommendations regarding HIV testing as a prerequisite for life insurance and recommend that voluntary testing be offered, supported by adequate pre- and post-test counselling. We consider that all health care workers should accept as their moral obligation the care and management of HIV-infected individuals, and that they should be adequately educated and skilled in such work. These recommendations were reached largely by consensus, although there were occasions when individual authors condoned recommendations with which they did not personally agree. PMID- 3282333 TI - AIDS and South Africa--towards a comprehensive strategy. Part III. The role of education. AB - In this, the third of a three-part series of articles in which we emphasise the urgent need for and propose steps towards a comprehensive strategy for the control of HIV infection, we highlight the fundamental importance of an education campaign and the three critical essentials for a successful campaign. The first concerns the responsibility of the State in administering the programme, in providing adequate funds on an on-going basis and in delegating responsibility for the day-to-day activities to the appropriate local authorities and non governmental organisations. The second relates to the need to establish a multidisciplinary AIDS group representative of groups at risk and of relevant scientific expertise to ensure that appropriate policies are developed and that changes to policy are made in response to changing circumstances, based on sound epidemiological, managerial and educational principles. These must take particular account of circumstances peculiar to South Africa, such as the migrant labour system, which may promote both promiscuity and homosexuality. Thirdly, the need to ensure open, appropriate communication with the groups at risk and the public at large in the development, implementation and evaluation of the education campaign is emphasised. In this context we plead for more psychosocial research. These recommendations were reached largely by consensus, although there were occasions when individual authors condoned recommendations with which they did not personally agree. PMID- 3282334 TI - Bread-making as a source of vaginal infection with Saccharomyces cerevisiae. Report of a case in a woman and apparent transmission to her partner. AB - We report the case of a woman, who baked her own bread, acquiring a vulvovaginal infection caused by saccharomyces cerevisiae, a yeast used extensively in the baking and brewing industries. Her partner was also infected, and the infections proved difficult to eradicate. Oral and topical treatment with nystatin along with disinfection of both patients' underwear produced clinical and microbiologic cure. PMID- 3282335 TI - Screening for Chlamydia trachomatis infection in a sexually transmitted disease clinic: comparison of diagnostic tests with clinical and historical risk factors. AB - Of 212 consecutive male patients and 212 consecutive female patients attending a sexually transmitted disease (STD) clinic, 36 (17%) men and 28 (13%) women had urethral or cervical cultures positive for Chlamydia trachomatis. When compared with culture, the direct fluorescent antibody test (MicroTrak, Syva Co., Palo Alto, CA) had a sensitivity of 75% and a specificity of 97% in men; for women the sensitivity and specificity were 68% and 82%, respectively. One percent of test slides from men and 11% of slides from women were uninterpretable. Designation of high-risk patients for presumptive treatment, i.e., those with suggestive clinical syndromes, gonococcal infection, or exposure to others considered at high risk for chlamydial infection, as recommended by the Centers for Disease Control, proved to be 94% sensitive, 22% specific in men, and 82% sensitive, 35% specific in women when compared with results of culture. Three different screening methods using mucopurulent cervicitis, a cervicitis score, and a series of key risk factors were less sensitive than presumptive treatment and performed worse in our study than in those published previously. Our findings suggest that use of presumptive treatment guidelines appears to be effective in directing treatment to STD clinic patients with chlamydial infection. PMID- 3282337 TI - John Marshall Knox, M.D. (1925-1987). PMID- 3282336 TI - Chronic suppression for six months compared with intermittent lesional therapy of recurrent genital herpes using oral acyclovir: effects on lesions and nonlesional prodromes. AB - Forty-seven patients with frequently recurrent genital herpes were treated with 200 mg of acyclovir or placebo capsules taken orally three times daily for six months; the drug was then withdrawn. Active lesional events were treated with open-labeled 200-mg acyclovir capsules five times daily for five days during the six months of suppression and for six months thereafter if the patient returned to the clinic for culture and treatment. During the six months of treatment, seven of 24 acyclovir recipients and none of 23 placebo recipients reported no lesions (P less than 0.01), while 17 of 24 acyclovir and none of 23 placebo recipients failed to return for lesion assessment (P less than 0.0001). The median time to first recurrence was 72 days in the acyclovir recipients vs. 14 days in placebo recipients (P less than 0.0001). Home-recorded prodromes without lesion development were common in both groups but occurred more often in the acyclovir-treated group (P less than 0.05). During follow-up all patients experienced lesional episodes, and no differences could be detected between the acyclovir- and the placebo-treated groups. Resistance to acyclovir was not encountered either before, during, or after suppression by this drug. Adverse events were not significantly different between the groups. We conclude that suppression by oral acyclovir of frequently recurrent genital herpes remains effective for at least six months. Nonlesional prodromes have undetermined significance but are more common during acyclovir suppression. PMID- 3282338 TI - [The treatment of acute leukemias in adults]. PMID- 3282339 TI - [Allogeneic bone marrow transplantation]. PMID- 3282340 TI - [Hematopoietin, a new class of hematological hormones]. PMID- 3282341 TI - [Resorption of cyclosporin administered by oral route to renal transplant patients. Influence of breakfast and an antacid drug]. PMID- 3282342 TI - [Blood pharmacokinetic parameters of cyclosporin A and nephrotoxicity. Diagnostic and predictive value in renal transplantation]. PMID- 3282343 TI - [Non-invasive method of arterial oxygen saturation monitoring in the neonatal intensive care unit (with a review of blood oxygen monitoring methods)]. AB - Recently a new method (pulse oximetry) became available, which enables us to monitor non-invasively the arterial oxygen saturation in neonates. We tested this new method in several premature infants, from the time that oxygen therapy was instituted (IPPV; CPAP), in order to evaluate its potential clinical use. In stable patients we found a better correlation (r = 0.90) between the oxygen saturation measured transcutaneously and that measured in an arterial blood sample that the correlation (r = 0.22) between oxygen tensions measured either transcutaneously or in a blood sample. Although transcutaneous monitoring of the arterial oxygen saturation, especially because it is a continuous process, can be a valuable adjunct in monitoring premature infants who receive extra oxygen, it can not replace the necessity for intermittent blood sampling to determine 'arterial blood gases'. One should also remember that; due to the fact that the position of oxyhemoglobin dissociation curve depends on several factors; the SO2 can not simply be derived from the pO2 or vice versa. Continuous transcutaneous monitoring of oxygen saturation may decrease the frequency with which arterial blood samples for blood gas measurement have to be taken. PMID- 3282344 TI - [Bacterial meningitis in the aged. Pitfalls in medicine]. AB - Bacterial meningitis in aged patients is a diagnosis that can be difficult to make. Three case-histories, one of them being diagnosed non-purulent bacterial meningitis, are presented to demonstrate this. If classic symptoms and signs are being absent, evidence of an infection should suggest meningitis, if other common infections, like urinary tract or respiratory infections, are excluded, and even in these cases a concomitant meningitis may be possible. Even then a high mortality should be taken into account. Only tenacity at diagnostics will be able to reduce this. PMID- 3282345 TI - [Reduction of the alveolar ridge: causes, sequelae and prevention]. AB - The alveolar ridge (of upper and lower jaw) serves as a supporting tissue for the teeth. This function disappears after natural dentition has been extracted. Even so, the alveolar ridge remains very important, serving as it does to support and give retention to dentures. However, after removal of the natural dentition alveolar ridge reduction occurs, initially at a fairly rapid rate, slowing down later, but in an ever-continuing process, which, particularly in the long run, may have unpleasant consequences. As many factors may affect this reduction process unfavourably, it is very difficult to take one specific preventive measure. The most effective way of preventing alveolar ridge reduction is obviously the prevention of any edentulous condition, which unfortunately is not always possible. Nowadays a frequently used treatment of which a great deal is expected, is the application of the so-called overdenture. Further research is needed, however, for a proper evaluation of its long-term favourable effects on alveolar ridge reduction. PMID- 3282346 TI - [Are preventive home visits to the elderly by district nurses sensible? The debate in The Netherlands and research abroad]. AB - There has been a tradition of preventive home visiting to the elderly by Public Health Nurses for quite a time. There is no agreement as to the effect of these visits; until now no study has been performed on this topic in the Netherlands. Studies from other countries suggest a positive effect: viz. a reduction in mortality and hospital admissions. Recommendations for a replication study in the Netherlands are made. PMID- 3282347 TI - Principles of solid-organ preservation by cold storage. PMID- 3282348 TI - Synergistic effects of combined immunosuppressive modulation. I. Unresponsiveness to dendritic cell-depleted renal allografts in dogs exposed to total-lymphoid irradiation. AB - Attenuation of the allogeneic stimulus provided by dendritic cells (DC) was achieved by irradiation of the donors, followed by their reconstitution with bone marrow from the prospective DLA-identical recipient. Following long-term (131-187 days) recovery free of graft-versus-host (GVH) disease, the chimeric kidneys were placed into the corresponding recipients; such allografts were rejected at 55, 55, and 60 days, respectively. Four other recipients were conditioned with 1750 1790 cgy of total lymphoid irradiation (TLI) and were then given a similar chimeric kidney from the corresponding partner. These allografts currently survive for 296, 295, 290, and 252 days, respectively. A third group of four dogs was exposed to TLI prior to transplantation of a normal DLA-identical kidney. These grafts were rejected at 20, 42, 46, and 242 days, respectively. Thirteen DLA-identical renal allografts transplanted into normal dogs survived for 13-38 days (mean survival time = 28.6 days). Depletion of allogeneic DC alone, or TLI alone, produced relative prolongations in allograft survival in canine recipients. Combined use of these two modalities, however, resulted in long-term allogeneic unresponsiveness in the recipients. PMID- 3282349 TI - Thallium kinetics in rat cardiac transplant rejection. AB - Cardiac transplant rejection is a very complex process involving both cellular and vascular injury. Recently, thallium imaging has been used to assess acute transplant rejection. It has been suggested that changes in thallium kinetics might be a sensitive indicator of transplant rejection. Accordingly, thallium kinetics were assessed in vivo in acute untreated rat heterotopic (cervical) transplant rejection. Male Lewis rats weighing 225-250 g received heterotopic heart transplants from syngeneic Lewis rats (group A; n = 13), or allogeneic Brown Norway rats (group B; n = 11). Rats were imaged serially on the 2nd and the 7th postoperative days. Serial cardiac thallium content was determined utilizing data collected every 150 sec for 2 hr. The data were fit to a monoexponential curve and the decay rate constant (/sec) derived. By day 7 all group B hearts had histological evidence of severe acute rejection, and demonstrated decreased global contraction. Group A hearts showed normal histology and contractility. However, thallium uptakes and washout of the two groups were the same. Peak thallium uptake of group B was +/- 3758 1166 counts compared with 3553 +/- 950 counts in the control group A (P = 0.6395); The 2-hr percentage of washout was 12.1 +/- 1.04 compared with 12.1 +/- 9.3 (P = 1.0000); and the decay constant was -0.00002065 +/- 0.00001799 compared with -0.00002202 +/- 0.00001508 (P = 0.8409). These data indicate that in vivo global thallium kinetics are preserved during mild-to-severe acute transplant rejection. These findings suggest that the complex cellular and extracellular processes of acute rejection limit the usefulness of thallium kinetics in the detection of acute transplant rejection. PMID- 3282350 TI - Influence of the hepatic drug-metabolizing enzyme-inducer phenobarbitone on cyclosporine nephrotoxicity and hepatotoxicity in renal-allografted rats. AB - We have investigated the influence of phenobarbitone ([PB]; 40 mg/kg/day), an inducer of hepatic drug metabolism, on high-dose cyclosporine ([CsA] 40 mg/kg/day) nephrotoxicity in normal Lewis (Lew) and renal allografted (DA X Lew F1----Lew) rats of both sexes. In untreated normal animals, CsA nephrotoxicity, assessed biochemically and histologically, in terms of acute and chronic renal structural damage, was consistently greater in male than in female rats. The capacity of PB to induce CsA metabolism was accompanied in normal rats by reductions in nephro- and hepatotoxicity and by prolonged survival of both female and male rats. Similar reductions in CsA-induced renal functional impairment and acute tubular cell injury were achieved in transplanted female (but not male) animals by concomitant PB administration. Continuous PB treatment in transplanted rats was, however, associated with the appearance of hepatic necrosis. While this effect of PB, and its failure to reduce CsA-induced chronic renal damage mitigate against its prospective value in reversing CsA toxicity, PB may nevertheless prove valuable in assessing further the role of drug metabolism in the pathogenesis of CsA nephrotoxicity. PMID- 3282351 TI - Polymeric IgA antibody response to rabbit antithymocyte globulin in renal transplant recipients. AB - Treatment of transplant recipients with heterologous antithymocyte globulin (ATG) can induce the production of antibodies to the ATG itself. Such responses have, however, not been fully defined in terms of the kinetics, class, and quantities of antibodies produced. We have studied these parameters in 32 renal transplant recipients who had received rabbit ATG as treatment for acute rejection episodes. Antibodies to rabbit IgG were detected in the sera of all patients; employing an enzyme-linked immunosorbent assay (ELISA), the majority of patients were shown to produce specific antibodies of the IgG, IgA, and IgM class. Anti-ATG antibodies were first detected 6-48 days after the initial injection of ATG and usually attained peak values within 23 days. The IgM and IgA responses decreased within 1 2 months, whereas the IgG response remained elevated for 2-12 months. Gel filtration studies indicated that the IgA and IgM antibodies directed to the rabbit ATG were polymeric. Furthermore, the polymeric IgA bound secretory component, indicating the presence of J chain. In 6 patients, circulating immune complexes that contained rabbit IgG were detected. The clinical symptoms and laboratory findings did not correlate with the production or quantities of the different classes of antibodies. Possible explanations for the prominent IgA response to intravenous injections of ATG are discussed. PMID- 3282352 TI - Transitional epithelial lesions of the ureter in renal transplant rejection. AB - The spectrum of ureteric lesions of human renal allografts, long attributed exclusively to postsurgical complications such as ischemia, has recently been shown to include the types of rejection seen in the kidney. Since the rejected ureter also exhibits transitional epithelial lesions that may impact on renal and ureteral function, we studied, by light, immunohistochemical, immunofluorescent, and electron microscopic techniques, ureters of 65 irreversibly rejected kidneys. Seven unused cadaver kidneys served as controls. Urothelial lesions, noticed in 57 of 65 ureters (88%), ranged from minimal basal vacuolization to complete sloughing with or without necrosis of the epithelial lining. Epithelial exfoliation was noticed in 31 cases (54.4%), and basal vacuolization, severe enough to produce cleavage of the epithelial junctions and thus create bullae, was noticed in 21 cases (36.8%). Immunofluorescent and immunoperoxidase stains, performed in 16 cases, were all positive for immunoglobulins but yielded varied results ranging from granular to linear staining, particularly in the region of the basal cells and the basement membrane. Electron microscopic findings confirmed the light microscopic alterations. By contrast, control ureters showed no lesions. Urothelial ureteric lesions might impede ureteral functions and result in obstruction or infection, thus compounding the consequences of renal allograft rejection. Moreover, elucidation of the pathophysiology of the process will advance the understanding of various cutaneous and transitional epithelial autoimmune conditions. PMID- 3282354 TI - Use of OKT3 monoclonal antibody in the treatment of acute cardiac allograft rejection. AB - OKT3 is a murine monoclonal antibody that recognizes the T3 surface antigen present on mature T cells, and it has been used to successfully treat renal allograft rejection. We report our experience with OKT3 in the treatment of cardiac allograft rejection. Eight patients with endomyocardial biopsy evidence of moderate or severe rejection were given fourteen daily intravenous treatments of OKT3. Six of the eight patients had complete recovery following OKT3 therapy; one required additional steroid therapy for recurrence and one patient failed to respond. Five of the six patients with a complete response have experienced no further rejection (mean follow-up 437 days). Adverse reactions to OKT3 were common early in the treatment course, but were well tolerated. We concluded that OKT3 is a safe and effective treatment of cardiac allograft rejection and that a majority of patients experience long-term rejection-free periods. PMID- 3282353 TI - Probability of finding HLA-matched unrelated marrow donors. AB - Bone marrow transplantation has become the treatment of choice for certain hematologic diseases. However, only 30-40% of patients who might benefit from this procedure have a suitable family donor. Consequently, many centers have begun to explore the use of unrelated volunteer donors. Initial results have demonstrated the feasibility of this approach. As a result, a national effort has begun to recruit HLA-typed volunteers in order to establish a registry of individuals who would be willing to serve as bone marrow donors. This manuscript explores the potential impact of establishing such a registry. We find that a registry of attainable size could more than double the number of marrow transplants now being performed. However, even with a registry of enormous size, it will still not be possible to identify an HLA-matched donor for some patients. PMID- 3282355 TI - Enlargement of the human spleen in graft-versus-host disease. AB - The spleens of 49 patients who had undergone allogeneic bone marrow transplantation for leukemia were compared at autopsy to determine the pathological changes associated with graft-versus-host disease (GVHD). The only significant finding was an increase in weight of about 1.7 times that of spleens from patients without GVHD. This was not explained by differences in the patients' sex, length of survival after transplantation, presence of infection, or liver pathology. On histological examination, there was no detectable increase in congestion, siderosis, or numbers of lymphocytes, macrophages, antigen presenting cells, blast cells, pyknotic cells, plasma cells, or hemopoietic cells to explain the increase in spleen weight. On the contrary, there was actually a reduction in CD8+ T lymphocytes. No proliferative phase of GVHD could be identified, possibly due to a lack of specimens examined less than 8 days after transplantation and to prophylactic measures undertaken to minimize GVHD. The pathogenesis of splenomegaly in human GVHD is unclear. PMID- 3282356 TI - Efficacy of OKT3 monoclonal antibody therapy in steroid-resistant, predominantly vascular acute rejection. A report of three cases with morphologic and immunophenotypic evaluation. AB - We describe three patients who became oliguric and uremic in the early posttransplantation period. Following treatment with pulse methylprednisolone, all had biopsy evidence of severe residual rejection that was predominantly vascular. T cells formed the bulk of the infiltrates. Subsequent treatment with the monoclonal antibody OKT3 was associated with an immediate diuresis and improvement in serum creatinine. Repeat renal biopsy, obtained in clinical remission, in two of the three patients, showed marked improvement in the vascular lesions. All three patients maintain normal renal function 9, 13, and 18 months later. We conclude that OKT3 was effective in reversing steroid-resistant rejection despite a predominantly vascular pattern of cellular infiltration not usually considered amenable to any antirejection therapy. PMID- 3282358 TI - T cell depletion with CAMPATH-1 in allogeneic bone marrow transplantation. AB - A total of 282 patients with leukemia have been treated by transplantation from HLA-matched siblings using marrow depleted of T cells with CAMPATH-1 and autologous complement. The incidence of graft-versus-host disease (GVHD) of grades 2-4 was only 12% but the maximum incidence of graft failure was 15%. A significant increase in relapse cannot yet be detected in acute leukemia but relapse in chronic granulocytic leukemia (CGL) was substantially above that reported before T cell depletion. The most important predictive factor for relapse in CGL appeared to be slow engraftment. This finding suggests an alternative explanation for the graft-versus-leukemia effect other than a direct attack on leukemia cells. This is that donor T cells may affect the balance of competition between donor and recipient haemopoesis by preventing a rejection reaction to donor stem cells. Recipient leukemic cells would benefit (i.e. relapse) if recipient hemopoiesis gained an advantage. If this explanation were true we would expect extra immunosuppressive preconditioning of recipients to reduce the incidence of relapse, as well as preventing graft rejection. PMID- 3282357 TI - Increased expression of major histocompatibility antigens in the liver as a result of cholestasis. AB - Increased expression of major histocompatibility complex (MHC) antigens may occur following liver transplantation. The mechanism by which this occurs is unclear. Postoperative complications may result in cholestasis. We have investigated the possibility that cholestasis may cause increased expression of MHC antigens in the liver. Cholestasis was induced in rat livers by bile duct ligation and transection. Total serum bilirubin rose markedly postoperatively and remained elevated over a period of 21 days. Samples of bile taken from rats were shown to remain sterile during the study period and there was no evidence of viral infection. Liver tissue taken 1, 3, 7, and 21 days postobstruction showed a marked increase in the expression of rat class I MHC antigens but not class II antigens. We suggest that cholestasis itself can induce increased MHC class I antigens in the liver. Therefore, if cholestasis occurs postoperatively in the human liver transplant recipient this might lead to increased expression of human class I MHC antigens and add to the overall cellular immune activity in a rejection reaction, although cholestasis probably cannot initiate rejection. PMID- 3282359 TI - Lack of correlation between the induction of donor class I and class II major histocompatibility complex antigens and graft rejection. AB - The induction of donor major histocompatibility complex (MHC) antigens on nonrejected and rejected rat renal allografts was compared at various times after transplantation in two strain combinations, DA-to-PVG and LEW-to-DA. Graft rejection was prevented by preoperative donor-specific blood transfusion (DST). Quantitative absorption analysis and immunohistology were performed using monoclonal antibodies specific for donor class I and class II MHC antigens. A significant increase in the expression of donor MHC antigens, both class I and class II, was demonstrated on nonrejected as well as rejected kidneys after transplantation. A kinetic analysis showed that induction of donor class I antigens was accelerated on the nonrejected grafts, and by day 5 the nonrejected kidneys showed increased expression of class I antigen when compared with the rejected grafts (a 37- vs. a 25-fold increase in expression). Increased expression of donor class I antigens persisted on the nonrejected grafts and was still detectable on long-term-surviving kidneys, 50 days after transplantation. The magnitude of class II antigen induction was similar on both rejected and nonrejected grafts (8-fold by 5 days after transplantation). Immunohistology demonstrated that class I and class II antigens were induced on identical structures in the kidney in both situations. In particular the vessel endothelia, which do not express class II antigens in normal kidney, become strongly positive in both rejected and nonrejected grafts 5 days after transplantation. Although renal allograft rejection is completely suppressed in rats given a single donor specific blood transfusion before transplantation, graft survival cannot be explained by the lack of induction of donor MHC antigens. Donor MHC antigens are induced on these nonrejected kidney grafts, and therefore they could act as target molecules for the effector cells that mediate graft destruction. Thus the induction of donor MHC antigens on tissue allografts should not be considered as indicative of a rejection response resulting in graft destruction. PMID- 3282360 TI - Biochemical characterization of human vascular endothelial cell-monocyte antigens defined by monoclonal antibodies. AB - Although the clinical relevance of endothelial cell-monocyte (E-M) antigens has been demonstrated in organ graft transplantation, very limited data exist describing the nature of these antigens. The current study presents biochemical characterization of three different surface antigens of endothelial cells and monocytes that are defined by murine monoclonals produced against gamma interferon-induced human umbilical vein endothelial cells. The antigens gp150, gp48, and gp24 have molecular weights of 150,000, 48,000, and 24,000, respectively, under reducing conditions. The antibody binding sites of gp150 and gp48 are destroyed by pronase and chymotrypsin, indicating that the molecules are at least partly protein in nature. The inability to label the gp48 molecule with 125I using lactoperoxidase suggests that there is little protein structure exposed to the cell surface or that the molecule lacks sufficient cell surface tyrosine residues to enable detection. Immunoprecipitation of the gp24 molecule under nonreducing conditions shows that a molecule with a higher molecular weight ranging from 40,000-70,000 is detected. Although it is possible that this higher molecular-weight species is a multimer of the 24,000 Mr species, it is also possible that there is another molecule(s) bound to the 24,000 Mr molecule. All three E-M antigens have some carbohydrate nature as evidenced by lectin-binding studies. The possible relevance of these antigens in the rejection of transplanted organ grafts is discussed. PMID- 3282361 TI - Cyclosporine-induced cell-mediated injury of the thymic medullary epithelium. AB - Cyclosporine (CsA) can induce prolonged tolerance to alloantigens, but it requires an intact thymus. In normal rats, CsA causes a rapid but reversible ablation of the thymic medulla with an associated loss of the Hassall's corpuscles and apparent maturation arrest of the thymocytes. We have tested the hypothesis that CsA induces a cell-mediated lysis of the medullary epithelium. Normal rats were treated with CsA (15 mg/kg) or vehicle. The thymocytes were then adoptively transferred into syngeneic target rats, purged of thymocytes by recent total-body irradiation. After 4-48 hr, the target animals were sacrificed. The target thymi showed increased lymphocytic exocytosis of the Hassall's corpuscles with OX-8+ (CD8+) T lymphocytes (OX-19+, OX-44+) and associated epithelial cell injury. Compared to recipients of control thymocytes, ultrastructural evaluation showed broad-based and point contact between lymphocytes and adjacent medullary epithelium with increased epithelial cell injury. The results support a cell mediated injury to the Hassall's corpuscles in CsA-treated animals. PMID- 3282362 TI - The question of whether previous exposure to HLA-DR antigens is a hazard in renal transplantation. PMID- 3282365 TI - Life insurance for kidney donors--an update. PMID- 3282363 TI - Comparison of two intravenous cyclosporine infusion schedules in marrow transplant recipients. PMID- 3282364 TI - Late steroid-resistant rejection response to OKT3. PMID- 3282366 TI - Inadvertent administration of a greater-than-usual pre-marrow transplant dose of busulfan--report of a case. PMID- 3282367 TI - A simple method for orthotopic liver transplantation with arterial reconstruction in rats. PMID- 3282369 TI - Selective loss of nonparenchymal cell viability after cold ischemic storage of rat livers. PMID- 3282368 TI - OKT3 therapy as a cause of high panel-reactive antibodies in serum using standard microcytotoxicity techniques. PMID- 3282370 TI - The value of the relationship between true and calculated values of serum beta 2 microglobulin in renal transplant recipients. PMID- 3282371 TI - [The cytoskeletal proteins of erythrocytes]. AB - The erythrocyte membrane skeleton is composed of the number of proteins isolated and characterized. One of the major proteins of cytoskeleton is actin presented in erythrocytes in the form of short protofilaments. This review will focus on the manner of attachment of actin protofilaments to the red cell membrane, and on the relationships between skeleton membrane proteins. Membrane skeleton proteins in erythrocytes are not unique. Recently a lot of proteins similar to the red cell membrane skeleton proteins were found in a wide variety of non-erythroid cells. This fact gives the opportunity to suppose the existence of a unique protein system in erythroid and non-erythroid cells which provides the attachment of actin filaments to cell membranes and which might be the centre for the assembling of actin structures in the cortical cytoplasm. PMID- 3282372 TI - [Epidermal growth factor with insulin used for stimulation of exogenous colony formation in the spleen of mice irradiated with lethal doses of X-rays]. AB - Epidermal growth factor (12 ng per 1 g of body mass) and insulin (0.004 units per 1 g of body mass) were introduced into X-ray irradiated (1.8, 2.12, 2.7 Cr) mice. Four hours later bone marrow was extracted from femurs to be introduced into syngenic lethally irradiated recipients. On the 11th day after transplantation the number of exogenic spleen colonies was computed. The epidermal growth factor, in combination with insulin, stimulates in the organism the restoration of hemopoietic colony-forming cells after radiation injury. PMID- 3282373 TI - [Hormone-dependent characteristics of the myocyte cell surface in the human myoma and myometrium cultured in diffusion chambers]. AB - The normal and the pathologically changed human myometrium was cultured in the diffusion chamber implanted in the subcutaneous cellular tissue of the rat. In the absence of hormonal influence the growth of myometrium culture is only insignificant, while no myoma cell growth was found at all. Estradiol stimulates the growth and development of the myometrium culture and the myoma. A combined action of estradiol and progesterone stimulates the collagen formation. PMID- 3282375 TI - Diagnosis and therapy of anticoagulant rodenticide intoxications. AB - The mechanism of toxicity and agents of anticoagulant rodenticides are discussed. The diagnosis of anticoagulant poisoning is outlined and discussed by applying clinical, laboratory, and therapeutic response measures as a means to confirm poisoning. Additional therapeutic concerns and newly developed diagnostic tests are discussed. Application of the therapeutic and diagnostic measures provides a successful plan to manage anticoagulant poisonings. PMID- 3282374 TI - Hemostatic abnormalities in nephrotic syndrome. AB - Nephrotic syndrome is often associated with a hypercoagulable state and thrombotic complications. Thrombosis may be due to a number of abnormalities in blood, including AT III deficiency, increased concentrations of fibrinogen, factors V and VIII, and platelet hyperaggregability. The therapeutic approach to thrombosis in nephrotic syndrome is the use of anticoagulants as a preventive measure or an attempt at thrombolysis with streptokinase, urokinase, or stanozolol. PMID- 3282376 TI - Platelets and neoplasia. AB - Numerous platelet abnormalities have been recognized in animals with malignancy. Because platelets play a key role in hemostasis, it is vital that clinicians recognize those neoplastic conditions that are associated with platelet disorders. A review of these platelet abnormalities, their underlying pathophysiology, and treatment is presented in this article. PMID- 3282377 TI - Coagulation abnormalities associated with neoplasia. AB - Subclinical abnormalities in hemostasis occur commonly in small animal patients with cancer, but the incidence of clinical thrombosis or hemorrhage is unknown. Malignancy can lead to abnormalities in both primary and secondary hemostasis, which in turn can lead to either thrombotic or hemorrhagic tendencies. These coagulation abnormalities can be associated with the tumor itself, with anticancer chemotherapy, or with secondary organ dysfunction. Thrombocytopenia and DIC are probably the most common defects associated with clinical bleeding in small animal patients. PMID- 3282378 TI - Disseminated intravascular coagulation. AB - Etiology, pathogenesis, clinical features, laboratory findings, and therapy of disseminated intravascular coagulation (DIC) in the dog and the cat are reviewed. PMID- 3282379 TI - Hereditary and acquired thrombopathias. AB - Normal platelet function is essential for hemostasis. The pathophysiologic processes that result in acquired quantitative platelet abnormalities are detailed. Platelet pathophysiology associated with acquired qualitative disorders, either drug-induced or secondary to disease, is discussed. Numerous hereditary platelet defects also exist. Their functional and biochemical features are presented. PMID- 3282380 TI - Canine von Willebrand's disease. A heterogeneous group of bleeding disorders. AB - The term "von Willebrand's disease," refers to a group of inherited bleeding disorders, all of which are caused by a deficiency of the multimeric plasma glycoprotein, von Willebrand factor. The various forms of canine von Willebrand's disease can be categorized into one of three major types: in type I canine von Willebrand's disease, all sizes of von Willebrand factor multimers can be detected in the plasma; in type II canine von Willebrand's disease, only the smaller von Willebrand factor multimers are found in the plasma (larger multimers are absent); and in type III canine von Willebrand's disease, von Willebrand factor is completely absent from the plasma or present in only trace amounts. Von Willebrand's disease is common in dogs, but some forms of the disease are so mild that they are of questionable clinical significance. PMID- 3282381 TI - Clinical and laboratory diagnosis of bleeding disorders. AB - The diagnosis of hemostatic abnormalities requires a detailed clinical and laboratory evaluation of the patient. The clinical assessment includes a detailed history and a thorough physical examination. The patient's history may provide clues as to the time of onset of the bleeding tendency, the clinical severity of the abnormality, and the possible contributing role of other disease processes or of drugs. The nature of the bleeding symptoms may provide clues as to the nature of the hemostatic defect. Hemostatic screening tests are invaluable in helping to differentiate between platelet, vascular, coagulation, and fibrinolytic abnormalities. Specific tests, including specific factor assays, platelet aggregometry, and antiplatelet antibody assays are usually required to characterize the exact nature and severity of hemostatic defects. PMID- 3282382 TI - Inherited coagulation disorders. AB - Inherited coagulation disorders have been diagnosed in many breeds of dogs as well as in mongrels and cats. This article presents the different coagulation factor deficiencies that are known to exist in small animals. A description is given of each coagulation factor along with the relevant clinical signs, inheritance, and the breeds affected. Suggestions are also given for the diagnosis and therapy of these deficiencies. PMID- 3282383 TI - Quantitative platelet disorders. AB - Thrombocytopenia may be caused by abnormal platelet production, accelerated removal owing to immunologic or nonimmunologic reasons, or sequestration of platelets in the spleen. Bleeding associated with thrombocytopenia usually presents as petechial or ecchymotic hemorrhages or epistaxis. Immunologic and nonimmunologic cases of thrombocytopenia may be diagnosed with routine hematology, bone marrow cytology, and platelet specific tests. Thrombocythemia may also be associated with platelet functional abnormalities, contrasting the normal platelet function noted in reactive thrombocytosis. PMID- 3282384 TI - An overview of hemostasis. AB - The normal hemostatic system is complex yet exquisitely well regulated. Interrelationships exist between responses of the vasculature, circulating platelets, coagulation proteins, and fibrinolytic mechanism. These relationships serve to limit blood loss, preserve tissue perfusion, and stimulate local repair processes. Natural inhibitors of coagulation and fibrinolysis modulate these systems to prevent uncontrolled thrombosis or hemorrhage following pathologic stimuli. Vascular endothelial cells play an important role in the maintenance of a thromboresistant luminal interface with circulating cells and proteins. Normal hemostasis also requires the synthetic, metabolic, and repair processes of the vascular endothelium. The initial vascular response to injury produces brief vasoconstriction and exposes subendothelial substances that attract circulating platelets and activate coagulation proteins. Platelets respond by adherence and aggregation at the site of injury, with subsequent release of substances that mitigate blood loss. Platelet adherence to collagen requires von Willebrand's factor, fibrinogen, fibronectin, and specific glycoprotein receptors on platelet surfaces. Platelet-to-platelet interactions (aggregation) recruit additional platelets to the primary hemostatic plug. Aggregation requires fibrinogen, energy, and calcium. Release of ADP, serotonin, and the contents of intracellular granules as well as generation of prostaglandins prepares platelet surfaces for reactions with the coagulation proteins. Activation of the intrinsic or extrinsic coagulation pathway, or of both, causes formation of fibrin from fibrinogen by means of an elaborate and intricate system that also entraps platelets and activated coagulation proteins. The intrinsic system is activated by the contact of factor XII with a negatively charged surface, most likely collagen. Through a series of reactions with prekallikrein, HMWK, and factors XI, IX, and VIII, the common coagulation pathway is propagated. The extrinsic, or tissue factor, system stimulates both the common pathway and factor IX the intrinsic pathway. Discovery of this stimulation of the intrinsic pathway by factor VII in the extrinsic pathway has stimulated reassessment of the biologic importance of the extrinsic system. The common pathway includes factors X and V and causes thrombin to convert fibrinogen to fibrin. Calcium and platelet phospholipids are substances that have important roles in steps in the coagulation scheme. Once fibrin is formed, factor XIII interacts with the substance, providing a stabilizing effect.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3282385 TI - Thrombocytopenia and drugs. AB - Thrombocytopenia is a relatively common side effect of drug therapy. The pathogenetic mechanisms of drug-induced thrombocytopenia are varied and sometimes poorly understood. Immunologic and other cytotoxic effects may result in decreased production and/or increased destruction of platelets. The pathogenesis of drug-induced thrombocytopenia is reviewed. Diagnosis and treatment are also discussed. PMID- 3282386 TI - Drugs that alter the hemostatic mechanism. AB - This article offers a brief review of antiplatelet drugs, anticoagulants, fibrinolysins, and antifibrinolysins. Aspirin and heparin are discussed in detail. Warfarin, streptokinase, urokinase, and tissue-type plasminogen activator are also considered. Indications for use, mechanism of action, monitoring therapy, and current investigational studies are discussed. PMID- 3282387 TI - Coagulation disorders and liver disease. AB - A definite association exists between hepatic disease and abnormalities of the coagulation system. These abnormalities can be detected by both routine and specialized coagulation tests. Extrahepatic causes of coagulation defects must first be ruled out by anamnesis, physical findings, and clinical laboratory tests before attributing the coagulopathies to hepatic disease. The routine use of coagulation tests to diagnose hepatic disease is not practical in veterinary medicine at the present time, but it can be a valuable adjunct to existing tests for hepatic disease and as a prognostic indicator during the course of treatment for established chronic disease. PMID- 3282388 TI - Pathophysiology of antithrombin III deficiency. AB - This article focuses on the pathophysiology of thrombosis in patients with acquired antithrombin III deficiency. Antithrombin III is an important natural inhibitor of the hemostatic mechanism, and a hypercoagulable state is often induced in diseases causing antithrombin III deficiency. Laboratory determination of antithrombin III activity is particularly useful in the clinical evaluation and therapeutic management of patients with disseminated intravascular coagulation, nephrotic syndrome, and severe hepatopathy. PMID- 3282389 TI - Chronic small airway disease in the horse: immunohistochemical evaluation of lungs with mild, moderate and severe lesions. AB - The peroxidase anti-peroxidase technique was used to demonstrate free and intracellular immunoglobulin (Ig) within the lungs of 23 horses with chronic small airway disease. Histologically, all the horses had chronic bronchiolitis; however, the lesions varied in degree from mild in eight horses, to moderate in nine horses and severe in six horses. Lungs from three horses which had no gross or histopathological lesions were used as controls. In comparison with control horses, horses with mild chronic bronchiolitis had increased numbers of Ig A containing and non-immunoglobulin staining cells around the vasculature and bronchioles. As the severity of the lesions increased so did the number of IgA-, IgG(Fc)- and in several cases non-immunoglobulin staining cells around the vasculature, bronchioles and in the alveolar septa. In severely affected horses, large amounts of free IgG(Fc) were observed interstitially and in alveoli. In areas of mucosal epithelial hyperplasia and metaplasia large amounts of free IgA and IgG(Fc) were sometimes observed interepithelially in a pattern which differed from that in control horses. PMID- 3282391 TI - [Age-related changes in the activity of enzymes metabolizing carcinogens]. PMID- 3282392 TI - [Primary lymphosarcoma of the thyroid gland]. PMID- 3282390 TI - Mycobacterium bovis in the anterior respiratory tracts in the heads of tuberculin reacting cattle. AB - Twenty-five of 50 randomly selected tuberculin-reacting cattle were confirmed as tuberculous in the laboratory. All 25 cattle had macroscopic lesions in lymph nodes associated with the respiratory tracts but only one had lung lesions. M bovis was isolated from the anterior respiratory tracts in the heads of four of the 25 tuberculous animals and from a nostril lesion found in a fifth. For at least three of these five animals, the intervals between the final tuberculin test and their previously negative tests indicated that infection had established relatively rapidly. Four of them had been tuberculin tested solely because they were animals in contiguous 'at risk' herds. It would appear that although M bovis can be isolated from the anterior respiratory tracts in the heads of tuberculin reacting cattle, it is unlikely that primary foci of infection exist in regions other than the lungs or associated tissues. The study demonstrates the potential for reactors with lesions to excrete M bovis and the continued importance of infected cattle in the epidemiology and eradication of the disease. PMID- 3282393 TI - [Evolution of approaches to cancer chemotherapy]. PMID- 3282394 TI - Bilateral Pseudallescheria boydii endophthalmitis in an immunocompromised patient. PMID- 3282395 TI - Runaway reproductive technology. PMID- 3282396 TI - [Solid cystic acinar cell tumor of the pancreas. Immunohistologic studies of histogenesis]. AB - A case of a very rare solid and cystic tumor of the pancreas in a 25-year-old woman was examined by immunohistochemical methods, e.g. antiglucagon, antisomatostatin, antivip etc. The stainings by the PAP- or biotin-avidin-method were negative and also those with S-100 protein and especially with chromogranin. A tumor of the endocrine system was therefore excluded. Some areas of the tumor showed positive staining with alpha-1-antitrypsin as is known in acinar cell carcinoma. The classification of the neoplasm as an acinar adenoma of the pancreas seems to be well established, mainly because several authors electronmicroscopically demonstrated structures resembling acini and zymogen granules. PMID- 3282397 TI - [Diagnosis and surgical tactics in adrenal gland tumors]. AB - Adrenal tumours are relatively rare. For localisation and reliable identification, stepwise radiological or nuclearmedical diagnosis should be added to targeted endocrinological diagnosis. Highest accuracy has been recordable from computed tomography, followed by phlebography, and arterial angiography. The authors feel that the extraperitoneal, lumbar approach can be considered a non invasive, low-complication surgical method. It should be applied more often to cope with benign unilateral adrenal processes. PMID- 3282398 TI - [Our surgical heritage. Status and responsibility of the physician in society from Hammurabi to Theoderic]. PMID- 3282399 TI - Parasternal mediastinal sonography: sensitivity in the detection of anterior mediastinal and subcarinal tumors. AB - Twenty-seven patients with anterior mediastinal and subcarinal mediastinal tumors confirmed by CT and 30 control subjects were prospectively investigated by sonography performed via a parasternal approach in both decubitus positions. The sonograms and CT scans were interpreted blindly by two investigators and the results of the two procedures were compared. In the group of 30 controls, sonography via the right parasternal approach showed the anterior mediastinum in 29 (97%) and the subcarinal space in 27 (90%). Fifteen (94%) of 16 anterior mediastinal tumors and 16 (94%) of 17 subcarinal tumors were identified sonographically. These results show that parasternal sonography is a sensitive technique for the detection of tumors in the anterior mediastinal and subcarinal mediastinal spaces. PMID- 3282400 TI - Diagnosis of recurrent hyperparathyroidism: comparison of MR imaging and other imaging techniques. AB - Several reports have indicated good results with MR imaging of hyperparathyroidism. However, its use in recurrent hyperparathyroidism has not been assessed separately. Thirty patients with recurrent hyperparathyroidism were evaluated by MR with both T1- and T2-weighted images. Twenty-six and 23 of these patients, respectively, also had thallium-201 scintigraphy and high-resolution sonography. For the 28 patients who eventually had surgical exploration and histologic evidence of adenoma (21 cases) or hypoplasia (seven cases), MR accurately located abnormal parathyroid glands in 75% evaluated prospectively and 89% evaluated retrospectively. Scintigraphy located 68% prospectively and 76% retrospectively. Sonography detected 57% prospectively and 67% retrospectively. For patients undergoing three studies, the prospective and retrospective detection rate was significantly better (p less than .05) for MR compared with sonography but was not significantly different for MR and scintigraphy. MR detected three of four mediastinal adenomas evaluated prospectively and retrospectively. One false-positive case was seen with MR, one with scintigraphy, and one with sonography. Thus, MR can be used to locate abnormal parathyroid tissue at a rate equal to or better than scintigraphy or sonography. PMID- 3282401 TI - Retained surgical sponge: diagnosis with CT and sonography. AB - The diagnosis of a retained surgical sponge was made by CT and sonography in four patients. The plain abdominal radiograph was normal in all cases. In each of four cases of gauze granuloma, CT showed a well-defined round mass with a thick wall; internal heterogeneous densities with a wavy, striped, and/or spotted appearance; mottled calcifications; and gas bubbles. Sonography disclosed a well-defined hypoechoic mass containing highly echogenic foci with a strong posterior shadow. In these cases, CT and sonographic findings, together with a history of surgery, permitted the correct preoperative diagnosis of a retained foreign body. PMID- 3282403 TI - Serial transabdominal sonography of bladder cancer. AB - In 23 patients with known transitional cell carcinoma of the bladder, 58 serial transabdominal sonograms were obtained, providing 35 cases in which interval change could be evaluated by sonography. Results were correlated with cystoscopy or surgery. Sonography accurately gauged change in 29 instances (83%), of which 13 showed increase, four decrease, and 12 stability of tumor. Errors in assessing interval change occurred when surgery between sonograms caused secondary bladder deformity or patchy edema of the bladder wall; these were misinterpreted as tumor growth. When smooth bladder thickening was present, sonography could not differentiate flat tumor from edema. In no case in which the bladder wall was normal on sonography was tumor found. In four cases sonography was a more accurate indicator of depth of tumor than cystoscopy was. These results suggest that sonography is a useful adjunct to cystoscopy and may be a dependable means of decreasing the frequency of invasive procedures to evaluate the extent of bladder disease. The use of these two techniques together may improve the accuracy achieved by using cystoscopy alone. PMID- 3282402 TI - Hydatid cyst of the liver: rupture into the biliary tree. AB - Hydatid cyst rupture into the biliary tree may involve the common hepatic duct, lobar biliary branches, or the small intrahepatic bile ducts. We studied seven patients with hydatid cyst rupture into the larger bile ducts in whom sonography suggested the diagnosis. The findings included an echogenic cyst in all cases; intrabiliary hydatid material (echogenic or nonechogenic daughter vesicles and/or echogenic fragmented membranes) in six patients; and cyst-bile duct communication (observed in five cases as an interruption in the cyst wall adjacent to a bile duct). In the four cases in which CT was performed, both the cyst and high density linear intrabiliary material were seen; in three patients, cyst wall rupture was detected. Sonographic and CT demonstration of a hydatid cyst in the liver together with intrabiliary hydatid material suggests rupture of the cyst into the biliary tree. In some cases, the diagnosis is reinforced by the detection of the communication itself. PMID- 3282404 TI - Infiltrative renal lesions: CT-sonographic-pathologic correlation. AB - The CT and sonographic findings in 23 cases of renal lesions in which the abnormality was infiltrative, as opposed to expansile, were analyzed (invasive transitional cell carcinoma [seven], renal lymphoma [six], metastasis to the kidney [three], acute bacterial nephritis [three], mesoblastic nephroma [two], squamous cell carcinoma of the renal pelvis [one], and renal cell carcinoma [one]). CT scans were evaluated for shape and density of the mass, pelvocaliceal displacement, effect on the renal sinus fat, and the presence of perirenal involvement. Sonograms were evaluated for the shape and echogenicity of the mass and for the effect on the renal sinus echoes. Findings of infiltrative growth included poorly defined margins of the mass; trapped, nondisplaced infundibulae; and calices with occasional calicectasis, diminished contrast enhancement, occasional nephrographic striations, replacement of central sinus fat, loss of central sinus echoes, and variable renal parenchymal echogenicity. The reniform shape was usually preserved and was present in 19 of 20 cases with CT and 13 of 15 cases with sonograms. These observations indicate that analyses of the margins, architecture, and effects on the collecting system and renal sinus by the mass are helpful in the diagnosis of those diseases that characteristically infiltrate the kidney. PMID- 3282405 TI - Sonography of the postoperative shoulder. AB - Fifty-three patients with 60 symptomatic shoulders underwent shoulder sonography for recurrent postoperative symptoms after either acromioplasty (10 shoulders) or repair of a full-thickness rotator cuff tear in addition to acromioplasty (50 shoulders). Because surgery distorts landmarks, an understanding of the surgical procedures and their characteristic sonographic appearances is essential. After acromioplasty, the characteristic sharp margination or the acromion was replaced by a less distinct, irregular surface. After repair of a cuff tear, characteristic sonographic appearances included visualization of a reimplantation trough and loss of the echogenic subdeltoid bursa. When the cuff was intact after surgery, echogenicity was abnormal in all cases (17 shoulders). Sonography accurately diagnosed recurrent cuff tears in all 26 shoulders in which surgical proof was available and confirmed an intact cuff in 10 of 11 cases. In one shoulder, a cuff hematoma was incorrectly interpreted as a full-thickness tear. These findings suggest that sonography is an effective procedure for evaluating a postoperative patient with recurrent shoulder symptoms. PMID- 3282406 TI - Intraparenchymal hemorrhage in preterm neonates: a broadening spectrum. AB - Among 800 neonates screened for cerebral bleeding, perinatal sonography identified 35 preterm neonates with intraparenchymal hemorrhage (IPH). The observed IPHs were categorized in five general groups: classical grade-IV hemorrhage (16 patients), grade-IV hemorrhage with coexisting but anatomically separate hemorrhages (four patients), grade-IV hemorrhage with later development of secondary parenchymal hemorrhages at distant sites (five patients), hemorrhagic periventricular leukomalacia (four patients), and parenchymal hemorrhage unrelated to grade-IV hemorrhages (six patients). Thirty IPHs had concurrent germinal matrix hemorrhages, but in only 16 patients did the IPH represent an extension of the subependymal hematoma and therefore qualify as pure grade-IV hemorrhage according to the most popular classification. The high concurrence of periventricular leukomalacia (80-100% in most groups) and germinal matrix-remote IPHs supports the concept that most IPHs in preterm neonates represent secondary hemorrhages into ischemic brain tissue. PMID- 3282407 TI - The distinction between femoral artery pseudoaneurysms and other causes of groin masses: value of duplex Doppler sonography. AB - With the increasing use of percutaneous transfemoral coronary angioplasty in conjunction with thrombolytic as well as anticoagulant therapy, the sonographic evaluation of groin masses, with particular emphasis on differentiating pseudoaneurysms from hematomas and other abnormalities, has become more common. Seventy-three sonograms of the groin in 60 patients (65 different groins) were reviewed retrospectively to determine the accuracy of duplex Doppler sonography in distinguishing femoral artery pseudoaneurysm (a surgical condition) from other causes of groin masses (e.g., hematomas) that are generally treated conservatively. Nineteen cases of pseudoaneurysm, 19 cases of hematoma, and 27 other conditions were studied. Of the 73 sonograms performed, 53 included duplex Doppler studies; one Doppler study was false-negative and two were possibly false positive. The sensitivity, specificity, and accuracy of duplex Doppler sonography in the detection of femoral artery pseudoaneurysm was 95 +/- 5.8%, 94 +/- 6.4%, and 94 +/- 6.4%, respectively (95% confidence limit). We conclude that duplex Doppler sonography is of value in the differential diagnosis of groin masses. PMID- 3282408 TI - The usefulness of diagnostic tests. PMID- 3282409 TI - Duplex sonographic assessment of portosystemic shunts. PMID- 3282410 TI - Roentgenologic diagnosis of pancreatic disease. By Josef Rosch, 1967. AB - On the basis of his own experience and of literary sources, the author reports the present situation of the roentgenologic diagnosis of the pancreas. He evaluates the various examination methods and gives a general description of the typical characteristics of the diseases of the pancreas. In conclusion, he suggests ways for further improvements. PMID- 3282411 TI - Josef Rosch: a biographical sketch. PMID- 3282412 TI - Radiology of the pancreas: two decades of progress in imaging and intervention. PMID- 3282413 TI - Sonography of the hepatic vascular system. AB - The possibility of blood-flow analysis with Doppler techniques is a valuable addition to B-mode real-time scanning and enhances the role of sonography as the primary noninvasive imaging method for the liver and its vessels. Duplex sonography has already proved useful for qualitative assessment of hepatic blood flow in clinical practice. Preliminary experience with color Doppler flow imaging suggests that this technique may make assessment of the presence and direction of blood flow in intra- and perihepatic vessels easier and less time-consuming. PMID- 3282414 TI - Hyperthermia in the treatment of cancer. PMID- 3282415 TI - ACE inhibitors as initial therapy for hypertension. AB - Angiotensin-converting enzyme inhibitors are being used increasingly as initial therapy in the management of mild to moderate hypertension. As monotherapy, ACE inhibitors are effective in lowering blood pressure in over 50 percent of patients. When a combination of an ACE inhibitor and a diuretic is used, 80 to 95 percent of patients respond. The adverse metabolic effects associated with diuretics and beta blockers do not occur with ACE inhibitors. PMID- 3282416 TI - Gastroesophageal reflux in children. AB - Pediatric gastroesophageal reflux is a common cause of morbidity in family practice. The numerous presentations of the condition are determined by four factors: the reflux barrier, the reflux material, esophageal clearance and tissue reactivity. Several diagnostic tests are available, but no one test is applicable to all cases. Treatment, which may be dietary, behavioral, pharmacologic or surgical, depends primarily on the clinical presentation. PMID- 3282417 TI - 3-Hydroxymyristic acid as a measure of endotoxin in cotton lint and dust. AB - A series of samples consisting of purified cellulose, purified cellulose spiked with endotoxin, and cotton lint and dust samples from the Human Panel Acute Exposure Studies at Clemson, South Carolina, were extracted with pyrogen-free water and with phenol-water. Phenacyl esters of the dried, hydrolyzed extract were prepared and chromatographed on a high performance liquid chromatograph. A peak assigned to the phenacyl ester of 3-hydroxymyristic acid appears in the chromatograms of extracts of celluloses that have been spiked with endotoxins and not in those of unspiked celluloses. This peak also appears in the extracts of cotton lint from samples that cause the greatest decrement in lung function in the Clemson human exposure studies. The area of this peak increases with increasing amounts of endotoxin and may serve as a measure of endotoxin concentration in cotton lint and dust, at least when fairly high levels of endotoxin (0.50 micrograms or greater) are present. The effect of extraction method on the determined amount of endotoxin is discussed. PMID- 3282419 TI - Prognosis in stable angina pectoris and silent myocardial ischemia. AB - The results of current investigation suggest that a former clinical standby, namely, the presence or absence of angina, is no longer the principal prognostic factor for determining a patient's risk of cardiac events, including myocardial infarction. In a retrospective analysis, patients with chronic stable angina were compared on the basis of presence or absence of angina during ischemia detected by thallium imaging. Patients were similar in terms of risk factors, clinical characteristics and catheterization data. At 30 months of follow-up, the myocardial infarction rate was 22% in the silent group compared with 4% in the group with angina. Transient asymptomatic ischemia has prognostic value independent of other variables such as exercise stress testing or cardiac catheterization data. Future prognostic studies should be careful to include patient populations with similar characteristics; they also will need to provide protracted follow-up and utilize sensitive and reproducible diagnostic techniques. PMID- 3282418 TI - Clinical outcome of silent myocardial ischemia. AB - Asymptomatic coronary artery disease can be detected by an abnormal electrocardiogram at rest, by a positive exercise test result unaccompanied by pain, or by the demonstration of silent ischemic episodes during daily activities. However, the clinical outcome of patients with silent myocardial ischemia has not yet been clearly defined. In a study of 356 patients with documented coronary disease--211 of whom had previous myocardial infarction--the prognostic information of spontaneous ST-segment depression was found to be independent of that associated with a positive exercise test result, ejection fraction, and extent of arteriographically documented coronary artery disease. Patients with asymptomatic ischemia had a higher coronary event rate than those without ischemia. Cardiac event rates followed a similar pattern for patients with silent, symptomatic and mixed ischemia--whether or not there was previous myocardial infarction. PMID- 3282420 TI - Myocardial perfusion imaging for detection of silent myocardial ischemia. AB - Despite the widespread use of the exercise stress test in diagnosing asymptomatic myocardial ischemia, exercise radionuclide imaging remains useful for detecting silent ischemia in numerous patient populations, including those who are totally asymptomatic, those who have chronic stable angina, those who have recovered from an episode of unstable angina or an uncomplicated myocardial infarction, and those who have undergone angioplasty or received thrombolytic therapy. Studies show that thallium scintigraphy is more sensitive than exercise electrocardiography in detecting ischemia, i.e., in part, because perfusion defects occur more frequently than ST depression and before angina in the ischemic cascade. Thallium-201 scintigraphy can be performed to differentiate a true- from a false-positive exercise electrocardiographic test in patients with exercise-induced ST depression and no angina. The development of technetium labeled isonitriles may improve the accuracy of myocardial perfusion imaging. PMID- 3282421 TI - Mitoxantrone: an active agent in refractory non-Hodgkin's lymphomas. AB - A phase II oriented study with mitoxantrone was undertaken in 31 patients with refractory non-Hodgkin's lymphomas (NHL); 30 patients had evaluable disease. The drug was administered through a 30-min intravenous infusion at the dose of 14 mg/m2 every 3 weeks. A minimum of two cycles were required to define treatment response. Twenty patients were previously treated with Adriamycin whose total dose was not exceeding 300 mg/m2. Complete response (CR) was documented in 9 patients, and partial response (PR), in 5 for a total response rate of 47% (14 of 30). Of 20 patients previously treated with Adriamycin, CR occurred in five and PR in two. The median time to progression was 3 months. Mitoxantrone was well tolerated, and no patient refused treatment. Mild leukopenia was evident in 10 patients and thrombocytopenia in 5 patients. In all cases, electrocardiograms (EKGs) was obtained before each treatment cycle. Systolic time intervals and left ventricular ejection fraction were repeated after 3 cycles and at the end of therapy. Laboratory tests failed to document any major cardiac abnormality. Mitoxantrone is an effective agent in refractory NHL and should be taken into consideration in the design of salvage regimens. PMID- 3282422 TI - Simultaneous chemotherapy and radiotherapy for squamous cell lung cancer. AB - Simultaneous chemotherapy and radiotherapy was evaluated in 13 patients with inoperable, limited stage squamous cell lung cancer. The chemotherapeutic agents bleomycin, methotrexate, 5-fluorouracil, vinblastine, and cisplatin were administered on days 1 and 5 of two treatment cycles given 5 weeks apart. Radiation therapy was given in three 2-week cycles, the first two starting on the second day of each chemotherapy cycle and the third starting 3 weeks after the second course of radiation. The total dose was 5000-5500 rad (50-55 Gy) in 180 rad fractions. The objective response rate (complete response + partial response) was 85%, with 38% complete responders. Median survival was 7 months with two patients surviving 34 months, one with disease and one disease-free. Treatment toxicity was predominantly hematopoietic and renal. Two patients died with massive pulmonary hemorrhage while receiving treatment and a third patient died of acute respiratory failure 1 month after completing therapy. The severe toxicity and the failure to obtain long duration tumor control makes this regimen unsuitable for future use. PMID- 3282423 TI - Intraocular lymphoma: report of three cases and review of the literature. AB - Three cases of intraocular lymphoma are presented. One patient had only ocular involvement, one had involvement of the eye and central nervous system, and in the third patient, ocular lymphoma developed 1 year after the diagnosis of a systemic lymphoma. One patient died before treatment could be initiated, but the other two patients responded well to local radiotherapy. Only one patient who received radiation to both eyes and the whole brain, followed by systemic chemotherapy, remains alive 4 years after diagnosis. Eighty-seven cases of intraocular lymphoma reported in the literature are reviewed. Only 16.7% of cases involved the eyes alone without central nervous system or systemic disease. In more than one-half of the cases (59.7%), the eye was the primary site of involvement. Craniotomy or enucleation was required for diagnosis in 52.7% of patients, and diagnosis frequently followed a significant period of delay during which time patients were treated unsuccessfully for uveitis or iritis. Death for most patients was due to progressive central nervous system involvement. Therefore, we recommend combined modality therapy with radiation to the whole brain and both eyes, followed by systemic chemotherapy with or without intrathecal medications. PMID- 3282424 TI - The role of radiation therapy in the treatment of recurrent adult laryngeal papillomatosis. AB - Laryngeal papillomatosis is an uncommon condition in the adult, but it can be severe enough to require tracheostomy for obstructive changes following multiple recurrences, despite surgical local excisions and medical therapies. Few satisfactory treatments are available for such cases to restore both airway function and speech. Some patients may require laryngectomy for progressive dysfunction. The role of radiation therapy has been controversial, with some reports of malignant transformation following treatment. The authors describe two cases treated with irradiation, resulting in complete clearance of the lesions and return of airway and vocal function. Follow-up is given, and the available literature is reviewed. PMID- 3282425 TI - Etoposide (VP-16) in the treatment of advanced adenocarcinoma of the pancreas. AB - Twenty-six patients with advanced adenocarcinoma of the pancreas were treated with etoposide (VP-16), 100-180 mg/m2 i.v., days 1, 2, and 3, monthly. Twenty five had bidimensionally measurable disease and one had evaluable disease only. This regimen and dosage schedule were well tolerated, with minimal toxicity including myelosuppression; a median WBC count nadir of 3,600 cells/mm3 (range 200-2,400); and a median platelet nadir of 215,000 cells/mm3 (range 15,000 405,000). However, no patients responded and only two had stable disease for 3.5 and 4 months, respectively. At this dosage and schedule, there is no role for VP 16 in the treatment of advanced pancreatic adenocarcinoma. PMID- 3282426 TI - Gastrointestinal stromal tumors. An immunohistochemical study of cellular differentiation. AB - Forty-five benign and 11 malignant gastrointestinal stromal tumors (GIST) were immunohistochemically studied for the presence of desmin, muscle actins (MA) and S-100 protein. To facilitate the analysis, the tumors were divided into four groups by light microscopy: (1) typical leiomyomas comparable to peripheral leiomyomas (n = 9); (2) cellular spindle cell tumors (n = 29); (3) round cell tumors ("leiomyoblastomas" n = 7); and (4) sarcomas (n = 11). The typical leiomyomas were desmin- and MA-positive throughout, and showed well differentiated smooth muscle cells by electron microscopy, similar to the normal gastric smooth muscle cells. All esophageal leiomyomas belonged to this group. Nineteen of 29 of the Group 2 tumors showed desmin positivity and 20 of 29 showed MA positivity, but usually only in less than 10% of the tumor cells, and in many instances it was very difficult to determine whether the positive cells were real tumor cells or entrapped muscle cells. Only 5 of 29 of Group 2 tumors showed widespread desmin positivity and 11 of 29 showed similar MA positivity. Of round cell tumors, only 1 of 7 showed desmin-positive cells and 3 of 7 MA-positive cells. None of the sarcomas showed desmin, while MA positivity was found in 6 of 11 cases, often in a large number of tumor cells. Seven tumors showed a significant number of S-100 positive tumor cells, but four of these also showed a high number of desmin- and MA-positive cells, suggesting that these tumors represented complex proliferations of muscle and Schwann cell elements. Two purely S-100 positive benign probably Schwann cell-like tumors were found, both in the small bowel. Small number of S-100 positive cells were commonly found in GIST, and these probably represented entrapped Schwann cells, because many tumors showed simultaneous proliferation of non-neoplastic nerves. PMID- 3282427 TI - Isoenzymes of alkaline phosphatase in germinoma cells. AB - Utilizing 18 germinomas, the characteristics of isoenzymes of alkaline phosphatase (ALP) in germinoma cells were examined by light and electron microscopic enzymohistochemical and immunohistochemical techniques and biochemical methods including inhibition tests, electrophoresis and electrosyneresis. ALP in germinoma cells was generally located on the cell surface. In a few germinoma cells, however, ALP was seen not only on the cell membrane but also in the endoplasmic reticulum. Enzymohistochemically as well as biochemically, ALP in germinoma cells was little sensitive to L-phenylalanine, moderately sensitive to L-homoarginine and somewhat resistant to heat in its inhibition tests. Immunohistochemical examinations and electrosyneresis showed the presence of the placental type of ALP in germinoma cells and biochemical analyses revealed that the heat-stable component of ALP in germinoma cells was consistent with the D-variant of the placental type of ALP. Therefore, germinoma cells possessed mixed isoenzymes of ALP, consisting mainly of the liver/bone type and a small amount of D-variant of the placental type on the cell surface. The prominent expression of ALP in germinoma cells may be due to the enhanced expression of gonadal genes active in the germinoma genome. PMID- 3282428 TI - Pneumocystis carinii infection of the small intestine in a patient with acquired immune deficiency syndrome. AB - The authors describe a patient with acquired immune deficiency syndrome (AIDS) who presented with an acute abdomen. A plaque-like tumor of the small intestine was resected and found to consist of masses of Pneumocystis carinii organisms. The organisms also exhibited a perivascular and intravascular distribution. Identical changes were found in regional lymph nodes. In addition to silver stains and electron microscopy, an immunohistochemical method for the demonstration of P. carinii was employed. The technique may have advantages over silver staining, as it identifies trophozoites in addition to cysts. A review of the literature concerning extrapulmonary pneumocystosis indicates that affected patients nearly always have concurrent pulmonary infection. The pattern of organ involvement and the finding of perivascular and intravascular organisms are consistent with lymphatic or hematogenous dissemination from the pulmonary focus. Pulmonary pneumocystosis was not documented in the patient described herein, although there were radiographic densities in one pulmonary lobe. PMID- 3282430 TI - Bacteremia with group A streptococci in childhood. AB - Medical records of 60 patients with bacteremia caused by group A streptococci who were treated at the Yale-New Haven (Conn) Hospital from 1973 to 1986 and the Boston Children's Hospital Medical Center from 1977 to 1984 were reviewed. Seven children (12%) were immunocompromised, seven (12%) had varicella, and two (3%) had cavernous hemangiomas. Fifty-two children (87%) had an identifiable focus of infection. The most commonly documented sources of bacteremia were in the skin (22 children) and the respiratory tract (19 children). Metastatic foci of infection included osteomyelitis (nine children), septic arthritis (eight children), and meningitis (three children). Seven episodes were nosocomial (four were catheter related and three occurred postoperatively). Four patients (7%) died: two were severely immunocompromised, one of whom had extensive hemorrhagic varicella; the third had widespread hemorrhage into a large cavernous hemangioma of the skin; the fourth had an initial diagnosis of sudden infant death syndrome. Bacteremia with group A streptococci, although uncommon, continues to cause serious infections in children during the antibiotic era. PMID- 3282429 TI - Cutaneous and pericardial extramedullary hematopoiesis with cardiac tamponade in chronic myeloid leukemia. AB - A 48-year-old woman with Philadelphia chromosome-positive chronic myeloid leukemia developed skin and pericardial extramedullary hematopoiesis. The echocardiogram revealed massive pericardial effusion with signs of tamponade. The cytocentrifuge preparation of pericardial fluid demonstrated all three hematopoietic components. Assays for the granulocyte-macrophage progenitor cells and erythroid progenitors on her pericardial fluid gave rise to colony numbers comparable to those of normal bone marrow cells. The patient was successfully treated with pericardiocentesis followed by short-term indwelling catheter drainage and administration of hydroxy-urea. There was no reaccumulation of fluid at ten months. PMID- 3282431 TI - Selection to coffee drinking by health--who becomes an adolescent coffee drinker? PMID- 3282432 TI - Causality inference in observational vs. experimental studies. An empirical comparison. PMID- 3282434 TI - Analysis of case-control data derived in part from proxy respondents. PMID- 3282433 TI - The ecological fallacy. PMID- 3282435 TI - Prevalence of genetic and partially genetic diseases in man and the estimation of genetic risks of exposure to ionizing radiation. PMID- 3282437 TI - The surgical management of overcorrection in myopic epikeratophakia. AB - Three patients underwent myopic epikeratophakia that resulted in overcorrection. The surgical management of these cases involved resuturing the myopic lenticule to flatten the peripheral curvature and reduce the amount of minus power. A reduction in the overcorrection was achieved in all cases. PMID- 3282436 TI - Penetrating keratoplasty for pseudophakic bullous keratopathy after extracapsular cataract extraction. AB - Seventeen women underwent simple penetrating keratoplasty for pseudophakic bullous keratopathy after extracapsular cataract extraction. Corneal edema occurred an average of eight months after cataract surgery (range, zero to 32 months). Of 17 corneal grafts, 16 (94%) have remained clear during an average follow-up period of 14 months (range, two to 32 months). One eye had a nonimmunologic graft failure. Of 16 eyes with clear grafts, 14 (87%) achieved a visual acuity of 20/40 or better after surgery. Two eyes with a visual acuity of 20/50 and 20/200 had opacified posterior capsules and one demonstrated age related macular degeneration. One eye with a postoperative visual acuity of 20/40 demonstrated cystoid macular edema. Fifteen of 17 contralateral eyes showed slit lamp evidence of endothelial dystrophy. PMID- 3282439 TI - Ferrous intraocular foreign bodies and magnetic resonance imaging. AB - We placed various sized ferrous foreign bodies in and around the eye, sclera, and orbit in a rabbit model before performing magnetic resonance imaging studies. All foreign bodies were detected on plain x-rays. Only one of the largest fragments (3 x 1 x 1 mm) demonstrated movement on exposure to the magnetic field. PMID- 3282438 TI - Immunohistopathologic findings in proliferative diabetic retinopathy. AB - We performed immunopathologic studies on pars plana specimens obtained by biopsy in patients with diabetes mellitus type I or II and by autopsy in diabetic patients and normal subjects. Frozen sections were treated with several antisera, including anti-IgG, complement components, and major histocompatibility complex antigens, as well as anti-factor VIII to detect vascular structures. The results showed IgG in a linear pattern at the basal pole of pigment epithelial cells and complement deposits of C3c, C3d, and C4 at the same location and in the stroma. HLA-DR expression was found at the level of the pigmented cells. These data suggest that some autoimmune processes may be involved in proliferative diabetic retinopathy at the level of the pigment epithelium, but it is unknown whether they are an epiphenomenon of neovascularization or if they play a role in its initiation. PMID- 3282440 TI - Bilateral diffuse choroiditis and exudative retinal detachments with evidence of Lyme disease. PMID- 3282441 TI - Amiodarone keratopathy in the donor cornea. PMID- 3282442 TI - A simplified plastic embedding and immunohistologic technique for immunophenotypic analysis of human hematopoietic and lymphoid tissues. AB - Routine fixation and paraffin embedding destroys many hematopoietic and lymphoid differentiation antigens detected by flow cytometry or frozen section immunohistochemistry. On the other hand, morphologic evaluation is difficult in flow cytometric or frozen section studies. A simplified three-step plastic embedding system using acetone-fixed tissues embedded in glycol-methacrylate (GMA) resin has been found to provide both excellent morphologic and antigenic preservation. With our system, a wide variety of antigens are detected in plastic sections without trypsinization or prolonged embedding procedures; pan-B (CD19, CD22), pan-T (CD7, CD5, CD3, CD2), T-subset (CD4, CD8, CD1, CD25) markers as well as surface immunoglobulin and markers for myeloid and mononuclear-phagocyte cells are preserved. In summary, modifications of plastic embedding techniques used in this study simplify the procedure, apparently achieve excellent antigenic preservation, and facilitate evaluation of morphologic details in relation to immunocytochemical markers. PMID- 3282443 TI - Immunohistochemical analysis of sarcoid granulomas. Evaluation of Ki67+ and interleukin-1+ cells. AB - Proliferating cells have been immunophenotypically characterized in lymph node and bronchoalveolar lavage (BAL) samples obtained from patients with active and inactive sarcoidosis with the cell-cycle-related antigen Ki67. Ki67 monoclonal antibody was used by combined immunohistochemical methods together with antibodies recognizing macrophage- and T-cell-subset-related antigens using avidin-biotin peroxidase (ABC) and alkaline phosphatase-anti-alkaline phosphatase (APAAP) systems. Many proliferating Ki67+ cells were found in affected mediastinal lymph nodes. These cells were mainly located around granulomas and exhibited phenotypical markers of helper/inducer T cells (CD3+, CD4+). Ki67+ macrophages could not be detected in the same lesions with this technique. A different picture was found in BAL preparations where proportions of both T lymphocytes and macrophages were Ki67+. The presence of replicating lymphocytes could be correlated to disease activity, whereas the proportions of Ki67+ macrophages did not show significant differences between active and inactive disease. Interleukin-1 (IL-1) expression was investigated in the same samples with a specific antiserum. Epithelioid macrophages in granulomas and BAL macrophages in all cases exhibited cytoplasmic staining revealing an activated status. Interestingly, giant cells in granulomas were mainly devoid of IL-1 immunoreactivity. These studies support the concept that activated cells at different sites of ongoing inflammation play a central role in the mechanisms accounting for granuloma formation. PMID- 3282444 TI - Immunohistochemical characterization of a set of monoclonal antibodies to human neuron-specific enolase. AB - This paper describes the immunohistochemical staining properties of four monoclonal antibodies (MAbs) (CF, EB, AD, and KB) which had been previously shown to be specific for purified neuron-specific enolase (NSE) by a solid-phase radioimmunoassay. In this study, the authors immunostained a spectrum of normal and neoplastic neuronal, "neuroendocrine," and nonneuronal tissues fixed in formalin and embedded in paraffin. Positivity was generally restricted to normal neuronal structures and neuronal tumors, including adrenal neuroblastoma, ganglioneuroblastoma, olfactory neuroblastoma, pheochromocytoma, carotid body paraganglioma, duodenal gangliocytic paraganglioma, and teratoma with neuroepithelial components. Three staining patterns of the normal or neoplastic neuronal structures were observed: two MAbs (CF and EB) stained predominantly the nerve fibers (axoplasm); one (AD) stained predominantly the cell bodies (perikaryon); and one (KB) stained both the axoplasm and the perikaryon. "Neuroendocrine" tumors such as pulmonary small cell carcinoma, pancreatic islet cell tumor, thyroid medullary carcinoma, and carcinoid tumors from various locations showed a variable staining pattern. Tumor cells undergoing mitotic division were usually positive regardless of type. Normal structures other than neuronal or "neuroendocrine," including normal glial cells, were negative. The authors also studied a range of glial cell tumors with MAbs CF and AD as well as with Dako polyclonal antiserum to NSE. The results showed that CF stained the axonal fibers in the normal white matter surrounding these tumors; it did not stain the tumor cells or the perikarya of neurons in the surrounding normal gray matter. AD stained the glioma cells as well as the perikarya and dendrites of neurons in the surrounding normal gray matter; it did not stain the axonal fibers in the surrounding normal white matter. By contrast, the polyclonal antiserum stained all of these structures. The high degree of staining specificity of the MAbs should prove them to be valuable in immunohistochemical diagnosis of tumors as well as in further understanding the role of NSE in neuronal differentiation. PMID- 3282445 TI - Detection and localization of renin messenger RNA in human pathologic tissues using in situ hybridization. AB - In order to investigate the synthesis of renin in human pathologic tissues, the authors used in situ hybridization to detect and localize renin messenger RNA (mRNA). The probe was a 35S-radiolabeled 1.1-kb length complementary DNA of human renal renin. To compare the synthesis with the presence and the storage of renin, renin antigen was assessed by immunohistochemistry in the same tissues. The human pathologic tissues were as follows: two ischemic kidneys related to renovascular hypertension; two renal juxtaglomerular cell tumors; one extrarenal renin secreting epithelioid sarcoma of soft tissues. In ischemic kidneys, the cells containing both renin mRNA and renin protein were found in numerous juxtaglomerular apparatus and in the wall of arterioles, shown by combined in situ hybridization and immunohistochemistry. Most of the tumor cells in the juxtaglomerular cell tumors and scarce tumor cells in the epithelioid sarcoma of soft tissues were positive by in situ hybridization and immunohistochemistry. These findings demonstrate that the presence of renin in these tissues is associated with local cellular production of renin. In particular, smooth muscle cells of the wall of arterioles are definitely capable of synthesizing renin. Moreover, in these tissues, gene expression (renin synthesis) and renin storage are concordant. PMID- 3282446 TI - Stainable bone iron in undecalcified, plastic-embedded sections. Occurrence in man related to the presence of "free" iron? AB - Iron demonstrable with the Prussian blue reaction at the osteoid/mineralized tissue interphase (osteoid seam) of trabecular bone was observed in only 2.3% of a total of 1536 conventionally fixed and processed, undecalcified, plastic embedded biopsy specimens taken from the iliac crest of patients for various diagnostic purposes. In marked contrast, clearly stainable bone iron was noticed in all 4 biopsy specimens from the iliac crest and in 11 of 15 vertebral bone fragments obtained at autopsy from individuals with verified primary or secondary hemochromatosis. Findings, including results obtained in vitro, suggest that a positive Prussian blue reaction at the surface of trabecular bone signals the presence of low-molecular-weight ("free") iron, which can bind to the osteoid matrix directly, ie, without the help of osteoblasts. Stainable bone iron may thus be a useful criterion for early detection of hemochromatosis and other types of potentially toxic iron overload. PMID- 3282447 TI - Site-specific monoclonal antibodies against peanut agglutinin (PNA) from Arachis hypogaea. Immunohistochemical study of tissue-cultured cells and of 27 cases of Hodgkin's disease. AB - The purpose of this study was to increase the sensitivity of the staining reaction for the T antigen on the surface of neoplastic cells grown in vitro with the use of site-specific monoclonal antibodies (MAbs). The authors describe anti peanut agglutinin (PNA) MAbs selected by screening the hybridomas with PNA and PNA bound to bovine serum albumin conjugated with the T antigen. The selected hybridomas (F2C8, F3D12, F3A5) were then grown in pristane-sensitized mice or in the Amicon Hollow Fiber System (F2C8). The affinity constant values for PNA were measured, and all the purified MAbs were tested on both native and denatured PNA, wheat germ agglutinin, concanavalin A, and ricin by using the immunoassay dot test and immunoblotting methods. Eleven different cell lines were stained with the three MAbs; similar results were obtained with F2C8 and F3D12. In each case the fluorescence, if present, was associated with the cell membrane, and the intensity of the staining was always stronger when the cells were incubated with the MAbs than when stained with fluorescein-labeled PNA. On the other hand, F3A5 failed to stain unfixed cells preincubated with PNA but stained the same cells after fixation, independently of the presence of PNA. One of the antibodies, F2C8, was used to stain histologic preparations from 27 cases of Hodgkin's disease and was compared with the anti-granulocyte antibody, Leu-M1, which has been used by numerous authors to identify the characteristic Reed-Sternberg cells. The results obtained were qualitatively similar; ie, F2C8 was at least as efficient as anti-Leu-M1 in its ability to stain the typical diagnostic cells in Hodgkin's disease. PMID- 3282448 TI - Privatization of psychiatric services. AB - The authors provide an overview of privatization, a major trend in mental health policy, focusing in particular on the reasons for and consequences of substantial growth and change in ownership of private psychiatric hospitals; the proportion of all nonfederal psychiatric inpatient beds in private facilities has increased from less than 10% in 1970 to 35% today. It is estimated that between 1970 and 1986, the proportion of total nonfederal psychiatric inpatient beds in the United States that were under corporate for-profit auspices increased from about 1% to 15%. The authors distinguish and examine several aspects of privatization and assess the implications of these changes for psychiatry and for public policy and research. PMID- 3282449 TI - Lies and liars: psychiatric aspects of prevarication. AB - The authors discuss the phenomenon of lying, a common psychic process that has received remarkably little scrutiny. The ubiquity of lying and others forms of deception suggests that they have "normal" aspects, but lying which is persistent or destructive to the quality of a person's life becomes pathological. Lying has many determinants, including developmental, biological, social, and psychodynamic. Antisocial, histrionic, narcissistic, borderline, and compulsive personalities have been associated with lying. The treatment of lying needs to be individualized according to the overall symptom complex in which it is embedded. PMID- 3282450 TI - The idiot savant: a review of the syndrome. AB - Since it was first described a century ago, the phenomenon of the idiot savant- the juxtaposition of severe mental handicap and prodigious mental ability--has remained unexplained. The author defines the condition, reviews and summarizes the world literature on this topic since the early reports, describes more recent cases, and catalogs and categorizes idiot savant abilities. Theories to explain the condition are reviewed, newer research findings are highlighted, and the far reaching implications of the idiot savant syndrome for understanding normal brain function, particularly memory, are outlined. PMID- 3282451 TI - A pilot study of treatment of social phobia with alprazolam. AB - Fourteen patients with DSM-III social phobia were treated with alprazolam in an open study. Multiple measures of symptoms and disability showed significant improvement. The symptoms improved during the first and second weeks, and disability improved at 3 weeks and beyond. After medication withdrawal the symptom and disability measures were no longer significantly different from those at baseline. PMID- 3282453 TI - Separation-free dual solid phase enzyme immunoassay for macromolecules. PMID- 3282452 TI - Response to memory training and individual differences in verbal intelligence and state anxiety. AB - Prior studies have documented the effectiveness of several types of memory training for the elderly with normal age-related memory losses. Despite these positive results, there is substantial variability of individual response to treatment. The authors describe attributes of individuals most likely to benefit from two types of memory training. They found that for 40 elderly volunteers performance on the WAIS vocabulary subscale correlated with response to a treatment combining mnemonics and verbal elaboration techniques and scores on the Spielberger State-Trait Anxiety Inventory correlated with response to a treatment combining mnemonics and relaxation techniques. PMID- 3282454 TI - Polarographic adsorption analysis and tensammetry: toys or tools for day-to-day routine analysis? PMID- 3282455 TI - Complement: function and clinical relevance. AB - There is a remarkable array of proteins participating in the complement cascade, regulating the activation of the system, or recognizing a fragment of a component as a biologic signal. The classical pathway of complement activation depends on antigen-antibody interaction and is important as an effector arm of acquired humoral immunity to microorganisms. The alternative pathway functions as a form of innate humoral immunity by attacking membranes not having the characteristics of self-membrane. In addition, the alternative path provides amplification after triggering by either path. Absence or dysfunction of many of the components is associated with autoimmune or immunodeficiency disease. Absence of the inhibitor C1INH is associated with the unique syndrome of hereditary angioedema. PMID- 3282456 TI - Effects of mizoribine on canine renal allograft recipients. AB - Heterotopic renal allograft transplantation and bilateral nephrectomies were performed on 12 mixed-breed dogs. Histoincompatibility was confirmed by serologically defined and lymphocyte-defined antigen testing. Mizoribine (5 mg/kg, q 24 h) was administered orally starting the day of surgery. Body weights, blood cell counts, serum biochemical and electrolyte values, immunoglobulin concentration, and serum mizoribine concentrations were determined. Complete urinalyses, including bacteriologic culturing and lymphocyte stimulation assays were performed. The mean survival time for the allograft recipients was 20 +/- 14 days; significantly longer than nontreated historic controls surviving 8.1 +/- 0.6 days (P = 0.0098). Death was attributed to the combined effects of renal allograft rejection and development of a mizoribine-dependent gastroenteritis. Serum mizoribine concentrations were greater in dogs undergoing rapid allograft rejection because of compromised renal excretion of the drug. This resulted in a rapid onset of gastroenteritis. There were no complications resulting from infection, myelosuppression, or hepatotoxicosis. PMID- 3282457 TI - Rabbit pasteurellosis: induced disease and vaccination. AB - Pasteurellosis was induced in rabbits by conjunctival inoculation with 2 strains of Pasteurella multocida. The LD50 of strain P1062 (a bovine isolate) was 10(5.1) colony-forming units and that of strain P1059 (a turkey isolate) was 10(5.5) colony-forming units. Pasteurella-free rabbits were vaccinated IV or mucosally with boiled cells of P multocida or a cross-reactive uridine diphosphogalactose epimerase-deficient mutant of Escherichia coli J5. In rabbits challenge exposed with P multocida strain 1062 or 1059, homologous P multocida strain gave the best protection against fatal bacteremia. Partial protection was provided by J5; mucosal routes of vaccination (aerosol or conjunctival) gave better protection than did the IV route. Serum antibody titers were lower in rabbits vaccinated by mucosal routes than in those vaccinated IV. Cross-reactive IgG and IgM titers to P multocida were demonstrated when rabbits were vaccinated with J5. On the basis of bacteriologic examination of nasal secretions, rabbits that died were considered culture positive sooner than were those that survived. On the basis of bacteriologic examination of blood, rabbits that died were considered culture positive, and those that survived were considered culture negative. Seemingly, heat-stable antigens were protective, the cross-reactive E coli J5 mutant (with only core lipopolysaccharide) provided partial protection against pasteurellosis, and the mucosal route was somewhat useful for cross-protective immunization. PMID- 3282458 TI - Effect of naturally occurring intramammary infections by minor pathogens on new infections by major pathogens in cattle. AB - New mammary infections were recorded in 3 dairy herds during a lactation period by bacteriologic examination of milk samples at 3-week intervals. Influences of the infection status of quarters at the time of new infection and of microorganisms responsible for bacterial invasion were analyzed. The new infection rate in uninfected quarters was about 3 times the rate in quarters already harboring bacterial considered minor pathogens (coagulase-negative staphylococci and Corynebacterium bovis) or major pathogens (Staphylococcus aureus, streptococci). The frequency of new infections with major pathogens was almost halved by preexisting infections with minor pathogens (P = 0.05), mainly because of coagulase-negative staphylococci (P = 0.05) and, to a lesser extent, C bovis (P = 0.19). New infections by minor pathogens also were less frequent in quarters harboring a major pathogen (P less than 0.05), indicating that the competition or antagonism between mammary infections was a general phenomenon. PMID- 3282459 TI - Combined rotavirus and K99 Escherichia coli infection in gnotobiotic pigs. AB - Fifty nine 3-day-old gnotobiotic pigs were randomly assigned to 4 experimental groups: 14 pigs were orally inoculated with rotavirus (RV), 14 were orally inoculated with enterotoxigenic Escherichia coli (ETEC), 18 were orally inoculated with both agents, and 13 were controls. Pigs inoculated with RV plus ETEC were given the RV inoculum at 3 days of age and then, 24 hours later, were given the ETEC inoculum. Three pigs inoculated only with RV, 3 pigs inoculated only with ETEC, 4 pigs inoculated with RV plus ETEC, and 3 pigs in the control group were euthanatized at 5 and 7 days of age. Two pigs in each of the 4 experimental groups also were euthanatized at 9 days of age. Intestinal segments from 6 sites in the small intestine were examined by virologic, bacteriologic, and histologic procedures. For 10 days after inoculation, the remaining pigs in each group were observed clinically to monitor severity and duration of diarrhea, mortality, and shedding of RV or ETEC. Pigs inoculated with the combined RV plus ETEC inoculum developed more severe diarrhea, compared with pigs inoculated with the single agents; all dually inoculated pigs died between 3 and 6 days after inoculation. There was no mortality in pigs inoculated with either RV or ETEC. Lesions were restricted to the small intestine in pigs inoculated with RV plus ETEC and in pigs inoculated with RV or ETEC. There was no difference in the severity of the villus atrophy between the dually inoculated pigs and pigs inoculated only with RV.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282461 TI - Borreliosis in equids in northeastern United States. AB - During 1982 and 1985, blood samples from 705 equids were examined for antibodies to Borrelia burgdorferi. By indirect immunofluorescence staining, IgM and total immunoglobulin (IgM and IgG) antibodies were detected in 37 (5.3%) and 90 (12.8%) serum specimens, respectively. The geometric mean titer for IgM antibody (140.4) was highest during July, whereas total immunoglobulin ranged from 94.1 in October to 338 in May. Eighty-six equids with total immunoglobulin to B burgdorferi lived in areas of Connecticut where the primary tick vector, Ixodes dammini, was present. Of the 86 equids, 9 from Lyme, Connecticut and Westchester County, New York had antibodies to B burgdorferi and developed limb or joint disorders that resulted in single or recurrent episodes of lameness. PMID- 3282460 TI - Effects of single-dose and three-day trimethoprim-sulfadiazine and amikacin treatment of induced Escherichia coli urinary tract infections in dogs. AB - Efficacy of single-dose and 3-day trimethoprim-sulfadiazine (TMS) and amikacin treatment regimens for induced Escherichia coli urinary tract infections (UTI) in dogs was evaluated. Using each regimen, effects of giving TMS combination or amikacin were compared in males and females, and the response of treated dogs was compared with that of nontreated controls. Response to treatment was evaluated, using results of quantitative urine cultures and urinalyses obtained on 4 occasions. Abacteriuria was identified by finding a lack of bacterial organisms in specimens collected for the initial and final posttherapy evaluations. Before treatments, magnitudes of bacteriuria were similar in all experimental groups, and UTI persisted in all nontreated dogs. Single-dose treatment regimens did not reliably eradicate UTI in males or females, whether amikacin or TMS was administered. Magnitude of bacteriuria often diminished immediately after single dose treatment, and such reductions of bacteriuria persisted in 2 of 8 dogs. However, no male dogs and only 1 of 4 females became abacteriuric after a single dose treatment regimen. The single female in which UTI was eradicated was treated with a single dose of amikacin. The 3-day TMS treatment regimen eradicated UTI in each of 4 females, but the 3-day amikacin treatment regimen resulted in abacteriuria in only 1 of 4 females. Three-day treatment regimens were not effective in male dogs, regardless of the antimicrobial drug used. Of the short course treatments for canine UTI evaluated by this model, only 3-day TMS treatment of females was consistently effective. PMID- 3282462 TI - Adverse metabolic effect of omega-3 fatty acids in non-insulin-dependent diabetes mellitus. AB - Increased interest in using omega-3 fatty acids led us to examine their metabolic effects in six men with type II (non-insulin-dependent) diabetes mellitus. After 1 month of a diet supplemented with these fatty acids, the patients' fasting glucose rose from 13.1 +/- 1.3 to 15.3 +/- 1.3 mmol/L (P = 0.03) and glucose area during a mixed meal profile rose by 22% (P = 0.04). Basal hepatic glucose output rose from 97 +/- 9 to 122 +/- 8 mg/m2 . min (P = 0.004) but glucose disposal rates measured by euglycemic glucose clamp were unchanged. Fasting insulin levels were similar; peak insulin levels stimulated by meals or intravenous glucagon fell by 30% and 39%, respectively. Plasma and erythrocyte content of omega-3 fatty acid rose significantly. After omega-3 fatty acid withdrawal, fasting glucose returned to baseline. Omega-3 fatty acid treatment in type II diabetes leads to rapid but reversible metabolic deterioration, with elevated basal hepatic glucose output and impaired insulin secretion but unchanged glucose disposal rates. Caution should be used when recommending omega-3 fatty acids in type II diabetic persons. PMID- 3282464 TI - Proliferative response of bronchoalveolar lymphocytes to beryllium. A test for chronic beryllium disease. AB - STUDY OBJECTIVE: to ascertain whether measuring the proliferative response of bronchoalveolar lymphocytes to beryllium salts is useful for diagnosing chronic beryllium disease. DESIGN: prospective case series compared to normal volunteers and patients with sarcoidosis. SETTING: university referral center. PATIENTS: twenty-three consecutive beryllium workers were evaluated. Fourteen had chronic beryllium disease diagnosed on the basis of histologic evidence of a progressive pulmonary granulomatosis. Four had biopsy evidence of non-beryllium disease. Three had probable chronic beryllium disease but did not have lung biopsies. Two did not have biopsies and had basilar fibrosis on chest roentgenogram suggestive of non-beryllium lung disease. These patients were compared with 6 normal volunteers and 16 patients with sarcoidosis. MEASUREMENTS AND MAIN RESULTS: bronchoalveolar lavage was done and the proliferative response of the lung cells to two beryllium salts was tested. A positive proliferative test was defined as a stimulation index of more than five on two determinations. The sensitivity of this test was 100% in the 14 patients with definite chronic beryllium disease. The specificity of the test was also 100% among the normal volunteers and the 16 patients with sarcoidosis. The test was positive in none of the four patients with biopsy evidence of non-beryllium disease, none out of two patients with lower lobe fibrosis suggestive of non-beryllium disease, and all of three patients with probable chronic beryllium lung disease. CONCLUSIONS: the proliferative response of bronchoalveolar lymphocytes to beryllium appears to be a useful test for chronic beryllium disease. PMID- 3282463 TI - Gallium nitrate for acute treatment of cancer-related hypercalcemia. A randomized, double-blind comparison to calcitonin. AB - STUDY OBJECTIVE: To determine whether gallium nitrate therapy is superior to maximally approved doses of calcitonin for acute control of cancer-related hypercalcemia. DESIGN: Randomized, double-blind comparison of active treatments. SETTING: Comprehensive cancer center. PATIENTS: One hundred ninety-eight consecutive hypercalcemic events in 164 patients screened for entry. ELIGIBILITY CRITERIA: hospitalization and intravenous hydration for at least 2 days; persistent elevated serum calcium levels of 2.99 mmol/L or greater (adjusted for serum albumin); serum creatinine levels of 221 mumol/L or less; no cytotoxic chemotherapy, radiation, or mithramycin within the preceding 7 days or during study; no concurrent use of aminoglycoside antibiotics; life expectancy greater than 4 weeks; lymphoma and parathyroid carcinoma excluded. Patients were stratified by histologic type of tumor (epidermoid or nonepidermoid). Fifty patients were randomized and treated. INTERVENTIONS: Gallium nitrate 200 mg/m2 body surface area for 5 days by continuous intravenous infusion, or salmon calcitonin 8 IU/kg body weight every 6 hours for 5 days by intramuscular injection. Patients randomized to receive gallium nitrate received sham injections of saline to simulate calcitonin; patients randomized to receive calcitonin received 1000 mL 5%-dextrose solution to simulate gallium nitrate. MEASUREMENTS AND MAIN RESULTS: All patients were evaluable. Eighteen of twenty four patients who received gallium nitrate achieved normocalcemia compared with 8 of 26 patients who received calcitonin for an observed difference of 44% (95% confidence interval, 19% to 69%; P = 0.002). Median duration of normocalcemia before other cytotoxic or hypocalcemic therapy was 6 days for patients treated with gallium nitrate compared with 1 day for patients treated with calcitonin (P less than 0.001). Median duration of normocalcemia regardless of intercurrent treatment and without adjustment for serum albumin was 11+ days for patients treated with gallium nitrate and 2 days for patients treated with calcitonin (P less than 0.01). Mean daily fluid intake and mean daily dose of furosemide were similar in both treatment groups. No additional benefit was seen in 9 patients randomized to receive calcitonin who incidentally received corticosteroids. CONCLUSIONS: Gallium nitrate therapy is highly effective and superior to maximally approved doses of calcitonin for acute control of cancer-related hypercalcemia. PMID- 3282465 TI - Diagnosis of Chlamydia trachomatis genitourinary infections. AB - The lack of a widely available diagnostic test for genital infections with Chlamydia trachomatis, coupled with their often nonspecific clinical nature, have been important factors contributing to the increasing incidence of these infections. Recent studies have more clearly defined the clinical manifestations of C. trachomatis infections, especially mucopurulent cervicitis and pelvic inflammatory disease. In addition, methods for the direct detection of chlamydial antigen in genital secretions have been developed. Although less sensitive than traditional cultural methods, these noncultural methods are more widely available than cultures and can facilitate the earlier recognition and more specific diagnosis of chlamydial genital infections. This article reviews these recent developments and outlines specific applications of tests for diagnostic purposes and for screening of high-risk populations. PMID- 3282466 TI - New issues in geriatric care. AB - The rapid growth of the elderly population has increased the need for improved geriatric care and prevention of disability. For example, the prevalence and severity of osteoporosis can be reduced significantly by the use of estrogen, with or without added progestin, in postmenopausal women. A common and devastating problem of frail elderly persons is urinary incontinence, most cases of which can be classified without referral for urologic services. Appropriate treatment can improve nearly half of all cases of persistent incontinence. Comprehensive geriatric assessment is effective in guiding the treatment of frail elderly patients and leads to significantly improved outcomes under appropriate conditions. The advent of the teaching nursing home has shed light on the medical problems of elderly residents of nursing homes, including malnutrition, dysregulation of water and electrolyte balance, falling, cognitive and affective illnesses, behavior disturbances, infections, and pathogenic drug use. The future application of advanced technology may revolutionize nursing home care. PMID- 3282468 TI - Potential costs of preventing extension of myocardial infarction. PMID- 3282469 TI - Studies of omega-3 fatty acids. PMID- 3282467 TI - 2'-Deoxycoformycin (pentostatin) for lymphoid malignancies. Rational development of an active new drug. AB - A new antimetabolite, 2'-deoxycoformycin (pentostatin), has striking antitumor activity in several lymphoid neoplasms. Isolated from cultured soil organisms, this purine analogue is a potent inhibitor of adenosine deaminase (ADA), and is thus selectively toxic to lymphocytes. Early clinical trials showed that high doses of pentostatin caused severe and unpredictable toxicity, but responses in refractory lymphoid malignancies were encouraging. Careful pharmacologic studies led to the definition of a safe and effective low weekly dose, at which protracted ADA inhibition occurs in neoplastic cells. The most sensitive tumor identified is hairy cell leukemia, in which durable remissions are achieved in more than 90% of patients with a relatively brief course of treatment. Other responsive diseases include chronic lymphocytic leukemia, prolymphocytic leukemia, mycosis fungoides, and acute T-cell lymphoma or leukemia. Response has been seen in acute lymphocytic leukemia, but the higher doses required are substantially more toxic. Pentostatin is valuable for treatment of indolent lymphoid malignancies and may be useful in non-cancer-related lymphocyte research. PMID- 3282470 TI - Ultrasonography in Wilson disease. PMID- 3282471 TI - Streptococcus pyogenes and the toxic shock syndrome. PMID- 3282472 TI - The idiopathic nephrotic syndrome and renal biopsy. PMID- 3282473 TI - Retinal toxicity study of intravitreal carboplatin and iproplatin. AB - We tested the intravitreal toxicity of two second-generation, antineoplastic, platinum-coordination compounds, carboplatin and iproplatin, in the rabbit. No histologic or electroretinographic changes were observed in doses of 3 micrograms or less. These analogues of cisplatin are 30 times less toxic than the parent compound and may be useful in the prevention of cell proliferation in the vitreous. PMID- 3282474 TI - Conservative excision of penile melanoma. AB - Penile melanoma is a rare disease, especially in younger men. Most authorities advocate aggressive surgical management by partial or radical phallectomy and in some cases inguinal lymph node dissection. A 27-year old man with a clinical stage I, Clark's level II, microinvasive (less than 0.76 mm) superficial spreading penile melanoma underwent conservative resection and skin grafting without inguinal node dissection. He has normal penile function and is disease free 5 years following surgery. We believe that in clinical stage I, microinvasive penile melanoma, local excision without inguinal node dissection should be the treatment of choice. PMID- 3282475 TI - Oncogene expression in adenocarcinomas of the colon and in colon tumor-derived cell lines. AB - Six colon cancer cell lines, 13 colon tumors and ten normal colon tissues were analyzed for RNA expression using probes for c-myc, c-k-ras, c-myb, and c-fos and for the p53, TGF-alpha, and EGF receptor genes. No aberrant transcripts were detected. Levels of expression in tumors ranged from two-fold below that of normal tissue when the v-fos probe was used to 10 fold above the normal level when the c-myc probe was used. Enhanced c-myc expression was also observed in the cell lines. Southern and DNA dot blot analyses revealed c-myc amplification in three of the six cell lines. PMID- 3282476 TI - Immunobiology of a spontaneously regressive tumor, the canine transmissible venereal sarcoma (review). AB - Canine transmissible venereal sarcoma (CTVS) is a contagious neoplasm of dogs that can be transplanted with intact viable cells across major histocompatibility (MHC) barriers among dogs and even other Canine such as foxes, coyotes, and jackals. After two to four months of progressive growth, the tumor regresses in adults, but metastasizes in immunosuppressed dogs and neonatally inoculated pups. The mechanisms of how the tumor cells manage to overcome histocompatibility barriers so successfully for such a long period and yet succumb later are not known. Immunologic studies have demonstrated serum antibodies in dogs that have the tumor. Tumor cells have been shown to contain a tumor-associated antigen (TAA). In contrast to TAA expression, cells from progressor tumors lacked the expression of either Class I or Class II MHC antigens whereas 30 to 40% of those from early regressor tumors expressed both Class I and Class II MHG antigens. This in turn may provoke additional immune reactions of the host to speed up the rejection process and cause the tumor mass to regress in two to three weeks. Tumors growing in adult dogs are smaller but infiltrated with greater numbers of lymphocytes than are the larger tumors growing in pups. Analyses of the neoplasms at different stages of growth have shown that regressing tumors contain higher numbers of lymphocytes, most of which are T cells. Electron microscopic studies have revealed that most cells in progressively growing tumors are round cells with microvilli, whereas those at steady-state and regressive stages are "transitional" cells with features that are intermediate between round cells and spindle-shaped fibroblastic cells. Regressing tumors have spindle-shaped cells with "abnormal" intracellular collagen bundles in vacuoles. Regressing tumors have spindle-shaped cells suggestive of tumor cell differentiation toward fibroblastic cells. It is tempting to speculate that lymphokines secreted by infiltrating lymphocytes may be important in the regression process by diffusion through the tumor mass to induce differentiation of round cells into spindle shaped cells. CTVS is thus an experiment of nature showing that tumor cell differentiation and, in turn, spontaneous regression can be induced. Elucidation and exploitation of the underlying mechanism which is available in the body will be of great significance and practical importance. PMID- 3282477 TI - Overview of the Cross-National Collaborative Panic Study. AB - The Cross-National Collaborative Panic Study is a two-phase multinational, multicenter controlled trial for the evaluation of drug treatment of panic disorder and associated agoraphobia. The First Phase compared alprazolam with placebo in a large sample of more than 600 subjects at eight centers--five in the United States, two in Canada, and one in Australia. The Second Phase compared alprazolam, imipramine hydrochloride, placebo in more than 1100 patients in 14 countries. The scientific background, aims and purposes, governance, and policies regarding statistical analyses and scientific presentations and publications are reviewed as background for the series of individual articles reporting detailed findings from the First Phase. PMID- 3282479 TI - Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. III. Discontinuation effects. AB - Preliminary reports of discontinuation of alprazolam therapy in patients with panic disorder have revealed worsening of symptoms despite gradual withdrawal of medication. In this study, 126 patients with panic disorder and phobic avoidance received either alprazolam or placebo in doses of 2 to 10 mg daily for eight weeks. The medication was tapered over a period of four weeks, and patients were observed for another two weeks after all medication was discontinued. Sixty of the 63 alprazolam-treated patients and 49 of the 63 placebo-treated patients entered the taper and discontinuation study. After improvement in the active treatment period, the alprazolam-treated group had significant relapse between the first and last week of taper. However, during the second postdiscontinuation week, outcome scores were not significantly different from those of the placebo treated group who did not deteriorate during taper. Twenty-seven percent of the alprazolam-treated group reported a rebound of panic attacks during taper and 13% reported a rebound of anxiety on the Hamilton Anxiety Scale. No serious or life threatening withdrawal symptoms were reported, but distinct, transient, mild to moderate withdrawal syndrome occurred in 35% of the alprazolam-treated group and in none of the placebo-treated group. The coexistence of symptom rebound and a withdrawal syndrome occurred in 10% of the alprazolam-treated group, but both subsided by the end of the second week without alprazolam. We recommend that patients with panic disorder be treated for a longer period, at least six months, and that medication be tapered over a more prolonged period, at least eight weeks, especially where high doses are employed. PMID- 3282478 TI - Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. I. Efficacy in short-term treatment. AB - Following promising preliminary evidence, the benzodiazepine-derivative alprazolam was studied in a large, placebo-controlled, eight-week, flexible-dose trial in patients with agoraphobia with panic attacks and panic disorder. Of 526 patients, 481 completed three weeks of treatment; however, significantly more placebo (102/234) than alprazolam (21/247) recipients subsequently dropped out of the trial, primarily citing ineffectiveness (of placebo) as the reason. Alprazolam was found to be effective and well tolerated. There were significant alprazolam-placebo differences in improvement for (1) spontaneous and situational panic attacks, (2) phobic fears, (3) avoidance behavior, (4) anxiety, and (5) secondary disability, all significant by the end of week 1. At the primary comparison point (week 4), 82% of the patients receiving alprazolam were rated moderately improved or better vs 43% of the placebo group. At that point, 50% of the alprazolam recipients vs 28% of placebo recipients were free of panic attacks. PMID- 3282480 TI - Secondary depression in panic disorder and agoraphobia. I. Frequency, severity, and response to treatment. AB - Depressive symptomatology in 481 subjects with panic disorder and phobic avoidance was studied as part of an investigation of the efficacy of alprazolam in panic disorder. Subjects who had a major depressive episode (MDE) before the onset of their panic disorder were not included in the trial. With this exclusion criterion, 31% of subjects had a secondary MDE occurring after the onset of the panic disorder. The occurrence of secondary MDE was related to the length of time subjects were ill with panic disorder. Compared with the subjects without depression, those subjects with current MDE had higher scores on measures of anxiety and depression but not on the number of panic attacks per week. The presence of depression and the degree of phobic avoidance contributed independently to measures of the severity of the panic illness. Alprazolam was effective in reducing panic and depressive symptomatology in both depressed and nondepressed subjects with panic disorder. The presence of an MDE was not predictive of the outcome of treatment for the panic and phobic symptoms. Subjects with or without depression responded similarly to alprazolam. PMID- 3282481 TI - Clomipramine treatment of agoraphobic women. An eight-week controlled trial. AB - The efficacy of clomipramine hydrochloride in the treatment of agoraphobia was investigated in an eight-week placebo-controlled double-blind study. One hundred eight women diagnosed as agoraphobic by DSM-III guidelines were randomly assigned to the clomipramine or placebo group; 70 women (mean age, 36.6 years) completed the eight-week trial. The study medication was prescribed on the basis of weekly increments to a maximum of 300 mg/d, with a mean dosage at week 8 in the clomipramine hydrochloride group of 82.8 mg/d. Assessments performed prior to the trial and at the four- and eight-week points included the completion of standardized questionnaires and daily diaries, as well as the administration of a Behavioral Approach Test. Clomipramine was significantly superior to the placebo on several indexes of phobic symptoms and on measures of depression and dysphoria. Results are discussed in terms of the hypothesized action of clomipramine and the pattern of significant findings. PMID- 3282482 TI - Phenelzine vs placebo in 50 patients with bulimia. AB - To examine the efficacy of the monoamine oxidase inhibitor phenelzine sulfate in the treatment of bulimia, a double-blind, placebo-controlled trial was conducted. In 50 women who completed the trial, phenelzine was significantly superior to placebo in the reduction of binge frequency (64% vs 5%), in the fraction of patients who had ceased bingeing at the end of the trial (35% vs 4%), and in several measures of psychological state. The superiority of phenelzine over placebo was not confined to a depressed subgroup of patients. Although no patient experienced a hypertensive crisis during the study, other side effects of phenelzine were problematic and limit the usefulness of phenelzine in this population. PMID- 3282483 TI - Epidemiological approaches to developmental psychopathology. AB - Developmental psychopathology as a research approach draws on both developmental and psychopathologic perspectives to tackle questions about causal mechanisms. Developmental perspectives are discussed in terms of the implications that flow from age differences in prevalence, age trends in remission of disorders, developmental appropriateness of psychiatric conditions, continuities and discontinuities in psychopathology between childhood and adult life, and age differences in the effects of psychiatric risk factors. Psychopathologic perspectives are considered in terms of continuities and discontinuities between normality and pathology and the contrasts between pervasive and situation specific disorders, and by the differences between single variables and behavioral composites. The use of epidemiological data to examine causal processes is discussed, with attention to the need to consider development in its social context and to examine indirect, as well as direct, causal chains of connection. PMID- 3282484 TI - Does the immune response play a role in the pathogenesis of chronic liver disease? AB - The pathogenesis and perpetuation of hepatocellular injury in chronic inflammatory liver disease is still unclear. Several pieces of circumstantial evidence point to the importance of antigen-specific immune responses. In chronic hepatitis B virus infection, the hepatitis B virus nucleoprotein appears to be a major target antigen for both helper and cytotoxic T lymphocytes. In autoimmune chronic active hepatitis, several autoantibodies have been identified that are associated with different disease subgroups and that may be helpful to distinguish this form of chronic active hepatitis from that caused by non-A, non B agents. In primary biliary cirrhosis, antimitochondrial antibodies are almost invariably present and have now been characterized at the molecular level. PMID- 3282486 TI - Immunohistochemical studies on local antitumor effects of streptococcal immunopotentiator, OK-432, in human solid malignant tumors. AB - Immunocytochemical techniques were used to clarify the local inhibitory effects of a streptococcal immunopotentiator, OK-432, against solid malignant tumor growth. Natural killer (NK) cells and fibronectin were chosen as immunostaining markers to demonstrate the antitumor effects. Immunocytochemical staining was performed by the avidin-biotin-peroxidase complex method. These investigations demonstrated that (1) local administration of OK-432 seems to promote a marked induction of NK cells and fibroblasts around or entering into the cancerous lesions and (2) the cancer cell-killing effect of NK cells and the fibronectin enriched stromal reaction augmented by the injection of OK-432 suggest at least the possibility of protection against neoplastic growth with invasion and the spread of distant or nodal metastases of solid carcinomas. PMID- 3282487 TI - Standard method for the investigation of bone transplants, ceramics, or other material in a human bony layer. AB - A new model for the investigation of human bone regeneration is introduced. We use the iliac crest as a bony layer for implants, which are the object of research. For therapy in cases of delayed bone healing the cancellous bone is removed. The empty iliac crest is then filled with the material we want to investigate. During a further operation necessitated by therapy of the bone disease, we obtain a probe of bone and material by drilling a hole through the iliac crest. This bony cylinder can be examined by histological techniques. We have used this procedure in 69 patients to date. No specific complications were caused by the implants. Fifteen biopsies could be taken and are now under examination. In the future it may be possible to breed new bone in this layer for further therapy and to fill the gaps at donor sites. PMID- 3282485 TI - Immunocytochemical identification of Campylobacter pylori in gastritis and correlation with culture. AB - Endoscopic biopsy specimens of antral mucosa from 25 patients presenting with gastric complaints were obtained for culture and histologic and immunocytochemical studies. The histopathologic study revealed chronic gastritis in 22 patients and borderline chronic gastritis in three patients. The unlabeled antibody peroxidase-antiperoxidase (PAP) method was applied for the detection of Campylobacter pylori, and its results were compared with those obtained with the culture technique. Strongly positive immunoperoxidase staining was localized in spiral, curved bacteria that were present in the mucus layer adjacent to the gastric epithelial cell surface. The microorganisms were frequently congregated in clumps and were sectioned in several directions. The PAP stains were positive in 19 specimens (76%), and the cultures were positive in 20 (80%). All results negative by culture were also negative by PAP method. Compared with the cultures, the sensitivity and positive predictive value of the PAP method for identification of C pylori in antral mucosa obtained from endoscopic biopsy specimens were 95% and 100%, respectively. PMID- 3282488 TI - Memorial for Harry Benjamin. PMID- 3282490 TI - Sexual attitudes as correlates of sexual details in human figure drawing. AB - The hypothesis that sexual attitudes, as measured by the Sexual Opinion Survey, are related to the explicitness with which nude figures are drawn was examined. The presence or absence of various sexual and nonsexual anatomical features, as well as length and width measurements, were assessed in the drawing of nudes by 17 male and 23 female undergraduates. Individuals with relatively positive sexual attitudes (erotophiles), as compared with individuals with relatively negative attitudes (erotophobes), were more likely to include such details as a glans, a urinary meatus, and chest hair on male figures and pubic hair and nipples on female figures. Positive sexual attitudes were also associated with drawing figures with longer and wider penises, breasts, testicles, and mons. Relationships between sexual attitudes and the drawing of nonsexual body parts were generally not significant. The results are discussed in terms of the pervasive generality of sexual attitudes in influencing quite varied sex-related behaviors. PMID- 3282489 TI - Neuroendocrine response to estrogen and brain differentiation in heterosexuals, homosexuals, and transsexuals. AB - Since 1964, we have found positive estrogen feedback to be a relatively sex specific reaction of the hypothalamo-hypophyseal system in rats as well as in human beings. It is dependent on the estrogen-convertible androgen level during sexual brain differentiation and also on estrogen priming in adulthood. The lower the estrogen-convertible androgen or primary estrogen level during brain differentiation, the higher the evocability of a positive estrogen action on LH secretion in later life. In clinical studies, we induced a positive estrogen feedback luteinizing hormone secretion in most intact homosexual men, in clear cut contrast to intact heterosexual or bisexual men. In addition, the evocability of a positive estrogen feedback was also demonstrable in most homosexual male-to female transsexuals in significant contrast to hetero-or bisexual male-to-female transsexuals. The following relations have been found between sex hormone levels during brain differentiation and sex-specific responses in adulthood: (i) Estrogens, which are mostly converted from androgens, are responsible for the sex specific organization of gonadotropin secretion and hence the evocability of a positive estrogen feedback in later life; (ii) both estrogens and androgens, occurring during brain differentiation, predetermine sexual orientation, and (iii) androgens, without conversion to estrogens, are responsible for the sex specific organization of gender role behavior. Furthermore, the organization periods for sex-specific gonadotropin secretion, sexual orientation, and gender role behavior are not identical but overlapping. Thus, combinations as well as dissociations between deviation of the neuroendocrine organization of sex specific gonadotropin secretion, sexual orientation, and gender role behavior may occur. PMID- 3282491 TI - Beyond transplantation. Third annual Samuel Jason Mixter lecture. PMID- 3282492 TI - Use of oxygen radical scavengers on autografted pig kidneys after warm ischemia and 48-hour perfusion preservation. AB - Oxygen free radicals generated during the reperfusion of an ischemic organ may cause further cellular injury; removal of these oxygen radicals by scavengers protects tissue from reperfusion injury. Thus, oxygen radical scavengers could protect kidneys after warm ischemia and long hypothermic perfusion. Porcine kidneys were incubated at 37 degrees C for 45 minutes, placed on a pulsatile perfusion apparatus at 7 degrees C for 48 hours, and then autografted to iliac vessels. Superoxide dismutase (10 mg) and catalase (10 mg) in 10 mL of phosphate buffered saline solution were infused into the renal artery during a three-minute interval before reperfusion. The kidneys treated with the superoxide dismutase catalase solution had significantly improved function compared with controls receiving only phosphate-buffered saline solution. The mean (+/- SEM) serum creatinine level on postoperative day 5 was 510 +/- 100 mumol/L (5.75 +/- 1.12 mg/dL) (n = 12) vs the control value of 840 +/- 90 mumol/L (9.54 +/- 1.01 mg/dL) (n = 11). There was more extensive cellular damage in the control kidneys. This demonstrates the efficacy of oxygen radical scavengers in protecting pig kidneys after warm ischemia and prolonged preservation. PMID- 3282493 TI - Parathyroid gland exploration with local anesthesia in elderly and high-risk patients. AB - The management of symptomatic hyperparathyroidism in elderly and medically compromised patients, who are at risk under general anesthesia, may be safely and effectively accomplished using local anesthesia. Positive localization with ultrasound, thallium 201-technetium Tc 99m subtraction, and computed tomography permit surgical exploration with local anesthesia in one or two stages, or bilaterally in one stage, in selected cases, by employing the surgical lateral approach to parathyroid surgery. Our study of 29 patients selected for this technique affirms the value and the safety of this method, especially as surgical experience has grown and localization studies have improved. During the latter 24 months of our study, 11 (30%) of 36 operations were performed using local anesthesia by one of us. A success rate in ten of 11 cases was achieved, with one patient requiring a second exploration for adenomatous hyperplasia while under local anesthesia. PMID- 3282494 TI - Combined kidney and pancreas transplantation in diabetics. AB - Kidney and pancreaticoduodenal transplantation were simultaneously performed in 12 insulin-dependent diabetic patients. These patients had advanced secondary complications, including blindness, vascular disease, and disabling neuropathy. Average posttransplant hospitalization and charges were 17.7 days and $42,780 compared with 11.2 days and $29,000 for patients who received renal allografts alone. Following transplantation, blood glucose and glycosylated hemoglobin A levels promptly returned to normal in all patients. Two patients subsequently died, one after five months of a cytomegalovirus infection and one after seven months of a ruptured bladder. After a mean of 11.6 months of follow-up, ten patients (83%) remained independent of insulin and dialysis. The success of pancreas transplantation in diabetics with advanced complications now approaches that of other organ allografts. It therefore appears reasonable to recommend transplantation for diabetics with less severe secondary complications, since these candidates are most likely to realize the potential benefits of long-term normoglycemia. PMID- 3282496 TI - Anaphylatoxin formation in sepsis. AB - Complement activation and anaphylatoxin formation were studied in 27 septic patients. The patients were treated with antibiotics and high-dose corticosteroids. Blood samples were drawn on admission and every week thereafter. Plasma levels of complement components C1INH, C3, C4, and C5 were low before the start of treatment but were above normal one week later in both successfully and unsuccessfully treated patients. In contrast, plasma levels of anaphylatoxins C3a/C3adesArg and C5a/C5adesArg were elevated on admission. After successful treatment, plasma levels of C3a/C3adesArg and C5a/C5adesArg returned to normal within one week. Nine patients had ongoing sepsis one week after the start of treatment and a persistent rise in anaphylatoxin concentration. They developed multisystem organ failure with respiratory, hepatic, and renal insufficiency. In vitro studies of Escherichia coli incubation in fresh serum indicated a dose related formation of C3a/C3adesArg and C5a/C5adesArg. High concentrations of methylprednisolone inhibited the anaphylatoxin formation in vitro. PMID- 3282495 TI - Advances in the diagnosis and treatment of pheochromocytoma. AB - Diagnosis and management of pheochromocytoma, once dangerous and uncertain, have been dramatically altered in recent years by advances in imaging, assays, and pharmaceuticals. During the past ten years we have treated 18 patients who had pheochromocytoma. Biochemical diagnosis was made in all patients by measurement of 24-hour urinary total catecholamine excretion or by epinephrine-norepinephrine fractionation. Determination of epinephrine-norepinephrine ratios was instrumental in making the diagnosis of pheochromocytoma in two patients in whom total catecholamine levels were normal. Localization of the pheochromocytoma in the most recently treated cases was accomplished by ultrasound, computed tomography, or iodine I 131 iobenguane (iodine I 131 metaiodobenzylguanidine) scanning. Nine patients in the series were prepared for surgery with phenoxybenzamine hydrochloride and six with prazosin hydrochloride. Preoperative total alpha-adrenergic blockade with phenoxybenzamine offered no advantage over selective blockade with prazosin in terms of perioperative fluid requirements or intraoperative hemodynamic stability. PMID- 3282497 TI - The scalp as a donor site in burns. AB - The scalp can be used as a donor site in the extensively burned patient. A series of 21 patients in whom this procedure has been performed, including up to 12 occasions in the same patient, is reviewed. No associated complications were encountered. The technique of harvesting the split-thickness skin grafts in this area requires the use of Pitkin's syringe and Brown air dermatome. The advantages include the availability of a large donor site that is well concealed and heals rapidly. The anatomic basis of the advantageous characteristics of the scalp and the need for subgaleal injections of fluid to stabilize the scalp are reviewed. The occasionally more pressing need to use this area in the extensively burned child because of relative body surface area distributions is also noted. Excessive blood loss, hypertrophic scarring, and the need for hair transplantation have not been noted. Complete hair regrowth has been experienced in nearly all cases. PMID- 3282498 TI - Egas Moniz and internal carotid occlusion. AB - Egas Moniz discovered cerebral angiography in 1927 and introduced leukotomy as a form of treatment of mental illness, for which he received the Nobel Prize in 1949. His work on occlusive cerebrovascular disease is less known. In 1937 he originally described internal carotid occlusion as documented by angiography. His observations and comments on the clinical, pathogenic, and therapeutic aspects of internal carotid thrombosis are reviewed. PMID- 3282499 TI - Septic thrombosis of the cavernous sinuses. AB - Cavernous sinus thrombosis may occur as a complication of infectious and noninfectious processes. Septic thrombosis of the cavernous sinuses most commonly follows infections of the middle third of the face due to Staphylococcus aureus. Other antecedent sites of infection include paranasal (usually sphenoid) sinusitis, dental abscess and, less often, otitis media. Fever is a nearly constant finding, but headache may not be prominent. Periorbital edema, chemosis, proptosis, and limitation of extraocular movements (especially lateral gaze) develop in almost all recognized cases. Involvement of the opposite eye frequently appears within two days following the onset of unilateral signs. Although computed tomography may be helpful, magnetic resonance imaging is probably the diagnostic procedure of choice. Treatment includes appropriate antibiotics and, oftentimes, surgical drainage of the primary focus of infection. Less than half of the patients recover completely; the mortality rate is approximately 30%. PMID- 3282500 TI - Hypotony form occult bridle suture perforation. PMID- 3282502 TI - Neck pain: an update. PMID- 3282501 TI - Long-term evaluation of 0.25% levobunolol and timolol for therapy for elevated intraocular pressure. AB - In a one-year, double-masked, randomized study, the ocular hypotensive efficacy of twice-daily treatment with 0.25% levobunolol hydrochloride or timolol maleate was evaluated in 78 patients with glaucoma or ocular hypertension (phase 1). If intraocular pressure (IOP) was not well controlled during the study, the concentration of medication was increased to 0.5%, and the patient was followed up for an additional three months (phase 2). During phase 1, the mean IOP was reduced by 4.6 mm Hg in the timolol treatment group and by 5.1 mm Hg in the levobunolol treatment group. Seventy-one percent (29/41) of the patients in the timolol treatment group and 70% (26/37) of the patients in the levobunolol treatment group successfully completed phase 1. Of those patients who required the higher concentration of medication, 89% (8/11) in the timolol treatment group and 75% (3/4) in the levobunolol treatment group successfully completed phase 2. Higher concentration, however, did not produce greater IOP reduction. No statistically or clinically significant differences between the groups were noted in any of the efficacy or safety variables evaluated. PMID- 3282503 TI - The orthopaedic basis for repetitive strain injury. PMID- 3282504 TI - Protein structure determination by nuclear magnetic resonance. PMID- 3282505 TI - Disulphide bonds and protein stability. PMID- 3282506 TI - Analysis, design and modification of loop regions in proteins. PMID- 3282507 TI - Antibodies to DNA. PMID- 3282509 TI - Evolution of haemoglobin studied by protein engineering. PMID- 3282508 TI - Engineering of antibodies. PMID- 3282510 TI - Genetic engineering and the serpins. PMID- 3282511 TI - Rapid and transient induction of c-fos, c-myc and c-Ha-ras in rat liver following glycine administration. AB - Administration of glycine (2.5 mmoles/100 g., i.p.) results in an increased expression of several cell cycle dependent genes such as c-fos, c-myc and c-Ha ras in the rat liver. The increased expression could be noticed as early as 20-40 minutes and declined by 2 hours following glycine administration. The rapid rise and decline in the mRNA levels of c-fos, c-myc and c-Ha-ras in response to glycine is of significance because in response to a wide variety of growth stimuli, these proto-oncogenes exhibit a temporal sequence in their expression; for example, the expression of c-fos precedes that of c-myc, which in turn precedes the increased expression of c-Ha-ras. The experimental model using a simple amino acid such as glycine will be useful in exploring some of the mechanisms of regulation of expression of these proto-oncogenes. PMID- 3282512 TI - Identification of different charged species of a human monocyte derived neutrophil activating peptide (MONAP). AB - Lipopolysaccharide-stimulated human monocytes secrete a 10 kD peptide (MONAP) of high neutrophil, not however monocyte or eosinophil stimulating activity. By reversed phase HPLC MONAP could be distinguished from Interleukin 1. Analytic isoelecto-focusing of pure MONAP (single line upon sodiumdodecylsulfate polyacrylamide gel electrophoresis, single peak after RP-18-HPLC), obtained by size exclusion HPLC followed by two different reversed phase HPLC steps revealed charge heterogeneity giving major components with isoelectric points at 4.7, 4.9, 6.4 and 6.9, all of which exhibited chemotactic activity. PMID- 3282513 TI - Inhibition of c-H-ras oncogene induced transformation of rat embryo fibroblasts by cotransfected polynucleotides containing alternating purine-pyrimidine sequences. AB - When Rat 6 cultures were cotransfected with an activated c-H-ras oncogene (pT24) and poly(dG-m5dC), a synthetic polymer that has the potential to form Z DNA, there was marked inhibition of cell transformation. Cotransfection of pT24 DNA with poly(dG-dC) caused somewhat less inhibition, poly(dA-dC). (dG-dT) caused moderate inhibition, and poly(dG). (dC) exerted negligible inhibition. Evidence was obtained that the inhibition seen with poly(dG-m5dC) was not simply due to an inhibition of cellular uptake of the pT24 DNA. Our results suggest that certain polymers that have the potential to form Z DNA can inhibit the integration and expression of a transfected oncogene. PMID- 3282514 TI - Alpha-factor-directed synthesis of Bacillus stearothermophilus alpha-amylase in Saccharomyces cerevisiae. AB - Promoter and leader sequence of Bacillus stearothermophilus alpha-amylase gene were removed and the gene was joined in-frame to sequences encoding the leader region of Saccharomyces cerevisiae mating pheromone alpha-factor on plasmid p69A (a hybrid of pBR322 and S. cerevisiae 2-microns plasmid). S. cerevisiae cells were transformed with plasmids containing the hybrid genes, obtaining yeast transformants which exhibit a significant extra-cellular amylolytic activity in solid medium, but not in liquid medium. Levels of alpha-amylase activity in solid medium were found to depend on the mode of fusion of the alpha-amylase gene to the alpha-factor leader region. PMID- 3282515 TI - A supersensitive dot-hybridization method: rapid and quantitative detection of host-derived DNA in recombinant products at the one picogram level. AB - We have developed a highly sensitive method of DNA dot-blotting hybridization to detect host-derived DNA (nuclear DNA and plasmid DNA) in a recombinant product. This method has two distinctive features compared to the conventional hybridization method: firstly, a highly specific radioactive probe is prepared by using ultrasonicated DNA, instead of untreated DNA, as a template for the oligo labeling reaction; secondly, the signal to noise ratio is increased by the use of lambda phage DNA as non-homologous DNA. This method enabled us to detect host derived DNA at the one picogram level without using a radioisotope of high specific activity and long exposure times. PMID- 3282516 TI - Physiologically based models and strategic experiments in hepatic pharmacology. PMID- 3282518 TI - Role of hydrogenase 1 of Clostridium pasteurianum in the reduction of metronidazole. AB - Competition studies between the phosphoroclastic reaction and the metronidazole reduction reaction using dialyzed crude cell-free extracts of Clostridium pasteurianum which were essentially devoid of Hydrogenase 1 activity demonstrated that this enzyme plays an important role in the reduction of metronidazole. To determine further the exact function for Hydrogenase 1 in the reduction of the drug, this enzyme was highly purified from C. pasteurianum. Metronidazole reduction activity copurified with Hydrogenase 1 specific activity throughout the purification procedure. Drug reduction required the presence of an electron carrier and could not be accomplished by the enzyme alone. Ferredoxin, and also the low potential electron carrier dyes, methyl and benzyl viologen, and the flavin coenzymes, FAD and flavin mononucleotide (FMN), could couple the reduction of metronidazole. Hydrogenase 1 activity and its metronidazole reduction activity were inactivated irreversibly in the presence of oxygen. Metronidazole could be reduced only by an electron carrier-Hydrogenase 1 mechanism or directly by sodium dithionite. PMID- 3282517 TI - Identification of human lung mast cell kininogenase as tryptase and relevance of tryptase kininogenase activity. AB - We have described previously the IgE-mediated release of kininogenase activity from purified human lung mast cells. Using supernatant fractions from mast cells stimulated with anti-IgE in the presence of deuterium oxide, we have purified this kininogenase to homogeneity by gel filtration and heparin-agarose chromatography and have demonstrated that it is identical to tryptase, the major neutral protease of human lung mast cells. Thus, tryptase and kininogenase activities co-chromatographed through both purification steps with equivalent yields. The final purified kininogenase was free of detectable chymotryptic and carboxypeptidase activities and was identified as tryptase on the basis of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), amino acid composition and inhibition profile. Three such preparations of tryptase were all capable of releasing kinin from each of two different preparations of purified, single-chain, human low molecular weight kininogen. Interestingly, kinin generation was optimal at pH 5.5 and was enhanced by heparin, which has been reported to stabilize tryptase. SDS-PAGE analysis of kininogen hydrolysis by tryptase revealed the formation of a diffusely stained region in the molecular weight range of 60,000-65,000, rather than a discrete heavy chain band. Under optimal conditions, the three tryptase preparations released 10-12 micrograms kinin/hr/mg but released only 2 micrograms kinin/hr/mg at pH 7.2. HPLC analysis revealed that the kinin released was bradykinin. We conclude that the kininogenase activity from human lung mast cells is attributable to tryptase. The unique pH optimum of this reaction of a serine protease, however, raises doubts as to the physiologic significance of this activity. PMID- 3282519 TI - Autoantibodies to mitochondria in systemic sclerosis. Frequency and characterization using recombinant cloned autoantigen. AB - Mitochondrial autoantibodies, a hallmark of primary biliary cirrhosis (PBC), have been widely described for many years in patients with systemic sclerosis, and there have been several reports of the concurrence of systemic sclerosis and PBC. However, there is very little information with respect to the significance of these autoantibodies or any definitive evidence that the antigens involved represent the mitochondrial autoantigens (M2 complex) described in PBC. We have cloned and sequenced a rat complementary DNA which encodes for all the epitopes recognized by autoantibodies to the major, or 70-kd, mitochondrial autoantigen in patients with PBC. Using this recombinant fused autoantigen, as well as by immunoblotting with human placental mitochondria, we tested for antimitochondrial antibody specificity in sera from 250 patients with systemic sclerosis. Nineteen sera (7.6%), including those from patients with CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias) and diffuse scleroderma, had reactivity with human placental mitochondria proteins by immunoblot testing. All 19 sera reacted with the M2 complex. All sera that reacted with the 70-kd protein likewise reacted with the recombinant cloned autoantigen. The predominant autoantibody isotype to the 70-kd protein was IgG3. Interestingly, the 70-kd protein is 11% proline, an amino acid which is frequently preceded by hydrophobic amino acids. PMID- 3282520 TI - Tibialis posterior tendon rupture: a cause of rheumatoid flat foot. AB - Flat foot, a major cause of foot pain and disability, may result from rupture of the tibialis posterior tendon. We describe 2 patients with rheumatoid arthritis who developed flat feet secondary to surgically confirmed tendon rupture, and we discuss the anatomy and diagnosis of this condition. In the second patient, we also present the results of tendon imaging with both magnetic resonance and ultrasound. PMID- 3282521 TI - The influence of ethanol on hepatic transmethylation. AB - One of the most important biochemical pathways in the organism is the biosynthesis of methionine from the methylation of homocysteine. Two different reactions are responsible for this methylation, one utilizing N5-methyltetra hydrofolate as a methylating agent and the other using betaine as the methyl donor. This paper reviews some recent findings in this laboratory, which demonstrate that ethanol-feeding to rats impairs the folate-induced reaction. Our findings also show that this impairment is compensated for through the adaptive increase in the enzyme using betaine in the biosynthesis of methionine. Further studies indicate that the mechanism of action in the impairment may occur through the formation of individual adducts between the folate-induced enzyme (methionine synthetase), its essential cofactors and acetaldehyde, a metabolic product of ethanol. These findings suggest a basis for why rats are more resistant to alcoholic liver injury than humans and may offer a means of protecting against alcoholic liver injury in man. PMID- 3282522 TI - The identification of accident blackspots: a comparison of current methods. AB - A recent survey reported that, in order to identify accident blackspots, most highway authorities use annual accident total (AAT), without making any allowance for any measure of exposure or the nature of the site. An alternative, and apparently improved criterion, known as potential accident reduction (PAR), has been proposed. The basis for this is that statistically significant relationships can be established between accident frequency and traffic flow, for a variety of site categories. PAR is calculated, for a site, as the difference between the observed number of accidents and the expected number for that type of site with that level of flow. If this expected frequency can be estimated accurately, then PAR should inevitably perform better than AAT, since AAT tends to identify high flow sites which do not necessarily have the potential for accident reduction. This work attempts to quantify the additional benefits to be gained by the use of PAR instead of AAT. It demonstrates that, because of the inaccuracy of the estimation of the expected frequency at a site required in PAR, it is quite possible for AAT to perform as well as, or better than PAR. If the sites, identified as blackspots, are then given some remedial treatment, the analysis of the effectiveness of this treatment must allow for what has become known as the "regression-to-mean" effect. A method which provides a proper basis for such before and after studies is described. PMID- 3282523 TI - [Infantile sporotrichosis]. PMID- 3282524 TI - [Congenital selective aplasia of the red cells. Study of 13 cases]. PMID- 3282525 TI - Immunology of lymphoid cancer: probing of tumours and tumours as probes. PMID- 3282526 TI - Critique of sensory integration therapy and its application in mental retardation. AB - Studies on the use of sensory integration therapy with mentally retarded persons were critically reviewed. Experimental design and statistical procedures were found inadequate to support the use of this therapy on an empirical basis. In addition, certain methodological and design problems seriously cloud interpretation of research results on this topic. Alternative explanations of positive outcome as well as equivocal findings among studies appear related, in part, to the conceptual foundation of sensory integration therapy. Recommendations for future directions in research and restraint in application were discussed. PMID- 3282527 TI - [On anterior horn cells of the spinal cord]. PMID- 3282528 TI - [Pathology of ventral spinal outflow in the neurodegenerative diseases--size dependent axonal loss]. PMID- 3282529 TI - [Changes in the neuronal size in the brain by aging and of Alzheimer's dementia]. PMID- 3282530 TI - [Some aspects of the normal nerve cell size]. PMID- 3282531 TI - Pimobendane (UD-CG 115 BS) in the treatment of severe congestive heart failure. An acute haemodynamic cross-over and double-blind study with two different doses. AB - 1. We compared the effects of two doses (5 and 10 mg) of oral pimobendane (UD-CG 115) on haemodynamics in eight patients suffering from chronic congestive heart failure. The two doses were given according to a randomized cross-over double blind protocol; haemodynamics and plasma levels of pimobendane and its main metabolite UD-CG 212, were determined 1, 2, 3, 5, 7, 9, 11 and 12 h after each dose. 2. Both doses significantly improved the left and right ventricular functions of these patients, with a peak action 3 h after drug intake and long duration (more than 12 h). A significant dose-effect relationship was observed only for pulmonary wedge pressure and right atrial pressure. Significant correlations were found between UD-CG 212 plasma levels and cardiac index (r = 0.54, P less than 0.05), and pulmonary wedge pressure (r = 0.74, P less than 0.001); no correlation was found between these haemodynamic variables and pimobendane plasma levels. 3. One patient developed a transient drop in blood platelets together with a cutaneous rash, while three others had a transient and mild decrease of thrombocytes. 4. In conclusion, pimobendane improved right and left ventricular functions in severe heart failure. Both doses (5 and 10 mg) were effective. The higher dose induced marked improvement of the haemodynamic variables but the difference between doses was only significant for right atrial and pulmonary wedge pressures. PMID- 3282532 TI - Time course of the effects of epoprostenol on effective pulmonary blood flow in normal volunteers. AB - 1. Epoprostenol (prostacyclin) has been widely used as a vasodilator, but its effects on cardiac output are controversial and the time course of its effects little studied. 2. We report its cardiovascular effects in doses of 5 and 10 ng kg-1 min-1 in six healthy volunteers. 3. Each of the two doses caused a mean 20% rise in effective pulmonary blood flow and a 15% rise in heart rate. These effects appeared to reach a maximum within 10 min of starting or increasing the rate of infusion, with no evidence of a rebound effect. 4. When the dose was reduced, heart rate and effective pulmonary blood flow appeared to reach a new steady state within 5 min of reducing or stopping the infusion. Only minor side effects were encountered, and they were rapidly reversed on stopping the drug. 5. These results should be applied to the therapeutic use of epoprostenol as a vasodilator, particularly when titrating the optimum dose for a given individual. PMID- 3282533 TI - Erythromycin enhances the absorption of cyclosporin. PMID- 3282534 TI - Cyclosporin-verapamil interaction. PMID- 3282535 TI - Carcinoma of the cervix uteri: an assessment of tumour proliferation using the monoclonal antibody Ki67. AB - Thirty-one cervical biopsies of invasive carcinoma have been studied by immunohistochemical means using the monoclonal antibody Ki67 to determine tumour cell proliferation rates. A wide range (10-50%) in the extent of Ki67 staining (expressed as the percentage of labelled tumour cells) was observed indicating considerable variation on tumour growth rates. There was no significant relationship between the percentage of positive cells and conventional histological parameters such as cell type or tumour differentiation. Immunostaining with monoclonal antibody Ki67 therefore provides a new approach to the assessment of cervical tumour biopsies which will require long term clinical follow-up to establish its prognostic significance. PMID- 3282536 TI - The impact of social support on mental and physical health. AB - Early research on life-stress grappled with the question of whether significant life-events bring about changes in health status. The emphasis has now shifted to the identification of factors that explain why some people seem to be so severely affected by life's adversities and others are not. From a class of what might be called 'vulnerability variables' (Kessler, 1979), support from one's social network has emerged as a significant factor that can account for at least some of the vulnerability differences between groups of stressed individuals. Since Cassel's (1974) review of the evidence linking social upheavals to adverse health consequences for both humans and animals, hundreds of empirical studies have been completed that assess the direct and indirect effects of social support on mental and physical health. This literature is so voluminous as to require several books devoted to reviews of various aspects of it (e.g. Cohen & Syme, 1985; Gottlieb, 1981; and Gottlieb, 1983). In this paper we will distil these as well as highlight some of the recent empirical developments, particularly in those areas that have received less attention in prior reviews. Social support has been defined as the presence of others, or the resources provided by them, prior to, during, and following a stressful event. While there is no general agreement on a single definition, the variety has spawned a number of typologies attempting to organize the literature (e.g. Cohen & Syme, 1985; Cohen & Wills, 1985; Gottlieb, 1983; House & Kahn, 1985). Most of these typologies initially distinguish between functional and structural operationalizations of social support. PMID- 3282537 TI - Type A behaviour and the healthy individual. AB - The Type A behaviour pattern (TABP) is an interesting and controversial construct that has generated debate, empirical testing, and behavioural modification attempts. TABP is depicted as consisting of impatient or hurried behaviour, a strong orientation toward work responsibilities and task completion, and intensive competitive behaviour in situations that involve evaluation. Recently, the importance of what is called the anger/hostility dimension has been emphasized in research studies. After more than two decades of debate, testing, and attempting to modify the entire TABP there is now a growing acceptance of the proposition that a major overhaul or change in the TABP is not necessary or even feasible. The Type A person is also now being presented as possessing many desirable characteristics and healthy behaviours that are worth reinforcing. The present paper provides a brief review of the contradictory research evidence surrounding the Type A syndrome. Theorists, researchers, and organizational practitioners are encouraged to seek improvements in understanding the TABP through improved assessment and how it can be modified in generally healthy individuals. A theoretical model to guide improvement efforts in measurement and intervention is provided as a viable framework to examine causal pathways between antecedents, Type A core behaviours, responses, and consequences. PMID- 3282538 TI - Personality, stress and cancer: prediction and prophylaxis. AB - This paper reports results from three prospective studies, in which probands were followed over periods of 10 years, before inquiring about death and cause of death. Personality inventories were administered at the beginning of the 10 year period, as were questions concerning smoking, drinking, medical diseases, etc. It was found that personality variables were much more predictive of death from cancer or cardiovascular disease than was smoking, and that different personality types were susceptible to either of these two diseases. Personality type was defined in terms of differential ways of dealing with interpersonal stress, and it was found that stress was a very potent cause of death, in the sense that stressed probands had a 40 per cent higher death rate than non-stressed probands. PMID- 3282539 TI - Immunological consequences of acute and chronic stressors: mediating role of interpersonal relationships. AB - This review presents recent studies examining the relationship between acute and chronic stressors, changes in immune function, and interpersonal relationships. Data are given which document immunosuppressive effects of commonplace, short term stressors, as well as more prolonged stressors, such as marital disruption and caregiving for a relative with Alzheimer's disease. Immune changes included both quantitative and qualitative changes in immune cells, including changes in herpes virus latency, decreases in the percentages of T-helper lymphocytes and decreases in the numbers and function of natural killer cells. These effects occurred independently of changes in nutrition. Psychological variables, including loneliness, attachment and depression were related to the immune changes. The data are discussed in a framework in which quality interpersonal relationships may serve to attenuate the adverse immunological changes associated with psychological distress, and may have consequences for disease susceptibility and health. PMID- 3282540 TI - Fetal growth, glucose tolerance and plasma insulin concentration in rats given a marginal-zinc diet in the latter stages of pregnancy. AB - 1. Wistar rats were fed on a control semi-synthetic diet throughout pregnancy, or a control diet in the first 2 weeks and a marginal-zinc diet in the 3rd week of pregnancy. On day 20, after an overnight fast, half the animals in each group were given glucose by gavage and the 0-30 min rise in blood glucose measured in tail blood. After 60 min blood was taken by cardiac puncture for glucose and insulin assay. Maternal pancreases were removed and the Zn contents measured. Fetuses from each litter were combined for wet/dry weights, protein and DNA determinations. 2. Plasma insulin concentration was higher, and glucose concentration and pancreatic Zn content lower, in pregnant v. non-pregnant animals of similar age, fed on the same diet. Pancreatic Zn content was lowest in the marginal-Zn group of pregnant rats. Fetuses from mothers fed on the marginal Zn diet during the last week of pregnancy were slightly heavier than controls and had a significantly higher protein: DNA ratio. The 0-30 min rise in blood glucose was significantly greater in the marginal-Zn animals. 3. In a second experiment, pregnant rats were given similar diets to those used in the first study, but the marginal-Zn diet was given for a shorter period (days 15-19 of pregnancy). On day 19 the rats were meal-fed and on day 20, after an overnight fast, an oral glucose dose was administered. Tail-blood was taken at timed intervals up to 60 min post dosing for glucose assay.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282542 TI - Mapping and regulation of the pifC promoter of the F plasmid. AB - The pif region of the F plasmid, which causes abortive infection of Escherichia coli by T7 bacteriophage, is autogenously controlled by the product of the pifC gene. Here we describe the identification of the pif operon promoter by S1 nuclease mapping, and show that it is autoregulated at the transcriptional level and that its activity is modulated by integration host factor. PMID- 3282541 TI - Overexpression, purification and properties of alcohol dehydrogenase IV from Saccharomyces cerevisiae. AB - We have purified ADHIV, a novel alcohol dehydrogenase (ADH) isozyme in the yeast Saccharomyces cerevisiae, after increasing the normally low amount of ADHIV protein in laboratory strains. This was done by overexpression of the structural gene (ADH4) on a 2micro-based multicopy vector. Characterization of the purified enzyme revealed a dimeric structure as well as a different substrate specificity and pH profile as compared to other alcohol dehydrogenase isozymes. On the other hand, we could demonstrate that ADHIV is activated by zinc ions, like the other yeast alcohol dehydrogenase isozymes, and not by ferrous ions, like a structurally similar alcohol dehydrogenase from the bacterium Zymomonas mobilis. PMID- 3282543 TI - All three human ras genes are expressed in a wide range of tissues. AB - We examined the expression of the ras gene family (Ha-ras, Ki-ras, N-ras) in human fetal tissues (14 week) and in several human tumor cell lines. Dot blot hybridization showed that the three ras genes were expressed in all of the samples analysed, with a range of expression between 10 and 180 molecules/cell. There was no correlation between levels of expression of ras genes and the type of ras gene activated in different tumor types. PMID- 3282544 TI - The inducible trimethylamine-N-oxide reductase of Escherichia coli K12: biochemical and immunological studies. AB - The inducible trimethylamine-N-oxide reductase which migrates on non-denaturing polyacrylamide gels with an RF of 0.22, has been purified from the soluble fraction of wild-type E. coli K12. The molecular weight of the purified enzyme estimated by molecular-sieve chromatography is about 230,000. It is composed of two subunits of molecular weight 110,000. Antiserum specific for the enzyme has been produced. Gel filtration on Sephadex G-200 of the soluble fraction gave two peaks of trimethylamine-N-oxide reductase, one with an Mr of 230,000 and an RF of 0.22, and another with an Mr of 120,000 and an RF of 0.36. Since the anti trimethylamine-N-oxide reductase serum recognises the two forms and shows a single subunit with an Mr of 110,000, we conclude that in E. coli there is a single inducible trimethylamine-N-oxide reductase which can exist as a dimer or a monomer. Other immunological studies with anti-trimethylamine-N-oxide reductase serum on crude extracts prepared from cells grown in the absence of inducer showed that the constitutive trimethylamine-N-oxide reductase was not recognised by the antiserum. The same analyses carried out on a tor mutant (defective in the structural gene of the inducible enzyme) confirmed without ambiguity that the constitutive enzyme is immunologically distinct from the inducible enzyme. In the same way, using the anti-trimethylamine-N-oxide reductase serum, rocket immunoelectrophoresis analyses were able to show that the inducible apoenzyme is not regulated by the fnr gene product and that molybdate does not seem necessary for the synthesis or stabilisation of this enzyme. PMID- 3282545 TI - Interaction of alkylputrescines with ornithine decarboxylase from rat liver and Escherichia coli: an in vitro and in vivo study. AB - The inhibitory effect of a series of 2-alkylputrescines on rat liver and Escherichia coli ornithine decarboxylase (L-ornithine carboxy-lyase, EC 4.1.1.17) was examined. At 2.5 mM concentrations, 2-methyl-, 2-propyl-, 2-butyl-, 2-pentyl- and 2-hexylputrescines were stronger inhibitors of the mammalian enzyme than putrescine. Only the higher homologues (from 2-propyl- to 2-hexylputrescine) were inhibitors of the E. coli enzyme. An analysis of the effect of increasing concentrations of the 2-alkylputrescines showed that the main difference in the behaviour of the mammalian and E. coli decarboxylases toward 2-alkylputrescines was that the former was strongly inhibited by 2-methylputrescine whereas the latter was not. 2-Alkylputrescines were found to be competitive inhibitors of both the bacterial and mammalian enzyme. The smallest Ki values (0.1 and 0.5 mM) were found for the 2-hexyl- and 2-pentylputresciens. N-Methyl-, N-ethyl-, N propyl- and N-butylputrescines (50 mumol per 100 g body weight) were assayed as inhibitors of thioacetamide-induced rat liver ornithine decarboxylase. N Propylputrescine was found to be the most inhibitory (66% inhibition) and although the N-alkylputrescines were taken up by the liver, they did not inhibit the liver polyamine pools. Both putrescine and N-methylputrescine were found to stabilize the thioacetamide-induced ornithine decarboxylase at the onset of the enzyme's degradation, while 2-alkylputrescines were inhibitory under similar conditions. N-Methylputrescine induced antizyme in thioacetamide-treated rats. In thioacetamide- or dexamethasone-treated rats, 2-methylputrescine was found to be the strongest in vivo inhibitor of the liver decarboxylase. Although 2 alkylputrescines were efficiently taken up by the liver, they did not noticeably inhibit its polyamine pools. 2-methylputrescine decreased the putrescine concentration of the liver, but not its spermidine and spermine content. No induction of ornithine decarboxylase antizyme by 2-methylputrescine could be detected. The intrahepatic concentration of the latter decreased with time, very likely due to its degradation by a diamine oxidase, since the decrease was inhibited by aminoguanidine. PMID- 3282546 TI - Two biochemically distinct classes of fumarase in Escherichia coli. AB - Biochemical studies with strains of Escherichia coli that are amplified for the products of the three fumarase genes, fumA (FUMA), fumB (FUMB) and fumC (FUMC), have shown that there are two distinct classes of fumarase. The Class I enzymes include FUMA, FUMB, and the immunologically related fumarase of Euglena gracilis. These are characteristically thermolabile dimeric enzymes containing identical subunits of Mr 60,000. FUMA and FUMB are differentially regulated enzymes that function in the citric acid cycle (FUMA) or to provide fumarate as an anaerobic electron acceptor (FUMB), and their affinities for fumarate and L-malate are consistent with these roles. The Class II enzymes include FUMC, and the fumarases of Bacillus subtilis, Saccharomyces cerevisiae and mammalian sources. They are thermostable tetrameric enzymes containing identical subunits Mr 48,000-50,000. The Class II fumarases share a high degree of sequence identity with each other (approx. 60%) and with aspartase (approx. 38%) and argininosuccinase (approx. 15%), and it would appear that these are all members of a family of structurally related enzymes. It is also suggested that the Class I enzymes may belong to a wider family of iron-dependent carboxylic acid hydro-lyases that includes maleate dehydratase and aconitase. Apart from one region containing a Gly-Ser-X-X-Met-X-X Lys-X-Asn consensus sequence, no significant homology was detected between the Class I and Class II fumarases. PMID- 3282547 TI - [Effect of Ca2+ on the motility of myosin head in the F-actin-HMM complex]. AB - Using polarization microfluorimetry, the effect of Ca2+ on the mode of interaction between heavy meromyosin labeled with 1.5-IAEDANS and F-actin was studied. The results obtained suggest that both the orientation and motility of myosin heads in the F-actin-heavy meromyosin complex depend on Ca2+ concentration. The experimental results are suggestive of the existence of a myosin-coupled regulatory system in skeletal muscles. PMID- 3282549 TI - [Blood coagulation and fibrinolysis in ischemic heart disease. The relationship to risk factors]. AB - The data on blood coagulation and fibrinolysis in patients with coronary heart disease are reviewed. The relationship of the coagulating and fibrinolytic systems with cardiovascular risk factors is analysed. PMID- 3282548 TI - [Effect of arginine and its analogs on the activity of lysosomal and nonlysosomal peptide hydrolases in rat tissues]. AB - The autolysis intensity and proteolysis activity at pH 4,5, 7,4, 8,5 and lysosomal and nonlysosomal peptide hydrolase activity have been studied in brain and liver tissues of rats. L-arginine has been found to increase the peptide hydrolase activity in neutral and alkaline media in case of autolysis and proteolysis estimation according to the amino nitrogen increase. When the peptide hydrolase activity is estimated according to the increase of folin-positive components its decrease under the action of arginine in neutral and alkaline media has been revealed. Arginine doesn't change the lysosomal peptide hydrolase activity. In both tissues under the influence of arginine the nonlysosomal peptide hydrolase activity defined by amino nitrogen increases, estimated by the folin-positive components--decreases. Arginine shows the specific influence on the nonlysosomal peptide hydrolase activity. The L-arginine analogues (D arginine, guanidine) and products of the arginase reaction (ornithine and urea) don't exert such an effect on the nonlysosomal proteolysis. PMID- 3282550 TI - [Changes in metabolism of the nervous system in exposure to ionizing radiation at supralethal doses]. AB - Some biochemical disorders in the animals' central nervous system mainly in brain have been analysed after the exposure to superlethal doses of ionizing radiation as well in a state of the so-called early transient incapacity. The metabolism of gamma-aminobutyric acid, ammonia, histamine, cyclic nucleotides, prostaglandins and other biologically active substances is compared. Their investigation as metabolic regulators and modulators for nerve tissue seems to be of particular importance for deciphering the molecular mechanisms of changes in the central nervous system functional state and for discovering the possibility of its maintaining at a given level of activity. PMID- 3282551 TI - Hypothalamic-pituitary function in chronically cystic and regularly cycling dairy cows. AB - Studies were conducted to characterize, in detail, serum luteinizing hormone (LH) profiles 1) before and at various times after ovariectomy (OVX) in chronically cystic (CC) and regularly cycling (control) cows and 2) after injection of luteinizing hormone-releasing hormone (LHRH) and estradiol-17 beta (E2) to OVX CC and control cows. Blood samples were drawn from follicular-phase control cows and CC cows (pre-OVX) for 8 h at 15-min intervals. Cows were bilaterally OVX, and blood samples were collected for 8 h at 15-min intervals at 1, 2, and 4 wk after OVX. Five weeks after OVX, cows were challenged with 20 micrograms LHRH i.m. Six weeks after OVX, cows were challenged with 1 mg E2 i.m. Pulse frequency, pulse amplitude, and interpulse interval were not different (p less than 0.05) before or after OVX in CC and control cows. Peak LH, time to the peak, and area under the curves were not different (p greater than 0.05) after LHRH administration in CC and control cows. After injection of E2, peak LH levels were higher (p less than 0.05) in CC cows than in control cows. However, the time to the peak or the area under the curves were not different (p greater than 0.05) between groups. It appears that the feedback regulation of the hypothalamic-pituitary axis to circulating estrogen levels is altered as a result of the cystic condition. PMID- 3282553 TI - Immunocytochemical localization of beta-N-acetyl glucosaminidase in human reproductive organs. AB - Immunocytochemical localization of hexosaminidase activity in human males revealed that the enzyme activity is localized mainly in the Sertoli cells and interstitial tissue of the testis and in the columnar cells of the epididymis. In seminal vesicles, activity was observed around the glandular epithelium in the form of fine granules. PMID- 3282552 TI - Identification of a protein in the fibrous sheath of the sperm flagellum. AB - The fibrous sheath is a unique cytoskeletal component in the principal-piece segment of the mammalian sperm flagellum. Monoclonal antibody ATC was shown by indirect immunofluorescence (IIF) to bind to the principal piece of the flagellum of permeabilized mouse, rat, and hamster sperm, but not to that region of guinea pig, rabbit, or human sperm. IIF on isolated fibrous sheaths confirmed that the antigen was present in the fibrous sheath of mouse, rat, and hamster sperm. On Western blots of mouse spermatozoa, ATC identified a relatively insoluble major antigen with an apparent molecular weight of 67,000 (Mr 67,000). Hamster sperm fibrous sheaths contain an antigen of Mr 66,000, while rat sperm fibrous sheaths contain an antigen of Mr 65,500. The antigen was first detected in late spermatids, as determined by immunohistochemical procedures on sections of mouse, rat, and hamster testis. The antigen was not detected on Western blots of mouse brain, kidney, liver, or thymus. These results indicate that ATC recognizes a protein integral to the fibrous sheath of the principal piece of sperm detected by immunohistochemistry late in spermiogenesis that is probably restricted to the male germ cell line. PMID- 3282554 TI - Nuclear and manchette development in spermatids of normal and azh/azh mutant mice. AB - Germinal cells or nuclei with attached cytoskeletal elements were prepared from the testes and epididymides of normal mice and mice homozygous for the recessive azh mutation, which results in abnormal sperm heads. To make observations, we utilized phase-contrast microscopy, immunofluorescence microscopy with antitubulin antibodies, and a direct-view stereo electron microscope system developed by A. Cole. Sperm nuclei, tails, manchettes, and other cytoskeletal structures were studied at various stages of development. The tail architectures were similar in the normal and mutant forms, but the shape of the heads at the attachment regions were markedly different. Normal sperm nuclei were very flat, whereas the posterior regions of mutant nuclei were tapered cylinders. The manchette, an organized microtubular structure that girdles the posterior region of the spermatid nucleus, differed in size and configuration between normal and mutant forms. In normal midstage spermatids, the manchette microtubules extended outward at a 45 degree angle from the long axis of the flattened head, whereas in mutant spermatids, the microtubules formed tapered cylinders around the long axis of the caudal part of the nucleus. Radical differences in head shapes between normal and mutant sperm could be related, in part, to the manner in which manchettes formed and matured on the spermatids. PMID- 3282555 TI - Purification and characterization of the primary acrosomal autoantigen of guinea pig epididymal spermatozoa. AB - Previous studies showed that sperm auto- and alloantigens participate in guinea pig (GP) fertilization. In an effort to determine how alloantibodies to GP sperm acrosomal contents (AC) inhibit fertilization, we identified acrosomal auto- and alloantigens using Western blots. The predominant autoantigens migrated with Mr = 25,000, Mr = 51,000, and Mr = 55,000 under nonreducing conditions. The primary (Mr = 25,000) acrosomal autoantigen, AA1, was purified to homogeneity from AC by gel filtration, cation-exchange chromatography, chromatofocusing, and a final gel filtration. We also purified AA1 from an acidic glycerol extract of spermatozoa by gel filtration, chromatofocusing, and high-performance liquid chromatography on hydroxylapatite. AA1 is a protein and shares at least one antigenic determinant with a 51,000 Mr acrosomal component. AA1 is acrosome-specific, as determined by immunoabsorption and by indirect immunofluorescence on testicular cells. By quantitative enzyme-linked immunosorbent assay, AA1 comprises 6.4% of acrosomal protein in GP spermatozoa. On the basis of its physiochemical properties and localization, we conclude that AA1 is a unique sperm autoantigen. Surprisingly, several antibody preparations, including allo- and heteroantibodies with high anti-AA1 titers, did not inhibit fertilization in vitro. Thus, the mechanism by which alloantibodies to AC inhibit GP fertilization in vitro is not by binding to AA1. PMID- 3282556 TI - Protease activity in brook trout (Salvelinus fontinalis) follicle walls demonstrated by substrate-polyacrylamide gel electrophoresis. AB - Proteolytic activity was demonstrated in the follicle wall surrounding oocytes of brook trout (Salvelinus fontinalis) by an assay system that incorporated protein substrates into sodium dodecyl sulfate-polyacrylamide gel electrophoresis (substrate-SDS-PAGE). At least six proteolytic enzymes (78, 70, 67, 59, 22 and 20 kDa) were present when follicle wall extracts were electrophoresed and incubated in gels containing gelatin. Of these six enzymes, only two enzymes (20 and 22 kDa) were present when follicle wall extracts were resolved and incubated in gels containing casein. The activities of the 78 and 70 kDa enzymes were completely inhibited with metallo- and collagenolytic protease inhibitors and partially inhibited with serine protease inhibitors. The activities of the 67 and 59 kDa enzymes were completely blocked with metallo- and collagenolytic protease inhibitors. The activities of the 22 and 20 kDa enzymes were only slightly decreased with a serine protease inhibitor. PMID- 3282558 TI - Ca2+ in contractile processes. AB - The concept of Ca2+ regulation, first discovered and developed in muscle research, is historically surveyed. Ca2+ regulation mechanisms in actomyosin dependent contractile processes are compared, emphasis being placed on the great diversity. The mode of action of Ca2+ is discussed with the examples of troponin and calmodulin, the most differentiated and conservative Ca2+-receptor proteins, respectively. PMID- 3282557 TI - Testing for linear trends in proportions using correlated otolaryngology or ophthalmology data. AB - This paper is concerned with the issue of testing for trend with correlated binary data. We consider the problem where one has either one or two ears (or eyes) available for analysis at baseline and one wishes to look at changes over time in a dichotomous outcome taking into account the correlation between responses from two ears. A reparameterization of Rosner's (1982, Biometrics 38, 105-114) correlated binary data model is presented and applied to a test for trend where the stratifying variable is age (or any other subject-specific variable). Observed and expected values are calculated for the trend statistic separately for both unilateral and bilateral cases and are then summed to obtain an overall summary statistic. The proposed method is illustrated by a reanalysis of data presented in a published study of the efficacy of antibiotics for the treatment of otitis media. PMID- 3282559 TI - Temperature adaptation of lactate dehydrogenase. Structural, functional and genetic aspects. AB - Comparison of the primary structures of thermophilic, mesophilic and psychrophilic lactate dehydrogenase (LDH) reveals a multitude of temperature related amino acid substitutions. In the substitutions amino acid residues occurring preferentially in thermophilic, mesophilic (psychrophilic) LDH were found. On this basis, amino acid residues could be classified in an order from typical thermophilic (thermostabilizing) to typical mesophilic (thermolabilizing, increasing dynamics of the enzyme molecule) residues. The temperature-dependent ratio between thermostabilizing and thermolabilizing amino acid residues forms the basis for the specific structural and functional properties of thermophilic or mesophilic LDH. It is interesting that there appears to be a relationship between this order from thermophilic to mesophilic amino acid residues and the type of bases coding for these individual residues in the translation step of protein biosynthesis. Temperature-related amino acid substitutions are based on temperature-related base substitutions. A possible mechanism of temperature adaptation of LDH through alternative selection of thermophilic and mesophilic amino acid residues at the level of tRNA (anticodon)-mRNA (codon) interactions is discussed. These temperature-adaptation processes are evolutionary events in which the evolution and structure of the genetic code are involved. PMID- 3282560 TI - The molecular and fibrillar structure of collagen and its relationship to the mechanical properties of connective tissue. AB - The conformation of type I collagen molecules has been refined using a linked atom least-squares procedure in conjunction with high-quality X-ray diffraction data. In many tendons these molecules pack in crystalline arrays and a careful measurement of the positions of the Bragg reflections allows the unit cell to be determined with high precision. From a further analysis of the X-ray data it can be shown that the highly ordered overlap region of the collagen fibrils consists of a crystalline array of molecular segments inclined by a small angle with respect to the fibril axis. In contrast, the gap region is less well ordered and contains molecular segments that are likely to be inclined by a similar angle but in a different vertical plane to that found in the overlap region. The collagen molecule thus has a D-periodic crimp in addition to the macroscopic crimp observed visually in the collagen fibres of many connective tissues. The growth and development of collagen fibrils have been studied by electron microscopy for a diverse range of connective tissues and the general pattern of fibril growth has been established as a function of age. In particular, relationships between fibril size distribution, the content and composition of the glycosaminoglycans in the matrix and the mechanical role played by the fibrils in the tissue have been formulated and these now seem capable of explaining many new facets of connective tissue structure and function. PMID- 3282561 TI - About the organisation of condensed and decondensed non-eukaryotic DNA and the concept of vegetative DNA (a critical review). AB - Experiments are reviewed that allow one to assign naturally occurring DNA containing plasmas to either of two classes by virtue of their sensitivity to aggregation upon dehydration in organic solvents. The interphase nuclei of higher cells are relatively insensitive, while the DNA plasmas represented by bacterial nucleoids, vegetative bacteriophage and the chromosomes of dinoflagellates are sensitive. In higher cells the bulk of DNA is organised with histones in the form of nucleosomes. In prokaryotes and in the pool of vegetative phage DNA the most abundant histone-like protein HU is not associated with the bulk DNA, but localised in the border region with ribosomes where transcription and translation occur. These experimental results strongly suggest that the two classes of DNA plasmas are distinguishable by a low (1:10) or high (1:1) protein-to-DNA ratio. The hypothesis is formulated that the vegetative DNA (replicating and transcribing), throughout the living world, is nucleosome-free; during evolution, nucleosomes would have been introduced as a simple and adequate means for compacting the resting DNA. Condensation of DNA does not occur with prokaryotic nucleoids, but does take place when DNA is withdrawn from the vegetative phage pool to become packaged into phage heads. Dinoflagellate chromosomes are rather condensed although structurally different from eukaryotic chromosomes (e.g., those from Euglena) and are much more aggregation-sensitive. PMID- 3282562 TI - Time-resolved optical spectroscopy and structural dynamics following photodissociation of carbonmonoxyhemoglobin. AB - A summary is presented of our current understanding of the kinetics of ligand rebinding and conformational changes at room temperature following photodissociation of the carbon monoxide complex of hemoglobin with pulsed lasers. The events which occur subsequent to excitation have been followed over 12 decades in time, from about 100 fs to the completion of ligand rebinding at about 100 ms. Experiments with picosecond and subpicosecond lasers by others, together with molecular dynamics simulations, indicate that by 1 ns the deoxyhemoglobin photoproduct is in a thermally equilibrated ground electronic state, so that subsequent processes are unaffected by the initial laser excitation. The principal results have been obtained from time-resolved optical absorption spectroscopy using a sensitive nanosecond laser spectrometer. Five relaxations have been observed which are interpreted as geminate rebinding at about 50 ns that competes with motion of the ligand away from the heme which produces a tertiary conformational change, a second tertiary conformational change at 0.5-1 microseconds, transition from the R to T quaternary structure at about 20 microseconds, and overall bimolecular rebinding of ligands from the solvent to the R and T quaternary structures at about 200 microseconds and 10 ms. Assuming that the dissociation pathway in photolysis experiments is the reverse of the association pathway, we find that for the R state there is a 40% probability that the ligand will bind to the heme after entering the protein, and a 60% probability that it will return to the solvent. Studies on the alpha subunit of an iron-cobalt hybrid hemoglobin indicate that carbon monoxide enters the protein at the same rate for both R and T quaternary structures. For the alpha-subunit in the T state the probability of binding after entry is much lower, and the ligand returns to the solvent more than 99% of the time, accounting for the 60-fold overall lower association rate. This decreased probability of binding results from a decreased rate of binding to the heme from within the protein, and not an increased rate of return to the solvent. There are still unresolved problems on the basic structural description of carbon monoxide binding and dissociation, particularly the functional significance of the tertiary relations in both the R and T states, and the precise number of kinetic barriers within the protein. PMID- 3282563 TI - A type II beta-turn in a flexible peptide: proton assignment and conformational analysis of the alpha-factor from Saccharomyces cerevisiae in solution. PMID- 3282564 TI - [Interferon activation of the production of a factor increasing the bactericidal properties of mouse macrophages]. AB - It has been established that the administration of homologous interferon to mice activates the production by splenocytes of a factor increasing the bactericidal properties of macrophages in the peritoneal exudate. The activation effect was dose-dependent. The maximum production was noted on day 3 after the injection of interferon, type I, or its inducers. Cell-producers of the factor are mainly lymphocytes. PMID- 3282565 TI - [Inhibition of the growth of the Ca-755 tumor in mice with reconstitution of hematopoiesis]. AB - Data on the growth inhibition of Ca-755 tumor transplanted to mice two months after hemopoiesis recovery with syngeneic bone marrow cells or allogeneic fetal liver are presented. PMID- 3282566 TI - Cytogenetic events after bone marrow transplantation for chronic myeloid leukemia in chronic phase. AB - Forty-eight patients treated by allogeneic bone marrow transplantation (BMT) for Philadelphia (Ph) chromosome-positive chronic myeloid leukemia in chronic phase had serial cytogenetic studies of marrow performed at intervals after transplant. Twenty patients received marrow cells from donors of opposite sex. Ph+ marrow metaphases were identified in 24 of 48 (50%) of patients after BMT; they were first seen early (within 1 year) in 16 cases and late (greater than 1 year after BMT) in eight cases. Ph-positivity after BMT occurred more commonly in recipients of T-depleted than nondepleted marrow (19 of 28 v 5 of 20). In 4 cases the Ph+ metaphases were found only transiently after BMT; in 11 cases the Ph+ metaphases have persisted but hematologic relapse has not ensued; in 9 cases the finding of Ph+ metaphases coincided with or preceded hematologic relapse. Chromosomes in cells of donor origin had morphological abnormalities in two cases. No relapses were identified in cells of donor origin. Our data suggest that the relationship between cells of recipient and donor origin is complex: cure of leukemia may depend on factors that operate for some months or years after BMT. PMID- 3282567 TI - Introduction of a human colony stimulating factor-1 gene into a mouse macrophage cell line induces CSF-1 independence but not tumorigenicity. AB - The SV40-immortalized mouse macrophage cell line, BAC1.2F5, is strictly dependent on CSF-1 for its survival and proliferation in culture. Introduction of a retroviral vector containing a 1.6 kilobase (kb) pair human CSF-1 cDNA into these cells abrogated their growth factor dependence but did not render the cells tumorigenic in nude mice. The infected macrophages contained multiple copies of the vector provirus, expressed both membrane-bound and secreted forms of CSF-1, and exhibited constitutive down modulation of the murine CSF-1 receptor. Because insertion of the v-fms gene has previously been shown to abrogate factor dependence and induce tumorigenicity in BAC1.2F5 macrophages, the failure of these cells to express a fully transformed phenotype after persistent stimulation by endogenous CSF-1 suggests that the v-fms and c-fms gene products provide different signals for cell proliferation. PMID- 3282568 TI - High-molecular weight kininogen is present in cultured human endothelial cells: localization, isolation, and characterization. AB - The presence of high-molecular weight (mol wt) kininogen was demonstrated in cultured human endothelial cells derived from the umbilical cord by immunofluorescence techniques. Cultured human endothelial cells contain 58 +/- 11 ng (n = 16) high-mol wt kininogen/10(6) cells as determined by an enzyme-linked immunosorbent assay (ELISA) specific for high-mol wt kininogen. High-mol wt kininogen was isolated from cultured human endothelial cells by immunoaffinity chromatography. Nonreduced sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) demonstrated that endothelial cell high-mol wt kininogen consisted of five protein bands with mol wts of 95,000, 85,000, 65,000, 46,000, and 30,000 daltons. Immunoblotting of the endothelial cell high-mol wt kininogen by using specific antisera against the heavy and light chain indicated that the 95,000-, 85,000-, and 65,000-dalton bands consisted of the heavy and light chain whereas the 46,000- and 30,000-dalton bands reacted only with the anti-light chain antiserum. Immunoprecipitation studies performed with lysed, metabolically labeled endothelial cells and monospecific antisera directed against high-mol wt kininogen suggested that high-mol wt kininogen is not synthesized by the endothelial cells. Endothelial cells cultured in high-mol wt kininogen-free medium did not contain high-mol wt kininogen. These studies indicate that endothelial cell high-mol wt kininogen was proteolytically cleaved in the culture medium and subsequently internalized by the endothelial cells. Binding and internalization studies performed with 125I-labeled, proteolytically cleaved, high-mol wt kininogen showed that endothelial cells can indeed bind and internalize proteolytically cleaved high-mol wt kininogen in a specific and saturable way. PMID- 3282569 TI - Bone marrow transplantation for the treatment of acute nonlymphoblastic leukemia in children aged less than 2 years. AB - Eleven children with acute nonlymphoblastic leukemia in first remission who were less than 2 years of age at diagnosis were treated with 120 mg/kg of cyclophosphamide, 12-Gy fractionated total-body irradiation, and marrow transplantation. Seven patients remain in complete remission from 3.5 to 13.8 years posttransplant, four for more than 6.75 years. The immediate posttransplant course was relatively uncomplicated in surviving patients. No child developed severe graft-v-host disease. The major long-term side effect has been a slowing in growth. Although the prognosis for such children with conventional chemotherapy remains poor, intensive cytotoxic therapy and marrow transplantation offers an alternative therapy with a chance for cure. PMID- 3282570 TI - Identification and characterization of a differentiation antigen in human neutrophils and monocytes. AB - Human promyelocytic leukemia (HL-60) cells were induced to differentiate into macrophage-like cells by treatment with 10(-7) mol/L 1,25-dihydroxyvitamin D3 (VD3). A monoclonal antibody (MoAb, 60B8), reactive with the particulate of the differentiated cells but not of the untreated cells, was isolated. The antigen recognized by the MoAb became apparent two days after VD3 treatment, and its concentration increased and peaked on day 6. Human neutrophils, followed by monocytes and differentiated HL-60 cells, showed the greatest abundance of the antigen. Monocytes cultured for eight days in vitro lost the antigen. No 60B8 antigen was seen in other blood cells. The MoAb precipitated two polypeptides with an apparent molecular weight (mol wt) of 15,000 (15 k) and 13 k in the detergent-solubilized, 35S-methionine-labeled lysate of the differentiated HL-60 cells. Double-sandwich type enzyme-linked immunosorbent assay (ELISA) devised for the quantitative assay of 60B8 antigen indicated that some 2% to 5% of neutrophil protein was 60B8 antigen. This antigen was not exposed on the neutrophil cell surface, since the cells were not stained immunofluorescently with either mono- or polyclonal antibody, unless they had become permeable. The neutrophil membrane and the granules were separated on the Percoll density gradient, and the antigen was found localized in the plasma membrane-rich fraction. These findings suggested that 60B8 antigen is a novel differentiation antigen for phagocytic cells. PMID- 3282571 TI - Allogeneic marrow grafting with partially mismatched, unrelated marrow donors. AB - Forty patients with advanced hematologic malignancies or severe aplastic anemia received marrow grafts from partially mismatched, unrelated marrow donors. All patients were administered conventional prophylaxis for acute graft-v-host disease (GVHD) consisting of methotrexate and low-dose glucocorticoids. All but two patients who survived at least 30 days showed durable engraftment. Six patients survive 17+ to 36+ months following transplantation. Severe acute GVHD was seen in 47% of the patients; however, no direct correlation between GVHD and the degree of mismatching could be determined. Fatal infections were seen in 29 patients, and in the majority the infection occurred after the granulocyte count had risen to greater than 500 cells/microL. We conclude that the problems encountered in this pilot study can potentially be solved, and that further studies with this type of marrow grafting are warranted. PMID- 3282572 TI - Prevention of refractoriness and HLA-alloimmunization using filtered blood products. AB - Depletion of leukocytes from all blood products may decrease the incidence of alloimmunization to HLA antigens present on the white cells and thus delay the onset of refractoriness to random donor platelet support. In order to test this hypothesis, 54 patients with hematologic malignancy or marrow aplasia were entered on a prospective randomized trial using cotton-wool filtration as a method of leukocyte depletion of red cell and platelet concentrates. Forty patients were considered evaluable; 20 patients received filtered products and 20 patients in the control group received standard unfiltered products. The filter was 99% efficient in removal of leukocytes (average number of WBC/platelet product, 6 X 10(6)). Platelet loss by this technique was 8%. Alloimmunization was assessed by detection of de novo formed lymphocytotoxic and platelet specific antibodies by microcytotoxicity test, Staph A protein radioimmunoassay, and solid phase red cell adherence test. In the group receiving filtered products, three of 20 (15%) patients developed lymphocytotoxic antibodies while ten of 20 (50%) patients in the control group developed cytotoxic antibodies (P = .01 by actuarial methods). Platelet antibodies were detected in seven of ten alloimmunized patients in the control group and three of three patients in the study group. Clinical evidence of refractoriness was seen in three of 20 patients in the filtered group and ten of 20 in the control group (P = .01 by actuarial methods). The cost of filtration was a fraction of the cost of a plateletpheresis product. Filtration appears to be an effective and economical method for reducing alloimmunization and clinical refractoriness to random donor platelets in patient receiving long-term transfusion support. PMID- 3282573 TI - [Intensive chemotherapy and bone marrow grafting during the consolidation phase of stage IV neuroblastoma]. AB - Sixty-five patients more than one year of age at diagnosis with stage IV neuroblastoma were prospectively treated since january 1983. Seventeen per cent were not consolidated with massive therapy and ABMT (progression: 3 cases; died at induction: 4 cases; died at surgery: 1 case; parental refusal: 2 cases) and all died. Among 49 evaluable cases, 31 were grafted in PR and 18 in CR or VGPR. Actuarial progression free survival at 35 months is 33% for the grafted group and 24% for the whole group. These results are better than previous experience of this group (8% at 30 months). PMID- 3282574 TI - [Metastatic neuroblastoma: consolidation treatment with 2 courses of high-dose chemotherapy followed by a bone marrow autograft]. AB - Among 62 children over 1 year of age at diagnosis who were treated for stage IV neuroblastoma, 33 entered remission after conventional therapy. They received high-dose chemotherapy and in vitro purged bone marrow transplantation as consolidation therapy. Fifteen patients received one course and 18 two courses. At present, 16/33 grafted patients are alive in CR with a median follow-up of 28 months. Toxicity of this regimen was tolerable. Under this treatment, actuarial disease free survival is improved compared with that observed under conventional therapy. PMID- 3282576 TI - [Cytologic detection of neuroblasts in the bone marrow]. AB - Cytological detection of bone marrow involvement by neuroblastoma is improved by sampling at ten sites because metastatic cells have a multifocal distribution. Examination of spread films from ten bone marrow aspirates has been compared to density separation of the pool of bone marrow aspirates followed by cytocentrifugation onto glass slides. Of 103 procedures performed, 3 positive results by concentration of the pool were found negative by examination of spread films from each bone marrow aspirate. Cytological examination of the pool of bone marrow aspirates after density separation is a simple, rapid and accurate technique for the detection of small aggregates of metastatic cells in patients with neuroblastoma. Additional immuno-enzymatic techniques may be used for the detection of isolated neuroblastoma cells. PMID- 3282575 TI - An approach to reduce treatment and invasive staging in childhood Hodgkin's disease: the sequence of the German DAL multicenter studies. AB - From June 1978 through March 1987, 506 children under the age of 16, representing approximatively 70% of the children with Hodgkin's disease in West-Germany entered 3 consecutive multicenter studies at 68 centers. The general objective of these study sequence is to maximize the chance of cure while minimizing radiotherapy and chemotherapy as much as possible in a combined modality treatment concept. The purpose was also to reappraise the need for splenectomy and laparotomy and to define a staging policy which provides adequate evaluation of intraabdominal disease. Study II (HD-82) is described in detail. 203 protocol patients were enrolled between Dec. 1981 and Dec. 1984. Laparotomy was performed in 202 patients, but splenectomy only in 78 (38.4%) using an intraoperative decisional strategy, developed in Study I (HD-78). Patients were stratified according to stage into 3 groups (PS I/IIA, IIB/IIIA and IIIB/IV) receiving 2, 4 or 6 cycles of OPPA/COPP-chemotherapy. Radiotherapy was given only to the involved fields, the dose depending on the extent of chemotherapy (35, 30 or 25 Gy). RESULTS AND CONCLUSIONS: The event-free survival rates after 5 years are 96% (entire group), 99% (stage I/IIA), 96% (stage IIB/IIIA) and 90% (stage IIIB/IV). Thus, only involved field radiotherapy with reduced doses is needed, if a stage dependent chemotherapy with 2, 4 or 6 cycles of OPPA/COPP is given. The strategy of selective splenectomy has proven very useful. Based on statistical analyses concerning abdominal involvement a clinical decisional strategy for selective laparotomy was developed. Further efforts are needed to reach a stepwise cautious and controlled narrowing-in on the therapy combining the lowest long-term toxicity with the highest chance of cure. PMID- 3282577 TI - [Value of immunological analysis for the detection of residual neuroblasts in the bone marrow]. AB - Immunological analysis is complementary of morphological analyses in the detection of neuroblastoma BM metastases. It attests the neuroblastic nature of rare pseudolymphocytic isolated cells. The combination of immunocytochemical technique (alkaline phosphate) and double-immunofluorescence technique allows the detection of as few as 10(-5) residual neuroblastoma cells. At the time of bone marrow harvest, it permits a precise evaluation of malignant cells in the graft. PMID- 3282578 TI - [Mutagenesis and responses induced by DNA damage in Escherichia coli: principle of bacterial tests for detecting carcinogenic or antitumoral substances]. AB - Various bacterial tests are used for the detection of potential carcinogenic or antitumoral agents. These so-called short-term tests measure different processes triggered by DNA damage: mutagenesis ("Mutatest"), induction of genes that belong to the recA-lexA regulon ("Umu-test" and "SOS-chromotest"), and induction of provirus ("Inductest"). Although these tests share common properties, each exhibits characteristic properties which are revealed by analyzing the various DNA repair mechanisms brought about in E. coli. PMID- 3282579 TI - [Pharmacokinetics of new anthracyclines]. AB - Several new anthracyclines have been recently made available for clinical use or for clinical trials. Each molecule is characterized by original metabolic and pharmacokinetic features, which can be compared to those of the reference anthracyclines, doxorubicin and daunorubicin. Idarubicin is transformed into idarubicinol to a high extent, similarly to the transformation of daunorubicin to daunorubicinol, whereas the 13-dihydroderivatives of esorubicin, epirubicin or pirarubicin are present in plasma at lower levels than the parent drugs. Epirubicin is the only anthracycline able to form glucuronides, and pirarubicin can be transformed into doxorubicin itself. The elimination half-life of epirubicin or esorubicin is similar to that of doxorubicin (30 h) and the elimination half-life of unchanged idarubicin or pirarubicin is shorter (15-20 h). The novel anthracyclines have generally a higher plasma clearance than doxorubicin or daunorubicin, and a higher volume of distribution. Less than 10% of the injected dose of any anthracycline is found in urines, the major elimination pathway being the bile. The knowledge of anthracycline pharmacokinetics may allow the prediction of their behavior when special administrations are used (continuous infusion, locoregional therapy...). PMID- 3282581 TI - Wanda A. Scott. Independent contractor. PMID- 3282580 TI - [Thomas Hodgkin]. PMID- 3282582 TI - Bone banks in the 1980s. PMID- 3282583 TI - Developmental screening and surveillance. AB - This article reviews the practice of and state of knowledge concerning developmental screening and surveillance of preschool children in the UK. It includes testing for defects of hearing and vision but does not constitute a "how to-do-it" guide. This is available elsewhere (Egan et al, 1969; Sheridan, 1975). PMID- 3282584 TI - The emotional impact of mastectomy. AB - Over the last few decades the psychosocial problems following mastectomy have become well recognized and surgical treatment for breast cancer has become less mutilating. For women with small cancers a number of equally effective treatments are available and involving the patient in the choice of treatment appears to reduce morbidity. PMID- 3282586 TI - The modern treatment of epilepsy. AB - Epilepsy is a varied condition. For some patients it is a disorder that afflicts them for a short part of their life while for others it may be a chronic condition demanding life-long treatment. The most difficult decisions in treating the patient with epilepsy are when to start treatment, which drug to choose, when to stop therapy and how to manage chronic epilepsy. This short review considers each of these areas. PMID- 3282585 TI - Tuberculous meningitis. AB - Tuberculous meningitis is a grave, yet curable, illness. It is a rare condition nowadays and may present special problems when the clinical picture is untypical. Clinical awareness, early diagnosis and vigorous treatment are the key to therapeutic success. PMID- 3282587 TI - Respiratory manifestations of AIDS. AB - Respiratory disorders are present in at least 40% of patients with the acquired immunodeficiency syndrome (AIDS) and are the commonest mode of presentation. Lung pathology ranges from infections, both opportunistic and non-opportunistic, to Kaposi's sarcoma and lymphoid interstitial pneumonia. AIDS-related lung problems must increasingly be considered in the differential diagnosis of the breathless patient. PMID- 3282588 TI - Role of the reticuloendothelial system in the pathogenesis of organ damage. AB - Macrophages ingest foreign materials, effete and damaged tissues, and bacterial products. They also secrete biologically active products which promote and regulate host inflammatory responses. The balance between these macrophage activities may lead to the development of an effective and self-limiting inflammatory response or one that results in tissue damage and potentially in organ failure. PMID- 3282589 TI - Bone marrow transplantation for patients with chronic myeloid leukaemia. AB - Patients with chronic myeloid leukaemia may be rendered asymptomatic with conventional chemotherapy but this does not increase their life expectancy. Bone marrow transplantation provides not only the chance of increased survival but also an opportunity to cure the leukaemia. PMID- 3282590 TI - Survival in systemic lupus erythematosus. AB - The prevalence of SLE has increased throughout the world, due in part to the recognition of milder forms. Significant renal disease is now less common but late cardiovascular disease is being reported more often. The latter was previously attributed to steroid therapy, but we believe that the thrombotic tendency associated with antiphospholipid antibodies provides a significant contribution. Infection still ranks high in the mortality statistics in SLE, despite the move to more conservative treatment. PMID- 3282591 TI - The architecture of the hospital: a study of spatial organization and medical knowledge. PMID- 3282592 TI - Occupational urothelial cancer. PMID- 3282593 TI - Ureteric obstruction secondary to endometriosis. Report of three cases with a review of the literature. AB - Three cases of endometriosis are presented. In one patient bilateral obstruction was noted; in a second patient bilaterally enlarged kidneys with unilateral obstruction were found and in the third patient only unilateral obstruction was defined. Intrinsic ureteric obstruction and bilateral obstruction, both rare findings, are described in this report. The diagnosis, evaluation and management of these patients are discussed. PMID- 3282594 TI - Spontaneous resolution of lymphocele in a renal transplant patient. PMID- 3282595 TI - Modern treatment of varicose veins. PMID- 3282596 TI - Regional anaesthesia and surgical morbidity. AB - This review assesses the results of studies examining the influence of regional anaesthesia on surgical morbidity. Morbidity appears to be reduced when procedures below the umbilicus are concerned, but evidence is less convincing for upper abdominal and thoracic procedures. PMID- 3282597 TI - Bacterial short-chain fatty acids and mucosal diseases of the colon. AB - This review examines the potential association between short-chain fatty acids and mucosal diseases of the colon, and discusses the implication of these relationships and the surgical management of large bowel disorders. PMID- 3282598 TI - Pulse-generated runoff: a new method of determining calf vessel patency. AB - A non-invasive method of determining calf vessel patency before femorodistal bypass has been developed. This pulse-generated runoff (PGR) system generates blood flow in patent calf arteries by means of a pulsatile cuff even if the existing Doppler signal is inaudible. PGR was compared with pre-operative arteriography in 95 ischaemic limbs and both were compared with the peripheral resistance measured at operation in 62 limbs. There was a highly significant correlation between the PGR and arteriogram scores (rs = 0.74, P less than 0.001) but PGR tended to detect more patent vessels than arteriography. The peripheral resistance correlated better with PGR than arteriography (rs = -0.71 and -0.54 respectively, P less than 0.001). PGR is a simple, non-invasive method of determining calf and foot vessel patency pre-operatively. PMID- 3282599 TI - Immunohistochemical localization of gamma-aminobutyric acid- and aspartate containing neurons in the rat deep cerebellar nuclei. AB - The immunohistochemical localization of gamma-aminobutyric acid (GABA)- and aspartate-containing neurons was evidenced in the rat deep cerebellar nuclei, using purified antisera to GABA and aspartate, respectively. Most GABA-containing neurons had small cell bodies and were scattered unevenly throughout the deep cerebellar nuclei. The medial cerebellar nucleus had a few GABA-containing cell bodies and interpositus and lateral nuclei contained many GABA-containing cell bodies. GABA-containing terminals were distributed throughout the nuclei. A large number of various-sized aspartate-containing cells were present in the deep cerebellar nuclei and most of these cells were large or medium-size. Aspartate containing cells in the medial, interpositus and lateral nucleus were surrounded by GABA-like immunoreactive terminals, thereby suggesting the modulation of aspartate-containing neurons by GABA-ergic fibers from Purkinje cells. PMID- 3282600 TI - GABAergic ganglion cells in the rabbit retina. AB - The ganglion cells are the output neurons of the retina. There is, however, relatively little known about the neurotransmitters used by these cells. In the present study, ganglion cells identified with a ganglion cell-specific monoclonal antibody (AB5) are shown in separate double-label experiments to be gamma aminobutyric acid (GABA)-like immunoreactive and to possess a high-affinity uptake mechanism for [3H]GABA accumulation. The localization of these markers of GABA activity to AB5-labelled ganglion cells provides the first definitive evidence for the presence of a classical transmitter in retinal ganglion cells and suggests that GABA may perform a role as a neurotransmitter in these cells. PMID- 3282601 TI - Immunocytochemical evidence for direct synaptic connections between corticotrophin-releasing factor (CRF) and gonadotrophin-releasing hormone (GnRH) containing neurons in the preoptic area of the rat. AB - Electron microscopic double-label immunostaining with peroxidase and avidin ferritin was used to study connections between corticotrophin-releasing factor (CRF) and gonadotrophin-releasing hormone (GnRH) immunoreactive elements in the medial preoptic area of the rat. Synaptic contacts were observed between CRF immunoreactive axon terminals and the dendrites of GnRH-immunopositive neurons. These results suggest that the inhibitory effects of stress-induced CRF release on reproductive function may involve a direct CRF input to the GnRH-producing cells. PMID- 3282602 TI - Histaminergic nerve fibers in the median eminence and hypophysis of rats demonstrated immunocytochemically with antibodies against histidine decarboxylase and histamine. AB - Histaminergic fibers in the median eminence and hypophysis of rats were examined immunocytochemically with antibodies against histidine decarboxylase (HDC), the sole histamine-synthesizing enzyme, and against histamine itself. A similar distribution of immunoreactive fibers was observed with these two antibodies. In the median eminence, immunoreactive fibers were mainly located in the internal layer and could be traced to the posterior lobe of the hypophysis. A few fibers were detected in the external layer of the median eminence, but none in the anterior or intermediate lobe of the hypophysis. These observations suggest that neuronal histamine may take part in regulation of the hypothalamo neurohypophysial neuroendocrine system in rats. PMID- 3282604 TI - Immuno-electron microscopic study of calcitonin gene-related peptide (CGRP) in axis cylinders of the vagus nerve. CGRP is present in both myelinated and unmyelinated fibers. AB - The localization of immunoreactive calcitonin gene-related peptide (IR-CGRP) in vagus nerve fibers of the rat was studied with pre-embedding electron immunocytochemistry. IR-CGRP was localized in a small number (approximately 5%) of myelinated fibers and approximately 50% of unmyelinated fibers of the vagus. The immumoreactivity was observed in the dense cored vesicles (75-150 nm) and in the axoplasm, but absent in the clear vesicles. PMID- 3282603 TI - Putative serotonergic bipolar and amacrine cells in the chicken retina. AB - Four populations of putative serotonergic cells could be detected in the chicken retina by histofluorescence and immunohistochemistry. Numerous (10,000/mm2) small (6 micron diameter) bipolar cells were located towards the middle of the inner nuclear layer, as were sparser (1000/mm2) larger (12 micron diameter) amacrine cells. Very sparse large (greater than 30 micron diameter) and more numerous small (12 micron diameter) ganglion cells were also detected. Prominent fibre plexuses were detected in the inner plexiform layer, close to the inner nuclear and ganglion cell layers, and appeared to be formed by the processes of the bipolar cells, amacrine cells and at least the large ganglion cells. Exogenous serotonin (5-HT) was detected in the chicken retina. From the effects of neurotoxins on 5-HT levels and 5-HT-like immunoreactivity (5-HTLI), most of this appeared to be associated with the amacrine cells. 5-HTLI bipolar cells were selectively destroyed by intravitreal injections of 5-10 nmol of kainic acid, while 5-HTLI amacrine cells were destroyed by N-methyl-D,L-aspartic acid and 5,7 dihydroxytryptamine. The sensitivity of the bipolar cells to kainic acid indicates that they are OFF-cells. PMID- 3282606 TI - Inhibitory effect of kassinin on salt intake induced by different natriorexigenic treatments in the rat. AB - Pulse intracerebroventricular (i.c.v.) injection of kassinin, 100-500 ng/rat, potently inhibits salt intake induced by sodium depletion. The effect appears to be selective since the same doses of kassinin do not inhibit milk intake or solid food intake. When given by continuous i.c.v. infusion kassinin elicits a clear anti-natriorexic effect at doses of 1-10 ng/min/rat. Kassinin not only suppresses sodium depletion-induced salt appetite, but it also inhibits sodium intake induced by pulse i.c.v. injection of renin or by subcutaneous (s.c.) deoxycorticosterone. Finally it also suppresses the elevated need-free intake of 1.5% NaCl in multidepleted female rats, which is not mediated by the renin angiotensin-aldosterone system. These findings show that kassinin exerts a general suppressive effect on salt intake, irrespective of the natriorexigenic treatment. The present study suggests that the kassinin-like peptides that are endogenous to the rat brain may be involved in the behavioral regulation of extracellular body fluids in the rat by inhibiting sodium intake. PMID- 3282605 TI - Antigenic markers and laminin expression in cultured enteric neural cells. AB - In this study, polyclonal and monoclonal antibodies have been used in conjunction with standard immunohistochemical methods to define markers which can be used to identify and study the main cell types present in the outgrowth area of explant cultures of myenteric plexus from newborn guinea pig. We show that all of the neurons binds antibodies to the glycoprotein Thy-1 and the antibody A2B5 which recognizes gangliosides. All enteric glial cells bind antibodies to the calcium binding protein S100, and the A2B5 monoclonal antibody and ca. 95% of glia are labeled by the antibody LB1, which recognizes the GD3 ganglioside. Most fibroblasts are labelled by antibodies to Thy-1 and the matrix glycoprotein fibronectin. Thus enteric neurons can be defined serologically as Thy 1+/A2B5+/S100- cells; enteric glia as S100+ cells and fibroblasts as A2B5-/S100 cells. The markers have been used to demonstrate that laminin is made by both enteric glia and fibroblasts. They have also been used to show that ca. 5% of neurons and less than 5% of enteric glia bind the antibody Leu 7 (HNK-1, L2), thus revealing the subpopulations of neurons and glia show differential cell surface expression of the carbohydrate epitope recognized by the antibody. In the accompanying paper, we demonstrate that two of the antibodies (LB1 and Thy-1) can be used to generate purified populations of neurons and glia. PMID- 3282607 TI - Immuno-labelling for freeze-fracture: application to a cell surface attachment antigen. AB - The cell-surface attachment (CSAT) antigen was investigated by using a technique that combines freeze-fracture with thin-sectioning. Chick heart cells were labelled using colloidal gold secondary antibodies, then fractured and shadowed with platinum vapor. The cells were dehydrated and embedded with their gold labels and replicated surfaces still intact. Sectioning revealed gold particles superimposed with external (E) fracture faces. The gold was definitely not coincident with E face particles and did not appear to be associated with pits. Therefore, it can be concluded that the CSAT glycoproteins is not represented by an E face particle. Whether it may be seen as an E face pit, or is not visible at all in freeze-fracture, is still an open question. PMID- 3282608 TI - Facilitation of lordosis in female rats by CNS-site specific infusions of an LH RH fragment, Ac-LH-RH-(5-10). AB - Structural alterations of the luteinizing hormone-releasing hormone (LH-RH) molecule have been performed to yield analogs which are more potent than, or which compete with, the parent hormone to increase the release of LH from the pituitary gland. The effects of these analogs on mating behavior, however, do not always parallel their effects on LH release. The present study tested the effectiveness of a pituitary-inactive fragment of LH-RH, namely Ac-LH-RH-(5-10), in potentiating mating behavior in the ovariectomized, estrogen-primed female rat. This fragment, when infused bilaterally into the medial preoptic area (POA), the ventromedial hypothalamus (VMH), or the midbrain central gray (MCG), significantly enhanced lordosis. Infusion of the fragment into the cerebral cortex was ineffective. Elevated lordotic responding was first apparent in the POA at 15 min postinfusion and was maintained for the duration of the testing session (180 min). Ac-LH-RH-(5-10) infused into the VMH or MCG enhanced lordotic behavior at 90 and 180 min postinfusion. The results indicate that only a portion of the LH-RH molecule may be required for behavioral activity and suggest that degradation of the LH-RH molecule is physiologically relevant. PMID- 3282609 TI - Purification and immunocytochemical detection of a protein that reveals layer V pyramidal cells in the rat cortex. AB - Protein 36 is a soluble protein isolated and purified from a high-speed supernatant fraction from homogenates of rat brain. To identify this protein in the brain, two-dimensional gel electrophoretograms of soluble proteins were prepared. The protein was separated by ion exchange and gel filtration chromatography. The chromatographic fractions were analyzed by two-dimensional electrophoresis. Protein 36 is a homodimer with a molecular weight of 64,000 Da and monomeric weight of 37,000 Da with an isoelectric point of 6.5. A rabbit antibody was raised to this protein. Immunocytochemical studies indicate that protein 36 is localized in large pyramidal cells, dendrites and axons of layer V of the cerebral cortex. The hippocampus contained cells in the stratum radiata and processes in the stratum pyramidalis. A variety of cell types were also observed in the globus pallidus, thalamus and hypothalamus. PMID- 3282610 TI - VIP-like immunoreactivity in the anterior hypothalamic area of a hibernating bat varies with physiological state. AB - Vasoactive intestinal polypeptide (VIP)-like immunoreactivity in the anterior hypothalamic area (AHA) was studied in 15 bats which are seasonal hibernators, using the unlabeled antibody enzyme method of Sternberger. Our results showed that the density of immunoreactive fibers and terminal plexuses in the AHA was greatest in euthermic animals and decreased dramatically when body temperature and cardiac rate were depressed and animals entered hibernation. PMID- 3282611 TI - Ultrastructure of serotonin-containing nerve fibres in the middle cerebral artery of the rat and evidence for its localization within catecholamine-containing nerve fibres by immunoelectron microscopy. AB - This study has examined the ultrastructural characteristics of serotonin (5-HT) like immunoreactive (5-HT-I) nerves in the perivascular plexus of a major cerebral blood vessel and their relationship with catecholaminergic (CA) nerves. This was achieved by immunohistochemistry for 5-HT used alone and in combination with simultaneous 5-hydroxydopamine (5-OHDA) false transmitter preloading to demonstrate catecholaminergic nerves examined by electron microscopy. About 15% of perivascular nerves showed some 5-HT-like immunoreactivity. These nerves were characterised by a predominance of small pleomorphic vesicles with a diameter of 40-50 nm and a few large granular vesicles about 100-150 nm diameter. 5-HT-I nerves were found at all levels of the perivascular plexus, from the outer adventitia where they were formed together with non-reactive nerves into bundles by Schwann cells and their processes, to more singly at the adventitia-media border, sometimes in close apposition to smooth muscle cells, separated by some 125 nm. Examination of animals treated by 5-OHDA preloading revealed that 5-HT-I nerves were almost invariably identified as catecholaminergic. However, CA nerves did not always show 5-HT-like immunoreactivity, some 25% only being doubly labelled in this study. Treatment of animals with the catecholaminergic nerve uptake blocker desmethylimipramine resulted in abolition of 5-HT-like immunoreactivity. These results provide direct ultrastructural evidence for the localisation of 5-HT within the perivascular catecholaminergic nerves of a major cerebral vessel and suggest that the contained 5-HT is mainly derived by uptake rather than synthesis within them. PMID- 3282612 TI - GABA axon terminals in synaptic contact with enkephalin neurons in the hypothalamus of the guinea pig. Demonstration by double immunocytochemistry. AB - By using a method combining pre-embedding immunoperoxidase staining for enkephalin and postembedding immunocolloidal gold labeling for gamma-aminobutyric acid (GABA) it has been demonstrate that many GABAergic boutons made synapses on enkephalin-reacting soma in the magnocellular dorsal nucleus of the guinea pig hypothalamus. The gold particles revealing the presence of GABA were essentially located over the small clear vesicles and mitochondria present in these GABAergic nerve endings. All the synapses observed were symmetrical. Taking into account the great number of these nerve endings, we conclude for a strong regulatory role of GABA on enkephalin-containing cells of the magnocellular dorsal nucleus. PMID- 3282613 TI - Quantitative analysis of synaptic input to gonadotropin-releasing hormone neurons in normal mice and hpg mice with preoptic area grafts. AB - Mutant hypogonadal (hpg) mice with a truncated gene for the precursor to gonadotropin-releasing hormone (GnRH) show certain aspects of recovery of reproductive function after receiving grafts of normal preoptic area into the third ventricle. We have previously shown that GnRH neurons from within the grafts can innervate the appropriate neural-hemal target in the host. To determine if in turn these exogenously derived neurons receive a synaptic input comparable to the GnRH neurons in the normal animal we have now carried out a quantitative ultrastructural analysis to compare the synaptic input to GnRH neurons in the normal preoptic area and in the grafts. In almost all cases GnRH cells or dendrites in normal brains and within the grafts received a synaptic input. In normal animals, input to GnRH dendritic profiles was significantly greater (P less than 0.001) than to the somatic plasma membrane and this trend was also observed within the grafts though the difference was not statistically significant. In addition, no statistically significant difference was found between the input to GnRH structures within the grafts and in normal preoptic area. However, a substantial variability in input among grafted animals was evident which was not observed in normal animals. The sources of variability within the grafts are discussed and we suggest that the deficiencies and differences that exist in regulation of gonadotropin secretion among grafted hpg animals may be reflected in aberrant synaptic input. PMID- 3282614 TI - An ultrastructural study of the projections from the midbrain periaqueductal gray to spinally projecting, serotonin-immunoreactive neurons of the medullary nucleus raphe magnus in the rat. AB - In this triple-label, electron microscopic study in the rat, a lesion of the midbrain periaqueductal gray (PAG) was made so that the distribution and targets of degenerating PAG terminals could be identified in the medullary nucleus raphe magnus (NRM). Spinally projecting NRM neurons were identified by the retrograde transport of wheat germ agglutinin-horseradish peroxidase from the cervical cord. We also used immunocytochemistry to define the subpopulation of NRM neurons which were serotonin-immunoreactive. We report that both serotonergic and non serotonergic neurons of the medulla, which project to the spinal cord, receive monosynaptic inputs from the PAG. PMID- 3282615 TI - Inhibition of N-methyl-D-aspartate evoked sodium flux by MK-801. AB - The inhibition of N-methyl-D-aspartate (NMDA) stimulated 22Na+ efflux from rat hippocampal slices was studied using competitive and non-competitive receptor antagonists. There was a good correlation between the abilities of the competitive antagonists to block NMDA evoked 22Na+ efflux and their potencies as inhibitors of L-[3H]glutamate binding. The recently reported novel NMDA receptor antagonist, (+)-5-methyl-16,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine (MK 801) was shown to non-competitively inhibit NMDA stimulated 22Na+ efflux with an IC50 value of 0.4 microM. Relatively high (10 microM) concentrations of MK-801 had no effects on quisqualic acid, alpha-amino-3-hydroxy-5-methyl-isoxazole-4 propionic acid (AMPA), or kainic acid stimulated efflux. However, MK-801 was able to block 22Na+ efflux induced by ibotenic acid and L-homocysteic acid, amino acids that act as NMDA receptor agonists. MK-801, (-)-MK-801, and non-competitive NMDA receptor antagonists of the arylcyclohexylamine and dioxolane classes inhibited NMDA stimulated 22Na+ efflux with potencies that reflected their abilities to compete for [3H]MK-801 binding sites in rat cortical membranes. These results indicate the utility of the 22Na+ efflux assay in studying the properties of NMDA receptors and confirm the nature and selectivity of the inhibition of NMDA receptor linked ion channel activation by MK-801. PMID- 3282616 TI - Developmental changes in neuronal sensitivity to excitatory amino acids in area CA1 of the rat hippocampus. AB - The laminar distribution of decreases in extracellular free calcium and concomitant field potentials induced by repetitive orthodromic stimulation, ionophoretic application of N-methyl-D-aspartate and quisqualate, was studied in the CA1 field of rat hippocampal slices, at two different stages during postnatal development. While stimulation-elicited and quisqualate-induced signals remain maximal in stratum pyramidale during the first postnatal month, the laminar profiles of responses to N-methyl-D-aspartate (NMDA) depend on age: the responses to this agonist are maximal in stratum pyramidale in 5-9-day-old rats and in stratum radiatum in 12-30-day-old rats. Our findings suggest that, during the second postnatal week, the apical dendrites of pyramidal neurons in area CAl become more sensitive to NMDA, which is expressed by big influxes of calcium at this level. PMID- 3282617 TI - [Changes in the cardiovascular system due to aging]. PMID- 3282620 TI - [Function of polymorphonuclear leukocytes in patients after cholecystectomy]. PMID- 3282619 TI - [Electrical activity of the heart atria]. PMID- 3282618 TI - [Topochemistry of proteases in central nervous system structures after administration of atropine and scopolamine]. PMID- 3282621 TI - [Bone allotransplants in orthopedic practice]. PMID- 3282622 TI - The future of biomaterials. PMID- 3282623 TI - Oral health status and treatment needs of elderly patients in a teaching hospital in Saskatchewan. PMID- 3282625 TI - [From the original to the removable partial denture stress-breaking framework]. PMID- 3282624 TI - Comparison of dental caries and oral hygiene indices for 13-14 year old Quebec children between 1977 and 1984. PMID- 3282626 TI - Capability of the right ventricle. AB - This article reviews the limitations of the right ventricle in certain clinical settings. There is doubt whether the right ventricle can do systemic work for a lifetime. The right ventricle maintains its output with difficulty after an acute increase in pulmonary vascular resistance. Under certain conditions a reasonable life can be pursued without a right ventricle and systemic blood draining directly into the lungs. PMID- 3282627 TI - Circadian patterns in coronary disease: the mournfulness of morning. AB - A circadian pattern is present for all of the manifestations of coronary artery disease discussed in this review; typical angina, variant angina, myocardial infarction and sudden cardiac death. The peak incidence for typical angina is from 06:00 to noon, and earlier, from midnight to 09:00 in variant angina. The peak incidence of myocardial infarction and sudden cardiac death are the same as for typical angina, even though different mechanisms are involved. PMID- 3282630 TI - Footwear and ankle stability in the basketball player. AB - Ankle stability in basketball players is affected by footwear. Athletic shoe manufacturers have introduced specialized lacing systems and high-top performance shoes to improve ankle stability. These performance shoes not only aid in preventing ankle injuries, but also protect injured ankles. PMID- 3282628 TI - Vaccine and antiviral strategies against infections caused by human immunodeficiency virus. AB - Human immunodeficiency virus type 1 (HIV-1) has been clearly associated with a variety of new illnesses, including profound immunodeficiency (acquired immune deficiency syndrome [AIDS]), wasting syndromes (formerly termed AIDS-related complex [ARC]) and neurologic syndromes, including neuropathy, myelopathy and encephalopathy (often termed subacute encephalitis or AIDS dementia complex). HIV 1 preferentially infects T lymphocytes by binding to a membrane receptor protein, CD4, associated with helper function. The virus can also attack macrophages and, possibly, other cells such as neuronal cells, colonic epithelial cells and B lymphocytes. Infection of macrophages or monocytes may be involved in neurologic disease. Knowledge about HIV-1 has rapidly increased, and investigators have characterized its structure, ways in which it infects cells, replicates and is cytopathic for certain cells, and how the immune system responds to it. The ideal vaccine would prevent adsorption of the virus into the cell, but it is difficult to develop stable resistance because the virus has many antigenic patterns and mutates frequently. The results of vaccine trials in animals have not been promising, but work is being done with monoclonal antibodies. Antiviral therapies being investigated include those to prevent virus binding and entry, to inhibit reverse transcription, to inhibit the virus's life cycle and to restore immune competence in immunocompromised patients. PMID- 3282631 TI - Prescription drug therapy in the podiatric outpatient population: interactions and precautions. AB - A survey of 2,000 outpatients at the clinic of the Dr. William M. Scholl College of Podiatric Medicine was conducted analyzing both medications reported by the patients at the time of treatment and drugs by the attending podiatrist. The major groups of medications already used by the patients included diuretics, vitamins and minerals, nonsteroidal antiinflammatory drugs, cardiovascular medications, insulin and oral hypoglycemics, estrogen and thyroid hormone replacement, and antibiotics. Patients with asthma, ulcers, epilepsy, affective disorders and Parkinsonism represented significant subgroups. The major drugs used by podiatrists in the outpatient clinic included analgesics and antiinflammatory agents, local anesthetics, antibiotics, sedative-hypnotics, and a variety of topical agents. These two sources of medication serve as the basis for a review of drug interactions in the podiatric outpatient population. In addition, precautions for the use of drugs commonly administered by podiatrists are reviewed. PMID- 3282629 TI - Birth prevalence and recurrence rates of neural tube defects in southern Alberta in 1970-81. AB - Given the observed variation in birth prevalence and recurrence rates of neural tube defects, it is important to obtain such data specific to a given locality for research and genetic counseling purposes. A review of hospital medical charts, the patient lists of the Medical Genetics and Myelomeningocele clinics at Alberta Children's Hospital and data from the Canadian Congenital Anomalies Surveillance System revealed the annual birth prevalence rate of neural tube defects in southern Alberta in 1970-81 to be 1.62/1000 total births. This figure suggests southern Alberta to be a low-frequency area. There was no significant variation in the annual rates of spina bifida, encephalocele or all neural tube defects combined over the study period. A significant linear decline in the frequency of births of anencephalic infants, however, was noted (p = 0.025). Information on the total reproductive history of the mothers revealed that the empiric risk of recurrence of a neural tube defect was 2.2%, and the risk to all siblings was estimated to be 2.3%. In future prevalence studies multiple sources of case ascertainment should be used, including data on pregnancies terminated because of a fetal neural tube defect. PMID- 3282632 TI - The biomechanics of forward power skating. AB - The authors review and discuss the biomechanics of forward power skating with respect to starting, acceleration, and striding. Comparisons are made to the biomechanics of walking. The dynamics of foot function within the skate boot are also discussed. PMID- 3282633 TI - A literature review of midtarsal joint function. AB - This article focuses on nearly 50 years of research by various authors documenting function and motion of the midtarsal joint. Subtalar joint control of the midtarsal joint, axes of motion, and quantification of range of motion are examined. The evolution of the joint from primates to man and the associated changes in functional requirements are considered. PMID- 3282634 TI - Fractures of the neck of the talus and the Blair fusion: a review of the literature and case report. AB - Historically, fractures of the neck of the talus have been serious injuries with sometimes devastating results. Several mechanisms have been reviewed to explain the types of injuries most commonly seen. Hawkin's classification of the types of talar neck fractures has been explained and used as a guideline in a review of treatment and results of talar neck fractures. Hawkin's group I fractures generally require only immobilization and are frequently without serious sequelae. Hawkin's group II fractures are more serious injuries, which may frequently be treated with closed reduction. Open reduction is occasionally necessary. Hawkin's group III fractures have the most potentially devastating results. These generally require open reduction with internal fixation or occasionally primary salvage procedures. Secondary salvage procedures are also sometimes necessary. Avascular necrosis of the talar body is reviewed in detail, including correlation with the type of fracture as well as diagnostic techniques and treatment. Other complications, including soft-tissue damage, osteomyelitis, malunion, and posttraumatic arthrosis, are discussed. The Blair tibiotalar arthrodiesis is reviewed in detail, with the consideration that it may be used as a primary or secondary salvage procedure with good results. Finally, a case in which the Blair fusion was used successfully is reported with 1-year follow-up. PMID- 3282635 TI - Capgras' syndrome: a synthesis of various viewpoints. AB - The authors review the literature on Capgras' Syndrome and note that there has been little attempt to integrate the various etiological theories into a cohesive synthesis which accounts for both the organic and the psychodynamic theories. It is proposed that Capgras' Syndrome represents a nonspecific symptom of regression to an early developmental stage characterized by archaic modes of thought, resulting from a relative activation of primitive brain centres. Thus, either psychological regression alone or organic disorders that compromise higher cerebral functioning may result in Capgras' Syndrome. Two cases are presented for discussion and elaboration of these concepts. PMID- 3282636 TI - Tricyclic maintenance therapy in unipolar depression. AB - The risk of recurrence of depression must be balanced against the problems and risks of maintenance therapy. The goal of maintenance therapy is to prevent new episodes of depression. A review of the literature reveals that the existing data does not provide sufficient evidence to demonstrate the usefulness of tricyclic maintenance therapy. Nonetheless, it would be premature to conclude that this type of treatment is not useful. Further studies of maintenance therapy are indicated and should include a continuation period of at least 16 weeks during which patients are symptom free (that is, Global Assessment Scale 71 or more). In the interim, each patient should be evaluated individually to determine the optimum duration of treatment. PMID- 3282637 TI - The development and application of fiberoptic endoscopy. PMID- 3282638 TI - The genetic origins of human cancer. PMID- 3282639 TI - Subclavian artery occlusion after radiotherapy for carcinoma of the breast. AB - Disturbance of the arterial circulation in the ipsilateral upper limb following mastectomy is a rare sequel attributed to adjuvant radiotherapy. A review of the literature revealed 20 such cases, and two more are presented. Different mechanisms of injury leading to arterial occlusion have been proposed. This is a late complication with a considerable time lag between irradiation and onset of symptoms. The symptoms vary in type and severity, but are consistent with peripheral occlusive arterial disease. To alleviate symptoms and prevent limb loss, reconstructive vascular surgery is advocated, and was successfully performed in one of our patients. PMID- 3282640 TI - Malignant peritoneal mesothelioma after remote abdominal radiation. AB - Peritoneal mesothelioma in a 61-year-old man, occurred 26 years after abdominal radiotherapy for a testicular seminoma. The patient had no history of asbestos exposure. After asbestos, radiation is the second most frequent defined cause of mesothelioma in North America, but the number of well-documented cases is small; this case represents only the fifth example of peritoneal mesothelioma after therapeutic irradiation of the abdomen. PMID- 3282641 TI - Non-Hodgkin's malignant lymphomas in patients older than 80. 70 cases. AB - In two centers (a comprehensive cancer center and a university hospital) 1300 patients with non-Hodgkin's lymphomas (NHL) were observed during the past 15 years. Seventy patients (5.4%) were diagnosed after they were 80 years old. Thirty-four patients had low-grade NHL, eight had intermediate grade, and 28 had high-grade NHL. The majority of them were classified as Stage I (n = 24) or II (n = 18), and the rest as Stage III (n = 16) or IV (n = 12). Treatment varied with grade of NHL, tumoral extension, and performance status. Forty-seven patients were given chemotherapy, 37 radiotherapy, and six patients had surgery. Overall, treatment was considered to be optimal in 12 patients, good in 34 patients, and limited in 24 patients. Toxicity was minimal in 62 patients, treatment-limiting in two patients, and lethal in six patients. Thirty-seven patients achieved a complete remission (CR), 21 a partial remission, five experienced stabilization, and seven failed to respond. For all patients, the median survival (MS) was 18 months. In contrast to younger patients, malignancy grade had no significant influence. The only significant parameter is CR (P = 0.02). In conclusion, very old patients must be treated correctly but carefully. Better tolerated treatments are needed to improve results that are neither very poor nor as good as in younger patients. PMID- 3282642 TI - Primary retroperitoneal mucinous cystadenocarcinoma. AB - A case of primary retroperitoneal cystadenocarcinoma is presented as the fourth reported case in the world literature to date. The cyst was removed intact and demonstrated an infiltrating malignant process with nuclear pleomorphism and mitotic activity. No ovarian tissue was identified and a cancer antigen 125 (CA 125) test was normal. The patient underwent a staging procedure subsequently that included peritoneal washings, hysterectomy, bilateral salpingoophorectomy, and iliac node dissection. No metastases were found and the patient is without recurrence 22 months postoperative. The literature is reviewed to better define the origin and prognosis of these tumors. PMID- 3282643 TI - Oncocytic carcinoid of the kidney associated with periodic Cushing's syndrome. AB - An oncocytic carcinoid of the kidney producing a periodic Cushing's syndrome in an adolescent is described. The tumor displayed gross, histologic, and ultrastructural features similar to renal oncocytoma, another unusual renal neoplasm. A review of renal carcinoids and possible associations between oncocytic change and periodic hormone production are discussed. PMID- 3282644 TI - Mutagenic activities of fecapentaene derivatives in the Ames/Salmonella test system. AB - The direct mutagenic activities of a pair of naturally-occurring and several synthetic fecapentaenes were measured in the Ames/Salmonella test system. We found that strain TA100 with preincubation was the most sensitive procedure for the naturally-occurring fecapentaene-12 (FP-12). Its natural analog, FP-14, and the synthetic isomer, cis-FP-12, yielded similar mutagenic activities to FP-12 in the range of 1000-2000 TA100 revertants per microgram of compound. The synthetic analogs of FP-12 and FP-14, MFP-12 and MFP-14, wherein the glycerol moiety was replaced by methoxy, exhibited consistently higher mutagenic activities than their parent fecapentaenes (MFP-12 was about 20 times more potent than FP-12; MFP 14 was about twice the potency of FP-14). The standard rat liver metabolizing system (S9) reduced the activities of all the fecapentaenes in a dose-related manner. PMID- 3282645 TI - Celebration of an era of public service at the National Institutes of Health and the National Cancer Institute. PMID- 3282646 TI - The glucocorticoid receptor at the protein level. PMID- 3282647 TI - Determinants of tumor blood flow: a review. AB - Blood flow rate in a vascular network is proportional to the pressure difference between the arterial and venous sides and inversely proportional to the viscous and geometric resistances. Despite rapid progress in recent years, there is a paucity of quantitative data on these three determinants of blood flow in tumors and several questions remain unanswered. This paper reviews our current knowledge of these three parameters for normal and neoplastic tissues, the methods of their measurements, and the implications of the results in the growth and metastasis formation as well as in the detection and treatment of tumors. Microvascular pressures in the arterial side are nearly equal in tumor and nontumorous vessels. Pressures in venular vessels, which are numerically dominant in tumors, are significantly lower in a tumor than those in a nontumorous tissue. Decreased intravascular pressure and increased interstitial pressure in tumors are partly responsible for the vessel collapse as well as the flow stasis and reversal in tumors. The apparent viscosity (viscous resistance) of blood is governed by the viscosity of plasma and the number, size, and rigidity of blood cells. Plasma viscosity can be increased by adding certain solutes. The concentration of cells can be increased by adding cells to blood or by reducing plasma volume. The rigidity of RBC, which are numerically dominant in blood, can be increased by lowering pH, elevating temperature, increasing extracellular glucose concentration, or making the suspending medium hypo- or hypertonic. Effective size of blood cells can be increased by forming RBC aggregates (also referred to as rouleaux). RBC aggregation can be facilitated by lowering the shear rate (i.e., decreasing velocity gradients) or by adding macromolecules (e.g., fibrinogen, globulins, dextrans). Since cancer cells and WBC are significantly more rigid than RBC, their presence in a vessel may also increase blood viscosity and may even cause transient stasis. Finally, due to the relatively large diameters of tumor microvessels the Fahraeus effect (i.e., reduction in hematocrit in small vessels) and the Fahraeus-Lindqvist effect (i.e., reduction in blood viscosity in small vessels) may be less pronounced in tumors than in normal tissues. Geometric resistance for a network of vessels is a complex function of the vascular morphology, i.e., the number of vessels of various types, their branching pattern, and their length and diameter. Geometric resistance to flow in a single vessel is proportional to the vessel length and inversely proportional to vessel diameter to the fourth power.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3282648 TI - Oligodeoxynucleotides as inhibitors of gene expression: a review. AB - The past several years have seen an explosive growth in the application of antisense oligodeoxynucleotides as modulators of gene expression. In this review, we discuss the various classes of compounds currently receiving attention. These include unmodified oligodeoxynucleotides, methylphosphonates, phosphorothioates, and alpha-oligonucleotides. The relative advantages and disadvantages of each class with regard to parameters such as (a) duplex stability (b) nuclease resistance, and (c) effectiveness of specific gene inhibition are noted. Oligodeoxynucleotides covalently linked to intercalating and other reactive groups are also described, as are possible mechanisms of oligodeoxynucleotide action. Finally, we consider potential future directions for this field and note that it holds the promise for specific gene therapy. PMID- 3282649 TI - Body composition changes in rats with experimental cancer cachexia: improvement with exogenous insulin. AB - Exogenous insulin treatment has been shown to improve food intake and host weight of cachectic tumor-bearing (TB) rats, but the composition of the host weight gain has not been quantitated. Sixty-six Fischer 344 rats were randomized to seven groups: early nontumor-bearing (NTB) (n = 10) who underwent compositional analysis (CA) on the day the methylcholanthrene sarcoma was implanted in TB rats; pretreatment-NTB (n = 10) and pretreatment-TB (n = 10) who underwent CA 25 days later when rats began treatment with saline or insulin; and finally saline treated NTB (n = 9), saline-treated TB (n = 9), insulin-treated NTB (n = 9), and insulin-treated TB (n = 9), who underwent CA following 5 days of treatment with daily saline or neutral protamine hagedorn insulin 2 units/100 g. Body weight and food intake were measured daily. For compositional analysis, the tumor was separated from the host in TB rats and the entire rat in NTB animals was homogenized, lyophilized and analyzed for fat, water, protein, potassium, chloride, and sodium. The tumor was processed in a similar fashion. In response to insulin, NTB rats ate significantly more food, and had an increase in body weight gain. Compositional analysis of insulin-treated NTB rats indicated a slight, but insignificant, increase in body fat and a similar insignificant decrease in body protein. TB rats ate significantly less than NTB rats during the 5-day experimental period, and insulin treatment significantly increased food intake to levels similar to NTB animals. Compositional analysis indicated that the tumor-bearing state resulted in a significant decrease in total host water, protein, fat, potassium, sodium, and chloride. Insulin administration resulted in preservation of host nitrogen, fat, potassium, sodium, and chloride in cachectic tumor-bearing rats. Insulin treatment did not affect tumor dry weight or composition. The results suggest that exogenous insulin, can preserve normal host composition of TB rats during cachectic decline. PMID- 3282650 TI - The clinical biology of hormone-responsive breast cancer. PMID- 3282652 TI - Chemical approaches in anticancer drug development. PMID- 3282651 TI - Medullary carcinoma of the breast. PMID- 3282653 TI - Comparative structural elucidation of the K18, K22, and K100 antigens of Escherichia coli as related ribosyl-ribitol phosphates. AB - The structures of the capsular K18, K22, and K100 antigens of E. coli O23:K18:H15, O23:K22:H15, and O75:K100:H5, respectively, were elucidated by determination of composition, 1H-, 13C-, and 31P-n.m.r. spectroscopy, periodate oxidation, alkaline hydrolysis followed by incubation with alkaline phosphatase, and methylation analysis of the polymers and their neutral fragmentation products. The polymers are poly(ribosyl-ribitol phosphates) related to the capsular antigen of H. influenzae (Hib). The K22 antigen has the repeating unit P-2)-beta-Rib-(1----2)-RibOH-(5-, and the K18 antigen has the same polymer chain with partial 3-O-acetylation of the ribose moiety. The K100 antigen consists of repeating units of -P-3)-beta-Rib-(1----2)-RibOH-(5- and seems to have a secondary structure different from that of the other antigens. Together with the Hib capsular antigens, the structure of which was reported as -P-3)-beta-Rib-(1-- -1)-RibOH-(5-, these capsular antigens represent a structurally related group of capsular polymers. PMID- 3282656 TI - [Antiplatelet drugs and prevention of aortocoronary bypass occlusion]. PMID- 3282655 TI - CEA-containing immune complexes in sera of patients with colorectal and breast cancer--analysis of complexed immunoglobulin classes. AB - A sandwich enzyme immunoassay was developed to detect circulating immune complexes containing carcinoembryonic antigen (CEA) and immunoglobulin (Ig) G, IgA, or IgM using a nitrocellulose-bound anti-CEA antibody as the solid phase reagent. Elevated levels of CEA-containing circulating immune complexes (CEA-IC) were found in 15.4% of 117 sera from patients with colorectal cancer in a postsurgery follow-up study. Also in 24.5% of 102 sera from patients with breast cancer in different states of disease CEA-IC were found. The predominant Ig determined in CEA-IC of colorectal cancer patients was IgA, followed by IgG and IgM, whereas IgG and IgM were the most frequent Igs in CEA-IC of breast cancer patients. Elevated CEA levels were found in 12.0% of the colorectal cancer patients and in 25.4% of sera from breast cancer patients. No significance for the coincidence of elevated CEA levels and CEA-IC was recorded in all patients sera tested. In sera of patients with disease recurrence, however, both parameters were shown to be elevated (CEA 80.7% and CEA-IC 42.3%). The data presented indicate the detection of CEA-IC as an additional parameter for the identification of patients at increased risk for disease recurrence. PMID- 3282654 TI - Macrophage infiltration in tumors and tumor-surrounding tissue: influence of serotonin and sensitized lymphocytes. AB - In a delayed-type hypersensitivity reaction serotonin released from mast cells plays an important role in the induction of a cellular infiltrate at the site of antigen challenge. In analogy, we have studied whether it is possible to enhance the number of intratumoral macrophages by injecting serotonin into a s.c. SL2 lymphosarcoma. The vessels in the tissue surrounding the tumor responded well to serotonin, as there was an influx of i.v. injected 51Cr-labeled sensitized spleen cells in this tissue during the first 4 h after intratumoral injection of serotonin. At 24 h after serotonin injection there was an influx of macrophages into this tumor-surrounding tissue. No influx of cells was detected in the tumor itself during the first hours after injection of serotonin. In the tumor, similar phenomena occurred as in the surrounding tissue, but with a delay of about 24 h. This suggests that lymphocytes leave the blood circulation in the tumor surrounding tissue and migrate to the tumor. The influx of macrophages into the tumor after intratumoral injection of serotonin is probably due to an immunological reaction as the lymphocyte influx preceeds the macrophage influx into tumors. In addition, transfer of sensitized lymphocytes, as well as lymphocytes from a tumor-bearing host caused an enhanced influx of macrophages into the tumor. To test the specificity and serotonin dependency of the phenomenon of infiltrating cells in tumors we have used a footpad swelling assay in which the serotonin dependency and the antigen specificity of the response against syngeneic tumor cells was shown. The following picture emerged: an intratumoral serotonin injection enables lymphocytes to leave blood vessels in the tumor-surrounding tissue. These lymphocytes with specificity for tumor antigens migrate to the tumor. After contact with the antigenic tumor cells, these lymphocytes secrete chemoattractive factors for monocytes/macrophages. Also these monocytes/macrophages leave the circulation in the tumor-surrounding tissue. Subsequently the macrophages invade the tumor. We conclude that the number of intratumoral macrophages can be enhanced by serotonin. PMID- 3282657 TI - [Extracardiovascular effects of nifedipine in the treatment of hypertensive patients: glucose tolerance and behavior of immunoreactive insulin]. PMID- 3282658 TI - [Correlations between islet-pancreatic activity and blood pressure in obesity]. PMID- 3282659 TI - [Heterotopic heart transplantation in the evaluation of myocardial preservation technics]. PMID- 3282660 TI - Computer analysis of arrhythmias in the aid of ambulatory ECG monitoring. PMID- 3282661 TI - Ambulatory blood pressure measurements: practical considerations, methodology, feasibility, and implications in the management of hypertension. AB - Automated ambulatory blood pressure monitoring is a safe new technique that allows a more exact assessment of the diagnosis and treatment of hypertension than has been possible previously. It should be of great value in helping avoid unnecessary pharmacologic treatment of certain patients and in tailoring therapy to individual needs. Further research is needed to determine the role of ambulatory monitoring in the detection of hypertension, in the assessment of cardiovascular symptoms, and in the definition and treatment of labile hypertension. Because this technique has been developed subsequent to the research that underlies our current understanding of the effect of hypertension and the treatment of hypertension on cardiovascular disease, further prospective studies are needed to confirm its value in predicting hypertensive complications. A growing body of evidence indicates that ambulatory blood pressure may be a much more powerful predictor of cardiovascular risk than conventional blood pressure measurements. PMID- 3282662 TI - Monitoring physical activity in ambulatory patients with chronic cardiac failure. AB - Static or dynamic work in patients with chronic cardiac failure elicits a variety of pathophysiologic responses that impair the ability of the cardiopulmonary unit to sustain O2 delivery at a rate that is commensurate with the O2 requirements of working skeletal muscle. Regional abnormalities in the circulation of skeletal muscle may further compromise nutritive blood flow to muscle. As a result, the patient experiences a sense of fatigue during physical activity. Dyspnea, or an abnormal awareness of breathing, may also accompany exercise in these patients. This sense of breathlessness may be due to an abnormally elevated work of breathing secondary to decreased pulmonary compliance, a heightened chemical drive to ventilation, and a possible imbalance in the O2 supply and demand of the respiratory muscles. The ambulatory monitoring of physical activity in patients with chronic cardiac failure has not been systematically examined. Potential monitoring techniques that may provide accurate and reproducible results regarding the exercise response in these patients include the thoracic impedance principle to measure minute ventilation and portable O2 uptake sensors. PMID- 3282663 TI - Echocardiographic detection and ambulatory monitoring of valvular heart disease. PMID- 3282664 TI - Rest and exercise radionuclide ventriculography in the ambulatory monitoring of patients with valvular heart disease. AB - Radionuclide angiography serves as a valuable adjunct in the noninvasive evaluation and monitoring of patients with valvular heart disease. Although estimations of regurgitant fractions and the differences between left and right ventricular stroke volumes can be made, the limitations of the techniques do not enable adequate quantitation of the severity of valvular insufficiency to warrant routine use in ambulatory management. The importance of radionuclide ventriculography, however, lies in its ability to examine global ventricular function both at rest and with exercise, thus enabling assessment of the functional reserve of the left and right ventricles. Such data are of considerable value in determining the need for invasive evaluation and the timing of valve replacement in patients with valvular heart disease. PMID- 3282665 TI - Ambulatory ECG recording for detecting silent myocardial ischemia. PMID- 3282666 TI - Transtelephonic ECG monitoring in myocardial ischemia and infarction. PMID- 3282667 TI - Ambulatory ECG (Holter) monitoring in management of acute myocardial ischemia. AB - Ambulatory ECG monitoring for detection of transient myocardial ischemia is useful because most ischemic episodes that occur outside the exercise laboratory are not accompanied by symptoms. Special considerations, not required for AEM when used for arrhythmia analysis, must be employed. Although many commercially available recorders provide excellent ST-segment reproduction, some playback systems may have a nonlinear phase response resulting in signal distortion, making ST-segment analysis difficult. Conventional Holter-type AEM devices do not allow for patient or physician intervention during acute myocardial ischemia. Considerable cost and time are required to analyze ST-segment data of prolonged monitoring periods from these tape-recorded signals, and human error and fatigue play an important role in diminishing accuracy of ST-segment interpretation. Automated analysis is done with computer and technician interaction but the accuracy and validation of the various systems for ST-segment analysis from tape recordings requires further detailed study. Newer, real-time ambulatory ECG analyzers are designed for prolonged monitoring periods and directed toward ST segment analysis. Some devices also alert the patient to an acute ischemic or arrhythmic event allowing for intervention immediately. Some real-time systems have undergone some very encouraging validation studies. These recent studies suggest excellent sensitivity and specificity for detection of ischemic-type ST segment depression. However, more work is needed before the accuracy of other such devices is known with certainty. As the central goal of therapy for patients with coronary artery disease evolves from simply controlling angina to reduction or elimination of ischemic episodes and their consequences, use of AEM devices will play an increasingly important role in management of these patients. PMID- 3282668 TI - Transtelephonic electrocardiographic monitoring for the detection and treatment of cardiac arrhythmias. AB - TTEM as a means for ambulatory arrhythmia detection and management of cardiac patients has demonstrated the potential for considerable clinical utility. Because it is easy to use, relatively inexpensive, and highly effective in aiding in the diagnosis of various cardiac arrhythmias, it may be a preferred mode of surveillance for a number of cardiac patients of all ages. TTEM is presently used most widely for pacemaker followup. TTEM can be used alone and in conjunction with Holter monitoring in the management of cardiac arrhythmias, and has lately become a recognized tool in the followup of patients with ischemic heart disease, especially post-myocardial infarction patients. It is important to emphasize that TTEM is only one part of an overall approach to ambulatory monitoring that also includes Holter monitoring and exercise testing. It must be noted, however, that the studies comparing the efficacy of TTEM with that of other surveillance methods are few and consist of only a relatively small number of patients. Therefore, it would be premature to draw conclusions regarding the ultimate role of TTEM and its comparative value in the routine management of most cardiac arrhythmia problems. However, available data do support an increasing role for these systems in the future. PMID- 3282669 TI - [Unveiling of the monument to Samuel Basch in Marienbad]. PMID- 3282670 TI - Flunarizine in prophylaxis of childhood migraine. A double-blind, placebo controlled, crossover study. AB - An 8-month, double-blind, placebo-controlled, crossover trial of flunarizine in the prophylaxis of migraine has been performed in 70 children. After 4 weeks of medication-free base-line observation, 35 children (group A) received flunarizine (5 mg/day) and 35 (group B) received placebo over a 12-week period. After a 4 week washout they crossed treatments for another 12 weeks. Sixty-three patients completed the trial. In both groups flunarizine significantly reduced the frequency and average duration of headache attacks. In group A efficacy was maintained after placebo crossover for the last 4 months of the study. Five subjects in group B stopped placebo because of ineffectiveness; two children in group A discontinued flunarizine treatment, one because of excessive daytime sedation and the other because therapy was ineffective. The main side effects were daytime sedation and weight gain. It is concluded that flunarizine is an effective drug for the treatment of childhood migraine. In a study of this length no serious side effects were discovered. PMID- 3282671 TI - The platelet and the neuron: two cells in focus in migraine. AB - Reports of platelet abnormalities in migraine are abundant, and the present paper discusses the role of platelets in the migraine aetiology. Platelets are considered good models for pre- and post-synaptic functions in serotonergic neurons. We propose that migraine is associated with a lowered threshold for stimulus response in both platelets and serotonergic neurons and that the alterations in platelet function reflect central serotonergic disturbances. The platelet abnormalities in migraine approach those found in depression, and there are several links between the two disorders. The clinical significance of platelet hyperactivity in migraineurs for the occurrence of thrombotic disorders is also discussed. Studies of platelet functions in migraine, using platelets as models for serotonergic neurons, may broaden our understanding of the neuronal processes that take place during a migraine attack. The platelet can also be an investigative tool for better understanding of the modes of action of anti migraine drugs. PMID- 3282672 TI - On the origin of pancreatic endocrine cells. PMID- 3282673 TI - Tumor suppressors: recessive mutations that lead to cancer. AB - Several lines of evidence point to the involvement of recessive mutations in the predisposition to, and hence initiation of, cancer in vivo. Analyses of the genetic behavior of transformed cells suggest that at least one way to explain these events is to invoke loci which suppress the tumorous phenotype and which are inactivated by mutation. These suppressors are the subject of much speculation, but whether or not they are ultimately determined to be the regulators of differentiation antigens, growth factors, or proto-oncogenes, it is certain that the investigation of such loci will allow yet another glimpse at the inner mysteries of organismal development. PMID- 3282675 TI - Hybrid insulin genes reveal a developmental lineage for pancreatic endocrine cells and imply a relationship with neurons. AB - Insulin appears in the developing mouse pancreas at embryonic day 12 (e12). Transgenic mice harboring three distinct hybrid genes utilizing insulin gene regulatory information first express the transgene product two days earlier, at e10, in a few cells of the pancreatic bud. Throughout development and postnatal life, all of the insulin-producing (beta) cells coexpress the hybrid insulin gene. In addition, islet cells containing glucagon, somatostatin, pancreatic polypeptide, and the neuronal enzyme tyrosine hydroxylase coexpress the transgene when they first arise. Similarly, coexpression of these normally distinct islet cell markers occurs during differentiation of the four endocrine cell types. The transgene product also appears transiently during embryogenesis in cells of the neural tube and in neural crest. The results suggest a common precursor for the endocrine cells of the pancreas. Moreover, they imply a relationship between neural and pancreatic endocrine tissue. PMID- 3282674 TI - The complete sequence of dystrophin predicts a rod-shaped cytoskeletal protein. AB - The complete sequence of the human Duchenne muscular dystrophy (DMD) cDNA has been determined. The 3685 encoded amino acids of the protein product, dystrophin, can be separated into four domains. The 240 amino acid N-terminal domain has been shown to be conserved with the actin-binding domain of alpha-actinin. A large second domain is predicted to be rod-shaped and formed by the succession of 25 triple-helical segments similar to the repeat domains of spectrin. The repeat segment is followed by a cysteine-rich segment that is similar in part to the entire COOH domain of the Dictyostelium alpha-actinin, while the 420 amino acid C terminal domain of dystrophin does not show any similarity to previously reported proteins. The functional significance of some of the domains is addressed relative to the phenotypic characteristics of some Becker muscular dystrophy patients. Dystrophin shares many features with the cytoskeletal protein spectrin and alpha-actinin and is a large structural protein that is likely to adopt a rod shape about 150 nm in length. PMID- 3282676 TI - Infiltrating decidual natural killer cells are associated with spontaneous abortion in mice. AB - Immunohistochemistry was used to study a murine model which spontaneously aborts at a frequency of 25 to 30%. Our results show that natural killer (NK) cells are not only the predominant infiltrating cells in aborting feto-placental units, but that they also appear in a similar proportion of feto-placental units before abortion is detectable. The frequency of feto-placental units with significantly elevated NK infiltrates corresponds to the subsequent abortion frequency, indicating a causal relationship. Immunization of the mother with BALB/C splenocytes prevents these NK infiltrates and decreases the abortion frequency to normal levels. These results suggest for the first time that maternal NK cells may have an instrumental role in the etiology of spontaneous abortion. PMID- 3282677 TI - Virus-specific memory T cells are Pgp-1+ and can be selectively activated with phorbol ester and calcium ionophore. AB - Memory lymphocytic choriomeningitis virus (LCMV)-immune cytotoxic T-lymphocyte precursors (CTLp) can be stimulated to proliferate and to mediate specific cytotoxic activity following incubation with phorbol myristate acetate (PMA), calcium ionophore (CaI), and interleukin 2 (IL-2). This protocol can be used to selectively induced virus-specific CTL activity under both bulk culture and limiting dilution conditions, in the absence of added antigen. There is no concurrent stimulation of alloreactive CTLp. Proliferation of the effector Lyt-2+ population in medium containing PMA and CaI requires L3T4+ cells, which can be replaced by adding IL-2, and the development of cytotoxicity is totally IL-2 dependent. The LCMV-specific memory T cells are also characterized by the expression of the Pgp-1 (Ly24) glycoprotein. The availability of this marker, together with the capacity to selectively stimulate primed CTLp in the absence of antigen, should greatly facilitate the analysis of T-cell memory in virus infections. PMID- 3282678 TI - Adhesion-mediating molecules of human monocytes. AB - Adhesion of monocytes to each other and to T cells and substrates is increased by phorbol esters. In the presence of these compounds monocyte aggregation was almost completely inhibited (greater than 90%) by monoclonal antibody 60.3. This antibody recognizes GP90 (CD18), a leukocyte surface glycoprotein which is separately and noncovalently associated to either GP160 (CD11a), GP155 (CD11b), or GP130 (CD11c). Anti-LFA-1 antibody (CD11a) was only partially inhibitory (35%) while antibodies 60.1 (CD11b) and anti-Leu-M5 (CD11c) had a minimal inhibitory effect (10%). Antibody LB-2 recognizing a single glycoprotein distinct from the GP90-GP160 complex and expressed on activated B and T cells, monocytes, and vascular endothelial cells was partially inhibitory (22%). Monoclonal antibodies anti-C3bR (CD35), T29/33 (CD45, leukocyte common antigen 200). TA-1 (CD11a), OKM1 (CD11b), F10-44-2 (brain-leukocyte antigen), OKM5 (monocyte-endothelial cell antigen) and to class I or class II molecules exerted no inhibition on the monocyte aggregation. Fab fragments of antibody 60.3 efficiently inhibited not only monocyte aggregation in the absence or presence of phorbol esters but also adhesion of these cells to autologous or allogeneic T lymphocytes and, to a lesser extent, to plastic surfaces. It is thus concluded that GP90, either alone or associated to the larger glycoproteins, and LB-2 antigen mediate monocyte adhesion. PMID- 3282680 TI - Alternatives to metal-ceramics. PMID- 3282681 TI - Esthetic dentistry. Application of the fundamentals. PMID- 3282679 TI - Potentiation of Balb/3T3 fibroblast proliferative response by interleukin-1 and epidermal growth factor. AB - Balb/3T3 fibroblasts respond to interleukin-1 (IL-1) by proliferating in a dose dependent fashion. Increasing proliferative responses were observed with increasing IL-1 concentration in serum-free medium when the medium was supplemented with insulin, transferrin, and selenium. This response was evident only if the cell culture medium also contained the cyclooxygenase inhibitor indomethacin. When another fibroblast mitogen, epidermal growth factor (EGF) was cocultured with either purified monocyte-derived IL-1 beta or recombinant IL-1 beta, there was a potentiation of proliferation above the expected additive response. Unexpectedly, the response to recombinant IL-1 alpha was only additive with EGF. This suggests that IL-1-mediated activation of synovial fibroblasts in rheumatoid arthritis may be compounded by EGF as well as by other fibroblast mitogens secreted by cells found in the joint. The results further suggest that IL-1 and EGF interactions may play a significant role in wound healing, scarring, and bone resorption. In addition, these results imply that there may be different cellular activation pathways brought to bear in vivo which may depend, in part, on the IL-1 isotype available. PMID- 3282682 TI - Endosteal implants. PMID- 3282683 TI - Open wider! PMID- 3282684 TI - Indirect veneers. PMID- 3282685 TI - Motility of the spirochete Leptospira. AB - Spirochetes are a group of bacteria with a unique ultrastructure and a fascinating swimming behavior. This article reviews the hydrodynamics of spirochete motility, and examines the motility of the spirochete Leptospira in detail. Models of Leptospira motility are discussed, and future experiments are proposed. The outermost structure of Leptospira is a membrane sheath, and within this sheath are a helically shaped cell cylinder and two periplasmic flagella. One periplasmic flagellum is attached subterminally at either end of the cell cylinder and extends partway down the length of the cell. In swimming cells, each end of the cell may assume either a spiral or a hook shape. Translational cells have the anterior end spiral shaped, and the posterior end hook shaped. In the model of Berg et al., the periplasmic flagella are believed to rotate between the sheath and the cell cylinder. Rotation of the anterior periplasmic flagellum causes the generation of a gyrating spiral-shaped wave. This wave is believed sufficient to propel the cells forward in a low-viscosity medium. The cell cylinder concomitantly rolls around the periplasmic flagella in the opposite direction--which allows the cell to literally screw through a gel-like viscous medium without slippage. This model is presented, and it is contrasted to previous models of Leptospira motility. PMID- 3282687 TI - Reduction of the painful sequelae of migraine headache by use of the occlusal diagnostic splint: an hypothesis. PMID- 3282686 TI - Dr. Albert Gerber, a European pioneer in the craniomandibular field. PMID- 3282688 TI - [February 1948 and the further development of Czechoslovak pharmacy]. PMID- 3282689 TI - [Prognosis for the development of Czechoslovak pharmacy using the delphi method]. PMID- 3282690 TI - [Drug carriers for directed therapy. II. Monoclonal antibodies]. PMID- 3282691 TI - [Changes in the metabolism of amino acids in liver damage and the effect of amino acids on liver regeneration]. PMID- 3282692 TI - [Experimental models of myocardial hypoxia and ischemia]. PMID- 3282693 TI - A colony procedure for transformation of Saccharomyces cerevisiae. AB - A rapid and simple yeast transformation procedure has been developed using colonies on agar plates. Saccharomyces cerevisiae SHY3 cells were picked up from colonies on YPD plates grown freshly or stored at 4 degrees C and incubated with M13RK9-T DNA at 30 degrees C for 1-2 h in a solution of Li+, Ca2+, Mg2+, triacetin and polyethylene glycol. About 3,500 transformants were obtained per microgram of double stranded M13RK9-T DNA. Unlike the existing spheroplast techniques, single stranded M13RK9-T DNA transformed intact cells below one hundredth frequency of the duplex form. PMID- 3282694 TI - Interspecific actions of alpha mating pheromones on the a mating-type cells of three Saccharomyces yeasts. AB - The alpha mating pheromones synthesized in three Saccharomyces yeasts (S. cerevisiae, S. kluyveri, and S. exiguus) displayed interspecific actions on the a cells of all three species despite the fact that the amino acid sequences of all three alpha pheromones are different. Mating between species, however, did not occur. The interspecific alpha pheromone--a cell reaction was not necessarily more effective than the interspecific one. PMID- 3282695 TI - Allelism between pso1-1 and rev3-1 mutants and between pso2-1 and snm1 mutants in Saccharomyces cerevisiae. AB - In the yeast Saccharomyces cerevisiae, allelism between the pso1-1 and the rev3-1 mutants on the one hand and the pso2-1 and snm1 mutants on the other, is demonstrated by the comparison of phenotypes, complementation tests and meiotic segregation analysis. PMID- 3282696 TI - [Ultrasonic diagnosis in a group of children examined at the Eye Clinic in Brno]. PMID- 3282697 TI - [Arlt's years in Prague]. PMID- 3282698 TI - [On the birthday of Dr. Pavel Skerik]. PMID- 3282699 TI - [50 years' existence of the Ceskoslovenska Neurologie a Neurochirurgie as a separate journal and 83 years of neurological science journals]. PMID- 3282700 TI - [The importance of Jan Evangelista Purkinje (1787-1869) for research in cerebellar structure and function]. PMID- 3282701 TI - [On the 100th anniversary of the birth of the Slovak playwright, Dr. Ivan Stodola]. PMID- 3282702 TI - [Digital subtraction angiography in the cervico-cranial area]. PMID- 3282703 TI - [Primary carcinoma of the gallbladder: ultrasonic features (remarks on 8 cases)]. AB - The authors illustrate the ultrasound features of gallbladder carcinoma after reviewing literature and basing upon their own experience. The diagnosis of this neoplasia is formulated more frequently today by introduction of scanning means, but it remains very difficult on initial phase because of its precocious lymphatic and hilar infiltration. PMID- 3282704 TI - The Edwards family: generations of dentists. PMID- 3282705 TI - Presidential address at the European Society for Medical Oncology, Nice, 30 November 1986. AB - Medical oncology is now accepted in Europe as a branch both of internal medicine and of clinical oncology. In this article the present situation of this discipline is analysed with reference to the plateau in the results achieved in chemosensitive tumours and to the small effect of chemotherapy in tumours considered to be "big killers". Although new avenues in tumour biology do not necessarily mean therapeutic success in the near future, at present basic discoveries are being developed for clinical therapy faster than before. Besides biological response modifiers, the development of new drugs should receive constant attention from medical oncologists. This attitude has persisted despite an awareness that the political community has had little interest in the allocation of funds for the development of new anticancer agents. Clinical trials have recently been subjected to some criticism. But unless large multicentre trials are continued with better quality control and organization it will not be possible to provide adequate resources for the many and various new drugs and biological response modifiers expected to enter the field in the next few years. The active involvement of medical oncologists in controlled clinical trials should then continue. Finally, the task and achievements of the scientific society, which allows close contacts among European medical oncologists, are briefly underlined. PMID- 3282706 TI - Potentiation of platinum analogue cytotoxicity by hyperthermia. AB - Carboplatin and iproplatin, two new analogues of cisplatin, appear to have comparable activity in the treatment of advanced ovarian cancer, but minimal nephro- and neurotoxicities. Hyperthermia can potentiate the cytoxicity of cisplatin in vitro and in vivo, but systemic treatment with the combination has proven unsafe in patients. To provide the rationale for an alternative approach, we evaluated the relative degree of additivity between hyperthermia and the three platinum analogues in vitro against a human ovarian adenocarcinoma cell line, UACC-66. All drug and heat treatments were simultaneous for 1 h. Platinum analogue concentrations covered a five-log range from 0.001 to 100 micrograms/ml and hyperthermia temperatures included 38.5 degrees, 40 degrees, 41.5 degrees, and 43 degrees C. A tumor clonogenic assay was used to quantitate heat-drug interactive effects against the UACC-66 cells, and statistical analysis was performed using the median-effect equation of Chou. When combined with heat, the in vitro concentrations of the three platinum analogues were between 5% and 25% of those required at 37 degrees C to inhibit 50%-70% of the UACC-66 tumor colony forming units. For each drug when combined with heat, a 3 degrees C incremental increase in temperature (i.e., from 37 degrees C to 40 degrees C or from 40 degrees C to 43 degrees C) was associated with a ten-fold decrease in ID50 drug concentration. We conclude that the synergistic effects of both carboplatin and iproplatin with hyperthermia at all temperatures above 37 degrees C provide a rationale for design of clinical trials in patients with ovarian cancer using these hyperthermia-drug combinations. PMID- 3282707 TI - The disposition of carboplatin in the beagle dog. AB - Carboplatin was administered i.v. to four groups of three male beagle dogs at doses of 3, 6, 12, and 24 mg/kg (60-580 mg/m2). Plasma samples were obtained at appropriate times and protein-free plasma ultrafiltrates (PU) were generated with Amicon Centrifree micropartition systems. Urine was collected at 24-h intervals for 96 h. PU and urine samples were analyzed for carboplatin by HPLC and for total platinum by atomic absorption spectrophotometry. Carboplatin accounted for about 90% of the free platinum in plasma. The Cmax and AUCinf values for carboplatin and for free platinum increased linearly with dose. The terminal elimination half-life and mean residence times for carboplatin and free platinum were each about 1 h. Total-body clearances for carboplatin (5.6 l/h per m2) and free platinum (5.1 l/h per m2) were constant over the dose range studied, as were the respective volumes of distribution (5.7 and 5.0 l/m2). A mean of 46% of the dose was excreted as carboplatin in 24-h urine; and by 72 h, 70% of the platinum administered was excreted in the urine. Free platinum was cleared by both renal and non-renal processes. These results show that a dose of carboplatin is rapidly excreted in the urine and that carboplatin and plasma-free platinum exhibit linear pharmacokinetics in the beagle dog. PMID- 3282708 TI - Cytogenetic effect of carboplatin on human lymphocytes. AB - Carboplatin, a second generation cisplatin analogue, was tested for induction of sister chromatid exchange (SCE) as well as chromosomal aberrations in human lymphocytes in vitro and in vivo. A dose-dependent effect was observed for increased frequency of metaphases with SCE (r = 0.984, P less than 0.001) as well as chromosomal aberrations (r = 0.994, P less than 0.001), primarily chromatid gap or break, in vitro. SCE induction by carboplatin was less than that by cisplatin at the same concentration. When patients were treated with a single dose of carboplatin at a dose of 450 mg/m2, the frequency of SCE and chromatid type aberrations increased significantly. However, even when considering dose and peak plasma concentration in patients receiving carboplatin, it appears that the ability of carboplatin to induce SCE and chromosomal aberrations is weaker than that of cisplatin. SCE frequencies induced by carboplatin decreased with time going by, and in one patient who was tested 5 weeks after treatment, SCE frequency showed a decrease to the pretreatment level. It thus appears that carboplatin has an improved therapeutic index over the parent compound, cisplatin, because of its less mutagenic or carcinogenic hazard, in addition to the largely reduced incidence of untoward effects. PMID- 3282709 TI - Late intensification with high-dose melphalan and autologous bone marrow support in breast cancer patients responding to conventional chemotherapy. AB - Fifteen patients with advanced breast cancer who had achieved either a good partial or a complete response to conventional chemotherapy were selected to receive intensification treatment with high-dose melphalan 140-200 mg/m2 (HDM). All patients received autologous bone marrow rescue. All patients experienced marked haematological toxicity, and most experienced moderate or mild gastrointestinal side effects. There were three treatment-related deaths. Of twelve assessable patients eleven have relapsed; median time to relapse after HDM is 7 months. Nine of these eleven have died from recurrent breast cancer. Of the three patients remaining alive, only one is disease-free, at 18 months after HDM. Analysis of the pattern of metastatic relapse suggests that recurrence was due to failure of HDM to eradicate residual disease in the patient, rather than reinfusion of viable tumour cells. Treatment intensification with HDM has not succeeded in prolonging survival in patients already in good remission. PMID- 3282711 TI - Flow cytometric evaluation of leukocyte function. AB - The marriage of monoclonal antibody technology and flow cytometry has provided clinical researchers with a powerful tool for the characterization of leukocytes from various sources. In this regard, flow cytometry has been primarily used for the immunophenotyping of peripheral blood lymphocytes in leukemias and various immunodeficiency disorders. Flow cytometry is also useful for the evaluation of leukocyte function in vitro and in vivo. This review discusses the various applications of flow cytometry for the assessment of leukocyte function. Since several cell surface antigens are important constituents involved in cell function, immunofluorescence identification of these markers can provide significant information regarding cell function. Analysis of activation antigen expression by monoclonal antibodies and flow cytometry can provide significant insights about the presence of functional leukocyte populations in patients. Flow cytometry can also be used to directly analyze leukocyte function. Procedures for the quantitative flow cytometric analysis of proliferation of activated lymphocyte subsets are reviewed. Early cell activation is also amenable to flow cytometric measurement. Early activation events such as alterations in membrane potential, intracellular free calcium redistribution, intracellular pH, and changes in membrane fluidity, as well as the direct measurement of enzyme activity, are also described. PMID- 3282710 TI - A behaviour management and life stress course for a group of mothers incorporating training for health visitors. AB - Six mothers of preschool children presenting behaviour problems attended a 10 week course on behaviour management and life stress run jointly by a clinical psychologist and a family health visitor. Results indicated benefits to the family in terms of changes in childrens behaviour, the development of friendship networks, and increased knowledge of and willingness to apply behavioural principles to current and potential child management problems. Treatment in groups required fewer professional hours per family than an equivalent individual service and served a training function for the family health visitor. PMID- 3282713 TI - Analysis, characterization, and diagnostic utility of filarial antigen fractions isolated from immune complexes in bancroftian filariasis. AB - Circulating immune complexes isolated from clinical filarial patients' sera by 3% polyethylene glycol precipitation were analyzed by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) on vertical slab gel. Silver staining of the gel after electrophoresis revealed 20 and 30 protein bands without and with reduction of immune complexes, respectively, in the molecular weight range of 148-18K. Filarial antigen in protein eluates from gel slices was detected by sandwich enzyme-linked immunosorbent assay. The eluates from four gel slices, viz., IC-2, IC-4, IC-7, and IC-9, showed filarial antigenic activity. These antigen fractions were characterized and explored for their diagnostic use. IC-7 and IC-9 fractions and microfilariae excretory-secretory (mf ES) antigen share common antigenic determinants as revealed by the fact that saturation of immobilized antibodies with IC-7 or IC-9 inhibited the binding of mf ES antigen coupled to penicillinase. IC-9 fraction appears to be useful in serological differentiation of Wuchereria bancrofti infected persons from those with disease manifestations. Biochemical characterization of the IC-9 fraction revealed the protein nature of the antigen. Comparison of the electrophoretic profiles of immune complexes and W. bancrofti mf ES antigen revealed several common protein bands. The 55 K protein band with antigenic activity was observed in both preparations. PMID- 3282712 TI - Human IgG subclasses and their relation to carbohydrate antigen immunocompetence. AB - Human IgG responses to carbohydrate antigens, such as those found on many infectious bacteria, are primarily restricted to the IgG2 subclass. This phenomenon, known as isotype restriction, has led us and others to examine the prevalence of IgG2 deficiency among infection-prone individuals. IgG2 deficiency (below 3 SD of the age group mean) is fairly common among patients suffering from chronic bacterial infections and suggests the utility of IgG subclass measurements in evaluating such patients. However, we also describe exceptions to isotype restriction in human responses to carbohydrate antigens. Furthermore, we describe individuals who, while responding very poorly to carbohydrate antigens, have normal IgG2 levels for their age group. These findings indicate the complexity of IgG subclass regulation and suggest that evaluation of infection prone individuals should include measurements of both IgG subclasses and antibodies to carbohydrate antigens such as phosphocholine. PMID- 3282714 TI - Eicosanoids and control of mesangial cell contraction. AB - Contraction of glomerular mesangial cells is stimulated in vitro by the vasoconstrictor metabolite of arachidonic acid, thromboxane A2. To establish the role of mesangial prostaglandin (PG) synthesis in the modulation of contractile responses, we studied the effects of the stable thromboxane A2/endoperoxide analogue U-46619 on cultured rat mesangial cells preincubated with 1) four structurally unrelated, nonsteroidal anti-inflammatory drugs, indomethacin, acetylsalicylic acid, meclofenamate, and piroxicam, to inhibit the synthesis of PGE2, the major mesangial metabolite of arachidonic acid; 2) exogenous PGE2 and the stable analogue of PGI2, iloprost; and 3) indomethacin in the presence of exogenous PGE2. Computer-assisted image analysis microscopy demonstrated enhancement of spontaneous and agonist-induced contraction by nonsteroidal anti inflammatory drugs in individual cells grown on a glass substrate, from 37.2 +/- 7.3% to a maximum of 75.5 +/- 6.4% of the cells with piroxicam, at 1 microM U 46619. PGE2 and iloprost dose-dependently inhibited U-46619-induced contraction, to 5.0 +/- 2.8% and 12.5 +/- 4.7% of the cells, respectively, at 1 microM U 46619. PGE2 also completely reversed the effects of indomethacin. Both PGE2 and iloprost dose-dependently stimulated intracellular cyclic AMP (cAMP) accumulation during 3-minute incubations, an effect that was blocked by the inhibitor of adenylate cyclase, 2',5'-dideoxyadenosine. The latter reversed the inhibitory action of PGE2, enhancing spontaneous and agonist-induced contractility, thus indicating a modulatory role of cAMP. We conclude that endogenous arachidonate metabolism regulates mesangial cell contraction through elevation of intracellular cAMP. PMID- 3282715 TI - Torsional deformation of the left ventricular midwall in human hearts with intramyocardial markers: regional heterogeneity and sensitivity to the inotropic effects of abrupt rate changes. AB - The spiral orientation of left ventricular (LV) fibers suggests that twisting about the ventricular long axis of the apex with respect to the base, i.e., torsional deformation, may be characteristic of LV contraction. To demonstrate this twisting motion, 10 orthotopic human cardiac allograft recipients were studied with biplane cineradiography of tantalum helices implanted within the LV midwall at 12 specific sites. Counterclockwise twisting about the LV long axis (as reviewed from apex to base) accompanied ventricular ejection in all patients. Torsional deformation angles, measured relative to a reference minor axis at the base, were substantially smaller in the anteroapical wall, as compared with counterparts in the apical third of the inferior and lateral walls (anterior = 13.3 +/- 6.0 degrees, inferior = 18.7 +/- 6.3 degrees, and lateral = 23.4 +/- 10.7 degrees). Torsional angles at the midventricular level were roughly half as much and exhibited similar regional variabilities (anterior = 7.6 +/- 3.3 degrees, inferior = 9.0 +/- 3.3 degrees, lateral = 10.7 +/- 5.2 degrees, and septal = 8.8 +/- 3.8 degrees). Comparison of control beats and the initial beat after abrupt cessation of rapid atrial pacing (126 +/- 10 beats/min) with return to the control heart rate (96 +/- 9 beats/min) permitted the mild positive inotropic effect of tachycardia to be assessed at similar levels of ventricular load. Torsional deformation of the anteroapical and inferoapical sites increased significantly (p less than 0.05) over control values to 15.6 +/- 7.5 degrees and 21.2 +/- 5.5 degrees, respectively. In contrast, torsional deformation of the lateral wall was essentially unchanged. These data provide direct evidence for torsional deformation of the left ventricle in humans, demonstrate that torsion of the LV chamber is nonuniform, and suggest a dependence of LV torsion upon contractile strength that is attenuated in the lateral wall. PMID- 3282716 TI - Effects of procainamide on intra-atrial [corrected] electrograms during atrial fibrillation: implications [corrected] for detection algorithms. AB - The effects of antiarrhythmic drugs on electrograms have implications for arrhythmia-detection algorithms in implantable antitachycardia devices. Filtered and unfiltered intra-atrial electrograms were analyzed in eight patients who received procainamide (50 mg/min iv, up to 1000 mg) during 11 episodes of atrial fibrillation. Continuous recordings were made before, during, and after the infusion. The recordings were digitized, divided into 4.27 sec segments, and analyzed for atrial rate, median frequency and amplitude probability density function. Significant differences were noted before and after infusion of procainamide for atrial rate (498 +/- 97 vs 356 +/- 146 beats/min; p less than .005), median frequency (5.50 +/- 1.22 vs 4.24 +/- 0.99 Hz; p less than .0005), and density (58.3 +/- 13.9% vs 69.1 +/- 15.0%; p less than .005). Pre- and postprocainamide values were compared with published criteria for detection of atrial fibrillation. Before procainamide, only 2.3%, 5.7%, and 3.4% of the data segments failed to meet criteria for atrial fibrillation by rate, frequency content, and density, respectively. In contrast, after procainamide, 50%, 36.4%, and 28.4% of the data segments failed to meet these same criteria, despite electrograms still meeting morphologic criteria for atrial fibrillation. Thus procainamide resulted in changes sufficient to cause failure of published criteria for detection of atrial fibrillation. These findings have broad implications for the function of antitachycardia devices in patients receiving antiarrhythmic drug therapy. PMID- 3282718 TI - Fifty years of progress in cardiology: a personal perspective. PMID- 3282717 TI - Large conduit arteries in hypertension: role of the vascular renin-angiotensin system. PMID- 3282719 TI - The potential role of viruses in the pathogenesis of atherosclerosis. PMID- 3282721 TI - Comparison of Roche RIA, Roche EIA, Hybritech EIA, and Abbott EIA methods for measuring carcinoembryonic antigen. AB - Using 600 clinical specimens, we compared the concordance of four methods for carcinoembryonic antigen: the Roche RIA (I); the Roche EIA (II); Hybritech EIA (III); and Abbott EIA (IV). EDTA-treated plasma was used for Methods I and II and serum for Methods III and IV. However, no significant difference was found between results for serum and plasma in Method II. The normal reference interval (in micrograms/L) was I (222 specimens), 1.94 +/- 1.54; II (57 specimens), 0.8 +/ 0.5; III (100 specimens), 2.94 +/- 2.47; and IV (614 specimens), less than 5.0. The precision of all four methods was acceptable. Concordance among all of the methods exceeded 90%. PMID- 3282720 TI - Comprehensive drug screening for a pediatric population. PMID- 3282722 TI - Antiblastic chemotherapy and reproductive life. AB - In the present work the Authors, on the basis of most recent literature have tried to show some general outline with regard to the effects of antiblastic chemotherapy on the "ovarian function" in patients of pre-puberal and fertile age, understood that this would mean complex interference between endocrine and gametogenic; they have besides faced the problem of the gestational capacity of such patients. Notable difficulties have derived from the fact that the data in Literature are often non-comparable among themselves and, at times, discordant. However, although they have been unable to reach unequivocal conclusions, they hope to have made some practical contribution to those who, ever more often, find themselves having to face such problems. PMID- 3282723 TI - Prediction of ovulation using a dipstick sensitive to urinary luteinising hormone. AB - Accurate prediction of ovulation is essential for patients receiving donor insemination (AID). In 9 patients, detection of the urinary luteinising hormone (LH) surge by monoclonal antibody immunospecific dipstick tests (Ovustick) for both home and laboratory use was assessed with simultaneous quantitative estimations of plasma and urinary LH. In all patients the Ovustick accurately detected within 24 hours the beginning of the plasma LH surge. This test may prove to be a useful method for ovulation prediction but further evaluation is required. PMID- 3282724 TI - Intestinal injury in cesarean section. AB - A case of intestinal injury when suturing the hysterotomy during cesarean section is examined. This is a gross and accidental complication that, however, may occur even to a skillful surgeon. The intestinal overstretching and the bilateral bleeding of the hysterotomy wound are predisposing factors: then the control of the posterior uterine wall before closing the abdomen is opportune. PMID- 3282725 TI - Life stress and gastrointestinal upset. PMID- 3282726 TI - Partial duplication of the lower limb with agenesis of ipsilateral kidney--a new syndrome: report of a case and review of the literature. AB - A detailed account is given of a 19-month-old female infant with partial duplication of the left lower limb and aplasia of the ipsilateral kidney, plus other congenital malformations. Although the etiology is unknown, we believe this constellation of findings, which has been reported previously, represents a new congenital malformation syndrome. PMID- 3282727 TI - A family with pseudodeficiency of acid alpha-glucosidase. AB - A unique family is presented which consists of a patient with the juvenile muscular dystrophy form of glycogenosis type II and four healthy individuals, both parents and sisters, with low acid alpha-glucosidase activity. It was almost impossible to distinguish the homozygote from the heterozygous members by lymphocyte assay alone. In cultured skin fibroblasts, acid alpha-glucosidase activity measured with a synthetic substrate was less than 1% of the normal mean value in the patient and about 15% in the parents. The activity toward glycogen was not detectable in the patient and was about 30% of the normal mean value in the parents. These values are also lower than expected in heterozygotes. To explain these results properly, a new mutant allele of acid alpha-glucosidase is proposed. Both parents could be compound heterozygotes for the pseudodeficiency allele and the juvenile form of glycogenosis type II allele. PMID- 3282728 TI - Diploid/tetraploid mosaicism in a liveborn infant demonstrable only in the bone marrow: case report and literature review. AB - A case of a multiply malformed liveborn infant with mosaic tetraploidy on examination of bone marrow but not of peripheral lymphocytes or skin fibroblasts is presented. The literature is reviewed and the clinical features of our patient are compared with those of the nine previously reported cases. We suggest that when the clinical suspicion of polyploidy is strong, it may be prudent to expand the search for the abnormality to include cytogenetic studies of the bone marrow, despite a normal karyotype in peripheral blood. PMID- 3282730 TI - Successful outcome of a complicated pregnancy in a renal transplant recipient taking cyclosporine A. AB - The successful outcome of a pregnancy complicated by reversible renal failure secondary to total ureteral obstruction caused by a pregnant uterus and treated temporarily with nephrostomy is reported. The cyclosporine A (CsA) and prednisone treated female recipient of a cadaveric renal allograft gave birth to a male child, which at 2080 grams was small for gestational age (35 weeks of pregnancy). The child presented neither signs of congenital anomalies or chromosome aberrations nor nephrotoxicity, hepatotoxicity or anemia. Simultaneous measurement of trough CsA blood levels (CsA RIA, Sandoz) displayed reduced values in the child's blood (mother 864 ng/ml-4 hours after oral CsA intake; son 312 ng/ml). Beside postrenal failure the patient's pregnancy was complicated by 7 rejection episodes treated with high doses of methylprednisone (total dose 5 g) with reversible damage of the transplant function, two episodes of a urinary tract infection and increasing anemia necessitating blood transfusions. The HIV negative patient had developed a Kaposi's sarcoma 6 weeks after grafting. The progression of infiltrating skin lesions during pregnancy was not seen. PMID- 3282729 TI - Short-term treatment with captopril in hypertension due to acute glomerulonephritis. AB - We report that the inhibition of the angiotensin converting enzyme is an effective short-term treatment of low-renin hypertension in acute glomerulonephritis (AGN). We treated 9 patients who had AGN with moderate to severe hypertension and suppressed plasma renin activity with 25-50 mg of captopril per os every 6-8 hours. Control of blood pressure was achieved in 1-2 hours and maintained thereafter. Captopril therapy was associated with an increase in plasma renin activity, a decrease in plasma aldosterone and an increase in the urinary excretion of prostaglandin E2 and kallikrein, independent of changes in urine output. Creatinine clearance increased 39.6 +/- SE 15.2% with captopril and decreased in the postcaptopril period, suggesting that captopril exerted a reversible effect on glomerular filtration rate, possibly modifying intrarenal vasoconstriction. Our study shows that rapid control of hypertension in AGN may be obtained with oral inhibition of the angiotension converting enzyme. Stimulation of PGE2 and kinins, as well as angiotensin II blockade appear to contribute to the hypotensive effect of the drug; by inference, the suppressed activity of vasodilator systems seems to play a significant role in the hypertension of AGN. PMID- 3282731 TI - Erythrocythemia following renal transplantation: influence of diuretic therapy. AB - Post-transplant erythrocythemia (PTE) is a common finding in renal allograft recipients, although the etiology of this disorder has not been clearly established. We identified 22 patients (9.8%) with PTE from among 225 renal transplant recipients followed for an average of 5.5 years. To characterize possible predisposing factors and to study the clinical significance of PTE, these patients were compared with a control group matched for age, race, sex and etiology of renal failure. Plasma volume (PV) and red blood cell mass (RBCM) were measured in the majority of patients with PTE. Peripheral serum erythropoietin (Ep) levels were determined in the majority of patients in the control and PTE groups. PTE occurred an average of 11.4 months after transplantation. Risk factors for the development of PTE were pretransplant hypertension, retention of native kidneys, higher pretransplant hematocrit, and diuretic use for treatment of post transplant hypertension. Ep levels in the PTE and control groups were not significantly different. Twenty of the 22 patients with PTE were receiving concurrent diuretic therapy, and hematocrits fell to normal levels in all of these patients following cessation or dose reduction of diuretic. No other treatment of PTE was utilized, excluding the phlebotomy of a single unit of blood from one patient. No thromboembolic complications were noted during the follow-up period. We conclude that PTE is frequently induced by overzealous diuretic therapy for treatment of post-transplant hypertension. Discontinuation or reduction of diuretic therapy results in resolution of PTE in nearly all patients. From this experience we have developed an algorithm for the investigation and management of PTE. PMID- 3282732 TI - Hemolytic-uremic syndrome associated with an infection by verotoxin producing Escherichia coli 0111 in a woman on oral contraceptives. AB - A case of hemolytic-uremic syndrome (HUS) associated with an infection by a verotoxin-producing Escherichia coli (VTEC), serotype 0111:NM, in a 22-year-old woman who had been on oral contraceptives is presented. VTEC-associated cases of HUS infected by E. coli 0111 have been reported before, but never in adults. The kinetics of the humoral immune response to verotoxin in the patient is observed over three months and described for the first time. The possible role of contraceptives that have been incriminated in the etiology of HUS before is discussed as well. Possible benefits of therapeutical interventions such as hemodialysis, therapeutic plasma exchange, converting enzyme inhibitors, or antibiotics still need clarification. However, it is strongly suggested to include tests for VTEC in the work-up of patients suffering from HUS. PMID- 3282734 TI - Obstetric ultrasound update. PMID- 3282733 TI - Estimation of insulin sensitivity in uremic patients before and after initiation of a low-protein diet. PMID- 3282735 TI - Sonographic detection of cervical incompetence. AB - The diagnosis of cervical incompetence is based primarily on prior obstetrical history and clinical findings. Sonographic evaluation of the cervix and lower uterine segment does offer an objective means of establishing this diagnosis during gestation. Bulging of the membranes into a partly dilated cervical canal seems to be the most reliable sign of cervical incompetence. Standardization of the scanning techniques and large prospective studies will be necessary in order to determine the value of this diagnostic tool. PMID- 3282736 TI - Ultrasound in the management of the twin gestation. AB - In summary, ultrasound plays an important role in a twin gestation from the time of diagnosis of the pregnancy until the time the second fetus is delivered. Although it has never been quantitated, ultrasound has made a large impact on the safe management of the twin gestation. As techniques are refined and technology is improved, ultrasound will become even more sensitive in detecting chorionicity and congenital anomalies. Doppler assessment of uterine and umbilical blood flows may also become an important tool in assessing fetal well-being in the multiple gestation. PMID- 3282737 TI - Cordocentesis. PMID- 3282738 TI - Percutaneous fetal umbilical blood sampling. PMID- 3282739 TI - Clinical Doppler ultrasonography: uterine and umbilical blood flow. PMID- 3282740 TI - Sonographic diagnosis of fetal growth disorders. AB - In summary, accurate identification of fetal growth disorders remains a difficult clinical challenge. Many diagnostic parameters have been devised to diagnose these conditions, however, no single test alone allows a confident antenatal diagnosis of IUGR or macrosomia to be established. Until new criteria or new methods such as Doppler analysis of umbilical artery flow permit a more accurate prediction of growth disturbances, multiple parameters should be monitored. Evaluation of the amniotic fluid volume, BPD, FL, AC, and EFW should be included in all studies. In high risk cases (unexplained oligohydramnios, previous history of growth retardation, poor nutritional status, abnormal sonographic parameters, maternal obesity, diabetes mellitus, etc.) additional measurements such as the HC/AC ratio and the FL/AC ratio should also be evaluated. Similarly, evaluation of suspected excessive fetal growth requires careful evaluation of AC measurements. Patients with suspected growth disorders should be reevaluated with serial scans at 2 to 3 weeks intervals. Careful monitoring of fetuses with suspected IUGR and macrosomia may decrease much of the morbidity and mortality associated with these conditions. PMID- 3282741 TI - The role of ultrasound in the management of preterm labor. AB - Careful ultrasonographic evaluations of patients with PTL or PROM can provide critical information about estimated gestational age and birthweight. In addition, examination of FBM and perhaps objective ultrasonographic measurements of the lower uterine segment and cervix may provide valuable information to help us distinguish true preterm labor from false labor. Further research in these areas is necessary before these new approaches are widely adopted. PMID- 3282742 TI - Termination of pregnancy following diagnosis of fetal malformation: the need for improved follow-up services. AB - Eighty parents were offered an emotional support and counseling service following termination of pregnancy for fetal abnormality detected by second trimester ultrasound examination. Twenty couples took up the invitation to talk about their experiences. It was found that these women and their partners were profoundly affected by their decision to terminate the pregnancy. The lack of organized follow-up by existing agencies and the availability of professional support for these parents is a serious deficiency in our prenatal diagnostic services. PMID- 3282743 TI - Multimodal evoked potentials in neurology. PMID- 3282744 TI - Cause and treatment of insufficiency in the cerebral circulation. AB - The term cerebrovascular insufficiency describes reversible attacks of focal cerebral ischaemia affecting patients with extensive extracranial artery disease. The attacks are caused by failure of collateral blood supply and are often related to minor reductions in blood pressure. Characteristic clinical features such as jerking, involuntary movements and loss of vision in response to bright light may allow insufficiency attacks to be distinguished from other varieties of focal cerebral ischaemia. The treatment of patients with cerebral insufficiency aims to increase collateral blood supply by surgical removal of arterial obstruction and by medical therapy to prevent episodes of systemic hypotension. PMID- 3282745 TI - Blood pressure and both venous and urinary catecholamines after cerebral infarction. AB - Blood pressure, both venous and urinary catecholamines and plasma renin activity (PRA) were studied in 10 patients (6 men and 4 women, mean age 70 +/- 10 years) on the first three days after cerebral infarction. Blood pressure fell significantly (p less than 0.02) on the second and third day after stroke. There was a small but significant (p less than 0.01) decrease in plasma epinephrine concentration on the third day. The norepinephrine values remained constant on the three days. The PRA showed a significant (p less than 0.01) rise on the third day. No significant correlation was detected between the course of the blood pressure and the plasma catecholamines or PRA. When blood pressure was correlated with the urinary catecholamines, however, a significant correlation with epinephrine (r = 0.45; p less than 0.05) and with norepinephrine (r = 0.44; p less than 0.05) was found. We conclude that the changes in blood pressure after stroke are at least partly mediated by the changes in catecholamine production. PMID- 3282746 TI - Familial meningioma. Case report with cytogenetic study. AB - A family is presented of which two members were shown to have an intracranial meningioma. We performed a chromosome study in the affected living individual and several other relatives, with special attention for chromosome 22 anomalies. In neither of them a chromosomal abnormality could be detected. However, in view of the recent cytogenetic findings reported in meningioma, it is suggested that karyotyping should be performed in every family with two or more members affected by meningioma. PMID- 3282747 TI - The use of solid-phase chemistry in therapeutic drug monitoring. PMID- 3282750 TI - Effect of internalization and degradation of insulin on rat adipocyte insulin receptor binding kinetics. AB - We have assessed the influence of nondisplaceable (internalized) insulin and insulin degradation during binding reactions at 37 degrees C on the numbers and affinities of insulin binding sites on isolated rat adipocytes. Corrections for nondisplaceable insulin caused a 33% reduction in the number of the high affinity sites (p less than 0.01) and a 24% reduction (p less than 0.01) in the number of the low affinity sites which was associated with a 20% increase (p less than 0.01) in affinity when a two-site model was applied. With a one-site model, the number of insulin receptors decreased by approximately 33% (p less than 0.01), but the affinity did not change. These results indicate that the internalization and degradation of insulin that occurs during the binding reaction can significantly affect the estimation of insulin binding kinetics. Potential variations in internalization and degradation of insulin by cells obtained under various physiological or pathologic conditions should, therefore, be taken into consideration in the interpretation of insulin binding data. PMID- 3282748 TI - Pulse dosing versus continuous infusion of antibiotics. Pharmacokinetic pharmacodynamic considerations. AB - The issue of whether it is better to administer antibiotics as an intermittent bolus dose or a continuous intravenous infusion has been debated for several decades. This paper reviews the extensive literature on the topic, considering both the pharmacokinetic and pharmacodynamic aspects of antibacterials as well as experimental results from studies conducted in vitro, in animals and in humans. It is evident from reviewing the literature that neither mode of administration is clearly superior to the other. The decision regarding the mode of administration must take into account the antibiotic being used, the bacteria, the patient and the infection, as well as the pharmacokinetics of the particular drug in the individual patient. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) are useful indicators of the relative in vitro effectiveness of antibiotics, but it is not clear what relevance these parameters have to the desired antibiotic concentrations in vivo. Furthermore, questions of serum vs tissue fluid concentrations, peak concentrations vs AUC, and free vs total concentration are all important issues to consider in assessing the optimal mode of administration. The importance of newer indices such as the post-antibiotic effect are now beginning to be recognised. A number of scientists are actively engaged in developing a system to identify the most appropriate mode of administration based upon the integration of an antibiotic's pharmacodynamics and pharmacokinetics. Within the next few years we anticipate that appropriate guidelines should have been developed to aid the optimisation of parenteral administration, at least for some antibiotics. PMID- 3282751 TI - Haemodynamic effects of angiotensin II in conscious, non-ascitic cirrhotic rats. AB - The effect of angiotensin II (AII) on systemic and regional haemodynamics was studied in 18 control and 18 cirrhotic, non-ascitic conscious rats (CCl4/phenobarbital model). Cirrhotic rats were found to retain sodium and to have normal plasma renin and plasma aldosterone concentrations when compared with control animals. Cirrhotic rats showed an enhanced cardiac output (34.4 +/- 0.5 vs. 27.5 +/- 2.0 ml/min in controls) and decreased peripheral resistances (2.96 +/- 0.25 vs. 3.95 +/- 0.31 mm Hg/min/100 g/ml in controls) under basal conditions. When AII was administered cardiac output decreased by 10.7 +/- 1.2% in cirrhotic rats, whereas it increased in control animals (11.2 +/- 2%, p less than 0.005). The AII-induced increase in arterial pressure was lower in cirrhotic than in control rats. The renal blood supply was particularly impaired by AII in cirrhotics, with a maintained flow to other organs (muscle, testes). It is concluded that the response to AII is disturbed in rats with hepatic cirrhosis even in a stage without ascites and with plasma renin and aldosterone concentrations similar to those of control animals. PMID- 3282749 TI - Clinical pharmacokinetics of the newer antibacterial 4-quinolones. AB - Structural modification of the so-called 'first-generation' or 'urinary' quinolones has led to a considerable increase in their intrinsic antibacterial activity, together with marked changes in the pharmacokinetic properties. Tissue penetration is the most notable change, and the newer quinolones are comparable with the newer broad spectrum beta-lactams in their clinical spectrum of activity. Marketed compounds in the 4-quinolones group include pefloxacin, ofloxacin, enoxacin, ciprofloxacin and norfloxacin; many more compounds are in various stages of research and development. The 4-quinolones act by inhibition of bacterial DNA gyrase, a process which is pH and concentration dependent. The bactericidal activity can be partly abolished if protein synthesis is inhibited by chloramphenicol, or if RNA synthesis is inhibited by rifampicin (rifampin). The antibacterial spectrum of activity includes methicillin- and gentamicin resistant staphylococci, multiresistant non-fermenters, all Enterobacteriaceae, Legionella, Neisseria species, Branhamella and Haemophilus influenzae. With the exception of norfloxacin, which is only 30 to 40% bioavailable from the oral route, the 4-quinolones are 80 to 100% bioavailable, absorption occurring within 1 to 3 hours. Food does not significantly alter Cmax, AUC or elimination half life, although tmax, may be increased. The 4-quinolones are widely distributed throughout the body, with volumes of distribution greater than 1.5 L/kg. Protein binding is less than 30% in most cases. Penetration into most tissues is good. With the exception of ofloxacin and lomefloxacin (NY 198), which are metabolically stable, metabolism of the 4-quinolones occurs primarily at the C7 position in the piperazinyl ring. Biotransformation is extensive (85%) with pefloxacin, medium (25 to 40%) with ciprofloxacin and enoxacin, and low (less than 20%) with norfloxacin. Elimination half-lives vary between 3 and 5 hours (ciprofloxacin) and 8 to 14 hours (pefloxacin). Biliary concentrations of the 4 quinolones are 2 to 10 times greater than those in serum or plasma, with several compounds undergoing enterohepatic circulation. There is some evidence that ciprofloxacin, norfloxacin, ofloxacin and enoxacin have an active renal tubular excretion pathway. In impaired renal function, reduction of the glomerular filtration rate below 30 ml/min (1.8 L/h) is associated with an increase in elimination half-life and AUC, and a decrease in renal and total clearance of the 4-quinolones, and a decrease in 24-hour urinary recovery.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3282752 TI - Electrophysiology of the auditory system. AB - This review has attempted to summarise the properties of electro physiological responses in the auditory system. The treatment was broad and consequently somewhat sketchy. For a more detailed recent treatment of the physiology of the auditory system the reader is referred to Pickles (1982), Moller (1983), or Altschuller et al (1986). The data on acoustic injury have been reviewed recently by Schmiedt (1984). Discussions of a number of topics such as development, hair cell function and speech encoding are found in Berlin (1984). PMID- 3282753 TI - Measurement of subcutaneous fat thickness with high frequency pulsed ultrasound: comparisons with a caliper and a radiographic technique. AB - This paper reports the use of a 10 MHz pulsed A-scan ultrasound system to measure the thickness of subcutaneous fat and its comparison with two other established techniques. Measurements using both ultrasound and Harpenden's skin calipers were made on the abdomen, over the scapula region, over the triceps and on the front of the thigh. Computerised axial tomography (CAT) was also used to obtain measurements of subcutaneous fat over the abdomen. In most instances the different techniques were significantly correlated. The ultrasound method showed non-dependency or bias upon the size of measurement when compared with the other two techniques. In addition, the ultrasound method was considered more accurate, reproducible and sensitive compared with the caliper technique and much more convenient than CAT scanning. However, the presence of septa at some sites in the more obese subjects was revealed by CAT scanning and made ultrasound assessment at these sites more difficult. PMID- 3282754 TI - Determination of the mean transit time for the transport of aerosolized 99mTc DTPA across the pulmonary epithelial membrane. A plasma sample method. AB - During the last decade it has been customary to estimate pulmonary epithelial permeability (P-P) as the pulmonary clearance of inhaled nebulized 99mTc-DTPA from a time-activity (t-a) curve registered externally by monitoring over the chest. The t-a curve, however, is not defined by the degree of P-P alone but also by factors such as the deposition of the 99mTc-DTPA in the lungs. To avoid these problems a plasma sample method was derived. It describes P-P by the mean transit time (t) for the transport of 99mTc-DTPA across the pulmonary epithelial membrane, t(L). The calculation of t(L) involves two steps. Following the inhalation of Tc-DTPA the plasma t-a curve is defined and used to calculate t for the transport for 99mTc-DTPA across the pulmonary epithelial membrane, through the ECV and until elimination by the kidneys, t(L+ECV). Subsequently, 99mTc-DTPA is injected as a bolus i.v. and the new t-a curve is used to calculate t for the transport of 99mTc-DTPA through ECV to the kidneys, t(ECV). Finally t(L) is calculated as t(L) = -t(L + ECV) t(ECV). We applied the method in nine non smoking individuals (median age 25.5 years, range 20-28) and compared the results to t as calculated from the initial slope of an externally derived t-a curve. The individual t(L) values were systematically greater than those of the external detection method (P less than 0.05). It is concluded that the initial slope method overestimates total PC1 as measured by the plasma sample method. When choosing between the two methods, special interest should be paid to the inherent problems of the methods. PMID- 3282756 TI - Normal B-lineage cells: their differentiation and identification. AB - This article reviews the normal differentiation of B-lineage cells. The scheme of normal differentiation of the B lineage provides a context in which to analyze patients with immunodeficiencies and B-lymphoproliferative disorders. PMID- 3282755 TI - Differentiation of human T cells. AB - This article discusses the ontogeny of human T cells along with the relationship of normal T-cell maturation to the development of various malignant T-cell syndromes. The impact of monoclonal antibody technology, the discovery of the T cell receptor for antigen, and the discovery of mechanisms of thymocyte-thymic microenvironment interactions on the analysis of human T-cell development are emphasized. PMID- 3282757 TI - Immunophenotyping in the diagnosis and classification of acute lymphoblastic leukemia. AB - The identification of ALL immunophenotypes with distinctive clinical features and prognostic significance indicates the importance of these studies in the evaluation of ALL patients for both clinical and research purposes. For differential diagnosis, the expression of pan-B-cell or pan-T-cell lymphoid antigens and the absence of myeloid/monocyte antigens represent the most useful markers for distinguishing ALL from AML. However, the increasing appreciation of large numbers of patients with clinically significant mixed lymphoid-myeloid phenotypes suggests that rigid classification of acute leukemias into exclusive lymphoid and myeloid categories may be somewhat artificial. In adult ALL, patients with My+ phenotypes (B+sIg-T-My+ and B-sIg-T-My+) have a lower incidence of complete remission and shorter survival times than do patients with My- marker profiles. Preliminary studies in childhood ALL also suggest a correlation between myeloid antigen expression and poor prognostic factors. In addition, children with sIg+ "B-cell," cIg+ "pre-B-cell," and T-cell ALL phenotypes have shorter disease-free survival times than do patients with more common "early pre-B" (B+cIg-sIg-T-) marker profiles. Application of immunologic markers in concert with cytogenetic and gene rearrangement studies has led to the identification of novel subgroups of leukemia with distinct clinical characteristics. Future studies incorporating a multiparameter diagnostic approach including immunophenotyping, gene rearrangement studies, and karyotypic analyses should further our understanding of the heterogeneity of acute leukemias, guide the development of new therapeutic strategies, and provide for more clinically relevant classification of these disorders. PMID- 3282758 TI - Hairy-cell leukemia. Morphologic, cytochemical, and immunologic features. AB - Hairy-cell leukemia is a unique lymphoproliferative disorder that has fascinated clinicians and researchers for nearly 3 decades. It can, in most cases, be diagnosed correctly on the basis of a bone marrow biopsy specimen, and the diagnosis is supported by the demonstration of tartrate-resistant acid phosphatase activity in the leukemic cells. Nevertheless, as outlined, rare "variant" cases may pose diagnostic problems, and other lymphoproliferative disorders may have features that closely mimic those of HCL. In virtually all cases of HCL, the hairy cells are of B-cell lineage, representing a relatively mature B cell that is closely related to plasma cells. Treatment of HCL with splenectomy, IFN-alpha, or 2' deoxycorformycin has led to excellent responses in most cases. Much of the progress in our understanding of the nature of this rare leukemia has been made possible through the cooperation of community physicians with referral institutions, or groups of institutions, that are interested in studying HCL. Despite the remarkable advances in the treatment of this disorder over the last 5 years, and the ready availability of IFN-alpha, much remains to be learned regarding the biology of hairy cells, and further advances in therapy still must be made. The needed information can be obtained only through continued referral of patients to centers with expertise and an interest in HCL. PMID- 3282759 TI - Neoplasms of terminally differentiated B lymphocytes. AB - The pathophysiology of, and diagnostic criteria for, multiple myeloma are discussed. There is evidence that the malignant cell population in multiple myeloma may retain at least some capacity for immune modulation/inhibition. As the molecular biology of this disease progresses, clinical access to proliferation manipulation may become possible. PMID- 3282760 TI - An approach to practical problems in the diagnosis of lymphoproliferative disorders using cytochemistry and immunocytochemistry. AB - The use of enzyme histochemical and immunohistochemical markers has improved our understanding of the biology of lymphoproliferative disorders. These same techniques can now provide practical information when applied to the diagnosis of lymphoproliferative disorders. PMID- 3282761 TI - Use of the APAAP method in the classification and diagnosis of hematologic disorders. AB - The APAAP technique is a sensitive and relatively easy immunocytochemical method to perform. It requires only a modest amount of laboratory space and no expensive equipment with the exception of a light microscope. Staining can be performed on peripheral blood and bone marrow films as well as cryostat and paraffin-embedded tissue sections. Prior to staining peripheral blood and bone marrow films as well as cryostat sections, slides can be stored at -70 degrees C, thus allowing for batch processing of specimens. Stained slides can be kept at room temperature for prolonged periods of time without loss of label. Surface or cytoplasmic determinants can be stained with the APAAP method. Because the preparations are usually counterstained, the identification of the labeled cells can be observed and photographed. The APAAP method is a reliable procedure and a significant addition to the routine hematology and histopathology laboratory. PMID- 3282762 TI - Lymphocytic surface markers in lymphoid leukemoid reactions. AB - Although mononuclear cell surface markers are primarily used to determine the lineage and stage of differentiation of leukemias and lymphomas, they can also be helpful in discriminating between some cases of neoplastic and reactive conditions. Peripheral blood lymphocytosis secondary to infection most often shows increased numbers of activated T cells of the suppressor/cytotoxic subset. A few exceptions, such as in pertussis, show predominantly T-helper cells. Although persistent B-cell lymphocytosis is most often associated with neoplastic conditions, B-cell predominant reactive conditions may also occur. Lack of light chain restrictions on B-cell membranes suggests non-neoplastic disorders. Reactive lymphadenopathy most often shows a predominance of T cells with normal to increased T-helper/T-suppressor cell ratios. In addition, normal ratios of kappa/lambda light chain surface immunoglobulin usually occur on B cells of reactive lymph nodes. Benign lymphocytic infiltrates in skin most often show a predominance of activated T-helper cells. Distinguishing reactive from neoplastic dermal infiltrates by mononuclear cell markers can be extremely difficult and may require DNA genotypic analysis. Mononuclear cell markers applied to bone marrow in patients treated for leukemia and other disorders must also be interpreted with caution. The presence of CD10 antigen (CALLA) may herald recurrence of leukemia; however, this determinant is not leukemia-specific and may be found on normal cells. Similarly, lymphoid cells bearing TdT often represent recurrent leukemia, and they must be differentiated from immature nonmalignant TdT-positive cells. Immunologic surface markers must be interpreted together with a careful review of the morphology of the tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282763 TI - Immunoglobulin gene rearrangement and its implications for the study of B-cell neoplasia. AB - Molecular biologic investigation of the process of immunoglobulin gene rearrangement has elucidated the mechanism of immunologic diversification and has provided essential tools for the study of B-cell neoplasia. The use of immunoglobulin gene probes has permitted a clearer understanding of B-cell malignancies, but has also raised new questions and pointed out new directions for ultimately clarifying the mechanism of B-cell transformation. Thus, we have a difficult challenge ahead, but with our present knowledge, we are in a better position than ever to address critical issues relating to the genesis of lymphoid neoplasia. PMID- 3282764 TI - Coagulase-negative staphylococcal infections. PMID- 3282765 TI - Congenital syphilis. PMID- 3282766 TI - Bacterial meningitis. PMID- 3282767 TI - Acute infectious illness in children. AB - The young child with fever represents a diagnostic challenge. The physician has powerful allies with which to meet this challenge--the carefully performed observation, history, and physical examination. This evaluation, along with an appreciation of age and temperature risk factors, can lead to optimum patient care and to a more apposite use of both screening and diagnostic laboratory studies. Decisions about hospitalization and therapy are based on an appreciation of causative agents, a comprehensive knowledge of disease processes, and any aspects of the social situation that could have an adverse influence on outpatient management. PMID- 3282768 TI - Forecasts of preserved teeth and denture wearers among Danish adults early in the next century. AB - To assist in the planning of oral health services, forecasts were made and goals specified with regard to the numbers of preserved teeth and subjects wearing full or partial dentures among Danish adults in 1992 and 2002. Forecasting was based on existing data, viz. a survey in 1982, including clinical examination, of a representative sample of 20-80-yr-olds (n = 2548), on register data from the National Health Insurance, and survival rates. By combining information from these sources, an increase was estimated in number of preserved teeth among 20-99 yr-olds from 68 million in 1982 to 82 and 92 million in 1992 and 2002, respectively. Correspondingly, a 28% increase in the mean number of remaining teeth was proposed as a goal for the year 2002. A decrease was estimated in the number of denture wearers, from 1.4 million in 1982 to 1.07 and 0.74 million in 1992 and 2002, respectively. The corresponding goal was specified as a 50% reduction in the proportion of denture wearers in 2002. In the middle aged and older part of the population the increasing number of remaining teeth may be expected to imply considerable needs for professional care even in the beginning of the next century. PMID- 3282769 TI - Microcomputer BASIC program to calculate the probability of graft and patient survival in renal transplantation. AB - A BASIC program was written for the estimation of the probability of graft and patient survival in renal transplantation on a microcomputer. The program was developed for single-centre statistics in renal transplant units and uses the life table and logrank test method for calculation of survival rates. The program structure is described in detail to make rewriting easy. It is hoped that this report will help transplant centres without access to main-frame computers to develop user-friendly software running on their own computer. PMID- 3282770 TI - Computerized diagnosis of gastrointestinal helminths of humans. AB - An interactive computer program written in BASIC with the objective of assisting the identification of species of common gastrointestinal parasites of humans is presented. The computer program acquires observational information needed for the identification of a parasite from the user. The user selects a description from a set of given descriptions that best fits the parasite observed. Depending on the response of the user, the program presents another set of descriptions from which the user must choose again, and so on, until the program concludes with the species of the parasite, the mode of infection, the affected system(s), and the treatment of choice. PMID- 3282771 TI - BACTID: a microcomputer implementation of a PASCAL program for bacterial identification based on Bayesean probability. AB - A computer program (BACTID) is described which enables the identification of bacteria based on a priori data and Bayesean probability testing. The program is not limited to a specific format, has a short execution time, can be easily applied to a variety of situations, and can be run on almost any microcomputer system operating under either 8-bit CP/M or 16-bit MS-DOS or PC-DOS. Additionally, BACTID is not limited to one type of computer (hardware independent); is not limited by size of the computer's random access memory (RAM independent); can recognize various database matrices (format independent); is able to compensate for missing data; and allows for various methods of data entry. The efficacy of the program was checked against a commercially available test system and a 99.34% agreement was obtained. Also, the execution time for a 46 x 21 data matrix was as little as 3.5 seconds. These results show that microcomputer identification programs not only are viable alternatives to code book registers, but also offer flexibility which is not found in commercial systems. PMID- 3282772 TI - Consensus development summaries. Magnetic resonance imaging. National Institutes of Health. PMID- 3282773 TI - Hemodialysis membranes in transition. PMID- 3282774 TI - Autoimmune mechanisms in nephritis. PMID- 3282775 TI - Mercury-induced autoimmune glomerulonephritis in animals. PMID- 3282776 TI - New insights in systemic lupus erythematosus glomerulonephritis. PMID- 3282777 TI - Auto-immunity and systemic vasculitis. PMID- 3282779 TI - Antihypertensive therapy in dialysed patients. PMID- 3282778 TI - Role and clinical significance of rheumatoid factors in glomerulonephritis. PMID- 3282780 TI - Ischemic heart disease and its management in uremic patients on hemodialysis. PMID- 3282781 TI - Incidence, prognosis and therapy of cardiac arrhythmias in dialysis patients. PMID- 3282783 TI - International reflux study in children. PMID- 3282782 TI - Urography and sonography in the diagnosis of reflux nephropathy. PMID- 3282784 TI - AIDS in dialysis centers: an emerging risk? PMID- 3282786 TI - Dialysis-associated amyloidosis and beta-2-microglobulin. PMID- 3282785 TI - Viral infection in kidney-transplanted patients. PMID- 3282787 TI - High-efficiency hemodialysis: an overview. PMID- 3282788 TI - Structural and functional renal changes in the elderly. PMID- 3282789 TI - Alport's syndrome and related hereditary nephropathies. PMID- 3282790 TI - Preventive approach to diabetic kidney disease. PMID- 3282791 TI - Hemodialysis materials. PMID- 3282792 TI - Interactions of blood with surfaces: hemocompatibility and thromboresistance of biomaterials. PMID- 3282793 TI - Interleukin-1 and biocompatibility in haemodialysis. PMID- 3282794 TI - Hemodialysis-associated complications due to sterilizing agents ethylene oxide and formaldehyde. PMID- 3282795 TI - Phagocyte oxidative metabolism in hemodialysis. PMID- 3282796 TI - Clinical significance of bio-incompatibility in haemodialysis. PMID- 3282797 TI - Structure and metabolism of beta-2-microglobulin. PMID- 3282798 TI - How far can plasmatic levels of beta-2-microglobulin in hemodialysis be relied upon? PMID- 3282799 TI - Amyloidosis and dialysis: pathophysiological aspects. PMID- 3282800 TI - Amyloidosis in chronic hemodialysis: rheumatological aspects. PMID- 3282801 TI - Hemodialysis and the skin. PMID- 3282802 TI - Complement activation and induction of interleukin-1 production during hemodialysis. PMID- 3282803 TI - Role of antioxidants in organ preservation and transplantation. PMID- 3282804 TI - Acute complications of Crohn's disease. AB - Crohn's disease can be acute. If proper diagnosis is not made and appropriate therapy instituted, morbidity and mortality can be high. A team approach with cooperation between gastroenterologists and surgeons is mandatory. PMID- 3282805 TI - Adrenal and pseudoadrenal masses: CT and US findings. AB - Computed tomography (CT) is currently the imaging modality of choice for assessing the morphology of the adrenal glands in adult patients. Much useful information can be gained using CT in disease processes which primarily involve one or both of the adrenal glands, such as adenomas, as well as in entities which secondarily affect the adrenals, such as pituitary or metastatic disease. The size and configuration of the glands can be readily determined, and masses may be detected. We discuss CT of normal and abnormal adrenal glands with sonographic (US) and pathological correlation, when available. Entities which may mimic adrenal abnormalities are emphasized. Relative advantages of US over CT in the pediatric patient are discussed. PMID- 3282806 TI - Current concepts in the radiographic evaluation of the rotator cuff. AB - This review discusses the disease of the rotator cuff and evaluates our current tools for imaging it. The rotator cuff consists of the cojoined tendons of the short rotator muscles of the shoulder. Derangements of the cuff, which can result from degeneration, trauma, or overuse, are frequent causes of shoulder pain. Until the present decade, imaging of the cuff depended on injection of contrast into either the underlying joint (arthrogram) or overlying bursa (bursogram). Computed tomography (CT) has added additional dimensions to arthrography but has not played a major role in the diagnosis of cuff pathology. Ultrasonography (US) has been shown to be of diagnostic value in imaging cuff tears and has shown promise in defining pathology in the intact cuff. Magnetic resonance imaging (MRI) has the potential for imaging the cuff; its roles here are not yet defined. PMID- 3282807 TI - Coronary heart disease in women: special considerations. PMID- 3282808 TI - Portal hypertension. PMID- 3282809 TI - Bone mineral metabolism in human type 1 (insulin dependent) diabetes mellitus. AB - Decreased bone mineral content has been observed in several studies of type 1 (insulin-dependent) diabetics in comparison with age and sex matched control subjects. In type 2 diabetics contradictory results have been obtained, probably related to varying degrees of body overweight in the patients investigated. The decrease in bone mineral content in type 1 diabetics was most pronounced in patients with childhood or adolescent onset of the disease, with ceased beta-cell function, with high insulin dosage, and poor glucose regulation. In a subgroup of patients having all these "risk factors" bone mineral content was decreased some 20%, as compared with patients without any "risk factors", and/or with sex and age matched controls. Bone mineral homeostasis was characterized by increased urinary excretions of bone minerals (calcium, phosphate and magnesium) related to the degree of hyperglycaemia and insulin dosage, by decreased serum concentrations of ionized calcium and magnesium, by increased to normal serum concentrations of phosphate, by a low-normal serum concentration of parathyroid hormone, and by a low-normal serum concentration of 1,25-dihydroxyvitamin D. This indicates a state of functional hypoparathyroidism in type 1 diabetics. Several mechanisms may thus contribute to diabetic osteopenia: Proneness to metabolic acidosis, hypocalcaemia, insulin deficiency and perhaps also hypomagnesaemia and hypoparathyroidism. PMID- 3282810 TI - B lymphocyte function in patients with rheumatoid arthritis: impact of regulatory T lymphocytes and macrophages--modulation by antirheumatic drugs. AB - The present work analyses B lymphocyte functions in vitro in patients with rheumatoid arthritis (RA). The impact of gold salts and penicillamine on human B lymphocyte function in vitro is discussed. Synovial fluid monocytes/macrophages increased both the polyclonally induced and the antigen-induced blood lymphocyte proliferation and increased the numbers of immunoglobulin-secreting blood B lymphocytes generated by pokeweed mitogen (PWM), a T cell-dependent polyclonal activator. The lymphostimulatory factor(s) interleukin-1, which can be produced by monocytes/macrophages, was found in most cell-free synovial fluid specimens, but only in a few paired serum samples. Thus, in vivo activated synovial monocytes/macrophages may modulate lymphocyte functions. Compared to blood, synovial fluid T lymphocytes comprised fewer T4+ (helper/inducer) cells and more T8+ (suppressor/cytotoxic) cells. Synovial fluid lymphocytes proliferated poorly when stimulated polyclonally. However, the proliferative responses to microbial antigens as well as the lectin-induced lymphokine production equaled those of blood lymphocytes. In about half of RA patients, T4+ cells from synovial fluid increased the PWM-induced immunoglobulin secretion by autologous blood B lymphocytes to higher levels as compared to similar experiments with blood T4+ cells. Synovial fluid T8+ cells suppressed PWM-induced immunoglobulin production of autologous mononuclear cells to the same degree as seen with blood T8+ cells. A large proportion of synovial fluid T subsets expressed Ia antigens, probably due to in vivo activation. Thus, synovial T helper/inducer and T suppressor/cytotoxic cells may modulate the functional activities of synovial B lymphocytes. Among mononuclear cells isolated from synovial fluid and synovial tissue, considerable numbers of B lymphocytes spontaneously secreting IgG were found; fewer B cells secreted IgM and IgA. Rheumatoid factor activity was noted in about 7% of the IgG-producing cells. Synovial fluid mononuclear cells did not produce immunoglobulins in cultures stimulated with PWM, unless synovial T cells were removed and replaced with autologous blood T cells. Under these conditions synovial fluid B lymphocytes were induced by PWM to considerable IgG synthesis; fewer cells secreted IgM and IgA. About 8-9% of the induced IgM- and IgG synthesizing cells displayed rheumatoid factor activity. Aurothiomalate markedly inhibited PWM-induced immunoglobulin production by normal lymphocytes cultured in vitro, probably by affecting monocyte/macrophage-lymphocyte interactions. The drug also had a direct inhibitory action on B lymphocytes, whereas T cells were resistant.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3282811 TI - Oral contraceptives: effects on glucose and lipid metabolism in insulin-dependent diabetic women and women with previous gestational diabetes. A clinical and biochemical assessment. PMID- 3282812 TI - Individual therapy-dependent prognosis based on data from controlled clinical trials in chronic liver disease. AB - In a given disease the manifestations and course of disease may vary markedly between the patients. This complicates prediction of the prognosis and treatment effect in individual patients. Most controlled clinical trials present only the "average" effect e.g. the therapy-dependent survival in the studied patient group. To estimate the therapy-dependent prognosis in individual patients it is necessary to utilize the covariation between survival time and variables characterizing each patient including the therapy given. This paper describes current methods for identification of variables which covary with survival time (prognostic variables) or the effect of therapy (therapeutic variables). Analyzing data from two large controlled clinical trials in patients with chronic liver disease: 1) the multicenter trial of prednisone versus placebo in cirrhosis conducted by the Copenhagen Study group for Liver diseases (CSL-1) and 2) the multinational trial of azathioprine versus placebo in primary biliary cirrhosis (PBC-1) we have developed indices for prediction of prognosis and therapeutic effect using Cox's multiple regression model for censored survival data. Using the indices one can estimate the therapy-dependent prognosis in new patients from their base-line data. Furthermore, a time-dependent index by which the risk of a given patient can be estimated repeatedly to update prognosis during the course of the disease is presented. To simplify application "pocket charts" have been devised by which a prognostic index for a patient can easily be obtained at the bedside. By simple graphs, a prognostic index can be translated to estimates of the probability of surviving a given time or the median survival time predicted for the patient. The indices have been validated by comparing the survival predicted by the indices with the observed survival in new patients or using data splitting. The results allow a more differentiated treatment strategy based on the characteristics of the individual patient. Even if the results apply to chronic liver disease, the general principles are valid for study of the individual therapy-dependent prognosis in other diseases. PMID- 3282813 TI - Relationships of oxygen uptake and oxygen delivery in respiratory failure not due to the adult respiratory distress syndrome. AB - Previous studies have suggested that oxygen uptake (VO2) may be dependent on oxygen delivery (QO2) at most levels of QO2 in patients with the adult respiratory distress syndrome (ARDS); however, the adequacy of substrate delivery in patients with non-ARDS respiratory failure is unclear. The purpose of the present study was to examine the relationship between VO2 and QO2 in a group of critically ill patients (n = 10) with non-ARDS respiratory failure (ie, cardiac pulmonary edema, chronic obstructive pulmonary disease [COPD], or pneumonia). For comparison, these relationships were also examined in a group of patients (n = 6) with ARDS. The data indicate that VO2 is dependent on QO2 in both patients with ARDS and non-ARDS respiratory failure. In contrast, regional venous oxygen tension differences varied considerably between the two groups of patients, indicating differences in local adaptations to critical reductions in QO2. Finally, over a similar range of QO2, oxygen extraction was greater in patients with ARDS compared to patients with non-ARDS respiratory failure (r = -0.67 and slope = -0.62 vs r = -0.45 and slope = -0.35; p less than 0.05). These data suggest that a linear relationship between VO2 and QO2 is not unique to patients with ARDS and may not predict regional adaptations to critical reductions in substrate availability. PMID- 3282814 TI - Minimal positive end-expiratory pressure (PEEP) may be "best PEEP". AB - In the absence of clinical trials, positive end-expired pressure (PEEP) has been accepted as efficacious for treatment of postoperative decreases in arterial oxygen tension (PaO2) from a variety of causes including adult respiratory distress syndrome (ARDS). PEEP is thought to increase PaO2 by alveolar recruitment, which in turn, has been hypothesized to play a decisive role in pulmonary recovery. One hundred and eighteen patients were followed prospectively, and after development of decreased PaO2, randomized to receive recruitive PEEP (determined by blood gas criteria) or supportive PEEP (the minimal PEEP required to maintain PaO2 above 60 mm Hg on .5 inspired O2 fraction (FIO2). No prognostic factors were significantly different between the two groups. Recruitive PEEP application in 22 patients yielded a significantly increased incidence of hypotension (55 percent), pneumothorax (20 percent), and death during treatment (27 percent) when compared to the 28 supportive PEEP patients who had no hypotension or pneumothorax and only one death during treatment (4 percent). After PEEP treatment, deaths in each group were similar (19 percent and 15 percent, respectively). We find no evidence that PEEP treatment promotes beneficial outcomes and conclude that recruitment attempts may be harmful. PMID- 3282815 TI - Preoperative radioactive therapy for esophageal carcinoma. Randomized evaluation trial in eight institutions. AB - A cooperative, prospective, randomized study to evaluate the effectiveness of preoperative irradiation in curatively resected esophageal carcinoma was performed in 364 cases in eight institutions from August 1982 to November, 1983. Based on the survival curves, postoperative irradiation alone was superior to preoperative plus postoperative irradiation. Because of the progression of the disease and complications after operation, there were many inevaluable cases in this study. However, analysis revealed there was no bias caused by a greater number of unfavorable patients being selectively included in inevaluable cases in the postoperative irradiation only group. Our data question the value of preoperative irradiation being performed in addition to resection plus postoperative irradiation. PMID- 3282816 TI - Amiodarone pulmonary toxicity. Recognition and pathogenesis (Part I). AB - Amiodarone represents an important new approach in the treatment of serious cardiac rhythm disturbances and is associated with significant pulmonary toxicity in approximately 5 to 10 percent of patients. The recognition of APT in patients receiving the drug early in the course of the disease will likely preclude the development of a permanent loss of pulmonary function in these patients. It is important for the clinician to individualize both the diagnostic and therapeutic approach to the patient receiving amiodarone who is thought to have pulmonary toxicity secondary to the drug. Several diagnostic and therapeutic decisions are available, and it is important to constantly reevaluate the risk-benefit ratios of the decision making process. Future studies may improve insight into the assessment of APT and may permit the clinician to diagnose this toxicity at an earlier and potentially more reversible stage of the disease process. PMID- 3282819 TI - Ventilatory support. PMID- 3282818 TI - Exercise testing in patients with aortic stenosis. PMID- 3282820 TI - After quibbles and contrasts, concepts and caveats. PMID- 3282817 TI - The contribution of viral respiratory infections to the pathogenesis of airway hyperreactivity. AB - From this review, it is apparent that the effects of respiratory viral infection on airway reactivity are multiple. Although virus-associated changes are many, we have at present no evidence to show that respiratory viruses cause intrinsic abnormalities in airway smooth muscle function. Rather, respiratory viruses influence bronchial smooth muscle function through a variety of other means: epithelial injury, PMN-dependent inflammation, and greater mediator release. These observations suggest that a common pathway to development of airway hyperreactivity during respiratory viral illnesses is to enhance those factors which participate in the inflammatory response. When the target of this enhanced inflammatory response becomes the airway, greater bronchial reactivity and obstruction result. Although many questions remain to be answered, we feel that future studies to evaluate the biology of respiratory virus effects on mechanisms of airway responsiveness will lead to a greater understanding of asthma pathogenesis. PMID- 3282821 TI - Usefulness and safety of pharmacologic bronchoprovocation challenge in evaluating patients with normal spirometric tests who are suspected of having asthma. PMID- 3282822 TI - Cardiovascular effects of conventional positive pressure ventilation and airway pressure release ventilation. AB - The hemodynamic sequelae of conventional positive pressure ventilation (CPPV), airway pressure release ventilation (APRV), and spontaneous breathing were compared with continuous positive airway pressure (CPAP) in ten anesthetized dogs who had ventilatory failure with and without parenchymal lung injury. The APRV corrected respiratory acidosis without significantly effecting arterial blood oxygenation, venous admixture, cardiovascular function, or tissue oxygen utilization. Application of CPPV precipitated marked depressions in blood pressure, stroke volume, and cardiac output. A concomitant decrease in venous admixture did not compensate for these adverse cardiovascular effects. Deterioration of tissue oxygen delivery resulted in oxygen supply-demand imbalance during CPPV. The results of this experimental study indicate that if ventilatory augmentation of subjects who require CPAP is desired, APRV will enhance alveolar ventilation without compromising circulatory function and tissue oxygen balance, whereas CPPV will impair cardiovascular function significantly. PMID- 3282823 TI - Efficacy and safety of two-year therapy with transdermal clonidine for essential hypertension. AB - We evaluated the safety and efficacy of transdermal clonidine (TC) in 23 patients with essential hypertension over a two-year period. Fourteen patients achieved control of blood pressure using TC alone. Six patients achieved control with a combination of TC and the diuretic chlorthalidone (CH). Three patients had control with CH alone or did not achieve control with either TC alone or TC plus CH and were dropped from the study. Of the 20 patients remaining in the study, six patients remained on TC or TC plus CH for the two-year study. Ten of the 20 patients quit the study because of skin reactions and four because of other side effects. No clinically significant changes were noted in serum or urinary laboratory parameters. Finally, TC was effective as long-term monotherapy for essential hypertension in only four of our patients. The major limitation is skin related side effects. PMID- 3282824 TI - Utility of airway endoscopy in the diagnosis of respiratory complications of cardiac transplantation. AB - We evaluated 39 episodes (in 32 patients) of pulmonary parenchymal infiltrates following cardiac transplantation with fiberoptic bronchoscopy (FOB) in a prospective study of 94 consecutive recipients. Initial FOB established the diagnosis in 24/39 (62 percent) instances. Subsequent examinations included repeat FOB (five), open lung biopsy (five), needle aspiration (two), and autopsy (nine), establishing 49 diagnoses. Specific pathogens were identified in 45 instances, neoplasm in two, and idiopathic interstitial pneumonitis in two. Bronchoalveolar lavage alone yielded diagnoses in 63 percent and transbronchial biopsy and bronchial washings/brushings in 46 and 43 percent, respectively. Transbronchial biopsy suggested idiopathic interstitial pneumonitis in 17 instances, but four had spontaneous clearing, and open lung biopsy or autopsy showed alternative diagnoses (particularly CMV and Aspergillus) in 11. The main complication of FOB was moderate (25 to 100 ml) hemorrhage after transbronchial biopsy (10 percent); no severe episodes occurred despite elevated pulmonary vascular pressures. In this population of immunocompromised hosts: (1) bronchoalveolar lavage is the most sensitive bronchoscopic technique for detecting infection; (2) transbronchial biopsy is not useful in detecting CMV or Aspergillus infection; (3) pulmonary hypertension is associated with some risk of moderate but not severe hemorrhage after transbronchial biopsy. PMID- 3282825 TI - Dietary supplementation and respiratory muscle performance in patients with COPD. AB - We studied the effects of oral nutritional supplementation on respiratory muscle (RM) performance in 25 ambulatory patients with severe chronic obstructive pulmonary disease (COPD). There was a relationship between body weight and anthropometric parameters of nutritional status (triceps skinfold thickness [r = 0.67; p less than 0.005], midarm muscle circumference (r = 0.53; p less than 0.005), but body weight did not correlate with daily caloric intake, serum albumin, transferrin, or blood lymphocyte count. None of these measurements of nutritional status correlated with any measure of RM strength or endurance. In a randomized observer-blinded crossover trial, patients were allocated to one of two groups. In the first eight weeks of the study, group A received nutritional supplementation, and patients in group B were control subjects. In the second eight weeks, patients in group A were control subjects, and group B received supplement. Mean daily caloric intake and body weight increased in both groups while receiving supplement (both p less than 0.05). Calories provided by the supplement were frequently substituted for normal dietary calories. Any increases in RM performance in the group receiving supplement were matched by increases (due to learning) in controls. We conclude that oral dietary supplements have no important effects on RM performance in ambulatory patients with COPD. PMID- 3282826 TI - Six-month double-blind, controlled trial of high dose, concentrated beclomethasone dipropionate in the treatment of severe chronic asthma. AB - A six-month double-blind controlled trial compared a 2,000 microgram per day dose of beclomethasone dipropionate aerosol (BDP), with current upper level doses of 800 micrograms per day of the standard BDP, in asthmatics requiring oral corticosteroids in addition to BDP and bronchodilators. Both groups showed a significant reduction in their oral steroid requirements during the study, with a 34 percent reduction in the lower dose group and a 57 percent reduction in the high dose BDP group while maintaining good symptomatic control of asthma; there was an associated improvement in baseline serum cortisol levels. Over the same period, the pulmonary function of the lower dose group showed significant worsening relative to that of the group receiving the high dose BDP which improved. There was no increase in dysphonia or oropharyngeal candidiasis among those using the concentrated BDP. We conclude that high dose concentrated BDP appears to be a safe medication in long-term steroid-dependent asthma, and is effective in reducing dependence on the use of oral corticosteroid with associated improvement both in pulmonary and adrenal function. PMID- 3282828 TI - [Biological effect of the thermal laser]. PMID- 3282829 TI - [Use of laser surgery on parenchymatous organs]. PMID- 3282827 TI - [Right-sided acute abdomen--ultrasonic diagnosis of a normal appendix]. PMID- 3282830 TI - [Principles of photodynamic laser therapy procedures]. PMID- 3282831 TI - Simple GATCA repeats characterize the X chromosomal heterochromatin of Microtus agrestis, European field vole (Rodentia, Cricetidae). AB - The sex chromosomes of Microtus agrestis are extremely large due to the accumulation of constitutive heterochromatin. We have identified two prominent satellite bands of 2.0 and 2.8 kb in length after HaeIII and HinfI restriction enzyme digestion of genomic DNA, respectively. These satellites are located on the heterochromatic long arm of the X chromosome as shown using Microtus x mouse somatic cell hybrids. By in-gel hybridization with oligonucleotide probes, the organization of the two satellites was studied: among the many copies of the simple tandem tetranucleotide repeat GATA are interspersed rare single GACA tetramers. One of the satellites also harbours related GGAT simple tandem repeats. In situ hybridizations with plasmid-carried or oligonucleotide GATCA probes show clustered silver grains on the long and short arm of the X chromosome. Interspersion of differently organized (GATA)n elements is also demonstrable in the autosomal complement and on the Y chromosome. These results are discussed in the context of the evolution of vertebrate sex chromosomes in relation to heterochromatin and simple repetitive DNA sequences. PMID- 3282833 TI - Cardiovascular disease in the elderly. AB - Cardiovascular disease is the major cause of death and disability in the elderly. Atherosclerotic coronary heart disease is the most prevalent problem, followed by hypertensive cardiovascular disease. Calcific aortic stenosis is the most common haemodynamically important valvular lesion; surgical correction significantly improves the prognosis. Pulmonary embolism occurs frequently, related to immobilization and co-morbidity. Congestive heart failure is both under-diagnosed and over-diagnosed. Complete heart block and sick sinus syndrome increase with age; appropriate pacemaker therapy can improve the length and quality of life. Clinical evaluation of elderly patients is often hampered by multiple co-existing disease involving other organ systems, problems in reporting symptoms, and associated functional and structural changes of ageing that may mimic or mask cardiovascular disease. Presentations of cardiac illness often differ from those in a younger population. Most of the available data on therapy and prognosis do not apply to contemporary practice, so that clinical decisions are often extrapolated from information acquired in younger patients. Elderly patients are at high risk of complications of most diagnostic and therapeutic procedures, more related to co-morbidity than to age; they have more frequent and serious adverse drug reactions, due both to co-morbidity and to multiple medications. Age as such should not constitute a barrier to cardiac care; in the USA at least one-third of all cardiovascular procedures are performed in elderly patients. The goals of therapy are improvement in function and postponement of debilitating illness, enabling an extended active independent lifestyle. PMID- 3282832 TI - DNase I sensitivity of Microtus agrestis active, inactive and reactivated X chromosomes in mouse-Microtus cell hybrids. AB - We isolated Microtus agrestis-mouse somatic cell hybrid clones which had retained either the active or the inactive M. agrestis X chromosome. In both hybrid clones the X chromosomes retained their original chromatin conformation as studied by the in situ nick translation technique--the active X chromosome retained its high sensitivity to DNase I while the inactive one remained insensitive. A clone in which the hypoxanthine guanine phosphoribosyltransferase (HPRT) gene had been spontaneously reactivated was isolated from the hybrid containing the inactive X chromosome. The in situ nick translation technique was used to study possible DNA conformation changes in the euchromatin of the inactive X chromosome with special reference to the reactivated HPRT locus. We found that the euchromatin in this X chromosome exhibited the same low sensitivity to DNase I as is characteristic of the inactive X chromosome. PMID- 3282834 TI - Osteoporosis and age-related fracture syndromes. AB - Osteoporosis is one of the most important age-related diseases. Each year in the United States it causes at least 1.2 million fractures and costs 7 to 10 billion dollars. The main cause of the fractures is increased bone fragility due to low bone density, although in the elderly an increase in the frequency of falls and in the trauma produced by the falls also contributes to fractures. Low bone density in osteoporosis has multiple causes which can be grouped into the categories of low initial bone mass and bone loss due to ageing, menopause, and sporadic factors. Given the magnitude of the problem, prevention is the only cost effective approach. Enough is known about causes of bone loss leading to osteoporosis that an effective programme of prevention can be designed. Its implementation in the population should substantially reduce the incidence of this major public health problem. PMID- 3282835 TI - Ageing and infection. AB - An increased morbidity and mortality due to infectious disease has been noted in the ageing. Two alternative explanations may account for this. Changes in the immune system and inflammatory responses with age or an increase in age-related diseases may underlie the increased susceptibility. A review of studies of healthy older individuals demonstrates changes in the immune system with ageing but minimal change in the inflammatory response. Investigations of severe infection in older nursing-home patients requiring hospitalization indicate that infection as a cause of admission and death is significantly more common in individuals who are bedridden because of serious cardiovascular or neurological disease and require urinary catheterization. The evidence indicates that underlying disease, not the senescence of host resistance, leads to severe infection in the ageing. PMID- 3282836 TI - Malignant disease and the elderly. AB - Most cancers are diseases of the ageing. Approximately 50% of all cancers occur among those over 65 and nearly 60% of all cancer deaths occur among the elderly. The cumulative risk of acquiring cancer among those aged 65-85 is 17% in females and 23% in males. Cancer incidence increases steadily as a function of age, reaching 23 per 1000 population among those aged 85 and older. Recent estimates of age-specific cancer prevalence rates for women over 70 were 106 per 1000 population and were 118 per 1000 population among men over 70. The rapidly shifting age distribution in most industrialized nations, including the growth of the 'old-old', means that the actual number of older people with cancer will increase at least in proportion to the ageing of the population. This trend will have an impact on the health-care system and may affect social norms regarding the treatment of elderly cancer patients. This paper reviews these trends and presents data from a series of research projects and the related literature to examine how older people respond to cancer symptoms and treatment and whether the treatment received by aged cancer patients differs from that given to younger patients. The relationship between age and stage of disease at presentation is explored, together with the manner in which older cancer patients' disease is identified, the 'aggressiveness' of treatment pursued, and patients' responses to those treatments. PMID- 3282837 TI - Questions in the psychiatry of old age. AB - The last ten to fifteen years have been a time of rapid development in the psychiatry of old age. Biological research on the dementias has moved forward impressively, but significant too has been the development in many countries of local services specially designed to meet the needs of old people with mental disorders, and of those who look after them. Such services are built on the experience both of psychiatry and of geriatrics, but have also broken new ground: the UK experience is described. The facts have belied earlier misgivings about the potential of this field of work to attract and satisfy able staff in the health professions; indeed, this work has developed with style and enthusiasm, and with widespread educational programmes and growing research activity. This paper reviews briefly these developments and considers some broader issues of policy as they bear on the care of mentally ill old people. Considered also is tentative evidence that the dementias of old age may be becoming less prevalent. Finally, current studies in Nottingham which look at the social associations of old age mental disorders are briefly described and the implications are considered of the broadening of the base of 'psychogeriatrics' which such studies represent. PMID- 3282838 TI - Acousto-optic laser-scanning cytometer. AB - An instrument has been developed that uses a computer-controlled rapidly scanning laser beam to make cytometric measurements on cells or particles and which can measure low levels of fluorescence when using low-power lasers (Gershman, Hoffman, and O'Connell, "Methods and Apparatus for Analysis of Particles and Cells.") The method used is based upon acousto-optic principles of light diffraction. A vertically polarized 5-mW He-Ne laser is directed into an acousto optic Bragg cell in which a portion of the incident light undergoes a small angular variation or deflection. Suitable optics focus the beam to a 25 microns diameter spot, at the 1/e2 point, in a sample cuvette while translating the angular variation into a linear scan. The cuvette enclosing the sample is slowly moved (approximately 1 micron/ms) via a stepper drive into the scanning beam while the forward angle light scatter sensor is monitored for the presence of valid signal events. When an event occurs, appropriate software optimizes the position of the focused laser beam onto the cell. Subsequently, scanning is stopped to allow for cell interrogation times that last for milliseconds or longer. PMID- 3282839 TI - Piles of defeat. Napoleon at Waterloo. AB - Major events of history have frequently turned on seemingly trivial matters. One such situation involves Napoleon Bonaparte at Waterloo. Napoleon was not feeling well on the day of the battle of Waterloo, despite fighting well at Ligny, a few days before the last, dramatic June 18 battle. There is considerable indication that Napoleon was bothered by very painful thrombosed hemorrhoids. Did this affect his generalship that day? What is the evidence that Napoleon was afflicted with thrombosed hemorrhoids? What contribution could this factor have made to the French defeat at Waterloo? PMID- 3282840 TI - Occult gastrointestinal carcinoma causing metastatic clostridial soft-tissue infection. Report of two cases. AB - The association between nontraumatic, metastatic, clostridial soft-tissue infection and malignancy is well recognized, particularly when Clostridium septicum is involved. This report presents two patients with nontraumatic, metastatic, soft-tissue infection due to C. septicum and reviews the English medical literature. Eighty-four percent of the reported patients were found to have colon carcinoma, which was postulated to be the portal of entry. Prognosis is poor, but early recognition and antimicrobial therapy with prompt and aggressive surgical intervention, both for the soft-tissue infection and the abdominal process, may lower the high mortality. PMID- 3282841 TI - Primary perianal actinomycosis. Report of a case and review of the literature. AB - A case of primary perianal actinomycosis presenting as recurrent perianal abscesses is reported. Although this is a rare presentation of actinomycosis, it is easily recognized when encountered and should be treated with surgical drainage, examination under anesthesia, and long-term antibiotic therapy. PMID- 3282842 TI - Spontaneous isolated mesenteric fibromatosis. Report of a case. AB - A rare case of spontaneous isolated mesenteric fibromatosis (mesenteric desmoid) unassociated with Gardner's syndrome or prior abdominal surgery is presented. Computed tomography revealed a nonenhancing, well-defined, large, soft-tissue mass in the mesentery. The clinical and radiographic features of mesenteric fibromatosis are reviewed and the differential diagnosis is discussed. PMID- 3282843 TI - Adenosquamous-cell carcinoma in ulcerative colitis. Report of a case. AB - Three adenosquamous carcinomas and 2813 adenocarcinomas of the colon proximal to a line 7 cm craniad to the dentate line were treated between 1946 and 1986. Of these, one adenosquamous carcinoma and 42 adenocarcinomas were associated with ulcerative colitis. Therefore it was calculated that adenosquamous carcinoma occurs 0.07 percent as frequently as adenocarcinoma of the colon in the general hospital population and 2.4 percent as frequently in patients with ulcerative colitis, a 33-fold increase. It is concluded that, although adenosquamous-cell carcinoma of the colon is a rare tumor, its frequency in relation to adenocarcinoma increases in the presence of ulcerative colitis. PMID- 3282844 TI - Edmund Andrews 1824-1904. The treatment of hemorrhoids by injection. PMID- 3282845 TI - Abdominal tuberculosis. PMID- 3282846 TI - Omeprazole (40 mg) is superior to ranitidine in short-term treatment of ulcerative reflux esophagitis. AB - The efficacy and safety of omeprazole, 40 mg once daily for four to eight weeks of treatment, were studied in 61 patients with ulcerative reflux esophagitis. A double-blind controlled study design was used, and the patients were randomly allocated to treatment with either omeprazole 40 mg once daily or ranitidine 150 mg twice daily. Endoscopy was performed prior to inclusion into the study, after four weeks and, if unhealed, again after eight weeks. Healing of esophagitis was defined as complete disappearance of all esophageal ulcerations. Symptoms were recorded before entry, after four weeks, and again after eight weeks in unhealed patients. Fifty-one patients were included in the per-protocol analysis at day 29, and 50 patients at day 57. The healing rate after four weeks of treatment was 22 of 26 patients (85%) treated with omeprazole and 10 of 25 patients (40%) treated with ranitidine (P less than 0.001). The corresponding figures after eight weeks were 24 of 25 (96%), and 13 of 25 (52%) (P less than 0.001). These results were confirmed in the intent-to-treat analysis. Patients treated with omeprazole showed a significantly faster and more profound relief in heartburn than patients treated with ranitidine: 85% had no heartburn after four weeks of treatment with omeprazole compared to 24% in patients treated with ranitidine (P = 0.00007). The percentage of patients who were free of all reflux symptoms was significantly greater in the omeprazole-treated group as compared to the ranitidine-treated group (62% and 12% respectively; P = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282847 TI - Effect of nifedipine on gastric emptying and gastrointestinal motility in man. AB - Nifedipine, a calcium-blocking agent, inhibits smooth muscle contractions in various organs including gastric muscle in vitro. Despite this, nifedipine has been found to have no effect on gastric emptying in man. We have investigated the effect of nifedipine on gastric emptying of liquids and solids and on gastrointestinal motility in six healthy subjects. For this, isotopic techniques and manometric methods were used. We confirm that nifedipine 30 mg per os does not modify gastric emptying of liquids or solids. By contrast, antral motility was significantly inhibited (P less than 0.05) and duodenal motility increased. These results could be interpreted as (1) gastroduodenal motility changes are not severe enough to alter emptying or (2) isotopic techniques are not sensitive enough to detect subtle changes in gastric emptying. PMID- 3282848 TI - Gallbladder contraction and its relationship to interdigestive duodenal motor activity in normal human subjects. AB - Gallbladder volume and interdigestive gastric and duodenal motor activity were evaluated simultaneously in 12 normal subjects. After overnight fasting, gallbladder volume was monitored every 4 min in each subject by means of real time ultrasonography, and gastroduodenal motor activity was measured by means of a probe consisting of three polyvinyl catheters with one side opening for each catheter, placed 15 cm apart and constantly perfused with deionized water. Real time ultrasonography and intestinal manometry were performed by different investigators and continued until at least two consecutive spontaneous phase III activities of migrating motor complexes were observed. The results show a cyclic variation of gallbladder volume, which reached its minimum value before the end of phase II in the proximal duodenum and its maximum in early phase II, 25 min after the beginning of phase III. These results suggest that there is a relationship between the cyclic gallbladder volume changes, which occur during fasting in humans, and with the various phases of duodenal migrating motor complex. PMID- 3282849 TI - Comparative studies on immunoglobulins, complement component (C3), albumin, and immunoglobulin A-containing circulating immune complexes in serum and bile of patients with biliary obstruction. AB - We measured the concentrations of IgA, IgG, IgM, secretory IgA, albumin, complement component (C3), and IgA-containing circulating immune complex (IgA CIC) in the serum and bile of patients with biliary obstruction. The bile-to serum (BS) ratio of the concentrations of albumin and IgG increased with the increase in total serum bilirubin. This indicates that the permeability from blood to bile increases with the degree of biliary obstruction, and the blood bile barrier function breaks down. The BS ratios of IgA and IgM, which are selectively secreted into bile, did not show a significant correlation with total serum bilirubin. The index of the BS ratio to the BS ratio of albumin (BS/BS-Alb index) of IgA and IgM was significantly larger than that of IgG. This indicates that the selective transport of IgA and IgM into bile is present even in patients with obstructive jaundice. Since the BS/BS-Alb index of C3 is larger than that of IgG, and the SGOT correlated directly with the BS ratio of C3, some of the C3 in bile may come from damaged hepatocytes. PMID- 3282851 TI - Magnesium metabolism in health and disease. AB - Magnesium is an important element for health and disease. Magnesium, the second most abundant intracellular cation, has been identified as a cofactor in over 300 enzymatic reactions involving energy metabolism and protein and nucleic acid synthesis. Approximately half of the total magnesium in the body is present in soft tissue, and the other half in bone. Less than 1% of the total body magnesium is present in blood. Nonetheless, the majority of our experimental information comes from determination of magnesium in serum and red blood cells. At present, we have little information about equilibrium among and state of magnesium within body pools. Magnesium is absorbed uniformly from the small intestine and the serum concentration controlled by excretion from the kidney. The clinical laboratory evaluation of magnesium status is primarily limited to the serum magnesium concentration, 24-hour urinary excretion, and percent retention following parenteral magnesium. However, results for these tests do not necessarily correlate with intracellular magnesium. Thus, there is no readily available test to determine intracellular/total body magnesium status. Magnesium deficiency may cause weakness, tremors, seizures, cardiac arrhythmias, hypokalemia, and hypocalcemia. The causes of hypomagnesemia are reduced intake (poor nutrition or IV fluids without magnesium), reduced absorption (chronic diarrhea, malabsorption, or bypass/resection of bowel), redistribution (exchange transfusion or acute pancreatitis), and increased excretion (medication, alcoholism, diabetes mellitus, renal tubular disorders, hypercalcemia, hyperthyroidism, aldosteronism, stress, or excessive lactation). A large segment of the U.S. population may have an inadequate intake of magnesium and may have a chronic latent magnesium deficiency that has been linked to atherosclerosis, myocardial infarction, hypertension, cancer, kidney stones, premenstrual syndrome, and psychiatric disorders. Hypermagnesemia is primarily seen in acute and chronic renal failure, and is treated effectively by dialysis. PMID- 3282850 TI - The treatment of gastric ulcer with antisecretory drugs. Relationship of pharmacological effect to healing rates. AB - Published clinical trials (N = 56) of antisecretory drugs in the treatment of benign gastric ulcer were reviewed. Composite healing rates for various drug regimens were calculated using a method previously described for duodenal ulcer. Healing rates were compared with data on suppression of intragastric acidity to see if any relationship was evident. No significant correlations between the two existed, unless placebo data were included in the analysis. Correlations were stronger with suppression of total 24-hr rather than nocturnal acidity. Using Williams' method for assessing trends, it was found that an increase in antisecretory effect is not associated with a concomitant increase in healing rates. Duration of medical treatment is the single most important factor in healing of benign gastric ulcer; healing rates for all drug regimens and placebo show a consistent increase with prolongation of treatment. PMID- 3282852 TI - Regulated secretion of MuGM-CSF in Saccharomyces cerevisiae via GAL1:MF alpha 1 prepro sequences. AB - Murine granulocyte-macrophage colony-stimulating factor (GM-CSF) was expressed in Saccharomyces cerevisiae using a novel regulated secretion system. This system involves the fusion of the GAL1 upstream regulatory region to the signal sequence of the alpha mating pheromone, and the integration of this GAL1:MF alpha 1 prepro:MuGM-CSF construct into the yeast chromosome. These constructs were very stable under both selective and nonselective conditions: after 30 generations of growth no plasmid loss was observed. The expression and secretion of MuGM-CSF were analyzed by biological assays and Western blots of yeast culture medium and yeast cell extracts. Expression of MuGM-CSF was regulated by galactose induction. In addition, expression levels were proportional to the number of tandem copies of the gene inserted into the yeast chromosome. PMID- 3282853 TI - A simple and efficient procedure for generating random point mutations and for codon replacements using mixed oligodeoxynucleotides. AB - A very simple and highly efficient procedure for the generation of single and multiple substitutions in segments of DNA is described which has no requirements for conveniently placed restriction sites, and allows all DNA sequences to be equally accessible. A mixed pool of oligodeoxynucleotides is synthesized by contaminating the monomeric nucleotides with low levels of the other three nucleotides such that the full-length oligonucleotide contains on the average one to two changes per molecule. This pool is used in priming in vitro synthesis of the complementary strand of cloned DNA fragments in M13 or pEMBL vectors which have previously been passed through a dut-, ung- Escherichia coli host. Strong selection for the newly synthesized strand is provided by transforming the heteroduplex into a dut+, ung+ host. Single and multiple substitutions in the carboxy-terminal coding region of the MATa1 gene of Saccharomyces cerevisiae are introduced at high efficiency (25-55%) and the changes are identified by direct sequencing alone. The same principle can be used to generate multiple sets of changes at any specified codon. PMID- 3282855 TI - Glycosylation and processing of high levels of active human glucocerebrosidase in invertebrate cells using a baculovirus expression vector. AB - A human cDNA containing the complete coding region for the lysosomal glycoprotein glucocerebrosidase (EC 3.2.1.45) was introduced into the genome of Autographa californica nuclear polyhedrosis virus downstream from the polyhedrin promoter. Infection of Spodoptera frugiperda cells (SF9) with recombinant virus produced high levels of glucocerebrosidase, 40% of which was in the culture medium. The amino-terminal amino acid sequence of the recombinantly produced enzyme was identical to that of mature, human placental glucocerebrosidase, demonstrating that the signal sequence of the human preenzyme was recognized and appropriately removed in the SF9 invertebrate cells. The glucocerebrosidase in both the culture supernatant and SF9 cell pellet was glycosylated and contained, in part, high mannose oligosaccharide. These results demonstrate that insect cells can be used to produce abundant quantities of active mature human glucocerebrosidase that contains high mannose oligosaccharide as a consequence of post-translational processing. PMID- 3282854 TI - A second antigenic heat shock protein of Plasmodium falciparum. AB - We describe here an antigen of Plasmodium falciparum, defined by a cDNA clone designated Ag361. The antigen is a soluble cytoplasmic 70-kD polypeptide present in all isolates analyzed and in all stages of asexual development in the blood. The antigen is a natural immunogen, although it lacks repeating epitopes of many P. falciparum antigens. Ag361 shares extensive sequence homology with the hsp70 proteins of Xenopus laevis, Drosophila melanogaster, Escherichia coli, and man, as well as a previously isolated P. falciparum hsp70 protein. The genome of P. falciparum contains at least five hsp70-like genes, located on at lest four different chromosomes. PMID- 3282856 TI - Insulin binding to circulating monocytes in children with insulin-dependent and non-insulin-dependent diabetes mellitus. AB - This study describes insulin binding to circulating monocytes in 24 children with insulin-dependent diabetes mellitus (IDDM), five children with non-insulin dependent diabetes mellitus (NIDDM), and 10 healthy and 12 obese control children. Insulin binding to monocytes was greatly increased in untreated IDDM children with obvious ketoacidosis (5.51 +/- 3.49 vs. 1.91 +/- 0.47 pg/10(6) cells, P less than 0.01), whereas it was decreased in those without obvious ketoacidosis (1.39 +/- 0.30 vs. 1.91 +/- 0.47 pg/10(6) cells, P less than 0.01). Insulin treatment restored insulin binding almost to the level of control children in both ketoacidotic and non-ketoacidotic patients. Insulin binding to monocytes was markedly decreased in untreated NIDDM children with hyperinsulinemia compared with healthy control children (0.73 +/- 0.27 vs. 1.91 +/- 0.47 pg/10(6) cells, P less than 0.01) or obese control children (0.73 +/- 0.27 vs. 1.33 +/- 0.35 pg/10(6) cells, P less than 0.01). These data indicate that changes in insulin secretion and metabolic conditions might be involved in the fluctuation of the number of insulin receptors in IDDM children as well as in NIDDM children. PMID- 3282857 TI - [Diagnosis of deep leg vein thromboses by real-time sonography]. AB - Real-time ultrasonography was performed on both legs of 104 patients with suspected deep-vein thrombosis of the legs. The results were compared with those of phlebography (146 one-extremity phlebograms) independently performed. During the first part of the study (69 individual phlebograms) only the upper leg and popliteal region were assessed: absent compressibility of the vessel lumen was the only criterion of thrombosis. In the second part (77 phlebograms) the lower leg was also investigated: non-compressible, echo-poor vessels were typical of thrombosis. Phlebography demonstrated 21 thromboses of the common femoral vein, 36 of the superficial femoral vein, and 41 of the popliteal vein. The 77 phlebograms in the second part demonstrated 29 thromboses of the deep veins of the lower leg. Sonography had a sensitivity of 100% and a specificity of 99% for the region of the common femoral vein, 95% and 99%, respectively, for the superficial femoral vein, 95% and 99% for the popliteal vein and 89% and 100% for the deep veins of the lower leg. Real-time ultrasonography of the deep-vein system of the leg is thus of great diagnostic value both for the upper and the lower leg and is very useful as the initial physical method of examination if thrombosis is suspected. PMID- 3282858 TI - [Diagnosis of hypothyroidism in old age]. PMID- 3282859 TI - [Trained skeletal musculature as a heart muscle substitute. A new therapeutic concept]. PMID- 3282860 TI - [Endoscopic sonography of the upper gastrointestinal tract. An experimental technic or a clinically important method?]. PMID- 3282861 TI - [Primary hyperparathyroidism with acute pancreatitis during pregnancy]. AB - During her second pregnancy a 27-year-old woman had recurrent acute pancreatitis, in the course of which primary hyperparathyroidism was diagnosed. After regression of the acute signs and under conservative treatment a parathyroid tumour was removed in the 26th week of pregnancy. Comparison of surgical and conservative treatment of primary hyperparathyroidism during pregnancy has indicated that the risk of complications in the neonate is much lower after surgical removal of the adenoma than with an attempt to postpone by symptomatic drug treatment the parathyroidectomy until after delivery. PMID- 3282862 TI - [Surgical therapy of cardial carcinoma]. PMID- 3282863 TI - [Combination therapy with insulin and sulfonylurea]. PMID- 3282864 TI - [Sonographically guided punctures in the abdominal space]. PMID- 3282865 TI - [Fluoroquinolone. 2. Pharmacokinetics and clinical use]. PMID- 3282866 TI - Symposium on therapeutic aspects of tiaprofenic acid. PMID- 3282867 TI - Multicentre double-blind comparison of sustained action formulations of tiaprofenic acid and indomethacin in osteoarthritis. AB - In a randomised double-blind, multicentre, crossover study, the short term efficacy and tolerance of a sustained action preparation of tiaprofenic acid 600 mg once daily was compared with sustained release indomethacin 75 mg once daily in 98 patients with osteoarthritis. After a minimum washout period of 3 days, patients were randomly allocated to receive each treatment in turn for a period of 4 weeks. There were no significant differences between the 2 treatments in the clinical assessments of pain level, duration of morning stiffness, articular index and functional impairment performed at the end of each treatment period. High pain levels on movement were reduced by both treatments, and reduction was also seen in night pain, where initial levels were lower. There was no significant difference between the number of patients who reported side effects on the 2 treatments. 37 patients (39%) reported 49 side effects while taking sustained release tiaprofenic acid, and 35 patients (37%) reported 53 side effects while taking sustained release indomethacin. Daily diary cards showed that both treatments provided improvements in duration of morning stiffness and in pain relief. Thus sustained action tiaprofenic acid and sustained release indomethacin were shown to be equally well tolerated and efficacious. PMID- 3282868 TI - Comparative double-blind study of tiaprofenic acid versus piroxicam in the treatment of osteoarthritis of the knee. AB - A double-blind, parallel-group study was carried out to compare the clinical efficacy and tolerance of tiaprofenic acid and piroxicam in 80 patients suffering from osteoarthritis of the knee. Tiaprofenic acid was administered orally at a dosage of 900 mg daily for 14 days and piroxicam at a dosage of 40 mg daily. The following parameters were assessed: spontaneous morning pain; spontaneous night pain; pain during walking; pain on passive mobilisation; pain on squatting; morning stiffness; duration of morning stiffness; local inflammatory signs; and overall mobility of the joint. All these parameters were evaluated before treatment started and at days 7 and 14. At the end of the study, the physician made an overall assessment, and the results were statistically evaluated. The results showed that in both groups of patients, the signs and symptoms improved significantly from the seventh day of the trial, but there were no significant differences between the 2 groups for any of the assessed parameters. However, the physician's overall assessment was in favour of tiaprofenic acid due to a greater number of important improvements. PMID- 3282869 TI - Comparison of injectable formulations of tiaprofenic acid and ketoprofen in acute lumbar sciatica. Single-blind randomised trial. PMID- 3282870 TI - Is tiaprofenic acid different from other NSAIDs with regard to effects on renal function in the elderly? AB - In a study of the effects of various NSAIDs on renal function in the elderly, indomethacin, tiaprofenic acid and sulindac were administered to patients ranging in age from 54 to 97 years for a period of 3 months. Indomethacin sustained release (25 mg tid) was administered to 66 patients, tiaprofenic acid (200 mg tid) to 54 patients, and sulindac (100 mg tid) to 59 patients. A control group, to whom no NSAIDs were administered, comprised 60 patients. Renal function before and after NSAID administration was compared, the parameters investigated being blood urea nitrogen (BUN), serum creatinine (SCR), and serum beta 2-microglobulin (beta 2-m) concentrations. Patients whose levels of BUN, SCR and beta 2 microglobulin were all within normal ranges at the beginning of the study were considered to have 'normal' renal function; those who showed an abnormal value for at least 1 of the 3 parameters were considered to have 'abnormal' renal function. The administration of indomethacin resulted in a significant increase in the serum creatinine concentration, and in the normal renal function subgroup, a significant increase in BUN. Sulindac administration resulted in a significant increase in BUN and beta 2-microglobulin concentrations, but no significant change in serum creatinine. In comparison, the administration of tiaprofenic acid resulted in no significant changes in any of 3 parameters. An additional study of the effects of 4 weeks' administration of the same NSAIDs on N-acetyl-beta-D glucosaminidase concentrations in the urine of elderly patients revealed no significant changes with any of the 3 drugs. This suggests that the drugs do not damage the proximal tubules. PMID- 3282872 TI - Orchidectomy induces temporal and regional changes in the processing of the luteinizing hormone-releasing hormone prohormone in the rat brain. AB - The structures of the complementary DNA (cDNA) that encode the rat and human hypothalamic LHRH prohormones were recently determined and the corresponding amino acid sequences deduced. In addition to the LHRH decapeptide, the prohormone contains a 56-amino acid peptide sequence which has been designated gonadotropin releasing hormone associated peptide (GAP). In the present study we examined the effect of orchidectomy on LHRH prohormone processing in three brain regions known to contain the various elements of the LHRH neuronal system; the preoptic anterior hypothalamic area, the hypothalamus (HYP), and the median eminence. Both LHRH-like and GAP-like immunoreactivities (LHRH-LI and GAP-LI) were quantitated in these regions in intact male rats and male rats orchidectomized for 1, 2, 3, 5, 7, 14, or 40 days. In addition, the LHRH and GAP immunoreactivities were localized and the effects of orchidectomy examined using immunocytochemical techniques. One day after orchidectomy, a small decrease in GAP-LI and an increase in LHRH-LI were evident in extracts of the preopticanterior hypothalamic area which resulted in a significant decrease in the GAP/LHRH molar ratio. A similar selective decrease in GAP-LI and in the GAP/LHRH molar ratio was also observed in extracts of the HYP, but not until 2 days after orchidectomy. The GAP/LHRH ratio in both regions gradually returned to that of the intact controls. In both the HYP and median eminence, GAP-LI and LHRH-LI gradually declined in parallel through 14 days after orchidectomy. The gradual loss of immunoreactivity in these regions was evident by both RIA quantification and immunocytochemistry. These observations suggest that 1) production and processing of both LHRH and its prohormone are affected by testicular factors, 2) that divergent enzyme and/or transport systems, regulating LHRH and GAP processing, may exist at the level of the perikarya, and 3) long term orchidectomy results in decreased biosynthesis of the prohormone and/or in parallel increases in LHRH and GAP degradation or transport. PMID- 3282871 TI - Ligand-induced changes in insulin receptors in cell surface and Golgi fractions of fetal rat liver. AB - The studies described in this paper were undertaken to characterize the insulin receptors present in the plasma membranes and Golgi fractions of fetal rat liver and to determine their subcellular distribution after the administration of exogenous insulin. Purification patterns of both types of liver membranes from fetal and adult rats were similar, as verified by morphological and biochemical approaches. In both groups insulin binding was significantly greater in plasma membranes than in Golgi fractions. However, in plasma membranes insulin binding was similar in both groups, while in Golgi fractions it was greater in fetal than in adult rats, although the difference was not statistically significant. The modifications in insulin binding reflect changes in the number of receptors, but not in the affinity constants. The time courses of insulin association and dissociation from liver membranes were unaffected by development. Degradation of insulin by liver membranes was lower in fetal than in adult rats, although this does not seem to be responsible for the differences observed in binding. No significant differences in the degradation of insulin receptors between different groups of liver membranes were found. The effects of a single injection of insulin on the subcellular distribution of insulin receptors in liver were examined. Insulin administration to adult rats resulted in a marked decrease in insulin binding in liver plasma membranes but a significant increase in Golgi fractions, occurring within 1.5 min. By contrast, in 21-day-old fetuses insulin injection slightly increased insulin binding to liver plasma membranes at 15 min, while in Golgi fractions an increase in insulin binding was only observed 30 min after insulin injection. These findings suggest that the slow ligand-induced translocation of the insulin receptor from the cell surface to Golgi fractions in the fetus might explain the absence of insulin receptor down-regulation in fetal hepatocytes. PMID- 3282873 TI - Insulin as a regulator of androgen biosynthesis by cultured rat ovarian cells: cellular mechanism(s) underlying physiological and pharmacological hormonal actions. AB - It is the objective of the in vitro studies reported herein to further evaluate the role of insulin in the regulation of ovarian androgen biosynthesis, to assess its dose requirements, and to elucidate the cellular mechanism(s) underlying its high dose action. To this end, use was made of recently developed primary culture systems of ovarian androgen-producing cells, the differentiation of which is subject to regulation by gonadotropic and insulinotropic signaling. Treatment of collagenase-processed whole ovarian dispersates or highly enriched (greater than 90%) thecal-interstitial cells from immature rats with insulin (1 microgram/ml) or hCG (1 ng/ml), resulted in 1.5- and 2.6-fold increments in the accumulation of androsterone (3 alpha-hydroxy-5 alpha-androstan-17-one), the main androgenic steroid identified in culture medium by HPLC. However, combined treatment with both agents unmasked a synergistic interaction resulting in 5.7-fold amplification of hCG action, the increase in androsterone accumulation representing enhanced biosynthesis rather than diminished degradation. Unaccounted for by cellular growth and independent of the cellular density of plating (1 X 10(4)-1 X 10(6) viable cells/culture) or the hCG dose (0.1-10 ng/ml) employed, the insulin effect proved time and dose dependent with a minimal time requirement of 72 h. [125I-TyrA14]Iodoinsulin binding to untreated highly enriched thecal-interstitial cells proved highly specific, saturable, and reversible, displaying a single class (Hill coefficient = 0.93 +/- 0.07) of high affinity (Kd = 1.7 X 10(-10) M), low capacity (4746 +/- 283 sites/cell) binding sites. Treatment with physiological concentrations (10 ng/ml) of insulin produced limited, albeit measureable, down-regulation of the insulin receptor. In contrast, provision of relatively high concentrations (1 microgram/ml) of insulin resulted (despite marked adsorption/degradation) in substantial (greater than 60%) down-regulation of the insulin receptor, but not the type I insulin-like growth factor receptor, the ligand of which has also been shown to amplify hCG supported androgen biosynthesis. These findings suggest that the thecal interstitial cell is a site of insulin reception and action, that physiological concentrations of insulin are capable of participating in the regulation of ovarian androgen biosynthesis, and that this effect is probably mediated via high affinity insulin receptors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3282874 TI - Role of insulin in growth hormone-stimulated 3T3 cell adipogenesis. AB - The role of insulin during GH-stimulated adipogenesis of 3T3-F442A fibroblasts was investigated. Adipogenesis in defined medium (DM), as quantified by the level of glycerol-3-phosphate dehydrogenase activity, revealed that there existed a strict requirement for both insulin and GH during adipogenesis. The concentration of insulin required to elicit half-maximal adipogenesis was approximately 20 nM. Insulin-like growth factor I was less effective than insulin in promoting adipogenesis, indicating that insulin action during differentiation was most likely mediated through the insulin receptor. Cellular viability was not compromised by the absence of insulin, as judged by colony-forming efficiency or trypan blue exclusion. Deletion of insulin from DM supplemented with 1 nM recombinant human GH reduced glycerol-3-phosphate dehydrogenase activity to uninduced levels. Removal of other individual DM constituents did not have this effect. The growth factors fibroblast growth factor, platelet-derived growth factor, and bombesin did not substitute for insulin during GH-stimulated adipogenesis. The characteristic increase in cell number observed during serum based differentiation, reflecting clonal expansion of young adipocytes, did not occur in DM supplemented with insulin, and insulin-like growth factor I were necessary for this event. These results suggest that insulin functions in concert with GH as a coinducer of the differentiating signals. PMID- 3282875 TI - Insulin and insulin-like growth factors stimulate deoxyribonucleic acid synthesis in PC12 pheochromocytoma cells. AB - The effects of insulin and insulin-like growth factors (IGFs) on the replication of PC12 pheochromocytoma cells were investigated. Incubation of PC12 cells for 2 3 days in low (0.3%) serum medium decreased [3H]thymidine incorporation into PC12 cell DNA to approximately 30% of that in control (15% serum) medium. Incubation of the cells in low serum medium also slowed the growth of the cultures and increased the percentage of cells in the G0/G1 phase of the cell cycle. Addition of insulin to cells in low serum medium increased [3H]thymidine incorporation into the cells, increased the number of cells in PC12 cultures, and decreased the percentage of cells in the G0/G1 phase of the cell cycle. IGF-I and IGF-II also increased [3H]thymidine incorporation into PC12 cells incubated in low serum medium. IGF-I (EC50, approximately 0.3 nM) was a more potent stimulus of [3H]thymidine incorporation than was insulin (EC50, approximately 3.5 nM). These data suggest that insulin and IGFs are growth factors for PC12 cells, and that the growth-promoting effects of these agents may be mediated by a type I IGF receptor on PC12 cells. PMID- 3282876 TI - Muscarinic control of pancreatic B cell function involves sodium-dependent depolarization and calcium influx. AB - Mouse pancreatic islets were used to investigate the mechanisms and functional significance of the B cell membrane depolarization by acetylcholine (ACh). At low glucose (3mM), ACh (20 microM) increased 22Na+ influx, and slightly depolarized the B cell membrane but did not induce electrical activity or stimulate 45Ca2+ influx. ACh also accelerated 86Rb+ and 45Ca2+ efflux and barely affected basal insulin release. At a stimulatory concentration of glucose (10 mM), ACh stimulated 22Na+ influx, depolarized the B cell membrane, increased glucose induced electrical activity, and stimulated 45Ca2+ influx. ACh also accelerated 86Rb+ and 45Ca2+ efflux and strongly potentiated insulin release. Omission of extracellular Ca2+ did not impair ACh stimulation of 22Na+ influx or 86Rb+ efflux, slightly modified the acceleration of 45Ca2+ efflux, and almost completely suppressed the increase in insulin release. Na+ omission (with N methyl-D-glucamine as substitute) prevented the B cell membrane depolarization and the stimulation of 45Ca2+ influx, largely inhibited the acceleration of 86Rb+ efflux and insulin release, and suppressed the late phase of 45Ca2+ efflux otherwise produced by ACh. On the other hand, ACh stimulation of 3H efflux from islets prelabeled with myo-[2-3H]inositol was not affected by Na+ omission. All effects of ACh were blocked by atropine and unaffected by nicotinic antagonists. It is concluded that activation of muscarinic receptors depolarized the B cell membrane by increasing its permeability to Na+. When the membrane is already depolarized by glucose, this further depolarization augments Ca2+ influx and, hence, potentiates insulin release. PMID- 3282877 TI - Progesterone augments copper-prostaglandin E2 stimulation of the release of gonadotropin-releasing hormone from explants of the median eminence of immature female rats: an estrogen-dependent process. AB - We have previously shown that extracellular copper (Cu) amplifies prostaglandin E2 (PGE2) stimulation of LHRH release from explants of the median eminence area (MEA) of adult male rats, and that amplification is a post-PGE2 receptor event involving the adenylate cyclase system. We addressed the question: Is the process of Cu-amplified PGE2 stimulation of LHRH release regulated by ovarian steroids and, if so, is the regulatory steroid estrogen and/or progesterone? Immature female rats (30-32 days old) were ovariectomized and 6 days later treated with a combination of these steroids: E, sc implant of 17 beta-estradiol in a Silastic capsule for 3 days; EEi, E plus im injection of 17 beta-estradiol (2 micrograms/rat) 24 h before killing; and P, either im injection of 0.08 mg/kg progesterone 1 h before killing or 10(-9) M P included in the incubation buffer starting 1 h before Cu/PGE2 exposure. Controls were treated with the vehicle. MEAs were incubated for 5 min with 150 microM Cu, for 15 min with 10 microM PGE2, and then for 45 min with buffer (Cu/PGE2); LHRH release into the medium was measured by RIA. Cu/PGE2-stimulated LHRH release from MEA of intact rats was about 10 times greater than basal release. Ovariectomy led to a 50% reduction in Cu/PGE2-stimulated release [sham, 20.6 +/- 2.0 (mean +/- SE); ovariectomized, 9.4 +/- 1.8], pg/30 mm/MEA; and neither E, EEi, nor P significantly altered this response. In contrast, administration of P to either E- or EEi-primed rats augmented Cu/PGE2 stimulation of LHRH release 3.5-fold (E vs. EP or EEi vs. EEiP); however, P did not augment stimulation of LHRH release by Cu alone or PGE2 alone. Also, inclusion of P in the incubation buffer was as effective as in vivo P in augmenting Cu/PGE2 stimulation of LHRH release from the MEA of EEi-primed rats. On the other hand, in vitro P by itself did not alter LHRH release. These effects of P on the response of the MEA to Cu/PGE2 were not accompanied by a significant increase in the MEA content of LHRH. The process of Cu/PGE2 stimulation of LHRH release is regulated by ovarian steroids, so that ovariectomy leads to a marked reduction of the response of the MEA to Cu/PGE2, and P augments this response in an estrogen-dependent manner. Moreover, it is the secretory process elicited by the combined effects of Cu and PGE2 that is augmented by P.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3282878 TI - Evidence that hypothalamic neuropeptide Y secretion decreases in aged male rats: implications for reproductive aging. AB - The decrease in circulating testosterone and LH titer that occurs in aged male rats may in part be a consequence of decreased excitatory neurochemical signals that promote the episodic discharge of LHRH from the hypothalamus. In view of evidence that neuropeptide Y (NPY) stimulates the release and potentiates the action of LHRH on LH secretion, the present studies investigated age-related changes in the concentrations of NPY in individual hypothalamic nuclei and in the ability of hypothalamic tissues to release NPY in vitro. Compared with tissues of 2.5-month-old male rats, medial basal hypothalamic tissues of 13-month-old rats released significantly less NPY in response to K+ depolarization. In contrast, K+ evoked LHRH release from the same tissues was unimpaired. Aged male rats also exhibited markedly reduced concentrations of NPY in the median eminence and in the arcuate, medial preoptic, suprachiasmatic, paraventricular, dorsomedial, and ventromedial hypothalamic nuclei, which are sites of NPY perikarya and nerve terminal networks. These neurochemical changes occurred in association with decreased serum testosterone and LH levels. These findings demonstrate a widespread age-related decline in NPY levels and release in the hypothalamus, which may be responsible for the reduction in testosterone secretion and may contribute to the decline in reproductive function in aged male rats. PMID- 3282879 TI - Insulin-like effects of vanadate in isolated rat adipocytes. AB - Vanadate has been shown to have a number of insulin-like effects in various cells, including isolated rat adipocytes. In the present study we compared the activities of vanadate and insulin in isolated fat cells using a number of different assays of insulin-like activity. Both insulin and vanadate stimulated [2-3H]glucose incorporation into fat cell lipid in a dose-dependent manner, but the maximal effect of vanadate was markedly greater than that of insulin. At 10( 2) M vanadate the effect was 3-4 times as great as the maximal effect of insulin. This effect was dependent on specific glucose transport. Combinations of insulin and vanadate were not more effective than vanadate alone. Vanadate also produced antilipolysis with an effect somewhat greater than that of insulin. Using [U 14C]glucose both vanadate and insulin stimulated 14CO2 production and [14C]glucose incorporation into lipid, and again the effect of vanadate was greater than that of insulin. Vanadate had a greater effect on 14CO2 production than on [14C]glucose incorporation into lipid. When [1-14C]glucose was used vanadate again had a significantly greater effect on 14CO2 production than did insulin, but when [6-14C]glucose was used the effects of vanadate and insulin were equal. These results demonstrate that vanadate has insulin-like effects in isolated fat cells, but it selectively stimulates certain pathways to a greater extent than does insulin. The greater effect of vanadate than insulin appears to be primarily on the pentose phosphate shunt, suggesting that this agent may be useful for examination of this intracellular pathway in fat cells. PMID- 3282880 TI - Heterogeneity in mammotrophs prepared from diethylstilbestrol-induced prolactinomas. AB - Pituitary glands from ovariectomized F-344 rats bearing diethylstilbestrol containing capsules for 70-100 days were dissociated and separated into three size classes by unit gravity sedimentation. The average percentage of large mammotrophs in fraction I was 86 +/- (SE) 2%, the percentage of intermediate sized mammotrophs in fraction II was 86 +/- 4%, and the percentage of small mammotrophs in fraction III was 72 +/- 3%. By electron microscopy, cells in fractions I and II contained cytoplasmic secretory granules, whereas those in fraction III were either sparsely granulated or agranular. Cells retained their morphology after culture. Biological (B) and immunological (I) assays of PRL released into the medium after 24-h culture both showed that fraction I and II cells released more hormone than fraction III cells. The B/I ratios of released PRL were consistently greater than 1. Analysis of the separated mammotrophs by flow cytometry indicated major differences in light scatter profiles, both before and after culture. Since these differences have been shown to reflect secretory granule content, changes in perpendicular light scatter after culture were interpreted to indicate that small mammotrophs accumulated granules, whereas some of the large mammotrophs lost granules. Results from a cell blot assay indicated that fraction I and II cells secreted more hormone than fraction III cells. This same rank order was found when live cells were stained and analyzed for surface PRL. However, the reverse plaque assay yielded different information, viz. more plaques were found around fraction III cells than in fraction I or II cells. Finally, PRL contained in alkaline extracts of fraction I, II, and III cells was analyzed by Western blotting after electrophoresis under nondenaturing, denaturing, or denaturing and reducing conditions. Fraction III cells contained a prominent and unique PRL variant that had low mobility in native gels and an apparent mol wt in the range of 10-14K. After 24 h the culture medium from fraction III cells also contained this low mol wt variant. Our data indicate considerable heterogeneity in form and function within the mammotroph population of diethylstilbestrol-induced prolactinomas. PMID- 3282881 TI - In memoriam Edward A. Doisy, Ph.D. PMID- 3282882 TI - Contacts between the LexA repressor--or its DNA-binding domain--and the backbone of the recA operator DNA. AB - Using hydroxyl radical footprinting and ethylation interference experiments, we have determined the backbone contacts made by the entire LexA repressor and its amino-terminal fragment with the recA operator DNA. These techniques reveal essentially the same contacts between both proteins and one side of the DNA helix if one assumes that the DNA stays in the normal B-conformation. This result is somewhat unexpected because protection of guanine bases against methylation suggested a somewhat twisted recognition surface. The backbone contacts revealed by both methods are symmetrically disposed with respect to the center of the operator, providing further evidence that the operator binds two LexA monomers. Each half-operator contains seven interfering phosphates. These phosphates are found on both sides of the 5'-CTGT sequence that is believed to be the principal recognition target. On the side close to the center of the operator are found two phosphates, whereas the other five are clustered on the side apart from the dyad axis. We are not aware of such an extended cluster of interfering phosphates for any other DNA-binding protein. A quantification of the hydroxyl radical footprints allowed us to compare further the affinity of the LexA repressor for the recA operator with that of its isolated DNA binding domain. We find an only 13-fold higher binding constant for LexA than for its amino-terminal domain, which is in good agreement with our earlier results for the uvrA operator using a completely different binding assay. PMID- 3282884 TI - Cardiac nuclear medicine tomographic systems. AB - There are two competitive measuring techniques in emission tomography: SPECT and PET. The superiority of PET is founded not only on using physiological radionuclides and tracers such as carbon 11, oxygen 15, and nitrogen 13, but also on achieving a physical performance far in excess of that of SPECT. Considering the demands of cardiac studies, the performance of both methods is analyzed and compared and the inherent limitations are stated. PMID- 3282883 TI - Cardiac nuclear medicine, present status, future hopes as seen from the view of a cardiologist. AB - The present techniques of nuclear medicine that are used in cardiology are critically evaluated. They are used mainly for the assessment of coronary circulation (measurement of regional flow and perfusion), on the determination of left ventricular muscle function (radionuclear ventriculography) and on the study of cardiac metabolism. The last-mentioned technique is unique insofar as (except for magnetic resonance imaging) there is no other method available to analyse myocardial metabolism noninvasively in living man. Of immense practical importance is the diagnosis and quantitation of the abnormal coronary flow and perfusion, as coronary artery disease is one of the major diseases of the Western world. Finally, the value of nuclear imaging techniques is compared with that of other nonnuclear methods. In present-day medicine, with its increasingly high costs, the value of nuclear techniques must be assessed very carefully. PMID- 3282886 TI - Radionuclide ventriculography (equilibrium gated blood pool scanning)--its present clinical position and recent developments. AB - Myocardial scanning (MS) and radionuclide ventriculography (RNV) are the foundation of nuclear cardiology. These procedures aim in two completely different directions: RNV tries to image heart motion, that is, mechanical (pump) function, and therefore belongs to the group of first-order functional imaging (FI, imaging mechanical function), whereas MS is based on myocardial metabolism, and therefore can be attributed to third-order functional imaging (metabolism). This statement is relevant for the assessment of the clinical position of RNV: Third-order (metabolism) functional imaging is the domain of nuclear medicine (NM), whereas first-order FI has to face the competition of alternative noninvasive procedures such as ultrasound (US), digital subtraction angiography (DSA), computer tomography (CT), and nuclear magnetic resonance (NMR). The domain of RNV includes stages two (acute infarction) and three (postinfarction period) of coronary arterial disease (CAD). The advantageous combination of quantitative data on global, left ventricular (LV) function and imaging of regional motion ensures the superiority of RNV over US. However, RNV is inferior to MS in physical examinations in the preinfarction stage of CAD, whereas US is clearly inferior to both NM procedures. Recent progress could be attained by gated SPECT (GASPECT). A proposal is presented for simplification of this time-consuming procedure. Technetium-labeled isonitriles offer the chance for the combination of "perfusion-motion" imaging of the myocardium. However, even standard RNV offers new possibilities. The multitude of parameters produced by quantitation has not yet been exploited completely. This can be done by discriminant analysis. The computer finds out an optimal subset from the whole set of parameters for the solution of a significant clinical problem. The software "learns" to find the "label" of a special pathognomonic entity. This computer work is supported by a relational data bank (Oracle) and an optical disk. Two examples for the effectiveness of the computer in problem solving are presented. It is concluded that RNV, even in the very competitive class of first-order functional imaging, enjoys a preferred position. The future indeed seems brighter because labeled isonitriles offer the chance for the combination of perfusion-motion imaging of the myocardium. PMID- 3282887 TI - Cardiac nuclear medicine: positron emission tomography in clinical medicine. AB - Positron-emission tomography (PET) and radioactively labelled substrates permit metabolic studies to be carried out in vivo and in situ with few if any limitations regarding the choice of substrates as long as they can be tagged with positron-emitting radionuclides, especially those like 11C and 13N. With respect to cardiology, 13N-ammonia and 82Rb are helpful in the examination of myocardial perfusion. The evaluation of myocardial glucose and fatty acid metabolism with 18F-deoxyglucose (FDG) and 11C-palmitate has proved to be clinically useful. Thus, myocardial ischemia and hypoxia, infarct size, the transmural extent of the infarction and tissue viability after it can all be examined as can pathological biochemistry in patients with primary or secondary cardiomyopathies. Single photon-emitting labelled substances such as 123I-labelled fatty acid analogues also provide information equivalent to that which can be gathered by PET for clinical use. Thus, one major task of PET is the validation of methods and the transformation of these methods to single-photon-emitting radiotracers for broad clinical application, in situations where the expense of PET cannot at present be justified. PMID- 3282889 TI - Basilar artery disease--clinical outcome and Doppler sonographical follow-up. AB - In the past 5 years we have investigated 29 patients with symptomatic basilar artery stenoses (14 cases) and occlusions (14) and a patent primitive trigeminal artery with thin-calibered basilar and vertebral arteries (1) using directional continuous-wave Doppler sonography of the vertebral arteries. A total of 19 patients survived, and 17 of them were clinically and sonographically reexamined after 40.4 +/- 15.8 months (mean +/- SD). Among the 8 patients with basilar stenoses, 6--with no further transient ischemic attacks (TIAs) in the interval- exhibited an increase in the summed modified Pourcelot indices (relative end diastolic flow velocities) of the vertebrals by 0.18 +/- 0.16; the other 2 showed a decrease by 0.26 each, in 1 case temporally related to a TIA, in the 2nd case without further clinical deterioration. In the 8 survivors with basilar occlusions, 5 remained--by sonographic criteria--unchanged with summed modified Pourcelot indices of the vertebrals of 0.00, while 3 patients exhibited a slight increase in the summed modified Pourcelot indices of 0.13 +/- 0.03. While the difference between the outcome of subsets of patients treated with regimens of 30,000-40,000 units heparin/day or phenprocoumon and less radical drugs were statistically not significant, the former regimen appeared clinically more efficacious in preventing further deterioration in approximately two-thirds of the patients affected. Due to the potential recurrence of neurological symptoms, a treatment period with phenprocoumon of 6 months after discharge from hospital appears justified. Due to these therapeutic efforts, approximately half of the patients initially affected survived with no or only a mild neurological deficit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282888 TI - Nuclear magnetic resonance imaging of the heart. AB - NMR imaging is a noninvasive technique that has been shown to provide high quality images of the heart. Due to the signal characteristics of flowing blood, inherent contrast between blood pool and myocardium is achieved without the use of contrast media. This paper briefly describes technical aspects of NMR imaging of the heart, normal cardiovascular anatomy, applications of the technique in patients with ischemic heart disease, and the potential of NMR imaging for functional studies in various forms of heart disease. PMID- 3282890 TI - Short-term and stabilized effects of percutaneous nephrolithotomy on the kidney. AB - A homogeneous group of 15 patients was investigated before and after percutaneous nephrolithotomy (PCN). Creatinine and electrolyte clearances evaluated both before and during saline (NaCl 0.9%) infusion, 4-7 days after PCN remained unchanged with respect to the preoperative values. A significant decrease of urinary PGE2 was observed postoperatively both before and after extracellular volume expansion. 99mTc-DTPA renography performed 26-40 days after surgery showed a scar on the convex margin of one kidney in the area of the nephrostomy and an improved renographic curve in 5 renal units. No difference between pre- and post PCN isotopic clearances was evident. On the basis of our results we can affirm that PCN is an efficient and safe method for the treatment of nephrolithiasis. PMID- 3282891 TI - Experimental testicular torsion: fixation without parenchymal trauma. AB - Acute testicular torsion has been investigated using experimental models which either do not mimic torsion or cause parenchymal trauma. Valid conclusions regarding possible immunological activation cannot be made from such models. Techniques for experimental torsion in the rat are compared in this study to a standard venous occlusion model. Vascular dye injections and gross assessment were made at 0, 1 and 12 h. Testicular torsion of 720 degrees with fixation by a transmesorchial suture was the model which produced changes most similar to those in the venous occlusion model. This model causes torsion without parenchymal trauma and mimics acute testicular torsion more accurately than previously existing models. PMID- 3282885 TI - Myocardial scintigraphy--25 years after start. AB - The development of myocardial scintigraphy (MS) reflects the clinical success of a representative procedure in nuclear medicine. Radiopharmaceuticals for visualizing vital and damaged myocardium and techniques (planar-qualitative, planar-quantitative, SPECT-qualitative-quantitative with comparative sensitivities) are briefly reviewed with the main focus on their clinical application in coronary (CHD) and noncoronary heart disease, where recent literature from the United States and Europe is considered. The limited value of MS for screening of CHD is outlined and its present and future role in detecting asymptomatic (silent) ischemia/infarction and symptomatic patients at professional risk is stressed. The present state of MS in coronary heart disease is discussed for single and multivessel disease, previous infarction, and risk stratification (myocardial washout, pulmonary uptake, ischemic dilation, absent heart sign), reflecting the importance of the procedure in exercise-induced ischemia as well as in ischemia at rest for prognostication of the natural and therapeutic course, i.e., therapy control (angioplasty, bypass, lysis, cardiac drugs). More marginal but upcoming clinical indications are mentioned, such as progressive systemic sclerosis, cardiac transplantation, pediatric cardiology, and problems of nephrology/urology. The "normal" values and the impact of digital radiology and of contrast cardiography are touched upon. Preliminary cases with 111In-antimyosin and 99mTc-Isonitriles are presented including correlative results between global ejection fraction determination according to gated 99mTc isonitrile and conventional 99mTc-erythrocyte ventriculogram (r = 0.75; n = 10). PMID- 3282893 TI - A double-blind comparison of felodipine and hydrochlorothiazide added to metoprolol to control hypertension. AB - Seventy-six uncomplicated hypertensive patients treated in General Practice, whose seated diastolic blood pressure (Phase V) (dBP) remained greater than or equal to 95 mmHg after a minimum of 4 weeks treatment with metoprolol 50 mg b.i.d. as antihypertensive monotherapy, were randomized to receive the selective 'calcium antagonist' felodipine 5 mg b.i.d. or hydrochlorothiazide 12.5 mg b.i.d. in addition to metoprolol 50 mg b.i.d. The trial duration was 8 weeks, the dose of the felodipine or hydrochlorothiazide being doubled after 4 weeks if 'control' of BP (dBP less than 90 mmHg) was not achieved on the initial doses. Over the trial period of 8 weeks, felodipine reduced dBP from 102 to 85 mmHg and hydrochlorothiazide from 101 to 91 mmHg; the dBP reduction in the felodipine group was greater than that in the hydrochlorothiazide group (17 vs 9 mmHg) and the attained dBP lower in the felodipine group. About half of the patients in each group required the higher dose. Both regimes were effective and well tolerated. In the dosages used, felodipine was a slightly more effective antihypertensive drug than hydrochlorothiazide when added to metoprolol. There was no apparent difference in the tolerability of the two regimes. PMID- 3282896 TI - Captopril-induced oesophagitis. PMID- 3282892 TI - Drug treatment and prevention of malaria. PMID- 3282895 TI - Effectiveness of acarbose, an alpha-glucosidase inhibitor, in uncontrolled non obese non-insulin dependent diabetes. AB - The effect of acarbose, an alpha-glucosidase inhibitor, on glycaemic control, was compared with placebo in a double-blind, randomised, group comparison study during 16 weeks in 20 non-obese non-insulin dependent diabetic patients in whom sulphonylurea treatment had been withdrawn. There was significant deterioration in glycaemic control as assessed by HbA1 following withdrawal of the sulphonylurea. There was no significant improvement in HbA1 between weeks 0 and 16 in either the acarbose (11.3% and 12.4% respectively) or the placebo group (10.6% and 12.2% respectively). In both the acarbose and placebo treated groups fasting glucose and insulin concentrations were unaltered. This study also suggests that acarbose was not an effective substitute for sulphonylureas in non obese Type 2 diabetes uncontrolled by diet alone. PMID- 3282897 TI - Growth factor- and phorbol ester-induced changes in cell morphology analyzed by digital image processing. AB - We have developed the computer-aided image processing analysis to visualize and quantitate the cell motility and morphological changes in living cultured cells. The effect of growth factors on cell motility and morphology has been analyzed by this method. Insulin, insulin-like growth factor-I (IGF-I), and epidermal growth factor (EGF) elicited membrane rufflings in rat embryo fibroblast 3Y1 cells as well as in human epidermoid carcinoma KB cells. Insulin and IGF-I also induced ruffling membranes in Balb/c-3T3 cells. The quantitative analysis by the programmed trace mode of the AVEC system has shown that the motion of the membrane rufflings was observed within 2 min, reached the maximum level within 4 8 min, and rapidly decreased within 10-15 min after the addition of these growth factors. The analysis also revealed the temperature- and growth factor concentration-dependent changes in the motion of membrane rufflings elicited by these growth factors. 12-O-Tetradecanoylphorbol-13-acetate, one of the well-known tumor promoters, rapidly induced cell rounding in Balb/c-3T3 cells. This change of cell morphology could be also quantified by the trace mode analysis. The fluorescent phalloidin staining experiment indicated that these growth factor- or phorbol ester-induced morphological changes were accompanied by the reorganization of filamentous actin. Furthermore, we were able to visualize actin stress fibers in living EBTr cells by enhancing the video image and to follow the reduction of stress fibers induced by cytochalasin B without any fixation or fluorescent probes. PMID- 3282894 TI - Effect of a single daily dose treatment of fenofibrate on plasma lipoproteins in hyperlipoproteinaemia IIb. AB - The safety and efficacy of a single daily dose of fenofibrate (200 mg) have been evaluated in 12 Type IIB hyperlipidaemic patients in a three-month study. At the same time the pharmacokinetics was studied to check whether this new dosage schedule would give a therapeutic plasma levels of fenofibrate. At the single daily dose of 200 mg, fenofibrate was highly effective, very well tolerated, and it reached therapeutic plasma levels without accumulation. It appears that fenofibrate can usefully be employed at this dosage in hyperlipidaemia, especially since patient compliance is better when only one daily dose need be taken. PMID- 3282898 TI - Independent variations of myc amplification, inducibility, maturation, and proliferation states in HL60. AB - We have investigated the possible relationship between c-myc gene activity and other variable traits in HL60. In a panel of variant lines, a good correlation was observed between myc gene copy number and the level of myc mRNA. There was no correlation between myc amplification or expression and the resistance of the lines to induction of terminal neutrophilic or monocytic differentiation. Therefore, myc mRNA level does not appear to determine the ability of the variant HL60 lines to respond to inducers of differentiation. Flow cytometric analyses of the expression of a differentiation antigen (AGF 4.36) revealed stable negative and positive subpopulations in growing HL60. myc amplification, expression, and inducibility were identical in these subpopulations, suggesting that variation of these traits in HL60 sublines and variants is not due to maturation state differences. myc gene copy number was also identical in transferrin receptor positive (proliferating) and negative (resting) populations. These data contradict the notion that myc amplification has been important in determining the in vitro biological properties of HL60. PMID- 3282899 TI - Immortalized differentiated hepatocyte lines derived from transgenic mice harboring SV40 T-antigen genes. AB - Hepatocytes of transgenic mouse fetuses harboring SV40 virus transforming gene sequences in the SV delta e-MGH fusion gene construct 202 driven by the mouse metallothionein (MT-I) enhancer [R. D. Palmiter, H. Y. Chen, A. Messing, and R. L. Brinster (1985) Nature (London) 316, 457-460] were cultured at Day 19 of gestation and established as a differentiated line expressing albumin and alpha fetoprotein (AFP) mRNAs. Hepatocyte line FMH-202 contains integrated SV40 sequences, expresses SV40 T-antigen genes, and exhibits unlimited growth potential because it has been cultured 18 months without apparent decrease in cell viability or in growth rate that could suggest the occurrence of a crisis period. Immortalized cells multiply in chemically defined medium deficient in arginine with transferrin plus insulin, whereas EGF, insulin, and transferrin are obligatory requirements for fetal or newborn mouse hepatocyte multiplication in primary cultures. Cells did not grow in agar and were not tumorigenic in nude mice. Their immortalized, nonmalignant phenotype was further documented by low saturation densities of confluent monolayers showing no overgrowth, and by growth arrest in the absence of insulin with subsequent induction of DNA synthesis and resumption of cell growth in response to insulin. Thus, it appears that immortalized SV40 T-antigen-expressing hepatocytes are present in the liver of the transgenic mice. However, at later points in liver development the transforming activity of T-antigen becomes apparent and leads to hepatocellular carcinoma formation in vivo. PMID- 3282900 TI - Membrane glycoproteins involved in hepatocyte adhesion to collagen type I. AB - Liver membrane glycoproteins with affinity for immobilized collagen type I were subjected to preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) followed by electroelution of the separated proteins. Electroeluted glycoproteins with ability to neutralize the inhibitory effect of anti-CollCAM antibodies on hepatocyte adhesion to collagen were collected from several consecutive runs and used to raise a high titer antiserum, denoted anti CollCAM II. IgG from this antiserum inhibited the attachment of hepatocytes to dishes coated with collagen type I, but not to fibronectin- or collagen type IV coated dishes. When the antibodies were immobilized to Sepharose CL-4B they bound three sets of glycoproteins with apparent Mr's of 105,000, 115,000, and 130,000 as analyzed by SDS-PAGE under nonreducing (NR) conditions. Upon reduction (R) the glycoproteins migrated with apparent Mr's of 115,000, 130,000, and 160,000, respectively. The Mr 105,000-115,000 (NR) glycoproteins effectively neutralized the inhibitory effect exerted by both anti-CollCAM and anti-CollCAM II antibodies, on hepatocyte spreading and attachment to collagen type I substrates. Peptide mapping suggested the Mr 160,000 (R) species to be different from the Mr 115,000 (R). PMID- 3282902 TI - Pattern of response of megakaryocyte colony-stimulating activity in the serum of patients undergoing bone marrow transplantation. AB - Bone marrow transplantation has become an accepted form of therapy for several malignant, hematologic, and genetic disorders. Platelet recovery is delayed after bone marrow transplantation. To better understand the mechanisms involved in platelet recovery we studied 23 patients undergoing bone marrow transplantation for the presence of megakaryocyte colony-stimulating activity (Mk-CSA) in their serum. Shortly after beginning the pretransplant preparative regimen the Mk-CSA level in the serum of these patients increased. This increase was transient, and the level returned to baseline, to later increase again. The second increase in Mk-CSA level occurred during the second week after bone marrow transplantation at the time of hematopoietic recovery. Most patients who failed to engraft did not show a rise in Mk-CSA during the second week after transplantation. All patients showing engraftment had an Mk-CSA rise during the second week after transplantation. The difference between these two groups was highly significant (p = 0.0007). The biphasic response of Mk-CSA after bone marrow transplantation is similar to the response seen in a rat model after lethal irradiation. We postulate that the first elevation in Mk-CSA is due to tissue injury and nonspecific response whereas the second elevation of Mk-CSA is a physiologic response to marrow aplasia and associated with effective bone marrow engraftment. PMID- 3282901 TI - The roles of granulocyte-macrophage colony-stimulating factor and interleukin 3 in stromal cell-mediated hemopoiesis in vivo. AB - Adherent cells from murine long-term marrow cultures (LTMC) were examined for presence of mRNA for granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin 3 (Il-3). Six hours after medium replacement, GM-CSF mRNA was detected but was no longer detectable 24 h after feeding; Il-3 mRNA was not detected at any time. Neutralizing antibodies against these factors had no effect on hemopoiesis. Exogenous Il-3 increased cell production, notably mature erythroid progenitors, whereas GM-CSF had little long-term effect even at high concentrations. Furthermore, GM-CSF appeared to be specifically removed from the medium, whereas virtually all of the Il-3 could be recovered under identical incubation conditions. These results show that Il-3 is not required for maintaining long-term hemopoiesis in vitro, whereas the precise role of GM-CSF in this system remains unclear. PMID- 3282903 TI - Skepticism about the paranormal: legitimate and illegitimate. AB - With the growth of belief in the paranormal, skepticism can play a vital role in the scientific appraisal of claims. There are two forms: the first, hardly legitimate, is negative or total skepticism. It is nihilistic and dogmatic, and essentially self-defeating and self-contradictory. The second, a legitimate form, is selective skepticism. Here skepticism operates as a methodological principle of inquiry, testing hypotheses and theories in the light of evidence, but always open to new departures in thought. Skepticism has been applied historically to epistemology, metaphysics, religion, and ethics. The paranormal field has been full of fraud. Here the skeptic insists upon replicable experiments by neutral or skeptical observers before he will accept a claim as confirmed. PMID- 3282904 TI - Astrology. AB - As a divinatory practice, astrology is without equal in both its colorful history and modern day popularity. Astrology has grown, over thousands of years, into a huge and ornate superstructure that lacks a central design. Although astrology has been dimly veiled by its occult mystique for centuries, the light of modern day inquiry has shown its substance to be mostly illusionary and revealed its foundation to be the shakiest possible: that of self-justification and anecdotal evidence. Despite the many claims of its practitioners and followers, extensive investigation has revealed astrology to be a great teetering monument to human gullibility. PMID- 3282905 TI - Misuses of biology in the context of the paranormal. AB - Public suspicion of science stems from science's challenging of perceptions and myths about reality, and a public fear of new technology. The result is a susceptibility to pseudoscience. In claiming that creation 'science' is as valid as evolution the creationists misquote scientists and seek to spread their own 'scientific' myths concerning a young age for the earth, an act of creation based on a particular literalist interpretation of the Christian Bible and a single worldwide flood. They use methods of debate and politics, rather than scientific research. A selection of their arguments is examined and the nature of the evidence for evolution is discussed. Problems with the creation 'science' model are noted. In the myth of the hundredth monkey phenomenon, original research is misquoted to denigrate scientific research and support sentimental ideas of paranormal events. The misuse of science is seen as damaging to society because it reduces the effective gathering and application of scientific information. However, pseudoscience provides a valuable guide to gaps in public scientific education. PMID- 3282907 TI - Psi experiments: do the best parapsychological experiments justify the claims for psi? AB - Since the founding of the Society of Psychical Research in 1982, psychical researchers have, in each generation, generated research reports which they believed justified the existence of paranormal phenomena. Throughout this period the scientific establishment has either rejected or ignored such claims. The parapsychologists, with some justification, complained that their claims were being rejected without the benefit of a fair hearing. This paper asks the question of how well the best contemporary evidence for psi--the term used to designate ESP and psychokinetic phenomena--stands up to fair and unbiased appraisal. The results of the scrutiny of the three most widely heralded programs of research--the remote viewing experiments, the psi ganzfeld research, and the work with random number generators--indicates that parapsychological research falls short of the professed standards of the field. In particular, the available reports indicate that randomization is often inadequate, multiple statistical testing without adjustment for significance levels is prevalent, possibilities for sensory leakage are not uniformly prevented, errors in use of statistical tests are much too common, and documentation is typically inadequate. Although the responsible critic cannot argue that these observed departures from optimal experimental procedures have been the sole cause of the reported findings, it is reasonable to demand that the parapsychologists produce consistently significant findings from experiments that are methodologically adequate before their claims are taken seriously. PMID- 3282906 TI - Firewalking. AB - Firewalking is known throughout recorded history and around the world. Ordinarily it is associated with religious beliefs or mystical states of mind in which the gods or unusual mental powers provide extraordinary protection for true believers or those with proper training. However, firewalking commonly involves hot materials of low heat capacity and poor thermal conductivity and sometimes the use of insulation. The excited or trance-like states of firewalkers contribute to the firewalkers' subjective experience but are not required for a successful walk. We conclude that elementary knowledge of physics and psychology is sufficient to explain the known observations of firewalking. PMID- 3282908 TI - The psychology of paranormal beliefs. AB - Investigation of paranormal claims has failed to find any repeatable phenomena, yet beliefs in such phenomena are extremely prevalent. Some of the psychological mechanisms which support these beliefs are described. Mental imagery, subjective validation, coincidence, hidden causes, and fraud all contribute to the folklore in this field. Magical thinking is as evident today as it ever has been. Recent research suggests that increased skepticism concerning paranormal claims can result from special educational procedures which emphasize critical thinking rather than learning scientific facts. PMID- 3282909 TI - Reversion of Lactobacillus lactis protoplasts. AB - More than 99% of L. lactis cells have been converted to protoplasts upon digestion of cell walls with mutanolysin (N-(acetyl)muramidase). Functional protoplasts were obtained even with the lowest level of the enzyme that was used (0.1 U.ml-1 of the cell suspension) and after incubation at 37 degrees C for 2 min. The regeneration of the polymerized cell wall appears to be induced by a cell homogenate of the same organism. PMID- 3282910 TI - Prevention and reversal of endotoxin-induced pulmonary hypertension by a leukotriene antagonist. AB - We investigated the role of leukotrienes in endotoxin-induced changes in pulmonary circulation. In six conscious sheep, haemodynamic measurements were obtained for the calculation of pulmonary vascular resistance (PVR), along with measurements of arterial oxygen tension (PaO2), leucocyte count (WBC), thromboxane B2 (TxB2), 6-Keto-PgF1 alpha and PgF2 alpha, before and at predetermined intervals after a 10-min infusion of E. coli endotoxin (0.3 microgram/kg), with and without treatment with the leukotriene receptor antagonist, FPL-57231. Endotoxin caused a biphasic response (i.e., phase I = 0-1 h, phase II = 1.5-4 h), with a mean +/- SE increase in PVR to 415 +/- 112% of baseline during phase I and a lesser increase of 175% (range = 153-199%) of baseline during phase II. Mean +/- SE PaO2 decreased from 86 +/- 4 to 67 +/- 6 mmHg and WBC count decreased from 8.6 +/- 0.6 to 2.8 +/- 0.7 thousand/mm3 during phase I, whereas TxB2 increased from 145 +/- 28 to 3164 +/- 1082 pg/ml, 6-Keto PgF1 alpha from 129 +/- 14 to 438 +/- 114 pg/ml and PgF2 alpha from 122 +/- 7 to 242 +/- 43 pg/ml. One hour infusion of FPL-57231 (1 mg/kg/min) administered prior to and throughout phase I attenuated the phase I increases in PVR without preventing the increases in TxB2; however, it partly attenuated 6-Keto-PgF1 alpha and enhanced generation of PgF2 alpha during phase I. Discontinuation of FPL 57231 was followed by an exaggerated response of PVR during phase II to an average of 209% of baseline (range = 186-235%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282911 TI - The clinical effect and the effect on the ciliary motility of oral N acetylcysteine in patients with cystic fibrosis and primary ciliary dyskinesia. AB - The effect of peroral N-acetylcysteine (NAC) in patients with cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) was investigated. 41 CF patients and 13 PCD patients completed the study which was a double-blind, placebo-controlled, cross-over trial. The patients received either NAC or placebo for two periods of three months followed by a three month follow-up period. Active treatment consisted of NAC, either 200 mg x 3 daily (patients weighing less than 30 kg) or 400 mg x 2 daily (greater than 30 kg). The effect was evaluated in terms of a subjective clinical score, weight, sputum bacteriology, blood leucocyte count, sedimentation rate, titres of specific antimicrobial antibodies, lung function parameters and measurement of the ciliary function. No effect was seen in PCD patients, but in CF patients an improved lung function was seen in the period when the patients suffer most from lower airway infections. PMID- 3282913 TI - Generation and gender: normative and covert hierarchies. AB - This essay argues that gender is an irreducible category of clinical observation and theorizing, as crucial to the family therapy paradigm as the concept of "generation." Gender, therefore, is not a secondary, mediating variable like race, class, or ethnicity, but, rather, a fundamental, organizing principle of all family systems. The author analyzes the history and politics of family therapy in order to explicate how gender, as a co-equal concept, was erased as a universal principle of family organization, leaving only generation. The theoretical and clinical implications of situating gender at the center of family therapy are then discussed. PMID- 3282912 TI - Tonic sensory pathways of the respiratory system. AB - Both respiratory centres and the preganglionic vagal motoneurones, which control respiratory (striated) and airway (smooth) muscles respectively, receive information on the lungs, the circulation and the skeletal and respiratory muscles. Each of these nervous pathways has two components: one is phasic, i.e. in phase with biological rhythms, and comes from mechanoreceptors connected to large myelinated fibres; the second has a tonic low frequency firing rate and corresponds to the spontaneous activity of polymodal receptors connected to thin sensory fibres, which act mostly as sensors of changes in extracellular fluid composition (O2 and/or CO2 partial pressure, pH, release of algesic agents etc...). Some of them also detect large mechanical disturbances or local temperature changes. The influence of tonic background sensory activity is well known in animals concerning the role played by arterial chemoreceptors in the control of ventilation and of thin vagal afferents from the lungs (bronchopulmonary C-fibres and irritant receptors) in reflex facilitation of the bronchoconstrictor vagal tone. Moreover, the stimulation of thin sensory fibres in particular circumstances is responsible for hyperventilation (arterial chemoreceptors and muscle afferents), increased airway tone (arterial chemoreceptors and mostly thin vagal afferent fibres) or bronchodilation (muscle afferents). These peripheral inputs project centrally on different structures and also on brain stem neurones, which integrate simultaneously chemosensory, vagal and muscle information. This results in complex interactions between the different sensory pathways. PMID- 3282914 TI - [Interaction of diuretics with the prostaglandin system of the kidneys]. PMID- 3282915 TI - [Kinetic characteristics of drugs against a background of immunomodulator action]. PMID- 3282916 TI - [Functional adaptation to psychotropic substances]. PMID- 3282917 TI - [Mechanism of the action of hepatoprotectors in toxic liver lesions]. PMID- 3282918 TI - Structure and function of epidermal growth factor-like regions in proteins. PMID- 3282919 TI - Autoantibodies to the core proteins of hnRNPs. AB - A novel autoantibody reacting the the core polypeptides of hnRNP particles has been detected in the serum of a patient with systemic lupus erythematosus (SLE) and Sjogren's syndrome manifestations. Immunoblot analysis, using either rat liver or HeLa nuclear extracts as the antigen source, demonstrated that the autoantibody interacts with a specific subgroup of the core polypeptides of hnRNP particles, namely A2, B1 and B2, but not with A1, C1 and C2. PMID- 3282920 TI - Pertussis toxin reverses the inhibition of insulin secretion caused by [Arg8]vasopressin in rat pancreatic islets. AB - When rat pancreatic islets were incubated with 10(-8) M arginine vasopressin in the presence of 15 mM glucose there was a pronounced inhibition of insulin release in comparison with controls. This inhibitory effect appeared to be specific for vasopressin since it was antagonised by vasopressin antibody. Moreover, pertussis toxin (100 ng/ml) reversed the inhibition of insulin release due to vasopressin, indicating the possible involvement of a guanyl-nucleotide regulatory protein in the inhibitory effect. Nevertheless, 10(-8) M vasopressin increased islet concentrations of cyclic AMP even under conditions where insulin release was decreased. PMID- 3282921 TI - Formation of the 680 nm-absorbing form of the cytochrome bd oxidase complex of Escherichia coli by reaction of hydrogen peroxide with the ferric form. AB - Reduced minus aerated difference spectra of membranes from Escherichia coli (grown under oxygen-limited conditions) show, in addition to the 650 nm trough attributed to the oxygenated form of cytochrome d, a smaller trough centred at about 680 nm of unknown origin. When the reference spectrum is that of a sample oxidized with ferricyanide and to which hydrogen peroxide was added, the trough proportions changed, the 680 nm species being more dominant. Similarly, when 8.8 mM hydrogen peroxide is added to a persulphate-oxidized sample, a peak at 680 nm is immediately formed. No such compound is observed when peroxide is added to persulphate-oxidized membranes from a cytochrome d-deficient mutant. It is concluded that the 680 nm species represents a peroxy form of haem d, which is stable at room temperature and is probably an intermediate in the reaction mechanism of this oxidase. PMID- 3282923 TI - Evidence that insulin increases the proportion of polysomes that are bound to the cytoskeleton in 3T3 fibroblasts. AB - The association of polysome redistribution with changes in protein synthesis was investigated in insulin-stimulated fibroblasts. Free polysomes were released by Nonidet-P40 and 25 mM KCl, cytoskeletal-bound polysomes were retained at 25 mM KCl but released at 130 mM, while membrane-bound polysomes were released by deoxycholate. Insulin increased the proportion of polysomes which were retained at 25 mM KCl but had no effect when extraction was carried out at 130 mM KCl, suggesting that more polysomes were associated with the cytoskeleton. Insulin also reduced the amount of actin released from the detergent-insoluble cytoskeleton indicating that the hormone affects microfilament organization. PMID- 3282922 TI - Iron storage in Saccharomyces cerevisiae. AB - A ferritin-like molecule was purified from iron-loaded cells of Saccharomyces cerevisiae, but its iron content was very low and was not representative of the cellular iron content. A study of the intracellular distribution of iron has shown that the vacuoles are involved in the storage of iron in the yeast cell. Moreover, it seems that this vacuolar iron can be further utilised by the cells for iron-requiring processes such as mitochondriogenesis. PMID- 3282924 TI - Processing by inverted plasma membrane vesicles of in vitro synthesized major lipoprotein from Escherichia coli. AB - Synthesis, lipid modification and proteolytic processing of the major lipoprotein from Escherichia coli is shown to occur in a homologous in vitro transcription translation system containing inverted plasma membrane vesicles. The primary translation product (cross-reacting with anti-lipoprotein antiserum) is a precursor which is converted into a lower molecular mass species of the size of mature lipoprotein by the addition of inverted membrane vesicles from E. coli. Conversion is prevented by globomycin, a specific inhibitor of the unique lipoprotein-signal peptidase II, which is active only on lipid-containing precursors. The inverted plasma membrane vesicles used here must therefore contain active lipid-modifying enzymes and signal peptidase II. PMID- 3282925 TI - Is the 9 kDa thylakoid membrane phosphoprotein functionally and structurally analogous to the 'H' subunit of bacterial reaction centres? AB - Although the amino acid sequence of the 9 kDa (phospho)protein of chloroplasts has been determined, the function of this thylakoid membrane protein in photosynthetic electron transport and the reason for its physiological control remains unclear. In this paper, I briefly review the evidence which indicates that the phosphorylation of the 9 kDa protein results in a partial inhibition of photosynthetic oxygen evolution by increasing the stability of the semiquinone bound to QA the primary, plastoquinone-binding site of photosystem II (PS II). I propose that in its dephosphorylated state, the 9 kDa thylakoid membrane protein may serve PS II to ensure efficient photochemical charge separation by aiding the transfer of reducing equivalents out of the reaction centre to the attendant plastoquinone pool. This function is analogous to that proposed for the H-subunit of the reaction centre of photosynthetic eubacteria. Whether these two proteins have evolved from a common ancestral reaction centre protein is discussed in the light of a comparison of their amino acid sequences and predicted secondary structures. PMID- 3282926 TI - Sequence-specific chemical modification of a hybrid bacteriophage M13 single stranded DNA by alkylating oligonucleotide derivatives. AB - Alkylating oligonucleotide derivatives react with the complementary sequences in hybrid M13mp7 bacteriophage single-stranded DNA and destroy the infecting ability of the DNA. The reagents do not damage M13mp9 single-stranded DNA lacking the target nucleotide sequence. PMID- 3282927 TI - Cloning and sequence analysis of cDNA encoding the precursor of a human endothelium-derived vasoconstrictor peptide, endothelin: identity of human and porcine endothelin. AB - A cDNA encoding a human endothelium-derived vasoconstrictor peptide, endothelin, was isolated from a human placenta cDNA library. The nucleotide sequence of this cDNA clone showed that the primary structure of the human preproendothelin has 212 amino acid residues and is highly homologous to porcine preproendothelin, and that human endothelin is identical with porcine endothelin. PMID- 3282928 TI - The Netherlands Cancer Institute 75 years; strategies in the surgical department. PMID- 3282929 TI - Cryopreservation of embryos and ova. AB - Development of techniques for cryopreservation of embryos of several species, principally the mouse, laid the foundation for cryopreservation of human embryos. As IVF has become more widely available and the need for the cryopreservation of human embryos has become apparent, pressure for technical development has increased. The ideal method would be simple, inexpensive, and effective. The most effective method for cryopreservation of early human embryos, such as those at the 1-cell pronuclear stage and up to the 4-cell stage, now appears to be stepwise cooling in 1,2-propanediol with sucrose in plastic ministraws. The preferred method for intermediate stage embryos uses DMSO with cooling and thawing at slow rates in a programmed biologic freezer. For the human blastocyst, slow cooling in glycerol and rapid thawing is the only method reported with survival rates comparable to those achieved for intermediate stage embryos using DMSO. The rates of survival from freezing and thawing blastocysts are not sufficiently high, however, to justify the losses associated with prolonged in vitro incubation. Even at the current level of technical achievement, cryopreservation of human embryos provides the clearest opportunity to improve the clinical results obtained with IVF. Research now underway in the modification of methods for vitrification and ultrarapid freezing holds promise for both simplification of technology and improvement of outcome. In view of legal and ethical considerations involved in embryo preservation, the desirability of ova preservation is widely accepted. Although a small number of human unfertilized mature ova have been cryopreserved using various methods, success rates are still low. Methods for the cryopreservation of eggs should be developed, but these methods probably should be proved by animal experiments to be safe, especially with regard to genetic damage, before a policy of transfer of embryos derived from frozen-thawed human ova is applied on a large scale. PMID- 3282930 TI - Early detection of pregnancy with transvaginal ultrasound. AB - The gestational age and the serum human chorionic gonadotropin (hCG) at which an intrauterine pregnancy can be detected using transvaginal ultrasonography (TVU) is not known. In this study, ten pregnant women were serially scanned with TVU from the time of initial positive pregnancy test, to determine when an intrauterine sac greater than 2 mm, fetal pole greater than 2 mm, and fetal heart motion could be detected. A gestational sac was seen 34.8 +/- 2.2 days from the last menstrual period (LMP), at which time the hCG was 1398 +/- 155 mIU/ml of the International Reference Preparations (IRP) or 914 +/- 106 mIU/ml of the Second International Standard (second IS). A fetal pole was seen 40.3 +/- 3.4 days from the LMP when the hCG was 5113 +/- 298 mIU/ml of the IRP or 3783 +/- 683 mIU/ml of the second IS. Fetal heart motion was detected 46.9 +/- 6.0 days from the LMP when the hCG was 17,208 +/- 3772 mIU/ml of the IRP or 13178 +/- 2898 mIU/ml of the second IS. From these results, it can be concluded that transvaginal ultrasonography can detect an intrauterine gestation earlier than what has been previously reported with transabdominal ultrasonography. PMID- 3282931 TI - Pregnancies after ultrasound-guided fallopian insemination with cryostored donor semen. AB - Twenty-nine patients, previously treated unsuccessfully with a median 9.5 cycles of conventional intracervical donor insemination, were offered fallopian catheterization on the side of the dominant follicle and direct insemination at the presumed site of fertilization, the ampullary-isthmic junction. Forty-five of 50 cycles were associated with successful tubal catheterization and 6 of these cycles were conceptional. Five viable intrauterine pregnancies resulted. We conclude: (1) that direct sperm transfer to the fallopian tubes is possible without the need for anesthesia or operation; and (2) that at the time of ovulation, the fallopian tube isthmus can be catheterized without later interfering with ovum or embryo transport to the uterus. Optimum timing for fallopian catheterization in relation to ovulation and the risk of side effects both remain to be established. PMID- 3282932 TI - Alternate delivery systems for contraceptive progestogens. AB - Research continues toward developing an universally acceptable, safe, and effective contraceptive to inhibit the female reproductive process. Progestational systems, either alone or in combination with small amounts of estrogen, approach such an ideal. The pregnane and 19-nortestosterone progestins were examined in this review with regard to contraceptive mechanisms of action and major side effects, such as menstrual abnormalities, metabolic changes, neoplasia, and teratogenicity. These steroids provide highly effective and long acting contraception, and bypass the oral route of administration, resulting in fewer gastrointestinal and systemic side effects. Data regarding the lack of a deleterious effect of contraceptive progestogens on fetal malformation or cancer of the breast and genital tract reinforce their safety. Further study and refinement are needed, however, to lower the incidence of menstrual abnormalities, hypertension, and detrimental lipid alterations prior to approval for general use. PMID- 3282933 TI - Drug interactions with oral contraceptives: compilation and analysis of an adverse experience report database. AB - Over 700 alleged OC/drug interactions were reported for antituberculous drugs, other antibiotics, anticonvulsants, antidepressants, and analgesics. Fewer than ten reports of OC/drug interactions were found involving antihistamines, thyroid hormone, vitamin C, antacids, ulcer medication, or diuretics. These may represent a set of OC/drug interaction problems that need to brought into medical awareness. Pregnancy is the first event reported when OCs appear to interact with another drug. However, menstrual disturbances are reported more often. BTB is the most frequently reported menstrual disturbance: it has been considered a warning signal that OC efficacy may be compromised. In such circumstances, contraceptive backup may be warranted. Reports of interference with OC efficacy have been most common for drugs used to treat tuberculosis, epilepsy, and depression, so patients and their physicians should be aware of potential problems. However, the average woman is more likely to encounter antibiotics, analgesics, and antihistamines, and current package inserts contain appropriate warnings. In recent years, prescriptions for low-estrogen OCs have outnumbered those for high dose preparations. Many physicians became concerned that there was an increased risk of OC drug failure with the low-dose products. The database does not seem to suggest that this has happened. The dose of estrogen is not correlated with total adverse experience reports, time of appearances of the first adverse experience reports, or rate of reporting of the interactions. Likewise, reports of potential interactions with menstrual disturbances are not correlated with lower estrogen doses in OCs. There is, however, an association between low-estrogen OCs and recently reported pregnancies attributed to OC/drug interactions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282934 TI - Lipid and lipoprotein changes in relation to oral contraception and hormonal replacement therapy. AB - Estrogens and progestins for contraception or hormonal replacement therapy are widely used by practitioners. These steroids have substantial effects on lipids and lipoproteins that appear to be primarily related to chemical structure of the compound, dosage, and a patient's hormonal status. Although the mechanisms by which alterations in lipid and lipoproteins affect atherogenesis are not fully understood, epidemiologic studies clearly associate alterations with risk of coronary heart disease. Attention to these alterations by progestins and estrogens, as well as further research on how these steroids may exert other cardiovascular effects, is important because atherosclerotic heart disease is a major cause of morbidity and mortality for women as they age. PMID- 3282936 TI - Embryonic and neonatal myosin heavy chain in denervated and paralyzed rat skeletal muscle. AB - Using immunofluorescence procedures with specific polyclonal and monoclonal antimyosin antibodies we have found that embryonic and neonatal myosin heavy chains (MHCs), which in rat skeletal muscle disappear during the first weeks after birth, are reexpressed in adult muscle after denervation. Reactivity for embryonic and neonatal MHCs was detected in some fibers as early as 3 days after denervation, became more evident by 7 days, and occurred exclusively in the type 2A fiber population. Paralysis of innervated muscles by tetrodotoxin block of the sciatic nerve also resulted in the reappearance of embryonic and neonatal MHCs in type 2A fibers. Significant variation in the degree of immunoreactivity was observed in different segments of the same muscle fiber, suggesting that coordination of muscle fiber nuclei in the control of myosin heavy chain gene expression is partially lost following denervation. PMID- 3282935 TI - Differential secretion of proLHRH fragments in response to [K+], prostaglandin E2 and C kinase activation. AB - ProLHRH contains the luteinizing hormone-releasing hormone (LHRH) decapeptide and a 56 amino acid peptide designated gonadotropin-releasing hormone-associated peptide (GAP). We studied the effects of various known secretagogues of LHRH on the in vitro release of proLHRH fragments from the median eminence (ME) and subsequently characterized these immunoreactive products according to molecular weight (MW). GAP- and LHRH-like immunoreactive (LI) materials were secreted simultaneously into the media under basal conditions. Prostaglandin E2 stimulated release of both peptides by approximately 2-fold. Both phorbol ester and [K+] stimulated release of GAP-LI by 4-fold and LHRH-LI by 9-fold over baseline levels. When materials from [K+]-stimulated media were separated according to MW by high performance size-exclusion chromatography, a single peak eluted at 1300 MW in the same position as synthetic LHRH. Two GAP-LI peaks were observed. One eluted in the void volume, while the predominant peak co-eluted with synthetic rat GAP1-56 at approximately 6500 MW. These results indicate that GAP and LHRH are co-secreted, that they are released as intact peptides, and that activation of different intracellular pathways may cause their differential secretion. These results emphasize the importance of using both in vitro and chromatographic methodologies to evaluate the changes which may occur in LHRH prohormone processing and secretion. PMID- 3282937 TI - Osteoclast development in marrow cultured in calvaria-conditioned media. AB - The precise signals responsible for recruitment and differentiation of osteoclasts (OCs) from their mononuclear precursors are poorly understood. Marrow mononuclear cells, a reputed source of OC precursors, fuse in culture, forming multinucleated cells. These cells, although similar to OCs, differ from osteoclasts in cell-surface morphology and are not recognized by an OC-specific monoclonal antibody. We have used the expression of an osteoclast-specific membrane epitope designated by monoclonal antibody 121F to delineate OCs from marrow-derived giant cells (MAGC). In this report we describe a series of experiments designed to better define the role of the bone environment in the osteoclast differentiation process. Periosteum-free calvariae from hatchling chicks or their conditioned media were combined with adherent Day 1 cultured marrow cells. The time course of OC marker expression was monitored by ELISA and the requirement for live bone and PTH was investigated. Freshly isolated marrow, MAGC, and calvariae were devoid of OC expression. Antigen expression developed in cultured MAGC after 4 days of coplating with either live bone or live bone conditioned media. The presence of PTH in the cocultures or conditioned media from PTH-treated calvariae did not significantly alter the level of expression. These data indicate that live bone is, in part, responsible for the production of osteoclasts from mononuclear precursors. PMID- 3282938 TI - The entire mesodermal mantle behaves as Spemann's organizer in dorsoanterior enhanced Xenopus laevis embryos. AB - The body plan of Xenopus laevis can be respecified by briefly exposing early cleavage stage embryos to lithium. Such embryos develop exaggerated dorsoanterior structures such as a radial eye and cement gland (K.R. Kao, Y. Masui, and R.P. Elinson, 1986, Nature (London) 322, 371-373). In this paper, we demonstrate that the enhanced dorsoanterior phenotype results from an overcommitment of mesoderm to dorsoanterior mesoderm. Histological and immunohistochemical observations reveal that the embryos have a greatly enlarged notochord with very little muscle tissue. In addition, they develop a radial, beating heart, suggesting that lithium also specifies anterior mesoderm and pharyngeal endoderm. Randomly oriented diametrically opposed marginal zone grafts from lithium-treated embryos, when transplanted into ultraviolet (uv)-irradiated axis-deficient hosts, rescue dorsal axial structures. These transplantation experiments demonstrate that the entire marginal zone of the early gastrula consists of presumptive dorsal mesoderm. Vital dye marking experiments also indicate that the entire marginal zone maps to the prominent proboscis that is composed of chordamesoderm and represents the long axis of the embryo. These results suggest that lithium respecifies the mesoderm of Xenopus laevis embryos so that it differentiates into the Spemann organizer. We suggest that the origin of the dorsoanterior enhanced phenotypes generated by lithium and the dorsoanterior deficient phenotypes generated by uv irradiation are due to relative quantities of organizer. Our evidence demonstrates the existence of a continuum of body plan phenotypes based on this premise. PMID- 3282939 TI - A spatial and temporal analysis of dorsal root and sympathetic ganglion formation in the avian embryo. AB - The present study explores the formation of the dorsal root and sympathetic ganglia in the trunk of the avian embryo. Particular emphasis was given to the timing of gangliogenesis and the relative positions of the neural crest-derived ganglia with respect to the somites. Neural crest cells and their derivatives were recognized by the HNK-1 antibody. The time at which neural crest cell coalesced to form ganglia was assessed by the state of cellular aggregation. The state of ganglionic differentiation was assessed by the expression of neurofilament proteins and the neural cell adhesion molecule (N-CAM). At the level of the 15th somite, neural crest cells were observed in the rostral half of the somite at stage 15, during active neural crest migration, and occupied the rostral two-thirds of the somite at progressive stages. HNK-1 positive cells appeared to be organized in three to four streams of cells oriented mediolaterally and dorsoventrally. The dorsal root ganglia and sympathetic ganglia were first detectable at stages 20 and 21, respectively. Both ganglionic rudiments were aligned with the rostral portion of the somite. The dorsal root ganglia occupied the rostral two-thirds of each somite, whereas cells in the sympathetic ganglia occupied a region corresponding to approximately one-third of each somite. At the time of condensation of the dorsal root ganglia, abundant neurofilament staining was observed within the ganglia. However, no N-CAM immunoreactivity was detected until three stages later at stage 23. In contrast, the sympathetic ganglia demonstrated both neurofilament and N-CAM immunoreactivity at the time of condensation. The observation that both dorsal root and sympathetic ganglia form in register with the rostral portion of somite suggests that cues localized at these axial levels, perhaps within the rostral somite, may influence the position where neural crest cells condense to form ganglia. In sensory ganglia, N-CAM expression does not correlate with the onset of gangliogenesis, suggesting that molecules other than N-CAM may play an important role in the aggregation of some neuronal populations. PMID- 3282940 TI - Minimal effects of phorbol esters on glucose transport and insulin sensitivity of rat skeletal muscle. AB - Protein kinase C (PKC) has been suggested as a mediator of insulin's effect on glucose transport, and PKC-mediated modulation of tyrosine kinase activity in the insulin receptor has been implicated in regulating the insulin sensitivity of tissues. Because skeletal muscle is a major target of insulin action, we examined the effects of 12-O-tetradecanoylphorbol-13-acetate (TPA), 1-oleoyl-2-acetyl-rac glycerol, and dioctanoyl diacylglycerol, known activators of PKC, on glucose metabolism in rat skeletal muscles. In contrast to results reported for other tissues, incubation of muscles with PKC activators produced only small increases in glucose transport and had minimal effects on the ability of insulin to stimulate transport. However, TPA treatment of muscles produced a significant decrease in basal glycogen synthesis. Incubation of muscles with TPA did not affect insulin binding or the tyrosine kinase activity of partially purified insulin receptors measured under basal conditions or after stimulation by insulin in situ or in vitro. Our findings do not support activation of PKC as a major mechanism for regulating glucose uptake or insulin receptor activity in skeletal muscle. However, the data do not rule out the possibility that glucose transport in skeletal muscle may respond to physiological activators of PKC. PMID- 3282941 TI - Regulation of whole-body leucine metabolism with insulin during mixed-meal absorption in normal and diabetic humans. AB - To determine the effects of insulin on dietary and endogenous leucine metabolism, five normal subjects, seven insulin-insufficient insulin-dependent (IDDM) diabetic patients, and five diabetic patients controlled with continuous subcutaneous insulin infusion (CSII) were studied before and for 8 h after ingestion of a chemically defined elemental test meal (10 cal/kg) containing crystalline amino acids. L-[1-14C]leucine was included in the meal to trace the entry and oxidation of the dietary leucine. Total (meal + endogenous) entry of leucine into the circulation was estimated with a constant infusion of [2H3]leucine. Postabsorptive and meal-related increases in the plasma leucine concentration were greater (P less than .05) in the insulin-insufficient IDDM than in the normal subjects but returned to near-normal values with CSII. Baseline leucine flux was approximately 40% greater in the insulin-insufficient IDDM than in normal subjects (2.17 +/- 0.17 vs. 1.55 +/- 0.15 mumol.kg-1.min-1, respectively; .05 less than P less than .01) but were near normal during CSII treatment (1.85 +/- 0.25 mumol.kg-1.min-1). Furthermore, total leucine entry during meal absorption was greater in the insulin-insufficient IDDM (1.41 +/- 0.10 mmol.kg-1.8 h-1) than in either normal (0.96 +/- 0.08 mmol.kg-1.8 h-1, P less than .01) or IDDM subjects during CSII treatment (1.09 +/- 0.11 mmol.kg-1.8 h-1, P less than .05). Fractional oxidation (approximately 40-50%) and entry of dietary leucine were similar in all three groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282942 TI - Role of host immune system in BB/Wor rat. Predisposition to diabetes resides in bone marrow. AB - The role of the immune system in the development of autoimmune diabetes mellitus in the BB/Wor rat was studied with bone marrow transplantation methodology. In the first experiment, diabetes-prone (DP) and diabetes-resistant (DR) BB/Wor rats were irradiated and reconstituted with bone marrow to create both reciprocal (DP donor----DR host; DR donor----DP host) and syngeneic (DR----DR; DP----DP) histocompatible chimeras. Both susceptibility and resistance to subsequent spontaneous diabetes in these chimeras were found to be a function of the type of donor bone marrow transplanted and not the genetic background of the host. In a second experiment, rats from three strains that share the RT1u major histocompatibility complex haplotype of the BB/Wor and rats from three non-RT1u strains were lethally irradiated and reconstituted with DP BB/Wor bone marrow. To rapidly induce diabetes and/or insulitis, they were then injected with mitogen activated spleen cells from acutely diabetic DP BB/Wor donors, with standard passive-transfer methods. Diabetes and pancreatic insulitis were observed in RT1u recipients, whereas non-RT1u rats developed insulitis but not diabetes. The data suggest that predisposition to spontaneous diabetes in BB rats resides in bone marrow cells. PMID- 3282943 TI - Counterregulatory hormone responses preserved after long-term intravenous insulin infusion compared to continuous subcutaneous insulin infusion. AB - The counterregulatory hormone responses of cortisol, growth hormone, glucagon, epinephrine, norepinephrine, and dopamine to a fixed hypoglycemic stimulus (50 mg/dl for 1 h) were studied in five type I (insulin-dependent) diabetic subjects during conventional insulin therapy (CT), after 3 mo of continuous subcutaneous insulin infusion (SC), and after 3 mo of continuous intravenous insulin infusion (IV). During the two infusion periods, the overall mean levels of preprandial blood glucose (116 +/- 6 SC vs. 114 +/- 5 mg/dl IV) and glycosylated hemoglobin (6.1 +/- 2 SC vs. 5.9 +/- 2% IV) were virtually identical, but there were more hypoglycemic episodes and greater variability of preprandial blood glucose levels during SC than with IV. During the last 30 min of the hypoglycemic clamps, the mean levels of epinephrine and cortisol were significantly lower after 3 mo of SC (epinephrine, 268 +/- 80 pg/ml; cortisol, 14 +/- 1 microgram/dl) than with both CT (epinephrine 485 +/- 80 pg/ml; cortisol, 20 +/- 2 micrograms/dl) and IV (epinephrine, 443 +/- 62 pg/ml; cortisol, 19 +/- 2 micrograms/dl)(P less than .05). The mean growth hormone level was significantly (P less than .05) lower after SC (37 +/- 9 ng/ml) than after IV (79 +/- 12 ng/ml), but it did not reach statistical significance compared with CT (66 +/- 12 ng/ml). The mean glucagon, dopamine, and norepinephrine levels during the same period of hypoglycemia were not different when all treatment regimens were compared. We conclude that intensified insulin therapy with SC leads to significant blunting of the counterregulatory hormone response to hypoglycemia, whereas IV does not.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282944 TI - Modulation of insulin activity by hydrochloride salts. AB - The influence of hydrochloride salts of various amino acids and other drugs on the activity of exogenously administered insulin was studied in the rat. Insulin activity was assessed in terms of insulin's effects on lowering of blood glucose and nonesterified fatty acids (NEFA), release of adrenaline (epinephrine) from the adrenal medulla, and the elevation of urinary catecholamines. Insulin alone produced a 60-70% fall in blood glucose and NEFA, 70% depletion of adrenal epinephrine, a 10-fold increase in urinary epinephrine, and a 2-fold elevation of adrenal dopamine. Concurrent administration of hydrochloride salts completely abolished all clinical manifestations that usually accompany insulin injection. Serum glucose and NEFA remained unchanged, the fall in adrenal epinephrine was blocked, and the increase in urinary catecholamines was abolished. These data suggest that certain hydrochloride salts possess an anti-insulin property. They decrease tissue responsiveness to insulin, thus rendering its action ineffective. The implication of these findings on the treatment of diabetic subjects requiring insulin therapy is discussed. PMID- 3282945 TI - Insulin gene in familial NIDDM. Lack of linkage in Utah Mormon pedigrees. AB - Although non-insulin-dependent diabetes mellitus (NIDDM) is well recognized to be an inherited disease, the genetic lesion responsible remains to be determined. Several pedigrees have been reported in which defects of the insulin gene result in glucose intolerance or diabetes in affected members, but the role of insulin gene mutations in NIDDM is unknown. To evaluate this role, we ascertained 23 Caucasian pedigrees for a diabetic individual with at least one diabetic family member, sampled the unaffected individuals by a 75-g glucose tolerance test, and prepared leukocyte DNA on all family members. Included in the pedigrees ascertained were those with both predominantly lean and predominantly obese diabetic members and four pedigrees included as insulin-dependent diabetic individual. Insulin gene involvement was evaluated via previously described restriction-fragment-length polymorphisms (RFLPs) for the insulin gene and the nearby c-Ha-Ras oncogene (HRAS). Combination of these RFLPs resulted in the ability to trace the insulin alleles in all pedigrees studied. Analysis of individual pedigrees for sharing of insulin alleles was possible in 12 pedigrees, and lack of linkage was demonstrated in 6 of them. Neither linkage nor lack of linkage could be proved in the remaining pedigrees. Analysis of the pooled pedigree data failed to demonstrate linkage under several models, including autosomal-dominant and -recessive inheritance with different sporadic frequencies of diabetes and different prevalence figures. These results show that mutations of the insulin gene and the immediately surrounding area, including regulatory regions of the insulin gene, are unlikely to account for a significant subset of NIDDM in Caucasian individuals. PMID- 3282946 TI - Day-long integrated serum insulin and C-peptide profiles in patients with NIDDM. Correlation with urinary C-peptide excretion. AB - To determine whether non-insulin-dependent diabetes mellitus (NIDDM) is characterized by day-long hypoinsulinemia, we measured 24-h serum profiles for glucose, insulin, and C-peptide by use of a constant-rate blood-withdrawal technique in diabetic and control subjects fed isocaloric meals. When only lean subjects were considered, diabetic subjects (relative body weight 0.99 +/- 0.3) and control subjects (relative body weight 0.95 +/- 0.03) had similar 24-h integrated serum insulin concentrations (13.4 +/- 2.5 vs. 16.1 +/- 2.0 microU/ml, P NS) due to the offsetting effects of increased basal levels and decreased postprandial responses in NIDDM. In contrast, both basal and meal-stimulated insulin levels were decreased in obese NIDDM subjects (relative body weight 1.39 +/- 0.07) compared with obese control subjects (relative body weight 1.60 +/- 0.08), resulting in a 61% reduction in the 24-h integrated insulin value (18.7 +/ 1.5 vs. 48.4 +/- 13.7 microU/ml). Thus, the capacity to increase 24-h integrated serum insulin as a function of relative body weight was impaired in NIDDM subjects (r = 0.27, P NS) compared with control subjects (r = .70, P less than .01). In contrast, 24-h integrated C-peptide was decreased (P less than .01) in both lean (0.92 +/- 0.13 pM/ml) and obese (1.52 +/- 0.19 pM/ml) NIDDM patients compared with the respective control groups (1.50 +/- 0.13 and 3.03 +/- 0.44 pM/ml). The molar ratio of 24-h integrated C-peptide to insulin was diminished in lean but not obese NIDDM compared with control subjects. A 3-wk period of intensive insulin therapy led to normalization of the mean 24-h integrated insulin (but not integrated serum C-peptide) value in NIDDM compared with a control group that had an identical mean relative body weight. The 24-h urinary C peptide measured on the same day as the serum profile was correlated (P less than .01) with both the 24-h integrated serum insulin (r = .69) and C-peptide (r = .67) concentrations in control subjects but not in NIDDM subjects (r = .20 and .04, respectively, P NS). Additionally, the urinary clearance of C-peptide was increased in NIDDM (38.1 +/- 7.8 vs. 20.4 +/- 1.7 ml/min in control subjects, P less than .05) and varied with treatment status (26.0 +/- 4.6 ml/min after insulin therapy).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3282947 TI - Severe diabetes induced in subtotally depancreatized dogs by sustained hyperglycemia. AB - Chronic clamping of plasma glucose levels at greater than or equal to 250 mg/dl in four partially depancreatized but previously nondiabetic dogs was followed within 2 wk by persistent hyperglycemia and glycosuria of less than or equal to 500 g/day, ketonuria, and weight loss. Three of the four dogs required daily insulin injections to control these catabolic manifestations. There was no evidence of spontaneous improvement of the severe diabetic state during the 39-69 days of observation after discontinuation of intravenous glucose infusion. Impairment of intravenous glucose tolerance, loss of the insulin response to glucose and arginine, fasting hyperglucagonemia, exaggerated glucagon responsiveness to arginine, and a significant reduction in sensitivity to insulin were characteristic of all diabetic dogs. Morphometric analysis of the endocrine pancreas revealed a profound reduction in the number and size of identifiable islets of the hyperglycemic dogs compared with islets from their own pancreases resected months earlier and with those from pancreatic remnants of eight subtotally depancreatized control dogs that had not been subjected to chronic hyperglycemic clamping. The reduction in number and size of islets of the hyperglycemic dogs was largely the consequence of depletion of insulin-containing cells and was similar to that of dogs with long-standing alloxan-induced diabetes. In the eight control dogs, clinical evidence of diabetes did not develop during a follow-up period of 193-296 days. In this group, there was no evidence of diminution of intravenous glucose tolerance, of the insulin response to glucose or arginine, or of insulin sensitivity as determined by an acute hyperinsulinemic hyperglycemic clamp. The number and size of islets and number of beta-cells in pancreatic remnants from these dogs did not differ morphometrically from those of the pancreatic segment that had been resected. We conclude that in subtotally depancreatized but nondiabetic dogs, maintenance of constant hyperglycemia of greater than or equal to 250 mg/dl by means of intravenous glucose infusion causes a severe, persistent, and often insulin-requiring diabetic state that does not occur in the absence of the hyperglycemia. PMID- 3282948 TI - Morphological evidence for pancreatic polarity of beta-cell within islets of Langerhans. AB - Reconstructions from serial paraffin sections were used to define the relationships of the pancreatic endocrine cells and the microvasculature of the islets of Langerhans of the rat. We have reported that the afferent vessel to an islet, an arteriole, enters the islet directly in the beta-cell core. Immediately after entering the islet, this arteriole branches into capillaries. Herein, we report that beta-cells have two capillary faces. When viewed in cross section, 8 10 beta-cells form a tubelike structure around a central capillary. The outer side of each beta-cell also abuts a capillary. A clear polarity of secretory granules was seen on the ultrastructural level when the beta-cells were partially degranulated by prior in vivo treatment with glyburide. Of the remaining granules, 75.7 +/- 1.7% were accumulated in the apical portion of the cell, even though this portion was only 50.4 +/- 3.2% of the cytoplasm. beta-Cells around a particular cross-sectioned capillary shared the same orientation of granular accumulation. These findings provide morphological evidence of in situ beta-cell polarity that could be an anatomical basis for functional compartmentalization. PMID- 3282949 TI - Binding of cytoplasmic islet cell antibodies is blocked by human pancreatic glycolipid extracts. AB - With biochemical and enzymatic treatment of frozen sections of pancreas, we have previously shown that cytoplasmic islet cell antibodies (ICAs) react with carbohydrate determinants of islet cell glycoconjugates. As a first step toward purifying these glycoconjugates, human pancreas tissue was extracted in a mixture of chloroform and methanol, and the glycolipids were obtained by effecting a Folch partition. The protein pellet, lipid fraction, and glycolipid fraction so obtained were assessed for their ability to block the binding of ICAs to frozen sections of human pancreas, the effect being quantitated with a photometer. Only the glycolipid extract could block ICA binding, and blocking was dose dependent. Subfractionation of the glycolipid extract by hydrophobic interaction on C18 cartridges demonstrated that blocking activity resided in the fraction bound and eluted with methanol, consistent with the autoantigen being a glycolipid. Furthermore, the binding of an anti-islet cell ganglioside monoclonal antibody, 3G5, could be blocked with these extracts, whereas the binding of an anti-islet cell protein monoclonal antibody, 4F2, was unaffected. The major gangliosides of the pancreas were seen to be GM3 and GD3 by thin-layer chromatography (TLC). Fractions scraped and eluted from TLC plates were tested for their ability to block ICA binding to pancreatic sections. Neither GM3- nor GD3-containing fractions could block ICA binding; however, a fraction containing minor pancreatic gangliosides (including GM2) of monosialoganglioside mobility was a potent inhibitor of ICA binding to pancreas sections. TLC of a chloroform methanol extract of human islets demonstrated that islets differentially express monosialogangliosides (especially GM2). PMID- 3282950 TI - Heart glucose transport and transporters in rat heart: regulation by insulin, workload and glucose. AB - Aspects of the regulation of the glucose transport by perfused hearts of normal rats have been studied by measuring glucose transport (via the efflux of labelled 3-O-methyl-D-glucose) and glucose transporters (via the labelled cytochalasin B binding assay). Similarly to what is observed with insulin, increasing workload (by raising perfusion pressure from 50 to 100 mm Hg) stimulated glucose transport 7 to 8-fold. Glucose (via its analog 3-O-methylglucose, used at 15 mmol/l) stimulated its own transport 4-fold. The three stimuli favored the translocation of glucose transporters from an intracellular pool (microsomes) to the plasma membrane. Insulin increased the apparent affinity (decreased dissociation constant values) of plasma membrane transporters for cytochalasin, as well as the Hill coefficient, indicating the occurrence of a positive cooperativity amongst plasma membrane transporters. Workload increased only the Hill coefficient, glucose only the apparent affinity for cytochalasin of plasma membrane transporters. This study shows that insulin, workload and glucose itself stimulate glucose transport by favouring the translocation process of glucose transporter as well as by changing, albeit by a different mechanism, the functional properties of the transporters once translocated to the plasma membrane. PMID- 3282951 TI - Strict insulin therapy normalises organ nitrogen contents and the capacity of urea nitrogen synthesis in experimental diabetes in rats. AB - Rats with experimental diabetes due to streptozotocin (75 mg/kg body weight) and free access to food were divided into two groups. One group (n = 9) was optimally treated with insulin (glucosuria less than 4.0 mmol/24 h), using heat treated very long-acting ultralente insulin. The other group (n = 10) was poorly treated with insulin (glucosuria 20-30 mmol/24 h). The nitrogen balance and energy balance of optimally treated diabetic rats was positive and not different from the control group (n = 6). In the poorly treated diabetic rats the nitrogen balance was reduced whereas the energy balance was not different from that of control rats. After 4 weeks the fasting glucagon was: 50 +/- 21 ng/l (mean +/- SEM) in control rats, 62 +/- 18 ng/l in optimally treated diabetic rats and 249 +/- 58 ng/l in poorly treated diabetic rats (p less than 0.01). The capacity of urea nitrogen synthesis determined during alanine loading was: 9.6 +/- 1.0 mumol/(min 100 g body weight) in control rats, 10.6 +/- 1.7 mumol/(min 100 g body weight) in optimally treated diabetic rats and 17.3 +/- 1.3 mumol/(min 100 g body weight) in poorly treated diabetic rats (p less than 0.01). Nitrogen contents of carcass, heart, intestines, liver, and kidneys as determined by Kjeldahl analyses were identical in control rats and optimally treated diabetic rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282953 TI - Between and within subject variation of the first phase insulin response to intravenous glucose. AB - Eight normal subjects underwent two intravenous glucose tolerance tests to determine the between and within subject variation of the first phase insulin response. Variability was represented by the coefficient of variation. The between subject variation for the incremental 0-10 min insulin area was 58%, and the within subject variation was 22% (median value), range 3-55%. The variation of the first phase response expressed in four different ways was compared. The total and incremental (above fasting levels) 0-10 min areas provided less variable results (variation 52 and 58%) than the 1 + 3 min insulin levels (variation 72%) or mean of the incremental 3-5 min insulin levels (variation 66%). The ratio of the incremental 0-10 min insulin to glucose areas was as variable (variation 53%) as the insulin responses alone. The variability of insulin responses to intravenous glucose severely limits their value as early predictors of B-cell failure. PMID- 3282954 TI - Elevated serum uric acid. PMID- 3282952 TI - Insulin-dependent changes in lysosomal cathepsin D activity in rat liver, kidney, brain and heart. AB - Streptozotocin-induced diabetes resulted in a decrease in the cathepsin D activity (free and total) in rat liver, kidney, brain and heart with a concomitant increase in tissue protein content and amino acids pool size. Treatment with insulin brought about the restoration of the cathepsin D activity to normal or greater than normal levels; tissue protein content and amino acids pool size also returned to normal values. PMID- 3282955 TI - Is insulin atherogenic? PMID- 3282956 TI - Regional variation in skin blood flow response to hypoglycaemia in type 1 (insulin-dependent) diabetic patients without complications. AB - Body temperature falls during hypoglycaemia, perhaps as a protective mechanism. To test the hypothesis that the skin blood flow response to hypoglycaemia is specifically designed to facilitate heat loss we studied both nutritional blood flow and arteriovenous shunting of blood in skin during prolonged, controlled hypoglycaemia in man. We studied eight otherwise healthy, male, Type 1 (insulin dependent) diabetic patients. Under Biostator control blood glucose was clamped at 8.0 (7.9-8.9), mmol/l (median and range) for 30 min, reduced to symptomatic hypoglycaemia, 1.7 (1.0-2.6) mmol/l for 20 min then raised to 4.9 (3.3-6.7) mmol/l. Interdigital skin web blood flow (laser doppler flowmeter, nutritional flow) fell during hypoglycaemia from 3.1 (2.2-3.8) to 2.4 (1.2-2.8) volts and remained depressed. In contrast, finger blood flow (venous occlusion plethysmography, arteriovenous shunt flow) started high at 54.7 (17.4-85.6), remained high at 52.7 (38.1-81.4) during hypoglycaemia but fell sharply to 25.3 (4.2-66.2) ml.min-1.100 ml-1 when symptoms were relieved. Plasma adrenaline and vasopressin both rose during hypoglycaemia from 0.4 (0.05-0.8) to 4.5 (2.3-20.2) nmol/l and from 0.5 (0.5-3.5) to 4.4 (2.0-13.9) pg/ml, respectively, and both fell sharply thereafter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3282957 TI - Changing patterns of obstetric practice in Washington State: the impact of tort reform. AB - Rapidly rising malpractice premiums have profoundly altered patterns of obstetrical practice. In the summer of 1986, the state of Washington enacted major tort reform legislation intended to stabilize the costs of liability insurance. Following passage of the legislation, we surveyed obstetricians, family physicians, and midwives in the state to assess the likely impact of tort reform on future practice patterns. Largely because of malpractice concerns, 40% of family physicians, 15% of obstetricians, and 27% of midwives had discontinued obstetrical practice. Although obstetrical participation has decreased most dramatically for family physicians, the mean number of deliveries per physician has increased to the extent that the proportion of deliveries attended by family physicians has remained stable at about 30%. However, as fewer family physicians practice obstetrics, the availability of care has diminished in rural areas. The passage of tort reform legislation has induced one-third of those respondents currently practicing obstetrics to at least temporarily continue to practice obstetrics. Despite tort reform, however, the majority of respondents either do not provide or ration care to the medically indigent. The major deleterious social impact of the professional liability problem is reduced access to care in rural areas and a severe curtailment of care to the medically indigent. Tort reform alone will not solve these problems. PMID- 3282958 TI - Comparison of three prenatal risk scores in a series of low-risk pregnancies. AB - Three prepartum obstetrical risk-scoring methods (Goodwin, Halliday, Hobel) were retrospectively applied to a consecutive series of 795 singleton pregnancies. The study population was low risk overall, with a perinatal mortality rate of 11 per 1000 and a primary cesarean section rate of 9.7%. The predictive ability of the scores was tested for individual outcomes as well as for a "combined measure" designed to group outcomes of clinical interest. Outcome variables examined included labor arrests, need for augmentation of labor, fetal heartrate abnormalities during labor, selection of or transfer to a more intensive level of care, indicated forceps delivery, cesarean section, resuscitation, Apgar scores, permanent injury, and perinatal deaths. Along with expected differences in sensitivity and specificity, there were differences among the three scores in performance as measured by positive and negative predictive value. Goodwin's system performed somewhat better overall. All three systems performed better in multiparous than in primiparous patients, but primiparas experienced more adverse outcomes. PMID- 3282959 TI - Glomerular hemodynamic and structural alterations in experimental diabetes mellitus. AB - Elevated glomerular filtration rate (GFR) is a frequent finding in patients with early insulin-dependent diabetes mellitus (IDDM). The mechanisms responsible for this glomerular hyperfiltration in IDDM are unclear. Rats made diabetic with alloxan or streptozotocin, and treated daily with supplemental insulin, have moderate hyperglycemia and elevated GFR, and thus have been used to study mechanisms of glomerular hyperfiltration in diabetes. Renal micropuncture techniques have shown that single-nephron GFR (SNGFR) is elevated in moderately hyperglycemic diabetic rats. In some cases, this is because of elevated glomerular capillary pressure (Pgc), but in other cases, Pgc is normal despite elevated SNGFR. Several potential mediators of increased SNGFR have been examined, including hyperglycemia, increased glomerular prostaglandin production, and decreased sensitivity of the tubuloglomerular feedback mechanism. Renal failure is a common complication of human IDDM. Diabetic rats with long-term moderate hyperglycemia have been used to study the mechanism by which glomerular injury develops in diabetes mellitus. It has been postulated that glomerular hyperfiltration or some determinant of elevated GFR in early diabetes may ultimately cause glomerular damage, leading to a progressive loss of renal function (diabetic nephropathy). Diabetic rats with long-term moderate hyperglycemia, however, do not develop characteristic glomerular lesions of human diabetic nephropathy and, in fact, develop only minimal glomerular injury even after 1 year of diabetes. Thus, although the diabetic rat with moderate hyperglycemia may be useful to study the mechanisms of glomerular hyperfiltration in early diabetes, it may not be an appropriate model of renal failure in IDDM. PMID- 3282960 TI - Regulation of protein kinase C activity by lipids. AB - Protein kinase C is activated by the simultaneous presence of phospholipid, a diglyceride, and Ca2+. Under physiological conditions the activity of the enzyme is regulated by the availability of diglycerides, which are the products of phosphoinositide hydrolysis. The phospholipid-kinase interactions appear not to be of a highly specific nature. Phosphatidylserine (PS) is presumed to be the endogenous lipid that interacts with the kinase, but other acidic lipids can substitute. On the other hand, the kinase-diglyceride interactions are highly specific in nature, as would be expected of a physiological regulator. These interactions are stereo-specific and stoichiometric with respect to diglyceride. The specificity is directed toward the glycerol backbone and hydrophilic oxygen moieties of the diglyceride. The removal of one or more of the oxygen atoms or the addition of a single methyl group to the glycerol backbone virtually abolishes the activity of a putative diglyceride activator. The extreme specificity of the kinase toward the diglycerides, however, must be contrasted with the abilities of structurally diverse tumor promotors and irritants to activate the kinase. Specific small-molecule antagonists of protein kinase C have yet to be developed. The small-molecule antagonists that have been developed so far have been relatively nonspecific cationic lipids that appear to function by interfering with the interaction between the acidic phospholipids and Ca2+. PMID- 3282961 TI - Quantification of the pathways followed in hepatic glycogen formation from glucose. AB - Quantitative contributions of the direct and indirect pathways to liver glycogen formation from a glucose load have been estimated from 1) the distribution of label in glycogen formed from specifically carbon-labeled loads of glucose, 2) the specific activity of the glycogen compared with that of the circulating glucose, 3) the 3H:14C ratios in glycogen formed from loads specifically labeled with 3H and 14C, 4) the incorporation of 3H from 3H2O into the glycogen, and 5) the balance of glucogenic substrates across the splanchnic bed. A number of assumptions are made in the use of each of these methods. Estimates have been made for animals and humans fasted overnight or longer. Results obtained with the different methods are compared. Under these conditions, the contribution of the pathways appears to be determined by the size of the load, with larger contributions of the indirect pathway occurring with smaller loads. PMID- 3282962 TI - Intramural hemorrhage simulating gastric neoplasm. AB - We report a case of benign gastric ulcer with secondary extensive intramural hemorrhage causing a radiographic appearance consistent with a large ulcerated gastric neoplasm. This is the second such case reported and the first studied with sonography and computed tomographic scan. A brief review of the literature on intramural gastric hematoma is presented. PMID- 3282963 TI - Ultrasound, CT, and MRI comparison in primary and secondary tumors of the liver. AB - Thirty-five patients with surgically removed or percutaneous biopsy-proven tumors were examined by ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). This retrospective study describes the appearance of the primary tumors and metastases and compares the sensitivity and specificity of the 3 imaging methods. Ultrasound, CT, and MRI examinations as well as clinical, operative, and/or histologic data were available for all 35 patients. Paramagnetic contrast agent gadolinium-diethylenetriamine pentaacetic acid (Gd DTPA) was used in 23 patients and a short TI inversion recovery MRI sequence was used in 23 patients, in addition to various spin echo MRI sequences. Thirteen patients were examined using both Gd-DTPA and the short TI inversion recovery sequence. Our comparative study--based on the following criteria: detection, size, location of the tumor, and portal vein involvement and bile duct dilatation -demonstrated an advantage of MRI over ultrasound in 16 of 35 cases, equal results in 17 of 35 cases and a disadvantage of MRI compared to ultrasound in 2 of 35 cases. With the identical criteria, MRI proved to be more informative than CT in 10 of 35 cases, equal in 21 of 35 cases, and less informative in 4 of 35 cases. PMID- 3282965 TI - Ultrasound of the traumatized spleen: left butterfly sign in lesions masked by echogenic blood clots. AB - Ultrasonic display of blood on both sides of the splenogastric ligament (left butterfly sign) in the left traumatized patient indicates hemoperitoneum within the lesser sac. Particular attention must be paid then to the splenic parenchyma, where isoechogenic blood clots can mask a hematoma. The association of subtile parenchymal changes and of a left butterfly sign are relevant of frank splenic lesions. PMID- 3282964 TI - Hepatic abscess: sensitivity of imaging tests and clinical findings. AB - The imaging studies of 63 patients with hepatic abscess were evaluated to determine the sensitivity of specific imaging tests and define causes of false negative test results. Computed tomography (CT) detected 57 of 59 (97%) separate episodes of hepatic abscess. The two false-negative CT examinations were in patients with a diffuse low-density pattern throughout the liver. The radionuclide (RN) examination detected 16 of 20 (80%) cases, missing abscesses less than 2 cm in diameter. Ultrasound detected 33 of 42 (79%) cases, missing abscesses in the dome of the liver, small abscesses, and 2 large early abscesses. For all three imaging modalities, a specific diagnosis of abscess was possible only in those patients in whom CT scans demonstrated abscess gas (15%). The results of the imaging studies were correlated with the patients' clinical condition and laboratory findings. Thirty-one percent of patients were afebrile while 23% had normal white blood cell counts. Thirteen percent had totally normal liver function tests. We conclude that the clinical absence of fever, leukocytosis, or elevated liver function tests does not permit exclusion of the diagnosis of hepatic abscess. A CT scan is highly specific in excluding the diagnosis of hepatic abscess in the absence of diffuse liver disease. In this retrospective study CT was the most sensitive imaging modality available for the detection of hepatic abscess. PMID- 3282967 TI - Our president--John M. Dietschy, M.D. PMID- 3282966 TI - Pseudocyst following splenectomy: impact of CT and ultrasound on its diagnosis and management. AB - Three cases of pseudocysts occurring after splenectomy are presented. Sonography and computed tomography were helpful in diagnosing the pseudocysts as well as providing guidance for subsequent drainage. Demonstration of a cystic mass adjacent to the tail of the pancreas following splenectomy suggests the diagnosis of postsplenectomy pseudocyst and has important implications for clinical management. PMID- 3282968 TI - Epithelioid hemangioendothelioma of the liver. Diagnostic features and role of liver transplantation. AB - Five cases of epithelioid hemangioendothelioma of the liver are reported. This unusual type of vascular tumor is often difficult to diagnose; its angiogenic nature is not overt at the radiologic level and may be overlooked by conventional histologic examination. At imaging procedures, epithelioid hemangioendothelioma of the liver presents as multiple focal hypovascular areas, disseminated in both lobes. The combination of these imaging abnormalities with a peculiar set of demographic and clinical features, including young age, good general condition, and progressive course, is suggestive. However, the final diagnosis can be established only by histologic examination of appropriate material collected by guided liver biopsies and may be helped by immunohistochemistry and ultrastructural examination. The accurate diagnosis of epithelioid hemangioendothelioma of the liver is of clinical and therapeutic relevance. In view of its favorable clinical course, orthotopic liver transplantation may be considered for the treatment of this tumor when intrahepatic dissemination contraindicates partial hepatectomy and extrahepatic extension, excluded by exploratory laparotomy, is absent. PMID- 3282969 TI - Benign peptic ulcers penetrating pericardium and heart: clinicopathological features and factors favoring survival. AB - Penetration of the pericardium and heart by benign peptic ulcers is rare. Before 1965 it was almost invariably fatal, but about 20% of recently reported cases have survived. We report 4 representative cases and review 91 additional cases from the literature. The ulcers arose in esophagus, hiatus hernias, abdominal stomach, and near anastomoses, and the predominant predisposing factor was previous surgery to the esophagogastric region. Whereas penetrating esophageal ulcers had a slightly better prognosis than gastric lesions, the principal determinant of clinical presentation, findings, and prognosis was the site of cardiac involvement. The clinicopathological features of pericardial, atrial, and ventricular involvement are distinct. We evaluate the different implications of these features for diagnosis, management, and prognosis and make some tentative recommendations regarding diagnostic procedures and treatment. Early diagnosis and prompt surgical intervention are critical to successful treatment of this entity, which may present with predominantly cardiac or gastrointestinal symptomatology. PMID- 3282970 TI - [Prenatal diagnosis of hereditary hemoglobinopathies]. PMID- 3282971 TI - Insulin-like material from the digestive tract of the tunicate Pyura pachydermatina (sea tulip). AB - Gut tissue from the tunicate Pyura pachydermatina (sea tulip) was found to contain a compound or compounds which react with anti-porcine insulin antibodies, but not anti-hag-fish insulin antibodies, and which also stimulate lipogenesis in isolated rat fat cells. The insulin-like material is present in two immunologically active forms, a species of Mr 6000 apparently similar to mammalian insulin, and a high Mr form which expresses biological activity only after further purification by reverse-phase HPLC. The bioactivity of both species is suppressed in the presence of anti-porcine insulin antibodies. PMID- 3282972 TI - Enhancement of water intake by captopril (SQ14225), an angiotensin I-converting enzyme inhibitor, in the goldfish, Carassius auratus. AB - Single intraperitoneal (ip) injections of angiotension II (ANG II) stimulated water intake for 60 min in a dose-related manner in the goldfish, Carassius auratus. Single ip injections of captopril (SQ14225), an angiotension I converting enzyme (ACE) inhibitor, at lower doses (0.4 and 4.0 micrograms/fish), stimulated water intake for 60 min. This stimulation cannot be ascribed to an increase in levels of plasma ANG I, since ANG I (2.2 micrograms/fish) did not stimulate drinking in the presence of SQ14225 (two injections of 9.9 micrograms/fish). It is suggested that the elevated plasma ANG I concentration achieved after blockade of ACE was converted into ANG II approximately 50 min after SQ14225 injections (4.0 g/fish), when the injected SQ14225 was effectively metabolized. Thus, the newly elevated level of ANG II may have been responsible for the vigorous drinking. Higher doses of SQ14225 (40 and 200 microgram/fish) did not affect the water intake for 60 min, indicating that the rate of basal water intake is independent of the renin-angiotensin system in the goldfish. PMID- 3282973 TI - Localization of immunoreactive gastrin-like cells in the alimentary tract of the ascidian Styela plicata. AB - The occurrence of a gastrin-like immunoreactivity in the alimentary tract of the ascidian Styela plicata has been investigated using immunocytochemical methods. Gastrin-like cells are present only in the gastric epithelium among the cell types responsible for digestion and absorption of food. The physiological role played by the ascidian gastrin-like peptides is discussed together with the evolutionary history of peptides of the gastrin/cholecystokinin family. PMID- 3282974 TI - Isolation of alligator gar (Lepisosteus spatula) glucagon, oxyntomodulin, and glucagon-like peptide: amino acid sequences of oxyntomodulin and glucagon-like peptide. AB - Oxyntomodulin, glucagon, and a glucagon-like peptide (GLP) have been isolated from the endocrine pancreas of the alligator gar (Lepisosteus spatula), a ganoid fish. The three peptides were isolated by gel filtration and HPLC and were identified by size, composition, and glucagon-like immunoreactivity. The amino acid sequences of the oxyntomodulin and GLP were determined. The oxyntomodulin contains 36 amino acid residues and its sequence is H S Q G T F T N D Y S K Y L D T R R A Q D F V Q W L M S T K R S G G I T. The composition of the glucagon is identical to the N-terminal 29 residues of the gar oxyntomodulin. The single form of GLP found contains 34 amino acid residues in the following sequence: H A D G T Y T S D V S S Y L Q D Q A A K K F V T W L K Q G Q D R R E. These findings suggest that all three peptides are derived from a common precursor. PMID- 3282975 TI - In memoriam John Guest Phillips (1933-1987). PMID- 3282977 TI - Isolation and structure of lamprey (Petromyzon marinus) insulin. AB - Insulin has been purified to homogeneity from the caudal and cranial pancreas of the adult sea lamprey (Petromyzon marinus). The final yield was 18.6 nmol/g (127.8 micrograms/g). The structures of both A- and B-chains have been determined using amino acid analyses, gas-phase sequence analyses, and proteolytic mapping by fast atom bombardment-mass spectrometry. The sequence of the A-chain was found to be GIVEQCCHRKCSIYDMENYCN. The sequence of the B-chain, extended at the amino terminus, was determined to be SALT-GAGGTHLCGSHLVEALYVVCGDRGFFYTPSKT. Lamprey insulin retains the common features of vertebrate insulins. Sea lamprey insulin has no more homology to hagfish (Myxine glutinosa) insulin than it has to the teleost fish or to mammalian insulins. PMID- 3282976 TI - Effects of [D-Arg6, Trp7, Leu8, Pro9NEt]-luteinizing hormone-releasing hormone (sGnRH-A) and [D-Ala6, Pro9NEt]-luteinizing hormone-releasing hormone (LHRH-A), in combination with pimozide or domperidone, on gonadotropin release and ovulation in the Chinese loach and common carp. AB - The effects of LHRH-A and sGnRH-A alone and in combination with the dopamine receptor antagonists pimozide (PIM) and domperidone (DOM) on stimulation of gonadotropin (GtH) secretion and ovulation in Chinese loach (Paramisgurnus dabryanus) and common carp (Cyprinus carpio) were studied. When tested in the absence of a dopamine receptor antagonist, sGnRH-A was about 10-fold more potent than LHRH-A in stimulating GtH secretion in loach, whereas these peptides were of similar effectiveness in common carp. Both peptides were effective alone in inducing ovulation in loach, but were ineffective in common carp. PIM and DOM stimulate a small but significant increase in serum GtH, and greatly potentiate the effects of LHRH-A and sGnRH-A on GtH secretion and ovulation in both species. DOM was of equal or somewhat greater potency than PIM in potentiating the action of releasing hormone agonists in loach; however, DOM had markedly greater effectiveness in common carp. sGnRH-A in the presence of DOM was more effective than LHRH-A in stimulating GtH secretion and ovulation in common carp. The present studies suggest that there are marked differences in the relative contribution of GnRH and dopamine in the control of GtH secretion in loach and common carp, and indicate in particular that the more intense dopaminergic inhibitory control of GtH release in common carp modifies the responsiveness of the pituitary to GnRH peptides. PMID- 3282978 TI - Morphometry of pancreatic beta cell populations during larval growth and metamorphosis of Rana catesbeiana. AB - Insulin secreting (beta) cell and pancreas volumes were estimated from bullfrogs at different stages in the life cycle. Estimations were made after immunostaining and planimetry of serial pancreas sections. The beta cell volume increased during larval life and is the most likely source of the increased insulin-like immunoreactivity extracted from tadpole pancreases (J. Hulsebus and E. S. Farrar (1985) Gen. Comp. Endocrinol. 58, 114-119). Metamorphic climax was associated with a loss of pancreas and beta cell volumes and insulin-like immunoreactivity. The beta cell pancreatic volume increased following metamorphosis and growth continued in juveniles and adults. The beta cell mass formed a relatively constant percentage of the total pancreatic volume throughout the life cycle. PMID- 3282979 TI - Gonadotropin-releasing hormone from brains of reptiles: turtles (Pseudemys scripta) and snakes (Thamnophis sirtalis parietalis). AB - Gonadotropin-releasing hormone (GnRH)-like peptides were present in whole brain extracts of turtle (Pseudemys scripta) and snake (Thamnophis sirtalis parietalis) with higher content and concentration in the turtle brain. The peptides were identified by cross-reactivity profiles with four GnRH antisera and by retention times on reverse-phase high-pressure liquid chromatography (HPLC) compared with synthetic GnRH standards. Turtle brain extracts contained two HPLC peaks that cross-reacted with GnRH antisera; these peaks eluted from the HPLC in the same positions as chicken I and II GnRH. Snake brain extracts contained only one major HPLC peak (and two minor peaks in some brains) that cross-reacted with anti-GnRH sera; the major peak eluted with the same retention time as chicken I GnRH. Mammalian, salmon, and lamprey GnRH-like peptides were not detected. In extracts from both turtle and snake brains, the cross-reactivity profile of the HPLC peaks compared with those of synthetic chicken I and II GnRH showed a similar order of sensitivity with four antisera. It is likely that chicken I and II GnRH-like peptides were present in ancestral reptiles prior to the evolution of the three living reptilian subclasses of Anapsida (turtle), Lepidosauria (snake and lizard), and Archosauria (alligator). This assertion is based on the present demonstration and work by others showing that chicken I and II GnRH-like peptides are in turtle and alligator, chicken I is in snake, and chicken II is in lizard. PMID- 3282981 TI - Power of the affected-sib-pair method for heterogeneous disorders. AB - We have examined the sample sizes required to detect linkage using the affected sib-pair (ASP) method for major psychiatric disorders that are characterized by population prevalences of 1-7%, decreased penetrance, phenocopies, and heterogeneity. In addition, the nature of these illnesses makes large, multigenerational pedigrees difficult to collect. We calculated the sample sizes needed to have 80% power of finding linkage (with a type I error rate of 5%) under dominant and recessive models with incomplete penetrance and allowing for recombination rates of up to 10% between the disease gene and marker gene. We have assumed that the identical-by-descent (IBD) status of ASPs is known exactly. For a disease like schizophrenia (1% population prevalence), if 50% of families are linked to a marker locus at 10% recombination, then 60 and 120 pairs are needed under recessive and dominant inheritance, respectively. For a disorder such as major affective disorder (7% population prevalence), the sample size is similar if the inheritance is recessive, but larger (160 pairs) if the inheritance is dominant. We conclude that this method may be a reasonable alternative for psychiatric disorders, especially to confirm that a linkage found in a specific pedigree or population isolate is also present in the general population. PMID- 3282980 TI - Identity of gonadotropin-releasing hormone in passerine birds: comparison of GnRH in song sparrow (Melospiza melodia) and starling (Sturnus vulgaris) with five vertebrate GnRHs. AB - Gonadotropin-releasing hormone (GnRH) was detected in the brains of passerine birds, a recently evolved and diverse avian group. The molecular forms of GnRH in two species of birds under breeding conditions were deduced using methods of HPLC and immunology. The brain extracts of song sparrows (Melospiza melodia) contained a form of GnRH identified as chicken I GnRH-like peptide by its HPLC elution pattern and cross-reactivity with four antisera. In contrast, starling (Sturnus vulgaris) brain extracts showed molecular heterogeneity of GnRH forms; equal amounts of chicken I and chicken II GnRH-like peptides were present. Neither bird contained GnRH that could be identified as mammalian, salmon, or lamprey GnRH. Chicken II GnRH-like peptide may not have evolved after the separation of the song sparrow and starling as both peptides are found in chicken, a more primitive bird. The possibility remains that different stages of the life cycle are associated with the expression of these GnRH-like peptides or their ratio. Only determination of the primary structure will establish whether our chromatographic and immunological evidence is correct that chicken I and II GnRH are present in passerine birds and have been conserved in representatives throughout the reptiles and birds. Starlings can be added now to the growing list of submammalian species that express multiple forms of GnRH in their brains. PMID- 3282982 TI - Equilibration and cognition: a review and elaboration of Piaget's genetic epistemology. AB - Piaget's concept of equilibration--and its current status--has been briefly reviewed. Two fundamental and essentially related issues were identified: the question of conformity between cognitive structures and their referent external reality and, from a cognitive viewpoint, the description of a "growing self regulatory adaptive system." These issues were reconsidered in relation to, and elaborated on the basis of, relevant ideas mainly from philosophy, cybernetics, and artificial intelligence. A model of a cognitive homeostatic system was developed from an innate subsystem to a learning-based control hierarchy that additionally involves a naturomorphic cognitive subsystem and an abstract cognitive subsystem. The process of equilibration of cognitive structures was approached in terms of the information processing characteristics of these two cognitive subsystems and their inherent sources of error, and the theoretical requirements for ensuring conformity between cognitive structures and their external referents have been indicated. The model, which takes into account these requirements, constitutes a systematic description of a learning based "growing self-regulating adaptive system." PMID- 3282983 TI - Escherichia coli mutations that prevent the action of the T4 unf/alc protein map in an RNA polymerase gene. AB - Bacteriophage T4 has the substituted base hydroxymethylcytosine in its DNA and presumably shuts off host transcription by specifically blocking transcription of cytosine-containing DNA. When T4 incorporates cytosine into its own DNA, the shutoff mechanism is directed back at T4, blocking its late gene expression and phage production. Mutations which permit T4 multiplication with cytosine DNA should be in genes required for host shutoff. The only such mutations characterized thus far have been in the phage unf/alc gene. The product of this gene is also required for the unfolding of the host nucleoid after infection, hence its dual name unf/alc. As part of our investigation of the mechanism of action of unf/alc, we have isolated Escherichia coli mutants which propagate cytosine T4 even if the phage are genotypically alc+. These same E. coli mutants are delayed in the T4-induced unfolding of their nucleoid, lending strong support to the conclusion that blocking transcription and unfolding the host nucleoid are but different manifestations of the same activity. We have mapped two of the mutations, called paf mutations for prevent alc function. They both map at about 90 min, probably in the rpoB gene encoding a subunit of RNA polymerase. From the behavior of Paf mutants, we hypothesize that the unf/alc gene product of T4 interacts somehow with the host RNA polymerase to block transcription of cytosine DNA and unfold the host nucleoid. PMID- 3282984 TI - An in vitro assay for frameshift mutations: hotspots for deletions of 1 bp by Klenow-fragment polymerase share a consensus DNA sequence. AB - The fidelity of in vitro DNA synthesis catalyzed by the large fragment of DNA polymerase I was examined. The templates, specifically designed to detect shifts to the +1 or to the -1 reading frame, are composites of M13mp8 and bacteriophage T4 rIIB DNA and were designed to assist in the identification of the types of frameshifts that are the specific consequence of DNA polymerization errors. In vitro polymerization by the Klenow fragment produced only deletions, rather than the mixture of duplications and deletions characteristic of in vivo frameshifts. The most frequent frameshifts were deletions of 1 bp opposite a template purine base. Hotspots for these deletions occurred when the template purine immediately preceded the template sequence TT. The highest mutation frequencies were seen when the TTPu consensus sequence was adjacent to G:C rich sequences in the 3' direction. The nature of the consensus sequence itself distinguishes this 1-bp deletion mechanism from those operating in DNA repeats and attributed to the misalignment of DNA primers during synthesis. Deletions that were larger than 1 or 2 bp isolated after in vitro replication were consistent with the misalignment of the primer. Deletions of 2 bp and complex frameshifts (the replacement of AA by C) were also found. Mechanisms that may account for these mutations are discussed. PMID- 3282986 TI - Emotional adjustment to cardiac transplantation. AB - Emotional adjustment to cardiac transplantation is a phasic process. Each step is associated with a milestone in the transplantation protocol. The adjustment process is divided into seven distinct stages: 1) transplant proposal, 2) evaluation, 3) awaiting a donor organ, 4) perioperative period, 5) inhospital convalescence, 6) discharge, and 7) post-discharge adaptation. Patient adjustment to transplantation is influenced by the adaptive task of each stage in the procedure, personality factors, previous experience with illness, and social support. Patients need time to adjust to each stage. Do not pressure them into premature acceptance of transplantation. Verbalization of feelings should be encouraged, and adequate support ensured. Contact with already transplanted patients is helpful to surgical candidates. Psychiatric assistance can greatly aid in patient management and emotional adjustment. PMID- 3282985 TI - Polarity effects in the hisG gene of salmonella require a site within the coding sequence. AB - A single site in the middle of the coding sequence of the hisG gene of Salmonella is required for most of the polar effect of mutations in this gene. Nonsense and insertion mutations mapping upstream of this point in the hisG gene all have strong polar effects on expression of downstream genes in the operon; mutations mapping promotor distal to this site have little or no polar effect. Two previously known hisG mutations, mapping in the region of the polarity site, abolish the polarity effect of insertion mutations mapping upstream of this region. New polarity site mutations have been selected which have lost the polar effect of upstream nonsense mutations. All mutations abolishing the function of the site are small deletions; three are identical, 28-bp deletions which have arisen independently. A fourth mutation is a deletion of 16 base pairs internal to the larger deletion. Several point mutations within this 16-bp region have no effect on the function of the polarity site. We believe that a small number of polarity sites of this type are responsible for polarity in all genes. The site in the hisG gene is more easily detected than most because it appears to be the only such site in the hisG gene and because it maps in the center of the coding sequence. PMID- 3282987 TI - Beyond "the men of steel". The origins and significance of house staff training stress. AB - Stress is a common and significant component of house staff training. It has a dual capacity to support and hinder the trainee's education and well-being. However, there has been infrequent attention to the purpose and significance of training stress in the medical literature. The myths and traditions of medicine that foster sayings such as "in the days of the giants" or "the men of steel" do not sufficiently explain the dynamics of house staff stress. This article examines the origins, effects, and meaning of house officer stress. Stress seems to originate from as well as influence: the psychology of physicians, patient care, hospital economics, and the relationship between trainees and educators. Adaptations to stress acquired in training influence the house officer's future professional and personal well-being. Evaluation of training stress can help clarify related issues such as physician impairment and mentoring in medical education. PMID- 3282988 TI - Mental disorders in primary care: epidemiologic, diagnostic, and treatment research directions. AB - An extensive series of investigations over the past 2 decades clearly demonstrate that mental disorders are present in approximately 25% of primary care patients and that physicians underdiagnose these illnesses. The factors producing this bias are poorly understood and should be focused upon in future research. Also requiring much more study is the efficacy of pharmacologic and psychosocial treatments initially validated with psychiatric populations. Clinical trials should determine whether standardized interventions can be utilized with medical patients whose symptom profiles and organic comorbidity may differ from those of psychiatric populations. PMID- 3282989 TI - [Rare variants of blood proteins in human populations]. AB - Rare variants of blood proteins occur, due to mutations (mutant alleles) in monomorphic loci encoding various proteins. A number of authors studied the distribution of these variants in human populations using the method of electrophoresis. The population of USA, South America, Japan, Europe was analysed. 1334 rare variants (1.0.10(-3)) were discovered out of 1,329,558 alleles (test locus in 664,779 individuals). 7 mutant alleles (3.6.10(-6)) were found among 1,957,305 alleles. The low frequency of occurrence of mutations in the loci encoding rare blood protein variants, when testing the speed of mutagenicity and its alteration, necessitates electrophoresis of blood proteins to be done in large scales. A method was proposed, based on accounting rare variants in children with congenital disorders, which are supposed to have a heavy load of mutations. The data collected demonstrated that the majority of rare variants in a given generation were obtained from parents. Accumulation of rare protein variants at low concentrations, as neutral alleles, in conditions of low mutation frequency in monomorphic loci takes place in the population. Comparison of frequencies of rare variants among healthy newborns and the children with congenital disorders revealed their identity (1.0.10(-3)), as compared to 1.05.10(-3)). Simplification of the method for scoring mutations judging by rare blood protein variants, which is necessary for monitoring for gene mutations in human populations, stimulates development of novel approaches. PMID- 3282990 TI - [Genomic fingerprints of organisms from different taxonomic groups: the use of phage M13 DNA as a hybridization probe]. AB - Hypervariable polymorphic patterns were detected using wild-type M13 DNA as a probe in genomic DNAs of very different organisms ranging from procaryotes and lower eucaryotes to upper plants and animals, including human beings. Due to somatic stability of highly polymorphic patterns and their discrete inheritance, individual-specific restriction pattern analysis ("DNA fingerprinting") with this test probe was found to be useful in applied human genetics, in particular, for identifying paternity and maternity, and mapping of human genomes. The data obtained also demonstrate some possibilities of the DNA fingerprinting technology in genetics and selection of agricultural plants and animals, such as variety analysis, classification and registration of individual inbred lines and strains, as well as identification of bacterial strains. PMID- 3282991 TI - [Parametric identification of mathematical models of population genetics taking into account the geographical dispersion in finite samples]. AB - A method for parameter identification of population genetics' mathematical models, taking account of geographical disperse at limited samples of experimental data on mutant frequency values has been developed. The existence of the MLS (method of the least squares) estimations of the models' parameters studied has been proved, zero approach of the looked for estimations found and the iterative procedure of making them precise shown. A means of building up the a posteriori function of probability density of the zero and following approximations of the models' parameters is pointed out. The possibility of application of the proposed method to find estimations of mathematical models' parameters of population genetics, taking account of geographical disperse, has been shown on the particular example. PMID- 3282992 TI - Depletion of Saccharomyces cerevisiae ribosomal protein L16 causes a decrease in 60S ribosomal subunits and formation of half-mer polyribosomes. AB - We constructed yeast strains containing deletion-insertion null alleles of the RPL16A or RPL16B genes encoding the 60S ribosomal subunit protein L16 to determine the role of L16 in the synthesis and function of ribosomes. Strains lacking a functional RPL16A gene grow as rapidly as wild type, whereas those containing a null allele of RPL16B grow more slowly than wild type. RNA analysis using RPL16 probes revealed that both RPL16 genes are transcribed and that RPL16B transcripts accumulate to twice the level of RPL16A transcripts. No evidence was obtained for the occurrence of dosage compensation at the level of RPL16 mRNA accumulation in either mutant. Strains lacking both RPL16 genes are apparently inviable, demonstrating that L16 is an essential yeast ribosomal protein. Introduction of an extra copy of either RPL16 gene into rpl16b mutants restored wild-type growth rates, indicating that the two forms of the L16 protein are interchangeable. rpl16 mutants are deficient in 60S ribosomal subunits relative to 40S subunits. 43S preinitiation complexes accumulate in half-mer polyribosomes in the absence of sufficient 60S subunits. We postulate that the slow-growth phenotype of rpl16 mutants results from the perturbation of initiation of protein synthesis. PMID- 3282993 TI - Practical management of non-malignant pain in the elderly. AB - The optimal management of chronic non-malignant pain in the elderly is founded first on comprehensive assessment and classification of the pain. The resulting pain diagnosis both targets appropriate areas for intervention and guides an often necessary multimodal approach to therapy. The indications for these various therapies, referral strategies, and guidelines for analgesic pharmacotherapy in the elderly are discussed. PMID- 3282994 TI - A noncyclopean diagram of binocular vision in strabismology. AB - Most diagrams concerning binocular vision and squint contain the cyclopean eye, which is a vestige of the 2000-year-old projection theory. The author's previously published diagram is based on a motor theory of spatial localization which has been formulated by Descartes, Lotze, and Roelofs. PMID- 3282995 TI - Management of superior oblique overaction in A-pattern deviations. AB - Surgical management of overaction of the superior oblique muscle is discussed with reference to such conditions as A-pattern, Brown's syndrome, torsional torticollis, and homolateral inferior oblique or contralateral inferior rectus paresis. The authors perform weakening of the superior oblique from the temporal side of the superior rectus for slight or moderate overaction. They prefer posterior tenectomy for mild overaction and scleral disinsertion of the tendon in moderate overaction causing A-pattern of no more than 25 pd. With 25-30 pd. they perform translation-recession of the muscle by the nasal approach. PMID- 3282996 TI - Central motor control in concomitant strabismus. AB - Basic research in the field of oculomotor physiology has advanced rapidly during the last decade. The new knowledge has been largely incorporated into the research and the clinical practice of neurology and neuroophthalmology [14, 16], but the influence on strabismus research has been rather limited [15]. This presentation will point out the elements of basic research that are believed important for our understanding of concomitant strabismus. The description will concentrate on the role of different central motor factors, mainly brainstem mechanisms, in the genesis and development of infantile esotropia or convergent strabismus, i.e. strabismus with an early onset in life [8]. Strabismus of late onset seems less enigmatic, since it probably originates from abnormalities of the vergence system, particularly its coupling with accommodation. PMID- 3282998 TI - Gender, race, and class: beyond the feminization of poverty in later life. PMID- 3282997 TI - Split lengthening of the inferior oblique muscles. AB - Split lengthening of the inferior oblique muscle(s) was performed in 20 patients for the correction of V-pattern, employing bilateral or unilateral surgery. In four patients unilateral split lengthening of the inferior oblique was done for the correction of hypertropia. The average correction of V-pattern was 16.9 pd with bilateral surgery and 13.3 pd with unilateral surgery. The average correction of hypertropia was 11.8 pd with only unilateral surgery. PMID- 3283000 TI - Reperfusion-induced arrhythmias: do free radicals play a critical role? AB - This article assesses whether oxygen-derived free radicals are one of the molecular causes of life-threatening arrhythmias that arise upon reperfusion of the ischemic myocardium. Evidence supporting this proposition has been obtained from studies of the effects of free radical scavengers and antioxidants, free radical generating systems, inhibition of various sources of free radicals and studies investigating the formation of free radicals and their products during early reperfusion. It has been hypothesized that free radical formation causes localised membrane damage to the sarcolemma that results in focal alterations in transmembrane ionic fluxes, particularly potassium. These changes in ionic fluxes may then lead to electrophysiological abnormalities that culminate in ventricular arrhythmias. PMID- 3282999 TI - Effect of 4-hydroxypyrazolo (3,4-d) pyrimidine (allopurinol) on postirradiation cerebral blood flow: implications of free radical involvement. AB - In an attempt to elucidate mechanisms underlying the irradiation-induced decrease in regional cerebral blood flow (rCBF) in primates, hippocampal and hypothalamic blood flows of rhesus monkeys were measured by hydrogen clearance, before and after exposure to 100 Gy, whole body, gamma irradiation. Systemic blood pressures were monitored simultaneously. Compared to control animals, the irradiated monkeys exhibited an abrupt decline in systemic blood pressure to 35% of the preirradiation level within 10 min postirradiation, falling to 12% by 60 min. A decrease in hippocampal blood flow to 32% of the preirradiation level was noted at 10 min postirradiation, followed by a slight recovery to 43% at 30 min and a decline to 23% by 60 min. The hypothalamic blood flow of the same animals showed a steady decrease to 43% of the preirradiation levels by 60 min postirradiation. The postradiation systemic blood pressure of the allopurinol treated monkeys was not statistically different from the untreated, irradiated monkeys and was statistically different from the control monkeys. However, the treated, irradiated monkeys displayed rCBF values that were not significantly different from the nonirradiated controls. These findings suggest the involvement of free radicals in the postirradiation decrease in regional cerebral blood flow but not necessarily in the postirradiation hypotension seen in the primate. PMID- 3283001 TI - Cultural stability of Streptomyces fradiae in the production of xylose isomerase: studies in shake flasks. AB - Comprehensive studies of pure colonies of Streptomyces fradiae in the production of xylose isomerase by submerged fermentation at shake flask level revealed poor culture stability with respect to enzyme production, biomass formation, degree of pigmentation, quantity of glucose and xylose utilization, level of enzyme in cell free culture broth and final pH of the fermentation medium. The results serve to stress obligatory evaluation of culture stability of Streptomyces strains in determining their suitability for use in developing fermentation processes for commercial exploitation. PMID- 3283002 TI - A rapid preparation of plasmid DNA from Saccharomyces cerevisiae. AB - A procedure for extraction of plasmid DNA from Saccharomyces cerevisiae is described. The plasmid DNA of interest is extracted together with 2-micron circular DNA naturally occurring in many yeast strains. Spheroplasts are lyzed at alkaline pH which denatures linear but not covalently closed circular (CCC) DNA. The CCC DNA is recovered by ethanol precipitation and can be detected by gel electrophoresis or used for routine bacterial transformation. PMID- 3283003 TI - Mutation analysis of the receptor for colicins E1-E7. A pilot study. AB - Thirty eight mutant clones of the colicin indicator strain Escherichia coli K 12 ROW, selected by their insensitivity to any of the colicins E1-E7, were isolated. Comparison of their sensitivity-resistance patterns to colicins E1-E7 enabled us to draw a rough preliminary map of the receptor for E colicins. In this receptor, the highly specific binding site for colicin E1 partially overlaps with the domain shared by all colicins E2 through E7. A specific binding site of this domain appears to be common for colicins E3 and E6; a part of the E3 and E6 binding site is also common for colicins E4 and E5 and a small, least specific, part also for colicins E2 and E7. Using colicin assay experiments, the binding capacity of colicin E receptor mutants could be estimated. A decreased, but not completely lost ability of certain mutants to bind colicins E, correlated to their lowered sensitivity to them, was found. Thus the phenomenon of partial colicin resistance was established, showing that colicin sensitivity--resistance is not a qualitative but a quantitative marker. PMID- 3283005 TI - [Medical healing over 5 millennium ]. PMID- 3283004 TI - Mycobacteria in the light of modern genetics development. AB - It is generally assumed that genetic research of mycobacteria is delayed as compared with other, more commonly used, bacterial models, particularly in the field of genetic transfers. In the field of mutagenesis the problems have been studied to such an extent that replication maps of the chromosome of M. phlei and M. tuberculosis H37 Rv have already been constructed and a new model of the cell cycle of bacteria exhibiting a slow growth rate has been worked out. When the problems of mycobacterial genetics are looked upon in the light of gene manipulations it may be concluded that mycobacteria belong to a few models whose genes are used for cloning and that problems of practical significance will be studied by means of the most modern approaches. PMID- 3283006 TI - [Aortocoronary bypass operations--indications and long-term prognosis. What is definite?]. PMID- 3283007 TI - [Treatment of acute sprains of the ankle joint. Double-blind study assessing the effectiveness of a homeopathic ointment preparation]. PMID- 3283008 TI - [Significance of model psychoses]. AB - Empirical findings and arguments in the hitherto controversial field of experimental psychosis are reviewed historically and systematically. Similarities and differences of experimental psychosis and schizophrenia are discussed on the background of disturbances of perception, consciousness and ego experience ("reflektierender Ich-Rest"). Better psychopathological, biochemical and neuropsychological assessment strategies could lead to a revival of experimental psychosis which some brief suggestions are made for. PMID- 3283009 TI - [The biology of gliomas: growth factors and oncogene expression. A current review]. AB - In recent years several proteins with in vitro cell growth promoting activity were chemically identified and termed growth factors. Their role in normal glial development has been studied in vitro in different defined systems. In addition it has been tried to elucidate their role in the biology of gliomas. Some clues were obtained from the study of growth factor receptors and the expression of oncogenes. It has to be assumed that from the correlation and synthesis of results obtained from studies of growth factors, oncogene expression, gliogenesis and cytogenetics there will emerge useful biological concepts for specific therapeutic approaches. PMID- 3283010 TI - Hospital PPS profits: past and prospective. PMID- 3283011 TI - Nursing and private philanthropy. PMID- 3283012 TI - Are relative value scales the answer? PMID- 3283013 TI - Improving the medical decision-making process. PMID- 3283014 TI - Biliary sludge-cast formation following liver transplantation. AB - The development of biliary sludge, in the absence of anastomotic obstruction in the common bile duct, has become a very rare complication following orthotopic liver transplantation since the adoption of modern techniques of biliary reconstruction and routine biliary flushing before cold preservation. We describe the successful treatment of this serious complication in an 18-year-old woman whose biliary sludge aggregated into firm casts occupying the extrahepatic and intrahepatic bile ducts causing obstruction and cholangitis necessitating operative intervention followed by interventional radiological approaches to treat the intrahepatic bile duct strictures. Postoperative choledochofiberscopy was also used to remove the retained biliary casts. The pathogenesis of biliary sludge appeared to be multifactorial, but cold ischemic damage to the bile duct wall seemed to play an important role in this case. PMID- 3283015 TI - [A case of subacute thyroiditis associated with acute hepatitis]. AB - We report one case of subacute thyroiditis associated with acute hepatitis, which is histopathologically diagnosed. A 43-year-old woman visited our hospital with chief complaints of fever, sore throat and anterior neck pain. Thyroid gland was found to be swollen and tender. Laboratory findings gave high ESR and positive test for CRP. High values of T3, T4 and RT3U indicated that the patient had hyperthyroidism. However no autoantibodies against thyroglobulin and microsome were found. High activities of serum AIP, LAP and gamma-GTP were observed. Serum GOT and GPT activities increased moderately. AIP type 2 was dominant in zymograms. Histopathological findings of liver specimen obtained by needle biopsy showed ballooning degeneration of hepatocytes with a slight focal necrosis and hyaline bodies. In addition bile plugs were observed in some biliary tubules. These findings were consistent with those of acute hepatitis. After three months all laboratory data were found to be within normal ranges and no recurrence has been observed. Subacute hepatitis associated with liver dysfunction is considered to be relatively frequent. However very few reports have been published on the case in which histopathological evidence for acute hepatitis was presented. PMID- 3283016 TI - [A study on the effects of different keratectomies for astigmatism in rabbits' eyes]. AB - Three kinds of wedge resections with sutures at limbus were carried out in grown rabbits. Keratometry was performed for 8 weeks. Corneal curvature and corneal astigmatism were not significantly changed by 90 degrees of the circumference. But in the group of 180 degrees resection, the radius perpendicular to the wound increased and 3. 5 D corneal against-the-rule astigmatism was brought about in a week after surgery. Therefore, when operated at the limbus by same extension, one longer wedge resection changed more the radius than 2 symmetric resections did. It was thought this against-the-rule astigmatism was due to the decrease of total surface, another side of the wound being sclera, and other factors. They are properties of suture material, the provoked tissue reaction, and so on. Pulling on domed tissue should be looked at again. Loss of effect was remarkable. So, to get permanent effect, we should study more about the time of suture removal, acting over the sclera and the sutures penetrating cornea. Secondly, two kinds of keratectomies perpendicular to vertical meridian were situated midway between limbus and corneal apex. The changes of total refractive power were followed up by skiascopy for 3 months. As a result, 1.0 D-1.5 D against-the-rule astigmatism was surgically induced in both keratectomies. This was almost due to myopic change of the opposite meridian, which was parallel to the resections. Loss of effect of rectangle-shaped keratectomy was less than that of crescent-shaped. It suggested cutting Ligamentum Circulatum situated near limbus was necessary to prevent the reduction of induced astigmatism with time. In addition, limbus of wedge resection was histologically observed. Markedly wavy appearance of lamellas was seen in the stroma. Like this, reactions to 8-0 virgin silk proved to be intensive. So, suture associated with less inflammatory reaction like 10-0 monofilament is recommended. PMID- 3283017 TI - PhysPRC recommends more UR to cap Part B costs. PMID- 3283018 TI - IG cites bad debt, unnecessary admissions. PMID- 3283019 TI - ProPAC: don't link capital payments to occupancy. PMID- 3283020 TI - Recession, PPS drain Texas hospital profits. PMID- 3283021 TI - MIGs: demo projects privatize health care. PMID- 3283022 TI - FMG residents expensive to replace. PMID- 3283023 TI - Internists call for PPS reform. PMID- 3283024 TI - IG seeks clearer regulations on fraud and abuse. Interview by Michele L. Robinson. PMID- 3283025 TI - HCFA, Stark eye Medicare ESRD expenditures. PMID- 3283026 TI - Transplants: new life for heart programs? PMID- 3283027 TI - 17% price hike for independent surgicenters. PMID- 3283028 TI - CFOs share their asset-management strategies. PMID- 3283029 TI - Government will examine waiver programs. PMID- 3283030 TI - Low-cost strategies aid physician bonding. PMID- 3283031 TI - [Monitoring of sterilization procedures for plasma derivatives using bacteriophages]. AB - Since 1968 the combination of beta-propiolactone (beta-PL) plus UV-inactivation for the sterilization of plasma derivatives is in use at Biotest. In 1981, a bacteriophage test system was established for routine monitoring of the efficacy of this sterilization procedure, using the bacteriophages phi x 174, phi e, Kappa and f2. In the period of 1981 to 1986, 88 control experiments were performed under production conditions demonstrating a mean inactivation of these test viruses of greater than or equal to 6.7 log10. This constant and high efficacy of the beta-PL/UV sterilization procedure guarantees the longstanding safety of beta PL/UV sterilized blood derivatives. Bacteriophages are also useful experimental viruses for monitoring the efficacy of pasteurization processes. PMID- 3283032 TI - Fatal ischaemic colitis in renal allograft recipients. PMID- 3283033 TI - A modified form of insulin (Hollander's) test for determination of completeness of vagotomy. PMID- 3283034 TI - HLA-A,-B,-C matching in renal transplantation. PMID- 3283035 TI - Antimicrobial prophylaxis in neutropenic patients after bone marrow transplantation. AB - Fourty-one patients with haematological malignancies or severe aplastic anaemia underwent allogeneic or syngeneic bone marrow transplantation and received one of two forms of infection prophylaxis while granulocytopenic: total decontamination in strict reverse isolation (ITD, 26 patients) or selective decontamination of the digestive tract with barrier nursing (SD, 15 patients). The patients were evaluated for infection acquisition, fever days, days on systemic antibiotics and granulocyte transfusions from 48 hours after the beginning of the decontamination procedure until 1,000 granulocytes/microliter have been reached. Ten of 26 patients of the ITD group remained free of febrile episodes and infections, whereas all patients of the SD group acquired infections (p less than 0.001). During granulocytopenia patients of the ITD group had fewer fever days, were less frequently on systemic antibiotics and received fewer granulocyte transfusions as compared with the SD group. Both methods were obviously very effective in preventing gram-negative infections, infections caused by Staphylococcus aureus and infections due to yeasts or fungi. No death due to infection occurred in either group. However, the data of this study provide evidence that ITD is a more effective antimicrobial prophylaxis in bone marrow transplant recipients than SD. PMID- 3283036 TI - Infections after experimental cadaver bone marrow transplantation in beagle dogs. Transplantations with and without selective gastrointestinal decontamination. AB - Experimental transplantations of cadaver bone marrow (BMT) in beagle dogs were performed to evaluate the problems and potentials in a preclinical setting. The effectiveness of selective decontamination of the gut (SD) and gnotobiotic surveillance in preventing infections during longer aplastic periods was investigated. Three groups of dogs were compared. Group A: controls. Group B: dogs with BMT, without SD and irregular gnotobiotic surveillance. Group C: dogs with BMT, with SD and regular gnotobiotic surveillance. The intestinal colonization of normal healthy beagles shows similarities as well as dissimilarities to the human intestinal microflora. Aerobic potentially pathogenic organisms do not colonize the gut of healthy beagles under our keeping conditions. SD resulted in a significant decrease in infections with Escherichia coli and Plesiomonas. Infections with anaerobes, as well as bacterial infections of the respiratory tract were, however, not prevented. The intestinal colonization in dogs of group C with Clostridium difficile is another obvious effect of SD. The infections encountered during the study indicate the importance of the "take" for the clinical significance and outcome of intestinal colonization with potentially pathogenic organisms. In order to reduce the drug burden of BMT patients, we consider the elimination of routine SD after BMT not to be superior to gnotobiotic surveillance and germ-specific short term decontamination. PMID- 3283037 TI - New aspects in the treatment of gram-negative bacteraemia and septic shock. PMID- 3283039 TI - New developments in medical microbiology: computer-assisted diagnosis and automated instruments. AB - Time and accuracy required for diagnosis are two of the most important factors in medical microbiology. Computer-assisted diagnosis is one tool to overcome these problems. The software of such systems, much more than the hardware, is of utmost importance and both have to fulfill several items. 1) High flexibility and integration within the already existing working schemes of the laboratory. 2) Terminals in every laboratory. 3) High speed of calculation. 4) Online data transfer from automated instruments. 5) External terminals on intensive care units. 6) Epidemiological and etiopathological investigations have to be possible at any time. In the laboratory the burden of simple, repeating tasks is diminished, inquiries can be made in a minute and precise information about the epidemiological situation can be gained within a few hours. Thus, calculated antimicrobial therapy depending on the incidence of certain pathogens in given specimens in different departments is possible. In the case of fast-growing bacteria, preliminary reports, including susceptibility testing available within the first 24 h, are possible and will be of great help to the clinician in monitoring the calculated antimicrobial regimen. External terminals will allow continuous flow of data from the laboratory to wards and vice versa. PMID- 3283038 TI - Comparative efficacy of ciprofloxacin, ceftazidime and gentamicin, given alone or in combination, in a model of experimental septicemia due to Klebsiella pneumoniae in neutropenic mice. AB - The therapeutic efficacy of ciprofloxacin, used alone and in combination with either ceftazidime or gentamicin, was evaluated in a model of experimental Klebsiella pneumoniae septicemia in neutropenic mice. Therapeutic results were compared to those achieved by treatment with ceftazidime or gentamicin alone, as well as their combination. Infections were induced by i.v. injection of two strains of K. pneumoniae. Therapy with i.m. antibiotics was performed in 8 h intervals for a total of 13 doses, and survival rates were recorded at the end of treatment as well as seven days later. Ciprofloxacin alone proved to be significantly more effective than ceftazidime and gentamicin, producing survival rates similar to the combination of ceftazidime plus gentamicin. Bacterial counts of spleens and blood confirmed the superior bactericidal activity of ciprofloxacin. Except for the combination of ciprofloxacin with ceftazidime, there was no apparent advantage of combinations of ciprofloxacin with the other agents compared to ciprofloxacin alone. These data suggest a high in vivo activity of ciprofloxacin in systemic infection due to K. pneumoniae. PMID- 3283040 TI - Benefit and advantage to clinicians of a computer-assisted microbiological diagnosis and database system. AB - Computer-assisted diagnostic systems may accelerate transmission of microbiological reports and facilitate evaluation of the epidemiological situation and thus improve the collaboration between microbiologists and clinicians. This possible benefit is demonstrated by four examples. It became evident that incidences of pathogens in urinary tract and respiratory tract infections varied within a great range, depending on patient groups and clinical departments involved. Even within a department, different incidences of penicillin G and oxacillin-resistant coagulase-negative staphylococci were demonstrated. An apparent homogeneity of distribution of pathogenic bacteria in a hospital tends to be the result of a nondiscriminating overall evaluation, thus necessarily misleading the clinician especially in empirical chemotherapy. In the last example the evaluation of susceptibility testing revealed changing patterns of some pathogens during the observation period. By rapid exchange of data between the laboratories and the clinical departments supplying the clinicians with information relevant for actual therapeutical decisions, an empiric therapy may change into a so-called calculated therapy based upon data directly related to the site of infection, department and susceptibility patterns. PMID- 3283042 TI - Stridor. PMID- 3283043 TI - Establishing the pediatric airway. PMID- 3283041 TI - A review on the impact of 4-quinolones on the normal oropharyngeal and intestinal human microflora. AB - During the last few years the impact of the newer 4-quinolones, ciprofloxacin, enoxacin, norfloxacin, ofloxacin and pefloxacin, on the human microflora has been studied by several investigators. This review article summarizes the published data concerning these studies. The results show that the oropharyngeal flora is affected only slightly or not at all by the 4-quinolones. All the newer 4 quinolones have a similar effect on the normal intestinal flora. The gram negative aerobic flora is strongly suppressed during administration of 4 quinolones, while the gram-positive flora is only slightly affected. The anaerobic microflora is hardly affected at all. The emergence of resistant bacterial strains is uncommon, although one study shows increased MIC-values for anaerobes during ciprofloxacin administration. Replacement by yeasts or other inherently resistant microorganisms does not often seem to be a problem. High concentrations of the 4-quinolones are reached in faeces, values between 100 2,200 mg/kg being reported. Since the 4-quinolones do not cause marked ecological disturbances in the intestinal microflora, they may be suitable for selective decontamination in immunocompromised patients, for prophylaxis of urinary tract infections and for treatment of bacterial intestinal infections. PMID- 3283044 TI - The pediatric airway: radiology and new imaging. PMID- 3283045 TI - Trauma to the larynx and upper trachea. PMID- 3283046 TI - Intrathoracic tracheobronchial injuries in childhood. AB - Trauma to the intrathoracic tracheobronchial tree is a rare but usually fatal injury. Patients with pneumothorax, subcutaneous emphysema, and a history of blunt or penetrating injury to the lower neck or chest must undergo early bronchoscopy to evaluate the lower airway. Thoracotomy should be performed as soon as the patient's condition allows an attempt at primary repair. The diagnosis is frequently missed because it is so uncommon and its symptoms may resolve after chest tube drainage of the pneumothorax. Airway stenosis or occlusion usually follows. Still, local resection of the stricture and reanastomosis frequently result in recovery of lung function. Neglected cases complicated by infection usually require lung resection. PMID- 3283047 TI - Anesthetic considerations for laser surgery. PMID- 3283048 TI - Tonsillar and adenoid airway obstruction: modes of treatment in children. PMID- 3283049 TI - Tonsillectomy and adenoidectomy. PMID- 3283050 TI - Airway function tests in infants and children. PMID- 3283051 TI - Craniofacial surgery: otolaryngological concerns. PMID- 3283052 TI - Craniofacial surgery: airway problems and management. AB - Airway problems are the greatest cause of morbidity and mortality during operations to repair craniofacial anomalies. These problems can be managed by awareness of the risks and prophylactic intervention rather than by desperate steps when acute problems occur in treatment. Airway obstruction is the major problem in managing patients with such deformities in the preoperative period, at the time of intubation, during the operation, and in the early postoperative period. Congenital craniofacial problems that may lead to airway difficulties are extremely rare, and for physicians to gain sufficient experience to prevent morbidity, these patients should be referred to regional centers, where at least two or three such operations are performed per week. PMID- 3283053 TI - Pharyngeal flap surgery and the pediatric upper airway. PMID- 3283054 TI - Observations on social gerontology in France. AB - In this article, the author attempts to make an assessment of some of the most important French contributions to social gerontology, isolating the main characteristics of the works encountered. We successively review some of the few studies concerning old women as well as studies dealing more generally with the social and economic aspects of aging. These lines show social gerontology in France as a forum for specialists from various disciplines; it is a specialty still in its infancy, but its multi-disciplinary approach will, no doubt contribute to its fruitfulness. PMID- 3283055 TI - Artificial pancreas: state of the art. PMID- 3283056 TI - Beta-2-microglobulin: a possible new uremic toxin? PMID- 3283057 TI - Intraperitoneal insulin in diabetic CAPD patients. PMID- 3283058 TI - Cardiologists and molecular biology. PMID- 3283059 TI - Functional aspects of cellular and transforming oncogenes and their relationship to heart disease. PMID- 3283060 TI - Severe hypophosphataemia induced by glucose-insulin-potassium therapy. A case report and proposal for altered protocol. AB - A case is described where severe hypophosphataemia was induced by a widely used protocol for glucose-insulin-potassium (GIK) infusion. Hypophosphataemia was found to be a universal sequel to the use of this infusion. A new regimen for administering this agent was designed, and shown to lack the potentially serious side effect of phosphate depletion. PMID- 3283061 TI - Comparison of nicardipine and verapamil in the management of chronic stable angina. AB - Twenty-two patients with stable angina were studied in a randomised double-blind, placebo-controlled crossover trial to compare the antianginal effects of nicardipine (30 mg) and verapamil (120 mg), each given three times a day. Efficacy was assessed using treadmill exercise testing and 24-hour ambulatory electrocardiographic monitoring performed after an initial 2-week placebo phase and at the end of each 4-week active treatment period. Exercise time (mean +/- standard error of mean) increased from 7.4 +/- 0.5 min on placebo to 8.4 +/- 0.7 min on nicardipine (P less than 0.05) and to 9.9 +/- 0.7 min on verapamil (P less than 0.001). Resting heart rate was decreased by verapamil (P less than 0.002) and increased by nicardipine (P less than 0.02). Exercise heart rate was increased on nicardipine (P less than 0.005) but heart rate gain was higher on verapamil (P less than 0.01). Blood pressure and peak ST segment depression were unaltered by either drug but the time to 1 mm ST segment depression increased on both drugs. Ambulatory heart rates were lower on verapamil than on nicardipine and patient subjective preference was in favour of verapamil. This study confirms that both nicardipine and verapamil improve exercise capacity, but verapamil produces a greater improvement in exercise tolerance and indices of myocardial ischaemia whilst nicardipine is associated with an increase in the number of episodes of ST segment depression on ambulatory monitoring. PMID- 3283062 TI - Reproducibility and persistence of abnormal transmitral flow velocity patterns detected by pulsed Doppler ultrasound. AB - This prospective study examines the reproducibility and persistence of abnormal transmitral flow detected using pulsed Doppler ultrasound on 2 separate occasions between 2 days and 6 weeks apart. The 22 patients included were accepted consecutively from those having an abnormal diastolic flow pattern at initial examination. Abnormal flow velocity patterns were defined as those exhibiting reversal of the ratio of the passive filling velocity (E) and active atrial transport velocity (A). There was no significant difference between the separately recorded values for the ratio of the peak E and A velocities or of the ratio of the planimetered areas beneath each of the velocity waves, with positive correlations for both sets of values (r = 0.68, r = 0.67). Significant positive correlation also existed between the mean rates of acceleration to each of the E and A velocity peaks of the transmitral waveform recorded on separate occasions (r = 0.68, r = 0.95). Interobserver variation for the analysis of hard-copy pulsed Doppler recordings between two trained observers was less than 5% and intraobserver error for recording analysis was less than 2% for both observers. Abnormal transmitral flow velocity patterns persist unchanged in the absence of therapeutic intervention and the acceptably small observer error in the recording and analysis of such flow patterns allows consistent and clinically reliable data to be obtained. PMID- 3283063 TI - Physical exercise for patients with cystic fibrosis: a review. AB - Cystic fibrosis (CF) is an inherited, chronic disease which mainly affects the lungs and the nutrition. Intensive treatment has gradually improved the outcome for the patients. Exercise therapy has been increasingly advocated to be included in the CF regimen. Our own studies indicate that both short-term and long-term training ameliorate the physical conditions for CF patients, that there is no danger for well-trained CF patients--both boys and girls--to take part even in vigorous, prolonged exercises, and that CF patients might have a positive attitude toward physical activities. Of course, all physical activities have to be individually designed. A review of the literature is also given: The specific ventilatory factors in CF, the limitations of exercise, the problem with exercise induced asthma, the training effect on lung drainage, on lung function, on infections, on biochemical and hormonal variables, on nutrition and the gastrointestinal tract, on the musculoskeletal apparatus, and on the mind. Nearly all these reports are favorable for a carefully monitored, high activity in CF patients. Practical considerations for activities are given. PMID- 3283065 TI - Hair shaft dysplasias. PMID- 3283064 TI - A brief history of the dermatologic moulage in Europe. Part I. The origin. PMID- 3283066 TI - Effect of antimicrobial therapy on bowel flora and bacterial infection in irradiated mice. AB - Mice exposed to 10 Gy cobalt-60 radiation were given intramuscular antimicrobial therapy of gentamicin, or metronidazole, or a combination of the two. Mortality in the mice treated with metronidazole alone or in combination with gentamicin occurred earlier than in the controls (P less than 0.001). Microorganisms were recovered from the blood, spleen, and liver of the metronidazole-treated mice earlier than from other groups. The predominant organisms recovered from these animals were Enterobacteriaceae. Quantitative cultures of the ileal flora showed a decrease in the number of aerobic, facultative anaerobic and strict anaerobic bacteria after irradiation, and a subsequent increase only in the number of strict aerobic bacteria. As compared to untreated mice, a rapid decrease (by 8.8 logs) in the number of anaerobic flora occurred in the mice treated with metronidazole 5 days after irradiation. This was followed by a rapid increase in the number of aerobic organisms which coincided with the earlier mortality in this group. These data suggest that antimicrobial agents that decrease the number of the strict anaerobic component of the gut flora enhance systemic infection by aerobic or facultative anaerobic bacteria, and this facilitates mortality after irradiation. PMID- 3283067 TI - Enhanced survival of gamma-irradiated Escherichia coli following pretreatment with dithiothreitol. AB - Survival of three strains of Escherichia coli K12 was studied with respect to radiation protection by dithiothreitol (DTT). The three strains compared were AB2462 recA, AB2470 rec21 and their DNA repair-competent prototype, AB1157. The strains were incubated in 10 mmol dm-3 DTT for 60 min and allowed an expression period for SOS functions to appear which may have been induced by DTT. Following the expression period the DTT-incubated cells and incubated control cells were irradiated. When AB1157 cells were pretreated with chloramphenicol (200 micrograms cm-3) for a period of 30 min prior to addition of the induction media no increase in survival was seen. When catalase (0.1 mg cm-3) was added to the AB1157 cells prior to the induction media a decrease in the degree of induction was noted with an enhancement ratio (ER) of 0.893 (ER-1 = 1.12). Furthermore, DTT treated AB2462 and AB2470 demonstrated no increase in survival when compared to control cells. In radiation experiments on either strain of E. coli with or without DTT present during irradiation, the following were observed: (1) survival of AB1157 was enhanced with a dose modification factor (DMF) of 1.7 with DTT present and 1.3 with pretreatment; (2) the rec mutants showed no change in survival at any dose with a DMF of approximately 1.0. Results indicate that, using our protocol, inducible repair is of more importance than free radical scavenging by DTT. Furthermore, DTT-treated AB2462 demonstrated no increase in survival when compared to control cells. In radiation experiments on either strain of E. coli with and without DTT present during irradiation, the following were observed: (1) survival of AB1157 was enhanced with a DMF of 1.7 with DTT present during irradiation and 1.3 with only pretreatment; (2) the recA and recB mutants showed no change in cell survival at any dose with a DMF of approximately 1.0. Results indicate that, using our pretreatment protocol, inducible repair is of more importance in protection than free radical scavenging by DTT. PMID- 3283068 TI - Transmission of the human immunodeficiency virus: an updated review. AB - Despite the inexorable spread of HIV infection and disease worldwide, only three routes of transmission (inoculation of blood, sexual and perinatal) still remain important. This article reviews current information related to the routes of transmission of HIV infection. PMID- 3283069 TI - The role of ultrasound-guided percutaneous transhepatic aspiration of the gallbladder content in the management of hydrops/empyema caused by acute cholecystitis. AB - Ultrasonically guided percutaneous transhepatic gallbladder aspiration (UG-PTGA) was used in the treatment of hydrops caused by acute cholecystitis in 21 patients. The interventions had no complications. This kind of aspiration is believed to be suitable for the relief of gallbladder tension causing acute complaints and of subsequent pathological changes. PMID- 3283070 TI - Fracture of the penis: surgical management. AB - Fracture of the penis is a rare injury, only 135 patients having been reported by 1985. Our recent experience with six patients who underwent emergency surgery, has been documented. The results of treatment were excellent with complete recovery of function. The study recommends operative management as the treatment of choice. PMID- 3283071 TI - Bone scintigraphy, radiographic survey and prostatic acid phosphatase in patients with prostatic carcinoma. A comparison of sensitivity. AB - In 62 patients with histologically confirmed carcinoma of the prostate bone scintigraphy, radiographic survey and serum prostatic acid phosphatase determinations were carried out to evaluate the progression of the disease and to compare the relative sensitivity of the diagnostic tools. Thirty-five patients had scintigraphic evidence of skeletal metastases, whereas abnormal X-ray survey and elevated prostatic acid phosphatase levels were found in only 4 and 19 patients, respectively, all of whom had positive scintigraphic findings. Radiographic evidence of metastases was not found in any of the patients with normal scintigraphy, while elevated prostatic acid phosphatase was found in two patients. It is concluded that bone scintigraphy is far more sensitive than either radiographic survey or determination of prostatic acid phosphatases in the diagnosis of skeletal involvement in prostatic carcinoma, and should be the method of choice for this purpose. PMID- 3283073 TI - Value of renal biopsy in chronic renal failure. AB - A total of 120 patients with chronic renal failure secondary to parenchymatous kidney disease were biopsied. Percutaneous approach was tried and open technique was employed when there was contraindication to or failure of the percutaneous technique. In 72 cases the histopathologic lesions were identified, in 30 cases it was not possible to identify them and in 18 cases there was no sufficient kidney tissue. The diagnosis was very critical in at least 10 cases: there were 3 cases of primary oxalosis, one case of haemolytic uraemic syndrome, one case of necrotizing glomerulonephritis, one case of Wagner's granulomatosis, 3 cases of focal segmental glomerulosclerosis and one case of Fabry's disease. All but one of these were not diagnosed clinically. There was no patient mortality, and morbidity was significantly higher after open approach. We concluded that kidney biopsy in patients with chronic renal failure is mandatory especially if they are going to be transplanted and it is relatively safe especially when the percutaneous technique is employed. PMID- 3283072 TI - Therapeutic results of primary aldosteronism with special reference to renal or renovascular lesions. AB - A study was made of 9 patients with primary aldosteronism due to aldosterone producing adenoma (APA) and 8 subjects with idiopathic adrenal hyperplasia (IHA) to clarify the pathogenesis of sustained hypertension after surgical or non surgical treatment. Following each treatment, a complete improvement of hypertension was obtained in 12 patients (6 APA, 6 IHA), while 5 (3 APA, 2 IHA) showed still hypertensive status. Renal or renovascular lesions were prominent only in the hypertension-unchanged group. Under regular sodium diet, the ratio of urinary excretion of sodium to creatinine of this hypertensive group was significantly lower than that of the hypertension-improved group. However, the results of other renal function tests were similar in both groups. After respective treatments, suppressed plasma renin activity and elevated plasma aldosterone concentration were improved in all patients. In addition, patients of both groups showed normal response of the renin-aldosterone system following diuretic and dietary induced sodium and volume depletion. Based on these findings, renal or renovascular lesions appear to play an important role in the pathogenesis of maintenance of hypertension in this disorder after respective treatments. PMID- 3283074 TI - Acute pseudo-obstruction of the colon in a kidney-transplanted patient (Ogilvie's syndrome). AB - Ogilvie's syndrome is an acute massive dilation of the large bowel without organic obstruction. It can occur from a variety of causes and organ failures. We report on the first patient who has developed this syndrome twice, in both cases after kidney transplantation. The world literature concerning the subject is also reviewed. PMID- 3283075 TI - [90 years of the Dusseldorf dermatology clinic]. PMID- 3283076 TI - [Bullous pemphigoid in hypernephroma]. AB - The case is reported of a 75-year-old man with bullous pemphigoid that was resistant to conventional treatment with prednisone and azathioprine. A hypernephroma was discovered and surgically excised, whereafter the skin lesions healed completely without any other therapeutic measures being taken. PMID- 3283078 TI - Teratogenic effects of exposure to radiofrequency radiation (27.12 MHz) from a shortwave diathermy unit. PMID- 3283077 TI - [Pathophysiology of fibroses. Progressive systemic scleroderma as a model disease]. AB - Fibrosis is characterized by excessive deposition of connective tissue in the involved organs. Although the prime event in the pathogenesis is still poorly understood, several mechanisms are discussed, which finally result in the activation of fibroblasts. Recent studies have demonstrated that immunocompetent cells play a crucial role during the initial phases of the development of fibrosis. Therefore, several mediators have been characterized, which are secreted by platelets, lymphocytes and macrophages and which can attract fibroblasts, induce proliferation and collagen synthesis in mesenchymal cells. These include PDGF, EGF, TGF--beta and many others. In addition, gamma-interferon has been shown to inhibit chemotaxis of fibroblasts and to reduce collagen mRNA levels. A controlled interaction of all the different mediators is required to guarantee a normal functioning of connective tissue. Alterations in these regulation steps can result in excessive deposition of connective tissue and the development of fibrotic processes. PMID- 3283079 TI - [Ultrasonic diagnosis of the pseudoglottis in laryngectomized patients]. AB - The validity of ultrasonic imaging as a tool for the investigation of pseudoglottal movements was studied in five good to excellent esophageal speakers. The length of pseudoglottis and vibration rate during phonation of vowels was evaluated by means of B-mode and M-mode sonography respectively. The pseudoglottal vibration rate as seen in M-mode sonography was in high agreement with the fundamental frequency of the simultaneously recorded sound as assessed by speech analysis. Ultrasound imaging is a promising diagnostic and therapeutic tool for the control and development of esophageal speech. PMID- 3283080 TI - [How best to present the radiological picture of the temporal bone today?]. AB - The detailed evaluation of anatomy and pathology of the temporal bone requires imaging modalities that are superior to plain x-ray films. Conventional polytomography has today largely been replaced by high-resolution CT. High resolution CT provides excellent demonstration of the delicate bony structures and provides superior information about the soft tissues. The axial 1 mm scans of a complete temporal bone examination can be reformated in any number of planes. These reconstructions display the temporal bone in various projections. This theoretically well-founded procedure of individual processing has proven to be highly practical in more than 1000 examinations of the skull base. High resolution CT with image reconstruction is the diagnostic method of choice for the evaluation of the skull base and especially the temporal bone, as the complex anatomy is best demonstrated by this technique. Six axial computed tomographic scans are demonstrated in detail. The special value of multiplanar reconstructions is illustrated by reconstructions in the coronal, sagittal and longitudinal plane. PMID- 3283081 TI - Computerized optimization of 125I implants in brain tumors. AB - A computer program for treatment planning for the interstitial radiotherapy of brain tumors with 125I stereotactic implants is presented. To minimize brain traumatization only 1-3 catheters loaded with several seeds are implanted. It is possible to position the catheters very accurately due to CT guided stereotactic techniques. Precise treatment planning is necessary because of the high dose gradient of the radiation field. Two planning methods are available: conventional planning with interactive optimization of source configurations and an automatic optimization procedure. The goal of optimization is to identify source parameters (catheter positions and seed activities) for which a prescribed dose at the target surface is approximated as closely as possible. PMID- 3283083 TI - Radiobiological studies with pig skin. PMID- 3283082 TI - Reflections in rectosigmoid: retro-peritoneal vs. intra-peritoneal. PMID- 3283084 TI - Venocclusive disease of the liver after allogeneic bone marrow transplantation in man. AB - One hundred and fifty-one consecutive patients underwent allogeneic bone marrow transplantation (B.M.T.) following high-dose chemotherapy and single dose total body irradiation (T.B.I.) for hematologic malignancies between September 1980 and December 1985. All patients included in this study were treated using a 60 Co beam to deliver a prescribed dose of 10 Gy to the mid-plane of the abdomen. Total body irradiation was performed the day before B.M.T. The mean instantaneous dose rate was 3.5 cGy/min (range: 2.6 to 4.7). The real dose received was measured using thermoluminescent dosimeters (lithium borate). The difference between the doses delivered to the liver and to the mid-plane of the abdomen did not exceed 5%. The mean real dose delivered to the reference point was 10 Gy (range 8.3 to 11.7). Ninety five per cent of the patients received a dose ranging from 9.1 Gy to 10.9 Gy. High-dose cyclophosphamide was given to 126 patients with a "standard risk" of relapse (60 mg/kg on day 5 and 4 before B.M.T.). Chemotherapy was intensified by the addition of other drugs in 25 patients with "higher-risk" of relapse. We analyzed the effect of the following pretransplant characteristics on the subsequent posttransplant development of V.O.D.: age, sex, ASAT and/or ALAT before conditioning regimen, diagnosis and status of malignant disease, history of liver disease, interval between diagnosis of hematologic malignancy and B.M.T., conditioning regimen (i.e., classical or intensified) and dose delivered to the liver during T.B.I. Seventeen patients were classified as having clinical V.O.D. giving a prevalence of 11.2%. In the first 2 months following B.M.T., death occurred respectively in 9 of 17 (53%) and 23 of 134 (17%) patients with and without clinical V.O.D. Univariate analysis showed that four characteristics were significantly related to an increased prevalence of V.O.D.: sex (11/62 females vs 6/89 males; p less than 0.05); history of liver disease (7/28 vs 10/117 patients without antecedent; p less than 0.01); ASAT and/or ALAT levels greater than 1.5 upper normal limit (11/49 vs 6/102 patients with levels less than 1.5; p less than 0.01) and intensified conditioning regimen (6/25 vs 11/126 patients with classical regimen; p less than 0.05). The conditioning regimen and history of liver disease were highly correlated to transaminases levels. Only two factors, transaminases levels and female sex, remained significantly associated with V.O.D. after multivariate analysis. PMID- 3283086 TI - Applicability of animal tumor data to cancer therapy in humans. AB - The problem of applying experimental tumor studies to clinical cancer therapy is a complex one. The radiotherapy literature contains many examples of premature efforts to apply laboratory observations to the clinic, and many examples of failures to adequately consider animal tumor observations in the design of clinical studies. This review covers three areas: tumor hypoxia, where clinical trials based on animal tumor data have been conducted with radiosensitizers, hyperbaric oxygen, and systemic oxygen carriers; dose fractionation, where current trials of hyperfractionation are based in part on animal tumor studies; and chemo-radiotherapy, where clinical trials are only beginning to exploit concepts developed in animal tumor systems. The use of animal tumor systems extends past the screening of new agents. Animal tumor models can be used in biological, physiological, and pharmacological studies to elucidate the biological factors influencing the efficacy of therapeutic agents. Tumor studies can be combined with studies of normal tissues to predict the toxicities to be anticipated in clinical trials, and to assess the potential for therapeutic gain. Animal studies can also provide data which are useful in designing optimal clinical trials of new agents and maximizing the potential for successful clinical application of new approaches. In general, it is not possible to apply specific laboratory data directly to man. To translate, rather than transpose, information from the laboratory to the clinic, the model studies must be directed at evaluating principles, rather than merely quantifying results. Only through studies of mechanisms, by designing experiments to test or refute a hypothesis, will it be possible to apply model studies to man. PMID- 3283087 TI - Homosexual identity development. AB - This paper presents an ideal-typical model of homosexual identity development that describes how committed homosexuals (i.e., women and men who see themselves as homosexual and adopt corresponding lifestyles) recall having developed perceptions of themselves as homosexual. The model consists of four stages: sensitization, identity confusion, identity assumption, and commitment. Often repeated themes in the life histories of lesbians and gay males, clustered according to life stages, provide the content and characteristics of each stage. PMID- 3283085 TI - Neutron therapy in cervical cancer: results of a phase III RTOG Study. AB - Between October 1976 and May 1984, 156 patients with locally advanced cervical cancer were entered into a Phase III trial with the participation of five institutions. Patients were randomly assigned to receive photons only (50 Gy in 25 fractions over 5 weeks plus intracavitary applications or external-beam boost) or mixed-beam radiotherapy (2 fractions a week of neutrons, 3 fractions a week of photons to a total RBE-adjusted dose of 50 Gy over 5 weeks plus intracavitary applications or external mixed-beam boost). Only patients with squamous carcinoma of FIGO Stages IIB, III, or IVA with negative para-aortic nodes on lymphangiogram were eligible. Ten patients were excluded from the analysis because of ineligibility or cancellation. Of the 146 patients analyzed, 80 were treated with mixed-beam radiotherapy and 66 with photons. Patients were grouped by stage and institution. The percentage of patients undergoing intracavitary applications was 50% on mixed beam and 75% on photons (p less than 0.01). Tumor clearance was 52% and 72% for mixed beam and photons, respectively (p less than 0.03). Local control at 2 years was 45% for mixed beam and 52% for photons. Median survivals were 1.9 years on mixed beam and 2.3 years on photons. Severe complications occurred in 19% and 11% in mixed beam and photons respectively (p less than 0.13). The inferior outcome with neutron therapy in this study may have resulted from the use of horizontal neutron beams of varying energy and penetration. A new randomized trial using high-energy hospital-based cyclotrons with gantry-mounted beam-delivery systems has recently been activated to evaluate more rigorously the role of fast-neutron therapy for advanced cervical cancer. PMID- 3283088 TI - Mental health issues of gay and lesbian adolescents. AB - The mental health concerns of gay and lesbian adolescents are best understood within the context of cultural limitations, including a problematic conceptualization of adolescence, homophobia, and erotophobia. Within this framework, background information about homosexuality is presented; and the special social pressures and psychologic problems of gay and lesbian youth are discussed, with particular attention paid to internalized homophobia, developmental issues, and the "coming-out" process. Differences between gay and lesbian mental health issues are highlighted. Finally, practical suggestions regarding treatment planning are provided. PMID- 3283089 TI - Sexually transmitted diseases in homosexual adolescents. AB - In 1986, an estimated 13 million cases of sexually transmitted diseases (STDs) were diagnosed in the United States, with the highest incidence rates occurring within the adolescent age group. Homosexual adolescent men are at particularly high risk for STDs. Because of the myriad clinical presentations of STD in gay men, these diseases are often not recognized as being sexually transmitted. In this paper, the epidemiology and clinical features of STDs in gay adolescents are discussed. The sexual history is emphasized as an integral tool in developing a differential diagnosis. A priori, the sexual history also can give a risk assessment profile for STD. Clinical aspects of STD are reviewed using a syndrome approach, and the diagnostic workup is outlined for the etiologic agents most likely implicated in each syndrome. Clinical signs and symptoms of urethritis, genital ulcers and papular lesions, pharyngitis, and hepatitis are reviewed. Sexually acquired gastrointestinal disorders are described. As the AIDS epidemic continues, disease prevention, risk reduction, and patient education are becoming more important. Current recommendations for "safer sex" practices are reviewed. PMID- 3283091 TI - Theoretical perspectives accounting for adolescent homosexuality. AB - Few topics in sexology elicit such a diversity of opinions and emotions as the question of etiology of homosexuality. Views frequently carry with them implicit or explicit messages concerning the psychologic health of this sexual orientation. Theories of sexual development usually portray adolescence as a critical time in the life course because of changes in: 1) anatomy and physiology; 2) psychologic functioning: the reawakening, renewal, and reliving of previously established sexual relations and drives; and/or 3) social conditions: an increased exposure and adherence to societal messages concerning appropriate and inappropriate social and sexual behaviors and relationships. This paper provides a brief overview of several major theories--evolutionary biology, psychoanalysis, and social processes--as they relate to the development of sexual orientation. In addition, an ethologic perspective that synthesizes various etiologic theories, as they relate to homosexuality during adolescence, is briefly reviewed. In these discussions, the issue of whether homosexuality is a normal or abnormal developmental state during adolescence is also addressed. PMID- 3283090 TI - Preventing the sexual transmission of AIDS during adolescence. AB - In order to be effective, the national effort to contain the spread of Acquired Immunodeficiency Syndrome (AIDS) must include a youth focus. Knowledge of adolescent sexual behavior, drug use, and sexually transmitted diseases suggests that many adolescents are in jeopardy of acquiring Human Immunodeficiency Virus (HIV) infections; and they are among those most likely to benefit from preventative efforts as they explore adult roles and lifestyles. Preventative education should particularly target gay and other homosexually active young men. Effective teaching uses a variety of approaches and media, both inside and outside the classroom. Learning about AIDS is most likely to effect behavioral change when accompanied by other programs to build social supports, self-esteem, and positive identity. The ethical and rational use of HIV antibody testing may be a helpful adjunct to education for certain adolescents. Ultimately, our society's ability to address complex, associated social issues will determine our ability to control AIDS. PMID- 3283092 TI - Cochlear nonlinearity and gain control as determinants of the response of primary auditory neurons to harmonic complexes. AB - Earlier papers reported a calculational "model" (Greenwood, 1985, 1986a, b, c), composed of an initial compressive nonlinearity accompanied by a nonlinear gain control and "rectification", to demonstrate in principle certain "two-tone suppression" effects seen in primary fiber response. This paper presents simulations of primary fiber response to more complex stimuli. When harmonic stimuli of Horst et al. (1985a, b; 1986a, b) are used, the calculated spectra closely agree with the empirical spectra they report, from fibers with both low or high spontaneous activity. Thus, the simulated nonlinear motion of the cochlear partition reflects a sufficient degree of compressive distortion and an appropriate form to calculate spectra closely matching the empirical spectra in respect to the pattern of intermodulation products and the main "enhancement" and cancellation effects. Comparison of spectra of full and truncated waveforms assess added effects of "rectification". The gain control, as for simpler stimuli, leads to appropriate growth and saturation of Fourier coefficients and average firing rate. The implication that the measured transverse motion of the cochlear partition could provide sufficient distortion to account for the main features of the histograms has a two-part corollary: that the mechanism which produces severe overall saturation does not add much compressive distortion to the waveform passed radially to IHC and primary fibers, and that the IHC is kept operating chiefly in an approximately linear part of its range, by a prior gain control that is, perforce, cochlear and mechanical. Further consequences, for IHC synapses and fiber types, stem from the sufficiency of negatively biased waveform centerlines in generating simulated period histograms and spectra which match those of at least some primary fibers characterized by low spontaneous activity. PMID- 3283093 TI - A randomized double blind controlled trial comparing two amoxycillin regimens in the treatment of acute exacerbations of chronic bronchitis. AB - A randomized double blind trial comparing two amoxycillin regimens in the treatment of acute exacerbations of chronic bronchitis was performed. Forty-one patients were entered into the study. Twenty patients received amoxycillin sachets 3g twice daily for three days and 21 patients received amoxycillin capsules 500 mg three times daily for seven days. There was no significant difference between the two groups in terms of duration of hospital admission, reduction in sputum volume, clearance of pus from the sputum or the number of treatment failures. No patient developed unwanted effects from the treatment with high dose amoxycillin. Twenty-eight patients were followed for one year and there was no difference in the number of exacerbations experienced by patients treated with short course high dose therapy compared with low dose therapy. It is concluded that short course high dose amoxycillin may be as effective as conventional course amoxycillin in the treatment of acute exacerbations of chronic bronchitis. PMID- 3283095 TI - Antibiotic-associated hypoprothrombinaemia. AB - Hypoprothrombinaemia is regarded as a serious adverse effect of antimicrobial therapy. This effect has commonly been attributed to the potential of these drugs to kill intestinal bacteria, a possible source of vitamin K, which is a necessary co-factor in the synthesis of four of the clotting factors. This review examines the evidence for and against this hypothesis, first in experimental animals, then in humans, and assesses the reports of antibiotic associated hypoprothrombinaemia in man, with particular attention to information about the mechanism. The hypothesis that it is the destruction of intestinal bacteria that ultimately results in hypoprothrombinaemia may not be justified. Certain antibiotics, which contain thiol-leaving groups, may produce hypoprothrombinaemia because the thiol group inhibits the vitamin K-dependent step in clotting factor synthesis. PMID- 3283094 TI - The use of aztreonam in serious gram-negative infections. AB - Aztreonam, the first available monobactam, was used to treat 38 episodes of serious infection presumed or proven to be due to aerobic Gram-negative bacteria. On 15 occasions it was used empirically in combination with other antibiotics and on 23 occasions as therapy specifically directed against Gram-negative pathogens. Thirty-six Gram-negative infections were documented (including 23 septicaemias) and 35 of them were clinically cured by aztreonam. Likewise 35 of the 36 aerobic Gram-negative pathogens were eradicated. Both of the failures (one clinical and one microbiological were Salmonella infections). No major toxicity was seen but there were five superinfections (four due to Streptococcus faecalis). The results indicate that aztreonam is a useful alternative to the aminoglycosides or the broad-spectrum beta-lactam antibiotics for the treatment of severe Gram-negative infections. PMID- 3283096 TI - Kinetic properties of two plasmid-mediated beta-lactamases from Klebsiella pneumoniae with strong activity against third-generation cephalosporins. AB - We determined the kinetic constants for two plasmid-mediated beta-lactamases with strong activity against third-generation cephalosporins: CTX-1 and SHV-2. The enzymes had many similar properties: their synthesis was constitutive and they were significantly active against penicillins as well as cephalosporins. The two enzymes thus differed considerably from the chromosomal cephalosporinases, but bore some resemblance to the commonly-encountered plasmid-coded penicillinases, such as TEM beta-lactamases. Moreover, like the TEM enzymes, the plasmid-mediated CTX-1 and SHV-2 enzymes were highly sensitive to the action of the inhibitors clavulanic acid and sulbactam. These inhibitors protected cefotaxime from hydrolysis by these enzymes. Both CTX-1 and SHV-2 lacked activity against the cephamycins, cefoxitin, latamoxef (moxalactam) and cefotetan. The CTX-1 and SHV-2 enzymes had a low activity against oxacillin and were not sensitive to chloride ions. Thus, they were not related to the OXA type beta-lactamases. For the third generation cephalosporins the rates of hydrolysis were high and thus bore no relation with those observed for the other presently-known beta-lactamases, with perhaps the exceptions of those produced by K. oxytoca. Imipenem was very resistant to the action of these CTX-1 and SHV-2 beta-lactamases. PMID- 3283098 TI - Biological photographic collections: the Burns Archive. PMID- 3283097 TI - Enoxacin in the treatment of sexually transmitted diseases. AB - Enoxacin was evaluated in two double-blind comparative trials in a total of 200 male and female patients with urethral and/or endocervical gonorrhoea. Single 400 mg doses were effective in eradicating Neisseria gonorrhoeae (including penicillinase-producing strains) from patients. Enoxacin was as effective as the parenteral drugs approved for treatment. Adverse events occurred in 3% of patients. Enoxacin has been shown to be an effective well tolerated and convenient treatment for gonorrhoea. PMID- 3283099 TI - AIDS in children and adolescents. PMID- 3283100 TI - Analysis of children's human figure drawings. PMID- 3283101 TI - Historical roots of ADHD. PMID- 3283102 TI - Incorporation of LL-diaminopimelic acid into peptidoglycan of Escherichia coli mutants lacking diaminopimelate epimerase encoded by dapF. AB - Recently a dapF mutant of Escherichia coli lacking the diaminopimelate epimerase was found to have an unusual large LL-diaminopimelic acid (LL-DAP) pool as compared with that of meso-DAP (C. Richaud, W. Higgins, D. Mengin-Lecreulx, and P. Stragier, J. Bacteriol. 169:1454-1459, 1987). In this report, the consequences of high cellular LL-DAP/meso-DAP ratios on the structure and metabolism of peptidoglycan were investigated. For this purpose new efficient high-pressure liquid chromatography techniques for the separation of the DAP isomers were developed. Sacculi from dapF mutants contained a high proportion of LL-DAP that varied greatly with growth conditions. The same was observed with the two DAP containing precursors, UDP-N-acetylmuramyl-tripeptide and UDP-N-acetylmuramyl pentapeptide. The limiting steps for the incorporation of LL-DAP into peptidoglycan were found to be its addition to UDP-N-acetylmuramyl-L-alanyl-D glutamate and the formation of the D-alanyl-DAP cross-bridges. The Km value of the DAP-adding enzyme for LL-DAP was 3.6 x 10(-2) M as compared with 1.1 x 10(-5) M for meso-DAP. When isolated sacculi were treated with Chalaropsis N acetylmuramidase and the resulting soluble products were analyzed by high pressure liquid chromatography, the proportion of the main peptidoglycan dimer was lower in the dapF mutant than in the parental strain. Moreover, the proportion of LL-DAP was higher in the main monomer than in the main dimer, where it was almost exclusively located in the donor unit. There are thus very few D alanyl-LL-DAP cross-bridges, if any. We also observed that large amounts of LL DAP and N-succinyl-LL-DAP were excreted in the growth medium by the dapF mutant. PMID- 3283103 TI - Attachment site of the genetic element e14. AB - The Escherichia coli K-12 genetic element, e14, contains a 216-base-pair region that is homologous to a portion of the host chromosome. This region serves as the integration site for the element. The 216-base-pair homology is interrupted by 28 mismatches distributed through the sequence. The actual integrative crossover occurs within the first 11 base pairs from one end of the region. To test factors which affect e14 site-specific recombination, we cloned the attachment sites of free e14 and the host chromosome into the same plasmid. The cloned attachment sites recombined intramolecularly in a process that required the presence of a chromosomal copy of e14 in the host cell as well as the induction of SOS. Recombination events that mimicked both integration and excision occurred under the same conditions and to roughly the same extent. PMID- 3283104 TI - Synthesis of an Escherichia coli protein carrying a signal peptide mutation causes depolarization of the cytoplasmic membrane potential. AB - A deletion mutation (lpp delta 9 delta 13 delta 14) in the signal peptide of the major outer membrane lipoprotein of Escherichia coli (Lpp) was found to cause severe effects on cell physiology, resulting in cessation of growth within 10 min of induction of lpp delta 9 delta 13 delta 14 expression and rapid cell death. Further investigation revealed that lpp delta 9 delta 13 delta 14 expression caused slow processing of several other exported proteins. The origin of this effect was traced to depolarization of the electrochemical potential across the cytoplasmic membrane, which is known to be required for efficient protein export. Analysis of the processing rate of the mutant, either prior to complete depolarization or in a suppressor strain in which depolarization does not occur, indicates that the mutant protein was capable of secretion at a rate which, while less than that of the wild type, was reasonably rapid compared with the rates of other E. coli secreted proteins. The existence of this type of signal peptide mutation suggests that the cell may have a mechanism to avoid membrane damage from secretory proteins carrying membrane-active signal peptides which is bypassed by the lpp delta 9 delta 13 delta 14 mutant. PMID- 3283105 TI - Anaerobic metabolism of the L-rhamnose fermentation product 1,2-propanediol in Salmonella typhimurium. AB - When grown anaerobically on L-rhamnose, Salmonella typhimurium excreted 1,2 propanediol as a fermentation product. Upon exhaustion of the methyl pentose, 1,2 propanediol was recaptured and further metabolized, provided the culture was kept under anaerobic conditions. n-Propanol and propionate were found in the medium as end products of this process at concentrations one-half that of 1,2-propanediol. As in Klebsiella pneumoniae (T. Toraya, S. Honda, and S. Fukui, J. Bacteriol. 139:39-47, 1979), a diol dehydratase which transforms 1,2-propanediol to propionaldehyde and the enzymes involved in a dismutation that converts propionaldehyde to n-propanol and propionate were induced in S. typhimurium cultures able to transform 1,2-propanediol anaerobically. PMID- 3283106 TI - murH, a new genetic locus in Escherichia coli involved in cell wall peptidoglycan biosynthesis. AB - A temperature-sensitive mutant of Escherichia coli defective in peptidoglycan synthesis was characterized. The incorporation of radiolabeled meso diaminopimelate into peptidoglycan by the mutant was inhibited at the restrictive growth temperature, resulting in autolysis. The defective step appeared to be part of the terminal stage in peptidoglycan synthesis involving the incorporation of disaccharide peptide units into the wall peptidoglycan. The mutation was assigned to a new locus, designated murH, at 99.2 min on the E. coli linkage map. PMID- 3283107 TI - Export of hybrid proteins FhuA'-'LacZ and FhuA'-'PhoA to the cell envelope of Escherichia coli K-12. AB - The fhuA gene of Escherichia coli K-12 encodes an outer membrane protein that acts as the ferrichrome-iron(III) receptor. To determine the export signals and sorting information within FhuA, gene fusions of fhuA'-'lacZ and fhuA'-'phoA were constructed. Although a FhuA'-'LacZ hybrid protein was detected in the Triton X 100-insoluble fraction of the cell envelope, direct immunoelectron microscopic observation showed that this protein remained in the cytoplasm. FhuA'-'PhoA hybrid proteins were all exported across the cytoplasmic membrane. Those hybrids containing up to 88 amino acids of FhuA (FhuA88) fused to PhoA were released along with other periplasmic proteins. Hybrids containing 180 or more amino acids of FhuA (FhuA180) fused to PhoA were associated with the outer membrane. It is proposed that some information inherent in the sequences between FhuA88 and FhuA180 confers stable association with the outer membrane. PMID- 3283108 TI - Near-UV stress in Salmonella typhimurium: 4-thiouridine in tRNA, ppGpp, and ApppGpp as components of an adaptive response. AB - We have examined the role of 4-thiouridine in the responses of Salmonella typhimurium to near-UV irradiation. Mutants lacking 4-thiouridine (nuv) and mutants defective in the synthesis of ppGpp (guanosine 5'-diphosphate-3' diphosphate) (relA) were found to be sensitive to killing by near-UV. Near-UV induced the synthesis of a set of proteins that were not induced in the nuv mutant. Some of these proteins were identified as oxidative defense proteins, and others were identified as ppGpp-inducible proteins. Over 100-fold increases in ApppGpp (adenosine 5', 5"'-triphosphoguanosine-3"'-diphosphate, the adenylylated form of ppGpp) were observed in wild-type cells after near-UV irradiation but not in the 4-thiouridine-deficient mutant. These data support a model in which ppGpp and ApppGpp, a dinucleotide proposed to be synthesized by tRNA-aminoacyl synthetases as a response to the cross-linking of 4-thiouridine in tRNA by near UV, induce the synthesis of proteins necessary for resistance to near-UV irradiation. PMID- 3283109 TI - Regulation of cytoplasmic proline levels in Salmonella typhimurium: effect of osmotic stress on synthesis, degradation, and cellular retention of proline. AB - I investigated the effects of osmotic stress on the synthesis and catabolism of proline in Salmonella typhimurium by measuring the intracellular and extracellular proline levels in various strains. In the wild-type strain, exposure to 0.8 M NaCl did not cause a significant change in the intracellular proline level; however, it brought about a 6.5-fold increase in the intracellular glutamate pool size. These results indicate that gamma-glutamyl kinase is inhibited by proline in wild-type cells in media of normal or elevated osmolarity. I also tested whether proline is subject to turnover in cells wild type with respect to the enzymes of the proline degradation pathway. In strains that were wild type for proline biosynthesis, the loss of the proline catabolic enzymes, due to putA mutations, did not result in a statistically significant increase in the intracellular proline levels. Therefore, in the wild-type strain, proline turnover does not seem to be important for control of the intracellular proline levels. However, in a proline-overproducing mutant, a putA lesion caused a threefold increase in the intracellular proline level and a 6.5-fold increase in the extracellular proline level, indicating that proline is subject to turnover in the overproducing mutant. The proline-overproducing mutants excreted large quantities of the proline into the culture medium; osmotic stress altered the partitioning of proline such that the ratio of intracellular to extracellular levels of proline increased with increased osmotic stress. The increased cellular retention of proline in media of high osmolarity is probably due to the functioning of the ProP and ProU proline transport systems, which are stimulated under conditions of osmotic stress. PMID- 3283110 TI - Genetic and phenotypic analyses indicating occurrence of the recN262 and radB101 mutations at the same locus in Escherichia coli. AB - The radB101 and recN262 mutations showed essentially identical phenotypes when compared in isogenic Escherichia coli strains for their effects on gamma and UV radiation survival and on conjugal recombination in a uvrA recB recC sbcB sbcC strain. Complementation tests involving attempts to reconstitute a radB+ recN+ strain by transductions between radB101 and recN262 donors and recipients, and tests involving plasmids carrying recN+ and recN::Tn1000 inserts, indicated that the radB and recN genes are identical. We suggest that the radB101 mutation now be referred to as recN2001. PMID- 3283111 TI - Microcin B17, a novel tool for preparation of maxicells: identification of polypeptides encoded by the IncFII minireplicon pMccB17. AB - The DNA replication inhibitor peptide microcin B17 is shown to be a useful tool for preparing Escherichia coli maxicells. To illustrate its usefulness, we have identified polypeptides synthesized from pMccB17 and R100 IncFII miniplasmids. After comparing the respective polypeptides and the miniplasmid restriction maps, we concluded that these plasmids share extensive homology in the basic replicon but are different for an adjacent region (parD) that is involved in plasmid stability and maintenance. PMID- 3283112 TI - Characterization of rabbit liver cytochrome P-450 (laurate omega-1 hydroxylase) synthesized in transformed yeast cells. AB - Three cDNAs for chimeras between cytochrome P-450s (pHP3 and pHP2-1) were constructed and inserted between the alcohol dehydrogenase promoter and terminator regions of the yeast expression vector pAAH5 to form expression plasmids, pAH3P2, pAH3E2, and pAH3A2. pAH3P2 contained the entire coding sequence of cytochrome P-450 (pHP2-1) except for the 3rd, the 8th, the 36th, and the 42nd residues of the total of 490 amino acids. Nucleotide sequences of pAH3P2 were replaced with those of cytochrome P-450 (pHP3) in the region coding for the NH2 terminal 210 and 262 amino acid residues to yield pAH3E2 and pAH3A2, respectively. The three expression plasmids were introduced into Saccharomyces cerevisiae AH22 cells and cytochrome P-450 s (3P2, 3E2, and 3A2) were purified from the microsomal fractions of the transformed yeast cells. In the oxidized state either of the cytochromes exhibited a low- and high-spin mixed-type spectrum of cytochrome P-450. The reduced CO complex of the cytochromes showed a Soret absorption maximum at 450 nm. When laurate or caprate was added to ferric cytochrome P-450 s (3P2 and 3E2), the spectrum was converted to that of the typical high-spin type, indicating the binding of the fatty acids to the substrate site of the cytochromes. On the other hand, the addition of the fatty acids to ferric cytochrome P-450 (3A2) induced no spectral change. Only chemicals having a carboxyl group caused such spectral conversion of cytochrome P-450 (3P2) among dodecyl compounds examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283113 TI - Determination of the amino acid sequences of the two major isozymes of rhizopuspepsin. AB - The amino acid sequences of the two major isozymes of rhizopuspepsin, an aspartic proteinase from Rhizopus chinensis, were determined by analyzing the tryptic peptides derived from the reduced and carboxymethylated (RCm-) derivative of each isozyme. Amino acid substitutions were shown to occur at eight positions. Rhizopuspepsin I, with an isoelectric point of 5.1, had Ile-15, Asn-61, Ser-116, Lys-162, Ile-230, Tyr-241, Asp-293, and Glu-325, whereas rhizopuspepsin II, with an isoelectric point of 5.8, had Val-15, Lys-61, Asn-116, Ser-162, Val-230, Ser 241, Asn-293, and Gln-325, the other parts of the two isozymes being identical with each other. Thus, rhizopuspepsin I had two more net negative charges than rhizopuspepsin II. This is consistent with the difference in isoelectric point of these two isozymes. PMID- 3283114 TI - Coupled transcription-translation of silkworm cytoplasmic polyhedrosis virus injected into oocytes of the frog, Xenopus laevis. AB - The cytoplasmic polyhedrosis virus of the silkworm, Bombyx mori, contains a ten segmented, double-stranded RNA genome and five species of polypeptides, V1 (Mr 146,000), V2 (Mr 140,000), V3 (Mr 128,000)), V4 (Mr 62,000), and V5 (Mr 32,000). The virus contains an RNA-dependent RNA polymerase that transcribes the duplex genome RNA to form mRNA either in the infected animals or under appropriate conditions in vitro. We co-microinjected the virus, [alpha-32P]GTP and actinomycin D into oocytes of the frog, Xenopus laevis, and found that at least eight species of mRNA were formed in the oocytes. Virus-injected oocytes were labeled with [35S]methionine and cell extracts were treated with rabbit anti cytoplasmic polyhedrosis virus immunoglobulin G. Analysis of the immunoprecipitates by sodium dodecyl sulfate polyacrylamide gel electrophoresis revealed that V1, V2, and V3 were produced in the virus-injected oocytes whereas V4 and V5 were not. By injecting the separated double-stranded genome segments immediately after heat-denaturation into oocytes, it was found that V1 was coded for by segment 1 with a chain length of 4.2 kilobase pairs, V2 by segment 2 or 3, whose chain lengths are both 4.0 kilobase pairs, and V3 by segment 4 with a chain length of 3.2 kilobase pairs. These results demonstrate that the Xenopus oocyte is a very useful system for the coupled transcription-translation of double stranded RNA viruses. PMID- 3283115 TI - Gene amplification in cultured cells. PMID- 3283116 TI - Evidence for modification of lamin B by a product of mevalonic acid. AB - Previous work from this laboratory has shown that a derivative of mevalonic acid is post-translationally incorporated into a number of specific proteins in Swiss 3T3 cells. Neither the nature of the modification nor the identities of the modified proteins have been determined to date. Here we describe results concerning modified proteins of approximately 67 kDa from HeLa cells and Chinese hamster ovary cells. We show that these proteins are specific to the nucleus and remain associated with a Triton/salt-insoluble nuclear fraction. Furthermore, immunological studies demonstrate that one of the modified proteins comigrates on two-dimensional gels with lamin B, a structural protein associated with the nuclear envelope. Using antibodies directed against lamin B in an immunoprecipitation experiment, we further show that this mevalonic acid-modified protein specifically coprecipitates with lamin B. These results support the hypothesis that lamin B is modified by a derivative of mevalonic acid. PMID- 3283117 TI - Affinity labeling of Escherichia coli DNA polymerase I by 5' fluorosulfonylbenzoyladenosine. Identification of the domain essential for polymerization and Arg-682 as the site of reactivity. AB - Preincubation of Escherichia coli DNA polymerase I (pol I) with 5' fluorosulfonylbenzoyladenosine (5'-FSBA) results in an irreversible inactivation of DNA polymerase activity with concomitant covalent binding of 5'-FSBA to enzyme. pol I-associated 3'-5' exonuclease activity, however, remains unaffected. Kinetic studies of inactivation indicate that the degree of inactivation is directly proportional to the concentration of 5'-FSBA and increases linearly with time. The presence of the metal chelate form of dNTP substrates or template primer, but not the template or primer alone, protects the enzyme from inactivation by 5'-FSBA. A complete inactivation of polymerase activity occurs when 2 mol of 5'-FSBA are covalently linked to 1 mol of enzyme, suggesting two sites of modification. Tryptic peptide mapping of 5'-FSBA-treated enzyme revealed the presence of two distinct peptides containing the affinity label, confirming the presence of two reactive sites in the enzyme. However, we find that only one of the two sites is essential for the polymerase activity since, in the presence of substrate dNTP or template primer during preincubation of enzyme with 5'-FSBA, incorporation of the affinity label is reduced by only 1 mol. Peptide analysis of dNTP or template primer-protected enzyme further revealed that a peptide eluting at 35 min from the C-18 matrix was protected from the 5'-FSBA reaction. It is therefore concluded that this peptide contains the domain essential for polymerase activity. Staphylococcus aureus V-8 protease digestion, amino acid composition, and sequence analysis of this peptide revealed this domain to span residues 669 to 687 in the primary amino acid sequence of pol I, and arginine 682 was found to be the site of 5'-FSBA reactivity. PMID- 3283118 TI - Angiotensin II and guanine nucleotides stimulate formation of inositol 1,4,5 trisphosphate and its metabolites in permeabilized adrenal glomerulosa cells. AB - Angiotensin II (AII) interacts with specific receptors in the adrenal glomerulosa cell and stimulates the hydrolysis of plasma membrane phosphoinositides by phospholipase C, with production of inositol 1,4,5-trisphosphate (Ins-1,4,5-P3) and subsequent mobilization of intracellular Ca2+. In electrically permeabilized, [3H]inositol-labeled glomerulosa cells, AII stimulated Ins-1,4,5-P3 production within 15 s with half-maximal potency of 10(-9) M. The nonhydrolyzable GTP analog, guanosine 5'-O-thiotriphosphate (GTP gamma S), stimulated Ins-1,4,5-P3 formation in a dose-dependent manner with half-maximal effect at 10(-7) M. AII activated Ins-1,4,5-P3 production was further increased by guanine nucleotides. The rate at which GTP gamma S-stimulated inositol polyphosphate production was consistently slower than that of AII. In adrenal membrane preparations, GTP gamma S-stimulated polyphosphoinositide hydrolysis was enhanced by Ca2+, with half maximal activity at 300 nM free Ca2+. Ins-1,4,5-P3 formation was also increased by NaF, further indicating the involvement of a guanine nucleotide regulatory protein. In addition to Ins-1,4,5-P3 and its metabolites formed during degradation via the 4-monophosphate pathway, AII and GTP gamma S stimulated the formation of the phosphorylated metabolite inositol 1,3,4,5-tetrakisphosphate and inositol 1,3,4-trisphosphate in permeabilized cells. The absence of a significant rise in inositol 1-monophosphate indicated that phosphatidylinositol hydrolysis was not stimulated by AII or GTP gamma S. Pretreatment of glomerulosa cells with pertussis toxin for 12 h before permeabilization did not inhibit AII- or GTP gamma S-stimulated inositol polyphosphate formation. However, treatment with cholera toxin, forskolin, or 8-Br-cAMP for 12 h enhanced both basal and ligand stimulated Ins-1,4,5-P3 production. These observations suggest that agonist binding to the AII receptor activates a polyphosphoinositide-specific phospholipase C in the adrenal glomerulosa cell, and that a distinctive guanine regulatory protein is involved in this mechanism. PMID- 3283119 TI - Intracellular insulin-receptor dissociation and segregation in a rat fibroblast cell line transfected with a human insulin receptor gene. AB - The cellular processing of insulin and insulin receptors was studied using a rat fibroblast cell line that had been transfected with a normal human insulin receptor gene, expressing approximately 500 times the normal number of native fibroblast insulin receptors. These cells bind and internalize insulin normally. Biochemical assays based on the selective precipitation by polyethylene glycol of intact insulin-receptor complexes but not of free intracellular insulin were developed to study the time course of intracellular insulin-receptor dissociation. Fibroblasts were incubated with radiolabeled insulin at 4 degrees C, and internalization of insulin-receptor complexes was initiated by warming the cells to 37 degrees C. Within 2 min, 90% of the internalized radioactivity was composed of intact insulin-receptor complexes. The total number of complexes reached a maximum by 5 min and decreased rapidly thereafter with a t 1/2 of approximately 10 min. There was a distinct delay in the appearance, rate of rise, and peak of intracellular free and degraded insulin. The dissociation of insulin from internalized insulin-receptor complexes was markedly inhibited by monensin and chloroquine. Furthermore, chloroquine markedly increased the number of cross linkable intracellular insulin-receptor complexes, as analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis autoradiography. These findings suggest that acidification of intracellular vesicles is responsible for insulin receptor dissociation. Physical segregation of dissociated intracellular insulin from its receptor was monitored, based on the ability of dissociated insulin to rebind to receptor upon neutralization of acidic intracellular vesicles with monensin. The results are consistent with the view that segregation of insulin and receptor occurs 5-10 min after initiation of dissociation. These studies demonstrate the intracellular itinerary of insulin-receptor complexes, including internalization, dissociation of insulin from the internalized receptor within an acidified compartment, segregation of insulin from the receptor, and subsequent ligand degradation. PMID- 3283120 TI - Site-specific substitutions of the Tyr-165 residue in the catalytic chain of aspartate transcarbamoylase promotes a T-state preference in the holoenzyme. AB - The amino acid residue Tyr-165C of aspartate transcarbamoylase (EC 2.1.3.2) of Escherichia coli has been proposed to be involved in the transition from the T state to the R-state upon binding of the bisubstrate analogue N-(phosphonacetyl) L-aspartate. Site-specific mutagenesis has been used to substitute phenylalanine for tyrosine, thus maintaining the aromatic R-group but removing the charged hydroxyl moiety. This mutation dramatically altered the aspartate requirements for the holoenzyme but did not substantially affect the homotropic or heterotropic characteristics of the oligomer. The aspartate requirements for half maximal saturation increased from 5.5 mM at pH 7.0 for the native holoenzyme to approximately 90 mM in the mutant enzyme. Nonetheless, estimates of the kinetic cooperativity index remained similar (Hill coefficients: Tyr-165C, n = 2.1; Phe 165C, n = 2.5). CTP inhibited both enzymes approximately 70% and ATP activated approximately 40% at the aspartate concentrations required for half-maximal saturation (5 and 90 mM, respectively). The maximal velocity of the mutant holoenzyme is almost identical to that of the wild-type enzyme. The phenylalanine substitution does not affect the stability of the holoenzyme to heat or mercurials, and the Vmax of the catalytic trimer was 444% greater than that of the holoenzyme. Upon dissociation of the wild-type native enzyme into catalytic trimers, the Vmax increased 450%. The Km for aspartate in the separated catalytic trimer is approximately 2-fold higher than for the native catalytic trimer (16.5 versus 8 mM at pH 7.0). It is clear from the data that although Tyr-165C is not directly involved in the active site of the enzyme, it does play a pivotal role in catalytic transitions of the holoenzyme. In addition, the homotropic and heterotropic characteristics of the enzyme do not seem to be altered by the substitution of phenylalanine for Tyr-165C in the E. coli aspartate transcarbamoylase, although other substitutions have been reported (Robey, E. H., and Schachman, H. K. (1984) J. Biol. Chem. 259, 11180-11183) which show more complex effects. PMID- 3283121 TI - Pertussis toxin treatment attenuates some effects of insulin in BC3H-1 murine myocytes. AB - The effects of pertussis toxin (PT) treatment on insulin-stimulated myristoyl diacylglycerol (DAG) generation, hexose transport, and thymidine incorporation were studied in differentiated BC3H-1 myocytes. Insulin treatment caused a biphasic increase in myristoyl-DAG production which was abolished in myocytes treated with PT. There was no effect of PT treatment on basal (nonstimulated) myristoyl-DAG production. Insulin-stimulated hydrolysis of a membrane phosphatidylinositol glycan was blocked by PT treatment. ADP-ribosylation of BC3H 1 plasma membranes with [32P]NAD revealed a 40-kDa protein as the major PT substrate in vivo and in vitro. The time course and dose dependence of the effects of PT on diacylglycerol generation correlated with the in vivo ADP ribosylation of the 40-kDa substrate. Pertussis toxin treatment resulted in a 71% attenuation of insulin-stimulated hexose uptake without effect on either basal or phorbol ester-stimulated uptake. The stimulatory effects of insulin and fetal calf serum on [3H]thymidine incorporation into quiescent myocytes were attenuated by 61 and 59%, respectively, when PT was added coincidently with the growth factors. Nonstimulated and EGF-stimulated [3H]thymidine incorporation was unaffected by PT treatment. These data suggest that a PT-sensitive G protein is involved in the cellular signaling mechanisms of insulin. PMID- 3283122 TI - Mapping sites of interaction between rhodopsin and transducin using rhodopsin antipeptide antibodies. AB - Site-directed antipeptide antibodies generated against the predicted cytoplasmic sequences of rhodopsin were used to map the binding domains for transducin, the retinal G-protein, on the photoreceptor. Antibodies against synthetic peptides corresponding to loop 3-4, loop 5-6, and the serine/threonine-rich region of the COOH terminus recognize rhodopsin by immunoblot analysis and also recognize the native protein within the membrane, allowing these probes to be used for functional studies. Rhodopsin reconstituted into phospholipid vesicles binds transducin in the light which significantly reduces the binding of antipeptide antibodies corresponding to loop 3-4 and the COOH terminus of rhodopsin. However, the binding of the antibody raised against a 14-amino-acid peptide corresponding to a sequence within loop 5-6 of rhodopsin was unaffected by the presence of transducin. These results suggest a preferential involvement of regions in or near loop 3-4 and the COOH terminus in the binding of transducin to rhodopsin. In contrast, a significant portion of loop 5-6 does not form a binding domain for the G-protein. PMID- 3283124 TI - Epidermal growth factor (EGF) receptor gene transcription. Requirement for Sp1 and an EGF receptor-specific factor. AB - We have studied in vitro transcription of the human epidermal growth factor (EGF) receptor proto-oncogene using nuclear extracts of A431 human epidermoid carcinoma cells, which overproduce the EGF receptor. With the in vitro system we found that Sp1 and other trans-acting factors bound to the EGF receptor promoter regions and are required for maximal expression. Fractionation showed that a DEAE-Sepharose fraction (BA) contained a novel factor, which specifically stimulated EGF receptor transcription 5- to 10-fold. The molecular mass of the native form of the factor is about 270-kDa based on its migration on Sephacryl S-300. This factor may activate transcription of the proto-oncogene through a weak or indirect interaction with the DNA template. PMID- 3283123 TI - Prepro-alpha-factor has a cleavable signal sequence. AB - MAT alpha Saccharomyces cerevisiae secrete a small peptide mating pheromone termed alpha-factor. Its precursor, prepro-alpha-factor, is translocated into the endoplasmic reticulum and glycosylated at three sites. The glycosylated form is the major product in a yeast in vitro translation/translocation system. However, there is another translocated, nonglycosylated product that contains a previously unidentified modification. Contrary to previous results suggesting that the signal sequence of prepro-alpha-factor is not cleaved, amino-terminal radiosequencing has identified this product as prepro-alpha-factor without its signal sequence, that is, pro-alpha-factor. The translocated, glycosylated proteins are also processed by signal peptidase. Moreover, we have found that both purified eukaryotic and prokaryotic signal peptidase can process prepro alpha-factor. Experiments using a yeast secretory mutant (sec 18) blocked in transport from the endoplasmic reticulum to the Golgi indicate that the protein is also cleaved in vivo. Finally, characterization of the Asn-linked oligosaccharide present on pro-alpha-factor in the yeast in vitro system by use of specific glucosidase and mannosidase inhibitors indicates that they have had the three terminal glucoses and probably one mannose removed. Therefore they most likely consist of Man8GlcNAc2 structures, identical to those found in the endoplasmic reticulum in vivo. PMID- 3283126 TI - DNA polymerase III holoenzyme of Escherichia coli. II. A novel complex including the gamma subunit essential for processive synthesis. AB - Processive DNA synthesis, a property of DNA polymerase III holoenzyme of Escherichia coli, was not achieved by combining the pol III core (alpha, epsilon, and theta subunits) and the beta and gamma subunits. An activity that restored processivity to these subunits was found in crude extracts and was overproduced 4 fold in cells with plasmids amplifying the tau and gamma subunits. Purified to homogeneity, the activity, assayed by reconstitution of processivity, was represented by five polypeptides which were copurified. Judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, these correspond to the known subunits gamma (52 kDa) and delta (35 kDa) and to three new polypeptides: delta' (33 kDa), chi (15 kDa), and psi (12 kDa). The five polypeptides form a tight complex with a native molecular weight of about 200 kDa and a subunit stoichiometry of two gamma subunits to one each of the others. Processive DNA synthesis, now achieved with only three components (pol III core, beta, and the auxiliary complex), provides the opportunity to assess the functions of each and the contribution that the remaining auxiliary tau subunit makes to reconstitute a holoenzyme. PMID- 3283125 TI - DNA polymerase III holoenzyme of Escherichia coli. I. Purification and distinctive functions of subunits tau and gamma, the dnaZX gene products. AB - Escherichia coli dnaZX, the gene which when mutant blocks DNA chain elongation, was cloned into a lambda PL promoter-mediated expression vector. In cells carrying this plasmid, the activity that complements a mutant dnaZ extract in replicating a primed single-stranded DNA circle was increased about 20-fold. Two polypeptides of 71 and 52 kDa were overproduced. Upon fractionation, two complementing activities were purified to homogeneity and proved to be the 71- and 52-kDa polypeptides. Immunoassays revealed their respective identities with the tau and gamma subunits of DNA polymerase III holoenzyme. The N-terminal amino acid sequences of the first 12 residues were identical in both subunits, as were their molar specific activities in dnaZ complementation. Thus, the tau subunit complements the defect in the mutant holoenzyme from the dnaZts strain as efficiently as does the gamma subunit. Inasmuch as the 71-kDa subunit (tau) can also overcome the enzymatic defect in a dnaX mutant strain, this polypeptide has dual replication functions, only one of which can be performed by the gamma subunit. Availability of pure tau and gamma subunits for study has provided the basis for proposing an asymmetry in the structure and function of a dimeric DNA polymerase III holoenzyme. PMID- 3283127 TI - DNA polymerase III holoenzyme of Escherichia coli. III. Distinctive processive polymerases reconstituted from purified subunits. AB - The 10 distinctive polypeptides of DNA polymerase III holoenzyme, purified as individual subunits or complexes, could be reconstituted to generate a polymerase with the high catalytic rate of the isolated intact holoenzyme. Functions and interactions of the subunits can be inferred from partial assemblies of the pol III core (alpha, epsilon, and theta subunits) with auxiliary subunits. The core possesses the polymerase and proofreading activities; the auxiliary subunits provide the core with processivity, the capacity to replicate long stretches of DNA without dissociating from the template. In a sequence of reconstruction steps, the beta subunit binds the primed template in an ATP-dependent manner through the catalytic action of a complex made up of the gamma, delta, delta', chi, and psi polypeptides. With the beta subunit in place, a processive polymerase is produced upon addition of the core. When the tau subunit is lacking, binding of polymerase to the primed template is less efficient and stable. The tau-less reconstituted polymerase is more prone to dissociation upon encountering secondary structures in the template in its path, such as a hairpin region in the single strand or a duplex region formed by a strand annealed to the template. With the tau subunit present, the interaction of the core.beta complex (the basic unit of a processive polymerase) with the primed template is strengthened. The tau-containing reconstituted polymerase can replicate DNA continuously through secondary structures in the template. The two distinctive kinds of processivity demonstrated by the tau-less and tau-containing reconstituted polymerases fit nicely into a scheme in which, organized as an asymmetric dimeric holoenzyme, the tau half is responsible for continuous synthesis of one strand, and the less stable half for discontinuous synthesis of the other. PMID- 3283128 TI - DNA Polymerase III holoenzyme of Escherichia coli. IV. The holoenzyme is an asymmetric dimer with twin active sites. AB - Pol III, a subassembly of Escherichia coli DNA polymerase III holoenzyme lacking only the auxiliary beta subunit, was purified to homogeneity by an improved procedure. This assembly consists of nine different polypeptides, likely in a 1:1 stoichiometry: a catalytic core (pol III) of alpha (132 kDa), epsilon (27 kDa), and theta (10 kDa), and six auxiliary subunits: tau (71 kDa), gamma (52 kDa), delta (35 kDa), delta' (33 kDa), chi (15 kDa), and psi (12 kDa). The assembly behaves on gel filtration as a particle of about 800 kDa, indicating a content of two each of the subunits. A new procedure for purifying the core yielded a novel dimeric form which may provide the foundation for the dimeric nature of the more complex pol III and holoenzyme forms. Pol III readily dissociates into several subassemblies including pol III', likely a dimeric core with two tau subunits. The holoenzyme, purified by a similar procedure with ATP and Mg2+ present throughout, retained the beta subunit (37 kDa) as well as all the subunits present in pol III; the mass of the holoenzyme was estimated to be 900 kDa. The isolated initiation complex of holoenzyme with a primed template DNA and the elongation complex (formed in the presence of three deoxynucleoside triphosphates) had the same composition and stoichiometry as observed for pol III with two beta dimers in addition. An initiation complex assembled from a mixture of monomeric pol III core, gamma 2 delta delta' chi psi complex (gamma complex), beta, and tau retained the core, one beta dimer, and two tau subunits but was deficient in the gamma complex. When tau was omitted from the assembly mixture, the initiation complex contained one or two gamma complexes instead of the tau subunit. Based on these data, pol III holoenzyme is judged to be an asymmetric dimeric particle with twin pol III core active sites and two different sets of auxiliary units designed to achieve essentially concurrent replication of both leading and lagging strand templates. PMID- 3283129 TI - The mechanism of glucose 6-phosphate transport by Escherichia coli. AB - To evaluate anion exchange as the mechanistic basis of sugar phosphate transport, natural and artificial membranes were used in studies of glucose 6-phosphate (Glc 6-P) and inorganic phosphate (Pi) accumulation by the uhpT-encoded protein (UhpT) of Escherichia coli. Experiments with intact cells demonstrated that UhpT catalyzed the neutral exchange of internal and external Pi, and work with everted as well as right-side-out membrane vesicles showed further that UhpT mediated the heterologous exchange of Pi and Glc-6-P. When loaded with Pi, but not when loaded with morpholinopropanesulfonate (MOPS), everted vesicles took up Glc-6-P to levels 100-fold above medium concentration in a reaction unaffected by the ionophores valinomycin, valinomycin plus nigericin, and carbonyl cyanide p trifluoromethoxyphenylhydrazone. Similarly, right-side-out vesicles were capable of Glc-6-P transport, but only if a suitable internal countersubstrate was available. Thus, in MOPS-loaded vesicles, oxidative metabolism established a proton-motive force that supported proline or Pi accumulation, but transport of Glc-6-P was found only if vesicles could accumulate Pi during a preincubation. After reconstitution of UhpT into proteoliposomes it was possible to show as well that the level of accumulation of Glc-6-P (17 to 560 nmol/mg of protein) was related directly to the internal concentration of Pi. These results are most easily understood if the transport of glucose 6-phosphate in E. coli occurs by anion exchange rather than by nH+/anion support. PMID- 3283131 TI - Isolation of insulin degradation products from endosomes derived from intact rat liver. AB - Rats were injected with [125I]iodoinsulin labeled at either the A14 or B26 tyrosine, and the animals were killed and livers subcellularly fractionated to yield light (early or neutral) endosomes and heavy (late or acidic) endosomes. 125I-Labeled material was extracted from endosomes and analyzed by Sephadex G-50 filtration and high performance liquid chromatography (HPLC). Radiolabeled material in both types of endosomes is comprised of high molecular weight, insulin-sized, and low molecular weight components, with B chain-labeled small molecular weight material in two peaks, one corresponding to iodotyrosine and one to small peptides (Mr less than 1500). As compared with A chain label, however, less of the B chain material appears in the degradation components (both high and low molecular weight fractions) suggesting that a fragment of B chain containing the B26 residue is lost from the endosomes. Analysis on HPLC shows that significant amounts of the insulin-sized and high molecular weight material have proteolytic cleavage(s) in the B chain with an intact A chain. The B chain derived labeled peptides elute from HPLC identically with products generated by insulin protease. These results therefore show substantial insulin degradation occurring in light endosomes prior to endosomal acidification and to receptor dissociation, suggesting receptor-bound insulin is a substrate for insulin protease. PMID- 3283132 TI - The effects of pore size and endothelial cell seeding upon the performance of small-diameter e-PTFE vascular grafts under controlled flow conditions. AB - The purpose of this study was to determine the effects of endothelial cell seeding and graft internodal distance upon the performance of 4-mm-ID e-PTFE grafts during acute reduced blood flow conditions. PTFE grafts especially manufactured with three different mean internodal distances (28, 40, and 52 microns) were evaluated. Fifteen dogs (n = 5 for each design of PTFE graft) underwent bilateral carotid artery replacements with 6 cm lengths of 4-mm-ID PTFE grafts. In each dog one graft was seeded with enzymatically derived endothelial cells; the contralateral graft was nonseeded. All grafts were evaluated 5 weeks postoperatively. Dogs with bilaterally patent grafts were subsequently subjected to flow conditions through the graft that were maintained at 30% of the initial flow rates for 4 hr. Following controlled low flows the grafts were excised and assessed for patency, thrombus-free surface area, inner capsule thickness and prostacyclin production. Endothelial cell seeding of these small-diameter e-PTFE vascular grafts improved patency and thrombus-free surface areas in grafts of all pore sizes, with these parameters being greatest in the 40-microns grafts. Inner capsule healing in these grafts was controlled and related to the pore size. PGI2 production was improved in endothelial cell seeded grafts of all pore sizes. However, neither endothelial cell seeding nor graft pore size affected the performance of these e-PTFE grafts under conditions of reduced blood flows. PMID- 3283130 TI - Characterization of the copper-thiolate cluster in yeast metallothionein and two truncated mutants. AB - Cu-metallothionein was purified from Saccharomyces cerevisiae harboring plasmids containing mutated CUP1 metallothionein genes resulting in deletions at the carboxy-terminal end of the polypeptide. The truncated polypeptides are recovered as polypeptides of 35 and 48 residues in length. The Cu-S cluster in the wild type metallothionein and the two truncates were characterized. The truncated proteins, designated T35 and T48, contain 4 and 2 fewer cysteinyl residues, respectively, compared to the 12 cysteines in wild-type metallothionein; yet the mutant molecules bind Cu(I) ions in a stoichiometry comparable to the wild-type protein, i.e. 7-8 mol eq. The Cu(I) ions bound to T48 are as tenaciously bound as those bound to the wild-type molecule. The electronic transitions in the ultraviolet are similar for Cu-T48 and the wild-type protein. Both mutants and wild-type Cu-protein exhibit luminescence. The corrected emission maxima occurs at 609 nm with a corrected excitation peak near 277 nm. The luminescence quantum yield and lifetime of fluorescence decay of Cu-T48 and wild-type Cu metallothionein are similar. The absolute quantum yield of the wild-type Cu protein luminescence is 0.0058 and has a 440-ns lifetime. The similar fluorescence rate constant in the two molecules suggests they possess a similar chromophore. The Cu-T35 protein is more labile than Cu-T48 or the wild-type protein in the association of Cu(I) ions and the air sensitivity of the electronic transitions and luminescence. Although T48 lacks 2 of the 12 cysteines in the wild-type protein, we are unable to detect any differences in the properties of the native metal clusters in the two molecules; T35 lacking 4 cysteinyl residues forms a Cu(I) cluster with properties significantly different from the wild-type molecule. Properties of the Cu-thiolate cluster were also studied in Cu(I)-reconstituted samples. The cluster in wild-type metallothionein forms in all-or-nothing fashion. This conclusion is based on copper binding stoichiometry and luminescence studies. The relative quantum yield of samples with intermediate Cu(I) levels was constant, consistent with all-or-none cluster formation. PMID- 3283133 TI - Lack of immediate effects of wound excision on the hyperdynamic circulation of burned patients. AB - The high cardiac output (CO) observed during the chronic phase in burned patients has been ascribed, among other factors, to the elevated blood flow in the burn wound. The hemodynamic effects of wound excision to fascia have been studied in eight patients with second- and third-degree burns ranging from 42% to 70% total body surface area (TBSA) undergoing debridement and skin-grafting procedures. The study was performed on the 4th to the 51st postburn day when all patients were in a hyperdynamic state. Serial hemodynamic measurements, including arterial and mixed-venous blood O2 saturation and content, were made before induction of anesthesia, during surgery both before and after wound excision, and in the recovery room a few hours after surgery. During anesthesia, the elevated CO decreased probably as a consequence of decreased metabolic requirements, but no further hemodynamic change was observed following wound excision. The size of burn wound excised to fascia averaged 24% TBSA and ranged from one-third to more than one-half of the initial burn. With discontinuation of anesthesia, CO rose rapidly above preoperative values, apparently to meet a similar increase in oxygen consumption. The excision of large areas of burned tissue did not attenuate the hyperdynamic circulation in burned patients, at least during and immediately after surgery. The data suggest that the elevated blood flow in the burn wound does not play a significant role in the pathogenesis of the hyperdynamic state. PMID- 3283134 TI - Salvage of both lower extremities using simultaneous bilateral gastrocnemius and soleus muscle flaps: a case report. AB - We present a case of bilateral lower limb salvage in a young man with extensively exposed tibial bone following thermal injury. The medial head of the respective gastrocnemius muscle was used to cover the proximal third of debrided tibia, and the soleus muscle was used for the middle third coverage of each leg. This provided adequate, stable soft-tissue coverage for full recovery of both extremities and sufficient residual function for unassisted ambulation six months postoperatively. PMID- 3283135 TI - Halo immobilization in the treatment of burns to the head, face, and neck. AB - The care of burns to the head, face, and neck remains a challenge to the clinician. From 1978 to 1986, halo traction was used as an immobilizing device and as a protective frame for 31 patients with burns to the head (n = 8), face (n = 24), and neck (n = 28). The patients ranged in age from 8 months to 80 years (mean = 16 years) and had second- and third-degree burns covering a total body surface area of 8% to 75% (mean = 28%). The halo was used for an average of eight days (range one to 19 days) and served to immobilize and protect areas of fresh skin grafts, as well as to elevate and protect scalp donor sites (n = 10). Traction was initially used in patients who were confused and uncooperative, and in patients whose burns involved the neck to provide extension for prophylaxis against contractures. Treatment side effects included intermittent headache and backache, the latter occurring especially in the patients subjected to hyperextension. Eight patients (26%) complained of discomfort, which was reduced with adequate analgesia, sedation, and emotional support. The halo had to be removed from one patient after one day because of a loose pin, and in another patient after eight days because of the development of cellulitis at a pin site. Halo immobilization was used successfully to minimize graft loss in 30 of 31 patients. PMID- 3283136 TI - Temporary skin substitutes for burn patients: a nursing perspective. AB - The conversion of an open wound to a closed wound is the primary focus in caring for the burned patient. When there are inadequate amounts of noninjured skin to cover the open wound, alternative methods for wound coverage are indicated. Temporary skin substitutes are materials designed to be placed on an open wound to temporarily restore an impaired barrier. These materials may be left on until the wound is healed or until replaced by the patient's own skin. Results of a nationwide survey are reported which identify the various products available for use as skin substitutes. Skin substitutes discussed are pigskin, allograft, and Biobrane. OpSite, Xeroform, and scarlet red are also included. The properties, indications for use, and application procedures for these skin substitutes are described. PMID- 3283137 TI - Comments from University of Iowa Hospitals and Clinics Burn Center. PMID- 3283138 TI - Comments from the University of South Alabama Burn Center. AB - The above discussion summarizes our current treatment protocols at the University of South Alabama Burn Center. These are always undergoing evaluation and change. There are many materials currently available for treating the burn wound and even more new ones on the horizon. The efficacy of these materials is often unit dependent, and because of specific unit microbial flora may produce wonderful results at one center and poor results at another. Constant review of outcome is mandatory. The ideal skin substitute for all wounds and all clinical situations does not exist. The clinician must be thoroughly familiar with the properties of many products and be prepared to change from one material to another as the clinical situation dictates. PMID- 3283139 TI - New wire suture for sternal fixation. AB - A new sternal fixation wire, 60 cm in length, was tested clinically. The center portion of the wire is 30 cm in length and 0.8 mm in diameter, while the two end portions of the wire are 15 cm in length and 0.3 mm in diameter. A drill or gimlet with a small hole in the tip was employed to bore a hole in the sternum. The thin ends of the wire were inserted into the hole of the drill, making it easier to pass the wire through the sternal bone. We have found wire penetration through the sternum to be simpler and less traumatic using this technique. PMID- 3283140 TI - PTFE versus human umbilical vein in above knee femoro-popliteal bypass. Early results of a randomized clinical trial. AB - The results of a prospective randomized clinical trial comparing PTFE and HUV grafts in above knee femoro-popliteal reconstruction are presented. A total of 93 limbs were randomized, three patients died in the early postoperative period, leaving 90 (45 PTFE and 45 HUV bypasses) to be analysed. During 18 months of follow-up only 3 HUV grafts occluded in contrast to 15 occluded PTFE grafts. After one year patency rates for HUV were 90% versus 67% for PTFE grafts, after 18 months 86% and 63% respectively. From one year postoperatively onwards these results are statistically and significantly different. When an above knee femoro popliteal reconstruction is performed and autologous vein is not available or purposely not used, HUV gives better results than PTFE and is the graft of choice. PMID- 3283141 TI - Evaluation of the color coded Doppler ultrasound in detecting carotid bifurcation disease. AB - The color coded continuous wave doppler ultrasound was compared with angiography in 201 arteries, 83 with greater than 50% diameter stenosis and 118 with less than 50% stenosis. Overall accuracy in identifying hemodynamically significant (greater than 50% diameter stenosis) was 87% in the presence of peak velocities greater than 5000 Hz and a blue color coded image. Negative predictive value was 94.5%. False positives were mainly due to the presence of severe external carotid stenosis and increased flow due to contralateral carotid occlusion. Within the limitations of the test being an indirect method, it is a reliable screening method for detecting hemodynamically significant carotid artery disease. PMID- 3283142 TI - Occlusion of the left common femoral artery after total hip replacement. Report of a case and review of the literature. AB - Total occlusion of the left common femoral artery occurred after total hip replacement. Presumably the occlusion was caused by polymerization heat produced by the methyl-methacrylate. Only two similar cases have been reported previously. The vascular complications after hip surgery are discussed. PMID- 3283143 TI - SEC11 is required for signal peptide processing and yeast cell growth. AB - Among the collection of temperature-sensitive secretion mutants of Saccharomyces cerevisiae, sec11 mutant cells are uniquely defective in signal peptide processing of at least two different secretory proteins. At 37 degrees C, the restrictive growth temperature, sec11 cells accumulate core-glycosylated forms of invertase and acid phosphatase, each retaining an intact signal peptide. In contrast, other sec mutant strains in which transport of core-glycosylated molecules from the endoplasmic reticulum is blocked show no defect in signal peptide cleavage. A DNA fragment that complements the sec11-7 mutation has been cloned. Genetic analysis indicates that the complementing clone contains the authentic SEC11 gene, and that a null mutation at the SEC11 locus is lethal. The DNA sequence of SEC11 predicts a basic protein (estimated pI of 9.5) of 167 amino acids including an NH2-terminal hydrophobic region that may function as a signal and/or membrane anchor domain. One potential N-glycosylation site is found in the 18.8-kD (Sec 11p) predicted protein. The mass of the SEC11 protein is very close to that found for two of the subunits of the canine and hen oviduct signal peptidases. Furthermore, the chromatographic behavior of the hen oviduct enzyme indicates an overall basic charge comparable to the predicted pI of the Sec11p. PMID- 3283144 TI - Prepro-carboxypeptidase Y and a truncated form of pre-invertase, but not full length pre-invertase, can be posttranslationally translocated across microsomal vesicle membranes from Saccharomyces cerevisiae. AB - We have determined that prepro-carboxypeptidase Y and a truncated form of pre invertase can be translocated across the yeast microsomal membrane post translationally in a homologous in vitro system. The yeast secretory protein prepro-alpha-factor which was previously shown to be an efficient posttranslational translocation substrate is therefore not unique in this regard, but rather the yeast ER protein translocation machinery is generally capable of accepting substrates from a ribosome-free, soluble pool. However, within our detection limits, full-length pre-invertase could not be translocated posttranslationally, but was translocated co-translationally. This indicates that not every fully synthesized pre-protein can use this pathway, presumably because normal or aberrant folding characteristics can interfere with translocation competence. PMID- 3283145 TI - Targeting of the hepatitis B virus precore protein to the endoplasmic reticulum membrane: after signal peptide cleavage translocation can be aborted and the product released into the cytoplasm. AB - The major hepatitis B virus (HBV) core protein is a viral structural protein involved in nucleic acid binding. Its coding sequence contains an extension of 29 codons (the "precore" region) at the amino terminus of the protein which is present in a fraction of the viral transcripts. This region is evolutionarily conserved among mammalian and avian HBVs, suggesting it has functional importance, although at least for duck HBV it has been shown to be nonessential for replication of infectious virions. Using in vitro assays for protein translocation across the endoplasmic reticulum membrane, we found that the precore region of the HBV genome encodes a signal sequence. This signal sequence was recognized by signal recognition particle, which targeted the nascent precore protein to the endoplasmic reticulum membrane with efficiencies comparable to those of other mammalian secretory proteins. A 19-amino acid signal peptide was removed by signal peptidase on the lumenal side of the microsomal membrane, generating a protein similar to the HBV major core protein, but containing 10 additional amino acids from the precore region at its amino terminus. Surprisingly, we found that 70-80% of this signal peptidase-cleaved product was localized on the cytoplasmic side of the microsomal vesicles and was not associated with the membranes. We conclude that translocation was aborted by an unknown mechanism, then the protein disengaged from the translocation machinery and was released back into the cytoplasm. Thus, a cytoplasmically disposed protein was created whose amino terminus resulted from signal peptidase cleavage. The remaining 20-30% appeared to be completely translocated into the lumen of the microsomes. A deletion mutant lacking the carboxy-terminal nucleic acid binding domain of the precore protein was similarly partitioned between the lumen of the microsomes and the cytoplasmic compartment, indicating that this highly charged domain is not responsible for the aborted translocation. We discuss the implications of our findings for the protein translocation process and suggest a possible role in the virus life cycle. PMID- 3283146 TI - Ultrastructural and biochemical analysis of the stress granule in chicken embryo fibroblasts. AB - The ultrastructure and biochemical composition of cytoplasmic particles that form in chicken embryo fibroblasts during stress have been analyzed. We showed previously that these particles contained the small stress protein, sp 24, and antibodies specific to sp 24 were used here to identify the stress granule. In thin sections, the stress granule was a densely staining, membraneless, cytoplasmic body and appeared as a highly condensed area of cytoplasm in freeze fracture preparations. Hypotonic swelling of cells before freeze-fracture analysis revealed a basketlike structure composed of interconnecting protein cables. No other proteins could be cross-linked to sp 24 when stress granules were treated with dithiobis-(succinimidyl propionate). High resolution autoradiographic analysis with [3H]uridine failed to identify any associated RNA synthesized in the period immediately before the stress. Thus the stress granule appears to be composed predominantly of sp 24 aggregates. Sp 24 could be purified to homogeneity from the stress granule by solubilization in 8 M urea and anion exchange chromatography. PMID- 3283147 TI - Intracellular targeting of isoproteins in muscle cytoarchitecture. AB - Part of the muscle creatine kinase (MM-CK) in skeletal muscle of chicken is localized in the M-band of myofibrils, while chicken heart cells containing myofibrils and BB-CK, but not expressing MM-CK, do not show this association. The specificity of the MM-CK interaction was tested using cultured chicken heart cells as "living test tubes" by microinjection of in vitro generated MM-CK and hybrid M-CK/B-CK mRNA with SP6 RNA polymerase. The resulting translation products were detected in injected cells with isoprotein-specific antibodies. M-CK molecules and translation products of chimeric cDNA molecules containing the head half of the B-CK and the tail half of the M-CK coding regions were localized in the M-band of the myofibrils. The tail, but not the head portion of M-CK is essential for the association of M-CK with the M-band of myofibrils. We conclude that gross biochemical properties do not always coincide with a molecule's specific functions like the participation in cell cytoarchitecture which may depend on molecular targeting even within the same cellular compartment. PMID- 3283149 TI - Microtubule dynamics and chromosome motion visualized in living anaphase cells. AB - Chromosome segregation in most animal cells is brought about through two events: the movement of the chromosomes to the poles (anaphase A) and the movement of the poles away from each other (anaphase B). Essential to an understanding of the mechanism of mitosis is information on the relative movements of components of the spindle and identification of sites of subunit loss from shortening microtubules. Through use of tubulin derivatized with X-rhodamine, photobleaching, and digital imaging microscopy of living cells, we directly determined the relative movements of poles, chromosomes, and a marked domain on kinetochore fibers during anaphase. During chromosome movement and pole-pole separation, the marked domain did not move significantly with respect to the near pole. Therefore, the kinetochore microtubules were shortened by the loss of subunits at the kinetochore, although a small amount of subunit loss elsewhere was not excluded. In anaphase A, chromosomes moved on kinetochore microtubules that remained stationary with respect to the near pole. In anaphase B, the kinetochore fiber microtubules accompanied the near pole in its movement away from the opposite pole. These results eliminate models of anaphase in which microtubules are thought to be traction elements that are drawn to and depolymerized at the pole. Our results are compatible with models of anaphase in which the kinetochore fiber microtubules remain anchored at the pole and in which microtubule dynamics are centered at the kinetochore. PMID- 3283148 TI - A temperature-sensitive mutation of the Schizosaccharomyces pombe gene nuc2+ that encodes a nuclear scaffold-like protein blocks spindle elongation in mitotic anaphase. AB - A temperature-sensitive mutant nuc2-663 of the fission yeast Schizosaccharomyces pombe specifically blocks mitotic spindle elongation at restrictive temperature so that nuclei in arrested cells contain a short uniform spindle (approximately 3 micron long), which runs through a metaphase plate-like structure consisting of three condensed chromosomes. In the wild-type or in the mutant cells at permissive temperature, the spindle is fully extended approximately 15-micron long in anaphase. The nuc2' gene was cloned in a 2.4-kb genomic DNA fragment by transformation, and its complete nucleotide sequence was determined. Its coding region predicts a 665-residues internally repeating protein (76.250 mol wt). By immunoblots using anti-sera raised against lacZ-nuc2+ fused proteins, a polypeptide (designated p67; 67,000 mol wt) encoded by nuc2+ is detected in the wild-type S. pombe extracts; the amount of p67 is greatly increased when multi copy or high-expression plasmids carrying the nuc2+ gene are introduced into the S. pombe cells. Cellular fractionation and Percoll gradient centrifugation combined with immunoblotting show that p67 cofractionates with nuclei and is enriched in resistant structure that is insoluble in 2 M NaCl, 25 mM lithium 3,5' diiodosalicylate, and 1% Triton but is soluble in 8 M urea. In nuc2 mutant cells, however, soluble p76, perhaps an unprocessed precursor, accumulates in addition to insoluble p67. The role of nuc2+ gene may be to interconnect nuclear and cytoskeletal functions in chromosome separation. PMID- 3283150 TI - Posttranslational modifications of alpha tubulin: detyrosination and acetylation differentiate populations of interphase microtubules in cultured cells. AB - Subsets of microtubules enriched in posttranslationally detyrosinated (Gundersen, G. G., M. H. Kalnoski, and J. C. Bulinski. 1984. Cell. 38:779) or acetylated (Piperno, G., M. Le Dizet, and X. Chang. 1987. J. Cell Biol. 104:298), alpha tubulin have previously been described in interphase cultured cells. In this study an immunofluorescence comparison of these minor populations of microtubules revealed that, in African green monkey kidney epithelial cells (TC-7 line), the population of microtubules enriched in detyrosinated tubulin was virtually coincident with the population enriched in acetylated alpha tubulin. In some cell types, however, such as human HeLa or marsupial PtK-2 cells, only one posttranslationally modified form of tubulin, i.e., acetylated or detyrosinated, respectively, was detectable in microtubules. In TC-7 cells, although both modifications were present, dissimilar patterns and kinetics of reappearance of microtubules enriched in detyrosinated and acetylated tubulin were observed after recovery of cells from microtubule-depolymerizing treatments or from mitosis. Thus, a minor population of microtubules exists in cultured cells that contains an elevated level of tubulin modified in either one or two ways. While these two modifications occur primarily on the same subset of microtubules, they differ in their patterns of formation in vivo. PMID- 3283151 TI - A phosphatidylinositol-linked peanut agglutinin-binding glycoprotein in central nervous system myelin and on oligodendrocytes. AB - Here we report the isolation and initial biochemical characterization of a 120-kD peanut agglutinin-binding glycoprotein from the adult human central nervous system (CNS), which is anchored to membranes through a phosphatidylinositol linkage. Myelin incubated with phosphatidylinositol-specific phospholipase C released the protein as a soluble polypeptide of 105 kD, which was isolated with peanut agglutinin-agarose affinity chromatography. The protein was found to be highly glycosylated. The protein appears to be confined to the CNS, where its developmental expression is region specific and parallels myelination. It is in greater quantity in white matter than in gray matter and it is in isolated human CNS myelin. Furthermore, ovine oligodendrocytes in culture contain the protein on their surfaces and release it into the supernatant as a soluble 105-kD form. We call this protein the oligodendrocyte-myelin protein. PMID- 3283154 TI - E. B. Wilson medalist, 1987: Marilyn Gist Farquhar. PMID- 3283152 TI - Cell-substrate adhesion during Trypanosoma cruzi differentiation. AB - The transformation of Trypanosoma cruzi epimastigotes to the mammal infective metacyclic trypomastigotes (metacyclogenesis) can be performed in vitro under chemically defined conditions. Under these conditions, differentiating epimastigotes adhere to a surface before their transformation into metacyclic trypomastigotes. Scanning and transmission electron microscopy of adhered and non adhered parasites during the metacyclogenesis process show that only epimastigotes and few transition forms are found in the first population, whereas metacyclic trypomastigotes are exclusively found in the cell culture supernatant. PAGE analysis of the [35S]methionine metabolic labeling products of adhered and non-adhered parasites shows that although most of the polypeptides are conserved, adhered parasites express specifically four polypeptides in the range of 45-50 kD with an isoelectric point of 4.8. These proteins might be involved in the adhesion process and are recognized by an antiserum against total adhered parasite proteins. This antiserum also recognized a group of 45-50 kD in the iodine-radiolabeled surface proteins of differentiating cells, providing direct evidence that these components are indeed surface antigens. The results suggest that epimastigotes must adhere to a substrate before their transformation to metacyclic trypomastigotes, being released to the medium as the metacyclogenesis process is accomplished. This could correspond to the process naturally occurring within the triatomine invertebrate host. PMID- 3283155 TI - Therapeutic progress--review XXVIII. Are we making progress in the management of cytotoxic drug-induced nausea and vomiting? PMID- 3283156 TI - Therapeutic progress--review XXX. Therapeutic progress in intensive care sedation and analgesia. Part I--Principles. PMID- 3283153 TI - Phenotypic modulation of endothelial cells by transforming growth factor-beta depends upon the composition and organization of the extracellular matrix. AB - Transforming growth factor beta (TGF-beta) is angiogenic in vivo. In vitro, endothelial cell proliferation is inhibited by TGF-beta. We have correlated this inhibitory effect with an increase in cellular fibronectin synthesis and deposition in a two-dimensional culture system using specific matrix coatings. The inhibitory effect was mimicked by addition of soluble fibronectin to cultures. In contrast, TGF-beta was found to elicit the formation of tube-like structures (mimicking angiogenesis) when microvascular endothelial cells were grown in three-dimensional collagen gels. In this culture system TGF-beta elicited rapid extensive formation of complex, branching, tube-like structures, while cell proliferation was not inhibited. These data confirm and support the hypothesis that TGF-beta is angiogenic and may exert some of its effects through modulation of matrix synthesis and are consistent with the hypothesis that the organization of the extracellular environment influences cellular responses to this "panregulin." PMID- 3283157 TI - Therapeutic progress--review XXXI. Therapeutic progress in intensive care sedation and analgesia. Part II--Drug selection. AB - In part I of this review the principles governing the uses of analgesics and sedatives in the ITU were considered. In part II we shall review the drugs available considering first, symptomatic therapy and secondly, regional analgesia. PMID- 3283158 TI - Pholcodine. AB - Pholcodine has antitussive activity similar to, or somewhat greater than, that of codeine in animal test systems. The drug, which has been formulated in many combination medications (45)--some rational and some quite irrational pharmacologically--also appears to be active in man, although the clear-cut demonstrations, unfortunately, are in artificially-induced cough models. Additional efficacy studies are needed. Preclinical toxicity studies demonstrate a generally safer profile for pholcodine than codeine, although pholcodine appears to have greater depressant effects on the respiratory and cardiovascular systems in animals. These effects have not been observed in man after administration of therapeutic doses. Pholcodine appears to be devoid of addiction liability in man. In contrast to codeine, pholcodine is not metabolised to morphine in man, a fact which may contribute to its more favourable toxicity profile, and it is metabolised and eliminated much more slowly than codeine. PMID- 3283159 TI - Simplified determination of captopril in plasma by high-performance liquid chromatography. PMID- 3283160 TI - Growth hormone stimulates insulin gene expression in cultured human fetal pancreatic islets. AB - The total body mass of the human fetus increases about 100-fold from 10-20 weeks of gestation, and peak serum GH concentrations occur at 20 weeks. Since insulin has an essential growth-promoting influence in the fetus, these experiments were designed to determine whether GH can function as a growth factor with insulin releasing activity by stimulating insulin gene expression during embryogenesis. Pancreatic islets were isolated from human fetuses (n = 36) of 18-22 weeks gestational age. Insulin gene expression was quantified by measuring insulin mRNA by blot hybridization analysis using a [32P] cDNA probe encoding human insulin. We found that by 48 h of culture insulin gene expression was stimulated by 1.25 micrograms recombinant human GH/mL medium to 216% of the control value (n = 2). Insulin secretory capacity was expressed as a fractional stimulation ratio (FSR = F2/F1) of insulin release rates during two successive 1-h static incubations. After 48 h of culture 1.25 micrograms/mL GH stimulated the FSR value to 273% of the control value (n = 5). We conclude that recombinant human GH significantly enhances the steady state level of insulin mRNA concurrent with an increase in insulin secretory capacity, hence providing evidence for a regulatory function of GH on insulin gene expression during fetal development. PMID- 3283161 TI - Fluctuation of insulin resistance in a leprechaun with a primary defect in insulin binding. AB - A 3-month-old female leprechaun demonstrated extreme insulin resistance with hyperinsulinemia (330 mumol/L) and resistance to exogenous insulin. Insulin binding to erythrocytes, cultured lymphocytes, and fibroblasts from the patient were decreased to less than 20% of normal, whereas insulin-like growth factor I binding to fibroblasts was normal. Antiinsulin receptor antibody binding to cultured lymphocytes was also decreased to 20% of normal, indicating a decreased concentration of insulin receptors on the cell surface. The ability of insulin to stimulate D-[14C]glucose uptake was decreased to 35% of normal in the patient's fibroblasts, and the dose-response curve was shifted to the right. With time, the insulin resistance fluctuated from near normal (fasting insulin, 244.0 pmol/L) to severe resistance (fasting insulin, 5740-9328 pmol/L), and an insulin tolerance test revealed amelioration of insulin resistance during remission. However, insulin binding to erythrocytes and adipocytes was decreased persistently to 20% of normal. These results indicate that the patient had a primary defect in her insulin receptors, i.e. decreased insulin receptor concentration. The variable degree of insulin resistance was possibly due to variable receptor function in the signal transmission process. PMID- 3283162 TI - In memoriam: Edward A. Doisy, Ph. D. PMID- 3283163 TI - Prorenin secretion from human testis: no evidence for secretion of active renin or angiotensinogen. AB - To determine if the testis secretes active renin and prorenin, we collected internal spermatic venous blood from 29 young men undergoing varicocelectomy and measured plasma prorenin and active renin together with angiotensinogen and testosterone. Prorenin was higher in internal spermatic venous plasma than in peripheral plasma (+5.3 +/- 1.2 (+/- SE) ng/mL.h [+1.21 ng/(L.s)]; P less than 0.001) as was testosterone [+344 +/- 32 ng/mL [(+1193 nmol/L; P less than 0.001], but there was no significant difference in either active renin (-0.74 +/- 0.45 ng/mL.h [-0.17 ng/(L.s)] or angiotensinogen [+12 +/- 24 ng/mL (+0.01 mumol/L)]. These results demonstrate that the testis secretes prorenin, but not active renin or angiotensinogen, into the general circulation. They support the hypothesis that extrarenal renin systems cannot process prorenin to renin. PMID- 3283165 TI - [The influence of insulin on hepatocellular glycogenesis in growing rats]. PMID- 3283164 TI - Secretion and hepatic extraction of insulin after weight loss in obese noninsulin dependent diabetes mellitus. AB - We assessed the effects of weight loss on pancreatic secretion and hepatic extraction of insulin in 11 obese subjects with noninsulin-dependent diabetes mellitus. Weight loss of 15.4 +/- 2.0 kg (mean +/- SE) resulted in decreased fasting insulin [20.2 +/- 2.5 to 9.8 +/- 2.5 microU/mL (145 +/- 18 to 70 +/- 18 pmol/L); P less than 0.02] and C-peptide (850 +/- 80 to 630 +/- 110 pmol/L; P less than 0.05) levels. The plasma glucose response to oral glucose and iv glucagon was improved with unchanged peripheral insulin levels. When plasma glucose levels were matched to those before weight loss, peripheral serum insulin and plasma C-peptide responses to iv glucagon were increased and similar to those in obese nondiabetic subjects studied at euglycemia. The total insulin response (area under the curve) to iv glucagon was reduced 30% (P less than 0.005), while the total C-peptide response area did not change after weight loss. At matched hyperglycemia, the total response area was enhanced 72% for insulin (P less than 0.002) and 64% for C-peptide (P less than 0.001). Incremental (above basal) response areas after weight loss did not change for insulin, but increased 66% for C-peptide (P less than 0.05). The incremental areas were augmented nearly 2 fold (196%) for insulin (P less than 0.01) and 1.7-fold (173%) for C-peptide (P less than 0.01) when assessed at matched hyperglycemia. Both basal (7.3 +/- 0.5 to 14.1 +/- 1.8; P less than 0.01) and total stimulated (6.1 +/- 0.4 to 8.8 +/- 1.4; P less than 0.05) C-peptide to insulin molar ratios increased after weight loss. We conclude that after weight loss in noninsulin-dependent diabetes mellitus, 1) insulin secretion is decreased in the basal state but increased after stimulation; 2) changes in insulin secretion are reflected by peripheral levels of C-peptide but not insulin, due in part to enhanced hepatic insulin extraction; and 3) at matched levels of hyperglycemia insulin secretion is markedly increased and similar to that in obese nondiabetic subjects studied at euglycemia. PMID- 3283166 TI - [The role of oxygen free radicals in the pathogenesis of cellular injuries]. PMID- 3283167 TI - [Albuminuria in primary and junior high school pupils after running]. PMID- 3283168 TI - Taxing health insurance: effects on employees in firms with older workforces. PMID- 3283169 TI - Production of polyclonal antibodies in ascitic fluid of mice: technique and applications. AB - Balb/c mice immunised intraperitoneally with insulin developed significantly higher antibody concentrations in their serum than mice immunised subcutaneously. The antibody response was dose related, 50 ug amounts being more effective than either 20 ug or 5 ug amounts. In contrast, the antibody titres in the ascitic fluid of mice immunised with growth hormone were significantly higher after 5 ug when compared to 25 and 100 ug amounts. Repeated intraperitoneal injections of an emulsion of sheep IgG or human growth hormone in complete Freund's adjuvant, together with a single intraperitoneal injection of Pristane, induced ascites formation in most mice within 5 weeks. Up to 90 mL could be obtained from a single mouse by abdominal tapping, and the antibodies derived from the ascitic fluid proved suitable for application in a radioimmunoassay. PMID- 3283171 TI - A fluorescent enzyme immunoassay for Salmonella detection. AB - A double antibody sandwich immunoassay (EIA) was developed for the detection of Salmonella. The assay utilizes a beta-galactosidase-murine myeloma monoclonal antibody (M467) conjugate prepared with the heterobifunctional coupling reagent, N-succinimidyl 3-(2-pyridyldithio) propionate (SPDP) and uses 4-methyl umbelliferyl beta-D-galactoside as a fluorogenic substrate for the enzyme. The EIA is sensitive and rapid, and compared favorably with the conventional cultural technique in the analysis of 60 feed samples naturally contaminated with Salmonella. Proteins or natural contaminants from the sample did not interfere in the assay. PMID- 3283170 TI - Production of antibodies and development of an immunoassay for the anticoagulant, diphacinone. AB - Diphacinone, a commonly used anticoagulant rodenticide, was coupled to protein via an (O-carboxymethyl) oxime bridge. Immunization in rabbits produced antibodies with good ability to recognize the hapten as demonstrated by indirect EIA and affinity column adsorption. A competitive EIA was developed which clearly measured 10 micrograms/L diphacinone concentrations showing the sensitivity of the assay. Cross-reactivity study with chlorophacinone showed that the antisera possessed a high degree of diphacinone specificity. PMID- 3283172 TI - Effects of education and relaxation training with essential hypertension patients. AB - Thirty subjects with essential hypertension were assigned randomly to either a no treatment control, education, or education with relaxation training group. Independent blood pressure recordings were collected by medical staff at pretest, posttest, and 8-week follow-up. Results suggest a significant interaction between treatment and time for the dependent physiological measure, systolic blood pressure. During the pretest to follow-up period, the control group averaged a 5.9 mm. Hg. increase, the education with relaxation group an 8.8 mm. Hg. decrease, and the education group a 14.9 mm. Hg. decrease in systolic blood pressure. There was no significant difference in group means for diastolic blood pressure within groups over time. As measured at follow-up, education appeared more effective in reducing systolic blood pressure than education with relaxation training. More than one-third of subjects associated unpleasant side effects with their antihypertensive medication. Almost all treatment subjects rated the education and relaxation as helpful for understanding and managing their hypertension. PMID- 3283173 TI - Immunohistological determination of proliferative activity in seminomas. AB - The proliferative activity and growth pattern of 20 seminomas were determined immunohistologically with the monoclonal antibody Ki-67. A growth fraction of tumour cells between 50 and 80% was found in seminomas with an almost even distribution of proliferating cells in all sections, regardless of tumour size. There was a slight tendency towards a greater growth fraction in tumours at an advanced histopathological stage. No positive correlation could be found between growth fraction and tumour size or lymphocytic infiltration. The results confirm the well known sensitivity of seminomas to radiation and chemotherapy and show that the determination of proliferative activity should be included in the histopathological routine diagnosis of malignant tumours with regard to systemic treatment and prognosis. PMID- 3283174 TI - Use of lectin histochemistry in pancreatic cancer. AB - Lectin peroxidase histochemical analysis was carried out on pancreatic tissue from patients with pancreatic carcinoma and chronic pancreatitis and from subjects with normal pancreas to find a tumour specific pattern of lectin binding that would aid histological and cytological diagnosis. There were striking differences between the lectin binding characteristics of the different cell types in the normal pancreas. Acinar cells were uniformly positive for binding with wheat germ agglutinin and soy bean agglutinin while islet cells were usually negative for these lectins. Ulex europaeus I lectin however, was found not to be specific for endothelium, showing positivity also for acinar and ductal tissue. Griffonia simplicifolia II lectin was found to be highly specific for ductal epithelium, and because of this was tested in a hamster pancreatic cancer model where it was not specific for ductal epithelium, reflecting differing carbohydrate expression in the hamster pancreas. Pancreatic carcinomas and chronic pancreatitis bound all five lectins without any qualitative distinction from each other or from normal pancreatic tissue, but there was increased intensity of peanut agglutinin binding to secreted mucins in pancreatic carcinoma, which may be of potential use in radiolabelled lectin scanning. PMID- 3283175 TI - Four hour rapid urease test (RUT) for detecting Campylobacter pylori: is it reliable enough to start treatment? PMID- 3283176 TI - The efficacy results and safety profile of imipenem/cilastatin from the clinical research trials. AB - Imipenem/cilastatin is highly effective for infections in many body sites against a broad range of gram-positive and gram-negative aerobic and anaerobic bacteria. During therapy, development of resistance is uncommon except in the case of Pseudomonas aeruginosa in which the incidence appears similar to that for other beta-lactam antibiotics. There appears to be a very low probability of cross resistance. The clinical and laboratory adverse reactions are similar in type to those for other beta-lactam antibiotics. The frequency of colonization and superinfection during treatment with imipenem/cilastatin has been comparable to other antibiotics in comparative trials and to literature reports for other antibiotics for noncomparative trials. PMID- 3283177 TI - Penems: in vitro and in vivo experiments. PMID- 3283178 TI - Glycopeptide antibiotics. AB - Numerous glycopeptides continue to be described in the literature. They all share a similar heptapeptidic structure with a fixed spatial configuration that forms the basis of their ability to recognize D-alanyl-D-alanine-containing structures in the cell wall. This complexation results in block of peptiglycan elongation; hence, inhibition of growth; and, eventually, cell death. The great variety of substituents on the heptapeptide forms the basis of a wide gradation of physico chemical characteristics, namely net charge and lipophilicity, which, in turn, might explain the widely differing pharmacologic properties. PMID- 3283179 TI - Mode of action, and in vitro and in vivo activities of the fluoroquinolones. PMID- 3283180 TI - The quinolones: an overview and comparative appraisal of their pharmacokinetics and pharmacodynamics. PMID- 3283181 TI - System approaches in pharmacokinetics: II. Applications. AB - Pharmacokinetic system approaches mathematically describe a general property of a pharmacokinetic system without modeling in specific terms the kinetic processes responsible for the general property. Certain applications of the system approach including methods for evaluating drug delivery, drug distribution, drug secretion, and biotransformation in linear and nonlinear pharmacokinetics are presented and discussed. Linear system formulae for various mean time disposition parameters and a disposition decomposition-recomposition system approach for predicting drug levels when the drug clearance changes are presented and discussed. System approaches offer certain advantages over traditional approaches for many practical applications. PMID- 3283183 TI - The drug regulatory process of the Republic of China. PMID- 3283184 TI - Academic-industrial cooperative graduate program in clinical pharmacology. AB - Because a new level of sophistication among clinical investigators is necessary for the testing of new agents in human subjects, a close integration of basic science, clinical medicine, and pharmaceutical medicine is required. Experts from the Departments of Pharmacology and Medicine at Temple University School of Medicine and Smith Kline and French Laboratories have combined to form a joint training program in clinical pharmacology. This structured graduate program for physicians couples didactic courses with a defined program of independent research, leading to a Master of Science degree in pharmacology. The development of new technologies and the transfer of them from the "bench to the bedside" demands that the clinician have special competence in clinical pharmacology. This unique joint academic-industrial program sets the goals ensuring that this objective is met. PMID- 3283185 TI - Clinical pharmacokinetics of carboplatin. AB - The pharmacokinetics of carboplatin were investigated in cancer patients after single, IV infusion doses of 75, 150, 247.5, 300, 375, and 450 mg/m2. Total plasma and urine platinum and plasma ultrafilterable platinum concentrations were determined by atomic absorption spectrometry. Carboplatin was analyzed in plasma by a specific high-performance liquid chromatography (HPLC) procedure. Total plasma platinum, which represented free carboplatin, protein-bound platinum and metabolites, declined triexponentially; plasma half-lives (t1/2 lambda 1, 0.2 to 0.4 hr; t1/2 lambda 2, 1.3 to 1.7 hr; t1/2 lambda 3, 22 to 40 hr) and total body clearance (CLTB 2.8 +/- 0.5 L/m2/hr) were dose independent. Maximum plasma concentrations (Cmax) and area under the plasma concentration time curve (AUC) increased proportionally with dose. Plasma ultrafilterable platinum and carboplatin concentrations at doses of 375 and 450 mg/m2 declined in a biphasic manner. Plasma carboplatin elimination (t1/2 lambda 1, 0.50 hr; t1/2 lambda 2, 2.2 hr) and CLTB (4.4 to 5.6 L/m2/hr) were also independent of dose; AUC and Cmax increased proportionally to dose. Plasma free platinum was essentially all carboplatin for 8 or 12 hours after administration. Carboplatin did not bind to plasma protein in vitro but did degrade (t1/2-26 hours) to yield a reactive intermediate that bound rapidly and irreversibly to protein. The long terminal elimination half-life of plasma platinum was associated with irreversible binding of a platinum metabonate to plasma protein. The urinary excretion of platinum (0 to 24 hours) accounted for 58 to 72% of doses in 12 to 24 hours. The remainder of the dose is slowly excreted. The pharmacokinetics, in vivo stability, protein binding, and elimination of carboplatin are distinct from the first-generation analog cisplatin. PMID- 3283182 TI - Current concepts of migraine therapy. PMID- 3283186 TI - A comparison of three methods to evaluate change in the spontaneous language of aphasic individuals. AB - Three methods for evaluating change in the spontaneous language of aphasic subjects were compared. Clinical judgments (CJ) of experienced speech-language pathologists showed excellent agreement and served as a comparison with the Shewan Spontaneous Language Analysis (SSLA) and the WAB Spontaneous Speech subtest. Although reliable and easy to use, however, the CJ method does not provide comprehensive information needed for treatment planning. The SSLA, although more time-consuming, provided comprehensive information and agreed highly with CJ for detecting change. The WAB method, although almost as economical timewise as the CJ method, did not agree as highly with CJ and did not provide adequate information for treatment planning. PMID- 3283187 TI - Behaviors of treated hypertensive patients and patient demographic characteristics. AB - The relationships between self-reported hypertension-related patient behaviors and patient demographic characteristics were examined in a sample of 2,044 patients being treated for hypertension in 111 primary care medical practices. The patient behaviors of sodium intake, weight, alcohol, exercise, relaxation and adherence to medication regimen could be predicted to some extent by patient demographic characteristics. Whether patients recalled receiving advice from their physicians about these behaviors could also be predicted by patient demographic characteristics. Patients demographically similar to physicians, i.e., male, younger, more educated and White, reported receiving more advice from their physicians. Patients with behavioral problems who received relatively less advice from their physicians included: less educated younger patients whose sodium intake was relatively high; younger and less educated over-weight women; overweight Black patients; and older women who exercised less than average. PMID- 3283188 TI - Needle holders--an instrument especially for the left-handed surgeon. PMID- 3283189 TI - Verrucous carcinoma arising in ulcerative lichen planus of the soles. AB - Verrucous carcinoma is a low-grade squamous cell carcinoma. Chronic inflammation is an important factor in its pathogenesis. This is the first case of plantar verrucous carcinoma arising in a lesion of ulcerative lichen planus. This paper also lends further support to the successful use of Mohs micrographic surgical technique as the treatment of choice for verrucous carcinoma. PMID- 3283190 TI - The management of active variceal bleeding. PMID- 3283191 TI - Intermittent positive pressure ventilation by nasal mask: technique and applications. AB - Intermittent positive pressure ventilation delivered non-invasively through a well-fitting nasal mask has been used to control nocturnal hypoventilation in three patients with severe, combined cardiorespiratory and skeletal disease. The advantages of this approach to domiciliary ventilation are described and the requirements of the ventilator are defined. PMID- 3283192 TI - Real-time continuous estimation of gas exchange by dual oximetry. AB - We designed a ventilation-perfusion index (VQI) to estimate venous admixture (Qsp/Qt) in a real-time fashion by simultaneous pulse and pulmonary artery oximetry in 17 patients with acute respiratory failure. Changes in Qsp/Qt were produced by altering the level of continuous positive airway pressure. VQI correlated well with Qsp/Qt (r = 0.78). This contrasts with the poor correlation found between Qsp/Qt and the commonly used oxygen tension based indices such as PaO2/FIO2 (r = -0.51), PaO2/PAO2 (r = 0.47), and PAO2-PaO2 (r = 0.23). The use of dual oximetry to derive a VQI appears to be a reliable and accurate method for real-time assessment of pulmonary gas exchange in patients with acute respiratory failure. PMID- 3283193 TI - The medical prevention of variceal bleeding. PMID- 3283194 TI - Selective fetal malnutrition: the fetal alcohol syndrome. PMID- 3283195 TI - Effect of source of dietary fats on serum glucose, insulin, and gastric inhibitory polypeptide responses to mixed test meals in subjects with non-insulin dependent diabetes mellitus. AB - We recently demonstrated that normal subjects given mixed test meals of varying fatty acid composition showed significantly greater serum insulin responses to meals enriched with polyunsaturated fat as compared to those in which the fat content was derived from saturated fatty acids. To determine if a similar phenomenon occurs in subjects with non-insulin dependent diabetes mellitus (NIDDM), serum glucose, insulin, C-peptide, and gastric inhibitory polypeptide (GIP) responses to three mixed test meals of varying fatty acid composition were assessed in twelve subjects with NIDDM. Baseline means (+/- SEM) fasting serum glucose concentration was 205 +/- 15 mg/dl and mean glycosylated hemoglobin was 8.5 +/- 0.5%. Fatty acids in the test meals were either saturated fats, or polyunsaturated fats derived from vegetables or fish. Each test meal provided 40% of the subjects' calculated daily caloric requirement and contained approximately 45% carbohydrate, 40% fat, and 15% protein. No appreciable differences in serum glucose, insulin, and C-peptide responses occurred during the three mixed test meals. Although GIP values were higher in the saturated fat and the vegetable meals when compared to the fish meal, the differences did not reach statistical significance. The inability of NIDDM subjects to evoke a greater insulin response to polyunsaturated fatty acids than to saturated fatty acids suggests another pathogenetic factor contributing to their glucose intolerance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283196 TI - Adventures with vitamins. PMID- 3283198 TI - Psychotropic drug practice in nursing homes. AB - This study examined the administration of psychotropic medication to Medicaid recipients who resided continuously in an Illinois nursing home during 1984. Of these residents, 20,037 (60%) received at least one such medication during the year, with administration most likely for those from the ages of 45 to 74 years. Haloperidol, thioridazine, and flurazepam were the most frequently prescribed drugs of those examined. The study also investigated the relationship of demographic and institutional variables to the probability of drug administration and the amount administered. These variables were most strongly related to the probability of antipsychotic, antiparkinson, and antimanic (lithium) administration. The association of these variables with the amount of drug administered was strongest for antimanic and antipsychotic medications, particularly the latter. In all analyses, the addition of institutional variables increased goodness of fit minimally over that produced by demographic variables alone. This finding supports the conclusion that the prescription of psychotropic medication is more influenced by individual patient characteristics than by the nature of the institutional setting in which the patient resides. PMID- 3283197 TI - Diabetes mellitus in elderly nursing home patients. A survey of clinical characteristics and management. AB - The clinical features of 47 frail nursing home diabetic patients with a mean age of 81 +/- 1.6 years were compared to those of 61 nondiabetic nursing home residents with a mean age of 80.2 +/- 1.2 years. Diabetic patients had a higher prevalence of renal failure, proteinuria, retinopathy, neuropathy, and infections than did other nursing home residents. Macroangiopathic disease tended to be equally common in both age groups. Diabetic nursing home residents had higher body weights compared to nondiabetic nursing home residents. Surprisingly, however, 21% of nursing home diabetics were greater than 20% below average body weight (compared to 24.5% of other nursing home residents), suggesting that undernutrition is a major problem in diabetic patients in a nursing home setting. Overall, the diabetic nursing home patients had better blood glucose control than younger ambulatory diabetic patients (mean age 66.2 +/- 4.7 years). The glycosylated hemoglobin (HbA1) level in those on oral agents was 8.9% +/- 0.7% for nursing home patients compared to 11.8% +/- 0.7% in ambulatory patients (P less than 0.01). The HbA1 in insulin-treated patients was similarly lower in nursing home diabetics (9.6% +/- 0.4% vs 11.8% +/- 0.7, P less than 0.05). There were only two mild hypoglycemic episodes in nursing home patients over 6-month observation period, whereas 12 ambulatory patients reported hypoglycemic episodes during the same period of time. We conclude that although the diabetic nursing home patients are sicker than the ambulatory diabetics, it is possible to achieve a fair blood glucose control in nursing home patients without a significant risk of recurrent hypoglycemia. PMID- 3283200 TI - The treatment of asymptomatic bacteriuria in the elderly. PMID- 3283199 TI - Clinical spectrum and diagnostic techniques of coronary heart disease in the elderly. AB - Coronary heart disease is a major cause of morbidity and mortality in the older population. The recognition of such disease in the elderly varies in a number of parameters from that noted in younger patients. There are a number of physiologic changes in cardiac function as a result of aging, and they have an important bearing on the recognition of cardiac disease in the elderly. This review stresses the particular features of coronary disease in the aged and contrasts them with features more readily recognized in younger patients. Changes in the development of angina pectoris, heart failure, and the diagnosis of myocardial infarction vary significantly in the elderly population. The role of diagnostic modalities varies considerably in sensitivity and specificity when comparing younger and older patients. Potential areas for further research are stressed. PMID- 3283201 TI - Stargardt's disease: a review of the literature. AB - In 1909, Dr. Stargardt described seven patients who developed a juvenile onset macular degeneration with a striking presentation of yellowish flecks surrounding the macula. The eponym "Stargardt's disease" has since been used to describe this condition. However, there is some ambiguity in the literature concerning the characteristics which differentiate this condition from other hereditary retinal dystrophies. We have undertaken a review of the literature in an attempt to clarify the parameters of Stargardt's disease. PMID- 3283202 TI - Adult visual system plasticity. AB - The functional area of optometry assumes plasticity of the neurological input to the visual system. This paper reviews the literature which investigates adult visual system plasticity. Literature on development of the visual system, as well as adult central nervous system plasticity, provides additional inferences. A discussion is presented suggesting that there exists a multiplicity of sensitivity periods within the visual system. PMID- 3283203 TI - The efficacy of optometric vision therapy. The 1986/87 Future of Visual Development/Performance Task Force. AB - Vision is not simply the ability to read a certain size letter at a distance of 20 feet. Vision is a complex and adaptable information gathering and processing system which collects, groups, analyzes, accumulates, equates, and remembers information. In this review, some of the essential components of the visual system and their disorders which can be physiologically and clinically identified, i.e., the oculomotor, the accommodative, and the fusional vergence systems have been discussed. Any dysfunctions in these systems, can lessen the quality and quantity of the initial input of information into the visual system. Deficiencies in one or more of these visual subsystems have been shown to result in symptoms, such as blurred or uncomfortable vision or headaches, or behavioral signs such as rubbing of the eyes, eyes turning inward or outward, reduced job efficiency or reading performance, or simply the avoidance of near point tasks. In addition, these signs/symptoms may contribute to reducing a person's attention and interest in near tasks. The goal of vision therapy is to eliminate visual problems, thereby reducing the frequency and severity of the patient's signs and symptoms. Vision therapy should only be expected to be of clinical benefit to patients who have detectable visual deficiencies. In response to the question, "How effective is vision therapy in remediating visual deficiencies?," it is evident from the research presented that there is sufficient scientific support for the efficacy of vision therapy in modifying and improving oculomotor, accommodative, and binocular system disorders, as measured by standardized clinical and laboratory testing methods, in the majority of patients of all ages for whom it is properly undertaken and employed. The American Optometric Association reaffirms its long-standing position that vision therapy is an effective therapeutic modality in the treatment of many physiological and information processing dysfunctions of the vision system. It continues to support quality optometric care, education, and research and will cooperate with all professions dedicated to providing the highest quality of life in which vision plays such an important role. PMID- 3283204 TI - Cumulative index. Volume 44-Volume 58, 1973-1987. PMID- 3283205 TI - Psychoanalysis, psychoanalytic science, and psychoanalytic research--1986. AB - The present standing of psychoanalysis as a science and the vitality of psychoanalytic research effort are reviewed. The two are interdependent, since the possibilities for empirical research rest on the necessary assumption that psychoanalysis is indeed enough a science to be susceptible to knowledge advance by the (research) methods of science. Concerning our status as a science, I review attacks on our scientific credentials (both from within our ranks and without) by the logical positivists, by the hermeneuticists (a rubric comprising a variety of hermeneutic, phenomenological, exclusively subjectivistic, and/or linguistically based conceptualizations of our field), and the most recent by the philosopher of science, Adolf Grunbaum. I try to demonstrate what I feel to be the failure of each of these assaults, and why I feel there is no reason to see psychoanalysis as anything other than a scientific psychology and, therefore, in theory amenable to empirical research approaches. I then review the history and the current status of these systematic research efforts in psychoanalysis, and the reasons why these have been far less in scope and in accomplishment than has been possible or than has been needed. Here I have focused especially on research involving technique and our theory of change and cure--i.e., research on the analytic process; on what changes take place (outcome) and how those changes come about or are brought about (process). PMID- 3283207 TI - Hormone and epilepsy. PMID- 3283209 TI - Food restriction in rodents: an evaluation of its role in the study of aging. PMID- 3283208 TI - Oxytocin response to insulin-induced hypoglycemia in obese subjects before and after weight loss. AB - The response of plasma oxytocin to an iv bolus injection of crystalline insulin (0.15 U/kg) was evaluated in 14 normal weight [mean body mass index (BMI) = 23] and in 9 obese (mean BMI = 42) men. Similar blood glucose decrements after insulin injection were observed in the two groups. Obese and normal weight subjects presented similar basal oxytocin levels. In both groups, oxytocin rose significantly during the insulin tolerance test (ITT); however, the peak oxytocin response in the obese men was significantly lower than in the normal weight subjects. Obese men were restudied after substantial weight loss. Basal oxytocin levels and glucose response to insulin did not change after weight reduction. The oxytocin response to the ITT was significantly higher than before slimming and did not differ from that observed in the normal weight subjects. A significant negative correlation between BMI values and oxytocin peak levels during ITT was observed in the lean controls and obese subjects (r = 0.516, p less than 0.02). These results demonstrate that in obese subjects the oxytocin secretory response during an insulin tolerance test is reduced, suggesting the existence of a hypothalamic-pituitary disorder in obesity. PMID- 3283206 TI - Calcium metabolism in thyroid disease. PMID- 3283210 TI - An approach to airway management in the acutely head-injured patient. AB - The rapid and safe establishment and maintenance of an adequate airway in patients with acute, severe head injuries is of central importance in the "ABC" approach to the trauma victim. It is also necessary before hyperventilation can be instituted as a means of controlling intracranial pressure. A method of establishing an airway in a manner that best protects the patient from unnecessary elevations in intracranial pressure with the least possible risk is presented. This method can be applied in virtually all emergency departments, from community hospitals to teaching centers, using materials and expertise currently available. PMID- 3283211 TI - "Occult" Boerhaave's syndrome. AB - Spontaneous rupture of the esophagus (Boerhaave's syndrome) usually presents in a dramatic fashion. Classically, following repeated episodes of vomiting, patients present with chest pain, dyspnea, cyanosis, shock, and cardiovascular collapse. We present a case of occult Boerhaave's syndrome diagnosed by an upper gastrointestinal series in a 33-year-old man who arrived at the emergency department with a chief complaint of hematemesis. This case report reviews the usual presenting signs and symptoms of Boerhaave's syndrome and concludes with a caution to physicians not to ignore the possibility of this disease entity in relatively stable patients. PMID- 3283212 TI - Catheter embolism. AB - With the increasing utilization of intravenous catheters, complications from their use may be anticipated. We report the case of one such complication, a venous catheter fragment embolization. A review of the literature addressing catheter embolization is provided. Specific recommendations are offered to the emergency physician in an effort to minimize such untoward occurrences. PMID- 3283213 TI - Acute occlusion of the left renal artery manifested by hypertensive crisis. AB - Because the signs and symptoms of acute renal artery occlusion mimic those of many more common diseases, prompt diagnosis is aided by an awareness that an occlusive renovascular event may have occurred. No routine, noninvasive laboratory test can confirm the diagnosis. Renal arteriography is the procedure of choice after excretory urograms have ruled out an obstructive uropathy. Early assessment of kidney viability is important. The endpoints of emergency treatment are to decrease symptoms, decrease diastolic blood pressure to less than or equal to 105 mm Hg, and to maintain urine output at greater than 50 mL/h. Restoration of a lower blood pressure must not be so prompt that renal perfusion decreases too rapidly. Definitive surgical treatment versus medical management of the renal artery occlusion remains a controversial topic. Where surgery is not feasible, medical management consists of streptokinase acutely followed by heparin and then chronic coumarin therapy. PMID- 3283214 TI - Rupture of a pancreatic pseudocyst following blunt abdominal trauma. AB - This report describes a case of intraperitoneal rupture of a pancreatic pseudocyst (PPC) following blunt abdominal trauma. Cause of the pseudocyst was likely alcoholic pancreatitis. Peritoneal aspiration of hemorrhagic fluid prompted laparotomy and led to diagnosis. Trauma-induced intraperitoneal rupture of a preexisting PPC has been rarely reported. PMID- 3283215 TI - Subacute acetaminophen overdose after incremental dosing. AB - A case of acetaminophen poisoning following the ingestion of 26 g of acetaminophen by incremental dosing over a 25-h period is reported. At presentation, seven h after the last ingestion, the patient experienced hematemesis, the acetaminophen level was 150 micrograms/mL, and the SGOT was normal. The patient recovered uneventfully following N-acetylcysteine therapy. A review of the pharmacology and toxicity of acetaminophen is discussed. The case illustrates the problems of judging hepatotoxic potential in a multiple-dose acetaminophen ingestion and describes the successful use of N-acetylcysteine in a patient with a "subacute" acetaminophen overdose. PMID- 3283216 TI - Atrial flutter. AB - Atrial flutter is a supraventricular tachydysrhythmia believed to arise from electrophysiologic disturbances in the atria. It tends to be an unstable rhythm and is usually associated with intrinsic cardiac or pulmonary disease or adverse extrinsic influences on the heart. It is due to either a reentry mechanism or an increased atrial automaticity. Atrial depolarization is regular at a rate of 260 to 340 beats per minute. With a normal atrioventricular (AV) node there is usually a physiologic second-degree block with resultant 2:1 conduction. Higher degrees of AV block can occur in patients with AV nodal disease, increased vagal tone, or when certain drugs are in use. One-to-one conduction may occur in patients with accessory AV nodal pathways. In this situation, serious adverse effects are often seen, including palpitations, dizziness, syncope, angina, and dyspnea. Electrical cardioversion is the safest and most reliable way of terminating atrial flutter and its use should not be delayed in an unstable patient. In the nonemergent situation a variety of medications alone or in combination can be used to convert the rhythm or slow ventricular response. PMID- 3283219 TI - Transmission of Creutzfeldt-Jakob disease. PMID- 3283218 TI - Sydney Ringer: water supplied by the New River Water Company. AB - Lactated Ringer's solution has been used for decades in the resuscitation of hypovolemia and hemorrhagic shock. Its origin relates to a serendipitous substitution of water in the London laboratory of Sydney Ringer in the 1880s. A number of controversies have related to the use of lactated Ringer's solution. Some of these have involved the potential exacerbation of lactic acidosis and the question of whether administration of colloid or crystalloid is preferable in severe hypovolemia. The use of hypertonic saline solutions in shock is an issue of current investigative interest. PMID- 3283217 TI - Hemodialysis-related emergencies--Part II. AB - The management of medical emergencies in hemodialysis patients is not simple and is best carried out in consultation with experienced nephrologists. However, emergency staff who are likely to encounter such emergencies must be familiar with the principles of their diagnosis and treatment and have practical management strategies at their disposal. PMID- 3283220 TI - Malassezia furfur skin colonization in infancy. AB - Malassezia furfur, a lipophilic yeast, has become recognized as a cause of sepsis in infants receiving parenteral fat emulsions via indwelling deep venous catheters. Colonization of infants' skin may be a prerequisite to colonization of the intravascular catheter and subsequent infection with M furfur. Three hundred ninety-three surveillance cultures were performed on 146 infants during their first 12 weeks of hospitalization in the intensive care unit (ICU) or the neonatal transitional unit (NTU). In addition, 47 full-term newborn infants and 38 healthy infants in the well-baby clinic were cultured. Colonization rates were greatest (48%) during the second month of hospitalization for the infants in the ICU/NTU group. In contrast, 0 of 47 newborn infants and 2 of 38 healthy infants were colonized. Prematurity and a prolonged length of stay were identified as risk factors for colonization. PMID- 3283221 TI - Along the data-information continuum: pitfalls and opportunities. AB - Opportunities and problems in hospital information have been reviewed. At this juncture, it is clear that problems exist in much of the data that administrators and regulators accept as valid. This is due in part to the lack of attention to clinical information systems compared with financial and other management systems. At individual institutions, opportunities exist not only to upgrade the quality of data collected, but also to enhance the integration of these data to provide better clinical information. If this process can occur in an environment of cooperation between larger teaching institutions, larger clinically sophisticated databases can be constructed to better evaluate medical practice and clinical care. PMID- 3283222 TI - Medical museum notes. William Henry Wishard. PMID- 3283223 TI - Medicine's lighter moments. The Dean. PMID- 3283224 TI - Bibliography of the current world literature in hypertension. PMID- 3283225 TI - The blood pressure seeking properties of the central nervous system. PMID- 3283226 TI - Vascular binding sites and biological activity of vasopressin in DOCA-salt hypertensive rats. AB - In order to understand the regulation of vascular vasopressin receptors in hypertension, vasopressin (AVP) binding sites and the pressor response to AVP in the perfused mesenteric vasculature of DOCA-salt hypertensive rats, sodium-loaded and DOCA-treated rats were investigated. The binding capacity for AVP (Bmax) was significantly reduced (P less than 0.05) in uninephrectomized, DOCA-treated rats (70 +/- 17 fmol/mg protein) and in DOCA-salt hypertensive rats (90 +/- 9 fmol/mg protein) with respect to uninephrectomized rats (130 +/- 32 fmol/mg protein) or uninephrectomized salt-loaded rats (155 +/- 47 fmol/mg protein), with no change in affinity. In these rats with lower receptor density, however, the maximal pressor response to AVP in the perfused mesenteric vascular bed was increased (P less than 0.05). In DOCA-salt hypertensive rats plasma AVP was higher than in the other groups. In similarly treated rats with intact kidneys, which therefore did not become hypertensive, receptor density was significantly decreased after combined DOCA-salt treatment, together with an exaggerated pressor response to AVP and increased plasma AVP concentrations. These results suggest that AVP receptors are down-regulated when there is an increment in the plasma concentration of AVP, although other factors may also play a role. Biological responses to AVP are, however, increased in spite of decreased receptor density and this phenomenon is independent of the elevation in blood pressure and results from an exaggerated response mediated by post-receptor mechanisms. PMID- 3283227 TI - Comparison of betaxolol with verapamil in hypertensive patients: discrepancy between office and ambulatory blood pressures. AB - The purpose of this study was to compare in the individual hypertensive patient the blood pressure lowering effect of a beta-blocking agent i.e. betaxolol with that of a calcium entry blocker, i.e. verapamil. The antihypertensive efficacy of the drugs was evaluated both at the physician's office and by monitoring ambulatory daytime blood pressure using a portable blood pressure recorder (Remler M2000). Seventeen patients with uncomplicated essential hypertension (aged 35-67 years) were treated for two consecutive 6-week periods with either betaxolol, 20 mg/day or a slow-release formulation of verapamil, 240-480 mg/day. The sequence of treatment phases was randomly allocated and a 2-week wash-out period preceded each treatment. Both betaxolol and verapamil had a significant blood pressure lowering effect when assessed at the physician's office. However, ambulatory recorded blood pressures were significantly reduced only with betaxolol. In the presence of a physician, the best responders to betaxolol tended to be also the best responders to verapamil, whereas there was no relationship between the fall in ambulatory recorded blood pressure observed during betaxolol and the corresponding fall during verapamil administration. The blood pressure response to both betaxolol and verapamil was not related to age. PMID- 3283228 TI - Quantification of renin mRNA in various mouse tissues by a novel solution hybridization assay. AB - A new solution hybridization assay was established for the measurement of renin mRNA. The assay makes use of a radioactively labelled renin complementary RNA as hybridization probe and allows rapid and sensitive detection of renin mRNA in amounts as low as 0.5 pg. With this assay it was possible to quantify renin mRNA in tissues with low-gene expression such as brain and heart as well as in testis, kidney and the submandibular gland (SMG) of mice. The concentrations in these organs were 0.03, 0.07, 1, 5.2 and 164 pg renin mRNA/micrograms RNA, respectively. These results are in agreement with Northern blotting experiments. The general applicability and ease of the solution hybridization assay described here should greatly improve the rapidity of mRNA measurements in future functional studies. PMID- 3283229 TI - Controlled trial of low calcium versus high calcium intake in mild hypertension. AB - A controlled trial of the effect of low versus high calcium intake on blood pressure was performed in 15 patients with mild essential hypertension (supine blood pressure after a 1-month run-in period: 145.7 +/- 2.6/97.8 +/- 0.9 mmHg, mean +/- s.e.m.). After a 1-week baseline period on a standard calcium intake (900 mg/day, obtained by giving a 500-mg calcium tablet daily, in addition to a 400-mg calcium diet), the patients were randomly entered into a double-blind crossover study of 4-week low calcium intake (400 mg calcium diet plus two placebo tablets/day) and 4-week high calcium intake (1400 mg/day: 400-mg calcium diet plus two 500-mg calcium tablets/day). Compliance with the diets appeared to be satisfactory, based on the results of food record analysis. No significant blood pressure change was observed at the end of the low-compared to the high calcium regimen. Serum ionized calcium was slightly, but not significantly lower, while 24-h urinary calcium excretion was significantly reduced during the low calcium diet. No difference was found in urinary sodium and potassium excretion between the two study periods. We conclude that moderate modifications of oral calcium intake are not associated with changes in blood pressure within the time span of this study. PMID- 3283230 TI - The genetic origin of human autoantibodies. PMID- 3283231 TI - Keyhole limpet hemocyanin-propagated Peyer's patch T cell clones that help IgA responses. AB - Four T cell clones, isolated from Peyer's patches of keyhole limpet hemocyanin (KLH)-primed BALB/c mice, were selected on the basis of their ability to help IgA responses by TNP-KLH-primed BALB/c mouse B cells. Two were KLH-dependent both in terms of their own proliferative response and in terms of their help for that of B cells. The other two were autoreactive and helped B cells proliferate independently of the presence of Ag. Both primed and unprimed B cells proliferated to some extent when helped by the KLH-reactive clones in the presence of high concentrations of either KLH or TNP-KLH. Much higher proliferation was, however, induced when primed, but not unprimed, B cells were exposed to the T cells in the presence of low concentrations of TNP-KLH but not KLH, i.e., under conditions favoring direct, cognate interaction between the T and B cells. Only modest IgM, and no IgG or IgA plaque-forming cell (PFC) responses were generated by TNP-primed B cells upon interaction with either autoreactive T cells in the absence of Ag or KLH-reactive T cells in the presence of high concentrations of KLH. For high IgM responses as well as for the appearance of IgG and IgA PFC responses, TNP-KLH was required whatever the source of the T cell help. The isotype ratios depended on the TNP-KLH concentration; IgA responses were highest and IgM responses lowest at the lowest TNP-KLH concentrations suggesting that the precursors of the IgA PFC have higher average affinity for TNP than the precursors of IgM PFC. Overall, the results are compatible with the idea that the precursors of IgA and IgG PFC and many of the precursors of IgM PFC in the long term primed B cell populations used in these experiments require engagement of their Ag-receptors before they express sufficient class II Ag and/or receptors for "switch" and differentiation factors for cognate interaction with T cells leading to PFC responses. PMID- 3283232 TI - Abrogation of diabetes in BB rats by acute virus infection. Association of viral lymphocyte interactions. AB - The BB rat spontaneously develops an insulin-dependent diabetes mellitus (IDDM) that closely resembles this disease in man. The pathogenesis involves autoimmune destruction of pancreatic beta-cells. In the present study, inoculation of diabetes-prone BB rats at 30 days of age with a lymphotropic variant of lymphocytic choriomeningitis virus significantly reduced the incidence of diabetes. Such virus-inoculated, diabetes-free rats had normal levels of pancreatic insulin and little or no mononuclear cell infiltration in the islets. Virus was recovered from lymphocytes by cocultivation with permissive cells. In contrast, virus was not detected in a wide variety of organs, indicating that infection in BB rats was primarily lymphotropic. PBL analyzed by FACS and monoclonal markers showed a marked reduction of pan-T. Th, and T suppressor/cytotoxic lymphocyte subsets restricted to 4 and 7 days after infection when compared with numbers of lymphocytes in uninoculated diabetes prone rats. To prevent IDDM, replicating virus was required, because the expected incidence of IDDM in diabetes prone rats inoculated with UV-inactivated virus was equivalent to that of untreated animals. These results suggest that a virus can suppress the autoimmune response that would otherwise have caused IDDM and may be useful as a probe in dissecting the molecular basis of this autoimmune disorder. PMID- 3283233 TI - Defective primary and secondary IgG responses to thymic-dependent antigens in autoimmune PN mice. AB - Palmerston North (PN) mice spontaneously develop autoimmune disease resembling SLE. Because immune responsiveness has not been defined in this strain, a study was designed to assay primary splenic plaque-forming cell (PFC) responses to thymus-dependent (TD) and thymus-independent (TI) Ag. Initial surveys of PN mice inoculated with the TD Ag SRBC showed adequate production of IgM PFC, but small numbers of IgG PFC were developed with polyspecific antiserum. In contrast, H-2 compatible DBA/1 control mice gave the expected responses to SRBC (IgG plaques elevated twofold compared with IgM plaques). PN mice had the usual responses to Ag that are largely TI; both PN and DBA/1 mice had active IgM and modest IgG responses to TNP-LPS and TNP-Ficoll. Additional experiments determined that PN mice had similar patterns of defective IgG responses to several different TD Ag (SRBC, horse RBC, and DNP-keyhole limpet hemocyanin). In each instance, the usual predominance of IgG1 plaques was absent, and total numbers of plaques developed with antisera specific for IgG isotypes were suppressed. Defective PN IgG production was evident as early as 3 wk of age, was not influenced by aging to 43 wk, and was not corrected by increasing the antigenic challenge 10-fold. PN spleen cells treated with monoclonal anti-Thy-1.2 and C were injected with pools of DBA/1 T cells into 850-rad irradiated (DBA/1 x PN)F1 hybrids. These recipients expressed low IgG1 responses to SRBC, suggesting that the B cell-containing fraction that was not lysed by anti-Thy-1.2 transferred the PN defect. PN mice, which do not respond to TD Ag with active IgG production, contradict the proposal that autoimmunity is associated with hyper-responsiveness to TD and TI Ag. PMID- 3283234 TI - In vitro analysis of the interactions of recombinant IL-2 with regenerating lymphoid and myeloid cells after allogeneic marrow transplantation. AB - Although administration of rIL-2 post-T depleted allogeneic bone marrow transplantation (TD-BMT) offers the prospect of augmenting immune reconstitution and thereby reducing the risks of infection and relapse, it has been unclear what direct or indirect effects this agent would have on the regenerating myeloid system. We find that addition of 200 IU or rIL-2 to patient lymphocytes obtained within 6 wk of TD-BMT results in a substantial (2 to 3 log) increase in INF-gamma secretion and the production of TNF. Cytokines present in supernatants obtained from IL-2-stimulated patient lymphocytes have two contrasting effects on myeloid cells from normal donors and from marrow recipients. They prime granulocytes for enhanced oxidative metabolism as measured by ability to generate chemiluminescence in response to FMLP, whereas IL-2 added directly to neutrophils has no effect. However, these IL-2-induced cytokines also act to inhibit myeloid progenitor growth and reduce granulocyte macrophage (GM) colony formation by a mean of 53%. Preincubation of supernatants with anti-IFN-gamma antibody partially abrogates both enhancement of granulocyte chemiluminescence and suppression of marrow CFU-GM. Addition of IL-2 directly to recipient marrow also produces inhibition, leading to a 25% reduction of GM-colony growth. This effect is not due to direct interaction between myeloid progenitor cells and IL-2, because it is completely abrogated by removal of CD8 and Leu-7+ lymphocytes from the marrow. Although the suppressive effects on marrow growth in vitro are of particular concern after BMT, the potential of IL-2 to promote granulocyte function, immune reconstitution, and anti-leukemic activity after TD-BMT justify further consideration of IL-2 therapy in this setting. PMID- 3283235 TI - Lung-specific delivery of cytokines induces sustained pulmonary and systemic immunomodulation in rats. AB - The recombinant cytokines IFN-gamma and TNF-alpha stimulate several macrophage mediated functions important in host defense. However, systemic administration of cytokines may be limited by significant host toxicity. We investigated whether aerosolized cytokines can stimulate alveolar macrophage and blood monocyte function, and whether they induce an inflammatory response in the lungs of normal rats. We found that aerosolized murine rIFN-gamma or recombinant human TNF-alpha increased IL-1 production by both alveolar macrophages and blood monocytes for at least 5 days after administration. Furthermore, murine rIFN-gamma increased the expression of Ia Ag on alveolar macrophages and human rTNF-alpha increased alveolar macrophage- and blood monocyte-mediated tumor lysis. Sequential aerosolization of IFN-gamma and TNF-alpha significantly increased both IL-1 release and Ia expression compared to either cytokine administered alone. Aerosolized human rTNF-alpha achieved lung levels comparable to those produced by an i.v. TNF-alpha dose reported to cause diffuse organ injury and death in rats. However, plasma TNF-alpha levels were several thousand-fold lower after aerosol administration. Aerosolized cytokines did not induce lung edema or an inflammatory cell infiltrate within the airways or alveoli. Aerosolized human rTNF-alpha alone, or murine rIFN-gamma and human rTNF-alpha, induced margination of leukocytes in pulmonary blood vessels 1 day after aerosolization, and a few small foci of pulmonary hemorrhage 5 days later. We conclude that aerosol administration of IFN-gamma or TNF-alpha enhances both pulmonary and systemic monocyte function, and that the combination of IFN-gamma and TNF-alpha produce additive or synergistic effects. Aerosolized cytokines induce only a minimal pulmonary inflammatory response. Aerosolized TNF-alpha produces high cytokine levels in the lung but very low uptake into the circulation. PMID- 3283236 TI - Reaction of anti-HLA-B monoclonal antibodies with envelope proteins of Shigella species. Evidence for molecular mimicry in the spondyloarthropathies. AB - Immunologic cross-reactivity between enteric bacteria and the HLA-B27 protein may play a role in the etiology of Reiter's syndrome and reactive arthritis. The reactivity of two anti-B27 mAb (B27M1 and B27M2) with envelope proteins of Shigella flexneri isolated from Reiter's syndrome patients was studied by Western blot analysis. Proteins with an apparent Mr of approximately 36 and 23 kDa reacted with both mAb in ascites. mAb against related HLA class I Ag B7 and B40 did not react with the 23 kDa protein. Relatively high concentrations of antibody were required for reactivity, suggesting a low affinity interaction. Additional evidence for cross-reactive epitopes was obtained by ELISA against whole envelope and by using unsolubilized envelope to inhibit binding of M1 and M2 to B27 positive cell lines, as measured by quantitative flow microfluorimetry. The presence of cross-reactive proteins was not related to the presence of the intact virulence-associated plasmid or the invasive phenotype. Two Shigella sonnei isolates not implicated as causative agents of Reiter's syndrome or reactive arthritis showed a similar pattern of cross-reactivity. These results indicate that cross-reactive epitopes may be present on "arthritogenic" bacteria, but their presence is not a unique feature of such strains and is not the sole factor in induction of arthritis in B27-positive individuals. PMID- 3283237 TI - Demonstration of a specific C3a receptor on guinea pig platelets. AB - Guinea pig platelets reportedly contain receptors specific for the anaphylatoxin C3a based on both ligand-binding studies and functional responses. A portion of the human 125I-C3a that binds to guinea pig platelets is competitively displaced by excess unlabeled C3a; however, the majority of ligand uptake was nonspecific. Uptake of 125I-C3a by guinea pig platelets is maximal in 1 min, and stimulation of guinea pig platelets by thrombin, ADP, or the Ca2+ ionophore A23187 showed little influence on binding of the ligand. Scatchard analysis indicated that approximately 1200 binding sites for C3a exist per cell with an estimated Kd of 8 x 10(-10) M. Human C3a des Arg also binds to guinea pig platelets, but Scatchard analysis indicated that no specific binding occurred. Because the ligand-binding studies were complicated by high levels of nonspecific uptake, we attempted to chemically cross-link the C3a molecule to a specific component on the platelet surface. Cross-linkage of 125I-C3a to guinea pig platelets with bis(sulfosuccinimidyl)suberate revealed radioactive complexes at 105,000 and 115,000 m.w. on SDS-PAGE gels by autoradiographic analysis. In the presence of excess unlabeled C3a, complex formation was inhibited. No cross-linkage could be demonstrated between the inactive 125I-C3a des Arg and the putative C3a-R on guinea pig platelets. Human C3a, but not C3a des Arg induces serotonin release and aggregation of the guinea pig platelets. Human C3a was unable to induce either serotonin release or promote aggregation of human platelets. Uptake of human 125I-C3a by human platelets was not saturable, and Scatchard analysis was inconclusive. Attempts to cross-link 125I-C3a to components on the surface of human platelets also failed to reveal a ligand-receptor complex. Therefore, we conclude that guinea pig platelets have specific surface receptors to C3a and that human platelets appear devoid of receptors to the anaphylatoxin. PMID- 3283238 TI - Shared idiotypes on anti-DNA and anti-poly (ADP-ribose) antibodies. AB - Hed 10 is a ssDNA-specific mAb derived from an NZB/W autoimmune mouse. ADP 1 is a poly(ADP-ribose)-specific mAb derived from a C57BL/6 mouse. Rabbit anti-idiotypic sera were raised against Hed 10 and ADP 1. By affinity chromatography it was shown that at least 20 to 30% of DNA-binding antibodies contained these idiotypes. The sera were also used to evaluate idiotypic cross-reactivity among 26 diverse, predominantly anti-nucleic acid, murine mAb. Each serum bound directly to several mAb and in addition inhibited the binding of several antibodies to their appropriate Ag. The anti-Hed 10 serum detected an idiotype which was restricted to antibodies that bound to poly(dT) and/or poly(ADP ribose). The anti-ADP 1 serum detected a more widely distributed idiotype contained in antibodies which bound to a variety of nucleic acids. Although both sera bound directly to Hed 10, only the anti-Hed 10 serum could compete for the binding of Hed 10 to poly(dT). On the other hand, both sera could compete for the binding of ADP 1 to poly(ADP-ribose) as well as bind directly to ADP 1. In addition anti-ADP 1 serum appeared to enhance, rather than inhibit, the binding of one mAb to native calf thymus DNA and poly[d(AT)] but had no effect on the binding to several ssDNA. These results demonstrate that many antibodies which recognize DNA and poly(ADP-ribose) have shared idiotypes. This may be of relevance to the development of autoimmunity because poly(ADP-ribose) is ubiquitous and immunogenic. PMID- 3283239 TI - Purification and partial biologic characterization of a human lymphocyte-derived peptide with potent neutrophil-stimulating activity. AB - A novel neutrophil-activating peptide is detected in supernatants from mitogen stimulated human T lymphocyte preparations. This chemotaxin was purified to apparent homogeneity by sequential Gel G-75 permeation chromatography, wide pore reversed phase (RP-8) HPLC, size exclusion HPLC, and reversed phase (RP-18) HPLC. Additional characterization of this lymphocyte-derived neutrophil-activating peptide (LYNAP) resulted in a single peak upon reversed phase HPLC and size exclusion HPLC. SDS-PAGE under nonreducing conditions revealed a single line at 10 kDa. LYNAP stimulated neutrophil chemotaxis (ED50 of 3 +/- 3 ng/ml), chemokinesis (ED50 of 2 +/- 2 ng/ml), and caused degranulation of cytochalasin B pretreated human neutrophils (ED50 of 20 ng/ml). In purified human monocytes, chemotactic responses to LYNAP at doses up to 100 ng/ml were absent, indicating nonidentity with a lymphocyte-derived monocyte chemotactic factor previously described by other workers. LYNAP shows biochemical and biologic similarities to a recently detected monocyte-derived neutrophil-activating peptide (MONAP). Moreover, desensitization experiments revealed cross-deactivation between LYNAP and MONAP, not, however, between these two chemotactic peptides and other well characterized polymorphonuclear leukocyte chemotaxins, e.g., C5a, FMLP, leukotriene B4, or platelet-activating factor. This finding points toward structure identity or homology of both chemotaxins, MONAP and LYNAP. PMID- 3283240 TI - A centenary tribute. Michael Heidelberger and the metamorphosis of immunologic science. PMID- 3283242 TI - Dissociation between increased surface expression of gp165/95 and homotypic neutrophil aggregation. AB - Whether homotypic neutrophil aggregation depends on the quantitative increase of gp165/95 molecules (Mac 1, CR3) recruited to the cell surface during activation was studied using mAb of the CD11b group that recognize distinct epitopes encoded by the alpha-subunit of this glycoprotein. After the addition of antibody MN41, neutrophils did not aggregate in response to a chemoattractant, FMLP. Blockade of preexisting surface gp165/95 by mAb MN41, followed by removal of the excess antibody from the mixture, was used to show that the molecules of gp165/95 newly expressed in response to stimulation by a chemoattractant were incapable of effectively mediating the induced cell-cell interactions of aggregation. Flow cytometry studies confirmed that binding of unlabeled antibody MN41 did not block further increases in surface expression of gp165/95 after stimulation with FMLP. These data suggest that molecules of gp165/95 exhibit two functionally distinct forms, one, present on the surface of freshly isolated neutrophils, that becomes competent to mediate the aggregation response upon activation by a stimulus and a second form that can be translocated to the cell surface by the stimulus but is greatly diminished if not lacking in the ability to participate in that aggregation event. PMID- 3283241 TI - Exacerbation of arthritis by IL-1 in rat joints previously injured by peptidoglycan-polysaccharide. AB - The arthropathic activity of mouse recombinant IL-1 (mrIL-1) after intraarticular (i.a.) injection into rat ankles was investigated. Nanogram quantities of either mrIL-1 alpha or mrIL-1 beta induced an acute transient arthritis. Arthritis induced by i.a. mrIL-1 developed more rapidly and was more severe in ankles previously injured by i.a. injection of group A streptococcal peptidoglycan polysaccharide (PG-APS) fragments. In addition, a protracted pain response, as judged by severe limping, occurred 60 to 90 min after mrIL-1 injection into joints previously injured by PG-APS or 4 to 6 h after mrIL-1 injection into naive joints. The severity of arthritis was related to the mrIL-1 dose. Arthropathic activity of mrIL-1 alpha was neutralized by goat anti-mouse IL-1 alpha IgG, and the activity of both the alpha and beta preparations was heat labile. Repeated episodes of acute inflammation were induced by repeated i.a. injection of mrIL-1. In naive ankles this led to chronic synovitis without histologic evidence of erosions. However, in joints previously injured by PG-APS, repeated mrIL-1 injection induced a more severe chronic synovitis with a 50% incidence of early pannus formation and limited marginal erosions of cartilage and subchondral bone. Thus, mrIL-1 induces an acute exacerbation of arthritis in joints previously injured by PG-APS and repeated exposure of these joints to mrIL-1 promotes chronic erosive synovitis. These studies provide evidence for an in vivo function of IL-1 and are consistent with its role as one of the mediators in the local regulation of inflammation in recurrences of arthritis induced by bacterial cell wall polymers. PMID- 3283244 TI - Human antibodies to group A streptococcal carbohydrate. Ontogeny, subclass restriction, and clonal diversity. AB - To investigate immuno-incompetence to polysaccharide Ag in young children, antibodies to the polysaccharide and protein Ag of Streptococcus pyogenes were studied. S. pyogenes was chosen because it commonly causes natural infections and has well-characterized polysaccharide and protein Ag. In children over the age of 2 yr it was found that the maturation of antibody responses to the polysaccharide Ag of S. pyogenes (A-CHO) appeared to occur in parallel with, or even earlier, than the responses to streptococcal protein Ag. When antibodies to group A carbohydrate (A-CHO) were studied in detail, qualitative differences between the antibodies of children and adults were demonstrated. Although anti-A-CHO antibodies of adults were strikingly restricted to the IgG2 subclass, those of children were found in both the IgG1 and IgG2 subclasses. In addition, the clonal diversity of IgG antibodies to A-CHO increased with age, and additional clonotypes were detectable in convalescent sera of some subjects of all ages after infection. Two cases with major additional clonotypes after group A streptococcal infection were studied in detail. In these two cases the additional clonotypes belonged to a different IgG subclass than the previously dominant clonotypes, and the expression of the additional major clonotypes occurred in both IgG1 and IgG2 subclasses. PMID- 3283243 TI - Host resistance to mucosal gram-negative infection. Susceptibility of lipopolysaccharide nonresponder mice. AB - The effect of Lps on the resistance of mice to gram-negative infection was compared in two genetically different backgrounds; C3H and C57BL. To mimic the natural sequence of pathogenetic events, infection was induced via a mucosal surface (intravesically), with Escherichia coli which remained at the mucosal site and Salmonella typhimurium which invaded to e.g., livers and spleens. Susceptibility was assessed as the bacterial persistence in kidneys, bladders, livers, and spleens at various times after infection. The initial clearance of both bacterial species from the mucosal site was significantly impaired in Lpsd mice both in the C3H and C57BL backgrounds. In the C57BL mice, additional unknown determinants conferred increased resistance to mucosal infection compared to the C3H mouse. For S. typhimurium, these resistance factors and alleles at the Lps locus dominated over Ity as determinants of resistance to mucosal infection. The Itys genotype conferred a significant increase in the susceptibility only to systemic infection, especially in the Lpsd, Itys mice. These results demonstrate an important difference between the genetic determinants of host resistance at mucosal and systemic sites, and emphasize the role of LPS induced host defense mechanisms for bacterial clearance from mucosal surfaces. PMID- 3283245 TI - Heat production as a quantitative parameter of phagocytosis. AB - Microcalorimetry was applied to measure phagocytosis by human peripheral blood neutrophils and monocytes. Heat production was 9.1 +/- 2.6 microW by 1 X 10(6) unstimulated neutrophils and increased to 28.4 +/- 3.2 microW in association with phagocytosis. The increase in heat production was directly proportional to the number of Saccharomyces cerevisiae particles phagocytosed as well as to the concentration of opsonizing serum. No heat increase was observed in the absence of phagocytosis. An increase in heat production by monocytes was also observed in association with phagocytosis, but it was much less obvious than that by neutrophils. Heat production can thus be used as a quantitative measure of phagocytosis. PMID- 3283246 TI - Simple enzyme immunoassay methods for recombinant human tumor necrosis factor alpha and its antibodies using a bacterial cell wall carrier. AB - We have developed simple methods for measuring recombinant human tumor necrosis factor alpha (rHu-TNF alpha) and antibodies to rHu-TNF alpha in the sera of animals intravenously injected with rHu-TNF alpha. rHu-TNF alpha was measured by a competitive binding enzyme immunoassay (C-EIA) using standard rHu-TNF alpha, beta-galactosidase labeled rHu-TNF alpha as enzyme-labeled antigen (E-Ag) and anti-rabbit IgG goat immunoglobulins coupled to bacterial cell walls (insolubilized second antibody). In contrast, anti-rHu-TNF alpha antibodies were measured by a sandwich EIA (S-EIA) using purified anti-rHu-TNF alpha rabbit IgG as standard, beta-galactosidase labeled rHu-TNF alpha as E-Ag, and rHu-TNF alpha coupled to bacterial cell walls as insolubilized antigen. C-EIA permits the determination of serum rHu-TNF alpha within the range of 2-150 U/ml (about 0.7-52 ng/ml) with a CV of below 7.6% and 99% recovery. S-EIA permits the determination of anti-rHu-TNF alpha antibodies within the range of 70-1000 ng/ml with a CV of less than 4% and 94.8-106.9% recovery. PMID- 3283247 TI - Use of cellulose ethers as peptide antigen carriers in the ELISA. AB - A procedure for surface immobilisation of peptides is described. Insulin, a model for peptide antigens, was covalently coupled to alkyl-hydroxyalkyl-cellulose ethers. The cellulose-insulin conjugate was then adsorbed to the plastic surface of microtitre wells and was used as antigen in an ELISA assay. The adsorbed conjugate was shown to be stable in undiluted plasma or serum whereas adsorbed insulin was removed from the surface by incubation in undiluted serum or plasma. Adsorption of serum albumin or cellulose ether polymers to the microtitre plates followed by incubation with whole blood, showed that adsorbed albumin but not the cellulose ether was exchanged by fibrinogen at the surface. The results indicate that coupling of peptides to alkyl-hydroxyalkyl-cellulose ethers is an efficient means of immobilising peptide antigens to hydrophobic surfaces. PMID- 3283248 TI - Type VII collagen is a normal component of epidermal basement membrane, which shows altered expression in recessive dystrophic epidermolysis bullosa. AB - The murine monoclonal antibody LH 7:2, which reacts with the basement membrane of stratified squamous epithelia including epidermis, has been characterized biochemically and shown to bind to part of the type VII collagen molecule. Immunoblotting reveals that the antibody binding site lies in the non-helical carboxy terminal region of the type VII collagen dimer and immunoelectron microscopy shows that the epitope is within the lamina densa of the basement membrane. Loss of LH 7:2 binding in the hereditary blistering disease recessive dystrophic epidermolysis bullosa suggests that inadequate synthesis or excessive breakdown of type VII collagen may form the biologic basis for the disease. PMID- 3283249 TI - Identification of secretory immunoglobulin A in human sweat and sweat glands. AB - Secretory immunoglobulin A (sIgA) plays an important role in local immune defense mechanisms. Although skin is always exposed to external antigens, the role of local immune defenses involving sIgA in the skin has not been adequately studied. In order to evaluate the presence of sIgA in sweat, we have measured the concentration of sIgA in human sweat by enzyme immunoassay and have localized the components of sIgA in the sweat glands of human axillary skin. The concentration of sIgA in sweat was found to be 10 times higher in men than in women (13.0 +/- 0.9 micrograms/ml versus 1.6 +/- 0.9 micrograms/ml). Secretory component (SC) was localized immunohistochemically in protein synthetic organelles, such as the perinuclear spaces and Golgi complex, in cytoplasmic vesicles, and along the external surface membranes of mucous cells on the terminal segment of eccrine sweat glands. IgA and J chain were present in plasma cells in the protein synthetic organelles. The luminal aspects of eccrine sweat ducts also strongly express SC, as well as IgA and J chain. Neither SC, IgA, or J chain were identified in epithelial cells of apocrine sweat glands. These findings are consistent with the theory that J chain complexed with dimeric IgA is synthesized in plasma cells and is transported by SC-mediated endocytosis transfer across mucous cells of eccrine sweat glands and thus into sweat. PMID- 3283250 TI - Human dermal fibroblasts synthesize laminin. AB - Laminin, a glycoprotein of approximately 900,000 daltons, is a major component of the basement membrane that separates the epidermis from dermis in human skin. Previous studies have shown that keratinocytes and other epithelial cells synthesize laminin and utilize it for attachment to other extracellular matrices such as heparan sulfate proteoglycan and basement membrane collagen. The relationships between phenotypically normal mesenchymal cells and laminin have been much less emphasized in the literature. In this study, we have used antibodies that specifically label the A and B chains of laminin (but not fibronectin or other unrelated proteins) by Western blot analysis to immunoprecipitate biosynthetically derived laminin from [35S] methionine labeled cultures of neonatal and adult human skin fibroblasts. To be sure that the precipitated bands were laminin and not fibronectin, which has a molecular size very close to that of the laminin B chains, experiments were performed in which fibronectin was removed from the radiolabeled proteins by first immunoprecipitating with antifibronectin antibody and then sequentially immunoprecipitating laminin from the fibronectin-depleted supernates with antilaminin antibody. These experiments definitively demonstrate that human dermal fibroblasts synthesize and secrete laminin. PMID- 3283251 TI - Phototherapeutic, photobiologic, and photosensitizing properties of khellin. AB - Khellin, whose chemical structure closely resembles that of psoralen, is reported to be an efficient drug for treating vitiligo when combined with ultraviolet A irradiation. Photobiological activity on yeast is found to be much lower than that of bifunctional psoralens such as 5-methoxypsoralen. In vitro experiments reveal that khellin is a poor photosensitizer. It behaves as a monofunctional agent with respect to DNA photoaddition. It does not photoinduce cross-links in DNA in vitro or in Chinese hamster cells in vivo. This behavior may explain the low photogenotoxicity in yeast and the lack of phototoxic erythemal response when treating vitiligo with khellin. PMID- 3283252 TI - Differential expression of HLA-DR, DQ, and DP antigens in primary and metastatic melanoma. AB - Fifty-five primary and 33 metastatic surgically removed melanoma lesions were stained in indirect immunoperoxidase with anti HLA-DR, DQ, and DP monoclonal antibodies and with the monoclonal antibody CL203.4 to a 96-K melanoma associated antigen (MAA). The latter antigen may represent a marker to monitor susceptibility of melanoma cells to modulation by IFN-gamma, because it is highly susceptible to induction by IFN-gamma. In primary melanomas 44%, 29%, 10%, and 55% of the lesions tested were evidently stained by anti HLA-DR, DQ, DP, and 96-K MAA monoclonal antibodies, respectively. A statistically significant association (P less than 0.01) was demonstrated between the degree of intratumoral lymphocytic infiltrate and the expression of HLA-DR and HLA-DQ antigens. In addition, a high degree of concordance in the reactivity pattern of individual lesions stained for HLA-DR antigens and for the 96-K MAA was found. In metastases 64%, 33%, 47%, and 100% of the lesions tested were evidently stained by anti HLA DR, DQ, DP, and 96-K MAA monoclonal antibodies, respectively. This study indicates that HLA-DR and HLA-DP antigens are expressed in a higher percentage of metastatic than of primary melanomas and that there is no marked difference in the expression of HLA-DQ antigens between primary and metastatic melanomas. The data suggest that the regulatory mechanisms which control the expression of HLA DR and DP antigens in primary and metastatic melanoma lesions are different. Locally produced IFN-gamma may play a role in the regulation of HLA Class II antigens in primary melanomas. PMID- 3283253 TI - Pathogenesis of shigella diarrhea: evidence for a developmentally regulated glycolipid receptor for shigella toxin involved in the fluid secretory response of rabbit small intestine. AB - Shigella toxin reproduces the major manifestations of shigellosis in ligated intestinal loops from adult rabbits and binds to a microvillus membrane (MVM) glycolipid receptor, globotriaosylceramide (Gb3). Because neonatal human shigellosis is uncommon, we used the animal model for obtaining MVMs from rabbits of different ages to determine the presence of toxin receptors and Gb3 and to measure the fluid secretory response to toxin in ligated ileal loops. A single class of MVM receptors for 125I-labeled shigella toxin, first detected at 20 d of age, reached adult levels by 24 d (n = 1.7-23.8 X 10(10)/micrograms of protein; K = 1.1-3.8 X 10(9) M-1). Binding was specific for toxin subunit B. A toxin binding MVM glycolipid, identified as Gb3, was detected in animals greater than or equal to 16 d of age by high-performance thin-layer chromatography and autoradiography. Fluid secretion in response to shigella toxin in ligated small bowel loops occurred in temporal relation to the appearance of Gb3, a result thus indicating the involvement of Gb3 in mediating the toxin effects. PMID- 3283254 TI - Comparison of translocation rates of various indigenous bacteria from the gastrointestinal tract to the mesenteric lymph node. AB - Bacterial translocation is defined as the passage of indigenous bacteria from the gastrointestinal (GI) tract through the lamina propria to the mesenteric lymph nodes (MLN) and other organs. We compared the relative abilities of various aerobic, facultatively anaerobic, and obligately anaerobic bacteria to translocate from the GI tract to the MLN in gnotobiotic mice colonized with single strains of bacteria. Indigenous gram-negative enteric bacilli translocated in large numbers to the MLN, whereas gram-positive bacteria translocated at intermediate levels and obligately anaerobic bacteria at only very low levels. Our results suggest that enteric bacilli such as Escherichia coli, Proteus, and Enterobacter are associated with a higher incidence of bacteremia in debilitated patients, because these bacteria translocate more efficiently from the GI tract than do other bacteria, especially obligate anaerobes. PMID- 3283255 TI - Use of an enzyme immunoassay to detect serum IgG antibodies to Haemophilus ducreyi. AB - An experimental enzyme immunoassay (EIA) for detecting serum IgG antibody to Haemophilus ducreyi was developed using an ultrasonicated whole-cell antigen. The mean optical densities (OD) for sera from men with proven chancroid from Nairobi (47 patients) and Bangkok (72 patients) were significantly higher than those obtained from Nairobi men with genital ulcers not due to H. ducreyi, from Nairobi men with urethritis, from pregnant women in Nairobi, and from European men with sexually transmitted disease. When an OD of 0.500 was taken as the cutoff value, 89% and 55% of men with proven chancroid in Nairobi and Bangkok, respectively, were positive for H. ducreyi antibody, as compared with 2%-17% in the control groups. A rise in OD was observed in five of 18 patients with clinical chancroid. These results confirm the development of circulating antibodies in chancroid and suggest that this EIA may be useful for the diagnosis and epidemiological study of H. ducreyi infection. PMID- 3283256 TI - Epidemiology of sporadic diarrhea due to verocytotoxin-producing Escherichia coli: a two-year prospective study. PMID- 3283257 TI - Effect of hyperbaric oxygenation, combined with antimicrobial agents and surgery, in a rat model of intraabdominal infection. PMID- 3283258 TI - Serum antibodies to lipopolysaccharide and natural immunity to shigellosis in an Israeli military population. PMID- 3283259 TI - From the National Institutes of Health. Summary of the International Symposium and Workshop on Infections due to Verocytotoxin (Shiga-like toxin)-producing Escherichia coli. PMID- 3283260 TI - Mycobacterium avium complex infection. PMID- 3283261 TI - Recognition of Treponema pallidum antigens by IgM and IgG antibodies in congenitally infected newborns and their mothers. AB - Immunoblotting techniques were used to examine the proteins of Treponema pallidum recognized by IgM and IgG antibodies in sera from infants with congenital syphilis and their mothers. Infected infants' serum IgM reactivity to treponemal antigens differed from that of control infants born to normal, serofast, and biologic false-positive mothers. Each of the infected infants' sera exhibited IgM reactions to the 47- and 37-kilodalton (kDa) proteins of T. pallidum. Although rheumatoid factor was detected in the sera of half of the infected infants, removing this factor did not alter the pattern of IgM blots. IgG reactions in infants were almost exclusively of the IgG1 and IgG3 subclasses and mirrored those of the mother, except for IgG1 and IgG3 reactions to the 83-kDa treponemal protein, which were unique to infants' sera. Our results suggest that the findings of IgM antibody directed against the 47- or 37-kDa antigens of T. pallidum may help to diagnose congenital syphilis at birth. PMID- 3283262 TI - Diminished activity of protein kinase C in tetanus toxin-treated macrophages and in the spinal cord of mice manifesting generalized tetanus intoxication. AB - In previous studies, we have demonstrated that tetanus toxin (TT) inhibits macrophage (MO) lysozyme secretion and that the inhibition of secretion was not directly linked to perturbation of cytosolic calcium homeostasis. Because MO secretion in response to phorbol myristate acetate, a stimulus that activates protein kinase C (PKC), was inhibited by TT, we examined whether TT might interfere with PKC activity. We report that MOs treated with TT have diminished PKC activity. Purified TT as well as commercial TT diminished PKC activity, whereas heated TT and supernatant from which TT had been removed had no effect on PKC activity. We further examined PKC activity in homogenates of brain and spinal cord from mice manifesting generalized tetanus. Spinal cord cytosolic PKC activity (pmol/mg of protein per min) was depressed in TT-intoxicated mice (87.3 +/- 25) compared with controls (182.6 +/- 47; P less than .02, n = 7). In contrast, cytosolic protein kinase A activity was similar in control- and TT treated MOs and mice. These results provide the first evidence that PKC activity is diminished during TT intoxication. PMID- 3283263 TI - Intragastric colonization of infant mice with Candida albicans induces systemic immunity demonstrable upon challenge as adults. AB - A murine model of long-term colonization with Candida albicans, established by intubating infant CBA/J mice, was used to study the effects of colonization on the development of Candida-specific immune responses in mature animals. Two striking consequences were stimulation of protective immune responses, as evidenced by increased survival and decreased numbers of colony-forming units in mice challenged intravenously (iv), and priming of the T cell component responsible for delayed hypersensitivity (DH). Colonized mice, tested as adults by using a cell wall-derived antigen, had little or no demonstrable DH. If inoculated once cutaneously with viable Candida, however, they responded with significantly enhanced DH reactions that could not be correlated with the cutaneous inoculation. Inoculation of the same number of dead organisms into infant mice neither primed animals for enhanced DH nor stimulated protective immunity. Antibody to cytoplasmic antigens of Candida was demonstrable in colonized animals, and its production was increased significantly in animals challenged iv with the highest dose of blastoconidia. PMID- 3283264 TI - Laboratory tests in the diagnosis of the chronic pancreatic diseases. Part 5. Stool enzyme measurements. PMID- 3283265 TI - Biliary and pancreatic obstruction during gallstone migration. AB - A prospective study on biliary and pancreatic obstruction during gallstone migration was performed in patients without acute pancreatitis. From January to October 1986, 125 patients with upper abdominal pain due to cholelithiasis were admitted to the hospital. Ultrasonography performed in all patients at admission demonstrated a distal bile duct measuring 7 mm or more in 39 patients, who were monitored for diameter changes of the biliary and pancreatic duct every 24 h and their stools screened for gallstones. Patients underwent surgery at least 8 days after admission. Gallstone migration was found preoperatively in 10 patients, of whom 6 had total serum bilirubin values lower than 2 mg/100 ml. Migration time was accurately determined by the sudden decrease in bile duct caliber. Simultaneous dilatation of biliary and pancreatic duct was found in 4 out of 10 patients with migrating gallstones and in 7 out of 23 patients without gallstone migration, though differences proved non-significant. Acute pancreatitis developed in 2 patients with lithiasis of the distal bile duct who ingested a fatty meal against medical advice. Gallstone migration, even of small stones, was preceded by a period of biliary obstruction. Pain and jaundice before migration were not as frequent as expected. PMID- 3283266 TI - Rationale for use of local hyperthermia with radiation therapy and selected anticancer drugs in locally advanced human malignancies. AB - The addition of local hyperthermia to radiation therapy has significantly improved the ability of oncologists to control superficial malignancies. Large tumours, tumours which cannot be heated adequately, and those situated in areas where surrounding normal tissues have decreased radiation tolerance, however, are difficult to eradicate even with this combination treatment. We believe that properly selected and scheduled anticancer drugs will add substantially to the efficacy of local hyperthermia and radiation. A review of the literature concerning the cytotoxic interactions of various anticancer agents with hyperthermia, with radiation and with relevant physiological parameters is presented. From this review, anticancer drugs which are good candidates for trimodality therapy are identified and a general approach to trimodality scheduling is suggested. PMID- 3283267 TI - Regional hyperthermia for deep-seated malignancies using the BSD annular array. AB - Forty-four patients were treated using the BSD-1000 Annular Phased Array between April 1983 and December 1986. There were 32 pelvic, nine abdominal, two extremity, and one thoracic sites treated. Mean tumour volume was 646 cc. Thirty nine patients had concurrent radiation therapy, receiving a mean dose of 38 Gy. Mean average temperature was 41.0 +/- 1.4 degrees C. Most patients experienced local or systemic toxicity, requiring temporary treatment interruption in 33 patients, and termination of treatment in eight. Chronic complications were seen in four, but these were in patients receiving high total radiation doses as well. There were six complete and five partial responses. Among the 32 patients with pelvic tumours, mean tumour volume was 317 cc, mean radiation dose was 42 Gy, and mean average temperature was 41.3 +/- 1.2 degrees C. There were five complete and four partial responses. Achieving tumour temperatures greater than or equal to 42 degrees C with the annular array is difficult, due to both systemic and local toxicity. To improve clinical hyperthermia for thoracic, abdominal, and pelvic tumours, new technologies such as steerable phased array microwave systems; scanned, focused ultrasound; and permanently implantable thermoregulating ferromagnetic seeds, or new approaches such as using drugs to alter blood flow, or combining hyperthermia with antineoplastic drugs or biological agents, will be necessary. PMID- 3283268 TI - [Study on luteal insufficiency by the two-step LH-RH test]. AB - To clarify both the releasing function and the self-priming effect of LH-RH on gonadotropins of the anterior pituitary gland, two step administration of 100 micrograms of synthetic LH-RH at a 60 minutes interval (two step LH-RH test) was carried out in 29 women with luteal insufficiency, 10 women in luteal phase just after spontaneous abortion, 12 women in puerperium and 24 women with normal menstrual cycles. Native LH, FSH and their subunits were measured by radioimmunoassay and serum progesterone (P), estradiol (E2) and prolactin (PRL) were also measured before administration of LH-RH. By defining hormone release (1st peak level-0' level) as delta 1, self-priming effect (2nd peak level-60' level) as delta 2 and delta 2/delta 1 as delta 1 delta 2 ratio, in the luteal insufficiency group, especially in the cases with lower of serum P and E2, delta 1 was significantly higher and the delta 1 delta 2 ratio was lower than those in the control group. In the abortion group, delta 1 and delta 2 were similar to those in the control group, indicating rapid recovery of the anterior pituitary function. In the puerperium group (approximately 1 month after delivery), delta 1 was higher and the delta 1 delta 2 ratio was lower than those in the control group. This suggests that the puerperium is more or less similar to the period of luteal insufficiency. The results also indicate that the two step LH-RH test can be one of the useful methods for the study of luteal insufficiency in terms of the pituitary gonadotropin synthesis and release. PMID- 3283269 TI - [Ultrasonically guided puncture of endometrial cysts--aspiration of contents and infusion of ethanol]. AB - Ultrasonically guided transvaginal or transabdominal puncture of an endometrial cyst with a transvaginal or transabdominal sector probe was done safely and correctly. In 7 endometrial cysts in 5 patients, we aspirated the contents, flushed with saline solution and cleaned the interior cysts. At last 99.9% ethanol was infused into 6 cysts for 30 minutes. In all cases puncture of the endometrial cyst was successful and the contents of the endometrial cyst were collected. There were no major side effect and no recurrence of endometrial cyst. It was proven that the aspiration of contents and infusion of ethanol were superior methods for treating endometrial cysts. PMID- 3283270 TI - [The significance of prostaglandins in the perinatal period]. PMID- 3283271 TI - [Progress in the care of very low birth-weight infants]. PMID- 3283272 TI - [A case of prenatal ultrasonographic diagnosis of an intracranial arachnoid cyst]. PMID- 3283273 TI - Hands and the artist--Barbara Hepworth. PMID- 3283274 TI - The history of carpal tunnel syndrome. AB - Carpal tunnel syndrome is the most frequently diagnosed, best understood and most easily treated entrapment neuropathy. During the first half of the 20th century, however, most patients with carpal tunnel syndrome were diagnosed as having compression of either the brachial plexus or thenar nerve motor branch of the median nerve. As late as 1950, only twelve patients with operative release of the transverse carpal ligament for idiopathic carpal tunnel syndrome had been reported. The delay in accurate anatomical localization of this compressive neuropathy can be attributed both to the confusion caused by the diverse manifestations of median nerve compression in the carpal tunnel, and to some interesting developments that altered early investigations in this area. PMID- 3283275 TI - A diagnostic test for carpal tunnel syndrome using ultrasound. AB - The paper describes the details of an ultrasound test for carpal tunnel syndrome and compares the results of this with E.M.G. studies in a series of 19 patients. The equipment used was a standard therapeutic ultrasound unit and the tests were performed by a physiotherapist. The results were encouraging, with a 90% correlation with E.M.G. results. PMID- 3283276 TI - Micro-arterial anastomosis using only two sutures and an autogenous cuff. AB - Microvascular anastomosis using only two sutures and an autogenous cuff was carried out in an experimental model of Wistar albino rats. 40 femoral and 40 epigastric arteries were used for this cuff technique and compared with conventional technique in the same number of vessels. The cuff technique is simple, quick, causes less trauma to the vessel wall and gives a good patency rate. Anastomosis of an artery 0.5mm in diameter is very easy with the cuff technique (98% patency) which remains difficult using conventional technique (0% patency). The disadvantage of this technique may be leakage of blood just after releasing the clamps due to restoration of blood flow, but this is easily controlled within few minutes by mild compression. PMID- 3283277 TI - Psychological and physical aspects of occupational arm pain. PMID- 3283278 TI - Non-union of the scaphoid: Russe graft vs Herbert screw. AB - The results of treatment in 50 consecutive patients with established non-union of the scaphoid are presented. All patients were treated under the care of a single consultant, for the same indications. Russe bone graft is compared with wedge bone graft plus Herbert screw fixation, in terms of union and function. Overall, a higher success rate was obtained by wedge graft plus Herbert screw, and a significantly better range of movement. However, Russe bone graft appears equally satisfactory for fibrous non-union. PMID- 3283279 TI - Single-layer anastomosis in surgery of the large bowel. A prospective study on 316 cases in a university hospital. AB - A prospective study was undertaken to evaluate the results of a single layer appositional technique for large bowel anastomoses used in a University Hospital. 316 patients were entered during an 18-month period. Anastomoses were situated within the peritoneal cavity in 277 patients and below the peritoneal reflection in 39. No covering stoma was made. The incidence of clinical leakage was 1.6% and of wound infection 1.9%. These results compare favourably with those obtained by stapling. For intraperitoneal anastomoses and high anterior resection manual suture remains the standard technique and is less expensive than stapling. For low rectal tumours, there is still debate on the relative merits of stapling and various manual techniques of colo-anal anastomosis in terms of morbidity, tumour clearance and functional results. PMID- 3283280 TI - Activation of human immunodeficiency virus. PMID- 3283281 TI - Walter Bradford Cannon (1871-1945). PMID- 3283282 TI - Copperhead snakebites reported to the Kentucky Regional Poison Center 1986: epidemiology and treatment suggestions. PMID- 3283283 TI - Generational equity and social insurance. AB - In recent years, critics have argued that, when inter-generational transfer programs such as Medicare are judged by the standard of "generational equity", these programs are seen to be unfair. It is argued that, under a pay-as-you-go system, future generations are committed to burdens without their consent; that claims are not contractually guaranteed; that early entrants reap windfalls gains; that successive cohorts are tempted to provide insupportably high benefit levels; and, finally, that fluctuations leave future generations at unacceptable risk. Attempts have been made to defend social insurance programs by means of a "lifespan prudential model" of age-group resource allocation, but this defense does not adequately take account of uncertainties and inequities faced by historical birth cohorts. A deeper defense must acknowledge an element of risk sharing and solidarity while trying to limit inequities within reasonable bounds. PMID- 3283284 TI - Reflections on Medicare. AB - At its inception, the Medicare program was seen as a way to bring the elderly into the mainstream of American medicine. The program after twenty years is increasingly viewed as an instrumentality to influence the nature and costs of American medicine. The first part of this article reviews the origins, history, and evolution of the Medicare program in order to explain how and why this change has come about. In the concluding section, the article explores further the implications of the program's concentration on the aged, its uncertain notion of entitlement, and the bewildering character of the current claims of generational inequity allegedly imposed by Medicare's present outlays of +70 billion and its persistingly high rate of cost increases. PMID- 3283285 TI - Ought the young make health care decisions for their aged selves? AB - Though the chief responsibility for providing for the health care of older Americans has been (and should remain) society's, there has been increasing interest in private solutions. Individual provision, however, would require not only adequate wealth but prudent planning, demanding in turn more discipline, self-control, and foresightedness than many individuals are normally capable of. One possible corrective is pre-commitment, a strategy of binding oneself to a plan chosen to allocate resources optimally over the life span. Though pre commitment may have some important uses, however, it is far from clear that people should be encouraged or enabled to rely upon it for old-age health care planning. The present paper examines some of the philosophical and policy concerns attendant to the use of pre-commitment strategies for resource allocation in old age. PMID- 3283286 TI - Urinary level of sulfadoxine in falciparum malaria patients after treatment with sulfadoxine-pyrimethamine. PMID- 3283287 TI - Omeprazole in the treatment of duodenal ulcer: the first study in Thai patients. PMID- 3283288 TI - Effect of food intake on the relative bioavailability of moclobemide (Ro 11 1163). AB - Twelve healthy adult volunteers received a single 100-mg tablet of moclobemide in an open-label crossover study designed to determine the influence of food on moclobemide absorption. Moclobemide was administered 30 min after a standard breakfast as well as under fasting conditions. Moclobemide absorption was rapid in the absence of food. Bioavailability parameters obtained when drug was taken 30 min after the meal suggested that the rate of absorption was slightly decreased in the presence of food (mean Tmax 0.71 h vs. 1.14 h), while the extent of absorption of moclobemide given with food was unaltered. The decreased absorption rate in the presence of food is not expected to be of clinical significance. PMID- 3283289 TI - Some in vitro effects of moclobemide and other MAO inhibitors on responses to sympathomimetic amines. AB - The use of inhibitors of monoamine oxidase (MAO) in the treatment of some forms of depression has been marred by the occurrence of unpleasant or even fatal side effects. Of these the most serious has been the risk of sudden hypertensive crises following the ingestion of food or drink containing indirectly-acting sympathomimetic amines such as tyramine (cheese effect). This effect, due to long lasting or irreversible inhibition of MAO in the gut and vasomotor neurones is much less obvious with the new generation of reversible inhibitors. Acceptance into clinical practice of these agents will depend upon the provision of clear and unequivocal evidence that there is little or no risk of unexpected cheese effects. The use of in vitro methods has provided a most sensitive way of revealing and measuring any such propensity in these new agents including moclobemide, cimoxatone and toloxatone. Use of isolated smooth muscles, such as the vas deferens and anococcygeus muscles of the rat together with vascular smooth muscle, typified by the perfused mesenteric arterial bed may be used as reliable preliminaries to in vivo and human volunteer studies in an attempt to introduce into clinical medicine an antidepressant that acts through the inhibition of MAO but carries little or no risk of the cheese effect. PMID- 3283290 TI - On tyramine, food, beverages and the reversible MAO inhibitor moclobemide. AB - The pathways for the biosynthesis and metabolism of tyramine are described as a basis for the discussion of the interaction between MAO inhibitors and tyramine. While a role of endogenous tyramine in the antidepressant action of MAO inhibitors remains purely hypothetical at this time, the mechanisms leading to the potentiation of the tyramine pressor effect ("cheese effect") are well known. Experiments in animals and man have provided concordant quantitative information on the effect of irreversible and some novel reversible MAO inhibitors on the presystemic disposition of orally ingested tyramine and on the noradrenaline releasing action of tyramine in noradrenergic nerve terminals. There is a profound difference in the magnitude of tyramine potentiation between the irreversible inhibitor tranylcypromine and the reversible inhibitor moclobemide. A systematic analysis of the tyramine content of current European food and beverage is reported and serves as a rational basis for providing advice to patients on moclobemide. Most of the food and beverages analyzed contain less tyramine than previously reported and a few rules concerning rare cheeses with high tyramine content are sufficient to eliminate the risk of hypertensive crises. PMID- 3283291 TI - Antidepressant drug therapy: associated risks. AB - Aspects of risks associated with treatment with three classes of antidepressants: tricyclic (TCA), second generation ("new") antidepressants and monoamine oxidase inhibitor (MAOI), are discussed. Moclobemide, a benzamide derivative, is a new MAOI antidepressant with reversible and preferential inhibition of the A-form of monoamine oxidase. Moclobemide is free of liver toxicity and the risk of a pressor response with tyramine-containing food is so low that strict diet restrictions are unnecessary. That MAOIs have a low incidence of side effects, particularly so called anticholinergic side effects is also true for moclobemide. A serious risk with antidepressant drugs is that the patient will use them to attempt suicide. Therefore important aspects of antidepressants are that they should take effect rapidly and be safe in overdose. No deaths from overdose have been observed with toloxatone, the only reversible MAOI antidepressant on the market to date. It is concluded that the new reversible MAOI antidepressant moclobemide is similar to other antidepressants in terms of efficacy but very noticeably superior in terms of tolerance and safety. PMID- 3283292 TI - Interaction of moclobemide, a new reversible monoamine oxidase inhibitor with oral tyramine. AB - In a double-blind placebo-controlled cross-over study in 8 healthy volunteers possible interactions between moclobemide and tyramine were studied. Eight volunteers received either moclobemide or placebo for a period of 6 days and received tyramine on day 5 and day 6 of each treatment period. Moclobemide was given in a daily dose of 450 mg to be taken in three divided doses at the end of the meals. Tyramine was administered in the form of an artificially tyramine enriched cheese (camembert) together with a meal at noon. The total tyramine doses administered were 50 mg on day 5 and 100 mg on day 6 of each treatment period. Comparisons of blood pressure and heart rate changes after tyramine ingestion between moclobemide and placebo conditions did not indicate any relevant moclobemide-tyramine interaction. It is concluded that tyramine in quantities of up to 100 mg does not lead to clinically relevant blood pressure reactions in moclobemide-treated subjects, if moclobemide is taken at the end of the meal. PMID- 3283293 TI - Muscarinic acetylcholine receptors from avian retina and heart undergo different patterns of molecular maturation. AB - Muscarinic acetylcholine receptors (mAChRs) from the avian CNS exist in two molecular weight forms whose concentrations change during development. Here, we have compared the development of mAChRs from embryonic hearts with those of the CNS. Analysis of [3H]-propylbenzilylcholine mustard (PrBCM)-labeled retina and heart mAChRs by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed two atropine-sensitive peaks for each tissue. Apparent molecular masses of retina mAChRs, 86 +/- 0.7 kilodaltons (kDa) and 72 +/- 0.7 kDa, were different from those of heart mAChRs, 77 +/- 1.0 kDa and 52 +/- 0.9 kDa. During retina development, the major receptor type changed from 86 kDa to 72 kDa. No such change occurred during heart development. Furthermore, the 52-kDa species appeared to be generated by endogenous proteolysis, as prolonged incubation of heart membranes at 37 degrees C increased the amount of 52-kDa peptide with a decrease of 77-kDa peptide. Protease inhibitors blocked this conversion. Incubation of retina membranes at 37 degrees C did not result in a conversion of the 86-kDa peptide into the 72-kDa peptide, but it did cause the appearance of a minor amount of 52-kDa peptide. The proteolysis of retina mAChRs was not enhanced by cohomogenizing them with heart tissue, arguing against the presence of releasable proteases in heart. Membrane-bound retina and heart mAChRs displayed similar sensitivity to exogenous (Staphylococcus aureus V8) protease, indicating that heart receptors were not unusually susceptible to proteolytic attack; analysis of the labeled polypeptides with the V8 protease showed different patterns of digestion for the retina and heart receptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283294 TI - Cholinergic surface antigen Chol-1 is present in a subclass of VIP-containing rat cortical synaptosomes. AB - The colocalization of vasoactive intestinal polypeptide (VIP) with the cholinergic specific surface antigen Chol-1 was investigated in synaptosomes derived from the rat cerebral cortex. Immunoaffinity purification of cortical synaptosomes using antisera to Chol-1 resulted in the copurification of VIP and cholinergic nerve terminals. VIP was purified with a yield of 75% of that of choline acetyltransferase (ChAT). These results suggest that approximately 53% of the cortical cholinergic terminals contain VIP, whereas 75% of the cortical VIP content is present in these cholinergic terminals. Both hypotonic lysis and depolarization of the nerve terminals resulted in the differential release of VIP and acetylcholine (ACh), indicating the different compartmentalization in the same nerve terminal. Complement-mediated lysis of cholinergic nerve terminals, using antisera to Chol-1, resulted in the release of 64% of the ChAT, 71% of ACh, and 27% of the VIP. The application of our method enables quantifying and mapping, with a fast, efficient, and specific technique, the coexisting peptides in cholinergic neurons of distinct brain areas. PMID- 3283295 TI - CT-assisted stereotactic brain biopsy: value of intraoperative frozen section diagnosis. AB - In 100 recent CT-guided brain biopsies, the value of intraoperative histologic examination using frozen section technique was evaluated. In 87 of these cases, the biopsy was performed stereotactically. In the remaining 13 cases, a CT-guided free hand technique was used. Of the 100 biopsies performed, adequate tissue for histopathologic diagnosis was obtained in 97, and in three the biopsy was nondiagnostic. In 61 procedures the initial biopsy specimen was adequate for diagnosis. Two specimens were required in 25 and in the remaining cases it was necessary to obtain three to four biopsy specimens before a definitive diagnosis could be made. Ultimately, the histologic diagnosis was made on frozen section examination in 93 of the cases. The lesions identified were neoplastic disease in 83 cases, vascular disease in seven, infectious disease in five, demyelinating disease in one, and radiation necrosis in one. Comparison between the frozen section diagnosis and the final diagnosis based on the permanent sections revealed that they matched in 89 cases (92%). Of the 83 cases of neoplasms the exact grade of malignancy was determined by frozen section to make a final diagnosis revealed that even if the specimen volume was less than 2 mm3, the biopsy was generally successful. The disadvantages of the small sample size obtained through needle biopsy are best overcome by careful targeting and assessment of sample quality by intraoperative frozen section examinations, which will give the definitive diagnosis in most of the cases without paraffin-embedded sections. PMID- 3283296 TI - Propranolol and propranolol-LA in essential tremor: a double blind comparative study. AB - In a double blind, comparative study with 15 patients, a long-acting formulation of propranolol taken once daily (at doses of 160, 240 and 320 mg), was shown to be as effective as conventional propranolol (80 mg three times daily) in reducing the amplitude of essential tremor. The specific protocol employed demonstrated problems inherent in chronic pharmacological trials in essential tremor which have implications for future studies. PMID- 3283298 TI - New onset choreiform disorder in an adult with recent group A beta haemolytic streptococcal pharyngitis. PMID- 3283297 TI - Histocompatibility antigens in multiple sclerosis patients participating in a multicentre trial of azathioprine. British & Dutch Multiple Sclerosis Azathioprine Trial Group. AB - The human leucocyte antigen (HLA) types of 283 patients with multiple sclerosis participating in a trial of azathioprine treatment were studied. The prevalence of HLA types was compared with those of over 3,300 controls from tissue typing centres in the UK. The prevalence of HLA A3 (38.5% cp 26.1%), HLA B7 (44.9% cp 27.3%) and HLA DR2 (58.3% cp 30.6%) was increased in the multiple sclerosis patients compared with the controls. Age at onset, disease status (relapsing remitting or currently progressive) and disease severity did not show an association with any particular HLA type. PMID- 3283300 TI - Bias in biologic monitoring caused by concomitant medication. AB - Medication of the worker with pharmacotherapeutic agents and its meaning for individual pharmacokinetics of the agent(s) to which the worker is exposed is a largely unexplored zone, on the border of both occupational and clinical medicine. Medication and exposure to occupational agents can result in pharmacodynamic and/or pharmacokinetic interactions; the latter type of interactions will be discussed in this paper. Using styrene, toluene, tetrachloroethylene, and 1,1,1-trichloroethane as examples of solvents with various kinetic properties, it is demonstrated in what way concomitant therapy can influence the elimination of the solvent. Major emphasis is laid on the effects on conclusions drawn from biomonitoring studies in exhaled air and venous blood. To achieve this purpose, a physiologic simulation model, run on a 640 kilobyte microcomputer, is used. The simulated variation of several parameters is illustrated with examples from pharmacologic practice. PMID- 3283299 TI - Soluble glucan and lymphokine-activated killer (LAK) cells in the therapy of experimental hepatic metastases. AB - Previous studies have indicated the efficacy of adoptive immunotherapy utilizing recombinant interleukin-2 (rIL-2) and lymphokine-activated killer (LAK) cells in the treatment of advanced neoplastic disease. However, this therapeutic approach is associated with considerable toxicity, primarily due to the systemic administration of rIL-2. The present study was undertaken to determine the efficacy of a newly developed water-soluble glucan, when administered in combination with LAK cells, in the therapy of experimental hepatic metastases. Mice were challenged subcutaneously (1 X 10(4) cells) with reticulum cell sarcoma M5076 on day 0. Therapy was initiated on day 15, when a palpable primary tumor mass and hepatic micrometastases were evident, and continued at 3-day intervals up to day 54. Sarcoma-bearing mice received glucan (250 mg/kg) intravenously, either alone or in combination with LAK cells (1 X 10(7)/mouse). Control mice received 5% (wt/vol) dextrose in water. Glucan-LAK cell therapy significantly suppressed primary tumor growth, inhibited the progression of hepatic metastases and prolonged survival in sarcoma-bearing mice. Splenocytes, incubated with rIL-2 for 72 h, exhibited significant natural killer (NK) cell activity and were cytotoxic to sarcoma cells in vitro. Glucan-LAK cell administration resulted in significant increases in splenic NK cell activity and Kupffer cell-mediated tumoricidal activity. In addition, bone marrow proliferation was enhanced following the co-administration of glucan and LAK cells. Due to its nontoxic nature and immunostimulating properties, soluble glucan may prove to be an attractive biological response modifying agent for utilization in adoptive immunotherapy of advanced neoplastic disease. PMID- 3283301 TI - Issues in assessing the carcinogenic hazards of ethylene oxide. AB - Characterization of the health risks associated with occupational and environmental exposure to ethylene oxide (a gaseous sterilization agent and chemical building block) is made difficult by the limited dose-response information contained in the few published epidemiologic studies available, and the absence of toxicologic data for chronic exposures in species other than the rat. Federal regulatory agencies have relied heavily on conventional quantitative risk assessment techniques in setting revised occupational exposure standards for ethylene oxide. This paper indicates the variability in risk assessment results that can be obtained using the multistage dose-response model and a single animal study depending on the method used to characterize risk, the health endpoint selected, the use of confidence intervals, and the method used to equate animal and human exposure levels. Selection of the most pessimistic options available in each of these four areas is shown to result in a virtually safe dose being characterized as 0.005 ppb, whereas other reasonable assumptions yield a safe dose estimate of 1.3 ppm. PMID- 3283302 TI - Unemployment and alcohol abuse: a review. AB - Unemployment rates in alcohol treatment programs are strikingly high, yet the drinking behavior of unemployed populations has been neglected by alcohol researchers. Stress-based and socioenvironmental theories of alcoholism coupled with empirical research on the health and social costs of unemployment have suggested that the unemployed may be "at risk" for abusing alcohol. Specifically, the unemployed are said to abuse alcohol as a means of coping with financial stress triggered by job loss. Research on job loss and alcohol abuse has been beset by methodologic problems, which prevents drawing firm conclusions. For example, little attention has been paid to variables that intervene between job loss and alcohol abuse and that may actually account for the observed associations. Investigators have too often assumed that unemployment leads to alcohol abuse without considering the reverse. Controls for pre-job loss drinking behavior are virtually absent in studies to date. If future research does confirm that job loss leads to alcohol abuse, then alcohol policy implications may include: (1) the use of job loss as a diagnostic marker by alcohol treatment professionals, (2) the establishment of cooperative arrangements between those in the employment and training and alcohol fields, (3) a re-examination of the policy which ties health insurance coverage for alcohol treatment to current employment, and (4) the targeting of prevention and treatment resources to areas of high unemployment. PMID- 3283303 TI - The costs and financing of ambulatory medical education. PMID- 3283306 TI - The making of a profession. PMID- 3283305 TI - Expanding the site of clinical education: moving beyond the hospital walls. PMID- 3283304 TI - Current successes in medical education beyond the bedside. PMID- 3283307 TI - Theresa Hunt-Tyler: Watonga's first resident dentist. PMID- 3283308 TI - Reconstruction of the mandibular denture bearing area and freeing of the tongue after tumor surgery. AB - Vestibuloplasty together with a loosening of the tongue and covering the mucosal defects either with a split thickness skin graft or an autologous mucosal graft was performed on 35 patients previously treated for squamous cell carcinoma. The interval between tumor resection and the reconstructive procedures averaged 20 months. In 34 patients the denture bearing area improved, and in 31 patients, better mobility of the tongue occurred with, therefore, better phonation. PMID- 3283309 TI - Accidental intra-arterial injection. AB - The potential for an accidental intra-arterial injection is present whenever an intravenous route of drug administration is used. Because of the serious nature of the morbidity associated with this iatrogenic injury, and its preventability, this article is presented to update the available information on the etiology, diagnosis, treatment, and prevention of this problem. PMID- 3283310 TI - Treatment of an asymmetric mandibular prognathism in an acromegalic patient. PMID- 3283311 TI - Unilateral multiple solitary bone cysts. PMID- 3283313 TI - Master impressions for complete dentures. PMID- 3283312 TI - Modified technique for the placement of titanium plasma sprayed Swiss screw implant. PMID- 3283314 TI - Renal failure in sick hypertensive premature infants receiving captopril therapy. AB - A retrospective study of nine sick premature infants with chronic lung disease who received captopril for control of systemic hypertension (systolic blood pressure (BP) greater than 113 mm Hg) was carried out to determine efficacy of therapy and associated complications. All nine infants had markedly elevated peripheral renin values, 134.3 +/- 128.1 ng/mL/hr (mean +/- SD). Five infants had abnormal renal sonographic and perfusion scans with evidence of renal artery thrombosis, parenchymal disease, or both. Captopril therapy (0.3 mg/kg) was instituted at a postnatal age of 123 +/- 108 days. After the initial dose, the systolic BP decreased significantly in all infants, the decrease ranging from 21% to 58% of the pretreatment value. Dosage was subsequently halved in all infants. Seventeen episodes of unpredictable decreases in BP more than 40% from baseline occurred during the reduced maintenance therapy. Four infants had a total of seven episodes during which the BP decreased by 57 +/- 10% from baseline; this decrease persisted for 17 +/- 6 hours and was unresponsive to volume reexpansion and inotropic therapy. All seven episodes were accompanied by oliguria (urine output less than 1 mL/kg/hr) that persisted for 18 +/- 12 hours. These episodes were accompanied by neurologic signs (subtle seizures, lethargy, and/or apnea) within 18 +/- 6 hours after the onset of oliguria. The remaining five infants had a total of 13 episodes of decreased BP of 50 +/- 8% of baseline, which were of significantly shorter duration and responded to volume reexpanders, inotropic therapy, or both and were unaccompanied by oliguria. These data suggest the need for close observation of BP in infants receiving maintenance captopril therapy. PMID- 3283315 TI - The pediatrician's role in atherosclerosis prevention. AB - Prevention of atherosclerosis, a major cause of illness and death in our society, is a pediatric responsibility in 1988 and beyond. Significant cardiovascular risk factors are identifiable and alterable in children and adolescents, and are associated with arterial lesions. Cost-effective atherosclerosis prevention can be achieved by identification and treatment of high-risk children and adolescents. The pediatrician should record the family history of all patients at 2 years of age, with periodic updates. The serum cholesterol concentration can then be measured in the office if there is a commitment to quality control; otherwise, a monitored commercial laboratory must be used. It is not unreasonable to measure serum cholesterol concentrations once in all school-age patients. The majority of high-risk patients will respond to nutritional intervention and will not require pharmacotherapy. Until the efficacy and safety of the therapeutic diet are proved beyond doubt, its use should be limited to high-risk patients under pediatric supervision. Studies documenting the growth and development of children receiving dietary therapy must be a major priority of pediatric nutrition. Until that is accomplished, although some pediatricians may prefer to wait, most will use the extensive scientific evidence at hand and their clinical judgment to identify and treat their high-risk patients. PMID- 3283316 TI - Interference by third-generation cephalosporins with neonatal screening for galactosemia. PMID- 3283317 TI - Tracheobronchial injury with high-frequency oscillatory ventilation. PMID- 3283318 TI - Validation of a heating cell for precisely controlled studies on the thermal destruction of endotoxin in glass. PMID- 3283319 TI - The effect of retained subgingival calculus on healing after flap surgery. AB - This study investigated the effects of retained subgingival calculus on healing of the periodontium at ten, 30 and 120 days. Eight beagle dogs between eight and ten years old with naturally occurring periodontal disease were used. One dog that died before any procedures were done provided information on the extent of gingival inflammation prior to surgery. Quadrants from seven dogs meeting the criteria for inclusion were selected, and each quadrant was randomly designated as either an instrumented or noninstrumented, surgical site. The gingival index for the selected sites was recorded along with clinical probing measurements. Instrumented sites were treated by reflection of a facial mucoperiosteal flap followed by thorough root planing. Non instrumented sites were treated by a facial mucoperiosteal flap alone. All flaps were returned to their preoperative position and secured with interrupted sutures. No antibiotics were given. Meticulous daily plaque control was begun the day after surgery and continued until sacrifice. There was a statistically significant reduction in gingival index scores for the 30- and 120-day instrumented sites and for the 120-day noninstrumented sites. Mean probing depths for the instrumented group showed a significant reduction at 30 and 120 days and for the noninstrumented group at 120 days after surgery. Forty percent of the noninstrumented roots and 10% of the instrumented roots displayed subgingival calculus. At all evaluation periods and in both instrumented and noninstrumented roots, inflammation was more intense when calculus was present; the difference was significant at ten days with the instrumented and at ten and 30 days with the noninstrumented specimens.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283321 TI - Direct provisional restoration technique. AB - A technique has been presented for the efficient fabrication of a temporary or provisional restoration with emphasis on esthetics, proper contour, and marginal integrity. Attention to details in these procedures can be most rewarding to both the patient and the dentist. PMID- 3283320 TI - Metabolism of angiotensins II and III by membrane-bound peptidases from rat brain. AB - This study examines the metabolism of 125I-angiotensin II (125I-ANG II) and 125I angiotensin III (applied 125I-ANG III or 125I-ANG IIIapp) by membrane peptidases. The first step in the metabolism of 125I-ANG II was the formation of 125I-ANG III (generated 125I-ANG III or 125I-ANG IIIgen). The ability of both ANG II and ANG III to reduce 125I-ANG IIIgen production without ANG(1-5), ANG(2-5), amastatin or bestatin being similarly effective suggests that this step may be highly substrate-specific. Subsequent metabolism of 125I-ANG IIIgen was similar to that of 125I-ANG IIIapp in that 125I-ANG(2-7) and 125I-ANG(2-4) fragments were produced. The formation of 125I-ANG(2-7) appeared to be a very substrate-specific process because it was only inhibited by ANG II and ANG III. In contrast, the production of 125I-ANG(2-4) was unaffected at the concentration of inhibitors used and is considered to be a relatively nonspecific process. However, despite these similarities sequential N-terminal cleavage leading to the formation of 125I-ANG(3-8), 125I-ANG(4-8) and 125I-Tyrosine appears to be the preferred pathway in the metabolism of 125I-ANG IIIapp. The absence of this pathway in the metabolism of 125I-ANG IIIgen suggests that applied and generated 125I-ANG III may be metabolized in separate degradative compartments. These data demonstrate that 125I-ANG II and 125I-ANG III are metabolized by membrane-bound peptidases in an orderly and sequential manner.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283322 TI - Bonding of amalgam to tooth structure: tensile adhesion and microleakage tests. AB - Amalgam can be bonded to etched enamel by a thin coat of Panavia resin cement with a resulting mean bond strength of 1404 psi to enamel and 469 psi to dentin as tested in tension. Less microleakage was observed in resin-bonded amalgam restorations than in Copal varnish-lined or unlined restorations. The technique could be used clinically with possible implications for cavity design, fracture resistance of restored teeth, and recurrent caries. These properties as well as the variables affecting bond strength need further exploration. PMID- 3283323 TI - Clinical evaluation of etched-metal resin-bonded fixed partial dentures. PMID- 3283324 TI - Dimensional accuracy of combined reversible and irreversible hydrocolloid impression materials. PMID- 3283325 TI - Marginal adaptation of porcelain margins in ceramometal restorations. PMID- 3283326 TI - The porcelain butt margin with hydrocolloid impression technique. AB - After preliminary scientific data, the dentist commonly evaluates the success of a recommended clinical technique. However, the accuracy of a restoration constructed in the laboratory depends directly upon the abilities of the laboratory technician. The communication between the dentist and the laboratory technician is crucial for success. This study examined the practicality of the porcelain/butt margin. When combined with the appropriate tissue management, sulcular placement, and impressions, this consistent procedure was easily evaluated, financially sound, and time-conserving. PMID- 3283327 TI - The effect of recasting on the oxidation layer of a palladium-silver porcelain alloy. AB - The oxidation zone of a commercial palladium-silver porcelain alloy was compared after repeated casting with and without the addition of new alloy. The intensity of palladium, silver, tin, indium, and O K-alpha near the oxidation zone was analyzed with XMA. The intensity curves of tin, silver, and oxygen increased progressively through each generation despite the addition of new alloy. The thickness of the oxidation zone and the microporosities at the internal oxidation zone increased through each generation without the addition of new alloy. Although the findings indicated that the oxidation zone was favorably formed by adding new alloy, 50% by weight, for four generations, the silver and metallic oxides of the oxidation zone increased through each generation. The reuse of the palladium-silver porcelain alloy remains questionable. PMID- 3283328 TI - Incomplete seating of cemented crowns: a literature review. PMID- 3283329 TI - Presurgical prosthodontics. PMID- 3283330 TI - Endodontic problems in an overdenture population. PMID- 3283331 TI - Technique for converting an existing complete denture to a tissue-integrated prosthesis. AB - A technique for modification of an existing complete denture into a tissue integrated prosthesis is described. An acceptable conventional denture is clinically attached to titanium abutments in the maxillomandibular position that has proved to function well during a trial period. The framework is fabricated to fit the reduced denture base (Fig. 16). The advantages of this technique include (1) the appearance of the tissue-integrated prosthesis is known in advance; (2) the technique is simple and requires only four visits to complete; (3) the framework fit is predictable; (4) there is minimum insertion and removal; (5) the base has a natural look and the lips have support; and (6) minimum phonetic problems are encountered. PMID- 3283332 TI - A technique for visible light-cured provisional restorations. PMID- 3283333 TI - The hollow denture: an alternative treatment for atrophic maxillae. AB - This technique is an adaptation of the double-flask technique that is well-known for the fabrication of the hollow bulb portion of a maxillary obturator. It can be used only for patients with both an atrophic maxillary alveolar ridge and a greater than usual interocclusal distance. Anything less will not permit fabrication of a hollow denture. PMID- 3283334 TI - Stabilizing functionally generated path recording tables. PMID- 3283335 TI - Tinfoil substitute applicator. PMID- 3283336 TI - [Isolated traumatic rupture of the gallbladder. Apropos of 2 cases]. AB - Two cases of isolated traumatic rupture of gallbladder are reported, including results of ultrasound and CT scan imaging, and the relevant literature reviewed. Preoperative diagnosis is suggested by presence of a perivesicular collection. Fine needle puncture aspiration of the collection provides confirmation of diagnosis if a bilious or biliohemorrhagic fluid is withdrawn. PMID- 3283337 TI - [Pseudotumoral hepatic tuberculosis. Ultrasonics and x-ray computed tomography apropos of a case]. AB - Results of CT scan and ultrasound exploration were discordant in a patient with the pseudotumoral form of hepatic tuberculosis. Although rare, this localization should not be unrecognized because of the curable nature of the affection. Tissular characterization of lesion was not possible by medical imaging alone and liver puncture-biopsy examination was necessary. PMID- 3283338 TI - [Evaluation of the permeability of aortocoronary bypass by digital angiography]. AB - Evaluation of coronary artery bypass graft patency by intra-arterial digital subtraction angiography was performed in 201 patients. A first group of 150 asymptomatic patients was systematically evaluated for post-operative screening 8.5 days after surgery as an immediate check on surgical results. Grafts were found occluded in 2.3%. A second group of 51 patients complaining of recurrent angina was studied 10 months (range 2 months to 9 years) after operation. Angiography revealed that 90% of grafts were patent but 8 grafts stenoses were diagnosed. In both groups, opacification of the run-off was achieved in 83%, but the quality of opacification was very low. PMID- 3283339 TI - [Radiological manifestations of splenic and gastroduodenal sarcoidosis. Apropos of 2 cases]. AB - Two cases of abdominal sarcoidosis with radiologic signs are presented. One patient had signs of a calcified splenic pseudo-tumor without other evidence of sarcoidosis, the other a typical pulmonary lesion with parietal infiltration of duodenum on esophagogastroduodenal follow-through radiography. Radiologic forms of splenic and gastroduodenal sarcoidosis reported in the literature are reviewed. PMID- 3283340 TI - [Cystic or pseudocystic ovarian masses in young girls. The role of ultrasonic diagnosis]. AB - Twenty adnexal tumors have been discovered between 7 and 16 years old girls. With few exceptions, the sonographic appearance in nonspecific. They were grouped in four categories: teratomas, cystadenomas, adnexal torsions, polycystic diseases. Surgery with be discussed upon consideration of age, clinical signs and sonography, and diagnostic emergency will be emphasized in case of acute adnexal torsion. PMID- 3283341 TI - [Neonatal ovarian cysts. The role of ultrasonic diagnosis]. AB - Nine cases of adnexal cysts diagnosed by antenatal ultrasonography, have been followed after birth and operated upon. Simple ovarian cysts as well as old adnexal torsions appear as sonolucent masses. Acute adnexal torsion appears as mixed or solid masse. Sonographic appearance can help the post natal management of these masses. PMID- 3283342 TI - Musculocutaneous grafts with draining vein: an experimental study. AB - Venous drainage of a musculocutaneous graft was shown to be of importance for the prevention of necrosis and successful graft take. An experimental model was provided in which the iliolumbar veins were used as draining veins in creating musculocutaneous grafts 4 X 3 cm and 4 X 6 cm in size. In the study, it was demonstrated that necrosis could be prevented by preserving draining veins. The number and size of these veins were of some significance in the survival of the grafts. PMID- 3283343 TI - Muscle fiber regeneration in grafted skeletal muscles. PMID- 3283345 TI - Immunoassay of gonadotrophin-releasing hormone in brain tissue of Booroola Merino ewes. AB - The presence of a fecundity gene (F) in Booroola Merino ewes increases the ovulation rate. To test how F gene expression affects the gonadotrophin-releasing hormone (GnRH) concentration in hypothalamic or extrahypothalamic regions of the brain, GnRH was measured by radioimmunoassay in acetic acid extracts of various brain tissues from Booroola ewes which were homozygous (FF), heterozygous (F+) or non-carriers (++) of the F gene. The GnRH concentration in brain tissues from FF, F+ and ++ animals which had been ovariectomized 5 months previously was also evaluated. No significant F gene-specific differences were noted in any of the brain areas tested, in intact or ovariectomized animals. However, in ovariectomized ewes, the concentrations of GnRH increased about 2-fold in the median eminence of the hypothalamus, remained unchanged in the medial basal hypothalamus and dropped to less than 10% of the values in intact ++ animals in the preoptic area. These studies suggest that the changed pituitary sensitivity and increased gonadotrophin release in Booroolas carrying the F gene(s) is not attributable to increased hypothalamic GnRH concentrations in these animals. PMID- 3283344 TI - Microsurgical management of complex fingertip injuries: comparison to conventional skin grafting. AB - In selected cases of severe fingertip injuries, an aggressive approach using microvascular and microneural techniques can yield functional results equal or superior to conventional methods of treatment in less severe injuries. A series of 20 patients were treated microsurgically from 1983 to 1986 for severe acute distal finger injuries or their early sequelae--five distal replantations, eight neurovascular free tissue transfers, and nine distal neurorrhaphies/nerve grafts with or without vascular conduit. Concurrently, 33 simpler tip avulsions were treated with full-thickness skin grafts for comparison. In the microsurgical series, one replant and the distal 1 cm of a free toe flap necrosed. Replants averaged two-point discrimination of 9.8 mm and pulp pinch 65 percent of normal; free toe transfers, two-point of 6 mm, pulp pinch 58 percent; distal nerve reconstruction, two-point 6 mm. Operating time per digit averaged 5.0 hours for replants, 4.3 hours for toe flaps, and 1.5 hours for nerve repair/grafts. All patients returned to full pre-injury employment within six months. None required revisional surgery for dysesthetic fingertips. In the conventional skin graft series, greater than six months follow-up is available in 17 patients. Average two-point was 7 mm (range: 3 to greater than 15 mm) and pulp pinch 83 percent of normal. There were seven poor results with cold intolerance, numbness, and paresthesias, three of which required revisional surgery. The data suggest that microsurgical management of fingertip injuries achieves results comparable to skin grafts, despite the greater complexity of the initial injury. This approach has resulted in fewer secondary tip revisions. Operative times are acceptable. Parameters of sensory return are similar, although pulp pinch is slightly less. Disability times are comparable to the average in major pulp losses. Of importance, final permanent partial factors of disability are diminished in rating, due to retained digital length, improved esthetic appearance, and less dysesthesia/cold intolerance. PMID- 3283346 TI - Pre-loading of mouse oocytes with DNA-specific fluorochrome (Hoechst 33342) permits rapid detection of sperm-oocyte fusion. AB - Mouse oocytes exposed to 1 microgram Hoechst 33342 (H-33342)/ml and then fertilized in vitro developed normally into blastocysts and blastocyst outgrowths. After penetration of the zona, the fertilizing spermatozoon showed intense fluorescence upon fusion with the vitelline membrane. Due to fluorochrome leakage from the perivitelline space a faint fluorescence was detected in zona bound spermatozoa. This fluorescence of zona-bound spermatozoa intensified with increased fluorochrome concentration (10 micrograms/ml), obscuring the fluorescence of the fertilizing spermatozoa. Spermatozoa added to zona-free mouse oocytes (pre-loaded with 1 or 10 micrograms H-33342/ml) fluoresced within 10 min of insemination, provided the zonae were removed mechanically. Removal by protease digestion induced leakage of fluorochrome, so that all spermatozoa in the vicinity of an oocyte pre-loaded with 10 micrograms H-33342/ml became labelled. This leakage was not visibly apparent when protease-treated oocytes were exposed to only 1 microgram H-33342/ml. The technique could not be applied to zona-free hamster oocytes under our conditions, since the fluorochrome leaked freely from the oocytes whether the zona was removed mechanically or enzymically. PMID- 3283347 TI - Introductory remarks on the milieux of the egg and the early embryo. PMID- 3283348 TI - Physiological factors underlying the formation of ovarian follicular fluid. PMID- 3283349 TI - The formation and function of oviduct fluid. PMID- 3283350 TI - The blood-uterine lumen barrier and exchange between extracellular fluids. AB - The concept of a blood-tissue barrier defines the rates at which matter exchanges among the vascular and extravascular fluids of the tissue. The remarkably slow rates at which substances such as mannitol (Mr 182) enter uterine fluid from plasma demonstrate the existence of a blood-uterine lumen barrier. Available evidence indicates that the uterine microvascular endothelium and the uterine epithelium behave as lipoid layers interrupted by water-filled channels. Furthermore, both cell layers appear to select actively certain substances over others for exchange with opposing extracellular fluids. In contrast to these similarities, the uterine epithelium and endothelium differ considerably with regard to restrictiveness. For most substances the primary rate-limiting boundary between blood and the uterine lumen is the epithelium. The extracellular fluid compartments of the lumen and endometrium are also influenced by the internalization and release of materials into and out of intracellular compartments including those of the stromal and migratory cells of the endometrium, the epithelium and the developing conceptus. Considerable evidence suggests that the luminal milieu of the developing embryo is created and maintained by the transport and permeability properties of the blood-uterine lumen barrier in conjunction with the cellular activities of the endometrium and embryo. This milieu probably fulfils the informational and nutritional needs of the developing embryo. PMID- 3283352 TI - Antepartum testing in postterm pregnancy. AB - Antepartum testing in postdate pregnancy was reviewed. No method of testing has been uniformly found to prevent all antepartum deaths in pregnancies with confirmed dates greater than 42 weeks. Perinatal mortality varies according to both the test and the institution. When comparing results according to the method of testing, perinatal mortality appears to be lowest (1.8/1,000) with the use of a 3-cm vertical pocket on ultrasound. Nearly as good is the use of a contraction stress test (2.5/1,000) on a weekly basis. Ultrasound using a 1-cm pocket and a biweekly non-stress test (NST) resulted in slightly worse perinatal mortality (5/1,000 and 6/1,000, respectively). If variable decelerations during the NST are not interpreted as abnormal, the perinatal mortality using a biweekly NST is 15/1,000. Induction of labor at 41-42 weeks with a favorable Bishop score will obviate the need for antepartum testing in some patients. PMID- 3283351 TI - The functions of uterine secretions. AB - The likely functions of uterine secretions, often termed histotroph, in the nurture of the early conceptus are reviewed. Particular emphasis has been placed on the pig in which the uterus synthesizes and secretes large amounts of protein in response to progesterone. In this species, which possesses a non-invasive, diffuse type of epitheliochorial placentation, the secretions provide a sustained embryotrophic environment which is distinct from that of serum. A group of basic proteins dominates these uterine secretions after Day 11 of pregnancy and its best characterized member is uteroferrin, an iron-containing acid phosphatase with a deep purple colour. Evidence has accumulated to suggest that uteroferrin, rather than functioning as an acid phosphatase, is involved in transporting iron to the conceptus. Three basic polypeptides which are found noncovalently associated with uteroferrin have been shown to be antigenically closely related to one another and to have arisen by post-translational processing from a common precursor molecule. Their function is unknown. A group of basic protease inhibitors has been identified which bear considerable sequence homology to bovine pancreatic trypsin inhibitor (aprotinin) and may control intrauterine proteolytic events initiated by the conceptuses. The last basic protein so far characterized is lysozyme which is presumed to have an antibacterial role. Finally, two low molecular weight (Mr approximately 18,000) acidic polypeptides have been purified and have sequence homology to a plasma retinol binding protein. Like uteroferrin, these proteins may be responsible for transport of an essential nutrient to the conceptus. PMID- 3283353 TI - Abbreviated tables for estimating fetal weight with ultrasound. AB - Tables containing 23 entries for estimating fetal weight with ultrasound parameters have proven to be equivalent to the longer tables in current use. PMID- 3283354 TI - The acardiac twin. A case report. AB - The acardiac twin is a rare consequence of monozygotic twinning and occurs in 1 per 35,000 deliveries. One percent of all monozygotic twins is affected. Prenatal diagnosis is possible with ultrasonography. Complications associated with the presence of an acardiac twin include sequelae from the twin-to-twin transfusion syndrome, polyhydramnios, dystocia, ruptured uterus and congestive heart failure in the normal twin. In utero fetal therapy is possible in some instances. PMID- 3283355 TI - Pregnancy complicated by maternal spina bifida. A report of two cases. AB - Pregnancy occurred in two women who had undergone corrective surgery for meningomyelocele. Both women had urinary incontinence leading to urinary tract infections and, in one, to vulvitis urinosa. There is limited literature on maternal meningomyelocele and its complications. PMID- 3283356 TI - Comparison of three pulse methylprednisolone regimens in the treatment of rheumatoid arthritis. AB - Twenty-nine patients with active rheumatoid arthritis entered a 6-week, parallel, randomized, double blind trial, comparing 1000 mg IV-methylprednisolone (MP), 320 mg IV-MP and 320 mg IM-MP. Although clinical benefit was noted in all groups, there were no differences among groups for duration of benefit (days: 1000 mg IV: 23.4; 320 mg IM: 17.2; 320 mg IV: 21.9) (p = 0.72), patient global scale (p = 0.57), or MD global scale (p = 0.36). Power to tell a 33% difference among groups for joint tenderness and patient global scale was 0.64 and 0.78. No serious drug related toxicity occurred. This preliminary study in a small patient group suggests that no large differences (33%) can be discerned among these 3 regimens. However, a larger study is indicated to reduce possible beta errors. PMID- 3283357 TI - The characterization of normal and scleroderma skin fibroblasts cultured in a collagen gel matrix. AB - Fibroblasts from normal and progressive systemic sclerosis involved skin more closely resemble in vivo cells when cultured in a collagen gel matrix, than do fibroblasts cultured on plastic. Ultrastructural studies show that the cytoskeleton and secretory organelles from these cells are better developed in the presence of a collagen gel. Fibronectin, glycosaminoglycans and collagen fibrils are produced by the cells and deposited in the preformed matrix. Collagen synthesis is greater in the scleroderma derived fibroblasts for all culture conditions with increased deposition in the matrix. Total collagen production form cells associated with the gel is less than that from those cultured on plastic, suggesting an inhibition of collagen synthesis by the preformed collagen matrix. PMID- 3283358 TI - Evaluation of a functional index and an articular index in ankylosing spondylitis. AB - We describe an index of functional impairment and a system of scoring joint tenderness for use in the assessment of ankylosing spondylitis. The functional index consists of 20 questions and the articular index is based on the scoring of a total of 10 joint responses after movement or firm digital pressure. These indices are simple to establish and not time consuming. They have a high degree of intra- and interobserver reproducibility. The indices showed changes in short term clinical trials of antiinflammatory drugs; these changes were highly correlated with the patient's overall assessment of his own clinical condition. PMID- 3283359 TI - Candida albicans infection of a prosthetic knee replacement: a report and review of the literature. AB - A woman with rheumatoid arthritis who underwent total knee arthroplasty is described. The implant became infected with Staphylococcus epidermidis and she received a prolonged course of postoperative antistaphylococcal antibiotics. Four months postoperatively she developed a calf ulcer that grew Pseudomonas aeruginosa and required further antibiotic therapy. One year later she presented with a painful, swollen knee with radiographic findings suggesting loosening of the prosthetic knee implant. Arthrocentesis cultures grew Candida albicans. She was treated with arthrodesis, amphotericin B, 5-fluorocytosine, and ketoconazole and remains free of infection 21 months after removal of the prosthesis. The clinical course of 6 other cases of Candida prosthetic joint infections is reviewed. PMID- 3283360 TI - Septic arthritis due to dual infection with Mycoplasma hominis and Ureaplasma urealyticum. AB - Acute septic arthritis of a knee and shoulder developed in a 32-year-old renal transplant patient. Cultures yielded Mycoplasma hominis and at least 1, and possibly 2, strains of Ureaplasma urealyticum. Doxycycline therapy controlled the symptoms and signs, and the joints became culture negative. On stopping therapy after 7 months, the arthritis recurred and U. urealyticum was again isolated from the shoulder joint. Cessation of doxycycline almost 4 years after the initial episode resulted in another recurrence. To our knowledge, this is the 1st case in which both M. hominis and U. urealyticum have been isolated from a joint. PMID- 3283361 TI - Ultrasound imaging of Achilles tendon. PMID- 3283362 TI - A review of Legionella pneumophila in horses and some South African serological results. AB - An examination of the sera of 329 horses for L. pneumophila antibodies revealed a much lower exposure rate than that reported in the United States of America. Further serological investigations of persons closely associated with a sero positive horse indicated that the horse could not be considered to be a source of infection but that both humans and animals were probably exposed to a common source of infection. The results showed that 192/329 (58.4%) of the sera tested negative, 114/329 (34.7%) had end-point titres of 1/2, 22/329 (6.7%) end-points of 1/16 and one an end point of 1/256 (0.3%). Serological testing of the people closely associated with horses showed that out of 22 people, 3 had a positive end point titre of 1:64 and only one person showed an end-point titre of 1:256. PMID- 3283363 TI - Bovine brucellosis in the Highveld region: incidence in dairy herds. AB - Bulk tank milk samples which were collected twice with an interval of 2 months from 2103 herds were tested for brucellosis by employing the brucella ring test. Farmers involved were all supplying industrial milk to the National Co-operative Dairies. A questionnaire was circulated to these farmers in which they were asked to indicate how heifer calf vaccination with strain 19 vaccine was practised on their properties. Of the herds tested, 18.1% could be regarded as infected. This figure varied from 8.9% in the Potchefstroom area to 30.9% in the northern districts of the Hoopstad area. An important cause of this rate of infection should be sought in improper calfhood vaccination. At least 9% of the respondents did not practice heifer calf vaccination whilst another 8.1% only commenced with vaccination during 1985 or later. About 12.4% of farmers commenced heifer calf vaccination prior to 1970. PMID- 3283364 TI - Asymmetrical bisintercalators as potential antitumor agents. AB - Ditercalinium and its analogues are dimeric molecules made up of two identical 7H pyrido[4,3-c]carbazole rings linked by symmetrical linking chains. These dimers elicit antitumor properties through a new mechanism of action. Recently, a relationship was found between their antitumor properties and their cytotoxic effect on the polA Escherichia coli mutant strain, suggesting that 7H-pyrido[4,3 c]carbazole dimers might induce a DNA deformation that could be recognized by the E. coli SOS repair system. Thus, the role of symmetry in ditercalinium analogues for their DNA binding, antitumor properties, and bacterial toxicity is investigated in the present study, by introducing asymmetric parameters in their structures. Dimers were either synthesized with an asymmetrical rigid linking chain or made up of two chemically different chromophores, i.e., acridine and 7H pyrido[4,3-c]carbazole. The asymmetrical dimers remain able to bisintercalate into DNA with high affinities, but a dramatic loss in their antitumor potency is observed. On the other hand, these asymmetrical dimers are cytotoxic for polA E. coli mutants, like their symmetrical analogues. These results show that the symmetry plays a crucial role for the antitumor potency in the 7H-pyrido[4,3 c]carbazole dimers series. PMID- 3283365 TI - Spotlight on Dr. Lawrence Crawford. PMID- 3283366 TI - Considerations for managing cases of chronic periodontitis with immediate prosthetic therapy. PMID- 3283367 TI - Dr. Paul A. Jacobs: American success story. PMID- 3283368 TI - The use of allografts in anterior cervical interbody fusion. PMID- 3283369 TI - Patterns of alcohol use and psychiatric inpatient admissions. AB - The role of alcohol problems in psychiatric inpatient hospital admissions is not fully reflected in diagnostic statistics. A model is presented to guide the design and aid the interpretation of epidemiological research into the relationships between alcohol use and psychiatric disorder. The difficulties encountered in evaluating the role of alcohol in hospitalizations are discussed. Our preliminary research suggests that not enough attention has been paid to self imposed abstinence from alcohol as a precipitant of symptoms and a precursor to hospitalization. PMID- 3283371 TI - [Determination of mercury and arsenic concentrations in urine by cold vapor and hydride atomic absorption spectrophotometry]. PMID- 3283370 TI - Cocaine psychosis and AIDS: a contemporary diagnostic dilemma. AB - This article examines some of the differential diagnostic considerations associated with the interaction between advanced cocaine psychosis and the neuropsychiatric manifestations of AIDS-Spectrum Disorders. A clinical case is presented to illustrate the potential for institutional countertransference in the treatment of substance abusing patients. The role of a multi-dimensional hypotheses testing model in cocaine related cases is discussed. PMID- 3283372 TI - Role of imaging and interventional techniques in the diagnosis of respiratory disease in the immunocompromised host. AB - A pure "pattern-recognition" approach to lung diseases in immune compromised patients as seen on the chest film is of limited value since any infection can present with several different patterns, and processes such as embolism, aspiration, edema, and hemorrhage may give appearances similar to infection. However certain pulmonary infections do occur commonly in association with one type of immunosuppression but rarely with others. Knowledge of these associations assists in narrowing down the differential diagnosis and in deciding upon the most appropriate next confirmatory diagnostic step. PMID- 3283373 TI - Radiology of immunologic diseases of the lung. AB - In the last two decades research in immunology has greatly expanded our knowledge of this important medical specialty. Many diseases of previously unknown etiology are now much better understood. This review emphasizes the basics of immunology in order to assist the reader in understanding the mechanisms that cause immunologic lung disease. The radiologic appearance of these diseases is discussed. PMID- 3283374 TI - Regional myocardial glucose metabolism in angina pectoris obtained from positron emission tomography. AB - This article presents a review of studies carried out with positron tomography on myocardial blood flow and glucose metabolism in patients with coronary artery disease and either stable (SA) or unstable angina (UA) pectoris. Regional blood flow was assessed with rubidium 82, an analogue of potassium, and glucose metabolism both with fluorine 18-labeled fluorodeoxyglucose (FDG) and carbon 11 labeled glucose (CG). There were no clear differences in regional myocardial blood flow between SA and UA patients and a group of normal volunteers. FDG uptake was low and homogeneous in both SA patients and normals. In contrast, all UA patients showed abnormally high FDG uptake in at least one left ventricular region at rest in the absence of symptoms or signs of acute ischemia. In the recovery from a period of exercise-induced angina, FDG uptake in SA patients was observed to be higher in previously ischemic regions than in nonischemic regions (as defined by 82Rb). It is postulated that higher FDG uptake in the postischemic myocardium of SA patients is due to repletion of glycogen stores. It remains unclear whether the high uptake in UA patients is due to a recent ischemic episode or is a reflection of a chronic adaptation to repeated stress. PMID- 3283376 TI - Experience with a modification of the Cloutier technique for hypospadias repair. AB - A modification of the Cloutier technique of hypospadias repair is described. The technique is applicable to all but the most minor degree of the anomaly. When free of complications the final result approximates a cosmetically and functionally normal penis. Since June 1985, 35 children have undergone both stages of the repair. The only complication encountered was fistula formation in 5, for a complication rate of 14.3 per cent. PMID- 3283375 TI - The diagnosis of neoplasia in patients with asymptomatic microscopic hematuria: a decision analysis. AB - Clinical decision analysis and a computer model were used to evaluate the performance of alternative strategies for the diagnosis of neoplasia in adults with asymptomatic microscopic hematuria. Strategies consisted of sequences of diagnostic tests, including ultrasound, excretory urography, angiography, computerized tomography and cystoscopy. The strategies have a sensitivity of 98 to 100 per cent for bladder cancer and 90 to 94 per cent for renal carcinoma, and a specificity of 99 per cent. The cost per carcinoma diagnosed is $75,000 to $86,000 at 1 per cent prevalence and $5,000 to $5,800 at 15 per cent prevalence. Strategies using cystoscopy or ultrasound as the initial diagnostic test minimized cost and morbidity while maintaining diagnostic accuracy. Excretory urography does not add significantly to diagnostic accuracy but it does add to cost and morbidity. PMID- 3283377 TI - Caution in antenatal intervention. AB - We assessed 18 fetuses who harbored a urinary tract malformation that was diagnosed by antenatal sonography. The antenatal diagnosis corresponded to the postnatal diagnosis in 66 per cent of the cases. We review the course of 6 fetuses who had catheters placed percutaneously to drain dilated urinary tracts that were believed to be caused by posterior urethral valves (5) or an obstructed megaureter (1). Only 2 of these fetuses exhibited valves postnatally. No fetus had any recognized benefit from the antenatal intervention. We found that sonography may not readily differentiate fetuses with hydronephrosis with obstruction from those without obstruction. From this experience we conclude that intervention in pregnancies suspected of harboring a fetus with a malformed urinary tract should be done cautiously. Antenatal sonography is useful to identify the fetus with a dilated urinary tract. This identification permits perinatal specialists to be alerted so that preparations for reconstructive surgery in such cases can be made early postpartum. PMID- 3283378 TI - Small bowel obstruction secondary to migration of an inflatable penile prosthesis reservoir: recognition and prevention. AB - A patient is described in whom placement of an inflatable penile prosthesis after cystectomy resulted in corporeal erosion with a semirigid rod. He presented 18 months later with small bowel obstruction secondary to migration of the reservoir into the peritoneal cavity and its incorporation into several loops of ileum, necessitating resection of 15 cm. of small bowel. The prevention of this complication is discussed. PMID- 3283379 TI - Multiple penile horns: case report and review. AB - We report a case of unusually large multiple penile horns following removal of condylomata acuminata. Penile horns can grow rapidly, although malignant degeneration is uncommon. Wide excision with deep biopsy of skin at the base of the lesion probably is appropriate treatment. PMID- 3283380 TI - Nuclear roundness factor measurement for assessment of prognosis of patients with prostatic carcinoma. II. Standardization of methodology for histologic sections. AB - A nuclear shape descriptor, nuclear roundness factor, predicted outcome in patients with prostatic carcinoma whereas standard pathological grading by Gleason's architectural pattern did not. The inability of others to duplicate those successes warranted a reevaluation of the technique for NRF measurement. We previously described our digitization system and measured the perimeter and area of a microscopic circle similar in size to prostatic carcinoma nuclei with a reproducibility and accuracy of greater than 95%. We have applied our improved system to nuclear contour digitization and standardized our method for NRF measurement. In order to calculate accurately the NRF for prostatic carcinoma, the histologic section must have been reviewed by a pathologist and 150 nuclei traced after random selection. NRF measurement reproducibility within and between observers exceeded 90%. This system for NRF measurement successfully predicted outcome in 13 of 15 patients with stages A2, B1, and B2 prostatic carcinoma. Our success with a carefully tested and improved system for NRF determination warrants further evaluation of NRF for assessment of prognosis of patients with prostatic carcinoma. PMID- 3283381 TI - Inhibition of Dunning tumor growth by melatonin. AB - Injections of the pineal hormone melatonin reduced growth and increased doubling time of the R3327H Dunning prostatic adenocarcinoma in the Copenhagen X Fisher rat. This occurred even though testosterone levels (50% of normal) were ostensibly high enough to maintain normal tumor growth. Melatonin may act directly upon the conversion of testosterone to dihydrotestosterone to inhibit tumor growth. Alternatively, a more complicated mechanism may be involved since studies on MCF breast cancer tissue indicate an estrogen requirement for inhibition of growth by melatonin. PMID- 3283383 TI - Sutureless renal repair after low-velocity ballistic trauma. AB - The tissue adhesive butyl cyanoacrylate was evaluated in the repair of injured porcine kidneys following low-velocity ballistic trauma. This technique was compared to the classic renal repair using chromic suture and a patch of perirenal fat. The repair with butyl cyanoacrylate was less time consuming (four minutes vs. 28 minutes for the controls) and decreased blood loss (67 cc vs. 180 cc for the controls). Ten days post injury the kidneys repaired with tissue adhesive showed minimal intraparenchymal hemorrhage or perirenal bleeding, while two of the four (50%) suture-repaired kidneys showed intrarenal microhemorrhages and one (25%) developed a perirenal hematoma. Perirenal adhesions were noted in both groups. Vital signs, IVP's, creatinine clearance, and serum and urine chemistries were nearly identical in the two groups. The results show that low velocity ballistic injuries of renal tissue can be repaired effectively and more efficiently with the use of butyl cyanoacrylate when compared to conventional suturing methods. PMID- 3283382 TI - Urinary glycosaminoglycan levels following induced cystitis in monkeys. AB - Urinary glycosaminoglycan (GAG) levels were measured by the Whiteman assay in five monkeys following induction of an E. coli urinary tract infection. Urinary GAG levels rose as the infection developed and returned to baseline levels as the infection resolved. Elevated urinary GAG levels may be a marker for the tissue injury incurred by such infections and may offer insight into their pathophysiology. PMID- 3283384 TI - Trial of ibuprofen to prevent post-vasectomy complications. AB - Sperm granuloma and epididymitis remain 2 of the most common and incapacitating complications of vasectomy. A study was designed to evaluate the possibility of reducing these inflammatory complications with a prophylactic course of a nonsteroidal anti-inflammatory drug. Patients undergoing outpatient vasectomy were randomized into 2 groups. Group 1 received a prophylactic course of ibuprofen and group 2 received no medication. The ibuprofen was tolerated well and no adverse reactions were noted. There was no increase in postoperative bleeding or hematoma formation. There was no clinical benefit or decrease in complication rate in the ibuprofen-treated group. PMID- 3283385 TI - Treatment of chronic prostatitis: intraprostatic antibiotic injections under echography control. AB - We treated 51 patients diagnosed as having chronic bacterial prostatitis (gram negative) with 2 ml. intraprostatic amikacin (500 mg.) or tobramycin (100 mg.) weekly for 2 to 4 weeks. Administration was perineal with echographic control and injection was done in the echogenic zone or external gland. In each case the diagnosis was obtained by fractioned microbiological study via the method of Meares and Stamey. This test was repeated 4, 12 and 24 weeks after the end of treatment. Of the patients 25 (49 per cent) were cured microbiologically, 11 (21.5 per cent) were cured after a second cycle of treatment and the remaining 15 (29.4 per cent) failed to respond. The clinical cure rate was 43.1 per cent and 41.1 per cent of the patients were improved. After 6 months 5 patients had relapse and 1 had reinfection. No differences were observed with both antimicrobials. The microbiological cure indexes of 70.5 and 58.8 per cent after 3 and 6 months, respectively, compared favorably with that obtained by oral therapy with antimicrobials that reach effective levels in the prostatic fluid. Transitory post-injection hemospermia was observed in 11 patients. Together with pain during or after injection (8 and 5 patients, respectively), these were the sole adverse effects observed with this therapy. PMID- 3283386 TI - Prostatic aspiration biopsy: an assessment of accuracy based on long-term observations. AB - We present the results of transrectal thin needle aspiration biopsy of the prostate in 133 patients. Test specificity was 94 per cent and sensitivity also appeared to be high initially. However, with repeated rectal examinations and biopsies during an 11-year period a number of additional false negatives became apparent, which resulted in an apparent test sensitivity of 82 per cent, lower than most previously published reports. Our data suggest that aspiration biopsy has specificity and sensitivity similar to core biopsy, it is important to re test patients who have a palpable abnormality and an initially benign biopsy, and aspiration biopsy simplicity allows for a low threshold of suspicion of subtle abnormalities and for repeating biopsies after negative findings. PMID- 3283387 TI - Prognostic role of preoperative nutritional and immunological assessment in the surgical patient. AB - The utilization of delayed hypersensitivity response (DHR) for the identification of high-risk patients with regard to postoperative septic complications is still discussed. The aim of this study was to clarify how much DHR may improve the prognostic capacity of nutritional assessment (NA). Nutritional and immunological evaluations were performed at admission on 405 patients undergoing elective general surgical procedures. Subjects with serum albumin less than or equal to 3.0 g/dl or total iron-binding capacity less than or equal to 220 micrograms/dl or weight loss greater than or equal to 10% with respect to usual body weight were classified as malnourished. DHR was assessed by performing skin tests with four recall antigens: PPD, candida, trichophyton, sk-sd. The incidence of postoperative complications resulted higher among the 187 malnourished patients (31.0%) than in the 218 well-nourished ones (14.2%) (p less than 0.001), and among the 213 anergic patients (29.6%) than in the 192 normal responders (13.5%) (p less than 0.001). To determine how much skin tests may improve the prognostic ability of NA, the relationship between DHR and postoperative complications was also studied in the malnourished and in the well-nourished patients, separately. In the malnourished group, the patients with an impairment of DHR had a higher incidence of postoperative infections than normal responders (p less than 0.05). In the well-nourished group, no significant differences were found between anergic patients and normal responders. In our study, DHR slightly improved the prognostic capacity of NA. Therefore, the first approach to identify the high risk patients seems to be the unexpensive, quick and available determination of nutritional status. PMID- 3283388 TI - Role of biochemical mediators in clinical nutrition and surgical metabolism. AB - Over the past several decades, research on the role of mediators in inflammation, immunity, repair processes, cell growth, and substrate metabolism have centered around the use of purified products of stimulated macrophages. With the current availability of recombinant mediators, the participation of individual monokines in cellular metabolism has been more clearly defined. Interactions among various mediators have been demonstrated, but their exact role in metabolism is currently under intense study. With the use of recombinant monokines, formal evidence for their participation in the acute phase response has been developed. Their use has also assisted in the reinterpretation of data gathered in older studies using purified preparations, which were almost certainly contaminated with several monokines. In this review we will try to give the reader insight into recent advances in the understanding of the role of cellular mediators in relation to nutrition and intermediary metabolism. With a clearer knowledge of the role of cellular mediators in the pathophysiology of disease, it may be possible to develop rationales for their therapeutic use as modulators of substrate metabolism during critical illness. PMID- 3283389 TI - A case of myocarditis with immunological identification of myocardial and peripheral lymphocyte subsets. AB - Immunological identification of lymphocyte subsets in a patient with myocarditis revealed an increase in myocardial OKT 11 (pan T), OKT 4 (inducer/helper T) and OKT 8 (suppressor/cytotoxic T) subsets associated with a transient decrease in the percentage of circulating OKT 3 (pan T) and OKT 4 (inducer/helper T) subsets. This decrease may be explained by the accumulation of these subsets in the diseased myocardium. Specific antigenic markers on lymphocytes at the site of myocardial inflammation in the acute stage of myocarditis differ from those on corresponding peripheral lymphocytes. This observation may highlight the immuno pathogenetic mechanisms involved in the development of myocarditis. PMID- 3283390 TI - [Pacemaker implantation in the first month of life--a case report and review of 14 cases appearing in the Japanese literature]. PMID- 3283391 TI - [Successful repair of isolated levocardia associated with ventricular septal defect, interrupted inferior vena cava and azygos continuation]. PMID- 3283392 TI - [A case of aortitis syndrome subjected to aortic valve replacement in the active phase of the disease]. PMID- 3283393 TI - Antigenic characteristics of larval Paragonimus westermani. PMID- 3283394 TI - Immunohistochemical study on the distribution of lymphoid tissues in the upper alimentary and respiratory tracts of chickens. PMID- 3283395 TI - Implantation of canine transmissible sarcoma cells to X-ray irradiated and nude mice. PMID- 3283396 TI - Characteristics of lactate dehydrogenase isozymes in tissue extracts of herbivorous vole, Microtus arvalis pallas. PMID- 3283397 TI - Histiocytic sarcoma in a cat. PMID- 3283398 TI - Existence of the large molecules of immunoglobulin G with another component. PMID- 3283399 TI - Decrease in insulin secretion in lactating rats. PMID- 3283400 TI - Circulating DNA and lupus nephritis. PMID- 3283401 TI - Glutathione transferase in the urine: a marker for post-transplant tubular lesions. AB - Basic glutathione transferase released from the proximal tubular epithelium in the kidney was monitored in the urine of 69 recipients of renal allografts. The enzyme was isolated from human liver and the urinary analysis performed with radioimmunoassay. Patients receiving cyclosporine A without toxicity or rejection did not excrete this enzyme in their urine; whereas the urine of patients with cyclosporine A-induced nephrotoxicity contained significant amounts of the transferase (P less than 0.001). Patients with allograft rejection also showed increased urinary concentrations of the basic glutathione transferase, but had significantly lower values than patients with cyclosporine induced nephrotoxicity (P less than 0.001). During aminoglycoside and co-trimoxazole treatment, the urinary concentration of this transferase also increased. Patients with renal infarction showed a sudden increase in urinary transferase to very high levels. The results indicate that quantitative analysis of the basic glutathione transferase in urine is useful for monitoring renal tubular lesions present in various complications following transplantation, such as cyclosporine and antibiotic induced nephrotoxicity and renal infarction. PMID- 3283402 TI - The long-term course of cyclosporine-associated chronic nephropathy. AB - We evaluated a chronic renal injury in 37 cardiac transplant recipients treated for 12 to 24 months with cyclosporine (CsA). Twenty-four cardiac transplant recipients treated with azathioprine for more than 24 months served as controls. Despite equivalent cardiac performance, GFR in those treated with CsA was depressed, 47 +/- 3 versus 94 +/- 4 ml/min/1.73 m2 (P less than 0.001). CsA therapy was also associated with significant elevation of renal vascular resistance (RVR), proteinuria, arterial hypertension, and impaired intrarenal conversion of inactive prorenin to active renin. Histopathological changes associated with CsA included an obliterative arteriolopathy with deposition of proteinaceous material in necrotic arteriolar walls, and associated tubulointerstitial damage. A minority of glomeruli exhibited either ischemic collapse or sclerosis. Area perimeter analysis revealed enlargement of the remaining glomeruli with significant expansion of the mesangium. Longitudinal examination over a 48 month period (N = 15) during which CsA was reduced in dosage or withdrawn revealed persistent hypofiltration, increasingly elevated RVR and heavier proteinuria. Further histopathological deterioration was observed when renal tissue was sampled a second time in six patients, and three members of the experimental group developed end-stage renal disease. We conclude that continuous CsA therapy for more than 12 months causes a chronic injury to renal microvessels that is rarely reversible and potentially progressive. PMID- 3283403 TI - Cystic kidneys. PMID- 3283404 TI - Comparison of continuous ambulatory peritoneal dialysis and hemodialysis. PMID- 3283406 TI - Dialysis or transplant: an integrated approach to end-stage kidney disease management. AB - Technological and immunological developments within the last decade have evolved a variety of therapeutic modalities by which ESRD may be satisfactorily managed. With the exception of renal transplantation between identical twins, none of these modalities provide permanent and complete correction of the uremic state, however, and the challenge now facing those involved in the management of irreversible renal failure is to devise an individualized treatment program permitting optimal long-term physical and psychological well-being and the maintenance of a valuable and productive role in society. Such a goal is most effectively achieved by an integrated approach combining both dialysis and renal transplantation. In the program proposed and utilized at our institution, all therapeutic options are presented to the patient with incipient renal failure, and a rational long-term management strategy devised based on clinical status, psychological stability, convenience, and acceptability. Dialysis is normally employed as a limited term maintenance procedure pending renal transplantation from a living or cadaver donor, thus permitting optimal correction of the uremic state. Early rehabilitation and social reintegration are actively pursued to minimize disease impact and maximize quality of life. In subjects with chronic deterioration of graft function, retransplantation may be performed prior to requirement for dialysis, thus minimizing hospitalization time, cost, and social disruption. The definition of risk factors predicting graft success has facilitated the individualization of therapy within this integrated program. While allograft survival exceeding 90% may now be anticipated in the non sensitized first-graft recipient, predicted outcome is poor in subjects who are highly sensitized following previous transplantation or with rapid loss of a prior graft.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283405 TI - Coagulation defects in uremia. PMID- 3283407 TI - Aluminum and iron overload in chronic dialysis. PMID- 3283408 TI - Cardiovascular instability during hemodialysis. PMID- 3283409 TI - Choice of ESRD treatment strategy according to cardiac status. PMID- 3283410 TI - Interleukin-1 and its relevance in patients treated with hemodialysis. PMID- 3283411 TI - Beta 2-microglobulin: evidence for a new form of hemodialysis-associated amyloid protein. PMID- 3283412 TI - Uremic toxins. PMID- 3283414 TI - [Epilepsies in childhood. 1. Classification and diagnosis]. PMID- 3283413 TI - Adequacy of dialysis. AB - (1) There is no single measurement of adequacy in dialysis available now, and there likely never will be. (2) With present knowledge, it is rational to model patients for removal of both small and middle molecules. Minimum weekly clearances for urea and for a middle molecule the size of Vitamin B12 should be 120 and 30 liters per week per 1.73 m2 respectively. (3) In prescribing a dialysis treatment, a Kt/v urea greater than 1 should be targeted, a value of under 0.8 is unacceptable. (4) Attention to the nutritional status of the patient is important, and one should strive for a PCR of 1.1 to 1.3 g/kg/day. (5) Studies on living cells (for example, platelets) and systems (for example, CNS function) are valuable if there is doubt as to the patient's status. (6) Assessments of treatment stresses and quality of life should be used in monitoring dialysis patients. (7) In clinical trials of different treatment methods, it is important to equate findings to solute clearance profiles and to include studies on functions of cells or systems and to measure the impact of the treatment upon quality of life. PMID- 3283416 TI - [Closure of the duodenal stump in gastric resection for ulcer exclusion]. PMID- 3283415 TI - [Use of the lacto dipping culture in the bacteriologic study of breast milk]. PMID- 3283417 TI - [A method of appendectomy]. PMID- 3283418 TI - [Historical aspects of the surgical treatment of chronic duodenal obstruction (a review of the literature)]. PMID- 3283419 TI - [Use of long-term peridural blockade combined with hyperbaric oxygenation and heparin in dynamic intestinal obstruction (a review of the literature)]. PMID- 3283420 TI - [Intravascular catheter hemostasis in hemorrhages in the digestive tract]. PMID- 3283421 TI - [Clinical course and treatment of gallstones]. PMID- 3283423 TI - [The role of therapeutic endoscopy in Mallory-Weiss syndrome]. PMID- 3283422 TI - [Incompetence of the gastrointestinal anastomosis after resection of the stomach in peptic ulcer]. PMID- 3283424 TI - [Metabolic disorders in infectious-toxic shock in patients with peritonitis]. PMID- 3283425 TI - [Indications for reconstructive interventions on the branches of the aortic arch in patients with a combined lesion of the abdominal aorta and the extracranial arteries]. PMID- 3283426 TI - [Treatment of a severe course of keratoconjunctivitis sicca with eledoisin]. AB - Cases of keratoconjunctivitis sicca with keratitis filiformis (with and without Sjogren's syndrome) with severe courses cannot be treated adequately with artificial tears. Only since the discovery of Eledoisin, which was introduced for ophthalmological therapy by Bietti, has a drug been available which directly stimulates tear secretion. Eledoisin was discovered in the salivary glands of certain Mediterranean species of octopus and can meanwhile be produced synthetically. A randomized study conducted at the University clinics in Heidelberg, Cologne, and Ulm showed that Eledoisin is significantly superior if the statistics are based on cases with severe courses. Cases with less severe courses also respond well to therapy with artificial tears. PMID- 3283427 TI - [The history of color theories]. AB - The origins of color theories are closely linked to the Greeks' theories of vision. Plato explained vision as a combined action of light from within (i.e. from the eye) and light from without: this view was, in a certain sense, revived by Goethe. Aristotle, on the other hand, defined vision as the passive reception, by the eye, of an action originating in objects: thus, he was the originator of scientific optics, as propounded 2000 years later by Newton. The present author compares Newton's experimental analysis of spectral colors produced by triangular glass prisms with Goethe's more intuitive theory of the primordial phenomena (Urphanomene) of color vision. Apparently, Goethe started from the same point as Newton: experimentation with optical prisms. But he looked, as it were, in the opposite direction: he did not examine the objective image formed by a prism but described what he himself perceived when looking through a prism. It was this subjective image which he analyzed and on which he built his own color theory. The direction of his argument was fixed right from the beginning: from the very first glance through his prism he was convinced--by intuition, not by reflection- that Newton must have been wrong. No wonder this prejudice led him astray! However, Goethe's careful and skillful analysis of the subjective perception of light and colors bore other fruits. Under the heading of "physiological colors" he describes, in his "Farbenlehre", some important phenomena of visual physiology such as simultaneous and successive color contrasts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283428 TI - [The nervous system and uveitis]. AB - This paper presents a short review of some inflammatory diseases which involve both the nervous system and the uvea, and of some forms of uveitis whose onset could be neurogenic. Multiple sclerosis and reticulum cell sarcoma are examples of systemic neurologic diseases which can be accompanied by uveitis or pseudo uveitis. Syndromes such as Behcet's or Vogt-Koyanagi-Harada are characterized not only by a highly severe panuveitis but also by the participation of optic nerve, meningeal, and brain tissues in the inflammatory process. The occurrence of sympathetic ophthalmia and herpetic uveitis could to a certain extent be due to a neurogenic transmission of the antigen. For Fuchs' heterochromic cyclitis, however, the old theory of sympathetic nerve dysfunction at its origin is no longer widely accepted. PMID- 3283429 TI - [Heterochromia complicata Fuchs]. AB - We are indebted to I. Loewenfeld and her ophthalmologist colleague H. S. Thompson for having called for an explanation of the clinical picture of Fuchs's heterochromic cyclitis in their "Critical Review." In the present author's view, the reason why so many different opinions are held concerning the clinical picture and the etiology is that only a few authors (Franceschetti, Francois, Georgiades, Hollwich, Huber, Kimura, Hogan and Thygeson, Perkins, Sugar and others) have been able to follow up collectives of their own, of up to 50 patients and more, for many years. None of the investigators deny the presence of typical precipitates, observed both under direct light and retroillumination; typical because they are only found in Fuchs's heterochromia and its variation Posner-Schlossman syndrome. The course is inflammation-free, since, in contrast to all other forms of diseases of the anterior uvea, neither external signs of inflammation nor posterior synechiae occur. Etiologically, according to the behavior of the pupil (Francois 1949, 1954), there is sympathicoparalysis, while according to Amsler and Huber as well as Verrey, Franceschetti and Herrmann there is a corresponding pathologically increased fluorescein permeability of the vessels in the anterior segment and an extreme tendency to bleeding, as shown by the filiform bleeding when the anterior chamber is opened. The sympathicoparalysis also explains the inflammation-free vascular fragility, with escape of cell elements, primarily protein (albumins) and lymphocytes (Verrey, Matteucci, Franceschetti and Hermann, and Francois) into the aqueous and vitreous. Therefore, the syndrome should no longer be termed "heterochromic cyclitis" but rather "heterochromia complicata" as proposed by E. Fuchs. In view of the somatic features, amounting to a status dysraphicus, the condition is probably connected with a congenital developmental anomaly of the sympathetic nerve (Francois); these features have been described by Franceschetti, Hollwich, Passow, Perkins, Sugar, Huber and many others. There may also be immunologic factors (Loewenfeld and Thompson); however, research into these is still only at an early stage. PMID- 3283430 TI - [Detection of HIV-1 antigen--determination using 3 different test systems]. AB - 51 human sera containing antibodies to human immunodeficiency virus 1 (= HIV-1) were examined for HIV-1-antigen by three different enzyme immunoassay procedures (= EIA) of Abbott, Organon and Dupont. Sensibilities, handling as well as the correlation with the clinical stages of HIV-infection were compared. The EIA's diagnosed in accordance 6 sera which contained HIV-1-antigen and 42 sera to be HIV-1-antigen negative. 3 sera showed differences: according to the EIA of Organon none of these sera contained HIV-1-antigen, the EIA of Abbott (but not of Dupont) analysed HIV-1-antigen in one of these sera, in the other two sera only the EIA of Dupont showed HIV-1-Antigen. It is concluded that the differences in these 3 serum samples may originate not only in the different types of EIA used (indirect/direct procedure) but also in the different capture antibodies provided (antibodies against p-24 antigen or polyvalent antibodies). PMID- 3283432 TI - [Ultrasonic examination in emergency surgery of diseases of the abdominal organs]. PMID- 3283431 TI - [Relation between body fat distribution, insulin levels and glucose tolerance in obese females]. AB - Relationship between body fat distribution, serum insulin, and glucose tolerance in obese, non-diabetic women. Recent studies suggest that hyperinsulinemia and upper body obesity are predictive factors for the development of non-insulin dependent diabetes mellitus. To further characterize the relationship between body fat distribution, serum insulin, and glucose tolerance an oral glucose tolerance test was performed in 48 obese, non-diabetic women. Fasting insulin levels were correlated to both total body fat calculated as body mass index (r = 0.58, p less than 0.001) and upper body fat distribution expressed as waist-to hip ratio (WHR, r = 0.47, p less than 0.01). In the women with upper body fat localization (WHR greater than 0.90) significantly higher basal and glucose stimulated insulin concentrations were established than in the women with a lower body type of obesity (WHR less than 0.78) (basal insulin 27.4 +/- 11.5 vs. 15.4 +/- 8.8 mU/l, p less than 0.05, insulin area 779 +/- 320 vs. 468 +/- 237 U, p less than 0.05). They also had impaired glucose tolerance (glucose area 925 +/- 139 vs. 633 +/- 147 U, p less than 0.01). Fasting triglyceride concentrations were correlated both with WHR (r = 0.63, p less than 0.001) and fasting insulin (r = 0.33, p less than 0.05) but not with BMI (r = -0.02, n.s.). A positive association was found between systolic and diastolic blood pressure and both WHR (r = 0.43 and r = 0.44 resp., p less than 0.01) and BMI (each r = 0.35, p less than 0.05). Interestingly, basal insulin was also associated with blood pressure (r = 0.30, p less than 0.1, and r = 0.40, p less than 0.01 resp.).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283433 TI - [Antibiotic treatment of suppurative peritonitis]. PMID- 3283435 TI - [History of the medical education of women]. PMID- 3283434 TI - [Chronic pancreatitis: current theories on its etiology, pathogenesis, clinical course and drug treatment (review of foreign literature)]. PMID- 3283436 TI - [History of G.W.F. Hegel's illness]. PMID- 3283437 TI - [The role of the kallikrein-kinin system in the pathology of the digestive organs]. PMID- 3283438 TI - [Ultrasonic amplitude histography in the evaluation of hepatic, renal and splenic structures in patients with post-infarction cardiosclerosis]. PMID- 3283439 TI - [Results of comparative studies of the effects of antidepressants pyrazidole and amitriptyline on stenocardia]. PMID- 3283440 TI - [Use of oxodoline in patients with arterial hypertension]. PMID- 3283441 TI - [Dalargin electrophoresis as a method of treatment in duodenal ulcer]. PMID- 3283443 TI - [Causes of erroneous results of ultrasonic diagnosis of gallstones]. PMID- 3283442 TI - [Evaluation of the effectiveness of anti-ulcer preparations (dalargin, gastrocepin, solcoseryl) in the ambulatory treatment of peptic ulcer]. PMID- 3283444 TI - [Bone examination by noninvasive methods during prolonged hypokinesia]. AB - The effect of 120-day bed rest on skeletal bones of 15 volunteers was investigated by noninvasive methods, viz. gamma-photon absorption, ultrasonic and neutron-activation analysis. The test subjects were divided into 4 groups one of which served as control and three others used different countermeasures (drugs, exercise or drugs in combination with exercise). Calcium loss in skeletal bones was not more than 0.5% per month; calcium loss in leg tubular bones was 1 to 2% per month in 6 test subjects; calcium loss in heel bones was on the average 3-4% per month in the control, exercise and combination groups. No strict correlation between the negative balance of calcium and mineral content in leg compact bones and foot spongy bones was found. There was a correlation between changes in the mineral content of leg bones and ultrasound propagation along certain compartments of the tibial median surface. In terms of negative and positive trends leg and foot bones were in better condition in the drug group. The techniques used were assessed with respect to their diagnostic and prognostic value. PMID- 3283445 TI - [Contribution of N. M. Dobrotvorskii to the development of aviation medicine in the USSR]. PMID- 3283446 TI - Emilie Melanie Viett Rundlett, M.D.: South Carolina's first lady medical graduate. PMID- 3283447 TI - Emilie Viett Rundlett, M.D. 1876-1959. PMID- 3283448 TI - An analysis of commitments made by student clinicians in speech-language pathology and audiology. AB - This study identified and classified commitments made by student clinicians in speech-language pathology and audiology supervisory conferences and provides a methodology for documenting change in supervisees' behavior as a result of supervisory interaction. Five different types of commitments were isolated and served as the basis of the Commitment Classification System. They included clinical procedures, clinical process administration, supervisory procedures, supervisory process administration, and academic information/teaching function. The independent variables were condition (written agreement or no written agreement between supervisee and supervisor), order of conditions, experience level of supervisee, week number within each condition, and type of commitments. Frequency data were collected for 6 consecutive weeks. The resulting 1,389 commitments made by 64 student clinicians in 384 individual conferences at 12 universities were analyzed within a multiple analysis of variance. Significant findings (p less than .05) indicated that the greatest number of commitments made involved planning, analysis, and evaluation of the clinical process with particular attention on client behavior; and the number of commitments made was a function of written accountability and order of conditions. PMID- 3283449 TI - Thermal entrainment methods for studying Raynaud's phenomenon. AB - Entrainment occurs when an externally applied periodic temperature stimulus forces the peripheral bloodflow component of thermoregulation to oscillate at the same frequency. This phenomenon can be demonstrated using frequency transforms to analyse the spectral content of the bloodflow, and can be used as a diagnostic test for Raynaud's phenomenon. Correlations were performed between the clinical diagnosis and the objective tests. The average inter-clinical correlation coefficient was r = 0.66. When the average clinical diagnosis was compared with a combination of thermal entrainment and digital patency testing the correlation coefficient rose to r = 0.68. These results highlight the difficulties encountered when assessing patients with Raynaud's phenomenon and the necessity of applying both physiological and clinical techniques. PMID- 3283451 TI - Doppler ultrasound signal analysis based on the TMS320 signal processor. AB - Doppler ultrasound is an established method for the study of haemodynamics. Considerable improvement in accuracy and resolution can be achieved by utilizing advanced data processing techniques. Such a system has been developed and used to assess the cardiac component of the Baroreceptor Reflex in adults and to examine cerebral blood flow in neonates. PMID- 3283450 TI - Pulsatile infusion of gonadotrophin releasing hormone (GnRH): investigative and therapeutic applications. AB - Normal gonadotrophin secretion, and therefore normal ovarian function, depend on delivery to the pituitary of the hypothalamic neuropeptide gonadotrophin releasing hormone (GnRH) in a pulsatile pattern. In the mid-follicular phase of the menstrual cycle, for example, discrete pulses of luteinizing hormone (LH) can be observed at approximately 90 min intervals. Many disorders of ovulation are caused by abnormalities of this natural pulsed signal. We have developed and used a small portable infusion pump to deliver GnRH to women with hypothalamic amenorrhoea; our studies, and those of other groups, have shown that successful ovulation and pregnancy result from such treatment. The results of treatment at St Mary's Hospital show that 16 women with hypogonadotrophic amenorrhoea received a total of 31 cycles of treatment with pulsatile GnRH; 25 (81%) of these cycles were ovulatory and 11 of the 14 women who were trying to conceive became pregnant. There was only one multiple pregnancy (twins). PMID- 3283452 TI - Extrinsic factors affecting surgical training. PMID- 3283453 TI - Insulin administration protects from paraplegia in the rat aortic occlusion model. AB - The effect of insulin induced hypoglycemia was evaluated in a rat aortic occlusion model of ischemic paraplegia. One hour before aortic occlusion, 200-250 g Sprague-Dawley rats received either 1 cc of saline or 0.5 units regular insulin in 1 cc saline. Rats were then anesthetized, intubated, and ventilated with halothane (1-1.5%). The aortic arch was exposed and snares were placed on the right and left subclavian arteries and the aorta distal to the left subclavian. The three vessels were occluded for 10 min. Lower extremity neurologic deficit was evaluated at 1, 4, 18, and 24 hr postocclusion based on a 15-point scale (0 = normal, 15 = severe deficit). Lower extremity neurologic deficit was significantly decreased in the insulin-treated group at 18 and 24 hr postocclusion (P = 0.005 and 0.006, respectively, Student's test). Blood glucose concentration was significantly lower at the time of occlusion in the insulin treated group when compared to the saline-treated group (P = 0.001). We conclude that in this rat model of paraplegia, insulin induced hypoglycemia is associated with a reduction in lower extremity neurologic deficit produced by temporary aortic occlusion. PMID- 3283454 TI - The role of intestinal flora on the interactions between nonparenchymal cells and hepatocytes in coculture. AB - Kupffer cells are exposed directly to a number of factors in the portal circulation that can modify or regulate their responses to septic stimuli. The gut represents a potential source of a number of these factors including endotoxin, lymphokines, and prostaglandins. We examined Kupffer cells from germfree rats and germfree rats exposed to endotoxin or bacteria via their GI tracts to determine the importance of the intestinal flora in maintaining or modulating Kupffer cell responses. Kupffer cells from germfree animals were reduced in numbers and failed to respond to LPS in Kupffer cell: hepatocyte coculture. When germfree rats were exposed to bacterial endotoxin or bacteria via the gastrointestinal tract their Kupffer cells increased in numbers to normal and the cells responded to LPS in culture. Intestinal overgrowth with Escherichia coli for 2 days activated the Kupffer cells and significantly increased Kupffer cell sensitivity to LPS. These data suggest that the environment of the gastrointestinal tract is important for normal Kupffer cell responses and that intestinal bacterial overgrowth can modify Kupffer cell responses to septic stimuli. PMID- 3283455 TI - Neutrophil phagocytosis during endotoxin-induced lung injury. AB - Depressed neutrophil (PMN) phagocytosis in patients with ARDS may contribute to the known increased incidence of pulmonary sepsis. To evaluate changes in phagocytosis, circulating PMNs from normal rats were compared to circulating and alveolar PMNs (obtained by bronchoalveolar lavage, BAL) from rats after 72 hr of endotoxin infusion (LPS-Rx)-induced acute lung injury. Since phagocytosis correlates with adherence, PMN adherence to coverslips and to a standard nylon wool column was also measured. PMN adherence to nylon wool was 65% for control, 77% for circulating LPS-Rx, and 20% for BAL PMNs. As a measure of phagocytosis the PMNs were incubated for 30 min with opsonized fluorescent (FITC) tagged yeast. Total PMN with yeast were 95.4 +/- 2.1% for control; 96.4 +/- 1.8% for circulating LPS-Rx; and 78.7 +/- 7.8% (P less than 0.05 compared to control) for BAL PMNs. Total numbers of yeast particles per 100 PMN are 270 +/- 64 for control, 300 +/- 42 for circulating LPS-Rx, and 170 +/- 45 (P less than 0.05 compared to control) for BAL PMN. CONCLUSIONS: (1) Intraalveolar (BAL) PMNs have decreased adherence; (2) nonadherent PMNs have decreased uptake of yeast; (3) BAL PMNs, overall, have a significantly decreased uptake of yeast; (4) this depression in BAL PMN phagocytosis may partially explain the known decreased rate of bacterial clearance in injured lungs and the increased risk of pulmonary sepsis with adult respiratory distress syndrome. PMID- 3283456 TI - American College of Dentists presents William John Gies Award to Dr. Frank P. Bowyer, Jr. PMID- 3283457 TI - Prognostic significance of estrogen and progesterone receptors in stage II breast cancer. AB - Estrogen (ER) and progesterone receptors (PgR) were evaluated in samples from primary tumors in 539 patients with stage II breast cancer participating in a randomized multicenter controlled clinical trial on adjuvant therapy. At the cut off points of 10 fmol ER/mg protein and 30 fmol PgR/mg protein, no significant difference in recurrence-free survival (RFS) existed between premenopausal patients with receptor-positive and negative tumors, respectively. After recurrence, premenopausal patients with receptor-positive tumors had a significant longer survival than patients with receptor-negative tumors. In postmenopausal patients not treated with adjuvant tamoxifen, no correlations between RFS and receptor status were found. Patients with ER+ tumors survived longer than patients with ER-tumors. In postmenopausal patients treated with adjuvant tamoxifen, highly significant differences in RFS and in survival were observed when receptor-positive patients were compared with receptor-negative patients. No differences in survival after recurrence were registered among these patients. PMID- 3283458 TI - Papillary-cystic neoplasm of the pancreas. AB - Papillary-cystic neoplasm of the pancreas is a rare tumor which has recently been described as a distinct, clinicopathological entity. Forty-four previously described cases from the literature and an additional 52 cases referred to in a brief abstract are reviewed. An additional case occurring in a 25-year-old woman is reported. This tumor occurs primarily in young women (mean age 23.3 years) and presents as a large abdominal mass (mean size 10.3 cm) in 63% of patients. Treatment is surgical resection of the involved portions of the pancreas and results of treatment are excellent following this form of therapy alone. The tumor appears to represent a low-grade malignancy, possibly of ductal cell origin. Only two patients with recurrences and two patients with metastatic disease have been reported. Surgeons should be aware of this curable pancreatic malignancy as they are most often responsible for the evaluation and treatment of the patient presenting with a large abdominal mass. PMID- 3283459 TI - 17th annual UCLA symposium. Abstracts: Cellular proteases and control mechanisms. PMID- 3283460 TI - Improving myocardial metabolic and functional recovery after cardioplegic arrest. AB - The myocardial oxidation of fatty acids and glucose, the predominant substrates for aerobic metabolism, is impaired after cardioplegic arrest for coronary revascularization. Because lactate can be readily metabolized to pyruvate, it may be the preferred substrate for aerobic metabolism after cardioplegic arrest when arterial concentrations are elevated. Nineteen patients undergoing elective coronary revascularization with blood cardioplegia were randomized to receive LOW (nine patients, no exogenous lactate) or HIGH (10 patients, a perioperative infusion of Ringer's lactate) arterial lactate concentrations. Coronary sinus catheterization and lactate labeled with carbon 14 permitted calculation of myocardial oxygen consumption and lactate oxidation which were significantly increased during reperfusion in the group with HIGH arterial lactate concentrations. Atrial pacing at 110 beats/min on cardiopulmonary bypass resulted in myocardial lactate production (suggesting ischemic anaerobic metabolism) in the LOW lactate group, but atrial pacing increased lactate consumption and oxidation in the HIGH lactate group (suggesting increased aerobic metabolism). Systolic function (the relation between end-systolic pressure and volume) as assessed by nuclear ventriculography 3 hours postoperatively was significantly better (p less than 0.05 by analysis of covariance) in the HIGH lactate group. Postoperative myocardial creatine kinase release was significantly lower in the HIGH lactate group, which suggested less perioperative ischemic injury. Lactate was the preferred substrate for myocardial oxidative metabolism after cardioplegic arrest, and the higher arterial lactate concentrations improved myocardial metabolic and functional recovery and reduced perioperative ischemic injury. PMID- 3283461 TI - Effects of cardiopulmonary bypass on eicosanoid metabolism during pediatric cardiovascular surgery. AB - Cardiopulmonary bypass in children with congenital heart disease is associated with significant morbidity manifested by increased complement degradation products, heightened pulmonary vascular activity, and coagulopathy. In adults with cardiac disease, the prostaglandins (eicosanoids) have been shown to contribute to the pathophysiologic response to extracorporeal circulation. This study assessed the effect of cardiopulmonary bypass in infants and children on two potent eicosanoids: thromboxane, a vasoconstrictor and platelet aggregating agent, and prostacyclin, a vasodilator and platelet disaggregating agent. The biochemical profiles of thromboxane and prostacyclin were evaluated in temporal relationship to selected parameters of platelet loss and pulmonary vascular hemodynamics during and after cardiopulmonary bypass. Twenty-one children, aged 3 days to 9 years, with congenital heart defects who were undergoing repair with cardiopulmonary bypass were studied. Nine pediatric patients undergoing palliative heart operations with no cardiopulmonary bypass served as the control group. In the group having cardiopulmonary bypass, the thromboxane concentration significantly increased during bypass (195 +/- 10 to 910 +/- 240 pg/ml, +/- standard error of the mean, p less than 0.005), whereas the control group demonstrated no significant change in thromboxane concentration. The highest thromboxane values were seen in the youngest patients (p less than 0.002). There was no significant correlation between thromboxane changes with alterations in pulmonary vascular resistance, platelet loss, duration of cardiopulmonary bypass or aortic cross-clamping. Prostacyclin levels rose significantly in both the bypass group (100 +/- 20 to 570 +/- 80 pg/ml, p less than 0.01) and in the control group (109 +/- 44 to 589 +/- 222 pg/ml, p less than 0.01), which apparently is due to surgical manipulation of vascular endothelium. These data show that eicosanoid production is significantly altered in children during cardiopulmonary bypass. Although thromboxane, a potent vasoconstrictor, is produced in significant amounts during and after cardiopulmonary bypass, our data show that thromboxane does not directly mediate changes in pulmonary artery hypertension and is not quantitatively related to platelet loss during pediatric cardiovascular operations. PMID- 3283462 TI - Surgical treatment for aneurysm of aberrant subclavian artery based on a case report and a review of the literature. AB - Experiences with the recent successful treatment of a patient with an aneurysm arising from an aberrant subclavian artery are described. The reported experiences with surgical treatment by others were reviewed in detail: Only 16 such patients were found, with a surprising frequency of serious complications. These data led to the conclusion that a two-stage approach, through right cervical and left thoracotomy incisions, seems to offer the ideal method of treatment for this unusual problem. PMID- 3283463 TI - Composite graft replacement of the ascending aorta and aortic valve. Late follow up with intra-arterial digital subtraction angiography. AB - Between 1979 and 1986, 30 patients underwent replacement of the aortic valve and ascending aorta by a composite graft, with aortic wrapping of the graft. Thirteen patients had annuloaortic ectasia; six had DeBakey type I dissection (five acute, one chronic); three had DeBakey type II dissection (one acute, two chronic); three had left ventricular-aortic discontinuity caused by prosthetic valve endocarditis; three had sinus of Valsalva aneurysms after previous aortic valve procedures; and two had atherosclerotic aneurysms. Three patients died (10%). The mean duration of follow-up was 54 months. Fifteen patients consented to be restudied by intra-arterial digital subtraction angiography; studies were performed 6 to 58 months (mean 25 months) after composite graft replacement. Two patients had pseudoaneurysms at the right coronary anastomosis, which were repaired successfully. One patient showed persistent dissection beyond the distal aortic anastomosis; no reoperation has been done. One patient had pulmonary edema. Emergency study and reoperation showed disruption of the proximal aortic anastomosis and right coronary anastomosis. Anastomotic dehiscence after composite graft replacement is potentially lethal. Follow-up by means of intra arterial digital subtraction angiography is simple and highly accurate. We suggest that dehiscences may occur early in the postoperative period and that restudy may be appropriate within a few months after operation. PMID- 3283464 TI - The Carrel-Guthrie distinction. PMID- 3283465 TI - A simple and rapid method for the production of cholera B-chain coupled to horseradish peroxidase for neuronal tracing. AB - A simple and rapid method is described for the production of cholera B-chain coupled to horseradish peroxidase suitable for neuronal tracing. Horseradish peroxidase was activated with a mild sodium periodate oxidation followed by incubation with the cholera B-chain, to yield the conjugates, samples of which were fractionated further by size exclusion chromatography. Both fractionated material and unfractionated conjugates were tested in vitro by a binding assay on rat synaptic membranes, and in vivo by their ability to undergo retrograde transport following injection into the adrenal medulla of rats. These assays showed that the unfractionated conjugates were equivalent to the fractionated conjugates in binding to the rat synaptic membranes, and that they both provided good retrograde labelling of neurones in the spinal cord after injection into the adrenal medulla, with extensive labelling of the distal dendrites. PMID- 3283467 TI - Effect of lymphokine treatment on the invasion of cultured animal cells by Eimeria tenella. AB - Cultured animal cells were pretreated with crude cytokines from E. tenella-immune chicken spleen cells to determine whether the invasion of these cells by sporozoites of E. tenella could be affected. Treatment of both primary chicken kidney (CK) cells and the established Madin-Darby bovine kidney cell line (MDBK) with the crude avian cytokines caused an increased invasion of the cultures by the parasite. Apparently, the cytokine treatment of the cells increased the susceptibility or sensitivity of the host cells to invasion as evidenced by the increased number of the total cells infected and not by an increased number of sporozoites/infected cell. This increased host cell susceptibility to infection induced by the crude avian cytokines was: (a) dose-dependent; (b) non-host species specific, since it affected both avian and bovine cells; and (c) non parasite species specific, since cytokines from E. tenella and E. maxima-immune chicken spleen cells and E. nieschulzi-immune rat spleen cells also increased the invasion of the CK and MDBK cells by E. tenella. However, treatment of MDBK cells with lymphokines induced from purified E. tenella-immune splenic T lymphocytes inhibited the invasion of the cells by E.tenella sporozoites. Therefore, the increased susceptibility of the host cells is caused by a B cell-or macrophage mediated factor. Although the identity of the factor or factor(s) is unknown, this in vitro-lymphokine-E.tenella system should provide an excellent model to aid in the identification of cellular binding sites and/or penetration mechanisms for cellular invasion by the Eimeria. PMID- 3283466 TI - Studies on leukocyte migration inhibitory factor (LIF) produced by activated T and B cells. AB - Human T and B cells produce leukocyte migration inhibitory factor (T-LIF and B LIF, resp.). Some properties of T-LIF and B-LIF were compared in this study. T cells were activated by PHA or by a synthetic peptide, representing the Epstein Barr virus (EBV) nuclear antigen, EBNA1, B cells were exposed to polyclonal activators, anti-IgM or EBV. The kinetic profile of T-LIF and B-LIF released into the culture supernatants from 6 hrs until 24 hrs after activation was identical and termed "peak 2". B cells, in addition, released LIF activity after 30-60 min ("peak 1"). Molecular weight determinations by HPLC gel filtration showed that both peaks contained activity in fractions around 70 Kd. B-LIF also showed a lower molecular weight activity peak. T-LIF and B-LIF activity was equally abrogated with a rabbit anti- human LIF serum. Polymixin-B, a protein kinase C inhibitor and verapamil, a calcium channel-blocking drug, inhibited antigen induced T-LIF and B-LIF present in "peak 2", whereas the lysosomotropic chloroquine abrogated "peak 1" early activity. We conclude that T-LIF and B-LIF are identical or very similar molecules. B cells might store presynthetized LIF in lysosomic granulae which will be degranulated very early after activation. The second peak represents de novo LIF synthesis, that requires external calcium and intact protein kinase C activity. PMID- 3283468 TI - Intra-lymphatic administration of interleukin-2 (IL-2) in cancer patients: a pilot study. AB - Seven patients suffering from advanced metastatic tumours, unresponsive to standard therapies, were treated with 3 to 5 intra-lymphatic injections of interleukin-2 (IL-2) and IL-2-activated-peripheral blood lymphocytes (PBL). A partial (50-70%) regression was obtained in three of the patients, and complete regression in the other four. It thus seems that intra-lymphatic injections of IL 2 and PBL can be used for the treatment of certain solid tumours (e.g., hypernephroma, adenocarcinoma, seminoma, epidermoid carcinoma) without noticeable side effects. This method could advantageously replace intravenous IL-2 administration and warrants further investigation. PMID- 3283469 TI - The molecular genetics of cancer: 1988. AB - Cancer has myriad causes, but many of these may act by damaging DNA. Both dominant and recessive forms of genetic damage have been found in human cancer cells. The damage is likely to play a role in tumorigenesis, and it can therefore form the basis for new approaches to the diagnosis, prognosis, and therapy of cancer. PMID- 3283470 TI - Reply to Z. Arlin "Bone marrow transplantation for chronic myelogenous leukemia: some thoughts about future prospects". PMID- 3283471 TI - Estrogen replacement therapy: current recommendations. AB - Estrogen replacement therapy is effective for the prevention and treatment of postmenopausal osteoporosis and should be offered to all women at high risk for osteoporosis. Such therapy is particularly beneficial for prevention of spinal compression fractures; in addition, it alleviates menopausal symptoms (hot flushes, genitourinary symptoms, and changes in mood). In each patient, these benefits must be weighted against the potential risks of endometrial hyperplasia and carcinoma, breast tenderness, hypertension, vascular headaches, and the inconvenience of menstrual bleeding if the uterus is intact. The risk of endometrial cancer associated with estrogen replacement therapy can be considerably reduced by the addition of a progestin, and other side effects can be diminished or eliminated by use of the new transdermal estrogen preparations. Thus, estrogen replacement therapy should be considered in all women who have experienced natural or surgically induced menopause, and it is advisable in women who have osteoporosis or an increased risk for this disorder and no contra indications to its use. Estrogen replacement therapy should be instituted as soon after menopause as possible and seems to be well tolerated until at least 75 years of age. PMID- 3283473 TI - Anterior knee pain. AB - Anterior knee pain is a common symptom, especially in adolescence, and often no specific cause is sought or identified. Physicians who treat patients with knee pain should understand the normal anatomic features and the biomechanics of the patellofemoral joint. We review this information and discuss important aspects of the physical examination and roentgenographic evaluation in patients with anterior knee pain. Once the clinical cause of anterior knee pain has been established, directed nonoperative treatment including physical therapy should be initiated. Surgical intervention is generally reserved for patients in whom nonoperative management is unsuccessful and identifiable abnormalities exist. PMID- 3283472 TI - Striational autoantibodies: quantitative detection by enzyme immunoassay in myasthenia gravis, thymoma, and recipients of D-penicillamine or allogeneic bone marrow. AB - Striational autoantibodies (StrAb) are a useful serologic marker of thymoma in patients with myasthenia gravis (MG). We compared a standard immunofluorescence method with a new enzyme immunoassay (EIA) for detection of StrAb. Retrospective testing of 264 stored sera by the two methods yielded well-correlated results (58 sera were positive by both assays; r = 0.8). For 104 patients with spontaneously acquired MG or thymoma, results were 100% concordant, of which 53% were positive. For 34 recipients of D-penicillamine, StrAb were found in 15% by EIA and in 6% by immunofluorescence. StrAb were detected in two of four bone marrow recipients by EIA and in one by immunofluorescence. Prospective testing of 434 fresh sera (of which 49 were positive by the two methods) yielded discordant results in only 4. Serial EIA quantitation of StrAb in two patients with MG and thymoma proved useful in monitoring immunosuppressant therapy and in a third patient predicted recurrence of the tumor. A high prevalence of StrAb was detected by both assays in elderly patients with spontaneous MG, but StrAb were more readily quantifiable by EIA. The EIA method proved to be highly sensitive and specific for detecting StrAb in patients with thymoma with and without MG, in patients treated with D penicillamine, and in those with graft-versus-host disease after bone marrow transplantation. PMID- 3283474 TI - Camille Flammarion--astronomer and science writer. PMID- 3283475 TI - In memoriam Alvin B. Hayles, M.D. (1915-1988). PMID- 3283476 TI - [Obstructive apnea syndrome during sleep: a treatment trial of continuous positive airway pressure]. PMID- 3283477 TI - [Arterial hypertension in the elderly. An open subject]. PMID- 3283478 TI - [Biliary lithiasis: the conceptual evolution and the therapeutic revolution]. PMID- 3283479 TI - Comparison of ciprofloxacin assays. AB - Two high pressure liquid chromatography methods developed independently and two different microbiological methods assayed samples containing ciprofloxacin derived from four volunteers: 46 sera, 19 saliva and 27 urine specimens. Each subject had received 500 mg of ciprofloxacin by mouth, with the samples collected in the ensuing six hours. Fifteen mock unknowns, prepared by adding known amounts of ciprofloxacin to normal human serum, were also assayed by the four procedures. The limits of sensitivity of the HPLC assays were less than 0.01 microgram/ml; the sensitivity limits of the bioassay were 0.02 microgram/ml (disc method) and 0.06 microgram/ml (well method). The inter-assay data was analyzed by linear regression. Ciprofloxacin concentrations in serum samples correlated well (R = 0.90) with all methods. Values obtained with urine samples also correlated well (R greater than or equal to 0.80). We conclude that either microbiological assay or quantitation by HPLC is satisfactory for quantitation of ciprofloxacin. PMID- 3283480 TI - Screening and evaluation of anticancer agents. AB - The screening and evaluation procedures for the development of anticancer agents indicated that the entire process is a rather difficult task. This is particularly true in choosing screening models and criteria for activity. If the criteria were set too low, then some clinically false-positive results may be faced; and if the criteria were set too high, some agents could be missed which might be effective against certain types of human cancer. Presently, active compounds are selected by prescreening and screening against transplanted mouse tumors and human tumor xenografts as well as by the in vitro systems. Xenografts of human tumor in athymic nude animals represent metabolic characteristics of human malignant disease which appear to be of value in the preclinical screening. Human tumor cloning assays have gained increased attention as a promising in vitro test system for the screening as well as for the prediction of patient responses. Application of chemosensitivity tests in the prediction of the responses of individuals to chemotherapy, especially in the identification of drug resistant tumors are, in general, quite reliable. Human tumor xenografts, human tumor cloning assays and chemosensitivity tests may be regarded as the major impetus in screening during the past decade. After promising agents are selected from the screening procedures, before the filing of an investigational new drug application, the preclinical toxicology and pharmacology should be completed. Information on the nature of toxicity, dose-response effects, and dose schedule are necessary for predicting the effects of the drug in man. The new drugs then go through three phases of clinical trials to assure safety, effectiveness, and reliability of the drugs. During the past fifteen years eight three antineoplastic drugs were evaluated clinically under the NCI sponsorship and twenty-four are active in at least one disease. Among these active drugs, eleven possess novel clinical structure, the remaining thirteen are analogues of known active compounds already in clinical trials. After an investigational anticancer drug is approved by the U.S. Food and Drug Administration it becomes a commercial product on the market and the benefits can be shared by the general public. The time required for evaluation and development from the first discovery of activity to final FDA approval for fifty-two therapeutic drugs are tabled. The average interval is 8.8 years, but in the 1950s the average was only 2.8 years, in the 1960s, 6.5 years; in the 1970s, 13.9 years; and in the 1980s, 16.0 years. This reflects the increasing stricter requirements for an antineoplastic drug to be officially recognize PMID- 3283481 TI - [Swedish heart transplantation patients--background, choice, long-term results]. PMID- 3283483 TI - [Orthopedics and language--a history of deformities]. PMID- 3283482 TI - [Intravenous administration of antibiotics at home in patients with cystic fibrosis improves quality of life]. PMID- 3283484 TI - A hemostatic device for endoscopic surgery. PMID- 3283485 TI - [The effect of low doses of ionizing radiation on living organisms with special emphasis on evaluating the risk of these doses]. PMID- 3283486 TI - [Development of pediatric and child health care in Croatia up to 1960]. PMID- 3283487 TI - [The effect of anticoagulant therapy in patients with congestive cardiomyopathy]. PMID- 3283489 TI - Diagnosis of cholestasis: an analytic view. AB - The authors analyzed two invasive procedures used to visualize the biliary tree, endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC), and also explored the utility of preinvasive workups for patients with suspected cholestasis. For this analysis they used published ranges for success, fatality, complications, diagnostic accuracies of the procedures, and prognostic information about the underlying diseases. The choice between ERCP and PTC was found to be a "close call," but ERCP was generally favored as the first-choice procedure. The results suggest that noninvasive imaging does not help decide between ERCP and PTC. Although noninvasive imaging may identify those patients with common duct dilation, the higher success rate with PTC in these patients is offset by a slightly higher mortality rate. Consequently, the choice between ERCP and PTC remains close even if ultrasound has shown that biliary ducts are dilated. Furthermore, it is shown that these noninvasive tests are most useful when they can conclusively determine the presence or absence of biliary obstruction. For many patients, noninvasive imaging will not obviate the need for invasive tests. PMID- 3283488 TI - Characterization and possible opioid modulation of N-methyl-D-aspartic acid induced increases in serum luteinizing hormone levels in the developing male rat. AB - It has been previously reported that the excitatory amino acid, N-methyl-D aspartic acid (NMDA), elicits prompt increases in serum luteinizing hormone (LH) levels in young male rats. The present studies were carried out to determine whether the effects of NMDA on LH were mediated by the release of LHRH from the hypothalamus. We also examined whether NMDA-sensitive neuronal pathways interacted with the endogenous opioid system regulating LHRH release and the ontogeny of NMDA-evoked increases in serum LH. We found that the age-response curve for NMDA-induced increases in LH was an inverted U; at early ages (10 and 15 days) the amino acid was marginally effective in increasing LH levels, it became maximally effective from post-natal days 20-40 and thereafter rapidly lost its efficacy such that it was virtually inactive in adult animals. Dose-response curves revealed that adult animals were more than 10-fold less sensitive to NMDA than their younger counterparts. Our studies also demonstrated that NMDA increased LH via a direct effect on the hypothalamic release of LHRH since a potent LHRH antagonist competitively inhibited the effects of NMDA. Finally, we observed that morphine competitively inhibited the effects of NMDA on LH release, suggesting a relationship between NMDA-sensitive neuronal pathways and those endogenous opioid-containing systems which are known to regulate LH release. PMID- 3283491 TI - Status of researches on medical dialectics in China. PMID- 3283490 TI - Prostatic cancer in a patient with asymptomatic HIV infection: are some lives more equal than others? PMID- 3283493 TI - Presidential address. The Society for Medical Decision Making: the right place at the right time. PMID- 3283492 TI - Interpretation of "life expectancy". PMID- 3283494 TI - Patient management problems: heuristics and biases. PMID- 3283495 TI - How did the acute ischemic heart disease predictive instrument reduce unnecessary coronary care unit admissions? AB - The use of the acute ischemic heart disease predictive instrument reduced coronary care unit (CCU) admissions for patients without acute ischemic heart disease by 30%. One hypothesis holds that it reinforced physicians' correctly low estimates of the probability of acute ischemia, supporting a decision against CCU admission, another that it lowered physicians' over-high probability estimates for acute ischemia so that CCU admission was felt to be unnecessary. The authors asked 86 physicians to estimate the probability of acute ischemia for each of three study cases and to decide on CCU admission. For the low-probability case, the mean of physicians' probability estimates for acute ischemia was 46%, vs. the predictive instrument's calculated probability of 19% (p less than 0.00001), a 142% over-estimation by the physicians. For the medium-probability case, the mean of physicians' estimates was 54%, vs. the calculated probability of 58% (not significant). For the high-probability case, the mean of physicians' estimates was 82%, vs. the calculated probability of 78% (not significant). All cases for which physicians considered not admitting to the CCU corresponded to their probability estimates of acute ischemia's being in a threshold range of approximately 10 to 30%. These results support the hypothesis that the mechanism by which the predictive instrument reduces unnecessary CCU admissions is by downward correction of physicians' overly-high suspicions of acute cardiac ischemia into a threshold range for which CCU admission is considered unnecessary. PMID- 3283497 TI - Prolog: a language for programming medical logic. PMID- 3283496 TI - To biopsy or not to biopsy in suspected herpes simplex encephalitis: a quantitative analysis. AB - The authors performed a decision analysis to determine whether a patient suspected to have herpes simplex encephalitis (HSE) should undergo a brain biopsy or be treated empirically with medical therapy. In most cases, empiric treatment with acyclovir would be slightly favored; brain biopsy was not essential in management. However, brain biopsy was found useful for patients who had low CSF glucose at the time of initial lumbar puncture; such patients may have a very high risk to have other treatable conditions such as tuberculosis, brain abscess, toxoplasmosis, or cryptococcosis. The results of the analysis suggest that even with the advent of safe antiviral drug therapy such as acyclovir, brain biopsy is useful in a well-defined subset of patients with possible HSE. The rationale, however, is not to confirm HSE but rather to detect other treatable conditions. PMID- 3283498 TI - [Air microturbines for use in oral medicine]. AB - Different design principles of turbine stomatological air tips, their advantages and shortcomings are described. The development of microturbines is analysed. Main approaches to their perfection are considered. The necessity to develop a joint comprehensive theory is emphasized. PMID- 3283500 TI - Dr. Fuszner keeps his dental office on track. PMID- 3283499 TI - Optimization of MR protocols: a statistical decision analysis approach. AB - A new method of optimizing MRI data acquisition protocols is presented. Tissues are modeled with probability density functions (PDFs) of tissue parameter values (such as T1, T2). The imaging data acquisition process is modeled as a mapping from a tissue parameter space to a signal strength space. Tissue parameter PDFs are mapped to signal strength PDFs for each tissue in a clinical problem. The efficacy of an MRI protocol is evaluated using the methods of statistical decision analysis applied to the signal strength PDFs, including the propagation of noise. This procedure evaluates the ability to discriminate different tissues based on the signal strengths produced with the protocol. The model can incorporate an arbitrary number of tissues, parameters, and pulse sequences in the protocol. The multivariate nature of MRI and the observed broad distribution of tissue parameter values makes this model more appropriate for optimizing data acquisition protocols than methods which maximize the signal-difference-to-noise ratio between discrete values of the tissue parameters. It is shown that these two methods may calculate different optimal protocols. The method can be used to optimize data acquisition for quantitative computer-based tissue classification, as well as imaging. Data acquisition and image processing philosophies are discussed in light of the method. PMID- 3283501 TI - Highlights of the 1987 Omnibus Budget Reconciliation Act. PMID- 3283503 TI - Kalamazoo ophthalmologist battles Medicare woes. PMID- 3283502 TI - The future of Medicare. PMID- 3283504 TI - Renal transplantation from living donors. PMID- 3283505 TI - The living, related kidney donor: a follow-up study. AB - Thirty-eight children received 41 living-donor kidney transplants in an 11-year period; 73% of the grafts are functioning well. The parents of the recipients were the usual donors (60% of the donors were mothers and 25% of the donors were fathers); however, there were five donations from siblings and one donation from a donor who was related emotionally to the recipient. The most frequent perioperative complications were respiratory but these were not serious and did not cause any long-term sequelae. The principal long-term complications that related to--or were perceived by the donor as being related to--the procedure were incisional pain (20% of donors) and depression (25% of donors). These were not related to the success or otherwise of the transplantation. At follow-up, five (12%) donors had diastolic blood pressure levels of greater than 90 mmHg or were receiving antihypertensive therapy; this prevalence is similar to that which is found in the community. Two donors had urinary protein excretion rates of greater than 200 mg/24 h (210 mg/24 h and 350 mg/24 h, respectively). Creatinine clearance rates fell by 15% in women and by 5% in men. Serum creatinine levels had risen by 40% in men and by 35% in women after the nephrectomy; these levels had changed little at follow-up. All donors said that they would have proceeded with the donation even with fore-knowledge of what they would experience during and after the donation. Living-donor renal transplantation is a procedure with very low but definite operative risks which nevertheless provides a means for the early effective replacement of renal function in children with growth potential. The donors are enabled to make a major contribution to the life and well-being of the child, and they regard the perioperative complications as minimal. There do not appear to be any serious long-term complications of renal donation. PMID- 3283506 TI - Diagnosis of skin cancer in the general population: clinical accuracy in the Nambour survey. AB - The accuracy and validity of diagnoses of skin cancer that were made by experienced dermatologists in a Queensland community survey have been investigated. Histological examination confirmed 54% of 100 clinical diagnoses of basal-cell carcinoma, squamous-cell carcinoma or intraepidermal carcinoma. Clinical accuracy was higher for basal-cell carcinoma (59%) than for squamous cell carcinoma (39%) or intraepidermal carcinoma (38%). Such levels of diagnostic accuracy are to be expected when an unselected population is surveyed because of the relatively low prevalence of skin cancer compared with that in the patient population of a specialist practice. This reduction in diagnostic accuracy is unrelated to clinical skills, and should be borne in mind when conducting any skin-cancer screening programme in the general community. PMID- 3283507 TI - Brain resuscitation and protection. AB - No drug that is used for brain protection after global brain ischaemia as a result of cardiac arrest has been shown to be of benefit. Barbiturate agents have been proved not to be beneficial whereas studies of calcium-channel blocking drugs are inconclusive. Hypothermia, haemodilution and mechanical hyperventilation are not of proven benefit. Immediate defibrillation with rapid restoration of blood pressure is the best method to improve the neurological outcome after a cardiac arrest. After severe head injury, prompt emergency care to restore ventilation, oxygenation and blood pressure improves the neurological outcome. The early evacuation of extracerebral intracranial haematomas also improves the outcome. Corticosteroid therapy does not improve the outcome. The monitoring of intracranial pressure and the control of increased intracranial pressure by hyperventilation, cerebrospinal-fluid drainage and mannitol, frusemide and barbiturate therapy appear to improve the outcome after a severe head injury, although this has not been proved by randomized controlled studies. PMID- 3283508 TI - Mesalamine for ulcerative colitis. PMID- 3283509 TI - The microscopic double immunofluorescence technique, a method for quantitative differentiation between extra- and intracellularly located bacteria in isolated polymorphonuclear granulocytes. AB - A simple microscopic double immunofluorescence staining technique for the study of phagocytosis of living bacteria by human polymorphonuclear granulocytes (PMN) is presented. This technique enables the differentiation between cell-attached and ingested bacteria and allows the kinetics of phagocytosis to be monitored. The practicability and accuracy of this method is demonstrated by using two genetically defined Yersinia enterocolitica strains of different virulence, and isolated PMN resuspended in serum-free and serum-containing medium, respectively. The advantages of this method over other techniques are discussed. PMID- 3283510 TI - [Bacterial spondylitis]. PMID- 3283511 TI - [Dental pathology and sugar]. PMID- 3283512 TI - [Odontokeratoprosthesis. The dental aspects]. PMID- 3283513 TI - [The Dental Clinic of the University of Turin (1912-1987)]. PMID- 3283514 TI - [Healing of radicular cysts by root canal therapy alone. 3]. PMID- 3283515 TI - [A very rare case of a long-term neurilemmoma of the oral cavity]. PMID- 3283516 TI - Immunoassays for IgG subclasses: quantitative and methodologic considerations. AB - In summary I have tried to provide my own statement of the status quo in current efforts to develop quantitative and reliable immunoassays for IgG subclass proteins and antibodies. Some of the trends I have commented upon are summarized in Table III. First, monoclonal antibodies have clearly won the day for almost all IgG subclass work. Second, solid phase immunoassays are almost indispensable for most IgG subclass antibody assays in order to circumvent the problem of subclass antibody competitions for soluble antigen. Third, the "captured" antigen or antibody by insolubilized antisera has a number of demonstrated advantages over passive adsorption or covalent linkage, in terms of assay parallelism, sensitivity, and specificity. Fourth, subclass immune responses can only be compared directly if serum dilution curves are parallel. More attention is needed for further technical refinements to achieve this important goal. Finally, the value of absolute quantitation, that is specification of nominal value in terms of weight/volume units, is an important ultimate goal. Among the feasible approaches to this problem are solid phase elution techniques, myeloma protein based quantitation, and by comparison to a single allergen system where nominal values can be established by conventional techniques. We have come a long way since IgG subclasses were first recognized more than 25 years ago. We are not in a phase of rapid expansion of techniques which seek to quantify IgG subclass immune responses. Much work remains to be done, but the tools for ultimate success are, I believe, within our grasp. PMID- 3283517 TI - [Intraoperative ultrasound imaging and its application to cardiovascular operations]. AB - Intraoperative ultrasound imaging was employed for qualitative and quantitative studies during cardiovascular operations in 36 patients. A 7.5M Hz high frequency ultrasound scanner was used to image. The ultrasound probe was sterilized by gas and placed directly on the heart by the hand of surgeon. On the clinical application, 10 cases of patients with coronary artery disease were scanned. Left main trunk and proximal portion of other three branches were visualized and pathological lesions were demonstrated clearly. Four cases of myocardial bridging were observed. Intramyocardial coronary arteries were easily detected and supraarterial myotomy was performed safely. Four cases of valvular disease were examined. We could evaluate valvular anatomy and physiologic aspects of valvular disease and 15 cases of aortic root disease were examined intraoperatively. In aortic root dissection, the size and site of the true and false lumens were clearly demonstrated in all patients. In conclusion intraoperative ultra-sound imaging is a versatile technique with quantitative and qualitative studies of cardiovascular surgery during operation and the perioperative period. PMID- 3283518 TI - [Pseudocoarctation of the aorta associated with aortic arch aneurysm--a case report]. AB - A twenty-nine-year old female was diagnosed as the associated aortic arch aneurysm 14 years after the initial diagnosis of the pseudocoarctation of the aorta. The aneurysm was asymptomatic and aortogram revealed that it was located just proximal to the pseudocoarctation. The aneurysmal wall was so thin that intraluminal blood stream could be visible easily during operation. Aneurysmectomy and Dacron graft implantation was successfully performed with temporary bypass procedure. In most of the cases, pseudocoarctation of the aorta has been reported to be a congenital entity without indication for any surgical intervention. However some cases in the literature were combined with formation of the aneurysm during the long term follow-up period. Careful observation must be needed for a case of pseudocoarctation of the aorta and the associated aneurysm should be treated surgically even if asymptomatic. PMID- 3283519 TI - [A case report of hemosuccus pancreaticus caused by a ruptured splenic aneurysm]. AB - A 65-year-old female with hematemesis due to hemosuccus pancreaticus observed by endoscopy was reported. Selective angiography demonstrated 4 aneurysms of the splenic artery ramificated from the superior mesenteric artery (SMA). Of these 4 aneurysms, the largest one was located at 5mm distal from the SMA ruptured into the pancreatic duct. Resection of the splenic aneurysms, splenectomy and cholecystectomy for concomitant gallstone were successfully performed and the patient had no further gastrointestinal bleeding. True aneurysms with marked arteriosclerosis were confirmed histopathologically. Of 48 cases of hemosuccus pancreaticus reported in the literature, 15 cases caused by ruptured true aneurysms were reviewed. Pathogenesis, diagnosis and surgical procedure for this rare syndrome were discussed. PMID- 3283520 TI - [A case of rupture of a posterior pancreaticoduodenal artery aneurysm]. AB - A 75 year old man complaining of right upper abdominal pain was admitted to our hospital. He became shocked with hypotension and cold sweat, and immediately underwent operation. Laparotomy revealed massive hemorrhage in the retroperitoneal region, particularly in the right upper space. It was derived from the rupture of the posterior pancreaticoduodenal artery aneurysm. The arterial trunk was ligated above and below the aneurysm and the aneurysmectomy was carried out. The patient recovered and was discharged from the hospital 56 days after operation. There was no other visceral artery aneurysm and the etiology of this aneurysm was unknown. Four cases of pancreaticoduodenal artery aneurysm have been reported in Japan and three of them were operated, but this is the first surgically resected case for the rupture of pancreaticoduodenal artery aneurysm with success. PMID- 3283521 TI - [Experimental study on the pathophysiology of endotoxin shock as analysed by alterations in thromboxane B2 and 6-keto-PGF1 alpha levels]. AB - To evaluate the pathophysiological role of thromboxane A2 (TXA2) in endotoxin shock, plasma concentrations of TXA2 and PGI2 following E. coli endotoxin (ET) administration were measured in dogs and rats by radioimmunoassay of their stable metabolites TXB2 and 6-keto-PGF1 alpha, respectively. Also, the effects of TXA2 synthetase inhibitor (OKY046) on eicosanoid levels, haemodynamics and survival were assessed. The following results were obtained: 1) Survival rates of the rats given 50 mg/kg of ET were 31% at 12 hrs and 17% at 24 hrs. Pretreatment with OKY046 markedly improved the survival rates. 2) Plasma concentrations of TXB2 were rapidly elevated in untreated control dogs and rats following ET administration, whereas plasma 6-keto-PGF1 alpha levels were gradually elevated. TXB2/6-keto-PGF1 alpha ratio showed an early elevation at 15 minutes after ET administration. The ratio became lower than base line, thereafter. 3) In contrast to the controls, animals pretreated with OKY046 did not exhibit significant elevations in plasma TXB2 levels. On the other hand, plasma levels of 6-keto-PGF1 alpha were not altered by OKY046 treatment. 4) In the control dogs given ET, the early elevations in pulmonary artery pressure (PAP) and reduction in lung compliance correlated with the early elevation in plasma TXB2/6-keto-PGF1 alpha ratio. 5) In OKY046-treated dogs, the early elevation in TXB2/6-keto-PGF1 alpha ratio was not seen and PAP increase and lung compliance reduction were prevented. The results suggest that TXA2 plays an important pathophysiological role in the development of endotoxin shock. PMID- 3283523 TI - [Orthotopic liver transplantation in miniature pigs: some technical considerations in recipient]. AB - We compared temporary aortic occlusion technique (TAO) with venous bypass in anhepatic phase of the recipient in the liver transplants in miniature pig, using cuff technique in connecting the portal vein and/or the inferior vena cava. Twenty four hour survival rate after liver transplant by TAO in anhepatic phase was almost the same as that by venous bypass. There was no difference in the posttransplant changes of serum transaminase and coagulating factors between the two groups above. Profound hypotension and metabolic acidosis were encountered on the release of occluded aorta. Rapid blood transfusion and fluid infusion were necessary with the administration of bicarbonate to keep the blood pressure constant. Though we had to take special care to stabilize the general condition during the operation, the operation technique with TAO was quite simple. The hemodynamic state of the venous bypass group was also stable, but the operation was more complex and troublesome. Cuff technique was useful in connecting veins and recipients' survival rate with cuff technique was better than that with suturing method but the anastomosis by cuff technique always resulted in chronic stenosis and our new method, temporary cuff technique, was effective to prevent chronic stenosis. PMID- 3283522 TI - [Changes in carbohydrate metabolism after major resection of the pancreas, with special reference to the fibrotic pancreas caused by ligation of the pancreatic duct]. AB - Fibrotic pancreas was caused by ligation of the pancreatic ducts in mongrel dogs. Four weeks later, reconstruction of the pancreatic duct and major pancreatic resection were performed. Changes of carbohydrate metabolism and functional and morphological changes of islet cells in the remnant pancreas were investigated. 1) Immediately after resection of more than 84% of the fibrotic pancreas, diabetes developed, and insulin and glucagon secretion decreased, accompanied with marked degeneration of B, A and D cells in the islets. 2) During the early periods after 63 to 84% pancreatectomy, secretion of both insulin and glucagon decreased, and then showed a tendency to recover, but later the secretion gradually decreased again and so-called Sandmeyer's diabetes developed. The size of the islets and the number of B cells decreased, but the rate of A and D cells in the islets increased relatively in the remnant pancreas. 3) After resection of less than 63% of the fibrotic pancreas, secretion of both insulin and glucagon decreased temporarily with subsequent recovery. Diabetes did not develop. There were no marked morphological changes in the islets, nor significant changes in the distribution of B, A and D cells of the islets in the remnant pancreas. Diabetes developed after resection of more than 63% of the fibrotic pancreas 4 weeks after ligation of the pancreatic duct, while it developed after resection of more than 74% of the normal pancreas in dogs. Therefore, with regard to carbohydrate metabolism, resectability of the fibrotic pancreas was about 10% less than that of the normal pancreas in dogs. PMID- 3283524 TI - [Aorto-caval fistula due to a ruptured abdominal aortic aneurysm--an emergency operation following echoic diagnosis]. AB - A successful emergency operation for a 75-year-old man with aorto-caval fistula secondary to rupture of the abdominal aortic aneurysm is reported. A definite diagnosis of aorto-caval fistula was made by echography with characteristic engorgement of the caval vein. Clinical signs and symptoms characterized by lung edema, sudden onset, and circulatory collapse were also noticeable. In the operation, the fistula was closed via inside of the aneurysm with several mattress sutures following control of aortic flow and opening of the aneurysm. Back-flow of the blood through the fistula was readily controlled by finger tip. The aneurysm was replaced conventionally by a vascular prosthesis. There might be several suitable surgical selection available properly to individual case. No delay in surgical treatment depending on definite diagnosis by echography in such urgent condition should be stressed. PMID- 3283525 TI - Mucosal immunity--from past to present. PMID- 3283526 TI - Does complement play a role in mucosal immunity? PMID- 3283527 TI - Functional studies of Peyer's patches based on emigrant cell analysis. PMID- 3283528 TI - Neuropeptides, neurons and mucosal lymphoid cell migration. PMID- 3283529 TI - Cellular and molecular events accompanying IgA B cell differentiation. PMID- 3283530 TI - Oral tolerance. PMID- 3283531 TI - Contrasuppression and the control of microenvironmental immune responses. PMID- 3283532 TI - IgA receptors on human alveolar macrophages. PMID- 3283533 TI - Association of pathogens with the intestinal mucosa and the design of vaccines. PMID- 3283534 TI - Cell biology of the IgA receptor in polarized epithelia. PMID- 3283535 TI - Adherence, lipopolysaccharide and mucosal inflammation. PMID- 3283536 TI - Directed exocytosis in the NK-cell-mediated cytotoxicity. A review. PMID- 3283538 TI - pH induced damage and repair in E. coli. AB - Escherichia coli lost its colony-forming ability when suspended in Tris/NaOH or Tris/Mg2+ buffers of pH 10.0 and 4.0, respectively. A significant decrease in the survival of radiation-sensitive mutants recA, polA, res, rer and lexA was observed as compared to their wild-type counterpart under these conditions. The alkali-injured cells were found to recover when incubated at 37 degrees C for 2 h in 0.05 M phosphate buffer of pH 8.0, whereas no such liquid holding recovery was observed in recA and lexA mutants. Recovery in phosphate buffer was not affected by metabolic inhibitors. As a result of alkali treatment, the sensitivity of bacteria to ultraviolet light (UV) was enhanced. However, on incubation for 2 h in recovery buffer at 37 degrees C, the bacteria regained partial UV resistance. Bacteria exposed to alkaline environment exhibited an enhanced level of mutagenesis. Contrary to the treated wild-type, the mutants recA and lexA did not exhibit any increase in the mutation frequency. Alkali treatment to GC----AT transition mutants of Salmonella typhimurium, TA102 and TA104 resulted in the highest number of revertants per plate. PMID- 3283537 TI - The DNA-repair enzyme uracil-DNA glycosylase in the human hematopoietic system. AB - The expression of the DNA base-excision-repair enzyme uracil-DNA glycosylase in the human hematopoietic system followed a tightly regulated pattern: high enzyme activities were recorded in proliferating bone marrow progenitor cells and in peripheral blood T- and B-cells, both groups of cells requiring the integrity of their genetic information for their proper function. The blood quiescent immunocompetent cells retained their DNA-uracil exclusion capacity, even in the oldest age groups. Peripheral blood mature end cells, granulocytes, platelets and red cells had little activity, consistent with the fact that these cells are anuclear or short-lived, so that no template-primer functions of their DNA are required. Uracil-DNA glycosylase expression is high in all types of human leukemia, providing a selective advantage for survival of leukemic cells. Overall results show that a deficiency of this DNA base-excision-repair pathway is not likely to be an etiopathogenetic factor in the formation of non-random or other chromosomal abnormalities or in the leukemogenesis itself. PMID- 3283539 TI - Mutants of Aspergillus nidulans with increased resistance to the alkylating agent, N-methyl-N'-nitro-N-nitrosoguanidine. AB - The isolation and characterisation of mutants of Aspergillus nidulans showing resistance to MNNG is described. Such isolates were stable through prolonged subculture in the absence of the selective agent, and resistance segregated as an allele of a single gene in meiotic and mitotic analysis. MNNG-resistant strains showed an increase in resistance to EMS and UV irradiation but no cross resistance to MMS was detected. Possible mechanisms of resistance to alkylating agents are discussed. PMID- 3283540 TI - Frameshift lesions induced by oxazolopyridocarbazoles are recognized by the mismatch repair system in Escherichia coli. AB - The simple reversible intercalating agent isopropyl-OPC (iPr-OPC) induces frameshift-1 mutations in Salmonella typhimurium and Escherichia coli. The mutagenic responses of S. typhimurium and E. coli wild-type strains are not proportional to the amount of drug intercalated into double-stranded nucleic acids in living bacteria; it occurs only above a minimum level of binding. The fact that mismatch-repair-deficient (mutS) as well as adenine-methylation deficient (dam) E. coli mutants are hypermutable at low concentrations of iPr-OPC suggests that the majority of mutants induced by this intercalating drug occur as mismatch-repairable mutations (or lesions) in the newly synthesized DNA strand close to the replication fork. PMID- 3283541 TI - Genotoxicity of active oxygen species in mammalian cells. PMID- 3283542 TI - The ras gene family and human carcinogenesis. AB - It has been well established that specific alterations in members of the ras gene family, H-ras, K-ras and N-ras, can convert them into active oncogenes. These alterations are either point mutations occurring in either codon 12, 13 or 61 or, alternatively, a 5- to 50-fold amplification of the wild-type gene. Activated ras oncogenes have been found in a significant proportion of all tumors but the incidence varies considerably with the tumor type: it is relatively frequent (20 40%) in colorectal cancer and acute myeloid leukemia, but absent or present only rarely in, for example, breast tumors and stomach cancer. No correlation has been found, yet, between the presence of absence of an activated ras gene and the clinical or biological features of the malignancy. The activation of ras oncogenes is only one step in the multistep process of tumor formation. The presence of mutated ras genes in benign polyps of the colon indicates that activation can be an early event, possibly even the initiating event. However, it can also occur later in the course of carcinogenesis to initiate for instance the transition of a benign polyp of the colon into a malignant carcinoma or to convert a primary melanoma into a metastatic tumor. Apparently, the activation of ras genes is not an obligatory event but when it occurs it can contribute to both early and advanced stages of human carcinogenesis. PMID- 3283543 TI - Genotoxic properties of 1,3-butadiene. PMID- 3283544 TI - Evidence for a specific regulation of recA gene transcription in Escherichia coli. AB - The kinetics of the recA, sfiA and umuDC genes transcription were studied during a double SOS-inducing treatment in Escherichia coli cells using several strains carrying lacZ gene fusions. A transient inhibition in recA, but not in sfiA or umuDC promoted beta-galactosidase synthesis was detected after successive UV irradiations. Results obtained with a recA--lacZ fusion introduced in several DNA repair mutants demonstrated that neither a lower LexA inactivation nor a decrease in the production of the inducing signal are the events through which the successive UV-irradiation promoted the arrest of recA transcription. On the contrary, a specific UV-dose-dependent delay appears to be the reason for the inhibition of the recA gene transcription in cells irradiated twice. PMID- 3283545 TI - An uvsB mutant of Aspergillus nidulans with high variable spontaneous mutation and intergenic mitotic recombination frequencies. AB - An UV-sensitive mutant has been isolated with a new technique which allows isolation of UV-sensitive and UV-non-mutable mutants in Aspergillus nidulans. This mutant is an allele of the known uvsB gene but shows some features not previously described in the alleles so far isolated. Its more important characteristics are: (1) Frequency of mitotic intergenic recombination is strongly increased in uvs/uvs diploids and it is highly variable in different clones: it varies from a minimum of 40-fold to a maximum of about 1000-fold in comparison with uvs+/uvs+ strains. (2) The frequency of mitotic intergenic recombination is increased also in the heterozygous diploids. (3) The frequency of spontaneous mutation is higher and highly variable in different subclones: it may be increased up to 1000-fold. PMID- 3283546 TI - The chemical and enzymatic interaction of glutathione with the fungal metabolite, fusarin C. AB - Glutathione (GSH) interacts both chemically and enzymatically with fusarin C, a mutagenic metabolite produced by Fusarium moniliforme. The chemical reaction, which is pH-dependent, results in the formation of both fusarin A and a compound that lacks the 2-pyrrolidone moiety thereby suggesting an interaction at the C-13 C-14 epoxide. Enzymatic interaction of fusarin C with GSH also appears to occur at this site as fusarins A and D, which lack the epoxide, do not serve as substrates for GSH-S-transferases. The interaction of GSH with fusarin C appears to be an important deactivation step which could explain the lack of carcinogenicity observed for fusarin C in rats. PMID- 3283547 TI - CASE, the computer-automated structure evaluation method, correctly predicts the low mutagenicity for Salmonella of nitrated cyclopenta-fused polycyclic aromatic hydrocarbons. AB - Recently Goldring et al. [Mutation Res., 187 (1987) 67-77] reported the synthesis and purification of a series of nitro-substituted cyclopenta-fused polycyclic aromatic hydrocarbons. On the basis of expected charge distributions, these chemicals were predicted to be potent mutagens and, yet, contrary to expectation, they were found to be only weakly mutagenic for Salmonella. In their discussion, the authors suggest that application of CASE, an artificial intelligence system recently developed in these laboratories, would also not predict the low mutagenicity of this group of chemicals. In the present report, it is shown that CASE, in fact, correctly predicts the low mutagenicity of nitro-substituted cyclopenta-fused polycyclic aromatic hydrocarbons. PMID- 3283548 TI - Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of subcutaneous heparin. Overview of results of randomized trials in general, orthopedic, and urologic surgery. PMID- 3283549 TI - Cocaine and other stimulants. Actions, abuse, and treatment. PMID- 3283550 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 18-1988. A 30-year-old man with bilateral pulmonary consolidation and cavitation. PMID- 3283551 TI - Monoclonal gammopathies in HBsAg-positive patients with renal transplants. PMID- 3283552 TI - Impaired glucose tolerance as a disorder of insulin action. Longitudinal and cross-sectional studies in Pima Indians. AB - Impaired glucose tolerance often presages the development of non-insulin dependent diabetes mellitus. We have studied insulin action and secretion in 24 Pima Indians before and after the development of impaired glucose tolerance and in 254 other subjects representing the whole spectrum of glucose tolerance, including subjects with overt non-insulin-dependent diabetes. The transition from normal to impaired glucose tolerance was associated with a decrease in glucose uptake during hyperinsulinemia, from 0.018 to 0.016 mmol per minute (from 3.3 to 2.8 mg per kilogram of fat-free body mass per minute) (P less than 0.0003). Mean plasma insulin concentrations increased during an oral glucose-tolerance test, from 1200 to 1770 pmol per liter (from 167 to 247 microU per milliliter). In 151 subjects with normal glucose tolerance, the insulin concentration measured during an oral glucose-tolerance test correlated with the plasma glucose concentration (r = 0.48, P less than or equal to 0.0001). This relation was used to predict an insulin concentration of 1550 pmol per liter (216 microU per milliliter) in subjects with impaired glucose tolerance (actual value, 1590 pmol per liter [222 microU per milliliter]; P not significant), suggesting that these subjects had normal secretion of insulin. In contrast, plasma insulin concentrations in the diabetics decreased as glucose concentrations increased (r = -0.75, P less than or equal to 0.0001), suggesting deficient secretion of insulin. This relative insulin deficiency first appears at the lower end of the second (diabetic) mode seen in population frequency distributions of plasma glucose concentrations. Our data show that impaired glucose tolerance in our study population is primarily due to impaired insulin action. In patients with non-insulin-dependent diabetes mellitus, by contrast, impaired insulin action and insulin secretory failure are both present. PMID- 3283553 TI - Impaired pulsatile secretion of insulin in relatives of patients with non-insulin dependent diabetes. AB - In fasting nondiabetic subjects, insulin is secreted in regular pulses every 12 to 15 minutes, but patients with non-insulin-dependent diabetes lack regular oscillatory insulin secretion. To investigate whether abnormal insulin oscillations are an early feature of diabetes, we studied 10 minimally glucose intolerant first-degree relatives of patients with non-insulin-dependent diabetes and 10 controls matched for age and obesity. We performed a time-series analysis of fasting plasma insulin levels in blood samples obtained at 1-minute intervals for 150 minutes. Fasting plasma glucose levels were higher in the relatives than in the controls (mean +/- SD, 5.4 +/- 0.7 vs. 4.4 +/- 0.3 mmol per liter). Autocorrelation of pooled data showed no regular oscillatory activity in the relatives but a 13-minute cycle in the controls (r = 0.23, P less than 0.001). Similarly, Fourier transform analysis showed no significant peak in the relatives but the expected significant peak at 13 to 14 minutes in the controls (P less than 0.05). First-phase (0 to 10 minutes) insulin secretory responses to glucose administered intravenously were not significantly impaired in the relatives (geometric mean, 188 pmol per liter [26.2 mU per liter]; range of SD, +103 to -67 pmol per liter [+14.4 to -9.3 mU per liter]), as compared with the controls (geometric mean, 231 pmol per liter [32.2 mU per liter]; range of SD, +131 to -83 pmol per liter [+18.2 to -11.6 mU per liter]). We conclude that abnormal oscillatory insulin secretion may be an early phenomenon in the development of non-insulin-dependent diabetes. PMID- 3283554 TI - Abnormal patterns of insulin secretion in non-insulin-dependent diabetes mellitus. AB - To determine whether non-insulin-dependent diabetes is associated with specific alterations in the pattern of insulin secretion, we studied 16 patients with untreated diabetes and 14 matched controls. The rates of insulin secretion were calculated from measurements of peripheral C-peptide in blood samples taken at 15 to 20-minute intervals during a 24-hour period in which the subjects ate three mixed meals. Incremental responses of insulin secretion to meals were significantly lower in the diabetic patients (P less than 0.005), and the increases and decreases in insulin secretion after meals were more sluggish. These disruptions in secretory response were more marked after dinner than after breakfast, and a clear secretory response to dinner often could not be identified. Both the control and diabetic subjects secreted insulin in a series of discrete pulses. In the controls, a total of seven to eight pulses were identified in the period from 9 a.m. to 11 p.m., including the three post-meal periods (an average frequency of one pulse per 105 to 120 minutes), and two to four pulses were identified in the remaining 10 hours. The number of pulses in the patients and controls did not differ significantly. However, in the patients, the pulses after meals had a smaller amplitude (P less than 0.03) and were less frequently concomitant with a glucose pulse (54.7 +/- 4.9 vs. 82.2 +/- 5.0, P less than 0.001). Pulses also appeared less regularly in the patients. During glucose clamping to produce hyperglycemia (glucose level, 16.7 mmol per liter [300 mg per deciliter]), the diabetic subjects secreted, on the average, 70 percent less insulin than matched controls (P less than 0.001). These data suggest that profound alterations in the amount and temporal organization of stimulated insulin secretion may be important in the pathophysiology of beta-cell dysfunction in diabetes. PMID- 3283555 TI - Protection by milk immunoglobulin concentrate against oral challenge with enterotoxigenic Escherichia coli. AB - Enterotoxigenic Escherichia coli is a common cause of traveler's diarrhea. Prophylaxis against traveler's diarrhea has been associated with side effects from bismuth subsalicylate and the development of resistance to antimicrobial agents. We undertook a double-blind controlled trial in which a bovine milk immunoglobulin concentrate with high titers of antibodies against enterotoxigenic E. coli was used as prophylaxis against E. coli challenge in volunteers. Lyophilized milk immunoglobulins were prepared from the colostrum of cows immunized with several enterotoxigenic E. coli serotypes and fimbria types, E. coli heat-labile enterotoxin, and cholera toxin. As a control, an immunoglobulin concentrate with no anti-E. coli activity was prepared. Ten volunteers received buffered immunoglobulin concentrate against enterotoxigenic E. coli, and 10 received the control immunoglobulin concentrate, dissolved in water, three times a day. No side effects were observed. On the third day of immunoglobulin prophylaxis, the volunteers were given 10(9) colony-forming units of enterotoxigenic E. coli H10407 (O78:H11). This strain produces colonization factor antigen I and heat-labile and heat-stable enterotoxins. None of the 10 volunteers receiving the immunoglobulin concentrate against E. coli had diarrhea, but 9 of the 10 controls did (P less than 0.0001). All volunteers excreted E. coli H10407. We conclude from these preliminary results that milk immunoglobulin concentrate may be an effective prophylaxis against traveler's diarrhea. PMID- 3283556 TI - Beta-cell deficiency, insulin resistance, or both? PMID- 3283557 TI - The benefit of exchanging donor kidneys among transplant centers. AB - Whether kidneys from cadaver donors should be exchanged among transplant centers is controversial. We analyzed the effect of matching for HLA-B and HLA-DR antigens on graft survival in patients treated with cyclosporine. The results in 9369 recipients of kidneys obtained and transplanted in the same center were compared with those in 5553 recipients of kidneys shipped from one center to another. In both patient subgroups, the association of HLA matching with graft survival was statistically significant (P less than 0.0001). Moreover, well matched exchanged kidneys survived better than poorly matched locally transplanted kidneys. Among patients receiving their first cadaver transplant, graft survival at one year was 13 percentage points higher (P less than 0.0001) in exchanged kidneys without mismatches than in local kidneys with four mismatches. Among patients receiving their second transplant, graft survival was 21 percentage points higher (P less than 0.001). Kidney preservation for up to 48 hours did not affect graft survival significantly. Transplantation of poorly matched local kidneys preserved with a short period of cold ischemia (less than 24 hours) had significantly lower rates of success than did transplantation of well-matched exchanged kidneys with a longer period of cold ischemia (up to 48 hours) (P less than 0.0001). Our data indicate that the exchange of cadaver kidneys among transplant centers to obtain grafts with better HLA matching can improve the success rate of renal transplantation. PMID- 3283558 TI - Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. PMID- 3283559 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 20-1988. A 10-year-old boy with papilledema after treatment for otitis externa and tonsillitis. PMID- 3283561 TI - Insulin-gene regulation. PMID- 3283560 TI - Optimal use of organs for transplantation. PMID- 3283562 TI - Primitive ancestry of transfer RNA. PMID- 3283564 TI - Intraorganellar calcium and pH control proinsulin cleavage in the pancreatic beta cell via two distinct site-specific endopeptidases. AB - Insulin is produced from an inactive precursor, proinsulin, through initial endoproteolytic cleavage at sites marked by pairs of basic amino-acid residues. We report here that lysates of insulin secretory granules contain two distinct Ca dependent acidic endoproteases; one (type I) cleaving exclusively on the C terminal side of Arg 31.Arg 32 (B-chain/C-peptide junction), the other (type II) preferentially on the C-terminal side of Lys 64.Arg 65 of proinsulin (C-peptide/A chain junction). The Ca and pH requirements of these proteinases suggested that the type-II proteinase would be active in the Golgi apparatus and the secretory granule, whereas type-I activity would be compatible only with the intragranular environment. Kinetic analyses of (pro)insulin conversion intermediates in [35S]methionine-pulsed rat islets support this supposition. Our results suggest a simple mechanism whereby different dibasic sites can be cleaved in different cellular compartments. In conjunction with the regulation of the ionic composition of such compartments and the operation of post-Golgi segregation, our results also suggest how proteolytic conversion of diverse proproteins destined for different cellular sites can occur differentially and in a regulated manner. PMID- 3283563 TI - A vaccine candidate from the sexual stage of human malaria that contains EGF-like domains. AB - Malaria vaccines are being developed against different stages in the parasite's life cycle, each increasing the opportunity to control malaria in its diverse settings. Sporozoite vaccines are designed to prevent mosquito-induced infection; first generation recombinant or synthetic peptide vaccines have been tested in humans. Asexual erythrocytic stage vaccines, developed to prevent or reduce the severity of disease, have been tested in animals and in humans. A third strategy is to produce sexual stage vaccines that would induce antibodies which would prevent infection of mosquitoes when ingested in a bloodmeal containing sexual stage parasites. Although not directly protective, the sexual stage vaccine combined with a sporozoite or asexual stage vaccine (protective component) could prolong the useful life of the protective component by reducing transmission of resistant vaccine-induced mutants. In areas of low endemnicity, the sexual stage vaccine could reduce transmission below the critical threshold required to maintain the infected population, thereby assisting in the control or eradication of malaria. Transmission of Plasmodium falciparum, the major human malaria, can be blocked by monoclonal antibodies against three sexual stage-specific antigens. We have cloned the gene encoding the surface protein of relative molecular mass Mr 25,000 (25K; Pfs25), expressed on zygotes and ookinetes of P. falciparum. The deduced amino-acid sequence consists of a signal sequence, a hydrophobic C terminus, and four tandem epidermal growth factor EGF-like domains. PMID- 3283565 TI - [Cyclosporin as a possible new therapy in severe psoriasis]. PMID- 3283567 TI - [The value of echography in the early diagnosis of congenital hip dysplasia]. PMID- 3283566 TI - [Echography of the hip joint in newborn infants]. PMID- 3283569 TI - [Total hip prosthesis consensus]. PMID- 3283568 TI - [Late sequelae of the treatment of children with acute lymphatic leukemia]. PMID- 3283570 TI - [The Angelchik prosthesis in the treatment of gastroesophageal reflux: a failed experiment]. PMID- 3283572 TI - [Difficult choices at the sickbed; don't count on decision making]. PMID- 3283571 TI - [Antimalaria agents]. PMID- 3283573 TI - [Quantitative modernism in medicine: an attempt at arrangement]. PMID- 3283574 TI - [Decision support technics for clinical practice]. PMID- 3283575 TI - [Methotrexate: from sword to ploughshare]. PMID- 3283576 TI - [Panencephalopathy of the Creutzfeldt-Jakob disease type]. AB - Creutzfeldt-Jakob disease (CJD) occurring in later life has a duration of about one year. Gait disturbance, myoclonic jerks, dementia and akinetic mutism occur. Post-mortem examination of the brain shows nerve cell loss, gliosis and spongiform changes of the grey matter. Clinical and neuropathological features of a case of the panencephalopathic type of CJD, with additional extensive degeneration of the cerebral white matter, are described. The panencephalopathic type of CJD is characterized clinically by a longer duration and a biphasic course. PMID- 3283577 TI - [In memoriam Walter von Baeyer 1904-1987]. PMID- 3283578 TI - [Family therapy and the course of schizophrenia]. PMID- 3283579 TI - [Alzheimer's disease: findings and hypotheses]. PMID- 3283580 TI - ["Consent for the destruction of patients unfit for life" by Binding and Hoche from the viewpoint of German psychiatry before 1933]. PMID- 3283581 TI - The PABA test for evaluation of exocrine pancreatic function: a review of the literature. PMID- 3283583 TI - Idiopathic calcium phosphate nephrolithiasis. PMID- 3283582 TI - Diagnosis and treatment in metastatic adenocarcinoma of unknown primary tumour. PMID- 3283585 TI - Effect of captopril on renal function during exercise in a patient with unilateral renal agenesis. PMID- 3283586 TI - Captopril and transplant renal artery stenosis. PMID- 3283584 TI - Steroid-induced hypertension in patients with nephrotic syndrome. AB - In 35 initially normotensive patients with chronic glomerulonephritis and lupus nephritis (including 27 patients with nephrotic syndrome; NS), blood pressure (BP), urinary sodium excretion, plasma renin activity (PRA), plasma aldosterone level (PA), urinary aldosterone excretion (Au and blood volume were measured before and during prednisolone treatment. In 7 patients (all with NS) steroid induced hypertension has developed. The patients prone to develop hypertension were hypervolemic nephrotics with initial depression of PRA, PA, Au, and severe sodium retention. In these patients prednisolone did not produce diuresis of natriuresis nor did it decrease proteinuria. In normo- and hypovolemic patients prednisolone produced significant diuresis and natriuresis and failed to induce hypertension. Thus, two types of response to prednisolone could be observed in patients with NS. PMID- 3283587 TI - Doppler ultrasonography in the evaluation of renal graft artery stenosis. PMID- 3283588 TI - Lysosomal enzymes in experimental allergic encephalomyelitis: time course and evidence of the source. AB - The lysosomal enzymes acid proteinase and beta-glucuronidase, were assayed in spinal cords of rats during the course of experimental allergic encephalomyelitis (EAE). Histological and histochemical examination was carried out versus controls, in selected areas of the same cords biochemically assayed, to look at the distribution of the lysosomal enzyme acid phosphatase. The biochemical assay showed a significant increase of the enzyme activities during the disease and the increase was significantly correlated with the intensity of the disease. The distribution in the nervous tissue of the increase in acid phosphatase activity observed in animals with EAE, suggests that endogenous nervous cells may contribute to the lysosomal enzyme increase in EAE. PMID- 3283591 TI - [Surgery of orbital tumor]. PMID- 3283590 TI - [Surgical treatment for hypertensive cerebellar hemorrhage--indication and characteristics of stereotaxic aspiration surgery]. AB - From May 1976, through May 1985, eighty-nine patients with hypertensive cerebellar hemorrhage were admitted to our university hospital and affiliated hospitals. The age at onset ranged from 42 to 86 years, with a mean of 65.1 years. Thirty-one of these patients underwent conservative treatment, 20 were given ventricular drainage, 23 underwent suboccipital craniectomy and 15 underwent stereotaxic aspiration surgery. The patients were classified into four categories according to the grading of hypertensive cerebellar hemorrhage proposed by Matsumoto in 1982. Twenty-two cases were of benign type, 20 were moderate type, 30 were severe type, and 17 were fulminant type. The 22 benign type cases showed good recovery (ADL 1 or ADL 2), whereas the mortality rate of severe type cases was 26.7%, and that of fulminant type cases was 70.6%. The site and extension of hematoma were identified by CT. Fourty cases (45.0%) were confined to the left hemisphere, and 19 (21.3%) were localized in the vermis. When the hematoma volume was more than 15 ml, surgical evacuation of the hematoma was considered. Since 1981, stereotaxic aspiration surgery has been performed in cases of hypertensive cerebellar hemorrhage with a mean patient age of 66.9 years, ranging from 51 to 82 years. Patients treated have consisted of 2 with moderate type hemorrhage, 10 with severe type, and 3 with fulminant type, with an overall surgical mortality rate of 33.3%. However, the outcome of fulminant type hemorrhage has remained ADL 2 or ADL 3. The benefits of this type of surgery are that it is not only indicated as an emergency treatment for patients who are aged or at high risk, but that it can be also performed for fulminant type hemorrhage. PMID- 3283592 TI - [Three cases of acute interhemispheric subdural hematoma]. AB - Traumatic acute subdural hematomas over the convexity of the cerebral hemispheres are often encountered, but acute interhemispheric subdural hematomas are rare. Fourty-eight cases of acute subdural hematomas was admitted to our hospital between 1977 and 1986, and three cases of them (6%) were located in the interhemispheric subdural space. In this paper, these three cases are reported with 20 documented cases. Case 1: an 81-year-old female was admitted to our hospital because of headache, nausea and vomiting. She hit her occiput a week ago. CT scan demonstrated contusion in the right frontal lobe and a high density in the interhemispheric space of the right frontal region. Her complaints disappeared gradually by conservative therapy and she returned to her social life. Case 2: a 50-year-old male fell downstairs and hit his vertex. As he lost consciousness, he was admitted to our hospital. He was stuporous and had left hemiparesis. Skull X-ray film showed fracture line extending from the right temporal bone to the left parietal bone across the midline. CT scan revealed intracerebral hematoma in both frontal lobe and right parietal lobe and subarachnoid hemorrhage in the basal cistern and Sylvian fissure of the right side. And interhemispheric subdural hematoma in the right parietal region was visualized. Angiography demonstrated a lateral displacement of the right callosomarginal artery and an avascular area between the falx and the callosomarginal artery. After admission his consciousness recovered and convulsion was controlled by drug. Left-hemiparesis was improved by conservative therapy and he was discharged on foot.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283593 TI - [Two cases of persistent trigeminal artery variant]. AB - Two cases of persistent trigeminal artery variant were found in 2000 cases who had examination of cerebral angiography in our hospital from 1975 to 1986. The first case was a 44-year-old female who admitted in our hospital for the examination of vertigo. Cerebral angiography demonstrated a superior cerebellar artery originating from the precavernous portion of the right internal carotid artery. The second case was a 67-year-old female who admitted in our hospital for the treatment of subarachnoid hemorrhage. Cerebral angiography demonstrated an anterior inferior cerebellar artery originating from the precavernous portion of the right internal carotid artery. In this case, a fusiform aneurysm was found in the origin of the persistent trigeminal artery variant. The ruptured aneurysm was thought to be a basilar artery aneurysm. PMID- 3283594 TI - Giant axonal disease: report of three cases and review of the literature. AB - We describe three cases of Giant Axonal Neuropathy (GAN) with clinical signs of central nervous system involvement and an abnormal CT in one case. Two of these cases are sibs, pointing to an autosomal recessive inheritance as two other families previously reported. The review of the literature shows that most cases have central nervous system and cranial nerves involvement suggesting a generalized disorder in keeping an inborn error of organization of intermediate filaments. According to this, we think that Giant Axonal Disease (GAD) is a better designation to this condition. PMID- 3283595 TI - Controlled study of nimodipine in aneurysm patients treated early after subarachnoid hemorrhage. AB - We enrolled 75 consecutive patients admitted with subarachnoid hemorrhages in a randomized, double-blind, placebo-controlled trial to determine the effect of early intervention with nimodipine on outcome and cerebral blood flow. The cardioprotective effect of nimodipine was assessed by measuring the electrocardiographic changes over the first 3 days of drug treatment. There was a mild lowering of the mean cerebral blood flow in the nimodipine-treated group over the 21-day period. Analysis of the continuous electrocardiographic traces showed no difference between the nimodipine and placebo groups in the frequency or type of abnormality detected. At 3 months, 4 of the 38 patients receiving nimodipine had died, compared with 10 of the 37 placebo-receiving patients. Of the 50 eligible patients who had a proven cerebral aneurysm, 1 patient (4%) on nimodipine died compared with 6 (24%) receiving placebo (0.01 less than P less than 0.05, chi 2 test; approximate 95% confidence interval for mortality difference, 0.4% to 39.6%). We conclude that nimodipine does not increase the cerebral blood flow or protect the heart after a subarachnoid hemorrhage. There were no side effects from nimodipine. The trend toward improved outcome should be verified in a larger series of patients. PMID- 3283596 TI - New stereotactic technique for percutaneous thermocoagulation upper thoracic ganglionectomy in cases of palmar hyperhidrosis. AB - To perform unilateral or bilateral upper thoracic ganglionectomy, we established a three-dimensional system of coordinates for T2 and T3 ganglia. For this purpose, the spatial relations were represented by drawings obtained from 50 Chinese cadavers. A simple stereotactic frame was constructed as an aid in performing the procedure. Then, according to the established three-dimensional system of coordinates, percutaneous thermocoagulation of both T2 and T3 ganglia was performed on 10 patients (20 sides) with palmar hyperhidrosis, under local anesthesia and fluoroscopic guidance at the posteroanterior projection. Excellent relief of abnormal sweating in 19 of the 20 hands was achieved. Partial relief was obtained in the remaining hand. No complication was observed in our patients. The technique has been proved to be safe, effective, and simpler than other methods now in use. PMID- 3283589 TI - Are astroglial cells involved in morphine tolerance? AB - Morphine gives rise to a cascade of events in the nervous system affecting, among others, neurotransmitter metabolism. Tolerance develops for various effects shortly after administration of the drug. Also, physical dependence develops and can be demonstrated by precipitation of withdrawal reactions. Biochemical events in nervous tissue have been extensively studied during morphine treatment. This overview will focus upon brain protein metabolism since macromolecular events might be of importance for development of long-term effects, such as tolerance and physical dependence. Both dose- and time-dependent changes in brain protein synthesis and the syntheses of specific proteins have been demonstrated after morphine treatment, although methodological considerations are important. Different experimental models (animal and tissue culture models) are presented. It might be interesting to note that astroglial protein synthesis and the secretion of proteins to the extracellular medium are both changed after morphine treatment, these having been evaluated in astroglial enriched primary cultures and in brain tissue slices. The possibility is suggested that proteins released from astroglial cells participate in the communication with other cells, including via synaptic regions, and that such communication might of significance in modifying the synaptic membranes during morphine intoxication. PMID- 3283597 TI - Long-term retention of computer learning by patients with memory disorders. AB - Previous research has demonstrated that patients with memory disorders resulting from closed-head injury can acquire the complex knowledge and skills necessary for the use of a microcomputer. The present paper extends the generality of those findings by showing that (1) amnesic patients with other etiologies could similarly learn how to operate a computer and (2) the knowledge and skills acquired were retained over intervals of up to 9 months. PMID- 3283598 TI - Immunocytochemical identification of luteinizing hormone-releasing hormone positive fibres and terminals in the olfactory system of the rat. AB - Luteinizing hormone-releasing hormone immunoreactivity was studied in the olfactory system of the rat in combination with acetylcholinesterase histochemistry. Neuronal perikarya containing luteinizing hormone-releasing hormone lie in the medial septal nucleus, the vertical limb of the diagonal band of Broca, the olfactory tubercule and the ganglionated plexus of the terminal nerve. Labelled fibres spread in the superficial layers of the main and accessory olfactory bulbs, some encompassing the strongly acetylcholinesterase-positive atypical glomeruli. Others are observed on the medial side of the bulb, running along the terminal nerve bundles and ganglia. These fibres join the vomeronasal nerve branches and proceed distally towards the nasal cavity. In the septal submucosa, immunoreactive fibres are partly associated with the terminal nerve network. Conspicuous endings filled with luteinizing hormone-releasing hormone are observed on blood vessels of the olfactory mucosa. Such well-differentiated terminals might be the neurosecretory afferents of a new neurohemal area. Immunoreactive terminals are also observed around the excretory ducts of the anterior medial glands. We have failed to observe any labelled fibres in the olfactory and vomeronasal epithelia. The results of the present study are discussed with respect to possible functional interpretations. It is suggested that significant amounts of luteinizing hormone-releasing hormone could be released in the submucosal capillaries in spite of the scarcity of immunoreactive fibres. Similar afferents could also modulate the secretory activity of some nasal glands. Synaptic events involving the neuropeptide might occur in the olfactory bulb, particularly in atypical glomerular areas previously characterized by their high acetylcholinesterase content. Finally, no anatomical support for a chemosensory function of fibres containing luteinizing hormone releasing hormone has been brought out by our work. PMID- 3283600 TI - Depiction of facial paralysis on an African mask. PMID- 3283601 TI - [Procurement of kidneys from donor cadavers. Methodological and clinical aspects]. PMID- 3283599 TI - Double-blind comparison of primidone and phenobarbital in essential tremor. AB - In a double-blind cross-over trial, primidone was superior to both placebo and phenobarbital in reducing essential tremor in 13 patients. Phenobarbital, at a dosage yielding serum barbiturate levels greater than those seen with primidone, was not better than placebo. Thus, primidone has an effect in essential tremor independent from that of its metabolite phenobarbital. PMID- 3283602 TI - [Occurrence of acute pancreatitis in biliary microlithiasis]. PMID- 3283603 TI - [The He/Neon soft-laser in the treatment of decubitus ulcer]. PMID- 3283604 TI - [Primary adenocarcinoma of the duodenum]. PMID- 3283605 TI - [Sparing the inferior mesenteric artery during anterior resection of the rectum]. PMID- 3283606 TI - [Gardner syndrome. Case contribution and considerations]. PMID- 3283607 TI - [Treatment of differentiated carcinoma of the thyroid gland]. AB - In this paper the Authors, after a description of the prognostic factors in patients with differentiated thyroid carcinoma, propose a rationale for the therapy. The role of surgery, radioiodine treatment, endocrine therapy, radiotherapy and chemotherapy is described. The follow-up for the disease is briefly outlined. The authors suggest that treatment and follow-up protocols should be in accordance with the prognostic factors. PMID- 3283609 TI - Brand medically necessary. PMID- 3283608 TI - [Electric stimulation and neuromuscular diseases. Effects on denervated and dystrophic muscle]. AB - The literature on the effects of electrical stimulation on denervated and dystrophic muscles is reviewed. Analysis of the information supplied suggests that denervated muscles of experimental animals may benefit from the treatment that cannot be used on human patients due to technical limitations. However electrical stimulation can be used in the treatment of dystrophic muscles in human. PMID- 3283610 TI - Proposed criteria for referring diabetic retinopathy. AB - Diabetic retinopathy is a leading preventable cause of blindness in the United States. The primary care nurse practitioner is often confronted with the decision of whether to refer a person with diabetes to an ophthalmologist. Because ophthalmoscopy may be technically difficult with a particular patient, current recommendations are to refer all diabetics. Unfortunately, many studies reveal that this approach is not working. This article defines criteria for the nurse practitioner to determine who is most in need of referral. The tested criteria have a sensitivity of 77 percent and a specificity of 81 percent when compared with ophthalmoscopy. The criteria are based on the results of ophthalmoscopy, duration of diabetes, status of glycemic control, status of achilles tendon reflex, status of serum creatinine, amount of alcohol consumption and the presence of hypertension. Using the criteria is feasible in a clinic or hospital setting. Use of this tool may improve appropriate ophthalmological referral of persons with diabetes. PMID- 3283611 TI - Static exercise--physiologic dangers and proper training techniques. AB - Static exercise is commonly encountered occupationally and in normal activities of daily living. In addition, weight training, a form of static exercise, is one of the fastest growing physical activities in the United States. Static exercise is a stressor to the cardiovascular system. At high intensities it produces immediate and profound systolic and diastolic hypertension, moderate tachycardia and enhanced contractility resulting in a moderate increase in cardiac output without an increase in stroke volume. Static exercise is well tolerated in healthy people. People with cardiovascular disease appear to tolerate static exercise of low intensity if they have normal left ventricular fraction and reserve. However, in people with impaired left ventricular function and reserve, the exercise stress causes tachycardia, a hypertensive state, increased systemic vascular resistance, and left ventricular end diastolic pressure. If the exercise stress persists, stroke volume and ejection fraction decline. This article helps nurse practitioners in wellness and preventive patient education. An analysis of current research covers the relationship between client variables and the cardiovascular effects of static exercise. Nurse practitioners learn how to identify and advise clients who should avoid static exercise. The proper selection of a health fitness club and the proper components of a basic weight training program are comprehensively reviewed. PMID- 3283612 TI - Neuroleptic malignant syndrome: case report and review. AB - A patient with neuroleptic malignant syndrome is reported. The clinical features, complications and management are discussed and literature reviewed. PMID- 3283613 TI - Resistance of urinary tract isolates of Escherichia coli to trimethoprim, cotrimoxazole and ampicillin. PMID- 3283614 TI - Prostheses by computer. PMID- 3283615 TI - Multiple persistent vesiculobullous and ulcerative oral lesions. PMID- 3283616 TI - Esthetics: the reliability of a tooth indicator in selecting maxillary central incisors. PMID- 3283618 TI - Reproduction technology: cataloging the criticisms (Part II). The medical views. An obstetrician's view. PMID- 3283617 TI - Reproduction technology: cataloging the criticisms (Part II). The medical views. An ethics professor's view... PMID- 3283619 TI - High-dose cytosine arabinoside and mitoxantrone: preliminary results of a pilot study with sequential application (S-HAM) indicating a high antileukemic activity in refractory acute leukemias. AB - In an attempt to further improve on the encouraging results achieved by high-dose cytosine arabinoside (HD AraC) and mitoxantrone (HAM) in refractory acute leukemias, a timely modified sequential schedule of both drugs was developed (S HAM) and applied to 13 patients with far advanced acute leukemias, 8 of whom had been treated with the original HAM protocol before. Based on the cell kinetic and pharmacokinetic rationale outlined by Capizzi et al., HD AraC 3 g/m2 was applied every 12 h on days 1 and 2 followed by mitoxantrone 10 mg/m2/day on days 3 and 4. After 3 days without therapy the identical sequence was repeated on days 8 and 9 (HD AraC) and 10 and 11 (mitoxantrone), respectively. Of the 13 patients 9 (69%) achieved a complete remission, 2 were resistant and 2 were early deaths. Six of the 8 patients with prior HAM treatment obtained a further complete remission with S-HAM. In 2 of these patients a longer remission was induced by S-HAM than by the preceding original HAM treatment. Although these data are preliminary and need confirmation on larger numbers of patients, they strongly suggest a high antileukemic activity of the S-HAM protocol which may even be superior to the previously used HAM regimen. PMID- 3283620 TI - Intensive maintenance treatment in acute myelogenous leukemia (AML): single institution experience of a multicenter randomized trial. AB - Sixty-three AML patients were entered into a randomized, prospective trial to investigate the impact of intensive maintenance treatment on remission duration and survival. The maintenance program consisted of either a rotating combination of alternative drugs (HD-Ara C, mAMSA, 5-AZA) not used during induction and consolidation or, alternatively, of a repeated induction type chemotherapy early after consolidation (DNM, VCR, Ara C). In 48 out of 63 patients reaching CR, no prolongation of either remission duration or survival was achieved as compared to a preceding randomized study using conventional maintenance treatment. PMID- 3283621 TI - [Intensive combined therapy for high-risk ALL patients]. AB - In the risk-adapted multicenter trial (02/84) for adult ALL the effectiveness of a consolidation therapy consisting of VM26 and Ara-C for high-risk patients was tested. Out of a total of 442 patients in the study, 79.2% achieved a complete remission. For the 182 high-risk patients the median remission duration is 17 months and the probability of being in continuous complete remission (CCR) is 34%. Improved results were found for elderly ALL patients between 35 and 65 years of age, whose median remission duration and CCR rate are 19 months and 40% respectively, compared to 15 months and 26% in the former study 01/81. The consolidation therapy has apparently also benefited patients with the immunological subtype c-ALL, for whom the CCR rate at 3 years is 53% in comparison to the previous value of 34%. PMID- 3283622 TI - [Chemotherapy of chronic myelocytic leukemia. Status of the German Multicenter Study on busulfan versus hydroxyurea versus alpha interferon, October 1897]. AB - For palliative therapy during the chronic phase of CML busulfan has proved to be the drug of choice. During the past years hydroxyurea and also interferon-alpha have gained increasing significance since they might prolong the duration of the chronic phase. In a multicenter study it is being determined, whether the use of hydroxyurea or of interferon-alpha instead of busulfan prolongs the duration of the chronic phase of Philadelphia-positive CML. Additional goals are the examination, whether the types of disease evolution and the terminal phases differ between the treatment groups, and the prospective recognition of prognostic criteria for the duration of the chronic phase of CML. By November 26, 1987, 321 CML-patients had been randomized, 147 for busulfan, 149 for hydroxyurea and 25 for interferon-alpha. The average age is about 50 years. 59 patients reached the end of the chronic phase, 55 died. The mean observation time of all patients is 1.34 years. At present no significant difference in survival is recognizable between the busulfan and hydroxyurea groups. Fewer adverse effects have been observed in the hydroxyurea group. Philadelphia chromosome-negative patients show a higher average age and tend to have lower white blood cell and platelet counts. The number of patients having received interferon-alpha is still too small to allow evaluation. This report intends to document organization and progress of this study which to our knowledge is, at present, the largest ongoing prospective multicenter study on the therapy of CML. PMID- 3283623 TI - Deoxycoformycin in therapy of refractory lymphoid neoplasms. AB - Knowledge of the vital role of the purine degradative enzyme adenosine deaminase (ADA) in the differentiation of T and B lymphocytes has stimulated interest in the pharmacologic inhibition of ADA as specific cytotoxic therapy for lymphoproliferative diseases. 2'-Deoxycoformycin (DCF) is a tight-binding ADA inhibitor and has shown activity in T and B cell neoplasms. In this phase-II study, the efficacy and toxicity of DCF in chronic T and B cell neoplasms is investigated. We report the preliminary results of treatment in 27 patients (8 with Sezary syndrome, 11 with B-chronic lymphocytic leukemia (CLL), and 8 with hairy cell leukemia (HCL)), who were refractory to conventional therapy. DCF was applied at a dosage of 4 mg/m2 weekly x 3, then 4 mg/m2 every other week x 3. Three of the 8 patients with Sezary syndrome and 3 of the 11 patients with B-CLL attained a partial remission. One complete and 7 partial remissions have been achieved thus far in the 8 patients with HCL refractory to interferon alpha treatment. Other than nausea in 10 patients (mainly grade 1 and 2), transient skin rash in 4 patients and Herpes infections in 4 patients (mainly grade 2), no other major toxicities were observed. Thus DCF is highly active in hairy cell leukemia that did not respond to interferon alpha, and shows moderate activity in refractory Sezary syndrome and B-CLL. PMID- 3283624 TI - [Induction and maintenance therapy in multiple myeloma. Results of a multicenter study]. AB - In a prospective study by the German Myeloma Treatment Group, 320 untreated patients with multiple myeloma, stage II and III, were randomized into 2 groups receiving courses of either MP or VCMP as induction treatment every 6 months. 72% of the patients evaluable by TCM changes remitted, 21% showed a no change, and progress occurred in 7%. The corresponding results in BJ and nonsecretory myelomas were 56% remissions, 11% no change, 33% progress. The response rates were equal in both treatment groups. The overall survival was 60% after 4 years. However, MP-treated patients lived significantly longer than patients in the VCMP group. After successful remission induction, patients were randomized into one group with maintenance treatment using the induction scheme Q 8 weeks, and another group without further chemotherapy. Although the relapse rate of the latter group was significantly higher, differences between both groups concerning survival have not been observed. PMID- 3283625 TI - [Alpha interferon in the therapy of hairy cell leukemia. Results of 3 prospective multicenter studies in West Germany]. AB - Within 19 months of recruitment 51 centers enrolled 84 patients in our prospective multicenter trial for low-dose IFN alpha-2c for HCL (1.2 x 10 IU/m x 28 days s.c.- or lower). Induction therapy of 84 days was followed by maintenance with 2 weekly doses. Patients who reached stage Jansen I or A were then randomized to 2 arms either to receive further IFN or to stop treatment. Reinduction was reinstituted whenever any patient lost Jansen stage A or I. Only 3 patients failed. But enrollment was discontinued when it became apparent that fatalities in splenectomized (SX) patients due to septicemia outnumbered deaths given in the literature. Low-dose IFN administered daily might compromise host defense. Our next study aimed at improving the safety of IFN for SX patients. Pulsatile IFN on 7 consecutive days within a 28-day period was given to all SX patients. A randomization of non-SX patients either to receive daily or pulsatile IFN should provide proof of the efficiency. The intermissions ought to be as suitable for in-vitro investigations as for observations concerning the capacity of IFN to produce 'induction of inducers'. Pulsatile treatment has so far been safe in 13 splenectomized patients. Central diagnostic procedures remained the same during both studies. It seems important to us to use an intermittent schedule for the injection of IFN in SX patients and to restrict splenectomy to selected patients. PMID- 3283626 TI - [Induction and intensive combined therapy of acute myeloid leukemia in adults]. AB - In a prospective multicenter study the efficacy and toxicity of an induction therapy with daunorubicin, cytosine-arabinoside and VP 16-213, followed by an intensified consolidation with high-dose cytosine-arabinoside and daunorubicin, is evaluated in adult patients with acute myelogenous leukemia. The upper age limit for inclusion in the study was 50 years. Within the first two years of this study 91 patients were enrolled. In 84 patients who have finished the remission induction therapy the rate of complete remissions is 67%. The median survival time of all patients is 22 months and the probability of survival is 46% after 24 months. So far 34 patients in complete remission have been given one or two courses of the intensified consolidation therapy with high-dose cytosine arabinoside and daunorubicin. The probability of relapse-free survival in these patients is 46% after 22 months and the median remission duration is 20 months. PMID- 3283627 TI - Recombinant human granulocyte-macrophage colony-stimulating factor in patients with myelodysplastic syndromes--a phase-I/II trial. AB - A phase-I/II trial was initiated to study the effect of rhGM-CSF in patients with myelodysplastic syndromes who were not eligible for other kinds of therapy, rhGM CSF was given to 9 patients in doses of 15 micrograms/m2-150 micrograms/m2 as an intravenous 8-h infusion for a cycle of 7 days followed by an interval of 14 days and a second 7-day treatment course. A dose-dependent increase in the leukocyte count was observed in 7 out of 9 patients. No change in reticulocyte numbers was seen and only 1 patient experienced an increase in platelet count. Toxicity mainly consisted of mild local phlebitis at the site of infusion and sternal pain after bolus injection. PMID- 3283629 TI - Vindesine-mitoxantrone (VM) versus vindesine-4'-epidoxorubicin (VE) in metastatic breast cancer: a prospective randomized trial. AB - 182 patients with metastatic breast cancer were randomized to V (mg/m2 i.v.) and M (10 mg/m2 i.v.) or E (40 mg/m2 i.v.) every 3 weeks x 3 and then every 4 weeks; they were stratified by sites of disease (visceral, bone, or soft-tissue dominant) and by prior chemotherapy. In a preliminary analysis there is a significant difference regarding frequency of alopecia (WHO Grade 3 or 4) favoring regimen VM; gastrointestinal, hematologic and neurotoxic side effects were mild and similar for both groups. Of 114 evaluable women there is a response rate (CR + PR) of 26% and 34% for VM and VE respectively (n.s.), and there is no significant difference between the 2 groups in time to progression and survival. Both regimens are well tolerated and seem to be equally effective. The median follow-up time is too short to draw final conclusions. PMID- 3283628 TI - Treatment of acute graft-versus-host disease after HLA-partially matched marrow transplantation with a monoclonal antibody (BMA031) against the T cell receptor. First results of a phase-I/II trial. AB - As part of an ongoing phase-I/II trial, 2 patients received a 5-day treatment course with a murine monoclonal antibody (MAB) directed against the human T cell receptor (BMA031) as primary therapy of acute grade III skin and gastro intestinal graft-versus-host disease (GvHD) occurring after allogeneic bone marrow transplantation (BMT). All MAB infusions were tolerated without side effects. A complete response of all symptoms of acute GvHD could be attained by MAB therapy under a continued baseline immunosuppression with cyclosporin (CSP), and both patients remain alive and disease-free at 7 and 8 months after therapy without evidence of chronic GvHD. Although the exact treatment scheme has still to be defined, we conclude that this MAB may be useful as primary therapy of acute GvHD. However, the potential hazards of 'in vivo' therapy with MABs directed against T lymphocytes call for a critical evaluation of this treatment modality. PMID- 3283630 TI - Planning for the future. Report on the oral health of Ontario's seniors. PMID- 3283631 TI - Posterior chamber intraocular lens implantation in the absence of posterior capsular support. AB - Because of the high incidence and great variety of complications associated with anterior chamber intraocular lenses, we have developed a technique for the implantation of a posterior chamber intraocular lens in the absence of posterior capsular support. The posterior chamber IOL is placed in the ciliary sulcus by suturing the superior haptic to the iris and the inferior haptic to the sclera at the ciliary sulcus. We have used this technique successfully in both complicated extracapsular surgery and secondary intraocular lens implantation. PMID- 3283632 TI - [Effect of nonspecific and cardioselective beta receptor blockers on the formation of aqueous humor. An oculopressure tonometry study]. AB - The aim of the present study was to show the effect of different topical beta blocking agents on aqueous humor formation with a clinically practicable method. In a clinical, randomized, prospective double-blind study, 60 healthy volunteers were examined by means of oculopression tonometry according to Ulrich. The placebo was applied to 29 subjects; a nonselective beta-blocker (timolol maleate 0.5%) was given to 14 volunteers and 17 subjects received a cardioselective, beta 1-blocking agent (betaxolol-HCl 0.5%). On the 1st day, intraocular pressure (IOP) was lowered by the suction cup method and then we measured the time required for IOP to return to the initial value. The examination procedure of the 1st day was repeated on the 2nd day 3 h after application of the ophthalmic solution. After evaluation of the different groups, we could show that the recovery times in the placebo groups were comparable. Furthermore, we showed that both beta-blockers slow down the increase of IOP to the initial value. There was a statistically significant difference in recovery time between timolol and placebo. This difference was statistically not significant between betaxolol and placebo. PMID- 3283633 TI - Temporomandibular joint arthrography without fluoroscopy. AB - An arthrographic technique for the temporomandibular joint that can be performed in a dental surgical room is described. This technique utilizes a dental radiographic unit and extraoral cassettes for visualization of the needle tip in the inferior synovial space for arthrography. The radiographic visualization is combined with tactile discernment of the needle tip on the mandibular condyle. The successful application of these two methods makes fluoroscopy unnecessary. After an initial success rate of 81% (34 of 42 attempts), we have used the technique successfully in more than 100 cases. Most of the problems encountered with this technique can be attributed to initial operator inexperience. This technique is not suggested as a replacement for fluoroscopy. However, it is a convenient, economical technique that can be used in the dental surgical room by trained clinicians when arthrography is indicated to determine meniscal-condylar relationships and meniscal perforations. PMID- 3283634 TI - Oral hairy leukoplakia among HIV-positive intravenous drug abusers: a clinicopathologic and ultrastructural study. AB - During a prospective investigation of oral lesions of 120 consecutive patients positive for human immunodeficiency virus, belonging to the intravenous drug abuser risk group and other risk categories, we observed hairy leukoplakia (HL) in 23 cases (19%). The median age of the patients was 27 years (range, 20 to 50 years). Twenty patients were men and three were women. All but two of the twenty three patients used intravenous drugs for a median period of 6 years (range, 5 to 18 years) and were involved in several episodes of needle sharing. Eight men were also bisexual, one man was homosexual, and one man was hemophiliac and bisexual. Eleven patients had asymptomatic infection, five had lymphadenopathy syndrome, six had AIDS-related complex, and one had acquired immunodeficiency syndrome. In all patients, HL lesions were localized on the lateral borders of the tongue. In twelve patients, the lesion was unilateral, and in eleven patients, it was bilateral. Microscopically, hyperparakeratosis and the presence of koilocytes were observed in all cases. Surface candidiasis could be detected with staining with periodic acid-Schiff in two thirds of the cases. In four cases, electron microscopy showed the presence of intracellular and extracellular hyphae of Candida albicans in the parakeratin layer associated with coccobacilli in the spaces between surface epithelial cells. The spinous layer included koilocytes, which had a clear cytoplasmic matrix, sparse organelles and tonofilaments, and dispersed chromatin. These cells were found to be infected by a herpes-type virus in all cases examined. There was no ultrastructural evidence of human papillomavirus in the nuclei of the epithelial cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283635 TI - Craniofrontonasal dysplasia: phenotypic expression in females and males and genetic considerations. AB - The phenotype and pattern of inheritance of craniofrontonasal dysplasia were analyzed in 66 affected persons from 18 families, including one four-generation kindred personally studied. Females were more severely affected than males. Affected females had hypertelorism, broad nasal root, frontal bossing, craniosynostosis, syndactyly of toes and fingers, and vertical grooving of nails. Males had increased bony interorbital distances and distances between the inner canthi of the eyes, broad nasal root, broad halluces, and vertical grooving of nails but no craniosynostosis. Affected men transmitted the condition to all of their daughters but to no sons, while affected women transmitted the disorder to about half their daughters and half their sons. This pattern is compatible with X linked dominant inheritance, but the far milder manifestation of the syndrome in males cannot be explained by simple mendelian genetics. PMID- 3283636 TI - [A new approach to the treatment of post-burn contractures and deformities of the elbow joint]. PMID- 3283637 TI - [The role of the Kharkov M.I. Sitenko Scientific Research Institute of Orthopedics and Traumatology in the development of Russian Prosthetics and Orthotics (on the 80th anniversary of the founding of the Institute)]. PMID- 3283639 TI - [The founding of a coronary care unit--20 years ago]. PMID- 3283638 TI - [Gleanings from clinical pharmacology]. PMID- 3283640 TI - [Current data on the work of Ignac Stahly]. PMID- 3283641 TI - [The pioneer of chronobiology in Hungary: Gusztav Modlinger, zoologist (1898 1984)]. PMID- 3283642 TI - [Ovulation induction in Kallman syndrome by intravenous pulsatory infusion of gonadotropin releasing hormone]. PMID- 3283643 TI - [A method for reducing blood requirements for open heart surgery]. PMID- 3283644 TI - [Left ventricular function and coronary morphology in intermittent bundle branch block]. PMID- 3283645 TI - [Advances in the treatment and prevention of thromboembolism]. PMID- 3283646 TI - [Gyorgy Makara, M.D. (1909-1987)]. PMID- 3283647 TI - [Medico-historical postcards from Komarom]. PMID- 3283648 TI - [Klara Valyi, pioneer of Hungarian balneology]. PMID- 3283649 TI - [Acute childhood leukemia]. PMID- 3283650 TI - [Treatment of skin graft donor sites and second degree burns with epidermal cell suspension--initial experience]. PMID- 3283652 TI - Transcription of the c-myc oncogene is altered in spontaneously immortalized rodent fibroblasts. AB - Cellular immortalization seems generally to be a necessary, but not sufficient step in tumourigenesis. We have analysed the role of the cellular oncogene, c-myc in the process of in vitro cellular ageing and spontaneous cellular immortalization using rodent fibroblasts. The steady-state level of c-myc of mouse and rat fibroblasts does not change significantly during cellular ageing in vitro. By contrast, the steady state level of c-myc mRNA increases 3- to 20-fold upon spontaneous establishment of these rodent fibroblasts. The increase in the steady-state level of this mRNA is essentially due to an increase in the transcriptional rate. Not all oncogenes respond in this way; the mRNA levels of both c-fos and c-K-ras do not show the same alteration. The changes in the steady state level of c-myc mRNA are not due to gene amplification nor to gross gene rearrangements or translocations. However, the response of the myc gene to growth factor stimulation is present apparently equally in both mortal and immortal cells; a difference is seen in an increased maintenance of high c-myc mRNA levels after growth stimulation in established cell lines. Both young and senescent mortal cells, as well as immortal cells, respond to mitogen stimulation with a sharp increase in c-myc mRNA levels. Thus, senescent cells are able to see mitogen signals, but do not go on to initiate DNA synthesis. We also demonstrated that the c-myc mRNA levels do not respond to serum concentration above a minimum level, nor do they respond to factors in the conditioned medium of immortal cell cultures. PMID- 3283651 TI - Four murine c-abl mRNAs arise by usage of two transcriptional promoters and alternative splicing. AB - The c-abl gene in mice is transcribed into two major and at least two minor mRNAs which have different 5'-ends, but are otherwise colinear. Here we show that the two major mRNAs are initiated by separate promoters and that the minor transcripts arise by alternative splicing. Like in the human gene, one of the alternative murine 5' c-abl exons lies far upstream of the remaining exons. The major mRNA that begins with this exon has about 1275 nucleotides upstream of the abl coding region. Interestingly, this unusually long upstream mRNA segment contains multiple short open reading frames both in mouse and man and is highly conserved in sequence between these species. The 5'-most c-abl promoter contains several sequence motifs that are highly conserved between mouse and man. The downstream promoter is much less conserved. PMID- 3283653 TI - Fusion of the bcr and the c-abl genes in Ph'-positive acute lymphocytic leukemia with no rearrangement in the breakpoint cluster region. AB - Two types of Philadelphia (Ph') chromosome positive acute lymphoblastic leukemias (ALL) have been described. One shows rearrangements within the 5.8 kb breakpoint cluster region (bcr), which forms the mid-portion of the bcr gene, on chromosome 22, while the other carries rearrangements involving a more proximal region on chromosome 22. To understand the nature of the breakpoints on chromosome 22 in bcr rearrangement negative, Ph'-positive ALLs, we have cloned and sequenced the cDNA of the c-abl oncogene in such ALL cells. The 5' ends of the cDNA clones correspond to the normal sequences of the bcr gene first exon with two of the clones extending beyond the GCCATGG consensus sequence for the initiation of translation. The bcr sequence stops at nucleotide 1813 of the coding sequence of the bcr gene, while the c-abl sequence starts at the beginning of the second c abl exon (nucleotide 227). Thus the joining point between bcr and c-abl is at the boundary between two exons, suggesting intronic fusion and the occurrence of a splicing event. Our current observations indicate that the Ph' translocation in bcr negative ALL involves bcr gene sequences, albeit only a proximal portion of those involved in CML. These genomic differences may be important factors in the pathogenesis of the distinct phenotypes of ALL and CML. PMID- 3283654 TI - Initial characterization of a potential transcriptional enhancer for the human c K-ras gene. AB - The nucleotide sequence of the 5' end distal region of the human c-K-ras gene promoter was determined. This region, coincident with a variable DNAse I hypersensitive site in native chromatin, contains sequence similarities with known enhancers. A 400 bp MstII DNA fragment of this region stimulated in cis the correctly initiated transcription of the human beta-globin gene in transfected Hela cells. The stimulation of beta-globin transcription (5-6 fold) was dependent on the distance and orientation of the c-K-ras sequences and on the presence of the CCAAT and CACCC elements in the beta-globin promoter. Interaction of nuclear factors with these c-K-ras sequences was analysed by DNAase I footprinting assays using Hela nuclear extracts. A protein binding to these sequences was identified as nuclear factor 1 (NF-1) by DNAase I competition footprinting experiments. However, disruption of the c-K-ras NF-1 binding site by insertion mutagenesis had no effect on the transcriptional activity of the c-K-ras element. PMID- 3283655 TI - The c-myc protein is constitutively expressed at elevated levels in colorectal carcinoma cell lines. AB - In this study, we have employed both indirect immunofluorescence and ELISA assays to compare the relative levels of c-myc protein in cell lines derived from normal human colon and colon adenocarcinomas. We show that the levels of protein found in the majority of carcinoma cell lines are consistent with the levels of mRNA expressed, and that both are significantly elevated with respect to the levels found in normal cells. Growing populations of fibroblastic and epithelial cell lines derived from normal colonic mucosa exhibit small numbers of steady-state transcripts and immunofluorescence signals which are weak and confined to the nucleus. The adenocarcinoma cell lines, however, express 5- to 10-fold elevated levels of c-myc mRNA and exhibit correspondingly intense immunofluorescence signals which appear to reside principally in the nucleus. Quantitation of c-myc protein levels in these tumor cell lines by ELISA assay indicates that they are 8 to 37-fold higher than the levels of protein in normal cells. Elevated expression of the c-myc gene at both the mRNA and protein levels occurs constitutively in the colorectal carcinoma cell lines during their growth in culture, in contrast to the transiently elevated levels of expression observed in normal cells which have been subjected to a mitogenic stimulus. The constitutively elevated expression of the c-myc protein in colorectal carcinoma cell lines is not typically accompanied by gross rearrangement or amplification of the gene. PMID- 3283656 TI - Detection of activated ras oncogenes in human thyroid carcinomas. AB - Focus formation following DNA transfection of mouse 3T3-Vill cells was used to search for the presence of activated oncogenes in human thyroid tumors. Oncogenes belonging to the ras family were detected in four out of six thyroid carcinomas (Ki-ras in one anaplastic tumor and one follicular moderately differentiated tumor and Ha-ras and N-ras in two papillary tumors). Normal thyroid tissue samples obtained from two patients, one with an anaplastic tumor and one with a benign adenoma, and samples from 4 benign adenomas and from one toxic goiter of a patient with Graves' disease gave negative results. In one case, restriction enzyme analysis demonstrated the presence of a mutation in codon 12 of the activated Ha-ras oncogene. Our data show that all three ras proto-oncogenes can become activated in malignant thyroid tumors. PMID- 3283657 TI - Alteration of morphogenesis by the v-myc oncogene in transplants of mammary gland. AB - To see if individual oncogenes can alter three-dimensional growth in vivo, we have inserted the v-myc oncogene into transplants of mouse mammary gland. Primary cultures of mammary epithelial cells were infected with helper-free retrovirus to insert v-myc oncogenes, and transplanted into cleared mammary fat pads (mammary glands from which the natural epithelium had been removed) of host mice. Uninfected transplants, and transplants infected with retrovirus constructs that carry no oncogene, grew to form an epithelial 'tree' resembling normal mammary gland, as expected. Transplants infected with retroviruses carrying v-myc oncogenes grew to form a characteristic, abnormal (hyperplastic) pattern in which the ducts were more densely packed than normal. Integration of the retrovirus in the transplants was demonstrated. The effect of the oncogene was local, not systemic, as some transplants showed adjacent areas of normal and hyperplastic growth. Thus v-myc can alter morphogenesis without growth becoming disorganized. PMID- 3283658 TI - Chromosomal localization of the hst oncogene and its co-amplification with the int.2 oncogene in a human melanoma. AB - In this report we described the linkage between two oncogenes of the fibroblast growth factor family. Using in situ hybridization to human metaphase chromosomes we mapped the hst gene to chromosome 11 at band q13. This is also the location of the int.2 gene. Furthermore, the two genes are co-amplified in a human melanoma, raising the possibility that amplification in human tumors may be a mechanism of activation of genes of the FGF family. PMID- 3283659 TI - Assessment of adult cancer pain: shortcomings of current methods. AB - The evaluation of cancer pain remains a problematic clinical problem, not only due to the subjective and multidimensional nature of pain per se, but also because of its specific characteristics. Cancer pain has an insidious onset, often involves many sites, and is frequently multicausal. Tools have been developed to quantify pain, the most commonly used being the verbal rating scale (VRS), the visual analogue scale (VAS), and the McGill Pain Questionnaire (MPO). The first 2 scales are short, easy to administer and to score, but only measure pain intensity. The VRS is assumed to be an ordinal scale although unequal differences between pain descriptors have been demonstrated; it offers a restrictive choice of words that may not represent pain experience with sufficient precision, and is not sensitive to change especially for mild pain. The VAS on the other hand, represents pain as a continuum and is sensitive to change. The MPQ has the advantage of evaluating the sensory, affective and evaluative dimensions of pain. However, it is lengthy to administer and some words are not readily understandable. In addition, the words within a given category are considered to be equidistant, the number of words in each category are unequal, and the number of categories evaluating a given dimension are not taken into account when calculating the total pain rating index. A further issue in assessing pain, other than the choice of a valid and reliable tool, is the frequency with which pain evaluations should be repeated. To date no studies have addressed this problem.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283660 TI - Changing chronic pain experience. AB - Training in relaxation is a prominent component in multi-disciplinary approaches to the management of chronic pain, although its specific potency in modulating pain has not yet been established. Using a within-session design, the specific effects of relaxation induction were evaluated in a group of benign chronic pain patients (n = 24), and compared to similar patients undergoing a control procedure (n = 22). The results indicated that irrespective of the focus of pain complaint, induction of relaxation over a 20 min period led to significant and sizeable reductions in both sensory and affective pain experience. The overall intensity of pain was significantly reduced. These effects were shown to be reliable and independent of onset level of sensory experience or depression. No significant changes occurred in the control group over a comparable period. The implications of these results were discussed with respect to the process by which relaxation reduces pain. PMID- 3283661 TI - Measurement of the analgesic effects of aspirin with a new experimental algesimetric procedure. AB - Using controlled long lasting noxious squeeze stimuli applied to the interdigital webs we have tried to develop experimental methods allowing us to measure the effects of peripherally acting analgesics. In the present double-blind cross-over study with 12 subjects we tested the effects of aspirin (1000 and 1500 mg) vs. placebo on subjective pain induced by alternately applied 12 N (Newton) and 8 N stimuli. During the sessions blood samples were taken in regular intervals to measure acetylsalicylate (ASA)- and salicylate (SA)-plasma levels. Analyses of variance were computed with several psychophysical parameters. Both the '12 N' and the '8 N' ratings discriminated between placebo and aspirin, however, only the ratings obtained from the stronger stimuli discriminated between two doses of aspirin. Subsequently we computed analyses of covariance with the ASA- and SA plasma levels as covariates. Significant (negative) correlations of pain ratings and SA-plasma levels were found for the high dose of aspirin, but there were no significant correlations of ASA levels and ratings. PMID- 3283662 TI - Behavioral management of childhood headache: a pilot study and case history report. AB - Many chronically recurrent disorders of children and adolescents are often unresponsive to standard medical therapy. The Stress and Headache Management Clinic was established as a prototype behavioral medicine clinic to provide integrated therapeutic modalities. Using biofeedback and relaxation/mental imagery techniques, 119 patients with the chief complaint of recurrent headache were evaluated. This paper describes the use, application, and efficacy of behavioral techniques for the management of headache in children and adolescents. Relevant treatment factors in behavioral treatment of pediatric headache are also discussed. PMID- 3283664 TI - DNA synthesis in gametocytes of Plasmodium falciparum. AB - The DNA content of Plasmodium falciparum gametocytes during intra-erythrocytic development and during gametogenesis was established by cytophotometric methods. Intraerythrocytic micro- and macrogametocytes (Stage I-Stage VB) contain about twice the amount of DNA of haploid sporozoites and ringstages, indicating that DNA is synthesized during transformation of ringforms into Stage I gametocytes. Microgametocytes, after activation at pH 8, rapidly duplicate their genome several times, while the DNA content of macrogametocytes remains constant during gametogenesis. PMID- 3283663 TI - Immobilization and restraint effects on pain reactions in animals. AB - Acute physical restraint represents a potent stressor in several animal species and is accompanied by a complex pattern of hormonal responses and functional changes in the central nervous system. Repeated immobilization leads to partial blunting of the behavioral and hormonal responses, with transient modifications of neurotransmitter systems in the brain. Pain reactions, as investigated by different kinds of nociceptive tests, are usually attenuated both during and immediately following acute immobilization and the analgesic effect of opiate compounds potentiated; these behavioral alterations may be attributed at least in part to activation of an endogenous opioid system. In some species, restraint may induce a reflex immobility (animal hypnosis or tonic immobility) which is also characterized by suppression of pain reactions in rabbits, probably subserved by different mechanisms. Analysis of available data suggests that pain testing in unanesthetized, restrained animals may involve alterations of the animal's reactivity to noxious stimuli. PMID- 3283665 TI - [Methods of assessing residual disease in the bone marrow in onco-hematology. First French Autograft Symposium. Besancon, June 1986-Lyons, October 1986]. PMID- 3283666 TI - [Contribution of immunohistochemical technics to the study of malignant infiltration of bone marrow]. AB - Immunohistochemistry using monoclonal antibodies has been proved of diagnostic value in bone marrow pathology. Several monoclonal antibodies identifying antigens not denatured by fixation are now available. In anaplastic tumors infiltrating bone marrow these antibodies allow the distinction of large cell lymphomas which express the leucocyte common antigen (Dako-LC+) from undifferentiated carcinomas which are reactive with anti-cytokeratin antibodies (KL-1+, Dako-EMA+), neuroblastoma (NSE+) and rhabdomyosarcoma (desmin+). KL-1 and Dako-EMA antibodies are also considered to be powerful tools to disclose micrometastases from carcinoma, particularly breast carcinoma, which otherwise may be undiagnosed. The detection of residual or minimal bone marrow involvement in malignant lymphomas (particularly Burkitt type) remains difficult. However, in some cases, Dako-LC and MB2 (anti-B) antibodies are useful to detect bone marrow involvement in some lymphoproliferative disorders composed of small or medium sized cells scattered among hematopoietic cells, and in some large cell lymphomas (i.e. centroblastic or immunoblastic types). These antibodies allow the detection of minimal or residual involvement by malignant cells, which can be confused with immature hematopoietic cells, on routine stainings. No anti-T antibody was found to react satisfactorily with T cell on decalcified biopsy specimens. In anaplastic large cell lymphomas (so-called malignant histiocytosis), malignant cells coexpress Ki-1 and EMA antigens. Antibodies recognizing these two antigens were found to be of value to demonstrate scarce neoplastic cell in bone marrow. PMID- 3283667 TI - The limitations in utilizing phenotypic markers to detect minimal residual disease in acute leukaemias (AL). AB - So far, in spite of the evergrowing number of available anti-leucocyte mAb, phenotypic markers proved to be of limited value for the detection of a minimal residual disease in leukemias. The question is to detect malignant leucocytes in a normal hematological environment. However no marker is specific for the malignant state perse. In addition, many markers are not absolutely specific of a given lineage of differentiation. Consequently the precise characterization of a leukaemic population must rely on a battery of markers. Finally, normal leucocyte populations are much more heterogeneous than initially thought. Prospects for efficient methods are discussed; they rely mainly on the possibilities to enrich the malignant clone and to induce its in vitro expansion. PMID- 3283668 TI - [The significance of immunological analysis for the detection of residual neuroblasts in bone marrow]. AB - Immunological analysis is complementary to morphological investigation to detect bone marrow (BM) metastases in neuroblastoma patients. It is essential at time of BM harvest for an autograft, since it is the only examination which allows a precise evaluation of the graft contamination by malignant cells. Simple indirect immunofluorescence staining with anti-neuroblastoma monoclonal antibodies (UJ13A and HSAN 1-2) allows a final detection of about 1% malignant cells in the BM, and 1% when cells are gathered in clumps. The use of an immunocytochemical method (alkaline phosphatase) together with double immunofluorescence staining permits to detect as few as one residual neuroblastoma cell in 10(4) normal ones. These two methods used together have allowed to assess the neuroblastoma nature of rare isolated cells with pseudo-lymphocytic aspect. PMID- 3283669 TI - [Cell kinetics and diagnosis of residual disease of a tumor in bone marrow]. AB - Cell-cycle studies of bone marrow do not allow the detection of minimal residual disease in lymphoma or carcinoma. However, cell kinetics in acute myeloid leukemia may be a predictive test for relapse. Detection of minimal residual disease is all the more difficult that leukemic blast cells can differentiate to form mature cells. PMID- 3283670 TI - [Cytogenetic study of cell sub-populations in human leukemias (AML, CML) sorted by flow cytometry]. AB - Multivariate analysis, flow cytometry and sorting were used to distinguish and enrich subpopulations of bone marrow cells in cases of acute myeloblastic leukemia and blast crisis of chronic myelocytic leukemia: blast cells with a high rate of S/G2-M phase of the cell cycle; non-blast cells or blasts with a low rate of S/G2-M. These populations were separated on the basis of their forward angle and large angle light scatter of the laser beam, and of their Hoechst 33342 fluorescence intensity. About one million cells of each population were sorted and sorting purity was controlled by cytometry and microscope examination. Cell viability was good. Karyotypes of sorted cell populations were carried out using a cell synchronisation technique and showed different chromosomal markers. PMID- 3283671 TI - [Flow cytogenetics. Principles, advantages and limitations. What trends for onco hematology?]. AB - Human chromosomes can be observed after coloration with ADN specific fluorochromes. Measurement of fluorescence intensity may be done by flow cytometry and it allows achievement of flow karyotypes. It is possible to define a standard karyotype and-by comparison-to bring to the fore chromosomes abnormalities (translocation, deletion, polysomy). Various genomic abnormalities are observed with leukemia. Flow cytometry allows a multiparameter analysis which could be used to detect rare events, unknown in classic karyotyping. With Flow Cytometry and cell sorting, the abnormal chromosomes could be separated and secondly observed after Q banding or analysed after molecular hybridization to confirm leukemia diagnosis or prognostic. Flow cytometry, an analytical technology already used in onco-hematology, allows, which chromosome analysis associated with other technics (molecular biology,...) a new approach of particular diagnosis. PMID- 3283672 TI - [The contribution of cytogenetics to the evaluation of residual disease in malignant hemopathies]. AB - Autologous bone marrow transplantation is now a major tool in the treatment of human leukemias and lymphomas. Evaluation of residual disease by standard cytological methods is difficult. Cytogenetics provide clonal markers which are specific features of leukemic cells. Detection of minimal disease by chromosomal methods is possible in acute leukemias, it requires karyotyping of a few hundred metaphases from a short term culture. A preselection of the material to be examined will improve the degree of sensitivity of the method. PMID- 3283673 TI - Cell cultures and detection of minimal residual disease: significance and limitations. AB - This introductory article puts into perspective the usefulness of cell cultures in the area of detection of minimal residual disease. We stress the role of single cell cultures in selective media as a means to increase the number of residual tumor cells, thereby facilitating their detection by other methods. Prior treatment may affect the growth potential of cells for a very long time. Quantitation of the event to be detected is thus highly dependent on the characteristics of the cells which are also influenced by their growth environment. This environment may be optimized by the judicious use of growth factors in defined media. PMID- 3283674 TI - [Processing of clonogenic findings in limited dilution. Application to the quantification of autograft depletion]. AB - Limiting dilution culture is a powerful tool for the quantification of residual clonogenic cells in the evaluation of a depletion procedure in bone marrow purging. The definition of suitable numerical indicators and the choice of the statistical technique for data treatment are of crucial importance. Most common techniques are presented and discussed. A standardization for data treatment is proposed. PMID- 3283675 TI - [The detection of residual clonogenic cells using limited dilution analysis]. AB - Limiting dilution analysis, a technique which measures the ability of cells to form colonies in liquid media has been used to quantitative residual cells subsequent to treatment. The reliability of this in vitro test as a tool in the selection of process of bone marrow purging was examined. With conventional methods like release of 51Chrome a 2 log reduction could be evaluated, while a reduction of 4 log was assessed by limiting dilution analysis for a same treatment. However the sensibility of this method depends of several factors which we have been examined in this study. PMID- 3283676 TI - Detection of residual disease in acute myeloid leukemia using light density gradients and culture assay. AB - For monitoring the effect of chemotherapy in acute myeloid leukemia (AML), we attempt to detect minimal numbers of AML clonogenic cells (CFU-L) during remission using light density gradients combined with PHA-LCM methyl cellulose assay. Fifteen patients in complete remission (CR) of AML were studied: 8 patients with Auer Rods (AR+), and 7 without Auer Rods (AR-). The cluster/colonies ratio and the granulocytic maturation of cells from pooled colonies were not significantly different whatever the density cut used (1077, 1062 or 1059). In all the AR+ patients, few AR+ cells (.06% +/- .03) were observed in bone marrow cultures during remission, without differences between density gradients, but not before plating. These AR+ cells were not found in culture of AR- patient bone marrows nor in normal marrows. The serial studies performed in 6 patients (4 AR+, 2 AR-) were not contributive for relapse prediction. In 2 cases, the second examination failed to detect AR+ cells: one was performed after an autologous bone marrow transplantation and the other in a patient with prolonged CR (54+ months). A quantitative analysis of residual CFU-L with our technique requires a cytological examination of each colony, that is very time consuming and limits its routine use. PMID- 3283677 TI - [Why a growing interest in cancerology for residual disease? Is bone marrow a preferential site for detection?]. PMID- 3283679 TI - [Cell cultures in Burkitt's lymphoma. Detection of residual disease and application to autologous graft purging]. AB - We describe a new liquid cell culture system for propagating Burkitt lymphoma (BL) cells contaminating the bone marrow (BM). The percentage of BL cells at day 10 of culture is correlated with the number of BL cells in the initial sample, which permits the detection of as few as one BL cell in 10(6) normal cells. We currently use such an assay to detect minimal BM involvement in our patient's follow up. This has allowed to define in which clinical situations the BM collected for autologous transplantation (though cytologically normal) had to be "purged". With the help of this modified liquid system it was possible to quantify the efficacy of various purging procedures on different models; an experimental model of allogenic irradiated BM contaminated with BL cell lines was used. Pre-clinical assays were also conducted on our patients' BM contaminated with their own tumour cells, or on invaded BM collected for autologous transplantation and for which the system had evidenced the efficacy of the purging procedure. PMID- 3283678 TI - [Culture of leukemic progenitor cells in acute non-T lymphoid leukemia]. AB - A preliminary study of the culture of leukemic progenitor cells (CFU-L) from acute non-T lymphoblastic leukemia was undertaken for 25 patients (19 were considered in complete remission and 6 in the acute phase of the disease). Two culture systems were tested; a double layer agar-liquid phase and a single layer of methylcellulose. The major problem was the characterization of the colonies: immunological labelling coupled with cytofluorometry, as well as cytomorphology, cytogenetic and more recently molecular biology may allow the characterization of the CFU-L. The culture of CFU-L appears to be an efficient method for detecting residual leukemic cells which can be used to evaluate the quality of both the remission obtained and that of autologous bone marrow after purging. PMID- 3283680 TI - [Detection of residual disease: analysis of the gene arrangement of immunoglobulins and T-cell antigen receptors]. AB - T and B cells specifically recognize antigens using a receptor located at the cell surface. The repertoire of lymphoid cells chiefly results from somatic rearrangements involving the variable segments of the genes encoding these receptors. The modifications of the DNA structure induced by these rearrangements are found in all cells of the same clone. Immunoglobulin (Ig) or T-cell antigen receptor (TCR) gene rearrangements are usually found in most lymphomas as well as in B or T lineage acute lymphoblastic leukemias. Thus, the study of Ig or TCR gene rearrangement could be useful in the detection of minimal disease in such malignancies. However the sensitivity of molecular hybridization on Southern blots is still not a sensible enough technique to be used in clinical practice. PMID- 3283681 TI - [The significance of resin-embedded bone marrow histology for the detection of rare cells in the bone marrow]. AB - Different methods for identification of cell types in resin sections of undecalcified bone marrow cores are described and discussed. These newer immuno histo-cyto-chemical technics are usefull for the visualization of cell types and may provide a valuable tool for the detection of rare cells in marrow sections. PMID- 3283683 TI - [Application of the diagnostic ability coefficient to the comparison of 3 identification miniaturized systems for identifying anaerobic bacteria]. AB - The authors compare the performances of three identification systems for anaerobic bacteria. The computation of diagnosis ability coefficient (Descamps and Veron) made it possible to classify these systems to identify a batch of eighty strains coming from pathologic samples. The results are very close. This study shows profile catalogues' short coming and the disadvantages of their use which appears to be insufficiently critical. Every-day practice of these supplementary tests and the use of gas-liquid chromatography seem necessary to identify completely the anaerobic bacteria of the studied batch. PMID- 3283682 TI - [Detection of residual disease in onco-hematology: the contribution of molecular biology]. AB - The development of the tools of recombinant DNA technology has implications for clinical oncology. We briefly describe in this article the use of DNA probes as diagnostic tools for the study of leukemias and other malignancies and for the detection of minimal residual disease. Useful DNA markers can be used to assess successful engraftment in bone marrow transplanted patients and to detect mixed chimerism. Immunoglobulin and T cell receptor gene rearrangements can be analysed to investigate the presence of clonal lymphoid populations with pathologic samples and to determine their B or T cell lineage. Point mutations associated with oncogene activation can be detected by hybridization with allele specific oligonucleotide probes, allowing molecular analysis of certain tumors. The level of sensitivity of the different assays are discussed along with their usefulness in the detection of residual malignant cells after appropriate therapy. PMID- 3283685 TI - [Influence of aminoglycosides on the activity of urinary N-acetyl-beta-D glucosaminidase (NAG) and its isoenzymes]. AB - Lysosomal enzyme activities can be modified by aminoglycosides. In this study, we have investigated the "in vitro" effect of gentamicin (G), tobramycin (T), dibekacin (D), netilmicin (N) and amikacin (AK) on urinary N-acetyl-beta-D glucosaminidase (NAG) and its isoenzymatic forms. G, D and N are activators of this enzyme, specifically of the B isoenzymatic form, while T inhibits slightly the A, I1 and I2 forms. At usual therapeutical urinary concentration of AK during antibiotherapy, NAG and its isoenzymes are very strongly inhibited (more than 65%). Dixon plot indicates that the nature of inhibition is "competitive apparent", without binding of inhibitor to the active site of the enzyme. This binding of aminoglycosides to NAG as to other lysosomal enzymes may represent one of the accumulation mechanisms of aminoglycosides in tubular cells. It can explain the specific alteration of lysosomes during nephrotoxic antibiotherapy. Consequently, when urinary NAG determination is used as indicator of nephrotoxicity during therapy, the activation or inhibition of the enzyme by aminoglycosides could lead to false assay results. PMID- 3283684 TI - [Determination of tumor marker CA 125 in the cancer of the ovary: comparison of immunoenzyme and immunoradiometry methods]. AB - CA 125, tumor marker newly appeared, is used in ovarian carcinomas. Its determination in serum is an important progress, not only in diagnosis but above all at the time of monitoring of clinical course during the treatment. The determination is possible with immunoradiometric assay (IRA) or enzyme immunoassay (EIA). The comparative study show a good correlation between these two methods. Both give comparable results. The choice for either method depends on equipment of laboratory. PMID- 3283686 TI - [Humoral immunity, 5 years after anti-tetanus vaccination, in a group of malaria infected and malnourished African children]. AB - In 1978 a campaign of vaccination against tetanus was conducted in a savannah biotope of Burkina Faso (Garango). The effects of 1 or 2 tetanus toxoid injections and of concomitant malnutrition and malaria infection were assessed by measurements of specific antibody and cell-mediated responses. None of these 2 variables did interfere with the development of anti-tetanus immunity. In 1983, 5 years later, similar results were obtained, giving evidence that in spite of malnutrition and malaria, factors known for their immunosuppressive action, a good degree of specific protection was acquired. This local survey revealed also that multiple schemes of vaccination, 1 to 5 injections of vaccine over 5 years, had been performed by unidentified operators. The issues raised by such incongrous, costly and possibly detrimental practices are discussed within the frame of national vaccination policies. PMID- 3283687 TI - [Urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG) and its isoenzyme B as a marker of the nephrotoxicity of gentamicin: re-test from an animal model]. AB - A high level of NAG urinary excretion with marked isoenzyme B excretion are commonly considered as an indicator of aminoglycoside nephrotoxicity. The urinary excretion of NAG following gentamicin treatment was studied in rabbit. The rabbits received gentamicin at equivalent therapeutic (5 and 20 mg/kg/j) or toxic (50 mg/kg/j) doses during four days. Activities were measured daily and isoenzyme patterns were determined on the day of maximal urinary enzyme excretion. Isoenzyme patterns of kidney cortex, urinary control, and urinary gentamicin treated rabbits were compared. As compared with control rabbit, no changes in isoenzyme profiles appeared following the administration of gentamicin at 5-20 mg/kg/j. Thus, NAG enzymuria is constituted almost exclusively by isoenzyme A. Surprisingly, the high level of NAG excretion following the administration of gentamicin at 50 mg/kg/j is not accompanied by a marked excretion of isoenzyme B. The present results confirm controversy still exists regarding the clinical significance of urinary NAG excretion. These data indicate that increases in urinary NAG and isoenzyme B excretion following gentamicin treatment in Human are not always reliable indicators of renal tubular cell lysis. PMID- 3283688 TI - [Phenotypes of resistance to antibiotics of Acinetobacter baumannii. Impact on therapeutic orientation]. AB - By studying the sensitivity to antibiotics of 74 Acinetobacter baumannii strains, four phenotype groups were distinguished. The resistance of one of them (11% of the strains) to imipenem, argues against the therapeutic attitudes that now prevail. From studies on the kinetics of bactericidal activity of antibiotics and there association we propose what should be done in the laboratory to provide help to the physician for the antibiotic choice. PMID- 3283689 TI - [Electrophoretic behavior of beta-lactamases in gram-negative bacteria]. AB - The ongoing discoveries of new beta-lactamases, mainly penicillinases, in Gram negative bacteria has emphasized the problem of their precise identification, and thus their phylogeny. Crude extracts, prepared by sonication, of 14 plasmid beta lactamases, types TEM, carbenicillinases (CARB or PSE) and oxacillinases (OXA) were analysed by a simple, rapid (3.5 to 4 hours) method of electrophoresis on polyacrylamide (7%) agarose (1.4%) gels, using Tris-glycine buffer at pH 8.7. Preliminary serial dilutions were made to determine enzymic activity levels. Enzymes were then characterized by their relative electrophoretic mobilities. These mobilities had coefficients of variability between 2% and 10%, ranged from 5 to 61, and were correlated with their isoelectric points (pI). Thus, the lower the pI is, the greater the mobility is. Despite the high resolving power of the polyacrylamide-agarose gel system, enzymes with similar pI's and of similar types (PSE-1 and CARB-3, or OXA-1 and OXA-4) or different types (SHV-1 and OXA-6) could not be distinguished on the basis of their mobilities. However, this technique provides for rapid and easy identification of the major penicillinases in Gram negative bacteria. A combination of polyacrylamide-agarose gel electrophoresis and pH gradient electrophoresis (titration curve) could provide a powerful approach to the study of the molecular structure of these enzymes. PMID- 3283690 TI - [Resistance to antibiotics of Salmonellae other than typhi and paratyphi isolated in Algeria from 1979 to 1985]. AB - Monitoring of the antibiotic resistance patterns of non typhoid Salmonella is needed. In this paper, we report the results of our study of strains isolated in Algeria from 1979 through 1985. Studied strains were isolated in our laboratory from stool or blood samples or sent to us for confirmation of the diagnosis. We used agar diffusion with IPA 20 medium (Mueller-Hinton medium with tryptophan). Of 3,072 strains tested, 2,467 (80.3%) were resistant to one or more antibiotics. For the most frequent serotypes, the resistance was about 99% whereas, for less frequent ones, it was about 51%. The most part of strains were found to be resistant to more than two antibiotics. The strains showed high rate of resistance to (in decreasing order): ampicillin, sulfamides, chloramphenicol, streptomycin and tetracycline. PMID- 3283692 TI - [Exploration and modulation of the chemotaxis of lymphocytes]. AB - Lymphocytes migrate and concentrate at inflammatory sites in part under the control of chemotactic factors. Lymphocyte chemotaxis has been studied in vitro using direct microscopic observation, the Boyden chamber technique and the migration under agarose or collagen gels. Various chemical compounds such as casein and cytokines such as interleukins 1 and 2 have been found to be chemotactic factors for lymphocytes. In addition, chemotaxis inhibitors have been described. Lymphocyte chemotaxis abnormalities have been described in various conditions: inflammation, auto-immune diseases, cancer. A better understanding of lymphocyte chemotaxis may provide a more specific therapeutic approach of such diseases. PMID- 3283691 TI - [Identification of Salmonella in 4 hours: comparison of 2 technics]. AB - Sixty Salmonella reference strains were identified with two ready-to-use rapid systems (API Rapid 20E and Spectrum 001/002). Genus identification was possible with both the two kits; however, some reactions being uneasy to read, distinction between Salmonella typhi or non typhi is not reliable. PMID- 3283693 TI - [Diagnosis of cerebral cysticercosis on Reunion Island by an immuno-enzymological method (ELISA): comparison with x-ray computed tomography]. AB - An immunoenzymologic (Elisa) serodiagnosis of cysticercosis is evaluated in 75 encephalic cysticercosis patients whose diagnosis of the disease and its progression in assessed by tomodensitometry. A Taenia solium antigen is used. Only IgG are investigated. The sensibility of serodiagnosis is 85% and specificity 87% when there is a progression of the disease; no difference is noticed in the patients without any progression of the disease and in control normal subjects. This serodiagnosis of cysticercosis appears of value for the evaluation of the activity of the disease. PMID- 3283694 TI - [Proteinases and proteins in the epithelial and mesenchymal tissues in disordered innervation]. PMID- 3283695 TI - [Aleksei Dmitrievich Speranskii (on the centenary of his birth)]. PMID- 3283696 TI - [Mechanisms of the stability of cardiovascular functions in experimental emotional stress]. PMID- 3283697 TI - [Ultrasonic examination of the biliary tract and pancreas in children with gastroduodenobiliary diseases]. PMID- 3283698 TI - [Location of latent urinary tract infection in children using the results of the bladder lavage test]. PMID- 3283699 TI - [A method of echotomography under anesthesia of neoplasms in children]. PMID- 3283700 TI - [Pneumocystosis]. PMID- 3283701 TI - Personality and relaxation therapy: changes among clinical and normal subjects. AB - There are increasing numbers of self-referral stress-management programs, a few of which use group-relaxation techniques, but few data are available on the personalities of the symptomatic and asymptomatic clients who attend or on any changes in personality after the program. Scores on the Eysenck Personality Inventory, Multiple Health Locus of Control, and State-Trait Anxiety Inventory as well as demographic information were obtained from 255 adults who attended a 10 session, university-based, group-relaxation program. The symptomatic clients reported significantly less anxiety, less neuroticism, were more extraverted and ascribed less of their behavior to chance at a 1 month post-treatment follow-up than at intake. The small group of asymptomatic clients also reported less anxiety and neuroticism at the follow-up. There were no sex differences on the Eysenck inventory or the anxiety scales but there were for the Multiple Health internal and control scales. It was concluded that group relaxation appeared to improve mental health scores effectively for both stressed and nonstressed adults and that age was significantly related to some personality scores. PMID- 3283702 TI - Covalent cross-linking of poly(A) to Escherichia coli ribosomes, and localization of the cross-link site within the 16S RNA. AB - Poly(A) can be cross-linked to E. coli 70S ribosomes in the presence of tRNALys by mild ultraviolet irradiation. The cross-linking reaction is exclusively with the 30S subunit, and involves primarily the RNA moiety. Following a partial nuclease digestion, cross-linked complexes containing poly(A) and fragments of the 16S RNA were isolated by affinity chromatography on oligo(dT)-cellulose. The complexes were purified by gel electrophoresis and subjected to oligonucleotide analysis, which revealed a single cross-link site within positions 1394-1399 of the 16S RNA. The same pattern of cross-linking, at about one-fifth of the intensity, was observed in the absence of tRNALys. The cross-link site to poly(A), together with other sites in the 16S RNA that have been implicated in ribosomal function, is discussed in the framework of our recent model for the three-dimensional structure of 16S RNA; all of the functional sites are clustered together in two distinct groups in the model. PMID- 3283703 TI - Effects of tRNA-intron structure on cleavage of precursor tRNAs by RNase P from Saccharomyces cerevisiae. AB - RNase P derived from S. cerevisiae nuclei was tested for its ability to cleave a variety of naturally occurring and selectively altered precursor-tRNA molecules to yield matured 5' termini. Precursors were synthesized in vitro in order to test which aspects of substrate structure are crucial to recognition and cleavage by RNase P. Base modifications in the precursor substrates are not required for cleavage by the enzyme, but deletion and substitution mutations affecting any portion of the precursor tertiary structure reduce cleavage. In particular, a number of alterations in the intervening sequence (IVS) reduce the susceptibility of the substrate to cleavage by RNase P. The significance of these results is discussed in reference to the contribution of the IVS to the structure of the precursor-tRNA. PMID- 3283705 TI - Coding sequence of human rho cDNAs clone 6 and clone 9. PMID- 3283704 TI - Structure and expression of the PHO80 gene of Saccharomyces cerevisiae. AB - In yeast, the repression of acid phosphatase under high phosphate growth conditions requires the trans-acting factor PHO80. We have determined the DNA sequence of the PHO80 gene and found that it encodes a protein of 293 amino acids. The expression of the PHO80 gene, as measured by Northern analysis and level of a PHO80-LacZ fusion protein is independent of the level of phosphate in the growth medium. Disruption of the PHO80 gene is a non-lethal event and causes a derepressed phenotype, with acid phosphatase levels which are 3-4 fold higher than the level found in derepressed wild type cells. Furthermore, over-expression of the PHO80 gene causes a reduction in the level of acid phosphatase produced under derepressed growth conditions. Finally, we have cloned, localized and sequenced a temperature-sensitive allele of PHO80 and found the phenotype to be due to T to C transition causing a substitution of a Ser for a Leu at amino acid 163 in the protein product. PMID- 3283706 TI - Utility dressing. PMID- 3283707 TI - Cooking methods, carcinogens, and diet-cancer studies. AB - A neglect of natural, preservative, and cooking-induced carcinogens or mutagens in food, along with a neglect of dietary patterns during the first portion of a person's lifetime, may be responsible for the many conflicting epidemiological reports dealing with dietary factors and cancer. From animal and occupational studies, we know that the two most important factors in the study of cancer are the dose of carcinogen and allowance for a long latent period. Most of the recent nutrition and cancer studies have ignored both factors. Some bile acids or other endogenous factors may be influenced by diet and may act as cancer-promoting agents, but promoting agents cannot be studied in the absence of knowledge about, or control of, the cancer-initiating events with which they must interact. PMID- 3283708 TI - Tryptophan, urinary quinolines, and bladder cancer. PMID- 3283709 TI - Suture technicians in a children's hospital emergency department. AB - A program that employs technicians for suturing lacerations is presented. Careful selection of the candidates, intensive training, and ongoing monitoring of their activities have been major factors in the success of the program. The curriculum of a course for suture technicians and their job description are discussed. PMID- 3283710 TI - Retropharyngeal abscesses in children: a 10-year review. AB - Retropharyngeal abscess is a rather rare, deep-neck infection of children and may seriously compromise the airway and mimic other diseases. A retrospective review of 17 cases of retropharyngeal abscess presenting to The Children's Hospital, Denver, from 1976 to 1986 was performed. Nine children (56%) had stridor or airway obstruction. Seven patients (41%) had perforations of their hypopharynx or esophagus, including two neonates (most likely associated with intubation attempts). Two patients presented in the emergency department with a tentative diagnosis of "epiglottitis," while another referred to as having "persistent fever" was found to have a needle embedded in the hypopharynx. Fourteen children (81%) were brought to the operating room for examination and/or drainage of the abscess under general anesthesia. One child received an elective tracheotomy, and two others remained intubated postoperatively, pending resolution of their airway compromise. X-rays of the lateral neck were confirmatory in all these cases, with an unusually high incidence of "air/fluid levels," probably reflecting the corresponding large number of perforations of the hypopharynx or esophagus with subsequent communication into the retropharyngeal space. PMID- 3283712 TI - Leukemia derived from intermediately differentiated lymphocytic lymphoma. AB - The availability of monoclonal antibodies has facilitated the immunophenotypic characterization of malignant lymphocytes from patients with lymphoma and leukemia. The chronic lymphocytic leukemias are diseases of both clinical and morphological diversity and the application of monoclonal antibodies can prove helpful in their classification. Enzyme cytochemistry, surface markers, mouse rosetting, and electron microscopy were used to determine the phenotype of cells from an atypical case of B-CLL. The use of monoclonals Leu-1, CALLA and BA-2 on bone marrow and peripheral blood provided the opportunity to diagnose this patient's disease as intermediately differentiated lymphoma. Leu-1 was found to be a useful alternative to mouse rosetting, a technique not easily performed in a routine setting. Ultrastructural studies helped to prove the prolymphocytic component of this patient's disease. It was concluded that phenotypic characterization of lymphoid cells using monoclonal antibodies directed against membrane antigens facilitated the assessment of this patient's disease. PMID- 3283711 TI - Proteolytic inactivation of luteinizing hormone-releasing hormone (LHRH) by the whole rat ovary in vitro. AB - Using 3H-labeled luteinizing hormone-releasing hormone (LHRH) at low concentrations, the in vitro proteolytic inactivation of the peptide hormone by whole rat ovaries was studied and compared with that by the soluble and particulate rat ovarian fraction. Whole rat ovaries were found to express the three proteolytic activities that were, according to their properties, also observed in rat ovarian homogenates: (1) soluble intracellular activity which was released into the medium, (2) released activity of membrane-bound origin, and (3) firmly membrane-bound activity. It is suggested that in vivo LHRH is largely inactivated extracellularly at least by enzymes that are located in the plasma membrane although the membrane-bound activity comprises only about 1% of the whole LHRH-inactivating capacity of the ovary. PMID- 3283713 TI - The body-weight set point. What can you tell your patients? AB - Body weight can be viewed as a physiologic variable that, like core temperature, is regulated at a specified level or set point. Adjustments in both food intake and energy expenditure are used to stabilize weight at the set-point level. Animal studies indicate that some forms of obesity can be regarded as instances of regulation at an elevated set point, while other forms seemingly result from a regulatory dysfunction. Possibly, a similar distinction between regulated and unregulated forms of obesity can be made in humans. Traditional weight-loss programs may be effective in treating unregulated forms. However, if obesity is the consequence of regulation at a high set point, a metabolic resistance to weight change will be encountered and weight loss will be difficult to achieve or maintain. Help for such patients will await development of safe and effective methods for altering the set point. PMID- 3283714 TI - Impotence in elderly men. AB - Impotence in not a concomitant of aging. A diligent search must be undertaken to determine the cause, which may be endocrine, pharmacologic, vascular, neurologic, psychological, or miscellaneous (eg, chronic illness). Many therapies are available for elderly impotent men. Some are based on pharmacology (eg, testosterone supplementation, thyroid replacement, self-injection), some on surgery (eg, vascular reconstruction), and some on a prosthesis (semirigid, inflatable, or mechanical). In choosing the type of treatment, the physician must consider the patient's underlying medical condition, activities of daily living, social life, and partner's expectations in addition to the cause of the impotence. PMID- 3283715 TI - [Children with disorders of immune defense in isolation units. Review of psychological changes]. PMID- 3283716 TI - The BOR syndrome and renal agenesis--prenatal diagnosis and further clinical delineation. AB - This is the first report of prenatal diagnosis of a fetus with brachio-oto-renal dysplasia (BOR) syndrome with right-sided renal agenesis and severe left hypoplasia. The father of this fetus had malformed external ears, a left-sided preauricular pit and branchial cyst, and bilateral mild to moderate deafness without a demonstrable renal anomaly. This family highlights the variable expressivity seen in the autosomal dominant BOR syndrome, the importance of genetic counselling for families with BOR syndrome, and the aetiologic heterogeneity of renal agenesis. PMID- 3283717 TI - Accuracy of ultrasound diagnoses in pregnancies complicated by suspected fetal anomalies. AB - Referral of pregnancies complicated by suspected fetal anomalies to level III perinatal centres for further evaluation and management is increasing as use of real-time ultrasound spreads, but the sensitivity and specificity of the prenatal diagnoses made in this population are unknown. We undertook a prospective study that followed pregnancies referred to a designated programme dealing with suspected fetal abnormalities. Follow-up of 257 pregnancies revealed that 282 separate anomalies were accurately diagnosed in 212 cases. Normal anatomy was correctly predicted in 42 cases, 16 per cent of the referred population. False positive and false-negative rates were 1.5 per cent (4/257) and 2 per cent (1/46), respectively. However, 37 per cent of those infants born with anomalies had additional problems not prenatally detected by ultrasound. These results indicate that prenatal ultrasound diagnoses are remarkably accurate overall but that they may be insensitive to associated anomalies in individual cases. PMID- 3283719 TI - Congenital pleural effusion: prenatal ultrasonic diagnosis and therapeutic management. AB - A case of fetal pleural effusion detected by ultrasound at 33 weeks of gestation is described. PMID- 3283718 TI - Prenatal diagnosis of the pterygium syndrome. AB - We report two second trimester pregnancy terminations in the same woman following intrauterine ultrasonic findings of hydrops fetalis, polyhydramnios, lack of fetal movements, and short, fixed malformed limbs. One fetus also showed a cystic mass at the back of the head. Radiographic and anatomic studies of the fetuses demonstrated multiple pterygia, flexion contracture of multiple joints, abnormal facial appearance, cleft palate, pulmonary hypoplasia, and gracile bones. The cystic mass of the back of the head was found to be a cystic hygroma. These findings are consistent with the lethal variant of multiple pterygium syndrome. Early prenatal diagnosis of this condition is possible using ultrasonography. PMID- 3283720 TI - Safety of amniocentesis. PMID- 3283721 TI - Prenatal evaluation and outcome of fetal obstructive uropathies. AB - Between January 1982 and January 1986, 76 pregnant women between 15 and 40 weeks of gestation were referred because of suspected fetal obstructive urinary tract pathology. A total of 14 high-level (ureter) and 17 low-level (urethral) obstructions were diagnosed. High-level obstructions were at the uretero-pelvic level in 11 and at the uretero-vesical level in 3 cases. Increased amniotic fluid volume was observed in 28 per cent. The survival rate was 86 per cent. In the 17 cases of urethral obstruction, oligohydramnios was present in 70 per cent, associated structural defects in 30 per cent, and abnormal karyotype in 6 per cent. Pregnancy was terminated because of progressive massive hydronephrosis in 41 per cent; intrauterine or neonatal death occurred in 47 per cent, resulting in a survival rate of only 12 per cent. PMID- 3283722 TI - [Island changes in insulin-dependent diabetes in old age. Immunocytochemical pancreas studies in a diabetic patient with hypothyroidism]. PMID- 3283724 TI - Acute atherosis. A histopathological hallmark of immune aggression? AB - Acute atherosis is a maternal vascular lesion observed regularly in cases of pre eclampsia and idiopathic intrauterine growth retardation. This vasculopathy is characterized by fibrinoid necrosis of the vessel wall, an accumulation of lipid laden macrophages, and a mononuclear perivascular infiltrate. Similar vascular lesions are seen in the decidual vessels of patients with autoimmune diseases, and in renal, cardiac and hepatic homograft rejection. Immunohistochemical studies often reveal extensive vascular deposition of IgM and complement in acute atherosis-like lesions. Granular deposition of immunoglobulins and complement within the vessel walls and mononuclear perivascular infiltrate may be a histopathological hallmark of a maternal immunological aggression against fetal tissues. PMID- 3283723 TI - Abnormal expression of class II MHC antigens in placentae from patients with pemphigoid gestationis: analysis of class II MHC subregion product expression. AB - Abnormal expression of class II MHC antigens was consistently observed in an immunohistological study on placentae from patients with pemphigoid gestationis. The area affected in all the placentae was the chorionic villi adjacent to the maternal decidua. The villous stroma, and in some cases the chorionic fetal endothelium, had abnormal expression of class II MHC antigens. Monoclonal antibodies specific for the class II MHC subregion products (DR, DP and DQ) were used to analyse the class II MHC antigen expression. Differential expression of the class II MHC subregion products was observed on the villous stroma and chorionic fetal endothelium; DR and DP were always expressed but DQ in some cases was heterogeneous. This abnormal expression of class II MHC antigens may reflect an immunological attack on the placenta in pemphigoid gestationis. PMID- 3283725 TI - [Use of human insulin preparations in the treatment of patients with insulin dependent diabetes mellitus]. AB - The authors presented the results of a study of human insulin drugs Monotard HM and Actrapid HM (Novo, Denmark) for type I diabetes mellitus. They stressed their efficacy in therapy of insulin dependent diabetes mellitus: a course of disease became less labile, the time of achieving compensation was reduced; the drugs proved to be effective in the treatment of post-injection insulinlipodystrophies, in body mass deficiency; a tendency to a decrease in daily insulin requirement, serum insulin binding capacity, and in increase in the content of free insulin were noted. PMID- 3283726 TI - [Physical loads in patients with diabetes mellitus type 1]. PMID- 3283728 TI - [The role of thymus hormones in the recognition of autologous cells by T lymphocytes]. PMID- 3283727 TI - [Effect of propranolol on the indicators of carbohydrate metabolism and lipid transport in patients with diabetes mellitus type 2]. AB - The paper is concerned with some data on the time course of indices of carbohydrate metabolism and lipid spectrum in patients with type II diabetes mellitus with concomitant CHD or arterial hypertension during therapy with mean doses of propranolol. The course treatment with propranolol resulted in the deterioration of carbohydrate metabolic indices and unfavorable shifts in the lipid spectrum of some patients. Patients on insulin therapy might demonstrate a significant decrease in the blood sugar level after physical exercise. The results obtained indicate the necessity of control over indices of carbohydrate and lipid metabolism in patients with type II diabetes mellitus during propranolol therapy. PMID- 3283729 TI - [Changes in the proteinase-inhibitor balance in bronchoalveolar lavage in experimental inflammation of the lung]. PMID- 3283730 TI - Pancreatic carcinoma associated with chronic calcifying pancreatitis in Taiwan: a case report and review of the literature. AB - A 62-year-old Chinese woman suffering from pancreatic carcinoma coexisting with chronic calcifying pancreatitis is reported. Ultrasonography and computed tomography disclosed multiple intraductal calcifications in the pancreatic head and body and a tumor at the tail. Laparotomy revealed cancerous peritonitis in addition to verifying the presence of calcifications at the head and body and a cancer at the tail. Histology confirmed adenocarcinoma. The incidence of pancreatic carcinoma in chronic calcifying pancreatitis varied from 0.8 to 25% in a thorough review of the literature. It is emphasized that patients with chronic calcifying pancreatitis should be closely followed for detection of possible coexisting pancreatic malignancies. PMID- 3283731 TI - Effects of epidermal growth factor, insulin and insulin-like growth factor I on rat pancreatic acinar cells cultured in serum-free medium. AB - The effects of epidermal growth factor (EGF), insulin, and insulin-like growth factor I (IGF-I) were examined alone and in combination on rat pancreatic acinar cells cultured 48 h in serum free medium. IGF-I at a concentration of 2.7 nM maintained viability of cultured acinar cells comparably to EGF. In contrast, insulin was less effective in maintaining acinar viability, even at high concentrations (170nM). There were no additive or interactive effects of these growth factors on acinar viability. EGF significantly increased [3H] phenylalanine incorporation into acinar protein and the specific activity of phenylalanine-acylated transfer RNA (tRNAphe), but did not change the apparent rate of protein synthesis when compared with insulin of IGF-I. EGF with insulin, IGF-I, or both resulted in significantly lower specific activities of tRNAphe when compared to EGF alone, but all had comparable rates of total phe incorporation. Acinar cells readily degraded insulin, but not EGF or IGF-I. These results demonstrate some specificity in the acinar requirement for growth factors (EGF = IGF-I greater than insulin) in maintaining viability in culture. PMID- 3283733 TI - Sequence comparisons in the aminoacyl-tRNA synthetases with emphasis on regions of likely homology with sequences in the Rossmann fold in the methionyl and tyrosyl enzymes. AB - Amino acid sequences of aminoacyl-tRNA synthetases specific for 12 different amino acids have now been published. Differences in origin at the species and organelle level result in 20 distinct sequences being available for comparison. Some of these were compared in small groups as they were determined and, although some homologies were detected, it was generally concluded that there was surprisingly little sequence homology in this functionally related group of enzymes. We have made comparisons of all of the available sequences by using a combination of computer and manual alignment methods and knowledge of the sequences in the Rossmann fold region of methionyl-tRNA synthetase from E. coli and tyrosyl-tRNA synthetase from B. stearothermophilus, enzymes whose three dimensional structures have been described. It emerges that all of the aminoacyl tRNA synthetase sequences thus examined show considerable homology with each other over at least parts of this region, some over virtually all of it. We conclude that a great deal more similarity than had previously been suspected exists in these proteins. In particular, the alignments we have made strongly imply the existence of a mononucleotide binding site of the Rossmann fold configuration in all of the synthetases compared. PMID- 3283732 TI - A comparison of the insulinotropic and the insulin-inhibitory actions of gut peptides on newborn and adult rat islet cells. AB - The objective of this study was to examine the release of insulin from cultured islet cells, taken from the pancreas of newborn and adult rats, in response to gastric inhibitory polypeptide (GIP), cholecystokinin-8 (CCK-8), calcitonin gene related peptide (CGRP), and pancreastatin. GIP (10(-9)-10(-7) M) potentiated glucose-stimulated release of insulin in a dose-dependent fashion from both newborn and adult islet cells. CCK-8 (greater than 10(-8) M) also increased glucose-stimulated release of insulin from newborn islet cells, however its effect was not significant and not as strong as that observed with adult islet cells. Culture of newborn islet cells for 3 weeks with media containing high concentrations of glucose (16.7 mM) enhanced insulin release in response to CCK 8. CGRP did not affect the release of insulin from newborn islet cells, whereas at 10(-10) M, it reduced the release of insulin from adult islet cells by 66 +/- 4%. Pancreastatin (10(-9)-10(-8) M) did not affect the release of insulin from newborn islet cells when cells were incubated with 4.2 mM glucose, whereas it stimulated the release of insulin from adult islet cells in a dose-dependent fashion. When incubated with 16.7 mM glucose, pancreastatin inhibited the release of insulin from both newborn and adult islet cells. These results indicate that newborn islet cells experience developmental changes which render them responsive to enteric peptides. PMID- 3283734 TI - Blood group antigens as differentiation and tumor-associated markers in oral epithelium. PMID- 3283735 TI - Role of domain II of Pseudomonas exotoxin in the secretion of proteins into the periplasm and medium by Escherichia coli. AB - Pseudomonas exotoxin (PE) is composed of structural domains I, II, and III; when interacting with mammalian cells the function of domain I is cell recognition, the function of domain II is membrane translocation, and domain III functions in ADP ribosylation. PE is secreted by Pseudomonas aeruginosa into its growth medium. The domain responsible for secretion has been examined by expressing modified PE genes in Escherichia coli under the control of a T7 promoter. Without a signal sequence, PE accumulates within the cell, but PE is secreted into the periplasm when part or all of domain I is removed. PE appears in the periplasm and medium when domain I and part of domain II are removed. Domain II alone is secreted into the periplasm, whereas domain III alone remains within the cell. Addition of an OmpA signal sequence results in secretion of mature PE into the periplasm and secretion of domains II-III into the medium. A protein composed of transforming growth factor alpha fused to the amino terminus of domains II-III is secreted into the periplasm without a signal sequence and into the medium with a signal sequence. A protein composed of domain(s) II or II-III fused to the amino terminus of alkaline phosphatase is secreted into the periplasm and the medium with or without a signal sequence. We conclude that domain II contains important information for protein secretion. PMID- 3283736 TI - Purification of maturation-promoting factor, an intracellular regulator of early mitotic events. AB - Maturation-promoting factor causes germinal vesicle breakdown when injected into Xenopus oocytes and can induce metaphase in a cell-free system. The cell-free assay was used to monitor maturation-promoting factor during its purification from unfertilized Xenopus eggs. Ammonium sulfate precipitation and six chromatographic procedures resulted in a preparation purified greater than 3000 fold that could induce germinal vesicle breakdown within 2 hr when injected into cycloheximide-treated oocytes. Proteins of 45 kDa and 32 kDa were correlated with fractions of highest activity in both assays. These fractions contained a protein kinase activity able to phosphorylate the endogenous 45-kDa protein, as well as histone H1, phosphatase inhibitor 1, and casein. The highly purified preparations described here should help to identify the mechanism of action of maturation promoting factor and to elucidate the role of protein kinases in the induction of metaphase. PMID- 3283737 TI - A second DNA methyltransferase repair enzyme in Escherichia coli. AB - The Escherichia coli ada-alkB operon encodes a 39-kDa protein (Ada) that is a DNA repair methyltransferase and a 27-kDa protein (AlkB) of unknown function. By DNA blot hybridization analysis we show that the alkylation-sensitive E. coli mutant BS23 [Sedgwick, B. & Lindahl, T. (1982) J. Mol. Biol. 154, 169-175] is a deletion mutant lacking the entire ada-alkB operon. Despite the absence of the ada gene and its product, the cells contain detectable levels of a DNA-repair methyltransferase activity. We conclude that the methyltransferase in BS23 cells is the product of a gene other than ada. A similar activity was detected in extracts of an ada-10::Tn10 insertion mutant of E. coli AB1157. This DNA methyltransferase has a molecular mass of about 19 kDa and transfers the methyl groups from O6-methylguanine and O4-methylthymine in DNA, but not those from methyl phosphotriester lesions. This enzyme was not induced by low doses of alkylating agent and is expressed at low levels in ada+ and a number of ada- E. coli strains. PMID- 3283738 TI - An alternative approach to somatic cell gene therapy. AB - Mouse primary skin fibroblasts were infected with a recombinant retrovirus containing human factor IX cDNA. Bulk infected cells capable of synthesizing and secreting biologically active human factor IX protein were embedded in collagen, and the implant was grafted under the epidermis. Sera from the transplanted mice contain human factor IX protein for at least 10-12 days. Loss of immunoreactive human factor IX protein in the mouse serum is not due to graft rejection. Instead, the mouse serum contains anti-human factor IX antibodies, which react with the protein. We suggest that retroviral-infected primary skin fibroblasts offer an alternative approach to somatic cell gene therapy. PMID- 3283740 TI - Defects in early and late stages of nucleotide excision repair and the origins of cancer. PMID- 3283739 TI - Neural and humoral factors separately regulate neuropeptide Y, enkephalin, and chromogranin A and B mRNA levels in rat adrenal medulla. AB - The influence of neurogenic versus humoral factors on mRNA levels of several secretory proteins of rat adrenal medulla was studied in vivo. Increased splanchnic nerve activity was generated (reflexly) with insulin treatment. Twenty four hours after insulin injection, levels of mRNAs encoding neuropeptides (enkephalin and neuropeptide Y) were increased 6.5-fold, whereas those of mRNAs for the major secretory proteins (chromogranins A and B) were unchanged. Bilateral transection of the splanchnic nerves completely prevented this increase. Hypophysectomy decreased levels of chromogranin A mRNA to 32% of control, suggesting a dependence on hormones of the pituitary-adrenal axis. Treatment of hypophysectomized rats with dexamethasone restored chromogranin A mRNA to basal levels. Chromogranin B mRNA levels were not changed by either insulin treatment or hypophysectomy. These results demonstrate (i) that different classes of secretory proteins present in chromaffin granules are regulated by different mechanisms, (ii) that this regulation occurs at a pretranslational site, and (iii) that the relative concentration of secretory constituents of chromaffin granules may vary. The significance of an altered composition of secretory-granule constituents, which may be important in hypotension or stress, is discussed. PMID- 3283741 TI - Modification by vitamins and nutrients of induction of terminal differentiation of myeloid leukemia cells. PMID- 3283742 TI - Levels of epidemiologic proof in studies of diet and cancer with special reference to dietary fat and vitamin A. PMID- 3283743 TI - The status of zinc, copper, and metallothionein in cancer patients. AB - Metallothioneins that bind copper and zinc have an Mr of 6500 daltons, consist of a single polypeptide chain of 61 amino acids, 25-30 percent of whose residues are cysteine, have a metal-binding capacity of between 5 and 7 g atoms/mol, and contain no disulfide bonds or aromatic amino acids. Zincthionein has been postulated to participate in the transport and storage of zinc, which is involved in more than 235 metalloenzymes, including thymidine kinase, RNA polymerase, and ribonuclease, which in turn play crucial roles in the replication and transcription of DNA during cell division. In addition, trace elements including zinc modulate immune response and function. Conversely, zinc deficiency state causes, for example, thymic atrophy and lymphopenia and modifies antibody mediated responses to both T-cell-dependent and T-cell-independent antigens. The concentrations of copper, zinc, and metallothionein and the copper/zinc ratio are modified in a number of malignancies. For example, the levels of metallothionein in normal and in malignant human livers are 471 and 75 micrograms/g, respectively. In addition, the copper/zinc ratio is significantly increased in human pancreatic cancer from 1.40 to 2.70. Furthermore, studies involving 64Cu in tumor-bearing mice showed that the distribution of 64Cu was altered and that all tumors contained a relatively high level of 64Cu. Moreover, the activity of superoxide dismutase to remove free oxygen radicals is lower in malignant tissues. Finally, the results of clinical studies suggest that the monitoring of the serum copper/zinc ratio may be a valuable tool, not only in determining the extent of malignancies, but also in predicting the efficacy of treatments. PMID- 3283744 TI - Cancer chemoprevention by carotenoids. Experimental evidence and human interventions after radical surgery. PMID- 3283745 TI - Tumor promotion, vitamin A, and fibronectin. A review of recent work. PMID- 3283747 TI - Retinoids as anticancer agents. PMID- 3283746 TI - Vitamin A, beta-carotene and cancer. PMID- 3283748 TI - Inhibition of phorbol ester-induced ornithine decarboxylase gene transcription by retinoic acid: a possible mechanism of antitumor promoting activity of retinoids. AB - We have shown that retinoic acid, applied either to the skin or administered in diet, inhibits skin tumor promotion by TPA. Retinoic acid does not inhibit the initiation step of mouse skin carcinogenesis. Our results indicate that retinoic acid inhibits both stage I and stage II of tumor promotion, and the inhibition of tumor promotion depends upon the duration of retinoic acid treatment. The inhibition of skin carcinogenesis by retinoic acid is not universal; retinoids exhibit specificity towards carcinogens and tumor promoters. In conclusion, the results presented indicate that the inhibition of TPA-induced ODC gene expression may be one of the mechanisms contributing to the antitumor promoting property of the retinoids. However, other mechanisms concerning the effect of retinoic acid on chromatin structure (Porter et al., 1986), glycoprotein synthesis (Levin et al., 1983), peptide growth factors (Sporn et al., 1986), induction of transglutaminase (Lichti and Yuspa, 1985) and the host-immune system (Dennert, 1985) may also explain the molecular basis of retinoid action. PMID- 3283749 TI - Vitamin A analogs (retinoids) as biological response modifiers. PMID- 3283750 TI - Molecular aspects of cell differentiation at the level of messenger polyadenylation-deadenylation. PMID- 3283751 TI - Vitamin B6 status in cancer patients: effect of tumor site, irradiation, hormones and chemotherapy. PMID- 3283752 TI - New experimental possibilities in nutritive oncology by the model of human tumors, xenotransplanted and passaged into athymic nude mice. AB - The model of human tumors, heterotransplanted and subsequently passaged into athymic nude mice, enlarges the scale of possibilities in experimental oncology considerably. The model is mostly used in testing therapeutic schedules and principles. But the results of our research indicate that the model can be successfully used in nutritive oncology also. Tumor specific dependencies on dietary ingredients or on nutritive substances may be evaluated. PMID- 3283753 TI - Vitamin C and cancer. PMID- 3283754 TI - Analyses of vitamin C in biological samples with an emphasis on recent chromatographic techniques. AB - AA analyses are rife with problems - but primarily stability of the sample AA and specificity are the most prevalent shortcomings of the assays reviewed. Should one desire to quantify AA alone with no consideration for DHAA or DKG, chromatographic separations such as those described by Nahrwold (1981) with reductants added to samples and standards using UV detection, or Iwata et al. (1985) with fluorescence or Tsao and Salimi (1982) with EC detection would probably be appropriate depending upon the equipment available. The initial preparation of sample must be tested to ensure that no spontaneous oxidation of AA occurs during the sample preparation. The main advantage of these chromatographic assays is simply that one is measuring AA directly. On the other hand, manual assays such as that proposed by Zannoni et al. (1974) or Samyn (1983) have apparently demonstrated sufficient specificity and sensitivity to be used as well. When other vitamin C compounds need to be quantified, chromatographic assays should be considered but the selection is largely dependant on the sample size (and thus sensitivity required), the possible interfering compounds, and the detector available. Ideally HPLC should ensure the specificity by resolving the compounds of interest from artifacts. However, the optical characteristics of DHAA and DKG which are quite different from that of AA and detection limitations have fostered a number of complicated manipulations to quantify the former. PMID- 3283755 TI - Prolongation of the survival time of tumor bearing Wistar rats through a simultaneous oral administration of vitamins C + E and selenium with glutathione. PMID- 3283756 TI - Factors influencing glia growth in culture: nutrients and cell-secreted factors. PMID- 3283757 TI - An overview of the role of diet and nutrition in carcinogenesis. PMID- 3283758 TI - Concepts in cancer biology. PMID- 3283759 TI - Multiple cell markers and flow cytometry in invasive bladder cancer. PMID- 3283760 TI - Ongoing trials in bladder cancer conducted by the EORTC Genito-Urinary Tract Cancer Cooperative Group. PMID- 3283761 TI - Transurethral echography. PMID- 3283762 TI - Transurethral ultrasound versus CT scan. PMID- 3283764 TI - The relationship between transurethral ultrasound and pathological findings in 16 cases of tumour of the bladder. PMID- 3283763 TI - Transurethral ultrasonography, CT scan, nuclear magnetic resonance (NMR) imaging and pathological control in staging and follow up of invasive bladder carcinoma. AB - Diagnostic accuracy in clinical staging of bladder cancer, using traditional methods, is still imperfect. Clinical and pathological staging do not always correlate. The accuracy of the new imaging techniques in the staging and in the follow-up of this kind of neoplasia, has yet to be assessed. Our study involved 7 patients with invasive bladder cancer who had undergone transurethral ultrasonography, CT scan, NMR and transurethral resection of the tumour. We have compared the clinical staging accuracy of the three imaging methods with the pathological reports. We conclude that transurethral ultrasonography is superior to the other methods, as far as local staging is concerned. In regional staging, NMR has shown very promising results and, in our preliminary opinion, may be more accurate than CT scan. PMID- 3283765 TI - Lymphadenectomy in the management of bladder cancer. PMID- 3283766 TI - Combination therapy with flutamide and castration (orchiectomy or LHRH agonist): the minimal endocrine therapy in both untreated and previously treated patients with advanced prostate cancer. AB - One hundred fifty-four patients with clinical stage D2 prostate cancer with no previous endocrine therapy or chemotherapy received the combination therapy with the pure antiandrogen Flutamide and the LHRH agonist [D-Trp]LHRH ethylamide for an average of 22 months (3 to 49). The objective response to the treatment was assessed according to the criteria of the US NPCP. There was a 6.3-fold increase (29.2 versus 4.6%) in the percentage of patients who achieved a complete response as compared to the results achieved in 5 recent studies limited to removal (orchiectomy) or blockade (DES or Leuprolide) of testicular androgens. Only 4.5% of patients did not respond to the combination therapy as compared to an average of 18% by standard therapy. The duration of response is also significantly increased in the patients who received the combination therapy while the death rate was decreased by approximately 2-fold between 2 and 3 years of treatment. The marked (6.3-fold) improvement in the rate of complete objective responses coupled with the 4-fold decrease in the number of non responders, the increased duration of the positive responses and the 2-fold decrease in the death rate at 2 to 3 years of treatment are obtained with the combination therapy using Flutamide and castration with no or minimal secondary effects. In addition, two hundred nine patients with biopsy-proven stage D2 prostatic adenocarcinoma showing disease progression after orchiectomy, DES or an LHRH agonist used alone received the combination therapy with the pure antiandrogen Flutamide. In patients treated with DES, the estrogen was replaced by the LHRH agonist [D-Trp6]LHRH ethylamide. Objective response to therapy was also assessed according to the criteria of the US NPCP. Thirteen patients (6.2%) had a complete response to treatment while partial and stable responses were achieved in 20 (9.6%) and 39 (18.7%) patients, respectively, for a total objective response rate of 34.5%. The mean duration of response was 24 months. While, in the non responders, the median survival was 8.13 months with a 17% probability of survival at 2 years, the probability of survival of patients who showed partial and stable responses at 2 years was 87 and 67%, respectively. All patients who achieved a complete response are still alive. Considering the excellent tolerance coupled with an objective response observed in 34.5% of the patients, the combination therapy with Flutamide and castration (surgical or LHRH agonist) appears to be the treatment of choice for prostate cancer patients in relapse after standard endocrine therapy. PMID- 3283767 TI - Chemotherapy for metastatic bladder cancer; the EORTC experience. PMID- 3283768 TI - M-VAC: methotrexate (MTX), vinblastine (VLB), adriamycin (ADM), and cisplatin (DDP) for metastatic and node positive carcinoma of the urothelium. PMID- 3283769 TI - Analysis of trials using chemotherapy for metastatic bladder cancer. AB - Reported rates of tumour response for metastatic bladder cancer vary widely among different institutions, even when similar drug regimens are employed. These differences are due to selection of patients, quality of supportive care, and to methodological differences in the design, analysis and reporting of clinical trials. Because of these factors, intercomparison of response rates from different phase 2 trials is not very meaningful. Trials from the Princess Margaret Hospital have demonstrated palliation from several regimens, but it remains uncertain whether aggressive regimens using several drugs are superior to less toxic chemotherapy. Current clinical trials which randomize patients to receive aggressive chemotherapy or single agents should help to resolve some of these problems. PMID- 3283771 TI - Hemotherapy--oncological checkmate or surgical aid? PMID- 3283770 TI - Neo-adjuvant M-VAC chemotherapy trials in transitional cell carcinoma: perspectives for first line chemotherapy. PMID- 3283772 TI - Phase III trials. Medical Research Council. PMID- 3283773 TI - A comparative study of spectrophotometric methods for the determination of captopril in pharmaceutical formulations. PMID- 3283774 TI - Monitoring adverse drug reactions in the postmarketing phase. PMID- 3283775 TI - An open clinical trial with 2% miconazole plus 1% hydrocortisone ointment in the treatment of eczematous lesions. AB - An open, multi-centre study was carried out to assess the efficacy and acceptability of an ointment formulation of 2% miconazole and 1% hydrocortisone ('Daktacort') in 73 patients with eczematous lesions, with or without bacterial superinfection. Patients were instructed to apply the ointment to the lesions morning and evening for 14 days; those with residual lesions were asked to continue treatment for a further 14 days. Assessments of the severity of the patients' symptoms were made by investigators before and after 7 and 14 days of treatment, and a global evaluation of response was made at the end of the treatment period. Patients kept a daily diary for 14 days in which they recorded the severity of their symptoms, acceptability of the ointment and details of any problems associated with treatment. Investigator rating of pruritus, weeping/bleeding, scaling, crusting, erythema, excoriation and burning/pain showed a significant improvement in these symptoms after 7 days and global assessment showed 85% of patients had responded after 14 days of treatment. Patient assessment using a diary card confirmed this improvement, and 96% found the ointment to be an acceptable form of treatment. PMID- 3283776 TI - The haemorheological and antithrombotic potential of pentoxifylline ('Trental'): a review. AB - Haemorheological knowledge achieved in the past decade has revealed the essential interactions of flow properties of blood with haemostatic, coagulation, and vessel wall mechanisms in blood flow disturbances. Fine tuning of these factors maintains the physiologically adequate perfusion of the nutritive microcirculation. Under pathological conditions, therefore, the most beneficial effect can be expected from the therapeutic approaches which, apart from the disturbed flow properties of the blood itself, improve also all the other factors involved. In consequence, it is suggested that treatment of circulatory disturbances should be directed not only at the reduction of enhanced red blood cell aggregation and improvement of impaired red blood cell deformability, but also at a diminuation of enhanced platelet and white cell hyperreactivity as well as at an amendment of hypercoagulability and of the affected endothelial and vessel wall systems. Experimental and clinical studies are reviewed to show that pentoxifylline meets these different requirements to a great extent. Its multi functional pharmacological profile suggests new aspects in the treatment of circulatory disorders in many diseases and in the prevention of thrombotic events. PMID- 3283777 TI - Controlled clinical trial of pentoxifylline versus cinnarizine in the treatment of labyrinthine disorders. AB - Seventy-six patients with labyrinthine diseases of vascular origin were treated in a 6-week double-blind comparative study with either 400 mg pentoxifylline ('Trental') or 75 mg cinnarizine 3-times daily. Clinical evaluations, supported by audiological tests and vectornystagmography, were carried out before and after treatment. Statistical analysis of the results showed pentoxifylline to be globally superior to cinnarizine and especially to have a more intense antivertiginous effect. No significant differences were observed between the two drugs in respect of tinnitus and hearing loss therapy. Side-effects were occasional, mild and well tolerated in the pentoxifylline group, and more pronounced and frequent with cinnarizine. PMID- 3283778 TI - D-1 and D-2 receptor blockade have additive cataleptic effects in mice, but receptor effects may interact in opposite ways. AB - The dopaminergic role of D-1 and D-2 receptors in catalepsy was evaluated using drugs with preferential receptor affinities. The D-1 antagonist, SCH 23390, caused distinct catalepsy in mice at 1, 2, and 10 mg/kg, IP, but not at two lower doses. The selective D-1 blocker, molindone, also caused catalepsy at 5 and 10 mg/kg; and blockade of both receptor types produced additive cataleptogenic effects. Apomorphine (4 mg/kg), which is an agonist for both receptors, potentiated SCH 23390-induced catalepsy much more than it did the catalepsy induced by molindone; the potentiation was produced by higher, not lower, doses of apomorphine. To determine if the apomorphine potentiation was mediated by D-1 or D-2 receptors, we tested selective agonists in mice that were concurrently injected with selective blockers. SCH 23390-induced catalepsy was potentiated by a large dose of the D-2 agonist, bromocriptine. The catalepsy of D-2 blockade with molindone was not potentiated by the D-1 agonist, SKF 38393, which slightly disrupted the catalepsy of D-2 blockade. We conclude that catalepsy is not a simple D-2 blockade phenomenon and that preferential antagonism of either receptor type can cause catalepsy. Catalepsy is most profound when both receptor types are blocked. Dopamine agonists, in large concentrations, are known to promote movements, and thus it is not surprising that they tend to disrupt catalepsy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3283779 TI - Interaction between opioid agonists or naloxone and 5-HTP on feeding behavior in food-deprived rats. AB - Morphine and the enkephalin analogs DAME, DADLE and FK-33824, as well as the opioid antagonist naloxone, decrease feeding in food-deprived rats after intraventricular or subcutaneous administration, FK-33824 being by far the most potent drug tested. The administration of subeffective doses of either morphine or naloxone given by the subcutaneous route induces anorexia when given in combination with a subeffective dose of 5-HTP whereas the treatment with subeffective intraventricular doses of any of the opioids or naloxone fails to potentiate 5-HTP. Similarly, the anorexia induced by FK-33824 is blocked by either morphine or naloxone given subcutaneously but not by intraventricular administration of the same two drugs. The results appear to suggest that central or peripheral opioid receptors differentially affect feeding behavior in the rat and, on the other hand, that the interaction of opiates with the serotonergic system appears to occur preferentially in the periphery. PMID- 3283780 TI - Reinforcing properties of caffeine: studies in humans and laboratory animals. AB - Three types of experimental studies are reviewed: (1) intravenous and oral caffeine self-administration by laboratory animals, (2) oral caffeine self administration by humans, and (3) human subjective effects of caffeine relevant to reinforcing effects. These studies show that, under appropriate conditions, caffeine can serve as a reinforcer and can produce elevations in subjective drug liking and/or euphoria. In this regard, caffeine can be distinguished from a wide range of behaviorally active compounds, such as the amphetamine analog fenfluramine and the major tranquilizer chlorpromazine, which do not produce such effects. Caffeine can also be distinguished from classic drugs of abuse such as cocaine, d-amphetamine or pentobarbital which generally maintain high levels of self-administration (or liking) in contrast to caffeine which tends to maintain lower levels of self-administration (or liking) or maintain self-administration under a more narrow range of parametric conditions. Several human studies and one animal experiment suggest that physical dependence substantially potentiates the reinforcing effects of caffeine. Other human and animal studies indicate that there may be substantial differences between individual subjects in the reinforcing effects of caffeine. An important challenge for future human and animal drug self-administration research will be to delineate more precisely the conditions under which caffeine does and does not serve reliably as a reinforcer. PMID- 3283781 TI - Adenosine antagonists as potential therapeutic agents. AB - The methylxanthine caffeine has been identified in more than 60 plant species and has been in human use for its various therapeutic actions for many hundreds of years and perhaps, with the exception of aspirin and related compounds, is the most widely consumed drug today. Pharmacologically, the xanthines are prototypic inhibitors of the enzyme, cyclic nucleotide phosphodiesterase, are calcium mobilizers and have been reported to inhibit the enzymes, monoamine oxidase and cyclooxygenase as well as affect uptake of the putative neuromodulator, adenosine. However, many of the therapeutic effects ascribed to caffeine are due to its selective ability to antagonize the actions of adenosine. Many xanthines, especially those substituted in the 8-position with a phenyl derivative, are potent and selective adenosine antagonists. The xanthine adenosine antagonists have mild psychostimulant, analgesic adjuvant, diuretic, cardiotonic and antiasthmatic activity. Adenosine antagonists also have nootropic activity. A major limiting factor to the development of this class of compound has been in the lack of selectivity for either of the major classes of adenosine receptor. Several non-xanthines including the pyrazolopyrimidine, DJB-KK, the pyrazoloquinoline, CGS 8216 and the pyrazolopyridine, etazolate have been shown to have adenosine antagonist activity. The triazoloquinazoline, CGS 15943 A has been identified as the first, potent (IC50 = 3 nM) nonxanthine, A2-selective adenosine antagonist while the phenylquinazoline, HTQZ, has 25-fold selectivity for the A2 receptor. The availability of such novel entities may permit the development of a new class of therapeutic agents able to affect neuromodulator, as opposed to neurotransmitter, function. PMID- 3283782 TI - Possible role of prolactin in the induction of hypogonadism by chronic alcohol treatment in the male rat. AB - Treatment of adult male rats with ethanol for a period of six weeks resulted in a numerical but not significant increase in plasma prolactin levels together with a reduction in plasma luteinizing hormone (LH) levels. Although basal plasma testosterone (T) levels were not affected in ethanol-treated animals, testicular weight was reduced and seminiferous tubules exhibited signs of atrophy. The responses of LH to luteinizing hormone releasing hormone (LHRH) and T to hCG were significantly impaired in ethanol-treated rats (p less than 0.01). Treatment with bromocriptine (1 mg/kg body weight/day), resulted in the expected decrease in plasma levels of prolactin and an increase in basal plasma LH levels to the levels found in control groups. Basal plasma T levels were not affected by bromocriptine. However, both plasma LH responses to LHRH and plasma T responses to hCG were significantly improved by bromocriptine treatment in alcoholic rats and became similar to the responses measured in control animals. The results suggest that bromocriptine-induced suppression of prolactin release has a beneficial effect on ethanol-induced hypogonadism. PMID- 3283783 TI - Are tricyclic antidepressants useful for mild depression? A placebo controlled trial. AB - Depressions in general practice tend to be mild and non-endogenous. The value of antidepressants and indications for their use in such depressions are not well documented. One hundred and forty one general practice depressives were treated from four to six weeks with amitriptyline in median dose 125 mgs daily or placebo in a randomised controlled trial. Significant drug placebo differences were apparent by two weeks and were strong by six weeks. Detailed examination of symptom ratings showed that the effect was a true antidepressant one, on core symptoms of depression. Interactions were examined between drug-placebo differences and a range of predictor characteristics. There were no significant interactions for demographic characteristics, history of illness or endogenous depression in terms of symptom pattern, absence of life stress or non-neurotic personality. Drug was superior to placebo in all subgroups. Only for initial severity of illness were significant interactions found. Amitriptyline was superior to placebo in probable and definite major depressions on the Research Diagnostic Criteria but not in minor depressions. It was also superior to placebo in patients with initial Hamilton Scale scores of more than 12, but not 6-12. Overall these findings indicate that tricyclic antidepressant is of clear therapeutic benefit in a spectrum of milder depressions except for the most mild of these. PMID- 3283784 TI - Monoamines, depression and antidepressant drugs. AB - The noradrenergic control of melatonin secretion in rat and man appears to have the property of a typical central noradrenergic system. Using the pineal as a model, increases and decreases in plasma melatonin levels are used to monitor the respective changes in noradrenergic transmission. Although in rats chronic imipramine treatment reduced pineal adrenoreceptor binding sites and melatonin levels, in depressed patients chronic treatment with desimipramine results in increases in plasma melatonin levels. These data support the classical view that in man antidepressants act by increasing monoamine transmission. The author postulates in depression a primary lesion distal to the monoaminergic projections but proximal to the hypothalamic nuclei, and further, that antidepressants may have a common effect on an as yet unidentified, hypothalamic neuropeptide. PMID- 3283786 TI - Aggressive approach to physical therapy management of the burned hand. A clinical report. AB - Hand burn care requires physical therapy involvement from the earliest stage of wound management. Hand burns may cause loss of sensation, decreased range of motion, loss of tissue and digits, or a combination of these conditions. The initial evaluation must include careful analysis of the extent and depth of the hand burn and concomitant injuries. Proper-positioning splints and active and passive range-of-motion exercises are vital to the preservation and restoration of function of the burned hand. This clinical report describes an aggressive physical therapy hand burn management program that is initiated early in patient care and continued throughout patient hospitalization and outpatient follow-up. PMID- 3283785 TI - The fenfluramine challenge test in the affective spectrum: a possible marker of endogeneity and severity. AB - In order to investigate the role of serotonergic mechanisms in depressive disorders, the fenfluramine challenge test was performed in 31 patients suffering from different types of depression. The strategy was to select a simple method (i.e., easier to perform than CSF studies for instance) to be applied to a wide range of patients, as close as possible to everyday cases in a clinical setting (i.e., not only to such severe or highly selected groups as is normally the case in biological research in psychiatry). The neuroendocrine test (which consisted of the measurement of variations in the secretion of prolactin, growth hormone and Cortisol after the administration of 60 mg dl-fenfluramine p. o.) did not correlate with symptoms of behavior patterns previously identified with a "serotonin deficit" (i. e., suicidal behavior or attempts, lowering of the control of impulses, sleep disturbances) but only with the severity of the diagnosis (in the DSM-III hierarchical scale) or with indexes of endogeneity (Newcastle scale). This fact could be explained by methodological artifacts (i. e., dlfenfluramine is not a clean probe, showing influence in the dopamine and noradrenaline metabolism; the absorption of fenfluramine was not controlled) or by the fact that the involvement of serotonin in affective disorders is not a selective, isolated dysfunction, but is integrated in more complex interrelationships. Nevertheless, our preliminary findings (even without the results of the comparison with a control group and the evaluation of a few more data and cases) do coincide with the absence of predictors or the lack of specific patterns of response of symptoms with new selective re-uptake blockers of serotonin antidepressants. PMID- 3283787 TI - Comparison of effectiveness of interactive videodisc versus lecture-demonstration instruction. AB - The purpose of this study was to compare the effectiveness of interactive videodisc and lecture-demonstration instruction in teaching preprofessional physical therapy students a psychomotor skill, the sliding board transfer. Advocates of interactive videodisc technology claim that it is a powerful educational tool. Because most practicing physical therapists spend some portion of their workday educating other persons, the effectiveness of interactive videodisc programs may influence the way that physical therapists provide instruction. Preprofessional physical therapy students were divided into three groups that received videodisc, lecture-demonstration, or no instruction. Learning was assessed with written examinations and performance analyses. The results showed that interactive videodisc instruction was as valuable as lecture demonstration in teaching a particular psychomotor skill. Suggestions are made for how physical therapists can integrate interactive videodisc technology into their regular clinical education activities. PMID- 3283788 TI - Presuturing--a new technique for closing large skin defects: clinical and experimental studies. AB - We have developed a new technique termed presuturing for aiding in the closure of large skin defects which may have otherwise required a skin graft or flap. This technique is based on biomechanical properties of skin (creep, stress relaxation) which allow skin to stretch beyond its inherent extensibility. Presuturing is performed under local anesthesia and consists of plicating intact skin over the area of planned excision the night prior to operation. Experimental studies in a pig model showed the decrease in force required to close a standard-sized wound to be 40.1 percent less than control (p less than 0.001). Fourteen patients who underwent wide excision of skin lesions had their wounds presutured. All but one wound could be closed primarily without undermining. Presuturing seems to be an easy and clinically useful technique in aiding the primary closure of large defects. PMID- 3283789 TI - Comparison of midazolam and diazepam for sedation during plastic surgery. AB - A randomized double-blind study was designed to compare midazolam, a rapid-acting water-soluble benzodiazepine, with diazepam for sedation when administered as an adjuvant to ketamine during local anesthesia. In the preliminary dose-ranging study, midazolam (0.05 to 0.15 mg/kg IV) was found to produce a spectrum of central nervous system activity (e.g., sedation, amnesia) that was similar to diazepam (0.1 to 0.3 mg/kg IV). However, the slope of midazolam's dose-response curve for sedation appeared to be steeper (i.e., a narrower therapeutic dosage range). In a comparative evaluation of their relative sedative-amnestic properties and recovery characteristics, the median effective doses of the two benzodiazepines were compared. Midazolam (0.1 mg/kg IV) was found to produce more profound sedation and amnesia than diazepam (0.2 mg/kg IV). Midazolam was associated with significantly less pain on injection and a lower incidence of postoperative venoirritation. Overall patient acceptance was higher with midazolam compared to diazepam. Finally, recovery characteristics were similar for the two benzodiazepines in our outpatient setting. PMID- 3283790 TI - Microvascular polytetrafluoroethylene prostheses: the cellular events of healing and prostacyclin production. AB - This study was undertaken to obtain more insight into the morphologic and functional performance of microvascular polytetrafluoroethylene (PTFE) prostheses. Therefore, both the cellular events of healing (n = 30) and the prostacyclin production (n = 18) of microvascular polytetrafluoroethylene prostheses (length 10 mm, internal diameter 1.5 mm) were evaluated from 1 hour up to 3 months after implantation into the abdominal aorta of rats. After implantation, the graft surface became scarcely covered with platelets. From 1 week onward, endothelial cells originating from the anastomotic sides grew in over the graft surface, covered only about half the prostheses after 3 months of implantation, but did produce normal amounts of prostacyclin as compared to normal endothelium. Only near the anastomotic sides one to two layers of smooth muscle-like cells developed underneath the neoendothelial lining. Perigraft tissue ingrowth into the wall of the polytetrafluoroethylene prostheses was scarce. The overall patency rate was 98 percent. It was concluded that optimalization of the healing characteristics of microvascular polytetrafluoroethylene prostheses may provide a prosthesis that is more suitable for clinical microsurgery. PMID- 3283792 TI - Ganglions of the temporomandibular joint: case report and review of literature. AB - We present the third reported case of a ganglion cyst arising from the temporomandibular joint. Like the previous two cases, this lesion occurred in a woman over the age of 40. Unlike the lesions in previous reports, the cyst in our patient was not associated with pain or tenderness, making the diagnosis of parotid tumor more likely. Nevertheless, the case serves to illustrate the need for including ganglion in the differential diagnosis of well-encapsulated preauricular masses in the region of the temporomandibular joint. PMID- 3283791 TI - Foreign-body granuloma following bilateral facial reconstruction with an omental flap. AB - Bilateral facial reconstruction using an omental free-flap transfer for soft tissue augmentation was performed on a 23-year-old man who had undergone previous surgical resection of an embryonal-cell rhabdomyosarcoma followed by radiation and chemotherapy. Eight weeks following surgery, the patient presented with pain and edema from a foreign-body reaction documented by electron microscopy. This was successfully managed with a course of steroid administration. The patient has remained symptom-free for 5 years. PMID- 3283793 TI - Scalping injuries: new technique for stabilization of flaps to the skull. AB - Extensive scalping injuries offer a unique challenge for tissue coverage because of the wide expanse of bone and lack of deep soft tissue or significant perforating vessels. For smaller injuries, pedicle flaps offer ideal coverage. Larger defects can be covered by omental flaps. Coverage with a free muscle flap followed by split-thickness skin grafting offers optimal long-term coverage. Two new techniques are introduced. The wire-button technique offers stabilization, and the halo frame provides good support and protection for a new free-flap graft and may increase the success rate of flaps in patients with scalping injuries. PMID- 3283794 TI - [Remarks on a case of acute alcoholic hallucination with delusions of jealousy]. AB - A case of acute alcoholic hallucinosis accompanied by insane jealousy is reported, together with a discussion of various aspects of alcoholic psychosis, with consideration of the relevant literature. The most justifiable approach to the subject would appear to be one of a complex, multifactiorial ("universal genetic") nature. PMID- 3283795 TI - Sleep patterns in trauma victims with disturbed dreaming. PMID- 3283797 TI - Reflections on the Vermont story or foresight, insight, and hindsight. PMID- 3283796 TI - Combat addiction post-traumatic stress disorder re-explored. PMID- 3283798 TI - Nicotine addiction in the psychiatric hospital: a preliminary report. PMID- 3283799 TI - The matching of transference with placement in the treatment of adolescents. PMID- 3283800 TI - The deficit of thought in senile dementia Alzheimer's type. PMID- 3283801 TI - On the "organicity" of paranoid syndromes. PMID- 3283802 TI - Cotard's syndrome and temporal lobe epilepsy. PMID- 3283803 TI - Choosing a risky treatment. PMID- 3283804 TI - Comparison of adinazolam, amitriptyline, and placebo in the treatment of melancholic depression. AB - Adinazolam, a triazolobenzodiazepine, was compared with amitriptyline and placebo in a double-blind protocol involving melancholic depressives. Forty-eight patients entered the study, and 35 completed 6 weeks of evaluation. Patients were well matched in each of the groups. Initially, the adinazolam group showed more improvement than the placebo group, but this trend did not persist beyond day 7. The amitriptyline group tended to show more improvement than either the placebo or adinazolam groups, and final scores were significantly better for amitriptyline. Depressive symptoms in the amitriptyline dropout group appeared improved, whereas in the adinazolam and placebo dropout groups they were unchanged or worse. Both amitriptyline and adinazolam were more frequently associated with complaints of side effects than placebo. Thus, amitriptyline was observed to be superior to adinazolam and placebo in improvement in depressive symptoms while adinazolam had only a brief early advantage over placebo. PMID- 3283805 TI - Immune reactions and mental disorders. PMID- 3283806 TI - Research in stress, coping, and health: theoretical and methodological issues. PMID- 3283808 TI - The Geriatric Mental State (GMS) used in the community: replication studies of the computerized diagnosis AGECAT. AB - Three studies are reported using the Geriatric Mental State in one of its community forms on a total of 647 subjects aged over 65 and living in their own homes. The concordance between the computer diagnosis AGECAT and psychiatrists' diagnosis is at least as good in these replication samples as in the original studies (Copeland et al. 1986). AGECAT has been shown to be useful for epidemiological surveys and as a diagnostic guide for non-medical interviewers. PMID- 3283807 TI - Metals and magnets in medicine: hysteria, hypnosis and medical culture in fin-de siecle Paris. AB - It is well known that the end of the nineteenth century represented a 'golden age' of hysteria and hypnosis research under Jean-Martin Charcot in Paris, but the extent to which metals and magnets figured in this strange and provocative world has been very incompletely told. This paper offers itself as a first corrective to this neglect. In 1876 a certain elderly physician and mesmerist, Victor Burq, asked the Parisian Societe de Biologie formally to establish the validity of his so-called 'metallotherapy' (later 'metalloscopy') treatment for hysteria. The paper argues that Charcot's participation in the investigation of Burq's work--undertaken in conjunction with two other leading French neurologists, Amedee Dumontpallier and Jules Bernard Luys--served as a major catalyst in arousing the great neurologist's interest in hypnosis in the first place, and was subsequently responsible for several of his key beliefs about the underlying physiological link between hypnosis and hysteria. It is also shown how these early metalloscopy studies--and especially the discovery by Charcot and his colleagues of so-called metalloscopic 'transfer'--opened the door to the rise of a neo-mesmeric, and increasingly occult, branch of hypnosis research in French psychiatry, which has to date, in the secondary literature, gone almost wholly unremarked. PMID- 3283809 TI - Insulin-induced hypoglycaemic response and release of growth hormone in depressed patients and healthy controls. AB - As part of the Collaborative Study of the Psychobiology of Depression, we have examined the pretreatment growth hormone response (delta GH) to insulin (0.1 U/kg) and the magnitude of the hypoglycaemic response in a large number of well defined depressed patients (N = 132) and healthy controls (N = 80). After applying rigorous exclusion criteria, data were analysed from 93 patients and 66 controls for blood glucose response and from 56 patients and 52 controls for delta GH. Depressed patients, either unipolar or bipolar, showed less of a fall in glucose than controls. A weak association was found between the magnitude of the fall in glucose and the severity of depression. No significant differences were found in values for delta GH between the unipolar or bipolar depressed patients and controls either for males, pre-menopausal or post-menopausal females, or the total female group. These data do not support previous claims of a lowered delta GH response to insulin in depressed patients. However, the resistance to hypoglycaemia seen in the depressed patients is consistent with previous reports. PMID- 3283810 TI - Language and dementia: a review. AB - In the literature on dementia the presence or absence of language deficits has come to occupy a pivotal position with respect to certain nosological and nosographical issues. These are reviewed critically, together with the results of experimental investigations which have sought to elucidate the nature of the language deficit(s) in patients with dementia, especially that of the Alzheimer type. Attention is drawn to important gaps in current knowledge and suggestions are made regarding the direction of future research. PMID- 3283811 TI - Appraisal of the self-schema construct in cognitive models of depression. PMID- 3283812 TI - Dysrhythmia, dysphoria, and depression: the interaction of learned helplessness and circadian dysrhythmia in the pathogenesis of depression. PMID- 3283813 TI - Footedness: asymmetries in foot preference and skill and neuropsychological assessment of foot movement. PMID- 3283814 TI - Illusion and well-being: a social psychological perspective on mental health. PMID- 3283815 TI - Serial marriage: a heuristic analysis of an emerging family form. PMID- 3283816 TI - Moral reconation therapy: a systematic step-by-step treatment system for treatment resistant clients. PMID- 3283817 TI - The value of personal psychotherapy for psychotherapists. PMID- 3283818 TI - [Conceptualization and clinical experience of coping with illness--background theories, methodologic problems and current possibilities]. PMID- 3283819 TI - [Defense and coping--recommendations for an integrated approach]. PMID- 3283820 TI - [Coping and psychological adaptation: is there appropriate and inappropriate coping?]. PMID- 3283821 TI - [Outlook for the genetic engineering approach in radiobiology]. AB - Present evidence on the use of genetic engineering methods in studying the molecular mechanism of radiation damage and repair of DNA, as well as radiation mutagenesis and carcinogenesis has been summarized. The new approach to radiobiological research has proved to be extremely fruitful. Some previously unknown types of structural disorders in DNA molecule have been discovered, some repair genes isolated and their primary structure established, some aspects of radiation mutagenesis elucidated, and research into deciphering the molecular bases of neoplastic transformations of exposed cells are being successfully investigated. The authors discuss the perspectives of using genetic engineering methods in radiobiology. PMID- 3283823 TI - [The oxygen effect in cells of E. coli K-12 with different repair genotypes during irradiation with neutrons and gamma rays]. AB - The oxygen enhancement ratio, as estimated after the effect of 137Cs-gamma quanta, depends on the repair genotype of E. coli K-12 cells and increases in the studied strains in the following order: recA-uvrA(-)----recA(-)----wild type--- pol A-. These variations are levelled with the effect of fast neutrons of division spectrum (0.75 MeV); the oxygen enhancement ratio for the strains under study decrease, while the oxygen effect is virtually absent in recA-uvrA--mutant. PMID- 3283822 TI - [Increase in gene expression in the rat liver following whole body x irradiation]. AB - The method of hybridization in a dot was used to study the dynamics of expression of pRL genes inducible in dividing cells of the regenerating rat liver and c-myc oncogene after whole-body X-irradiation. As overall incorporation of mRNA into a polyribosomal fraction was inhibited the level of mRNA in the most studied pRL genes and c-myc oncogene within the translated mRNA increased. The maximum induction of pRL gene expression occurred 6-12 h following X-irradiation depending on radiation dose. It is suggested that X-radiation induction of pRL gene expression is related to the increased transcription of the corresponding mRNA since their level does not change in conditions of cycloheximide blockade of the protein synthesis. PMID- 3283824 TI - [Effect of the conditions of incubating bone marrow from totally irradiated mice on the expression of its stem cell potentials]. AB - Incubation, in various conditions, of bone-marrow samples taken from irradiated (7 Gy) (CBA X C57Bl)F1 mice and the subsequent testing thereof for stem potency in the exposed (8.5 Gy) recipients have demonstrated, with certain admissions, that stem cells can recover from radiation injury in certain experimental conditions. PMID- 3283825 TI - [Effect of laser radiation and combined ionizing and laser radiation on the cell division time of bacteria]. AB - Irradiation of E. coli K-12 cells of the wild-type AB 1157 strain with helium neon continuous laser radiation leads to a temporary delay in their division. The delay was found to be the same in cells exposed to ionizing radiation alone and in cells exposed to a combination of ionizing and laser radiation. PMID- 3283827 TI - [Projections in conventional shoulder joint diagnosis]. AB - Numerous projections are described in the literature for plain film radiography of the shoulder joint. A review is given of the indications, advantages and disadvantages of the most common views. The significance of special, additional views is discussed. PMID- 3283826 TI - [Diseases of the shoulder joint from the orthopedic viewpoint]. AB - The cardinal symptom in all shoulder disorders is shoulder pain. We have to differentiate between genuine shoulder pain originating from the glenohumeral joint and its periarticular structures and referred pain originating at a site distant from the shoulder joint, e.g., the cervical spine or the internal organs. The differential diagnosis of genuine shoulder pain is discussed. The options open to the radiologist for reaching a correct diagnosis in different sorts of shoulder pain are shown. PMID- 3283828 TI - [Sonography of the shoulder joint. Study technic, sonomorphology and diagnostic significance]. AB - In the evaluation of the impingement syndrome, conventional radiography can only show secondary bony changes. Sonography is able to demonstrate the anatomy of the musculotendinous structure of the rotator cuff. Lesions can be detected with the same accuracy and specificity as by contrast arthrography. As sonography is a non invasive method, it should be used routinely to test rotator cuff integrity. Joint effusions and proliferative synovial changes are easily demonstrated by sonography. It is thus possible to perform follow-up studies in a pre-erosive stage of rheumatoid arthritis. PMID- 3283829 TI - [Computerized tomography imaging of shoulder joint injuries]. AB - In addition to conventional radiography using standard and special projections, CT offers valuable information in selected cases. Native CT allows detection of minimal bony lesions, which may cause severe pain that is resistant to therapy. Small amounts of joint effusion as well as the Hill-Sachs impression fracture of the humeral head can be detected with a high degree of accuracy. Following intra articular injection of contrast medium, CT-arthrography enables visualization of capsular and ligamentous injuries of the shoulder joint. Lesions of the glenoid labrum following shoulder dislocation can be detected and classified by this method. PMID- 3283830 TI - Nonionic versus ionic contrast media in intravenous urography: clinical trial in 1,000 consecutive patients. AB - A double-blind clinical trial was performed in 1,000 consecutive patients to compare the safety and efficacy of intravenously administered nonionic (iohexol) and ionic (metrizoate) urographic contrast media. The patients ranged in age from 10 to 80 years. The incidence of mild to moderate adverse effects was 7.7% with iohexol and 31.2% with metrizoate. No serious reactions were recorded with either of the contrast media. Urography with iohexol was found to give better parenchymal opacification, pelvocalyceal opacification, and overall quality. The sum of examinations with good and excellent overall quality was 97.8% with iohexol and 91.1% with metrizoate. The frequency of poor overall quality urograms was 1.6% with iohexol and 7.5% with metrizoate. The data suggest that iohexol is safer and more frequently produces urograms of better quality. PMID- 3283831 TI - Early pregnancy complications: endovaginal sonographic findings correlated with human chorionic gonadotropin levels. AB - Endovaginal sonography results were compared with quantitatively determined human chorionic gonadotropin (hCG) levels in 84 women referred for early pregnancy complications. Of the 27 with normal intrauterine pregnancies, an intrauterine gestational sac was prospectively identified in one of five cases (20%) in which hCG levels were below 500 IU/L (Second International Standard), four of five (80%) with hCG levels of 500-1,000 IU/L, and all 17 with hCG levels above 1,000 IU/L. In comparison, 17 of the 26 women with ectopic pregnancies (65%) had hCG levels greater than 1,000 IU/L, and none of the 26 had an intrauterine gestational sac. Endovaginal sonography demonstrated an adnexal mass and/or a gestational sac-like structure in 16 of the 17 cases (94%) in which hCG levels were above 1,000 IU/L, compared with only three of the nine (33%) with lower hCG levels (P less than .01). These findings indicate that an intrauterine gestational sac should be normally visualized with endovaginal sonography when the hCG level exceeds 1,000 IU/L, and that visualization of an extrauterine gestational sac and/or adnexal mass is significantly more likely in ectopic pregnancies when the hCG level exceeds 1,000 IU/L. PMID- 3283832 TI - Renal dysplasia: sonographic findings. AB - In 38 pediatric patients (predominantly neonates) with a proved pathologic diagnosis of renal dysplasia, a variety of sonographic appearances were seen. When the obstruction was at the level of the ureteropelvic junction (12 patients, 12 kidneys), the typical appearance was of a large kidney containing multiple large or moderate-sized cysts. When the obstruction was at the level of the distal ureter (14 patients, 14 kidneys), a smaller kidney containing a few cysts of variable sizes was usually seen. When the obstruction was at the level of the urethra (eight patients, 13 kidneys), the kidney was typically small with few or no cysts. In four patients (seven kidneys) in whom no cause of the obstruction was evident, the kidneys were small and echogenic. There was one case of segmental dysplasia. PMID- 3283833 TI - Uterine leiomyomas in the infertile patient: preoperative localization with MR imaging versus US and hysterosalpingography. AB - Eleven women with a history of infertility and uterine leiomyomas underwent magnetic resonance (MR) imaging of the pelvis prior to myomectomy. Nine also underwent preoperative pelvic ultrasonography (US), and ten underwent hysterosalpingography. All studies were interpreted prospectively by independent observers. With each imaging modality, the location (one of 11 anatomic segments), size, and appearance of detected uterine leiomyomas were determined and compared with surgical and histologic findings. Among the nine patients who underwent both MR and US, the sensitivity (85%) and accuracy (94%) of MR imaging for abnormal segments was significantly better than that of US (sensitivity = 69%, P = .015; accuracy = 87%, P = .043). For the ten patients who underwent both MR and hysterosalpingography, the sensitivity (91%) and accuracy (96%) of MR imaging was better than that of hysterosalpingography (sensitivity = 18%, P = .0005; accuracy = 72%, P = .0005). The specificities of the three modalities did not significantly differ (100%, 97%, and 98% for MR, US, and hysterosalpingography, respectively). These data suggest that MR imaging is superior to US or hysterosalpingography for preoperatively locating uterine leiomyomas. PMID- 3283834 TI - Imaging the testis: comparison between MR imaging and US. AB - The potential role of magnetic resonance (MR) imaging in the diagnosis and local staging of testicular tumors was evaluated in 23 patients who subsequently underwent surgery or biopsy. Findings at MR imaging were compared with those at ultrasonography (US) and were correlated with the surgical-histologic findings. At surgery, three patients were found to have extratesticular and 20 patients intratesticular abnormalities. This distinction had been correctly made with both imaging modalities, but US did not demonstrate the intratesticular abnormality in four patients with diffuse infiltrating tumors. Neither modality allowed differentiation of benign from malignant disorders. When local tumor staging was analyzed in 11 patients, the accuracy of both modalities was disappointing (true positive findings with MR imaging in seven patients and with US in five). At present, US remains the primary imaging modality for testicular disease. MR imaging should be employed when findings at physical examination and US are discrepant and considered when diffuse infiltrative disease is suspected. PMID- 3283835 TI - Puerperal ovarian vein thrombosis: evaluation with CT, US, and MR imaging. AB - Five women suspected of having puerperal ovarian vein thrombosis (POVT) were examined with either computed tomography (CT) (five patients), ultrasonography (US) (three patients), magnetic resonance (MR) imaging (one patient), or a combination of these modalities. CT findings included tubular retroperitoneal mass (five patients), periuterine mass (four patients), enlarged uterus (four patients), fluid in the uterus (five patients), central ovarian vein thrombus (four patients), inferior vena cava thrombus (one patient), right hydroureter (one patient), and right ureteral compression (one patient). US findings were similar to CT findings except for an inability to demonstrate the right hydroureter and ureteral compression. MR imaging demonstrated the retroperitoneal mass and central ovarian vein thrombus. CT proved to be superior for the initial evaluation and subsequent diagnosis of POVT. US was useful for follow-up examinations, and MR imaging results confirmed a case of POVT that was suspected following CT. PMID- 3283836 TI - Decreased breast cancer mortality through mammographic screening: results of clinical trials. AB - A combined analysis of data from five major screening studies indicates that annual screening of all women aged 40 and over by means of state-of-the-art mammography, with two views per breast and physical examination, could reduce breast cancer mortality by at least 40% and possibly as much as 50%. PMID- 3283837 TI - Acute cholecystitis: diagnostic accuracy of percutaneous aspiration of the gallbladder. AB - Results of gallbladder bile aspiration and culture were correlated with presence or absence of acute cholecystitis in 36 patients to test the role of these procedures in hospitalized patients with sepsis. Diagnostic aspiration of the gallbladder was performed in 11 patients, and in the remaining patients a combination of percutaneous aspiration, percutaneous cholecystostomy, or cholecystectomy was used. Bile culture was not helpful in the prediction of acute cholecystitis, since results were not available for a minimum of 24-48 hours after aspiration. In addition, gram-stained smears and bile cultures suffered from low sensitivity (48% and 38%, respectively); consequently, a negative test does not allow the diagnosis of acute cholecystitis to be excluded. Bile aspiration of the gallbladder thus has a limited role in the diagnosis of this condition. PMID- 3283838 TI - Pancreatic transplant imaging. AB - Forty-four clinical episodes of suspected (pancreas) transplant rejection in 17 pancreatic transplantation patients were reviewed retrospectively. The clinical impression of acute graft rejection, chronic rejection, or nonrejection in each episode was correlated with the results of 19 nuclear medicine, 12 ultrasound (US), and 44 magnetic resonance (MR) imaging studies. US was found to be a moderately sensitive (82%) method of detecting graft rejection. US also was effective in identifying intra- and peripancreatic fluid accumulations. Nuclear medicine imaging was also a sensitive technique (86%) and the only modality that provided physiologic information regarding graft perfusion. MR imaging allowed correct prediction of the presence or absence of graft rejection in 39 of 44 cases (sensitivity, 100%; specificity, 76%) and was an effective means of detecting pathologic fluid collections. Nuclear medicine, US, and MR imaging are all believed to be sensitive methods of detecting graft rejection and are complementary adjuncts to the clinical evaluation of pancreatic transplants. PMID- 3283839 TI - Pancreatic transplantation: scintigraphy, US, and CT. AB - Twenty-one patients with insulin-dependent diabetes mellitus received simultaneous renal and segmental pancreatic transplants. A retrospective analysis of 112 real-time ultrasound (US) images, 108 technetium-99m glucoheptonate scinti scans, 55 computed tomography (CT) scans, and 11 cystograms was performed. Complications that were observed included pancreatic transplant rejection, pancreatitis, arteriovenous occlusions, hemorrhage, abscesses, and extravasation at the pancreaticocystostomy site. Scintigraphy is a sensitive indicator of normal transplant function but is non-specific when findings are abnormal. Real time US aids in the differentiation of acute rejection from pancreatitis and arteriovenous occlusion. CT is helpful for evaluation of postoperative complications. Imaging may play an important role in the noninvasive management of pancreatic transplants. PMID- 3283840 TI - Dilated abdominal paraaortic lymphatic duct: a possible pitfall in retroperitoneal US. AB - Three cases of dilated abdominal left paraaortic lymphatic duct are described. The diagnosis was established by means of sonography and confirmed with lymphography in all three patients. A sonographically guided puncture of the lymphatic duct was performed in one patient. Dilatation of these lymphatic ducts was possibly the consequence of previous upper abdominal surgery in two patients and a coronary bypass operation in one. PMID- 3283841 TI - Intravascular tumors: transvenous biopsy. AB - A technique is described for transfemoral biopsy of intravenous tumors. Positive results were obtained at biopsy in three patients who had an intraluminal mass in the inferior vena cava and in one patient with a mass in the iliac vein. Transvenous biopsy is helpful in obtaining a histologic diagnosis and provides an alternative method to surgery or percutaneous transabdominal needle biopsy. PMID- 3283842 TI - In vivo H-1 spectroscopy in humans at 1.5 T. AB - Water-suppressed and section-selective proton (hydrogen-1) magnetic resonance (MR) spectra were recorded from human brain, leg muscle, liver, and heart with a 1.5-T imager. Signal from water was well suppressed, and resonances from several metabolites were consequently seen. The spectra from brains of healthy volunteers (n = 5) showed resonances from N-acetylaspartate, glutamine, aspartate, phosphocreatine/creatine, choline, taurine, and glycine. In five large brain meningiomas, resonances from N-acetyl-aspartate and phosphocreatine/creatine were either not visible or markedly decreased in intensity. The spectra from leg muscles of healthy volunteers showed resonances from protons in saturated fatty acyl chains, whereas resonances from unsaturated fatty acyl chains predominated in spectra from leg muscles of two patients with spina bifida. The spectra from livers of three healthy volunteers showed resonances from aliphatic and aromatic amino acids, choline, carnitine, and both saturated and unsaturated fatty acyl chains, and spectra from hearts of six healthy volunteers showed major resonances from phosphocreatine/creatine and taurine and smaller resonances from amino acids and fatty acyl chains. PMID- 3283843 TI - Ultrasonography in evaluation of lymph nodes of the neck. PMID- 3283844 TI - Theophylline: an overview. PMID- 3283845 TI - Partitioning of monosynaptic Ia EPSP connections with motoneurons according to neuromuscular topography: generality and functional implications. PMID- 3283846 TI - Temperature as a dependent variable in the study of cholinergic mechanisms. AB - 1. Change in core temperature over time can be used as a dependent variable when studying the effects of manipulations on neurotransmitter systems. This article focuses on the measurement of core temperature as a strategy for detecting changes in the status of cholinergic systems. 2. Cholinergic neurons participate in the process of thermoregulation and interventions affecting them alter the thermal response to cholinomimetics. For example, chronic treatment with amitriptyline, chronic swim stress and inescapable footshock supersensitize rats to the hypothermic effects of oxotremorine. 3. This is consistent with the hypothesis that the pathophysiologies of tricyclic antidepressant withdrawal phenomena and stress involve supersensitivity of muscarinic mechanisms. 4. Uses of thermoregulation paradigms for investigating the actions of lithium ion, electroconvulsive shock and substances of abuse on muscarinic mechanisms are discussed. Applications to problems in the arena of clinical research are highlighted. PMID- 3283847 TI - Serum prostacyclin binding and half-life in the umbilical circulation. AB - Serum prostacyclin binding and half-life was measured in twenty pairs of maternal and umbilical venous samples and in twenty non-pregnant controls. When compared to non-pregnant values both umbilical and maternal samples demonstrated significantly lower albumin concentrations, percentage of prostacyclin binding and shorter prostacyclin half-life. PMID- 3283848 TI - The biology and pharmacology of PGD2. PMID- 3283849 TI - Second malignancies and Hodgkin's disease--the Royal Marsden Hospital experience. AB - The frequency of secondary malignant neoplasms occurring in patients treated for Hodgkin's disease at the Royal Marsden Hospital between 1963 and 1978 is reported and the literature is reviewed. 730 patients were reviewed and 583 patients permanently resident in the United Kingdom were included in the analysis. The frequency of leukaemia and solid tumors was determined from age- and sex corrected data from the South Thames Cancer Registry. Thirty-seven malignancies were recorded in 36 patients including 9 leukaemias, 10 lung cancers, 6 skin cancers and 2 non-Hodgkin's lymphoma, all of which were observed in significant excess. When all remaining sites are combined, there was a slight excess but no one site is individually significant. PMID- 3283850 TI - An approach to the interpretation of clinical data on the tumour control probability-dose relationship. AB - A conventional statistical model allows predicting the sterilisation rate as a function of dose. However, the computation requires data on biological parameters (proportion of clonogenic cells, survival per fraction, multiplication rate) which are inaccessible for human tumours. The curative dose 50% (TCD50) can be used as a synthesis of these parameters and its significance for the response dose relationship of a population of tumours of uniform radiosensitivity is discussed. The slope of the dose-control curve provides vital information regarding the variation in radiocurability of the various individual tumours. The model allows the analysis of the clinical data and the separation of tumour subsets with different radiation responsiveness. It provides an evaluation of the benefit which could be obtained from the identification of the subsets and a guidance for the clinical, pathological and biological studies which relate to this identification. The change in the response-dose relationships with the tumour size cannot (usually) be explained by the cell number increase alone. Other possible factors of reduced radiocurability are discussed. PMID- 3283851 TI - Growth and transformation in workplace alcoholism programming. AB - The origins of contemporary workplace programs to provide constructive assistance to employees with alcohol problems are described. The transformation from industrial alcoholism programming to employee assistance programming is delineated in terms of a seven-component "core technology." The high degree of reported success of these programs is described with general findings from a survey of 480 private-company sites. Increasing rates of self-referral for assistance with alcohol problems are described in terms of factors facilitating such referrals. Basic research knowledge is summarized, together with a projection of new studies considered to be critical for maximizing the effectiveness of alcoholism intervention as it relates to workplace programs. Throughout the chapter the large-scale impact of workplace programming is emphasized, with an urgency for greater attention to be paid to these activities by the alcohol problem research community. PMID- 3283852 TI - Constructive confrontation and other referral processes. AB - Constructive confrontation is a workplace strategy used to identify alcoholic employees and motivate them to change their behavior, either with their own resources or with the counseling services provided by employee assistance programs. This paper describes the strategy's use by supervisors, peers, unions, and occupational groups, and it reviews the effectiveness of the evaluation research. The paper concludes with a discussion of "self-referral" in employee assistance. PMID- 3283853 TI - Identification of alcoholics in the workplace. AB - Workplace programs make the supervisor responsible for identifying alcoholics through their job performance. However, research indicates that those so identified are a small proportion of the alcoholic employed population and tend to be in the later stages of the disease. This is due in part to the relatively small number of alcoholics who demonstrate performance deterioration in the early stages. In addition, only a few members of the drinking population are responsible for the costs to the organization resulting from poor job performance. The identification rate differs for alcoholics depending on their sex and level in the organization and the supervisory style of their managers. Hiding symptoms and cover-up for others adds to the proportion remaining unidentified. While identification through performance evaluation may be considered the only legitimate procedure in the workplace, it is not in fact identifying anywhere near the estimated number of alcoholics. The administrators and researchers in the employee assistance/occupational alcoholism field will have to decide whether to try innovative procedures that will broaden the scope of traditional programs. Such procedures may include cooperating with health promotion programs and identification through genetic and familial screening. While the current model identifies those most destructive to the organization, it bypasses a significant group of employees who are currently a danger to themselves or potentially a problem for the organization. PMID- 3283854 TI - New occupations and the division of labor in workplace alcoholism programs. AB - New occupations surrounding workplace alcoholism and employee assistance programs have emerged. The impetus for the development of the new occupations was grants from the NIAAA to fund individuals to initiate, develop, and maintain employee alcoholism/assistance programs, followed by large-scale privatization. Two other organizations also figure prominently in the development, the NCA and ALMACA. Thus, the alcoholism roots in workplace programming are undeniable. A certification process of employee assistance professionals is now underway. The content areas for employee assistance certification are agreed upon, representing a core of competency-based knowledge and skills desirable for workplace alcoholism/assistance programming. The certification process can establish the boundaries of employee programming and maintain the ability of employee assistance to provide constructive solutions for alcoholic employees and their families. PMID- 3283855 TI - Effects of moderate consumption of alcoholic beverages on endocrine function in postmenopausal women. Bases for hypotheses. AB - That alcoholic beverage consumption has not yet received attention as a variable that might influence the estrogenization of postmenopausal women is discussed within the context of the growing proportion of postmenopausal women in the population, their disease risk vis-a-vis estrogenization, and survey findings that report that the majority of postmenopausal women use alcoholic beverages to at least some degree. The available literature is reviewed concerning the effects of acute or chronic ethanol administration, alcoholic beverage consumption, or the administration of phytoestrogen-containing congeners of bourbon on the endocrine status of postmenopausal women or relevant animal models. The basic components of postmenopausal endocrine function and the factors known to affect endocrine status are presented. The importance of incorporating known endocrine modulating factors into the design of future studies so as to maximize the detection of alcohol effects in postmenopausal women is emphasized. PMID- 3283856 TI - Effects of alcohol abuse on reproductive function in women. AB - Alcohol abuse and alcoholism are associated with disorders of reproductive function in both men and women. Amenorrhea, anovulation, and luteal phase dysfunction may occur in alcohol-dependent women and alcohol abusers. Yet there has been relatively little research on the consequences of alcohol abuse for female reproductive function. Recent clinical and survey studies of alcohol effects on pituitary gonadotropins and gonadal steroid hormones in women are reviewed. Experimental studies of the acute and chronic effects of alcohol on the hypothalamic-pituitary-gonadal axis in normal women and in animal models are also described. Recent studies of the acute effects of alcohol on opioid antagonist and synthetic LHRH-stimulated pituitary gonadotropins are summarized. Possible mechanisms underlying alcohol-induced disruptions of menstrual cycle regularity are discussed. PMID- 3283857 TI - The interrelationship of substance abuse and posttraumatic stress disorder. Epidemiological and clinical considerations. AB - This chapter reviews the data available on the relationship of substance abuse and posttraumatic stress disorder (PTSD). Delimiting the review to those studies of Vietnam veterans, we found that levels of combat exposure seemed to be positively related to subsequent alcohol use, although not all studies confirmed this relationship. When studies of patients seeking treatment for PTSD were examined, we learned that 60-80% of these patients had concurrent diagnoses of substance abuse, alcohol abuse, or dependence. Methodological limitations of all the studies are discussed and conclusions regarding the status of the PTSD substance abuse relationship are drawn cautiously. Alternative suggestions for treatment are presented and discussed. PMID- 3283858 TI - Maternal ethanol use and selective fetal malnutrition. AB - Maternal ethanol ingestion may cause fetal injury, particularly impaired somatic and brain growth, by at least two mechanisms: (1) directly, by fetotoxicity from ethanol and/or acetaldehyde; (2) indirectly, by ethanol-induced placental injury and selective fatal malnutrition. There is ample evidence that ethanol and/or acetaldehyde is fetotoxic. In addition, alcoholics are frequently in a state of poor nutrition. However, regardless of maternal nutritional status, ethanol can be placentotoxic, impairing the normal transfer of essential fetal nutrients. Ethanol and/or acetaldehyde has been shown to inhibit placental uptake and/or transfer of amino acids, zinc, and glucose. These effects have been evaluated in animal models and in human tissue. Recent use of the isolated perfused human placental cotyledon has begun to delineate the pathophysiology of ethanol-induced placental injury. PMID- 3283859 TI - Ethanol metabolism and hepatotoxicity. Does sex make a difference? AB - The role of gender as a variable that might affect the metabolism of ethanol and thus the hepatotoxicity of ethanol is evaluated. First, the pharmacodynamics of ethanol are reviewed with particular attention to hormone effects on ethanol absorption and metabolism. Specific differences between males and females relative to ethanol pharmacokinetic parameters are discussed, including gender differences in the volume of distribution and putative hormonal effects on achieved blood alcohol levels. In addition, attention is directed toward the metabolic capacity of alcohol dehydrogenase and the microsomal ethanol-oxidizing system with respect to effects of both sex differences and hormonal manipulations on the activity of these ethanol-metabolizing enzymes. Finally, the studies on the concept of sex-related differences in susceptibility to alcohol hepatotoxicity are examined. PMID- 3283860 TI - Physiological and psychological factors as predictors of alcoholism risk. AB - This chapter synthesizes data accruing since January 1984 from studies of populations at elevated risk for the future development of alcoholism. These recent data demonstrate the continued potential importance of the decreased intensity of reaction to ethanol in sons of alcoholics, a conclusion bolstered by replications of the less intense postethanol subjective ratings by the higher risk group, as well as their demonstration of less intense changes in several hormones following drinking. Additional studies also indicate a possible importance of neuropsychological test deficits in higher-risk boys studied in their preteen or early-teen years; information continues to support the importance of the aldehyde dehydrogenase isoenzyme pattern for the alcoholism risk among Orientals, but little consistent information has yet identified other enzyme activity levels or personality profiles as factors significantly different for higher-risk and lower-risk populations. Although studies of populations at high risk for the future development of alcoholism are relatively new, the findings to date have been interesting and could lead to important future developments in prevention and treatment of this prevalent disorder. PMID- 3283861 TI - Blood markers of alcoholic liver disease. AB - Not all heavy drinkers develop severe alcoholic liver disease. Genetic factors are probably involved, but no corresponding useful markers have been developed thus far. Of greater practical applicability is the recognition of early changes in the liver that may indicate that the process of scarring or fibrosis has been initiated. Measurement of breakdown products of collagen, the protein of the fibrotic tissue, have been found to be useful for detecting these early stages. Assessment of glutamic dehydrogenase activity in the serum also provides some indication of the degree of inflammation and necrosis present in the liver, but not of the alcohol intake. The severity of the latter can be assessed with a variety of biological markers, to which circulating antibodies against acetaldehyde adducts have recently been added. PMID- 3283862 TI - Discriminant function analysis of clinical laboratory data. Use in alcohol research. AB - There has been a growing interest in the use of discriminant function analysis of routinely collected laboratory data to differentiate between alcoholic and nonalcoholic individuals. However, no consensus has been reached concerning the validity and reliability of this form of analysis regarding the diagnosis of, or screening for, alcoholism. In addition, this technique may provide important information concerning the multivariate nature of the pathophysiological effects of alcohol. However, this issue is seldom discussed. Because of differences in methodology across studies and the growing confusion regarding conceptual issues associated with this statistical technique, there have been few critical reviews. This chapter is directed at critically evaluating the current literature, particularly with respect to the methodological and conceptual issues associated with the use of discriminant function analysis in alcohol research. As part of this approach we suggest guidelines for future research in this area. PMID- 3283863 TI - Acetaldehyde and its condensation products as markers in alcoholism. AB - Several studies show that recently abstaining alcoholics generate higher circulating levels of acetaldehyde than nonalcoholics following ethanol administration. It is conceivable that levels of stable adducts (tetrahydroisoquinolines and tetrahydro-beta-carbolines) derived from acetaldehyde condensations with biogenic amines also might be increased in alcoholics consuming ethanol, thus serving in body fluids as chemical markers that are more persistent than acetaldehyde itself. Limited human and rat studies indicate that urinary excretion of an oxidized tryptamine condensation product (harmane) and of an acetaldehyde/serotonin condensation product is elevated by chronic ethanol. Salsolinol, the derivative of acetaldehyde and dopamine, does not appear to be a meaningful urinary marker, but levels of the related pyruvic acid/dopamine product may be increased by ethanol. Blood assays of condensation products have been limited in number and equivocal. Condensation product measurements are complicated not only by artifacts (formation during analyses), but by other inherent problems. Products of interest often are constituents of diets and alcoholic beverages. For this and perhaps endogenous metabolic reasons, traces of condensation products are normally excreted by nondrinking individuals. Furthermore, the assays require high sensitivity and specificity and are not easily adapted to routine use. Thus, although several condensation products have initial appeal as clinical or pathological indicators in chronic alcoholism, thorough and statistically sound studies are needed before conclusions can be reached concerning any particular biogenic amine-derived product. PMID- 3283864 TI - Biological mechanisms in posttraumatic stress disorder. Relevance for substance abuse. AB - Recent studies suggest a significant biological contribution to posttraumatic stress disorder (PTSD). In particular, central catecholamine and endogenous opioid systems have been implicated both in this syndrome and in substance abuse. We review relevant animal and human studies that support these hypotheses and suggest that this overlap may contribute to the incidence of substance abuse in PTSD. The animal studies have primarily employed the learned helpless and conditioned emotional response models and have included assessments of brain catecholamines, locus ceruleus activity, and behavioral correlates in rodents and nonhuman primates. Human studies have used only indirect measures to assess these variables. However, both therapeutic approaches and attempts at self-medication for PTSD have supported this hypothesis. PMID- 3283865 TI - Posttraumatic stress disorder and substance abuse. Clinical issues. AB - A review of clinical issues relevant to the treatment of individuals with a combination of posttraumatic stress disorder and substance abuse disorder is presented. There are several issues that these two disorders share, including the need for heightened awareness on the part of clinicians, the ability to make the diagnoses, the conceptualization of etiological factors, and the issues of therapeutic attitudes and countertransference problems. In addition, a brief review of relevant therapeutic approaches is presented and treatment priorities discussed. PMID- 3283866 TI - Undiversion of the urinary tract: the pre-and postoperative evaluation. AB - Each uroradiologic procedure performed in the pre- and postoperative evaluation of the child undergoing undiversion contributes unique information. Function and anatomy of both the upper and lower urinary tracts must be carefully assessed. If the immediate postoperative studies show that the undiversion has been successful, the patient should be monitored yearly with excretory urography. If urinary tract symptoms develop, a more extensive radiographic evaluation (voiding cystourethrography, excretory urography, scintigraphy) may be warranted. PMID- 3283867 TI - Crohn's disease: less common radiographic manifestations. AB - Unusual manifestations of common diseases are still relatively common events. Crohn's disease may involve the entire gastrointestinal tract from the pharynx to the anus. Although the classic findings of ileocolic disease are well known, the changes described above are less commonly encountered. They may be subject to misdiagnosis unless the protean manifestations of Crohn's disease are kept in mind. PMID- 3283868 TI - The radiology of cardiac valve prostheses. AB - The radiographic findings associated with the complications of valve implantation are presented. Complementary roles of echocardiography and cine fluoroscopy in the recognition of complications associated with this procedure are emphasized. Identification of prosthetic valves and the knowledge of the modes of action of the various types of valves are stressed. PMID- 3283869 TI - Pediatric case of the day. Delayed right diaphragmatic hernia following group B streptococcal infection. PMID- 3283870 TI - Ultrasound case of the day. Bilateral arachnoid cysts, diagnosed in utero. PMID- 3283872 TI - [List of the members of the Spanish Society of Digestive Pathology]. PMID- 3283871 TI - [Usefulness of ATG as a coadjuvant of cyclosporin and methylprednisolone in the immediate postoperative period after liver transplant]. PMID- 3283873 TI - [Acute post-transplant pancreatitis]. PMID- 3283874 TI - [Present status of our knowledge of pancreas divisum and its surgical treatment]. PMID- 3283875 TI - [Budd-Chiari syndrome in a case of essential thrombocythemia]. PMID- 3283876 TI - [Hydatid cysts of the pancreas. 2 new surgical cases]. PMID- 3283877 TI - [Diarrhea and colitis caused by antibiotics]. PMID- 3283878 TI - The effect of chronic administration of indomethacin in captopril-treated renal hypertensive rats. AB - To examine the possible involvement of prostaglandins (PG) in the antihypertensive action of captopril, a PG synthetase inhibitor (indomethacin) was administered to normal and one-kidney renovascular hypertensive rats treated with captopril for 2 weeks. Continuous infusion of captopril (40 micrograms/hr SC) to normal and renal hypertensive (RH) rats via an implantable osmotic pump for 14 days lowered systolic blood pressure (SBP) in RH rats only. However, administration of indomethacin (5 mg/kg SC) 3 times a week to normotensive rats pre-treated with captopril by continuous infusion (40 micrograms/hr SC), lowered SBP significantly 24 hours after the injection of indomethacin. In RH rats pre treated with captopril, subsequent administration of indomethacin further reduced SBP. In this study, indomethacin given alone to both RH and normal rats produced no significant alteration in SBP. However, indomethacin potentiated the hypotensive effect of captopril. This action may be attributed to inhibition of PG biosynthesis. It has been reported that the effects of PGE2 within the kidneys are species dependent and in the case of the rat, cause vasoconstriction of the renal vasculature. Therefore, administration of indomethacin would attenuate the vasoconstricting effects of PGE2 and thus lower blood pressure. Accordingly, based on these observations, PGs may perhaps play a role in mediating the hypotensive effect of captopril. PMID- 3283879 TI - The role of chronic bronchitis in the pathogenesis of chronic obstructive pulmonary disease. AB - Emphysema and a variety of lesions directly involving the conducting airways constitute the morphologic basis of air-flow obstruction in chronic obstructive pulmonary disease (COPD). Traditionally, inflammation and hypertrophy of the mucus-secreting elements within the central airways (chronic bronchitis), manifest clinically by chronic cough and recurrent bouts of purulent sputum expectoration due to infection, were held to be important in the development of COPD. While chronic cough and purulent bronchitis contribute to the morbidity associated with established COPD, epidemiologic studies suggest that neither is an independent factor in its causation. Furthermore, structure-function studies indicate that lesions in the distal bronchial tree (peripheral airways disease) are functionally more important than central airways disease in the genesis of air-flow obstruction. The severity of peripheral airways increases with advancing age, but it is only weakly related to the history of cigarette use. Other causes of peripheral airways disease have not been clearly elucidated, but a role for viruses, and certain other infectious agents, has been suggested by experimental animal studies. PMID- 3283880 TI - Asthmatic bronchitis. AB - Asthmatic bronchitis is a term that encompasses a large number of patients who generally smoke cigarettes and demonstrates chronic mucous hypersecretion and airway hyperreactivity. These patients are frequently labelled simply as asthmatic. In this setting, however, "asthma" is a nonspecific term applied to patients with a variety of symptoms. On the basis of history, bronchodilator response, and response to bronchoprovocating agents, it is frequently difficult to differentiate between groups of chronic bronchitics and asthmatics. Subjects with chronic bronchitis clearly demonstrate bronchial hyperreactivity to bronchoprovocating agents. This response does not appear to be due to an abnormality in bronchial smooth muscle. Chronic bronchitics may also respond to a variety of bronchodilating agents, again demonstrating the presence of bronchial hyperreactivity. Potential mechanisms for the observed bronchial hyperreactivity include reduced airway caliber, reduced resistance to airway narrowing, and airway inflammation. Airway inflammation may be the common link between airflow obstruction and airway hyperreactivity frequently seen in these patients. The finding of airway hyperreactivity in chronic bronchitis has implications far beyond simple therapeutic considerations and may lead to a better understanding of bronchial hyperreactivity under any circumstance. PMID- 3283881 TI - Leukocyte function and chronic bronchitis. AB - Chronic bronchitis is a condition of mucous hypersecretion. It represents an interface between airway structures, cigarette smoke, and inflammatory cells. Chronic bronchitis is a late complication of smoking, typically occurring after 30 pack years. Stable patients have mucous hypersecretion and little evidence of acute inflammation. In contrast, during acute attacks of bronchitis, an intense accumulation of neutrophils occurs in the airways. Mechanisms of injury to airway structures include chemicals and reactive oxygen species within cigarette smoke, and secreted products of recruited neutrophils. Recent studies demonstrate that secreted products of polymorphonuclear leukocytes (PMNs) can cause secretory cell metaplasia and increase mucous production. Thus, the role of the PMN in chronic mucous hypersecretion appears to be a significant one. Cessation of cigarette smoking remains a most important aspect of caring for patients with chronic mucous hypersecretion. PMID- 3283882 TI - Respiratory physical therapy in the treatment of chronic bronchitis. AB - Currently recommended respiratory physical therapy procedures include measures designed to improve the clearance of secretions from the lungs, improve distribution of inspired air, and improve the general physical condition. In patients with chronic bronchitis there is frequently an abundance of thick, tenacious bronchial secretions associated with defective mucociliary function due to diffuse disease of the airways. Those who are unable to clear their secretions adequately are candidates for one or more of the techniques discussed here. In designing a treatment plan for the chronic bronchitic, it is important to use only those techniques with demonstrated benefit and minimal hazard in that particular patient. PMID- 3283883 TI - Chronic bronchitis: when and how to treat. AB - Chronic bronchitis, as defined by the magnitude and duration of sputum production, is a diagnosis that encompasses a variety of patients with physiological abnormalities ranging from mild to severe. The first element of therapy is the cessation of smoking, the single most frequent cause of chronic bronchitis. In assisting patients to stop cigarette abuse, nicotine-containing gum has been useful. Therapy directed at airway narrowing continues to be the most widely prescribed. The use of metered dose inhalers containing either beta adrenergic stimulants or, more recently, ipratropium bromide, an atropine-like agent, continues to be the mainstream of therapy. Theophylline remains a widely prescribed bronchodilator. The use of corticosteroids remains controversial in the stable patient, but appears to be indicated clearly in the patient with an acute exacerbation. The usefulness of antibiotics in acute exacerbations is still uncertain; further studies are needed. Augmentation of survival by the use of chronic supplemental O2 is now certain; more efficient ways to administer O2 are now available. Finally, pulmonary rehabilitation provides a means of improving quality of life in severely disabled patients. PMID- 3283884 TI - Prophylactic treatment of chronic bronchitis. AB - Exacerbations of chronic bronchitis may be caused by a variety of bacterial and viral agents. There is ample documentation of a role for Hemophilus influenza, Streptococcus pneumonia, Mycoplasma pneumoniae, influenza A and B viruses, and several other respiratory viruses in causing these exacerbations. Because of the lack of frequency of exacerbations (once every 20 to 78 weeks) and the wide range of pathogens, trials of prophylaxis with antibiotics have been difficult to conduct. Controlled trials conducted since the 1950s have shown mixed results, some demonstrating a reduction in the number of exacerbations and others failing to show efficacy. Of the antibiotics used, tetracycline seemed the most effective. Both the pneumococcal polysaccharide and killed influenza virus vaccines have been suggested for patients with chronic bronchitis. The antiviral drug amantadine has been recommended when vaccine cannot be used. This reviewer concludes that prophylactic antibiotics should be used in selected patients with one or more exacerbations yearly using a drug such as tetracycline. A one-time dose of pneumococcal vaccine and the annual use of killed influenza vaccine are also reasonable. During an influenza A epidemic, amantadine should be considered for unvaccinated patients. Future studies should study intermittent v chronic prophylaxis with cheap but appropriate antibiotics (chosen for their microbial spectrum), and should test newer antiviral vaccines and antiviral drugs as they become available. PMID- 3283885 TI - Ocular ultrasonography in veterinary medicine. PMID- 3283886 TI - Diagnosis and differentiation of retinal diseases in small animals by electroretinography. PMID- 3283888 TI - Use of contact lenses to treat corneal diseases in small animals. PMID- 3283887 TI - Contemporary pharmacology in veterinary ophthalmology. PMID- 3283889 TI - Laser therapy in veterinary ophthalmology: perspective and potential. PMID- 3283890 TI - Current status of canine cataract surgery. PMID- 3283891 TI - Infection-related chronic interstitial nephropathy. AB - Kidney infection, when uncomplicated by anatomic abnormalities such as reflux or obstructing lesions, does not appear to lead to renal damage or hypertension. In children in whom predisposing anatomic causes (reflux) are particularly prominent or in adults who have or develop these abnormalities, progressive renal injury with hypertension can occur with infection. Infection appears to enhance the damaging effects of the underlying anatomic abnormalities. The mechanisms of progressive damage include the inflammatory effects of the infection itself, potentially "autoimmune" effects, and the inflammatory and infection-promoting effects of bacterial products, especially ammonia. After initial renal damage, the hemodynamic effects of systemic hypertension and of intrarenal hyperperfusion of residual nephrons may further promote progressive injury. PMID- 3283892 TI - Chronic obstructive nephropathy. PMID- 3283893 TI - Tubulo-interstitial nephritis associated with systemic disease and electrolyte abnormalities. PMID- 3283894 TI - Chronic tubulo-interstitial nephritis: saga of the ubiquitous. PMID- 3283895 TI - Analgesic-induced papillary necrosis. PMID- 3283896 TI - Patterns of tubulo-interstitial damage associated with nonsteroidal antiinflammatory drugs. PMID- 3283897 TI - Drug-induced tubulo-interstitial nephritis: special cases. PMID- 3283898 TI - Toxic interstitial nephropathy from metals, metabolites, and radiation. PMID- 3283899 TI - Acute interstitial nephritis. PMID- 3283900 TI - [Indications and technics in surgery of the spleen in children]. PMID- 3283901 TI - [Current concepts in surgery of the spleen]. PMID- 3283902 TI - [Non-pharmacologic treatment of cardiac arrhythmias]. PMID- 3283904 TI - [Treatment of anxiety]. PMID- 3283903 TI - [Medicine since the founding of universities]. PMID- 3283905 TI - [Prevention and treatment of diarrhea in travelers]. PMID- 3283907 TI - [Intensified insulin therapy in Type-I diabetes]. PMID- 3283906 TI - [Oral antidiabetic agents]. PMID- 3283908 TI - [New insulins]. PMID- 3283910 TI - Sleepiness as a consequence of shift work. AB - The results reviewed clearly demonstrate that shift work is associated with increased subjective, behavioral, and physiological sleepiness. Apparently, the effects are due to combined circadian and homeostatic (sleep loss) influences. Sleepiness is particularly pronounced during the night shift, and may terminate in actual incidents of falling asleep at work. In some occupations this clearly constitutes a hazard that may endanger human lives and have large economic consequences. These risks clearly involve a larger number of people and should be of great significance to society. PMID- 3283909 TI - Catastrophes, sleep, and public policy: consensus report. PMID- 3283911 TI - [Death in utero of a twin during the 2d and 3d trimester of pregnancy]. AB - The study of a series of 9 cases of monofetal death during the last trimester of a twin pregnancy, permits to emphasize the relative frequency of this accident (7.14% in our series, markedly higher than those noted in the literature). An early diagnosis, essentially on ultrasonography, of monofetal death, enables monitoring of the mother and the surviving fetus for whom there is a non negligible risk. It is often necessary to deliver this fetus as soon as it is mature. Systematic and repeated clinical and ultrasonographic monitoring of any twin pregnancy during the third trimester ensures, in a large number of cases, prophylaxis of this accident. PMID- 3283912 TI - [A case of fetal cystic hygroma. Clinical and echographic study]. AB - In reference to a case of fetal cystic hygroma discovered on ultrasonogram, after 16 weeks of amenorrhea, the authors remind of the need for a karyotype; this is absolutely necessary in the therapeutic decision. Most of the time, it is related to a Turner's syndrome. In case of abnormal karyotype, a therapeutic interruption of pregnancy may be proposed. If the karyotype is normal, the ultrasonogram should be rechecked since hygroma regression has been described. If these images persist or become worse, it is related, most often, to a Noonan's syndrome and interruption of pregnancy may also be indicated. PMID- 3283914 TI - [Malaria and pregnancy. Epidemiological situation in Kinshasa (Zaire)]. AB - By regular blood smears to 730 women (430 pregnant women and 250 non pregnant) authors state precisely epidemiologic situation of malaria to women at Kinshasa. The prevalence of malaria of pregnant women is 22 per cent against 6.1 per cent for non pregnant adult women. Malarial infestation in gravido-puerperal period is : mother : 23.7 per cent ; umbilical cord : 3.1 per cent ; newborn : 5.4 per cent ; placenta : 10.1 per cent. Plasmodium falciparum is the principal agent of malaria at Kinshasa. Neither age, nor parity constitute risk factors of malaria. Many cases of malaria without fever exist at Kinshasa. Newborn with malaria and from pregnancies with infected placentas present at the birth a small weight. Placentas of pregnancies with malaria and infected have invariably the same weight. PMID- 3283913 TI - [The truth about noninvasive methods of obstetrical analgesia. Round table at the Lyons Seminars, 26 September 1986]. PMID- 3283915 TI - Role of epidermal growth factor in gastroprotection and ulcer healing. PMID- 3283916 TI - Maintenance ranitidine treatment after haemorrhage from a duodenal ulcer. A 3 year study. AB - Forty patients with a recently healed duodenal ulcer (DU) that presented with haemorrhage were entered into a blind, randomized study of maintenance ranitidine therapy (150 mg at night) versus a placebo preparation, to determine whether prolonged ranitidine therapy could influence the natural history of the ulcer diathesis. Duodenal ulceration or duodenal cap erosions of Lanza grade 3 recurred in 24 of the 40 patients studied during the 2-year trial period but was associated with further bleeding in only 2 cases. Maintenance ranitidine therapy significantly reduced the incidence and symptoms of DU/erosion recurrence at all time intervals beyond 3 months, the maximum protective effect being observed after 12 to 15 months of treatment (incidence, p less than 0.001; symptoms, p less than 0.03). The DU/erosion recurrence rate without treatment after 2 years of successful maintenance ranitidine therapy was significantly less than for patients randomized to the placebo group at entry to the study (p less than 0.03). Two years of maintenance ranitidine therapy appear to be beneficial for patients who have a healed DU that presented with haemorrhage. This treatment, however, cannot be recommended without reservation until the implications of the associated high incidence of asymptomatic duodenal ulceration have been fully evaluated. PMID- 3283917 TI - Are endoscopic and/or histologic findings in gastroduodenal mucosa a predictor of clinical outcome in peptic ulcer disease? A 1-year follow-up study after initial healing with either cimetidine or medium-dose antacid. AB - Patients with duodenal ulcer (DU; n = 79) or prepyloric ulcer (PPU; n = 39) received cimetidine, 400 mg twice daily, or Novaluzid, 10 ml four times daily (acid-neutralizing capacity, 340 mmol/day), in a multicentre, randomized, double blind trial. Ulcer healing was almost identical with the two treatments at 4, 6, and 12 weeks in the DU group. Cimetidine was significantly more effective than antacids in alleviating symptoms in PPU disease, with no significant difference in ulcer healing. In the PPU group the symptomatic improvement was inferior irrespective of treatment, and there was a significantly lower healing rate at 4 weeks (p less than 0.05) than in the DU group. The relapse rate over a 1-year follow-up period with no therapy did not differ between the two treatment groups or between the two ulcer groups. No factors in history of disease or endoscopic or histologic variables were of predictive value with regard to delayed healing. The macroscopic appearance of the duodenal and antral mucosae improved significantly when ulcers had healed. In the subgroup of about 50% DU patients who experienced a relapse during the 1-year follow-up period, the histologic scoring of duodenitis remained basically unchanged, contrary to the significant improvement seen in the non-relapsing subgroup. The microscopic changes of the antral mucosa from the time of inclusion to healing seen in the PPU patients were of no predictive value with regard to relapse rate. PMID- 3283918 TI - Low-dose antacids and pirenzepine in the treatment of patients with non-ulcer dyspepsia and erosive prepyloric changes. A randomized, double-blind, placebo controlled trial. AB - One hundred consecutive patients with non-ulcer dyspepsia (NUD) and the endoscopic diagnosis of erosive prepyloric changes (EPC) were included in a 4 week double-blind, placebo-controlled trial. The patients were randomly allocated to treatment with either Al-Mg antacids (one tablet four times daily; acid neutralizing capacity, 120 mmol/day) or antacid placebo, in combination with either pirenzepine (50 mg twice daily) or pirenzepine placebo. Ninety patients completed the study. Symptoms improved during the 4 weeks in all treatment groups, irrespective of the treatment given. Neither pirenzepine nor antacid was significantly superior to placebo. Re-endoscopy after 4 weeks of treatment showed no significant change in the EPC grade. No serious side effects were observed, but xerostomia occurred more frequently in patients treated with pirenzepine than in those treated with placebo (p less than 0.01). PMID- 3283919 TI - The effects of famotidine, 40 mg at night, on 24-hour intragastric acidity and plasma gastrin concentration in healthy subjects. AB - The effects of 40 mg oral famotidine at 2115 h on 24-h intragastric acidity and plasma gastrin concentration were measured in a double-blind placebo-controlled study in 10 healthy subjects. The subjects were studied on the 7th day of treatment with either famotidine or placebo. Famotidine, 40 mg at night, caused a pulse of decreased intragastric acidity during the night, with a longer-lasting elevation of plasma gastrin concentration. However, in the latter part of the day there was complete recovery from the antisecretory effects of the drug, with normal intragastric acidity and normal concentrations of plasma gastrin. PMID- 3283920 TI - The effect of bearing tumours on the ability of mice to reject bone marrow transplants. AB - To examine the possible relationship between the cells mediating resistance to tumour cells and those mediating rejection of foreign bone marrow transplants (BMT), the effect of tumour-bearing on BMT rejection has been measured by means of the spleen colony assay. Moderate doses (less than 5.0 X 10(6] of bone marrow cells from DBA/2 strain mice, which normally produce few haemopoietic spleen colonies in gamma-irradiated (950R) CBA/J strain mice, gave numerous (confluent) colonies when given soon after injection of Ehrlich ascites tumour (EAT) cells. Transfusion of [3H]UdR-labelled DBA/2 bone marrow cells demonstrated that the increased spleen colony formation in tumour-bearing mice was not due simply to changes in the total number of injected cells homing to the spleen. Injection of EAT ascites fluid alone, given to CBA/J mice before 950R + BMT, transiently reduced spleen colony development, the effect being more marked when fluid from older tumors was used. Supernatant fluid from EAT cells grown in vitro also depressed growth of BMT in vivo. The results reveal two processes in progress in mice bearing an ascites tumour: (1) an early reduction in the natural resistance to BMT allowing successful grafting and spleen colony formation, and (2) a progressive production by the tumour cells of short-acting soluble factors tending to suppress the proliferation of colony forming bone marrow cells in the transplant. The effect of the tumour-bearing state in weakening the natural resistance to foreign BMT strongly suggests that both tumour and foreign marrow graft resistance are mediated by the same or closely related effector cells. PMID- 3283921 TI - A comparative study of aztreonam and procaine penicillin/probenecid in the treatment of uncomplicated gonorrhoea. AB - 236 patients with uncomplicated gonorrhoea were randomly allocated to receive either aztreonam or procaine penicillin plus probenecid. 115 patients (50 men and 65 women) with uncomplicated gonorrhoea were treated with 1 g aztreonam as a single intramuscular injection. The success rate among those who attended at least one follow up examination after treatment was 99%. The antibiotic was well tolerated and there were no side effects. The observed minimum inhibitory concentrations (MICs) of aztreonam in vitro were very much lower than obtainable serum concentrations. The penicillin treated patients who were evaluable showed a failure rate of 12.8%. We conclude that aztreonam is effective against Neisseria gonorrhoeae, including penicillinase-producing strains, both in vivo and in vitro. PMID- 3283922 TI - Significance of group B streptococci in urine cultures from males and non pregnant females. AB - Over a 2-year period, 1% of 24,000 urine cultures with possible relevant bacteria from males and non-pregnant females greater than or equal to 15 years of age were found to harbour group B streptococci (GBS) in quantities greater than or equal to 10(5) colony forming units (cfu)/ml; a further 0.9% harboured GBS in quantities greater than or equal to 10(4) but less than 10(5) cfu/ml. Patients with GBS in urine were evenly distributed by age. Those with greater than or equal to 10(5) cfu GBS/ml in voided urine more frequently had true bacteriuria (i.e. bacteria in the urine bladder) than did patients with less amounts (p = 0.01) as determined by suprapubic aspiration of 23 patients. One third (3/9) of the aspirated patients with greater than or equal to 10(5) cfu GBS/ml in simultaneously voided urine, had contaminated urine only and no true bacteriuria. The acute symptoms and clinical conditions of 128 patients with greater than or equal to 10(5) cfu GBS/ml urine were studied by matching 128 patients with negative urine cultures (less than 10(2) cfu/ml) and 128 patients with comparable quantity of Escherichia coli. The incidence of acute lower urinary tract symptoms in patients with GBS was greater than that in patients with negative urine cultures (p less than 0.01), and the same as that in patients with E. coli. The incidence of fever was lower in patients with GBS than in those with E. coli (p less than 0.01). The incidence of urinary tract abnormalities was greatest in patients with GBS in urine. No GBS serotype seems to have particular affinity to the urinary tract. PMID- 3283923 TI - A prospective study of serum antibody responses to enterotoxinogenic Escherichia coli in Swedish travellers. AB - Serological responses to relevant enterotoxinogenic Escherichia coli (ETEC) antigens were studied in 85 Swedish travellers to subtropical and tropical areas. Serum samples were collected from the travellers before and then after 3-5 weeks, i.e. within a week after return to Sweden, when a faecal specimen was also taken. 40% of the participants had traveller's diarrhoea during their visit abroad, while 21% reported "loose stools" and 39% had no such problems. ETEC was rarely isolated from the stool of any of the travellers on their return to Sweden (6%). Salmonellae, Shigellae or Campylobacter jejuni were isolated from 13 (15%) of the travellers, 12 of whom were healthy when the specimens were collected and 4 of whom had been healthy during travel as well. Significant serum antibody responses to E. coli heat-labile enterotoxin (LT) and colonization factor antigens CFA I or II were seen in 33% and 20% of the travellers, respectively. Anti-LT responses were comparable in participants with traveller's diarrhoea or "loose stools" and in the healthy ones, whereas anti-CFA responses were more frequent in those with symptomatic infections. Of 34 Swedes in a non-travelling control group none responded to LT and one to CFA I or CFA II. PMID- 3283924 TI - An in vivo model for evaluation of the postantibiotic effect. AB - A new experimental model to evaluate the postantibiotic effect (PAE) in vivo was developed using subcutaneously implanted tissue cages in rabbits with normal host defence mechanisms. The rabbits received benzylpenicillin i.v. in a dose giving a free penicillin concentration of 10 X MIC in the tissue cage fluid (TCF). A log phase suspension of group A streptococci was injected into the tissue cages exposing them to penicillin in vivo. After 2 h bacterial samples were withdrawn, treated with penicillinase and transferred to 2 tissue cages in untreated rabbits. Simultaneously, unexposed streptococci were implanted in 2 other cages in the same animals. By repeated sampling of TCF, growth curves of the streptococci exposed to penicillin and the controls could be compared and a PAE of 1.6-2.4 h demonstrated. The PAE was of the same magnitude as that found in vitro. The model has several advantages for the demonstration of PAE in vivo: repeated samplings are easy to perform percutaneously, the effect of subinhibitory antibiotic concentrations are avoided, interindividual variations are eliminated since each animal is its own control, and the experiments can be performed in animals with undisturbed host defence mechanisms. PMID- 3283925 TI - [Technical aspects of ultrasound equipment today and tomorrow]. AB - From the very beginning any progress in the technique of instruments used in sonography has been strongly dependent upon the general technical progress, and any such progress must take place within the physically postulated marginal conditions. Now that the image quality has been considerably improved, the present situation is characterised by the fact that sonographic diagnosis is developing from a qualitative method into a quantitative one. This will be made possible by means of computerised tissue differentiation which is already being utilised in practice by means of trend analyses, by new sonography parameters (multiparameter imaging) and by the use of digital reconstruction methods. Another substantial improvement in the technique of instruments will be brought about mainly by the extremely rapid strides made by digital technique, by further development of the weak point represented by the transducers, and by improved possibilities of display. PMID- 3283926 TI - [Intrauterine fetal weight assessment using ultrasound. A comparison of several weight assessment methods and development of a new formula for the determination of fetal weight]. AB - At the Department of Gynaecology and Obstetrics of the University of Mainz, the foetal weights were estimated in 196 foetuses between 24 and 42 weeks of gestation. All estimates were based on sonographic determination 0-6 days prior to delivery. In a prospective study the equations of Hansmann, Schillinger et al., Campbell and Wilkin, Warsof et al., Shepard et al., Higginbottom et al., Thurnau et al. and an own unpublished formula of Merz were compared. In addition, with the aid of computer analysis, a new equation for predicting foetal weight was evolved from the data measured in this study. This formula should be valid for all weight groups. In 25.5% of the newborn the actual birth weights ranged from 610 to 2499 g, in 42.9% from 2500 to 3499 g and in 31.6% from 3500 to 4520 g. On comparing the individual equations for the entire study group, the most reliable formulas for estimating foetal weights were found to be those of Shepard et al. (72.4%), Hansmann (61.2%) and Merz (61.2%). In the very low birth-weight range less than 2500 g the formula of Shepard et al. proved to be the most reliable for estimating foetal weight with 72%. In the group between 2500 and 3499 g reliability in estimating foetal weight was over 60% with the equations of Shepard et al. (72.6%), Hansmann (67.9%) and Merz (61.9%). In the birth-weight group of 3500 to 4520 g the most reliable formula for predicting foetal weight was found to be that of Schillinger et al. (91.9%), Hansmann (83.9%), Shepard et al. (72.6%) and Merz (69.4%). The formula which was derived from own data was as follows: W (g) = -3200.40479 + 157.07186 AC (cm) + 15.90391 (BPD)2 (cm). With this formula we obtained 71.4% reliability in predicting foetal weight with a mean absolute weight difference of 221 g for the complete study group. Are of validity for this formula could be defined as follows: BPD 7.0-10.5 cm AC 21.8 36.5 cm (all measurements from outer to outer margin). PMID- 3283927 TI - [Diagnostic ultrasound: biological effects and potential risks]. AB - All competent scientific groups and institutions involved in ultrasound bioeffect research have accepted the safety of diagnostic ultrasound. If, however, bioeffects have been produced by the use of higher intensities, such effects had been caused by heat production or cavitation. Nevertheless, one has to face the fact that individuals have been successfully doubting this assumption of safety. They succeeded in formulating hypotheses which cannot be disproved at all or at short notice. This holds good especially for any possible unspecified late effects. Such effects, however, can never be excluded in any technical innovation. These remarks refer to all diagnostic ultrasound applications except Doppler blood flow measurements, since for the latter techniques no sufficient knowledge is yet available on possible bioeffects. PMID- 3283928 TI - [Pulsed Doppler flow measurements using a vaginal ultrasound probe--integration into fetomaternal hemodynamics]. AB - A recently developed "Panorama" sector scanner emitting in frontal direction (KretzTechnik, Zipf, Austria), combined with pulsed Doppler signal processing, makes it possible to visualize the main branch of the uterine artery already during its passage through the parametrium, and to adjust the Doppler beam under visual control. This makes it possible for the first time to receive flow signals that are free from superimpositions and are reliable, from both vessels supplying the pregnant uterus. It was the aim of our study to describe the haemodynamic changes at the uterine arteries in the course of pregnancy and to collect first experiences on the blood flow of the entire uterus. 42 women with an uneventful course of pregnancy were examined between the 8th and the 40th week of pregnancy. Angle-independent parameters such as the A/B ratio and pulsatility index dropped significantly during the course of pregnancy. The A/B ratio dropped from 5.4 during the first trimenon to 2.2 during the third trimenon, and the pulsatility from 2.6 to 1.3. This new method makes it possible to receive at more reliable and in respect of the total blood flow of the uterus more representative values for insertion into the second part of the haemodynamic equation for the pregnant uterus. PMID- 3283929 TI - [Transvaginal Doppler sonography for measuring blood flow in the pelvis]. AB - This is a report on our first experience with transvaginal Doppler sonography. In this way we can measure the different blood flow parameters in the internal iliac, ovarian and uterine arteries during the menstrual cycle. The detection of the particular vessels and their typical waves of flow are described in detail. In 279 measurements taken from 107 patients in the stimulated cycle we could show that the systolic blood flow after induction of ovulation or before ovulation increases significantly both in the internal iliac and in the ovarian artery. This experience made in the stimulated cycle could also be confirmed in the natural cycle where a preovulatory increase of systolic blood flow in the uterine artery was also noticed. During administration of a contraceptive pill only slight uncoordinated increases of blood flow could be registered. Any possible connections between the above mentioned changes with factors depending on the blood flow or on organic resistance on one hand or on endocrine parameters on the other, and possible practical applications, are discussed. PMID- 3283930 TI - [Percutaneous layer differentiation of the colonic wall by ultrasound. Clinical case examples and experimental results]. AB - Based on 3 case observations, the feasibility of the percutaneous sonographic objectivation of a five-layer image of the colon wall using a 5 Mhz linear transducer is reported for the first time. Sonographic stratification is promoted by means of "ultrasound windows" or contrasting borderlines. Employing stepwise dissection of autoptic specimens and ultrasonic comparison, it was possible to identify the hypodense zones 2 and 4 as mucous membrane and muscle layer, divided by the reflecting submucous layer (zone 3). The hyperdense bands 1 and 5 were found to represent borderline echos of the large bowel wall. This preliminary report is a step towards an eventual percutaneous staging of colon neoplasms. PMID- 3283931 TI - [Quantitative evaluation of knee joint effusions with high resolution real-time sonography]. AB - In three human cadaver specimens an intraarticular effusion of the knee was simulated by injecting sodium chloride in 10 ml portions. The sonographic appearance and quantification as well as the location of the fluid were evaluated. Effusions of the knee joint are a principal sign for many diseases. Their sonographic evaluation is easy and provides valuable clinical information. PMID- 3283932 TI - [Sonographic meniscus imaging: which scanning head is suitable?]. AB - Real-time scanning of the meniscus with different sector and linear ultrasound heads were tested. Visualisation of all meniscal components as well as reliable differentiation from surrounding structures was only possible with a 7.5 MHz head in the sector scanning mode. Both, the medial and lateral meniscus, were shown as a homogeneous, grey, wedge-shaped structure between the femoral condylus and the tibial plateau on the longitudinal ultrasound scan. A standardised method of examination is described. PMID- 3283933 TI - [Technical safety in ultrasound diagnosis]. AB - Technical devices and systems are getting more and more complex in diagnostic ultrasound. Safety aspects of ultrasound equipment are defined as "electrical safety", "safety of ultrasound" and "functional safety". Proposals are made to increase the safety of ultrasound and its interactions with mammalian cell cultures in order to establish a biological standard. A model of safety control is discussed. In future it will be necessary to pay increasing attention to questions on the efficiency of ultrasonic diagnosis and the responsibility of the examiner, since safe equipment alone cannot guarantee safe results if the examiner is unable to use the equipment properly and to interpret the resulting data correctly. PMID- 3283934 TI - Is fluoride a mutagen? AB - Recent studies suggest that fluoride may be genotoxic. While the concentration of fluoride in artificially fluoridated water (1 mg Fl-1) is generally considered to be "safe", levels of fluoride present in a number of widely used dental health products, such as fluoride-containing toothpaste, appear to be potentially mutagenic. Since fluoride is increasingly being used as a drug, and contamination of the total environment by fluoride emissions and solid wastes from industry is a growing problem, a review of the evidence regarding the potential mutagenicity of fluoride may be in order. PMID- 3283935 TI - Apolipoprotein E: cholesterol transport protein with expanding role in cell biology. AB - Apolipoprotein E is a plasma protein that serves as a ligand for low density lipoprotein receptors and, through its interaction with these receptors, participates in the transport of cholesterol and other lipids among various cells of the body. A mutant form of apolipoprotein E that is defective in binding to low density lipoprotein receptors is associated with familial type III hyperlipoproteinemia, a genetic disorder characterized by elevated plasma cholesterol levels and accelerated coronary artery disease. Apolipoprotein E is synthesized in various organs, including liver, brain, spleen, and kidney, and is present in high concentrations in interstitial fluid, where it appears to participate in cholesterol redistribution from cells with excess cholesterol to those requiring cholesterol. Apolipo-protein E also appears to be involved in the repair response to tissue injury; for example, markedly increased amounts of apolipoprotein E are found at sites of peripheral nerve injury and regeneration. Other functions of apolipoprotein E, unrelated to lipid transport, are becoming known, including immunoregulation and modulation of cell growth and differentiation. PMID- 3283936 TI - Segregation of form, color, movement, and depth: anatomy, physiology, and perception. AB - Anatomical and physiological observations in monkeys indicate that the primate visual system consists of several separate and independent subdivisions that analyze different aspects of the same retinal image: cells in cortical visual areas 1 and 2 and higher visual areas are segregated into three interdigitating subdivisions that differ in their selectivity for color, stereopsis, movement, and orientation. The pathways selective for form and color seem to be derived mainly from the parvocellular geniculate subdivisions, the depth- and movement selective components from the magnocellular. At lower levels, in the retina and in the geniculate, cells in these two subdivisions differ in their color selectivity, contrast sensitivity, temporal properties, and spatial resolution. These major differences in the properties of cells at lower levels in each of the subdivisions led to the prediction that different visual functions, such as color, depth, movement, and form perception, should exhibit corresponding differences. Human perceptual experiments are remarkably consistent with these predictions. Moreover, perceptual experiments can be designed to ask which subdivisions of the system are responsible for particular visual abilities, such as figure/ground discrimination or perception of depth from perspective or relative movement--functions that might be difficult to deduce from single-cell response properties. PMID- 3283937 TI - The design of molecular hosts, guests, and their complexes. AB - The origins, definitions, tools, and guiding principles of host-guest chemistry are developed. Perching, nesting, and capsular complexes are exemplified through molecular model and crystal structure comparisons. The degree of preorganization of a host for binding is a central determinant of its binding power. Complementarity of binding site placement in host and guest is a central determinant of structural recognition in complexation. Examples are given of chiral recognition in complexation, of partial transacylase mimics, of caviplexes, and of a synthetic molecular cell. PMID- 3283938 TI - Insulin-resistant diabetes due to a point mutation that prevents insulin proreceptor processing. AB - A point mutation in the human insulin receptor gene in a patient with type A insulin resistance alters the amino acid sequence within the tetrabasic processing site of the proreceptor molecule from Arg-Lys-Arg-Arg to Arg-Lys-Arg Ser. Epstein-Barr virus-transformed lymphocytes from this patient synthesize an insulin receptor precursor that is normally glycosylated and inserted into the plasma membrane but is not cleaved to mature alpha and beta subunits. Insulin binding to these cells is severely reduced but can be increased about fivefold by gentle treatment with trypsin, accompanied by the appearance of normal alpha subunits. These results indicate that proteolysis of the proreceptor is necessary for its normal full insulin-binding sensitivity and signal-transducing activity and that a cellular protease that is more stringent in its specificity than trypsin is required to process the receptor precursor. PMID- 3283940 TI - Genetics of alcoholism and related end-organ damage. PMID- 3283939 TI - The steroid and thyroid hormone receptor superfamily. AB - Analyses of steroid receptors are important for understanding molecular details of transcriptional control, as well as providing insight as to how an individual transacting factor contributes to cell identity and function. These studies have led to the identification of a superfamily of regulatory proteins that include receptors for thyroid hormone and the vertebrate morphogen retinoic acid. Although animals employ complex and often distinct ways to control their physiology and development, the discovery of receptor-related molecules in a wide range of species suggests that mechanisms underlying morphogenesis and homeostasis may be more ubiquitous than previously expected. PMID- 3283941 TI - Epidemiology of alcoholic liver disease. AB - Although there exists a relationship between alcohol consumption and alcoholic liver disease at both the aggregate and individual levels, it is also well established that less than one-third of alcoholics or heavy drinkers develop serious alcohol-related liver damage. A number of factors have been proposed to account for this susceptibility. Evidence supporting the direct dose-response relationship and the role of genetic and environmental factors in influencing vulnerability are reviewed. To date, no consistent evidence attests to the significance of any one factor in the susceptibility to developing alcoholic liver disease. PMID- 3283942 TI - Metabolic effects of ethanol and its interaction with other drugs, hepatotoxic agents, vitamins, and carcinogens: a 1988 update. PMID- 3283943 TI - Effects of ethanol on protein trafficking in the liver. PMID- 3283945 TI - Evaluating the impact of medical treatment on the quality of life: a 5-year update. AB - A comparison of the studies investigating the impact of medical care on quality of life over a recent 5-year period (1980-1984) with those appearing during the preceding 5 years from 1975 to 1979 [1]reveals; that (a) 3 times as many (69 as compared to 23) appeared during the time span, that (b) almost two-thirds (60%) of the recent studies included a subjective measure of quality of life as compared to only 1 in 10 for the previous 5-year period, but that (c) one-shot, case studies designs still predominate. On the other hand, (d) the use of control groups doubled from 1981 to the present, although (c) the majority of studies continues to use samples of convenience (e.g. consecutive patients or treatment survivors) rather than employing random assignments or random sampling. Nevertheless, (f) the average size of samples has doubled from 90 to 178, and (g) whereas almost all of the studies in the earlier review concluded that the intervention being studied improved quality of life, now approx. 1 in 5 report negative outcomes with another 30% reporting mixed results. It is concluded that in spite of increasing methodological sophistication, investigation of the impact of medical care on quality of life will be hindered until there is better agreement as to what constitutes adequate assessment of the construct. Suggestions for how a consensus might be attained are discussed. PMID- 3283944 TI - Digital subtraction wrist arthrography: use of double contrast technique as a supplement to single contrast arthrography. AB - A new technique using double contrast after digital subtraction wrist arthrography is presented. Results of the double contrast wrist arthrograms were essential to the diagnosis, confirmed the diagnosis, or salvaged an otherwise poor or nondiagnostic examination. It was found that intra-articular injection of air augments the information obtained during postarthrogram active motion studies under fluoroscopy. Double contrast wrist arthrography has proved valuable when the standard contrast arthrogram fails to yield diagnostic information. PMID- 3283946 TI - Fluoride and fluoridation. AB - To date, many of the ways of controlling tooth decay involve the use of fluorides. Either systemically via fluoridated water and tablets, or, topically, with fluoride-containing toothpaste and mouthrinses. There is now evidence that the prevalence of dental caries is declining in communities with unfluoridated water, as well as in those with fluoridated water. This phenomenon may be related to an increase of fluoride in the food chain; the unintentional ingestion of fluoride-containing dental health products; and the increasing contamination of the total environment with fluoride emissions and solid wastes from many industries. The apparent usefulness of fluoride as a preventive against dental caries does not mean that unnecessary exposure to the element should be tolerated. Fluoride at very low concentrations is phytotoxic and harmful to livestock; and in man, excessive intakes of fluoride over many years may lead to a well-defined disorder--skeletal fluorosis. In addition, a number of recent studies have suggested that fluoride may be genotoxic. PMID- 3283948 TI - Ethno-ophthalmology in the Egyptian delta: an historical systems approach to ethnomedicine in the Middle East. AB - Ethnomedical studies of the Middle East may be enriched by a long-term historical perspective, which takes into consideration the complex syncretism, through time, of both literate and nonliterate medical systems in this region, as well as the tumultuous history of conquest and colonialism in the Middle East. In this paper, the authors place the seemingly idiosyncratic, local, 'ethno-ophthalmological' practices of one northern Egyptian community, which is afflicted by the binding eye disease, trachoma, into a broader historico-political context, through examination of the four major literate medical systems of Egypt and the imperialistic forces responsible for their entrenchment. PMID- 3283947 TI - The political economy of health care: colonial Namibia 1915-1961. AB - The political economy of health care services in colonial Namibia during 1915 1961 closely reflected the extreme racial and class imbalance of power in a conquest state. The colonial power allocated to the indigent nine-tenths, the poorest nine-tenths of the people, an average 43% of the health care budget between 1922 and 1954. The League of Nations mandate proved toothless in pressuring the Mandatory power to rectify this or other inequalities. PMID- 3283949 TI - Are subarctic Indians undergoing the epidemiologic transition? AB - The applicability of A. R. Omran's 'epidemiologic transition' theory to subarctic Indians in Canada is examined in a historical review of health and demographic data. The major trends since the time of European contact include the rise-and fall of infectious diseases, the emergence of chronic, degenerative diseases, and the preeminence of the social pathologies in the post-World War II era. The divergences of the Amerindian experience from the 3 models in the epidemiologic transition theory and their implications for health care delivery are discussed. PMID- 3283950 TI - [Use of aminoglutethimide (orimeten) in advanced breast cancer]. PMID- 3283951 TI - [Primary sclerosing cholangitis]. PMID- 3283952 TI - [Diagnosis of autoimmune thyroiditis]. PMID- 3283953 TI - [Controlled drug therapy with the preparations immobilized on magnetic microphores]. PMID- 3283955 TI - [Autologous skin transplantation in burns]. PMID- 3283954 TI - [Thrombolytic therapy of myocardial infarction]. PMID- 3283956 TI - [Experiences with intra-arterial digital subtraction angiography in routine neuroradiologic diagnosis]. PMID- 3283957 TI - The 'smart bomb' replaces the 'magic bullet'. Targeted chemotherapy using tumour markers. PMID- 3283958 TI - Evolution of the care of the injured child. AB - Pediatric trauma care has become an art form practiced by pediatric surgeons who regard it as their field of special interest. The emotional and physiologic differences of young patients and the need to cope with pediatric trauma as a syndrome require special techniques and organization best provided by pediatric trauma centers. Improved outcome in trauma centers, both adult and pediatric, has been documented beyond reasonable doubt, and the trauma center movement has matured to the point where legislative and regulatory bodies and insurance carriers are directing seriously injured patients to specialized facilities. We hear so much about rare diseases that it is possible to forget that trauma kills more children than all other diseases combined. Seventy years after Dr. Ladd's vision the day may finally be at hand in which every pediatric hospital and children's service has a pediatric trauma program. The essential ingredient of pediatric trauma care is commitment to the special needs of injured children- personal, institutional, and community commitment. The future belongs to those who understand the past. PMID- 3283959 TI - Pancreas divisum and pancreatitis. PMID- 3283960 TI - Bone and soft tissue sarcomas. A rational approach to their curative management. PMID- 3283961 TI - Continent colostomy devices. PMID- 3283962 TI - Hepatic dearterialization. PMID- 3283964 TI - Current status of the management of patients with portal hypertension. PMID- 3283963 TI - Obstructive jaundice. Renal failure and other endotoxin-related complications. PMID- 3283965 TI - Continent urinary reservoirs. PMID- 3283966 TI - Normal and abnormal gastrointestinal motility. AB - The study of GI motility is an area of great current interest and excitement. Our knowledge of normal and abnormal GI motility is expanding exponentially. Perhaps one of the most satisfying consequences of this new knowledge is the ability to reassure patients that their symptoms may not be functional but may be based on a specific physiologic dysfunction. Unfortunately, our ability to treat effectively these newly described disorders has lagged behind our ability to diagnose them, but progress is being made, with promising new therapeutic agents on the horizon. Gastroenterologists remain the best friends of surgeons; most of these patients can and should be managed without surgical intervention. Therapeutic nihilism is not justified, because a carefully considered and properly timed operation may be of tremendous symptomatic benefit to selected patients. As more information and follow-up results are gained, the proper role of surgical intervention in these disorders will be better defined. PMID- 3283967 TI - Experiences with in situ lower extremity saphenous vein bypass procedures. PMID- 3283968 TI - The measurement of gastric emptying and its role in surgery. PMID- 3283969 TI - Segmental surgery of the liver. PMID- 3283970 TI - Respiratory function in surgical patients. Perioperative evaluation and management. PMID- 3283971 TI - An update on pancreatic transplantation. AB - The number of pancreatic transplants and the success rate have continued to increase. Most pancreatic transplants have been placed in diabetic recipients of renal transplants with end-stage renal disease, but application to nonuremic patients not undergoing renal transplants is increasing. Drainage of the graft duct into the bladder allows direct assessment of exocrine function and leads to earlier diagnosis and treatment of rejection episodes. There has been an improvement in graft survival rates associated with the use of cyclosporine in combination with other immunosuppressants. The effect of successful pancreatic grafts on the specific complications of diabetes is just beginning to be discerned, but a salutary effect appears to occur if the transplant is performed sufficiently early in the course of the disease. PMID- 3283972 TI - Basic scientific and clinical applications of peripheral nerve regeneration. PMID- 3283973 TI - Randomized double-blind comparison of mezlocillin versus cefoxitin prophylaxis for vaginal hysterectomy. AB - One hundred patients undergoing vaginal hysterectomy were enrolled in a randomized double-blind comparative antibiotic prophylaxis study. Forty-six patients received mezlocillin and 54 patients received cefoxitin. No significant difference was found among patients who developed febrile morbidity. Failure rate for mezlocillin was 17 per cent and for cefoxitin, 15 per cent. There was an increase in colonization of Streptococcus faecalis and Enterobacter species in patients receiving three doses of cefoxitin prophylaxis. PMID- 3283974 TI - Local treatment of carcinoma of the rectum. AB - LE is a management modality offered, at present, to less than 5 per cent of all patients with carcinoma of the rectum. It is indicated, as a primary curative procedure, in the subgroup of patients with early lesions of a favorable histologic grade. It has also been used, for palliation, in patients with overt disseminated malignant disease or in patients too old or too ill, or both, to withstand a radical operation or unwilling to accept a colostomy. Various techniques have been described and can be divided into two categories: excision of the intact tumor, best suited for a curative procedure when tumor characteristics can be accurately determined, and tumor destruction therapy, more generally used for palliation. The results of local excision, compared with those of radical operations, are very good when a strict selection policy is implemented and coupled with adequate patient follow-up study. PMID- 3283975 TI - Eldridge Houston Campbell, Jr. PMID- 3283976 TI - Neural transplantation. AB - Neural transplantation has recently emerged as an exciting extension of neural regeneration and plasticity studies. In this review, the roots of current attempts at autologous and heterologous grafting of neural tissue are traced. Grafts of peripheral and central nervous tissue have been shown to be viable after implantation in a variety of locations in adult animals' brain and spinal cord, and survival data are impressive. Donor tissue is optimal when harvested from fetuses, and successful growth and differentiation of neural grafts have been demonstrated in host animals in a broad age range. A variety of morphologic, physiologic, and behavioral parameters suggest a certain degree of integration of graft tissue into the host central nervous system, although technical limitations do not yet allow definitive statements regarding the extent of functional reinnervation. Perhaps the most promising and innovative of current studies are those that utilize a combination of peripheral and central neural tissue as transplant material. There are a number of possible applications of neural transplantation to clinical neurology and neurosurgery, some of which are discussed. PMID- 3283977 TI - Intracranial blood velocity in head injury. A transcranial ultrasound Doppler study. AB - We report our experience monitoring head-injured patients by means of transcranial Doppler sonography. Cerebral velocity measurements and waveforms change in a consistent pattern with the existence of intracranial pressure, and it is possible to discriminate low versus high flow states. The technique, in contrast to cerebral blood flow measurement, is reliable, atraumatic, and repeatable so that diagnostic assessments can be made and the patient can be followed for therapeutic efficacy. PMID- 3283979 TI - Hemodynamic function in acute pancreatitis. AB - Acute pancreatitis is often associated with impaired cardiovascular function. This study examined the systemic cardiovascular effect of acute pancreatitis induced by injection of autologous bile (0.5 ml/kg) into the canine pancreatic duct. After acute pancreatitis was induced, eight dogs were given no resuscitation (group 1, untreated pancreatitis), and lactated Ringer's solution was infused in 11 dogs (group II, treated pancreatitis) to maintain mean arterial pressure and pulmonary wedge pressure at control values. In the untreated pancreatitis group, mean arterial pressure, cardiac output, stroke volume, and stroke work values decreased (mean arterial pressure from 101 +/- 4 to 74 +/- 12 mm Hg, cardiac output from 118 +/- 7 to 56.2 +/- 1.1 ml/min/kg; stroke volume from 0.93 +/- 0.08 to 0.22 +/- 0.07 ml/beat/kg; p less than 0.05), whereas heart rate and peripheral resistance increased (heart rate from 125 +/- 7 to 185 +/- 10 beats/min, peripheral vascular resistance from 3130 +/- 410 to 4436 +/- 610 dynes/sec/cm5; p less than 0.05). Although coronary blood flow, endocardial epicardial flow ratio, and myocardial oxygen delivery values decreased progressively in group I after induction of pancreatitis, these changes did not achieve statistical significance. All indices of cardiovascular function and coronary blood flow remained unchanged in group II. Neither dP/dt max, the maximal rate of left ventricular pressure increase, nor dP/dt at a developed pressure of 40 mm Hg (an index of myocardial contractility minimally affected by changes in preload and afterload) were depressed by bile-induced acute canine pancreatitis in either group. Our data indicate that the detrimental effects of acute pancreatitis on cardiovascular function are related solely to hypovolemia and reduced cardiac filling and not to humoral or reflex effects induced by the disease. PMID- 3283978 TI - Glucose, fat, and protein kinetics in patients with primary and secondary hyperparathyroidism. AB - We performed a series of isotopic studies in 16 normal volunteers, four patients with secondary hyperparathyroidism (SHPT), and in nine patients with primary hyperparathyroidism (PHPT). Using the primed constant infusion of stable and radioisotopes, we have determined glucose, glycerol, free fatty acids, and urea kinetics, as well as glucose oxidation. Measurements were performed both in the basal state and during glucose infusion (4 mg/kg body weight/min). Compared with normal volunteers, PHPT patients are intolerant of glucose because of a limited suppression of endogenous glucose turnover during glucose infusion (34% versus 96% suppression). In addition, the plasma cortisol level increased in the PHPT patients during glucose infusion. Glucose oxidation and fat kinetics in both PHPT patients and volunteers were similar, but the rate of net protein loss was significantly greater in the PHPT patients than in the volunteers (2.1 +/- 0.5 versus 1.4 +/- 0.2 gm/kg/day). Rates of VO2 in the PHPT patients and volunteers were similar, but the value in the SHPT patients was higher (120 +/- 9 versus 142 +/- 20 mumol/kg/min for PHPT and SHPT patients, respectively). The SHPT patients had significantly increased rates of glucose turnover, glucose clearance, and glycerol turnover, compared with the other two groups, as well as an increased reliance on glucose for energy. We conclude from these studies that (1) SHPT patients are catabolic and have increased rates of glucose and fat turnover; (2) PHPT patients have limited suppression of endogenous glucose turnover after glucose infusion compared with volunteers and higher rates of net protein loss; (3) fat metabolism and glucose utilization are unimpaired in PHPT patients; and (4) these alterations in metabolism and hormonal response to glucose infusion suggest that some of the symptoms seen in these patients may have a metabolic hormonal basis. PMID- 3283981 TI - Penetration of clindamycin, cefoxitin, and piperacillin into pancreatic juice in man. AB - In our segmental pancreatic transplantation technique the pancreatic juice is temporarily diverted to the exterior via a pancreatic duct catheter. This permits studies on pure pancreatic juice to be carried out. In 11 such patients we studied the penetration of clindamycin, cefoxitin, and piperacillin into pancreatic juice. These three antibiotics all have good effect against the bacteria commonly isolated during pancreatic infections. Simultaneous blood and pancreatic juice samples were collected immediately before drug administration and at 30, 60, 90, and 120 minutes and 3, 4, 5, 6, and 8 hours after administration. The concentration of clindamycin in pancreatic juice was 34% of that in serum and exceeded the minimum inhibitory concentration for most bacteria associated with pancreatic infections. In spite of adequate serum concentrations of cefoxitin and piperacillin, the concentrations in pancreatic juice were only 8% and 5%, respectively, and did not exceed the minimum inhibitory concentration for the relevant bacteria. In view of these findings, clindamycin seems to be preferable in the treatment of pancreatic infections. PMID- 3283980 TI - Spontaneous and polyclonal Ig secretion by circulating B cells after surgery. AB - Abnormalities of the immune response are commonly observed after surgery. In many cases, they are part of a physiologic rather than of a pathologic response to trauma. In this study we show that after elective surgery in otherwise healthy subjects the B cell compartment is deeply affected, as documented by the appearance, 7 days after the intervention, of circulating lymphoblastoid B cells spontaneously secreting in vitro IgG and IgA antibodies. Analogous lymphoblastoid B cells have been described after in vivo immunization and represent a sensitive marker of the B cell response against the immunizing antigen. To better understand the origin of the reaction, we have analyzed the specificity of the antibodies secreted in culture supernatants. We show that the antibody response is polyclonal, since low titers of antibodies against several different bacterial antigens--such as tetanus toxoid, pneumococcal capsular polysaccharides (PCPs), and the lipopolysaccharides (LPSs) of several enteropathogenic strains of Escherichia coli--are detected. This response seems to reflect the previous immunologic experience of the single patient and to be caused by antigens released from traumatized tissues or absorbed through breaches in skin or mucous membranes. PMID- 3283983 TI - Diagnosis and treatment of cystic disease of the thyroid by aspiration. AB - One hundred forty-one cases of euthyroid solitary "cold" and "uniform" nodules, each of which contained at least 3 ml of fluid obtained on aspiration, are presented. Sixty-three patients had complete disappearance of swelling after one aspiration. Seventy-eight patients were selected for surgery on the basis of cytologic findings of malignancy in the aspirated fluid (one patient), on the basis of recurrent cyst formation after one aspiration (17 patients; in these cases the incidence of malignancy was similar to that in solid, cold nodules), and on the basis of palpable tissue after aspiration that indicated a partially cystic lesion (60 patients). Surgicopathologic findings revealed six malignant lesions; all of these nodules were more than 3 cm in diameter. In percentage, 6.6% of the partially cystic and 2.5% of the purely cystic nodules were malignant. The color of the aspirated fluid did not add to the discriminant value of the aspirate. The identification of malignant conditions in thyroid cysts was handicapped by the yield of acellular material in three of five cases of malignant disease and in more than 50% of benign lesions. However, the study suggests that aspiration biopsy of cystic thyroid nodules when used in association with the above clinical criteria is a useful technique of selecting patients for operation and, by itself, is a safe and reliable means of treating the disorder. PMID- 3283982 TI - Cholelithiasis after Billroth II gastric resection. AB - We evaluate whether Billroth II (BII) gastric resection is a predisposing condition in the formation of gallstones. In our department radiologic and echographic imaging is a routine examination before abdominal surgery. From 1980 to 1985, 202 patients underwent cholecystography or ultrasonography before BII gastric resections for peptic ulcers. The prevalence of cholelithiasis in a random sample of the population of the town near our institution was used to calculate the expected frequency of gallstones. The comparison of the expected and the observed frequencies of cholelithiasis in these patients did not show any statistically significant difference between men and women. All these patients were recalled for a follow-up of the long-term effects of gastric surgery, and 66% (133/202) returned and were examined. They underwent ultrasonography of the biliary tract. Again the observed and the expected (obtained as before) frequencies of cholelithiasis were compared. A statistically significant difference was apparent in male patients. We conclude that BII gastric resection could be a predisposing factor in the formation of gallstones in men. PMID- 3283984 TI - The effect of chronic acidification of the canine duodenum on gastrin release from the antrum transplanted into the colon. AB - Exogenous infusion of acid into the canine duodenum inhibits acid secretion stimulated by endogenously released and exogenously administered gastrin. The importance of this mechanism in normal acid homeostasis and in the inhibition of chronic endogenous acid hypersecretion is not established. In this study the classic Dragstedt model antral colonic transplant (ACT) was used to produce endogenous hypergastrinemia and acid hypersecretion. The effects of the ACT when the duodenum was retained in continuity with the stomach (gastroduodenostomy) were compared with those obtained when the duodenum was no longer in continuity with the stomach (gastrojejunostomy). The duodenum markedly suppressed gastrin release (p = 0.003) and gastric acid secretion (p = 0.005) in each of the four dogs. The dogs remained free of ulcers for 8 months after gastroduodenostomy and ACT. However, after conversion to gastrojejunostomy, large, chronic peptic ulcers developed after a mean of 3.5 months. The inhibitory effect of the duodenum on gastric release and gastric acid secretion protected the dog against ulceration for an extended period. The duodenum may be the major site of inhibitory control of acid secretion and endogenous gastrin release in dogs. PMID- 3283985 TI - Bilateral elastofibroma dorsi. AB - Elastofibroma, a rare, noncapsulated, benign entity (pseudotumor), is characterized by the proliferation of fibrous tissue with elastin and scattered islands of adipose tissue that occurs most often in the infrascapular area of elderly women. We report on a 44-year-old man with bilateral infrascapular elastofibromas. PMID- 3283986 TI - [Value of ultrasonic diagnosis of popliteal cysts]. AB - Ultrasonography of the knee joints in 55 patients with rheumatoid arthritis permitted diagnosing of popliteal cysts in 14 of them including 7 patients without any clinical symptoms. The method permitted measurements of cyst size and assessment of cysts before and after therapy. Ultrasonic B-scanning is a non invasive, informative and reliable technique for the detection and assessment of popliteal cysts. PMID- 3283987 TI - [Use of various non-pharmacological methods in the treatment of patients in the early stages of arterial hypertension]. AB - Patients with labile hypertension received various kinds of nonmedicinal therapy: psychological intervention (40 patients), acupuncture (25 patients), physical training (11 patients). Chemotherapy was provided to 38 patients. A significant antihypertensive effect was achieved with the use of the nonmedicinal therapeutic methods. Their efficacy was comparable with that of chemotherapy. PMID- 3283988 TI - [Possibilities and limitations of using inhaled sympathomimetics in patients with bronchial asthma in older age groups]. AB - Using a method of circadian ECG monitoring, the authors detected a peculiar phenomenon of frequent arrhythmic action of sympathomimetic inhalants in patients with bronchial asthma, mainly during remission. Possible interpretation of the results obtained was as follows: reduction during remission of functional beta block including heart block determining "cardioprotective" action in sympathomimetic inhalations; depletion of reserves of myocardial sympathetic mediators at the height of exacerbation of bronchial asthma; peculiarities of absorption of sympathomimetic inhalants with relation to a stage of disease. The authors discussed the potentialities and limitations of the use of sympathomimetic inhalants during exacerbation and remission of bronchial asthma with relation to patients' age and concomitant coronary heart disease. PMID- 3283990 TI - Communicating with your Spanish-speaking patients. PMID- 3283989 TI - [The role of ultrasonics in the diagnosis of kidney diseases]. AB - A retrospective comparative assessment of the diagnostic value of excretory urography (EU), scintigraphy (SCG) and ultrasonography (USG) of the kidneys was conducted in 100 patients. The diagnosis in 26 patients was confirmed by CT, angiography, at operation or autopsy. Chronic pyelonephritis was diagnosed in 54% of the patients, renal changes in essential hypertension--9%, hydronephrosis in 8%, abnormal shape and position of the kidneys in 8%, malignant tumors in 7%, chronic glomerulonephritis in 8%, renal cysts in 2%, multicystosis in 1%, kidney contusion in 1%, paranephritis in 1%, and apostematous nephritis in 1%. The sensitivity of EU was 71%, that of SCG 52%, that of USG 93%. The specificity of EU was 66%, SCG--8%, that of USG 90%. PMID- 3283992 TI - Fibrinolysis after heart transplantation. PMID- 3283991 TI - Cytoadhesins, integrins, and platelets. PMID- 3283993 TI - Robert Gwyn Macfarlane, 26 June, 1907-26 March, 1987. PMID- 3283994 TI - Robert Gwyn Macfarlane's contribution to the organization of biorheology--and other reminiscences. PMID- 3283995 TI - Quantitative determination of human protein C. Evaluation of a "fast" functional assay in comparison to a "traditional" functional and an immunological assay. AB - A fast functional assay for protein C was evaluated and compared with a traditional functional and an enzyme linked immunosorbent assay in parallel for the same plasma samples derived from 43 healthy subjects, 12 patients with severe hepatic dysfunction, and 23 patients under stable oral anticoagulation. By all three test systems significantly lower levels of protein C were obtained in both groups of patients compared with normal subjects (p less than 0.0001). No significant between - assay differences were found in normal subjects and in patients with hepatic dysfunction; by correlation analysis coefficients higher than 0.8 were calculated between the measurements of the three tests. In patients under stable oral anticoagulation, however, the immunologic test yielded higher values than the traditional (p less than 0.05) and, more pronounced, the fast functional assay (p less than 0.0001); no or only borderline significant correlations between the results were found. In these patients protein C levels measured with the traditional functional assay were in the same range as the activity levels of factors II, VII, IX, and X, whereas the fast functional test yielded significantly lower levels. The presented results indicate that very similar protein C levels were obtained with both functional and the immunologic assay except in patients under oral anticoagulation. PMID- 3283996 TI - Distribution of plasma fibronectin in the metastatic lesion of cancer: experimental study by autoradiography. AB - The author studied the distribution, localization and participation of plasma fibronectin in the metastatic lesion of experimental cancer in mice. The experimental animals used were Lewis lung carcinoma (LLC)-bearing C57BL/6 female mice. Radioactivity in the lungs of LLC-bearing mice were higher than those of the lungs of normal mice. Radioactive compounds were identified in the lung metastasis of LLC-bearing mouse lungs by whole body macroautoradiography and microautoradiography. PMID- 3283997 TI - [Calcium antagonists. Effect on blood platelets and atherosclerosis]. PMID- 3283999 TI - [Bacteriological study of fresh, preserved, damaged and contaminated pig spleens]. AB - Since the amendment of the Meat Inspection Act as on January 1, 1979, only the spleen is used as an indicator organ to detect bacteraemia in bacteriological examinations. The spleens should be handled carefully during slaughter, inspection, storage, transportation and laboratory testing in order to prevent false positive results of bacteriological examination caused by errors of inoculation, damage, contamination and unduly high storage temperatures. Bacteria could not be isolated from 86.2 per cent of 399 directly examined spleens of clinically normal pigs. Positive cases may have been due to acute bacteraemia in which the primary source of infection escaped notice, transient bacteraemia or errors of inoculation. Moreover, examination of damaged or contaminated spleens and spleens stored at too high temperatures showed that the usual method of sterilisation of the splenic surface singing is inadequate in some cases. In view of the fact that storage at 4 degrees C was not found to affect the results of bacteriological examination, the spleens which are to be examined should be intensively chilled immediately after slaughter. PMID- 3283998 TI - [Chemotherapy of tumors in dogs]. AB - The general principles of chemotherapy in oncology and the various types of antineoplastic drugs are discussed. Particular attention was paid to the results of chemotherapy in dogs and cats as reported in the literature. Chemotherapy is indicated in neoplastic disease characterised by early metastasis and/or local invasive growth. The results of chemotherapy in dogs and cats are so far moderate. Chemotherapy studies in the Netherlands are discussed: predictive in vitro, PEG-asparaginase studies in canine lymphosarcoma and regional perfusion in canine osteosarcoma. PMID- 3284000 TI - Intravenous insulin infusion system to determine insulin regimen in diabetics. AB - An algorithm for insulin infusion system to control blood glucose was derived from results of intravenous (i.v.) insulin infusion performed on 10 diabetics. I.v. insulin infusion was done on 14 diabetics for 24 hr using the algorithm, and blood glucose was controlled within the proper range in all cases; mean blood glucose was 130 +/- 42 mg/100 ml. During the examination, 4 of 14 cases did not need insulin infusion from midnight to the morning (type A) and 7 cases needed insulin infusion from midnight to the morning (type B). In 3 cases, insulin infusion was not needed at midnight, but blood glucose rose markedly in the early morning followed by insulin infusion (type C). The insulin regimen was determined according to the amount of insulin infused during the examination, dividing insulin dosages into two separate doses using semilente in the morning and a mixture of regular and lente insulin in the evening. In all the cases of type A and B, blood glucose was controlled well on the calculated regimen of insulin. However, good control of blood glucose was not obtained in 3 diabetics of type C. It is concluded that the algorithm is reliable in the estimation of the insulin infusion rate to control blood glucose in the diabetics, and the insulin regimen calculated from the result of intravenous insulin infusion is proper in about 78% of the diabetics. PMID- 3284001 TI - Evaluation of monoclonal antibody against human pulmonary surfactant apoprotein. AB - Lung sections of 104 newborn infants stored for 20 to 25 years and of seven cases of paraquat (PQ) intoxication were examined to detect the pulmonary surfactant apoprotein with the monoclonal antibody PE10 by immunoperoxidase staining technique. Specific peroxidase staining was observed in alveolar Type II cells and on alveolar walls of normal adult lungs. In the lungs of liveborn infant up to 28 weeks' gestation, peroxidase staining was negative. However, faint positive staining was observed in a specimen of 29 weeks' gestation, and the rate of positive staining increased with gestational age. Fifteen cases of newborn lungs with hyaline membranes revealed no positive staining except one. In the lungs of stillborn infants, peroxidase staining was weak and the rate of negative staining was more than that of liveborn infants. The specimens of PQ intoxication up to 5 days survival showed positive staining on alveolar walls, while those of 10 days or more survival, in which fibrotic changes and hyaline membranes were developed, showed no positive staining. PMID- 3284003 TI - Some properties of a proteolytic enzyme from the venom of Agkistrodon caliginosus (kankoku-mamushi) which increases capillary permeability. AB - The molecular weight of the capillary permeability-increasing enzyme from the venom of A. caliginosus was estimated to be about 32,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. This enzyme consists of a single polypeptide chain with an isoelectric point of pH 4.80. The enzyme is composed of 266 amino acid residues, based on a molecular weight of 32,000, and contained 11.4% carbohydrate. The enzyme more readily hydrolyzed arginine esters than lysine esters and did not hydrolyze tyrosine ester. Both the arginine ester hydrolytic and capillary permeability-increasing activities were inhibited by treatment with diisopropylfluorophosphate, indicating that the enzyme is an arginine esterase of the serine proteinase type. The substrate specificity of the enzyme toward synthetic chromogenic or fluorogenic substrates for mammalian serine proteinases and the pH and heat stabilities of the enzyme were also investigated. PMID- 3284002 TI - Characterisation of a monoclonal antibody capable of neutralising the haemorrhagic activity of West African Echis carinatus (carpet viper) venom. AB - A murine monoclonal antibody (SV-1/F10) was highly specific immunologically for West African E.carinatus venom both by ELISA and immunoblotting. In cross protection tests in vivo, it possessed strong antihaemorrhagic activity. This IgGl monoclonal antibody recognised an epitope present in a protein band of 124,000 mol. wt using immunoblotting of non-reduced Nigerian and Ghanaian E.carinatus venoms, as well as in a second protein band of 105,000 mol. wt in Ghanaian E.carinatus venom. The SV-1/F10 monoclonal antibody is of potential use for the isolation of West African E.carinatus venom haemorrhagin from whole venom, allowing the possibility of elucidation of the mechanism of its actions as well as its interactions with antibody. PMID- 3284004 TI - The sites of cleavage in oxidized insulin-B chain by a hemorrhagic protease derived from the venom of the habu (Trimeresurus flavoviridis). AB - The substrate specificity of a hemorrhagic protease derived from habu (Trimeresurus flavoviridis) venom was determined using oxidized insulin-B chain as a substrate. The enzyme was shown to be a fairly specific protease; it cleaved the substrate essentially at two positions, His10-Leu11 and Ala14-Leu15. The sites cleaved with the protease were compared to those reported with hemorrhagic proteases from other snake venoms. PMID- 3284005 TI - [Transplantation of a skin flap from the back of the foot to the face by using a microsurgical technic]. PMID- 3284007 TI - [Use of bridge dentures with abutments on equator crowns]. PMID- 3284006 TI - [Replacement of facial skeleton defects with demineralized bone allografts]. PMID- 3284008 TI - [Experience in replacing defects of the dental arches with metal ceramic dentures]. PMID- 3284010 TI - [Method of preparing graded hinge clasps in clasp denture manufacture]. PMID- 3284009 TI - [Experience with the use of gold-coated clasp dentures]. PMID- 3284011 TI - [Role of temperature stress in the development of enamel and dentin fissures]. PMID- 3284012 TI - [A. P. Levitskii (1860-1915)--one of the founders of the history of Russian dentistry (on the 125th anniversary of his birth)]. PMID- 3284013 TI - [Age-related characteristics of the enamel surface microrelief before and after exposure to acid]. PMID- 3284014 TI - [Molding materials for the casting of dental articles]. PMID- 3284015 TI - Relation between blood lipids, lipoproteins, and cerebrovascular atherosclerosis. A review. AB - Although blood lipids and lipoproteins are strongly related to coronary atherosclerosis, their association with cerebrovascular atherosclerosis is less clear. A review of more than 20 publications in which a relation was sought between plasma lipid and lipoprotein concentrations and cerebrovascular atherosclerosis leads to the general conclusion that such a relation exists and that it is stronger in older than in younger individuals. A relation was found between blood lipids and/or lipoproteins and the extent and/or severity of cerebrovascular atherosclerosis in all but three of 26 reviewed studies. However, the specific nature of the relation is obscure because the various studies cannot easily be compared with one another. Interstudy variations in lipoprotein fraction analyzed, methodology for the analysis of lipids and lipoproteins, arterial segment examined, population sampled, control selection in case-control studies, statistical analytic approach taken, and methodology for the assessment of arterial disease preclude pooled analyses. There is a clear need for further evaluation of this relation using standardized and up-to-date methodologies both for analyses of lipids and lipoproteins and for assessment of cerebrovascular disease in symptom-free volunteers as well as in symptomatic patients. PMID- 3284016 TI - Ultrasonographic follow-up of subclavian stenosis and occlusion: natural history and surgical treatment. AB - Continuous-wave Doppler ultrasonography and clinical examination were used over a 2-year period to monitor the natural history of subclavian stenoses and occlusions in 67 patients. Thirty-nine presented with subclavian steal and 28 without. We also studied an additional group of 29 patients who had undergone surgery for subclavian steal syndrome and vertebrobasilar transient ischemic attacks. The results, in terms of both ultrasonographic and clinical criteria, demonstrate the benign nature of the subclavian steal syndrome: all neurologic signs and symptoms were of a transient character. Spontaneous remission of vertebrobasilar transient ischemic attacks occurred in approximately 50% of the initially symptomatic patients, and only 15% of the initially asymptomatic patients experienced vertebrobasilar transient ischemic attacks during follow-up. Doppler ultrasonography revealed progression during follow-up in only 17% of the subclavian stenoses, and in 13% a stenosis was no longer detectable. Still ongoing brainstem transient ischemic attacks were reported in 24% of the operated patients. The most important factor for the lack of improvement was the occlusion of the bypass. Continuation of transient neurologic symptoms could be observed in only 14% of the patients with intact carotid-subclavian bypass. In conclusion, indications for surgical treatment of the subclavian steal syndrome should be restricted to cases in whom vertebrobasilar transient ischemic attacks occur frequently and are either debilitating or greatly frighten the patient. PMID- 3284017 TI - Antiplatelet agents in the secondary prevention of stroke: meta-analysis of the randomized control trials. AB - Randomized control trials of antiplatelet agents in the prevention of stroke following transient ischemic attacks have had conflicting results. The decision to employ aspirin instead of placebo as the control regimen in trials testing newer antiplatelet agents emphasizes the need for an accurate estimate of the efficacy of older drugs. A meta-analysis of seven randomized control trials comparing aspirin and/or sulfinpyrazone or dipyridamole with placebo was performed. For aspirin compared with placebo, a nonsignificant reduction in stroke of 15% (odds ratio 0.85, 95% confidence interval 0.60-1.19; chi 2 = 0.78, p greater than 0.30) was found. For aspirin combined with sulfinpyrazone or dipyridamole compared with placebo, a 39% reduction in stroke was observed (odds ratio 0.61, 95% confidence interval 0.39-0.95; chi 2 = 4.22, p less than 0.05); at the same time a 350% increase in gastrointestinal hemorrhage or peptic ulcer was noted (odds ratio 3.5, 95% confidence interval 1.26-9.75; chi 2 = 4.61, p less than 0.05). A trend in reduction of strokes for men was observed (odds ratio 0.58, 95% confidence interval 0.32-1.07; chi 2 = 2.52, p less than 0.15) for any regimen containing aspirin. The significant benefit of aspirin-combination therapy on stroke must be interpreted cautiously because of a number of possible biases. It is still conceivable that aspirin alone may decrease the incidence of stroke by as much as 40%, but a sample of greater than 13,000 patients would be needed to confirm the benefit observed in our analysis. PMID- 3284018 TI - Detection of cerebral vasculopathy in sickle cell disease using transcranial Doppler ultrasonography and magnetic resonance imaging. Case report. AB - We describe a case of homozygous sickle cell anemia in which noninvasive transcranial Doppler ultrasonography and magnetic resonance imaging were used to detect angiographically documented occlusive lesions of intracranial arteries. PMID- 3284019 TI - Correlation of continuous-wave Doppler spectral flow analysis with gross pathology in carotid stenosis. AB - Preoperative continuous-wave Doppler spectral analysis was used to generate two parameters, peak frequency in the internal carotid artery (fmax) and the ratio of peak frequencies in the internal and common carotid arteries (carotid index). These were compared with direct measurement of residual lumen diameter in pathologic specimens obtained from carotid endarterectomy in 37 patients. Doppler shift frequency parameters were well correlated with residual lumen diameter when the latter was at least 1 mm. Residual lumens of less than or equal to 2 mm were found to have an fmax of greater than 7.5 kHz and a carotid index of greater than 3.8. If fmax was greater than 14 kHz or the carotid index was greater than 7, the residual lumen diameter was nearly always less than or equal to 1 mm. Thus, the severity of the stenosis correlated directly with Doppler shift frequencies. The length of stenoses did not affect the correlations. PMID- 3284020 TI - Effect of internal carotid artery occlusion on intracranial hemodynamics. Transcranial Doppler evaluation and clinical correlation. AB - Neurologic deficits that occur simultaneously with or subsequent to internal carotid artery occlusion may be influenced by the adequacy of the intracerebral collateral circulation. Transcranial Doppler ultrasonography was used to evaluate mean middle cerebral artery blood velocity and blood flow in major collateral arteries in 78 patients, including 39 patients with 40 internal carotid artery occlusions and 39 control patients with less severe extracranial cerebrovascular disease, matched for age and sex distribution. Middle cerebral artery blood velocity was 38.9 +/- 17.9 cm/sec ipsilateral to an occlusion, 50.9 +/- 18.3 cm/sec contralateral to an occlusion (p less than 0.01), and 56.8 +/- 14.4 cm/sec in the controls (p less than 0.01). Pulsatility index ipsilateral to an occlusion (0.86 +/- 0.32) was reduced compared with contralateral and control pulsatility indexes (1.05 +/- 0.33 and 1.03 +/- 0.18) respectively; p less than 0.05). Major intracerebral collateral arteries were detectable in 94.9% of occlusion patients and in 53.8% of controls (p less than 0.01). A posterior communicating artery was demonstrated ipsilateral to an occlusion in 80.0% of the patients and contralateral to an occlusion in 39.5% (p less than 0.01). An ipsilateral posterior communicating artery was identified in all 10 asymptomatic occlusions and in 75.8% of the symptomatic ones. Pulsatility index was 1.02 +/- 0.34 for asymptomatic occlusions and 0.76 +/- 0.30 for symptomatic occlusions (p less than 0.01). Transcranial Doppler ultrasonography permits noninvasive quantification of the cerebral hemodynamic consequences of internal carotid artery occlusion and direct evaluation of the collateral blood supply, which can be correlated with symptomatology. PMID- 3284021 TI - Prognosis of acute hemiplegia estimated by transcranial Doppler ultrasonography. AB - Blood velocity in the middle cerebral artery was measured by transcranial Doppler ultrasonography in 15 patients suffering complete hemiplegia of less than 12 hours' duration, presumed due to cerebral ischemia. Among seven patients in whom blood velocity was greater than 30 cm/sec, five made complete or partial useful recovery of the involved hand and arm. Among eight patients in whom blood velocity was less than 30 cm/sec, one recovered completely while the other seven retained permanent total paralysis of the hand and arm. PMID- 3284022 TI - Culture and the management of family planning programs. AB - Integrating family planning programs with local cultures can increase or undermine their effectiveness. Program design and organization will be influenced by kinship and reproductive decision-making, which varies across regions, racial and communal divisions, and religions. Program implementation depends on four aspects of culture: (1) the understanding, acceptance, and continued practice of family planning by clients; (2) the climate in the organizations responsible for fieldwork, which affects the disposition to work and the tasks to be done; (3) the ability and willingness of field implementers to do their work; and (4) the communities in which clients live, including collective attitudes toward family planning and local pressures put on clients to participate. The Indonesian family planning program is a case in which these elements of culture are often positive. Other programs, such as that in Kenya, have a more negative environment for action. PMID- 3284023 TI - Is the Asian family planning program model suited to Africa? AB - This paper examines four Asian countries where fertility declines between the early 1960s and early 1980s ranged from 29 to 57 percent and contrasts their situations with seven African countries where fertility either remained constant or rose. It is shown that the difference is not explained by the African countries being at an earlier stage of socioeconomic development nor by the failure to provide family planning programs. The explanation is a lack of African demand for limiting family size, the result of family structures and economies quite different from Asia, and of essentially religious attitudes toward fertility that have an impact both on family economics and the acceptability of various forms of fertility control. These attitudes, together with the nature of the African state, mean that governments could not implement the forceful family planning policies that have at times characterized the programs of China, India, and Indonesia. PMID- 3284024 TI - [Conditions for preserving the species specificity of blood in stains during enzymatic hydrolysis]. PMID- 3284025 TI - [Absorption-elution reaction in detecting ABO system antigens in histological preparations]. PMID- 3284026 TI - [Determination of antigens of the MNSs system by immunofluorescence]. PMID- 3284027 TI - [Status and outlook of research into the problems of the mechanical and morphological origin of injuries to the soft tissues and internal organs due to the action of heavy blunt objects]. PMID- 3284029 TI - [Dissertations in forensic medicine (1986)]. PMID- 3284028 TI - [A method of readying bone preparations by using adhesive tape]. PMID- 3284031 TI - The cellular and molecular basis of allograft rejection: what do we know? PMID- 3284030 TI - Congenital neutropenia and low serum immunoglobulin A: description and investigation of a large kindred. AB - A kindred is described in which neutropenia and low serum immunoglobulin A levels has occurred. The affected members have variable clinical courses which do not appear to relate to the degree of neutropenia. The bone marrows show a maturation delay in granulocyte production, with increased numbers of lymphocytes. In vitro cultures of the bone marrows failed to produce granulocyte colonies. Studies of peripheral blood and bone marrow lymphocyte subpopulations give inconsistent results, although a general increase in T suppressor lymphocytes compared with T helper lymphocytes emerges. A therapeutic trial of corticosteroid and then of lithium carbonate was without effect on one of the patients. The pathogenetic basis for this probably X-linked disorder remains unclear. PMID- 3284032 TI - In vitro and in vivo human T cell repertoire in kidney allograft rejection. PMID- 3284033 TI - Pancreatic juice cytology after pancreas allotransplantation. PMID- 3284034 TI - Mathematical analysis of organ invasion by hemopoietic cycling grafted cells during a graft-versus-host reaction in mice. PMID- 3284035 TI - Intraperitoneal nucleopore chambers: a murine model for allograft rejection. PMID- 3284037 TI - Cellular immunologic in vitro studies of kidney and bone marrow transplantation: cytotoxic T cell activity--an advantage or disadvantage? PMID- 3284036 TI - Propagation of lymphocytes from human heart transplant biopsies: methodologic considerations. PMID- 3284038 TI - Products of HLA class I and class II (B,C,DP,DQ,DR) genes all contribute to induction of recipient anti-donor responses in rejected kidneys. PMID- 3284039 TI - TRG alpha, beta, and gamma gene rearrangements in human alloreactive T cell clones extracted from a rejected kidney. PMID- 3284040 TI - Human renal allograft infiltrating T cells: phenotype-function correlation and clonal heterogeneity. PMID- 3284041 TI - Increased HLA-DR antigen expression in human hepatocytes after liver transplantation: kinetic analysis using fine needle aspiration biopsy. PMID- 3284042 TI - Phenotypic and functional comparative analysis between infiltrating kidney transplant and peripheral blood immunocompetent cells after allograft nephrectomy. PMID- 3284043 TI - Double-staining analysis of mononuclear cells infiltrating rejected kidney. PMID- 3284044 TI - Lymphocyte infiltration and Ia expression in liver allografts in rats. PMID- 3284045 TI - Characteristics of cells lavaged from rejecting lung allografts in rats. PMID- 3284047 TI - Results of treatment in hepatic allograft rejection depend on the immunohistologic pattern of the portal T lymphocyte infiltrate. PMID- 3284049 TI - Analysis of cytotoxic lymphocyte precursor frequency during kidney transplant rejection in rhesus monkeys. PMID- 3284046 TI - Allospecificity of liver allograft-derived lymphocytes and correlation with clinicopathologic findings. PMID- 3284048 TI - Immunohistologic profile of cells infiltrating acutely rejecting and long surviving rat cardiac allografts. PMID- 3284050 TI - The roles of T cell subpopulations in allograft rejection. AB - In principle, cell-mediated allograft rejection can be brought about by cytotoxic T cells or by a DTH-like reaction. The first part of this article reviews the relative importance of these two mechanisms in graft rejection and concludes that the bulk of evidence points to cytotoxic T cells as being of major importance. In the discussion an operational definition of DTH is adopted--namely a mechanism that mediates bystander killing and depends on the existence of a radiation sensitive effector mechanism. The rejection of skin and organ allografts in mammals is T cell dependent and the demonstration that such rejection can occur in heavily-irradiated T cell reconstituted animals and in the absence of demonstrable bystander effects leads to the conclusion drawn. This is not to imply that concomitant DTH reactions may not augment the rejection process nor to deny the possibility that in special circumstances DTH reactions may play an essential part. In the second part of this article, the roles in graft rejection of CD4+ and CD8+ cytotoxic T cells are considered. The classical collaborative interaction between class II-restricted CD4+ cells that play an inductive role, and class I restricted CD8+ cells that differentiate into cytotoxic effector cells, seems to be unnecessary in some allograft responses. Thus, not only can CD4+ T cells differentiate into class II-restricted cytotoxic T cells but CD8+ T cells, at least in some class I MHC-incompatible strain combinations, can develop into mature effector cells without an inductive signal from CD4+ T cells. This autonomy seems to be limited to MHC incompatibilities so that CD8+ cells alone are unable to mediate the rejection of minor-H incompatible grafts. For these latter types of grafts, CD4+ T cells can bring about graft rejection if multiple minor-H determinants are present, but for weak minor-H responses the classical collaborative scheme is necessary. PMID- 3284051 TI - Tumor necrosis factor-alpha in rejecting rat cardiac allografts. PMID- 3284052 TI - Effect of the 5-lipoxygenase inhibitors EP 10045 and EP 10161 on cardiac graft cellular infiltrate and thromboxane formation. PMID- 3284053 TI - Correlation of renal inflammatory cell infiltrate with thromboxane. PMID- 3284054 TI - Induction of donor major histocompatibility complex antigens may not always correlate with graft rejections. PMID- 3284055 TI - Phenotype and function of T cells propagated from donor-specific blood transfusion enhanced and autologous blood transfused rejecting rat renal allografts. PMID- 3284056 TI - Novel effector monocytes against human RBC antigens invading rejected renal allografts. AB - A novel effector SPFC-MO may be involved in human renal allograft rejection, and the involvement of SPFC in rejected grafts may be reflected by the preoperative antidonor SPFC reactivity detected by the MLC-SPFC assay. PMID- 3284058 TI - Suppression of donor-reactive T cells by pretransplant sera of renal transplant recipients. PMID- 3284057 TI - Host-versus-graft and graft-versus-host reactions in pancreas grafts. PMID- 3284059 TI - A novel type of allogeneic skin graft rejection revealed through delay in graft exposure to T lymphocytes. PMID- 3284060 TI - Relationships among renal allograft biopsy infiltrates, growth of T cell lines, and irreversible rejection. PMID- 3284061 TI - Donor-specific cytotoxic T cells recovered from transvenous biopsies after clinical heart transplantation. PMID- 3284062 TI - Understanding what infiltrating cells do in autoimmunity: combination of cellular and molecular approaches. PMID- 3284064 TI - Effects of cyclosporine immunosuppression in humans. PMID- 3284063 TI - The immunologic network. PMID- 3284065 TI - Effects of cyclosporine, azathioprine, and steroids on the renal transplant, on the cytologic patterns of intragraft inflammation, and on concomitant rejection associated changes in recipient blood. AB - We have investigated the impact of various immunosuppressive drugs and their combinations on the graft, on the intragraft inflammatory patterns of rejection, and on rejection-associated effects in the recipient circulation by fine-needle aspiration biopsy and an extensive computer program. The patients were randomized into three treatment groups, 32 patients each, with the following postoperative immunosuppression: (1) Aza (2.1 mg/kg/d) plus MP (3.6 mg/kg/d tapered to 0.5 mg/kg/d by day 15), (2) CsA (10 mg/kg/d tapered to 8 mg/kd/d by day 28) and, (3) CsA (as above) plus MP (3.6 mg/kg/d tapered to 0 mg/kg/d by day 9). The groups were homogeneous in regard to all tested pretransplantation parameters. Graft parenchymal cell morphology was significantly (P less than .05) deteriorated and urine output reduced in CsA-treated patients, compared to those receiving Aza + MP; concomitant administration of steroids partially (P = NS) protected against the CsA-associated effects. The first episode of inflammation occurred significantly earlier (P less than .001) in patients receiving initially only CsA, compared to those receiving Aza + MP or CsA + MP, the total duration of intragraft inflammation was longer and the clinical signs of rejection were significantly prolonged (.001 less than P less than .05). Although the influx of lymphocytes and monocytes into the graft and the peak intensity of intragraft inflammation was similar in the three groups of patients, the inflammatory patterns of rejection were distinctly different. The number of (T) lymphoblasts in CsA-treated grafts was significantly (P less than .05) lower and their appearance delayed, compared to those treated with Aza + MP and even lower and more delayed in grafts treated initially with CsA + MP. The number of (B) plasmablasts was also reduced and their appearance delayed, but the differences to conventional treatment with Aza + MP were smaller and no longer significant. On the other hand, a significant (P less than .01) early maturation of blood borne monocytes into tissue macrophages was observed in the CsA-treated grafts in context of first rejection, which was lacking from those treated with CsA + MP or Aza + MP. In the blood, the first episodes of inflammation under CsA were associated with significant (P less than .001) thrombocytosis, which was lacking from the Aza + MP- and CsA + MP-treated patients.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3284066 TI - The influence of cyclosporine A treatment on immune responsiveness in vitro and in vivo in kidney transplant recipients. PMID- 3284067 TI - Pien Ch'iao, the legendary exchange of hearts, traditional Chinese medicine, and the modern era of cyclosporine. PMID- 3284068 TI - Effects of mizoribine and combination mizoribine/cyclosporine immunosuppression on canine renal allograft recipients. PMID- 3284070 TI - A comparison of the effects of cyclosporine and steroids on human T lymphocyte responses. PMID- 3284069 TI - Combination low-dose thalidomide and cyclosporine prophylaxis for acute graft versus-host disease in a rat mismatched model. PMID- 3284071 TI - Neurophysiologic aspects of allogeneic skin and upper extremity composite tissue transplantation in primates. PMID- 3284072 TI - Prolongation of rat renal allograft survival by injection of a small dose of cyclosporine into the thoracic duct. PMID- 3284073 TI - Cyclosporine--mechanism of action. PMID- 3284074 TI - Monoclonal antibodies for the radioimmunoassay of cyclosporine. PMID- 3284075 TI - Is the new specific monoclonal radioimmunoassay for cyclosporine of value in liver transplantation? PMID- 3284076 TI - Cyclosporine and metabolites in blood from renal allograft recipients with nephrotoxicity, rejection, or good renal function: comparative high-performance liquid chromatography and monoclonal radioimmunoassay studies. PMID- 3284077 TI - Comparison and correlation of assays for monitoring cyclosporine drug levels in renal transplant recipients. PMID- 3284078 TI - Comparison of Abbott TDx fluorescence polarization immunoassay, Sandoz radioimmunoassay, and high-performance liquid chromatography methods for the assay of serum cyclosporine. AB - We have had the opportunity to compare the new FPIA method for the measurement of serum Cs to established assays. The technique used a precipitation step prior to the fluorescence polarization measurement. We compared serum HPLC and RIA to the FPIA procedure. The within run coefficients of variation were 7.2%, 9.5%, and 4%, respectively. Between run CVs were 8.0%, 12.2%, and 3.8%. The correlation coefficient for HPLC and both of the immunoassays was less than 70%, showing the influence of the different specificities of the techniques. Medical centers that have based patient care on the HPLC assay that measures only parent drug will have difficulty using an immunoassay that measures a combination of parent and metabolites. There was a good correlation (R2 = 0.93) between the two immunoassays indicating that those currently using the serum RIA for monitoring could, through careful correlation studies in their patient population, use the FPIA technique. The regression equation was as follows: serum FPIA = 1.27 serum RIA + 1.9. This indicates the higher bias of the FPIA measurements. The advantages of the FPIA assay are that 20 assays could be done in less than one hour. This is in contrast to the longer turnaround time of the standard Sandoz RIA procedure. The technical competence required to perform the assay is less than that needed to perform the current RIA procedure. The assay can be recommended for replacement of the serum RIA; however, a correlation of levels with clinical experience is necessary in view of the difference in values between RIA and FPIA. PMID- 3284079 TI - Comparison of two radioimmunoassay kits for the determination of cyclosporine concentrations in transplantation. PMID- 3284080 TI - Modification of the specific Sandimmun kit radioimmunoassay for the measurement of blood cyclosporine by use of a nylon-based second antibody separation. PMID- 3284081 TI - Cyclosporine A-induced side effects related to a low total serum cholesterol level: an indication for a free cyclosporine A assay? PMID- 3284082 TI - Optimizing cyclosporine therapy: dose, levels, and monitoring. AB - The use of CsA has evolved considerably in concept and practice since the First International Congress on this drug in 1983. CsA is now increasingly used as a component of a multiagent protocol, rather than as a single, potent agent, with adjunctive therapy selected to optimize induction or maintenance immunosuppression. Novel clinical developments include the prophylactic use of the MoAb OKT3 as an alternative to polyclonal ALG, and the coadministration of bromocriptine to inhibit prolactin-dependent immune augmentation. Other combinations with site-selective pharmacologic agents are now under investigation in vitro or in vivo to improve both the selectivity and potency of immunosuppression while reducing further the toxicity and cost of CsA. With the introduction of MoAb to CsA, rapid and specific measurement of the parent molecule will now become widely possible. Because of its simplicity and rapidity, this technique may well replace HPLC for routine monitoring, although the latter will remain indispensable in a research setting for measurement of individual metabolites. Specific measurement of the parent molecule is clearly important in heart or liver transplantation when hepatic metabolism is frequently grossly disturbed. There is less evidence that this will prove of value in renal transplantation, however, and it remains possible that by virtue of the biologic effect of certain metabolites, a more broadly crossreactive polyclonal assay is equal or superior in this setting. In this regard, the fluorescence polarization immunoassay is particularly attractive as a clinical monitoring system. It is simple, accurate, and cost-effective, and by virtue of its automation and speed, particularly adapted to outpatient monitoring. The planned introduction of new kits allowing measurement by monoclonal or polyclonal antibody in either serum or whole blood will make this a versatile system for the measurement of CsA. PMID- 3284083 TI - Minimal low dosage of cyclosporine therapy in renal transplantation by careful monitoring of high-performance liquid chromatography whole blood trough levels. PMID- 3284085 TI - Cyclosporine monitoring in kidney and liver transplant patients: comparison between radioimmunoassay (37 degrees C plasma) and high-performance liquid chromatography (whole blood) measurements. PMID- 3284084 TI - Cyclosporine dose adjustment in patients with normal serum creatinine and trough levels: a challenge for successful long-term treatment. PMID- 3284086 TI - Cyclosporine levels are not helpful. PMID- 3284087 TI - Rigid-dose regimen versus blood level-adjusted cyclosporine in elderly cadaveric renal allograft recipients. PMID- 3284089 TI - Monitoring of blood cyclosporine concentration by a finger stab method and its applications. PMID- 3284088 TI - Significance of cyclosporine pharmacokinetics. PMID- 3284090 TI - Absorption profiles of renal allograft recipients receiving oral doses of cyclosporine: a pharmacokinetic study. PMID- 3284091 TI - An application of population pharmacokinetics to the clinical use of cyclosporine in bone marrow transplant patients. PMID- 3284092 TI - The chronopharmacokinetics of cyclosporine and its metabolites in recipients of pancreas allografts. PMID- 3284093 TI - Different pharmacokinetics of cyclosporine A early and late after renal transplantation. PMID- 3284094 TI - Alterations in cyclosporine pharmacokinetics after renal transplantation are linked to rapid increases in hematocrit, lipoproteins, and serum protein. PMID- 3284095 TI - Cyclosporine pharmacokinetics in pancreas transplant recipients. AB - Ten CsA pharmacokinetic studies were performed on five pancreas transplant recipients to determine proper doses and dosing intervals. These cadaver pancreas transplants were performed with exocrine ductal drainage into the urinary tract through a bladder anastomosis in four cases and into the bowel in one case. Four CsA pharmacokinetic studies were performed on diabetic renal transplant recipients and an additional six studies were performed while with pancreas transplant patients taking metoclopramide in an effort to enhance absorption of CsA. Mean CsA dose was 3.7 mg/kg/dose (range 2.1 to 7.5 mg/kg/dose). All patients but one were on twice daily dosing intervals yielding an average daily dose of 7.4 mg/kg/d. Noncompartmental pharmacokinetic analyses were used. The adequacy of a 1-, 2-, or 3-exponential model was determined by breakpoint analysis of the log concentration v time curve using the F statistic. The terminal rate constant was calculated by nonlinear regression analysis. The AUC and AUMC were calculated by the trapezoidal method with exponential extrapolation and these were used to calculate the MRT and Vdss. The unknown fractional absorption, F, was used to correct the oral data. The average CsA concentration maximum (Cmax) was 528 ng/mL with an average time to maximum concentration (Tmax) of 4.7 hours, a mean residence time of 7.75 hours, with a Vdss/%F of 9.61 L/kg in the pancreas transplant recipients. Additional studies of six patients receiving metoclopramide with CsA revealed an average Cmax of 723 ng/mL, an average Tmax of 2.3 hours, an average MRT of 6.08 hours, and an average Vdss/%F of 5.7% L/kg. These results indicate that coexistent gastroparesis in diabetic recipients of either pancreatic or renal transplants may result in reduced bioavailability of CsA. PMID- 3284096 TI - Biologic assessment of cyclosporine in serum of kidney transplant patients. PMID- 3284097 TI - Cyclosporine metabolite disposition after oral administration in pretransplant end-stage renal disease patients. AB - The results of this study have shown large interpatient variability in the disposition of M17 and M1 following a single oral dose of CsA in pretransplant end-stage renal disease patients. The differences in the distribution of M17 and M1 in WB and P at 37 degrees C has particular relevance in the interpretation of CsA therapeutic drug monitoring by nonspecific assays such as the RIA. Additional studies characterizing the disposition of M17 and M1 in WB and P separated at 37 degrees C following chronic CsA therapy will be needed to further understand the role of these metabolites in therapeutic drug monitoring of CsA. New analytical techniques or refinements in the present techniques will be required to identify and separate coeluting substances that are now being recognized with the present techniques. PMID- 3284098 TI - Influence of biliary T tube clamping on cyclosporine pharmacokinetics in liver transplant recipients. PMID- 3284100 TI - The effect of Roux-en-Y biliary enterostomy on the absorption of cyclosporine: relevance to poor drug bioavailability in children after orthotopic liver transplantation. PMID- 3284099 TI - Is elimination of cyclosporine in bile dependent on liver graft function and biliary drainage? PMID- 3284101 TI - Computer-assisted graphic display of serial cyclosporine determinations in blood with parallel creatinine concentrations. PMID- 3284102 TI - Interaction of erythromycin with cyclosporine. PMID- 3284104 TI - Inhibition of cyclosporine metabolism by other drugs in vitro. PMID- 3284105 TI - Effect of the calcium channel blocker diltiazem on cyclosporine A blood levels and dose requirements. PMID- 3284103 TI - Interaction of calcium blockers and cyclosporine. PMID- 3284106 TI - Cyclosporine-cyclophilin interaction. PMID- 3284107 TI - Cyclosporine metabolite concentrations in the blood of liver, heart, kidney, and bone marrow transplant patients. PMID- 3284108 TI - Isolation and characterization of cyclosporine metabolites using high-performance liquid chromatography and tandem mass spectrometry. PMID- 3284109 TI - Identification of cyclosporine metabolites in human bile, blood, and urine by high-performance liquid chromatography/radioimmunoassay/fast atomic bombardment mass spectroscopy. PMID- 3284110 TI - Measurement of cyclosporine and 18 metabolites in blood, bile, and urine by high performance liquid chromatography. PMID- 3284111 TI - Changes in the pharmacokinetics of cyclosporine and three of its metabolites in renal transplant patients early in the posttransplant period. PMID- 3284112 TI - The measurement of cyclosporine A and metabolite M17 in whole blood by high performance liquid chromatography. PMID- 3284114 TI - Cyclosporine A capsules: bioavailability and clinical acceptance study in renal transplant patients. PMID- 3284113 TI - Effect of the application form of cyclosporine on blood levels: comparison of oral solution and capsules. PMID- 3284115 TI - Transdermal application of cyclosporine prolongs skin allograft survival. PMID- 3284116 TI - The prolongation of skin allograft survival by topical use of cyclosporine A. AB - The absorption of CsA applied topically on normal or grafted skin was studied. When care was taken to prevent the rat from ingesting the CsA off their backs, the CsA blood levels was about 100 ng/mL or less, a suboptimal level to prevent rejection. The mean survival time of BUF grafts topically treated with 12 mg CsA/d was still significantly prolonged from 9.8 +/- 0.4 to 12.0 +/- 0.3 days. In bilateral grafting experiments where one graft was treated with CsA and one was not, the treated graft survived longer. Both grafts survived significantly longer than control animals with single grafts. These findings indicate that there is both a systemic and local immunosuppressive effect of topical CsA. PMID- 3284118 TI - Cyclosporine A administration: once a day or in fractional doses? PMID- 3284117 TI - Species-specific cyclosporine metabolism. PMID- 3284119 TI - Pharmacology: profiles, parameters, interpretations, and drug interactions. PMID- 3284120 TI - Cyclosporins: basic science summary. PMID- 3284121 TI - [The nature of methanol-induced acidification of the medium by products of metabolism of methylotrophic yeasts]. AB - The washed cells of Hansenula polymorpha and Pichia pinus grown on the medium with methanol rapidly acidify the medium during incubation with the mentioned alcohol or formaldehyde. It is found that proton extrusion is coupled with formate anion efflux. Acidification is proved to be energy-dependent process since it is inhibited by respiration poisons, uncouplers of oxidative phosphorylation, and by ATPase inhibitors. PMID- 3284122 TI - Nephropathy of nail-patella syndrome. AB - Ultrastructural renal lesions of a sporadic case of nail-patella syndrome are described. Although the patient, an 8-year-old Japanese boy, had no clinical renal syndrome, electron microscopy disclosed the presence of collagen fibrils and electron lucent areas within glomerular basement membrane. Comparative observation of glomeruli in sections stained by uranyl-acetate and lead-citrate and those by PTAH-uranyl revealed evidence of many collagen fibrils in mesangial matrix, as well as glomerular basement membrane. At the follow-up study 3 years after the biopsy, he still showed normal urinalysis and no renal dysfunction. Characteristic ultrastructure of glomerulus of this disease can be present even in cases without any apparent clinical renal involvement. It is concluded that the glomerular lesions in nail-patella syndrome may be caused by abnormal metabolic processes of collagen in glomeruli rather than entrapment of circulating collagen precursors. PMID- 3284123 TI - An ultrastructural study of the membranoproliferative variant of transplant glomerulopathy. AB - In this study we analyzed the ultrastructural features of the membranoproliferative variant of transplant glomerulopathy in 6 patients from a group of 64 renal transplant recipients who had evidenced graft dysfunction and histological diagnosis of chronic allograft rejection. The principle changes observed by electron microscopy were thickening of glomerular basement membranes by polymorphous changes that included widening of the lamina rara interna by an electron lucent material resembling plasma constituents, replication of lamina densa-like material, and inclusion of microfilaments, membranous profiles, and other cellular remnants. Proliferation of endothelial cells was a prominent finding, suggesting that a reparative endothelial response to injury may be significant to the pathogenesis of this form of transplant glomerulopathy. PMID- 3284124 TI - Tubular ultrastructure in rejected human renal allografts. AB - Twenty percutaneous renal transplant biopsies and 20 removed allografts were investigated ultrastructurally. Most of the detected alterations were of a degenerative or regenerative nature and not specific of rejection. The most interesting phenomenon was the tubulitis, namely, the migration of the interstitial inflammatory cells (IC) through the tubular basement membrane (BM) and the invasion of the tubular epithelium in this way. Tubular epithelial cells (TEC) in the vicinity of IC were often necrotic. The composition of cells invading the tubules corresponded to those infiltrating the interstitium. The distal tubule was more frequently infiltrated than the proximal tubule. The TEC were always in very close contact with the BM. The invading IC were in direct contact with the inner surface of the BM only while passing through it. IC that passed the BM were immediately separated from it by a thin epithelial layer. The tubular ultrastructural changes did not reveal substantial differences between the various rejection types, except for the pronounced thickening and lamellation of the BM in chronic rejection. PMID- 3284125 TI - [Internal mammary artery: the second generation in coronary bypass surgery]. PMID- 3284126 TI - [Etiological deliberations in neonatal jaundice]. PMID- 3284127 TI - [Dietary treatment of hypercholesterolemia]. PMID- 3284128 TI - [Measurement of function in gerontological research. I. Physical activities of daily living]. PMID- 3284129 TI - [Pathogenesis of emphysema--the protease/antiprotease theory]. PMID- 3284130 TI - [Irrigation before colon radiography. Is the effect of bisacodyl exaggerated?]. PMID- 3284131 TI - [Fetal arrhythmias. Diagnosis and clinical significance]. PMID- 3284132 TI - [A randomized comparison between acebutolol and metoprolol in 215 patients with hypertension. Significance of the self-stimulating effect and awareness of the occurrence of adverse effects]. PMID- 3284133 TI - [Thrombosis prevention with heparin/dihydroergotamine versus heparin/Sintrom in Ender nailing of pertrochanteric fractures]. AB - The effect of either (randomized) Heparin/Dihydroergotamine (HDHE) or heparin acenocoumarin (Hep/S) on the incidence of deep-vein thrombosis in the legs was studied in 212 women of more than 60 years of age with hip fractures. All patients were screened with the 125-I-fibrinogen uptake test (FUT) confirmed by a bilateral ascending venogram upon positive FUT. This revealed good sensitivity and specificity (85/84%) for the FUT. Deep vein thrombosis developed in 37.6% of the HDHE group and in 59.1% of the Hep/S group which was significantly different (p less than 0.005). The calculated thrombosis risk was significantly diminished (by 38% - p less than 0.005) in the HDHE group. Therefore we conclude that in traumatology Heparin/Dihydroergotamine seems to be the prophylaxis of choice. PMID- 3284134 TI - [Current findings in the pathogenesis of the shock process in traumatology]. AB - Traumatology deals with two different types of shock - the early hypovolemic traumatic, and the late, so called septic shock, which is often associated with multi-organ failure. Both types of shock are triggered by several mediator systems of humoral and cellular origin, with numerous interactions between each other. In hypovolemic-traumatic shock central events are a perfusion deficit (ischemia with reperfusion injury via the xanthine-xanthine oxidase system) and activation of the humoral axis - of coagulation, of fibrinolysis, of the complement and kallikrein-kinin system by injured tissue. Coagulation and complement are responsible for the activation of platelets and granulocytes respectively. These cells further interact with each other e.g. via platelet activation factor, which finally causes tissue damage. Granulocytes play a central role because of their ability to release oxygen radicals and neutral proteinases, which can be monitored (elastase) and probably used to predict organ failure. The gut area is less resistant to the events of shock and therefore is a "locus minoris resistentiae" for further development of endotoxemia, bacteremia, septic shock and multi-organ failure without a typical septic focus. By this "septic challenge" further mediator systems get involved, especially those of macrophages like interleukin-1 or cachectin. Similar to the activation marker of PMN-elastase, we could demonstrate that it was possible to use neopterin for monitoring macrophage activation in sepsis and organ failure. By the action of these cellular elements in microcirculation at the endothelial and interstitial level tissue damage occurs, which finally leads to individual and multi-organ failure. PMID- 3284136 TI - [Dynamics of the tubular activity of a long-functioning cadaveric kidney after allogeneic transplantation]. PMID- 3284135 TI - [Treatment of oleogranuloma of external genital organs]. PMID- 3284137 TI - [Diagnostic possibilities of captopril in arterial hypertension in the terminal stage of chronic renal failure in recipients of a cadaveric kidney]. PMID- 3284139 TI - [Ultrasonic characteristics of sclerotic changes in the male urethra in stricture]. PMID- 3284138 TI - [Pretransplantation analysis of blood levels of beta lysins for predicting the complications in kidney recipients after kidney transplantation]. PMID- 3284140 TI - [Chemotherapy of cancer of the bladder]. PMID- 3284141 TI - [Status of the coagulation and fibrinolytic systems of the blood in patients with chronic pyelonephritis]. PMID- 3284142 TI - [Memorable and anniversary dates in the history of urology and related sciences 1988]. PMID- 3284144 TI - [Value of prostaglandin El in the diagnosis of erectile dysfunction in comparison with papaverine and papaverine/phentolamine in 61 patients with erectile dysfunction]. AB - In 61 patients with erectile dysfunction a comparative study with intracavernous injection of prostaglandin E1 (PGE1), papaverine and a mixture of papaverine and phentolamine was performed. All patients underwent comprehensive multidisciplinary examinations, including bulbocavernosus reflex (BCR) latencies and somatosensory evoked potentials, penile Doppler sonography, dynamic or pharmaco-cavernosonography, and for 11 patients nocturnal penile tumescence (NPT) was also recorded with the Rigiscan. This diagnostic approach suggested that in 24 (39.3%) of the 61 pts the etiology was psychogenic and in the remaining 37 (60.7%) it was organogenic. PGE1 had a much higher erectile potency than papaverine and a somewhat higher potency than the mixture of papaverine and phentolamine. Complete erection was achieved in 41 of the 61 patients (67.2%) with PGE1, as against 20 of the 61 patients (32.8%) with papaverine alone and 20 of the 61 (32.8%) with papaverine/phentolamine. Whereas 7 of 61 patients (11.5%) had priapism of more than 6 h duration and requiring therapy after injection of papaverine or papaverine/phentolamine, no priapism occurred after PGE1. Thus, compared with papaverine and phentolamine, PGE1 offers important advantages in the diagnosis and perhaps also in the therapy of erectile dysfunction. PMID- 3284143 TI - [Open multicenter study of the differential diagnosis of erectile dysfunction with a papaverine-phentolamine combination (BY023)]. AB - We report the results of an open multicenter clinical trial with 115 patients. The results of a pharmacological test using intracavernously applied mixture of papaverine and phentolamine were compared with the results of a multidisciplinary evaluation of erectile dysfunction. Sensitivity and specificity of our test were determined. The injection of our drug solution caused an increase in tumescence and/or rigidity in all patients. The evaluation of the dose dependent erectile response makes it possible to distinguish between the three main pathogenetic principles: non-vascular, arterial and venous etiology of erectile dysfunction. The pharmacological test requires one to four intracavernous injections of 0.5 3.0 ml of the drug solution (7.5-45 mg papaverine hydrochloride, 0.25-1.5 mg phentolamine mesylate). PMID- 3284145 TI - [Complete separation of the cavernous bodies with penis deviation--an epispadias equivalent]. AB - The presented case report describes the not-yet-published existence of an epispadia equivalent, which consists of the complete separation of both cavernous bodies associated with both an atypical location of the urethral orifice on the dorsal site of the glans and a considerable ventral deviation of the penis. This separation was simultaneously associated with a unilateral arterialization of the whole penis via the right internal pudendal artery. The patient complained about an inadequate sexual performance, which was due to a marked ventral penile curvature requiring surgical correction. The operative approach included not only a corporoplasty, but also a complicated fusion of the cavernous bodies, accomplished by a fenestration and subsequent anastomosis. The result was cosmetically and functionally optimal. PMID- 3284146 TI - [Malacoplakia of the urinary tract]. AB - Malacoplakia is a granulomatous disease that most frequently involves the genitourinary tract. Because of the great variability of symptoms and lack of typical radiologic findings, this disease is usually not considered preoperatively. Generally of benign nature in the lower urinary tract, it leads to destruction and loss of renal function when affecting ureter and kidney. Progression of the latter can only be prevented by surgical intervention. Malacoplakia of the lower urinary tract requires long-term treatment with intracellularly active antibiotics in combination with drugs enhancing phagocytosis. PMID- 3284147 TI - [Experimental comparison of Maxon and chromic catgut in suturing of the urinary bladder]. AB - The new monofile absorbable suture material Maxon was compared with Chromic catgut in bladder suturing in rabbits. Comparisons were made after 1, 2, 4, 8 and 12 weeks. The rate of stone formation was mainly determined by the suture technique used and not so much by the suture material. This was demonstrated by the low number of stones formed after using extramucosal suturing technique. Once a suture, be it Maxon or Chromic catgut, comes in contact with urine, concrements may form and the new monofile properties of Maxon do not offer any advantages here. On the other hand, Maxon does not enhance stone formation either. E. coli or Proteus infections did not influence formation of stones. The histological examinations showed Maxon to cause fewer inflammatory reactions. Sutures with Chromic catgut caused inflammation of the bladder wall, subsiding after 4 weeks. An existing urinary infection did not appear to influence the inflammatory process. Maxon offers an advantage over Chromic catgut in extramucosal sutures causing fewer inflammatory reactions. PMID- 3284148 TI - [Comparison of papaverine-induced Doppler sonography and angiography in the diagnosis of erectile dysfunction]. AB - In the course of the evaluation of 500 patients with erectile dysfunction the results of penile Doppler-sonography and penile angiography could be compared in 65 patients, in whom both investigations were carried out under standardized conditions. Criteria for the evaluation of penile Doppler-sonography were the wave form analysis and especially the increase of blood-flow in the investigated arteries after intracavernous injection of papaverine. Criteria for the evaluation of the angiograms were the depiction of the penile arteries as well as the evidence of obstruction and collaterals of the internal iliac and pudendal arteries. In regard to the dorsal penile artery an all over correlation of 96.1% and in regard to the deep penile artery of 92.3% could be found. Based on these findings the conclusion can be drawn that papaverine-induced Doppler-sonography is able to replace penile angiography, thus no longer serving as the golden standard in the diagnosis of arterial insufficiency. PMID- 3284149 TI - Medical castration using megestrol acetate and minidose estrogen. AB - Sixty-two men who presented with previously untreated metastatic carcinoma of the prostate (D0: 10 patients; D1: 29 patients; D2: 23 patients) received oral megestrol acetate (80 mg twice daily) and minidose estrogen (diethylstibestrol 0.1 mg or ethinyl estradiol 0.05 mg once daily) as a means of achieving total androgen ablation (testicular and adrenal). A high incidence of feminizing side effects (70-74%), a higher than expected rate of cardiovascular complications (18%), an unexpected need for cortisone replacement (13%), and failure of patients with Stage D2 disease to obtain results better than those of standard therapy during the first year of observation suggest this regimen offers no advantage over other more conventional therapy. PMID- 3284150 TI - Bone fixation technique for transvaginal needle suspension. AB - Bone fixation of the suprapubic suspension sutures has been used in conjunction with transvaginal needle suspension in 115 women with genuine stress urinary incontinence over the last two years with excellent results being obtained. Utilizing the pubic tubercle as the fixation point for the suspension sutures (rather than the anterior abdominal wall) has decreased postoperative discomfort and obviated the need for any synthetic material. PMID- 3284151 TI - Gonococcal infections of penile prostheses. AB - The first two known cases of Neisseria gonorrhoeae infection of a penile implant are reported. The literature regarding periprosthetic infections is reviewed, and the mode of transmission of the gonococcal organism to the corpora is discussed. PMID- 3284152 TI - Effects of renal autotransplantation on ureteral peristalsis. AB - The ureteral peristalsis following autotransplantation is being investigated. It seems surprising that denervation does not cause more detectable changes in peristaltic pattern. PMID- 3284154 TI - Is cytology capable of adequately grading prostate carcinoma? Matched series of 50 cases comparing cytologic and histologic pattern diagnoses. AB - A perceived disadvantage of fine-needle aspiration biopsy of the prostate is that aspiration biopsies cannot be correlated with current tissue-grading systems. We compared patterns of cellular arrangement among 50 cases of prostate carcinoma studied in histologic and cytologic specimens obtained simultaneously. Cell patterns were independently scored in a semiquantitative fashion on both histologic and cytologic material, and "predicted Gleason scores" were assigned to the cytologic specimens. When carcinomas were classified as well differentiated (Gleason score 2 to 4), moderately differentiated (Gleason score 5 to 7), or poorly differentiated (Gleason score 8 to 10), there was 84 per cent agreement between histology and cytology. In no instance was there overlap between well-differentiated and poorly differentiated adenocarcinoma in the matched specimens. We believe that it is possible to accurately predict tissue patterns of prostate carcinoma and to estimate Gleason scores in aspiration biopsy specimens. PMID- 3284153 TI - Tuberculous epididymo-orchitis. AB - In the clinical course of epididymitis in a forty-four-year-old male patient, enlargement of ipsilateral testis developed which was difficult to distinguish clinically from testicular tumor. High inguinal orchiectomy was performed. Microscopic sections revealed many granulomas with caseous necrosis and giant cells. Tuberculous bacilli also were demonstrated in the histologic examination. PMID- 3284155 TI - Can transabdominal ultrasound estimation of postvoiding residual (PVR) replace catheterization? AB - In 81 outpatients the postvoiding residual urine (PVR) using real-time B-mode ultrasonography (3.5 MHz transducer) was measured. For the calculation of the bladder volume the formula for an ellipsoid (V = 4/3 pi X r1 X r2 X r3) was found to be most accurate in predicting the actual volume measured by in-and-out catheterization (r = 0.982). Other volume formulas, using only one diameter of the bladder, were found to be much less accurate. For any arbitrary value of PVR, used in determining clinical management, the incidence of misjudgment by ultrasound was negligibly low. We conclude, that sonographic measurement of the PVR as a quick, noninvasive method, should replace catheterization, if the basic equipment is available. Additional information, e.g., prostate size, bladder configuration, diverticula, etc., can be obtained during the procedure without additional costs or loss of time. PMID- 3284156 TI - [Coronary heart disease. Prognostic indicators and life expectancy as determining factors of insurability]. PMID- 3284157 TI - Immune-mediated hemolytic anemia and thrombocytopenia in a cat after bone marrow transplantation. PMID- 3284158 TI - IFAT detection of IgG specific to toxoplasma in thoracic fluids from aborted lambs: evaluation on routine diagnostic submissions. AB - Thoracic fluids from 171 aborted lambs from 55 flocks were examined by the indirect fluorescent antibody test for the presence of IgG specific to Toxoplasma gondii. The technique was shown to be both sensitive and specific for the diagnosis of toxoplasma abortion at a titre of 1/256, when compared with diagnoses made in the flocks and in the small number of individual fetuses in which the pathology of the cotyledons and the serology of the ewe were known. PMID- 3284159 TI - Absorption of neomycin from the equine uterus: effect of bacterial and chemical endometritis. AB - Plasma concentrations of neomycin were measured after intrauterine infusion of 3.3 mg/kg neomycin sulphate. Mares infected two hours previously with an intra uterine infusion of beta-haemolytic streptococci absorbed approximately 12 per cent of the neomycin in both the oestrous and the luteal phases of the cycle. Normal mares in oestrus absorbed 6 per cent of the neomycin infused and luteal mares absorbed 56 per cent. In infected mares the peak plasma concentrations occurred two hours after neomycin infusion, earlier than in healthy mares. Cervical flushings after neomycin infusion in infected luteal mares revealed an increased reflux of neomycin when compared with healthy mares. Prior infusion of 30 ml of 10 per cent Lugol's iodine into the uterus resulted in 31 per cent of neomycin being absorbed by oestrous mares and 64 per cent by mares in the luteal phase. Peak plasma concentrations occurred 30 minutes after infusion in both phases. In the luteal phase the mares' absorption of neomycin may have been maximal. PMID- 3284161 TI - Importance of diagnostic aspects in ostertagism. AB - Diagnostic methods which reveal only the presence or absence of Ostertagia in grazing animals are of little importance since all will acquire some degree of infection when grazed in the temperate regions of the world. Ostertagia infections may be (1) light--no disease or performance losses occur; (2) moderate -disease may or may not be overtly visible but performance losses occur or (3) heavy--disease is overt with or without death loss. The differentiation of these levels of infection is a quantitative matter insofar as the number of parasites correlates with the degree of pathology and is much less certain than is the presence or absence of infection. Historically, the quantitative parasite egg count in feces (eggs per gram (e.p.g.)), combined with the usual subjective and objective information obtained in clinical examinations has been the procedure used to obtain a quantitative estimate of the level of infection. More recently, the use of plasma pepsinogen levels as an indication of gastric pathology has been adopted by some laboratories. Neither of these methods have met with the desired level of accuracy, but they do have considerable value when their limitations are recognized. In the present era of emphasis on epidemiologically based control programs we are faced with yet another aspect of diagnosis, namely that of a quantitative estimate of numbers of infective stages (L3) on herbage. Methods to assess the number of L3 on forage are not satisfactory for routine clinical use. This paper evaluates the primary objectives of diagnosis as applied to the herd and flock. It briefly evaluates current methodology insofar as the diagnosis of parasitic gastroenteritis is concerned. The use of e.p.g. counts in clinical practice is discussed. Examples applicable to herds of weaner and stocker cattle are presented. PMID- 3284160 TI - Control strategies for ostertagiasis. AB - There are currently four major options for control of ostertagiasis and other ruminant gastrointestinal parasites. These are the traditional, suppressive, integrated and strategic approaches. Strategic dosing is the most realistic and beneficial approach for most regions of the world, including the U.S.A. It is effective, practical, labor-saving and can yield big economic returns. Today this approach is even more appropriate because of important advances in the technology of controlled release and pulse-release devices. Top priority in worm control programs should be given to dairy replacement heifers in their first year at pasture and to beef calves in the immediate post-weaning period. This is preferable to recommendations for blanket treatment of all beef and dairy cattle, regardless of age, immune status or pasture infectivity. An anthelmintic overkill is both wasteful and potentially harmful in that it increases the selection pressure for drug resistance. It is suggested that better dissemination of information is needed to make producers aware of the benefits of strategic dosing programs. This would eliminate much of the confusion about parasite control and focus attention on simple and effective programs that could significantly reduce current losses to the livestock industries. PMID- 3284162 TI - Aspects of the biology of Ostertagia ostertagi in relation to the genesis of ostertagiasis. AB - Adaptations such as the capacity of free-living stages to survive environmental stress, inhibition and density-dependent effects on population size and fecundity show O. ostertagi to be a consummate parasite of cattle in temperate environments. Knowledge of these adaptations, within an animal management context, provides the key to understanding the occurrence of disease and a basis for control of parasite numbers. Substantial infections do arise from low egg contamination rates of pastures. Discontinuities in rates of infection are caused by poorly predicted seasonal events such as the effects on eggs of oxygen deficient environments, fluctuating temperatures and the absence of sufficient moisture for migration of infective larvae from faeces to herbage. Time delays of several months between pasture contamination and availability of infection are therefore common. Ingestion of large numbers of larvae, over a short period early in the grazing season, gives rise to Type I disease or subclinical infections which decrease liveweight gains. In some ecotypes, environmentally induced inhibition leads to the accumulation of large populations of early 4th stage parasites within the host. These populations, under poorly defined conditions, can mature synchronously to produce severe diarrhoea, debility and even death in a proportion of mature cattle--the Type II disease. PMID- 3284163 TI - Evaluation of abomasal enzyme and hormone levels in the diagnosis of ostertagiasis. AB - Pathophysiological changes in the ruminant abomasum caused by Ostertagia infections include changes in the activity and concentration of gastrointestinal enzymes and hormones. Under certain circumstances, increases in concentration also occur in the bloodstream and, as such, are detectable. Determination of serum pepsinogen levels is useful in evaluating the risk or presence of ostertagiasis Type I in a herd. It seems less reliable when used to diagnose (pre) ostertagiasis in individual animals. Measurement of the concentration of other zymogens is not useful. The variations in methodology to determine pepsinogen levels (e.g. biochemical and immunological measurements) are discussed. Serum gastrin levels are, generally, increased in animals with ostertagiasis. At present, gastrin is mainly determined by RIA assays using human gastrin antibodies, but few baseline data are available on normal levels in ruminants. The use of gastrin determination as a diagnostic tool in Ostertagia infected ruminants is limited. PMID- 3284164 TI - Immunity to Ostertagia ostertagi. AB - Control of ostertagiasis is a major economic problem in the temperate areas of the world. An immunological control scheme for cattle is an important aspect of integrated control and its achievement is dependent on our understanding of how immunity is acquired. Also, host mechanisms regulated by Ostertagia need to be understood in order to address immunological questions. Little is known about acquired immunity to Ostertagia infection in cattle. The degree of immunity is incomplete and its development slow. Evidence is accumulating for impairment of antibody and cellular immune responses by Ostertagia which is responsible for the survival of the parasite in the young host. Other experimental work suggests that local factors, such as eosinophil accumulation, mucosal mast cell kinetics and other cellular and humoral immune responses, may play a role in pathogenesis and immunity. At the present time these areas are also totally unexplored in the study of Ostertagia infection. PMID- 3284165 TI - Epidemiology of Ostertagia ostertagi in warm temperate regions of the United States. AB - For many years our general knowledge on the epidemiology of Ostertagia ostertagi in the U.S.A. was based on research conducted in Scotland and England. During the last 10 years, epidemiologic investigations on O. ostertagi and other gastrointestinal nematodes of cattle have been conducted in various sections of the U.S.A. and Canada. Definite seasonal patterns of O. ostertagi larval inhibition have been demonstrated, but occurrences of the Type I and Type II clinical entities have not been adequately described and associated with the epidemiology of the parasite. All information to the present time suggests that there are seasonal differences in ostertagiasis based on a north and south plane, with larval inhibition occurring during autumn in the north and during spring in the south and parts of the west. Under environmental and management conditions of the south and those other regions where O. ostertagi is significantly and summer is the dominant season, some minimal numbers of inhibition-prone O. ostertagi may be acquired during autumn and winter. However, the early pre-Type II phase (acquisition of inhibition-prone larvae) begins in late winter and reaches peak levels during spring. From January to April, young cattle between weaning and 16 months of age may be affected by Type I disease. Pasture transmission basically ceases from late spring into autumn with consistent high temperature and alternating wet and dry periods. From late summer through autumn (occasionally earlier), Type II disease is possible primarily in yearling cattle and also in older cattle. September and October are months of greatest prevalence. The probability of Type II disease effects occurring, i.e. effects ranging from mild clinical signs and minimal production loss to acute disease and deaths, is dictated by numbers of worms present and characteristics of maturation of inhibited larvae, which in turn may be influenced by current weather factors and management conditions, as well as those of the previous winter and spring. PMID- 3284166 TI - Systematics of the nematodes that cause ostertagiasis in cattle, sheep and goats in North America. AB - The systematics of the Ostertagiinae is unsettled with no agreement on how many genera and species are present in cattle and sheep. Ten species of Ostertagiinae are commonly parasitic in cattle and sheep. The males can be identified on the basis of differences in morphology of spicules and genital cones but the females of most species cannot be identified. The species-level systematics have been complicated by the proposal that the ten species are polymorphs of only five species. The systematics at genus level has been complicated by the use of numerous genera for the ten species, at present most commonly Ostertagia, Teladorsagia and Marshallagia. This report (1) describes the current knowledge of the systematics and (2) provides diagnoses of the genera recommended for the ten species. The morphology of the ten species was studied to determine whether characteristics could be found to identify females or to further differentiate the males. Characters studied included the system of longitudinal and surface cuticular ridges (synlophe), the internal morphology of the esophagus and the orientation of rays of the copulatory bursa. The study of species morphology resulted in additional support for the polymorphism proposal. All minor species were found to be identical to their major species in characteristics of the synlophe, esophagus and rays of the copulatory bursa. Two recent classifications of the Ostertagiinae both recommended the use of the genus Teladorsagia for the species T. circumcincta and the two minor species that occur with it, T. trifurcata and T. davtiani. Teladorsagia is characterized by a copulatory bursa in which the five lateral rays are arranged 2-2-1 and a ventral swelling of the genital cone (proconus) is absent. One pair of species, Marshallagia marshalli (major species) and Ostertagia occidentalis (minor species) should be included in the genus Marshallagia. This genus has been characterized by an elongated bursa in which the posterior pair of lateral rays are much longer than the ventral pair. The remaining two pairs of species (O. ostertagi and its minor species O. lyrata, and O. leptospicularis and its minor species O. kolchida) and O. bisonis belong in the genus Ostertagia which is characterized by a 2-1-2 arrangement of the five lateral rays of the copulatory bursa and the presence of a proconus. PMID- 3284167 TI - The epidemiology of bovine ostertagiasis in the north temperate regions of North America. AB - Ostertagia ostertagi is widely distributed and is the most pathogenic of the parasitic nematodes affecting cattle in this region. Clinical ostertagiasis is seen mainly in calves and yearlings but outbreaks tend to be sporadic; the subclinical disease is of greater importance. Studies on the population dynamics of the free-living stages have shown that infective larvae can survive on pasture over the relatively severe winter conditions encountered in this region but that such pasture contamination declines during the succeeding grazing season and is lost by midsummer. In the host there is gradual acquisition of worms from pasture over the summer period, with relatively high burdens accumulating in the autumn. A dramatic shift in the proportion of adult to immature worms occurs during the autumn (October). By the time calves are housed, the proportion of larvae (mainly L4) is greater than 80%. This relative distribution of adults to larvae continues through the winter months until early spring when there appears to be a shift to a higher proportion of adults, presumably due to resumption of development of the L4. These persistent L4 stages are considered to be undergoing hypobiosis. Spring infections of calves appear to be mainly acquired from larvae that have successfully overwintered on pasture, and availability of these larvae is drastically reduced by midsummer. There appears to be negligible development of the eggs that result from the spring infections until late summer and early autumn. At this time because of favorable climatic conditions there is rapid larval development which can result in heavy infections in susceptible calves in the autumn.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284168 TI - Control of Ostertagia ostertagi infections in Australia. AB - The control of Ostertagia ostertagi infections in Australia is aimed specifically at young cattle in their first and second year of grazing after weaning. Mature breeding stock are not routinely treated. The recommended strategy is preventive, using an integrated approach of timed anthelmintic treatments in relation to the epidemiology of ostertagiasis in different environments. Best results are obtained when treatments, given at weaning and 6 months later, are combined with a move to 'safe' pastures which have not been grazed by cattle for the previous 6 months. Good results are also obtained in the winter rainfall regions when set stocked cattle are treated before and during autumn to prevent contamination of pastures at this time. More complicated grazing management, involving the spelling of pastures during autumn and winter, combined with anthelmintic treatments, is needed in some summer rainfall regions where weather conditions are especially favourable for the development and survival of the free-living stages of O. ostertagi. PMID- 3284169 TI - Epidemiology and control of bovine ostertagiasis in South America. AB - Gastrointestinal parasitism has been recognized by practitioners as the most common disease in beef cattle, mainly in weaning calves and fattening steers. Among the different genera, Ostertagia ostertagi is the predominant parasite in the temperate climate, in which the major beef and dairy cattle area of South America is situated. Outbreaks of Type I ostertagiasis are usually seen after weaning time (autumn-winter) when larvae counts are high and food availability is low. The development of the disease is rapidly established and 15-30 kg are lost in 30-50 days. Epidemiological studies have demonstrated a fast evolution of parasite eggs to larvae (L3) in summer (1 week or less), evolution being 30-45 days during winter. Inhibition O. ostertagi occurs during spring (September December) and development resumes in late summer and early autumn. The production effect is seen as a significant reduction in body weight gain and occasionally clinical Type II ostertagiasis appears. A similar epidemiological pattern of inhibition of Ostertagia sp. has been recorded in Uruguay and temperate areas in southern Brazil. PMID- 3284171 TI - Drug resistance in ostertagiasis. AB - Benzimidazole- and levamisole-resistant Ostertagia circumcincta from sheep have been reported from several countries, but there are no reports of anthelmintic resistant O. ostertagi in cattle, where resistance has been confirmed in controlled trials. The reasons for this may include (1) the biology of the worm, (2) avoidance of drug action by inhibition, (3) host metabolism of drugs, (4) less anthelmintic used in cattle than in sheep, (5) high costs of controlled trials, (6) lack of adequate in vitro tests to detect resistant worms and (7) lack of reporting of anthelmintic failures. Reduced efficacy of the anthelmintics levamisole and thiabendazole to adult O. ostertagi and of modern benzimidazoles to the inhibited L4 larvae has been reported in cattle. This latter effect might, in part, represent a stage-specific expression of resistance. Although anthelmintic resistance in O. ostertagi is not known to be a problem at present, it could potentially become a serious issue. PMID- 3284172 TI - Anthelmintics and control. AB - Anthelmintic control of Ostertagia ostertagi in cattle presents some special problems because the arrested larval stage (hypobiotic EL4) tolerates all of the older anthelmintics. The only anthelmintics on the North American market that are effective against this stage as well as the adult and developing stages are ivermectin and fenbendazole. In addition to these, the newer broad-spectrum benzimidazoles and probenzimidazoles, albendazole, febantel, netobimin and oxfendazole, are effective and available in other countries. These anthelmintics can be used for prophylaxis of Type II ostertagiasis. The older anthelmintics, levamisole, morantel tartrate, thiabendazole, coumaphos, haloxon and phenothiazine, are effective against the adults and to some extent the developing stages of O. ostertagi so that they can be used to treat Type I ostertagiasis. They can also be used to prevent incoming larvae from establishing if they are administered continuously over a long period of time. This is possible with long term in-feed administration or by the use of the morantel slow release bolus. In cooler temperature regions, where cattle are housed over the winter, this bolus is given at turnout to remove any parasites in the animals and to kill incoming larvae for 60-90 days. This can prevent the build up of significant infective larvae on pasture so that very few arrested L4 larvae accumulate in the summer/autumn, effectively preventing Type II ostertagiasis from occurring later. The use of ivermectin and the newer benzimidazoles in intermittent or slow release devices should prove highly effective in the control of Type I and II ostertagiasis, as well as of subclinical ostertagiasis. To achieve maximum economic benefit, the use of anthelmintics should be based on sound epidemiological considerations, so that stock are not rapidly reinfected after treatment. PMID- 3284170 TI - Mathematical models of the population biology of Ostertagia ostertagi and Teladorsagia circumcincta, and the economic evaluation of disease control strategies. AB - The construction and use of mathematical models of the population biology of Ostertagia ostertagi and Teladorsagia circumcincta is discussed. Simulated field trials implemented by deterministic mathematical models currently share with actual field trials the disadvantage that they convey no information concerning the risk associated with the net return demonstrated by the trial. This has important implications when it is necessary to rank disease control strategies in order of usefulness. PMID- 3284174 TI - [Ultrasonic and x-ray parallels in the study of abdominal aortic aneurysms]. PMID- 3284173 TI - [Optimal parameters of the injection of contrast media in digital subtraction ventriculography]. PMID- 3284175 TI - [Potentialities of ultrasonographic study in the diagnosis of kidney diseases]. PMID- 3284176 TI - [Use of digital subtraction angiography for planning arterial catheterization]. PMID- 3284177 TI - Nucleotide sequence and molecular genetic analysis of the large subunit of ribonucleotide reductase encoded by vaccinia virus. AB - We have mapped the vaccinia virus (VV) gene encoding the large subunit of ribonucleotide reductase (VV M1) within the HindIII I restriction fragment by using an oligonucleotide probe. Nucleotide sequencing revealed a 2340-bp open reading frame (orf), 1-3, whose amino acid sequence is highly homologous to the mouse M1 protein. The 1-3 gene was expressed as an immediate-early gene product, being transcribed in a leftward direction into a 2.7-kb polyadenylated transcript. Hybrid-selected translation of cycloheximide-amplified immediate early viral RNA demonstrated that this mRNA encoded an 86-kd protein, which agrees with the expected size of the reductase large subunit. The 5'- and 3' boundaries of the 1-3 transcriptional unit were determined by primer extension and S1-nuclease analysis, respectively, and shown to contain sequence elements typical of other VV early genes. Surprisingly, the predicted amino acid sequence of the VV enzyme subunit shares 72.5% homology with the mouse large subunit, M1. PMID- 3284178 TI - Nucleotide sequence of the first exon of the rat c-myc gene: proviral insertions in murine leukemia virus-induced lymphomas do not affect exon 1. AB - We have previously reported that proviruses are integrated adjacent to the c-myc gene in rat thymomas induced by murine leukemia viruses. In order to characterize these insertions, we have isolated recombinant DNA clones from normal rat DNA containing all of the normal rat c-myc gene, and from two Moloney murine leukemia virus-induced lymphomas containing both proviral and adjacent rat c-myc sequences. We determined the DNA sequence of portions of the normal and one tumor derived clone. The normal and tumor-derived exon 1 sequences are identical. By comparing our sequence to the sequences of mouse and human c-myc, we located the first exon of the rat c-myc gene. Analysis of the tumor-derived rat c-myc clones showed that proviral integration occurred approximately 1.4 kb upstream of exon 1 of c-myc in the case of one tumor and 0.55 kb upstream of c-myc exon 1 in the other. Thus, we conclude that the proviral insertions in these tumors did not affect the rat c-myc gene by altering the structure of the c-myc RNA. Consistent with this, the c-myc RNA present in a cell line derived from one of these tumors is identical in size to the normal c-myc RNA. Furthermore, the level of c-myc expression is not dramatically elevated in this cell line. Exon 1 of the rat c myc gene contains no ATG start codons and contains multiple stop codons in all three reading frames, indicating that it, like the chicken and mouse exon 1 sequences, is noncoding. The extent of homology between our sequence of rat c-myc exon 1 and the published sequence of human c-myc exon 1 is similar to the extent of homology between the sequences of mouse and human c-myc exon 1. The rat and mouse c-myc exon 1 sequences differ from each other by about the amount predicted from the known divergence times of mice from rats. Exon 1 of c-myc is only slightly conserved, evolving at a rate similar to that seen for introns and pseudogenes. PMID- 3284180 TI - [Metoprolol in the treatment of hypertension]. PMID- 3284179 TI - Molecular organization of the chicken ets locus. AB - Chicken DNA segments homologous to the ets region from the transforming gene of avian erythroblastosis virus, E26, were molecularly cloned and shown to be almost identical to v-ets by sequence analysis. The transforming gene acids from two cell-derived sequences, myb and ets. Whereas the mammalian ets genes are present on two chromosomes, the chicken ets sequence is present as a single locus with v ets homologous sequences found in nine regions over about 60 kb of genomic DNA. The major sequence difference between the v-ets and c-ets is found at the 3' end, resulting in different carboxy termini of p135 and the chicken proto-ets product. The chicken locus is primarily expressed in normal thymus cells as a 7.5-kb mRNA. The first two viral homologous regions are not found in this c-ets transcript or any other minor species, suggesting that they may not be true exons. Thus, the v ets region of E26 demonstrates that two major structural differences may have occurred during the transduction of proto-ets sequences by the virus: (1) Truncation of sequences present at the 5' and 3' ends of the gene; and (2) Acquisition of noncoding proto-ets sequences into the virus. Either or both of these differences may be, in part, responsible for the oncogenic potential of this retrovirus. PMID- 3284181 TI - [Personal experience with the stabilized blood glucose test (blood glucose clamp)]. PMID- 3284182 TI - [The insulin pump in type II diabetics]. PMID- 3284183 TI - [Glucose tolerance, immunoreactive insulin and glycated proteins in middle-aged women]. PMID- 3284184 TI - [Corticoids and glucose tolerance--effects on the oral glucose tolerance test in hyperbilirubinemia]. PMID- 3284185 TI - [Does diabetes increase the risk of cholelithiasis?]. PMID- 3284186 TI - [Contrast echocardiography of the heart muscle: a new method for the evaluation of regional perfusion]. PMID- 3284187 TI - [The significance of calcium in the pathogenesis and treatment of arterial hypertension]. PMID- 3284188 TI - [Medical service of the Red Army on the eve of World War II]. PMID- 3284189 TI - [Contribution of medics in western Siberia to the medical support of wounded troops]. PMID- 3284190 TI - [Role of the front-line dentist in organizing specialized care for the wounded]. PMID- 3284191 TI - [Use of computer technology in military public health]. PMID- 3284192 TI - [Diagnosis of acute surgical diseases of the abdominal organs using a shipboard computer during a cruise]. PMID- 3284193 TI - [An early transient incapacity syndrome in acute radiation lesions]. PMID- 3284194 TI - [Prospects for the use of neuropeptides]. PMID- 3284195 TI - [Arteriovenous malformations of the brain]. PMID- 3284196 TI - [The formation, organization and work of the Main Medical Storage Facility of the National Liberation Army of Yugoslavia during the closing operations of the National War of Liberation]. PMID- 3284197 TI - [Vitamins and immunity. 2. Vitamin B6]. PMID- 3284198 TI - [20th anniversary of the creation of the multivitamin preparation Undevit]. PMID- 3284199 TI - [Topical caries-preventing action of food products]. PMID- 3284200 TI - [Pharmacotherapy for reduced activity of microsomal liver enzymes (review of the literature)]. PMID- 3284201 TI - [Prophylaxis and treatment of hypertensive disease (review of the literature)]. PMID- 3284202 TI - [Etiology and pathogenesis of myasthenia (review of the literature )]. PMID- 3284203 TI - [Neurological complications of the most widespread otolaryngological operations (review of the literature)]. PMID- 3284204 TI - [Hygienic standardization of asbestos-containing dust (review of the literature)]. PMID- 3284206 TI - Creutzfeldt-Jakob disease, 1988. PMID- 3284205 TI - Rapidly progressive dementia caused by spongiform encephalopathy. PMID- 3284207 TI - [Syncopal consciousness disorders and drop attacks from the neurologic viewpoint]. AB - The most important neurological disorders leading to syncope and/or drop attack are presented. With respect to epilepsy it is important to consider generalized absence seizures (petit mal), generalized tonic-clonic seizures (grand mal) and some types of complex partial seizures. Additionally, some sleep and arousal disorders must be mentioned, such as narcolepsy, disorders of excessive somnolence associated with sleep-induced respiratory impairment, as well as the Kleine-Levin-Critchley syndrome. Vagotonic, asympathicotonic, sympathicotonic and central autonomic disorders are comprised in the group of autonomic attacks. Among other brain diseases manifesting syncope and/or drop attack, cerebrovascular disorders are of major importance in view of their high incidence. Psychogenic seizures also have to be taken into account in the differential diagnosis. PMID- 3284208 TI - [Does alcohol consumption promote the manifestation of strokes? Considerations on pathophysiology]. AB - Arterial hypertension is the most important risk factor in all types of stroke. The significance of alcohol in the pathogenesis of stroke is less well defined. Chronic alcoholism leads to an elevation of blood pressure. Thus, the association between alcohol and stroke might be the blood pressure effect of alcohol. However, some studies have shown a significant influence of alcohol on the incidence of stroke--especially of intracerebral haemorrhage and subarachnoid haemorrhage--even after adjustment for blood pressure. Many possible pathomechanisms are discussed. Alcohol inhibits aggregation of thrombocytes, and chronic alcohol abuse may induce thrombocytopenia, which could lead to a haemorrhagic stroke. Alcohol withdrawal leads to rebound thrombocytosis. Acute alcohol ingestion induces a decrease in fibrinolytic activity and an increase in factor VIII activity, which enhances the thrombotic potential. Additionally, alcohol increases plasma osmolarity, erythrocyte aggregability, haematocrit and blood viscosity, and decreases deformability of erythrocytes. The effects of alcohol on cerebral blood flow are still under debate; there is a deterioration in autoregulation of cerebral blood flow anyway. In animal studies alcohol induced dose-dependent vasospasm of the cerebral blood vessels, which could be a possible pathomechanism in ischaemic, as well as in haemorrhagic stroke. Chronic alcoholism is the most common cause of secondary non-ischaemic cardiomyopathy, which can lead to cerebral embolism via rhythm disorders or intracardiac thrombus formation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284209 TI - The enhanced transfer of drug-resistant genes in NIH-3T3 cells transformed by the EJras oncogene. AB - The spontaneous transfer of drug resistance genes has been shown to take place between cultured mammalian NIH-3T3 cells and occurs with a hierarchy of transfer efficiencies, transformed cells being more efficient than non-transformed cells. This experiment was accomplished by co-cultivating two NIH-3T3 sublines, each transfected by standard plasmid methods with a different drug resistance gene, subjecting the mixed population to double selection by adding both drugs to the mixed cell culture, and isolating single cells which were resistant to both drugs. The genes used were the neo gene and gpt gene which conferred resistance to the drugs G418 and mycophenolic acid, respectively. DNA analysis confirmed the presence of both resistance genes in the cells which were resistant to both drugs. The mechanism of this gene transfer was by cell fusion rather than by chromosomal DNA uptake. The efficiency of gene transfer, as indicated by the number of double-resistant colonies standardized by number of cells cultured, was much higher between two sublines of cells transformed by the EJras oncogene than between one transformed and one non-transformed subline, which in turn was higher than between two non-transformed sublines. The higher efficiency of gene transfer between the transformed cells also occurred when these cells were injected into nude mice, thus demonstrating that the same process occurred in vivo. It would appear that drug resistance genes may be transferred spontaneously in cultured mammalian cells by cell fusion, and that transformed cells have a higher efficiency of gene transfer compared to non-transformed cells. PMID- 3284210 TI - The effect of leucovorin on the therapeutic index of fluorouracil in cancer patients. AB - Fluorouracil has been in clinical use as an anticancer drug for 30 years. Although this drug has a broad spectrum of anticancer activity, including significant activity against the common solid tumors of the gastrointestinal system, only a minority of patients treated with fluorouracil experience an objective response to therapy. Furthermore, in randomized clinical trials completed to date, it has not been possible to demonstrate that fluorouracil therapy significantly prolongs the life span of patients with advanced cancer. Recent laboratory studies have indicated that leucovorin can enhance the cytotoxicity of fluorouracil in vitro, evidently by enhancing inhibition of the key enzyme, thymidylate synthetase, by the fluorouracil metabolite, FdUMP (fluorodeoxyuridine monophosphate; a stable inactive FdUMP-reduced folate thymidylate synthetase complex is formed). Pilot, uncontrolled studies of leucovorin-fluorouracil combinations have suggested that leucovorin may significantly increase both the clinical efficacy and the clinical toxicity of fluorouracil in cancer patients. These findings have led to the initiation of several randomized, controlled studies of leucovorin plus fluorouracil versus fluorouracil alone in the treatment of patients with advanced colorectal cancer. Three of these studies have recently completed patient accrual, and the preliminary results of each of the three studies indicate that leucovorin fluorouracil combinations will have a better therapeutic index than fluorouracil used alone in this disease. Further follow-up of these studies will be needed to determine whether leucovorin-fluorouracil combination therapy will prolong the life span of patients with colorectal cancer. PMID- 3284211 TI - Effects of extracellular matrix on the malignant phenotype. AB - Extracellular matrix molecules, including collagen, glycosaminoglycans (usually linked to a protein core as proteoglycan), elastin, and glycoproteins, influence the initiation and maintenance of differentiation of a variety of cell types. These molecules bind to the cell surface at specific sites and nonspecifically by electrostatic forces. Such interactions may alter the cell's response to growth and differentiation factors. After neoplastic transformation, most cells retain some dependence on these factors. This paper reviews the influence of matrix components on the phenotype of a variety of malignant cells and concludes that in vitro studies of malignant cell behavior require the utilization of an appropriate microenvironment. PMID- 3284215 TI - [Diagnosis and therapy of common acquired foot deformities]. PMID- 3284214 TI - [Sarcoidosis--diagnosis and therapy from the current viewpoint]. PMID- 3284213 TI - [Oral contraceptives--risk factors for cardiovascular events--chance association or causal relation?]. PMID- 3284216 TI - [Diagnosis and conservative therapy of common acquired foot deformities in adulthood]. PMID- 3284212 TI - Methods for determination of optic nerve blood flow. AB - A variety of studies have been conducted over the past two decades to determine if decreased optic nerve blood flow has a role in the etiology of glaucomatous nerve damage. Five basic methods have been employed in examining blood flow. Invasive studies, utilizing electrodes placed in the optic nerve head, represent one of the first attempts to measure blood flow. More recently, the methodologies have included axoplasmic flow analysis, microspheres, radioactive tracers such as iodoantipyrine, and laser doppler measurements. The results of these studies are inconclusive and frequently contradictory. When the studies are grouped by methodology, only the iodoantipyrine data are consistent. While each of the experimental techniques has limitations, iodoantipyrine appears to have better resolution than either invasive studies or microspheres. PMID- 3284217 TI - [Berlin contributions to the development of hepatology]. PMID- 3284218 TI - [Effect of intravenous diltiazem on stress-induced myocardial ischemia (study of hemodynamics and reproducibility of repeated studies]. AB - To obtain data about (a) the reproducibility of repeated standardized exercise tests, under blank and placebo conditions and (b) the improvement of ischaemic symptoms and of haemodynamics after intravenous application of diltiazem (0.3 mg/kg body weight), 20 patients with angina pectoris and angiographically proven coronary heart disease were analysed in a randomized double-blind study. RESULTS: a) A control exercise test 1 h after the first blank test showed no significant changes of the following parameters neither at rest nor during exercise: heart rate, systolic and diastolic blood pressure, double product, pulmonary capillary wedge pressure, cardiac output, peripheral vascular resistance, stroke volume, ST segment depression, symptoms of angina pectoris, and maximal work tolerance (steady state, supine position). b) After intravenous application of diltiazem, at rest, both systolic blood pressure (-13 mm Hg, p less than 0.03); diastolic blood pressure (-10 mm Hg, p less than 0.01) and peripheral vascular resistance ( 189 dyn x s x cm-5, p less than 0.02) decreased. During exercise testing, diastolic blood pressure (-9 mm Hg, p less than 0.02), pulmonary capillary wedge pressure (-13 mm Hg, p less than 0.01) and peripheral vascular resistance (-152 dyn x s x cm-5, p less than 0.02) were reduced, and angina pectoris was less severe (p less than 0.01): in comparison to placebo the onset of anginal symptoms occurred later (24 vs 49 W, p less than 0.01). Maximal exercise tolerance and maximal cardiac output were improved, and ST-segment depression was less pronounced. The study shows that haemodynamic data and ischaemic parameters are well reproducible in repeated exercise tests.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284219 TI - [Cardiac side effects of anti-arrhythmia agents]. AB - Antiarrhythmic drugs have typical cardiac side effects. These effects are due to their electrophysiological action on the one hand and to the negative inotropy on the other. These electrophysiological effects can cause a depression of sinus node function and/or AV conduction leading to severe bradycardia or asystole. However, the proarrhythmic effects of these drugs are clinically more important, especially the induction of ventricular tachycardia and "torsades". The incidence of these proarrhythmic effects is at least 5% of all patients treated. Patients with reduced ventricular function, "malignant" ventricular arrhythmias, and QT prolongation are especially endangered. Proarrhythmic effects may occur after the first dose. However, in most instances the risk is increased with higher dosage. The hemodynamic effects of antiarrhythmic drugs are especially important in patients with reduced cardiac function. The negative inotropy of antiarrhythmic drugs is often counterbalanced by the simultaneous decrease in blood pressure leading to an afterload reduction. Antiarrhythmic drugs causing an increase in systemic resistance may have a more pronounced depressive effect on cardiac function. However, if the acute treatment of severely ill patients in the CCU is excluded, the negative inotropy of antiarrhythmic drugs is not such an important problem as the proarrhythmic effect. As a consequence, antiarrhythmic treatment should be restricted to severely symptomatic patients on the one hand and to those with arrhythmias of prognostic importance on the other. In addition, the patient's treatment should be carefully controlled, especially during the early phase of treatment with antiarrhythmic drugs. PMID- 3284220 TI - [Psychodynamics of suicide in the aged]. AB - The highest rates of suicide are found in the aged, especially among the old men. The analysis of the literature shows three main aspects: 1. The decrease of the strength of the body is seen as an important factor, but exists only in the background. 2. The keeping of one's ground in the arrangement with his/her entourage, in which feelings of oppression often occur. 3. The balance-sheet of one's life, in which the possibilities for the final stage of life are playing a decisive role. The independence of the suicide in the aged is found to be not so. Differences in motivation between the sexes are not demonstrated. It is assumed that men react quicker with a suicide than women do in a corresponding situation. PMID- 3284221 TI - [Microwave fixation of labile uridine phosphates in the rat hippocampus]. PMID- 3284222 TI - [Enzyme immunoassay for the determination of methotrexate in serum]. PMID- 3284223 TI - [Basic trends in the use of optical holography in biomedical research]. PMID- 3284224 TI - [The perception of respiration and the nature of dyspnea]. PMID- 3284225 TI - [Integration levels and mechanisms in the activities of the kidney]. PMID- 3284227 TI - [Interhemispheric differences and the interaction of the hemispheres]. PMID- 3284226 TI - [Problems of internal inhibition]. PMID- 3284228 TI - [Mechanism of oxygenase reactions: the main products, intermediates and by products of the oxygenase cycle]. PMID- 3284229 TI - [Molecular organization and reconstitution of the hepatic microsomal monooxygenase system]. PMID- 3284230 TI - [Role of glutathione in detoxification processes]. PMID- 3284231 TI - [The past--in the present and future (on the centenary of A. D. Speranskii's birth)]. PMID- 3284232 TI - [Current role and prospects of roentgenotherapy in dermatology]. PMID- 3284233 TI - [Insulin-induced panniculitis]. PMID- 3284234 TI - [Relation of the cell differentiation of a megakaryocyte line to the phases of its mitotic cycle and the number of cells in different subpopulations of the bone marrow]. PMID- 3284235 TI - [Electrophysiology of the chemosensory systems and the behavioral analysis of caudate amphibia]. PMID- 3284236 TI - Indigenous malaria in the D'Entrecasteaux Islands, Papua New Guinea. PMID- 3284237 TI - Hypoglycaemia in malaria. PMID- 3284238 TI - [Local autovaccine treatment of experimental urinary tract infections in the rat]. AB - The effect of a local autovaccination therapy on the course of an experimental pyelonephritis should be investigated in the rat. A total of 114 animals were infected by E. coli O2:K1:H4 by the hematogenic route. In the first group a suspension of formalin-inactivated germs of the infection strain was applicated, in the second group a suspension of formalin-inactivated germs of a E. coli rough strain and in the third group isotonic saline solution was given on the 6th, 7th, and 8th week after infection, respectively. The fourth group was untreated after infection. The autovaccination therapy led to a significantly decrease of bacterially contaminated kidneys and a significantly reduction of pyelonephritis foci in the primary infected kidneys. An ascending reinfection resulted in a higher bacterial colonization of the kidneys in the vaccinated animals than in the control animals. Nevertheless, in the vaccinated animals fewer kidneys were affected by inflammatory changes. PMID- 3284239 TI - [Relations between vascular, interstitial and tubular changes in the transplanted kidney]. AB - To determine the question of the extent of fibrous intimal swelling in chronic transplant vasculopathy, of fibrous interstitial broadening and of tubular atrophy, we performed semi-quantitative histological examinations on 139 biopsy specimens, 70 removed kidney allografts and 35 allografts after autopsy, respectively. A positive correlation was found between vascular and interstitial changes. Morphometric analyses were done in 9 removed transplants and 2 normal kidneys, at which in each case 4 cortical regions including the supplying middle sized and small arteries are examined. It was shown, that the extent of intimal swelling was variable and in the same sense also the degree of interstitial proliferation. Thus, the correlation as mentioned above is confirmed. Therefore, it is presumed that the extent of chronic transplant vasculopathy with reduction of the blood supply is most important to the formation of interstitial broadening and tubular atrophy. On principle other causes are possible and must be excluded by histological and/or angiographic investigations. PMID- 3284240 TI - [Metabolic changes in bones and modification of growth in children with chronic renal failure, dialyzed and with kidney transplant]. AB - Forty to fifty percent of the children with chronic renal insufficiency show a growth retardation. The cause of this disorder is supposed on the cellular level of the target organ bone. Objective prospective studies on the growth characteristics of children with chronic renal insufficiency after dialysis and transplantation, respectively, are necessary in consideration of the internal milieu and external influences. PMID- 3284241 TI - [Autopsy analysis of the cause of death in patients with kidney transplants]. AB - 68 cases of autopsy of 950 patients who underwent a kidney transplantation in Berlin from 1970 to 1986 were analysed with regard to their main disease, the disease directly leading to death and secondary disease. The average age of the deceased was 39.6 years (15-56 years), the duration between kidney transplantation and death was 51.2 months (1-192 months). In the first place there are diseases of the liver (30 times primary disease, 28 times secondary disease), in which cases 24 times a liver cirrhosis was existing and in 11 cases a coma hepaticum caused death. Apart from this septic-septicopyaemic processes (23 times) were of great importance for the exitus, in which cases there were frequently close relations to liver diseases (10 times liver diseases primary disease, 12 times secondary disease). Furthermore are important for the occurrence of death the renal hypertension as well as hemorrhages particularly in the gastrointestinal tract. 15 times a diabetes mellitus was stated, in 13 cases severe changes of bones and joints were diagnosed. 4 times a neoplasia was present (3 times immunocytoma, once liver carcinoma). The diseases diagnosed are to be regarded as a sequela of the primary disease, above all, however, caused by the long-lasting immunosuppressive therapy and the influence on the endocrine system. PMID- 3284243 TI - [Surgical treatment of echinococcosis of the lung based on 575 personal cases and a study of the literature]. AB - Echinococcosis has continued to be a worrying problem in endemic zones. An account is given in this paper of 25 years of experience in echinococcosis treatment. Reported are 575 patients on whom operations had been performed at the Surgical Clinic of Malaga University under the supervision of Professor Vara Lopez. Fifty-six per cent of these patients were males and the remainder females. The disease was found to occur with regularity to all age groups. Cough, pain, lung bleeding, and geographic origin were characteristic phenomena of the disease and its anamnestic background. Diagnosis was confirmed by these parameters together with eosinophilia, complement fixation reaction according to Weinberg, intracutaneous testing according to Casoni, and radiography. Surgical approaches were pericystectomy in 415 cases, cystectomy in 57 cases, segmentectomy in 64, lobectomy in 34, and pneumectomy in five cases. Postoperative complications occurred to seven per cent of the patients, and the lethality rate amounted to 1.5 per cent. The absence of clinical information in publications is discussed together with lack of analyses of clinical situations, modes of treatment, and complications. PMID- 3284242 TI - [Adaptation of the bronchi using rotation anastomosis]. AB - Seventeen dogs were examined for experimental peculiarities of bronchial adaptation techniques and for effects such techniques may have on the formation and regeneration of anastomoses, following upper bilobectomy with sleeve resection of the primary bronchus. The difference in diameters of bronchus stumps to be interconnected was overcome by means of rotational anastomosis in twelve animals. The caudal stump was turned by 60 degrees (width of membranous part of cranial stump), and steps between sutures on the cranial stump were enlarged relative to the caudal stump. Also, the membranous wall of the lower lobar bronchus was pulled over the cartilagenous semicircle of the primary bronchus. The animals were kept under follow-up observation for one year maximum. Bronchological, radiological, and morphological checks were made at different postoperative intervals to obtain information about the condition of the anastomosis. Results have shown that in several cases rotational anastomosis can be recommended as a convenient and rational approach with no negative consequences to bridging gaps between bronchial diameters. The heterogeneous tissues of bronchial walls, following rotational anastomosis, were found to consolidate with each other within a period of time identical with that required by homogeneous tissue. Rotational anastomosis has been applied with good success to four patients. PMID- 3284244 TI - [Anatomy of the choledocho-pancreatico-duodenal junction in infancy, childhood and adolescence]. AB - Series of histological sections of the major duodenal papilla were examined. The samples had been taken from human aged between 28 gestational weeks and 19 years. Reflux-preventing structures were found regularly developed in all specimens. Short common terminal canals (duodenal diverticle) were seen in 44 of 46 cases (96 per cent). Pancreatico-biliary union at the level of the duodenal window or below was established even from immature newborns. In two cases, the common bile duct and the main pancreatic duct had orifices in close neighbourhood to each other. They ended on the papilla without formation of a common canal. Abnormal pancreatico-biliary duct union above the duodenal window was not found. Pathophysiological consequences of supra-duodenal duct junction are discussed. PMID- 3284245 TI - [Etiology and therapy of peritonitis in childhood]. AB - The causes of peritonitis in childhood, particularly in infancy, were found to differ substantially from those in adult age. An overall account is given in this paper of general and differential diagnosis of extra-abdominal diseases which may be potentially mistaken for peritonitis. Clinical diagnosis is of crucial importance in childhood. Perforated appendicitis was the absolutely major cause of peritonitis in 119 children who received surgical treatment in the course of 18 years. An initial antibiotic combination of gentamicin with ampicillin, and metronidazole together with immune treatment have proved to be an effective therapeutic approach to this form of peritonitis. PMID- 3284246 TI - [Developmental trends in reproduction medicine]. AB - In the last few years reproductive medicine has developed into a medical research field of its own. It deals with the theoretical and practical problems of human reproduction and is characterized by close cooperation between medical and scientific specialists both clinically and in research. Far-reaching social effects arise from the application of hitherto unknown research and treatment methods. The results of research in reproductive medicine led, due to the development of effective contraceptives, to a reduced connection between sexual intercourse and reproduction, and have made possible reproduction even without sexual intercourse, by means of artificial insemination and in-vitro fertilization. These latest and most exciting developments in reproductive medicine are based on and justified by the right of every couple to a child of their own. In-vitro fertilization and related treatments, eg. gamete intrafallopian transfer, are expected to dominate the treatment of the sterile couple in future. The social effects of the new techniques in reproductive medicine nessecitate the development of ethical standpoints, in which human welfare must predominate. In the GDR, in accordance with the recommendations of the "Ethics in medicine" working group, in-vitro fertilization using gametes of the same couple is ethically accepted, as is also oocyte and embryo donation, provided they aim to fulfil a couple's wish for a child. Surrogate mothers are rejected, however. The combination of in-vitro fertilization and genetic engineering could potentially be used in the treatment of certain types of hereditary disease, but there is also the possibility of misuse.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284247 TI - [Tubal transplantation in the treatment of sterility]. AB - The methods of tubal transplantation, tubal transposition, artificial tube and transposition of ovary and uterine cornu have been described in a historic survey. An allogenous tubal transplantation today because of the risk is not indicated but on the other hand autologous transplantations or transposition of the tube may be done in single cases. Precondition for that is a good microsurgery team which includes one vascular surgeon. PMID- 3284248 TI - [Vaginal Streptococcus B colonization in pregnancy]. AB - 500 women in late pregnancy (III. trimenon) have been examined for colonization of group B streptococci by means of vaginal swabs. Identification of bacteria was effected with modified Wallerstromtest, CAMP-test and coagglutination. In 19 pregnant women (3.8%) B-streptococci could be found. In most cases type I was predominant, followed by type II and III. One newborn child died with symptoms of early onset disease. In mother and infant the same serotype could be found (III/R). The titre of maternal antibody, performed in B-streptococci ELISA was too low. A carrier with B-streptococci had a stillbirth. There existed a congenital abnormality. Both in mother and infant the serotype Ib/c was present. The titre of maternal antibody in B-streptococci ELISA was lowered. PMID- 3284249 TI - [Kinetic analysis of the action of cetyltrimethylammonium bromide on the membranes of the capsular variant of Escherichia coli CA189 recorded by ethidium bromide fluorescence]. AB - A mathematical model, describing the kinetics of ethidium bromide probe fluorescence in the suspension of E. coli CA 189 capsular antigen after introduction of cetyltrimethylammonium bromide (a detergent), has been developed. Experimental testing of this mathematical model has confirmed that it describes the kinetics of the probe fluorescence augmentation sufficiently accurately. The new model permits the quantitative characterization of the rate of surfactant diffusion through the bacterial capsule. PMID- 3284250 TI - [Epidemiological and ecological problems of El Tor cholera]. PMID- 3284251 TI - [Serological diagnosis of staphylococcal infections]. PMID- 3284252 TI - [Use of immunoenzyme analysis on nitrocellulose membranes for assessing different methods of purifying the yellow mosaic virus of beans]. AB - The comparative study of different methods for the purification of bean yellow mosaic virus isolated from lupine has been made. To evaluate the method of purification, electron-microscopic, spectrophotometric and ELISA techniques have been used. The possibility of using ELISA on nitrocellulose filters with the utilization of a peroxidase-antiperoxidase complex, manufactured in the USSR, for the determination of viral carriership in plants has been shown. PMID- 3284254 TI - [Isotypic characteristics of serum and secretory O antibodies and local immunological memory in the parenteral immunization of guinea pigs with a ribosomal Shigella vaccine]. AB - Guinea pigs were immunized subcutaneously with ribosomal vaccine prepared from S. sonnei and their systemic and local humoral response was studied by means of ELISA techniques with the use of monospecific antisera to guinea pig IgA and IgG. Injection of the ribosomal vaccine leads to a significant rise in the levels of IgA O-antibodies in tears, IgG and IgA O-antibodies in the serum. The presence of IgA O-antibodies in tears was seemingly the result of their local synthesis rather than the seepage of serum IgA. The stimulation of the local and systemic anti-O response was more pronounced after parenteral immunization with the ribosomal vaccine than after immunization with the corresponding dose of lipopolysaccharide (LPS). Parenteral immunization with the ribosomal vaccine induced the development of both systemic and local memory. The priming effect produced by relatively small doses of this vaccine (40 micrograms), administered parenterally, was similar to the effect of prolonged and intensive stimulation ensured by 10-day feeding with LPS (the total dose being 5,000 micrograms). PMID- 3284253 TI - [The role of IgM in paratyphoid immunity]. AB - The authors analyze the results of studies on the effect produced by the immunization of calves with paratyphoid vaccine on the production of agglutinins, changes in the blood serum immunoglobulin levels, and the specificity of IgM to Salmonella dublin and Salmonella typhimurium antigens. The highest level of agglutinins to paratyphoid antigens in the blood sera of the immunized calves was registered on days 14-21 after immunization, changes in the levels of different immunoglobulin classes being insignificant. The agglutination test and the enzyme immunoassay have revealed that antibodies to S. dublin anb S. typhimurium antigens belong to IgM. PMID- 3284255 TI - [Interrelation between the blood neutrophil damage test and the passive hemagglutination reaction in detecting antibodies]. AB - Statistical analysis of the results of examinations of vaccinees against plague has revealed that the values of the neutrophil damage index (NDI) and antibody titers as determined in the passive hemagglutination (PHA) test qualitatively (but not quantitatively) correlate. The statistical series for the PHA test and NDI belong to different variations, i. e. they describe different functions of antibodies with respect to the same antigen. Besides, the determination of NDI permits the detection of antibodies in 95% of cases with probability equal to 0.06, while the PHA test determines antibodies in 67% of the vaccinees with probability equal to 0.30. The determination of NDI, used as an alternative qualitative method for antibody detection, is particularly effective in the evaluation of faintly immunogenic antigens, as well as at the early and late periods of immune state. PMID- 3284256 TI - [Use of the reaction of macrophage disappearance from peritoneal exudate for characterizing cellular immunity in Salmonella immunization]. AB - The test of macrophage disappearance from peritoneal exudate quite effectively shows the state of cell-mediated immunity in guinea pigs immunized with both live and killed S. typhimurium culture. The macrophages of the animals immunized with killed S. typhimurium culture react to the protein extract of these bacteria more actively than the macrophages of the animals immunized with killed S. sonnei cultures, which indicates the specificity of this test. PMID- 3284258 TI - [Lacunar infarcts of the brain (a review)]. PMID- 3284257 TI - [Interaction of Candida albicans with macrophages]. AB - Study of the in vitro interaction of mouse peritoneal macrophages with C. albicans has revealed that these macrophages, though easily phagocytizing C. albicans blastospores, are incapable of destroying the fungus. The phagocytic, but not candidostatic, activity of these macrophages has been found to depend on the conditions on their cultivation, as well as on the age and viability of fungal cells. The representatives of 7 C. albicans strains, obtained from various sources and stored at the museum for different spans of time, have shown practically no difference in the character of their interaction with mouse peritoneal macrophages. PMID- 3284259 TI - [Dexamethasone test in the diagnosis of depressions in childhood and adolescence (a review)]. PMID- 3284260 TI - [Use of iotrol for myelography]. PMID- 3284261 TI - [Mycobacteria isolated from patients with osteoarticular tuberculosis]. PMID- 3284262 TI - Dopamine receptors and hypertension. PMID- 3284263 TI - Belgian multicenter study on the in vitro activity of aztreonam against gram negative bacilli. PMID- 3284264 TI - Nodular regenerative hyperplasia of the liver and esophageal varices in Felty's syndrome: a clinicopathologic case report with review of the literature. PMID- 3284265 TI - Antibody to anti-delta in 218 hospitalized HBsAg carriers in Belgium. PMID- 3284267 TI - Respiratory effects of nitrous oxide during halothane or enflurane anaesthesia in children. AB - The respiratory effects of nitrous oxide (N2O) were studied during halothane and enflurane anaesthesia in 12 children (mean age 46.4 +/- 29.3 months, mean weight 15.3 +/- 4.2 kg) during surgery under continuous extradural anaesthesia. Four equipotent anaesthetic states were studied in random order: 1) halothane 1 MAC in oxygen, 2) halothane 0.5 MAC + 50% N2O, 3) enflurane 1 MAC in oxygen, 4) enflurane 0.5 MAC +50% N2O. End-tidal fractions of CO2 (PetCO2) and halothane and enflurane were measured using infrared analysers. The respiratory variables (tidal volume VT, minute ventilation VE, respiratory frequency F, inspiratory time Ti, mean inspiratory flow VI, effective inspiratory time Ti/Ttot) were measured using a pneumotachograph. Significant changes were observed between the four states for VE, VI, F and PetCO2, whereas the values of VT, Ti and Ti/Tot did not differ significantly. The respiratory depressant effect of 1 MAC of either halothane alone or of the mixture of halothane and N2O was very similar. During enflurane anaesthesia, PetCO2 was less increased when N2O was substituted for enflurane, owing to a significant increase in respiratory frequency. A marked decrease in VE together with an increase in PetCO2 was observed during enflurane anaesthesia (states 3 and 4) when compared to the corresponding states during halothane anaesthesia (states 1 and 2). The respiratory depressant effect of enflurane is greater than that of halothane in unpremedicated children, even when substituting N2O for an equal MAC fraction of enflurane.2+ The effect of N2O on respiratory patterns seems to depend on the inhalational agent used and/or on the vesting respiratory frequency. PMID- 3284266 TI - Opioid treatment for radiating cancer pain: oral administration vs. epidural techniques. AB - In order to determine the optimal pain treatment for patients with cancer involvement of the brachial or lumbar nerve plexuses, a prospective comparative study was carried out using peroral opioid therapy (SO), epidural opioid by a conventional tunnelled epidural catheter (CE) or an epidural catheter connected to an implanted injection port (Port). Pain relief, measured by a visual analog scale (VAS), was similar and adequate in every group already after the first 24 h. CNS side-effects were less frequent and the Karnofsky performance grades slightly superior in the epidural groups. Occlusion and catheter disconnection complicated the pain therapy of five epidural port patients. Epidural dislocation occurred three times in the conventional epidural group. One local infection in the CE group and two in the Port group were recorded. However, no signs of epidural infection were seen at autopsy. The results suggest that due to a lower incidence of side-effects, epidural catheter techniques are superior to peroral opioid in treating pain in these patients. However, complete pain relief was not achieved in all patients, suggesting neurogenic, non-nociceptive pain components. Both epidural techniques seem suitable for long-term pain therapy. Technical improvements are needed in the epidural catheter and the port. The long-term epidural catheter does not seem to cause any major changes in the histology of the dura mater or the connective tissue of the epidural space. PMID- 3284268 TI - Detection of embolized material in the right atrium during cementation in hip arthroplasty. AB - Precordial Doppler ultrasound, hemodynamic changes and end-tidal carbon dioxide (ETCO2) were monitored in 36 patients undergoing hip surgery in general anesthesia. Changes in Doppler ultrasound indicative of embolization were recognized in 22 out of 36 patients during femoral cementation. The character of the ultrasound was suggestive of air emboli, though simultaneous embolization of bone marrow could not be excluded. Embolization was associated with a fall in arterial oxygen tension (PaO2). Both embolization and reduction of PaO2 were influenced by the cementation technique. Digital anterograde insertion and insertion by syringe of acrylic bone cement into the femoral cavity caused ultrasound changes in 92% and 75% respectively, whereas retrograde insertion of low viscosity bone cement was accompanied by ultrasound activity in only one patient (9%). The blood levels of monomeric methylmethacrylate (MMA) released from the low viscosity bone cement ranged from 0.04 to 7.01 micrograms/ml-1. Doppler ultrasound monitoring gave valuable help during cementation, as the ultrasound change immediately signalled a warning of embolism and an imminent decrease in PaO2. PMID- 3284269 TI - Thiopentone reduces the haemodynamic response to induction of high-dose fentanyl pancuronium anaesthesia in coronary artery surgical patients. AB - Thirty-three coronary artery bypass graft patients anaesthetized with high-dose fentanyl (50 micrograms/kg)-pancuronium-oxygen were divided into one control group receiving additional saline and two groups receiving additional 1 mg/kg or 2.5 mg/kg of thiopentone before laryngoscopy and intubation. During laryngoscopy and intubation, systemic arterial pressures, heart rate and rate-pressure-product remained at considerably elevated levels caused by pancuronium in the control group. Both doses of thiopentone reduced these haemodynamic values close to their initial levels. Cardiac index and left ventricular stroke work index were significantly decreased, especially by the higher thiopentone dose, as compared with the control group. However, there were no statistical differences between the haemodynamic changes produced by the two doses of thiopentone. Sedative or hypnotic supplementation of high-dose fentanyl anaesthesia seems to be necessary if pancuronium is used as a muscle relaxant. A small increment of thiopentone, 1 mg/kg, was enough to return haemodynamic parameters almost to their initial levels, whereas the effect of 2.5 mg/kg of thiopentone was unnecessarily strong. PMID- 3284270 TI - Optimal time interval between pretreatment with alcuronium and suxamethonium during anaesthetic induction. AB - Alcuronium 0.03 mg/kg was studied in a double-blind randomized fashion as a pretreatment before suxamethonium using different time intervals between the administration of the drugs in 78 patients (ASA I-II) undergoing otolaryngological surgery. Alcuronium was given 1, 2 or 3 min before suxamethonium 1.5 mg/kg. The control group received saline as a pretreatment and suxamethonium 1 mg/kg. Anaesthesia was induced with thiopental 5.5 mg/kg over 60 s. Muscle fasciculations, intubating conditions, cardiovascular responses to endotracheal intubation and duration of neuromuscular block were assessed. Muscle fasciculations were statistically and similarly inhibited (P less than 0.01) at all time intervals between alcuronium and suxamethonium. Intubating conditions were worse (P less than 0.05) in the 3-min group than in the other groups. Cardiovascular responses to endotracheal intubation were similar in all groups. The neuromuscular block after suxamethonium was significantly shorter (P less than 0.05) in the 2- and 3-min groups than in the other groups. In conclusion, from the clinical point of view the 1-min time interval between alcuronium and suxamethonium is optimal since muscle fasciculations are inhibited and intubating conditions are satisfactory. PMID- 3284272 TI - Mechanisms of brain damage in focal cerebral ischemia. AB - Ischemic stroke is a major disabling disease. There are 500,000 new cases in U.S. every year, and the middle cerebral artery (MCA) is the artery most often occluded. In this paper recent results of experimental MCA occlusion are reviewed, with special emphasis on those factors contributing to irreversible damage. Occlusion of MCA in the rat causes a pronounced decline of flow in the neostriatum to less than 10% of normal. The area of low flow is surrounded by a zone 0.2-0.5 mm wide, across which blood flow increases steeply. Beyond this zone, changes in flow are more gradual, and perfusion is reduced to about 1/3 of normal in the adjacent ipsilateral cortex. The MCA occlusion leads to a sharply demarcated infarct and to scattered neuronal injury in the adjacent cortical tissue. It is suggested that the ischemic core is identical with the tissue infarct, i.e. that it is the initial pattern of blood flow which determines the volume and topography of infarction. Waves of spreading depression are detected in the cortical low perfusion area during the first hours of MCA occlusion, and glucose consumption is increased, presumably due to an increased demand for ionic transport. In hyperglycemic animals, the number of spreading depressions is reduced as is the glucose consumption. The repeated waves of spreading depression in combination with partial energy depletion may induce selective neuronal injury in the peri-infarct zone, a suggestion which finds support in the fact that hyperglycemia ameliorates neuronal injury around the infarction. PMID- 3284271 TI - Impact of surgical stress on the haemodynamic profile of isoflurane-induced hypotension. AB - It has been suggested that stimulation of adrenoreceptors could be responsible for some of the haemodynamic effects of isoflurane. But there are no solid data demonstrating the role of sympatho-adrenal stimulation induced by pain during isoflurane administration. The impact of surgical stress on the haemodynamic profile of isoflurane-induced hypotension has been investigated in 28 patients (47-76 years), scheduled for total hip arthroplasty. After premedication with morphine hydrochloride (0.1 mg/kg), patients were randomly assigned to receive either no fentanyl (control group) or fentanyl (5 micrograms/kg before tracheal intubation, 5 micrograms/kg before skin incision, and 2 micrograms/kg each 15 min during the 1st hour). Isoflurane was given to maintain mean arterial blood pressure in the range 6.7-8 kPa in both groups. Haemodynamic data and blood samples for determination of plasma renin activity (PRA) and epinephrine (E) and norepinephrine (NE) levels were collected before and during hypotension. The fentanyl group and the control group differed significantly during hypotension: heart rate, cardiac index, oxygen consumption and E, NE and PRA were lower (P less than 0.01) in the fentanyl group than in control group. Fentanyl lowered the required concentration of isoflurane to achieve the same degree of hypotension (end-tidal concentration: 0.8 +/- 0.2% in the fentanyl group and 1.4 +/- 0.15% in the control group; P less than 0.001). Our results demonstrate that the cardiovascular effects of higher isoflurane concentrations in the absence of narcotic analgesia are counterbalanced by adrenergic stress stimulation of released epinephrine and norepinephrine. Among the likely reasons for catecholamine release during isoflurane administration, inadequate analgesia may be considered. PMID- 3284273 TI - T-lymphocyte subsets in the human lacrimal gland. AB - This study examines the microscopical appearance, location, distribution, subdivision and density of T-lymphocytes in the human lacrimal gland. Fourteen glands, 7 from either sex, were removed and frozen shortly after the donors' death, and processed for immunoperoxidase staining, utilizing a biotinavidin system and one of the following monoclonal antibodies: Anti-Leu-1 and -Leu-4, which recognize T-lymphocytes, anti-Leu-2a, which binds to suppressor/cytotoxic T cells, and anti-Leu-3a + 3b, which recognizes helper/inducer cells. The T lymphocytes in the human lacrimal gland were small to medium sized, mainly located in the interacinar tissue, often adjacent to an acinus or close to a collecting duct. The median number of each T-cell subset per defined field (0.086 mm2) at x 500 magnification was as follows: Males: Leu-1: 3.1, Leu-2a: 4.9, Leu 3a + 3b: 2.8, Leu-4: 4.5. Females: Leu-1: 4.3, Leu-2a: 5.0, Leu-3a + 3b: 3.7 and Leu-4:5.8. The sex difference was not statistically significant. The helper/suppressor cell ratio in the human lacrimal gland was 0.57 for males and 0.74 for females. PMID- 3284274 TI - The corneal endothelium following autokeratoplasty. A case report. AB - An autokeratoplasty was performed on the left eye of a 64-year-old female, with the graft transferred from the contralateral, blind eye. The endothelial morphology and thickness of the central cornea were studied pre-operatively and yearly for 6 years after surgery. The endothelial cell density decreased rapidly during the first 2 years post-operatively (55.5%), after which cell loss occurred at a considerably slower rate (about 2% of the pre-operative cell density per year). During the observation period, the coefficient of variation in cell size stayed relatively constant (approximately 0.3). When the corneal thickness returned to normal 2 months after surgery, the endothelium showed a significant decrease in the percentage of hexagonal cells (15.0%). Between 2 months and 2 years post-operatively, the percentage of hexagonal cells gradually returned to normal. These endothelial changes noted are remarkably similar to those previously seen in homografts, suggesting that cell damage due to immunologic reactions may not be a major factor in long-term endothelial changes after homografting. PMID- 3284275 TI - Impact of aging and gender on the Ig-containing cell profile of the lacrimal gland. AB - The present study investigated the influence of age and gender on the number of IgA- and IgM-containing cells in the lacrimal gland. Tissues were obtained from male and female rats at 0.2 (infant), 0.6 (pre-pubertal), 1.3 (pubertal), 3 (adult), 8 (mid-life) and 17 (senescent) months of age, then processed for immunofluorescence microscopy. No IgA-containing cells could be detected in lacrimal glands from infant rats, but a significant accumulation had occurred by 0.6 months of age. The extent of this increase was gender-dependent: tissues from male rats had significantly higher IgA-positive cell densities than those of females. After 0.6 months of age, no further variations in the density of IgA containing lymphocytes were observed in female gland. In contrast, male glands exhibited marked fluctuations in the density of IgA-containing lymphocytes during the time period spanning puberty (0.6----3 months). Of interest, the frequency distribution of IgA-containing cells in tissue sections was not uniform in rats older than 0.2 months. Correction of cell densities for age-related elevations in lacrimal gland weight demonstrated that the total accumulation of IgA-containing cells was both age- and gender-related. Highest cell numbers were attained at 3 months in females and 3 and 17 months in males. Moreover, at all assessed ages, the total IgA-containing cell number in glands of males was greater than, or equal to, that in tissues of females.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284276 TI - Clinical trial of sustained-release artificial tears in keratoconjunctivitis sicca and Sjogren's syndrome. AB - The effect of sustained-release artificial tear inserts on symptoms and signs of reduced tear production in keratoconjunctivitis sicca (KCS) was evaluated in an open clinical trial including 30 patients. A significant relief of sicca symptoms and a decrease in keratoconjunctival staining were seen in 10 patients fulfilling the study, whereas no significant effect on Schirmer test and tear break-up-time could be detected, neither in patients with pure KCS nor with KCS as a manifestation of Sjogren's syndrome. Twenty patients (67%) withdrew due to adverse effects, which were reported in total 80% of the patients. Absence of measurable tear secretion predicted treatment failure. Due to the frequent side effects, the artificial tear inserts cannot be recommended as a first line treatment in KCS patients. PMID- 3284277 TI - Oral nerve sheath myxoma. Report of a case with findings of ultrastructural and immunohistochemical studies. AB - The first Asian case of oral nerve sheath myxoma is presented, along with the findings of light and electron microscopy, and immunohistochemistry. Ultrastructurally, intracytoplasmic microfilaments and convoluted basement membrane were identified in the tumor cells. Immunohistochemically, S-100 protein and neuron-specific enolase were positive in the tumor cells. These findings may indicate that the tumor is a lesion of Schwann-cell origin. The literature on oral nerve sheath myxoma is also reviewed and discussed. PMID- 3284279 TI - A comparison of different diagnostic tools for childhood depression. AB - A comparison was made of the agreement of 5 different diagnostic tools for childhood depression. The diagnostic tools used were: 1) a non-directive interview with projective testing; 2) a semi-structured psychiatric interview developed by Herjanic; 3) the child behaviour check list developed by Achenbach; 4) the Kovacs child depression inventory and 5) the DSM-III criteria diagnosis. In the diagnostic tools using classic psychiatric techniques of interview there was a fairly high diagnostic agreement for depression, while the non-interview techniques (questionnaires) were less reliable in diagnosing affective disorder. Depressive symptoms were found to play an important part in non-affective disorder psychopathology in children. The good correlation between the standard intake procedure and the research methods is encouraging in that it seems that clinicians can make the diagnosis of childhood affective disorder in their everyday clinical work. PMID- 3284278 TI - Cognitive disturbances in schizophrenics: what are they, and what is their origin? AB - Cognitive disorders are neither a unique nor a constant phenomenon in schizophrenia. Among the dysfunctions that may be observed at times, primarily during acute phases and in patients with a non-paranoid symptomatology, certain disturbances in attention-focusing and information processing seem to be most conspicuous. Some of these cognitive dysfunctions may have been transmitted from parent(s) to the patient, either genetically or through simple forms of learning. the empirical evidence for this assumption is to be found in the fact that some of the same cognitive deficits as those found in schizophrenic patients also found in their first-degree relatives, although usually in a milder form. Other forms of cognitive dysfunction may have developed as complementary strategies in response to communication deviances and cognitive behavior found in their parents. A developmental model, in which genetic, physiological and environmental factors are included is described as a way of illustrating how predisposing factors, as well as intermediating and stress factors, contribute to the debut and maintenance of cognitive disorders in schizophrenics. PMID- 3284280 TI - [The effect of insulin on body weight gain and changes in serum triiodothyronine levels]. PMID- 3284281 TI - Decreased albumin secretion in serum-free primary cultures of adult rat hepatocytes during proliferation induced by epidermal growth factor and insulin. AB - Upon addition of epidermal growth factor (EGF, 0.1 microgram/ml) and insulin (0.1 microM), adult rat hepatocytes proliferated and increased 120-134% in number in serum-free primary culture. However, in the absence of the growth factors, hepatocytes decreased in number with time. The average albumin secretion per cell was much lower in the proliferating cultures than in the non-proliferating cultures. The results suggest that albumin production in hepatocytes decreases during cell proliferation. PMID- 3284282 TI - Contingency contracting with polydrug-abusing methadone patients. AB - The study assessed the effects of contingency contracting for medication take home privileges on the polydrug use of methadone patients. Comparisons were made among 20 patients using cocaine, 13 using other illicit drugs, and seven exhibiting other noncompliant behavior. A within-subjects reversal design showed that there was no overall difference in the percentage of positive urines between the pre-contingency and contingency periods, nor between the pre- and post contingency periods. During the first contingency month, however, one group of patients eliminated drug use, while the remaining had an increased percentage of positive urines. This increase may have been due to the heightened urinalysis regimen during the contingency period rather than to more actual drug use. During the first month, drug-related contracts not involving cocaine were more successful than those targeting cocaine, and non-drug-related contracts were more successful than drug-related ones. The study concluded that contracting had a favorable, though transient, effect primarily on non-cocaine-abusing methadone patients. Further research using stronger or multiple reinforcers is indicated. PMID- 3284283 TI - Two and four mg nicotine chewing gum and group counselling in smoking cessation: an open, randomized, controlled trial with a 22 month follow-up. AB - The aim of this study was to examine any dose response effect of 2 and 4 mg nicotine gum (Nicorette) as well as the effect of the treatment in relation to a control group. One hundred seventy-two cigarette smokers were randomly allocated to group counselling and 2 mg- (n = 62) or 4 mg- (n = 54) nicotine chewing gum or to an "advice only" control group (n = 56). Six group meetings in a three month period were guided by physicians in groups of 10-12 members. The 4 mg gum was replaced by 2 mg after 4 weeks. The overall chemical verified success rate was significantly higher for the treatment group compared with the control group. The success rate for the gum group was 45.6% after three months versus 7.1% for the control group, 33.3% versus 3.7% after 12 months, and 27.2% versus 5.7% after 22 months, respectively (p less than 0.001). We could not demonstrate any significant dose response effect of 2 and 4 mg nicotine gum. The low dependent smokers had the best outcome. The subgroup of self-reported chronic bronchitis subjects had a significantly lower success rate than their healthy counterparts (p less than 0.002). Neither the p-nicotine level after smoking or chewing gum nor the difference between these two could predict the outcome. The gum p nicotine after a week was only 37.1% for 2 mg and 64.3% for 4 mg of the corresponding smoking p-nicotine levels. Nicotine compensation was best for the high dependent smokers. PMID- 3284284 TI - Active and basal cerebrometabolic rate for oxygen (CMRO2) after complete global brain ischemia in rats. PMID- 3284285 TI - Can blood gas analysis indicate when mechanical ventilation should start in patients with acute myocardial infarction? AB - Arterial blood gas analysis of 69 patients with acute myocardial infarction were evaluated to provide a basis for respiratory care. Patients were divided into two groups: group A which received oxygen therapy only (n = 38) and group B which received oxygen therapy with mechanical ventilation (n = 31). The patients in group B were further divided into surviving cases (n = 14) and fatal cases (n = 17). On admission patients assigned to group B had lower PaO2 values than those placed in group A. In group B, there was no difference in the P/F value before mechanical ventilation of the surviving and the fatal cases, but the survivors demonstrated an improvement of the P/F value and an increase in cardiac index after mechanical ventilation. It may be reasonable to assume that a P/F value of less than 250 serves as an indicator for the initiation of mechanical ventilation. An increase in the P/F value after mechanical ventilation seems to be a valuable index to estimate prognosis in respiratory failure. PMID- 3284286 TI - Emulsified perfluorochemicals for oxygenation of microbial cell cultures? AB - PFCs and their emulsions may have value for increasing the efficiency of O2 transport to microbial cultures. Therefore, the effects of emulsion components on growth of S. cerevisiae and E. coli have been examined. Viable cell counts revealed that perfluorodecalin or the commercial emulsion, Fluosol-DA 20%, produced no obvious growth-inhibition over 6h. However, incubation of cells with up to 10% of the Pluronic F-68 surfactant reduced absorbance at 600nm. Further experiments to assess the effects of PFC emulsion components on growth and structure of microbial cells are in progress. PMID- 3284287 TI - Emulsified perfluorochemicals for oxygen-transport to tissues: effects on lymphoid system and immunological competence. AB - Data from both in vivo and in vitro studies to assess lymphoid tissue and immune system responses to emulsified PFCs and their components have been discussed. It may be concluded that the extent to which PFC emulsions are retained in lymphoid tissues and their effects on the manifestation of humoral immune responses to immunological "challenges" is variable and depends upon: (1) Emulsion composition; (2) Dose administered; (3) Route of administration; (4) Tissue examined; (5) Timing of emulsion administration relative to immune challenge; and (6) Species studied. Such variability in the responses to emulsified PFCs has inevitably introduced difficulties in assessing their effects upon immunological competence. Further work is needed determine the extent to which lymphoid tissue functions may be altered by PFC emulsions and identify the active component(s) and mechanism(s) involved. PMID- 3284288 TI - The clonotype repertoire of B cell subpopulations. PMID- 3284289 TI - Characterization of functional surface structures on human natural killer cells. AB - Recent studies on human NK cells have identified a number of surface antigens that can be utilized to define this population of cells and to identify functionally distinct subsets within this heterogeneous population. In addition, it has been possible to associate specific functional activities with several antigens expressed on NK cells as well as other hematopoietic cells. This information, which is summarized in Table III can be utilized to develop a framework for the classification of cytolytic effector cells. Of primary importance, this classification identifies subsets of cytolytic cells with distinct functional repertoires and distinct cytolytic mechanisms. The majority of NK cells in unstimulated peripheral blood and the majority of NK clones express NKH1 and CD2 antigens but do not express CD3 antigen. These cells morphologically appear as large granular lymphocytes and have broad cytolytic activity against a variety of allogeneic targets without primary sensitization. Consistent with the finding that these cells are CD3 negative, they have not been found to have rearrangement of genes encoding for TCR, or functional mRNA transcripts of either TCR alpha, TCR beta, or TCR gamma genes. In addition, these cells do not express heterodimeric surface proteins similar to those that have now been demonstrated to be MHC-restricted T cell receptors for antigen. Taken together, these findings provide strong evidence that NKH1+CD3- NK clones do not interact with target cells through a T cell receptor-like structure. Nevertheless, these NK cells do share several properties with conventional CTL. These functional T cell characteristics include (1) expression of CD2-T11/E rosette receptor antigen, and (2) utilization of LFA-1 surface antigen to enhance effector cell adhesion to target cells. As previously demonstrated for T cells, NK cells can be activated through the CD2 molecule and this has recently been shown to result in the enhancement of cytolytic function by these effectors. Since CD2 can also function as a cell surface ligand for LFA-3, an antigen expressed on NK targets, the CD2 molecule may be considered as a potential NK receptor structure. The fact that a very small subset of NK cells (approximately equal to 10%) as well as some NK clones (JT11) does not express CD2 argues against a potential role for CD2 as the NK cell receptor. Certainly, further studies will be necessary to clarify the role of CD2 on NK cells and to identify the mechanisms whereby NKH1+CD3- NK cells interact with targets in a non-MHC restricted fashion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3284290 TI - Myasthenia gravis. PMID- 3284291 TI - Alterations of the immune system in ulcerative colitis and Crohn's disease. PMID- 3284293 TI - Charcot's lectures on senile diseases. PMID- 3284292 TI - A study of the use of captopril in elderly hypertensive patients. AB - Captopril (12.5-25 mg b.d.) was compared with placebo in a double-blind, cross over study in elderly, hypertensive subjects. Sixteen patients, aged between 65 and 80 years, were studied. The mean baseline blood pressure off treatment was 204.7 +/- 24.5/111.8 +/- 11.1 mmHg. In the 14 patients who completed the study, captopril significantly reduced the systolic and diastolic pressures compared with baseline (P less than 0.001) and compared with placebo (P less than 0.01). The fall in blood pressures was significantly greater at 4 weeks than at 2 weeks (P less than 0.001). No significant change in blood pressure was noted from baseline whilst on placebo. No significant serious side-effects were encountered during the study. We conclude that captopril would appear to be an effective antihypertensive agent which can be safely used in the elderly. PMID- 3284294 TI - [The value of medical imaging in the diagnosis of renal hydatidosis]. PMID- 3284295 TI - [Pyelo-ureteral duplication with ectopy. Value of abdominal echography and of percutaneous antegrade pyelography with chromoscopy. Apropos of a clinical case]. PMID- 3284296 TI - Hemorrhagic angiomyolipoma of the kidney. Sonographic diagnosis and acute treatment in one case. PMID- 3284297 TI - [Continent cystostomy]. PMID- 3284298 TI - The hairless pediculate island flap in urethroplasty. PMID- 3284299 TI - Bilateral renal cell carcinoma. AB - Renal carcinoma is frequently detected incidentally during abdominal ultrasound studies or computed tomographic scanning. Although clinical studies report bilateral tumors in fewer than 4 percent of patients with renal carcinoma, an autopsy study has shown a much higher incidence. Various surgical approaches are available. PMID- 3284300 TI - Pharmacologic management of eating disorders. AB - Treatment of eating disorders is difficult regardless of the methods employed. Pharmacologic management in anorexia nervosa and in bulimia nervosa is especially helpful when it is part of a multimodal treatment approach that includes individual, family and behavioral therapy. Care must be taken to guard against side effects, abuse and noncompliance in a group of patients that tends to be prone to all three. PMID- 3284302 TI - Prenatal screening. AB - Routine obstetric screening for all patients should include a Pap smear, urinalysis and urine culture, complete blood count, blood type, Rh factor and direct Coombs' test. Patients should also be screened for syphilis, rubella, gonorrhea and diabetes. For patients at high risk for certain conditions, additional studies of value include obstetric ultrasound, amniocentesis, serum alpha-fetoprotein level and screening for sickle cell anemia, herpes, hepatitis B, Chlamydia and human immunodeficiency virus. PMID- 3284301 TI - Psychotropic effects of caffeine. AB - Chronic, heavy caffeine ingestion may cause or exacerbate anxiety and may be associated with depression and increased use of antianxiety drugs. Caffeine may cause anxiety and panic in panic disorder patients and may aggravate the symptoms of premenstrual syndrome. Chronic users who are caffeine-sensitive may have symptoms of caffeinism at relatively low doses. Individuals who regularly consume moderate to heavy amounts of caffeine may develop caffeinism, or they may show signs of caffeine withdrawal syndrome after abstaining from the drug. PMID- 3284303 TI - Otitis media and language development. AB - Otitis media can be a vexing, recurrent problem. An episode is often treated with antibiotics, followed by reevaluation at two weeks. The complete resolution of effusion, however, may never be documented. Impairments in children's speech, language and cognition have been related to chronic and continuous middle ear disease. Responses to antibiotic regimens must be carefully monitored. Follow-up is essential. PMID- 3284304 TI - Diarrheal infections. AB - Infectious agents usually cause diarrhea by invading and damaging the intestinal mucosa or by producing enterotoxins that alter the secretory and absorptive capacities of the intestinal mucosa. Some infectious agents may do both. Physical malabsorption produced by proliferative outgrowth of bacteria or protozoa may also occur. Rotavirus is the most common cause of pediatric infectious diarrhea in the United States. Escherichia coli and Campylobacter species are the most common bacterial agents. PMID- 3284305 TI - Passive smoking. AB - Absorption of harmful and irritative components of cigarette smoke by nonsmokers may result in both acute and long-term health problems. Persons with asthma or coronary artery disease are at particularly high risk of developing problems. Children living with smokers are at increased risk of persistent middle ear effusions and lower respiratory tract infections. Nonsmokers married to smokers have an increased risk of lung cancer. PMID- 3284306 TI - Becker's nevus. AB - Becker's nevus is a benign lesion that may be congenital or acquired, macular or papular, hairless or hypertrichotic. It is most commonly located on the upper trunk of young men. Histologic examination shows characteristic changes, but dermal nevus cells are never present. Bony and soft tissue structural anomalies occur with increased frequency in patients with Becker's nevus. PMID- 3284307 TI - Gunshot wounds. AB - Wounds caused by high-velocity projectiles are different from those caused by low velocity projectiles. High-velocity bullets, such as those fired from deer hunting rifles, cause large temporary cavities as they pass through tissue, producing extensive damage to adjacent structures that were not touched by the bullet. Essentially all of the damage caused by low-velocity bullets, such as those fired from most handguns, occurs in structures touched by the bullet. PMID- 3284308 TI - Management of the near-drowning victim. AB - The family physician should be skilled in the treatment of victims of immersion accidents. Specific management at the scene and in the emergency room is critical to survival and a good neurologic outcome. Hospital admission with careful evaluation and observation is usually indicated. Patients and community groups must be reminded of precautions that will prevent many injuries and deaths. PMID- 3284309 TI - Fluoroquinolones. PMID- 3284310 TI - Effect of oral combination therapy with mexiletine and quinidine on left and right ventricular function. AB - Combination therapy with mexiletine (MEX) and quinidine (Q) may be more efficacious than monotherapy with either drug in suppressing ventricular arrhythmias, but its effects on ventricular performance are not known. Thus, right ventricular ejection fraction (RVEF) and left ventricular ejection fraction (LVEF) and wall motion score (WMS) were assessed in 14 patients with ventricular tachycardia before antiarrhythmic therapy, during MEX and Q monotherapies, and during combination therapy. During monotherapy, the daily doses and serum drug levels were: MEX, 621 mg/day and 3.4 microM/L; Q, 1573 mg/day and 8.3 microM/L, respectively. With combination therapy, the daily doses and serum drug levels were: MEX, 636 mg/day and 3.3 microM/L; Q, 1643 mg/day and 9.5 microM/L, respectively. Drug therapy did not affect group LVEF (drug free = 36 +/- 19%, MEX = 34 +/- 18%, Q = 36 +/- 19%, and combination MEX-Q = 35 +/- 19%), RVEF (drug free = 34 +/- 11%, MEX = 35 +/- 11%, Q = 36 +/- 13%, and combination MEX-Q = 36 +/- 12%), or WMS. Ventricular function reserve was assessed in five patients. Drug therapy did not affect group exercise LVEF (drug free = 44 +/- 14%, MEX = 42 +/- 12%, Q = 43 +/- 13%, and MEX-Q = 45 +/- 12%), RVEF (drug free = 38 +/- 10%, MEX = 40 +/- 11%, Q = 39 +/- 12%, and MEX-Q = 40 +/- 12%), WMS, or exercise duration. Combination MEX-Q therapy did not have a significant effect on exercise performance or ventricular function in seven additional patients in whom no exercise studies were done during monotherapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284311 TI - ACE inhibition for the failing heart: experience with captopril. PMID- 3284312 TI - Myocardial preservation during ischemia and reperfusion. PMID- 3284313 TI - Group A beta-hemolytic streptococcal endocarditis precipitating rupture of sinus of Valsalva aneurysm: evaluation by two-dimensional, Doppler, and contrast echocardiography. PMID- 3284314 TI - Doppler findings in nonimmune hydrops fetalis and cerebral arteriovenous malformation. PMID- 3284315 TI - Short-term effect of coronary artery bypass grafting on the signal-averaged electrocardiogram. AB - Ventricular late potentials at the end of the QRS can be detected on the body surface during sinus rhythm by recording a signal-averaged electrocardiogram (SAECG). In patients with coronary artery disease, these late potentials have been shown to be markers for spontaneous or inducible ventricular tachycardia, or both. The short-term (before and 10 +/- 4 days after coronary revascularization) influence of coronary artery bypass grafting (CABG) on the quantitative SAECG variables was studied in 40 patients with chronic coronary artery disease. Twenty five of these patients had a previous myocardial infarction. In the 15 patients without previous myocardial infarction, no abnormal SAECG indexes were recorded before CABG and no change in the quantitative SAECG variables was observed after surgery. In the patients with a previous myocardial infarction, 7 (28%) had a late potential before CABG. After CABG, 5 (71%) patients remained late potential positive, whereas the other 2 (29%) lost their late potential. The mean values of their SAECG variables improved after coronary revascularization. In the entire group of postmyocardial infarction patients, the high-frequency QRS duration had shortened (p less than 0.01) after CABG (the other SAECG indexes did not change). The postoperative arrhythmic complications (transient atrial fibrillation, new onset of ventricular couplets) tended to be more frequent in the postmyocardial infarction group and in patients with late potentials. Our findings suggest that the reported increase in ventricular arrhythmias after CABG is probably not related to a change in the arrhythmogenic substrate for ventricular reentry but is associated with changes in the arrhythmogenic milieu. PMID- 3284317 TI - Early assessment of the effect of map-guided transcatheter intracardiac electric shock on sustained ventricular tachycardia secondary to coronary artery disease. AB - Short-term efficacy of transcatheter intracardiac electric shock was evaluated in 25 patients with recurrent sustained ventricular tachycardia (VT) secondary to coronary artery disease. Pace mapping and activation sequence mapping during VT were both used to direct intracardiac electric shocks applied between the distal electrode of the catheter (cathode) and a chest wall plate (anode) using a mean total energy of 588 +/- 209 J/patient. The short-term outcome of the procedure was considered successful in 3 patients (12%) who neither developed spontaneous VT nor had sustained VT in response to programmed electrical stimulation 1 week after the procedure. The short-term outcome in the remaining 22 patients (88%) was considered unsuccessful: 7 of the 22 patients developed spontaneous sustained VT and in 19 patients, including 15 with no spontaneous VT, sustained VT was still inducible by programmed electrical stimulation 7 +/- 2 days after the intracardiac electric shock. All 22 patients were subsequently treated with other modes of antiarrhythmic therapy. Using the technique described, the short-term efficacy of map-directed transcatheter intracardiac electric shock in eliminating VT is poor. PMID- 3284316 TI - Electrophysiologic effects of intravenous and oral sotalol for sustained ventricular tachycardia secondary to coronary artery disease. AB - The electrophysiologic effects of intravenous sotalol (1.5 mg/kg load followed by 0.008 mg/kg maintenance, mean dose 150 +/- 23 mg) and oral sotalol (mean dose 583 +/- 204 mg daily) were prospectively evaluated in 16 patients undergoing electrophysiologic evaluation for sustained ventricular tachycardia (VT) secondary to coronary artery disease. Electrocardiographic intervals, indexes of sinus and atrioventricular node function and indexes of atrial and ventricular function were assessed. Inducibility or noninducibility of sustained VT and characteristics of the induced arrhythmia were also evaluated. Intravenous and oral sotalol exerted similar beta-blocking effects, which included significant prolongation of sinus cycle length (baseline 820 +/- 165 ms, intravenous sotalol 1,077 +/- 206 ms, oral sotalol 1,141 +/- 306 ms), AH interval (baseline 126 +/- 43, intravenous sotalol 169 +/- 42, oral sotalol 197 +/- 55 ms) and Wenckebach cycle length (baseline 375 +/- 70, intravenous sotalol 460 +/- 84, oral sotalol 449 +/- 68 ms). Both intravenous and oral sotalol also prolonged repolarization and refractoriness including significant increases in QT interval (baseline 338 +/- 47, intravenous sotalol 417 +/- 35, oral sotalol 450 +/- 70 ms), atrial effective refractory period (baseline 240 +/- 38, intravenous sotalol 330 +/- 71, oral sotalol 299 +/- 26 ms) and right ventricular effective refractory period (baseline 241 +/- 16, intravenous sotalol 289 +/- 35, oral sotalol 291 +/- 22 ms).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284318 TI - Facilitating influence of disopyramide on atrial flutter termination by overdrive pacing. AB - Long-lasting (mean 30 days) type I atrial flutter was treated with overdrive pacing in 30 patients (mean age 69 years) with organic heart disease. To evaluate the effect of pretreatment with disopyramide, the study population was divided in 3 groups of 10 patients each: group A, no disopyramide therapy; group B, intravenous disopyramide (maximum dose 250 mg in 1 hour); and group C, oral disopyramide (400 mg daily for 4 days). There were no differences in baseline cycle length of atrial flutter among the 3 groups before drugs were given. The stimulation protocol included overdrive atrial pacing up to the shortest paced cycle of 150 ms performed at a maximum of 3 atrial sites. Reversion to sinus rhythm occurred in 2 patients in group A, 7 in group B (p less than 0.01) and 5 in group C. Pacing was performed from a mean number of 2.1 sites/patient in group A, 1.2 in group B and 2.0 in group C. Atrial fibrillation occurred in 7, 3 and 4 patients, respectively. Acceleration to a faster form of atrial flutter occurred in 3, 3 and 4 patients, respectively, and reversion to sinus rhythm occurred in all patients who had intravenous disopyramide and in 1 who took the drug orally. The administration of disopyramide before overdrive pacing improved the rate of conversion to sinus rhythm and allowed an easier stimulation protocol with a lower incidence of pacing-induced atrial fibrillation. Disopyramide is beneficial when overdrive atrial pacing is performed for the treatment of long-standing atrial flutter in patients with organic heart disease. PMID- 3284320 TI - Delayed reversal of impaired vasodilation in congestive heart failure after heart transplantation. AB - The effects of changes in central cardiovascular function on peripheral vasodilation were investigated. Strain gauge plethysmography was used to measure the maximal blood flow response following release of forearm arterial occlusion and the peak reactive hyperemic blood flow response (ml/min.100 ml) before and twice after orthotopic heart transplantation in 10 subjects with severe congestive heart failure. The 2 posttransplantation studies were done before hospital discharge (mean 18 days after transplantation) and again after discharge (mean 114 days after transplantation). Transplantation led to a significant but delayed increase in maximal vasodilation (reactive hyperemic blood flow: pretransplant 21 +/- 3; predischarge 25 +/- 2; postdischarge 43 +/- 5) and a concurrent significant reduction in minimal forearm resistance. Although the improvement in peripheral vasodilator function may be linked to improvement in cardiac function, this linkage is not direct, nor is it immediate. If the normalization of maximal metabolic blood flow is related to resumption of normal physical activity postdischarge, then much of the basic abnormality in vasodilator capacity in congestive heart failure may be related to physical deconditioning. PMID- 3284319 TI - Relation of acute antiarrhythmic drug efficacy to left ventricular function in coronary artery disease. AB - This study assessed the relation between acute antiarrhythmic drug efficacy and left ventricular (LV) function in patients with sustained ventricular tachyarrhythmias, that is, sustained ventricular tachycardia (VT) or ventricular fibrillation (VF). Electrophysiologic studies (n = 560) were performed in 201 patients, separated for analysis into less than 30 and greater than or equal to 30% ejection fraction groups. Coronary artery disease was present in all patients. The 8 acute antiarrhythmic regimens were procainamide, quinidine, mexiletine, mexiletine + type 1A agent, flecainide or indecainide, amiodarone, amiodarone + type 1A and "miscellaneous" agents. At least 1 successful acute antiarrhythmic regimen was found in 47% of patients and in a significantly greater proportion of patients with ejection fraction greater than or equal to 30% (52 of 81 = 64%) than in those with ejection fraction less than 30% (43 of 120 = 36%, p less than 0.001). Drug trials were successful (initiation of less than 15 repetitive ventricular responses) in 32% of patients with ejection fraction greater than or equal to 30% versus 19% of those with ejection fraction less than 30% (p less than 0.001). There were no statistically significant differences between the 2 ejection fraction groups in type of heart disease, acute antiarrhythmic dosages or mean serum drug levels. A logistic regression analysis incorporating multiple clinically relevant factors found that ejection fraction was the only factor that correlated significantly with drug success or failure (p less than 0.002). Acute antiarrhythmic drug efficacy relates to LV function per se or to other pathophysiologic mechanisms of which ejection fraction may be a marker. PMID- 3284321 TI - Isolated descending thoracic aortic aneurysm in Marfan's syndrome. PMID- 3284322 TI - Prognostic significance of ventricular ectopic activity in survivors of acute myocardial infarction who receive propranolol. AB - Beta blockers are frequently prescribed for survivors of acute myocardial infarction (AMI). Although ventricular ectopic activity was found to be associated with mortality in several cohorts, there are no data on the relation of ventricular ectopic activity to mortality in patients with AMI who receive beta blockers. One thousand six hundred and fifty participants in the Beta Blocker Heart Attack Trial who were randomized to receive propranolol (60 or 80 mg 3 times daily) had 24-hour ambulatory electrocardiography at baseline. By multivariate analysis considering 16 variables, ventricular ectopic activity was independently associated with sudden death (p = 0.02 to 0.001) and total mortality (p = 0.04 to 0.0001) for an average follow-up of 25 months. By univariate analysis, ventricular ectopic activity was associated with increased total mortality (odds ratios 2.13 to 3.54) and sudden death mortality (odds ratio 2.26 to 3.93). The association of ventricular ectopic activity with mortality was observed in both high- and low-risk patient subsets with odds ratios similar to the placebo group. Thus, treatment with propranolol does not alter the relation between ventricular ectopic activity and mortality. PMID- 3284323 TI - Prognostic significance of angina pectoris before first acute myocardial infarction. AB - To delineate the clinical significance and prognostic importance of a history of chronic or new onset angina pectoris before acute myocardial infarction (AMI), 732 consecutive patients admitted for a first AMI were studied and divided into 3 groups. Two hundred patients (27%) had chronic angina before AMI (greater than 1 month); 247 patients (34%) had new onset angina before AMI (less than 1 month) and the 285 remaining patients (39%) never had angina before AMI. All clinical characteristics were similar in the group of patients with chronic angina and in the group of patients with new onset angina, including in-hospital mortality (10 vs 9%) and 3-year post-hospital mortality (16 vs 16%). Compared to the 285 patients without angina, the 447 patients with angina before AMI were older, more likely to be women, and had a higher frequency of anterior AMI and early post infarction angina. Both groups had a similar in-hospital mortality (10 vs 8%, not significant), but patients with angina had a higher 3-year post-hospital mortality (16 vs 7%, p less than 0.001). In the group of patients with angina before AMI who were discharged from the hospital, the comparison of nonsurvivors and survivors showed that the patients who died were older, presented more frequently with a non-Q-wave myocardial infarct and more often had left ventricular failure and complete bundle branch block during hospital stay. Chronic and new onset angina before AMI have the same clinical characteristics and deleterious long-term prognostic significance. PMID- 3284324 TI - Balloon valvuloplasty for treating pulmonic, mitral and aortic valve stenosis. AB - Percutaneous balloon valvuloplasty is a technique that has been developed in the cardiac catheterization laboratory over the last 5 years for the treatment of pulmonic, mitral and aortic valve stenosis in children and adults. This review will attempt to summarize recent advances in this new field of invasive cardiology over the last several years. PMID- 3284325 TI - Pulmonary intravascular macrophages in domestic animal species: review of structural and functional properties. AB - In dogs, laboratory animals, and man, the clearance of bacteria and particulates from blood occurs predominantly in hepatic Kupffer cells and splenic macrophages. In contrast, removal of blood-borne particulates in calves, sheep, goats, cats, and pigs occurs predominantly in pulmonary intravascular macrophages (PIMs). Review of recent studies indicates that PIMs are a resident cell population, junctionally adherent to the capillary endothelium of lungs and morphologically similar to hepatic Kupffer cells. PIMs are a pulmonary constituent of the mononuclear phagocyte system with respect to secretory, endocytic, and functional properties. Differentiated PIMs are rare in newborn pigs, and the majority of cells closely apposed to capillary endothelium consists of monocytes, which are occasionally in mitosis. In 7-day-old and older pigs, most cells apposed to capillary endothelium have characteristics of differentiated PIMs. This suggests a monocytic origin of PIMs in pigs. Perinatal colonization of lung capillaries by monocytes and their subsequent differentiation into PIMs represent a component of postnatal lung development. Estimates of relative PIM numbers in ovine and porcine lung parenchyma suggest cell densities similar to that of rat hepatic Kupffer cells. Apart from phagocytic properties, PIMs participate in the removal and disintegration of aged and impaired blood cells. After phagocytic stimulation, isolated PIMs secrete oxygen radicals, which are essential for microbicidal function. Similarly, by secreting bioactive lipids, stimulated PIMs may contribute to regulation of pulmonary hemodynamics. After receiving minute amounts of bacterial endotoxin, pulmonary injury is pronounced in sheep, calves, pigs, and cats, but not in laboratory animals and dogs. This presumably is related to the secretion of bioactive lipids by PIMs. PMID- 3284326 TI - Hypnosis as a function of adaptive regression and of transference: an integrated theoretical model. PMID- 3284327 TI - Hypnosis and concurrent denture construction for a patient with a hypersensitive gag reflex. PMID- 3284328 TI - Resting metabolic rate and postprandial thermogenesis in highly trained and untrained males. AB - The purpose was to compare the resting metabolic rate (RMR) and thermic effect of a meal (TEM) in exercise trained and untrained individuals. TEM was measured for 180 min and blood samples were drawn for determination of plasma insulin, glucose, triiodothyronine (T3) and thyroxine (T4). Results indicated that highly trained subjects demonstrated a higher RMR when expressed in kilocalories per minute and per kilogram fat-free weight (FFW) than do untrained subjects. TEM was lower in trained (55.8 +/- 3.1 kcal) than in untrained (79.2 +/- 3.7 kcal) subjects. No differences were noted between the two groups for plasma levels of insulin, glucose, T3, and T4. A higher RMR and lower TEM persisted in the trained group compared with the untrained group when groups were matched for FFW and body fat. Results support a higher RMR in endurance athletes and a lower TEM even after control is exerted over differences in body composition. PMID- 3284329 TI - Impression cytology detects subclinical vitamin A deficiency. AB - The vitamin A status of 16 children with normal eyes and liver disease was evaluated by plasma retinol concentration and by liver vitamin A concentration or iv relative-dose-response test. Conjunctival impression cytology was performed on each child. All children with normal vitamin A status had normal conjunctival impression cytology. All children with abnormal vitamin A status had abnormal conjunctival impression cytology despite their seemingly normal clinical ocular examination. These results suggest that impression cytology can identify individuals with physiologically significant, preclinical vitamin A deficiency. PMID- 3284330 TI - Combination anchorage technique: an update of current mechanics. AB - Experience and advances in design and technique have greatly enhanced combination orthodontic techniques during the past 5 years. Improvements have made the delivery of treatment more effective and reduced the problems with appliance adjustment and esthetics. Some of these improvements are in the bracket itself, which has been modified for efficiency and esthetics. A modification of treatment technique by the addition of tandem wires, stabilizing arch wires, Dual Flex arch wires, and sectional wires have increased the movement capabilities and anchorage control. A technique of orthodontic mechanics has evolved that is called combination anchorage technique (CAT). The technique is designed to broaden the treatment effectiveness of the orthodontist by providing a combination of orthodontic technical capabilities. Use of the two different bracket slots provides a simple and efficient means to vary (1) anchorage (dynamic or static), (2) movement (tipping or bodily), (3) technique (light wire or straight wire), (4) resistance (one tooth or multiple teeth), and (5) treatment compensation (skeletal or dental). PMID- 3284331 TI - An American Board of Orthodontics case report. Use of the face mask in the treatment of maxillary skeletal retrusion. PMID- 3284332 TI - Long-term cytotoxicity of orthodontic direct-bonding adhesives. AB - The purpose of this study was to examine the potential toxic effects of several orthodontic adhesives immediately after polymerization and at various time intervals up to 2 years postopolymerization by means of an in vitro overlay assay. Adhesive samples were incubated on tissue cultures containing an agar overlay with a vital dye (neutral red). Viable cells were stained red; nonviable cells were unstained. The circular pattern of nonviable cells demonstrated a zone of inhibition that was measured and compared. All materials tested showed cytotoxic effects immediately after polymerization and the toxic effect decreased with time postpolymerization. However, 2 years after initial polymerization, significant zones of inhibition indicating continued in vitro toxicity were still evident in all but one of the adhesives. PMID- 3284333 TI - Esophageal dilation: personal experience with current instruments and techniques. AB - The popularity and widespread use of flexible panendoscopy has produced a dramatic change in the management of benign strictures of the esophagus. Most are now managed medically. Two new esophageal dilators, the balloon and Savary, have made a major impact on the endoscopist's armamentarium. The Maloney dilator is still used 56% of the time, in the author's experience with strictures that are symmetrical and greater than 1.2-1.4 cm in diameter. Hydrostatic balloon dilators are used 24% of the time with strictures that are asymmetrical and 1.2 cm or more in diameter. The Savary thermoplastic dilators have replaced Eder-Puestow dilators and are used 20% of the time in strictures 1.2 cm or less in diameter. Morbidity and mortality rates should be under 1% with all dilators and are 0.1% and 0.05%, respectively, in the author's last 2000 dilations. PMID- 3284334 TI - Bezoars: classification, pathophysiology, and treatment. AB - Bezoars, accumulations of foreign material in the stomach, have been known to occur in animals and man for centuries. The incidence of bezoars in human patients has increased as a result of operative manipulation of the gastrointestinal tract. Composed of vegetable matter, hair, or more unusual materials like shellac or cement, they may lead to anorexia, weight loss, bleeding, obstruction, or perforation of the alimentary tract. Although this entity is often recognized radiologically, endoscopy provides the most accurate means for identification and classification. Many bezoars can be removed endoscopically, but some will require operative intervention. Once removed, emphasis must be placed upon prevention of recurrence. Physicians must learn to recognize and classify bezoars correctly in order to provide the most appropriate therapy in each instance. PMID- 3284335 TI - In memoriam William Harris Bachrach 1911-1987. PMID- 3284336 TI - Ethanolamine oleate versus absolute alcohol as a variceal sclerosant: a prospective, randomized, controlled trial. AB - Forty-seven patients with esophageal variceal bleeding were randomly allocated to undergo sclerotherapy on a 3 weekly schedule with either 5% ethanolamine oleate (23 patients) or absolute alcohol (24 patients), in an attempt to compare the efficacy and safety of the two sclerosants. Sclerotherapy with absolute alcohol eradicated esophageal varices significantly earlier compared with ethanolamine oleate (12.9 +/- 5.2 vs 22.3 +/- 8.2 wk, respectively, p less than 0.001). The mean number of injection courses and the mean amount of sclerosant required for variceal obliteration was also significantly (p less than 0.001) less in the alcohol-injected group. Although the total number of rebleeding episodes were significantly (p less than 0.05) less in the alcohol-injected group, the frequency of rebleeding was not significantly different between the two groups (20.8% vs 30.4%, respectively, p greater than 0.05). Two (8.1%) patients died due to rebleeding in the ethanolamine-injected group, whereas in the alcohol group, none died. There was no significant difference in the frequency of complications with the two sclerosants. Besides the relative ease of rapid injection due to its aqueous nature, alcohol is readily available and relatively economical (total cost of sclerosant per patient; alcohol US $0.50, ethanolamine US $60). In conclusion, absolute alcohol appears to be a useful alternative to 5% ethanolamine oleate as a variceal sclerosant. PMID- 3284337 TI - Study of mortality among chemical workers in the Kanawha Valley of West Virginia. AB - To assess the mortality experience of a cohort of chemical workers in the Kanawha Valley of West Virginia, 29,139 males who worked at any one of three facilities over a 39-year period were followed-up for vital status. The facilities include two chemical manufacturing plants and a research and development center. From this cohort, 5,785 men were found to have died as of the study end, December 31, 1978. This was less than the 6,148.5 men expected to have died, based upon the United States white male population (standardized mortality ratio (SMR) = 94, 95% confidence interval (CI) = 92-96). Eighty-six specific causes of death were examined. Statistically significant increased deaths were observed for two causes; cancers of the liver (not specified as primary or secondary) (SMR = 174; CI = 102-280) and lympho- and reticulosarcoma (SMR = 140; CI = 104-187). When all biliary and liver cancer was examined by duration and time since initial employment, the SMR for those who worked at least 25 years and whose deaths occurred 30 years or more after first employment was 301 (95% confidence limit = 168-497). The identification and follow-up of this complete cohort provides the basis for future study of subcohorts with specific chemical and process exposures and case control studies of specific causes of death. PMID- 3284338 TI - Cost accounting, management control, and planning in health care. AB - Advantages and pharmacy applications of computerized hospital management-control and planning systems are described. Hospitals must define their product lines; patient cases, not tests or procedures, are the end product. Management involves operational control, management control, and strategic planning. Operational control deals with day-to-day management on the task level. Management control involves ensuring that managers use resources effectively and efficiently to accomplish the organization's objectives. Management control includes both control of unit costs of intermediate products, which are procedures and services used to treat patients and are managed by hospital department heads, and control of intermediate product use per case (managed by the clinician). Information from the operation and management levels feeds into the strategic plan; conversely, the management level controls the plan and the operational level carries it out. In the system developed at New England Medical Center, Boston, Massachusetts, the intermediate product-management system enables managers to identify intermediate products, develop standard costs, simulate changes in departmental costs, and perform variance analysis. The end-product management system creates a patient level data-base, identifies end products (patient-care groupings), develops standard resource protocols, models alternative assumptions, performs variance analysis, and provides concurrent reporting. Examples are given of pharmacy managers' use of such systems to answer questions in the areas of product costing, product pricing, variance analysis, productivity monitoring, flexible budgeting, modeling and planning, and comparative analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284339 TI - Amphotericin B-resistant yeast infection in severely immunocompromised patients. AB - Systemic yeast infections are a major cause of morbidity and mortality in severely immunocompromised patients. The in vitro susceptibility to amphotericin B of 29 yeasts causing fungemia was examined in 26 patients undergoing allogeneic or autologous bone marrow transplantation and/or myelosuppressive chemotherapy. The minimal inhibitory concentrations (MICs) of amphotericin B observed with blood isolates from these patients were significantly higher than those observed with blood, sputum, or skin isolates from non-immunocompromised patients (p less than 0.01). All episodes (10 of 10) of bloodstream infection in immunocompromised patients caused by isolates with MICs greater than 0.8 micrograms/ml were fatal, versus eight of 17 episodes of bloodstream infection caused by yeasts with MICs of 0.8 micrograms/ml or less (p = 0.04). Although 15 of 26 patients received empiric treatment with amphotericin B before laboratory evidence of fungemia developed, the amphotericin B susceptibilities of their isolates were not significantly different from those of patients who had not received empiric amphotericin B treatment. It is concluded that yeast fungemia in severely immunocompromised patients is often caused by organisms resistant to the usual concentrations of amphotericin B obtainable in vivo, and that this finding is clinically significant. PMID- 3284340 TI - Comparison of norfloxacin with cotrimoxazole for infection prophylaxis in acute leukemia. The trade-off for reduced gram-negative sepsis. AB - A total of 63 neutropenic patients receiving cytotoxic therapy for acute leukemia were randomly allocated to receive norfloxacin (400 mg every 12 hours) or cotrimoxazole (160/800 mg every 12 hours) to prevent bacterial infection. Compliance was more than 95 percent and no adverse effects attributable to the study drugs were observed. The overall incidence of febrile illness (67 percent) was similar between the groups; however, no gram-negative bacillary infections were observed in 31 norfloxacin recipients compared with four of 32 cotrimoxazole recipients. Furthermore, nine norfloxacin recipients had 17 gram-positive bacteremias compared with two in two cotrimoxazole recipients (p = 0.0034). Norfloxacin was more effective than cotrimoxazole for preventing acquisition of aerobic gram-negative bacilli in surveillance cultures. Neither study drug allocation nor the presence of an indwelling central venous catheter influenced outcome among the 42 patients who subsequently received empiric systemic antibiotics for suspected infection. Although gram-positive infection remains an unsolved problem, norfloxacin appears to be a safe, effective, well-tolerated alternative to cotrimoxazole for preventing gram-negative infection in neutropenic patients with acute leukemia. PMID- 3284341 TI - Comparison of labetalol and prazosin in hypertensive patients using automated ambulatory monitoring. AB - The differential effects of prazosin and labetalol on blood pressure and heart rate in the clinic and during daily activity were measured in a double-blind study utilizing automatic ambulatory monitors. One hundred five patients with essential hypertension (sitting diastolic blood pressure equal to 101 mm Hg) were randomly assigned to receive prazosin (n = 52) or labetalol (n = 53). Sixty-eight percent of labetalol-treated patients and 50 percent of prazosin-treated patients achieved blood pressure control during clinic visits (sitting diastolic blood pressure less than 90 mm Hg) and were subsequently monitored for 12 hours of normal daily activities. Ambulatory monitoring revealed labetalol-treated patients to have significantly greater decreases in systolic and diastolic blood pressures during daily activity than prazosin-treated patients. Heart rate and rate-pressure product were significantly reduced in the labetalol group but not in the prazosin group. It is concluded that the potential benefits of dual adrenergic blockade, not readily apparent in the non-stressful clinic environment, become more evident during the course of daily activities. PMID- 3284342 TI - Factors predisposing to seizures in seriously ill infected patients receiving antibiotics: experience with imipenem/cilastatin. AB - Observations on 1,754 patients treated with imipenem/cilastatin in phase III dose ranging studies in the United States were reviewed to determine risk factors for seizures. The patients were moderately to severely ill with numerous background disorders known to be associated with an increased risk of seizures. Fifty-two patients (3 percent) had seizures and in 16 (0.9 percent) of them the seizures were judged by the investigators to be possibly, probably, or definitely related to imipenem/cilastatin. An incidence of seizure of 2 to 3 percent was noted among patients treated with other antibiotics (usually including a beta-lactam in the regimen) at times when imipenem/cilastatin was not being given. The average time of onset of seizures for patients receiving imipenem/cilastatin was seven days after start of therapy. As with other beta-lactam antibiotics, central nervous system lesions and disorders including seizures and renal insufficiency were found to be strong risk factors for seizures. Imipenem/cilastatin dosages in excess of those currently recommended by the manufacturer, particularly in patients with renal insufficiency, were also associated with an increased risk of seizures. There was an association with Pseudomonas aeruginosa infection that remained statistically significant even after controlling for imipenem/cilastatin dosage as well as for the other factors indicated. A high background incidence of seizures in general in a group of severely ill patients makes it both difficult to assess the etiology of a seizure and important to consider the risk factors when choosing the appropriate dose of an antibiotic. Guidelines are presented for appropriate dosing of imipenem/cilastatin in relation to renal function, body weight, and infecting pathogen. PMID- 3284343 TI - Azathioprine hypersensitivity. Case report and review of the literature. AB - Fever in a transplant recipient is an important sign of graft rejection or infection. Rarely, fever may result from an immunosuppressive agent used to prevent graft rejection. A case of fever, rigors, arthralgias, and myalgias is reported in a cardiac transplant recipient in whom azathioprine therapy was recently begun. These findings resolved on discontinuation of the azathioprine, recurred on rechallenge, and were most consistent with a hypersensitivity reaction. The clinical spectrum of reported azathioprine hypersensitivity reactions is reviewed. PMID- 3284344 TI - Proceedings of the Muirhead Symposium, a meeting on Antihypertensive and Hypertensive Mechanisms. October 13-14, 1987, Memphis, Tennessee. PMID- 3284345 TI - The renomedullary system of blood pressure control. PMID- 3284346 TI - The role of the renal medulla in blood pressure control. AB - It is well established that the renal medulla exerts a potent endocrine-like antihypertensive action. The purpose of this paper is to summarize the data that define the extent to which the renomedullary antihypertensive action is involved in blood pressure regulation. It appears that in animals kept under physiological conditions, the renal medulla is not necessary for the maintenance of normotension, since its destruction does not usually result in hypertension. However, in animals exposed to hypertensive stimuli, the presence of renomedullary tissue appears to be the key factor in resisting the increase in blood pressure. Evidence is presented to show that inherited or acquired deficiency of renomedullary antihypertensive function may contribute to the development of various forms of hypertension. It is suggested that inherited differences in the antihypertensive capacity of the renal medulla may account for differing sensitivities of various strains of animals to hypertensive stimuli. Finally, data are presented to show that renomedullary deficiency induced by a decrease in renal perfusion pressure, which could be a consequence of hypertensive damage to renal vessels, may contribute to the increase in blood pressure in various forms of hypertension. PMID- 3284347 TI - Renal vasodepressor mechanism: characterization by chemical medullectomy. AB - The features of hypertension produced in the rat by chemical medullectomy with 2 bromoethylamine hydrobromide are described. This procedure partially prevents the fall in blood pressure that occurs when the constriction is removed from the renal artery of rats with two-kidney one-clip Goldblatt hypertension. In normal rats, chemical medullectomy causes a moderate but consistent blood pressure elevation that is dose related and associated with elevation of peripheral resistance; the venous side of the circulation is normal. The hypertension is not associated with sodium retention or with activation of the renin angiotensin system. Although vasopressin levels are elevated, the rise is only modest, and blood pressure is not reduced by a vascular AVP antagonist. It is concluded that chemical medullectomy removes the source of a humoral substance that has been shown by other workers to carry out a vasodepressor role. The chemical medullectomy model therefore offers new insights into the renomedullary vasodepressor system. PMID- 3284348 TI - Morphometric studies of the renomedullary interstitial cells. AB - The renomedullary interstitial cell (RIC) is a unique cell found in the renal medullary interstitium among the collecting ducts, Henle's loop, and the vasa recta. A combination of morphologic and physiologic studies has defined some of the properties of this cell, which is the apparent source of the mediators of the antihypertensive function of the kidney. These may include prostaglandins (PGE2), APRL or platelet activating factor, and the incompletely defined neutral lipid, ANRL (or medullipin), the most likely candidate for this function. The lipid droplets in the RIC apparently are the precursors of the mediator(s). Degranulation of the RIC by an experimental maneuver usually indicates increased activity of these cells. The presence of abundant well-granulated RIC in a kidney indicates a resistance of that animal to the induction of salt-sensitive forms of experimental hypertension. There is definite evidence for an extrarenal antihypertensive function of the RIC mediators, but an intrarenal effect also is considered. PMID- 3284349 TI - Experimental depletion of different renal interstitial cell populations. AB - To define different populations of renal interstitial cells and investigate some aspects of their function, we studied the kidneys of normal rats and rats with hereditary diabetes insipidus (DI, Brattleboro) after experimental manipulations expected to alter the number of interstitial cells. DI rats showed an almost complete loss of interstitial cells in their renal papillae after treatment with a high dose of vasopressin. In spite of the lack of interstitial cells, the animals concentrated their urine to the same extent as vasopressin-treated normal rats, indicating that the renomedullary interstitial cells do not have an important function in concentrating the urine. The interstitial cells returned nearly to normal within 1 week off vasopressin treatment, suggesting a rapid turnover rate of these cells. To further distinguish different populations of interstitial cells, we studied the distribution of class II MHC antigen expression in the kidneys of normal and bone-marrow depleted Wistar rats. Normal rats had abundant class II antigen-positive interstitial cells in the renal cortex and outer medulla, but not in the inner medulla (papilla). Six days after 1000 rad whole body irradiation, the stainable cells were almost completely lost, but electron microscopic morphometry showed a virtually unchanged volume density of interstitial cells in the cortex and outer medulla, as well as the inner medulla. Thus, irradiation abolished the expression of the class II antigen but caused no significant depletion of interstitial cells. PMID- 3284350 TI - The humoral renal antihypertensive system: nervous and hemodynamic effects in normotensive and unclipped renal hypertensive rats. AB - A series of studies of the humoral renal antihypertensive system in normotensive and 2K 1C-renal antihypertensive rats is outlined. The rapid structural upward resetting of the cardiovascular system in renal hypertensive rats was associated with a structural downward resetting in the vasculature of the hypotensive clipped kidney. Unclipping of this kidney caused a pronounced release of renomedullary depressor agents, explaining the rapid normalization of pressure seen after unclipping. This normalization of pressure masks a state of pronounced functional hypotension in a structurally still hypertensive cardiovascular system, characterized by marked splanchnic vasodilatation and a lack of neurogenic counter-regulation. Only when this state has lasted long enough to normalize the structural upward resettings, characteristic of hypertension does the cardiovascular system return to normal. Further, cross-circulation techniques have shown that the humoral antihypertensive agents suppress tonic sympathetic activity, thereby inhibiting normal reflex counter-regulation of their vasodilator effects. Presumably this occurs via both vagal cardiac afferents and central actions. Further, behavior and awareness become depressed during intense and prolonged renomedullary release. Finally, experiments for which a normotensive kidney is cross-circulated from a normotensive rat suggest that the humoral renomedullary antihypertensive system has its threshold of release set so low as to contribute to normal blood pressure regulation, presumably in reciprocal balance with the renocortical renin-angiotensin system. Stepwise pressure elevations increasingly enhance release of the depressor agents from the cross-perfused kidney.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284351 TI - Prostanoids as mediators of prohypertensive and antihypertensive mechanisms. PMID- 3284352 TI - Role of vasopressin in regulation of sodium excretion. AB - It has been proposed that arginine vasopressin (AVP) contributes to the regulation of renal sodium excretion by direct intrarenal actions, by neural hormonal interactions, and via secondary effects of fluid volume retention. The present studies were designed to determine the extent to which the natriuretic effects of AVP are secondary to volume expansion. Three groups of dogs were studied: the first was infused with AVP for 2 weeks in amounts that increased plasma levels from 3 to 15 pg/mL, while water intake was maintained constant by intravenous (iv) water infusion. The second group received the same amount of AVP and was permitted to drink ad libitum. The third group was infused with the same amount of AVP, while total body weight and volume were maintained at a constant level by use of an electronically servo-controlled water infusion system. The results showed a large increase in total body weight (+1.5 kg) and arterial pressure (mean arterial pressure (MAP); +40 mm Hg) in dogs receiving a fixed water intake. This was accompanied by a continuing natriuresis over a 2-week period and severe hyponatremia (115 mEq/L). Dogs allowed ad libitum drinking retained much less fluid (+0.5 kg). MAP was not significantly elevated, and natriuresis did not occur in this group, but hyponatremia was observed (130 mEq/L), and plasma renin activity (PRA) was suppressed. Servo-controlled dogs exhibited no change in MAP, plasma sodium, or PRA, and only a small (-15 mEq) natriuresis occurred on day 1 of AVP infusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284353 TI - Studies on neural and humoral contributions to arterial pressure lability. AB - The mechanisms of arterial pressure lability in rats following sinoaortic deafferentation (SAD) remain unknown. In this paper, we review several studies that have investigated the potential mechanisms of this lability. Combined ganglionic and alpha-adrenergic receptor blockade reduced lability but not to control levels, indicating that the sympathetic nervous system plays a major role but is not the only mechanism involved in the generation of lability. When ganglionic blockade was combined with blockade of an endogenous humoral vasoconstrictor (vasopressin or angiotensin), lability was returned to control levels in SAD rats; however, humoral blockade alone did not alter lability. Infusion of phenylephrine or endogenous vasoconstrictors in the presence of combined neural and humoral blockade increased arterial pressure lability to levels similar to those found in rats with SAD. The neurogenic contribution to lability was further investigated by recording renal sympathetic nerve activity in conscious freely moving intact rats and rats with SAD. These studies demonstrated that one day after SAD, there was little direct correlation between transient changes in renal sympathetic nerve activity and arterial pressure lability. Thus, the evidence presented in this paper is consistent with the hypothesis that arterial pressure lability is not the direct result of unbuffered variations in sympathetic discharge but rather is produced by an interaction between neural and humoral components. PMID- 3284354 TI - Acute hypertensive and natriuretic responses following preoptic hypothalamic lesions. AB - The tissue surrounding the anteroventral portion of the third ventricle (the AV3V region) is critical for control of sodium balance and cardiovascular regulation. Ablation of this brain area results in an acute natriuresis and an increase in blood pressure. The purposes of these experiments were to determine the mechanism of the natriuretic response and assess whether the natriuresis contributes to the decreased blood volume following AV3V ablation. Rats were instrumented with metal lesioning electrodes in the AV3V region and with catheters in the femoral artery and jugular vein. Following electrolytic lesioning or control procedures, blood pressure, heart rate, urine flow rate and urinary sodium excretion were monitored. In separate groups of animals, plasma and blood volume were measured by calculating dilution of 125I-labelled serum albumin and hematocrit. Results from these studies showed that ablation of the AV3V region resulted in a significant elevation in blood pressure (18 +/- 3 mm Hg), increase in sodium excretion (212 +/- 36 mu Eq/hour), and decrease in plasma volume (10.3 +/- 0.4 mL) compared with control-treated animals (2 +/- 4 mm Hg; 89 +/- 34 mu Eq/h, 12.0 +/- 0.5 mL). This natriuretic response was accompanied by an increased plasma aldosterone concentration. Further, prevention of the hypertensive response abolished the natriuresis. These data suggest that AV3V ablation produces an acute pressure-mediated natriuresis, resulting in decreases in plasma and blood volume. PMID- 3284355 TI - Hemodynamic and neurohormonal changes in the development of DOC hypertension in the dog. AB - In this article we summarize studies of the hemodynamic and endocrine effects of desoxycorticosterone (DOC)-induced hypertension in dogs and also review new data of the action of this steroid on baroreceptors. The hemodynamic effect of subcutaneous injections of DOC to dogs, without supplementation of salt in their diet, consisted of increases in arterial pressure that were sustained for a 28 day observation period and associated with augmented cardiac output. At the early stage of the hypertensive response there was a rise in plasma Na+ concentration accompanied by increases in the plasma and cerebrospinal fluid (CSF) levels of vasopressin. The activity of the peripheral renin angiotensin system, as evaluated by the longitudinal changes in plasma renin activity and plasma immunoreactive angiotensin II (irAng-II), was markedly depressed in the hypertensive dogs. In contrast, the concentration of irAngII in the CSF did not change. Additional studies of the carotid occlusion reflex in anesthetized dogs revealed an enhanced buffering baroreceptor capacity in the early (less than day 10), but not the late (greater than day 28), stages of the hypertension. The abnormality in baroreflex function may be mediated by an effect of the steroid on an activity of brain angiotensin II that influences the inhibitory interaction between high and low pressure baroreceptors. The data acquired in these studies agree with the notion that excess mineralocorticoid production causes hypertension by mechanisms that influence the neurohormonal control of blood pressure by the central nervous system. PMID- 3284356 TI - Sodium sensitivity in normotensive and borderline hypertensive humans. AB - The responses to sodium depletion and repletion were studied in subgroups of 92 normotensive and 65 borderline hypertensive individuals. The borderline hypertensives were characterized by significantly higher blood pressure, weight, cardiac output, hematocrit and decreased density of conjunctival capillaries and venules. Sodium-sensitivity was defined as an increase in mean arterial blood pressure exceeding 5% during sodium repletion. The prevalence of sodium sensitivity was higher in blacks than in whites and greater in hypertensives than in normotensives. Sodium-sensitive individuals were characterized by significantly increased forearm vascular resistance and decreased plasma renin activity and aldosterone concentration. The resemblance of these changes to those reported in the Dahl salt-sensitive rat suggests a genetic basis for the response to sodium. PMID- 3284357 TI - Cell membrane in hypertension. AB - Several alterations in membrane transport systems are observed in rat and human hypertension. Na+ flux changes are numerous, and cellular homeostasis to Na+ loading is impaired. Transmembrane Ca2+ movements are also numerous but clearly defined by a reduction in Ca2+ binders, a hypersensitivity of membrane phospholipase C, possible increased Ca2+ leak and reduced sensitivity of the Ca2+ pump to calmodulin. The resulting Ca2+ increase within arterial cells can be responsible for increased contractility and tone, leading to hypertension. These functional alterations in membrane transport can be secondary to a few well defined membrane defects of genetic origin or to a diffuse structural perturbation in membranes involving lipid changes. PMID- 3284358 TI - Angiotensin II: an intraovarian regulatory peptide. AB - Mammalian ovarian follicles contain the enzymes and prohormones necessary to elaborate the active octapeptide hormone angiotensin II. In the rat ovary, angiotensin II receptors are located primarily in the theca interna and granulosa cell layers of a discrete subpopulation of follicles. Angiotensin II stimulates both androgen and estrogen secretion from rat ovarian slices. These findings suggest an autocrine/paracrine role for angiotensin II in ovarian follicular development. PMID- 3284359 TI - Life at what cost? PMID- 3284360 TI - Soft tissue expansion. PMID- 3284361 TI - Renin and reproduction. PMID- 3284362 TI - Intravascular monitoring and management of erythroblastosis fetalis. AB - Over a 27-month period 17 pregnancies in 16 patients with severe red blood cell isoimmunization were managed with intravascular transfusions performed in utero. Fourteen of these women were Rh negative and sensitized to D or to both D and C, and the remaining two patients were sensitized to the Kell antigen (K). In 12 of the 17 cases (71%) the first intravascular transfusion was performed at 26.5 weeks' gestation or earlier. Thirty-nine of 45 attempted transfusions (87%) were successfully performed. All were done percutaneously under ultrasonic guidance. Two procedures were partial exchanges, while the remainder were straight transfusions. Thirteen of the 17 fetuses (76%) were alive at birth and survived the neonatal period. Four fetuses died in utero at 25 to 26 weeks' gestation, all within 12 hours of an intravascular transfusion. When the 27 procedures attempted during the most recent 9 months of this series were compared with the 18 procedures attempted during the preceding 18 months, no appreciable differences in technical success or fetal outcome were evident. An analysis of this experience is presented, along with modifications in technique that have been implemented. Unresolved issues are discussed. PMID- 3284363 TI - The relationship between calcium intake and pregnancy-induced hypertension: up-to date evidence. AB - In 1980 we pointed to a relationship between calcium intake and pregnancy-induced hypertension. The original epidemiologic observations showed an inverse association between calcium intake and incidence of eclampsia after adjusting by several confounding factors. A series of recent randomized clinical trials have demonstrated a reduction in blood pressure with calcium supplementation in animals, in healthy and mildly hypertensive subjects, and in pregnant women. It is hypothesized that parathyroid hormone plays a role since it is affected by calcium intake and can partially regulate the concentration of free cytosolic ionized calcium, thus triggering smooth muscle contraction. Randomized clinical trials showing a reduction in the incidence of pregnancy-induced hypertension with calcium supplementation have not as yet been published. However, preliminary observations appear to support this hypothesis. PMID- 3284364 TI - The reversal of hydrops fetalis by intravascular intrauterine transfusion in severe isoimmune fetal anemia. AB - Seventy-two intrauterine intravascular transfusions were performed on 26 patients with severe erythroblastosis fetalis. Twenty of the 26 fetuses were hydropic at the time of referral. Of the 20 hydropic fetuses, 16 (80%) survived. Hydrops was completely reversed in 13 of the 16 fetuses (81%). Total protein of less than 3 gm/dl, albumin less than 2 gm/dl, and a hematocrit level of less than 15% were associated with hydrops fetalis. After hydrops was reversed, total protein greater than 3 gm/dl, albumin greater than 2 gm/dl, along with a sustained hematocrit level of greater than 15%, were found. Only three neonates were born with minimal ascites, two of whom had had intraperitoneal transfusions before intravascular treatments. There were 21 survivors of the total group, giving an overall survival rate of 82%. There was one neonatal death from severe respiratory distress syndrome. Thirty-eight percent of the neonates did not require exchange transfusions in the newborn period. Intrauterine intravascular transfusions appear to be an effective mode of therapy in severe erythroblastosis fetalis and not only increase survival rates but also decrease neonatal morbidity and mortality. PMID- 3284366 TI - Establishing a correct diagnosis of vulvovaginal infection. AB - Vulvovaginitis is a common problem and a prime reason for physician consultation. The organism most frequently responsible for vulvovaginal infection is Candida albicans, and in a large majority of cases identification of the causative organism and diagnosis are easy to establish. Recurrent or persistent infection, however, presents a perplexing diagnostic problem that usually can be solved with the use of appropriate supportive laboratory tests and awareness of the distinguishing features of the possible etiologic agents. Problems in diagnosis or complications in treatment are usually due to concurrent infection by two or more organisms or to treatment without proper identification of the infectious agents. PMID- 3284365 TI - The use of intrauterine contraceptive devices, pelvic inflammatory disease, and Chlamydia trachomatis infection. AB - With the same epidemiologic approach taken in a recent study that suggested that oral contraceptive use may not protect against chlamydial pelvic inflammatory disease, the risks of chlamydial pelvic inflammatory disease were evaluated for intrauterine contraceptive device users. Compared with women using no method of contraception, intrauterine contraceptive device users were not found to be at any higher risk of cervical chlamydial infection. Whether this places intrauterine contraceptive device users at no increased risk of chlamydial pelvic inflammatory disease cannot be ascertained from the available data. Further research is needed before any conclusions can be made regarding the risks of chlamydial pelvic inflammatory disease to users of intrauterine contraceptive devices, oral contraceptives, and other contraceptive methods. PMID- 3284367 TI - Mycology of vulvovaginitis. AB - The life cycle of the yeast Candida is characterized by rapid budding, maturation, and degeneration. Pathogenic species and strain differences are identified and these differences are important in the study of recurrent infections. The relationships between Candida and other fungi, and between Candida and hormones, are discussed. PMID- 3284368 TI - Vaginal colonization by bacteria and yeast. AB - A number of different factors have been found to influence the microflora of the vagina. Studies showing an increased rate of colonization associated with pregnancy, menses, oral contraceptive use, and estrogen replacement therapy illustrate the influence of hormones, glycogen content, and pH on vaginal colonization. The microorganisms found in the vagina may also be dependent on the existence of specific attachment sites, which may differ in the various areas of the vagina. Vaginal colonization appears to be altered in patients with diabetes mellitus, those receiving steroid therapy, and immunosuppressed individuals. Surgical manipulation of the vagina and the use of broad-spectrum antibiotics may also contribute to the growth of organisms in the vaginal tract. PMID- 3284369 TI - Antifungal therapy in the management of chronic candidiasis. AB - The most pathogenic Candida species are identified and the structure of imidazole compounds and their mechanism of action on yeast cells are described. Not all yeast species react in the same way to imidazole preparations, and these actions are documented. PMID- 3284370 TI - High-frequency switching in Candida albicans and its relations to vaginal candidiasis. AB - Candida albicans possesses the ability to switch reversibly and at high frequency between a number of heritable phenotypes distinguishable by colony morphology and in some cases cellular phenotype. In the original switching system identified in C. albicans, it was demonstrated that cells could switch at frequencies as high as 10(-2) among seven distinct colony phenotypes including smooth, star, ring, stipple, irregular wrinkle, hat, and fuzzy. In a second switching system first discovered in a systemic infection, cells switched at high frequency between a white and an opaque colony former. Recently, switching was discovered in isolates from patients with vaginal candidiasis and multiple switch phenotypes were cloned from an individual vagina. Switching may contribute to the pathogenesis of C. albicans by providing it with the capacity to invade diverse sites in the body, to change resistance to antifungal agents, or to change antigenicity. The molecular basis of switching is probably due to the reversible transposition or rearrangement of genomic elements, although a direct correlation between recently identified genomic rearrangements and phenotypic switching has not been made. PMID- 3284372 TI - A review of manifestations of diabetes mellitus in the anterior eye and cornea. AB - Diabetes mellitus can lead to blindness through its effects on the retina and lens, yet diabetes is a systemic disease influencing the entire eye. The current interest in extended wear contact lenses emphasizes the need for the practitioners to have a thorough knowledge of the pathophysiology of the anterior eye and cornea of the diabetic. The current literature is reviewed, and its relevance to contact lens wear is discussed. PMID- 3284371 TI - Relative allergenic potential of four proteases used as contact lens cleaners. AB - The general use of enzymatic cleaners for soft contact lenses has led to reports of incidents of allergic reactions in previously sensitized patients. In light of this, experiments were performed to assess the relative allergenic potential of four such enzymes: papain, subtilisin A, subtilisin B, and pancreatin. Mice immunized intraperitoneally (i.p.) with either subtilisin A or papain exhibited little serum immunoglobulin E (IgE), even after tertiary doses of protein. Primates immunized intradermally (i.d.) with the four enzymes showed various levels of response to challenges: none to papain, mild to moderate to subtilisin A and pancreatin, and severe to subtilisin B. Finally, guinea pigs instilled ocularly with enzymes weekly for 15 weeks exhibited significant hyperemia and chemosis only to the positive control protein, ovalbumin, and not to any of the enzymes tested. We conclude that three of the four enzymes tested have low potential to sensitize human beings, and, further, that animal models may find increased use in screening products of biotechnology. PMID- 3284373 TI - Surgical treatment of Meniere's disease since Thomsen. AB - The effects of Thomsen's 1981 report of a controlled double-blind study on the surgical treatment of Meniere's disease were studied by reviewing the current literature and Thomsen's subsequent reports. The current surgical literature was found to contain reasonable support for the continued use of endolymphatic shunt procedures despite the criticism of such procedures by Thomsen. Surgical therapy for Meniere's disease continues to be divided into auditory sparing or conservative procedures and auditory ablative or destructive procedures. Conservation procedures are important because approximately 30% of patients with Meniere's disease progress to bilateral involvement. Endolymphatic sac procedures continue to be classified as conservative. Important findings in the current literature are reports of long-term follow-up of patients after sac surgery. These question the long-term control of hearing loss but support the use of the procedure due to its low morbidity and consistent control of vertigo. Other authors have described the different types of endolymphatic procedures and confirm their equal effectiveness. The results of middle fossa and retrolabyrinthine vestibular neurectomy were also reviewed, and its continued control of vertigo were affirmed. The increased number of severity of complications (compared with endolymphatic shunt procedures) were noted. Finally, a strategy for surgical treatment of Meniere's disease, beginning with the patient with uncontrollable vertigo, is presented. PMID- 3284374 TI - Tuning fork tests: forgotten art. AB - Four examples are cited in which tuning fork tests helped in proper selection of patients for surgery, after audiometric air and bone tests were equivocal or gave the wrong diagnostic and prognostic indication. PMID- 3284375 TI - Obituary: J. Lawrence Angel, 1915-1986. PMID- 3284376 TI - Secular changes in the angle of divergence of the first two metatarsals in the Japanese. AB - This investigation concerns secular changes of the intermetatarsal M1-M2 angle in the foot of Japanese, from the prehistoric Jomon period to early modern times. The divergence of the first metatarsal from the second in both sexes in the reconstructed tarsometatarsal bones gradually decreased during this period. In addition, the difference between sexes or sides in each period is small and statistically insignificant. With time, the first metatarsocuneiform angles, in both sexes, also decreased in parallel with the reduction of the intermetatarsal M1-M2 angle, while the second metatarsocuneiform angles in both sexes increased. Both may play a role in decrease of the intermetatarsal M1-M2 angle. A conspicuous angular divergence of the first metatarsal from the second one occurred in comparatively recent times. This change would be accelerated by modification in life-style, together with the effects of footwear. PMID- 3284377 TI - Metastasizing carcinoma in a medieval skeleton: differential diagnosis and etiology. AB - The paper describes the skeleton of an aged adult male from the Middle Ages who most probably suffered from a bronchogenetic carcinoma. The differential diagnosis is based on macroscopic and microscopic examination, X-ray studies, and trace element analysis. Hypothesis for the etiology of the disease are discussed. PMID- 3284378 TI - An analysis of crania from Tell-Duweir using multiple discriminant functions. AB - Historical and archaelogical evidence suggests that the Iron Age biblical city of Lachish had a multinational population of diverse geographical origins. A multivariate analysis of crania, using canonical discriminant functions and metric variables, tends to confirm this. The approach employed stresses that population discriminant analysis studies should be both biologically and statistically legitimate. An ecological interpretation of the data suggests a research design for analyzing the affinities of cranial series. Similarities probably should be assessed in an analytical space containing the widest possible range of variation. PMID- 3284380 TI - On the composition of the cytosol of relaxed skeletal muscle of the frog. AB - This review summarizes a variety of estimates for the concentrations of the principal cytosolic constituents in frog skeletal muscle. From these estimates (listed in the APPENDIX), we chose representative values and used electroneutrality and osmotic considerations to ensure that all major constituents have been considered. Given total cytosolic concentrations of these constituents from the literature, we employed a computer program to calculate the concentrations of all the major ionic species in the cytosol. In relaxed muscle, electroneutrality and osmotic constraints are fulfilled if, in addition to diffusible species, the charge contribution of the myofilaments is considered. Mean buffer power of the diffusible cytosolic species is calculated to be less than one-third of that experimentally determined for whole muscle. Computations indicate that recent estimates of intracellular free magnesium concentration approximately 1 mM are likely to be correct. PMID- 3284381 TI - Effects of lack of exercise on insulin secretion and action in trained subjects. AB - We employed the hyperglycemic clamp technique to investigate the effects of short term inactivity on insulin secretion in nine (8 men, 1 woman) well-trained subjects. A 3-h hyperglycemic clamp (plasma glucose approximately 180 mg/100 ml) was performed approximately 16 h after a usual training bout and again 14 days after stopping exercise training. There was no significant change in body composition during this short period of inactivity. The mean plasma insulin response to an identical glycemic stimulus was 67% higher after 14 days without exercise (45 +/- 7 after vs. 27 +/- 4 microU/ml before stopping exercise training). Marked increases in the early (0-10 min, 150 +/- 28 vs. 101 +/- 15 microU.ml-1.min) and late (10-180 min, 6,051 +/- 1,257 vs. 3,521 +/- 749 microU.ml-1.min) incremental insulin areas were observed as a result of the physical inactivity. Incremental areas for C-peptide were also elevated significantly in the inactive state for early (12 +/- 2.0 vs. 7 +/- 1 ng.ml 1.min) and late (567 +/- 90 vs. 467 +/- 85 ng.ml-1.min) phases. Urinary excretion of C-peptide increased from 12.1 +/- 1.5 ng/240 min in the exercising state to 21.8 +/- 3.6 ng/240 min in the inactive state. Rates of whole body glucose disposal were not different between exercising and inactive states, indicating a large increase in resistance to the action of insulin. These findings indicate that the decreased insulin secretory response to a glucose stimulus in people who exercise regularly is a relatively short-term effect of exercise. PMID- 3284379 TI - Stature variation in the British American Colonies: French and Indian War records, 1755-1763. AB - Personnel records kept by military units of American colonials during the French and Indian War (1755-1763) are analyzed for relationships between environmental factors and stature. A robust American economy and direct access to high-quality food were apparently critical to tallness of this white American male sample. American-born men were taller at all ages than those who had migrated from Europe. January temperatures, rural versus urban birth, and ethnicity also showed stature relationships within the American-born group; thermal effects were by far the strongest of the non-nutritional factors. PMID- 3284382 TI - Skeletal muscle glucose uptake during dynamic exercise in humans: role of muscle mass. AB - To study the role of muscle mass in glucoregulation, six subjects worked with the knee extensors of one leg on a specially constructed cycle ergometer. The knee extensors of one leg worked either alone or in combination with the knee extensors of the other leg and/or with the arms. Substrate usage was measured across both knee extensors by femoral arterial and venous catheterization and measurement of femoral venous blood flow. Glucose uptake by the working knee extensors was absolutely (by approximately 20%) or relatively decreased when arm cranking was added to knee extensions. The decrease in glucose uptake was not compensated for by increased uptake of free fatty acids but was accompanied by decreases in plasma insulin and increases in plasma epinephrine and norepinephrine. During work with large muscle masses, arterial lactate increased to approximately 6 mM, and net leg lactate release reverted to net lactate uptake. Decreased glucose uptake could not be explained by decreased perfusion. It is concluded that thigh muscle glucose uptake is affected by the size of the total muscle mass engaged in exercise. The decrease in thigh glucose uptake, when arm cranking was added and O2 uptake was increased above 50% of maximum aerobic capacity, may be elicited by neuroendocrine adjustments or lactate-induced inhibition of glycolysis and may represent a mechanism for protecting against premature hypoglycemia during prolonged exercise. PMID- 3284383 TI - Effects of age on metabolic responses to acute and chronic stress. AB - The effect of age on the capacity of an organism to mobilize glucose and free fatty acids during stress and to adapt these responses from an acute to a chronic stress situation is not known. The purpose of this study was to determine whether aging impaired the capacity to 1) raise glucose and free fatty acid levels and suppress insulin release in acute stress situations and 2) develop adaptation of these responses to exposure to chronic stress. Our results indicate that 6-mo-old rats (young) trained to escape electric shock (short-term modulation) showed greater acute stress-induced hyperglycemic, hypoinsulinemic, and lipolytic responses than untrained young rats. By contrast, in 22-mo-old rats (old), responses of trained and untrained animals were not different. In the chronic stress (long-term adaptation) experiments, it was found that 1) adaptation of stress-induced hyperglycemia occurred at a faster rate in young than in old animals; 2) in young but not in aged rats, a strong positive correlation was observed between adaptation of stress-induced hyperglycemia and hypoinsulinemia; and 3) in young rats, stress-induced lipolytic responses declined proportionately to the duration of chronic stress exposure, whereas by contrast in chronically stressed aged rats steady-state levels of free fatty acids were not raised during exposure to stress. Thus we conclude that 1) glucose intolerance may play a key role in the altered stress-induced metabolic responses of aged rats; 2) with age, there is a loss of plasticity in physiological adaptive response mechanisms associated with metabolic responses to stress. PMID- 3284384 TI - A role for insulin in cephalic phase of postprandial thermogenesis in dogs. AB - The influence of insulin in the cephalic phase of postprandial thermogenesis was investigated in dogs. O2 consumption (VO2) and respiratory quotient (RQ) were continuously monitored 1 h before and 2 h after a 1,015-kcal meal during a control, an atropine, or a pancreatic-denervation experiment. A first phase (cephalic phase) in VO2 increase, lasting at least 50 min, followed by a second phase (digestive phase) were found in the control experiment. During both the atropine and pancreatic-denervation experiment, the first phase of VO2 was inhibited by 52%. The second phase was completely abolished with atropine, whereas it remained comparable to the control in the case of pancreatic denervation. A peak increase for insulin (70 microU/ml over 0 time) was observed 2 min after the onset of feeding in control. It was followed after 25 min by a second increase related to changes in glycemia. Maximal rises of norepinephrine (NE) and epinephrine corresponded to 215 and 120 pg/ml above basal values at 2 min in control experiment. During both atropine and pancreatic denervation the cephalic phase of insulin release was suppressed and the NE increase was inhibited by congruent to 65%. During the digestive phase pancreatic denervation caused an increase in plasma insulin comparable to that of the control, whereas atropine produced no such effect. It is suggested that the cephalic phase of postprandial thermogenesis is mediated through a causal relationship between insulin and NE release. PMID- 3284385 TI - Mechanism of insulin action on glucose transport in rat skeletal muscle. AB - This study was designed to examine the effect of insulin stimulation on glucose transport in rat skeletal muscle. Sarcolemmal vesicles (SL) were isolated from the gastrocnemius-plantaris and quadriceps muscles from insulin-stimulated and control groups. The insulin-stimulated group received an intravenous insulin injection (1 U/kg) 10 min before isolation. The early time course of specific D glucose transport was linear through 2 s. Michaelis-Menten kinetics at 1.5 s indicated that the Vmax for glucose transport was increased after insulin stimulation compared with controls (4,424 +/- 668 vs. 1,366 +/- 124 pmol.mg protein -1.s-1), whereas the Km remained unchanged (19.4 +/- 0.6 vs. 21.6 +/- 3.1 mM). Scatchard plots for the D-glucose-inhibitable class of cytochalasin B binding sites indicated that insulin stimulation increased the number of binding sites in the SL vesicles (9.3 +/- 0.6 vs. 5.5 +/- 0.3 pmol/mg protein) without altering the Kd (48 +/- 3 vs. 46 +/- 3 nM). That the increase in Vmax was greater than the increase in cytochalasin B binding sites indicates that insulin stimulation caused an increase in the turnover rate of existing transport molecules as well as an increase in the total number of SL glucose transport molecules. PMID- 3284386 TI - Lipoprotein lipase uptake by the liver: localization, turnover, and metabolic role. AB - We have studied the binding and metabolism of 125I-labeled bovine lipoprotein lipase (LPL) by use of isolated, perfused rat livers. Our data suggest the presence of two types of binding sites, i.e., heparin-sensitive sites that bind primarily the catalytically active form of the lipase and are present at the endothelium in all blood vessels and heparin-insensitive sites that bind both active and inactive forms and are present only within the sinusoids. Forty minutes after uptake by the liver, approximately 50% of the LPL had lost its catalytic activity or been degraded. Three processes were evident: 1) colchicine sensitive degradation to acid-soluble products, 2) partial proteolysis to fragments similar to those formed by limited digestion with trypsin or plasmin, and 3) a conformational change leading to loss of catalytic activity. Exogenous LPL bound in the liver caused a dramatic increase in the utilization of a perfused triacylglycerol emulsion (Intralipid), with rapid formation of free fatty acids and water-soluble metabolites. When the liver was flushed with heparin, it lost its ability to utilize the fat emulsion. Measurement of the hepatic extraction showed that rat livers take up 100-200 mU endogenous LPL per hour. PMID- 3284388 TI - Sodium restriction corrects hyperfiltration of diabetes. AB - The effect of a low-sodium diet on the abnormal glomerular hemodynamics of early diabetes was studied in rats. Starting 5 to 7 days after onset of streptozotocin induced insulin-dependent diabetes mellitus (IDDM), rats were fed a low-sodium diet for 4-5 days. Normal rats fed the same diet served as controls. Micropuncture measurements were made during a control period, followed by a second period when saralasin was infused into the left renal artery. During the first period, single-nephron glomerular rate (SNGFR), glomerular plasma flow (QA), glomerular blood flow (SNBF), filtration fraction (SNFF), and glomerular hydraulic pressure (PG) in the diabetic rats were not significantly different from the normal controls. Saralasin infusion resulted in striking increases in SNGFR, QA, SNBF, and Kf, and significant decreases in SNFF, PG, and delta P. The responses to saralasin imply that the low-sodium diet resulted in ANG II-mediated vascular constriction at pre- and postglomerular sites, and probably the glomerular mesangial cells as well. Our observations suggest that the abnormally elevated glomerular blood flow and filtration rate of early IDDM can be corrected by a low-sodium diet via stimulation of endogenous ANG II. PMID- 3284387 TI - The amphibian diluting segment. AB - Diluting segments function to reabsorb NaCl and to reduce the osmolality of tubule fluid. These segments in amphibians are important in the conservation of NaCl. The diluting segment of mammals, the thick ascending limb, besides being an important site for the reabsorption of NaCl, supplies the energy that enables the kidney to excrete a concentrated urine. We focus in this review on the mechanisms involved in cellular and paracellular transport of Na+, K+, Cl-, and H+ in the amphibian diluting segment and how the transport of these ions is regulated. Also discussed is the action of loop diuretics and hormones on both transepithelial and cellular function. The large size of amphibian cells and their viability in various artificial conditions have allowed experiments to be performed that are not possible in the mammalian kidney, providing important information on the mechanisms of ion transport common to both mammalian thick ascending limb and amphibian diluting segment. PMID- 3284389 TI - Effects of sodium intake and aldosterone on the renal pressure-natriuresis. AB - To study the effects of dietary sodium and plasma aldosterone on pressure natriuresis (PN) we examined six groups of adult, male Sprague-Dawley rats. Group 1 received normal-sodium diet, group 2 high-sodium diet, and group 3 low-sodium diet for 3 wk; group 4 was given low sodium for 3 wk then high sodium for 3 wk; groups 5 and 6 received high sodium for 3 wk but during the 3rd wk were also given aldosterone by subcutaneous infusion to mimic the plasma aldosterone seen in groups 1 and 3, respectively. After the diets, rats were killed, and urinary sodium excretion, glomerular filtration rate (GFR), and calculated tubular sodium reabsorption (FRNa) were measured during stepwise increases in perfusion pressure in isolated perfused kidneys from each group. No significant differences in blood pressure were seen between any of the groups. The PN curves for groups 2 and 3 were significantly different (P less than 0.001) and shifted to the left and right of group 1, respectively. These shifts appeared to be the result of significant (P less than 0.001) differences in FRNa rather than changes in GFR. PN was not significantly different in groups 4 and 2, indicating that the effects of low-sodium diet were reversible. The infusion of aldosterone in groups 5 and 6 was associated with modest and significant (P less than 0.001) shifts, respectively, of the PN curve to the right of the curve of rats in group 2. In group 6 this shift appeared to be due to significant (P less than 0.001) changes in FRNa, so as to resemble that seen in low-sodium rats of group 3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284390 TI - Impaired control of renal hemodynamics and renin release during hyperkalemia in rabbits. AB - We analyzed the changes in control of renal hemodynamics and renin release resulting from hyperkalemia in the rabbit. Plasma potassium activity was maintained at a controlled elevated level by intravenous infusion of KCl. The potassium activity of the control group (n = 23) averaged 3.20 +/- 0.06 meq/l and that of the hyperkalemic group (n = 13) averaged 5.80 +/- 0.13 meq/l. Renal blood flow (RBF), glomerular filtration rate (GFR), and renin release were measured over a range of renal perfusion pressures achieved by constriction of the suprarenal aorta. The control group's RBF and GFR exhibited excellent autoregulatory capability from 100 to 80 mmHg. However, significant impairment of autoregulation was apparent in the hyperkalemic group. At 100 mmHg, RBF and GFR in the hyperkalemic group averaged 33 and 34% greater, respectively, than those of the control group (P less than 0.005); both variables in the hyperkalemic group were greater than the values of the control group over the autoregulatory range (100-80 mmHg). The renin release values for the two groups were not different at the 100-mmHg pressure level, although renin release of the hyperkalemic group increased to higher levels than those of the control group as perfusion pressure was reduced. At the 70- and 60-mmHg levels renin release from the hyperkalemic group averaged approximately 300% greater than that of the control group (P less than 0.05). However, when expressed as percentage change, the stimulatory effect of hyperkalemia was not apparent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284391 TI - Angiotensin II-stimulated prostaglandin production by canine renal afferent arterioles. AB - Production of prostaglandin E2 (PGE2) and prostacyclin (PGI2) as 6 ketoprostaglandin F1 alpha (PGF1 alpha) in isolated canine superficial and juxtamedullary afferent arterioles was measured in the basal state and after administration of angiotensin II and bradykinin. Individual afferent arterioles were obtained by microdissection, and pooled collections were incubated at 37 degrees C for two consecutive 30-min periods. Prostaglandin content of the incubation media was measured by radioimmunoassay and expressed as picograms prostaglandin per incubation vial per 30-min period. Bradykinin (10(-7) M) produced significant stimulation of both PGE2 and 6-keto-PGF1 alpha production in superficial (PGE2 from 0.44 +/- 0.32 to 5.46 +/- 3.77 pg/period and 6-keto-PGF1 alpha from 6.5 +/- 5.0 to 104.5 +/- 25.5 pg/period) and juxtamedullary afferent arterioles (PGE2 from 0.31 +/- 0.06 to 7.47 +/- 1.55 pg/period and 6-keto-PGF1 alpha from 12.0 +/- 0.01 to 184.4 +/- 14.8 pg/period). Angiotensin II in concentrations of 10(-12) M to 10(-7) M produced no stimulation of prostaglandin production. Angiotensin II (10(-6) M) produced significant stimulation of 6-keto PGF1 alpha production only in superficial afferent arterioles (from 4.4 +/- 0.8 to 17.3 +/- 3.1 pg/period). Angiotensin II-stimulated 6-keto-PGF1 alpha production was blocked by saralasin (2 X 10(-6) M). A heterogeneous renal vascular response to angiotensin II is demonstrated, since the latter stimulated PGI2 production in superficial afferent arterioles only. PGI2 could potentially antagonize the vasoactive effect of angiotensin II in superficial afferent arterioles. PMID- 3284393 TI - Cardiovascular and hormonal response to hemorrhage in conscious rats. AB - The effect of arginine vasopressin (AVP) pressor blockade on the response to graded hemorrhage was investigated on conscious, unstressed, freely moving rats. The parameters studied were mean arterial pressure (MAP), heart rate (HR), blood velocity in the ascending aorta (ABV), and plasma concentrations of AVP (pAVP), renin (PRC), corticosterone (pCS), and catecholamines. After the first hemorrhage (0.75% of body wt over 5 min), MAP remained unchanged while ABV declined and HR increased. The two subsequent hemorrhages brought about significant reduction in MAP, HR, and ABV. pAVP, pCS, and PRC increased gradually during the experiment, while plasma catecholamine levels remained unchanged except for epinephrine, which increased after the third hemorrhage. After pretreatment with the AVP pressor antagonist, [d(CH2)5Tyr(Me)]AVP, the hemorrhage-induced cardiovascular changes were practically identical to those seen in control animals. Results with AVP blockade performed after the third hemorrhage were also negative. A pressor role of AVP after hypotensive hemorrhage could only be revealed in the presence of converting-enzyme inhibition and alpha-adrenergic blockade. In addition, [d(CH2)5Tyr(Me)]AVP did not modify the effect of hemorrhage on pCS and catecholamines and caused only a slight enhancement of the increase in PRC. It is concluded that conscious, nonstressed rats, if all compensatory mechanisms are allowed full expression, exhibit a normal cardiovascular compensatory response to hemorrhage in the absence of functional AVP pressor receptors. PMID- 3284392 TI - Disparity between renal venous norepinephrine and renin responses to sodium depletion. AB - To evaluate the hypothesis that sodium depletion produces a chronic increase in renal nerve activity, arterial and renal venous plasma norepinephrine (NE) concentrations were measured in conscious dogs subjected to various degrees of sodium depletion. After 9 days of sodium depletion (LS), there was a net loss of 69 +/- 10 meq sodium, and mean arterial pressure (MAP) was reduced from 94 +/- 5 to 88 +/- 4 mmHg. At this time plasma renin activity (PRA) was increased from a control level (sodium intake = 45 meq/day) of 0.34 +/- 0.08 to 1.47 +/- 0.26 ng angiotensin I (ANG I).ml-1.h-1 in association with an approximately sixfold increase in the PRA gradient across the kidneys. Subsequently, when captopril was infused during an additional 7 days of sodium deprivation [(LS + converting enzyme inhibitor CEI)], there was further sodium depletion (31 +/- 11 meq) and hypotension (MAP = 65 +/- 6 mmHg) and PRA and the renal PRA gradient increased even further. In marked contrast, there were no significant changes in either arterial plasma NE concentration (control = 102 +/- 5 pg/ml) or the renal arteriovenous gradient of plasma NE concentration during either LS or LS + CEI. These experiments show a distinct disparity between changes in the PRA and the plasma NE concentration gradient across the kidneys during LS and fail to support the contention that increased renal nerve activity is an important long-term adaptive response to sodium depletion. PMID- 3284394 TI - Evidence for lack of importance of oxygen free radicals in Escherichia coli endotoxemia in dogs. AB - Reactive oxygen species have been proposed as pathophysiological factors responsible for the hypodynamic circulatory response to gram-negative endotoxin. To test this hypothesis, we examined the cardiorespiratory effects of mechanistically different oxygen free radical scavenging agents during Escherichia coli endotoxemia in beagle dogs. Pentobarbital-anesthetized dogs were instrumented for repeated sampling of cardiorespiratory, hematologic, and tissue blood flow (radiolabeled 15-micron microspheres) indexes. Four groups were studied: 1) time-matched control dogs (n = 6); 2) dogs receiving only endotoxin (1.5 mg/kg; n = 6); 3) dogs receiving endotoxin and combination therapy with allopurinol (150 mg/kg) plus superoxide dismutase (5 mg/kg) and catalase (5 mg/kg; n = 6); and 4) dogs receiving endotoxin and deferoxamine (30 mg/kg; n = 5). Measured variables in control dogs were constant during the 4-h study, whereas endotoxin-injected dogs consistently demonstrated the following: 1) maintained reductions in blood pressure (greater than 45%), left ventricular systolic pressure (greater than 43%), left ventricular maximum rate of pressure development (+/- dP/dtmax) (greater than 41%), cardiac index (greater than 33%), and blood flow in all sampled tissues except liver and skeletal muscle; 2) transient tachypnea, bradycardia, and arterial acidosis; and 3) persistent neutropenia and hemoconcentration. Neither of the free radical scavenging protocols significantly improved measured variables during endotoxemia (P greater than 0.05). This lack of efficacy suggests that superoxide anion, hydrogen peroxide, and hydroxyl radical may lack primary pathophysiological importance during the development of E. coli endotoxicosis in intact dogs. PMID- 3284395 TI - Adenosine potentiates insulin-stimulated myocardial glucose uptake in vivo. AB - Myocardial adenosine (ADO) has long been regarded as a regulator of coronary blood flow. In other tissues, such as adipose and skeletal muscle, much attention has focused on the role of ADO as a metabolic regulator of the actions of insulin. In the present study, we determined the effect of ADO infusion on insulin-stimulated myocardial glucose uptake (MGU). Mongrel dogs of either sex were instrumented to obtain arterial-coronary sinus differences for glucose, lactate, and oxygen. These were multiplied by circumflex artery blood flow (Q) to obtain uptake values. Measurements were made before and during hyperinsulinemic (4 U/min)-euglycemic clamp (clamp) with intracoronary infusions of saline, ADO, adenosine deaminase (ADA), or nitroprusside (NP). During clamp, MGU increased from a basal value of 3.0 +/- 0.8 mg/min (mean +/- SE) to 5.53 +/- 0.8 mg/min. Adenosine infusion potentiated this response, raising MGU further to 9.02 +/- 1.1 mg/min while not significantly affecting lactate or oxygen uptakes. Infusion of ADA confirmed the specificity of the response by blocking the metabolic effect of exogenously infused ADO. When NP was infused, Q increased significantly without altering MGU, indicating that the metabolic response to ADO was independent of the changes it caused in Q. A dose-response relationship existed between ADO and insulin-stimulated MGU. The metabolic response to ADO was more sensitive than the vasodilator response. It is concluded that ADO acts as a regulator of insulin in heart. This metabolic regulation occurs independent of changes in coronary blood flow. PMID- 3284396 TI - Dupuytren's (subungual) exostosis. AB - Because it may produce a bewildering array of histologic patterns, the clinical entity of subungual exostosis (Dupuytren's exostosis), is sometimes confused with chondrosarcoma. However, this lesion is a distinct entity. It begins as a reactive growth of cellular fibrous tissue and metaplastic cartilage, which undergoes enchondral ossification. The rate of growth may be exuberant, but it is limited. We present a series of 15 cases as well as a review of the literature. Postadolescents and young adults are most commonly affected, and the majority of cases (80%) occur on the dorsal-medial aspect of the great toe. Trauma, whether chronic or acute, and infection are frequent inciting factors. The radiologic picture is consistent and can be diagnostic. In more than half our cases, chondrosarcoma was suspected initially. However, if the entire clinical picture is evaluated, the histologic findings should not lead to confusion with a malignant process. This acquired exostosis is benign; local excision is curative. However, recurrence is common (53%) after incomplete excision or when the lesion has not achieved full maturation. PMID- 3284397 TI - Spindle-cell proliferations of the urinary tract. An immunohistochemical study. AB - In order to define the immunohistochemical features of spindle cell proliferations of the urinary tract, we studied 18 lesions of this type with a panel of antibodies to epithelial and mesenchymal determinants. Histologically, 13 cases showed features that were not conclusively those of either spindle cell carcinoma or sarcoma, three contained overtly epithelial areas, and two were classified as "postoperative spindle cell nodules" (PSCN). Nine tumors in the indeterminate group and three with focally overt carcinomatous growth stained for cytokeratin and epithelial membrane antigen (EMA) and were classified as carcinomas. Eleven of these coexpressed vimentin, but desmin and muscle-specific actin were undetectable. The four remaining indeterminate neoplasms expressed desmin and muscle-specific actin as well as vimentin, but they lacked epithelial markers; these were categorized as leiomyosarcomas. Both PSCN were reactive for cytokeratin with each of three separate monoclonal antibody preparations. Desmin, actin, and vimentin were also observed in such lesions, but EMA was not. Because spindle cell proliferations may be difficult to interpret in routinely stained tissue sections, the additional information provided by immunohistochemical studies is helpful in establishing a diagnosis and separating biologically disparate lesions. PMID- 3284398 TI - A clinicopathologically distinctive primary splenic histiocytic neoplasm. Demonstration of its histiocyte derivation by immunophenotypic and molecular genetic analysis. AB - We describe a primary splenic neoplasm composed of cytomorphologically malignant appearing erythrophagocytic histiocytoid cells reminiscent of those seen in malignant histiocytosis. However, this neoplasm displayed certain distinctive clinicopathologic features--including localization to the spleen, where it grew as separate discrete nodules--that distinguish it from all previously reported cases of malignant histiocytosis. The cells expressed a monocyte/histiocyte immunophenotype and lacked clonal immunoglobulin and T-cell receptor beta-chain gene rearrangements. Our results suggest that this neoplasm represents a clinicopathologically distinctive and possibly unique tumor derived from the tissue macrophage lineage. PMID- 3284399 TI - Allergic reactions to raw, pasteurized, and homogenized/pasteurized cow milk: a comparison. A double-blind placebo-controlled study in milk allergic children. AB - Five children aged 12-40 months with IgE-mediated adverse reactions to cow milk (immediate onset clinical pattern of cow milk allergy) were orally challenged double-blind in random order with three different milk preparations processed from the same batch of milk 1) raw untreated cow milk, 2) pasteurized cow milk, 3) homogenized and pasteurized cow milk, and 4) Nutramigen (a commercial hypoallergenic infant formula based on hydrolysed casein) as placebo. Skin prick tests with the same preparations were also performed. On oral challenge the three different processed milk types provoked significant and similar allergic reactions in each child, and no adverse reactions followed the challenge with placebo (Nutramigen). Skin prick test with the same milk products were positive in all children and comparable to the results with an extract of purified raw cow milk protein (Soluprick), whereas Nutramigen did not elicit any skin reactions. A tendency towards a lower threshold of reaction and larger skin reactions induced by the processed milk preparations might indicate an increased ability of pasteurized and homogenized/pasteurized milk to evoke allergic reactions in patients allergic to milk. PMID- 3284401 TI - [Adsorption of insulin to the Perfusor systems]. AB - Using radioimmunoassay determination we examined the recovery rate of 100 units of regular insulin that had been added to 50 ml. of a carrier solution in a plastic Perfusor syringe. We measured the recovery rate with sodium chloride 0.9% as carrier and after adding albumin (10 g./l.) and gelatine (6 g./l. resp. 12 g./l.). An initial insulin loss of 26% (with albumin) to 37% (with gelatine) was followed by only a small loss (less than 9%) during the next 24 hours. We conclude from our results that it is unnecessary to add substances with high molecular weight in order to reduce insulin adsorption to Perfusor systems. PMID- 3284400 TI - [Postoperative pain therapy by transdermal fentanyl]. AB - INTRODUCTION: Several investigations have shown that constant rate infusions of opioids are highly effective in the provision of postoperative pain relief. However, such treatment require intravenous access, the availability of infusion pumps and adequate monitoring system. We have studied a transdermal fentanyl formulation (F-TTS, developed by ALZA Corporation, Palo Alto, USA) which should avoid these problems. METHODS: The study was performed in orthopaedic patients scheduled for hip arthroplasty. 40 patients were included consecutively in a double-blind parallel comparison of F-TTS (n = 20) and placebo (n = 20) patches. The patches were applied 0.5 hours prior to epidural anaesthesia and changed after 24 hours. F-TTS is designed to deliver fentanyl at the same rate of 75 micrograms/h. For 36 hours blood samples, pain scores, respiratory patterns and vital signs were collected frequently. Patients could have supplemental pethidine on demand (50 mg/2 h) if the pain relief was inadequate. RESULTS: Fentanyl blood concentrations increased (verum) during the 24 hours period (removal) and decreased slightly after that. At the end of the investigation (36 h) fentanyl concentration remained significantly elevated (about 60% of 24-hours value). F TTS provided good postoperative pain relief although 11 patients (of 20) required supplemental pethidine. Patients with F-TTS, however had very little pethidine compared to patients with placebo. Two patients (one of each group) had to be eliminated from the study due to severe respiratory depression or inadequate pethidine requirement respectively. The incidence of other side effects such as nausea, vomiting and micturition difficulties were similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284402 TI - Pain-free injection in infants. Use of a lignocaine-prilocaine cream to prevent pain at intravenous induction of general anaesthesia in 1-5-year-old children. AB - A randomised, placebo-controlled, double-blind study was undertaken in 111 children between the ages of 1 and 5 years to assess the efficacy of EMLA 5% cream in the alleviation of venepuncture pain at intravenous induction of general anaesthesia using 27-gauge needles. Pain assessment was made by an operating department assistant using both verbal rating scale and visual analogue scale methods. Seventy-five children, of whom 24 were premedicated, were treated with EMLA cream and 36 with placebo, 14 of whom were premedicated. Significantly lower pain scores were recorded in the children treated with EMLA cream (verbal rating scale: premedicated p less than 0.05, unpremedicated p less than 0.001; visual analogue scale: premedicated p less than 0.0005, unpremedicated p less than 0.0002). No variation in analgesia was found for application times between 30 and 300 minutes and there were no serious side effects. PMID- 3284403 TI - Use of negative pressure ventilation to facilitate the return of spontaneous ventilation. AB - Negative pressure ventilation was used to facilitate the return of spontaneous ventilation in 10 patients with severe, chronic respiratory disability. All patients had required tracheal intubation and intermittent positive pressure ventilation, and conventional weaning techniques had failed. Details of the method are described. It permits extubation before spontaneous ventilation can be sustained indefinitely and thus assists the return of normal speech, sleep pattern and nutrition. The lack of flexible control of ventilatory variables and absence of access to the trachea for sputum clearance limit its widespread application. PMID- 3284404 TI - Spinal haematoma following epidural analgesia. Report of a patient with ankylosing spondylitis and a bleeding diathesis. AB - A patient who developed an epidural haematoma with multifactorial aetiology (bleeding diathesis, ankylosing spondylitis, chronic alcoholism and acute pancreatitis) after epidural analgesia for pain relief is described. Our conclusion is that adequate laboratory screening of blood coagulation, including platelet count, should be carried out in this category of patient before attempted epidural blockade, the risks of which must be weighed against the benefits. The block should be allowed to wear off intermittently and repeated neurological assessment performed if an epidural catheter is used for repeated injections or for a continuous infusion of local anaesthetic. Neuroradiological examination should be carried out promptly if an epidural haematoma is suspected and surgical decompression performed without delay if the diagnosis is confirmed. PMID- 3284405 TI - Asystole not corrected by glycopyrronium. PMID- 3284406 TI - [Quality of buprenorphine and morphine as components of combined anesthesia]. AB - Perioperative effects of buprenorphine during and after combined anesthesia for gynecological laparotomies were compared to those of morphine. In a controlled, randomized study two similar groups of patients received flunitrazepam (0.016 mg/kg) and either buprenorphine (0.008 mg/kg) or morphine (0.333 mg/kg); all patients were ventilated with a N2O/O2-mixture. To maintain adequate anesthesia, additional injections of buprenorphine or morphine and a volatile anesthetic agent (enflurane, less than 1.0 vol.%) were administered as needed. In some patients in both groups the injection of thiopental (1-2 mg/kg) became necessary for induction of anesthesia. Hemodynamic parameters showed a slight but not significant increase during intubation and remained stable intraoperatively (Figs. 1 and 2). The frequencies of additional intraoperative injections of buprenorphine or morphine and modalities of enflurane administration were similar in both groups. Based on an awakeness score, recovery from anesthesia was similar in both groups (Fig. 3). All patients were pain-free for a long period postoperatively (pain score 1-2, duration 6-10 h) (Fig. 4). In both groups respiratory depression could be demonstrated by means of ventilatory CO2 response (Figs. 6 and 7). The respiratory depression was of no clinical importance and seems to have been due to the combination of a long-acting benzodiazepine with an opiate. There were no differences in the occurrence of nausea and vomiting in both groups. Buprenorphine seems to be an alternative to morphine in combined anesthesia. PMID- 3284407 TI - Medical decision making and decision analysis. PMID- 3284408 TI - Pulse meters and pulse oximeters. PMID- 3284409 TI - Monitoring other haemodynamic variables and oxygen consumption. PMID- 3284410 TI - Patient safety in the recovery room. PMID- 3284411 TI - Light scattering measurements of the gels of gelatin and acto heavy meromyosin solutions by sample rotation method. AB - The gelation processes of gelatin and acto heavy meromyosin solutions were investigated by a new method of light scattering. The sample was given a constant slow rotation around a vertical axis in a typical dynamic light-scattering setup. The measurements were made on solutions in which polystyrene latex spheres were added as the scattering probes. When a sample reached the gel state, the intensity of the light scattered from the sample fluctuated highly. The relative standard deviation of the intensity fluctuation has been shown to be a good measure of gelation. In addition, computer simulations of this scattering system were found to simulate well the experimental results. PMID- 3284412 TI - A simplified lysis method allowing the use of biotinylated probes in colony hybridization. AB - A method is described for the lysis of bacterial cells grown on nitrocellulose filters which allows the use of nonradioactive (biotin labeled) probes in colony hybridization. Used in conjunction with a colorimetric assay involving streptavidin and alkaline phosphatase this lysis method allows the detection of clones containing a target nucleic acid sequence. Sites of positive hybridization produce dark blue-purple signals, while nonreacting clones give very light blue signals. The occurrence of false-positive and background signals is minimal. With pBR322 as the target sequence it was possible to detect approximately 20 clones in the presence of 10(5) plasmid-free cells. It was also possible to detect low frequency plasmid-free cells in a population of clones containing the target sequence. PMID- 3284413 TI - Immunological detection of B-DNA to Z-DNA transition of polynucleotides by immobilization of the DNA conformation on a solid support. AB - We studied the B-DNA to Z-DNA transition of poly(dG-dC).poly(dG-dC) and poly(dG m5dC).poly(dG-m5dC) in the presence of NaCl using an enzyme immunoassay. The polynucleotides were coated on microtiter plates at varying concentrations of NaCl and treated with a monoclonal anti-Z-DNA antibody, Z22. The plates were subsequently treated with alkaline phosphatase conjugated polyvalent mouse immunoglobulins and the enzyme substrate, p-nitrophenyl phosphate. The color development due to the enzyme-substrate reaction was quantitated using a microplate autoreader. Our results show that the antibody does not recognize the polynucleotides in the B-DNA conformation and binds strongly to the Z-DNA conformation. A smooth transition curve is obtained at intermediate concentrations of the counterions. From the transition curves, we determined the concentration of the counterions at the midpoint of B-DNA to Z-DNA transition. The midpoint concentrations for poly(dG-dC).poly(dG-dC) and poly(dG-m5dC).poly(dG m5dC) are 2.3 and 0.74 M NaCl, respectively. Using the immunological method, we also examined the B-DNA to Z-DNA transition of poly(dG-m5dC).poly(dG-m5dC) in the presence of naturally occurring polyamines. The midpoint concentrations of the polyamines are as follows: putrescine, 2.5 mM; spermidine, 34 microM; spermine, 1.8 microM. The midpoint values determined by the enzyme immunoassay are in good agreement with those determined by circular dichroism and ultraviolet absorption spectroscopic measurements. These results demonstrate that immobilization of a preexisting conformation or a mixture of conformations of DNA on a solid support followed by a titration of the DNA conformations using a monoclonal anti-DNA antibody is an excellent method to study the conformational dynamics of DNA. PMID- 3284415 TI - An assay for the detection of superoxide dismutase in individual Escherichia coli colonies. AB - A method for detecting superoxide dismutase activity in individual colonies of Escherichia coli was developed. The assay involves the lysis of individual cells in colonies on filter papers by a series of lysozyme, chloroform, and freeze-thaw treatments. Filters are placed on agar plates to allow diffusion of cellular enzymes into a solid matrix. A nitroblue tetrazolium overlay is applied to detect superoxide dismutase activity. Colonies possessing activity produce achromatic zones against a dark Formazan background. The assay can detect the presence of superoxide dismutase and the relative amount of enzyme as well. This assay provides a method for screening a population of cells for mutants deficient in or overproducing superoxide dismutase. PMID- 3284414 TI - Screening of monoclonal antibodies using antigens labeled with acetylcholinesterase: application to the peripheral proteins of photosystem 1. AB - An original immunoenzymatic screening method, based on the use of antigens labeled with the stable enzyme acetylcholinesterase (AChE, EC 3.1.1.7), is described. The high turnover of this enzyme results in a very sensitive detection of antibodies. In this method, monoclonal antibodies from the supernatants of hybridoma cultures are immobilized on a solid phase coated with anti-mouse immunoglobulins and react simultaneously with the appropriate antigen labeled with biotin molecules. In a second step, biotinylated acetylcholinesterase is in turn associated to the system via avidin interactions and subsequently detected by a colorimetric assay. The method appears more sensitive and easier to use than either the corresponding radioimmunological test using a 125I-iodinated antigen or the same type of enzymatic immunoassay performed with biotinylated horseradish peroxidase instead of biotinylated AChE. The combined use of microtiter plates, solid-phase separation, and colorimetric detection allows a high level of automation of the method which makes it very efficient to process a large number of samples. This technique has been successfully applied to the screening of monoclonal antibodies directed against peripheral proteins of the photosystem 1 (PS1) membrane complex in photosynthesis. A complete set of antibodies recognizing these PS1 components was selected. The same technique was also tested in competition immunoassays and appears to be a very precise and useful tool for quantifying PS1 polypeptides in different biological extracts, including sodium dodecyl sulfate-denatured membranes. This can be of special interest for studying the biogenesis of membrane complexes. PMID- 3284416 TI - Ultrastructure of the main excretory duct epithelia of the rat parotid and submandibular glands with a review of the literature. AB - The fine structure of the main excretory duct (MED) epithelia of the rat parotid and submandibular glands was investigated by scanning and transmission electron microscopy. The structure of these two MED epithelia was compared. Five principal cell types were observed in the MED epithelium of the parotid gland--cuboidal, basal, light (types I and II), dark, and tuft cells. The cuboidal cells, which were stratified in two or three layers, were the most numerous. Basal cells were situated adjacent to the basal lamina of the epithelium. The type I light cells had well-developed basal plasma membrane infoldings. The type II light cells had poorly developed basal plasma membrane infoldings. The dark and tuft cells resembled those of the MED epithelium of the rat submandibular gland. Four principal cell types were observed in the MED epithelium of the submandibular gland--light cells (types I and II), dark, tuft, and basal cells. The two types of light cells were the most numerous. Dark cells with regular and dense microvilli were relatively narrow in shape and had complicated basal plasma membrane infoldings. There were numerous vesicles or channel-like vesicles in their apical cytoplasm. Tuft cells were characterized by prominent microvilli, many vesicles of various sizes in the apical cytoplasm, and no basal infoldings. Peroxisomes were present in the MED epithelia of the rat parotid and submandibular glands, especially in light and cuboidal cells. PMID- 3284417 TI - Effects of various insulin dosages on hepatic lipogenesis. AB - Insulin treatment of diabetic rats fed a high-carbohydrate, fat-free diet produces a dramatic accumulation of hepatic lipids. However, this increase in hepatic lipids may only be a response to injections of exceptionally high doses of insulin. This study addresses this possibility. Alloxan-diabetic rats, fed a high-carbohydrate, fat-free diet, were given insulin every 12 h for 60 h at the following dosages: 1/2 unit each, 1 unit each, 2 units each, and 4 units each of regular and NPH insulins. At the end of the treatment period, liver samples were collected and used for morphological and biochemical analyses. Histologic examination revealed hepatic lipid accumulations at all insulin doses; the amount of lipid increased until maximal levels were reached at an insulin dosage of 1 + 1, which was maintained at doses of 2 + 2 and 4 + 4. Thus, hepatic lipid accumulation occurs regardless of the dosage of insulin administered to the diabetic animal. It is not simply an abnormal cellular response to excessive hormone levels. Similarly, the activity of the hepatic lipogenic enzyme, malic enzyme, increased at initial insulin dosages and reached maximal levels at 2 + 2. However, in contrast to lipid accumulation, enzyme activity decreased at the final insulin dosage of 4 + 4. Thus, there appears to be a direct relationship between increasing insulin levels and malic enzyme activity until an optimal insulin concentration is reached. After this point, excessive insulin levels do inhibit malic enzyme activity. PMID- 3284418 TI - Q and non-Q wave myocardial infarction: current views. AB - The new terminology "Q and non-Q wave myocardial infarction" (MI) tends to replace the traditional terms "transmural" and "subendocardial" MI since the anatomy cannot be accurately predicted by electrocardiography. Although some subtypes of non-QMI display a favorable early or in-hospital prognosis, the long term outlook seems less benign, particularly when early or late recurrence of MI occurs. Coronary arteriograms show an equal number of diseased vessels in both types of MI, but complete coronary artery occlusion is less frequent in non-QMI. The management of patients with non-QMI should be mainly directed to preventing extension or recurrence of MI by using either drugs such as thrombolytic agents and drugs against coronary artery spasm or invasive techniques like percutaneous transluminal coronary angioplasty. PMID- 3284419 TI - Continuous-wave Doppler of vertebral arteries in noninvasive diagnosis and management of vertebro-basilar TIAs. AB - Continuous-wave Doppler and angiography of the vertebro-basilar system were used in 38 patients with vertebro-basilar transient ischemic attacks. 63 vertebral arteries were studied. Among 47 normal Doppler parameters, 46 were confirmed by angiography. The sonographic diagnostic procedure showed a very high negative predictive value (97.87%), while the positive predictive value was relatively low (56.25%). Data from literature were reviewed. The authors suggest that when Doppler of vertebral arteries is negative, there is a very low probability that a follow-up angiography will reveal pathologic conditions calling for a surgical approach. PMID- 3284420 TI - [Mechanical methods of treating refractory cardiac failure]. AB - Mechanical means tend to be used more frequently nowadays for the treatment of congestive heart failure which does not respond to more normal treatment. The indications and limits of such devices, as well as their cost, must be defined. The new problem created by these therapeutic tools is the evolution of the underlying cardiac disease: should it improve the patient will be weaned from the machine, whereas if it worsens heart transplantation would be the only answer. Three types of mechanical support are described. Balloon pumping, and especially intra-aortic balloon pumping, is the technique used most often. It has a true but limited efficacy. Its best indication is cardiogenic shock by left ventricular ischaemia with normal or slightly increased peripheral resistances. Intrapulmonary balloon pumping is occasionally used, but the system can only be set up surgically. Its best indication would seem to be right-sided heart failure by pulmonary hypertension. Circulatory assistance is the second type considered. All types of bypass pumps can be used. The output used is usually less than the patient's theoretical output, the aim being to allow the myocardium to recover. Vascular access for these pumps is either femoral or intrathoracic. An oxygenator may or may not be added to the bypass circuit, and support may be mono- or biventricular. Although the non pulsatile flow has not been shown to be detrimental, this has to be investigated further. The use of these devices is limited by their effects on blood coagulation and pulmonary function. The artificial heart or artificial ventricles are the last devices described.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284421 TI - [Prolongation of spinal anesthesia with hyperbaric bupivacaine by adrenaline and clonidine in the elderly]. AB - So as to determine the effects of vasoconstriction on the duration of hyperbaric bupivacaine spinal anaesthesia, a prospective controlled study was carried out on 80 ASA class II or III patients, aged 75 years or more, who were scheduled for spinal anaesthesia for lower limb surgery. They were randomly allocated to four groups, and were each given 3 ml (15 mg) of 0.5% bupivacaine in plain solution with 0.5 ml of 30% dextrose solution, together with 1 ml normal saline in group I, 0.15 mg clonidine in group II, 0.2 mg adrenaline in group III, and 0.4 mg adrenaline in group IV. All patients therefore received 4.5 ml of 0.33% bupivacaine solution in 3.3% dextrose solution. The injection was made in the lateral position, and the patients turned supine immediately afterwards. The segmental level of sensory loss was tested using forceps. The time course required for maximal spread of the sensory blockade did not differ in the four groups. No difference was observed between median highest levels of sensory analgesia. Adding 0.15 mg clonidine or 0.4 mg adrenaline significantly prolonged mean times for two- and four-segment regression and mean times for regression to L2 level. The addition of 0.2 mg adrenaline only prolonged the mean regression time to L2 level. Regression times tended to increase more with 0.4 mg than with 0.2 mg adrenaline. Significant prolongation of motor block was also associated with the addition of vasoconstrictors. It is concluded that addition of 0.15 mg clonidine or 0.4 mg adrenaline may be useful to increase duration of hyperbaric bupivacaine spinal anaesthesia in elderly patients. PMID- 3284422 TI - Pneumatic anti-shock garment: state of the art 1988. AB - The responses of hypovolemic patients would be expected to be similar to experimental animals that were hypovolemic. Normovolemic patients would be expected to respond as do the normovolemic experimental animals. Hypovolemic patients do not necessarily respond the same as do normovolemic patients or volunteers. The amount of external pressure applied by the device is directly proportional to the amount of tissue pressure increase. Tissue pressure is transmitted to the vessel as reduction transmural pressure, or in change in the size of the vessels and subsequent increase in SVR. Patient response to external pressure varies with the amount of device pressure. The optimal pressure of the PASG is in the range of 60 to 80 torr. Although exceeding this value does not appear to be necessary, it is not harmful in the short term (less than 90 minutes). Using less pressure reduces the SVR and, therefore, the blood pressure response. Keeping the external pressure at approximately 40 torr appears to be ideal for hemorrhage control. Of the more than 300 articles that have appeared in the recent literature addressing the PASG, at least 190 have discussed specific scientific experiments in the animal laboratory, in the human laboratory, or in the clinical environment, in which results gathered addressed how, why, or if the PASG worked. These studies demonstrate that the PASG does, in fact, improve blood pressure, control hemorrhage, improve carotid and upper body blood flow, improve the ability of the prehospital provider to start IV lines, and improve survival (particularly short-term) with few hospital and even fewer prehospital complications. The device produces its blood pressure response by improving preload, increasing SVR, and mobilizing some blood (500 to 1,000 mL) to the upper body compartment above the device. These responses are most probably produced by decreasing the radius of the vessels compressed by the device, decreasing the compartment volume, and differentially affecting the blood flow without and within the device. Hemorrhage is controlled by increasing the external pressure on the vessel by the transmitted increased tissue pressure, reducing the vascular lumen, and reducing the area of the laceration. Short-term survival is improved by decreasing intra-abdominal hemorrhage and improving perfusion (maintaining better oxygenation in the heart-brain-lung circulation.) Long-term survival is improved because the device controls hemorrhage, maintains blood pressure, and allows delivery of the severely injured patient to the trauma center and within the hospital while awaiting an OR, as in the case of a leaking aortic aneurysm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3284423 TI - The subliminal psychodynamic activation method. A critical review. PMID- 3284424 TI - [Anatomo-clinical conference. Pitie-Salpetriere Hospital. Case n. 1-1988. Degradation of the respiratory function in a patient followed for severe sarcoidosis]. PMID- 3284425 TI - Upregulation of striatal dopamine receptors and improvement of motor performance in senescence. PMID- 3284426 TI - Intracerebral neuronal grafting in experimental animal models of age-related motor dysfunction. AB - The combined morphological, biochemical, electrophysiological, and behavioral data summarized above show that implanted embryonic nerve cells in some cases can substitute quite well for a lost intrinsic neuronal system in mammals. The intracerebral implants probably exert their effects in several ways. The functional effects seen with grafts placed into one of the cerebral ventricles (such as those described in the studies of Perlow et al., Freed et al., and Gash et al.) are thus probably explained on the basis of a diffuse release of an active amine or peptide into the host CSF and adjacent brain tissue. In other instances, as in animals with DA-rich grafts reinnervating the neostriatum, we believe that the available data provide quite substantial evidence that the behavioral recovery is caused by the ability of the grafted neurons to reinnervate relevant parts of the host brain. This is illustrated by the studies mentioned above that show that the degree of functional recovery in 6-OHDA lesioned rats with nigral transplants is directly correlated with the extent of striatal DA reinnervation and that the "profile" of functional recovery is dependent on that area of the striatal complex that is reinnervated by the graft. This point is particularly well illustrated in a further study in which rats with electrodes implanted into the center of intracortical nigral grafts were allowed to "self-stimulate" via the graft. The results show that the graft can indeed sustain self-stimulation behavior and that the rate of lever-pressing is related to the proximity between the electrode tip and the DA-containing neurons in the graft. This strongly supports the notion that the implanted DA neurons can transmit behaviorally meaningful and temporally organized information to the host brain via their efferent connections. To what extent the intracerebral implants can be functionally integrated with the host brain is still poorly known, though, and it therefore remains an interesting question for further investigation. The chances for extensive integration may be greatest for neuronal suspension grafts implanted as deposits directly into the depth of the brain, but even solid grafts inserted as whole pieces into the brain have, in several cases, been seen to become reinnervated from the host brain in adult and developing recipients. Nevertheless, a recent HRP study failed to detect any host afferents to intracortical solid nigral grafts, despite the fact that these grafts had themselves formed extensive DA connections in the host striatum and had produced behavioral recovery.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3284427 TI - Neurodegenerative disorders and aging. Alzheimer's disease and Parkinson's disease--common ground. PMID- 3284428 TI - [Neonatal respiratory distress and congenital pulmonary lymphangiectasis. Apropos of a case and review of the literature]. PMID- 3284429 TI - [Multicenter comparative study of a new formulation of pancreatin in gastro resistant microgranules for the treatment of exocrine pancreatic insufficiency in children with mucoviscidosis]. PMID- 3284430 TI - [Hormones and pulmonary maturation]. PMID- 3284431 TI - [Intravenous furosemide during renal scintigraphy with TC-99M DTPA]. PMID- 3284432 TI - [Study of the functional role of phospholipids in pulmonary surfactants. Importance in perinatology]. PMID- 3284433 TI - Is topical application of epinephrine at skin graft donor sites during halothane anesthesia safe? AB - Topical epinephrine is useful in controlling the bleeding of skin graft donor sites. However, the use of exogenous epinephrine during halothane anesthetization increases the risk of cardiac arrhythmias. This study shows that there is no significant increase in plasma epinephrine levels after topical administration of up to 80 cc of 1:500,000 epinephrine, suggesting that the use of this dose in conjunction with halothane anesthesia is safe. PMID- 3284434 TI - Use of the latissimus dorsi and the serratus anterior muscles as a combined flap. AB - Flaps composed of the latissimus dorsi and the serratus anterior muscles have been used to repair extensive defects in 10 patients with no remarkable disabilities of shoulder function. The latissimus dorsi and serratus anterior muscles are consistently nourished through the subscapular-thoracodorsal vessels. Thus, the 2 flaps can be based on 1 vascular pedicle. If required, the ribs beneath the serratus anterior muscle, which are vascularized by the periosteal circulation, can be transferred with the muscle. The vascular pedicle of this flap is long and anatomically reliable. Care must be taken to avoid tension or torsion of the pedicle when positioning the flap. PMID- 3284435 TI - Detailing the human tail. AB - There have been 23 true vestigial tails reported in the literature since 1884. A new case is described, and its magnetic resonance imaging and pathological features are presented. A review of the literature and analysis of the pathological characteristics reveal that the vestigial human tail may be associated with other abnormalities. Vestigial tails contain adipose and connective tissue, blood vessels, and nerves and are covered by skin. Bone, cartilage, notochord, and spinal cord elements are lacking. Tails are easily removed surgically without residual effects. Since 29% (7 of 24) of the reported tails have been associated with other malformations, careful clinical evaluation of these patients is recommended. PMID- 3284436 TI - Repeated tissue expansion in reconstruction of a huge combined scalp-forehead avulsion injury. AB - A 29-year-old woman sustained a severe combined forehead-scalp avulsion injury (20 X 17 cm) in an automobile accident 4 years ago. The skull was covered with split skin-grafts. The defect was successfully removed by the use of simultaneous and repeated tissue expansion of the normal occipital area and the remains of the forehead. The case illustrates the possibility of using large expander volumes (1,700 cc) in the head area and the fact that even narrow skin bridges (2.0 cm above the left eyebrow) can be expanded. The expander shape can be chosen to create a desired flap size and form. Finally, hair thickness and growth can be quite acceptable even after huge expansions of the scalp. PMID- 3284437 TI - Looking back, looking forward. PMID- 3284438 TI - Tachykinins. PMID- 3284439 TI - Topography of cognition: parallel distributed networks in primate association cortex. PMID- 3284440 TI - Animal solutions to problems of movement control: the role of proprioceptors. PMID- 3284441 TI - Sexually dimorphic behaviors. AB - Sex differences in behavior are the result of natural and sexual selection. The dimorphic classes of behavior described here, courtship, copulatory, and parental behaviors, reflect both kinds of evolutionary selective pressures. We can further distinguish two kinds of mechanisms that produce differences in male and female behaviors. In one, both sexes can perform a behavior but one does not because of sex differences in the external stimuli or the endocrine milieu. Maternal behavior in rodents falls into this category, as do certain other reproductive behaviors. In the other, the sensory, CNS, or motor components that produce behaviors are different in males and females. Many courtship and copulatory behaviors are in this category. I have considered some cellular mechanisms that generate sex differences in behavioral effector neurons, including sensitivity to hormones, cell number, and synaptic connectivity. A common feature of many such systems is a degree of developmental arrest: sexually dimorphic, hormone sensitive neurons or muscles are immature at stages when other cells have completed differentiation. The cellular and molecular processes whereby hormones harness the developmental programs of behavioral effector cells remain largely unknown and are the focus of active investigation. PMID- 3284442 TI - Anatomical organization of macaque monkey striate visual cortex. AB - I hope that this review of the internal anatomy of the monkey primary visual cortex makes clear the high degree of specialization that exists in each of the cortical laminae and their constituent neurons. Each lamina is driven by different patterns of relays from the LGN and by different patterns of intrinsic interlaminar projections. The elaborate laminar and intralaminar segregation of efferent neuron arrays suggests that the extraordinary precision of inter- and intralaminar connectivity provides a unique functional role for each set of efferent neurons. The organization of aspinous (presumed inhibitory) local circuit neurons suggests that they are highly specialized, and within each lamina and via interlaminar relays each variety may only accomplish a single, particular task. The cortex neuropil does not give the immediate impression of "random" networks, and if such exist, they must surely be between very tightly determined subgroups of neurons. Clearly a very detailed physiological exploration of V1 is still needed, with new consideration of thalamic axon function, of efferent neuron characteristics, of laminar differences, and of spatial organization of properties within laminae, in order to match known anatomical detail with function. The concept of columnar organization in cortical organization of V1 may eventually be redefined in more complex terms that accurately describe the anatomical and functional parcellation evident in cortical depth and perhaps may link it to a means by which a correlation of different aspects of the visual image is achieved. PMID- 3284443 TI - Formation of topographic maps. AB - The catalogue of data presented here form many systems demonstrates that multiple mechanisms are involved in the formation of topographic maps. We are not yet in a position to explain why a particular mechanism appears to dominate in some situations and not in others. Certain generalizations can be made, however. First, at least some form of chemospecificity can be invoked to help explain connectivity in all of the experiments we have cited. Often, the differential identities of a population of neurons can be reflected in an orderly pattern of axon outgrowth and in the actively maintained preservation of neighbor relations as the axons grow toward their targets; such orderly arrangements are not obligatory, but, where present, they facilitate the speedy establishment of orderly maps when the axons reach their target nuclei. Within a terminal zone, chemospecific cues may dominate and constrain a given axon to terminate in a specific location, but axon-axon interactions commonly supercede chemospecific matching. At least two forms of axon-axon interaction occur, one based on some sort of biochemical properties related to the axon's embryological identity and another based on the axons' electrical activity. Tasks for the future are to identify the cellular bases of each of these mechanisms and to understand the situations in which each is manifested. PMID- 3284444 TI - Microtubule-associated proteins: their potential role in determining neuronal morphology. PMID- 3284445 TI - Behavioral studies of Pavlovian conditioning. PMID- 3284446 TI - Transgenic mice: applications to the study of the nervous system. PMID- 3284447 TI - The control of neuron number. AB - In comparing strategies used to control neuron number, we find it useful to view nervous system development as occurring in three phases. The phases overlap--each is a process, not an event. The first phase is the development of a genetic nervous system. This is a nervous system of simple genetic intention, not a blueprint or pile of bricks. Its characteristics are abstract: How many neurons in this stem cell destined to produce, which cells are programmed to die, how much target does this cell need to survive. At the level of the individual, the genetic nervous system is essentially fixed, but over generations it is fluid. As this genetic intent interacts within a world of cells, a real brain appears. A new set of rules only tacitly present in the genome is expressed--the embryonic nervous system emerges. The interaction of its parts defines the shape and size of the nervous system. Neuron numbers are adjusted interactively by changes in proliferative potential and the severity of cell death. Cell fates are established in part through interactions with other cells and with hormones. Glial cell numbers are adjusted to match the neuron populations. This phase of brain development is what the embryologist sees under the microscope. The third and final phase of development begins when the brain starts to function and the animal starts to deal with its world. Small changes in neuron number may occur during this period, but these changes are generally of minor functional importance. At this point, the smaller elements of neuronal organization are refined in shape, number, and distribution. Axons are lost or rearranged; dendrites grow, branch, and retract; synapses are fine-tuned; and finally, receptor densities and transmitter titres are adjusted. Some of these interactions and numerical adjustments continue until the animal dies. PMID- 3284449 TI - Neuroethology of electric communication. PMID- 3284448 TI - 5-Hydroxytryptamine receptor subtypes. PMID- 3284450 TI - [Proximal migration of a caval filter. Apropos of a case]. AB - We are reporting of proximal migration, intracardiac, of a percutaneous caval filter (LEM type), resulting in the death of the patient. It is a true, early (1st week) migration after accurate positioning, opposite L4, and not an incident of insertion. PMID- 3284451 TI - [New inotropic drugs in chronic cardiac insufficiency: progress or wrong track]. AB - The first results of the long-term treatment of chronic heart failure with inotrope positive medications are disappointing, especially in that survival is not prolonged and even a greater mortality is suggested. Is it because of the regular failure of specific medications, of a class of medications or because the overall concept of inotropism stimulation during chronic heart failure should be condemned? The mechanisms of inotropism of normal muscles or muscles in human chronic heart failure are reviewed as well as the various pharmacological means available to stimulate inotropism. PMID- 3284452 TI - Characterization of a new permanent squamous carcinoma line from human lung B 109. AB - A permanent squamous carcinoma cell line was established from human lung. The cells exhibit good growth characteristics in vitro and in nude mice. Many marker chromosomes were detected. Histological examination and electron micrographs of B109 revealed at least two morphologically different subpopulations. The presence of steroid receptors and tumor associated antigens defined by monoclonal antibodies is discussed with regard to previously published results. PMID- 3284453 TI - Effects of benzamidine derivatives on Ha-ras-1 mRNA accumulation in a Chinese hamster cell line transformed with the activated human T24 Ha-ras-1 oncogene. AB - Tetra benzamidine derivatives were found to inhibit proteinase activity, cell proliferation and accumulation of the Ha-ras-1 mRNA in the FHO6T1-1 Chinese Hamster cell line, transformed with the activated human T24-Ha-ras-1 oncogene. Di and Tri-benzamidine derivatives were also found to be potent inhibitors of proliferation of FHO6T1-1 cells. These latter compounds could be proposed as useful substrates in the synthesis of drug-conjugated monoclonal antibodies or growth factors. PMID- 3284454 TI - In vitro assay to demonstrate high-level erythromycin resistance of a clinical isolate of Treponema pallidum. AB - We have previously demonstrated that cells of Treponema pallidum freshly extracted from infected rabbit testes can be intrinsically radiolabeled with [35 S]methionine to very high specific activities. In this study we used the inhibition of [35 S]methionine incorporation into trichloroacetic acid precipitable protein in vitro as an assay to test the susceptibilities of three different pathogenic treponemal strains to various antibiotics. In general, the results correlated very well with the known efficacies of these antibiotics in treating human patients with syphilis. One of the strains tested, however, a clinical isolate of T. pallidum designated street strain 14, was found to exhibit high-level resistance to erythromycin and a closely related macrolide, roxithromycin (RU 965). Street strain 14 was originally isolated from a human patient with active secondary syphilis who failed to respond to erythromycin therapy. Thus, our results indicate that an erythromycin-resistant strain of T. pallidum can be responsible for erythromycin treatment failure. In addition, street strain 14 treponemes were found to be generally less susceptible by this assay to a variety of antibiotics than were treponemes of the T. pallidum Nichols strain. These findings suggest that the outer envelope of street strain 14 treponemes may be generally less permeable to antibiotics than is that of Nichols strain treponemes. PMID- 3284455 TI - Activity of a combination of three cinchona bark alkaloids against Plasmodium falciparum in vitro. AB - In vitro studies with quinine, quinidine, cinchonine, and cinchonidine showed that despite a similarity of chemical structure, the effectiveness of these cinchona bark alkaloids against several culture lines of Plasmodium falciparum varied widely. Depending on the strain tested, quinidine and cinchonine were 1 to 10 and 1 to 5 times, respectively, more active than quinine. A combination made of equal parts of quinine, quinidine, and cinchonine was found to have several interesting features; it had activity similar to that of quinine against quinine susceptible strains but was found to be 2 to 10 times more effective against strains resistant to quinine and had a more consistent effect than any of the alkaloids used singly. The potentiation was found to depend mainly on the presence of cinchonine in the mixtures studied. Synergism was also confirmed in a study of 25 P. falciparum strains isolated from Thai patients. Combinations of cinchona bark alkaloids could thus be of interest in areas where P. falciparum is becoming less susceptible to quinine. PMID- 3284456 TI - Role of pharmacokinetics in the outcome of infections. PMID- 3284457 TI - Effect of protein binding on serum bactericidal activities of ceftazidime and cefoperazone in healthy volunteers. AB - The effect of protein binding on antibiotic efficacy is controversial. The pharmacologic effect of an antibiotic is believed to be related to its unbound concentration at the site of infection. It is unknown whether antibiotics with a low degree of serum protein binding are clinically superior to antibiotics that are highly protein bound. In a randomized, crossover investigation, the serum bactericidal activities of a single dose of ceftazidime (30 mg/kg) and cefoperazone (30 mg/kg) were studied in six healthy volunteers against three clinical isolates of Pseudomonas aeruginosa for which both antibiotics had similar MICs and MBCs. Serum samples were collected over 12 h. The total and unbound antibiotic concentrations were determined by high-pressure liquid chromatography. Mean peak total concentrations of ceftazidime and cefoperazone in serum were 101.7 +/- 18.6 and 264.1 +/- 149.6 micrograms/ml, respectively. Due to its lower protein binding (21 +/- 6%), ceftazidime had significantly higher unbound concentrations in serum than did the highly bound cefoperazone (91.5 +/- 2%). Mean peak unbound concentrations were 78.5 +/- 12.5 and 24.2 +/- 17.8 micrograms/ml for ceftazidime and cefoperazone, respectively. The unbound concentration of ceftazidime at each sampling time was higher than that of cefoperazone. Although total concentrations were consistently higher than the MICs, serum containing cefoperazone showed minimal bactericidal activity against the isolates. In contrast, despite lower total concentrations, ceftazidime had greater antibacterial activity than cefoperazone. Serum bactericidal activity was more closely related to unbound rather than total antibiotic concentrations. Our data support the concept that only the unbound drug is microbiologically active. PMID- 3284459 TI - Antibacterial activities of fluorovinyl- and chlorovinylglycine and several derived dipeptides. AB - The in vitro antibacterial activities of several halovinylglycine compounds and their L-norvalyl peptide derivatives are presented. The most potent of them, L norvalyl-L-chlorovinylglycine, displayed good activity against gram-positive organisms, including methicillin-resistant Staphylococcus species. Chlorovinylglycine is an efficient inhibitor of alanine racemase, but the antibacterial activity of L-norvalyl-L-chlorovinylglycine may involve other physiological targets as well. PMID- 3284458 TI - Enzyme immunoassay to assess effect of antimicrobial agents on Toxoplasma gondii in tissue culture. AB - Toxoplasma gondii grown on MRC5 fibroblasts in 96-well tissue culture plates was tested for susceptibility to five antimicrobial agents. T. gondii growth was quantitated by an enzyme-linked immunosorbent assay, which was performed directly on the fixed cultures, using a rabbit anti-T. gondii immunoglobulin G as the first antibody and a phosphatase-labeled anti-rabbit immunoglobulin G as the second antibody. Optical density values were highly correlated with the number of T. gondii organisms in the Giemsa-stained cultures (r = 0.89), and an enzyme linked immunosorbent assay was used to assess the effect of antimicrobial agents at various concentrations. For each drug, regression models were used to quantify the relationship between optical density values and antimicrobial agent concentrations in the cultures. A significant inhibitory effect was found with pyrimethamine and sulfadoxine for concentrations greater than or equal to 0.05 and 30 micrograms/ml, respectively. With spiramycin, a progressive increase in inhibition of T. gondii was observed for increasing concentrations from 1 to 100 micrograms/ml. Ornidyl (difluoromethylornithine) and (2R,5R)-6-heptyne-2,5 diamine, which are ornithine decarboxylase inhibitors, were found to have a marked inhibitory effect for concentrations greater than or equal to 25 and 2 mM, respectively. This proposed method was sensitive and easy to perform and does not require the use of radiolabeled compounds; since it allows experimental design on replicate cultures and can be partially automated, it thus may prove useful for the systematic screening of the activity of new compounds against T. gondii. PMID- 3284460 TI - Interference with effects of amphotericin B on Candida albicans cells by 2 chloroethyl-1-nitrosoureas. AB - Two nitrosoureas, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) and 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU), with strong carbamoylating and weak alkylating activities, interfered with the induction of potassium leakage and lethal action of amphotericin B (AmB) on Candida albicans. 2-Cyclohexyl isocyanate, the product of decomposition of CCNU, and 2-chloroethyl isocyanate, the product of decomposition of BCNU, also interfered with the anticandidal actions of AmB. In contrast, two nitrosoureas with weak carbamoylating and strong alkylating activities, 1-(2-chloroethyl)-3-(2,6-dioxo-3-piperydyl)-1-nitrosourea and 2-[3-(2-chloroethyl)-3-nitrosoureido]-D-glucopyranose, did not affect AmB action against C. albicans. These results indicate that the inhibitory action of CCNU and BCNU on the anticandidal effects of AmB is associated with the carbamoylating activity of these nitrosoureas. PMID- 3284462 TI - Hypospadias repair. Preoperative preparation, intraoperative techniques, postoperative care. AB - The location of the defect and the need for surgery causes these children and their parents more emotional concern than the actual defect. Voiding usually prevents no problem, especially because they are still in diapers. Children this age are not affected by an altered body image, but their parents' are concerned about their children having an acceptable physical appearance and adequate future sexual competency. These fears can be transmitted to the children. It is important to communicate with the parents and the children about realistic expectations of the surgery--this will help avert problems later problems. The overall success rate to correct hypospadias is approximately 85%. The goals of hypospadias repair are restoration of normal urination, relief of chordee, assurance of a sexually adequate penis, and placement of the urethral meatus at the tip of the glans penis. A successful surgery will enable the child to void in the standing position by voluntarily directing the stream in the usual manner. PMID- 3284463 TI - Glycyl-tRNA synthetase of Escherichia coli: immunological homology with phenylalanyl-tRNA synthetase. AB - Antibodies to Escherichia coli glycyl-tRNA synthetase (GlyRS) cross-react extensively with E. coli phenylalanyl-tRNA synthetase (PheRS). These data indicate that structural homology exists between these two enzymes, the only two aminoacyl-tRNA synthetases in E. coli having an alpha 2 beta 2 subunit structure. Although only limited similarities are found in the protein sequences deduced from their known gene sequences, the presence of common epitopes in GlyRS and PheRS adds to a rather long list of physical and chemical similarities between those proteins. In addition, antibodies directed at the alpha- and beta-subunits of GlyRS inhibit both GlyRS and PheRS in the same relative manner, indicating that the function as well as the structure of subunits is similar in each enzyme. In contrast, GlyRS antibodies did not cross-react with a number of other aminoacyl-tRNA synthetase activities from E. coli, yeast, or Bacillus. PMID- 3284461 TI - Influence of cephalosporins and iron on surface protein antigens of Klebsiella pneumoniae in vivo. AB - The outer membrane protein (OMP) profiles of Klebsiella pneumoniae grown in a rabbit peritonitis model in the presence or absence of cephalosporins were investigated. Six high-molecular-weight OMPs (Mr 69,000 to 83,000) were induced under iron-depleted conditions in vitro. Three of these proteins (the 69,000-Mr protein [69K protein] and the 70K and 78K proteins) and trace amounts of the 73K and 75K proteins were induced in the OM of bacteria infecting the peritoneal cavity of rabbits. Addition of iron either to the growth medium in vitro or to the peritoneum in vivo repressed the expression of these proteins. Cephaloridine had no significant effect on the OMP profiles. An additional 56,000-Mr protein was observed in the OM of bacteria cultivated in vivo in the presence of CGP 17520 and also to a lesser extent in vivo under conditions of iron excess. A difference in recognition of OM antigens between cells grown in vitro and in vivo was observed by immunoblotting techniques. The 26K, 27.5K, and 28.5K antigens present in the OM of cells grown in vitro (but not in vivo) were recognized by antibodies raised against bacteria cultivated in vitro under conditions of iron depletion, but were not recognized by antisera raised against bacteria harvested directly from infections. Antisera raised against a nonencapsulated K. pneumoniae strain caused no agglutination of encapsulated K. pneumoniae grown in vivo in the absence of cephalosporins. Rapid agglutination was observed with this antiserum when the same encapsulated strain was grown in vivo in the presence of either cephalosporin, indicating less occlusion of critical antigens by the capsule. PMID- 3284464 TI - Proteolysis as a probe of ligand-associated conformational changes in rat carbamyl phosphate synthetase I. AB - Elastase, V8 protease, subtilisin, trypsin, and chymotrypsin all cleaved the 1462 residue polypeptide of rat carbamyl phosphate synthetase I in segment C 160-180 residues from the COOH-end. Its activator N-acetylglutamate (AcGlu) increased the rate of cleavage approximately ninefold, presumably by binding preferentially to the conformation in which C is exposed. ATP/Mg2+ prevented proteolysis both +/- AcGlu. Kd,app for AcGlu (66 microM) and ATP (4.2 microM with AcGlu and 5 mM Mg2+) was estimated from the pseudo-first-order rate constants for inactivation caused by cleavage with elastase at C. Chymotrypsin and trypsin also hydrolyzed the enzyme, independent of AcGlu, at site D within less than 20 residues of the COOH end. D was protected by ATP only in the presence of AcGlu and K+, and enzyme hydrolyzed exclusively at D had greater than 30-fold higher Km's for AcGlu and ATP. Digestion by trypsin at a third site (B) approximately 530 residues upstream from C appeared to occur subsequent to hydrolysis at C. Slow cleavage by elastase at an additional site (A) to give 360- and 1100-residue peptides was unaffected by AcGlu and ATP, and caused only modest loss of activity. These peptides were isolated by chromatography on DEAE-cellulose. Assignment of the smaller one to the NH2-end on the basis of its cysteine content places site A in the junction between the segments homologous to the small glutaminase and large synthetase subunits of Escherichia coli carbamyl phosphate synthetase II. Neither peptide alone was active; maximal regain of activity (approximately 25%) occurred on combining them in equimolar proportions. The sizes of the peptides produced by further digestion of the site A digest gave the approximate locations of the other sites. Sites A (Ala-417) and B (Arg-787) have recently been identified by NH2-terminal sequencing (S. G. Powers-Lee and K. Corina (1986) J. Biol. Chem. 261, 15349-15352). Reasons for the low value of KAcGlu,app are examined, and protection by ATP is discussed in relation to previous models for the conformational equilibria of the enzyme. PMID- 3284465 TI - Primary cutaneous nocardiosis mimicking sporotrichosis. PMID- 3284467 TI - Cutaneous angiomas in POEMS syndrome. An ultrastructural and immunohistochemical study. AB - Cutaneous manifestations of POEMS (polyneuropathy, organomegaly, endocrinopathies, M-protein, and skin changes) syndrome in a 51-year-old white man included two types of hemangiomas, ie, cherry-type and subcutaneous hemangiomas. By light microscopy and immunohistochemistry, both types of tumors showed features of capillary hemangiomas. By electron microscopy, a peculiar finding of subcutaneous hemangiomas was the presence of slender abluminal processes of endothelial cells that were frequently anastomosing to form electron lucent blebs. Although the precise etiopathogenesis of the vascular proliferations remains speculative, these lesions merit study since they constitute an easily recognizable marker of POEMS syndrome. PMID- 3284466 TI - Acute follicular graft-vs-host reaction. A distinct clinicopathologic presentation. AB - Human graft-vs-host disease (GVHD) is a life-threatening complication that may occur following allogeneic bone marrow transplantation. In acute GVHD, skin involvement is frequent, and the skin is often the initial organ involved. The rash typically is a blanchable, erythematous macular eruption. We present the first report of follicular cutaneous GVHD. Three patients developed follicular papules simulating bacterial or fungal folliculitis as a major clinical expression of cutaneous involvement in acute GVHD following allogeneic bone marrow transplantation. In each case, histopathologic examination demonstrated features of acute graft-vs-host reaction involving hair follicles. This suggests that follicular epithelium may be an early target in acute GVHD. PMID- 3284468 TI - The extracellular matrix is a soluble and solid-phase agonist and receptor. AB - The components of the extracellular space have well-recognized structural functions. The role of the matrix as a conduit and/or repository for signals, however, has received much less attention. Because we know that cells require contact with the extracellular matrix for their normal function, that intact matrix and/or fragments of matrix in either soluble or solid phase can effect significant changes in cellular physiology, and that matrix components can be integral membrane proteins, we conclude that a major function of the matrix is as a soluble and solid-phase agonist and receptor. PMID- 3284470 TI - Clinicopathologic types of epidermolysis bullosa and their nondermatological complications. AB - The various epidermolysis bullosa syndromes are classified into (1) epidermolytic, (2) lamina lucidolytic (junctional), and (3) dermolytic (dystrophic) subgroups. The mode of inheritance and the clinical manifestations, both cutaneous and noncutaneous, are systematically summarized. This report provides an overview of the diverse epidermolysis bullosa syndromes, particularly from the perspective of their nondermatological manifestations. PMID- 3284469 TI - The basement membrane. Interface between the epithelium and the dermis: structural features. AB - Epidermolysis bullosa is a disease originating at or close to the epidermal dermal junction. The structural features of this interface are reviewed in detail, with particular emphasis on the basement membrane and associated intracellular and extracellular components that may be involved in the pathogenesis of various forms of epidermolysis bullosa. PMID- 3284471 TI - Extracutaneous epithelial involvement in inherited epidermolysis bullosa. AB - Epithelia of all types are involved in the heritable forms of epidermolysis bullosa in a relatively nonselective fashion. The concept that the disease is restricted primarily to tissues lined by squamous epithelium is itself too restricted. This article considers the various types of epithelia with regard to their involvement in epidermolysis bullosa. PMID- 3284472 TI - Tissue stress and tumor promotion. Possible relevance to epidermolysis bullosa. AB - Cutaneous carcinomas often arise in patients with severe epidermolysis bullosa (or other cutaneous ulcers) at multiple primary sites. Chronic tissue stress thus appears to promote carcinogenesis in preexisting somatic mutants in a stem cell population. Altered contractile properties of fibroblasts cultured from skin with epidermolysis bullosa may result from an altered interaction of these cells with their surrounding, chronically stressed, connective tissue matrix. PMID- 3284473 TI - Nutritional problems of the acute and chronic burn patient. Relevance to epidermolysis bullosa. AB - The hemodynamic response and metabolic needs of the burn patient may provide insights into the changes occurring in patients with epidermolysis bullosa as well as into potential therapeutic interventions. PMID- 3284474 TI - Nutritional management in the child with epidermolysis bullosa. AB - Children with dystrophic forms of epidermolysis bullosa and oropharyngeal lesions often evidence the features of chronic malnutrition. Nutritional assessment plays a key role in the long-term management of these patients. PMID- 3284475 TI - Surgical restoration of the hand in epidermolysis bullosa. AB - The extremities are affected by epidermolysis bullosa with blistering, scarring, and joint contractures. The hands are particularly vulnerable because of contact and shearing forces. Repeated cycles of blistering and scarring result in gradual encasement of the hand by an epidermal "cocoon." This article reviews the treatment approaches to loss of motion and independent digital function in the hands of several juvenile patients. All experienced an increase in joint motion and enhanced function as a surgical outcome of epidermal "degloving." Indications for surgery, preoperative planning, and postoperative care are discussed. PMID- 3284476 TI - Blood pressure. PMID- 3284477 TI - Brittle or battered. PMID- 3284478 TI - Inequalities in child health. PMID- 3284479 TI - Captopril in heart failure secondary to a left to right shunt. AB - Captopril was used in 20 infants aged less than 1 year with heart failure secondary to defects with predominantly a left to right shunt that was poorly controlled with digoxin and diuretics. Total daily dose of captopril ranged from 0.88 to 2.5 mg/kg (mean 1.3 mg/kg) in three divided doses. Improvement in the control of heart failure was seen mainly as an increase in the rate of weight gain from a mean of 48 g/week before treatment to 102 g/week on treatment and a decrease in the mean respiratory rate from 68 breaths/minute to 60 breaths/minute. Side effects were seen in four patients--two with asymptomatic mild hypotension, one with renal insufficiency which improved with a reduction in dose, and one with severe oliguria progressing to renal failure. Significant changes in plasma electrolyte concentration did not occur except in the infant who developed acute renal failure. PMID- 3284480 TI - Neonatal patient triggered ventilation. AB - Patient triggered ventilation was assessed in 14 neonates (gestational age 24-40 weeks). Inspiratory changes in airflow, monitored by a pneumotachograph, were used to trigger the ventilator and this was not associated with complications. Patient triggered ventilation was maintained for up to eight hours (mean duration five hours). In 13 of 14 infants oxygenation improved and this was associated in most with an increase in rate of delivered positive pressure inflations and inflating volumes. A greater improvement in oxygenation was shown when trigger mode was used during the recovery phase of respiratory distress syndrome. Only one infant, who made very little respiratory effort, failed to improve. We conclude that patient triggered ventilation may be used as an effective form of neonatal ventilation. PMID- 3284481 TI - Psychological effects of day case surgery compared with inpatient surgery. AB - Short term psychological disturbance in 70 children undergoing minor surgery was compared in two randomly allocated groups by means of questionnaires answered by their parents. Significantly less psychological disturbance was reported in children undergoing day case surgery compared with children admitted on the day before and discharged on the day after surgery. Children who had day case surgery were less often reported to require extra attention in the first week after discharge home, and at three months after operation these children were less often said to be still affected by their hospital stay. It is concluded that a reduced psychological upset can now be added to the other arguments in favour of day case surgery in children. PMID- 3284482 TI - The trisomy (5)(q31-qter) syndrome: study of a family with a t(5:14) translocation. AB - We report a child with multiple malformations caused by trisomy for the distal part of the long arm of chromosome No 5. A neonatal diagnosis of Down's syndrome had previously been made on the basis of clinical examination and the detection of an additional chromosome not unlike No 21. A subsequent clinical re evaluation, with the cooperation of the parents who permitted further studies, led to the confirmation of the true diagnosis. The mother was the carrier of a balanced translocation between chromosome No 5 and No 14. The child had severe growth and psychomotor retardation and characteristic features: microcephaly, antimongoloid slant, epicanthus, low set ears, down-turned mouth, and long upper lip. She was hypertonic and a congenital heart disease (atrial septal defect) was present. We have compared this case with others known to be trisomic for segment 5q31-qter. PMID- 3284483 TI - Intravenous immunoglobulin for prophylaxis of neonatal sepsis in premature infants. AB - The incidence of sepsis, mortality due to sepsis, total mortality, and minor infections was evaluated in a group of 46 premature newborn infants who were treated with intravenous immunoglobulins. They were compared with an untreated control group. No significant differences were observed between the two groups. PMID- 3284484 TI - Copper deficiency and non-accidental injury. PMID- 3284485 TI - Cystosonography in the staging of gynecological malignancy. AB - Five patients with carcinoma of the cervix and one with carcinoma of the vagina were examined by both cystoscopy and endosonography. Both techniques revealed malignant infiltration of the bladder in 4 patients. In the other 2 cystoscopy showed an intact bladder mucosa despite cystosonographic evidence of invasion of the bladder wall by tumor. PMID- 3284487 TI - Benign uterine leiomyoma suspected of sarcomatous change on an ultrasound scan and computerized tomography. AB - We report a 54-year-old postmenopausal woman with a leiomyoma which on an ultrasound scan and on computed tomography (CT) had cystic areas and extensive necrosis suggesting sarcomatous change. PMID- 3284486 TI - Immunohistochemical study of distribution of estrogen receptors in corpus and cervix uteri. AB - An immunohistochemical assay based on monoclonal antiestrophilin antibodies has been used to localize estrogen receptor (ER) in frozen sections of normal human endometrial, myometrial and cervical tissues from menstruating, hormonally treated, pregnant and postmenopausal women. Specific staining was confined to the cellular nuclei. In proliferative phase endometrium, postmenopausal emdometrium, and endometrium from patients treated with hormone ERs were easily detected in most glandular and stromal cells. After ovulation and in early pregnancy a quick and distinct decrease of ER expression was noted. This was especially the case with the more superficial layers of endometrium (endometrium functionalis), the majority of whose cells had either weak localization of ER or none at all. In the endometrium basalis, however, the reduction of ER localization turned out to be more moderate. More then half of the epithelial and stromal cells displayed nuclear staining, partly strong. The myometrium of the corpus uteri showed a similar ER localization and dependence on hormonal stage when compared with the endometrium functionalis. The endocervical mucosa displayed a high degree of ER expression in the proliferative phase, in postmenopausal women and in women who had been treated with hormones. Unlike the endometrium and myometrium, the endocervical glands underwent minimal changes in nuclear ER content during the menstrual cycle. Although the endocervical stroma showed cyclic alterations in ER levels, their reduction after ovulation was less marked than in the corresponding endometria. In cervical squamous epithelium ER localization was predominantly confined to the basal layers. In the course of cellular maturation, specific nuclear staining vanished. In the proliferative phase, after the menopause and in early pregnancy, the basal, parabasal and intermediate cells were specifically stained. In the postovulatory phase, However, nuclear staining was confined to the basal and parabasal cells. Hormonally treated squamous epithelia almost completely lacked nuclear ER localization. PMID- 3284489 TI - Synovial lining cell hyperplasia in rheumatoid arthritis: dogma and fact. PMID- 3284488 TI - Co-trimoxazole in rheumatoid arthritis: a comparison with sulphapyridine. AB - The antirheumatoid activity of sulphasalazine and sulphapyridine may result from their antibacterial properties. The second line activity of sulphamethoxazole, in the form of cotrimoxazole (CTZ), has been investigated by treatment of 13 patients with RA for 24 weeks with CTZ (480 mg three times a day). The drug was found to be poorly tolerated, only five of the thirteen patients recruited completing the study. High circulating concentrations of sulphamethoxazole were found, with mean (SD) steady state serum concentrations reaching 54.02 (23.38) micrograms/ml. A significant reduction in serum IgM from 280 to 130 IU/l was observed, but otherwise disease activity remained unchanged or deteriorated throughout the course of the study. In contrast, patients with RA treated with sulphapyridine (1.25 g a day) showed improvement in disease activity. The results argue against an antibacterial mechanism of action for sulphasalazine and sulphapyridine in rheumatoid arthritis, unless this occurs at a site inaccessible to sulphamethoxazole. PMID- 3284490 TI - Another look at reperfusion asystole. PMID- 3284491 TI - The effect of glucose priming solutions in diabetic patients undergoing coronary artery bypass grafting. AB - To assess the impact of glucose-containing priming solutions on plasma glucose level in diabetic patients during and after coronary artery bypass graft surgery, we studied 50 diabetic patients and 10 nondiabetic patients who underwent bypass graft surgery. Glucose-containing priming solutions profoundly elevated plasma glucose levels during and after bypass graft surgery. In diabetic patients who received glucose primes, intraoperative peak plasma glucose levels averaged 696 +/- 48 mg/dl as compared with 341 +/- 17 mg/dl in diabetic patients who received nonglucose primes (p less than 0.001). Despite an insulin infusion, diabetic patients underwent a much slower decline in plasma glucose levels postoperatively over a 2-hour period than did nondiabetics (who did not receive an insulin infusion). We conclude that during and immediately after coronary artery bypass surgery in diabetic patients, it is desirable to avoid administration of glucose containing priming solutions, since such solutions profoundly elevate plasma glucose levels. PMID- 3284492 TI - Transaxillary thoracotomy revisited. AB - Transaxillary thoracotomy is a well-known but underused approach to both benign and malignant conditions in the chest. The traditional posterolateral thoracotomy affords little advantage over this incision in terms of staging of disease or therapeutic resection. Previous reports have emphasized the wide range of conditions for which this approach is suitable, but advances in the technique and design of stapling devices and routine use of the double-lumen endotracheal tube have further enhanced its indications. We have reviewed 54 consecutive patients who have undergone transaxillary thoracotomy over a 2 1/2-year period. The wide range of procedures performed up to and including pneumonectomy indicates the versatility of the approach. We now consider transaxillary thoracotomy to be the incision of choice for most pulmonary and mediastinal lesions and an attractive alternative to mediastinoscopy for the identification and staging of chest tumors. PMID- 3284493 TI - The use of autologous pericardium for ventricular aneurysm closure. AB - Closure of the ventriculotomy following ventricular aneurysm resection usually requires buttressing material to provide strength and hemostasis. Although Teflon felt has usually been used, this material is bulky, noncompliant, and prone to infection. Autologous pericardium appears to offer an ideal substitute without the disadvantages of artificial material. A simple technique is described to apply pericardial tissue as a natural buttressing agent for ventriculotomy closure. PMID- 3284494 TI - Closure of the calcified patent ductus in the elderly: avoidance of ductal clamps and shunts. AB - A technique for closure of the calcified ductus in the adult is described that avoids systemic heparinization or the use of shunts or bypass. An aortotomy is performed and the ductus is closed from within the aorta. Use of a running suture technique and closure from the inside should allow for a short clamp time, and therefore avoid the occurrence of paraplegia. PMID- 3284496 TI - Carcinoma of the lung. PMID- 3284495 TI - Combined carotid and coronary artery surgery: a review of the literature. AB - This article reviews 41 different reports that describe various means of surgical management of coexistent carotid and coronary artery disease in almost 1,500 patients. Stroke is the major risk for patients undergoing myocardial revascularization in the presence of symptomatic carotid artery disease or an asymptomatic carotid bruit that reflects an ulcerative lesion or stenosis exceeding 75%. However, patients with asymptomatic carotid stenosis should not routinely undergo prophylactic carotid endarterectomy. Myocardial infarction is the major hazard in patients undergoing carotid endarterectomy who have coronary artery disease. This risk is magnified when the disease is silent. A high level of awareness and rigorous screening are essential in all patients suspected of having coexistent disease. Although a protocol for the management of these patients is important, individual assessment is essential. PMID- 3284497 TI - Potential and limitations of cultivated fibroblasts in the study of senescence in animals. A review on the murine skin fibroblasts system. AB - Senescence is the last period of the life span, leading to death. It happens in all animals, with the exception of a few didermic species (Hydras) having a stock of embryonic cells and being immortal. The causes of animal senescence are badly known. They depend both on genetic characters (maximum life span of a species) and on medium factors (mean expectation of life of the animals of a species). Animal senescence could depend on cell aging: (1) by senescence and death of the differentiated cells, (2) by modified proliferation of the stem cells of differentiated tissues, (3) by alterations in the extracellular matrices, (4) by interactions between factors (1) (2) and (3) in each tissue, and (5) by interactions between the several tissues of an organism. This complexity badly impedes the experimental study of animal senescence. Normal mammal cells are aging when they are cultivated (in vitro aging). Present literature upon in vitro aging of cultivated human fibroblasts consists essentially of papers devoted to proliferation and differentiation characteristics and not to cell senescence. Murine skin fibroblasts have been studied in our laboratory, using different systems: (1) primary cultures isolated from peeled skins of mouse embryos, (2) mouse derms analysed in the animals, (3) cultivated explants of skins, (4) serial sub-cultures of fibroblasts isolated from these explants, (5) cells cultivated comparably on plane substrates (glass, plastic, collagen films) and on three dimensional matrices (collagen fibres). In primary cultures (system 1) all the cell generations have been analysed, including the last one until death of the culture. We have shown that many characters are varying with cell generation. All the observed variations were: progressive, non-linear and correlated (intracellular feedbacks). We come to the conclusion that the main effects of cell mitotic age are (1) to depress the plasticity of the chromatin, (2) to change the organization of the cytoplasmic filaments, (3) to change the organization of the extracellular matrix. The collagen fibres are also acting upon nucleus and filaments either in the animals or in the cultures. The phenotype of a fibroblastic cell is thus both age- and environment-dependent. Overall data on in vitro cell aging point to the hypothesis that senescent cells are phenotypic variants and not mutant cells. Aging cell cultures are remarkably useful to the studies on cell proliferation decrease and cell cycle lengthening shown by the stem cells in animal tissues. We propose the hypothesis that the fibroblasts of the vertebrates would be homologous to the pluripotent mesenchyme cells of their embryos. PMID- 3284498 TI - A note on 'aging-pharmacodynamics' with application to the analysis of the age dynamics of adipocyte response to epinephrine and insulin. AB - This note aims at clearing some semantic problems in the literature concerning the analysis of the effect of age on dose-response curves as well as standardize the way such data should be presented. In particular it is shown how to assess the age-dynamics (i.e. the pattern of change as a mathematical function of age) of the sensitivity of a receptor system to a given agent, of the quantitative overall changes of the cellular response apparatus which affect response capacity, and of the interaction between different simultaneously acting agents. The concepts and theory are illustrated using as an example the in vitro isolated rat fat cell (or adipocyte) which we have recently studied extensively with regards to the age-dynamics of its lipolytic response to epinephrine and insulin. This 'aging-pharmacodynamics' analysis has led to the surprising conclusion of a rebound effect of age (decrease at maturity followed by increase at old age) on the sensitivity of the fat cell to epinephrine and to its antagonist (with respect to lipolysis) insulin, as well as a negative correlation of these sensitivities with fat cell size. PMID- 3284499 TI - Thyroid and pituitary function following allogeneic bone marrow transplantation. AB - Thyroid function was evaluated in 13 consecutive patients with chronic myelogenous leukemia to verify in allogeneic bone marrow transplantation if the fractionated irradiation protocol with low dose rate, previously applied to reduce the damage to various organs, also prevents the 43% incidence of primary hypothyroidism that occurs after the administration of single dose with higher dose rate. Following bone marrow transplantation, decreased plasma levels of total thyroxine and triiodothyronine and impaired response of thyrotropic cells to thyrotropin-releasing hormone were observed. These alterations reverted to normal in nine months and none of the patients was hypothyroid at the end of follow-up. The damage to thyrotropic cells appears to be selective because the secretion of prolactin was not impaired and that of gonadotropins even increased, as a consequence of gonadal failure. Longer follow-up is needed to determine if this irradiation protocol, which prevents the complication of permanent primary hypothyroidism and does not cause any destruction of thyroid cells, may increase the risk of irradiation-related thyroid tumors. PMID- 3284500 TI - Living kidney donation. Attitudes outside the transplant center. AB - Many transplant centers are opposed to the use of living unrelated kidney donors and donors at added risk. To see how the public and nontransplant physicians view these issues, we surveyed samples of these groups in Rochester, NY. We found that the majority of respondents supports the use of unrelated donors and believes that donors should be allowed to accept added risk. Our findings were confirmed by a Gallup Poll of a random sample of the US adult population. It appears that many transplant centers are out of step with public opinion, as well as that of other members of the medical profession. We hope our data will induce the centers to become more attuned to public attitudes and give donors a greater voice in determining their own suitability. If this occurs, more donors will likely become available and the number of patients with end-stage renal disease receiving transplants will increase. PMID- 3284501 TI - Tetracycline for sclerosis of thyroid cysts. A randomized study. AB - In a prospective study, 53 consecutive patients with solitary thyroid cysts were randomized to ultrasonically guided cyst aspiration and subsequent flushing with isotonic saline (n = 30) or tetracycline hydrochloride (n = 23). The patients were followed up clinically and ultrasonically 1, 3, 6, and 12 months after treatment. If the cyst recurred, a repeated treatment was offered. Cure was defined as the absence of any residual nodule and an ultrasonic cyst volume of less than 1 mL 12 months after the last treatment. During follow-up, two patients without recurrence after saline treatment and six patients without recurrence after tetracycline treatment developed solid cold nodules. Fourteen (47%) of 30 patients in the saline group and ten (43%) of 23 patients in the tetracycline group were cured (not statistically significant). Tetracycline does not seem to offer any advantage over isotonic saline in the treatment of thyroid cysts, and some of these patients still need thyroid surgery. PMID- 3284502 TI - Effects of caffeine on blood pressure. AB - Initial reports indicated that caffeine has a pressor effect, raising the possibility that it might contribute to hypertension. However, further studies have demonstrated that caffeine does not produce a persistent increase in blood pressure. Individuals who do not regularly consume caffeine may experience a slight increase in blood pressure when they are exposed to caffeine, but tolerance develops rapidly and blood pressure returns to baseline. PMID- 3284503 TI - Hansenula anomala: a new fungal pathogen. Two case reports and a review of the literature. AB - Fungal infections are characteristic of severely immunocompromised patients. Noncandidal yeasts represent a growing proportion of such infections. Risk factors for developing fungal infections include the use and abuse of central venous catheters. Two patients with gynecologic malignant neoplasms became fungemic with Hansenula anomala, a yeast of the Ascomycetes class, after insertion of central venous catheters. Frequent catheter manipulation and prolonged use favored the development of fungemia in both patients. A review of the literature revealed 19 additional cases over the course of four decades, all in hosts with underlying diseases. Thirteen of these cases have been described in the last 18 months, suggesting either increased recognition or increased frequency of infection with this organism. All tested isolates have been susceptible to amphotericin B. Patients have generally responded to catheter withdrawal and amphotericin B administration. Hansenula anomala is an opportunistic pathogen, whose clinical behavior resembles that of Candida species. PMID- 3284504 TI - Stimulation of an alpha like DNA polymerase by v-myc related protein of Halobacterium halobium. AB - Partial DNA sequencing of a genomic clone of the archaebacterium Halobacterium halobium, which hybridized with an avian v-myc probe, showed especially the presence, in the organism of one of the conserved regions through myb, myc and adenovirus E1a oncogenes. The archaebacterial deduced amino acid sequence displayed significant homology with the v-myc gene product. In accordance with the partial DNA sequencing which assured a sufficient homology to have similar epitopes, a protein having a molecular weight of 70,000 and possessing high antigenicity with a polyclonal antiserum against avian v-myc protein was isolated and purified from H. halobium extracts. The purified v-myc like protein stimulated in vitro DNA synthesis carried out by the alpha like DNA polymerase of H. halobium. PMID- 3284506 TI - [Transient dilatation of the intra- and extra-hepatic bile ducts. A new aspect of bile duct involvement in scarlet fever]. AB - An extra- and intra-hepatic bile duct dilatation has been observed in a child in the course of scarlet fever. Manifestations of cholestasis, cytolysis and inflammation were present. Pruritus disappeared within 2 months, biological abnormalities within 3 months and ultrasonic bile duct abnormalities between 3 and 6 months, with a follow-up of 9 months. This case report suggests a relationship between a transitory obstruction, possibly toxic in origin, of the bile ducts and the scarlet fever. PMID- 3284507 TI - [Etiopathogenesis of Kawasaki's syndrome]. PMID- 3284508 TI - [Ultrastructural bases of the development of the neural apparatus of the heart]. AB - By means of electron microscopy developmental dynamics of the human and mammalian innervation has been studied during prenatal period of ontogenesis. Regularities in formation of the intracardiac nervous ganglia and in differentiation of nervous-muscular connections in the myocardium have been stated. Ultrastructural peculiarities of proneuroblasts and the nervous fiber terminals, growing to differentiating cardiomyocytes have been described during the premediator stage of the vegetative nervous system development. Peculiarities of synaptogenesis have been followed, among them those demonstrated as heterochromic formation of pre- and post-synaptic membrane and as uneven accumulation of synaptic vesicles. Development of the nervous-muscular connections have been studied. At the beginning of the mediator stage of the vegetative nervous system development formation of simple contacts between the nervous terminals and cardiomyocytes is intensified, and glial tunics develop rather poorly. Therefore, at the beginning the terminal parts of axons are not surrounded with processes of gliocytes. Simultaneously, formation of small intensively luminescent cells takes place. Development of afferent nervous terminals occurs not only in the myocardium, but in the intracardiac ganglia. PMID- 3284509 TI - [Structure of the jugular fossa]. AB - In 111 skulls and in saw-cuts of 119 pairs of the temporal bones of persons belonging to various age groups, age and individual changeability of the volume, form, thickness and foramina in the wall of the jugular fossa have been studied. During the postnatal period the jugular fossa increases in its volume twice and average meaning of its volume predominates on the right in the all age groups. The deepest place of the jugular fossa in more than half cases is displaced backward and laterally. The jugular fossa wall in the area of the inferior wall of the tympanic cavity is less thick on the right than on the left side. The foramina in the inferior wall of the tympanic cavity are found in mature persons in 6%, on the right 3 times as often as on the left; in children of younger age- in 45% and on the right more than 2 times as often as on the left. PMID- 3284505 TI - Glycine betaine reverses the effects of osmotic stress on DNA replication and cellular division in Escherichia coli. AB - The accumulation of glycine betaine to a high internal concentration by Escherichia coli cells in high osmolarity medium restores, within 1 h, a subnormal growth rate. The experimental results support the view that cell adaptation to high osmolarity involves a decrease in the initiation frequency of DNA replication via a stringent response; in contrast, glycine betaine transport and accumulation could suppress the stringent response within 1-2 min and restore a higher initiation frequency. High osmolarity also triggers the cells to lengthen, perhaps via an inhibition of cellular division; glycine betaine also reverses this process. It is inferred that turgor could control DNA replication and cell division in two separate ways. Glycine betaine action is not mediated by K+ ions as the internal level of K+ ions is not modified significantly following glycine betaine accumulation. PMID- 3284510 TI - [Current concepts of the functional morphology of the cochlea]. PMID- 3284511 TI - [Pathogenesis of the tumor process]. AB - The paper deals with fundamentals underlying current views on cancerogenesis, morphogenesis and tumor growth with special emphasis on the mechanisms of malignant sequential and spasmodic transformation of target cells, a morphologic pattern of malignant transformation (uni- and multicenter development, tumor field theories) and mechanisms of tumor dissemination. Recent conceptions and theories are delineated. Original ideas of the nature of neoplastic process are suggested. PMID- 3284512 TI - [Detection of fibronectin and collagen types I, III, IV and V in semithin sections of the human aorta]. AB - Localization of fibronectin and types I, III, IV and V collagen was investigated in semithin sections of fibrous atherosclerotic plaques and apparently normal intima of human aorta. The effect of different techniques of fixation and processing of the sections on immunostaining under peroxidase-antiperoxidase techniques have been examined. The tissue fixation in paraformaldehyde solution, removing the resin with sodium ethoxide and enzymatic pronase digestion of the sections resulted in successful specific staining of the antigens. It was found that some cells in fibrous plaques formed a cap of multiple layers of dense connective tissue containing fibronectin and type III, IV and V collagen in the absence of collagen type I. PMID- 3284513 TI - [Myoglobin of the myocardium and skeletal musculature]. AB - Clinical and experimental literature data reviewed by the author concern myoglobin structure, function and content in normal myocardium, skeletal muscles and serum. The assessment was aimed at elucidation of myoglobin diagnostic potential for a variety of pathologies. Its role in human and animal adaptation in exposure to cold, physical stress and high-altitude factors is demonstrated. PMID- 3284514 TI - Quality assurance in perinatal and obstetrical care: the Norwegian approach. AB - OBJECTIVE: To review the structure of all obstetrical units in Norway and to monitor the performance of care in terms of perinatal mortality, ultrasound examination and selected clinical events in routine obstetrical care. METHOD: I. Audit of all perinatal deaths (270) in five Norwegian counties during one year. II. Consensus conference to review the practice and distribution of all antenatal diagnostic ultrasounds performed country-wide over one week. III. Statistical review of quality indicators or flag events in routine obstetrical care. RESULTS: I. Identification of a significant percentage of "avoidable" perinatal deaths, most frequently related to antenatal and neonatal care rather than to obstetrical care--resulting in official guidelines for antenatal care and the routine audit of perinatal deaths. II. 96% of women surveyed had ultrasonography, an average of 2.5 examinations each. An investigational procedure already established practice, it was recommended that one ultrasound performed in week 17-20 should be offered each pregnant woman. III. Clinical obstetrical practice varied significantly and it was noted that junior obstetricians had not adhered to established routines. Short and long term monitoring of clinical trends is considered. PMID- 3284515 TI - Substance dependency, standards and the need for accreditation. PMID- 3284516 TI - Enterocolitis in cattle associated with Yersinia pseudotuberculosis infection. AB - A syndrome in cattle of diarrhoea and death associated with enteric Yersinia pseudotuberculosis infection is described. Outbreaks occurred during winter and early spring in adult cattle grazing pastures waterlogged by recent flooding or persistent heavy rain. Antibiotic therapy was effective early in the course of the syndrome. At necropsy there was severe acute enterocolitis, and bacteria consistent with Y. pseudotuberculosis were observed in the lesions. This organism could usually be isolated from the intestines of affected animals but was recovered less often from other organs. Representative isolates were identified as Y. pseudotuberculosis serotype III. The association of this syndrome with waterlogged pastures and low temperatures suggests that these conditions favour transmission of Y. pseudotuberculosis infection in cattle. The role of Y. pseudotuberculosis as primary pathogen requires confirmation. PMID- 3284517 TI - Phenotypic variation in populations. Relevance to risk assessment. Proceedings of a symposium. December 7-10, 1986, Upton, New York. Dedicated to Alexander Hollaender. PMID- 3284518 TI - Fragile sites, mutagens and genomic rearrangements in cancer. PMID- 3284519 TI - Constitutional, somatic genetic and environmental aspects of the phenotypic diversity of aging in human subjects. PMID- 3284520 TI - Variability in cognitive function in the elderly: implications for societal participation. PMID- 3284521 TI - The membrane skeleton--a distinct structure that regulates the function of cells. PMID- 3284522 TI - Int-1 and int-2: oncogenic proteins, mitogens and morphogens? PMID- 3284523 TI - Removal of the 33, 23 and 18 kDa extrinsic proteins of photosystem II by sulfite treatment at alkaline pH. AB - We found that sulfite incubation of photosystem II submembrane fractions can induce selective depletion of the 18, 23 and 33 kDa polypeptides of the PSII oxygen evolving complex. When the sulfite treatment was done at pH 8.0, the 18 and 23 kDa proteins were removed efficiently from the PSII oxygen evolving complex. Under the same conditions, the 33 kDa subunit remained bound (even when 2 M sodium sulfite was used). However, in more alkaline conditions (pH 9.8), we show extensive removal of the 33 kDa in the presence of a low sulfite concentration (50 mM). The different extraction affinity for the 18, 23 and 33 kDa of the photosystem II complex was interpreted to mean that the 33 kDa polypeptides are bound to photosystem II by both electrostatic and hydrogen bonding forces. PMID- 3284524 TI - The 28k and 70k dalton polypeptide components of mouse Ra-reactive factor are responsible for bactericidal activity. AB - Ra-reactive factor is a complement-dependent bactericidal factor that reacts specifically with Ra chemotype strains of Salmonella, and is ubiquitous in sera of a wide variety of vertebrates. Here we prepared an antiserum by immunizing rabbit with mouse Ra-reactive factor. This serum neutralized markedly the bactericidal activity of the factor. This action of the antiserum was inhibited by the factor whose bactericidal activity has been inactivated by heating for 30 min at 55 degrees C. Component polypeptides with apparent molecular weights of 28k and 70k in the factor were separated by SDS-polyacrylamide gel electrophoresis. They were also found to inhibit the antiserum activity. This indicates that these polypeptides carry the active site of the factor. PMID- 3284525 TI - Heterogeneous photochemical and chloroplasts mediated activation of spinach fructose-1,6-bisphosphatase. AB - A heterogeneous photochemical electron relay system was constructed, mimicking the chloroplast electron transport reaction, in order to activate fructose-1,6 bisphosphatase in light. The photocatalyst acridine orange or proflavin sensitizes EDTA dependent reduction of ferredoxin. In a complete system, consisting of a dye-donor couple, ferredoxin, thioredoxin and ferredoxin thioredoxin reductase, light activation of purified spinach fructose-1,6 bisphosphatase was observed in vitro. The ferredoxin was not essential for activation of fructose-1,6-bisphosphatase using heterogeneous photochemical system while chloroplasts mediated redox activation essentially required ferredoxin. The heterogeneous photochemical system activated fructose-1,6 bisphosphatase by about 6 fold similar to chloroplasts mediated ferredoxin dependent redox activation. These observations suggest that a thiol mediator is essential for the reductive activation of carboxylating enzymes of photosynthesis. The mechanism of activation is discussed. PMID- 3284526 TI - Globotriosyl ceramide is specifically recognized by the Escherichia coli verocytotoxin 2. AB - Two Escherichia coli cytotoxins (verotoxins 1 and 2) have been previously implicated in the cytopathology of the Hemolytic Uremic Syndrome. We have examined the glycolipid binding specificity of verotoxin (VT)2. This toxin specifically binds to globotriosyl ceramide (galactose alpha 1-4 galactose beta 1 4 glucosyl ceramide). Removal, or substitution of the terminal a galactose residue with N-acetyl galactosamine in beta 1-3 linkage, deletes binding activity. The toxin does not recognize similar terminal a galactose residues on a glycoglycerolipid. Thus the binding specificity of VT2 is the same as previously reported for VT1. Liposomes containing globotriosyl ceramide are able to specifically remove VT1 and VT2 cytotoxicity and cell lines selected in vitro for resistance to VT1 are cross resistant to VT2. PMID- 3284527 TI - Immunoaffinity purification of human prorenin produced in Chinese hamster ovary cells. AB - A simple immunoaffinity column chromatographic procedure is described whereby recombinant human prorenin secreted from Chinese hamster ovary cells may be isolated in a high state of purity from serum-free culture medium. Prorenin thus purified has been characterized by SDS-polyacrylamide gel electrophoresis and by partial sequence analysis which has revealed the expected N-terminal sequence. Trypsin treatment gives rise to renin, and reversible acid activation has also been demonstrated for the recombinant zymogen. PMID- 3284528 TI - Reaction of S-nitrosoglutathione with sulfhydryl groups in protein. AB - The covalent modification of sulfhydryl groups by S-nitrosoglutathione has been examined using model compounds. S-Nitrosoglutathione and thiol compounds causing extremely fast transnitrosation reaction and subsequent production of mixed disulfide. Yeast alcohol dehydrogenase is rapidly inactivated by S nitrosoglutathione. The reversibility and Ellman test demonstrate that the inactivation is the result of covalent modification of sulfhydryl groups in this enzyme. PMID- 3284529 TI - Characterization of a functional recombinant rat liver aldehyde dehydrogenase: expression as a non-fusion protein in E. coli. AB - A cDNA encoding a rat liver inducible aldehyde dehydrogenase carried in a pUC8 plasmid is expressed in E. coli as a dimeric enzyme molecule functionally and physically identical to the authentic rat enzyme. The cDNA appears to be transcribed using the lac promoter, but is translated from an initiator codon 174 base pairs from the 5' end of the cDNA. The aldehyde dehydrogenase polypeptide is not produced as a fusion protein. This is the first example of the production by E. coli of a catalytically active, multimeric eukaryotic protein which is not a fusion protein. PMID- 3284532 TI - Molecular genetics: the key to the puzzle of stuttering? PMID- 3284530 TI - Experience with thymopentin in the treatment of periarthritis humeroscapularis, tendinitis, and gonarthrosis by local infiltration. AB - A total of 122 patients with periarthritis humeroscapularis, tendinitis, and gonarthrosis were accepted into a controlled, randomized double-blind study; of these patients, 61 subjects were administered local infiltrations of thymopentin (Timunox) 1 ml (50 mg) plus lidocaine 1 ml (2%), once a week for a period of 5 weeks. 61 subjects were during the same time treated with methylprednisolone depot 1 ml (40 mg) plus lidocaine 1 ml (2%). Demographic and clinical parameters were comparable in both groups. Intergroup comparison on completion of the therapy with regard to the criteria "pain at rest", "pain on pressure", "disability of articulation", and "pain relief" revealed statistically significant superiority of thymopentin. No unexpected drug experiences were observed in this double-blind study. PMID- 3284531 TI - Effects of cadralazine on systemic blood pressure, renal function and plasma renin activity in anesthetized dogs. AB - Renal effects of ethyl 6-[ethyl(2-hydroxypropyl)amino]-3-pyridazinecarbazate (cadralazine), a newly synthesized vasodilator with a pyridazine ring, were studied in anesthetized dogs. 30 min after intravenous (i.v.) injection of cadralazine in a dose of 1 mg/kg diastolic blood pressure (DBP) decreased from the control value of 115 +/- 4 mmHg to 108 +/- 3 mmHg. The decrease continued, being accompanied by an increase in heart rate, throughout the experimental period of 5 h. Renal vascular resistance was decreased significantly, while glomerular filtration rate and urine volume remained unchanged. Urinary excretions of sodium and potassium were increased about 1.5 to 2 times as compared to pre-injection control values. Hypotension and natriuresis were followed by increased plasma renin activity in the artery or renal vein. On the other hand, i.v. injection of hydralazine (0.3 mg/kg) promptly decreased DBP and urinary sodium excretion, 15 min after administration, with blood pressure tending to revert to the control value. These results indicate that cadralazine has hypotensive and renal vasodilating actions, characterized by a slow onset and long duration, when compared with hydralazine. PMID- 3284534 TI - Payment sources for speech-language-hearing services. PMID- 3284533 TI - Monitoring productivity in a hospital based speech-language pathology and audiology program. PMID- 3284535 TI - Council of Graduate Programs documents continuing decline in student enrollment. PMID- 3284536 TI - Ultrasonographic measurement of the common carotid artery wall thickness in hypercholesterolemic patients. A new model for the quantitation and follow-up of preclinical atherosclerosis in living human subjects. AB - Ultrasound high resolution B-mode imaging of human arteries allows in vivo an accurate and non-invasive determination of the thickness of the intimal-medial complex. A computer assisted procedure to measure this parameter at the level of common carotid arteries was developed. The average difference between duplicate thickness determinations was 4.6%. The thickness of the intimal medial complex of common carotid arteries was then measured in a group of hypercholesterolemic patients. This parameter was significantly greater in these patients as compared to controls (P less than 0.001). The prevalence of small plaques in the carotid arterial tree was also significantly increased in patients. Analysis of data showed that in controls, but not in patients, the thickness of the intimal medial complex increases with age (r = 0.46, P less than 0.05). Within the hypercholesterolemic group, intimal-medial complex values were greater in male patients and in smokers. It is concluded that the common carotid arteries of hypercholesterolemic patients show thickening of the intimal-medial complex. Cigarette smoking, male sex and age increase the extent of this modification. The determination of this parameter using a non-invasive technique may represent an important tool to monitor in vivo the progression and/or the regression of early atherosclerosis in man. PMID- 3284537 TI - Nurses and back injuries: a literature review. PMID- 3284538 TI - New thoughts on carbohydrate digestion. PMID- 3284540 TI - Assessment of gestational age. PMID- 3284539 TI - Dermatologic clues to the diagnosis of human immunodeficiency virus infection. PMID- 3284541 TI - Involvement of apurinic sites in the synergistic action of alkylating and intercalating drugs in Escherichia coli. AB - The toxicity of the intercalating compounds 9-aminoellipticine (9AE) and isopropyl-oxazolopyridocarbazole (Ipr-OPC) were studied. The inhibitory effect of non-toxic doses of 9AE, which incises DNA at apurinic (AP) sites, or Ipr-OPC, which does not cleave DNA at AP sites, with non-toxic doses of the alkylating agent dimethylsulphate (DMS) on the growth of Escherichia coli strain AB1157, is additive. The same result has been observed with an exonuclease III mutant which has only 10% of the AP endonuclease activity. However, 9AE or Ipr-OPC display a synergistic toxic effect with a DMS concentration which allows 20% of E. coli AB1157 survival. This synergy is increased for 9AE in the AP endonuclease mutant when compared to the wild-type strain. Under identical conditions 9AE and Ipr-OPC have no synergistic effect on a mutant deficient in the enzymes which generate AP sites. Therefore AP sites are involved in the synergistic toxicity of DMS and the studied intercalating agents. However, the precise role of the interaction of intercalating agents with AP sites, either without cleavage (type 1 compounds) or with cleavage (type 2 compounds), in the observed effect remains an open question. PMID- 3284542 TI - [Metabolism of bilirubin. I. Normal metabolism]. PMID- 3284543 TI - [Escherichia coli: pathogenic mechanisms and enterohemorrhagic strains]. PMID- 3284544 TI - [Vero cytotoxin-producing Escherichia coli]. PMID- 3284545 TI - Effects of stress on morphine-elicited locomotor activity in hamsters. AB - Two experiments were conducted to investigate the effects of stress on morphine elicited locomotor activity in hamsters. In Experiment 1, half of the animals were habituated to handling and injection procedures (low-stress condition) and half were not (high-stress condition) prior to 6 days of testing with a low dose (2.5 mg/kg) of morphine. On the first test day, morphine elicited hyperactivity among habituated animals, whereas among nonhabituated animals morphine elicited hypoactivity. The effects of handling diminished across test days, so that on the last test day, morphine elicited hyperactivity in both habituated and nonhabituated animals. In Experiment 2, the effect of a noise stressor on activity elicited by three doses of morphine (2.5, 5.0, and 15 mg/kg) was investigated. Half of the animals were tested under conditions of low noise stress (70 dB), and half were tested under conditions of high noise stress (90 dB). Results indicated that the effects of each dose of morphine were potentiated in the high-stress relative to the low-stress condition. Both experiments demonstrated that environmental stressors can potentiate the response to exogenous opiate administration in hamsters. Moreover, the results are consistent with the hypothesis that stress induces the release of endogenous opioids which summate with exogenous opiates to determine the final effective dose. PMID- 3284546 TI - Tenth Adolf Butenandt lecture. Control of gene expression by steroid hormones. PMID- 3284547 TI - Secondary laryngeal tumors. Report of seven cases with review of the literature. AB - Laryngeal metastases are uncommon, particularly if we consider only secondary involvement from the remote primary neoplasm, via lymphohematogenous dissemination. In the 21-year period from 1966 to 1986, only seven cases of secondary laryngeal cancers were observed at the Department of Otolaryngology of Padua (Italy) University. A review of the world literature resulted in the identification of 113 previously reported cases. Cutaneous melanoma is the neoplasm most frequently metastasizing to the larynx, but adenocarcinoma may also often occur, especially from renal origin. A correct differential diagnosis from primary laryngeal cancer is most important. Identification of tumor location beneath intact mucosa, use of particular biochemical and histochemical stains, and electron microscopy may assist in establishing the presence of a metastatic growth. The prognosis is almost generally unfavorable because laryngeal involvement often occurs with metastases to other organs. PMID- 3284548 TI - Postirradiation sarcoma in retinoblastoma. Induction or predisposition? AB - An alarmingly high rate of postirradiation sarcomas following treatment for retinoblastoma has been described in the literature. We present four new cases and report 57 others from the English literature. Osteogenic sarcoma was the predominant histologic type (58%), followed by fibrosarcoma (21%) and various other sarcomas (21%). The average latency period between irradiation and development of the second primary (sarcoma) was 12.4 years. Irrespective of irradiation, a genetic linkage between retinoblastoma and osteogenic sarcoma on the 13q14 chromosome is recognized. Through a pleiotropic effect of this same chromosome, a predisposition for other sarcomas may exist as well. Finally, a strong role for radiation induction is proposed for all of these postirradiation sarcomas. This is based on the increased number of sarcomas arising in the field of prior irradiation (sites uncharacteristic of spontaneously occurring primary sarcomas) and the prolonged latency periods. PMID- 3284549 TI - Efficacy of defibrinogenation and steroid therapies on sudden deafness. AB - Effects of defibrinogenation therapy and steroid therapy for sudden deafness were compared by paired double-blind testing. The average hearing recovery for five frequencies (250 to 4000 Hz) was more than 30 dB; overall improvement rate was 57.3% (47/82) for the patients assigned to defibrinogenation therapy and 38.7% (31/80) for the patients assigned to steroid therapy. Thus, the former treatment resulted in significantly better hearing recovery. PMID- 3284550 TI - Treatment of severe recurrent aphthous stomatitis with colchicine. AB - Recurrent aphthous stomatitis (RAS) is characterized by necrotizing ulcers of the oral mucosa that persist, remit, and recur for variable periods of time. Despite the benign nature of the disease, persistent pain and ulceration may disable patients from performing their daily activities. We describe three patients with long-standing active RAS treated with oral colchicine. All patients experienced a marked decrease in symptoms and a remission of the disease. Recurrences, however, occurred within three days of discontinuation of the therapy. In one patient, colchicine therapy was discontinued because of persistent diarrhea. In another, a second remission was more difficult to achieve on the same regimen. The literature on the subject is reviewed, and the beneficial effects of colchicine therapy are discussed in relation to the immunopathogenesis of this disease. We conclude that colchicine therapy should be considered as an alternative in the treatment of the major or persistent form of RAS. PMID- 3284551 TI - Reconstruction of the anterior skull base following cranial facial resection. PMID- 3284552 TI - Estrogen and progesterone receptor determinations in breast cancer. Technology, biology and clinical significance. AB - Our present state of knowledge regarding estrogen and progesterone receptors (ER and PgR) has led to changes in treatment strategies: patients without receptors in their tumor tissues cannot be expected to respond to endocrine therapy. Furthermore, groups of patients with specifically good or poor prognoses can be selected. Treatment of the disease now approaches being of a rational rather than of an empirical nature. However, it is imperative that we achieve a considerably higher level of understanding before we can predict, with high probabilities, which patients will benefit from endocrine therapy. Only through a coordinated effort by many centers can we hope to attain this goal. In such collaborations there are several factors that must be taken into consideration if reproducible conclusions are to be reached: a) sampling of the tumor biopsy for analysis, b) potential differences in assay procedures which may affect results, and c) the composition of the population studied. Since the traditionally used ligand binding assay (dextran-coated charcoal (DCC) method) is highly sensitive even to slight modifications in assay procedure, intra- and interlaboratory standardization of receptor analyses is challenging. Accordingly, correlations between receptor status and/or concentrations and the clinical course of the disease from different centers often demonstrate discrepant results. With the greater reproducibility and sensitivity of the newly developed immunoenzymometric assay (IEMA) methods, many of these problems might be solved in the future and inter-center clinical studies will thus be facilitated. In the national Danish Breast Cancer Cooperative Group (DBCG) project, approximately 90% of all patients with primary breast cancer are registered. Estrogen and progesterone receptor (ER and PgR) determinations have been performed on tumor tissue from approximately 30% of these patients in one single laboratory. The results of these analyses are presented here for approximately 4,000 patients in relation to age, menopausal status, tumor size, grade of anaplasia, and lymph node involvement. Biologically and clinically there appear to be three fundamental types of tumor tissues; hormone responsive (ER+PgR+ and ER-PgR+), hormone non-responsive (ER-PgR-), and tissues of a more dubious hormone responsive nature (ER+PgR-), which occur predominantly among postmenopausal patients. Several lines of evidence indicate that among the postmenopausal patients there may be an estrogen binding molecule similar to but distinct from the normal, physiologically functioning ER molecule.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3284553 TI - Primary gastrointestinal non-Hodgkin lymphoma. A review of 36 cases. AB - A retrospective study was made of 36 patients with primary gastrointestinal (GI) non-Hodgkin lymphoma (NHL), of which 16 occurred in stomach, 14 in small intestine, 3 in ileocecal region and 3 in large intestine. The mean age was 57 years. According to the 'Working Formulation' large cell lymphomas were most common. All patients were surgically explored, 27 undergoing resection and 9 laparotomy with biopsy. Radiotherapy was given to 14 patients and 27 received chemotherapy. Patients with stomach as the primary site had a slightly better outlook than patients with intestinal tumors. In patients with stage I and II disease the group which had been resected and received both radiation treatment and chemotherapy had the best prognosis with a 3-year survival of 76%. The material also indicates that radiotherapy is of value for GI-NHL in stage I or II. PMID- 3284554 TI - Whole blood collection on filter paper is an effective means of obtaining samples for human immunodeficiency virus antibody assay. AB - The suitability of collecting whole blood specimens on filter paper disks for HIV antibody assay was evaluated. ELISA and Western blot assay results were in complete agreement for serum and blood spot disk samples. Sensitivity of the two methods was tested using diluted whole blood and sera from HIV-seropositive individuals. Results demonstrate that ELISA and Western blot assays performed on punched-out disks of the blood-impregnated papers had the same sensitivities as those obtained with serum samples. This study suggests that whole blood collection on filter paper can be effectively substituted for serum sampling in HIV antibody screening programs. PMID- 3284555 TI - Differential neutralizing capacity to different human immunodeficiency virus (HIV) isolates by a rabbit antiserum against LAV: sensitive assays with HTLV-I positive MT-4 cells. AB - A rabbit antiserum against LAV was prepared. This serum reacted with both LAV and HTLV-III identically in the immunodiffusion and immunoprecipitation. It was also confirmed that the rabbit serum in the immunofluorescence (IF) studies contained several isolates of human immunodeficiency virus (HIV) including LAV, HTLV-III, ARV and YU-6 similarly as human reference antibodies. The neutralizing capacity of this antiserum to HTLV-III and YU-6 isolates was further studied using three methods, such as 3[H]-thymidine uptake in HIV infected MT-4 cells, IF assay, and plaque forming assay. All experiments showed that the rabbit antiserum could not neutralize YU-6 but HTLV-III, while human sera neutralized both viruses equally. These data suggest that rabbit antibody recognizes narrower neutralizing epitopes than HIV-infected human antibodies, although there exist no differences as to recognition of antigens responsible for IF between them. Furthermore, we showed that this type-specific neutralization was not due to the absorption of neutralizing serum by the noninfectious viral particles. These data may be important in understanding heterogeneities of HIV and in development of an effective vaccine. PMID- 3284556 TI - Doppler flow determination. AB - Doppler ultrasound provides a non-invasive alternative to the established methods of blood flow measurement. The standard principle of the Doppler-echographic determination of volume flow rate is based upon the assessment of three quantities: the vascular cross-section, the angle of incidence of the ultrasound relative to the direction of the velocity vector, and the cross-sectional average velocity. In the literature reporting comparisons between Doppler and invasive cardiac output measurements, correlation coefficients ranging from 0.8 to 0.95 are given for adult patients. Error limits of less than 20% for individual measurements, however, require a skillful investigator, a high quality instrument, and an appropriate subject. From a technical point of view, the highest accuracy is achieved by directing the ultrasound beam parallel to the flow, by measuring the true cross-sectional area instead of the diameter, and in the presence of well-behaved transluminal blood velocity distributions. PMID- 3284557 TI - Measurement of ventricular ejection fraction in the acutely ill. PMID- 3284558 TI - Species differences. PMID- 3284559 TI - Effects of basal anaesthesia on cardiac function. PMID- 3284560 TI - The problem created by myocardial structure in assessing function. AB - The clinical understanding of the dynamics of myocardial contraction is hampered by an over-simplified interpretation of the intramural pattern of force generation. This limits the anaesthetist's knowledge of the direct effects of commonly used anaesthetics. A discrimination between a negative inotropic effect and changes in pre- and afterload is usually impossible in clinical conditions. By using needle force probes, it is now possible to measure intramyocardial mesh tension in volumes as small as 3 mm3. Force mapping in 20 to 30 layers of the hearts of five normal dogs has shown that there are different patterns in the basal, middle and apical portions of the free wall of the left ventricle. An inhomogeneity is also observed when myocardial hypertrophy is produced by a 6 week period of aortic banding. However, this decreased the gradient in wall tension between the basal and the other portions of the ventricle. Inhomogeneities in wall tension increase the difficulty of assessing the contractile state of heart muscle. It may, however, be useful to compare local wall dynamics in the more isometrically-contracting basal segment with those in the middle portion which brings about most of the emptying of the ventricle. In the future, transoesophageal echocardiography may be used to measure variations in wall thickness which change the global loading conditions in the basal midwall compartments of the left ventricle. PMID- 3284561 TI - Biochemistry: index of the functional state of the heart? AB - The description of metabolic patterns during well defined conditions has been, and will be, a very helpful tool in characterizing reactions of cells, tissues and organs to physiological and pathophysiological situations. As a rule, the measurements yield global values. Discrimination between the integrity of different cellular compartments and individual cell functions is difficult and possible only in particular circumstances. Metabolism is not a static, but a dynamic cellular activity. Status analyses are like stills from a movie. With the present state of the art, however, it seems neither possible nor justified to describe or predict functional performance of the heart using analyses of metabolism, which can be performed simply, rapidly, reliably and with general validity. The best way to assess functional performance is to measure function! Metabolism and metabolites are the fuel and constituent parts of structure and its functions. Because of this, there must be a link between function, structure and metabolic activities and metabolite patterns. The successful symptomatic therapy of myoadenylate deaminase deficiency in patients by administration of ribose [20, 21] is just one good example of the relation between metabolism and function, and of the value of subtle studies of metabolism and analyses of metabolic patterns in animals and in man. PMID- 3284562 TI - The isolated heart preparation. AB - The major advantage of the isolated heart over isolated cardiac muscle for studying the effect of anaesthetics relates to the maintenance of the anatomy and function of the heart as a pump and the use of the native coronary circulation for cardiac nutrition and oxygenation. For the latter function, perhaps the blood perfused heart-lung preparation is more physiological but less controllable, particularly for metabolic studies. However, both preparations are predominantly useful for evaluating mechanisms and comparative biochemical pharmacology, rather than being relevant for clinical management. PMID- 3284564 TI - The acute open-chest model. PMID- 3284563 TI - Use of cardiopulmonary bypass in studies of the circulation. AB - In summary, CPB provides a complex set of physiological circumstances during which the patient is subjected to severe physiological alterations with surprisingly few adverse sequelae. Our ultimate goal in performing medical research is to provide scientific insights that improve patient care. Results of studies of animal models may not always be applicable to man. Although CPB possesses faults inherent to any experimental model, it nonetheless provides a unique opportunity to study safely and effectively a variety of physiological and pharmacological variables that affect cardiovascular functions in man. PMID- 3284565 TI - Acute closed-chest canine model for anaesthesia research. AB - An acute closed-chest canine model may be useful to study a wide variety of hypotheses relevant to cardiovascular physiology and pharmacology in circumstances which are clinically relevant. The absence of anatomical perturbations allows recovery of the subjects for conservation of animal resources and to serve as their own controls. The use of a chronic tracheostomy has facilitated inhalation anaesthesia without the use of other agents and allows easy access to the trachea in awake animals with minimal adverse effects. A thorough understanding of the techniques utilized aids in the interpretation of results obtained with this as with any other model. PMID- 3284566 TI - Clinical possibilities and limitations of techniques assessing the effects of anaesthetics on myocardial function. PMID- 3284567 TI - Regional length and thickness measurements. PMID- 3284568 TI - The pressure-length loop. PMID- 3284569 TI - Local forces in the myocardium. PMID- 3284570 TI - Use of the Walton-Brodie strain gauge arch to measure contractile force during anaesthesia. AB - The Walton-Brodie strain gauge arch is an instrument that quantitatively measures CF. Like many methods, the strain gauge arch is affected by loading conditions and heart rate. Nevertheless, this methodology, when properly used, has proved very useful in describing the direct action of anaesthetic drugs. Knowledge from strain gauge arch use has stimulated research to explain the negative inotropic effect of anaesthetics and helped clinicians understand the cardiovascular effects of drugs that they may wish to use. PMID- 3284571 TI - Reliability of PCWP as an index for left ventricular preload. PMID- 3284572 TI - Is the measurement of cardiac output useful in clinical practice? AB - The derivation of the "cardiac output" in man is fraught with difficulties whatever principle of measurement is used. The theories underlying the principles involved are sound; the problem arises in their application to the measurement in man. Of equal moment are the immense practical difficulties in applying the techniques available. Together these difficulties frequently give rise to unacceptable errors in the derivation of the "cardiac output". There is no "gold standard" of measurement; all methods have inherent difficulties in their application to man. If intense attention is paid to the practice of any one of the techniques available, then it is possible to reduce the variability of the measurement to acceptable proportions, but the conditions necessary to obtain such narrow ranges of variability in the human subject rarely obtain in routine clinical practice. These realizations apply to the techniques available at present, and it is difficult to imagine that there will be further development of the invasive methods available which would negate these. In contrast, it is possible that refinement of some of the non-invasive techniques now being introduced will allow reasonably reliable measurement of the cardiac output with greater facility than is possible at present. Finally, this brings into question the whole objective of the utility of measurement of cardiac output in practice. Frequently it is measured without due deference to its usefulness. Doubtless there are situations in which the measurement of cardiac output may be of scientific, if not of individual clinical benefit, for example the influence of drugs in hypertension and heart failure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284573 TI - Transoesophageal two-dimensional echocardiographic evaluation of anaesthetic effects on left ventricular function. PMID- 3284574 TI - Lipid requirement of the branched-chain amino acid transport system of Streptococcus cremoris. AB - The role of the membrane lipid composition on the transport protein of branched chain amino acids of the homofermentative lactic acid bacterium Streptococcus cremoris has been investigated. The major membrane lipid species identified in S. cremoris were acidic phospholipids (phosphatidylglycerol and cardiolipin), glycolipids, and glycerophosphoglycolipids. Phosphatidylethanolamine (PE) was completely absent. Protonmotive force-driven and counterflow transport of leucine was assayed in fused membranes of S. cremoris membrane vesicles and liposomes composed of different lipids obtained by the freeze/thaw-sonication technique. High transport activities were observed with natural S. cremoris and Escherichia coli lipids, as well as with mixtures of phosphatidylcholine (PC) with PE or phosphatidylserine. High transport activities were also observed with mixtures of PC with monogalactosyl diglyceride, digalactosyl diglyceride, or a neutral glycolipid fraction isolated from S. cremoris. PC or mixtures of PC with phosphatidylglycerol, phosphatidic acid, or cardiolipin showed low activities. In mixtures of PC and methylated derivatives of PE, both counterflow and protonmotive force-driven transport activities decreased with increasing degree of methylation of PE. The decreased transport activity in membranes containing PC could be restored by refusion with PE-containing liposomes. These results demonstrate that both aminophospholipids and glycolipids can be activators of the leucine transport system from S. cremoris. It is proposed that aminophospholipids in Gram-negative bacteria and glycolipids in Gram-positive bacteria have similar functions with respect to solute transport. PMID- 3284576 TI - Mechanisms of membrane assembly: general lessons from the study of M13 coat protein and Escherichia coli leader peptidase. PMID- 3284575 TI - Expression of human DNA polymerase beta in Escherichia coli and characterization of the recombinant enzyme. AB - The coding region of a human beta-polymerase cDNA, predicting a 335 amino acid protein, was subcloned in the Escherichia coli expression plasmid pRC23. After induction of transformed cells, the crude soluble extract was found to contain a new protein immunoreactive with beta-polymerase antibody and corresponding in size to the protein deduced from the cDNA. This protein was purified in a yield of 1-2 mg/50 g of cells. The recombinant protein had about the same DNA polymerase specific activity as beta-polymerase purified from mammalian tissues, and template-primer specificity and immunological properties of the recombinant polymerase were similar to those of natural beta-polymerases. The purified enzyme was free of nuclease activity. We studied detailed catalytic properties of the recombinant beta-polymerase using defined template-primer systems. The results indicate that this beta-polymerase is essentially identical with natural beta polymerases. The recombinant enzyme is distributive in mode of synthesis and is capable of detecting changes in the integrity of the single-stranded template, such as methylated bases and double-stranded region. The enzyme recognizes a template region four to seven bases downstream of the primer 3' end and utilizes alternative primers if this downstream template region is double stranded. The enzyme is unable to synthesize past methylated bases N3-methyl-dT or O6-methyl dG. PMID- 3284577 TI - A description of conformational transitions in the Pribnow box of the trp promoter of Escherichia coli. AB - Selective changes in the NMR parameters of the sequence of CGTACTAGTTAACTAGTACG, which corresponds to the trp operator of Escherichia coli, were observed as a function of temperature. The changes were localized to the sequence TTAA in the Pribnow box (underlined). Differential changes in chemical shift were analyzed in terms of a three-state model (states I, II, and III) to give the equilibrium constants, enthalpy changes, and populations. The midpoints of the first and second transitions were 9 and 30 degrees C, with enthalpy changes of 58 and 35 kcal/mol, respectively. Measurement of the spin-lattice and cross-relaxation rate constants at different temperatures allowed some structural conclusions to be drawn about the nature of the transitions. The line width of the H2 of A11 goes through a maximum at about 30 degrees C, indicating moderately fast exchange between the states. The rate constants for exchange at the midpoints were about 200 (I----II) and 250 (II----III) s-1. Taking these findings into account, we propose a mechanism for the interaction between RNA polymerase and the promoter. This mechanism can explain the temperature dependence observed for the initiation of transcription. PMID- 3284578 TI - Effect of secondary substrate binding in penicillopepsin: contributions of subsites S3 and S2' to kcat. AB - The kinetic parameters kcat, KM, and kcat/KM were determined at 25 degrees C and pH 4.5, 5.5, and 6.0 for the series of penicillopepsin substrates Ac-Alam-Lys (NO2)Phe-Alan-amide, where (NO2)Phe is p-nitrophenylalanine and m and n equal 0 3. KM values at pH 6.0 were the same for all 12 peptides and averaged 0.088 +/- 0.02 mM but increased to different degrees at lower pH. In contrast, kcat values increased with increasing chain length. At pH 6 and at the pH optimum of kcat, the largest increases (about 37-fold on average) were obtained when alanine residues were added in positions P2' and P3. Only 1-2-fold increases were observed for positions P2, P3', P4, and P4'. These results show that occupation of subsites S2' and S3 is largely responsible for the rate enhancements caused by secondary substrate interactions with this series of peptides. Additional support for an important role of subsite S3 comes from the observation that the two peptides where m = 1 and n = 1 or 2, respectively, are cleaved not only between lysine and p-nitrophenylalanine but also between the latter and alanine, suggesting that occupation of subsite S3 by the N-terminal alanine overcomes the unfavorable interaction of alanine in subsite P1'. Subsite S3 is also important in the binding of pepstatin analogues and in transpeptidation reactions. It is proposed that the roles of subsites S3 and S2' are to facilitate the conversion of the first enzyme-substrate complex into a productive complex and to assist in the distortion of the scissile bond.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284579 TI - Site-directed mutagenesis of histidine-388 in the hinge region of yeast 3 phosphoglycerate kinase: effects on catalytic activity and activation by sulfate. AB - It has been proposed that the catalytic mechanism of 3-phosphoglycerate kinase (PGK) and the regulation of its enzymatic activity by sulfate ions involve relatively large conformational changes. We have applied site-directed mutagenesis to assess the role of the interactions between glutamate-190 and histidine-388, located in the interdomain hinge region, in the substrate- and sulfate-induced conformational transitions. We have shown previously that substitutions of Glu-190 with either glutamine or aspartate resulted in a complete loss of sulfate activation and in decreased activities; corresponding to 26% and 36% of the activity of native PGK, respectively [Mas, M. T., Resplandor, Z. E., & Riggs, A. D. (1987) Biochemistry 26, 5369-5377]. In contrast, the Lys 388 and Ala-388 mutants retain the ability to undergo sulfate-induced activation and exhibit a larger decrease in activity (relative activities of 6% and 13%, respectively). The decrease of the enzymatic activities of these mutants and the relatively small changes of the Km values for the substrates imply that both residues participate in the catalytic mechanism by contributing to the conformational flexibility of the enzyme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284580 TI - Properties of the high-affinity single-stranded DNA binding state of the Escherichia coli recA protein. AB - The properties of the high-affinity single-stranded DNA (ssDNA) binding state of Escherichia coli recA protein have been studied. We find that all of the nucleoside triphosphates that are hydrolyzed by recA protein induce a high affinity ssDNA binding state. The effect of ATP binding to recA protein was partially separated from the ATP hydrolytic event by substituting calcium chloride for magnesium chloride in the binding buffer. Under these conditions, the rate of ATP hydrolysis is greatly inhibited. ATP increases the affinity of recA protein for ssDNA in a concentration-dependent manner in the presence of both calcium and magnesium chloride with apparent Kd values of 375 and 500 microM ATP, respectively. Under nonhydrolytic conditions, the molar ratio of ATP to ADP has an effect on the recA protein ssDNA binding affinity. Over an ATP/ADP molar ratio of 2-3, the affinity of recA protein for ssDNA shifts cooperatively from a low-to a high-affinity state. PMID- 3284581 TI - Structure of phenylalanine-accepting transfer ribonucleic acid and of its environment in aqueous solvents with different salts. AB - Yeast tRNA(Phe) was studied in different salt-containing solvents by UV absorbance and small-angle neutron scattering (SANS). This extends results obtained previously in NaCl and KCl solutions [Li, Z.-Q., Giege, R., Jacrot, B., Oberthur, R., Thierry, J. C., & Zaccai, G. (1983) Biochemistry 22, 4380-4388]. As expected, at low concentrations of all salts studied, the tRNA molecule is unfolded. The importance of specific counterion interactions and the flexibility of the macromolecule are emphasized by the observation that it cannot take up its folded structure in N(CH3)4Cl solvents, even when that salt concentration is increased to 1 M, in the absence of Mg ions. In CsCl solvents, on the other hand, the folded conformation is obtained in salt concentrations above about 0.2 M, similar to NaCl or KCl. By a comparison of SANS results in CsCl H2O and CsCl 2H2O solvents with the data from NaCl and KCl solvents, thermodynamic and structural parameters were derived for the solvated macromolecule. All the data are accounted for, quantitatively, by a model for the particle in NaCl, KCl, or CsCl solution made up of tRNA76-, closely associated with 76 positive hydrated counterions, surrounded by an aqueous solvent layer that excludes salt (and, therefore, of density different from that of bulk solvent). The mass of water in that layer depends on salt concentration, and the values found are consistent with those predicted by the Donnan effect. PMID- 3284582 TI - Deoxycytidylate hydroxymethylase: purification, properties, and the role of a thiol group in catalysis. AB - Deoxycytidylate (dCMP) hydroxymethylase from Escherichia coli infected with a T-4 bacteriophage amber mutant has been purified to homogeneity. It is a dimer with a subunit molecular weight of 28,000. Chemical modification of the homogeneous enzyme with N-ethylmaleimide (NEM) and 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB) leads to complete loss of enzyme activity. dCMP can protect the enzyme against NEM inactivation, but the dihydrofolate analogues methotrexate and aminopterin alone do not afford similar protection. Compared to dCMP alone, dCMP plus either methotrexate or aminopterin greatly enhances protection against NEM inactivation. DTNB inactivation is reversed by dithiothreitol. For both reagents, inactivation kinetics obey second-order kinetics. NEM inactivation is pH dependent with a pKa for a required thiol group of 9.15 +/- 0.11. Complete enzyme inactivation by both reagents involves the modification of one thiol group per mole of dimeric enzyme. There are two thiol groups in the totally denatured enzyme modified by either NEM or DTNB. Kinetic analysis of NEM inactivation cannot distinguish between these two groups; however, with DTNB kinetic analysis of 2-nitro-5-thiobenzoate release shows that enzyme inactivation is due to the modification of one fast-reacting thiol followed by the modification of a second group that reacts about 5-6-fold more slowly. In the presence of methotrexate, the stoichiometry of dCMP binding to the dimeric enzyme is 1:1 and depends upon a reduced thiol group. It appears that the two equally sized subunits are arranged asymmetrically, resulting in one thiol-containing active site per mole of dimeric enzyme. PMID- 3284583 TI - Stereochemical studies of D-glucal hydration by alpha-glucosidases and exo-alpha glucanases: indications of plastic and conserved phases in catalysis by glycosylases. AB - Alpha-Glucosidases from Aspergillus niger, pig serum, ungerminated rice, buckwheat, and sugar beet seeds (but not from brewers' yeast or honeybee) were found to catalyze the hydration of D-glucal. Each reactive alpha-glucosidase, incubated with D-glucal in D2O, was shown to protonate (deuteriate) this prochiral substrate from above its re face, i.e., from a direction opposite that assumed for protonating alpha-D-glucosidic substrates. At the same time, D-glucal hydration catalyzed by three of the alpha-glucosidases that acted rapidly enough in D2O to determine product configuration was found to yield 2-deoxy-D-glucose of the same specific (alpha-) configuration as the D-glucose produced from alpha-D glucosidic substrates. These findings substantially extend those reported earlier for the hydration of D-glucal by one (Candida tropicalis) alpha-glucosidase preparation. Together with other recent results, they suggest that the process of catalysis by alpha-glucosidases (and perhaps glycosylases in general) may comprise two separate and separately controlled parts, namely, a "plastic" phase concerned with substrate protonation and a substrate-unrelated "conserved" phase concerned with the creation of product configuration. In contrast to the alpha glucosidases, three "inverting" exo-alpha-glucanases (Arthrobacter globiformis glucodextranase; Rhizopus niveus and Paecilomyces varioti glucoamylase) were found to protonate D-glucal from below its si face. Further, whereas the catalysis of D-glucal hydration by the alpha-glucosidases was intensively inhibited by excess substrate, that promoted by the exo-glucanases showed no detectable substrate inhibition. PMID- 3284584 TI - Reconstruction by site-directed mutagenesis of the transition state for the activation of tyrosine by the tyrosyl-tRNA synthetase: a mobile loop envelopes the transition state in an induced-fit mechanism. AB - Site-directed mutagenesis of the tyrosyl-tRNA synthetase followed by kinetic studies has shown that residues which are distant from the active site of the free enzyme are brought into play as the structure of the enzyme changes during catalysis. Positively charged side chains which are in mobile loops of the enzyme envelope the negatively charged pyrophosphate moiety during the transition state for the formation of tyrosyl adenylate in an induced-fit mechanism. Residues Lys 82 and Arg-86, which are on one side of the rim of the binding site pocket, and Lys-230 and Lys-233, which are on the other side, have been mutated to alanine residues and also to asparagine or glutamine. The resultant mutants still form 1 mol of tyrosyl adenylate/mol of dimer but with rate constants up to 8000 times lower. Construction of difference energy diagrams reveals that all the residues specifically interact with the transition state for the reaction and with pyrophosphate in the E.Tyr-AMP.PPi complex. Yet, the epsilon-NH3+ groups of Lys 230 and Lys-233 in the crystalline enzyme are at least 8 A too far away to interact with the pyrophosphate moiety in the transition state at the same time as do Lys-82 and Arg-86. Binding of substrates must, therefore, induce a conformational change in the enzyme that brings these residues into range. Consistent with this proposal is the observation that all four residues are in flexible regions of the protein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284585 TI - Evaluation of 5-enolpyruvoylshikimate-3-phosphate synthase substrate and inhibitor binding by stopped-flow and equilibrium fluorescence measurements. AB - The binding of substrates and the herbicide N-(phosphonomethyl)glycine (glyphosate) to enolpyruvoylshikimate-3-phosphate (EPSP) synthase was evaluated by stopped-flow and equilibrium fluorescence measurements. Changes in protein fluorescence were observed upon the binding of EPSP and upon the formation of the enzyme-shikimate 3-phosphate-glyphosate ternary complex; no change was seen with either shikimate 3-phosphate (S3P) or glyphosate alone. By fluorescence titrations, the dissociation constants were determined for the formation of the enzyme binary complexes with S3P (Kd,S = 7 +/- 1.2 microM) and EPSP (Kd,EPSP = 1 +/- 0.01 microM). The dissociation constant for S3P was determined by competition with EPSP or by measurements in the presence of a low glyphosate concentration. At saturating concentrations of S3P, glyphosate bound to the enzyme--S3P binary complex with a dissociation constant of 0.16 +/- 0.02 microM. Glyphosate did not bind significantly to free enzyme, so the binding is ordered with S3P binding first: (formula; see text) where S refers to S3P, G refers to glyphosate, and E.S.G. represents the complex with altered fluorescence. The kinetics of binding were measured by stopped-flow fluorescence methods. The rate of glyphosate binding to the enzyme--S3P complex was k2 = (7.8 +/- 0.2) X 10(5) M-1 s-1, from which we calculated the dissociation rate k-2 = 0.12 +/- 0.02 s-1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284586 TI - Deuterium isotope effects in norcamphor metabolism by cytochrome P-450cam: kinetic evidence for the two-electron reduction of a high-valent iron-oxo intermediate. AB - The kinetics of NADH consumption, oxygen uptake, and hydrogen peroxide production have been studied for norcamphor metabolism by cytochrome P-450cam. The kinetic deuterium isotope effects on these processes, with specifically deuteriated norcamphor, are 0.77, 1.22, and 1.16, respectively. Steady-state UV-visible spectroscopy indicates that transfer of the second electron to the dioxy ferrous P-450 is the rate-limiting step, as it is when camphor is the substrate. The inverse deuterium isotope effect for NADH consumption is consistent with an isotope-dependent branching between monooxygenase and oxidase activity, where these reactivities differ in their NADH:oxygen stoichiometries. However, no isotope-dependent redistribution of steady-state intermediates was detected by isotopic difference UV-visible spectroscopy in the presence of norcamphor. The kinetic isotope effects and steady-state spectral results suggest that the high valent iron-oxo hydroxylating intermediate [FeO]3+ is reduced by NADH and the physiological electron-transfer proteins to afford water. PMID- 3284587 TI - Theoretical calculations on the acidity of the active site in aspartic proteinases. AB - Semiempirical minimal neglect of differential overlap-self-consistent field calculations, corrected and modified for multiple hydrogen-bonding interactions, were applied to models of the active site of aspartic proteinases (AP). The propensities of the two active-site aspartates to ionize were compared under the influence of various neighboring residues and of water molecules. Asp-32 and Asp 215 in three aspartic proteinases (endothiapepsin, Rhizopus pepsin, and penicillopepsin) are found to be basically asymmetric, Asp-32 being preferentially (by 2-3 kcal) ionized with respect to Asp-215. In penicillopepsin, this asymmetry is compensated by effects of surrounding residues. In our largest model for the active site, which includes such other residues, near equality is found for the ionizing tendency of Asp-32 and Asp-215. The pK difference is rationalized in terms of first and second ionizations of the full active-site model. Its ionization enthalpies correlate well with those of other small organic diacids. This "gas-phase" approach to AP active-site interactions represents the main possible contributions to the acidity of the active site. PMID- 3284588 TI - Influence of DNA sequence on the nature of mispairing during DNA synthesis. AB - A series of synthetic oligonucleotide primers, annealed at various positions along the lacZ-alpha region of bacteriophage M13mp9 template, were elongated by purified DNA polymerases in the presence of only 3 of the 4 deoxynucleoside triphosphates to achieve misincorporation at a total of 49 different positions along the template. The newly synthesized strands (containing misincorporated bases) were isolated and sequenced to determine the identity of misincorporated deoxynucleoside monophosphates. The results indicate that the kind of mispairing that occurs during DNA synthesis is greatly influenced by the nucleotide sequence of the template. Transition-type base substitutions predominated overall, but at many template positions, transversion-type base substitutions occurred, most commonly via A.A mispairing. The results of parallel determinations made with Escherichia coli DNA polymerase I ("large fragment" form) and DNA polymerase of Maloney murine leukemia virus indicated that, overall, the identity of polymerase had only a small effect on the kind of misincorporation that occurred at different positions along the template. However, at certain template positions, the nature of mispairing during DNA synthesis was reproducibly affected by differing polymerase active-site environment. PMID- 3284589 TI - Effect of pH on the base-mispairing properties of 5-bromouracil during DNA synthesis. AB - We have utilized an electrophoretic assay of misincorporation to investigate the possibility that ionization of 5-bromouracil (BU) may play a role in its mispairing during DNA synthesis in vitro. We examined the effects of increasing pH on the relative rates of formation of BU.G and T.G mispairs during chain elongation catalyzed by various DNA polymerases. For the Klenow fragment of Escherichia coli DNA polymerase I, increasing pH facilitated BU.G mispair formation (relative to T.G mispairing) when BU was present in the template strand. This effect showed a strong dependence on sequence context. Increasing pH had little effect on the relative rate of misincorporation of BrdUMP versus dTMP (at template G) by the Klenow polymerase. Misincorporation opposite template BU residues catalyzed by Maloney murine leukemia virus DNA polymerase and DNA polymerase beta (Novikoff hepatoma) also increased with pH, but for these two enzymes, there was no apparent dependence on sequence context. With T4 DNA polymerase and E. coli DNA polymerase III holoenzyme, a similar occurrence of BU.G and T.G mispairing during polymerization was observed, whether BU was present in the template or in the incoming nucleotide, and there was little effect of pH. The results reported here are consistent with a mispairing mechanism for template BU wherein the anionic form of the base mispairs with G. PMID- 3284590 TI - Effect of acceptor membrane phosphatidylcholine on the catalytic activity of bovine liver phosphatidylcholine transfer protein. AB - Protein-mediated transfer of phosphatidylcholine (PC) by bovine liver phosphatidylcholine transfer protein (PC-TP) was examined using a vesicle-vesicle assay system. Donor and acceptor membranes were prepared from Escherichia coli phospholipids and limiting amounts of egg yolk PC. PC transfer between vesicles of E. coli lipid/egg PC was markedly higher than transfer of PC from vesicles of E. coli lipid/egg PC to vesicles of E. coli lipid. Kinetic parameters of the interaction between PC-TP and E. coli lipid vesicles with or without PC was investigated. The apparent dissociation constants of the complex formed between PC-TP and these vesicles were determined kinetically and from double-reciprocal plots of intrinsic PC-TP fluorescence intensity increase versus vesicle concentration. The magnitude of the dissociation constant decreased as the PC content of the vesicles increased from 0 to 5 mol%. In addition, kinetic analysis revealed that the presence of PC in acceptor vesicles increased both the association and dissociation of PC-TP from vesicles. The effect of membrane PC molecules on transfer rates was examined using bis-phosphatidylcholine, a dimeric PC molecule which is not transferred by PC-TP. Rates of PC transfer to acceptor vesicles comprised of E. coli lipid/bis-PC were virtually identical to rates observed with acceptors vesicles prepared from E. coli lipid. The results suggest that transfer of PC by PC-TP is enhanced only when insertion of protein-bound PC occurs concurrently with the extraction of a molecule of membrane PC, i.e., a concerted, one-step catalytic mechanism for phospholipid exchange. PMID- 3284591 TI - Autolysis and inhibition of proteinase K, a subtilisin-related serine proteinase isolated from the fungus Tritirachium album Limber. AB - The activity of proteinase K (EC 3.4.21.14), a subtilisin-related serine proteinase, was assayed with azoalbumin that showed non-expected behavior in substrate saturation curve because of interaction between albumin molecules. Succinyl-(Ala)n-p-nitroanilide with n = 2 and 3, yielded specific activities of 3.5, 13 units/mg protein, respectively, reflecting a chain length dependence. The influence of peptide chain length on binding to proteinase K was also observed using mono- and dipeptide chloromethyl ketone inhibitors. They showed a maximum inhibition. They showed a maximum inhibition of proteinase K in solution of only about 50% even at a more than 20-fold molar excess. With the above substrates, the Vmax is not affected in presence of 10, 20 and 30% methanol, but the Km differs remarkably, suggesting competitive inhibition. The activity of proteinase K shows a maximum at 37 degrees C, and a temperature profile with more than 80% maximum activity in the range 20-60 degrees C. Autolysis of the enzyme is observed during sample preparation for SDS-gel electrophoresis and at low concentration (0.01 mg/ml) in aqueous solution. It does not occur at higher proteinase K concentrations at or above 1.0 mg/ml, consistent with crystallographic studies. PMID- 3284592 TI - Degradation of apolipoprotein B-100 in human chylomicrons. AB - The purpose of this study was to investigate the molecular forms of apolipoprotein B (ApoB) in human chylomicrons under well-preserved conditions. To this end, plasma and serum were collected from the same normal subjects after ingestion of a fatty meal. The samples were divided into three or four aliquots before the addition of various preservative mixtures, including antibiotics, antioxidants and proteinase inhibitors. The chylomicrons were isolated immediately, and all steps were carried out at or below 4 degrees C. Changes in the molecular weight of ApoB in chylomicrons were followed by a time study using 3.3% polyacrylamide gel electrophoresis containing SDS. ApoB from chylomicrons analyzed within 5 h of blood collection showed a single band with mobility identical to that of ApoB (ApoB-100) in low-density lipoproteins. When analyzed after 1-2 days, satellite bands smaller than ApoB-100 were observed, and a very faint band with Mr 200,000 appeared, which comigrated with intestinal ApoB (ApoB 48). Upon storage, the molecular weight of ApoB was smaller in chylomicrons subjected to a higher number of reflotations than those in chylomicrons washed less frequently, suggesting that purified chylomicrons degrade faster. A longer storage time at 4 degrees C (i.e., 7 or 14 days) revealed a stepwise degradation of ApoB, yielding Mr 200,000 band as the prominent form. The degradation of ApoB 100 was slower when both proteinase inhibitors, leupeptin and epsilon-amino caproic acid, were employed, and the appearance of Mr 200,000 band was quicker when the chylomicrons were processed at higher temperature (15-25 degrees C) in the absence of a proteinase inhibitor. Immunoblotting shows that the segment removed from ApoB-100 was the carboxyl-terminal portion. These results suggest the possible presence of a proteinase(s), which copurified with chylomicrons, and which converts ApoB-100 from a large to a smaller molecular form. Although the stop codon has been discovered recently in intestinal ApoB mRNA, which explains the mechanism for direct synthesis of ApoB-48, apparently ApoB-100 is also synthesized in the intestine of all eight subjects studied here, and the ApoB-100 degrades to a form which is ApoB-48-like. PMID- 3284593 TI - Lipoprotein lipase in heart cell cultures is suppressed by bacterial lipopolysaccharide: an effect mediated by production of tumor necrosis factor. AB - Exposure of rat heart cell cultures, consisting mainly of nonbeating mesenchymal cells, to 50 ng/ml of bacterial lipopolysaccharide (LPS) for 24 h resulted in a more than 80% reduction in lipoprotein lipase activity. The loss of enzymic activity was accompanied by a concomitant reduction in enzyme protein, as shown by immunoblotting. Addition of LPS to the culture medium resulted also in the production of tumor necrosis factor (TNF), and the fall in lipoprotein lipase in LPS-treated cultures could be prevented by an antibody to TNF. Addition of recombinant human TNF to the heart cell cultures also depressed lipoprotein lipase activity. LPS treatment of preadipocytes in culture resulted in a fall in lipoprotein lipase activity and TNF production. Since TNF is known as a macrophage product, the cultures were tested for phagocytic capacity, and only 0.2-1.3% of the cells were shown to engulf Staphylococcus albus. Immunofluorescent staining with monoclonal antibodies OX-1, which identify leukocyte common antigen, was negative, and only 0.1 +/- 0.07% of the cells were positive after staining with OX-42 antibody to iC3b receptor. Both antibodies stained more than 98% of rat peritoneal macrophages used as controls. Since LPS treatment of macrophages at numbers comparable to or exceeding the number of phagocytic cells present in the heart cell cultures did not induce measurable amounts of TNF, it is suggested that in the heart cell cultures, TNF may be produced by cells other than macrophages. PMID- 3284594 TI - Interspecific pregnancy: barriers and prospects. AB - Investigations on the mechanisms that allow survival of the fetal allograft have been extended by pregnancies in which the fetus and pregnant female are from different species. Such interspecific pregnancies are useful models for the study of maternal/fetal interactions and also may assist in the preservation of endangered species. Results of experiments with three different interspecific model systems are discussed: a murine model using Mus musculus and M. caroli; an equine model involving primarily the domestic horse and donkey, but including several wild Equidae; and a bovid model that crosses genera--pregnancy between the domestic sheep and goat. Species differences are reflected in results of experiments involving the various models. An immunological barrier appears to restrict interspecific pregnancy, but how the barrier is manifested appears to differ with species. Evidence for inappropriate interaction between trophoblast and endometrium is also presented. Results of experiments aimed at overcoming barriers to interspecific reproduction are discussed. PMID- 3284596 TI - Why aren't embryos immunologically rejected by their mothers? PMID- 3284595 TI - Episodic luteinizing-hormone release in the ovariectomized female guinea pig: rapid inhibition by estrogen. AB - Negative feedback of estrogen was investigated in ovariectomized female guinea pigs. Two weeks after ovariectomy, indwelling catheters were inserted into the jugular vein, and 3 days later, blood samples were taken every 10 min to determine the pattern of luteinizing hormone (LH) secretion. LH secretion in these guinea pigs was episodic, with a mean pulse period of 32 min. The mean pulse amplitude was 2.1 ng/ml, with mean plasma LH levels of 1.8 ng/ml. Twenty five micrograms 17 beta-estradiol (E2), given i.v., caused a pronounced inhibition of pulsatile LH release. Twenty-five microliters of 100% ethanol (vehicle) had no effect on plasma LH values. In a second set of experiments, ovariectomized female guinea pigs were given two injections of luteinizing hormone-releasing hormone (LHRH) (1 microgram/kg BW, i.v.) separated by 30 min. Sharp rises in serum LH values were detected after each injection. A third injection of LHRH was administered after an injection of either 25 micrograms E2 or 25 microliters vehicle. In the presence of E2, the LH response was significantly (p less than 0.005) diminished, whereas the vehicle did not change the LH response to LHRH. These rapid effects of E2 on LH secretion and the pituitary responsiveness to LHRH infusion indicate that in the ovariectomized guinea pig E2 can directly block gonadotropin secretion. These findings are consistent with the hypothesis that negative feedback actions of E2 are directly on the membrane of the gonadotrope. PMID- 3284597 TI - The biochemistry of female reproductive tissues studied by phosphorus nuclear magnetic resonance spectroscopy: effects of pregnancy, hormonal manipulation, and disease. PMID- 3284598 TI - Magnetic resonance imaging: a noninvasive tool for fetal and placental physiology. AB - Nuclear magnetic resonance imaging (MRI), a technique that utilizes biochemical information reflected in nuclear magnetic moments, can be used to image the uterus, fetus, and placenta of the human and nonhuman primate. MRI studies during pregnancy in the human and nonhuman primate provide soft-tissue structural information of considerable detail. MRI also offers the opportunity for noninvasive pharmacokinetic and toxicokinetic studies during pregnancy. Paramagnetic ions (Cu, Ni, Gd, Fe, Mn) after spin-lattice (T1) and spin-spin (T2) relaxation times in reproductive tissues. Changes in T1 and T2 alter the MRI image, reflecting uptake of paramagnetic ions by the uterus, placenta, or fetus. MRI provides a noninvasive method of monitoring body burden of selected xenobiotics during gestation. The use of paramagnetic labels on endogenous substances may also allow noninvasive determination of physiological parameters such as intervillous blood flow, placental metabolism, and placental transport during gestation. PMID- 3284599 TI - Sperm thrusts and the problem of penetration. PMID- 3284600 TI - Informed consent issues in the cardiac transplantation evaluation. AB - As consultation-liaison psychiatrists to a cardiac transplantation team, we have observed various informed consent issues that are particularly associated with evaluation for cardiac transplantation. We discuss complicating factors that relate to each component of informed consent and present the defense mechanism of denial as a barrier to making the decision to accept or refuse transplantation. Changes in the evaluation protocol could preclude existing impediments to provision of information and patient autonomy; however, certain intrapsychic issues must be recognized as ongoing clinical realities to be addressed as the doctrine of informed consent continues to evolve. PMID- 3284602 TI - A gas chromatographic/mass spectrometric assay for catechol estrogens in microsomal incubations: comparison with a radiometric assay. AB - A gas chromatographic/mass spectrometric assay for quantifying two catechol estrogens, 2-hydroxyestradiol and 4-hydroxyestradiol, in microsomal preparations is described. The assay employs deuterium-labeled analogs of the catechol estrogens as internal standards and permits quantification of catechol estrogens, in microsomal incubations, at low (1-2) microM concentrations. The compounds are analyzed as their trimethylsilyl derivatives following separation by capillary gas chromatography. PMID- 3284601 TI - The effects of progressive muscular relaxation on subjectively reported disturbance due to hospital noise. AB - Hospital noise has repeatedly been demonstrated to exceed levels recommended by the Environmental Protection Agency. Hospital noise from staff and machinery has been implicated in the etiologies of many behavioral disorders such as sleep deprivation, sensory overload, and altered comfort levels. Relaxation techniques have been shown to be effective in decreasing the aversiveness of many situations. This study tested the effects of progressive muscular relaxation (PMR) on subjectively reported disturbance due to hospital noise. In addition, noise sensitivity as a personality attribute was correlated with disturbance due to hospital noise and efficacy of PMR. A sample of 100 acutely ill hospitalized patients were randomly assigned to an experimental group or control group. The experimental group was instructed in the Bernstein-Borkovec technique of PMR; the control group received a short visit. Results revealed that the experimental groups had a significantly lower amount of disturbance due to hospital noise after being instructed in the use of PMR than prior to the intervention. Control group subjects demonstrated no such change. Noise sensitivity was found to be unrelated to either disturbance due to hospital noise or efficacy of PMR in decreasing disturbance due to hospital noise. PMID- 3284603 TI - Prevalence of maternal Ro (SS-A) and La (SS-B) autoantibodies in relation to congenital heart block. AB - The prevalence of autoantibodies to ribonucleoprotein antigens in cases of congenital heart block was established using immunofluorescence, counterimmunoelectrophoresis, double immunodiffusion and Western blots. All of 35 mothers of babies with congenital heart block, none of five mothers of babies with other types of heart block, 10 of 29 women with connective tissue disease but no babies with heart block, four of 445 normal pregnant women and two of 109 healthy nonpregnant women had either Ro (SS-A) or La (SS-B) antibodies. Of 15 babies with congenital heart block, 10 of 10 who were less than 3 months old possessed antibody. Antibody titres in affected but not in normal infants were lower compared with their mothers' titres, suggesting deposition of antibodies in the baby's tissues. The findings indicate that placental transfer of anti-Ro (SS A) or anti-La (SS-B) is essential for development of congenital complete heart block. PMID- 3284604 TI - The polymorphonuclear cell in rheumatoid arthritis. PMID- 3284605 TI - Rheumatoid factor: Dr. Jekyll or Mr. Hyde? PMID- 3284606 TI - Nonsteroidal anti-inflammatory drugs--another look. PMID- 3284608 TI - Gonadal regulation of corticotropin-releasing factor immunoreactivity in hypothalamus. AB - The effect of gonadectomy and subsequent gonadal steroid administration on hypothalamic corticotropin-releasing factor immunoreactivity (CRF-ir) in male and female rats was determined using a radioimmunoassay specific for rat CRF. When compared to appropriate controls, gonadectomy resulted in significantly decreased CRF-ir in both males and females (p less than 0.025). Short-term replacement with testosterone or estradiol did not significantly alter hypothalamic CRF-ir. Acute IC administration of gonadotropin-releasing hormone to male rats significantly decreased CRF-ir in the median eminence 15 minutes later. Chronic administration of estradiol for 3 weeks significantly reduced CRF-ir in ovariectomized rats (p less than 0.005). This decrease was shown not to correlate to the marked increase in anterior pituitary weight (r2 = 0.063, not significant). Chronic administration of estradiol to hypophysectomized female rats significantly decreased hypothalamic CRF-ir (p less than 0.01), an effect localized to the median eminence (p less than 0.005). These data imply that the gonadectomy induced reduction in hypothalamic CRF-ir was not directly mediated by the loss of gonadal steroids. Chronic estradiol treatment decreased hypothalamic CRF-ir, by a non-pituitary mechanism. These data show significant effects of the gonadal axis in the regulation of CRF in the hypothalamus in both sexes. PMID- 3284609 TI - Male breast cancer in renal allograft recipient. PMID- 3284607 TI - Kufs' disease: a critical reappraisal. AB - A review of 118 cases published as Kufs' disease revealed only 50 cases, including 2 patients described herein, that fulfilled our criteria for this diagnosis. Of the other 68 cases, 16 had inadequate data for analysis, 21 had evidence of a storage disease other than Kufs' disease, 10 did not have clear evidence of any neuronal storage, and 21 had atypical clinical features considered outside the spectrum of Kufs' disease. The 50 cases accepted as Kufs' disease comprised two clinical phenotypes; progressive myoclonus epilepsy (Type A) and dementia with motor disturbances (Type B). Marked photosensitivity was a striking feature of some Type A cases, and facial dyskinesias were common amongst Type B patients. Onset was typically at around the age of 30 years. A few cases began in adolescence; these differ from the protracted juvenile form of neuronal ceroid-lipofuscinosis by the absence of visual failure. Demonstration of fingerprint profiles or granular osmiophilic deposits by electron microscopy is mandatory for definitive diagnosis. Urinary sediment dolichol levels were markedly elevated in our 2 cases. This biochemical finding confirms the relationship of Kufs' disease to the early forms of neuronal ceroid lipofuscinosis and is consistent with our hypothesis that these diseases are due to defects in the intracellular processing of lysosomal and related membranes. PMID- 3284610 TI - Neurological paraneoplastic syndromes. PMID- 3284611 TI - Targeting of cytotoxic cells with heterocrosslinked antibodies. PMID- 3284612 TI - Child abuse as an international issue. AB - This paper provides a background and suggests a strategy for an international approach to policy development concerning child abuse. First, child abuse is defined in a way that makes it applicable across cultures and national boundaries as that portion of harm to children that results from human action that is proscribed, proximate and preventable. A number of other dimensions, such as the degree of social sanction or social censure, are outlined that also affect the likelihood that given harm will be regarded as child abuse. Cross-cultural research also reveals that certain categories of children--such as those in poor health, females, unwanted children and those born under difficult circumstances or with disvalued traits or under conditions of rapid socioeconomic change--are more vulnerable to maltreatment in many countries. The paper argues for a two pronged international strategy that first urges individual countries to make a priority of the particular types of abuse that are in most urgent need of attention in their society as well as participating at the same time in a concerted international focus on three widely occurring forms of child abuse: parental child battering, selective neglect, and sexual abuse. PMID- 3284613 TI - The sexual victimization of male children: a review of previous research. AB - The evidence available at this time indicates that male children are more likely to be abused by nonfamily rather than family members. Residing in a neglectful home or a mother-headed household and having previous homosexual contact tend to heighten risk for sexual abuse by nonfamily members. Familial sexual abuse appears related to residence in a home where other siblings are being abused, where the father was a victim of sexual abuse as a child, and where parents suffer myriad personal and social adjustment difficulties. Effects of male child sexual abuse appear to be serious and long lasting. The scant writings available at this time imply that the sexually abused male child experiences a range of adjustment and self-esteem problems as an adult and may be at heightened risk to become a child sexual abuser. PMID- 3284614 TI - Child abuse in nineteenth century Queensland. AB - Various forms of the social and medical dilemma now referred to as child abuse occurred in 19th century Queensland. Incidents ranging from parental carelessness and neglect to deliberate injury and murder were reported in the lay and medical press. This paper investigates abuse of infants in Queensland in the latter half of the 19th century in the context of socioeconomic conditions, family stress, concepts of morality and prevailing social mores. Identifiable incidents include infanticide, injury, deliberate neglect, neglect due to ignorance and poverty, and accidents or poisonings where abuse appears to have been a factor. Child abuse stimulated the medical profession, religious bodies, groups of concerned citizens, and eventually the state to intervene to protect and care for endangered children. These initiatives and the social and moral attitudes they reflected are also examined. Legal definitions and records of court proceedings are evaluated as well so that changes in official as well as social attitudes can be better understood. PMID- 3284615 TI - [Selection of the technic and intravenous agent for suspension laryngoscopy]. PMID- 3284616 TI - [Anesthesia in the surgical treatment of laryngo-tracheal stenoses after intubation or tracheotomy]. PMID- 3284617 TI - [Problems presented by the surgery of hepatic injuries: vascular clamping and metabolic complications]. PMID- 3284618 TI - [Our 2 hearts are only one. Anesthesia for detachment of the retina in a patient with a heterotopic heart graft]. PMID- 3284619 TI - [Vaporization--vaporizers]. PMID- 3284621 TI - Cardiac rejection following transplantation in dogs: transmural myocardial blood flow changes. AB - In cardiac allografts acute rejection produces deleterious effects on blood flow adjustments. In order to differentiate the role of rejection over that of denervation cardiac denervated and cardiac transplanted dogs were compared. A canine model of orthotopic cardiac transplantation was utilized. Electronic devices were implanted for chronic hemodynamic studies. Regional myocardial blood flow distribution was assessed by radioactive microspheres (15 micron in diameter). Studies were carried out when animals had fully recovered (two to three days postoperatively), then in the 'early rejection' stage (five to six days post transplant) and in the 'severe rejection' stage (24 h before death). No significant difference in hemodynamic data or blood flow values were observed between groups in the recovery stage. In the denervated group, adequate cardiac function and myocardial blood perfusion was maintained throughout the study. In the transplanted group, significant loss of function was observed at the severe rejection stage. This was combined with significant decrement in blood flow to all areas of the myocardium. No selective area of underperfusion nor an early reduction in total blood flow could be observed. This study indicates that within cardiac rejection there is a parallel impairment in function and transmural myocardial blood flow which is unrelated to denervation or interruption of lymphatics. PMID- 3284620 TI - A hundred years of progress in electrocardiography. 2: The rise and decline of vectorcardiography. AB - Throughout the 20th century electrocardiography has been almost exclusively preoccupied by the single dipole concept as a model to account for body surface manifestations of cardiac electrical activity. Vectorcardiography, based on the single dipole approximation as an equivalent cardiac generator, has prevailed for over one half of this century as one of the most prominent components of electrocardiographic research. In retrospect, vectorcardiography has had conceptually an important impact on the progress in electrocardiography although it never became widely used in clinical practice. Recent comparative studies have confirmed that the diagnostic information contents of the standard 12-lead electrocardiogram and the vectorcardiogram are practically identical if adequately powerful, identical diagnostic classification procedures are used in extracting diagnostic information. After serving a useful role as a conceptual model, vectorcardiography is gradually fading away, being replaced by more realistic cardiac source models and by body surface leads supplementing in a better way the information content of the standard ECG leads. PMID- 3284622 TI - Ivalon sponge wrap operation. PMID- 3284623 TI - Treatment of experimental peritonitis with intraperitoneal povidone-iodine solution. AB - Intraperitoneal lavage with povidone-iodine solution has been reported by some to be beneficial in the treatment of peritonitis and by others to cause local and toxic side effects. In this study, 200 white mice, divided into four groups of 50, were subjected to bacterial peritonitis. The first group had no treatment; peritoneal lavage was carried out using povidone-iodine solution in the second group and a 0.9% sodium chloride solution in the third. In the fourth group, antibiotics (clindamycin and gentamicin) were instilled intraperitoneally without peritoneal lavage. The povidone-iodine solution had no beneficial effect, the death rate after 1 week (76%) being similar to that in the control group (78%) and much higher than that in mice treated with sodium chloride lavage (38%) and antibiotics without lavage (16%). A second series of experiments was, therefore, carried out to investigate the toxic effect of povidone-iodine solution intraperitoneally on mice without peritonitis; the solution was found to be toxic. PMID- 3284624 TI - Lipomas of the colon: a clinicopathologic review. AB - The authors review their experience with lipomas of the colon at St. Boniface General Hospital in Winnipeg, Man., during the period 1974 to 1985, and compare their clinicopathologic evaluation with that reported in the literature. Among 15 patients (average age 66.7 years), the majority of whom were women, 17 lipomas were found; all were submucosal. One-third of the lesions were symptomatic. The most frequent symptoms were abdominal pain, rectal bleeding and a change in bowel habit. Only one patient had multiple lesions. The right colon was most frequently affected. Five patients underwent major colonic resection either because the diagnosis was confused with carcinoma or because of intussusception. Only one patient was treated by colotomy and polypectomy. Although most lipomas are small and asymptomatic, tumours larger than 2 cm tend to produce complications or be confused with carcinoma. PMID- 3284625 TI - Further remembrances of that revered anatomist, Dr. J. C. Boileau Grant. AB - From access to a detailed curriculum vitae written by Dr. Grant when he was about 75 years old, the author has learned some little-known facts of his background and life. His ancestors came from France and had been ennobled. One predecessor was a mayor of Paris. Several of his family decided to emigrate to Great Britain with the Huguenot movement. Grant graduated from the University of Edinburgh in 1908 in the same class as his future brother-in-law, William Boyd. When World War I was declared, he immediately volunteered for the army. During service on the Western Front, he was mentioned in dispatches in 1916, won the Military Cross in 1917 and a bar to the Military Cross in 1918. At the outbreak of World War II, Grant, who had been a professor of anatomy first in Winnipeg and then in Toronto for many years, volunteered again for war service, but was rejected as being too valuable a teacher to be allowed to enlist. PMID- 3284627 TI - Evaluation of a kit for rapid detection of group A streptococci in a pediatric emergency department. AB - We evaluated a kit for the rapid detection of group A streptococci from throat swabs (Culturette Brand 10-Minute Group A Strep ID, Marion Scientific, Division of Marion Laboratories, Inc., Kansas City, Missouri) in the laboratory and in a busy pediatric emergency department. The sensitivity of the kit in the laboratory was 80% for all specimens and 94% for specimens with more than 10 colony-forming units of group A streptococci; the specificity was 99%. After initial training, emergency department pediatricians and nurses achieved sensitivities of 72% and 69% respectively. The specificity achieved by the pediatricians was 76% initially but 96% after further training. Untrained residents achieved a sensitivity of 58%. We conclude that this kit is potentially useful in the hands of adequately trained personnel, but without training the accuracy of the results is unacceptable. We recommend that the kit be used by designated staff trained and monitored by laboratory personnel. PMID- 3284626 TI - Ventricular arrhythmias. AB - Sudden cardiac death claims thousands of Canadians annually. Ventricular tachycardia and fibrillation account for up to 85% of these deaths. Identifying the patients at risk remains a major challenge. Those who have recurrent ventricular tachycardia or have been resuscitated from ventricular fibrillation are generally considered to be at highest risk. Although ventricular premature beats in the absence of previous ventricular tachycardia or fibrillation are not helpful in identifying such patients in most cases, they can indicate increased risk for sudden cardiac death in the presence of a structural cardiac abnormality, particularly recent myocardial infarction; however, the need for treatment in such cases is speculative and is being investigated. Treatment is mandatory for survivors of an episode of ventricular fibrillation and those with recurrent sustained ventricular tachycardia or torsade de pointes ventricular tachycardia. The approach to management is either invasive or noninvasive. Selection of an antiarrhythmic agent is facilitated by knowledge of some basic electrophysiologic features of the heart and of the classification of antiarrhythmic drugs. However, drug therapy has to be individualized on the basis of efficacy, left ventricular function and adverse effects or potential adverse effects of the drug. Amiodarone therapy or nonpharmacologic therapy should be considered if a suitable antiarrhythmic agent cannot be found. PMID- 3284628 TI - Aspergillosis of the nose and paranasal sinuses in immunocompromised children. PMID- 3284629 TI - Dr. Mary Fanning: caring for AIDS patients at Toronto General. PMID- 3284630 TI - Treatment of bulimia with desipramine: a double-blind crossover study. AB - The purpose of this study was to evaluate the effect of desipramine, a tricyclic antidepressant with relatively specific noradrenergic effects, on bulimic behaviour, eating attitudes, and mood. Using a double-blind crossover design, 47 normal weight bulimics were randomly assigned to receive either desipramine (150 mg/day) for six weeks, no drug for three weeks, followed by placebo for six weeks, or the reverse sequence. At weeks 0, 2, 4, 6, 9, 11, 13, and 15, each subject was assessed using the EDI, SCL-90, POMS and binge records. Plasma desipramine levels were obtained at weeks 4 and 13. Twenty-four subjects completed the entire fifteen week protocol, while 23 dropped out. Desipramine was significantly more effective than placebo in reducing the frequency of weekly binding, weekly vomiting, and the fatigue scale of the POMS. No significant effect of the drug was obtained on the EDI or the SCL-90. The clinical effect was modest. Desipramine's antibulimic effects were not associated with an alleviation of depressive symptoms. PMID- 3284631 TI - [Passive-aggressive personality and dependent personality-- current status of the question]. AB - The author makes a critical review of the literature concerning dependent and passive-aggressive personalities. After putting them in a historic perspective, he presents the various etiologic hypotheses. Special attention is given to the clinical and therapeutic aspects. The author concludes that despite the supposed high incidence of these two personality disorders, the reliability of the diagnoses and the natural history of the disorders remain to be explored in a prospective and systematic manner, before definite conclusions can be drawn regarding therapy. PMID- 3284632 TI - Dysthymia: a randomized study of cognitive marital therapy and antidepressants. AB - Preliminary data from a randomized study of the effectiveness of combined marital therapy and antidepressant medication in the treatment of dysthymic married women is presented. The study compares doxepin with placebo, and a marital therapy designed to enhance intimacy through facilitating self-disclosure between spouses with a more supportive and educational therapeutic approach. After ten weeks of combined treatment, the dysthymic women show statistically significant improvement on all the depression measures as well as on the intimacy scale. A trend is developing for greater reduction of depressive symptomatology in the group treated with self-disclosure. The evidence appears to suggest the possibility that the presence of a patient's husband as a supportive figure may of itself be a potent therapeutic manoeuvre in the treatment of dysthymic women. PMID- 3284633 TI - The scope of the problem of primary tumor control. AB - The purposes of this article are (1) to point out several aspects of the magnitude and importance of the overall cancer problem, (2) to emphasize that the treatment of the primary lesion is far from being uniformly successful, and (3) to consider one component of a strategy to help assure an effective level of support for research at the laboratory and clinical level to promote improvement in the efficacy of primary treatment modalities. PMID- 3284634 TI - TNM classification of malignant tumors. A comparison between the new (1987) and the old editions. AB - A major revision of the tumor, nodes, metastasis (TNM) classification has been published. It eliminates previous differences between the International Union Against Cancer (UICC) and American Joint Committee on Cancer (AJCC) versions. It also updates existing site classifications and adds chapters on previously unclassified tumors. This article summarizes the major changes from the past to the present editions of the TNM classification. PMID- 3284635 TI - Monoclonal antibody detection of carcinoma cells in bone marrow biopsy specimens from breast cancer patients. AB - The possibility of using immunologic methods for detecting metastatic cells in bone marrow samples from breast cancer patients was investigated. The MBr1 monoclonal antibody, which recognizes a membrane antigen on breast carcinoma cells and is unreactive on normal bone marrow cells, seemed to be an adequate reagent for this kind of approach. When human leukocyte suspensions artificially contaminated with mammary tumor cells were tested by MBr1 immunofluorescence, it was demonstrated that the added tumor cells could be specifically discriminated from normal cells and that as little as one tumor cell in 200,000 could be detected. With the same methodology we screened bone marrow biopsies from breast cancer patients with apparently uninvolved lymph nodes at the moment of surgery. Immunoreactive tumor cells were detected by the MBr1 antibody in 17% of N- patients. None of the bone marrow samples showed any evidence of tumor involvement by conventional histologic analysis. PMID- 3284636 TI - The proliferative potential of human ependymomas measured by in situ bromodeoxyuridine labeling. AB - Twelve patients with ependymomas received a 30- to 60-minute intravenous infusion of bromodeoxyuridine (BrdU), 150 to 200 mg/m2 at surgery, to label tumor cells in the DNA synthesis phase. Labeled cells were detected in excised tumor specimens by indirect immunoperoxidase staining using anti-BrdU monoclonal antibody as the first antibody. The BrdU labeling index (LI, defined as the percentage of labeled cells in relation to the total number of cells scored) was calculated for each specimen. All four spinal cord ependymomas had a BrdU LI of less than 1%, which is consistent with our clinical experience that most such tumors grow slowly and have an excellent prognosis. Five of the eight intracranial ependymomas also had a low BrdU LI of approximately 1% or less, and three had a BrdU LI of 3.2%, 3.4%, and 4.8%. The latter three tumors, only one of which was diagnosed as a malignant ependymoma at the time of study, were either recurrent or recurred within 2 years after gross or subtotal removal. Cytologic analysis of cerebrospinal fluid (CSF) was performed in five cases; CSF seeding of tumor cells was found in only one patient, who had a malignant ependymoma. A high BrdU LI did not always correlate with CSF seeding. Measurement of the LI using BrdU and anti-BrdU monoclonal antibodies can provide more accurate information on the proliferative potential of individual tumors and may lead to a more rational grading system of ependymomas. The results of such studies do not always predict the potential for CSF seeding. PMID- 3284637 TI - Solid cancer risk after treatment of Hodgkin's disease. AB - We pooled the data from seven studies of second cancer risk after treatment of Hodgkin's disease (HD) and estimated the relative risks (RR) of solid cancers (SC) for the following two treatment groups: (1) radiotherapy, with or without chemotherapy; and (2) chemotherapy alone. For all treatment groups combined, the RR of SC was 2.1 (95% confidence limits: 1.8 to 2.4). In the radiotherapy group, statistically significant RR were found for SC for all anatomic sites (RR: 2.2; 95% confidence limits: 1.9 to 2.6) and for SC of the bones and joints (RR: 20.0), soft tissues (RR: 18.3), non-HD lymphomas (RR: 8.1), melanomas of the skin (RR: 6.7), buccal cavity and pharynx (RR: 4.1), nervous system (RR: 3.6), respiratory system (RR: 2.5), and digestive system (RR: 1.8). In the chemotherapy alone group, none of the RR differed significantly from unity, and the RR for SC of all sites was 1.1 (95% confidence limits: 0.5 to 1.9). The average duration of follow up for patients with chemotherapy was shorter than the duration of follow-up for patients with radiotherapy. This may explain the general absence of elevated RR after chemotherapy. PMID- 3284638 TI - Breast cancer metastasizing to the uterine cervix. AB - Three cases of breast cancer that metastasized to the uterine cervix are presented. A review of the literature disclosed 21 additional cases. Seventy-five percent of the patients presented with abnormal vaginal bleeding, 62% had no gross evidence of malignancy on examination, and in 89% the cervical metastases were a manifestation of widespread disease. PMID- 3284639 TI - Roles of cytochrome P-450 enzymes in chemical carcinogenesis and cancer chemotherapy. PMID- 3284640 TI - Identification of the human papillomavirus type 18 E6 and E6 proteins in nuclear protein fractions from human cervical carcinoma cells grown in the nude mouse or in vitro. AB - We recently reported the transcription patterns of human papillomavirus (HPV) type 18 sequences in human cervical carcinoma cell lines. The open reading frames (ORFs) E6* and E6 represent the 5'-terminal cistrons in HPV18 mRNAs. ORF E6* was assumed to be specific for HPV types associated with genital carcinomas. To identify the predicted gene product, ORF E6* from a HeLa cDNA clone was expressed as an MS2 fusion protein in Escherichia coli. The C-terminal 23 amino acid residues were chemically synthesized. A panel of monoclonal antibodies was generated, recognizing E6* and E6* plus E6, respectively. In human cervical carcinoma cell lines grown in vitro these monoclonal antibodies specifically immunoprecipitate the putative Mr 17,000 and 18,000 HPV18 E6 proteins in nuclear protein fractions. In a HPV18 DNA containing human cervical carcinoma established in nude mice, these monoclonal antibodies specifically immunoprecipitate a polypeptide with a molecular weight of 6500 as predicted for the HPV18 ORF E6* gene product in a nuclear protein fraction. PMID- 3284642 TI - Novel method for selective killing of transformed rodent cells through intercellular communication, with possible therapeutic applications. AB - A novel method for killing transformed cells selectively, without affecting surrounding nontransformed cells, has been developed. The method is based on our finding that transformed cells form their own gap-junctional communication compartment which is independent of that of adjacent nontransformed cells; transformed cells and adjacent normal cells transfer molecules through gap junctions among their homologous cells, but there is no heterologous transfer. Thus, when Lucifer Yellow CH is microinjected into transformed cells, it spreads only among the transformed cells and not to surrounding nontransformed cells. Subsequent irradiation of cells with blue light (around 430 nm) kills only those cells containing Lucifer Yellow CH (i.e., transformed cells), and surrounding normal cells continue to grow after treatment. We succeeded in killing BALB/c 3T3 transformed foci induced in situ by a chemical carcinogen or by an activated oncogene, and in killing tumorigenic rat liver epithelial cells cocultured with nontumorigenic counterparts. Potential development of this phenomenon for cancer therapy is suggested. PMID- 3284641 TI - Tissue uptake, distribution, and potency of the photoactivatable dye chloroaluminum sulfonated phthalocyanine in mice bearing transplantable tumors. AB - The potency of chloroaluminum sulfonated phthalocyanine (ClAlSPc) as a photosensitizing agent for photodynamic therapy of cancer was evaluated in vivo by its ability to be taken up and retained by murine tumors of diverse histological origin. Antitumor effects following laser irradiation were evaluated by measurement of the tumor weights of dissected-out tumor masses. Three tumors (Colo 26, a colorectal carcinoma; M5076, a reticulum cell sarcoma; and UV-2237, a fibrosarcoma) growing s.c. in the flank region retained substantially greater quantities of ClAlSPc than did adjacent skin and muscle achieving peak values 24 48 h after the i.v. administration of ClAlSPc (10 mg/kg). The relative magnitude of ClAlSPc retention by these tumors was Colo 26 greater than M5076 greater than UV-2237. However, normal liver and spleen were organs which retained the greatest amounts of ClAlSPc even compared to the s.c. grown tumors and other normal tissues examined. Flow cytometric analysis of tumor cell suspensions obtained from collagenase-digested tumors showed that individual neoplastic cells were capable of taking up and retaining ClAlSPc. Photodynamic therapy, undertaken by i.v. administration of dye (5 mg/kg) followed 24 h later by local laser light irradiation (675 nm, 100 J), brought about significant (Colo 26, M5076, and 3LL tumors) and obvious but nonsignificant (UV-2237 tumor) reductions in tumor weights, as assessed 5 days later. Thus, selective tumor retention of ClAlSPc coupled with a significant response to red light produced dramatic alterations in cancer growth. PMID- 3284643 TI - Diastolic ventricular function. A short overview. PMID- 3284644 TI - [Platelet concentrates]. PMID- 3284645 TI - [Diagnosis of bacteremia using a hemoperfusion column]. PMID- 3284646 TI - [Purkinje's commemoration 100 years ago]. PMID- 3284647 TI - [The Vietnam-Czechoslovak Friendship Hospital in Haiphong]. PMID- 3284648 TI - [Hungarian medical students at Charles University]. PMID- 3284649 TI - [The Prague Botanical Gardens]. PMID- 3284650 TI - [The original series of Otto's encyclopedia and Czech physicians]. PMID- 3284651 TI - Immunocytochemical localization of the major glycoprotein of epididymal fluid from the cauda in the epithelium of the mouse epididymis. AB - The most abundant protein in fluid from the mouse cauda epididymidis, designated CP 27, is a glycoprotein that migrates at approximately 27000 daltons on SDS polyacrylamide gels. Samples of CP 27 were isolated by preparative gel electrophoresis and were used to raise a guinea-pig polyclonal antiserum, which reacted with a single band on western blots of caudal epididymal fluid. This antiserum was used for immunocytochemical localization of CP 27 in histological sections of mouse epididymis using the peroxidase-antiperoxidase and protein A gold methods. The most proximal staining with anti-CP 27 was in segment 6 of the distal caput epididymidis, where the lumen and a portion of the supranuclear cytoplasm of principal cells were stained. In contrast, in the distal corpus and cauda epididymidis (segments 8-11), there was pronounced staining of the luminal contents, sterocilia, and scattered cells identified as the "light" cells of the epididymal epithelium. Although CP 27 was found in the epididymal lumen of all segments distal to segment 6, the intensity of staining appeared to decline distally in the cauda epididymidis. Control sections exposed to pre-immune serum instead of anti-CP 27 showed no reaction. The results suggest that CP 27, the major glycoprotein of cauda epididymal fluid, is synthesized by principal cells of segment 6 of the distal caput epididymidis. CP 27 may be among the substances absorbed from the lumen by the light cells of the distal epididymis. PMID- 3284652 TI - Epithelial and neuronal calbindin in avian intestine. An immunohistochemical study. AB - It is well known that calbindin immunoreactivity is highly concentrated in the duodenal absorptive cells of young birds. We have shown that in the adult intestine of three avian species, calbindin content is much more variable. In addition to absorptive cells, we have detected throughout the gut of both sexes of the domestic fowl and in the large intestine of the Japanese quail a second type of calbindin-positive epithelial cell which has the shape of a typical endocrine cell. These cells were particularly abundant in the large intestine, in contrast to the usual distribution of endocrine cells along the gut. Calbindin was also detected in the nervous system of the intestine. Calbindin-positive nerve fibres were rare in the duodenum and ileum, numerous in plexuses and nerve processes in both muscular layers and lamina propria of the large intestine in domestic fowl and Japanese quail. In the mallard, nerve fibres were rarely calbindin positive while definitively positive for VIP. Calbindin of the peripheral nervous system of the domestic fowl and Japanese quail comigrates with the duodenal calbindin (27,000 dalton) in SDS gel electrophoresis. PMID- 3284653 TI - Capsule loss in H. influenzae type b occurs by recombination-mediated disruption of a gene essential for polysaccharide export. AB - The capsulation locus cap in H. influenzae type b contains directly repeated segments of DNA flanking a bridge region. Here we show that this bridge region contains a gene, bexA, encoding a 24.7 kd protein essential for export of capsular polysaccharide. bexA is disrupted, with loss of part of its coding sequence, in the spontaneous reduction of the duplicated cap locus to single-copy that accompanies loss of capsule expression. The predicted amino acid sequence of BexA aligns significantly with that of MalK from E. coli and with HisP and OppD of S. typhimurium. Thus, polysaccharide export might occur via an energy dependent transporter with similarities to those identified for the import of various substrates into Gram-negative bacteria, BexA being the "energizer" of the transporter. PMID- 3284654 TI - A single amino acid determinant of the membrane localization of lipoproteins in E. coli. AB - When beta-lactamase was fused with the signal peptide plus the amino-terminal 9 amino acid residues of the major outer membrane lipoprotein, the resultant lipo beta-lactamase (LL-1) was shown to be localized to the outer membrane. However, when the 9 residue sequence was replaced with the amino-terminal 12 residue sequence of lipoprotein-28, an inner membrane protein, the resultant lipo-beta lactamase (LL-2) was found exclusively in the inner membrane. The localization of LL-2 was shifted to the outer membrane simply by substituting the second amino acid residue (Asp) of LL-2 with Ser. Conversely, the alteration of the second residue (Ser) of LL-1 to Asp resulted in the localization of LL-1 to the inner membrane. These results suggest that the second amino acid residue of the lipoproteins plays a crucial role in determining their final locations in the E. coli envelope. PMID- 3284655 TI - A yeast replication origin consists of multiple copies of a small conserved sequence. AB - Autonomously replicating sequences (ARSs) of the yeast S. cerevisiae function as replication origins on plasmids and probably also on chromosomes. ARS function requires a copy of the ARS core consensus (5'-[A/T]TTTAT[A/G]TTT[A/T]-3') and additional sequences 3' to the T-rich strand of the consensus. Our analysis of an ARS from chromosome III, the C2G1 ARS, suggests that ARS function depends on the presence of an exact match to the core consensus and the presence of additional near matches in the 3' flanking region. We have demonstrated that ARS function can be mediated by multiple matches to the core consensus by constructing synthetic ARS elements from oligonucleotides containing copies of the consensus sequence. We find that two copies of the core consensus are sufficient for ARS activity and that an artificial ARS as efficient as a natural chromosomal ARS can be constructed from multiple core consensus elements in a specific orientation. PMID- 3284656 TI - The presence of autoantibodies specific for NZB serum factors in adult NZB mice and the establishment of monoclonal autoantibodies against these humoral factors. AB - Humoral factors in serum of young NZB mice enhance maturation of B-lymphocyte precursors in vitro. A blot ELISA assay identified autoantibodies against the serum factors. NZB-SFs (designated NZB-SF alpha, pI 3.5-4.0, and NZB-SF beta, pI 7.8) were purified by sequential steps. Both had a molecular weight (MW) of approximately 23,000 in SDS-PAGE. NZB mice develop autoantibodies against NZB-SFs by 2 months of age; titers increased progressively with age. Non-autoimmune-prone mice did not produce autoantibodies against NZB-SFs. We then developed two hybridoma clones, IIC1C1 and IIC1M4, which produce monoclonal autoantibodies against NZB-SF alpha and NZB-SF beta, respectively. Both IgM autoantibodies could be affinity purified with a column of CNBr-Sepharose 4B gel conjugated with anti mouse IgM antibody. Neither IIC1C1 nor IIC1M4 abolished bioactivity of recombinant mouse IL-1 alpha, human IL-1, mouse, rat, or human IL-2, mouse IL-3, or colony-stimulating factor. Neither antibody reacted to recombinant mouse IL-1 alpha, IL-4, TNF alpha, or IFN gamma in blot ELISA assays. Monoclonal autoantibodies IIC1C1 and IIC1M4 were used to purify NZB-SFs. SDS-PAGE of the affinity-purified NZB-SFs revealed bands of 23 and 60 kDa, and proteins extracted from the bands were reactive to our monoclonal autoantibodies. PMID- 3284657 TI - Colocalization of F-actin and 34-kilodalton actin bundling protein in Dictyostelium amoebae and cultured fibroblasts. AB - The Ca2+-sensitive actin-binding protein isolated from Dictyostelium discoideum, 30,000-D protein (Fechheimer and Taylor: J. Biol. Chem. 259:4514-4520, 1984;) has recently been localized in filipodia of substrate-adhered amoebae (Fechheimer: J. Cell Biol. 104:1539-1551, 1987). We have determined that this protein has a Mr of 34,000 daltons and is strictly colocalized with actin filaments in both substrate attached Dictyostelium amoebae and cultured fibroblasts. 3T3 fibroblasts, as well as normal and virally transformed rat kidney fibroblasts (NRK) contain a 34 kilodalton (kD) protein that cross-reacts specifically with antibody to the Dictyostelium bundling protein. Mammalian 34-kD protein is colocalized with F actin in stress fibers and the cortical cytoskeleton in substrate-adhered fibroblasts. In substrate-adhered vegetative Dictyostelium, F-actin and 34-kD protein are concentrated in regions of the cell cortex exhibiting filipodia and membrane ridges. Multiple filipodia formed after exposure to the chemoattractant folic acid stain intensely for 34-kD protein, implying participation in the assembly of actin bundles during filipod formation. The cortex of pseudopodia also contained high concentrations of bundling protein, but pseudopod interiors did not. In contrast to vegetative Dictyostelium, F-actin and 34-kD protein were not colocalized in cells that had progressed through the developmental cycle. In fruiting bodies, 34-kD protein was detected by immunofluorescence microscopy only in prespore cells, while F-actin appeared in stalk cells and spores. PMID- 3284658 TI - Microtubule rearrangements during mitosis in multinucleate cells. AB - The peroxidase-antiperoxidase (PAP) method for the detection of polymerized tubulin has been used to study the microtubule rearrangements during mitosis in PtK1 and HeLa multinucleate cells obtained by polyethyleneglycol (PEG)-mediated fusion. We demonstrate here that the transition of the microtubular cytoskeleton from interphase to mitosis is an inducible event and independent of the factor(s) responsible for chromatin condensation and nuclear envelope breakdown. However, for the induction of the microtubule rearrangements nuclear envelope breakdown is required. At midprophase, cytoskeletal microtubule rearrangements start for multinucleate PtK1 cells, whereas in HeLa cells such changes are delayed, and a more abrupt transition is observed here. After complete nuclear envelope breakdown (prometaphase) mitotic asters and spindles but no cytoplasmic (interphase) microtubuli can be observed in both systems. Metaphase is characterized by an interaction between the different mitotic poles which show the form of bipolar spindles, but individual separated mitotic poles far removed from the chromatin can also be seen. PMID- 3284660 TI - [40 years of psychiatry at the University in Olomouc]. PMID- 3284659 TI - [Arlt's years in Prague (continued)]. PMID- 3284661 TI - [Prof. Frank and the beginnings of the Institute for Normal and Topographic Anatomy at the Medical School of Charles University in Bratislava]. PMID- 3284662 TI - DNA repair, oncogenes and carcinogenesis. PMID- 3284663 TI - Role of oncogenes in metastases. PMID- 3284665 TI - Focus on: implants. PMID- 3284664 TI - Not a laughing matter. PMID- 3284666 TI - Physicochemical changes in contact lenses and their interactions with the cornea and tears: a review and personal observations. PMID- 3284667 TI - An improved method for lamellar keratoplasty. PMID- 3284668 TI - Tryptase from human mast cells does not activate purified human Hageman factor. AB - The effect of tryptase, a neural protease released from human lung mast cell secretory granules, on purified human Hageman Factor (Factor XII) was examined. No increase in Hageman Factor enzymatic activity was detected after incubation with tryptase at 37 degrees C; activation of Hageman Factor by bovine trypsin served as a positive control. Furthermore, pre-incubation of Hageman Factor with tryptase did not diminish the subsequent activation of Hageman Factor by trypsin. Polyacrylamide gel electrophoresis was also performed to show that incubation with tryptase does not alter the molecular weight of Hageman Factor. Therefore, tryptase neither activates nor destroys human Hageman Factor. PMID- 3284669 TI - Risk factors for the development of chronic cyclosporine-nephrotoxicity. AB - Ninety CSA-treated kidney transplants recipients entered the study. The patients were allocated to three groups based on serum creatinine at 12 months and kidney biopsy findings: control group (serum creatinine less than 177 mumol/l), rejection group (verified by biopsy, serum creatinine greater than 177 mumol/l), nephrotoxicity group (verified by biopsy, serum creatinine greater than 177 mumol/l). Thirty variables were systematically evaluated. The following parameters had a predictive value for the development of chronic CSA nephrotoxicity: number of CSA-induced episodes of acute deterioration of renal function, CSA trough level (day 0-30, day 31-90), number of unexplained episodes of acute deterioration of renal function, number of nephrotoxic drugs, number of rejection treatments, number of rejection episodes and primary poor renal function. The results indicate that all factors leading to acute renal failure, favor the development of CSA-nephrotoxicity. PMID- 3284670 TI - The influence of kidney transplantation on carnitine metabolism. AB - In this study, we examined all three plasma carnitine fractions, free carnitine (FC), short-chain acyl- (SCC), and long-chain acylcarnitine (LCC), as well as the urinary excretion of FC and SCC in 62 patients with functioning renal allografts 1-70 months following the kidney transplantation (KT). Patients were classified into three groups according to their transplant function, as characterized by the serum creatinine concentration (CR). A comparison with normal subjects (n = 20) and with patients on chronic hemodialysis (HD, n = 46) revealed a complete normalization of all carnitine plasma fractions for group I patients (Cr less than 120 mumol/l). In contrast, significant elevations of plasma free and esterified carnitine were found in group II (Cr greater than 120, less than 200 mumol/l; with FC + 27%, SCC + 82%, and LCC + 49% and group III patients (Cr greater than 200 mumol/l; with FC + 39%, SCC + 122%, and LCC + 106%), as compared to healthy subjects (p less than 0.001). The elevations in concentrations of SCC were more pronounced than those of FC; consequently, we found a higher ratio of acylcarnitine (AC) to FC in group III than in group I patients (+ 41%, p less than 0.001). Yet even in the former group, this ratio was found to be markedly reduced when compared to HD patients (-41%, p less than 0.001). We found no significant differences in the urinary excretion of FC and SCC between the 3 groups of KT patients. It is thus to conclude that in patients with a well functioning transplant, the pattern of carnitine fractions in plasma is fully normalized. The decrease in the ratio of AC to FC following a successful KT might suggest a better availability of FC and thereby be associated with an enhanced fatty acid oxidation. PMID- 3284671 TI - A positive response to any of seven intradermal antigens predicts favorable outcome in patients hospitalized with community-acquired pneumonia. AB - We used the commercially available Multitest (R) CMI to assess the response of 100 adults hospitalized with community-acquired pneumonia to the following seven antigens: tetanus toxoid, diphtheria toxoid, Streptococcus, Proteus, tuberculin, Candida, and trichophyton. Thirty-one of the patients responded to one or more of these antigens and survived their acute illness. Of the Multitest (R) CMI negative patients, 49 lived and 20 died. A comparison of the three groups revealed that the 31 patients with positive tests were significantly younger and had a higher mean serum albumin than did those with negative tests who died. Multivariate analysis revealed that a positive Multitest (R) CMI and the albumin level were independent predictors of survival. A positive Multitest (R) CMI identified a less seriously ill group of patients as evidenced by 100% survival, by a very low rate of complications (0.18/patient), and by less utilization of resources (fewer hemograms and chest radiographs). Thus a positive Multitest (R) CMI may identify patients who could be discharged earlier, and a negative test should target its patients for more aggressive therapy. PMID- 3284672 TI - T-cell depletion with ricin A-chain T101 in allogeneic bone marrow transplantation to prevent severe graft-versus-host disease. AB - Bone marrow cells from 10 marrow transplant donors were treated with an immunotoxin, which couples A-chain of ricin with a monoclonal anti-T-cell antibody T101 to prevent graft-versus-host disease by the elimination of mature T cells. Marrow cells treated with the anti human T-cell immunotoxin (IT101) were cultured for erythropoietic colonies, granulocytic colonies, and multilineage hematopoietic colonies (CFU-GEMMT) containing myeloid cells and T-cells, and optimal conditions were defined for the elimination of T-cells present in the harvested donor marrow prior to marrow transplantation. Marrow samples purged with IT101 were examined for residual T-cells by fluorescence activated cell sorting, using anti-T-cell antibodies, [3H]-thymidine incorporation after PHA stimulation, and an assay for clonogenic T-cells. The number of T-cell colonies observed in the treated marrows was less than 5% of the number in comparable unpurged donor marrows. Treatment with IT101 did not alter the plating efficiency of hematopoietic colonies compared to untreated donor marrow cells. These data suggest that multilineage progenitors responsible for the reconstitution of the recipient hematopoietic system are not affected by marrow IT101 purging. The clinical data on 10 patients indicate that the depletion of T-cells in the donor marrow with IT101 is effective in decreasing the severity of acute graft-versus host disease in allogeneic marrow transplantation and warrants continued investigation. PMID- 3284673 TI - Rapid detection of group B streptococcal carriage in parturient women using a modified starch serum medium. AB - Group B streptococcal disease is the most frequent infectious cause of morbidity and mortality of newborns in North America. There is evidence that vertical transmission, the major route of neonatal acquisition, may be interrupted by administration of antibiotics during the intrapartum period. A modified starch serum medium has been developed that will allow the rapid identification of group B streptococci, by observation of a color change, in vaginal and rectal swabs. This medium was compared to a "gold standard" of routine culture. The sensitivity and specificity of the test were found to be 100% and 99%, respectively, in 237 specimens from women attending different clinics who submitted vaginal swabs. All color changes occurred within 6 hours. Vaginal and rectal carriage of the organism were found in 8% and 12%, respectively, of women in preterm labor. In this population the sensitivity and specificity of the test for vaginal specimens were 97% and 98%, respectively. The corresponding values for rectal swabs were 94% and 100%. The test can potentially select carrier mothers who could benefit the most from intrapartum antibiotics. This medium may also be used for transport to enhance detection of colonization. PMID- 3284674 TI - Unstable thoracolumbar fractures, with emphasis on the burst fracture. AB - There is much controversy as to the appropriate treatment of unstable thoracolumbar fractures. If surgery is decided upon, this article suggests a plan to accomplish the reduction of the fracture and decompression of the neural elements. The fractures are divided into compression injuries, seat belt injuries, fracture-dislocations, and burst fractures. In each case the goal is to realign and stabilize the spine and allow adequate room for the spinal cord or the cauda equina. A burst fracture requires the most careful planning. Some decompression can be accomplished by distraction alone but impaction of the fragments posteriorly or removal of the fragments anteriorly may be required. The experience at the author's university has demonstrated that by using these techniques, the preoperative neurocanal compromise can be significantly improved over those series using posterior distraction alone. If canal compromise cannot be accomplished posteriorly, then anterior surgery is required. PMID- 3284675 TI - Acute traumatic spondylolysis. Report of a case and review of the literature. AB - Acute traumatic bilateral spondylolysis and spondylolisthesis was observed in a 34-year-old man. The literature on pathologic and biomechanical factors leading to acute fracture of the pars interarticularis emphasizes the importance of distinguishing spondylolysis resulting from acute trauma from the more common lytic-fatigue pars defect. PMID- 3284676 TI - Extensive hemosiderin deposition in the medial meniscus of a knee. Its possible relationship to degenerative joint disease. AB - Hemosiderin deposition in the tissues of the musculoskeletal system is unusual, and deposition of these pigments in the menisci of the knee is extremely rare. Conditions that may predispose to these changes include rheumatoid arthritis, hemochromatosis, pigmented villonodular synovitis, hemophilia, and tuberculous arthritis. A 79-year-old woman developed extensive hemosiderin deposition in the medial meniscus of a knee. Hemosiderin within meniscal chondrocytes was associated with degenerative joint disease and suggested a cause and effect relationship. PMID- 3284677 TI - An irreducible dislocation of the great toe. Report of two cases and review of the literature. AB - Irreducible dislocation of an interphalangeal (IP) joint of the great toe is a rare condition. Twenty-two cases including the present two cases are reported in available literature. Two different types are identifiable. In one type, where the ruptured volar plate is displaced into the joint space between two phalanges, the toe is slightly elongated, but the deformity of the toe is not so marked. In the other type, where the volar plate is completely displaced over the proximal phalangeal neck, the deformity of the toe is extreme as the IP joint is locked in hyperextension. In the former type, the dislocation is often misinterpreted to have been repositioned manually because of relatively slight deformity. In either type of dislocation, the volar plate is detached from both the distal and proximal phalanges, and so displaced into the joint, as to form a barrier to manual repositioning. Open reduction is mandatory. PMID- 3284678 TI - Bone morphogenetic protein augmentation grafting of resistant femoral nonunions. A preliminary report. AB - Twelve patients with intractable nonunions of the femoral diaphyseal or metaphyseal-diaphyseal shaft were successfully treated by a combination of internal fixation and implants of human bone morphogenetic protein (h-BMP). There was an average of 4.3 surgical procedures per patient attempting union prior to h BMP implantation. Union was obtained in 11 of 12 patients and in one patient with a repeat stabilization and implantation of h-BMP. Four patients received autogeneic cancellous bone graft and four patients received allogeneic bone grafts. The BMP implant was prepared in the form of an aggregate of h-BMP and bone matrix water-insoluble noncollagenous proteins (h-BMP/iNCP). Fifty to 100 mg of h-BMP/iNCP was either implanted in the fracture gap in ultra thin gelatin capsules, or incorporated in a strip of polylactic/polyglycolic acid copolymer (PLA/PGA) and placed as an onlay across the fracture gap. The average time to union was 4.7 months. Further clinical investigations are planned as a series of matched cases with and without BMP augmentation in order to distinguish h-BMP effects from new or improved methods of fracture fixation combined with autogeneic cancellous bone grafts. PMID- 3284679 TI - Metastatic carcinoid of bone. Report of two cases and review of the literature. AB - The skeletal manifestations of malignant carcinoid seem not to have been reported in the orthopedic literature. Bronchial and hindgut carcinoid tumors are less numerous than midgut tumors but metastasize to bone much more frequently. Carcinoid skeletal deposits are usually osteoblastic and most commonly affect the axial skeleton. The radiologic appearance is frequently indistinguishable from prostatic skeletal metastases or chronic sclerosing osteomyelitis. Two cases of skeletal metastases from midgut carcinoid are reported to demonstrate that metastases from carcinoid should be considered in the differential diagnosis of either bone malignancy or chronic sclerosing osteomyelitis. PMID- 3284680 TI - Response of bone marrow stroma cells to demineralized cortical bone matrix in experimental spinal fusion in rabbits. AB - The effect of autogeneic bone marrow (BM) cells and allogeneic demineralized bone matrix (DBM), alone or combined, as transplantation materials was studied in an experimental posterior thoracic spinal fusion model in rabbits. Transplantation of composite grafts composed of BM and DBM showed the first signs of fusion between two spinal segments after four weeks, reaching 86% after 20 weeks. Late fusion results achieved with DBM alone were similar. The capacity of BM per se to build up a spinal fusion was insignificant. Calcified tissue, documented roentgenographically, was shown to develop locally with time, and the earliest bridging of an interspace was noted after four weeks. Histologically, formation of new bone and cartilage was observed after two weeks, showing mature lamellar bone formation between thoracic segments after 20 weeks. Furthermore, increased 45Ca activity was still observed in the fused tissues after 20 weeks. Although, with grafting materials used, this model for experimental spinal fusion gave promising results, further investigations with other fusion techniques could give still better effects. PMID- 3284681 TI - Displaced fractures of the scaphoid. AB - The scaphoid is the most commonly fractured carpal bone. The displaced fracture poses a particular surgical problem. While scaphoid fractures as a group show a 90%-95% union rate, those fractures with greater than 1 mm of displacement are associated with a 55% incidence of nonunion and a 50% rate of avascular necrosis. Displaced fractures that unite spontaneously do so only after prolonged immobilization and are associated with a greater incidence of painful malunion. Displaced scaphoid fractures that result in malunion or nonunion are more prone to develop late carpal osteoarthritis. The higher incidence of complications with the displaced scaphoid fracture suggests that an anatomic reduction is essential. If closed manipulation is unsuccessful, open reduction and internal fixation are indicated. PMID- 3284682 TI - Comminuted intraarticular fractures of the distal radius. AB - The comminuted intraarticular fracture of the distal radius requires early, accurate reduction of the articular surfaces and sustained restoration of anatomic position. The most commonly employed methods are pins and plaster, external fixation, percutaneous pinning, and open reduction and internal fixation. There are pitfalls, advantages, and disadvantages inherent in each method. Careful preoperative analysis of individual patients and fractures determines the therapeutic options. PMID- 3284683 TI - Comminuted fractures of the proximal humerus. AB - Difficulty in fully defining the injury, patient characteristics, osteoporosis, technically difficult surgery, the need for carefully supervised physiotherapy, and the realization that a poor initial result is very difficult to reconstruct make the comminuted fracture of the proximal humerus a problem fracture. The literature on this fracture is also incomplete and confusing. The solutions are many and complex: use adequate roentgenograms to understand the traumatic lesion, be careful to avoid denying older patients effective surgical treatment, use a safe and simple surgical approach, know the options for internal fixation, recognize the values of prosthetic replacement, avoid technical pitfalls, and thoughtfully supervise the postoperative patient care. PMID- 3284684 TI - Closed unstable fractures of the tibia. AB - Unstable closed tibial fractures are those with major soft tissue damage, complete displacement, significant comminution, direct force mechanism, or articular surface involvement. Although the "average" tibial fracture is effectively managed without surgery, patients with such injuries frequently have prolonged convalescence and unsatisfactory anatomic and functional results. This review of recent literature reveals that in appropriately chosen patients, surgical fixation of unstable closed tibial fractures produces faster recovery and less residual disability or deformity. This is especially true when intramedullary nailing is indicated, as in transverse, short oblique, or segmental fractures. Plate and screw fixation is preferable for metaphyseal fractures. External fixation may be safest when soft tissue crushing is extensive, especially if fasciotomy is required. PMID- 3284685 TI - Fractures of the tibial pilon. AB - Fractures of the tibial pilon are difficult to manage because of their severity. They are the product of high-energy compression forces and too frequently result in comminution and impaction of the weight-bearing surface of the distal tibia. Other fractures involving the roof of the ankle joint may be called "pilon fractures," but have a better prognosis because the compressive force is coupled with torsional forces. Operative reduction with the application of stable fixation in a clinically proven sequence of steps may lead to a satisfactory outcome in approximately three fourths of the cases, but must be accomplished with a sound understanding of the anatomy of the ankle joint and the principles of stable internal fixation by a surgeon with good atraumatic technique. PMID- 3284686 TI - Preface to "Deformities after fractures". By Frank H. Hamilton, 1855. PMID- 3284687 TI - Detection of Chlamydia trachomatis in adolescent females using direct immunofluorescence. AB - Direct immunofluorescent slide tests for the detection of genital Chlamydia trachomatis have attracted considerable attention because of their speed and economy, but most evaluation trials have concentrated on adult, high-risk populations. Using 152 paired specimens, we compared the Syva Micro Trak direct specimen test with culture in a population of adolescent females attending a general adolescent medicine clinic. The direct slide test was 90 percent sensitive and 95 percent specific overall, with positive and negative predictive values of 74 percent and 98 percent, respectively. Prevalence by culture was 13 percent. Six of our 23 positive slide tests could not be confirmed by culture. A positive chlamydia culture was significantly associated with nonwhite race, a positive Gram's stain, and the presence of mucopurulent endocervical discharge, but not with oral contraceptive pill use, obstetrical history, Pap smear results, multiple sexual partners, coexisting vaginitis or gonorrhea, or a history of prior sexually transmitted diseases. The direct test appears to be an acceptable substitute for culture in higher prevalence adolescent settings and a useful screening adjunct in lower prevalence groups. PMID- 3284688 TI - Neonatal diabetes mellitus in first cousins. AB - The cases of two first cousins with neonatal diabetes mellitus are presented in this report. In one child the condition was transient, whereas the other has permanent diabetes mellitus. It seems unlikely that the difference in outcome was related to the degree of diabetic control early in the course of the disorder. The possibility of genetic influence in the etiology of neonatal diabetes is stressed. Chlorpropamide was not useful in curing neonatal diabetes mellitus in one case. PMID- 3284689 TI - Furosemide pharmacokinetics and pharmacodynamics in renal transplantation. AB - Furosemide was administered intravenously to four patients who had undergone renal transplantation in the past and four creatinine clearance--matched control subjects. Both patients who had undergone renal transplant and control subjects displayed similar pharmacokinetic and pharmacodynamic behavior, as assessed by drug delivery to the urine and sodium excretion, respectively. Despite similar degrees of natriuresis, patients who had undergone renal transplantation demonstrated a clear defect in urine potassium excretion. This defect in potassium excretion was not related to altered responsiveness of the renin angiotensin-aldosterone axis because plasma renin activity increased in a normal fashion after furosemide in both control and transplant subjects. Although the plasma aldosterone response to increases in plasma renin activity was sluggish in patients undergoing renal transplantation, normal increases in plasma aldosterone levels were achieved in both groups, suggesting that there may be an intrinsic defect in distal tubular potassium secretion that can be unmasked by furosemide. PMID- 3284690 TI - The combination of prazosin and verapamil in the treatment of essential hypertension. AB - An exaggerated fall in blood pressure has been reported with the combination of an alpha 1-blocker and a calcium antagonist. This study investigated, in a placebo-controlled, randomized crossover trial, the clinical usefulness of the combination of prazosin (2 mg b.i.d.) and verapamil (160 mg b.i.d.). Therapeutic efficacy was monitored at regular outpatient visits: average supine and erect blood pressures were, respectively, 175/99 and 176/103 mm Hg with placebo, 160/91 and 164/96 mm Hg with single drug treatment, and 152/84 and 152/89 mm Hg with combination therapy. This significant and clinically useful reduction in blood pressure had an overall magnitude of approximately 28/18 mm Hg (supine) and 29/19 mm Hg (erect). Further measurements were made during a series of intensive study days, and the most important additional finding was a pharmacokinetic interaction that resulted in increased peak concentrations and bioavailability of prazosin. In conclusion, the combination of prazosin and verapamil proved effective in the treatment of 12 patients with essential hypertension who had been poorly responsive to conventional treatment with a beta-blocker and thiazide diuretic. PMID- 3284692 TI - Use of cephalosporins with enhanced anti-anaerobic activity for treatment and prevention of anaerobic and mixed infections. AB - The microbiology, adverse-effect profiles, pharmacokinetics, published results of comparative clinical trials, and costs of cephalosporins with enhanced antianaerobic activity are reviewed. Cefoxitin, ceftizoxime, cefotetan, and moxalactam have been used as single agents in the treatment or prophylaxis of anaerobic or mixed aerobic and anaerobic infections, including intra-abdominal, female genital tract, and soft-tissue infections. None of these agents is as active against Bacteroides species as is clindamycin or metronidazole, but differences among the four cephalosporins do not appear to be clinically important. These agents differ somewhat in their activity against gram-positive and gram-negative bacteria. The majority of adverse reactions to these agents are immunological; disulfiram-like reactions and alterations in normal hemostasis have also been observed with cefotetan and moxalactam. All of these agents are well absorbed after intramuscular injection and produce serum concentrations adequate to treat most infections. Only ceftizoxime and moxalactam produce cerebrospinal fluid concentrations adequate for treatment of gram-negative meningitis. The primary route of elimination is renal, and each agent requires dosage adjustments in patients with renal impairment. Major differences exist among the elimination half-lives of the agents in patients with normal renal function. The decision to use a cephalosporin for treatment of anaerobic infections should be based on the results of clinical trials that have demonstrated the efficacy of the agent. Data are available to support the use of cefoxitin, ceftizoxime, and moxalactam in the treatment of intra-abdominal infections; cefoxitin and moxalactam to prevent infection of traumatic injury to the abdomen; all four agents in the treatment of female genital tract infections; and all four agents for prophylactic use in surgical procedures that may involve enteric anaerobes, especially B. fragilis. Cephalosporins with enhanced antianaerobic activity appear to have similar in vitro microbiological activity and have efficacy similar to that of combination regimens for the treatment and prophylaxis of intra-abdominal infections, abdominal contamination, obstetric and gynecological infections, and soft-tissue infections. PMID- 3284691 TI - Pharmacokinetics of high-dose etoposide. AB - The pharmacokinetics of etoposide at doses of 1 gm/m2 to 3 gm/m2 were studied in patients with hematologic malignancies. The noncompartmental systemic clearance, mean residence time, steady-state volume of distribution, and elimination half life were independent of the dose of etoposide, whereas the AUC was proportional to the dose. Comparison of these results with those reported previously indicates that etoposide exhibits linear pharmacokinetics over a thirtyfold range in doses (0.1 to 3 gm/m2). PMID- 3284693 TI - The use of the H*1 in predicting marrow recovery following ablative chemotherapy in leukaemia and lymphoma. AB - Twenty-three cytopenic episodes in 18 patients undergoing ablative chemotherapy for the treatment of leukaemia or lymphoma were monitored from commencement of treatment until recovery, by automated differential counts using the Technicon H*1 Autoanalyser, with particular reference to abnormal white cell flags and large unstained cell (LUC) percentage. The blast flag was indicated in this recovery phase in 100% of patients and in 85% this preceded bone marrow recovery (defined as neutrophil count greater than 0.5 X 10(9)/l) by a mean of 10 days. On average the blast flag was indicated for 8 days in total. Bone marrow function continued to improve in all patients with no evidence of relapse. An increase in the LUC percentage on the differential count reached a maximum at 18 days, 6 days prior to marrow recovery. The ability to detect impending marrow recovery by means of the positive blast flag, may be of great value when patients have been cytopenic for many days. PMID- 3284694 TI - A study of erythroid progenitor cells in the bone marrow of Gambian children with falciparum malaria. AB - There was a wide variation in the number of BFUe and CFUe in the bone marrow of Gambian children with falciparum malaria and moderate or severe anaemia. However, such children were often not deficient in these erythroid progenitors. The number of BFUe in patients who had parasitaemias greater than 1% was significantly lower than that in patients with parasitaemias less than 1%. There was also a statistically significant negative correlation between the number of BFUe and CFUe in the entire group of children studied. When autologous serum (30%, v/v) was used in the culture system, CFUe growth was observed even in the absence of added erythropoietin (EPO), indicating the presence of high levels of EPO or an EPO-like substance in the anaemic sera. It is concluded that children with Plasmodium falciparum malaria show no major abnormality in their erythroid progenitor cells and that the perturbation of erythropoiesis in such children occurs mainly in the morphologically recognizable erythroid precursor cells. The wide variation observed in the number of CFUe and BFUe in different patients, and the correlations between the number of BFUe and parasitaemia and the number of BFUe and CFUe are all probably largely related to the changing clinicopathological situation in patients with malaria and anaemia. PMID- 3284695 TI - Relapsing large cell immunoblastic lymphoma complicating well-differentiated lymphocytic lymphoma: a report of two cases showing prolonged survival with therapy. AB - Two patients presented with co-existing large cell immunoblastic and well differentiated lymphocytic lymphomas. Prolonged remissions from the large cell lymphomas were achieved following intensive combination chemotherapy but both patients suffered relapses after many years. Previous reports have grouped such patients with those developing classical Richter's syndrome implying a uniformly poor prognosis. This report suggests that this is not the case. It was not possible with immunohistochemical stains to prove or disprove that these tumours had the same stem cell origins. PMID- 3284696 TI - The central nervous system--immune system relationship. AB - Research investigating the pathogenesis of schizophrenia has demonstrated that cellular immune reactions, such as those that occur in known autoimmune diseases, may participate in producing alterations of the central nervous system. Furthermore, epidemiologic studies of immune-mediated diseases have suggested that activation of the central nervous system by stressful stimuli may be capable of influencing the function of the immune system. In support of that interaction, research using animal models of stress has provided valuable information as to the effect of stress on basic immune function and susceptibility to infectious disease. Possible hormonal and direct mechanisms of the central nervous system immune system interaction have been proposed. PMID- 3284697 TI - Autoimmune liver diseases. AB - Autoimmune-type chronic active hepatitis (AI-CAH) and primary biliary cirrhosis (PBC) are the two main autoimmune liver diseases. Although the etiologic agents of autoimmune liver diseases are unknown, a loss of tolerance against self antigens is regarded to be responsible for target cell destruction, that is, hepatocytes in AI-CAH and bile duct epithelia in PBC. AI-CAH is heterogeneous, and at least three different subgroups of AI-CAH can be distinguished by circulating autoantibodies including antinuclear antibodies (ANA), liver membrane autoantibodies (LMA), liver kidney microsomal antibodies (LKM), and antibodies to a soluble liver antigen (SLA). This has clinical relevance, because only autoimmune-type CAH seems to profit from immunosuppressive therapy. These serologic diagnostic markers may help to distinguish AI-CAH from CAH due to non A, non-B virus infection. Antimitochondrial antibodies (AMA) and their PBC specific subtypes characterize PBC, a chronic progressive cholestatic liver disease. Despite numerous therapeutic trials in the past, an effective medical treatment is not available. However, good results have been observed with orthotopic liver transplantation in end-stage PBC. This article has characterized autoimmune liver diseases, dealing with clinical, histologic, and immunopathologic aspects and concentrating on immune phenomena leading to their diagnosis. This has therapeutic consequences. PMID- 3284698 TI - Recent advances in laboratory tests for autoantibodies to thyrotropin receptor protein in Graves' disease. AB - Graves' disease is characterized by the presence of autoantibodies with variable reactivities to TSH receptor protein. These autoantibodies are heterogeneous in nature and may act as TSH agonists or infrequently as TSH antagonists (blocking antibodies). With new technical advances, it has become possible to quantitate these antibodies and their reactivities in clinical laboratories. Technical aspects of these assays and their clinical utility in the diagnosis and management of patients with Graves' disease are discussed. PMID- 3284700 TI - Modulation of T-cell-mediated regulation of antibody production by interaction with specific immune complexes. AB - The importance of the phlogogenic effects of immune complexes in disease pathogenesis has been emphasized, but they also have a role in immunoregulation. We examined the effects of DNA: anti-DNA immune complexes, formed at different antigen:antibody ratios, on the ability of T cells to modulate DNA antibody production in vitro. We found that antigen-excess complexes promote IgM anti-DNA synthesis, whereas antibody-excess complexes favor a switch to IgG anti-DNA production. We suggest that interaction of T cells with immune complexes is an important feedback mechanism in control of the immune response. PMID- 3284699 TI - Autoreactivity and altered immune responses in inflammatory bowel disease. AB - Inflammatory bowel disease (IBD) is a poorly understood condition that is associated with a wide variety of immunologic alterations. Because its pathogenesis is unknown, these immunologic alterations have been investigated with an eye toward unraveling the complex mechanism of injury in the bowels of these patients. There are several lines of evidence suggesting that IBD is related to immunologic events. The histopathology of active disease resembles the Arthus reaction, whereas the presence of antiepithelial cell antibodies is reminiscent of Goodpasture's disease. Antibodies against many microorganisms and autoantibodies to mucosal components are commonly found in these patients. Further, there is a marked increase in plasma cells in the lamina propria of patients with active IBD. It is important to keep these findings in perspective. No studies to date have been able to determine whether the features are entirely primary events, that is, related to the initial damage to the intestinal mucosa. If the surface mucosa is injured by an as-yet-unidentified agent, the immunologic findings in IBD may be secondary events. Nonetheless, the similarity in histopathology of the experimental immunologic models of IBD to the human disease encourages investigators to pursue the etiology of this complex disease. PMID- 3284701 TI - The HLA histocompatibility system in autoimmune states. AB - The HLA system of antigens identified serologically and, in some cases, by cellular techniques has shown important associations with numerous autoimmune diseases. As DNA technology becomes more widely used, there is great expectation that restriction fragment length polymorphisms (RFLP) and oligonucleotide probing of the HLA genes will soon provide for clinical use even more definitive relationships with these diseases and possibly insights into their pathogenetic mechanisms. PMID- 3284702 TI - Autoimmunity and otologic disease: clinical and experimental aspects. AB - Each of the anatomic structures of the ear (external, middle, and inner) is subject to immunologic influence and injury. Studies in experimental animals have shown that primary immune responses to foreign antigens can be induced within the middle and inner ear as indicated by (1) infiltration and local persistence of mononuclear leukocytes and plasma cells, (2) appearance of antibody in perilymph, and (3) eventual development of systemic immunity. Protective effects of inner ear immunization against subsequent viral challenge have also been shown. Clinically, otologic disease can occur in association with a wide variety of systemic autoimmune and immunologic disorders: systemic lupus erythematosus, rheumatoid arthritis, Behcet's disease, Sjogren's syndrome, relapsing polychondritis, ulcerative colitis, Cogan's syndrome, and vasculitis-related disease. Evidence for immunologic involvement has also been found in cases of idiopathic sensorineural hearing loss frequently accompanied by vestibular dysfunction (Meniere's disease). Many of these cases progress into systemic autoimmune disorders. Autoimmune-associated hearing loss has been recognized as one of the few types of treatable hearing dysfunction, with good responses to immunosuppressive therapy. The pathogenesis of autoimmune-related otologic disease has not been established; however, evidence suggests three possible types of immunologic injury: (1) autoantibody binding to type II collagen or other otologic components (type II immunologic injury); (2) immune complex formation leading to vasculitis (type III); and (3) T cell-mediated autoreactivity to inner ear membranous elements (type IV). These mechanisms may not be mutually exclusive. Clinical laboratory procedures should be directed at evaluating these possibilities to assist in diagnosis. PMID- 3284704 TI - Male hypogonadism: risks for myocardial infarction and bone fracture. PMID- 3284703 TI - Anti-idiotypes and autoimmune disease. AB - Idiotypes represent structural sites located on the Fab fragment of antibodies. Even though these sites are combining sites for antigenic determinant, their uniqueness makes them antigenic, generating anti-Ids that have functionally performed as suppressive agents for the further production of the antibody. Jerne's network theory of idiotypes has provided a basis upon which investigators have searched for means to reduce, or explain the reduction of, Ab production. A principal area of this reduction of Ab expression concerns the autoAbs in autoimmune diseases. Experimental and clinical evidence suggests a role for anti Ids in suppressing autoAb production and an inverse relationship between serum levels of anti-Ids and autoimmune disease activity. PMID- 3284705 TI - Recent developments in aortic stenosis. AB - There have been several recent advances in our understanding of aortic stenosis and in its diagnosis and treatment. Aortic stenosis is now most commonly due to a bicuspid valve. Rheumatic aortic stenosis has become much less common and calcific stenosis of valves in the elderly is a rapidly increasing cause. The prognosis of patients with aortic stenosis can be largely determined by their symptoms, with a mean length of survival of 3 to 5 years for patients with angina, 3 years for patients with syncope, and only 12 to 24 months for patients with heart failure. Virtually all symptomatic patients should be operated on, even those with reduced left ventricular function. The risk of sudden death in asymptomatic adults is low, and thus surgery is generally not needed in these cases. Recently, the noninvasive diagnosis of aortic stenosis has improved dramatically with the advent of two-dimensional and Doppler echocardiography. These techniques provide information on the pressure gradient and can even allow accurate estimates of valve area. Cardiac catheterization is still required, however, to determine the anatomy of the coronary arteries prior to surgery since many patients will have concomitant coronary artery disease. The newest development in the treatment of aortic stenosis is catheter balloon valvuloplasty, which is relatively safe and has shown early promise in reducing the pressure gradient across not increased to the normal range and is significantly less than that following aortic valve replacement. The long-term results of balloon valvuloplasty are still being evaluated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284706 TI - Recurrent renal calculi: an update on management. PMID- 3284707 TI - Update on asthma therapy. PMID- 3284708 TI - Diagnosis, etiology, and management of fibromyalgia syndrome: an update. AB - Recent controlled studies suggest a physiologic basis for FMS, which should be diagnosed by its own characteristic features and not by exclusion of other conditions alone. Diffuse musculoskeletal aching, accompanied by multiple TPs in the absence of an underlying arthritic or systemic condition, are the key features for diagnosis. Based on our controlled study, guidelines for diagnosis are provided in Table 5. Successful management of an FMS patient is often challenging, but frequently gratifying if approached with a positive and caring attitude. The most important aspects of management are a firm diagnosis, reassurance regarding the benign nature of the condition, help in changing patient behavior in order to accept pain and increase functional activities and exercise tolerance, and the use of tricyclic agents. Overall, management of fibromyalgia is an art that requires the combined ingredients of patience, understanding, and firmness in helping patients to assume responsibility for their pain management through behavior modifications. PMID- 3284709 TI - A bumpy ride. PMID- 3284710 TI - Contact allergy to denture materials in the burning mouth syndrome. AB - Several factors may be responsible for stomatitis in general and the burning mouth syndrome in particular. The results of patch testing are reported in 4 patients with burning mouth symptoms thought to be due to sensitization to denture material. 2 patients reacted to substances in Luxene dentures, but the allergens were not identified. In a 3rd patient, sensitization was found to monomeric methyl methacrylate. The other patient gave positive patch tests to epoxy resin (and bisphenol A), probably present in glue used for repair of dental plates. To obtain a complete diagnosis in cases of suspected contact stomatitis due to allergens in dentures, a reliable standard test series is required. PMID- 3284711 TI - Long-term use of an injectable contraceptive: effect of depot-norethisterone oenanthate on carbohydrate metabolism. AB - In order to determine the metabolic effects of long-term use of the injectable contraceptive norethisterone oenanthate, plasma glucose and serum insulin concentrations were studied in two groups of women who had used the method continuously for at least five years. Group 1 comprised 24 subjects, from whom only fasting blood samples were taken. Despite similar plasma glucose concentrations to those of the controls, the subjects had significantly increased serum insulin concentrations (164.5 (39.9) v 120.3 (34.3) pmol/l, p less than 0.01). In addition the insulin:glucose ratios were also significantly increased (34.3 (8.5) v 24.6 (6.7), p less than 0.01), consistent with decreased insulin sensitivity. Group 2 comprised 13 of the original 24 subjects who also had an oral glucose tolerance test. Basal plasma glucose concentrations were similar in the subjects and their controls, whilst the significantly increased insulin:glucose ratios (35.0 (7.7) v 28.7 (5.6), p less than 0.05) were consistent with the results of the larger group. Following oral glucose challenge, plasma glucose concentrations, serum insulin concentrations and insulin:glucose ratios were similar in the subjects and their controls throughout the test. Thus, long-term use of norethisterone oenanthate injections is associated with a decrease in peripheral insulin sensitivity. However, these changes are not associated with any evidence of oral glucose intolerance. PMID- 3284712 TI - Positional isotope exchange. AB - The detection of intermediates in enzyme-catalyzed reactions can be accomplished by several techniques. For those intermediates which do not have easily observed electronic spectra, use can be made of isotope exchange phenomena if the chemistry of the reaction is appropriate. Recently, the technique of positional isotope exchange (intramolecular isotopic scrambling) has been used to study several reactions which have been thought to involve high-energy intermediates in their mechanisms. A review of some of these reactions and the limitations of the method are presented in this article. PMID- 3284713 TI - Viral RNA polymerases. AB - Recent progress in molecular biological techniques revealed that genomes of animal viruses are complex in structure, for example, with respect to the chemical nature (DNA or RNA), strandedness (double or single), genetic sense (positive or negative), circularity (circle or linear), and so on. In agreement with this complexity in the genome structure, the modes of transcription and replication are various among virus families. The purpose of this article is to review and bring up to date the literature on viral RNA polymerases involved in transcription of animal DNA viruses and in both transcription and replication of RNA viruses. This review shows that the viral RNA polymerases are complex in both structure and function, being composed of multiple subunits and carrying multiple functions. The functions exposed seem to be controlled through structural interconversion. PMID- 3284714 TI - Cultured human fetal pancreatic tissue reverses experimentally induced diabetes in nude mice. PMID- 3284715 TI - Mechanism of impaired ketosis during hyperdynamic sepsis. PMID- 3284716 TI - Computers in surgery. PMID- 3284717 TI - New technology in platelet immunology. PMID- 3284718 TI - Hereditary thrombocytopenias. PMID- 3284719 TI - Immunological structures of the platelet membrane. PMID- 3284720 TI - Biochemistry of the platelet membrane. PMID- 3284721 TI - Alloimmune thrombocytopenia in the newborn. PMID- 3284722 TI - Incontinentia pigmenti: a review. AB - The first reported case of the rare genodermatosis incontinentia pigmenti (Bloch Sulzberger syndrome) affecting a 6-week-old Qatari girl is presented. An interesting feature in our patient is the simultaneous presence of several stages of lesion evolution. The clinical and pathologic features of incontinentia pigmenti are reviewed briefly. PMID- 3284723 TI - Pyogenic granuloma following laser treatment of a port-wine stain. AB - A pyogenic granuloma occurred in a port-wine stain treated with first an argon, and subsequently a carbon dioxide, laser. Although reports of this phenomenon are infrequent in the literature, our review suggests that this is not a rare complication. The pathogenetic implications are discussed. PMID- 3284725 TI - New dietary anticarcinogens and prevention of gastrointestinal cancer. AB - Dietary anticarcinogens are found in minute amounts in many fruits and vegetables and often are the flavor and fragrance components that characterize them. Natural product chemists have isolated more than 100 chemical species from the plant kingdom that are antimutagenic, anticarcinogenic, or antipromotional in their mechanisms of inhibition. This paper will review the activity of newer agents including dialkyl sulfides in garlic and onion and calcium salts as potential compounds for the prevention of gastrointestinal cancer. PMID- 3284724 TI - Short-term prophylaxis with cefotaxime in colorectal surgery. A prospective, randomized trial. AB - In a controlled, randomized study the effect of penicillin and streptomycin on postoperative septic complications in colorectal surgery (penicillin, 2 ml, IU, intramuscularly, three times daily for a period of six days and concomitantly streptomycin, 0.5 gm, intramuscularly, two times daily for a period of four days) was compared with the effect of cefotaxime, 2 gm, intravenously, three times on the day of surgery. One hundred patients completed the study: 48 were treated with penicillin and streptomycin (Group 1) and 52 with cefotaxime (Group 2). Wound infection occurred in one patient (2.1 percent) in Group 1, but not in Group 2 (0%, N.S.). Rupture of the wound occurred in one patient in each group (2.1 percent vs. 1.9 percent, N.S.). Insufficiency of the anastomosis occurred in four patients in Group 1 (8.3 percent) and in one patient in Group 2 (1.9 percent). It is concluded that short-term prophylaxis with cefotaxime is as effective as long-term prophylaxis with penicillin and streptomycin. PMID- 3284726 TI - Neostigmine in postoperative intestinal paralysis. A double-blind, clinical, controlled trial. AB - The effect of neostigmine on postoperative intestinal paralysis in 90 patients was investigated in a controlled study. Neostigmine, 0.5 mg, was administered intramuscularly every third hour on the third day after laparotomy, either until passage of flatus or stools was observed, or until a total of three injections were given. No difference between treated and untreated patients was found, and it is suggested that neostigmine is of little or no value in postoperative intestinal paralysis. PMID- 3284727 TI - Preoperative colonoscopic diagnosis of villous adenoma of the appendix. Report of a case and review of the literature. AB - This case of villous adenoma of the appendix reported is unique by virtue of its having been diagnosed preoperatively using colonoscopy. Only 45 such lesions have been described previously, and a review of those cases reveals that 93 percent were discovered at appendectomy performed either incidentally or for acute appendicitis. The malignant potential of this entity is unknown and its treatment is controversial. Because of a report association between adenomas of the appendix and other gastrointestinal neoplasms, long-term surveillance is recommended. PMID- 3284728 TI - [Recombinant plasmid for detecting mutagens inducing the SOS function in Escherichia coli cells]. PMID- 3284729 TI - The role of calcium channel blocking agents in the prevention of migraine. AB - Vascular headache pathophysiology and manifestations are reviewed along with the role that calcium channel blocking agents play in prevention of these vascular headaches. Of the calcium channel blockers presently marketed in the U.S., verapamil has been the most widely studied. Verapamil has been shown to produce a significant improvement in frequency and duration of migraine as compared with placebo. Calcium channel blocking agents that have been studied and used outside of the U.S. are flunarizine and nimodipine, both of which provide significant improvement in measures of migraine severity, duration, frequency, and other pain and severity indices. There have been no controlled trials comparing these agents with each other as with beta-blocking agents and other prophylactic agents presently marketed in the U.S. Calcium channel blocking agents may become the drugs of first choice in migraine prophylaxis due to their effectiveness and mild side effect profile. PMID- 3284730 TI - Bacterial vaccines for splenectomized patients. AB - The spleen is an important organ in the defense of the body against pathogenic bacteria. Major functions of the spleen include antibody production and mechanical filtration of blood. Anatomically or functionally asplenic individuals are at increased risk of fulminant infection by encapsulated bacteria, particularly Streptococcus pneumoniae, Hemophilus influenzae, and Neisseria meningitidis. Polysaccharide vaccines are available against some strains of these pathogenic bacteria. More data are required to define specific age and risk groups. A search for better and more immunogenic vaccines, which may prove effective in a wider variety of patients, is currently under way. Although the current vaccines are not always effective and future revaccination may increase the incidence of adverse effects, most asplenic persons should receive the currently available vaccines to minimize their risk of life-threatening infection. PMID- 3284731 TI - Monoamine oxidase inhibitors: safety and efficacy issues. AB - Controversy has historically centered on the use of monoamine oxidase inhibitors (MAOI) in the treatment of depression because of safety and efficacy issues. Hypertensive crisis following ingestion of foods containing tyramine is the most feared problem associated with MAOI therapy. The authors conclude that only four tyramine-containing foods clearly warrant absolute prohibition, but indicate situations where moderation should apply. Although MAOI remain second-line agents in the treatment of endogenous depression, it is unclear whether MAOI or tricyclic antidepressants should be the drugs of choice in atypical depression and this question necessitates future research. PMID- 3284732 TI - Bibliography: handling considerations for cancer chemotherapeutic agents. AB - Since the introduction of antineoplastic agents in the 1940s, there have been reports of the effects of these agents on workers who have had prolonged contact with them. The Regional Oncology Drug Information Center (RODIC) at Memorial Sloan-Kettering Cancer Center receives numerous inquiries nationwide regarding our policies and procedures for handling antineoplastic agents. In August 1987, RODIC conducted a computerized literature search on the handling of antineoplastic agents and the risks to hospital employees, coming in contact with these agents. We used the MEDLINE system from 1966 to the present, limiting the search to English-language articles. This article provides a comprehensive bibliography on the handling of antineoplastic agents. PMID- 3284733 TI - Pharmacoepidemiologic methods for identifying and quantifying behavioral effects of neuropharmacological agents. AB - The possibilities and limitations of the pharmacoepidemiologic methods of determining neuropharmacologic drug efficacy and safety in psychiatric patients are discussed in this review. Such methods can improve both the scientific evaluation and clinical practice aspects of our knowledge of these drugs by providing: (1) incidence rates of drug usage and adverse events from computerized information on large populations; (2) quantitative methods for risk-to-benefit assessments that incorporate multiple outcome measures, provide long-term effectiveness and safety data, and use statistical methods to distinguish drug induced from illness-based behaviors; and (3) systematic epidemiologic approaches to resolving dilemmas that involve the political and social context in which neuropharmacological drugs are used. PMID- 3284734 TI - [The "false-positive" patch test reaction]. AB - If a positive patch test reaction occurs in the absence of sensitization to a certain antigen, we call it a false positive reaction. There may be several reasons for this: impurities of the test substances, too high a concentration, wrong choice of test location and reading time; positive reactions against test vehicle, or adhesive tape, nonspecific reactions due to adjacent strongly positive patch test reactions and finally wrong interpretation by the doctor. Diagnosis of contact allergy, especially to potent allergens or topical medications and questions relating to occupational disease may be of eminent importance to the patient. Therefore false positive as well as false negative test reactions should be recognized; this also appears particularly important for medicolegal reasons. PMID- 3284736 TI - [Tumor, thrombocytosis and thrombosis risk]. PMID- 3284735 TI - [Tuberculosis following liver transplantation]. AB - Seven months after orthotopic liver transplantation because of terminal postnecrotic cirrhosis, a 55-year-old patient was found to have pulmonary tuberculosis with fever, cough and an infiltration in the left upper lobe. Sputum culture grew M. Tuberculosis. He received ethambutol (1.6 g/d) and isoniazid (400 mg three times weekly, after 1 1/2 months 200 mg thrice weekly). After eleven months the tuberculosis had healed with only minor residua. The function of the transplant was very good in the fourth year after the operation. The main side effect was a reversible rise in liver enzymes. If possible, patients should not be given hepatotoxic tuberculostatic agents after liver transplantation, in no circumstances rifampicin. Dosage should be adapted to the liver function so as to avoid damage to transplant function. PMID- 3284737 TI - [Heart failure in dilated cardiomyopathy and coronary heart disease. The contribution of biochemical parameters to assessing the prognosis]. PMID- 3284738 TI - [Hyperthermia. The foundations and value of a new therapeutic modality in oncology]. PMID- 3284739 TI - The causes and consequences of hyposalivation. PMID- 3284741 TI - Fibrosarcoma of the maxillary sinus. PMID- 3284740 TI - Treatment of hyposalivation. PMID- 3284743 TI - Comparison of empirically developed sepsis score with a computer generated and weighted scoring system for the identification of sepsis in the equine neonate. PMID- 3284742 TI - Low resolution structures of biological complexes studied by neutron scattering. PMID- 3284744 TI - The glutathione transferase activity and tissue distribution of a cloned Mr28K protective antigen of Schistosoma mansoni. AB - A protective Mr28K antigen of Schistosoma mansoni, expressed from its cDNA, has been purified in a single step and shown to possess glutathione (GSH) transferase activity as predicted from sequence homologies with two mammalian GSH transferase multigene families. It is notable for its high 1-chloro-2,4-dinitrobenzene GSH transferase and linoleic acid hydroperoxide GSH peroxidase activities. The major GSH transferase of S. mansoni has been purified and its subunit is identical to this Mr28K antigen by criteria of Mr, immunochemistry, substrate specificity and peptide sequence analysis. In the parasite, the antigen is present in the tegument, protonephridial cells and subtegumental parenchymal cells. No significant immunological cross-reactivity between the S.mansoni and mammalian (human and rat) GSH transferases was observed. PMID- 3284745 TI - The NAM2 proteins from S. cerevisiae and S. douglasii are mitochondrial leucyl tRNA synthetases, and are involved in mRNA splicing. AB - We have cloned and sequenced the NAM2 gene of Saccharomyces douglasii, which is a homologue of the NAM2 gene of Saccharomyces cerevisiae. The wild-type S.douglasii gene possesses the suppressor functions of the mutant S. cerevisiae NAM2-1 allele, being able to cure a mitochondrial b14 maturase deficiency. By sequence comparisons and direct measurements we have demonstrated that the NAM2 genes encode mitochondrial leucyl tRNA synthetases (EC 6.1.1.4.). Using a derivative of the NAM2 gene, where the expression of the gene is under the control of the UAS GAL10, we have shown that the processing of the pre-mRNA from the two mosaic genes oxi3 and cob-box is impaired when transcription of the gene is repressed. These results lead us to conclude that the mitochondrial leucyl tRNA synthetase is involved in protein synthesis and mRNA splicing. Sequence comparisons show that the mitochondrial and Escherichia coli leucyl tRNA synthetases are highly homologous; however, significant features which may be important for the splicing functions of the mitochondrial enzymes are absent from the bacterial enzyme. PMID- 3284746 TI - Characterization of a transcription factor involved in mother cell specific transcription of the yeast HO gene. AB - The yeast HO gene, which encodes an endonuclease involved in initiating mating type interconversion, is expressed in mother cells but not in daughters. It has been demonstrated that the SWI5 gene, which is an activator of HO expression, plays a critical role in this differential mother/daughter expression of HO. In this paper we describe the cloning and sequencing of the SWI5 gene. The predicted amino acid sequence derived from the cloned SWI5 gene shows homology with the repeated DNA-binding domains ('zinc fingers') of Xenopus transcription factor TFIIIA. A region of the HO promoter involved in the SWI5-dependent transcriptional activation of HO was identified by deletion analysis of the HO promoter in the chromosome, and by testing the ability of HO DNA fragments to activate transcription in the context of a heterologous promoter. The SWI5 gene product was overproduced in yeast from the GAL1-10 promoter, since the SWI5 protein is made at very low levels in wild-type strains, and protein extracts were used to demonstrate that the SWI5 protein binds in vitro to a segment of the HO promoter required for transcriptional activation in vivo. PMID- 3284748 TI - Sonographic demonstration of portal venous gas in necrotizing enterocolitis. AB - Portal vein gas embolism was demonstrated by ultrasound in a preterm infant with necrotizing enterocolitis. This sign could not be detected radiographically. It is speculated that portal venous gas occurs more frequently than hitherto inferred from radiological studies. This observation points to the value of ultrasonography in providing early objective evidence in support of the diagnosis of NEC. The favourable outcome for the patient proves that portal venous gas embolism is not necessarily associated with a fulminant course of enterocolitis. PMID- 3284749 TI - Cerebral infarctions studied by [123I]iodoamphetamine. Clinical aspects of the findings on single photon emission computed tomography and transmission computed tomography. AB - We have used single photon emission computed tomography (SPECT) and the radioisotope [123I]-iodoamphetamine to study 16 patients with cortical and central cerebral infarctions. In 12 cases SPECT, in addition to changes at the site of infarction, showed areas of deficient uptake in other regions of the brain. Diaschisis as well as infarctions, not detected on the transmission computed tomography scanning, seem to explain these findings. PMID- 3284747 TI - Vitamin K in infancy. AB - Vitamin K has regained paediatric interest due to a recurrence of bleeding caused by deficiency of the vitamin in newborns and young infants. Increasing awareness of these clinical problems, the development of new methods for the detection of vitamin K deficiency and the direct measurement of vitamin K in tissues have stimulated research. Much new data obtained from these studies has proved helpful to the understanding of vitamin K deficiency in infancy. For example low concentrations of vitamin K have been found in fetal and neonatal livers. The implications of these findings with respect to manifest vitamin K deficiency and to new methods for detection of subclinical vitamin K deficiency are discussed. Breast-feeding is a major risk factor for classical haemorrhagic disease of the newborn and for late onset bleeding due to vitamin K deficiency in young infants. The interdependencies between breast-feeding and vitamin K deficiency are discussed on the basis of new data obtained from direct measurement of vitamin K in maternal milk. The review further focuses on pathophysiological concepts of bleeding due to vitamin K deficiency in infancy and current concepts of vitamin K prophylaxis. PMID- 3284750 TI - Diabetes mellitus in Kearns-Sayre syndrome. AB - A 20-year-old woman with Kearns-Sayre syndrome (KSS) suddenly experienced two episodes of diabetic coma. She was studied to determine whether diabetes mellitus (DM) resulted from insulin resistance or from an insulin secretion abnormality, using the euglycemic glucose clamp technique and the glucagon tolerance test. She had a deficiency of insulin secretion from beta cells. It is important to recognize in practice the onset of DM in patients with mitochondrial myopathy. We would suggest that a genetic linkage or mitochondrial dysfunction may be responsible for the association of both disease states. PMID- 3284752 TI - Mianserin and trazodone for cardiac patients with depression. AB - In a placebo controlled double-blind cross-over study, the cardiovascular and antidepressant effects of three weeks' treatment with mianserin (30-80 mg daily) and trazodone (150-400 mg daily) were studied in depressed patients who had co existant cardiac disease. In 14 of the 16 patients, no haemodynamic deterioration occurred with either drug. Two patients withdrew from the study. One with coronary artery disease, whose concomitant medication included a calcium antagonist and a beta-adrenoceptor blocker and who developed severe postural hypotension after his first dose of trazodone while the other had an increased frequency of transient cerebral ischaemic attacks with both mianserin and trazodone, but not with placebo. Mianserin and trazodone are comparable for both antidepressant efficacy and paucity of cardiovascular effects. Although unwanted effects were generally mild, the incidence of dizziness was greater in those patients receiving trazodone. Caution is advised, however, when prescribing either drug to patients with transient cerebral ischaemic attacks or those with coronary artery disease receiving medication. PMID- 3284751 TI - Reflex-epilepsy induced by immersion in hot water. Case report and review of the literature. AB - A patient with reflex epilepsy is described, in whom seizures were induced by bathing in hot water. The literature is reviewed. PMID- 3284754 TI - Comparison of saline and streptokinase-streptodornase in the treatment of leg ulcers. AB - In 31 patients with leg ulcers the wounds were randomly allocated to treatment either with a solution of streptokinase plus streptodornase in saline or physiological saline alone. The occurrence of pus and debris in the wounds was evaluated by a "blinded" investigator at the initiation of treatment and on Days 5, 10 and 15. In 12 out of 13 patients treated with the streptokinase streptodornase solution and in 8 out of 16 saline-treated patients the wounds were clean by Day 10. PMID- 3284755 TI - [Serum insulin concentration and arginine tolerance test in the cynomolgus monkey (Macaca fascicularis)]. AB - The standard value of serum insulin was determined to be less than 75 microU/ml with ninety-eight female adult cynomolgus monkeys of wild origin. Then, fifteen apparently healthy laboratory-bred female cynomolgus monkeys aged 6-8 years were studied to know the usefulness of the arginine tolerance test (ATT) by measuring blood glucose, insulin and glucagon. Prior to ATT, all animals had been diagnosed as non-diabetic by the intravenous glucose tolerance test (IVGTT). Arginine hydrochloride was infused intravenously at a dose of 0.5 g/kg. BW under anesthesia. According to the standard value of insulin, fifteen animals were divided into two groups, that is, the low (n = 7) and the high (n = 8) value groups. In the low value group, glucose and insulin value did not change significantly after arginine infusion and their responses were similar to those in the control group (saline infused, n = 4). But glucagon markedly increased from 10 to 45 minutes post infusion. In the high value group, glucagon response was similar to that in the low value group, while glucose and insulin values significantly decreased. It is concluded that the pancreatic alpha-cell function (glucagon secretion) can be judged by the ATT in the cynomolgus monkey but the beta-cell function (insulin secretion) can not be diagnosed. PMID- 3284753 TI - The acute renal haemodynamic and endocrine response to felodipine in normal man. AB - Felodipine (0.075 mg/kg p.o.), a calcium antagonist, was given to 9 male volunteers, with and without indomethacin pretreatment. Diuresis and natriuresis occurred after felodipine without significant change in effective renal plasma flow or glomerular filtration rate. There was no significant change in urinary 6 keto PGF 1 alpha or urinary kallikrein excretion and indomethacin did not inhibit the natriuretic or diuretic response to felodipine. The felodipine induced diuresis and natriuresis appears most likely to be mediated by an action of the drug on renal tubules. PMID- 3284756 TI - [Characteristics of tear proteins in the vole, Microtus arvalis]. AB - Tear proteins were detected by polyacrylamide gel electrophoresis in the vole, Microtus arvalis. The tear proteins were separated to 6 to 8 bands and the bands were divided to three regions on the anodic side. In the adult male vole, a male specific band (Vtp-1) was detected in the first region. The first region of adult female and immature voles contained two specific bands (Vtp-2, 3). In the castrated adult males or adult males injected with estrogen, the male specific hand, Vtp-1, disappeared and Vtp-2 and 3 bands appeared. In all castrated voles, the Vtp-1 band appeared and Vtp-2 and 3 bands disappeared after the administration of testosterone. Thus, sex hormone-dependent proteins are present in vole tears. PMID- 3284757 TI - Plasmodium malariae: distribution of circumsporozoite protein in midgut oocysts and salivary gland sporozoites. AB - The distribution of the circumsporozoite protein within developing Plasmodium malariae oocysts and salivary gland sporozoites was examined by immunoelectron microscopy using protein A-gold and a monoclonal antibody specific for the CS protein of P. malariae. Gold particles were found along the capsule of immature oocysts but rarely within the cytoplasm. Gold label was detected on the inner surface of peripheral vacuoles during oocyst maturation and the plasma membrane of the sporoblast. Salivary gland sporozoites and budding sporozoites in mature oocysts were labeled uniformly on the outer surface of their plasma membranes. The surface of sporozoites that ruptured into midgut epithelial cells were entirely covered with gold particles. No label was seen on the surface of sporozoites which ruptured into the midgut lumen. In addition, a rabbit polyclonal antibody against repeat a region of P. brasilianum CS protein reacted with P. malariae sporozoites. PMID- 3284758 TI - Plasmodium falciparum: cloning by single-erythrocyte micromanipulation and heterogeneity in vitro. AB - Natural isolates of Plasmodium falciparum represent a genetically heterogeneous population of parasites. To obtain stable strains of the parasites for long term experiments, a rapid and definitive method of cloning was developed using micropipets and a micromanipulator. Homogeneous parasite clones prepared by this technique were characterized and compared with the parent isolates during 4 years of continuous culture. The process of phenotypic dominance and selection of drug resistance which occur in nature was also simulated in vitro by evaluating population dynamics of two cocultured isolates of P. falciparum. PMID- 3284759 TI - The combined effects of histamine and methacholine on the maximal degree of airway narrowing in normal humans in vivo. AB - In normal subjects in vivo the dose-response curve to inhaled nonsensitizing stimuli reaches a plateau at mild degrees of airway narrowing. We investigated whether the limitation of the response is due to non-optimal smooth muscle activation, by administering high doses of histamine and methacholine together. In fifteen normal subjects a complete dose-response curve to methacholine was recorded by a tidal breathing method on three randomized days. On a separate day a complete histamine inhalation test was carried out. Each methacholine test was directly followed by double blind inhalation of the highest dose of either histamine or methacholine, or a dose of saline. The response was measured by flows from partial flow-volume curves (V 40p), and was expressed in % fall from baseline. Twelve subjects reached a maximal response plateau to methacholine which was reproducible. The addition of saline or extra methacholine did not change the response from its methacholine plateau value. Histamine caused a small increase in the response on top of the methacholine plateau (+ 9.0% fall; p less than 0.001). However, the response to the combined histamine and methacholine was not significantly larger than the maximal response to histamine alone. We conclude that there is no interaction between histamine and methacholine on the maximal degree of airway narrowing. This suggests that the plateau of the dose response curve in normal subjects in vivo is due to other factors than limited smooth muscle activation. PMID- 3284760 TI - The alveolitis of hypersensitivity pneumonitis. AB - In the pathogenesis of hypersensitivity pneumonitis (HP) several immune mechanisms are involved. The initial phase, 4-48 h after antigen inhalation, appears to be immune complex mediated and is characterized by an early increase in bronchoalveolar lavage (BAL) neutrophils and the histopathologic features of oedema, neutrophil infiltration of the alveolar wall, and vasculitis. After 12 h to several days, the immune response possibly shifts to a cell-mediated reaction, and the alveolitis consists of cytotoxic effector cells as well as suppressor cells which may be required to modulate the B cell response of antibody production by plasma cells. In this phase, lymphocytes of the OKT8 positive phenotype, natural killer cells, and occasionally a few plasma cells are increased in BAL fluid. The characteristic histopathologic finding is a mononuclear infiltrate consisting of lymphocytes, plasma cells, and foamy histiocytes. After weeks to months, a delayed type hypersensitivity reaction may lead to a slight predominance of OKT4 positive cells in BAL fluid and to granuloma formation. Finally, after months to years, repeated immune-mediated injury to the alveolar wall with release of proteolytic enzymes and fibroblast growth factors may result in pulmonary fibrosis and end stage lung with concomitant increase in BAL neutrophils as in other fibrotic diseases. PMID- 3284761 TI - Proliferation and differentiation in mammalian airway epithelium. PMID- 3284762 TI - Corneel Heymans and his work on respiratory reflexes. PMID- 3284763 TI - Application of the small-angle X-ray scattering technique for the study of equilibrium enzyme-substrate interactions of phenylalanyl-tRNA synthetase from E. coli with tRNAPhe. AB - The small-angle X-ray scattering technique (SAXS) is proposed for the investigation of equilibrium macromolecular interactions of the enzyme-substrate type in solution. Experimental procedures and methods of analysing the data obtained from SAXS have been elaborated. The algorithm for the data analysis allows one to determine the stoichiometric, equilibrium and structural parameters of the enzyme-substrate complexes obtained. The thermodynamic characteristics for the formation of complexes of tRNAPhe with phenylalanyl-tRNA synthetase have been determined and demonstrate negative cooperativity for binding of the two tRNAPhe molecules. The structural parameters (Rg, Rc, semi-axes) have been determined for free phenylalanyl-tRNA synthetase and tRNAPhe from E. coli MRE-600 and of enzyme complexes possessing one and two tRNAPhe molecules, indicating structural rearrangements of the enzyme in the interaction with tRNAPhe. PMID- 3284764 TI - Escherichia coli hemolysin permeabilizes small unilamellar vesicles loaded with calcein by a single-hit mechanism. AB - Escherichia coli hemolysin produces small unilamellar lipid vesicles permeable to the fluorescent dye calcein by forming pores through their membrane. The process of permeabilization proceeds as a pseudo first-order reaction, indicating that the toxin is active as a monomer; consistently no evidence for cooperativity has been found in a dose-response titration. The rate of interaction increases on lowering the pH of the solution and by introducing negatively charged lipids into the vesicles. The overall pore formation mechanism resembles that of other toxins of bacterial origin such as colicins, diphtheria, tetanus and botulinum toxin. PMID- 3284765 TI - [Epidemics in the Middle Ages]. PMID- 3284766 TI - [Structural-functional mechanisms of bulbar chemosensitivity of respiration]. PMID- 3284767 TI - [A new approach to the evaluation of hemodynamics in the carotid arteries of humans using the ultrasonic Doppler method]. PMID- 3284769 TI - Self-directed learning. PMID- 3284768 TI - [Retrospective analysis of the survival of the transplanted kidney as a function of the content of anti-T- and anti-B-lymphocytotoxic antibodies in the blood serum of recipients and in eluates obtained from kidney allotransplants]. PMID- 3284770 TI - Computerized Cheirometer for assessing grip-strength indices and classification of rheumatoid patients. PMID- 3284771 TI - Recent progress in biosensor development. PMID- 3284772 TI - Multiple carboxylase deficiency. AB - 1. The multiple carboxylase deficiencies are inborn errors in the metabolism of biotin in which there is defective activity of propionyl CoA carboxylase, 3 methylcrotonyl CoA carboxylase and pyruvate carboxylase. 2. Two distinct disorders have been described. 3. In one the fundamental defect is in the enzyme holocarboxylase synthetase which catalyzes the molecular activation of the apocarboxylase proteins. 4. In the other the fundamental defect is in biotinidase which catalyzes the reutilization of biotin and may be involved in its digestion and intestinal absorption. PMID- 3284773 TI - Expression of the mouse lactate dehydrogenase-A promoter fused with the bacterial gpt gene in Chinese hamster ovary cells. AB - The promoter region of the cloned mouse lactate dehydrogenase-A gene was fused with the gpt gene of Escherichia coli, and this fusion gene was shown to express in Chinese hamster ovary cells. This result demonstrates that the cloned LDH-A promoter is indeed functional. PMID- 3284774 TI - Laminin, fibronectin and type IV collagen in BM-like material from cultured arterial smooth muscle cells. AB - 1. The intra- and extracellular distribution of fibronectin and laminin was studied by immunofluorescence in cultures of rabbit and human arterial smooth muscle cells. 2. Basement membrane (BM)-like material was isolated from the cell layer of arterial smooth muscle cells cultures and analysed by sodium dodecyl sulphate gel electrophoresis (SDS-PAGE) and immunoblotting. The major 220-240 kD component of arterial BM-like material was identified as fibronectin. Also a 200 kD fibronectin band was observed. 3. The 200 kD subunit of laminin was contained in isolated BM-like material, but no slower migrating laminin chains were detected. 4. Collagens were prepared from pepsinized BM-like material. The band pattern as resolved by SDS-PAGE and silver staining suggested that type IV collagen is the major collagen of arterial BM-like material. PMID- 3284776 TI - [Multiple primary intraductal tumors of Wirsung's duct: demonstration of a relation between benign and malignant tumors]. AB - A case of multiple villous and, more rarely, tubulovillous adenomas of the main pancreatic duct, associated with a diffuse infiltrating adenocarcinoma of the pancreas in which evidence for a link between these lesions is supported by histopathologic features, is reported in a 53 year old patient. Clinical presentation included abdominal pain, weight loss and chronic diarrhea with steatorrhea related to pancreatic insufficiency. Retrograde endoscopic pancreatography showed a complete stenosis of the main pancreatic duct located 3 mm beyond the ampulla of Vater. CT scan showed an heterogeneous cephalic pancreatic tumor with extensive enlargement of the main pancreatic duct. After total pancreatectomy, recovery was maintained (follow-up 18 months). By analogy to colorectal tumors, a new pathologic classification of these rare neoplasms may be proposed. PMID- 3284775 TI - [Mechanism of action of hormones at the level of the regulator proteins of adenylate cyclase]. PMID- 3284777 TI - [Hepatic fibrosis: changes in collagen and serum markers related to its metabolism]. PMID- 3284778 TI - The important role of EUS in the assessment of patients with portal hypertension. PMID- 3284779 TI - [Criteria in the evaluation of breast sonography]. AB - The use of sonography to diagnose pathologic changes of the breast is constantly increasing. It is well known that this method can be employed to distinguish cystic from solid processes. Of greater interest is the question as to the usefulness of sonography in prognosticating the pathology of such processes. This prognosis of pathology is linked to assessment criteria which are not uniformly defined worldwide and which are also applied differently. The study reported here -an evaluation of 755 sonographic focal findings--points out the possible distinctiveness of each individual assessment criterion and indicates the degree of confidence with which malignant and benign breast processes can be distinguished. There are statistically significant differences (p less than 0.0001) in the patterns of distinctiveness of all the assessment criteria mentioned depending on whether the processes are malignant or benign. The most important criterion is the edge contour. Every sonographic focus finding should be checked with regard to its edge contour, retrotumorous acoustic behavior, echo structure, and echo density. In the dynamic part of the examination, changes in the form and structure of the finding must be recorded. The authors estimate the changes of being able to distinguish malignant from benign processes on the basis of the above-mentioned criteria as good. The guide to the classification of echographic phenomena presented here may be of help to learners. PMID- 3284780 TI - Immunocytochemical and morphometric study of prolactin cells during amphibian morphogenesis. AB - The peroxidase-antiperoxidase (PAP) immunocytochemical technique and rabbit antihuman prolactin (PRL) antiserum were used to localize and identify PRL producing cells in the pars distalis of Bufo calamita, Hyla meridionalis, Alytes cisternasii, Pelobates cultripes, and Rana perezi tadpoles at different stages of development as well as in 1-year-old post-metamorphic animals. This cell type was located throughout the gland in P. cultripes and R. perezi and in the caudal two thirds in B. calamita, H. meridionalis, and A. cisternasii in premetamorphic animals. These distribution patterns do not show changes throughout development. Morphometry was used to evaluate the changes observed in pars distalis volume and stereological parameters of PRL immunoreactive cells during development. Pars distalis volume increased during the larval growth period and decreased throughout the metamorphic climax. PRL volume density and cellular area showed different patterns in the different species, although the correlation between these parameters suggests a period of great proliferative rate followed by changes in cellular size. The changes observed in PRL total volume suggest the existence of two phases in amphibian development: (i) a period of PRL storage during pre- and prometamorphosis and (ii) a period of release at the metamorphic climax. PMID- 3284781 TI - Glucose tolerance and pancreatic hormones in thyroidectomized and thyroid hormone injected cockerels. AB - The effect of surgical thyroidectomy and of T4/T3 injections on basal and glucose induced concentrations of plasma insulin and glucagon has been investigated in 20 week-old domestic chickens. Birds injected daily (im) for 2 weeks with T4/T3 (50 micrograms/day) had marginally lower fasting glucose concentrations whereas thyroidectomy had no effect. Glucose tolerance to an intravenous injection of glucose (0.5 g/kg) was impaired in T4/T3 injected animals although the peak hyperglycemia was identical with sham-operated animals. This was associated with significantly reduced basal and glucose-induced insulin concentrations. However, fasting plasma glucagon concentrations were significantly elevated in this group as was the magnitude of the glucose-induced suppression of glucagon release 10 min after injection (48% decline vs 34% in sham-operated animals). Basal concentrations of plasma insulin were markedly elevated in thyroidectomized animals and were associated with only mildly depressed plasma glucagon levels. The absolute concentrations of plasma insulin remained higher in the thyroidectomized birds as compared with those of sham-operated or T4/T3 injected animals after the glucose challenge, although within 30 min after glucose injection they had significantly declined below preinjection levels. This was associated both with significantly reduced plasma glucose concentrations 30 min after injection and the lowest absolute levels of plasma glucagon. The rebound in plasma glucagon in sham-operated animals in response to the rapid decline in glucose concentrations was not as pronounced in either thyroidectomized or T4/T3 injected animals. In conclusion these studies illustrate the secretory dynamics of avian pancreatic endocrine islets in response to both absolute glucose levels and glucose requirements as affected by the thyroid state of the bird. PMID- 3284782 TI - Mutations that improve the binding of yeast FLP recombinase to its substrate. AB - When yeast FLP recombinase is expressed from the phage lambda PR promoter in a Salmonella host, it cannot efficiently repress an operon controlled by an operator/promoter region that includes a synthetic, target FLP site. On the basis of this phenotype, we have identified four mutant FLP proteins that function as more efficient repressors of such an operon. At least two of these mutant FLP proteins bind better to the FLP site in vivo and in vitro. One mutant changes the presumed active site tyrosine residue of FLP protein to phenylalanine, is blocked in recombination, and binds the FLP site about five-fold better than the wild type protein. A second mutant protein that functions as a more efficient repressor retains catalytic activity. We conclude that the eukaryotic yeast FLP recombinase, when expressed in a heterologous prokaryotic host, can function as a repressor, and that mutant FLP proteins that bind DNA more tightly may be selected as more efficient repressors. PMID- 3284783 TI - Maintenance of the 2 micron circle plasmid of Saccharomyces cerevisiae by sexual transmission: an example of a selfish DNA. AB - Many eukaryotic mobile elements have been identified, but few have any obvious function. This has led to the proposal that many such elements may be parasitic DNA. We have used the 2 micron circle plasmid of Saccharomyces cerevisiae as a model system to investigate the maintenance of a cryptic genetic element. We find that under certain conditions this plasmid can spread through experimental populations despite demonstrable selection against it. This spread is dependent upon outbreeding, suggesting that cell to cell transmission of the plasmid during the yeast sexual cycle can counterbalance selection, and maintain the plasmid in populations. This result provides experimental support for the idea that some mobile elements may be parasitic DNA. PMID- 3284784 TI - A mutation affecting the regulation of a secA-lacZ fusion defines a new sec gene. AB - It was shown previously that the secA gene of Escherichia coli is derepressed in cells that have a defect in protein export. Here it is demonstrated that the beta galactosidase produced by a secA-lacZ gene fusion strain is regulated in the same way. Studies on the fusion strain reveal that the promoter or a site involved in regulation of the secA gene is located considerably upstream from the structural gene. The properties of the fusion strain provide a new selection for mutants that are defective in protein export. Selection for increased lac expression of a secA-lacZ fusion strain yields mutations in three of the known sec genes, secA, secD and prlA/secY. In addition, mutations in several genes not previously known to affect secA expression were obtained. A mutation in one of these genes causes a pleiotropic defect in protein export and a cold-sensitive growth defect; this gene, which maps at approximately 90 min on the bacterial chromosome, has been named secE. PMID- 3284785 TI - Repair of single base-pair transversion mismatches of Escherichia coli in vitro: correction of certain A/G mismatches is independent of dam methylation and host mutHLS gene functions. AB - Six different base-pair transversion mismatches are repaired with different efficiencies in an in vitro mismatch repair system. In particular, the T/T and C/C mismatches appear to be less efficiently repaired than the A/A and G/G mismatches. Four A/G and four C/T mismatches at different positions are repaired to different extents. One of the A/G mismatches is repaired equally efficiently when DNA heteroduplexes are fully methylated or hemi-methylated at the d(GATC) sequences. This type of mismatch repair appears to be unidirectional with A to C conversion by acting at A/G mispairs to restore the C/G pairs. This methylation independent correction is not controlled by the mutH, mutL, mutS, uvrE, uvrB, phr, recA, recF, and recJ gene products. The independence of the transversion mismatch repair of these genes and methylation distinguishes this from the known mismatch repair pathways. PMID- 3284786 TI - Nonsense mutations in essential genes of Saccharomyces cerevisiae. AB - A new method for isolating nonsense mutations in essential yeast genes has been used to develop a collection of 115 ochre mutations that define 94 complementation groups. The mutants are isolated in a genetic background that includes an ochre suppressor on a metastable plasmid and a suppressible colony color marker on a chromosome. When the parental strain is plated on a rich medium, the colonies display a pattern of red, plasmid-free sectors on a white background. Mutants containing an ochre mutation in any essential yeast gene give rise to nonsectoring, white colonies, since cell growth is dependent on the presence of the plasmid-borne suppressor. Analysis of the data suggests that mutations are being recovered from a pool of approximately 250 genes. PMID- 3284787 TI - Mutations affecting the tRNA-splicing endonuclease activity of Saccharomyces cerevisiae. AB - Two unlinked mutations that alter the enzyme activity of tRNA-splicing endonuclease have been identified in yeast. The sen1-1 mutation, which maps on chromosome 12, causes temperature-sensitive growth, reduced in vitro endonuclease activity, and in vivo accumulation of unspliced pre-tRNAs. The sen2-1 mutation does not confer a detectable growth defect, but causes a temperature-dependent reduction of in vitro endonuclease activity. Pre-tRNAs do not accumulate in sen2 1 strains. The in vitro enzyme activities of sen1-1 and sen2-1 complement in extracts from a heterozygous diploid, but fail to complement in mixed extracts from separate sen1-1 and sen2-1 haploid strains. These results suggest a direct role for SEN gene products in the enzymatic removal of introns from tRNA that is distinct from the role of other products known to affect tRNA splicing. PMID- 3284788 TI - The story of elderly care. 4. Wartime and the beginnings of geriatric nursing. PMID- 3284791 TI - Cisplatin-induced hypomagnesemia with seizures: a case report and review of the literature. PMID- 3284789 TI - A new gene controlling sulphite reductase in Aspergillus nidulans. PMID- 3284792 TI - Carcinoid of the cervix: natural history and implications for therapy. AB - Carcinoid tumors rarely occur in the cervix. We present a patient with FIGO stage IB disease who developed brain metastases 4 years after initial diagnosis and treatment. The clinical course of a collected series of patients with carcinoid of the cervix is reviewed. Even patients with low stage lesions frequently die of disseminated disease. Adjuvant chemotherapy may have a role in the treatment of such patients. PMID- 3284790 TI - Nucleotide sequences of the Escherichia coli nagE and nagB genes: the structural genes for the N-acetylglucosamine transport protein of the bacterial phosphoenolpyruvate: sugar phosphotransferase system and for glucosamine-6 phosphate deaminase. AB - The genes coding for the enzymes of N-acetylglucosamine (GlcNAc) uptake and metabolism (nagA, nagB, and nagE) are located next to glutaminyl-tRNA synthetase gene (glnS) in the Escherichia coli genome. We determined the nucleotide sequence of the nagE (ptsN) gene, encoding the GlcNAc-specific enzyme II (NagE) of the phosphoenolpyruvate: sugar phosphotransferase system, and the sequence of the putative nagB gene, for glucosamine-6-phosphate deaminase. S1 mapping identified the mRNA transcript for nagE, indicating that nagE might be a sole constituent of the nagE operon, and divergent transcripts which are probably of the nagB, nagA genes. An evaluation of the hydrophobic and hydrophilic properties of NagE shows characteristics of a membrane protein. Also, NagE shows homologies to lactose permease and to the glucose-specific transport protein (enzyme IIGlc), and the glucose-specific phosphoryl carrier protein (enzyme IIIGlc). The latter two homologies are particularly interesting since no enzyme III-like protein for GlcNAc transport has been reported and enzyme IINag is of similar size as the combined enzymes IIGlc plus IIIGlc. This supports the idea that these two transport and phosphorylation systems may have evolved from a common ancestral gene. PMID- 3284793 TI - Malignant extraovarian endometriosis: two case reports and review of the literature. AB - Two cases of adenocarcinoma arising in extraovarian endometriosis 19 and 8 years following abdominal hysterectomy and bilateral salpingo-oophorectomy are described. Both patients presented with hydronephrosis. One had been on chronic estrogen therapy. The literature is reviewed in reference to frequency, tumor type, and sites of occurrence. PMID- 3284794 TI - [Interventional catheterization in congenital heart disease: present state and future expectations]. PMID- 3284795 TI - [Autoimmune syndromes in malignant disorders]. PMID- 3284796 TI - [Septic shock--1987]. PMID- 3284797 TI - [Unusual manifestation of temporal arteritis]. PMID- 3284799 TI - Tensile strength comparison of dowel plug technique to standard techniques of tendon-bone attachment. AB - Since tendon transplantation relies on successful fixation of the tendon transplant, a quantitative comparison of various methods of tendon attachment to bone was investigated in mongrel dogs. The methods included attaching tendon to periosteum, suturing a tendon to itself after passing through bone, stapling, and wedging a dowel plug into a hole with the tendon. Tests to failure were conducted at 0, 10, 28, and 63 days of healing. The dowel plug technique provided strong immediate fixation. After 63 days the staple, the tendon passed through bone, and the dowel plug techniques showed significant increases in strength. On tendons of similar size, the dowel plug method showed the greatest tensile strength when compared to the staple fixation. This method was a simple, reproducible technique. PMID- 3284800 TI - Large cell lymphoma of bone. A report of three cases of B-cell origin. AB - Clinicopathological and immunohistological features of three cases of large cell lymphoma of bone are reported. On histological grounds, all the cases were diagnosed as histiocytic lymphomas (Rappaport) or primary centroblastic lymphomas, polymorphic subtype (Kiel). On immunophenotyping, malignant cells strongly reacted with the anti-leucocyte antibodies PD7/26 and ROS-220C, thereby indicating their lymphomatous nature, and expressed the B-cell antigens CD19 and CD22. Further studies are warranted to determine whether the B-cell phenotype observed in our cases is typical of the majority of primary large cell lymphomas of bone. Immunohistological analysis with monoclonal antibodies is expected to be of great value not only in defining the immunological phenotype of this rare pathological entity, but also in differentiating it from other neoplasms that involve the skeleton, either primarily or secondarily. PMID- 3284801 TI - Malignant lymphoma presenting as an isolated renal mass. PMID- 3284798 TI - Genotoxicity studies on selected organosilicon compounds: in vitro assays. AB - A series of 12 organosilicon compounds representing potential intermediates in the synthesis and degradation of polydimethylsiloxanes were evaluated for genotoxic potential with a battery of in vitro assays. Microbial assays included the Ames bacterial reverse mutation in Salmonella, mitotic gene conversion in Saccharomyces cerevisiae D4 and DNA repair in E. Coli pol A +/-. These assays were conducted with and without a metabolic activation system containing Aroclor 1254-induced rat-liver homogenate. Forward gene mutation, sister-chromatid exchange, DNA alkaline elution and chromosome aberration potential were evaluated in mouse lymphoma L5178Y tissue culture cells. The tissue culture assays were performed with and without metabolic activation mixture utilizing uninduced mouse liver S-9. The use of this enzyme preparation was felt to more closely mimic the actual in vivo situation and to be more compatible with mouse cells employed in the assay. No evidence of gene mutation was observed. However, six of the 12 compounds evaluated demonstrated potential in vitro clastogenic (chromosome damaging) activity. PMID- 3284802 TI - Congenital Leydig cell hyperplasia. AB - The testes and epididymes collected at autopsy from 21 newborns showed apparent Leydig cell hyperplasia which was studied by light and electron microscopy. Twelve newborns were the sons of diabetic mothers, two had undergone rhesus isoimmunization, two were twins of a non-diabetic mother, three had Beckwitz Widemann's syndrome, and two had leprechaunism. In the first two groups the placentas were also collected and studied. All the testes showed normal seminiferous tubules and diffuse Leydig cell hyperplasia in the testicular interstitium. In addition one son of a diabetic mother and another with Beckwitz Widemann's syndrome presented multiple Leydig cell nodules in the mediastinum testis and epididymis. The number of Leydig cells per unit area of the testis was calculated on histological sections stained with the peroxidase-anti-peroxidase method for the detection of testosterone. These numbers varied from 1.4 to 3.2 times those found in age-matched controls, except for the two testes with nodular hyperplasia in which the increase in Leydig cells was even greater. The differential diagnosis between Leydig cell hyperplasia, ectopic adrenal cells and leydig cell tumour is discussed. It is proposed that the cause of congenital Leydig cell hyperplasia might be related to placental secretion of human chorionic gonadotrophin. PMID- 3284803 TI - Hairy cell leukemia: characteristics of the neoplastic cells. PMID- 3284804 TI - Diffuse dermal neutrophilia in urticaria. AB - Twenty-three cases of diffuse dermal neutrophilia and urticaria were reviewed. Evidence of vasculitis or other disease was not present. Direct immunofluorescence was done in 19 cases and was positive but nonspecific in 14. The presence of angioedema (10 cases), dermographism (2 cases), atopy (4 cases), drug reactions (6 cases), and infections (6 cases) was similar to that seen in cases of urticaria without diffuse dermal neutrophilia. Nearly 9% of the cases of urticaria show this histologic pattern, and when cases of neutrophilic urticaria are added, 15.8% of cases of urticaria were found to show a major neutrophil component in the inflammation. In urticaria, neutrophilia may be part of an intense stimulus response pattern. PMID- 3284805 TI - Immunophenotyping of hematopoietic malignancies in paraffin sections. AB - Immunophenotyping of hematopoietic malignancies is usually accomplished in frozen sections or cell suspensions. To determine whether this procedure was also feasible in paraffin sections, we performed a double-blind immunoperoxidase study of 65 hematopoietic tumors whose phenotypes had been determined previously in fresh tissue. A selected antibody panel was used, including anti-LN2, UCHL-1, anti-cathepsin B, anti-Leu M1, anti-MB2, and anti-MT1. A correct phenotype was obtained on paraffin sections in 95% of cases. All 31 B-cell malignancies were properly classified, showing reactivity for LN2 and MB2. In 14 of 15 T-cell hematopoietic malignancies, all cells reacted with anti-MT1 and/or UCHL-1; the 1 case negative for these antigens was misdiagnosed as a B-cell tumor because of misinterpreted LN2 reactivity in benign histiocytes. Four of 5 true histiocytic neoplasms were positive for cathepsin B and LN2 but lacked other antigens; the fifth case was wrongly considered a B-cell proliferation because only bland histiocytes displayed cathepsin B. Only 1 of 7 Hodgkin's lymphomas was misdiagnosed (as a T-cell tumor); in the other 6 cases, Reed-Sternberg cells were reactive for LN2 and LEU M1. Five of 6 extramedullary myeloid leukemias also stained for LN2, MT1, and LEU M1. One showed LN2, MB2, and MT1; this case was classified as a B-cell neoplasm and indeed represented a pre-B-cell transformation of chronic myelogenous leukemia. These results show that the specified panel of antibodies may be useful for immunophenotyping of hematopoietic neoplasms when only paraffin sections are available for analysis. However, it cannot supplant traditional cell-marker studies of hematopoietic tumors because of its lesser accuracy. PMID- 3284806 TI - Paracortical immunoregulatory subpopulations in lymph nodes from homosexual men with persistent generalized lymphadenopathy. AB - Homosexual patients with persistent generalized lymphadenopathy usually show an abnormal expansion of paracortical T8+ lymphocytes relative to T4+ cells in lymph nodes with reactive follicular hyperplasia (RFH). This study was designed to characterize further the paracortical lymphocyte population in homosexual men with reactive follicular hyperplasia, because T8+ lymphocytes are antigenically and functionally heterogeneous. Frozen lymph node tissue from 10 patients was evaluated. Monoclonal antibodies to T8, Leu-15, NKH-1, Leu-7, and HLA-DR antigens were employed in the avidin-biotin complex immunoperoxidase technique. With digitized morphometry, positively stained cells for each marker were counted in five 0.145-mm2 microscopic fields. Four tonsils with RFH were used as controls. Most paracortical cells were T8+ (median, 4182 T8+ cells/five fields), and values were significantly higher than those for controls (median, 1518 T8+ cells p less than 0.006). In every case there were markedly fewer Leu 15-, NKH-1, Leu 7-, and HLA-DR-positive cells than T8+ cells (median values per five fields: Leu-15, 144; NKH-1, 12; Leu-7, 3; HLA-DR, 195). Moreover, these values were not significantly different from control values. Our findings suggest that the expanded paracortical T8+ population comprises cells with the immunophenotype of cytotoxic Leu-15-, T8+ lymphocytes, rather than natural killer or Leu-15+, T8+ suppressor cells. PMID- 3284807 TI - Silent thyroiditis: a histologic and immunohistochemical study. AB - Twenty-six specimens obtained from 23 patients with clinically and laboratory proven silent thyroiditis were examined histologically; 11 specimens were obtained during the thyrotoxic phase, and 15 specimens during the early or late recovery phase. All specimens showed chronic thyroiditis, focal or diffuse type; and lymphoid follicles were present in about half of the specimens. Most specimens showed neither stromal fibrosis nor oxyphilic cell changes. The follicular disruptions, which varied from moderate to severe and involved nearly all the visible follicles, were characteristic and common histologic features of this disorder. Giant cells were present in about two thirds of specimens. Six of the 7 specimens taken during the late recovery phase showed no follicular disruption. In 3 patients who had follow-up biopsies, the histologic involvement in the initial biopsy specimens clearly had disappeared in the second biopsy specimens. These histologic features indicate that silent thyroiditis may be a form of chronic thyroiditis, i.e., "chronic thyroiditis with marked follicular destruction." Thyroid biopsy is recommended as a useful tool in differentiating this disease from other thyroid diseases causing hyperthyroidism. In addition to the histologic analysis, intrathyroidal lymphocyte subsets were examined immunohistochemically and compared to those in chronic thyroiditis (Hashimoto's thyroiditis). In both silent and chronic thyroiditis, a great majority of lymphocytes infiltrating between thyroid follicles showed a T-cell phenotype, and no significant differences in T-cell and B-cell distribution between the diseases were observed. PMID- 3284808 TI - Immunoperoxidase stains of ganglion cells and abnormal mucosal nerve proliferations in Hirschsprung's disease. AB - Hirschsprung's disease is congenital aganglionosis of the distal colon. The affected bowel shows an abnormal proliferation of mucosal nerve fibers by acetylcholinesterase stains. We retrospectively reviewed biopsy specimens from patients with suspected and proven Hirschsprung's disease, performed immunoperoxidase stains for S-100 protein and neuron-specific enolase (NSE), and compared these results to routine histologic findings and acetylcholinesterase stains. Ganglion cells were demonstrated by immunoperoxidase in 63 of 69 specimens containing ganglion cells and in 1 specimen interpreted as aganglionic by hematoxylin-eosin staining. Increased numbers of nerve fibers in the muscularis mucosae and deep lamina propria by S-100 staining were detected in 8 of 8 specimens diagnostic for Hirschsprung's disease by hematoxylin-eosin and acetylcholinesterase stains and in 1 specimen diagnostic for colonic neuronal dysplasia (a disorder related to Hirschsprung's disease). Whereas 45 of 67 specimens from unaffected bowel showed a normal number and distribution of nerve fibers by S-100 staining, in 22 the pattern resembled that of Hirschsprung's disease. Specimens from affected colon also showed hypertrophied submucosal nerve trunks by S-100 stain (average nerve trunk thickness, 29.8 micron in affected bowel, 16.1 micron in unaffected segments--p less than 0.03). We conclude that NSE and S-100 stains are of value in demonstrating ganglion cells in suspected cases of Hirschsprung's disease and colonic neuronal dysplasia. The acetylcholinesterase stain is preferred over S-100 stain for detecting mucosal nerve proliferations in affected bowel. Submucosal nerve trunk thickness, although significantly different in affected and unaffected colon, is not of diagnostic value because of the wide variation in the measurements in the two groups. PMID- 3284810 TI - Lymphocytic lymphoma of intermediate differentiation. PMID- 3284809 TI - Pathologic features of extraosseous Ewing's sarcoma: a report from the Intergroup Rhabdomyosarcoma Study. AB - Eighty-four cases of extraosseous Ewing's sarcoma (EOE) were found during the pathology review of the Intergroup Rhabdomyosarcoma Study I and II. Patients commonly presented during or after adolescence with the most common primary sites including the trunk, extremities, and retroperitoneum. Males were slightly more affected. Histologic sections of 74 tumors in the pathology repository were re reviewed with attention to rosette formation (positive in 18 cases) and glycogen deposition (++ in 21, + in 36, +/- in 11, and - in 2 of 70 cases examined). Fourteen tumors (7 with rosettes and 7 without) were selected for immunohistochemical and ultrastructural studies, and 13 showed single or multiple neural markers (neuron-specific enolase in 8, S-100 protein in 6, and neurosecretory-type granules in 9). These possible cases of neural EOE could be divided into three subgroups: tumor with bidirectional neuroblastic and schwannian differentiation (5 cases), tumor with monodirectional neuroblastic differentiation (7 cases), and tumor with monodirectional schwannian differentiation (1 case). EOE with a neural nature may be categorized into a spectrum of peripheral primitive neuroectodermal tumors. Clinical, histopathologic, and biologic differences between this disease and conventional sympathetic neuroblastoma are discussed. PMID- 3284811 TI - William Feurer: a lawyer with a literary twist. PMID- 3284812 TI - T cell-replacing factor (TRF)/interleukin 5 (IL-5): molecular and functional properties. AB - TRF has originally been defined as a T-cell-derived lymphokine that triggers activated B cells for a terminal differentiation into Ig-secreting cells. HPLC purified TRF from Sup of a murine TRF-producing B151 cell is an acidic glycoprotein, exerts BCGF II activity and induces expression of IL-2 receptors. It does not show IL-1, IL-2, IL-3, BSF-1/IL-4, or IFN gamma activity. We prepared monoclonal TB13 and NC17 antibodies against HPLC-purified B151-TRF which are specific for and can inhibit TRF as well as BCFG II activity of B151-TRF. Moreover, TB13 as well as NC17 antibody can immunoprecipitate the 46 Kd molecule from B151 Sup which exerts TRF as well as BCGF II activity. Complementary DNA (pSP6K-mTRF23) encoding for murine TRF/IL-5 was cloned and its entire nucleotide sequences were determined. The murine TRF/IL-5 cDNA encodes 133 amino acids including N-terminal strongly hydrophobic regions. Secreted recombinant TRF/IL-5 (apparent m.w. of 46 Kd) has 113 amino acid residues and also comprises homodimers of a molecule with an apparent m.w. of 25 to 30 Kd. TRF/IL-5 mRNA is constitutively expressed in constitutively TRF-producing B151 and is inducible in some T cell lines upon stimulation with PMA or Con A. TRF/IL-5 mRNA is also expressed in Tbc-primed T cells upon the stimulation with PPD, whereas its expression is not effectively induced in non-primed spleen cells by stimulation with Con A or PMA plus calcium ionophore. The translation product of murine TRF/IL-5 cDNA triggers resting as well as activated (DNP-primed or LPS stimulated) murine B cells for terminal differentiation into Ig-secreting cells (IgM, IgG1, or IgA) accompanied by increased mRNA expression for secreted forms of relevant Ig heavy chain (mu, gamma, or alpha). Among these, increases in the level of mu, and alpha-specific mRNA for the secreted form of IgM and IgA, respectively, are prominent. Moreover, TRF/IL-5 induces maturation of resting B cells into IgM-secreting cells. TRF/IL-5 promotes growth of activated B cells as well as BCL1 cells. TRF/IL-5 is, therefore, a growth as well as a differentiation inducing factor for B cells. Moreover, it induces functional IL-2 receptors on resting as well as activated B cells, besides TRF and BCGF II activities.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3284813 TI - Molecular biology of interleukin 4 and interleukin 5 genes and biology of their products that stimulate B cells, T cells and hemopoietic cells. PMID- 3284814 TI - Structure and function of interleukin 4 and 5. PMID- 3284815 TI - Molecular and cellular biology of eosinophil differentiation factor (interleukin 5) and its effects on human and mouse B cells. PMID- 3284816 TI - Regulation of IgG1 and IgE production by interleukin 4. PMID- 3284817 TI - Macrophage activity in resistant and susceptible mouse strains infected with Mycobacterium lepraemurium. AB - The level of activation of peritoneal macrophages following subcutaneous inoculation of resistant (C57BL) and susceptible (BALB/c) mice was assessed by monitoring superoxide anion and hydrogen peroxide production and also tumour cell cytostasis. The level of systemic macrophage activation appeared to correlate with bacterial load, rather than resistance to infection. It was observed that the more susceptible (BALB/c) strain developed higher and more sustained levels of systemic macrophage activation, whereas the more resistant (C57BL) strain showed only low transient levels of macrophage activation. In contrast, in vivo challenge of subcutaneously infected C57BL mice, via the intra-peritoneal route, with heat-killed Mycobacterium lepraemurium and thioglycollate resulted in a high level of macrophage activation compared with similarly treated uninfected mice. Similar treatment of susceptible BALB/c mice, however, did not result in enhanced macrophage activation. It was also observed that high levels of macrophage activation occurred in T-cell deprived C57BL mice following infection with M. lepraemurium. PMID- 3284818 TI - Expression of class II MHC gene products by macrophages in human uteroplacental tissue. AB - The expression of class II MHC determinants by fetal and maternal macrophages in human uteroplacental tissues was examined with monoclonal antibodies directed against HLA-DR, DP and DQ antigens. Maternal macrophages in early and full-term pregnancy decidua were HLA-DR positive, and a substantial proportion also expressed DP and DQ antigens. Fetal macrophages in chorionic villous stroma in first-trimester pregnancy were rarely HLA-DR positive, and DQ and DP antigens were never expressed. In term placental tissues, groups of villous stromal macrophages were HLA-DR positive, as were fetal macrophages within amniotic mesenchyme. In contrast, DP and DQ antigens were detected on a small minority of fetal macrophages in term placental tissues. DP and DQ antigens were not detected in the absence of DR antigens. PMID- 3284819 TI - Immunolocalization of thymosin alpha 1, thymopoietin and thymulin in mouse thymic epithelial cells at different stages of culture: a light and electron microscopic study. AB - The secretory evolution of the thymic hormones (thymulin, thymosin alpha 1 and thymopoietin) in cultured thymic reticuloepithelial cells (TREC) was studied by immunocytochemical techniques using monoclonal anti-thymulin or anti-thymosin alpha 1 and polyclonal anti-thymopoietin antibodies (Ab). The culture of TREC was performed with a medium where L-valine was replaced by D-valine, thus ensuring rapid and selective development of these cells. The number of thymulin, thymosin alpha 1 or thymopoietin-containing cells increased progressively from Day 6 to Day 12 of the culture. The localization of the three thymic hormones within the TREC also varied according to the age of the culture. By light microscopy the staining of the three hormones was localized in some cytoplasmic granules at the beginning of the culture and at Day 90, while at Day 12 it was throughout the cytoplasm. In electron microscopy these localizations corresponded respectively to vacuoles of different sizes and to cytosol. All these results show that the synthesis and excretion of thymulin, thymosin alpha 1 and thymopoietin evolve during the development of TREC in culture. PMID- 3284821 TI - Role of angiotensin II in renal prostaglandin E2 production after furosemide administration. AB - The role of plasma angiotensin II (Ang II) in furosemide-stimulated renal prostaglandin E2 (PGE2) production was evaluated in eight healthy subjects. Urine was collected for 60 minutes after furosemide administration (20 mg i.v.) with or without captopril pretreatment, and urinary excretion of PGE2, sodium, and furosemide was determined. Plasma renin activity (PRA) and Ang II were also measured before and 60 minutes after furosemide administration. Urinary PGE2 excretion, PRA, and Ang II increased after furosemide administration without captopril pretreatment, and there was a significant correlation between the increment in Ang II and that in urinary PGE2 excretion. Urinary PGE2 excretion and Ang II did not increase after furosemide administration with captopril pretreatment. Urine volume and urinary excretion of sodium and furosemide were not influenced by captopril pretreatment. These results suggest that Ang II may play an important role in furosemide-stimulated PGE2 production. PMID- 3284820 TI - Plasma kinin concentration in deoxycorticosterone-salt hypertension. AB - We investigated the status of circulating kinins in rats with severe hypertension caused by drinking 1% NaCl (saline) and treatment with deoxycorticosterone (DOC, 25 mg/kg/wk s.c.) for 5 weeks. Saline-drinking rats treated with DOC had a higher systolic blood pressure (210 +/- 4 mm Hg) than did rats without DOC treatment drinking water (138 +/- 3 mm Hg) or saline (141 +/- 3 mm Hg). The concentration of kinins in the inferior vena cava plasma of DOC-salt hypertensive rats did not differ from the venous plasma kinin concentration in normotensive rats drinking water or saline. In contrast, the arterial plasma kinin concentration in DOC-salt hypertensive rats (7.0 +/- 0.8 pg/ml) was lower (p less than 0.002) than that in water-drinking controls (14.0 +/- 2.2 pg/ml); it also was lower (p less than 0.005) in saline-drinking rats (8.1 +/- 0.9 pg/ml) than in water-drinking controls. Infusion of bradykinin (20 micrograms/kg/min i.v.) increased arterial plasma kinins in all the groups. Nonetheless, the arterial plasma kinin concentration achieved during bradykinin infusion in DOC-salt hypertensive (1590 +/- 130 pg/ml) and in saline-drinking rats (1540 +/- 100 pg/ml) was lower than that in water-drinking rats (2140 +/- 210 pg/ml). On the other hand, during infusion of the kininase II inhibitor captopril (80 micrograms/hr i.p.) for 3 days, neither DOC-salt hypertensive rats nor saline-drinking normotensive rats exhibited significant reduction of arterial plasma kinins relative to the level in water-drinking controls. These data indicate that high salt intake, irrespective of the level of blood pressure, causes the arterial plasma concentration of kinins to fall.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284822 TI - Mediation of augmented monocyte adhesiveness by thromboxane. AB - We examined the potential contribution of thromboxanes in human monocyte adherence to plastic. Monocyte adherence to plastic could be augmented by various stimuli including lipopolysaccharide, chemotactic peptide, and supernates of antigen-stimulated lymphocytes. Increments in monocyte adhesiveness were suppressed by inhibition of cyclooxygenase, thromboxane synthetase, or by antiserum to thromboxane B2. Neither prostaglandin E2 or F2 alpha significantly affected baseline or lipopolysaccharide-stimulated monocyte adherence. Additional experiments confirmed incremental production of thromboxane B2 by monocytes after incubation with lipopolysaccharide. Thromboxane B2 itself did not stimulate monocyte adhesiveness. These data demonstrate that monocytes release thromboxane A2 following stimulation and suggest that thromboxane A2 may play a significant role in monocyte-substrate attachment. PMID- 3284823 TI - Ectopic expression of the Y (Ley) antigen defined by monoclonal antibody 12-4LE in distal colonic adenocarcinomas. AB - Monoclonal antibody (MAb) 12-4LE reacts specifically with the alpha Fuc(1-2) beta Gal(1-4) [alpha Fuc(1-3)]GlcNAc-R synthetic oligosaccharide and consequently characterizes the Y (Ley) antigen. In normal individuals, this MAb reacts more strongly on samples from blood group O persons, indicating that the Y structure is better recognized when terminal A or B sugars are not added to the Y structure. In fetal and normal adult gastrointestinal tract, this antibody reacts with the epithelium of stomach, small intestine and proximal colon, but not of distal colon. In the adult, cells from the surface epithelium of the gastric, small intestinal and cecal mucosae express the Y antigen according to the secretor phenotype of each individual, thus characterizing the so-called "upward differentiation" pattern. In contrast, mucus cells of the pylorus and duodenal Brunner glands, as well as Paneth cells, always express the Y antigen irrespective of secretor phenotype, thereby characterizing the so-called "downward differentiation" pattern. Proximal fetal colonic mucosa has the same genetic control as the downward differentiation pattern of the adult. Distal fetal colonic mucosa is negative with anti-Y, as in the adult. Y antigen was not expressed in hyperplastic (10 cases), juvenile (5 cases) or adenomatous (43 cases) polyps, except for some spreading villous adenomas in which rare Y positive foci could be observed but which were not specifically associated with dysplastic glands. Polyps from familiar polyposis did not express this antigen. In adenocarcinomas, the Y antigen was expressed in 41/45 (91%) of distal tumors and 15/35 (43%) of cecal tumors, independently of ABO phenotype. The ectopic expression of this Y antigen on distal colon adenocarcinomas may be a useful tool in the detection of distal colonic carcinomas. PMID- 3284825 TI - A psychometric study of the prevalence of DSM-III personality disorders among treated opiate addicts. AB - Using the DSM-III criteria for personality disorders, prevalence rates of these disorders were evaluated, among opiate addicts in treatment, with a psychometric test--the Million Clinical Multiaxial Inventory. We found that 27% of addicts met criteria for multiple personality disorders. While all 11 DSM-III disorders were diagnosed in our sample, the disorders of antisocial (22%), narcissistic (18%), borderline (16%), and dependent (16%) were more frequent among opiate addicts. These rates were compared to two similar studies that used SADS/RDC criteria with addicts, and the similarities and differences were noted. It is suggested that future research compare rates using both structured psychiatric interviews and psychometric tests to determine the extent of instrument variance on prevalence rates estimates. PMID- 3284824 TI - Both N-ras and c-myc are activated in the SHAC human stomach fibrosarcoma cell line. AB - A transforming N-ras gene was isolated from the SHAC human stomach fibrosarcoma cell line. A single-point mutation resulting in the substitution of histidine for glutamine at codon 61 was found in the SHAC transforming allele. The N-ras gene is overexpressed in the tumor cells and transformant cells. The N-ras p21 product was studied by immunoprecipitation and showed no alteration in mobility as compared to the normal p21 protein. The c-myc gene is amplified and overexpressed in these cells. This report gives evidence that an amplified c-myc and a mutated N-ras gene are both present in this tumor cell line and provides support for the idea that co-operation of at least 2 activated cellular oncogenes is required for carcinogenesis. PMID- 3284826 TI - Ethnic differences in narcotics addiction. I. Characteristics of Chicano and Anglo methadone maintenance clients. AB - This paper reviews the research literature comparing Chicano (Mexican American) to Anglo heroin addicts. In addition, characteristics of 546 Chicano and Anglo men and women who had been clients of southern California methadone maintenance programs in 1978 are compared. Background factors examined include nativity, family socioeconomic status (SES) and family interpersonal relationships, education, and gang membership. Lifetime characteristics and status at follow-up interview are reported with particular attention to legal status, criminality, employment, and interpersonal relationships. Drug experimentation history and circumstances surrounding narcotics initiation are also compared. Most observed differences prior to addiction are similar to ethnic differences found in the general population. Part II analyzes ethnic differences progressing through five stages of the addiction career. PMID- 3284827 TI - The effectiveness of drinking-driving treatment programs: a critical review. AB - The evaluation of the effectiveness of drinking-driving treatment programs has recently been proliferating. However, despite the increasing recognition of the need for assessment, adequate evaluation is presently lacking in most drinking driving programs. In this paper drinking-driving education and therapy programs which have been reported in the literature are critically reviewed. Various problems are considered to exist which limit the value of these programs. Suggestions for some specific priorities in future research are outlined. PMID- 3284828 TI - Personality correlates of habitual alcohol use. AB - The first part of this study explored relationships of 41 individual-difference measures to an earlier self-report measure of habitual alcohol use. Five measures of individual differences relating to anxiety exhibited negative correlations with habitual alcohol use. Also, obesity was not correlated significantly with alcohol use. The second part showed that a bored temperament was associated with the highest level, and a docile temperament was associated with the lowest level of habitual alcohol use. The second lowest level of habitual alcohol use was associated with an anxious temperament. PMID- 3284829 TI - Generalizing a predictor of male alcoholic treatment outcomes. AB - A predictive index was developed using 34 intake variables from 416 alcoholic inpatient program participants at a Veterans Administration Medical Center (VAMC). Using drinking behavior as the outcome criteria, an R-squared value of 0.562 was achieved and 65% of the index-generating sample was correctly classified. The index was cross-validated on 61 inpatients at 4 months posttreatment. It achieved a point biserial correlation of 0.389 and correctly classified 66% of the sample. The index, unprecedentedly, was generalized to three other VAMCs and achieved an overall r of 0.393 and correctly classified 61% of the generalization subjects. PMID- 3284831 TI - Serum selenium levels in diuretic-treated hypertensives: a double-blind trial of piretanide against hydrochlorothiazide plus amiloride. AB - In a double-blind parallel group study carried out on 47 patients with mild to moderate essential hypertension, the effects of 6 mg piretanide once or twice daily on serum selenium levels were compared with 50 mg hydrochlorothiazide plus 5 mg amiloride before treatment and after 6 and 12 weeks of treatment. Serum levels of the trace element, selenium, over a treatment period of 12 weeks remained unchanged in all three treatment groups, indicating that the selenium homeostasis is not disturbed during a treatment period of three months with either piretanide or a potassium sparer/thiazide-diuretic combination. PMID- 3284830 TI - Evaluation of the activity of the carbocysteine-sobrerol combination on mucus spinnability. AB - Among the rheological properties of bronchial mucus, "spinnability", i.e. the ability to form threads under the effect of traction, should be regarded as the most closely related to the mucociliary transport function. In the present study the "spinnability" parameter was included in the functional tests aimed at evaluating the efficacy of the carbocysteine-sobrerol combination in 16 patients suffering from chronic abstructive lung disease with bronchial hypersection. Treatment was administered for ten days under double-blind conditions compared with a placebo. The results obtained showed the tested combination to be able to favourably affect all the most important rheological parameters of mucus, including spinnability, leading to a rapid disappearance of signs and symptoms and to the improvement of the most important respiratory function indexes. PMID- 3284832 TI - Carbohydrates for exercise: dietary demands for optimal performance. PMID- 3284833 TI - Stereochemistry of collagen. AB - This review article, based on a lecture delivered in Madras in 1985, is an account of the author's experience in the working out of the molecular structure and conformation of the collagen triple-helix over the years 1952-78. It starts with the first proposal of the correct triple-helix in 1954, but with three residues per turn, which was later refined in 1955 into a coiled-coil structure with approximately 3.3 residues per turn. The structure readily fitted proline and hydroxyproline residues and required glycine as every third residue in each of the three chains. The controversy regarding the number of hydrogen bonds per tripeptide could not be resolved by X-ray diffraction or energy minimization, but physicochemical data, obtained in other laboratories during 1961-65, strongly pointed to two hydrogen bonds, as suggested by the author. However, it was felt that the structure with one straight NH...O bond was better. A reconciliation of the two was obtained in Chicago in 1968, by showing that the second hydrogen bond is via a water molecule, which makes it weaker, as found in the physicochemical studies mentioned above. This water molecule was also shown, in 1973, to take part in further cross-linking hydrogen bonds with the OH group of hydroxyproline, which occurred always in the location previous to glycine, and is at the right distance from the water. Thus, almost all features of the primary structure, X ray pattern, optical and hydrodynamic data, and the role of hydroxyproline in stabilising the triple helical structure, have been satisfactorily accounted for. These also lead to a confirmation of Pauling's theory that vitamin C improves immunity to diseases, as explained in the last section. PMID- 3284834 TI - Structure-conformation relationships of synthetic peptide inhibitors of human renin studied by resonance energy transfer and molecular modeling. AB - The structure-conformation relationships of a series of angiotensinogen6-13 (ANG6 13, His-Pro-Phe-His-Leu-Val-Ile-His) congeners substituted by Nin-For-Trp (Ftr), D-Ftr or Trp at the N-terminus, Tyr at the C-terminus and Phe psi[CH2NH]Phe at the P1-P'1 cleavage site (i.e. Leu10-Val11) were studied using resonance energy transfer coupled with molecular modeling of the peptide conformation using macromolecular energy refinement and dynamics simulation. Average end-to-end intramolecular distances (r) of the peptides in solution were determined by fluorescence spectroscopy. For example, Ac-Ftr-Pro-Phe-His-Phe psi[CH2NH]Phe-Val Tyr-NH2 (U-70714E) gave an average intramolecular donor (Tyr)-acceptor (Ftr) distance of 16.3A in aqueous solution. This experimental value was consistent with a distance of 17.9 A determined by molecular modeling of U-70714E to a human renin 3-D structure (developed from known homologous aspartyl protease inhibitor X-ray crystallographic data) followed by simulation of the solution phase conformation of the peptide. An extended backbone secondary structure of U-70714E is suggested from these studies and the relationship(s) of structure-conformation to structure-activity was explored by analysis of several congeners of U-70714E, a potent (IC50 = 3.0 X 10(-9)M) inhibitor of human renin in vitro. PMID- 3284835 TI - Secondary structure prediction and determination of proteins--a review. AB - The rapid increase in sequence data in combination with a greater understanding of the forces regulating protein structure has been the impetus for an upsurge in the development of theoretical prediction methods. These methods have afforded protein chemists the ability to identify and quantify the various secondary structures along the protein chain. Concurrently, various physico-chemical techniques have been developed such as nuclear Overhauser enhancement n.m.r. and laser Raman spectroscopy. In addition, traditional methods such as infrared and circular dichroism spectroscopy have been refined. Although both predictive and physico-chemical techniques are limited in the types of secondary structure they are capable of determining, they have provided valuable information with regards to protein folding and topology in the absence of X-ray data, and have formed the basis for the development of improved methods for secondary structure determination. This paper reviews some of the predictive and physico-chemical methods presently used to determine protein secondary structure. PMID- 3284836 TI - Analogues of luteinizing hormone-releasing hormone (LH-RH) containing dehydroalanine in 6th position. AB - (Phe5, delta Ala6)-LH-RH and des-Gly10(Phe5, delta Ala6)-LH-RH ethylamide, two analogues of luteinizing hormone-releasing hormone (LH-RH), have been synthesised using fragment condensation approach in solution phase with minimum protection of the side chains. The presence of dehydroalanine in peptide fragments was confirmed by 1H n.m.r. and chemical analysis. Both the analogues were found to be inactive in comparison to LH-RH, indicating that alpha,beta-dehydrogenation of alanine in 6th position is not tolerated and suggesting that flexibility at this position may be crucial for the retention of biological activity. PMID- 3284837 TI - 1987 directory of the members of the Iowa Dental Association. PMID- 3284838 TI - Hansen's disease in Hawaii--current status. PMID- 3284839 TI - A review of immunopathologic studies of human leprosy lesions in situ. PMID- 3284840 TI - Progress in the serology of leprosy at the University of Hawaii. PMID- 3284841 TI - Relapse in Hansen's disease. PMID- 3284842 TI - Challenging the stigma: Hawaii's role in dispelling the myths of leprosy. PMID- 3284843 TI - Kalaupapa as part of the National Park System. PMID- 3284844 TI - Sensory-perceptual alterations: delirium in the intensive care unit. AB - The delirium that is commonly associated with admission to an intensive care setting (intensive care unit [ICU] psychosis) may be terrifying to the patient, but may go undetected by the nurse. Our current understanding of this delirium is discussed according to incidence, defining characteristics, and etiologic or contributing factors such as predisposing patient factors, pharmacologic agents, and environmental factors. We examine several episodes of delirium that were recounted retrospectively by patients who were discharged from a surgical ICU. These episodes of delirium are examined with reference to sensory-perceptual, perceptual or sensory alterations. We discuss nursing interventions that help to prevent or lessen the impact of delirium before an ICU admission, during the ICU course, and after discharge from the ICU. PMID- 3284845 TI - Biofeedback and progressive relaxation in weaning the anxious patient from the ventilator: a brief report. AB - Weaning patients with chronic obstructive pulmonary disease from mechanical ventilators is occasionally a long and difficult process complicated by the patient's fear of losing his or her breath during the weaning procedure. A case is presented of an anxious 58-year-old man who was taught to relax using biofeedback and progressive relaxation during aerosol "T-piece" weaning trials. The relaxation effect was elicited by having the patient contract and relax specific muscle groups in a progressive manner, to experience the difference between the states. Ear oximetry served as physiologic feedback as well as a safety feature in the event of oxygen desaturation during exercise. During and after the exercises he felt secure breathing without the ventilator as measured by the physiologic parameters: heart rate, respiratory rate, and oxygen saturation determined by oximetry. PMID- 3284846 TI - Will nurses control care at home? PMID- 3284847 TI - Medicare and the nurse. The denial dilemma revisited. PMID- 3284848 TI - International Hemoglobin Information Center. IHIC variants list. PMID- 3284849 TI - Dedicated to Professor Dr. T.H. Schiebler on the occasion of his 65th birthday. PMID- 3284850 TI - Are picro-dye reactions for collagens quantitative? Chemical and histochemical considerations. AB - Previous studies of picro-dye reactions demonstrated wide variations in the binding of different dyes. Picro-Sirius Red F3BA was recommended because it colors all collagens intensely and is suitable for polarization microscopy. Recent publications on quantitative uses of this stain were surprising. To obtain further information on the chemical mechanisms of dye binding by proteins, 94 sulfonated azo dyes were tested under the conditions of the picro-Sirius Red F3BA reaction. Reaction patterns varied widely, from failure to compete successfully with picrate ions for binding sites to strong coloration of all tissue structures. Only a few dyes stained collagen, reticulum fibers and basement membranes intensely and selectively. The reactivity of dyes was determined by their molecular configuration and the nature and position of substituents. Correlation with physico-chemical data showed that dye binding is due to non ionic interactions, i.e. van der Waals and dispersion forces and hydrophobic bonding. Coulomb forces do not impart affinity - increasing sulfonation actually decreases dye uptake - but draw dyes within reach of non-ionic sites. Bound dyes form aggregates with additional dye ions; the aggregation number can range from 2 to many powers of 10. Clearly, dye binding by proteins is not stoichiometric. PMID- 3284851 TI - The expression of specific proteins in cultured renal collecting duct cells. AB - It is still uncertain whether cell cultures attain the functional maturity of corresponding in vivo cells. The degree of differentiation of cultured collecting duct (CD) epithelium cells was therefore examined using immunohistochemical procedures. Three monoclonal antibodies (mabs CD1, CD2, and CD3) were raised against proteins (PCD) isolated from the renal papilla. At Western-blot analysis, each of these antibodies reacted with a specific protein that was distinguishable according to its molecular weight [PCD1, 190 kilodaltons (kDa); PCD2, 210 kDa; PCD3, 50 kDa]. Using immunofluorescence, these proteins were found to be localized exclusively in the renal CD system. Other renal structures, such as the proximal or distal tubular portions, the glomeruli and the interstitial network, were not reactive. The mabs, CD2 and CD3, labeled both the cortical and medullary CD in a uniform way, whereas mab CD1 produced heterogeneous immunolabeling along the length of the cortical, medullary, and papillary CD. As revealed by immunohistochemistry, the mabs revealed differences with respect to the expression of the specific renal proteins in cultured CD cells. In polar differentiated epithelium cultured for 5 days on a specific renal support, mab CD1 was unreactive, whereas mabs CD2 and CD3 were positive. This demonstrated the biochemical immaturity of this cultured epithelium with respect to CD1 reactivity. In morphologically dedifferentiated CD monolayer cells grown on the bottom of a culture dish, only a weak reaction for mab CD3 was observed. The loss of epithelial polarization in CD monolayer cells obviously coincides with the absence of the renal proteins PCD1 and PCD2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284852 TI - Immunocytochemistry and heterogeneity of rat brain vimentin. AB - In unfixed cryostat sections of the brains of early postnatal and adult rats, we screened for cells containing vimentin-positive intermediate filaments (VI+-IFs) by applying a panel of four monoclonal antibodies (Mabs VI-01, VI-02, VI-05 and VI-5B3) using indirect immunofluorescence. All of the Mabs stained VI+-IFs in the stromal part of the choroid plexus, in endothelial cells of blood vessels and in meninges in both adult and immature brains, although with varying strength (VI 5B3 and VI-01 stained more strongly than VI-05 and VI-02). In the brain parenchyma of adults, intense staining was mainly localized in ventricular ependymal cells (VI-5B3/VI-01 greater than VI-02/VI-05) and fibrous astrocyte like cells (FAs). In the immature brain, the ependymal cells were activated in appearance, with evidence of cell enlargement, greater spreading of VI+-IFs within the cytoplasm and more pronounced VI+ cytoplasmic protrusions into the brain parenchyma. VI+-FAs were found near the ependymal and meningeal borders as well as in the white matter tracts of adult brain (VI-5B3/VI-01 greater than VI 05 greater than VI-02). In immature animals, VI+-FAs were less frequently encountered in the forebrain regions, except in and near the subepenydmal layer (in the adjacent parenchyma) as well as in submeningeal layers. Weaker staining was usually elicited by Mabs VI-02 and VI-05. In the cerebellum, Bergmann cell fibers were stained in both age groups. In adults, the most intense fluorescence usually occurred in segments close to the pia (VI-5B3/VI-01 greater than VI-05 greater than VI-02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284853 TI - Histochemistry of proteases in ependyma, choroid plexus and leptomeninges. AB - Aminopeptidase M (APM), aminopeptidase A (APA), dipeptidyl peptidase IV (DPP IV) and gamma-glutamyl transferase (GGT) were demonstrated histochemically in cryostat sections of the rat brain to show the reaction pattern of ependyma, choroid plexus and leptomeninges. GGT was only demonstrable in the cell membranes of ependymal cells and in the leptomeninges; however, APA, APM and DAP IV showed a variable degree of activity in the capillary endothelium of the choroid plexus as well as in the leptomeninges. On the basis of these results, it is postulated that peptides in the cerebrospinal fluid can be cleaved extraventricularly by the enzymes demonstrated in the leptomeninges. PMID- 3284855 TI - Major histocompatibility complex polymorphism: a nonimmune theory for selection. PMID- 3284854 TI - Ultrastructural localization of a lysosomal enzyme in resin-embedded lymphocytes. AB - The intracellular distribution of lysosomal enzymes in lymphocytes has previously been only poorly defined, mainly by cytochemical procedures of low resolution. In the present study we have used a post-embedding immunogold technique to identify the precise ultrastructural localization of a lysosomal enzyme, beta glucuronidase, in activated lymphocytes embedded in Lowicryl K4M resin. We show that this enzyme is present in the rough endoplasmic reticulum, in the Golgi complex, and in vesicular organelles which probably include lysosomes. PMID- 3284857 TI - Neuropsychiatric sequelae of HIV infection. PMID- 3284856 TI - Association between HLA phenotype and HLA concentration in plasma or platelets. AB - To understand the relationship between HLA phenotype and plasma or platelet HLA better, concentrations of plasma and platelet HLA were measured in 215 individuals of known HLA phenotypes. Precise quantitation of HLA antigens was achieved by means of an enzyme-linked immunoassay using the W6/32 monoclonal antibody and purified HLA molecules. The mean plasma and platelet HLA concentrations were 2.04 +/- 1.67 micrograms/ml (+/- SD, n = 215) and 11.28 +/- 4.65 fg/cell (+/- SD, n = 213), respectively. Statistical analysis of associations between HLA phenotypes and plasma HLA revealed that the mean plasma HLA concentration of individuals with HLA-A23 or HLA-A24 was 1.4 (p less than 0.002) or 1.9 (p less than 0.001) times higher than those without these two HLA antigens. Furthermore, the mean plasma HLA concentration of individuals who have HLA-A26 was 25% less than those without HLA-A26 (p less than 0.05). In contrast, the only association between HLA phenotypes and HLA concentrations of platelets was observed in HLA-B7-positive individuals. The mean platelet HLA concentration of HLA-B7 individuals was 27% higher than those without HLA-B7 (p less than 0.005). This finding is in accordance with previous observations made on red blood cells. The results indicate that the HLA concentrations in plasma are regulated, at least in part, by genetic factors that are different from those regulating platelet HLA. PMID- 3284858 TI - Superior mesenteric arteriovenous fistula: case report and literature review. PMID- 3284859 TI - Choriocarcinoma-induced thyrotoxicosis: report of a case and review of the literature. PMID- 3284860 TI - My half century with the veterinary profession. PMID- 3284861 TI - Borrelia burgdorferi borreliosis. PMID- 3284862 TI - Heartwater disease of domestic and wild ruminants. PMID- 3284863 TI - Myomycin: mode of action and mechanism of resistance. AB - Myomycin is an unusual pseudodisaccharide antibiotic with a beta-lysyl oligopeptide ester side chain that has structural similarities with kasugamycin, streptomycin and streptothricin. We show that the mode of action of myomycin in vivo and in vitro closely resembles that of streptomycin; in addition, spontaneous myomycin-resistant mutants of Escherichia coli are essentially indistinguishable from streptomycin-resistant mutants at the rRNA and r-protein level. Myomycin is not a substrate for the known streptomycin-modifying enzymes and could be useful in the characterization of natural streptomycin-resistant isolates and in counterselecting against the presence of streptomycin-modifying enzymes. The relationship between structure and inhibition of protein synthesis has been examined for a series of derivatives of myomycin. PMID- 3284864 TI - Uterine contractions in nonpregnant and early pregnant mares and jennies as determined by ultrasonography. AB - Uterine contractions in 8 nonpregnant and 13 pregnant mares were studied using ultrasonography. A 1-min video tape recording was made of longitudinal real-time images of the uterine body. An overall uterine contractile activity score (0 = no or minimal activity to 4 = maximal activity) was assigned to each video tape segment. There was a day effect (P less than .01) and an interaction (P less than .01) of reproductive status X day. Uterine activity scores were highest on d 14 to d 18 (d 0 = day of ovulation) for nonpregnant mares and on d 10 to d 14 for pregnant mares. Uterine activity scores on d 10, d 12, and d 14 were greater (P less than .02) for pregnant mares (2.5 +/- .3, 3.1 +/- .3, and 3.2 +/- .1, respectively) than for nonpregnant mares (1.2 +/- .3, 1.5 +/- .3, and 2.6 +/- .3). Uterine activity scores for six pregnant and five nonbred jennies were assigned daily from d 0 to d 24. There were main effects of reproductive status and day (P less than .01) and an interaction of status X day (P less than .01). Uterine activity scores for pregnant jennies were highest on d 13 and d 14 and then declined. In the nonbred jennies, scores were highest on d 14 to d 20. The mean score on d 13 was greater (P = .05) in pregnant jennies (2.8 +/- .2) than in nonbred jennies (1.9 +/- .5).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284865 TI - Pulmonary clearance of 99mTc-DTPA: influence of background activity. AB - We examined the effect of intravascular and tissue accumulation of tracer when measuring pulmonary clearance of sodium pertechnetate-labeled diethylenetriamine pentaacetate (99mTc-DTPA). Pigs were intubated with endobronchial tubes, permitting deposition of an aerosol of 99mTc-DTPA only into the left lung. Scintillation detectors recorded radioactivity separately from one thigh and from the lung and chest wall on the left and right side. 99mTc-DTPA was given intravenously after 30 min, so that the chest counts from the left lung could be corrected for background activity in either the right lung or the thigh. The uncorrected clearance half time (t1/2) mean +/- SE from the left chest was 118.5 +/- 14.4 min. When corrected for background activity in the right chest, the t1/2 was 82.1 +/- 10.5 min, and when corrected for background activity in the thigh, the t1/2 was 80.9 +/- 10.6 min. There was no significant difference between t1/2 corrected by the measurements from the right chest or the thigh, and in four of five animals the corrected t1/2 by either method was significantly different from the uncorrected t1/2 (P less than 0.05). There was no correlation between the uncorrected t1/2 and the magnitude of the required correction. We conclude that correction for intravascular and tissue accumulation of tracer is an important refinement of the technique and can easily be accomplished by measuring accumulation of tracer in the thigh. PMID- 3284866 TI - Effects of lung volume on clearance of solutes from the air spaces of lungs. AB - Several investigators have shown that the clearance rate of aerosolized 99mTc labeled diethylenetriamine pentaacetate (DTPA, mol wt = 492, radius = 0.6 nm) from the air spaces of the lungs of humans and experimental animals increases with lung volume. To further investigate this phenomenon we performed a compartmental analysis of the 2-h clearance of DTPA from the lungs of anesthetized sheep using a new method to more accurately correct for the effects of DTPA recirculation. This analysis showed that the DTPA clearance in eight sheep ventilated with zero end-expired pressure was best described by a one compartment model with a clearance rate of 0.42 +/- 0.15%/min. Ventilating eight sheep with an end-expired pressure of 10 cmH2O throughout the study increased the end-expired volume 0.4 +/- 0.1 liter BTPS and created a clearance curve that was best described by a two-compartment model. In these sheep 56 +/- 16% of the DTPA cleared from the lungs at a rate of 7.9 +/- 2.9%/min. The remainder cleared at a rate similar to that measured in the sheep ventilated with zero end-expired pressure (0.35 +/- 0.18%/min). Additional control and lung inflation experiments were performed using 99mTc-labeled human serum albumin (mol wt = 66,000, radius = 3.6 nm). In six control sheep ventilated with zero end-expired pressure the albumin clearance was best described by a one-compartment model with a clearance rate of 0.06 +/- 0.02%/min. The clearance rate in six sheep with increased lung volume was slightly larger (0.09 +/- 0.02, P less than 0.05) but was well described by a one-compartment model.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284867 TI - Synthetic smoke with acrolein but not HCl produces pulmonary edema. AB - The chemical toxins in smoke and not the heat are responsible for the pulmonary edema of smoke inhalation. We developed a synthetic smoke composed of carbon particles (mean diameter of 4.3 microns) to which toxins known to be in smoke, such as HCl or acrolein, could be added one at a time. We delivered synthetic smoke to dogs for 10 min and monitored extravascular lung water (EVLW) accumulation thereafter with a double-indicator thermodilution technique. Final EVLW correlated highly with gravimetric values (r = 0.93, P less than 0.01). HCl in concentrations of 0.1-6 N when added to heated carbon (120 degrees C) and cooled to 39 degrees C produced airway damage but no pulmonary edema. Acrolein, in contrast, produced airway damage but also pulmonary edema, whereas capillary wedge pressures remained stable. Low-dose acrolein smoke (less than 200 ppm) produced edema in two of five animals with a 2- to 4-h delay. Intermediate-dose acrolein smoke (200-300 ppm) always produced edema at an average of 147 +/- 57 min after smoke, whereas high-dose acrolein (greater than 300 ppm) produced edema at 65 +/- 16 min after smoke. Thus acrolein but not HCl, when presented as a synthetic smoke, produced a delayed-onset, noncardiogenic, and peribronchiolar edema in a roughly dose-dependent fashion. PMID- 3284868 TI - Pulmonary clearance of three aerosolized solutes in oleic acid-induced lung injury. AB - We studied the effects of oleic acid (OA) on pulmonary clearance of three aerosolized radioactive solutes: 99mTc-diethylenetriamine pentaacetate (99mTc DTPA), 67Ga-desferoxamine (67Ga-DFOM), and 111In-transferrin (111In-TF). Either 0.09 ml/kg OA or an equivalent volume of 0.9% NaCl (controls) was administered intravenously to 48 anesthetized, paralyzed dogs. Each animal received one aerosolized solute either 60 min after (protocol A) or 30 min before (protocol B) the infusion of OA or NaCl. In protocol A clearances of all three solutes were similar in OA and control animals. In contrast, in protocol B clearances of all three solutes increased significantly during OA infusion; during the next 60 min clearances of 99mTc-DTPA and 67Ga-DFOM returned to control values but 111In-TF remained increased. We conclude that 1) in OA-induced permeability edema pulmonary clearance of aerosolized solutes is increased when the aerosol is delivered 30 min before but not 60 min after injury, and 2) increased clearance persists only for large molecules, presumably because smaller molecules cross injured epithelium quickly and completely. These phenomena are best explained by a nonhomogeneous distribution of OA-induced injury. PMID- 3284869 TI - Thermal recovery after passage of the pulmonary circulation assessed by deconvolution. AB - For indicator-dilution studies, complete thermal recovery after passage of heat through the pulmonary circulation would be desirable. However, the results in the literature obtained by extrapolation techniques are inconsistent. To overcome problems of the extrapolation approach, transport functions of the pulmonary circulation (including the left heart) were computed by deconvolution of pulmonary arterial and aortic pairs of thermodilution curves after central venous indicator injection (10 ml of an ice-cold blood indocyanine green dye mixture). Thermal recovery was determined as the finite integral of the transport function. Thirteen mongrel dogs under piritramid-N2O anesthesia were examined under base line conditions, in orthostasis to alter the distribution of pulmonary blood flow (9 dogs), and in oleic acid edema (8 dogs). Using the deconvolution approach, thermal recovery was 0.97 +/- 0.04 under base-line conditions, 0.96 +/- 0.03 in orthostasis, and 0.96 +/- 0.05 in pulmonary edema. Thermal recovery determined from extrapolated dilution curves was greater than 100% in all groups, a physically impossible finding. It is concluded that thermal recovery is incomplete but insensitive with respect to the distribution of blood flow and to the size of the extravascular compartment. Monoexponential extrapolation is unsuited for the determination of thermal recovery. PMID- 3284870 TI - Tracheal narrowing during histamine-induced bronchoconstriction. AB - To determine whether tracheal narrowing accompanies histamine-induced bronchoconstriction and whether a cholinergic reflex is involved in the tracheal and bronchial responses, we determined specific pulmonary resistance between the carina and the pleura (sRL) and tracheal volume (Vtr) with an indicator-dilution technique in conscious sheep. Immediately postdelivery of histamine aerosol (7.5 mg histamine base) mean sRL increased by 223% (P less than 0.05), and mean Vtr decreased by 25% (P less than 0.05). The duration of the changes was similar, with a return to base-line values within 60 min. With increasing doses of histamine up to 30 mg, there was a corresponding increase in mean sRL, whereas the maximum effect on Vtr was already reached after 7.5 mg of histamine. Atropine (0.2 mg/kg iv) increased mean Vtr by 77% (P less than 0.05) and blunted the histamine effects on sRL, whereas the histamine effects on Vtr were abolished. Intravenous histamine or carbachol aerosol had similar effects on sRL and Vtr. We conclude that in conscious sheep 1) histamine produces both tracheal and bronchial constriction with a similar time course, 2) there is a base-line vagal tone in the trachea and not the bronchi, 3) the cholinergic reflex component of histamine-induced constriction is greater in the trachea than the bronchi, and 4) this difference between the trachea and bronchi is not due to differential aerosol deposition or cholinergic responsiveness. PMID- 3284871 TI - Influence of early nutrition on growth and adipose tissue characteristics in male and female rats. AB - The purpose of this investigation was to assess the effects of early nutrition on adipose tissue characteristics and growth by altering litter size. After birth, rats were redistributed into large (15-18 pups), control (10 pups), or small (4 pups) litters. During the postweaning phase of growth half of the small-litter animals were pair-fed to animals raised in large litters for 5 wk and then allowed to feed ad libitum until they were 80 days of age. The small-litter males gained weight at a more rapid rate than the other litter types, both before and after weaning, and attained a final body weight twofold greater than the other groups. The small-litter males had significantly higher (P less than 0.05) numbers of adipocytes per epididymal fat pad than the other litter groups with 60.4, 51.4, and 79.0% greater cell number per pad than control, large, and pair fed animals, respectively. Limiting food intake to small-litter animals after weaning (pair-fed) inhibited this growth and prevented fat cell proliferation. Litter manipulation had significant effects on male rats, but the same treatment did not influence female rats. Litter size influenced fat cell characteristics but had little effect on the adipocytes' ability to take up or metabolize glucose. The major finding, in terms of insulin responsiveness, was the difference between the sexes. The uptake of tritiated 2-deoxyglucose by the fat cells of female litter groups was significantly higher than that of the males whether insulin was present or not, whereas the conversion of [1-14C]glucose to CO2 by the adipocytes of females was lower than that of the males.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284872 TI - Oleic acid-induced lung injury in rabbits: effect of fibrinogen depletion with Arvin. AB - The role of fibrinogen in the evolution of the increased permeability after oleic acid-induced lung injury was studied in New Zealand White rabbits. Animals depleted of fibrinogen by treatment with Malayan pit viper venom were compared with untreated rabbits immediately and at 1 and 24 h after injury. The increased permeability to albumin and elevated extravascular lung water (EVLW) associated with lung injury returned to control values by 24 h in untreated animals. Fibrinogen-depleted animals had a higher mortality (10/25 vs. 2/17, P less than 0.02) and showed a greater immediate increase in permeability to albumin that returned to control values at 1 and 24 h after injury, as well as trends toward elevated blood-free dry lung weight and larger increases in EVLW that persisted for 24 h. These findings indicate that fibrinogen-related proteins play an important role in controlling the microvascular injury that is produced by oleic acid. However, when these proteins are depleted, other mechanisms partially control the leak at later stages of the repair process. PMID- 3284873 TI - Postexercise dose-response relationship between plasma glucose and insulin secretion. AB - To investigate whether exertion changes beta-cell reactivity to glucose stimulation and to characterize the beta-cell response to glucose in humans, we performed four sequential 90-min hyperglycemic clamps (7, 11, 20, and 35 mM). Concentrations of hormones and metabolites involved in glucoregulation were measured. Metabolic rate and substrate utilization were studied by indirect calorimetry. Studies were performed without prior exercise, as well as 2 and 48 h after 60 min of bicycle exercise at 150 W. We found 1) a progressive increase in insulin concentrations reaching 1,092 +/- 135 microU/ml with increasing glucose levels, 2) linear relationships between glucose concentrations and concentrations of C-peptide (r = 0.931 +/- 0.008) and proinsulin (r = 0.952 +/- 0.009),3) increased glucose oxidation with increasing glucose uptake, 4) increased plasma norepinephrine, O2 uptake, and beta-hydroxybutyrate at greater than or equal to 20 mM glucose, and 5) no change in beta-cell response or glucose-induced thermogenesis after one bout of exercise despite no compensating changes in plasma concentrations of hormones or metabolites. We conclude that the beta-cell has a very large secretory potential. Secretion of the beta-cell increases linearly with prolonged, graded hyperglycemia. The processing of proinsulin is unchanged during prolonged beta-cell stimulation. In addition, hyperglycemia and sympathetic nervous activity induced by hyperinsulinemia enhance metabolic rate and ketone body production. Finally, a single bout of exercise does not influence either the beta-cell response to intravenous glucose or glucose-induced thermogenesis. PMID- 3284875 TI - Rapid assessment of islet viability with acridine orange and propidium iodide. AB - A simple, rapid method for estimating the viability of isolated islets of Langerhans with fluorescent dyes is described. Low concentrations of acridine orange and propidium iodide (AO/PI) were used to visualize living and dead islet cells simultaneously. AO/PI-stained islets can be divided into three distinct groups. Group A islets fluoresce green, contain insulin, and have normal ultrastructure; group C islets fluoresce primarily red, contain little or no insulin, and have cells with disrupted cellular membranes. Group B islets fluoresce red, green, and yellow. The yellow color is due to the addition of two primary colors from the superimposed red and green fluorescing cells. In this assay, the interpretation that red islet cells are dead and green islet cells are alive was confirmed by sequentially staining single islet cells with AO/PI and trypan blue. The observation that red islets are dead was confirmed by heat killing, enzymatically damaging, treating with ethanol, or depriving islets of nutrients and observing the red fluorescence. This assay should be useful in studies where the assessment of islet viability is essential. PMID- 3284876 TI - Growth of H-35 rat hepatoma cells in unsupplemented serum-free media: effect of transferrin, insulin and cell density. AB - Serum-free tissue culture medium consisting of a 1:1 mixture of Dulbecco's modified Eagle's medium (DMEM) and Ham's F12 medium is herein shown to support growth of Reuber H-35 cells over several days in culture. Cells were initially plated in serum containing DMEM medium for 3 h. After cell attachment, serum is removed and replaced with a serum-free 1:1 mixture of these two commercially available tissue culture media. The doubling time of cell growth in this unsupplemented serum-free medium was 46 h in lightly plated cultures over the first 5 d. The presence of transferrin (5 micrograms/ml) and insulin (3.3 nM) results in a cell doubling time of 17 h, which equaled the growth rate in medium containing 10% fetal bovine serum. In the absence of transferrin, growth rates in serum-free medium were correlated with the cell density of cultures. Conditioned medium from dense, serum-free cultures has growth-stimulating activity in recipient lightly plated cultures. This simple, serum-free culture medium will facilitate studies on the growth regulation of H-35 rat hepatoma cells. PMID- 3284877 TI - Effect of tyrosine on attention deficit disorder with hyperactivity. AB - A single-blind study was conducted to evaluate the effect of oral tyrosine on attention deficit disorder (ADD) with hyperactivity in seven outpatient children. Since most biological evidence of ADD supports a norepinephrine or dopamine deficiency, the authors hypothesized that tyrosine, which has been shown to increase catecholamine synthesis, would be beneficial in the treatment of ADD. None of the subjects, however, showed any significant improvement with tyrosine. Implications for the catecholamine deficiency hypothesis and treatment strategies for ADD are discussed. PMID- 3284874 TI - Nobel lecture in physiology or medicine--1987. Somatic generation of immune diversity. PMID- 3284878 TI - Endotoxin stimulates glycogenolysis in the liver by means of intercellular communication. AB - Escherichia coli endotoxin (lipopolysaccharide) was shown to increase glycogenolysis in the perfused liver 2-3-fold. In isolated parenchymal liver cells, however, endotoxin did not influence glycogenolysis, whereas stimulation by endotoxin of glycogenolysis in the perfused liver could be blocked by aspirin. This suggests that the effect of endotoxin on liver glycogenolysis is mediated by eicosanoids. The amount of prostaglandin D2 (which is the major prostanoid formed by Kupffer cells) in the liver perfusates was increased 5-fold upon endotoxin addition, with a time course which preceded the increase in glucose output. It is concluded that endotoxin stimulates glycogenolysis in the liver by stimulating prostaglandin D2 release from Kupffer cells, with a subsequent activation of glycogenolysis in parenchymal liver cells. This mechanism of intercellular communication may be designed to provide the carbohydrate source of energy necessary for the effective destruction of invaded microorganisms, by phagocytic cells, including the Kupffer cells. PMID- 3284879 TI - Inhibition of the RNA polymerase-catalyzed synthesis of RNA by marcellomycin. Preferential interference of the inhibitor with the stabilization of the ternary promoter-RNA polymerase-nascent RNA complex. AB - Marcellomycin is a strong inhibitor of the Escherichia coli RNA polymerase catalyzed synthesis of RNA from the strong A promoters of bacteriophage T7 DNA. Marcellomycin inhibits preferentially the last phase of transcription initiation. During this phase a stabilized ternary complex is formed consisting of RNA polymerase, DNA template, and a nascent RNA oligonucleotide about 11 nucleotides long, resulting from the extension of the RNA dinucleotide component of the corresponding early ternary complex. Marcellomycin is also responsible for minor inhibition of the formation of the open binary RNA polymerase-template complex, which serves as the precursor of the ternary complex. These findings suggest that marcellomycin may be a potentially useful tool in the study of the late stages of transcription initiation. The present findings may also contribute to a better overall understanding of the mode of drug action at the level of individual genes. PMID- 3284880 TI - Evaluation of carbon flux and substrate selection through alternate pathways involving the citric acid cycle of the heart by 13C NMR spectroscopy. AB - A previous 13C NMR technique (Malloy, C. R., Sherry, A.D., and Jeffrey, F.M.H. (1987) FEBS Lett. 212, 58-62) for measuring the relative flux of molecules through the oxidative versus anaplerotic pathways involving the citric acid cycle of the rat heart has been extended to include a complete analysis of the entire glutamate 13C spectrum. Although still simple in practice, this more sophisticated model allows an evaluation of 13C fractional enrichment of molecules entering both the oxidative and anaplerotic pathways under steady-state conditions. The method was used to analyze 13C NMR spectra of intact hearts or their acid extracts during utilization of 13C-enriched pyruvate, propionate, acetate, or various combinations thereof. [2-13C]Pyruvate was used to prove that steady-state flux of pyruvate through pyruvate carboxylase is significant during co-perfusion of pyruvate and acetate, and we demonstrate for the first time that a nine-line 13C multiplet may be detected in an intact, beating heart. Acetate or pyruvate alone provided about 86% of the acetyl-CoA; in combination, about 65% of the acetyl-CoA was derived from acetate, about 30% was derived from pyruvate, and the remainder from endogenous sources. Propionate reduced the contribution of exogenous acetate to acetyl-CoA to 77% and also reduced the oxidation of endogenous substrates. Equations are presented which allow this same analysis on multiply labeled substrates, making this technique extremely powerful for the evaluation of substrate selection and relative metabolic flux through anaplerotic and oxidative pathways in the intact heart. PMID- 3284881 TI - Characterization of the glycosylation sites in yeast external invertase. I. N linked oligosaccharide content of the individual sequons. AB - External invertase is the product of the SUC2 gene of Saccharomyces cerevisiae. The deduced sequence of this enzyme (Taussig, R., and Carlson, M. (1983) Nucleic Acid Res. 11, 1943-1954) reveals it to contain 14 potential N-linked glycosylation sites, or sequons, although only 9-10 appear to be glycosylated (Trimble, R. B., and Maley, F. (1977) J. Biol. Chem. 252, 4409-4412). To determine the location of the glycosylated sequons, external invertase was deglycosylated with endo-beta-acetylglucosaminidase H and its component peptides analyzed by both fast atom bombardment mass spectrometry (FABMS) and classical peptide isolation procedures. By use of the former technique most of the glucosamine-containing sequons could be located and by the latter sufficient amounts of small glucosamine-containing peptides were isolated to enable their quantitation. From the combined FABMS and glucosamine analyses, it was established that eight of the sequons in a subunit of invertase are either completely or almost completely glycosylated, while five others are glycosylated to the extent of about 50% or less. In the case of two overlapping sequons (4 and 5), which include Asn92-Asn93-Thr-Ser, only the first Asn was glycosylated. Thus, all but one of the sequons of external invertase are glycosylated to some extent, giving an appearance of only 9-10 N-linked oligosaccharides/subunit. The sequence identity of both external and internal invertase was verified by FABMS and by peptide sequence analysis. In only one site was an amino acid found to differ from that deduced from the DNA sequence of the SUC2 gene. This occurred at position 390 where a proline was found in place of alanine, which could result from a single base change in the triplet specifying the latter amino acid. PMID- 3284882 TI - Effect of mutation of cysteinyl residues in yeast Cu-metallothionein. AB - Metallothioneins have been isolated from Saccharomyces cerevisiae CUP1 mutants generated by Wright et al. (Wright, C. F., Hamer, D. H., and McKenney, K. (1986) Nucleic Acids Res. 14, 8489-8499). In the mutant metallothioneins, pairs of cysteinyl residues have been converted to seryl residues. The mutant proteins differ only in the positions of the double substitutions; each mutant molecule contains 10 cysteinyl residues. Each mutant protein lacks the first 8 residues at the amino terminus from the decoded gene sequence of the CUP1 locus. Mutant molecules consist of 53 residues analogous to the wild-type metallothionein and are designated 9/11, 24/26, 36/38, and 49/50 (in reference to the sequence positions of the Cys----Ser conversions). The properties of the mutant metallothioneins are vastly different, and host cells harboring the different plasmid-encoded mutant molecules show marked differences in sensitivity to CuSO4. Growth inhibition was observed at CuSO4 concentrations up to mM in cells containing the 9/11, 24/26, and 36/38 molecules, but not for cells containing protein 49/50. A CuSO4 concentration of 5 mM was required to inhibit the growth of yeast containing either 49/50 or the wild-type metallothionein. In the purified proteins the copper binding stoichiometry of each molecule, except protein 24/26, was nearly 8 mol eq. Protein 24/26 bound 5.5 copper ions/molecule. The Cu(I) chelator bathocuproine disulfonate reacted with over 50% of the copper ions in proteins 9/11, 24/26, and 36/38, but less than 10% of the copper ions in proteins 49/50 and wild-type metallothionein were reactive. The thiolates in 9/11, 24/26, and 36/38 were also more reactive in a disulfide exchange reaction with dithiodipyridine compared with the sulfhydryls in 49/50 and the wild-type molecules. The four mutant copper proteins are luminescent and exhibit a similar quantum yield. The cluster structures contributing to the particular electronic transitions are markedly more sensitive to oxygen in proteins 9/11, 24/26, and 36/38 compared with 49/50 and the wild-type molecules. The air-sensitive proteins exhibit a tertiary fold not recognized by polyclonal antibodies directed to a conformational epitope on yeast Cu-metallothionein. Protein 49/50 cross-reacts with the antibody in a concentration-dependent fashion similar to the wild-type protein. Mutation of 2 cysteinyl residues in the carboxyl portion of metallothionein does not significantly alter properties of the molecule, whereas mutation of several cysteines in the amino-terminal portion of the molecule yields a different conformation. PMID- 3284883 TI - Chelating peptide-immobilized metal ion affinity chromatography. A new concept in affinity chromatography for recombinant proteins. AB - We report our experimental results supporting the hypothesis that a specific metal-chelating peptide (CP) on the NH2 terminus of a protein can be used to purify that protein using immobilized metal ion affinity chromatography (IMAC). The potential utility of this approach resides with recombinant proteins since the nucleotide sequence that codes for the protein can be extended to include codons for the chelating peptide and thereby generate the gene for a chimeric CP protein that can be cloned, expressed, and affinity-purified with immobilized metal ions. The chelating peptide purification handle could then be removed chemically or enzymatically after purification has been achieved to generate a protein with the natural amino acid sequence. The feasibility of using a chelating peptide as a purification handle has been demonstrated using a leuteinizing hormone-releasing hormone (LHRH) analog, 2-10 LHRH, which contains the previously identified chelating peptide, His-Trp, on the NH2 terminus. 2-10 LHRH had a high affinity for a Ni(II) IMAC column due to the NH2-terminal dipeptide sequence His-Trp, forming a coordination complex with Ni(II), whereas the controls, 3-10 LHRH and 4-10 LHRH, lacking the CP sequence, did not bind. Furthermore, 2-10 LHRH could be purified from a mixture of histidine-containing peptides on a Ni(II) IMAC column in one step. His-Trp proinsulin was used as a model of a recombinant CP-protein. The S-sulfonates of His-Trp-proinsulin and proinsulin were isolated from Escherichia coli engineered to overproduce these proteins as trpLE' fusion proteins. His-Trp-proinsulin(SSO3-)6 had a higher affinity for immobilized Ni(II) than proinsulin (SSO3-)6. Both proteins were eluted by decreasing the pH or by introducing a displacing ligand into the buffer. Ni(II) eluted from the column with much higher concentrations of displacing ligand than the proteins. PMID- 3284884 TI - A functional decaisoleucine-containing signal sequence. Construction by cassette mutagenesis. AB - An alkaline phosphatase signal sequence optimized for formation of a hydrophobic alpha-helix functions very efficiently in the transport process. This mutant contained a core region comprised of 9 consecutive leucine residues (Kendall, D. A., Bock, S. C., and Kaiser, E. T. (1986) Nature 321, 706-708). We have now constructed a second mutant containing a decaisoleucine core region. Isoleucine was chosen because it is an isomer of leucine with comparable hydrophobicity but in synthetic peptides isoleucine favors beta-sheet formation. Surprisingly, this mutant precursor was also processed efficiently, and mature alkaline phosphatase was correctly targeted to the Escherichia coli periplasm. Since the effective length of a beta-strand is extended relative to an alpha-helix, conformational differences should be mirrored by the relative effectiveness of shortened polyisoleucine and polyleucine core regions. However, analysis of two additional mutants containing truncated segments of either polyleucine or polyisoleucine did not reveal any differences and both accumulate as precursors. We conclude that these mutants do not adopt critically different structures. This comparative analysis was facilitated by construction of a new plasmid, CASS3. This plasmid contains unique restriction sites flanking the DNA region coding for the signal sequence hydrophobic core segment. Consequently, the wild type core-encoding region can be readily replaced with synthetic oligonucleotides coding for new structural units and multiple amino acid substitutions can be made without the need for step-wise mutagenesis. PMID- 3284885 TI - Subunit stoichiometry of the chloroplast photosystem I complex. AB - A native photosystem I (PS I) complex and a PS I core complex depleted of antenna subunits has been isolated from the uniformly 14C-labeled aquatic higher plant, Lemna. These complexes have been analyzed for their subunit stoichiometry by quantitative sodium dodecyl sulfate-polyacrylamide gel electrophoresis methods. The results for both preparations indicate that one copy of each high molecular mass subunit is present per PS I complex and that a single copy of most low molecular mass subunits is also present. These results suggest that iron-sulfur center X, an early PS I electron acceptor proposed to bind to the high molecular mass subunits, contains a single [4Fe-4S] cluster which is bound to a dimeric structure of high molecular mass subunits, each providing 2 cysteine residues to coordinate this cluster. PMID- 3284886 TI - Characteristics of Z-DNA helices formed by imperfect (purine-pyrimidine) sequences in plasmids. AB - The capacities of three synthetic sequences to adopt left-handed helices were evaluated in recombinant plasmids. The sequences consisted of very short runs of (CG)n (n = 2-4) interspersed with runs of alternating A.T base pairs and/or with regions of non-alternating base pairs. The plasmids were studied by two dimensional gel electrophoresis to determine the natures of the conformational transitions and their free energies of formation. These results coupled with analyses with chemical (diethyl pyrocarbonate, osmium tetroxide, and bromoacetaldehyde) and enzymatic (S1 nuclease, T7 gene 3 product, and MHhaI) probes indicated that the entire sequence was adopting a left-handed helix in each case. In one of these sequences, Z-DNA formation necessitated the retention of the anti conformation of one of the guanines in a region of non-alternation. In a sequence which contains out-of-phase regions of alternation, our results indicate the formation of a separate left-handed helix in the central (CG)2 region, thus forming two Z-Z junctions. In summary, we conclude that only very short regions of alternating CG are necessary to effect the B to Z transition and that this conformational change can be transmitted through non-alternating regions. A set of empirical rules governing the characteristics of the B to Z transition and the types of left-handed helices in supercoiled plasmids was derived from studies on a systematic series of 17 plasmids. PMID- 3284887 TI - Soluble factor(s) released by the PF-382 T-cell line enhances the stimulatory effect of monocytes on the BFU-E growth. AB - PF-382 is a human T-cell line that has been shown to elaborate factors that modulate normal hemopoiesis in vitro. In the present study we report that this cell line constitutively releases in both serum-containing and serum-free supernatants a potent enhancer of BFU-E growth. The factor(s), partially purified by gel filtration, is a heat-stable molecule(s) degradable by trypsin and 2 mercaptoethanol treatments, equally active on bone marrow and peripheral blood erythroid progenitor cells, but not on CFU-GM. Unlike other sources of BPA, this stimulatory factor(s) exerts its effect in the presence of mononuclear adherent cells. In fact, the addition of conditioned medium obtained by 48 hr preincubation of isolated monocytes with 10% PF-382 supernatant (M-CM2) or the concomitant addition of supernatant from PF-382 cells (PF-382-CM) and from unstimulated monocytes (M-CM1) are capable of fully replacing the presence of monocytes in the BFU-E assay. Since the independent addition of PF-382-CM or of M CM1 is devoid of stimulatory function, we suggest that the PF-382 derived BFU-E growth inducer, which differs from IL-1, IL-3, IL-4, GM and G-CSF, exerts its activity "via" a synergistic mechanism with a monokine. PMID- 3284889 TI - Relaxation. PMID- 3284888 TI - A monoclonal antibody that recognizes a basolateral membrane protein in A6 epithelial cells. AB - The A6 cell line is a model for tight epithelia and studies of epithelial polarity. Monoclonal antibodies (MAbs) were produced by immunization of mice with intact A6 cells and fusion of spleen cells to generate hybridomas. Hybridoma supernatants were screened by ELISA to select MAbs binding to the apical membrane of confluent A6 cells. Localization of MAb binding was examined by indirect immunofluorescence using cross sections of A6 monolayers grown on collagen coated filters. One MAb, designated 13F12, was positive by apical surface ELISA but localized specifically to the basolateral membrane of cross sections of A6 monolayers on filters. Immunofluorescence labeling of confluent A6 cells grown on glass cover slips revealed that MAb 13F12 does not bind to the apical membrane, but binds to basolateral determinants in the regions of domes, where it appears able to penetrate cellular junctions. Subconfluent A6 cells express the antigen all over the cell surface. Cells approaching confluency express the antigen on the apical membrane of some cells but not others, and as the cells reach confluency, the antigen disappears from the apical surface, and the cells become fully polarized. A6 cells at confluency on glass cover slips are equally polarized as cells grown on filters with respect to this antigen. The antigen has been identified by immunoprecipitation as a 22 kDa protein. High concentrations of MAb 13F12 did not inhibit cell plating, indicating that the antigenic site is not directly involved in cell adhesion to the substrate. MAb 13F12 should prove to be a useful tool to study many aspects of epithelial polarity, including the signals involved in sorting of proteins to specific membrane domains. PMID- 3284890 TI - Biofeedback and holism in clinical practice. PMID- 3284891 TI - [Perforation of a solitary diverticulum of the transverse colon. Contribution of preoperative x-ray computed tomography and echography]. AB - Diagnosis of perforation of a solitary diverticulum of transverse colon followed the discovery at operation of an abdominal mass, ultrasound and CT scan imaging demonstrating a heterogeneous mass of enhanced density provoking apparent extrinsic compression of colon. A literature review showed the rarity of this complication, only 22 cases being reported but associated almost constantly with a pseudo-tumoral abscess centered on the diverticulum. This was the case in the patient reported but current imaging methods (ultrasound and particularly CT scanning) allowed correct evaluation of the nature and relations of the mass preoperatively, eliminating, its neoplastic nature by precise morphologic criteria. Despite its rarity, the diagnosis of perforation of an isolated transverse colon diverticulum should be evoked systematically by an extrinsic mass developed in contact with its wall, the nature of which is now simple to define preoperatively by CT scan imaging. PMID- 3284892 TI - [Contusions of the liver]. PMID- 3284893 TI - [Spinal fixation of the vagina in the treatment of prolapse after hysterectomy]. AB - An elegant and only weakly traumatic solution to the often difficult problem of treatment of prolapse after total hysterectomy is by spinal fixation of vagina: anchoring of base of vagina to sacroiliac small ligament approached through "natural pathways" by means of median colpotomy and section of "pillar of rectum". The technic is described and results published in the literature reviewed. PMID- 3284894 TI - Use of the avidin-biotin peroxidase system to detect rabies antigen in formalin fixed paraffin-embedded tissues. AB - We stained rabies-infected nervous and salivary-gland tissues fixed in formalin or acetone and embedded in paraffin with the avidin-biotin peroxidase system. With this system, rabies-virus antigen was detected in neurons, glandular acinar cells, and vascular endothelial cells more effectively than by immunofluorescence, especially when tissues were enzyme-digested with pronase before immunoperoxidase staining. The avidin-biotin peroxidase system should be useful for routine diagnosis, retrospective studies of rabies, and identification of specific cells involved in the spread of virus in rabies-infected hosts. PMID- 3284896 TI - Subclass distribution of human IgG autoantibodies in pemphigus. AB - The distribution of IgG subclasses in the intercellular substance (ICS) reactive autoantibodies in serum of 10 patients with pemphigus was analyzed by semiquantitative indirect immunofluorescence (IF) using the HP series of monoclonal antibodies specific for the four human IgG subclasses. IgG4 ICS specific autoantibody was present in all 10 sera at a titer of 10 to 320, while IgG1 antibodies were found in 9 of 10 sera at a seemingly lower level. IgG3 autoantibodies were detected in the serum of one patient, only after isolation of IgG using ion-exchange chromatography. Autoantibodies of IgG subclass 2 were not detectable in any of the 10 sera tested. One of the ten patients displayed circulating anti-ICS antibodies of only the IgG4 isotype. PMID- 3284897 TI - Evaluation of the Rapid Mastitis Test for identification of Staphylococcus aureus and Streptococcus agalactiae isolated from bovine mammary glands. AB - A latex agglutination test system (Rapid Mastitis Test [RMT]; Immucell, Portland, Maine) containing reagents for the identification of Staphylococcus aureus and Streptococcus agalactiae from bovine intramammary infections was evaluated with 527 staphylococcal and 267 streptococcal isolates. The RMT Staphylococcus aureus reagent detected 94.2% of 242 Staphylococcus aureus isolates, 80% of 25 Staphylococcus intermedius isolates, and 42.8% of 21 tube coagulase-positive Staphylococcus hyicus isolates. All Streptococcus agalactiae isolates were correctly identified by the RMT Streptococcus agalactiae reagent. Cross-reactions were observed with one Streptococcus dysgalactiae and three Streptococcus uberis strains. The RMT was found to be an acceptable method for the detection of Staphylococcus aureus and Streptococcus agalactiae isolated from bovine mammary glands. The occurrence of coagulase-positive staphylococci other than Staphylococcus aureus requires biochemical testing for species level identification. PMID- 3284895 TI - Late-phase IgE-mediated reactions. PMID- 3284898 TI - In vitro method to differentiate isolates of type III Streptococcus agalactiae from symptomatic and asymptomatic patients. AB - Streptococcus agalactiae (group B streptococci) isolates from infected infants have been demonstrated to have three- to fourfold or higher levels of cell associated lipoteichoic acid than isolates from asymptomatically colonized infants, suggesting a role for this cell surface polymer in the relative virulence of these organisms. The present study indicates that symptomatic isolates of type III group B streptococci can be readily differentiated from asymptomatic strains by their response to various levels of phosphate in a chemically defined medium (FMC). Both classes of isolates had the same doubling time (TD of 30 to 35 min) in FMC containing 65 mM sodium phosphate. However, levels of phosphate greater than 125 mM distinguished the two classes of strains. Asymptomatic strains pregrown in 65 mM phosphate to the stationary phase rapidly initiated growth at elevated phosphate levels, while symptomatic strains initiated growth only after a prolonged incubation period (greater than 400 min). These results suggest that the physiological growth response of clinical isolates of group B streptococci to phosphate can serve as a diagnostic aid in screening potentially virulent strains in pregnant women and newborn infants. PMID- 3284899 TI - Comparison of three techniques for detection of Chlamydia trachomatis in endocervical specimens from asymptomatic women. AB - Culture in DEAE-dextran-treated HeLa 229 cells, a solid-phase enzyme immunoassay (EIA) (Chlamydiazyme; Abbott Laboratories, North Chicago, Ill.), and a direct immunofluorescence test (DFA) (MicroTrak; Syva Co., Palo Alto, Calif.) were compared for the detection of Chlamydia trachomatis in endocervical specimens from 715 asymptomatic women. Response to antibiotic therapy was also monitored at least 4 weeks after completion of therapy. An additional sample was collected at a control visit, and a second culture was performed if discrepancies were observed between the three tests. A total of 48 infections were diagnosed, for a prevalence of 6.7%. At the first visit, 37 specimens were positive by culture. The respective sensitivities of EIA and DFA were 78.4 and 81.1% and the respective specificities were 96.8 and 97.9% when compared with the cell culture technique. The positive predictive values were 56.9 and 68.2%, respectively. When the additional 11 infections detected by the second culture were included to establish a new standard of positivity, the sensitivity of the first culture was estimated at 77.1%. The positive predictive values of EIA and DFA increased to 77.6 and 83.7%, respectively. EIA and DFA performed as well as culture for control of therapy; a 100% agreement among the three techniques was observed. PMID- 3284900 TI - Role of specific immunoglobulin E to excretory-secretory antigen in diagnosis and prognosis of hookworm infection. AB - Total immunoglobulin E (IgE) and specific IgE were assayed by a radioimmunosorbent test and a reverse enzyme immunoassay in patients with hookworm infections before and after treatment. A total of 77 subjects (30 patients with hookworm infections and 47 subjects as controls) were studied. Both specific and total IgE levels in serum and jejunal juice were raised in hookworm patients. There was a significant decrease in IgE levels after therapy. Total IgE levels were raised in other nematode infections, but specific IgE levels were low. The reverse enzyme immunoassay for specific IgE was highly specific (96%) and sensitive (100%) and may be used in the serodiagnosis of hookworm infections. PMID- 3284901 TI - Quality of powdered substitutes for breast milk with regard to members of the family Enterobacteriaceae. AB - Members of the family Enterobacteriaceae were cultured from 52.5% of 141 milk substitute infant formulas which were obtained in 35 countries. The concentration did not exceed a level of 1 CFU/g in any product. The species which were isolated most frequently were Enterobacter agglomerans, cloacae, Enterobacter sakazakii, and Klebsiella pneumoniae. If infections due to these organisms occur, it can be useful to include a check of the hygienic precautions which are taken during the preparation and storage of the formula. Milk powders without members of the Enterobacteriaceae might offer extra protection to the newborn if some multiplication does occur in the formula. PMID- 3284902 TI - Evaluation of a nonisotopically labeled oligonucleotide probe to detect the heat stable enterotoxin gene of Escherichia coli by the DNA colony hybridization test. AB - A commercially available, alkaline-phosphatase-conjugated oligonucleotide probe for detecting the heat-stable enterotoxin gene of Escherichia coli was compared with cloned gene probes by examining E. coli isolates from traveler's diarrhea by DNA colony hybridization tests. The oligonucleotide probe was useful in specifically identifying the so-called STh gene. No deproteinization of sample was necessary to prepare the colony blots. PMID- 3284903 TI - Failure to detect the presence of pluripotential haemopoietic stem cells in the mouse brain. AB - Single cell suspensions prepared from adult mouse brains were tested for the presence of pluripotential haemopoietic stem cells (colony-forming units, CFU) by transfer into an irradiated recipient and enumeration of the CFU in the recipient's spleen. In contrast to the findings of others (Bartlett, 1982), we did not detect CFU after injection of brain cell suspensions, although they were detectable after inoculation with bone marrow cells. The number of CFU in recipients after transfer of increasing numbers of brain cells was the same as that detected in the irradiated controls which had not received any transferred cells. Finally, cells from the brain, in contrast to bone marrow cells, were not able to protect recipient animals from the effects of lethal irradiation. PMID- 3284904 TI - The evolving slope of the proximal femoral growth plate relationship to slipped capital femoral epiphysis. AB - We measured the physeal angle (slope) of the proximal femoral physis on the standard anteroposterior (AP) radiographs. Controls consisted of 307 hips in children aged 1-18 years. Similar measurements were made on the affected (slip) and unaffected (nonslip) sides of 107 children with manifest unilateral slipped capital femoral epiphysis. An age-related increase of 14 degrees occurs in the slope of the proximal femoral physis between ages 1 and 18 years, with maximal increase between ages 9 and 12 years. Increasing obliquity of the proximal femoral physis may be yet another factor contributing to slipped capital femoral epiphysis. PMID- 3284905 TI - Macrodactyly of the hands and feet. AB - Fifteen new cases of macrodactyly of the hands and feet are presented. These cases were combined with those already reported in the literature to determine if lesions of the upper extremity are clinically the same as those in the lower extremity. Similarities were found in the incidence, specific digits involved, multiplicity of digital involvement, and sex ratio. Differences were found in growth behavior, extent of bony involvement, and presence of neural involvement. These findings suggest that this rare, usually isolated, congenital anomaly may be two distinct entities. PMID- 3284906 TI - Congenital pseudarthrosis of the clavicle: a review of the literature and surgical results of six cases. AB - This article is a retrospective review of six symptomatic patients who, when treated surgically, all healed with excision of pseudarthrosis, bone grafting, and plating. We discuss congenital pseudarthrosis of the clavicle with emphasis on etiologies, clinical presentation, differential diagnosis, and method of treatment. Our patients' chief complaints were cosmesis, pain, or shoulder deformity. PMID- 3284908 TI - Hyperostosis with hyperphosphatemia: a case report and review of the literature. AB - This is a report of a 6-year-old girl with the rare syndrome of hyperostosis with hyperphosphatemia. Only eight cases have been previously reported. The main features of this syndrome are repeated attacks of bone pain and swelling, the radiologic finding of periosteal reaction with cortical hyperostosis, and the laboratory finding of increased serum phosphorus level with normal serum calcium and parathyroid hormone levels. The purpose of this article is to review the clinical picture, laboratory and radiological findings, and the differential diagnosis. PMID- 3284907 TI - Osteitis caused by BCG vaccination. AB - A survey of 26 Czechoslovakian children diagnosed with BCG osteitis during 1981 1986 is presented. Mycobacterial culture was attempted in 19 cases with confirmation of bacillus Calmette-Guerin (BCG) Mycobacterium bovis strain in nine cases. Symptoms appeared approximately 17 months after vaccination; the proximal tibial end, distal femur, and proximal humerus were most affected. Although vaccination has been obligatory since 1953, a different vaccine was introduced in 1980, which led to the diagnosis of BCG osteitis in 1981. The vaccination doses, symptomatology, and methods of treatment are described. The risk of complications and a project for vaccination at later age are discussed. PMID- 3284909 TI - Genetics of multidrug resistance. PMID- 3284910 TI - Endocytotic uptake, processing, and retroendocytosis of human biosynthetic proinsulin by rat fibroblasts transfected with the human insulin receptor gene. AB - The cellular itinerary and processing of insulin and proinsulin were studied to elucidate possible mechanisms for the observed in vivo differences in the biologic half-lives of these two hormones. A rat fibroblast cell line transfected with a normal human insulin receptor gene was used. Due to gene amplification, the cells express large numbers of receptors and are ideal for studying a ligand, such as proinsulin, that has a low affinity for the insulin receptor. Competitive binding at 4 degrees C showed that the concentration of unlabeled insulin and proinsulin that is needed to displace 50% of tracer insulin or proinsulin was 0.85-0.95 nM and 140-150 nM, respectively. Binding to surface receptors and internalization occur at rates that are four to five times faster in cells incubated with insulin compared with proinsulin. Chloroquine led to an increase in cell-associated radioactivity of approximately 1.4-fold in cells incubated with insulin or proinsulin, but inhibited the appearance of degraded insulin by 54% and degraded proinsulin by only 10%. To study the fate of internalized ligand, cells were incubated with insulin and proinsulin until steady state binding occurred. Surface bound ligand was removed by an acid wash and the remaining cell-associated radioactivity represented internalized ligand. Cells were then reincubated in 37 degrees C buffer and the cell-associated radioactivity and radioactivity released into the medium were analyzed by TCA precipitation, Sephadex G-50, and HPLC. The results demonstrated that proinsulin more readily bypasses the intracellular degradative machinery and is therefore released intact from the cell via the retroendocytotic pathway. These results may help to explain the prolonged metabolic clearance rate and biologic responsiveness of proinsulin in vivo. PMID- 3284911 TI - Activation of protein breakdown and prostaglandin E2 production in rat skeletal muscle in fever is signaled by a macrophage product distinct from interleukin 1 or other known monokines. AB - During sepsis or after injection of endotoxin into rats, there is a large increase in muscle protein breakdown and prostaglandin E2 (PEG2) production. Prior studies showed that partially purified interleukin 1 (IL-1) from human monocytes can stimulate these processes when added to isolated rat muscles. The availability of pure recombinant IL-1 and other monokines has allowed us to investigate the identity of the active agent in this process. Incubation of muscles with recombinant human or murine IL-1 alpha or IL-1 beta or with IL-1 plus a phorbol ester did not stimulate muscle proteolysis or PGE2 production. Homogeneous natural porcine IL-1 ("catabolin") and mouse or human IL-1 beta were also not effective in vitro. In addition, a variety of other human cytokines, including tumor necrosis factor ("cachectin"), epidermal thymocyte-activating factor, eosinophil cytotoxicity-enhancing factor, interferon-alpha, beta, and gamma, platelet-derived growth factor, and transforming growth factor (TGF) beta, which are all released by activated macrophages, TGF-alpha, or mixtures of these polypeptides, also failed to activate proteolysis or PGE2 production. By contrast, a large increase in net protein breakdown could be induced in the rat soleus by polypeptides released from porcine monocytes or by the serum from febrile cattle which had been injected with Pasteurella haemolytica or bovine rhinotracheitis virus. Therefore, a still-unidentified product of activated monocytes appears to be responsible for the negative nitrogen balance that accompanies infectious illness. PMID- 3284912 TI - Minimal chronic hyperglycemia is a critical determinant of impaired insulin secretion after an incomplete pancreatectomy. AB - We now describe experiments that allow one to determine the consequences of B cell reduction alone vs. those that result from superimposed mild hyperglycemia. Male CD rats underwent a 60% pancreatectomy (Px); controls were sham operated. 1 wk later, either 10% sucrose (SUC) was substituted as fluid supply or tap water was continued (WAT). Plasma glucose and insulin values in Px-WAT remained equal to the sham groups; in Px-SUC the values were euglycemic for 25 d, but then nonfasting plasma glucose rose 15 mg/dl. After 6 wk, B cell mass in Px-WAT was reduced by 45% and non-B cell mass by 57%. In contrast, in Px-SUC both masses were comparable to the sham groups. The insulin response to 27.7 mM glucose was measured using the in vitro perfused pancreas. The responses were reduced in Px WAT but in proportion to their reduced B cell mass; in contrast, it was 75% less than expected in Px-SUC. Also, the response to arginine given at 16.7 mM glucose was reduced only in Px-SUC. These results show that a lowering of B cell mass that does not result in hyperglycemia has no adverse effect on the remaining B cells. On the other hand, if even mild hyperglycemia develops, B cell function becomes impaired and results in inappropriately reduced insulin stores and insulin responses to marked stimuli. PMID- 3284913 TI - Acquired deficiencies of protein S. Protein S activity during oral anticoagulation, in liver disease, and in disseminated intravascular coagulation. AB - Protein S is a vitamin K-dependent plasma protein which serves as the cofactor for activated protein C. Protein S circulates in both an active, free form and in an inactive complex with C4b-binding protein. To elucidate the role of protein S in disease states and during oral anticoagulation, we developed a functional assay for protein S that permits evaluation of the distribution of protein S between free and bound forms and permits determination of the specific activity of the free protein S. In liver disease, free protein S antigen is moderately reduced and the free protein S has significantly reduced specific activity. In disseminated intravascular coagulation, reduced protein S activity occurs due to a redistribution of protein S to the inactive bound form. During warfarin anticoagulation, reduction of free protein S antigen and the appearance of forms with abnormal electrophoretic mobility significantly decrease protein S activity. After the initiation of warfarin, the apparent half-life of protein S is 42.5 h. In patients with thromboembolic disease, transient protein S deficiency occurs due to redistribution to the complexed form. Caution should be exercised in diagnosing protein S deficiency in such patients by use of functional assays. PMID- 3284914 TI - Role of the hepatic artery in canalicular bile formation by the perfused rat liver. A multiple indicator dilution study. AB - The role of the hepatic artery in tracer water exchange and regulation of permeation of small solutes during canalicular bile formation was studied in the rat using a system that permitted perfusion of both hepatic artery and portal vein. Hepatic vein and biliary multiple indicator dilution curves were obtained after injection of indicators into either vessel. The main difference in hepatic venous dilution curves was a 3.1-fold longer t0 (time spent in nonexchanging vessels) and a 5% larger equivalent water space after injection into the hepatic artery. Biliary tracer recovery of water was markedly higher after arterial injection than after portal vein injection. Both taurocholate and taurodehydrocholate stimulated bile flow and increased biliary tracer recovery after injection into either vessel. The biliary recovery of sucrose relative to that of water, which is a measure of biliary sucrose permeation, was much lower when given into the hepatic artery than when given into the portal vein. During taurocholate infusion, it decreased by 33% in the hepatic artery but increased 36% in the portal vein. Taurodehydrocholate, by contrast, did not affect permeation of sucrose given into the portal vein. Our studies demonstrate marked exchange of tracer water in the biliary epithelium. Taurocholate, but not taurodehydrocholate, increases permeation of sucrose into bile in the portal vein bed while both bile salts decrease it in the arterial bed. PMID- 3284917 TI - Psychological preparation of families for hospitalization. PMID- 3284915 TI - Hormonal control of substrate cycling in humans. AB - Recent studies have established the existence of substrate cycles in humans, but factors regulating the rate of cycling have not been identified. We have therefore investigated the acute response of glucose/glucose-6P-glucose (glucose) and triglyceride/fatty acid (TG/FA) substrate cycling to the infusion of epinephrine (0.03 microgram/kg.min) and glucagon. The response to a high dose glucagon infusion (2 micrograms/kg.min) was tested, as well as the response to a low dose infusion (5 ng/kg.min), with and without the simultaneous infusion of somatostatin (0.1 microgram/kg.min) and insulin (0.1 mU/kg.min). Additionally, the response to chronic prednisone (50 mg/d) was evaluated, both alone and during glucagon (low dose) and epinephrine infusion. Finally, the response to hyperglycemia, with insulin and glucagon held constant by somatostatin infusion and constant replacement of glucagon and insulin at basal rates, was investigated. Glucose cycling was calculated as the difference between the rate of appearance (Ra) of glucose as determined using 2-d1- and 6,6-d2-glucose as tracers. TG/FA cycling was calculated by first determining the Ra glycerol with d5-glycerol and the Ra FFA with [1-13C]palmitate, then subtracting Ra FFA from three times Ra glycerol. The results indicate that glucagon stimulates glucose cycling, and this stimulatory effect is augmented when the insulin response to glucagon infusion is blocked. Glucagon had minimal effect on TG/FA cycling. In contrast, epinephrine stimulated TG/FA cycling, but affected glucose cycling minimally. Prednisone had no direct effect on either glucose or TG/FA cycling, but blunted the stimulatory effect of glucagon on glucose cycling. Hyperglycemia, per se, had no direct effect on glucose or TG/FA cycling. Calculations revealed that stimulation of TG/FA cycling theoretically amplified the sensitivity of control of fatty acid flux, but no such amplification was evident as a result of the stimulation of glucose cycling by glucagon. PMID- 3284916 TI - Identification and isolation of a platelet GPIb-like protein in human umbilical vein endothelial cells and bovine aortic smooth muscle cells. AB - Glycoprotein Ib (GPIb) is an intrinsic platelet membrane protein that plays a major role in platelet adherence and mediates ristocetin-dependent platelet von Willebrand factor binding. Recent reports that the platelet membrane glycoprotein complex IIb/IIIa is expressed in several cell types prompted us to look for GPIb expression in other vascular cells. Immunoperoxidase staining of human stomach and skin histologic sections with polyclonal as well as monoclonal anti-GPIb antibody revealed the presence of GPIb in the endothelial cell and smooth muscle cell layers. Western blotting using monospecific polyclonal anti-GPIb antibodies confirmed the presence of immunoreactive GPIb in human umbilical vein endothelial and bovine aortic smooth muscle cell cultures. Fab fragments of a monoclonal anti GPIb antibody were used to immunoprecipitate [3H]leucine labeled GPIb from metabolically labeled cells. The GPIb in these cells was functional as measured by ristocetin-dependent cell agglutination and by vWF binding. Endothelial cells as well as smooth muscle cells bound 125I-labeled vWF in a ristocetin-dependent manner, with a Kd of 7.9 nM. PMID- 3284919 TI - 50 year history of the American Academy of Dermatology. PMID- 3284918 TI - Electron microscopy of undecalcified human bone. AB - An alternative approach for the electron microscopical examination of undecalcified human bone was investigated. The method required bone to be chilled to -70 degrees C, sectioned at 10 microns in a special bone cryostat, and these sections to be fixed and embedded for ultrathin sectioning. Good preservation of bone cells was seen. The advantages of this method are that it allows numerous particular regions of the 10 microns thick sections to be selected under normal light microscopy, and these regions to be then selected for electron microscopy. The 10 microns sections allow for excellent penetration of the fixative and thus better preservation of the tissue is more likely. PMID- 3284920 TI - Fifty years of benefits. PMID- 3284921 TI - Organizing American dermatology and the founding of the American Academy of Dermatology. PMID- 3284922 TI - Founding of the Academy. PMID- 3284923 TI - Howard Fox: founding father of the American Academy of Dermatology--a personal reminiscence. PMID- 3284924 TI - Earl D. Osborne, M.D. PMID- 3284925 TI - Some early Academy personalities. PMID- 3284926 TI - The Gold Medal of the American Academy of Dermatology. Committee on History, American Academy of Dermatology. PMID- 3284927 TI - How past presidents view the American Academy of Dermatology's growth and status. PMID- 3284929 TI - Academy reminiscences: honorary members. PMID- 3284928 TI - Past presidents' perspectives on the Academy: 1987. PMID- 3284930 TI - Academy reminiscences: senior members. PMID- 3284931 TI - The Academy and Pearl Harbor. PMID- 3284932 TI - Medical musicians' merry melodies. PMID- 3284933 TI - Reminiscences from the Academy office. PMID- 3284934 TI - The Academy's transition years. PMID- 3284935 TI - National Program for Dermatology. PMID- 3284936 TI - The birth of the blues--2. PMID- 3284937 TI - The Committee on History of the American Academy of Dermatology. PMID- 3284938 TI - Remember when? An organizational review. PMID- 3284939 TI - Dental caries, fluorosis, and fluoride exposure in Michigan schoolchildren. AB - This study relates the prevalence of caries and fluorosis among Michigan children, residing in four different areas, to the various concentrations of F in the communities' water supplies. Demographic information, details of F history, and dental attendance data were collected by a questionnaire form filled out by parents. Children ages six to 12 were screened for caries by means of the NIDR criteria and for fluorosis by means of the TSIF index. Results pertain only to continuous residents and the permanent dentition. The prevalence of both caries and fluorosis was significantly associated with the F concentration in the community water supply. Approximately 65% of all children were caries-free, ranging from 55.1% in fluoride-deficient Cadillac to 73.7% in Redford (1.0 ppm F). About 36% of all children had dental fluorosis, ranging from 12.2 in Cadillac to 51.2 in Richmond (1.2 ppm). All of the fluorosis was very mild. From logistic regression, the prevalence of caries was significantly associated with age, dental attendance, and the use of a water supply fluoridated at 1.0 ppm. The odds of experiencing fluorosis increased at every F level above the baseline (Cadillac), with the use of topical F rinses, and with age. Results suggest that children in the four communities may be ingesting a similar level of F from sources such as dentifrices, dietary supplements, and professional applications, but the factor that differentiates them with respect to the prevalence of caries and fluorosis is the F concentration in the community water supply. PMID- 3284940 TI - Quantification of free water in human dental enamel. AB - The amount of free water in 50 samples of air-dried enamel from permanent and deciduous teeth was measured by the Karl Fischer method. Samples included both contemporary and burial specimens. The mean values obtained showed that free water constituted about 1% of enamel mass. However, the range of individual values varied considerably, from 0.56 to 1.48%. The proportion of free water did not seem to depend on the patient's age, the type of tooth, or the relationship between the tooth and its oral environment. On the other hand, the deciduous enamel tested displayed a mean free water content that was three times the mean for the permanent teeth (3.01 vs. 1.00%) and the five burial teeth, a mean content of 1.68%. PMID- 3284941 TI - A microelectrode technique for the analysis of microscopic volumes of oral fluids. PMID- 3284942 TI - [Changes in the components of saliva in rats during the development of mammary cancer]. PMID- 3284943 TI - Multicenter reperfusion trial of intravenous anisoylated plasminogen streptokinase activator complex (APSAC) in acute myocardial infarction: controlled comparison with intracoronary streptokinase. AB - The recent establishment of a firm therapeutic role for reperfusion in acute myocardial infarction has stimulated interest in the development of more ideal thrombolytic agents. Anisoylated plasminogen streptokinase activator complex (APSAC) is a new plasminogen activator possessing properties that are promising for intravenous thrombolytic application in acute myocardial infarction. To assess the reperfusion potential of intravenous APSAC, a multi-center, angiographically controlled reperfusion trial was performed. An approved thrombolytic regimen of intracoronary streptokinase served as a control. Consenting patients with clinical and electrocardiographic signs of acute myocardial infarction were studied angiographically and 240 qualifying patients with documented coronary occlusion (flow grade 0 or 1) were randomized to treatment in less than 6 h of symptom onset (mean 3.4 h, range 0.4 to 6.0) with either intravenous APSAC (30 U in 2 to 4 min) or intracoronary streptokinase (160,000 U over 60 min). Both groups also received heparin for greater than or equal to 24 h. Reperfusion was evaluated angiographically over 90 min and success was defined as advancement of grade 0 or 1 to grade 2 or 3 flow. Rates of reperfusion for the two treatment regimens were 51% (59 of 115) at 90 min after intravenous APSAC and 60% (67 of 111) after 60 min of intracoronary streptokinase (p less than or equal to 0.18). Reperfusion at any time within the 90 min was observed in 55 and 64%, respectively (p less than or equal to 0.16). Time to reperfusion occurred at 43 +/- 23 min after intravenous and 31 +/- 17 min after intracoronary therapy. The success of intravenous therapy was dependent on the time to treatment: 60% of APSAC patients treated within 4 h exhibited reperfusion compared with 33% of those treated after 4 h (p less than or equal to 0.01). Reperfusion rates were also dependent on initial flow grade (p less than or equal to 0.0001): 48% (81 of 168) for grade 0 (APSAC = 43%, streptokinase = 54%), but 78% for grade 1 (APSAC = 78%, streptokinase = 77%). APSAC given as a rapid injection was generally well tolerated, although the median change in blood pressure at 2 to 4 min was greater after APSAC than after streptokinase (-10 versus -5 mm Hg). Mean plasma fibrogen levels fell more at 90 min after the sixfold higher dose of APSAC than after streptokinase (to 32 versus 64% of control). Reported bleeding events were more frequent after APSAC but occurred primarily at the site of catheter insertion and no event was intracranial.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3284944 TI - Neutrophils as potential participants in acute myocardial ischemia: relevance to reperfusion. AB - An interaction among leukocytes, platelets and endothelial cells is important in atherogenesis and in maintenance of blood flow and vascular tone. These complex cell-cell interactions are mediated by release of such metabolic substances as arachidonic acid metabolites, growth factors, oxygen free radicals and endothelium-derived relaxing factor. These substances participate in the regulation of blood flow in health and disease, and perturbation in the delicate equilibrium among various cellular elements may lead to evolution and propagation of myocardial ischemia. During reperfusion of ischemic myocardium, neutrophils together with platelets cause capillary plugging in the coronary microcirculation and exert detrimental effects on endothelial function resulting in the "no reflow" phenomenon, ventricular arrythmias, loss of coronary vascular reserve and, perhaps, extension of cellular injury. This review addresses the mechanisms of cell-cell interactions with special reference to myocardial ischemia and the potential for development of improved therapy to protect and preserve ischemic myocardium. PMID- 3284945 TI - Paul Dudley White lecture. Balancing the benefits, risks and unknowns of thrombolytic therapy in acute myocardial infarction. PMID- 3284946 TI - Exercise echocardiography: ready or not? PMID- 3284947 TI - Intraoperative echocardiography: who monitors the flood once the flood gates are opened? PMID- 3284948 TI - Immunohistochemical localization of fibronectin and chondronectin in canine articular cartilage. AB - We compared the distribution of fibronectin and chondronectin within the matrix of canine articular cartilage. Fibronectin was found throughout the matrix as well as pericellularly. In contrast, chondronectin was observed predominantly associated with the cell or pericellular matrix. Interactions of these molecules with matrix components in the pericellular matrix probably differs, however, since concentrations of hyaluronidase which prevented detection of pericellular fibronectin allowed detection of chondronectin. Chondronectin and fibronectin were detected in osteoarthritic cartilage as well as in disease-free cartilage. Penetration of biotinylated fibronectin into cartilage from the external medium occurred only in osteoarthritic cartilage and proceeded only from the articular surface. Disease-free cartilage appeared to maintain a barrier to fibronectin penetration from the articular surface which was sustained even after the proteoglycan content was markedly depleted by incubation of cartilage with catabolin or lipopolysaccharide. In cartilage that was proteoglycan-depleted, the only detectable penetration of external fibronectin was from the cut surface. PMID- 3284949 TI - PAP labeling enhancement by osmium tetroxide-potassium ferrocyanide treatment. AB - We describe a procedure to intensify staining of antigens labeled by the peroxidase-antiperoxidase (PAP) method. Routinely PAP-stained samples were enhanced by application of 5% osmium tetroxide for 30 min followed by freshly prepared 2% potassium ferrocyanide, plus 1% hydrochloric acid for 15 min. The staining color changed from the original golden-brown, through transient gray, to a very dark brown that was almost black. In addition to stronger labeling, antigen locations not apparent in untreated specimens may thus be disclosed. Furthermore, retrospective staining intensification can be performed in stored PAP-labeled samples even years later. PMID- 3284950 TI - Osteomyelitis of the femur complicating Serratia marcescens bacteraemia arising from an infected intravascular catheter. PMID- 3284951 TI - The hazard of infection from the shared communion cup. AB - Interest and concern that the shared communion cup may act as a vehicle for indirectly transmitting infectious disease was reawakened when the human immunodeficiency virus (HIV) was detected in the saliva of infected persons. Bacteriological experiments have shown that the occasional transmission of micro organisms is unaffected by the alcoholic content of the wine, the constituent material of the cup or the practice of partially rotating it, but is appreciably reduced when a cloth is used to wipe the lip of the cup between communicants. Nevertheless, transmission does not necessarily imply inoculation or infection. Consideration of the epidemiology of micro-organisms that may be transmitted via saliva, particularly the herpes group of viruses, suggests that indirect transmission of infection is rare and in most instances a much greater opportunity exists for direct transmission by other means. There is substantial evidence that neither infection with hepatitis B virus nor HIV can be transmitted directly via saliva so that indirect transmission via inanimate objects is even less likely. No episode of disease attributable to the shared communion cup has ever been reported. Currently available data do not provide any support for suggesting that the practice of sharing a common communion cup should be abandoned because it might spread infection. PMID- 3284952 TI - Streptococcus pyogenes bacteraemia: an old enemy subdued, but not defeated. AB - Bacteraemia with Streptococcus pyogenes (Group A haemolytic streptococci) was reviewed in patients admitted to University Hospital, Nottingham over a period of 7 years. Altogether, 40 cases were encountered, representing 2% of all cases of bacteraemia. Mortality was 35%. Most cases were community-acquired and 28% of patients were less than 40 years of age. A third of the patients were previously fit. The most common sources of bacteraemia were the skin and soft tissue (23 patients) and the respiratory tract (eight patients). Shock was recorded in 40% of cases and carried a 60% mortality. This feature of streptococcal bacteremia has not received sufficient attention in the past. Despite its unique susceptibility to penicillin, S. pyogenes continues to pose a challenge to the physician. PMID- 3284953 TI - [Histological observations on muscle tissue reactions to porous hydroxyapatite sintered bodies in rats]. AB - Blocks of porous hydroxyapatite (dimensions, 2 X 3 X 4 mm3; sintering temperature, 1,150 degrees C; macroporosity, 48%; pore diameter, 50-300 microns) were implanted into the intervening space between the tibial periosteum and the tibialis anterior muscle in 36 male Wistar rats at the age of 5 months. Specimens from the lower leg were obtained 1, 2, 3, 5, 8 and 12 weeks after implantation. The implants were found to adhere firmly to the tibialis anterior in the 5 and 12 week-specimens. No inflammatory reactions were seen around the implants and a layer of fibrous tissue was observed between the implanted apatite block and the muscle in all specimens. The fibrous tissue penetrated deeply into pores of the apatite block. The resistance to pulling of the interface (3 X 4 mm2) between porous hydroxyapatite and the tibialis anterior muscle was measured using a universal testing machine. The mean of the resistance to pulling was 24.7 +/- 5.1 gf/mm2 in 4 specimens of 12 weeks implantation. PMID- 3284954 TI - [Physiology and pathophysiology of proteoglycans--outlook for matrix technology]. PMID- 3284955 TI - Does exposure of preovulatory oocytes to ultrasonic radiation affect reproductive performance? AB - Ultrasonography of preovulatory oocytes has been reported to lead to reduced litter size in rats. Because of the growing popularity of ultrasound-guided follicular aspiration in human in vitro fertilization programs, further study of ultrasonic radiation's effect on the preovulatory oocyte is warranted. We used 106 virgin Sprague-Dawley rats which, on the evening of proestrus, received ultrasonic radiation of sham treatment after the onset of the luteinizing hormone (LH) surge. No differences were found between control (C) and experimental (US) animals in pregnancy rate, number of corpora lutea, implantations, pups, and mean pup and placental weights at autopsy on day 22 of pregnancy. Ultrasonic radiation applied to meiotically active, preovulatory oocytes did not affect the reproductive performance of these rats. PMID- 3284956 TI - Lipid thermotropic transitions in Triatoma infestans lipophorin. AB - The structure and lipid thermotropic transitions of highly purified lipophorin of Triatoma infestans were examined by several techniques: steady-state fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene (DPH), cis-parinaric acid (cis-PnA) and trans-parinaric acid (trans-PnA), light scattering fluorescence energy transfer between the lipophorin tryptophan residues and the bound chromophores, DPH, trans-parinaric acid cis-parinaric acid, gel electrophoresis, and gel filtration. Fluorescence polarization of PnAs and DPH revealed a reversible lipid thermotropic transition in intact lipophorin at about 20 degrees C and 18 degrees C, respectively. In lipophorin, lipid dispersion fluorescence polarization of DPH detected a lipid transition approximately at 20 degrees C, while trans-PnA showed a gel phase formation at a temperature below 30 degrees C. Similar experiments in which trans-PnA was incorporated into diacylglycerols and phospholipids extracted from the lipophorin revealed gel phase formation below 30 degrees C and 24 degrees C, respectively. Light scattering measurements showed that lipophorin particles aggregate irreversibly at 45 degrees C, increasing the molecular weight, as determined by gel filtration on Sephacryl S-300, from 740,000 to values larger than 1,500,000. The particle aggregation did not change the physical properties of the lipophorin studied by fluorescence polarization, indicating that the aggregation is apparently a non-denaturing process. Energy transfer between the lipophorin tryptophans and the bound chromophores cis-PnA, trans-PnA, and DPA revealed a different location of the fluorescent probes within the lipophorin. Temperature-dependence on the energy transfer efficiency for all probes confirmed a change in the ordering of the lipophorin lipids at 24 degrees C. PMID- 3284957 TI - Confederate medical manuals of the Civil War. PMID- 3284958 TI - The Crawford W. Long Museum--a tribute to physicians' support and generosity. PMID- 3284959 TI - Collecting antique medical instruments. Interview by Stephen Davis. PMID- 3284960 TI - Chronicling the history of MCG: an interview with Dr. Phinizy Spalding. Interview by Stephen Davis. PMID- 3284961 TI - Autoreactive T cell clones specific for class I and class II HLA antigens isolated from a human chimera. AB - T cell clones of donor origin that specifically react with recipient cells were obtained from a SCID patient successfully reconstituted by allogeneic fetal liver and thymus transplantation performed 10 yr ago. The majority of these clones displayed both cytotoxic and proliferative responses towards PBL and an EBV transformed B cell line derived from the patient. In addition, these T cell clones had proliferative and cytotoxic responses towards the parental PBL, EBV cell lines, and PHA blasts. Blocking studies with anti-class I and anti-class II HLA mAbs indicated that the activity of the CD4+ T cell clones was specifically directed against class II HLA antigens of the recipient. On the other hand, the cytotoxic and proliferative responses of the CD8+ T cell clones were specific for class I HLA antigens which are ubiquitously expressed on the recipient cells. Thus, the establishment of transplantation tolerance observed in this stable human chimera is not due to the elimination of host-reactive T cells from the repertoire and suggests the presence of a peripheral autoregulatory suppressor mechanism. PMID- 3284963 TI - Obstetric ultrasound training for family physicians. Results from a multi-site study. AB - A practical program to train family physicians in obstetric ultrasound was tested with 13 family physicians. Each physician completed 6.5 days of course work and ultrasound laboratory apprenticeship prior to beginning a clinical preceptorship of approximately 14 months' duration. During the clinical preceptorship the physicians performed ultrasound studies in their own offices. All studies were reviewed by a local consultant radiologist utilizing examination data sheets and videotapes. At the conclusion of the training program, the physicians took a combined practical and written proficiency examination administered by an independent sonographer. Eight physicians completed the training, performing during the preceptorship an average of 78 examinations. The rated performance of the physicians improved markedly over the course of the preceptorship. During the last segment of the preceptorship the radiologist preceptors rated 94 percent of the ultrasound studies as acceptable, compared with 79 percent rated acceptable at the beginning of the preceptorship. Seven of the eight physicians completing the protocol took the proficiency examination: all passed. This study can provide a blueprint for an individual family physician to design his own training, or it can guide an academic department of family medicine in developing and evaluating ultrasound training programs for residents and practicing physicians. PMID- 3284962 TI - Chromosomal location of the genes encoding the leukocyte adhesion receptors LFA 1, Mac-1 and p150,95. Identification of a gene cluster involved in cell adhesion. AB - The adhesion receptors Mac-1, LFA-1, and p150,95 are cell surface alpha/beta heterodimers that play a key role in leukocyte adhesion processes. The genes for Mac-1, LFA-1, and p150,95 alpha subunits have been located to chromosome 16 by means of Southern blot analysis using a series of somatic cell hybrids. Chromosomal in situ hybridization has demonstrated that the genes for the three alpha subunits map to the short arm of chromosome 16, between bands p11 and p13.1, defining a cluster of genes involved in leukocyte adhesion. The gene encoding the LFA-1/Mac-1/p150,95 beta subunit, and defective in leukocyte adhesion deficiency, has been located on chromosome 21, band q22. The leukocyte adhesion receptor alpha and beta subunits are mapped to chromosomal regions that have been shown to be involved in cytogenetic rearrangements in certain patients with acute myelomonocytic leukemia and the blast phase of chronic myelogenous leukemia, respectively. PMID- 3284964 TI - Screening and early diagnosis of breast cancer. AB - Long-term survival in breast cancer currently rests on detection and appropriate therapy at the earliest possible stage, with survival being excellent in patients whose cancers are discovered at a small size and without dissemination. Discovery of lesions at the smallest possible size is therefore desirable. Of the available imaging modalities, only modern mammography has been shown consistently to detect small breast lesions. The efficacy of screening mammography in asymptomatic women has been demonstrated in large-scale trials in women older than 49 years of age and has been strongly supported by follow-up results in the Breast Cancer Detection and Demonstration Project in women aged 40 to 50 years. Mammographic screening has been advocated by the American Cancer Society (ACS) beginning at 40 years of age, while the National Cancer Institute recommends mammographic screening beginning at 50 years of age. The ACS recommends also that breast self examination begin at 20 years of age. Unfortunately, a great majority of women do not practice breast self-examination, nor do they know that mammography is useful in detecting breast cancer. Further, only a minority of physicians recommend screening mammography, although most recommend breast self-examination and perform physical examination of the breast. Physicians are therefore urged to recommend regular screening to their patients. PMID- 3284965 TI - Use of Wellcogen group B streptococcal latex fixation test to detect group B streptococcus in amniotic fluid. PMID- 3284967 TI - Mandatory assignment must be rejected. PMID- 3284966 TI - The maturing of family medicine: challenges to behavioral science. AB - For family medicine to maintain the unique creativity and risk taking that were present at its inception, behavioral scientists must be allowed to play, and be willing to assume, an essential role in the ongoing process of defining the field of family medicine, formulating its assumptions and asserting its future direction both in terms of academic research and clinical teaching. As co creators and co-inspirers, behavioral scientists have the rare challenge of synthesizing their perspectives and values with those of the physicians with whom they work. It is to be hoped that through this interactive process, the practice of family medicine will continue to be an experience of real healing and wholeness for both patients and physicians. PMID- 3284968 TI - Toxic shock syndrome: a problem in the surgical patient. PMID- 3284969 TI - Treatment of obsessive-compulsive disorder. PMID- 3284970 TI - Cerebral glycosidases in experimental Creutzfeldt-Jakob disease. AB - In Creutzfeldt-Jakob disease (CJD), there are prominent ultrastructural alterations of the plasma membrane, which contains many glycolipids and glycoproteins. Glycosidases can degrade glycolipids and glycoproteins. Gangliosides, a subset of glycolipids, are decreased in amount at the terminal stages of CJD, and CJD infectivity is closely associated with membrane rich fractions. We therefore studied 10 glycosidases, and found a statistically significant increase in beta-xylosidase, beta-glucuronidase, N-acetyl-beta-D glucosaminidase and N-acetyl-beta-D-galactosaminidase activities in CJD. In contrast, alpha-glucosidase, beta-glucosidase, alpha-galactosidase, alpha mannosidase, alpha-fucosidase, and beta-galactosidase were not significantly changed. The above results are consistent with degenerative membrane changes observed morphologically, and with increased degradation of sugar residues on lipids and/or proteins. These changes may be effected by the accumulation of the CJD agent in cell membranes. We suggest that the higher activities of these enzymes in CJD may be partially responsible for some of the structural and biochemical alterations in CJD infected brains. PMID- 3284971 TI - Evaluation of intracranial pressure from transcranial Doppler studies in cerebral disease. AB - The extent to which estimations of intracranial pressure can be derived from intracranial flow patterns was studied. The blood flow velocity in the middle cerebral artery was recorded with the EME TC 2-64 transcranial Doppler (TCD) device in 26 patients suffering from various severe cerebral diseases. Simultaneously the mean intracranial pressure (ICP) was measured by means of an epidural device. Arterial carbon-dioxide tensions were monitored by blood gas analysis. In all patients it was observed that the middle cerebral artery flow patterns changed distinctly when the ICP increased; these changes were distinguished by a decrease of the mean flow velocity and an increase of the Pourcelot index. A good correlation between the ICP and the flow parameters (especially the product mean systemic arterial pressure x Pourcelot index/mean flow velocity) was found in a select group of 13 patients, in whom comparable initial conditions existed and in whom additional parameters influencing the TCD recordings could be kept constant (r = 0.873; P less than 0.001). PMID- 3284972 TI - Use a gentle approach for refractory myeloma patients. PMID- 3284973 TI - Questions about clinical trials in hypercalcemia. PMID- 3284974 TI - An update of two randomized trials in previously untreated multiple myeloma comparing melphalan and prednisone versus three- and five-drug combinations: an Argentine Group for the Treatment of Acute Leukemia Study. AB - An update of two consecutive randomized studies in previously untreated multiple myeloma was performed. The first study (10-M-73) began in 1973; 150 patients were treated with melphalan and prednisone (MP) or semustine, cyclophosphamide, and prednisone (MeCP). In a second randomized study (3-M-77), begun in 1977, 260 patients were treated with MP or melphalan, prednisone, cyclophosphamide, semustine, and vincristine (MPCCV). A total of 27 of the 67 patients (40%) treated with MP and 33 of the 83 patients (40%) treated with MeCP showed a good response in protocol 10-M-73; 48 of 145 patients (33%) treated with MP and 51 of the 115 patients (44%) treated with MPCCV in protocol 3-M-77 obtained a good response (P is not significant). Median survival in protocol 10-M-73 was 30 months for MeCP and 38 months for MP. At 84 months, 19% and 9% remain alive, respectively. Median survival for protocol 3-M-77 was 44 months for those treated with MPCCV and 42 months for MP. At 60 months, 9% and 11% remain alive; this difference was not significant. Also, there was no survival difference for favorable or unfavorable prognostic groups among the four treatment arms of both protocols. It can be concluded, with a long-term follow-up of both protocols, that the combination of MP is as effective as the three- and five-drugs combinations, and in view of its simplicity and cost-saving advantages, it should be favored for initial therapy of multiple myeloma patients. PMID- 3284976 TI - N-methylformamide: cytotoxic, radiosensitizer, or chemosensitizer. AB - N-methylformamide (NMF), a polar solvent, is currently being evaluated by the National Cancer Institute (NCI) as an antineoplastic agent because of its activity against colon, mammary, and lung tumor xenografts. Results from preclinical studies suggest that it has radiosensitizing, chemosensitizing, and differentiating activity. Its mechanism of action remains unknown, but may involve cellular depletion of glutathione, cell membrane changes, or modulation of proto-oncogene expression. Preclinical toxicology studies conducted in mice, rats, and beagle dogs showed reversible hepatotoxicity to be dose-limiting. Clinically, NMF is administered both orally and by intravenous (IV) injection. The bioavailability with oral administration is 90% to 95%. The highest reported plasma concentration of NMF is approximately 4 mmol/L in a patient who received a dose of 2,000 mg/m2 of IV NMF. Biphasic elimination with IV NMF is seen on both the daily for five days and weekly for 3 weeks schedule. Approximately 5% to 7% of the total administered IV dose is excreted in the urine. In phase I studies, dose-limiting toxicities included reversible hepatotoxicity, a generalized malaise syndrome, and nausea and vomiting. One partial response has been reported in the 111 patients treated on phase II trials in colorectal, head and neck, and renal carcinomas. Suggestions for the future development of this drug are presented. PMID- 3284975 TI - Randomized clinical trial of tamoxifen alone or combined with fluoxymesterone in postmenopausal women with metastatic breast cancer. AB - A randomized clinical trial was performed to determine if combination hormonal therapy with tamoxifen (TAM) and fluoxymesterone (FLU) was more efficacious than TAM alone for the treatment of postmenopausal women with metastatic breast cancer. Patients failing TAM could subsequently receive FLU. The dose of both drugs was 10 mg orally twice daily. Objective responses were seen in 50 of 119 TAM patients (42%) and 63 of 119 TAM plus FLU patients (53%) (one-sided P = .05). Time to disease progression distributions were better for TAM plus FLU (median, 350 days v 199 days), but the log rank test only approached statistical significance (one-sided P = .07). Duration of response and survival distributions were similar between the two treatment arms. Toxicities, in terms of androgenic side effects, were greater on the TAM plus FLU regimen. Fifty-two patients are evaluable for response with FLU following TAM and 21 (40%) have achieved a response. We conclude that the advantages in terms of response rate and time to progression observed with TAM plus FLU probably represent a biological effect, but are not of sufficient magnitude to justify the routine clinical use of this combination given the lack of survival advantage and side effects encountered. PMID- 3284977 TI - Chromosome studies in the non-Hodgkin's lymphomas: the role of the 14;18 translocation. AB - The 14;18 translocation [t(14;18)] is the most common chromosome abnormality noted in the non-Hodgkin's lymphomas (NHL). Although the translocation is seen in various histologic subtypes, it is most commonly associated with the follicular lymphomas, especially the small-cleaved cell (FSC) and mixed-cell (FM) subtypes. The translocation breakpoint has been cloned and DNA probes from the junction on chromosome 18 can now be used to detect the genetic consequences of the translocation in tumors with few dividing cells. This will allow a more precise classification of this subset of lymphomas and should lead to better understanding of the biology of this category of lymphomas. Finally, these insights will help in the development of more effective and possibly less toxic therapy. PMID- 3284978 TI - George O. Burr and the discovery of essential fatty acids. PMID- 3284979 TI - Role of carnitine in human nutrition. PMID- 3284980 TI - Protein-fat interaction on serum cholesterol level, fatty acid desaturation and eicosanoid production in rats. AB - The combined effects of dietary protein (casein or soybean protein) and fat (palm olein or mold oil) on several lipid parameters were studied in rats. The fatty acid composition of the dietary fats was made comparable except for the proportions of polyunsaturated fatty acids; mold oil contributed gamma-linolenic acid (GLA) at the expense of a portion of the linoleic acid in palm olein. When animals were fed casein rather than soybean protein, serum cholesterol levels were higher irrespective of the fat source, but it took a longer time to produce a significant difference when the dietary fat was mold oil. Soybean protein increased fecal steroid excretion, and mold oil tended to stimulate the excretion of neutral steroids. The ratio of arachidonate to linoleate in phosphatidylcholine from plasma, liver and thoracic aorta was markedly higher in the casein than in the soybean protein groups. Mold oil predictably improved a reduction of arachidonate by vegetable protein. The aortic production of prostacyclin was higher with mold oil than with palm olein irrespective of the protein source, although there was a trend toward a higher production with casein. No protein-fat interaction was observed on the concentration of plasma thromboxane B2. Thus GLA effectively modified metabolic consequences of dietary protein. PMID- 3284981 TI - Analysis of the immunosuppressive and nephrotoxic effects of cyclosporin G. AB - Nephrotoxicity has limited the effectiveness of cyclosporine in transplantation therapy and has precipitated the need to develop a new immunosuppressive agent that lacks this nephrotoxicity or has a higher therapeutic index. Prior studies have suggested that cyclosporin G may be equally effective immunosuppressively, but less nephrotoxic than cyclosporine. To compare the immunosuppressive effects of the two agents, graft survival was analyzed in Lewis-Brown Norway rats, which received heterotopic ACl heart allografts and were treated orally with cyclosporin G or cyclosporine at 5 and 10 mg/kg/day. To compare nephrotoxicity the group of rats that had transplantations and an additional group of surgically intact Lewis-Brown Norway rats, treated orally with cyclosporin G or cyclosporine at dosages ranging from 10 to 50 mg/kg/day and for durations ranging from 50 to 180 days, were analyzed in terms of kidney morphology (fibrosis, glomerular damage, interstitial infiltrate, and tubular dilation) and kidney function (blood urea nitrogen and serum creatinine levels) in this model cyclosporin G was significantly less effective than cyclosporine in prolonging graft survival at 5 mg/kg/day but equally effective at 10 mg/kg/day. In addition, cyclosporin G was substantially less nephrotoxic both morphologically and functionally at low (10 mg/kg/day) and high (50 mg/kg/day) dosages. Further studies are indicated to determine the therapeutic index of cyclosporin G and to evaluate its use in combination with other immunosuppressive agents. PMID- 3284982 TI - Conversion from cyclosporine to azathioprine in heart transplant recipients. AB - Cyclosporine has proved to be of benefit for heart transplantation. Complications of therapy, however, occasionally require discontinuation of the cyclosporine and replacement with azathioprine. We report two cases in which changing from cyclosporine to azathioprine was followed by fatal rejection episodes. PMID- 3284983 TI - Comparison of nutritional status in patients before and after heart transplantation. AB - Nutritional status before and after heart transplantation was analyzed from retrospective data on 65 patients (82% male, mean age, 43.1 years, and mean length of illness before transplantation, 57.3 months). Of all the patients 93% were on a 2 gm low sodium diet, and 55% were on a low saturated fat and low cholesterol diet before surgery. After surgery 100% of patients were on the same salt-, fat-, and cholesterol-restricted diet. Visceral protein stores (determined from albumin and total lymphocyte count) and somatic protein stores (determined from weight-for-height calculations, triceps skin fold, and arm muscle circumference) increased significantly from before surgery to 6 months after surgery. The number of patients with adequate visceral protein stores increased from 66.1% to 98.1%, and those with adequate somatic protein stores increased from 67.2% to 84.6%. Weight was analyzed over time with analysis of variance. Patients gained weight (preoperative mean = 72.8 kg and postoperative mean at 6 months = 80.2 kg), and ideal body weight increased from 102% to 114%. With paired t tests the following differed before and after surgery (p less than or equal to 0.05): cholesterol levels increased from 180 to 262 mg/dl, and triglyceride concentrations increased from 139 to 221 mg/dl. In conclusion, patient protein stores returned to normal after surgery, patients increased body weight to more than 110% of ideal, and cholesterol and triglyceride levels became elevated. PMID- 3284984 TI - Clinical significance of pericardial effusion after heart transplantation. AB - Fifty-two consecutive patients who underwent orthotopic heart transplantation at our institution were evaluated by two-dimensional (2D) echocardiography at frequent intervals for 12 weeks after transplantation and at three monthly intervals for 1 year. Thirty-eight of 52 patients had adequate 2D echocardiograms and comprised the retrospective study group. Pericardial effusion was documented in 15 of 38 patients (40%). Pericardial effusion was moderate in two (5%) and small in seven patients (18%). Large pericardial effusion was demonstrated in six of 38 patients (16%). Three of 38 patients (8%) developed cardiac tamponade manifested by hypotension in the presence of a large pericardial effusion. The diagnosis of cardiac tamponade was aided by 2D echocardiography leading to prompt pericardiocentesis. The presence of pericardial effusion in patients after their transplantation did not demonstrate independent correlation with chest tube output after operation, cyclosporine therapy, acute rejection, level of blood urea nitrogen (BUN), infection or preoperative diagnosis of idiopathic dilated cardiomyopathy. The presence of cyclosporine therapy, acute rejection, and a preoperative diagnosis of idiopathic dilated cardiomyopathy, however, yielded an 86% probability of having pericardial effusion. Follow-up 2D echocardiograms obtained 301 +/- 106 days after transplantation were available in 25 patients. Fifteen patients (60%) had no pericardial effusion present on either the initial or follow-up 2D echocardiogram. The majority of cases of the pericardial effusion present on initial or follow-up echocardiograms were resolving on the follow-up study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284985 TI - Systolic and diastolic ventricular performance at rest and during exercise in heart transplant recipients. AB - Left ventricular dysfunction has been described in the transplanted heart. To further define these abnormalities in cardiac performance and relate for the first time diastolic to systolic function in the transplanted heart, we investigated 28 clinically stable recipients of orthotopic heart transplantation. Patients underwent blood pool radionuclide angiography performed at rest early after transplantation (18 +/- 13 days, mean +/- SD) and at rest and at exercise late after transplantation (248 +/- 194 days). Systolic ventricular performance was assessed by right and left ventricular ejection fractions, whereas diastolic left ventricular function was evaluated by the peak diastolic filling rate and its time of occurrence. Early after transplantation the left ventricular ejection fraction (54.0% +/- 6.0%) was significantly lower (p less than 0.001) than that of normal subjects of similar ages (61% +/- 6.6%). Mean right ventricular ejection fraction (47% +/- 6.0%) was comparable with that of normal subjects (49% +/- 4%) and abnormal in only three of 21 patients. Rest peak diastolic filling rate and time to peak diastolic filling rate were comparable with values from normal subjects in our laboratory. Late after transplantation resting left and right ventricular ejection fractions, peak diastolic filling rate, and time to peak diastolic filling rate were similar to the values found early after transplantation. During exercise significant increases occurred in the left ventricular ejection fraction (p less than 0.02), the right ventricular ejection fraction (p less than 0.02), and the peak diastolic filling rate (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3284986 TI - The Italian Heart Transplant Project: organization of a multicenter program. AB - The Italian Heart Transplant Project is a national program coordinated by the Health Ministry and involves eight cardiac surgery centers, two coordination centers for organ procurement, and one national registry. An intercenter network for the solution of logistic problems regarding organ procurement and assignment has been built up. Preintervention and clinical follow-up data are recorded in each center and in a national registry by the implementation of a computerized data base. This is realized by employing low cost and diffuse software and hardware. The complex goal of common data collection and standardization is also being pursued for collateral areas such as cardiac pathology and immunologic surveillance. Data collection is useful for clinical monitoring and also for costs and/or requirements analysis. PMID- 3284987 TI - Survival of a heart transplant recipient after pulmonary cavitary mucormycosis. AB - Pulmonary infections can be a major complication of heart transplantation. Bacterial pneumonia has decreased markedly in the last few years among heart recipients receiving cyclosporine as immunosuppressive therapy. Fungal infections of the lung can cause serious problems in the compromised condition of these patients, with several deaths attributed to Aspergillus and Candida. To our knowledge, however, there has been no report of pulmonary mucormycosis in heart transplant recipients. We describe, therefore, a heart transplant patient with insulin-dependent diabetes mellitus who developed serious cavitary pulmonary mucormycosis. Diagnosis was made by transbronchial biopsy, and treatment required both prolonged administration of amphotericin B and surgical resection to effect a cure. The diagnostic problems and therapeutic considerations associated with pulmonary mucormycosis are discussed. PMID- 3284989 TI - Heart transplantation for cardiac amyloidosis: successful one-year outcome despite recurrence of the disease. AB - Systemic amyloidosis has been considered a theoretical contraindication for heart transplantation because of the concern that amyloidosis is a systemic disease that could potentially recur in the allograft. To date, no patients have been reported to have undergone heart transplantation. One year ago a patient with amyloidosis had a transplantation at the Oregon Health Sciences University, Portland. Results of kidney, rectal, and bone marrow biopsies were normal; however, endomyocardial and gingival biopsies showed positive results for amyloidosis. Recurrence of amyloidosis was detected by electron microscopy 14 weeks after transplantation; however, light microscopy has not shown any amyloidosis at 1 year. No other organ involvement has been documented. The patient is New York Heart Association functional class I, with normal resting hemodynamic parameters 1 year after transplantation. Amyloid heart disease does not necessarily portend a poor early outcome. PMID- 3284990 TI - Cytoimmunologic monitoring in early and late acute cardiac rejection. AB - The absolute concentration of circulating lymphoblasts and prelymphoblasts has been shown repeatedly to closely correlate with acute cardiac rejection in heart transplant recipients. Little information, however, is available with respect to the reliability of this measurement in the late postoperative course. Fifty-two heart transplant recipient operated on from October 1985 through September 1986 were studied with cytoimmunologic monitoring for lymphocyte activation in peripheral blood. Immunosuppressive therapy consisted of azathioprine, cyclosporine, and steroids. Endomyocardial biopsies were obtained at regular intervals. Cytoimmunologic monitoring was performed daily during hospitalization and together with endomyocardial biopsy at outpatient visits. A total of 768 endomyocardial biopsies and 1077 mononuclear concentrates for study of lymphocyte activation were obtained. Concentration of activated cells showed a significant increase during acute rejection. Cytoimmunologic monitoring had an overall sensitivity of 76% and a specificity of 79%. Within 90 days after transplantation cytoimmunologic monitoring showed a sensitivity of 84%, which decreased to 71% beyond 3 months. We therefore conclude that cytoimmunologic monitoring, a noninvasive adjunct for diagnosis of acute allograft rejection, cannot replace routine endomyocardial biopsy, particularly in view of a significant loss in sensitivity in the late postoperative course. PMID- 3284991 TI - Assessment and selection of patients for heart transplantation. PMID- 3284988 TI - Aortic rupture caused by fungal aortitis: successful management after heart transplantation. AB - A 26-year-old man with end-stage idiopathic cardiomyopathy was supported with a Pierce-Donachy left ventricular assist device for 31 days before orthotopic heart transplantation. Fungal endocarditis was discovered at the time of recipient cardiectomy, and antifungal therapy was begun. Fungal mediastinitis developed 4 days after transplantation and was treated with mediastinal irrigation. Massive mediastinal hemorrhage caused by fungal aortitis occurred on two occasions and was successfully treated with a bovine pericardial patch. The patient is well 9 months after transplantation. PMID- 3284993 TI - Primary intraosseous carcinoma: report of two cases. PMID- 3284992 TI - Leaders in medicine. John W. Records, MD. PMID- 3284994 TI - The femoral condyle as an alternative source of cancellous bone for grafting of maxillofacial defects. AB - A technique for obtaining cancellous bone from the distal femoral condyle had been presented. This had been an effective source for grafting selected maxillofacial defects. The method involves an uncomplicated surgical approach and has low morbidity. PMID- 3284995 TI - AF-DX 116: a selective antagonist of the slow inhibitory postsynaptic potential and methacholine-induced hyperpolarization in superior cervical ganglion of the rabbit. AB - AF-DX 116 [11-([2-[(diethylamino)methyl]-1-piperdinyl]acetyl)-5, 11-dihydro-6H pyrido[2,3-b][1,4]benzodiaze pine-6-one], a muscarinic receptor antagonist that divides the M2-type muscarinic receptor into additional functional classes, modified muscarinic responses recorded from the superior cervical ganglion of the rabbit with sucrose or air gap techniques. Incubation of ganglia with AF-DX 116 suppressed the amplitude of the slow-inhibitory postsynaptic potential (s-IPSP) in a concentration-dependent and highly specific manner. At concentrations which reduced the amplitude of the s-IPSP by 80 to 90%, there was no significant reduction of the amplitudes of the muscarinic slow-excitatory postsynaptic potential or the nicotinic fast-excitatory postsynaptic potential. In addition, superfusion of ganglia with AF-DX 116 resulted in the concentration-dependent suppression of ganglionic hyperpolarization induced by methacholine without suppression of methacholine-induced depolarization. Ganglionic hyperpolarization that was produced by norepinephrine was unaffected by AF-DX 116. Increasing the level of acetylcholine available for interaction with muscarinic receptors by increasing the number of stimulus volleys that were applied to the preganglionic nerve resulted in a parallel shift, to the right, of the concentration-response curve for suppression of the s-IPSP by AF-DX 116. Similarly, incubation of ganglia with the specific antiacetylcholinesterase, BW 284 (1-5-bis[4-allyl dimethylammonium phenyl]pentan-3 one dibromide), increased the concentration of AF-DX 116 that was required to produce a comparable suppression of the s-IPSP. These results indicate that the s-IPSP in mammalian superior cervical ganglion involves an action of acetylcholine at the M2 type receptor that is preferentially blocked by AF-DX 116. PMID- 3284997 TI - Long term cryopreservation of the amastigote stages of hemoflagellates. AB - Tissue homogenates containing amastigotes of either Leishmania donovani, L. tropica, or Trypanosoma cruzi were rapidly frozen with 10% glycerol as cryoprotectant. Viability and pathogenicity were maintained for at least 23 years with the Khartoum strain of L. donovani, 22 years with the Malakal strain of L. donovani, and 7 years for L. tropica and T. cruzi. Similar results over a shorter period of time were obtained with a slow-freezing technique. PMID- 3284996 TI - Fluorescence-activated cell-sorting analysis of fibronectin peptides binding to Trypanosoma cruzi trypomastigotes. AB - The binding of synthetic peptides modeled from the sequence of the cell attachment site of fibronectin to T. cruzi trypomastigote surface receptors was investigated by fluorescence-activated cell-sorting analysis using fluorescein labeled peptides. Peptides with the sequence Arg-Gly-Asp-Ser bound to the parasite surface. A low percentage of fresh parasites recently liberated from infected fibroblasts had the capacity to bind the peptide. In contrast, these parasites showed a time-dependent several-fold increase in their ability to bind the Arg-Gly-Asp-Ser-containing peptides during extracellular incubation. From these observations, it appears that the expression of surface receptors on a particular, mature stage of the parasite parallels its ability to adhere to and infect host cells. PMID- 3284998 TI - A monoclonal antibody to alpha tubulin recognizes host cell and Trypanosoma cruzi tubulins. AB - A mouse monoclonal anti-alpha-tubulin antibody was used to investigate the disposition of the cytoskeletal microtubules of three tissue culture cell lines- J774 macrophages, BSC-1, and Vero cells--infected with the Brazil strain of Trypanosoma cruzi. Indirect immunofluorescence light microscopy was used to demonstrate the antigenic response in host cells and parasites, simultaneously. In all morphotypes of T. cruzi, the monoclonal antibody reacted with all subpopulations of microtubules, inclusively, the subpellicular, flagellar, cytopharyngeal, and mitotic. The host cell cytoskeletal microtubule framework was revealed and the redistribution and destruction of the microtubular lattice in response to parasite infection over a 120 h period recorded. Our results show that after the initial inoculation of tissue cultures with trypomastigotes, the parasites penetrate the cells and locate in the perinuclear region of the cell where they multiply. The number and distribution of host cell microtubules were altered during the infection. The normal radial distribution of microtubules extending from the center of the cell to the periphery was destroyed. The remaining microtubules were observed at the periphery encircling, but well removed from the proliferating parasites. The complete transformation of the parasites was monitored throughout the infection with the end result being the liberation of parasites and the near complete destruction of the microtubular framework of the host cell. A residual population of dividing spheromastigotes was observed in cells liberating trypomastigotes. Colloidal gold labeling of thin sections as seen in the electron microscope affirmed the specificity of our monoclonal antibody to all subpopulations of microtubules in T. cruzi. PMID- 3284999 TI - Ultrastructural evidence for the presence of bacteria, viral-like particles, and mycoplasma-like organisms associated with Giardia spp. AB - Giardia trophozoites and cysts, isolated from mammalian and avian hosts, were examined by transmission electron microscopy (TEM), scanning electron microscopy (SEM), and by fluorescent light microscopy for the presence of microbial symbionts. Mycoplasma-like organisms were observed on the surfaces of trophozoites isolated from the prairie vole, laboratory rat, and beaver. Intracellular bacteria were observed by TEM in the trophozoites and cysts of G. microti and by fluorescence microscopy in trophozoites and cysts of Giardia spp. isolated from beaver, muskrat, great-blue heron, and the green heron. Trophozoites of G. muris from rat small intestine contained viral-like particles measuring 60 nm in diameter. These observations suggest that biological associations between Giardia spp. and diverse microbes may be more common than formerly appreciated. It also raises the possibility of transmission of these apparent symbionts, via the Giardia cyst, to other mammalian hosts including man. PMID- 3285001 TI - Morphology of the cyst of Giardia microti by light and electron microscopy. AB - Cysts of Giardia microti, isolated from feces and intestinal contents of Microtus ochrogaster, were examined by light and electron microscopy. These cysts differed morphologically from cysts of other G. duodenalis morphological types in that these cysts often contained two apparently differentiated trophozoites with mature ventral discs. Cysts more closely resembling those reported for G. lamblia and G. muris were in greater abundance in preparations made from intestinal contents and were interpreted as immature cysts. "Multiple fission" cysts, reported in G. muris and G. microti by earlier workers, were not observed; however, endosymbiotic bacteria were found in the cysts of G. microti and may have been responsible for reports of multiple fission in the cysts of Giardia. PMID- 3285000 TI - Plasmodium falciparum glycolipid synthesis: constant and variant molecules of isolates and of strains with differing knob and cytoadherence phenotype. AB - Plasmodium falciparum-infected erythrocytes were metabolically labeled with tritiated glucosamine. Lipid extracts were analyzed by high-performance thin layer chromatography to compare labeled molecules of eleven isolates from patients, six cytoadherent in vitro strains, and two knobbed and two knobless strains from Aotus monkeys. Up to nineteen labeled bands were identified. Glycolipid GL1, previously identified in Malayan Camp, was present in all isolates and strains. Other molecules, between CG and GM1 and between GM1 and GD1a, varied in mobility or presence. There was no apparent association between labeled molecules and the presence of knobs or the property of cytoadherence. PMID- 3285002 TI - Linkage disequilibrium in natural populations of Trypanosoma cruzi (flagellate), the agent of Chagas' disease. AB - We have studied linkage disequilibrium in natural populations of Trypanosoma cruzi, the agent of Chagas' disease, by analyzing (i) a set of 524 stocks from the whole geographical range of the parasite, characterized at four gene loci coding for enzymes; (ii) a subsample of 121 stocks characterized at 12 enzyme loci; and (iii) a subset of 386 stocks from six locations in Bolivia, characterized by four enzyme loci. Our results show that the linkage disequilibrium reaches the maximum possible value, given the observed allelic frequencies, for almost all the locus pairs. This result is most consistent with the hypothesis that genetic recombination is absent or very rare in T. cruzi natural populations. Partition of the linkage disequilibrium variance for the six Bolivian populations shows that both inter- and intrapopulation components are substantial and that the relationships among the components are D2IS less than D2ST, and D'2IS less than D'2ST. These inequalities are interpreted as the result of an interplay between genetic drift, rare or absent mating, and clonal selection in generating linkage disequilibrium in T. cruzi populations. PMID- 3285003 TI - Psychiatric home care. AB - Overall, psychiatric home care fills a gap in the mental health continuum of care. This health care delivery system integrates the skill of the psychiatrist with the specialized skill, knowledge, and abilities of the psychiatric nurse. Nurses bring with them a complete armamentarium with which to effectively monitor and change dysfunctional behavior. Through teamwork, clients receive coordinated services aimed at keeping them active and functional in their most treasured and familiar environment, their home. PMID- 3285005 TI - Infarction of the omentum after cesarean section. A case report. AB - Omental infarction occurred in a woman immediately after cesarean section. This entity is difficult to diagnose, as illustrated by the course and management of this case. PMID- 3285004 TI - Estimated weight of the term fetus. Accuracy of ultrasound vs. clinical examination. AB - A prospective analysis was done of the accuracy of fetal weight estimation comparing clinical and ultrasound estimation with actual birth weight in 100 women at term. The mean error of clinical estimation was 277 g, or 79.4 g/kg, for a 7.9% error. The error of ultrasound in the same population was 286 g, or 81.7 g/kg, for an 8.2% error. Analysis of these data revealed no statistical difference between clinical estimation and ultrasound estimation of birth weight in the term fetus, even at the extremes of birth weight. PMID- 3285006 TI - Fetal urinary tract obstruction and trisomy 18 mosaicism. A case report. AB - Routine ultrasound examination has led increasingly to antepartum detection of fetal anomalies. Management decisions remain difficult, however, because information on the presence of other anomalies is frequently unobtainable. A case of fetal urinary tract obstruction, although apparently an isolated defect, proved to be associated with a lethal chromosome abnormality, trisomy 18 mosaicism. PMID- 3285007 TI - Expectant management of abdominal pregnancy. A report of two cases. AB - In two recent consecutive cases of abdominal pregnancy the diagnosis was made at 18 weeks' gestation, and the patients refused immediate surgery and elected to maintain the pregnancy until fetal viability developed. Both patients were managed expectantly with continuous antepartum hospitalization. Fetal assessment was by serial ultrasound assessment of growth and amniotic fluid volume and by nonstress testing. Planned operative delivery was accomplished at 28 1/2 weeks and 33 weeks' gestation. In the second case the diagnosis was confirmed by magnetic resonance imaging. That fetus was also assessed with umbilical artery Doppler flow studies. Despite significant morbidity, both the mothers and infants are alive and well. PMID- 3285008 TI - A family showing apparent X linked inheritance of both anencephaly and spina bifida. AB - A family is reported which includes five males, two with spina bifida, two sibs with anencephaly, and one with both high and low spinal lesions. The affected subjects came from four sibships in three generations. The mode of inheritance of these neural tube defects is consistent with X linkage. PMID- 3285009 TI - Comparison of glucose and insulin concentrations in macaque sera and plasma. AB - The glucose and insulin concentrations in blood from Macaca nigra and M. mulatta were determined after an overnight fast and 3 min after a glucose infusion. Blood treatment included clotting for serum or additions of fluoride, heparin, or heparin plus fluoride. Samples were centrifuged at 0 min or after being held at 22 degrees C for 20, 40, or 60 min. Levels of glucose and insulin generally agreed within 1 SD at all times examined for samples removed at 0 or 3 min. PMID- 3285010 TI - Statistical analysis of DNA sequences. AB - Developments in the statistical analysis of DNA sequence data since 1984 are reviewed. Mathematical methods employing dynamic programming or incorporating Markov chain theory have been developed to search sequences for regions of similarity and to align sequences. When the biological forces of mutation and genetic drift are included in models, distances between aligned sequences allow the construction of evolutionary trees. Theory based on models may lead to estimates of variation of parameter estimates and so give a means of assessing the statistical significance of observed patterns and relationships. The complexity of DNA sequences, however, suggests that most statistical inferences will rest on random permutations of sequences. PMID- 3285011 TI - H-ras p21 and the metastatic phenotype. PMID- 3285012 TI - Clonal heterogeneity, experimental metastatic ability, and p21 expression in H ras-transformed NIH 3T3 cells. AB - We examined individual clones of murine NIH 3T3 cells, transformed with the human bladder cancer (T24) H-ras oncogene, for p21 expression and for experimental metastatic ability in the immunodeficient chick embryo. We found that the clones were heterogeneous for both of these properties. In general, p21 expression was a good predictor of metastatic ability of the clones. Cells from poorly metastatic clones were passaged in the chick embryo metastasis assay to determine whether cells with increased metastatic ability could be selected. We found that the selected cells were more metastatic and that substantial increases in expression of p21 also accompanied this increase in metastatic ability. The relationship between p21 expression and metastatic ability appeared linear, with a high correlation coefficient (r = .85), suggesting that in this model system quantitative increases in metastatic properties can result from increased expression of the ras oncogene protein product p21. PMID- 3285014 TI - Flow cytometric characterization of rat thymus cells in a radiation-dominated model of combined injury. AB - Thymuses of rats that had been: a) gamma-irradiated [500 cGy whole-body radiation (R)], or b) thermally injured [20% BSA dorsal, scald burn (TI)], or c) combined injured [irradiation followed by burn (CI)] were studied for involution and recovery processes after sublethal treatments. The expression of surface antigens on thymic cells before and after injuries was evaluated using the monoclonal antibodies (mcAB) MRC OX4, MRC OX7, MRC OX8, W3/13 HLK, and W3/25 and flow cytometric analysis. Thymic cellularity decreased to less than 1% of normal (N), age-matched rats by 4 days after R or CI. Recovery reached 60% to 70% of N by 28 days post treatments. TI caused a biphasic thymic recovery pattern with nadirs of 40% of N on days 7 and 21. Recovery at day 28 was similar to that after R and CI. Expression of OX7, OX8, W3/13, and W3/25 antigens all reached nadirs of 40% of N by day 4 after R and CI. Recovery of antigen expression, except for W3/25, was near completion by day 7 after R and CI. Changes in antigen expression after TI were less pronounced for all mcAB tested. Decreases in labeling of thymocytes with the helper T-cell marker, W3/25, observed after TI, could not be correlated with elevated expressions of the suppressor/cytotoxic T-lymphocyte antigen, OX8. Variations in relative labeling of nonlymphoid thymic cells with OX4 (Ia-antigen) reflected the disappearance and recovery of radiosensitive lymphoid thymocytes. The similarity of results after R and CI demonstrate that the model of CI is 'radiation-dominated.' The addition of burn injury to radiation trauma had no synergistically damaging effect on the parameters studied. PMID- 3285013 TI - Substrate specificity of cerebral cathepsin D and high-Mr aspartic endopeptidase. AB - The specificity of action of bovine brain cortex cathepsin D (EC 3.4.23.5) and high-Mr aspartic endopeptidase (EC 3.4.23.-) was studied with the vasoactive peptides renin substrate tetradecapeptide (RSTP), substance P (SP), and angiotensins I and II, and with model peptides--Lys-Pro-Ala-Glu-Phe-Phe (NO2)-Ala Leu (I), Gly-Gly-His-Phe (NO2)-Phe-Ala-Leu-NH2 (II), and Abz-Ala-Ala-Phe-Phe-pNA (III). Cerebral aspartic peptidases show identical substrate specificity, cleaving the Leu10-Leu bond in RSTP and Phe-Phe in SP and peptide I-III, and not splitting angiotensins I and II. Because of the higher catalytic efficiency of cathepsin D (Kcat value), the specificity constants (Kcat/Km) for cathepsin D catalyzed hydrolysis of substrates 1-111 are much higher than those for the high Mr enzyme. High-Mr aspartic peptidase shares a number of properties with cathepsin D (sensitivity to pepstatin, substrate specificity, pH activity profile) and shows partial immunological identity; however, high-Mr aspartic peptidase has a specific activity 7-10 times lower than that of cathepsin D. The kinetic parameters of proteolysis of model peptides presented indicate that the high-Mr enzyme may be a complex of a single-chain cathepsin D with another polypeptide, although the possibility that it is an independent aspartic peptidase cannot be excluded. PMID- 3285015 TI - Transtracheal ventilation with oscillatory pressure for complete upper airway obstruction. AB - Another study documented that percutaneous transtracheal ventilation with a special 3.5-mm I.D. cannula was possible in experimental complete upper airway obstruction (CAO) using Ambu-assisted ventilation. The effects of ventilation during CAO by occlusion of the endotracheal tube was evaluated by use of a portable oscillatory pressure device (POPD) attached to a 10-g (I.D. 2.4 mm) angiocath catheter inserted through the tracheal wall. Eight pigs were anesthetized and ventilated with the POPD for 15 minutes after CAO with a mean peak airway pressure of 14 cm H2O and continuous positive airway pressure of 5-7 cm H2O, tidal volume below 100 ml, and a rate below 0.5 Hz. A Venturi delivered an FIO2 of 0.68-0.92. All eight showed markedly stable blood gases and cardiovascular parameters (heart rate and systemic and pulmonary arterial pressures). A similar trend was obtained in a separate group of four pigs ventilated with an Ambu bag for 30 minutes; however, the PO2 was lower. In the control group, asphyxia after CAO produced cardiorespiratory failure in every animal in less than 6 minutes. Low-frequency ventilation with a POPD for CAO ensures adequate gas exchange using a standard transtracheal catheter of only 2.4 mm I.D. PMID- 3285016 TI - Shotgun wound ballistics. AB - Shotguns are popular world wide and more of these weapons exist than the rifled types. With an increasing incidence and prevalence of gunshot wounds it is important for traumatologists to be familiar with shotgun wound ballistics. Shotgun wounds differ from those of other missiles because the spectrum of wound severity is large owing to the fact that the pellets scatter as they travel. Close-range shotgun wounds can be as destructive as those from a high-velocity rifle, but longer weapon-victim ranges may produce only minimal injury. The type of shot (size and weight of pellets) used also determines the type of injury, with more serious injuries produced by the larger type of buckshot (greater than 0.14 inches in diameter). The severity of injury from birdshot depends mainly on the "effective" weapon-victim range which can be calculated from the shot size and shot pattern either clinically or from X-ray. Wounds may then be classified according to severity, yielding information on prognosis and extent of investigation and treatment required. We propose a four-level severity scale based upon birdshot pellet scatter patterns which correlate well with morbidity and mortality rates. PMID- 3285017 TI - Ketoconazole prevents acute respiratory failure in critically ill surgical patients. AB - Effective prophylaxis against acute respiratory failure (ARDS) has not been established. This study investigated whether or not ketoconazole could prevent ARDS in critically ill surgical patients. Seventy-one Surgical Intensive Care Unit (SICU) patients without liver dysfunction received either ketoconazole (n = 35), 200 mg daily via the gastrointestinal tract, or placebo (n = 36), for 21 days or until discharge from the SICU, in a prospective, randomized, double-blind study. Patients were monitored clinically for signs of ARDS, defined as all the following: intrapulmonary shunt greater than 15%, a PaO2/FIO2 ratio less than 150, normal central venous, pulmonary capillary wedge, or left atrial pressure, no other cause of hypoxemia, and a consistent chest X-ray. Thirteen patients (18%) developed ARDS with significantly increased mortality versus non-ARDS patients (69% vs. 29%). The incidence of ARDS was decreased among ketoconazole patients compared to placebo (6% vs. 31%; p less than 0.01), as was median SICU stay (7.0 days vs. 15.5 days; p less than 0.05), and median SICU cost (+5,600. vs. +12,400.; p less than 0.05). Mortality is increased with ARDS after trauma and surgery. We conclude that ketoconazole prevents ARDS, shortens SICU stay, and lowers hospital costs. PMID- 3285018 TI - Heterotopic bone formation in burned patients. AB - Heterotopic bone formation about joints and in soft tissues is known to cause joint immobilization and permanent physical impairment in burned patients. Despite aggressive physical therapy aimed at prevention, heterotopic bone formation still occurs in a small percentage of patients. Prolonged immobilization in concert with trauma or burn about the involved joint is recognized as being responsible for this heterotopic bone formation. Specifically, immobilization of extremities, particularly the elbow and upper extremity, should be minimized by early grafting for preservation of function. As burn therapy has enabled increasing numbers of patients to survive extensive burns, it is imperative that preservation of function not be ignored and that attention be directed at improved function early in the postburn course. PMID- 3285020 TI - Transvaginal longitudinal ultrasonography in diagnosis of carcinoma of the urinary bladder. AB - In order to determine the staging of urinary bladder tumors accurately, it is very important to choose a suitable method of treatment and to reach the correct prognosis. In 1974, Watanabe and Holm performed the first transurethral and transrectal ultrasonography. They obtained sonograms of the involved bladder wall by radial scanning using a rotation transducer. The only weak point of this method is the difficulty of staging tumors in the apex, the neck, and the fundus of the bladder by transverse scanning. In 1982, Sekine et al repeated the results of testing a new transrectal transducer for electronic linear scanning in a urologic clinic. However, to our knowledge, no description of the transvaginal technique for routine vesical ultrasonography has appeared in the English-written literature. The purpose of this study is to visualize bladder tumors by longitudinal transvaginal scanning and to evaluate the new method for the staging of urinary bladder tumors. PMID- 3285021 TI - Factors affecting prenatal sonographic estimation of weight in extremely low birthweight infants. AB - Because critical management decisions are based on sonographic estimation of fetal weight in fetuses less than 1000 g, we sought to evaluate the accuracy of birthweight prediction in this range and to identify factors affecting this accuracy. Fetal weight was estimated using several published methods in 53 fetuses with birthweights less than 1000 g. Standard deviations greater than 12.3% indicate more random error in the sonographic weight prediction than has been reported in higher weight groups. No statistically significant differences were found between patient groups with decreased, normal, or increased amniotic fluid volume or portable examination. There was a trend toward lower mean deviation (2.9 vs 6.0%) and standard deviation (8.9 vs. 15.0%) in studies with scan quality judged "good" compared with "poor" based on ability to visualize anatomic landmarks. PMID- 3285022 TI - Hepatic morphotypes. Their statistical individualization using ultrasonography. AB - The shape, topography, and vascular disposition of the liver depend on a subject's morphotype. The definition and classification of morphotypes was previously based on cadaver observation. In this study, 74 healthy adults (42 women, 32 males) were assessed using ultrasonographic parameters (hepatic diameters, xiphoid angle, orientation of the inferior face of the liver). The results were analyzed by discriminant analysis to differentiate the morphotypes. The three groups known by anatomists as breviligne (endomorphic), longiligne (ectomorphic), and normotype were again demonstrated and individualized in a significant manner. However, with the exception of the normotype group, fundamental differences were observed between our results and those of the anatomists. Ultrasonographic assessment shows that in the breviligne, the liver occupies the right hypochondrium and extends only slightly to the left of the midline; in the longiligne it extends into the left hypochondrium. PMID- 3285023 TI - Nomograms for ultrasound visualization of fetal organs. AB - Although there is extensive literature regarding ultrasonic biometric evaluation of the fetus, our goal is to establish nomograms for the visualization of fetal organs, as they have not previously been reported. Data from the first complete ultrasound examination of 2,389 consecutive gravidas at greater than or equal to 14 weeks gestation were analyzed. The examinations were performed by three registered sonographers during a 20-month period. Fetal cerebral ventricles, heart, stomach, kidneys, intestines, bladder, diaphragm, spinal column, extremities, and umbilical cord were examined routinely and classified as normal, abnormal, or suboptimally visualized. Ultrasound visualization of these organs varied with gestational age (P less than 0.0001) and patterns of visualization varied markedly by organ. These nomograms could be useful in the timing of ultrasound examinations, the timing and method of delivery, detection of anomalies amenable to in utero therapy, parental counseling, quality assurance programs, and medicolegal liability defense. PMID- 3285024 TI - Maternal urinary bladder filling for middle and late trimester ultrasound. Is it really necessary? AB - A retrospective study was conducted to determine if there was a correlation between maternal urinary bladder filling and the ability to obtain fetal measurements. The ultrasonographic examinations of 400 randomly selected second and third trimester patients were evaluated. The patients examined either had a full bladder or an empty bladder. Although all patients were considered to have adequate examinations, 91.5% of those with a full bladder and 93% of those with an empty bladder had complete (four parameter) biometric evaluations. No statistical correlation was found between maternal bladder size and the ability to obtain fetal measurements. PMID- 3285019 TI - Bullet embolus to the right hepatic vein after a gunshot wound to the heart and its percutaneous retrieval. AB - Bullet emboli are rare and their management when in the venous circulation is controversial. A 26-year-old female with a gunshot wound to the heart, followed by embolization of the bullet to the right hepatic vein, had successful percutaneous retrieval of the bullet via a catheter inserted through the right femoral vein. PMID- 3285025 TI - Sonographic diagnosis of placenta accreta. Presentation of six cases. AB - Placenta accreta is a rare complication of pregnancy that risks the life of pregnant women. We report six cases, five of which had ultrasound examination performed before delivery, and one whose diagnosis was made retrospectively. PMID- 3285026 TI - Chest wall hamartoma in a fetus. PMID- 3285028 TI - Tenosynovitis of the wrist. A sonographic demonstration. PMID- 3285027 TI - Antenatal diagnosis of meconium peritonitis with inguinal hernias by ultrasonography. Therapeutic implications. PMID- 3285029 TI - Transitory bilateral isolated fetal pleural effusions. PMID- 3285030 TI - Antenatal demonstration of axillary cystic hygroma. PMID- 3285031 TI - Fetal heart rate (FHR) is not an indicator of the baby's sex. PMID- 3285034 TI - Carotid endarterectomy--a crisis in confidence. PMID- 3285035 TI - Surgical treatment of carotid paragangliomas presenting unusual technical difficulties. The value of preoperative embolization. AB - Although the application of reconstructive vascular surgical procedures to the treatment of carotid paragangliomas has made their resection the method of choice and has produced excellent cure rates, it has not obviated some of the technical problems presented by excessively vascular, adherent, or bulky lesions. Our experience with preoperative trans-catheter embolization for the reduction of the vascularity in six cases of this group of lesions is presented and the conclusion is made that preoperative embolization greatly reduced operative technical difficulties. PMID- 3285032 TI - Inoculation of baboons and macaques with simian immunodeficiency virus/Mne, a primate lentivirus closely related to human immunodeficiency virus type 2. AB - A primate lymphotropic lentivirus was isolated on the human T-cell line HuT 78 after cocultivation of a lymph node from a pig-tailed macaque (Macaca nemestrina) that had died with malignant lymphoma. This isolate, originally designated M. nemestrina immunodeficiency virus (MnIV) and now classified as simian immunodeficiency virus (SIV/Mne), was inoculated intravenously into three juvenile rhesus monkeys (Macaca mulatta), three juvenile pig-tailed macaques (M. nemestrina), and two juvenile baboons (Papio cynocephalus). All six macaques became viremic by 3 weeks after inoculation, whereas neither of the baboons developed viremia. One pig-tailed macaque died at 15 weeks with suppurative peritonitis secondary to ulcerative, necrotizing colitis. Immunologic abnormalities included a marked decrease in CD4+ peripheral blood lymphocytes. Although five macaques mounted an antibody response to SIV/Mne, the animal that died at 15 weeks remained antibody negative. Three other macaques (two rhesus and one pig-tailed) died 66 to 87 weeks after inoculation after exhibiting progressive weight loss, anemia, and diarrhea. Histopathologic findings at necropsy included various manifestations of immune deficiency, nephropathy, subacute encephalitis, pancreatitis, adenocarcinoma, and lymphoid atrophy. SIV/Mne could be readily isolated from the spleens and lymph nodes of all necropsied macaques, and from the cerebrospinal fluid, brains, bone marrow, livers, and pancreas of some of the animals. SIV antigens were localized by avidin-biotin immunohistochemistry to pancreatic islet cells and to bone marrow endothelial cells. The data suggest that African baboons may be resistant to infection by SIV/Mne, whereas Asian macaques are susceptible to infection with this pathogenic primate lentivirus. PMID- 3285033 TI - Distribution of a macaque immunosuppressive type D retrovirus in neural, lymphoid, and salivary tissues. AB - Simian acquired immune deficiency syndrome (SAIDS) in rhesus macaques (Macaca mulatta) at the California Primate Research Center is caused by a type D retrovirus designated SAIDS retrovirus serotype 1 (SRV-1). This syndrome is characterized by profound immunosuppression and death associated with opportunistic infections. Neurologic signs and lesions have not been described as part of this syndrome. The distribution of SRV-1 in the salivary glands, lymph nodes, spleens, thymuses, and brains of eight virus-infected rhesus macaques was examined by immunohistochemistry. Electron microscopy, in situ RNA hybridization, and Southern blot hybridization were also performed on selected tissues to detect viral particles, RNA, and DNA, respectively. In seven of eight SRV-1-infected animals, the transmembrane envelope glycoprotein (gp20) of SRV-1 was present in three or more tissues, but never in the brain. In the remaining animal, no viral antigen was detected in any tissue. In this same group of animals, viral nucleic acid was detected in the lymph nodes of six of six animals by Southern blot hybridization, in the salivary glands of two of five animals by both Southern blot and in situ hybridizations, and, surprisingly, in the brains of three of three animals by Southern blot and of three of five animals by in situ hybridization, including the one animal in which viral gp20 was undetectable. None of these animals had neurologic signs or lesions. The detection of viral nucleic acid in the absence of viral antigen in the brain suggests latent SRV-1 infection of the central nervous system. PMID- 3285036 TI - Progress in the diagnosis of deep venous thrombosis: the efficacy of real-time B mode ultrasonic imaging. AB - Seventy-six limbs with clinically suspected acute deep venous thrombosis (DVT) were evaluated by means of ultrasonic imaging (UI) to define the ability of this technique to detect acute and chronic venous obstruction and to determine the origin and distribution of venous thrombi. UI was compared with ascending contrast phlebography in 46 limbs and was found to be 100% accurate in detecting both acute and chronic venous thrombosis. Overall, acute DVT was present in 63 of 76 limbs (83%) studied. Acute DVT was found in 24% and recurrent acute DVT in 76%. Our results indicate that although the calf veins are the most common site of involvement (89%), thrombi may frequently arise simultaneously in multiple anatomic sites. All limbs with recurrent acute DVT had evidence of previous calf thrombi but only 13% had previous proximal disease. This suggests that asymptomatic calf DVT is common and the prevalence of recurrent acute DVT is significantly greater than previously believed. We found UI is a practical, accurate, non-invasive method for investigating the pathogenesis of venous disease. PMID- 3285037 TI - The effect of distal arterial anatomy on the success of popliteal aneurysm repair. AB - The success of bypass grafting for popliteal aneurysms may be compromised by the natural history of these lesions. During a 9-year period 35 patients had repair of 48 popliteal aneurysms. Elective repair was performed in 26 limbs and the remaining 22 limbs required urgent or emergent treatment after aneurysm thrombosis (16) or embolic digital ischemia (six). Retrospective review of preoperative and intraoperative arteriograms and CT or ultrasound scans was done to define the relationship of distal runoff anatomy to initial symptoms and long term grafting success during a mean follow-up of 48 months. Only five of 48 limbs (10%) had three continuous tibial vessels and a patent pedal arch. Twenty-six limbs (55%) had one or no named calf vessels and 11 limbs had incomplete pedal arches. When thrombosis or symptomatic embolism occurred, the anatomy was significantly worse; 15 of 22 such limbs (68%) had one or no patent tibial vessels and seven had incomplete pedal arches. Nineteen of 28 aneurysms examined by CT or ultrasound scanning showed intraluminal thrombus. Eight of 13 patent aneurysms with intraluminal thrombus had one or no patent tibial vessels. The 5 year graft patency rate was 74% for the entire study group. Bypass for repair of asymptomatic aneurysms had a patency rate of 91% at 5 years vs 54% for symptomatic patients (p less than 0.05). Patients with popliteal aneurysms often have advanced tibial disease that appears worse in those with symptoms. The occurrence of a patent popliteal aneurysm with intraluminal thrombus and advanced runoff disease suggests that chronic microembolism may be an etiologic factor in the tibial disease observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285038 TI - Thoracic vascular trauma. PMID- 3285039 TI - Validation of screening tools for identifying hearing-impaired elderly in primary care. AB - Two instruments for the detection of hearing impairment, the Welch-Allyn audioscope (Welch-Allyn Inc, Skaneateles Falls, NY) and the Hearing Handicap Inventory for the Elderly--Screening Version (HHIE-S), were validated against pure tone audiometry in 178 patients over 65 years old screened in primary care practice. The prevalence of hearing impairment in this sample was 30%. The audioscope yielded reproducible results in the physicians' offices and a hearing center. The sensitivity of the audioscope was 94% in both locations, while its specificity was 90% in the hearing center and 72% in the physicians' offices. The HHIE-S yielded reproducible results between the two test locations. An HHIE-S score from 0 to 8 resulted in a likelihood ratio of 0.36 (95% confidence interval, 0.19 to 0.68), and a score of 26 or more yielded a likelihood ratio of 12.00 (95% confidence interval, 2.62 to 55.00) for predicting the presence of hearing impairment. Used together, the two instruments had a test accuracy of 83%. The audioscope and HHIE-S are valid, reliable, inexpensive tools for detecting hearing impairment in the elderly. PMID- 3285040 TI - Antitrypsin and emphysema. Perspective and prospects. PMID- 3285041 TI - Fetal heart rate response to maternal exertion. AB - Doppler monitoring of fetal heart rates during maternal exertion has suggested that fetal bradycardia occurs frequently during vigorous exercise, causing concern for fetal safety. Doppler determination of fetal heart rate during vigorous maternal effort is difficult. To avoid motion artifact, we observed fetal heart rate using two-dimensional ultrasound and determined the incidence of fetal bradycardia in 45 pregnant women (age, 29.0 +/- 3.7 years [mean +/- SD]; gestational age, 25.2 +/- 3.0 weeks) during 85 submaximal and 79 maximal cycle ergometer tests. Average fetal heart rate did not change during exercise. A single episode of fetal bradycardia (heart rate less than 110 beats per minute for greater than or equal to 10 s) occurred during submaximal exertion during a maternal vasovagal episode. Sixteen episodes of fetal bradycardia were noted within three minutes after cessation of exercise, 15 of which followed maximal maternal effort. We conclude that brief submaximal maternal exercise up to approximately 70% of maximal aerobic power (maternal heart rate less than or equal to 148 beats per minute) does not affect fetal heart rate. In contrast to submaximal maternal exertion, maximal exertion is commonly followed by fetal bradycardia. This may indicate inadequate fetal gas exchange. PMID- 3285042 TI - The transmission of AIDS: the case of the infected cell. PMID- 3285043 TI - National Bone Marrow Donor Registry to begin recruiting in general population this summer. PMID- 3285044 TI - Raymond marrow registry is privately funded. PMID- 3285045 TI - Ivermectin for the treatment of Wuchereria bancrofti filariasis. Efficacy and adverse reactions. AB - Ivermectin treatment was evaluated for efficacy and side effects in 40 patients in South India who had microfilaremia and bancroftian filariasis. Ivermectin was administered once orally at four dose levels (range, 25 to 200 micrograms/kg), and at each it was found to be completely effective in clearing blood microfilariae within five to 12 days. In most patients, microfilariae reappeared by three months; by six months the levels averaged 14% to 32% of pretreatment values in the four study groups, and all groups showed equivalent efficacy. Detailed monitoring identified some side effects in almost all patients: usually fever, headache, light-headedness, myalgia, sore throat, or cough that occurred most prominently 18 to 36 hours after treatment. These were most frequent and severe in patients with the greatest microfilaremia, but only when treated with the two higher doses of ivermectin (100 and 200 micrograms/kg). The low-dose (25 micrograms/kg) ivermectin group, despite equivalent efficacy in parasite killing, had clinical reaction scores that were minimal and that were not correlated with parasitemia. Since efficacy and side effects of ivermectin therapy compare favorably with those reported for treatment with the standard antifilarial drug diethylcarbamazine citrate, the major advantage of single-oral-dose administration makes ivermectin the best candidate to replace diethylcarbamazine as the treatment of choice for bancroftian filariasis. PMID- 3285046 TI - Treatment of steroid-resistant acute graft-vs-host disease by in vivo administration of an anti-T-cell ricin A chain immunotoxin. AB - The A chain of the toxin ricin has been conjugated by a disulfide bond to a murine monoclonal antibody that recognizes the CD5 (T,p67) antigen present on 95% of peripheral blood T lymphocytes. This immunotoxin was used to treat a patient with severe grade III-IV, steroid-resistant, acute graft-vs-host disease (GvHD) after an allogeneic, human leukocyte antigen-identical bone marrow transplant for acute myelogenous leukemia. Immunotoxin therapy produced a complete clinical response in the skin and gastrointestinal tract. The patient tolerated a 14-day course without symptoms or signs of toxic effects. After two days of therapy, circulating T cells could not be demonstrated by indirect immunofluorescence. After therapy, acute GvHD did not recur. However, seven months after therapy the patient demonstrated mild signs of chronic GvHD that were easily controlled with low-dose immunosuppressive therapy. These findings indicate that an anti-T-cell ricin A chain immunotoxin can be given safely for treatment of acute GvHD and may be an effective therapy for this significant posttransplant complication. PMID- 3285048 TI - A student becomes a surgeon: 1932. PMID- 3285047 TI - Science, ethics, and the making of clinical decisions. Implications for risk factor intervention. AB - Recent improvements in the clinical care of individual patients are rooted in advances in two distinct fields of modern medicine: biomedical research and clinical ethics. In this article, we review the differing roles of these two disciplines in guiding decision making for individual patients. Particular attention is placed on decisions involving risk factor intervention, using the common problem of mild hypertension as an illustration. Both the importance and the limitations for decision making of some recently published clinical trials are reviewed. Differences in interpretation of these trials are a source of major disputes about the proper threshold for medical intervention. The ethical aspects of treatment decisions are then reviewed, with particular emphasis on the doctrine of informed consent and on the role of patient participation in treatment decisions. Finally, new directions for clinical research are suggested that may yield a more complete scientific basis for treatment decisions and that may aid in fulfilling the ethical ideals that underlie the physician-patient relationship. PMID- 3285049 TI - National initiatives for care of the medically needy. PMID- 3285051 TI - [Risk and prevention of infections in clinical laboratories. In the field of clinical bacteriology]. PMID- 3285050 TI - [Spinal anesthesia with isobaric or hyperbaric 0.5% bupivacaine solution]. PMID- 3285052 TI - [Human cancer and oncogene--application to clinical diagnosis]. PMID- 3285053 TI - [Recent progress in oncogene research]. PMID- 3285054 TI - [Cronkhite-Canada syndrome associated with rectal cancer]. PMID- 3285055 TI - [Imaging of liver and spleen candidiasis in patients with acute leukemia]. PMID- 3285056 TI - [Radiation therapy of paraaortic lymph nodes in carcinoma of the uterine cervix. II. Complications--retrospective review of 86 patients based on a survey of Kansai Cancer Therapist Group]. PMID- 3285057 TI - [Sonographic diagnosis of hypertrophic pyloric stenosis]. PMID- 3285059 TI - [Occlusion of the left innominate vein: report of a case]. PMID- 3285058 TI - [Ultrasonographic study of splenic mass lesions]. PMID- 3285060 TI - [A case report of pulmonary varix in childhood]. PMID- 3285061 TI - [Sonographic analysis of the diaphragmatic echo]. PMID- 3285064 TI - Effect of captopril treatment on proteinuria in NZB/NZW F1 hybrid mice. AB - Oral treatment of female NZB/NZW F1 hybrid mice with captopril prevented the development of proteinuria and prolonged survival in mice demonstrating slight (trace to 1+) proteinuria. Captopril treatment also markedly reduced the incidence and magnitude of proteinuria and prevented death in mice showing significant (3+ or greater) proteinuria. Histopathological studies of the kidneys of treated mice further demonstrated improvements in the renal lesions of autoimmune mice. The mechanisms whereby captopril treatment influences the course of disease in NZB/NZW mice are not known. PMID- 3285062 TI - Monoclonal gammopathies in patients with Sjogren's syndrome. AB - We studied 18 sera of Sjogren's syndrome (SS) with monoclonal gammopathy. Monoclonality was established by typical immunoelectrophoretic findings in all patients and confirmed by idiotypic (Id) studies in 12 patients. Four of the monoclonal gammopathies were of the IgG class, 8 were of the IgA class and 4 were of the IgM class, and 2 patients had 2 M proteins (IgMK/IgGK and IgAK/IgGK). The monoclonal rheumatoid factor (RF) was found in 6 patients (4 IgA and 2 IgM). A review of the literature revealed additional 19 monoclonal gammopathies (2 IgG, 9 IgA, 7 IgM and one Bence Jones protein) in Japanese SS patients. In non-Japanese SS patients, 27 monoclonal gammopathies (4 IgG, 2 IgA, 20 IgM and once Bence Jones protein) were reported. Both Japanese and non-Japanese patients showed a higher incidence of monoclonal gammopathies in primary than in secondary SS. The non-IgM class monoclonal gammopathies were predominant in Japanese SS patients, whereas monoclonal gammopathies were mostly confined to the IgM class in non Japanese SS patients. These results indicate that monoclonal gammopathy is another significant complication of SS. PMID- 3285063 TI - Postpartum toxic shock syndrome: a report of a case. AB - We describe a case of a 29-year-old Japanese woman with toxic shock syndrome which occurred 6 days after a normal vaginal delivery. This is the second case of postpartum toxic shock syndrome in Japan, so far as we know. Staphylococcus aureus was isolated from the uterine cavity. The isolate was coagulase type II and it produced both enterotoxin C and toxic shock syndrome toxin-1. The clinical course and laboratory data for this patient were in conformance with previously reported typical postpartum toxic shock syndrome, except for the onset time after delivery, because the previously reported postpartum TSS cases were clearly divided into two groups, early onset within 3 days of delivery and late onset 2 or more weeks after delivery. PMID- 3285065 TI - Uterine leiomyoma: problems during pregnancy. PMID- 3285066 TI - The University of Kentucky College of Dentistry: a silver anniversary portrait. PMID- 3285067 TI - Provisional repair of a fractured abutment cusp associated with an inlay supported fixed partial denture. PMID- 3285069 TI - Extracorporeal techniques in the treatment of exogenous intoxications. PMID- 3285068 TI - Induction, prevention and mechanisms of contrast media-induced acute renal failure. AB - This study describes the development of an experimental model of reversible acute renal failure following infusion of contrast media radiographic dye. Experiments were also performed to investigate possible methods of prevention as well as examine single nephron mechanisms involved in the pathogenesis of the renal failure. Acute renal failure was consistently produced by indomethacin treatment (18 mg/kg) and an intravenous infusion of contrast media (7 ml/kg) into New Zealand rabbits that had been on a low sodium diet for one week. Glomerular filtration rate (GFR), measured by daily creatinine clearance in unanesthetized animals, was significantly decreased (P less than 0.001) 24, 48, and 72 hours following infusion of the contrast dye. Two weeks after induction of acute renal failure, GFR had returned to control. GFR was unchanged during the same time period when the sodium deprived rabbits were given either indomethacin or contrast media alone. Chronic administration of DOCA (1 mg/kg s.c.) and saline drinking water which increased sodium and solute excretions and decreased plasma renin activity also prevented the decrease in GFR. However, acute infusion of either saline or mannitol, which transiently increased sodium and solute excretions and decreased plasma renin activity, did not protect against the development of acute renal failure. Light microscopy revealed no glomerular or tubular changes and no visible obstruction. Micropuncture experiments were performed on three additional groups of anesthetized rabbits: control, acute renal failure, and recovery. Recovery rabbits were allowed a two week period after renal failure before they were micropunctured.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285070 TI - [Local prevention of suppuration of surgical wounds]. PMID- 3285071 TI - [Effect of suture technic and type of suture material on wound healing]. PMID- 3285072 TI - [Hermetization of gastric and intestinal sutures using preserved dura mater]. PMID- 3285074 TI - [Irrigation treatment of the abdominal cavity in diffuse suppurative peritonitis]. PMID- 3285073 TI - [Treatment of suppurative wounds using the CO2 laser]. PMID- 3285075 TI - [Spontaneous pneumoperitoneum]. PMID- 3285076 TI - [Electromagnetic low-intensity irradiation of the millimeter range and its use in medicine and biology]. PMID- 3285077 TI - [Use of magnetic fluids in clinical medicine]. PMID- 3285078 TI - [Current problems of ultraviolet irradiation of the blood]. PMID- 3285079 TI - [Extensive resections of the small intestine]. PMID- 3285080 TI - [Primary cancer of the resected stomach and its problems]. PMID- 3285082 TI - [Our experience with the use of a mechanical suturing device in gastrectomies over a 7-year period]. PMID- 3285081 TI - [Immunology of malignant neoplasms of the urogenital system]. PMID- 3285083 TI - [Percutaneous drainage under echographic and x-ray control in suppurative cholecystitis and liver and subphrenic abscesses]. PMID- 3285084 TI - [Modified 2-stage suture in colorectal anastomoses]. PMID- 3285086 TI - Juvenile type of chronic myeloid leukaemia in a four year old boy. AB - Chronic myeloid leukaemia (CML) is a rare disease in children. Three varieties of CML occur in childhood. Juvenile (Infantile), adult and familial types, each with distinct clinical and laboratory findings. Prognosis of all these types of CML in childhood is uniformly bad. The mean survival of a juvenile CML is 9 months and that of adult variety is 2.5 years. The adult form of childhood CML responds to therapy, but the patient succumbs to the disease during the blast crisis. Various modalities of treatments are being tried in the juvenile CML without any beneficial effect. We report a case of juvenile CML with characteristic findings in a four year old boy. PMID- 3285085 TI - [High-dose chemotherapy: principles, indications and complications]. AB - Cure rates of children and adolescents with malignant diseases have improved since the introduction of systemic chemotherapy in cooperative trials in the recent 10 to 15 years. Tumors resistant to conventional doses have responded to high dose regimens. The rationale for the use of high dose regimens is discussed as well as adequate methods of protecting against severe and often lifethreatening complications. PMID- 3285087 TI - [Late results following partial and total colectomy in infancy]. AB - 26 children were investigated on an average 11.5 years after partial (n = 13) and total (n = 13) colonic resection. Total colectomy was followed by an increased frequency of gastrointestinal symptoms such as recurrent abdominal pain, flatulence, attacks of diarrhoea, frequent and pasty or liquid stools with strange smell. An increased salt or fluid intake was observed in one half of these patients. Their height and bone age was slightly but significantly reduced. Laboratory investigations revealed no significant deficiencies of electrolyts, vitamins or trace elements. However Renin (mean and 2s-range = 5.2; 2.7-6.8 ng/ml.h, normal values (NV) 1.3; 0.5-4.0 ng/ml.h, p less than 0.02), aldosterone (242.1; 168.4-357.8 pg/ml, NV 78.9; 39.4-168.4 pg/ml, *p less than 0.02), conjugated bile acids (11.3; 5.2-20.0 mumol/1, NV 4.2; 1.5-7.0 mumol/1, p less than 0.01) and serum urea concentration (32.5; 20.8-48.7 mg/dl, NV 14.6; 6.0-22.5 mg/dl, p less than 0.01) were significantly elevated. Three postprandial plasma levels of gastrin, VIP and neurotensin were within normal limits. In patients with partial large bowel resection all signs were less pronounced. According to our results a special diet in children years after colectomy seems not to be required. PMID- 3285088 TI - [Use of the Broviac/Hickman catheter in pediatric oncology]. AB - This retrospective study reports data from 28 children with malignancy aged from 4 months to 15 years to whom 32 Broviac/Hickman indwelling central venous catheters were inserted. Catheter placement ranged from 36 to 381 days with a median of 177 days; thus a cumulative period of more than 12 patients' years could be analyzed. The patients were not continuously hospitalized but spent a median of 44% of their time as catheter-patients at home. The maintenance of the catheter was performed by the parents in an uniformed regimen daily. We registered a total of 22 manageable complications - corresponding to one complication per 202 implantation days. No patient suffered sequelae from the Broviac/Hickman-catheter. Occlusion (12 times) was the most common mechanical complication but patency could be resolved in all cases by installing streptokinase. Four dislocations demanded reimplantation of the catheter. One leak of the external segment was repaired using the commercial repair kit. There were 62 febrile episodes in 22 of 28 patients with simultaneously profound neutropenia in 45% of the febrile episodes. Blood cultures were positive in 11 patients and in 5 of these a catheter-related bacteremia persisted during antibiotic treatment thus requiring catheter explantation. At the end of therapy 40% of the catheters could be removed by manual pull, the rest required surgical explantation. These results demonstrate that with strict maintenance the implantation of a Broviac-Hickman-catheter is associated with an acceptable complication rate even in immunocompromized patients. PMID- 3285089 TI - [Reference values of beta 2 microglobulin concentrations in the serum of children]. AB - Concentrations of beta 2-microglobulin were determined using a competitive enzyme immunoassay in blood serum of 271 "healthy" children (male = 156, female = 115). The concentration of beta 2-microglobulin in children is age dependent. The values of the newborn 2.84-3.38 mg/l (95% confidence interval) decrease till the first year and stabilize later on between 1.48-1.56 mg/l (95% confidence interval). PMID- 3285090 TI - [Giant lymph nodes in combined autoimmune neutro- and thrombocytopenia]. AB - A boy aged 15 years is described in whom a combined autoimmune neutro- and thrombocytopenia developed since the age of 11. Cell-membrane bound IgG antibodies were detected on neutrophils and platelets. A therapy with prednisone and/or immunoglobulins showed only a transient normalization of the peripheral blood values. In the course of this disease a lymph node adenopathy occurred showing histologically follicle hyperplasia with multiple plasma cells and relative atrophy of the paracortical T-cell region. PMID- 3285091 TI - [Spinal sonography of a newborn infant with postpartal paraplegia]. AB - Cranial ultrasonography is a well established diagnostic procedure. In contrast ultrasonography of the spine and the spinal cord is less frequently used. It is indicated in infants with spinal dysraphism and may help to diagnose patients with meningomyelocele, spinal lipoma or cord tethering. We present a newborn with parplectic symptoms as a result of an epidural hematoma, which could be demonstrated exclusively by ultrasonography. We want to stress that spinal ultrasonography is a method of high clinical value. PMID- 3285093 TI - [Clinical significance of vitamin B1, B6, B12 in pain therapy. Results of a scientific meeting of experts 5-7 November 1987 in Pommersfelden]. PMID- 3285092 TI - [The development of pharmacogenetics--a retrospective on the 75th birthday of Hans Herken]. PMID- 3285094 TI - Multidrug chemotherapy of tuberculosis in rhesus monkeys. AB - Occurrence of tuberculosis caused by Mycobacterium bovis in a colony of rhesus monkeys allowed evaluation of a modern multidrug therapeutic regimen. Fifteen tuberculin positive rhesus monkeys with disseminated tuberculosis were evaluated for extent of disease by radiographic techniques, physical examination and laparotomy prior to treatment. Monkeys were divided into treatment groups of 3, 6 and 12 months duration and were treated once daily with isoniazid, rifampin and ethambutol. All animals survived their treatment course, had marked clinical improvement and rapid resolution of radiographically demonstrable lesions. Lesion regression evaluated by necropsy and histopathology correlated positively with length of treatment interval. Mycobacterium bovis was not isolated from any animal following treatment. Multidrug chemotherapy of tuberculosis was considered successful and practical in rhesus monkeys at the 12 month treatment interval. Chemotherapy may provide a reasonable alternative to destruction of valuable animals infected with tuberculosis. PMID- 3285095 TI - Campylobacter-like omega intracellular antigen in proliferative colitis of ferrets. AB - Proliferative colitis in the ferret consistently displays, along with marked proliferation of mucosal cells, intracytoplasmic campylobacter-like organisms within the apical portion of the epithelial cells. Fluorescent antibody to "omega" campylobacter antigen present in porcine intestinal adenomatosis and hamster proliferative ileitis was demonstrated at the site of bacterial colonization within hyperplastic epithelial cells of six colons from ferrets affected with proliferative colitis. PMID- 3285096 TI - Transgenic mice--a gold mine for furthering knowledge in pathobiology. PMID- 3285097 TI - Phenotype of thymic stromal cells. An immunoelectron microscopic study with anti IA, anti-MAC-1, and anti-MAC-2 antibodies. AB - To better comprehend the thymic microenvironment, it is necessary to identify the antigenic profile of cells forming the thymic reticulum which are involved in intrathymic T cell differentiation. These cells are of three types: epithelial cells, macrophages, and interdigitating cells (IDC). Although several studies have been done on thymus section in light microscopy, identification of the positive cells, and mainly the antigenic equipment of the macrophages and IDC has not been clearly analyzed. Morphology, in electron microscopy is so far the best method to identify the different types of cells, and immunoelectron microscopy on thymic sections may be the best method to define clearly stromal cell phenotypes. In the present paper, we analyzed two antigens which classically define the macrophage family, Mac-1 and Mac-2, as well as major histocompatibility complex class II antigen which is present on epithelial cells and on bone marrow derived stromal cells. We show that epithelial cells are Ia+ Mac-1-, Mac-2-; macrophages are all Mac-1+, Mac-2+ but only half are Ia+; IDC are Ia+, Mac-1+, Mac-2+. These results show that IDC and macrophages both express antigens which were originally described as macrophage-specific. PMID- 3285098 TI - Monoclonal antibodies against laminin A chain and B chain in the human and mouse kidneys. AB - Three monoclonal antibodies against laminin A and B chains derived from mouse EHS sarcoma were isolated and designated Lam 1, Lam 2, and Lam 3. Lam 1 recognized laminin A and B chains, whereas Lam 2 and Lam 3 reacted with only A chain. By using the immunofluorescence method, three monoclonal antibodies equally stained the human skin basement membrane and Descemet's membrane of cornea. In the kidney, however, these monoclonal antibodies showed the different distribution; Lam 1 stained the glomerular basement membrane, the mesangium, Bowman's capsule, and the tubular basement membrane in the mouse kidney. In the human kidney, Lam 1 stained the mesangium very slightly bud did not stain the glomerular basement membrane. Both Lam 2 and Lam 3 stained the mesangium, Bowman's capsule, and proximal tubular basement membrane in the mouse kidney. In the human kidney, however, Lam 2 stained the mesangium and slightly stained the glomerular basement membrane, although Lam 3 stained only the mesangium. Oxidation of the kidney sections by sodium periodate changed the staining pattern of Lam 2 and Lam 3 in the human kidney, whereas it did not change the staining pattern of Lam 2 and Lam 3 in the mouse kidney. PMID- 3285099 TI - Blood group ABO-related antigens in fetal and normal adult bladder urothelium. Immunohistochemical study of type 2 chain structures with a panel of mouse monoclonal antibodies. AB - Seven monoclonal antibodies with specificity for blood group antigens carried by type 2 chain core structures (N-acetyllactosamine, H, Le(x), LeY, A monofucosylated, A difucosylated (AleY), A type 3) were used to study the distribution of these antigens in normal human bladder urothelium. The urothelial samples were from 7 fetuses (aged 7 to 21 weeks), and 22 adults. By means of an immunohistochemical method applied to frozen and fixed tissues, localization of antigens in the 3 cell layers of urothelium was compared with individual ABO, Lewis, and Secretor type. During fetal development, N-acetyllactosamine, H, and LeY antigens were continuously expressed, whereas Le(x) varied with age. The A type 3 chain was present in fetal urothelium but A type 2 chain was not. In adults, we observed a unique blood group distribution: with complex antigens like LeY and ALeY in all cell layers, and a unique expression of most of the less complex antigens in the luminal cell layer. Pretreatment of tissue sections with neuraminidase proved that Le(x) and N-acetyllactosamine could be partly substituted by sialic acid A type 3 chain and most of N-acetyllactosamine antigens were present only in cytoplasm, whereas all other examined antigens could be present both in cytoplasm and on cell membranes. Blood group A antigen expression was related to erythrocyte A1 and A2 subtype, and a remarkable correlation was found between type 1 chain related secretor status and expression of Le(x), LeY, and A antigens. PMID- 3285100 TI - Automated contrast fluorometry. I. Lymphocytotoxicity testing. AB - Automated contrast fluorometry has been carried out in lymphocytotoxicity testing using a computer-controlled microscope and direct comparison of the data with controls. The method uses heparinized lymphocytes and permits simultaneous evaluation of both fluorescein and ethidium bromide fluorescence by calculating the quotient between the green/red measurements. After comparison of the quotient with that of control samples, the raw data are automatically transformed into cytotoxicity scores. Fast and reliable measurements with minimum background fluorescence can be obtained for up to 24 hours after performance of the assay by controlling complement reactivity and the exposure time of the cells to the fluorescein. The evaluation of 15,204 cytotoxic reactions showed excellent correlation between the automated and visual results of 125 tissue typings using 120 different antibodies and of 17 HLA antibody titers using case-by-case analysis of variance. The values for the automated cytotoxicity readings were slightly higher and showed more intermediate scores than those of the visual readings suggesting a high sensitivity and objectivity of the automated system. In conclusion, this is a methods paper comparing parallel lymphocytotoxicity testing using automated and manual methods. The automated method was found to be more sensitive and faster than the manual method. PMID- 3285101 TI - Twelve steps in developing a schoolsite health education/promotion program for faculty and staff. AB - A comprehensive school health program should not be limited to improving the health of children enrolled in school. Boards of education should consider protecting and improving the health of its employees. This article describes a 12 step approach to setting up a health education/promotion program for school employees. PMID- 3285102 TI - Brenda C. Wilson. PMID- 3285104 TI - On the potential role of cyclosporin in the treatment of lymphoproliferative diseases. AB - Lymphomas and leukemias, as cancers of the immune system, may still retain some susceptibility to regulatory mechanisms which govern the proliferation of their cells of origin. According to this concept, an enhanced immune suppression as induced by irradiation and chemotherapy may contribute to their cytotoxic effect in inducing and maintaining a remission of the disease. Cyclosporin selectively and reversibly inhibits activation and proliferation of both normal and neoplastic T lymphocytes. In-vitro experiments and preliminary clinical data from small uncontrolled studies indicate that cyclosporin might be a promising agent in the treatment of mycosis fungoides, Hodgkin's disease, acute leukemia, and possibly other lymphoproliferative disorders, but the experience is still limited and no definitive conclusions may be made. In addition to its direct effect on lymphocytes, cyclosporin reverses the resistance of cancer cells to several antineoplastic agents and may thus find its place in combination with chemotherapy. It is hoped that a more systematic basic and clinical research will help define the role of this new therapeutic approach. PMID- 3285103 TI - Hematopoietic growth factors (BPA and Epo) induce the expressions of c-myc and c fos proto-oncogenes in normal human erythroid progenitors. AB - We investigated serial expressions of eight proto-oncogenes during in-vitro differentiation of normal human burst-forming unit, erythroid (BFU-E), and found that c-myc and c-fos are expressed in progenies of BFU-E. The expressions of the two proto-oncogenes correlated to the replating efficiency and adversely to erythroid differentiation. The absence of hematopoietic growth factors decreased the expressions, but the addition of erythropoietin together with burst promoting activity induced a re-expression of the c-myc and c-fos after 2 h of incubation. These observations suggest that the c-myc and c-fos proto-oncogenes have a physiological role in the proliferation of erythroid progenitors and that activations of the two proto-oncogenes are early cellular events after the stimulation by hematopoietic growth factors. PMID- 3285105 TI - On the thermodynamical and biological interpretation of the Gompertzian mortality rate distribution. AB - "Thermodynamical" foundations of a Gompertzian representation of mortality rate distribution vs. age are reviewed. The two fundamental assumptions of the original model (as developed by Strehler and Mildvan) are: (1) challenges that threaten the lives of organisms of a given species have an exponential distribution in harmfulness; and (2) vitality ("energetic" reserve to be used to counteract the challenges and restore proper function of the organism) declines linearly with age. It is proposed that the external environment should not only be characterized by a "temperature", but also by a "pressure" (related to the average time between successive hits). While recent progress of health sciences have essentially lowered the "temperature" factor, future progress might also lower the "pressure" factor. The effect of this would be to provide only a slight extension of observed longevity in humans. Internal cause(s) of ageing that lead to death are not specified in the model (except that they should be compatible with the linear decline in vitality). It is shown that death cannot be attributed to a slowing down of the recovery machinery that restores the organism's state following a challenge or a disease. A mechanism of this kind would instead lead to a gamma- (rather than a Gompertzian) distribution of ages at death, at great ages. Whatever the modalities of the challenges (they are, of course, not necessarily of a literally energetic nature), the model is shown to assume that death is linked to single, large amplitude challenges, rather than to the conjunction of independent, small amplitude damages. The concept of programmed longevity is proposed and integrated into the model. In this new model, Gompertzian distributions are characterized by the two parameters alpha (slope) and L (longevity) rather than by the two traditional parameters alpha and R0 (mortality rate at birth). This new presentation is more parsimonious than the original one, in that only alpha (not L) is temperature dependent. Models with fixed longevity automatically display a negative correlation between ln R0 and alpha, as was noted by Strehler and Mildvan. There exists a definite lag of time (of 23-29 years) between longevity and the most probable age at death. Assuming that the human species has a maximum programmed longevity of 120 years, this implies that the progress of health sciences will allow the present survival curve to evolve, not towards a rectangular shape as previously believed, but rather to a given limiting curve such as is depicted. PMID- 3285106 TI - Biochemical mechanisms of cephaloridine nephrotoxicity. AB - Large doses of the cephalosporin antibiotic, cephaloridine, produce acute proximal tubular necrosis in humans and in laboratory animals. Cephaloridine is actively transported into the proximal tubular cell by an organic anion transport system while transport across the lumenal membrane into tubular fluid appears restricted. High intracellular concentrations of cephaloridine are attained in the proximal tubular cell which are critical to the development of nephrotoxicity. There is substantial evidence indicating that oxidative stress plays a major role in cephaloridine nephrotoxicity. Cephaloridine depletes reduced glutathione, increases oxidized glutathione and induces lipid peroxidation in renal cortical tissue. The molecular mechanisms mediating cephaloridine-induced oxidative stress are not well understood. Inhibition in gluconeogenesis is a relatively early biochemical effect of cephaloridine and is independent of lipid peroxidation. Furthermore, cephaloridine inhibits gluconeogenesis in both target (kidney) and non-target (liver) organs of cephaloridine toxicity. Since glucose is not a major fuel of proximal tubular cells, it is unlikely that cephaloridine-induced tubular necrosis is mediated by the effects of this drug on glucose synthesis. PMID- 3285107 TI - Isolation from subcellular preparation of a mediator of hypoglycaemic hGH peptides. AB - This study demonstrated the release into the incubation medium of a cellular mediator from isolated fat adipocytes and hepatocytes after treatment with the hypoglycaemic fragment of human growth hormone, hGH 6-13. The activity of the putative mediator observed in the cell "ghosts" of both liver and rat cells suggests that the active component is likely to be derived from plasma membranes and has an ubiquitous cellular distribution. The hGH fragment-induced release of the mediator from plasma membranes depends upon the physiological status of the animals. Liver plasma membranes of starved rats yield significantly higher levels of the cellular mediator in response to treatment with hGH 6-13. The studies of the physiological factors influencing the release of the material from cellular systems clearly enhance the production of adequate amounts of the cellular mediator for molecular characterization. The precise chemical nature and the physiological role of the hGH cellular mediator are currently unknown. PMID- 3285109 TI - The AIDS epidemic: AIDS research in the life sciences. PMID- 3285108 TI - Inhibition of insulin receptors by vanadate and ouabain. AB - Insulin binding studies were performed, using cells from 5 non-obese, non diabetic subjects, on four separate days: 2 were paired control studies to demonstrate precision, and 2 other sets were binding studies in which one incubation solution was a control and the other contained either vanadate, (10( 4) M) or ouabain (10(-4) M). For both substances tracer binding of 125I insulin was reduced significantly, 27% by vanadate and 30% by ouabain. Furthermore, at all points on the binding curve these substances inhibited binding by 18-98%, in a pattern consistent with reduced receptor number. The concentrations of vanadate or ouabain which we used did not change cell volume or inhibit trypan blue dye exclusion, as an index of cell viability. Because vanadate and ouabain inhibit Na+K+ATPase and have largely dissimilar effects on a variety of cell systems, our observations may reflect specific involvement of Na+K+ATPase in binding or closely related processes. PMID- 3285110 TI - Role of angiotensin II in renal hemodynamic functions during the initial stages of acute ureteral obstruction. AB - This investigation examines the role of Angiotensin II in renal hemodynamic functions during acute unilateral ureteral obstruction (UUO) in a dog model. An electro magnetic flow probe was utilized to assess renal blood flow while the arteriovenous extraction technique of technetium 99m DTPA was utilized for the assessment of changes in filtration fraction and glomerular filtration rate. The effects of Angiotensin II receptor blockade on renal hemodynamic functions during acute UUO was evaluated in six dogs and compared to acute ureteral obstruction without receptor blockade in seven dogs. Angiotensin II blockade with (Sar1, Thr8)-Angiotensin II during UUO led to a striking increase in renal blood flow that was significantly different in comparison to normalized values from UUO alone (+delta 63 +/- 17 vs. +delta 22 +/- 6% at 30 min; p less than 0.05). There were, however, no significant differences in the magnitude of the decrease in filtration fraction and glomerular filtration rate in comparison to UUO alone. This investigation demonstrates that Angiotensin II has an inhibitory effect on the initial increase in renal blood flow with acute UUO. The possibility of successful pharmacologic intervention in the setting of UUO can be examined using animal models similar to the one described here. Pharmacologic treatment in the setting of acute UUO in patients might permit better preservation of renal function. PMID- 3285111 TI - Histological changes in the liver and portal hypertension subsequent to repeated intraportal injections of killed E. coli in the dog. AB - The etiology of idiopathic portal hypertension (IPH) is not known. To obtain clues to the pathogenesis, an attempt was made to produce a hepatic lesion similar to that in IPH by repeated injections of aggregated killed non-pathogenic E. coli directly into the portal vein. In the treated dogs, histology of the liver showed dense fibrosis in the portal tract and an aberrant vasculature around the portal area after 1 month. Portal pressure was elevated and middle-to small-sized portal branches were decreased in number as studied by portography. These changes closely mimic those seen in human IPH. The possibility is discussed that chronic entrance of an antigen such as bacteria from the intestine to the portal venous system plays an etiologic role in IPH. PMID- 3285113 TI - History of nonpenetrating chest trauma and its treatment. PMID- 3285112 TI - Hyperglycemia in type II. PMID- 3285114 TI - [Protection of the health of soldiers of the revolution]. PMID- 3285115 TI - [N. S. Korotkov--author of the bloodless method of measuring the arterial pressure]. PMID- 3285116 TI - [Participation of women in caring for the wounded and ill during the Crimean and Russo-Turkish Wars]. PMID- 3285117 TI - Effect of pre-exercise fructose ingestion on endurance performance in fed men. AB - Twelve trained males, in a fed state, were studied to examine the effect of pre exercise fructose ingestion on endurance capacity during prolonged cycling exercise. Sixty minutes prior to exercise, subjects ingested either 60 or 85 g fructose or a sweet placebo. Mean exercise intensity initially required 62% of the maximal aerobic power and thereafter increased to elicit 72 and 81% of maximal aerobic power at 90 and 120 min of exercise, respectively. Exercise time (mean +/- SE) to exhaustion was significantly increased after fructose ingestion, as compared to placebo ingestion (145 +/- 4 vs 132 +/- 3 min, P less than 0.01). During the exercise, no differences were observed between both trials for oxygen uptake, heart rate, or perceived exertion. Serum glucose and insulin levels between both trials were not significantly different throughout the experiment. There were also no significant differences in serum-free fatty acids and glycerol levels as well as respiratory exchange ratio between fructose and placebo trials during the exercise. The results suggest that fructose ingestion is of benefit before prolonged exercise, because it provides a carbohydrate source to contracting muscles without transient hypoglycemia and a depression of fat utilization, and thereby delays the fatigue. PMID- 3285118 TI - Resistive training can reduce coronary risk factors without altering VO2max or percent body fat. AB - Eleven healthy, untrained males (age = 44 +/- 1 yr; range = 40 to 55 yr) were studied to determine the effects of 16 wk of high-intensity resistive training on risk factors for coronary artery disease. Lipoprotein-lipid profiles, plasma glucose and insulin responses during an oral glucose tolerance test, and blood pressure at rest were determined before and after training. The training program resulted in a 13% increase in high-density lipoprotein-cholesterol (39 +/- 2 vs 44 +/- 3 mg.dl-1, P less than 0.05), a 43% increase in high-density lipoprotein cholesterol (7 +/- 2 vs 10 +/- 2 mg.dl-1, P less than 0.05), a 5% reduction in low-density lipoprotein cholesterol (129 +/- 5 vs 122 +/- 5 mg.dl-1, P less than 0.05), and an 8% decrease in the total cholesterol/high-density lipoprotein cholesterol ratio (5.1 +/- 0.3 vs 4.7 +/- 0.3, P less than 0.01), despite no changes in VO2max, body weight, or percent body fat. Glucose-stimulated plasma insulin concentrations during oral glucose tolerance testing were significantly lower, and supine diastolic blood pressure was reduced (P less than 0.05) as a result of the training program. No changes in any of these variables occurred in a sedentary control group. These findings indicate that resistive training can lower risk factors for coronary artery disease independent of changes in VO2max, body weight, or body composition. PMID- 3285119 TI - [Malaria morbidity in a hospital environment in Burkina Faso (West Africa)]. AB - We carried out a study on malaria morbidity from November 1982 to October 1983 in the Pediatric Department of the Hospital of Bobo Dioulasso (Burkina Faso, West Africa). Malaria fever attacks were present in 21.4% of all febrile cases. The highest rate was observed in the 2-4 age group (42%). We observed 97.4% of all malaria fever attacks during the rainy season and the beginning of the dry season (June to December). PMID- 3285120 TI - Chronic eosinophilic pneumonia. A report of 19 cases and a review of the literature. AB - Clinical, roentgenographic and pathologic findings in patients with chronic eosinophilic pneumonia, including 19 additional cases, have been reviewed and summarized. Most patients present with subacute respiratory and constitutional symptoms and have failed to respond to therapy for presumptive pneumonia. A previous history of atopy, most often asthma, will be obtained in one-half. Eosinophilia occurs in most cases and its absence may be the major indication for lung biopsy. Although pulmonary infiltrates are more often peripheral than not, the classic "photographic negative of pulmonary edema" is seen in less than one third of cases. Pathologic findings include an intra-alveolar and interstitial infiltrate which comprises eosinophils, histiocytes, and exudate. Bronchiolitis obliterans and eosinophilic microabscesses occur less frequently. Open-lung biopsy is preferable when atypical features prevent a confident clinical diagnosis. The exquisite responsiveness of CEP to corticosteroids should encourage use of a therapeutic trial when there is a strong clinical suspicion of the disorder. The rapid clinical response should not deter the clinician from giving a prolonged course of treatment. The differential diagnosis includes other diseases characterized by PIE and the more recently recognized bronchiolitis obliterans and organizing pneumonia, a disorder which is also marked by peripheral pulmonary infiltrates. PMID- 3285122 TI - Fumarate reductase of Escherichia coli: an investigation of function and assembly using in vivo complementation. AB - Recombinant plasmids which carried portions of the Escherichia coli frd operon were constructed and their expression examined by in vivo complementation of E. coli MI1443. This strain lacked a chromosomal frd operon and was unable to grow anaerobically on glycerol and fumarate. Introduction of all four fumarate reductase subunits into E. coli MI1443 was essential for the restoration of growth. The FRD A, FRD B dimer (but neither subunit alone) was active in the benzyl viologen oxidase assay. Both FRD C and FRD D were required for membrane association of fumarate reductase and for the oxidation of reduced quinone analogues. Introduction into E. coli MI1443 of the frdABC and frdD genes on two separate plasmid vectors failed to restore anaerobic growth on glycerol and fumarate. Thus separation of the DNA coding for the FRD C and FRD D proteins affected the ability of fumarate reductase to assemble into a functional complex. PMID- 3285121 TI - Acute graft-versus-host disease: clinical characteristics in the cyclosporine era. AB - Graft-versus-host disease (GVHD) remains the major problem in allogeneic bone marrow transplantation. GVHD has limited the use of this technique to HLA-matched donor recipient pairs. Thus, only a quarter of patients who ultimately may have benefited from bone marrow transplantation are currently eligible. Even in matched patient recipient pairs, GVHD accounts for approximately 40% of the deaths following allogeneic bone marrow transplants. One of the major challenges for transplantation is to derive better strategies to prevent and treat GVHD while retaining the allogeneic benefit of graft-versus-leukemia. Current pharmacologic approaches have used cyclosporine, usually in combination with other drugs. More experimental approaches have removed lymphocytes from the marrow grafts. With either approach, maintaining the anti-leukemic benefit of an allogeneic transplant (i.e., immunologic attack of the leukemia resulting in a lower relapse rate), will need to be maintained if that approach will ultimately prove to be useful. PMID- 3285123 TI - DNA sequence of the gene scrA encoding the sucrose transport protein EnzymeII(Scr) of the phosphotransferase system from enteric bacteria: homology of the EnzymeII(Scr) and EnzymeII(Bgl) proteins. AB - The nucleotide sequence of the structural gene, scrA, which codes for sucrose specific EnzymeII(Scr) (EII(Scr)) of the phosphoenolpyruvate-dependent carbohydrate:phosphotransferase system (PTS), was determined. EllScr requires an EnzymeIII, the product of the gene crr, for full activity. The gene scrA is preceded immediately by a classical Shine-Dalgarno sequence (AAGAGGGTA). It contains 1368 nucleotides with an increased GC-content (58%) corresponding to a polypeptide of 455 amino acid residues (Mr 47,500). The protein has the hydropathic profile (average hydropathy +0.82) of an integral membrane protein lacking extended alpha-helical structures and a signal peptide. Comparison with the sequence of the beta-glucoside-specific EnzymeII (EII(Bgl), 625 amino acids, Mr 66,480; Bramley and Kornberg, 1987a; Schnetz et al., 1987) revealed strong homologies between EiI(Scr) and the first 458 residues of EII(Bgl). The 162 carboxyterminal residues of EII(Bgl), however, showed a high homology with the sequence of EnzymeIII (Nelson et al., 1984), a homology also described recently by Bramley and Kornberg (1987b). The evolutionary and functional significance of the similarities with four other EnzymesII is discussed. PMID- 3285124 TI - 'Designer drugs'. A problem in clinical toxicology. AB - 'Designer drugs' are substances intended for recreational use which are derivatives of approved drugs so as to circumvent existing legal restrictions. The term as popularised by the lay press lacks precision. Contrary to the popular belief that 'designer drugs' are original creations, the majority of these agents are 'borrowed' from legitimate pharmaceutical research. They merely represent the most recent developments in the evolution of mind-altering chemicals. The most extensively studied class of psychoactive compounds is the phenylethylamines (mescaline analogues). This class includes catecholamines, therapeutic agents and numerous illicit derivatives. Subtle alterations of the phenylethylamine molecule give rise to a spectrum of pharmacological properties ranging from pure sympathomimetic stimulation to primarily psychoactive effects. Although most of these compounds are only of historical interest, amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine (MDA), and 3,4-methylenedioxymethamphetamine (MDMA) continue to be used recreationally. Many deaths have been ascribed to this class of compounds. In overdose the differences between these compounds blur and the clinical presentation is similar to that of amphetamine overdose characterised by tachycardia, hypertension, hyperthermia, diaphoresis, mydriasis, agitation, muscle rigidity, and hyper-reflexia. Death usually results from arrhythmias, hyperthermia or intracerebral haemorrhage. Treatment is aggressive and supportive with careful attention to temperature, blood pressure and seizure control. Synthetic opioid derivatives, which represent the second major class of 'designer drugs', are derivatives of fentanyl (e.g. alpha-methylfentanyl, 3-methylfentanyl) or pethidine (meperidine) and are extremely potent compounds responsible for numerous overdose deaths. Attempts to synthesise pethidine have resulted in the accidental production of MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), a compound which is metabolised in the brain by the monoamine oxidase system to a toxic intermediate (MPP+) which selectively destroys the sustantia nigra, resulting in the rapid onset of severe Parkinsonian symptoms. Naloxone will antagonise the opiate effects of this drug class, although high doses may be required. Arylhexylamines constitute the third class of 'designer drugs'. The predominant member of this class is phencyclidine (PCP), a derivative of the anaesthetic ketamine. This unique class of psychoactive agents exhibits broad and complex pharmacological effects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3285125 TI - Clinical features and management of lithium poisoning. AB - Lithium salts, in particular the carbonate and citrate, were formerly in widespread use, forming part of alkaline salt mixtures which were used for treatment of the many disorders belonging to the uric acid diathesis. Among these disorders were mania, depression, acute mania, acute melancholia and periodic depression. Satisfactory prophylactic effects on periodic depression were directly claimed. Daily doses of 3 to 26 mmol of lithium were recommended as standards. Only slight or moderate symptoms of poisoning were reported in a very few cases during the period in question (1860 to 1930), when the popularity of these lithium-containing prophylactic drugs with a favourable therapeutic index was at its peak. Lithium intoxication was not a serious clinical problem until 1949 when Cade introduced his fortuitously effective, but nevertheless high, dosage regimen which was continued until signs of recovery from mania appeared. For the maintenance dose, Cade in principle recommended, but seldom adhered to, 17 mmol/day. Chronic lithium intoxication starts insidiously with silent affliction of the kidneys followed by 'prodromal' symptoms, and when moderate severity has been reached, an accelerating renal vicious circle with decreasing kidney function is imminent. After this point the chronic intoxication resembles acute intoxication. Active detoxification at this, or an earlier stage, leaves the patient with a good chance of recovery. At a later stage, with the occurrence of oliguria, semi-coma or coma, and latent convulsive movement, recovery is less certain. There is no specific antidote for the toxic effects of lithium. Haemodialysis is the most effective treatment for acute lithium poisoning. For patients with impaired, or potentially impaired renal function, peritoneal dialysis may be an alternative, but less effective, treatment. Forced diuresis demands unimpaired renal function, and is little more effective than withdrawal of treatment, supplemented with correction of water and electrolyte balance. Sodium overloading is not recommended. Patients on lithium prophylaxis are treated on an outpatient basis. Prevention of intoxication depends on cooperation between patient and clinician, and possibly on the use of smaller, low risk dosages in most patients. PMID- 3285126 TI - Oral activated charcoal in the treatment of intoxications. Role of single and repeated doses. AB - Activated charcoal has an ability to adsorb a wide variety of substances. This property can be applied to prevent the gastrointestinal absorption of various drugs and toxins and to increase their elimination, even after systemic absorption. Single doses of oral activated charcoal effectively prevent the gastrointestinal absorption of most drugs and toxins present in the stomach at the time of charcoal administration. Known exceptions are alcohols, cyanide, and metals such as iron and lithium. In general, activated charcoal is more effective than gastric emptying. However, if the amount of drug or poison ingested is very large or if its affinity to charcoal is poor, the adsorption capacity of activated charcoal can be saturated. In such cases properly performed gastric emptying is likely to be more effective than charcoal alone. Repeated dosing with oral activated charcoal enhances the elimination of many toxicologically significant agents, e.g. aspirin, carbamazepine, dapsone, dextropropoxyphene, cardiac glycosides, meprobamate, phenobarbitone, phenytoin and theophylline. It also accelerates the elimination of many industrial and environmental intoxicants. In acute intoxications 50 to 100g activated charcoal should be administered to adult patients (to children, about 1 g/kg) as soon as possible. The exceptions are patients poisoned with caustic alkalis or acids which will immediately cause local tissue damages. To avoid delays in charcoal administration, activated charcoal should be a part of first-aid kits both at home and at work. The 'blind' administration of charcoal neither prevents later gastric emptying nor does it cause serious adverse effects provided that pulmonary aspiration in obtunded patients is prevented. In severe acute poisonings oral activated charcoal should be administered repeatedly, e.g. 20 to 50g at intervals of 4 to 6 hours, until recovery or until plasma drug concentrations have fallen to non-toxic levels. In addition to increasing the elimination of many drugs and toxins even after their systemic absorption, repeated doses of charcoal also reduce the risk of desorbing from the charcoal toxin complex as the complex passes through the gastrointestinal tract. Charcoal will not increase the elimination of all substances taken. However, as the drug history in acute intoxications is often unreliable, repeated doses of oral activated charcoal in severe intoxications seem to be justified unless the toxicological laboratory has identified the causative agent as not being prone to adsorption by charcoal. The role of repeated doses of oral activated charcoal in chronic intoxication has not been clearly defined.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3285127 TI - Failure of haemoperfusion and haemodialysis to prevent death in paraquat poisoning. A retrospective review of 42 patients. AB - In this review the efficacy of haemoperfusion in the treatment of paraquat poisoning is addressed. 42 reports containing sufficient information of paraquat poisoned patients were evaluated. These reports, from 35 patients reported in the literature and 7 new cases, were chosen for the following reasons: the timed plasma paraquat concentrations were known, patient outcome was known, and details of haemoperfusion were available. In some cases, haemodialysis was also performed. The plasma paraquat concentrations and the specific times post ingestion were plotted on a contour graph that predicts the probability of survival. Comparison of the predicted probability of survival versus the actual outcome showed that haemoperfusion, single or repeated, did not affect patient survival. None of the patients whose initial plasma concentrations were greater than 3 mg/L paraquat survived, regardless of the time after ingestion that the concentrations were measured, and despite haemoperfusion. Therefore, such patients might not be considered for haemoperfusion because of their uniformly bad prognosis, despite the procedure being used, and because of the morbidity, discomfort and cost associated with it. Clearly, the need for better techniques to remove paraquat and to prevent the consequences of the metabolic effects of the compound are required urgently before the treatment of the paraquat-poisoned patient will be successful. PMID- 3285128 TI - Effects of branched-chain amino acids on postprandial 3-OH butyrate and glucagon in the baboon. AB - Although chronic postprandial elevation of branched-chain amino acids (BCAAs) occurs in diabetic subjects and in subjects consuming high-protein diets, the metabolic effects of simultaneously increasing levels of these three amino acids are unclear. In this study, a mixture of the BCAAs was infused intravenously into baboons, beginning 30 minutes after the daily meal and continuing for 200 minutes on four consecutive days. Blood samples were collected on the last day of treatment. Infusion of the BCAAs into fed baboons promoted an increase in peak levels of glucagon, a decrease in postprandial levels of seven amino acids, and an increase in plasma levels of 3-OH butyrate. The ketone body response occurred despite an increase in the plasma ratio of insulin/glucagon in four of the five animals and was not associated with a change in the rate of lipolysis as indicated by plasma glycerol measurements. These findings raise the possibility that ketone bodies are one of the metabolic products of BCAA metabolism induced by high concentrations of leucine or ketoisocaproate. The observation that chronic elevation of BCAAs augments glucagon secretion may explain the parallel increases in plasma glucagon and plasma BCAAs observed in subjects fed high protein diets. PMID- 3285129 TI - Following weight loss in massively obese patients correction of the insulin resistance of fat metabolism is delayed relative to the improvement in carbohydrate metabolism. AB - Intermediary metabolite and serum insulin concentrations have been measured during incremental intravenous low-dose insulin infusion in massively obese patients before, and 3 months and 12 months after gastroplasty. Fasting blood glucose was similar on the three occasions, but fasting serum insulin was significantly higher preoperatively and showed a progressive fall with weight loss. Significant negative linear correlations were found between serum insulin and blood glucose, plasma nonesterified fatty acids, blood glycerol and blood total ketone bodies concentrations. The insulin-glucose dose-response curve showed a significant left shift at 3 months with a further significant improvement at 12 months. No significant change in the responses for nonesterified fatty acids, glycerol, and ketone bodies was observed at 3 months, but all three showed a significant left shift at 12 months. Massively obese patients are resistant to the action of insulin on carbohydrate and fat metabolism. Weight loss following gastroplasty results in an improvement in sensitivity to insulin, which is evident earlier in carbohydrate metabolism than in fat metabolism. PMID- 3285130 TI - Elevated adipose tissue lipoprotein lipase activity in craniopharyngioma patients. AB - The activity of lipoprotein lipase (LPL) was measured in adipose tissue (AT-LPL) and postheparin plasma (PH-LPL) of 13 obese patients (aged 11 to 31 years) who had surgery for craniopharyngioma 1 to 13 years earlier. AT-LPL activity (mean +/ SEM) was higher in them than in subjects matched with respect to age, sex, and relative body weight (4.6 +/- 1.1 v 2.1 +/- 0.4 mumol free fatty acids (FFA).h 1.g-1, P less than .05). The activity was also higher when expressed per fat cell. PMID- 3285131 TI - Impaired pancreatico-biliary response to vagal stimulation and to cholecystokinin in human obesity. AB - We previously found that massively obese patients respond with less gastric acid secretion in response to vagal stimulation. This is compatible with the described association between experimental obesity and altered vagal function in the rat. To confirm this observation, the pancreatic and biliary responses to vagal stimulation were examined in nine nondiabetic obese patients against a background secretin infusion of 15 CU x h-1, and monitored after a subsequent injection of 75 IDU of cholecystokinin. Two separate marker perfusion systems were used in the stomach and duodenum, respectively, and blood samples were drawn for hormone analyses. In contrast to controls having normal body weight, the obese patients failed to respond with increments of pancreatic enzyme secretion and duodenal bile acids after stimulation with modified sham feeding. Cholecystokinin stimulated the pancreatic secretion of trypsin, amylase, and lipase, the emptying of bile acids, and the release of gastrin, but the patients' responses were only half that of the controls. In the resting state the obese had higher outputs of bile and pancreatic enzymes and higher plasma levels of pancreatic polypeptide compared with controls, but the pancreatic bicarbonate secretion rate was not different. The almost complete suppression of the basal gastric acid secretion by a low dose of intravenous (IV) secretin in controls did not occur in the obese. We conclude that massive obesity is associated with a reduced pancreatic and biliary response to vagal stimulation. Compared with controls, the digestive functions of the obese patients seem to be less sensitive to stimulation by exogenous cholecystokinin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285132 TI - The development of electroretinogram abnormalities and the possible role of polyol pathway activity in diabetic hyperglycemia and galactosemia. AB - This study examined the induction of electroretinogram abnormalities in hyperglycemia and the possible role of increased polyol pathway activity in the development of these changes. Both diabetic hyperglycemia and galactosemia caused the prolongation of peak latencies and in some cases a reduction in the amplitudes of oscillatory potentials on the b-wave. Diabetic hyperglycemia associated abnormalities were prevented and normalized by insulin or ADN-138, an aldose reductase inhibitor. Galactosemia-induced abnormalities were inhibited by ADN-138, and were reversed either by ADN-138 treatment or by withdrawal of galactose from the diet. Polyol accumulation was prevented by insulin or ADN-138, and the elevated polyol level was reversed by insulin, ADN-138, or withdrawal of galactose in diabetic hyperglycemia and/or galactosemia. These results suggest that the increased polyol pathway activity in the hyperglycemia may be involved in the development of electroretinogram abnormalities similar to those in human diabetes; therefore, ADN-138 could be a useful drug for therapy of retinopathy in the early diabetic stage. PMID- 3285133 TI - Triglyceride-rich lipoprotein metabolism during acute hyperinsulinemia in hypertriglyceridemic humans. AB - Chronic endogenous hyperinsulinemia is associated with increased rates of triglyceride production in humans. The effect of acute exogenous hyperinsulinemia on triglyceride production was studied in seven hypertriglyceridemic men before and during six hours of hyperinsulinemic-euglycemic clamping, and in two men before and during six hours of hyperinsulinemic-hyperglycemic clamping. Apparent triglyceride production rates were assessed qualitatively by examining the rate of decline of 3H-glycerol-labeled plasma triglyceride specific activity in the preclamp period, and again when a new steady state had occurred, during the final three hours of the clamp. During the euglycemic (91.2 +/- 3.0 mg glucose/dL plasma) clamps, plasma insulin levels were increased by 700% (0.76 +/- 0.12 to 5.3 +/- 0.29 ng/mL, P less than .001) and plasma glucagon levels decreased by 19%, compared with baseline. The apparent triglyceride production rate did not increase in five of six men during the euglycemic-hyperinsulinemic clamp, or in either man during the hyperglycemic-hyperinsulinemic clamp. During the clamp period the triglyceride declined in the plasma by 23.4 +/- 3.1%; and the apolipoprotein B by 10.5 +/- 1.5%. Hyperinsulinemia with euglycemia was also associated with a decline in the ratio of triglyceride to apolipoprotein B in the triglyceride-rich lipoproteins. This was more pronounced in very low density lipoprotein (VLDL) than in intermediate density lipoprotein (IDL). In this study, hyperinsulinemia led to a decrease in the plasma glucagon concentration. This decrease was positively correlated with the decrease in the slope of the triglyceride specific activity v time curve. Hence, the changes in triglyceride production were not due to an increase in plasma glucagon concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285134 TI - Insulin action is normalized in newly diagnosed type I diabetic patients after three months of insulin treatment. AB - We studied insulin action at submaximal and maximal insulin levels in seven newly diagnosed type I (insulin-dependent) diabetic patients after 2 weeks (t1/2) and after 3 months (t3) of insulin treatment, and in seven control subjects. Insulin action was determined with a sequential euglycemic (5.0 mmol/L) glucose clamp technique using insulin infusion rates of 0.5, 1.0, 2.0, and 5.0 mU.kg-1.min-1 in four periods of two hours each. The final 30 minutes of each infusion period (referred to as steady-state) were taken for the assessment of insulin action. Steady-state insulin levels were similar in the diabetic patients at t1/2 and t3, and in control subjects. During the first and second infusion periods, steady state glucose infusion rates (SSGIR) were lower at t1/2 than at t3 (12.2 +/- 1.7 v 18.8 +/- 2.4, P less than .05, and 34.3 +/- 3.8 v 47.6 +/- 2.5 mumol.kg-1.min 1, P less than .02, respectively), and were lower at t1/2 compared to controls (12.2 +/- 1.7 v 22.4 +/- 2.3, P less than .01, and 34.3 +/- 3.8 v 47.3 +/- 2.8 mumol.kg-1.min-1, P less than .02). No differences were found during the third and fourth infusion periods between t1/2 and t3, or t1/2 and controls. When these data were used to construct dose-response curves, insulin action was decreased in the diabetic patients at t1/2 at submaximal insulin levels (shift to the right), while insulin responsiveness was unchanged. This finding may be regarded as a still-present manifestation of the metabolic derangement at the onset of the disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285135 TI - Direct inhibition of collagen production in vitro by diabetic rat serum. AB - Diabetes mellitus is associated with a generalized defect in connective tissue metabolism, including decreased growth, poor wound healing, and osteopenia. To determine the role of circulating factors in the etiology of these defects, we studied the effects of diabetic rat serum (DRS) on collagen, the major protein component of connective tissues. After preincubation of costal cartilage from hypophysectomized rats with experimental serum for 20 hours, [3H] proline was added for final four hours of incubation. Collagen and noncollagen protein were quantitated using purified bacterial collagenase. Compared to incubation of tissue in buffer without added serum, collagen production in cartilage incubated with 2% DRS was decreased by 23% (P less than .05), and with 4% serum by 88% (P less than .01). In contrast, serum from normal rats (NRS) increased collagen to 158% above buffer-incubated cartilage at 1.0% (P less than .02) and to 196% at 2% serum (P less than .01). Noncollagen protein production decreased below buffer only after addition of 2% or more DRS and increased above buffer after addition of 2% or more of NRS (178%, P less than .05). Addition of insulin at 10 and 100 mU/mL to DRS did not reverse defective collagen production, and addition of glucose (up to 900 mg/dL) or ketones (20 mmol/L) to NRS did not induce the changes in collagen production seen after addition of diabetic serum. Chromatographic separation of serum revealed that the inhibitory activity of DRS was in the high molecular weight fraction (less than 5000).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285136 TI - Whole body glucose kinetics in type I diabetes studied with [6,6-2H] and [U-13C] glucose and the artificial B-cell. AB - Dynamic aspects of whole body glucose metabolism were assessed in ten young adult insulin-dependent (type I) diabetic men. Using a primed, continuous intravenous infusion of [6,6-2H]glucose and [U-13C]glucose, endogenous production, tissue uptake, carbon recycling, and oxidation of glucose were measured in the postabsorptive state. These studies were undertaken after blood glucose had been maintained overnight at 5.9 +/- 0.4 mmol/L (n = 10), and on another night at 10.5 +/- 0.4 mmol/L (n = 4) or 15.2 +/- 0.6 mmol/L (n = 6). In the normoglycemic state, endogenous glucose production averaged 2.15 +/- 0.13 mg x kg-1 x min-1. This value, as well as the rate of glucose carbon recycling (0.16 +/- 0.04 mg x kg-1 x min-1) and glucose oxidation (1.52 +/- 0.16 mg x kg-1 x min-1) are comparable to those found in nondiabetic controls. In the hyperglycemic states at 10 or 15 mmol/L, endogenous glucose production was increased by 11% (P less than .01) and 60% (P less than .01) compared to the normoglycemic states, respectively. Glucose carbon recycling contributed only a small percentage to this variation in glucose production (15% at the 15 mmol/L glucose level). This suggests that if gluconeogenesis participates in the increased glucose output, it is not dependent on a greater systemic supply of three-carbon precursors. The increased rate of glucose production in the hyperglycemic state was quantitatively offset by a rise in urinary glucose excretion. Glucose tissue uptake, as well as glucose oxidation, did not vary between normoglycemic and hyperglycemic states.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285137 TI - The sporulation capable (sca) mutation of Saccharomyces cerevisiae is an allele of the SIR2 gene. AB - We have used the special properties of the spo13-1 mutation in order to study the regulation of yeast meiosis by the mating type loci. We have found that both the rme1-1 mutation and the sca mutation allow haploid meiosis in spo13-1 strains. Therefore, haploid meiosis is regulated in the same manner as diploid meiosis. Unlike rme1-1, the sca mutation allows meiosis through derepression of the silent mating type cassettes; sca strains can sporulate only because they express both MATa and MAT alpha information. We have found further that sca is an allele of SIR2, one of the genes involved in repression of the silent cassettes. Therefore, the RME1 gene is the only known candidate for a master negative regulator through which the MAT locus controls meiosis. PMID- 3285138 TI - Cloning of a chromosomal locus (exp) which regulates the expression of several exoprotein genes in Staphylococcus aureus. AB - Insertion of the erythromycin resistance transposon Tn551 into a single site of the Staphylococcus aureus chromosome resulted in decreased production of alpha toxin, serine and metallo-proteinases and several other extracellular proteins and a simultaneous increase in the production of protein A. The site of insertion, designated exp, was separate from the structural gene for alpha-toxin and protein A. Hybridization analysis showed that the effect of the insertional mutation on the expression of the alpha-toxin and protein A was at the level of transcription. The chromosomal DNA flanking the transposon and the corresponding DNA of the wild-type strain was cloned in Escherichia coli. Northern blot hybridization experiments revealed that the exp locus codes for a major RNA of approximately 3.5 kb. This RNA was not found in the insertional mutant nor in a spontaneous exp mutant. A map of the exp locus constructed by Northern blot and restriction enzyme analysis showed that the insertional mutation was located in the middle of the coding sequence of the 3.5 kb RNA. The insertional mutant was reverted to wild type by inserting a recombinant plasmid containing most of the coding sequence of the 3.5 kb RNA. PMID- 3285139 TI - Mitotic gene conversion of large DNA heterologies in Saccharomyces cerevisiae. AB - Gene conversion of large DNA heterologous fragments has been shown to take place efficiently in Saccharomyces cerevisiae. It has been found that a 2.6 kb LEU2 DNA fragment in a multicopy plasmid was replaced by a 3.1 kb PGI1 chromosomal DNA fragment, when both fragments were flanked by homologous DNA regions. Gene conversion was asymmetric in a total of 481 recombinants analyzed. In contrast, truncated PGI1 or LEU2 genes in multicopy plasmids, gave no recombinants that restored a complete plasmid copy of these genes in a total of 242 recombinants studied, confirming that a conversion tract is disrupted by a heterologous region. The asymmetry of the events detected suggest that gene conversion of large DNA heterologies involves a process whereby a gap first covers one heterologous fragment and then this is followed by new DNA synthesis using the other heterologous fragment as a template. Therefore, it is likely that large DNA heterologies are converted by a double-strand gap repair mechanism. PMID- 3285140 TI - Increase in plasmid transformation efficiency in SOS-induced Escherichia coli cells. AB - UV irradiation of competent cells of Escherichia coli K12 produced an increase in the efficiency of transformation with plasmid DNA. This phenomenon has been called IPTE (increase in plasmid transformation efficiency) and is dependent on the activated state of the RecA protein. IPTE is independent of the lexA, recB recC, and recF genes. It is not related to the size or the replicon type of the plasmid. Furthermore, it is also induced in cells which have been previously treated with other SOS system-inducing agents such as bleomycin, mitomycin C, or nalidixic acid. IPTE is therefore similar to other repair (SOS) functions inducible by DNA damage since all of them are dependent upon activation of the RecA protein. IPTE differs from other SOS functions in the absence of a direct control by the LexA repressor. PMID- 3285142 TI - On the prevention and treatment of calcification disorders of old age. AB - From several investigations it is known that magnesium oxide or hydroxide therapy causes a considerable delay of kidney stone recurrence in man. Further, it is known that the mortality of populations due to cardiovascular disease in areas with hard drinking water containing more magnesium and having a higher Mg/Ca ratio than soft water, is considerably lower than in soft water areas. In the present study a physiological model for the homeostasis of calcium and phosphate is given. It is shown that and why a slight magnesium deficiency causes the pH of bone extracellular fluid to decrease at or below the pH level of the other body fluids. This decrease makes the other body fluids supersaturated with octocalcium phosphate and this is the prime reason for calcification disorders in the soft tissues. Therefore, the hypothesis is proposed that soft tissue calcifications can be stopped and even prevented by magnesium therapy. However, they are not reversible and treatment with chelate therapy is contraindicated. PMID- 3285143 TI - Reappraisal of AIDS--is the oxidation induced by the risk factors the primary cause? AB - The emergence of AIDS as a recognizable disease, its epidemiology, the clinical and laboratory data and the way in which they have been interpreted to deduce the currently acceptable hypothesis of its aetiology and mechanism of transmission are critically examined. There is no compelling reason for preferring the viral hypothesis of AIDS to one based on the activity of oxidizing agents. In fact, the latter is to be preferred, since unlike the viral hypothesis it leads to possible methods of prevention and treatment using currently available therapeutic substances. PMID- 3285141 TI - Glucose starvation is required for insulin stimulation of glucose uptake and metabolism in cultured microvascular endothelial cells. AB - In the present study we determined the uptake and disposition of glucose in serum deprived rabbit coronary microvessel endothelial (RCME) cells. RCME cells exhibited stereospecific hexose uptake inhibited by cytochalasin B. Pretreatment of the RCME cells with potassium cyanide or 2,4-dinitrophenol inhibited 2 deoxyglucose uptake but not 3-O-methylglucose transport. A major proportion (30 60%) of the 2-deoxyglucose present in the RCME cells was not phosphorylated. These two observations suggested that the rate-limiting step in the uptake of 2 deoxyglucose was not transport but rather the phosphorylation of 2-deoxyglucose to 2-deoxyglucose 6-phosphate. When glucose-deprived cells were incubated 2 hr with [U-14C]glucose the disposition of the label was as follows: glycogen 60%, acid-soluble fraction 30%, and lipid less than 5%. In contrast glucose-fed cells exhibited lower overall glucose incorporation, and a slightly different disposition: glycogen 45%, acid-soluble fraction 50%, and lipid 5%. Glucose deprived RCME cells also exhibited greater basal levels of 2-deoxyglucose uptake compared to glucose-fed cells. RCME cells incubated in the absence of glucose and serum for 16 hr exhibited dose-dependent insulin stimulation of hexose uptake and subsequent metabolism to macromolecules (i.e., glycogen and the acid-soluble fraction). Significant effects of insulin were observed with concentrations as low as 2 x 10(-10) M, well within the physiological range. In contrast, cells preincubated in serum-free culture medium containing 5.5 mM glucose did not exhibit insulin-enhanced hexose uptake or glucose metabolism (even at doses as high as 10(-7) M). These studies indicate that the effects of insulin on rabbit coronary microvascular endothelial cell glucose uptake and metabolism require both serum and glucose deprivation. PMID- 3285144 TI - Do bone marrow fat cells or their precursors have a pathogenic role in idiopathic aplastic anaemia? AB - Idiopathic aplastic anaemia (AA), aplastic anaemia of unknown aetiology, is usually defined as marrow failure with fatty replacement of hemopoietic tissue and peripheral pancytopenia. The pathophysiology is largely unknown, though many mechanisms have been hypothesized. These include the absence of or defects in hemopoietic stem cells (HSC), abnormalities of the bone marrow (BM) microenvironment, immune system disorders and abnormalities of the regulatory factors that control hemopoiesis. The characteristic feature of AA is the replacement of hematopoietically active marrow by fat cells; however, the fat cells themselves have received little attention to date, and this apparent fatty marrow infiltration has been considered a secondary phenomenon. That the marrow fat cells in AA may be abnormal and may have a pathogenic role has never been considered. This communication, postulates that AA may result from an abnormal and excessive proliferation of marrow fat cells and the displacement of the hematopoietic tissue of the marrow; and that the resultant marrow failure could be a secondary phenomenon. PMID- 3285145 TI - Endourology and ureteroscopy. AB - Over the past 10 years, endourology and ureteroscopy have revolutionized the field of urinary endoscopy. No longer limited to cystoscopic examination of the lower genitourinary tract, endoscopy incorporates the upper tracts as well. With this surge in upper tract endoscopy has come a rise in the variety of medical instruments available to the endourologist. Beginning with rigid instruments that offered only a limited view, technology has advanced both flexible and rigid instruments that allow access to the entire urinary tract for examination and treatment. Lenses have been designed to give a clearer and wider view of the kidney and ureter, and forceps and graspers have been developed to treat the underlying pathologic conditions. Stents, wires, and nephrostomy tubes have been developed to keep the urinary system patent and readily accessible for reexamination. It is only through the continuous improvement of these instruments that endourology has advanced in the frontier of urologic surgery. PMID- 3285146 TI - Devices for monitoring intravesical pressure during transurethral resection of the prostate. AB - The importance of maintaining a low intravesical pressure during transurethral resection of the prostate has been demonstrated in studies of the relationship between bladder pressure and the amount of irrigating fluid absorbed during the procedure. Several methods of monitoring pressure are described, and the advantages and disadvantages of each are discussed. PMID- 3285147 TI - Clinical electroejaculation. AB - Anejaculation is a disorder that occurs infrequently in the general population, but it occurs in some cases of spinal cord injury and dissection of retroperitoneal lymph nodes for testicular cancer. It is associated with multiple sclerosis, transverse myelitis, and diabetes mellitus. Electroejaculation, which involves electrodes in a probe placed in the rectum, electrically stimulates emission of seminal fluid. Semen thus obtained can be used for artificial insemination if a patient and his spouse wish to become natural parents. PMID- 3285148 TI - Trade in human tissue needs regulation. Introductory perspective. PMID- 3285149 TI - Mass product-liability litigation. PMID- 3285150 TI - Angiotensin converting-enzyme inhibitors--the balance sheet. PMID- 3285151 TI - Stress and cardiovascular disease. PMID- 3285152 TI - Symptoms and the diagnosis of bowel cancer: a critical view. PMID- 3285153 TI - Stress and cardiovascular disease: a report from the National Heart Foundation of Australia. Stress Working Party. PMID- 3285154 TI - Haemopoietic growth factors. AB - Erythropoietin, GM-colony-stimulating factor and G-colony-stimulating factor are the first recombinant haemopoietic growth factors to reach clinical use. There are a number of additional haemopoietic regulators that have now been cloned and are being mass-produced with a view to clinical use. The next decade should witness exciting advances in the clinical treatment of haematological diseases and infections that will be comparable with those that were seen last with the introduction of effective treatments for pernicious anaemia. PMID- 3285155 TI - A skinful of dermal whine. PMID- 3285156 TI - [The possibility of a resting state in the cycle of erythrocytic schizogony in P. falciparum cultured in vitro]. PMID- 3285157 TI - [Echinococcosis in the Transcaucasian republics and the northern Caucasus]. PMID- 3285158 TI - [Electron microscopy study on the action of oocysts and sporozoites of the malaria parasite on the epithelium of the mosquito midgut]. PMID- 3285159 TI - Ion-selective potentiometry in clinical chemistry. A review. AB - Ion-selective potentiometry is used more and more in clinical medicine for the determination of electrolytes in various body fluids. With regard to K+, Na+, Ca2+ and Cl- this technique has almost completely displaced flame photometry, atomic absorption spectrophotometry and coulometry. Moreover, reliable automated devices have facilitated routine analyses. Until now there are 6 different types of ion-selective sensors: glass membrane, solid phase, fluid membrane, carrier, gas-sensitive, and enzyme electrodes with immobilized enzymes. The latter are particularly used for in vivo monitoring, especially for continuous blood glucose monitoring. The essential fields of application in the clinical laboratory are the determinations of the cations H+, K+, Na+, Ca2+, Mg2+ and NH3+, and the anions F-, I-, Br-, Cl- and HCO3-. Despite the wide-spread application of ion selective potentiometry a number of disturbing factors have to be taken into account by the user as well as by the manufacturer in order to get satisfactory results. For instance, there are differences between direct and indirect potentiometry. Moreover, the activities measured cannot be extrapolated readily to the desired concentrations. A careful and accurate calibration, a suitable sample preparation and an adjustment of the measuring conditions to the characteristics of the specimen and the matrix of the sample is necessary before each measurement. Therefore, a consequent internal and external quality control is necessary to achieve an optimal quality of these methods determining vital parameters in medicine. Thus, the technique of ion-selective potentiometry represents an important milestone in clinical chemistry. Moreover, being a very rapid procedure it is indispensable to clinical diagnostics. PMID- 3285160 TI - Materials aspects of implantable cardiac pacemaker leads. AB - The reliability of the leads of the entire pacemaker system is vital as the risks of failure include: (1) loss of pacing due to the deterioration of the polymeric insulator in the physiological environment; (2) thromboembolism due to inadequate blood compatibility of the insulator; (3) tissue reactions at the electrode/tissue interface; (4) general foreign body rejection phenomena; (5) perforation of the leads; and (6) excessive stress applied by sutures causing abrasion and stress cracking. Although silicone has been used widely, some years ago Pellethane (a segmented polyetherurethane-urea) has been introduced as an alternate lead insulator, chiefly because it can be extruded using additives into smooth and thin tubes. The additives (antioxidants), extrusion aids, and low molecular weight polymer chains (oligomers) together represent up to approximately 8% by weight of leachables, depending on the extraction medium. The in vivo degradation of Pellethane is biologic in nature and is most likely associated with the absorption and premeation of body fluids from the surrounding physiologic environment leading to stress cracking via the formation of microvoids. Thermally and biologically unstable biuret and allophonate groups in this polyurethane, exposure of the polymer to high extrusion temperatures, and stresses created within the polymer also play key roles in the degradation process. In the case of electrodes, some corrosion can occur even with noble metals and ions formed with the involvement of penetrating body fluids which may combine with the urethane and/or urea groups of the polyurethane, leading to its further degradation in vivo. The totality of the situation indicates a need for the development of a standard guideline for the uniform and consistent pre clinical testing and evaluation of new materials and fabrication processes of implantable pacemaker leads. Such guidelines should take into consideration, among others, the physiological environment, species-differences between test animals and humans, and observe reliable statistical interpretations based on sufficient data. PMID- 3285161 TI - [Immunoadsorption--a new treatment of myasthenia gravis]. PMID- 3285162 TI - [Vascular complications of the compression syndrome of the anterior thoracic aperture (thoracic outlet syndrome)]. PMID- 3285163 TI - [Idiopathic torticollis spasmodicus. Differential diagnosis and therapy]. PMID- 3285164 TI - [Pseudomembraneous colitis following antibiotic administration--a diagnostic and therapeutic challenge]. PMID- 3285165 TI - [Old and new technics of endoscopic lithotripsy]. PMID- 3285166 TI - [Giardiasis]. PMID- 3285167 TI - First day issue commemorating the Second Pan Arab Congress on Anesthesia & Intensive Care. Egypt 1987. PMID- 3285168 TI - Pathophysiology and treatment of venous air embolism--a review. PMID- 3285169 TI - Thrombolitic therapy--an overview. PMID- 3285170 TI - Failure of lidocaine to modify suxamethonium induced biochemical changes. AB - Twenty patients were studied in a prospective double-blind randomized trial to determine the effects of intravenous lidocaine pretreatment on suxamethonium induced biochemical changes. Lidocaine 1 mg. kg-1 failed to attenuate changes in serum potassium, significantly decreased serum calcium, and prolonged duration of suxamethonium blockade. There were no significant changes in plasmacholinesterase activity or other biochemical parameters. It is concluded that pretreatment with 1 mg. kg-1 lidocaine failed to attenuate suxamethonium induced biochemical changes. PMID- 3285171 TI - [Today's oral hypoglycemic agents]. PMID- 3285172 TI - The way we were: a nostalgic look at 50 years of progress (?). PMID- 3285173 TI - Meniere's disease. Recent advances. PMID- 3285174 TI - Credit where credit is due. PMID- 3285175 TI - Oxidation of 17 alpha-ethynylestradiol by human liver cytochrome P-450. AB - One of the classic examples of adverse drug interactions involves pregnancies in women using the oral contraceptive 17 alpha-ethynylestradiol who also ingest rifampicin or barbiturates or hydantoins. Previous work had demonstrated increased metabolism (2-hydroxylation) of 17 alpha-ethynylestradiol in individuals using rifampicin. In this report evidence is presented for the involvement of a specific form of human cytochrome P-450, termed P-450NF, in this phenomenon. Although purified P-450NF has only relatively low catalytic 17 alpha ethynylestradiol 2-hydroxylase activity, antibodies raised to P-450NF specifically inhibited greater than 90% of the activity in liver microsomes which had either high or low catalytic activity. When different liver samples were compared, rates of microsomal 17 alpha-ethynylestradiol 2-hydroxylation were highly correlated with amounts of immunochemically measured P-450NF or rates of nifedipine oxidation, a characteristic activity of P-450NF. Prior incubation of human liver microsomes with NADPH and troleandomycin resulted in decreased 17 alpha-ethynylestradiol 2-hydroxylation. In addition, 17 alpha-ethynylestradiol appears to be a mechanism-based inhibitor in human liver microsomes, as shown by the loss of both spectrally detectable cytochrome P-450 and 17 alpha ethynylestradiol 2-hydroxylase activity during incubation in the presence of NADPH. Additional experiments did not show any evidence for the involvement of a number of other human cytochrome P-450 enzymes in 17 alpha-ethynylestradiol 2 hydroxylation (i.e., P-450DB, P-450PA, P-450MP, P-450j). These results are consistent with the view that P-450NF is the major enzyme involved in 17 alpha ethynylestradiol oxidation and that drugs and hormones which influence the expression and activity of this enzyme can influence the efficacy and side effects of this compound. PMID- 3285176 TI - Domain structure and functional analysis of the carboxyl-terminal polyacidic sequence of the RAD6 protein of Saccharomyces cerevisiae. AB - The RAD6 gene of Saccharomyces cerevisiae, which is required for normal tolerance of DNA damage and for sporulation, encodes a 172-residue protein whose 23 carboxyl-terminal residues are almost all acidic. We show that this polyacidic sequence appends to RAD6 protein as a polyanionic tail and that its function in vivo does not require stoichiometry of length. RAD6 protein was purified to near homogeneity from a yeast strain carrying a RAD6 overproducing plasmid. Approximately the first 150 residues of RAD6 protein composed a structural domain that was resistant to proteinase K and had a Stokes radius typical of a globular protein of its calculated mass. The carboxyl-terminal polyacidic sequence was sensitive to proteinase K, and it endowed RAD6 protein with an aberrantly large Stokes radius that indicates an asymmetric shape. We deduce that RAD6 protein is monomeric and comprises a globular domain with a freely extending polyacidic tail. We tested the phenotypic effects of partial or complete deletion of the polyacidic sequence, demonstrating the presence of the shortened proteins in the cell by using antibody to RAD6 protein. Removal of the entire polyacidic sequence severely reduced sporulation but only slightly affected survival after UV irradiation or UV-induced mutagenesis. Strains with deletions of all but the first 4 or 15 residues of the polyacidic sequence were phenotypically almost wild type or wild type, respectively. We conclude that the intrinsic activity of RAD6 protein resides in the globular domain, that the polyacidic sequence has a stimulatory or modifying role evident primarily in sporulation, and that only a short section apparently functions as effectively as the entire polyacidic sequence. PMID- 3285177 TI - Purification of complexes of nuclear oncogene p53 with rat and Escherichia coli heat shock proteins: in vitro dissociation of hsc70 and dnaK from murine p53 by ATP. AB - Oligomeric protein complexes containing the nuclear oncogene p53 and the simian virus 40 large tumor antigen (D. I. H. Linzer and A. J. Levine, Cell 17:43-51, 1979), the adenovirus E1B 55-kilodalton (kDa) tumor antigen, and the heat shock protein hsc70 (P. Hinds, C. Finlay, A. Frey, and A. J. Levine, Mol. Cell. Biol. 7:2863-2869, 1987) have all been previously described. To begin isolating, purifying, and testing these complexes for functional activities, we have developed a rapid immunoaffinity column purification. p53-protein complexes are eluted from the immunoaffinity column by using a molar excess of a peptide comprising the epitope recognized by the p53 monoclonal antibody. This mild and specific elution condition allows p53-protein interactions to be maintained. The hsc70-p53 complex from rat cells is heterogeneous in size, with some forms of this complex associated with a 110-kDa protein. The maximum apparent molecular mass of such complexes is 660,000 daltons. Incubation with micromolar levels of ATP dissociates this complex in vitro into p53 and hsc70 110-kDa components. Nonhydrolyzable substrates of ATP fail to promote this dissociation of the complex. Murine p53 synthesized in Escherichia coli has been purified 660-fold on the same antibody affinity column and was found to be associated with an E. coli protein of 70 kDa. Immunoblot analysis with specific antisera demonstrated that this E. coli protein was the heat shock protein dnaK, which has extensive sequence homology with the rat hsc70 protein. Incubation of the immunopurified p53-dnaK complex with ATP resulted in the dissociation of the p53-dnaK complex as it did with the p53-hsc70 complex. This remarkable conservation of p53-heat shock protein interactions and the specificity of dissociation reactions suggest a functionally important role for heat shock proteins in their interactions with oncogene proteins. PMID- 3285178 TI - Transforming growth factor alpha: mutation of aspartic acid 47 and leucine 48 results in different biological activities. AB - To study the relationship between the primary structure of transforming growth factor alpha (TGF-alpha) and some of its functional properties (competition with epidermal growth factor (EGF) for binding to the EGF receptor and induction of anchorage-independent growth), we introduced single amino acid mutations into the sequence for the fully processed, 50-amino-acid human TGF-alpha. The wild-type and mutant proteins were expressed in a vector by using a yeast alpha mating pheromone promoter. Mutations of two amino acids that are conserved in the family of the EGF-like peptides and are located in the carboxy-terminal part of TGF alpha resulted in different biological effects. When aspartic acid 47 was mutated to alanine or asparagine, biological activity was retained; in contrast, substitutions of this residue with serine or glutamic acid generated mutants with reduced binding and colony-forming capacities. When leucine 48 was mutated to alanine, a complete loss of binding and colony-forming abilities resulted; mutation of leucine 48 to isoleucine or methionine resulted in very low activities. Our data suggest that these two adjacent conserved amino acids in positions 47 and 48 play different roles in defining the structure and/or biological activity of TGF-alpha and that the carboxy terminus of TGF-alpha is involved in interactions with cellular TGF-alpha receptors. The side chain of leucine 48 appears to be crucial either indirectly in determining the biologically active conformation of TGF-alpha or directly in the molecular recognition of TGF-alpha by its receptor. PMID- 3285179 TI - A DNA sequence conferring high postmeiotic segregation frequency to heterozygous deletions in Saccharomyces cerevisiae is related to sequences associated with eucaryotic recombination hotspots. AB - The meiotic behavior of two graded series of deletion mutations in the ADE8 gene in Saccharomyces cerevisiae was analyzed to investigate the molecular basis of meiotic recombination. Postmeiotic segregation (PMS) was observed for a subset of the deletion heterozygosities, including deletions of 38 to 93 base pairs. There was no clear relationship between deletion length and PMS frequency. A common sequence characterized the novel joint region in the alleles which displayed PMS. This sequence is related to repeated sequences recently identified in association with recombination hotspots in the human and mouse genomes. We propose that these particular deletion heterozygosities escape heteroduplex DNA repair because of fortuitous homology to a binding site for a protein. PMID- 3285180 TI - The a-factor pheromone of Saccharomyces cerevisiae is essential for mating. AB - The Saccharomyces cerevisiae pheromone a-factor is produced by a cells and interacts with alpha cells to cause cell cycle arrest and other physiological responses associated with mating. Two a-factor structural genes, MFA1 and MFA2, have been previously cloned with synthetic probes based on the a-factor amino acid sequence (A. Brake, C. Brenner, R. Najarian, P. Laybourn, and J. Merryweather, cited in M.-J. Gething [ed.], Protein transport and secretion, 1985). We have examined the function of these genes in a-factor production and mating by construction and analysis of chromosomal null mutations. mfa1 and mfa2 single mutants each exhibited approximately half the wild-type level of a-factor activity and were proficient in mating, whereas the mfa1 mfa2 double mutant produced no a-factor and was unable to mate. These results demonstrate that both genes are functional, that each gene makes an equivalent contribution to the a factor activity and mating capacity of a cells, and that a-factor plays an essential role in mating. Strikingly, exogenous a-factor did not alleviate the mating defect of the double mutant, suggesting that an a cell must be producing a factor to be an effective mating partner. PMID- 3285182 TI - [Significance of endocrinology in clinical pediatrics]. AB - Hormones are involved essentially in the general biological program of growth and differentiation. An important aim of clinical endocrinology is to recognise variants of normal development which should be evaluated against pathological conditions. As a context, growth in length and pubertal progress may be seen as "key-words" leading to special diagnostic procedures. With regard to some endocrine disorders, data being of principal and actual importance and dealing with diagnosis and therapy, were discussed shortly. PMID- 3285183 TI - The screening, diagnosis and evaluation of genotoxic agents with batteries of bacterial tests. AB - Bacterial tests can be used for several related purposes: the screening for genotoxic agents, genetic analysis of the mode of action of genotoxins and attempts to predict their effects in mammals. We examine various aspects of the assembly of tests into batteries with emphasis on the genetic properties of target bacterial cells. We discuss the problems of carcinogenicity prediction, the identification of particular types of DNA lesions, the study of mutagenic specificity and the elucidation of metabolic steps towards the ultimate genotoxin. PMID- 3285181 TI - Two-step stimulation of B lymphocytes to enter DNA synthesis: synergy between anti-immunoglobulin antibody and cytochalasin on expression of c-myc and a G1 specific gene. AB - Previously we demonstrated that stimulation of resting murine splenic B lymphocytes with goat anti-mouse immunoglobulin antibody (GaMIg) plus cytochalasin D (CD) led to DNA synthesis; GaMIg and CD added simultaneously, or GaMIg added before CD, induced this response (T. L. Rothstein, J. Immunol. 136:813-816, 1986). Cells similarly treated with GaMIg or CD alone did not enter S phase. Here we have measured the effects of this two-signal stimulation on the c-myc, 2F1, and gamma-actin genes. The expression of these growth-related genes is known to change either during the G0-to-G1 transition or in the G1 phase of the cell cycle. For the 2F1 and c-myc genes, neither the GaMIg nor CD stimulus alone led to a prolonged increase in mRNA levels, whereas GaMIg plus CD allowed for continuous elevated expression of these genes. Furthermore, GaMIg pretreatment rendered expression of the c-myc and 2F1 genes susceptible to subsequent action by CD. In contrast, CD alone was sufficient to produce changes in gamma-actin gene expression. Thus there are synergistic effects of competence- and progressionlike factors on the expression of the c-myc and 2F1 genes, and these effects correlate with the progression of B lymphocytes to DNA synthesis. PMID- 3285184 TI - Short-term testing--are we looking at wrong endpoints? AB - Short-term testing has been performed and interpreted on the basis of correlation between these tests and animal carcinogenicity. This empirical approach has been the only feasible one, due to a lack of knowledge of the actual genetic endpoints of relevance in carcinogenicity. However, the rapidly growing information on genetic alterations actually involved in carcinogenicity and in particular activation of oncogenes, provides facts of basic importance for the strategy of short-term testing. The presently used sets of short-term tests focus on standard genetic endpoints, mainly point mutations and chromosomal aberrations. Little attention has been paid in that connection to other endpoints, which have been shown or suspected to play an important role in carcinogenicity. These endpoints include gene amplification, transpositions, hypomethylation, polygene mutations and recombinogenic effects. Furthermore, indirect effects, for instance via radical generation and an imbalance of the nucleotide pool, may be of great significance for the carcinogenic and cocarcinogenic effects of many chemicals. Modern genetic and molecular technology has opened entirely new prospects for identifying genetic alterations in tumours and in its turn these prospects should be taken advantage of in order to build up more sophisticated batteries of assays, adapted to the genetic endpoints actually demonstrated to be involved in cancer induction. Development of new assay systems in accordance with the elucidation of genetic alterations in carcinogenicity will probably constitute one of the most important areas in genetic toxicology in the future. From a regulatory point of view the prerequisite for a development in this direction will be a flexibility of the handling of questions concerning short-term testing also at a bureaucratic level. PMID- 3285185 TI - The genetic toxicology of Gene-Tox non-carcinogens. AB - The Gene-Tox Program has identified 61 chemicals that have been tested in chronic rodent carcinogenesis bioassays and found to be inactive. The genetic toxicology data of these 61 non-carcinogens is reviewed and summarized. A large proportion of these chemicals have been tested to a limited extent in genetic toxicity bioassays: 32 in 2 tests or less. Of the remaining 29 chemicals, 28% have been tested in 9 or more tests which encompass a range of genetic endpoints: gene mutation, chromosomal effects, other genetic endpoints, and cell transformation. The genetic toxicity of 12 chemicals with sufficient data is discussed in detail: benzoin, caffeine caprolactam, ethanol, halothane, hycanthone methanesulfonate, malathion, maleic hydrazide, methotrexate, 1-naphthylamine, 4-nitro-o phenylenediamine, and p-phenylenediamine. A new technique for the evaluation of multiple test data, the "genetic activity profile", has been applied to 6 of these chemicals, allowing the qualitative and quantitative information to be compared collectively. In the evaluation of the genotoxicity effects of these non carcinogens, a number of discrepancies between the results from genetic toxicity bioassays and chronic rodent bioassays have been uncovered. These discrepancies are discussed in light of current knowledge on the strengths and weaknesses of both genetic toxicity bioassays and chronic rodent bioassays. PMID- 3285186 TI - Statistical analysis of Salmonella test data and comparison to results of animal cancer tests. AB - A quantitative framework for the analysis of results of the Salmonella (Ames) test is presented, and the relationship between mutagenesis and carcinogenesis is examined. Color graphics are used for the Salmonella data to describe variability, and trends across multiple chemicals and test conditions. Positivity in the Salmonella test, using statistical criteria to classify results, is compared to positivity in carcinogenesis bioassays for 48 chemicals tested in NCI/NTP-sponsored programs. Sensitivity of the Salmonella test across 5 tester strains was 91% (21/23), while specificity was only 36% (9/25). Results were most concordant for TA100 Aroclor-induced rat S9: sensitivity was 87%, specificity 64%. The correlation of mutagenic potency and carcinogenic potency was 0.41 (p less than 0.001) for 80 chemicals, using results from both the general published literature and the NCI/NTP-sponsored programs. After removal of 3 extreme values, the correlation was 0.24 (p = 0.04). PMID- 3285187 TI - An analysis by chemical class of Salmonella mutagenicity tests as predictors of animal carcinogenicity. AB - For a number of years, investigators have recognized that humans potentially are exposed to large numbers of genotoxicants. Many efforts have attempted to validate various short-term bioassays for use as rapid, inexpensive screens for genotoxicants--especially carcinogens. In this analysis, we examine Salmonella mutagenicity as an indicator of potential carcinogenicity by comparing published (and when possible, evaluated) Salmonella results with the evaluated Gene-Tox animal carcinogen data base. The Salmonella bioassay does especially well in those cases where the level of evidence for carcinogenicity is the strongest. Analysis shows that except for specific classes of compounds, the plate incorporation protocol and the preincubation protocol are equally efficient at detecting mutagens. This paper also demonstrates how validation values (sensitivity, specificity, etc.) vary with chemical class. Overall, this analysis demonstrates that when used and interpreted in a meaningful chemical class context, the Salmonella bioassay remains extremely useful in identifying potential animal carcinogens. PMID- 3285188 TI - Predicting carcinogenicity with short-term tests: biological models and operational approaches. AB - This paper illustrates the basic biological models that have had an influence on the development and deployment of short-term assays for carcinogens. A tentative description of such a conceptual framework is provided with the use of methods for the quantitative analysis of information. This picture is contrasted with the results of a series of statistical mathematical analyses carried out on real genotoxicity data bases. The resulting evidence indicates that the biological models derived from basic laboratory research are not adequate or sufficient to interpret the operational performances of short-term assays. Obviously these models are of great importance, but, this observed discrepancy suggests the need for articulated approaches, with particular emphasis on analytical tools able to interpret the complexity of these systems. In particular, the multivariate data analysis methods are indicated as suitable for the description of large and complex bodies of data, and the identification of typologies and regularities. A number of applications of such methods are also presented. The conclusion is that biological models and operational approaches have to interact on the same level. The operational approach should indicate whether the conceptual framework of the experimenter is adequate to describe the experimental situation and possibly point to new relationships and trends, as well as to practical solutions. PMID- 3285190 TI - The significance of DNA and protein adducts in human biomonitoring studies. PMID- 3285189 TI - An analysis of the Gene-Tox Carcinogen Data Base. AB - The Gene-Tox Carcinogen Data Base is an evaluated source of cancer data on 506 chemicals selected in part for their previous assessment in genetic toxicology bioassays. This data base has been analyzed for the distribution of these chemicals into chemical classes. The major chemical classes (6% or greater of the total data base) are: acyl-, alkyl-, and aryl-halides; alcohols and phenols; aliphatic and aromatic amines, amides, and sulfonamides; benzene-ring-containing chemicals; organo-lead, -mercury, -phosphorous compounds, metals and derivatives, phosphoric acid esters, and phosphoramides; and polycyclic aromatic hydrocarbons. Cancer studies representing a subset of the Gene-Tox Carcinogen Data Base, 199 chemicals which were rated as Sufficient Positive/Negative or Limited Positive/Negative, were examined for distribution of those studies by animal species, gender, route of chemical administration, duration of study, major tumor sites, and major tumor types. These analyses revealed that the Gene-Tox Carcinogen Data Base contains a large number of lifetime studies involving the rat and mouse treated by oral routes of administration. The major organs that were targets were: liver, lung, skin, forestomach, bladder, and mammary gland, while the major tumor types were: carcinoma, sarcoma, papilloma, and adenoma. Chemicals in the data base have been assessed for species-specific carcinogenic effects, and these results indicate that for mice and rats there is a high correspondence (85%). This number is higher than that (71%) reported by Tennant et al. (1986) based on the recent results of 72 chronic cancer bioassays performed by the National Toxicology Program. This difference is probably based on the nature of the chemicals selected for inclusion in both data bases. Although the absolute value of this correspondence is unknown, it would seem to be within this range. When chemicals in the Gene-Tox Carcinogen Data Base were examined for their previous evaluation in 73 genetic toxicology bioassays, only 26 of these bioassays had 30 or more chemicals. In these 26 bioassays, the prevalence of positive chemicals was generally greater than 80-90%. This suggests that a thorough evaluation of genetic toxicology bioassays in regard to their ability to predict carcinogenic effects in animals is premature at this time. PMID- 3285191 TI - Application of new techniques for the detection of carcinogen adducts to human population monitoring. AB - Several techniques have recently been developed for the detection and quantitation of carcinogen-DNA or -protein adducts without the requirement for radioactive carcinogens. These assays can be used to detect adducts in animals or cultured cells exposed to test compounds or in humans exposed to environmental carcinogens. Immunologic, 32P-postlabeling and fluorescence techniques, used on human samples for DNA adduct measurement, are reviewed here. Methods for the detection of carcinogen-protein adducts on human samples are also summarized. PMID- 3285192 TI - International Commission for Protection Against Environmental Mutagens and Carcinogens. ICPEMC publication No. 16. Testing for mutagens and carcinogens; the role of short-term genotoxicity assays. AB - The problems currently besetting approaches to the detection of chemicals likely to pose a mutagenic or carcinogenic hazard to humans are analysed. Some solutions to these problems are offered. PMID- 3285193 TI - Genetic toxicology: can we design predictive in vivo assays? AB - The present analysis examines the assumptions in, the perceptions and predictivity of and the need for short-term tests (STTs) for genotoxicity in light of recent findings that most noncarcinogens from the National Toxicology Program are genotoxic (i.e., positive in one or more in vitro STTs). Reasonable assumptions about the prevalence for carcinogens (1-10% of all chemicals), the sensitivity of these STTs (ca. 90% of all carcinogens are genotoxic) and their estimated "false positive" incidence (60-75%) imply that the majority of chemicals elicit genotoxic responses and, consequently, that most in vitro genotoxins are likely to be noncarcinogenic. Thus, either the usual treatment conditions used in these in vitro STTS are producing a large proportion of artifactual and meaningless positive results or else in vitro mutagenicity is too common a property of chemicals to serve as a useful predictor of carcinogenicity or other human risk. In contrast, the limited data base on in vivo STTs suggests that the current versions of these assays may have low sensitivity which appears unlikely to improve without dropping either their 'short-term' aspect or the rodent carcinogenicity benchmark. It is suggested that in vivo genotoxicity protocols be modified to take into consideration both the fundamentals of toxicology as well as the lessons learned from in vitro genetic toxicology. In the meantime, while in vivo assays are undergoing rigorous validation, genetic toxicology, as currently practiced, should not be a formal aspect of chemical or drug development on the grounds that it is incapable of providing realistic and reliable information on human risk. It is urged that data generated in new, unvalidated in vivo genotoxicity assays be exempted from the normal regulatory reporting requirements in order to encourage industry to participate in the laborious and expensive development of this next phase of genetic toxicology. PMID- 3285194 TI - The use of short-term tests for the detection of genotoxic activity in body fluids and excreta. PMID- 3285195 TI - Short-term tests for teratogens. PMID- 3285196 TI - The equivalence of assays within individual guidelines for the testing of the potential mutagenicity of chemicals: problems associated with battery selection. AB - Many individual Mutagenicity Guidelines contain suggested test systems with choices of such parameters as strains, cell types and even endpoint assayed. Comparisons have been made of data obtained from variants of yeast assays for the induction of mitotic recombination, in vitro assays for the induction of chromosome aberrations and assays for the induction of cell transformation. Individual test variants included in guidelines of the EEC and OECD show considerable qualitative and quantitative variability of response to potential mutagens and carcinogens. Such variability between assays within the same guideline raises considerable problems in the selection of test batteries chosen from published Mutagenicity Guidelines. Improved battery selection is dependent upon the reduction of choice within guidelines to those assays which produce consistent and reproducible results. PMID- 3285197 TI - Reflections on the declining ability of the Salmonella assay to detect rodent carcinogens as positive. AB - It is suggested that urgent attempts should be made to define and gain general agreement for the existence of two classes of animal carcinogen, those which are genotoxic and those which are not. In the absence of such a step, attempts to validate in vivo genotoxicity assays, and to derive a meaningful structure activity database for chemical carcinogenesis, will be frustrated. These suggestions are supported by the preliminary findings of a detailed analysis of the carcinogen database accrued by the United States National Toxicology Program. The possibility that many non-genotoxic carcinogens should be regarded as tumour promoting agents is considered. PMID- 3285198 TI - Quantifying genotoxicity and non-genotoxicity. AB - Since the ability to induce genotoxicity is often equated with the potential for initiating the carcinogenic process, a method for quantitating genotoxicity would provide a useful measure for this potential. It is demonstrated herein that CPBS, the Carcinogenicity Prediction and Battery Selection method, provides a useful quantitative measure of genotoxicity as well as allowing for the detailed evaluation of the performance of batteries of short-term tests in order to select those predictive of carcinogenic potential. PMID- 3285199 TI - Evolution of testing strategies for genetic toxicity. AB - Shortly following the inception of genetic toxicology as a distinct discipline within toxicology, questions arose regarding the type and number of tests needed to classify a chemical as a mutagenic hazard or as a potential carcinogen. To some degree the discipline separated into two sub-specialties, (1) genetic risk assessment and (2) cancer prediction since data from experimental oncology also supports the existence of a genotoxic step in tumor initiation. The issue of which and how many tests continued to be debated, but is now focused more tightly around two independent phenomena. Tier or sequential testing was initially proposed as a logical and cost-effective method, but was discarded on the basis that the lower tier tests appeared to have too many false responses to force or exclude further testing of the test agent. Matrix (battery) testing was proposed for screening on the hypothesis that combinations of endpoints and multiple phylogenetic target organisms were needed to achieve satisfactory predictability. As the results from short-term test 'validation' studies for carcinogen prediction and evaluations of EPA's Gene-Tox data accumulated, it became obvious that qualitative differences remained between predictive and definitive tests and by assembling different combinations of short-term assays investigators did not appear to resolve the lack of concordance. Recent trends in genetic toxicology testing have focused on mathematical models for test selection, and standardized systems for multi-test data assessment. PMID- 3285200 TI - Application of a cellular test battery in the decision point approach to carcinogen identification. AB - The assessment of the potential carcinogenicity of a chemical requires a systematic approach taking into account various types of data. Important information on the DNA reactivity and other genetic effects of chemicals can be obtained from a battery of cellular tests. A battery is described which includes DNA repair in hepatocytes, mutagenesis in Salmonella typhimurium, mutagenesis, chromosome alterations, and transformation in mammalian cells. The interpretation of findings in this battery for the identification of potential carcinogenicity of chemicals is discussed. PMID- 3285201 TI - The ability of plant genotoxicity assays to predict carcinogenicity. AB - A number of assays have been developed which use higher plants for measuring mutagenic or cytogenetic effects of chemicals, as an indication of carcinogenicity. Plant assays require less extensive equipment, materials and personnel than most other genotoxicity tests, which is a potential advantage, particularly in less developed parts of the world. We have analyzed data on 9 plant genotoxicity assays evaluated by the Gene-Tox program of the U.S. Environmental Protection Agency, using methodologies we have recently developed to assess the capability of assays to predict carcinogenicity and carcinogenic potency. All 9 of the plant assays appear to have high sensitivity (few false negatives). Specificity (rate of true negatives) was more difficult to evaluate because of limited testing on non-carcinogens; however, available data indicate that only the Arabidopsis mutagenicity (ArM) test appears to have high specificity. Based upon their high sensitivity, plant genotoxicity tests are most appropriate for a risk-averse testing program, because although many false positives will be generated, the relatively few negative results will be quite reliable. PMID- 3285202 TI - The mutagenic activity of chlorpromazine. AB - The mutagenic activity of chlorpromazine hydrochloride based on the Ames plate incorporation test and the modified fluctuation test in the presence and absence of liver microsomal enzyme (S9 fraction) and NADPH was determined. The results indicated that chlorpromazine required activation for mutagenic activity for the reversion of some of the tester bacterial strains from tryptophan and histidine dependence to independence respectively. The positive response of Escherichia coli WP2 trp, uvrA, E. coli WP2 trp (pKM101 and pAQ1) and Salmonella typhimurium his TA102 indicated that chlorpromazine mediates base-pair substitution and frame shift mutagenesis. PMID- 3285203 TI - Harman and norharman induce SOS responses and frameshift mutations in bacteria. AB - Norharman and harman, beta-carboline derivatives with comutagenic activity in Salmonella typhimurium, were examined for their activity to induce SOS responses in S. typhimurium using the umu-test and mutations in Escherichia coli. The inducibility of the umuC gene by norharman and harman was assayed by measuring the levels of beta-galactosidase activity in tester cells harbouring the umuC' 'lacZ fusion gene on a plasmid. In the umu-test, both norharman and harman weakly induced umuC gene expression at 25-100 and 50-150 micrograms/ml, respectively. In the mutation test using reversion from trpE9777 to Trp+, harman was relatively more potent than norharman in inducing the mutations. These results indicate that norharman and harman induce SOS responses as well as reversion of trpE9777 frameshift mutation in bacteria. PMID- 3285204 TI - Interaction between cigarette smoke condensate and radiation for the induction of genotoxic effects in yeast. AB - Induction of gene conversion in diploid yeast strains BZ34 and D7 was investigated following exposure to cigarette smoke condensate (CSC) and gamma radiation. Cells treated with CSC for 1 h showed 5-10-fold increase in gene conversion over the background frequency. Log-phase cells were 2-3 times more sensitive compared to stationary-phase cells. Cells exposed to a combination of CSC and radiation suggested an additive response of the 2 agents, irrespective of the order of the 2 treatments. PMID- 3285205 TI - Metabolic fate of N1-methyladenine in yeast auxotrophic to adenine. AB - The metabolic fate of N1-methyladenine in yeast with respect to its incorporation into RNA has been studied. Chromatographic analysis of the PCA-soluble and insoluble fractions of cells grown in the combined presence of adenine and 3H labeled N1-methyladenine show that (a) N1-methyladenine can enter the cells, (b) however, it is very poorly utilized by the salvage pathway for nucleic acid synthesis and (c) the inhibition occurs probably at the first stage of conversion of the methylated base to the corresponding nucleotide. PMID- 3285206 TI - Sequence and structure of a Plasmodium falciparum telomere. AB - We have isolated a 3 kb cloned DNA fragment which originated from a telomere of the human malaria parasite Plasmodium falciparum. The complete nucleotide sequence of the clone is presented. The clone is composed of several distinct structural regions which vary in their sequence complexity. Using oligonucleotide probes for the different structural regions, we analyzed the genetic conservation of sequence organization near telomeres in various strains of P. falciparum. Our results suggest that rapid sequence variability is generated in the vicinity of chromosome ends. PMID- 3285207 TI - Characterization of dystrophin in muscle-biopsy specimens from patients with Duchenne's or Becker's muscular dystrophy. AB - A deficiency of the protein dystrophin has recently been shown to be the probable cause of Duchenne's muscular dystrophy. We sought to determine the relation between the clinical phenotype and the status of dystrophin in muscle-biopsy specimens from 103 patients with various neuromuscular disorders. We found very low levels (less than 3 percent of normal levels) or no dystrophin in the severe Duchenne phenotype (35 of 38 patients), low concentrations of dystrophin in the intermediate (outlier) phenotype (4 of 7), and dystrophin of abnormal molecular weight in the mild Becker phenotype (12 of 18). Normal levels of dystrophin of normal molecular weight were found in nearly all the patients (38 of 40) with 20 other neuromuscular disorders we studied. These data show the clinical consequences of both quantitative alterations (in Duchenne's and intermediate dystrophy) in a single protein. The biochemical assay for dystrophin should prove helpful in delineating myopathies that overlap clinically with Duchenne's and Becker's dystrophies, and it shows promise as an accurate diagnostic tool. PMID- 3285208 TI - Activation of the c-myc oncogene in a precursor-B-cell blast crisis of follicular lymphoma, presenting as composite lymphoma. PMID- 3285209 TI - Dystrophin: a triumph of reverse genetics and the end of the beginning. PMID- 3285210 TI - Amyand's hernia. PMID- 3285211 TI - Current concepts. Treatment of infections associated with human immunodeficiency virus. PMID- 3285212 TI - Loss of ras oncogene mutation in a myelodysplastic syndrome after low-dose cytarabine therapy. PMID- 3285213 TI - Propylthiouracil for alcoholic liver disease. PMID- 3285214 TI - Plasma glucose concentrations at the onset of hypoglycemic symptoms in patients with poorly controlled diabetes and in nondiabetics. AB - We tested the hypothesis that during decrements in plasma glucose concentration, symptoms of hypoglycemia may occur at higher glucose concentrations in patients with poorly controlled insulin-dependent diabetes mellitus than in persons without diabetes. Symptoms of hypoglycemia and counterregulatory neuroendocrine responses were quantified during hypoglycemic and euglycemic clamp studies in eight patients with insulin-dependent diabetes mellitus selected because their hemoglobin A1 levels were above 10 percent. These data were compared with similar observations in 10 nondiabetic subjects studied previously. Glycemic thresholds- the plasma glucose concentrations during each hypoglycemic clamp study at which a given symptom or biochemical measurement first exceeded its 95 percent confidence interval determined in the euglycemic clamp studies--were calculated for each variable. The mean (+/- SE) glycemic threshold for the symptoms of hypoglycemia was 4.3 +/- 0.3 mmol per liter (78 +/- 5 mg per deciliter) in patients with poorly controlled diabetes--significantly higher (P less than 0.001) than the value of 2.9 +/- 0.1 mmol per liter (53 +/- 2 mg per deciliter) in subjects without diabetes. The mean glycemic thresholds for growth hormone, epinephrine, and cortisol secretions were not significantly different in the two groups. Thus, during decreases in the plasma glucose concentration, patients with poorly controlled insulin-dependent diabetes mellitus may experience symptoms of hypoglycemia at higher plasma glucose concentrations than persons without diabetes. The mechanism underlying this observation remains to be defined. PMID- 3285216 TI - Thrombolytic therapy: current status (1). PMID- 3285215 TI - Comparison of three immunosuppressive regimens in cadaver renal transplantation: long-term cyclosporine, short-term cyclosporine followed by azathioprine and prednisolone, and azathioprine and prednisolone without cyclosporine. AB - We conducted a randomized trial in seven Australian hospitals of the efficacy and safety of three immunosuppressive regimens after first transplantation of a cadaver kidney: long-term cyclosporine, short-term (three months) cyclosporine followed by azathioprine and prednisolone, and azathioprine and prednisolone without cyclosporine. Patients assigned to long-term cyclosporine (n = 138) or short-term cyclosporine followed by azathioprine and prednisolone (n = 141) had similar actuarial 12-month survival (98.4 vs. 96.4 percent) and graft survival (83.9 vs. 82.1 percent). Patients assigned to receive only azathioprine and prednisolone (n = 138), with optional use of antithymocyte globulin, had a significantly poorer survival rate (91.3 percent, P = 0.015) because of deaths from cardiac causes and infection, but their graft survival of 76.0 percent (P = 0.31) did not differ significantly from that of either group receiving cyclosporine. After the switch from cyclosporine to azathioprine and prednisolone, 15 percent of patients had reversible rejection episodes, but the frequency of rejection and graft loss did not differ from that in the long-term cyclosporine group. After the change to azathioprine and prednisolone, serum creatinine levels declined in nearly all patients, so that after three months they were comparable to those in the group receiving azathioprine and prednisolone only, and significantly lower than those in the group receiving long term cyclosporine therapy (P less than 0.003). We conclude that the two cyclosporine regimens result in comparable patient and graft survival, but that changing to azathioprine and prednisolone at three months improves graft function. PMID- 3285217 TI - Nocturnal hypoglycemia as a cause of fasting hyperglycemia (Somogyi phenomenon) PMID- 3285218 TI - Cyclophosphamide and bone marrow transplantation. PMID- 3285219 TI - Quantitative assessment of worldwide contamination of air, water and soils by trace metals. AB - Calculated loading rates of trace metals into the three environmental compartments demonstrate that human activities now have major impacts on the global and regional cycles of most of the trace elements. There is significant contamination of freshwater resources and an accelerating accumulation of toxic metals in the human food chain. PMID- 3285220 TI - A simple structural feature is a major determinant of the identity of a transfer RNA. AB - Analysis of a series of mutants of an Escherichia coli alanine transfer RNA shows that substitution of a single G-U base pair in the acceptor helix eliminates aminoacylation with alanine in vivo and in vitro. Introduction of that base pair into the analogous position of a cysteine and a phenylalanine transfer RNA confers upon each the ability to be aminoacylated with alanine. Thus, as little as a single base pair can direct an amino acid to a specific transfer RNA. PMID- 3285221 TI - Insulin-regulatable tissues express a unique insulin-sensitive glucose transport protein. AB - At least three different glucose transport systems exist in mammalian cells. These are: (1) the constitutively active, facilitative carrier characteristic of human erythrocytes, Hep G2 (ref. 2) cells and rat brain; (2) the Na-dependent active transporter of kidney and small intestine; and (3) the facilitative carrier of rat liver (B. Thorens and H. F. Lodish, personal communication). A fourth possible glucose transport system is the insulin-dependent carrier that may be specific to muscle and adipose tissue. This transporter resides primarily in an intracellular compartment in resting cells from where it translocates to the cell surface upon cellular insulin exposure. This raises the question of whether hormonal regulation of glucose transport is conferred by virtue of a tissue-specific signalling mechanism or a tissue-specific glucose transporter. Here we present data supporting the latter concept based upon a monoclonal antibody against the fat cell glucose transporter that identifies a unique, insulin-regulatable glucose transport protein in muscle and adipose tissue. PMID- 3285222 TI - Commercial venture to speed up AIDS drug tests in California. PMID- 3285223 TI - Cingulin, a new peripheral component of tight junctions. AB - The tight junction (Zonula occludens), a belt-like region of contact between cells of polarized epithelia, serves as a selective barrier to small molecules and as a total barrier to large molecules, and is involved in the separation between lumenal and basolateral compartments of the epithelium. In the electron microscope, tight junctions show focal regions of apparent fusion between the adjoining cell membranes, and freeze-fractured membranes display an elaborate network of branching and anastomosing strands. Very little is known about the molecular composition and architecture of tight junctions. The first specific zonula occludens-associated protein, designated ZO-1, has recently been identified in mammalian epithelial and endothelial cells. Here we describe the identification and purification of a new component of this junctional complex in avian brush-border cells, which we name cingulin. Cingulin is an acidic, heat stable protein, with a highly elongated shape. Immunofluorescence and immunoelectron microscopy of brush-border cells with anti-cingulin antibodies show that cingulin is localized in the apical zone of the terminal web, at the endofacial surfaces of the zonula occludens. PMID- 3285224 TI - [Change and controversy of paradigms in the neurophysiology of motor control]. AB - A review is given of the theoretical trends in modern neurophysiology of motor control. Three periods are distinguished to which paradigmatic basic concepts, in the sense of Th. Kuhn, can be assigned. The main exponents of these concepts, their ideological background and their critics are briefly presented. Detailed consideration is given to the present controversial discussions on the basic understanding of the psycho-mental processes in the brain. Here, the old struggle between dualists and monists has awakened to new life. Recently, science itself has discovered fundamental limitations to the epistemological capacities of the human mind, which indicate a "metatheoretical ambiguity" of natural occurrences. This allows for several different (but provisional) interpretations even of human thought and action, which, however, remain ultimately unresolved. PMID- 3285225 TI - The mechanism of yohimbine-induced renin release in the conscious rat. AB - These studies were designed to determine the role of the central nervous system, the sympathetic nervous system, the adrenal glands and the renal sympathetic nerves in yohimbine-induced renin release in conscious rats. Yohimbine (0.3-10 mg/kg, s.c.) caused time- and dose-related increases in plasma renin activity (PRA) and concentration (PRC) which were accompanied by time- and dose-related elevations of plasma norepinephrine (NE) and epinephrine (Epi) concentrations. Significant positive correlations were found between the increases in PRA and the increases in plasma NE and Epi concentrations caused by yohimbine, and propranolol (1.5 mg/kg, s.c.) blocked 90% of yohimbine (3 mg/kg, s.c.)-induced renin release. Over the entire spectrum of doses of yohimbine, the increases in PRA and plasma NE and Epi concentrations were positively correlated with the decreases in mean arterial pressure (MAP), but the y-intercept was positive in every case and the 1 mg/kg dose of yohimbine consistently increased PRA independent of any change in MAP. Complete renal denervation, as evidenced by a greater than 90% reduction in renal NE content, did not alter the increase in PRA caused by yohimbine (3 mg/kg, s.c.). An increase in circulating plasma catecholamine concentrations appeared to mediate yohimbine-induced renin release since propranolol prevented the rise in PRA caused by yohimbine in renal denervated rats. Prior adrenalectomy (Adx) also failed to prevent the rise in PRA produced by yohimbine (3 mg/kg, s.c.), but a combination of Adx and renal denervation caused a significant impairment of yohimbine-induced renin release. However, neither Adx alone nor the combination of Adx and renal denervation affected the increase in plasma NE concentration caused by yohimbine. Complete transection of the spinal cord at C8 caused a drastic reduction in plasma catecholamine concentrations but did not change basal PRC. Yohimbine (3 mg/kg, s.c.) did not increase PRC or plasma catecholamine concentrations after spinal transection. Based on these results, we conclude that 1) the stimulation of renin release by yohimbine is a secondary neurohormonal consequence of the generalized increase in sympathetic activity caused by yohimbine, 2) the sympathoadrenal activation produced by yohimbine results from an action in the brain which is amplified by the simultaneous blockade of prejunctional alpha 2 adrenoceptors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3285226 TI - Fendiline and calmidazolium enhance the release of endothelium-derived relaxant factor and of prostacyclin from cultured endothelial cells. AB - We investigated the effects of fendiline, calmidazolium and trifluoperazine, compounds described as calmodulin antagonists, on the release of the endothelial autacoids prostacyclin (PGI2) and endothelium-derived relaxant factor (EDRF). Cultured bovine aortic endothelial cells were grown on microcarrier beads and continuously superfused with Tyrode's solution. Samples collected from the superfusate were assayed for PGI2 concentration (6-keto PGF1 alpha radioimmunoassay) and for EDRF activity (stimulation of soluble guanylate cyclase in vitro). Stimulation of endothelial cells by ATP (3 microM) resulted in a 6.9 +/- 1.4-fold increase of PGI2 concentration in the superfusate (p less than 0.01) and an 8.6 +/- 3.4-fold enhanced guanylate cyclase activity (p less than 0.01). In the presence of calmidazolium (10 microM), the basal values of PGI2 concentration increased 28-fold (p less than 0.01) and the guanylate cyclase activity 10-fold (p less than 0.01). Further enhancement of both was observed after additional administration of ATP. Fendiline (30 microM) did not affect autacoid release by non-stimulated cells. However, the ATP-induced release of PGI2 and EDRF was more than doubled (p less than 0.01) in the presence of this drug compared to ATP-stimulation alone. Trifluoperazine (10 microM) had no enhancing effect on EDRF release, and the ATP-induced release of PGI2 was even significantly attenuated by 84 +/- 12% (p less than 0.01). Calmidazolium and fendiline were also applied to endothelial cells loaded with the fluorescent indicator of free calcium concentration (Ca2i+), indo-1. However, effects of calmidazolium on Ca2i+ could not be quantified since calmidazolium caused some leakage of indo-1 out of the cells. A smaller leakage was observed during the combined application of fendiline and ATP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285228 TI - Primary hyperparathyroidism. PMID- 3285227 TI - Effects of thromboxane synthase inhibitors on renal function. AB - In general the effects of thromboxane A2(TXA2) on renal function are opposite those produced by other prostanoids. TXA2 synthase inhibitors decrease the biosynthesis of TXA2 and may increase the production of other prostanoids by causing endoperoxide shunting. Therefore, in situations of increased kidney arachidonate mobilization, inhibition of renal TXA2 synthase might alter renal function by reducing TXA2 production and/or increasing prostaglandin (PG) biosynthesis. This hypothesis was tested by comparing the changes in renal function induced by suprarenal aortic constriction in anesthetized dogs pretreated with either a TXA2 synthase inhibitor (UK38,485; n = 7 or OKY1581; n = 7) or vehicle (0.1 M Na2CO3; n = 9). Several renal function parameters were compared in control versus treated animals by analysis of variance. Neither UK38,485 (1 mg/kg, i.v.) nor OKY1581 (10 mg/kg, i.v.) significantly altered renal artery hypotension-induced changes in mean arterial blood pressure, heart rate, renal blood flow, renal vascular resistance, glomerular filtration, filtration fraction, urine flow rate, sodium excretion rate, fractional sodium excretion, potassium excretion, or fractional potassium excretion. However, both UK38,485 and OKY1581 seemed to attenuate the increase in renal renin secretion rate induced by suprarenal aortic constriction. We conclude that acute administration of TXA2 synthase inhibitors does not modify acute renal artery hypotension induced changes in either electrolyte excretion or renal hemodynamics. However, acute administration of TXA2 inhibitors attenuates suprarenal aortic constriction induced increases in renin release in anesthetized dogs by unknown mechanisms. PMID- 3285229 TI - An attempt to prevent private practitioners and Bryan Memorial Hospital in performing renal transplantation. PMID- 3285230 TI - My dear rural Medicare patients. PMID- 3285231 TI - AIDS update 1988. PMID- 3285232 TI - [An autopsy case of a persistent primitive trigeminal artery aneurysm]. AB - A case of an aneurysm on the persistent primitive trigeminal artery (PPTA) is reported. A seventy-five-year-old woman with subarachnoid hemorrhage was admitted to the Hospital six hours after the onset. She was lethargic and had stiffness of her neck with severe headache and vomiting. Computed tomographic examination showed marked subarachnoid hemorrhage in the basal cisterns, especially in the ambient cistern on the right side. Cerebral angiogram revealed the right PPTA having a saccular aneurysm on the trunk. Her advanced age and the special location of the aneurysm did not allow direct operation in the acute stage. She died of rebleeding of the aneurysm thirty days after admission. Pathological study showed that the PPTA was originated from the cavernous portion of the right internal carotid artery and joined to the cephalad portion of the basilar artery. The aneurysm, 10 X 7 mm in size, was located at the curved midportion of PPTA, 9 mm proximal to the basilar artery. The proximal portion of the PPTA to the aneurysm had severe arteriosclerosis, whereas the distal portion showed less sclerotic change. However, there were no evidences of developmental anomaly in the wall of the PPTA. Eighteen cases of PPTA with the aneurysm arisen from PPTA itself or at its junction with internal carotid artery have been previously reported. PPTA in any case has not been examined pathologically. It has been speculated that dysplasia of the PPTA wall contributes to initiating the aneurysm on the PPTA. However our histopathological examination of the PPTA revealed no evidence of dysplasia in the PPTA wall.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285233 TI - [Werner's syndrome associated with meningioma: case report]. AB - We present two cases of Werner's syndrome associated with intracranial meningioma. Characteristic clinical features of Werner's syndrome include short stature with slender extremities, premature senility, juvenile cataract, skin changes, a tendency to diabetes mellitus and familial occurrence. A 44-year-old female, who had been treated for diabetes mellitus, was diagnosed as having Werner's syndrome because of various characteristic features. A falx meningioma was incidentally found on CT scan, and was surgically removed. Her diabetes mellitus improved. The second case was a 28-year-old male was diagnosed as having Werner's syndrome, diabetes mellitus, juvenile cataract, together with diabetes insipidus, and liver dysfunction. He developed severe headache, gait disturbance and then became unconscious with right hemiparesis. He was found to have a parasagittal meningioma by CT scan and angiography. After removal of the tumor, diabetes mellitus, diabetes insipidus and liver dysfunction improved. The reported incidence of neoplasms associated with Werner's syndrome is about 10%. The majority of associated tumors were mesenchymal in origin. Ten meningiomas, 1 neurinoma and 2 gliomas are reported as associated tumors in the central nervous system. Most of the associated meningiomas were asymptomatic and found incidentally at autopsies or CT scans. Diabetes mellitus associated with Werner's syndrome is generally mild with high immunoreactive insulin value and is controllable by diet therapy and oral antidiabetic drugs. Daily profile of blood sugar improved after the removal of tumor in our cases. In 50 gm glucose tolerance test, tendency of delayed appearance of peak value, which is common in Werner's syndrome, was not altered in our cases. Discussion is made as to the association of Werner's syndrome with meningioma and diabetes mellitus. PMID- 3285234 TI - [Report of a case of intraosseous meningioma]. AB - Cases of intraosseous meningioma appear to be very rare. In the present paper, we report such a case and discuss its etiological histogenesis on the basis of a review of 26 cases previously reported. A 71-year-old female was admitted to our department because of a painless mass in the right parietal region. Neurological findings were normal. Plain skull radiograph showed a 6 X 5-cm osteolytic lesion in the right fronto-parietal bone. CT scan demonstrated this lesion as a mass showing homogeneous enhancement with contrast medium. A right common carotid angiogram showed an avascular area in the parietal region and no tumor stain. The tumor, which was partly attached to the underlying dura, was totally removed surgically, and the postoperative course was uneventful. Histological examination of the specimen revealed fibroblastic meningioma, which was limited only to the outer membrane of the dura. The inner membrane was intact and free of tumor invasion. The histogenesis of intraosseous meningioma is still controversial but the following theories seem to be widely accepted: (1) The tumor arises from a part of the dura which has become trapped in a suture during embryological development. (2) The tumor arises from a part of the dura which has become trapped in a suture due to pressure on the head during delivery. (3) The tumor arises from a part of the dura which has become trapped in the bone due to trauma. (4) The dura which has become trapped in a suture during embryological development may undergo neoplastic change following traumatic stimulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285235 TI - [Subacute subdural hematoma associated with moyamoya phenomenon--a case report]. AB - A case of subacute subdural hematoma associated with moyamoya phenomenon is reported. On May 8, 1986, a 61-year-old female was referred to Mito National Hospital for evaluation of a left-sided hemiparesis and headache 8 days after minor head injury. Seventeen years ago she experienced the sudden onset of a left sided hemiparesis which improved by rehabilitation. CT scans showed a thin high density area on the right cerebral convexity and a small low density area in the right semiovale center. On May 12, she was admitted because of aggravation of her symptoms. A repeat CT scan showed an enlarged right temporoparietal subdural hematoma with significant mass effect. Cerebral angiograms revealed the occlusion of right internal carotid artery. There were so-called moyamoya vessels bilaterally and transdural anastomosis on the right side. Avascular area confirmed subdural hematoma. The hematoma was evacuated via two burr holes with preservation of the middle meningeal and superficial temporal arteries. By the time of discharge two months postoperatively, she was walking well without assistance. We reviewed four cases of acute or subacute subdural hematoma associated with moyamoya phenomenon and emphasized the possibility of occurrence of acute or subacute subdural hematoma due to rupture of vault moyamoya vessels. PMID- 3285236 TI - [Two cases of spontaneous occlusion of the internal carotid artery due to a giant intracranial internal carotid artery aneurysm]. AB - Although spontaneous thrombosis of a giant intracranial aneurysm is comparatively common, its parent artery occlusion is rare. Recently we experienced two cases in which spontaneous thrombosis of giant intracranial internal carotid artery aneurysm and occlusion of its parent artery were occurred. Case 1. A 49-year-old man, complaining esotropia was referred to us by an ophthalmologist. He had no particular past history. Neurological examination revealed left oculomotor, abducens palsy and disturbance of left trigeminal first branch. CT scan revealed a round high density mass in the left middle fossa. The size was 3 cm in diameter. Left CAG revealed severe stenosis of left internal carotid artery and in delayed phase, faint shadow was seen near posterior clinoid process. MRI revealed a high intensity mass of the intraaneurysmal thrombus in the left middle fossa with small low intensity area indicating residual lumen. With conservative treatment, the symptom was gradually improved and one month after admission, complete occlusion of the left internal carotid artery was seen by angiography. The patient returned to his previous occupation. Case 2. A 21-year-old man was admitted to our hospital complaining dysarthria and left hemiparesis. He had been diagnosed as left internal carotid giant aneurysm 5 years before when he had suffered from right visual disturbance. Neurological examination revealed left hemiparesis and dysarthria. CT scan revealed high density mass which extended from the base of the right middle fossa to the third ventricle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285237 TI - The patterns of [14C]2-deoxyglucose uptake in female rat brain produced by electrical stimulation of hypothalamic and limbic brain areas. AB - The aim of this study was to investigate the pattern of [14C]2-deoxyglucose uptake in anaesthetized rat brain produced by electrical stimulation of brain areas implicated, by previous electrical stimulation studies, in the neural control of pituitary hormone and especially gonadotrophin secretion. Stimulation of the median eminence led to a significant increase in the relative metabolic activities of the arcuate, ventromedial hypothalamic, supraoptic and paraventricular nuclei and the preoptic area. Stimulation of the suprachiasmatic or paraventricular nuclei or the medial preoptic area, anterior hypothalamic area, the dorsal or ventral hippocampus or amygdala led to an increase in the relative metabolic activity of many brain regions known to have direct connections with these areas, but in addition produced increases in the relative metabolic activity of areas which have secondary connections. Hippocampal stimulation confirmed previous neuroanatomical findings of major intrinsic functional connections between different fields of the ipsilateral and contralateral hippocampus. Stimulation of the amygdala, unexpectedly, did not change the relative metabolic activity of the arcuate nucleus and medial preoptic area which have neuroanatomical connections with the amygdala. Similarly, stimulation of the medial preoptic area did not change significantly the relative metabolic activity of the mamillary body and dorsomedial thalamic area. The effect of preoptic area stimulation on the relative metabolic activity of several brain regions was changed by ovariectomy and by injection of oestradiol benzoate. Stimulation of the preoptic area and suprachiasmatic nuclei, but not the anterior hypothalamic area or other brain regions, increased significantly the plasma concentrations of luteinizing hormone. These results show that (i) electrical stimulation of brain areas concerned with the control of gonadotrophin and other pituitary hormone secretion changes the metabolic activity of nuclei and neural pathways extrinsic as well as intrinsic to the hypothalamic-pituitary system, (ii) the [14C]2-deoxyglucose method can detect changes in antidromic as well as orthodromic activity and in multi-synaptic pathways, (iii) neuroanatomical pathways are not always activated metabolically by electrical stimulation, and (iv) the preoptic-suprachiasmatic nucleus gonadotrophin control system is discrete and is little affected by increased metabolic activity of the hypothalamus produced by stimulation of the anterior hypothalamic area or other brain areas. PMID- 3285238 TI - Immunoelectron microscopy identifies several types of GABA-containing efferent synapses in the guinea-pig organ of Corti. AB - Using an immunoperoxidase technique, we have localized by light and electron microscopy GABA-immunostained fibers within a component of the efferent innervation of the organ of Corti. At the light microscopic level, GABA immunostained fibers were observed within the inner spiral bundle (below the inner hair cells) and the tunnel spiral bundle. The immunostaining was clearly more intense in the upper turns than in the basal turns. Mostly in the upper turns, GABA-immunostained fibers were seen crossing the tunnel of Corti to reach the outer hair cells where they formed large immunostained patches at the base of the cells. Unevenly distributed throughout these upper turns, immunostained fibers were seen climbing along the outer hair cells and traveling near the non sensorineural Hensen's cells. The electron microscopic observations of GABA immunostained fibers in the upper turns allowed us to identify within the inner spiral bundle vesiculated varicosities synapsing with radial dendrites connected to the inner hair cells. In the outer hair cell area, the GABA-immunostained fibers made several kinds of synaptic contacts. They included a minor population of the large axosomatic synapses with the basal pole of the outer hair cells and many axodendritic synapses with the spiral dendrites connected to these cells. Occasionally, the GABA-immunostained climbing fibers also synapsed with the outer hair cells at a supranuclear level. These result confirm previous light microscopic data dealing with the projection of the GABA-immunostained fibers along the cochlear partition. Moreover, they extend them in characterizing several kinds of GABA-immunostained synapses. These latter findings agree with previous neurochemical electrophysiological data which suggests an efferent neurotransmitter role for GABA. Nevertheless, such an existence of an efferent innervation predominantly projecting to the upper turns of the cochlea adds another criterion distinguishing the "apical" from the "basal" cochlea. PMID- 3285239 TI - The first laminectomy. PMID- 3285240 TI - Atherosclerotic carotid artery disease in patients with retinal ischemic syndromes. AB - The extracranial carotid systems of 105 patients with retinal ischemia were examined using B-mode ultrasonography with integrated pulsed Doppler. Sixty-four patients had amaurosis fugax (AF), 17 central retinal artery occlusions (CRAO), and 21 branch retinal artery occlusions (BRAO). The prevalence of carotid stenosis (greater than or equal to 60%) ipsilateral to the symptomatic eye was low (16%). Eighty-six percent of AF patients had either no plaque causing less than a 60% stenosis. A significant proportion of subjects with normal duplex scans had alternative explanations for their retinal ischemia (eg, migraine, cardiac embolus). Patients with Hollenhorst plaques were more likely to have stenotic or ulcerated plaque (p = 0.04). The degree of carotid stenosis correlated significantly with the number of vascular risk factors identified in individual patients (p = 0.02). The presence of risk factors was more common in CRAO and BRAO patients compared with the AF group. Combined ultrasound-Doppler investigations of the carotid bifurcation are valuable noninvasive tools for the screening of patients with retinal ischemia. PMID- 3285241 TI - Progressive multifocal leukoencephalopathy after cardiac transplantation. PMID- 3285242 TI - [Bochdalek's hernia in adults. Review of cases from 1967 to 1986. Description of 12 surgical cases]. PMID- 3285243 TI - [Comparative study of echography and pneumocystomammography in the diagnosis of breast cysts]. PMID- 3285244 TI - [The role of echography in the screening of liver neoplasms]. PMID- 3285245 TI - [Use of echography in the screening of pancreatic carcinoma]. PMID- 3285246 TI - [Ultrasonics in the diagnosis of liver abscess]. AB - Echography is a quick and simple method for the diagnosis and monitoring of liver abscesses. It provides accurate information on the nature of the lesion and permits echo-guided percutaneous aspiration of the abscess, a manoeuvre presenting almost no risk of complications. The latter technique has proved a valid alternative to surgery since it permits the introduction of the drug employed into the abscess cavity and the consequent healing of bacterial and amoebic lesions in a very few days. Some personal results are presented. PMID- 3285247 TI - [Echography in the diagnosis and therapy of hepatic hydatidosis]. AB - Echography is the method of choice for the study of hydatidosis, since it permits the diagnosis of cysts, the long-term monitoring of patients, and via the use of an echo-guided needle, the performance of cytological, chemical and cultural studies, as well as curative treatment by means of percutaneous drainage and sterilisation with alcohol. PMID- 3285248 TI - [Snake bites by Italian viperids: diagnosis and therapy]. AB - In Italy ophidiasis by viper snakes seems to be in light, but in continuous increase; may be the mortality is to be inferior to one per cent, even if there aren't any reliable statistics. The Authors, finding embarrassment and unpreparedness from the Italian physician in such a situation, intend to provide with this work a correct diagnostic-therapeutic iter to be followed in a case of snakebite. Here are reported and discussed the essential data for the diagnosis of viper bite: snake identification, wound inspection, local and general symptomatology, laboratory data and principal complications. Afterwards, they face the treatment, dividing it in interventions to be always effected and if necessary; they suggest to treat hypovolemic shock with an dopamine intravenous infusion (in more serious cases: antiophidic serum). The Authors illustrate the cases where they can use the antivenom, indicating doses, administration modalities and therapy of the incidental anaphylaxis; besides they warn its abuse, that in Italy seems to be rather frequent and totally unjustified. PMID- 3285249 TI - Role of membrane lipids in metabolic regulation. PMID- 3285250 TI - Bone mineralization and growth in term infants fed soy-based or cow milk-based formula. PMID- 3285251 TI - Impaired glucose utilization in essential hypertension. PMID- 3285252 TI - Vitamin A controls fibronectin gene expression. PMID- 3285253 TI - Hepatic carnitine palmitoyltransferase turnover and translation. PMID- 3285254 TI - A double blind comparison of tiaprofenic acid with placebo. AB - The results of a double blind crossover comparative trial of the nonsteroidal antiinflammatory drug tiaprofenic acid with placebo in the treatment of rheumatoid arthritis are reported. Tiaprofenic acid was confirmed as being an effective drug of this class and no untoward side effects were encountered. Individual response was varied and not related to disease activity. PMID- 3285255 TI - Cardiac transplantation and donor privacy. PMID- 3285256 TI - Strategic planning: an effective management tool for nursing. PMID- 3285257 TI - Splenic torsion and rupture in pregnancy. AB - Splenic rupture in pregnancy and the puerperium is a rare and potentially catastrophic event. A case of splenic rupture in pregnancy due to partial torsion and internal trauma of a floating spleen is presented, and represents the 89th pregnancy-puerperal report of splenic rupture. Nineteen additional cases have been identified by the authors over the past 20 years. A 20-year review (1967 1986) of clinical presentations, pathogenesis, and therapy are presented. PMID- 3285258 TI - Frequency of asymptomatic genital herpes in pregnant women at term. AB - A group of 579 asymptomatic women from Jackson Memorial Hospital, Miami, Florida, and 207 from Kaiser Foundation Hospital in Honolulu, Hawaii, admitted in labor at 37 to 40 weeks of gestation had vaginal cultures for herpes simplex virus (HSV). No cultures were positive and no neonates developed HSV infection. Seven patients gave a history of previous HSV infection in the group from Florida and three from the group in Hawaii. Herpes appears to be a low incidence risk factor in both the populations studied. PMID- 3285259 TI - Hair loss in the female. PMID- 3285260 TI - Association of eclampsia and hydatidiform mole: case report and review of the literature. AB - A patient with a hydatidiform mole complicated by eclampsia is presented. The findings from 57 other cases discovered in a review of the literature since 1866 are summarized to define the clinical characteristics of women experiencing eclampsia as a manifestation of their hydatidiform mole. Eclampsia complicating a molar pregnancy is generally preceded by typical preeclamptic symptomatology and uniformly by severely elevated blood pressure. Neurological or visual symptoms also commonly warn of impending eclampsia. Although the reported cases of eclampsia complicating molar pregnancies are rare, this risk argues for the liberal use of prophylactic antiseizure medication when caring for women with a hydatidiform mole and hypertension, neurological complaints, or other preeclamptic symptoms. PMID- 3285261 TI - The pineal gland: its possible roles in human reproduction. PMID- 3285262 TI - The effect of retropubic urethropexy on detrusor stability. AB - A group of 86 women with genuine stress incontinence who underwent retropubic urethropexy were evaluated with both pre- and postoperative urodynamics. Twenty of these 86 women (23.3%) also had unstable detrusors preoperatively. Eleven of these 20 women (55%) had stable detrusors after retropubic urethropexy. Five of the 66 patients (7.6%) who had stable detrusors preoperatively were found to have unstable detrusors on postoperative urethrocystometry. The overall cure rate for women with detrusor instability and genuine stress incontinence was only 30%. Analysis of symptoms, previous anti-incontinence procedures, age, parity, and cystometric parameters revealed no differences between those women who had stable detrusors after retropubic urethropexy and those who remained unstable. Similarly, patients whose bladders became unstable after retropubic urethropexy could not be distinguished from those who remained stable. Patients undergoing retropubic urethropexy should understand the possibility that the operation may cause urinary incontinence due to detrusor instability even if it cures their genuine stress incontinence, and that if they have both genuine stress incontinence and detrusor instability, their chances for an operative cure of both conditions are low. PMID- 3285263 TI - Cervical adenocarcinoma in situ. AB - Cervical adenocarcinoma in situ is a rare disease. Eighteen patients with this disease seen at the University of Michigan Medical Center are reported, with a review of their clinical characteristics and pathologic data. These patients represented 9.2% of all endocervical adenocarcinomas seen during the study period. Their median age was 37 years, compared with a median age of 47 years in those women with invasive disease. Sixty percent presented with abnormal bleeding. Cone biopsy margins were examined in 12 patients, and accurately predicted the presence or absence of disease in ten of 12 hysterectomy specimens. One patient developed recurrent adenocarcinoma, and died of disease 16 years after initial diagnosis. Based on these data, it is suggested that hysterectomy and pelvic lymph node evaluation be used to treat these patients. PMID- 3285264 TI - Peritoneal cytology as an indicator of disease in patients with residual ovarian carcinoma. AB - Cytologic assessment of peritoneal washings or ascites in ovarian cancer patients has been suggested as a method of evaluating response to therapy or disease status, although the accuracy of this technique has not been clearly established. Ascitic fluid or peritoneal washings were obtained during 96 reassessment laparotomies that were biopsy-positive for residual intraperitoneal ovarian cancer. Cytologic studies done on these samples failed to detect malignant cells in 66% of the cases with gross residual disease and 78% of the cases with only microscopic residual disease on biopsy. The accuracy of peritoneal cytology in detecting residual ovarian cancer was unrelated to residual tumor size, original clinical stage, histologic tumor grade, and tumor cell type. Examination of ascitic fluid found at the time of surgery was somewhat more reliable than assessment of peritoneal washings, although this difference was of borderline statistical significance. Peritoneal cytology cannot reliably detect residual ovarian cancer after initial treatment with surgery and chemotherapy. Negative peritoneal cytology is frequently seen in the presence of gross residual tumor. PMID- 3285265 TI - Transabdominal cerclage for fetal wastage due to cervical incompetence. AB - From 1978-1986, nine transabdominal cervicoisthmic cerclage procedures were performed on eight patients at the University of California, San Francisco. In six of the patients, the decision to perform the procedure was based on failed transvaginal cerclages. In five of these six cases, the cervix had deep traumatic defects. In the remaining two patients, the cervix was extremely short. Before the procedure, the eight patients had 25 pregnancies lasting beyond the first trimester, with 20 fetal losses (fetal salvage rate 20%). After the transabdominal procedure, the eight patients had 13 pregnancies resulting in eight term births, three premature births (at approximately 36 weeks' gestation), and two fetal losses (salvage rate 85%). All infants were delivered by cesarean section. The transabdominal cerclage may increase the fetal salvage rate in selected women when poor obstetric outcome is related to failed transvaginal cerclage and/or an anatomically defective cervix. PMID- 3285266 TI - Repair of symptomatic diaphragmatic hernia during pregnancy. AB - Congenital diaphragmatic hernia complicating pregnancy is a rarity, accounting for only six out of 17 cases of diaphragmatic hernia reported in the English literature. This case report describes the first successful repair of an acutely symptomatic foramen of Bochdalek hernia during pregnancy, with maternal and fetal survival. In the asymptomatic patient, surgery should be performed promptly on an elective basis in the first and second trimesters. During the third trimester, an asymptomatic defect should be repaired at the time of elective cesarean section. Active labor should be avoided. If symptoms of obstruction arise, this lesion represents a true surgical emergency, and immediate operative intervention should be undertaken regardless of the stage of pregnancy. Delay can result in both fetal and maternal mortality in up to half of cases. Tube gastrostomy may be performed at the time of repair to avert a potential prolonged gastric ileus and gastric volvulus. PMID- 3285267 TI - The nitrite and leukocyte esterase tests for the evaluation of asymptomatic bacteriuria in obstetric patients. AB - The purpose of this investigation was to compare the reliability of a urine dipstick evaluation for nitrites and leukocyte esterase activity with that of a urine culture in diagnosing asymptomatic bacteriuria in obstetric patients. A clean-catch midstream urine specimen was obtained from 750 consecutive obstetric patients presenting for initial evaluation. One portion of the specimen was tested for nitrites and leukocyte esterase activity with Chemstrip LN dipsticks. A second aliquot of urine was plated on blood and MacConkey agar and incubated aerobically. The cost of the nitrite and leukocyte esterase test was $0.35. The per patient charge for the urine cultures would have been $28. Sixty-two women (8.3%) had urine cultures of 100,000 or more colony-forming units of a uropathogen per milliliter. The sensitivities of the nitrite and leukocyte esterase test in identifying patients with positive cultures were 43 and 77%, respectively, and the specificities were 99 and 96%, respectively. The sensitivity and specificity for the two tests combined (either test abnormal) were 92 and 95%, respectively. Five patients had negative screening tests but positive urine cultures; all five isolates were gram-positive organisms, three group B streptococci and two enterococci. We conclude that neither the nitrite test nor the leukocyte esterase test alone is a sensitive enough screening test to detect asymptomatic bacteriuria in obstetric patients. The combination of the two tests, however, may provide an acceptable cost-effective alternative to screening all asymptomatic obstetric patients with urine cultures. PMID- 3285268 TI - Polyhydramnios and oligohydramnios in twin gestations. AB - Seven twin pregnancies with concurrent polyhydramnios and oligohydramnios resulted in a perinatal mortality rate of 71%. The occurrence of this complication before 26 weeks' gestational age resulted in deaths of all fetuses, despite a variety of attempted therapies. PMID- 3285269 TI - Birth weight prediction from remote ultrasound examination. AB - From 259 cases studied, 245 were selected in which a live-born infant was delivered within 35 days of a complete fetal ultrasound evaluation. Multiple linear regression using the least-squares method enable us to generate an equation that incorporated lapse time (examination-to-birth interval) with the natural logarithm of head circumference, femur length, and abdominal circumference to estimate birth weight. With a lapse time mean of 16 +/- 11 days and a range of zero to 35 days, the generated equation accurately predicted birth weight (R2 = 0.84; P less than or equal to .0001). For all birth weights, the mean error was -15 +/- 306 g, the percent mean error was 0.51 +/- 10.2%, and the mean absolute error of the estimate was 82 g/kg birth weight. This accuracy was maintained across the full range of lapse time observed. For examinations performed within one week of delivery (N = 71), this formula more accurately predicted birth weight than five existing static formulas tested. The accuracy observed during model development was confirmed during testing upon 167 non-model cases. The accurate prediction of birth weight from remote ultrasound data is possible when lapse time is included in the predicting equation. The clinical value of this model is suggested when ultrasound is unavailable or unreliable. PMID- 3285270 TI - Perinatal antecedents of cerebral palsy. AB - The dramatic reduction in perinatal morbidity and mortality over the last decade has not been accompanied by any diminution in the incidence of cerebral palsy. We investigated retrospectively the relationship of certain perinatal events to the subsequent development of cerebral palsy in 75 infants. Cerebral palsy occurred in association with acute intrapartum asphyxia in 8% and traumatic delivery in 11%. Thirty-five percent of cases were associated with chronic fetal distress, defined by a unique fetal heart rate (FHR) pattern consisting of a normal baseline rate with persistently absent variability and mild variable decelerations with overshoot. This pattern was found frequently in association with postmaturity, meconium staining, intrauterine growth retardation, and neonatal seizures. Acid-base studies, when available, did not reveal acidosis. Twenty-seven percent of the cases involved a combination of chronic fetal distress, acute intrapartum fetal asphyxia, and/or traumatic delivery. We postulate that antenatal intermittent umbilical cord compression secondary to oligohydramnios results in repetitive transient central nervous system ischemia, insufficient to cause death, but resulting in a characteristic FHR pattern and impaired neurologic development. If these data are confirmed, this FHR pattern may be an important marker for the development of subsequent neurologic handicap or other adverse outcome. PMID- 3285271 TI - Perinatal management of gastroschisis. AB - Fetal anterior abdominal wall defects will be recognized with increasing frequency with the widespread use of maternal serum alpha-fetoprotein screening. A clear distinction must be made between omphalocele and gastroschisis, and counseling and obstetric management must be specific for each. Sixteen cases of gastroschisis were identified antepartum and followed through delivery between 1980-1986. There was one antepartum fetal death before institution of a protocol to deliver all such affected fetuses at 36 weeks. One patient was lost to follow up. There were no antenatal or neonatal deaths among the 14 infants seen subsequently, all of whom were delivered by cesarean section. Only one infant had an additional nongastrointestinal defect (mild hearing loss), and all 14 were of appropriate weight for gestational age. Twelve infants had a single operative procedure for repair of the defect, with a mean hospital stay of 19.6 days. Scheduled cesarean delivery at 36 weeks, after confirmation of fetal lung maturity, presents the infant to the pediatric surgeon under controlled conditions and shortens neonatal hospital stay. PMID- 3285272 TI - Premature placental calcification in maternal cigarette smokers. AB - Ultrasonographic examinations, including placental grading, were done in 145 smoking and 100 nonsmoking low-risk obstetric patients at 37 weeks' gestation. Extensive calcification--grade III changes--occurred significantly more often in smokers than in nonsmokers (36 versus 14%; P less than .0001). Two groups of smokers, consuming five to 15 cigarettes per day or one or more packs per day, also had significant differences in grade III placenta when compared with nonsmokers. Smokers under age 20 years were more likely to have premature grade III changes; however, parity did not influence premature placental calcification in smokers and nonsmokers. The incidence of small for gestational age infants delivered was not significantly higher in smokers, and grade III placental changes appeared to occur no more often in SGA infants of smokers than of nonsmokers. Our findings suggest that the smoking gravida is at increased risk for premature placental calcification. PMID- 3285273 TI - Reproductive hazards in the workplace: what the practitioner needs to know about chemical exposures. AB - A growing body of scientific evidence implicates occupational chemical exposures in the etiology of human adverse reproductive outcomes. Most reproductive toxins that have been investigated in sufficient detail have been shown to exert multiple effects on and through both men and women. In the face of growing public awareness, it is essential that clinicians develop a knowledgeable and effective approach to patient concerns about reproductive hazards in the workplace. Of vital importance is the accurate characterization of exposure at the worksite. Intervention strategies for worrisome situations include amelioration of worksite exposure or, as a last resort, temporary, compensated job modification or transfer. The clinician can obtain assistance in addressing the problem from several resources, including local regulatory agencies and occupational health clinics. Widespread involvement of knowledgeable health professionals can have a dramatic impact on improving this important contemporary public health problem. PMID- 3285274 TI - Sonographic evaluation of cervical length in pregnancy: diagnosis and management of preterm cervical effacement in patients at risk for premature delivery. AB - Sonographic measurement of cervical length during pregnancy can provide an objective, noninvasive assessment of anatomical shortening associated with premature labor and delivery. One hundred fifty normal women underwent serial sonographic cervical length measurements during uncomplicated pregnancy. The mean cervical length was 52 +/- 12 mm until 34 weeks' gestation, when gradual effacement and cervical length shortening began. Using these data, we managed 88 pregnant women with previous second-trimester pregnancy losses by a combination of cerclage placement for cervical length less than 40 mm and aggressive therapy for premature uterine contractions. The results showed the following: 1) 97% of women with diethylstilbestrol exposure and 80% of women with mullerian abnormalities exhibited cervical length shortening; 2) only 60% of women with a normal uterine cavity showed cervical lengths of less than 40 mm; and 3) all three groups of high-risk patients, independent of cervical length, showed significant premature uterine activity. These observations suggest that sonographic cervical length measurement may be a useful adjunct in the assessment of anatomical cervical integrity and the decision for cerclage placement. Furthermore, the presence of both premature cervical length shortening and preterm uterine activity in 65% of high-risk patients suggests that "cervical incompetence" and premature labor may not be distinct entities, but common symptoms associated with an increased risk of preterm delivery. PMID- 3285275 TI - Epiurethral suprapubic vaginal suspension: a report on 52 cases. AB - Fifty-two epiurethral suprapubic vaginal suspension procedures for the treatment of stress urinary incontinence were reviewed. The long-term results (80.5% success rate) were comparable to those of other urethropexy procedures. Complications included deep vein thrombophlebitis (3.8%), excessive bleeding (5.8%), prolonged (more than seven days) postoperative catheterization (32.7%), or tape rejection (3.8%). The performance of a simultaneous or previous hysterectomy had no effect on the outcome of the procedure (P greater than .10). These results differ from those in the other published report on this procedure. PMID- 3285276 TI - Prophylactic insulin in gestational diabetes. PMID- 3285277 TI - 100 years of industrial nursing has vastly improved workplace safety. PMID- 3285278 TI - Long-term survival following levamisole or placebo adjuvant treatment of colorectal cancer: a Western Cancer Study Group Trial. AB - In 1976, the Western Cancer Study Group initiated a prospectively randomized, double-blind trial of an 18-month adjuvant program comparing levamisole with placebo treatment following surgical resection in patients with colorectal adenocarcinoma. After stratification for site of disease (colon vs. rectum) and stage (B vs. C), 78 patients were entered. The levamisole schedule was 2.5 mg/kg/day given on days 1 and 2 of each week. The median follow-up of entered patients is now 7.5 years. Toxic effects of treatment were minimal. However, no long-term survival advantage was associated with levamisole compared to placebo administration in this population with resected large-bowel adenocarcinoma. PMID- 3285279 TI - Beta-2-microglobulin as a tumor marker in solid malignancies. AB - Beta-2-microglobulin (beta 2-MG) and CEA were measured in the sera of 186 cancer patients divided into two groups: at diagnosis (D) and at follow-up (F). Four groups of patients at diagnosis (D-I, D-II, D-III and D-IV according to TNM classification) and two at follow-up (in remission, F-RS, and in relapse, F-RP) were considered. All patients had normal serum creatinine and urea concentrations. beta 2-MG values in D-I were significantly (p less than 0.01) lower than those for D-II and D-III, while in D-IV they overlapped those of group D-I. No significant difference was observed between F-RS and F-RP patients. Patients with serum CEA concentration greater than 100 ng/ml revealed beta 2-MG values close to those of groups D-I and D-IV. In 10% of patients in stage IV or with CEA greater than 100 ng/ml beta 2-MG was lower than the mean value of the healthy population. From data beta 2-MG is probably produced by an aspecific reaction to the tumor and the decrease in advanced stages could express a decreased immunologic response. On the other hand, high serum beta 2-MG in the initial stages of the neoplasia may reflect an elevated cell turnover, while low beta 2-MG during the final stages may be due to a weak expression of the protein by highly undifferentiated cells. PMID- 3285280 TI - Effects of PSK on resistance to bacterial infection in splenectomized mice. AB - Nontumor-bearing C3H/He mice were splenectomized and intravenously inoculated 7 days later with Streptococcus pneumoniae, Pseudomonas aeruginosa, or Escherichia coli. The survival rate was reduced by splenectomy in the animals inoculated with S. pneumoniae, but did not change in those inoculated with P. aeruginosa or E. coli. When splenectomy was performed 2 days after transplantation of X5563, and bacteria were inoculated 7 days after the operation, the survival rate was reduced even in those inoculated with P. aeruginosa or E. coli, and elimination of the bacteria from the blood and liver was delayed. This reduction in resistance to infection was alleviated by oral administration of PSK after the splenectomy. PMID- 3285281 TI - [Existence of pre-CFU-S in the liver of mouse embryos]. AB - Two types of CFU-s different in the size of their colonies have been found in the liver of 14 day old mice embryo. Statistic processing of the data allowed to prove that large spleen colonies are formed directly by CFU-s, whereas small colonies are formed by pre-CFU-s which undergo preliminary proliferation and only the stochastically differentiate into CFU-s. Approximate concentration of pre-CFU s constitutes 2.67 per 10(5) embryo liver cells. PMID- 3285282 TI - [Insulin binding by receptors of the plasma membranes of the liver in hens in ontogenesis]. AB - Specific binding of 125I-insulin to the liver plasma membranes was studied in the chick embryos from the 10th day of incubation on, in chickens and adult fowl. The level of binding was the same in all cases although the insulin concentration of blood increases during ontogenesis, the number of receptors and their affinity to the hormone remaining constant. The data on insulin-receptor interactions in the liver have been compared with the earlier results of the authors obtained on the chick skeletal muscle and erythrocytes. PMID- 3285283 TI - [The Institute of Experimental Biology]. PMID- 3285284 TI - Historical perspective: the problem of the origin of life in the context of developments in biology. AB - The structure of the history of scientific ideas on the origin of life, after Darwin's theory of evolution brought the problem into focus, is discussed. 19th century theories in the mainstream of historical development already included some notion of chemical evolution. These theories were limited, however, by their reliance on a protoplasmic view of life, according to which the protoplasmic substance combines all vital properties. It was only when this holistic concept of protoplasm was abandoned that a clear distinction between different vital functions such as metabolism and replication was made. This led to two schools of thought in the origin of life field, one inspired by biochemistry and one by genetics. Oparin's theory, which was rooted in the metabolic traditions of biochemistry, provided a model which has had a lasting impact in methodological terms and which helped to transform the field from a largely theoretical one to an area of active research. Genetically based theories, on the other hand, had a delayed impact in this respect, because of long-lasting uncertainty regarding the structural basis of gene function. PMID- 3285286 TI - [The effect of sexually transmitted diseases on the reproductive processes]. PMID- 3285285 TI - Evolution of E. coli tRNA(Trp). AB - Earlier studies (1) have shown there are direct correlations between the hydrophobicity ranking of most amino acids and their anticodonic nucleotides. However, four anticodonic assignments, i.e. those for Trp, Tyr, Ile and the XGA anticodons for Ser, did not correlate. It was our proposal that this failure to correlate was due to the fact that these assignments were made late, relative to the bulk of the assignments, in evolution through the mutation of existing tRNAs. We have shown (2) that E. coli tRNA(Ile 1) and tRNA(Ile 2) were likely derived from tRNA(Val 1) and tRNA(Lys) respectively and E. coli tRNA(Tyr) was possibly derived from E. coli 5s rRNA or a common precursor with 5s rRNA (3). The fact that quite high homologies were observed in these comparisons is consistent with the late evolution of the tRNAs in question. We now examine the evolution of E. coli tRNA(Trp) by comparing its homology with other E. coli tRNAs. The data suggest a possible evolutionary relationship with E. coli tRNA(Gly) or tRNA(Arg). The data support the idea of the late assignment of anticodons to Trp. PMID- 3285287 TI - [Changes in gonadal function after treatment of malignant diseases in children]. PMID- 3285288 TI - [Disseminated histiocytosis X]. PMID- 3285289 TI - [Post-traumatic dystrophic calcification of the muscles with tumorous calcinosis of soft tissues]. PMID- 3285290 TI - [Irritation of the urinary bladder as a rare complication of a LeVeen shunt and its surgical correction]. PMID- 3285291 TI - bcr genes and transcripts. AB - Human chronic myelogenous leukemia (CML) is a clonal hematologic disorder. CML is characterized by the t(9:22) chromosome translocation which results in translocation of the oncogene abl from chromosome 9 into the breakpoint cluster region (bcr) gene on chromosome 22. We cloned and characterized the cDNA of the normal bcr gene. The bcr gene codes for a protein of 1271 amino acids. The open reading frame is preceded by a region high in GC. At the 5' of this region we identified several GC motifs which are probably involved in the initiation of bcr transcription. bcr transcripts of 7.0 and 4.5 kb are expressed in all cell types examined. These transcripts share all cDNA sequences analysed, including the 5' untranslated region. The latter as well as 902 or 927 amino acids are included within the CML-specific bcr-abl mRNA transcribed from the chimeric bcr-abl gene on chromosome 22. In addition to the complete bcr gene, the human genome contains 3 bcr-related genes containing the last seven exons of the intact bcr gene. One of these genes was analysed in detail and showed high sequence homology with the latter. The three bcr-related genes were probably derived from the intact gene by subsequent steps of duplication. PMID- 3285292 TI - The hamster polyomavirus transforming properties. AB - The hamster papovavirus (HaPV) is a polyomavirus isolated from hair follicle tumor arising spontaneously in newborn hamsters which can also induce lymphoma and leukemia. This tissue specificity displayed in vivo can be bypassed in vitro since HaPV carries the full transforming properties of a polyomavirus (immortalization and transformation). We report here the phenotypic characterization of cells that were selected as immortalized or transformed and express constitutively the HaPV early genes. The viral genome is integrated in the host DNA and the early region is actively transcribed and translated. PMID- 3285293 TI - Rapid induction of an experimental metastatic phenotype in first passage rat embryo cells by cotransfection of EJ c-Ha-ras and c-myc oncogenes. AB - First passage rat embryo cells were transfected with plasmids carrying a mutated EJ c-Ha-ras oncogene alone or in combination with the c-myc oncogene. Three days later, unselected cultures were harvested and injected into nude mice either subcutaneously to assay for tumorigenicity or intravenously to assay for metastasis to the lung. The results indicate that a transcriptionally-enhanced EJ c-Ha-ras oncogene alone can convert normal rat cells to a tumorigenic but not metastatic phenotype. Co-transfection of a c-myc oncogene with the EJ c-Ha-ras oncogene was necessary to produce the rapid, phenotypic conversion of normal cells to transformed cells with both tumorigenic and metastatic potential. No tumors were observed in animals injected with c-myc-transfected cells. Cell lines established from EJ c-Ha-ras-induced shoulder tumors were metastatic when reinjected intravenously into nude mice. These results support the hypothesis that the cooperative action of c-Ha-ras and c-myc oncogenes is more potent in inducing malignant transformation than either oncogene acting alone. Our results also suggest that the phenotypic conversion of normal cells to tumorigenic cells with experimental metastatic potential by ras and myc oncogenes can be completed within 3-4 cell divisions after transfection. PMID- 3285294 TI - ras oncogene activation in human ovarian carcinoma. AB - Samples of 37 fresh human ovarian tumor biopsies were screened to detect proto oncogene amplification and ras mutations. Three samples showed c-K-ras2 amplification; none of the other oncogenes tested revealed any gene amplification. 5-, 25-, and 120-fold amplifications were assessed by dilution experiments and soft laser densitometry. Corresponding elevated levels of c-K ras2 mRNA and p21 ras protein were found in the three tumors. Analysis by the polymerase chain reaction method to detect point mutations of codon 12 or codon 61 of Harvey-, Kirsten-, or N-ras showed only the wildtype sequence in all specimens. No correlation was found between ras activation and degree of tumor progression or histological subtype. DNA from one of the tumors with c-K-ras2 amplification proved to have high transforming activity in the NIH 3T3 tumorigenicity assay, but the transforming gene was not c-K-ras2. PMID- 3285295 TI - Immunohistochemical detection of the neu protein in tissue sections of human breast tumors with amplified neu DNA. AB - Amplification of the neu (or c-erbB-2 or HER) oncogene is relatively frequent in human breast carcinomas. We have raised a polyclonal rabbit serum in order to detect the neu protein product in tissue sections of tumors. This serum specifically reacted with a 185 kilodaltons neu protein in SKBR-3 cells, a mammary carcinoma cell line with amplified neu. Immunohistochemistry on paraffin embedded sections of tumors in which the neu gene was amplified showed distinct membrane staining of groups of tumor cells. Sections of tumors with normal copy numbers of neu were negative. Lymph node metastases from tumors positive for neu overexpression also showed the membrane staining pattern, whereas lymph node metastases from tumors negative for neu staining never did. Neu amplification is thus associated with neu protein overproduction in tumors and lymph node metastases, and a routine antibody staining technique can discriminate a high level of neu protein expression from levels commonly present in tumors with normal neu copy numbers. PMID- 3285296 TI - Primary structure of the chicken c-mil protein:identification of domains shared with or absent from the retroviral v-mil protein. AB - The complete primary structure of the protein product of the proto-oncogene c-mil was deduced from the nucleotide sequence of chicken c-mil cDNA clones. The c-mil protein contains 647 amino acid residues and has a calculated molecular weight of 73,132. Based on sequence comparisons with proteins of known or presumed biochemical function, two domains were recognized on the c-mil protein. In the carboxyl-terminal half of the protein, a 250-amino acid segment displays significant homology to the protein kinase domains of the src oncogene protein or of protein kinase C. In the amino-terminal half, a cysteine-rich segment (Cys-X2 Cys-X9-Cys-X2-Cys-X7-Cys-X7-Cys) of the c-mil protein shares significant homology with two similar repetitive domains of protein kinase C. Of the two structural and presumably functional domains of the c-mil protein, only the kinase domain is contained within the carboxyl-terminal 379-amino acid polypeptide encoded by the transduced v-mil allele of avian oncogenic retrovirus MH2. Hence, truncation of the 5' coding region in the course of the transduction and the resulting lack of the authentic amino-terminal domain in the protein product of the transduced allele may be a critical event in changing mil function from physiologic to oncogenic. PMID- 3285297 TI - Identification and characterization of c-raf phosphoproteins in transformed murine cells. AB - Protein products of the c-raf gene were detected and characterized in two transformed murine cells lines by immunoprecipitation analysis with raf-specific sera. Both proteins reacted with an antiserum directed to the carboxyl terminus of the c-raf coding region. The p48raf (Mr48,000) phosphoprotein was found in a cell line transformed by an LTR-activated c-raf gene (Mueller & Mueller, 1984). It was found to be phosphorylated on serine and threonine residues and became phosphorylated in immunoprecipitates when supplied with [gamma-32]ATP. In contrast, P74raf, which was detected into a spontaneously transformed 3T3 (R+/Cl 3) cell line and may represent the full-length gene product of c-raf, appeared to incorporate [32P]PO4 less efficiently in vivo and exhibited a barely detectable associated kinase activity in only half of the experiments. The p48raf is a transforming protein which, like P75gag-raf, lacks the amino-terminal region of the c-raf coding region. P74raf, which retains the amino-terminal region, differs from p48raf in its phosphorylation characteristics and may not be a transforming protein. These data are consistent with a model in which lack of amino-terminal sequences in the c-raf gene product p48raf may, in and of itself, suffice to make it a transforming protein. PMID- 3285298 TI - Ultraviolet light induces the expression of oncogenes in rat fibroblast and human keratinocyte cells. AB - The exposure of a polyoma virus transformed rat fibroblast cell line H3 to UV-C irradiation (254 nm) causes a transient increase in the abundance of RNAs for the cellular oncogenes c-H-ras, c-myc and c-fos, as well as RNAs homologous to an endogenous rat leukemia virus-related sequence (RaLV). Treatment with cycloheximide also causes a transient increase in the c-H-ras, c-myc and RaLV RNAs, with a time course similar to that obtained with UV irradiation. UV-C irradiation also causes a transient increase in the RNAs for c-H-ras and c-myc in an SV40 transformed human keratinocyte cell line SVK-14. Dose response studies with UV light at the various wavelengths found in sunlight indicate that UV-B (270-330 nm) and UV-A (345-440 nm) are much less potent than UV-C in inducing increased levels of c-H-ras and c-myc RNAs in SVK-14 cells. Thus, in addition to the well known mutagenic effects of UV irradiation, UV damage to DNA can also lead to increased expression of cellular oncogenes in both rodent fibroblasts and human keratinocytes. PMID- 3285299 TI - Characterization and localization of the products of the human homologs of the v ets oncogene. AB - The avian erythroblastosis virus, E26, an acute leukemia virus, contains a transforming gene composed of two cellular components, v-myb and v-ets. The v-ets related sequences of man and other mammals consist of two transcriptionally active genes, ets-1 and ets-2, located on separate chromosomes. By contrast, both of these genes are contiguous in birds, are located on the same chromosome, and are coordinately transcribed. The human ets-1 and ets-2 gene products were identified by means of antibodies directed against the ets-1 and ets-2 encoded products. A 51 kD protein has been identified as the ets-1 gene product, and a 56 kD protein as the ets-2 gene product. Cellular fractionation studies indicated that the ets-1 protein is located in the cytoplasm and the ets-2 protein is nuclear. By comparison, the chicken ets protein, which contains both the ets-1 and ets-2 domains, distributes equally between the cytoplasm and nucleus. The differential compartmentalization of the ets gene products and their non coordinate expression suggest that these proteins have different biological functions. PMID- 3285300 TI - Functions of diacylglycerol in glycerolipid metabolism, signal transduction and cellular transformation. AB - Clearly, cellular DAG levels are regulated at the levels of synthesis, degradation and compartmentalization. This complex regulation enables DAG to perform its two distinct roles: supporting the biosynthesis (and degradation) of glycerolipids, and regulating PKC activity. Further definition is needed as to how DAG fulfills both functions, with particular emphasis on how distinct DAG pools are maintained, the interrelationships between the numerous pathways of DAG metabolism, and the role which elevated DAG plays in cellular transformation. Cellular function and growth control may be profoundly altered by perturbation of DAG metabolism. Defects in the regulation or the activity of enzymes responsible for attenuation of DAG second messengers (eg. DAG kinase and lipase) would be expected to elevate plasma membrane DAG levels. This could lead to persistent PKC activation and cellular transformation. Defects in the enzymes which utilize DAG in the biosynthetic pathway (eg. diacylglycerol acyltransferase, and choline and ethanolamine phosphotransferases) could elevate DAG levels in the ER. One consequence of this could be activation of PKC, perhaps at intracellular sites where activation does not normally occur. DAG undergoes rapid transbilayer movement and can be rapidly transferred between cellular membranes by a facilitated process. Therefore, elevated pools of DAG in the ER may lead to elevated DAG in other membranes (eg. plasma membrane) and PKC activation. These DAG utilizing enzymes may, therefore, represent products of unidentified recessive oncogenes. PMID- 3285301 TI - Consequences of the t(14;18) chromosomal translocation in follicular lymphoma: deregulated expression of a chimeric and mutated BCL-2 gene. AB - The t(14;18) chromosomal translocation of human follicular lymphoma recombines the candidate transforming gene bcl-2, located at 18q21, with the immunoglobulin (Ig) H-chain joining region (JH) at 14q32. To elucidate the consequences of this translocation, we cloned bcl-2 cDNAs from a pre-B cell line (Nall-1) and a t(14;18) lymphoma cell line (SU-DHL-6) and compared these sequences with their genomic counterparts. These studies revealed the complexity of bcl-2 gene expression in which six potential polyadenylation signals in exon 3 and two different 5' exons (exons 1 and 2) and promoters are alternatively used to generate different sized bcl-2 mRNAs. A single open reading frame (ORF), at the junction of exons 2 and 3, predicts a 239 amino acid, 26 kD protein. Most chromosome 18 breakpoints cluster within a 150 bp region of exon 3. In SU-DHL-6 the t(14;18) translocation juxtaposes a truncated bcl-2 gene with J6 in a tail-to head configuration, resulting in the deregulated expression of chimeric bcl-2/Ig transcripts. Importantly, the SU-DHL-6 bcl-2 cDNA also contained several point mutations in the ORF, two of which altered the primary amino acid sequence. The deregulated expression of an altered bcl-2 gene may play a critical role in the disordered growth and differentiation of follicular B cell lymphoma. PMID- 3285302 TI - Mathilda Scheuer: a biographical sketch. PMID- 3285303 TI - [Transabdominal sacral rectopexy in children]. PMID- 3285304 TI - [Infantile cortical hyperostosis]. PMID- 3285305 TI - The ultrasonographic diagnosis of typhlitis (neutropenic colitis). AB - Typhlitis is a necrotizing inflammatory disease of the cecum, usually with secondary infection. It is most often found in acute leukemia patients on chemotherapy but has also been reported in other patients on chemotherapeutic drugs. Diagnostic features of typhlitis have been reported on plain radiographs, barium enema, angiography, CT, and one other reported case with ultrasound. We report three cases of typhlitis with a characteristic echogenic thickening of the mucosa on ultrasound. The sonographic findings in the one previous report were identical to those of our three cases. We believe that the sonographic findings of typhlitis are unique and that ultrasound offers an easy noninvasive method of diagnosing this potentially lethal disease. PMID- 3285306 TI - The renal lesions of tuberosclerosis (cysts and angiomyolipoma)--screening with sonography and computerized tomography. AB - The two most common sonographic abnormalities in the kidneys of 23 tuberous sclerosis (TS) patients ranging in age from newborn to 30 years are angiomyolipomas (12/23) (AML) and renal cysts (10/23). These usually both occur in the same patient with only 9 cases (39%) having sonographically normal kidneys. Of the 14 affected patients, 2 had cysts without AML and 4 others had AML without cysts. The sonographic appearance of an AML varied from a large 6 cm solid mass with little increased echogenicity (1/12) to subtle small (4 mm) extremely echogenic regions in the periphery of the kidney (11/12). The sonographic appearance of the cysts were anechoic lesions varying in size from 2 mm to 2 cm with thin uniform posterior walls and posterior enhancement. Renal lesions are found more frequently with increasing age. Sonography is the preferred screening procedure for the renal lesions of T.S. PMID- 3285307 TI - Alexander's disease: cranial ultrasound findings. AB - This is thought to be the first report of the recognition by cranial ultrasound of the abnormal pattern of cerebral tissues which occurs in Alexander's disease. This finding suggests that cranial ultrasound could be a useful adjunct in the diagnosis of this cerebral leukodystrophy, particularly in those infants presenting with megalencephaly. PMID- 3285308 TI - Bilateral multicystic dysplastic kidneys. AB - High-resolution ultrasound examination of the fetus enables early detection of congenital malformations of the urinary tract. This information is of value in determining fetal prognosis, in deciding the method of delivery, and in alerting the pediatricians to supportive and corrective measures which may need to be taken in the postnatal period. Prenatal diagnosis of bilateral multicystic kidneys was made in a 33-34 week old fetus. A short discussion of this anomaly follows. PMID- 3285309 TI - Transient protein-losing gastropathy (Menetrier's disease) in childhood. PMID- 3285310 TI - Tuberculosis in children. PMID- 3285311 TI - Clinical experience during a large Shigella sonnei outbreak: when the "hoofbeats" were really "zebras". PMID- 3285312 TI - Parental counseling compared with elimination of cow's milk or soy milk protein for the treatment of infant colic syndrome: a randomized trial. AB - Treating the infant colic syndrome by counseling the parents concerning more effective responses to the infant crying is compared to the elimination of soy or cow's milk protein from the infant's diet in a randomized clinical trial. Because symptoms of vomiting and diarrhea are not part of the infant colic syndrome, infants with these gastrointestinal symptoms were excluded from the study. Dietary changes were accomplished by either feeding the infants a hydrolyzed casein formula or by requiring mothers to eliminate milk from their diets. In phase 1 of the study, the group receiving counseling (n = 10) had a decrease in crying from 3.21 +/- 1.10 h/d to 1.08 +/- 0.70 h/d (P = .001). The crying in the group that received dietary changes (n = 10) decreased from 3.19 +/- 0.69 h/d to 2.03 +/- 1.07 h/d (P = .01), a level still greater than twice normal. The decrease in those receiving counseling was faster and greater than that of those given dietary changes (P less than .02). In the second phase of the study, group 2 infants were reexposed to cow's milk or soy protein and the parents received counseling. In this phase, counseling again decreased crying significantly from 2.09 +/- 1.07 h/d to 1.19 +/- 0.60 h/d (P = .05). No infant in the study who improved with changes in his or her diet had a significant increase in crying, with reexposure to soy or cow's milk protein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285313 TI - Bladder fungus ball: a reversible cause of neonatal obstructive uropathy. AB - Very low birth weight infants often have multiple predisposing conditions for the development of invasive candidiasis. In patients with systemic candidiasis, the kidney is vulnerable to the formation of cortical abscesses or obstructive intrarenal masses ("fungus balls"), usually at the ureteropelvic junction. Ureteropelvic junction obstructive fungal uropathy necessitates invasive debridement to restore renal function. A very low birth weight infant, infected with Candida, was first seen with hypertension, renal insufficiency, and urine cultures positive for fungus; obstructive bladder fungus ball was diagnosed by ultrasonography. Mechanical disruption with amphotericin B bladder irrigation was accomplished via ultrasonographic guidance, relieving renal obstruction and insufficiency. Systemic antifungal therapy was completed with amphotericin B and flucytosine. The first reported case of bladder obstructive fungal uropathy in a neonate is added to a review of 16 cases of neonatal renal obstructive uropathy. PMID- 3285314 TI - Echocardiographic assessment of cardiac function during respiratory syncytial virus infection. AB - Respiratory syncytial virus infection has been associated with increased morbidity and mortality in infants with underlying cardiac and pulmonary disease. To understand better the cardiopulmonary interaction in patients with acute respiratory syncytial virus bronchiolitis, we performed M-mode echocardiograms and pulsed Doppler assessment of pulmonary arterial flow in 19 patients with structurally normal hearts during acute illness. Studies were repeated in 11 of these patients following complete recovery. Based on severity of respiratory compromise, patients were grouped into those with severe illness (ten patients) or mild illness (nine patients). Left ventricular dimensions and shortening fraction were used to assess left ventricular function. Right ventricular systolic time intervals and specific Doppler flow velocity measurements were used to assess right ventricular function and elevation of pulmonary artery pressure. Comparisons were made between patients with severe and mild illness and between acute and follow-up studies. No statistically significant differences in left ventricular function, right ventricular systolic time intervals, or Doppler flow measurements were observed. We conclude that in patients with structurally normal hearts, respiratory syncytial virus bronchiolitis is not associated with significant depression of cardiac performance or elevation in pulmonary resistance. PMID- 3285315 TI - Pyoderma gangrenosum as a manifestation of leukemia in childhood. AB - Pyoderma gangrenosum is an uncommon skin lesion often associated with autoimmune diseases. A clear association between leukemia and pyoderma gangrenosum in adults has been established. Two cases of pyoderma gangrenosum in children with leukemia in whom it may be an initial finding are presented. PMID- 3285316 TI - Misidentification of Neisseria species in a neonate with conjunctivitis. PMID- 3285317 TI - Sn-protoporphyrin: a consideration of the first clinical trial in human neonates. PMID- 3285318 TI - What does the cryotherapy preliminary report mean? PMID- 3285319 TI - Repeat throat cultures? PMID- 3285320 TI - [Round atelectasis]. PMID- 3285321 TI - [CT of anomalies of the inferior vena cava and left renal vein]. PMID- 3285322 TI - [Clinical usefulness of ioxaglate (isotonic contrast material, ER-61) in digital subtraction angiography]. PMID- 3285323 TI - Effective use of instructional information systems: a preparation for nurse teachers. PMID- 3285324 TI - A yeast tRNA(Arg) gene can act as promoter for a 5' flank deficient, non transcribable tRNA(SUP)6 gene to produce biologically active suppressor tRNA. AB - In S. cerevisiae most tRNA genes are located and expressed as single entities. The tDNA(Arg)-tDNA(Asp) pair, however, is transcribed into a dimeric precursor before being processed into two mature tRNA species. The second gene of this pair, tDNA(Asp), is totally dependent on the first gene, tDNA(Arg), and its promoter components, for homologous in vitro transcription. The second gene in the pair is now replaced by the ochre suppressor tDNA(SUP)6-o, which, by itself, cannot be transcribed because of a nonfunctional 5' flanking region. The tDNA(Arg)-tDNA(SUP)6-o was transcribed into a dimeric precursor which was processed to mature tRNA molecules as judged in vitro by electrophoretic separation, and in vivo by their ability to suppress ochre but not amber yeast mutations. Mutations in the internal promoter of the first gene decreased transcription, both in vitro and in vivo, of the second-tRNA(SUP)6-o-gene. Thus tDNA(Arg) with its 5' flanking region can act as an external promoter for other RNA polymerase III-read genes that are by themselves inactive due to impaired promoter/modulator regions. PMID- 3285325 TI - The AGG codon is translated slowly in E. coli even at very low expression levels. AB - Data are presented which indicate that AGG codons for arginine are translated significantly more slowly than the CGU codons for the same amino acid even when their expression level from the probe is very low. The two types of codons were inserted (three in tandem) on a multicopy plasmid in an artificial leader peptide gene in front of the pyrE attenuator where the frequency of transcription termination is regulated by the degree of coupling between transcription and translation. Transcription of the operon is initiated from the lac-promoter dependent on the concentration of the lac-operon inducer IPTG. At all induction levels it was found that the frequency of transcription past the pyrE attenuator was approximately nine times lower when the AGG codons were present in the leader than with CGT codons present. This shows that AGG codons decouple translation from transcription in the pyrE attenuator region even when the concentration of this codon is not increased significantly relative to that in the unperturbed wild type strain. Thus the results indicate that AGG codons are always slowly translated in Escherichia coli. PMID- 3285326 TI - A simple and low cost DNA amplifier. PMID- 3285327 TI - A policy agenda for the nursing shortage. PMID- 3285328 TI - Infant feeding. Plus ca change. PMID- 3285329 TI - Let me whisper in your ear. PMID- 3285330 TI - Spotlight on children. PMID- 3285331 TI - Spotlight on children. No more potty rounds. PMID- 3285332 TI - Diversification and corporate restructuring revisited. Back to square one? AB - An historical overview of corporate restructuring in the health care industry is presented. Initial reasons for forming multicorporate structures centered on avoiding regulations governing certified home health agencies and maximizing third party payer reimbursement. As competition increased, home care agencies employed diversification strategies for survival and reorganized their single corporate structures to launch new businesses and engage in profit-making activities. Corporate restructuring is a time-consuming and complex endeavor that should only be undertaken as a part of an agency's strategic plan. Evaluating an agency's corporate structure is a continual process and the criteria for evaluating change over time. The current experience with diversification in the health care industry suggests that the proliferation of multicorporate structures is stemming as health care providers begin to refocus on their core business. PMID- 3285333 TI - Marketing in home health care. A practical approach. AB - Home health marketing brings special problems and opportunities. One cannot rely on physical factors such as the physical plant and food service of a hospital or on the durability of a consumer product to judge home health. Opportunities exist within home health to identify activities that carry marketing value. Applying marketing principles to activities such as intake, customer service and public relations allows the home health agency to build referrals by meeting the wants and needs of the market. The home health organization needs to consider different wants and needs of those involved in the home health transaction: the decision maker, the purchaser, and the user. The success of the marketing function in meeting the organization's objectives will be aided by the placement of marketing at the senior management level. PMID- 3285334 TI - Review of the brachial plexus. Part I: Acute injuries. AB - Acute injuries of the brachial plexus are open or closed, and occur by compression, traction, sharp laceration, or missile injuries. Following initial resuscitation, a proper evaluation and treatment plan must be formulated. A review of the literature showed an obvious trend away from conservative treatment of many brachial plexus lesion toward an early, aggressive surgical approach to these injuries. An extensive literature review also provided the opportunity to devise a rational classification of brachial plexus injuries, which allows for a treatment regimen that reflects the trend of the recent literature. PMID- 3285335 TI - Review of the brachial plexus. Part II: Reconstruction after chronic upper plexus injuries. AB - Chronic and complete, brachial plexus injuries are a burden for society and the patient. A literature review reveals the different options in treating upper plexus deficits. Analysis of early, and more recent, results is provided with an emphasis placed on the more reliable procedures to date. PMID- 3285336 TI - Why come if you can't be here? PMID- 3285337 TI - [Pathogenesis of pneumonias in ventilated patients]. PMID- 3285338 TI - [Visual perception, eye contact and gaze avoidance in early childhood autism. On the reconstruction of a frightening experience and its manifestation in the autism syndrome]. PMID- 3285339 TI - [Enzymatic synthesis of L-malic acid from fumaric acid using immobilized Escherichia coli cells]. AB - Optimal conditions were chosen for cultivation of Escherichia coli 85 cells with a rather high fumarate-hydratase activity on a cheap medium containing no edible raw material. An active biocatalyst for the synthesis of L-malic acid from fumaric acid was obtained based on E. coli 85 cells immobilized in carrageenan. The enzymatic synthesis of L-malic acid from potassium fumarate was kinetically studied and optimized. Some thermodynamic parameters of fumaric acid hydration into malic acid were determined. A technique for assaying the reaction mixture was developed that involved high performance liquid chromatography. PMID- 3285340 TI - [Effect of polymer modification of insulin on its enzymatic hydrolysis and conformation properties]. AB - AI, B29 insulin polymeric derivatives in which the polymeric chains (N polyvinylimidazole, N-polyvinylpyrrolydone and polyacrylic acid) are bonded to the insulin molecule at one point were synthesized. The hydrolysis of the modified insulin by trypsin is dependent to a great extent on the chemical nature of the modifying polymer and is virtually independent of its molecular weight up to 20 kD. The effect of the modifying polymer manifests itself mainly in a change of the Michaelis constant. Investigation of the conformational properties of the insulin derivatives by the method of optical rotatory dispersion revealed that insulin modification by polymers caused a decrease of the amino acid content in the alpha-helical sequence from 41 to 33-30%. The chemical nature of the modifying polymer and its molecular weight have a profound effect on the conformational stability of the residual spatial structure of the modified insulin in alkaline media. PMID- 3285341 TI - [Evaluation of the vitamin D activity of yeasts with altered sterol metabolism]. AB - The sterol content of Saccharomyces strains with altered ergosterol metabolism was studied by UV-spectrophotometry, thin-layer chromatography and chromatographic mass-spectroscopy. A technique for estimation of D-vitamin activity of the yeast strains is proposed. The irradiated biomass of the strains accumulated ergosta-5,7-dien-3 beta-ol and also cholesta-5,7,24-trien-3 beta-ol and cholesta-5,7,22,24-tetraen-3 beta-ol is characterized by high antirachitic activity. PMID- 3285342 TI - The cytoplasmic domain of Escherichia coli leader peptidase is a "translocation poison" sequence. AB - Leader peptidase is an integral, transmembrane protein of the plasma membrane of Escherichia coli. Its membrane assembly requires its internal, uncleaved signal sequence, its large periplasmic carboxyl-terminal region, and an apolar domain that is known as a "hydrophobic helper." We now show that the polar cytoplasmic domain of leader peptidase is a unique membrane assembly element, which we term a "translocation poison" sequence. This sequence is defined by its ability to block the action of a signal sequence that either precedes or follows it. To our knowledge, this is the first entirely polar topogenic element. Deletion analysis shows that the role of the leader peptidase hydrophobic helper sequence in its membrane assembly is to overcome the block to assembly caused by the poison sequence. PMID- 3285343 TI - A viral cleavage site cassette: identification of amino acid sequences required for tobacco etch virus polyprotein processing. AB - Mature viral-encoded proteins of tobacco etch virus (TEV) arise by proteolytic processing of a large precursor. The proteinase responsible for most of these cleavages is a viral-encoded 49-kDa protein. All known or predicted cleavage sites in the TEV polyprotein are flanked by the conserved sequence motif Glu-Xaa Xaa-Tyr-Xaa-Gln-Ser or Gly, with the scissile bond located between the Gln-Ser or Gly dipeptide. By using cell-free systems to manipulate and express cloned cDNA sequences, a 25-amino acid segment containing a putative proteolytic cleavage site of the TEV polyprotein has been introduced into the TEV capsid protein sequence. This recombinant protein is cleaved by the 49-kDa proteinase at the introduced cleavage site, thus demonstrating portability of a functional cleavage site. The role of the conserved amino acid sequence in determining substrate activity was tested by construction of engineered proteins that contained part or all of this motif. A protein that harbored an insertion of the conserved 7-amino acid segment was cleaved by the 49-kDa TEV proteinase. Cleavage of the synthetic precursor was shown to occur accurately between the expected Gln-Ser dipeptide by microsequence analysis. Proteins containing insertions that generated only the Gln-Ser, or only the serine moiety of the conserved sequence, were insensitive to the 49-kDa proteinase. PMID- 3285344 TI - Saturation mutagenesis of a major histocompatibility complex protein domain: identification of a single conserved amino acid important for allorecognition. AB - The interactive association between T lymphocytes and their target cells is an important system of cell-cell interactions. Major histocompatibility complex class I molecules are the cell surface structures recognized by cytolytic T lymphocytes. To define the molecular structures recognized by cytotoxic T lymphocytes, we have saturated the 270-base-pair alpha 1 exon of the H-2Dp gene with point mutations, rapidly producing a "library" of 2.5 x 10(3) independent mutants. The library contains enough recombinant clones (each clone encoding approximately one amino acid replacement mutation) to predict a mutation at each nucleotide position of the alpha 1 exon. The functional analysis of the first five transfected gene products tested has shown that mutation of a conserved tyrosine at position 27 to asparagine destroys recognition of the H-2Dp gene product by polyclonal alloreactive cytotoxic T lymphocytes. Recognition of the same mutant molecule by three monoclonal antibodies and H-2-restricted lymphocytic choriomenengitis virus-specific cytotoxic T lymphocytes is unaffected. PMID- 3285345 TI - Prognostic significance of "short-term" effects of chemotherapy on MYC and histone H3 mRNA levels in acute leukemia patients. AB - We have found that administration of chemotherapy alters expression of growth regulated genes in leukemia blast cells. To determine if such changes might be correlated with therapeutic outcome, we studied steady-state mRNA levels of MYC and histone H3 in the leukemic blasts of patients just prior to and 24 hr after the administration of the first doses of antileukemic drug therapy. Among nine patients with acute myelogenous leukemia, mRNA levels of MYC and histone H3 were reduced in five patients, and hematologic remission was achieved in three of these individuals. No remission was obtained in the four patients without reduction in MYC and histone H3 mRNA. Among acute lymphocytic leukemia patients, the mRNA levels of MYC and/or histone H3 were reduced by the therapy in seven of nine patients. A complete hematologic remission was obtained in five of them, and a partial remission was obtained in the other two. No remission was obtained in the patients in which MYC and H3 mRNA levels were unaffected by the therapy. These studies are of interest because they suggest that a decrease in the mRNA levels of MYC and histone H3 24 hr after a single dose of antineoplastic drugs may predict which patients will achieve complete remission; lack of reduction in these mRNAs correlates with failure to achieve remission. In addition, these studies also provide further proof of the heterogeneity of altered growth regulation among human leukemias. PMID- 3285346 TI - Treponema pallidum invades intercellular junctions of endothelial cell monolayers. AB - The pathogenesis of syphilis reflects invasive properties of Treponema pallidum, but the actual mode of tissue invasion is unknown. We have found two in vitro parallels of treponemal invasiveness. We tested whether motile T. pallidum could invade host cells by determining the fate of radiolabeled motile organisms added to a HeLa cell monolayer; 26% of treponemes associated with the monolayer in a trypsin-resistant niche, presumably between the monolayer and the surface to which it adhered, but did not attain intracellularity. Attachment of T. pallidum to cultured human and rabbit aortic and human umbilical vein endothelial cells was 2-fold greater than to HeLa cells. We added T. pallidum to aortic endothelial cells grown on membrane filters under conditions in which tight intercellular junctions had formed. T. pallidum was able to pass through the endothelial cell monolayers without altering tight junctions, as measured by electrical resistance. In contrast, heat-killed T. pallidum and the nonpathogen Treponema phagedenis biotype Reiter failed to penetrate the monolayer. Transmission electron micrographs of sections of the monolayer showed T. pallidum in intercellular junctions. Our in vitro observations suggest that these highly motile spirochetes may leave the circulation by invading the junctions between endothelial cells. PMID- 3285348 TI - Control of melanogenesis and melanoma oncogenesis. PMID- 3285347 TI - Neural plasticity without postsynaptic action potentials: less-active inputs become dominant when kitten visual cortical cells are pharmacologically inhibited. AB - Models of synaptic plasticity in the nervous system have conventionally assumed a mechanism in which spike activity of a postsynaptic cell enhances the efficacy of recently active presynaptic inputs. Making use of the prompt and dramatic response of the visual cortex to occlusion of vision in one eye during the critical period, we tested the role of postsynaptic activity in ocular dominance plasticity. To do so, we selectively blocked cortical cell discharges with a continuous intracortical infusion of the inhibitory neurotransmitter agonist muscimol during a period of monocular deprivation. This drug inhibits cortical cell discharges with no apparent effect on the activity of their presynaptic geniculocortical inputs. Recording from single cortical cells after they had recovered from the muscimol-induced blockade, we found a consistent shift in the responsiveness of the visual cortex in favor of the less-active, closed eye, while the normal shift in favor of the more-active, open eye was evident in regions not affected by the treatment. Such an inhibition-coupled expression of plasticity in favor of the less-active, closed eye cannot be explained by a nonspecific disruption of cortical function. We interpret these results to indicate (i) that the postsynaptic cell is crucially involved in plasticity of the visual cortex, (ii) that the direction of cortical plasticity depends on postsynaptic membrane conductance or polarization, and (iii) that plasticity can occur in the absence of postsynaptic spike activity. PMID- 3285349 TI - Mechanisms of hypopigmentation in human oculocutaneous albinism. AB - The synthesis of melanin is ubiquitous in the animal kingdom and is under complex genetic control. Inborn errors of melanin formation, as with other inborn errors of metabolism, provide models to explore this genetic control. Human OCA is a fascinating group of disorders of melanin formation, and careful analysis of each type allows the development of hypothesis on probable mechanisms of development. The broader category of mild to moderate hypopigmentation without all of the features of albinism may ultimately prove to be as important in understanding melanin metabolism. PMID- 3285350 TI - Vitiligo and antibodies to melanocytes. AB - The cause of vitiligo is not known. It is reasonable to suspect that immune mechanisms are involved because some cell surface antigens are selectively expressed on pigmented cells, the immune system has the ability to respond to these antigens, but seems to do so most in persons or animals who have vitiligo. It is not known whether the specific immune abnormalities seen in vitiligo are a cause or a result of the disease, nor whether they damage melanocytes, simply aggravate melanocyte injury initiated by other causes, or are interesting but irrelevant epiphenomena. PMID- 3285351 TI - Animal models of an acquired pigmentary disorder--vitiligo. AB - Vitiligo appears to be a complex disorder that involves a melanocyte dysfunction and/or an autoimmune response. Further investigations of the animal models described in this report, and the less well-studied models that exist, is needed to clarify the mechanisms of this disorder. Three additional animal lines which appear potentially to be excellent animal models for vitiligo are: the Barred Plymouth Rock chicken which exhibits periodic degenerating melanocytes presumably due to a cytotoxic agent (Bowers et al, 1986), the White Leghorn chicken which exhibits preprogrammed melanocyte autophagocytosis (Jimbow et al, 1974), and the Duroc pig which exhibits spontaneous tumor regression and depigmentation (Hordinsky, personal communication). These numerous animal studies must be undertaken with the understanding that the specific etiologies and characteristics differ among these animal models and that each model represents only a facet of the complex condition, vitiligo. To unravel the complexity of this syndrome, the insightful correlation of the results of many investigators working with multiple model systems is required. PMID- 3285352 TI - Chemical and drug induced hypermelanoses. PMID- 3285353 TI - The status of oncogenes in malignant melanoma. PMID- 3285354 TI - Comparative strategies of pigmentary regulation in invertebrates. AB - This brief survey of color change strategies among invertebrates has dealt mainly with the diversity encountered in three aspects of their pigment cell biology: (1) the types of chromatophores they possess, (2) the control of color changes by nerves or hormones if the chromatophores are not acting only as independent effectors and (3) the functions of the physiological color changes these animals exhibit. Of these three topics, much less is known about the last one, the functions of the color changes, than about the first two. There has been much hypothesizing about the functions of color changes and the advantages such changes presumably confer, but relatively few data have been generated to support the hypotheses. PMID- 3285355 TI - Chemistry of crustacean chromatophorotropins. PMID- 3285356 TI - Comparison of pigment responses in human skin to UVB and UVA radiation. AB - Several pieces of evidence suggest that UVB and UVA exposure results in pigmentation via distinct pathways. The character of the action spectrum suggests that DNA may be the chromophore in the UVB region, with a different target in the UVA region. The oxygen dependence of the response to UVA, but not UVB is consistent with this hypothesis. Peak et al [1984] have postulated two distinct mechanisms for certain cellular effects of UV, such as lethality and mutagenesis: a "UVC mechanism," which results from direct DNA photochemistry, with an action spectrum mainly in the UVC and UVB regions, and a "UVA mechanism" which results from oxygen-dependent effects, induced mainly by UVA; the two action spectra overlap in the short UVA region. At 333 nm, it was calculated that the two mechanisms contributed equally to mutagenesis. It is possible that an analogous process occurs for certain cutaneous responses and could account for some of the observed differences between the effects of different wavebands. This could also account for recent observations suggesting that the effects upon skin of different regions within the UVA spectrum differ qualitatively as well as quantitatively. In particular, the biological effects of "full spectrum UVA" (320 400 nm) appear to be different from those of UVA from which the wavelengths between 320-340 nm have been excluded. "Full spectrum UVA" appears to be more damaging with respect to connective tissue alteration [Kligman et al, 1985], Langerhans cell depletion [Aberer et al, 1981], and the ability to increase photocarcinogenesis by UVB [Staberg et al, 1983a; Staberg et al, 1983b]. An untested hypothesis is that this phenomenon is the result of overlapping "UVC mechanism" and "UVA mechanism" action spectra in the 320-340 nm region, with these wavelengths resulting in changes typical of both regions. PMID- 3285358 TI - Cytology and pigments of non-melanophore chromatophores in the avian iris. PMID- 3285357 TI - Thymosin modulates immune and endocrine events. PMID- 3285359 TI - Colon: relationship between epithelial transport and motility. AB - Although our knowledge of colonic function is still incomplete, the available data support the concept that for most of the time colonic motor activity is adapted to promote absorption and bacterial metabolism. The possibility that this mode of activity may be enhanced and promoted by the products of fermentation is intriguing and needs to be established. Substances that irritate or stimulate the colon, such as unabsorbed fat, bile acids, bacterial enterotoxins and laxatives and excessive delivery of fluid from the small intestine, flush out colonic contents by causing secretion and colonic propulsion. PMID- 3285360 TI - Role of motility in pathogenesis of constipation and diarrhea. AB - Several attempts have been made in order to classify the gastrointestinal motility disorders; they are mainly based upon the type of disorder in transit and the region of the gastrointestinal tract affected. Many digestive motor disturbances do not constitute entities, but are pathophysiologic mechanisms that may contribute to the production of symptoms and signs of various diseases. The abnormal interdigestive motility pattern or the migrating motor complex often corresponds to the absence of phase 3 and several observations strongly suggest that this disordered motility pattern is the cause rather than the consequence of intestinal bacterial overgrowth. Disturbances of colonic motility are often associated with diarrhea; however, the nature of motor alterations depends on the diarrheal disease (episodic, continuous with or without pain). Finally, both gastrointestinal and colonic motor disturbances may contribute to the pathogenesis of constipation and diarrhea; however, several findings suggest that colonic motor alterations are the consequence rather than the cause of changes in bowel habits. PMID- 3285361 TI - Effect of sennosides on colon motility in dogs. AB - Oral administration of sennosides (20-30 mg/kg) to fasted dogs has been shown to induce a strong and long-lasting inhibition of myoelectric colon activity which was evident after a delay of 6-10 h corresponding to oro-cecal transit and colonic metabolism and was accompanied by abundant diarrhea. When sennosides were given 1 h before a meal, the postprandial increase in colon motility failed to appear. Recent studies with strain gage transducers confirm the inhibition of colonic motility after oral sennosides but, in addition, 3-10 'giant contractions' with a high amplitude appeared during the period of inhibition. Most of these single contractions were propagated over the second half of the colon at a velocity of 0.5-2 cm/min. Elimination of liquid feces was always associated with giant contractions. These giant contractions have also been described with other stimuli (i.v. guanethidine or neostigmine, oral castor oil, intraluminal hypertonic glucose) and are therefore not specific for sennosides. PMID- 3285362 TI - Senna--an old drug in modern research. AB - Senna was introduced in therapy in the 9th century by the Arabs. In the second half of the 19th century chemical investigation of the drug was undertaken, but only a century later the sennosides were isolated. Pharmacological research on senna started at the beginning of this century. During the last 25 years interest in the pharmacology of synthetic and natural laxatives steadily increased. Senna, containing only dianthrones as active substances, is still in the center of scientific research and merits this special attention. PMID- 3285363 TI - Sennosides and human colonic motility. AB - The effects of stimulant laxatives on colonic motility in man still remain controversial. Stimulation of peristalsis or a decrease of intraluminal pressure has been described manometrically after intraluminal administration of laxatives including senna. In contrast to manometry, electromyographic methods using an endoluminal probe enable continuous colonic motor recordings over a long colonic segment for at least 24 h, and consequently studies following the course of laxative effects after oral administration, the classical therapeutic route, are possible. Preliminary results using sennosides obtained with few subjects provide evidence for an increase in propulsive activity expressed as an increased number of migrating long-spike bursts in the left and sigmoid human colon. This motor colonic pattern seems to be a common feature in nonspecific or induced diarrhoea. PMID- 3285364 TI - Gastrointestinal motility: some basic concepts. AB - The spatial and temporal patterns of phasic contractions in the gastrointestinal tract are regulated by a complex interplay between the myogenic, neural and chemical control mechanisms. These contractions are largely responsible for the mixing and propulsive movements of the gut after a meal. In the fasted state, organized groups of contractions called cyclic motor activity and migrating motor complex keep the upper digestive tract clean of residual food and debris. In addition, the small intestine and the colon generate giant migrating contractions which are several-fold stronger than the postprandial phasic contractions and migrate uninterrupted over long distances. The giant migrating contractions are effective in rapid propulsion. The upper small intestine and the antrum generate retrograde giant contractions that generally precede vomiting. PMID- 3285365 TI - Males increase progestin receptor binding in brain of female voles. AB - In female prairie voles, behavioral estrus is induced by exposure to an unfamiliar male and ovulation is induced by mating. Experiments were conducted to determine whether a saturable high-affinity progestin binding site (PRC) is present in cytosols of brain tissue from females exposed to male stimuli for a period of time which is sufficient to bring most females into heat. PRC were detected in both the medialbasal hypothalamus (MBH) and preoptic area (POA). However, PRC levels increased in response to male stimuli in the MBH but not in the POA. The lack of an increase in the POA could not be attributed to changes in circulating progesterone. These results indicate that social stimuli can influence cellular events within specific areas of the female brain and suggest that one distinguishing feature between the spontaneous and induced ovulators may be the pattern of estrogen-induced progestin receptors within areas of the brain which are involved with the control of sexual behavior and/or ovulation. PMID- 3285366 TI - Hysteria, anorexia and the culture of self-denial. AB - Anorexia and hysteria seem to be expressions of age-specific conflicts intensified by constrictive cultural ideas and certain kinds of familial constellations. The disorder that ensues appears to represent the individual's desperate attempt to escape the conflicts of adult life according to models offered by the prevailing cultural values. PMID- 3285367 TI - [A taxonomy of affect and its use in understanding "early" disorders]. PMID- 3285368 TI - ["Neurotic" masking and episodic structural weaknesses in psychosomatic patients]. PMID- 3285369 TI - [Considerations on the use of co-therapists in the therapy of psychoses]. PMID- 3285370 TI - Psychological reactions of individuals at risk for AIDS during an experimental drug trial. PMID- 3285371 TI - The protection of the ischemic myocardium: surgical success v clinical failure? PMID- 3285372 TI - [Chemical modification of anticancer agents for improved properties: towards macromolecular therapeutics and prospects]. PMID- 3285373 TI - [Bispecific antibodies]. PMID- 3285374 TI - [Recent advances in the arachidonate cascade research (II)]. PMID- 3285375 TI - [Structure and function of HU protein]. PMID- 3285376 TI - [HPLC-electrochemical detection method]. PMID- 3285377 TI - Des-Leu angiotensin I: biosynthesis and drinking response. AB - The crude rat and bovine synaptosomal lysate from brain can hydrolyze angiotensin I (AI) to des-Leu angiotensin I (AI-dL) and no further. This cytosolic enzyme has a specificity for angiotensin-related sequences, R-His-Pro-Phe-His-Leu and therefore named angiotensin-related carboxypeptidase (ARC). These studies led to the biosynthesis and purification of AI-dL in order to determine if it can provoke a drinking response. This nonapeptide is a potent dipsogen when injected into the cerebroventricles of rats. The drinking response probably requires a second hydrolysis to angiotensin II (AII) since both captopril and saralasin can inhibit this response. PMID- 3285378 TI - Goitrogens and thyroid follicular cell neoplasia: evidence for a threshold process. AB - Thyroid neoplasia can result from many different causes. These include low iodine diets, subtotal thyroidectomy, radioactive iodine, natural goitrogens such as rape seed and cabbage, chemotherapeutic agents such as sulfathiazole, and pesticides such as amitrole. All of these appear to act through either direct or indirect interference with thyroid hormone synthesis. Decreased circulating levels of thyroid hormones in the blood result in increased release of thyroid stimulating hormone by the anterior pituitary gland. This, in turn, results in hypertrophy and hyperplasia of the thyroid without a corresponding increase in blood thyroid hormone levels. Hyperplasia of the pituitary is also observed due to increased functional demand for continued production of thyroid-stimulating hormone. After prolonged stimulation of the pituitary/thyroid axis, hyperplasia may progress to neoplasia. Cessation of exposure prior to the induction of neoplasia results in a return to the normal state. It is clear that some degree of thyroid inhibition can be accommodated within the bounds of the normal feedback mechanism without the induction of either hyperplasia or neoplasia. A threshold for thyroid follicular neoplasia is therefore indicated. PMID- 3285379 TI - Cross-species extrapolations and the biologic basis for safety factor determinations in developmental toxicology. AB - Designations of agents as teratogenic or nonteratogenic often are inaccurate, as adverse effects are more a reflection of the timing and severity of treatment during pregnancy than agent nature. Careful consideration of both the similarities and the differences between developmental effects in animals and humans and the extent and nature of the data available are essential for protection of the human conceptus. Animal surrogates prove reliable predictors of human developmental effect levels. When the data are evaluated consistent with contemporary concepts of developmental toxicity, for example, where the effect in the embryo is only seen at maternally toxic doses and exposure is below the adult toxic level, relatively modest safety factors are sufficient for safe cross species extrapolation. Developmental toxicity safety factor magnitude is predicated on data quality and the fact that thresholds of effect exist in mammalian pregnancy. Safety of human concepti is achieved by considering both the developmental hazard index of the chemicals in question and the severity of exposure. PMID- 3285380 TI - [200 years later]. PMID- 3285381 TI - [In vitro activity of 9 antimicrobials against Bacteroides fragilis]. PMID- 3285382 TI - [Recurrent polychondritis: clinical, pathological and immunological study of 6 cases]. PMID- 3285383 TI - [Prevention of cerebral vasospasm caused by the rupture of intracranial aneurysms]. PMID- 3285384 TI - [Control of health care quality, a shared responsibility]. PMID- 3285385 TI - [Sublingual nifedipine or captopril as treatment of hypertensive crisis]. PMID- 3285386 TI - [Splenic abscess]. PMID- 3285387 TI - [Ischemic cardiomyopathy (II). Physiopathologic mechanisms of ischemia and myocardial reperfusion]. PMID- 3285388 TI - [Prevention of ventricular tachycardia and sudden death after myocardial infarct. Strategies in the new cardiology]. PMID- 3285389 TI - [Effectiveness of sclerosing therapy as a primary therapeutic measure in active hemorrhage from esophageal varices]. PMID- 3285390 TI - [Acute volvulus of the sigmoid colon. Surgical aspects and 1-14 year follow-up]. PMID- 3285391 TI - [Development of mortality from colorectal cancer in Spain 1951-1980]. PMID- 3285392 TI - [Absence of hypocalcemic response to calcitonin in patients with chronic liver diseases]. PMID- 3285393 TI - [Preoperative diagnosis in choledocholithiasis]. PMID- 3285394 TI - [Cyst of the common bile duct: diagnosis by imaging]. PMID- 3285395 TI - [Anatomo-clinical study of chronic pancreatitis: apropos of 22 cases]. PMID- 3285396 TI - [Percutaneous drainage of intra-abdominal fluid accumulations under echographic control. Analysis of 32 cases]. PMID- 3285397 TI - [Diffuse giant cavernous hemangioma of the liver: apropos of 2 cases]. PMID- 3285398 TI - [Leiomyoma of the esophagus. Report of 2 new cases]. PMID- 3285399 TI - [Primary adenocarcinoma of the appendix: report of a new case]. PMID- 3285400 TI - [Inflammatory mesenteric pseudotumor]. PMID- 3285401 TI - [Thyroid-liver interactions in clinical medicine]. PMID- 3285402 TI - [Asthma and complement]. AB - The complement system has an important place in the development of the inflammatory reaction. The complement may be activated by the classical pathway (itself activated by immune complexes, CRP etc.) or the alternative pathway (activated by bacterial endotoxins, different lung allergens etc.). This activation culminates in the release of opsonising, chemotactic, smooth muscle constrictor, and mast cell activating factors. The complement system is present locally at the level of the bronchi and could participate in the development of bronchial inflammation narrowly associated with asthma. Study of the complement system in the plasma in asthmatics has not shown a relation between its state of activation and bronchomotor tone. However, in view of recent studies of the complement in the bronchi, analysed on broncho-alveolar lavage, the potential role of complement in asthma should be re-evaluated. PMID- 3285403 TI - [French Language Society of Pneumology. List of members (1988)]. PMID- 3285404 TI - Minimal neoplasia as a challenge for early cancer detection. PMID- 3285405 TI - Immunological approaches for early cancer detection. PMID- 3285406 TI - Therapeutic consequences of minimal neoplasia of the colon. PMID- 3285407 TI - Early cancer of the lung. PMID- 3285408 TI - Minimal thyroid neoplasia. PMID- 3285409 TI - Minimal thyroid cancer: clinical consequences. PMID- 3285410 TI - Molecular biology of minimal invasion. PMID- 3285411 TI - Cryptic gliomas. PMID- 3285412 TI - Cytobiology and clinical findings of myelodysplastic syndromes. PMID- 3285413 TI - Minimal neoplasias in experimental liver carcinogenesis. PMID- 3285414 TI - Minimal endometrial carcinoma. PMID- 3285415 TI - Therapeutic procedure for minimal endometrial cancer. PMID- 3285416 TI - Minimal cervical cancer: definition and histology. PMID- 3285417 TI - Anatomic markers of human mammary premalignancy and incipient breast cancer. PMID- 3285418 TI - Treatment aspects of minimal breast cancer. PMID- 3285419 TI - Morphology of minimal invasion. PMID- 3285420 TI - Incipient cancer of the colon: definition and histology. PMID- 3285421 TI - [Pulmonary arterial hypertension and systemic lupus erythematosus. Apropos of 2 cases. Review of the literature]. AB - Pulmonary arterial hypertension may develop in patients with systemic lupus erythematosus (SLE) in the absence of lung tissue lesion or embolism in the pulmonary circulation. Its mechanisms and prognosis are imperfectly known, although various suggestions have been made concerning the possible role of pulmonary arterial spasm, immune complex arteritis or arterial wall fibrosis. We report two cases of SLE in female patients who presented with clinical signs of pulmonary arterial hypertension. The fact that pulmonary arterial hypertension regressed completely in one patient and resulted in death in the other points to different pathogenic mechanisms. In the first patient the dramatic therapeutic effectiveness of a calcium inhibitor suggests that an arterial spasm was involved, whereas the anatomical lesions found in the second patient are in favour of a fibrotic inflammatory arteritis. This pathogenic heterogeneity of pulmonary arterial hypertension in SLE, which may correspond to different evolutive stages of the disease, is documented by a review of the literature with special attention to the frequency and to the clinical biochemical, haemodynamic and histological aspects of this complication of SLE. PMID- 3285422 TI - [Indications and results of parathyroidectomy in the treatment of hyperparathyroidism in dialyzed and kidney transplant patients. Apropos of 68 cases]. AB - Between 1972 and 1985, 78 parathyroidectomies were performed in 60 patients under chronic haemodialysis and in 6 recipients of renal transplants. These patients had severe hyperparathyroidism and radiological evidence of fibrous osteitis. This series shows a recrudescence of tertiary hyperparathyroidism in renal transplant recipients under ciclosporin. The post-operative course was favourable in 55 cases; 13 patients had to be reoperated upon, revealing the presence of supernumerary glands in 6 of them. PMID- 3285423 TI - [Intracoronary thrombolysis and coronary angioplasty in the acute stage of infarction]. PMID- 3285424 TI - [The kidney in Bourneville's tuberous sclerosis]. PMID- 3285425 TI - [Pyoderma gangrenosum in myeloid splenomegaly: a case]. PMID- 3285426 TI - [Deficiency of the 6th component of complement. Recurrent meningococcal and streptococcal meningitis]. AB - A 39-year old male patient with a history of four episodes of meningitis (two of them due to Neisseria meningitidis) since the age of 12 developed meningitis caused by an ungroupable streptococcus. Deficiency of the sixth component of complement was discovered, making this the ninth case of recurrent meningitis associated with C6 deficiency. Streptococcal meningitis had never been reported in such cases. PMID- 3285427 TI - [Buspirone: pharmacological and clinical properties of the first member of a new anxiolytic drug family]. AB - Buspirone is a new anxiolytic agent with an original chemical structure. Its activity in doses of 15 to 30 mg per day has been demonstrated in patients presenting with manifestations of generalized anxiety. Its mode of action is still imperfectly known; in animals, it influences several neuromediator systems but does not act on benzodiazepine receptors. Its main pharmacokinetic features are: complete absorption when given orally, short half-life (4 to 8 h), reduced plasma clearance in patients with hepatic cirrhosis or renal impairment and no major interaction with most of the other psychotropic drugs. Controlled clinical studies have provided evidence of its anxiolytic properties; against anxiety symptoms buspirone has proved more effective than placebo and as effective as several reference benzodiazepine derivatives, with a lesser incidence of sedative effects. However, it is not effective in the treatment of benzodiazepine withdrawal. Gastrointestinal disorders and moderate headache have been reported in less than 10 p. 100 of the patients treated. Administered acutely, buspirone does not seem to alter cognitive mechanisms. Unlike benzodiazepines, it does not potentiate the effects of alcohol and does not lead to drug-dependence. Its usefulness in panic disorders, anxious-depressive states and obsessional symptoms remains to be determined. PMID- 3285428 TI - Two cases of calcified cysts of the spleen. AB - Presented in this paper are two cases of calcified cyst of the spleen. The first case is an epidermoid cyst of a 20-year-old male who visited our hospital because of vomiting and epigastric discomfort. The second case is a pseudocyst of a 38 year-old male who was referred to our hospital for evaluation of an abdominal mass. Both patients had no history of abdominal trauma. Linear or curvelinear calcification was revealed in the left epigastric region in the plain X-ray films of the abdomen. Ultrasonography, computed tomography and selective celiac angiography led to the diagnosis of a cyst of the spleen, and surgical operations were performed because the cysts were large and symptomatic. Splenic cyst is a relatively rare disease. However, the cases including asymptomatic cases with small cyst have been increasing in number with the improvement of diagnostic methods and the common use of ultrasonography and computed tomography. In Japanese literatures, 332 cases had been reported by 1983. PMID- 3285429 TI - The effect of long-term pulsing electromagnetic field stimulation on experimental osteoporosis of rats. AB - The author performed experiments in order to investigate what biological effect on the bone would be produced by long-term pulsing electromagnetic field (PEMF) systemic stimulation. In some of the mature female rats used as experimental animals, bilateral ovariectomy and right sciatic neurectomy were performed in order to make a model osteoporosis. PEMF stimulation was produced by repetitive pulse burst (RPB) waves at a positive amplitude of 25 mV, negative amplitude of 62.5 mV, burst width of 4.2 ms, pulse width of 230 microseconds and 12 Hz, with the magnetic field strength within a cage being set at 3-10 Gauss. PEMF stimulation over 6 months did not produce any effects on the physiologically aged bones. PEMF stimulation also did not produce any effects on losed cortical bone in osteoporotic hindlegs. On the other hand, an increase of bone volume and bone formation activity was observed in the cancellous bone of osteoporotic hindlegs. These findings suggested that PEMF stimulation exerted a preventive effect against bone loss of osteoporotic hindlegs. Furthermore, an observed increase in bone marrow blood flow seemed to be related with this increase of bone volume and bone formation activity. PMID- 3285430 TI - [Echography in urology? 1. Echography of the lower urinary tract]. PMID- 3285431 TI - [Monoclonal gammapathy of indeterminate origin and myeloma]. PMID- 3285432 TI - [The states of iron overload: hemosiderosis and hemochromatosis]. PMID- 3285433 TI - [Non-rheumatoid arthritis]. PMID- 3285434 TI - Benefits of aerobic conditioning and diet for overweight adults. AB - Excess bodyweight and obesity are one of the most common problems facing adult men and women of modern industrialised societies. Obesity is associated with alternations in glucose tolerance and lipoprotein profiles, which produces an increased risk for coronary heart disease. Starvation and low-calorie diets under 500 kcal/day reduce bodyweight and fat, but serious life-threatening problems can develop. For these reasons, moderate caloric restrictions between 1000 and 1500 kcal/day have been shown to produce the most successful long term weight loss. Exercise conditioning without caloric restrictions has been shown to reduce bodyweight, primarily fat weight, and increase lean bodyweight. However, this occurs only when the energy expenditure is greatly elevated and the exercise sessions are long in duration. Well controlled multiple-group studies indicate that exercise combined with caloric restriction is the best method for bodyweight and fat reduction. Including exercise in the diet regimen increases cardiorespiratory functional capacity, decreases cholesterol and triglyceride levels, and helps to retard the loss of lean muscle mass. The diet and exercise prescription which produces the best and safest results includes a diet of approximately 1200 kcal/day and a physical activity programme of at least 3 days/week, 20 to 30 minutes in duration, and at a minimum intensity of 60% of maximum heart rate. PMID- 3285435 TI - Free radical chemistry. Relationship to exercise. AB - Free radicals are molecules or molecular fragments containing an unpaired electron in the valence shell. Radicals interested only a few chemists until 18 years ago when an enzyme was discovered which functioned to remove a specific oxygen-centered radical. That discovery renewed interest in radicals and has already begun to alter thinking on many clinical problems. Free radicals have been shown to be common phenomena that play a role in normal biochemistry but require an elaborate control system to be held in check. Since oxygen-centered radicals are produced in intermediate metabolism, exercise should increase their production and that has been shown to be so. There is also evidence that the consumption of large quantities of ambient oxygen during exercise induces harmful chemistry known as lipid peroxidation. Presently, there are insufficient data available to ascertain how the human body tolerates such increased production of free radicals and lipid peroxidation and how the consequences of that chemistry might relate to the overall well being of exercising humans. PMID- 3285436 TI - Iron, zinc and magnesium nutrition and athletic performance. AB - During the last decade there has been considerable interest in the idea that dietary trace elements supplementation can result in an improvement in athletic performance. The current paper discusses this idea as it relates to 3 elements: iron, zinc and magnesium. Emphasis has been placed on examining the implicit assumptions underlying the idea that mineral supplements help the athlete. These assumptions include the beliefs that the athlete has a higher than normal requirement for minerals; that the athlete consumes a diet inadequate in these minerals; and that a marginal deficiency of these elements has a direct effect on athletic performance. Evidence is presented that both iron deficiency and magnesium deficiency can result in a significant reduction in exercise performance; however, the biochemical lesions underlying the reductions in exercise performance have not been identified. There is evidence that dietary magnesium intake may be suboptimal in some individuals, thus dietary supplementation of this element may be useful in some population groups. Excessive magnesium supplementation is not thought to be a serious health problem. Similar to magnesium dietary iron supplements can improve athletic performance in individuals severely deficient in this element. However, few studies have documented a need for iron supplements in healthy athletes. If iron supplements are used, it is important that the level of supplementation is not excessive, as excess iron in the diet can result in an induced zinc deficiency. In marked contrast to iron and magnesium, there is little evidence for the idea that zinc deficiency influences exercise performance in humans. Despite this fact, zinc supplements have been widely advocated for the athlete, as it is known that intense exercise can result in changes in zinc metabolism. If zinc supplements are used, it is important that they are not excessive, as excess zinc in the diet can result in a secondary copper deficiency. PMID- 3285438 TI - [Alzheimer's disease, amyloidosis, microglia and astrocytes]. AB - Recent data favor the hypothesis of a genetically-induced overproduction of amyloid protein as the cause of Alzheimer's disease. This could be responsible for the occurrence of senile changes (senile plaques and neurofibrillary tangles) which are both characteristic of so-called normal aging of the brain and of Alzheimer's disease and lead to neuronal death. However, as shown by studies of twins, epigenetic factors must be very important in the triggering and/or acceleration of this process since the concordance between monozygotes does not reach higher levels than 41. It is argued that brain microglia, and/or astrocytes are the most likely candidates to the regulatory function of amyloid deposit in the brain. These cells could act by modulation of either the hydrolysis of the precursor protein during amyloidogenesis or the resorption of amyloid fibrils, which could occur in Alzheimer's disease as suggested by recent data. Further research on this topic could have therapeutical repercussions. PMID- 3285437 TI - Muscular coordination and strength training. Implications for injury rehabilitation. AB - Strength training is commonly used in the rehabilitation of muscles atrophied as a result of injury and/or disuse. Studies on the effects of conventional leg extension training in healthy subjects have shown the changes to be very task specific to the training manoeuvre itself. After conventional leg extension training for the quadriceps muscle the major improvement was in weightlifting ability with only small increases in isometric strength. The maximum dynamic force and power output during sprint cycling showed no improvement. These results suggest that the major benefit of this type of training is learning to coordinate the different muscle groups involved in the training movement rather than intrinsic increases in strength of the muscle group being trained. Other studies have shown changes in strength to be specific to the length and speed at which the muscle has been trained. The implication for rehabilitation is that strength training for isolated muscle groups may not be the most effective way of increasing functional ability. As the major changes are task-specific it may be better to incorporate the training into task-related practice. This would have the advantage of strengthening the muscle groups affected whilst increasing performance in those activities which are required in daily life. PMID- 3285439 TI - [Hemangioblastoma of the cerebellum, bulbo-spinal cord syringomyelia and bilateral pheochromocytoma]. AB - A probable diagnosis of an incomplete form of von Hippel Lindau disease was made in a case of combined cerebellar hemangioblastoma, pontobulbar cavitation and bilateral pheochromocytoma. A survey of the literature review found only 3 similar cases among 64 patients reported as having combined lesions. A wide variety of lesions are in fact encountered. PMID- 3285440 TI - [Cerebral atrophy and chronic alcoholism]. AB - Fifty chronic alcoholic male patients, were investigated to determine characteristics of alcohol intoxication, neurologic and hepatic complications and degree of cerebral atrophy by CT. CT imaging criteria for definition of alcoholic cerebral atrophy are proposed, discussed and compared with those previously reported. Findings showed that alcoholic cerebral atrophy is added to atrophy due to age and is in correlation with the duration of intoxication. It appears after 40 years of age and increases progressively in parallel with polyneuropathy, cerebellar disorders and dementia. It appears to progress independently of the hepatic lesions. PMID- 3285441 TI - The organisation of cardiovascular neurons in the spinal cord. PMID- 3285443 TI - [The trauma of the hysterotomy incision]. AB - In order to obtain, after caesarean section, a uterine scar of the best quality, the authors have studied the role of trauma on the edges of the wound during the procedure, especially the role of haemostatic clamps. Clinical studies (hysterography) and the comparison with experimental scars on dog's uterus, operated at term, show that instrumental trauma of the edges of the uterine wound affects the quality of the scar. PMID- 3285442 TI - [Serodiagnosis of toxoplasmosis developing during pregnancy and of congenital toxoplasmosis]. AB - During the first prenatal serodiagnosis of toxoplasmosis, the test must permit to differentiate between immunized and non-immunized patients and to screen recently contracted toxoplasmosis. In a group of 33 women affected with toxoplasmosis during pregnancy a critical study of serodiagnosis criteria is carried out by comparing the theoretical protocol of the evolution of the serology during acquired toxoplasmosis with the situations observed under usual prenatal monitoring. Seroconversion was noted in 26 women and the variability of the results emphasizes the difficulties in determining the date of the contamination when an evolutive form of toxoplasmosis is suspected at the first examination, which is the case in 7 other patients. In children, 11 congenital toxoplasmosis were diagnosed, all on laboratory examinations. It must be emphasized that 16 children were prematurely lost to follow-up. It should be necessary to devote our energies to screening and information in order to validate the protocol of prevention of congenital toxoplasmosis. PMID- 3285444 TI - [Psychotropic drugs and pregnancy]. AB - The multiplicity of psychotropic medications and their widespread prescription, justifies a review of the possible effect of psycholeptics and psycho-analeptics on the fetus in-utero, and on lactation. The authors attempt to differentiate between diverging if not conflicting opinions in most cases. They conclude that it is necessary to prescribe these products only with precise indications and after careful consideration. PMID- 3285445 TI - [Mullerian adenosarcoma of the uterus. Review of the literature. Apropos of a case]. AB - The authors report a case of mullerian adenosarcoma in an 86 year old woman. This tumor is characterized by the association of proliferative benign epithelium with a sarcomatous mesenchyma. It was described for the first time in 1974 by Clement and Scully. It is a cancer of decreased malignancy, revealed either by isolated metrorrhagias, or by an increase of the size of the uterus in a post-menopausal woman. Its course shows the occurrence of local recurrences and pulmonary or peritoneal metastases. The only appropriate treatment is total abdominal hysterectomy with salpingo-oophorectomy. PMID- 3285446 TI - The anatomy of an experiment--the Rhode Island Hospital and the Colonel Rice Mission. PMID- 3285447 TI - Crohn's disease in Ireland: then and now. PMID- 3285448 TI - Reminiscences of an octogenarian. PMID- 3285449 TI - Azorean (Machado-Joseph) disease. PMID- 3285450 TI - Nasal antrostomy. AB - With chronic maxillary sinusitis the pathological changes in the diseased mucosa used to be considered irreversible, thus necessitating its radical removal, which is only possible with the Caldwell-Luc operation. The discovery of the reversibility of the pathology caused a shift from the Caldwell-Luc towards endonasal procedures, of which the inferior meatal antrostomy became the most widely used. Nasendoscopy, later combined with computed tomography, led to the development of the concept of the osteomeatal unit, and hence the functional endoscopic sinus surgery, which is concentrated round the infundibulum region. In view of possible risks and complications of that method it is propagated here to differentiate between these two techniques: When the focus of chronic sinusitis appears to be situated in the infundibulum/anterior ethmoid region, the functional endoscopic surgery seems preferable; For cases where the inflammatory process was restricted largely to the maxillary sinus a modified inferior meatal antrostomy technique proved to have a 92% success rate in 378 sinuses. PMID- 3285451 TI - [The effect of 4-acetamidosalicylic acid on the inhibition of leukocyte adherence]. PMID- 3285452 TI - Evaluating non-steroidal antiinflammatory drugs. PMID- 3285453 TI - Sternocostal joint swelling--clinical Tietze's syndrome. Report of sixteen cases and review of the literature. AB - Sixteen patients with painful tender swelling in the region of the sternocostal joint (SCJ) are reported and analysed against the background of a review of 106 previously reported patients with Tietze's syndrome. Seven patients fulfilled all the diagnostic criteria for Tietze's syndrome. The radiographic findings and/or the history of these patients suggested that local strain generated by respiration is a pathogenetic factor. Nine patients had a systemic arthritic disorder, skin disease, or psoriasis in their family. They differed from the 7 patients with local involvement and from those reviewed, by the rather frequent bilateral involvement, a frequent affection of the first SCJ and the manubriosternal joint, and a female predominance. Their SCJ swellings may be viewed as part of a seronegative arthritis. PMID- 3285454 TI - Electron energy loss spectroscopic imaging in biology. AB - One of the goals in biology is to relate the ultrastructure with the movement of elements to understand better physiological and pathophysiological mechanisms. Electron energy loss spectroscopy (EELS) imaging, which was developed in the last decade, appears to be an ideal technique to make such correlation. EELS takes advantage of the energy distribution of transmitted electrons which interacted with the specimen. All these electrons are collected and can be displayed as an energy loss spectrum for analytical purposes. Images can be produced from selected regions from the energy distribution allowing the mapping of specific elements. The main advantage of EELS imaging in biology is its spatial resolution of 0.5 nm or less and its great sensitivity allowing nearly a single atom detectability. The limitations reside essentially in specimen preparation. In order to obtain optimal results with EELS imaging, only very thin specimens can be used. This restricts the way biological specimens can be prepared. This is a real challenge for the analysis of diffusible elements. Other limitations reside in the difficulty of quantifying the results obtained. This is greatly due to the fact that theoretical considerations still have to be experimentally validated. The purpose of this review is not to repeat in length the principle of EELS but to emphasize its achievement in biology and to assess the present advantages and limitations. Also, as EELS imaging is still in its development phase, results already obtained are a strong indication that this technique has a great prospect in the analysis of dynamic biological processes. PMID- 3285455 TI - Influence of cytomatrix proteins on water and on ions in cells. AB - This review concerns the influence that cytomatrix proteins have on the motional properties of water and on the major inorganic ions in cells. The techniques we used for study of water in cells and on the cytomatrix proteins include: pulsed NMR of water protons, quench cooled ice crystal imprint size, and osmotic behavior. The technique for study of ions involved use of electron-probe X-ray microanalysis of thin cryosections of cells. The cytomatrix was found to play the major role in determining the extent of hydration water in cells. The amount of hydration water varied greatly between cell types (e.g., lens fiber cells have no detectable bulk water) and varied in the same cell type studied under different states (e.g., unfertilized and fertilized sea urchin eggs). Aggregation of cytomatrix proteins (actin in particular) is a determinant of the extent of hydration water in cells. Hydration water appears not to participate in the ideal osmotic equation of van't Hoff. The ionic content of cells does not accurately predict the chemical activity of the ions in cytoplasm. A major proportion of intracellular K+ and a substantial fraction of Cl- was found to be influenced by the cytomatrix such that their diffusion was impaired. The cytomatrix is responsible for the decreased motional properties of a substantial portion of cellular water and ions. PMID- 3285456 TI - Age dependent dehydration of postmitotic cells as measured by X-ray microanalysis of bulk specimens. AB - In this paper we give a brief outline of our bulk specimen technique developed to measure intracellular water concentration in frozen-hydrated biological specimens by means of energy dispersive X-ray microanalysis. Fractured surface of the deep frozen tissue samples is analyzed in an electron microscope (a specimen area of 15 x 11.5 micron is scanned) using 20 kV accelerating voltage and 1-5 pA effective beam current (measured in the specimen). Strong electric charging, which is the main problem associated with the low temperature X-ray microanalysis of frozen-hydrated specimens, is reduced by choosing optimum temperature range for the measurements (170-185 K) and by etching a thin surface layer on specimen surface. The main advantage of the method over other X-ray microanalytical techniques using sections and bulk specimens for water and dry-mass content determinations in cells (which are shortly reviewed) is the simple specimen preparation, the easy sample handling and the good stability of specimen during measurements. The main disadvantage is the poor spatial resolution as compared to the analysis of sections. Measurements with our method provided meaningful results of the change in intracellular water contents in various postmitotic cells of rats dependent on age. The observed decline of the intracellular water contents results in increased ionic strength and slower diffusion in old cells than in young ones. These effects may be implicated in senescent deterioration of cell metabolism. PMID- 3285457 TI - The bulk specimen X-ray microanalysis of freeze-fractured, freeze-dried tissues in gerontological research. AB - The rationale for choosing the freeze-fracture freeze-drying (FFFD) method of biological bulk specimen preparation as well as the theoretical and practical problems of this method are treated. FFFD specimens are suitable for quantitative X-ray microanalysis of biologically relevant elements. Although the spatial resolution of this analytical technique is low, the application of properly selected bulk standard crystals as well as the measurement of the intracellular water and dry mass content by means of another method developed in the same laboratory, allow us to obtain useful information about the age-dependent changes of ionic composition in the main intracellular compartments. The paper summarizes the problems with regard to specimen preparation, beam penetration and the quantitative analysis of FFFD specimens. The method has been applied so far mainly for the analysis of intranuclear and intracytoplasmic concentrations of Na, C1 and K in various types of cells and has resulted in a significant contribution to our understanding of the cellular mechanisms of aging. PMID- 3285458 TI - 3-dimensional imaging of biological structures by high resolution confocal scanning laser microscopy. AB - Imaging in confocal microscopy is characterized by the ability to make a selective image of just one plane inside a specimen, virtually unaffected -within certain limits- by the out-of-focus regions above and below it. This property, called optical sectioning, is accompanied by improved imaging transverse to the optical axis. We have coupled a confocal microscope to a computer system, making the combination of both an excellent instrument for mapping the 3-dimensional structure of extended specimens into a computer memory/data array. We measured that the volume element contributing to each data point has, under typical fluorescence conditions, a size of 0.2 X 0.2 X 0.72 micron. The data can be analysed and represented in various ways, i.e., stereoscopical views from any desired angle. After a description of the experimental arrangement, we show various examples of biological and food-structural studies. The microscope can be operated either in reflection or in fluorescence. In the latter mode a spectral element allows selection of the wavelength band of fluorescence light contributing to the image. In this way, we can distinguish various structures inside the cell and study their 3-dimensional relationships. Various applications in biology and the study of food structure are presented. PMID- 3285459 TI - X-ray microanalysis of dentin: a review. AB - The aim of this review was to present a condensed summary of the literature on X ray microanalysis of dentin, including both energy-dispersive (EDS) and wavelength-dispersive (WDS) analysis. Estimations of concentrations by XMA of dentin should be regarded as semiquantitative values. The Ca level in rat odontoblasts was elevated in the secreting end of the cell body. In predentin Ca accumulated at a concentration of 2% that of mineralized dentin. In coronal dentin the peritubular areas were hypermineralized (Ca, P, Mg). Primary caries lesions showed a decrease of Ca, P, Mg and Cl, and usually an increase of S and Zn. The mineralized surface often present contained especially high concentrations of F and K. Considerable uptake of various ions in cavity walls exposed to filling materials was assessed: from silver amalgam, Zn and Sn, from silicate cement and glassionomer cement F, Al and Zn, and from zinc oxide-eugenol cement, Zn. The highest F concentrations following topical application were found with solutions of TiF4 and with the varnishes Duraphat and Fluor Protector. Dentin wall lesions adjacent to amalgam fillings exhibited considerably reduced Ca and P values, but concomitantly considerable amounts of Zn and Sn, that explained the increased radiopacity seen in some microradiographs. PMID- 3285460 TI - Scanning electron microscopy of oral mucosa in vivo and in vitro: a review. AB - The oral mucosa is classified by function into lining, masticatory and specialized oral mucosa, with regional structural adaptation. In this review, the surface structures of the human oral mucosa have been studied in the scanning electron microscope (SEM). Regional variations in regard to keratinization, cell arrangements and microplications with related specific structures observed in SEM are described and correlated with the appearance of similar areas observed in the light microscope. Furthermore, human oral tissue and cell cultures have also been studied. These systems offer usable and complementary models for performing similar studies in vitro under controlled experimental conditions. We now show that explant cultures of human oral mucosa can propagate both normal epithelial cells and fibroblasts. The surface morphology of both cell types has been investigated in SEM. PMID- 3285461 TI - Scanning electron microscopy, X-ray microanalysis and immunohistochemistry on worn soft contact lenses. AB - The deposits accumulated on the surfaces of soft contact lenses are a cause of problems for the wearer of these lenses, as the deposits are never completely removed by the available washing solutions. Therefore it appears of interest to investigate the composition of these deposits. In this paper we review the major findings in the literature and, in addition, present our personal experience. We have studied new, continuously and daily worn soft contact lenses by scanning electron microscopy (SEM), X-ray microanalysis and immunohistochemistry. We have carefully evaluated preparative methods, and we can conclude that SEM and X-ray microanalysis are best carried out on unfixed, air-dried lenses. The deposits present consist mainly of mucus, especially on the tarsal side of the lenses. Chloride and potassium, coming from the tear fluid, as well as sulfur, derived from proteins, were found. Calcium was very rarely detected. IgG, IgA, IgE and C3c complement fractions were found only on the outer surfaces and not within the lens. We believe that the best characterization of the deposits is achieved by means of correlative techniques on the same lens. In fact, this approach integrates morphology and composition. PMID- 3285462 TI - Trophectoderm: the first epithelium to develop in the mammalian embryo. AB - The first epithelium to appear during mammalian embryogenesis is the trophectoderm, a polarized transporting single cell layer that comprises the wall of the blastocyst. The trophectoderm develops concurrently with blastocoele fluid production as the morula develops into a blastocyst. The process whereby the morula becomes a fluid-filled cyst is called 'cavitation', which can be regarded as the first functional expression of the trophectoderm phenotype. The outer layer of cells of the morula comprise the nascent trophectoderm and are already morphologically polarized prior to the onset of cavitation. A major working hypothesis in the field of mammalian embryogenesis is that such polarization is a prerequisite for the initiation of cavitation. To test this hypothesis we examined morulae for their ability to cavitate during treatments that modify morphological polarity in nascent trophectoderm cells. These treatments included ouabain, different concentrations of extracellular K and Na, cytochalasins and colcemid. Ouabain and extracellular K and Na affect the activity of Na/K-ATPase, which has been implicated in the maintenance of morphological polarity of nascent trophectoderm cells. Cytochalasins and colcemid also modify apical-basal polarity of nascent trophectoderm cells and impair cavitation. The endpoints that were monitored included incidence of cavitation, rate of cavitation and the status of morphological polarity of nascent trophectoderm cells. Collectively, all of these treatments indicate that there is a functional association between an asymmetric distribution of organelles along the apical-basal axis of nascent trophectoderm cells and the ability of the embryo to produce nascent blastocoele fluid efficiently. In addition, the preimplantation embryo appears to possess two mechanisms for accumulating blastocoele fluid. PMID- 3285463 TI - Somites and axon guidance. AB - The somites are arrayed in a repeating pattern along the longitudinal axis of the embryo, as are the developing sensory and sympathetic ganglia and the spinal nerves. This pattern is not a coincidence: the somite imposes a segmental pattern on the cells and axons that invade it. Both neural crest cells and axons prefer the anterior portion of the sclerotome (the ventral part of the somite) for outgrowth. What differences in anterior and posterior sclerotome are responsible? I used scanning electron microscopy to ask whether these populations differed on the tissue level in chick embryos. This study shows that differences in tissue organization are of insufficient magnitude or develop too late to explain the preference of neural crest cells and axons for the anterior half of each sclerotome. For instance, the extracellular matrix does not differ dramatically in density at the dorsal sclerotome boundary and yet neural crest cells promptly enter the anterior sclerotome when they reach this boundary. These cells have access to the cell processes of somitic cells that extend through the matrix. This suggests that neural crest cells could detect important differences in anterior and posterior populations by direct cell contact. Likewise, barriers and consistent differences in cell density, shape or orientation were not obvious before or during initial axon outgrowth. The absence of significant differences in tissue organization suggests that axons and neural crest cells become segmented by responding to diffusible cues, to differences in extracellular material or to the cell surfaces of individual anterior and posterior sclerotome cells. PMID- 3285464 TI - Developmental angiogenesis: quail embryonic vasculature. AB - We have examined the segregation and early morphogenesis of the embryonic vasculature by using a monoclonal antibody for immunofluorescence and by scanning electron microscopy. This antibody labels the presumptive endothelial cells (PECs) as they segregate from mesoderm. Similar embryos prepared for SEM revealed finer details of how these segregated cells interact to form the rudiments of the major blood vessels. Here we concentrate on the development of the dorsal aortae and the posterior cardinal veins. The dorsal aortae form from single PECs which segregate from the lateral mesoderm and aggregate into a loose cord ventral to the somites. These cells become more closely associated and a lumen forms. The posterior cardinal veins form from a loose plexus of cells segregated from the lateral mesoderm on its dorsal surface. These cells become intimately associated with the Wolffian ducts. PMID- 3285465 TI - Thermal enhancement of cellular radiation damage: a review of complementary and synergistic effects. AB - Hyperthermia treatment can kill mammalian cells in a time and temperature dependent manner. Thermal sensitivity varies extensively among various cell lines in culture and cellular molecular and ultrastructural studies have not resolved which cellular mechanisms underlie thermal cell killing and radiosensitization. The response of cells to heat and radiation are complementary under certain conditions found in human tumors, such as hypoxia, low pH, low nutrient and the S phase of the cell cycle. Thus, hyperthermia can be used as a complementary treatment modality in the radiotherapy of human cancer. Further studies show that heat treatment causes radiosensitization which is in part associated with the inhibition of repair of radiation damage and is strongly dependent on temperature and on the sequencing. In addition, the conditions such as pH and oxygenation during treatment sequencing can influence the degree of recovery of cells. These factors may be exploited in optimizing therapeutic gain in clinical cancer therapy. Data are shown that transformation from the normal to the tumorigenic state causes random small changes in radiosensitivity and heat sensitivity. Also, treatments combining heat and radiation can lead to increased or decreased transformation in cells depending on the treatment sequence. PMID- 3285466 TI - Scanning electron microscopy of vertebrate cerebellar cortex. AB - In this study, the Golgi method for light microscopy, transmission and conventional scanning electron microscopy, the ethanol-cryofracturing technique, the freeze-fracture method for SEM, and the freeze-etching method have been used in conjuction to analyze the three-dimensional cytoarchitectonic arrangement and intracortical circuits of vertebrate cerebellar cortex. Approximately more than 100 specimens of mice, rat, teleost fishes and human cerebelli were processed by the above mentioned techniques. A chronological review of other methods for studying hidden surfaces of cerebellar nerve cell has been also described. The three-dimensional morphology, outer and inner surfaces of granule, Golgi, Purkinje and stellate cells were reviewed by means of a correlative and comparative study. The cerebellar circuits formed by mossy and climbing fibers with granule cell dendrites and Purkinje cell-granule cell synapses have been traced by ethanol-cryofracturing technique, freeze-fracture method for SEM and freeze-etching technique. These findings have been correlated with previous light and electron microscope findings published in the last century. Some advantages and limitations of each method are pointed out. The review emphasizes the paramount importance of correlating light microscope Golgi method with ethanol cryofracturing and slicing techniques for SEM. The correlation between freeze fracture method for SEM and freeze-etching technique provides a new approach for studying three-dimensional morphology of nerve cells at cellular and macromolecular levels. This modern methodology of three-dimensional analysis offers new potential areas for future experimental investigation in embryology and pathology of the central nervous system. PMID- 3285467 TI - Hair cells. PMID- 3285468 TI - Essential fatty acid depletion of renal allografts and prevention of rejection. AB - A central hypothesis in transplantation biology is that resident leukocytes expressing class II histocompatibility antigens may determine the immunogenicity of an organ. By means of a novel method to deplete the kidney of resident leukocytes, essential fatty acid deficiency (EFAD), this hypothesis was tested in an intact, vascular organ. Kidneys subjected to EFAD and thus depleted of resident Ia-positive macrophages survived and functioned when transplanted across a major histocompatibility antigen barrier in the absence of immunosuppression of the recipient. Control allografts were rejected promptly. Allografts from donors subjected to EFAD normalized their lipid composition and were repopulated with host macrophages by 5 days. Administration of Ia-positive cells at the time of transplantation established that the resident leukocyte depletion induced by EFAD was responsible for the protective effect. These observations may provide insights into the mechanisms underlying tissue immunogenicity and the population of normal tissues with resident leukocytes. PMID- 3285469 TI - Aldolase activity of a Plasmodium falciparum protein with protective properties. AB - Immunization with a 41-kilodalton blood stage antigen (p41) of Plasmodium falciparum induces immunity to malaria in monkeys. However, antigenic polymorphism and repetitive amino acids commonly found in protective antigens complicate vaccine development. The gene encoding p41 has now been cloned and analyzed. Sequencing and hybridization studies revealed that the gene structure is highly conserved in 14 parasite isolates from three continents. This finding and the lack of repetitive amino acids in the translated DNA sequence may indicate that p41 has an essential function. In this study the protein was found to be 60 percent homologous to the key glycolytic enzyme aldolase from vertebrates, and the affinity-purified p41 protein from parasites showed aldolase activity. PMID- 3285470 TI - Assembly of a functional immunoglobulin Fv fragment in Escherichia coli. AB - An expression system was developed that allows the production of a completely functional antigen-binding fragment of an antibody in Escherichia coli. The variable domains of the phosphorylcholine-binding antibody McPC603 were secreted together into the periplasmic space, where protein folding as well as heterodimer association occurred correctly. Thus, the assembly pathway for the Fv fragment in E. coli is similar to that of a whole antibody in the eukaryotic cell. The Fv fragment of McPC603 was purified to homogeneity with an antigen-affinity column in a single step. The correct processing of both signal sequences was confirmed by amino-terminal protein sequencing. The functionality of the recombinant Fv fragment was demonstrated by equilibrium dialysis. These experiments showed that the affinity constant of the Fv fragment is identical to that of the native antibody McPC603, that there is one binding site for phosphorylcholine in the Fv fragment, and that there is no inactive protein in the preparation. This expression system should facilitate future protein engineering experiments on antibodies. PMID- 3285471 TI - Escherichia coli secretion of an active chimeric antibody fragment. AB - A chimeric mouse-human Fab protein that binds specifically to the human carcinoma cell line C3347 has been expressed and secreted from Escherichia coli. This molecule, which contains functionally assembled kappa and Fd proteins, binds as effectively to sites on the surface of C3347 cells as Fab fragments prepared proteolytically from whole chimeric or mouse antibody. The production in Escherichia coli of foreign heterodimeric protein reagents, such as Fab, should prove useful in the management of human disease. PMID- 3285472 TI - [Open spongiosaplasty in infected defect pseudarthroses of the tibia--a still justifiable treatment principle?]. PMID- 3285473 TI - [Initial experiences with nuclear magnetic resonance tomography imaging of extensive bone chip grafts]. PMID- 3285474 TI - [Experimental studies of the healing of collagen and fibrin collagen in spongioid and cortical rabbit bones]. PMID- 3285475 TI - Tumors of the small intestine. AB - Tumors of the small intestine offer a unique challenge. As a result of their infrequent occurrence, they invariably present difficult problems in diagnosis and management. Although the prognosis for benign lesions is excellent, malignant small bowel tumors are perhaps the most devastating GI malignancies; at the time of diagnosis, only approximately 50% of these lesions are completely resectable for cure. Symptoms are often absent until the tumor has progressed to produce a complication. Even then, the presentation is often vague and nonspecific, intermittent pain, obstruction, and chronic anemia. The cornerstone of diagnosis is the contrast radiograph. However, in practice only about 50% of these lesions are diagnosed radiographically before surgery. This situation is further complicated by the variety of small bowel tumors, each with different symptoms and manifestations. Surgical excision is the treatment of choice for almost every small intestinal neoplasm. For most benign lesions simple excision is adequate. In contrast, for malignancies, segmental resection including as much adjacent mesentery as is reasonable, is required. In the duodenum, these tumors may necessitate pancreaticoduodenectomy; in the ileum, right colectomy may be required. In the case of advanced disease, palliative resection to relieve bleeding or obstruction may be indicated. The challenge of the future will be to reduce the morbidity and mortality of small bowel neoplasms not only by earlier recognition, diagnosis, and therapy but also through the development of alternative or adjunctive therapy for patients in whom surgical cure is not possible. This will require not only a high index of suspicion when confronted with patients with vague abdominal complaints but also an aggressive approach to diagnosis in the face of normal initial studies. In addition, multi-institutional trails of chemotherapy and radiation therapy of these tumors are needed. PMID- 3285476 TI - Appendiceal malignancies. AB - Malignancies of the appendix are extremely rare. Of the reported cases, carcinoid tumors are most common, with mucinous cystadenocarcinomas and adenocarcinomas next in frequency. Adenocarcinoids, which share morphologic and clinical features that are a composite of adenocarcinomas and carcinoids, have been described. Concomitant second malignancies, most often in the GI tract, occur with greater than expected frequency in patients with appendiceal tumors. Treatment and prognosis are markedly different for each of the histologic variants of appendiceal malignancy. In general, carcinoid tumors (smaller than 2 cm in diameter) may be treated by appendectomy alone and are associated with long term survival. Adenocarcinomas, unless well differentiated and extremely superficial and localized, required hemicolectomy and confer a prognosis that is, stage for stage, similar to that of adenocarcinoma of the colon. Mucinous cystadenocarcinomas may spread widely through the abdomen, resulting in P peritonei, but can be associated with long survival duration if surgical treatment is aggressive. There is evidence that adenocarcinoids develop from simultaneous neoplastic change in two stem cell populations. Metastases may show histologic features of adenocarcinomas alone, of carcinoid tumors alone, or may resemble a composite neoplasm. The prognosis is variable and treatment recommendations are not well defined. PMID- 3285477 TI - Surgical adjuvant therapy of rectal cancer. AB - Surgery is the preferred method of curative therapy for carcinoma of the rectum. However, in spite of complete gross tumor resection, many patients with locally advanced tumors will experience recurrence of malignant disease in the pelvis and/or distant metastases. This article summarizes the roles of radiotherapy and chemotherapy, administered alone and in combination, as surgical adjuvant treatment for patients with resectable rectal cancer. A biostatistical overview is presented. It is concluded that strong evidence exists supporting the efficacy of combined postoperative radiotherapy and chemotherapy. Further clinical trials are indicated to determine the optimum chemotherapy regimen, sequence, and duration of the therapy. PMID- 3285478 TI - Carcinoma of the anal region. AB - Longer follow up and greater numbers of patients will be required to determine the ultimate curative potential of surgery sparing regimens. Current reports suggest that combination chemotherapy and radiotherapy is equivalent to abdominoperineal resection. Furthermore, the incidence of local recurrence in most series suggests that abdominoperineal resection alone may be insufficient for locoregional control of disease. Patients with canal tumors who develop recurrent disease to inguinal nodes should be treated by groin dissection. Local recurrence of tumors at the anal margin can be satisfactorily treated by further local excision or by groin dissection if there are inguinal node metastases. Further studies are needed to evaluate the efficacy of chemotherapy and irradiation in pelvic recurrence following abdominoperineal resection. Further clinical trials to develop more effective salvage therapy in visceral metastatic disease are needed. PMID- 3285479 TI - Primary gastrointestinal lymphoma. PMID- 3285480 TI - Gastrointestinal sarcomas. PMID- 3285481 TI - The central role of progesterone receptors and progestational agents in the management and treatment of breast cancer. AB - This article summarizes the role of progesterone receptors (PgRs) as markers of hormone-dependent breast cancers and the use of progestational agents in breast cancer treatment. We discuss the structure of PgRs, their purification, the production of anti-PgR monoclonal antibodies, and the use of these antibodies for clinical assays. PMID- 3285482 TI - Steroid receptors and other prognostic factors in primary breast cancer. AB - A review and update of published studies on prognostic factors support the following conclusions: The number of axillary lymph nodes involved with tumor remains the most important prognostic factor for women with primary breast cancer. In stage I disease, the lack of estrogen receptor (ER) seems to be the most important factor for predicting earlier recurrence and poorer survival. In stage II breast cancer, progesterone receptor (PgR) content appears to be better than ER content in predicting disease-free and overall survival. Measurement of proliferative activity (S-phase DNA) by thymidine labeling or flow cytometry (FCM) and of aneuploidy by FCM also provides prognostic information. Patients with aneuploid tumors, or with high S-phase diploid tumors, are at increased risk for relapse. Amplification of oncogenes, particularly HER-2/neu, may provide additional prognostic information in combination with other established prognostic factors. PMID- 3285483 TI - An overview of megestrol acetate for the treatment of advanced breast cancer. AB - Megestrol acetate was one of the first progestational agents to be evaluated for use in the hormonal therapy of advanced breast cancer. Since that time, megestrol acetate has become a standard for progestin antitumor research because of its progestational potency and excellent safety profile. As single-agent therapy, the average overall response rate to megestrol acetate therapy is 30%. This response rate is equivalent to that reported for tamoxifen, another hormonal agent widely used in treatment of breast cancer. Furthermore, although the side-effect profiles of these two agents are similar, the weight gain associated with megestrol acetate use may be beneficial in breast cancer patients who also have cancer cachexia. Because megestrol acetate and tamoxifen have been shown to be somewhat non-cross-resistant, megestrol acetate may prove useful as first-line treatment for disease that progresses during adjuvant tamoxifen therapy. Other focuses of research, including treatment of estrogen- and progestogen-receptor negative disease and moderation of weight loss for cancer cachexia, may offer hope to many cancer patients, even those with a currently unfavorable prognosis. PMID- 3285484 TI - Advantages of total androgen blockade in the treatment of advanced prostate cancer. AB - Total androgen blockade has been proposed as a better therapeutic technique than castration alone for the management of metastatic prostate cancer. This is based on the theory that links adrenal androgens to tumor growth. We have carefully examined the role of adrenal androgens in prostate cancer. Work done in our laboratory, as well as the work of many others, has demonstrated the following in regard to the role of adrenal androgens in prostate cancer: (1) The adrenal cortex secretes significant amounts of adrenal androgens into the blood. (2) Adrenal androgens are converted into dihydrotestosterone (DHT), as indicated by studies of labeled DHT recovered from prostates resected one-half hour after infusion of 3H-androstenedione or 3H-dehydroepiandrosterone sulfate into patients. We have also shown that biopsies of prostates from patients who were previously castrated may contain significant amounts of DHT, which could only be derived from adrenal androgens. (3) We have quantified DHT derived from adrenal androgens by measuring prostate DHT concentrations in castrates and in patients treated with combined gonadal and adrenal blockade. The mean difference between these two groups, 0.32 ng/g of DHT lower with combined blockade, is statistically significant and represents DHT derived from adrenal androgens. (4) We have also demonstrated that the small amounts of DHT derived from adrenal androgens may be biologically significant in stimulating prostatic epithelial cell protein synthesis in humans; others have reported similar findings in animals. (5) A review of patients in relapse after castration, who are treated with adrenal androgen blockade, indicates that approximately one out of three patients will show an objective remission based on National Prostate Cancer Project (NPCP) criteria. Despite data supporting the importance of adrenal androgens in prostate cancer, clinical trials using combined adrenal and gonadal blockade in prostate cancer have shown only modest benefit over castration. The largest and best study to date is the Southwest Oncology Group (SWOG) study, which did show a near significant (P less than 0.065) difference between patients treated for 20 months with a luteinizing hormone-releasing hormone (LH-RH) plus flutamide compared with LH-RH alone. The difference in median time to progression was approximately 2 months between the groups. However, when one considers the fact that two out of three patients are probably not responding to the total androgen blockade, the 2 month difference may actually represent 6 or more months in a subset of one-third of patients receiving that therapy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3285485 TI - Megestrol acetate plus minidose diethylstilbestrol in the treatment of carcinoma of the prostate. AB - A multicenter randomized trial comparing megestrol acetate 120 mg/d, plus diethylstilbestrol (DES) 0.1 to 3 mg/d in patients with stage D2 prostate cancer was undertaken to compare the efficacy and toxicity of these two regimens. Pretreatment characteristics, including pathologic grade, performance status, age, and disease-related symptoms were similar in the two groups. Of 81 patients who have been entered in the study, 77 are evaluable for response and toxicity at a mean follow-up of 13.3 months. Using National Prostate Cancer Project (NPCP) criteria, no difference in response rate is noted (73% v 76%) or in disease-free survival and overall survival. The ability to suppress serum testosterone to castration levels and to maintain this suppression is equivalent in both treatment groups. However, treatment-related toxicity, including edema, hypertension, and gynecomastia, occurred at a significantly greater frequency, severity, and after a shorter treatment period in the DES-treated group. No difference in major cardiovascular events was noted. Since megestrol acetate plus minidose DES is equivalent to DES in achieving treatment responses in patients with carcinoma of the prostate, it is a preferable treatment because of its improved side-effect profile. PMID- 3285486 TI - Studies of high-dose megestrol acetate: potential applications in cachexia. AB - Cachexia can be a severe problem in the management of patients with cancer and other illnesses because it produces an ever-increasing spiral of anorexia, undernutrition, loss of tissue mass, muscle wasting, and increased susceptibility to infection and treatment toxicity. Megestrol acetate has been observed to produce weight gain in patients with hormone-sensitive tumors and has recently been noted to produce a similar degree of weight gain in those with hormone insensitive tumors. A review of our experience in a phase I-II study of escalating doses of megestrol acetate for advanced breast cancer revealed that weight gain occurred in more than 80% of all treated patients and in 90% of those patients who received treatment for 6 or more weeks. The median maximum weight gain was 5.5 kg, with a range of -5.6 to 44 kg. Subjective improvement in appetite occurred in most patients. These data provided the impetus for a series of further studies of the role of megestrol acetate in the control of cachexia, including a randomized study in cancer cachexia, AIDS cachexia, and anorexia nervosa. In addition, a number of laboratory trials seeking the mechanism of action have been initiated, as well as whole-animal studies to define the compartment of increased weight. Our data and the preliminary observation of weight gain in patients with hormone insensitive tumors suggest that megestrol acetate has a potential role in producing a possibly dose-related subjective improvement and an increase in appetite and weight. Further research is necessary to understand the mechanism of appetite stimulation and anabolic effect. PMID- 3285487 TI - Lumbar herniated disk and related topics. PMID- 3285488 TI - Lumbar spinal stenosis. PMID- 3285489 TI - Thoracic disk herniation. PMID- 3285490 TI - Diskogenic disease of the cervical spine. PMID- 3285491 TI - The postoperative lumbar spine. PMID- 3285492 TI - Diskogenic diseases of the spine: clinical aspects. PMID- 3285493 TI - Psychogenic fugue states: a review. AB - In this paper we review psychologic theories on the development of fugue states, as well as organic causes of the disorder and the history of its diagnostic classification from DSM-I through DSM-III-R. We believe the diagnostic criterion that requires the patient to assume a new identity as part of the overall psychogenic fugue state should be reevaluated, since change of identity is not a consistent aspect of the syndrome as described in the psychiatric literature. PMID- 3285494 TI - Proctalgia fugax: a clinical enigma. AB - Proctalgia fugax is a benign condition characterized by paroxysms of anorectal pain in the absence of identifiable anorectal lesions. The cause is unknown but may involve spasm of smooth or striated muscle. Surveys indicate the disorder is common in the general population, with only a minority of victims seeking medical attention. There is no universally accepted treatment for proctalgia fugax. The diagnosis is established by the typical history and the exclusion of other pelvic and anorectal abnormality. PMID- 3285495 TI - Update on the management of obesity. AB - This article updates a paper published in this journal more than a decade ago. We detail the ensuing decade's developments in the treatment of obesity, reviewing innovations, established techniques, and the current status of behavior modification. We evaluate newer developments, such as anorectic drugs, very low calorie diets, and intragastric balloon bezoars, and we describe other approaches to the treatment of obesity, such as residential and comprehensive outpatient programs. We conclude by recommending a multidisciplinary approach to this complex problem. PMID- 3285496 TI - Great men among us. PMID- 3285497 TI - Rapid spontaneous resolution of cholelithiasis in a newborn. AB - We have described a newborn who had rapid resolution of cholelithiasis after a gallstone was incidentally discovered during sonographic evaluation of a renal mass. This case emphasizes the importance of conservative management and serial sonograms in infants with tumefacient sludge or gallstones without clinical or imaging evidence of biliary tract disease. PMID- 3285498 TI - [The combined removal of the heart and kidneys for transplantation purposes]. PMID- 3285499 TI - [Hemochromatosis: the clinical picture, diagnosis and treatment]. AB - A survey of literature data and the author's own observation of 18 patients with hemochromatosis (H) have shown that H is a polysyndrome disease. Men aged 35 to 60 suffer more frequently. Its most significant symptoms and syndromes are skin hyperpigmentation, hypersideremia, liver cirrhosis, diabetes, cardiomyopathy, and endocrinopathy. Three variants in a course of H--mild, average severe and severe (complicated)--were defined with regard to the duration of disease, a degree of morphofunctional changes and insufficiency of the affected organs. Intravital diagnosis of H was possible in clinical awareness and in the detection of hypersideremia and hemosiderin in liver and skin biopsy specimens. Multimodality therapy (blood-letting, desferal and insulin) promoted compensation of metabolic derangement, stabilization and even regression of disease. PMID- 3285500 TI - [Modern concepts of the heterogeneity of duodenal peptic ulcer]. PMID- 3285501 TI - [Role of gastrointestinal hormones in regulating gastric secretion and ulcer formation]. PMID- 3285502 TI - [Characteristics of the gastric excretory function in chronic glomerulonephritis (a review of the literature and the authors' own data)]. PMID- 3285503 TI - [Secretion of cortisol and growth hormone in patients with peptic ulcers of the stomach and the duodenal bulb]. AB - A total of 42 patients with gastric ulcer and ulcer of the duodenal bulb were investigated. A decrease in the blood concentration of STH and cortisol, high indices of gastric acidifying function in the 2nd hour after insulin administration were noted in the patients with gastric ulcer indicating a decrease in the trophic influence of the hormones of the hypophysis-adrenal system on the GI tract, on the one hand, and raised sensitivity of parietal cells to the effects of this system, on the other hand. In the patients with duodenal ulcer the blood levels of STH and cortisol did not change, indices of gastric acidifying function within the 1st hour after insulin administration were higher than during the 2nd hour indicating an important role of the vagus nerve hypertonicity in the pathogenesis of this disease. PMID- 3285504 TI - [Biorhythms in gastroduodenal pathology]. PMID- 3285505 TI - [Patterns of the formation of endocrine reactions in relation to the nature and manifestation of a pathological process in the gastroduodenal area]. AB - Correlation between a degree of activation of hormonal secretion and the expression of a pathological process in the gastroduodenal area was established in patients with peptic ulcer, chronic gastroduodenitis with raised secretory gastric function and in patients after vagotomy. A sequence of involvement in the reaction to disease of the regulatory systems of the local (gastrin, serotonin and histamine mechanisms), systemic (enteroinsular axis) and organic (glucocorticoid and adrenal function of the adrenal glands) levels was revealed. PMID- 3285506 TI - [Characteristics of disordered duodenal acidification in patients with duodenal peptic ulcer]. AB - Duodenal acidification was studied in 53 peptic ulcer patients. Gastric and duodenal pH was studied using an electric probe with silver chloride and antimony electrodes. For a study of the mechanisms of changes of duodenal acidification gastrin was investigated using various exercise tests. Two types of disorders of duodenal acidification were established in the patients: related and unrelated to the vagus nerve. Characterization of the mechanism of disorders of duodenal acidification was provided. A study of duodenal acidification in peptic ulcer gave an opportunity for the development of effective pathogenetically substantiated therapeutic measures. PMID- 3285507 TI - [Immunoreactive insulin, C-peptide and insulin-containing erythrocytes in chronic pancreatitis]. AB - The levels of immunoreactive insulin, C-peptide and insulin containing erythrocytes were studied in 26 patients on the 2nd and 12th day of their stay in hospital. A higher level of C-peptides was found in the patients as compared to healthy subjects. The level of immunoreactive insulin of the patients did not differ significantly from that of healthy subjects. The number of insulin containing erythrocytes in the patients was much lower than in healthy subjects. Their number after therapy did not rise considerably. There was no correlation between these indices. PMID- 3285509 TI - Dental implants: an overview with an emphasis on the Branemark System. PMID- 3285508 TI - [Pancreatic endocrine function of patients with nonspecific ulcerative colitis]. AB - Pancreatic endocrine function was investigated in 43 patients with nonspecific ulcerative colitis by studying the blood concentrations of insulin, C-peptide and glucagon using a radioimmunoassay. In such patients the level of C-peptide was on a decrease, that of glucagon--on an increase. The level of insulin in nonspecific ulcerative colitis showed a tendency to increase. These alterations were closely connected with pancreatic excretory function. The most profound changes were noted in patients with markedly lowered pancreatic excretory function. PMID- 3285510 TI - But murderers can have all the children they want: surrogacy and public policy. PMID- 3285511 TI - [The deep-seated ureteral calculus--extracorporeal litholysis or endoureteral manipulation?]. PMID- 3285512 TI - [The staghorn calculus]. PMID- 3285513 TI - [Mechanisms for preventing urinary calculi]. PMID- 3285514 TI - [Stress, health and production in swine]. AB - The "porcine stress syndrome" is a well established concept. Effects exerted on part of the meat type pig populations by their increased susceptibility to stress, resulting in meat quality defects, are meant by it. The problem of stress is rather a complex phenomenon. Stress is a part of daily life and can have negative as well as positive effects on performance and health, depending on its intensity and duration. These connections are discussed in the following paragraphs: 1. Definition of stress, and of stress-related reactions and possibilities of their assessment. 2. Stressors and their effects on the performance and health of pigs with regard to genetic dispositions. 3. Conclusions for the avoidance of stress effects in pig production. PMID- 3285515 TI - [Breeding adaptation to avoid antagonisms between production and health in swine]. AB - Lerner (1954) with his hypothesis of genetic homeostasis has provided the explanation for most of our present antagonism-problems in high performing farm animal populations. Effective artificial selection for highly heritable traits (such as lean content and muscularity in pigs) leads to negatively correlated responses in other traits, particularly the components of reproductive fitness. There are three main antagonisms in our present breeding populations of meat type pigs, which are all caused by the dramatic genetic changes in lean content and muscularity: 1. Poor meat quality and high stress susceptibility. 2. Decreasing reproductive performance. 3. Increased leg weakness problems. The most efficient breeding strategies against these antagonisms are 1. Elimination of the recessive Halothane stress gene from at least one parental population by systematic progeny test procedures. Crossbred progeny from one homozygous stress resistant parent are at least heterozygous stress resistant and have good meat quality. 2. Use of crossbred sows from two parental breeds leads on an average of 10% to a better litter performance than purebred sows. Hybrid sows from selected dam lines can have a markedly better litter performance than 10%. 3. Avoidance of extreme muscularity or carcass length as well as tests and the selection of the breeding stock under practical (strawless) management conditions reduces the incidence. Moreover crossbred boars from unrelated parent breeds show much less leg and libido problems. PMID- 3285516 TI - [Genetic aspects of systematic mineralization disorders]. AB - Forced selection for high daily gains and meatiness induced biological maladaptations of genetical-hormonal origin. They manifest themselves not only by well-known myopathies and predispositions to stress, but also in the so-called leg weakness of pigs, in dyschondroplasias of broilers; similar "correlated" effects are observed even in dogs and laboratory animals. As far as bones, cartilages and joints are concerned by these deficiencies in mineralization and synthesis of fibrous structures, the terms "osteochondrosis" or "osteochondropathies" were introduced recently. Manifestations and severeness of this phenomenon--induced by antagonistic selection criteria--species not always directly comparable from species to species or even from breed to breed within species. This variability can be interpreted as an indication for the compound effects of heredity and environment. Even in pure breeds like German landrace and Pietrain and even under identical rearing and fattening conditions a significant individuality was found with respect to utilization of minerals; this is documented by different biomechanical strength and mineralization of bones and cartilaginous structures in these animals and by estimates of heritability for these traits, which range slightly higher than those estimated for "leg weakness". Selective measures, therefore, against the antagonisms mentioned could be feasible. On the other hand these investigations revealed that at least in some contingents of domestic animals a biological borderline was trespassed when selecting rigorously for a few economically important traits. PMID- 3285517 TI - [Forensic aspects of atrophic rhinitis of swine]. AB - Atrophic rhinitis in swine is presented by means of recently published research work. Thereby it is emphasized as a significant forensic matter, that a reliable diagnosis could only be produced by combined application of clinical, pathoanatomical and bacteriological investigations and that the isolation of toxin-producing strains of Pasteurella multocida in a herd without clinical symptoms of atrophic rhinitis is to be considered as a proof of latent atrophic rhinitis. PMID- 3285518 TI - [Wound healing and wound dressing]. AB - This review article intends to discuss the clinical management of wounds in respect to a pathophysiological background. Recent results of research in the field of wound healing are demonstrated. Wound healing can be seen as aseptic inflammatory response to a traumatic stimulus. The activation of the clotting cascade by the trauma induces a sequence of humoral and cellular reactions. Platelets, granulocytes and macrophages are activated stepwisely. In the first phase of wound healing the wounded tissue area will be prepared for phagocytosis by enzymatic degradation of ground substance and depolymerisation of protein macromolecules (wound edema). Following the phagocytic microdebridement mesenchymal cells proliferate and produce matrix substance. Microcirculation within the traumatized area will be restored by angiogenesis, macroscopically observed as new formed granulation tissue. This leads to the wound healing phase of scar tissue formation. In this complexity of reactions naturally many possibilities of impairment are given. The most common complication during wound healing is the infection. It can be seen as self reinforcing process. The therapy of the impairment of wound healing consists in the disruption of the specific vicious circle, in the case of an osseus infection that would be a macrodebridement (that is necrectomy) and biomechanical stabilization. The surgical management of wounds principally consists in ensuring an undisturbed sequence of the healing process. This can be done by the wound excision that supports the phagocytic microdebridement. A further possibility is to avoid overwhelming formation of edema by eliminating the traumatic stimulus, by immobilization of the injured region and by ensuring a physiological microenvironment with a primary suture if possible. There are up to the present no drugs available to enhance cell proliferation and to regulate wound healing but it seems that experimental research is successful in characterizing substances as growth factors and mediators. A second way of managing is to prevent the wound healing from troubles by using preventive measures: unbroken aseptic chain, stopping bleeding exactly and introducing sufficient drainage, avoiding of ischaemia and last not least inserting foreign substances into the tissue as few as possible. PMID- 3285519 TI - [Urachal abscess without pathologic changes in the extra-abdominal navel in a cow. Case report]. AB - A rarely diagnosed case of urachal abscessation without any signs of inflammation of the extra-abdominal navel in a seven-month-old Braunvieh heifer is described. The symptoms of this disease, its diagnosis by the means of ultrasonographic examination and its therapy are explained. The technique of ultrasonographic examination is supposed to be a facilitation of presurgical diagnosis of umbilical disease. Nevertheless the value of this diagnostic procedure should be checked up on more patients. PMID- 3285520 TI - Blood pressure elevation in young dogs during low-level lead poisoning. AB - Clinical and experimental studies suggest an association between low-level lead exposure and hypertension. This association was investigated in six 3-month-old dogs who were randomly paired with their littermates. The daily oral dose of lead acetate was 1.0 mg Pb/kg body wt for 5 months; the controls received equimolar sodium acetate. Blood pressure was measured indirectly without anesthesia and was similar in the two groups at the start of the study. The mean blood pressure was higher in the lead-exposed group at every follow-up, from 10 days to 20 weeks. This treatment group difference in profiles was statistically significant (repeated-measures ANOVA, p = 0.0048). The final mean blood pressures were 120 +/ 6.4 (x +/- SE) vs 108 +/- 1.5 mm Hg. At 4 weeks the plasma renin activity was higher in the lead-exposed group: 3.4 +/- 0.25 vs 1.2 +/- 0.15 ng/ml/hr. The difference decreased during the study but the elevated trend persisted (repeated measures ANOVA, p = 0.014). Lead exposure did not alter renal functions or extracellular fluid volume. This study shows that low-level lead intake in young dogs can cause an early increase in blood pressure which persists during ongoing exposure and which is associated with a small increase in the activity of the renin-angiotensin system. PMID- 3285521 TI - The alveolar type II epithelial cell: a multifunctional pneumocyte. AB - The epithelial surface of the alveoli is composed of alveolar type I and type II cells. Alveolar type I cells comprise 96% of the alveolar surface area. These cells are extremely thin, thus, minimizing diffusion distance between the alveolar air space and pulmonary capillary blood. Type II cells are spherical pneumocytes which comprise only 4% of the alveolar surface area, yet they constitute 60% of alveolar epithelial cells and 10-15% of all lung cells. Four major functions have been attributed to alveolar type II cells: (1) synthesis and secretion of surfactant; (2) xenobiotic metabolism; (3) transepithelial movement of water; and (4) regeneration of the alveolar epithelium following lung injury. Therefore, alveolar type II cells play important roles in normal pulmonary function and in the response of the lung to toxic compounds which may cause lung damage. Techniques have now been developed to isolate and purify alveolar type II epithelial cells from lung tissue. Such cellular preparations afford bioassay systems to monitor the effects of occupational or environmental pollutants on alveolar pneumocytes and should yield important information concerning the etiology of pulmonary disease in the alveolar region of the lung. PMID- 3285522 TI - Effects of the respiratory tract on inhaled materials. AB - Inhalation exposure is often compared to intravenous or oral routes of administration with regard to the biological fate of inhaled materials. Such comparisons, however, overlook the contribution of respiratory tract enzymes to the metabolic fate and toxicity of inhaled materials. The effect of respiratory tract metabolism on the toxicity of inhaled materials is thought to be substantial for many compounds for the following reasons. (1) High concentrations of xenobiotic metabolizing enzymes occur in the nose and substantial concentrations occur in the lung. (2) The respiratory tract tissues are the first exposed to inhaled materials and are exposed to the highest concentrations (barring tissue specific uptake). (3) The products of respiratory tract metabolism may have different toxicities from those of hepatic metabolism. (4) Tissues at risk to toxic metabolites formed in the respiratory tract are different from those formed in the liver. These four reasons for concluding that respiratory tract metabolism may influence the toxicity of inhaled materials are backed by a solid body of expanding experimental data. Therefore, a complete assessment of the fate of inhaled materials should include assessment of potential contributions of respiratory tract metabolism. PMID- 3285523 TI - Sites for xenobiotic activation and detoxication within the respiratory tract: implications for chemically induced toxicity. AB - Results of in situ immunohistochemical investigations on several enzymes which participate in the bioactivation and detoxication of xenobiotics and of histochemical studies on aryl hydrocarbon hydroxylase activity summarized in this report clearly demonstrate that there are numerous sites within the respiratory tract at which xenobiotics can be bioactivated and detoxicated. The data presented, however, also reveal that xenobiotic-metabolizing enzymes and benzo[a]pyrene hydroxylase activity may not be distributed uniformly within individual segments (e.g., the nasal mucosa) of this organ system. Thus, it should be apparent from these findings that one cannot generalize as to how a given xenobiotic-metabolizing enzyme or xenobiotic monooxygenase activity normally is distributed either within or among the different segments of the respiratory tract. Additionally, since enzymes catalyzing the bioactivation and detoxication of xenobiotics usually are present within the same respiratory tract cells, it obviously is difficult to predict from these results which cell types within individual segments of this organ system most likely would be damaged as a consequence of exposure to xenobiotics which are biotransformed into cytotoxic metabolites by cytochrome(s) P-450. Although the cellular localizations and intercellular distributions of cytochromes P-450 BNF-B and MC-B parallel those of benzo[a]pyrene hydroxylase activity within the different segments of the respiratory tract in untreated rats, immunohistochemical findings on the inductions of these cytochrome P-450 isozymes are not entirely consistent with histochemical observations on the enhancement of benzo[a]pyrene hydroxylase activity by Aroclor 1254 within the nasal mucosa and by both Aroclor 1254 and 3 methylcholanthrene within the lung. It must be appreciated, however, that other cytochrome P-450 isozymes undoubtedly are present and inducible in the nasal mucosa and lung and, further, that these hemeproteins, although being immunochemically unrelated to the cytochrome P-450 isozymes studied, also could catalyze aryl hydrocarbon hydroxylase activity. Nevertheless, these immunohistochemical and histochemical findings do demonstrate that one cannot generalize as to how chemicals which induce the same xenobiotic-metabolizing enzyme will affect that enzyme within different segments of the respiratory tract and, moreover, that inducers of cytochromes P-450 can alter differentially the extents to which different cells within a given segment of the respiratory tract (e.g., the nasal mucosa) participate in the oxidative metabolism of xenobiotics. PMID- 3285524 TI - Detection of HLA antibodies by platelet crossmatching techniques. AB - Thirty-seven monospecific HLA antibodies directed against all common HLA-A and -B loci and reactive by the microlymphocytotoxicity assay (LCT) were tested against platelets carrying the corresponding antigen by three platelet crossmatch methods, the platelet immunofluorescence test (PIFT), platelet enzyme-linked immunosorbent assay (P-ELISA), and platelet radioimmunoassay (P-RIA). Positive reactions were obtained with the PIFT in 67 percent, the P-ELISA in 41 percent, and the P-RIA in 49 percent of 85 cell-serum pairs. The same cell-serum combinations gave 49 percent positive reactions in the lymphocyte immunofluorescence test. Three multispecific HLA antisera were positive in nine of nine cell-serum combinations by all four methods. Thirteen transfusions were given to eight patients with known HLA antibodies. All donor-recipient pairs were LCT positive, six were PIFT positive, and seven were PIFT negative. Three of seven PIFT-negative and none of six PIFT-positive transfusions were successful. Thus, platelet crossmatching is less sensitive than the LCT for the detection of complement-binding monospecific HLA antibodies. The platelet crossmatch, however, is able to identify some potentially successful HLA-incompatible donors for patients with multispecific HLA antibodies and limited access to HLA-identical donors. PMID- 3285525 TI - TREACT. An expert system consultation program to aid in the diagnosis of transfusion reactions. AB - We have developed a rule-based, expert system consultation program, TREACT, to aid in the diagnosis of transfusion reactions. Given clinical signs, symptoms, and laboratory results, the program generates diagnoses, alerts the user when a medical director should be called, suggests follow-up actions, and makes recommendations for future transfusion. Diagnoses made by TREACT, including 121 reactions, were compared with those of the medical directors over a 6-month period. The overall diagnostic concordance between the medical directors and the program was 0.777. When this was corrected for chance association (kappa statistic), the concordance was 0.703 (p less than 0.0001), which can be interpreted on a qualitative scale as substantial agreement. The program has also been used successfully as a tool for training new technologists. Other advantages and possibilities that expert systems offer to transfusion medicine are discussed. PMID- 3285526 TI - Clinical significance of anti-Yt(b). Report of a case using a 51chromium red cell survival study. AB - Several published reports have documented the variable survival of Yt(a+) red cells (RBC) in patients with anti-Yt(a) as measured by 51Chromium (Cr)-labeled RBC survival studies. Similar studies with anti-Yt(b) have not been reported. A 51Cr-labeled RBC survival study was performed using Yt(b+) RBCs and a monocyte monolayer assay in a young hemodialysis patient who required chronic transfusion therapy and who had developed anti-Yt(b). The survival of the transfused RBCs was 100 and 93 percent at 1 and 24 hours, respectively, with a half life of 21 days at termination of the study (normal, 28 to 32 days). These results showed no evidence of rapid destruction of the Yt(b+) RBCs, indicating that this patient could be transfused safely with blood from Yt(b+) donors. Long-term survival of the 51Cr-labeled Yt(b+) RBCs was shortened moderately, however, a finding that correlated with a slightly abnormal monocyte monolayer assay test. PMID- 3285527 TI - Effect of danazol on cyclosporine pharmacokinetics. PMID- 3285528 TI - Ultraviolet irradiation in transplantation biology. Manipulation of immunity and immunogenicity. AB - Ultraviolet irradiation, particularly in the UVB range, has profound effects on immunological mechanisms. Optimum and tolerable doses of exposure vary from species to species, and from organ to organ. As a result of limited depth penetration and possibly significant energy absorption in nontargeted cells, every model requires diligent determination of an effective nontoxic approach. Nevertheless, it is clear that UVB and UVC irradiation can abolish proliferative and stimulatory ability as well as accessory/antigen-presenting ability of leukocytes in vitro. UV treatment alters cell-surface properties, calcium mobilization, cytokine production and release, and other subcellular processes. Preliminary data suggest that these manipulations also suppress immunity and reduce immunogenicity in vivo. Exposure of solid organs and of large volumes of blood is difficult due to technical problems--in particular poor depth penetration and absorption of UV energy in generally available transfusion bags. PMID- 3285529 TI - Urinary thromboxane B2 as an indicator of acute rejection in lung allotransplantation. AB - The behavior of urinary thromboxane B2 (TXB2) during acute rejection of lung allotransplants was evaluated. Unmatched mongrel dogs were submitted to a left lung orthotopic allotransplantation (groups I and II), or a sham operation (group III). All animals had an initial significant elevation of TXB2 excretion due to surgical trauma; however, in sham-operated animals (group III) this elevation returned to basal levels after 3 days. All transplanted animals (groups I and II) had persistent TXB2 elevation with 2 important peaks on postop days 5 and 9. The elevated TXB2 excretion persisted in spite of immunosuppressive treatment with azathioprine and prednisone (group II). Rejection was followed by means of an objective grading system applied to chest roentgenograms taken on all animals. It was found that TXB2 levels correlated directly with the grade of radiographic changes seen, thus indicating degree of rejection. TXB2 can be useful as a noninvasive indicator for surveillance of lung allograft rejection. PMID- 3285530 TI - Effects of combination cyclosporine/mizoribine immunosuppression on canine renal allograft recipients. AB - Heterotopic renal allografts following bilateral nephrectomies were placed in 21 healthy mongrel dogs. One group of 11 dogs received cyclosporine (5 mg/kg/24 hr, orally), and 1 group of 10 dogs received cyclosporine and mizoribine (5 mg/kg and 3 mg/kg/24 hr, orally). Body weights, blood cell counts, serum chemistry profiles, serum electrolyte levels, urinalysis with cytology and culture, lymphocyte stimulation assays, immunoglobulin levels, whole blood levels of cyclosporine, and serum levels of mizoribine were followed. At the end of each survival period, necropsy and histopathologic examinations were performed. The mean survival time for the cyclosporine group was 12.8 +/- 7 days. The mean survival time for the cyclosporine/mizoribine group was 33.6 +/- 16.4 days, significantly longer (P = .0006) than the cyclosporine group. Death in the cyclosporine/mizoribine group was attributed to the combined effects of renal allograft rejection and development of a mizoribine-dependent enteritis. Serum levels of mizoribine were greater in the last half of the survival period due to compromised renal excretion of the drug. There were no complications due to infection, myelosuppression, or hepatotoxicity. Combination cyclosporine/mizoribine immunosuppression enhanced canine renal allograft survival in this study. Monitoring serum concentrations of mizoribine is imperative to determine toxic (enteritis) levels. Availability of an intravenous form of mizoribine would facilitate immunoregulation during periods of variable intestinal absorption or renal excretion. PMID- 3285531 TI - Airway pathology in the transplanted rat lung. AB - Bronchiolitis obliterans has emerged as the most significant long-term complication of human heart-lung transplantation. Possible causes include rejection, infection, altered bronchial circulation, and denervation. We attempted to assess the role of some of these possibilities by reviewing the airway histology in nonimmunosuppressed orthotopic rat left lung allografts in three strain combinations: BN-to-LEW (major histocompatibility complex [MHC] incompatible) n = 27; (LEW X BN)F1-to-LEW, n = 11; and F344-to-LEW (minor loci incompatible) n = 18. Fifteen syngeneic transplants (LEW-to-LEW) served as controls. After assigning the lungs to a rejection phase (latent, vascular, alveolar, or destructive), the airway pathology was specifically examined. In the latent phase, only changes attributable to transplantation per se were identified. In the vascular phase in the BN-to-LEW rats and (LEW X BN)F1-to-LEW rats, the bronchioles were surrounded by dense cuffs of activated lymphocytes. The lymphocytic infiltrate then progressively involved the lamina propria and epithelium, where it became associated with focal epithelial cell necrosis. Eventually the epithelium became ulcerated (alveolar phase), and the submucosa and luminal surface became replaced by granulation tissue, which frequently protruded into the lumen in a bronchiolitis obliterans pattern. In the destructive phase the changes were similar to those in the alveolar phase, but were more severe. In the F344-to-LEW rats the airway changes were less prominent, although the remainder of the lungs was at comparable phases of rejection. These changes were not observed in the right (nontransplanted) lungs or the control (LEW-to-LEW) lungs. The findings in these animals suggest that the process of rejection affects the airways and may result in posttransplantation bronchiolitis obliterans. PMID- 3285532 TI - Bone marrow transplantation in miniature swine. III. Graft-versus-host disease and the effect of T cell depletion of marrow. AB - Graft-versus-host disease (GVHD) has been evaluated in partially inbred miniature swine in order to study this complication of allogeneic bone marrow transplantation (BMT) in a major histocompatibility complex (MHC) genetically defined large animal model. Bone marrow from MHC homozygous ("parental") swine was injected into irradiated (900 rads total-body irradiation) MHC heterozygous ("F1") swine that shared one haplotype with the donor. All 18 animals successfully engrafted with donor bone marrow, and 17 of these developed skin rash of varying intensity depending on the extent of T cell depletion of infused marrow. Of 18 animals, 8 received undepleted bone marrow from exsanguinated donors and 2 also received additional peripheral blood lymphocytes (PBL) as a source of mature T cells. All 8 showed a moderate-to-severe rash, and the 2 pigs that received additional donor PBL developed the most severe rash. The cutaneous eruption seen in this model clinically, histologically, and immunologically resembled human GVHD. Two protocols of T cell depletion of donor bone marrow by antiporcine T cell monoclonal antibodies plus complement were tested for their effect on development of GVHD. The combination of two monoclonal antibodies, 74 12-4 (PT4) and 76-2-11 (PT8), had a marginal effect on the subsequent development of cutaneous manifestations of GVHD. However, treatment of the donor marrow by a combination of three monoclonal antibodies--PT4, PT8, and MSA4 (PT11)- effectively decreased the severity of the GVHD skin rash. These results indicate that (1) the GVHD associated with allogeneic bone marrow transplantation in swine is dependent on T cells in the marrow; (2) effective T cell depletion of donor marrow by monoclonal antibodies and complement does not prevent engraftment; and (3) this swine GVHD model, which allows study with F1 and homozygous parental combinations in an MHC genetically defined large animal, is particularly useful for the understanding of GVHD pathogenesis, prevention, and treatment. PMID- 3285533 TI - The effect of the referring dialysis center on renal transplant results. AB - Between 1/1/76 and 12/31/86, 448 patients underwent transplantation (360 first transplants). Of these, 286 (230 first) were referred by 5 dialysis centers, each referring more than 40 recipients. The remainder were referred by a large number of centers. Using our 5 largest referral centers, we studied the effect of dialysis center on graft and patient survival. There was no difference between dialysis centers in patient survival. Actuarial graft survival differed significantly for all cadaver transplants and for first cadaver transplants (P less than 105). Significant differences persisted when groups were subdivided by type of immunosuppression (azathioprine vs cyclosporine). Demographic (age, race, cause of renal disease) and immunologic (transfusions, PRA, matching) differences between groups did not explain the difference in graft survival. We conclude that referring dialysis center is a previously unrecognized factor affecting transplant outcome. Further studies with larger numbers will be required to determine the underlying reasons for ths phenomenon. PMID- 3285534 TI - Urinary calculi in renal transplant recipients. AB - Urinary calculi are an uncommon complication in renal transplant recipients. During a 15-year period, in 544 cases of kidney transplantation with a functioning allograft for more than 3 months, and a long-term follow-up, we have observed 9 cases (1.7%) of urinary calculi. Calculi occurred in 6 male and 3 female patients, 6 patients were recipients of living related and 3 of cadaveric kidneys. Calculi were diagnosed as early as 3 months and as late as 3.5 years after transplantation, but most were detected within the first year. The location of the calculi was the bladder in 4 cases, the transplant in 3, and indeterminant in 2. Crystallographic analysis of retrieved stones revealed calcium oxalate and/or phosphate in 4 cases, triple phosphate in 2, and uric acid in 1. All patients had one or more stone-predisposing factors, such as obstructive uropathy and recurrent urinary tract infection (4 cases), hyperoxaluria (3), or hypercalciuria (2). During long-term follow-up (mean 60 months), only one patient lost the renal graft, 14.5 years after transplantation, primarily from causes unrelated to urinary calculi. One instance of stone recurrence was noted. IN CONCLUSION: (1) urinary calculi after renal transplantation are relatively uncommon; (2) predisposing factors and crystallographic composition of the calculi are identical in type, but not frequency, to those of nontransplant patients; and (3) with proper medical and surgical management, post-transplant urolithiasis does not appear to affect graft prognosis. PMID- 3285535 TI - The Milan clinical trial with cyclosporine in cadaveric renal transplantation. A three-year follow-up. AB - Between February and November 1983, 108 recipients of cadaveric renal transplants entered a randomized multicenter trial and were treated either with cyclosporine (CsA) and prednisone (n = 55) or with conventional treatment based on azathioprine (Aza) and glucocorticoids (n = 53). The graft survival probability at 3 years was 76% for CsA patients and 48% for Aza patients (P less than 0.001). The cumulative number of acute rejections was significantly lower in the CsA group (32 vs. 104, P less than 0.001). Incidence of early posttransplant anuria was similar in both groups and did not affect renal function after three years. Nephrotoxicity in CsA patients, when present, was handled by reducing the dose of CsA, but in 12/55 patients a change to conventional therapy was thought to be necessary. However, in this group of 12, one patient lost the allograft because of irreversible rejection and one patient died 14 months later because of an infection. Mean creatinine clearance after three years was significantly lower in the CsA patients (54.7 +/- 2.6 ml/min) than in Aza patients, (67.2 +/- 4.9 ml/min, P less than 0.05). Considering only patients with grafts functioning after three years and still on the original randomized therapy, the mean creatinine clearance was similarly and significantly decreased from 1 to 3 years in both groups. There were no significant differences in occurrence of severe infections. Side effects such as hypertension, hypertrichosis, tremor and gum hyperplasia were more frequent in CsA patients. PMID- 3285536 TI - A randomized trial comparing triple-drug and double-drug therapy in renal transplantation. AB - A controlled trial was carried out in 86 cadaveric and 14 living haploidentical renal transplant recipients to compare the effects of low doses of cyclosporine (CsA), azathioprine (Aza) and steroids with those of higher doses of CsA plus steroids. Patients were followed for 12-26 months after transplantation. The actuarial 2-year patient and graft survival rate was 100% for living-donor transplants. In cadaver renal transplants the 2-year patient survival rate was 100% for patients assigned to the triple regimen and 93% for those allocated to the double regimen. The actuarial 2-year cadaver graft survival rates were 86% and 90.6%, respectively. There were significantly more patients who had severe infections (P less than 0.05), particularly interstitial pneumonia (P less than 0.005), in the double-therapy group. On the other hand, there were more patients who rejected and more patients with severe rejections; more pulses of steroids were also required for patients on the triple regimen, although these differences were not significant. The mean trough blood levels of cyclosporine at the various times were about half as high in patients on triple therapy. There were no differences between the two groups in creatinine clearance at any time. A control renal biopsy, taken from patients with stable renal function after 6-12 months, showed only mild abnormalities. The lesions were semiquantitatively assessed. There was a higher score for interstitial infiltrate in patients on triple therapy (P less than 0.05). On the other hand, the incidence and the mean score of interstitial fibrosis were greater in patients on double therapy, although these differences were not significant. Thus, although similar results were obtained with both regimens, at the doses we used double therapy seems to have more powerful immunosuppressive effects and may prevent rejection, either acute or chronic, better. However, it might expose the patient to a greater risk of infection and of cyclosporine-related nephrotoxicity than triple therapy. PMID- 3285537 TI - Serum C-reactive protein concentrations in cyclosporine-treated renal allograft recipients. AB - Acute or persistent elevations in serum C-reactive protein (CRP) concentration have been shown to be of value in diagnosing acute rejection episodes in azathioprine (AZA)-treated renal transplant recipients. To assess whether changes in serum CRP level might assist in differentiating nephrotoxicity from acute rejection in cyclosporine (CsA)-treated renal transplant recipients, we measured changes occurring in serum CRP concentrations in 74 CsA patients in response to transplant operation, acute rejection, cyclosporine nephrotoxicity, and serious infection, and compared these values with changes in AZA patients. Serum CRP concentration rose in response to operation in virtually all patients, regardless of immunosuppressive regimen, from mean baselines of 5.9 +/- 2.7 mcg/ml (AZA) and 6.8 +/- 6.5 mcg/ml (CsA) to mean peak levels of 43.8 +/- 33.4 mcg/ml and 65.1 +/- 39.5 mcg/ml, respectively. CRP rose during 76% of acute rejection episodes in AZA patients by a mean of 29.7 +/- 37.4 mcg/ml. In contrast, in 80% of acute rejection episodes of CsA patients, CRP remained undetectable or failed to rise above a stable, minimally elevated baseline. Similarly, there was no elevation in CRP in 9 of 10 episodes of nephrotoxicity. In 14 CSA patients with serious infections (8 pulmonary, 3 intraabdominal, 3 genitourinary), CRP rose by a mean of 67.7 +/- 50.7 mcg/ml. Thus, although CRP rises significantly with operation or serious infection in CsA patients, CRP fails to rise with nephrotoxicity or acute rejection. PMID- 3285538 TI - Alterations in immunologic measurements in patients experiencing early hepatic allograft rejection. AB - We compared lymphocyte subsets, the T4:T8 ratio, and assays of lymphocyte function in 11 recipients of hepatic allografts who showed signs of early graft rejection (less than 3 weeks after transplant) with 13 patients who had no evidence of graft rejection. Both patient groups had similar values for lymphocyte subsets, lymphocyte transformation in the presence of phytohemagglutinin, and in vitro immunoglobulin synthesis prior to allografting. Nonrejectors had a decline in both T3 and T4 cells one week after transplant. Those who had evidence of graft rejection did not show a significant decline in either of these T cell subsets. The T4:T8 ratio declined in 11/13 nonrejectors in the week after transplant but in only 4/11 rejectors (P less than 0.05). Monitoring immunologic markers in blood may represent a means of determining which subjects are at greatest risk for developing early hepatic allograft rejection. PMID- 3285539 TI - The interaction between the Lewis blood group system and HLA-matching in renal transplantation. AB - A retrospective study was initiated to investigate the influence of recipients' Lewis subtype and HLA-matching on cadaveric kidney graft outcome. A total of 1111 patients receiving a first cadaveric kidney graft were analyzed. No difference in one-year graft survival was found between Lewis-negative (73%, n = 133) and Lewis positive (73%, n = 978) recipients. Further subdivision of the study group into HLA-A,-B well-matched (0 or 1 mismatches [MM]) and poorly matched (2, 3, or 4 MM) revealed a strong deleterious effect of HLA-A,-B mismatching in the Lewis negative group only. One year graft survival in Lewis-negative HLA-A,-B poorly matched (2, 3, or 4 A,B MM) patients was 60% (n = 67) versus 86% (n = 66) in the Lewis-negative HLA-A,-B well-matched (0 or 1 A,B MM) group (P = 0.004). For the Lewis-positive group the one-year graft survival rates were 72% (2, 3, or 4 A,B MM; n = 498) and 74% (0 or 1 A,B MM; n = 480), respectively (P = n.s.). The additional beneficial effect of HLA-DR matching again turned out to be strongest in the Lewis-negative group. In Lewis-negative, HLA-DR (0 MM) and -A,-B well matched recipients (n = 36) graft survival was 94% versus only 64% in the Lewis negative, DR matched, A,-B mismatched (2, 3, or 4 A,B MM) group (n = 25; P = 0.09). In the Lewis-positive, HLA-DR 0 mismatched group the one-year survival rates were 78% (0 or 1 A,B MM; n = 240) and 73% (2, 3, or 4 A,B MM; n = 253), respectively (P = 0.05). Our data suggest that donor recipient selection should not be based on Lewis matching per se. However, since Lewis-negative patients are at high risk of graft failure when receiving HLA mismatched kidneys, they should preferentially receive optimally HLA matched grafts. PMID- 3285540 TI - Characteristics of dendritic cells in rat liver. AB - The properties of rat liver dendritic cells (DC) were analyzed after collagenase digestion of the tissue and enrichment with density gradient centrifugation. The liver macrophages (Kupffer cells) were eliminated by adherence before the gradient centrifugation. The morphology of isolated DC in May-Grunwald-Giemsa (MGG) stained cytocentrifuge preparations resembled that of monocytes with certain dissimilarities. The expression of major histocompatibility complex (MHC) class II antigens (Ia) on DC was analyzed with the Staphylococcus aureus rosette method using a monoclonal antibody. The binding of anti-Ia antibody to rat liver DC was 3 times stronger than to passenger lymphocytes and 10 times stronger than to hepatocytes. All DC were Ia-positive tested with indirect immunofluorescence technique, and none of them were able to phagocytize antibody-coated human red cells. The DC did not express intracytoplasmic lysozyme, or surface Fc-receptors, and they all were negative in alpha-naphtylacetate esterase (ANAE) staining. Thus, although the dendritic cells of rat liver seem to belong to the monocytic series according to morphologic criteria, they were all negative when tested for typical monocyte/macrophage markers. The immunocenic potential of DC was analyzed by testing their ability to prime a naive recipient for graft rejection. The number DC needed for the priming was comparable with the number of spleen lymphocytes needed for an equivalent effect, indicating that the DC were highly immunogenic. The hepatocytes showed practically no immunogenic effect. Thus the immunogenic potential of the tested cells, i.e. their ability to induce accelerated transplant rejection, carries a good correlation with the expression of Ia-antigens on the cell surface. PMID- 3285541 TI - Morphologic studies of acute rat cardiac allograft rejection across an isolated major histocompatibility complex class I (RT1A) disparity. AB - To define the morphologic correlates of acute rat cardiac allograft rejection across an isolated major histocompatibility complex (MHC) class I disparity, rejecting PVG.R1 cardiac allografts transplanted to (PVG x WF)F1 recipients were studied from days 4-8 posttransplantation. Documented ultrastructural tracer techniques as well as immunohistologic and immunoelectron microscopic methods were employed for morphologic analysis. Using intravenously administered horseradish peroxidase as a tracer probe for cell membrane permeability dysfunction, it was shown that severe diffuse loss of integrity of the microvascular endothelium preceded functional rejection, providing strong evidence that the allograft microcirculation is a central target of graft destruction. Also, rejection was associated with localized cardiac myofiber alterations prior to development of significant endothelial changes, indicating that cardiac muscle cells are additional cellular targets of immunologic injury. The ultrastructural features of progressive endothelial and myofiber injury, the predominance of MRC OX8+ lymphocytes and MRC OX6+ macrophages sequestered within the grafts, and the pattern of donor class I expression by allograft endothelium and cardiac myofibers were similar to those observed in rejecting allografts in full MHC-disparate combinations. Since it has been previously shown that MRC OX8+ class I-reactive T cells are absolutely required for rejection in this isolated class I-disparate model, the morphologic data raise the possibility that the OX8+ T lymphocyte subpopulation may also play a highly significant role in rat cardiac allograft rejection across a full MHC disparity. PMID- 3285542 TI - Engraftment following T cell-depleted bone marrow transplantation. III. Differential effects of increased total-body irradiation on semiallogeneic and allogeneic recipients. AB - Three different doses of total-body irradiation (TBI) (1100, 1300, 1500 cGy) have been analyzed as conditioning regimens for semiallogeneic B6AF1 (H-2b X H-2a) and allogeneic A/J (H-2a) recipients of T cell-depleted C57BL6 (H-2b) bone marrow transplants. Recipient survival and engraftment of both donor erythrocytes and lymphocytes were examined in each group. The large majority of allogeneic mice prepared with 1100 cGy rejected their grafts, which resulted in poor survival (less than 30%); improved survival (up to 80%) and complete donor engraftment were noted as the TBI dose was increased. By contrast, survival in semiallogeneic B6AF1 recipients was independent of TBI dose and was greater than 80% in all groups. Outright failure of marrow grafts (less than 10% donor hematopoiesis) did not occur in these recipients, but mixed chimerism (simultaneous occurrence of both donor and host cells) was frequently observed at lower TBI doses. Complete (greater than 90%) donor engraftment was noted for erythrocytes but not for lymphocytes. Possible mechanisms accounting for these differences between semiallogeneic and allogeneic recipients of marrow transplants are discussed. PMID- 3285543 TI - Injury of myocardial conduction tissue and coronary artery smooth muscle following brain death in the baboon. AB - Experimental brain death was induced in 36 chacma baboons. In group A (n = 17), brain death was induced with no pharmacologic or surgical manipulation. Group B (n = 7) underwent bilateral vagotomy, unilateral left cardiac sympathectomy, or bilateral adrenalectomy before induction of brain death. Group C (n = 7) underwent total cardiac sympathectomy. Group D (n = 5) was pretreated with verapamil hydrochloride. Following induction of brain death, group A animals were maintained on a ventilator for a mean of 12 hr and 6 hr for the remaining groups. At the end of the experiment, the heart was excised, and tissue blocks were examined with light microscopy at (A) the atriaventricular node-bundle of His; (B) the major coronary arteries; and (C) myocardial tissue from the ventricular septum or left ventricular wall. In group A, 41% of the hearts showed histologic features of injury to the conduction tissue, 70% presented contraction band necrosis of the smooth muscle of the coronary arteries, and an incidence of 100% of the groups showed myocyte injury, more evident in the subendocardial area. In group B animals, conduction tissue injury was seen in 6 animals; the coronary arteries were not examined in this group; the incidence of myocyte injury was seen in 80% of the animals. Animals in groups C and D show no histopathologic injury in the conduction tissue (group A vs. C P less than 0.04), nor in the coronary arteries (group A vs. C P less than 0.002; group A vs. D P less than 0.01), preserving the myocytes (P less than 0.001). The catecholamine storm associated to acute increment of the endocranial pressure at the time of induction of brain death induces major histopathologic changes in the myocardium, as a result of endogenous catecholamines released inducing calcium overflow injury, affecting the conduction tissue, the smooth muscle of the coronary arteries, and the contractile myocardium. This can be prevented by calcium blockers or cardiac denervation. PMID- 3285544 TI - Major histocompatibility complex class I and class II expression by myocytes in cardiac biopsies posttransplantation. AB - A total of 85 cardiac biopsies from patients 23-265 days posttransplant were studied for the correlation of the rejection grade score with the level of major histocompatibility complex (MHC) class I and class II expression on cardiac myocytes and endothelial cells, the quantitative level of leukocytic infiltrate, and the immunophenotype of the leukocytes. Results indicate a lack of absolute correlation between rejection grade scores and levels of MHC antigen expression. Further, a lack of absolute correlation was also seen with quantitation of leukocytic infiltrates and relative levels of MHC antigen expression. Of great interest was our preliminary finding that as early as 4 weeks prior to a rejection episode scored by routine histological criteria as grade 4, cardiac biopsy from the patient demonstrated high levels of MHC class I and class II expression. Similar increases of MHC antigen expression prior to an increase in histological rejection score grades were also noted in serial biopsies of 2 other patients. These data suggest that it may be quite useful to examine levels of MHC antigens on cardiac biopsies posttransplantation as an additional parameter for monitoring of cardiac rejection episodes. PMID- 3285545 TI - Renal transplantation in secondary oxalosis. PMID- 3285546 TI - Successful pregnancy in renal transplant recipients treated with cyclosporine. PMID- 3285547 TI - Mycotic pseudoaneurysm of the gastroduodenal artery--an unusual cause of lower gastrointestinal tract hemorrhage following liver transplantation. PMID- 3285548 TI - Cyclosporine levels in whole blood. Comparison of the polyclonal Sandoz Ciclosporin Radioimmunoassay Kit with the specific antibody in the new Sandimmun Kit. PMID- 3285549 TI - Prolongation of male skin graft survival in female mice treated with amniotic fluid. PMID- 3285550 TI - Examination of sputum for acid-fast bacilli by the concentration method (a reminder) PMID- 3285551 TI - Layered versus mass closure of vertical midline laparotomy wounds in Negro Africans. PMID- 3285552 TI - [Use of the micronucleus test in the screening and monitoring of mutagens]. AB - Data from literature on the use of micronuclear test to determine mutagenicity in agents of physical, chemical and biological nature are presented. The objects on which this method is used most frequently are enumerated. Great attention is paid to the analysis of micronuclei in blood erythrocytes and bone marrow of animals. It is shown that the animal sex, age and the way of mutagen injection are of great importance in micronuclear testing of mutagens. Methodical papers concerning the peculiarities of fixation colour, analysis and mathematical testing are given. Mutagen factors tested by the method of micronuclear analysis are enumerated. A high resolution and small labour input of the micronuclear test are shown. PMID- 3285553 TI - Serum beta 2-microglobulin in malignant lymphoproliferative disorders. AB - Beta 2-microglobulin (B2m) was measured on serum samples in 274 patients with acute and chronic lymphoproliferative disorders (85 non-Hodgkin lymphomas-NHL, 30 Hodgkin lymphomas-HL, 34 B-cell chronic lymphocytic leukemias-B-CLL, 8 Waldenstrom macroglobulinemias-WM, 76 multiple myelomas-MM, 31 acute lymphoblastic leukemias-ALL, 10 hairy cell leukemias-HCL). Two hundred and four patients were studied at the time of diagnosis, and results were correlated to clinical stage, and histologic subtype in NHL, immunoglobulin type in MM, and immunologic phenotype in ALL. Moreover, B2m was tested during and after chemo- and/or radiotherapy, and results were correlated to response, progression or relapse. Elevated pretreatment B2m values were found in widespread forms of NHL and HL, in patients with B symptoms and in the unfavorable histologic subgroups of NHL. Rapid falls in levels followed therapy institution. In B-CLL and in MM a close relationship between B2m and cell mass was found. A significant B2m level reduction followed treatment, whereas its increase could detect a relapse. In ALL, serum B2m was only slightly above the normal range. B2m seems to reflect the total burden of malignant cells mainly in MM and B-CLL; in other lymphoproliferative disorders it provides less prognostic information. PMID- 3285554 TI - Antigenic phenotype of radial growth phase melanomas with or without a vertical growth phase portion. AB - The expression of 4 melanoma-associated antigens and of class I and II HLA antigens was investigated in 12 superficial spreading melanomas (SSM) and in 8 SSM with a vertical growth pattern portion (SS + NM) by the use of monoclonal antibodies and an indirect immunoperoxidase procedure. Monoclonal antibodies 225.28, 763.74, CL.203, VF19-LL217, Q5-13, W6-32 and anti-HLA-DR, were used. Each antigen was more frequently expressed by SS + NM on the whole than by SSM and also by the radial growth pattern portions of SS + NM than by SSM. Vertical growth pattern portions of SS + NM were not antigenically similar to radial growth pattern portions in the same tumors. The high frequency of antigen expression in radial growth pattern melanomas seems to be associated with the appearance of a more invasive cell population. PMID- 3285555 TI - Radioligand-labeled binding assay and immunochemical assay for estrogen receptor in 115 human breast cancers. AB - The aim of this study was to evaluate the results obtained from a new enzyme immunoassay (Abbott-ER-EIA) for the determination of estrogen receptor levels in tumor cytosols in comparison with the currently used DCC method. One hundred and fifteen consecutive primary breast cancer specimens were examined; 66 of the women were postmenopausal and 49 were premenopausal. A good correlation (r = 0.88, p less than 0.001 and a slope of 1.3) was found between ER-EIA and the steroid binding assay (DCC). When these data were analyzed according to menopausal status, no differences were observed for the slopes and correlation coefficients in pre' and postmenopausal groups. The ER-EIA appears to produce results comparable to those obtained with the conventional DCC method for the determination of ER in breast tumor cytosols. PMID- 3285556 TI - [Respiratory problems in patients with muscular dystrophy]. PMID- 3285557 TI - [Doppler ultrasound in the evaluation of the hemodynamics of the human fetus]. PMID- 3285558 TI - [Tissue expansion in reconstructive surgery]. PMID- 3285559 TI - [Doppler ultrasonic diagnosis in acute scrotal conditions]. PMID- 3285560 TI - [Ultrasonic scanning or cholangiography. Examination for biliary disease in patients following cholecystectomy?]. PMID- 3285561 TI - [Potter's syndrome diagnosed by early routine ultrasonic examination during pregnancy]. PMID- 3285562 TI - [Fosfomycin (Fosfocin). A new antibiotic agent]. PMID- 3285563 TI - Myocardial backscatter analysis in animal experiments. AB - This paper describes the instrumentation and data analysis procedures for cardiac tissue characterization by a backscatter method. Experimental results obtained with a 'button' transducer in direct contact with the myocardium are discussed. PMID- 3285567 TI - Bone marrow transplantation. PMID- 3285568 TI - Long-term perspective of hematologic malignancies. PMID- 3285569 TI - Renal transplantation at the Mayo Clinic. PMID- 3285570 TI - AIDS: underwriting practices. PMID- 3285571 TI - [The role of erythrocyte aggregation in the pathogenesis of microcirculatory changes in the retina of patients with diabetes mellitus]. PMID- 3285572 TI - Antibiotic resistance: an overview. AB - The results of large scale surveys have indicated that in general terms antibiotic resistance in bacteria has not increased, especially in Europe and North America. When the prevalence of resistance in specific bacteria has increased the increase has usually been associated with the introduction of a novel antimicrobial agent, whether in human or veterinary clinical practice, but the prevalence of resistance that is recognised may be very small. It would appear that the use of antibiotics in livestock farming during the past 20 years has not compromised public health. Any problems in human medicine which are due to bacterial resistance have resulted from the use of antibiotics in man and not from their use in agriculture. Similarly, any problems in veterinary medicine which are due to bacterial resistance have resulted from the use of antibiotics in animals and not from their use in man. PMID- 3285573 TI - The pathogenicity and immunologic relationship of a virulent and a tissue-culture adapted Babesia bovis. AB - Babesia bovis grown in tissue culture was used to inoculate 12, 2-year-old Holstein steers. All 12 developed serological evidence of infection but only six had a febrile response of greater than or equal to 40 degrees C, and only one had a demonstrable B. bovis parasitemia. An average modest drop of 19% was observed in packed cell volume (PCV) during the period of reaction. All 12 steers were subsequently challenged with virulent B. bovis: seven on day 78 post inoculation (p.i.), two on day 106 p.i., and three on day 251 p.i. No demonstrable clinical response was observed in any of the 12 steers previously exposed to the tissue culture organism, whereas severe signs of babesiosis occurred in seven 2-year old, non-vaccinated control steers given a comparably virulent B. bovis challenge. All seven controls showed a febrile response, B. bovis parasitemias, with an average drop of 55% in PCV and a 28% mortality. PMID- 3285574 TI - Rift Valley fever virus M segment: cell-free transcription and translation of virus-complementary RNA. AB - A cell-free system has been used to study gene expression of the M segment RNA of the Phlebovirus Rift Valley fever virus (RVFV). RVFV sequence-containing plasmids were used to synthesize M segment mRNA-like transcripts. These transcripts were then translated in vitro in the absence or presence of microsomal membranes. Cell free translation of a transcript which closely resembled authentic M segment mRNA (RNA-7) yielded a primary translation product of 133 kilodaltons (kDa), the size expected of a polypeptide encompassing the entire open reading frame (ORF) of the M segment. When translations were conducted in the presence of microsomal membranes, this primary protein was cotranslationally processed to yield the two viral glycoproteins, G1 and G2, as well as proteins of 78, 21, and 14 kDa. With one exception, these in vitro processed polypeptides comigrated with M segment encoded proteins found in RVFV-infected cell lysates. A polypeptide corresponding to the in vitro 21-kDa protein was not detected in vivo. To investigate translational initiation and processing of the protein products of the M segment, additional transcripts were generated in which varying portions of the amino terminal "preglycoprotein" region of the M segment ORF were deleted. Translation results indicated that the 78- and 21-kDa proteins were initiated from the first methionine codon of the ORF, and the 14-kDa polypeptide began from the second in phase ATG. These products and a major portion of the preglycoprotein region sequence were not required for the proper synthesis and processing of the viral glycoproteins in vitro. In light of these results, possible expression strategies used by this Phlebovirus M segment RNA are discussed. PMID- 3285575 TI - Fusion glycoprotein (F) of rinderpest virus: entire nucleotide sequence of the F mRNA, and several features of the F protein. AB - The full-length cDNA corresponding to the mRNA for the fusion protein of rinderpest virus (RV) was cloned and its complete nucleotide sequence was determined. The mRNA for the F protein was composed of 2359 nucleotides and contained a single large open reading frame which was capable of encoding 566 amino acids with a molecular weight (MW) of 58,929. The RV-F mRNA had a long noncoding region at the 5' end (586 bases) which was C-rich like the measles virus (MV)-F mRNA but they did not appear to be homologous with each other. Their secondary structure with long G-C stems suggested that they are easily folded. The coding region of RV-F mRNA was significantly homologous with that of MV-F; 74% of the nucleotides and 79.0% [corrected] of the amino acids were identical. The predicted RV-F protein had a basic amino acid region (104-108) which may be cleaved by protease to yield an activated form of F1,2. Three regions (1-19, 109 133, 418-513) were highly hydrophobic, and the N-terminal hydrophobic region of F1 or the positions of cysteines were significantly conserved compared with those of the other paramyxovirus F proteins. Three potential sites for glycosylation existed only in the F2 protein. Several features of the predicted RV-F protein were confirmed in polyacrylamide gel electrophoresis. PMID- 3285576 TI - [Ultrasonic determination of the position of the kidney for needle biopsy]. PMID- 3285577 TI - [Importance of the ideas of Z. P. Solov'ev in the field of military hygiene under today's conditions]. PMID- 3285578 TI - [Experience of military field surgery in the battles of Lake Khasan]. PMID- 3285579 TI - [Medical support of a ski troop detachment in the Arctic]. PMID- 3285580 TI - [The courage and selflessness of naval physicians]. PMID- 3285581 TI - [Kind hearts, golden hands]. PMID- 3285582 TI - [4 Orders of the Military Surgeon (Eduard Vladimirovich Chernov)]. PMID- 3285583 TI - [V. I. Lenin on the defense of the socialist Fatherland and the protection of the health of soldiers]. PMID- 3285584 TI - [The Military Medical Academy during the civil war]. PMID- 3285585 TI - [Incretory function of the pancreas in alcoholic liver diseases]. AB - Impairments in pancreas incretory functions were detected in patients with chronic liver diseases of alcohol etiology (lipid dystrophy, cirrhosis) after radioimmunologic examination of immunoreactive insulin, C-peptide and glucagon in blood under these conditions and during glucose-tolerance test. Mechanisms of resistance to insulin and to hyperinsulinemia under conditions of these pathological states are considered. Role of liver tissue has been emphasized in maintaining of blood pancreatic hormones level. PMID- 3285586 TI - [Effect of various types of vagotomy on prostaglandins (E, F2 alpha), thromboxane and prostacyclin synthesis in the mucosa of the gastroduodenal zone in experimental ulcer in the rat]. AB - Synthesis of prostaglandins E2 and F2 alpha (PGE2, PGF2 alpha) thromboxane B2 (TXB2) and prostacycline (PGI) was studied in mucose of gastroduodenal area under conditions of experimental ulcer in rats after complete truncal vagotomy as well as after incomplete vagotomy involving dissection of one vagus trunk, proximal selective dissection, dissection of vagus nerve. Estimation of PGE2, PGF2 alpha, TXB2 and PGI biosynthesis in mucose of stomach fundal and anthral parts and in duodenal mucose showed that dissection of vagus nerve, as compared with complete truncal vagotomy or with dissection of one vagus trunk, was the most effective type of operation in ulcers of duodenum. After this operation the synthesis of the eucosanoids (PGE2 and PGI) was activated, which caused cytoprotective and secrete-regulating effects, while production of PGE2 and TXB2 alpha (the tissue deteriorating substances) was inhibited. Dissection of vagus nerve appears to contribute to secretion of hydrogen chloride in stomach as well as to accelerate reparative processes in gastroduodenal mucose via the metabolic mechanisms studied. PMID- 3285587 TI - [The role of enzyme systems in the regulation of the "trigger" function of physiologically active peptides (review of the literature)]. AB - Studies of enzymes, involved in metabolism of biologically active peptides, showed that the same substance may be used as a substrate of hydrolysis catalyzed by various peptidases. This principle should be applied for elucidation of polyfunctional properties of regulatory peptides, their ability to participate in dissimilar physiological responses. Investigation of the enzymatic step indicated also the pathways of possible neuropeptide level regulation within the definite regions of nervous tissue. The following principles are involved in evaluation of neuropeptides regulating functions: substrate specificity of particular peptidases, specificity of these enzymes in relation to their regional localization in brain or peripheric tissues, estimation of enzymatic activity in dynamics of physiological (pathophysiological) process. The examples are considered, which illustrate these points (principle "what-where-when") as well as data are discussed, which enabled to postulate the "trigger" function of neuropeptides (angiotensin II and bradykinin) in some long-term behavioral and somatic responses of a body. PMID- 3285588 TI - [Soluble and membrane-bound forms of neutral alpha-glucosidase in human urine in normal conditions and in kidney diseases]. AB - Soluble and membrane-bound forms of neutral alpha-glucosidase, which are immunologically similar to the corresponding forms of kidney enzymes, were found in urine of healthy persons and of patients with kidney impairments. Membrane bound enzyme was only slightly active in urine of healthy persons and constituted 3-10% of total urine activity although the ratio of membrane-bound enzyme was simultaneously elevated under pathological conditions. The increased rate of soluble enzyme secretion was responsible for distinct activation of neutral alpha glucosidase in urine of the patients with kidney impairments. PMID- 3285589 TI - [Lipid-carrying plasma proteins (review of the literature)]. PMID- 3285590 TI - [Role of natural cytotoxic lymphocytes (natural killers) in the pathogenesis of influenza]. PMID- 3285591 TI - [Immunoenzyme test system based on antibody F(ab)2-fragments for detecting the NP protein of the influenza virus]. AB - A test system has been proposed for the detection of influenza A virus NP protein by solid-phase enzyme immunoassay in a modified system of "double" antibodies: the primary antibodies were F(ab)2-fragments of immunoglobulin class G isolated from rabbit antiserum specific for NP protein which was also used as the source of secondary antibodies. The antigen-bound antibodies were detected by protein A (from St. aureus) conjugate with horseradish peroxidase. The high specificity and sensitivity of the test system (0.3 ng/ml NP protein) and a minimal level of nonspecific reactions were demonstrated. The advantages of this method are discussed. PMID- 3285592 TI - [Properties of the HBsAg gene expression product in yeast cells]. AB - The Saccharomyces cerevisiae DBY 746/pNMVG-20 strain produces HBsAg similar in its properties to HBsAg from hepatitis B patients' plasma. The paper analyses variants of extraction of HBsAg from yeast cells, presents data on immunogenic potency of yeast HBsAg in mice, and describes gel filtration of yeast extracts containing HBsAg. PMID- 3285593 TI - [Immunodiagnosis of AIDS using preparations of the recombinant antigen of the surface protein of the HTLV-III virus]. AB - A technological scheme has been developed for purification of recombinant antigen of surface protein (ASP) of the causative virus of AIDS from Escherichia coli cells carrying plasmid pL2 which codes for the synthesis of a hybrid polypeptide consisting of phage lambda N protein (59 amino acid residues) and a fragment of SP (env) of HIV virus (569 a.r.). Purification of ASP is based on two separation principles: fractionation of polypeptides of bacterial lysates by preparative isoelectrofocusing in a granulated gel layer and the method of preparative polyacrylamide gel electrophoresis in "Multiphor" apparatus (Pharmacia). The ASP purified by these methods was used for construction of an immunodiagnostic preparation for AIDS, employing for this purpose solid-phase enzyme-immunoassay in two modifications: competitive sandwich method and analysis of the tested sera with direct sorption of ASP on nitrocellulose filters. PMID- 3285594 TI - [100 years of the Society of Gynecology and Obstetrics in Australia 1887-1987. From the history of the Austrian Society of Gynecology and Obstetrics]. PMID- 3285595 TI - [Ernst Wertheim]. PMID- 3285596 TI - [Great men associated with the 1st Vienna Gynecologic Clinic since 1888]. PMID- 3285597 TI - [Great gynecologists of the Graz Medical School]. PMID- 3285598 TI - [Obstetrics and gynecology of the Innsbruck Medical School]. PMID- 3285599 TI - [Parkinson disease--new aspects of therapy]. AB - Treatment of Parkinson's disease has to be considered as long-term treatment of a progressive illness. Basically we try a substitution of the dopamine deficiency by administration of levodopa in combination with a decarboxylase inhibitor. The occurrence of long-term complications such as fluctuations of mobility (on/off phenomena) and dyskinesias caused the use of lower levodopa doses and the simultaneous application of other antiparkinson drugs, e. g. anticholinergics, amantadines, dopamine agonists and MAO-B-inhibitors. When administering additional drugs, kind and severity of the parkinsonian symptomatology as well as the specific side effects of the different drugs have to be taken in consideration. According to recent experimental and clinical findings MAO-B inhibitors may have protective effects on the neurons thus delaying the course of the disease. PMID- 3285600 TI - [Structures in the treatment of patients with cardiac phobias]. AB - The treatment of patients with cardiac phobias includes several therapeutic procedures following different indications. Determining are the various needs of the patients. This concept attempts to overcome the myth of universality which consists in the assumption of an unique therapeutic proceeding for different neurotic disorders (10). Heterogeneous aspects of treatment like relaxation, partner-therapy, exposure in vivo, cognitive behaviour therapy (attributions, expectancies) as well as orthopaedic-physical methods are taken into consideration. In that way the therapeutic principles go beyond the limitations established by the various theories of neurotic behaviour. Certainly by doing so the degree of comparison generally is reduced. For that reason the various teams involved in these therapeutic problems should make every effort to come to an optimal treatment program by controlled studies for cardiac phobic patients. PMID- 3285601 TI - [Stroke. Status and general practice of conservative treatment and rehabilitation]. AB - Adequate help for the apoplectic patient according to recent standards can be given only by simultaneous and equivalent orientation towards both acute therapy and rehabilitation, which should merge smoothly into each other. This can be achieved only by specialised hospitalisation. The idea of totally domestic treatment, as advocated in times past, has to be abandoned for good. In the foreground of acute therapy are treatment of edema, cardiac output and blood pressure, rheological factors: blood viscosity, thrombocyte aggregation, erythrocyte elasticity. In the foreground of rehabilitation efforts we place the principle of "totality and permanence" regardless of prognostic selectivity. The principle of permanence refers to rehabilitative efforts from the very beginning to long-term rehabilitation for months and years with the help of our special rehabilitation service and systematic training of relatives. At least, it has to be stressed that the rehabilitation patient is not a medical waste product and not a symbol of medical surrender either. It would be unfair and senseless to help him through the acute phase and leave him alone during his rehabilitation period. Permanent attention for the apoplectic patient is essential within a system of social medicine. Much is lacking in this respect, as far as academic institutions, advanced training, and information is concerned. We hope that we herewith demonstrate that not only the acute therapy, but also the rehabilitation of the apoplectic patient is a field of scientific fascination, still being in consequent further development. It is intended to give an additional stimulus for the optimal after-care of the apoplectic. PMID- 3285602 TI - [Threatened premature labor--causes, mechanisms and strategy for its prevention]. PMID- 3285603 TI - [New recommendations by the American Heart Association for cardiopulmonary resuscitation. A critical review]. PMID- 3285604 TI - [Artificial antigens for synthetic vaccines]. PMID- 3285605 TI - [Public health aspects of carcinogenesis research]. PMID- 3285606 TI - [Epidemiologic studies of the effect of air pollutants on the human body]. PMID- 3285607 TI - [Mercury pollution in the environment and mercury resistance of bacteria]. PMID- 3285608 TI - [Selected physical, chemical and microbiologic parameters of the water of the Cojimar river]. PMID- 3285609 TI - [History of heat damage from the military medicine viewpoint]. PMID- 3285610 TI - [The first step in the development of the Charite Microbiologic Project for computer-assisted data processing of routine clinical microbiologic data. Data registration and structure of the data bank]. PMID- 3285611 TI - [Ultrasound study of the spleen]. AB - The sonography is the method of choice for the determination of the size of the spleen. Normally, this has, represented from the left flank, a size of 12 x 5 cm (length and thickness) and a regular structural pattern. Splenomegalies with diffusely changed echo-structure are found in infections, congestion spleens as well as haemoblastoses. Focal lesions are typical for cysts, abscesses and haematomas of the spleen. The sonography of the spleen plays a particular role in the staging of malignant lymphomas, whereas metastatic changes of the spleen may more infrequently be stated sonographically. The authors deal with the great importance of the sonography of the spleen in abdominal traumas. PMID- 3285612 TI - [Clinical value of fetal flow measurements with pulsed Doppler ultrasound]. AB - 326 fetal flow-measurements with Doppler ultrasound were carried out in the umbilical arteries and fetal aortas of 236 newborn babies. The pulsatility index and the resistance index were used for the flowprofile analysis. The dystrophy rate and the rate of serious perinatological problems of newborn babies with pathological flow (n = 26) are compared with those of newborn babies with a normal flow. It appears that in the group with pathological flowindices, the dystrophy rate is 7.8 times and the morbidity rate 17 times higher. Most important, however, was the fact that all endangered SGA fetuses were diagnosed with flowmeasurements while SGA fetuses with a normal flow had no perinatological problems at all. Enddiastolic flow reductions, based on an increased placental resistance, are provable relatively early, whereas a beginning centralization of the fetal circulation is only recognizable in a closer temporal connection with the fetal imperilment on account of pathological flowprofiles. PMID- 3285613 TI - [Vaginal sonographic flow measurements in the uterine artery in pregnancy- advantages of the pulsed Doppler method]. AB - Uterine artery velocimetry was performed transvaginally in 42 healthy pregnant women by means of a newly developed "panorama" sector scanner which provides a real time image of the vessel in combination with the recording of a pulsed and gated Doppler signal. Measurements were made on both uterine arteries and averaged. A/B ratios and pulsatility indices declined as pregnancy advanced. A/B ratios I. Trimenon vs. III. Trimenon = 5.44 vs. 2.20, PI = 2.59 vs. 1.32. These changes may be secondary to the conversion of spiral arteries into dilated tortuous vessels by the trophoblast invasion. Flow velocity measurements of the proximal uterine arteries provide a summery of the blood supply to all the arcuate arteries. This method will enhance our understanding of adequate placentation and may provide a new tool in the diagnosis and monitoring of complicated pregnancies. PMID- 3285614 TI - [Reliability of duplex sonography in non-quantitative determination of blood flow in comparison to inductive flow measurement--an in vitro study]. AB - Using an experimental design permitting generation of a pulsatile "flow-velocity waveform" corresponding to the fetal aortic signal, the influence of measurement depth, the angle between the Doppler beam and the vessel, the high-pass filter and the extent of overlap between the "sample volume" and the vessel cross section were studied in vitro. The Resistance Index showed the best relation to inductive flow measurement, which was defined as standard. Considering the conditions prevailing during clinical studies, good reliability is likely at angles of between 0 degrees and 60 degrees (120 degrees-180 degrees) over the entire range of measuring depths (4-13 cm) and when using 100-200 Hz high-pass filters. The magnitude and location of the sample volume does not seem to play a decisive role provided a part of it is within the sonographically imaged "vessel" and there is no likelihood of interference from vessels in the immediate vicinity in which blood flow is in the same direction. PMID- 3285615 TI - [Degree of placental maturity and histopathologic finding: clinical prospective studies of a sample of term births and premature births]. AB - By analogy with Grannum et al.'s sonographic classification of the placenta (1979), macroscopic observation of the cut surfaces of the afterbirth enables the extent of placental segmentation to be determined and macroscopic maturity to be established in accordance with sonographic findings. Out of a total of 767 clinically-prospectively documented obstetrical cases, 674 were identified as term births and 93 as premature. For the purposes of comparison they were subdivided into two groups: term births with stage 0 to II and stage III maturity; and premature births with stage 0 to II and stage III maturity. Proceeding from this morphological classification and grouping, the clinical data, such as age of the mother, parity, gravidity, diseases during pregnancy, premature labour, type of delivery, fetal outcome, and biometric data of the newborn, as well as histologic findings regarding villous maturity, were recorded and statistically analyzed. The findings revealed no significant differences between term births with stage III maturity and those in the control group of placentas with stage 0 to II maturity and the same gestation time. Therefore, stage III maturity at term corresponds chronopathologically to a normal temporal development of fetomaternal flow units of the mature human placenta at term and does not imply any perinatological risk. Histopathologically, placentas with stage III maturity manifest a significantly advanced degree of villous maturity, with lower mean placental weight as the morphological correlate to threshold placental function, which is reflected in the clinical data of perinatological complications. Therefore, premature detection of a stage III placenta before term indicates a risk that should be kept in mind in the overall concept of prenatal monitoring parameters. PMID- 3285616 TI - Capping placenta. A new etiologic factor in midtrimester bleeding. AB - The results of an echographic study to determine the causal factors in 63 consecutive cases of second-trimester bleeding are presented. True second trimester bleeding is uncommon (0.8% of pregnancies during the study period), but the impact on fetal outcome is serious because the condition is associated with late abortion, preterm intra-uterine demise, preterm birth, and neurologic sequelae. Various placental structural anomalies occurred in 8% of our cases, and another 8% showed marginal solution of the placenta. In 6% there was retro amniotic bleeding, whereas placenta praevia was seen in only 3%. The prevailing placental localization (27%) found in patients with second-trimester hemorrhage was a peculiar one in that the placenta literally "capped" the lateral as well as the anterior and posterior walls of the uterine cavity, while the lower margin failed to reach the isthmic region. This type of placentation, which we call capping placenta, occurs in only 2.6% of normal pregnancies. The implication of the findings are discussed. PMID- 3285617 TI - [Polyhydramnios in congenital myotonic dystrophy]. AB - A case of hydramnion by congenital myotonic dystrophy is presented. By a 31 years old primipara typical causes of hydramnion as fetal malformations, immunologic or non-immunologic hydrops, diabetes mellitus or intrauterine infections could be excluded. Because of a severe fetal dystrophy with imminent asphyxia a caesarean section has been performed in the 35th. week of pregnancy. The newborn showed all clinical symptoms of congenital myotonic dystrophy and died after four weeks in a respiratory distress. A muscle biopsy of the m. quadriceps confirmed the diagnosis. EMG examination of the parents revealed a conductoring state of the mother. Possible causes of "idiopathic" hydramnion and possibilities of prenatal diagnosis of congenital myotonic dystrophy are discussed. PMID- 3285618 TI - [Early ultrasonic diagnosis of thoracopagus]. AB - Two cases of early ultrasonic diagnosis of conjoined twins (thoracopagi) in the 13th and 21th week of pregnancy, respectively, are reported. Heart and liver were fused in both and the upper gastrointestinal tract in one of the pairs. Once an ophalocele was seen. The most important ultrasonic criteria were close and fixed position of the twins to each other, ventral fusion of the thoracal and abdominal contours and detection of joint organs. Since hearts and livers were not paired, there was no chance of any successful therapy and on the parent's request, both pregnancies were terminated. PMID- 3285619 TI - [Development of immunoenzyme assays for the demonstration of thyroid autoantibodies. 2. Autoantibodies against microsomal antigens]. PMID- 3285620 TI - [Pathobiochemical processes in chronic inflammatory joint diseases: catabolic and anabolic mechanisms in proteoglycan and glycosaminoglycan metabolism]. PMID- 3285621 TI - Risk factors in breast cancer. PMID- 3285622 TI - Rickettsial pox and the rheumatoid factor. PMID- 3285623 TI - [Carotid artery lesion, concomitant diseases and risk factors in patients with coronary heart disease and peripheral arterial occlusive disease in Japan]. PMID- 3285624 TI - Correlations of Doppler frequency spectrum analysis and vessel wall surface qualities in stenoses of the extracranial carotid arteries. PMID- 3285625 TI - [Detection of Campylobacter jejuni and C. coli in waste water]. AB - For the detection of C. jejuni and C. coli in waste water the content of rifampicin in selective media was reduced from 10 micrograms/ml (Bolton and Robertson 1982) to 5 micrograms/ml and the content of polymymyxin B was increased from 0,25 microliter/ml (Skirrow 1977) to 2.5 micrograms/ml. On the Basis of this modification the isolation of C. jejuni and C. coli from waste water samples by membrane filter technique as well as by enrichment procedure was possible. Before inoculation of waste water samples the enrichment broth was preincubated at least 1 d at 37 degrees C under microaerophilic conditions. The Campylobacter test strains showed significant differences of growth between preincubated and non preincubated enrichment broth in the first hours of incubation. PMID- 3285626 TI - [Guidelines for the use of cardiotocography]. PMID- 3285627 TI - [Partial mole with lung metastases and multiple abnormalities of the fetus]. AB - The authors report on a patient with partial mole, multiple malformations and lung metastases requiring chemotherapy. This case shows that the partial hydatidiform mole must therefore be carefully monitored by serial beta-hCG titres following evacuation to ensure the achievement of complete sustained remission. PMID- 3285628 TI - The application of energy dispersive X-ray microanalysis in studies of irritant contact reactions. A mini-review. PMID- 3285629 TI - Selected papers from Ove Groth's bibliography 1963-86: studies utilizing experimental contact reaction models. PMID- 3285630 TI - Pustulosis palmoplantaris and chronic eczematous hand dermatitis. Treatment, epidermal Langerhans cells and association with thyroid disease. AB - Long-standing hand and foot dermatoses, e.g. pustulosis palmoplantaris (PPP) and chronic eczematous hand dermatitis, severely affect the patients' quality of life. The cause of PPP is unknown and the disease usually responds unsatisfactorily to treatment. The aims of the studies of PPP were to determine the prevalence of thyroid disease and to evaluate the relative merits of treatment with etretinate, psoralen photochemotherapy (PUVA), and a combination of the two. Furthermore, epidermal Langerhans cells (LC) were quantified in lesional skin before and after treatment. The prevalence of thyroid disease was significantly increased in a group of PPP patients compared to normal individuals and psoriasis patients. Both hypo and hyperthyroidism were found. In addition, circulating autoantibodies to thyroid antigens were more common in patients with PPP than in the control group. The thyroid status was further examined in a new and larger group of PPP patients, including a 4-year follow-up examination of those with thyroid antibodies or subclinical thyroid dysfunction. The increased prevalence of thyroid diseases was corroborated when this PPP group was compared to an age and sex-matched control population sample from the same city. Some patients also showed biochemical evidence of gastric autoimmunity. Ninetyfour percent of the PPP patients were smokers at the time of onset of the skin disease, compared to 33% of the subjects in a control group. Patients with treatment-resistant PPP were recruited for a randomised, double-blind and placebo controlled trial. A combination of etretinate and PUVA was more effective than monotherapy with etretinate or PUVA. The latter were equally effective. Etretinate frequently provoked side effects. Follow-up examinations showed a high relapse rate. Epidermal LC were visualised with monoclonal antibodies to Leu 6 and HLA-DR antigens utilizing an immunoperoxidase technique. Their number was increased in lesional skin. The number of HLA-DR positive LC was decreased following etretinate, and normalised with etretinate + PUVA. Chronic eczematous hand dermatitis is a common clinical challenge. These studies aimed at an evaluation of PUVA and UVB phototherapy in patients with recalcitrant lesions and to enumerate epidermal LC before and after treatment. PUVA was a highly effective mode of treatment and cleared all treated hands. UVB was better than no treatment but the dermatitis did not clear in any patient. The number of epidermal LC was increased in lesional palmar skin in both allergic contact dermatitis, irritant contact dermatitis and hyperkeratotic dermatitis of the palms.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3285631 TI - [Belgian Society of Anesthesia and Resuscitation. Membership of the Society- 1988]. PMID- 3285632 TI - Should amiodarone be discontinued before cardiac surgery? AB - Between October 1985 and October 1986, 37 patients, chronically treated with amiodarone, underwent general anesthesia for cardiac, thoracic or vascular surgery. Among them, the 8 non-cardiac surgery patients showed neither intra-, nor postoperative complications. The 29 cardiac surgery patients, had various complications ranging from dysrhythmias (52%), sometimes necessitating a pacemaker (24%), to marked and even fatal vasoplegia. We describe the only fatal case and compare our complication rate with that described in the available literature. Most complications could be symptomatically treated. In addition, amiodarone has a very long elimination half-life: therefore withdrawal before surgery implies delaying operations by several weeks, and puts patients at increased risk of malignant dysrhythmias. However, fatal vasoplegia does occur, and its real incidence should be assessed by a broader survey. PMID- 3285633 TI - Dehydrobenzperidol as peroperative anti-emetic: most effective administration time. AB - 206 female patients undergoing curettage or laparoscopy were randomized in 4 comparable groups. Group 1 did not receive dehydrobenzperidol (DHBP), group 2 was given DHBP during premedication, group 3 during induction of anesthesia and group 4 when patients presented symptoms of nausea and/or vomiting. Again, the statistical results confirm the strongly anti-emetic effects of DHBP. Because of the existing trend towards a more beneficial effect of DHBP if given during induction and the avoidance of a possible adverse reaction, administration during induction is to be preferred, at least in non-ambulatory patients. PMID- 3285634 TI - Treatment with probucol of children with familial hypercholesterolaemia. AB - Nine children with familial hypercholesterolaemia, age range 2 to 12 years, were treated with a low cholesterol diet and probucol (10 mg/kg/day). The year before, the children received, as only treatment, a low fat-cholesterol diet. During this period their mean plasma total cholesterol level fell from 8.2 +/- 1.45 mmol/l to 7.17 +/- 0.84 mmol/l (12.6%). This level was further reduced to 5.92 +/- 0.63 mmol/l (17.1%) after the addition of probucol. Plasma high density lipoprotein cholesterol levels were lowered in absolute terms but not in relation to total cholesterol. No apparent side effects were observed. However, the use of probucol should be restricted for the moment to severe cases of hypercholesterolaemia as the long-term excretion of the drug in children is not yet known. PMID- 3285635 TI - The alcohol intoxicated child and its prognosis. AB - This article is a review of Swedish and international literature concerning children apprehended for drunkenness. The need for a thorough psychosocial investigation before deciding how to interpret the episode is stressed. A high risk group of children, in whom the drunkenness is to be looked upon as a warning signal of developing alcoholism, is described. Increased co-operation between the Department of Paediatrics and of Child and Youth Psychiatry, Social Welfare Authorities and School Health Care regarding the treatment of these children is recommended. PMID- 3285636 TI - Glucose tolerance and insulin receptor binding to monocytes and erythrocytes in patients with cystic fibrosis. AB - Cystic fibrosis (CF) is the most frequent life threatening hereditary disease in the Western World with an incidence of approximately 1:2000. Due to increasing survival rates the high frequency of abnormal glucose tolerance has become an important problem. We compared insulin concentrations during oral glucose tolerance test and insulin receptor binding to both monocytes and erythrocytes from 9 patients with CF, with results from 10 healthy controls of similar body weight. The insulin: glucose ratio was increased in the fasting state (p less than 0.05) in patients with CF compared to controls, indicating an increased insulin resistance in CF-patients. The total insulin secretion during oral glucose tolerance test as judged by the area beneath the insulin curve was similar in the two groups, but insulin secretion was significantly delayed in patients with CF. Insulin receptor binding to monocytes and the number of receptors were significantly increased (p less than 0.01 and 0.02, respectively) in patients with CF whereas the dissociation constant was similar in patients with CF and controls. No difference was observed in insulin receptor binding to erythrocytes between the two groups. No correlations were found between insulin receptor binding to monocytes or erythrocytes and glucose tolerance or insulin concentrations. PMID- 3285637 TI - Double blind study on the need for vitamin D supplementation in prepubertal children. AB - Fifty-one healthy prepubertal schoolchildren were followed for 13 months in a double blind study. Twenty-four of them were supplemented with 400 IU of vitamin D2 5-7 times weekly, while 27 received a placebo. The children were examined in winter both at the beginning and at the end of the study, and in the middle of the study in autumn. Mean 25-hydroxyvitamin D levels in the supplemented group were significantly higher than those in the placebo group both in autumn and in winter, when the study ended. The vitamin D supplementation did not, however, affect other vitamin D metabolites, serum calcium, albumin, inorganic phosphorus, parathyroid hormone concentrations or alkaline phosphatase activity. Moreover, the supplementation caused no alterations in the weight or height gain or bone mineral content of the distal radius of the children, and thus subclinical rickets could not be shown. PMID- 3285638 TI - A randomized double-blind, placebo-controlled trial of dexamethasone and racemic epinephrine in the treatment of croup. AB - Seventy-two children hospitalized for croup received on admission a single dose of either 0.6 mg/kg dexamethasone or an equivalent placebo intramuscularly from randomized ampules; subsequently the same patients were randomized to receive either nebulized racemic epinephrine or saline by intermittent positive pressure breathing. Of the four treatment groups those receiving a placebo injection and nebulized saline had the slowest recovery by all criteria. Dexamethasone and nebulized epinephrine reduced the symptoms and hastened recovery, but dexamethasone was more effective by clinical evaluation at 6 and 12 hours post admission. The patients given dexamethasone had a significantly shorter hospital stay than those receiving placebo. We conclude that a single injection of a potent corticosteroid is beneficial in acute spasmodic croup. Nebulized racemic epinephrine given with an appropriate device is also effective, but the effect of epinephrine is less remarkable in patients treated with dexamethasone. PMID- 3285639 TI - Diet and cancer. Review of the literature. PMID- 3285640 TI - Dental aspects of an elderly population. AB - A study of 414 elderly residents of sheltered accommodation in West Essex investigated the degree to which health, physical handicap and support from community care services affected dental needs and utilization of dental services. The study population had a mean age of 77 years, 77% lived alone, 17% were housebound and 37% relied heavily on the home help service. The majority of subjects were edentulous (78%) and prosthetic treatment was the main requirement. Despite the high normative need for dental treatment (75%), only 22% of subjects perceived any such need. Only 3% claimed to have any difficulties in obtaining dental treatment and utilization of dental services was associated with positive attitudes towards dental health. The presence of oral handicaps was a realistic indicator of treatment needs and could be identified by the primary health team. PMID- 3285641 TI - An assessment of methacholine inhalation tests in elderly asthmatics. AB - We have assessed the feasibility and value of measuring nonspecific bronchial responsiveness to methacholine in investigation of asthma in the elderly. Results from duplicated tests in 20 subjects aged 65-82 years were expressed as dose provoking a 20% decrement in 1 second forced expiratory volume (PD20.FEV1) or peak expiratory flow (PD20.PEF). Repeatability for PD20.FEV1 was satisfactory but less good than in younger subjects, 95% confidence limits being 0.39-2.57 and 0.52-1.91, respectively, x initial PD20. For PD20.PEF, confidence limits were wider (0.26-3.91 x initial PD20) but multiple PEF measurements were better tolerated than those of FEV1, which commonly caused fatigue and dizziness. PD20.FEV1 and PD20.PEF correlated closely (r = 0.95, P less than 0.0001) and both predicted bronchodilatation following a 6-week course of inhaled corticosteroid and beta agonist. This was not predicted by the response to a single dose of beta agonist. We conclude that measurement of bronchial responsiveness is feasible and clinically valuable in elderly subjects. PMID- 3285642 TI - Nascher writes about geriatrics. PMID- 3285643 TI - Idiopathic hypertrophic subaortic stenosis. By Irwin M. Freundlich, J. Thomas McMurray, J. Stauffer Lehman, 1967. AB - In patients with a systolic ejection murmur and without a history of rheumatic fever, a probable diagnosis of idiopathic hypertrophic subaortic stenosis (IHSS) can be made from the roentgenologic findings. Left ventricular enlargement, associated at times with minimal left atrial enlargement, without intracardiac calcification and with a normal ascending aorta are the most frequent roentgen findings. For a positive diagnosis, a pressure gradient within the left ventricle and hypertrophic muscular obstruction should be demonstrated by angiocardiography. PMID- 3285644 TI - Hypertrophic cardiomyopathy: changing concepts over the last two decades. PMID- 3285645 TI - Spine imaging: history, achievements, remaining frontiers. PMID- 3285646 TI - Gallstone ESWL--the first 175 patients. PMID- 3285647 TI - Digital radiography of the chest: promises and problems [publihsed erratum appears in AJR 1988 Sep;151(3):preceding 641]. PMID- 3285648 TI - Evaluation of the musculoskeletal system with sonography. AB - Although musculoskeletal sonography historically has received little attention, its use in certain specific situations has clear advantages over use of other imaging techniques. The wide availability of sonography, its modest cost, and its lack of ionizing radiation are other reasons that its use in musculoskeletal conditions is expected to increase. We have reviewed potential applications; some of these applications are new and have been used in a small series of patients, and others, such as infant hip sonography, have already been used in thousands of cases. Additional applications may be possible [64]. Those learning the techniques of musculoskeletal sonography will find that progress is made most quickly when there is close cooperation between the sonographer and the clinician. While experience is being gained, each party must endeavor to understand what the technique is able to determine and what it cannot determine. Only through close cooperation, and with adequate opportunity to learn, will the sonographer and the clinician develop confidence in the technique to the point that it becomes the effective imaging alternative that best suits the needs of the patient. PMID- 3285649 TI - Balloon-expandable intravascular stent. PMID- 3285650 TI - Imaging of vascular complications after hepatic transplantation. AB - Vascular complications after hepatic transplantation can compromise graft and patient survival. Angiography defines the need for revascularization or retransplantation, but the value of noninvasive imaging in this setting is not clear. To assess the relative merit of noninvasive imaging techniques (sonography, scintigraphy, CT, and MR), we retrospectively reviewed 19 major vascular complications that occurred in 15 of 98 hepatic recipients over a 3 1/2 year period. Portal venous thrombosis was seen in seven patients, donor aortic or hepatic arterial thrombosis in seven, and inferior vena caval thrombosis in five. Sonography provided the initial diagnosis of portal venous thrombosis in three, arterial compromise in five, and caval obstruction in four. CT was the first diagnostic examination to identify portal occlusion in two, donor aortic thrombosis in one, and inferior vena caval thrombosis in one. Scintigraphy and MR imaging provided complementary data. Both sonography and CT are useful in the evaluation of vascular complications that occur after hepatic transplantation; however, neither is sufficiently sensitive to obviate angiographic assessment. PMID- 3285651 TI - Renal involvement in AIDS: sonographic-pathologic correlation. AB - Renal sonography was performed in 36 patients with clinical and/or laboratory evidence of AIDS, usually because of deteriorating renal function. In 15 patients, histopathologic specimens were reviewed to characterize renal pathologic changes underlying the sonographic findings. Sonographic evaluation included determination of renal size and cortical echogenicity according to a standard grading system. Pathologic specimens were evaluated for tubular and glomerular abnormalities. Sonography showed either normal-sized or enlarged kidneys with grade I cortical echogenicity in 13 patients (36%), grade II in three patients (8%), and grade III in five patients (14%). Fifteen patients (42%) had normal renal echogenicity. In addition to focal segmental glomerulosclerosis the pathologic examination showed different degrees of tubular abnormalities. Striking, irregularly dilated, infolded tubules with flattened epithelium and intratubular deposits of proteinaceous material, and sometimes cystlike formation involving the medulla and cortex, were seen in two patients with grade III kidneys, and mild dilatation of the tubules was seen in four patients with grade I disease. Moderate tubular dilatation was observed in one patient with grade I disease. No significant tubular abnormality was seen in one patient with grade I disease or in seven patients with normal renal echogenicity. Although glomerular changes contribute to the increase in renal echogenicity, we postulate that the main factors responsible for the increased echogenicity in AIDS nephropathy are the striking tubular abnormalities seen in these patients. PMID- 3285652 TI - CT diagnosis of uterine lipoma. PMID- 3285653 TI - Placental abruption associated with cocaine abuse. PMID- 3285654 TI - Sonographic findings in infants with macrocrania. AB - This study compares the sonographic and CT findings in a group of infants with macrocrania and correlates those findings with neurologic outcome to determine the diagnostic accuracy and prognostic value of sonography. Sonographic findings in 255 infants with macrocrania are described. Of the 195 term infants examined, 130 had normal sonograms, 11 (5.6%) had significant abnormalities, and 54 had increased intra- and/or extraaxial fluid spaces. Of the 60 former preterm infants, 33 had normal sonograms, four (6.7%) had significant abnormalities, and 23 had increased fluid spaces or small resolving germinal matrix hemorrhages. The patients with significant abnormalities usually had head circumferences greater than the 95th percentile and had neurologic abnormalities. There was good correlation between sonography and CT in 30 of the 36 patients evaluated by both. In six there was mild discrepancy in the volume of the extraaxial fluid. No significant abnormality was missed by sonography. CT did not contribute any additional information. Neurologic follow-up was available for 202 patients. Nineteen percent of the term infants and 24% of the former preterm infants were abnormal on neurologic follow-up. Most patients with normal sonograms were normal on follow-up. Twelve of the term and four of the preterm infants with normal sonograms were developmentally delayed on follow-up. Increased CSF in the ventricles and/or extraaxial spaces was a common abnormality, but it usually is associated with a normal neurologic outcome and represents "benign macrocrania." We conclude that an infant with an enlarged or enlarging head should have a neurologic examination and head circumference measurement. If the patient has a head circumference greater than the 95th percentile, particularly if there are abnormal neurologic findings, further evaluation is indicated. Sonography is the initial procedure recommended since it accurately evaluates ventricular size, extraaxial fluid, and congenital malformations. If sonography is normal or shows mildly increased fluid spaces, then follow-up head circumference measurement and clinical evaluation will probably suffice. CT is indicated if there is a significant abnormality on sonography that requires further clarification. PMID- 3285655 TI - Sonographic diagnosis of hypertrophic pyloric stenosis. AB - In many pediatric centers, sonography has become the primary imaging method for the diagnosis of hypertrophic pyloric stenosis, but investigators have disagreed about which dimension of the gastric outlet is most useful and accurate. We analyzed 326 consecutive sonograms in 319 infants who presented with vomiting in order to further evaluate the sonographic criteria for the diagnosis of hypertrophic pyloric stenosis. Four observers retrospectively measured three parameters: (1) the thickness of the muscle in the wall of the gastric outlet, (2) the length of that muscle, and (3) the length of the pyloric channel. In the patients with hypertrophic pyloric stenosis, muscle thickness was 4.8 +/- 0.6 mm, muscle length was 2.1 +/- 0.3 cm, and channel length was 1.8 +/- 0.3 cm. In the patients without hypertrophic pyloric stenosis, muscle thickness was 1.8 +/- 0.4 mm, muscle length was 1.3 +/- 0.3 cm, and channel length was 1.1 +/- 0.3 cm. The mean measurement for each parameter was significantly larger in patients who had hypertrophic pyloric stenosis than in those who did not (p less than .01). However, histograms of the three parameters show significant overlap in the measurements of muscle length and channel length between the patients with and those without hypertrophic pyloric stenosis. The thickness of the muscle is the most discriminating and accurate criterion for hypertrophic pyloric stenosis. PMID- 3285656 TI - Drug therapy for hyperlipidemia. PMID- 3285657 TI - Skin cancers: detection, prevention, and therapeutics. PMID- 3285658 TI - Current concepts in tuberculosis. Part I. PMID- 3285659 TI - Transitional cells at the junction of seminiferous tubules with the rete testis of the rat: their fine structure, endocytic activity, and basement membrane. AB - Transitional cells line the intermediate region of rat seminiferous tubules situated between the rete testis and the seminiferous epithelium proper. These tall elongated cells orient themselves in a downstream direction and converge on one another distally in the lumen of the rete testis where they form a distinct papillalike structure through which a narrow patent lumen is apparent. In addition to widely dispersed Golgi apparatus and mitochondria, these cells contain an abundance of microtubules, cisternae of endoplasmic reticulum, and a distinct lobulated nucleus showing clumps of chromatin and a prominent nucleolus. The endocytic activity of these cells was examined by employing adsorptive (cationic ferritin, concanavalin A ferritin) and fluid-phase tracers (native ferritin, horseradish peroxidase-colloidal gold complex, and concanavalin A ferritin in presence of alpha methyl-D-mannoside). Such tracers were injected separately into the lumen of the rete testis, and the animals were killed at 2, 5, 15, and 30 min and 1, 2, and 6 hr after injection. At 2 min, both adsorptive and fluid-phase tracers were found within coated and uncoated pits of the apical plasma membrane of these cells as well as in large, subsurface, uncoated spherical, C-shaped, and tubular membranous elements. At 5 min the tracers were seen in endosomes of different sizes; while at 15 min and 30 min, pale and dense multivesicular bodies of small and large sizes, respectively, were labeled. At 1 hr and longer time intervals secondary lysosomes became labeled. While both fluid phase and adsorptive tracers followed the same pathway and fate, binding to the apical and lateral plasma membranes of the transitional cells and to the membrane delimiting coated and uncoated pits was observed only with the adsorptive tracers. These results demonstrate that the transitional cells are actively involved in both fluid-phase and adsorptive endocytosis, which may play an important role in modifying the composition of the luminal fluid. The transitional cells of the distal zone of the intermediate region rest on an elaborate basement membrane (BM) complex which includes a thin BM immediately underlying these cells, a thick distal layer of BM, and strands of BM spanning the distance between the two in the form of a loose anastomotic network. Use of antisera against heparan sulfate proteoglycan, laminin, and type IV collagen revealed the presence of all three components within all areas of the BM complex. In the meshes of the anastomotic BM network, extracellular vesicles were observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3285660 TI - Evaluation of two commercial tests for human immunodeficiency virus antigens in culture supernatant fluid. AB - Two commercial enzyme-linked immunosorbent assays (EIAs) for human immunodeficiency virus (HIV) antigens were evaluated for sensitivity and reproducibility by use of supernatant fluid from cell cultures of peripheral mononuclear cells of 18 patients with acquired immunodeficiency syndrome (AIDS) and 12 asymptomatic HIV antibody-positive patients. Both commercial assays detected HIV antigen in all cultures by day 21; however, the Abbott HIV antigen EIA (Abbott Laboratories, North Chicago, IL) detected HIV antigen three to seven days earlier in 15 of 48 cultures (31%), on the same day in 32 cultures (67%), and three days later in 1 culture (2%) when compared with the DuPont HIV antigen EIA (DuPont Laboratories, Wilmington, DE). In serial twofold dilution experiments, the Abbott HIV Ag EIA was found to have at least a twofold to eightfold increased sensitivity over the DuPont assay. Repeat testing of 15 initially positive supernatant fluids by both assays revealed that 13 of 15 and 12 of 15 were consistently positive by the Abbott and DuPont assays, respectively. The authors conclude that the Abbott EIA demonstrated better performance in this study than the DuPont EIA for detection of HIV in cell culture because of its shorter time-to-positivity and greater sensitivity. PMID- 3285661 TI - Evaluation of the IDS RapID SS/u system for rapid identification of urinary microorganisms. AB - The accuracy of a new rapid identification system for common urinary pathogens was compared with that of conventional methods and of miniaturized 18-24-hour identification panels. The rapid system, RapID SS/u (Innovative Diagnostic System Inc., Atlanta, GA) is a non-growth-dependent micro-method that identifies selected gram-negative bacilli, gram-positive cocci, and yeasts in two hours by detection of constitutive enzymes acting on chromogenic substrates. A total of 185 representative clinical urinary isolates were tested, including 24 gram positive cocci, 140 gram-negative bacilli, and 21 yeasts. Identifications by the rapid system were compared with the ones obtained by reference conventional methods for gram-positive cocci and yeasts. For gram-negative bacilli, identifications were compared with the ones obtained by MicroScan Combo Panel (American MicroScan, Mahwah, NJ), and all discrepancies were resolved by testing with API 20E (Analytab Products, Plainview, NY). Overall, the RapID SS/u system correctly identified to genus 160 of 185 isolates (86.5%). For 14 additional isolates (7.6%) the system provided probability overlap identifications that required further testing. Two (1%) isolates failed to be identified, and nine isolates (4.9%) were misidentified by the system. Discrepancies involved five strains of Citrobacter, one Enterobacter, one Morganella, and one Providencia species. The authors conclude that the RapID SS/u system provided rapid and accurate genus identification of most microorganisms commonly isolated from urine. PMID- 3285662 TI - Association of supernumerary nipples and renal anomalies. PMID- 3285663 TI - Fatal pepper aspiration. AB - Eight patients (five previously undescribed) died due to aspiration of pepper. Seven deaths involved homicides, and one death was accidental in a child with documented pica. The pepper was administered by the mothers in three children and by a foster mother, the mother's boyfriend, an adult male friend, and the child's godfather in one case each. Homicidal pepper aspiration shares many of the features of more conventional child abuse: in each instance, the child was being punished, four of the seven assailants initially gave incorrect histories, and four children were chronically abused. The facts that each death occurred in a different state and that five of the seven homicides occurred within the two years preceding the preparation of this report suggest that this form of child abuse is not confined to any single part of the country and may be increasing in infrequency. PMID- 3285664 TI - Radiological case of the month. Klebsiella multifocal osteomyelitis. PMID- 3285665 TI - Mammographic parenchymal pattern and breast cancer risk: a critical appraisal of the evidence. PMID- 3285666 TI - Control selection with incomplete case ascertainment. PMID- 3285667 TI - Random donor platelet crossmatching: comparison of four platelet antibody detection methods. AB - The standard lymphocytotoxicity assay (LCT), a biotin-avidin enzyme immunoassay (ELISA), platelet suspension immunofluorescence test (PSIFT), and platelet radioactive antiglobulin test (PRAT) were examined in prospective crossmatching for selection of compatible random donor platelets for refractory patients. One hundred seven episodes of pooled random donor platelet transfusions were evaluated in 26 patients. There was good reproducibility of results by individual techniques. Concordance of results by the different methods was 40-60%. One-hour and 24 hr posttransfusion corrected count increments (CCI) were compared as parameters for assessing success or failure of the transfusion. Using a rank scoring system, the relative efficiency of predictiveness for all transfusions was PRAT greater than LCT greater than PSIFT greater than ELISA. Combination of PRAT and LCT afforded the best predictability and sensitivity was higher than for either PRAT or LCT alone (93 vs. 79 and 62%, respectively). Mean posttransfusion CCI (x 10(9)/L) following PRAT-compatible platelets was 13.9 +/- 12.7 at 1 hr and 7.3 +/- 6.9 at 24 hr; following PRAT-incompatible platelets, 5.7 +/- 7.8 (1 hr) and 2.1 +/- 4.1 (24 hr). Results were similar for LCT-tested platelets. A radioimmunofiltration modification of the PRAT developed and used in selected cases was simple, fast, efficient, and inexpensive. The study indicated that the techniques evaluated are practical and feasible for routine use in the provision of compatible random donor platelets to the refractory patient who has no other cause for increased platelet destruction. PMID- 3285668 TI - Renal osteodystrophy: some new questions on an old disorder. AB - The two major lesions of renal osteodystrophy are osteitis fibrosa cystica (OFC) and osteomalacia (OM). OFC is the characteristic bone lesion of uremic hyperparathyroidism. Although renal failure causes predictable parathyroid hyperplasia, the precise pathogenetic mechanism is still not defined. The "hyperphosphatemia-hypocalcemia-parathyroid hormone (PTH) hypersecretion" sequence of events is no longer an adequate model for the pathogenesis of uremic hyperparathyroidism. Other abnormalities associated with uremia include reduced 1,25-dihydroxyvitamin D (1,25D) synthesis, changes in intracellular phosphorus content or transcellular phosphate fluxes, or alteration in PTH metabolism, eg, change in set-point for PTH secretion. Each abnormality interacts with others and contributes to PTH hypersecretion, but none can completely account for the development and persistence of hyperparathyroidism in renal failure. The possibility that uremia may directly cause parathyroid hyperplasia remains open. It is also possible that factor(s) that initiate hyperparathyroidism may turn out to be quite different from that which sustains the hyperparathyroid state. Although both vitamin D-deficient and vitamin D-resistant OM may develop in patients with renal failure, the majority of uremic OM seen currently is "vitamin D-refractory." Although now there is persuasive evidence implicating aluminum (Al) accumulation as the major pathogenetic cause for the mineralization defect seen in this disorder, additional disturbances may play important contributory roles. Such factors would include extraskeletal effects of Al, differences in host-susceptibility to this element, the localization of Al within bone, uremia per se, and the participation of other metals and toxins. Finally, possible interactions between hyperparathyroidism and OM of uremia are speculated on. PMID- 3285669 TI - False-positive results of screening for antibodies to human immunodeficiency virus in chronic hemodialysis patients. AB - Eighty-three chronic hemodialysis patients were tested for human immunodeficiency virus (HIV) infection. Testing included screening enzyme immunoassay (EIA) for HIV antibodies, competitive EIA for envelope and core antibodies, EIA for HIV antigen, and lymphocyte culture. Five (6%) of the patients had positive screening EIA at low reactivity. Four of these five had antibodies to H-9 cellular antigens. Comparison of the five seropositive patients to matched controls showed no significant differences in number of lymphocytes or helper/suppressor ratio. Six months later, the five patients had negative screening EIA results using a kit with a manufacturing change approved by the Food and Drug Administration that provided improved specificity. In addition, their Western blot analysis was negative. We conclude that (1) false-positive screening EIA results are more common in chronic hemodialysis patients than other populations; (2) evaluation of chronic hemodialysis patients for HIV infection requires confirmatory tests; and (3) newer EIA screening kits appear to have improved specificity. PMID- 3285670 TI - Determination of acquired immunodeficiency syndrome (AIDS) after renal transplantation. AB - Diagnosing the acquired immunodeficiency syndrome (AIDS) in transplant recipients can be difficult due to the patient's medication-induced immunosuppressed state. We report two renal allograft recipients who acquired HIV infection at the time of transplantation and later went on to develop multiple opportunistic infections. Careful documentation of HIV antibody status of the donor and recipient, when available, the nature of immunosuppressive therapy used, the type of infections and their timing after transplantation, as well as the patient's absolute T4 lymphocyte count, T cell ratio, and B cell humoral response to infection were used as factors to distinguish between infection related to immunosuppressive therapy and that seen in HIV-induced immunodeficiency. Reduction in immunosuppressive therapy because of the HIV-related immunodeficiency state did not result in allograft rejection. Both patients died of their multiple infections. The determination of AIDS in the transplant recipient has both therapeutic and prognostic significance. This diagnosis should be considered when transplant patients develop unusual infections in relationship to their posttransplant course. PMID- 3285671 TI - Cryptococcal peritonitis in patients on peritoneal dialysis. AB - Peritonitis is an unusual complication of infections caused by Cryptococcus neoformans and has rarely been reported in patients with end-stage renal disease who are maintained on peritoneal dialysis. We report two patients on chronic peritoneal dialysis in whom the first known manifestation of cryptococcal infection was dialysate cultures positive for Cryptococcus neoformans. One patient was on prednisone for systemic lupus erythematosis. The other patient was severely malnourished with type I diabetes mellitus. Both patients were found to have cryptococcal meningitis. Both patients were treated with intravenous (IV) amphotericin B and removal of the dialysis catheter. Evaluation and care of peritoneal dialysis patients with cryptococcal peritonitis include serial cryptococcal cultures and antigen titers, investigation for cryptococcal meningitis, removal of the peritoneal dialysis catheter, and IV amphotericin B. PMID- 3285672 TI - Economic aspects of clinical decision making: applications of clinical decision analysis. AB - Clinical decision analysis as a basic tool for decision making is described, and potential applications of decision analysis in six areas of clinical practice are identified. Clinical decision analysis is a systematic method of describing clinical problems in a quantitative fashion, identifying possible courses of action, assessing the probability and value of outcomes, and then making a calculation to select the ultimate course of action. Clinical decision analysis provides a structure for clinical decision problems, helps clarify medical controversies, and encourages decision makers to speak a common language. Applications of clinical decision analysis in the areas of diagnostic testing, patient management, product and program selection, research and education, patient preferences, and health-care-policy evaluation are described. Decision analysis offers health professionals a tool for making quantifiable, cost effective clinical decisions, especially in terms of clinical outcomes. PMID- 3285673 TI - Formulary evaluation of third-generation cephalosporins using decision analysis. AB - A structured, objective approach to formulary review of third-generation cephalosporins using the decision-analysis model is described. The pharmacy and therapeutics (P&T) committee approved the evaluation criteria for this drug class and assigned priority weights (as percentages of 100) to those drug characteristics deemed most important. Clinical data (spectrum of activity, pharmacokinetics, adverse effects, and stability) and financial data (cost of acquisition and cost of therapy per day) were used to determine ranking scores for each drug. Total scores were determined by multiplying ranking scores by the assigned priority weights for the criteria. The two highest-scoring drugs were selected for inclusion in the formulary. By this decision-analysis process, the P&T committee recommended that all current third-generation cephalosporins (cefotaxime, cefoperazone, and moxalactam) be removed from the institutions's formulary and be replaced with ceftazidime and ceftriaxone. P&T committees at other institutions may structure their criteria differently, and different recommendations may result. Using decision analysis for formulary review may promote rational drug therapy and achieve cost savings. PMID- 3285674 TI - Interdisciplinary committee on infusion-control devices: managing product use. AB - The development of an interdisciplinary approach to the management of infusion control devices (ICDs) in a university teaching hospital is described. An ICD committee composed of staff from the pharmacy, nursing, bioinstrumentation, and materiel management departments was created to identify and solve problems with the existing system of ICD management. These problems included untimely delivery of malfunctioning ICDs to the bioinstrumentation department for repairs, chronic shortages of ICDs, inappropriate use of these devices, and lost charges for ICDs and cassettes. The committee decided on joint control of the ICD program by the pharmacy and nursing departments. Guidelines for appropriate use of ICDs were developed and distributed to all nursing units and pharmacy satellites. The pharmacist was responsible for screening requests for ICDs to determine whether they conformed to those guidelines. New policies for delivery of malfunctioning ICDs to the bioinstrumentation department resulted in improved turnaround time for repairs. Responsibility for billing was shared by the pharmacy and nursing departments. These changes resulted in increased availability of ICDs for patient use and an increased charge capture of $247,000 per year. Through the combined efforts of the pharmacy and nursing departments in this institution, the distribution and collection of ICDs has been made more efficient and lost patient charges have decreased. PMID- 3285675 TI - Use of bibliographic, abstracting, and computer resources in drug information centers. PMID- 3285676 TI - Brief review of the literature on decentralized drug distribution in hospitals. AB - Literature pertaining to decentralization of drug distribution in hospitals since 1972 is reviewed. A chronological list of the articles cited, as well as information on the type of decentralization and outcomes in each article, was compiled. Advantages of decentralization reported in the literature include allowance for expansion of clinical services, more-efficient medication handling, improved communication between pharmacists and medical and nursing staff, decreased floor stock, and decreased medication-related nursing time. Some studies reported that the system minimally increased costs. Although the literature reviewed confirms that decentralization improves the quality of pharmaceutical services, more evidence of cost-effectiveness is needed. PMID- 3285677 TI - Detection of glomerular sialic acids in patients with diabetic nephropathy. AB - A study on immunofluorescence of sialic acids in glomeruli from patients with diabetic nephropathy is described. Measurement of sialic acid in sera from 25 patients with diabetes mellitus was also performed. Renal biopsy specimens from 12 patients with diabetic nephropathy were stained with FITC-labeled antihuman IgG antiserum and rhodamine-labeled Triticum vulgaris (WGA) or Limulus polyphemus (LPA). These specimens were also stained with such reagents after treatment with neuraminidase, trypsin or citrate buffer. Both deposition of IgG and binding of WGA in the glomerular capillary walls were observed in all patients with diabetic nephropathy. The binding of WGA in the glomerular capillary walls in diabetic nephropathy was significantly increased compared with that in four normal renal tissues. However, the binding of LPA was hardly observed in the glomerular capillary walls of patients with diabetic nephropathy. The binding of WGA in the glomeruli was markedly decreased after treatment with neuraminidase although it was hardly decreased after treatment with trypsin or citrate buffer. The levels of sialic acid in sera from patients with diabetic nephropathy were markedly increased. It is suggested that accumulated substances in the glomerular capillary walls with an affinity for WGA are mainly composed of N-acetyl glucosamine and/or N-acetyl neuraminic acid in patients with diabetic nephropathy. PMID- 3285678 TI - The utility of cytodiagnostic urinalysis for monitoring renal allograft injury. A clinicopathological analysis of 87 patients and over 1,000 urine specimens. AB - Cytodiagnostic urinalysis was tested to determine its utility in the evaluation of allograft dysfunction in renal transplant patients. Specimens were prepared using the Papanicolaou stain on cytocentrifuge preparations of standardized quantities of urine. Differential counts of blood cells (neutrophils, lymphocytes, red cells), renal tubule cells (convoluted, collecting duct, necrotic), and casts (i.e. hemoglobin, renal tubule cell) were included in the sediment evaluation. Receiver operating characteristic curves demonstrated collecting duct cell exfoliation at 20 per 10 hpf to be a more sensitive and specific reflector of acute rejection than lymphocytes at their optimum decision point of 13 per 10 hpf. Sixty-four percent of cytodiagnostic urinalysis diagnoses preceded the clinical diagnoses. Ciclosporin nephrotoxicity was differentiated by the exfoliation of renal tubule convoluted cells in excess of collecting duct cells. The advantages of this technique over membrane-filter or phase-microscopic techniques for examining urine sediment of both transplant and nephrology patients include improved sensitivity and specificity in identification of sediment elements and reliable quantitative data for use in detecting renal disease and for monitoring therapy. PMID- 3285679 TI - Noninvasive diagnosis of renal vein thrombosis by digital subtraction venography. AB - The definitive diagnosis of renal vein thrombosis (RVT) depends upon the demonstration of a persistent filling defect or defects within the renal vein by renal venography or selective renal angiography during the venous phase. We describe here the utilization of digital subtraction venography to diagnose RVT in a young nephrotic male patient. We injected 40 cm3 of contrast substance in a foot vein, having 4-second delayed films over the inferior vena cava and renal veins. We demonstrated a retrograde propagation of the dye into the right renal vein indicating intrarenal venous thrombosis. 'Renal vein thrombosis and digital venography'. PMID- 3285680 TI - Renal dysfunction and microangiopathic changes in a renal transplant patient. PMID- 3285681 TI - Rapid immunofluorescence by microwave incubation. PMID- 3285682 TI - The technique of transvaginal sonography with the use of a 6.5 MHz probe. AB - Ultrasonography has become an important tool in infertility and obstetric practice. Its use in gynecology, while effective, has been less. This article describes the use of a high-frequency 6.5 MHz probe specially designed for intravaginal use. The technique is presented, along with a description of its uses and findings by organ. Patient acceptance has been universal. Its high resolution makes this technique more useful in general gynecologic practice. PMID- 3285683 TI - Subnormal cerebellum in fetuses with spina bifida. AB - The results of a prospective ultrasound study of the posterior fossa structures in 19 fetuses with spina bifida are reported. The transverse cerebellar diameter is below the normal limits and the cisterna magna is obliterated in all cases. Decreased cerebellar size and failure to visualize the cerebellum appear to be specific findings for spina bifida since they are not present in a group of 17 fetuses with isolated hydrocephalus. The results of this study indicate that ultrasound investigation of the posterior fossa may prove useful in the prenatal diagnosis of spina bifida. PMID- 3285684 TI - The role of CA 125 in the evaluation of palpable or enlarged postmenopausal ovaries. AB - A serum CA 125 assay provided a method of more accurately identifying a postmenopausal woman at high risk for ovarian cancer when a screening ultrasound examination revealed a 2 X 3 cm ovary that could not be detected by palpation. PMID- 3285685 TI - Efficacy of the fetal-pelvic index for delivery of neonates weighing 4000 grams or greater: a preliminary report. AB - The fetal-pelvic index was recently introduced as an accurate method of prospectively identifying the presence or absence of fetal-pelvic disproportion. In that report the ability to detect fetal-pelvic disproportion in patients with macrosomic fetuses was not specifically addressed. The objective of this study is to compare the efficacy of three methods used to identify the presence or absence of fetal-pelvic disproportion (the fetal-pelvic index, Colcher-Sussman x-ray pelvimetry, and estimated fetal weight greater than or equal to 4000 gm) in patients delivered of neonates weighing greater than or equal to 4000 gm after an adequate trial of labor (N = 34). Of the 18 patients requiring operative intervention, all but one had a positive fetal-pelvic index value (sensitivity = 94%). Of the 16 patients in whom vaginal deliveries were spontaneous, all but one had a negative value (specificity = 94%). On the basis of these data, the fetal pelvic index is an accurate method of predicting the presence or absence of fetal pelvic disproportion in patients delivered of neonates weighing greater than or equal to 4000 gm. PMID- 3285686 TI - Prognostic components of computerized fetal biophysical testing. AB - Fetal biophysical testing with arbitrary scores for fetal heart rate (FHR), breathing movements, body movements, tone, and amniotic fluid volume has not proved to be highly sensitive or significantly better than FHR testing alone. Using a computerized analysis system for simultaneously acquired biophysical variables, we studied 200 high-risk fetuses near term. The dynamic parameters obtained for each fetus were compared with established nomograms, and overall test results correlated with the presence or absence of perinatal mortality, fetal distress, a 5-minute Apgar score less than 7, and intrauterine growth retardation for those delivered within 7 days of the last test. A test was considered abnormal if two or more parameters fell more than 2 standard deviations from the population mean. A decreased incidence of fetal body movements, amniotic fluid volume, and frequency of FHR acceleration were the most common individual test abnormalities. Test sensitivity (86%), specificity (89%), positive predictive value (75%), and negative predictive value (93%) exceeded those of the "standard" scoring approach and correctly identified all fetuses with malformation, perinatal death, and 19 of 22 fetuses with intrauterine growth retardation. PMID- 3285687 TI - Sonographic estimation of fetal weight and Doppler analysis of umbilical artery velocimetry in the prediction of intrauterine growth retardation: a prospective study. AB - A prospective study was undertaken to examine whether Doppler velocimetry studies of the umbilical artery give a better or an earlier prediction of intrauterine growth retardation (IUGR) than do sonographic estimation of fetal weight. A total of 385 examinations were performed between 30 and 42 weeks of gestation on 168 patients who were at risk for IUGR. Forty-two (25%) of the patients delivered an infant with a birth weight below the tenth percentile. Although sensitivity was lower for the systolic to diastolic ratio (55%) of the umbilical artery than for the sonographic estimation of fetal weight (76%), the umbilical artery studies had a higher specificity (92% versus 80%) and predictive value of a positive test (73% versus 58%) when the last study to delivery interval was within 2 weeks. Furthermore, among 21 IUGR pregnancies with serial studies, the umbilical systolic to diastolic ratio was abnormal at a significantly earlier gestational age than when the sonographic estimate of fetal weight identified growth retardation. These findings indicate that sonographic biometry is a more sensitive technique for identifying IUGR but that the umbilical artery waveforms are a valuable adjunct for improving the diagnostic accuracy for the prenatal detection of IUGR. These data also provide suggestive evidence that umbilical artery velocimetry may be predictive of IUGR at an earlier gestational age than sonographic estimation of fetal weight. PMID- 3285688 TI - Fetal thoracic circumference: a prospective cross-sectional study with real-time ultrasound. AB - We report a prospective cross-sectional study of ultrasound fetal chest growth during normal pregnancy. The fetal chest circumference was measured in 100 normal pregnancies from 13 to 41 weeks' gestation. Nomograms of chest circumference versus gestational age and femur length were constructed. Data from 18 cases at risk for pulmonary hypoplasia indicated that the fetal chest circumference measurement may be useful in the antenatal prediction of lethal or clinically severe pulmonary hypoplasia. PMID- 3285689 TI - Spontaneous abortion in patients with insulin-dependent diabetes mellitus: the effect of preconceptional diabetic control. AB - Fifty-nine of 94 pregnant women with juvenile-onset insulin-dependent diabetes who attended a preconceptional clinic were periodically examined by a diabetologic team. Glycemic control was obtained by intensified insulin therapy and monitored by blood glucose self-monitoring. These women were compared with the 35 pregnant women who did not receive preconceptual glycemic control. The initial glucose and maternal hemoglobin A1 values of the latter group experiencing spontaneous abortions were significantly higher (p less than 0.001) when compared with women receiving preconceptional diabetologic counseling whose pregnancies continued beyond 22 weeks' gestation. The frequency of spontaneous abortions among patients not seen before pregnancy was significantly higher (p less than 0.001), in contrast to attending women, whose rate represented the normal rate in the general population. We confirm the evidence accumulated in the recent literature that poor metabolic control around conception and in the early weeks of pregnancy may be the determining factor favoring abortion. PMID- 3285690 TI - Effects of pregnancy and fasting on muscle glucose utilization in the rabbit. AB - The effects of fasting on maternal glucose metabolism were investigated in nonpregnant and 29-day pregnant conscious rabbits. Pregnancy decreased the glucose metabolic index by 60% in maternal red postural muscles. Fasting induced similar modifications in nonpregnant rabbits and exaggerated the changes observed in fed pregnant animals. These data suggest that the decreased glucose utilization by maternal red muscles observed during pregnancy and fasting is related to the increase in circulating fat-derived substrates, because the fall in plasma insulin concentration is a specific adaptation to fasting. PMID- 3285691 TI - Sonographic findings of dense amniotic fluid. PMID- 3285692 TI - Narrow-band filtering for monitoring low-amplitude cone electroretinograms in retinitis pigmentosa. AB - Low amplitude (less than 10 microV) cone electroretinograms, elicited with 30-Hz white flicker from 59 patients with retinitis pigmentosa, were computer-averaged alone or in combination with a narrow-band electronic filter that increases the signal to noise ratio, thereby making it possible to evaluate the electroretinograms of most patients with retinitis pigmentosa. Narrow-band filtering reduced the amplitude of computer-averaged responses by an average of 7%, but the change in amplitude was independent of the size of the unbandpassed response. Narrow-band filtering also allowed measurement of 30-Hz cone responses in patients followed up over an 11- to 15-year period and quantitation of responses of less than 1 microV, which were not detectable with computer averaging alone. PMID- 3285693 TI - Presumed autoimmune corneal endotheliopathy. AB - I reviewed 20 previously published cases of presumed autoimmune corneal endotheliopathy. The disease appeared clinically with stromal edema and a slowly migrating line of keratic precipitates. All patients had acute stromal edema and keratic precipitates, and decreased visual acuity. Anterior chamber cells were noted in 11 patients. Inflammatory processes, such as pars planitis and iritis, and intraocular lens implantation were present in 13 patients. PMID- 3285694 TI - Vitamin A eyedrops for superior limbic keratoconjunctivitis. AB - We treated 12 patients with superior limbic keratoconjunctivitis with topical vitamin A (retinol palmitate) eyedrops. After a follow-up period of at least three months, this therapy was found to be effective, to a varying extent, in ten patients (83%). Superior limbic keratoconjunctivitis lesions did not recur in these patients as long as topical application was continued. PMID- 3285695 TI - Maternal orbital hematoma associated with labor. AB - We examined two women with orbital hematomas that occurred during labor. Both women developed sudden diplopia, proptosis, and orbital pain. The location of the hematoma was confirmed by orbital echography and computed tomography. The patients were observed without surgical intervention. Neither patient developed clinical or echographic signs of compressive optic neuropathy. Clinical resolution occurred during the following two weeks. Serial standardized orbital echographic examinations documented resolution of the hematomas. PMID- 3285696 TI - Chiasmal compression caused by a catheter in the suprasellar cistern. PMID- 3285697 TI - Sampling biases and implications for child abuse research. AB - The influence of sampling decisions on outcome in research on child abuse is examined. The extent to which the literature on child abuse reflects the problems of criterion-dependent biases and method-dependent biases is discussed and recommendations are made for minimizing sampling biases. PMID- 3285698 TI - Exploring the helping relationship between the schizophrenic client and rehabilitation therapist. AB - This paper argues that the enhanced efficacy of current rehabilitation strategies compared to insight-oriented therapies for schizophrenic clients cannot be understood in terms of differences in technique alone. Rather, the relationship that develops between rehabilitation therapist and schizophrenic client may represent a potent therapeutic ingredient warranting further study. The concept of therapeutic alliance is examined as a means toward understanding the mechanisms underlying successful rehabilitation. PMID- 3285699 TI - Preventing infant mortality and morbidity: developmental perspectives. AB - Developmental approaches to the etiology of low birthweight and to the design and evaluation of antenatal programs are reviewed. Examples are presented of interventions focusing on family planning, educational program content, modification of health-related behavior, and improvement of access to antenatal care. A Harlem Hospital program, designed to alter pregnant women's behavior, is discussed as an exemplar of possible collaboration among pediatricians, obstetricians, and developmentally oriented mental health professionals. PMID- 3285700 TI - Drugs and the DST: need for a reappraisal. AB - It has generally been assumed that psychotropic drugs do not influence results on the dexamethasone suppression test (DST), except in some specific situations. Yet they directly affect the activity of many neurotransmitter systems, which in turn regulate hypothalamic-pituitary-adrenal (HPA) axis functioning. Several reports have shown correlations between the intake of or recent withdrawal from psychoactive substances and changes in DST results. A review of the DST literature reveals that these effects have not been controlled in most DST studies. It is therefore possible that the consequences of intake of psychotropic agents may have contributed to the debate surrounding the DST by producing unappreciated spurious DST results. PMID- 3285701 TI - Polydipsia and hyponatremia in psychiatric patients. AB - Many psychiatric patients have polydipsia and polyuria without identifiable underlying medical causes. Hyponatremia develops in some polydipsic patients and can progress to water intoxication with such symptoms as confusion, lethargy, psychosis, and seizures or death. This syndrome is sometimes called "compulsive water drinking," "psychogenic polydipsia," and "self-induced water intoxication." Although the underlying pathophysiology of the syndrome is unclear, several factors have been implicated in producing polydipsia and symptomatic hyponatremia. These include a possible hypothalamic defect, the syndrome of inappropriate secretion of ADH (SIADH), and neuroleptic medication. Evaluation of psychiatric patients with polydipsia includes a search for other medical causes of polydipsia, polyuria, hyponatremia, and SIADH. Treatment modalities currently available include fluid restriction and medications. PMID- 3285702 TI - A carbamazepine trial in chronic, treatment-refractory schizophrenia. AB - Carbamazepine was given to 12 chronic, treatment-refractory schizophrenic patients for 5 weeks. No overall change was found, but four patients significantly improved while eight worsened. Given the paucity of successful treatments for refractory schizophrenia, further study of carbamazepine appears warranted. PMID- 3285703 TI - Freud in context: what do women/men want? PMID- 3285704 TI - The social and economic correlates of pregnancy resolution among adolescents in New York City, by race and ethnicity: a multivariate analysis. AB - This study utilizes a data set combining vital records from live birth and induced abortion certificates in New York City in 1984 to examine the correlates of the two outcomes among pregnant adolescents. Four groups totaling 31,207 teenagers were examined: Black non-Latinos (51 per cent), White non-Latinos (17 per cent), Puerto Ricans (25 per cent), and non-Puerto Rican Latinos (8 per cent). Multivariate regressions were fit for each group. Simulations based on the regressions reveal that the proportion of live births plus induced abortions among unmarried 18-year-olds, on Medicaid, with a previous live birth, no previous induced abortions, and nine years of completed schooling was .55 in the case of Puerto Ricans, .34 for non-Puerto Rican Latinos, .60 for Blacks, and .51 for Whites. For nulliparous adolescents of the same age and marital status, with an additional year of schooling, but not on Medicaid, and with a previous induced abortion, the fraction of pregnancies that were terminated rose to .84 in the case of Puerto Ricans, .81 for non-Puerto Rican Latinos, .87 for Blacks, and .96 for Whites. The results suggest that attitudes toward abortion as proxied by previous induced terminations substantially increase the likelihood of aborting as well as narrow the racial and ethnic differences with respect to pregnancy resolution. PMID- 3285705 TI - Public health at the 1984 Summer Olympics: the Los Angeles County experience. AB - During the 1984 Summer Olympic Games, the Los Angeles County Department of Health Services used its active disease surveillance system to monitor disease occurrence and other health concerns. Reports were collected by telephone three times a week from 198 participating facilities including hospitals, prepaid health plans, private physicians, and Olympic sites. Background data were obtained two months preceding the Olympic events. Less illness was recorded during the Olympics than during the same period for the three preceding years. PMID- 3285706 TI - What is known about blocking factors in renal allograft recipients. AB - A variety of substances present in serum or plasma, either at the time of renal transplant or during stable graft function in long-term recipients, may interfere with cell-mediated immune functions. In several cases the presence of serum blocking factors has been correlated with decreased graft vulnerability to acute rejection. The question is: are serum blocking factors important for the induction or maintenance of allograft tolerance or, alternatively, are they merely by-products of the tolerant state? Perhaps the most compelling case for an essential role of serum blocking factors can be made in instances where vigorous cell-mediated immune responses can be demonstrated in vitro, but anergy (for example, absence of DTH response) is seen in vivo. However, in renal transplant recipients the majority of studies that show the presence of receptor blocking antibodies or other immunoregulatory serum factors also found a decreased cell mediated immune response in vitro. Thus, allograft tolerance would appear to involve multiple mechanisms as suggested elsewhere. Due to the recent discovery of the molecular structure of the T cell receptor 33,34, it is now possible to identify determinants associated with the binding of T cell receptor blocking antibodies in renal transplant recipients; for example, one should be able to determine if families of V beta genes are involved. Alternatively, it may be possible to identify polymorphic structures on T cells other than the alpha, beta receptor complex as ligands for blocking antibodies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285707 TI - The fertilization antigen (FA-1): applications in immunocontraception and infertility in humans. PMID- 3285708 TI - ABH blood group antigens in human semen. AB - Human sperm, erythrocytes, and seminal plasma from the blood and semen of 20 men of known ABH, Lewis, and secretor phenotypes were assayed for ABH blood group antigens. A 1:1 correlation was found between the presence of ABH antigens in seminal plasma and on sperm and if the man had a secretor phenotype. Sperm from nonsecretors or from men of dissimilar ABO blood type could adsorb A antigen when incubated with A antigen-containing seminal plasma. The level of ABH antigens in seminal plasma correlated with the level of ABH antigens on the sperm surface. ABH antigens in semen were present only on a minority of spermatozoa as detected by flow cytometry, and the majority of these sperm were not in the swimup fraction. ABH antigens were not present on sperm within the seminiferous tubules of human testicular material. It was hypothesized that ABH antigens found on human sperm were adsorbed from seminal plasma on a minority of the sperm in an ejaculate. PMID- 3285709 TI - Correlations between results of the immunobead test and the sperm penetration assay. AB - Immunobead testing (IBT) and human sperm-hamster egg penetration assay (SPA) were performed in 233 infertile men. Positive immunologic results were recorded in 31 (13.3%). Significant reduction in SPA scores was found in patients with IgG antisperm antibodies alone but not in patients with IgA alone or in combination with IgG. Normal SPA scores were seen in 56% of immunonegative patients (n = 113) vs. 32% of immunopositive patients (n = 10). Therefore, a normal SPA does not rule out the presence of significant levels of antisperm antibodies. PMID- 3285710 TI - Isolation and characterization of rat trophoblast cells. AB - Previous immunohistochemical studies of the rat placenta using specific alloantisera and/or monoclonal antibodies showed that the basal zone trophoblasts stained for Pa and Aa class I major histocompatibility complex (MHC) antigens and for the human SP1-related antigen. In an effort to isolate the basal zone trophoblast cells from the rat placenta, we used these markers to assess the degree of purification of the cells separated by density gradient centrifugation using either Ficoll-Hypaque or Percoll as the gradient medium. The cells were put either on the top or at the bottom of discontinuous density gradients in the range of 1.005-1.10 g/ml. The cell separation profiles for the two media were different. With Percoll, most of the trophoblast cells (80-95%) were collected at the density gradients 1.04/1.06 and 1.06/1.08, whereas with Ficoll-Hypaque, these gradients separated only a small fraction (4-23%) of the trophoblast cells, and most of them pelleted at the bottom of the tube. The trophoblast cells separated by Ficoll-Hypaque, however, showed fewer contaminant cells than those separated by the Percoll gradients. PMID- 3285711 TI - Recollections, responsibilities, and rewards of a senior surgeon. PMID- 3285712 TI - Acute graft-versus-host disease of the intestine. A surgical perspective. AB - The general surgeon may be involved in assessment and treatment of intestinal complications in patients who have undergone bone marrow transplantation. It is important to recognize the major causes of intestinal morbidity in these patients and to be aware of the cause and natural progression of the entity of acute graft versus-host disease. Of 89 patients who underwent allogeneic bone marrow transplantation over a 6 year period, acute intestinal graft versus host disease developed in 29 (33 percent). Although surgical consultation for abdominal pain and peritonism was requested for 15 of these patients, intestinal perforation did not occur, and only two patients underwent laparotomy, both for obstruction (and hemorrhage in one case). Patients who require operation tend to be in the end stages of the disease, and the chance for salvage appears to be remote. PMID- 3285713 TI - Repeat parathyroid operation associated with renal disease. AB - One hundred ten patients who had undergone operation for secondary and tertiary hyperparathyroidism have been described. Ninety patients had secondary disease and 20 patients had tertiary disease after renal transplantation. From these two groups, 18 patients had repeat operations for control of recurrent or persistent disease. The incidence of repeat operations was 14 percent. Causes were graft dependent hyperparathyroidism, supernumerary glands in the neck or mediastinum, and incomplete identification of glands in the neck. The most important risk factor is continued long-term dialysis in functionally anephric patients. We recommend that patients with hyperparathyroidism associated with chronic renal failure undergo total parathyroidectomy with autotransplantation. If repeat operation is necessary, a reduction in glandular mass with autotransplantation is preferred. In selected patients, total parathyroidectomy can be considered because of the increased risk of aluminum bone disease. PMID- 3285714 TI - The letters of William Stewart Halsted and John Chalmers DaCosta. PMID- 3285715 TI - [Possibilities of prenatal diagnosis of umbilical pathology by ultrasonic examination and cardiotocography]. PMID- 3285716 TI - [Possible use of echography for predicting fetal sex]. PMID- 3285717 TI - [Pathogenesis of the fetal alcohol syndrome]. PMID- 3285718 TI - [Possibilities of predicting the growth of newborn infants using ultrasonic biometry in the third trimester of pregnancy]. PMID- 3285719 TI - [The role of fetal renal function in fetal development]. PMID- 3285720 TI - [Levels of progesterone in the serum and of pregnanediol in the urine of women with habitual abortion treated by skin grafts]. PMID- 3285721 TI - [Progestin production in normal and pathological states]. PMID- 3285722 TI - [A method of transvaginal puncture of the ovarian follicles under ultrasonic control]. PMID- 3285723 TI - Megalencephaly: definition and classification. AB - The various definitions and classifications of megalencephaly are reviewed, and numerous diseases and syndromes associated with megalencephaly are listed. A new definition of megalencephaly based on quantitative radiographic features is proposed. We define megalencephaly as a brain volume which exceeds the mean by more than twice the standard deviation. Furthermore, a modified etiopathogenic classification of megalencephaly results in three main groups, viz anatomic, metabolic and dynamic megalencephaly. The clinical pictures in these main groups of megalencephaly, and the largest subgroup of anatomic megalencephaly, familial anatomic megalencephaly, appear to be quite different. PMID- 3285724 TI - Mitochondrial abnormalities in choroid plexus of Leigh disease. AB - Morphological study of the choroid plexuses in three patients with Leigh disease revealed a marked increase in the number of mitochondria in almost all of the choroidal epithelial cells. This finding is considered the morphological expression of a biochemical defect in the mitochondrial metabolism underlying Leigh disease, and the probable explanation for increased CSF levels of lactate and pyruvate in this disease. PMID- 3285725 TI - Symmetrical bithalamic hyperdensities in asphyxiated full-term newborns: an early indicator of status marmoratus. AB - Three severely asphyxiated full-term newborns showed tomographic findings of bilateral symmetrical hyperdensities restricted to the thalamic region. All these patients had a strikingly similar poor neurological outcome characterized by dystonia, severe mental retardation and acquired microcephaly. We presume that these bithalamic hyperdensities could be an early predictor of the later status marmoratus. PMID- 3285726 TI - Analytical strategies for the use of DNA probes. PMID- 3285727 TI - Dissociation of proteinase-inhibitor complexes by trichloroacetate. AB - It was demonstrated that the addition of high concentrations of the chaotrope, sodium trichloroacetate, to proteinase assays provided for a dissociation of proteinase-inhibitor complexes. The complexes evaluated contained a heat-stable, polypeptide inhibitor of cysteine proteinases isolated from the cellular slime mold, Dictyostelium discoideum. The proteinases that were present in separate complexes included either D. discoideum proteinases or the plant proteinase papain. The general assay procedures described may be useful in detection of endogenous proteinase-inhibitor complexes in many systems. PMID- 3285728 TI - Disturbance of peripheral microcirculation by LHRH-agonists. II. AB - It could be demonstrated with the aid of a cheek pouch model of the hamster that the LHRH-agonist lutrelin (Wyeth, WY 40972) caused disturbances of microcirculation within minutes, for example constriction of the arterioles and venules, reduction in capillary density and increased permeability, effects which were not reversible within the observation period (1 h) and could not be antagonized by the cyclooxygenase inhibitor indomethacin. Likewise, the lutrelin induced accumulation of leucocytes in the capillaries of the testes of the rat could not be prevented within 6 hours after administration of indomethacin, whereas the harmful effect of lutrelin on the germinal epithelium could be antagonized by indomethacin within 24 hours. A biphasal course is assumed, characterised by an acute non-prostaglandin-dependent phase and a second prostaglandin-dependent phase, which causes the definitive damage to the testis of the rat. PMID- 3285729 TI - The immunobead technique: an indicator of disturbed sperm cervical mucus interaction. AB - A group of 20 couples with repeatedly poor post coital tests (PCT's) where no coital disorders or cervical mucus abnormalities were present, were included in the study. The results of the Direct Immunobead (IB) and Tray-agglutination tests were compared with the results of the sperm-cervical-mucus-contact (SCMC) and post coital tests (PCT's) of each couple in order to determine the sensitivity, specificity and predictive value of the Direct IBT as a screening test for sperm antibodies. The positive predictive value of the IBT was 80%. It was also clear that a strong positive SCMC-T result correlated with agglutinating antibodies in the semen or seminal plasma. In conclusion, the IBT is a sensitive, specific and predictable test for sperm antibodies. PMID- 3285730 TI - New routes of administration and new delivery systems of anesthetics. PMID- 3285731 TI - Anesthesia for ophthalmic surgery in the elderly: the effects of clonidine on intraocular pressure, perioperative hemodynamics, and anesthetic requirement. AB - The effects of clonidine on intraocular pressure and perioperative cardiovascular variables were studied by a randomized double blind design in 80 elderly patients (ASA physical status I-III) scheduled for elective ophthalmic surgery under general anesthesia (GA) and local anesthesia (LA). Group 1 (n = 40), the control group, received diazepam po (0.1 mg.kg-1) 90-120 min prior to arrival to the operating room. Group 2 (n = 40) received clonidine po approximately 5 micrograms.kg-1 po at the same time. Each group was divided into subgroups of 20 patients each to be managed with GA (GA subset) or LA (LA subset). Ninety to 120 minutes after the premedication, a large decrease in IOP from 20 +/- 3 to 12 +/- 3 mmHg (P less than 0.01) and a small but significant reduction of both systolic and diastolic BP and HR were observed in patients receiving clonidine, while no changes occurred in controls. In the patients managed with GA, clonidine effectively prevented IOP rise and attenuated the associated cardiovascular response (P less than 0.01) following laryngoscopy and tracheal intubation, and significantly reduced intraoperative cardiovascular lability and anesthetic requirement for isoflurane (P less than 0.05) and for fentanyl (P less than .001). In patients managed with LA, intraoperative systolic (P less than 0.01) and diastolic BP and HR variability (P less than 0.05) were significantly lower in patients receiving clonidine as compared to controls. Intraoperatively, a significantly higher incidence of hypertension (P less than 0.01) and tachycardia (P less than 0.05) were respectively observed in the LA subset and GA subset of the controls when contrasted with the corresponding subset of those receiving clonidine. Moreover, clonidine was more effective than diazepam as a premedication; in fact, satisfactory intraoperative sedation and cardiovascular stability were observed in 85% of the patients who received clonidine, and in 50% of those patients who did not receive clonidine (P less than 0.01). Thus, clonidine may represent a useful adjunct in the management of the aged patient in the setting of ophthalmic surgery. PMID- 3285732 TI - Continuous infusion epidural analgesia during labor: a randomized, double-blind comparison of 0.0625% bupivacaine/0.0002% fentanyl versus 0.125% bupivacaine. AB - The analgesic efficacy of the continuous epidural infusion of 0.0625% bupivacaine/0.0002% fentanyl was compared with the infusion of 0.125% bupivacaine alone in a randomized, double-blind study of nulliparous women. Each patient received, in sequence: 1) 3 ml of 0.5% bupivacaine with 1:200,000 epinephrine; 2) 6 ml of study solution 1 (bupivacaine-fentanyl group: 0.125% bupivacaine/0.0008% fentanyl; bupivacaine-only group: 0.25% bupivacaine alone); and 3) a continuous epidural infusion of study solution 2 at a rate of 12.5 ml/h (bupivacaine fentanyl group: 0.0625% bupivacaine/0.0002% fentanyl; bupivacaine-only group: 0.125% bupivacaine alone). The epidural infusion was discontinued at full cervical dilatation, but patients who lacked perineal anesthesia received one or two 5-ml boluses of study solution 3 (bupivacaine-fentanyl group: 0.0625% bupivacaine alone; bupivacaine-only group: 0.125% bupivacaine alone). During the first stage of labor, 36 of 41 (88%) women in the bupivacaine-fentanyl group, and 37 of 39 (95%) women in the bupivacaine-only group, had analgesia of excellent or good quality (P = NS). During the second stage, 22 of 37 (59%) women in the bupivacaine-fentanyl group, and 23 of 35 (66%) women in the bupivacaine-only group, rated their analgesia as excellent or good (P = NS). Women in the bupivacaine-only group were more likely to have motor block at full cervical dilatation (P less than .001). There was no significant difference between groups in duration of the second stage of labor, duration of pushing, position of the vertex before delivery, method of delivery, Apgar scores, or umbilical cord blood gas and acid-base values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285733 TI - PEEP does not affect left atrial-right atrial pressure difference in neurosurgical patients. AB - Positive end-expiratory pressure (PEEP) has been used to prevent and treat venous air embolism in patients in the seated position undergoing neurosurgical operations. However, the safety of PEEP has recently been questioned, because of concern that PEEP might increase right atrial pressure (RAP) more than left atrial pressure, thereby predisposing patients with a probe-patent foramen ovale to paradoxical air embolism. In a prior study in dogs, the authors found that to up 10 cm H2O PEEP did not affect the interatrial pressure difference. In the present study, the authors examined the effects of 0, 5, and 10 cm H2O PEEP in 12 anesthetized neurosurgical patients positioned both supine and seated prior to operation. Measurements were made of systemic arterial pressure, RAP, mean pulmonary artery pressure (PAP), pulmonary artery wedge pressure (PAWP), and cardiac output. PAWP was higher (average 2 mmHg) than RAP in all patients. PEEP increased RAP and PAWP in patients, both seated and supine (mean 3 mmHg at 10 cm H2O), but did not affect the PAWP-RAP difference. In an additional eight patients in the seated position, the authors examined the effects of 0, 10, and 20 cm H2O PEEP during operation. PEEP again increased PAWP and RAP, but did not significantly affect the PAWP-RAP difference. The PAWP-RAP difference became negative (-1 mmHg) in one patient with 20 cm H2O PEEP. The authors conclude that levels of PEEP up to 10 cm H2O do not alter the interatrial pressure difference in seated neurosurgical patients, and, therefore, would not predispose these patients to paradoxical air embolism. PMID- 3285734 TI - Asystole during spinal anesthesia in a patient with sick sinus syndrome. PMID- 3285735 TI - The use of caffeine in the control of post-anesthetic apnea in former premature infants. PMID- 3285737 TI - History of conjoined twins. PMID- 3285736 TI - Comparison of the analgesic effects of EMLA (eutectic mixture of local anesthetics) to intradermal lidocaine infiltration prior to venous cannulation in unpremedicated children. PMID- 3285738 TI - Precordial Doppler is not obsolete for venous air embolism monitoring. PMID- 3285739 TI - Air embolism during liver transplantation. PMID- 3285740 TI - Neuroimmunoallergic inflammation: new pathogenetic concepts and future perspectives of immediate and late allergic reactions: Part I (first of two parts). PMID- 3285741 TI - Delayed-type allergy to insulin of different species (bovine, pork, human) PMID- 3285742 TI - Modulation of airway hyperresponsiveness. PMID- 3285743 TI - Loss of human immunodeficiency virus type 1 (HIV-1) antibodies with evidence of viral infection in asymptomatic homosexual men. A report from the Multicenter AIDS Cohort Study. AB - Four asymptomatic homosexual men reverted from positive to negative serologic results for the human immunodeficiency virus, type 1 (HIV-1) over 2.5 years, as shown by enzyme-linked immunosorbent assay (ELISA) and Western blot. Antibody bands in the Western blot from three men were undetectable 6 to 12 months after being positive; gradual fading of the number and intensity of bands was seen in the other man. No HIV-1-p24 antigenemia was detected; cryopreserved peripheral blood mononuclear cells were negative for HIV-1 by standard culture assay. Polymerase chain reaction (gene amplification) assays were done on peripheral blood mononuclear cells and showed the HIV-1 provirus in all subjects 6 to 18 months after the last positive antibody test. Serum specimens from each participant were genetically identical. Polymerase chain reaction showed that peripheral blood mononuclear cells from one subject at different times matched by HLA DNA typing. Clinical and laboratory features of these four men were similar to those of other seronegative subjects. Rare, asymptomatic persons seropositive for HIV-1 may not remain seropositive, but may remain latently infected with HIV 1. PMID- 3285744 TI - Bone marrow transplantation for chronic myelogenous leukemia in chronic phase. Increased risk for relapse associated with T-cell depletion. AB - Data on 405 patients with chronic myelogenous leukemia who received bone marrow transplants in chronic phase were analyzed for factors predictive of outcome. The 4-year actuarial probability of relapse was 19% (95% confidence interval [CI], 12% to 28%) and of survival, 55%. In multivariate analyses the probability of relapse was higher for recipients of T-cell-depleted bone marrow compared with recipients of non-T-cell-depleted bone marrow (relative risk, 5.4; P less than 0.0001) and for patients who did not develop chronic graft-versus-host disease (95% CI, 50% to 60%) with patients who did (relative risk, 3.1; P less than 0.01). The probability of survival was lower for patients who developed moderate to severe acute graft-versus-host disease than for patients with no or mild acute graft-versus-host disease (relative risk, 3.7; P less than 0.0001), and in patients aged 20 or older than in younger patients (relative risk, 2.6; P less than 0.0002). Duration of disease before transplant was not associated with outcome. Bone marrow transplantation done in the chronic phase of chronic myelogenous leukemia offers some patients prolonged leukemia-free survival. The T cell-depleted grafts are associated with an increased probability of relapse. PMID- 3285745 TI - Antinuclear autoantibodies specific for lamins. Characterization and clinical significance. AB - In 11 patients, sera displaying a ringlike nuclear immunofluorescent staining on sections of rat liver tissue were shown by Western blotting to contain antibodies to lamins. Sera from 8 patients contained autoantibodies reacting with lamin B, whereas sera from the other 3 patients reacted with lamins A and C. All patients (9 women and 2 men) had a chronic autoimmune disorder, which rarely fulfilled the usual criteria for a diagnosis of systemic lupus erythematosus. The disorder was characterized by acute or chronic (active or granulomatous) hepatitis; steroid responsive blood cytopenia, often associated with a circulating anticoagulant, or anticardiolipin antibodies, or both; and cutaneous leukocytoclastic angiitis or probable brain vasculitis. Eight patients had at least two of these three conditions. Antilamin autoantibodies may thus be a marker for an unusual subset of autoimmune diseases. PMID- 3285746 TI - Health advice for international travel. AB - Travel to the developing world by U.S. citizens has been increasing. Exposure to illnesses such as travelers' diarrhea, malaria, and vaccine-preventable diseases challenges the internist to provide pre-travel advice. Each traveler's itinerary, duration of stay and medical history, including previous immunizations, should be reviewed. Immunizations that may be required by individual countries, such as yellow fever and cholera, may then be administered. Immunizations for diseases such as hepatitis, typhoid fever, and meningococcal disease can be given according to the type of exposure within each country. Restricting a traveler's diet to cooked foods and purified, carbonated, or heated beverages may prevent travelers' diarrhea and other enteric infections. Most travelers will want to carry medications to treat diarrhea promptly. Malaria is prevented by avoiding mosquitos, taking safe and appropriate anti-malarials and treating malaria if it occurs. Preparation before travel may prevent medical complications. PMID- 3285747 TI - NIH conference. New approaches to the immunotherapy of cancer using interleukin 2. AB - Experimental studies in animals have shown that therapy with high-dose interleukin-2 either alone or in combination with lymphokine-activated killer cells can reduce established pulmonary and hepatic metastases. Based on these experiments, recent clinical trials have shown that therapy with high-dose interleukin-2 alone or in combination with lymphokine-activated killer cells can mediate the regression of established metastatic disease in selected patients with advanced malignancy. Of 221 patients with advanced cancer treated with this immunotherapy, 16 have had a complete regression of all metastatic cancer, and an additional 26 have had a partial regression (greater than 50% reduction) of cancer. Toxicity from treatment was primarily due to increased capillary permeability, which led to fluid extravasation and organ dysfunction. Based on these findings, new approaches are being explored, including the use of tumor infiltrating lymphocytes and combinations of lymphokines. These studies show that the regression of established growing cancer can be mediated by manipulating the immune system. PMID- 3285748 TI - Non-ulcer dyspepsia: potential causes and pathophysiology. AB - Dyspepsia, defined as chronic or recurrent upper abdominal pain or nausea, is a common occurrence. Dyspepsia without an ulcer (non-ulcer dyspepsia) is diagnosed in patients at least twice as often as peptic ulceration. Diseases that may present with similar symptoms include gastroesophageal reflux, biliary tract disease, chronic pancreatitis, and irritable bowel syndrome. A careful history and physical examination, supplemented by selected tests, usually lead to a correct diagnosis. The pathogenesis of non-ulcer dyspepsia remains unknown. Gastric acid secretion, duodenogastric reflux, psychological factors, environmental exposures, and heredity probably do not play a major role. Some patients may have motility disturbances, but whether these disturbances cause dyspepsia is unknown. Campylobacter pylori infection and associated gastritis are common in non-ulcer dyspepsia, but their etiologic role is controversial, as is the importance of chronic duodenitis. By recognizing the heterogeneity of patients who present with non-ulcer dyspepsia, more rational management may be possible. Although an empiric trial of antacids or H2 blockers has been recommended to treat dyspepsia, most controlled trials show that although these substances reduce severity of symptoms, they are no more effective than placebos in non-ulcer dyspepsia. PMID- 3285749 TI - The coronary care unit turns 25: historical trends and future directions. AB - In the 25 years since the introduction of coronary care units the management of acute myocardial infarction has become oriented toward reducing infarct size and treating ongoing ischemia. The coronary care unit has been widely accepted as the standard of care for patients with acute myocardial infarction and has been considered appropriate for monitoring patients with acute chest pain until acute myocardial infarction is diagnosed or excluded. However, rising health care costs have created pressures to increase the efficiency of coronary care units. Possible strategies seek to decrease resource use by identifying low-risk patients for initial triage or early transfer to lower levels of care. The application of management algorithms and the development of intermediate care units as alternative triage sites for low-risk patients may be important future trends as a distinction is made between intensive coronary care and careful coronary observation. PMID- 3285750 TI - High-cost life prolongation: the National Kidney Dialysis and Kidney Transplantation Study. PMID- 3285751 TI - The future of occupational hygiene--an international overview. PMID- 3285752 TI - [Infantile acropustulosis associated with atopic dermatitis, recurrent cutaneous infections and hyper-immunoglobulinemia E]. PMID- 3285753 TI - [Apropos of a case of infantile acropustulosis with positive direct immunofluorescence]. PMID- 3285754 TI - [Bullous cutaneous localization with epidermotropism in monoblastic leukemia]. PMID- 3285755 TI - [A case for diagnosis: Grover's disease or transient acantholytic dermatitis]. PMID- 3285756 TI - [Treatment of epidermotropic lymphoma]. PMID- 3285757 TI - [Pilonidal cysts and sinuses]. PMID- 3285758 TI - [Magnetic resonance imaging of primary malignant vascular tumors of the liver. Apropos of 3 cases]. PMID- 3285759 TI - [Surgery of the thoracic aorta (segments II and III). Results of a multicenter survey. 687 cases]. PMID- 3285760 TI - [Intrapericardial diaphragmatic hernia. Review of the literature. Apropos of a case]. PMID- 3285761 TI - [A new technic for the implantation of aortic valve prostheses]. PMID- 3285762 TI - [Clinical and developmental aspects of Horton's disease. Retrospective study of 100 cases]. AB - 100 patients, from three internal medicine departments, were the subject of a retrospective study concerning the clinical manifestations and the evolution of Horton's disease. The mean age is 71 years, with a 2/1 female predominance. A temporal artery biopsy was obtained in all cases. Besides the prevalence of clinical symptoms (headaches: 80 p. cent; weight loss: 78 p. cent; fever: 65 p. cent; local inflammation: 52 p. cent, frequent pseudo-polyarthritis: 40 p. cent and sometimes severe ocular localizations (11 p. cent blindness), other signs should be emphasized: muscular pain (49%), skin hyperesthesias (37%), painful jaw (33%), etc. The inflammatory syndrome dominates the biological picture (96%); the alkaline phosphatases are increased in 37 p. cent of cases. Temporal artery biopsy was positive in 82 p. cent of cases, which confirms the excellent sensitivity of this test, preceded by a Doppler study in only 28 cases. Extension of the inflammatory process to the large vessels was demonstrated 8 times, on clinical data. Finally, the mean length of the steroid treatment was two years with 14 relapses and 8 deaths. PMID- 3285763 TI - [Verapamil versus propranolol in stable effort angina. Randomized, crossed, double-blind study]. AB - A randomised, crossover, double-blind study was carried out in sixteen coronary patients with stable effort angina to compare the effects of verapamil (360 mg) and propranolol (120 mg). All the patients received placebo for 2 days, underwent a coronary angiography which confirmed coronary heart disease and were then randomised into two groups to receive an initial treatment of either verapamil or propranolol for three days. The patients then took placebo for 3 days, then the second drug after cross-over also over 3 days. The therapeutic efficacy was assessed by stress testing on a treadmill (Bruce protocol) with automated analysis of the results (Case-Marquette), carried out on the last day of each of the phases with placebo and the test drug. The duration of the stress test increased significantly with propranolol (p less than 0.01) and verapamil (p less than 0.05) with respect to placebo. In comparison with placebo, propranolol and verapamil resulted in a similar decrease in ST segment depression at the time of maximum effort (p less than 0.01). The resting systolic blood pressure decreased with propranolol (p less than 0.02) and verapamil (p less than 0.01), whereas resting diastolic blood pressure only decreased with verapamil (p less than 0.01). Resting heart rate decreased during the propranolol phase (p less than 0.001). The systolic blood pressure at the time of maximum effort decreased especially with propranolol (p less than 0.05), whereas the diastolic blood pressure on exertion decreased during the verapamil phase (p less than 0.01). Heart rate during exertion only showed a significant decrease with propranolol (p less than 0.001) as compared with placebo.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285764 TI - ["Hidden" organic causes of impotence. Diagnostic methods and critical evaluation of their responsibility]. AB - In five per cent of impotent, sexual dysfunction obviously results from an organic factor which can be today qualified as "classical". "Hidden" organic factors have also been implicated in a variable ratio of the other cases. This paper constitutes a critical review of the role they play in impotence, and of the methods allowing their detection. On one hand, methods allowing evaluation of the respective responsibilities of organic and psychogenic factors (the most important of which remain nocturnal penile tumescence monitoring); on the other hand, specific investigations of each factor. It is no longer possible to deny the existence of "hidden" organic factors in impotence. These factors intervene to varying degrees in one third of cases. Among them erectile failure only by themselves. Hyperprolactinaemia, moderate hypogonadism, infraclinical neuropathies, arterial stenoses and moderate venous leakages seem to play a partial role of organic starter or cofactor, the sexual consequences of which are amplified by psychological factors, partly secondary to the initial sexual failures. Nevertheless, the conjunction of several "hidden" organic factors may probably be sufficient to induce an impotence without involvement of psychological factors. PMID- 3285765 TI - Intestinal pseudo-obstruction syndrome. AB - Intestinal pseudo-obstruction is a syndrome of many causes. Attempts must be made to determine the cause and the extent of the involvement of the gastrointestinal tract in each patient, because they will dictate the method of treatment for that patient. Family history must be taken from all primary chronic intestinal pseudo obstruction patients. If it is positive, genetic counseling and proper medical management can be given to newly identified cases in the family. PMID- 3285766 TI - Oncogenes, normal cell growth, and connective tissue disease. PMID- 3285767 TI - In vitro tests for immediate hypersensitivity. AB - In vitro measurement of IgE antibodies in serum has an established role in the study of allergic disease, but the place of in vitro tests in routine diagnosis is not well established. They are particularly helpful in confirming new allergens in the workplace and in situations where skin testing is potentially dangerous or technically not feasible. The basic procedure is the radioallergosorbent test (RAST). Each modification has its peculiar advantages and disadvantages. A clinician depending upon in vitro tests for diagnosis must be aware of the technical problems, the inherent limitation in sensitivity in comparison to skin testing, and above all, the fact that in vitro tests detect the presence of an IgE antibody in serum but give no direct information about its pathogenetic role in an individual patient. PMID- 3285768 TI - Swallowing disorders. AB - Swallowing is a coordinated activity that enables solids and liquids to pass uninterruptedly from the mouth to the stomach. Dysphagia occurs when this process is disrupted by organic or functional alterations at the level of swallow initiation or esophageal emptying. The differential diagnosis includes obstructive lesions and motility disorders. Symptoms and clinical features help distinguish these diseases. PMID- 3285769 TI - Oral antibiotic therapy for serious infections. AB - After a pathogen has been identified and the antibiotic susceptibility determined, parenteral antibiotic administration can be replaced by the oral route for certain patients with meningitis, brain abscess, endocarditis, and skeletal infections. Antibiotics should be administered with the stomach empty and accompanied by 3 ml/kg of water. Direct instillation into the lumen of the small intestine may be advantageous with selected patients. Documenting adequate antibiotic absorption and ensuring compliance are essential to efficacious therapy. PMID- 3285770 TI - Pathogenesis of human cystic renal disease. AB - Cystic diseases of the kidney are common, often progressive disorders. The best of several alternative hypotheses to explain their development cites tubular dilation and compression of adjacent tissue. The initiating event may involve focal proliferation of epithelial cells and a consequent increase in the resistance to flow along affected tubules. Decompression of cysts has re-emerged as a potentially beneficial approach to therapy in selected cases of renal cystic disease. PMID- 3285771 TI - Trophic factors in neurologic disease. AB - Recent studies suggest that diffusible factors released by neural targets enhance the survival, growth, and differentiation of neurons both peripherally and in the central nervous system. Evidence for such trophic factors exists for many of the neural systems involved in the degenerative neurologic diseases Alzheimer's disease, parkinsonism, and amyotrophic lateral sclerosis. It is our hypothesis that for each of these disorders there is both a primary insult and a secondary effect. The primary insult may have multiple etiologies, but the secondary effect is the result of retrograde degeneration. Such retrograde degeneration occurs because of an impairment of trophic factor function or an inadequacy of trophic effects to keep pace with the primary destructive process. Accordingly, it may be possible to exploit such trophic mechanisms to define further the pathobiology of neural degeneration and to develop specific treatments for currently incurable illnesses. PMID- 3285772 TI - Thrombotic thrombocytopenic purpura. AB - Platelet thrombus formation in small vessels is triggered by certain stimuli, including vascular injury, primary platelet agglutination, or both. The formation and dissolution of platelet thrombi is modulated by proteolysis, plasma factors, PGI2 synthesis and stability, and immune mechanisms. Some recent evidence now suggests that there is a subset of thrombotic thrombocytopenic purpura (TTP) patients possessing a specific platelet agglutinating factor that triggers the intravascular platelet agglutination. Identification and classification of TTP patients into subgroups with common triggering agents, and further clarification of the role of modifying factors will enable us to understand the disease better and to improve therapy. PMID- 3285773 TI - Silent myocardial ischemia. AB - Silent myocardial ischemia is increasingly recognized as a common phenomenon in a variety of people with coronary artery disease. The natural history is poorly understood, but available data suggest that silent ischemia adversely affects prognosis in all groups studied. Based on this information, we believe that efforts should be directed at detecting and aggressively treating silent ischemic episodes. PMID- 3285774 TI - Selective manipulation of the immune response in vivo by monoclonal antibodies. AB - The development of monoclonal antilymphocyte antibodies has greatly enhanced our ability to identify and bind specific antigens selectively on functionally distinct cells of the immune system. As a result, monoclonal antibodies have become a valuable tool in studies of the cellular mechanisms underlying immune responses. Moreover, because they can selectively alter immune responses in vivo, monoclonal antilymphocyte antibodies hold considerable promise as potential therapeutic agents for immunologically mediated disorders such as allograft rejection, graft-vs-host disease, and many autoimmune diseases. This review addresses the prospects for using monoclonal antilymphocyte antibodies in vivo and discusses some of the problems that remain to be solved. PMID- 3285775 TI - Intraglomerular hypertension: implications and drug treatment. AB - Systemic hypertension is both cause and consequence of progressive renal disease. Recent experimental studies indicate that systemic and glomerular capillary hypertension are not necessarily accompaniments, and that therapeutic interventions may affect systemic and glomerular pressures independently. Therapeutic interventions that control glomerular capillary hypertension protect against progressive renal injury, even in the presence of continued systemic hypertension. Conversely, therapy that controls systemic but not glomerular hypertension does not protect the kidney from continuing damage. Thus, control of intraglomerular hypertension is necessary if antihypertensive therapy is to be effective in preventing progression of renal injury. PMID- 3285776 TI - Clinical utility of fine-needle aspiration cytology of the thyroid. AB - Fine-needle aspiration cytology (FNAC) of the thyroid has radically changed the management of patients with thyroid disease. It is an inexpensive, safe, and rapid procedure that usually gives a definitive morphological diagnosis. It frequently eliminates the need for diagnostic surgery. FNAC should be the initial diagnostic test to evaluate any palpable thyroid lesion. This direct approach reduces the need for other time-consuming and expensive investigations. FNAC can also determine whether patients with hyper- or hypothyroidism have underlying thyroiditis. PMID- 3285777 TI - Symptomatic carotid artery disease and carotid endarterectomy. PMID- 3285778 TI - Surgical approaches to epilepsy. AB - Medically intractable epilepsy may be treated successfully with surgery in a high proportion of patients following appropriate clinical and diagnostic evaluation. Recent technical advances provide more precise diagnostic methods, especially for localizing the areas of seizure origin in the cerebral cortex. The excision of epileptogenic cortex remains the main surgical treatment for partial forms of epilepsy, while commissurotomies are appropriate for some patients with a secondary, generalized type of epilepsy. Limited experience with a variety of stereotaxic lesions and the modality of cerebellar stimulation has not yet provided definite evidence of efficacy of these techniques. Following surgical excisions, two thirds of the patients are significantly improved and over one third become seizure free, with morbidity-mortality rates of less than 0.5%. PMID- 3285779 TI - Applications of antigen receptor gene rearrangements to the diagnosis and characterization of lymphoid neoplasms. AB - During early stages of lymphocyte development, genes for antigen receptors (immunoglobulin and T-cell receptor proteins) undergo rearrangements of their DNA sequences. The resulting configurations of rearranged DNA are highly variable from cell to cell and serve as genetic markers for individual lymphocytes. These markers can be utilized to detect clonal lymphocytic proliferations, as seen in lymphoid malignancies, and to identify the lineage of lymphoid neoplasms. Chromosomal rearrangements involving recombination between the DNA of antigen receptor genes and other sites in the genome also occur in lymphoid neoplasms, and molecular analysis of such rearrangements is potentially useful in the diagnosis of lymphomas and leukemias. PMID- 3285780 TI - Evaluation of brain imaging techniques in mental illness. AB - Brain imaging is increasingly applied in psychiatry, both for clinical evaluation and as a research tool. Computerized tomography (CT) and magnetic resonance imaging (MRI) have documented that structural brain abnormalities occur in some types of psychiatric patients, particularly those who suffer from schizophrenia. Dynamic imaging techniques such as single-photon emission computed tomography (SPECT) and positron emission tomography (PET) have documented decreased temporoparietal activity in Alzheimer's disease, hypofrontality in schizophrenia, and a variety of abnormalities in affective and anxiety disorders. These techniques promise to teach us a great deal about the underlying neural mechanisms in mental illness. PMID- 3285781 TI - Management of nephrolithiasis: new approaches to "surgical" kidney stones. AB - The majority of kidney stones that come to clinical attention are large enough to cause symptoms but small enough to pass spontaneously. Recent technological developments have revolutionized the approach to kidney stones that heretofore required surgery. Percutaneous removal of stones through a nephrostomy tract, with or without ultrasonic or electrohydraulic lithotripsy, and extracorporeal shock wave lithotripsy (ESWL) have all but eliminated indications for open surgical procedures. These new techniques have their own advantages and are complementary. Despite these advances, any change in accepted indications for stone removal should await further evidence of the long-term safety of percutaneous techniques and ESWL. PMID- 3285782 TI - Chlamydial infections. AB - Chlamydia trachomatis infection is the most prevalent sexually transmitted disease in developed countries today. It produces a number of oculogenital syndromes in adults as well as conjunctivitis and pneumonitis in infants. However, the most important sequelae are infertility, ectopic pregnancy, and chronic pelvic pain in women. Available diagnostic tests including culture are less than 100% sensitive but may be of considerable value in detecting asymptomatically infected individuals. Antichlamydial therapy is usually effective and should be given empirically to individuals whose presentation places them at high risk for infection. PMID- 3285783 TI - Atrial fibrillation: natural history, complications, and management. AB - Atrial fibrillation is a clinically important arrhythmia that carries important prognostic and therapeutic implications. Hypertension, ischemic heart disease, and rheumatic valvular disease are the commonest causes of atrial fibrillation. The presence of chronic or paroxysmal atrial fibrillation places the patient at increased risk for embolic stroke and/or death. When atrial fibrillation develops, there is loss of the atrial transport factor ("atrial kick"), with consequent decrease of cardiac output. Stroke output declines by 20-30% in normal individuals with loss of atrial kick; the decline in stroke output is considerably larger in patients with heart disease. Atrial fibrillation can be electrically or pharmacologically reverted to sinus rhythm. Even patients with refractory atrial fibrillation can be reverted to sinus rhythm with amiodarone. PMID- 3285784 TI - Differential diagnosis of polyuria. AB - Diabetes insipidus (DI) is a syndrome characterized by chronic polyuria and polydipsia. It can result from any of three basic defects: (a) inadequate urinary concentration caused by a deficiency in the secretion or action of the antidiuretic hormone vasopressin (neurogenic or nephrogenic DI), or excessive intake of water caused by a defect in (b) thirst or (c) psychological function (dipsogenic or psychogenic DI). These four types of DI can be differentiated clinically only if they present in a complete and classical form. However, more sophisticated diagnostic approaches involving assays of plasma vasopressin or closely monitored trials of antidiuretic therapy usually are necessary when the patient has mild or incomplete defects in thirst or vasopressin function. Accurate diagnostic differentiation among the four basic types of DI is essential not only for safe and effective management but also for a proper understanding of the basic physiology and pathophysiology of water homeostasis. PMID- 3285785 TI - Exercise-induced menstrual dysfunction. AB - Menstrual cycle changes associated with vigorous exercise can range widely. They may be only subtle abnormalities, ranging from delayed onset of spontaneous menses or anovulatory cycles to loss of spontaneous menses. They may be more serious, however. Significant adverse bone mineral changes, resulting in clinically significant osteoporosis and fractures, may occur concomitantly with exercise-induced menstrual dysfunction. PMID- 3285786 TI - Serum creatinine and renal function. AB - Serum creatinine is widely interpreted as a measure only of renal function; however, the serum level reflects not only renal excretion, but also the generation, intake, and metabolism of creatinine. In this review, we demonstrate that serum creatinine does not provide an adequate estimate of glomerular filtration rate (GFR), and contrary to recent teachings, that the slope of the reciprocal of serum creatinine vs time does not permit an accurate assessment of the rate of progression of renal disease. In clinical investigation, it is essential to utilize more accurate and sensitive measures of renal function to estimate GFR and progression. As effective treatments for progressive renal diseases are discovered, it will also be necessary to employ these measurements in clinical practice. PMID- 3285787 TI - Treatment of sensorineural hearing loss by cochlear implantation. AB - Cochlear implantation, a form of neural prosthesis, is now being employed for some profoundly deaf individuals. The pathophysiology of profound deafness, the strategies inherent in cochlear implantation, the differences between various cochlear implant strategies and designs, medical and otologic evaluation of implant candidates, and the surgical procedure are each discussed. The results in speech recognition and speech reading that have been obtained with four commonly used cochlear implant systems are also presented. PMID- 3285788 TI - Dyspnea: physiological and pathophysiological mechanisms. AB - Dyspnea, the sensation of feeling breathless, is a symptom experienced under conditions in which there is an inordinately high ventilatory demand relative to the ability to breathe. Its major physical sign is tachypnea. New developments in monitoring ventilation during exercise have improved our ability to evaluate the symptom of dyspnea and to understand pathophysiological mechanisms contributing to the symptom. We briefly describe the range of mechanisms that determine exercise ventilation and their possible relationship to dyspnea. Questionnaires and psychophysical testing have been used to quantify dyspnea, but there is variability in dyspnea grade from these methods. Dyspnea-producing stimuli and the mechanisms by which they act are reviewed. Disorders producing dyspnea and the pathophysiological mechanisms underlying each are discussed. Perception of dyspnea is obviously through the central nervous system, where dyspnea-producing stimuli are integrated. The specific integration site is probably in the region of the brain stem, since occasional patients with brain stem lesions do not experience dyspnea despite the presence of a number of dyspnea-producing stimuli. PMID- 3285789 TI - Psychological dysfunction accompanying subcortical dementias. AB - Subcortical dementia occurs both in disorders affecting the basal ganglia (for example, Parkinson's disease, Huntington's disease, and progressive supranuclear palsy) and in a variety of subcortical vascular, infectious, inflammatory, neoplastic, and traumatic conditions. The principal features of subcortical dementia include bradyphrenia, impairment of executive function, recall abnormalities, visuospatial disturbances, depression, and apathy. The syndrome contrasts with dementia of the Alzheimer type in which cortical involvement produces aphasia, combined recall and recognition deficits, and indifference. Electrophysiologic, biochemical, and metabolic studies support a distinction between subcortical and cortical dementias. PMID- 3285790 TI - Mediators of ischemic renal injury. AB - Acute renal failure is a serious consequence of renal ischemia. The diagnosis carries an associated high mortality rate. When blood flow to the kidneys is inadequate to supply metabolic demands, a number of pathophysiological changes occur that ultimately result in cell death and tissue dysfunction, characterized by a marked reduction in glomerular filtration rate and associated accumulation of systemic toxins and disorders of fluid and electrolyte metabolism. In this chapter we review the factors that have been implicated as mediators of the renal tissue damage associated with ischemia and reperfusion. PMID- 3285792 TI - Cachectin, cachexia, and shock. PMID- 3285791 TI - Tumors of the immunocompromised patient. AB - Immunocompromised patients are prone to develop certain malignancies, particularly involving cells of the immune system itself (1-3). In this chapter we describe the various neoplasms, note the differences between these and similar cancers in the general population, emphasize similar tumor patterns in different types of immunodeficiency, and discuss possible etiologic factors. PMID- 3285793 TI - Pathogenesis of acute pancreatitis. AB - Recent studies using experimental models of acute pancreatitis suggest that events blocking evoked secretion of digestive enzymes from acinar cells may play an important role in the pathogenesis of this disease. Under these conditions, digestive enzymes become co-localized with lysosomal hydrolases within large intracellular vacuoles, where activation of trypsin by the lysosomal enzyme cathepsin B could initiate the cascade activation of the other pancreatic zymogens. Development of acute pancreatitis might, therefore, be initiated by events occurring within acinar cells rather than in the ductal system or the interstitium of the gland. PMID- 3285794 TI - Mechanism of induction of cytochrome P-450ac (P-450j) in chemically induced and spontaneously diabetic rats. AB - Previous studies demonstrated that a microsomal high-affinity N nitrosodimethylamine demethylase activity and cytochrome P-450ac (an acetone/ethanol-inducible form) were induced by streptozotocin-induced diabetes in rats. In the present work, the induction was studied in detail in two chemically induced (by streptozotocin and alloxan) diabetic rat models and one spontaneously (BB/Wor) diabetic rat model. All the diabetic conditions caused increases in three parameters: (a) microsomal N-nitrosodimethylamine demethylase activity which is known to be a good indicator of the level of P-450ac; (b) the levels of P-450ac as determined by immunoblot analysis; and (c) the levels of mRNA of P-450ac as determined by hybridization assays with a cDNA probe for this enzyme. These increases were abolished by treatment of the diabetic rats with insulin. The results suggest that the pathophysiological condition of diabetes is responsible for the induction of P-450ac and elevation of mRNA is involved in all of the three diabetic models investigated. PMID- 3285796 TI - [Application of monoclonal antibodies to bone marrow transplantation]. AB - For the last several years, monoclonal antibodies (MoAbs) have been applied to clinical bone marrow transplantation (BMT). In allogeneic BMT, anti-T cell MoAbs have been used for in vitro depletion of T cells from transplanted bone marrow. This treatment has remarkably reduced the incidence of acute graft versus host disease. However, the high rate of graft rejection and leukemia relapse remains to be resolved. Autologous BMT has also been performed in leukemia and malignant lymphoma. MoAbs have been used for in vitro purging of contaminated tumor cells from preserved bone marrow. These clinical trials have resulted in a significant increase in the number of disease-free long-term survivors. PMID- 3285795 TI - Quinone interactions with the chloroplast cytochrome b6-f complex. AB - The requirements for reconstitution of electron transfer activity with a plastoquinone (PQ)-depleted cytochrome b6-f complex from spinach have been considered. Full restoration of activity measured as plastocyanin reduction with either duroquinol in the dark or Photosystem II (PSII) in the light requires both PQ-9 and phospholipid. However, a substantial dark activity can be observed with duroquinol and phospholipid in the absence of any added PQ-9. PSII, with its associated PQ molecules, can also donate electrons in the light to the cytochrome complex which has been depleted of plastoquinone. Electron donation by duroquinol in the dark to the PQ-depleted cytochrome complex is stimulated by PSII, and this stimulation is dependent on the presence of the two PQ molecules in the PSII preparation. Measurements of proton translocation with the PQ-depleted complex indicate this quinone is not required for the observed H+/e- ratio of 2. Studies of cytochrome b6 kinetics with the free and liposome-incorporated PQ-depleted complex show this cytochrome undergoes redox reactions similar to those of a control complex which contains PQ. These results indicate the PQ that copurifies with the cytochrome complex is not essential for any of the measured activities. These findings are considered in relation to a quinone binding site(s) in the cytochrome complex which is not specific to PQ but can bind other quinones, such as duroquinol, in a lipid-dependent process. PMID- 3285798 TI - Coded nursing diagnoses on axes: a prioritized, computer-ready diagnostic system for psychiatric/mental health nurses. PMID- 3285797 TI - [Recent advances in L-asparaginase studies]. AB - We surveyed the progress of L-asparaginase studies for last ten years or so, on the progress and the present situation for its clinical application. At present, L-asparaginase is recognized as one of basic drugs for improvement of remission induction mainly in infant ALL and is being positively incorporated in the treatment of high-risk diseases such as intractable ALL and the myelogenous recurrence. L-asparaginase, an E. coli-derived protein preparation, has various side effects except bone marrow suppression. Immune responses caused by E. coli derived protein preparation is accordingly a characteristic side effect of the L asparaginase. For the purpose of avoiding this side effect, studies on immobilized enzymes and enzyme derivatives devoid of antigenicity are under progress. PMID- 3285799 TI - The prevalence and phenomenology of depression in elderly women: a review of the literature. PMID- 3285800 TI - [Microscopic innervation of the penis. I. Prepuce and glans penis]. PMID- 3285801 TI - [Giant condyloma of the penis. Presentation of 3 cases and review of the literature]. PMID- 3285802 TI - [Microscopic innervation of the penis. II. Corpora cavernosa and deep vessels]. PMID- 3285803 TI - [Bacterial diagnosis of Streptococcus agalactiae in milk samples: CAMP test, hydrolysis of esculin, hemolysis type]. PMID- 3285804 TI - Cycloplatam and oxoplatin--the new antitumor platinum compounds of the second generation. AB - Cycloplatam, ammine(cyclopentylamino)-S-(-)-malatoplatinum(II), and oxoplatin, cis-dichloro-diammine-trans-dihydroxoplatinum(IV), were first synthesized in the USSR. Their antitumor properties were found at the All-Union Cancer Research Center of the Academy of Medical Sciences of the USSR by the authors of this article. Both new drugs are less toxic than cisplatin and free from nephrotoxicity. Both new compounds exceed cisplatin considerably in their action on plasmacytoma MOPC-406 and in complete cure of mice. Cycloplatam and oxoplatin have no cross-resistance with cisplatin and with the alkylating agent sarcolysin. As to antitumor activity cycloplatam exceeds carboplatin, (cyclobutane-I,I dicarboxylato)-diammineplatinum(II), oxoplatin--iproplatin, cis-dichloro-bis (isopropylamine)-trans-dihydroxoplatinum(IV). Both drugs have been handed over for preclinical study. PMID- 3285805 TI - Neutrophil intracellular kill following thermal injury. Different bactericidal capability for patients' organisms and laboratory organisms. AB - Sixteen patients with septic complications of severe thermal injury were studied with respect to neutrophil intracellular-killing power against clinical isolates from the patients themselves and against other laboratory organisms. Simultaneous measurements of neutrophil chemotaxis, helper/suppressor lymphocyte ratios, and serum IgG concentrations were also carried out. Neutrophils from patients who survived had diminished intracellular-killing capacity for their own organisms, but normal capacity for killing laboratory organisms either matched or unmatched with the patients' own isolate's species. In these patients, the chemotactic index, the lymphocyte helper/suppressor ratio, and the serum IgG concentration remained within normal limits. Neutrophils from patients who died failed to kill their own, as well as laboratory, organisms. In these patients, the chemotactic index, lymphocyte helper/suppressor ratio, and IgG concentration were significantly diminished. The biological implications of these findings are noted. PMID- 3285806 TI - Simple ligation vs stump inversion in appendectomy. AB - The records of 886 patients who had appendectomy performed by the same surgeons within a five-year period were used to contrast appendiceal stump inversion vs simple ligation. Our analysis contrasted inversion vs simple ligation techniques as related to postoperative complications, hospital stay, and pathologic diagnosis. Adhesions requiring repeated operation to relieve bowel obstruction occurred in five of 87 patients with acute gangrenous appendicitis treated by inversion. Of 106 patients with acute gangrenous appendicitis treated with simple ligation, postoperative obstruction developed in none. No other statistically significant differences existed between the two techniques. These data suggest that simple ligation is at least as good as and probably better than inversion of the appendiceal stump. PMID- 3285807 TI - A review of the histologic changes in vein-to-artery grafts, with particular reference to intimal hyperplasia. AB - This article reviews the success of vein-to-artery grafts and the published data on patency rates and the major causes for graft failure, ie, intimal hyperplasia and atherosclerosis. It concentrates on the histogenesis of intimal hyperplasia and describes the histologic changes that occur in a vein graft after its insertion. The origin and behavior of intimal smooth-muscle cells are discussed in detail, with particular reference to their role in intimal hyperplasia. A brief experimental section is included to show the specific identification of vein-graft intimal smooth-muscle cells using light-microscopic histochemistry and electron microscopy. PMID- 3285808 TI - Pneumoperitoneum and its association with ruptured abdominal viscus. AB - Pneumoperitoneum is not invariably associated with ruptured or perforated intra abdominal viscus. To determine the incidence of free air associated with intra abdominal viscus perforation, the medical records of 77 consecutive patients whose discharge or autopsy diagnosis included pneumoperitoneum or perforated viscus at a community hospital were retrospectively reviewed between June 1980 and October 1985. Abdominal viscus perforation, as determined by contrast studies or at operation, was not invariably associated with free air. Sixty-nine percent (23/33) of gastroduodenal, 30% (3/10) of small-bowel, and 37% (11/30) of large bowel perforations had free air, as determined by preoperative x-ray film. Four cases with a total of six episodes of pneumoperitoneum were identified where viscus perforation was not documented. Pneumoperitoneum thus remains a reliable sign of viscus perforation; however, lack of this finding does not rule out perforation, and unusual causes must be considered. PMID- 3285809 TI - Moxalactam vs tobramycin-clindamycin. A randomized trial in secondary peritonitis. AB - One hundred five patients with peritonitis were randomized to receive either tobramycin sulfate plus clindamycin phosphate or moxalactam alone before surgical intervention. Fifty-nine patients were evaluable. A mean of 3.1 (moxalactam) and 3.5 (tobramycin-clindamycin) pathogens per patient were identified. Overall success rate was 85% (tobramycin-clindamycin, 24/30; moxalactam, 26/29). When patients with appendicitis were excluded, there was an observed but not statistically significant advantage of moxalactam over tobramycin-clindamycin (85% vs 67%). There were five deaths (tobramycin-clindamycin, four; moxalactam, one). Other complications included hypoprothrombinemia (tobramycin-clindamycin, five; moxalactam, five), renal dysfunction (tobramycin-clindamycin, three; moxalactam, one), and superinfection (tobramycin-clindamycin, nine; moxalactam, six). More wound infections were noted in the group given tobramycin-clindamycin. These data suggest that moxalactam is as safe and efficacious as tobramycin plus clindamycin. The observed benefits of this agent warrant study in a larger sample to verify advantages of moxalactam over combination therapy. PMID- 3285810 TI - Postoperative acute gastrointestinal tract hemorrhage and multiple-organ failure. AB - Acute upper gastrointestinal tract hemorrhage (AUGH) was evaluated postoperatively in 720 critically ill patients and correlated with multiple-organ failure (MOF). The AUGH incidence was 20.1%. Patients were divided into three groups. Group 1 (n = 77) patients were admitted without AUGH, but developed MOF and later AUGH, with renal failure as the most common previous failure. Group 2 (n = 36) patients were admitted with AUGH and other failures. Group 3 (n = 32) patients were admitted without AUGH, which appeared as the first or only failure. Means +/- SDs for MOF and mortality for groups 1, 2, and 3, respectively, were as follows: 3.2 +/- 0.8, 75.3%; 3.2 +/- 1.1, 63.9%; and 1.8 +/- 0.8, 28.1%. A control group (n = 90) with MOF but without AUGH presented 1.8 +/- 0.9 for MOF and 41.1% mortality. Mortality, sepsis, and mean MOF were higher in AUGH cases and lower in group 3 vs groups 1 and 2. Acute upper gastrointestinal tract hemorrhage is a component of MOF (Baue's syndrome) that is closely related to sepsis particularly after abdominal surgery. PMID- 3285811 TI - Lower gastrointestinal hemorrhage in renal transplant recipients. AB - A review of the literature and our own series revealed 38 patients with lower gastrointestinal (LGI) hemorrhage among 4086 renal transplant recipients (0.9%). These patients represent 30% of 128 patients with major colorectal complications in this group. Of the 32 patients whose treatment and outcome were reported, only 12 (38%) were treated operatively. The overall mortality rate was 72%. The causes of LGI hemorrhage included colitis from opportunistic infections (42%); pseudomembranous, ischemic, or uremic colitis (40%); and idiopathic ulcers of the colon (18%). Colonoscopic, gross, and histopathologic findings of a patient with massive LGI hemorrhage from a fungal ulcer of the colon are the focus of this study, as are the implications of such findings. We propose an algorithm for diagnostic and therapeutic management decisions. We emphasize prompt diagnosis and the importance of colonoscopy. We propose withdrawal of immunosuppression and early operative intervention if the patient survival rate is to improve. PMID- 3285812 TI - Hand infections. Bacteriology and treatment: a prospective study. AB - In a prospective, double-blind study, 193 patients hospitalized for established hand infections were randomized to receive either cefamandole intravenously followed by cephalexin by mouth or methicillin intravenously followed by dicloxacillin by mouth. Careful aerobic and anaerobic cultures were performed. Multiple organisms grew in cultures from 84% of the patients (over three isolates per infection on average). Human bite wounds contained anaerobes 43% of the time compared with 12% for other wounds. The majority of wounds (72%) required operative treatment. In 128 patients assessable for treatment outcome, results were unsatisfactory in 11 (9%). There was no difference in outcome between cefamandole (6/59, 10%) and methicillin (5/59, 8%). The presence of anaerobes, Eikenella corrodens, human bites, or an increasing number of organisms was associated with an unsatisfactory response. The presence of Staphylococcus aureus and/or beta-hemolytic streptococci was associated with a favorable response. The incidence of antibiotic-resistant isolates did not correlate with outcome. PMID- 3285813 TI - Balloon dilatation of anastomotic strictures. AB - Our experience with balloon dilatation of postoperative anastomotic strictures is reported herein. Six patients with strictures not responsive or accessible to standard bougie techniques were selected for balloon dilatation. A guidewire was passed through the stricture with an endoscope (four patients) or with fluoroscopic guidance alone (two patients). Balloon catheters were then advanced over the guidewire and distended with a water-contrast mixture. Sufficient pressure was applied to efface the stricture indentation of the balloon. Since August 1984, we have performed 12 dilatations in these six patients. We dilated four strictures to 20 mm and two strictures to 15 mm. With the exception of stenosis due to edema caused by cancer or radiation, balloon dilatation is an effective treatment of tight upper gastrointestinal tract strictures that have not responded to standard dilatation techniques. PMID- 3285814 TI - Complications of needle localization of foreign bodies and nonpalpable breast lesions. AB - Needle-wire localization of foreign bodies and nonpalpable breast lesions is commonly used to allow for more accurate excision or biopsy. We present three examples of complications of the localization procedure: (1) wire migration into the chest wall with retained fragment, (2) transection of a wire during biopsy with retained hook fragment, and (3) wire migration within the thigh soft tissues with breakage at the hooked end. Recommendations to minimize the incidence of these complications and their sequelae include (1) bending the hookwire 90 degree at the skin surface following localization, (2) transferring the patient between the radiology suite and the operating room via a stretcher, with minimal movement of the body part localized, and (3) accounting for the entire length of wire by the surgeon, pathologist, and radiologist following the procedure to exclude retained fragments. PMID- 3285815 TI - Obstructive jaundice. An unusual delayed presentation of congenital diaphragmatic hernia. AB - Most cases of congenital diaphragmatic hernia present as acute respiratory emergencies in the newborn period. Delayed presentation may be heralded by symptoms referred to the respiratory or gastrointestinal tract. An infant with unrecognized right-sided foramen of Bochdalek hernia presented with obstructive jaundice due to compression of the herniated common bile duct by the rim of the diaphragmatic defect. To our knowledge, this occurrence has not been previously observed in infancy or childhood. PMID- 3285816 TI - [The effect of different centrifugation conditions for the isolation of mixed rumen bacteria, on their nitrogen and diaminopimelic acid content]. AB - Three cows were given two rations, a silage diet (3 animals) and a green forage diet (2 animals). Samples of rumen content were collected and aliquots of these were separated in a fraction of feed particles and protozoa (FP-fraction) and a fraction of mixed bacteria, varying the conditions of differential centrifugation. The low speed centrifugation was practised at 100 X g/5 min, 400 X g/10 min, 1000 X g/10 min, and 2000 X g/10 min. High speed conditions were 30,000 X g/30 min 4 degrees C. The lyophylisated sediments were used for determination of N and DAP. The content of N gave similar results for all fractions of mixed bacteria, the mean value being 7.43 +/- 0.48% (n = 20), while the N-content of the FP-fractions being 5.68 +/- 0.37% (n = 19). The N:DAP-ratio gave similar values for the cows fed the silage diet, the values were 29.45 +/- 1.56 (n = 12). The values for the cows receiving the green forage diet differed, the mean values were 23.08 +/- 0.88 and 42.01 +/- 5.81 (n = 5), respectively. In all five experiments highest ratios were found at 100 X g. Further investigations showed that storage at -20 degrees C rumen fluid after isolation of feed particles and protozoa decreased both the N- and DAP- content without affecting the N:DAP-ratio. Centrifugation at low speed with 100 X g resulted in a markedly decreased contamination with DAP in all the FP-fractions. Optimal conditions for separation of feed particles and protozoa from rumen fluid to get a fraction best reflecting the rumen bacterial populations are 100 X g/5 min. PMID- 3285817 TI - [Restoration of the innervation of the extremity of the rat after joining the ends of the damaged nerve with a microsurgical suture]. AB - Morphofunctional restoration of the cut ischemic nerve has been studied after its connection by means of a microsurgical suture. The investigations have been performed on 20 male rats. In 6 months after the operation the average diameter of the regenerating nervous fibers is 5.0-6.5 mcm and, as in an intact nerve they have a wavy course. Myelin decay products and inflammatory infiltrates are revealed in the nerve but sometimes. All the parts of the plantar skin are well reinnervated. Cutaneous epidermis of the sole and the digital pads possesses an extremely rich innervation. Characteristics of M-responses, registered from the m. gastrocnemius, approaches the norm in 2 months after the operation. In 10% of fibers of the regenerating ischiatic nerve impulse activity begins to be registered in 20-30 days after the operation. Gradually the borders of the receptor fields become wider and in 3 months they spread all over the whole sole. In 5-6 months the impulse reaction of the regenerating nerve fibers does not differ from that in non-operated animals. Thus, use of the microsurgical suture results in a successful regeneration of the rat ischemic nerve and in a rather short time. The restorative dynamics of the extremity tissue innervation can be presented as following: at first somatic muscles get innervation and then, as the afferent fibers grow in the periphery, the plantar skin and the skin of the digital pads is the last to get innervation. PMID- 3285818 TI - [Reactive changes in the tissues of the skin and its appendages in different methods of transplanting full-thickness flaps]. AB - Free epidermoplasty and skin transplantation is performed on microarterial and microvenous anastomoses. Tissue reactions are studied in 3-21 days. Transplantation of a complex graft with application of microvascular anastomoses possesses definite advantages in comparison with a traditional method of free plasty. They are demonstrated as a complete survival of the transplant tissues, its revascularization, predominance of regenerative processes over the destructive ones in the epidermis, derm and appendages of the skin, preserved viability of tissue components in hair and sebaceous glands. All this is of certain importance for normal functioning of the skin as an organ, as well as an essential cosmetic importance. PMID- 3285819 TI - Hughlings Jackson. A Yorkshireman's contribution to epilepsy. AB - Hughlings Jackson (1835-1911), who was born in Yorkshire (England), was the most famous graduate of the York Medical School, which closed in 1862. In York, he received his earliest neurological influences under Laycock. Jackson's most outstanding contributions were in the field of epilepsy. His were the definitive studies of unilateral convulsions that led Charcot to introduce the term Jacksonian epilepsy. His radically new view of epilepsy in terms of discharging lesions was the first neuronal theory and the foundation stone of our modern understanding of the disorder. His theories were based on detailed clinical observation and were later confirmed by the experimental studies of Fritsch and Hitzig, and by his colleague David Ferrier. He was more concerned with the nature than with the classification of epilepsy, and he linked his concepts of the disease to his hierarchical views of nervous system function. His writings on epilepsy over 40 years are on a par with the Hippocratic writings on the Sacred Disease. PMID- 3285820 TI - David McQuarrie Worthen, 1936-1988. PMID- 3285821 TI - Hyperinsulinemia is characterized by jointly disturbed plasma VLDL, LDL, and HDL levels. A population-based study. AB - Plasma very low density lipoprotein (VLDL) cholesterol and triglyceride, low density lipoprotein (LDL) cholesterol and triglyceridea, high density lipoprotein (HDL) cholesterol, glucose and insulin response (sums of 1- and 2-hour postload oral glucose levels), body mass index (BMI), and blood pressure were determined in a representative sample (n = 542) of the adult Israeli Jewish population. Persons with diabetes or on antihypertensive medications were excluded. Total VLDL and LDL fractions were estimated from their cholesterol and triglyceride subfraction levels that were standardized relative to the mean of the reference group (participants free of glucose intolerance, obesity, and hypertension--the GOH conditions). Hyperinsulinemia and disturbed levels of VLDL and LDL were defined as levels equal to or greater than the 75th percentile and those of HDL, equal to or less than the 25th percentile of their respective reference group distributions. When VLDL was disturbed jointly with LDL and HDL, the mean insulin response adjusted for age, gender, glucose response, BMI, blood pressure, and smoking was high compared to the reference group (166.0 vs. 122.5, p less than 0.001). With isolated disturbed VLDL, or disturbed LDL and HDL but normal VLDL, the mean insulin response resembled the reference group. The adjusted risk ratio for this jointly disturbed lipoprotein profile among hyperinsulinemic individuals was 3.4 (95% confidence limits 2.6 to 4.4, p less than 0.001) with no further association with the GOH conditions. We conclude that hyperinsulinemia is characterized by an atherogenic lipoprotein profile. PMID- 3285822 TI - Atherosclerotic vascular disease in middle-aged, insulin-treated, diabetic patients. Association with endogenous insulin secretion capacity. AB - The prevalence of atherosclerotic vascular disease (ASVD) and its risk factors were investigated in 263 insulin-treated diabetic patients, ages 45 to 64 years, who were older than 30 years when their diabetes was diagnosed. The patients were divided into two groups based on the degree of endogenous insulin secretion capacity: Group A: glucagon-stimulated plasma C-peptide less than 0.20 nmol/l and Group B: C-peptide greater than or equal to 0.20 nmol/l. The age-adjusted prevalence of definite myocardial infarction was significantly higher in Group B than in Group A (16.8% vs. 5.2%, p less than 0.01). A similar difference between Groups A and B was found for definite or possible coronary heart disease (54.6% vs. 32.9%, p less than 0.001) and stroke (9.3% vs. 2.0%, p less than 0.05). In multivariate analysis, high glucagon-stimulated plasma C-peptide level (greater than or equal to 0.20 nmol/l) was positively associated with definite or possible coronary heart disease independently of other cardiovascular risk factors. Our results indicate that among insulin-treated patients with a late onset of diabetes, the prevalence of ASVD is markedly higher in those with persistent endogenous insulin secretion (noninsulin-dependent diabetes) than in those with low or no insulin secretion (insulin-dependent diabetes). PMID- 3285823 TI - Decreased coronary vascular reserve in Watanabe heritable hyperlipidemic rabbits. AB - Watanabe heritable hyperlipidemic (WHHL) rabbits have severe hypercholesterolemia due to a genetic defect in their low density lipoprotein receptors. Therefore, they develop severe premature atherosclerosis of the large arteries including the coronary arteries. In the present study, we measured the coronary vascular reserve of these rabbits to evaluate the total cross-sectional coronary surface area. This method allowed us to quantify the functional consequences of the coronary atherosclerotic lesions. To evaluate coronary vascular reserve, we measured coronary blood flow with the radioactive microsphere technique before and after induction of maximal coronary vasodilation by an intravenous dose of 9 mg/kg of carbocromen. A group of pure-bred WHHL rabbits was compared to a group of normal Burgundy rabbits at ages of 100 and 300 days. At 100 days, there was no difference in coronary vascular reserve between the two groups. However, at 300 days, the coronary vascular reserve in WHHL rabbits was 48% smaller than in the normal Burgundy rabbits (p less than 0.001). In addition, by making corrosion casts and morphological studies, we were able to show that at 300 days nearly all the WHHL rabbits had severe coronary atherosclerotic lesions located mainly at the origin of the large coronary arteries. We conclude that WHHL rabbits at 300 days have a severe impairment of their coronary vascular reserve due to proximal atherosclerotic lesions in the coronary arteries. PMID- 3285824 TI - A study of women who refused to participate in a community survey of psychiatric disorder. AB - The bias resulting from nonresponse causes problems for all epidemiological research. This study investigated the characteristics of those who refused to participate in a community survey of female psychiatric disorder. The demographic characteristics of refusers were similar to those previously reported. When compared to responders, those who refused tended to be older, never married and not widowed, of lower socioeconomic status and urban dwellers. No differences in physical illness requiring hospitalization or inpatient and outpatient psychiatric illness, as assessed through hospital records, were discerned between refusers and responders. Reasons for refusal are discussed. The bias problem may get worse as changing community attitudes to privacy and patients' rights lead to greater refusal rates. PMID- 3285825 TI - Psychoanalysis and the acquisition of knowledge. AB - From the myth of Prometheus to the trial of Galileo, history and literature are replete with examples of the clash between institutionally-bound power structures which exploit ignorance and ignore reality, and those that attempt to develop some movement towards scientific and personal truth. Within society as we know it, the genius or messiah figure and the establishment are bound together in an attempt to establish a relationship which can be of constructive relevance to both. The challenge of incorporating new and disruptive, though not necessarily disintegrative thought on the one hand, is contrasted with an uncompromising attack upon those who would lay claim to the previously exclusive rights of the established organisation and the power which accrued from them. Psychoanalysis today is joined in the battle with internal and external prohibitions against the acquisition of knowledge, which may in time point towards the truth of human personality, behaviour and existence. PMID- 3285826 TI - L-tryptophan: a rational anti-depressant and a natural hypnotic? AB - L-tryptophan is an essential amino acid which is the metabolic precursor of serotonin. Because of the evidence that serotonin deficiency may be an aetiological factor in some sorts of affective disorder and that serotonin is important in the biochemistry of sleep, L-tryptophan has been suggested as a "rational" anti-depressant and as a "natural" hypnotic. This paper reviews the biochemistry and pharmacology of L-tryptophan as well as the literature of the clinical trials that have been conducted with it and suggests that, by itself, L tryptophan may be useful in mild cases of depression accompanied by endogenous features and cases of bipolar disorder resistant to standard treatments. It also potentiates the monoamine oxidase inhibitors and possibly the serotonergic tricyclic drugs. L-tryptophan may improve the depressed mood of Parkinsonian patients and has a clinically useful hypnotic action. There is evidence it may be useful in organic mental disorders induced by levodopa. Dosage schedules, contraindications and complications are discussed. PMID- 3285827 TI - Prophylactic corticosteroid increases survival in experimental heat stroke in primates. AB - It has been suggested that endotoxins or lipopolysaccharides (LPS), may contribute to heat stroke pathophysiology. In this study, 11 anesthetised monkeys were divided into 2 groups. The steroid group (n = 5) had received a dose of MPSS (30 mg.kg-1, i.v.) before being heat-stressed and the control animals (n = 6) received saline equivolumetrically. The animals were heat-stressed to a rectal temperature of 43.5 degrees C in an environmental temperature of 41 +/- 0.3 degrees C and 100% relative humidity and then allowed to recover at room temperature. Blood samples for LPS and anti-LPS IgG analyses were taken both before treatment and before and after heat-stress. The administration of prophylactic MPSS increased the survival rate significantly from 33% to 100% (p less than 0.05). The plasma LPS level in the steroid group showed very little change after heat-stress, whereas in the non-surviving controls there was a significant increase in plasma LPS level (from 0.089 +/- 0.007 to 0.257 +/- 0.031 ng.ml-1) (p less than 0.005). The control animals that survived showed very little increase in plasma LPS levels, but had about 300% greater plasma Anti-LPS IgG levels. We conclude that pretreatment with MPSS improves the survival rate during heat stroke, possibly by suppressing the rise in plasma LPS concentration. PMID- 3285828 TI - The flying service, from a medical point of view. By Hardy V. Wells, 1915. PMID- 3285829 TI - Renal pharmacodynamic effects of torasemide and furosemide in normal man. AB - The effects of acute administration of torasemide (1-isopropyl-3-([4-(3-methyl phenylamino)pyridine]-3-sulfonyl)urea), a new potent loop diuretic, were compared with those of furosemide in 8 healthy male volunteers (aged 22-35 years). The subjects were studied on two separate occasions, at 1-week intervals. After two baseline urine collections of 30 min, either torasemide (20 mg i.v.) or furosemide (40 mg i.v.) was given, followed by further timed urine collections after 15, 40 and 60 min. There were significant increases in urine flow, and in sodium, potassium, chloride and calcium excretion, which were maximal within 15 min after administration of both drugs. These effects were of similar magnitude except for the natriuretic and chloruretic actions which were more pronounced after furosemide than after torasemide (p less than 0.02). The drugs induced no significant changes in effective renal plasma flow or glomerular filtration rate, as measured from the clearances of constantly i.v. infused 123I-orthoiodohippuran and 51Cr-EDTA, respectively. Urinary dopamine, urinary prostaglandin E excretion and plasma renin activity were increased by both drugs. It is concluded that the acute effects of torasemide are comparable to those of furosemide. PMID- 3285830 TI - Comparison of diuretic effects and pharmacokinetics of torasemide and furosemide after a single oral dose in patients with hydropically decompensated cirrhosis of the liver. AB - In a controlled double-blind randomized clinical trial, the pharmacodynamics and pharmacokinetics of 20 mg torasemide (1-isopropyl-3-([4-(3-methyl phenylamino)pyridine]-3-sulfonyl)urea) (n = 10) and 40 mg furosemide (n = 9) were compared over 24 h after single oral administration to patients with ascites due to cirrhosis of the liver. The overall 24-h excretion of volume and sodium was not significantly different between patients receiving torasemide or furosemide. The diuretic effect of torasemide, however, was longer in duration than that of furosemide. This was in accordance with the pharmacokinetic behaviour of torasemide and furosemide. The serum elimination half-life of torasemide was longer (4.8 h) than that of furosemide (2.2 h) in these patients and also longer than that in healthy volunteers (3 h). The areas under the serum concentration time curves for torasemide were higher than in healthy subjects by a factor of 2.5. In parallel with the considerably delayed formation of the diuretically inactive metabolite M5, which is formed via the diuretically active metabolite M1, the serum concentration of M1 was increased in these patients. However, the overall excretion of torasemide and the different metabolites was similar compared to healthy volunteers. These results indicate that the pharmacokinetics and metabolism of torasemide depend on liver function. No adverse reaction were experienced in either group. PMID- 3285831 TI - Comparative pharmacodynamics of torasemide and furosemide in patients with oedema. AB - The pharmacodynamics of torasemide (1-isopropyl-3- ([4-(3-methyl phenylamino)pyridine]-3-sulfonyl)urea), a new potent loop diuretic, were compared to those of furosemide in a double-blind controlled study in 18 patients with oedema of various origin. Torasemide behaved like furosemide in exerting a potent diuretic effect which culminated during the first 4 h after its administration. Nevertheless, torasemide was about 8 times more potent, exerted a longer lasting diuretic effect and was more potassium sparing than furosemide. Torasemide did not accumulate during repeated administration (5 days). It was well tolerated and efficient in the treatment of oedema due to congestive heart failure and hepatic cirrhosis. The long duration of action and the potassium sparing effect of torasemide compared to furosemide are promising features of this new potent loop diuretic. PMID- 3285832 TI - Efficacy and safety of torasemide in patients with chronic heart failure. AB - A double-blind multicenter trial was carried out to compare efficacy and safety of a maintenance treatment with 5 or 10 mg torasemide (1- isopropyl-3-([4-(3 methyl-phenyl-amino)phridine]-3-sulfonyl)urea) daily in patients who were pretreated with 40 mg furosemide for compensation of chronic congestive heart failure with oedema. Patients compensated with furosemide 40 mg for at least 4 weeks were switched over to either 5 mg torasemide (group 1) or 10 mg torasemide (group 2) once a day for 6 months. The dose could be doubled at any time, but only once during the first 4 weeks, if the efficacy was considered to be insufficient. The study lasted 24 weeks. 111 patients were statistically evaluated. 54 patients started with 5 mg torasemide, 35 of them continued on this dose till the end of the study (group 1.1). In the remaining 19 patients the dose was increased to 10 mg torasemide (group 1.2). 57 patients started with 10 mg and 42 continued on it till the end of the study (group 2.1); in 15 patients the dose was increased to 20 mg (group 2.2). Within the 4 groups body weight decreased significantly (p less than 0.05). There was no significant difference in body weight either before or after treatment between the groups that received either 5 mg or 10 mg torasemide during the whole study. 28 patients had residual oedema at the beginning of the study. In only 5 of them was this found at the end of study, 23 became free of oedema. The 83 patients without oedema remained free of oedema throughout the trial.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285833 TI - Comparative study on the antihypertensive efficacy of torasemide and indapamide in patients with essential hypertension. AB - In a double-blind randomized multicenter study the antihypertensive efficacy of 2.5 mg torasemide (1- isopropyl-3-([4-(3-methyl-phenylamino)pyridine]-3 sulfony)urea) and 2.5 mg indapamide was compared in patients with essential hypertension, known as responders to diuretic therapy. After a wash-out period of 4 weeks patients with a sitting diastolic blood pressure of 100-115 mmHg were included in the 12-weeks active treatment period. After 4 weeks of treatment with a once daily 2.5 mg dose of each drug, doses could once be doubled if blood pressure decrease was considered to be insufficient. 66 patients qualified for the statistical evaluation, 32 in the torasemide group and 34 in the indapamide group. In these patients both drugs caused a similar fall in blood pressure leading to a normalization of blood pressure in most of the patients. Serum parameters remained within normal limits. Only serum potassium was significantly lower with 2.5 mg indapamide compared to 2.5 mg torasemide at the end of the study. No side effects were reported for both drugs. As the lowest effective dose of a diuretic should be used for the treatment of hypertensive patients, 2.5 mg torasemide, which is below the threshold dose for significantly enhanced diuresis, seems to be the recommended dose for antihypertensive treatment. PMID- 3285835 TI - Dose-dependent salidiuretic efficacy of torasemide in comparison to furosemide and placebo in advanced renal failure. AB - In a controlled randomized double-blind clinical trial the salidiuretic efficacy of 20 and 100 mg torasemide (1-isopropyl-3-([4-(3-methyl-phenylamino)pyridine]-3 sulfonyl)urea) and 60 mg furosemide, respectively, was compared including a control group with placebo after a single i.v. administration in 46 patients with advanced chronic renal failure (creatinine clearance less than or equal to 30 ml/min). 20 mg torasemide exerted a significant natriuretic activity within the first 6 h, whereas 100 mg torasemide induced a significant 24-h extra-excretion if compared to placebo. The sodium excretion induced by 100 mg torasemide was superior to the one by 60 mg furosemide. The duration of action of torasemide was longer than that of furosemide. The tolerance was good in all groups. PMID- 3285834 TI - Single dose comparison of torasemide and furosemide in patients with advanced renal failure. AB - In a comparative study on the fluid and electrolyte excretion of 90 patients with chronic renal failure (serum creatinine greater than or equal to 3.0 mg/dl) 100 and 200 mg torasemide (1-isopropyl-3- ([4-(3-methyl-phenylamino)pyridine]-3 sulfonyl)urea) vs. 100 and 200 mg furosemide were administered intravenously. A long-acting salidiuretic effect was demonstrated for torasemide. Torasemide can thus be categorized as a high-ceiling, long-acting diuretic. Tolerance of both diuretics was comparable. PMID- 3285836 TI - Torasemide for diuretic treatment of advanced chronic renal failure. AB - In a double-blind randomized clinical trial the efficacy and safety of oral high dose torasemide (1-isopropyl-3- ([4-(3-methyl-phenylamino)pyridine]-3 sulfonyl)urea, T) therapy was compared with that of furosemide (F) in 10 patients with advanced chronic renal failure. The efficacy on edema, fluid and electrolyte balance including the influence on renin-angiotensin-aldosterone system and cochlear function was evaluated. Patients were randomly allocated to either 500 mg F/d (group 1) or 200 mg T/d (group 2). After 14 days of treatment doses were doubled in each group for further 14 days. With respect to the 2.5 times lower dose of T the clinical effect of both drugs on edema, fluid and sodium excretion was equipotent. Significant differences were noted on calciuresis. Serum calcium levels were reduced with F, while T had no influence on calcium balance. A significant increase in plasma renin activity (PRA) was observed after F, whereas T had no raising effect on PRA. No significant alteration of plasma aldosterone concentration occurred with T or F. No adverse effects were noted in both groups. Serial audiometries showed no significant impairment of cochlear function with both drugs. In conclusion, these results indicate that high-dose T is efficient and safe in the treatment of advanced chronic renal failure. The lack of a calciuric effect with T can be regarded as an advantage in patients with hypocalcemia in chronic renal failure. PMID- 3285837 TI - Comparison of efficacy and tolerance of different oral doses of torasemide and furosemide in patients with advanced chronic renal failure. AB - In a double-blind, randomised group comparative study the efficacy of daily oral administration of 100 mg and 200 mg torasemide (1-isopropyl-3-([4-(3-methyl phenylamino)pyridine]-3-sulfonyl)urea) were compared with that of 250 mg furosemide over 2 weeks in patients with advanced chronic renal failure, who had been pretreated with a maintenance therapy of 500 mg furosemide per day. Of the 19 patients 7 had been allocated strictly at random to 100 mg torasemide, 6 to 200 mg torasemide and 6 patients to 250 mg furosemide. The volume excretion after administration of 200 mg torasemide was significantly higher than after administration of 250 mg furosemide and non-significantly higher than after 100 mg torasemide. In comparison with baseline values under pretreatment with 500 mg furosemide there was a slight reduction of fluid and sodium excretion in the 100 mg torasemide group and a clear reduction in the 250 mg furosemide group. In contrast, in the 200 mg torasemide group excretion of fluid and sodium increased. The tolerance was good in all 3 groups. PMID- 3285839 TI - Fermentation with immobilized cell cultures. AB - For the production of monoclonal antibodies and complex recombinant human proteins or glycoproteins a number of immobilized cell culture systems have been developed. The advantages of such cell culture systems are that cells can be kept in small volumes of cell culture fluid and media can be changed continuously if necessary for induction of product synthesis or removal and harvest of metabolic products. Whereas the hollow fiber and the opticell culture systems can be limited in scaling up the microcarrier system, the fluidized bed bioreactor and the solid bed bioreactor are suitable for scaling up. In contrast to the other systems, the solid bed bioreactor requires no special manipulation for anchoring the cells to the wire springs. In situ cleaning is possible and the beads are reusable. With this cell culture fermentation system, production processes for interferon beta, monoclonal antibodies for interferon alfa and recombinant human tissue plasminogen activator were developed. PMID- 3285838 TI - Dopaminergic effects on kidney function and responsiveness of aldosterone, plasma renin activity, prolactin, catecholamines, and blood pressure to stimulation in patients with prolactinoma. Comparison of the efficacy of pergolide and bromocriptine therapy. AB - 8 beta-[(Methylthio)methyl]-6-propylergoline (pergolide) is a new, potent, long acting dopaminergic DA2 receptor agonist currently being investigated for therapeutic use in patients with hyperprolactinemia, acromegaly or Parkinsons's disease. Since the influence of bromocriptine, a well-established dopaminomimetic compound, on aldosterone responsiveness and plasma renin activity is still a matter of debate, the efficacies of both compounds on these parameters and on kidney function, blood pressure, catecholamine release and prolactin levels were compared in 16 patients with prolactinoma. Supine and furosemide (40 mg i.v.) stimulated plasma renin activity and aldosterone levels were similarly decreased by bromocriptine (2.5-30 mg/d) and pergolide (50-500 micrograms/d). Suppression of blood pressure, inhibition of stimulated norepinephrine release, increase in creatinine clearance, and decrease in base-line prolactin levels were similarly pronounced during treatment with both compounds. Metoclopramide (10 mg i.v.) induced stimulation of aldosterone and prolactin levels, however, were suppressed only by bromocriptine and not by pergolide. It remains to be studied whether this difference between bromocriptine and pergolide is due to a potential agonist effect of pergolide on dopaminergic DA1 receptors which are influenced by bromocriptine in an antagonistic manner, or whether pergolide can be more readily displaced from its receptors than bromocriptine. PMID- 3285840 TI - Code of ethics of the American Speech-Language-Hearing Association 1988 (revised January 1, 1986). PMID- 3285841 TI - Salaries of ASHA members: the 1987 update. PMID- 3285842 TI - Searching with computerized data bases. PMID- 3285843 TI - Provision of audiology and speech-language pathology services to older persons in nursing homes. PMID- 3285844 TI - Position statement: The delivery of speech-language pathology and audiology services in home care. PMID- 3285846 TI - Position statement: The roles of speech-language pathologists and audiologists in working with older persons. PMID- 3285845 TI - Position statement: The role of speech-language pathologists in the identification, diagnosis, and treatment of individuals with cognitive communicative impairments. PMID- 3285847 TI - Organizational resources for worksite health promotion. PMID- 3285849 TI - Environmental medicine: an annotated bibliography of the recent literature (Part II). PMID- 3285848 TI - Nonconvulsive status epilepticus in adults. PMID- 3285850 TI - The University of Greenland. PMID- 3285851 TI - Medical aspects of Arctic exploration: 2. A Russian voyage to Alaska: Otto van Kotzebue (1816-1817). PMID- 3285852 TI - The tuberculosis-miracle in Greenland. PMID- 3285853 TI - [Cyclosporin A in renal transplantation in children and its effects on growth]. PMID- 3285854 TI - [Congenital malaria. Presentation of 3 cases]. PMID- 3285855 TI - The primary structure of histone H3 from wheat. AB - Wheat embryo histone H3 has been isolated and purified and the elucidation of the complete amino-acid sequence is described. Peptides were generated by cleavages with CNBr, S. aureus V8 proteinase, endoproteinase Lys-C and trypsin. The peptides were purified by HPLC and the sequence determined by solid-state and gas phase sequencing methodology. The amino-acid sequence of the protein is identical to pea embryo histone H3 and the sequence deduced from the nucleotide sequence of a wheat embryo histone gene (Tabata T. et al. (1984) Mol. Gen. Genet. 196, 397 400). PMID- 3285856 TI - Responses to Mycobacterium leprae by lymphocytes from new and old leprosy patients: role of exogenous lymphokines. AB - Lepromatous leprosy patients generally have reduced response to Mycobacterium leprae antigens in an in vitro lymphocyte transformation test, which could be due to insufficient generation of reactions or to active suppression of any reaction generated. We could detect 3 types of lack of reactivity: one which could be restored by the addition of supernatants from healthy, PHA-stimulated lymphocyte cultures, one which could not thus be restored and one in which the culture supernatant contained factors able to suppress mitogen responses of healthy cells. We compared responses of cells from untreated patients, patients treated for 12-20 months with multiple drug therapy and patients with up to 20 years of dapsone treatment; all types of the disease were represented. Untreated patients of all types had low responses which were not always reconstituted by lymphokine rich supernatants, but they did not produce the non-specific soluble suppressive factors. In most cases, including BL/LL types, after the initial months of treatment, antigen response improved and was further increased by the addition of supernatants containing lymphokines. Most of the long-term-treated, stable patients had a lymphokine-reconstitutable antigen response, and in most cases also produced non-specific suppressive factor(s). The question as to why leprosy patients do not respond to M. leprae antigen is a complex one; our results suggest that it is related to the activity of the infection in each group of patients. PMID- 3285857 TI - Inhibition of anti-hapten antibody plaque-forming cells by a chemically reactive hapten. AB - The ability of the chemically reactive hapten 2-4-6-trinitrobenzene sulphonic acid (TNBSA) to inhibit anti-TNP IgM antibody plaque-forming cells (APFC) was investigated. TNBSA at a concentration of 1 mg (3 X 10(-3)M) to 0.3 mg (10(-3] completely inhibited IgM anti-TNP APFC after a 10-min incubation period at 37 degrees C. This inhibition was specific and did not alter the antifluorescein IgM antibody response. After a 24-h culture period in tissue culture medium without antigen, the non-dividing APFC remained inhibited, whereas the dividing APFC escaped this inhibition. PMID- 3285858 TI - The pathophysiological role of water-sodium balance and renal dopaminergic activity in overweight patients with essential hypertension. AB - Studies were conducted to evaluate the role of water-sodium balance and renal dopaminergic activity in the hypertensive mechanisms of overweight patients with essential hypertension (EHT). The body mass index (BMI) was correlated positively with mean arterial pressure, plasma volume, extracellular fluid volume, or total exchangeable sodium and negatively with plasma noradrenaline concentration or plasma renin activity in patients with EHT. Fractional excretion of sodium (FENa) was significantly lower in overweight patients than in normal weight patients with EHT. Hypotensive effect of sodium restriction or the natriuretic response to infused dopamine was more remarkable in overweight patients with EHT than in normal weight patients with EHT. Urinary excretion of free dopamine (UDA) was correlated positively with simultaneously measured urinary excretion of sodium or FENa and negatively with the natriuretic response to dopamine infusion. In addition, UDA was positively correlated with the BMI in normal weight patients with EHT, whereas the relation between the UDA and the BMI was significantly negative in overweight patients with EHT. These findings suggest that the expansion of body fluid volume and sodium might result from the blunted natriuretic ability due to an attenuation of the renal dopaminergic activity in overweight patients with EHT. The expansion of body fluid volume and sodium may play an important role in the hypertensive mechanisms of overweight patients with EHT. PMID- 3285859 TI - Reductions in total and extracellular water associated with calcium-induced natriuresis and the antihypertensive effect of calcium in blacks. AB - Previous data from this laboratory suggest that Ca-induced reductions in blood pressure may result in part from Ca-induced natriuresis and a possible reduction in intravascular volume. Consequently, the present study was conducted to directly determine the relative effects of dietary Ca and Na on total body water (TBW) and extracellular water (ECW) as measured by tetrapolar bioelectrical impedance and to determine the potential relationship of these changes to diet induced changes in blood pressure. Eleven hypertensive black adults were maintained for 14 days on each of four diets that contained 356 mg Ca or 1,000 mg Ca, each at 1,000 or 4,000 mg Na in a repeated measures design. Increasing dietary Na at the low Ca intake caused significant increases in supine systolic and diastolic pressure, reduced plasma renin activity (PRA), significantly increased TBW, and caused a significant reduction in total body reactance indicating an increase in ECW. Adding supplementary Ca to the low Na diet was without significant effect on blood pressure, PRA, TBW, or electrical reactance. In contrast, adding Ca to the low Ca-high Na diet caused a significant natriuretic effect that was accompanied by significant increases in PRA and electrical reactance and significant reductions in blood pressure and TBW, to baseline (low Ca-low Na levels). Thus, these data indicate that the antihypertensive effect of calcium in salt-sensitive blacks may be attributable, in part, to Ca-induced natriuresis and an associated volume contraction. PMID- 3285860 TI - Central serotonergic mechanisms in hypertension. AB - Serotonin-containing neurons in the central nervous system are grouped into a number of discrete and distinctive collections with cell bodies in the brainstem and projections passing to many regions of the brain and spinal cord. Evidence is presented that activation of one projection of serotonin-containing neurons from the midbrain to the hypothalamus elevates arterial pressure. Evidence is also presented that activation of a projection descending from the lateral B3 serotonin cell group to the spinal cord elicits a pressor response that is accompanied by increased release of serotonin in the spinal cord and is independent of the C1 adrenaline-containing neurons that lie close by. In contradistinction, experiments are described demonstrating that activation of the midline group of B3 serotonin cells in the raphe nucleus causes a fall in arterial pressure, consistent with the view that different groups of serotonin neurons in the brain and spinal cord participate in the control of blood pressure in diverse ways and can have different effects on blood pressure. Finally, experiments are described showing that the hypotensive action of methyldopa is mediated in part through central serotonin nerves. PMID- 3285861 TI - Mechanisms in obesity-related hypertension: role of insulin and catecholamines. AB - Although the association of obesity and hypertension is well recognized, the mechanisms involved in the pathogenesis of increased blood pressure in the obese are poorly understood. Recent studies addressing the impact of 1) body fat distribution on blood pressure and 2) dietary intake on sympathetic nervous system (SNS) activity suggest a plausible hypothesis that relates the hypertension of the obese to hyperinsulinemia and SNS stimulation. Hypertension in the obese is associated with fat accumulation in the upper body segments; this type of obesity is also characterized by hyperinsulinemia and insulin resistance. Insulin, moreover, is an important signal in the relationship between dietary intake and SNS activity: increased insulin levels are associated with SNS stimulation. The hyperinsulinemia of obesity may, therefore, increase blood pressure by 1) direct effects of insulin to stimulate renal sodium reabsorption, and 2) sympathetic stimulation of the heart, blood vessels, and kidney. Conversely, SNS suppression and diminished insulin following caloric restriction may explain the hypotensive effects of caloric restriction in obese hypertensive subjects. The hypothesis presented here emphasizes the important role of diet in the treatment of obese hypertensive subjects. The efficacy of caloric restriction, weight loss, and exercise in reducing blood pressure in the obese is linked to diminished insulin and SNS activity and may be viewed as evidence in favor of this hypothesis. PMID- 3285862 TI - Decelerative treatment practices with persons who have mental retardation: a review of five years of the literature. AB - The literature from 1981 through 1985 in seven major journals on the treatment of behavior problems in persons with mental retardation was reviewed. We included all studies designed to decrease a target behavior that included formal pre- and posttreatment data. Behavior problems were categorized into seven classes. Treatment procedures were grouped into three levels by degree of restrictiveness according to the model proposed by Brazier and MacDonald (1981). We reported the problems treated with various procedures and the frequencies and effectiveness values for all the problem--procedure combinations. Differential reinforcement and overcorrection were the two most widely used procedures. We drew conclusions about treatment of specific classes of problem behaviors based on the results of this review. PMID- 3285863 TI - Campylobacter jejuni/coli. PMID- 3285864 TI - Blood-monocyte functions in acute bacterial meningitis. AB - The blood-monocyte chemotactic, phagocytic and microbicidal activities were studied in 20 patients with acute bacterial meningitis. The cell functions were measured on admission, during treatment and after clinical recovery. In general, monocyte functions were within normal range on admission. However, in 2/2 patients with Neisseria meningitidis meningitis, complicated by disseminated intravascular coagulation, defective chemotaxis was observed. Other patients had normal or enhanced monocyte chemotaxis. Two patients died: one had normal monocyte functions, one had initially defective chemotaxis and microbicidal activity. During treatment, cell functions normalized and after recovery all but one patient had a normal blood-monocyte function profile. In conclusion, acute bacterial meningitis is not due to, or followed by, abnormal nonspecific functions of blood monocytes. However, development of disseminated intravascular coagulation is associated with depressed chemotactic responsiveness. PMID- 3285865 TI - Characteristics of the granulocyte chemiluminescence reaction following an interaction between human neutrophils and Salmonella typhimurium bacteria. AB - The production of reactive oxygen metabolites by neutrophils is thought to play a key role in the host defence against invading microorganisms. The production of these oxidative metabolites can be measured as chemiluminescence. In this study, two strains of Salmonella typhimurium were used as stimuli, and the opsonin independent CL response from neutrophils challenged with these bacteria was investigated. The strains used, S. typhimurium 395 MS and a rough (Rd Epi-2) mutant 395 MR10, differ with respect to physicochemical surface characteristics. When neutrophils were exposed to the phagocytic prey, only the MR10 bacteria induced a CL response. The response induced by the MS bacteria was less than 2% of that induced by MR10. In order to study the relation between intra and extracellularly generated CL, systems were used which selectively inhibit the intra and extracellular CL, respectively. Using these systems it was found that a predominant part of the response was of intracellular origin. When the neutrophils were treated with cytochalasin B (5 micrograms) before the addition of the bacteria, the CL response was reduced to around 37% of the value obtained from untreated cells, and the relation between the extra and the intracellular parts of the response was changed. The mechanism(s) and biological consequences of the extracellular and intracellular generation of oxygen metabolites, respectively, are discussed. PMID- 3285866 TI - Antigen expression of the pancreatic beta-cells is dependent on their functional state, as shown by a specific, BB rat monoclonal autoantibody IC2. AB - Antigen expression is studied corresponding to a monoclonal autoantibody (IC2) derived from a hybridoma of rat myeloma Y3 cells and splenocytes of the diabetic BB rat. The selective reactivity of IC2 with islet cells has earlier been proven. We studied the possible specificity for beta islet cells, and the possible variation in autoantigen expression. Islet cells were isolated by cautious collagenase and dispase treatment. The cells were labelled with IC2 alone or together with anti-insulin immunoglobulin in double-labelling experiments. Extensive series of cells were examined by immunofluorescence microscopy, and some samples also by flow cytometry. In double-labelling examinations we found that only anti-insulin positive cells could bind the IC2 antibody, thus showing beta-cell selectivity. On the other hand, not all anti-insulin positive cells were IC2-positive. Since insulin treatment has been shown to decrease the incidence of diabetes in the BB rat, islet cells were examined after reduced beta cell strain. Islet cells from Lewis and Wistar Furth rats display 21.4 +/- 1.4% IC2-positive cells, while islet cells from 24-hour fasting animals showed 7.0 +/- 1.4% (p less than 0.0001). Similar results were seen for BALB/c mice (25.0 +/- 1.8% vs. 13.7 +/- 2.3%, p less than 0.002). Also, after a week of insulin treatment, autoantigen expression was significantly decreased. Thus, the IC2 antibody is beta-cell-specific, and expression of the corresponding cell surface antigen depends on the functional state of the beta-cells. PMID- 3285867 TI - Large intramuscular spindle-cell lipoma. With review of the literature. A case report. AB - A case of a large spindle-cell lipoma in an intramuscular (subfascial) localization is reported. The tumour occurred in a 58-year-old male patient and was localized subfascially in his left deltoid muscle. The tumour measured 20 X 8 X 8 cm; its weight was 780 grams. After initial biopsy, the tumour was extirpated. Microscopically, the tumour tissue consisted of mature fat cells and spindle-cell areas in varying amounts, constituting a typical appearance of a spindle-cell lipoma. There were no histological signs of malignancy. Especially, no areas of liposarcoma differentiation were detected. The patient is well, with no signs of recurrence, one and a half years after the operation. We have reviewed the literature on spindle-cell lipoma, and we believe this is the first example of this neoplasm to be reported in an intramuscular (subfascial) localization. PMID- 3285868 TI - Effect of trans(E)-clopenthixol on Plasmodium berghei in vivo. AB - Previous in vitro studies have shown suppression of the growth of Plasmodium falciparum by the neuroleptic agents chlorpromazine and zuclopenthixol (formerly known as cis(Z)-clopenthixol) as well as by the neuroleptic inactive steroisomer trans(E)-clopenthixol. These compounds are chemically related to riboflavin and may act as inhibitors of riboflavin metabolism. As trans(E)-clopenthixol has been found active against chloroquine-resistant strains of P. falciparum in vitro and has been approved for human use, though inactive as a neuroleptic, this drug was selected for the present in vivo study. The dosage of trans(E)-clopenthixol was optimized through a pharmacokinetic study, and the suppression of the growth of Plasmodium berghei in vivo was tested in mice, with chloroquine acting as the positive and saline as the negative control. Trans(E)-clopenthixol did not inhibit the growth of P. berghei, whereas chloroquine almost eradicated the infection. The use of in vitro screening for anti-malarial activity in drugs approved for human use for other indications is discussed in the light of the results. It is concluded that the selection of drugs for further studies in vivo cannot solely be based on positive results in vitro. PMID- 3285869 TI - Inflammatory response to implants. AB - The implantation of artificial organs, medical devices, or biomaterials results in injury and initiation of the inflammatory response. This inflammatory response to implants has as its components acute inflammation, chronic inflammation, foreign body reaction with granulation tissue, and macrophage and foreign body giant cell interactions. The form and topography of the surface of the artificial organ, medical device, prosthesis, or biomaterial can determine the composition of the foreign body reaction. The normal foreign body reaction consists of macrophages and foreign body giant cells at the surface of the implant with subjacent fibroblastic proliferation and collagen deposition, and capillary formation. Macrophages play a pivotal role in the response of tissue to implants. An hypothesis on the role of complement activation and complement-mediated cellular adhesion to implant surfaces has been presented. Macrophage adhesion and subsequent activation leading to cell-mediator and cell-cell communication is described. PMID- 3285870 TI - The introduction of continuous ambulatory peritoneal dialysis (circa 1975). PMID- 3285871 TI - New graft materials and current approaches to an acceptable small diameter vascular graft. AB - Prosthetic graft material has not been successful for small artery bypass. Mechanical, cellular, and humoral factors have all been implicated as a cause of failure. In vitro, ex vivo, and in vivo methods have been developed to assess platelet and fibrinogen deposition, measure compliance, and study other factors theorized to relate to graft failure. Cell culture techniques have been used to determine the role of cellular mitogens. The goal of an arterial substitute that can maintain patency in a 3-4 mm diameter low-flow configuration and that is not associated with the development of anastomotic hyperplasia has yet to be reached. A variety of solutions are being researched. New nonthrombogenic polymers are being tested as are new coatings for standard materials. Endothelial cell seeding has been accomplished in animals and is being tried in human clinical studies. Problems and results of endothelial seeding trials are reviewed. Other biologic approaches include the in vitro construction of a blood vessel model using cell coculture techniques and the implantation of bioabsorbable prosthetics into animals. The role of pharmacologic agents in maintaining graft patency is addressed. PMID- 3285873 TI - A rotational path of insertion for Kennedy Class IV removable partial dentures. PMID- 3285872 TI - The effect of porosity and biomaterial on the healing and long-term mechanical properties of vascular prostheses. AB - Continuing efforts in vascular prosthetic design are focused on understanding the characteristics required for function of small internal diameter and low-flow prostheses. The pioneers of vascular surgery developed large diameter textile prostheses for successful reconstruction of the aortoiliac vessels, but fabric grafts function poorly in diameters less than six millimeters. Major advances in small vessel reconstruction include the use of autogenous vessels for coronary artery lesions and microvascular surgery of digital and cerebral vessels. The author believes that future advances in graft design will enable prosthetic repair of two to four millimeter arteries and reconstruction of veins. This manuscript discusses the development of improved synthetic blood compatible surfaces with detailed consideration of prosthetic design factors such as pore size, biomaterial mechanical properties and thrombogenicity of the blood flow surface. PMID- 3285874 TI - Ceramics in clinical dentistry. PMID- 3285875 TI - Badges of the dental profession. British Society for Restorative Dentistry. PMID- 3285876 TI - Determinants of left ventricular function one year after cardiac transplantation. AB - Left ventricular systolic function was assessed by radionuclide angiography in 107 consecutive transplant recipients who were alive one year after operation. Mean (SEM) ejection fraction was 62.4 (4.6) at rest and 68.8 (5.4) on exercise. The influence of donor-related factors (donor age and sex, ischaemia time), recipient-related factors (recipient age and sex, frequency of acute rejection), type of immunosuppression (cyclosporin/azathioprine or prednisolone/azathioprine), and frequency of hypertension on left ventricular function one year after operation was examined by univariate and multivariate analysis. There was a close association both at rest and on exercise between a higher ejection fraction and treatment with cyclosporin/azathioprine. There was a trend for lower donor and recipient age, shorter ischaemia time, and fewer rejection episodes to be associated with better left ventricular function, but this was not statistically significant. Left ventricular systolic function was well maintained in most patients a year after cardiac transplantation. The type of immunosuppression used had a strong influence on the left ventricular systolic function of the transplanted heart. PMID- 3285877 TI - Effect of nifedipine on enzymatically estimated infarct size in the early phase of acute myocardial infarction. AB - In a double blind placebo controlled trial, 434 patients with suspected myocardial infarction were randomised to treatment with nifedipine (n = 217) or placebo (n = 217) within six hours from the onset of chest pain. During the treatment period of 48 hours, a 10 mg capsule containing nifedipine or placebo was given sublingually every four hours for 24 hours, then orally every four hours for the next 24 hours. Acute myocardial infarction was confirmed in 295 patients (146 in the nifedipine group and 149 in the placebo group). The median delay time to intervention with nifedipine in patients with acute myocardial infarction was 111 minutes. Infarct size was assessed by the estimation of release of creatine kinase isoenzyme MB and creatine kinase from blood samples taken every four hours for 48 hours. The total mean (SEM) creatine kinase MB released was 406.4 (27.2) IU/l in the nifedipine group and 345.7 (20.5) IU/l in the placebo group. Total mean (SEM) creatine kinase released was 2749.6 (165.1) IU/l in the nifedipine group and 2698.4 (145.9) IU/l in the placebo group. In hospital mortality was similar for both the nifedipine and placebo groups (6.6% and 5.8% respectively). Treatment with nifedipine in the early phase of acute myocardial infarction seems to have no effect on enzymatically measured infarct size. PMID- 3285878 TI - Nifedipine in acute myocardial infarction: an assessment of left ventricular function, infarct size, and infarct expansion. A double blind, randomised, placebo controlled trial. AB - The influence of nifedipine on left ventricular ejection fraction, infarct size, and infarct expansion was studied in a prospective, double blind, randomised, placebo controlled trial in 132 patients with low risk acute myocardial infarction of less than 12 hours duration, defined by an initial left ventricular ejection fraction greater than 35% and clinical Killip class of less than or equal to II. Sixty four patients were assigned to nifedipine 120 mg/day and 68 to placebo. Treatment was started on average (SEM) 8.0 (0.2) hours after onset of pain and continued for six weeks. Gated blood pool scans, thallium scans, and cross sectional echocardiograms were performed before treatment and at 10 days. There were no significant differences between the two groups in age, sex, cardiac risk factors, or use of other medications. Mean (SEM) global left ventricular ejection fraction was not different before treatment (nifedipine group 53 (2%), placebo group 55 (2%) and did not differ at 10 days (nifedipine group 54 (2%), placebo group 52 (2%). There were also no differences in regional wall motion or regional ejection fractions. Thallium defects quantified by computer analysis were similar in both groups before treatment (nifedipine 7.8 (0.7), placebo 7.9 (0.7)) and at 10 days (nifedipine 5.3 (0.7) placebo 5.3 (0.7)). In the subgroup of patients with transmural infarction who had good quality echocardiograms and serial studies (n = 30), there was no difference in mean (SEM) baseline infarct segment lengths between the two groups (nifedipine 70 (4) mm, placebo 65 (4) mm); however, the nifedipine group demonstrated no significant change in infarct segment length between the initial and 10 day studies ( + 0.6 (3) mm) while there was a significant increase in the infarct segment length in the placebo group (+ 7.8 (4) mm). The infarct segment length increased by >/= 1 cm in seven (47%) placebo patients but in only one (7%) nifedipine patient. The nifedipine group had a significant initial 10% decrease in mean arterial pressure whereas there was no change in the in the placebo group; this blood pressure difference persisted for 10 days. Thus although the early administration of nifedipine has no detectable effect on clinical outcome and infarction size, it may reduce early infarct expansion via an afterload reduction mechanism in patients with transmural infarction. These initial results must be interpreted with caution and need to be confirmed in a larger trial. PMID- 3285879 TI - Accessory mitral valve leaflet causing aortic regurgitation and left ventricular outflow tract obstruction. Case report and review of published reports. AB - Arrhythmias, aortic regurgitation, and symptoms of severe intermittent ventricular outflow obstruction developed in a 14 year old boy with a heart murmur who had been followed from infancy. These were caused by an accessory mitral leaflet, which was successfully removed at open heart operation. A review of 21 previously reported cases found a high incidence of associated cardiac malformations, appreciable subaortic obstruction in most patients, and a consistent attachment of the accessory tissue to the ventricular aspect of the anterior mitral leaflet. The characteristic echocardiographic appearance of a mobile mass arising from the area of aortic-mitral continuity is sufficient for the diagnosis of accessory mitral leaflet and echocardiographic examination will facilitate the surgical management of this condition. PMID- 3285880 TI - Diseases of animals transmissible to man (zoonoses). PMID- 3285881 TI - Sex difference in fetal head growth. AB - Growth of the fetal biparietal diameter (BPD) throughout the second and third trimesters was measured in a prospective longitudinal study. Linear-cubic equations were fitted to the data of individual fetuses and from these equations mean growth curves were produced for males and females. The head growth trajectories of males and females were significantly different. The study illustrates why the practice of dating pregnancies by ultrasonic fetal BPD measurement at about 16 weeks gestation can lead to error. PMID- 3285882 TI - References ranges and sources of variation for indices of pulsed Doppler flow velocity waveforms from the uteroplacental and fetal circulation. AB - Variation in indices used to characterize the maximum frequency outline of waveforms obtained from the uteroplacental and fetal circulations by duplex Doppler ultrasound was studied between observers, over a 24-h period and before and after a meal. No significant differences were found. Reference ranges were derived for three indices, the A/B ratio, the resistance index and the pulsatility index, for waveforms from the fetal descending aorta, umbilical artery, and the placental and maternal sides of the uteroplacental circulation. Indices from waveforms from the uteroplacental circulation demonstrated a fall from 16 to 24 weeks gestation with no change thereafter. The umbilical artery indices demonstrated a continuing fall with increasing gestation but the A/B ratio and resistance index from the fetal descending aorta did not change with gestation. The pulsatility index from the aorta demonstrated a gentle rise. PMID- 3285883 TI - Amoxycillin-clavulanic acid (Augmentin) versus metronidazole as prophylaxis in hysterectomy: a prospective, randomized clinical trial. AB - In order to determine the most effective regimen for the prevention of infection after elective hysterectomy, 300 patients were randomly assigned to receive three perioperative doses of either amoxycillin-clavulanic acid (1.2 g intravenous) or metronidazole (1 g suppository). Of the 280 patients who were assessable 138 were given amoxycillin-clavulanic acid and 142 received metronidazole; 268 underwent abdominal hysterectomy and 12 had vaginal hysterectomy. Patients in the amoxycillin-clavulanic acid group had significantly less infectious morbidity (13.8%) than those in the metronidazole group (33.1%). There were also statistically significant differences in favour of amoxycillin-clavulanic acid with respect to operative site infection, duration of hospital stay, need for postoperative antimicrobials, and surgery for operative site infection. But for one isolate of Bacteroides fragilis, all pathogens isolated from wound infections in the metronidazole group were aerobes. No anaerobes were isolated from patients in the amoxycillin-clavulanic acid group. The results suggest that prophylaxis for hysterectomy should consist of an agent, or combination of agents, with activity against both aerobic and anaerobic bacteria. Amoxycillin-clavulanic acid fulfils this criterion and appears to be effective and safe. PMID- 3285884 TI - Recurrent intracranial haemorrhages in utero in an infant with alloimmune thrombocytopenia. Case report. PMID- 3285885 TI - The relation between fetal heart rate and Doppler flow velocity waveform A/B ratio. PMID- 3285886 TI - The effect of fetal heart rate on umbilical artery flow velocity waveforms. PMID- 3285887 TI - Leukoplakia of the labial commissure. AB - A white lesion located in the labial commissure can pose problems for both the clinician and the pathologist. The clinician may be limited in his surgical treatment because of aesthetic reasons, whilst the pathologist may be confronted with a lesion with or without candidal involvement, showing the histological features of hyperplastic candidiasis, verrucous hyperplasia, verrucous carcinoma, epithelial dysplasia, carcinoma-in-situ and, occasionally, squamous cell carcinoma. A retrospective study was undertaken of 10 patients with leukoplakic commissural lesions, who visited the Department of Oral Surgery in the Teaching Hospital of the Free University, Amsterdam in the period between 1973-1986. The clinical and histopathological findings are presented. Although a carcinoma in this particular region is rather rare, alertness remains necessary as one patient with the clinical appearance typical of leukoplakia, showed on biopsy the presence of a squamous cell carcinoma at this first visit. In another two patients the areas of leukoplakic change were shown histologically to be based on verrucous carcinoma. In one patient a squamous cell carcinoma developed after several years, in spite of treatment. In view of the small number of patients under discussion and also the somewhat debatable diagnosis of verrucous carcinoma, we do not feel justified in drawing any firm conclusions from our findings with regard to the malignant potential of leukoplakia of the oral commissures. PMID- 3285888 TI - Mediastinal emphysema complicating a zygomatic fracture: a case report and review of the literature. AB - A case of a man with an otherwise simple facial fracture which was complicated by mediastinal emphysema is reported. A review of the literature indicating the pathogenesis, clinical and radiographic features and management of this condition is given. PMID- 3285889 TI - Facial nerve paralysis complicating bilateral fractures of the mandible: a case report and review of the literature. AB - A case report of a unilateral lower motor neurone facial nerve paralysis complicating bilateral fractures of the mandible is described. The injury was the result of a fall. The differential diagnosis is discussed together with the treatment undertaken. The importance of a thorough examination of the cranial nerves following trauma is emphasised. A review of the literature is presented with special reference to the relative merits and indications for the use of cortico-steroids and surgical exploration. PMID- 3285890 TI - Citation for the presentation of the 1986 Down Surgical Prize to Professor Malcolm Harris. PMID- 3285891 TI - Metabolic and developmental aspects of the pulmonary surfactant system. PMID- 3285892 TI - Transcending the impenetrable: how proteins come to terms with membranes. AB - In the living cell, proteins are efficiently sorted to a whole range of subcellular compartments. In many cases, sorting specificity is mediated by short 'sorting signals' attached either permanently or transiently to the protein. At long last, a fairly coherent picture of the design and function of many such sorting signals is beginning to emerge. PMID- 3285893 TI - Transport of ascorbic acid and other water-soluble vitamins. PMID- 3285894 TI - Interactions of sugars with membranes. AB - Water profoundly affects the stability of biological membranes, and its removal leads to destructive events including fusion and liquid crystalline to gel phase transitions. In heterogeneous mixtures such as those found in biological membranes the phase transitions can lead to increases in permeability and lateral phase separations that often are irreparable. Certain sugars are capable of preventing these deleterious events by inhibiting fusion during drying and by maintaining the lipid in a fluid state in the absence of water. As a result, the increased permeability and lateral phase separations that accompany dehydration are absent. The weight of the evidence suggests strongly that there is a direct interaction between the sugars and lipids in the dry state. Although the evidence is less clear about whether these sugars can interact directly with hydrated bilayers, there are strong suggestions in the literature that sugars free in solution or covalently linked to membrane constituents can also affect the physical properties and presumably the stability of bilayers. Finally, we have far less evidence concerning the mechanism by which they do so, but the same sugars are also capable of preserving the structure and function of both membrane bound and soluble proteins in the absence of water. We believe these effects may be important in the survival of intact cells and organisms such as seeds in the absence of water. Furthermore, in view of the practical importance of preserving biological structures we suspect that the results described here will ultimately have important applications in biology and medicine. PMID- 3285895 TI - Effects of recombinant human interleukin 1 alpha and interleukin 1 beta on cell growth and alkaline phosphatase of the mouse osteoblastic cell line MC3T3-E1. AB - Recombinant human interleukin 1 (rhIL-1)alpha and rhIL-1 beta were examined for their effects on DNA synthesis, cell growth and alkaline phosphatase activity of the mouse osteoblastic cell line MC3T3-E1. The relative activity of rhIL-1 alpha and rhIL-1 beta was compared in terms of the units which induced half-maximal [3H]thymidine uptake into mouse thymocyte cultures exposed to IL-1. Both rhIL-1 alpha and rhIL-1 beta significantly inhibited DNA synthesis and division of the cells in a concentration- and cultivation time-dependent fashion. In contrast, rhIL-1 alpha and rhIL-1 beta markedly increased alkaline phosphatase activity, which is a marker of osteoblastic differentiation. This activity in cells treated with rhIL-1 alpha and rhIL-1 beta increased about 2.0- and 1.7-fold, respectively, compared with that of control cultures. Inhibition of the DNA synthesis and stimulation of alkaline phosphatase activity by both types of rhIL 1 were completely neutralized by treatment with their respective polyclonal antisera. Also, inhibition of DNA synthesis was unaffected by the addition of cyclooxygenase and lipoxygenase inhibitors, and stimulation of alkaline phosphatase activity was unaffected by the addition of indomethacin. These results indicate that both rhIL-1 alpha and rhIL-1 beta have qualitatively similar biological effects on osteoblastic cells. They also suggest that IL-1 is an important modulator of the growth and differentiation of osteoblasts. PMID- 3285896 TI - [Optimization of methods of immobilization of anti-immunoglobulins. Equilibrium parameters of the interaction of immobilized antibodies with an antigen]. AB - Methods for immobilization of anti-immunoglobulins on insoluble supports were optimized, and the interaction of immunoadsorbents obtained with [125I]-labeled rabbit IgG was investigated. It was shown that this interaction can be adequately described by a rather simple equilibrium model which reflects the interaction of a monovalent antigen with two independent types of binding sites. Within the framework of this model the association constants as well as the concentrations of high affinity binding sites which influence the capacity and efficiency of the separation system were determined. Optimization of the immobilization methods implicated a study on the role of certain functional groups of the antibody involved in the formation of covalent bonds, on the effect of the spacer arm length on the properties of immobilized antibody as well as on the role of the degree of immobilization. It was found that immunoadsorbents obtained after antibody immobilization via lysine or tyrosine residues on matrices with a specific spacer group are the optimal ones. PMID- 3285897 TI - [Effect of prostaglandins I2 and E1 on the cholesterol level in cultured smooth muscle cells from the human aorta]. AB - Prostaglandins I2(PGI2) and E1(PGE1) (5 X 10(-7) M) reduced by 30% the content of intracellular cholesterol in cultured human aorta smooth muscle cells after 24 hrs of incubation in a medium without fetal calf serum. Total HDL, as well as HDL3 and HDL2b fractions stimulated the effect of prostaglandins on the reduction (by 50%) of cholesterol level. PMID- 3285898 TI - Neutrophil-mediated killing, opsonization, and serum-mediated killing of Escherichia coli K1 by neonatal rats. AB - Neonates are particularly susceptible to infection with Escherichia coli K1. To investigate the mechanisms which lead to this susceptibility, we examined: (a) the bactericidal activity of neutrophils; (b) opsonization, and (c) the bactericidal activity of serum in developing rats. Neutrophils from adult rats killed E. coli K1 more efficiently than did neutrophils from young animals. Opsonization of E. coli by serum of prematurely delivered rats was poor. Serum from prematurely delivered and term rats promoted growth of E. coli K1, while serum from adult rats killed greater than 95% of the organisms within 90 min. However, the mixture of heat-inactivated serum from adult rats plus serum from prematurely delivered rats killed E. coli K1. PMID- 3285899 TI - Loss of the cortisol response to naltrexone in Alzheimer's disease. AB - The administration of a single dose of the opiate antagonist naltrexone (NT) was accompanied by significant elevations in plasma cortisol in normal elderly subjects; in contrast, the cortisol response to NT was absent in individuals of comparable age with Alzheimer's disease (AD). The differential effect of AD on the cortisol response was not accompanied by a significant group difference in plasma prolactin in response to NT administration. Furthermore, this differential cortisol response to NT was not associated with any evident differences in age, sex ratio, plasma levels of naltrexone or its major metabolite beta-naltrexol, or with differences in measures of nonspecific stress, such as plasma free MHPG, pulse, or blood pressure, between the two groups. The absence of the well characterized cortisol response to NT in AD, together with other reports of abnormal responses to other pharmacological challenges, suggests that neuroendocrine abnormalities might be an important concomitant and possibly a central contributor to the pathophysiology of Alzheimer's disease. PMID- 3285900 TI - Remembering Gjessing: 1887-1959. PMID- 3285901 TI - Delirium in liver transplantation candidates: discriminant analysis of multiple test variables. AB - We report the results of electroencephalograms, Mini-Mental State exam, Trailmaking Tests A and B, and serum albumin levels in 108 consecutive liver transplantation candidates. We compared test results to a clinical DSM-III diagnosis of delirium. Although each variable could differentiate between the two groups (delirium n = 18; nondelirium n = 90) at a statistically significant level, a discriminant analysis involving either all variables or only three particular variables (Trailmaking B, EEG code, and albumin) resulted in the highest specificity (97.8%) and sensitivity (83.3%), with a correct classification of 95.4% of subjects. The analysis also generates an equation that can be applied to clinical situations to enhance the accurate recognition of delirium. In addition, to explain abnormal Trailmaking B scores and/or EEGs in subjects who did not otherwise meet DSM-III criteria for delirium, we suggest the presence of a "subclinical delirium." PMID- 3285902 TI - Platelet MAO activity in hallucinating and paranoid schizophrenics: a review and meta-analysis. AB - Published studies of platelet monoamine oxidase (MAO) activity of paranoid (P) and nonparanoid (NP) schizophrenics and normal controls, and of hallucinating (H) and nonhallucinating (NH) schizophrenics and normal controls were critically reviewed, and summary analyses were conducted on the original published data. Methods of comparing results across studies are discussed. Meta-analysis of the results of 11 analyses from 9 studies, examining a total of 165 P and 152 NP schizophrenics and 985 normal controls, indicated that the typical P schizophrenic studied had platelet MAO activity lower than that of 61% of NP schizophrenics and 79% of normal controls. Meta-analysis of the results of 8 separate analyses from 6 studies comprising 130 H, 81 NH schizophrenics, and 186 normal controls indicated that the average H schizophrenic studied had platelet MAO activity lower than that of 84% of NH schizophrenics and 80% of normal controls. In comparison with normal control values, P schizophrenics had the greatest mean percentage decrease in platelet MAO activity (30%), followed by NP schizophrenics (24%), and H schizophrenics (24%). These findings could not readily be attributed to diagnostic, demographic, or methodological factors, nor to the effects of alcohol or neuroleptics. PMID- 3285903 TI - Lateral asymmetries of tardive dyskinesia in schizophrenia. PMID- 3285904 TI - Motor versus EEG seizure duration in ECT. PMID- 3285905 TI - Immobilization of yeast cells in acrylamide gel matrix. AB - Entrapment of yeast cells in a three-dimensional polymer matrix was achieved, and various properties of the polymer matrix as well as the invertase activity of the yeast cells were studied. When the matrix was highly cross-linked or synthesized from concentrated polymer solutions, its swelling ratio decreased. Invertase activity was found to increase with water content of the matrix. Cell content of the gel was found to affect adversely enzyme activity. The enzyme was found to retain its activity after seven runs with the same sample. PMID- 3285906 TI - Transplantation of human hairy cell leukemia in radiation-preconditioned nude mice: characterization of the model by histological, histochemical, phenotypic, and tumor kinetic studies. AB - Two cell lines (EH and HK) with hairy cell leukemia (HCL) immunophenotypes were recently derived from two HCL patients. Both cell lines were transplanted subcutaneously (2 x 10(5) or 2 x 10(6)/mouse) in male BALB/c nu/nu mice (n = 128) with a 97% success rate when coimplanted with nonproliferative HT-1080 fibrosarcoma cells (2 x 10(6)/mouse) in recipients preconditioned with total-body irradiation (200 R weekly for 3 weeks). Tumors appeared five to ten days postimplant and reached up to 25% of body weight after a mean survival of 8 weeks (range, 30 to 90 days). Tumor histology suggested large cell lymphoma. Cytochemically and immunophenotypically, tumor cells were indistinguishable from their parent cells. Species and lineage derivation of tumor cells was confirmed by antibody probes against the mouse histocompatibility antigen H-2, human T and B lymphocyte antigens, and the HCL-associated common chronic lymphocytic leukemia antigen (cCLLa). In order of decreasing frequency, metastases occurred in the spleen, lungs, pleura, lymph nodes, bone marrow, and kidneys. Up to 12% of circulating lymphoid cells in mice were cCLLa-positive, which suggested hematogenous tumor dissemination. This HCL xenotransplantation model might be useful in preclinical studies for exploring novel experimental therapies for the management of human HCL. PMID- 3285907 TI - Ultrastructural demonstration of tubular inclusions coinciding with von Willebrand factor in pig megakaryocytes. AB - The appearance of von Willebrand factor (vWF) in bone marrow megakaryocytes was studied by standard electron microscopy (EM) and immuno-EM using an original purification technique. Eighty percent pure megakaryocytes were isolated from porcine rib bone marrow using Percoll gradients followed by counterflow centrifugation. Activation was prevented by prostacyclin and prefixation with low concentrations of glutaraldehyde. In early megakaryoblasts, standard EM revealed the presence of tubular structures in the small vesicles located in the Golgi area, in the small immature alpha-granules and in the rare mature alpha-granules. Immunolabeling for vWF was simultaneously observed in small vesicles and small alpha-granules, mainly in the Golgi zone. In mature megakaryocytes, standard EM showed that tubular structures were numerous, regularly spaced, and aligned in parallel. Immunolabeling for vWF was intense, restricted to the alpha-granules, and distributed in a similar manner to porcine platelets. Gold particles were located eccentrically at one pole of the alpha-granule, labeling only its periphery or outlining one side of an elongated granule. Tubule profiles could be seen underlying the immunolabeling and were usually located at one side of the granule. In conclusion, this study demonstrates the presence of tubular structures in megakaryocyte alpha-granules, their association with vWF, and the appearance of both in the Golgi-associated vesicles. PMID- 3285909 TI - Mutation of Ki-ras and N-ras oncogenes in myelodysplastic syndromes. AB - Somatic mutation of the N-ras oncogene occurs frequently in de novo acute myeloid leukemia (AML). By virtue of their relation to AML, myelodysplastic syndromes (MDS) provide an in vivo model of human leukemogenesis. By using a strategy for analysis of gene mutation based on in vitro amplification of target sequences by the polymerase chain reaction (PCR) and selective oligonucleotide hybridization we analyzed the mutational status of codons 12, 13, and 61 of Ha-ras, K-ras, and N-ras in peripheral blood (PB) and/or bone marrow (BM) in 34 cases of primary MDS. Mutations at codon 12 of Ki-ras or N-ras were detected in three cases (9%): one of six cases of refractory anemia with excess blasts (RAEB) and two of nine cases of chronic myelomonocytic leukemia (CMML). The nucleotide substitution differed in each. In all cases the mutant allele was detectable in PB cells. A sustained hematologic remission was achieved after low-dose cytarabine therapy in the case of RAEB. Neither case of CMML exhibited signs of disease progression during follow-up at 7 and 12 months. In contrast, four of 31 patients without the ras mutation underwent transformation to AML within 12 months of genetic analysis. We conclude that ras mutations in MDS are heterogeneous and may develop at an early stage during the evolution of MDS. Their detection in PB cells illustrates the potential utility of ras mutation as a clonal marker in myeloid malignancy. PMID- 3285908 TI - The Wistar Furth rat: an animal model of hereditary macrothrombocytopenia. AB - The mechanisms that determine and regulate platelet size are unknown. By phase microscopy, we observed that Wistar Furth (WF) rats had macrothrombocytopenia. In this study, we have characterized and compared platelets and megakaryocytes of WF rats with those of Wistar, Long-Evans hooded (LE), and Sprague-Dawley rats. In addition, we have examined the mode of inheritance of this WF rat platelet abnormality. The average platelet count of WF rats was only one-third that of the other three rat strains. In contrast, the mean platelet volume (MPV) of adult WF rats was twice that of the other rat strains; however, the average megakaryocyte diameter and DNA content distribution of WF rats were not significantly different from those of LE rats. The average megakaryocyte concentration was 30% lower in the WF strain compared with that of LE rats. Mazelike membrane formations were observed in WF platelets and megakaryocytes by electron microscopy. Reciprocal crosses of WF and LE rats resulted in offspring with MPVs and platelet counts like those of LE rats, indicating that the macrothrombocytopenic trait is recessive in its inheritance. Reciprocal marrow transplants between the WF and LE strains resulted in MPVs like those of the donor strain, demonstrating that the macrothrombocytopenia is an intrinsic marrow abnormality of the WF strain. Splenectomy did not alter the MPV of WF rats. The response of WF megakaryocytes and platelets to severe, acute thrombocytopenia was similar to that of LE rats except that the shift to higher megakaryocyte DNA contents was muted and platelet recovery was slower in the WF rats. In summary, the WF rat has a hereditary macrothrombocytopenia that is recessive in nature and not due to differences in megakaryocyte size or DNA content. These results suggest that the macrothrombocytopenia of WF rats results from the formation of fewer platelets per megakaryocyte, possibly resulting from a qualitative or quantitative defect in some component necessary for proper subdivision of megakaryocyte cytoplasm into platelets. PMID- 3285910 TI - Use of a sensitive bioimmunoabsorbent assay to isolate and characterize monoclonal antibodies to biologically active human erythropoietin. AB - At present, one of the most sensitive assays for human erythropoietin (Ep) is a bioassay that measures the Ep-dependent proliferation of spleen cells from phenylhydrazine-treated mice after 24 hours in culture. We describe how this assay can be used as the basis of a very sensitive method for detecting mouse antibodies to biologically active human Ep. In this procedure, microtiter wells are first coated with goat anti-mouse Ig antibody, then treated with mouse antibodies (serum or hybridoma culture supernatants), and finally incubated with a fixed amount of pure human Ep. Specific binding of anti-Ep antibodies is detected by adding spleen cells from phenylhydrazine-treated mice to the wells and measuring the ability of the cells to incorporate 3H-thymidine 24 hours later. This bioimmunosorbent assay (BISA) revealed the presence of anti-EP antibodies in sera from mice immunized with either pure human urinary Ep or a synthetic dodecapeptide corresponding to the aminoterminal region of Ep and in the culture supernatants from three of eight stable anti-Ep antibody-producing hybridoma cell lines that we have isolated. The three monoclonal antibodies showed similar reactivities in the BISA, but showed different affinities for Ep, with Kd values of approximately 0.7, 8, and 240 nmol/L, respectively. Further studies showed that all antibodies were capable of neutralizing Ep bioactivity and of binding 125I-labeled Ep in a radioimmunosorbent assay (RIA) but were virtually unreactive to Ep adsorbed to the bottom of enzyme-linked immunosorbent assay (ELISA) wells. Our results suggest that the BISA strategy may be an important complement to conventional RIA and ELISA techniques for identification of monoclonal antibodies specific for biologically active growth factors. PMID- 3285911 TI - Flow cytometric characterization of chronic lymphocyte leukaemias using orthogonal light scattering and quantitative immunofluorescence. AB - Light scattering properties and antigen distribution of lymphocytes labeled with the monoclonal antibodies CD 5 and CD 20 were determined for 19 patients with a chronic B-cell derived leukaemia. The density of the antigen detected by the monoclonal antibody CD 5 appeared to be considerably lower on malignant B lymphocytes of the patients as compared with T lymphocytes. A large variation was observed in the amount of receptors for the monoclonal antibodies CD 5 and CD 20 on the malignant cells of the different patients. B-cell chronic lymphocytic leukaemia (B-CLL) patients were clearly distinguishable from leukaemic follicular non Hodgkin lymphoma patients (LF-NHL, formerly lymphosarcoma cell leukaemia) and from a patient with a prolymphocytoid transformation (PLT) of the B-CLL according to the amount of the antigens for CD 5 and CD 20. Within the B-CLL patient population, no relation of progression of the disease with distribution of these antigens could be observed. In one patient the extraordinary phenotype CD 20+, CD 11+, leu 8+, CD 5- of the malignant lymphocytes was observed. An experimentally simple method to differentiate between the various chronic lymphocytic leukaemias (CLL) appeared to be the determination of orthogonal light scattering properties of lymphocytes. In healthy donors one can always distinguish two populations of lymphocytes in the orthogonal light scatter histograms. Lymphocytes of B-CLL patients show one uniform population with a relatively small orthogonal light scattering signal, lymphocytes of our patients with PLT of B-CLL or with LF-NHL show one uniform population with a relatively large orthogonal light scattering signal. PMID- 3285912 TI - Recombinant human interferon-alpha induced cytoreduction in chronic myelogenous leukemia. Results of a multicenter study. AB - Fourteen patients with Ph'-chromosome positive chronic myelogenous leukemia (CML) in first chronic phase were treated with recombinant interferon-alpha 2c. Interferon-alpha 2c 5 to 10 X 10(6) units s.c. was given for 12 weeks as an induction therapy. Maintenance treatment consisted of interferon-alpha 2c 5 X 10(6) units twice weekly s.c.. Two patients (14%) attained a complete clinical remission and 6 (43%) a partial remission, 3 of whom developed progressive disease during maintenance therapy. A complete disappearance of Ph'-chromosome was achieved in 1 patient. All patients had a more than 45% initial decline of the leukocyte count. Four out of ten patients with an initially enlarged spleen demonstrated reduction in spleen size. Influenza-like symptoms, anorexia, nausea, weight loss and fatigue were common side effects. Interferon-alpha is active in CML but additional clinical investigations are warranted to assess more precisely the therapeutic value of the interferons in this disease. PMID- 3285913 TI - T-cell depleted bone marrow transplantation for plasma cell myeloma. Report of a case and review of the results of BMT for myeloma. AB - A 37-year-old male patient with advanced refractory plasma cell myeloma underwent T-cell depleted bone marrow transplantation (BMT) after 7 years of active disease previously treated with combination chemotherapy and irradiation. After the BMT there was marked clinical improvement and the patient is currently in good clinical condition two years after the BMT was performed. However, residual myeloma cells are still seen in the marrow and stable levels of paraprotein are still present in the serum. No GVHD was encountered after BMT. The problems of BMT in myeloma are discussed with a review of the current pertinent literature. PMID- 3285914 TI - A multicentre study on intensive induction and consolidation therapy in acute myelogenous leukaemia. PMID- 3285915 TI - Diagnosis of small round cell tumors of childhood. AB - Primitive tumors, especially in children, can be extremely difficult to diagnose by conventional means. A wide variety of new methods have appeared in biomedical research that are applicable to diagnosis. These include (but are not limited to) tissue culture, cytogenetics, molecular genetics, and immunophenotypic analysis. Application of these methods can both provide a diagnosis and resolve long standing ambiguity regarding the origin and relationship of several childhood tumors including: (1) the relationship of neuroblastoma to other neural tumors in children and young adults; (2) the origin of Ewing's sarcoma, a perennial enigma; (3) the relationship of embryonal to alveolar rhadomyosarcoma. These issues are resolved by demonstrating characteristic findings in each of these tumors as a result of the appropriate application of each of these methods. As a consequence, these tumors are understood in a different perspective, including striking changes in terminology, categorization, diagnosis, and therefore treatment. In particular, (1) neuroblastoma is distinguished biologically and diagnostically from all other neural tumors of children; (2) Ewing's sarcoma is revealed as a neural tumor; (3) primitive forms of alveolar rhabdomyosarcoma are defined and regrouped with the common forms. PMID- 3285916 TI - Toxicity of allyl isothiocyanate and cinnamic aldehyde assessed using cultured human KB cells and yeast, Saccharomyces cerevisiae. PMID- 3285917 TI - Evaluation of mutagenic activity of turmeric extract containing curcumin, before and after activation with mammalian cecal microbial extract of liver microsomal fraction, in the Ames Salmonella test. PMID- 3285918 TI - Effects of some metallic compounds on Klebsiella. PMID- 3285919 TI - Mutagenicity of heavy metals. PMID- 3285920 TI - Richard H. Shryock medal essay. Sufficient promise: John F. Fulton and the origins of psychosurgery. PMID- 3285921 TI - The care and treatment of the mentally ill. Essay review. PMID- 3285922 TI - Virchow and the mechanistic concept of life in 1845. Essay review. PMID- 3285923 TI - Edwin Chadwick and the French connection. PMID- 3285924 TI - The Koch-Pasteur dispute on establishing the cause of anthrax. PMID- 3285925 TI - Medical women abroad: a new dimension of women's push for opportunity in medicine, 1850-1914. PMID- 3285926 TI - Katharine Bement Davis, sex research, and the Rockefeller Foundation. PMID- 3285927 TI - The 40th anniversary of WHO. PMID- 3285928 TI - An evaluation of four end-user systems for searching MEDLINE. AB - This study compared features and determined which of four end-user systems (PaperChase, GRATEFUL MED, Med-Base, or Compact Cambridge: MEDLINE) would best serve the Medical Sciences and Optometry Libraries of Indiana University in providing biomedical information to faculty and graduate students through MEDLINE. Cost, ease of use, retrieval, training needs, equipment requirements, and adequacy of documentation were examined. The study consisted of a comparison of the features of each system based on available documentation; a controlled search performed by the investigators on each system and on regular NLM MEDLINE; and a user study based on observations, questionnaires, and interviews with eleven library patrons who performed the same search of their choice on each of the four systems. PMID- 3285929 TI - International programs of the National Library of Medicine. AB - The National Library of Medicine (NLM) has a broad mission in biomedical information service. There are three major reasons for NLM, as a national institution, having an international program: first, the global nature of disease; second, the international scope of medical literature; and third, the universal goal of better communication. This paper reviews NLM's programs in relation to international medical information exchange: International MEDLARS Centers, collaboration with WHO and PAHO, NLM Special Foreign Currency Program, and development of the NLM collection. PMID- 3285930 TI - User attitudes toward end-user literature searching. AB - A survey to determine attitudes toward end-user searching was made at Loyola University's Medical Center Library using MEDIS, an online full-text and bibliographic medical retrieval system. One hundred forty-one completed questionnaires were analyzed for this report. Information was collected on user familiarity with computers, end-user training, system use, mechanics of searching, and attitudes toward future use. Computer familiarity was highest among the faculty users. Ninety percent of the respondents saw librarians as a crucial agent in training and in providing end-user assistance. Respondents identified five major reasons for using the system: helpfulness, convenience, time savings, rapid feedback, and presentation of needed information. Searching the MEDLINE database rather than the full-text database was the search method of choice. Continued use of both mediated and end-user searching was intended by most of the respondents. Survey results support a perceived need for end-user searching and confirmed recommendations of the Association of American Medical Colleges on medical information science skills. PMID- 3285931 TI - Frank Bradway Rogers 1914-1987. PMID- 3285932 TI - Occupational therapy articles in serial publications: an analysis of sources. AB - This study was designed to locate and document serial literature on occupational therapy published since 1900. Emphasis is placed on finding articles on occupational therapy or by occupational therapists from sources other than those normally associated with the professional journals. Multiple sources were used including print indexes, online databases, occupational therapy bibliographies, and tables of contents or yearly indexes. Almost 7,000 articles were identified, not including those published in foreign journals. Occupational therapy publications have increased steadily since 1900, with the most rapid increase during the 1970s and 1980s when five new occupational therapy journals were initiated. Suggestions for formulating search strategies are included. PMID- 3285933 TI - Semantically assisted medical bibliographic retrieval: an experimental computer system. AB - An experimental computer-based bibliographic retrieval system has been implemented to explore how semantic (conceptual) relationships between MeSH terms might assist the retrieval process. To construct the experimental system's database, lists of abstracts were produced using MEDLINE. Each list contained papers discussing a specified pair of terms. Each abstract was then analyzed to determine the specific relationship(s) between the two terms discussed in that paper. The project then explored how these semantic relationships could be incorporated into the computer to enhance bibliographic retrieval. PMID- 3285934 TI - End-user programs in medical school libraries: a survey. AB - A questionnaire was sent to all medical school libraries listed in the Annual Statistics of Medical School Libraries in the United States and Canada (1983 1984) asking librarians to describe their end-user programs. Of the 113 responding libraries, 78 had an end-user program. All provided some kind of formal instruction, 39 made equipment available to end users, and 22 provided and administered passwords. The reasons most cited for starting a program were staff interest and patron requests. The two most frequently taught systems were NLM/MEDLINE and BRS/Colleague. In general, respondents felt positive about the programs and planned to continue them. The most frequently mentioned problem was need for more equipment. PMID- 3285935 TI - Building a miniMEDLINE database: which journals to choose? AB - Scott Memorial Library (SML) at Thomas Jefferson University has installed the Library Information System (LIS) developed by Georgetown University Medical Center Library. One component of the system is miniMEDLINE, a system for searching an inhouse database derived from NLM MEDLINE tapes. This paper describes the process involved in determining which journals should be included in SML's miniMEDLINE file; the number of titles and years covered; the balance between research and clinical titles; the representation of allied health fields; and the level of faculty involvement. PMID- 3285936 TI - Library workshops for special audiences: secretaries, research assistants, and other support staff. AB - Reports on library workshops for nonlibrary support staff, conducted by health sciences and other libraries, are reviewed. In 1985-86, similar workshops for secretaries, research assistants, and other support staff were offered at the Ohio State University Health Sciences Library. Evaluations made by participants immediately after the workshops and six to twenty months later have provided valuable input on the usefulness of subjects discussed and on recommendations for changes. PMID- 3285937 TI - Implementing RECONSIDER, a diagnostic prompting computer system, at the Georgetown University Medical Center. AB - RECONSIDER, a computer program for diagnostic prompting developed at the University of California, San Francisco, has been implemented at the Georgetown University Medical Center as part of the Integrated Academic Information Management System Model Development grant project supported by the National Library of Medicine. The system is available for student use in the Biomedical Information Resources Center of the Dahlgren Memorial Library. Instruction on use of the computer system is provided by the library and instruction on medical use of the knowledge base is directed by the faculty. The implementation, capabilities, enhancements such as the addition of Current Medical Information and Terminology (5th ed.), and evaluation of the system are reported. PMID- 3285938 TI - An evaluation of four end-user systems for searching MEDLINE. AB - This study compared features and determined which of four end-user systems (PaperChase, GRATEFUL MED, Med-Base, or Compact Cambridge: MEDLINE) would best serve the Medical Sciences and Optometry Libraries of Indiana University in providing biomedical information to faculty and graduate students through MEDLINE. Cost, ease of use, retrieval, training needs, equipment requirements, and adequacy of documentation were examined. The study consisted of a comparison of the features of each system based on available documentation; a controlled search performed by the investigators on each system and on regular NLM MEDLINE; and a user study based on observations, questionnaires, and interviews with eleven library patrons who performed the same search of their choice on each of the four systems. PMID- 3285939 TI - MEDLINE on compact disc: end-user searching on Compact Cambridge. PMID- 3285940 TI - Computer-assisted instruction: subject, audience, and program descriptors for an academic medical center. PMID- 3285941 TI - Ida Marian Robinson, 1903-1985. PMID- 3285942 TI - Injuries to Dutch sport parachutists. AB - From 1981 to 1985 193,611 jumps were made by sport parachutists in the Netherlands. Of these 267 (0.14%) resulted in injuries including 4 fatalities. In this report the different types of injuries and their causes are discussed and comments are given in relation to training, selection, precautions and equipment, as well as upon accident registration and possible modifications. PMID- 3285943 TI - A double-blind study comparing the efficiency, tolerance and renal effects of iopromide and iopamidol. AB - A randomized double-blind, group comparative study was carried out to investigate the diagnostic efficiency and side-effect profiles, with particular reference to renal tolerance, of iopamidol and a newer non-ionic contrast medium iopromide, when used in excretory urography. The trial demonstrated that, in a population of 137 patients undergoing excretory urography and being investigated from baseline up to 2 weeks after the administration of the contrast medium, there were no significant adverse effects on the indicators currently thought to reflect renal function. The efficiency of the two contrast agents proved to be very similar and the radiographic quality of opacification was adequate in nearly every case. PMID- 3285944 TI - An analysis of referrals for primary diagnostic abdominal ultrasound to a general X-ray department. AB - Abnormalities were found in 30% of examinations. Comparison of outpatient and family practitioner referrals in cases of suspected gallstones (24%:27%) indicated the value of GP access. There was also evidence, in the absence of a dilated common bile duct, that there was little value in extending the examination of the gallbladder. In post-cholecystectomy syndrome, endoscopic retrograde cholangiography is shown to be the investigation of choice. Abnormalities revealed in lower abdomen examinations were related only to pelvic organs and in this group examination should therefore be confined to this area. Pick-up rates of 15% were found in patients with left upper quadrant pain and a number of miscellaneous conditions. There is a marked increase in positive findings in the presence of a palpable mass. PMID- 3285945 TI - A technique for the removal of retained balloon bladder catheters. PMID- 3285946 TI - A variant of the Mirizzi syndrome. PMID- 3285947 TI - The 1988 BIR award winners. Dr Brian Kendall (Barclay Medal). PMID- 3285948 TI - The 1988 BIR award winners. Dr Malcolm Merrick (Barclay Prize). PMID- 3285949 TI - The 1988 BIR award winners. Dr Roger Dale (Rontgen Prize). PMID- 3285950 TI - A comparative study of magnetic resonance imaging and computed tomography assisted myelography in spinal dysraphism. AB - Thirty-seven patients with a wide spectrum of spinal dysraphic lesions were studied by both magnetic resonance imaging (MRI) and myelography complemented by computed tomography (CT). Magnetic resonance imaging proved to be superior for tissue characterization, overall anatomical definition, topographical relationships of the cranio-cervical junction and demonstration of the presence and extent of hydrosyringomyelia. Demonstration by CT myelography of fine neural structures such as the filum terminale and nerve roots remains the superior technique; however, with constantly improving spatial resolution and thinner slice imaging, MRI will become increasingly competitive in this respect. The osseous component of these lesions was best demonstrated by CT myelography. A high incidence of associated syrinx (8/15 cases) was found in the diastematomyelia group, with an overall incidence of 15 cases in all the dysraphic patients studied. The use of both T1- and T2-weighted sequences is required for tissue characterization. Whilst both imaging modalities proved complementary in the investigation of spinal dysraphism, we suggest that, with its superior tissue characterization and anatomical display of these lesions. MRI should be the primary imaging technique. Avoidance of an invasive procedure and use of ionizing radiation confers additional benefits upon MRI. The relative ease and shorter examination time of MRI makes this technique ideal for pre- and post operative monitoring and assessment. PMID- 3285951 TI - Non-obstructive kidney transplant dysfunction: magnetic resonance evaluation. AB - The value of magnetic resonance imaging in the differential diagnosis of non obstructive dysfunction of renal allografts was studied in a series of 58 examinations at 0.5 T. Four parameters were evaluated: the corticomedullary differentiation; the relative thickness of the cortex; the evolution, with echo number, of the relative signal intensities of kidney parenchyma and adjacent fatty tissue on images generated by a long time to repeat multiecho sequence; and the proximal vascularization. The loss of corticomedullary differentiation is the major finding in acute rejection, but it is not specific as it is also observed in chronic rejection and in the much rarer acute glomerulonephritis. Thickening of the cortex is helpful for the detection of rejected transplants with visible corticomedullary delineation (26% of the cases). Uncomplicated acute tubular necrosis appears as a normal transplant. PMID- 3285952 TI - Clinical trial of a new adaptive TGC system for ultrasound imaging. PMID- 3285953 TI - Proceedings of the British Medical Ultrasound Society, nineteenth annual meeting. Brighton, December 8-10, 1987. Abstracts. PMID- 3285955 TI - Seven principles for command and the neural causation of behavior. AB - The concept of command is central to motor control theories and explanations for the initiation of behavior patterns. As currently conceived, command is a process of individual command neurons that receive sensory and other integrative information and trigger the expression of behavioral acts. We show that this concept is an inadequate framework in which to discover the neural mechanisms underlying the decision and execution processes that occur when an animal begins a behavioral act. We herein propose a new concept of command which is based on a suite of principles. In this concept, command is a dynamic system property intermediate to neurophysiological and behavioral contexts and independent of preconceived causal paradigms, methods, or structures. We visualize command within a neurobehavioral or neuroethological context. This provisional concept provides a way of thinking, and an approach for discovering the neural processes that underlie behavioral performance. PMID- 3285954 TI - Cardiac transplantation in severely ill patients requiring intensive support in hospital. AB - Sixty four patients were referred for cardiac transplantation from a single cardiac team at this hospital between October 1984 and December 1986. Of these patients, 33 were referred for urgent transplantation, all of whom required intensive treatment in hospital with intravenous infusions of cardiac drugs, intra-aortic balloon counterpulsation, peritoneal dialysis, ventilation, or any combination of these to sustain life. Of these 33 patients, six died while awaiting transplantation, one was removed from the waiting list for a transplant, and 26 received cardiac transplants. There were five deaths within 24 hours of operation and one death 10 days after the operation. Twenty of those who had surgery had a successful outcome of transplantation, but there was one late death 10 weeks postoperatively and a further death 31 months after surgery. Eighteen patients were alive and well 10 to 33 months (mean 19.4 months) after transplantation, with an overall survival rate after surgery of 69%. Provided that surgery can be performed before renal failure has progressed such that renal dialysis [corrected] is necessary, the results are excellent (surgical survival 85.5%) and, we believe, justify the expenditure and staffing requirements necessary to treat these terminally ill patients. PMID- 3285956 TI - Immunocytochemical detection of GABAergic nerve cells in the human temporal cortex using a direct gamma-aminobutyric acid antiserum. AB - Recently, an immunocytochemical method using glutaraldehyde fixation and an antiserum developed against a GABA--glutaraldehyde--protein conjugate has permitted direct visualization of GABAergic structures in the brains of perfused animals. This paper reports a successful use of this technique on human temporal cortex fixed by immersion. The cerebral tissue was obtained from patients operated for focal epilepsy. GABA-positive somata, fibres and terminals are observed in all layers of the temporal cortex. Terminals are particularly abundant in the superficial portion of layer I and in layers II, III and IV. Dense plexuses of fibres are located in layers II, III, IV and VI and in the underlying white matter. Somata are found in all cortical layers and in the underlying white matter; they are round, oval, fusiform or triangular and exhibit a multipolar, bitufted or bipolar dendritic pattern. This technique for the visualization of GABAergic structures in the human brain may allow a better understanding of the pathogeny of epilepsy in which the GABAergic transmission has been implicated. PMID- 3285957 TI - Effect of oestrogen and progesterone on noradrenergic nerves and on nerves showing serotonin-like immunoreactivity in the basilar artery of the rabbit. AB - The effects of oestrogen and progesterone on noradrenergic nerves and nerves with serotonin (5-HT)-like immunoreactivity in the basilar artery were investigated in the rabbit using whole-mount stretch preparations. The noradrenergic nerves were demonstrated by glyoxylic acid fluorescence histochemistry and nerves with 5-HT like immunoreactivity by indirect immunofluorescence techniques. Quantitative image analysis of fluorescent nerve fibres revealed that nerve density and varicosity diameter of nerves with 5-HT-like immunoreactivity were significantly (P less than 0.01 and P less than 0.05 respectively) reduced after 4-week administration of oestrogen and the intensity of fluorescence was also reduced. However, there were no significant changes after progesterone. Neither oestrogen nor progesterone had any effect on noradrenergic innervation. The findings are discussed in relation to higher incidence of migraine headaches in females taking oral contraceptives. PMID- 3285958 TI - The N-methyl-D-aspartate antagonists CGS 19755 and CPP reduce ischemic brain damage in gerbils. AB - N-Methyl-D-aspartate (NMDA) antagonists reduce ischemic brain damage and associated hypermotility. Two potent, selective and competitive NMDA antagonists, cis-4-(phosphonomethyl)-2-piperidine-carboxylic acid (CGS 19755) and 4-(3 phosphonopropyl)-2-piperazine-carboxylic acid (CPP), were characterized in the gerbil ischemia model with respect to dose-response and time course effects. Both drugs were effective in reducing ischemia-induced hippocampal brain damage as well as hypermotility. In this model, CGS 19755 was more potent than CPP, and had protective effects when given after longer delays between ischemia and drug administration. PMID- 3285960 TI - Inhibition of long-term potentiation of the hippocampal CA1 EPSP by a negative cooperativity. AB - Tetanization of commissural-CA1 input to the apical dendrites of the dorsal hippocampal CA1 area was found to produce a marked long-term potentiation of the field EPSP. Whereas by concurrent tetanization of the commissural pathway and medial septo-CA1 input, this potentiation was significantly reduced. Thus a negative cooperativity in LTP induction was revealed. PMID- 3285959 TI - Stereotaxic microinjection of HSV-1 selectively decreases striatal dopamine concentrations in mice. AB - BALB/c mice were stereotaxically injected in the striatum with either the MP or MacIntyre strain of herpes simplex type 1. Three days later, at a time when the animals were free from overt signs of infection, they were killed by cervical dislocation and the striatum was rapidly removed. Concentrations of dopamine, norepinephrine, serotonin and their metabolites were subsequently determined by means of high-performance liquid chromatography with electrochemical detection. With both strains of virus, dopamine levels were reduced and the ratio of homovanillic acid to dopamine was elevated in MP-inoculated mice. Norepinephrine, serotonin and its metabolites were unaffected. Immunoperoxidase staining in separate, identically treated animals indicated that the infection was confined to the striatum and necrosis was minimal at this point in time. These results demonstrate that dopamine metabolism can be affected by herpes simplex in the absence of immunocytochemical evidence of infection of the cell bodies of dopaminergic neurons or cellular death. PMID- 3285961 TI - Possible target neurons of the reticulospinal cholecystokinin (CCK) projection to the lamprey spinal cord: immunohistochemistry combined with intracellular staining with lucifer yellow. AB - A subpopulation of reticulospinal neurons in the posterior rhombencephalic reticular nucleus in lamprey contains a cholecystokinin (CCK)-like peptide. Varicosities of these neurons, visualized by immunohistofluorescence, were found to be in close apposition to Lucifer yellow-filled spinal motoneurons and giant relay interneurons. Certain other types of interneurons and primary sensory neurons had no, or very few, close contacts with CCK-immunoreactive boutons. PMID- 3285962 TI - Peripubertal development of noradrenergic stimulation of luteinizing hormone releasing hormone neurosecretion in vitro. AB - The effect of age on norepinephrine (NE) stimulation of luteinizing hormone releasing hormone (LH-RH) secretion from preoptic area-mediobasal hypothalamic (POA-MBH) explants was examined in the present study. Explants were obtained from juvenile (9-day-old), prepubertal (29-day-old) and adult female rats. Following decapitation and surgical isolation, POA-MBH explants were individually perifused with culture medium which was collected for radioimmunoassay of LH-RH. Explants were exposed to two pulses of medium containing NE (5 x 10(-4) M, peak concentration) and a terminal pulse of medium containing KCl (45 mM, peak concentration) for assessment of viability. POA-MBH explants obtained from prepubertal female rats exhibited increased LH-RH release in response to the two pulses of NE and subsequent KCl pulse (P less than 0.05). NE was without effect in stimulating LH-RH neurosecretion from POA-MBH explants obtained from 9-day-old female rats although these explants were responsive to KCl (P less than 0.01). Two-day pretreatment of 9-day-old, and prepubertal rats with estradiol benzoate (EB) did not alter the LH-RH response to this dose of NE or KCl (no group or interaction effects) in prepubertal female rat explants and did not render the explants from 9-day-old rats responsive to NE. Furthermore, NE was equally effective in stimulating LH-RH release from explants obtained from estradiol treated or control ovariectomized adult rats. These observations demonstrate a peripubertal activation of the stimulatory effect of NE on LH-RH release from POA MBH explants in vitro. Although these data also suggest that estrogen is not obligatory for NE stimulation of LH-RH release from POA-MBH explants, further investigation is required to determine the developmental time course and estrogen dependency of the noradrenergic stimulation of LH-RH neurosecretion and to evaluate whether estrogen alters the sensitivity of POA-MBH explants to lower concentrations of NE as has been previously reported for median eminence fragments. PMID- 3285963 TI - Proceptive presenting elicited by electrical stimulation of the female monkey hypothalamus. AB - Proceptive presenting by female macaque monkeys was evoked by electrical stimulation of the ventromedial hypothalamic nucleus and the medial preoptic area, under conditions of partial restraint while sitting in a primate chair. This behavior could be elicited only when a male monkey was in close proximity and not when he was removed or was replaced with a female monkey or the human experimenter. This seems to be the first report on the effects of electrical brain stimulation on proceptivity in the female monkey. PMID- 3285964 TI - Immunohistochemical localization of gamma-aminobutyric acid in the rat pituitary gland and related hypothalamic regions. AB - The distribution of gamma-aminobutyric acid (GABA) containing neurons in the rat pituitary gland and related hypothalamic areas was immunohistochemically investigated using antibodies raised against GABA conjugated to bovine serum albumin by glutaraldehyde. A dense network of GABA-like immunoreactive fine varicose nerve fibers was observed within the posterior and intermediate lobes of the pituitary gland, surrounding endocrine cells and capillaries, but not in the anterior lobe. In the pituitary stalk, the dense varicose fibers ran along the anterior wall of the posterior lobe into the posterior and intermediate lobes. A small number of GABA-like immunoreactive cell bodies were evident in the intermediate lobe. GABA-like immunoreactive fibers occurred at low to high density in most parts of the hypothalamus. GABA-like immunoreactive neurons were observed in some regions related to the pituitary gland (such as periventricular nucleus, paraventricular nucleus, arcuate nucleus and accessory magnocellular nucleus). These results provide morphological evidence for the presence of GABAergic neurons in the rat hypothalamo-pituitary system. PMID- 3285965 TI - Two types of thalamic reticular cells in relation to the two visual thalamocortical systems in the rat. AB - We found in urethane-anesthetized rats that thalamic reticular (TR) cells responding to an electrical stimulus of the optic tract (OT) can be further subdivided into two types, viz. S- and L-type cells. S-type cells, which were selectively excited from area 17 of the visual cortex, were characterized by short latency responses (2.3-6.1 ms) to OT stimulation. TR cells activated antidromically from the dorsal lateral geniculate nucleus were all classified as S-type. Long OT latencies (5.2-15.3 ms) and selective excitation from area 18a were peculiar to L-type cells, which showed antidromic responses to the lateral posterior nucleus stimulation. Mapping studies documented that cells belonging to each type were segregated in the thalamic reticular nucleus; L-type cells were located in the most posterior part. It is suggested that S- and L-type cells are inhibitory interneurons modulating activity of geniculocortical and extrageniculocortical projection cells, respectively. PMID- 3285966 TI - Immunocytochemical localization of hypothalamic luteinizing hormone-releasing hormone in male ferrets. AB - LHRH-containing neurons within the hypothalamus were immunocytochemically identified in adult male ferrets that were either gonadally intact, castrated, or castrated and treated with testosterone. The distribution of LHRH-immunopositive neuron cell bodies was similar in the three treatment groups. The majority of these cells was located mediobasally in the retrochiasmatic area, including some within the ventrolateral aspects of the arcuate nucleus. These soma were associated with a dense basal LHRH fiber plexus which extended to the median eminence. A smaller number of cell bodies was found slightly more dorsal and lateral to the major concentration at the base and midline. Isolated LHRH perikarya were occasionally observed in dorsal areas of the hypothalamus. There were no differences in the mean total number of hypothalamic LHRH cell bodies identified in the three treatment groups. These results indicate that the documented negative feedback effects of testosterone on LH secretion in male ferrets are not the result of an alteration in the absolute number of neurons capable of synthesizing LHRH. PMID- 3285967 TI - Electron microscope study of the association between hypothalamic blood vessels and oxytocin-like immunoreactive neurons. AB - An association between oxytocin-like immunoreactive neurons and hypothalamic blood vessels has been observed with the light microscope. Recently, it has been demonstrated that oxytocin stimulates vascular smooth muscle contraction in vitro. A hypothesis has thus been proposed that oxytocin may play a role in modulating blood flow in certain brain regions. In a study on the golden-mantled ground squirrel (Spermophilus lateralis) we noted the association at the light microscope level between oxytocin-like immunoreactive neurons and blood vessels in preoptic and paraventricular nuclei of the hypothalamus. To determine if these neurons were associated with hypothalamic capillaries, transverse 30 micron immunostained hypothalamic sections were prepared for thin sectioning and observation by transmission electron microscopy. Oxytocin-like immunoreactive neurons were observed to lie within 77 nm of the edge of the lumen of capillary blood vessels. One neuronal cell body was observed approximately 380 nm from the edge of a capillary lumen and what appears to be an output region of a neuron was observed to terminate on the basement membrane of a capillary blood vessel. PMID- 3285968 TI - Surfasoft, a new graft dressing. AB - We present our preliminary experience using Surfasoft, a new dressing material, in the management of burns following skin grafting. It was found to be a useful dressing in awkward sites where conventional dressings have many disadvantages. PMID- 3285969 TI - The museum and traditional Asian medicine: a study in collaboration. PMID- 3285970 TI - Chinese medicine in American: a study in adaptation. PMID- 3285971 TI - The Kam Wah Chung & Co. Museum. PMID- 3285972 TI - Measuring oral health: a conceptual framework. PMID- 3285973 TI - The effects of pain and oral health on the quality of life. PMID- 3285974 TI - Knowledge representation in expert systems. Nursing diagnosis applications. PMID- 3285976 TI - Annual software exchange. PMID- 3285975 TI - A review of the effectiveness of computer assisted instruction in nursing education. PMID- 3285977 TI - Measurement of optic nerve head pallor with a video-ophthalmograph and with computerized boundary analysis. AB - Optic disc pallor was recorded in 53 eyes of 53 patients by means of global analysis with a video-ophthalmograph (Rodenstock Disk Analyzer) and computerized boundary analysis. The coefficients of correlation between the values obtained with the Rodenstock Disk Analyzer and those obtained with boundary analysis were r = 0.24 (p = 0.08) at the 0.29 cutoff level, r = 0.39 (p = 0.004) at the 0.39 level and r = 0.46 (p = 0.0005) at the 0.50 level. Although the correlation was significant, the correlation coefficients were not high. The Rodenstock Disk Analyzer uses global analysis, which does not take into account the spatial relationship of the pallor on the disc, whereas boundary analysis is sensitive to spatial relationship, which may account for the poor correlation. PMID- 3285978 TI - Visual paraneoplastic syndrome associated with undifferentiated endometrial carcinoma. AB - We report a case of visual paraneoplastic syndrome associated with undifferentiated endometrial carcinoma. This syndrome has not previously been reported with this type of tumour; it has occurred most often with small-cell carcinoma of the lung. Electroretinography and histopathological examination have consistently shown the site of injury to be the outer retina. We review the findings in the reported cases and the proposed causes of the loss of vision in this condition. PMID- 3285979 TI - New insights on the mechanism of the alcohol-induced increase in portal blood flow. AB - Acute administration of ethanol increases portal blood flow by 40-60%. This increase in blood flow compensates for the increase in O2 consumption that follows alcohol intake and may play a protective role against hypoxic hepatocellular necrosis. We have investigated the mechanism of this hemodynamic effect of ethanol in the rat using the labeled microsphere technique. We ruled out a direct role of systemic glucagon and of acetaldehyde in mediating the increase in portal flow. However, the increase in flow is maximal at a blood ethanol concentration of 3.5 mM, corresponding to that required to achieve the Vmax of alcohol dehydrogenase, and is suppressed by 4-methylpyrazole, an inhibitor of alcohol dehydrogenase. Alcohol ingestion results in zonal liver hypoxia and in increases in acetate, both of which have been shown to increase the levels of adenosine, a potent vasodilator, in blood and tissues. Ethanol produces a 400% increase in arterial adenosine. Adenosine infusion leads to a dose-dependent increase in portal blood flow of up to 100%, an effect that is suppressed by administration of 8-phenyltheophylline, an antagonist of adenosine at A1 and A2 receptors. Similarly, the ethanol-induced increase in portal blood flow is fully suppressed by 8-phenyltheophylline. In conclusion, adenosine appears to play an important role in the mechanism by which ethanol increases portal blood flow. PMID- 3285980 TI - Glucose and lactate turnover and gluconeogenesis in chronic metabolic acidosis and alkalosis in normal and diabetic dogs. AB - The turnover rate of glucose, the irreversible disposal rate of lactate, and the rate of gluconeogenesis from lactate were calculated by tracer methods in four normal and four alloxan-diabetic dogs under control conditions as well as in chronic, stable metabolic acidosis and alkalosis. Acidosis was produced by feeding dogs 0.8-1 g.kg-1.day-1NH4Cl over 1 week, alkalosis was produced by feeding dogs a chloride-free diet and injections of furosemide. Mean plasma pH in the three states were 7.28 +/- 0.013, 7.40 +/- 0.024, and 7.51 +/- 0.015 in normal dogs, and 7.22 +/- 0.025, 7.42 +/- 0.009, and 7.49 +/- 0.002 in the diabetic dogs. Respective mean plasma bicarbonate levels were 14.6 +/- 0.88, 22.0 +/- 0.80, and 32.4 +/- 1.88 mequiv. in normal dogs, and 12.3 +/- 1.30, 22.6 +/- 0.66, and 35.0 +/- 1.14 mequiv. in diabetic animals. In normal dogs shifts in acid-base balance had no effect on the level of plasma glucose or the turnover rate of glucose. In diabetic dogs plasma glucose level was significantly elevated by alkalosis. Plasma lactate was positively correlated with plasma pH (r = 0.69, p less than 0.01) and was in general higher in diabetic than in normal animals. The increment in concentration was due to a decreased clearance of lactate from the plasma. The irreversible disposal rate was not changed by the acid-base status. Whereas a larger fraction of lactate removed from the plasma appeared in glucose in diabetic animals, this fraction was not changed significantly by shifts in the acid-base status.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285981 TI - Short-term changes in serum luteinizing hormone, ovarian response and reproductive performance following gonadotrophin releasing hormone treatment in postpartum dairy cows with retained placenta. AB - Thirty-six postpartum Holstein cows consisting of eighteen cows that shed the placenta soon after calving (NRP) and eighteen cows that retained placenta greater than 24 h (RP) were used. There were four treatment groups. Group I consisted of 9 NRP cows which received intramuscular injection of sterile saline on day 15 postpartum. The second group consisted of 9 NRPN cows which received 100 micrograms of gonadotrophin releasing hormone on day 15 postpartum (NRPT). The third group consisted of 9 RP cows which received saline on day 15 postpartum (RPN) and the fourth group consisted of 9 RP cows which received 100 micrograms of gonadotrophin releasing hormone on day 15 postpartum (RPT). Blood samples were collected once daily during the first month and once every other day during the second month postpartum. In addition fourteen cows (RPT, n = 7; NRPT, n = 7), were used to study short-term changes in serum luteinizing hormone concentrations following gonadotrophin releasing hormone treatment on day 15 postpartum. Blood samples were obtained from these cows every 15 min during 1 h before and 6 h after gonadotrophin releasing hormone administration. Sera from all samples were assayed for progesterone and luteinizing hormone concentrations. Starting from four days after calving rectal palpations and ultrasound examinations of the ovaries were carried out once every four days until day 28 postpartum in order to monitor ovarian changes. All cows were inseminated on the first estrus after day 60 postpartum and examined for pregnancy between 35 and 42 days after insemination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3285982 TI - The effect of sodium chloride extract and commercial lipopolysaccharides of Escherichia coli and Salmonella typhimurium on chickens. AB - In chickens inoculated into the heart with a sodium chloride extract of Escherichia coli strain (serotype O2) isolated from a chicken with colibacillosis, characteristic hemorrhages into the anterior chamber of the eyes (hyphema) were found. Significant lesions were limited to the eyes. Cyclophosphamide-treated chickens were more sensitive to the extract than untreated chickens and hyphema was usually seen in association with hemorrhages of the iris. These activities were not reduced by heating the extract at 60 degrees C for one hour or by trypsin digestion. Chickens inoculated into the heart with commercial lipopolysaccharides of E. coli (serotypes O111:B4 and O55:B5) and Salmonella typhimurium showed similar lesions in the eyes as the chickens inoculated with the sodium chloride extract. These findings suggest that the endotoxin may induce hyphema in chickens. PMID- 3285983 TI - Natural infection with an attaching and effacing Escherichia coli in a diarrheic puppy. AB - Enteric infection with an attaching and effacing Escherichia coli was diagnosed in a puppy with protracted diarrhea. Extensive colonization of the small intestinal mucosa was observed by light and scanning electron microscopy and characteristic lesions of bacterial attachment of the brush border of the enterocytes were demonstrated by transmission electron microscopy. The E. coli strain isolated from the small intestine belonged to serotype O49:H10, did not produce any known E. coli enterotoxin or cytotoxin, was not invasive, and was negative for the known fimbrial colonization factors produced by animal and human enterotoxigenic E. coli. A positive immunoperoxidase reaction was obtained on the bacteria attached to the enterocytes with an anti-E. coli O49 antiserum. PMID- 3285984 TI - Unconventional cancer remedies. AB - Unproven and disproven remedies continue to abound for illnesses for which conventional treatment is only partially effective. This is particularly true with cancer, for which up to 50% of patients may be receiving unorthodox therapy. This article examines unconventional cancer remedies, their adverse effects, their common factors and the basis for their appeal, as well as what motivates and characterizes patients who choose these treatments. Also discussed is an approach that may be used by the conventional physician for patients who are likely to seek unorthodox treatment. This approach will help patients make the best decision about their treatment and protect them from the hazards of unconventional remedies. PMID- 3285986 TI - Living in Osler's shadow. PMID- 3285987 TI - Computer simulations may change way medical students taught. PMID- 3285985 TI - Transient ischemic attacks and stroke. AB - Transient ischemic attacks (TIAs) constitute the most specific and powerful warnings of impending stroke. They are defined as brief, focal neurological events of sudden onset. Their proper recognition and treatment rank second only to the modification of risk factors in importance for stroke prevention. Carotid endarterectomy, although widely used to treat TIAs, remains unproven; randomized clinical trials are attempting to define its role. Anticoagulant therapy appears worth while for suspected cardiac embolism and possibly for disabling TIAs. Acetylsalicylic acid is the only agent that has been found to be effective in controlled trials, but questions persist about its dosage, its efficacy in women and its use after stroke. Another platelet inhibitor, ticlopidine hydrochloride, is being investigated and may prove to be an effective alternative. PMID- 3285988 TI - Applied cancer prevention and the primary caregiver. A challenge to the community. AB - The cure rate for cancer can be increased from the current 51% to 75% by the year 2000. Two important actions that will make this goal possible are the prevention of cancers that are caused by known carcinogens and the earlier detection of cancer in asymptomatic individuals. Current knowledge about the cause of cancer makes it prudent for persons to change their lifestyles (primary prevention). Tobacco products are the number one culprit in cancer cause and it is estimated that 30% of all cancer deaths in the United States would not occur if tobacco use had been avoided. The sound principles of cancer prevention and early detection need to be applied by primary care physicians and community cancer centers working together. Caution must be advised when recommending a variety of diets and medicines that, as yet, have no proven value in cancer prevention. Cancer control research is needed to expand cancer control applications in a cost effective and acceptable manner. PMID- 3285989 TI - Who should pay for cancer prevention and detection? PMID- 3285990 TI - Cancer prevention and detection. An overview of variables influencing adoption and practice. AB - This paper presents an overview of factors, attitudes, and beliefs that may influence the adoption of cancer prevention and detection strategies by health care providers and the public. Health-care practitioners require education about prevention and detection approaches to health care and the social variations in the population that may influence acceptance and adoption of these measures. The need for consistent guidelines among health professional organizations is also stressed. PMID- 3285991 TI - Immunocytochemistry and sperm pathology. AB - In this paper the Authors describe the localization of some significative proteins (acrosin, actin, tubulin, vimentin) detected by immunocytochemical methods in human infertile spermatozoa and correlate their distribution with the ultrastructural characteristics of the same spermatozoa, in order to clarify the structural bases of infertility. PMID- 3285992 TI - Oncogenes. AB - Particular eukaryotic genes which play integral roles in the control of normal growth and differentiation programs are targets for mutagenic events which lead to the generation of malignancies. These genes, called proto-oncogenes can be activated to the oncogenic state by amplification, point mutation, deletion or chromosomal translocation. The protein products encoded by oncogenes include protein kinases, G-proteins, growth factors and nuclear transcription factors. It is likely that oncogene activation by viral infection or in concert with virally induced immunodeficiencies is responsible for the aetiology of human tumours. PMID- 3285993 TI - Polyamine metabolism and interconversion in NIH 3T3 and ras-transfected NIH 3T3 cells. AB - The effect of transfection of NIH 3T3 cells by the human ras (c-Ha-ras-1) oncogene on uptake, interconversion, and excretion of polyamines was studied. Uptake and interconversion of spermidine were higher in the ras-transfected cells. Acetylpolyamines were excreted into the medium by the ras-transfected cells, whereas they were retained by NIH 3T3 cells. In addition to acetylpolyamines, some unknown polyamine conjugates occurred in the ras transfected cells. PMID- 3285994 TI - Prediction of the ability to purge tumor from murine bone marrow using clonogenic assays. AB - The development of potential purging regimens for autologous bone marrow transplantation has been limited by the inability to predict the antitumor activity of these regimens at doses which will allow engraftment. We describe an in vitro model which estimates the in vivo efficacy of potential purging regimens in mice. The log kill of clonogenic L1210 cells after in vitro incubation with graded doses of 4-hydroperoxycyclophosphamide and vincristine (alone or in combination) was linearly related to the incubation dose of drugs. Clonogenic assays could only directly demonstrate about three logs of cell kill. However, the log linear dose-response allowed the extrapolation of cell kill for doses of drugs whose kill could not be determined directly. The extrapolated cell kill accurately predicted the in vitro activity of the drugs as established by determining the survival of B6D2F1 mice given injections of the drug-treated L1210 cells. Lethally irradiated B6D2F1 mice were given injections of mixtures of syngeneic bone marrow and L1210 cells purged with a combination of 4 hydroperoxycyclophosphamide and vincristine. Combining the results of in vitro granulocyte-macrophage colony-forming unit and clonogenic L1210 sensitivities to this drug combination predicted the survival of mice and, therefore, the effectiveness of the purging regimen. PMID- 3285995 TI - Invasiveness in hepatocyte and fibroblast monolayers and metastatic potential of T-cell hybridomas in mice. AB - Fusion of noninvasive, nonmetastatic BW5147 T-lymphoma cells with normal T lymphocytes usually resulted in highly invasive and metastatic T-cell hybridomas, apparently due to properties derived from the normal T-cell. Occasionally hybrids arose that were non- or low invasive, probably by loss of relevant genes upon chromosome segregation, since these cells contained much less DNA than highly invasive hybrids. The metastatic potential of 20 representative T-cell hybridomas was tested by tail vein injection in syngeneic mice and cells were found to be either nonmetastatic (NM), low metastatic (LM), or high metastatic (HM). NM hybrids were tumorigenic but did not form metastases and HM hybridomas caused wide-spread metastasis. LM cells formed metastases in a limited number of mice and predominantly in lymphoid tissues. In hepatocyte cultures, NM cell lines were found to be the least invasive, HM cells the most, whereas LM hybrids exhibited intermediate levels. Invasiveness was not only measured in rat hepatocyte cultures but also in rat embryo fibroblast monolayers, and the relative invasive capacity in both model systems correlated well. Pertussis toxin inhibited invasion in both systems to 20-30% of control values. This suggests that the mechanisms of invasion into hepatocyte and fibroblast cultures are at least partially similar and that the fibroblast invasion assay is a relevant model to study aspects of lymphoma metastasis. We conclude that invasive potential is a prerequisite for T-cell hybridomas to colonize tissues from the bloodstream and that a minimum level of invasiveness is necessary for extensive and wide-spread metastasis formation. PMID- 3285996 TI - Transformation of normal homologous cells by a spontaneously activated Ha-ras oncogene. AB - Several tumor-derived oncogenes have been shown to independently act as complete carcinogens following transfection into target cells from established tissue culture lines. However, the number and types of oncogenes required to transform primary cultures of normal mammalian cells is unclear. To clarify this issue in a simplified model system, we transfected genomic DNA from a naturally occurring rat tumor into NIH/3T3 cells as well as into early passage rat embryo fibroblasts. The 3T3 cells were transformed with high efficiency to malignant phenotypes; the rat embryo cells were transformed at lower frequencies following cotransfection with a selectable neomycin resistance marker and treatment with Geneticin (G418). The transformed rat cells had cancerous phenotypes as determined by in vitro, cytogenetic, and in vivo criteria. Moreover, the transformed mouse and rat cells contained new tumor DNA-derived nucleotide sequences homologous to the activated human Ha-ras oncogene. Elevated levels of Ha-ras-specific mRNA, as well as enhanced expression of the Mr 21,000 oncogene product, were detected in the transformed cells. Therefore, under well-defined experimental conditions, a spontaneously activated Ha-ras oncogene from a naturally occurring tumor was able to independently transform normal, homologous cells to a malignant phenotype. PMID- 3285997 TI - Hormonal regulation of CA125 tumor marker expression in human ovarian carcinoma cells: inhibition by glucocorticoids. AB - The CA125 tumor marker is an antigenic determinant present on a high-molecular weight glycoprotein expressed by more than 80% of newly diagnosed nonmucinous epithelial ovarian cancers. OVCA 433 human ovarian carcinoma cells express the CA125 marker at the cell surface and release large quantities of this antigen into culture medium. Here we show that release of CA125 by OVCA 433 cells is 90 to 95% inhibited by treatment with 1 x 10(-7) M dexamethasone, as determined using a biotin-based enzyme-linked immunosorbent assay utilizing OC125 monoclonal antibodies to CA125. The relative cell surface density of CA125 is also decreased following dexamethasone treatment as determined by immunofluorescence techniques using OC125 monoclonal antibodies. Inhibition of CA125 expression is specific for glucocorticoids, such as cortisol and dexamethasone, and does not occur with estrogens, progestins, androgens, or mineralocorticoids. CA125 inhibition is also dependent on the concentration of steroid used, with half-maximal and maximal inhibition by dexamethasone occurring at about 3 x 10(-9) M and 1 x 10(-7) M, respectively. Previous work has shown that OVCA 433 cells are growth inhibited by glucocorticoids and contain 14,000 glucocorticoid receptors per cell with an affinity for dexamethasone (Kd = 6.6 x 10(-9) M) which corresponds well with the concentration required for half-maximal CA125 inhibition. This correspondence, together with the specificity of CA125 inhibition for glucocorticoids, suggests that this effect is mediated by glucocorticoid receptors and is a specific biological effect of glucocorticoids on this cell type. Our results demonstrate glucocorticoid inhibition of CA125 expression by ovarian carcinoma cells and suggest that endogenous or therapeutically administered glucocorticoids can influence CA125 production by tumors in vivo. PMID- 3285998 TI - Structural studies of mannans from the cell walls of the pathogenic yeasts Candida albicans serotypes A and B and Candida parapsilosis. AB - A comparative study of three cell-wall mannans, of Candida albicans serotypes A and B and Candida parapsilosis, by means of methylation analysis supports a model of yeast mannans as having an alpha-(1----6)-linked backbone with some units (depending on the origin of the mannan) being substituted at O-2 with oligosaccharides joined by alpha-(1---2) and, to a lesser extent, by alpha-(1--- 3) glycosidic bonds. Branching points in the side chains of Candida albicans mannans were found in substantial proportions for the first time, and the corresponding branched hexasaccharides were isolated by means of acetolysis and subsequent gel filtration. 13C-N.m.r. spectroscopy of the mannans, as well as a 1H-n.m.r. spectroscopic study of the oligosaccharides obtained on acetolysis of the mannans, led to results that agreed with those of methylation analysis. PMID- 3285999 TI - Studies of lipopolysaccharides from two strains (C.D.C. 3607-60 and IP 421) of Serratia marcescens O13: structure of the putative O13 antigen. AB - Structural studies have been carried out on the putative O-specific polysaccharide of the reference strain (C.D.C. 3607-60) for Serratia marcescens O13. Circumstantial evidence that the O13 antigen is a microcapsular, acidic polymer, rather than an integral part of the lipopolysaccharide, has been obtained. Degradative and spectroscopic studies established that the polymer is based on the repeating unit shown, in which the glucuronic acid residue of the linear pentasaccharide carries the lateral 2-acetamido-2-deoxy-beta-D glucopyranosyl substituent in only about half of the units. The same polymer, again with non-stoichiometric substitution, is also produced by strain IP 421 (O13:H7). The latter strain also produces a neutral polymer which appears to constitute the side chain of the lipopolysaccharide. This polymer, which has a disaccharide repeating-unit of 2-substituted beta-D-ribofuranosyl and 4 substituted 2-acetamido-2-deoxy-alpha-D-galactopyranosyl residues, has been isolated previously from the lipopolysaccharides of the reference strains for S. marcescens serogroups O12 and O14, and appears to be the antigen known to be shared by these strains. (Formula: see text). PMID- 3286000 TI - Structure of a neutral polymer isolated from the lipopolysaccharide of Serratia marcescens O5 (C.D.C. 867-57). PMID- 3286001 TI - Bacterial tissue tropism: an in vitro model for infective endocarditis. AB - Since infective endocarditis may affect individuals without pre-existing valvar heart disease, and Staphylococcus aureus is the organism most commonly involved, the binding characteristics of S aureus to several components of normal vascular endothelium and subendothelium were studied. S aureus adhered specifically to endothelial monolayers (6.08(1.10)%; p less than 0.005), fibronectin (5.43(0.81)%; p less than 0.001), fibrinogen (7.13(1.43)%; p less than 0.001), and acid soluble calf skin collagen (2.38(0.90)%; p less than 0.001). S aureus also adhered specifically to Von Willebrand factor (1.62(0.28)%, p less than 0.001). Protein A containing (Cowan I) and deficient (Wood) strains of S aureus adhered similarly to all surfaces and substrates (NS). Escherichia coli adhered poorly. Immunofluorescence microscopy of preconfluent endothelial cells identified an extensive pericellular fibronectin network at regions of cell to cell contact. Light microscopy showed S aureus binding solely within these regions. Therefore, the ability of S aureus to infect valvar endothelium may be dependent on the presence of a fibronectin receptor. The existence of specific receptor for S aureus on the endothelial cell surface itself remains undetermined. PMID- 3286002 TI - Non-invasive measurement of renal blood flow with 99mTc DTPA: comparison with radiolabelled microspheres. AB - This technique for non-invasive measurement of renal blood flow is based on the principle of fractionation of cardiac output, and applicable with any recirculating gamma activity tracer. It effectively determines the count rate that would be recorded over the kidney if the tracer behaved like radiolabelled microspheres and was completely trapped in the kidney on first pass. After correction for kidney depth, the estimated first pass activity plateau, expressed as a fraction of the injected dose, is equal to the kidney's fraction of cardiac output. The principle of the technique was validated by comparison with renal blood flow based on radiolabelled microspheres. Nine separate comparisons were made in two anaesthetised dogs. A known dose of 99mTc radiolabelled microspheres (particle size 23-45 microns) was injected into the left ventricle and the count rate over each kidney recorded. A known dose of 99mTc diethylenetriaminepenta acetic acid (DTPA) was then given as an intravenous bolus and the data recorded dynamically with a gamma camera online to a computer. After subtraction of the stable signal arising from the preceding radiolabelled microspheres, the theoretical first pass activity plateau from the DTPA that would have been recorded if the DTPA, after reaching the systemic circulation, had behaved like radiolabelled microspheres and become completely trapped in the renal vascular bed, was estimated. Using doses based on syringe counts before and after injection the ratio of renal blood flow values given by the two techniques (DTPA:RLMS) was 1.14 (SD 0.22) for the left kidney and 1.1(0.17) for the right. Using doses based on whole body counts, corresponding ratios were 1.05(0.11) and 1.02(0.13).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286003 TI - In vitro identification of different degrees of mitral valve disease by online evaluation of radiofrequency ultrasound signal. AB - Sixty five mitral valves were studied in vitro with a 2.25 MHz transducer. Radiofrequency signals were analysed by a microprocessor system (implemented on an M-mode commercially available echocardiography) for online evaluation of ultrasonic backscatter (8 bits of amplitude resolution, 40 MHz sampling rate, 1 microsecond acquisition gate). The integrated value of the rectified signal amplitude was expressed as the integrated backscatter index (in db). The highest value recorded with ultrasonic scanning of each sample was taken as representative of that specimen. Calcification of mitral valves was assessed by radiography (24 mitral valves). Non-calcified mitral calves underwent pathological examination, and fibrotic valves (22 mitral valves) were differentiated from normal valves (19 mitral valves). A statistically significant (p less than 0.005) difference was recorded among the three groups for the index maximal value: calcific -7.4(3.1) db (mean(SD)), fibrotic -18.9(4.9) db, and normal -37.9(7.6) db. In conclusion, a microprocessor based system for online evaluation of radiofrequency ultrasonic signals, which may also be feasible for in vivo studies, provided a clear differentiation in vitro of calcific, fibrotic, and normal mitral valves. PMID- 3286004 TI - Disturbed immune regulation in spontaneous autoimmune thyroiditis. PMID- 3286005 TI - Autoimmunity in insulin-dependent diabetes mellitus: its detection and prevention. PMID- 3286006 TI - The diversity and idiotypic patterns of human rheumatoid factors in disease. PMID- 3286007 TI - Regulation of HLA class II expression and the pathogenesis of autoimmunity. PMID- 3286008 TI - Immunogenetics of HLA-associated diseases. PMID- 3286009 TI - Tight junction dynamics: is paracellular transport regulated? PMID- 3286010 TI - The molecular basis of blood coagulation. PMID- 3286011 TI - Study of a temperature-sensitive mutant of the ras-related YPT1 gene product in yeast suggests a role in the regulation of intracellular calcium. AB - Intragenic mutations were isolated that suppressed the dominant-lethal phenotype of the YPT1ile121 mutant gene in a temperature-dependent fashion. Among different amino acid substitutions resulting from single point mutations, two, Ala161--- Val (A161V) and Met165----Ile (M165I), restored the function of the YPT1ile121 mutant protein. Mutants expressing the YPT1ile121/val161 allele (ypt1ts) only, grew normally at temperatures up to 30 degrees C but were arrested at 37 degrees C. At the restrictive temperature, ypt1ts mutants accumulated ER membranes, small vesicles, and unprocessed invertase, and they exhibited cytoskeletal defects and an enhanced 45Ca2+ uptake. Similar alterations were seen in YPT1-depleted cells. The ypt1ts mutant cells could be rescued from growth arrest by increasing extracellular Ca2+, and, even at the permissive temperature, they displayed increased trifluoperazine sensitivity. PMID- 3286012 TI - Site-directed mutagenesis of the cell-binding domain of human fibronectin: separable, synergistic sites mediate adhesive function. AB - Polypeptide sequences required for function of the cell-binding domain of human fibronectin were analyzed by site-directed mutagenesis. Site-specific deletion of the putative recognition sequence Arg-Gly-Asp-Ser or an Asp-to-Glu mutation decreased the adhesive activity of fibronectin fusion proteins expressed in E. coli by greater than or equal to 97%. A second functional site over 0.5 kb away was identified by deletion mutagenesis. These mutants also showed a greater than or equal to 96% loss of activity, indicating cooperativity between sites. The two classes of mutant protein displayed synergism of activity in a trans complementation assay. Effective actin microfilament bundle organization was also dependent on the combined function of both sites. Thus, fibroblast adhesion and intracellular response to the fibronectin cell-binding domain involve two synergistic sites, each of major quantitative importance. PMID- 3286013 TI - Hierarchies of regulatory genes may specify mammalian development. PMID- 3286015 TI - Myogenic lineage determination and differentiation: evidence for a regulatory gene pathway. AB - Stable myogenic cell lines have been derived at a high frequency by transfection of a cloned multipotential mouse embryo cell line, C3H 10T1/2, with cloned human DNA linked to a selectable neomycin resistance gene. The myogenic phenotype remains linked to neomycin resistance during secondary transfections. Although proliferative in growth conditions, these cell lines maintain the ability to differentiate and express muscle-specific proteins. We conclude that there is a simple genetic basis for myogenic determination and that a single gene, myd, converts 10T1/2 cells to a myoblast lineage. Southern blot analysis demonstrates nonidentity of myd and the MyoD1 gene. Northern blot analysis shows that myd transfected myogenic lineages express MyoD1 mRNA while parental 10T1/2 cells do not. These results suggest that a dependent regulatory gene pathway mediates myogenic determination and differentiation. PMID- 3286014 TI - When polymerases collide: replication and the transcriptional organization of the E. coli chromosome. PMID- 3286016 TI - Homologous recombination within subtelomeric repeat sequences generates chromosome size polymorphisms in P. falciparum. AB - We present restriction maps for chromosomes 1 and 2 of six cloned lines of P. falciparum. These delineate the locations of eight genetic markers, including genes for five antigens. In parasites from diverse areas, chromosome structure is conserved in central regions but is polymorphic both in length and sequence near the telomeres. The telomeres and adjacent sequences comprise a conserved structure at the ends of most P. falciparum chromosomes. However, the subtelomeric zones are polymorphic and coincide with the locations of a repetitive element (rep20). Deletions of rep20 generate clones of P. falciparum that lack rep20 on one or both ends of chromosomes 1 or 2, and larger deletions remove telomere-proximal genes as well. The chromosome length polymorphisms can therefore be largely explained by recombination within these blocks of repeats, a mechanism that is also important in the generation of diversity in genes for repetitive antigens of P. falciparum. PMID- 3286017 TI - The expression of melanosomal matrix protein in the transdifferentiation of pigmented epithelial cells into lens cells. AB - A monoclonal antibody (MC/1) was constructed against melanosomes purified from the chicken pigmented epithelial cells (PECs) in order to characterize the differentiative phenotypes of PEC in the process of transdifferentiation into lens cells. Immunofluorescent studies revealed that MC/1 antibody specifically stains both retinal PECs in the eye and melanocytes in the skin, of chicken embryos. Immunoelectron microscopy showed that the antigen molecules are located on the peripheral region of the melanosomal matrix. A single protein band with an apparent molecular weight of 115,000 was labelled by MC/1 in Western blotting. The 115 kDa polypeptide identified by MC/1 is considered to be a member of the melanosomal matrix proteins. The maintenance of specificity of pigment cell nature is followed in the system of transdifferentiation of PEC into lens in vitro, utilizing 115 kDa protein as a marker. In the dedifferentiated PECs, this protein was undetectable. PMID- 3286018 TI - [A new method of preparing the conization specimen from the uterine cervix]. PMID- 3286019 TI - [Intra-tubal gamete transfer in the treatment of infertility]. PMID- 3286021 TI - [Blind-ending ureters. Apropos of 9 cases and review of the literature]. PMID- 3286020 TI - Nuclear omnipotent suppressors of premature termination codons in mitochondrial genes affect the 37S mitoribosomal subunit. AB - nam3 and R705, yeast nuclear omnipotent suppressors of mitochondrial mit- mutations, reverse the superimposed spectrum of trans-recessive splicing defects by affecting the protein composition of the small mitoribosomal subunit. Analysis of the suppressor's interaction suggests that suppression results from mutations in the mitoribosomal polypeptides. These data indicate an obligatory connection between mitoribosome function and splicing of introns bI2, bI4 and aI1 in yeast mitochondria. PMID- 3286022 TI - Dysplasia epiphysealis hemimelica of the carpal bones. Report of a case with a long-term follow-up after conservative treatment--review of the literature. PMID- 3286023 TI - [Congenital hemangiopericytoma. Apropos of 2 personal cases. Review of the literature]. PMID- 3286024 TI - Fatal esorubicin-induced cardiomyopathy: report of a case and review of the literature. AB - A case of fatal dilated cardiomyopathy induced by esorubicin (ESO) at a total dose of 740 mg/m2, given in 27 doses over 650 days, is reported. The sudden onset, rapid clinical deterioration, and fatal outcome are detailed. The outcome was not predicted by serial rest ejection fractions or clinical signs. The data from animal studies, phase 1 and phase 2 clinical testing, are reviewed, demonstrating the almost complete absence of reports of ESO-induced cardiotoxicity. Studies reviewing ejection fractions and myocardial biopsy scores show that ESO can be cardiotoxic and may produce fatal dilated cardiomyopathy. PMID- 3286025 TI - The effect of pyrazole, phenobarbital, ethanol and 3-methylcholanthrene pretreatment on the in vivo and in vitro genotoxicity of N-nitrosopyrrolidine. AB - The in vitro genotoxicity of N-nitrosopyrrolidine (NPy) has been studied in Salmonella typhimurium strain TA1535 in the presence of untreated and pyrazole-, phenobarbital (PB)-, 4-day ethanol (EtOH)-, 10-day EtOH- and 3-methylcholanthrene (3-MC)-pretreated male Sprague-Dawley rat liver S-9 fractions. Unless stated otherwise, the last pretreatment exposure was 24 h prior to sacrifice and isolation of hepatic enzymes. Pyrazole and EtOH (10-day exposure) both effectively induced the conversion of NPy into a mutagen at doses as low as 500 microM. PB and EtOH (4-day exposure) had a modest enhancing effect on the number of revertants scored, while 3-MC and uninduced S-9 fractions gave results not significantly different from background (no NPy). The same pretreatment protocols were used to determine the in vivo genotoxicity of NPy in rat liver using the technique of alkaline elution. The inducing agents had the exact opposite effect in vivo with control, 3-MC- and 4-day EtOH-treated animals showing the highest level of DNA damage. Pyrazole and 10-day EtOH pretreatments gave DNA elution rate constants comparable to animals not treated with NPy. However, in 10-day EtOH pretreated animals which were administered NPy without a 24-h interval between EtOH and NPy exposure, DNA damage was observed at the same high levels as was seen in uninduced and 3-MC treated rats. The results are discussed in terms of a detoxification role for microsomal proteins and that the observed in vivo DNA damage may be induced by enzymes associated with the nuclear compartment. PMID- 3286026 TI - Organospecific activation of azathioprine in mice: role of liver metabolism in mutation induction. AB - The organ-specific mutagenicity of azathioprine was examined by means of the intrasanguineous host-mediated assay in mice, combined with the D7 strain of Saccharomyces cerevisiae. To assay for changes in the frequency of mitotic gene conversion, mitotic crossing-over and point reverse mutation frequency, a single i.p. dose of azathioprine was administered. Kidney-mediated mutagenicity was significantly enhanced. The ability of liver, kidney and lung S9 fractions (from Na-phenobarbital + beta-naphthoflavone induced mice) to activate azathioprine into genotoxic intermediates was also evaluated in vitro by incubating organ homogenates with S. cerevisiae cells as a target organism. Organ-specific activation was demonstrated only in the liver. The relative role of liver metabolism in the induction of mutations and tumor induction was investigated in in vivo experiments with partially hepatectomized mice. The data demonstrated that liver affects both kidney- and lung-mediated mutagenicity and indicated that hepatic metabolism can contribute mutagenic metabolites for cancer initiation by azathioprine. PMID- 3286027 TI - HPLC enrichment of hydrophobic DNA--carcinogen adducts for enhanced sensitivity of 32P-postlabeling analysis. AB - The sensitivity of 32P-postlabeling analysis for the quantitation of DNA carcinogen adducts can be sharply increased by enriching adducted nucleotides relative to normal nucleotides in digested DNA samples prior to postlabeling. Normal and adducted nucleotides from benzo[a]pyrene-adducted DNA were injected onto a reverse phase HPLC column. Normal nucleotides were eluted with 5% methanol, 95% 1 M ammonium formate, pH 3.5. Hydrophobic adducted nucleotides were then recovered from the column using either a linear gradient of methanol (to fractionate adducts) or a step gradient of methanol to elute all hydrophobic adducts in one fraction. Recovered chromatographic fractions were dried, postlabeled with 32P, and aromatic DNA--carcinogen adducts were detected and quantitated using TLC on polyethyleneimine cellulose. Results from the HPLC adduct enrichment procedure were generally similar to those from an alternative enrichment scheme utilizing nuclease P1 to selectively dephosphorylate normal nucleotides. HPLC and nuclease P1 procedures are easily combined for the dual analysis of DNA samples from organisms exposed to environmental carcinogens. PMID- 3286028 TI - 32P-postlabeling analysis of DNA adducts in human and rat mammary epithelial cells. AB - The etiology of human breast cancer is currently undefined. However, it has been hypothesized that exposure to chemical carcinogens may be an important factor. Extrapolation from rodent models for chemically-induced mammary cancer suggests the possibility that human mammary epithelial cells in situ might contain DNA adducts due to exposure to environmental chemicals. We have therefore screened breast epithelial cells from 10 donors for the existence of DNA adducts using the 32P-postlabeling assay. In order to validate this analysis technique, we also examined the DNA adducts formed in human mammary cells exposed to benzo[a]pyrene (B[a]P) in vitro, and adducts formed in rat mammary epithelial cells exposed to B[a]P in vitro and in vivo. Confirming previous results using HPLC analysis of [3H]B[a]P-DNA adducts, the major B[a]P-DNA adduct formed by human mammary epithelial cells in vitro was (+)-anti-B[a]P-7,8-dihydrodiol-9,10-epoxide (BPDE):deoxyguanosine. This adduct did not appear to be formed by rat mammary cells exposed to B[a]P in vitro. However, 32P-postlabeling analysis of mammary epithelial cell DNA from rats exposed to B[a]P in vivo indicated that (+)-anti BPDE-deoxyguanosine was a major B[a]P-DNA adduct under these exposure conditions. When the mammary epithelial cells from 10 human donors were screened for DNA adducts formed in situ, cells from three donors exhibited distinct adduct patterns. None of these adducts appeared to be (+)-anti-BPDE-deoxyguanosine. The existence of DNA adducts in human mammary epithelial cells in situ, coupled with the data indicating that rat mammary cells form different B[a]P adducts in vitro and in situ, suggests the need for further study of human breast cell adducts. PMID- 3286029 TI - Diversity of the promoting action of cyclosporine on the induction of murine lymphoid tumors. AB - We have previously demonstrated that cyclosporine (CsA), a powerful immunosuppressant, enhanced the development of thymic lymphomas in Swiss Webster mice initiated with a single subcarcinogenic dose of N-methyl-N-nitrosourea and enhanced the spontaneous development of thymic tumors in AKR mice. In the present study, we examined whether the initiation of mice with a single dose of gamma radiation modified the target cell specificity of the CsA promotion of lymphoma induction. Male Swiss Webster and C57B/6 mice were divided into four groups. The mice in group 1 and 2 of both strains were given a single dose (350 rad) of gamma radiation; 10 days thereafter group 1 was given a basal diet and group 2 a basal diet containing 0.015% CsA for 25-35 weeks. Groups 3 and 4 consisted of control mice without radiation and were maintained on a basal or a CsA diet. None of the mice in either strain in groups 1, 3 and 4 developed tumors. Eighteen out of 39 (46%) Swiss Webster mice that received radiation followed by a CsA diet developed tumors involving mesenteric lymph nodes and the spleen. The tumor cells had immunoglobulins on their surface and were negative for Thy 1, suggesting lymphomas of B cell lineage. Four mice (10%) developed thymic tumors which were positive for Thy 1. Seven of 14 (50%) C57B/6 treated with radiation and CsA developed thymic tumors, while none developed tumors of B cell lineage. The results indicate that CsA is a potent promoter of the induction of lymphomas in mice and that the cell type is determined by the type of initiating agents and the strain of mice. PMID- 3286030 TI - Tobacco-specific nitrosamines, an important group of carcinogens in tobacco and tobacco smoke. AB - Tobacco-specific nitrosamines are a group of carcinogens that are present in tobacco and tobacco smoke. They are formed from nicotine and related tobacco alkaloids. Two of the nicotine-derived nitrosamines, NNK and NNN, are strong carcinogens in laboratory animals. They can induce tumors both locally and systemically. The induction of oral cavity tumors by a mixture of NNK and NNN, and the organospecificity of NNK for the lung are particularly noteworthy. The amounts of NNK and NNN in tobacco and tobacco smoke are high enough that their total estimated doses to long-term snuff-dippers or smokers are similar in magnitude to the total doses required to produce cancer in laboratory animals. These exposures thus represent an unacceptable risk to tobacco consumers, and possibly to non-smokers exposed for years to environmental tobacco smoke. The permission of such high levels of carcinogens in consumer products used by millions of people represents a major legislative failure. Indeed, the levels of tobacco-specific nitrosamines in tobacco are thousands of times higher than the amounts of other nitrosamines in consumer products that are regulated by government authorities. Although the role of tobacco-specific nitrosamines as causative factors in tobacco-related human cancers cannot be assessed with certainty because of the complexity of tobacco and tobacco smoke, several lines of evidence strongly indicate that they have a major role, especially in the causation of oral cancer in snuff-dippers. Epidemiologic studies have demonstrated that snuff-dipping causes oral cancer. NNK and NNN are quantitatively the most prevalent known carcinogens in snuff, and they induce oral tumors when applied to the rat oral cavity. A role for NNK in the induction of lung cancer by tobacco smoke is likely because of its organospecificity for the lung. Tobacco-specific nitrosamines may also be involved in the etiology of tobacco-related cancers of the esophagus, nasal cavity, and pancreas. Because they are derived from nicotine, and therefore should be associated only with tobacco, tobacco smoke and other nicotine-containing products, tobacco-specific nitrosamines as well as their metabolites and macromolecular adducts should be ideal markers for assessing human exposure to, and metabolic activation of, tobacco smoke carcinogens. Ongoing research has demonstrated the formation of globin and DNA adducts of NNK and NNN in experimental animals. Sensitive methods for the detection and quantitation of these adducts in humans would provide an approach to assessing individual risk for tobacco-related cancers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3286031 TI - Mutagenicity of hexachloro-1,3-butadiene and its S-conjugates in the Ames test- role of activation by the mercapturic acid pathway in its nephrocarcinogenicity. AB - The mutagenicity of hexachloro-1,3-butadiene and its S-conjugates 1-(glutathion-S yl)-1,2,3,4,4-pentachloro-1,3-butadiene (GTB), 1,4-(bis-glutathion-S-yl-1,2,3,4 tetrachloro-1,3-butadiene (BGTB) and 1,4-(bis-cystein-S-yl)-1,2,3,4-tetrachloro 1,3-butadiene (BCTB) was investigated in Salmonella typhimurium TA100 using a modified preincubation assay. GTB was a direct-acting mutagen; the mutagenic potency of GTB was markedly enhanced by rat kidney microsomes or mitochondria and less so by cytosol. The bis-conjugates BGTB and BCTB were not mutagenic in the strains TA100, TA2638 and TA98. Purified HCBD was not mutagenic either without exogenous metabolic activation or with rat liver microsomes fortified with NADPH. Preincubation with rat liver microsomes and glutathione resulted in an unequivocal mutagenic activity of HCBD which was increased by additional inclusion of rat kidney microsomes. The cysteine conjugate beta-lyase inhibitor aminooxyacetic acid decreased the mutagenicity of HCBD and its S-conjugates. These results provide strong evidence that formation of the corresponding monoglutathione S-conjugate from HCBD and subsequent cleavage of this conjugate by gamma-glutamyltranspeptidase and beta-lyase may be responsible for the nephrocarcinogenicity of the parent compound in vivo, whereas formation of the bis-glutathione S-conjugate probably plays no role in the organ specific effects of HCBD. PMID- 3286032 TI - Microsomal metabolism of 1-nitrobenzo[e]pyrene to a highly mutagenic K-region dihydrodiol. AB - Aerobic metabolism of 1-nitrobenzo[e]pyrene (1-nitro-BeP) by rat liver microsomes produced 1-nitro-BeP trans-4,5-dihydrodiol, 6-hydroxy-1-nitro-BeP, and 8-hydroxy 1-nitro-BeP. When 3,3,3-trichloropropylene 1,2-oxide was incorporated into the metabolism, 1-nitro-BeP 4,5-oxide was the predominant metabolite, and 1-nitro-BeP trans-4,5-dihydrodiol was not detected. All of the metabolites were purified by both reversed- and normal-phase HPLC and characterized by analysis of their mass and 500 MHz proton NMR spectral data. 1-Nitro-BeP was not metabolized under hypoxic conditions. 1-Nitro-BeP and its four metabolites were assayed in Salmonella typhimurium tester strains TA98, TA98NR and TA98/1,8-DNP6, both in the presence and absence of S9 activation. As predicted, 1-nitro-BeP was a weak mutagen without S9 (2 revertants/micrograms in TA98); the addition of S9 resulted in approximately 18, 17 and 4 revertants/micrograms in TA98, TA98NR and TA98/1,8 DNP6 respectively. The two phenolic metabolites were mutagenic both in the presence and absence of S9, producing moderate responses (19-84 revertants/micrograms). In addition, while the 1-nitro-BeP 4,5-oxide was only weakly mutagenic in TA98 (6-14 revertants/micrograms), 1-nitro-BeP trans-4,5 dihydrodiol was unexpectedly potent (approximately 300 revertants/micrograms both with and without S9). These results indicate that microsomal epoxidation of 1 nitro-BeP followed by epoxide hydrolase-catalyzed hydrolysis of the resulting epoxide to the 1-nitro-BeP trans-4,5-dihydrodiol results in the most potent mutagenic derivatives. The weak mutagenicity of 1-nitro-BeP 4,5-oxide demonstrates that not all epoxides of nitrated polycyclic aromatic hydrocarbons (PAHs) are more mutagenic than the corresponding parent nitro-PAHs. Also, the lower S9-mediated mutagenicity of 1-nitro-BeP in TA98/1,8-DNP6 compared with TA98 indicates that the mutagenicity of 1-nitro-BeP is dependent upon nitroreduction and transesterification. Finally, we previously hypothesized that nitrated PAHs with their nitro substituents perpendicular or nearly perpendicular to the aromatic rings are very weak or nondirect-acting mutagens in Salmonella typhimurium tester strains. The results reported in this communication demonstrate that ring-oxidized derivatives of nitro-PAHs do not always follow this structure--mutagenicity correlation. PMID- 3286033 TI - Changes in renal sympathetic nerve activity during experimental septic and endotoxin shock in conscious rats. AB - Changes in postganglionic renal sympathetic nerve activity, arterial pressure, and heart rate were measured in conscious rats during intravenous infusion of live E. coli bacteria (10(9)/h) or bolus injection of E. coli endotoxin (20 mg/kg). Bacteria infusion was associated with a marked and parallel increase in heart rate and sympathetic activity with only minor changes in mean arterial pressure. The early response to bolus injection of endotoxin was a short-lasting decrease in mean arterial pressure combined with a marked increase in sympathetic activity and heart rate, probably due to baroreceptor unloading. However, when mean arterial pressure returned to pre-endotoxin levels, sympathetic activity and heart rate remained markedly elevated, indicating a partly nonreflexogenic increase in central sympathetic outflow. This study using direct nerve recordings of sympathetic activity in conscious animals confirms earlier clinical observations of an increased activity of the sympathetic nervous system in septic shock. PMID- 3286034 TI - The domination of knowledge by ignorance: politics and regulation of animal research for diagnosis and treatment of disease. PMID- 3286035 TI - From 'Emax' to pressure-volume relations: a broader view. PMID- 3286036 TI - Insights into the pathogenesis of acute ischemic syndromes. PMID- 3286037 TI - Serum immunoglobulin E response to myocardial infarction. AB - Mast cells have been implicated in the pathogenesis of coronary heart disease. They can be activated by immunoglobulin (Ig) E-mediated mechanisms to release powerful mediators affecting local blood flow. We have determined systematically serum IgE concentrations in 100 patients with acute myocardial infarction. There was a consistent pattern of change in serum IgE, characterized by a significant increase on the third and fifth day, peak values on the seventh day, and a gradual decline to initial levels by the end of the third week after infarction. The increase in serum IgE shortly after myocardial infarction was similar to the increase in blood eosinophil count, but was in contrast to serum IgG levels. After infarction, patients with high initial IgE levels (greater than 200 IU/ml) had a greater increase in IgE and less frequent severe complications than those whose initial IgE levels were below 200 IU/ml. In 16 subjects with acute coronary insufficiency without infarction serum IgE levels remained unchanged. It is suggested that in myocardial infarction circulating IgE sensitizes both mast cells of coronary arteries and eosinophils, invading ischemic myocardium; this facilitates release of chemical mediators. Patients with high IgE levels might be protected against complications of infarction because of a favorable ratio of locally released mediators and because of decreased platelet function. PMID- 3286038 TI - Development of the coronary arteries in the embryonic human heart. AB - It is not known why the coronary arteries almost always originate only from the right and left aortic sinuses of Valsalva, since the structure and conditions appear to be the same for all six sinuses of the embryonic great arteries. We sought a possible mechanical explanation for the phenomenon by studying the development of the coronary vasculature in 351 staged, serially sectioned human embryos of Carnegie stages 9 through 23 from the Carnegie Embryological Collection. A plexus of blind epicardial capillaries appears on the heart in Carnegie stage 14 or 15 and acquires a coronary sinus connection in stage 15, 16, or 17. The connection of the proximal coronary arteries to the aorta does not appear until stage 18. We found no histologic features of the cardiac nerves or any other component of the tissues to account for the consistent origin of coronary arteries from the right and left aortic sinuses of Valsalva. However, serial section reconstructions showed that the two sinuses where coronary arteries develop acquire a positive transverse curvature and a negative longitudinal curvature, i.e., a catenoidal or saddle-shaped configuration, before the appearance of the coronary arteries. The four noncoronary sinuses also have a positive transverse curvature, but longitudinally, in contrast, they have a positive curvature or are straight. The results suggest that the coronary arteries originate from those sinuses of Valsalva where wall tension is increased by a catenoidal configuration. PMID- 3286039 TI - Does desmopressin acetate reduce blood loss after surgery in patients on cardiopulmonary bypass? AB - It has been suggested that desmopressin acetate (DDAVP) administration reduces blood loss after cardiac surgery. We have investigated the effect of DDAVP administration in a double-blind, randomized, prospective trial including 100 patients placed on cardiopulmonary bypass during surgery. Fifty patients received 0.3 micrograms/kg DDAVP and 50 patients received a placebo administered in a 50 ml saline solution over 15 min when cardiopulmonary bypass had been concluded. Results showed no significant differences either in total blood loss per square meter (458 +/- 206 ml in the DDAVP group vs 536 +/- 304 ml in the placebo group) or in necessity for red cell transfusions (1642 +/- 705 ml in the DDAVP group vs 1574 +/- 645 ml in the placebo group) in the first 72 hr after surgery. Only intraoperative blood loss per square meter was significantly lower (p less than .02) in the DDAVP group (131 +/- 106 ml) as compared with the placebo group (193 +/- 137 ml). The prolongation of bleeding time and the decrease of factor VIII:C and factor VIII:von Willebrand factor 90 min after treatment were significantly lower (p less than .001) in the DDAVP group as compared with the placebo group. We conclude that the administration of DDAVP in patients placed on cardiopulmonary bypass during surgery does not reduce total blood loss and is only effective in reducing intraoperative bleeding. PMID- 3286040 TI - Improvement in early saphenous vein graft patency after coronary artery bypass surgery with antiplatelet therapy: results of a Veterans Administration Cooperative Study. AB - To determine whether specific antiplatelet therapies improved vein graft patency after coronary artery bypass grafting (CABG) we compared (1) aspirin, 325 mg daily, (2) aspirin, 325 mg three times daily, (3) aspirin plus dipyridamole (325 mg and 75 mg, respectively, three times daily), (4) sulfinpyrazone (267 mg three times daily), and (5) placebo (three times daily). Therapy, except aspirin, was started 48 hr before CABG. When aspirin was a treatment, one 325 mg dose was given 12 hr before surgery and therapy was maintained thereafter according to the assigned regimen. Angiographic graft patency data were obtained within 60 days of surgery. Analysis of early graft patency in 555 patients (1781 grafts), revealed the following graft patency rates: aspirin daily, 93.5%; aspirin three times daily, 92.3%; aspirin and dipyridamole, 91.9%; and sulfinpyrazone, 90.2%. All aspirin-containing therapeutic regimens improved (p less than .05) graft patency compared with placebo (85.2%). Chest tube drainage measured within the first 35 hr after CABG revealed that the median loss with aspirin daily (965 ml), aspirin three times daily (1175 ml), and aspirin plus dipyridamole (1000 ml) exceeded (p less than .02) that with placebo (805 ml), while median loss with sulfinpyrazone (775 ml) did not. The reoperation rate was greater (p less than .01) in all the treatment groups that received aspirin (6.5%) compared with the two nonaspirin groups (1.7%). Overall operative mortality was 2.3%, without significant differences among treatment groups. Transient renal insufficiency occurred in 5.3% of patients taking sulfinpyrazone. Thus, early vein graft patency was improved after CABG with all aspirin-containing drug regimens.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286041 TI - Combination therapy with diltiazem and nifedipine in patients with effort angina pectoris. AB - The antianginal effects of diltiazem and nifedipine alone and in combination were evaluated in a double-blind, randomized, placebo-controlled trial in 11 patients (nine men and two women, 57 +/- 8 years old) with stable effort angina. Each patient received placebo, 30 mg of diltiazem, 10 mg of nifedipine, and 30 mg of diltiazem plus 10 mg of nifedipine four times daily for 1 week each. Antianginal efficacy was assessed by means of a treadmill exercise test. The exercise tolerance time was significantly prolonged from 235.1 +/- 52 (placebo period) to 342.2 +/- 101 sec by diltiazem (p less than .01) and to 325.6 +/- 73 sec by nifedipine (p less than .01). The drug combination further prolonged exercise time to 451.1 +/- 103 sec, which was significantly longer than the interval attained with either diltiazem (p less than .01) or nifedipine (p less than .01) alone. The plasma concentration of diltiazem was unaffected by the addition of nifedipine, whereas the plasma nifedipine concentration was significantly increased from 34.8 +/- 11 to 106.4 +/- 37 ng/ml (p less than .001) by the concomitant administration of diltiazem. These data suggest that exercise tolerance in patients with effort angina is increased by the concomitant administration of diltiazem and nifedipine associated with an increase in the nifedipine plasma concentration. PMID- 3286042 TI - New approaches to the study of the cellular biology of the cardiovascular system. AB - Recent findings suggest that the local renin-angiotensin systems, locally generated catecholamines, and possibly other locally generated peptides interact in a complex fashion to regulate the cellular biology of the myocardium, the vascular wall, and other tissues. New evidence indicates that the components of the renin-angiotensin system are synthesized in cardiovascular tissues, that the synthesis of these components can be modulated by pharmacologic agents, and that angiotensin II, the effector protein of the renin system, appears to be capable of producing hypertrophy or hyperplasia in specific tissues. In addition, recent studies suggest the participation of enhanced proto-oncogene transcriptional activity in the development of hyperplasia and hypertrophy in cardiovascular tissue. Taken together, these data raise the possibility that angiotensin and perhaps other components of the renin system can be viewed as locally active growth factors capable of acting in a fashion similar to that associated with cytokines in other systems. PMID- 3286043 TI - Intracardiac generation of angiotensin and its physiologic role. AB - The emerging recognition of the existence and potential biological significance of local tissue renin-angiotensin systems in a number of organs has fostered interest in a possible intrinsic cardiac renin-angiotensin system. Evidence for such a system was first provided by biochemical measurements of components of the renin-angiotensin system in cardiac tissue. It has recently been demonstrated that the genes coding for renin and angiotensinogen are expressed in all regions of the heart, an essential prerequisite for the postulated intracardiac biosynthesis of these proteins. Moreover, we have shown the presence of a functional and physiologically active pathway for the conversion of angiotensin I to angiotensin II in the beating mammalian heart. This conversion appears to be catalyzed by a specific cardiac converting enzyme that is susceptible to systemically administered converting-enzyme inhibitors. Evidence for the physiologic importance of the cardiac renin-angiotensin system comes from experimental data as well as indirect clinical evidence. The potent coronary vasoconstrictor properties of angiotensin II underscore its possible significance in myocardial ischemia and ischemic heart disease, in particular when viewed in the context of selective local activation. The long-known positive inotropic effects of angiotensin II are based on its direct myotropic properties and on its facilitatory effects on sympathetic neurotransmission and may be of added significance in metabolically compromised states. We have recently demonstrated that locally generated angiotensin may be a dominant etiologic factor in the pathogenesis of reperfusion arrhythmias. In addition, we have found experimental evidence for a deleterious effect of angiotensin II on myocardial metabolism in the setting of regional myocardial ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286044 TI - Differential influences of angiotensin converting-enzyme inhibitors on the coronary circulation. AB - The effects of captopril and zofenoprilate (the active form of the prodrug zofenopril and also a sulfhydryl-containing angiotension converting-enzyme inhibitor) on coronary flow in the isolated rat heart were compared with the effects of a nonsulfhydryl converting-enzyme inhibitor, ramiprilate (the active form of the prodrug ramipril) and of sulfhydryl-containing compounds with no converting-enzyme inhibiting properties such as glutathione, cysteine, and the (R,S)-isomer of captopril. Drug concentrations of the angiotensin converting enzyme inhibitors were equipotent in their effect on angiotensin I pressor response. Concentrations of the other compounds were equimolar with respect to the sulfhydryl group. Hearts treated with captopril, its isomer, zofenoprilate, cysteine, and glutathione showed significant increases in coronary flow by 5 min of perfusion. In contrast, ramiprilate treatment resulted in a slower increase in coronary flow that was only significant after 20 min of perfusion. The effect of ramiprilate was associated with a significant increase in 6-keto-prostaglandin (PG) F1 alpha overflow in the coronary effluent compared with that in saline treated hearts, whereas captopril and glutathione had no significant effect on overflow of the measured cyclooxygenase products 6-keto-PGF1 alpha, thromboxane B2, and PGE2. The effects of captopril, zofenoprilate, and glutathione on coronary flow were dose dependent. These results corroborate the view that ramiprilate enhances coronary flow by affecting prostacyclin synthesis, mediated by an increase of endogenous bradykinin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286045 TI - Circulating versus local renin-angiotensin system in cardiovascular homeostasis. AB - The renin-angiotensin system has traditionally been viewed as an endocrine system. Recent data demonstrate that renin and angiotensinogen genes and their products are expressed at many local tissue sites. The concept that multiple tissues synthesize angiotensin has changed our understanding of the physiology of the renin-angiotensin system. These potential autocrine-paracrine systems may be important in the regulation of local tissue functions in addition to the circulating endocrine system. The activity of the tissue system under different conditions can influence the pharmacologic response to inhibitors of the renin angiotensin system. For example, evidence suggests that tissue angiotensin converting enzyme (ACE) may be the primary site of action of ACE inhibitors. Consequently, the duration of action of an ACE inhibitor may be more dependent on the duration of tissue ACE inhibition than on the drug's serum half-life. The differential effects of these pharmacologic inhibitors on the tissue renin angiotensin systems may form the basis of differentiation between the various ACE inhibitors. PMID- 3286046 TI - Role of angiotensin in autoregulation of cerebral blood flow. AB - The presence of the renin-angiotensin system (RAS) in extrarenal tissues, namely the vascular wall and brain tissue, is well established. The availability of effective blocking agents, converting-enzyme inhibitors, has made it possible to further elucidate important functions of the extrarenal RAS. We have found that the angiotensin converting-enzyme inhibitor captopril shifts the limits of cerebral blood flow autoregulation to lower blood pressure levels in normotensive and in spontaneously hypertensive rats. This effect may explain our finding of a remarkable preservation of cerebral blood flow, despite significant blood pressure reduction, in patients with chronic heart failure. We suggest that the effect of angiotensin converting-enzyme inhibition on autoregulation of cerebral blood flow is mediated by a dilatation of larger cerebral arteries, which results from inhibition of the vascular tone normally maintained by locally produced angiotensin II. PMID- 3286047 TI - Angiotensin and the renal circulation in hypertension. AB - Converting-enzyme inhibition, whether teprotide, captopril, or enalapril is used, produces a larger increase in renal blood flow in patients with essential hypertension than in normal subjects when they are on a low-salt diet, a quantitative difference. When studies were performed in individuals on a high salt diet, normal subjects showed little or no response, whereas a substantial number of patients with essential hypertension displayed an increase in renal blood flow with these agents, a qualitative difference. The individuals that show this potentiated response we now are coming to recognize, have a number of features that suggest a distinct subgroup, the "nonmodulators." Normotensive offspring of hypertensive patients show a directionally similar but smaller renal vascular response to converting-enzyme inhibition. These hypertensive patients also show a blunted natriuresis in response to a sodium loading, which is corrected by converting-enzyme inhibition. Several lines of evidence suggest that the locus of action is intrarenal rather than systemic. Plasma renin activity and plasma angiotensin II concentration are not higher in these subjects, and thus cannot account for their potentiated response to converting-enzyme inhibition. Moreover, the infusion of captopril directly into the renal artery in doses far too low to induce a systemic effect increases renal blood flow specifically in these subjects. They also show a blunted rate of renin suppression after a sodium load, although plasma renin activity falls to the same low level at steady state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286048 TI - Bacterial interference with measurement of creatinine in stored plasma. PMID- 3286049 TI - Clinical diagnosis of mood disorders. AB - The history of syndrome-based diagnosis is reviewed. Recent criteria for the mood disorders according to the American Psychiatric Association are presented. Issues in the differential diagnosis of the mood disorders are discussed. Finally, commonly encountered pitfalls in clinical descriptive diagnosis and their potential remedies are summarized. PMID- 3286050 TI - Antidepressants in the medically ill: diagnosis and treatment in primary care. AB - Major depression is one of the most common clinical problems seen by primary-care physicians. The prevalence is 5% to 10% in primary-care outpatients and 15% in medically ill inpatients. Despite this high prevalence rate, depression is frequently not accurately diagnosed. Evidence suggests that misdiagnosis often occurs because patients with depression frequently focus preferentially on somatic complaints or amplify complaints of chronic medical illness. The tricyclic antidepressants are more effective than placebo, both in treating medically ill patients with depression and primary-care patients with major depression. Common side effects of the tricyclic antidepressants such as the anticholinergic, cardiac, and blood-pressure problems are reviewed, with emphasis on the use of specific tricyclics in medically ill populations. PMID- 3286051 TI - Antidepressants in the treatment of post-psychotic depression in schizophrenia: drug interactions and other considerations. AB - Adjunctive imipramine has been found to be useful in the treatment of a substantial number of patients with syndromally defined post-psychotic depressions. This paper examines the clinical effects of the combined anticholinergic activity of imipramine, when added to ongoing fluphenazine decanoate/benztropine treatment, in such patients. Little additional anticholinergic impact of the imipramine was observable beyond that already attributable to the benztropine, and no significant relationships were found between a clinical measure of peripheral anticholinergic activity and either global clinical outcome or antidepressive efficacy. This paper also reports on the concentrations of imipramine and its metabolites in plasma under the conditions of this therapeutic trial. The changes in relative concentrations of imipramine and metabolites with time were consistent with the concept that fluphenazine competes with tricyclic metabolism. The relationship of plasma imipramine and desipramine to clinical improvement in this group of secondary depressions did not parallel previously reported relationships of these antidepressant molecules to clinical outcome in primary depressions. PMID- 3286052 TI - Is there a practical alternative to therapeutic drug monitoring in therapy with tricyclic antidepressants? AB - Optimization of tricyclic antidepressant (TCA) therapy by dosage adjustments made in response to inappropriate concentrations in plasma or side effects can be extremely slow owing to the long half-lives of these drugs. I examine the practicality of alternative methods of arriving quickly and reliably at an adequate starting dosage. The clearance of a single test dose from plasma has been used to select individualized dosages before commencing therapy, but this takes several days and requires computer-assisted calculation of clearance. A simpler technique is to measure the concentration in a single timed plasma sample as an index of metabolism, and to infer the required dosage directly from a nomogram. Ideally, the nomograms should be interchangeable between patient populations and independent of the analytical method used, and the drug must have linear kinetics. Furthermore, TCAs are metabolized by common routes- demethylation and hydroxylation--so one might apply a single tolerance test for the entire class of drugs. Hydroxylation of TCAs can also be correlated with that of debrisoquine. The debrisoquine clearance test is non-invasive, faster, and analytically less demanding than TCA measurements. In the absence of rigid therapeutic ranges, tests that identify abnormally slow metabolizers may well be invaluable in preventing iatrogenic poisoning. Despite the usefulness of these methods in establishing effective initial dosages, their continued success depends upon good compliance, the maintenance of the patient's concurrent drug therapy, and a stable physical condition. In the non-ideal world, therefore, TDM cannot be dispensed with, but must be seen as an essential part of effective TCA treatment, based ultimately of course on sound clinical judgement. PMID- 3286053 TI - Measurement of antidepressants by liquid chromatography: a review of current methodology. AB - Antidepressant measurement by liquid chromatography (LC) has enhanced the therapy of patients who are being treated with some of the first generation tricyclic antidepressants; the merits of routinely monitoring the other antidepressants await further study. Currently, the role of LC is changing from dominant to complementary as a result of the recent availability of monoclonal antibody immunoassays with increased specificity. For successful application of LC, considerations would include designing the sampling protocol and matching assay that together are uniquely suitable for a particular laboratory. The assay should be simple, the sample preparation manual (liquid-liquid, solid-phase extraction columns), semi-automated, or automated. Normal- or reversed-phase columns with functionalities such as C-18, CN, C-8, and phenyl are used. Other useful LC variables include particle size, capping, ion-pairing, and recycling. This survey of LC methods includes the first and second generations, and new antidepressants such as alprazolam, amoxapine, bupropion, maprotiline, trazodone, and selected metabolites. Potential chromatographic interference by (e.g.) benzodiazepines and neuroleptics is addressed, followed by proposed guidelines for their resolution. Future developments are discussed. PMID- 3286054 TI - Cardiovascular effects of the standard tricyclic antidepressants. PMID- 3286055 TI - Reliability of antidepressant assays: a reference laboratory perspective on antidepressant monitoring. AB - Chromatography (gas and liquid) and immunoassays are used for monitoring the commonly prescribed tricyclic antidepressants. Many commercially available immunoassays are known to cross react with structurally similar compounds. Chromatographic methods make it possible simultaneously to resolve and quantify amitriptyline, nortriptyline, imipramine, desipramine, trimipramine, doxepin, desmethyldoxepin, protriptyline, and maprotiline-and potentially crossreactive compounds can be separated from the tricyclics. Immunoassays may have a valuable role in initial toxicological screening for the presence of a tricyclic-like compound, and they also may be helpful in a laboratory dedicated to a well controlled patient group. However, 10% of our specimens contain more or different antidepressants than we are requested to analyze for. With our analysis, we are able to report which antidepressants are present, and in what concentrations. Further, in the case of a potential overdose of tricyclic, the primary purpose for early toxicological analysis to anticipate subsequent clinical complications. Therefore, even in the case of toxicological analysis, it is important to know exactly what tricyclic antidepressant is present rather than just the semiquantitative presence of one or more structurally related compounds, because these various compounds differ markedly in their potential for adverse effects. There are too many potential, and possibly yet unknown, interactions for a reference laboratory routinely to rely on immunoassays for therapeutic drug monitoring or toxicological identification of antidepressants. PMID- 3286056 TI - Pharmacokinetic factors affecting antidepressant drug clearance and clinical effect: evaluation of doxepin and imipramine--new data and review. AB - The selection of a starting dose for an antidepressant, and subsequent clinical titration to an appropriate therapeutic dosage, should be based on pharmacokinetic and pharmacodynamic principles. In the past decade, therapeutic monitoring of antidepressant drugs and use of pharmacokinetic principles have been shown to be an improvement over the dose-response approach. Endogenous (e.g., genetic metabolic phenotype, hepatic blood flow, and protein binding) and exogenous factors (e.g., smoking, dietary habits, concurrent medications) are capable of influencing physiological and pharmacokinetic variables in patients, accounting for the marked interindividual differences in the clearance rates of cyclic antidepressants. Interpatient variability for steady-state concentrations in plasma (Cpss) greater than 20-fold are observed at a fixed dose of imipramine (r2 = 0.525, df = 346, t = 19.541, P less than 0.0001) or doxepin (r2 = 0.506, df = 128, t = 11.403, P less than 0.0001). Analysis of doxepin in plasma vs estimated in oral clearance for 61 patients demonstrates a significant decline in oral clearance as a function of Cpss. At doses approaching the upper range recommended for the treatment of depression, Cpss appear to approach, in at least a few individuals, the maximum metabolic capacity of the patient (Vmax), leading to greater-than-expected increases in concentrations for a given dosage increment. Significant alterations in oral clearance are observed when medications are administered concomitantly. A greater-than-threefold difference in mean oral doxepin clearance rates is observed between two groups of patients receiving additional medications that are either inducers or inhibitors (P less than 0.0001, df = 32, t = 6.687). Pharmacokinetic principles defining and explaining the determinants of oral clearance can provide the clinician with a greater insight into the reasons for therapeutic failure and toxicity. PMID- 3286057 TI - Compliance during tricyclic antidepressant therapy: pharmacokinetic and analytical issues. AB - Information on steady-state concentrations of parent tricyclic antidepressants (TCAs) and their major metabolites in plasma is useful in ascertaining compliance, for possible pharmacokinetic changes during longer treatment, and for prospective individualized dosing procedures. Adequate response can be maintained when there are relatively small fluctuations in drug concentration from visit to visit, but large fluctuations increase the liklihood of relapses during the acute treatment phase and recurrences afterwards. Changes in the individualized in dosage regimens complicate measurement of concentrations in plasma at steady state. Longitudinal examinations of concentration/dosage (L/D) values in our three-year imipramine (IMI) maintenance study reveal that patients having large intra-individual fluctuations can be classified as noncompliers, likely to have recurrences. The time course and magnitude of L/D values reflect higher accumulation of both components, IMI and desipramine (DMI), in plasma. Evidently, dose-dependent kinetics lead to higher steady-state concentrations in plasma than previously observed with similar dosages in shorter-term treatment. With amitriptyline (AMI), in a 12-month study, the mean total concentrations of both AMI and nortriptyline (NT) progressively increased, by 22% and 33%, respectively. The pharmacokinetic linearity of AMI and (or) NT, i.e., (L/D)high/(L/D)low, is maintained over much wider dosage and age range than with IMI or DMI. We advocate concurrent use of the L/D method and co-administration of riboflavin for identification of noncompliers. We describe our current experience with various analytical procedures in this regard, concluding that high-performance liquid chromatographic methods, with appropriate selection among ultraviolet, enhanced fluorescence, and electrochemical detectors for each TCA under specified therapeutic conditions, are most suitable and versatile, having superior analytical parameters. A suitable alternative procedure is gas-chromatography (N/P mode). Although immunoassays (EMIT, radiochemical) are most convenient for toxicological screens, their significant cross reactivities with several phenothiazines and the detection limits, requiring higher concentrations for EMIT, restrict their usage during research and (or) clinical monitoring. PMID- 3286058 TI - Immunonephelometric method evaluated for determining low concentrations of albumin in urine. PMID- 3286059 TI - Flow cytometry in the clinical laboratory. PMID- 3286060 TI - Stable isotope dilution analysis of succinylacetone using electron capture negative ion mass fragmentography: an accurate approach to the pre- and neonatal diagnosis of hereditary tyrosinemia type I. AB - A sensitive and accurate isotope dilution assay using electron capture negative ion mass fragmentography was developed for succinylacetone in amniotic fluid, plasma and urine. The method utilizes (D4)-5(3)-methyl-3(5)-isoxasole propionic acid as internal standard. Sample pretreatment consisted of oximation at pH less than 2 to 5(3)-methyl-3(5)-isoxasole propionic acid, clean up using liquid partition chromatography and further derivatization to the pentafluorobenzyl ester. Control values in plasma revealed a mean means = 0.044 mumol/l, range = 0.005-0.163 mumol/l, in urine means = 0.15 mumol/l, range 0.01-0.40 mumol/l corresponding to means = 0.03 mumol/mmol creat., range 0.01-0.14 mumol/mmol creat., and in amniotic fluid means = 0.016 mumol/l, range = 0.001-0.030 mumol/l. The utility of the method was demonstrated by quantification of succinylacetone in urine from patients with hereditary tyrosinemia type I (n = 8, excretion range 2.60-493.3 mumol/l corresponding to 0.67-197.3 mumol/mmol creat.) and in two amniotic fluid samples from fetuses affected with this disorder (concentration of succinylacetone 0.085 and 1.50 mumol/l, respectively). Maternal urine from a woman carrying an affected fetus did not show elevated urinary succinylacetone excretion. PMID- 3286061 TI - Microheterogeneity of paraproteins. I. Diagnostic value of isoelectric focusing followed by immunoblotting. AB - Isoelectric focusing (IEF) in thin-layer polyacrylamide gels followed by immunoblotting on nitrocellulose membranes is presently the most sensitive method in the routine detection of IgG paraproteins. With this technique, immunoglobulin class and light chain composition can be as reliably identified as in immunoelectrophoresis. The problem of firm adherence between IEF polyacrylamide gels and nitrocellulose membranes can be overcome by brief incubation in sodium dodecyl sulfate. After isoelectric focusing, IgG paraproteins display a characteristic pattern of limited electrophoretic heterogeneity. This pattern is easily recognized even in the few cases with a constant tendency to aggregate under IEF conditions and in the surprisingly high percentage of paraproteins with very alkaline isoelectric points in which it is altered due to a cathodal collection effect. It is independent of the total amount of IgG in serum and remains stable intraindividually over extended observation periods. On the other hand, there is a very high degree of interindividual variability while common paraprotein characteristics still remain recognizable. PMID- 3286062 TI - Effect of insulin treatment on fatty acids of plasma and erythrocyte membrane lipids in type 2 diabetes. AB - Serum lipoproteins and fatty acid compositions of serum and erythrocyte membrane lipids were analyzed from sixteen Type 2 diabetic subjects with secondary drug failure before and after four weeks' insulin therapy. The insulin treatment clearly improved diabetic control (p less than 0.01), decreased serum total cholesterol (-14%, p less than 0.01), triglycerides (-50%, p less than 0.001), plasma free fatty acids (-28%, p less than 0.01), and especially serum VLDL triglyceride levels (-62%, p less than 0.001) and resulted in a significant weight gain of patients (1.4 kg, p less than 0.05). Of the individual plasma fatty acids saturated (-32%) and monoenoic (-36%) fatty acids fell more than the polyunsaturated fatty acids of exogenous origin, eg linoleic acid (-11%), other n 6 polyunsaturated fatty acids (PUFA) (-11%), and n-3 PUFA (-13%) suggesting that the decrease in serum VLDL-triglycerides is mainly associated with the suppression of endogenous fatty acids. Before the insulin treatment but less strongly during it, the contents of linoleic acid were positively and those of dihomogammalinolenic acid, arachidonic acid, and arachidonic acid/linoleic acid ratios of plasma and erythrocyte membrane lipids inversely correlated with glycosylated HbA1 levels, suggesting that the conversion of linoleic acid to prostanoid precursor fatty acids is affected by the poor glycemic control in Type 2 diabetic patients. PMID- 3286063 TI - Application of heparin-conjugated Sepharose for the measurement of cobalamin saturated and unsaturated transcobalamin II. AB - The cobalamin-binding plasma protein transcobalamin II has a high affinity for the anticoagulant heparin. This phenomenon has been exploited in a new method for the quantification of cobalamin-saturated (holo-) and unsaturated (apo-) transcobalamin II in human plasma. Transcobalamin II is adsorbed from human plasma to heparin-conjugated Sepharose under suitable conditions and either cobalamin from adsorbed holo-transcobalamin II is measured by a radioisotope dilution assay or apo-transcobalamin II is determined by measuring the adsorbed unsaturated cobalamin-binding capacity with radioactive cobalamin. The assay results for apo- and holo-transcobalamin II are similar (r = 0.99 and 1.0, respectively) to those obtained with the established radioimmunosorbent assay using specific rabbit anti-human transcobalamin II-conjugated Sepharose. The assay cannot be carried out in heparin-anticoagulated plasma, because the free heparin competes with the immobilized heparin for the binding of transcobalamin II. The amount of heparin in plasma from patients being treated with subcutaneous or intravenous heparin is too low to interfere significantly with the measurement of transcobalamin II. Also the presence of circulating anti-transcobalamin II antibodies, as occur in some rare patients after frequent intramuscular injections of cobalamin, does not influence the assay. PMID- 3286064 TI - Growth hormone (GH) secretion during nocturnal sleep and after clonidine in patients with essential hypertension. AB - In order to estimate the neuroendocrine function of the central nervous system eventually leading to growth hormone (GH) secretion in essential hypertension, 17 patients with mild arterial hypertension (7 obese and 10 with normal body weight) were examined. The control group consisted of 16 normotensive volunteers (7 obese and 9 with normal body weight). The GH secretion was determined by radioimmunoassay during nocturnal sleep. In all the subjects, the serum GH was also measured after placebo and after the centrally acting alpha 2-adrenergic agonist-clonidine administered i.v. in a dose of 0.15 mg. The fasting serum insulin concentration was also measured in all the subjects. Clonidine decreased the mean arterial pressure in all the subjects investigated. However, in response to clonidine an increase in GH secretion in all hypertensive and normotensive cases with normal body weight was demonstrated, whereas in all obese hypertensive and normotensive patients no significant GH rise was found. It indicates that inhibition of GH secretion in patients with essential hypertension is related to coexistent obesity rather than with that of arterial hypertension. A strong (r = 0.76) and significant (p less than 0.0005) correlation demonstrated between the maximal GH concentration during the nocturnal sleep and after clonidine suggests that the mechanism of GH inhibition in response to both these stimuli is similar and it probably is related to the inhibition of neurohormonal secretion of the growth hormone releasing factor (GRF). However, the negative correlation between the fasting insulin concentration and GH response to clonidine shown in obese subjects only, points to a more complex mechanism of GH inhibition in obesity. PMID- 3286065 TI - Effect of calcium blocking agent verapamil on blood pressure, ventricular contractility, parathyroid hormone, calcium and phosphorus in plasma, catecholamines, corticosterone and plasma renin activity in spontaneously hypertensive rats. AB - In four-month-old spontaneously hypertensive rats (SHR) the effect of a calcium blocking agent verapamil on blood pressure, ventricular contractility indices, parathyroid hormone (PTH), plasma renin activity (PRA), plasma and adrenal corticosterone content and catecholamines in hypothalamus, myocardium and adrenal gland was evaluated. Calcium and phosphorus in plasma were also determined. Verapamil treatment resulted in a significant decrease in systolic and diastolic blood pressure and a reduction in maximum left ventricular pressure. Verapamil exerted a negative inotropic effect, evaluated by a decrease in dP/dt max and dP/dt neg. PRA was elevated, calcium tended to decrease, and no changes in PTH and phosphorus were found. The hypotensive effect of verapamil in SHR was accompanied by a decrease in plasma and adrenal corticosterone content, and a fall in catecholamine concentration in adrenal glands and myocardium. PMID- 3286066 TI - Cosegregation analysis of salt appetite and blood pressure in genetically hypertensive and normotensive rats. AB - Enhanced sodium appetite is a robust behavioral characteristic of spontaneously hypertensive rats (SHR) which neither causes nor depends upon elevated blood pressure. However, the possibility remains that salt appetite and blood pressure are related by some unidentified common factor. The present study investigated the possible genetic co-determination of blood pressure and salt appetite in this animal model of hypertension. Blood pressure of SHR, Wistar/Kyoto (WKY), and their F1 and F2 populations was measured prior to salt appetite testing by the tail cuff method. Sodium intake in these groups was measured daily for 5 days as the ad lib consumption of a 1.5% NaCl solution by subjects maintained on sodium deficient chow and demineralized water. Dynamic and stable components of salt appetite were identified in the parent strains and analyzed in the hybrid offspring. The expected differences in blood pressure between SHR and WKY were observed, and the average blood pressure of the F1 and F2 groups fell roughly midway between SHR and WKY values. The SHR consumed substantially greater quantities of saline than WKY, but the F1 population consumed saline at a rate that was not different from WKY, rather than intermediate between SHR and WKY. There was no relationship in the F2 population between blood pressure and any measure of salt appetite. Thus, the high salt appetite and high blood pressure traits of SHR do not appear to share a common genetic basis. These results, considered with previously published work, suggest that approach and avoidance aspects of salt appetite may be separately inherited and also strongly suggest that neither is linked to hypertension. PMID- 3286067 TI - Renin gene expression in rat tissues: a new quantitative assay method for rat renin mRNA using synthetic cRNA. AB - A genomic renin exon 9 fragment was subcloned into vector pSPT18 and used for in vitro transcription to obtain 32P-labeled rat renin cRNA. Using this cRNA, we established quantitative solution hybridization and specific Northern blotting assays for renin mRNA. We were able to detect renin mRNA in the kidney, heart ventricle and atrium, brain, testis, and adrenal gland of male rats in the concentrations of 430 +/- 8.1, 110 +/- 1.9, 43 +/- 0.9, 64 +/- 1.1, 47 +/- 0.9 and 11 +/- 0.2 pg mRNA/mg of total RNA, respectively. PMID- 3286068 TI - Oral tranexamic acid in the management of epistaxis. AB - This study evaluated oral tranexamic acid as an adjunct in controlling epistaxis and preventing or reducing recurrent epistaxis. Patients entered into the trial were randomized in double blind fashion to placebo or tranexamic acid 1 g, 3 times daily. Treatment continued for 10 days. The patients were reviewed daily and any rebleeds categorized into minor, moderate or severe according to length and briskness of bleed and subsequent treatment. Of the 89 patients who completed the course of tablets, 25 (57%) in the placebo group and 21 (47%) in the treatment group had a rebleed. More patients in the placebo group had minor and moderate rebleeds, but the same number of patients in the placebo and treatment groups had severe rebleeds; this difference was not statistically significant. Oral tranexamic acid is, therefore, of no proven value as an adjunct in the treatment of epistaxis in patients requiring hospital admission. PMID- 3286069 TI - Vocal cord nodules: a review. AB - Vocal cord nodules have a variety of synonyms in the literature, including laryngeal nodules, laryngeal nodes, corditis nodosa, singers' nodes, teachers' nodules, screamers' nodes, parsons' nodes, and nodular laryngitis. All of these refer essentially to the same condition. In 1954 referring to vocal cord nodules, Brodnitz and Froeschels wrote that, 'Ever since Tuerck first described the condition in 1868, discussion of the aetiology, the histological nature, and the therapy still has not ceased'. This statement still applies today. PMID- 3286070 TI - Screening for lymph nodes in the neck with ultrasound. AB - In a study of the value of ultrasound in staging patients with head and neck malignancies, we performed ultrasound of the neck. The results of this investigation were compared with palpation. A fine needle aspiration biopsy and/or histologic examination was carried out on lymph nodes which were found. One hundred and six patients were included in this study. In 44 of the patients no lymph nodes could be detected, either on palpation or by ultrasound examination. In the other 62 patients all palpable lymph nodes were also demonstrated by ultrasound. However, in 20 patients with negative palpatory findings, ultrasound revealed lymph nodes: 11 metastases and 9 benign nodes. In 40 patients an ultrasound guided fine needle aspiration biopsy (UGFNAB) was performed. In 85% of these patients a cytological diagnosis could be made. From these results we conclude that ultrasound and UGFNAB are of considerable value in staging head and neck malignancies. PMID- 3286071 TI - Autoantibodies: terms and concepts. PMID- 3286072 TI - Diaphragmatic paralysis due to partial diaphragmatic hypoplasia mimicking a localized muscular dystrophy: a case report. AB - A case of congenital diaphragmatic paralysis is reported in an infant who died because of respiratory failure at the age of 5 weeks. The histologic findings show a dystrophy-like muscle pathology restricted to the diaphragm with a normal somatic peripheral musculature and normal phrenic nervous structures. The previous death of a male sibling because of diaphragmatic eventration suggests that this case of diaphragmatic paralysis could have been a consequence of a partial and random hypoplasia of muscle fibers, mimicking an isolated muscle dystrophy of the diaphragm. PMID- 3286073 TI - Fate of bone grafts in acetabular roof reconstructions assessed by roentgenography and scintigraphy. AB - Autogeneic bone grafts--26 femoral heads, four femoral and two iliac bone grafts- were used in 32 total hip arthroplasties, mainly on patients with complete dislocation of the hip, to reconstruct deficiencies of the acetabular roof by a standardized procedure. At the follow-up examination after 24 to 101 months (median, 52 months), roentgenography demonstrated lateral resorption of the graft in 20 of 32 hips, but resorption involved bone support of the socket in only three of the hips. Analysis of serial roentgenograms showed that resorption was not a function of time. Complete incorporation of the grafts was observed in 27 hips; partial incorporation was shown in three. Roentgenographically, two grafts were not incorporated. None of three grafts of a cortical nature was incorporated. Graft uptake of radioactive tracer was found by 99mTc-diphosphonate emission scintigraphy in 16 of 21 hips, but did not correlate with progressive bone resorption, nonunion, or loss of bone structure. High quality serial roentgenograms showing good bone detail provided the best information about the integrity of the acetabular roof reconstructions. PMID- 3286074 TI - The patellofemoral component of total knee arthroplasty. AB - Patellofemoral complications continue to form a large proportion (up to 50%) of total knee arthroplasty (TKA) complications. If adequate attention is paid intraoperatively to patellar tracking and component position, the incidence of subluxation, component loosening, and fracture should decrease. When treating patellar subluxation and dislocation, tibial tubercle transfer should be avoided because there is an unacceptably high incidence of complications. Care should be taken to treat the underlying cause of dislocation with either a soft tissue procedure or component revision. Fracture of the patella may be treated nonoperatively in 50% and 80% of patients. Cysts, if large, may be bone-grafted to avoid the potential complications of stress fracture and component loosening. Loosening of the patellar component is likely to be symptomatic and to require surgery in up to 75% of cases. A displaced patellar component may cause attritional wear of the quadriceps tendon or patellar ligament. All rheumatoid patellae should be resurfaced. The present trend in the osteoarthritic patella is toward resurfacing more often. With improved implant design and a predicted decrease in complications, resurfacing in the osteoarthritic patella may become routine. Osteoarthritic patellae that maintain good cartilage, normal anatomic shape, and congruent tracking need not be resurfaced. PMID- 3286075 TI - Group B beta-hemolytic streptococcal osteomyelitis of the heel. A case report. AB - Staphylococcus aureus is the most frequently reported, though not the only, causative organism in children who have osteomyelitis. In an 11-year-old child with osteomyelitis of the calcaneus, the etiologic agent was identified as a Group B beta-hemolytic streptococcal organism. This organism seems not to have been previously reported as the cause of osteomyelitis in the heel. PMID- 3286077 TI - Five cases of dislocation of the hip. By Lewis A. Stimson, 1889. PMID- 3286076 TI - Cellular biology and biochemical mechanism of bone resorption. A review of recent developments on the formation, activation, and mode of action of osteoclasts. AB - The newest knowledge on the osteoclast allows us to consider bone resorption in a global perspective, as the resultant of three successive steps that may each be individually regulated by physiopathologic or pharmacologic agents. The first involves the formation of osteoclast progenitors in hematopoietic tissues followed by their vascular dissemination and the generation of resting preosteoclasts and osteoclasts in bone. The second consists in the activation of osteoclasts at the contact of mineralized bone. Osteoblasts appear to control this step by exposing the mineral to osteoclasts and preosteoclasts and/or by releasing a soluble factor that activates these cells. In a third step, activated osteoclasts resorb both the mineral and the organic of mineralized bone through the action of agents that they secrete in the segregated zone underlying their ruffled border. The mineral appears to be solubilized by hydrogen ions secreted by an ATP-driven proton pump located at that border and fed by protons generated from CO2 by carbonic anhydrase. The removal of organic matrix, which could be prepared by osteoblast collagenase at the level of nonmineralized bone surfaces, appears dependent on acid proteinases, particularly cysteine-proteinases, secreted, together with other lysosomal enzymes, in the acid microenvironment of the resorption zone. PMID- 3286078 TI - Osteonecrosis of the femoral head. Pathogenesis and long-term results of treatment. AB - Except after trauma resulting in an intracapsular fracture of the femoral neck or dislocation of the hip, the causes of pathogenesis in osteonecrosis of the femoral head have yet to emerge. The circulation to the femoral head may be impaired severely following a traumatic episode. Staging of the pathologic process is important as the selection of the appropriate surgical treatment depends upon the stage at the time of diagnosis. Anteroposterior and lateral roentgenograms are sufficiently accurate to make the diagnosis in Stages II to V. Tomography or Magnetic Resonance Imaging (MRI) are prescribed when roentgenograms are consistent with Stage II disease. This recommendation is made because subtle changes may be present that are not apparent on the roentgenogram, such as fracture of the surface or beginning segmental collapse. These changes would change the classification to Stage III rather than Stage II. MRI or core biopsy is required for diagnosis in Stage I. Many surgical treatment options have been proposed for the treatment of osteonecrosis of the femoral head. No one operation has been shown to be superior. Most papers do not have sufficient long-term follow-up evaluation or a significantly large number of cases to allow one to draw firm conclusions about the efficacy of the operation. Total hip replacement or hip arthrodesis is the treatment of choice for the end stages of the disease when the hip joint has degenerated. PMID- 3286079 TI - False aneurysm of the common femoral artery secondary to migration of a threaded acetabular component. A case report and review of the literature. AB - A 66-year-old woman with severe rheumatoid arthritis had revision of a protrusio acetabuli component with a threaded socket. Subsequent anteromedial migration of the socket and thread laceration of the common femoral artery resulted in a pseudoaneurysm and massive pelvic erosion seven months later. Vascular reconstruction and excisional arthroplasty were necessary. Later, gracilis and gluteal muscle flaps were swung to fill the resultant pelvic cavity. The hip was nonreconstructable. Ten months later the wound healed and the patient was ambulating in a walker. This represents a previously unreported cause of vascular injury complicating total hip arthroplasty (THA). A comprehensive review of the English and European literature illustrates the various mechanisms of vascular trauma in this setting and provides a rational basis for prevention. PMID- 3286080 TI - Comparison of magnetic resonance imaging and radionuclide imaging in the evaluation of renal transplant failure. AB - Magnetic resonance imaging (MRI) was compared with radionuclide scintigraphy (RNS) in 16 patients with renal transplants undergoing renal failure to determine which modality could best discriminate between rejection, acute tubular necrosis (ATN), and cyclosporin nephrotoxicity (CN). Although all rejecting transplants had reduced corticomedullary differentiation (CMD) on T1-weighted MR images, four of five cases of ATN had appearances that could not be distinguished from rejection. A normal CMD suggests nonrejection, but diminished CMD is nonspecific. Tc-99m DTPA/I-131 hippuran RNS was superior to MRI in differentiating rejection from ATN. Although ATN and CN have similar RNS patterns, this distinction can usually be made based on the clinical time course. Other potential uses of MRI in the evaluation of the renal transplants are discussed. PMID- 3286081 TI - Polycystic kidneys incidentally visualized during renal transplant imaging. PMID- 3286082 TI - Clinical pharmacokinetics of urapidil. AB - Urapidil is a selective alpha 1-adrenoceptor antagonist with central antihypertensive action which is increasingly used in the treatment of hypertension. Urapidil is readily absorbed, is subject to moderate first-pass metabolism and is eliminated primarily as metabolites of much lower antihypertensive activity than the parent drug. The influences of age, renal and hepatic disease on the disposition of urapidil are reviewed. Studies on the relationship between pharmacodynamics and pharmacokinetics show that the optimum use of urapidil in clinical practice depends on an understanding of the pharmacokinetic properties of the drug. PMID- 3286083 TI - Clinical pharmacokinetics of aztreonam. AB - Aztreonam (azthreonam) is practically completely absorbed after intramuscular injection. After intravenous injection plasma concentrations follow a 2 compartment open model, with a t1/2 alpha of 0.20 hours. Volume of distribution at steady-state (Vdss) after intravenous or intramuscular injection is about 0.16 L/kg (0.42 L/kg for the free drug). After oral administration less than 1% of the drug is absorbed. Over a large dosage range plasma concentrations increase linearly with dose. No accumulation occurs after multiple dosing. Plasma binding in healthy subjects is about 56% and is not concentration dependent. Diffusion into tissues is generally slow, and the ratio between mean tissue and plasma concentration seems to depend mainly on the composition of the tissue. In inflamed meninges, penetration of aztreonam into CSF is more rapid than with uninflamed meninges. Diffusion through the placenta is poor, as is diffusion into breast milk. The main route of elimination of aztreonam is by the kidney, partly by active tubular excretion, but this can be inhibited by probenecid. Extrarenal clearance is probably due to excretion by the liver. Metabolism occurs to a very limited extent. Total plasma clearance in healthy adults is about 140 ml/min (8.4 L/h) or 2 ml/min/kg (0.12 L/h/kg), and terminal half-life is 1.7 hours. In children clearance is similar to that in adults when expressed as a function of bodyweight, but in neonates, especially in low birthweight infants, it is less [about 1 ml/min/kg (0.06 L/h/kg)]. In various disease states the Vdss of aztreonam is not appreciably different from that found in healthy individuals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286085 TI - Non-invasive diagnosis of pyomyositis. AB - Two children, aged 6 and 8 years, were admitted to the hospital because of fever, pain, and tenderness over the muscular masses of the thigh and calf, respectively. The presumptive diagnosis of pyomyositis was confirmed by ultrasound studies. Antibiotic treatment was administered in both cases while one child also required surgical drainage of the muscular suppuration. Complete recovery was achieved in both cases. Performance of ultrasound studies is indicated whenever pyomyositis is suspected. PMID- 3286086 TI - Incidence, morbidity and mortality, and diagnosis of twin gestations. AB - Twin gestations have higher morbidity and mortality than singleton pregnancies. This is related to the teratogenic event of twinning itself, as well as to physiologic changes associated with twinning. Early diagnosis, careful monitoring, and knowledge of potential problems may help the alert obstetrician to improve outcome. PMID- 3286087 TI - Anesthesia for twin delivery. AB - The patient presenting for delivery with multiple gestation often produces extreme anxiety for those involved with her care. From the standpoint of anesthesia service, knowledge of what to expect, and better, the knowledge of what to do if and when the various potential problems present is paramount. With close communication and cooperation with the obstetrician and patient, a satisfactory anesthetic and obstetric outcome is achievable. Lumbar epidural anesthesia is highly recommended for pain management when labor and vaginal delivery is anticipated. However, the knowledgeable obstetrician and the knowledgeable anesthesiologist must be present and prepared for all circumstances. PMID- 3286084 TI - The significance of plasma protein binding on the fetal/maternal distribution of drugs at steady-state. AB - Maternal and fetal plasma differ in their concentrations of the important drug binding plasma proteins, albumin and alpha 1-acid glycoprotein, with albumin being slightly more concentrated in fetal plasma, and alpha 1-acid glycoprotein being only 37% of the maternal concentration at term. In general, these differences relate linearly to the bound to free concentration ratio of drugs associated with these proteins. Although only the free concentration is generally considered to be the pharmacologically active form, these differences can dramatically affect the total concentration and relative distribution of drugs between maternal and fetal plasma. In order to test our hypothesis that plasma protein binding is the major determinant of fetal/maternal drug distribution at steady-state, we examined whether fetal binding could be predicted from adult binding information. Data from studies of maternal plasma protein binding were used to predict fetal plasma protein binding based solely on the differences in protein concentrations. These predictions were compared with observed fetal binding data. This analysis showed a slope near unity and a high correlation (r2 = 0.900) which implies that there are no significant differences between the binding affinities of these proteins. A similar analysis performed using data on drug binding in non-pregnant adults gave an r2 or 0.971. Having established that fetal plasma proteins bind drugs similarly to their maternal counterparts, fetal/maternal plasma drug concentration ratios (F/M) were predicted for various drugs using information from literature on the drug's adult plasma protein binding, the protein to which it binds, and the fetal and maternal plasma concentrations of that binding protein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286088 TI - Morbidity and mortality factors in twins. An epidemiologic approach. AB - Some epidemiologic characteristics of twin pregnancies and twin infants have been reviewed. We found that twins are prone to be born prematurely and have lower birth weights than their singleton counterparts after 30 to 34 weeks of gestation. Twins are also more prone to birth asphyxia, hyaline membrane disease, respiratory disorders, and seizures. Congenital anomalies and nonrespiratory morbidity were not found to be increased in twins. Twins have a six times higher perinatal mortality rate than do singletons. This is accounted for by prematurity in the main. A part of the excess mortality in twins is accounted for by a higher mortality in larger, near-term twins. Efforts should be directed toward decreasing the incidence of prematurity in twins and understanding and managing the problems of near-term twins better. PMID- 3286089 TI - Placental considerations in multiple pregnancy. AB - This article contains a brief description of the placenta in multiple pregnancy, including a classification based on embryogenesis. The biologic and clinical importance of recognition of the different types of twin placentas is emphasized. Finally, a classification of the pathological lesions seen in these placentas, either because of the twinning process or simply associated with it, is proposed. PMID- 3286090 TI - Neonatal problems in twins. AB - Twins have higher rates of perinatal mortality, prematurity and its complications, low birth weight, intrauterine growth retardation, congenital anomalies, and long-term developmental morbidity. Monozygotic twins have lower birth weights and higher rates of congenital anomalies than dizygotic twins, which suggests that the etiology of these problems may be related to the monozygotic twinning process. Monochorionic twins have higher rates of perinatal mortality, intrapair birth weight discrepancies, and intrauterine growth retardation than dichorionic twins, which suggests that these complications may be related to placental vascular anastomoses. Monochorial vascular communications also can be responsible for twin transfusion syndrome, disseminated intravascular coagulation at birth and disruptive structural defects. Followup studies indicate that twins remain at a disadvantage for subsequent physical growth and intellectual achievement. The management of twins is challenging and fascinating because of the wide range of perinatal, neonatal, developmental, and parenting problems that can occur. PMID- 3286092 TI - Multiple pregnancy: antepartum management. AB - The critical aspects of twin pregnancy begin with early diagnosis. After that, diet, bed rest, and frequent visits to the physician's office will enhance fetal outcome. Additionally, frequent ultrasound evaluations to assess fetal growth and fetal surveillance are also invaluable adjuncts. Prompt treatment of any medical or obstetrical complications will contribute to an overall improvement in maternal and fetal outcome. PMID- 3286091 TI - Effects of twins: maternal, fetal, and labor. AB - During pregnancy, many physical changes, physiological alterations, and biochemical values have been well established. Twins bring differences to many of these normal pregnancy observations. The mother has exaggerations of normal pregnancy changes. The twin fetuses often respond differently from singletons, and labor in twins presents its own unique problems. This article examines many of the adaptations in a twin pregnancy, assuming knowledge of the normal pregnancy. PMID- 3286093 TI - Antepartum complications in twin pregnancies. AB - Women with twin pregnancies have some unique problems and some that occur more frequently than those seen in singleton pregnancies. Examples of the former are the vanishing twin and death of one fetus. Examples of the latter are congenital anomalies, hydramnios, hypertension, and anemia. Prenatal care must be altered because of these complications, and perinatal morbidity and mortality are increased. PMID- 3286094 TI - Twin pregnancy. The management of labor. AB - Management of twin labors is more challenging than that of labors of single pregnancies. Fetal monitoring can be technically more difficult, and more dysfunctional labor will be experienced, requiring more judicious use of oxytocin. Attention to all these details is reviewed in this article. PMID- 3286095 TI - Twin pregnancy. Management of delivery. AB - Management of the twin delivery remains controversial, particularly when the second twin in nonvertex and has an estimated fetal weight of 600 to 1500 gm. Management of schemes based on fetal presentation and estimated weights, as well as specific techniques and options for intrapartum care, are discussed. PMID- 3286096 TI - Catecholamine-containing grafts in parkinsonism: past and present. PMID- 3286097 TI - Transplantation strategies using embryonic astroglial cells to promote CNS axon regeneration in neonatal and adult mammals. PMID- 3286098 TI - Legal regulation of fetal tissue transplantation. PMID- 3286099 TI - Renal haemodynamics, sodium balance and the capacitance system in essential hypertension. PMID- 3286100 TI - Dwarfism. PMID- 3286101 TI - Legionella pneumonia treated with imipenem. PMID- 3286102 TI - Time series analysis of rhythmic bacterial resistance development to antibiotics. AB - The sensitivity data of Staphylococcus aureus and Escherichia coli to a large set of antibiotics have undergone time series procedures of analysis in order to highlight possibly periodical behavior in time. These oscillational patterns have been characterized through the use of FFT and cross-correlational and variance analysis and were proved to be species-specific and drug-independent. S. aureus was shown to have a large period of oscillation (40 months) when compared to E. coli (from 7 to 11 months). A perfect species distinction was only possible through cross correlation. These results may reflect the influence of the local environment, since this finding was not referred to in the literature. PMID- 3286103 TI - An expert system on the diagnosis of ascites. AB - We constructed an expert system on the diagnosis of ascites, using a combination of case reports and unpublished patient data. Rule production was by induction from examples, and the program operated on an algorithm which was a modification of Quinlan's ID3. The result was a small, but formally complete expert system. When tested against a new data set of patients, our expert system predicted the clinical diagnosis 82% of the time. PMID- 3286104 TI - An efficient method for smoothing indicator-dilution and other unimodal curves. AB - A mathematical function has been developed for approximating unimodal functions, particularly those which are non-Gaussian, skewed, and incomplete. It is useful as an alternative to cubic splines in smoothing noisy experimental data. Particular applications are to indicator-dilution curves and probability density functions of varied form. In its Fortran implementation, SMOEX, it is computationally inexpensive compared to standard cubic spline smoothing routines and requires less storage to preserve the smoothed function for retrieval or interpolation. PMID- 3286105 TI - [On the "Notes on Nursing" by Florence Nightingale (11)]. PMID- 3286106 TI - [The world of Hildegard von Bingen (1). Her life and historical background]. PMID- 3286107 TI - [Witches, midwives, and nurses: a history of women healers]. PMID- 3286108 TI - Behavior therapy for the treatment of obsessive-compulsive disorder: theory and practice. PMID- 3286109 TI - Anorexia and bulimia nervosa in married patients: a review. PMID- 3286110 TI - Mandatory assignment: stealing time and quality. PMID- 3286111 TI - Pap smears and fee schedules. PMID- 3286113 TI - A review of experimental approaches to the analysis of emotional behaviour and their relation to stress in farm animals. AB - The aims of the present paper are firstly to review the methods and techniques that have been developed to analyse and quantify the variables that can produce psychological distress; and, using an integrated approach, with examples where possible, to consider the significance of the information available relating to the keeping of domestic animals under present husbandry conditions. Secondly, suggestions for future research relevant to evaluating and improving farm animal welfare are discussed. PMID- 3286112 TI - Clinical experience with gossypol in non-Chinese men: a follow-up. AB - Gossypol monoacetic acid was administered to 12 Brazilian volunteers. The initial dose was 20 mg daily for 4 months. The dose was then reduced to 60 mg weekly (20 mg three times weekly). A significant reduction in sperm motility was detected in all subjects. An increase in the number of immature cells in the ejaculate was also detected in all subjects. Severe oligospermia or azoospermia developed in all subjects at the end of the loading phase. Two years following discontinuation, 3 men were still azoospermic. Only 1 man who was azoospermic 2 years after discontinuation had a late (3 years) recovery. Two of the 3 men who were subjected to high spermatic vein ligation because of varicocele remained azoospermic 2 years after the operation. The third patient, who did not have the operation, also remained azoospermic. Of the 9 patients who recovered, 3 had fathered children during the last 2 years. PMID- 3286114 TI - Computer graphics in medicine: a survey. AB - Increased interest is presently given to three-dimensional (3-D) medical applications due to simultaneous emergence of high-resolution imaging systems and computer graphics techniques. This paper intends to present a survey of this field together with discussion and prospective views. The general framework is composed of six parts: data acquisition and preprocessing, polygonal object representation, voxel description, system architecture, medical applications, and prospects. Data base acquisition includes characterization of imaging modalities and medical specificity. Preprocessing schemes are directed to improvements (filtering), windowing, and spatial anisotropy (linear or spline interpolation). The two following sections are devoted to descriptions of the main object representations. Particular emphasis is given to optimal contour approximation, surface triangulation, mathematical surfaces on one hand, and cuberille and voxel representations on the other. Display capabilities--hidden surface removal, surface normal shading, structure enhancement--and data base structuration- hierarchical and nonhierarchical (graph and tree encoding)--are, respectively, described. An overview of 3-D systems is further given (Section V), and features of medical applications are reviewed and gathered in basic functionalities, surgery, and radiotherapy specifications (Section VI). The last section provides some prospective views on reconstruction from a few projections, model-guided labeling, multimodality image overlay, and local image network. Some of these issues are illustrated by examples of 3-D images. PMID- 3286115 TI - Vibrations in orthopedics. AB - Measurements of various mechanical properties of skeletal material using vibration techniques have been reported. The purposes of such investigations include the monitoring of pathogenic disorders such as osteoporosis, the rate and extent of fracture healing, and the status of internal fixations. Early investigations pioneered the application of conventional vibration measurement equipment to biological systems. The more recent advent of the microcomputer has made available to research groups more sophisticated techniques for data acquisition and analysis. The economical advantages of such equipment has led to the development of portable research instrumentation which lends itself to use in a clinical environment. This review article reports on the developments and progression of the various vibrational techniques and theories as applied to musculoskeletal systems. PMID- 3286116 TI - Human fibrinogen. AB - The structure and physical properties of human fibrinogen and fibrin are reviewed along with methods for the detection of products of their metabolism. Interactions of human fibrinogen with thrombin, factor XIII, plasminogen, glycoprotein IIb/IIIa, and other proteins are related to their relevance to thrombosis and hemostasis. To the extent information is available, the structural determinants of these interactions are delineated, and kinetic and thermodynamic parameters associated with the interactions are listed. Individual steps in the reaction pathway for the conversion of fibrinogen to cross-linked fibrin are characterized. The altered hemostatic properties of mutational variants of fibrinogen are related to their altered structure. The structures of the genes coding for the polypeptide chains of fibrinogen are discussed along with the current state of knowledge of the control and regulation of fibrinogen synthesis. Fibrinogen catabolism and fibrinolysis are also reviewed. PMID- 3286117 TI - Autoimmune thyroid disease: immunological, pathological, and clinical aspects. AB - Autoimmune thyroiditis, most notably Hashimoto's thyroiditis, appears to be increasing in prevalence and is now more easily detected by sensitive laboratory tests and more invasive procedures such as fine needle aspiration. During the last decade, marked progress has been made in the understanding of these diseases. There is a greater awareness of the interaction between the humoral and cell-mediated arms of the immune system in autoimmune thyroiditis. Recent studies implicate a subpopulation of suppressor T lymphocytes which have an antigen specific defect, resulting in their suboptimal interaction with the helper T lymphocytes and subsequent autoimmune manifestations. There is some evidence that thyroid epithelial cells which inappropriately express HLA-DR may enhance presentation of thyroid antigens to the immune system, possibly significant in the initiation or enhancement of the autoimmune response. The presence of various antithyroid autoantibodies allows the use of laboratory assays to confirm the clinical diagnosis and predict the results of treatment. There appears to be predisposing genetic factors in the development of autoimmune thyroiditis, with some geographical and racial differences. Environmental factors, most notably dietary intake of iodine, have also been implicated in the pathogenesis of Hashimoto's thyroiditis. Several animal models have been developed addressing such issues. Ongoing studies in the areas of postpartum thyroiditis and childhood thyroiditis are helpful in clarifying their relationship with Hashimoto's thyroiditis. Graves' disease and postpartum thyroiditis are being investigated as possible causes of postpartum depression. The association of Hashimoto's thyroiditis and carcinoma of the thyroid gland is still controversial, but its relationship with malignant lymphoma is now well accepted. Thus, although the pathogenesis of autoimmune thyroiditis remains elusive, there has been significant refinement of the clinical diagnosis, and immunological abnormalities of specific intrathyroidal lymphocytes have been identified. Hopefully, these new areas of knowledge will assist in the treatment of these diseases and in the prevention of the development of malignant lymphomas of the thyroid gland. PMID- 3286118 TI - Plasma endotoxin concentration in healthy primates and during E. coli-induced shock. AB - The normal range for circulating plasma endotoxin concentration was determined in 62 healthy primates (vervet monkeys, Cerecopithecus aethiops) by the chromogenic substrate modification of the Limulus amoebocyte lysate test, and found to have a mean of 0.076 +/- 0.004 ng/ml (range 0.000 to 0.0127). Four anesthetized primates received an LD100 iv infusion of Escherichia coli over one hour. Plasma concentrations of endotoxin (lipopolysaccharide, LPS) and anti-LPS IgG, and viable E. coli colonies in circulating whole blood samples were determined at specified intervals. Plasma antiendotoxin IgG concentration was determined by an enzyme-linked immuno-absorbent assay, and viable bacterial counts were assayed by standard plate count techniques. LPS concentration increased during E. coli infusion to a mean of 1.13 +/- 0.068 ng/ml (p less than .001) with a concomitant decrease in the concentration of anti-LPS IgG to 59 +/- 5% of control values (p less than .005). Viable circulating E. coli colonies increased during the infusion to a maximum of 425 X 10(6) cfu/ml 10 min after the completion of the infusion, but fell precipitously 20 min later to 10.1 X 10(6) cfu/ml. When each animal succumbed, their respective plasma LPS concentrations were still raised, whereas no viable circulating E. coli colonies were present at a dilution of 10(2). Elevated plasma LPS could prove to be a significant circulating pathogen during Gram-negative bacterial shock and supports the possible association between plasma LPS and morbidity, and mortality in septic shock. PMID- 3286119 TI - Treatment of severe digitalis intoxication with digoxin-specific antibody fragments: a clinical review. PMID- 3286120 TI - Guide to ethical decision-making for the critically ill: the three R's and Q.C. AB - Ethical decision-making for the care of the critically ill and injured has never been more difficult than it is today. Major technologic advances prolong life but often provide questionable benefit in human terms. Both the ethical commitment to the individual patient and the competition for access to expensive and scarce health resources prompt the search for clinically useful and operationally appropriate criteria for decision-making. The mnemonic 3 R's and Q.C. was evolved as a practical tool by which the ethical basis for interventions may be tested. The first tier, the 3 R's, is likely to resolve the vast majority of ethical issues. These are appropriately addressed at the bedside by clinicians who determine whether a proposed intervention is Rational, Redeeming, and Respectful. When the ethical issues cannot be resolved at the bedside on the basis of the 3 R's, a second tier of testing of Quality of Life and Cost (Q.C.) is triggered. This addresses decision-making which is not exclusively or even primarily in the skill domain or authority of most physicians. It calls for assistance by those who represent a broader base of societal involvement including multidisciplinary experts in ethics and law who serve as consultants or who are organized into medical center-wide ethics committees. PMID- 3286121 TI - Hemodynamics and intrathoracic pressure transmission during controlled mechanical ventilation and positive end-expiratory pressure in normal and low compliant lungs. AB - PEEP can significantly reduce cardiac output. This reduction in cardiac output is frequently attributed to transmission of airway pressure to intrathoracic vascular structures. We designed an acute lung injury (ALI) model in swine (n = 7) characterized by low lung thorax compliance (CLT) and compared the fractional transmission of airway pressure to pleura (PPL) and pericardium (PPC) and hemodynamics to normal animals (n = 5) during controlled mechanical ventilation (CMV) and PEEP. Fractional transmission of PEEP to PPL and PPC was reduced significantly from 62 +/- 8% and 54 +/- 19 (SD)% to 34 +/- 7% and 36 +/- 9% in normal and ALI animals, respectively. End-inspiration tracheal pressure was significantly higher in the low compliant group; thus, cardiac output was equally depressed in both groups despite reduction in fractional airway pressure transmission in ALI animals, possibly because absolute inspiratory PPL and PPC were similar due to increased pressure required to inflate injured lungs. The results of this investigation do not support the presumption that low CLT blunts hemodynamic consequences of CMV and PEEP. PMID- 3286123 TI - External chest compression: 1934. PMID- 3286122 TI - Brain cell death following ischemia and reperfusion: a proposed biochemical sequence. PMID- 3286124 TI - Cryopreserved human fetal pancreas: a source of insulin-producing tissue? AB - Human fetal pancreata (HFP) were obtained from dilatation and extraction aborted fetuses of 11-18 weeks' gestation. The pancreas was excised under sterile conditions and kept in culture medium at 4 degrees C, prior to stepwise digestion into 50- to 150-micron fragments. The fragmented pieces were allowed to sediment by gravity, then transferred to tissue culture for 24-48 h, and cryopreserved. The freeze-thaw protocol used stepwise equilibration with dimethyl sulfoxide, nucleation of the sample at -10 degrees C, and a slow cooling rate of 0.25 degrees C/min to -40 degrees C, followed by submersion in liquid nitrogen (-196 degrees C). Rapid thawing at 300 degrees C/min from -196 degrees C was employed. Both fresh and frozen-thawed HFP fragments appeared viable as judged by light and electron microscopy, and secreted insulin in a perifusion system upon stimulation with glucose (28 mM) and theophylline (10 mM) or glucose (2.8 mM) and theophylline (10 mM). Six patients with Type I insulin-dependent diabetes mellitus, already requiring immunosuppression for a kidney transplant, had intraportal injection of 20 cryopreserved-thawed and pooled HFP fragments. Up to the 1-year post-transplant follow-up, there has been no evidence of in vivo insulin or C-peptide production. The usefulness of cryopreserved human fetal pancreata as a source of insulin-producing tissue for diabetic patients, therefore, remains to be demonstrated. PMID- 3286125 TI - Glucose, glycogen, and insulin responses in the hypothermic rat. AB - The rat appears to be unable to utilize glucose during hypothermia. The objective of this study was to examine carbohydrate homeostasis during induction, hypothermia, and rewarming phases. Groups of normothermic animals were euthanized to serve as time controls for comparison. Hypothermia (15 degrees C) was produced by exposure to helox (80% helium:20% oxygen) at 0 +/- 1 degree C. Hyperglycemia was noted during the induction process (169 +/- 8 in control vs 326 +/- 49 mg/dl). Serum glucose increased further during 4 hr of hypothermia, but following rewarming (Tre of 33 +/- 1 degrees C) was reduced (153 +/- 16 mg/dl) significantly (P less than 0.05). Serum insulin was depressed during hypothermic induction (from 48 +/- 4 in controls to 19 +/- 3 microU/ml in hypothermic rats) and increased only slightly during the arousal process, remaining significantly lower than in normothermic subjects. Initial hepatic, skeletal muscle, and cardiac glycogen concentrations were reduced 34, 68, and 75%, respectively, during hypothermic induction. While liver glycogen decreased further during 4 hr of hypothermia, skeletal and cardiac stores increased markedly. During rewarming, hepatic glycogen was markedly decreased, while skeletal and cardiac stores were maintained. These data suggest that hyperglycemia in the hypothermic rat can be accounted for by glycogenolysis and hypoinsulinemia. In addition, this study indicates repletion of skeletal and cardiac muscle glycogen during maintained hypothermia and sparing of muscle glycogen during rewarming. PMID- 3286126 TI - Preparation of overlapping peptides of bovine retinal S-antigen and their localization by immunoblotting with peptide-specific antibodies. AB - Bovine retinal S-antigen was cleaved by three chemical cleavage procedures including o-iodosobenzoic acid (IBA), mile acid and cyanogen bromide. The resultant peptides were used to study antibody-defined epitopes. Treatment with IBA, which cleaves primarily at tryptophanyl peptide bonds, produced at least 4 major fragments and several minor fragments. The peptides have been identified by their migration on SDS-PAGE and tested for their immunoreactivity to several affinity-purified anti-CNBr-peptide antibodies and to affinity-purified anti-IBA peptide antibodies. The presence of a single tryptophan residue 194 residues from the amino-terminus should result in 2 fragments of approximately 23,000 and 26,000 molecular weight based on the known size of intact S-antigen. The additional fragmentation is due to the presence of acid labile bonds and cleavage at IBA-sensitive tyrosyl residues associated with a side reaction. Western immunoblots using affinity-purified antibodies against the various IBA and CNBr peptides have allowed location of these peptides within the intact molecule. Specifically, IBA23K and IBA21K are overlapping fragments on the carboxy end, mutally exclusive of all other peptides. IBA15K and IBA5.6K overlap, and IBA18K and IBA10K overlap within IBA26K which comprises the N-terminal half of S-Ag. Additionally, IBA10K contains an antibody epitope destroyed by CNBr cleavage of the methionyl residue between CB53 and CB56. Further characterization of these IBA peptides will expedite the location of possible additional uveitogenic epitopes in the amino-terminal half of S-Ag as well as epitopes lost by other peptide generating techniques. PMID- 3286127 TI - Proteolytic changes in main intrinsic polypeptide (MIP26) from membranes in selenite cataract. AB - Experimental nuclear cataract produced by an overdose of sodium selenite exhibited limited proteolysis, including breakdown of main intrinsic polypeptide (MIP26) to 24 and 22 kD fragments. Micro-sequencing and site specific immunologic probes were used in the present study to determine regions of cleavage in MIP26 during selenite cataractogenesis. Data suggested that proteolysis occurred in the C-terminus of MIP26. This may have lead to exposure of normally hidden amino acid residues on the C-terminal extension of MIP26. Loss of antigenicity of the N terminus occurred. These significant changes to the MIP26 molecule might adversely affect communication between lens fiber cells and contribute to selenite cataract. PMID- 3286128 TI - Multi-centre, double-blind trial of a novel antispastic agent, tizanidine, in spasticity associated with multiple sclerosis. AB - A multi-centre, double-blind study was carried out in 100 patients suffering from chronic spasticity due to multiple sclerosis to compare the effectiveness of tizanidine hydrochloride with that of baclofen. Patients were allocated at random to receive treatment initially with daily doses of either 6 mg tizanidine or 15 mg baclofen and the dose was increased during the first 2 weeks up to a maximum of 24 mg tizanidine or 60 mg baclofen per day. Patients were then treated with the optimum dose for 6 weeks. Efficacy and tolerability parameters were evaluated after 2 and 8 weeks. Tizanidine and baclofen improved the functional status of patients in 80% and 76% of cases, respectively, but there were no significant differences between the two drugs. The antispastic efficacy of tizanidine was greater after 8 weeks than after 2 weeks, whereas the efficacy of baclofen decreased slightly with time. Both drugs showed good overall tolerability in more than 60% of patients. Thus, tizanidine is a well tolerated and effective muscle relaxant, the antispastic efficacy of which is well maintained over time, and it promises to be particularly useful in the treatment of spasticity due to multiple sclerosis. PMID- 3286129 TI - A multi-centre, double-blind trial of tizanidine, a new antispastic agent, in spasticity associated with hemiplegia. AB - A double-blind study was carried out in 105 patients with chronic spasticity associated with hemiplegia in order to compare the efficacy and tolerability of tizanidine with that of diazepam. Dosage was increased progressively, if tolerated, to a maximum of 24 mg tizanidine or 30 mg diazepam per day at the end of 2 weeks. The optimum dosage was then maintained for 6 weeks. Efficacy and tolerability parameters were assessed after 2 and 8-weeks' therapy. Patients on tizanidine but not those on diazepam showed a statistically significant improvement in functional status, as assessed by walking distance on flat ground. Analysis of the stretch reflex in four groups of muscles showed that both tizanidine and diazepam reduced the duration of contractions and increased the angle at which contraction occurred, but there were no significant differences between the two drugs. Clonus of the triceps surae resolved in 48% of tizanidine and 40% of diazepam patients. Evaluation of the effect of therapy revealed an improvement with each drug in approximately 83% of patients, with the overall evaluation being slightly (but non-significantly) in favour of tizanidine. There were fewer discontinuations of treatment in the tizanidine group as a result of side-effects. It would appear, therefore, that tizanidine is an effective and well-tolerated drug in the treatment of cerebral spasticity. PMID- 3286130 TI - Uterine corpus and cervical cancer. AB - Cancers of the cervix and uterus occur in approximately 50,000 women each year in the United States. As a group, these cancers represent our sixth most common cancer overall, are second only to breast cancer, and are roughly equal to the lung cancer incidence in women. Although they comprise 11% of all cancers in females, they represent only 4% of cancer deaths in women. This results from the effective application of surgery and radiation therapy in the management of these two malignancies as well as effective techniques for early diagnosis. The overall death rate from these two malignancies has decreased more than 70% in the last 40 years. Successful outcome rests on both early diagnosis and the careful application of established treatment approaches. This monograph summarizes the management approaches to both uterine corpus and cervical cancer and discusses the role of adjuvant therapy for these major malignancies. Detailed presentations of the management of special problems, including the uterine sarcomas, are also presented. Although standard management approaches are detailed, discussion of experimental approaches, including adjuvant hormonal treatment, single agent and combination chemotherapy, and the use of radiation sensitizers is included. PMID- 3286131 TI - The radiology of abnormal intrathoracic air. PMID- 3286132 TI - Radiologic imaging of AIDS. AB - The acquired immunodeficiency syndrome (AIDS) is an increasingly important disease that has become a social phenomenon. Although our therapeutic options for treating AIDS patients are limited at present, radiologic investigation is often of crucial importance in determining the extent and stage of opportunistic infections and neoplasms. This manuscript deals in depth with the manifestations of AIDS in the chest, abdomen, and central nervous system. It emphasizes the importance of cross-sectional imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound as well as guided fine needle aspiration biopsy. The first chapter is a brief overview of the general management of AIDS patients in the radiology department. It seeks to emphasize a careful caring approach to patients with this disease. It also emphasizes the importance of educating all radiology personnel to an awareness of how precautions can be taken to avoid the spread of AIDS while dealing with patients in a professional, courteous manner. PMID- 3286133 TI - Vaso-occlusive disorders of the upper extremity. PMID- 3286134 TI - Chronic dermatitis evolving to mycosis fungoides: report of four cases and review of the literature. AB - In four patients with long-standing chronic dermatitis, evolution into cutaneous T-cell lymphoma was observed. Two patients were men and two were women; they were aged forty-nine to sixty-five years at first presentation. Duration of dermatitis at admission was from two months to fifteen years, with the clinical and histologic diagnosis documented on initial examination. After another five to nine years, clinically and histologically verified mycosis fungoides occurred. In two patients, contact factors were verified as causative by results of patch testing; sensitivities documented included nickel, potassium dichromate, and formaldehyde. In a third patient, contact factors were implicated as causes, but patch testing was not performed. We propose that certain instances of cutaneous T cell lymphoma may be caused by chronic antigenic immunostimulation with resultant malignant lymphocyte clonality. PMID- 3286135 TI - Neonatal and childhood purpura fulminans: review of seven cases. AB - The cases of seven patients between the ages of seven days and three years with purpura fulminans have been reviewed. Causative agents in these new-borns were Escherichia coli, Enterobacter, and Staphylococcus; in older children they were varicella and E. coli. The clinical findings, medical and surgical interventions, and outcomes of the cases are presented here. PMID- 3286136 TI - The autopsy in fatal non-missile head injuries. PMID- 3286137 TI - Dementia in middle and late life. PMID- 3286138 TI - Effect of cold air exposure and exercise on nonspecific bronchial reactivity. AB - Exercise and eucapnic hyperventilation with cold air can produce bronchoconstriction in asthmatic subjects, but their enhancement of nonspecific bronchial reactivity remains unclear. We studied the effect of submaximal exercise and cold air exposure on bronchial reactivity to methacholine in a normal control group (n = 10) and in subjects with bronchial asthma (n = 17). Bronchial provocation testing was performed to determine the provoking dose (PD35) of methacholine that caused a 35 percent decrease in specific airway conductance (Gaw/VL) in the two groups. Each subject was studied on three different occasions to determine the PD35 to methacholine on a control day, after ten minutes of submaximal exercise, and after a 30-minute exposure to cold air. Methacholine challenge was performed after the Gaw/VL had returned to the baseline values. In the normal group, neither cold air exposure nor exercise challenge had any significant effect on baseline Gaw/VL, whereas in the asthmatic group, both stimuli caused 20 percent and 15 percent decreases in Gaw/VL, respectively (p less than .05). Mean +/- SD control PD35 was 6.1 +/- 11.6 breath units in the asthmatic group, which decreased to 2.2 +/- 2.8 after exercise and 3.0 +/- 5.0 breath units after cold air exposure (p less than .05). In the normal group, control PD35 was 73 +/- 32 breath units, which was not different from PD35 values of 64 +/- 75 and 52 +/- 64 breath units after exercise and cold air exposure, respectively (p = NS). These data suggest that submaximal exercise and cold air exposure enhance nonspecific bronchial reactivity in asthmatic but not in normal subjects. PMID- 3286139 TI - The treatment of endobronchial stenosis using balloon catheter dilatation. AB - Acquired bronchial stenosis has been associated with sleeve resection, tuberculosis, sarcoidosis, and prolonged intubation. Various modalities of therapy for the relief of such stenoses include surgery, cryotherapy, and laser photoresection. Several recent reports have described the use of angioplasty balloon catheters for dilatation of stenotic areas. In two patients with endobronchial stenosis, we found that balloon dilatation, using either angioplasty or valvuloplasty catheters, in combination with laser photoresection can be safely and effectively performed with alleviation of pulmonary symptoms. PMID- 3286140 TI - Effect of preoperative renin-angiotensin system blockade on hypertension following coronary surgery. AB - Renin-angiotensin system activation is suspected of being involved in postcoronary surgery hypertension, but appears to be useful in maintaining blood pressure during anesthesia and cardiopulmonary bypass. To clarify these points, 19 patients were compared: ten as a control group and nine who received captopril during two days before surgery. Anesthesia was the same for the two groups, and cardiopulmonary bypass ensured nonpulsatile flow rates. Anesthesia induced a slight decrease in the mean arterial blood pressure of the treated group (91.1 +/ 3.3 mm Hg to 83.3 +/- 3.9 mm Hg), which did not occur in the control group (89.9 +/- 5.8 mm Hg to 89.7 +/- 4.9 mm Hg). During cardiopulmonary bypass, the mean arterial blood pressure was maintained at comparable levels in the two groups (65.6 +/- 3.5 mm Hg in the control group, 72.6 +/- 3.0 mm Hg in the treated group), with same pump flow rates. After cardiopulmonary bypass, the mean arterial blood pressure returned nearly to prebypass values. Postoperatively, three patients in the control group and four in the treated group developed hypertension. Thus, preoperative renin-angiotensin system blockade by a converting-enzyme inhibitor did not impair blood pressure regulation during anesthesia and cardiopulmonary bypass, but failed to prevent hypertension following coronary surgery. PMID- 3286141 TI - Amiodarone pulmonary toxicity. Recognition and pathogenesis (Part 2). AB - The pulmonary toxicity associated with amiodarone therapy is clinically complex and likely reflects underlying mechanisms of lung injury that result from direct toxic effects of the drug (or its metabolites) as well as indirect inflammatory and immunologic processes induced by the drug therapy (Fig 2). A role for the direct toxicity of the drug is likely because (a) toxicity in part is related to dosage and duration of therapy, (b) many patients with amiodarone pulmonary toxicity have no evidence of an inflammatory or immune response in the lung, (c) in vitro studies indicate that amiodarone can be directly toxic to cultured lung cells or perfused isolated lung tissue, and (d) recent studies suggest plausible biochemical mechanisms that may explain in part the mechanism(s) of direct toxicity of the drug. A role for indirect inflammatory or immune processes within the lung of some patients with APT is supported by: (a) variable relationship of pulmonary toxicity to amiodarone dosages and blood levels, (b) preliminary studies suggest altered immunologic markers in the blood and lungs of some patients with APT, and (c) the cellular findings of bronchoalveolar lavage indicating a CD8 lymphocytosis with or without influx of polymorphonuclear leukocytes, which is consistent with previous studies of hypersensitivity reactions. As our understanding of the biochemical and cellular mechanisms of APT improve, a number of key clinical issues may be clarified: (1) risk factor assessment for APT, (2) criteria for early diagnosis of APT, and (3) improved therapeutic approach to patients with APT. PMID- 3286142 TI - Calcium antagonists in the treatment of hypertension. An overview. AB - The availability of calcium antagonists has provided yet another therapeutic option in the management of hypertension. Calcium antagonists lower the blood pressure in hypertensive individuals while preserving the blood flow at the microcirculatory level. While all the available calcium antagonists are effective in the treatment of hypertension, they differ in their hemodynamic and pharmacologic actions. Nifedipine appears to be suitable for immediate treatment of severe hypertension and for chronic treatment of uncomplicated or refractory hypertension. In some but not all patients, co-administration of a beta-blocker is necessary to blunt reflex tachycardia. This problem is less likely with the tablet/long-acting formulation of nifedipine. Verapamil and diltiazem are useful as initial therapy for chronic mild-to-moderate hypertension. They are as effective as other first-line drugs in the treatment of uncomplicated hypertension. The heart rate with verapamil or diltiazem does not change or is slightly reduced, thus contrasting with nifedipine. Experience to date suggests that calcium antagonists do not cause adverse biochemical effects and in this respect are superior to diuretics and certain beta-blockers. Currently, verapamil is available as a sustained release preparation. In the near future, nifedipine or diltiazem may also be available in the long acting formulation to permit simplicity and to enhance patient compliance in the treatment of hypertension. PMID- 3286143 TI - The cardiac and extracardiac microcirculation in heart disease. PMID- 3286144 TI - Pathogenesis of airway hyperreactivity. PMID- 3286145 TI - Cell-to-cell interaction in airways. Role of neural inflammation. PMID- 3286146 TI - The airway nonadrenergic noncholinergic inhibitory nervous system. PMID- 3286147 TI - The late asthmatic response. PMID- 3286148 TI - Noninvasive nasal mask-assisted ventilation in respiratory failure of Duchenne muscular dystrophy. AB - The effects of noninvasive nasal mask-assisted ventilation were studied in two patients with chronic respiratory failure due to Duchenne's muscular dystrophy. Observations were made with continuous recordings of transcutaneous CO2 and O2 and ear oximetry. In one case, the mean tcPCO2 fell from 72 mm Hg to 43 mm Hg. The tcPO2 increased from 38 mm Hg to 62 mm Hg without supplementary oxygen. In the second case, hypercapnia associated with supplementary oxygen was corrected, and at five months' follow-up, hypoxemia was corrected without supplementary oxygen. Prolonged therapy during sleep has resulted in sustained clinical improvement for more than 18 months. PMID- 3286149 TI - Surgical decompression of a tension pneumomediastinum. A ventilatory complication of status asthmaticus. AB - A case of status asthmaticus was associated with cardiorespiratory arrest, illustrating rarely reported complications of ventilatory therapy including tension pneumomediastinum and coronary air embolization. Proposed pathophysiologic mechanisms and recommendations for surgical management are discussed. PMID- 3286150 TI - Pulmonary hyperinflation following Nd-YAG laser resection of an obstructing mainstem tumor. AB - Nd-YAG laser resection of a completely obstructing right mainstem tumor in a 36 year-old man was complicated by right lung hyperinflation and left lung collapse and accompanying ventilatory failure. This was attributed to obstruction of the right mainstem bronchus during exhalation, but not inhalation, in a patent but irregularly shaped bronchus postresection. Intubation, positive pressure breathing, bronchodilator therapy, and laser excision of residual right mainstem tumor resolved the ventilatory failure. PMID- 3286151 TI - [Stomach replacement by the small intestine]. PMID- 3286152 TI - [Rectum replacement by the small intestine--the intrapelvic reservoir]. PMID- 3286153 TI - [The continent ileostomy--Kock's pouch]. PMID- 3286154 TI - [General surgical interventions in heart surgery patients]. AB - Due to the rapid development in cardiac surgery it is obvious that we now find more patients after heart operations requiring major noncardiac surgery. Knowledge concerning the special problems in treatment of patients with prior cardiac surgery is indispensable to guarantee a low perioperative risk. It is of great consequence, what kind of cardiac disease we are dealing with, whether the cardiac defect could be corrected partially or totally and how the cardiac index has been finally. We discuss the situation after different cardiac operations including coronary bypass grafting, heart valve surgery and heart transplantation. Several multi-case studies could prove that after successfully performed bypass grafting a coronary heart disease does not improve the perioperative risk of following surgical treatment. Some authors recommend a 6 month interval after coronary heart surgery. A higher risk for ventricular arrhythmias can be found in patients with a manifest coronary heart disease following operative revascularisation. Special comment is given to the recommended treatment of the different stages of coronary heart disease in respect to the time course with noncardiac surgery. General surgery after heart valve replacement can be complicated by the appearance of dysrhythmia and arrhythmia, left heart failure, tendency to bleed and higher risk of infections. Patients with a transplanted heart need special care on the part of narcosis and asepsis. PMID- 3286155 TI - Effect of diabetes mellitus on pancreatic exocrine secretion from isolated perfused pancreas in rats. AB - We studied pancreatic exocrine function in response to cerulein and carbamylcholine in isolated perfused pancreas obtained from control, streptozotocin-induced diabetic, and insulin-treated diabetic rats. The time course of pancreatic juice, protein, amylase, and trypsinogen secretion in response to cerulein or carbamylcholine in diabetic rats was similar to that in control rats. Basal as well as cerulein- or carbamylcholine-stimulated output of amylase from diabetic rat pancreas was significantly reduced, whereas that of trypsinogen was similar to the control. Amylase and trypsinogen outputs in response to 620 pM (1.0 ng/ml) cerulein from insulin-treated diabetic rat pancreas were significantly lower than those from control rat pancreas, although the pancreatic contents of these enzymes were similar to or greater than those in control rats. The dose-response curves of pancreatic juice, protein, amylase, and trypsinogen for cerulein and carbamylcholine were biphasic in both control and diabetic rats. The minimal and the maximal release in response to cerulein occurred with higher concentrations in diabetic rats compared with control rats. In contrast, the maximal responses were obtained with 1 microM carbamylcholine in control rats and with 0.1-1 microM carbamylcholine in diabetic rats. The present study demonstrates that the concentration of cerulein required to elicit maximal response was increased, whereas that to carbamylcholine was reduced in diabetic rat pancreas, and that the protein and enzyme outputs in response to cerulein were significantly reduced in insulin-treated diabetic rat pancreas despite restoration of the pancreatic enzyme contents to control levels. PMID- 3286156 TI - Distribution of a novel pituitary protein (7B2) in mammalian gastrointestinal tract and pancreas. AB - The distribution of a novel pituitary protein (7B2) was determined in the gastrointestinal tract and pancreas of four mammalian species (man, pig, guinea pig, and rat) by a specific radioimmunoassay. The highest concentrations of cross reacting immunoreactive 7B2 (IR-7B2) were observed in the pancreas and the proximal gut (antrum or duodenum). While the intestinal concentrations varied widely among species, pancreatic IR-7B2 concentrations appeared to be similar in all four species. In the rat, pancreatic islets were found to contain high concentrations of IR-7B2 (5.73 +/- 0.14 fmol/islet, mean +/- SEM). Neonatal capsaicin treatment and enteric nerve section did not affect the concentrations of IR-7B2 in the rat intestine. Layer separation of human gut showed that IR-7B2 is mainly (71 +/- 8%) present in the epithelial fraction. Chromatographic analysis of intestinal and pancreatic extracts from the four species on Sephadex G-100 showed the presence of two immunoreactive peaks at Kav 0.3 and 0.6, but there were both inter- and intraspecies variations in the proportions of the larger and smaller molecular forms. PMID- 3286157 TI - Insulin and C-peptide plasma levels in patients with severe chronic pancreatitis and fasting normoglycemia. AB - The aim of the present study was to evaluate insulin secretion by the pancreatic B cell in a group of patients with severe chronic pancreatitis and without overt diabetes. For this purpose we have measured plasma insulin and C-peptide peripheral levels in the fasting state and after a 100-g oral glucose load in 10 patients with severe chronic pancreatitis and fasting normoglycemia, and in 10 sex-, age-, and weight-matched healthy controls. As compared to normal subjects, patients with chronic pancreatitis showed: (1) significantly higher plasma glucose levels after oral glucose load (area under the plasma glucose curve 1708 +/- 142 vs 1208 +/- 47 mmol/liter X 240 min, P less than 0.005); (2) plasma insulin levels significantly higher at fasting (0.11 +/- 0.008 vs 0.08 +/- 0.005 nmol/liter, P less than 0.01) but not after oral glucose administration (area under the plasma insulin curve 79 +/- 12 vs 88 +/- 16 nmol/liter X 240 min); (3) significantly lower plasma C-peptide concentrations both in the fasting state (0.15 +/- 0.01 vs 0.54 +/- 0.05 nmol/liter, P less than 0.001) and after oral glucose load (area under the plasma C-peptide curve 211 +/- 30 vs 325 +/- 37 nmol/liter X 240 min, P less than 0.05). The finding of diminished plasma C peptide levels suggests that chronic pancreatitis is associated with an impaired B-cell function even in the absence of overt diabetes. The increased or unchanged plasma insulin levels in spite of decreased plasma C-peptide concentrations indicate that in chronic pancreatitis insulin metabolism is reduced, most likely within the liver. PMID- 3286158 TI - Stress-induced vascular damage and ulcer. AB - Factors controlling gastric mucosal blood flow are now better understood, and improved techniques have been established to study microcirculation in the gastrointestinal tract. In this paper, four areas are reviewed: gross and microscopic vessels that supply blood to the stomach; factors that control gastrointestinal blood flow; pathogenic role of disturbed mucosal blood flow circulation induced by stress; and findings in early vascular permeability and injury caused by cold restraint stress in the rat. PMID- 3286159 TI - Umbilical hernia rupture in cirrhotics with ascites. PMID- 3286161 TI - How to select a computerized medical office practice system. PMID- 3286160 TI - Maternal smoking and neonatal prostacyclin excretion. AB - To study the effect of smoking during pregnancy on the production of vasodilatory, antiaggregatory prostacyclin (PGI2) of the neonates, we measured the urinary excretion of 6-keto-prostaglandin F1a (6-keto-PGF1a, a metabolite of PGI2) on the first and on the third or fourth day of life of a group of babies of smoking (BSM, n = 14) and nonsmoking (BNSM, n = 13) mothers. The urinary excretion of 6-keto-PGF1a was similar in both groups (249.8 +/- 18.5, mean +/- SEM, and 262.7 +/- 35.0 pg 6-keto-PGF1a/mmol of creatinine for BSM and BNSM, respectively, on the first day of life; 109.4 +/- 18.6 and 133.3 +/- 18.5 pg/mmol for BSM and BNSM, respectively, on the third or fourth day of life). Thus smoking during pregnancy is not followed by such changes of PGI2 production that they were reflected by changes of urinary 6-keto-PGF1a of newborns on the first or on the third or fourth day of life. PMID- 3286162 TI - Common complications in critically ill patients. AB - Patients in intensive care units (ICUs) are subject to many complications connected with the advanced therapy required for their serious illnesses. Complications of ventilatory support include problems associated with short-term and long-term intubation, barotrauma, gastrointestinal tract bleeding, and weaning errors. Cardiac tachyarrhythmias can arise from a patient's intrinsic cardiac disease, as well as from drug therapy itself. Hemodynamic monitoring is crucial to careful patient management, but it is associated with technical complications during insertion such as pneumothorax, as well as interpretive errors such as those caused by positive end-inspiratory pressure. Acute renal failure can develop as a result both of therapy with drugs such as aminoglycosides and hypotension of many etiologies, as well as the use of contrast media. Nosocomial infection, which is a dreaded complication in ICU patients, usually arises from sources in the urinary tract, bloodstream, or lung. Complications frequently can arise if the interactions of drugs commonly used in the ICU are not recognized. Further, the ICU patient is subject to nutritional complications, acid base problems, and psychological disturbances. This monograph deals with the frequency, etiology, and prevention of these common ICU complications. PMID- 3286163 TI - Short-term efficient expression of transfected DNA in human hematopoietic cells by electroporation: definition of parameters and use of chemical stimulators. AB - The efficiency of DNA transfer into human hematopoietic cells by electroporation was investigated and compared to conventional transfection procedures. Important parameters of electroporation were optimized in human erythroleukemia cells using the chloramphenicol acetyltransferase (acetyl-CoA; chloramphenicol 3-O acetyltransferase, EC 2.3.1.28) gene linked to the cytomegaloviral enhancer promoter. In addition, selected chemicals with different modes of action were studied for their ability to aid DNA entry and gene expression in this system, and several were found to enhance gene transfection by electroporation in a significant manner. Using these chemical stimulators, many but not all human and mouse suspension cultures tested were successfully electroporated by the Baekon 2000 instrument. From these studies, it appears that electroporation can be enhanced by chemical additives. Because of its efficiency, reproductivity, and convenience electroporation is an attractive method of gene transfer in human hematopoietic cells. PMID- 3286164 TI - Site-specific oligonucleotide-directed mutagenesis using T4 DNA polymerase. AB - A simple and efficient mutagenesis procedure is described which uses both the 3'- --5' exonuclease and 5'----3' polymerase activities of T4 DNA polymerase. Different types of mutation-deletion, insertion, and substitution-can be introduced into the DNA in a single reaction. The technique uses recombinant M13 single-stranded DNA and two complementary DNA oligonucleotides to target and control the extent of deletions catalyzed by T4 DNA polymerase. The second oligonucleotide not only directs ligation, but also serves as a template for insertion or substitution of nucleotides by T4 polymerase. Mutant phages in a genetically pure form can be obtained at high efficiency, allowing their characterization directly by nucleotide sequencing without prior enrichment, plaque purification, and screening. We tested the versatility of this method by manipulating five regions of cDNA encoding the structural proteins of eastern equine encephalitis virus. PMID- 3286165 TI - Continuous subcutaneous insulin infusion during pregnancy. AB - The development of battery-powered pumps for continuous subcutaneous insulin infusion added new dimensions to control of diabetes during pregnancy. In this report, we describe our experiences with 28 pregnant diabetic women offered participation in an insulin pump program. Fifteen (54%) accepted pump therapy and ten continued usage during their pregnancies. Excluding abortions, eight women continuing pump use are compared to 11 others who declined such therapy and were treated with conventional methods. Although these two groups are small and not strictly comparable, the experiences now reported provide clinical insights into the application of this new technology during pregnancy. Women who successfully used insulin pumps were typically from the private sector and in better glucose control at study entry. The degree of control during pregnancy in women using pumps was not significantly different compared to conventional glucose control methods (mean glucose 120 mg/dl and 142 mg/dl, respectively). Similarly, several indices of pregnancy outcome including length of hospitalization, costs, and perinatal morbidity associated with diabetes were analyzed and no significant differences were observed. We conclude that insulin pumps are not acceptable to all pregnant diabetic women and that such therapy may not necessarily improve pregnancy outcome. PMID- 3286166 TI - Similar effects of pulsatile and constant intravenous insulin delivery. AB - Effects of constant and pulsatile i.v. insulin delivery were examined in seven healthy subjects by means of euglycemic clamp technique. Each subject received constant insulin infusion (0.175 mU/kg.min) or insulin pulses at 12-min intervals (2.1 mU/kg) in randomized order for 8-h periods (08.00-16.00 h). Endogenous secretion of insulin was inhibited by concomitant administration of somatostatin (300 micrograms/h). Serum insulin concentrations during constant infusion (12 +/- 1 microU/ml) did not differ from basal values (11 +/- 1 microU/ml). Pulsatile insulin delivery resulted in oscillations of mean concentrations between values of about 10 and 20 microU/ml. Mean blood glucose concentrations during experiments were kept at 80 +/- 1 mg/dl, irrespective of the mode of insulin administration. Moreover, dextrose requirements for maintenance of these glucose concentrations did not differ over the hole periods of examination. We conclude that effects of constant and pulsatile delivery of basal amounts of insulin are not different. This at least applies to peripheral, short-term insulin administration in somatostatin-treated normal man, during an euglycemic clamp. PMID- 3286167 TI - Impaired catecholamine secretion as a cause of diabetic autonomic neuropathy. AB - Human and animal studies were performed to investigate the causes of diabetic autonomic neuropathy. Human diabetics, with and without autonomic neuropathy, were measured for plasma catecholamine response to insulin hypoglycemia and for urinary catecholamine excretion. In streptozotocin-diabetic rats, plasma catecholamine response and tissue catecholamine concentrations were measured at various stages of the disease. As the duration of the diabetic state lengthens in rats, there is a time-proportional stepwise decrease in plasma catecholamine response. This is similar to the clinical course observed in human diabetics, which also includes a reduction of catecholamine excretion after the appearance of autonomic neuropathy. After 6 weeks of diabetes, rat tissue is found to have an increased concentration of catecholamines; this may represent a compensatory reaction to the difficulties of secretion. At 13 weeks of diabetes, tissue catecholamine concentrations return to almost normal, when plasma responses have disappeared. These results suggest that the impaired secretion of catecholamines in diabetics may be a cause of diabetic autonomic neuropathy. PMID- 3286169 TI - [Double effect of inversion in the karyotype of the common vole]. PMID- 3286168 TI - Alpha-glucosidase inhibition and timing of preprandial insulin in patients with insulin-dependent diabetes mellitus (IDDM). AB - Bay-m-1099, a new alpha-glucosidase inhibitor, was given along with insulin immediately before standard breakfasts, lunches and dinners to nine insulin dependent diabetic patients to determine whether this combination therapy would produce postprandial glycemic control comparable to that achieved when insulin alone was administered 30 min prior to eating. To avoid potential hypoglycemia, 20% less insulin (0.12 vs. 0.15 U/kg) was given with Bay-m-1099. Despite plasma free insulin concentrations which were less than those observed when insulin alone was given (9.4 +/- 1.0 vs. 12.8 +/- 1.6 microU/ml/min, area under curves for all meals), postprandial hyperglycemia (area under curve) was not significantly different (P greater than 0.1) when insulin plus Bay-m-1099 was administered immediately before each meal (124 +/- 26 mg/ml/min) than when insulin was administered 30 min before each meal (113 +/- 17 mg/ml/min). Thus, the combination of immediate preprandial administration of an alpha-glucosidase inhibitor along with insulin resulted in glycemic control comparable to that achieved when more insulin was taken 30 min prior to eating. We conclude that use of alpha-glucosidase inhibitors could lessen the inconvenience of intensive insulin regimens by permitting patients to take their insulin immediately before eating and thus result in greater patient compliance. PMID- 3286170 TI - Possible physiological roles of carboxylic ester hydrolases. PMID- 3286171 TI - The effect of peroxisome proliferators on microsomal, peroxisomal, and mitochondrial enzyme activities in the liver and kidney. PMID- 3286172 TI - Treatment of systemic lupus erythematosus. AB - Systemic lupus erythematosus (SLE) is an autoimmune disease with clinical manifestations involving a multitude of tissue sites. This article describes the pathophysiology, etiology, clinical manifestations, and therapy of SLE, and focuses mainly on drugs used in SLE treatment. The reader will be able to identify which pharmacologic agents are used in SLE and list the drugs that are useful for specific clinical manifestations. The reader will also be able to describe the common adverse drug reactions seen from SLE treatment and the potential risks involved with these therapies. Information on expected outcomes from drug therapy that will aid in monitoring patients receiving treatment for SLE is provided. PMID- 3286173 TI - A controlled clinical trial of the cardiovascular and psychological effects of phenylpropanolamine and caffeine. AB - Two hundred eighty-eight healthy normotensive volunteers with various degrees of obesity participated in a double-blind, placebo-controlled evaluation of the acute effects of phenylpropanolamine hydrochloride (PPA) and caffeine on blood pressure, pulse, and subjective effects. Dosage forms studied were PPA 75 mg sustained-release (SR), PPA SR 75 mg with caffeine 200 mg, caffeine 200 mg, and placebo. Data analysis indicated no significant cardiovascular or subjective effects due to PPA. Caffeine, however, was associated with statistically reliable though clinically insignificant changes from baseline diastolic blood pressure in both supine and standing positions. The rank order of the change indicated larger increases for the subjects who received caffeine, either alone or in combination with PPA, as compared with those who received PPA alone or placebo. No statistically significant differences between PPA and placebo were observed. Subjects in the heavier weight categories had higher blood pressure levels throughout the session as compared with those of normal weight. There was no difference among the study groups in subjective effects. These results provide evidence supporting the safety of currently recommended doses of sustained release PPA, either alone or in combination with small doses of caffeine in healthy individuals. PMID- 3286174 TI - Failure of intraarticular ceftazidime in a patient with Pseudomonas aeruginosa septic arthritis. AB - This report describes a patient with Pseudomonas aeruginosa septic arthritis who received ceftazidime by the intravenous and intraarticular routes. Concentrations of ceftazidime in the synovial fluid following both routes of administration were measured and found to be above the minimum inhibitory concentration. Despite this the organism was not eradicated. We were unable to find other literature describing the disposition of ceftazidime in synovial fluid and therefore this single-patient study provides novel information. We were unable to account for the apparent failure of therapy. PMID- 3286175 TI - Therapeutic drug monitoring in neonates: problems and issues. AB - Therapeutic drug monitoring has been applied in several patient populations to promote safer, more effective use of drugs. The development of therapeutic ranges allows clinicians to aim for a plasma drug concentration that is usually safe and effective, and calculation of specific pharmacokinetic parameters allows selection of doses that will achieve the desired plasma concentration. This concept certainly holds true in the intensive care nursery; however, the intensity of monitoring in this setting provides opportunities for far broader applications of the information obtained from drug concentration monitoring. This review provides an overview of the complexity of and potential applications for therapeutic drug monitoring in neonates based on literature and clinical experience. PMID- 3286176 TI - Antibiotics for community-acquired pneumonia in adults. PMID- 3286177 TI - Mianserin 10 years on. PMID- 3286178 TI - Asthma in the preschool child. PMID- 3286180 TI - Oral zinc--when is it useful? PMID- 3286179 TI - Naftidrofuryl (Praxilene). PMID- 3286181 TI - Dystonia: underdiagnosed and undertreated? PMID- 3286182 TI - [Cyclosporin-induced nephrotoxicity]. PMID- 3286183 TI - [Diagnosis of Lyell's syndrome: SSSS or TEN?]. PMID- 3286184 TI - [Molecular mechanism of action of sulfonylureas]. PMID- 3286185 TI - [Liver ultrasonics in the follow-up of breast carcinoma]. PMID- 3286186 TI - [Growth factors in the pathogenesis of malignant diseases]. PMID- 3286187 TI - ["Panem et circenses"; facts and figures--the use of animals in sports, play and leisure]. PMID- 3286188 TI - ["Animal protection and safety in sports, play and leisure". Continuing education meeting. 24-25 September 1987]. PMID- 3286189 TI - [The doping problem from an animal welfare view]. PMID- 3286190 TI - [Questions of animal welfare in horse racing and in jousting]. PMID- 3286191 TI - [The question of cooperation of horse teams in open traffic]. PMID- 3286192 TI - [Questions of animal welfare in trotting races]. PMID- 3286193 TI - [The use of neurectomized horses in heavy duty sports]. PMID- 3286194 TI - [Animal welfare aspects in equestrian games]. PMID- 3286195 TI - [Leisure riding and animal welfare]. PMID- 3286196 TI - [Flying competition with pigeons from the view of animal welfare]. PMID- 3286197 TI - [Legal animal welfare aspects in falconry]. PMID- 3286198 TI - [Animal welfare aspects of fishing law]. PMID- 3286199 TI - [Pain and stress in fish]. PMID- 3286200 TI - [Sport fishing and animal welfare]. PMID- 3286201 TI - [Wild animals and hunting practices under the aspect of animal welfare laws]. PMID- 3286202 TI - [Preprogrammed and induced behavior in dogs]. PMID- 3286203 TI - [Amphibians and reptiles as hobby animals]. PMID- 3286204 TI - [Fences and cages]. PMID- 3286205 TI - [Fire protection in animal housing]. PMID- 3286207 TI - [The practice of training and animal husbandry in the circus]. PMID- 3286206 TI - [Ethological ground rules for the training of animals]. PMID- 3286208 TI - [Estimation of the keeping of wild animals--also in private hands and in small establishments--after the German animal welfare act and Lower Saxony ordinance about the keeping of dangerous animals]. PMID- 3286209 TI - [Pig racing from the animal welfare view]. PMID- 3286210 TI - [The effect of sound on animals]. PMID- 3286211 TI - Mifegyne (mifepristone), a new antiprogestagen with potential therapeutic use in human fertility control. PMID- 3286212 TI - Acarbose. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential. AB - Acarbose delays the production of monosaccharides (notably glucose) by inhibiting the alpha-glucosidases associated with the brush-border membrane of the small intestine which are responsible for the digestion of complex polysaccharides and sucrose. In healthy subjects acarbose 100 to 200 mg significantly inhibits postprandial glucose, insulin and triglyceride responses, with some evidence of carbohydrate malabsorption with the higher dose. Clinical trials in patients with non-insulin-dependent diabetes mellitus showed that acarbose improved diabetic control, especially postprandial blood glucose levels, independent of whether the patients were receiving concomitant oral antidiabetic drugs in addition to dietary management. In comparative studies acarbose was significantly superior to placebo, and comparable to biguanides, when used alone or as an adjuvant to sulphonylurea therapy. Trials in patients requiring insulin to control their diabetes demonstrated that acarbose significantly reduced postprandial blood glucose concentrations, resulting in a smoother diurnal blood glucose-time curve and improved symptoms associated with nocturnal hypoglycaemia. Daily insulin requirements were sometimes reduced. In large multicentre trials acarbose up to 600 mg/day for 3 to 12 months improved glycaemic control in approximately 55% of patients with non-insulin-dependent or insulin-dependent diabetes mellitus. Apart from its use in diabetes, encouraging preliminary results have been obtained with acarbose in other therapeutic areas such as dumping syndrome, reactive hypoglycaemia, and types IIb and IV hyperlipoproteinaemias--however, further clinical experience is needed in these settings before clear conclusions can be drawn. No serious side effects have been reported during treatment with acarbose, although it is associated with a high incidence of troublesome gastrointestinal symptoms such as flatulence, abdominal distension, borborygmus and diarrhoea. The incidence of these reactions usually decreases with time. Thus, acarbose represents the first of a new class of oral antidiabetic drugs--the alpha glucosidase inhibitors. It has proven useful for improving glycaemic control when used as an adjunct to standard therapy involving dietary restriction, oral antidiabetic drugs and/or subcutaneous insulin. That being the case, acarbose should provide the clinician with an interesting treatment option which can be used in a broad range of patients with diabetes mellitus in whom 'traditional' management approaches produce suboptimal glycaemic control. PMID- 3286215 TI - Fibrositis (fibromyalgia). A common non-entity? AB - The literature on fibrositis (fibromyalgia), which originated in the early years of the last century in the UK and proliferated there in the first half of this century, has since diminished there in the last 30 years or so, but has increased in Canada and the US. Criteria suggested for diagnosis have created a syndrome with no diagnostic tests, serological or radiological signs, and no truly objective physical signs, but with predictable tender spots on pressure. The syndrome is largely, but not completely, confined to females, mostly of middle age; the symptoms include widespread aching of more than 3 months' duration, disturbed sleep, morning fatigue and stiffness, a failure to respond satisfactorily to any one form of therapy and a tendency to persist over long periods, but without permanent tissue changes. Features of psychological disturbance are present in many patients but not in all or even the majority. Definition of the condition as a disorder of pain modulation - a pain amplification syndrome - would seem to fit the facts best. Most would agree that an abnormal response to stress is an important factor in the appearance of the syndrome, as other stress related disorders, such as the irritable bowel syndrome and tension headaches, may coexist. Response to therapy, whether physical or pharmacological, is on the whole unsatisfactory. This type of patient has been well recognised in hospital clinic and general practice for many years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286216 TI - [Hyperplasiogenic polyps and risk of stomach cancer]. AB - In 731 hyperplasiogenic polyps which have been removed by endoscopical polypectomy there were 9 polyps with an early cancer and 8 polyps with severe dysplasias (borderline lesions) as well as 1 polyp, in which an advanced carcinoma has been developed. This is the outstanding greatest number of hyperplasiogenic polyps with a malignant transformation. In addition in 9 patients with hyperplasiogenic polyps carcinomas could be discovered, i.e. a rate for malignant developments of 3.7%. It seems that stomachs with multiple polyps are endangered in particular. The recurrence rate of follow-up examinations covering a period of up to 8 years was 36.1%. PMID- 3286217 TI - [Value of ultrasound tomography in the diagnosis and follow-up of fatty liver]. AB - In a prospective study 187 patients with diffuse fatty infiltration of the liver, estimated by ultrasound tomography, were investigated. In any case the history as well as the results of clinical investigation and the lab findings were known to the observer. Liver blind punctions were performed after a short time, on an average of 11 days. In 91.4% the sonographic diagnosis "fatty infiltration of the liver" could be confirmed by histological findings, while in the other cases the diagnosis was incorrect or incomplete respectively. Following sonographic criterions any results were graduated into three groups and compared with the percentage of fat infiltrated liver cells found by histological investigation. There was a high accuracy in patient with fatty liver: 90.9% could be established by ultrasound tomography. Only in those cases, in which the sonographic diagnosis "fatty infiltration" is not confirmed by case history, clinical and lab findings, the liver biopsy is to be performed. PMID- 3286213 TI - Diclofenac sodium. A reappraisal of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. AB - Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) advocated for use in painful and inflammatory rheumatic and certain non-rheumatic conditions. It is available in a number of administration forms which can be given orally, rectally or intramuscularly. Conveniently, dosage adjustments are not required in the elderly or in those patients with renal or hepatic impairment. The drug has a relatively short elimination half-life, which limits the potential for drug accumulation. In numerous clinical trials the efficacy of diclofenac is equivalent to that of the many newer and established NSAIDs with which it has been compared. As an analgesic it has a fast onset and long duration of action. When administered intramuscularly it is at least comparable to, and frequently superior to, many narcotic and spasmolytic combinations in renal and biliary colic. Extensive clinical experience has been gained with diclofenac, clearly establishing its safety profile. It is well tolerated compared with other NSAIDs and rarely produces gastrointestinal ulceration or other serious side effects. Thus, diclofenac can be considered as one of the few NSAIDs of 'first choice' in the treatment of acute and chronic painful and inflammatory conditions. PMID- 3286218 TI - [Histological and immunohistochemical studies on the endocrine pancreas in hyperglycemic obese ob/ob mice]. PMID- 3286219 TI - [Localization and persistence of the lipopolysaccharide isolated from E. coli O 111 in the parenchymatous organs of rats]. PMID- 3286214 TI - New antiarrhythmic drugs. AB - While controversy still exists as to the precise indications for the treatment of all forms of ventricular arrhythmia, advances in the number and, more importantly, type of antiarrhythmic drugs can provide the clinician with a rational basis for selecting antiarrhythmic drug therapy. A host of new agents with different pharmacokinetic and electrophysiological actions are now available, and can be compared or contrasted to conventional antiarrhythmic agents such as quinidine, procainamide, disopyramide, lignocaine (lidocaine) and bretylium. This review summarises the electrophysiological, haemodynamic, pharmacokinetic, and efficacy and safety data of mexiletine, tocainide, flecainide, encainide, propafenone, amiodarone, sotalol, pirmenol, cibenzoline (cifenline) and ethmozine (moracizine, moricizine), and aims to provide a basis on which clinicians can compare and contrast these agents and form an algorithm for selection of antiarrhythmic drug therapy in the treatment of patients with ventricular arrhythmias. PMID- 3286220 TI - [The kallikrein-kinin system and kidney function]. PMID- 3286221 TI - [Amplification, rearrangement and expression of the c-myc and c-Ha-ras1 proto oncogenes in patients with breast cancer]. AB - The restriction analysis of breast cancer DNA revealed amplification of c-myc and c-Ha-ras oncogenes in 3 of 19 and 4 of 22 carcinomas, respectively. In two tumours containing amplified c-Ha-ras1-fragment an additional ras-band absent in unchanged lymphatic nodule and blood leukocytes of the same patients was revealed. Amplification of myc gene was registered in poorly differentiated carcinomas with high metastatic potential. c-Ha-ras1 activation (amplification and elevated expression) was identified in nonaggressive tumours with prolonged progression. PMID- 3286222 TI - [Tumor heterogeneity and the mechanisms of natural resistance in the metastatic process]. AB - Data from literature concerning differences in cell populations between the primary and metastatic tumours are generalized. Their properties are considered as dependent on heterogeneity of the cell composition, karyotype, cell surface peculiarities and oncogene expression. The problem of the dependence of the ability of tumours to metastasize on their interaction with macrophages and natural killer cells is under discussion. PMID- 3286223 TI - Immunodiabetes in rabbits. AB - The changes of basal glycemia and of that during the glucose and insulin tolerance tests as well as of the production of hemagglutinating antibodies in rabbits immunized with crystalline insulin (CI), chromatographically purified insulin (CPI) and waste products of the chromatographic purification of insulin (WP), both with and without complete Freund's adjuvant (CFA) were studied. Following immunization with CI and its components the glycemia increased characteristically and the course of glucose and insulin tolerance tests was changed. The peak levels of antibodies were found following immunization with WP, while the lowest ones appeared following the application of CPI. Following the immunization with a mixture of antigens with CFA higher levels of antibodies were usually observed than following the administration of antigens without adjuvant. No association was found between the titers of antibodies and glycemia values. The principal morphological change in immunized animals was found to be a partial degranulation of B-cells, often accompanied by hyperplasia of A-cells. In groups immunized with CI or CPI mixed with CFA we detected even insulitis, which was absent in the other groups. Following immunization with CI mixed with CFA such cells were found whose granules in the ultrastructure showed conspicuous similarity to those of foetal (immature) rabbit B-cells. It was assumed that in insulin immunized rabbits the initial damage of islets was followed, at least in some regions, by reparative processes. This was indicated by the findings of mitosis figures in B-cells as well as by the islet A-cell hyperplasia. PMID- 3286224 TI - Influence of estrogens on mouse uterine epidermal growth factor precursor protein and messenger ribonucleic acid. AB - Estrogens stimulate the in vivo proliferation of epithelial cells of the mouse uterus. The cumulative evidence from several earlier studies suggests that the mitogenic effect of estrogens is mediated indirectly through a polypeptide growth factor. The primary focus of the present investigation was to determine whether an epidermal growth factor (EGF)-related polypeptide originates in the uterus of the immature or adult mouse under normal or altered estrogen status. Hybridization experiments revealed the presence of the 4.7-kilobase prepro-EGF mRNA in uteri of immature CD-1 mice. The level of this mRNA was augmented at least 2-fold in immature mice treated for 4 days with estrogen, but levels remained markedly low compared to those in submaxillary gland or kidney. Two preparations of pooled uterine luminal fluid from estrogen-treated immature mice contained EGF immunoreactivity (1.2 and 1.7 ng/ml) that was stable in response to acid (50 mM acetic acid) and heat. Negligible EGF (less than 20 pg/uterus) was detected in acid extracts of uteri from ovariectomized or cycling adult mice. After injection of 17 beta-estradiol (0.2 or 2.0 micrograms, ip), the levels of acid-extractable uterine EGF in ovariectomized adult mice up to 48 h after treatment were not different from those obtained with vehicle alone. Immunolocalization of EGF in the mouse uterus was demonstrated only after paraffin sections were first briefly treated with pronase. Staining was observed along the borders of luminal and glandular epithelial cells, especially at the apical region of the cells. Some staining was also observed in the myometrium; stromal cells were negative. Synthesis of the reactive material was apparently estrogen independent, since localization was retained in uteri of both ovariectomized and immature mice. Immunoblots of preparations of membranes from uterine homogenates or epithelial cells revealed a band at mol wt of about 130,000, which, along with other findings of the present study, suggests that EGF occurs predominantly as the membrane-bound precursor form in this organ, as has been previously shown for the kidney. Although the biological role of the precursor in the uterus is not known, we speculate that estrogens function in an autocrine circuit by stimulating processing of the membrane-bound EGF precursor. EGF elaborated by this mechanism might conceivably react with known complementary receptors on uterine epithelial cells to stimulate proliferation. PMID- 3286225 TI - Vitamin D-dependent calcium binding protein in rat uterus: differential effects of estrogen, tamoxifen, progesterone, and pregnancy on accumulation and cellular localization. AB - The present studies were undertaken to characterize the expression of calcium binding protein (CaBP or calbindin-D9k) in uterine tissues. Using immunohistochemical techniques, calbindin-D9k was localized to the uterine (luminal) epithelium of pregnant rats, but not present in the uterine epithelium of nonpregnant rats. Calbindin was found also in the uterine smooth muscle and endometrial stromal cells of pregnant animals. These latter localizations were reproduced in uteri of 21-day-old nonpregnant rats by administration of tamoxifen or physiological doses of estrogens. Estrogen and tamoxifen produced half-maximal increases of uterine calbindin at daily doses of 0.1 and 10 micrograms, respectively, and maximal responses at 0.3 and 40 micrograms/day. Testosterone and progesterone, at doses which increased the growth of the uterus, did not induce calbindin-D, and both hormones blocked estradiol's effect on uterine calbindin-D appearance. The epithelial localization of calbindin in pregnant uteri was not reproduced in nonpregnant animals by either estradiol (3 micrograms/day) or progesterone (1 mg/day). The localization of calbindin in uterine epithelium during pregnancy appears to be dependent upon an as yet unknown factor. In view of the large surface area of the luminal epithelium in pregnant animals, and the pregnancy-related expression of calbindin in these cells, we propose that uterine epithelium plays an important role in transport of calcium during pregnancy. PMID- 3286226 TI - The ontogeny of growth hormone receptors in the rabbit tibia. AB - To address the question of the mode of action of GH in stimulating longitudinal bone growth, we have used a panel of anti-GH receptor monoclonal antibodies to demonstrate GH receptors in the rabbit tibia and have studied the ontogeny of these receptors. In the neonate, receptors were localized in the hypertrophic zone between the cartilage canals, a region that develops into a secondary ossification center. In support of this finding, receptors were also localized on monolayer cultures of human infant costal chondrocytes. In 20- and 50-day-old rabbits, receptors were localized on reserve and proliferative chondrocytes in the growth plate. In 50- and 130-day-old rabbits receptors were localized on proliferative chondrocytes in the condylar cartilage. In older (180-day-old) rabbits with closed growth plates, GH receptors could not be detected, even in condylar cartilage. These results support the case for revision of the somatomedin hypothesis to accommodate a direct interaction between GH and receptors on epiphyseal chondrocytes. PMID- 3286227 TI - In situ hybridization histochemistry for messenger ribonucleic acid (mRNA) encoding gonadotropin-releasing hormone (GnRH): effect of estrogen on cellular levels of GnRH mRNA in female rat brain. AB - Using in situ hybridization histochemistry, we have detected perikarya containing mRNA encoding GnRH and GnRH-associated peptide (GAP) in rat brains. Synthetic DNA oligomers with sequences complementary to the rat cDNA encoding the GnRH structural region and the GAP structural region were hybridized to formaldehyde fixed coronal sections. The distribution and number of cells containing GnRH/GAP mRNA were similar to those shown by immunocytochemical studies. The areas in which GnRH mRNA perikarya were shown included the medial septal area, the diagonal band of Broca, the preoptic area, and the anterior hypothalamus. Up to 55 cells were detected in a single 12-micron section containing the diagonal band and organum vasculosum lamina terminalis (OVLT) whereas cell numbers diminished in more caudal regions. In addition, both probes labeled the same cells contained within adjacent sections. We used this technique to examine the effect of estrogen on GnRH mRNA levels in the area of the OVLT of normal and androgen sterilized female rats, using an estrogen treatment paradigm previously characterized in studies investigating the hypothalamic regulation of negative and positive estrogen feedback. We found that 7 days after ovariectomy, 2 days of estrogen treatment resulted in a significant reduction in the average cellular level of GnRH mRNA in both normal and androgen-sterilized females. Analysis of histograms relating the intensity of labeling to the abundance of cells suggested that a small population of GnRH cells responded to the estrogen treatment. However, we found no evidence for a discrete neuroanatomical segregation of such a subpopulation of GnRH-responsive cells within the area of the OVLT. PMID- 3286228 TI - Transfer of functional insulin receptors to receptor-deficient target cells. AB - Purified human insulin receptors incorporated into phospholipid vesicles have previously been shown to retain insulin binding as well as insulin-stimulated beta-subunit autophosphorylating activity. These vesicles were used as a vehicle to transfer receptors to the insulin receptor-deficient Madin-Darby canine kidney (MDCK) cell line. Fusion of control [14C] dioleoylphosphatidylcholine-labeled phospholipid vesicles with MDCK cells was found to be dependent on both the amount of time and the concentration of polyethylene glycol used for fusion. Optimal insulin receptor transfer, as determined by recovery of [125I]insulin binding, occurred when MDCK cells were incubated for 45 min at 37 C in the presence of 15% polyethylene glycol plus receptor-containing vesicles. Scatchard analyses for insulin receptor binding before and after vesicle fusion demonstrated no postfusion alteration in insulin receptor affinity and a 10-fold increase in the number of insulin receptors present in the MDCK cells. Fusion transfer of insulin receptors to MDCK cells rendered the cells sensitive to insulin (10-100 nM) for stimulation of glycogen synthesis. Chloroquine (0.1 mM) was found to block endosomal processing of receptor-bound [125I] insulin within 1 h. These findings indicate that insulin receptors function as dissociable units which can be inserted into target plasma membranes with resultant recoupling to cellular systems. PMID- 3286229 TI - Insulin regulates prolactin secretion and messenger ribonucleic acid levels in pituitary cells. AB - The regulation of PRL production in GH3 rat pituitary tumor cells and normal rat pituitary cells exposed to insulin was studied. Cells were treated with semisynthetic human insulin for up to 5 days. Insulin (0.7 nM) stimulated PRL production by 30%, and cortisol (100 nM) suppressed it by 80% in GH3 cells. Insulin (3.5 nM) partially blocked the suppression of PRL secretion induced by up to 100 nM cortisol. Equimolar doses of insulin-like growth factor I failed to consistently stimulate either basal PRL secretion into the medium or cortisol suppressed PRL in GH3 cells. A 65 nM concentration of insulin-like growth factor I was required to stimulate basal PRL secretion in GH3 cells. Relative levels of PRL mRNA sequences in both GH3 cells and normal rat pituitary cells were stimulated by insulin. When cells were incubated with cortisol (10 nM), PRL mRNA levels were suppressed to 40% of control values. Simultaneous incubation of cells with insulin (3.5 nM) partially reversed the cortisol-induced suppression of PRL mRNA to 60% of control values. The results show that insulin antagonizes cortisol induced suppression of PRL. Physiological doses of insulin stimulate PRL production and PRL mRNA levels, suggesting a direct effect of insulin on either PRL gene transcription or stabilization of PRL mRNA in these cells. PMID- 3286230 TI - Striated muscle fibers differentiate in primary cultures of adult anterior pituitary cells. AB - Anterior pituitary cells from adult male rats were cultured on a natural extracellular matrix (ECM). From the 5th day, spindle-shaped cells, fusing to form elongated fibers, were observed among the epithelial cells. These fibers later increased in size and number and were identified as striated muscle fibers, based on their multi-nucleation, cross-striation and rhythmic contraction. Striated muscle development was further validated by the appearance of cholinergic-nicotinic receptors, as demonstrated by the binding of 125I-alpha bungarotoxin (a-Btx). The effect of various supplements added to the cultures on a-Btx binding was used as a measure of muscle cell differentiation. ECM and serum were essential for myotube formation. Insulin (or IGF-I) and cortisol synergistically caused a 20-fold increase in myogenesis. FGF and EGF were effective only in the presence of insulin and cortisol. The data suggest that: (a) cells, derived from adult pituitary, differentiate, in primary culture, into striated muscle fibers; (b) the induction of this differentiation is multi factorial; ECM, serum, insulin and glucocorticoids facilitate this myogenesis. PMID- 3286231 TI - Autoantibodies to the thyrotropin receptor. AB - This review considers recent developments in our understanding of the properties of TRAb, particularly measurement of the antibodies and their sites of action and synthesis. Two new assay methods have allowed considerable improvements in the sensitivity, specificity, precision, and ease of measuring TRAb. In particular: 1) receptor assays based on inhibition of receptor-purified labeled TSH binding to detergent-solubilized TSH receptors and 2) bioassays based on stimulation of cAMP release from monolayer cultures of isolated thyroid cells. Detailed studies with the two assays indicate that TSH receptor antibodies nearly always act as TSH agonists in patients with a history of Graves' hyperthyroidism. Studies in areas of dietary iodine sufficiency suggest that measurement of the antibodies at various stages in the course of treating Graves' disease can be of value in predicting the outcome of therapy. However, in areas of iodine deficiency, difficulties in the ability of patients' thyroid tissue to recover from the effects of antithyroid drugs may prevent the receptor antibodies from causing a relapse of thyrotoxicosis. Consequently, the predictive value of receptor antibody measurements would be expected to be lower in these geographical areas. Although patients with a history of Graves' hyperthyroidism nearly always have TRAb which act as TSH agonists, about 20% of patients with frank hypothyroidism due to autoimmune destruction of the thyroid have TRAb which act as TSH antagonists (blocking antibodies). There is some evidence that these blocking antibodies can cause hypothyroidism particularly in the neonate. With regard to the site of synthesis of TRAb, there is now direct evidence that they are synthesized by thyroid lymphocytes, particularly the lymphocytes in close proximity to thyroid follicular cells. This is consistent with the well established effects of antithyroid treatment (drugs, radioiodine, or surgery) on TRAb levels in addition to their effects on thyroid hormone synthesis. Recent studies using affinity labeling with 125I-labeled TSH have enabled elucidation of the structure of the TSH receptor. TSH receptors in human, porcine, and guinea pig thyroid tissue have a two-chain structure in which the TSH binding site is formed on the outside surface of the cell membrane by a water-soluble A subunit (Mr approximately 50 K). The A subunit is linked by a disulfide bridge and weak noncovalent bonds to the amphiphilic B subunit (Mr approximately 30 K). This subunit, which penetrates the lipid bilayer, probably forms the site for interaction of the receptor with the regulatory subunits of adenylate cyclase.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3286232 TI - Immunoreactive gastric inhibitory polypeptide. PMID- 3286233 TI - Proopiomelanocortin processing in the pituitary, central nervous system, and peripheral tissues. PMID- 3286234 TI - Contemporary aspects of discrete peak-detection algorithms. I. The paradigm of the luteinizing hormone pulse signal in men. PMID- 3286235 TI - Cachectin (tumor necrosis factor): a macrophage hormone governing cellular metabolism and inflammatory response. PMID- 3286236 TI - Diabetes in the undernourished: coincidence or consequence? PMID- 3286237 TI - Mechanisms controlling corpus luteum function in sheep, cows, nonhuman primates, and women especially in relation to the time of luteolysis. PMID- 3286238 TI - Compensatory growth of the lung following partial pneumonectomy. AB - In a variety of species, partial resection of the lung initiates rapid compensatory growth of the remaining tissue adequate to restore normal total lung mass. Increases in tissue content of protein, RNA, and DNA in proportion to dry lung weight suggest hyperplastic growth of the tissue, rather than cellular hypertrophy. A general acceleration of cell division is supported further by the results of quantitative morphometric studies, which indicate that both cellular and functional characteristics of the peripheral lung, including alveolar and capillary volumes and thickness and surface area of the blood-gas barrier, are maintained when compensatory growth is complete. The rate and nature of the growth response are subject to hormonal modulation, particularly by adrenal steroids and growth hormone. Little is known, however, regarding the specific actions of these agents or of additional factors that may be primary regulators of the initiation and cessation of accelerated compensatory growth. Definition of such regulatory mechanisms is of critical importance in understanding normal growth and development of the lung and the response of the lung to injury, as well as in future efforts to manipulate growth and/or repair of the tissue. PMID- 3286239 TI - Intraphagosomal pH in alveolar macrophages after phagocytosis in vivo and in vitro of fluorescein-labeled yeast particles. AB - The pH in phagolysosomes of rabbit alveolar macrophages was studied using yeast particles labeled with fluorescein isothiocyanate (FITC). The yeast particles were added to the macrophages in vitro a few hours or 1 day after they had been lavaged from the lung and in vivo 3 h or 1 day before the lungs were lavaged. Intracellular pH was estimated from the ratio between the fluorescence intensity at wavelength 519 nm with excitation at wavelengths of 495 and 450 nm. In both the in vitro and in vivo experiments pH decreased significantly during the first hours after lavage, but after a few hours reached almost the day-2 levels, i.e., 4.9-5.4. The decrease in pH was related to time after lavage and not to time after phagocytosis of the particles. It is suggested that intracellular measurements of pH in alveolar macrophages should be combined with determinations of lung clearance of metal particles. PMID- 3286240 TI - Chronic exposure to cadmium did not impair vitamin D metabolism in monkeys. AB - Vitamin D metabolism in primates with chronic exposure to cadmium was studied in relation to Itai-Itai disease. In a series of experiments, crab-eating monkeys were fed cadmium-contaminated rice (1.33 micrograms Cd/g) or a diet containing 3 micrograms/g cadmium chloride for 6 years. These treatments had no effect on the 1,25-dihydroxyvitamin D (1,25(OH)2D), 24,25-dihydroxyvitamin D (24,25(OH)2D), and 25-hydroxyvitamin D (25(OH)D) in the serum. This is consistent with unchanged production of 1,25(OH)2D and 24,25(OH)2D by renal mitochondria prepared from the same animals. No indication of renal dysfunction was observed. In another series of experiments, rhesus monkeys were fed a diet containing 3, 10, 30, or 100 micrograms/g cadmium for 9 years. Serum vitamin D metabolites and renal production of 24,25(OH)2D also remained unchanged. In contrast, renal 25(OH)D-1 hydroxylase (1-hydroxylase), which is responsible for the production of 1,25(OH)2D, seemed to be suppressed in the animals fed 30 or 100 micrograms/kg cadmium-contaminated diet (no statistical significance). These animals had indications of mild renal dysfunction, and there was a strong negative correlation between 1-hydroxylase and urinary concentration of either protein or beta 2-microglobulin. These data suggest a slight change in the total enzyme activity, possibly due to mild renal dysfunction. Since substrate (25(OH)D) concentration is much lower and thus rate-limiting in vivo as compared with that in vitro assay system used in this study, the slight change of enzyme activity would not have been sufficient to affect the serum level of 1,25(OH)2D. No skeletal abnormality was observed in any of these animals. In view of these data, the length of cadmium exposure and the life span of animals as well as epidemiological data published elsewhere, factors other than cadmium may also be involved in the development of Itai-Itai disease. PMID- 3286242 TI - Glucose-lowering effect of fenugreek in non-insulin dependent diabetics. AB - The effect of fenugreek on postprandial glucose and insulin levels following the meal tolerance test (MTT) was studied in non-insulin dependent diabetics (NIDDM). The addition of powdered fenugreek seed (15 g) soaked in water significantly reduced the subsequent postprandial glucose levels. The plasma insulin also tended to be lower in NIDDM given fenugreek but without a statistical difference. Fenugreek had no effect on lipid levels 3 h following the MTT. Fenugreek may have a potential benefit in the treatment of NIDDM. PMID- 3286241 TI - Asbestos exposure indices. AB - The ability of inhaled asbestos to produce asbestosis, lung cancer, and mesothelioma in both humans and animals is well established, and asbestos exposures in the occupational and general community environment are recognized as significant hazards. However, it has not been possible to establish realistic and credible dose-response relationships, primarily because of our inability to define which constituents of the aerosols produce or initiate the pathological responses. It is generally acknowledged that the responses are associated with the fibers rather than the nonfibrous silicate mineral of the same chemical composition. Available data from experimental studies in animals exposed by injection and inhalation to fibers of defined size distributions are reviewed, alone with data from studies of fiber distributions in lungs of exposed humans in relation to the effects associated with the retained fibers. It is concluded that asbestosis is most closely related to the surface area of retained fibers, that mesothelioma is most closely associated with numbers of fibers longer than approximately 5 microns and thinner than approximately 0.1 micron, and that lung cancer is most closely associated with fibers longer than approximately 10 microns and thicker than approximately 0.15 micron. The implications of these conclusions on methods for fiber sampling and analyses are discussed. PMID- 3286244 TI - Collection of urine. PMID- 3286243 TI - Dose related effects of the kappa agonist U-50, 488H on behaviour, nociception and autonomic response in the horse. AB - Current opiate receptor theory suggests that kappa agonists should provide good analgesia without producing marked central nervous system stimulation. U-50,488H is an experimental narcotic analgesic that is a selective kappa agonist. In the present study, U-50,488H produced good analgesia in horses using both the skin twitch and hoof withdrawal reflex assays. Further, the analgesia was relatively long lasting (120 mins) compared to other mu-agonists tested in horses. The locomotor response to U-50,488H was less than observed with ethylketazocine and butorphanol, and has yielded the smallest locomotor response of any of the narcotic analgesics tested to date. Other work showed that the autonomic responses to U-50,488H were less than those of other narcotic analgesics, and that the analgesic response to this drug was blocked by naloxone. Based on its ability to produce analgesia with little other stimulatory action, U-50,488H shows promise of becoming a useful narcotic analgesic in equine medicine. PMID- 3286245 TI - Utility of short-term tests for genetic toxicity in the aftermath of the NTP's analysis of 73 chemicals. PMID- 3286246 TI - Commentary on the status of short-term tests for chemical carcinogens. PMID- 3286247 TI - Computer assisted short-term test battery design: some questions. PMID- 3286249 TI - Induction of mitotic chromosome loss in the diploid yeast Saccharomyces cerevisiae D61.M by genotoxic carcinogens and tumor promoters. AB - Three genotoxic carcinogens and eight tumor promoters were tested for induction of aneuploidy, specifically chromosome loss, in Saccharomyces cerevisiae D61.M. This is a heterozygous diploid yeast strain that permits the scoring of segregants expressing three linked recessive markers (cyhR2, ade6, and leu1), two of which (ade6 and leu1) are located close to the centromere on opposite arms of chromosome VII. The centromere marker leu was routinely checked, and a positive control (bavistan) was run with every experiment. The three genotoxic carcinogens aflatoxin B1, benzo(a)pyrene, and 7,12-dimethylbenz(a)anthracene did not induce aneuploidy, independent of the presence or absence of an exogenous metabolic activation system (rat liver homogenate; S9). Four of the eight tumor promoters tested induced chromosome loss but not mitotic recombination or mutation: cholic acid, lithocholic acid, phenobarbital, and saccharin. Diethylstilbestrol (DES) led to positive as well as to negative results in several independent experiments. In the case of the positive experiment, DES also induced putative recombinants. Three tumor promoters induced neither chromosome loss nor mitotic recombination: anthralin, 4,4'-dichloro-diphenyl-ethane (DDT) and gamma hexachlorcyclohexane (lindane). From our experiments it can be concluded that the hypothesis put forward by Parry et al. [Nature; 294:263-265], according to which tumor promoters induce chromosome loss in yeast, is not correct in a general sense. In our set of eight tumor promoters, only one half distinctly induced chromosome loss. PMID- 3286248 TI - Different mutational profiles induced by N-nitroso-N-ethylurea: effects of dose and error-prone DNA repair and correlations with DNA adducts. AB - The DNA adducts and mutational profile produced by N-nitroso-N-ethylurea (ENU) in Salmonella are examined. The adduct profile produced by ENU in isolated DNA and at two doses in Salmonella were similar, with one exception: O6-ethylguanine (O6 EtG) was not detected at the low dose in Salmonella. This adduct was presumably repaired by a constitutive repair system. The premutagenic adducts, O2-ethyl thymidine (O2-EtdT) and O4-ethylthymidine (O4-EtdT) were detected, with the former adduct present at higher levels. The mutational profile was also determined at the same doses by utilizing a system involving a series of histidine auxotrophs of Salmonella with differing mutagenic specificities and a further subclassification of the revertants. Four different patterns of mutagenesis were observed; these were dependent on dose and on the presence or absence of the plasmid pKM101. The mutational spectrum produced at the higher dose in strains without the plasmid consisted mainly of GC----AT transitions. At the high dose, in strains harboring pKM101, three base changes contributed importantly to the mutational spectrum: GC----AT, AT----GC, and AT----CG. At the low dose in the strains without pKM101, little mutagenesis was observed, and in strains containing pKM101, mutagenesis was greatly enhanced with the most frequent mutations resulting from AT----GC and AT----CG base changes. O6-EtG was presumably responsible for the bulk of the GC----AT transitions at the high dose. Calculations and evidence are presented indicating that O2-EtdT is responsible for at least some of the mutagenesis that occurs at AT base pairs. O4-EtdT and O2 EtdT are probably responsible for a major fraction of the AT----GC transitions, and we suggest that error-prone repair activity acting on O2-EtdT and/or O4-EtdT results in the AT----CG transversions. PMID- 3286250 TI - Induction of genetic duplications in Salmonella typhimurium by dialkyl sulfates. PMID- 3286251 TI - Hypotheses of peripheral and central mechanisms underlying occupational muscle pain and injury. AB - In an overview of the problem of occupational muscle pain the evidence indicates that injury is more common the greater the load and the worse the posture in which the work is performed. The commonest are backstrains or ligament or joint damage due to overuse. Fatigue is associated with alterations in energy metabolites in muscle while pain is often due to microscopical damage to the cellular architecture. The progress of pathological changes in muscle following occupational injury may be similar to those seen in primary fibromyalgia (fibrositis) because of a final common pathway involving calcium-induced secondary damage. Occupational muscle pain frequently occurs in the muscles supporting the upper limb girdle and head in workers engaged in repetitively performing skilled manipulations or activities requiring high or sustained mental concentration. It is suggested that both occupational myalgia of this kind may be due to an imbalance in the use of muscles for postural activity (holding or supporting fine movements) compared to phasic use in dynamic work. While there are undoubtedly muscular indications of damage these may be secondary to alterations in (unconscious) central motor control mechanisms. PMID- 3286253 TI - Clinical consideration in referred muscle pain and tenderness. Connective tissue reactions. AB - Muscle pain and tenderness is caused either by changes in the muscle itself or by disease promoting factors outside the muscle. This paper gives a review of referred causes of muscle pain and tenderness with special emphasis on pathology in the strong supportive types of connective tissue. PMID- 3286254 TI - Transcriptional regulation of genes for plant-type ribulose-1,5-bisphosphate carboxylase/oxygenase in the photosynthetic bacterium, Chromatium vinosum. AB - The content of ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) in the photosynthetic purple sulfur bacterium, Chromatium vinosum, grown either heterotrophically or autotrophically, was highly correlated with the level of 2.0 kb mRNA encoding genes for both large (rbcL) and small (rbcS) subunits. This result indicates the transcriptional regulation of Rubisco biosynthesis in Chromatium cells. In the analysis of transcripts for rbcL and rbcS in Escherichia coli transformed by a plasmid bearing both genes downstream of E. coli tac promoter (pCKS1), the mRNAs were found to be the same sizes as those from Chromatium. However, we were unable to detect mRNA for Rubisco in E. coli harboring a plasmid containing the genes for Rubisco and its own promoter without any E. coli promoters (pCUB1). In the in vitro transcription experiment of pCKS1 and pCUB1 by E. coli RNA polymerase, it was observed that the enzyme could not recognize the Rubisco promoter. Therefore, we have purified RNA polymerase from Chromatium cells and developed a homologous in vitro transcription system. We have detected factor(s) for transcriptional regulation from either heterotrophically or autotrophically grown cells of Chromatium using the homologous in vitro transcription system. PMID- 3286255 TI - Nucleotide sequence of the gene for aqualysin I (a thermophilic alkaline serine protease) of Thermus aquaticus YT-1 and characteristics of the deduced primary structure of the enzyme. AB - Aqualysin I is an alkaline serine protease which is secreted into the culture medium by Thermus aquaticus YT-1, an extreme thermophile [Matsuzawa, H., Hamaoki, M. & Ohta, T. (1983) Agric. Biol. Chem. 47, 25-28]. The gene encoding aqualysin I was cloned into Escherichia coli using synthetic oligodeoxyribonucleotides as hybridization probes. The nucleotide sequence of the cloned DNA was determined. The primary structure of aqualysin I, deduced from the nucleotide sequence, agreed with the NH2-terminal sequence previously reported and the determined amino acid sequences, including the COOH-terminal sequence, of the tryptic peptides derived from aqualysin I. Aqualysin I comprised 281 amino acid residues and its molecular mass was determined to be 28,350. On alignment of the whole amino acid sequence, aqualysin I showed high sequence homology with the subtilisin-type serine proteases, and 43% identity with proteinase K, 37-39% with subtilisins and 34% with thermitase. Extremely high sequence identity was observed in the regions containing the active-site residues, corresponding to Asp32, His64 and Ser221 of subtilisin BPN'. The nucleotide sequence of the cloned DNA (1105 nucleotides) revealed that it contains the entire gene encoding aqualysin I and one open reading frame without a translational stop codon. Therefore, aqualysin I was considered to be produced as a large precursor, which contains a NH2-terminal portion, the protease and a COOH-terminal portion. The G + C content of the coding region for aqualysin I was 64.6%, which is lower than those of other Thermus genes (68-74%). The codon usage in the aqualysin I gene was rather random in comparison with that in other Thermus genes. PMID- 3286252 TI - Biochemical correlates of fatigue. A brief review. AB - Muscle fatigue, defined as a decreased force generating capacity, develops gradually during exercise and is distinct from exhaustion, which occurs when the required force or exercise intensity can no longer be maintained. We have reviewed several biochemical and ionic changes reported to occur in exercising muscle, and analysed the possible effects these changes may have on the electrical and contractile properties of the muscle. There is no evidence that substrate depletion can account for the decreased force generating capacity, but this factor may be important for the rate of energy turnover and be a major determinant for endurance. Increased concentration of inorganic phosphate and hydrogen ions will depress the force generating capacity, but since fatigue can develop gradually without accumulation of these ions they can only be important when aerobic ATP production is insufficient to support the contractions. Evidence is presented showing that a disturbed balance of K+ alone might cause depolarisation block at high stimulation frequencies, but extracellular K+ accumulation does not increase gradually during prolonged dynamic or static exercise, and is therefore not closely related to fatigue. The repeated release of Ca2+ from the sarcoplasmic reticulum (SR) during muscular activity is suggested of Ca2+ by the mitochondria, increasing with stimulation frequency and duration and possibly also deteriorating mitochondrial function. We therefore speculate that decreased Ca2+ availability for release from SR might contribute to a gradual decline in force generating capacity during all types of exercise. PMID- 3286256 TI - Primary structure of glycolate oxidase from spinach. AB - The primary structure of glycolate oxidase from spinach has been determined. Six different types of peptide digest were investigated, utilizing CNBr, proteolytic enzymes, and chemical modifications to change a specificity of cleavage. In total, 90 peptides were purified and analyzed. The studies were aimed at correlation with crystallographic analysis of the same protein carried through in parallel and with cDNA studies which utilized initially determined amino acid sequences for synthesis of oligonucleotide probes. Continuous comparisons with the results from the crystallographic studies helped at an early stage to secure peptide overlaps, at the same time as the peptide data secured residue assignments in the electron density maps. In the end, all data agree and regions from all parts of the molecule have been checked by independent methods of analysis. The primary structure establishes the type of N-terminal post translational processing, and yields information on segments not fully defined in electron density maps. Combined, the chemical, crystallographic, and cDNA data give extensive reliability. The peptide analysis shows that the N-terminus is blocked by acylation of the initiator methionine, which is in a primary structure typical for non-removal of the methionine in the processing events of the nascent protein chain. The molecule is comparatively rich in menthionine and some other generally less common residues, but has only one cysteine residue and no extensive hydrophobic segment. An amino acid sequence homology with flavocytochrome b2 from yeast, as expected from known similarities in tertiary structure, is observed (33% residue identities). PMID- 3286257 TI - Aminopeptidase yscII of yeast. Isolation of mutants and their biochemical and genetic analysis. AB - Mutant strains of the yeast Saccharomyces cerevisiae defective in aminopeptidase yscII were isolated by screening for reduced external activity against the chromogenic substrate lysine beta-naphthylamide. One of the selected mutant strains analyzed in detail showed wild-type staining activity when tested at 23 degrees C but mutant activity after exposure to 37 degrees C, suggesting a temperature-sensitive mutation. Electrophoretic separation of mutant crude extracts on non-denaturing polyacrylamide gels and subsequent activity staining using lysine and leucine beta-naphthylamides as substrates revealed that in all strains isolated the same distinct activity band was affected, which corresponded to the aminopeptidase activity identified previously as aminopeptidase yscII [Achstetter, T., Ehmann, C. & Wolf, D. H. (1983) Arch. Biochem. Biophys. 226, 292 305]. All mutants strains isolated fell into the same complementation group. Tetrad dissection of sporulated diploids heterozygous for the wild-type and mutant allele resulted in a 2:2 segregation of mutant and wild-type phenotype indicating a single gene mutation. The characteristics of the mutations analyzed point to the gene which we called APE2 as the structural gene of aminopeptidase yscII. No vital consequences of aminopeptidase yscII deficiency on cell life and differentiation could be detected. However, the enzyme seems to be involved in the cellular supply of leucine from externally offered leucine-containing dipeptide substrates. PMID- 3286258 TI - Properties of N-terminal truncated yeast aspartyl-tRNA synthetase and structural characteristics of the cleaved domain. AB - Cytoplasmic aspartyl-tRNA synthetase from Saccharomyces cerevisiae is a dimer made up of identical subunits of Mr 64,000 as shown by biochemical and crystallographic analyses. Previous studies have emphasized the high sensitivity of the amino-terminal region (residues 1-32) to proteolytic enzymes. This work reports the results of limited tryptic or chymotryptic digestion of the purified enzyme which gives rise to a truncated species that has lost the first 50-64 residues with full retention of both the activity and the dimeric structure. In contrast the larger tryptic fragment is distinguished from the whole enzyme by its weaker retention on heparin-substituted agarose gels. The cleaved N-terminal part presents peculiar structural features, such as a high content in lysine residues arranged in a palindromic fashion. The properties of the trypsin modified enzyme and of the cleaved amino-terminal region are discussed in relation to the known structural characteristics of aspartyl-tRNA synthetase and of other eukaryotic aminoacyl-tRNA synthetases. PMID- 3286259 TI - The NADPH-linked acetoacetyl-CoA reductase from Zoogloea ramigera. Characterization and mechanistic studies of the cloned enzyme over-produced in Escherichia coli. AB - The NADPH-linked acetoacetyl-CoA reductase, (R)-3-hydroxyacyl-CoA dehydrogenase (EC 1.1.1.36), from the bacterium Zoogloea ramigera, involved in the formation of D-3-hydroxybutyryl-CoA for poly(D-3-hydroxybutyrate) biosynthesis, has been purified from an over-producing Escherichia coli strain. The purification was achieved in two steps, yielding an electrophoretically homogeneous enzyme of high specific activity (608 U/mg). The enzyme is an alpha 4 homotetramer of four 25 kDa subunits. It has a Km of 2 microM and a kcat/Km of 1.8 X 10(8) M-1 s-1 for acetoacetyl-CoA; it is inhibited by acetoacetyl-CoA above 10 microM. K is 10(-10) M for the dehydrogenation. Kinetic studies of the back reaction revealed a sequential mechanism involving a ternary complex. The stereospecificity of the hydride-equivalent transfer was demonstrated using NMR techniques to be 4S (B side). Using the fingerprint method proposed by Wierenga et al. [(1986) J. Mol. Biol. 187, 101-107], we identified a 28-residue stretch (residues 3-31) as a possible NADPH fold. Finally the specificity of the reductase was examined using 3-oxo-acyl-CoA analogs and analogs lacking the adenosine 3',5'-bisphosphate moiety of CoA. Only the straight-chain C5 analog (3-oxo-propionyl-CoA) was found to be an alternative substrate (40%) for the reductase. PMID- 3286260 TI - A novel fungal enzyme, NADPH-dependent carbonyl reductase, showing high specificity to conjugated polyketones. Purification and characterization. AB - A novel enzyme which specifically catalyzes the reduction of conjugated polyketones was purified to homogeneity from cells of Mucor ambiguus AKU 3006. The enzyme has a strict requirement for NADPH and irreversibly reduces a number of quinones such as p-benzoquinone, alpha-naphthoquinone and acenaphthenequione. The enzyme also reduces polyketones such as isatin and ketopantoyl lactone, and their derivatives. The apparent Km values for isatin and ketopantoyl lactone are 49.9 microM and 714 microM, respectively. The reduction of ketopantoyl lactone proceeds stereospecifically to yield L-(+)-pantoyl lactone. The pro-S (A) hydrogen at C-4 of NADPH is transferred to the substrate. The enzyme is not a flavoprotein and consists of two polypeptide chains with an identical relative molecular mass of 27,500. Quercetin, dicoumarol and some SH reagents inhibit the enzyme activity. 3-Methyl-1,2-cyclopentanedione and 1,3-cyclohexanedione are uncompetitive inhibitors with Ki values of 80.9 microM and 64.5 microM, respectively, to ketopantoyl lactone. PMID- 3286261 TI - The arrhythmogenic effects of antiarrhythmic drugs. PMID- 3286262 TI - Arrhythmogenesis and programmed stimulation techniques. PMID- 3286263 TI - Noninvasive techniques in the evaluation of the arrhythmogenic effects. PMID- 3286264 TI - Recorded sudden cardiac death: relationship to antiarrhythmic therapy. PMID- 3286265 TI - Delayed repolarization as antiarrhythmic action. PMID- 3286266 TI - How do kinetics relate to toxicity of antiarrhythmic drugs? PMID- 3286267 TI - Mode of action of antiarrhythmic drugs and the implicated arrhythmogenic risk. AB - The mode of antiarrhythmic action of drugs usually cannot be extrapolated from their electrophysiologic properties despite extensive in vitro and in vivo assessment: in most cases, the mechanism of arrhythmias remains uncertain and cannot be established by clinical evaluation including electrophysiologic study; in specific cases where the arrhythmia substrate is fully described, the exact origin of antiarrhythmic action is unknown, especially when chronic preventive treatment is considered where triggering events are probably important. Nevertheless, the profound electrophysiologic changes resulting from antiarrhythmic drugs alter several delicate balances, at the cellular level (repolarizing and depolarizing currents) and at the tissue level (refractory period/conduction time ratio). Some afterdepolarizations can be elicited, especially when repolarization is delayed by long cycle lengths and K+ current inhibition; reentry is enhanced when conduction impairment occurs without similar change in refractoriness. Proarrhythmic effects of drugs seem to relate to these alterations and caution should be exerted when ECG shows drug-induced QT or QRS prolongations. PMID- 3286268 TI - How do pharmacokinetics relate to pharmacodynamics of antiarrhythmic drugs? PMID- 3286269 TI - Arrhythmias in acute myocardial infarction: special considerations in treatment and monitoring. PMID- 3286270 TI - Evaluation of the carotid bifurcation by duplex ultrasound, intravenous and intra arterial digital subtraction angiography. AB - In 167 patients with cerebrovascular disorders 323 carotid bifurcations were investigated by Duplex ultrasound. In 100 of these patients, additionally intravenous digital subtraction angiography (DSA) was performed and in 35 patients, also intra-arterial DSA was carried out. In 32 patients all three procedures were performed. Comparing the results of Duplex scan and intravenous DSA with intra-arterial DSA it can be concluded that Duplex scan and intravenous DSA are comparable as screening methods for the evaluation of haemodynamically relevant stenoses and occlusions in extracranial artery disease. However, for the evaluation of stenotic vessels of less than 50% lumen reduction the Duplex scan showed a higher agreement rate with a contingency coefficient of 0.957 in comparison to intravenous DSA with a contingency coefficient of 0.903. PMID- 3286271 TI - Screening monoclonal islet cell surface antibodies (ICSA) by radioimmunoassay- detection of crossreactivity with ICSA from insulin-dependent (type 1) diabetic patients. AB - A radioimmunoassay for the detection of monoclonal islet cell antibodies was developed using rat insulinoma cells as antigen carriers and 125I-labeled affinity-chromatographically purified anti-mouse Ig antibodies for detecting cell bound mouse Ig. Prior to the assay cells had been attached to glass tubes by poly dimethyl-diallyl ammonium chloride thus allowing to perform the assay as easy as a solid-phase immunoassay. Incubation protocol and cell number were chosen to ensure a high sensitivity of the assay. Results compared well with immunofluorescence findings. Of seven monoclonal islet cell antibodies tested for crossreactivity only one was displaceable by islet cell surface antibodies from diabetic sera. This antibody was induced by immunization with human islets whereas all others were from mice which had been autoimmunized with streptozotocin and complete Freund's adjuvant. PMID- 3286272 TI - The effect of mixing regular- and intermediate-acting insulins on their absorption and biological activity. AB - Many insulin-dependent diabetics are now treated with different regimens of short and intermediate-acting insulins. The new L-insulin S.N.C. (Berlin-Chemie) is thought to be appropriate for a combination with regular insulin. We investigated whether or not absorption kinetics and biological activity changes when L-insulin S.N.C. is mixed with regular insulin S.N.C. Eight non-obese healthy male subjects were connected to the BIOSTATOR. After an overnight fast 0.1 U of insulin S.N.C. and 0.3 U per kg b.w. of L-insulin S.N.C. or Monotard MC insulin (NOVO) were administered either in a mixture or separately. Injecting L-insulin S.N.C. and insulin S.N.C. in a mixture there was some, but not a statistically significant, delay in absorption of insulin. A mixture of insulin S.N.C. and Monotard provoked a marked delay of absorption during the first two hours. To examine biological activity we used the BIOSTATOR (glucose controlled dextrose infusion system). Glucose infusion rate necessary to keep blood glucose steady state concentration was taken as a measure of insulin action. Whereas mixing of insulin S.N.C. and L insulin S.N.C. only slightly changed the profile of biological activity, a mixture of insulin S.N.C. and Monotard has a clear-cut higher potency during the late phase when compared with separately injected insulins. Therefore, insulin S.N.C. and Monotard should not be mixed. A mixture of insulin S.N.C. and L insulin S.N.C. is also not recommended but can be done in exceptional cases. PMID- 3286273 TI - Long-term trophic effect of sodium restriction on the rat adrenal zona glomerulosa. I. Its partial independence of the renin-angiotensin system. AB - The mechanism of the trophic effect of chronic sodium restriction on the zona glomerulosa of the rat adrenals was investigated by combined morphometric and biochemical techniques. In the normal rats, prolonged sodium deprivation caused a significant hypertrophy of the zona glomerulosa and its parenchymal cells, coupled with a conspicuous rise in the plasma concentration of aldosterone. Analogous results were observed in animals simultaneously administered captopril and maintenance doses of angiotensin II. However, in this last case, the changes were significantly lower than those observed in the normal rats. These findings are compatible with the view that the activation of the renin-angiotensin system is not the sole mechanism involved in the stimulation of the growth and steroidogenic capacity of rat adrenal zona glomerulosa induced by chronic sodium restriction. PMID- 3286274 TI - Long-term trophic effect of sodium restriction on the rat adrenal zona glomerulosa. II. The possible involvement of the inhibition of the dopaminergic system. AB - The effects of chronic administration of metoclopramide or bromocriptine (two drugs which act as antagonist and agonist of dopamine receptors) on the zona glomerulosa of captopril-treated rats administered maintenance doses of angiotensin II, were investigated by combined morphometric and biochemical techniques. It was found that metoclopramide provoked a significant hypertrophy of the zona glomerulosa and its parenchymal cells, coupled with a persistent rise in the plasma concentration of aldosterone, only in rats fed a normal diet. Conversely, bromocriptine exerted an evident inhibitory effect on the zona glomerulosa growth and steroidogenic capacity only in chronically sodium-deprived animals. These findings strongly suggest that sodium balance modulates the activity of the dopaminergic system, whose chronic suppression may be involved in the mechanism underlying the extra-angiotensin adrenoglomerulotrophic effect of prolonged sodium restriction. PMID- 3286275 TI - Exogenous ATP causes the contraction of intact fibroblasts in vitro. AB - The contraction of intact fibroblasts was investigated in vitro. The addition of ATP to the cells lead to a rapid, reversible reduction of cell area, which appeared to be a contraction. The change of cell area was measured using image analysis. ATP (15 mM) elicited the maximal contraction, with a 50% reduction in area achieved within 90 s. Adenosine was a partial agonist for the contraction. The contraction was dependent on control of the environmental calcium; cells in a calcium- and magnesium-free environment underwent spontaneous contraction. Replenishing the calcium and magnesium lead to stability of the cells. Since fibroblast contraction is involved in wound healing at many sites in the body, this system provides a physiological model for the direct investigation of fibroblasts with intact cell membranes, and allows for the testing of drugs which may influence wound healing in vivo. PMID- 3286277 TI - Codominant expression of a mutation affecting the cAMP-dependent protein kinase catalytic subunit in somatic cell hybrids of LLC-PK1 cells. AB - The LLC-PK1 mutant cell lines FIB4 and FIB6 are affected in the catalytic (C) subunit of cAMP-dependent protein kinase (cAMP-PK) such that they possess less than 10% parental activity. However, by Western blot analysis they were shown to possess normal levels of C subunit protein. Somatic cell hybrids were derived between mutant and LLC-PK1 cells, and examined for complementation of the cAMP-PK lesion. Codominant expression of mutant and normal alleles was observed, in that somatic cell hybrids between FIB4 and LLC-PK1, and between FIB6 and LLC-PK1 cells, exhibited cAMP-PK activity 60-75% that of LLC-PK1 cells, intermediate between mutant and normal parental cell lines. The cAMP-PK of the FIB6 x LLC-PK1 and FIB4 x LLC-PK1 hybrids was examined by ion exchange chromatography. In contrast to the FIB6 and FIB4 mutants which lack an active Type I cAMP-PK, the hybrids retained levels of active Type I cAMP-PK greater than 30% that of LLC PK1, concomitant with the retention of catalytic activity. It was concluded that the loss of Type I kinase in the FIB6 and FIB4 mutants is most likely a consequence of the lesion in the cAMP-PK C subunit. All somatic cell hybrids examined showed levels of cAMP-PK C subunit (as determined by Western blot analysis), and in vivo regulation of cAMP-PK activation (in response to hormonal or nonreceptor-mediated stimulation of adenylate cyclase), completely comparable to those of the parental LLC-PK1 cells. Hence, no aberrant regulation of either cAMP-PK subunit levels or cAMP-PK activities was evident in the somatic cells hybrids. All data were consistent with the hypothesis that FIB4 and FIB6 contain a structural mutation affecting the cAMP-PK catalytic subunit that is expressed phenotypically in the presence of the normal allele. PMID- 3286276 TI - Immunolocalization of 7-2-ribonucleoprotein in the granular component of the nucleolus. AB - Certain autoimmune sera contain antibodies against a nucleolar ribonucleoprotein particle associated with 7-2-RNA (R. Reddy et al. (1983) J. Biol. Chem. 258, 1383; C. Hashimoto and J. A. Steitz (1983) J. Biol. Chem. 258, 1379). In this study, we showed by immunofluorescence microscopy that antibodies reactive with 7 2-ribonucleoprotein immunolocalized in the granular regions of actinomycin D and 5,6-dichloro-1-beta-D-ribofurano-sylbenzimidazole (DRB)--segregated nucleoli from Vero cells. By electron microscopic immunocytochemistry, antigen-antibody complexes were located in the granular component of transcriptionally active nucleoli from rat liver hepatocytes and HeLa cells. Anti-7-2-RNP antibodies from two autoimmune sera immunoprecipitated a major protein of Mr 40,000 from [35S] methionine--labeled HeLa cell extract. The immunolocalization data suggest that 7 2-ribonucleoprotein may be involved in stages of ribosome biogenesis which take place in the granular component of the nucleolus, i.e., assembly, maturation, and/or transport of preribosomes. PMID- 3286278 TI - Recovery from severe hematopoietic suppression using recombinant human granulocyte-macrophage colony-stimulating factor. AB - The ability of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) to enhance recovery of a radiation-suppressed hematopoietic system was evaluated in a nonuniform radiation exposure model using the rhesus monkey. Recombinant human GM-CSF treatment for 7 days after a lethal, nonuniform radiation exposure of 800 cGy was sufficient to enhance hematopoietic reconstitution, leading to an earlier recovery. Monkeys were treated with 72,000 U/kg/day of rhGM-CSF delivered continuously through an Alzet miniosmotic pump implanted subcutaneously on day 3. Treated monkeys demonstrated effective granulocyte and platelet levels in the peripheral blood, 4 and 7 days earlier, respectively, than control monkeys. Granulocyte-macrophage colony-forming unit (CFU-GM) activity in the bone marrow was monitored to evaluate the effect of rhGM CSF on marrow recovery. Treatment with rhGM-CSF led to an early recovery of CFU GM activity suggesting that rhGM-CSF acted on an earlier stem cell population to generate CFU-GM. Thus, the effect of rhGM-CSF on hematopoietic regeneration, granulocyte recovery, and platelet recovery are evaluated in this paper. PMID- 3286279 TI - A new multichamber counterflow centrifugation rotor with high-separation capacity and versatile potentials. AB - A new closed system for counterflow centrifugation (elutriation) is described. The system was developed to increase the capacity of counterflow centrifugation in order to be able to separate bone marrow intended for allogeneic bone marrow transplantation within 3 h. The rotor has the capacity for up to four separation chambers, offering the possibility of separating either a single-cell suspension under equal or differing conditions, or four different suspensions simultaneously. Profiles of low-density nucleated cells from normal blood were shown to be identical after elutriation in four different chambers. Leucocytes could be depleted from platelet concentrates without significant loss. Most (98%) of the lymphocytes were removed from donor marrow intended for transplantation within 3 h and the recovery of myeloid and erythroid clonogenic cells in the graft was similar to that obtained from the standard single chamber centrifuge. PMID- 3286280 TI - Clonal proliferation in vitro of individual murine and human hemopoietic cells after fluorescence-activated cell sorting. AB - A modification of the fluorescence-activated cell sorter (FACS) was used to rapidly and reliably study the clonal proliferation of single hemopoietic cells. Murine FDC-P1 and human cord blood progenitor cells were examined for their ability to proliferate from single cells in 96-well microtiter plates containing agar medium and appropriate stimuli. FACS-sorted FDC-P1 single cells formed colonies in 345 out of 558 wells (62%), which compared favorably with control cultures (53%) and micromanipulated single cells (55%). Similarly, the frequency and type of day-14 colonies arising from cord blood progenitor cells when sorted as single cells by the FACS compared favorably with those grown from micromanipulated single cells or in control cultures. PMID- 3286281 TI - Abnormal GM-CSA generation by lymphocytes in patients with cyclic hematopoiesis. AB - Human cyclic hematopoiesis (CH) is a disease characterized by regular 21-day cyclic fluctuations of blood cell counts due to fluctuations in bone marrow cell production. The regular periodicity of the fluctuations suggests a defect in a regulatory feedback control loop. We examined the production of monocyte-derived recruiting activity (MRA) by monocytes and the response to MRA of lymphocytes from three patients with CH. MRA production was normal or increased in patients' monocytes, but granulocyte-macrophage colony-stimulating activity (GM-CSA) production in response to MRA was decreased in lymphocytes from patients with CH (p = 0.005). These data suggest that the regulatory defect in CH may involve defective lymphocyte generation of GM-CSA, resulting in deficient production of mature neutrophils. PMID- 3286282 TI - Optical monitoring of activity of many neurons in invertebrate ganglia during behaviors. AB - Optical methods for monitoring neuron activity were developed because these methods lend themselves to simultaneous multiple-site measurements. With the use of new voltage-sensitive dyes, the dye-related pharmacology and photodynamic damage appear to be relatively unimportant. Using multiple-site measurements made with a 124-element photodiode array, we estimated that approximately 30 of the 200 neurons present in the Navanax buccal ganglion make action potentials during feeding and that approximately 300 of the 1100 neurons present in the Aplysia abdominal ganglion are active during the gill-withdrawal reflex. The fact that a light mechanical touch to the siphon skin activated such a large number of neurons in the abdominal ganglion suggests that understanding the neuronal basis of the gill-withdrawal reflex and its behavioral plasticity may be forbiddingly difficult. PMID- 3286284 TI - Development of behavior and learning in Aplysia. AB - A set of fundamental issues in neuroethology concerns the neural mechanisms underlying behavior and behavioral plasticity. We have recently analyzed these issues by combining a simple systems approach in the marine mollusc Aplysia with a developmental analysis aimed at examining the emergence and maturation of different forms of behavior and learning. We have focussed on two kinds of questions: 1) How are specific neural circuits developmentally assembled to mediate different types of behaviors? and 2) how is plasticity integrated with these circuits to give rise to different forms of learning? From our analysis of the development of learning and memory in Aplysia, several themes have emerged: 1) Different forms of learning emerge according to different developmental timetables. 2) Cellular analogs of learning have the same developmental timetables as their respective forms of behavioral learning. 3) An analysis of non-decremented responses prior to the emergence of sensitization reveals a novel inhibitory process on both behavioral and cellular levels. 4) Sensitization emerges simultaneously in diverse response systems, suggesting an underlying general process. 5) A widespread proliferation of central neurons occurs in the same developmental stage as the emergence of sensitization, raising the possibility that some aspect of the trigger for neuronal proliferation may also contribute to the expression of sensitization. PMID- 3286283 TI - Multifunctional interneurons in behavioral circuits of the medicinal leech. AB - We are using the medicinal leech to study the neuronal basis of behavioral choice. In particular, we are recording from neurons, both extracellularly and intracellularly, in preparations that can express three different behaviors: the shortening reflex, crawling and swimming. We have found that particular mechanosensory neurons can elicit any of the behaviors, and that the movements are produced by just four sets of muscles, each controlled by a small number of motor neurons. Hence, there must be three different pattern-generating neuronal circuits, each of which can be activated by the same set of sensory neurons. We are studying how the choice is made among the three behaviors by recording, while one behavior is being performed, from neurons known to be involved in the initiation of the other two. We have found that an interneuron, cell 204, which is known to initiate and maintain swimming, is also active during shortening and crawling. The activity level in this interneuron can influence whether a mechanosensory stimulus produces shortening or swimming. The neuronal mechanisms by which this choice is normally effected awaits further elucidation of the circuits that elicit and generate shortening and crawling. PMID- 3286286 TI - Conceptual age and ultrasound measurements of gestational sac and crown-rump length in in vitro fertilization pregnancies. AB - The growth of the mean gestational sac diameter and the crown-rump length were evaluated from individual series and found to be linear in singletons, twins, and triplets from an in vitro fertilization program as well as in pregnancies with ovulation determined from serial ultrasound folliculograms. No difference in growth rate between the different groups was observed. The 95% confidence limits were 7.7 days before and 7.5 days after mean for the gestational sac diameter, and 5.2 days before and 5.6 days after mean for the crown-rump length. These limits, used together with new linear equations, create less anxiety and less unnecessary surgical intervention than current nonlinear standards when conceptual age is known and the gestational sac or the crown-rump length are too small to be measured. PMID- 3286285 TI - Is there a role for perioperative adjuvant therapy in the treatment of early breast cancer? AB - Despite having been investigated for many years, the role of adjuvant perioperative chemotherapy in the treatment of early breast cancer has still to be fully defined. This paper reviews the early trials of perioperative cytotoxic therapy and overviews the two largest trials; the Scandinavian Adjuvant Chemotherapy Study Group (SACSG) Trial, which began in 1965 and recruited 1026 patients, and the Cancer Research Campaign (CRC) Adjuvant Trial with 2230 patients entered between 1981 and 1985. Overview analysis of these two trials clearly shows a small but highly significant increase in time to first event (P less than 0.001). Increased survival, although significant in the SACSG trial, has not yet been demonstrated in the CRC study, but at this stage of follow-up (median 2.5 years) this is not surprising. PMID- 3286287 TI - Sperm antibodies and human in vitro fertilization. AB - In order to directly evaluate the effects of sperm antibodies in human in vitro fertilization (IVF), the authors preincubated donor sperm in female sera containing sperm antibodies and then inseminated supernumerary human oocytes from a gamete intrafallopian transfer (GIFT) program. The sperm were incubated for 30 minutes in medium containing 20% serum with antisperm activity (Test); or no antisperm activity (Control) as assessed by the immunobead test (IBT). Each oocyte was inseminated with 1 to 2 X 10(5)/ml of the preincubated motile sperm with Control or Test treatments allocated on a random basis. Six positive sera were tested in 17 experiments, resulting in a fertilization rate of 41% (25/61) versus 84% (36/43) for controls (P less than 0.001). When considered individually, three of six positive sera caused significant inhibition. The only serum that gave complete inhibition had the highest titer for IgG (10,000) and lower IgA (100). Absorption with protein A reduced the IgG titer to less than 10 and removed the fertilization inhibitory activity. These results confirm that sperm antibodies from female sera can inhibit human IVF. PMID- 3286288 TI - Therapeutic donor insemination: the impact of insemination timing with the aid of a urinary luteinizing hormone immunoassay. AB - The records of 120 patients undergoing therapeutic donor insemination were reviewed to determine if the use of the enzyme immunoassay of urinary luteinizing hormone (LH) to plan inseminations decreased the number of cycles required to achieve conception. All inseminations were performed with fresh semen. Patients in group 1 (n = 26) utilized urinary LH testing in addition to basal body temperature (BBT) and cervical mucus examinations to time their inseminations, while inseminations in group 2 (n = 94) were timed with only BBT and cervical mucus examinations. The monthly fecundability of patients in group 1 was 0.13, whereas the monthly fecundability of patients in group 2 was 0.11. The mean number of inseminations was 1.4 and 1.6 per cycle for groups 1 and 2, respectively. There were no significant differences between groups 1 and 2 in regard to the number of cycles required to achieve conception. The use of a urinary LH immunoassay for insemination timing offers no benefit over conventional methods of timing (BBT, cervical mucus) when fresh donor semen is used. PMID- 3286289 TI - The indirect mixed antiglobulin reaction test using a commercially available kit for the detection of antisperm antibodies in serum. AB - A simple procedure is described for the detection of antisperm antibodies of the IgG class in human serum using the indirect mixed antiglobulin reaction (MAR) test. The test uses only one dilution of serum (1/16) and no washing procedures. The test was performed in 361 sera. Comparative studies were conducted with the tray agglutination test (TAT) in 164 sera and with the direct MAR test on semen in 110 cases. In 24 sera with borderline test results, and in 13 sera with discordant findings, evidence of antisperm antibody activity was investigated by means of additional testing, namely, the adenosine triphosphate release cytotoxicity test (ARCT) and the indirect immunobead tests (IB) for IgA and IgM. Using the value of 40% reaction between motile spermatozoa and coated latex particles as the lower limit of significant activity, the indirect SpermMAR test has a sensitivity of 96% and specificity of 87%. The two false-negative indirect MAR results occurred in cases with IgM, the clinical significance of which is doubtful. Hence, the indirect MAR test appears to be an ideal screening procedure for sperm antibodies in serum since it is easy to perform and sensitive. Considering the false-positive rate of 13%, additional tests should, however, be performed on sera with a reaction of 40% or more in order to assess the relevance of the antibodies as a cause of infertility. PMID- 3286290 TI - Gender preselection: facts and myths. PMID- 3286291 TI - Pulsatile luteinizing hormone-releasing hormone therapy in women with polycystic ovary syndrome. AB - Induction of ovulation with pulsatile luteinizing hormone-releasing hormone (LH RH) therapy was attempted in 48 women with polycystic ovary disease (PCOD) and clomiphene citrate (CC) resistant anovulation. Fourteen women ovulated regularly, 23 ovulated variably, but 11 did not ovulate at all. Fifty-two of the 108 cycles of pulsatile LH-RH therapy alone (15 mu gm per pulse, one pulse every 90 minutes) administered through the subcutaneous route were ovulatory. In patients who did not ovulate on subcutaneous LH-RH, treatment with CC (100 mg per day for 5 days) was added to the LH-RH therapy in an additional 33 cycles, of which 21 were ovulatory. In those who did not respond to the combination of treatments, the same dose of LH-RH was administered intravenously: 14 of 29 cycles of intravenous therapy were ovulatory. The overall cumulative conception rate after 6 months of therapy was 60%. When recalculated for ovulatory cycles alone it was 90%, indicating that failure of ovulation was the only cause of the failure of conception. Analysis of the clinical and endocrine findings indicated that failure to ovulate was associated with obesity and hyperandrogenization. Ten of the 23 conceptions ended in miscarriage, 8 within 4 weeks of ovulation. The authors conclude that infertility in patients with PCOD is not optimally corrected by pulsatile LH-RH therapy. PMID- 3286293 TI - [The nurse in hospital hygiene? Observations on a 5-year experience in the Citadelle Hospital--C.P.A.S. Liege]. PMID- 3286292 TI - Comparison of magnetic resonance imaging and ultrasound in evaluating follicular and endometrial development throughout the normal cycle. AB - A prospective study was undertaken to evaluate and compare magnetic resonance imaging (MRI) and ultrasound (U/S) in monitoring follicular and endometrial development during the normal menstrual cycle. Results of MRI, U/S, estradiol (E2), and progesterone were obtained from five ovulatory volunteers on days 4, 8, 12, 16, 20, and 24 of the cycle. On U/S, all the women had only one dominant follicle, whereas MRI was able to detect a secondary cohort of follicles in three of five volunteers. Endometrial development on U/S and MRI showed similar patterns of growth with an increase on MRI from 5.8 +/- 1.1 mm on day 4 to a mean peak of 10.3 +/- 1.7 mm on day 24. A distinct feature of MRI was the demonstration of a junctional zone (JZ), which has a pattern of growth that resembles that of the endometrium, with accelerated growth from day 8 to day 16 (5.1 +/- .7 mm to 6.7 +/- .7 mm). The JZ corresponds anatomically to the distribution of the arcuate vessels and may therefore represent changes in blood supply to the endometrium. MRI, similar to U/S, is noninvasive and does not involve any radiation exposure but provides new information on uterine changes in the normal cycle. At present, its clinical applications are limited. PMID- 3286294 TI - [Regulation of coronary blood circulation]. AB - Specifics of the basal vascular tone, the metabolic mechanisms of its regulation, the interaction among cholinergic and adrenergic nerves, transmitters, hormones and metabolic mediators in regulation of the coronary circulation, are described. The main problems and prospects are discussed. PMID- 3286295 TI - [Effects of opioid peptides on rats with a second heart transplanted into the abdominal cavity]. AB - To determine whether opioid peptides have direct effects on myocardium we compared the effects of enkephalin analogs DAGO and DADL on both an innervated heart and a denervated heterotopically transplanted heart in the same animal. DAGO and DADL injected intravenously into anesthetized rats with two hearts produced hypotension, fall in end-systolic left ventricular pressure of both recipient's and donor's heart, bradycardia and decreasing of contractility in recipient's heart. Opioid peptides exerted no chronotropic effect and a slight positive inotropic effect on denervated transplanted heart. Both bradycardia and decreasing of contractility in recipient's heart have the neurogenic origin. PMID- 3286296 TI - Birth of modern inhalation anesthesiology. PMID- 3286297 TI - Like mother, like daughter. PMID- 3286298 TI - [Monolayer culture of pancreatic islet cells of the adult rat: effect of 2-deoxy 2-fluoroglucose]. AB - In the present study, the culture system for preparing monolayer islet cells of the neonatal rat was applied and modified for use with the pancreas of the adult rat. In this procedure, whole pancreatic tissues were enzymatically dispersed and then cultured for 30 days in TCM 199 medium with either 5.5 mM glucose or 5.5 mM glucose plus 1 mM 2-deoxy-2-fluoroglucose. Under culture conditions without 2 deoxy-2-fluoroglucose, the responsiveness of B cells was totally abolished by day 20 of culture. The addition of 2-deoxy-2-fluoroglucose destroyed fibroblasts selectively in a period of 20 days, yielding the monolayers mostly consisting of islet cells, and the morphological characteristics were well preserved at the end of the culture study period. After culture for 20 days in medium with 2-deoxy-2 fluoroglucose, insulin secretion was raised in a dose-dependent fashion due to the increasing concentrations of glucose, leucine and 2-ketoisocaproate. The dose response curve for insulin secretion evoked by glucose was sigmoid with a Km of 7 mM glucose, and the secretion threshold was observed at a concentration of between 2.8 and 5.5 mM glucose. The ratios of the maximum level to the basal were 6, 5 and 3 respectively for glucose, leucine and 2-ketoisocaproate. The secretory competence was preserved in the B cells on day 30 as well. Addition of epinephrine or clonidine inhibited the glucose-induced insulin secretion dose dependently. At a concentration of 10(-7) M, both drugs produced an 80% drop in insulin secretion evoked by glucose. The inhibitory effect of epinephrine or clonidine was reversed by 3 X 10(-5) M yohimbine or 10(-5) M phentolamine, whereas 10(-5) M propranolol had little or no effect and alpha adrenergic blockade of prazosin (5 X 10(-5) M) was weak as compared to that of yohimbine. At a high concentration (10(-5) M) of phenylephrine, a marked drop of insulin secretion was observed. In summary, the present culture system facilitates the establishment of monolayers of adult rat pancreas that consist mostly of islet cells. In addition, it is certain that the response of the B cells in 2-deoxy-2 fluoroglucose to nutrient secretagogues and the adrenergic modulation of insulin secretion are well preserved for a long-term culture period of 30 days. These preparations may provide a useful tool not only for the in vitro study of the B cell function, but also for use in implantation resource. PMID- 3286299 TI - [Impaired vasopressin secretion in patients with myotonic dystrophy]. AB - Hypernatremia has occasionally been observed in patients with myotonic muscular dystrophy (MyD). To elucidate the possibility of osmoregulatory dysfunction, we investigated hypothalamo-posterior pituitary function as well as serum electrolytes in eight patients with MyD. Blood samples were obtained early in the morning after overnight dehydration. Renal function was estimated by blood urea nitrogen, serum creatinine and creatinine clearance. Posterior pituitary function was evaluated by direct measurement of plasma vasopressin (AVP) during a 5% hypertonic saline infusion. Plasma AVP concentrations were determined by sensitive radioimmunoassay. In five patients, circulating blood volume (CBV), plasma renin activity (PRA) and serum aldosterone (S-Aldo.) were also measured. The mean serum sodium level (143.9 +/- 1.7mEq/1: Mean +/- SD) was significantly higher than in the controls (139.4 +/- 2.2mEq/1). A 5% hypertonic saline infusion showed a subnormal increase in AVP and diminished thirst, despite sufficient elevation of plasma osmolality, in all patients as compared with healthy adults. Renal function was intact. Biochemical evidence of dehydration, estimated by PRA, S-Aldo and CBV, was unremarkable in four of the five patients. These findings suggest that patients with MyD have neurogenic disorders of osmoregulation in addition to previously reported endocrine abnormalities. Impaired AVP secretion in response to osmotic stimuli and reduced thirst might be responsible for such failure. PMID- 3286300 TI - [Measurement of urine human growth hormone levels by ultra-highly sensitive enzyme immunoassay]. AB - A highly sensitive enzyme immunoassay (EIA) for measurement of urine hGH was set up by a modification of the method of Hashida and Ishikawa, which was a sandwich enzyme immunoassay using anti-hGH antibody coated polystyrene balls and anti-hGH antibody-peroxidase conjugate. Anti-hGH serum was obtained in rabbits by subcutaneous injections of hGH emulsified in complete Freund's adjuvant. In order to reduce non-specific binding to the solid phase, anti-hGH IgG was precipitated from rabbit serum followed by digestion to F(ab')2 and affinity purification. Fab'-peroxidase conjugate was produced by maleimide method. The assay procedure was as follows. 1. 100 microliters of urine samples or hGH standard were incubated with anti-hGH IgG coated polystyrene balls. 2. Polystyrene balls were then incubated with Fab'-peroxidase conjugate. Polystyrene balls were carefully washed three times in saline after incubation with Fab'-peroxidase conjugate, which reduced contamination and non-specific binding. 3. Peroxidase activity bound to the balls was assayed by enzyme reaction using 3(p-hydroxyphenyl) propionic acid as a substrate, and fluorescence intensity was measured by a spectrofluorophotometer (Shimadzu RF-540). Reducing the energy of excitation by setting the slit width of the spectrofluorophotometer at 2nm made it possible to gain stable fluorescence. The minimum detectable quantity of hGH was 30fg/tube in the assay, so that the detection limit was 0.3 pg/ml when 100 microliters of urine samples were used. Coefficient of intra- and inter-assay variation was 6.0% and 8.6%, respectively. The recovery was 98.8 +/- 2.8 (+/- SE) on average. Multiple dilution of acromegalic urine and urine after insulin injection produced dose-response curves parallel to those of the standards. Urine hGH levels in acromegalic patients were significantly greater than those in normal subjects. These findings indicate that sensitive EIA of urine hGH is potentially useful for evaluating the pituitary function. PMID- 3286301 TI - [Autonomic neuropathy in diabetics--autonomic function and plasma catecholamines]. AB - Autonomic neuropathy is one of the complications of diabetes. Recently, several authors reported that measuring R-R interval variation of ECG is a noninvasive and useful method for testing parasympathetic function. However, there were few reports about sympathetic function in diabetics. In order to evaluate sympathetic function in diabetics quantitatively, we studied the responses of plasma norepinephrine (NE), epinephrine (E) and related factors after 60 min bed rest and sequentially during 10 min of upright posture and 5 min handgrip while still upright. We also studied the responses of NE and E during 5 min smoking in supine position. Subjects were divided into four age-matched groups. These were 15 normal subjects (Group I), 20 diabetics without complications (Group II), 20 diabetics with peripheral neuropathy but no autonomic symptoms (Group III) and 15 diabetics with autonomic symptoms (Group IV). We also studied R-R interval variation (CV: Coefficient of Variation) as a parameter of parasympathetic function and compared this with sympathetic function. Upon standing, blood pressure (BP) dropped precipitously in Group IV, whereas no significant changes were observed in the other three groups. Heart rate (HR) increased in Groups I and II, but not in Groups III and IV. During handgrip, BP and HR did not change significantly in all groups. Basal NE levels in Group IV were significantly smaller than those in Group I. NE responses to both standing and handgrip stimuli were markedly reduced in Group IV and, even in Group III, increments were significantly smaller than those in Groups I and II. Basal E levels did not differ, and significant changes were not observed after standing and handgrip in all groups. Both plasma renin activity (PRA) and plasma aldosterone concentrations (PAC) in Groups III and IV were lower than those in Groups I and II at rest and standing. After smoking, both BP and HR increased significantly in Groups I, II and III, whereas no changes were observed in Group IV. Both NE and E responses were markedly reduced in Group IV and, even in Group III, responses were significantly smaller than those in Groups I and II. CV in Groups III and IV were significantly smaller than those in Groups I and II. In diabetics, CV was strongly correlated with NE increments after standing (r = 0.78, p less than 0.01). Also, CV was correlated with both NE and E increments after smoking (r = 0.71 (NE), r = 0.82 (E), p less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3286302 TI - Integrating the Delaware hospital: does any one remember? PMID- 3286303 TI - Access problems and solutions: ramifications for dental hygiene research. PMID- 3286304 TI - Dental hygiene job and career satisfaction. A review of the literature. PMID- 3286305 TI - Class II amalgam overhangs--prevalence, significance, and removal techniques. A literature review. PMID- 3286306 TI - [Demonstration of pemphigoid antibodies]. PMID- 3286307 TI - Coming alive. PMID- 3286308 TI - A source of alternative veneers. PMID- 3286310 TI - Genomic organization, structure and possible function of histidine-rich proteins of malaria parasites. AB - The current status of histidine-rich proteins in malaria parasites with regard to their genomic organization, protein structure and function is discussed, one of such protein present in an avian malaria parasite Plasmodium lophurae contains about 73% histidine and called as HRP (histidine-rich protein). Among human malaria parasites, in Plasmodium falciparum, only three such proteins have been described, namely knob protein also known as knob associated histidine-rich protein (KP or KAHRP), soluble histidine-alanine rich protein (soluble HARP or PfHRP II) and small histidine-alanine rich protein (SHARP) containing 8, 35 and 30% histidine contents respectively. With rapid emergence of powerful tools in molecular biology the genes of all these histidine-rich proteins have been cloned and sequenced within a short period of time. The genomic organizations of all these proteins are very much similar to each other, in each case the gene contains a signal peptide coding sequence (exon 1) followed by an intron. This intron is followed by the main coding region (exon 2) which has no further intervening sequences. In the main coding region of each gene, the histidine-rich sequences start after 25-30 amino acids from N-terminal end (75-90 nucleotides from 5' in exon 2). All the three histidine-rich proteins of P. falciparum share some homology with the HRP of P. lophurae; they all cross react with anti HRP and incorporate higher amount of exogenous histidine. The relationship between KP and HRP resides in the repeated polyhistidine sequences, (His) 6-9, from the core of the multiple tandem repeats of HRP, whereas, the peptide Ala-His-His is commonly shared by HRP and two other proteins of P. falciparum (soluble HARP and SHARP).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286309 TI - Lack of type VII collagen in unaffected skin of patients with severe recessive dystrophic epidermolysis bullosa. AB - Type VII collagen, the major structural component of the anchoring fibrils, was assayed in normal unaffected skin of patients with different forms of hereditary epidermolysis bullosa. Immunofluorescence staining with affinity-purified polyclonal antibodies to type VII collagen revealed a complete absence of staining in the skin of patients with severe dystrophic recessive epidermolysis bullosa. In all other forms, localized recessive dystrophic, dominant dystrophic, junctional and simplex forms there was an intense continuous linear staining of type VII collagen at the dermoepidermal junction. Also, obligate heterozygote carriers of the gene for severe dystrophic recessive form showed a normal pattern of staining. As internal controls and to define the clinical diagnosis, staining with antibodies to type IV collagen, laminin and bullous pemphigoid antigen was also performed. All these antibodies showed a normal staining pattern indicating an intact general morphology of the dermoepidermal junction zone. These results suggest that there is a defect of type VII collagen in patients with severe recessive dystrophic epidermolysis bullosa. The data also suggest that the group of recessive dystrophic epidermolysis bullosa may be heterogeneous not only clinically, but also at the molecular level. PMID- 3286311 TI - Variety and microheterogeneity in the carbohydrate chains of glycoproteins. PMID- 3286312 TI - Regulation of the lactose repressor. PMID- 3286313 TI - Two-dimensional electrophoresis computerized processing. AB - This paper describes various methods suitable for implementation of two dimensional processing software. The different steps leading to a complete processing are described, from the digitalization of the image to the processing of the resulting data. The characteristics of a convenient digitalization system are discussed. The different software devoted to spot detection is reviewed with respect to the presence or otherwise of a spot model and its characteristics. The major techniques for gel matching are compared as are designs for database structures suitable for tabulation of measurements. Finally, the need for a sophisticated system of data processing is stressed and its main requirements are described. PMID- 3286315 TI - Recovery of protein inclusion bodies. PMID- 3286314 TI - Effect of chloroquine on membrane permeability in yeast--release of cellular coproporphyrin. AB - 1. The influx and efflux of labelled substances with and without chloroquine was studied in yeast cells. 2. The uptake of delta-aminolevulinic acid by Saccharomyces cerevisiae is characterized by a KT of 3-4 mM and Jmax of 1.0-1.2 mumol min-1 g dry weight-1. 3. A method for loading yeast with labelled coproporphyrin is suggested. 4. The uptake of sorbitol and coproporphyrin was slightly stimulated, while the uptake of 6-deoxyglucose was slightly, that of 2 aminoisobutyric acid and leucine strongly inhibited by chloroquine. 5. The efflux of coproporphyrin, 2-aminoisobutyric acid and sorbitol was stimulated while that of leucine was not influenced by chloroquine. 6. The result showed that chloroquine influenced directly but nonspecifically the membrane permeability, apparently mainly that of the vacuolar membrane. PMID- 3286316 TI - Assessment of immunoblotting in the investigation of specific immune responses during infection. PMID- 3286317 TI - Immunoblotting and the immune response to leprosy. AB - Immunoblotting has provided a powerful and effective approach to dissection of the immune response to mycobacterial antigens in a situation in which the availability of isolated antigenic components is severely limited. The basic approach of blotting on to a solid-phase support has been used in combination with SDS/polyacrylamide-gel electrophoresis, t.l.c., recombinant DNA technology and T-cell cloning in order to carry out a comprehensive analysis of glycolipid and protein antigens involved in the immune response to mycobacterial infection. PMID- 3286318 TI - Flavoprotein disulphide oxidoreductases: protein engineering of glutathione reductase from Escherichia coli. PMID- 3286319 TI - Structure-function studies of the large subunit of ribonucleotide reductase from Escherichia coli. PMID- 3286320 TI - Thioredoxin and glutaredoxin: small multi-functional redox proteins with active site disulphide bonds. PMID- 3286321 TI - Evidence for synergism between copper and prostaglandin E2 in stimulating the release of gonadotropin-releasing hormone from median eminence explants: Na+/Cl- requirements. AB - Copper (Cu) and PGE2 are known to stimulate LHRH release from explants of the median eminence area (MEA) by two mechanisms distinguishable by their Ca2+ dependence. Moreover, exposure to Cu and PGE2 results in an amplified release of LHRH which is partially Ca2+ dependent, thus, resembling the release process stimulated by PGE2 alone. We have shown that LHRH release stimulated by Cu alone is Na+/Cl- dependent. By defining the Na+/Cl- dependence of PGE2- and Cu/PGE2 stimulated release of LHRH, we wished to ascertain if there is synergism between Cu and PGE2 actions. MEA of adult male rats were incubated for 5 min with 150 microM Cu and then for 15 min with 10 microM PGE2 (Cu/PGE2). Controls were incubated with Cu or PGE2. LHRH release into the medium was evaluated by RIA. Substituting Cl- in the incubation buffer with the non-permeant anion, isethionate, did not alter PGE2 stimulation of LHRH release, but it drastically inhibited Cu/PGE2 stimulation of LHRH release, indicating that this process requires a permeant monovalent anion. PGE2 and Cu/PGE2 stimulation of LHRH release were both inhibited when Na+ was substituted with Li+, or when 0.5 mM ouabain was included in the Na+-containing buffer; neither 10 microM tetrodotoxin (TTX) nor 100 microM amiloride were inhibitory. To ascertain if Na+ is required for Cu uptake, we evaluated the uptake of 67Cu by MEA explants and found that neither ouabain nor Li+ inhibited uptake, indicating that the extracellular Na+ and the activity of Na+/K+ ATPase are required for the process of LHRH release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286322 TI - A pure antiandrogen does not interfere with the LHRH agonist-induced blockade of testicular androgen secretion in the dog. AB - Daily subcutaneous administration of 50 micrograms of the luteinizing hormone releasing hormone (LHRH) agonist [D-Trp6]LHRH ethylamide in adult dogs causes a transient increase in the serum testosterone (T) concentration which reaches a maximum at 200% above control on days 2-4 of treatment and progressively decreases to 7% of the pretreatment value on day 21, the last time interval studied. After a transient increase, the concentration of serum bioactive luteinizing hormone (LH) was progressively decreased on days 11 and 19, thus suggesting that in analogy with human findings, the loss of LH bioactivity is responsible for the inhibition of testicular steroidogenesis induced in the dog by LHRH agonists. Of major significance is the finding that the changes in serum T levels observed during the first 3 weeks of treatment, as well as the complete inhibition of the intratesticular concentration of sex steroids observed at the end of this period of treatment with the LHRH agonist were not affected by simultaneous administration of flutamide (125 mg per os every 8 h). Such findings indicate that at the dose used, the LHRH agonist is in full control of gonadotropin secretion, thus completely overcoming feedback influences. Since the administration of the antiandrogen flutamide does not decrease the efficacy of the LHRH agonist as blocker of testicular androgen biosynthesis, the present data support the use of a pure antiandrogen in order to neutralize the effect of the transient rise in testicular androgen secretion which always accompanies the first days of treatment with LHRH agonists in patients with advanced prostate cancer. PMID- 3286323 TI - Release of gonadotropin alpha subunit from rat pituitary cultures in response to GnRH. AB - Gonadotropin releasing hormone (GnRH)-stimulated release of the alpha subunit common to the gonadotropins and to thyrotropin was studied in rat pituitary cell cultures. In these studies we took advantage of a recently prepared antiserum specific for the alpha subunit. We show that pituitary cells treated with GnRH released alpha subunit in a similar pattern to intact luteinizing hormone (LH) during short-term incubations (0-12 h); during prolonged incubations (12-48 h), however, release of alpha subunit did not desensitize in response to the releasing hormone and the pattern became different from that measured for intact LH. Further, we assessed the relative requirement for Ca2+ in the release of LH and alpha subunit. When pituitary cells were treated with 10(-8) M GnRH in the presence of a range of concentrations of the Ca2+ ion channel antagonist, methoxyverapamil (D-600), release of both LH and alpha subunit was inhibited in a similar and dose-dependent manner; 10(-4) M D-600 showed maximum inhibitory efficacy (IC50 = 10(-5) M). The calmodulin antagonist, pimozide, also inhibited both GnRH-stimulated LH and alpha subunit release (IC50 = 0.75 microM). These data suggested that although the Ca2+/calmodulin system appears to mediate both the release of LH and alpha subunit in response to GnRH, these processes appear differentially regulated during long-term exposure to the releasing hormone. PMID- 3286324 TI - The priming effect of glucose on insulin release does not involve redistribution of secretory granules within the pancreatic B-cell. AB - Short-term stimulation of the pancreatic B-cell with glucose produces a time dependent potentiation of this cell, which markedly enhances the insulin response to a renewed stimulation with the hexose. To study if a redistribution of the B cell secretory granules to a location close to the B-cell plasma membrane could underlie the priming effect of glucose, an investigation by ultrastructural morphometry was performed. After exposure of perfused rat pancreas to non-priming or priming concentrations of glucose, pale and dark B-cell secretory granules were distinguished and analysed both within a central and a peripheral zone of the B-cell. The pale secretory granules comprised 30-40% of the total granule population in the B-cell. Whereas no difference in diameter of the granules was observed, there was evidence for a greater numerical density of dark granules in the central than in the peripheral part of the B-cell. This finding may be in line with observations implying that newly synthesized insulin is released preferentially to older insulin. The present experiments did, however, not reveal any significant priming effect of glucose on the intracellular distribution of secretory granules in the pancreatic B-cell. The lack of morphological changes in the B-cell by glucose priming of insulin release should, rather, direct increased attention to the biochemical aspects of the priming phenomenon. PMID- 3286325 TI - Peptide mapping on Northern blot analyses of insulin receptors in brain and adipocytes. AB - Previous studies have demonstrated differences in the size of insulin receptor subunits in brain and adipocytes that appear to involve variations in glycosylation of the proteins. In this report, we examined the degree of homology in the protein backbones of insulin receptors in both tissues by peptide mapping and compared the mRNAs encoding the receptors by Northern blot analysis. Photoaffinity-labeled insulin receptors from rat brain and adipocytes were deglycosylated and then subjected to partial proteolysis by five different enzymes with differing substrate specificities. The intact receptors and their proteolytic fragments were analyzed by electrophoresis and autoradiography. Each enzyme yielded a unique pattern of fragments ranging from 70 to 11 kDa. In all cases, there was a striking similarity in the peptide maps generated from insulin receptors in brain and adipocytes. Northern hybridization experiments were carried out using poly(A)+ RNA from rat brain, rat adipocytes, and human hepatocarcinoma (HEP G2) cells. In rat brain, two bands of 9.5 and 7.4 kb were detected and, in rat adipocytes, the same two bands were observed. The two mRNA bands observed in rat tissues represented only two of the five mRNA species seen in human HEP G2 cells. The results indicate that the protein domains and the mRNAs encoding of insulin receptors in brain and adipocytes are very similar, if not identical. PMID- 3286326 TI - Effect of androgen and thyroid hormones on renin-1 messenger ribonucleic acid levels in mouse submandibular gland. AB - The synthesis of renin and other biologically active polypeptides in the granular convoluted tubule cells of the mouse submandibular gland (SMG) is regulated by androgen and thyroid hormones. In this study genetically hypothyroid (hyt/hyt) mice carrying a single renin structural gene (Ren-1) were used to investigate the mechanism of hormonal action in mouse SMG. Treatment of female mice with 5 alpha dihydrotestosterone (DHT) and/or thyroxine (T4) enhanced renin-1 activity and increased renin-1 mRNA, determined by Northern analysis. Compared to euthyroid (hyt/+) littermates, hyt/hyt mice had lower basal levels of renin-1 mRNA and a blunted response to either hormone alone. DHT and T4 acted synergistically to increase renin-1 activity and renin-1 mRNA in the SMG of hyt/hyt females. Furthermore, levels of renin-1 activity and renin-1 mRNA varied concordantly in the SMG of these animals. These data indicate that androgen and thyroid hormones influence levels of renin-1 in mouse SMG primarily by regulating the amount of renin-1 mRNA available for translation. PMID- 3286327 TI - Immunologic aspects of human proinsulin therapy. AB - We investigated the immunogenicity of human proinsulin (HPI) when used as the sole or principal insulin agonist in insulin-naive patients with insulin dependent (type I) and non-insulin-dependent (type II) diabetes mellitus. Sixty one patients (13 type I, 48 type II) were treated with rDNA human insulin (NPH HI with or without regular HI) and 53 were treated with HPI (8 type I, 45 type II). At 6 mo, virtually identical levels of HbA1c (5.2 vs. 5.3%, P = NS) were achieved. However, regular HI was added less often to the treatment regimen in HPI-treated patients (16 vs. 32 patients, P less than .001). Overall, there was no significant increase in proinsulin-specific antibodies in either treatment group. However, 8 of 51 (1 transiently) patients in the HPI group developed low levels of binding of HPI (highest percentage bound was 5%). Two patients in the HI group developed very low levels of HPI binding (1.2 and 1.9%). Binding of HI (greater than 2.4%) was seen in both treatment groups; however, the prevalence of HI binding was less in the HPI group at 6 mo (39 of 60 in HI group vs. 20 of 51 in HPI group, P = .008). Concomitant treatment with regular HI did not affect the prevalence or level of binding of HPI or HI. We conclude that human proinsulin is a weak immunogen when used as the principal insulin agonist and may reduce both the formation of anti-HI antibodies and the need for concomitant therapy with regular HI. PMID- 3286328 TI - Pancreastatin inhibits insulin secretion and stimulates glucagon secretion in mice. AB - Recently a new peptide, pancreastatin, was isolated from porcine pancreatic extracts. It contains 49 amino acids and shows a structural similarity to chromogranin A, which occurs in secretory granules of the endocrine pancreas. Furthermore, pancreastatin has been found to inhibit glucose-induced insulin secretion in the perfused rat pancreas. However, its effects under in vivo conditions have never been studied. We have therefore investigated the effects of this peptide on insulin and glucagon secretion in vivo in the mouse. We found that an intravenous injection of pancreastatin (4.0 nmol/kg) lowered basal plasma insulin concentration at 6 min from 55 +/- 8 microU/ml in control mice to 21 +/- 7 microU/ml (P less than .01). The peptide also inhibited the plasma insulin response to both glucose (P less than .01) and the cholinergic agonist carbachol (P less than .001). Furthermore, 2 min after injection of pancreastatin, plasma glucagon concentration had increased to 301 +/- 19 pg/ml compared to 190 +/- 12 pg/ml in control mice (P less than .001). The peptide did not, however, affect the carbachol-induced plasma glucagon response. In addition, pancreastatin induced a transient hyperglycemia. Combined adrenergic blockade by means of a pretreatment of phentolamine and propranolol did not prevent pancreastatin from exerting its effects on plasma insulin levels, whereas the increase in plasma glucagon levels was abolished. Thus, in the mouse, the newly discovered intrapancreatic peptide pancreastatin 1) lowers baseline plasma insulin levels, 2) inhibits glucose- and cholinergically induced insulin secretion, 3) stimulates baseline glucagon secretion, and 4) induces hyperglycemia. PMID- 3286329 TI - Maturation of insulin response to glucose during human fetal and neonatal development. Studies with perifusion of pancreatic isletlike cell clusters. AB - The insulin release in response to glucose was studied in perifused isletlike cell clusters (ICCs) obtained from human fetal or neonatal pancreases at various stages of development: 12-15 gestational wk (n = 7), 17-20 wk (n = 13), 22.5 wk (n = 2, 1 diabetic pregnancy), and 26-44 wk (n = 6, postnatal samples). The ICCs were stimulated with 20 mM glucose and subsequently with 10 mM theophylline plus 20 mM glucose as a viability test. Insulin release increased to a detectable level (greater than 0.1 pg.ICC-1.min-1) during glucose stimulation in four of seven of the youngest fetuses. At 17-20 wk the basal rate of insulin release had increased by at least 15-fold above the detection limit (1.5 pg.ICC-1.min-1), and glucose promoted a sustained monophasic response that was on the average 1.6-fold higher than the basal level. The response was significant (P less than .05) in 9 of 13 experiments. With postnatal ICC (gestational age 26-44 wk), an early-phase peak response was observed in 5 of 6 experiments. The mean rates of insulin release after 5-12 min of glucose stimulation were 4.8 pg.ICC-1.min-1 in newborn infants and 2.1 pg.ICC-1.min-1 in 17- to 20-wk fetuses. The corresponding mean relative insulin responses (stimulated to basal) were 3.3-fold (range 1.1-7.5) and 1.6-fold (1.0-3.4), respectively (P less than .05, Mann-Whitney U test). The results suggest that the human fetal pancreas is already responsive to glucose during the first half of gestation, but the biphasic insulin release does not start to mature until the postnatal phase. PMID- 3286330 TI - Muscle glycogen synthesis and disposition of infused glucose in humans with reduced rates of insulin-mediated carbohydrate storage. AB - Six men with a low rate of insulin-stimulated, non-oxidative carbohydrate disposal (storage) and six with a high storage rate were recruited for study of the fate of insulin-stimulated glucose uptake. [3-3H]glucose was infused before and during a 4-h hyperinsulinemic euglycemic clamp procedure in a dosage regimen designed to maintain a constant specific activity. From the disposition of label, the rate of insulin-mediated glucose incorporation into glycogen in the low storage subjects was one-fourth that of the high-storage subjects (P less than .02). The insulin-mediated increase in muscle glycogen synthase activity in the low-storage subjects was one-fourth that of the high-storage subjects (P less than .05), suggesting the possibility of a causal relationship. In the high storage but not the low-storage subjects, the rate of glycolysis inferred from the appearance of metabolized tritium in body water exceeded the carbohydrate oxidation rate (P less than .002). This suggests that in these subjects there is a significant fraction of glycolysis that is not oxidized and that this component of carbohydrate metabolism therefore contributes to storage. PMID- 3286331 TI - Lysosomes and pancreatic islet function. Time course of insulin biosynthesis, insulin secretion, and lysosomal transformation after rapid changes in glucose concentration. AB - The aim of this study was to estimate the time course of lysosomal transformations associated with crinophagy, i.e., the degradation of insulin within lysosomes, in the beta-cells of pancreatic islets. Primary and secondary lysosomes were identified in mouse islet beta-cells and subjected to ultrastructural morphometry. Islets from an in situ preparation were compared with isolated islets incubated in vitro. Under the in vitro conditions, the islets were initially exposed to 28 or 3.3 mM glucose for 24 h. Then the glucose concentration was rapidly changed to 3.3 and 28 mM glucose, respectively, and the islets were incubated for up to an additional 24 h. The beta-cell lysosomes were analyzed and related to alterations in insulin biosynthesis and secretion and islet insulin content after the rapid change in glucose concentration. In vivo, the beta-cell lysosomal population was predominantly composed of secondary lysosomes, which frequently contained secretory granule cores. After the initial 24-h period at 3.3 mM glucose, the volume density and the average volume of the secondary beta-cell lysosomes were increased, suggesting increased crinophagic activity. The mean diameter of the primary beta-cell lysosomes was decreased after 24 h at either 28 or 3.3 mM glucose. The change in glucose from 28 to 3.3 mM resulted in alterations in insulin biosynthesis and secretion, leading to an accumulation of insulin within the beta-cells. Lysosomal transformations suggestive of increased crinophagy were observed 24 h after the alteration in glucose concentration. The change from 3.3 to 28 mM glucose resulted in a parallel increase in insulin biosynthesis and secretion without a change in islet insulin content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286332 TI - Autoantibodies to insulin are present in sera of patients with autoimmune thyroid disease. AB - It has been clinically suspected that patients with autoimmune thyroid disease are at an increased risk of developing other autoimmune diseases later in life. To determine the presence and potential importance of a more generalized deregulation of immune response in patients with Grave's disease and Hashimoto's disease, sera from 33 patients with Graves' disease and 16 patients with Hashimoto's disease were screened for the presence of anti-insulin antibodies and anti-insulin-receptor antibodies. An enzyme-linked immunosorbent assay was used to identify the presence of IgG against human insulin. The optical density indicating the presence of IgG against insulin in sera from patients with Graves' disease averaged .172 +/- .024 (mean +/- SE; range .010-.802), compared to the mean normal value of .098 +/- .0009 (range .012-.238) in 33 control subjects. Ten of 33 patients with Graves' disease had values greater than .200, whereas control sera values were less than .200 in all but one case (P less than .005, Graves' sera vs. controls). The sera from patients with Hashimoto's disease had a mean optical density of .110 +/- .016, with 15 of 16 values between .010 and .200. These values were not significantly different from controls with an insulin binding inhibition assay. Anti-insulin-receptor antibodies were not detected in any of 33 patients with Graves' disease, and cytoplasmic islet cell antibodies were not detected in sera from seven patients with Graves' disease who had insulin-binding antibodies. These data support the hypothesis that the immunologic response in autoimmune thyroid disease may be more heterogeneous and polyclonal than previously believed. PMID- 3286333 TI - Measurement of rat insulin. Enzyme-linked immunosorbent assay with increased sensitivity, high accuracy, and greater practicability than established radioimmunoassay. AB - Total immunoreactive insulin (IRI) is conventionally determined by radioimmunoassays. IRI measurement in rats can be made more sensitive, accurate, and practical, as demonstrated by a new modified enzyme-linked immunosorbent assay (ELISA). It is characterized by indirect binding of an anti-insulin antibody by an antiglobulin antibody and uses the principle of competitive saturation. In this ELISA, IRI can be determined in a wide range of concentrations, corresponding to the standards. The standard curve ranges from 100 to 0.049 ng/ml IRI (1 ng/ml approximately 23.4 microU/ml approximately 172 pM rat insulin). The statistical analysis shows between- and within-assay coefficients of variation of less than or equal to 15%. PMID- 3286334 TI - Molecular mimicry between insulin and retroviral antigen p73. Development of cross-reactive autoantibodies in sera of NOD and C57BL/KsJ db/db mice. AB - Enzyme-linked immunosorbent assay (ELISA) was used to study temporal development of murine autoantibodies against insulin and both type C and intracisternal type A retroviral antigens. The nonobese diabetic (NOD) mouse, a model for autoimmune, insulin-dependent diabetes, was compared with a related, but diabetes-resistant, strain, nonobese normal (NON). Similarly, C57BL/KsJ db/db mice (insulin-resistant model of insulin-dependent diabetes and obesity) were compared with diabetes resistant C57BL/6 db/db mice. NOD mice developed much higher autoantibody titers than did NON mice. Whereas type C autoantibodies in NOD developed to peak titer shortly after mice were weaned, autoantibodies against insulin and p73 (group specific antigen of the intracisternal type A particle) did not develop until shortly before, or concomitant with, the development of hyperglycemia. Two NOD mice not developing hyperglycemia during the 40-wk study period were distinguished from the mice developing diabetes by a delayed onset of insulin (but not p73) autoantibodies. Our findings suggest that in NOD mice, the appearance of insulin and p73 autoantibodies signifies that extensive underlying necrosis of beta-cells occurred. C57BL/KsJ db/db mice (with extensive beta-cell necrosis and early hyperglycemia) developed much higher autoantibody titers to insulin and p73 than did the diabetes-resistant C57BL/6 db/db mice. However, the presence of autoantibodies in normoglycemic C57BL/KsJ +/db controls demonstrated that elevated autoantibody titers alone were insufficient to produce diabetes in this model. Absorption studies indicated that autoantibodies against p73 recognized a common epitope on insulin and IgE-binding factor. The potential significance of this molecular mimicry is discussed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286335 TI - Epilepsy precipitated by bathing. AB - A case of epilepsy precipitated by bathing is described and previously reported cases are reviewed. The prognosis for this rare form of reflex epilepsy seems to be good, in that the seizures resolve with age and neurodevelopment remains normal. PMID- 3286336 TI - Dysphagia in infantile cortical hyperostosis (Caffey's disease): a case study. AB - A four-month-old infant was treated for dysphagia associated with infantile cortical hyperostosis (Caffey's disease). Prolonged nutritional support was by nasal or gastrostoma intubation; therapeutic oral feeding was continued. This approach encouraged the development of oral feeding skills, infant-parent bonding and experience of oral satisfactions. The facial skeleton is the most frequent site of involvement in hyperostosis, and dysphagia is a typical component, usually signaled by refusal of food and failure to thrive. PMID- 3286337 TI - Relaxation in cerebral palsy. PMID- 3286338 TI - Unwanted effects of anti-epileptic drugs. PMID- 3286339 TI - Insulin autoantibodies at the clinical manifestation of type 1 (insulin dependent) diabetes--a poor predictor of clinical course and antibody response to exogenous insulin. AB - To study the possible clinical significance of the appearance of insulin autoantibodies prior to the diagnosis of Type 1 (insulin-dependent) diabetes, and their value in predicting the antibody response to exogenous insulin, we observed 46 newly diagnosed diabetic children and adolescents over the year following diagnosis for the occurrence and duration of clinical remission, daily insulin dose, metabolic control, residual B-cell function, insulin-binding antibodies and conventional as well as complement-fixing islet cell antibodies. Insulin-binding antibodies were determined using both monoiodinated human and porcine insulin. Sixteen children (34.7%) were positive for insulin autoantibodies upon diagnosis of Type 1 diabetes. These subjects were significantly younger (6.2 +/- 1.0 versus 10.8 +/- 0.8 years; mean +/- SEM, p less than 0.001), and their haemoglobin A1 levels were lower (14.1 +/- 0.6 versus 16.0 +/- 0.8%, p less than 0.05) at diagnosis than in the insulin autoantibody negative group. There were no significant differences in the occurrence and duration of clinical remission between insulin autoantibody-positive and -negative test groups. Daily insulin dose, haemoglobin A1 and serum C-peptide concentrations were of the same magnitude in both groups after the diagnosis, and no association could be found between the presence of insulin autoantibodies at diagnosis and persistently positive islet cell antibodies. In tests conducted 3 months after diagnosis, the group of patients with insulin autoantibodies showed significantly higher levels (p less than 0.05) of antibodies binding human insulin than the group negative for insulin autoantibodies, but no significant differences could be found between the insulin binding titres of the two groups in subsequent analyses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286340 TI - The influence of maternal glucose metabolism on fetal growth, development and morbidity in 917 singleton pregnancies in nondiabetic women. AB - To study the effects on the fetus of variations in maternal glucose tolerance, a 25 g rapid intravenous glucose tolerance test was performed at or about 32 weeks gestation in 917 randomly selected nondiabetic women with singleton pregnancies. The results were withheld from the patients and their obstetricians and paediatricians, and no treatment or advice was offered. Fasting plasma glucose and indices of glucose disposal (including a new index which we have termed "summed glucose") were distributed unimodally, with no evidence of a separate pathological group towards the diabetic end of the distributions. Significant associations were found between maternal glucose metabolism and various measures of neonatal nutrition and morbidity, including the incidence of congenital malformations and morbidity related to asphyxia, suggesting that variations within the normal range in maternal glucose metabolism can influence growth and development in the fetus. These relationships were continuous throughout the range of maternal glucose tolerance and were not of predictive value in individual cases. PMID- 3286341 TI - Relationship between serum insulin autoantibodies, islet cell antibodies and Coxsackie-B4 and mumps virus-specific antibodies at the clinical manifestation of type 1 (insulin-dependent) diabetes. AB - In order to elucidate the possible relationship between insulin autoantibodies (IAA), conventional (ICA-IgG) and complement-fixing (CF-ICA) islet cell antibodies and Coxsackie-B4 and mumps virus-specific antibodies (IgG, IgM and IgA classes), we studied 194 children and adolescents with newly diagnosed Type 1 (insulin-dependent) diabetes. Sixty-one (31.4%) of the subjects were IAA-positive at diagnosis and 73.8% (45/61) of these also had ICA-IgG compared to 51.1% (68/113, p less than 0.01) of IAA-negative children. CF-ICA showed no significant association with IAA. The levels of IAA were significantly higher in the patients with ICA-IgG compared to those without [5.9 +/- 1.6% (SEM) vs 2.5 +/- 0.3%, p less than 0.01]. The patients positive for IAA were younger at diagnosis than the IAA-negative ones; (7.1 +/- 0.5 vs 9.3 +/- 0.3 years, p less than 0.001) and this was also true for ICA-IgG-positive children (8.1 +/- 0.4 vs 9.4 +/- 0.5 years, p less than 0.05) in comparison to ICA-IgG-negative subjects. No significant associations were found between IAA or ICA on the one hand and a positive family history of Type 1 diabetes or metabolic derangements at diagnosis on the other. Subjects negative for ICA were more frequently positive for mumps virus specific IgG antibodies than the ICA-positive patients (50/80 vs 53/111, p less than 0.05), and Coxsackie-B4 virus-specific IgA antibodies were more common in the CF ICA-negative than the CF-ICA-positive children (53/111 vs 29/80, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286342 TI - Self-selected unrefined and refined carbohydrate diets do not affect metabolic control in pump-treated diabetic patients. AB - This study investigated whether unrefined or refined carbohydrate diets have any effect on metabolic control and on insulin requirement in near-normoglycaemic Type 1 (insulin-dependent) diabetic out-patients on continuous subcutaneous insulin infusion therapy. Two females and 8 males (aged 27 +/- 9 years; diabetes duration 13 +/- 8 years; duration of insulin pump therapy 22 +/- 5 months; means +/- SD) participated in a randomised cross-over study with two 6-week periods on self-selected refined and unrefined carbohydrate diets respectively. As a result, energy intake differed between the experimental diets (2372 +/- 669 kcal/day on unrefined diet vs 2757 +/- 654 kcal/day on refined diet, p = 0.04), as did the fibre intake (18 +/- 5 g/day with the refined carbohydrate diet vs 35 +/- 13 g/day with the unrefined carbohydrate diet, p = 0.02). The composition of nutrients was approximately 40% carbohydrate, 45% fat, and 13% protein with both diets. Body weight, HbA1c, daily mean blood glucose (7.2 +/- 0.6 mmol/l) and serum lipids remained virtually unchanged during the entire study. Insulin requirement varied between 40.1 +/- 7.9 U/day with the unrefined carbohydrate diet, and 42.5 +/- 10.1 U/day with the refined carbohydrate diet (NS). Thus, neither the refined nor the unrefined carbohydrate diet affected insulin requirement and metabolic control in these near-normoglycaemic, normolipaemic, non-obese, insulin-pump-treated Type 1 diabetic patients. PMID- 3286343 TI - Insulin as an amyloid-fibril protein at sites of repeated insulin injections in a diabetic patient. AB - A patient with Type 1 (insulin-dependent) diabetes mellitus developed localised amyloidosis at the sites of his injections of porcine insulin. A major amyloid fibril protein was extracted and, by means of its amino acid composition and amino acid sequence, it was shown to contain intact insulin molecules. Porcine insulin is the tenth protein and the first foreign protein to be chemically identified in human amyloid fibrils. PMID- 3286345 TI - Possible mechanisms to explain dust overloading of the lungs. AB - This paper briefly reviews the available evidence on dust overloading of the lungs, a condition which has come to the forefront in many recently reported chronic inhalation studies. A general hypothesis is developed that dust overloading, which is typified by a progressive reduction of particle clearance from the deep lung, reflects a breakdown in alveolar macrophage (AM)-mediated dust removal due to the loss of AM mobility. The inability of the dust-laden AMs to translocate to the mucociliary escalator is correlated to an average composite particle volume per alveolar macrophage in the lung. When this particulate volume exceeds approximately 60 micron3/AM, on the basis of a uniform distribution of particles over the AM pool size (approximately 2.5 X 10(7) cells) in the Fischer 344 rat, the overload effect appears to be initiated. When the distributed particulate volume exceeds approximately 600 micron3 per cell, the evidence suggests that AM-mediated particle clearance virtually ceases and agglomerated particle-laden macrophages remain in the alveolar region. This paper considers possible mechanisms why these particle-laden cells are immobilized, viz., one is based on excessive particle-cell, cell-cell chemotactic interactions, and migratory inhibition factors; the other considers the volumetric increase by phagocytized particles, per se, as leading to an inability of the AM to spread and migrate probably through a competitive requirement for surface membrane and cytoskeleton in both endocytotic and migratory functions. PMID- 3286344 TI - Increased proinsulin levels as an early indicator of B-cell dysfunction in non diabetic twins of type 1 (insulin-dependent) diabetic patients. AB - Glucose tolerance and insulin secretion were studied in two groups of non diabetic identical twins of recently-diagnosed Type 1 (insulin-dependent) diabetic patients: (1) a group of 5 twins with islet cell antibodies, and (2) a group of 6 twins without. Despite similar fasting glucose, insulin and C-peptide concentrations both groups of twins had significantly higher fasting proinsulin concentrations than the control group (p less than 0.05). The twins with complement-fixing islet cell antibodies had reduced glucose tolerance and clearance, whilst the twins without islet cell antibodies did not. Neither group of twins showed any abnormality in insulin, C-peptide or proinsulin response to oral or intravenous glucose. We conclude that increased fasting proinsulin levels precede abnormalities of insulin secretion, and are an early indication of minor B-cell damage in these twins irrespective of their risk of developing diabetes. PMID- 3286346 TI - Mouse strains for chemical carcinogenicity studies: overview of a workshop. PMID- 3286347 TI - Correlation of mutagenic and dermal carcinogenic activities of mineral oils with polycyclic aromatic compound content. AB - Mutagenicity, polynuclear aromatic compound content, and skin carcinogenicity were compared for a series of complex oil mixtures derived from the refining and processing of petroleum. Mutagenicity in a modified Ames Salmonella assay showed an excellent correlation with carcinogenicity, as determined in a mouse skin painting bioassay, for oil samples with median boiling points (defined as the temperature at which 50%/volume of an oil sample is recovered as condensate during distillation--50% recovered) above approximately 500 degrees F. A significant correlation was also observed between the 3-7 ring polycyclic aromatic compound (PAC) content and both mutagenic and carcinogenic potencies for samples ranging from those with median (50% recovered) boiling points above approximately 500 degrees F to those with initial boiling points of approximately 1070 degrees F. These results show that both PAC content and mutagenicity are predictive of dermal carcinogenic activity and indicate that PAC components are largely if not entirely responsible for both the carcinogenic and mutagenic activities. PMID- 3286348 TI - An evaluation of the genotoxic potential of glyphosate. AB - The potential genotoxicity of glyphosate, the active ingredient in Roundup herbicide, was tested in a variety of well-established in vitro and in vivo assays including the Salmonella typhimurium and Escherichia coli WP-2 reversion assays, recombination (rec-assay) with Bacillus subtilis. Chinese hamster ovary cell gene mutation assay at the hypoxanthine/guanine phosphoribosyl transferase gene locus, hepatocyte primary culture/DNA repair assay, and in vivo cytogenetics assay in rat bone marrow. No genotoxic activity was observed in the assays performed. The data suggest that glyphosate should not pose a genetic risk to man. PMID- 3286350 TI - [Non-ulcerous dyspepsia. Toward a rational approach in therapeutic studies]. PMID- 3286349 TI - Insulin-glycerolipid mediators and gene expression. AB - Insulin is an anabolic polypeptide hormone with pleiotrophic effects. During the decades since the initial description by Banting and Best, the acute effects of insulin have been widely studied with particular focus on the mechanism or mechanisms of insulin activation of hexose transport and regulation of metabolic enzyme activity. However, recently there has been a major expansion of investigation to include insulin regulation of gene expression with multiple insulin-sensitive specific mRNAs now reported. In this review, we explore the involvement of insulin-induced changes in plasma membrane glycerolipid metabolism in the transmembrane signaling process required for insulin regulation of mRNA levels. Insulin increases diacylglycerol levels in insulin-responsive cells, and synthetic diacylglycerols or their phorbol ester diacylglycerol analogs, such as 4 beta,9 alpha,12 beta,13 alpha, 20-pentahydroxytiglia-1,6-dien-3-one 12 beta myristate 13-acetate (TPA), mimic insulin regulation of ornithine decarboxylase mRNA, c-fos mRNA, and phosphoenolpyruvate carboxykinase mRNA levels. This suggests that insulin regulation of specific mRNA levels may be mediated by insulin-induced changes in phospholipid metabolism and that diacylglycerol may play a pivotal role in insulin regulation of gene expression. PMID- 3286351 TI - [Distribution of fibronectin and laminin during development of the human myenteric plexus and Hirschsprung's disease]. AB - The distribution of fibronectin and laminin, two glycoproteins involved in the migration of neural crest cells, was studied by an indirect immunohistofluorescence technique in 35 embryos and fetuses (from 6 weeks old to birth), 5 normal controls, and 6 patients with Hirschsprung's disease, in order to provide a new approach to the embryogenesis of human myenteric plexus and the pathogenesis of aganglionosis. Fibronectin was not seen near individual neuroblasts unlike myoblasts and mesenchymal cells which were surrounded by this macromolecule. There was a progressive and parallel cephalocaudal development of the plexus and the muscular layers from the esophagus to the intestine. However, in the rectum, at 7 weeks, neuroblasts were detected in close contact to fibronectin-labeled cells whereas they were not in the colon. These present results were in favor of two origins for neuroblasts: the vagal and the caudal neural crest cells. Faulty migration of caudal neural crest cells might be involved in the aganglionosis of Hirschsprung's disease in spite of the fact that local environment of fibronectin and laminin was identical to that of normal subjects. PMID- 3286352 TI - [Characterization and evaluation of the pathogenic nature of duodenogastric reflux by measurement of intragastric choline and sialic acid in normal subjects and in patients with duodenal ulcer]. AB - The high choline content in pancreatic juice and bile-contaminated gastric juice samples suggested that intragastric choline content could be related to duodenogastric reflux (DGR). In 308 secretory tests in normal subjects (38) and in duodenal ulcer patients (DU) (270), acid, pepsin, sialic acid and choline outputs were measured in basal secretion and after pentagastrin, insulin or secretin modulation. The distribution of choline output values in basal secretion showed that 77% subjects had no or small choline amounts (less than 10 mumol/h) and another population had high output values (greater than or equal to 10 mumol/h). Choline hourly outputs greater than or equal to 10 mumol/h could be related with positive DGR. DGR did not seem to modify acid or pepsin secretion except if acid outputs were low: in these cases the neutralizing activity reduced acid outputs and resulted in a pepsin inactivation. DGR by itself increased sialic acid outputs as evidenced by mucus erosion. In normal subjects, weak mucus erosion might be due to proteolytic activity. In DU patients without DGR, erosion was increased but was due to the same mechanism. In DU patients with DGR, erosion was stronger and no relationship with proteolytic activity could be established because of the introduction of eroded duodenal glycoprotein into the stomach. Pentagastrin, insulin and secretin were able to induce DGR. Reflux could contribute to mucus erosion either by its detersive properties or by the proteolytic material coming from the pancreas. PMID- 3286353 TI - [Free radicals and digestive pathology]. PMID- 3286354 TI - [Central actions of prostaglandins on the digestive tract]. PMID- 3286355 TI - [Is there a role for surgery in the treatment of portal hypertension in cirrhosis?]. PMID- 3286356 TI - [Natural history of esophageal varices in cirrhosis (from origin to rupture)]. PMID- 3286357 TI - [Autoimmune hemolytic anemia during treatment with cyclosporin after liver transplantation]. AB - Hemolytic anemia was observed in a 36 year-old liver transplant patient. The immunosuppressive regimen included cyclosporine A and prednisolone. Hemolysis appeared a few days after amoxicillin treatment. The presence of anti-D allo antibodies, auto-antibodies active against erythrocytes, and an immuno-allergic phenomenon against erythrocytic membrane coated by cyclosporine was demonstrated. Increase of daily dose of prednisolone without modification of cyclosporine doses was followed by the disappearance of allo- and auto-sensitization. The role of amoxicillin in promoting these hemolytic phenomenons may be suggested. PMID- 3286358 TI - [Budd-Chiari syndrome and Behcet's disease. A case treated by mesenterico-atrial prosthesis]. AB - A 36 year-old North African man, with Behcet's syndrome complicated by an inferior vena caval thrombosis, developed a chronic Budd-Chiari syndrome associated with bleeding esophageal varices. He was treated by an emergency mesoatrial shunt. Results at 2 years were good. Analysis of this case and the 13 other similar cases with associated Budd-Chiari syndrome and Behcet's syndrome found in the literature showed that hepatic veins thrombosis: a) is often due to inferior vena caval thrombosis or membranous obstruction; b) has a high spontaneous mortality rate by acute liver failure; c) remains a potential indication for porto-systemic shunt, as are other causes of Budd-Chiari syndrome. PMID- 3286359 TI - Production of viable Giardia cysts in vitro: determination by fluorogenic dye staining, excystation, and animal infectivity in the mouse and Mongolian gerbil. AB - The purpose of this research was to document the formation of viable Giardia cysts in vitro. Viability staining, using fluorogenic dyes that required metabolic conversion for detection, and immunocytochemistry at the light microscopic level provided information on viability and for the identification of formed in vitro. Analysis of cysts formed in vivo and in vitro showed similar morphologic appearances by both light and electron microscopy. Cysts formed in vitro were capable of establishing infections in both mouse and gerbil models for giardiasis. Trophozoites obtained from mice experimentally infected with in vitro formed cysts could be maintained in culture and induced a second time to form cysts in vitro. This model for the production of viable Giardia cysts in vitro should facilitate research on controlling the complete life cycle of Giardia outside an animal host. PMID- 3286360 TI - Evaluation of colchicine therapy in primary biliary cirrhosis. AB - We have conducted a double-blind controlled trial of colchicine in patients with primary biliary cirrhosis. Fifty-seven patients with biopsy-proven primary biliary cirrhosis were randomized to receive either 0.6 mg of colchicine twice daily or an identically appearing placebo. Patients underwent clinical and laboratory evaluation every 3 mo and liver biopsy annually. Differences in mean alkaline phosphatase and alanine aminotransferase values between the colchicine and placebo recipients were statistically significant at 4 yr. Differences in mean bilirubin and immunoglobulin M values, although lower in the colchicine group, did not reach statistical significance. In colchicine-treated patients, mean alkaline phosphatase values fell significantly compared with controls, from 281 to 112 IU/L (p less than 0.01). Similarly, mean alanine aminotransferase values fell significantly compared with controls, from 129 to 86 IU/L (p less than 0.05). Bilirubin values remained stable in drug-treated patients, even in those patients with initially elevated bilirubin values, whereas they nearly doubled in subjects receiving placebo. Although biochemical parameters of disease activity improved or stabilized in colchicine-treated subjects, no difference in histologic progression was detected between the two treatment groups. We conclude that colchicine is of clinical benefit to patients with primary biliary cirrhosis as judged by improvement in alkaline phosphatase and alanine aminotransferase activities as well as a tendency for stabilization of bilirubin values. PMID- 3286361 TI - D-xylose testing: a review. AB - The efficacy of D-xylose testing in clinical situations has been reviewed in the light of recent kinetic studies. The standard 25-g D-xylose test in adults, based on analysis of 5-h urine collection and a 1-h serum sample, discriminates between normal subjects and patients with proximal small intestinal malabsorption with greater than 95% specificity and sensitivity. The 1-h serum level measured after administering this dose is also useful in evaluating malabsorption in patients with intermediate degrees of renal insufficiency and in the elderly. The 1-h serum test after administration of 5 g of D-xylose should be used in pediatrics and is greater than 91% sensitive and close to 100% specific. The [14C]D-xylose breath test with 1 g of D-xylose has been useful in identifying malabsorption caused by bacterial overgrowth in the small intestine. PMID- 3286362 TI - Controlled treatment trials in the irritable bowel syndrome: a critique. AB - The irritable bowel syndrome (IBS) is a common and poorly understood chronic condition that is treated with a great variety of drugs and other therapies without notable enduring success. As there are no objective markers of improvement, and because there may be a very large placebo response, potential treatments for IBS are difficult to assess. Probably the only method that can reliably evaluate IBS therapies is the randomized, double-blind, placebo controlled treatment trial. The purpose of this review is to critically examine issues central to establishing the efficacy of treatments for IBS in such trials. These include the definition of IBS, measures of efficacy, the placebo response, trial length, maintaining blindedness, the crossover design, ability to generalize, and statistical considerations. With this background, all published IBS treatment trials are examined. It is concluded that not a single study offers convincing evidence that any therapy is effective in treating the IBS symptom complex. Well-designed and executed IBS treatment trials are urgently needed; suggestions are given for essential features of such trials. PMID- 3286363 TI - Fate and effects of the alpha-glucosidase inhibitor acarbose in humans. An intestinal slow-marker perfusion study. AB - The alpha-glucosidase inhibitor acarbose has been successfully used in diabetic patients to decrease the postprandial rise in blood glucose. The aim of the present experiments was to investigate the fate and effects of acarbose along the small intestine using a slow-marker perfusion technique. In 8 healthy volunteers, jejunal and ileal loads of acarbose, glucose, and total carbohydrates were determined following a liquid, 400-kcal formula meal containing either 200 mg of acarbose or placebo. Preprandial and postprandial plasma concentrations of glucose and several polypeptide hormones were determined. Recovery of acarbose during 4 h was 65% +/- 9% (mean +/- SEM) of ingested dose in the ileum but 94% +/ 9% in the jejunum, indicating that the compound was neither degraded nor absorbed by the intestine to a major degree. After acarbose administration, ileal loads of glucose and total carbohydrates were considerably higher, whereas postprandial plasma concentrations of glucose, insulin, and gastric inhibitory polypeptide were lower when compared with placebo. The retardation of carbohydrate digestion to be inferred from these findings is confirmed by significantly elevated plasma concentrations of enteroglucagon after acarbose administration compared with placebo administration. PMID- 3286364 TI - [Assessment by sonography and palpation of the cervical closure system]. AB - Sonography or palpation alone are inadequate procedures in evaluating cervical function. Only by combining both methods cervical incompetence can be detected at an early stage, adequate therapy instituted and unnecessary cerclage operations prevented. The value of sonography lies in the possibility of studying the functional changes of the cervix in premature labour. PMID- 3286365 TI - [Heterotopic cartilage tissue in the uterus. Report of 2 cases and review of the literature]. AB - The occurrence of heterotopic cartilage islands (HKI) in the uterus wall is a rare event. So far, less than 50 cases have been reported. The present paper describes two additional cases and renders a review of the pertinent literature. The following topics are discussed: epidemiology, localization, morphology, clinical findings, etiology and pathogenesis. The vast majority of the HKI will result from displacement and retention of fetal tissues in the uterine wall. In exceptional cases, a development of HKI due to metaplasia may be discussed. PMID- 3286366 TI - [Importance of immunochemical methods for determining fibrinogen degradation products in the blood plasma]. PMID- 3286367 TI - Seasonal variations of insulin and some metabolites in dogfish plasma, Scyliorhinus canicula, L. AB - Plasma levels in insulin, glucose, ketone bodies, and lactate were analyzed during a 1-year period in the lesser spotted dogfish (Scyliorhinus canicula) in captivity. Plasma insulin levels fluctuated similarly for both sexes. The highest insulin levels were found during late prespawning (from January to March) and another increase was observed during the active feeding period (September and October). During the spawning period, insulin decreased and in the postspawning period the lowest values were reached. Glucose, however, showed a different trend. It was at a minimum in late prespawning and it reached its highest values in postspawning. It decreased again in September and October. Plasma ketone body levels were highest in late prespawning and could be considered as an alternative energy source for this hypoglycemic period. In the summer months plasma lactate levels rose, with maximum levels occurring in July. PMID- 3286368 TI - Cholecystokinin immunoreactivity in the digestive tract of bowfin (Amia calva), bluegill (Lepomis macrochirus), and bullfrog (Rana catesbeiana). AB - The distribution of the intestinal hormone, cholecystokinin (CCK), was studied in the gastrointestinal tract of a holostean fish, the bowfin (Amia calva), and compared to a teleostean fish, the bluegill (Lepomis macrochirus), and an amphibian, the bullfrog (Rana catesbeiana), using an antiserum specific for the carboxyl terminal tetrapeptide of CCK in an unlabeled biotin-avidin immunoperoxidase procedure. In the bowfin CCK immunostained cells were detected only in the anterior and mid-intestine; the stomach and the rest of the gastrointestinal tract were negative. Immunoreactive cells were open in appearance and were scattered along the intestinal mucosal epithelium, with cells in mid-intestine relatively more abundant than in anterior intestine. These relative distributions were confirmed by radioimmunoassay of tissue extracts. Additional immunostained cells of uncertain function were detected in the lamina propria of the intestine. In bluegill gut immunoreactive cells were observed in the anterior and mid-intestine and in the pyloric caeca, where cells were clustered near the intestinal opening. Immunoreactive cells occurred relatively uniformly along the anterior and mid-intestine. Bullfrog CCK-containing cells were detected both in the antral stomach and in the duodenum. CCK in gut tissues likely originated in the intestine. The redistribution of CCK cells toward the anterior part of the intestine during evolution coincides with the development of a compact pancreas in higher classes of vertebrates. Such a redistribution constitutes an adaptive placement of endocrine cells for signaling during the intestinal phase of digestion. PMID- 3286370 TI - Coexistence of corticotropin-releasing factor-like immunoreactivity and vasotocin in perikarya of the preoptic nucleus in the eel. AB - A corticotropin-releasing factor (CRF)-like system has been identified in eels (Anguilla anguilla, A. rostrata, and A. japonica) with immunocytochemical techniques. Immunoreactive perikarya were located in the preoptic area, in magno- and parvocellular regions of the preoptic nucleus. Fine fibers reached the pituitary and terminated in the neurohypophysis close to the corticotropic cells of the rostral pars distalis and caudally close to the melanocorticotropic cells of the intermediate lobe. Double immunostainings revealed the presence of three subpopulations of perikarya: one population containing only CRF, a second containing only arginine vasotocin (VT), and a third one containing both CRF and VT. This coexistence of CRF and VT was also demonstrated by comparing adjacent sections stained with anti-CRF and anti-VT, respectively. Because antisera used in the present work were carefully absorbed, these data strongly suggest that CRF and VT coexist in some perikarya, at least in the animals studied. PMID- 3286369 TI - Stimulation of gonadotropin release and of ovarian development, by the administration of a gonadoliberin agonist and of dopamine antagonists, in female silver eel pretreated with estradiol. AB - In freshwater or seawater female silver eel, the release of gonadotropin (GTH) accumulated in the pituitary under estradiol (E2) influence could be stimulated by a conjugated treatment with a mammalian gonadoliberin agonist (GnRH-A = des Gly10, (D-Ala6)-LH-RH ethylamide) and a blocker of dopamine receptor (pimozide). Furthermore, despite the GTH release, no reduction or even a significant increase in pituitary GTH levels were noted, indicating a stimulation of GTH synthesis. In consequence of the endogenous GTH release, a stimulation of ovarian development was induced, as demonstrated by the gonadosomatic index and histological study. Similar results were obtained with a combined treatment with GnRH-A and an inhibitor of catecholamine synthesis (L-alpha-methyl-3,4-dihydroxyphenylalanine). In contrast, no effect was produced by GnRH-A, pimozide, or L-alpha-methyl-DOPA, given alone. The results suggest that a double neuroendocrine mechanism (a lack of GnRH production and a dopaminergic inhibition of GnRH action) is involved in the prepubertal blockage of eel gonadotropic function before the reproductive migration. PMID- 3286371 TI - The stimulatory and inhibitory role of the hypothalamus in the regulation of ovulation in grass frog, Rana temporaria L. AB - In our previous experiments it was found that lesions placed in the infundibular hypothalamus induced an advanced ovulation in hibernating frogs, Rana temporaria. It was suggested that this premature ovulation was the effect of gonadotropin releasing hormone (GnRH) due to the injury of some hypothalamic area inhibiting its release or its action on the pituitary gonadotrophs. To investigate this hypothesis, the following experiments were undertaken: (1) an attempt to induce ovulation with exogenous GnRH in hibernating frogs; (2) an attempt to inhibit ovulation with anti-GnRH serum in preovulatory hibernating animals nonlesioned and with lesions of the infundibular hypothalamus; and (3) administration of bromocriptine in hibernating animals to assess whether this substance, as an agonist of dopamine, possesses an inhibitory action on the ovulation. The following results were obtained: (1) lesions of the infundibular hypothalamus in hibernating preovulatory females caused an advanced ovulation during hibernation; (2) the exogenous GnRH administered to preovulatory females induced ovulation during hibernation; (3) the anti-GnRH serum injected into hibernating preovulatory lesioned females inhibited preterm ovulation during, but not after, hibernation; (4) the immunoneutralization of endogenous GnRH in nonlesioned females resulted in an inhibition of the posthibernatory ovulation; (5) bromocriptine inhibited posthibernatory ovulation in nonlesioned hibernating animals. Thus, the results of these experiments support the suggestion that induction of accelerated ovulation in lesioned hibernating animals involved the releasing action of GnRH. This action of GnRH seemed to be facilitated by the ablation of inhibitory dopaminergic function of hypothalamus in lesioned animals. PMID- 3286372 TI - A chemical modification/interference study of yeast pre-mRNA spliceosome assembly and splicing. AB - A chemical modification/interference assay was used to determine the yeast pre mRNA sequence requirements for in vitro spliceosome assembly and splicing. Modifications of any of the nucleotides within the 5' splice site and branch point (TACTAAC box) consensus sequences as well as less conserved intron and exon positions were found to inhibit assembly and/or splicing. The interference pattern of the 5' splice site and TACTAAC box lesions increased as spliceosome assembly proceeded (complex III----complex I----complex II) and as splicing proceeded, suggesting that these sequence elements play multiple roles in the assembly of yeast spliceosomes and in the removal of intervening sequences. Furthermore, modification (or mutation) of a TACTAAC-like sequence upstream of the branch point was found to inhibit the rate of spliceosome assembly, implying a possible role for degenerate branch point sequences in modulating the efficiency of spliceosome assembly. PMID- 3286373 TI - Dwarf mice produced by genetic ablation of growth hormone-expressing cells. AB - Fusion of the 310 bp located 5' of the rat growth hormone (GH) gene to the human GH structural gene resulted in somatotrope-specific expression in transgenic mice. Human GH transcripts were detected only in pituitaries of these mice, and immunocytochemical analyses revealed that this expression was limited to GH expressing cell types. The rat GH 5' sequences were then used to direct the expression of diphtheria toxin to the GH-expressing cells of transgenic mice. A line of mice was established which lacks detectable levels of circulating GH. This deficiency resulted in dwarfism; transgenic animals grew only to half the size of nontransgenic littermates. Nearly all somatotropes were absent, as shown by GH immunostaining in the transgenic pituitaries. Prolactin (PRL)-producing lactotropes, thought to share a common cellular origin with somatotropes, were also reduced in numbers. A model for the lineal relationships between GH- and PRL synthesizing cells is proposed. PMID- 3286375 TI - [Comparative characteristics of the current methods of studying the effect of environmental factors on health]. PMID- 3286374 TI - Site-directed mutagenesis with Escherichia coli DNA polymerase III holoenzyme. AB - Escherichia coli DNA polymerase III holoenzyme was used to synthesize double stranded DNA from M13 single-stranded DNA hybridized to a phosphorylated synthetic oligodeoxynucleotide containing a nucleotide substitution. The resulting DNA was transfected into E. coli JM101 without further treatment. Sequence analysis of randomly chosen phage clones revealed that the efficiency of mutagenesis was nearly 50%, which is the theoretical maximum. Treatment with DNA ligase after DNA synthesis was not necessary to obtain high efficiency of mutagenesis. Thus, use of DNA polymerase III holoenzyme provides a simple and efficient procedure for site-directed mutagenesis. PMID- 3286377 TI - [Hygienic aspects of the effect of iodine on the body of workers and measures for its prevention]. PMID- 3286376 TI - [Embryotoxic and teratogenic action of low-intensity chemical environmental factors]. PMID- 3286378 TI - [Combined action of chemical compounds and elevated air temperature on the body]. PMID- 3286379 TI - [Prevention of injuries among the navigational personnel in waterborne transport (a review of the literature)]. PMID- 3286380 TI - A simple but effective suture. PMID- 3286381 TI - Oncogenes and gastrointestinal cancer. PMID- 3286382 TI - Expression of HLA-DR antigens on bile duct epithelium in primary sclerosing cholangitis. AB - The expression of HLA class I (HLA-A, B, C) and class II (HLA-DR) antigens on the biliary epithelium of 10 patients (nine men) with primary sclerosing cholangitis (PSC) was investigated using an immunoperoxidase technique on cryostat sections. Five patients were staged as grade II and five grade III on hepatic histology. None were cirrhotic. as grade II and five grade III on hepatic histology. None were cirrhotic. Controls were nine patients with primary biliary cirrhosis (PBC), five with extra hepatic biliary obstruction, 15 with other forms of chronic liver disease and six with normal livers. Bile ducts from the normal subjects and patients with chronic liver disease did not express HLA-DR antigens. In contrast, all 10 of the PSC biopsies showed varying degrees of HLA-DR staining of the biliary epithelium. Expression of DR antigens was also found on the bile ducts of all five patients with extra hepatic biliary obstruction and in six of nine patients with PBC. Expression of HLA class I antigens was seen on the biliary epithelium of all the biopsies examined. Increased numbers of helper and suppressor T-cells were seen in the portal tracts of all the PSC patients. This study has confirmed that aberrant expression of HLA-DR may occur on the biliary epithelium of some, but not all, patients with PBC. In addition, the study has shown that aberrant expression of HLA-DR always occurs in PCS at an early stage of histological liver damage. While this may be important in the pathogenesis of PSC, the aberrant expression in extra hepatic biliary obstruction suggests that it may be a secondary phenomenon. PMID- 3286383 TI - Dissolution of gall stones with an ursodeoxycholic acid menthol preparation: a controlled prospective double blind trial. AB - In a controlled prospective double blind trial patients with cholesterol gall bladder stones are treated with ursodeoxy-cholic acid (group A: UDCA 11.1 mg/kg per day; n = 16) and Ursomenth respectively (group B: a mixture of UDCA/menthol: 4.75 mg/kg per day each; n = 17). With same stone number and size (10-12 mm) there is a complete dissolution rate in group A of 38%, and of 53% in group B within 15-16.9 months. The response rate (complete + partial dissolution) amounted to 75% and 76% respectively. In group A there is one case of stone calcification, in group B none. Both preparations are free of unwanted effects. This suggests that the cyclic monoterpene menthol enhances the effect of UDCA and is of comparable effect to a mixture of six different terpenes used in former times. PMID- 3286384 TI - Continuous intravenous infusions of famotidine maintain high intragastric pH in duodenal ulcer. AB - Three double blind crossover studies were carried out to assess the ability of primed infusions of famotidine to raise intragastric pH over 24 hours in 12 duodenal ulcer patients. pH was measured continuously using intragastric electrodes and solid state recording devices. The studies compared the effects of placebo, famotidine 10 mg bolus injection iv followed by continuous infusions of 3.2 mg/h and 4 mg/h in random order. Gastric acidity decreased significantly with both dose regimens (p less than 0.0005) but the effects of either dosage were similar. During fasting median pH rose from 1.35 to 7.1 and 7.05 respectively. During the day, when standard meals were taken, median pH rose from 1.30 to 4.3 and 3.65 respectively. Despite continuous infusions the H2-antagonist was less effective during this time. The latter finding raises questions about gastric secretory control during the day when food is eaten. PMID- 3286387 TI - Getting to know you. The benefits of oral histories. PMID- 3286386 TI - Pressure sore treatment: a case in point. PMID- 3286388 TI - Lucile Petry Leone. PMID- 3286385 TI - Deoxycholic acid and the pathogenesis of gall stones. PMID- 3286390 TI - [Principle possibilities of surgical therapy of female stress incontinence]. PMID- 3286389 TI - [Tonometric and tocographic studies of selective priming of the cervix with sulprostone gel in abortion in the 1st trimester]. PMID- 3286391 TI - [Chronic pelvic pain in the female]. PMID- 3286392 TI - [Reproduction medicine in the area spanning ethics and law]. PMID- 3286393 TI - Ritodrine infusion at term: effects on maternal and fetal prostacyclin, thromboxane and prostaglandin precursor fatty acids. AB - A prospective randomized study was performed to investigate the effect of a short term ritodrine infusion on the concentrations of maternal and fetal prostaglandins and their precursor fatty acids. Mothers gave birth by an elective cesarean section at term, and either ritodrine (study group) or physiological saline (controls) was infused 2 h prior to the operation. Ritodrine decreased the levels of thromboxane A2 significantly in the mother, while the concentration of prostacyclin remained unchanged. In the umbilical arterial plasma concentrations of prostacyclin or thromboxane A2 there were no differences between ritodrine treated and control subjects. Ritodrine had no effect on the prostaglandin precursor fatty acids and other fatty acids of plasma phospholipids of the mother or her fetus. It is concluded that ritodrine may suppress the maternal prostaglandin production, but has no effect on the levels of vasoactive prostaglandins or their precursor fatty acids in the fetus. PMID- 3286394 TI - Changes in pancreatic B cell function during late pregnancy, early lactation and postlactation. AB - Oral glucose tolerance tests were performed in 10 normal women during late pregnancy (36 +/- 1 weeks of gestation), early lactation (5 days after delivery) and postlactation (1 week after weaning). A marked decrease in basal plasma insulin and C peptide concentrations, as well as in the B cell secretory response to hyperglycemia, was observed at the 5th day of postpartum, compared to the high values recorded in late pregnancy. Except for a higher basal C peptide level and a lower plasma prolactin concentration, there was no major difference between early lactation and postlactation. At the 5th day after delivery, the insulin response to hyperglycemia was lower in lactating than in nonlactating women (14 subjects in each group). It is concluded that, in normal women, pancreatic B cell function undergoes a rapid normalization during the postpartum, at least when the latter coincides with the onset of lactation. PMID- 3286395 TI - [Clinical imaging of the mimetic muscles using high resolution ultrasound]. AB - In comparison to other techniques, high resolution ultrasound has proved to be a good method for clinical imaging of muscles. By free selection of the scan plane and multidimensional viewing it is possible to represent each muscle from origin to insertion and to observe them during function. Pathology produces different types of echogenity. By imaging an EMG needle electrode the exact position within the muscle can be demonstrated. The result of the EMG study can therefore be related to small individual muscles or muscle segments, which are below the size suitable for clinical examination. PMID- 3286396 TI - [A method for covering defects of the lip]. AB - Numerous methods have been described to reconstruct lower lip defects. A further method is presented which is suitable for lateral defects of the lower lip and employs a transposition flap similar to Goldstein's method. PMID- 3286397 TI - [Indications for primary wound closure in bite injuries of the face]. AB - Because of high infection rats and because of possible deformities after radical debridement there is still some restraint in primary wound closure in facial bite injuries. Today the sophistication of facial reconstructive surgery provides the possibility even with injuries with significant skin defects to gain primary healing with satisfactory results from a cosmetic point of view as well as from a functional one. PMID- 3286398 TI - [Early pressure on the gluteus maximus rotation flap in sacral decubitus ulcer]. AB - The myocutaneous gluteus maximus flap in V-Y technique has become the workhorse for covering extensive sacral pressure sores. clinical experience indicates that this flap can sustain pressure prior to the usual three week period. Transcutaneous pO2 measurements permitted us to follow the flaps perfusion and to develop a new mobilization regimen. Patients can lie in the supine position for 30 minutes immediately after surgery for two hourly intervals. Three days postoperatively the usual two-hour repositioning can be resumed. This regimen represents a considerable improvement for paraplegics and has shown a comparable complication rate in 18 cases. PMID- 3286399 TI - [Free vascularized nerve transplants, free donor nerves, suitable donor sites]. AB - The vascularized nerve graft offers an alternative to the conventional free nerve graft. Possible nerves for grafting, the anatomy of the donor sites, and the advantages and disadvantages of vascularized nerve grafts are discussed. The variations in blood supply and the loss of function caused by harvesting play an important role. Clear indications in our opinion are long nerve defects, scar in the wound bed and reconstruction of the brachial plexus. Exact planning, correct indications and good micro-neurovascular technique are all important in neuromicrosurgery and the basis for good results. PMID- 3286400 TI - [Surgical correction of congenital bilateral dislocations of the extensor tendons of the thumb]. AB - A congenital bilateral thumb-contracture due to dislocation of both extensor tendons over the metacarpophalangeal joint was treated in a fourteen-year-old boy. Intraoperatively the extensor tendons were shifted to a dorsal position and restrained over the center of the metacarpophalangeal joint of the thumb. By this method the previously useless thumbs were given normal function and cosmetic appearance. This congenital anomaly could not be classified as any known syndrome. PMID- 3286401 TI - [The fish hook technic--an aid in pulling tendon tissue through tight channels]. AB - Pulling tendon grafts through narrow bone-holes often frays and tangles the tendon ends. The following knot technique results in a concentric compression of the tendon end. The line of pull is directed to the mid-portion of the implant and provides an axial force. The technique is demonstrated on the anatomic model as well as on clinical cases. The technique is simple to perform, involves minimal trauma to the implant, and requires only a very small drillhole in the bone to allow optimum tendon-bone contact and healing. PMID- 3286402 TI - [Upper extremity lymphedema in bancroftial filariasis]. PMID- 3286403 TI - [Calcium channel blockers in nervous system disorders]. PMID- 3286405 TI - [Biological research of suicidal behavior]. PMID- 3286404 TI - [Decision making in out-of-hospital resuscitations: survey of the literature on factors associated with survival]. PMID- 3286406 TI - [New inotropic agents in the treatment of refractory congestive heart failure]. PMID- 3286407 TI - [Primary meningococcal pericarditis--a rare expression of a common infection]. PMID- 3286408 TI - [Spina bifida in Israel and its prevention]. PMID- 3286409 TI - [Corneal transplantation for fungal keratitis]. PMID- 3286411 TI - [The search for biological markers in schizophrenia]. PMID- 3286410 TI - [Patterns of bacterial distribution and susceptibility in patients of the Sharon region]. PMID- 3286412 TI - [Rapid tests for diagnosis of group A streptococcal pharyngitis--update]. PMID- 3286413 TI - [Blood glucose self-monitoring in diabetic pregnancy]. PMID- 3286414 TI - [Autoimmune disease of the eye]. PMID- 3286415 TI - [Spontaneous bacterial peritonitis]. PMID- 3286416 TI - [Aggressive and selective surgical management of severe peritonitis]. PMID- 3286417 TI - [Ginsenoside-Rb1 as a suppressor in central modulation of feeding in the rat]. AB - Ginsenosides, the main component of Panax ginseng root, have been reported to show several pharmacological actions on the peripheral metabolism of glucose and lipid and on endocrine secretion. The present study aimed to clarify the effects of ginsenoside-Rb1 on feeding behavior and endogenous chemical substances. Rb1 infusion into the rat third cerebroventricle was started at 1930 hr, and ingestive behavior was recorded in a soundproof room illuminated daily from 0800 to 2000 hr. Rb1 at doses of 0.05, 0.10 and 0.20 mumol potently decreased food intake dose-dependently during the first dark period after infusion. Analysis of meal patterns revealed that the suppressive effect was due to decreasing meal size, but not to postprandial intermeal interval and eating speed. Drinking episodes decreased concomitantly with feeding suppression only at the highest dose of 0.20 mumol. Ambulatory activity was not affected in the doses tested. Infusion of Rb1 increased plasma glucose, leaving insulin unaffected. Microinjection of 0.01 mumol Rb1 into the hypothalamic ventromedial nucleus (VMH) decreased food intake, but injection into the lateral hypothalamic area did not. Taking these data together, Rb1 was found to have a suppressive effect on feeding partly through the VMH. PMID- 3286419 TI - Cytomorphological comparison of mechanical and chemical defoaming of a yeast culture. AB - Defoaming of the medium by a rotating turbine during yeast cultivation, in contrast to defoaming by oil, results in fading away of cells of higher age categories and in an increase of dead cells proportion in the population. The negative effect of the mechanical defoaming device did not manifest itself in the amount of biomass obtained but in the cell numbers observed. PMID- 3286418 TI - Cultivation on cellophane agar as a method for the assay of bacterial enzymes. AB - Production of bacterial enzymes in a liquid medium and on cellophane-agar plates is compared. Using neutral proteinase, urease, alpha-amylase and thiosulfate sulfurtransferase as examples it was demonstrated that the cultivation on cellophane-agar plates yields higher concentrations of the enzymes and that the enzyme production is detected in a higher number of cultures. The method might be useful for the characterization of bacterial communities. PMID- 3286421 TI - [Reduced preliminary acid treatment of enamel in the bracket adhesion technic--a scanning electron microscopy and physical study]. PMID- 3286420 TI - Production of toxic antigens in dialyzed cultures of microorganisms. AB - Data on the production of clostridial toxins in dialyzed cultures are summarized. Principal modifications of this cultivation technique suitable for both research and production are shown. If toxins are released from the cells by autolysis (neurotoxins of Clostridium tetani, C. botulinum; lethal factors of C. novyi and C. sordellii), a 10-fold increase of the antigen concentration in filtrates of dialyzed cultures is found in comparison with normal cultures. If toxins are excreted already during growth (lethal factors of C. perfringens type A, C. septicum), the positive effect of the technique is less significant. A dialyzed culture ensures a well-balanced production of toxic filtrates that contain highly concentrated, relatively pure and strongly immunogenic antigens. PMID- 3286422 TI - [Iridocorneotrabecular dysgenesis in a patient sample of the Munster University Eye Clinic]. PMID- 3286423 TI - [Morphology of the aqueous outflow system in different forms of glaucoma]. PMID- 3286424 TI - [Epidemiology and risk factors in glaucoma]. PMID- 3286425 TI - [Classification and therapy of glaucoma in childhood]. PMID- 3286426 TI - [Sudden, non-traumatic death in sports. 1: Incidence and causes]. PMID- 3286427 TI - [Antihypertensive therapy in young hypertensive patients. Effect of tredalat in comparison with adalat on blood pressure behavior and metabolism, especially renin excretion]. PMID- 3286428 TI - [Sonography in rheumatic orthopedics. Current status and indications today]. PMID- 3286429 TI - [Standardized psychiatric anamnesis by computer]. PMID- 3286430 TI - [Sudden non-traumatic death in sports. 2. Risk factors and recommendations for prevention]. PMID- 3286431 TI - [Pain profile in activated osteoarthritis. Results of an open, multicenter study with ibuprofen]. PMID- 3286432 TI - [Early detection of breast cancer]. PMID- 3286433 TI - [Motility disorders of the bile ducts]. PMID- 3286435 TI - [Meniere's disease and disorders of the autonomic nervous system]. PMID- 3286434 TI - [Possible development of resistance to quinolones. Its significance for general practice]. PMID- 3286436 TI - [Clinical evaluation of endoscopic ultrasonography in diagnosis of lesions in upper alimentary tract, pancreas and biliary tract]. PMID- 3286437 TI - [Clinical studies on language creation by schizophrenics]. PMID- 3286438 TI - [On the lesions of bones of Yayoi people in southwest Japan]. PMID- 3286439 TI - Randomized, double-blind trial of exifone versus cognitive problems in Parkinson's disease. AB - Exifone is a novel substance of the benzophenone group that possesses potent scavenging properties. Initial findings demonstrate beneficial effects on age related cognitive disorders. In this double-blind clinical trial versus placebo, the efficacy of 2 dosages (600 and 1200 mg/d) was evaluated with regard to Parkinson's disease (PD)-related cognitive disorders, for which there is increasing suspicion of a free-radicals origin. Despite disparities between the treatment groups as assessed by validated scales and subtests, and a considerable placebo effect on main parameters, both dose levels of exifone produced statistically significant improvement of the cognitive items most commonly impaired by PD: immediate recall, naming of objects presented, spatiotemporal orientation, and calculation. These properties suggest a new slot for exifone in the range of therapeutics available. PMID- 3286441 TI - Pirenzepine and upper gastrointestinal tract motility in man. PMID- 3286442 TI - Histological diagnosis of different liver lesions using fine-needle aspiration biopsy. AB - The aim of our study was to elucidate the applicability of FNA biopsies for histomorphological analysis. Ultrasonically-guided fine-needle biopsy proved to be a simple, safe and time-saving method of high diagnostic value in discovering and establishing liver lesions. FNA biopsies performed in 58 patients offered enough material for histomorphological analysis of primary liver tumors (8x), metastases (8x) and diffuse liver diseases (25x). Only 27% of the cases examined remained histomorphologically unclear. Furthermore, no complications were seen with this procedure. PMID- 3286440 TI - Rabbit articular chondrocytes: an in vitro model for studying the effect of sodium aurothiopropanol sulfonate on proliferation kinetics, type II collagen phenotype and mitochondrial activity. AB - Despite the benefits of chrysotherapy the responsible mechanism of action of gold compounds remains unclear. At a concentration of 5 x 10(-4) M, sodium aurothiopropanol sulfonate (SAS) modified the in vitro proliferation kinetics of articular chondrocytes by reducing growth, viability and plating efficiency. Flow cytometry analysis, using propidium iodide DNA staining, revealed slight but significant cell arrest in G2+M which, in fact, represents an increase in the proportion of binucleate cells. SAS did not induce any variations in chondrocyte phenotype stability as far as the biosynthesis of type II collagen was concerned, and no appreciable changes in overall mitochondrial activity reflected by rhodamine 123 incorporation. PMID- 3286443 TI - An ultrasonic duplex system facilitates detection of portal hemodynamic changes following selective shunts for esophageal varices. AB - We used an ultrasonic duplex system (US system) to assess portal hemodynamics in 52 patients with liver cirrhosis and esophageal varices, who underwent 2 types of distal splenorenal shunt (DSRS), conventional DSRS (group A, 8 patients) or DSRS with splenopancreatic disconnection (group B, 44 patients). The portal blood flow rate (PBF) was determined in 64 out of 70 patients (91.4%) and the shunt flow rate (SVF) in 39 out of 42 patients (92.9%) who had angiographically confirmed patent portal vein and shunt vein, during the peri- and postoperative period. In group A, a remarkably small amount of postoperative PBF (193 ml/min) and a concomitant increase in SVF (1039 ml/min) were evident. Such ultrasonic findings were compatible with a reduction in portal vein diameter, in accordance with the poor portal perfusion grade of the liver, and a transpancreatic stealing of the portal blood flow to the shunt, as evidenced by postoperative angiography. In contrast, the reduction in PBF was minimal, that is 663 ml/min preoperatively to 562 ml/min at discharge, and 536 ml/min at late follow-up, in group B patients. Significant alterations in portal circulation of the group B patients were not evident angiographically. This US system is most useful to assess portal hemodynamics in patients with a selective shunt. PMID- 3286444 TI - Mutant insulin syndromes. AB - Highly sensitive procedures for the characterization of molecular species of insulin in the circulation and for the isolation of the gene encoding human insulin have recently been developed. Nine subjects with abnormal forms of insulin or proinsulin have been reported. These include: [Leu B25], [Ser B24], [Leu A3] insulin as well as others that have not yet been identified. The clinical syndrome associated with the secretion of an abnormal insulin or proinsulin molecule presents with apparent endogenous insulin resistance with inappropriate high levels of insulin for the prevailing blood glucose concentration and a high insulin/C-peptide ratio due to the reduced catabolism of the abnormal insulin molecule. Diabetes occurs if there is concomitant insulin resistance or pancreatic beta cell failure. In addition, abnormal forms of insulin have been found in the insulin autoimmune syndrome presenting with recurrent, self-limiting hypoglycemia. Abnormal insulin in the autoimmune insulin syndrome suggests that abnormalities in endogenous antigens may be important in the formation of antibodies in other autoimmune states. However, although abnormalities in the insulin molecule may provoke the autoimmune response, it is also feasible that the presence of antibodies to normal insulin and proinsulin in some way alters their metabolism to yield abnormal products on high performance liquid chromatography (HPLC). Abnormal forms of insulin have also been found in subjects with reactive hypoglycemia and exogenous insulin-resistance and appear to be transmitted in an autosomal dominant manner. A protocol for the sequence of investigating subjects who potentially harbor a mutant or otherwise abnormal form of insulin using HPLC and recombinant DNA technology is presented. PMID- 3286445 TI - Effect of insulin deficiency on low density lipoprotein metabolism in rabbits. AB - These studies have been carried out in rabbits with alloxan-induced diabetes in order to see if insulin deficiency affects low density lipoprotein (LDL) catabolism. The results showed that plasma LDL-cholesterol was lower in diabetic rabbits, associated with a fall in the cholesterol to protein ratio of LDL particles. In addition, 125I-LDL disappeared more slowly from plasma of diabetic rabbits, leading to a significant reduction in fractional catabolic rate and a decrease in residence time of 125I-LDL. These data demonstrated that LDL composition and catabolism are greatly altered as a consequence of insulin deficiency. PMID- 3286446 TI - Electrical stimulation of the suprachiasmatic nucleus of the hypothalamus causes hyperglycemia. AB - We have presented evidence suggesting that the suprachiasmatic nucleus (SCN) is involved in central regulation of glucose homeostasis. To elucidate this role of the SCN, we examined the effects of its electrical stimulation on glucose metabolism in male Wistar rats. During and shortly after this stimulation, we observed hyperglycemia associated with enhanced hyperglucagonemia but no immediate hyperinsulinemia. In addition, we detected significant increase in liver glycogen phosphorylase alpha activity and significant decrease in the liver glycogen content. These findings suggest that the SCN is important in control of glucose homeostasis through effects on glucagon and insulin secretions and liver glycogen metabolism. PMID- 3286447 TI - Comparison of effects of proglumide and CR 1409, a new glutaramic acid derivative, on CCK-8-induced pancreatic polypeptide and insulin secretion in the dog. PMID- 3286448 TI - Glucose-stimulated insulin release is normal from rachitic rat islets in vitro. PMID- 3286449 TI - Comparison of the acute metabolic effects of 22,000-dalton and 20,000-dalton growth hormone in human subjects. AB - The acute metabolic effects of 20,000-dalton human growth hormone (hGH20K) in man have not previously been tested. We compared changes in concentrations of free fatty acids (FFA), glucose, and insulin in nine growth hormone deficient children following injection of 22,000-dalton intact human growth hormone (hGH22K) and the smaller variant, hGH20K. There was a significant decline (37%) in the mean FFA concentration from baseline to 1/2 hour post-injection and from baseline to 1 hour post-injection (36%) in the children given hGH22K, but no such decline was seen after injection of hGH20K. No significant differences in mean insulin or glucose concentrations were noted between the two treatment groups, and glucose and insulin concentrations did not acutely change after injection of either hormone. The results of this study indicate that hGH20K has a diminished activity for suppression of FFA as compared to hGH22K. This suggests that GH residues 32 46, missing in hGH20K, constitute all or part of the region of hGH22K producing this response, or that the different primary structures of the two hormones result in tertiary structural differences and altered biological activity. PMID- 3286450 TI - Acute hypermagnesaemia retards glucose assimilation and inhibits insulin secretion during intravenous glucose tolerance test (IVGTT). PMID- 3286451 TI - Changes in phosphate do not affect insulin release from isolated mouse islets of Langerhans. AB - Phosphate affects glucose tolerance, insulin release and peripheral insulin sensitivity. In the present study moderate changes in the phosphate concentration of the incubation medium from 0.3 to 2 mmol/l (i.e., within the physiological range) did not affect insulin release from isolated mouse islets in vitro. In addition, the vitamin-D status of the animals had no effect on the glucose stimulated insulin response in the different phosphate concentrations. Therefore these data indicate that the impaired glucose tolerance seen in hypophosphatemic states is not due to a direct effect of phosphorus levels on the insulin releasing B-cell. PMID- 3286452 TI - Insulin effect on amino acid uptake by unloaded rat hindlimb muscles. PMID- 3286453 TI - Metabolism and action of insulin and glucagon in goat during lactating and dry period. AB - The metabolism and action of insulin and glucagon were investigated in goats during mid lactating (50 days postpartum) and during the dry period. The animals were fed hay and concentrate during lactation (1:1) and only hay during dry period. Pulse doses of unlabelled insulin and glucagon were injected intravenously. The disappearance of insulin from the circulation was faster during lactation than during dry period; the metabolic clearance rate of insulin was significantly increased during lactation. In contrast, the kinetic parameters of glucagon disappearance were very similar during the two periods. Basal plasma hormones (i.e. before hormone injection) were higher during lactation than during dry period; the molar ratio insulin:glucagon was left unchanged. The increase in plasma insulin following glucagon-stimulated hyperglycaemia was similar during the two periods. The ability of insulin to elicit a decrease in blood glucose was markedly impaired during lactation when compared to dry period. In contrast the ability of glucagon to increase blood glucose was slightly improved during lactation. Those endocrine changes could be related to the effect of both lactation and diet. PMID- 3286454 TI - Sulphonylureas-induced increase in insulin binding and glucose metabolism by isolated rat adipocytes. AB - The effects of oral hypoglycaemic drugs, SPC-703 (n-/p-toluenesulphonyl/-5-methyl 2-pirazoline-1-carbonami de) and tolbutamide on insulin binding and glucose metabolism by isolated adipocytes were studied. After 10 days of administration of both sulphonylurea derivatives, no differences were observed in insulin concentration between both experimental and the control groups of animals, despite a significant fall in blood glucose level. SPC-703 and tolbutamide in concentrations of 1 mM added in vitro to the suspension of adipocytes had no effect on insulin binding or on basal and insulin simulated glucose metabolism. Daily administration of 300 mg/kg body weight of SPC-703 or tolbutamide for 10 days resulted in 48% and 34% increase of specific binding of insulin by adipocytes, respectively. From the Scatchard plot analysis we noted that the increase of binding resulted from increased affinity of insulin receptors for hormone. Simultaneous increase in basal and insulin stimulated glucose metabolism by adipocytes, as measured by 14CO2 production and 14C incorporation into cellular lipids, was observed. The results indicate that hypoglycaemic action of sulphonylureas may be explained by increased affinity of insulin receptors and the stimulating action of these compounds on peripheral glucose metabolism. PMID- 3286455 TI - Multihormonal regulation of thyroglobulin production by the OVNIS 6H thyroid cell line. AB - The hormonal regulation of thyroglobulin production has been studied using a clone of the ovine thyroid cell line: OVNIS 6H. 3 among the 6 hormones proposed for serum replacement are required for an optimal thyroglobulin production; insulin, hydrocortisone and thyrotropin. Insulin alone stimulates thyroglobulin production. The presence of insulin is also required to observe hydrocortisone and TSH stimulations. Newborn calf serum inhibits thyroglobulin production. The best conditions for optimal thyroglobulin expression and TSH responsiveness are obtained in serum-free medium supplemented with 5 micrograms/ml insulin, 100 nM hydrocortisone and 1 mU/ml TSH. PMID- 3286456 TI - Hepatic transplantation survival: correlation with adenine nucleotide level in donor liver. AB - The hypothesis was tested that human donor livers with higher ATP content and energy charge achieve better results after hepatic transplantation. Biopsies were obtained from 25 donor livers immediately prior to implantation and analyzed for adenine nucleotides using high-performance liquid chromatography. The results were correlated with organ histology, transplant function and outcome. Significantly higher concentrations of ATP (4.22 +/- 2.87 vs. 0.71 +/- 0.69 nmoles per mg protein, p less than 0.01), ADP (8.75 +/- 2.96 vs. 4.49 +/- 1.95 nmoles per mg protein, p less than 0.01) and energy charge (0.43 +/- 0.15 vs. 0.21 +/- 0.04, p less than 0.02) were found in successful (n = 20) relative to failed (n = 5) livers. No significant differences were found in AMP, xanthine or hypoxanthine for the two groups, although the average values were higher in failed livers. Fifteen recipients with liver ATP concentration above 2 nmoles per mg protein and energy charge above 0.3 recovered well. Five other successful patients with lower ATP concentration (0.70 +/- 0.39 nmoles per mg protein) and energy charge (0.20 +/- 0.03) had postoperative courses complicated by infection or prolonged hyperbilirubinemia. In five patients whose livers failed, all had low ATP content and energy charge. Of these, three received a replacement liver and two died shortly after the transplantation. The study demonstrates a direct correlation between high ATP content and good posttransplant outcome. PMID- 3286457 TI - Ectopic soft tissue calcium deposition following liver transplantation. AB - We observed ectopic soft tissue calcification affecting seven patients following orthotopic liver transplantation. The cause of such calcification is unknown, but potential pathogenetic factors include hyperparathyroidism, calcium administered during and following surgery, renal failure, acid-base changes and citrate in fresh frozen plasma. To investigate some of the mechanisms underlying ectopic calcification following liver transplantation, we determined preoperative levels of ionized serum calcium, phosphate, magnesium, parathyroid hormone (midmolecule assay) and 1,25-(OH)2 vitamin D in 20 patients who underwent 24 liver transplants. In addition, these parameters were measured weekly in 15 patients during the first month after liver transplantation. Preoperatively, 5 of the 20 patients had elevated serum levels of parathyroid hormone, and 9 others had low levels of 1,25-(OH)2 vitamin D. After liver transplantation, ectopic calcification was found in seven patients (47%). The organs affected in order of frequency were lungs, liver graft, colon, vascular walls, kidneys, adrenal glands and gastric mucosa. One patient with ectopic calcification of both lungs had markedly restricted pulmonary function as well as radiologic evidence of osteopenia and pathologic fractures of three vertebrae. Postoperatively, increased parathyroid hormone levels were found in all patients who developed soft tissue calcification. Parathyroid hormone levels peaked during the second week after transplantation and were higher at all times compared to subjects without calcification. Five of the seven patients with ectopic calcification had associated renal failure. Individuals who developed calcification had received significantly more fresh frozen plasma, red blood cells and elemental calcium postoperatively, but showed no difference in serum levels of calcium, magnesium, vitamin D, total plasma CO2 or phosphate levels when compared to patients without calcification.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286458 TI - Interaction of woodchuck hepatitis virus surface antigen with hepatocyte plasma membrane in woodchuck chronic hepatitis. AB - The extent of association between woodchuck hepatitis virus surface antigen and host hepatocyte plasma membrane in chronic hepatitis was studied. Purified membranes containing the antigen were treated with various agents which perturb plasma membrane constituents to elute woodchuck hepatitis virus surface antigen. The products from disrupted membranes were analyzed by sedimentation in sucrose gradients and tested to identify the antigen reactivity. The results indicated that membrane-bound woodchuck hepatitis virus surface antigen was partially released by 4 M potassium chloride, potassium thiocyanate and guanidine, 6 M urea or 0.1 N sodium hydroxide (pH 13.5), but not in the presence of low concentrations of these reagents or by 10% 2-mercaptoethanol and 1% sodium dodecyl sulfate. No more than 15% of the total membrane-associated woodchuck hepatitis virus surface antigen was eluted by 0.1 N NaOH, which was found to be the most effective eluent among tested agents at the antigen removal. The remaining woodchuck hepatitis virus surface antigen was resistant to further extraction with sodium hydroxide, as expected for an integral membrane protein. Treatment of the infected membranes with 1% Triton X-100 or 50 mM deoxycholic acid, that solubilize the membrane lipid bilayer releasing most of the integral membrane proteins, resulted in the sedimentation of almost all detectable woodchuck hepatitis virus surface antigen reactivity with the detergent-insoluble membrane residues, suggesting a firm interaction of the antigen with the plasma membrane matrix.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286459 TI - Morphological and hemodynamic changes in the portal venous system after distal splenorenal shunt: an ultrasound and pulsed Doppler study. AB - We investigated a group of patients who underwent distal splenorenal shunt using high-resolution real-time equipment and a duplex scanner with the aims: (i) to evaluate the rate of visualization of shunt; (ii) to assess change in size in the portal vein, and (iii) to characterize the flow pattern in the splenic vein and to study flow direction and velocity in the portal vein, thus adding new data on the efficacy of this operation in maintaining hepatic perfusion. Real-time ultrasonography was performed in 29 patients before surgery, after 7 to 30 days and after 4 to 12 months. Direct visualization of the shunt was achieved in 53.5% of the patients. Mean caliber of the portal vein significantly decreased after the operation: preoperative = 1.52 +/- 0.32; after 7 to 30 days = 1.32 +/- 0.16 (p less than 0.001), and after 4 to 12 months = 0.99 +/- 0.19 (p less than 0.001). The overall postoperative incidence of portal thrombosis was 22.2%. Thirteen of these patients also underwent a postoperative (4 to 36 months) pulsed Doppler investigation. Flow towards anastomosis was demonstrated in the splenic vein in 11 patients, and in 7 cases, typical caval pulsatility was observed. Decreased hepatopetal flow in the portal vein was found in 10 of 13 patients. In two patients, no flow was detectable and in the other the flow was hepatofugal. On the basis of our data, we can affirm that pulsed Doppler investigation may provide useful data for the evaluation of shunt patency and preservation of a decreased portal hepatic perfusion in the majority of patients. PMID- 3286460 TI - Assessment of the effect of respiration on the esophageal variceal blood flow using transesophageal real-time two-dimensional Doppler echography. AB - The effect of spontaneous respiration on esophageal variceal flow was evaluated using 5 MHz color flow Doppler echography. Twenty-one patients with esophageal varices, of whom 19 had liver cirrhosis (95%), were examined with a convex array transesophageal transducer. The direction and velocity of the variceal flow during inhalation and exhalation could be inferred from the color, its brightness or the Doppler time-velocity spectrum. The mean intravariceal flow velocity was significantly higher during inhalation (20.6 cm per sec) than in exhalation (11.5 cm per sec; p less than 0.01). The direction of intravariceal flow at any given point did not change throughout the respiratory cycle. However, a combination of real-time color flow imaging and the doppler time-velocity spectrum revealed that, when the sampling point was near the peak of the curve of the varix, the spectrum falsely indicated reversal of direction between inhalation and exhalation. This semiinvasive method, which yields anatomical and physiological information simultaneously, appears to be very useful for the study of variceal flow. PMID- 3286461 TI - Clinical and statistical analyses of new and evolving therapies for primary biliary cirrhosis. AB - Primary biliary cirrhosis is a chronic, progressive, cholestatic liver disease thought to be related to abnormalities in immune regulation. The disease is associated with granulomatous bile duct destruction, cholestasis, hepatic copper overloading and the development of hepatic fibrosis or cirrhosis or both. There have been numerous therapeutic trials evaluating immunosuppressive, antifibrotic and cupruretic agents. Prednisolone, D-penicillamine, azathioprine, colchicine and chlorambucil have been evaluated in controlled clinical trials, and biochemical improvement of liver function has been noted with all of the agents, except D-penicillamine. Improved survival has also been reported in patients treated long-term with azathioprine and colchicine. However, none of the therapeutic agents has been demonstrated to halt histologic progression of the disease or to induce a complete clinical, biochemical and histologic remission as has been reported in patients with autoimmune chronic active hepatitis treated with corticosteroids. Many of the trials did not use a double-blind design, failed to use the "intent to treat" rule or failed to define an objective time to analyze results. Many of the studies involved small numbers of patients with short-term follow-up and thus potentially were inadequate to appreciate drug effects that might be of clinical benefit. Currently, there is no totally effective therapy for primary biliary cirrhosis. We believe that well-designed clinical trials can provide important information to better understand this disease until a totally effective therapy is available. New clinical trials should use well-established methodologic guidelines in study design and well accepted statistical standards in the analysis and interpretation of results. PMID- 3286462 TI - Antigen presentation and autoimmunity. PMID- 3286463 TI - Ischemia-reperfusion injury: a radical view. PMID- 3286464 TI - Therapeutic amelioration of jaundice: old and new strategies. PMID- 3286465 TI - Lymphoblastoid interferon in controlled trials of chronic hepatitis B virus infection. PMID- 3286466 TI - HLA class I antigen display on hepatocyte membrane in chronic hepatitis B virus infection: its role in the pathogenesis of chronic type B hepatitis. AB - It has been suggested that cytotoxic T cells are involved in the recognition and lysis of the infected hepatocytes in chronic hepatitis B virus infection, and that the target antigen is probably HBcAg which is displayed on the hepatocyte membrane during active viral replication. However, studies in other viral infection have demonstrated that cytotoxic T cells recognize viral antigen on the infected cells only in the context of HLA class I antigens. To test whether this mechanism is also operative in chronic hepatitis B virus infection, we studied the expression of HLA class I antigens in livers from 35 patients with chronic hepatitis B virus infection by indirect immunofluorescence using monoclonal antibody against HLA class I antigens. The blocking effect of monoclonal antibody against HLA class I antigens on the in vitro T cell cytotoxicity to autologous hepatocytes was also studied. The results revealed that HLA class I antigen was undetectable on the hepatocyte membrane in all of 10 HBeAg-positive carriers with minor hepatitic activity, whereas it was demonstrated in 15 (88%) of the 17 HbeAg positive patients with chronic active liver disease and in 7 (87%) of the 8 anti HBe-positive "normal" carriers. The in vitro T cell cytotoxicity to autologous hepatocytes in six HBeAg-positive patients with chronic active liver disease was significantly inhibited by preincubation of hepatocytes with monoclonal antibody (10 to 40 micrograms per ml) against HLA class I antigen, but not by monoclonal antibody against HLA class II antigens and non-HLA-associated surface molecules (Leu 11).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286467 TI - Cutaneous leucocyte composition after human allogeneic bone marrow transplantation: relationship to marrow purging, histology and clinical rash. AB - Immunohistological and morphometric techniques were used to study the skin after marrow transplantation with particular reference to the relationship of marrow purging, the presence of a clinical rash and histological changes to leucocyte numbers and phenotype. Recipients of T-cell-depleted marrow showed significant reductions in CD2+, CD4+ and CD8+ T-lymphocytes in the first 22 d after transplantation but not after this time. T-cell numbers in recipients of unpurged marrow were similar to those of normal donors, indicating a rapid repopulation by cells from the graft. Langerhans cells (CD1+ dendritic cells) and macrophages, on the other hand, were present in similar numbers in both groups of patients within the first 22 d; the former in low and the latter in normal numbers. Biopsies exhibiting graft versus host disease showed increases in CD2+, CD4+ and CD8+ T lymphocytes with significant lowering of the CD4:CD8 ratio. A proportion expressed markers of activation and HNK1+ cells and macrophages were also increased. Biopsies exhibiting epidermal basal abnormalities only (changes identical to graft versus host disease but without detectable leucocyte infiltration on conventional microscopy) showed a minor increase in macrophages and HNK1+ cells but no other leucocyte alterations to suggest a pathogenetic link with graft versus host disease. Langerhans cells were reduced in these biopsies, however, when taken more than 22 d post-transplant, suggesting that the epidermal changes are associated with Langerhans cell damage or repopulation. We were unable to identify any significant alteration in leucocytes in patients with strong clinical evidence of graft versus host disease but with histologically unremarkable biopsies. Although it is possible that perivascular increases in T cells and expression of activation markers precede the characteristic histological picture of graft versus host disease the time scale is probably too short to allow diagnostic value. PMID- 3286468 TI - Pathogenesis of graft versus host disease. PMID- 3286469 TI - Ependymoblastoma: a histological, immunohistological and ultrastructural study of five cases. AB - Five ependymoblastomas were studied by means of routine histological techniques, immunohistology and electron microscopy. The tumours were characterized histologically by medium sized, poorly differentiated cells with round or oval nuclei frequently in mitosis and by ependymoblastic rosettes. Reactions for cytokeratin and neurofilament were negative and tubular material positive for glial fibrillary acidic protein was scanty. All five tumors demonstrated positivity for vimentin and S-100 protein. Electron microscopy showed poorly differentiated cells with high nucleo-cytoplasmic ratio and scanty cytoplasmic organelles. Sparse rosettes were present and the cells were united by junctional complexes. Frequent rudimentary or incomplete cilia, a few basal bodies and a few short intercellular glial-like filaments were seen. Features differentiating ependymomas and anaplastic ependymomas from ependymoblastomas are discussed and the need for a definite category separating ependymoblastomas from the former tumours is emphasized. PMID- 3286470 TI - Renal vascular disease in diabetes mellitus. AB - Nephropathy remains a major cause of morbidity and mortality in diabetes mellitus and increasing numbers of patients require dialysis maintenance therapy. Diagnostic criteria of diabetic nephropathy are well established, but the relationship between the morphological changes of glomerular basement membrane thickening and increased mesangial volume and functional abnormalities, such as proteinuria and impaired renal function, are still not clearly understood. Tissue studies in patients with micro-albuminuria, as well as increased knowledge of the structure of the glomerular basement membrane, should lead to an understanding of how the diabetic process affects blood vessels throughout the body. PMID- 3286471 TI - Hyperplastic capillaries and renal tubules in chronic transplant rejection. PMID- 3286473 TI - Kaiser has withstood the test of time. Interview by Maria R. Traska. PMID- 3286472 TI - Modern perspectives on epilepsy in relation to psychiatry: behavioral disturbances of epilepsy. AB - In this paper, the second of a two-part series on current psychiatric aspects of epilepsy, the authors consider the classification and management of the various kinds of psychoses and other behavior disturbances associated with some cases of epilepsy. After discussing the common aspects of epilepsy and schizophrenia, they describe attempts to categorize epileptic psychoses, focusing on a classification of ten kinds of psychoses that they believe has broadest application. They present guidelines for psychopharmacological management of epilepsy accompanied by behavior disturbance, with emphasis on anticonvulsant monotherapy, and they discuss possibly related seizure disorders and possible etiologies of behavioral symptoms of epilepsy. PMID- 3286474 TI - No cuts for rural referral centers in FY 1989: HCFA report. PMID- 3286475 TI - Rand: Patients discharged quicker but not sicker. PMID- 3286476 TI - Fraud and abuse investigations: how to respond. PMID- 3286477 TI - Craniofacial morphology of two skeletal populations from Israel. PMID- 3286478 TI - Determination of stress episode duration from linear enamel hypoplasias: a case study from St. Catherines Island, Georgia. PMID- 3286479 TI - Natural killer cell infection and inactivation in vitro by the human immunodeficiency virus. AB - Cytolytic activity of human mononuclear peripheral blood leukocytes from healthy donors, cultured in interleukin-2 conditioned medium, was abrogated by in vitro infection with the lymphadenopathy associated virus (LAV) isolate of the human immunodeficiency virus (HIV). Although viral antigens are not expressed in cultured cells until 14 days postinfection, cytolytic activity was lost as early as 3 days after infection. Loss of cytolytic function was not a result of the release of suppressive factors from either infected cells or uninfected CEM cells since supernatants from neither infected cultures nor CEM cell cultures had any inhibitory effects on the function of uninfected cells. Cultured lymphocytes expressing Leu 11b were also shown to express HIV antigens via immunofluorescence after 14 days in culture. These results suggest that natural killer (NK) cells, as defined by expression of Leu 11b, were infected by HIV in vitro and the loss of lytic function was likely a direct consequence of that infection. PMID- 3286480 TI - Intermediate lymphocytic lymphoma: an immunophenotypic study with comparison to small lymphocytic lymphoma and diffuse small cleaved cell lymphoma. AB - Sixteen cases of intermediate lymphocytic lymphoma (ILL), including eight cases with mantle zone architecture, were studied using cryostat sections, a biotin avidin immunoperoxidase technique, and a large panel of monoclonal antibodies. The neoplastic cells invariably expressed IgM, most B lineage antigens (B1, TO15, Leu-12, 6A4, 41H, BA-1, and LN-2), and Ia. IgD was expressed in 12 cases. Leu-1 and Leu-8 were weakly expressed by the tumor cells in 12 and 11 cases, respectively. The neoplastic cells did not express common acute lymphoblastic leukemia antigen (CALLA) or the T10 antigen in any case. Because ILL is difficult to differentiate from small lymphocytic lymphoma (SLL) and diffuse small cleaved cell lymphoma (DSCCL) on the basis of light microscopic criteria, the immunologic findings of ILL were compared to 31 cases of B cell SLL and 11 cases of B cell DSCCL previously studied in the laboratory to determine if immunologic findings might aid in the distinction. No absolute, and five statistically significant, differences were found; IgD in combination with IgM was seen more commonly in cases of ILL and DSCCL than in SLL (P less than .01), IgG was found more often in SLL than in ILL and DSCCL (P less than .05), Leu-8 was more commonly expressed in ILL and SLL than in DSCCL (P less than .05), T9 expression was less frequent in ILL as compared with SLL (P less than .05) and more proliferating cells were seen in ILL and DSCCL than in SLL (P less than .01). The investigators conclude that these three classes of lymphoma are remarkable much more for their immunologic similarities than for their differences and that immunologic studies are of limited usefulness in differentiating the three neoplasms. Their results also support the concept that these lymphomas are closely related to each other. In particular, DSCCL immunologically appears to be more closely related to SLL and ILL than to follicular small cleaved cell lymphoma. PMID- 3286481 TI - Characteristics of gut specific monoclonal antibodies. AB - Eight distinct murine monoclonal antibodies that are directed to normal human mouse small intestinal epithelial cells have been characterized. Three of these called TPNG 2, 20 and 43 were directed to goblet cells and mucin components. One antibody, TPNC 10, was directed to basilar crypt cell inclusions and was specific for the small bowel and possible progenitor cells. Another antibody, TPNC 30, was directed to the microvilli of the brush border. Finally, three antibodies, TPNC 50, 51 and 52 reacted with epithelial cell membranes. These three antibodies reacted with intestinal epithelial cell membranes but also cross-reacted with hepatocyte cytoplasm. The availability of intestinal specific monoclonal reagents will be of significant interest in studies of normal and abnormal intestinal physiology. PMID- 3286482 TI - Expression of a high molecular weight mucin-type glycoprotein in human colon cancer as defined by monoclonal antibody 1D3. AB - Murine monoclonal antibody 1D3 recognizes a high molecular weight acidic mucin restricted to the epithelium of normal colonic mucosa and goblet cells. Of 72 colonic carcinoma specimens examined, 29 were found to have detectable level of 1D3 antigen by an indirect immunoperoxidase staining assay on fixed, paraffin embedded tissue sections. In some specimens a focal staining pattern was observed, while in others 50-90% of tumor cells were stained. Of 28 cases having adjacent normal mucosa, all 28 showed intense staining reaction in the normal mucosa and goblet cells despite the fact that 18 of the tumors were unstained. One of 1 colonic diverticulosis, 2 of 2 ulcerative colitis, 3 of 3 villo glandular polyps, 19 of 20 adenomatous polyps and 17 of 19 hyperplastic polyps were also stained heavily for the 1D3 antigen. Colonic carcinomas displayed a range of staining patterns and a great degree of antigenic heterogeneity. Well differentiated tumors characterized by typical goblet cells were almost always positive (10 of 12). As cellular structure became disorganized, as in moderately differentiated tumors, about 33% of the tumors (17 of 51) stained for 1D3 antigen. As the tumor became more invasive with further disorientation of cellular features, as in poorly differentiated tumors, very few specimens (2 of 9) were positive. It was apparent that with the progression of de-differentiation there was a gradual loss of 1D3 antigen in human colonic tumors. PMID- 3286483 TI - Unique monoclonal antibodies against soluble membrane proteins of human CML myelocytes reactive with human myeloid progenitor cells. AB - Monoclonal antibodies of IgG1 type immunoglobulin, directed against soluble CML antigen isolated from the reactive CML peripheral myelocytes, were reported. These MAbs were further investigated for their reactivity by 125I-Protein-A binding assays, indirect immunofluorescence tests, cytotoxicity, SDS-PAGE, immunoelectrophoresis, and by immunodiffusion suggesting that they recognized antigens specific mostly to undifferentiated cells. These were tested against various leukemic peripheral blood leukocytes, bone marrow cells, established cell lines of various origin, and with many solid tumor cells and demonstrated specific reactivity with CML myelocytes alone and cell lines of myeloid origin. Indirect immunoperoxidase staining of single cell preparation revealed peroxidase localization in most promyelocytes and in few mature myelocytes from CML PBL/BM cells, thus helping in identifying the exact type (morphology) involved in reacting specifically with these MAbs. PMID- 3286484 TI - Presence and characterization of lymphocytotoxins in acute and chronic Plasmodium berghei malaria. AB - The role of lymphocytotoxic antibodies in elimination of lymphocytes and characterization of these antibodies during Plasmodium berghei infection was examined in BALB/c mice. When assayed at 15 degrees, an increase in lymphocytotoxic levels above base line values was detected in acute infection when parasitaemia exceeded 10%. There was an increase in lymphocytotoxins with increase in parasitaemia to a plateau beyond 25% parasitaemia. When assayed at 37 degrees, lymphocytotoxic activity during acute infection was lower than at 15 degrees but the increase detected was significant. During chronic infection there was a lower increase in the activity detected at 15 degrees and no significant increase in activity assayed at 37 degrees (P greater than 0.05). In addition, peripheral blood lymphocyte counts also dropped during acute infection while there was little change in lymphocyte numbers in the chronic infection group. The lymphocytotoxic antibodies present in sera of infected mice were predominantly of IgM class during acute infection and IgM or IgG class during chronic infection. The relevance of these observations to plasmodium infection is discussed. PMID- 3286485 TI - Leprosy and immunity: genetics and immune function in multiple case families. AB - Genetic susceptibility to infection with M. leprae was studied in 10 multiple case families of Australian Aborigines. Of the 87 members available for study, 24 had proven stable clinical leprosy which had been or was still being treated with diamino diphenyl sulphone. Evidence of contact with M. leprae in the remaining 63 members as assessed by ELISA to M. leprae sonicate and phenolic glycolipid (PGL) or by indirect immunofluorescence antibody assay was found in 78%, 64% and 71%, respectively. By contrast, in vitro assays of T cell function (LMAT and LTT) were less reliable indicators of exposure. Evidence was sought for possible linkages between human leucocyte antigen (HLA) or non-HLA genes and four marker phenotypes including clinical leprosy, clinical subtype of leprosy and lymphocyte transformation or leucocyte migration inhibition factor (LIF) production in response to M. leprae antigen. No associations were found with any particular HLA or non-HLA gene. On the other hand, sequential analysis of the data from the 10 families was strongly suggestive of a linkage between HLA haplotype and non responsiveness to M. leprae as manifest by lack of LIF production but not lymphocyte transformation. The model which best fits the data is for a gene on chromosome 6 in close linkage with the HLA haplotype, with two alleles, autosomal recessive inheritance and penetrance of 90%. On this basis, it can be suggested that disease type (lepromatous leprosy) rather than disease susceptibility may be controlled by genes within or closely linked to the major histocompatibility gene complex. PMID- 3286486 TI - Cytokines amplify the function of accessory cells. AB - Accessory cells have two broad functions at the onset of T cell-mediated immunity. One is the "presentation" of antigen in association with MHC products. The other is a "sensitization" function which is thought to require IL-1 and leads to the development of lymphoblasts that secrete lymphokines and respond to T cell growth factors. This review summarizes evidence, much of it recent, that specific cytokines upregulate both the presentation and sensitization functions of accessory cells. Lymphokines, particularly IFN-gamma, upregulate class II MHC products on macrophages and many non-leukocytes, but not dendritic cells. The enhanced levels of class II improve presentation to T lymphoblasts, but not the sensitization of unprimed and memory T cells. Dendritic cells in lymph and lymphoid organs are active accessory cells for primary responses without any supplementation by exogenous cytokines. IL-1, while not a product of dendritic cells, further amplifies their function several fold. In thymus, IL-1 has a second effect, including the formation of Ia+ thymic dendritic cells from Ia- precursors. Granulocyte-macrophage colony stimulating factor (GM-CSF) is an important cytokine for epidermal Langerhans cells, which are immature dendritic cells. GM-CSF maintains viability in culture, and enhances the sensitization function for primary responses 10-20 fold. Why does the immune system regulate expression of Ia on many cell types, as well as dendritic cell function? In the discussion, it is proposed that the local modification of accessory cells by cytokines helps to reduce anti-self or autoreactive T cell responses, and to enhance the retention of sensitized T cells at sites of antigen deposition. PMID- 3286487 TI - A new simplified assay for evaluation of motile activity of human polymorphonuclear leucocytes. AB - We studied the adaptation of a filtration instrument to an assay for cell migration experiments. The commercially available Nuclepore filter holders were modified so that isolated human polymorphonuclear leucocytes (PMNs) were allowed to penetrate a porous filter membrane and to enter a compartment under the membrane. The total number of PMNs which had passed the pores during an hour of incubation could be counted. In this way we carried out experiments using Shigella sonnei lipopolysaccharide and dilutions of E. coli culture supernatant as chemoattractants for healthy human PMNs. These studies showed that the method can distinguish between random and directed movements of PMNs and it is sensitive to the concentrations of chemoattractant. Furthermore, the data obtained using PMNs from the same subject on different days seem to be comparable. PMID- 3286488 TI - Tolerance to minor histocompatibility antigens. AB - A neonatal tolerance model employing fully allogeneic lymphoid cells as tolerogen was used in an investigation of tolerance to self and donor minor histocompatibility antigens (miHA). Tolerance was assessed by skin grafting and subsequently by the generation of cytotoxic T lymphocytes. Two strain combinations were investigated. In the first, BALB/c-B10, none of the mice became tolerant to H-2d: all gave responses to BALB/c and B10.D2 antigens comparable to uninjected controls. However, tolerance was secured to BALB miHA in the face of reactivity to the original donor cells (i.e., BALB/c), showing that multiple miHA can induce tolerance independently of major histocompatibility complex (MHC) antigens. In the reverse strain combination, in which tolerance to B10 antigens was successfully established in BALB/c recipients, MHC restriction of tolerance to self miHA could not be demonstrated, as mice tolerant to B10 were unresponsive to BALB.B antigens, too. Again, the induction of tolerance to multiple donor miHA proved to be independent of tolerance to donor MHC antigens, and a great deal easier. PMID- 3286489 TI - Characteristics of blood cells responding to insulin in children with insulin dependent diabetes. AB - Cells responding to insulin in peripheral blood of children with insulin dependent diabetes mellitus were characterized using monoclonal antibodies and autoradiography. The results indicate that the cells responding to insulin were T cells mainly of the helper (CD4+) phenotype and that they required adherent cells of the monocyte/macrophage lineage for proliferation to occur. PMID- 3286491 TI - The role of drug timing and histoincompatibility barrier in prolongation of cardiac graft survival in mice treated with donor-specific blood and cyclophosphamide. AB - In the H-2-compatible donor-recipient combination (BALB/c----DBA/2), pretransplant donor-specific blood transfusion (DST) significantly prolonged graft survival. Concomitant use of immunosuppression by cyclophosphamide (CY) brought about potentiation of DST effect, resulting in long-term graft survival. In contrast, in the 'strong' H-2-incompatible combination (BALB/c----CBA/H) pretreatment of the recipients with donor-specific blood resulted in hyperacute graft rejection or in impairment of drug-induced immunosuppression when DST was used with a single dose of CY. In this model however, combination of DST with both pre- and posttransplant CY immunosuppression interacted beneficially to produce significant donor-specific prolongation of graft survival. PMID- 3286490 TI - Maternal T cells promote placental growth and prevent spontaneous abortion. AB - Transplantation immunologists have long been intrigued by the natural allograft that results from normal mammalian pregnancy. Its general success contrasts with the rejection problems associated with most artifactual organ transplantation and raises intriguing questions concerning the nature of the mechanisms involved in that success. This area of research has recently taken on added momentum because it is now clear that immunological maneuvers can prevent recurrent spontaneous abortion in mice, horses and humans [1-3]. The purpose of this review is to discuss some of these recent developments, which lead to the surprising conclusion that maternal T cells, rather than being potentially detrimental to the fetal allograft, promote its growth and viability during normal pregnancy. This review will address these questions by considering: (a) the nature of the exposure of fetal alloantigens to the maternal circulation in the chimeric zone of the placenta; (b) the evidence for maternal immune recognition of the fetal alloantigens; and (c) the consequences of that recognition with respect to the prevention of spontaneous abortion. As in other areas of immunology the T cell emerges as the most important component of this immune recognition. PMID- 3286492 TI - Histocompatibility antigen changes associated with pink-eyed dilute (p) mutations. AB - The tight linkage between the H-4 histocompatibility locus and the pink-eyed dilute (p) locus raises the possibility that a single gene is responsible for both a histocompatibility antigen and coat color phenotype. To examine this possibility, we have investigated the effects of a spontaneous coat color mutation, pink-eyed unstable (pun), which occurred at the p locus in the C57BL/6J inbred strain, on histocompatibility antigen phenotype. Skin grafts were transplanted from two independently maintained B6-pun substrains to coisogenic, wild-type C57BL/6 recipients; graft rejection uniformly commenced at 6-7 weeks but did not culminate in complete graft destruction as observed in other cases of "crisis" rejection. Neither the onset of rejection time nor the intensity of rejection could be accelerated by introducing new H-2 haplotypes into the wild type recipients. These results suggested that the pun allele was associated with a histocompatibility antigen not shared with C57BL/6. The pun allele is characterized by a relatively high frequency of reversion to wild-type. Therefore, skin grafts from B6-pun donors were transplanted to homozygous, revertant (+/+) recipients which were subline-matched with the donors; these grafts underwent crisis rejection with the same time of onset of rejection as observed with C57BL/6 recipients. These observations indicate that a new histocompatibility antigen is associated with the pun mutation and is lost upon reversion to wild type; this association is the first demonstration of a link between histocompatibility and coat color phenotypes. PMID- 3286494 TI - Drug resistance in Plasmodium falciparum malaria--a clinical study. PMID- 3286493 TI - Structural heterogeneity of human Pgp-1 and its relationship with p85. PMID- 3286495 TI - Slow-virus diseases. Review article. PMID- 3286497 TI - Biotype, serotype, and pathogenicity of attaching and effacing enteropathogenic Escherichia coli strains isolated from diarrheic commercial rabbits. AB - A total of 568 strains of Escherichia coli isolated from healthy and diarrheic rabbits were separated into 11 different biotypes according to the fermentation patterns of four carbohydrates. Strains belonging to biotypes 1 to 3, 6, and 8 induced lesions characteristic for attaching and effacing E. coli (AEEC). They attached to the intestinal epithelium of the terminal small intestine and the large intestine of 5-week-old rabbits after experimental infection and caused effacement of the microvillous brush border. However, pathogenicity for weaned rabbits, as judged by diarrhea score, anorexia, and reduced weight gain, varied according to the biotypes of the strains. Strains belonging to biotypes 1 and 6 produced only discrete clinical signs, strains belonging to biotypes 2 and 3+ (motile) induced diarrhea and growth depression, whereas strains belonging to biotypes 3- (immotile) and 8 caused severe clinical signs and high mortality. This confirms evidence from the field. Biotypes 3- and 8, accounting for 35.5 and 7.1% of AEEC strains in weaned diarrheic rabbits, respectively, were not detected in weaned healthy rabbits, while biotype 2 was the predominant strain in weaned healthy rabbits (62.3%). Finally, serotyping showed a close relationship between biotype and serotype of the AEEC examined. Most strains of biotypes 1+ and 2+ tested were O109:K-:H2 and O132:K-:H2, respectively, whereas all strains tested of biotype 3- were O15:K-:H- and those of biotype 8 were O103:K-:H2. These data indicate that specific clones of AEEC might be involved in juvenile rabbit enteritis. It was concluded that determination of biotypes allows the screening of highly pathogenic AEEC in weaned rabbits (biotypes 3- and 8). PMID- 3286498 TI - Molecular analysis of enterotoxin plasmids of enterotoxigenic Escherichia coli of 14 different O serotypes. AB - A total of 104 isolates of enterotoxigenic Escherichia coli derived from diarrheal patients from more than 10 countries were examined for serotype and toxigenicity. The transferability and molecular structure of the enterotoxin plasmids from each isolate were also examined. Enterotoxin plasmids from serotypes such as O6, O25, O27, O126, O128, and O159, which are frequently associated with E. coli diarrhea (classical strains) generally did not transfer by conjugation from clinical isolates, whereas those from serotypes such as O7, O17, O80, O98, O139, O150, and O153, which are rarely associated with diarrhea (rare strains) transferred almost always from the clinical isolates by conjugation. Analyses of enterotoxin plasmids by restriction endonucleases and DNA-DNA hybridization with the enterotoxin probes revealed that the strains with the same O serotype and toxigenicity carry closely related enterotoxin plasmids. These results suggest that classical strains resulted from the dissemination of ancestral clones which received enterotoxin plasmids long ago, while the rare strains acquired the enterotoxin plasmids recently by conjugation and have not yet been spread to the same degree as the ancestral clones. PMID- 3286496 TI - Idiotypic vaccines and infectious diseases. PMID- 3286499 TI - Demonstration of an outer membrane protein with antiphagocytic activity from Pasteurella multocida of avian origin. AB - A strain of Pasteurella multocida of avian origin was found to inhibit phagocytosis of Candida albicans by mononuclear phagocytes in vitro. Whole-cell lysates of P. multocida showed this effect, as did a 50-kilodalton (kDa) protein eluted from sodium dodecyl sulfate-polyacrylamide gels obtained by electrophoresis of whole-cell lysates. Heat, digestion with trypsin, and antibody specific for this 50-kDa protein neutralized the antiphagocytic effects of P. multocida, of the whole-cell lysates, and of the 50-kDa protein itself. Evidence that this protein was in the outer membrane of the bacterial cell included the findings that (i) treatment of encapsulated or unencapsulated P. multocida with trypsin reduced the antiphagocytic effect; (ii) whole-cell lysates prepared from trypsinized, unencapsulated P. multocida had reduced antiphagocytic activity; and (iii) antibody to outer membrane proteins neutralized the antiphagocytic effect. Turkeys given antibodies specific for the 50-kDa outer membrane protein were protected against lethal challenge with P. multocida. PMID- 3286500 TI - Lipopolysaccharide structure determines ionic and hydrophobic binding of a cationic antimicrobial neutrophil granule protein. AB - Bactericidal activity and binding of a 57,000-dalton cationic antimicrobial neutrophil granule protein (CAP57) are determined by the presence on bacteria of O-antigen polysaccharide chains and the availability of negatively charged groups in the lipid A region, the inner core region, or both regions of lipopolysaccharide. Polymyxin B (PMB)-resistant mutants with well-defined alterations in lipid A structure and charge (pmrA) are also more resistant to CAP57. We used biologically active radioiodinated CAP57 to study the characteristics and kinetics of binding to a sensitive Rb lipopolysaccharide chemotype, Salmonella typhimurium SH9178, and the relatively resistant pmrA mutant strain SH7426. Binding occurred rapidly and was specific and saturable. Because CAP57 appears to be bound in a manner similar to that of PMB, competition binding studies were performed. Excess PMB did compete with CAP57 for binding to SH9178. Nonapeptide, a polycationic derivative of PMB that has lost its hydrophobic portions, demonstrated a marked decrease in ability to compete for binding with CAP57 compared with PMB. This demonstrated the importance of hydrophobic binding in the interaction of CAP57 with the microbial surface. Thus, we have shown that binding of CAP57 to SH9178 is specific, saturable, and similar to binding of PMB. Both hydrophobic and ionic properties of CAP57 appear to be necessary for binding. PMID- 3286502 TI - Endotoxin-induced shedding of viable uroepithelial cells is an antimicrobial defense mechanism. AB - ICR mice were infected intravesically with a virulent (7343) or a nonvirulent (U+) Escherichia coli strain. The U+ strain induced considerably more shedding of uroepithelial cells than did the 7343 strain. The stimulus for this shedding was shown to be associated with lipopolysaccharide and was abrogated by pretreatment with aprotinin. Desquamation commenced within 1 h postinjection, and the cells that were shed proved to be viable. Comparison of C3H/HeJ and C3H mice revealed that only the latter responded to shedding inducers. However, C3H/HeJ mice succumbed to a systemic infection on injection of 10(6) U+ cells intravesically, whereas other mouse strains required a 100-fold dose of bacteria for this effect. Since the first stage of a bacterial infection entails adherence of the microbes to epithelial cells, inducible shedding is an antimicrobial defense mechanism. PMID- 3286501 TI - Endotoxin-associated protein: interleukin-1-like activity on serum amyloid A synthesis and T-lymphocyte activation. AB - Bacterial endotoxins or lipopolysaccharides (LPS) elicit a variety of biologic activities in intact animals and various in vitro systems. LPS from most gram negative bacteria have appeared to have similar biologic activities regardless of the species of origin or method of preparation of the LPS. More recent studies have suggested differences in the effects of protein-rich as opposed to protein free LPS in inducing mitogenesis of lymphocytes from endotoxin-resistant C3H/HeJ mice. These studies examine other activities of endotoxin-associated protein (EAP), purified to less than 0.007% contamination with LPS, and demonstrate that this material has activity mimicking some of the effects of interleukin-1 (IL-1). EAP proved to be as potent as LPS in eliciting rises in concentrations of serum amyloid A (SAA) and was active in both endotoxin-sensitive (CF1) and endotoxin resistant (C3H/HeJ) mice. In contrast to LPS, which mediates its SAA-inducing activity by release of an inducer (IL-1) from LPS-stimulated macrophages, EAP appeared to act directly to induce SAA production, in that incubation with macrophages failed to increase its activity. EAP also exhibited IL-1-like activity in the lymphocyte-activating factor assay when both CF1 and C3H/HeJ thymocytes and macrophages were tested. The lymphocyte-activating factor activity of EAP was not blocked by addition of polymyxin B. In addition, EAP exerted stimulatory activity on resting human T lymphocytes, costimulated with Sepharose bound anti-CD3 monoclonal antibody 64.1, comparable to that observed with purified human monocyte IL-1. These studies indicate that proteins from procaryotic cells may act as cytokines for some eucaryotic cells. PMID- 3286503 TI - Synthetic peptides of Shiga toxin B subunit induce antibodies which neutralize its biological activity. AB - Shiga toxin B chain, the binding subunit of Shiga toxin, was recently purified; and the amino acid sequence of this 7,716-dalton polypeptide was determined (N.G. Seidah, A. Donohue-Rolfe, C. Lazure, F. Auclair, G. T. Keusch, and M. Chretien, J. Biol. Chem. 261:13928-13931, 1986). In the present study, synthetic peptides corresponding to three overlapping sequences from the N-terminal region of this subunit were prepared. The peptides synthesized consisted of residues 5 to 18, 13 to 26, and 7 to 26. This region coincides with the major peak of hydrophilicity and surface area residues predicted from a computer analysis. For the purpose of immunization, the peptides either were conjugated with a protein or synthetic carrier or were polymerized with glutaraldehyde. Antisera against these peptide derivatives raised in rabbits reacted not only with the respective homologous peptide but also to a comparable extent with the intact Shiga toxin. The anti peptide antisera effectively neutralized the various biological activities of the Shiga toxin, namely, cytotoxicity to HeLa cells, enterotoxic activity (the fluid secretion into ligated ileal loops in rats), and neurotoxicity in mice. Furthermore, active immunization with the peptide conjugates was found to protect mice against the lethal effect of Shiga toxin. PMID- 3286504 TI - Acid phosphatase stimulation of the growth of Nocardia asteroides and its possible relationship to the modification of lysosomal enzymes in macrophages. AB - Lysosomal acid phosphatase levels are reduced in murine macrophages by virulent strains of Nocardia asteroides. At the same time, other lysosomal enzymes either remain unchanged or increase in activity, indicating that acid phosphatase is not lost because of degranulation or membrane leakage. This study shows that acid phosphatase was utilized as a sole carbon source by Nocardia asteroides and that acid phosphatase combined with glutamate as a carbon source enhanced nocardial growth. As a consequence, the inverse relationship that was observed between acid phosphatase activity and the bactericidal capacity of macrophages infected with N. asteroides appears to be due to the ability of N. asteroides to preferentially metabolize this lysosomal enzyme during growth within phagocytes. PMID- 3286505 TI - Cloning and expression of secreted antigens of Clostridium difficile in Escherichia coli. AB - The feasibility of the cloning and expression of Clostridium difficile antigens in Escherichia coli was investigated. The expression of a limited number of cloned clostridial antigens under the control of clostridial promoter elements in E. coli was observed. PMID- 3286506 TI - Cloning of the gene, speB, for streptococcal pyrogenic exotoxin type B in Escherichia coli. AB - The structural gene encoding streptococcal pyrogenic exotoxin type B, designated speB, was cloned in Escherichia coli and localized onto a 4.5-kilobase BamHI BglII DNA fragment. Streptococcal pyrogenic exotoxin type B, partially purified from E. coli clones, was immunologically related to streptococcus-derived toxin. Also, toxin derived from either E. coli or Streptococcus pyogenes had similar lymphocyte mitogenic activity and molecular weight (29,300) and displayed comparable microheterogeneity when evaluated by isoelectric focusing. PMID- 3286507 TI - Elevated serum beta-2-microglobulin--a prognostic marker for development of AIDS among patients with persistent generalized lymphadenopathy. AB - For evaluation of its prognostic value, the level of serum beta-2-microglobulin was determined in early serum samples from 88 patients with persistent generalized lymphadenopathy in a prospective longitudinal study. Patients with serum beta-2-microglobulin greater than 2.6 mg/l were found to have a significantly higher risk of developing AIDS earlier when compared to patients with a lower level (p less than 0.001). PMID- 3286508 TI - Persistence of Yersinia enterocolitica in man. AB - Ten patients with chronic Yersinia enterocolitica infections are described. The initial diagnosis was made by culture, significant agglutinin titres and indirect immunofluorescence (IF) on biopsies. During the chronic phase, culture and agglutinin titres were negative, but specific serum IgA and IgG antibodies reactive with at least two, i.e. the 36 kDa and the 46 kDa, virulence-associated released proteins were demonstrated in nine patients by immunoblot techniques. One patient had only IgG antibodies. The chronically elevated IgA production was the result of chronic stimulation of the gut-associated lymphoid tissue by virulent persistent Yersinia antigen, which was identified by IF with O-specific antiserum and monospecific antiserum to the 46 kDa released protein in biopsies. Virulent Yersinia bacilli were demonstrated in the intestinal mucosa and in the lymphoid tissue of the submucosa associated with macrophages in patients with chronic ileitis and arthritis, in granulomatous centres of lymph nodes in patients with chronic lymphadenopathy and in portal infiltrates in a patient with chronic hepatitis. Recognition of persistent Yersinia infections may have therapeutic implications. PMID- 3286509 TI - Ciprofloxacin and norfloxacin for selective decontamination in patients with severe granulocytopenia. AB - In a randomized multicenter study, ciprofloxacin and norfloxacin, each in two different dose regimens and in combination with non-absorbable antimycotics, were administered to 51 patients with acute leukaemia undergoing aggressive remission induction chemotherapy for infection prevention. Both drugs showed an effective elimination of gram-negative potential pathogens and Staphylococcus aureus not affecting the anaerobic flora of the gastrointestinal tract. A low incidence of side effects and a satisfactory patient compliance could be observed. A daily dosage of 1,000 mg ciprofloxacin or 800 mg norfloxacin is recommended for infection prevention in severely granulocytopenic patients. PMID- 3286510 TI - Bactericidal activity of ciprofloxacin, norfloxacin and ofloxacin in serum and urine after oral administration to healthy volunteers. AB - A 200 mg oral dose of ciprofloxacin, norfloxacin or ofloxacin was administered to six healthy male volunteers in a three way cross-over study in order to examine the kinetics in humans in relation to the bactericidal activity in serum and urine. Serum concentrations for ciprofloxacin were similar to norfloxacin and lower than ofloxacin. Despite this fact, ciprofloxacin showed the highest serum bactericidal titers compared to norfloxacin and ofloxacin when serum-resistant Escherichia coli C14 was used as a test organism. These results correlate with observations from timekill curve studies in human whole blood, where ciprofloxacin showed superior bactericidal activity compared to norfloxacin or ofloxacin. The amounts of unchanged drug excreted in urine (48 h period) were found to be 35%, 24% and 77% for ciprofloxacin, norfloxacin and ofloxacin respectively, indicating different excretion kinetics. The volumes of urine excreted in the different collection periods were comparable for the three drugs tested. Mean urine concentrations for ciprofloxacin were higher during the 0 to 4 h collection periods, whereas ofloxacin was excreted into the urine over a longer time period. Measurements of urine bactericidal activity showed that ciprofloxacin had the highest titers during the early collection periods, whereas the prolonged excretion of ofloxacin did not result in higher urine bactericidal titers, compared to ciprofloxacin. PMID- 3286512 TI - Pharmacokinetics of ciprofloxacin. AB - The fluorination of piperazinyl substituted quinolones has led to an interesting development of a series of new broad spectrum antibacterial agents that may be administered orally as well as parenterally and are well tolerated. Norfloxacin was an early compound, later followed by ciprofloxacin, enoxacin, ofloxacin and pefloxacin. In this overview the emphasis will be on the most extensively studied compound including comparisons, where data are available, with norfloxacin and ofloxacin. Enoxacin and pefloxacin will be omitted due to their pattern of side effects, which at present curtail their therapeutic use. More recent substances such as fleroxacin and defloxacin have not been sufficiently investigated to be considered in this context. PMID- 3286511 TI - Worldwide clinical data on efficacy and safety of ciprofloxacin. AB - During the clinical trials 8,861 patients have been treated with ciprofloxacin worldwide. 3,822 of the therapeutic courses were valid for analysis of efficacy according to FDA standards. The following dosages were usually administered: UTI: 100 to 500 mg twice daily orally or 100 mg twice daily intravenously; RTI: 250 to 1000 mg twice daily orally or 200 mg twice daily intravenously; septicemia: 200 mg intravenously twice daily; gonorrhea: 250 to 500 mg single tablet orally; all other infections: 500 to 1000 mg twice daily orally or 200 mg twice daily intravenously. Ciprofloxacin was administered to 762 courses of lower RTI, 88 courses of upper RTI, 108 courses of bacteremia, 766 courses of skin structure infection, 142 courses of bone and joint infections, 149 courses of intra abdominal infections, 33 courses of gastrointestinal infections, 1,633 courses of UTI, 49 courses of pelvic infections, 279 courses of STD, mainly gonorrhea, and three courses of meningitis. The clinical response was resolution in 76%, improvement in 18% and failure in only 6%. Bacteriologic response by all sites evaluable: pathogens were eradicated from 74%, markedly reduced in 2%, persisted in 10%. Relapse occurred in 4% and reinfection was observed in another 6%. The overall response was favourable for 90% of the patients. Drug safety was established on a data base of 8,861 courses worldwide. The following side-effects according to COSTART terminology were observed: digestive 5%, metabolic nutritional 4.6%, central nervous 1.6%, skin 1.4%, hemic and lymphatic 1%, cardiovascular 0.4%, body as a whole 0.4%, urogenital 0.3%, special senses 0.3%, musculo-skeletal 0.1%, respiratory 0.08%. Several courses had more than one reaction. Thus the total incidence of side-effects for the treated patient population was 10.2%. Ciprofloxacin is a highly effective drug and a breakthrough in several areas of medical interest. It is relatively safe and side-effects are usually mild or moderate in intensity and transient. PMID- 3286513 TI - Efficacy and safety of a single dose therapy of a 500 mg ciprofloxacin tablet in chancroid patients. AB - A single dose therapy of 500 mg ciprofloxacin was sufficient to cure 15 of 18 chancroid patients within six days and the remaining three within 7, 11 and 20 days respectively. The drug was well tolerated, and no serious side effects were observed. The MICs of ciprofloxacin for the isolated Haemophilus ducreyi strains ranged from 0.0015 to 0.02 mg/l (mean 0.01 mg/l). It may therefore be concluded from our study that the oral administration of ciprofloxacin to chancroid patients with or without buboes is highly effective and free from side effects. PMID- 3286514 TI - Efficacy of perioperative prophylaxis with ciprofloxacin or cefazolin in colorectal surgery. PMID- 3286515 TI - Is pelvic inflammatory disease an indication for treatment with ciprofloxacin? AB - This pilot study was carried out on 23 gynaecological patients suffering from salpingitis, salpingitis and pelviperitonitis, Douglas' abscess, and vaginal stump abscess. 21 courses were evaluable for clinical efficacy. The diagnoses had been established mainly by pelviscopy and by clinical gynaecological examinations. The dosage was 2 X 500 mg ciprofloxacin orally every 12 h for 7.6 (5-11) days. Cervical smears collected before therapy revealed the most common pathogens to be Escherichia coli and staphylococci, followed by Proteus mirabilis and streptococci. Clinically ciprofloxacin produced a complete cure in 16 patients (76%), and a clear improvement in four patients (19%). One patient left hospital before completing the therapy. Laboratory tests did not reveal any pathological findings, and ophthalmological examinations (fundoscopy, visus, colour perception) on 16 patients, before and after treatment, likewise did not show any changes. In one patient, therapy had to be discontinued after three days because of pruritic exanthema and vertigo. A second patient complained of strong pain behind the eyes and headache. In both patients these symptoms disappeared completely on discontinuation of treatment. The study showed clinical efficacy of orally administered ciprofloxacin in pelvic inflammatory disease. PMID- 3286516 TI - Bacterial infections of the skin treated with ciprofloxacin. AB - Bacterial infections of the skin or soft tissue responded to ciprofloxacin 500 mg tablets b.i.d. The treatment was well tolerated and effective, so that this drug can be recommended in cutaneous infections caused by sensitive bacteria. PMID- 3286518 TI - Bacterial infections of the lower urinary tract treated with ciprofloxacin or cefalexin--a comparative study. AB - 30/30 patients with lower UTI were enrolled in a randomized study to compare ciprofloxacin (250 mg/b.i.d.) and cefalexin (1 g/t.i.d.). In addition, 59 patients with cefalexin-resistant bacterial strains were treated in an open study arm. Ciprofloxacin showed convincingly better clinical and bacteriological efficacy than cefalexin. Both antibiotics were well tolerated. Ciprofloxacin has proved to be superior to cefalexin in the treatment of lower UTI. PMID- 3286519 TI - Antigenic profile of ICRC bacilli with special reference to isolation of immunogenic subunit. AB - A vaccine containing ICRC bacilli induces persistent immune conversion in lepromatous leprosy (LL) patients and lepromin-negative healthy subjects, in association with upgrading of the tissue responses in the former. With an idea to isolate the immunogenic 'subunit(s)', antigenicity of ICRC sonicate and its fractions were tested, with reference to both B- and T-cell responses. A very high molecular weight glycolipoprotein, named PP-I with an apparent molecular weight of 1,000,000, has been isolated using gel permeation high performance liquid chromatography (HPLC). PP-I, which focussed as a single band at pH 5 in an LKB isoelectric focussing column, quantitatively interacted with 80% of the circulating antibodies in pooled LL sera, and also induced a late (3 weeks) Mitsuda-type skin response which shows excellent correlation with host immunity against Mycobacterium leprae. These observations suggest that PP-I is a complex bifunctional antigen containing epitopes for both B and T cells. The PP-I fraction of ICRC and a similar high molecular weight HPLC fraction of M. leprae produced a line of identity against rabbit anti-ICRC serum in Ouchterlony gel diffusion and gave comparable skin responses in healthy volunteers in leprosy endemic areas. The data indicate that the PP-I fractions from the two organisms are antigenically closely related. Preliminary studies in human volunteers showed that administration of PP-I of ICRC resulted in immune conversion in lepromin negative healthy subjects. PP-I thus appears to be the appropriate immunogen that could be used in preparation of a 'subunit' antileprosy vaccine. PMID- 3286517 TI - Efficacy and safety of ciprofloxacin in the treatment of UTIs and RTIs in patients affected by liver diseases. AB - The clinical efficacy and the safety of ciprofloxacin was studied in 92 patients (aged 26 to 83 years; mean 57.5 years) affected by urinary tract infections (UTI) and respiratory tract infections (RTI) suffering also with various liver diseases. Ciprofloxacin was given orally at different dose regimens: 500 mg b.i.d. (22 cases), 250 mg b.i.d. (20 cases), 500 mg s.i.d. (20 cases) for the treatment of UTIs; 500 mg b.i.d. (ten cases) and 250 mg b.i.d. (20 cases) for the treatment of RTIs. The doses were not correlated to the severity of the infections. Patients were treated for five to 15 days. All the bacteria isolated from sputum or urine before treatment were sensitive to ciprofloxacin (MIC range less than or equal to 0.015 mg/l to 8 mg/l). The clinical and bacteriological responses were favourable in a high percentage of patients both for RTIs and UTIs, irrespective of the dose. Side effects were infrequent (7%) and mild (nausea, gastralgia, oral candidosis), never requiring the interruption of the treatment. No change in the blood chemistry tests was observed at any dose. PMID- 3286520 TI - Immunosuppression in malaria: effect of hemozoin produced by Plasmodium berghei and Plasmodium falciparum. AB - To a considerable degree, malaria-induced immunosuppression has been attributed to an inhibition of macrophage accessory cell function. In this study hemozoin, a plasmodium hemoglobin degradation product which readily accumulates in phagocytic cells and tissues during infection, was examined for its influence on immune responses. Hemozoin-laden liver and splenic macrophages from Plasmodium berghei infected mice, displayed accessory cell dysfunction which was likely due to hemozoin loading by these phagocytic cells. This indicated by the observation that hemozoin obtained from livers and spleens of infected mice as well as from Plasmodium falciparum cultures greatly inhibited splenic plaque-forming cell responses to sheep red blood cells. The results of the present study strongly suggest that the inhibition of macrophage accessory cell activity is due, at least in part, to the uptake and accumulation of hemozoin in their cytoplasms. PMID- 3286521 TI - Effect of irradiation and depletion of C3-complement component on the course of Treponema pallidum infection in a resistant guinea pig strain. AB - The role of complement and ionizing radiation in the natural resistance to Treponema pallidum infection of Albany guinea pigs was explored. Depletion of C3 by cobra venom factor for a period of 14 days affected neither the host's susceptibility to infection nor the humoral response. Total body irradiation with 420 or 800 R was fatal within 20-30 days and there was no multiplication of treponemes in the infected host. Animals showing lethal signs were euthanized and tissues removed for examination. Exposure to a nonlethal dose of 300 R increased the susceptibility to infection (46% symptomatic lesions) and facilitated multiplication of treponemes at the site of inoculation and in the lymphoid organs, but the humoral response was not different from that of non-irradiated controls. The results seem to suggest a defect in antigen recognition by the immunocompetent cells in the resistant Albany guinea pigs. PMID- 3286522 TI - Effects of tumour necrosis factor alpha and interleukin-1 alpha and beta on human neutrophil migration, respiratory burst and degranulation. AB - Recombinant human tumour necrosis factor alpha (rHuTNF alpha) was shown to inhibit human neutrophil migration in the presence or absence of a chemotactic gradient generated with the tripeptide, N-formyl-L-methionyl-L-leucyl-L phenylalanine (fMLP), at doses of 20-100 U/10(6) cells. In contrast, neither recombinant human interleukin-1 alpha (rHuIL-1 alpha), rHuIL-1 beta, human leucocyte-derived IL-1 alpha (1HuIL-1 alpha) nor 1HuIL-1 beta contained neutrophil migration inhibition properties. However, both the interleukins (1HuIL 1 alpha, 1HuIL-1 beta and rHuIL-1 alpha) and rHuTNF alpha stimulated a neutrophil respiratory burst and significantly elevated the neutrophil respiratory response to fMLP (measured as chemiluminescence and H2O2 production). The stimulatory effects were observed at doses of between 5 and 100 U/5 x 10(5) cells. A characteristic feature of the effects of the cytokines was the range of variation observed in neutrophil responses from different individuals. However, a concentration-related effect was observed with each experiment, delineating suboptimal, optimal and supra-optimal cytokine concentrations. Neutrophils treated with rHuTNF alpha and rHuIL-1 alpha and washed free of exogenous cytokine retained the capacity to show an enhanced response to fMLP. Pretreatment of cells with cytochalasin B enhanced their response to fMLP, and this response was further increased if the cells had also been pretreated with the cytokines. The response to phorbol myristate acetate was also enhanced by rHuTNF alpha and rHuIL 1 alpha. The effects of these cytokines on neutrophils could be abolished by boiling the preparation but not by treating it with polymixin B, suggesting that bacterial lipopolysaccharide was not responsible for the activity of these preparations. The rHuIL-1 alpha increased the release of lysozyme, beta glucuronidase and myeloperoxidase initiated by cytochalasin B/fMLP, while rHuTNF alpha only increased lysozyme release. PMID- 3286523 TI - Molecular interactions between human IgG, IgM rheumatoid factor and streptococcal IgG Fc receptors. AB - Group A streptococci type M15 were previously shown to bind both human IgG via the Fc component and a purified monoclonal IgM kappa rheumatoid factor (IgM RF). Using 125I-labelled IgG and 125I-labelled IgM RF, the present study gave association constants of 2.2 x 10(7) and 2.9 x 10(8) M-1, respectively. The binding of 125I-IgG to the streptococci was inhibited by unlabelled IgG, IgG Fc and fragment D of staphylococcal protein A but not by the IgM RF or F(ab')2 of anti-idiotype antibodies to RF (anti-Id RF). Inversely, unlabelled IgM RF and anti-Id RF inhibited the binding of 125I-IgM RF markedly and unlabelled human IgG and IgG Fc only slightly or moderately, respectively. Thus, group A streptococci type M15 showed different binding sites for IgG Fc and the antibody combining sites of a human monoclonal RF. The findings were still more complex on a background of previous reports showing that streptococcal IgG Fc receptors and RFs bind to the same amino acids on the Fc molecule. This complex pattern may play a role in the pathogenesis of rheumatoid arthritis. PMID- 3286524 TI - Effect of antispermatozoal antibodies in seminal plasma upon spermatozoal function. AB - The indirect immunobead test for antispermatozoal antibodies of the class IgA, IgG and IgM was applied to the seminal plasma of male partners of infertile couples. The presence of both IgA and IgG was associated with a decreased incidence of good post-coital test results and a reduced rate of fertilization of human oocytes. No significant differences were found for men with IgA or IgG alone when compared to men with no detectable antispermatozoal antibodies. PMID- 3286525 TI - Characterization of insulin binding and comparative action of insulin and insulin like growth factor I on purified Leydig cells from the adult rat. AB - Insulin binding and insulin action were characterized in adult rat Leydig cells, purified on discontinuous Percoll gradients. Binding of [125I]-porcine insulin was found to be dependent on time, temperature, cell concentration and Leydig cell specific gravity. Competition relative to porcine insulin (100) was as follows: insulin-like growth factor I (IGF-I) : less than 1; proinsulin : 5; guinea-pig insulin : 2; hCG, ovine prolactin and bovine GH : 0. High and low affinity binding sites for insulin were identified on purified Leydig cells with Ka values of 1.2 X 10(9) and 0.3 X 10(8) M-1, with 10,300 and 34,000 binding sites per cells, respectively. Using primary cultures of Leydig cells in serum free medium, the action of insulin on steroidogenesis was studied and compared with IGF-I action. Insulin and IGF-I used at 1-35 nM enhanced basal testosterone production in a dose-dependent manner; the effect was significant 4 h after administration. Insulin or IGF-I also potentiated the effect of hCG on steroidogenesis during short-term incubation (4 h). Insulin was shown to improve hCG responsiveness without modifying sensitivity to hCG. Moreover, neither cell number nor hCG-binding was altered by insulin, IGF-I or a combination of the two. Concomitant treatment with insulin and IGF-I at half-maximal and maximally effective doses, in the presence or absence of hCG, indicated that the two factors synergized in the stimulation of testosterone production via a common saturable mechanism. PMID- 3286526 TI - Bidirectional secretion by the Sertoli cell. PMID- 3286527 TI - Thrombotic microangiopathy of the miscellaneous secondary type responding to plasma exchange in a liver transplant recipient. AB - A thrombotic microangiopathy syndrome, clinically and pathologically similar to thrombotic thrombocytopenic purpura (TTP) has been reported in recipients of tissue transplants, including renal and bone marrow allografts. The diagnosis is made only after other causes of microangiopathic hemolytic anemia have been excluded. In this case report we present the outcome of the combination of plasma exchange, dipyridamole and aspirin in the management of a TTP-like syndrome that complicated the post-operative course of liver transplantation. PMID- 3286528 TI - The hazard of malarial nephropathy to the human race. PMID- 3286529 TI - The localization of aluminum in bone: implications for the mechanism of fixation and for the pathogenesis of aluminum-related bone disease. PMID- 3286530 TI - Human ovarian tumors in primary culture: growth, characterization and initial evaluation of the response to cis platinum treatment in vitro. AB - A novel cell culture system is reported for the growth of ovarian tumors. Two approaches were developed to isolate tumor cells, one for ovarian carcinomas and the other for benign cystomas or borderline cystadenomas, which yield virtually pure tumor-cell clusters. The plating efficiency exceeded 10% in approximately 80% of the processed surgical specimens. Cells grown in a newly developed KOV medium (a modification of MCDB 151 supplemented with 6 defined growth factors and a moderate amount of FBS) had an average growth rate of 0.23 population doublings/day. Primary tumor-derived cultures, including those derived from cystomas, were analyzed by flow cytometry demonstrating a DNA heteroploid content in 55% of the cases. The neoplastic origin of the cells in culture was further confirmed by 3 monoclonal antibodies (OC125; MOv2; MOv19) with high specificity against epithelial ovarian malignancies. Cultures were tested with cis-DDP to determine their suitability for pharmacological studies. Exposure to the drug (from 10 to 80 microM for 1 hr) resulted in variable cell-killing responses, and the prominent effect on cell-cycle progression in primary cultures was a prolonged arrest in S phase. The formation and persistence of DNA-ISC caused by an exposure to 40 microM cis-DDP for 1 hr was studied by alkaline elution in 6 different tumor-derived cultures. DNA-ISC equivalents were highest between 9 and 24 hr after treatment and were repaired only to a limited extent within 48 hr of recovery time. The present study confirms the usefulness of this culture system for pharmacological studies of active chemotherapeutic agents against human ovarian tumors. PMID- 3286532 TI - Medical history and the cardiologist. PMID- 3286531 TI - Hormonal changes following tumor transplantation: factors increasing corticosterone and the relationship of corticosterone to tumor-induced anti inflammation. AB - EL-4 lymphoma cells transplanted to syngeneic C57BL/6J mice induced a biphasic decrease in inflammation and a bi-phasic increase in serum levels of corticosterone. In addition, this tumor altered serum levels of 3 other hormones, resulting in a biphasic decrease in insulin, an early decrease in prolactin, and a terminal severe deficiency in thyroxine. Early changes occurred 16 to 48 hr after tumor transplantation and were of variable duration, while late-phase defects developed during the last few days of life. Soluble factors associated with tumor growth may mediate certain hormonal changes since serum levels of corticosterone increased and insulin decreased following injection of tumorous ascites into normal mice. Further, injection of cell-free tumor culture supernatants increased corticosterone levels. Hormonal changes following injection of soluble factors occurred after a delay of 16 hr indicating that the factors acted indirectly. Surgical adrenalectomy blocked the corticosterone increase induced by tumor transplantation or ascites injection and eliminated the anti-inflammatory effect of tumor transplantation while significantly decreasing the effect associated with injection of tumorous ascites. Thus, the physiologically induced increase in serum levels of corticosterone reached anti inflammatory levels. Further, elevated levels of corticosterone are a major contributing factor to anti-inflammation induced by tumorous ascites injection and constitute the principal mechanism of anti-inflammation following tumor transplantation. PMID- 3286533 TI - The proliferation of medical papers in several countries after discoveries in cardiology. AB - The numbers of papers on the Medline database concerning seven innovations in cardiology in the last 20 years were ascertained by year from the time of their discovery until the present. They were further divided into three geographical regions. The proliferation of papers in medical journals regarding new discoveries is initially exponential, with a plateau phase which is unrelated in magnitude to the constants in the model for the exponential phase. The magnitude of the plateau phase in the case of drugs is related to the number of indications for use of the drug. The proliferation of papers on a particular subject in English journals lags behind journals from the United States of America and the rest of the world. Eventually there are a larger number of papers published per year, per head of the population or per doctor in England than in the U.S.A. Current computer databases are not satisfactory for research audit. The department within an institution and an assessment of the quality of the research should be available. PMID- 3286534 TI - Contrast nephropathy, cardiology and the newer radiocontrast agents. PMID- 3286535 TI - Intracoronary versus intravenous streptokinase in acute myocardial infarction. AB - To assess the relative efficacy of coronary thrombolysis using intracoronary versus intravenous streptokinase, 32 patients with acute myocardial infarction were randomly assigned to receive intracoronary (n = 17) and intravenous streptokinase (n = 15). All patients underwent selective coronary arteriography before and after administration of streptokinase by either route within 4 hours of the onset of symptoms. Intravenous streptokinase was given as 750,000 units over 30 minutes, while a mean dose of 180,000 units was required for thrombolysis in the group having intracoronary delivery. Recanalization occurred in 71.4% (10 of 14) of patients receiving streptokinase, by the intracoronary group in contrast to only 25% of patients (3 of 12) who received the drug intravenously (P less than 0.05). Spontaneous thrombolysis was seen in 17.6% and 20% of the patients in the groups having intracoronary and intravenous delivery, respectively. Bleeding complications were few in both groups. Thus, when baseline coronary arteriography is performed, recanalization with intracoronary streptokinase is more effective in the treatment of acute myocardial infarction than intravenous streptokinase. PMID- 3286536 TI - Primary repair of flexor tendons in the hand with early passive mobilization. AB - Flexor tendon injuries in zones I-III in the hand were treated by meticulous suture of the tendons and peritendinous structures, followed by early passive mobilization of the injured fingers, the remaining fingers being kept extended by a plaster splint. This method was used in 51 cut tendons in 38 patients. The functional recovery approached normal in 72%, and only 8% were poor. PMID- 3286538 TI - The use of ultrasound scanning in the management of developmental disorders of the hip. AB - Ultrasound was used, together with clinical examination, to help in the diagnosis and to evaluate the treatment of 48 babies with congenital disorders of the hip. The femoral head, and its relation to the acetabulum, can be demonstrated before it becomes visible on radiographs. Ionising radiation is avoided. Ultrasound scanning can be used to visualise the repositioning of the femoral head. It is also possible to examine babies on an abduction frame. PMID- 3286537 TI - Two-day cefamandole versus five-day cephazolin prophylaxis in 965 total hip replacements. Report of a multicentre double blind randomised trial. AB - The aim of this trial was to compare a 5-day course of cephazolin with a regimen of 2 days of cefamandole in 965 total hip replacements (488 in the cefamandole group and 477 in the cephazolin group). The effect of the prophylactic antibiotic on the bacterial colonization of drains (mean duration of drainage: 3.2 +/- 0.3 days) and on the susceptibility of colonizing organisms was assessed. No significant difference was observed in the percentage of infected drains between the two groups. The cefamandole group had a lower rate of Gram-negative organisms (23% versus 44%, p less than 0.01). The rate of deep infections within one year after operation was 0.7% in the cefamandole group versus 0.5% in the cephazolin group, and the difference is not significant. Cefamandole given for two days appears to be an effective prophylaxis against sepsis in total hip replacements. PMID- 3286539 TI - Ultrasound examination of haematomas after total hip replacement. AB - We have used ultrasound after 84 total hip replacements to define the site and size of any haematoma present. Repeated examination after operation indicated when the haematoma had occurred. We have demonstrated that two suction drains were more effective than one in preventing haematomas around the prosthesis in the first week after operation. The early detection of a haematoma allows rational treatment which should reduce the risk of deep infection. PMID- 3286541 TI - Neural substrates of violent behavior: implications for law and public policy. PMID- 3286540 TI - Acute cholecystitis after orthopaedic operations. AB - When acute cholecystitis follows orthopaedic operations, the disease is frequently obscure and fulminating, with rapid progress to gangrene and perforation of the gallbladder, which may be fatal. Three cases are reported and the literature is reviewed. Various aspects of the disorder are discussed. It is important that orthopaedic surgeons should be aware of the condition in order to be able to make an early diagnosis and so prevent a lethal outcome. PMID- 3286542 TI - The intoxicated offender--refuting the legal and medical myths. PMID- 3286543 TI - Prostaglandin D2 in the skin. PMID- 3286544 TI - Dermatoses of the umbilicus. PMID- 3286545 TI - Immunology of reactions in leprosy. Current status. PMID- 3286546 TI - Widespread bullous fixed drug eruption mimicking toxic epidermal necrolysis. AB - This paper is written to heighten awareness of the presence of the most severe form of fixed drug eruption. Two patients with a widespread bullous form of fixed drug eruption (FDE) were initially given the diagnosis of toxic epidermal necrolysis (TEN). Both gave a history of a previous widespread eruption from the responsible drug, each had biopsies consistent with fixed drug eruption, and most importantly, both had an uncomplicated course, with complete cutaneous reepithelialization within 10 days. These observations suggest that widespread bullous fixed drug eruption may portend a more favorable prognosis than TEN, thus stressing the potential importance of distinguishing the two diseases. A review of fixed drug eruption and possible means of differentiating the widespread bullous form from TEN are discussed. PMID- 3286547 TI - Treatment of herpes zoster. Recombinant alpha interferon versus acyclovir. AB - Sixty-four patients received systemic alpha-interferon (10 million units subcutaneously daily) and 63 received systemic acyclovir (5 mg/kg body weight intravenously thrice daily) in a randomized study of acute herpes zoster. Start of healing, complete healing, development of new skin lesions in the primarily affected and in other dermatomes, and degree and duration of pain were evaluated. Both drugs proved equally clinically efficient without statistically different findings between the two groups; herpes zoster neuralgia was not prevented by either interferon or acyclovir therapy. Minor clinical side effects occurred slightly more frequently during interferon treatment and included fever and nausea. Transient and moderate leukopenia was observed in nearly all patients in the interferon group. PMID- 3286548 TI - Medical treatment of skin disease in late nineteenth century England. A review based on Diseases of the Skin by Henry Radcliffe Crocker. PMID- 3286549 TI - In memoriam Choh Hao Li, April 21, 1913-November 28, 1987. PMID- 3286550 TI - Purification and conformation of ribosomal protein L25 from E. coli ribosome. AB - Ribosomal protein L25 from the large subunit of E. coli ribosomes has been purified using a new procedure involving a 2M LiCl extraction followed by phosphocellulose chromatography in 6 M urea elution buffer. The conformation of purified L25 was studied employing circular dichroism and ultraviolet absorption spectroscopy in reconstitution buffer. The analysis of the far u.v. circular dichroism spectrum of L25 indicates L25 contains approximately 16% alpha-helix and approximately 19% beta-structure. The conformation of L25 was also studied using the predictive methods of Chou & Fasman and Maxfield & Scheraga. Both of these methods predict approximately three times the percent alpha-helix present in L25 as compared with that determined from the analysis of the circular dichroism spectrum. A structure for L25 is predicted which contains two positively charged binding domains and is consistent with published binding data on the interaction of 5S RNA and L25. The large difference in the % alpha-helix as determined from the analysis of the circular dichroism spectrum and the predictive techniques is suggested to result from the denaturing effects of 6 M urea used in the preparation of ribosomal proteins. PMID- 3286551 TI - Quantitative, functional and biochemical alterations in the peritoneal cells of mice exposed to whole-body gamma-irradiation. I. Changes in cellular protein, adherence properties and enzymatic activities associated with platelet-activating factor formation and inactivation, and arachidonate metabolism. AB - Changes in total number, differentials, cell protein, adherence properties, acetyltransferase and acetylhydrolase activities, prostaglandin E2 and leukotriene C4 production, as well as Ca2+ ionophore A23187 stimulation were examined in resident peritoneal cells isolated from mice 2 h to 10 days postexposure to a single dose (7, 10 or 12 Gy) of gamma-radiation. Radiation dose related reductions in macrophage and lymphocyte numbers and increases in cellular protein and capacity to adhere to plastic surfaces were evident. In vivo irradiation also elevated the activities of acetyltransferase and acetylhydrolase (catalysing platelet-activating factor biosynthesis and inactivation, respectively) in adherent and nonadherent peritoneal cells, particularly 3-4 days postexposure. Blood plasma from irradiated animals did not reflect the increased cellular acetylhydrolase activity. Prostaglandin E2 and leukotriene C4 synthesis were elevated postexposure, suggesting increased substrate (arachidonate) availability and increased cyclooxygenase and lipoxygenase activities. Ionophore stimulation of enzyme activities and eicosanoid release also differed in irradiated peritoneal cells. While the properties of adherence, platelet activating factor synthesis/inactivation-associated enzyme activities, and eicosanoid production are generally characterized as those of macrophages, lymphocytes or their products may influence or contribute to the observed radiation-induced changes. PMID- 3286552 TI - In vivo adenylate cyclase activity in ultraviolet- and gamma-irradiated Escherichia coli. AB - The incorporation of [14C]adenine into the cyclic AMP fraction by whole cells of Escherichia coli B/r was taken as a measure of the in vivo adenylate cyclase activity. This activity was significantly inhibited by irradiation of the cells either with 60Co gamma-rays or with UV light from a germicidal lamp, suggesting inhibition of cyclic AMP synthesis. The incubation of cells after irradiation with lower doses (50-100 Gy) of gamma-rays produced a significant increase of in vivo adenylate cyclase activity, whereas there was no significant change after higher doses (150 Gy and above). Dark incubation of cells after irradiation with UV light (54 J m-2) led to recovery of enzyme activity to the level measured in unirradiated cells. Thus it appears that the catabolite repression of L-arabinose isomerase induced by UV light, as well as gamma-irradiation, is due to reduced cyclic AMP synthesis in irradiated cells. PMID- 3286553 TI - Functional microangiopathy in alloxan-treated Syrian hamsters. AB - Intraperitoneally injected alloxan determined long term hyperglycemia in a group of Syrian hamsters (35 hyperglycemic hamsters); transitory hyperglycemia, with recovery of normal blood glucose concentration but impairment of glucose tolerance test, was observed in a second group of alloxan-treated animals (70 normoglycemic hamsters). Microvascular permeability by fluorescent microscopy technique, capillary basement membrane thickening and pancreatic islet B, A, and D cell degranulation by computer-assisted microdensitometry were studied in Syrian hamsters at different intervals (30, 40, 60, 90, and 120 days) after intraperitoneal alloxan administration. Hyperglycemic groups showed increased permeability of venous microvasculature to high molecular weight dextran in 50%, 71.4%, and 100% of animals studied at 30, 40, and 60, 90, 120 days from treatment, respectively; indeed, they revealed pancreatic islet B cell degranulation and no capillary basement membrane thickening. Normoglycemic groups presented increased venular leakage in 28.5%, 42.8%, 71.4%, and 100% of animals investigated at 40, 60, 90, and 120 days after treatment, respectively; moreover, they showed moderate pancreatic islet B cell degranulation and no capillary basement membrane thickening. In conclusion, more severe microvascular alterations seemed to be related to more severe impairment of glucose metabolism and to longer duration of diabetes; even in normoglycemic hamsters with pathological glucose tolerance test, enhanced permeability developed. PMID- 3286554 TI - Origin of congenital cholesteatoma from a normally occurring epidermoid rest in the developing middle ear. AB - The sites of involvement of congenital cholesteatoma, a lesion which has recently become more frequently recognized, are reviewed from literature sources. There is a propensity for its occurrence, especially when small, in the anterior superior part of the middle ear. The same situation is the precise location of an epidermoid cell rest, the epidermoid formation (EF). This is seen in most fetal ears at the junction of the Eustachian tube with the middle ear near the anterior limb of the tympanic ring, until 33 weeks gestation, when it disappears. Its origin is traced to early fetal life from the ectoderm of the first branchial groove. In embryonic and early in fetal life it seems to act as an organizer in the development of the tympanic membrane and middle ear. It is likely that congenital cholesteatoma is derived from the EF by its continued growth instead of regression. Congenital cholesteatomas show a thinner and flatter matrix than acquired cholesteatomas, probably because the former are most frequently 'closed' and therefore subject to pressure effects from the keratin within the cyst. 'Open' forms also occur in smaller numbers. It is possible that a screening program for congenital cholesteatoma in infants might reduce the incidence of the severe, extended form of the disease. PMID- 3286555 TI - Brain output dysregulation induced by olfactory bulbectomy: an approximation in the rat of major depressive disorder in humans? AB - Mounting evidence indicates that the emotional, cognitive, neurovegetative and behavioral symptoms of patients with major depressive disorder are due to abnormal neurochemical substrates in the brain. Although the specific neurochemical abnormalities responsible have not been identified, the presenting symptoms of major depression are consistent with a disruption of normal neural communications between the limbic system and hypothalamus. Following removal of the olfactory bulbs, rats display a syndrome of behavioral deficits that also reflect a disruption of the limbic-hypothalamic axis. Moreover, the bulbectomy induced deficits are selectively reduced by the chronic administration of the same drugs that alleviate the symptoms of depression when given chronically to the patients. In addition to this pharmacological similarity, there are also numerous behavioral parallels between bulbectomized rats and major depression patients. The bulbectomized rat provides a good model in which to study antidepressant drugs and also may provide neurochemical and neuroanatomical data that are relevant to understanding the biological substrates of emotion and the causes of depression in humans. PMID- 3286556 TI - Diaschisis, site, time and other factors in raven performances of adults with focal cerebral lesions. AB - Analyses of Raven matrices performances by 35 patients with acute and 22 with chronic focal lesions restricted to the anterior or posterior regions of the left or right hemispheres illustrate the importance of controlling for diaschisis, specific site, time, age and other factors determining neuropsychological performances. These findings have important practical and theoretical implications with respect to the elucidation of principles underlying organization, disorganization and reorganization of human brain functions. They also suggest that many of the previous controversial and conflicting reports may be reconciled when these and other significant underlying factors are accounted for. Finally, they confirm Jackson's earlier observations of the critical role of the right posterior lobe in "visuopsychic" non verbal mental processes. PMID- 3286557 TI - DSIP--a tool for investigating the sleep onset mechanism: a review. AB - Delta-Sleep-Inducing Peptide (DSIP) has several physiological effects in addition to its ability to promote sleep in animals under certain conditions. These effects include modification in thermoregulation, heart rate, blood pressure, pain threshold, and in the lymphokine system. DSIP effects are circadian cycle dependent. Moreover, some of DSIP effects appear before neurological or behavioral signs of sleep. DSIP may promote peripheral preparatory physiological mechanisms associated with sleep onset. PMID- 3286558 TI - New vistas in chronic schizophrenia. AB - In view of the distinct possibility that the disturbed glucose regulation in the frontal area and basal ganglia of chronic schizophrenia is very germane to the successful treatment of this condition, a survey is given of the many factors that have to be considered in developing a therapy that takes into account this new information. The suggestion is made that the balance between cAMP and cGMP in the cells affected are dysregulated so that there is an excessive activity of the cAMP generating system which eventually leads to the pathological picture found in this condition. To restore the normal metabolic balance, use will have to be made of the various substances that are known to enhance the cGMP generating system in the cell, thereby restoring a more normal metabolic integrity. In this connection, the use of high doses of insulin under cover of hyperglycaemia and also the addition of D-ribose could become the cornerstone of a series of treatments to enhance the action of currently used medications in this often intractable illness. PMID- 3286559 TI - Statistical brain topographic mapping analysis for EEGs recorded during Qi Gong state. AB - Spontaneous EEGs recorded with 12 channels (International 10-20 system) on the scalp were analyzed by statistical brain topographic mapping (t-test and correlation coefficient topographic mappings) to reveal changes of the electrical activity in the brain during Qi Gong state. The control subjects and two groups of masters and beginners in accordance with the time and the skilled degree practising Qi Gong were compared. The changes of EEGs of the Qi Gong masters during the Qi Gong state were clearly different from those recorded during the resting state with closed eyes. The EEG alpha activity occurred predominantly in the anterior half, and occurred silently in the posterior half of the brain during Qi Gong state. The peak frequency of EEG alpha rhythm during Qi Gong state was slower than resting state without practicing Qi Gong. The results of the t test and correlation coefficient topographic mappings showed this finding quantitatively and statistically significant. The changes in EEG between resting and Qi Gong state for Qi Gong masters appear to be opposite. This findings indicates that Qi Gong state is a special and unusual state and this state is not an inherent state existing in each person. The occurrence of this phenomenon of EEG depends on the duration and the skilled degree of the practising Qi Gong. PMID- 3286560 TI - A molecular basis for interactions between the immune and neuroendocrine systems. AB - Homeostatic and psychologic alterations associated with infections and tumors are very interesting yet poorly understood pathophysiologic responses. Numerous anecdotal and indirect examples suggest that these responses occur through a link between the central nervous and immune systems (for review see Blalock, Bost, & Smith, 1985; Spector & Korneva, 1981; Maestroni & Pierpaoli, 1981; Felton et al., 1985; Jankovic, 1985). Interactions between the two systems are just now being described. One possible mechanism is direct modulation of the immune system by the sympathetic nervous system. This could occur in innervated immune organs such as spleen, thymus, and bone marrow (Felton et al., 1985). The evidence for this is that sympathectomy and lesioning of specific regions of the brain can be shown to both enhance and/or suppress immune responses (Miles et al., 1985; Roszman et al., 1985). Also, the firing rate of hypothalamic neurons is altered during an immune response (Besedovsky et al., 1977). Alternatively, hormonal involvement in immune reactions has been known for some time, in particular the immunosuppressive effects of glucocorticoids (for review see Cupps & Fauci, 1982). Recently, we and others found that neuroendocrine peptide hormones will modulate T and B lymphocytes plus other immunocyte responses (Besedovsky et al., 1977; Cupps & Fauci, 1982; Johnson et al., 1982; Wybran et al., 1979; Hazum, Chang & Cuatrecasas, 1979; O'Dorisio et al., 1981; Gilman et al., 1982; McCain et al., 1982; Mathews et al., 1983; Plotnikoff et al., 1985; Johnson et al., 1984). Furthermore, lymphocytes themselves can synthesize biologically active neuroendocrine hormones (Blalock & Smith, 1980; O'Dorisio et al., 1980; Smith & Blalock, 1981; Smith et al., 1983; Lolait et al., 1984; Ruff & Pert, 1984), as well as possess specific hormone receptors (Blalock et al., 1985; Johnson et al., 1982; Wybran et al., 1979; Hazum et al., 1979; O'Dorisio et al., 1981; Lopker et al., 1980; Payan, Brewster & Goetzl, 1984; Pert et al., 1985). Immune responses (Besedovsky, del Rey & Sorkin, 1981), thymic hormones (Healy et al., 1983), and lymphokines (Lotze et al., 1985; Woloski et al., 1985) have all been shown to exert hormonal effects. Thus, another method for communication between the immune and neuroendocrine systems seems to be through soluble factors such as neuroendocrine hormones. This review will concentrate on the latter topic, in particular on work this laboratory has done over the past few years to show the lymphocyte production and immunoregulatory actions of neuroendocrine hormones. PMID- 3286561 TI - Embryological correlates of neuroimmunomodulation: a minireview. PMID- 3286562 TI - [Epidemiology of HIV infection]. PMID- 3286563 TI - [HIV infection and blood donation services]. PMID- 3286564 TI - [Prevention of HIV infection in the clinic and general practice]. PMID- 3286565 TI - [Structure and biological properties of human immunodeficiency viruses (HIV)]. PMID- 3286566 TI - [HIV serodiagnosis]. PMID- 3286567 TI - [Diagnosis and therapy of HIV-associated diseases]. PMID- 3286568 TI - [Ambulatory management of HIV-infected patients]. PMID- 3286569 TI - [Psychosocial management of patients with AIDS and AIDS-related complex]. PMID- 3286570 TI - Tumor-host interactions in the rabbit V2 carcinoma: stimulation of cathepsin B in host fibroblasts by a tumor-derived cytokine. AB - Organ cultures of explanted V2 carcinoma specimens as well as cultured V2 carcinoma cells produced a cytokine which stimulated rabbit skin fibroblasts to synthesize increased amounts of cathepsin B. The cytokine was released by the tumor cells as a heterogeneous family of polypeptides: two inactive forms (Mr = 55,000 and 68,000) which could be activated by limited proteolysis with trypsin and three active forms with Mr values of 12,000, 16,000 and 18,000. The treatment of inactive cytokine-containing tumor-conditioned media with trypsin, followed by chromatographic separation of the products, suggested that the high-Mr inactive components may represent precursors of the active forms. Cathepsin B was immunolocalized in the tumor-host interzone in co-cultures of tumor and host tissues. Some other possible activities of the tumor cytokine which emerged from previous studies, such as the induction of host cells to produce increased levels of collagenase and extracellular matrix, as well as the stimulation of host cell proliferation, are discussed in the light of the new findings and are proposed as an important mechanism in tumor invasion. PMID- 3286571 TI - Magnetic resonance imaging of the head and neck. PMID- 3286572 TI - Selective drug delivery systems. PMID- 3286573 TI - The promise of magnetic resonance spectroscopy for medical diagnosis. PMID- 3286575 TI - Radiation exposure. Responsibilities of the radiologist. PMID- 3286574 TI - Local intravascular effects of the nitinol wire blood clot filter. AB - To determine the biocompatibility and thrombogenicity of nitinol blood clot filters, we inserted 27 nitinol wire devices into the venae cavae of 16 dogs and one sheep and studied the results angiographically and at autopsy after periods of one week to four years. Filter shape, location in the vena cava, wire cleaning procedure and wire surface finish were varied. All 18 cleaned nitinol wire filters remained patent by venogram, although some showed small venographic filling defects caused by adherent organized thrombi. Filters in larger veins tended to have less thrombus. Surface polishing and filter shape had no observable effect on thrombogenicity. Histologic study revealed patchy chronic inflammation at the surface of uncleaned filters but only benign fibrous tissue reaction for the cleaned filters. Neointimal tissue overgrowth was observed where nitinol wire contacted the wall of the vena cava. Two filters implanted for four years had no appreciable weight loss caused by corrosion. Platelet adhesion and plasma coagulation effects of nitinol wire were tested in vitro in human blood and found to be similar to those of stainless steel, which is used in comparable devices. These encouraging results suggest that nitinol may be a promising material for human intravascular prosthetic applications. PMID- 3286576 TI - Pasteur and the process of discovery. The case of optical isomerism. PMID- 3286577 TI - Prevention of herpes simplex virus (HSV) infection in recipients of HLA-matched T lymphocyte-depleted bone marrow allografts. AB - The occurrence of HSV infection and the effect of prophylaxis with oral acyclovir were evaluated prospectively in 34 consecutive patients undergoing bone marrow transplantation (BMT). All allogeneic BMT procedures involved T-lymphocyte depletion for prevention of graft-vs.-host disease (GVHD). Five HSV-seronegative patients did not receive acyclovir, and they did not develop HSV infection. Oral acyclovir was administered to 15 HSV-seropositive BMT recipients; 14 untreated HSV-seropositive BMT recipients served as a control group. The adult dose of acyclovir was 400 mg three times a day on Days -6 to +14 and 200 mg three times a day on Days +15 to +90. Children received 500 mg/m2 per day divided into three equal doses on Days -6 to +14 and 250 mg/m2 per day again divided into three on Days +15 to +90. In the group on prophylaxis, only one developed HSV infection during the time prior to engraftment. In the reference group, 12 of 14 (85.7%) developed oral HSV infection within 0 to 16 days (median 11 days) after the transplantation. Time for engraftment (duration of neutropenia) was shorter in patients receiving acyclovir. After engraftment, HSV infection was not observed during administration or following discontinuation of acyclovir on Day 90, but occurred in three patients in whom acyclovir was discontinued on Days 25, 35 and 40 after BMT. In the untreated group, two patients had recurrence of HSV infection on Days 40 to 60, and one had two infectious episodes. GVHD occurred in only two recipients, neither of whom had HSV infection. We conclude that the incidence of HSV infection during the period until engraftment in recipients of T lymphocyte-depleted BMT is high, similar to that reported by others in recipients of whole BMT. Relatively low-dose oral acyclovir administered for 90 days can effectively prevent HSV infections in previously HSV-seropositive BMT recipients and may also shorten the period until engraftment. PMID- 3286579 TI - Early vs. late refeeding in acute infantile diarrhea. AB - A randomized ambulatory trial was performed to compare early (6-h) vs. late (24 h) refeeding in acute infantile diarrhea. Ninety infants with mild dehydration were enrolled in the study. Following an initial oral rehydration period (WHO formula), refeeding was introduced using a diet based on either breast milk or cow's milk. Early (n = 53) and late (n = 37) refeeding groups were similar in ethnic background, socioeconomic level, relevant past history, nutritional and clinical state, and stool pathogens. Infants were assessed upon their initial visit, at 24 and 48 h, and at 7 and 14 days thereafter for evaluation of weight, hydration state, stool frequency and need of hospitalization. No significant differences in the above parameters were observed between the two groups. Different patterns of refeeding (breast milk vs. cow's milk) in both early and late refeeding groups showed no significant differences in the features studied. Since the short-term clinical outcome following early refeeding in acute infantile diarrhea is not different from late refeeding, we suggest that early refeeding should be preferred, particularly in developing populations, in order to minimize the adverse nutritional effects of prolonged fasting during recurrent bouts of gastroenteritis. PMID- 3286578 TI - Delta virus infection in Jerusalem. AB - The role of hepatitis delta virus (HDV) infection was analyzed retrospectively in a highly selected population of 76 patients who were hospitalized in Jerusalem for hepatitis B surface antigen positive for chronic active hepatitis and cirrhosis. Of 25 patients in whom serum and liver tissue were available, 5 patients (20%) showed evidence for HDV infection using a serum anti-HDV IgG radioimmunoassay; in one of them, HDV was also detected in nuclei of infected hepatocytes by immunofluorescence (IF). When only serum was tested, 12 of 45 patients (27%) were anti-HDV IgG positive. The use of IF alone had a very low yield of HDV detection. All HDV-positive patients with available serum had superinfection with the delta agent as confirmed by a negative anti-HBc IgM assay. The majority of HDV-positive patients were immigrants from Rumanian or Middle Eastern and Mediterranean origin. The mean age of delta-positive patients was 10 years lower at clinical presentation as compared with HDV-negative patients. HDV-positive patients had a higher mortality as compared with the HDV negative group. In conclusion, HDV infection is prevalent among Israeli patients with chronic liver disease and persistent hepatitis B virus infection and leads to a significant morbidity and mortality. PMID- 3286580 TI - Menstrual migraine: new biochemical and psychological aspects. PMID- 3286581 TI - Breeding structure in two field vole populations. PMID- 3286583 TI - Sandor Ferenczi (1873-1933)--the father of the empathic-interpersonal approach. Part One: Introduction and early analytic years. PMID- 3286582 TI - Molecular analysis of the variant alloantigen HLA-B27d (HLA-B*2703) identifies a unique single amino acid substitution. AB - HLA-B27 is a human major histocompatibility complex class I product defined by its antigenic specificity with conventional alloantisera. Detailed studies using monoclonal antibodies, cytotoxic T lymphocytes (CTL), and isoelectric focusing (IEF) gel electrophoresis demonstrated the heterogeneity in the B27 antigen. We have previously identified a unique variant molecule of B27 designated locally as B27d which is distinguished from other B27 variants by isoelectric point, serologic reactivity, and by a cloned CTL recognition. A gene encoding the B27d variant has been cloned and a complete nucleotide sequence has been determined. Compared to the sequence of the prototype B27a, the B27d has a single base substitution at codon 59 (B27a:TAT--B27d: CAT) in exon 2 responsible for Tyr to His substitution. A His residue at this position in the alpha 1 domain is unique among the known class I sequences and this single amino acid change is apparently sufficient to alter the epitope(s) recognized by antibody and cytotoxic T cell receptor. Previous primary structural analysis of the other five B27 variants has revealed differences of two to four amino acids. The combined structural data on the B27 variants indicate that (1) HLA-B27 represents a family of closely related B locus alleles that share the B27 allospecificity and differ by a limited number (one to four) of amino acid substitutions and (2) point mutation as well as gene conversion might be the mechanism responsible for the allelic variation of B27 antigen family. PMID- 3286584 TI - Freud's mother, Ferenczi, and the seduction theory. PMID- 3286585 TI - Psychoanalytic concepts of "the self". PMID- 3286586 TI - [Jordemodern. Publication announcement 1888]. PMID- 3286587 TI - Effects of gelatin sponge implantation in cancellous bone defects in dogs. AB - Reports from oral surgeons suggested that packing bone defects with cellulose or collagen stimulated cancellous bone replacement. The study reported here was designed to evaluate a similar method for augmenting the remodeling of cancellous bone defects and graft donor sites. Gelatin sponge was implanted into bony defects created in the proximal humeral metaphysis of 5 adult Beagles after collection of cancellous bone. A similar defect created in the contralateral humerus was left unpacked. Four months after creation of the defect, the dogs were euthanatized, and the surgical sites were evaluated by use of correlated microradiographic and histologic examination. Unpacked sites had filled completely with loosely woven trabecular bone. Remodeling had not taken place in sites packed with gelatin sponge. Gelatin sponge did not elicit any reaction in the surrounding bone, but remained in situ and obstructed new bone formation. Gelatin sponge blocked rather than augmented cancellous bone replacement. PMID- 3286588 TI - Functional suture-holding layer of the esophagus in the dog. AB - Several investigators have stated that the suture-holding layer of the esophagus is the mucosa. In this study, the component layers of the esophagus were separated. Segments of the cervical esophageal wall, muscularis, submucosa, and submucosa-mucosa were each sutured, and the suture lines were subjected to tensile forces. When subjected to tensile force, all suture lines failed when sutures pulled through the tissue. The data were subjected to statistical analysis. Based on this analysis, it was concluded that the full esophageal wall had the greatest ability, and the muscularis the least ability, to hold sutures against tension. Therefore, when no significant difference in suture-holding ability between the submucosa alone and the submucosa-mucosa together was demonstrated, it was concluded that the submucosa was the suture-holding layer of the esophagus. PMID- 3286589 TI - Use of 99mTc diethylenetriaminepentaacetic acid for assessment of renal function in dogs with suspected renal disease. AB - The effectiveness of technetium 99m-labeled diethylenetriaminepentaacetic acid (99mTc DTPA) to assess renal function in 13 dogs with suspected renal disease was evaluated. Glomerular filtration rates (actual GFR) were determined on the basis of endogenous creatinine clearance. Predicted GFR were determined by using 99mTc DTPA within 72 hours after the determination of creatinine clearance. The percentage of an IV administered dose of 99mTc DTPA in the kidneys (percentage dose) was determined. Two equations were used to calculate predicted GFR, which were derived from previously reported linear regression analysis of inulin (In) and creatinine (Cr) GFR vs percentage dose 99mTc DTPA in dog kidneys. The correlations of actual GFR vs predicted GFR (In) and actual GFR vs predicted GFR (Cr) were both r = 0.92. The dogs' mean actual GFR was 1.73 +/- 1.35 ml/min/kg. Their mean predicted GFR (In) and predicted GFR (Cr) were 1.92 +/- 1.42 ml/min/kg and 1.85 +/- 1.27 ml/min/kg, respectively. Therefore, 99mTc DTPA can be used with high accuracy as an agent to predict GFR in dogs with suspected renal disease. The procedure for determining GFR by use of nuclear medicine was rapid and noninvasive and appeared to induce little stress in the animals evaluated. PMID- 3286590 TI - Ultrasonographic findings associated with congenital hepatic arteriovenous fistula in three dogs. AB - Three dogs were determined to have hepatic arteriovenous fistulas. This condition is similar to a portosystemic shunt; however, cure necessitates hepatic lobectomy instead of a venous ligature. Because of this, it is useful to differentiate these 2 conditions before surgery. Ultrasonography was found to be simple, sensitive, and specific in diagnosing hepatic arteriovenous fistulas and differentiating them from portosystemic shunts. PMID- 3286591 TI - Ultrasonographic features of splenic hemangiosarcoma in dogs: 18 cases (1980 1986). AB - The medical records of 18 dogs in which ultrasonography was useful in making a diagnosis of splenic hemangiosarcoma were reviewed. Splenic ultrasonography revealed masses with echo patterns that ranged from anechoic fluid to hyperechoic tissue. In 7 dogs, metastasis was detected ultrasonographically as anechoic to hypoechoic lesions in the liver. PMID- 3286592 TI - Prediction of empty body components in steers by urea dilution. AB - Empty body composition of 68 mixed-breed and 50 Angus steers was determined by chemical analysis of the right half-carcass and entire noncarcass fraction of each steer. Chemical composition was used to develop prediction equations for empty body protein (EBPRO) and fat (EBFAT) in steers using urea space (US) and body weight measurements. Previous research showed a significant positive correlation between empty body water (EBH2O) and urea space in these steers. For all steers studied, the percentage of EBH2O ranged from 44.8 to 69.2 (mean = 56.0), the percentage of EBPRO ranged from 14.1 to 19.8 (mean = 17.0) and the percentage of EBFAT ranged from 6.1 to 38.1 (mean = 22.1). The best predictions obtained were multiple regression equations with actual weight of body components as dependent variables and US and empty body weight (EB) as independent variables. Urea space alone was a poor predictor of EBFAT, but US improved predictions based on live weight (LW) or EB alone. Coefficients of determination for the best predictions of percentage of composition were not as high as coefficients of determination for the best predictions of actual weight of body components. These data suggest that US measurements can be used to predict empty body composition of live steers, but this may require repeated measurements and an independent estimate of EB from LW for greatest accuracy. PMID- 3286595 TI - HDA directory update. Listing of member dentists. PMID- 3286593 TI - A luteinizing hormone-releasing hormone-induced serum luteinizing hormone surge is not detectable in the milk of cows. AB - Six lactating Holstein cows were used to determine whether a serum luteinizing hormone (LH) surge induced by luteinizing hormone-releasing hormone (LHRH) could be detected in milk. A double antibody radioimmunoassay was evaluated for measuring LH in whole milk. Cows (d 10 of the estrous cycle) were injected with saline (time zero), followed by LHRH 12 h later. Blood samples were collected hourly for 12 h via jugular cannula following each injection; milk removal was accomplished every 2 h by a portable milking machine. On d 10 of the next estrous cycle, treatment, order was switched, with the same cows receiving LHRH at time zero and saline 12 h later. Approximately 2 h following LHRH treatment, serum LH levels peaked at 29 ng/ml and remained elevated for 5 h. There was no corresponding change in milk LH detected during the 12-h to 24-h period following the induced serum LH surge. Our conclusion is that the measurement of LH in the milk of cows shows little promise for predicting ovulation time in the cow. PMID- 3286594 TI - Characteristics of live and killed brewer's yeast slurries and intoxication by intraruminal administration to cattle. AB - The physical and nutritional characteristics of live and killed brewer's yeast slurries and the possible toxicity of intraruminal administration of loading doses of these by-products were evaluated. Dry-matter (DM) percentages of live brewer's yeast slurry ranged from 10.5 to 29.0, and DM percentages of killed brewer's yeast slurry ranged from 14.6 to 18.5. Total crude protein (N X 6.25) percentages of live and killed yeast slurries (DM basis) were 44.1 and 43.1; ethanol percentages (wet basis) were 6.96 and 1.84, respectively. Phase contrast photomicrographs showed distinct differences in morphology between live and killed yeast cells. Intraruminal administration of loading doses (0, 2.3, 4.5 and 6.8 kg) of live and killed brewer's yeast slurries to bull calves induced clinical intoxication at the 4.5-kg and 6.9-kg dosages of live brewer's yeast slurry. No toxicity was induced either with the killed brewer's yeast or with the 0-kg or 2.3-kg dose levels of live brewer's yeast slurry. The clinical signs and plasma ethanol concentrations suggested ethanol intoxication. Ruminal NH3 concentrations increased to over 70 mg/dl with the 4.5-kg and 6.9-kg dosages of live brewer's yeast slurry, but they did not exceed 35 mg/dl with an equivalent dosage of killed brewer's yeast slurry. PMID- 3286596 TI - Identification of Enterobacteriaceae with the Minitek system. AB - A total of 417 strains (361 Enterobacteriaceae, 56 Vibrionaceae) was examined in all the available Minitek system tests. The results were processed through four successive identification schemes devised by the manufacturer and the proportion of strains correctly identified, not identified or incorrectly identified determined for each scheme. From the results, a probability matrix was constructed incorporating all 35 Minitek tests. Test results for each strain were then processed through this matrix to determine its success in identification. From the matrix the order of separating value of the tests was determined. Forty three of the strains were each tested three times to assess the level of test reproducibility; the corrected error rate was 0.85%. PMID- 3286597 TI - Pulmonary microvascular permeability to fluid and macromolecules. AB - Research in pulmonary microvascular permeability has been a hot bed of activity for the last 20 years, primarily because increases in permeability contribute to the development of some forms of pulmonary edema in humans. New techniques and animal preparations have lead to significant advances, and most of these advances have been well described in several recent reviews. Unfortunately, there is still confusion over what the techniques measure and when they can be used to make reliable permeability estimates. Furthermore, we have a different point of view than previous authors. For instance: 1) we question the assumption that lymph flow rate is proportional to filtration rate, whereas other authors have implicitly assumed this relationship to be true; 2) we believe that the wide range of filtration coefficients measured with various techniques may be narrowed by consideration of the types of errors likely to result with each technique; 3) we place more emphasis than previous authors on the potential problems caused by the collection of impure lung lymph and the possibility that lymph composition may be altered within lymph nodes. For these reasons we believe that readers may benefit from a review of the techniques used in pulmonary permeability studies written from our perspective. PMID- 3286598 TI - Endotoxemia produces an increase in arterial but not venous lipid peroxides in sheep. AB - Our purpose was to determine the effect of an endotoxin-induced lung injury on circulating lipid peroxides. We measured both malondialdehyde (MDA) and conjugated dienes (as optical density at 233 nm) in aortic and venous plasma and lung lymph in 10 unanesthetized sheep given 1 microgram/kg of Escherichia coli endotoxin. Total lipids and prostanoids 6-ketoprostaglandin F1 alpha and thromboxane B2 were also measured. Six control sheep were also studied. Animals were monitored for a 12-h period and then killed, and lung tissue MDA was determined. A two-phase endotoxin response was noted with an initial pulmonary hypertension followed by a steady-state increase in protein-rich lung lymph flow (QL) between a 3- and 6-h period. Aortic plasma MDA was significantly increased from a base line of 4.8 +/- 1.4 to 8.9 +/- 1.6 and 7.5 +/- 1.3 nmol/ml at 1 and 4 h post-endotoxin. Aortic plasma conjugated dienes increased in all 10 sheep post endotoxin. Venous levels of both MDA and conjugated dienes were not significantly increased. Lung QL increased two- to three-fold. Lung lymph MDA increased significantly at 1 h post-endotoxin. Lymph conjugated dienes decreased. Plasma and lymph lipid peroxide levels returned to base line by 12 h in most animals. However, tissue MDA remained significantly increased in all sheep from base line of 45 +/- 9 to 85 +/- 14 nmol/g tissue. We conclude that both MDA and conjugated dienes are transiently released into aortic plasma during endotoxin-induced oxidant lung injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286599 TI - Effect of intravenous catalase on the pulmonary vascular response to endotoxemia in goats. AB - Neutrophils have been implicated in the pathogenesis of acute lung injury associated with clinical and experimental sepsis. Data from in vitro systems and experimental animals have suggested that neutrophil-derived oxidants, particularly H2O2, may be primarily responsible for endothelial damage, vasoconstriction, and lung edema. With the use of endotoxin infusion as an in vivo model of sepsis we tested the hypothesis that pretreatment with catalase, a peroxide scavenger, would ameliorate the resultant changes in pulmonary vasoconstriction and lung fluid balance. Paired experiments were performed in 16 goats with chronic lung lymph fistulas. One group of animals (n = 7) received endotoxin first alone and then again, several days later, after pretreatment with Ficoll-linked catalase. As a control, identical experiments were performed in a separate group (n = 6) with Ficoll-linked albumin substituted for Ficoll catalase. A third group (n = 3) was given endotoxin alone and then again during a continuous infusion of catalase. Plasma and lymph levels of catalase were comparable to or exceeded those previously shown to be completely protective in isolated perfused lung preparations and in vitro systems. Endotoxin caused neutropenia, pulmonary arterial hypertension, decreased cardiac output, and increases in lymph flow to approximately three times base line, with a return of all variables toward control values by 6 h. Catalase pretreatment produced no significant differences in any of these variables. These experiments do not support a role for H2O2 as a mediator of acute lung injury due to endotoxemia. PMID- 3286600 TI - Effect of exercise on nonspecific airway reactivity in asthmatics. AB - To investigate whether exercise increases the responsivity of the tracheobronchial tree to nonspecific stimuli, 11 atopic asthmatics underwent serial challenges with aerosolized methacholine before and 4 and 24 h after an asthma attack induced by cycle ergometry while breathing cold air (mean +/- SE = 11 +/- 1 degree C). Bronchodilator therapy was withheld the day before and throughout each study day. There were no significant differences in base-line lung function before exercise or any of the three methacholine bronchoprovocations. Exercise produced a 25 +/- 3% maximal fall in 1-s forced expiratory volume (FEV1) within 15 min. This attack was not associated with either an immediate or a delayed increase in methacholine sensitivity. The provocation concentration of methacholine required to reduce the FEV1 20% from saline control at base line and 4 and 24 h after exercise were 0.8 +/- 0.5, 0.9 +/- 0.5, and 1.1 +/- 0.8 mg/ml, respectively. This was not significant by a one way analysis of variance (F = 0.078, P = NS). These data demonstrate that exercise-induced asthma does not produce an increase in nonspecific bronchial reactivity. Hence, if mediators are elaborated with exercise as has been suggested, they appear to function differently than when released by antigen. PMID- 3286602 TI - P. falciparum infected erythrocytes are capable of endocytosis. AB - P. falciparum, an intraerythrocytic parasite, obtains nourishment primarily through phagocytosis of the host cytosol but also through the incorporation of extracellular small molecules which enter through the parasitized red cell's membrane via pores. Normal mature erythrocytes are incapable of endocytosis. Several lines of evidence suggest that extracellular large molecules may be taken up when the mature red cell is parasitized by P. falciparum, but direct evidence has been lacking. We now report the use of ferritin, an electron dense protein, to demonstrate endocytosis in P. falciparum infected red cells. Parasitized red cells incubated with ferritin internalize that macromolecule as demonstrated by electron microscopy. While normal red cells incubated with ferritin took up none of the tracer molecule, parasitized red cells internalized substantial amounts. In addition both ferritin and apoferritin inhibited the growth of P. falciparum in a dose dependent fashion, again indicating endocytosis of a macromolecule. These data indicate that P. falciparum can somehow stimulate the mature erythrocyte to engage in endocytosis. We also note that both infected and non infected red cells in a culture in which P. falciparum is growing become abnormally sticky for ferritin. Moreover, parasitized red cells bind I125 transferrin while non-parasitized erythrocytes do not. These observations suggest that a soluble parasite product alters the red cell membrane in a non-global manner, causing selective effects in relation to different proteins. PMID- 3286601 TI - Antagonistic effects of laminin and fibronectin in cell-to-cell and cell-to matrix interactions in MCF-7 cultures. AB - During morphogenesis, tumor progression and metastasis, cell adhesion, dissociation, and migration result from a complex balance between cell-to-cell and cell-to-matrix interactions. Two different organization patterns of MCF-7 cells were induced by different extracellular matrix proteins. When plated on plastic or polymeric type I collagen gel used as a model of interstitial matrix, MCF-7 cells spread and grew in monolayer. When cultured on a solid gel of basement membrane (BM) proteins (85% laminin) used as a model of BM, cells formed clusters attached to the matrix. Matrix proteins regulated these two types of cell organization by preferentially promoting cell-to-cell or cell-support interactions. On plastic in the presence of soluble laminin or on laminin-coated dishes, cells also formed clusters. Addition of soluble fibronectin induced spreading of the cells, suggesting that laminin and fibronectin have competitive antagonistic effects on MCF-7 cell morphology. Antilaminin antibodies inhibited cluster formation and attachment, emphasizing the important role of this glycoprotein not only in promoting cluster attachment but also in cell-to-cell contact formation. Such effects of extracellular matrix proteins could play significant roles in tumor progression and metastasis. PMID- 3286603 TI - [Echography and echography-guided punctures in adrenal gland pathology]. PMID- 3286604 TI - [Spectroscopy localized in vivo. Principles and potentials]. PMID- 3286605 TI - Conservation of an ATP-binding domain among RecA proteins from Proteus vulgaris, Erwinia carotovora, Shigella flexneri, and Escherichia coli K-12 and B/r. AB - The purified RecA proteins encoded by the cloned genes from Proteus vulgaris, Erwinia carotovora, Shigella flexneri, and Escherichia coli B/r were compared with the RecA protein from E. coli K-12. Each of the proteins hydrolyzed ATP in the presence of single-stranded DNA, and each was covalently modified with the photoaffinity ATP analog 8-azidoadenosine 5'-triphosphate (8N3ATP). Two dimensional tryptic maps of the four heterologous RecA proteins demonstrated considerable structural conservation among these bacterial genera. Moreover, when the [alpha-32P]8N3ATP-modified proteins were digested with trypsin and analyzed by high-performance liquid chromatography, a single peak of radioactivity was detected in each of the digests and these peptides eluted identically with the tryptic peptide T31 of the E. coli K-12 RecA protein, which was the unique site of 8N3ATP photolabeling. Each of the heterologous recA genes hybridized to oligonucleotide probes derived from the ATP-binding domain sequence of the E. coli K-12 gene. These last results demonstrate that the ATP-binding domain of the RecA protein has been strongly conserved for greater than 10(7) years. PMID- 3286606 TI - Nucleotide sequence and gene-polypeptide relationships of the glpABC operon encoding the anaerobic sn-glycerol-3-phosphate dehydrogenase of Escherichia coli K-12. AB - The nucleotide sequence of a 4.8-kilobase SacII-PstI fragment encoding the anaerobic glycerol-3-phosphate dehydrogenase operon of Escherichia coli has been determined. The operon consists of three open reading frames, glpABC, encoding polypeptides of molecular weight 62,000, 43,000, and 44,000, respectively. The 62,000- and 43,000-dalton subunits corresponded to the catalytic GlpAB dimer. The larger GlpA subunit contained a putative flavin adenine dinucleotide-binding site, and the smaller GlpB subunit contained a possible flavin mononucleotide binding domain. The GlpC subunit contained two cysteine clusters typical of iron sulfur-binding domains. This subunit was tightly associated with the envelope fraction and may function as the membrane anchor for the GlpAB dimer. Analysis of the GlpC primary structure indicated that the protein lacked extended hydrophobic sequences with the potential to form alpha-helices but did contain several long segments capable of forming transmembrane amphipathic helices. PMID- 3286607 TI - Osmotic regulation of biosynthesis of membrane-derived oligosaccharides in Escherichia coli. AB - The osmotic regulation of the biosynthesis of membrane-derived oligosaccharides (MDO) in strains UB1005 and DC2 of Escherichia coli K-12 was examined; this regulation was previously reported by Clark (J. Bacteriol. 161:1049-1053, 1985) to be different from that observed by Kennedy for other strains of E. coli (Proc. Natl. Acad. Sci. USA 79:1092-1095, 1982). Osmotic regulation of the synthesis of MDO in UB1005 and DC2 is in fact indistinguishable from that previously reported for other strains of E. coli, with maximum production of MDO occurring in the medium of lowest osmolarity. The report of Clark to the contrary was apparently based on the inadequate methods for the measurement of MDO employed in that study. MDO are localized in the periplasm of wild-type E. coli cells. However, strain DC2, selected for hypersensitivity to a range of antibiotics, released most of its MDO into the medium, apparently as a result of greater outer membrane permeability. PMID- 3286608 TI - Mutations in the leader sequence and initiation codon of the gene for ribosomal protein S20 (rpsT) affect both translational efficiency and autoregulation. AB - We have transferred the complete structural gene and part of the leader for ribosomal protein S20 of Escherichia coli to a controllable expression vector and have used oligonucleotide-directed mutagenesis to create mutations in the untranslated leader of the plasmid-borne gene. We have assayed for posttranscriptional regulation of the synthesis of S20 after inducing transcription of the mutant S20 mRNA from the expression vector. We found that two mutations lead to loss of feedback control of S20 synthesis: (i) a change of the initiation codon from UUG to AUG and (ii) a replacement of part of the S20 leader with a nonhomologous sequence including an AUG initiation codon. These mutations also lead to increases in both the intrinsic translational efficiency of the plasmid-encoded S20 mRNA in vitro and its half-life in vivo. A double mutation (GA to CT) at residues -3 and -4 relative to the initiation codon does not result in overproduction of S20. Rather, it reduces translational efficiency in vitro and mRNA stability in vivo. Our results demonstrate the fundamental importance of the UUG initiation codon in mediating autogenous repression of S20 synthesis. PMID- 3286609 TI - Sulfur-oxidizing bacterial endosymbionts: analysis of phylogeny and specificity by 16S rRNA sequences. AB - The 16S rRNAs from the bacterial endosymbionts of six marine invertebrates from diverse environments were isolated and partially sequenced. These symbionts included the trophosome symbiont of Riftia pachyptila, the gill symbionts of Calyptogena magnifica and Bathymodiolus thermophilus (from deep-sea hydrothermal vents), and the gill symbionts of Lucinoma annulata, Lucinoma aequizonata, and Codakia orbicularis (from relatively shallow coastal environments). Only one type of bacterial 16S rRNA was detected in each symbiosis. Using nucleotide sequence comparisons, we showed that each of the bacterial symbionts is distinct from the others and that all fall within a limited domain of the gamma subdivision of the purple bacteria (one of the major eubacterial divisions previously defined by 16S rRNA analysis [C. R. Woese, Microbiol. Rev. 51: 221-271, 1987]). Two host specimens were analyzed in five of the symbioses; in each case, identical bacterial rRNA sequences were obtained from conspecific host specimens. These data indicate that the symbioses examined are species specific and that the symbiont species are unique to and invariant within their respective host species. PMID- 3286610 TI - Cloning of the C-terminal cytoplasmic fragment of the tar protein and effects of the fragment on chemotaxis of Escherichia coli. AB - A gene encoding only the C-terminal portion of the receptor-transducer protein Tar of Escherichia coli was constructed. The gene product was detected and localized in the cytoplasmic fraction of the cell by immunoblotting with anti-Tar antibodies. The C-terminal fragments from wild-type and mutant tar genes were characterized in vivo. The C-terminal fragment generated from tar-526, a mutation that results in a dominant "tumble" phenotype, was found to be deamidated and methylated by the CheB and CheR proteins, respectively. The C-terminal fragment derived from a wild-type gene was poorly deamidated, and the C-terminal fragment derived from tar-529, a dominant mutant with a "smooth swimming" phenotype, was not apparently modified. Cells carrying the C-terminal fragment with the tar-526 mutation as the sole receptor-transducer protein showed a high frequency of tumbling and chemotaxis responses to changes in intracellular pH. These results suggest that the cytoplasmic C-terminal fragment of Tar retains some of the functions of the whole protein in vivo. PMID- 3286611 TI - Evidence that the fadB gene of the fadAB operon of Escherichia coli encodes 3 hydroxyacyl-coenzyme A (CoA) epimerase, delta 3-cis-delta 2-trans-enoyl-CoA isomerase, and enoyl-CoA hydratase in addition to 3-hydroxyacyl-CoA dehydrogenase. AB - Genetic complementation of a mutant defective in fatty acid oxidation (fadAB) with plasmids containing DNA inserts from the fadAB region of the Escherichia coli genome was studied. The mutant containing the hybrid plasmid with a 5.2 kilobase (kb) PstI-SalI fragment was found to overproduce 3-hydroxyacyl-coenzyme A (CoA) epimerase and delta 3-cis-delta 2-trans-enoyl-CoA isomerase as well as three other beta-oxidation enzymes by 16- to 18-fold compared with the wild-type parental strain LE392. The purification of a fully functional multienzyme complex of fatty acid oxidation from the transformant ultimately established that the 5.2 kb DNA fragment contained an entire fadAB operon. Since immunotitration of cell extracts with antibodies against the fatty acid oxidation complex proved that all 3-hydroxyacyl-CoA epimerase and delta 3-cis-delta 2-trans-enoyl-CoA isomerase activities were associated with the complex, no genetic loci other than the fadAB operon encoded these two enzymes. Moreover, the binding of antibodies caused parallel inhibition of four component enzymes, whereas 3-ketoacyl-CoA thiolase activity was slightly increased. These findings support the suggestion that the epimerase and isomerase as well as enoyl-CoA hydratase and L-3-hydroxyacyl-CoA dehydrogenase are located on the same polypeptide. The results of this study, together with published data (S.-Y. Yang and H. Schulz, J. Biol. Chem. 258:9780 9785, 1983), lead to the conclusion that 3-hydroxyacyl-CoA epimerase, delta 3-cis delta 2-trans-enoyl-CoA isomerase, and enoyl-CoA hydratase in addition to 3 hydroxyacyl-CoA dehydrogenase are encoded by the fadB gene. PMID- 3286612 TI - Perturbed chromosomal replication in recA mutants of Escherichia coli. AB - When initiation of DNA replication is inhibited in wild-type Escherichia coli cells by rifampin or chloramphenicol, completion of ongoing rounds of replication (runout of replication) leads to cells containing two, four, or eight fully replicated chromosomes, as measured by flow cytometry. In recombination-deficient recA strains, a high frequency of cells with three, five, six, or seven fully replicated chromosomes was observed in addition to cells with two, four, or eight chromosomes. recA mutants affected only in the protease-stimulating function behaved like wild-type cells. Thus, in the absence of the recombinase function of RecA protein, the frequency of productive initiations was significantly reduced compared with that in its presence. DNA degradation during runout of replication in the presence of rifampin was about 15%. The DNA degradation necessary to account for the whole effect described above was in this range or even lower. However, a model involving selective and complete degradation of partially replicated chromosomes is considered unlikely. It is suggested that the lack of RecA protein causes initiations or newly formed replication forks to stall but remain reactivatable for a period of time by functional RecA protein. PMID- 3286613 TI - Different effects of recJ and recN mutations on the postreplication repair of UV damaged DNA in Escherichia coli K-12. AB - Two mutations known to affect recombination in a recB recC sbsBC strain, recJ284::Tn10 and recN262, were examined for their effects on the postreplication repair of UV-damaged DNA. The recJ mutation did not affect the UV radiation sensitivity of uvrB and uvrB recF cells, but it increased the sensitivity of uvrB recN (approximately 3-fold) and uvrB recB (approximately 8-fold) cells. On the other hand, the recN mutation did not affect the UV sensitivity of uvrB recB cells, but it increased the sensitivity of uvrB (approximately 1.5-fold) and uvrB recF (approximately 4-fold) cells. DNA repair studies indicated that the recN mutation produced a partial deficiency in the postreplication repair of DNA double-strand breaks that arise from unrepaired daughter strand gaps, while the recJ mutation produced a deficiency in the repair of daughter strand gaps in uvrB recB cells (but not in uvrB cells) and a deficiency in the repair of both daughter strand gaps and double-strand breaks in uvrA recB recC shcBC cells. Together, these results indicate that the recJ and recN genes are involved in different aspects of postreplication repair. PMID- 3286614 TI - Truncated forms of Escherichia coli lactose permease: models for study of biosynthesis and membrane insertion. AB - Using in vitro DNA manipulations, we constructed different lacY alleles encoding mutant proteins of the Escherichia coli lactose carrier. With respect to structural models developed for lactose permease, the truncated polypeptides represent model systems containing approximately one, two, four, and five of the N-terminal membrane-spanning alpha-helices. In addition, a protein carrying a deletion of predicted helices 3 and 4 was obtained. The different proteins were radiolabeled in plasmid-bearing E. coli minicells and were found to be stably integrated into the lipid bilayer. The truncated polypeptides of 50, 71, 143, and 174 N-terminal amino acid residues resembled the wild-type protein in their solubilization characteristics, whereas the mutant protein carrying an internal deletion of amino acid residues 72 to 142 of the lactose carrier behaved differently. Minicell membrane vesicles containing truncated proteins comprising amino acid residues 1 to 143 or 1 to 174 were subjected to limited proteolysis. Upon digestion with proteases of different specificities, the same characteristic fragment that was also produced from the membrane-associated wild-type protein was found to accumulate under these conditions. It has previously been shown to contain the intact N terminus of lactose permease. This supports the idea of an independent folding and membrane insertion of this segment even in the absence of the C-terminal part of the molecule. The results suggest that the N-terminal region of the lactose permease represents a well-defined structural domain. PMID- 3286615 TI - Polyacrylamide gel electrophoresis of the capsular polysaccharides of Escherichia coli K1 and other bacteria. AB - Methods were developed for the polyacrylamide gel electrophoretic analysis of capsular polysaccharides of bacteria with Escherichia coli K1 as a model. Conditions were determined for the rapid and gentle extraction of the K1 polysaccharide by incubation of the bacteria in a volatile buffer and for the subsequent removal of the putative phospholipid moiety attached to the reducing end of the polysaccharide. Detection of the polysaccharides after gel electrophoresis was carried out by fluorography of samples labeled by sodium borotritiide reduction or by combined alcian blue and silver staining. The smallest components could be detected only by fluorography, owing to diffusion during staining. Components of the E. coli K1 polysialic acid capsule ranging from monomers to 80 sialic-acid-unit-containing polymers could be separated as distinct bands in a ladderlike pattern. A maximum chain length of 160 to 230 sialyl residues was estimated for the bulk of the K1 polysaccharide from the nearly linear reciprocal relationship between the logarithm of the molecular size and the distance of migration. Gel electrophoresis of capsular polysaccharides of other bacterial species revealed different electrophoretic mobilities for each polysaccharide, with a ladderlike pattern displayed by the fastest-moving components. There are many potential applications of this facile method for the determination of the sizes of molecules present in a polydisperse polysaccharide sample. When combined with the simple method for the isolation of the capsule, as in the case of the K1 capsule, it provides an efficient tool for the characterization and comparison of the capsular polysaccharides of bacteria. PMID- 3286616 TI - Derepression of high-affinity glucose uptake requires a functional secretory system in Saccharomyces cerevisiae. AB - The expression of high-affinity glucose uptake in Saccharomyces cerevisiae strains carrying conditional mutations conferring a block of secretion and cell surface growth (sec) revealed a requirement for a functional secretory pathway for derepression of carrier activity. Thus, in strains carrying the sec1-1, sec4 2, sec7-1, sec14-3, or sec17-1 mutation, no high-affinity carrier activity was expressed after a shift to derepressing glucose concentrations at the nonpermissive temperature. In the case of sec18-1, however, derepression of carrier activity did occur at both the permissive and nonpermissive temperature, but not to the same extent as found in the wild-type strain, suggesting that SEC18 function may not be essential for expression of carrier activity. In sec1 1, accumulation of high-affinity carrier activity (or a component thereof) in presecretory vesicles during incubation at the nonpermissive temperature was demonstrated. The presence of a high glucose concentration in the medium did not affect transfer of that accumulated carrier function to the cell surface. Carrier function did not accumulate in strains carrying the other sec mutations. Analysis of the stability of high-affinity carrier activity at 37 degrees C demonstrated rapid and unexpected loss of carrier activity not affected by the presence of glucose in the medium. Thus, blockage of cell surface growth seems to affect turnover rates of hexose carrier activities. PMID- 3286617 TI - Changes induced in the permeability barrier of the yeast plasma membrane by cupric ion. AB - A specific effect of Cu2+ eliciting selective changes in the permeability of intact Saccharomyces cerevisiae cells is described. When 100 microM CuCl2 was added to a cell suspension in a buffer of low ionic strength, the permeability barrier of the plasma membranes of the cells was lost within 2 min at 25 degrees C. The release of amino acids was partial, and the composition of the amino acids released was different from that of those retained in the cells. Mostly glutamate was released, but arginine was mainly retained in the cells. Cellular K+ was released rapidly after CuCl2 addition, but 30% of the total K+ was retained in the cells. These and other observations suggested that Cu2+ caused selective lesions of the permeability barrier of the plasma membrane but did not affect the permeability of the vacuolar membrane. These selective changes were not induced by the other divalent cations tested. A novel and simple method for differential extraction of vacuolar and cytosolic amino acid pools by Cu2+ treatment was established. When Ca2+ was added to Cu2+-treated cells, a large amount of Ca2+ was sequestered into vacuoles, with formation of an inclusion of a Ca2+ polyphosphate complex in the vacuoles. Cu2+-treated cells also showed enhanced uptake of basic amino acids and S-adenosylmethionine. The transport of these substrates showed saturable kinetics with low affinities, reflecting the vacuolar transport process in situ. With Cu2+ treatment, selective leakage of K+ from the cytosolic compartment appears to create a large concentration gradient of K+ across the vacuolar membrane and generates an inside-negative membrane potential, which may provide a driving force of uptake of positively charged substances into vacuoles. Cu2+ treatment provides a useful in situ method for investigating the mechanisms of differential solute pool formation and specific transport phenomena across the vacuolar membrane. PMID- 3286618 TI - Identification of a site of ATP requirement for signal processing in bacterial chemotaxis. AB - In Escherichia coli and Salmonella typhimurium, ATP is required for chemotaxis and for a normal probability of clockwise rotation of the flagellar motors, in addition to the requirement for S-adenosylmethionine (J. Shioi, R. J. Galloway, M. Niwano, R. E. Chinnock, and B. L. Taylor, J. Biol. Chem. 257:7969-7975, 1982). The site of the ATP requirement was investigated. The times required for S. typhimurium ST23 (hisF) to adapt to a step increase in serine, phenol, or benzoate were similar in cells depleted of ATP and in cells with normal levels of ATP. This established that ATP was not required for the chemotactic signal to cross the inner membrane or for adaptation to the transmembrane signal to occur. Depletion of ATP did not affect the probability of clockwise rotation in E. coli cheYZ scy strains that were defective in the cheY and cheZ genes and had a partially compensating mutation in the motor switch. Strain HCB326 (cheAWRBYZ tar tap tsr trg::Tn10), which was deficient in all chemotaxis components except the switch and motor, was transformed with the pCK63 plasmid (ptac-cheY+). Induction of cheY in the transformant increased the frequency of clockwise rotation, but except at the highest levels of CheY overproduction, clockwise rotation was abolished by depleting ATP. It is proposed that the CheY protein is normally in an inactive form and that ATP is required for formation of an active CheY* protein that binds to the switch on the flagellar motors and initiates clockwise rotation. Depletion of ATP partially inhibits feedback regulation of the cheB product, protein methylesterase, but this may reflect a second site of ATP action in chemotaxis. PMID- 3286619 TI - Localization of reaction center and B800-850 antenna pigment proteins in membranes of Rhodobacter sphaeroides. AB - The localization of the N- and C-terminal regions of pigment-binding polypeptides of the bacterial photosynthetic apparatus of Rhodobacter sphaeroides was investigated by proteinase K treatment of chromatophore and spheroplast-derived vesicles and amino acid sequence determination. Under conditions of proteinase K treatment of chromatophores, which left the in vivo absorption spectrum and the membrane intact, 15 and 46 amino acyl residues from the N-terminal regions of the L and M subunits, respectively, of the reaction center polypeptides were removed. The N termini are therefore exposed on the cytoplasmic surface of the membrane. The C-terminal domain of the light-harvesting B800-850 alpha and B870 alpha polypeptides was found to be exposed on the periplasmic surface of the membrane. A total of 9 and 13 amino acyl residues were cleaved from the B800-850 alpha and B870 alpha polypeptides, respectively, when spheroplasts were treated with proteinase K. The N-terminal regions of the alpha polypeptides were not digested in either membrane preparation and were apparently protected from proteolytic attack. Seven N-terminal amino acyl residues of the B800-850 beta polypeptide were removed after the digestion of chromatophores. C-terminal residues were not removed after the digestion of chromatophores or spheroplasts. The C termini seem to be protected from protease attack by interaction with the membrane. Therefore, the N-terminal regions of the beta polypeptides are exposed on the cytoplasmic membrane surface. The C termini of the beta polypeptides are believed to point to the periplasmic space. PMID- 3286620 TI - High-efficiency transformation of bacterial cells by electroporation. AB - We have developed a method for efficiently generating transient pores in the outer membranes of Escherichia coli K-12 derivatives by using a new type of electroporation apparatus. The pores are large enough and persist long enough to facilitate the equilibration of plasmid molecules between the intracellular and extracellular spaces. The method has been used to transform bacterial cells with an efficiency greater than 10(9) transformants per microgram of plasmid. It has also been used to extract intact plasmid from transformed cells with efficiencies comparable to those of the traditional alkaline lysis or CsCl equilibrium density gradient techniques. The technique is simple and rapid, allowing a transformation or the preparation of microgram quantities of plasmid to be accomplished in minutes. PMID- 3286621 TI - The fadL gene product of Escherichia coli is an outer membrane protein required for uptake of long-chain fatty acids and involved in sensitivity to bacteriophage T2. AB - The fadL+ gene of Escherichia coli encodes an outer membrane protein (FadL) essential for the uptake of long-chain fatty acids (C12 to C18). The present study shows that in addition to being required for uptake of and growth on the long-chain fatty acid oleate (C18:1), FadL acts as a receptor of bacteriophage T2. Bacteriophage T2-resistant (T2r) strains lacked FadL and were unable to take up and grow on long-chain fatty acids. Upon transformation with the fadL+ clone pN103, T2r strains became sensitive to bacteriophage T2 (T2s), became able to take up long-chain fatty acids at wild-type levels, and contained FadL in the outer membrane. PMID- 3286622 TI - Saccharomyces cerevisiae acquires resistance to 2-deoxyglucose at a very high frequency. AB - We have found that Saccharomyces cerevisiae acquires spontaneously increasing resistance to 2-deoxyglucose at a very high frequency. This finding allows the easy isolation of different types of resistant strains of interest for metabolic studies with 2-deoxyhexoses. On the other hand, it sounds a note of caution in the widespread use of 2-deoxyglucose as a selective agent for the isolation of yeast mutants with impaired hexose transport or phosphorylation systems. PMID- 3286623 TI - Aerobic excretion of 1,2-propanediol by Salmonella typhimurium. AB - Salmonella typhimurium excreted the rhamnose fermentation product 1,2-propanediol not only under anaerobic conditions, but also under aerobic conditions. The absence of an aldehyde dehydrogenase enzymatic activity that oxidizes to lactate the lactaldehyde formed in the dissimilation of rhamnose raised the intracellular concentration of the aldehyde which was alternatively reduced to the excretable 1,2-propanediol by a residual propanediol oxidoreductase activity. PMID- 3286624 TI - Complete nucleotide sequence of the 16S rRNA gene of Mycobacterium bovis BCG. AB - The complete nucleotide sequence of the 16S rRNA gene of Mycobacterium bovis BCG was determined. Its coding region was estimated to be 1,536 base pairs long. The nucleotide sequence of the gene in M. bovis BCG has homologies of 75 and 89% with those of Escherichia coli and Streptomyces lividans, respectively. PMID- 3286625 TI - Assessment and management of the AIDS patient with neuropsychiatric disturbances. AB - The studies reviewed here and ongoing work indicate a primary role for psychiatry in treating patients with the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection. Those patients often have neuropsychiatric disorders concurrent with the complications of physical disease. It is important to understand the diagnostic criteria for patients with HIV related disorders to distinguish CNS disturbances caused by infections from those psychiatric problems exacerbated by the social consequences of the syndrome. Although treatment is difficult in immunocompromised patients and treatments may cause serious side effects, many of the CNS symptoms of AIDS patients can be treated in the same way as other diseases of the CNS. Psychostimulants are the most promising therapeutic agents for AIDS patients. In the treatment of psychotic episodes, high-potency neuroleptics at low dosages have been used successfully. In all therapies, careful consideration must be given to possible adverse reactions, which may be more serious in HIV-related diseases. PMID- 3286626 TI - Psychosocial aspects of dementia. AB - The psychosocial elements of dementia range from the emotional responses seen in the person with a dementing illness to the broad societal questions of financing long-term care for the cognitively impaired elderly. The author outlines a number of current psychosocial dilemmas posed by the dementias and reviews what is currently known about them. PMID- 3286627 TI - Dementia update: diagnosis and neuropsychiatric aspects. AB - Many disorders--including vascular disease, alcoholism, Huntington's disease, drug toxicity, metabolic disorders, brain tumors, depression, and other psychiatric disorders--can cause dementia. Moreover, 50% of all dementia patients have Alzheimer's disease. Guidelines have been established to define the types of dementia. A detailed history, which may note previous depression, and a physical examination are essential. Assessment of the patient's mental status and a neurological examination may help to distinguish other forms of dementia from Alzheimer's disease. Brain imaging and psychometric testing may also help to establish a diagnosis. Metabolic screening for reversible causes of dementia, such as thyroid disturbance or electrolyte-imbalance, is essential. Common features of Alzheimer's disease include memory loss; difficulty with problem solving, abstractions, and calculations; and language and visuospatial deficits. Delusions are common in the early phase of the disease. It is not yet possible to diagnose Alzheimer's disease with complete accuracy. Additional neurophysiological and biochemical markers for diagnosis must be developed. PMID- 3286628 TI - Effect of H-protein on the formation of myosin filaments and light meromyosin paracrystals. AB - H-protein is a component of the thick filaments of skeletal myofibrils. Its effects on the assembly of myosin into filaments and on the formation of light meromyosin (LMM) paracrystals at low ionic strength have been investigated. H protein reduced the turbidities of myosin filament and LMM paracrystal suspensions. Electron microscopic observation showed that the appearances of the filaments prepared in the presence and absence of H-protein were different. The filament length was not substantially changed by H-protein, but the diameter of the myosin filament was markedly reduced. H-protein bound to LMM and co sedimented with it at low ionic strength upon centrifugation. Two types of paracrystals, spindle-shaped and sheet-like, were observed in LMM suspensions. H protein altered the structure of the LMM paracrystals, especially the spindle shaped ones. The thickness of the spindle-shaped paracrystals was reduced when H protein was present during LMM paracrystal formation. On the other hand, periodic features along the long axis of the sheet-like paracrystals were retained even at high ratios of H-protein to LMM. However, there were fewer sheet-like paracrystals in the LMM suspensions containing H-protein than in the control. These results suggest that H-protein interferes with self-association of myosin molecule into filaments due to its binding to the tail portion of the myosin. However, H-protein does not have a length-determining effect on the formation of myosin filaments. PMID- 3286629 TI - Coenzyme stimulation of isomerase activity of sepiapterin reductase in the biosynthesis of tetrahydrobiopterin. AB - The 6-lactoyl tetrahydropterin (C1'-keto PH4) isomerase activity of sepiapterin reductase, which was found in our recent work (Katoh and Sueoka (1987) J. Biochem. 101, 275-278) as a novel activity of the enzyme, i.e., the conversion of C1'-keto PH4 to 6-1'-hydroxy-2'-oxopropyl tetrahydropterin (C2'-keto PH4) without coenzymes, could be enhanced by a small amount of NADPH or NADP+. The concentration of NADP+ required for the maximal stimulation was approximately the same as the concentration of the enzyme subunit. When NADP+ was added with the enzyme and C1'-keto PH4 at pH 8.6, the reaction sequence of C1'-keto PH4----C2' keto PH4----tetrahydrobiopterin (BH4) was observed in the presence of dithioerythritol. These observations suggest that the coenzyme stimulating the isomerase function of sepiapterin reductase may be involved in the two sequential reductions, from pyruvoyl tetrahydropterin to BH4, by causing internal rearrangement of the keto group of the first intermediate, C1'-keto PH4, to form the second one, C2'-keto PH4. PMID- 3286630 TI - Secretion of an active nonglycosylated form of the repressible acid phosphatase of Saccharomyces cerevisiae in the presence of tunicamycin at low temperatures. AB - The role of mannan chains in the formation and secretion of active acid phosphatase of yeast (Saccharomyces cerevisiae), a repressible cell surface mannoprotein, was studied in yeast protoplast systems by using tunicamycin at various temperatures. At 30 degrees C, tunicamycin-treated protoplasts did not produce active acid phosphatase; however, at 25 or 20 degrees C they formed and secreted active enzyme. This form of acid phosphatase gave 59-, 57-, and 55-kDa bands on SDS-PAGE which neither bound to concanavalin A Sepharose, nor changed in molecular weight upon treatment with endoglycosidase H, indicating that the peptides are nonglycosylated. The nonglycosylated form, like its glycosylated counterpart, is a dimer on the basis of gel permeation chromatography. The Km for para-nitrophenyl-phosphate and Ki for inorganic phosphate of both glycosylated and nonglycosylated acid phosphatases were almost the same. These results suggested that 1) the conformation of the nonglycosylated acid phosphatase secreted at low temperatures is probably identical with that of the glycosylated one, and 2) the conformation of acid phosphatase is very important for its secretion. The rate of intracellular transport of nonglycosylated acid phosphatase is about one-fourth that of the glycosylated enzyme, indicating that glycosylation facilitates the transport of acid phosphatase proteins. PMID- 3286632 TI - K+/H+ antiport in mitochondria. AB - Mitochondria contain a latent K+/H+ antiporter that is activated by Mg2+ depletion and shows optimal activity in alkaline, hypotonic suspending media. This K+/H+ antiport activity appears responsible for a respiration-dependent extrusion of endogenous K+, for passive swelling in K+ acetate and other media, for a passive exchange of matrix 42K+ against external K+, Na+, or Li+, and for the respiration-dependent ion extrusion and osmotic contraction of mitochondria swollen passively in K+ nitrate. K+/H+ antiport is inhibited by quinine and by dicyclohexylcarbodiimide when this reagent is reacted with Mg2+-depleted mitochondria. There is good suggestive evidence that the K+/H+ antiport may serve as the endogenous K+-extruding device of the mitochondrion. There is also considerable experimental support for the concept that the K+/H+ antiport is regulated to prevent futile influx-efflux cycling of K+. However, it is not yet clear whether such regulation depends on matrix free Mg2+, on membrane conformational changes, or other as yet unknown factors. PMID- 3286633 TI - Expression of the primary biliary cirrhosis antigens in yeast: aspects of mitochondrial control. AB - The mitochondria of 21 yeast strains were tested for the expression of primary biliary cirrhosis (PBC) specific antigens. The amounts of the antigens in the mitochondrial preparations varied with the strains. Genetic analysis of the strain differences in antigen expression indicated nuclear control which was complex. Those strains expressing the least amounts of antigens exhibited coagulating mitochondria in organellar preparations. Additional evidence relating expression of antigens to the physiological/structural state of mitochondria was that cells grown in the presence of the mitochondrial uncoupling agent, 2,4 dinitrophenol (DNP), failed to produce any antigens, and that glucose repression of mitochondria suppressed antigen expression. Blockage of mitochondrial protein synthesis either through petite mutation or by culture in the presence of erythromycin decreased the content of antigens in the mitochondria but did not completely block antigen production. The presence of the PBC antigen in the mitochondria of these cells with nonfunctional mitochondrial synthesizing machinery further indicates that these antigens are cytoplasmically synthesized. Analysis of the pre- and postmitochondrial fractions of all homogenates confirmed that the antigens are not only cytoplasmically synthesized but also have an extramitochondrial location in cells, probably in the plasma membrane. PMID- 3286634 TI - Histatins, a novel family of histidine-rich proteins in human parotid secretion. Isolation, characterization, primary structure, and fungistatic effects on Candida albicans. AB - Histatins 1, 3, and 5 from human parotid secretion were isolated by gel filtration on Bio-Gel P-2 and reverse phase high performance liquid chromatography. The complete amino acid sequences of histatins determined by automated Edman degradation of the proteins, Staphylococcus aureus V8 protease, and tryptic peptides, are as follows: (Sequence: see text). Histatins 1, 3, and 5 contain 38, 32, and 24 amino acid residues, have molecular weights of 4929, 4063, and 3037, respectively, and contain 7 residues of histidine. Histatin 1 contains 1 mol of phosphate/mol of protein; histatins 3 and 5 lack phosphate. With the exception of Glu (residue 4) and Arg (residue 11) in histatin 1, the first 22 amino acid residues of all three histatins are identical, and the carboxyl terminal 7 residues of histatins 1 and 3 are also identical. The sequence, -Glu Phe-Pro-Phe-Tyr-Gly-Asp-Tyr-Gly- (residues 23-29), in histatin 1 is absent in histatin 3; and the sequence, -Gly-Tyr-Arg- (residues 23-25), in histatin 3 is absent in histatin 1. The complete sequence of histatin 5 is contained within the amino terminal 24 residues of histatin 3. The structural data suggest that histatins 1 and 3 are derived from different structural genes, whereas histatin 5 is a proteolytic product of histatin 3. All three histatins exhibit the ability to kill the pathogenic yeast, Candida albicans. PMID- 3286631 TI - The biochemical basis of mitochondrial diseases. AB - Dysfunctioning of human mitochondria is found in a rapidly increasing number of patients. The mitochondrial system for energy transduction is very vulnerable to damage by genetic and environmental factors. A primary mitochondrial disease is caused by a genetic defect in a mitochondrial enzyme or translocator. More than 60 mitochondrial enzyme deficiencies have been reported. Secondary mitochondrial defects are caused by lack of compounds to enable a proper mitochondrial function or by inhibition of that function. This may result from malnutrition, circulatory or hormonal disturbances, viral infection, poisoning, or an extramitochondrial error of metabolism. Once mitochondrial ATP synthesis decreases, secondary mitochondrial lesions may be generated further, due to changes in synthesis and degradation of mitochondrial phospholipids and proteins, to mitochondrial antibody formation following massive degradation, to accumulation of toxic products as excess acyl-CoA, to the depletion of Krebs cycle intermediates, and to the increase of free radical formation and lipid peroxidation. PMID- 3286635 TI - Primary structure of T4 DNA polymerase. Evolutionary relatedness to eucaryotic and other procaryotic DNA polymerases. AB - Bacteriophage T4 gene 43 codes for the viral DNA polymerase. We report here the sequence of gene 43 and about 70 nucleotides of 5'- and 3'-flanking sequences, determined by both DNA and RNA sequencing. We have also purified T4 DNA polymerase from T4 infected Escherichia coli and from E. coli containing a gene 43 overexpression vector. A major portion of the deduced amino acid sequence has been verified by peptide mapping and sequencing of the purified DNA polymerase. All these results are consistent with T4 DNA polymerase having 898 amino acids with a calculated Mr = 103,572. Comparison of the primary structure of T4 DNA polymerase with the sequence of other procaryotic and eucaryotic DNA polymerases indicates that T4 DNA polymerase has regions of striking similarity with animal virus DNA polymerases and human DNA polymerase alpha. Surprisingly, T4 DNA polymerase shares only limited similarity with E. coli polymerase I and no detectable similarity with T7 DNA polymerase. Based on the location of specific mutations in T4 DNA polymerase and the conservation of particular sequences in T4 and eucaryotic DNA polymerases, we propose that the NH2-terminal half of T4 DNA polymerase forms a domain that carries out the 3'----5' exonuclease activity whereas the COOH-terminal half of the polypeptide contains the dNTP-binding site and is necessary for DNA synthesis. PMID- 3286636 TI - Proliferative effects of insulin and epidermal growth factor on mouse mammary epithelial cells in primary culture. Enhancement by hydroxyeicosatetraenoic acids and synergism with prostaglandin E2. AB - Linoleate metabolism via the cyclooxygenase pathway enhances the proliferation of mammary epithelial cells in serum-free culture in the presence of epidermal growth factor and insulin (Bandyopadhyay, G.K., Imagawa, W., Wallace, D., and Nandi, S. (1987) J. Biol. Chem. 262, 2750-2756). Prostaglandin E2 (PGE2) can fully substitute for linoleic acid provided endogenous hydroxyeicosatetraenoic acids (HETEs, lipoxygenase metabolites) are available. The PGE2 effect is partial if lipoxygenase activity is inhibited by nordihydroguaiaretic acid. Any combination of two HETEs out of three tested (5-, 12-, and 15-HETEs) stimulates growth synergistically with PGE2; and together (i.e. PGE2 + HETEs), they completely substitute for linoleate. In the absence of PGE2, maximal stimulation cannot be attained with HETEs. Exogenous 5-HETE, compared with 12- or 15-HETE, is preferentially incorporated by the mammary epithelial cells, and about 25-30% of it is retained esterified in phospholipids. The cellular level of nonesterified, free HETE is low. Radioimmunoassay revealed that the concentrations of 12- and 15 HETEs in the culture media (with or without added linoleate) were always higher than that of 5-HETE. Both intra- and extracellular free HETEs are rapidly metabolized by the cells. Since these cells are capable of producing eicosanoids from linoleate, periodic supplementation of the cultures with linoleate allows maintenance of higher HETE and PGE2 levels. Thus, it appears that not only are HETEs short-lived in the cell cultures, but cells handle 5-HETE differently than 12- and 15-HETEs. Whatever may be the pathways of interaction, synergism between HETEs and PGE2 seems to explain how linoleate stimulates the growth of mammary epithelial cells in the presence of epidermal growth factor and insulin. PMID- 3286637 TI - Properties of a defined mutant of Escherichia coli thymidylate synthase. AB - A mutant of Escherichia coli thymidylate synthase (F3-TS), resulting from the replacement of a tyrosine for a cysteine 50 amino acids from the amino-terminal end, has been purified to homogeneity and found to contain less than 0.2% of the activity of the native enzyme (thyA-TS). Although this protein formed a ternary complex with 5-fluoro-2'-deoxyuridine 5'-monophosphate (FdUMP) and 5,10 methylenetetrahydrofolate, like the native enzyme, the extent of complex formation was significantly impaired as determined by equilibrium dialysis and circular dichroism. Thus, unlike the native enzyme, where 2 mol of FdUMP were present in each mole of ternary complex, F3-TS contained less than 1 mol of FdUMP/mol of ternary complex. Similarly, the binding of dUMP by F3-TS was greatly diminished relative to thyA-TS, but its binding as well as that of FdUMP could be improved by the presence of either the folate substrate or a tight binding folate analogue, 10-propargyl-5,8-dideazafolate (PDDF). However, despite the fact that PDDF enhanced the binding of FdUMP and dUMP to F3-TS, the binding of PDDF to the mutant enzyme was also greatly impaired. This contrasts with the native enzyme, which, under the same conditions, bound about 2 mol of PDDF/mol of enzyme in the presence or absence of either FdUMP or dUMP. Circular dichroism analyses with PDDF in the presence of dUMP or FdUMP yielded analogous results, but the effects were less dramatic than those obtained by equilibrium dialysis. Evidence in support of a structural difference between thyA-TS and F3-TS was obtained by demonstrating that the latter protein was 15-fold slower in forming a ternary complex with dUMP and PDDF than the former and that the mutant enzyme was less stable than the native enzyme. PMID- 3286638 TI - The NH2-terminal 21 amino acid residues are not essential for the papain inhibitory activity of oryzacystatin, a member of the cystatin superfamily. Expression of oryzacystatin cDNA and its truncated fragments in Escherichia coli. AB - Oryzacystatin, a proteinaceous cysteine proteinase inhibitor (cystatin) in rice, is comprised of 102 residues (Met1-Ala102) (Abe, K., Emori, Y., Kondo, H., Suzuki, K., and Arai, S. (1987) J. Biol. Chem. 262, 16793-16797). We constructed an expression plasmid containing a full length oryzacystatin cDNA at the multi cloning site of pUC18 and produced a lacZ'-oryzacystatin fusion protein in Escherichia coli. The partially purified expressed protein efficiently inhibits papain activity assayed using N-benzoyl-DL-arginine-2-naphthylamide as a substrate. We also constructed expression plasmids lacking the 5'- and 3'-regions of cDNAs that encode NH2- and COOH-terminally truncated oryzacystatins. An N truncated oryzacystatin lacking Gly5 and retaining Gln53-Val54-Val55-Ala56-Gly57 inhibited papain as efficiently as the full length oryzacystatin, although both Gly5 and Gln53-Gly57 (oryzacystatin numbering) are conserved among members of most cystatin superfamilies. However, another N-truncated oryzacystatin lacking the NH2-terminal 38 residues was almost completely inactive. On the other hand, a COOH-terminally truncated oryzacystatin lacking the COOH-terminal 11 residues possesses potent papain-inhibitory activity, whereas another COOH-terminally truncated oryzacystatin lacking 35 residues shows much less inhibitory activity, although it retains the two well conserved features Gly5 and Gln53-Gly57. These results indicate that the NH2-terminal 21 residues containing Gly5 and the COOH terminal 11 residues are not essential, suggesting that a portion of the polypeptide segment containing Gln53-Gly57 is necessary for oryzacystatin to elicite its papain-inhibitory activity efficiently. PMID- 3286639 TI - Purification and properties of the major nuclease from mitochondria of Saccharomyces cerevisiae. AB - The vast majority of nuclease activity in yeast mitochondria is due to a single polypeptide with an apparent molecular weight of 38,000. The enzyme is located in the mitochondrial inner membrane and requires non-ionic detergents for solubilization and activity. A combination of heparin-agarose and Cibacron blue agarose chromatography was employed to purify the nuclease to approximately 90% homogeneity. The purified enzyme shows multiple activities: 1) RNase activity on single-stranded, but not double-stranded RNA, 2) endonuclease activity on single- and double-stranded DNA, and 3) a 5'-exonuclease activity on double-stranded DNA. Digestion products with DNA contain 5'-phosphorylated termini. Antibody raised against an analogous enzyme purified from Neurospora crassa (Chow, T. Y. K., and Fraser, M. (1983) J. Biol. Chem. 258, 12010-12018) inhibits and immunoprecipitates the yeast enzyme. This antibody inhibits 90-95% of all nuclease activity present in solubilized mitochondria, indicating that the purified nuclease accounts for the bulk of mitochondrial nucleolytic activity. Analysis of a mutant strain in which the gene for the nuclease has been disrupted supports this conclusion and shows that all detectable DNase activity and most nonspecific RNase activity in the mitochondria is due to this single enzyme. PMID- 3286640 TI - Role of the cytochrome b6.f complex in the redox-controlled activity of Acetabularia thylakoid protein kinase. AB - The regulation of the protein kinase activity responsible for the phosphorylation of the light-harvesting complex of photosystem II (LHCII) 27-kDa polypeptide involved in the State I-State II transitions in Acetabularia thylakoids was investigated. The LHCII kinase of isolated thylakoids retains its activity in absence of light-driven electron flow or reductants added in the dark. However, the kinase is reversibly inactivated by addition of oxidants in vitro or by far red (710 nm) light in vivo. Inhibitors of the quinol oxidase site of the cytochrome b6.f complex inactivate the LHCII kinase in the dark, and also in the light, or in presence of duroquinol when the plastoquinone pool is reduced. Inhibitors of the quinone reductase site of the b6.f complex have practically no effect in the dark and stimulate the kinase activity in the light. Based on these data and on our previous report, showing specific loss of LHCII kinase activity in a Lemna mutant lacking the cytochrome b6.f complex (Gal, A., Shahak, Y., Schuster, G., and Ohad, I. (1987) FEBS Lett. 221, 205-210), we propose that the activity of the LHCII kinase is regulated by the redox state of a cytochrome b6.f complex component(s) which responds to the balance of electron flow from photosystem II via the plastoquinone pool to photosystem I. PMID- 3286641 TI - Substructure and higher structure of chicken smooth muscle alpha-actinin molecule. AB - Substructure of chicken gizzard smooth muscle alpha-actinin molecule was deduced by domainal mapping of the proteolytic fragments with alpha-chymotrypsin. There were three chymotryptic cleavage sites (Sites I, II, and III, from the amino terminus). Cleavage at Site I generated two fragments, i.e. an NH2-terminal 36 kDa fragment and a COOH-terminal 70-kDa fragment. The 70-kDa fragment generated either a 55-kDa fragment by cleavage at Site II or a 65-kDa fragment by cleavage at Site III. Purified NH2-terminal 36-kDa fragment bound to F-actin, whereas the 55-kDa fragment formed a dimeric molecule. Circular dichroism and electron microscopic experiments demonstrated that the alpha-helical content of the 55-kDa fragment was 14% higher than that of native gizzard alpha-actinin, coinciding with the apparently rod-shaped configuration of this fragment. A 110-kDa product was generated from two 55-kDa fragments in a cross-linking study with the zero length cross-linker 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide. Two cross linkable sites in the 55-kDa, A- and B-site, were shown to be involved in this reaction. Further, it was demonstrated by using N-(7-dimethylamino-4-methyl-3 coumarinyl)maleimide labeling and immunoblotting analyses that the A-site on one 55-kDa fragment was cross-linked to the B-site on the other. These results suggest that smooth muscle alpha-actinin formed an antiparallel dimeric molecule in which the 55-kDa fragments connected the two actin-binding domains composed of the 36-kDa fragments. PMID- 3286642 TI - Insulin-dependent covalent reassociation of isolated alpha beta heterodimeric insulin receptors into an alpha 2 beta 2 heterotetrameric disulfide-linked complex. AB - The purified human placental alpha 2 beta 2 heterotetrameric insulin receptor complex was reduced and dissociated into functional alpha beta heterodimers by a combination of alkaline pH and dithiothreitol treatment. Insulin treatment of the isolated alpha beta heterodimeric complex was observed to induce the complete reassociation to an alpha 2 beta 2 heterotetrameric state when analyzed by nondenaturing Bio-Gel A-1.5m gel filtration chromatography. Nonreducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis of 125I-insulin affinity cross linked and 32P-autophosphorylated alpha beta heterodimers demonstrated that the insulin-dependent reassociation to the alpha 2 beta 2 heterotetrameric state occurred both covalently and noncovalently under these conditions. Comparison by reducing and nonreducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that the insulin-dependent covalent reassociation to an alpha 2 beta 2 heterotetrameric complex was due to the formation of a disulfide linkage(s) between the alpha beta heterodimers. beta subunit autophosphorylation of the control alpha 2 beta 2 heterotetrameric insulin receptor preparation was maximally stimulated within 5 min of insulin preincubation and occurred exclusively in the Mr = 400,000 alpha 2 beta 2 complex. Similarly, maximal insulin-stimulated beta subunit autophosphorylation of the alpha beta heterodimeric preparation occurred within 5 min of insulin pretreatment in the Mr = 210,000 alpha beta complex. However, 4 h of insulin pretreatment of the alpha beta heterodimer preparation induced the formation (6-fold) of a covalent 32P labeled alpha 2 beta 2 heterotetrameric complex. Maximal stimulation of substrate phosphorylation for the alpha 2 beta 2 heterotetrameric complex was also observed to occur within 5 min of insulin treatment, whereas maximal insulin-stimulated substrate phosphorylation of the alpha beta heterodimeric complex required greater than 4 h. These data demonstrate that (i) insulin treatment can induce the reassociation of the alpha beta heterodimeric complex into a covalent alpha 2 beta 2 heterotetrameric state, and (ii) insulin-dependent protein kinase activation of the alpha beta heterodimeric insulin receptor correlates with the covalent reassociation into a disulfide-linked alpha 2 beta 2 heterotetrameric complex. PMID- 3286643 TI - The role of the TRP1 gene in yeast tryptophan biosynthesis. AB - Transcription of the gene for phosphoribosyl-anthranilate isomerase (TRP1) from the TRP1 promoter is initiated only approximately half as frequently as, for example, from the TRP3 promoter, but TRP1 mRNA is approximately twice as stable as TRP3 mRNA. Therefore, the steady state amount of TRP1 mRNA in yeast cells, grown without amino acid limitation, is similar to the steady-state amount of TRP3 mRNA. The protein concentration of both enzymes in yeast cells is about the same, but the basal specific enzyme activity in permeabilized cells of the TRP1 gene product N-(5'-phosphoribosyl-1)-anthranilate isomerase is about 2-3 times higher than that of any of the other TRP enzymes. According to the kinetic parameters of the purified isomerase protein, the enzyme is more active than, for example, the purified TRP3 enzyme indoleglycerol-phosphate synthase. It is suggested that the TRP1 gene of Saccharomyces cerevisiae might be the result of a rearrangement event, separating the N-(5'-phosphoribosyl-1)-anthranilate isomerase domain from the indoleglycerol-phosphate synthase domain and putting the catalytically more active isomerase domain behind a weak and nonregulated constitutive promoter. PMID- 3286644 TI - The three-dimensional structure of Bacillus amyloliquefaciens subtilisin at 1.8 A and an analysis of the structural consequences of peroxide inactivation. AB - The three-dimensional structure of the subtilisin from Bacillus amyloliquefaciens (BAS) has been refined to 1.8 A using the amino acid sequence deduced from the DNA coding sequence. The structure is essentially the same as the previously reported structures of subtilisin BPN' (Wright, C.S., Alden, R.A., and Kraut, J. (1969) Nature 221, 235-242) and Novo (Drenth, J., Hol, W. G. J., Jansonius, J. N., and Koekoek, R. (1972) Eur. J. Biochem. 26, 177-181) determined in different crystal forms, at 2.5 and 2.8 A resolution, respectively. The largest differences in the three crystallographic models are seen in regions where the amino acid sequence used in the fit to the electron density maps of BPN' and Novo differs from the gene sequence of BAS (Wells, J. A., Ferrari, E., Henner, D. J., Estell, D. A., and Chen, E. Y. (1983) Nucleic Acids Res. 11, 7911-7925). The refined BAS model shows new features of cation binding, hydrogen bonding, and internal solvent structure. The refined BAS model has served as a basis for the analysis of stereochemical factors involved in the peroxide inactivation of the enzyme. Methionine 222, which is adjacent to the catalytic Ser221, is quantitatively oxidized to the sulfoxide by hydrogen peroxide as had been previously shown for the related Bacillus licheniformis enzyme (Stauffer, C. E., and Etson, D. (1969) J. Biol. Chem. 244, 5333-5338). In addition to this site of modification, we observe partial to full oxidation of two of the four remaining methionines. The oxidation of the methionines does not correlate well with their solvent accessibility calculated from the x-ray structure coordinates; in addition, only one of the two possible stereoisomers of methionine sulfoxide is formed. We also detect hydrogen peroxide-induced modification of the hydroxyl groups of two tyrosines. Modeling suggests that most of the observed effect of oxidation on the enzyme's catalytic efficiency can be attributed to unfavorable interactions at the oxyanion binding site between the sulfoxide group at 222 and the carbonyl oxygen of the scissile peptide bond of the bound substrate. PMID- 3286645 TI - 2-Deoxy-2-fluoro-D-glycosyl fluorides. A new class of specific mechanism-based glycosidase inhibitors. AB - Mechanism-based glycosidase inhibitors are of considerable use in studies of enzyme mechanism, in studies of glycoprotein processing, and possibly therapeutically in control of sugar uptake. This paper describes a new general approach to mechanism-based inactivation of glycosidases which involves trapping a covalent glycosyl enzyme intermediate. This is achieved by use of 2-deoxy-2 fluoro-D-glycosyl fluorides, for which the rate of hydrolysis of the fluoroglycosyl enzyme intermediate is extremely slow, resulting in accumulation of the intermediate. Eleven different glycosidases were tested with their corresponding 2-deoxy-2-fluoro-D-glycosyl fluorides. Eight of the eleven were inactivated, four of them according to pseudo first-order kinetics and four according to a more complex kinetic scheme. The specificity of these inhibitors was investigated by assaying for inhibition of one enzyme with four different 2 deoxy-2-fluoro-D-glycosyl fluorides. Large differences in inactivation rate were observed which paralleled previously observed substrate specificities. PMID- 3286646 TI - Exonuclease V from Saccharomyces cerevisiae. A 5'----3'-deoxyribonuclease that produces dinucleotides in a sequential fashion. AB - A novel deoxyribonuclease, exonuclease V, has been purified approximately 30,000 fold from Saccharomyces cerevisiae. Exonuclease V is localized in the nucleus. The nuclease degrades single-stranded, but not double-stranded, DNA from the 5' end. The products of exonuclease action are dinucleotides, except the 3'-terminal tri- and tetranucleotides which are not degraded. Studies with synthetic oligo- and polynucleotides with specified sequence elements showed that exonuclease V cleaves off dinucleotides as primary digestion products. Thus, the polymers (pT)9pA(pT)n and (pT)10pA(pT)n yielded pTpA and pApT as digestion products, respectively. Removal of the 5'-terminal phosphate from the DNA substrate results in reduced binding of the enzyme to the substrate. In addition, the initial hydrolytic cut by exonuclease V on the dephosphorylated substrate produces a mixture of dinucleoside monophosphates and trinucleoside diphosphates. The enzyme is processive in action. PMID- 3286647 TI - X-ray absorption studies of yeast copper metallothionein. AB - The local structures of the metal sites in copper metallothionein from Saccharomyces cerevisiae have been investigated by x-ray absorption spectroscopy at the copper and sulfur K edges. Analysis of the EXAFS (extended x-ray absorption fine structure) data indicates that each copper is trigonally coordinated to sulfur at a distance of 2.23 A. Cu-Cu interactions at 2.7 and 3.9 A have also been tentatively identified. Sulfur K edge data are compatible with cysteinyl thiolates bridging each of the eight Cu(I) ions. The data support a model for the copper cluster in yeast metallothionein consisting of a Cu8S12 core. EXAFS data on two specifically engineered carboxyl-terminal truncated mutants reveal that the copper coordination in the mutants is similar to that observed in the wild-type protein. PMID- 3286648 TI - The presequence of yeast 5-aminolevulinate synthase is not required for targeting to mitochondria. AB - A truncated form of the yeast mitochondrial 5-aminolevulinate (ALA) synthase was constructed by deletion of the first 75 amino acid residues of its precursor form. This truncated ALA synthase which lost its entire presequence and 40 residues of the mature part possesses a new amino terminus quite different from a typical mitochondrial presequence. This modified protein expressed in vivo is found entirely located within mitochondria. Although it was now unable to reach the matrix space, it was internalized as shown by its resistance to protease in isolated mitochondria. Pulse-chase radiolabeling in the presence of an uncoupler suggests that a membrane potential is not required for the targeting of this truncated ALA synthase. Thus, the amino-terminal signal, if indispensable as a matrix targeting signal, could be replaced by an internal sequence or a particular folding for recognition by the import machinery. PMID- 3286649 TI - Differing modulation of protein kinase C by bryostatin 1 and phorbol esters in JB6 mouse epidermal cells. AB - Bryostatin 1 (Bryo), a macrocyclic lactone, stimulates some but not all of the biologic effects which are induced by phorbol esters (PEs). In vitro, it competes with PEs for binding to whole cells and activates the calcium/phospholipid dependent protein kinase, PK-C. To examine whether Bryo, like PEs, is able to stimulate the nonadherent growth of cells, we used the mouse epidermal cell line JB6, which is stimulated by PEs to grow in soft agar. Like PEs, Bryo stimulates both the adherent and nonadherent growth of these cells, but Bryo (0.001-1 microM) is less active than equivalent concentrations of PEs. To attempt to explain the biologic differences between these two agents, we examined the modulation of PK-C by both PEs and Bryo. In a phosphotransferase assay using partially purified PK-C from JB6 cells, Bryo (1-0.001 microM) stimulated less phosphorylation of histone substrate than did PMA. Also, when whole cells were treated with equal concentrations of Bryo or PMA, Bryo stimulated a decreased loss of PK-C from the cytosol. Using purified isozymes of PK-C from rat brain, Bryo demonstrated identical competition to PMA for binding to forms alpha and gamma but decreased binding to form beta. Hydroxylapatite chromatography of JB6 cytosol demonstrated that these cells contain largely peak 2, or beta-PK-C. Although Bryo more weakly activates PK-C from JB6 cells, prolonged exposure of JB6 cells to either 1.0 or 0.01 microM Bryo caused a more rapid loss of immunologically detectable PK-C than did similar concentrations of PEs. We conclude that Bryo is capable of stimulating both the nonadherent and the adherent growth of JB6 cells in a similar fashion to phorbol esters. The differences in biologic effects of Bryo and PMA may be partially explained by Bryo's modulation of PK-C. PMID- 3286650 TI - Evidence for the association of dystrophin with the transverse tubular system in skeletal muscle. AB - Polyclonal antibodies to dystrophin (the protein product of the human Duchenne muscular dystrophy gene) were used to identify and characterize dystrophin in isolated triads from rabbit skeletal muscle. Anti-dystrophin antibodies recognize an approximately 400,000-Da protein in isolated triads or heavy microsomes from skeletal muscle. Treatment of heavy microsomes with buffers containing high salt or EDTA to remove peripheral or extrinsic membrane proteins does not remove dystrophin; however, treatment of intact triads with trypsin shows that dystrophin is extremely sensitive to mild proteolytic digestion. Isolation of junctional complexes from skeletal muscle triads indicates that dystrophin is tightly associated with the triadic junction. Fractionation of the triadic junction into junctional transverse tubular membranes and junctional sarcoplasmic reticulum membranes has shown that dystrophin is enriched in junctional transverse tubular membranes. Thus, our results suggest that dystrophin is a component of the triad junction which is exposed to the cytoplasm and embedded in or attached to the transverse tubular membrane. PMID- 3286651 TI - Purification and characterization of acid trehalase from the yeast suc2 mutant. AB - Acid trehalase was purified from the yeast suc2 deletion mutant. After hydrophobic interaction chromatography, the enzyme could be purified to a single band or peak by a further step of either polyacrylamide gel electrophoresis, gel filtration, or isoelectric focusing. An apparent molecular mass of 218,000 Da was calculated from gel filtration. Polyacrylamide gel electrophoresis of the purified enzyme in the presence of sodium dodecyl sulfate suggested a molecular mass of 216,000 Da. Endoglycosidase H digestion of the purified enzyme resulted after sodium dodecyl sulfate gel electrophoresis in one distinct band at 41,000 Da, representing the mannose-free protein moiety of acid trehalase. The carbohydrate content of the enzyme was 86%. Amino acid analysis indicated 354 residues/molecule of enzyme including 9 cysteine moieties and only 1 methionine. The isoelectric point of the enzyme was estimated by gel electrofocusing to be approximately 4.7. The catalytic activity showed a maximum at pH 4.5. The activity of the enzyme was not inhibited by 10 mM each of HgCl2, EDTA, iodoacetic acid, phenanthrolinium chloride or phenylmethylsulfonyl fluoride. There was no activation by divalent metal ions. The acid trehalase exhibited an apparent Km for trehalose of 4.7 +/- 0.1 mM and a Vmax of 99 mumol of trehalose min-1 X mg-1 at 37 degrees C and pH 4.5. The acid trehalase is located in the vacuoles. The rabbit antiserum raised against acid trehalase exhibited strong cross-reaction with purified invertase. These cross-reactions were removed by affinity chromatography using invertase coupled to CNBr-activated Sepharose 4B. Precipitation of acid trehalase activity was observed with the purified antiserum. PMID- 3286652 TI - Biomaterial-associated calcification: pathology, mechanisms, and strategies for prevention. AB - Deposition of calcium-containing apatite mineral occurs widely in association with cardiovascular and noncardiovascular medical devices and biomaterials, is the leading cause of failure of contemporary bioprosthetic heart valves, and limits the functional lifetime of experimental (and potentially clinical) mechanical blood pumps and polymeric heart valves. Calcification of bioprosthetic tissue is primarily intrinsic, related to cuspal connective tissue cells and fragments, and collagen. In contrast, the predominant site of calcific crystals on flexing polymeric surfaces in blood pumps or valve prostheses is extrinsic, associated with adherent cells, thrombus, or pseudointima. Pathologic calcification shares key features with physiologic skeletal mineralization, including crystal initiation through the mediation of cell membranes, usually in the form of extracellular vesicles. This suggests a unified hypothesis for normal and abnormal mineralization. Several approaches are being studied experimentally for the inhibition of bioprosthetic heart valve calcification. Controlled-release diphosphonate therapy, perhaps in conjunction with an anticalcification cuspal pretreatment, appears most effective. Research objectives in biomaterial associated calcification include (1) development of animal models, (2) determination of initial crystal nucleation events and sites, (3) elucidation of the relative roles of host, implant, and mechanical determinants, and (4) development of approaches for the inhibition of mineralization. PMID- 3286653 TI - Fatigue properties of acrylic bone cements: review of the literature. PMID- 3286654 TI - Progress in management of malignant bone tumours. PMID- 3286655 TI - Homograft bone in revision acetabular arthroplasty. A clinical and radiographic study. AB - Thirty-seven patients with extensive acetabular defects due to loose implants had revisions with uncemented components, the acetabulum being augmented with homograft bone. In six of these, a histological study of graft incorporation was made. At a mean follow-up of 1.5 years 34 patients were free of pain and 35 could walk for 30 minutes or longer. No graft had obviously sequestrated. Two components had radiological evidence of migration but remain asymptomatic. We conclude that cementless revision surgery with homograft supplementation of the acetabulum is clinically successful in the short-term. The long-term outcome is unknown. PMID- 3286656 TI - Allograft versus autograft bone in scoliosis surgery. AB - The results of a study of the use of autograft versus allograft bone in the surgery of idiopathic adolescent scoliosis are presented. Two groups of patients, matched for age, sex, level and angle of curve, received bone grafts, 20 patients having autogenous bone from the iliac crest and the other 20 having donor bone from a bone bank. Both groups had otherwise identical posterior fusions and Harrington instrumentation. There was no difference between the two groups in a blind, radiographic assessment of bone graft mass at six months, nor in maintenance of the curve correction over the same period. No major operative complications nor failures of instrumentation were encountered. There was, however, a marked reduction in operative time and blood loss in the patients receiving donor bone and also a much lower incidence of late symptoms relating to the operative sites. We conclude that, even in the presence of adequate iliac crest, the use of bank bone is superior for grafting in idiopathic scoliosis surgery. PMID- 3286657 TI - Epidural buprenorphine for pain relief after spinal decompression. AB - We report a prospective double-blind trial of the efficacy of a single epidural dose of buprenorphine on pain after spinal decompression. Postoperative pain was assessed by a linear analogue pain chart and by the additional requirement for analgesia. The patients receiving buprenorphine were significantly more comfortable (p less than 0.005) and required less analgesia in the first 12 hours after operation (p less than 0.05) than the control group. This simple procedure is recommended as an effective and safe method of reducing pain. PMID- 3286658 TI - Amphibian oocyte maturation induced by extracts of Physarum polycephalum in mitosis. AB - The orderly progression of eukaryotic cells from interphase to mitosis requires the close coordination of various nuclear and cytoplasmic events. Studies from our laboratory and others on animal cells indicate that two activities, one present mainly in mitotic cells and the other exclusively in G1-phase cells, play a pivotal role in the regulation of initiation and completion of mitosis, respectively. The purpose of this study was to investigate whether these activities are expressed in the slime mold Physarum polycephalum in which all the nuclei traverse the cell cycle in natural synchrony. Extracts were prepared from plasmodia in various phases of the cell cycle and tested for their ability to induce germinal vesicle breakdown and chromosome condensation after microinjection into Xenopus laevis oocytes. We found that extract of cells at 10 20 min before metaphase consistently induced germinal vesicle breakdown in oocytes. Preliminary characterization, including purification on a DNA-cellulose affinity column, indicated that the mitotic factors from Physarum were functionally very similar to HeLa mitotic factors. We also identified a number of mitosis-specific antigens in extracts from Physarum plasmodia, similar to those of HeLa cells, using the mitosis-specific monoclonal antibodies MPM-2 and MPM-7. Interestingly, we also observed an activity in Physarum at 45 min after metaphase (i.e., in early S phase since it has no G1) that is usually present in HeLa cells only during the G1 phase of the cell cycle. These are the first studies to show that maturation-promoting factor activity is present in Physarum during mitosis and is replaced by the G1 factor (or anti-maturation-promoting factor) activity in a postmitotic stage. A comparative study of these factors in this slime mold and in mammalian cells would be extremely valuable in further understanding their function in the regulation of eukaryotic cell cycle and their evolutionary relationship to one another. PMID- 3286659 TI - Organization of microtubules in centrosome-free cytoplasm. AB - Many different cell types possess microtubule patterns which appear to be polarized and oriented, in part, by cytoplasmic factors not directly associated with a centrosome. Recently, we demonstrated that cytoplasmic extensions ("arms") of teleost melanophores will reorganize their microtubule population outward from their centers after surgical isolation (McNiven, M. A., M. Wang, and K. R. Porter. 1984. Cell. 37:753-765). In the study reported here, we examine microtubule dynamics within the centrosome-free fragments and find that, after severing, microtubule reorganization is initiated at the proximal (cut) end of an arm and migrates distally with the aggregated pigment mass until it becomes permanently positioned at the middle of the arm. Computer-aided image analysis demonstrates that this middle position is located at the arm centroid, implicating the action of a cytoplasmic gel in this process. Morphological studies of arms devoid of pigment reveal that microtubules do not emanate from a single site or structure within the centroid area, but from a more generalized region. Taken together, these findings suggest that factors distributed throughout cytoplasm participate in microtubule assembly and organization. PMID- 3286660 TI - Localization of phospholipase A2 in normal and ras-transformed cells. AB - The cellular localization of phospholipase A2 (PLA2) was examined in normal and ras-transformed rat fibroblasts using immunohistochemical techniques. Polyclonal antibodies were generated against porcine pancreatic PLA2 and were affinity purified for use in this study. The antibodies detected a 16-kD band on immunoblots of total cellular proteins from fibroblasts. In cell-free assays of phospholipase A2 activity, the purified antibodies inhibited the bulk of the enzyme activity whereas control IgG preparations had no effect. Immunofluorescence microscopy indicated that PLA2 was diffusely distributed throughout the cell. Increased concentration of PLA2 was detected under membrane ruffles in normal and ras-transformed cells. Specific immunofluorescence staining was also detected on the outer surface of the normal cells. Immunoelectron microscopy demonstrated the increased accumulation of PLA2 in membrane ruffles and also revealed the presence of the enzyme in microvilli and its association with intracellular vesicles. Ultrastructural localization of PLA2 and the ras oncogene protein, using a double immunogold labeling technique, indicated a spatial proximity between PLA2 and ras proteins in the ruffles of ras-transformed cells. The possible role of PLA2 in the structural rearrangements that underlie membrane ruffling is discussed. PMID- 3286661 TI - [Gastric ruptures caused by diving accidents. Apropos of 2 cases. Review of the literature]. AB - Underwater diving was responsible for gastric rupture in two cases seen personally and five cases of total gastric rupture reported in the literature. The various possible mechanisms for onset of this rupture are envisaged, the diagnosis of this rare accident being established from the existence of a large pneumoperitoneum. Emergency laparotomy allows suture of wound and ensures recovery. PMID- 3286662 TI - [Deep and localized hyperthermia of the liver induced by stereotaxic Nd-YAG laser irradiation]. AB - Thirty six hepatic lesions (12-18 mm) of localized hyperthermia are induced in eleven pigs by means of a Nd-YAG laser. Laser shots of 80 W/10 sec. are transmitted through a stereotaxic handpiece coupled to a water cooling circulation protecting the optic fibre. The handpiece placement is performed through an ultrasound-guided trocar. The efficiency of the irradiation is visualized by immediate temperature increasing, by ultrasonographic imaging and by anatomical verifications from operating time to four months. The center of lesion initially occupied by coagulative necrosis is rapidly marginated by a gaining ground fibrosis. At long term a fibrotic network invades the scar and confirms healing free of complications. This ultrasonographically assisted technique is proposed for deep vaporisation of disseminated hepatic metastases. PMID- 3286663 TI - [Isolated aneurysm of the common hepatic artery. Apropos of a case report]. AB - A case is reported of an isolated aneurysm of the common hepatic artery revealed by pain in liver region. The etiology is mainly dominated by atheroma and media dysplasia. Detection is currently during investigation of a pain syndrome or jaundice and no longer after rupture of aneurysm. Ultrasound imaging value is emphasized and angiography provides valuable data. Surgical treatment and particularly the indication for hepatic revascularization are discussed as a function of anamnestic and angiographic arguments and intraoperative findings. PMID- 3286664 TI - [Reexpansion pulmonary edema after pneumothorax. Apropos of a case. Review of the literature]. AB - Pulmonary edema after re-expansion of a pneumothorax occurs within a maximum of 3 days of the pneumothorax and manifests by intense clinical signs (cough, abundant foamy expectoration, major cyanosis), marked hypoxia and a "white lung" radiologic image. The outcome was rapidly favorable in the case reported, despite the severity of the initial symptomatology. Currently accepted physiopathologic mechanisms implicate numerous factors in the genesis of edema due to re expansion. The lesional pulmonary edema can be explained by alteration in alveolar capillary permeability, by the atelectasis, hypoperfusion and stretching during revascularization, and possibly by the action of free radicals. A hemodynamic edema also exists as a consequence of the reduction in pulmonary interstitial pressure. Possible prophylactic measures are discussed, the most appropriate appearing to be very progressive evacuation of the pneumothorax. PMID- 3286665 TI - [X-ray computed tomography in acute pancreatitis]. AB - Diagnostic imaging of acute pancreatitis has been revolutionized by the introduction of computed tomography (CT). The purpose of this report is to review the different CT findings of the disease. The authors emphasize the predictive value of the contrast enhanced CT. It seems to be the most reliable method for detecting the most severe forms of acute pancreatitis and their complications. Correlation of CT findings with clinical and biological prognostic signs allows an easier surgical management. PMID- 3286666 TI - Sibling influences on childhood development. AB - To summarize the main points concerning sibling influence: 1. That siblings play a causal role in the development of aggressive behavior, in children's style of conflict behavior and in cooperative fantasy play is strongly suggested by recent research. 2. Marked problems in the sibling relationship are indicative of other problems, but a causal role for siblings is not established, other than for aggressive behavior. 3. Family factors are closely involved in the quality of sibling relationships--and thus in sibling influence, namely differential parental behavior, and the emotional climate of the family. That is, it is important not to consider the sibling relationship in isolation from other family relationships. 4. Studies of families under stress indicate heightened importance of these family factors. 5. It is likely, but not yet established, that later born siblings are influenced by first-born in socio-cognitive development and gender identity. 6. Finally it should be noted that an important theme in current research on siblings is a concern with the question of why siblings develop to be so different from one another. It has been shown that the major source of environmental influence on the development of individual differences is within family rather than between-family differences in experience (Plomin & Daniels, 1987). The different experiences each sibling may have within their relationship is one potential source of such differential environmental influence. Thus documenting the influence of siblings upon each other takes on added significance: By clarifying the extent and nature of this influence we will gain not only useful clinical information but illumination on a developmental principle of very general significance. PMID- 3286667 TI - Synthesis of high-capacity immunoaffinity sorbents with oriented immobilized immunoglobulins or their Fab' fragments for isolation of proteins. AB - Two methods for synthesizing high-capacity immunoaffinity sorbents on Sepharose and Separon HEMA E-1000 are described. The first is the oriented immobilization of monovalent immunoglobulin Fab fragments on a maleimide derivative of Sepharose via the formation of a covalent bond between the SH group of the Fab fragment at the C-terminus of the molecule and the maleimide covalently coupled to Sepharose. The second method is based on the oxidation of the immunoglobulin carbohydrate component, located in the Fc fragment, by periodate with subsequent immobilization of the derivatives on hydrazide derivatives of Sepharose or Separon. Sorbents for the isolation of monoclonal antibodies from the culture supernatants and the elongation factor EF-G from a crude extract of Escherichia coli cells were obtained. These sorbents are characterized by a high capacity, minimal non-specific sorption and high stability. PMID- 3286668 TI - High-performance liquid chromatographic column-switching method for two cyclosporine metabolites in blood. AB - Cyclosporine (CSA) is biotransformed to many metabolites which may contribute to its immunosuppressive and nephrotoxic activity. We report a rapid and sensitive, automated column-switching high-performance liquid chromatographic (HPLC) method for measuring CSA-M17 in whole blood; the method also separates CSA-M1. CSA metabolite standards were isolated by a preparative-scale HPLC method. Samples were prepared by protein precipitation with acetonitrile followed by dilution with water. CSA-M17 was initially separated on a C8 column; final separation was on a C18 column. The inter-day relative standard deviation at 50 ng/ml was 8% (n = 3). Limit of detection was 20 ng/ml. PMID- 3286669 TI - A simple method of drying virus on inanimate objects for virucidal testing. AB - A simple method for drying virus on inanimate objects (cover slips) under vacuum in the cold is described. Following this procedure virus maintains high titers (10(6-7)) for periods of 1-3 wk at -70 degrees C depending on the virus. For virucidal assay of disinfectants, cover slips are exposed to medium simulating the disinfectant (virus control) or disinfectant in an upright position in an Ultra-Vu cuvette. Cover slips are readily removed and placed in tissue culture medium for dilution of virus and determination of virus titer. Cytotoxicity of disinfectant is determined by exposing cover slip without virus to disinfectant, then placing it in medium, diluting the medium and incubating with the indicator cells. The use of this technique results in high titers of virus on cover slips, which are inanimate objects requiring minimal manipulation. The titration of virus or cytotoxicity in microplates is cell, medium, serum, and labware economical. PMID- 3286670 TI - In vivo mass production in the cabbage moth (Mamestra brassicae) of a heterologous (Panolis) and a homologous (Mamestra) nuclear polyhedrosis virus. AB - In preparation for field trials, a nuclear polyhedrosis virus (NPV) of the pine beauty moth, Panolis flammea, was mass produced in vivo in an alternative (heterologous) host, the cabbage moth, Mamestra brassicae. Simultaneously, Mamestra NPV was also produced in M. brassicae. This homologous NPV/host system was a consistently more efficient production system than the heterologous one. Evidence is presented that increased humidity may improve levels of infection and, therefore, yield achieved. Full purification of the resultant product through a sucrose gradient resulted in a loss of virus of about 30%. PMID- 3286671 TI - Analysis of mammosomatotropic cells in normal and neoplastic human pituitary tissues by the reverse hemolytic plaque assay and immunocytochemistry. AB - The reverse hemolytic plaque assay (RHPA) was used to study hormone release from cultured normal and neoplastic human pituitary cells. The RHPA revealed a lower percentage of GH- and PRL-producing cells in normal and neoplastic pituitaries compared to the percentage of these cells revealed by immunocytochemical (ICC) staining for GH and PRL. Normal pituitary tissues as well as some PRL- or GH producing adenomas contained large numbers of mammosomatotropic (MS) cells when analyzed by RHPA, combined RHPA-ICC, and ultrastructural immunohistochemistry with immunogold labeling. The percentage of GH and PRL cells in normal pituitaries ranged from 37-51% and 30-60%, respectively, by RHPA, while the percentage of MS cells ranged from 29-49%. The percentage of GH and PRL cells in normal pituitaries estimated by ICC ranged from 53-65% and 32-55%, respectively, while the percentage of MS cells estimated with this technique ranged from 26 50%. Double labeling with the immunogold technique detected GH and PRL in the same cells and within the same granules in both normal and neoplastic pituitary cells. These results indicate that MS cells are present in normal human pituitaries as well as in some pituitary adenomas, and in some pituitaries these two hormones are stored within the same secretory granules. PMID- 3286672 TI - Urinary growth hormone (GH) measurements are useful for evaluating endogenous GH secretion. AB - Daily (24-h) urinary GH excretion was measured using a highly sensitive sandwich enzyme immunoassay in 10 normal adults, 6 patients with hypopituitarism, 25 normal but short children who had normal plasma GH responses (peak plasma GH level, greater than 10 micrograms/L) to provocative tests, and 8 patients with acromegaly. The mean urinary GH values in the normal adults, patients with acromegaly, and patients with hypopituitarism were 13.8 +/- 4.0 (+/- SE) and 431.1 +/- 149.1 ng/g creatinine (Cr) (1.56 +/- 0.45 and 48.77 +/- 16.87 ng/mmol Cr) and undetectable, respectively; these mean values were significantly different from each other. In the normal but short children the urinary values ranged from undetectable to 55.8 ng/g Cr (6.31 ng/mmol Cr). All of the normal but short children and 4 patients with hypopituitarism participated in a 24-h endogenous GH secretion study. The urinary GH values correlated significantly with the mean 24-h plasma GH concentrations as an index of endogenous GH secretion (r = 0.81; P less than 0.001) and plasma somatomedin-C levels (r = 0.67; P less than 0.001), respectively. In 6 patients with acromegaly whose plasma GH levels were constant throughout a 4-h period, the urinary GH values also significantly correlated with the mean plasma GH levels (r = 0.95; P less than 0.01). These data indicate that urinary GH measurements reflect endogenous GH secretion and that measurement of urinary GH excretion is a useful, simple, and practical method for evaluating endogenous GH secretion. PMID- 3286673 TI - Pulsatile insulin delivery is more efficient than continuous infusion in modulating islet cell function in normal subjects and patients with type 1 diabetes. AB - The respective modulating effects of continuous and intermittent insulin delivery on pancreatic islet cell function were studied in seven normal men and nine insulin-dependent (type 1) diabetic patients. In the normal men, saline or continuous (0.8 mU kg-1 min-1) or pulsatile (5.2 mU kg-1 min-1, with a switching on/off length of 2/11 min) human insulin were delivered on different days and in random order. Despite hyperinsulinemia, blood glucose was kept close to its basal value by the glucose clamp technique. The diabetic patients also were infused in random order and on different days with either saline or a smaller amount of insulin delivered continuously (0.15 mU kg-1 min-1) or in a pulsatile manner (0.97 mU kg-1 min-1 for 2 min, followed by 11 min during which no insulin was infused). In all experiments, 5 g arginine were given iv as a bolus dose 30 min before the end of the study, and plasma C-peptide and glucagon levels were determined to assess islet cell function. In the normal men, insulin administration resulted in a significant decline of basal plasma glucagon and C peptide levels and in a clear-cut decrease in the arginine-induced glucagon response. These effects of insulin were significantly more marked when insulin was delivered in a pulsatile rather than a continuous manner. In the insulin dependent diabetic patients, the lower dose of insulin infused continuously did not alter the basal or arginine-stimulated glucagon response. In contrast, when the same amount of insulin was delivered intermittently, arginine-induced glucagon release was greatly reduced. Thus, these data support the concept that insulin per se is a potent physiological modulator of islet A- and B-cell function. Furthermore, they suggest that these effects of insulin are reinforced when the hormone is administered in an intermittent manner in an attempt to reproduce the pulsatile physiological release of insulin. PMID- 3286674 TI - Electroencephalography and visually evoked potentials during moderate hypoglycemia. AB - The effects of hypoglycemia per se on the electroencephalogram (EEG) and visually evoked potentials (VEPs) were studied in eight normal young adults. The EEG and VEPs were recorded before and during hypoglycemic clamp studies, carried out at plasma insulin and glucose concentrations of about 287 pmol/L and 2.38 mmol/L, respectively. From the mean power EEG spectra obtained during each testing condition, several parameters in each frequency band considered were compared statistically. During the eyes closed recording, the mean frequency of the alpha band (8-13 Hz) decreased from 10.1 +/- 0.2 (+/- SE) Hz in both the right and left frontal leads during euglycemia to 8.8 +/- 0.2 and 8.8 +/- 0.1 Hz (left and right frontal leads, respectively; P less than 0.05) during hypoglycemia. In the same leads, the peak frequency decreased from 10.6 +/- 0.4 and 10.3 +/- 0.4 Hz to 9.6 +/- 0.4 and 9.5 +/- 0.3 Hz, respectively (P less than 0.05). A similar pattern of variation was found during the eyes open recording. In contrast, mean VEP latencies did not vary significantly; they were 118 +/- 3 ms (smallest image size; square wave signals subtending 30 min of arc) and 116 +/- 3 ms (largest image size; square wave signals subtending 60 min of arc) during euglycemia to 121 +/- 3 and 119 +/- 3 ms, respectively, during hypoglycemia. This study demonstrates that the earliest hypoglycemia-induced EEG alterations occur in the frontal regions and can be quantified in terms of decreased mean and peak frequencies of the alpha-band. VEP latency is less sensitive. If confirmed in diabetic patients, these data may provide a theoretical basis for developing a portable device to detect early hypoglycemia in those patients who lack warning symptoms. PMID- 3286675 TI - Ig class and IgG subclass responses to Treponema pallidum in patients with syphilis. AB - The Ig class and IgG subclasses of anti-Treponema pallidum antibodies in human serum were quantified using solid-phase enzyme-linked immunosorbent assays. Development of these assays with monoclonal antibodies, each specific for a human immunoglobulin class or IgG subclass, provided quantitative data concerning the major antibody specificities. In patients with primary syphilis, anti-T. pallidum activity was limited almost exclusively to IgG1 and IgM. Coordinate, restricted expression of IgG1 and IgG3 responses in T. pallidum-specific assays was observed with sera from patients with active secondary syphilis. IgG1 and IgG3 accounted for roughly 53 and 43% of the total anti-treponemal IgG antibody activity, respectively. While IgM antibody levels were elevated in the patients with secondary syphilis, IgG2 and IgG4 levels, if present at all, represented less than 10 and 2% of the total IgG activity, respectively. Ig in sera from patients who had been treated adequately for secondary syphilis were restricted almost entirely to IgG3 and IgG1. Considering the low level of IgG3 in serum, disproportionately high percentages of antitreponemal antibodies were found in this subclass during and after treatment for secondary syphilis. The restricted, coexpression of the IgG1 and IgG3 isotypes may reflect the close genetic linkage of the gamma 1 and gamma 3 genes and possibly the impact of immunoregulatory mechanisms in response to the induction and expression of autoantibodies which arise during the course of secondary syphilis. PMID- 3286677 TI - Immunology of spermatozoa and cervical mucus. AB - Auto-immunization of the male and iso-immunization of the female with spermatozoal or testicular material can lead to a significant impairment of fertility. Interference of sperm antibodies with reproductive processes may occur by impairment of sperm migration through cervix, uterus and tubes and by blocking adherence of spermatozoa to the surface of the zona pellucida of the oocyte. A very important point to consider in this context is the immunological situation in the female genital tract which is a target organ for sex hormones. Observations in human and subhuman primates as well as in other mammalian species have shown that the levels of immunoglobulins and specific antibodies in secretions of the different compartments of the female reproductive tract are low compared to the serum in general and show typical cyclic changes under the influence of oestrogens and progesterone. Antibody levels appear to be especially low during the preovulatory period in cervical mucus and--according to observations in primates--in tubal fluid. Complement is present in borderline concentrations or not detectable. Data on levels of immunoglobulins or specific antibodies in endometrial fluid are scarce. However, their presence has been demonstrated. There are indications that a secretory immune system may be operational mainly in the cervical compartment of the female genital tract. Serum antibody levels do not reflect properly the immunological situation in secretions of the genital tract in most instances. This may be different in the male. Demonstrations of sperm antibodies in serum or even in genital secretions are not necessarily indicative of permanent sterility; the chances of conception may, however, be reduced. Antibody specificity, immunoglobulin class and quantitative relationships between spermatozoa and antibodies and hormonal influences have to be taken into consideration. Immunity to spermatozoa does not seem to be an all or-nothing phenomenon and should be considered a relative rather than absolute cause of infertility. PMID- 3286676 TI - Bone marrow purging using monoclonal antibodies. PMID- 3286678 TI - Ultrastructural abnormalities of human spermatozoa. AB - The observation of sperm cells in the scanning and electron microscope reveals that malformed spermatozoa show either a single anomaly of each of their structural components--acrosome, nucleus, axoneme and accessory structures--or a combination of these anomalies. A defined semen profile can be established when the majority of ejaculated spermatozoa present a predominantly single anomaly or the same combination of associated anomalies. Only in these cases can there be a relationship between morphological defects and impairment of the fertilizing ability. The validity of the ultrastructural examination of sperm cells depends upon the data obtained by light microscopy, and quantification of the frequencies of the ultrastructural alterations is necessary to define clearly the limits of abnormality. PMID- 3286679 TI - The acrosome reaction in boar spermatozoa. AB - In order to gain more insight into the molecular alterations of the acrosome, boar spermatozoa were incubated in a calcium-containing medium in the presence of the ionophore A23187. The time-course of the acrosome reaction was assessed by phase-contrast microscopy. Different stages of the acrosome reaction were studied by immunoelectron microscopy using a specific antibody directed against the complete outer acrosomal membrane. The introduction of monoclonal antibodies generated by immunization of Balb/c mice with the isolated outer acrosomal membrane permitted a study of the topography of distinct membrane proteins during the acrosome reaction. The exposure of activation of a fucose-binding protein important for sperm--zona attachment was studied using neo-glycoproteins labelled with colloidal gold for transmission electron microscopy. PMID- 3286680 TI - Ultrasonically guided percutaneous and transvaginal follicle aspiration; a comparative study. AB - In this study we compare the efficacy of ultrasonically guided percutaneous oocyte collection for in-vitro fertilization with ultrasonically guided transvaginal oocyte collection. Forty-seven patients were prospectively randomized into two groups. Twenty-four patients underwent percutaneous follicle aspiration and 23 patients underwent a transvaginal puncture. The number of aspirated oocytes per patient showed a statistically significant difference in the two groups: 2.5 for the percutaneous puncture versus 5.2 for the transvaginal procedure. The number of embryos per patient was 2.7 in the transvaginal puncture group versus 1.6 in the percutaneous puncture group. This difference was not statistically significant. The clinical pregnancy rate per patient was 12.5% with the percutaneous approach and 30.4% with the transvaginal technique. This difference was also not statistically significant. Since the transvaginal procedure also creates less discomfort to the patient and is less time-consuming it is concluded that this approach is preferable to the percutaneous puncture technique in obtaining oocytes for in-vitro fertilization. PMID- 3286681 TI - The management of multiple pregnancies after induction for superovulation. AB - The high rate of multiple pregnancies after embryo transfer depends upon the number of embryos replaced and amounts to approximately 20% for four or more embryos. This incidence justifies a preventive or curative treatment after the induction of superovulation. Aspiration of one or more embryos via the cervix under ultrasound control has been undertaken on 42 patients since 1983, and involved two sextuplets, 10 quadruplets, 18 triplets and 12 twins. Twenty six embryo reductions were performed before 9 weeks of amenorrhoea. Five failures after 9 weeks were due, in the early stages of this procedure, to infection. In the case of twins, the indication was a scarred uterus in 10 cases and a psychiatric reason for two patients. In 19% of our cases delivery occurred within 32 weeks of amenorrhoea. PMID- 3286682 TI - A quantitative enzyme-linked immunosorbent assay for rat insulin. AB - A simple, quantitative micro-ELISA (Enzyme-Linked Immunosorbent Assay) has been developed for rat insulin. The micro-ELISA is a solid phase, indirect, competitive immunoassay. The useful range of the micro-ELISA was superior to that of a commercial RIA for rat insulin (e.g. 0.4 to 46.0 ng/ml for the ELISA; 0.2 8.6 ng/ml for the RIA). The ELISA's sensitivity (the lower limit of detection) was 1.0 ng/ml +/- 0.13 ng/ml, (mean, +/- SEm; 9 assays) or 20 +/- 2.6 pg/determination, and compared favorably with the sensitivity of a radioimmunoassay (RIA) for rat insulin (0.38 +/- 0.10 ng/ml; 4 assays). The ELISA measured pure rat insulin standards accurately. Correlation experiments showed that the results of the ELISA agreed with those of the RIA (r = 0.91), when rat insulin was assayed in crude extracts of isolated pancreatic Islets of Langerhans. When the standard curve was plotted as a log of the dose response curve, a sigmoidally shaped curve was obtained which could be transformed into a straight line relationship with a logit-log program. The goodness of fit of the transformed standard curve to a straight line relationship was excellent (r = 0.97 to 0.99: n = 4 ELISAs). The transform facilitated dose interpolation, tests of parallelism, and quality control. Tests of parallelism showed that the ELISA was specific for rat insulin. The precision of the ELISA was superior to the precision of the rat insulin RIA tested. The intraassay precision of the ELISA was always less than 10% (CV%), and its interassay precision was always less than or equal to 15% (CV%). The micro-ELISA is versatile, since it can be used to measure human, porcine, rat, and probably mouse insulin. PMID- 3286683 TI - Calcitonin determination by a fast and highly sensitive enzyme amplified immunoassay. AB - A colorimetric enzyme amplification system was used to develop an immunoassay for human calcitonin (hCT) with a sensitivity of 6 pmol/l, and intra- and inter-assay CVs of 12% and 11.8% respectively for the low pool, and 10% and 11.2% for the high pool. The mean recovery of added synthetic hCT (58.5 pmol) from the plasma of 10 patients was 110% (64.4 pmol). The correlation coefficient between radioimmunoassay (RIA) and amplified enzymo-immunoassay was found to be 0.96 (p 0.001). The assay was successfully applied to the measurement of elevated calcitonin levels in plasma from patients with medullary carcinoma of the thyroid (MCT). AEIA offered a reliable and sensitive alternative to RIA for calcitonin determination with the added advantage of convenience as the label employed was much more stable. PMID- 3286684 TI - Fluoxetine, a selective serotonin uptake inhibitor, for the treatment of outpatients with major depression. AB - In a double-blind, placebo-controlled study the authors found that fluoxetine, a potent and selective inhibitor of serotonin reuptake, was an effective antidepressant in moderately depressed, ambulatory outpatients. Typical adverse effects reported by patients treated with fluoxetine included agitation, nausea, fatigue, and insomnia. Compared to imipramine, fluoxetine was associated with fewer complaints of dry mouth, constipation, and dizziness. PMID- 3286685 TI - An open trial of maprotiline for the treatment of cocaine abuse: a pilot study. AB - Eleven consecutive severe cocaine abusers were treated openly with maprotiline. Nine completed a 7-week trial, and eight maintained abstinence for at least 1 month as outpatients. Treatment compliance and response appeared better than for a similar group of subjects treated without antidepressants. PMID- 3286686 TI - Alprazolam in the treatment of cardiology patients with atypical chest pain and panic disorder. AB - Ten cardiology chest pain patients without clinical evidence of coronary artery disease and with panic disorder were enrolled in an open label trial of alprazolam. Two dropped out at week 3 because of excessive side effects. The eight study completers showed significant decreases in both Hamilton Anxiety and Hamilton Depression scales by week 2 that remained significant by week 8. On the physician's global impression of change since baseline, all completers were rated at least "much improved." Seven experienced a 50% or greater reduction in panic frequency at week 8 compared to baseline. These results suggest that alprazolam is likely to be of benefit to this patient population. PMID- 3286687 TI - Captopril in the treatment of recurrent major depression. PMID- 3286688 TI - Veterinary microbiologists of the 19th century. PMID- 3286689 TI - More than a hundred years of parasitic zoonoses: with special reference to trichinosis and hydatid disease. PMID- 3286690 TI - Observations on the pathology of non-alimentary lymphomas in the horse. AB - A retrospective study was carried out on post-mortem and biopsy tissue samples from 26 horses with non-alimentary lymphoma. On the basis of their histopathology and cytology, the cases were grouped into several categories: (1) Lymphoblastic lymphomas (6 cases) and primary lymphoblastic leukaemia (2 cases). (2) Histiolymphocytic lymphomas involving the skin (6 cases) or lymph nodes (3 cases). (3) Lymphomas showing follicular development (4 cases). (4) Plasmacytic lymphomas (4 cases). (5) Lymphocytic lymphoma (1 case). Most affected horses were middle-aged or old but lymphoblastic neoplasms tended to affect younger horses than other forms. The course of the disease was highly variable. The most rapidly progressive forms were of lymphoblastic cytology, whereas some cases with histiolymphocytic skin nodules appeared to be only slowly progressive. Further information is needed on the pathology and clinical behaviour of some types of lymphoma, particularly those manifesting in the skin. Elucidation of the histogenetic relationships of the different cytological types of lymphoma will involve the development of immunohistochemical and other techniques which are specifically applicable to the horse. PMID- 3286691 TI - Selection of wound closure materials. AB - Selection of wound closure materials (sutures, needles, staples, and skin tapes) is presented. The characteristics of commonly used suture materials and needles are discussed as a background for their rational selection and usage. The attributes of staples and sutureless skin closures (skin tapes) are also given and contrasted with those of sutures. PMID- 3286692 TI - Aloe vera. AB - We review the scientific literature regarding the aloe vera plant and its products. Aloe vera is known to contain several pharmacologically active ingredients, including a carboxypeptidase that inactivates bradykinin in vitro, salicylates, and a substance(s) that inhibits thromboxane formation in vivo. Scientific studies exist that support an antibacterial and antifungal effect for substance(s) in aloe vera. Studies and case reports provide support for the use of aloe vera in the treatment of radiation ulcers and stasis ulcers in man and burn and frostbite injuries in animals. The evidence for a potential beneficial effect associated with the use of aloe vera is sufficient to warrant the design and implementation of well-controlled clinical trials. PMID- 3286693 TI - Topical ketoconazole treatment of cutaneous candidiasis. PMID- 3286694 TI - Growth responses of environmental mastitis pathogens to long-chain fatty acids. AB - Streptococcus uberis, Streptococcus faecalis, Escherichia coli, and Klebsiella pneumoniae were tested for susceptibility to long-chain fatty acids predominant in teat canal keratin. Antibacterial activity of free fatty acids on each bacterial species was measured after 12 h in synthetic media. Growth responses of all three strains of Streptococcus uberis were completely inhibited by C18:3 and those of two of three strains by C18:2 at 1 micrograms/ml. None of the fatty acids tested were bactericidal to Streptococcus faecalis. Saturated fatty acids C14 and C16 were more bacteriostatic to Streptococcus faecalis than were polyene fatty acids. Growth responses of coliform species were not affected by long-chain fatty acids. In general, environmental mastitis pathogens were resistant to fatty acids predominant in teat canal keratin. PMID- 3286695 TI - Determination of teat dip germicidal activity using the excised teat model. AB - Fifteen postmilking teat antiseptics were evaluated in seven trials using the excised teat model. All products were tested against Staphylococcus aureus Newbould 305 and Streptococcus agalactiae Cornell 48. Eight of nine iodophor products provided log reductions greater than 3 against Staph. aureus and Strep. agalactiae. A .045% iodophor product was ineffective. A .5% chlorhexidine product yielded a log reduction of 3.22 against Staph. aureus but only 2.92 against Strep. agalactiae. Two products containing fermented milk emulsified in detergent were tested upon receipt and after 1 yr storage. Fresh product provided log reductions greater than 3 against both pathogens. Storage for 1 yr resulted in minimal loss of germicidal activity. Three products containing 1, .5, and .2% dodecylaminoalkyl glycine provided log reductions greater than 3.5 against Staph. aureus and greater than 4 log reduction against Strep. agalactiae. PMID- 3286696 TI - Molecular cloning and expression of bovine kappa-casein in Escherichia coli. AB - A cDNA library was constructed using poly(A) +RNA from bovine mammary gland. This cDNA library of 6000 clones was screened employing colony hybridization using 32P labelled oligonucleotide probes and restriction endonuclease mapping. The cDNA from the selected plasmid, pKR76, was sequenced using the dideoxy-chain termination method. The cDNA insert of pKR76 carries the full-length sequence, which codes for mature kappa-casein protein. The amino acid sequence deduced from the cDNA sequence fits the published amino acid sequence with three exceptions; the reported pyroglutamic acid at position 1, tyrosine at position 35, and aspartic acid at position 81 are, respectively, a glutamine, a histidine, and an asparagine in the clone containing pKR76. The MspI-, NlaIV-cleaved fragment (630 base pair) from the kappa-casein cDNA insert has been subcloned into expression vectors pUC18 and pKK233-2, which contain a lac promoter and a trc promoter, respectively. Escherichia coli cells carrying the recombinant expression plasmids were shown to produce kappa-casein protein having the expected mobility on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and being recognized by specific antibodies raised against natural bovine kappa-casein. PMID- 3286697 TI - Selection of tests for monitoring the bacteriological quality of refrigerated raw milk supplies. AB - Raw milk samples were collected from 10 producer bulk tanks. Samples were then subdivided so that milks were subsequently stored at 1.7, 4.4, 7.2, and 10.0 degrees C for 24 and 48 h. After storage, samples were analyzed by seven plating methods: standard plate count, psychrotrophic bacterial count, rapid psychrotrophic count, preliminary incubation count, mesophilic plate count, laboratory pasteurized count, and coliform count by violet red bile agar technique. Impedance protocols on a Bactometer Model 123 for total count, psychrotrophic count, mesophilic count, and coliform count were also used to evaluate the bacteriological quality of the milks. Bacterial counts and impedance detection times were analyzed using nonparametric statistics. Impedance protocols for total count and psychrotrophic count were the best indicators of bacteriological quality. Preliminary incubation count was the best of the plating methods. The laboratory pasteurized count performed poorly. Impedance measurements provided information in the shortest time. PMID- 3286698 TI - Effects of abomasal or intravenous administration of arginine on milk production, milk composition, and concentrations of somatotropin and insulin in plasma of dairy cows. AB - Holstein cows just past peak lactation were used in a 3 x 3 Latin square design to determine the effects of arginine infusion on concentrations of somatotropin and insulin in plasma, milk production, and milk composition. Treatments were: 1) control; 2) arginine injection into jugular vein, and 3) arginine infusion into abomasum. Concentrations of arginine and ornithine in plasma were increased by injection of arginine into the jugular vein compared with the control. The concentration of ornithine in plasma was increased shortly after injection of arginine into the jugular vein, and both arginine and ornithine concentrations in plasma decreased rapidly. Abomasal infusion of arginine significantly increased concentrations of arginine, ornithine, and urea in plasma compared with concentrations in the control treatment. Injection of arginine into the jugular vein increased concentrations of somatotropin and insulin in plasma, but the increase did not persist for more than 30 min. A secondary peak in plasma somatotropin concentration occurred approximately 1 h after the initial peak. Arginine infusion into the abomasum did not alter plasma concentrations of either somatotropin or insulin. Dry matter intake, milk production, and milk composition were not affected by treatments. Lack of changes in milk production and milk composition suggest that acute increases in somatotropin with concomitant increases in insulin are not sufficient to stimulate synthesis of milk and milk components by cows during established lactation. PMID- 3286699 TI - Relationship of milk proteins in blood with somatic cell counts in milk of dairy cows. AB - Intramammary leucocytosis was induced by injection of Escherichia coli endotoxin via the teat canal in three lactating Holstein cows. Concentrations of alpha lactalbumin and casein in blood serum were measured, and somatic cell concentration and yield and composition of milk were determined. Endotoxin injection elicited mean increases of 100-fold in somatic cell concentration and 50% in protein concentration, whereas milk yield declined 5-fold and lactose concentration was halved. Concentrations of alpha-lactalbumin and casein in blood rose from 80 to 1909 and 0 to 1231 ng/ml, respectively. By 96 h postinjection, all variables were approximately equal to those preinjection. In a second study, concentration of alpha-lactalbumin was determined in blood of lactating cows in two herds (n = 332) and related to milk somatic cell count. Concentrations of alpha-lactalbumin in blood were correlated with somatic cell counts (r = .60). Mean concentrations of alpha-lactalbumin increased with increasing cell count even at low somatic cell concentrations (25 to 250 X 10(3)). Concentrations of milk proteins in blood serum apparently reflect competency of the blood-milk barrier and may therefore yield an indirect measure of udder health. PMID- 3286700 TI - Comparison of duplicate and single quarter milk samples for the identification of intramammary infections. AB - Results of bacteriological culture of 5426 pairs of duplicate quarter milk samples collected were analyzed for agreement. Overall, the percentage of agreeing pairs was 98.1%. The percentage agreement by infection type was greater for the contagious pathogens, Streptococcus agalactiae (96.4%) and Staphylococcus aureus (94.2%), than for other Streptococcus spp. (81.6%) and coliform organisms (55.6%). Single quarter samples may be adequate for determining status of quarter infection with Strep. agalactiae and Staph. aureus. PMID- 3286701 TI - Issues in personality conceptualizations of addictive behaviors. PMID- 3286702 TI - The addictive personality is the behavior of the addict. PMID- 3286703 TI - Are there inherited behavioral traits that predispose to substance abuse? PMID- 3286704 TI - MMPI characteristics of alcoholics: a review. PMID- 3286705 TI - Recurrent vascular headache: home-based behavioral treatment versus abortive pharmacological treatment. PMID- 3286706 TI - Topical hemostatic agents for dermatologic surgery. AB - Topical hemostatic agents are very helpful in attaining capillary and small vessel hemostasis in dermatologic surgery. The commonly used topical hemostatic agents, including oxidized cellulose, absorbable gelatin, and thrombin are reviewed, along with newer agents such as microfibrillar collagen, fibrin sealants, and acrylates. Agents best suited for certain situations are recommended. PMID- 3286707 TI - Biochemical and immunochemical properties of HPLC peak 2, an ion-exchange fraction of common cattle grub (Diptera: Oestridae). PMID- 3286708 TI - Chemotherapy: its effects on a stoma. PMID- 3286709 TI - The masking-level difference and overall masker level: restating the internal noise hypothesis. AB - Recent investigations of the masking-level difference (MLD) have often involved measurement of the MLD as a function of masker level. The results show, as had earlier work, that the size of the MLD decreases as the masker level decreases. These studies have usually not considered an earlier explanation of the dependency of the MLD on masker level, that is, that additive internal noise, which is partially interaurally uncorrelated, leads to decorrelated maskers at low levels of the external masking noise. Because maskers that are decorrelated yield small MLDs, the MLD is likewise small at low masker levels. This review article shows that this explanation provides a good fit to data obtained over the past four decades. It also shows that the MLD depends less on masker level with insert phones than with supraaural phones as would be predicted by the additive internal noise explanation and the observation of lower internal noise with the use of insert phones. It is concluded that the internal noise explanation should be considered when the MLD is measured as a function of masker level. PMID- 3286710 TI - Cross-sectional tongue shape during the production of vowels. AB - This study used ultrasound imaging to examine the cross-sectional shape of the tongue during the production of the ten English vowels ( see text ) in two consonant contexts--/p/ and /s/--and at two scan angles--anterior and posterior. Results were compared with models of sagittal tongue shape. A newly built transducer holder and head restraint maintained the ultrasound transducer in a fixed position inferior to the mandible at a chosen location and angle. The transducer was free to move only in a superior/inferior direction, and demonstrated reliable tracking of the jaw. Since the tongue is anisotrophic along its length, anterior and posterior scan angles were examined to identify differences in tongue shape. Similarly, the coarticulatory effects of the sibilant /s/ versus the bilabial /p/ were examined, to assess variability of intrinsic tongue shape for the vowels. Results showed that the subject's midsagittal tongue grooving was almost universal for the vowels. Posterior grooves were deeper than anterior grooves. In /s/ context, posterior tongue grooves were shallower than in /p/ context. Anteriorly, /s/ context caused deeper grooves for low vowels. Cross-sectional tongue shape varied with tongue position similarly to sagittal tongue shape. PMID- 3286711 TI - A practical approach to ultrasonic imaging using diffraction tomography. AB - A technique for ultrasonic imaging based on the theory of diffraction tomography is presented. The method utilizes a fixed, circular configuration of transmitters and detectors. This configuration was selected because it avoids many practical limitations associated with the design of a medical imaging device. Practical considerations also motivated the inclusion of effects associated with the transmitter beam pattern rather than pursuing the more conventional approach in which plane-wave illumination is required. In addition, the problem of separately imaging both density and compressibility variations is considered. PMID- 3286712 TI - Clinical reasoning in nursing. AB - This paper traces the development of the concept of nursing diagnosis and the various approaches being used to explain the cognitive processes used by practitioners in diagnosing patient problems. Three main types of explanation are compared; hypothesis generation/testing, decision analysis, and the information processing model. The recent development of the latter approach within the field of artificial intelligence is described and expert system research introduced. Finally, the potential benefits of the advent of expert systems into nursing are discussed. PMID- 3286713 TI - Patient education: a literature review. AB - The literature review has been carried out to examine the role of nurses as patient teachers. It attempts to determine why patient education is necessary and why it should be part of the nurse's role. Included is an account of the abilities required by the nurse in order to function in that role. It is generally agreed that it is part of the nurse's role to educate patients but this is often not carried out in reality. Where it is done it is mostly unplanned and haphazard in manner and the effectiveness uncertain. There are many reasons cited why this is the case and many of these reasons relate to the inadequate education and training of nurses for this role. Registered nurses are responsible for the nursing care of patients which should include their education. In order to be able to provide the necessary education nurses must have the opportunity to be taught to develop the appropriate skills during basic training. As a result, a study is now underway to attempt to determine the extent to which student nurses are being prepared for their role as patient educators during basic training. PMID- 3286714 TI - The what, why and how of hyperkinesis: implications for nursing. AB - Hyperkinesis refers to a combination of traits that typically include: overactivity; restlessness; short attention span; distractability; low frustration tolerance; impulsiveness. Its aetiology and prevalence have not been established but associating problems underscore the importance of early identification and treatment. Theories about aetiology relate to minimal brain damage, heredity, temperament variations, maturational lag, dysfunction of the reticular activating system, food sensitivity, and learned response to unorganized environment. Hyperkinesis may be distinguished only by its behavioural manifestations. Insightful analyses of behavioural problems require viewing the child from a development perspective, such as those advanced by Freud, Erikson, Berne and others. Sensitivity to the ramifications of labelling the child as deviant is critical. Multidimensional assessment is needed upon which management decisions are made. An eclectic approach merits consideration: medication, if it works; therapeutic counselling; parental counselling; intervention with school personnel; and above all, support for the child. The nurse plays a crucial role in providing the health team with key information basic to establishing accurate diagnosis and evaluating interventions. The problem of hyperkinesis bears many implications for nursing practice and research. PMID- 3286715 TI - An update on mast cell heterogeneity. PMID- 3286716 TI - Respiratory infections and bronchial hyperreactivity. PMID- 3286717 TI - The eosinophil as a mediator of damage to respiratory epithelium: a model for bronchial hyperreactivity. PMID- 3286718 TI - Studies on the allergic and nonallergic nasal inflammation. AB - Nasal lavage after antigenic and nonantigenic nasal stimulation has become an important tool for the study of inflammatory phenomena in the upper airway. Biochemical and cytologic information is relatively easily obtainable, and pharmacologic manipulations can be readily monitored. This article is of several studies aiming toward a more profound understanding of the mechanisms of allergic and nonallergic rhinitis by the use of laboratory-challenge procedures and nasal lavage techniques. An early and a late reaction are detected clinically in the nose after antigen challenge of allergic individuals. In addition, the sensitivity to antigen significantly increases after the initial challenge, and this phenomenon is not obligatorily linked to the presence of a late-phase reaction (LPR). Inflammatory mediators, mostly mast cell- and/or basophil derived, are detected in the nasal washes and correlate with the symptomatology in both the early and the late reactions. The allergen-induced LPR is marked by an early influx of eosinophils and, later, basophils and neutrophils. Elevation of major basic protein and histamine, but not prostaglandin D2, is detected during the LPR, giving evidence of active eosinophil and basophil participation. Systemic steroids can effectively suppress the clinical, biochemic, and cellular manifestations of antigen-induced LPR. Topical steroids have a similar effect but are also capable of suppressing the early reaction to antigen. A nonallergic form of rhinitis can be induced in the laboratory by nasal inhalation of dry air at freezing temperatures in individuals who report sensitivity to cold and windy environments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286719 TI - AIDS: state of the art, spring 1988. AB - In this article I have addressed many of the AIDS issues of concern to immunologists and allergists, both as citizens, physicians, and as specialists. HIV infection (AIDS) is going to be with us for some time to come. However, I think some solace can be gained from the fact that the human race has faced many such contagions in the past for example, bubonic plague, cholera, syphilis, and most recently, polio, to name a few. We are very fortunate today to have the scientific and medical tools that have provided us with tremendous insight into the basic and clinical aspects of this disease. These tools and a large cadre of dedicated people who have declared a war on AIDS will provide the answers. PMID- 3286720 TI - Transfer factor. AB - It has been more than 30 years since Dr. H. S. Lawrence first reported that it was possible to transfer delayed-type hypersensitivity from sensitized donors to unsensitized recipients with lysates of blood leukocytes. During recent years, research from several laboratories has demonstrated that this effect is immunologically specific. Although the molecules that possess this activity have not been completely characterized, there is a significant body of evidence that they are small polypeptides and that they can interact with antigen molecules in an immunologically specific manner. Studies with immune responses that are under genetic control have demonstrated that the ability of an animal to produce transfer factor is genetically regulated but that transfer of delayed hypersensitivity with transfer factor is not genetically restricted. In fact, when mice of low-responder phenotypes are administered transfer factor from high responder donors, they express delayed hypersensitivity responses that are comparable to the high responders. Clinical studies have demonstrated that transfer factor is an efficacious method for immunotherapy of certain viral and fungal infections. PMID- 3286721 TI - A clinical and pathologic study of chronic sinusitis: the role of the eosinophil. AB - Evidence exists that the eosinophil plays an important role in mediating injury to bronchial epithelium in chronic asthma. Here, the role of the eosinophil in chronic inflammatory disease of the paranasal sinuses was studied with tissue from patients who underwent surgery for chronic sinusitis. Paranasal tissue from patients with chronic asthma and/or allergic rhinitis was extensively infiltrated with eosinophils. Immunofluorescent studies demonstrated a striking association between the presence of extracellular deposition of major basic protein and damage to sinus mucosa. The histopathology of paranasal respiratory epithelium appeared similar to that described in bronchial asthma. These findings suggest that the eosinophil acts as an effector cell in chronic inflammatory disease of paranasal respiratory epithelium. Thus, sinus disease in patients with asthma may be due to the same mechanisms that cause damage to bronchial epithelium. PMID- 3286722 TI - Dose response of inhaled gallopamil (D600), a calcium channel blocker, in attenuating airway reactivity to methacholine and exercise. AB - To determine if there is a dose-response relationship for calcium channel blockers in preventing experimentally induced bronchoconstriction, we evaluated the effects of inhaled gallopamil (D600), a potent methoxy derivative of verapamil, on airway reactivity to methacholine and exercise in volunteers with mild asthma. Methacholine challenges were completed by 11 subjects 2 hours before and 20 minutes after placebo, and 1, 2, 5, 10, and 20 mg of inhaled gallopamil administered in a single-blind, randomized manner on different days. Gallopamil did not significantly alter FVC, FEV1, or forced expiratory flow rate between 25% and 75% of FVC, but increased the dose of methacholine required to produce a 20% decrease in FEV1 from baseline (p less than 0.0001). The mean +/- SEM fold increase in the dose of methacholine required to produce a 20% decrease in FEV1 from baseline was 1.0 +/- 0.1 after placebo, 2.4 +/- 0.2 after 1 mg, 2.2 +/- 0.2 after 2 mg, 2.5 +/- 0.2 after 5 mg, 2.5 +/- 0.3 after 10 mg, and 2.3 +/- 0.2 after 20 mg. Thirty minutes before a standardized exercise challenge, 10 subjects inhaled 1 and 10 mg of gallopamil or placebo in a randomized, double-blind, crossover manner. The mean +/- SEM maximum decrease in FEV1 after exercise was 25.1 +/- 5% after 10 mg of gallopamil (p less than 0.01), 34.4 +/- 5% after 1 mg (p greater than 0.05), and 39.0 +/- 6% after placebo. We conclude that inhaled gallopamil only modestly alters airway reactivity to methacholine; increasing the dose greater than 1 mg did not provide greater benefit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286723 TI - Platelet-activating factor as a mediator of allergic disease. PMID- 3286724 TI - Recent advances in immunologic reactivity in otitis media with effusion. AB - The role of IgE-mediated hypersensitivity in the development of middle ear disease has not been completely resolved. However, on the basis of our investigations and those of other laboratories, we suggest that approximately two thirds of patients with chronic recurrent otitis media do not have allergies. The other third may have allergic rhinitis, and this allergic rhinitis could play a direct role in producing eustachian tube dysfunction in recurrent otitis media. However, viral infections of the upper respiratory tract may also induce IgE mediated release of mast cell inflammatory mediators, and could cause otitis media on the basis of viral infection alone. Subtle immunologic deficiencies involving the IgG2 subclass and other immunoglobulin subclasses may also be lower in otitis-prone children, and this may be a genetically inherited disorder. Finally, the possibility of food allergy in otitis media must be considered, particularly in the young otitis-prone child with chronic recurrent otitis media. PMID- 3286725 TI - Diseases of the ear. AB - Otitis media with effusion is a major disorder in children and the most common cause for both major surgery (adenoidectomy with or without tonsillectomy) and minor surgery (middle ear ventilating tubes) in both the United States and Britain. It is frequently associated with respiratory allergy. Medical evaluation, diagnosis, and therapy are discussed. Environmental control measures and pharmacotherapy are reviewed, with a critical review of published appropriately designed studies for its treatment and prevention. PMID- 3286726 TI - Conductive hearing loss and speech development. AB - The central issue about conductive hearing loss and speech development is the impact of mild to moderate hearing loss that may be intermittent. Although opinions vary considerably about what this does to the ability of the child to learn, most studies support a position of concern. This concern should focus on identification and treatment of such children, with special teaching techniques in addition to medical and surgical treatment. PMID- 3286727 TI - Surgical management of otitis media (recurrent and nonsuppurative). AB - In 1977 Paradise outlined the role of tympanostomy tubes in nonsuppurative otitis media. Over the intervening 10 years the role has changed little. Exceptions would be the demonstrated advantage of tube placement over myringotomy alone in those patients with effusion for longer than 2 or 3 months, or over prophylactic sulfonamide or placebo in recurrent otitis media. PMID- 3286728 TI - Sinusitis in children. AB - Sinusitis is common in allergic children. We are now aware that the commonest presentation of this disorder in the pediatric age group is persistent cough and purulent rhinorrhea. Headache and facial tenderness, frequently noted in adults with sinusitis, are not common. Much remains to be learned about diagnostic techniques and therapy of sinusitis. Nasal cytology can be valuable for discriminating between allergic and infectious disease, but lacks both sensitivity and specificity. Although there is a high correlation between radiographs showing significant sinus membrane thickening or clouding and recovery of bacteria from antral taps, it is possible to see positive films in asymptomatic individuals. Similarly, films may be unremarkable, although the history and physical examination yield convincingly positive evidence for sinus infection. The clinician must sometimes decide on therapy when the diagnosis is not definitive. Antimicrobial therapy for sinusitis should be given for 3 to 4 weeks in many cases. Amoxicillin remains a good choice for therapy, but antibiotics capable of clearing infections by beta lactamase-producing bacteria should be considered in refractory situations. The value of antihistamines, decongestants, nasal steroids, and cromolyn sodium are unstudied at this time. If several antibiotic courses fail to alleviate the signs and symptoms of sinusitis, surgery is indicated. Antral lavage and creation of nasoantral windows is the usual approach in children. Patients with sinusitis often have concurrent middle ear disease. Patients with current sinusitis have a higher incidence of immunoglobulin disorders than found in a normal pediatric sample. It appears that patients with sinusitis are more often allergic than would be expected from 2 typical population distribution. More evaluation is needed to clarify these associations. PMID- 3286729 TI - Sinusitis in adults. AB - Sinusitis in adults is being increasingly recognized as a common clinical entity. To protect against infection of the paranasal sinuses, patent ostia, mucous of the proper viscosity, and actively beating cilia are necessary. The superior placement of the maxillary ostia predisposes to maxillary sinusitis. A number of surgical procedures are available to treat chronic sinusitis that does not respond to appropriate medical therapy. The recently introduced technique of endoscopic surgery of the sinuses shows great promise. The association of sinusitis and bronchial asthma is well recognized, but causality is more difficult to prove. There is suggestive evidence in both children and adults that medical or surgical treatment of underlying sinusitis frequently improves the asthmatic state, but well-designed prospective studies are needed that control or measure relevant variables. PMID- 3286730 TI - Upper airway complications of cigarette smoking. AB - Passive cigarette smoking is becoming increasingly implicated in upper respiratory tract infections. Some 9 million to 12 million children have significant exposure to cigarette smoke, which may result in pathologic changes in mucociliary transport and cellular composition of the respiratory tract. The physiologic changes related to chronic smoke exposure have been implicated as a risk factor for otitis media and bronchitis. Currently, the cellular effects of cigarette smoke or mucosa can only be reversed or eliminated with avoidance. The use of intranasal steroids or cromolyn sodium, in addition to antibiotic therapy, when an infection is present may reduce the severity or incidence of disease. PMID- 3286731 TI - Upper airway inflammatory diseases and bronchial hyperresponsiveness. AB - Inflammatory processes of the upper airway may alter the responsiveness of the lower airway. For example, bronchial hyperresponsiveness may be seen in patients with allergic rhinitis. This could represent coexistent but unrecognized asthma, but also suggests that IgE-dependent inflammation may occur in the lower airway that can increase bronchial hyperresponsiveness without at the same time precipitating obvious obstruction. Clearly, allergic rhinitis is a risk factor for asthma. A second example of the interaction of upper airway inflammation and bronchial hyperreactivity are reports that viral upper respiratory tract infections may cause otherwise healthy persons to respond abnormally to inhaled histamine or irritants for several months after the infections. These same viruses usually precipitate attacks in patients with asthma, who already have hyperresponsive airways. Both of these examples suggest that inflammatory processes occurring totally or primarily in the upper airway may participate in the pathogenesis of lower respiratory tract hyperresponsiveness and asthma. PMID- 3286732 TI - Indoor and outdoor pollutants and the upper respiratory tract. AB - The health effects of both indoor and outdoor air pollutants are of increasing concern. The health effects of outdoor air pollutants traditionally have been assessed through measurements of lower respiratory tract changes. However, it has been shown that one outdoor air pollutant, sulfur dioxide, decreases nasal mucus flow and increases nasal airway resistance. Along with cigarette smoke, indoor air pollutants such as formaldehyde, cadmium, and ammonium or sulfate ions have been shown to alter upper airway mucociliary function. Emissions from wood stoves are known to irritate the upper airways. Measurement of nasal airway resistance using posterior rhinomanometry allows quantification of nasal function. This technique recently has been used to demonstrate that adolescents with allergic asthma have increased work of breathing after inhalation of 0.5 ppm sulfur dioxide. Another study using posterior rhinomanometry showed that clerical workers had increased work of breathing after exposure to carbonless copy paper as compared with bond paper. This brief review of upper respiratory tract changes after pollutant exposure should serve as a reminder that a complete clinical history must include questions designed to ascertain the patient's exposure history to both outdoor and indoor air pollutants. These exposures can have a major impact on the health of the upper respiratory system. PMID- 3286733 TI - Foods and respiratory allergy. AB - Foods may induce respiratory symptoms by both reaginic and nonreaginic mechanisms. Asthma is one of the most common respiratory manifestations in children, and it is well known that many factors may provoke an attack. When considering the relationship between foods and asthma, we must keep in mind that food allergy may coexist with an inhalant allergy and that other nonallergens, such as pollutants, smoke, or additives, may modulate or modify bronchial reactivity and thus favor the food allergen action. In a study using clinical history, prick test, radioallergosorbent test, and double-blind food challenge, we demonstrated respiratory symptoms related to food allergy in 13 of 140 (9.2%) children with asthma. Asthma, in particular, was demonstrated in 8 of 140 (5.7%) patients. Food allergy respiratory symptoms are, in our experience, almost always associated with other clinical manifestations (e.g., cutaneous, gastrointestinal). The recognition of food-dependent IgE-mediated respiratory symptoms is essentially limited to those cases characterized by food allergy with asthmatic expression. It is possible, however, that in many cases foods may have a nonspecific role in the determination of asthma or in the preparation of bronchi for the possible consequent stimulus. PMID- 3286734 TI - Objective measurements of nasal airway testing. AB - The objective measurement of nasal airway function has become increasingly important in the evaluation of both clinical responses and nasal challenge testing methodology when both the diagnosis and treatment of upper respiratory tract disease are assessed. Such measurements include the quantitation of nasal symptoms by use of symptom diaries, nasal physical examination, and scoring systems, and assessment of structural and functional changes of the nasal mucosa by light and electron microscopy and by other methods using radioisotopes. In addition, quantitation of nasal secretions along with qualitative analysis of various components of nasal secretions has recently shed new light on the pathologic picture of nasal disease. Various means of measuring changes in nasal blood flow and nasal airflow have enjoyed increasing use in both investigative and clinical application. Measurement of nasal cross-sectional area along with objective assessment of eustachian tube dysfunction and the use of various pharmacologic and immunologic probes have allowed varying approaches to the evaluation of nasal airway structure and function in both health and disease. PMID- 3286735 TI - Chronic rhinitis in children. AB - Children are not small adults, and although many features of chronic rhinitis in children are similar to those in adults, there are significant differences in etiologic factors, manner of presentation, and therapy. The fact that children are growing and developing also has special therapeutic implications in the management of rhinitis. PMID- 3286736 TI - Effects of nasal obstruction on facial development. AB - The relationship between nasal obstruction and facial growth is controversial. Much of the controversy relates to the lack of sophistication in quantifying nasal versus oral respiration and the lack of longitudinal data. Nevertheless, a number of studies in laboratory animals, nonhuman primates, and humans have shown a relationship between nasal airway obstruction and aberrant facial growth. In monkeys, occlusion of the nares with silicon plugs triggered deviant muscle function and altered morphogenesis. In general, the nasally obstructed animals had longer faces and unusual dental malocclusions. In human studies allergic, mouth-breathing children have longer, narrower faces and retrognathic jaws, compared with control subjects. Medical intervention has not been shown to influence the pattern of facial growth in children with allergies. Surgical therapy to relieve nasal airway obstruction in children (whether adenoidectomy or turbinectomy) has not been shown to predictably affect ultimate facial form. Therefore, although an increasing body of literature demonstrates a relationship between nasal airway obstruction and facial growth, the clinician should be cautious in prescribing aggressive therapy or in promising dramatic results. PMID- 3286737 TI - Chronic rhinitis in adults. AB - Chronic rhinitis afflicts many American adults; the exact number is unknown because of the difficulty in establishing an exact diagnosis and because of the likely presence of overlap syndromes, including perennial allergic rhinitis, perennial nonallergic rhinitis with eosinophilia, and so-called vasomotor rhinitis. Nasal allergic reactions with release of pharmacologically active chemical mediators can participate in the pathogenesis of chronic rhinitis. In addition, reflex mechanisms probably play an important role in the initiation and maintenance of chronic nasal symptoms. Diagnosis is best achieved by a detailed history, with special attention to home, environmental, and occupation-related exposures and to selective epicutaneous skin tests and repeated smears of nasal secretions for detection of eosinophils. Therapy includes avoidance of all sorts of dust, fumes, sprays, and the like and appropriate attention to minimizing home environmental and occupational exposures. Pharmacotherapy is discussed elsewhere in this supplement. PMID- 3286738 TI - Anatomy and physiology of eustachian tube and middle ear related to otitis media. AB - The middle ear is part of a functional system composed of the nasopharynx and the eustachian tube (anteriorly) and the mastoid air cells (posteriorly). The only active muscle that opens the eustachian tube is the tensor veli palatini, which promotes ventilation of the middle ear. The eustachian tube also functions to protect the middle ear from excessive sound pressure, and nasopharyngeal secretions. The eustachian tube helps drain the middle ear during opening and closing by pumping secretions from the middle ear; clearance of secretions also occurs. An understanding of the anatomy and physiology of the system can aid the clinician in understanding the role of eustachian tube dysfunction in the cause and pathogenesis of middle ear disease and the possible contribution of allergy to this disease. PMID- 3286739 TI - Deep fungal infections in the elderly. PMID- 3286740 TI - Plastic surgery in podiatry (simplified illustrated techniques). AB - Soft-tissue loss in the foot is often a perplexing, time consuming, and frustrating treatment dilemma for both patient and surgeon. Fortunately, several plastic surgical techniques may be used to successfully deal with this clinical situation. These techniques are presented through an illustrated essay format. PMID- 3286741 TI - Pinch grafts--applications in podiatric wound closure. AB - Pinch grafts were initially described in the late nineteenth century as a technique that could be utilized, under selected conditions, to promote wound healing. This procedure remains a viable component of the podiatric surgical armamentarium. There has been relatively little information on this subject in the literature: podiatric, orthopedic, or general medical, during the past several decades. A review of the historic development of the procedure, and case presentations, for examples of current applications, are presented. PMID- 3286742 TI - Cutaneous horns: review of literature and case report. AB - Cutaneous horns, although rarely seen in the podiatric practice, must be considered in one's differential diagnosis when treating keratinous skin lesions. These lesions have been described as both malignant and premalignant, and an adequate amount of tissue at the base of the lesion must be obtained for proper biopsy. The authors discuss a case in which an unusual surgical technique is used in the treatment of a cutaneous horn. PMID- 3286743 TI - Lack of gonadotropic response to pulsatile gonadotropin-releasing hormone in isolated hypogonadotropic hypogonadism associated to congenital adrenal hypoplasia. AB - Congenital adrenal hypoplasia (AH) is a rare condition, known to be associated with isolated hypogonadotropic hypogonadism (IHH). Three studies have reported attempts to stimulate gonadotropin secretion with pulsatile gonadotropin releasing hormone (GnRH) in a total of 4 patients presenting such a syndrome, with conflicting results. In the present study, one patient with idiopathic IHH and AH was treated with pulsatile sc GnRH--doses ranging from 2.5 to 10.0 micrograms/pulse, every 90 min--during 8 weeks in an attempt to induce puberty. The prepubertal basal plasma levels of LH, FSH and testosterone, and saliva testosterone levels remained unaltered throughout treatment, at all doses of GnRH tested. The gonadotropin response to an acute iv GnRH administration (0.1 mg) also remained at the prepubertal level after pulsatile GnRH treatment. No circulating anti-GnRH antibodies were detected. The absence of gonadotropic response to exogenous pulsatile GnRH suggests that the IHH of patients with AH is due to an abnormal pituitary function rather than to a lack of endogenous GnRH. PMID- 3286744 TI - Combined pituitary stimulation test: interactions of hypothalamic releasing hormones in man. AB - The use of hypothalamic releasing hormones for the clinical assessment of anterior pituitary function is both simple and free of severe side effects. Tests with the recently discovered substances GRF and CRF as well as with combinations of several releasing hormones are therefore used in many clinics. A reliable interpretation of such combined tests, however, is only possible when positive or negative interactions between these releasing hormones are known. After a rest of 2 h to reach basal cortisol levels, 7 groups of 5 male volunteers each received an iv bolus injection consisting of either: A): GRF (100 micrograms) + CRF (50 micrograms) + TRH (200 micrograms) + LHRH (100 micrograms), B): CRF + TRH, C): GRF + TRH, D): LHRH + TRH, E): TRH, F): GRF, G): CRF. During the following 2 h, GH, TSH, cortisol, LH, FSH and prolactin were measured every 15 min. The TSH response after the injection of all 4 releasing hormones was significantly higher (delta TSH = 16.5 +/- 2.0 microU/ml, x +/- SE) compared to the injection of TRH alone (delta TSH = 9.3 +/- 1.4 microU/ml; p less than 0.025). This increment in TSH secretion was confirmed when 2 groups of 5 female volunteers were studied with the TRH-test (delta TSH = 9.9 +/- 1.8 microU/ml) or the combination of all four releasing hormones (delta TSH = 16.8 +/- 2.9 microU/ml; p less than 0.05). This exaggerated TSH-response to TRH was demonstrated to be entirely due to simultaneous administration of GRF, whereas CRF and LHRH in combination with TRH had no additional effect on TSH release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286745 TI - The evolution of ischemic cerebral infarction in infancy: a sonographic evaluation. AB - Cranial sonography provides a noninvasive, portable method for imaging the infant brain. This study describes the time-dependent, sonographic findings of infantile cerebral infarction, as well as computed tomographic (CT) scan and neuropathologic confirmation. Three hundred ninety-five infants under 18 months of age were sonogrammed over a period of 18 months. Three infants were diagnosed by cranial sonography and confirmed by CT scan and/or autopsy to have acute ischemic cerebral infarcts. The cases were followed with serial cranial sonograms for up to 18 months of age. The acute sonographic findings included a hyperechoic zone around the infarcted tissue. The subacute infarct had a checkerboard pattern, while the chronic infarcts were anechoic. PMID- 3286746 TI - Adrien Barrere and his caricatures of the medical faculty of the University of Paris: "A Vivid Grouping". PMID- 3286747 TI - Midline electrographic abnormalities and cerebral lesions in the newborn brain. AB - Electroencephalographic (EEG) abnormalities arising from the midline region were identified in 154 of 1008 (15.2%) consecutive neonatal EEGs during a 24-month period. These records were obtained on 97 neonates with a variety of clinical diagnoses. Premature infants made up 79% (77/97) of this group. All patients received at least one cranial ultrasound at 7 to 10 days of life. Sixty-two percent (60/97) of the patients had radiographic and/or neuropathological documentation of cerebral lesions: intraventricular hemorrhage (25), periventricular leukomalacia (18), cerebral infarction (10), cerebral malformation (4), and miscellaneous lesions (3). Six types of midline EEG abnormalities are described: negative sharp waves, positive sharp waves, electrographic discharges associated with myoclonus, electrographic seizures, attenuation of background, and rhythmic monofrequencies. Approximately 90% of the patients with background attenuation, discharges with myoclonus, and positive sharp waves and 72% of patients with EEG seizures had cerebral lesions. Midline positive sharp waves were associated with periventricular leukomalacia as well as intraventricular hemorrhage. No midline positive sharp waves, attenuation, EEG seizures or discharges with myoclonus were found in 25 healthy, asymptomatic neonates. Besides positive sharp waves, other specific midline EEG abnormalities can be associated with cerebral lesions in the neonate. The rapid identification of midline EEG abnormalities in neonatal recordings can enhance the accuracy of both electrographic diagnosis and anatomic localization of associated cerebral lesions. PMID- 3286748 TI - Bacterial meningitis: future directions. PMID- 3286749 TI - Update on bacterial meningitis. AB - Recently, advances in identifying the etiologic agent, improving antibiotic therapy, and understanding the pathogenesis of complications of bacterial meningitis have been made. The acute and long-term sequelae and their courses have been documented. Acridine orange staining of the cerebrospinal fluid may identify bacteria in children with partially treated meningitis when gram staining is not helpful. Monoclonal antibodies for meningococcus group B antigen have been developed and may prove useful for testing cerebrospinal fluid. Several newer cephalosporins have been shown to have excellent in vitro activity against the bacteria commonly associated with meningitis. They are indicated in the treatment of infants between 4 and 8 weeks of age, children in septic shock, children with liver disease, and children with infection with gram-negative enteric agents or bacteria resistant to ampicillin and chloramphenicol. Vasculitis and cerebral infarction may result in some of the complications, such as seizures and hemiparesis, noted in children, and their consequences can be documented by various neuroimaging procedures. The prognosis for ataxia is good, while that for sensorineural deafness is poor. The majority of children will have neither intellectual deficits nor difficulty with academic achievement. An effective vaccine against Haemophilus influenzae type b has been developed and is recommended for children between 18 and 60 months of age. PMID- 3286750 TI - The use of a selective staphylococcal broth v direct plating for the recovery of Staphylococcus aureus. AB - Nine hundred seventy-two cultures taken from the external nares and the vaginal vestibules of 54 women for the isolation of Staphylococcus aureus were studied. The swabs were plated directly to a trypticase soy agar plate containing 5% sheep blood and were then placed into a selective staphylococcal broth. Both culture methods were compared for the ability to recover S aureus. Twenty percent (26/131) and 66% (38/58) of the S aureus-positive cultures taken from the nares and vagina respectively were cultured from the selective broth only. We believe that a selective staphylococcal broth should be used in addition to routine culture techniques to isolate S aureus from infection control surveillance cultures. PMID- 3286751 TI - The reception of anthropological work in sociology journals, 1922-1951. AB - The gradual disenchantment of American sociologists with the validity of ethnographic reports is examined by tracing the reception of anthropological work from 1922-1951 in three leading sociological journals: The American Journal of Sociology, The American Sociological Review, and Social Forces. Although prominent American sociologists initially welcomed Boasian syntheses of Native American and of exotic foreign cultures in the 1920s and 1930s, by the 1940s they began to wonder if the earlier assertions of cultural anthropologists about these exotic cultures were as shakily based as were their later assertions about cultural patterns in the United States. PMID- 3286752 TI - Education, evangelism, and the origins of clinical psychology: the Child-Study legacy. AB - Both contemporary psychologists and historians of the discipline have disparaged the poor quality of research generated by the Child-Study movement. The real significance of this movement, however, lay not in its scientific findings but in its institutional innovations. Its most important legacy was the structuring of a new working relationship between psychologists and schoolteachers. This mutually beneficial collaboration subtly altered the shape of professional psychology by reorienting research toward practical classroom concerns. In the midst of controversies surrounding the social role and scientific potential of Child Study, a new clinical psychology began to emerge. PMID- 3286753 TI - Psychohistory before Hitler: early military analyses of German national psychology. AB - As part of a grandiose post-World War I psychological project to predict the behavior of nations, the U.S. Military Intelligence Division (MID) utilized racial and social psychological theories to explain an alleged problematic German national character. Though unsuccessful, this project has major significance in the history of psychohistory. For the newly discovered MID files reveal that ideas, attitudes, and biases many psychohistorians subsequently identified as manifestations of a peculiar German national character had previously been held by American officers and reputable psychologists. What American analysts would, in 1940, view as symptoms of a maladjusted German mind, their predecessors had, in 1920, considered valid scientific concepts. PMID- 3286754 TI - The reception of Freud by the British press: general interest and literary magazines, 1920-1925. AB - A survey of forty-three general interest magazines shows that popularizing materials about psychoanalysis greatly increased in 1920, peaked in 1921, and declined thereafter. The press was more favorable to Freud than has been assumed, for a number of writers accepted his theory of the unconscious and readily acknowledged the curative powers of psychoanalysis. But there was also much hostility to Freud, particularly to his sexual theories. The press was therefore more favorable to Jung and Adler, but especially to the British depth psychologists, who deemphasized sexuality while accepting the theory of a dynamic unconscious. PMID- 3286755 TI - A new history of Hartley's Observations on Man. AB - In 1749 David Hartley published his Observations, a work of great historical significance, yet the history of the Observations has been frequently debated. Establishing an accurate history of the Observations is, therefore, warranted. This has been undertaken here by reexamining known source materials, as well as additional primary documents not previously applied to Hartley studies. Significant historical information has been gleaned from transcribing the Hartley Lister shorthand correspondence. The synthesis of material from these sources has led to a new history of the stages of conceptual development, composition, and publication of Hartley's Observations that differs substantially from previous accounts. PMID- 3286756 TI - Doctors and historians. PMID- 3286757 TI - Sin vs. science: venereal disease in Baltimore in the twentieth century. PMID- 3286758 TI - Sick doctors: Bayle and Laennec on their own phthisis. PMID- 3286759 TI - Addenda: Henry James, chlorosis and diseases of the heart. PMID- 3286760 TI - Coroner's inquisitions from London parishes of the Duchy of Lancaster: the Strand, Clapham, Enfield, and Edmonton, 1831-1883. PMID- 3286761 TI - Bern Dibner 1897-1988. PMID- 3286762 TI - Are B lymphocytes the principal antigen-presenting cells in vivo? PMID- 3286763 TI - Leu-8 antigen expression is diminished during cell activation but does not correlate with effector function of activated T lymphocytes. AB - Previous studies have suggested that there is an inverse relationship between cell activation and the expression of the Leu-8 Ag, a cell surface protein that distinguishes functionally distinct T cell populations. This was confirmed in vitro, because when resting PBL were activated with PHA there was a rapid decline in expression of the Leu-8 Ag on all lymphocyte subpopulations. A decline in Leu 8 reactivity occurred after stimulation of lymphocytes with PHA, anti-CD3 plus PMA and ionomycin plus PMA, and an intermediate decline in Leu-8 expression occurred after stimulation with Con A. However, there was little loss of expression of Leu-8 after stimulation of lymphocytes with PWM or allogeneic lymphocytes. The decline in Leu-8 expression on activated lymphocytes occurred earlier than the decline in expression of CD45R. After removal of the activation stimuli, peripheral blood T cells or Jurkat cells rapidly re-expressed Leu-8. Finally, when the expression of Leu-8 on peripheral blood CD4+, Leu-8+ T cells was reduced by prior activation with PHA, these cells continued to exhibit suppressor function for PWM-stimulated Ig synthesis. Thus, there is a rapid decline in expression of the Leu-8 Ag but no change in regulatory function of CD4+, Leu-8+ T cells during cell activation. These results suggest that the molecule recognized by anti-Leu-8 plays a role in lymphocyte activation but not directly in the effector function of CD4+, Leu8+ T cells. PMID- 3286764 TI - Effects of in vivo administration of anti-T3 monoclonal antibody on T cell function in mice. I. Immunosuppression of transplantation responses. AB - Anti-T3 mAb are being increasingly used clinically in the treatment of organ graft rejection. However, there has not previously been a murine model in which the effects of these mAb on the immune system could be studied in vivo. We have established such a model using the anti-murine-T3 mAb, 145-2C11. Administration of 145-2C11 led to rapid depletion of T cells from peripheral blood and suppression of skin graft rejection. However, depletion of T cells from spleen and lymph node was both delayed and incomplete. Full recovery of T cell number was dependent on the presence of a thymus, but treatment of thymectomized animals revealed that depletion was not the mechanism by which the mAb induced immunosuppression. Rather, alterations in TCR expression may play a more important role. TCR had modulated from T cells in spleen and lymph node early after treatment, and TCR expression remained subnormal for at least 51 days posttreatment. However, subnormal TCR expression alone could not fully explain the observed T cell dysfunction, inasmuch as a period of time existed after TCR re-expression during which T cells appeared to be anergic to CTL and MLR reactivity. These findings implicate T cell dysfunction as an important element in the induction of immunosuppression after anti-T3 administration. PMID- 3286765 TI - Specific defects in the anti-listerial immune response in discrete regions of the murine uterus and placenta account for susceptibility to infection. AB - Infection of the murine uteroplacental region by the intracellular pathogen Listeria monocytogenes results in uncontrolled local bacterial growth. In this paper we examined infected and noninfected uteroplacental tissues by immunocytochemistry to delineate the nature of the aberrant anti-listerial response. Overall the data support the hypothesis that local immunoregulation, which ordinarily prevents maternal anti-fetal, responses also prevents an effective anti-listerial response at the maternal-fetal interface. Different types of response were seen in different anatomic regions. Listeria first localized to the maternal decidua basalis, which contains a mixture of fetal class I MHC-bearing trophoblast and maternal cells. Here the listeria proliferated in an uncontrolled manner due to a striking inability of monocyte/macrophages and lymphocytes to reach foci of infection. A second type of abnormal response was seen in the fetal chorioallantoic plate, a nontrophoblastic region of the placenta. Although macrophages were present, they were not appropriately activated as evidenced by a lack of Ia Ag and the presence of extracellular listeria colonies. Purely maternal tissues adjacent to the placenta had a normal anti-listerial response. During listeriosis, class I MHC expression was augmented throughout the placenta on cells normally bearing these Ag: trophoblast in the decidua basalis and both fetal and maternal stromal cells. Class II MHC Ag were induced on maternal and fetal endothelial cells but never appeared on trophoblast. PMID- 3286766 TI - Lymphocytes infiltrating human ovarian tumors. I. Role of Leu-19 (NKH1)-positive recombinant IL-2-activated cultures of lymphocytes infiltrating human ovarian tumors. AB - Tumor-infiltrating lymphocytes (TIL) were obtained from human ovarian tumors, expanded in the presence of IL-2 in culture and studied for cytotoxicity against fresh autologous and allogeneic ovarian carcinoma (CA) targets. TIL from ovarian tumors grew well in long term cultures, achieving from 8- to 682-fold expansion. TIL cultured with IL-2 were cytotoxic against both autologous and allogeneic fresh ovarian CA targets, and no specificity for autologous tumor could be demonstrated in any of the cultures. In all fresh TIL preparations, CD3+ lymphocytes were the major cell type and contained a high proportion (up to 51%) of activated (IL-2R+) cells as determined by two-color flow cytometry. Sorting of bulk TIL cultures followed by cytotoxicity assays identified the Leu-19+ cells, both CD3+ and CD3-, as effectors of cytotoxicity against autologous and allogeneic tumor cell targets. Cold target inhibition assays showed that allogeneic targets (both ovarian CA and a sarcoma) competed effectively with autologous ovarian CA targets for Leu-19+ effectors in TIL cultures. mAb to Leu 19 or Leu-2a did not block lysis of autologous targets by sorted effectors. OKT3 antibody augmented lysis of autologous targets by CD3+Leu-19- effectors only. These results show that non-MHC-restricted Leu-19+ effectors in cultures of TIL with 1000 U/ml of rIL-2 mediate lysis of autologous and allogeneic tumor cells. The CD3+Leu-19- cells, the main population in these cultures, do not mediate tumor lysis. To determine the phenotype of antitumor effectors in IL-2 cultures of TIL, cell sorting followed by functional assays are necessary. PMID- 3286767 TI - Autoimmune CD4+ T cells interfere with immune tolerance to a thymic-independent antigen. AB - The ability of autoimmune T cell subsets to interfere with tolerization of B cells can be studied by using thymic-independent Ag. We have defined an abnormality within the CD4+ T cell compartment in young NZB and MRL-lpr/lpr mice by studying tolerance of spleen and B cells to the thymic independent Ag, fluorescein-Brucella abortus. Tolerization of spleen cells is defective in MRL lpr/lpr mice, but not MRL-+/+ or C3H.lpr mice, suggesting that the defect requires both the autosomal MRL background and the lpr gene to be present. T enriched cells from NZB mice and from MRL-lpr/lpr mice (but not MRL-+/+ or C3H.lpr mice) reverse tolerance in spleen cells from [NZB X DBA/2]F1 and C3H/HeJ mice, respectively. This interference is removed by treatment with anti-CD4 antibody and C. Supernatants from cultured T cells of NZB and MRL-lpr/lpr mice also prevent tolerance in spleen cells of [NZB X DBA/2]F1 and MRL-+/+ mice, respectively, unless CD4+ cells are removed prior to T cell culture. Removal of T cells from NZB and MRL-lpr/lpr spleen cells allows normal tolerization of B cells, which is abrogated by the addition of syngeneic T cells or cultured T cell supernatants. This effect also depends on the presence of CD4+ T cells. These studies show that in MRL-lpr/lpr mice, through interaction of the lpr and MRL background genes in a T cell subset, and in NZB mice, CD4+ T cells interfere with B cell tolerance to a thymic-independent Ag. PMID- 3286768 TI - Lack of HLA class I and class II antigens on human preimplantation embryos. AB - The expression of HLA Ag on polyploid early human embryonic stages, obtained in an in vitro fertilization and embryo transfer program, was investigated by indirect immunofluorescence tests using a panel of mAb. Neither HLA class I Ag, beta 2-microglobulin, nor HLA class II molecules could be detected on blastomers. The zona pellucida also lacked these Ag, but granulosa cells expressed HLA class I Ag, beta 2-microglobulin, and HLA class II Ag. These results make it likely that the absence of HLA Ag is one of the mechanisms involved in protecting the implanting embryo from rejection by the immunocompetent mother. PMID- 3286769 TI - The influence of IL-1 treatment on the reconstitution of the hemopoietic and immune systems after sublethal radiation. AB - The influence of IL-1 administration on the recovery of the hemopoietic and immune systems from sublethal irradiation was assessed. Mice were irradiated (750 R) and injected twice daily with purified recombinant derived IL-1 beta (200 ng/injection). At various times after irradiation, the functional capacity of the hemopoietic and immune systems was determined. It was found that IL-1 therapy resulted in a significantly greater number of granulocyte-macrophage-CSF responsive colony-forming cells in the bone marrow of the irradiated mice on days 5 and 11 postirradiation but not at later times. In addition the radiation induced neutropenia recovered quicker in the IL-1-treated mice with significantly greater numbers of peripheral blood granulocytes being seen on days 15 and 20 after irradiation. The influence of IL-1 therapy on the recovery of the immune system was also assessed. Of note was the observation that mice receiving IL-1 therapy had chronically hypoplastic thymi. Although thymic cellularity increased with time after irradiation in the control mice, there was no such increase in the IL-1-treated mice. Similarly, the number of pre-B cells in the marrow of these mice was also diminished. Thus, in the IL-1-treated mice the regeneration of the peripheral immune function was retarded, characterized by a general lymphopenia and decreased splenic responses to mitogenic stimuli. PMID- 3286770 TI - H-2-dependent binding of xenogeneic beta 2-microglobulin from culture media. AB - Sera of C57BL/6 mice contained lymphocytotoxic antibodies after injections with syngeneic lymphoblasts. The antibodies were directed against bovine beta 2 microglobulin, a component of the culture medium, and mimicked H-2-specific antibodies by a preferential recognition of target cells expressing certain H-2 Ag. This "polymorphic" reactivity pattern was due to a variable capacity of H-2 molecules associated with bovine beta 2-microglobulin. PMID- 3286771 TI - Neutrophil chemoattractant and IL-1-like activity in samples from psoriatic skin lesions. Further characterization. AB - The IL-1-like neutrophil chemoattractant activity previously reported by us to be present in the stratum corneum of psoriatic skin lesions has now been characterized further. Aqueous extracts of stratum corneum samples from psoriatic lesions and from the heels of normal volunteers were ultrafiltered to yield 10- to 30-kDa fractions. The ultrafiltered psoriatic preparations consistently contained greater neutrophil chemokinetic activity than the normal heel preparations, but in contrast the latter contained markedly greater IL-1 activity than the former. Successive chromatographic purification of psoriatic lesional stratum corneum extracts showed that the neutrophil chemokinetic material previously reported to co-elute with IL-1 activity on reversed phase HPLC, but to be distinct from C5a des arg, could now be separated by anion exchange HPLC into at least four different chemokinetic compounds that were also resolved from the IL-1 activity. The reversed phase HPLC-purified chemokinetic material from psoriatic stratum corneum was also active in a neutrophil chemotaxis assay. These findings show that samples from psoriatic skin lesions contain a group of novel 10- to 30-kDa neutrophil chemoattractant compounds that are distinct from both C5a des arg and IL-1. The contrasting neutrophil chemokinetic and IL-1 activities in psoriatic lesional and normal heel stratum corneum preparations support the finding that the two activities are produced by different compounds. These neutrophil chemoattractant and IL-1-like compounds may be of pathogenic importance in inflammatory skin disease. PMID- 3286772 TI - Non-H-2 histocompatibility antigens encoded by Moloney-murine leukemia virus in Mov mouse strains are detectable by skin grafting and cytolytic T lymphocytes. AB - The integration and expression of Moloney-murine leukemia virus (M-MuLV) into the germ line of Mov mouse strains on the C57BL/6 background results in the expression of a cell-surface Ag with characteristics expected from non-H-2 histocompatibility Ag: the ability to stimulate graft rejection and generation of CTL. However, both the previously studied Mov-3 and Mov-14 strains differ from the coisogenic C57BL/6 strain by different length segments of chromosome derived from the ICR strain in addition to the integrated M-MuLV genome. To conclusively demonstrate that an Ag encoded by M-MuLV is solely responsible for rejection of Mov skin grafts by coisogenic recipients, we have studied additional Mov strains that differ from coisogenic 129 or BALB/c backgrounds only by integration of an M MuLV genome. A total of 129 strain recipients reject skin grafts from two viremic Mov strains, Mov-17 and Mov-18. A total of 129 strain hosts primed with either 1) multiple sets of Mov-17 and Mov-18 skin grafts or 2) single injections of Mov-17 and Mov-18 spleen cells produce M-MuLV-specific CTL that could be boosted in primary mixed lymphocyte culture. Generated CTL were reactive with Con A stimulated lymphoblasts from all tested viremic Mov strains on the B6 and 129 backgrounds as well as B6 lymphomas. Further, we have observed that 129 strain mice reject Mov-9 skin grafts if these skin grafts are transplanted to virgin 129 recipients which have not received prior skin grafts from non-viremic Mov donors. In addition, skin grafts were transplanted from two viremic Mov strains, Mov-15 and Mov-16, to coisogenic BALB/c recipients; rejection of both sets of grafts was observed. However, BALB/c responders did not generate specific CTL after priming in vivo, with either multiple sets of allogeneic grafts or spleen cell injections, and boosting in vitro. These observations confirm the ability of integrated and expressed M-MuLV genomes to encode what is operationally defined as a non-H-2 histocompatibility Ag. PMID- 3286773 TI - Functional analysis of mononuclear cells infiltrating into tumors. III. Soluble factors involved in the regulation of T lymphocyte infiltration into tumors. AB - We have analyzed the mechanisms controlling the accumulation of T lymphocytes in tumor tissues. Spleen cells, left or right popliteal lymph node cells, and tumor infiltrating cells were obtained from tumor-inoculated rats and were cultured for 24 h. Culture supernatants were obtained and assessed for lymphocyte migration factor (LMF) activity with the use of a modified Boyden chamber. We found that tumor-infiltrating cells derived from T-9-sensitized rats produced LMF. Two waves of LMF production were observed. The first wave of LMF production was detected between 6 and 12 h (LMF-a) and the second wave of LMF production was detected between 4 and 6 days (LMF-4d and -6d) after tumor inoculation. The tumor infiltrating cells consisted of heterogenous cell populations. We found that only tumor-infiltrating neutrophils of T-9-sensitized rats produced LMF-a. Five peaks of LMF (A through E) were detected upon fractionation of LMF-a using Mono Q anion exchange column chromatography. Peak D exhibited the strongest activity. The action of peak D was chemotactic, but not chemokinetic. The m.w. of peak D was 33,000 and 70,000. Only W3/25 (+) (helper/inducer) T cells were found to be sensitive to peak D. The production of LMF-a by purified tumor-infiltrating neutrophils in vitro is in agreement with the histologic observation that the infiltration of neutrophils precedes the appearance of W3/25 (+) T cells in tumor tissues of T-9-sensitized rats. It is thus likely that peak D of LMF-a is responsible for the infiltration of T lymphocytes into tumor tissues. PMID- 3286774 TI - The use of nitrocellulose immunoblots for the analysis of antigen recognition by T lymphocytes. AB - Antigen insolubilised on nitrocellulose is able to activate T lymphocytes following presentation by appropriate accessory cells. Furthermore, complex mixtures of antigens can be fractionated by polyacrylamide gel electrophoresis under denaturing conditions (SDS-PAGE), transferred to nitrocellulose membranes and then added to T cell proliferation assays. This allows a direct screening for recognition of individual polypeptides by monoclonal and polyclonal T cell populations, without a requirement for extensive biochemical purification and in the absence of initial serological preselection of antigen. The potential use of this technique for screening of recombinant DNA libraries for expression of antigens recognised by T cells is also illustrated. The technical aspects of T cell recognition of solid-phase antigen and its application to the identification of immunodominant epitopes with the potential to modulate T cell-mediated immunity is reviewed. PMID- 3286775 TI - Production of monoclonal antibodies to serum antigens in colorectal carcinoma. AB - Two monoclonal antibodies (mAb) to colorectal cancer were produced using a novel immunization technique. This involved immunizing mice with whole serum obtained from patients with cancer of the colon (three with metastatic disease) and resulted in antibodies which were reactive with colonic tumor tissue by immunoperoxidase testing. Two mAbs (O-1, I-1) were isolated which were non reactive with normal tissue and with tissues obtained from subjects with benign disease but were reactive with 34/50 (formalin-fixed) colon carcinoma specimens. Further testing on cell lines and other malignant tumors suggested both mAbs detect carcinoembryonic antigen (CEA) as their reactivities were similar to a known anti-CEA antibody, and they reacted with CEA in a solid-phase radioimmunoassay. The two mAbs were found to react with the same or closely associated epitopes on CEA by competitive tests. As the anti-CEA antibodies were made to serum (rather than tissue) CEA, it was possible that unique, highly specific mAb has been produced, particularly as there was a selective reaction of the mAbs for malignant but not normal tissues. A serum test with mAb I-1 was developed which detected raised serum CEA levels in 3/24 patients with benign colonic lesions, 7/19 patients with pancreatic cancer, 5/25 patients with colonic cancer but not in 20 normal individuals. There was direct correlation between these results and a commercially available CEA test kit. PMID- 3286776 TI - Quantitation of related proteins by Western blot analysis. AB - A spectrophotometric assay for quantitation of related proteins following Western blot analysis is described. Proteins were separated by polyacrylamide gel electrophoresis and electrophoretically transferred to nitrocellulose. In the system utilized in this study, immobilized interleukin-1 (IL-1) proteins were identified by ELISA reaction using a rabbit antibody specific for IL-1 beta. Subsequently, the membrane was probed with goat anti-rabbit antibody conjugated to horseradish peroxidase and IL-1 proteins were detected by incubation with 4 chloro-1-naphthol and hydrogen peroxide. The stained IL-1 bands were cut out, exposed to the peroxidase chromogenic substrate, o-phenylenediamine (OPD), and hydrogen peroxide and the rate of reaction was determined spectrophotometrically at 490 nM. A linear relationship between enzyme activity and IL-1 concentration was observed from 10 to 1000 ng/lane. Thus, this represents a sensitive and specific method for quantitating small amounts of IL-1 in complex protein mixtures. PMID- 3286777 TI - Founder's lecture. A tribute to Louis Pasteur. PMID- 3286778 TI - Abnormal sequence of expression of differentiation markers in psoriatic epidermis: inversion of two steps in the differentiation program? AB - This immunohistologic study was undertaken to compare epidermal differentiation in normal and psoriatic skin. Although basal cells retain a normal phenotype in this disease, suprabasal layers exhibit abnormal sets of differentiation markers. The 67-kD keratin and Bd5 antigen, which are found in normal epidermis immediately above the basal layer, appear several layers higher in involved psoriatic epidermis. On the contrary, KF2 antigen, which is found in the upper spinous layers of normal epidermis, appears more precociously in psoriatic epidermis. Paradoxically, in this disease characterized by the absence of a granular layer, some markers specific for this layer in normal skin, such as involucrin and transglutaminase, appear in lower skin cell layers, while other granular markers, such as filaggrin, are either absent or found in the parakeratotic scales. These results point out the existence in psoriasis of a suprabasal cell population characterized by a set of markers that are never coexpressed in normal epidermis. The existence of this abnormal population of cells can be explained as the result of the inversion of two steps in the differentiation program. Thus, instead of an inability to express a given differentiation marker, psoriasis seems to be characterized by an abnormal sequence of expression of these markers. PMID- 3286779 TI - Limited proteolysis of high molecular weight histidine-rich protein of rat epidermis by epidermal proteinases. AB - Epidermal proteinases, which may be involved in proteolysis of Mr greater than 300k histidine-rich protein in epidermis, were studied by SDS-PAGE analysis. Mr greater than 300k histidine-rich protein was extracted from granular cells of 2 day-old rats in citric acid-sucrose solution and separated from proteinases and smaller Mr proteins by Sephacryl S-300 column chromatography. The proteinase-free histidine-rich protein was stable in pH 3.5-9 at 37 degrees C for 12 h. Proteinases were partially purified from rat epidermis and inhibitor spectrum determined for each enzyme. Limited hydrolysis of Mr greater than 300k histidine rich protein yielded a derivative of Mr 56k with cathepsin D at pH 3.5-7.5 and a serine proteinase at pH 7-9. Further proteolysis of Mr 56k protein to Mr 44k and a doublet of Mr 45k and 47k also was detected with cathepsin D at pH 3.5 and 7.5, respectively, while the serine proteinase degraded Mr 56k protein to a number of protein bands. Cathepsins B and L degraded Mr greater than 300k protein but no specific predominant product was identified. We suggest that cathepsin D and the serine proteinase may play a role in in situ processing of histidine-rich protein during cornification. PMID- 3286780 TI - Comparison of proteinase activities in squamous cell carcinoma, basal cell epithelioma, and seborrheic keratosis. AB - The correlation between proteinase activities and invasive and metastatic potentials was investigated by comparing three different kinds of tumors. Extracts from tumor homogenate of 11 squamous cell carcinoma (SCC), 5 basal cell epithelioma (BCE), and 8 seborrheic keratosis (SK) were prepared in order to examine the activity of acid phosphatase and proteinases such as cathepsin B and D, type I and IV collagenase, and plasminogen activator (PA). There was no difference observed between acid phosphatase and cathepsin D activities among the three tumors. Cathepsin B and PA activities were slightly elevated in SCC. Type I collagenase activity of SCC was 9-fold higher than that of SK (p less than 0.01), and type IV collagenase was 3-fold higher per tissue DNA (p less than 0.05). Type I and IV collagenase of BCE were elevated per tissue protein but not elevated per tissue DNA. Correlation was found between the level of cell differentiation in SCC and the activities of cathepsin B, PA, and type I collagenase. Poorly differentiated SCC exhibited a tendency to have higher proteinase activities. Proteinases that showed high activities in malignant tumor homogenate may be related to the degradation of the surrounding cell matrix in addition to intracellular metabolism. Type I and IV collagenase, in cooperation with cathepsin B and PA, might play a major role in invading the dermal stroma and basement membrane. PMID- 3286781 TI - Pneumocystis carinii pneumonia: diagnosis. AB - Pneumocystis carinii pneumonia occurs at some point in the course of illness in approximately 85% of patients with AIDS. Because of the frequency of P. carinii pneumonia and because it is readily treatable, prompt, accurate, and efficient diagnostic schemes are extremely important. The clinical presentation is generally characterized by fever, nonproductive cough, and shortness of breath. Such symptoms in a patient from a recognized HIV transmission category should prompt a diagnostic evaluation to identify P. carinii or other opportunistic infections. A chest radiograph usually provides an objective indication of lung disease. Pulmonary function tests, particularly the DLCO and lung imaging using 67Ga-labeled citrate, are useful screening tests in patients with normal chest radiographs. Examination of sputum induced by inhalation of aerosolized hypertonic saline is a very useful means of identifying P. carinii. Bronchoalveolar lavage is nearly 100% sensitive to the presence of P. carinii and should be performed in patients who have a nondiagnostic sputum examination. Transbronchial biopsy increases the overall yield for diagnoses other than P. carinii and should be performed in patients in whom bronchoalveolar lavage does not provide a diagnosis. Because of the effectiveness of sputum examinations and bronchoscopic procedures, open lung biopsy is rarely necessary. PMID- 3286782 TI - Genetic evidence of clonal descent of Escherichia coli O157:H7 associated with hemorrhagic colitis and hemolytic uremic syndrome. AB - Genetic relatedness of 100 strains of Escherichia coli, isolated mostly from patients with hemorrhagic colitis or hemolytic uremic syndrome, was determined for chromosomal genotypes on the basis of allelic variation at 17 enzyme-encoding loci detected by multilocus enzyme electrophoresis. Fifteen of the 17 loci were polymorphic, with an average of 3.5 alleles per locus. Comparison of the observed combinations of alleles among strains revealed 25 distinct multilocus genotypes, which were used to define naturally occurring cell lineages or clones. Cluster analysis of the genotypic data revealed that isolates of serotype O157:H7 fall into a well-defined group of clonal genotypes that share alleles, on average, at 90% of their enzyme loci. The O157:H7 clonal group is only distantly related to other Verotoxin-producing strains belonging to other serotypes of E. coli. The results strongly support the hypothesis that isolates of E. coli O157:H7 obtained from geographically separate outbreaks and sporadic cases of hemorrhagic colitis and hemolytic uremic syndrome belong to a pathogenic clone that occurs throughout North America. PMID- 3286783 TI - Use of norfloxacin to treat chronic typhoid carriers. AB - High relapse rates and low tolerability to ampicillin characterize present therapy for carriers of Salmonella typhi. Norfloxacin, a carboxyquinolone with a 90% minimum inhibitory concentration for S. typhi of less than or equal to 0.5 micrograms/mL, is a promising alternative. Carriers of S. typhi were treated in a double-blind trial with either norfloxacin (400 mg) or matching placebo given every 12 h for 28 d. Twelve assessable individuals were treated in each group. After therapy, 11 of 12 individuals treated with norfloxacin had negative stool and bile cultures for S. typhi. All placebo-treated carriers still had positive cultures immediately after therapy. Subsequently, 11 individuals were treated openly with norfloxacin. S. typhi was eradicated in seven of 11. Overall, the eradication rate for 23 individuals treated with norfloxacin was 78%. Eighteen individuals were followed up for one year, and their stool and/or bile cultures remained negative. From our results, norfloxacin is an effective and well tolerated antimicrobial agent for eradicating the chronic typhoid carrier state. PMID- 3286784 TI - Interaction of Candida albicans with genital mucosal surfaces: involvement of fibronectin in adherence. PMID- 3286785 TI - Inhibitory activity of interleukin 2-activated lymphocytes on human granulocyte precursors (CFU-g). AB - Interleukin 2-activated lymphocytes (lymphokine-activated killer [LAK] cells) cultured from 2 to 14 days were added to the cultures of granulocyte precursors (CFU-g). The LAK cells inhibited colony formation of granulocyte precursors; LAK cells cultured for five days showed the strongest inhibitory activity on colony formation. The presence of cell-to-cell interaction between LAK cells and bone marrow mononuclear cells (BMNC) in CFU-g assays emphasized the LAK cell-derived colony inhibitory activity (LAK-CIA), but cell-to-cell interaction was not always a requirement for LAK-CIA, since LAK cells were also found to inhibit colony formation without such interaction. This report shows that LAK cells can inhibit in vitro colony formation of granulocyte precursors. We therefore concluded that the observed CIA is caused by soluble factor(s) derived from LAK cells, and that E-rosette-forming cells are manifesting LAK-CIA. PMID- 3286786 TI - Evaluation of ELISA and IHAT in immunodiagnosis of bancroftian filariasis using delipidized L. carinii antigen. PMID- 3286787 TI - The gall bladder as a cause of dyspepsia in Egyptian schistosomal hepatosplenomegalic patients. PMID- 3286788 TI - Vector competence to Wuchereria bancrofti in Culex pipiens collected from the Nile Delta. PMID- 3286789 TI - [Unwinding of double-helix promoted by recA protein and homologous pairing in genetic recombination]. PMID- 3286791 TI - [PAF and its physiological significance in normal tissue]. PMID- 3286790 TI - [Chemistry and biochemistry of unusual branched fatty acids with pheromonal activity from mature male goat]. PMID- 3286792 TI - [The T-cell antigen receptor and T-cell antigen recognition]. PMID- 3286793 TI - [Morphogenesis of TMV by self-assembly]. PMID- 3286794 TI - [46,XY gonadal dysgenesis without H-Y antigen--a case report]. PMID- 3286795 TI - Skin smears and the bacterial index (B) in multiple drug therapy leprosy control programs: an unsatisfactory and potentially hazardous state of affairs. PMID- 3286796 TI - Allergy and immunity in leprosy: are these concepts becoming obsolete? PMID- 3286797 TI - Determination of the D and L configuration of phenolic glycolipids of M. leprae and M. bovis. PMID- 3286798 TI - Effect of shipment of skin-biopsy specimens to a distant laboratory on viability of Mycobacterium leprae. PMID- 3286799 TI - Vaccination of human volunteers with heat-killed M. leprae: local responses in relation to the interpretation of the lepromin reaction. AB - The early (Fernandez) and late (Mitsuda) lepromin reactions were closely examined in a group of healthy, BCG-vaccinated individuals who were given four doses of a heat-killed, armadillo-derived vaccine, i.e., 1.5 X 10(7), 5 X 10(7), 1.5 X 10(8), and 5 X 10(8) bacilli. There was a clear dose-response relationship for both the early and late reactions with no leveling of the responses within the range of doses examined. While the early response was negative in most of the volunteers, the late response was positive in all of the volunteers. No association was found between the early lepromin test and the pre-vaccination skin test to PPD. There was also no association between the early lepromin test and the pre-vaccination skin test response to a soluble Mycobacterium leprae antigenic preparation (MLSA) in general, but there was a good correlation between these two parameters at the highest vaccine dose. The late lepromin response showed no association with either the prevaccination or post-vaccination skin test response to PPD. However, there was a significant correlation between the late lepromin response and the post-vaccination skin test response to MLSA. In general, no association could be found between the in vivo skin tests and the in vitro lymphocyte transformation test (LTT). Thus, the lepromin test is essentially a vaccination which elicits a specific response to M. leprae antigens provided that the dose of armadillo lepromin given is higher than 5 X 10(7). Therefore, it is unsuitable as a diagnostic test for leprosy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286800 TI - Soluble antigen of M. leprae coupled with liposomes elicits both "early" and "late" delayed hypersensitivity skin reactions. AB - The soluble antigen(s) of Mycobacterium leprae was(were) coupled to liposomes and used for skin testing of leprosy patients, hoping that this mode of antigen presentation would be identical to that of integral lepromin. The liposomized antigen(s) elicited both early (24-48 hr) and late (3-4 weeks) delayed-type hypersensitivity reactions, true to the nature of lepromin, unlike the soluble antigen(s) alone which elicit(s) only the early reaction. PMID- 3286801 TI - Nutrition in leprosy: a review. AB - The literature relating diet to leprosy is abundant between 1900 and 1960, peaking around 1940. Dietary factors that appear to influence the etiopathogenesis of Hansen's disease include: vitamin A, vitamin B group, vitamin C, vitamin D, vitamin E, calcium, and zinc. We noted a frequent lack of detailed dietary data in much of the literature cited. This is particularly true when the thrust of the investigation is not dietary. The literature strongly suggests the beneficial influence of adequate diet on the outcome of Hansen's disease and the deleterious effect of a deficient diet. In contrast with the paucity of reported hard data in the previous reviews concerned with the effect of nutrition and diet on leprosy, is the increasing volume of literature reviews and experimental studies showing the profound impact of nutrition and diet on the immune system of man and laboratory animals. That diet has a global, if poorly understood, effect on the immune system is being increasingly recognized. The difficult question that remains is how to use this information in the control and prevention of disease. Therefore, we believe that more emphasis should be given to diet in the study of this important worldwide disease in light of the current understanding of biochemistry and immunology. PMID- 3286802 TI - The 1987 Journal--a continuing perspective. PMID- 3286803 TI - [A case of myasthenia gravis with hypergonadotropic hypogonadism]. PMID- 3286804 TI - [Two cases of chronic idiopathic intestinal pseudoobstruction with abnormal esophageal motility and bilateral hydronephrosis]. PMID- 3286805 TI - [Chronic Budd-Chiari syndrome with abnormal collaterals; a case report]. PMID- 3286806 TI - [Two cases of nontyphoidal Salmonella septicemia in patients with immunocompromised hosts]. PMID- 3286807 TI - Nonspecific airway hyperreactivity in nonsmoking bituminous coal miners demonstrated by quantitative methacholine inhalation challenge. AB - Because nonsmoking underground bituminous coal miners often have symptoms of chronic bronchitis and because a high proportion of patients with chronic bronchitis have nonspecific airway hyperreactivity, we hypothesized that coal miners would have a higher prevalence of nonspecific airway hyperreactivity than nonminer nonsmoking control subjects. By use of a quantitative methacholine provocative inhalation challenge test, we evaluated 22 underground bituminous coal miners and 41 nonminer age- and sex-matched control subjects from the same community. We found that a significantly higher proportion of miners had reactivity to inhalation of 100 mg/ml or less of methacholine, X2 = 6.19, p less than 0.02. The slope of phase III of the single-breath nitrogen washout test was higher in the reactive miners than in the nonreactive miners and reactive control subjects, even though the reactive miners had only been working underground 8 +/- 3 (SEM) years. Within the reactive miner subgroup, the higher the reactivity to methacholine, the more abnormal the slope of phase III of the single-breath nitrogen test, r = 0.79. Miners had more symptoms than controls; the presence of methacholine reactivity was not associated with increased symptoms. We conclude that the bituminous coal miners in our study had an increased prevalence of nonspecific airway hyperreactivity and that within the reactive miner subgroup there was evidence of early airways disease. We speculate that the nonspecific airway hyperreactivity may be related to, and also be an indicator of, lung injury in coal miners. PMID- 3286808 TI - Maxwell M. Wintrobe (1901-1986). PMID- 3286810 TI - Macrophages, myeloperoxidase, and Mycobacterium lepraemurium. PMID- 3286809 TI - In vivo labeling of resident peritoneal macrophages. AB - A novel method for labeling resident peritoneal macrophages (M phi) by injection of a dye into the peritoneal cavity is described. The dye, which fluoresces green, is selectively taken up by the resident M phi. Dye labeled cells can be further characterized by labeling of cell surface antigens with monoclonal antibodies (Mabs) and phycoerythrin conjugated second antibody. After such labeling with the Mabs F4/80 or Mac 1 the resident M phi were labeled by both the green dye and the red Mab markers, while recruited M phi or neutrophils were labeled with just the red Mab; the two populations of cells were readily distinguished by two-color flow cytometry. This technique enabled identification of resident and recruited M phi in each animal without the use of radioisotopes, irradiation, or bone marrow ablation. Sufficient numbers of cells can be analyzed from each animal so that individual animals could be evaluated. We found no adverse effects of this labeling technique on expression of cell surface antigens or M phi mediated cytotoxicity. We did find evidence that the i.p. injection induced a mild inflammation in the peritoneal cavities of animals injected with either the dye or the balanced salt solution vehicle. Examination of the intracellular staining pattern indicated that the label rapidly sequestered in the cytoplasm of the M phi, possibly in the lysosomes. Dye solubility studies showed that the dye was partially soluble at the concentration used for in vivo labeling. We hypothesize that the M phi labeling occurred by a combination of phagocytosis of dye aggregates and endocytosis of labeled plasma membrane. PMID- 3286811 TI - Hospital Medicare payments. PMID- 3286812 TI - High resolution, low voltage scanning electron microscopy of uncoated yeast cells fixed by the freeze-substitution method. PMID- 3286813 TI - Anomalous behaviour of 86Rb as a tracer for transintestinal potassium transport in the fowl, Gallus domesticus. PMID- 3286814 TI - Asphyxial deaths as a result of aspiration of dental appliances: a report of three cases. AB - Three cases of asphyxial deaths as a result of aspiration of dental appliances are presented. The possible association of this condition with resuscitative effort and patient debilitation is discussed. A recommendation to improve diagnosis and facilitate resuscitation is offered. PMID- 3286815 TI - Designer drugs: past history and future prospects. AB - Historically, drugs of abuse have come from two sources: plant products and diverted pharmaceuticals. Today, new, totally synthetic drugs produced by clandestine laboratories have become an increasingly important source of abused substances. Of particular concern are the fentanyls, a family of very potent narcotic analgesics, which first appeared on the streets in California in 1979 under the name "China White". At least 10 different analogs have been identified to date and are thought to be responsible for over 100 overdose deaths. The fentanyls are not used by any particular ethic or age group, but rather by the general heroin using population. Their use, however, does seem to be restricted to suburban, rather than urban areas, and almost exclusively to the state of California. The most potent analogs, the 3-methyl- and beta-hydroxy-fentanyls, may be up to 1000 times as potent as heroin, but are not chemically related to the opiates and therefore not detected by conventional narcotic screening tests. However, using a sensitive radioimmunoassay highly specific for the fentanyls they can be measured at the very low concentrations observed in body fluids, generally less than 10 ng/mL. It is likely that, as efforts to restrict the importation of natural products and prevent diversion of pharmaceuticals become more effective, the fentanyls and other synthetics will become increasingly important drugs of abuse. PMID- 3286816 TI - Biochemical and serological comparisons of Australian bunyaviruses belonging to the Simbu serogroup. AB - Comparative analysis of the structural and possible non-structural proteins of seven Simbu serogroup bunyaviruses isolated in Australia revealed them all to be similar in size to those of Bunyamwera virus, the prototype of the Bunyavirus genus. The molecular weights of the structural proteins for these bunyaviruses (Akabane, Aino, Tinaroo, Douglas, Peaton, Facey's Paddock and Thimiri viruses) were 193K to 205K (L), 103K to 125K (G1), 33K to 37K (G2) and 25K to 26K (N). Analysis of the virion RNA of three viruses (Akabane, Douglas and Facey's Paddock) showed them all to be similar to Bunyamwera virus RNA, apparent Mr values being 2.6 X 10(6) (L), 1.4 X 10(6) to 1.9 X 10(6) (M) and 0.24 X 10(6) to 0.42 X 10(6) (S). Host cell protein synthesis was switched off late during infection, revealing four structural proteins L, G1, G2 and N. Comparative analysis of these protein profiles in infected Vero cells showed each virus, although similar, to be unique and easily identified; this method of comparison was efficient and rapid compared to the difficulty in obtaining adequate amounts of purified virus for analysis. Additionally, for all viruses except Douglas, two to four possible non-structural proteins were identified, with an Mr range from 12K to 30K. The viruses Akabane and Tinaroo, which have previously been shown to cross-react by plaque inhibition virus neutralization tests, were readily distinguished in migration of the G1 glycoprotein and by analysis of plaque reduction virus neutralization data using linear regression analysis of the dose response curves. Using these same analyses, the differences between Aino and Douglas viruses, also related by plaque inhibition, were even greater. Application of the biochemical analysis of virus-specified proteins and some serological comparisons identified a mixed pool of different viruses in two unknown isolates grouped as Simbu serogroup viruses, and further identified a potential teratogenic strain in one of the two pools. PMID- 3286817 TI - Behavioral and sociocognitive correlates of ratings of prosocial behavior and sociometric status. AB - Although peers' and teachers' evaluations of children's prosocial behavior and peers' sociometric ratings frequently have been used in studies of social development, the validity of young children's ratings of others has been questioned, as has that for teachers' ratings of prosocial behavior. In this study, preschoolers' ratings of peers' sociometric status and prosocial behavior, as well as teachers' ratings of children's prosocial dispositions, were obtained. These were correlated with children's naturally occurring prosocial or social behavior; ratings of prosocial behavior also were correlated with children's prosocial moral reasoning and prosocial self-attributions. Peers' sociometric ratings were positively related to children's sociability whereas prosocial ratings were related to helping (but not sharing) behavior. Teachers' ratings of prosocial behavior were not related to frequency of prosocial behaviors, but were positively related to developmentally mature moral judgments and self-reported motives. PMID- 3286818 TI - The right hemisphere in imagery, hypnosis, rapid eye movement sleep and dreaming. Empirical studies and tentative conclusions. AB - Visual imagery, hypnosis, creativity, dreams, and "imagination" have all been linked conceptually by theoreticians of various schools to an increased influence of right hemispheric processes compared with left hemispheric processes. This paper reviews empirical studies that have addressed the issue of whether there is an increased activation or efficiency of right hemispheric processes during imagery, hypnosis, rapid eye movement sleep, and dreaming. Overall, there is considerable evidence supporting the notion of increased right hemispheric activation in imagery. There is also some evidence supporting this view for rapid eye movement sleep, dreaming, and hypnotic phenomena. For the most part, however, the lack of adequate studies, contradictory or negative findings, and moderating variables make it difficult to draw definitive conclusions at this time. PMID- 3286819 TI - Thought disorder among the relatives of schizophrenics. A reaction to Callahan and Saccuzzo. AB - Callahan and Saccuzzo (J Nerv Ment Dis 174:240-242, 1986) claim that there has been no published research on thought disorder (associative cognitive dysfunction) in the first-degree relatives of schizophrenics and interpret the results of their preliminary study as indicative of familial psychopathology. In fact, there have already been numerous published studies on this topic drawing the same broad conclusion. Attention is drawn to these studies, and their findings are described. A fresh approach to research in this area is called for. PMID- 3286820 TI - Fibronectin-like immunoreactivity in Helisoma buccal ganglia: evidence that an endogenous fibronectin-like molecule promotes neurite outgrowth. AB - We examined the distribution of fibronectin-like (FNL) immunoreactivity associated with intact buccal ganglia, cell-cultured buccal ganglia neurons and nonneuronal cells, and brain-conditioned medium from the snail Helisoma. In addition, the possible roles of fibronectin in the regulation of neurite outgrowth were studied. Immunofluorescent staining for FNL antigens revealed intense staining in patches and fibrous arrays over the connective tissue sheaths of buccal ganglia and nerve trunks. Within the ganglia, heavy staining was seen surrounding neurons and in track-like arrangements. In cell cultures, specific staining was associated with nonneuronal cell surfaces and to a lesser degree with the surface of identified neurons. In addition, a noncellular, substrate bound component of brain-conditioned medium displayed FNL immunoreactivity. Since cultured Helisoma neurons require a substrate-associated, brain-derived conditioning factor (CF) in order to elaborate neurites with motile growth cones, we tested whether the FNL immunoreactive substance might act as a neuritotropic agent. Fibronectin antiserum suppressed, in a dose-dependent manner, the CF induced sprouting of identified neurons in isolated cell culture. When added at increasing concentrations to neurons already growing in response to CF, fibronectin antiserum exerted a biphasic effect on neurite elongation; outgrowth was accelerated at low, but inhibited at high, antiserum concentrations. In contrast, growth cone structures associated with motility (filopodia and lamellipodia) were progressively reduced by increasing levels of antiserum. A short peptide derived from fibronectin's cell-binding domain (Arg-Gly-Asp-Ser) also greatly reduced neurite outgrowth. The combined results of this study indicate an abundance of FNL immunoreactive molecules within the CNS of Helisoma, their probable production by nonneuronal cells, and their function as a substrate associated component of CF which promotes growth cone filopodial and lamellipodial activity. PMID- 3286821 TI - Synthesis and microbicidal activity of N-(2-substituted) phenyl ureas and their metal complexes. AB - N-2-carboxyphenyl urea (CPU), N-2-hydroxyphenyl urea (HPU), and N-2 mercaptophenyl urea (MPU) and their Cu(II), Ni(II), Zn(II), Co(II), and Mn(II) complexes were synthesized and characterized by elemental analysis, molecular weight determination, molar conductance, IR and electronic spectral data, and magnetic measurements. Antibacterial activity of these ligands and their metal complexes was determined on gram positive (Staphylococcus aureus) and gram negative (Escherichia coli) bacteria at 35 degrees C. Antifungal activity was determined on common fungi viz. Aspergillus niger, A. nidulense, and Candida albicans by the serial dilution method at 28 degrees C. A considerable increase in the biocidal activity of these ligands on being coordinated with the metal ions was reported in terms of their minimum inhibitory concentration (MIC) values. PMID- 3286822 TI - Developmental expression of neural cell adhesion molecules of oligodendrocytes in vivo and in culture. AB - Previously, we have shown that oligodendrocyte adhesion molecules are related to the 120,000-Mr neural cell adhesion molecule (NCAM-120). In this report, we present further evidence that the oligodendrocyte adhesion molecule is NCAM-120. Studies on the expression of NCAM-120 and other molecular forms of NCAM in vivo in rat brain, in vitro in primary mixed cultures, and in cultures enriched for oligodendrocytes are described. Western blot analysis of rat brain using anti NCAM showed that NCAM-120 first appears at postnatal day 7 and increases in quantity thereafter, coincident with the development of oligodendrocytes in vivo and comparable to the expression of myelin basic protein. Purified oligodendrocytes from 4-week-old rat brains expressed only NCAM-120. Quantitation of various forms of NCAMs in rat brain showed marked age-related differences in the expression of three molecular forms of NCAM. Immunofluorescence analysis showed that oligodendrocytes, at all ages tested, expressed NCAM, but in older oligodendrocytes, the intensity of staining was less. Western blot analysis of oligodendrocyte-enriched cultures showed that from day 1 after isolation (12 days of age) through day 7 after isolation (18 days of age) only NCAM-120 is seen. A possible role for NCAM in myelination and remyelination is discussed. PMID- 3286823 TI - Polygodial, an antifungal potentiator. AB - A series of sesquiterpene dialdehydes was isolated from the East African medicinal plants Warburgia stuhlmannii and Warburgia ugandensis (Canellaceae) as antibiotics, particularly against Saccharomyces cerevisiae, Candida utilis, and Sclerotinia libertiana. Among these sesquiterpene dialdehydes, polygodial [1] exhibited the most potent activity. When tested on S. cerevisiae, polygodial proved to be fungicidal rather than fungistatic. When the cells of S. cerevisiae are treated in vitro with polygodial for 10 min, the cell membrane becomes severely damaged, and many vesicles, possibly formed from the fragmented cell membrane, can be observed within the cytoplasm. The observation of cell membrane lesions led us to propose a rather innovative hypothesis: the use of polygodial to facilitate the transmembrane transport of exogenous chemicals into cells. For example, polygodial could be combined with an antibiotic having poor cell membrane permeability in an effort to increase its antibiotic activity by increasing its ability to gain entrance into the cell. We report here that a remarkably enhanced efficacy was obtained when actinomycin D was used in combination with polygodial. We believe polygodial may be acting as an "advance scout," punching holes in the plasma membrane and gaining an entrance into the cell for an antibiotic previously less effective because of problems with cell membrane permeability. PMID- 3286824 TI - Eradication of palpable intradermal murine bladder tumors by systemic interleukin 2 and cyclophosphamide in C3H mice. AB - The effect of cyclophosphamide on interleukin-2 (IL-2) therapy was investigated using the intradermal MBT-2 tumor in C3H mice. Human recombinant IL-2 (Biogen) was given intraperitoneally at doses ranging from 5,000 to 30,000 U, three times a day for 5 or 11-13 consecutive days beginning on day 10 after tumor implantation. When IL 2 was given alone, mice could not tolerate greater than 5 days of 5,000 U IL 2/injection: Administration of 10,000 and 15,000 U/injection of IL-2 for 5 days resulted in 64% (9 of 14) and 100% (14 of 14) mortality, respectively. Chemotherapeutic agents (cisplatin at 6 mg/kg or JM-8 75 mg/kg) and daily administration of cortisone acetate (75 mg/kg) partially protected mice from IL-2-induced toxic deaths. Coadministration of mannitol showed no protective effect. The combination of IL-2 and CY at 75 or 100 mg/kg, however, dramatically reduced the mortality induced by IL-2 and made it possible to escalate the dose and long-term administration of IL-2. Combination administration of 75 mg/kg CY with 15,000 U/injection of IL-2 for 11-13 days caused tumor regressions and resulted in a 66% (8 of 12) cure rate. PMID- 3286825 TI - Enzyme immunoassay measurement of thymosin beta 4 in human serum. AB - An enzyme immunoassay (EIA) for measurement of human serum thymosin beta 4 is described. Antiserum to synthetic thymosin beta 4, raised in rabbits, is incubated with a standard or serum. The unbound antibody in liquid-phase then binds with solid-phase thymosin beta 4. The EIA is both sensitive and accurate and is capable of detecting as little as 2.5 ng/ml thymosin beta 4 in serum. No cross-reactivity was observed with common serum proteins or other putative thymic hormones. High-performance liquid chromatography of serum samples reveals a single thymosin beta 4 peak that corresponds to the authentic thymosin beta 4 peak in the standard. Human serum levels range from 3 to 82 ng/ml in 142 healthy adult human volunteers. Newborn cord serum levels of thymosin beta 4 are lower than in adults. PMID- 3286827 TI - Does monitoring have an effect on patient safety? Monitoring instruments have significantly reduced anesthetic mishaps. PMID- 3286826 TI - Magnetic resonance imaging of the brain and spine. AB - The efficacy of magnetic resonance imaging (MRI) in the diagnosis of diseases of the central nervous system is reviewed. MRI, computed tomography (CT) and certain radionuclide studies are compared in the evaluation of intracranial tumours, cerebral vascular disease, multiple sclerosis and other white matter diseases, dementia, head injury, infection, epilepsy, spinal lesions and in paediatric central nervous system disorders. The measurement of cerebrospinal fluid volumes and dynamics by MRI is discussed. MRI most clearly has advantages where CT is degraded by bone hardening and streak artefacts (spine, skull base, posterior and temporal fossa, sella and parasellar regions) and in diseases in which the X-ray attenuation of the suspected lesion differs little from normal parenchyma (paediatric brain disorders, demyelination and dysmyelination, early oedema associated with infarction, infection or low-grade infiltrating neoplasm, subacute and chronic haemorrhage and lesions in the spinal subarachnoid space and cord). Elsewhere MRI and CT should be seen as complementary rather than competitive methods of imaging. In spite of an absence of information about the contribution of MRI to management decisions and a lack of rigorous, prospective controlled trials, MRI will play an increasing role in the diagnosis of diseases of the central nervous system. PMID- 3286828 TI - Electroencephalographic monitoring for ischemia during carotid endarterectomy: visual versus computer analysis. AB - In a retrospective study, we compared the use of computer-generated spectral electroencephalographic descriptors with a neurologist's interpretation of raw EEG data. Data were collected from patients undergoing carotid endarterectomy and anesthetized with isoflurane in nitrous oxide and oxygen. The EEG was recorded on magnetic tape during the period immediately before and after occlusion. These tapes were then analyzed off-line using a computer to generate averaged changes in 18 spectral descriptors. A strip-chart of raw EEG before and after the carotid occlusion was interpreted by a neurologist, who assigned changes in the EEG following occlusion to one of four visual inspection groups, depending on the severity of change. A descriptive examination of the distribution of changes in spectral descriptors revealed that no single descriptor adequately reflected the neurologist's interpretation of the raw EEG. Using data from 20 patients, the percent change from preocclusion to postocclusion values for total power, spectral edge frequency, spectral variance, and log spectral variance was examined. Only for the visual inspection group judged by the electroencephalographer to have the most severe ischemic change was there a significant difference in total power and log spectral variance. Although computer-processed EEG devices are of value as trending devices for detecting visual patterns associated with inadequate cerebral perfusion, single descriptors in this study did not consistently reflect a neurologist's diagnosis of ischemia. Single descriptors of spectral EEG analysis may not be sufficient to use as alarm variables in the recognition of cerebral ischemia. PMID- 3286829 TI - Peripheral blood B cell labeling indices are a measure of disease activity in patients with monoclonal gammopathies. AB - Labeling indices (LI) provide a rapid measure of the bone marrow (BM) plasma cell proliferation rate and are useful in the diagnosis and prognosis of monoclonal gammopathies. Because circulating B cells may be a part of the neoplastic clone, we examined peripheral blood B cells that were producing the same cytoplasmic light chain isotype as the patient's monoclonal; protein (M-protein) and determined the peripheral blood LI (PBLI) by a two-color immunofluorescence bromodeoxyuridine method. The 105 patients studied were divided into three disease activity groups by standard clinical criteria. Median PBLI was 0.2% for the 29 patients with inactive monoclonal gammopathies (monoclonal gammopathy of undetermined significance [MGUS] and smoldering multiple myeloma [SMM]), 0.8% for the 35 patients with new, untreated multiple myeloma (MM), and 1.7% for the 41 patients with relapsed MM. These differences between groups were statistically significant (P less than .001, Wilcoxon). Four patients had high PBLI but clinically inactive gammopathy at the time of study, and all developed active MM within 6 months that required treatment. In 92 patients a BMLI was performed simultaneously with the PBLI (rank correlation coefficient, 0.69). In patients with new, untreated MM, use of both tests identified 72% of patients (23 of 32) with high LI, rather than 56% (18 of 32) by BMLI alone or 63% (20 of 32) by PBLI alone. These results suggest that PB B cells bearing the same cytoplasmic light chain isotype as the monoclonal protein are part of the malignant clone and can be kinetically active. The LI of these cells can provide a measure of disease activity and may help to differentiate active from inactive disease. PMID- 3286830 TI - Adjuvant therapy in large bowel adenocarcinoma: long-term results of a Southwest Oncology Group Study. AB - The Southwest Oncology Group (SWOG) colorectal adjuvant study 7510 went through two phases. From 1975 to 1977, 309 patients were randomized to chemotherapy alone or the same chemotherapy plus immunotherapy. From 1977 until 1980, 317 patients were randomized among the same two therapy programs and a control group. With a minimum follow-up in either phase of greater than 7 years, data are now mature. They show no difference in relapse-free survival (RFS) nor overall survival (OS) in either the two-way phase or in the three-way phase. There is no indication, except possibly in one very small subset, that the addition of immunotherapy to chemotherapy provides an improvement in OS or in RFS. Using data from patients accrued after randomization to the control group, we fail to find evidence that either chemotherapy alone or chemoimmunotherapy improves OS or RFS when contrasted to outcomes obtained by patients on the control arm. In fact, we have significant evidence, at the P = .016 level, that chemotherapy does not improve OS by at least 50%; we also have significant evidence, at the P = .011 level, that chemoimmunotherapy will not improve OS by at least 25%. No evidence of efficacy was demonstrated for either treatment regimen, even though enough therapy was given to result in significant toxicities. Acute toxicity was at least moderate, but not fatal, in 75% of patients. Recognizable delayed toxicity included rare cases of fatal renal failure and acute leukemia. PMID- 3286831 TI - Methotrexate/fluorouracil scheduling influences normal tissue toxicity but not antitumor effects in patients with squamous cell head and neck cancer: results from a randomized trial. AB - To test the hypothesis that sequential scheduling of methotrexate (MTX) and fluorouracil (FU) produces a synergistic antitumor effect, we randomized 113 patients with recurrent or locally advanced squamous cell carcinoma of the head and neck to receive MTX-FU either 18 hours apart or simultaneously, with leucovorin rescue. There were 100 patients with locally advanced newly presenting disease and 13 patients with recurrence. Excessive toxicity was observed in the first 11 patients who received MTX 250 mg/m2 administered intravenously (IV) and leucovorin at 36 hours, therefore all subsequent patients received MTX 200 mg/m2 administered IV and leucovorin at 24 hours. FU 600 mg/m2 IV was administered to all patients, and treatment was given on days 1 and 8 of 21-day cycles. The treatment groups were well balanced for known prognostic variables. The response rate was 47.3% (26 of 55) for simultaneous v 44.8% (26 of 58) for sequential therapy. These results exclude a 20% difference in response rate favoring sequential therapy at P = .04. There was no observed difference in survival between the two treatment arms (P = .55) with a minimum follow-up of 8 months. Toxicity was greater in patients who received sequential therapy, and the difference was confined to the gastrointestinal (GI) tract. A comparison of the distribution in maximum Eastern Cooperative Oncology Group (ECOG) toxicity scores during chemotherapy for the two treatment groups showed greater stomatitis (P = .001), diarrhea (P = .04), and overall toxicity (P = .02) for sequential treatment without an observed difference in bone marrow toxicity. The results of this trial indicate that sequential MTX-FU is not superior to simultaneous therapy for the treatment of patients with head and neck cancer. Biochemical modulation of MTX-FU by drug scheduling may occur in vivo and may be organ specific. PMID- 3286832 TI - Primary central nervous system lymphoma. AB - Primary lymphoma of the central nervous system (CNS), including reticulum cell sarcoma, microglioma, and histiocytic lymphoma, represents less than 1% of all primary brain tumors. In the last 10 years, this tumor has tripled in frequency in the nonimmunosuppressed population. By 1991, the tumor will be the most common neurological neoplasm by virtue of the increase in sporadic occurrence and in the acquired immunodeficiency syndrome (AIDS) population. Three percent of AIDS patients will develop this tumor either prior to AIDS diagnosis or during their subsequent course. In addition to acquired immunosuppression, patients with inherited disorders (such as Wiskott-Aldrich syndrome, severe combined immunodeficiency, and X-linked immunodeficiency) and other acquired disorders of the immune system are predisposed to the development of CNS lymphoma. Immunological studies have suggested a role for Epstein-Barr virus in the production of this tumor. Although subtypes exist, non-Hodgkin's lymphoma of the CNS most commonly consists of histiocytic cells or large immunoblastic cells bearing B cell surface markers in close proximity to the lateral and third ventricles. Sixty percent of these deposits are multiple, and subarachnoid invasion is seen in one-quarter of patients. Vitreous involvement of the eye occurring prior to and during the course of CNS lymphoma has been noted in up to 25% of patients. The involvement of multiple areas of the neuraxis, the eye, and multiple intracranial sites often occurs in the absence of obvious systemic lymphoma. Therapeutic trials of brain radiation therapy are associated with median survivals of less than 1 year. Uniform complete responses of intracranial deposits are recorded following chemotherapy with high-dose intravenous methotrexate, CHOP (cyclophosphamide, hydroxydaunomycin/doxorubicin, Oncovin (vincristine), and prednisone), high-dose cytosine arabinoside, and intra arterial methotrexate with barrier modification. PMID- 3286833 TI - Subependymal giant-cell astrocytoma in children. An unusual discrepancy between histological and clinical features. AB - The authors describe five cases of subependymal giant-cell astrocytoma in children in which many clinical, histological, immunohistochemical, and ultrastructural features typical of this tumor were present. However, prominent focal necrosis and mitoses, features usually associated with high-grade tumors, were seen in all cases. Despite the presence of necrosis and mitoses, clinical follow-up studies have revealed a lack of aggressive tumor behavior after surgery alone. The discrepancy between the histological and clinical features in these cases is emphasized so that excessive treatment of a basically low-grade tumor may be avoided. Mast cells were seen in all five cases, often in large numbers. PMID- 3286834 TI - Seymour S. Kety, Louis Sokoloff to receive Hevesy Pioneer Award. PMID- 3286835 TI - William C. Eckelman to be honored for achievement in basic science. PMID- 3286836 TI - Lymphocytic interstitial pneumonitis: a cause of pulmonary gallium-67 uptake in a child with acquired immunodeficiency syndrome. AB - Lymphocytic interstitial pneumonitis (LIP) is currently recognized as a frequent pediatric manifestation of the acquired immunodeficiency syndrome (AIDS). We report the gallium scan findings in a 3-yr-old girl with this disorder and review its clinical, radiologic, and pathologic features. LIP must be a prime consideration in the differential diagnosis of diffuse pulmonary gallium uptake in pediatric AIDS patients. Further experience will afford greater perspective on the diagnostic role that nuclear medicine will ultimately play in this disease. PMID- 3286837 TI - Role of scintigraphy in focally abnormal sonograms of fatty livers. AB - Fatty infiltration of the liver may cause a range of focal abnormalities on hepatic sonography which may simulate hepatic nodular lesions. Discrete deposits of fat or islands of normal tissue which are uninvolved by fatty infiltration may stand out as potential space-occupying lesions on the sonograms. Twelve patients with such focally abnormal ultrasound images were referred for liver scintigraphy with 133Xe and 99mTc colloidal SPECT studies to clarify the issue. These examinations helped identify, in nine of 12 patients, the innocent nature of the sonographic abnormalities which were simply related to the fat deposition process. Further, [99mTc]RBC scans defined the additional pathologic process in three patients in whom actual space-occupying lesions were indeed present in the liver. Scintigraphy has an important role to play in the understanding of focal hepatic ultrasound abnormalities particularly in unsuspected hepatic steatosis. PMID- 3286838 TI - Condensing osteitis of the clavicle: case report and review of the literature. AB - Osteitis condensans of the clavicle is a benign, often painful disorder of unknown etiology manifested by bony sclerosis of the clavicular head with an uninvolved sternoclavicular joint. The case presented demonstrates the characteristic scintigraphic findings of osteitis condensans of the clavicle. A review of the published pathologically proven cases reveals this disorder to have distinctive clinical and radiological features that allow differentiation from infection, neoplasia, and arthritides in most instances. The frequent observation, as in this case, of devitalized bone and marrow fibrosis with remodeling of cancellous bone suggests that osteonecrosis may play an important role in the pathogenesis of this disorder. PMID- 3286839 TI - Positron emission tomography: clinical status in the United States in 1987. ACNP/SNM Task Force on Clinical PET. AB - PET studies are now being used to provide unique clinical information in several conditions. PET is an accurate, noninvasive method of identifying patients with coronary artery disease. Furthermore, PET studies can accurately differentiate patients who will or will not benefit from revascularization procedures. In patients with partial epilepsy being considered for surgery, PET studies provide spatial localization of the focus that complements other tests in improving the surgical management of these patients. PET studies give important diagnostic and prognostic information in the management of patients with gliomas and can direct recurrence of tumor and distinguish it from radiation necrosis. These uses of PET are well documented, and their utility has been independently confirmed in several institutions. Several other areas of research are being pursued with PET, and these will probably develop into clinically useful procedures in the future. PMID- 3286840 TI - Nuclear hepatology: where is it heading now? PMID- 3286841 TI - Measurement of glomerular filtration rate with technetium-99m DTPA: comparison of plasma clearance techniques. PMID- 3286842 TI - The potential of expert systems in nursing. AB - The newly emerging technology of expert systems will not replace nursing decision makers and problem-solvers, but it does promise to serve them as effective "intelligent assistants." An examination of what expert systems are, where expert systems are being used, whether they are possible and economically feasible in nursing, and the benefits, limitations, and future of expert systems, suggest that there is the potential for the development and use of expert systems in some areas of nursing practice, administration, and education. It is the role of nursing administrators to identify and to support the development of those applications that are the most promising. PMID- 3286843 TI - The effective nurse executive's blueprint for success. If we can't do the job, our successors will! PMID- 3286844 TI - Do protein and phosphorus cause calcium loss? AB - The widespread opinion that both protein and phosphorus cause calcium loss is examined. Controlled human studies show that commonly used complex dietary proteins, which have a high phosphorus content, do not cause calcium loss in adult humans. Similarly, a phosphorus intake of up to 2000 mg/d does not have adverse effects on calcium metabolism; however, the type of phosphate contained in carbonated beverages may not behave in the same manner. In contrast, a diet low in protein and phosphorus may have adverse effects on calcium balance in the elderly. Studies with adults suggest that high protein foods do not cause calcium loss. PMID- 3286845 TI - New markers for monitoring occupational cancer: the example of oncogene proteins. AB - Molecular epidemiology is making rapid strides in the area of biologic monitoring for occupational cancer. Approaches are being developed and applied at the level of internal dose indicators (eg, urinary mutagenicity), biologically effective dose indicators (eg, carcinogen adducts), and preclinical response indicators (eg, chromosomal alterations). However, significant questions remain to be answered before these markers can be applied on a wider basis. In particular, it remains unclear how these markers relate to the clinical outcome of significance, namely occupational cancer. Recent developments in the understanding of oncogenes and their protein products offer new opportunities for the molecular epidemiology of occupational cancer through the use of these markers which seem to be critically involved in the oncogenic process and closely related to disease outcome. Thus, for example, through the application of immunoblotting of urine or serum with monoclonal antibodies to various oncogene proteins in cohorts of workers with potential carcinogen exposure, it may be feasible to identify those individuals most at risk for the development of occupational cancer at a sufficiently early stage that the oncogenic process could be aborted. PMID- 3286846 TI - A paradigm for perspective. Occupational medicine in a deregulatory era: the beginnings, 1835-1970, Edwin Chadwick, John Farr, through Alice Hamilton. PMID- 3286847 TI - Transvaginal sonography provides a sharper view into the pelvis. AB - Transvaginal sonography with a high-frequency probe, a recent development gaining clinical application, obtains better image resolution of deep pelvic organs. Uses of transvaginal sonography include diagnosis and treatment in gynecology, infertility, and early pregnancy. Acceptance by health-care providers and patients is widespread. Advantages include greater clinical capability, increased efficiency, and reduced costs. The nurse's role in patient education and management is a vital component of the care of the patient undergoing transvaginal sonography. PMID- 3286848 TI - Identifying psychosocial obstacles to breastfeeding success. AB - Breastfeeding is an intimate process that requires psychosocial adjustment as well as technical skill. This article reviews research on the relationships of personality, family and social environments, attitudes, and emotional states to breastfeeding outcomes. Risk factors for breastfeeding difficulties are discussed, alternative feeding plans are outlined, and interventions to address psychosocial needs are described. PMID- 3286849 TI - Management of hemolytic-uremic syndrome. PMID- 3286850 TI - Festschrift in honor of Thomas K. Oliver, Jr. PMID- 3286851 TI - Thomas K. Oliver and the growth of neonatology. PMID- 3286852 TI - Role of certification in medicine: past, present, and future. PMID- 3286853 TI - Prevention of early-onset group B streptococcal sepsis. PMID- 3286854 TI - Gastroesophageal reflux and respiratory disease in children. PMID- 3286855 TI - Pelvic ultrasonography in girls with precocious puberty, congenital adrenal hyperplasia, obesity, or hirsutism. AB - Real-time ultrasonography of the pelvic organs was performed on 151 girls with various complete and incomplete forms of precocious puberty, 20 girls with congenital adrenal hyperplasia, 20 with hirsutism, 18 with obesity, and 133 age matched normal girls. Uterine and ovarian volumes were calculated and the ovarian morphologic picture was classified as homogeneous, nonhomogeneous (less than three small cystic areas), microcystic (four or more small cystic areas less than 9 mm in diameter), follicular (at least one cystic area greater than 9 mm), and macrocystic (large cystic area greater than 20 mm). Ultrasound imaging allowed an easy distinction between true precocious puberty and premature thelarche or idiopathic premature adrenarche. It was also helpful in the diagnosis of transient sexual precocity, although in these cases the differential diagnosis of precocious puberty can be difficult. In postmenarcheal patients with congenital adrenal hyperplasia, ultrasound study showed a low uterine volume and, frequently, a macrocyst in the ovary. In hirsute girls and in a few obese patients, ovaries had an increased volume and a microcystic structure, similar to those in polycystic ovary syndrome. Pelvic ultrasonography can be useful not only in diagnosing disorders in sexual development but also for greater understanding of the pathogenesis of these and other disorders. PMID- 3286856 TI - Effect of timing of cerebral ultrasonography on the prediction of later neurodevelopmental outcome in high-risk preterm infants. AB - To determine the predictive value of cranial ultrasonographic examination in high risk preterm infants at different postnatal ages, we scanned 110 infants less than or equal to 32 weeks gestational age at 1, 2, 3, and 6 weeks postnatal ages and at 40 weeks postconceptional age (PCA). Cranial abnormalities detected by ultrasonography at each postnatal age of examination were classified as minor (periventricular superolateral echogenicity with or without intraventricular hemorrhage, grades 1 to 3) or major (cystic periventricular leukomalacia with or without intraventricular hemorrhage, grade 4) and correlated with neurodevelopmental outcome determined by 1 year of age. Major abnormalities detected by ultrasonography were present in four infants at 1 week, four at 2 weeks, eight at 3 weeks, and 11 infants at 6 weeks and 40 weeks PCA, respectively. Nineteen infants (17%) had moderate to severe functional handicaps defined as cerebral palsy, cognitive or visual deficit, or deafness. The positive and negative predictive values of ultrasound examinations, with regard to later neurodevelopmental outcome, improved with increasing postnatal age at examination and was best at 40 weeks PCA. Negative results of ultrasound study at 40 weeks PCA most correctly predicted satisfactory outcome. Although only 58% of moderately to severely handicapped infants were correctly identified by ultrasound examination at 40 weeks PCA, all infants with major ultrasonographic abnormalities at 40 weeks PCA had moderate or severe handicap. Our data demonstrate that the timing of cerebral ultrasonography is important in the prediction of later neurodevelopmental outcome in high-risk preterm infants. PMID- 3286857 TI - Successful management of congenital atrioventricular block associated with hydrops fetalis. PMID- 3286858 TI - Effect of erythromycin on blood cyclosporine concentrations in kidney transplant patients. PMID- 3286859 TI - Microbial transformation of the antihistaminic drug triprolidine hydrochloride. AB - The production of a known mammalian metabolite of the antihistamine triprolidine through fungal metabolic transformation has been demonstrated. The filamentous fungus Cunninghamella elegans ATCC 9245 was grown in Sabouraud dextrose broth containing triprolidine hydrochloride monohydrate. One major metabolite was extracted with methylene chloride, isolated by high-performance liquid chromatography, and identified by its proton-nuclear magnetic resonance and desorption chemical ionization mass spectral properties as hydroxymethyl triprolidine (2-[1-(4-hydroxymethylphenyl)-3-(1-pyrrolidinyl-1-propenyl)] pyridine). After 240 h of incubation, the hydroxymethyl derivative represented approximately 55.0% of the initial dose. Fungal oxidation of hydroxymethyl triprolidine to the corresponding carboxylic acid triprolidine derivative (also a known mammalian triprolidine metabolite) was not observed. No mutagenic activity was observed for triprolidine and hydroxymethyl triprolidine by reversion of Salmonella typhimurium strains TA97, TA98, TA100, and TA104 at concentrations up to 1000 and 200 micrograms/plate, respectively. These results suggest that the fungal metabolism of triprolidine to the hydroxymethyl derivative occurs predominantly through pathways which do not result in mutagenic activation. Incubation of C. elegans with triprolidine under an 18O2 atmosphere and subsequent electron impact mass spectral analysis of the hydroxymethyl triprolidine formed indicate that molecular oxygen was incorporated into the methyl group and suggest a mono-oxygenase catalyzed reaction. This study parallels previous studies on the mammalian metabolism of triprolidine and clearly indicates that the microbial transformation of triprolidine is a useful alternative for the synthesis of potential mammalian metabolites. PMID- 3286860 TI - Liquid chromatographic procedure for the quantitative analysis of carboplatin in beagle dog plasma ultrafiltrate. AB - A specific and reproducible high-performance liquid chromatographic (HPLC) procedure was developed for the quantitative analysis of carboplatin (JM-8) in dog plasma ultrafiltrate. Plasma ultrafiltrate samples were generated using Amicon Centrifree micropartition systems or Amicon Centriflo cones, and injected onto a microBondapak NH2 column. The mobile phase consisted of acetonitrile:methanol:0.005 M sodium perchlorate, pH 2.4 (77-75:13-15:10, v/v/v); the flow rate was 1.5 mL/min. Detection was performed by monitoring UV absorbance of the column effluent at 229 nm. Carboplatin eluted between 9.5 and 11.0 min. The internal standard, JM-10, eluted between 11.0 and 13.0 min. The peak height ratio of carboplatin:internal standard versus carboplatin concentration was linear over a range of 0.2 to 20.0 micrograms/mL. The limit of quantitation was 0.2 microgram/mL. The intra-assay precision of this method, as measured by percent relative standard deviation (%RSD), was within 12% for the theoretical concentrations 0.5, 5.0, and 50.0 micrograms/mL. Accuracies were within 11%. The results of the validation procedures indicated that this procedure was accurate and specific. PMID- 3286861 TI - Hydroxocobalamin in chronic cyanide poisoning. PMID- 3286862 TI - From Wimpole Street to Stratford: Shakespeare, psychiatry and the unconscious. PMID- 3286863 TI - Psychiatry and the seven ages of man. PMID- 3286864 TI - 'Canst thou not minister to a mind diseas'd?: Shakespeare, the theatre and the Elizabethan psyche. PMID- 3286865 TI - Shakespeare's language of the unconscious. PMID- 3286866 TI - Specific therapy in severe fetal intrauterine growth retardation: failure of prostacyclin. AB - Two case histories of severe, early onset intrauterine growth retardation are presented. Intravenous prostacyclin was administered in an attempt to promote fetal growth and thus prolong the pregnancy, but was unsuccessful and resulted in intrauterine death in each case. The possible reasons for the failure of this treatment and alternative therapeutic options are discussed. PMID- 3286867 TI - Retinoblastoma--clinical and genetic aspects: a review. PMID- 3286868 TI - Information-processing under general anaesthesia: a review. PMID- 3286869 TI - An obituary to the transverse loop colostomy (Gone with the wind) PMID- 3286870 TI - Protoberberine alkaloids as antimalarials. AB - The protoberberine alkaloids berberine (1), palmatine (2), jatrorrhizine (3), and several berberine derivatives (4-10) were tested for antimalarial activity in vitro against Plasmodium falciparum and in vivo against Plasmodium berghei. The berberine derivatives 4-10 were designed and synthesized to maximize structural diversity within a modest set of compounds. Palmatine (2) and jatrorrhizine (3) were isolated as their chlorides from Enantia chlorantha. None of the protoberberine alkaloids was active in vivo, although compounds 1, 2, 3, 5, and 6 exhibited a potency comparable to that of quinine in vitro. PMID- 3286871 TI - Evaluation of a continuing medical education program for primary care physicians on the management of alcoholism. PMID- 3286872 TI - Adherence of Vero cytotoxin-producing Escherichia coli of serotype O157:H7 to human epithelial cells in tissue culture: role of outer membranes as bacterial adhesins. AB - Escherichia coli of serotype O157:H7 are Vero cytotoxin-producing enteric pathogens that have recently been associated with outbreaks of haemorrhagic colitis, sporadic cases of haemorrhagic colitis and with the haemolytic uraemic syndrome. The organisms demonstrate attaching and effacing binding to the caecum and colon of orally infected gnotobiotic piglets, chickens and infant rabbits. E. coli O157:H7 cells adhere to the surface but do not invade the cytoplasm of human epithelial cell lines in tissue culture. Since outer membranes, lipopolysaccharides and flagella have been identified as bacterial adhesins on other enteric pathogens, we evaluated their roles in the binding of non fimbriated E. coli O157:H7 to HEp-2 cells. Hyperimmune rabbit antisera were prepared to whole cells, outer membranes and flagella of E. coli O157:H7. The presence of antibody to homologous antigen was confirmed by dot blot immunoassays. Both antisera and purified outer membrane and flagellar antigens were co-incubated with bacteria and HEp-2 cells to quantitate inhibition of bacterial attachment. Adherence of E. coli O157:H7 to tissue culture cells was inhibited by rabbit antisera raised to whole cells (76.0 +/- 5.6% inhibition compared with bacterial adherence in the presence of pre-immune rabbit serum) and outer membranes (69.2 +/- 3.4% inhibition). In contrast, inhibition of bacterial attachment to tissue-culture cells was significantly less when two antisera to H7 flagella were co-incubated with E. coli O157:H7 and HEp-2 cells (12.4 +/- 7.6%; 6.0 +/- 3.5% inhibition). Outer-membrane extracts inhibited adherence to E. coli O157:H7 to HEp-2 cells in a concentration dependent manner whereas isolated flagella and lipopolysaccharide antigens did not inhibit bacterial attachment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286873 TI - Penetration of immunoglobulins through the Klebsiella capsule and their effect on cell-surface hydrophobicity. AB - The ability of antibodies to cell-surface components of Klebsiella to increase surface hydrophobicity and to gain access to antigens potentially masked by the capsule was investigated. Treatment of capsulate or non-capsulate strains with the respective autologous antiserum resulted in a marked increase in surface hydrophobicity. Antisera raised against a rough non-capsulate (K-O-) strain had little effect on the surface hydrophobicity of either of the capsulate strains K1+O1+ and K2+O1+, or of the non-capsulate K-O1+ strain. Whereas anti-K-O1+ sera or anti-K2+ sera increased the surface hydrophobicity of the K2+O1+ strain, only antisera containing anti-K1+ antibodies increased the hydrophobicity of the K1+O1+ strain. Immunoadsorption of anti-K-O1+ serum by whole capsulate cells revealed that neither the K1 nor the K2 capsular polysaccharide acted as a barrier to anti-O antibodies but that the K1 capsular polysaccharide masked the presence of the immunoglobulin at the cell surface. The Klebsiella capsular polysaccharide does not appear to present a permeability barrier to immunoglobulins although failure to detect outer-membrane proteins in the immune complexes of either of the capsulate strains or of the K-O1+ strain suggests that the O antigen may prevent access of antibodies to these antigens. PMID- 3286874 TI - Identification of leptospiral flagellar antigens by gel electrophoresis and immunoblotting. AB - Flagella extracted from five serovars, representative of the pathogenic and saprophytic species of the Leptospiraceae, were morphologically similar. Analysis of Leptospira interrogans flagellar preparations by polyacrylamide gel electrophoresis revealed three common major bands in the (30-40) x 10(3)-mol. wt region, and serovar-specific bands in the lower region of the gels. Although some differences were observed, flagella extracted from L. biflexa serovar patoc and Leptonema illini revealed similar electrophoretic profiles to those seen in L. interrogans flagella. Immunoblot analysis showed that while flagellar components in the (20-30) x 10(3)-mol. wt region were recognised only by homologous rabbit antisera, a major protein doublet of (33-34) X 10(3)-mol. wt, depending on the species, was also demonstrated by heterologous antisera. The serovar-specific bands in the (20-30) x 10(3)-mol. wt region were composed of lipopolysaccharide (LPS). These results show that leptospiral flagella are immunogenic and contain antigens which are conserved among the different genera of the family Leptospiraceae. PMID- 3286875 TI - Stereological analysis of three-dimensional structure organization of surfaces in multiphase specimens: statistical methods and model-inferences. AB - In a multiphase material the structural components or phases are everywhere in contact with each other. The relative area of surface contact between various phases is an important aspect of the short-range ordering or organization of the structure. The stereological quantitation of such specific interfaces is a simple and well-known technique. The proper statistical definition of realistic models for the frequency of contact and the quantitative estimation of phase-specific affinities is studied. The meaningful interpretation of sets of estimated affinities poses a major problem of statistical inference which is dealt with in detail and illustrated by a worked-out biological example. PMID- 3286876 TI - Patients caught in Medicare crossfire. PMID- 3286877 TI - Missense mutation in the lacI gene of Escherichia coli. Inferences on the structure of the repressor protein. AB - The lac repressor has been studied extensively but a precise three-dimensional structure remains unknown. Studies using mutational data can complement other information and provide insight into protein structure. We have been using the lacI gene-repressor protein system to study the mutational specificity of spontaneous and induced mutation. The sequencing of over 6000 lacI- mutations has revealed 193 missense mutations generating 189 amino acid replacements at 102 different sites within the lac repressor. Replacement sites are not distributed evenly throughout the protein, but are clustered in defined regions. Almost 40% of all sites and over one-half of all substitutions found occur within the amino terminal 59 amino acid residues, which constitute the DNA-binding domain. The core domain (residues 60 to 360) is less sensitive to amino acid replacement. Here, substitution is found in regions involved in subunit aggregation and at sites surrounding residues that are implicated in sugar-binding. The distribution and nature of missense mutational sites directs attention to particular amino acid residues and residue stretches. PMID- 3286878 TI - Corneas for the Kikuyu. PMID- 3286879 TI - Ifosfamide. AB - The alkylating agent ifosfamide, an analog of cyclophosphamide, has demonstrated significant activity in soft tissue sarcoma and testicular carcinoma. Understanding and control of the urinary toxicity of ifosfamide therapy has allowed greater use and inclusion of ifosfamide in combinations in the treatment of malignant diseases. While preliminary results with ifosfamide in a number of diseases are encouraging, final determination of its efficacy awaits further study. A comprehensive review of preclinical data and clinical trials with ifosfamide is presented. PMID- 3286880 TI - The role of methotrexate in osteosarcoma. AB - High-dose methotrexate (MTX) is one of the agents currently used in intensive adjuvant chemotherapy regimens for nonmetastatic osteosarcoma. To elucidate the role of high-dose MTX in this disease, we present the history of trials conducted with MTX from the first single-agent studies through progressively complex combination regimens. With this background, some of the basic issues concerning MTX therapy in osteosarcoma are discussed. PMID- 3286881 TI - Interobserver variability. A source of error in obstetric ultrasound. AB - Several sources of error encountered in obstetrical ultrasound examination have been analyzed from a computerized ultrasound database. The variability in measuring fetal landmarks and visualization of fetal structures were found to be significantly different among three registered sonographers who examined 1,410 consecutive second and third trimester patients. The rate of successful measurement of biparietal diameter (BPD) and average abdominal diameter (AAD), as well as successful visualization of fetal stomach and/or kidneys were statistically different among the three sonographers. Only the fetal femur length was consistently measured by all three sonographers. The bias in terms of actual millimeters measured was significantly different for both BPD and AAD. The bias related to the BPD was in the magnitude of 1 mm, while the bias related to the AAD was almost 3 mm. The clinical significance of these findings and the value of the computer to perform periodic checks to assure quality control in a busy ultrasound service are discussed. PMID- 3286882 TI - Prenatal diagnosis of agenesis of the corpus callosum. AB - The prenatal sonographic findings in seven cases of agenesis of the corpus callosum (AGCC) are reported. Findings that suggest AGCC on standard transverse views of the fetal cranium are emphasized. All seven cases demonstrated ventricular abnormalities including four fetuses (57%) who demonstrated laterally displaced lateral ventricles and/or disproportionate enlargement of the occipital horns. Two additional fetuses demonstrated a large midline fluid collection, representing a dilated third ventricle. The remaining case demonstrated atypical findings of a septated periventricular cystic mass. Following birth, additional malformations were found in 5 of the 7 fetuses (71%), including one fetus with trisomy 8. We conclude that AGCC can be suggested on the basis of prenatal sonographic findings and that awareness of typical findings should permit more frequent detection of this anomaly in utero. Due to the frequency of concurrent anomalies, identification of AGCC should initiate a careful search for additional malformations. PMID- 3286883 TI - Significance of a single umbilical artery in fetuses with central nervous system malformations. AB - To determine whether the presence of a single umbilical artery (SUA) is useful information for evaluating fetuses with known central nervous system (CNS) malformations, the present study reviewed 107 consecutive cases of fetal CNS malformations (hydrocephalus, meningomyelocele, Dandy-Walker malformation, and holoprosencephaly) identified by prenatal sonography. Of the 107 fetuses studied, 20 (18%) had a SUA noted at the time of delivery or autopsy and 87 (81.3%) had two umbilical arteries. Of the 20 fetuses with a SUA, six were prospectively recognized on sonography, six were identified retrospectively, and eight could not be evaluated due to oligohydramnios or technical factors. All 20 fetuses with a SUA had extra-CNS anomalies and 8 of 15 (53%) fetuses tested had chromosomal abnormalities. These rates were significantly higher (P less than .05) than observed in 87 fetuses with two umbilical arteries who had extra-CNS anomalies in 35 cases (39%) and chromosomal abnormalities in 11 of 45 (24%) cases tested. We conclude that identification of a SUA in combination with a CNS anomaly should suggest the presence of additional extra-CNS anomalies and is an indication for chromosomal analysis. PMID- 3286884 TI - Prenatal adrenal neuroblastoma. Case report with review of the literature. PMID- 3286885 TI - The "starry sky" liver with Burkitt's lymphoma. PMID- 3286886 TI - Borderline ovarian cystadenoma. Spontaneous rupture and reaccumulation documented by ultrasound. PMID- 3286887 TI - Ultrasonographic diagnosis of septic pelvic thrombophlebitis. PMID- 3286888 TI - Prenatal ultrasound diagnosis of a forearm constriction band. PMID- 3286889 TI - Mutational analysis of tobacco etch virus polyprotein processing: cis and trans proteolytic activities of polyproteins containing the 49-kilodalton proteinase. AB - The genome of tobacco etch virus contains a single open reading frame with the potential to encode a 346-kilodalton (kDa) polyprotein. The large polyprotein is cleaved at several positions by a tobacco etch virus genome-encoded, 49-kDa proteinase. The locations of the 49-kDa proteinase-mediated cleavage sites flanking the 71-kDa cytoplasmic pinwheel inclusion protein, 6-kDa protein, 49-kDa proteinase, and 58-kDa putative polymerase have been determined by using cell free expression, proteolytic processing, and site-directed mutagenesis systems. Each of these sites is characterized by the conserved sequence motif Glu-Xaa-Xaa Tyr-Xaa-Gln-Ser or Gly (in which cleavage occurs after the Gln residue). The amino acid residue (Gln) predicted to occupy the -1 position relative to the scissile bond has been substituted, by mutagenesis of cloned cDNA, at each of four cleavage sites. The altered sites were not cleaved by the 49-kDa proteinase. A series of synthetic polyproteins that contained the 49-kDa proteinase linked to adjoining proteins via defective cleavage sites were expressed, and their proteolytic activities were analyzed. As part of a polyprotein, the proteinase was found to exhibit cis (intramolecular) and trans (intermolecular) activity. PMID- 3286890 TI - The renal sinus: an imaging review and proposed nomenclature for sinus cysts. PMID- 3286891 TI - Torulopsis glabrata urinary infections: a review. AB - During a 12-year prospective period 9 referral patients were treated for proved Torulopsis urinary infections. Of the 9 patients 7 had irritative voiding symptoms and pyuria was present in 8. To estimate incidence of infection, a retrospective review was performed between January 1982 and December 1983. A total of 105 urine specimens from 57 hospitalized patients yielded Torulopsis glabrata. Two patients suffered symptomatic invasive infections. Patients were treated with antifungal therapy only when invasive symptomatic infections persisted despite elimination of predisposing factors. 5-Fluorocytosine eradicated Torulopsis funguria in 4 of 6 patients in whom it was used. Prolonged therapy with ketoconazole was also successful. Surgical removal of associated stones or fungal coagulum was sometimes required. PMID- 3286892 TI - Prevention of recurrent urinary tract infections in premenopausal women by post coital administration of cinoxacin. AB - A total of 21 sexually active premenopausal women, prone to recurrent urinary tract infections but who otherwise were healthy, underwent post-coital prophylaxis consisting of bladder voiding and a single 250 mg. tablet of cinoxacin. While 94 urinary tract infections occurred during a mean of 7.5 months before treatment, only 8 occurred during a mean of 12.5 months after prophylaxis. This difference was statistically highly significant. A mean of 106 cinoxacin tablets per patient were administered during post-coital prophylaxis. Cinoxacin represents an additional valuable and effective antibacterial in post-coital prophylaxis of recurrent urinary tract infection in otherwise healthy premenopausal women, although it is slightly less effective than cotrimoxazole or nitrofurantoin. Effective post-coital prophylaxis requires the use of much smaller quantities of antibacterial agents than the daily use of a single tablet and in women with a high incidence of recurrent urinary tract infections it is superior to intermittent self-administered antibacterial therapy. PMID- 3286893 TI - Primary malignant melanoma of the male urethra. AB - Primary malignant melanoma of the male urethra is a rare disease, with only 24 cases previously reported in the literature, including 1 black patient. We describe 2 additional patients with primary malignant melanoma of the urethra, one of whom was a black man. The literature is reviewed briefly and treatment recommendations are discussed. PMID- 3286894 TI - Spontaneous healing of Kaposi's angiosarcoma of the penis. AB - We report a case of Kaposi's angiosarcoma of the penis. Few cases have been reported of the initial and exclusive involvement of Kaposi's angiosarcoma of the glans penis and prepuce. Our case is unique because of the number of lesions and the spontaneous remission. PMID- 3286895 TI - Complex tunica albuginea cysts: a review of the literature. AB - Only 27 cases of tunica albuginea cysts have been reported. We review tunica albuginea cysts and describe the complex tunica albuginea cyst, a new entity not previously defined. A careful orderly approach to these lesions will result in a possible testicular sparing operation. PMID- 3286896 TI - Transrectal ultrasound and fine needle aspiration for malacoplakia of the prostate. AB - Clinically, malacoplakia of the prostate gland may mimic prostatic carcinoma. We report a case of prostatic malacoplakia in which transrectal ultrasound of the prostate was most compatible with carcinoma. However, fine needle aspiration cytology and biopsy revealed the classical histopathological features of malacoplakia so that a correct diagnosis could be made. PMID- 3286897 TI - Successful transurethral drainage of bilateral seminal vesicle abscesses. AB - We report the successful management of bilateral seminal vesicle abscesses with transurethral unroofing and drainage of the abscess cavities. The diagnosis was confirmed by computerized tomography. Transurethral drainage became necessary after percutaneous drainage had proved to be inadequate. PMID- 3286898 TI - Rat colonic carcinogenesis after ureterosigmoidostomy: pathogenesis and immunohistological study. AB - A group of 44 rats underwent the equivalent of a ureterosigmoidostomy (US), while a second group of 18 rats underwent a pediculated graft (PG) of urothelial tissue in the sigmoid wall. Histological lesions were observed in the colon near the bladder colon junction in US rats exclusively. These lesions included dysplasias (5/23), cystic glands (4/23) and 10 neoplasms (9/23), three of which were adenomas, showing elements of juvenile polyp and tubular adenoma in one case. The seven other tumors showed typical histological features of colonic adenocarcinomas, but no frank evidence of parietal tumoral invasion was observed and their cancerous nature was questionable. It is probably a true carcinogenesis since we induced the same histological changes as those in the mucosae adjacent to colonic adenocarcinomas after human US surgery. Moreover, by immunoperoxidase using antibodies against mucus associated antigens (M1 and M3C antigens) we demonstrated that US rat carcinogenesis differs from dimethylhydrazine (DMH) rat carcinogenesis. Furthermore, our results suggest that urine may be an important factor in inducing this type of US carcinogenesis. PMID- 3286899 TI - Congenital abdominal aortic aneurysms in the young. Case report and review of the literature. AB - Aneurysms of the aorta are rare in children and young adults. We report a case of a 19-year-old man with a saccular abdominal aortic aneurysm (AAA). No associated disorders were discovered in this patient. The aneurysm was resected and a Dacron aortic graft was implanted. Nine years after operation the patient was in good health without evidence of other aneurysms. Thirty-two cases of probable congenital abdominal aortic aneurysms were collected from the literature. In 19 cases, the cause of aneurysm was not ascertained. We identified two groups of patients with probably congenital AAAs: type I congenital AAA, in which there is a generalized disorder of the arterial tissue and usually aneurysms are present in other areas and type II congenital AAA, in which there is a localized defect of the abdominal aorta, without aneurysms in other areas. We speculate that a congenital defect localized to the wall of the abdominal aorta was the cause of the aneurysm in this patient (type II congenital AAA). PMID- 3286900 TI - Lower extremity edema from bladder compression of the iliac veins. AB - Two elderly men were referred to our vascular clinic for the management of bilateral lower extremity edema of 2 to 3 months' duration. Their evaluation included phlebograms, which demonstrated external compression of their iliac veins. CT scans of the pelvis suggested that large bladders caused the compression. Each patient had mild symptoms of prostatism. Transurethral resection of the prostate was recommended to and accepted by each patient. Decompression of the bladder was accompanied by complete relief of the lower extremity venostasis in both patients. Review of the literature yielded only eight similar cases of this unusual cause of lower extremity edema. PMID- 3286901 TI - Phenomenon of heparin-induced thrombocytopenia associated with skin necrosis. AB - Heparin, an anticoagulant medication used therapeutically and prophylactically, may have thrombotic complications that are paradoxical in nature. There is growing awareness, as evidenced by recent reports, that heparin has a small but definite incidence of causing thrombocytopenia (6 to 8 days after initiation of therapy) associated with platelet aggregation causing intravascular thrombosis, with potentially devastating morbidity and mortality. We review this phenomenon and bring attention to a recent case that resulted in a 10 X 19 cm full-thickness skin necrosis of the thigh. This case clearly implicates heparin as the "aggregating factor" of platelets, resulting in intravascular thrombosis. No risk factors have been identified that place a patient at increased risk for this phenomenon. This disorder occurs in patients who have received all forms of heparin. Therefore all patients receiving heparin are considered at risk. Early recognition of thrombocytopenia in patients receiving heparin will alert the physician to this disorder. PMID- 3286902 TI - Mycotic abdominal aortic aneurysm induced by immunotherapy with bacille Calmette Guerin vaccine for malignancy. AB - Successful surgical treatment of a mycotic abdominal aortic aneurysm infected with Mycobacterium bovis is described. The infecting organism can be traced to an intraneoplastic injection of bacille Calmette-Guerin (BCG) vaccine into a cutaneous malignant melanoma nodule 14 months before aneurysm detection (17 months before operation). Treatment consisted of aneurysm excision, in situ prosthetic graft placement, and antituberculous medications. This patient represents the first reported case of BCG-induced mycotic aortic aneurysm. PMID- 3286903 TI - Spontaneous dissection of the common carotid artery. Case report and review of the literature. AB - Spontaneous dissection of the internal carotid artery is not a rare occurrence. However, spontaneous dissection of the common carotid artery has not been recognized and the first reported case and its management are described. PMID- 3286904 TI - Koch is dead. AB - Although the foundation of Koch's postulates, that "if an agent is the cause of disease in one individual it should be capable of causing disease in a second individual," is basically sound, the ritual that has evolved into present day experimental studies has obscured almost completely what occurs in natural processes outside the laboratory. Through a series of examples, it is emphasized that just bringing the host and the parasite together is not enough, but that the circumstances under which this is done is equally important. These circumstances include: the prior history of the host; the host's behavioral patterns, environmental conditioning, and disease history; the circumstances of exposure; and the environmental factors related to the host and the parasite. Of equal importance is the individual variation (genetic, physiologic, immunologic, etc.) of the host and the individual variation (strains, immunogenicity, pathogenicity, virulence, etc.) of the parasite. Because the rigor of the present day "scientific method" demands clearcut and reproducible results and investigations require predictable performance of the parasite in an evenly maintained host that is in a highly constrained environment, we should not wonder why we cannot produce the events of nature. If we are going to understand diseases of wildlife, we must consider the genetic heterogenicity of the host and parasite population, and recognize the complexity of the environment in which both exist. Koch's postulates, in the narrow sense, will help us to identify parasitisms but will not provide us with an understanding of information about diseases in wildlife; the real significance of these parasitisms to the health of the individual and to the size of the population.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3286905 TI - Measurement of rabies-specific antibodies in carnivores by an enzyme-linked immunosorbent assay. AB - We describe an indirect enzyme-linked immunosorbent assay (ELISA) that utilizes anticanine immunoglobulin for the measurement of rabies-specific antibody in the sera of the major domestic and wildlife reservoirs of rabies in North America. Sufficient cross-reactivity was found to exist between anticanine IgG and serum antibody from all carnivores tested, including dogs, cats, foxes (Vulpes vulpes), skunks (Mephitis sp.) and raccoons (Procyon lotor). With sera of most species, good correlation was observed between results obtained with the ELISA and with the fluorescence inhibition microtest (FIMT). Some wildlife specimens, particularly of skunk and raccoon origin, were cytotoxic in the FIMT, resulting in possible false-positive reactions. In view of this, and since the ELISA is rapid, economical and reproducible (coefficient of variation less than 13%), we consider it to be a favorable alternative to the fluorescence inhibition test for assay of wildlife sera. PMID- 3286906 TI - Serological survey for rabies antibodies in raptors from California. AB - Fifty-three newly captive birds of prey were tested serologically for neutralizing antibodies against rabies virus, using a fluorescent focus inhibition test. No significant antibody titers were detected with this sensitive and specific technique in any of these birds. This study supports the contention that free-ranging birds of prey are of limited importance in the epidemiology of rabies. PMID- 3286907 TI - A survey of the prevalence of selected bacteria in wild birds. AB - We determined the prevalence of six genera of bacteria from a sample of 387 cloacal swabs from 364 passerines and woodpeckers. The prevalence of bacteria were as follows: Escherichia coli (1%), Pseudomonas spp. (22%), Salmonella spp. (0%), Staphylococcus spp. (15%), Streptococcus spp. (18%), and Yersinia spp. (1%). The prevalence of Streptococcus spp. was higher in omnivorous species than in granivorous species (20% versus 8%). Individuals captured at feeders had a lower prevalence of both Streptococcus spp. (15% versus 33%) and Escherichia coli (0.5% versus 4%) than birds that did not have access to feeders. These differences are probably not due to the feeder per se, but instead to other site related differences. The prevalence of bacteria did not differ between male and female black-capped chickadees, Parus atricapillus. For 279 color marked black capped chickadees, we calculated the cumulative mortality rate during 12 wk following swabbing. Although the cumulative mortality rates of infected birds were consistently higher than the rates of non-infected birds, none of these differences were significant. Infections may cause slight reductions in survival rates, but we were not able to confirm this with our data. PMID- 3286908 TI - The poor quality of early evaluations of magnetic resonance imaging. AB - To study the quality of early research on the clinical efficacy of diagnostic imaging with magnetic resonance, we assessed 54 evaluations published in the first four years after introduction of this modality using ten commonly accepted criteria of research methodology. The terms sensitivity, specificity, false positive or false-negative, accuracy, and predictive values were used infrequently. Nineteen percent of the evaluations used three terms appropriately, 48% used one or two terms, and 33% used none. Data were presented appropriately for one or more of the five terms in 59% of evaluations. A "gold standard" comparison with the results of an independent procedure, such as surgical or autopsy findings, was presented in 22% of evaluations. Results of another imaging procedure were described in 63% of evaluations. Only one evaluation clearly described a prospective study design, although 11 evaluations apparently were planned in advance. Not one evaluation contained an appropriate statistical analysis of the distributions of quantitative readings, "blinded" image readers to diagnosis or other test results, measured observer error, or randomized the order of magnetic resonance imaging and other imaging procedures. We conclude that health care professionals paying for expensive innovative diagnostic technology should demand better research on diagnostic efficacy. PMID- 3286909 TI - Effectiveness of a regional bone marrow donor program. AB - Because many potential bone marrow transplant patients lack HLA-matched siblings, there is growing interest in carrying out transplantations using matched, unrelated volunteer donors. We developed a local registry of 2147 informed donors who consented to be listed in the Bone Marrow Donor Registry. This registry was used to carry out 420 donor searches for 351 patients. The initial computer search involved matching for HLA-A and HLA-B locus antigens only because most donors had not been typed for HLA-DR antigens. Depending on the degree of HLA-A and HLA-B antigen mismatching allowed, suitably matched (HLA-DR-identical, mixed lymphocyte culture nonreactive) donors were located for 6% to 16% of patients. This resulted in 13 bone marrow transplants. This study shows that a small, local bone marrow donor registry can locate donors for a few patients; however, a large network involving an expanded number of donors will be necessary to allow an extensive evaluation of unrelated bone marrow transplantation. PMID- 3286910 TI - Captopril overdose resulting in hypotension. AB - We present a case in which a patient took an overdose of captopril (Capoten) and alprazolam (Xanax) in a suicide attempt. The patient presented with hypotension (systolic blood pressure of 80 mm Hg) and drowsiness. The hypotension initially responded to administration of intravenous fluids and dopamine; however, it recurred twice at 18.5 and 24.5 hours after ingestion. These episodes again responded to administration of fluids and dopamine. A plasma captopril level of 27,391.1 nmol/L (5982 ng/mL) was documented, as well as a depressed level of angiotensin converting enzyme. Captopril is an angiotensin converting enzyme inhibitor used in the management of hypertension and ventricular failure; to our knowledge, this is the first case of an acute captopril overdose reported in the English-language literature. The role of captopril in inducing hypotension is discussed herein. PMID- 3286911 TI - Medical care for the poor: no magic bullets. PMID- 3286912 TI - Neutropenia in an HIV-1-infected renal transplant recipient treated with zidovudine. PMID- 3286913 TI - Preadmission screening of Medicare patients. The clinical impact of reimbursement disapproval. AB - The clinical impact of a statewide Medicare preadmission certification program was assessed with a retrospective survey of Connecticut physicians. In a three month period, only 100 (0.37%) of 28,450 Medicare admission requests were disapproved for reimbursement. Following disapproval, 22 patients were admitted immediately, 44 received outpatient care, and eight additional outpatients were not evaluated or treated. The remaining 26 patients subsequently were admitted with preadmission approval due to changed clinical condition or failed outpatient plan. Although some patients had minor problems that their physicians believed would have been avoided by immediate admission, no severe morbidity resulted from admission delay. Many physicians expressed concern about preadmission certification program-related patient anxiety and inconvenience. Although this limited survey provides preliminary evidence that preadmission certification programs can be implemented without major deleterious short-term medical effects, continued monitoring of physicians and patients involved in disapproved admissions is necessary to evaluate potential medical and psychosocial problems. PMID- 3286914 TI - Relative efficacy of vasodilator therapy in chronic congestive heart failure. Implications of randomized trials. AB - We examined existing evidence concerning the relative efficacy of various vasodilator agents in chronic congestive heart failure. Only randomized placebo controlled trials with clinical end points and treatment durations of four weeks or more were selected from an exhaustive search of the English-language medical literature. Twenty-eight trials involving 1976 patients were found. Treatment durations of the trials varied from one month to two years. Patients with symptomatic heart failure despite digitalis and diuretic therapy were studied; most were middle-aged men and approximately half had coronary artery disease. Results of the trials were appraised by three independent observers, and mortality and functional status outcomes were pooled in a meta-analysis. All vasodilator agents except hydralazine hydrochloride were associated with improvements in functional status. Angiotensin converting-enzyme inhibitors were the only agents associated with both decreased mortality (odds ratio, 0.51; 95% confidence interval, 0.34 to 0.75) and improved functional status (odds ratio, 4.53; 95% confidence interval, 3.46 to 5.92). The optimal timing for initiation of these agents was not established. PMID- 3286915 TI - Computer-stored medical records. Their future role in medical practice. AB - Over the next few years, computer-stored medical records will become technically and economically feasible on a broad scale. Hybrid systems that include computer and traditional paper versions of the medical record and obtain their data from existing ancillary service systems will soon be widely available. Completely electronic medical records will follow. However, standards for exchanging clinical information between independent computers are needed to eliminate the reentry or interfacing costs otherwise required to obtain data from computerized ancillary services. Three kinds of benefits may be expected: (1) improved logistics and organization of the medical record to speed care and improve care givers' efficiency, (2) automatic computer review of the medical record to limit errors and control costs, and (3) systematic analysis of past clinical experience to guide future practices and policies. PMID- 3286916 TI - Legal limits of AIDS confidentiality. PMID- 3286917 TI - Captopril and digoxin in mild to moderate heart failure. PMID- 3286918 TI - Barefoot doctors. PMID- 3286919 TI - Escherichia coli O157:H7, an emerging gastrointestinal pathogen. Results of a one year, prospective, population-based study. AB - To examine the incidence of Escherichia coli O157:H7 enteric infections in the United States and to evaluate the vehicles of transmission for sporadic cases, we conducted a one-year, population-based study at a large health maintenance organization (HMO) in the Puget Sound area of Washington State. All stool specimens submitted for culture to the HMO laboratory were screened for E coli O157:H7; the organism was identified in 25 (0.4%) of 6485 stool specimens. All patients with E coli O157:H7 identified had diarrhea; 24 patients (96%) had bloody diarrhea. Exposure histories demonstrated that rare ground beef was consumed more often by patients (21%) than by age-matched control subjects (4%) in the week before onset of illness. Raw milk also was consumed by two patients but by none of the control subjects. Incidence rates for laboratory-confirmed enteric infections in the HMO population were as follows: Campylobacter, 50/100,000 person-years; Salmonella, 21/100,000 person-years; E coli O157:H7, 8/100,000 person-years; and Shigella, 7/100,000 person-years. The organism is a more common pathogen in the United States than is generally recognized, and the diagnosis should be considered for patients with suspected enteric infection. PMID- 3286920 TI - Adjuvant therapy of colorectal cancer. Why we still don't know. AB - All randomized controlled trials of adjuvant therapy of colorectal cancer, published up to December 1986 in English, were reviewed. Eight trials compared radiotherapy groups with control groups in rectal cancer (3062 patients), and 17 trials compared chemotherapy groups with control groups in colorectal cancer (6791 patients). The results of trials testing radiotherapy or chemotherapy were combined. Fluorouracil-containing regimens resulted in a small benefit of therapy in terms of overall survival, with a mortality odds ratio of 0.83 in favor of therapy (95% confidence interval, 0.70 to 0.98). All other combinations of trials failed to show statistically significant differences between treated and control patients, even though the odds of death tended to be slightly lower in treated patients, especially those with rectal tumors. Some overall survival benefit from adjuvant therapy cannot be excluded, but it is likely small. Such small benefit, if real, would be far from negligible in a common case of malignancy with long survival expectancy. Trials much larger than those published up to now are needed. PMID- 3286921 TI - [Plasma levels of catecholamine, renin activity and aldosterone during operations in patients with hypertension]. PMID- 3286922 TI - [The effect of anesthesia and partial hepatectomy on plasma renin and aldosterone -comparison between nitrous oxide-enflurane anesthesia and epidural nitrous oxide anesthesia]. PMID- 3286923 TI - [Fundamental and clinical evaluations of ceftriaxone in neonates]. AB - The antibacterial efficacy of ceftriaxone (CTRX) against group B Streptococcus and its clinical efficacy in newborns were examined, and the results obtained are summarized as follows. 1. MIC's of CTRX against 55 strains of B group Streptococcus from the pregnant vagina were 0.10 micrograms/ml or lower. 2. Efficacies of CTRX were good to excellent in 8 cases administered for treatment, 3 cases for prophylaxis and 1 for observation of adverse reactions. Observed adverse reactions included diarrhea in 4 cases and vomiting in 2 cases. As abnormal laboratory parameters, eosinophilia and thrombocytosis were observed in 1 case each. 3. An examination of intestinal bacteria in 9 cases revealed that CTRX gave as much influence to the flora as other third-generation cephems. 4. An examination for the vitamin K deficiency in 11 cases found a prolongation of prothrombin time (PT) in 3 cases and protein induced by vitamin K absence (PIVKA) II positive in 2 cases. 5. Testing of platelet aggregation with adenosine diphosphate (ADP) in 7 cases showed little influence of CTRX. PMID- 3286924 TI - [Clinical evaluation of ceftriaxone in the treatment of neonatal infections]. AB - Ceftriaxone (CTRX) was administered to the newborn and its clinical effectiveness as well as its blood and cerebrospinal fluid levels were studied. 1. Average blood levels of CTRX 1 hour after single intravenous administration were 39 micrograms/ml in 2 cases receiving about 10 mg/kg, 70 micrograms/ml in 2 other cases receiving 20 mg/kg and 208 micrograms/ml in one receiving 52.6 mg/kg. As is apparent from these cases data, blood levels of CTRX were dose dependent. Blood levels of the drug were between 3.7 to 12.4 micrograms/ml 24 hours later. Half lives of the drug in blood in the 5 newborns ranged from 7.13 to 10.6 hours. In a 53-day-old patient receiving 43.4 mg/kg of CTRX via intravenous injection, the one-hour blood level of the drug was 140 micrograms/ml and the half-life was 3.68 hours. The blood level of the drug 36 hours after single intravenous administration with 17.3 to 20.0 micrograms/ml to 5 other cases 0 to 5 days of age ranged from 4.6 to 13.7 micrograms/ml. 2. The cerebrospinal fluid level of CTRX 4 hours after intravenous administration with 49.6 mg/kg to cases of Escherichia coli meningitis was 9.7 micrograms/ml on the first day following the start of the treatment. It increased to 23.6, 25.2 and 31.0 micrograms/ml on the third, fourth and fifth days, respectively, and then gradually decreased. Cerebrospinal level was still 5.8 micrograms/ml on the 22nd day during the recovery period. These levels were far more than 1,000 times as much as the MIC for the pathogen at the highest level, and more than 100 times even at the lowest level. 3. CTRX was administered via intravenous injection once or twice a day (11.0-39.5 mg/kg in total) to 13 newborns and 3 infants. The efficacy of CTRX was good to excellent in 10 cases for treatment of 11 diseases (sepsis 1, pneumonia 4, urinary tract infection 4 and fetal infection 2) and all the pathogens (Streptococcus agalactiae 1, E. coli 3, Klebsiella pneumoniae 2, Citrobacter diversus 1) disappeared. In 6 cases where CTRX was used prophylactically, infection did not occur at all. The efficacy was excellent in another newborn with E. coli meningitis intravenously receiving 49.6 mg/kg of CTRX twice daily for 25 days. 4. No adverse reactions were observed. Mild eosinophilia was observed in 4 cases. Follow-up examinations of 3 of the 4 cases showed that these abnormal levels were returned to normal.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3286925 TI - [Bacteriological, pharmacokinetic and clinical studies on the use of ceftriaxone in the perinatal period]. AB - Laboratory studies and clinical evaluation of ceftriaxone (CTRX) were carried out with mothers and infants in perinatal period. The presence of synergistic effect between CTRX and amniotic fluid were studied using a broth dilution method. Stronger effects were recognized when both agents were present together compared to each agent alone by the fact that values of MIC and MBC became closer together for Escherichia coli as well as for Streptococcus agalactiae. Against the growth of E. coli, a synergism was observed, but for S. agalactiae, only an additive effect was found. The placental transmission of CTRX upon the administration was rapid, and the blood CTRX level reached its peak shortly after the intravenous administration of the drug. The transport of the drug into the fetus through placenta was excellent and one dose of 1 g of CTRX gave drug concentrations in the umbilical cord serum and amniotic fluid higher than MIC's against main pathogenic organisms. According to these results, it should be possible to treat or prevent perinatal infections by a dose of one gram per day of CTRX, once or twice daily. Cases of perinatal infections were treated with CTRX. An effective treatment without side effects was obtained. No physical abnormalities nor unusual laboratory test results were recognized in neonates delivered from mothers who received CTRX administration. The penetration of CTRX into mothers' milk was low, thus the drug transfer into neonates through the breast-feeding should not be a problem. It appears, from the above study, that CTRX is a clinically useful antibiotic for the prophylaxis and the treatment of perinatal infections. PMID- 3286926 TI - [Prevention of cerebral vasospasm by cisternal irrigation]. PMID- 3286927 TI - [Possibility of the production of a biological active substance using plant virus vectors]. PMID- 3286928 TI - [Standard of criteria for obesity and thinness according to the Japanese Department of Public Welfare]. PMID- 3286929 TI - [Diagnostic method of myocardial infarction by anti-myosin monoclonal antibody]. PMID- 3286930 TI - [Ulcerative colitis developing multiple colorectal carcinomas--report of a case with review of literature]. PMID- 3286931 TI - [Immunohistochemical stain of guanase using direct labelling antibody]. PMID- 3286932 TI - [Undifferentiated sarcoma of the liver--its histopathological peculiarities]. PMID- 3286933 TI - [A study on relationship between gallbladder carcinoma and gall stone]. PMID- 3286934 TI - [Description of Florence Nightingale and her ideals]. PMID- 3286935 TI - [The approach to English monographs. Discussion about review writing (3)]. PMID- 3286936 TI - [Progress in nursing in the post-war 40-year-period and prospects for the 21st century]. PMID- 3286937 TI - [Image of nursing students: a comparison between the images drawn by nursing instructors and results of projective tests]. PMID- 3286938 TI - [History of nursing in Japan. Pre-modern era. 6]. PMID- 3286939 TI - [History of nursing in Japan. Pre-modern era. 7]. PMID- 3286940 TI - [In search of nursing roots in public health nursing in land reclamation projects in Hokkaido. 22. Gaining personal satisfaction by contributing to the happiness of others]. PMID- 3286941 TI - [In search of the nursing roots in public health activities at the land reclamation project in Hokkaido. 23. The public health nurses who established the foundation of nursing legislation at the Bekkai Plain]. PMID- 3286942 TI - [Clinical evaluation of intravenous digital subtraction angiography of chest diseases in the elderly]. PMID- 3286943 TI - [Saccular aneurysm of the superior vena cava]. PMID- 3286944 TI - Frenkelia sp. from the red-backed vole, Clethrionomys rufocanus bedfordiae, in Hokkaido, Japan. PMID- 3286945 TI - The preservation of dignity. PMID- 3286946 TI - Overlooked gunshot wound in a motor vehicle accident victim: clinical and legal risks. PMID- 3286947 TI - Research in trauma nursing: state of the art and future directions. PMID- 3286948 TI - The ABCs of pediatric triage. PMID- 3286949 TI - Effectiveness of intradermally injected lidocaine hydrochloride as a local anesthetic for intravenous catheter insertion. PMID- 3286950 TI - Emergency services at the Indy 500. PMID- 3286951 TI - Hyperventilation syndrome. PMID- 3286953 TI - Teaching students how to take an examination. PMID- 3286952 TI - Standardized care plans: legal implications. PMID- 3286954 TI - Director of nursing at ... the race track. PMID- 3286955 TI - A code on the blue. PMID- 3286956 TI - Hyperphenylalaninemia syndromes: current status of diagnosis and management. PMID- 3286957 TI - Diagnosis and staging of prostate cancer. PMID- 3286958 TI - [Human infections caused by Mycobacterium malmoense]. PMID- 3286959 TI - [Structure analysis and granulomagenic activities of mycolic acid-containing glycolipids in acid-fast bacteria]. PMID- 3286960 TI - [Selection of individual anti-anginal therapy for patients with stenocardia using transesophageal electric stimulation of the heart]. PMID- 3286961 TI - [Clinical effectiveness of ethacizine in various methods of intravenous administration]. AB - Intravenous jet injections of 50 mg ethacizine (10 mg/min) are effective in 100% of cases of ventricular extrasystoles, and paroxysms of supraventricular and ventricular tachycardia, and in 59.5% of cases of atrial fibrillation paroxysms. A relationship has been demonstrated between the magnitude of therapeutic effect and the duration of atrial fibrillation as well as the type of underlying disease. The use of the drug is not justified in paroxysmal auricular flutter. Ethacizine is effective in 82.4% of patients with acute myocardial infarction, and in 65% of patients with other diseases. A similar effect was obtained with intravenous drip injections at the rate of 1.7 mg/min, while the incidence of side effects was reduced essentially. Therefore, drip injections of ethacizine are preferable for the treatment of heart rhythm disorders, such as extrasystoles, particularly in patients with acute myocardial infarction. PMID- 3286962 TI - [Clinico-pharmacological interactions of digoxin with ethmozine, disopyramide and amiodarone]. PMID- 3286963 TI - [Effect of ethmozin on the blood circulation system in patients with cardiac rhythm disorders]. PMID- 3286964 TI - [Treatment of right-sided nephroptosis associated with a right-sided mobile colon syndrome]. PMID- 3286965 TI - [Use of a single-row/wire suture in large intestine surgery]. PMID- 3286966 TI - [Etiology, pathogenesis and prevention of postoperative adhesive disease of the abdominal organs]. PMID- 3286967 TI - [Pathomorphological changes in the mucous membrane in the area of gastric and small intestinal anastomosis]. PMID- 3286968 TI - [Anaerobic paraproctitis]. PMID- 3286969 TI - [Intestinal suture]. PMID- 3286970 TI - [Retroperitoneal fixation of the transverse colon stump with decompression as a method of preventing complications after right-sided, hemicolectomy]. PMID- 3286971 TI - [Multiple-stitch cross suture in acute paraproctitis]. PMID- 3286972 TI - [Penetrating keratoplasty--indications with special reference to artificial lens keratopathy]. AB - During the period from 1980 until the beginning of 1986, 1,219 corneal buttons removed in the course of penetrating keratoplasty were histologically examined. In 16.5% (201 cases) a re-keratoplasty was necessary. Indications for a primary corneal transplant (n = 1,018) were keratitis-induced corneal changes (35.0%), dystrophies (30.5%), surgical traumas (17.2%), nonsurgical traumas (11.4%), congenital corneal clouding (3.1%) and degenerations (2.8%). Over the six-and-a half-year period the incidence of pseudophakic bullous keratopathy was 6.9%, with an increase from 1.6% in 1980 to 12.4% in 1986. Besides an unspecific endothelial cell atrophy, fibroblast-like cell structures, possible macrophages, were found in some specimens by histologic examination on corneal buttons as well as on explanted intraocular lenses. PMID- 3286973 TI - [Interface echos between the retina and choroid]. AB - In 61 patients echographically examined in A and AB mode at Munster University Eye Hospital a membrane-like echo was found between the retina and the choroid. The acoustic characteristics were studied. The usefulness for the differential diagnosis of retinal detachment was demonstrated with several situations of the retina. The thickness of the retina and choroid can be measured in routine examinations. PMID- 3286974 TI - [Penetrating keratoplasty in keratoglobus]. AB - The author reports on a patient with advancing keratoglobus in whom penetrating keratoplasty was carried out successfully. Three and a half years postoperatively his visual acuity is very good. PMID- 3286975 TI - [Pilots through 125 years of ophthalmologic science and practice. Aurel von Szily (1880-1945)]. PMID- 3286976 TI - [Pathophysiologic and surgical technic peculiarities of interventions on the base of the skull from the viewpoint of the neurosurgeon]. PMID- 3286977 TI - [Anesthesia in ophthalmology. Pathophysiologic and surgical technic peculiarities from the viewpoint of the ophthalmologic surgeon]. PMID- 3286978 TI - [Local anesthesia in ophthalmologic surgery]. PMID- 3286979 TI - [Effect of anesthetics and muscle relaxants on intraocular pressure]. PMID- 3286980 TI - [Anesthesia in interventions on the base of the skull]. PMID- 3286981 TI - [Anesthesia in interventions on the eye]. PMID- 3286982 TI - [Anesthesia for eye operations in children]. PMID- 3286983 TI - [Protecting ventilation and oxygenation in special diagnostic and therapeutic interventions on the larynx and trachea]. PMID- 3286984 TI - [Anesthesia in surgical interventions on the jaw]. PMID- 3286985 TI - [Neurophysiologic monitoring: EEG and evoked potentials]. PMID- 3286986 TI - [Anesthesia in diagnosis with imaging procedures in the area of the head]. PMID- 3286987 TI - [Initial management of head and neck injuries by the emergency physician]. PMID- 3286988 TI - [Anesthesiologic procedure in trauma of the brain and facial skull]. PMID- 3286989 TI - Dietary protein and atherogenesis. AB - Different dietary proteins determine different serum cholesterol levels if fed in a semisynthetic diet to some, but not all, animal species. In one species, the rabbit, this metabolic response is elicited without adding high sucrose or cholesterol supplements that have to be added to rat or pig diets in order to cause a similar response. Eleven out of 13 studies show that casein and soy protein do not induce different serum cholesterol levels in normal man. More important, protein-induced differences of serum cholesterol concentrations have not been reported when appropriate nutritional methodology has been applied. We conclude that no protein-induced hypercholesterolemia is observed in primates, particularly not in the human species. Dietary recommendations urging the general public to reduce consumption of animal protein because of a higher atherogenicity are not supported by the present data. The biochemical basis of the metabolic responses has been studied by many investigators, but no convincing unifying concept has yet been identified. The recent observation of higher serum thyroxine concentrations following soy protein consumption (and vegetable protein in general) when compared to casein shed new light on this problem. This endocrine response explains a wide array of metabolic features of soy-fed rodents: the lower hepatic VLDL secretion, the higher hepatic HMG-CoA reductase activity, the higher hepatic apo B, E receptor activity, the higher fecal bile acid excretion, and finally the lower serum cholesterol concentrations. PMID- 3286990 TI - [Cold agglutinin disease]. AB - Cold agglutinin disease is a normo- or macrocytic anemia due to antibodies, active under body temperature, mostly belonging to the immunoglobulin class M. Initially the agglutination of erythrocytes with acrocyanosis is reversible at body temperature. High antibody activity or long lasting period of coldness lead to intravascular or intrahepatic hemolysis, but high risk anemia is rare. Beside the idiopathic form, infection induced (especially infectious mononucleosis, cytomegalovirus, Mycoplasma pneumoniae, Klebsiella), and drug induced (especially quinidine, alpha methyldopa, penicillin, para-aminosalicylic acid, various analgetics, sulfonylurea), tumor associated (especially malignant lymphomas), and autoimmune disease associated (especially systemic lupus erythematosus) cold agglutinin anemias are discribed. "Cross reacting antigenity" to the hemolysing agent and the membrane of erythrocyte, exogenous induced changing of erythrocytic antigenity, and diversification concerning the production of antibodies are discussed as pathophysiological explanations. PMID- 3286991 TI - [Cushing syndrome--a leading symptom in bronchial carcinoid]. AB - Bilateral adrenalectomy was performed in a 27-year-old male because of Cushing's syndrome. After 7 years a peripheral bronchial carcinoid was diagnosed; ACTH values went back to normal only after removal of the carcinoid. In the literature, there are 31 case reports on bronchial carcinoids associated with Cushing's syndrome. The Cushing's syndrome precedes the diagnosis of a tumor for months to years in at least half of the cases. Most of these patients first underwent adrenalectomy and/or hypophysectomy for their primarily endocrine symptoms and signs. PMID- 3286992 TI - [New endoscopic diagnostic methods in gastroenterology]. PMID- 3286993 TI - [A new natural anticoagulant, protein C, and its clinical value]. PMID- 3286994 TI - [E.E. Eikhval'd, a prominent Russian scientist and physician-therapist (on the 150th anniversary of his birth)]. PMID- 3286995 TI - [Comparative evaluation of the hypotensive effects of finoptin and corinfar after their sublingual administration]. PMID- 3286996 TI - [Clinical study of the effectiveness of a new Russian diuretic buphenox (bumetanide) in cardiac insufficiency]. PMID- 3286997 TI - [Chemical dissolution of cholesterol gallstones with ursodeoxycholic acid]. PMID- 3286998 TI - [Use of curantyl in nephritis]. PMID- 3286999 TI - Elimination of microbial flora from conventionally raised Syrian hamsters by antimicrobial agents. AB - An attempt was made to identify and eliminate the normal endogenous microflora from conventionally-raised Syrian hamsters. A total of 14 bacterial and 2 yeast species were identified using enrichment, differential and selective media. The elimination of endogenous flora was carried out in two steps. In each step, hamsters were given a filter-sterilized mixture of two or more antibiotics for 10 weeks continuously through drinking water. During the second week, the hamsters were immersed once into a germicidal solution then housed in horizontal laminar flow units. They were monitored at weekly intervals for the presence or absence of microorganisms in their fecal samples and fur swabs which were cultured on media as mentioned above. In step I, up to four resistant bacteria were cultured. On the basis of the antibiotic sensitivity profile of the surviving bacteria, step II procedure was started. The antibiotic mixture containing Kanamycin and Amphotericin B was fatal for the hamsters in both steps. Within 4 to 5 weeks of step II, all groups of hamsters tested bacteria-free and remained so for the duration of the step. Two weeks following withdrawal of antibiotics from drinking water, only one group of hamsters showed the presence of Escherichia coli. The other groups of hamsters tested bacteria-free for the 5 week duration of the experiment. The autopsies of these hamsters revealed greatly enlarged and thin walled cecums, a characteristic of the germfree state. PMID- 3287000 TI - An outbreak in mice of salmonellosis caused by Salmonella enteritidis serotype enteritidis. PMID- 3287001 TI - Occupational dentistry: a review of 100 years of dental care in the workplace. PMID- 3287002 TI - Candida albicans translocation across the gut mucosa following burn injury. AB - Normal guinea pigs were challenged intragastrically with Candida albicans 1 hr prior to a 30 or 50% flame burn to determine if burn injury increased translocation of the yeasts across gut mucosa. Tissues were harvested between 3 and 24 hr postburn and cultured on Sabouraud dextrose agar. Control animals (no yeast challenge) showed no yeast in intestinal homogenates or in the mesenteric lymph nodes (MLN). At a dose of 1 X 10(9) yeasts, they did not escape from the gut lumen, with either a 30 or 50% burn. At a dose of 2 to 4 X 10(10) organisms, they translocated to the MLN in 92% of the 50%-burned animals (P less than 0.001), 75% of the 30%-burned animals (P less than 0.05), and 12.5% of unburned animals. The ileal mucosa appeared to be the most susceptible site for yeast invasion. To observe the penetration through the gut mucosa and/or translocation to other tissues, yeasts were labeled with biotin before administration, and tissues were stained with avidin-peroxidase diaminobenzidine sequence. With biotinylated yeasts, phagocytized organisms were observed in large numbers in the lamina propria and mesenteric lymph nodes but they were not viable upon culture. Toluidine blue staining of semithin sections revealed that translocated yeasts were located selectively in the lymphoid follicles of the MLN, entrapped by macrophages. PMID- 3287003 TI - Peripheral blood catalase in patients undergoing renal transplantation. AB - Oxygen free radicals are mediators of tissue injury and catalase is an enzyme which is involved in limiting this process. We examined peripheral blood catalase activity (PBCA) to assess its value as a marker in detecting tissue injury related to renal allograft rejection. Thirty-one consecutive recipients of kidney (n = 29) or simultaneous kidney/pancreas (n = 2) transplants and 10 normal volunteers were studied. Catalase activity, measured by the disk-flotation method, was expressed as Sigma units X 10(-3)/ml (SU/ml) of whole blood. Normal PBCA was determined to be greater than 76 SU/ml. Twenty-nine episodes of renal allograft rejection (diagnosed by clinical criteria +/- biopsy [79%]) were observed in 26 patients. PBCA (mean +/- SEM) was found to be low (64 +/- 1 SU/ml) in 28/29 episodes (chi 2 = 46.3, P less than 0.001), and the decrease (at least two consecutive daily catalase values less than 76 SU/ml) occurred 2 days prior to the clinical/biopsy diagnosis of rejection in 26/28 episodes. The sensitivity of PBCA as a discriminant of rejection was 97%, specificity was 96%, and test accuracy was 96%. PBCA less than 50 SU/ml on two or more occasions occurred in five cases and transplant nephrectomy was required in four of these because of uncontrollable rejection. Nine episodes of cyclosporine nephrotoxicity occurred in 7 patients and none of these episodes was associated with a decreased PBCA. Our data suggest that decreased PBCA is a sensitive and specific indicator of renal allograft rejection. PBCA remains normal during episodes of cyclosporine nephrotoxicity and therefore provides a rapid and inexpensive discriminant from allograft rejection. PMID- 3287004 TI - A comparison between intrarectal ultrasound and CT scanning in staging of experimental rectal tumors. AB - The purpose of this study was to compare the accuracy of preoperative staging of experimental rectal tumors by digital rectal exam, intrarectal ultrasound (IRUS), and CT scanning with pathologic exam. Rectal tumor masses were induced in 10 mongrel dogs by submucosal injection of 2-3 cc of Freund's complete adjuvant. One week later, the animals underwent digital rectal exam, IRUS, and pelvic CT scans. Pelvic exenteration specimens were submitted for pathologic evaluation. Evaluations and interpretations were done in blinded fashion by independent examiners. The rectal "tumor" was detected in 9 of 10 digital exams, 10 of 10 IRUS exams, and 1 of 10 CT scans. Correct Duke's staging occurred in 70% of digital exams, 90% of IRUS exams, and 10% of CT exams compared to pathological staging. Lymph nodes were detected on pathologic exam in all animals (8.7/animal, range 3-16), on IRUS in all animals (6.4/animal, range 5-13), and in none of the digital or CT examinations. IRUS was significantly more accurate in detecting (P less than 0.0001) and locally staging tumors (P less than 0.0001), and in detecting and localizing lymphadenopathy compared to CT scan. Intrarectal ultrasound is a simple, highly accurate device for assessing depth of wall penetration of rectal tumors and in detecting pararectal lymph nodes and should be considered the preoperative staging procedure of choice for rectal cancer. PMID- 3287005 TI - Plasma thromboxane A2 and prostacyclin concentrations in squamous cell carcinoma of the head and neck. AB - Circulating prostaglandins, including thromboxane A2 and prostacyclin, have been implicated as possible facilitative agents in the growth and dissemination of squamous cell carcinomas of the head and neck. The purpose of this study was to evaluate the relationship of plasma concentrations of these compounds to tumor stage and the effect of surgical resection on plasma prostaglandin levels. Blood samples were obtained from 40 patients with head and neck cancer. Ten treated patients were clinically disease-free (NED), and 30 patients with active disease were previously untreated at the time of this study. Plasma concentrations of thromboxane A2 and prostacyclin were measured by radioimmunoassay of their stable metabolites thromboxane B2 (TxB) and prostaglandin 6-keto-F1 (PGI). Platelet aggregation was performed with normal donor platelets (PRP) and normal control or patient plasma (PPP). TxB and TxB/PGI ratios were increased in T1N0M0 patients, compared with NED and with T4N0M0 primary lesions versus all other groups. With lymphatic and hematogenous metastases, TxB and TxB/PGI ratios fell to NED levels. ADP-induced platelet aggregation was significantly increased in head and neck cancer patients, compared with normal controls, and with T4N0M0 lesions, compared with NED. There were no significant differences in PGI levels. TxB, PGI, TxB/PGI, and platelet aggregometry did not change significantly with curative surgery. TxB and TxB/PGI interactions are involved in head and neck cancer. Changes in TxB and TxB/PGI may be related to increased platelet aggregation. PMID- 3287006 TI - Primary lymphoma of the head of the pancreas. AB - Primary and isolated lymphoma of the head of pancreas with secondary involvement of the lungs and obstructive jaundice, in a 31-year-old postpartum woman, is described. The histological diagnosis was diffuse histiocytic lymphoma. Chemotherapeutic treatment resulted in complete remission of the tumor. During therapy a pseudocyst of the pancreas developed and a gastrocystostomy was performed. This is the second reported case of primary pancreatic lymphoma in the English medical literature. PMID- 3287007 TI - Islet cell function in long-term surviving primates after segmental pancreatic allotransplantation. AB - Islet cell function was studied in pancreatectomized primates with functioning segmental pancreatic allografts more than 100 days after transplantation. Segmental allograft recipients were immunosuppressed with total lymphoid irradiation (TL1) and cyclosporine (CSA). After 100 days, islet function was assessed, at which stage immunosuppression was terminated. Glucose, insulin, glucagon, and C-peptide response was assessed during intravenous glucose tolerance test (IVGTT) and during arginine and tolbutamide stimulation. In eight normoglycaemic primates in which immunosuppressive treatment had been stopped and with mean graft survival of 145 days, islet stimulation was associated with moderate glucose intolerance, reduced K-values, hypoinsulinaemia, and low C peptide values. Postmortem findings in all animals intentionally killed revealed severe graft atrophy in the absence of significant rejection. Severe graft atrophy in normoglycaemic primates, together with significantly impaired graft function after segmental pancreatic transplantation compared to normal animals, suggest that transplantation of the whole pancreas may be mandatory if normal or near-normal function is to be achieved. PMID- 3287008 TI - The biological activity of Valerian and related plants. AB - A comprehensive review of the constituents of the Valerianaceae is presented with particular reference to the sedative activity of extracts from various constituent species. The sedative activity can be ascribed to the valepotriates present and to a lesser extent to the sesquiterpene constituents of the volatile oils. Recent research into the toxicology of the valepotriates is also considered. PMID- 3287009 TI - Plants as sources of antimalarial drugs, Part 6: Activities of Simarouba amara fruits. AB - Extracts prepared from Simarouba amara fruits collected in Panama have been found to be active against Plasmodium falciparum in vitro and against Plasmodium berghei in mice. Four active quassinoids have been identified as ailanthinone, 2' acetylglaucarubinone, glaucarubinone and holacanthone. PMID- 3287010 TI - Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. AB - After a short description of the uses of pineapple as folk medicine by the natives of the tropics, the more important new pharmaceutical applications of bromelain, reported between 1975 and 1978, are presented. Although the exact chemical structure of all active components of bromelain is not fully determined, this substance has shown distinct pharmacological promise. Its properties include: (1) interference with growth of malignant cells; (2) inhibition of platelet aggregation; (3) fibrinolytic activity; (4) anti-inflammatory action; (5) skin debridement properties. These biological functions of bromelain, a non toxic compound, have therapeutic values in modulating: (a) tumor growth; (b) blood coagulation; (c) inflammatory changes; (d) debridement of third degree burns; (e) enhancement of absorption of drugs. The mechanism of action of bromelain affecting these varied biological effects relates in part to its modulation of the arachidonate cascade. PMID- 3287011 TI - Echocardiographic evaluation of potential cardiac transplant donors. AB - Since the initiation of the UTAH Cardiac Transplant Program, echocardiography has been used to evaluate 74 potential donors including 65 of 71 hearts ultimately used for transplantation. Of these 65 donors, 46 had normal studies, nine had pericardial effusions, five had mild septal hypokinesia with otherwise normal function, four had equivocal mitral valve prolapse, and only one heart could not be visualized. All transplants were successful and all donor hearts exhibited satisfactory hemodynamic function immediately after transplantation, including the hearts that were mildly abnormal before transplantation. These hearts included 21 (29%) that could have been excluded by conventional screening criteria. Nine potential donor hearts with grossly abnormal echocardiograms were not used for transplantation, including eight hearts with severe hypokinesia and one heart with significant mitral and tricuspid regurgitation. Inspection or histologic analysis confirmed the presence of severe dysfunction or morphologic damage in those hearts subjected to these additional measures. We conclude that echocardiographic screening is a useful method of evaluating potential cardiac transplant donors. It can identify potential donors that would otherwise have been excluded and it can identify potential donors with severe cardiac dysfunction without the need for direct surgical inspection. PMID- 3287012 TI - The effect of superoxide dismutase and catalase on the extended preservation of the ex vivo heart for transplantation. AB - The applicability of heart transplantation remains limited in part by the inability to preserve the excised heart for long periods of time. Free radical scavengers have been shown to protect the anoxic myocardium by preventing damage to the cell membrane and may, therefore, be effective in extending successful preservation of donor hearts. We perfused 10 sheep hearts for 8 hours in an ex vivo perfusion system. The effect of superoxide dismutase combined with catalase, 60,000 units/L, was studied in five sheep, and five received placebo. Control determinations and determinations after 8 hours of preservation were obtained with the heart perfused with autologous blood at 37 degrees C at an aortic perfusion pressure of 60 mm Hg and flow of 180 to 200 ml/min. After control readings, the hearts were arrested and perfused with a cold (6 degrees to 8 degrees C) oxygenated buffered crystalloid solution with or without superoxide dismutase and catalase at a perfusion pressure of 30 cm H2O for 8 hours. Left and right ventricular compliance was measured sequentially with separate intraventricular balloons. After 8 hours of ex vivo preservation, hearts receiving superoxide dismutase and catalase had significantly better left and right ventricular performance, higher myocardial oxygen consumption, and lower lactate production than the control group. The hearts preserved with superoxide dismutase and catalase showed significantly better left and right ventricular compliance, much less increase in heart weight, and no change in the diastolic pressures. The results suggest that superoxide dismutase combined with catalase may be effective in extending ex vivo preservation of hearts for cardiac transplantation. PMID- 3287013 TI - Strut failure of the Starr-Edwards cloth-covered metallic ball prosthesis. Report of two asymptomatic cases and review of the overall experience. AB - Two cases of asymptomatic strut failure of an aortic Starr-Edwards cloth-covered metallic ball prosthesis are reported. Strut failure can be asymptomatic for years. Available information on the overall worldwide experience of six cases is reviewed and suggestions made for early diagnosis and treatment of this rare complication. PMID- 3287014 TI - Blowgun dart aspiration--a historical perspective. PMID- 3287015 TI - High dose cytarabine: a review. AB - High dose cytarabine (HDARAC) therapy is used increasingly to treat hematologic malignancies. Recent data indicate that HDARAC at doses of 2-3 g/M2 every 12 hr x 10-12 doses is of comparable or greater efficacy in remission induction as standard doses of cytarabine in acute myelogenous leukemia. HDARAC can also produce remissions in individuals resistant to conventional doses. HDARAC containing regimens are reported to result in substantially higher long-term, disease-free survival than previous approaches to post-remission therapy, but this has not yet been confirmed in controlled trials. HDARAC is also active in acute lymphocytic leukemia. Because intravenous HDARAC achieves high levels in the spinal fluid, it is useful to treat central nervous system leukemia and may provide adequate CNS prophylaxis in acute lymphocytic leukemia. HDARAC is reported to be active in advanced non-Hodgkin lymphomas and chronic myelogenous leukemia in acute phase; optimal use in these settings is under study. HDARAC has also been combined with other drugs. Randomized trials are needed to determine whether these combinations are more effective than HDARAC alone. Apart from potent myelosuppression, the dose-limiting toxicity of HDARAC is cerebellar damage. This occurs with increased frequency in patients greater than 50 years old. HDARAC is active in hematologic malignancies and may further improve therapeutic results if combined with other drugs. PMID- 3287016 TI - Prevention of graft-versus-host disease by ex vivo T cell depletion: reduction in graft failure with augmented total body irradiation. AB - Graft-versus-host disease prevention was attempted in 35 consecutive patients with hematological malignancy who received bone marrow from an HLA match sibling donor who was depleted of T cells ex vivo. Five of the first 8 patients who received cyclophosphamide 60 mg/kg on 2 consecutive days followed by fractionated total body irradiation (TBI) (6 x 2 Gy) had graft failure. The subsequent 27 patients had received an extra fraction of TBI (7 x 2 Gy), and only one failed to have stable engraftment. There were no differences in nucleated cell dose, granulocyte-macrophage colony-forming units, or T cell numbers given to the two groups. Neutrophil but not platelet regeneration of those patients who successfully grafted was slower than in a group of historical controls receiving unmanipulated marrow. Significant graft-versus-host disease was prevented with no increase in relapse rate. We suggest that engraftment can be reliably achieved by augmenting the TBI conditioning in recipients of T cell-depleted matched allogeneic bone marrow. PMID- 3287017 TI - Prolonged high dose ARA-C infusions in acute leukemia. AB - High doses of cytosine arabinoside (ara-C) were administered by continuous infusion to 24 patients with acute leukemia in relapse or blast phase of chronic myelogenous leukemia (CML). Ara-C was infused at a dose rate of 250 mg/M2/hr for 36 to 72 hr. The major toxicities were myelosuppression, diarrhea, and abdominal pain. Other toxicities included pulmonary edema, neurotoxicity, and liver function abnormalities. The gastrointestinal toxicity was dose-limiting and a phase II dose was established at 250 mg/M2/hr for 60-72 hr. Four patients treated with this dose schedule had objective responses. Two patients with CML in blast phase returned to chronic phase and have remained stable without maintenance therapy for 12 and 18 months. Two patients with acute myelogenous leukemia in relapse entered complete remissions which continued unmaintained for 4 and 6 months. Steady-state plasma ara-C levels ranged between 7 and 24 x 10(-6) M, while ara-U levels were as high as 4.5 x 10(-4) M. There was no detectable accumulation of ara-C or ara-U during the infusion period. These findings would suggest that the continuous infusion of high dose ara-C may be useful in the treatment of acute leukemia and CML in blast crisis. PMID- 3287018 TI - Rapid progress in chronic myelogenous leukemia. PMID- 3287019 TI - Ras mutations in Hodgkin's disease. PMID- 3287020 TI - A model system for leukemic transformation of immortalized hemopoietic cells in irradiated recipient mice. AB - Proliferation in vitro of the murine hemopoietic cell line FDC-P1 is dependent on stimulation by granulocyte-macrophage colony stimulating factor or multipotential colony stimulating factor. Although immortalized, the cells are not tumorigenic on subcutaneous inoculation. Intravenous injection of FDC-P1 cells into syngeneic DBA/2 mice was followed by the development of transplantable leukemias in 15% of nonirradiated animals and in virtually all animals that had received 100-350 rad whole-body irradiation prior to injection. Karyotypic analysis showed that the leukemias originated from FDC-P1 cells, and primary tumor cells from different animals displayed a wide spectrum of altered growth patterns when cultured in agar. In most cases, colony formation by leukemic cells in vitro exhibited autonomy with respect to stimulation by exogenous colony stimulating factors. These observations indicate that leukemic transformation of FDC-P1 cells is enhanced by irradiation of recipient mice and document a useful model for analyzing the mechanisms by which irradiation induces leukemia. PMID- 3287021 TI - In vitro growth patterns and autocrine production of hemopoietic colony stimulating factors: analysis of leukemic populations arising in irradiated mice from cells of an injected factor-dependent continuous cell line. AB - Cells of the factor-dependent hemopoietic cell line FDC-P1 become leukemic when injected intravenously to irradiated syngeneic mice. An analysis of 117 cell lines derived from 17 such leukemic mice showed that they displayed different patterns of growth in vitro ranging from full autonomy to absolute dependency on stimulation by granulocyte-macrophage colony stimulating factor (GM-CSF) or multipotential colony stimulating factor (multi-CSF). In contrast to parental FDC P1 cells, even the factor-dependent variant cell lines were tumorigenic in vivo. The behavior of these latter cell lines could not be explained by hyperresponsiveness to CSFs or prolonged survival in the absence of CSFs. Conditioned media and cell lysates from leukemic cell lines from 8 animals contained variable levels of GM-CSF or multi-CSF. Proliferation of a GM-CSF producing cell line was inhibited by anti-GM-CSF antibody, while both the parental FDC-P1 line and a leukemic line secreting multi-CSF remained unaffected. The patterns of growth in vitro of the leukemic cells tended to correlate with the amounts of CSFs produced. The observations show that leukemic transformation of FDC-P1 cells in vivo is frequently linked to autogenous production of hemopoietic growth factors. The range of abnormal in vitro growth patterns observed includes those typical of human acute myeloid leukemia, and the in vivo transformation model may be useful in analyzing the mechanisms leading to the development of this human disease. PMID- 3287022 TI - Effect of recombinant human M-CSF on the proliferation of leukemic blast progenitors in AML patients. AB - We studied the effects of recombinant human macrophage colony-stimulating factor (M-CSF) on the leukemic blast progenitors from 10 acute myeloblastic leukemia patients. Recombinant human (rh)M-CSF stimulated leukemic blast progenitors in methylcellulose in four patients, but the colonies by rhM-CSF were smaller in size and number than those by rh-granulocyte-CSF or human bladder carcinoma cell line 5637 conditioned medium. rhM-CSF did not increase the number of clonogenic cells in long-term suspension culture. The blast colony formation in methylcellulose and the exponential growth of clonogenic cells in long-term suspension culture are considered to reflect the terminal divisions and the self renewal of blast progenitors, respectively. The results show that M-CSF stimulates terminal divisions weakly but does not stimulate self-renewal of leukemic blast progenitors. M-CSF did not induce differentiation of blasts either in methylcellulose or in suspension culture. PMID- 3287023 TI - Acute gastrointestinal bleeding--a common problem revisited. AB - Acute gastrointestinal bleeding, a common problem, becomes a serious situation in the 15% of afflicted patients in whom the bleeding does not stop spontaneously. The typical high-risk patient is elderly, has multisystem disease, has a hemorrhagic episode during hospitalization for other disorders, or is an outpatient with severe bleeding of short duration and symptoms of volume depletion. Endoscopy can be performed to identify the active site of hemorrhage and is associated with an overall diagnostic accuracy that exceeds 90% in patients with upper gastrointestinal bleeding. The rate and character of observed bleeding have substantial predictive value for continued bleeding. The mortality among high-risk patients with bleeding in either the upper or the lower gastrointestinal tract ranges from 17 to 44%. Therefore, an organized aggressive approach to management of acute gastrointestinal bleeding is necessary. PMID- 3287024 TI - Management of lipids in primary and secondary prevention of cardiovascular diseases. AB - Although the frequency of cardiovascular disease is declining, it remains a major present and future threat to health in the United States. The deleterious effects of abnormal blood lipid concentrations have long been recognized, but the benefit of corrective intervention in this process has only recently been demonstrated. We review the major lipid abnormalities and the available clinical therapeutic interventions. In addition, we discuss data that address the premise that reducing low-density lipoprotein cholesterol or raising high-density lipoprotein cholesterol should decrease the progression of coronary atherosclerosis, and we summarize drug trials in which clofibrate, niacin, cholestyramine, and gemfibrozil decreased coronary heart disease events. Studies that used cholestyramine and the combination of colestipol and niacin resulted in decreased progression of coronary artery disease. On the basis of early experience with lovastatin, inhibitors of hydroxymethylglutaryl-coenzyme A reductase are likely to be effective in the treatment of hypercholesterolemia. The available information on the association of low cholesterol levels and cancer suggests that low total cholesterol is a consequence rather than a cause of carcinoma. Current data strongly support the concept of vigorous intervention directed at management of lipids, both with non-pharmacologic treatment and with drug therapy, for the primary and secondary prevention of coronary atherosclerosis. PMID- 3287025 TI - German scientist makes early practical contributions in electricity. PMID- 3287026 TI - The aging of the endocrine pancreas of the rat. I. Parameters of cell proliferation. AB - Morphometrical analysis of the endocrine pancreas of senile 30-month-old rats revealed that the volume density as well as the numeric density of islets of Langerhans were much lower than in 24-month-old rats, which coincided with a much higher percentage of pycnotic nuclei in islet cells. The proportion and localization of the different categories of endocrine cells (A, B, D and PP) remained however unchanged with aging. The apparent problem of cell renewal observed in vivo in the very old age was detected earlier in vitro by tritiated thymidine incorporation. Such experiments showed that 24-month-old islet cells had a decreased labelling index when compared to 3-month-old cells. The proliferation capacity of the old cells could be partially increased by changing the serum concentration or type. Similarly as being more sensitive to serum factors, these cells underwent also more pronounced negative influence of high oxygen pressure on replication. A stereological analysis of the ultrastructure of non-degenerated B-cell nuclei revealed that with age, the relative volume of the condensed chromatin increased progressively at the expense of the dispersed form. This suggests that the still functioning senile B-cells could reduce their transcriptional activity. PMID- 3287027 TI - The aging of the endocrine pancreas of the rat. II. Cytoplasmic parameters of the B-cell, including insulin synthesis and secretion. AB - Comparative ultrastructural stereology of 6 and 24-month-old rat B-cell cytoplasm revealed an increase with age in secondary lysosomes and a decrease in the volume density of RER and Golgi apparatus. The reduction of RER observed in freshly isolated islets could affect (pro)insulin biosynthesis in vitro: if the initial mobilization of precursor molecules for protein synthesis was the same, a delay was noted in their transit to the Golgi apparatus in B-cells of old islets. No further differences were seen in the autoradiographic distribution of radioactive amino-acids. More, the stock of insulin granules was similar in all age groups in both in vivo and in vitro conditions. Neither were any differences observed in the insulin secretion into culture media as well as during a subsequent incubation in supraphysiological glucose concentrations. PMID- 3287028 TI - Indirect techniques for composites. PMID- 3287029 TI - Implants: a balanced view. PMID- 3287030 TI - New denture system boasts less distortion, higher profits. PMID- 3287031 TI - Geriatric care needs and HMO technology. A theoretical analysis and initial findings from the National Medicare Competition Evaluation. AB - More than 770,000 Medicare beneficiaries were enrolled in 1986 in HMOs that have very little experience in providing health care to elderly patients. A general framework for assessing the effects of HMO as compared with fee-for-service delivery systems for the elderly is needed to guide the many studies of quality of care that are underway and will ensue. The following paper addresses the development of such a framework through analysis of the "fit" between the health care needs of the elderly and HMO technology and examination of initial findings from the National Medicare Competition Evaluation--a major project currently underway. PMID- 3287032 TI - [Pleural effusions: a diagnostic problem]. PMID- 3287033 TI - [Home hemodialysis: chronicle of a disappointment]. PMID- 3287034 TI - [Drug compliance: characteristics, determining factors and recommendations for its improvement]. PMID- 3287035 TI - [Hyporeninemic hypoaldosteronism]. PMID- 3287036 TI - [Gallbladder empyema caused by Salmonella enteritidis]. PMID- 3287037 TI - Anxiety and depression in the medical setting: an overview. AB - Many physicians fail to correctly diagnose, treat, or refer their patients with anxiety and depression. These are common and costly disorders, but many barriers often prevent effective care for them in medical settings. Greater knowledge about these disorders and closer working relationships with mental health specialists should lead to decreased morbidity and mortality. PMID- 3287038 TI - Diagnosis of anxiety and depression. AB - The differential diagnosis of anxiety and depression is often difficult as symptoms of generalized anxiety, panic disorder, and depression frequently coexist. PMID- 3287039 TI - The drug treatment of anxiety and depression. AB - The use of the broad range of antidepressant drugs in depression, panic agoraphobia, and generalized anxiety is reviewed and the current ambiguous status of the benzodiazepines in anxiety disorders discussed. The place of newer antianxiety drugs (buspirone, propranolol) and antidepressant drugs (floxetine, bupropion, trazodone) in treatment is considered. Methods for adjusting dose and counteracting common drug side effects are presented. PMID- 3287040 TI - Childhood depression. AB - The spectrum of depressive disorders found in children and adolescents presents diagnostic and treatment challenges for the physician. The increasing scientific rigor of child and adolescent mental disorder research has explicated the importance of clinical diagnoses. Distinctions have to be made between depressive symptoms that are transient and situational specific and the constellation of depressive symptoms that represent clinical disorders such as bipolar disorder, cyclothymia, major depressive disorder, or dysthymia. The clinically sensitive physician attuned to the diagnostic criteria of these disorders has the opportunity to promote effective treatment and to reduce the morbidity associated with these conditions. The established severity and persistence of these disorders over time suggests the need for definitive medical management of these conditions. The recognition of childhood depression as a medical entity of varying severity, persistence, and prognosis represents the first step in effective treatment. PMID- 3287041 TI - Geriatric depression. AB - Depression in later life can present unique clinical and therapeutic challenges. Phenomenology is often atypical and the concurrence of physical illness can confound both diagnosis and treatment. A review of current knowledge about epidemiology, pathogenesis, clinical features, and therapeutic issues is presented. PMID- 3287042 TI - Anxiety and depression in substance abuse: clinical implications. AB - Accurate diagnosis in patients presenting with anxiety and/or depressive symptoms requires that the contribution of substance abuse be carefully considered. When chemical dependence is identified, detoxification may be all that is necessary. However, if indicated, specific treatment of the mood or anxiety disorder may reduce substance use as well. PMID- 3287043 TI - Psychological approaches to the assessment and treatment of anxiety and depression. AB - Clinical psychology offers a unique and often complementary approach to assessment and treatment of anxiety and depression. Current practices are examined for their scientific validity and clinical utility. PMID- 3287044 TI - Psychiatric consultation and referral. AB - Over half of patients with psychiatric problems are seen by primary care physicians. Many of these patients will benefit from psychiatric consultation when the diagnosis is unclear or when the patient is not responding to treatment. Good communication between referring physician, consulting physician, and patient are essential to ensure a good result. Specific problems that should lead to consultation include: patient's request, unclear diagnosis, poor results from treatment, and crisis situations such as suicide attempts. Consultation-liaison psychiatry services in the primary care setting are becoming more popular and are an excellent way of improving communication between primary care physicians and psychiatrists. Further development of this role of the psychiatrist in the primary care setting has great potential of improving the quality of care delivered patients with psychiatric problems who seek care from their primary care physician. It appears that the majority of patients continue to seek care for their psychiatric symptoms from their primary care physician. Open communication and ease of consultation with psychiatrists can make the care of these patients even more rewarding to the primary care physician. PMID- 3287045 TI - Suicide: a guide to risk factors, assessment, and treatment of suicidal patients. AB - This article summarizes what is known about risk factors for suicide in both adolescent and adult populations. It also translates this knowledge base into practical considerations for the physician on the assessment and treatment of suicidal patients. Since most patients who commit suicide have seen a physician in the weeks to month prior to their deaths, and many kill themselves with medications prescribed by their doctors, the physician's early detection and treatment of suicidal behaviors and associated psychiatric disorders in his or her patients becomes a major suicide prevention strategy. PMID- 3287046 TI - [Dermatosis with the phenomenon of transepidermal elimination]. AB - A revision was carried out on all cases of dermatosis involving transepidermal elimination seen in the last 25 years in the Department of Medical Surgical Dermatology and Venereology, School of Medicine, University of Granada. The study included clinical-statistical, therapeutic, histopathologic and evolutional aspects. In the discussion the low incidence of perforating dermatoses in the Eastern Andalusian area is emphasized. PMID- 3287047 TI - [23 observations of subungual exostosis]. AB - Twenty-three cases of subungual exostosis are described, representing an incidence of 0.031% in our setting. Children and adolescents were most frequently affected, with a clear predominance of females. Eight lesions were observed in exceptional locations, three on the fingers and five on the third and fourth toes. The results of the surgical technique employed to excise the exostosis are evaluated. PMID- 3287048 TI - [Chronic lichenoid keratosis. Apropos of a case]. AB - A male patient of 28 years, with typical clinical features and histopathological changes of keratosis lichenoides (CLK) chronica is described. CLK has some histological features similar to lichen planus, but there are also histological and clinical differences. PMID- 3287049 TI - [Focal oral epithelial hyperplasia. First case described in Cuba]. AB - Focal oral epithelial hyperplasia (FOEH), also known as Heck's disease is an unusual condition. We had the possibility to observe and study the disease in a negro patient. This is the first case described in Cuba. PMID- 3287050 TI - [Purpura fulminans. Report of a case]. AB - A case of fatal purpura fulminans is reported. The etiology and the pathogenesis is discussed. We stress the need for an early diagnosis and treatment based on the use of heparin, fresh frozen plasma and platelets. PMID- 3287051 TI - [Malignant histiocytosis. Apropos of a case]. AB - The authors report a case of malignant histiocytosis occurring in a 39 year old female patient who presented an ulcerated cutaneous lesion which was the only clinical manifestation for one year and then widespread systemic involvement took place and death ensued. They emphasize the rarity of the condition and point out that erythrophagocytosis in the histopathological examination may be a valuable finding for the diagnosis of malignant histiocytosis. PMID- 3287052 TI - [Ashy dermatosis. Review of the literature and report of a case]. AB - The authors make a review of the epidemiologic, etiopathogenic, clinical, laboratory and therapeutic aspects of ashy dermatosis, described in 1957 by Ramirez in El Salvador, of which more than 150 cases have been described up to now in different continents. The disease is exclusively cutaneous, presents peculiar clinical features with a lichenoid tissue reaction, and has no specific treatment or known etiology. The authors report a case in a Brasilian man, followed up for three years. The treatment of a T. trichiura infestation did not change the cutaneous features, as opposed to what has been reported. PMID- 3287053 TI - [Familial eosinophilic fascitis induced by toxic oil]. AB - Three of four family members in husband, wife and one of two daughters developed in a short time interval (eleven months) eosinophilic fasciitis. The clinical, analytical and histopathological changes were characteristic of this disease. Familial cases of eosinophilic fasciitis have not been previously published. The process of these patients was probably caused by the ingestion of denatured oil (toxic oil syndrome), although the clinical picture begun two and a half years after the epidemic phase of the toxic oil syndrome declined. PMID- 3287054 TI - [Bowenoid papulosis in a patient with AIDS]. AB - A patient with a acquired immunodeficiency syndrome (AIDS) and Kaposi's angiosarcoma developed bowenoid papulosis of the genitalia (BP). The clinical and histopathological criteria were both characteristic of BP. With vinblastine treatment a moderate improvement of Kaposi's lesions was observed, but no significant changes of the BP lesions were noted during this treatment. PMID- 3287055 TI - [Familial acanthosis nigricans]. AB - After a brief introduction about the classification and clinicopathological findings of acanthosis nigricans, we present a clinical case of the familial type of acanthosis nigricans in a woman with lesions beginning in childhood and with three family members affected. We comment the characteristics that permit us to individualize this condition from the other forms of benign acanthosis nigricans. PMID- 3287056 TI - [Plantar myofibromatosis]. AB - A case of recurrent plantar myofibromatosis is described, in which myofibroblasts are shown ultrastructurally. The characteristics and properties of this presence in different types of fibromatosis are discussed. PMID- 3287057 TI - Sir Ronald Ross, malaria, and the rewards of research. PMID- 3287058 TI - The English wet-nurse and her role in infant care 1538-1800. PMID- 3287059 TI - Nineteenth-century American health reformers and the early nature cure movement in Britain. PMID- 3287060 TI - Mortality in fourteenth-century Exeter. PMID- 3287061 TI - "Nineteenth-century origins of neuroscientific concepts". By Edwin Clarke and L. S. Jacyna. Essay review. PMID- 3287062 TI - [The man behind the syndrome: Thomas Addison. One of the 3 giants at Guy's Hospital--he introduced science to diagnostics]. PMID- 3287063 TI - [Sir William Osler: a hard worker and an inspiration]. PMID- 3287064 TI - [Tuberous sclerosis--an overlooked disease?]. PMID- 3287065 TI - [The midwife's bag--a piece of medical history]. PMID- 3287066 TI - [In Karolina's footsteps. 100 years of female physicians in Sweden]. PMID- 3287067 TI - [Female medical pioneers--the Swedish climate found to be good for strong personalities]. PMID- 3287068 TI - [From syphilis to AIDS: our openness about sex and companionship, the fruit of Karolina Widerstrom's days]. PMID- 3287069 TI - [Women's health--new research looking for answers to big questions]. PMID- 3287070 TI - [Protective effect of 2 acellular pertussis vaccines in a double-blind placebo controlled clinical trial]. PMID- 3287071 TI - [Adequate substitution of insulin deficiency is the basis of treatment of diabetes in young people]. PMID- 3287072 TI - [Ex situ operation on the liver. A new possibility in liver surgery]. AB - A method for an ex situ operation of the liver is presented with the example of such an operation in a 40-year-old patient. With this operation bilateral liver metastases of a leiomyosarcoma--which were otherwise regarded as irresectable- were resected. Function of the liver after reimplantation was good. Liver protection was performed by perfusion with cardioplegic HTK-solution (Bretschneider). The techniques of liver ex- and implantation are based on the methods of liver transplantation. Extracorporal femoro-porto-axillary bypass for decompression of the inferior caval vein and portal vein was used throughout the anhepatic period of 6 h. It is supposed that the method described here--which according to the authors' knowledge has been performed for the first time in a patient--will open up new perspectives for the surgery of malignant and occasionally of benign tumors, if necessary also for other surgical liver diseases. As an additional possibility, in situ protection of the liver with consecutive operation of the bloodless liver in situ is discussed. This procedure will correspond for the most part to the ex situ technique described here. PMID- 3287073 TI - [Transplantation of a donor liver to 2 recipients (splitting transplantation)--a new method in the further development of segmental liver transplantation]. AB - A donor liver was divided in such a way that the left part (segment II and III without caval vein) could be transplanted into a child, the right part (segment I, IV, V to VIII) into an adult successfully. Common bile duct and common hepatic artery remained with the left part of the liver, portal vein with the right one. In the recipient of the left part of the liver the own caval vein was preserved and anastomosed with the left hepatic vein; the other anastomoses were carried out in the typical way. In the recipient of the right part of the liver the right hepatic artery of the graft was anastomosed with the recipient's common hepatic artery using a saphenous interponate. Two separate intrahepatic bile ducts were anastomosed with a Roux-en-Y loop of the jejunum. The other anastomoses were carried out in the typical way. Thus the possibility of using one donor liver for two recipients (splitting transplantation) has been demonstrated. PMID- 3287074 TI - Reconstruction of the pylorus. PMID- 3287075 TI - Chronic atrophic gastritis and risk of N-nitroso compounds carcinogenesis. AB - Chronic atrophic gastritis is considered a precancerous condition for carcinoma of the stomach. To evaluate the correlation between progressive alterations in the mucosa and gastric juice microenvironmental factors, retained involved on N nitroso compounds carcinogenesis, detailed analyses of biochemical and microbiological parameters such as pH, total viable counts (TVC), nitrate reductase positive bacterial counts (NRPBC), nitrite (NO2-) and thiocyanate (SNC ) levels, were carried out on 56 fasting gastric juices samples obtained at endoscopy from 28 patients with chronic atrophic gastritis (CAG), 14 with gastric cancers (GC), and 14 normal controls (NC). The mean values of pH, nitrite, TVC, and NRPBC were significantly lower in the juices of NC than in those of CAG and GC patients. Furthermore, the mean levels of the same parameters were higher in GC than in CAG juices. No significant difference was found in the three groups for SCN- level which principally resulted influenced by smoke habit. The 28 patients with CAG were subdivided into two groups (Group A = Diffuse chronic atrophic gastritis--DCAG; Group B = Multifocal chronic atrophic gastritis--MCAG) according to the involvement of gastric corpus and fundus besides antrum by a process of mucosal atrophy. The mean levels of pH, nitrite, TVC, and NRPBC were significantly higher in MCAG than in normal controls but statistically lower in reference to DCAG and cancers. In these two groups no difference was found for the same variables. The percentage of contaminated juices was higher for DCAG and cancers in respect to MCAG but no difference was found between DCAG and neoplastic stomachs. The results of this study suggest that the DCAG could be considered as the chronic atrophic gastritis type more exposed to the risk of N nitroso compounds carcinogenesis. PMID- 3287076 TI - [Sutureless anastomoses in the rat, rabbit and pig]. AB - Healing of intestinal anastomoses was found to be effective in rat, rabbit and pig even after temporary approximation by sutures for one hour. Approximation of bowel segments was achieved by interrupted inverting sutures. After one hour a fibrinous connection of inverted serosa segments was to be observed. Bursting pressure was determined on the 1st, 3rd and 7th postoperative day. There was no significant difference between sutureless and regular anastomoses. Determination of breaking strength of approximated anastomoses one hour and twenty-four hours after removal of sutures was found to be 0.19 N and 0.8 N, respectively. Extent of adhesions was similar in conventional and sutureless anastomoses. Histologic analyses revealed areas of necrosis in sutured anastomoses, whereas in sutureless anastomoses no necrosis could be detected. PMID- 3287077 TI - [Treatment of pain in advanced tumors in the area of the head and neck]. AB - Different mechanisms of pain development and strategies of pain treatment are briefly described as an introduction. Since medicaments are preferentially used for the treatment of cancer pain, pharmacology of analgesics and principles of analgetic therapy are pointed out in more detail. Based on own experiences, a stepwise schedule for the treatment of pain in patients with advanced head and neck cancer is presented. PMID- 3287078 TI - [Neck-induced myoneural irritation pain--a recommendation for therapy by the ENT physician]. AB - A number of typical ENT complaints which do not involve organic signs or symptoms are presented, such as sinusitis-like headache, otitis-like earache and tonsillo pharyngitis-like dysphagia. Since patients with such complaints usually visit an ENT specialist first, an introduction of additional diagnostic and therapeutic measures is imperative. Without having been trained in chirotherapy, it is possible to identify painful locations, myogeloses and functional disorders in the craniocervical area. In many cases treatment of these disorders leads to disappearance of associated irritational complaints. In addition to local treatment of the neck, the ENT specialist may employ a procedure as described. Superficial infiltration of the mucous membrane is performed with a local suprarenin-free anaesthetic in an area around the upper wisdom tooth and on the palatoglossal arch. This procedure often leads to spontaneous and lasting relief of symptoms. It is assumed that this has the effect of inhibiting the pathologically irritated afferents and thus of interrupting an altered reflex arc. Relief from the complaints is improved by physiotherapy and by avoiding the detrimental influence of bad posture, nervous stress, air draughts, cold chills etc. Extensive massage therapy can result in worsening of complaints. PMID- 3287079 TI - Experimental studies on round window structure: function and permeability. AB - Current research and an overall review of 12 years of round window membrane studies is presented. The approach, rationale, and concepts that have evolved from the studies are described. An ultrastructural study of the round window membrane of rhesus monkeys disclosed three basic layers: an outer epithelium, a middle core of connective tissue, and an inner epithelium. Morphologic evidence in monkeys, cats, and chinchillas suggests that these layers of the round window participate in absorption and secretion of substances to and from the inner ear, and that the entire membrane could play a role in the defense system of the ear. Cationic ferritin, horseradish peroxidase, 1-micron latex spheres, and neomycin gold spheres placed in the middle ear of these experimental animals were observed to traverse the round window membrane through pinocytotic vesicles. Three-micron latex spheres and anionic ferritin were not incorporated by the membrane. Cationic ferritin and 1-micron latex spheres placed in perilymph were incorporated by the inner epithelial cells, suggesting absorptive capabilities of the round window membrane. Cationic ferritin was observed within the mesothelial cells underlying the scala tympani side of the basilar membrane, suggesting a role for these cells in the inner-ear defense system. A review of the subject and a general perspective from the author's viewpoint are discussed. PMID- 3287080 TI - [Hydrogen (H2) exhalation tests--methods for general practice]. AB - According to the literature as well as to own experience hydrogen breath tests seem to be suitable for a gastroenterologist's practice because of their practicability (this means non invasive and cheap methods) and their diagnostic relevance (sensitivity, specificity). Although hydrogen breath test with lactose is now the best way for diagnosis of lactose intolerance, hydrogen breath test with glucose as a mean of investigation of small bowel bacterial overgrowth still is subject to discussion. Lactulose hydrogen breath test in order to estimate small bowel transit time is of minor importance in gastroenterologist's practice. Yet at special questions it still may be of relevance (e.g. suspicion of functional diarrhea). PMID- 3287081 TI - Depletion of brainstem epinephrine stores by alpha-methyldopa: possible relation to attenuated sympathetic outflow. AB - The antihypertensive effect of alpha-methyldopa (MD) is believed to be critically dependent on its ability to deplete endogenous catecholamines or cause the synthesis of false neurotransmitters. We used liquid chromatography with electrochemical detection (LCEC) and negative chemical ionization gas chromatography-mass spectrometry (GC-MS) for quantitation of catecholamines and MD metabolites in rat. MD intraperitoneally (100 mg/kg q12 hr X 12 days), significantly increased alpha-methylnorepinephrine (MNE) in brain (1.02 +/- 0.33 micrograms/g), heart (1.67 +/- 0.57 micrograms/g) and adrenal glands (114.93 +/- 50.47 micrograms/g) Endogenous norepinephrine (NE), epinephrine (E) and dopamine (DA) were reduced. ME levels were 2.19 +/- 0.44 micrograms/g (n = 6) in the adrenal gland but only 99 +/- 26 pg/g (n = 3) in the brainstem. MD-induced endogenous brainstem NE depletion was more than compensated by MNE production, but brainstem E depletion was not compensated for by a stoichiometric production of brainstem ME. We conclude (1) although ME is a metabolite of MD, it is present in extremely low concentrations in brainstem and (2) central epinephrine containing neurons are depleted of neurotransmitter by MD therapy. If this selective epinephrine depletion occurs in the bulbospinal tract neurons responsible for maintaining sympathetic tone, then this effect could contribute to the antihypertensive effect of MD. PMID- 3287082 TI - Treatment of tyramine-induced brain edema with anion transport inhibitor L 644,711. AB - Tyramine induces coma in phenelzine-treated dogs. Development of coma in these animals is associated with brain edema, abnormal brain scans of Tc-99m-diethylene triamine-penta-acetic acid (Tc-99m-DTPA), and elevated levels of CSF catecholamines. We found that the intravenous administration of 6-7 mg/kg of a single dose of L-644,711 given fifteen minutes after the oral administration of tyramine to phenelzine-pretreated animals followed by an infusion of normal saline containing 6-7 mg/kg of the drug given over a period of 2 hr caused reversal of brain injury. This was accompanied by full recovery within a period of 24 hr of all the animals tested. A follow-up study revealed that 24 hr after treatment with L-644,711 CSF levels of catecholamines and brain images of Tc-99m DTPA were indistinguishable from normal controls. Animals that received no drug died from unresolved coma within 4 to 24 hr. Animals that had recovered due to therapy with L-644,711 were given 10-14 days rest followed by a repetition of the phenelzine and tyramine treatment but denied L-644,711 therapy. These animals also died of unresolved coma within 24 hr. This preliminary study suggest that the use of L-644,711 may constitute an important advance in treatment of brain edema of a wide range of neurological disorders. PMID- 3287083 TI - Butter-enriched diets reduce arterial prostacyclin production in rats. AB - Rats were fed diets containing 10%, 30% or 50% energy as fat derived predominantly from butter or lard. The protein content of the diets was maintained at 20%. After three weeks on the diets, the rats were killed and the following parameters measured: prostacyclin production in vitro from abdominal aorta and mesenteric artery; platelet aggregation to ADP and thrombin; fatty acid composition of the phospholipids in plasma, thoracic aorta and liver; smooth muscle reactivity and release of endothelial derived relaxing factor (EDRF) from aortic endothelium stimulated by acetylcholine. There was no significant effect of increasing fat content of the diets (neither lard nor butter) on platelet aggregation. In contrast, prostacyclin production in both the mesenteric artery and the abdominal aorta fell in a concentration-dependent manner in the butter supplemented rats. However, no effect on prostacyclin production was detected in arteries from the lard-supplemented animals. The effects of the diets on prostacyclin (PGI2) production correlated very well with the changes in plasma, aortic and liver phospholipid arachidonic acid (AA) and eicosapentaenoic acid (EPA) contents. AA decreased in a concentration-dependent manner in the rats fed the butter-enriched diets but did not change in those fed the lard-enriched diets, whereas EPA rose in a concentration-dependent manner in the butter-fed rats and was unchanged in the lard-fed animals. The clear-cut effects of the butter-enriched diets on aortic phospholipid fatty acid composition and aortic PGI2 production were accompanied by a significant reduction in smooth muscle relaxation to EDRF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287084 TI - [Radioimmunologic evaluation of the evolution and nature of hyperparathyroidism following allotransplantation of the kidney]. AB - A study of the level of immunoreactive parathyrin in the peripheral blood of 81 patients after kidney allotransplantation (53 patients with satisfactory graft function and 28 patients after graft rejection) revealed hyperparathyroidism in 69.2% of the patients with satisfactory function and in 100% of the patients with chronic rejection of the kidney graft. With an increase in the postoperative period the involution of hyperparathyroidism was found only in half of the patients. In 66.1% of the patients hyperparathyroidism was of secondary nature, in 20.3%--of "tertiary" nature, and relative pseudohypoparathyroidism was observed in 13.5%. PMID- 3287085 TI - [Dilatation of the bile ducts on the sonogram--an early manifestation of developing mechanical jaundice]. PMID- 3287086 TI - [Monoclonal antibodies against malignant tumors of organs in the gastrointestinal tract]. PMID- 3287087 TI - Messenger RNA turnover in eukaryotic cells. PMID- 3287088 TI - Adverse reactions and interactions of cyclosporin. AB - Cyclosporin is a potent, widely used specific immunosuppressive agent which affects T-helper cells, and has little myelotoxicity. Its pharmacokinetics are complex and many of its actions remain poorly understood. Numerous side effects have been reported, affecting most organs. Most troublesome have been renal injury, systemic hypertension and vascular changes. Oral use is more effective than intramuscular and safer than the intravenous route. Interactions with other drugs include those which affect hepatic metabolism and those which reduce clearance. Aminoglycosides, macrolide antibiotics, imidazole derivatives, calcium channel blockers, sulphonamides and steroids are included in such interactions. Other metabolic effects of cyclosporin are more subtle and include hyperchloraemic alkalosis, changes in serum potassium and magnesium and effects on testosterone and prolactin levels. Acute poisoning with cyclosporin has been reported, again without myelosuppression. Cyclosporin is an important agent with multisystem toxicity, which requires precise monitoring of drug concentrations, liver and renal function, haemoglobin levels and plasma electrolytes. Cyclosporin pharmacodynamics and interactions with other drugs need to be carefully considered if lower rates of toxicity are to be achieved. PMID- 3287089 TI - Pharmaceutical excipients. Adverse effects associated with inactive ingredients in drug products (Part I). AB - Excipient reactions have resulted from the use of clearly toxic substances (e.g. diethyleneglycol), the use of certain excipients in a susceptible group (e.g. very low birthweight neonates, patients with large surface area burns, patients with a history of asthma or contact dermatitis), the alteration of an excipient mixture resulting in altered bioavailability (e.g. phenytoin), and the deliberate or inadvertent extradural administration of preserved medications intended for intravenous use. Inadvertent excipient overdose has also occurred when unusually large doses of a drug containing a preservative were used [chlorbutol in morphine, ethanol in glyceryl trinitrate (nitroglycerin)]. Most excipient problems are preventable with knowledge of the currently available formulation. Government drug regulatory agencies have largely prevented introduction of a new toxic excipient; however, the new use of previously approved (but not adequately studied) excipients continues to result in unfortunate tragedies (e.g. the E ferol incident). Populations at risk should be monitored carefully. Very low birthweight infants (less than 100g) have a well-demonstrated intolerance to many excipients, particularly during the first 2 weeks of life. Research should be directed toward development of non-preserved medications and safer diluents for this population. Drugs and excipients which have previously been demonstrated to be safer in other populations (e.g. doxapram) should be meticulously studied in this age group before widespread use is recommended. Asthmatic patients comprise another population that are frequently sensitive to excipient toxicity. In some cases, as in sulphiting agents, which are ubiquitous in foods as well as in medications, total avoidance may not be possible and prophylactic therapy may be beneficial. Inactive ingredients are clearly not consistently inert in their biological activity and therefore should not be listed as such. A more useful and concise term is excipient. It is highly recommended that all pharmaceutical manufacturers list all their excipients and make this available to practitioners and drug information centres. Alternatively or additionally, the package insert should list these excipients in accordance with good manufacturing procedures. This disclosure will help to determine the relative frequency and magnitude of problems (bioequivalence, toxicity, etc.) that excipients may have in the population, as well as enabling susceptible patients to avoid inadvertent exposure. PMID- 3287090 TI - Whole bowel irrigation as a gastrointestinal decontamination procedure after acute poisoning. PMID- 3287091 TI - The beta cell glucose stimulus-response curve in normal humans assessed by insulin and C-peptide secretion rates. AB - Insulin and C-peptide secretion rates have been measured and compared in 12 nondiabetic subjects to characterize the glucose stimulus-response of B cell secretion in man. On three different days, glucose concentrations were clamped for 150 minutes at 7.5, 10, and 15 mmol/L, respectively. Plasma samples taken during the clamps were assayed for C-peptide and insulin. C-peptide secretion rates were estimated by the technique of deconvolution. Model-based estimation of insulin secretion rates from insulin concentrations yielded concordant results. In response to glucose, C-peptide concentrations rose less quickly than did insulin concentrations, but the estimated first- and second-phase secretion rates were similar when assessed from either the C-peptide or insulin concentrations. First-phase secretion peaks were larger than inspection of the plasma concentration data might suggest, with median values of 1.3, 2.0, and 2.9 nmol/min for C-peptide in response to 7.5, 10, and 15 mmol/L glucose clamp levels, respectively. The second-phase reached steady state by 90 to 120 minutes, with median C-peptide secretion rates of 0.31, 0.56, and 0.85 nmol/min after 120 minutes at 7.5, 10, and 15 mmol/L, respectively. The slopes of the curves of steady-state insulin and C-peptide secretion rates v the four glucose levels (basal plus the three clamp levels) were maximally steep between 7.5 and 10 mmol/L in the majority of subjects, consistent with in vitro sigmoidal responses. A characterization of the secretory response of the B cell of normal humans at different glucose concentrations has been obtained. With appropriate models, insulin secretion rates may be estimated from either plasma insulin or C-peptide concentration data. PMID- 3287092 TI - Impact of methionine on net ketoacid production in humans. AB - An exogenous acid load (NH4Cl) inhibits net ketoacid production in the first week of starvation and the fourth to eighth weeks of ketogenic dieting. To determine whether an acid load produced by amino acid metabolism can similarly modify ketosis, five overweight volunteers ingested methionine (H2SO4), NH4Cl, and NaCl (control), in varying order, each day for seven days during weeks 5 to 8 of hypocaloric ketogenic dieting. During days 5 to 7 of each phase, blood pH, bicarbonate, and pCO2 were stable but lower in the NH4Cl phase (7.32 +/- 0.02, 18.1 +/- 1.2 mmol/L, 35.8 +/- 1.4 mmHg) and the methionine phase (7.33 +/- 0.01, 17.1 +/- 0.9 mmol/L, 34.0 +/- 2.0 mmHg) than in the NaCl phase (7.38 +/- 0.01, 22.3 +/- 0.2 mmol/L, 37.6 +/- 1.6 mmHg), P less than .05. Over this period, blood acetoacetate concentration was lower during the methionine and NH4Cl phases than during NaCl, P less than .05. In addition blood beta-hydroxybutyrate and total ketone-body concentrations were lower in the methionine than NaCl phases, P less than .05. Urinary acetoacetate and beta-hydroxybutyrate excretion fell with both acid loads, P less than .05. Compared with control values, urinary total ketone excretion was suppressed by 67 +/- 10% in the NH4Cl and 89 +/- 3% in the methionine periods. When NaCl was ingested after either of the acid loads, urinary ketone excretion increased by 300% to 700%. Thus, methionine ingestion, which results in an acid challenge equivalent to that of a large protein load, has an impact on net ketoacid production similar to that of NH4Cl.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287093 TI - Portable continuous blood glucose analyzer. PMID- 3287094 TI - Automated TELISA procedure for process monitoring. PMID- 3287095 TI - Soluble enzyme--albumin conjugates: new possibilities for enzyme replacement therapy. PMID- 3287096 TI - Immobilization of a cytochrome P-450 enzyme from Saccharomyces cerevisiae. PMID- 3287097 TI - Preparation of metal-hybrid enzymes. PMID- 3287098 TI - The phenotypic suppression of a mutation in the gene rplX for ribosomal protein L24 by mutations affecting the lon gene product for protease LA in Escherichia coli K12. AB - A suppressor mutation of a temperature-sensitive mutant of ribosomal protein L24 (rplX19) was mapped close to the lon gene by genetic analysis and was shown to affect protease LA. The degradation and the synthesis rates of individual ribosomal proteins were determined. Proteins L24, L14, L15 and L27 were found to be degraded faster in the original rplX19 mutant than in the rplX19 mutant containing the suppressor mutation. Other ribosomal proteins were either weakly or not at all degraded in both mutants. Temperature-sensitive growth was also suppressed by the overproduction of mutant protein L24 from a plasmid. Our results suggest that (1) either free ribosomal proteins or proteins bound to abortive assembly precursors are highly susceptible to the lon gene product and (2) the mutationally altered protein L24 can still function at the nonpermissive growth temperature of the mutant, if it is present in sufficient amounts. PMID- 3287100 TI - Susceptibility of fibronectin to degradation by various gram-negative and gram positive oral micro-organisms. AB - The degradative effects on tritiated human plasma fibronectin (FN) of proteases associated with twenty five Gram-negative (GN) and fifteen Gram-positive (GP) oral microbial isolates were examined. Ninety-two per cent of the GN and 20% of the GP isolates degraded the FN. In the GN group, the degradative effects were greatest for Bacteroides gingivalis and Treponema denticola, while in the GP group Streptococcus faecalis produced appreciable, and the two Lactobacillus casei isolates moderate and low, levels of FN degradation. PMID- 3287099 TI - Characterization of a sequence (hlyR) which enhances synthesis and secretion of hemolysin in Escherichia coli. AB - A sequence (hlyR) of about 600 bp which enhances the expression of hemolysin (HlyA) more than 50-fold was identified in the plasmid pHly152-specific hemolysin (hly) determinant. Deletion of this entire hlyR sequence led to the same low level of hemolysin synthesis and excretion as that expressed by the recombinant plasmid pANN202-312. HlyR was active in cis but its activity was orientation dependent. The enhancing sequence, hlyR, is separated from the promoter phlyI transcribing hlyC, hlyA and possibly hlyB by more than 1.5 kb including an IS2 element. Stepwise removal of the hlyR sequence from its 5' end by exonuclease III (ExoIII) digestion yielded several types of deletion mutants which expressed decreasing amounts of hemolysin. A similar observation was made when hlyR was shortened by ExoIII from its 3' end, which suggests that more than one functional region may be present in the hlyR sequence. A deletion of 717 bp within the adjacent IS2 element reduced the activity of hlyR only slightly, indicating that IS2 is not directly involved in the enhancement mechanism but that it may support an optimal positioning in hlyR relative to the hly promoter. The nucleotide sequence of hlyR is rich in A + T and does not contain an extended open reading frame, but exhibits several sequence motives that may represent sites for protein binding and DNA bending. PMID- 3287101 TI - Adhesion of enterotoxigenic (ETEC) and bovine mastitis Escherichia coli strains to rat embryonic fibroblasts: role of amino-terminal domain of fibronectin in bacterial adhesion. AB - Adherence of human enterotoxigenic and bovine mastitis Escherichia coli to rat embryonic fibroblasts was studied. Adhesion of E. coli strains B34289c (human) and 1407 (bovine) was rapid and reached maximum after 30-40 min. Strain 1410 (bovine), which binds fibronectin but not its 29K amino-terminal fragment, did not adhere to the fibroblasts. Strain B34289c grown at 25 C or below and at 40 C or above lost its binding and adhesive properties simultaneously. Maximum binding and adhesion for this strain was achieved when it was grown at 33 C. Strains grown at this temperature adsorbed to fibronectin-, 29K fragment-, and Octyl Sepharose, with the exception of bovine strain 1410, which did not adsorb to 29K Sepharose as expected. None of the strains adsorbed to cross-linked Sepharose 4B. 29K-IgG and Fab fragments thereof specifically blocked both binding (max 55%) and adhesion (greater than 95%). Sonicated and trypsin-treated bacteria were no longer able to bind or adhere. The supernatant of sonicated bacteria inhibited both binding and adhesion. Penicillin G at 0.5 micrograms/ml (1/5 minimal inhibitory concentration: MIC) and tetracycline at 0.2 micrograms/ml (1/5 MIC), when included in the growth medium, suppressed the cell surface components responsible for fibronectin binding and fibroblast adhesion. The presence of fibronectin was demonstrated in the fibroblast extracellular matrix by immunofluorescens with 29K-IgG antibodies. PMID- 3287102 TI - Chemotaxis for methamphetamine in Escherichia coli. AB - Escherichia coli showed the chemotactic response for methamphetamine, a biogenic stimulative amine. The response was qualitatively detected by using a paper disk filter. The quantitative assay showed that E. coli responded to methamphetamine at 10(-5) M or more. PMID- 3287103 TI - Hemagglutination activity and localization of Fc receptor of group A and G streptococci. AB - The IgG-Fc binding activity and binding sites on the cell surface of streptococci, strains AR1 (group A) and G148 (group G), and Staphylococcus aureus strain Cowan I were examined by hemagglutination (HA) and immunoelectron microscopic methods. No distinct difference was observed in the HA activity among these three strains. However, the strains differed in the distribution of Fc receptor. Cowan I cells (having protein A) were heavily covered with two layers of ferritin particles, whereas AR1 cells were heavily covered with a single, rough layer of ferritin particles. G148 cells (having protein G) were labeled with a relatively thin, rough ferritin layer. The trypsin susceptibility of the Fc receptors of the AR1 strain was much higher than that of the G148 strain. These results suggest that both streptococcal strains are distinctly different in the arrangement or in the conformation of the Fc receptor from the Cowan I strain. It is also suggested that the Fc receptor molecules of the streptococcal strains differ from each other not only in conformation but also in trypsin susceptibility. PMID- 3287104 TI - Homologous human macrophage hybridomas that produce a novel cytotoxic factor in their culture supernatants. AB - Homologous human macrophage hybridoma cell lines were obtained by somatic cell fusion between peripheral blood monocyte-derived macrophages and a subclone of the myelomonocytic cell line, U937-F9. The hybridoma cell lines grown in vitro for more than a year were confirmed by manifestations of phagocytosis, adherence, nonspecific esterase, acid phosphatase, chromosome numbers and other cell surface antigens. Cell surface antigens on hybridomas were detected by flow cytometry analysis with monoclonal antibodies. With interclonal differences, a typical phenotype of hybridoma cells was CDw14+, OKM5+, Mac-1+ (equivalent to OKM1 and Mol), OKT9+, HLA-DR- and CD20+. After stimulation with lipopolysaccharide and calcium ionophore A23187, culture supernatants of clones c18A and c29A showed cytotoxic activity against human melanoma A375 Met-Mix and other cell lines which were resistant to the tumor necrosis factor, lymphotoxin and interleukin 1. This cytotoxic factor was found to be distinct from the tumor necrosis factor, lymphotoxin and interleukin 1 using the anti-tumor necrosis factor, anti lymphotoxin and anti-interleukin 1 antisera. PMID- 3287105 TI - Nature of monocyclic beta-lactam antibiotic Nocardicin A to beta-lactamases. AB - Nocardicin A is the antibiotic which was first found to possess a monocyclic beta lactam ring. This antibiotic was inactivated by the cleavage of its beta-lactam ring. The direct spectrophotometric assay was applied to measure the rate of enzymatic hydrolysis of Nocardicin A. Nocardicin A was highly stable to both chromosomal and plasmid-mediated beta-lactamases. Of the nine beta-lactam antibiotics including cefoxitin and cefuroxime, Nocardicin A was the most stable to the beta-lactamases tested excluding those from Klebsiella oxytoca and Proteus vulgaris. The latter broad-spectrum beta-lactamases hydrolyzed Nocardicin A rather intensively. Extreme stability of Nocardicin A to beta-lactamases was suggested to be due to the combination of its low affinity to the enzymes and stabilization of its monocyclic beta-lactam ring. Nocardicin A was shown to have inducing ability toward beta-lactamases. PMID- 3287106 TI - In vitro hexagonal assembly of R-form lipopolysaccharides: effect of pH on the Mg+2-mediated hexagonal assembly. AB - The R-form lipopolysaccharide (LPS) from Escherichia coli K-12, from which cationic material had been removed by electrodialysis and the pH of which had fallen to 3.6, formed a rough hexagonal lattice structure with the lattice constant of about 19 nm. The rough hexagonal structure was maintained in buffers at pH 5 or lower but disintegrated into the ribbon-like structures in buffers at pH 6 or higher. However, in the presence of 10 mM Mg2+, the hexagonal lattice structure was not disintegrated even at alkaline pH levels but conversely it became more dense. At pH 8.3 to 8.9, the hexagonal lattice structure with the shortest lattice constant (15 nm) was formed. The same optimal pH levels were obtained for formation of the dense hexagonal lattice structure (lattice constant, 14 to 15 nm) by the electrodialyzed LPS from Klebsiella pneumoniae strain LEN-111 (O3-:K1-). The ability of Mg2+ to induce formation of the dense hexagonal lattice structure of the K-12 LPS depends upon the presence of buffers showing the optimal pH levels, since a very high concentration of Mg2+ such as 500 mM was required for the lattice formation in distilled water. The amount of the magnesium bound to the K-12 LPS did not significantly differ throughout the pH range of 3 to 9. Therefore, the optimal pH range is another essential factor for formation of the dense hexagonal lattice structure of the LPS in addition to binding of the magnesium to the LPS. PMID- 3287107 TI - Large plasmid in Shigella boydii is responsible for epithelial cell penetration. AB - A large plasmid in a virulent Shigella boydii 5 strain was transferred to plasmid cured avirulent strains of S. boydii 5, S. boydii 12, S. sonnei form II, and Escherichia coli K12. The transconjugants acquired the ability to invade tissue culture cells, which indicated that the large plasmid in S. boydii is responsible for epithelial cell invasiveness. PMID- 3287108 TI - Simplified method for preparation of concentrated exoproteins produced by Staphylococcus aureus grown on surface of cellophane bag containing liquid medium. AB - A simplified method for preparation of concentrated exoproteins including protein A and alpha-toxin produced by Staphylococcus aureus was successfully devised. The concentrated proteins were obtained by cultivating S. aureus organisms on the surface of a liquid medium-containing cellophane bag enclosed in a sterilized glass flask. With the same amount of medium, the total amount of proteins obtained by the method presented here was identical with that obtained by conventional liquid culture. The concentration of proteins obtained by the method, however, was high enough to observe their distinct bands stained on polyacrylamide gel electrophoresis. This method was considered quite useful not only for large-scale cultivation for the purification of staphylococcal proteins but also for small-scale study using the proteins. The precise description of the method was presented and its possible usefulness was discussed. PMID- 3287109 TI - The role of nuclear medicine in liver transplantation. AB - The role of hepatobiliary isotopic scanning after liver transplantation was assessed in the first 12 adult patients in the Pilot National Liver Transplantation Programme who underwent this procedure at the Royal Prince Alfred Hospital. Iminodiacetic-acid derivative (HIDA) studies were useful in the non invasive assessment of hepatic function and biliary excretion. The following four clinical situations were assessed by hepatobiliary scans: early graft function; rejection episodes; vascular complications; and biliary-tract problems. Nuclear medicine has an important and valuable role in the postoperative monitoring of patients after liver transplantation. The studies are non-invasive and can be performed readily at the bedside in the intensive care unit. PMID- 3287110 TI - The pathophysiology of shock. AB - Shock describes a group of circulatory syndromes, all of which result in generalized cellular hypoxia. This leads to the depletion of adenosine triphosphate, the failure of the sodium-potassium pump, mitochondrial dysfunction, and ultimately, the release of a variety of toxic substances. Eventually these given rise to irreversible cardiovascular collapse because of their effects on the microcirculation. Shock may arise due to a failure of preload (hypovolaemic shock), myocardial contractility (cardiogenic shock), afterload (septic shock) or combinations of these (for example, anaphylactic shock, traumatic shock and neurogenic shock). During shock, important physiological changes occur in the nervous, respiratory, renal and gastrointestinal systems, as well as in intermediary metabolism. Hypotension is not synonymous with shock, and emphasis should be placed on the detection of more subtle, early signs. Management requires a systematic approach in which diagnostic and therapeutic processes take place in parallel. Particular attention must be paid to ventilation, oxygenation, fluid and electrolyte therapy, haemodynamic monitoring and, where appropriate, inotropic drugs. Corticosteroid and opioid antagonist agents probably do not have a role, but other agents, such as thyroid hormones, are under investigation. PMID- 3287111 TI - [Early summer meningoencephalitis, rickettsial diseases, Borrelia infections: diseases carried by ticks]. PMID- 3287112 TI - [Organ transplantation. Aspects and perspectives based on the example of kidney transplantation]. PMID- 3287113 TI - [Therapy of hyperlipidemia. Recommendations of the European Arteriosclerosis Society]. PMID- 3287114 TI - [Sonographic assessment of diaphragm motility in patients with chronic obstructive respiratory diseases]. PMID- 3287115 TI - [Hemorheologic treatment of acute cerebrovascular disorders: what is safe?]. PMID- 3287116 TI - [Systemic non-typhoid salmonelloses]. PMID- 3287117 TI - [Computer-assisted medical diagnosis]. PMID- 3287118 TI - [Hypercalcemic crisis in primary hyperparathyroidism in pregnancy with medullary nephrocalcinosis]. PMID- 3287119 TI - Functional implications of structural differences between consecutive segments of microvascular endothelium. AB - Structural and functional data which can be ascribed to consecutive segments of the microvascular bed are reviewed and tentatively correlated. Compared to the knowledge of endothelial cells in general, little is known about segmental variations of the microvascular endothelium. The gradient in microvascular permeability has been quantified by single capillary techniques. The results conform to structural data on endothelial tight junctions which indicate that pathways through the junctions occur with increasing frequency towards the venous end of the microvascular bed. A number of compounds mediate gap formation in venular endothelium presumably via endothelial surface-receptors. It has been demonstrated that receptors to histamine are preferentially located at the luminal surface of venular endothelium. Immunocytochemical localization of metabolic activities of microvascular endothelium in situ has started; thus it has been shown that specific antibodies to xanthine oxidase bind only to endothelium of true capillaries. PMID- 3287120 TI - The role of venular endothelial cells in the regulation of macromolecular permeability. AB - It is well documented that inflammatory mediators produce increases in fluid filtration promoting massive edema formation in limb skin and skeletal muscle. The edema is attributable to an increase in the transmural hydrostatic pressure gradient subsequent to an increase in microvascular pressure (Pmv) and, more importantly, to a decrease in the transmural colloid osmotic pressure gradient subsequent to an increase in vascular permeability to macromolecules. The mediators produce increases in net fluid filtration, protein clearance, the L/P total protein ratio, and edema formation in the absence of increases in blood flow and Pmv demonstrating that increases in vascular permeability are not dependent on changes in blood flow, Pmv, or surface area per se. Since the inflammatory mediators produce increases in the L/P protein ratio and edema formation in vascular beds perfused with cell-free, artificial perfusates, the increase in permeability likely results from an interaction between the mediator and the vascular endothelium. The findings demonstrating that mediator-stimulated increases in net fluid filtration, protein clearance, the L/P ratio, and edema formation are subject to inhibition by selective mediator receptor antagonists suggests that the increase in vascular permeability is dependent on the activation of a receptor mediated physiological mechanism which regulates the porosity of the vascular endothelium to macromolecules. Findings from microscopic studies demonstrate that the inflammatory mediators trigger the extravasation of macromolecules exclusively from the postcapillary venules, and that increases in the flux of macromolecules between the vascular and interstitial fluid compartments is dependent on the formation of leakage sites in the postcapillary venules. Electron microscopic studies of the vascular leakage sites reveals the formation of large gaps between adjacent endothelial cells, and changes in cell shape including a wrinkling of the nucleus suggestive of endothelial cell contraction. Contractile proteins and receptors for many substances including inflammatory mediators are found in endothelial cells, and receptor modulated changes in endothelial cell shape associated with active changes in the contractile proteins have been demonstrated in endothelial cells in culture. The inflammatory mediators appear to trigger active endothelial cell contraction inducing the transient, reversible formation of large junctional gaps between adjacent cells in the postcapillary venules.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3287121 TI - Pharmacology of arterioles versus venules: an overview. AB - Although a considerable amount of information exists regarding the pharmacology, physiology and biochemistry of arterial and venous smooth muscles, little in the way of such precise quantitative information exists with respect to arterioles and venules within different regions of the microvasculature. From the available data, it is clear that microvessels from within a single microvasculature, as well as in different regions of the circulation, display heterogeneity with respect to their physiology, pharmacology and biochemistry. Differences in receptor sub-populations and composition exist along the microvascular tree as well as varying degrees of autonomic innervation and neurotransmitters between different microvessels. Although these factors in themselves are important in conferring microvasculature heterogeneity, a number of other physiologic, pharmacologic as well as experimental factors also seem to be a critical; included here are endothelial cells, sex hormones, ionic milieu, membrane composition, geometry, tissue metabolism, diet, physiologic state of host, anesthesia-analgesia, buffers, route of drug administration, etc. It is rather obvious that design of therapeutic drugs for specific cardiovascular problems must perforce take such factors into careful consideration. PMID- 3287122 TI - [Plasma renin activity in relation to sodium excretion. Evaluation in 76 healthy newborn infants and children on a free diet]. PMID- 3287123 TI - [Chronic benign mucous membrane pemphigoid. Remarks apropos of a case of desquamative gingivitis]. PMID- 3287124 TI - [Sturge-Weber syndrome]. PMID- 3287125 TI - [Nonsurgical etiological therapy. An analysis of the literature]. PMID- 3287126 TI - [Scaling and root planing: principles and modalities]. PMID- 3287127 TI - [The role of toxic cement in the pathogenesis of periodontitis]. PMID- 3287128 TI - [Scanning electron microscopic examination of root surfaces after scaling and root planing]. PMID- 3287129 TI - [Endodontic anatomy of the lower incisors. Radiographic studies and therapeutic approaches]. PMID- 3287130 TI - St. Louis University. PMID- 3287131 TI - [The role of in vivo interaction of proteins SSB with DNA polymerase II]. AB - In order to elucidate the role of in vivo interaction of single-strand DNA binding protein with DNA polymerase II isogenic strains of Escherichia coli were constructed combining the ssb+, ssb-1 alleles with DNA polymerases I or II mutations; their radiosensitivity and a level of UV-induced DNA degradation were studied. Received findings suggest a functional antagonism of SSB-proteins depending on intracellular conditions (from the balance of DNA and protein synthesis). The SSB-proteins provide the stability of the genome or, vice versa, perturb the stability of the genome, by degrading of DNA macromolecules. PMID- 3287132 TI - [Genetic engineering of peptide hormones. III. Cloning of the swine growth hormone cDNA and construction of the gene for expression of the hormone in bacteria]. AB - The clones containing cDNA of porcine growth hormone were obtained using poly(A) RNA from porcine pituitary as a template for reverse transcriptase. The analysis of their nucleotide sequences revealed that these cDNAs have differences not only on the nucleotide level but also on the amino acid level, i. e. the polymorphism of mRNA and protein occurs in the case of porcine growth hormone. To create the construction for expression of porcine growth hormone in E. coli, the 5'-part of cDNA, coding the first 15 amino acids of the mature hormone, was substituted by the artificial sequence. PMID- 3287133 TI - [Structural-functional organization of DNA in the interphase nucleus. Structural aspects]. AB - The role of residual nuclear structures (structures persisting upon the treatment of nuclei with a non-ionic detergent, nucleases and 2 M NaCl) in the spatial organization of DNA in the interphase nucleus has been considered. Experimental works that have engendered the concept of loop level of DNA organization in the nucleus are discussed. A comparison is made of the loop-domain and rosette-like patterns of DNA organization in the interphase nucleus. PMID- 3287134 TI - [Interaction of tryptophanase with substrate analogs]. AB - Tryptophanase from Escherichia coli was studied with respect to its interactions with L-alanine, beta-chloro-L-alanine, L-phenylalanine, L-methionine, L threonine, beta-phenyl-DL-serine (threo form) and also with a new tryptophan analog oxindolyl-L-alanine. Slow transamination of L-alanine in the active site of the enzyme was observed. Some evidence is presented which indicates that the side transamination reaction occurs during incubation of tryptophanase with an adequate substrate, beta-chloro-L-alanine. Absorption and circular dichroism (CD) spectra of the enzyme-quasisubstrate complexes have been recorded. Addition of beta-phenylserine and threonine to the enzyme induces a decrease of absorbance at 337 nm and an increase of absorbance at 420 nm. The spectral changes are associated with inversion of the CD sign, i.e. with disappearance of positive CD in the 420 nm band and appearance of negative CD in this band. It is inferred that beta-phenylserine and threonine form an external coenzyme-substrate aldimine which undergoes slow conversion to give a keto acid and the free enzyme. Addition of oxindolylalanine to tryptophanase results in the formation of an intense narrow absorption band at 504 nm with a shoulder at about 475 nm. This band belongs to a quinonoid intermediate. A positive CD is seen in the 504 nm band; the dissymmetry factor (delta A/A) in this band is much smaller than that in the absorption bands of the free enzyme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287135 TI - [Stability of normal, abnormal and recombinant proteins in Escherichia coli strains deficient for intracellular proteinase La--the product of the lon gene]. AB - Escherichia coli Lon-mutants deficient in intracellular protease La have been isolated. The rate of degradation of normal cellular proteins was 1.5-2-fold lower in Lon-mutants as compared with that of the wild type strain. The rate of degradation of canavanine-containing abnormal proteins, as well as foreign proteins was significantly higher in E. coli than that of normal proteins. Lon mutants possessed 2-2.5-fold lower rates of degradation of abnormal proteins as compared with Lon+-strains. The rate of degradation of human interferon alpha-2 was 10-fold higher in E. coli than that of abnormal proteins. B. amyloliquefaciens alpha-amylase degraded in E. coli with the rate comparable with that of abnormal proteins, since chloramphenicolacetyltransferase from Tn9 was stable in E. coli. The rate of degradation of interferon alpha-2 was 2-fold lower in Lon-mutants (half-life 23-26 min) than in the initial strain (11-12 min). Lon mutants were effectively used as recipient strains for constructing strains producers of several human alpha- and beta-interferons. PMID- 3287136 TI - [Comparative analysis of the structure of double-stranded RNA from killer strains of Saccharomyces cerevisiae]. AB - Double-stranded RNAs (M and L molecules) of two strains of the killer system Saccharomyces cerevisiae M437 (wild type) and ski-5 (superkiller mutant) were studied by means of electron microscopy and high resolution thermal melting. The M molecules of the ski-5 mutant were by 100 b.p. shorter than those of M437. L molecules were of the same length for both strains. Analysis of the differential melting curves of L molecules showed that L molecules differ significantly in their nucleotide sequences, whereas M molecules were practically identical. It was found that M molecules contained a long AU region: that of M molecules of M 437 was 170-180 b.p. long and contained almost no GC pairs, whereas the AU region of M molecules of the ski-5 mutant was three times shorter and contained GC pairs. PMID- 3287137 TI - [Informosomes and translation activity of mRNA in eukaryotic cells]. AB - In this review we summarize recent results which are obtained in the field of structure and functions of cytoplasmic mRNP, or informosomes. These data lead to conclusion, that the informosomal structure of mRNA in eukaryotic cells makes possible the establishment of translational control by masking-demasking of messages. PMID- 3287138 TI - [Physical and physico-chemical research in Soviet molecular biology 1977-1987]. PMID- 3287139 TI - Spectrotypic analysis of antibodies to insulin A and B chains. AB - Antibodies produced by immunization with native insulin were analyzed by isoelectric focusing for binding to isolated A and B chains. Antibodies to isolated A chain of beef insulin were found to have restricted spectrotypes and were seen after immunization with either beef or human insulin. Hyperimmunization with beef insulin, but not human, increased the heterogeneity of anti-A chain antibodies. Antibodies to isolated B chains were also electrophoretically restricted but showed less heterogeneity after hyperimmunization than anti-A chain responses. When binding to chains was carried out in the presence of excess cold insulin, anti-B chain spectrotypes were inhibited by the native molecule. In contrast, only a portion of anti-A chain spectrotypes were inhibited by native insulin, suggesting that these clonotypes are directed at epitopes not present on the surface of the molecule. These data indicate that the anti-insulin repertoire includes antibodies that can bind isolated chains as well as the native molecule. Some of the determinants on isolated A chain are not available on intact insulin and may arise from antigen catabolism. PMID- 3287140 TI - Monoclonal antibodies directed to the blood group A associated structure, galactosyl-A: specificity and relation to the Thomsen-Friedenreich antigen. AB - Two monoclonal antibodies, HH8 and HH9, have been established after immunization of mice with galactosyl-A glycolipid antigen having the terminal structure, Gal beta 1----3GalNAc alpha 1----3[Fuc alpha 1----2]Gal beta 1----R, which is the precursor for type 3 chain A (repetitive A) and type 3 chain H (A-associated H). Both antibodies react strongly and specifically with galactosyl-A, but HH8 (IgM) showed strong hemagglutination of blood group A1, A2, O and B erythrocytes after sialidase treatment, while HH9 (IgG1) did not react with human erythrocytes even after sialidase treatment. HH8 and anti-T antibody, but not HH9, reacted with glycophorin A after sialidase treatment. The reactivity of HH8 with glycophorin A was abolished by beta-galactosidase and was inhibited by liposomes containing galactosyl-A, but not other glycolipids. In addition, anti-T antibody and peanut lectin reacted specifically with galactosyl-A glycolipids. These findings indicate that HH8 recognizes the terminal disaccharide Gal beta 1----3GalNAc alpha 1----R, which is the same sequence as the classically known Thomsen Friedenreich antigen (T-antigen), whereas HH9 does not cross-react with T-antigen but recognizes the entire galactosyl-A structure. The T-antigen was also demonstrated by immunohistology with HH8 after neuraminidase treatment in a subset of cells in stratified epithelium. PMID- 3287141 TI - Peptide mapping studies of the pertussis toxin substrate in human neutrophils, platelets and erythrocytes. AB - Protease digestion of the ADP-ribosylated pertussis toxin substrate (PTS) protein was carried out after solubilization with SDS (Cleveland gels) and in the intact membrane. Cleveland gel analysis showed substantial similarities in the maps for the PTS component in neutrophils, platelets and erythrocytes and also in the S49 AC-lymphoma cell line. In the intact membrane ADP-ribosylation followed by digestion showed limited access of proteases to the PTS component. Of eight proteases tested, only papain and Staphylococcus aureus gave substantial digestion. This pattern was observed in the human platelet, erythrocyte and neutrophil plasma membranes. When the sequence was reversed and ADP-ribosylation was carried out after protease digestion, a very different pattern was observed with much greater susceptibility to digestion being noted with several proteases. By contrast, analysis of the murine AC-membrane showed some minor variations in the digest patterns. In addition, under all three conditions tested, maps of the cholera toxin substrate for the human platelet showed remarkable similarities to those obtained with the pertussis toxin substrate. Our results indicate that the protease sensitive sites of the alpha subunit of PTS and protection from proteolysis after ADP-ribosylation are properties which are shared by the PTS components of human platelets, erythrocytes and neutrophils. PMID- 3287142 TI - Antigenic competition in the immune response against protein mixtures: strain specific non-immunogenicity of Escherichia coli antigens. AB - Antigenic competition is argued to impair the immune response on the level of accessory cell-dependent antigen presentation to responsive T-cells (regulated by MHC encoded Ir gene products). A possible influence of these mechanisms on in vivo immunization with antigen mixtures was investigated by using cytoplasmic extracts of four different strains of Escherichia coli as antigen sources for immunizing rabbits. The immune response against these antigen mixtures was tested by crossed immune electrophoresis (CIE) and immunoblotting (IB) in a homologous system (a given antigen extract of one strain against the corresponding antisera) and in the heterologous system (antigen extract of one strain against the antisera of different other strains). Several proteins were non-immunogenic in the extract of one strain but elicited good antibody responses in other strains. One of the strain-specific non-immunogenic proteins was purified and revealed a normal immune response upon immunization. The data suggest that different antigenic competition effects are induced by different protein compositions of antigen mixtures. This strain-specific competition seems to determine the immunogenicity of certain molecules (and not only the immunogenic properties of the molecules themselves). Furthermore this method offers a practical approach to increase the antibody production against weak immunogens in antigen mixtures. PMID- 3287143 TI - [Significance of clinical pneumology in pediatrics]. AB - Pediatric pneumology is a new subspecialty within the field of pediatrics. There is a large overlap with general pediatrics, so that it is essential for pediatric pneumology to be fully integrated into the wider field of general pediatrics. The main topics treated within this subspecialty are: neonatology (artificial ventilation and bronchopulmonary dysplasia); childhood asthma (long-term treatment and epidemiology); immunology (local immune system, recurrent infections in children); and cystic fibrosis. Research should be concentrated on methods of studying lung function in preschool children. The missing link between pediatric pneumology and pneumology in adults must be found, especially in the interests of patients with such chronic conditions as asthma and cystic fibrosis. PMID- 3287144 TI - [Preventive long-term intravenous immunoglobulin infusion in children with acute lymphatic leukemia. I. Anticomplementary activity of gamma globulin preparations is a function of the preparation and IgG concentration prior to infusions]. AB - The influence of intravenous gammaglobulin infusions (ivGG) on hemolytic complement function and the concentration of serum C3 and its split product C3dg was studied in 20 children with acute lymphocytic leukemia (ALL) undergoing ivGG prophylaxis. IvGG was infused once monthly over a period of 20 months using two different preparations commercially available. Serum and EDTA-plasma were collected before initiation of ivGG therapy (time 1), after 10 and 20 months (time 2 and 3), before and immediately after the infusions. IvGG was infused in connection with chemotherapy (according to the CoAll 82 protocol). 16 of 60 sera collected prior to infusions contained less than 700 mg/dl IgG. Mean IgG concentrations could be raised to 198 mg/dl (time 1), 219 mg/dl (time 2), and 213 mg/dl (time 3), respectively. -CH 50 prior to infusions was below normal in 15 of 59 sera, afterwards in 25 of 59 sera. AP 50 before (after) infusions was decreased in 29 of 59 (36 of 60) sera, C3 in 18 of 60 (24 of 60) sera. C3dg was slightly elevated in one EDTA-plasma prior to ivGG infusions and in 5 of the plasmas following infusions. IvGG infusions resulted in a significant loss of hemolytic activity of serum complement (p less than 0.01, F-test). The effect was more profound if IgG concentrations before infusions were less than 700 mg/dl, but this was true for only one of the two used ivGG preparations. The long term follow up over two years showed no significant changes of complement functions (F test), indicating complete recovery of complement function from short term anticomplementary effects. PMID- 3287145 TI - [Current data on the cloning of virulence factors of pathogenic Streptococci]. AB - The data on the cloning of the main pathogenic determinants of group A streptococci including M-protein, erythrogenic toxin, streptokinase, streptolysin O are analyzed. The scientific importance and the possible ways to use the data obtained after cloning are discussed. The hypothesis on the operon system of a number of streptococcal virulence factors regulation is discussed. Construction of vector systems for streptococcal genes cloning is summarized. PMID- 3287146 TI - [Effect of the molecular weight of DNA on the effectiveness of plasmid transformation of E. coli K12]. AB - The level of plasmid transformation and transfection by the high molecular mass DNA was studied for Escherichia coli mutants having increased efficiency of plasmid transformation by low molecular mass DNA. Decreased level of plasmid transformation and transfection registered in some mutants as compared to the one in wild type strain suggests the specificity of Escherichia coli cells penetration for DNA of different molecular mass. PMID- 3287147 TI - [ptsS: a new regulatory element of the fructose operon in Escherichia coli]. AB - Expression of catabolite sensitive operons is repressed in E. coli mutants devoid of HPr--a component of glucose transport system. The ptsH mutants do not utilize the substrates for phosphoenolpyruvate dependent phosphotransferase system (PTS) except for fructose. Besides that, the mutants are deficient in utilization of many substrates entering the bacteria via the other transport systems. The ptsS mutation mapped in the region of the fructose regulon on the 46th min of the chromosomal map restores the growth of ptsH mutants on all substrates. The accumulation and PEP-dependent phosphorylation of proteins substrates of PTS is also restored. The synthesis of the fructose specific phosphotransferase system becomes constitutive under the effect of ptsS mutation. The mutation is supposed to impair the regulatory region of the fructose regulon. PMID- 3287148 TI - Towards an understanding of the malignant transformation of diploid human fibroblasts. AB - This paper reviews the major reports of the spontaneous or carcinogen-induced transformation of human fibroblasts to the malignant state, to infinite lifespan, or to anchorage independence. In some cases, the transformed cells and the parent cell with which the work began were made available to us to be tested to determine whether the cells shared common isozymes, HLA antigens, restriction fragment length polymorphisms, marker chromosomes, etc., as one would expect. When we examined the normal fibroblastic cell line KD for these markers, and the transformed HuT cell lines developed from it by Kakunaga (Proc. Natl. Acad. Sci. (U.S.A.), 75, 1334, 1978) for these markers, we found marked differences, indicating that KD cells and HuT cells are derived from different individuals. When we applied these techniques to the 3 human fibroblast cell lines transformed by Namba to acquire infinite lifespan in culture (Gann, 27, 221, 1981), it became clear that KSMT-6 was derived from the parent cell, KMS-6, but that both cell lines CT-1 and SUSM-1 were derived from the same parental cell line, AD387. Similar studies with other sets of cell lines are also reported. In the light of these studies, it appears that there is no example of the malignant transformation of human fibroblasts by carcinogen treatment. However, neoplastic transformation and transformation to infinite lifespan by carcinogen treatment have been achieved by a number of workers. We speculate as to how malignant transformation might be obtained by carcinogen treatment. PMID- 3287149 TI - Transformation of diploid human fibroblasts by transfection with the v-sis, PDGF2/c-sis, or T24 H-ras genes. AB - Gene transfection techniques have provided powerful methods to examine the roles of cellular and retroviral oncogenes in the transformation process in rodent fibroblasts. However, the use of such techniques with diploid human fibroblasts has been limited. We have developed transfection procedures to reproducibly transfect such cells with oncogenes, and methods for the biological characterization of the transformants. We have shown that the v-sis and T24 H-ras oncogenes, as well as the platelet-derived growth factor gene (PDGF2/c-sis), are capable of inducing a transformed phenotype in normal diploid human fibroblasts, but are not capable of conferring infinite lifespan or making such cells tumorigenic. PMID- 3287150 TI - Multi-step neoplastic transformation of normal human fibroblasts by Co-60 gamma rays and Ha-ras oncogenes. AB - As reported previously (Namba et al., 1985; Namba, 1985), normal human fibroblasts were transformed into immortal cells with abnormal karyotypes by Co 60 gamma-ray irradiation. These immortally transformed cells (KMST-6) showed no clonability in soft agar and were not tumorigenic. However, by treatment with Ha ras oncogenes derived from a human lung carcinoma or Harvey murine sarcoma virus, the KMST-6 cells acquired elevated clonability in soft agar and transplantability in nude mice. All the tumors produced grew progressively without showing regression and killed the mice. The tumors were also serially transplantable into other mice. The Ha-ras oncogene alone did not convert normal human fibroblasts into either immortal or tumorigenic cells. Our current data suggest that gamma rays worked as an initiator of carcinogenesis in normal human cells, giving rise to chromosome aberrations and immortality, and the Ha-ras oncogene played a role in the progression of the immortally transformed cell population to a neoplastic one showing enhanced colony formation in soft agar and tumorigenicity in nude mice. PMID- 3287151 TI - Professor Dr. A. Barthelmess, 1910-1987. PMID- 3287152 TI - Assessment of the potential germ cell mutagenicity of industrial and plant protection chemicals as part of an integrated study of genotoxicity in vitro and in vivo. AB - An approach is described that enables the germ cell mutagenicity of chemicals to be assessed as part of an integrated assessment of genotoxic potential. It is recommended, first, that the genotoxicity of a chemical be defined by appropriate studies in vitro. This should involve use of the Salmonella mutation assay and an assay for the induction of chromosomal aberrations, but supplementary assays may be indicated in specific instances. If negative results are obtained from these 2 tests there is no need for the conduct of additional tests. Agents considered to be genotoxic in vitro should then be assessed for genotoxicity to rodents. This will usually involve the conduct of a bone marrow cytogenetic assay, and in the case of negative results, a genotoxicity test in an independent tissue. Agents found to be non-genotoxic in vivo are regarded as having no potential for germ cell mutagenicity. Agents found to be genotoxic in vivo may either be assumed to have potential as germ cell mutagens, or their status in this respect may be defined by appropriate germ cell mutagenicity studies. The basis of the approach, which is supported by the available experimental data, is that germ cell mutagens will be evident as somatic cell genotoxins in vivo, and that these will be detected as genotoxins in vitro given appropriate experimentation. The conduct of appropriate and adequate studies is suggested to be of more value than the conduct of a rigid set of prescribed tests. PMID- 3287153 TI - Assessment of thoracic paraspinal muscles in the diagnosis of ALS. AB - The distribution of muscle involvement, assessed clinically and electromyographically, was analyzed prospectively in 55 consecutive amyotrophic lateral sclerosis (ALS) patients and in 54 patients with other predominantly motor syndromes, some of whom were referred with suspected ALS. In ALS patients, distal limb muscles and thoracic paraspinal muscles were affected most frequently, more so than proximal limb and cranial muscles. The incidence of bulbar symptoms in ALS was greater in women than in men. These patterns suggest selective vulnerability of specific neuronal populations. The vulnerability of truncal muscles, illustrated by thoracic paraspinal wasting or head and shoulder drooping, was a helpful differential sign in diagnosing ALS. Thoracic paraspinal electromyography was especially valuable in distinguishing ALS from other disorders, such as combined cervical and lumbar spondylotic amyotrophy or polymyositis, which may masquerade as ALS. The finding of denervation atrophy on biopsy of thoracic paraspinal muscles was diagnostic in difficult cases. Because the thoracic paraspinal muscles are frequently affected in ALS and spared in spondylotic amyotrophy, their assessment provides a practical strategy in differentiating ALS from other motor syndromes. PMID- 3287154 TI - Immunologic aspects in actinomycetes and actinomycetomas. PMID- 3287155 TI - Transmission and scanning electronmicroscopy study of the action of sage and rosemary essential oils and eucalyptol on Candida albicans. PMID- 3287156 TI - Variation among circumsporozoite protein genes from rodent malarias. AB - We investigated the effect of long term passage of parasites in naive animals on the circumsporozoite protein (CSP) gene of Plasmodium yoelii. The CSP gene sequence was determined from a non-lethal cloned line of P. yoelii and compared to the CSP gene sequence from a lethal strain of P. yoelii. The two parasite lines were originally derived from the same isolate, but were separated 17 years ago followed by continued passage. The sequence of the CSP gene and its surroundings from the non-lethal line remains identical to that from the lethal isolate except for a deletion within the repeated central domain. This result contrasts with the results obtained by sequencing a number of clones from different geographical field isolates of Plasmodium falciparum where there appears to be rapid accumulation of sense mutations within putative functional domains. These observations are consistent with the suggestion that strong biological pressure in a field environment results in selection of parasite types on the basis of different CSP gene sequences. PMID- 3287157 TI - Correlation of the efficiency of fatty acid derivatives in suppressing Plasmodium falciparum growth in culture with their inhibitory effect on acyl-CoA synthetase activity. AB - The intraerythrocytic malaria parasite depends on the surrounding medium for a supply of phospholipid precursors. Efficient inhibition (IC50 7-90 microM) of Plasmodium falciparum growth in vitro was achieved using modified fatty acids. The fatty acid analogues most effective in suppressing P. falciparum growth in culture were also the most active inhibitors of acyl-CoA synthetase from the monkey parasite P. knowlesi. PMID- 3287158 TI - Thrombolytic therapy: current status (2). PMID- 3287159 TI - Current concepts. Continuous ambulatory peritoneal dialysis. AB - As a long-term dialysis therapy, CAPD has attractive features for use in children (in whom access to the circulation and immobility are often problems), adults in whom blood access is difficult, patients with diabetes, patients prone to hypotension, and patients seeking independence from a machine or medical facility. CAPD and related procedures are still evolving and improving. Efforts to reduce the rates of peritonitis are ongoing and should decrease the rates of treatment dropout and increase the use of this alternative method of dialysis. Continued research toward improvements in catheter configuration and connection devices and the tailoring of technique to meet the particular needs of patients have made peritoneal dialysis an acceptable replacement therapy in patients with end-stage renal disease. Neither peritoneal dialysis nor hemodialysis is the superior long-term dialysis therapy for all patients; the choice depends on numerous medical, social, geographic, and life-style considerations. PMID- 3287160 TI - 5-ASA for ulcerative colitis. PMID- 3287161 TI - Prevention of skin cancer in xeroderma pigmentosum with the use of oral isotretinoin. AB - To confirm reports that skin cancer can be prevented with retinoids, we conducted a three-year controlled prospective study of oral isotretinoin (also called 13 cis retinoic acid) in five patients with xeroderma pigmentosum who had a history of multiple cutaneous basal-cell or squamous-cell carcinomas. Patients were treated with isotretinoin at a dosage of 2 mg per kilogram of body weight per day for two years and then followed for an additional year, without the drug. Before, during, and after treatment, biopsies of all suspicious lesions were performed, and skin cancers were surgically removed. The patients had a total of 121 tumors (mean, 24; range, 8 to 43) in the two-year interval before treatment. During two years of treatment with isotretinoin, there were 25 tumors (mean, 5; range, 3 to 9), with an average reduction in skin cancers of 63 percent (P = 0.019). After the drug was discontinued, the tumor frequency increased a mean of 8.5-fold (range, 2- to 19-fold) over the frequency during treatment (P = 0.007). Although all patients experienced mucocutaneous toxic effects, and triglyceride, liver function, or skeletal abnormalities developed in some, high-dose oral isotretinoin was effective in the chemoprophylaxis of skin cancers in patients with xeroderma pigmentosum. PMID- 3287162 TI - Expression in non-Hodgkin's lymphoma of the bcl-2 protein associated with the t(14;18) chromosomal translocation. AB - For many non-Hodgkin's lymphomas, the bcl-2 gene has been implicated as a likely proto-oncogene, since it is consistently located at or near the breakpoint sites of t(14;18) chromosomal translocations. To define the role of the protein product of the bcl-2 gene in lymphoid cancers, we used anti-bcl-2 antibodies to perform immunohistochemical studies of frozen sections of 136 tissue specimens affected by lymphoma or non-neoplastic lymphoid disorders. Immunoreactive bcl-2 protein was observed in the neoplastic cells in almost all the follicular lymphomas, whereas no bcl-2 protein was detected in follicles affected by non-neoplastic processes or in normal lymphoid tissue. Every tumor with molecular-genetic evidence of t(14;18) translocation expressed detectable levels of bcl-2 protein, regardless of whether the breakpoint was located in or at a distance from the bcl 2 gene. These data show consistent expression of a proto-oncogenic protein in a large proportion of non-Hodgkin's lymphomas and provide further support of a role for bcl-2 in the pathogenesis of all lymphomas with the t(14;18) karyotypic abnormality. Increased expression of bcl-2 after t(14;18) translocations may be a specific marker for B-cell cancers, and demonstration of the protein with use of anti-bcl-2 antibodies could be useful in the diagnosis of many non-Hodgkin's lymphomas. PMID- 3287163 TI - The progression of renal disease. AB - The diversity of its causes, the unpredictability of its clinical course, and our expanding knowledge of the conditions that may exacerbate or retard its progression suggest that glomerular sclerosis cannot be attributed to a single aberration in glomerular physiology. Nonetheless, the welter of clinical and experimental observations is beginning to yield a pattern. Agents or conditions injurious to glomerular epithelium tend to cause glomerular sclerosis. Agents or conditions that induce short-term or long-term activation of mesangial cells may lead to glomerular sclerosis. Indeed, one contribution of the healthy epithelium may be to serve as a tonic inhibitor of the intraglomerular processes arising from mesangial-cell activation. Long-term activation of the mesangium is associated with the proliferation and infiltration of cells and with the expansion of the mesangial matrix--the antecedents of sclerosis. We anticipate that different diseases associated with glomerular sclerosis will be found to depend to varying extents on these two potential mechanisms of sclerosis. Beyond a certain threshold of glomerular injury, glomerular diseases share an additional factor: the capacity of both intrinsic cells and infiltrating cells to alter the microenvironment of the glomerulus so that sclerosis progresses inexorably long after the disappearance of the initiating insult. Several potential risk factors may contribute to the progression of chronic renal disease. These factors include systemic hypertension, proteinuria, hyperlipidemia, high protein intake, and probably conditions that lead to glomerular hypertrophy. Interventions designed to minimize the potential contribution of these factors to the progression of renal insufficiency may halt or slow the loss of function of the kidney. Clinical trials designed to examine the effects of these factors on the progressive course of renal insufficiency will help to establish their role and relative importance in humans. PMID- 3287164 TI - Treatment of ventricular tachycardia. PMID- 3287165 TI - Treatment of gram-negative bacteremia in patients with cancer and granulocytopenia. PMID- 3287166 TI - Escherichia coli O157:H7 hemorrhagic colitis. PMID- 3287167 TI - Colchicine in the treatment of cirrhosis of the liver. AB - There is preliminary evidence that colchicine, an inhibitor of collagen synthesis, may be beneficial in the treatment of cirrhosis of the liver. To evaluate the use of colchicine (1 mg per day, five days per week) in the treatment of hepatic cirrhosis, we performed a randomized, double-blind, placebo controlled trial in which 100 patients were followed for up to 14 years. Forty five patients had alcoholic cirrhosis, 41 had posthepatitic cirrhosis, and the remaining 14 had cirrhosis with various other causes. Histologic studies were available for 92 percent of patients. Seventy-three patients were in Child Turcotte class A, 26 were in class B, and one was in class C. Fifty-four patients received colchicine, and 46 received placebo. The overall survival in the colchicine group was markedly better than in the placebo group (median survival, 11 and 3.5 years, respectively; P less than 0.001). The cumulative 5-year survival rates were 75 percent in the colchicine group and 34 percent in the placebo group; the corresponding 10-year survival rates were 56 percent and 20 percent. Among the 30 patients treated with colchicine who underwent repeated liver biopsies, histologic improvement was seen in 9; the liver appeared normal in 2, and 7 had minimal portal fibrosis. No histologic improvement was observed in the 14 members of the placebo group who had two or more biopsies. Few side effects were observed in either group. PMID- 3287168 TI - Is colchicine effective therapy for cirrhosis? PMID- 3287169 TI - Computer-based tutorials take off. PMID- 3287170 TI - Similarity of nucleotide sequences at splicing sites. PMID- 3287171 TI - The Duchenne muscular dystrophy gene product is localized in sarcolemma of human skeletal muscle. AB - Duchenne muscular dystrophy (DMD) and its milder form, Becker muscular dystrophy (BMD), are allelic X-linked muscle disorders in man. The gene responsible for the disease has been cloned from knowledge of its map location at band Xp21 on the short arm of the X chromosome. The product of the DMD gene, a protein of relative molecular mass 400,000 (Mr 400K) recently named dystrophin, has been reported to co-purify with triads of mouse and rabbit skeletal muscle when assayed using polyclonal antibodies raised against fusion proteins encoded by regions of mouse DMD complementary DNA. Here we show that antibodies directed against synthetic peptides and fusion proteins derived from the N-terminal region of human DMD cDNA strongly react with an antigen present in skeletal muscle sarcolemma on cryostat sections of normal human muscle biopsies. This immunoreactivity is reduced or absent in muscle fibres from DMD patients but appears normal in muscle fibres from patients with other myopathic diseases. The same antibodies specifically react with a 400K protein in sodium dodecyl sulphate (SDS) extracts of normal human muscle subjected to Western blot analysis. We conclude that the product of the DMD gene is associated with the sarcolemma rather than with the triads and speculate that it strengthens the sarcolemma by anchoring elements of the internal cytoskeleton to the surface membrane. PMID- 3287172 TI - The eye of the mantid shrimp. PMID- 3287173 TI - Intolerable secretion in tolerant transgenic mice. PMID- 3287174 TI - Mysteries of HIV: challenges for therapy and prevention. AB - A number of problems still surround infection by the human immunodeficiency virus and the pathogenesis of AIDS. Solutions to the problems would provide valuable information for the development of antiviral therapy and a vaccine. PMID- 3287175 TI - Diabetes in transgenic mice resulting from over-expression of class I histocompatibility molecules in pancreatic beta cells. AB - A class I histocompatibility gene, H-2Kb, linked to the rat insulin promoter, is overexpressed in the pancreatic beta cells of transgenic mice. The mice, whether syngeneic or allogeneic to the transgene, develop insulin dependent diabetes without detectable T cell infiltration, suggesting a direct, non-immune role for the transgenic class I molecules in the disease process. PMID- 3287176 TI - Platelet-derived growth factor promotes division and motility and inhibits premature differentiation of the oligodendrocyte/type-2 astrocyte progenitor cell. AB - The mitogens which modulate cell-cell interactions during development of the central nervous system are unknown. One of the few interactions sufficiently well understood to allow identification of such molecules involves the two glial lineages which make up the rat optic nerve. One population of glial cells in this tissue, the type-1 astrocytes, secrete a soluble factor(s) which promotes division of a second population of bipotential oligodendrocyte/type-2 astrocyte (O-2A) progenitor cells; these progenitors give rise to oligodendrocytes, which myelinate large axons in the CNS, and type-2 astrocytes, which enwrap bare axons at nodes of Ranvier. Type-1 astrocytes also promote progenitor motility, and inhibit the premature differentiation of progenitors into oligodendrocytes which occur when these cells are grown in the absence of type-1 astrocytes. We have now found that platelet-derived growth factor mimics the effects of type-1 astrocytes on O-2A progenitor cells, and antibodies to PDGF block the effects of type-1 astrocytes. PMID- 3287177 TI - Platelet-derived growth factor from astrocytes drives the clock that times oligodendrocyte development in culture. AB - The various cell types in a multicellular animal differentiate on a predictable schedule but the mechanisms responsible for timing cell differentiation are largely unknown. We have studied a population of bipotential glial (O-2A) progenitor cells in the developing rat optic nerve that gives rise to oligodendrocytes beginning at birth and to type-2 astrocytes beginning in the second postnatal week. Whereas, in vivo, these O-2A progenitor cells proliferate and give rise to postimitotic oligodendrocytes over several weeks, in serum-free (or low-serum) culture they stop dividing prematurely and differentiate into oligodendrocytes within two or three days. The normal timing of oligodendrocyte development can be restored if embryonic optic-nerve cells are cultured in medium conditioned by type-1 astrocytes, the first glial cells to differentiate in the nerve: in this case the progenitor cells continue to proliferate, the first oligodendrocytes appear on the equivalent of the day of birth, and new oligodendrocytes continue to develop over several weeks, just as in vivo. Here we show that platelet-derived growth factor (PDGF) can replace type-1-astrocyte conditioned medium in restoring the normal timing of oligodendrocyte differentiation in vitro and that anti-PDGF antibodies inhibit this property of the appropriately conditioned medium. We also show that PDGF is present in the developing optic nerve. These findings suggest that type-1-astrocyte-derived PDGF drives the clock that times oligodendrocyte development. PMID- 3287178 TI - Apology. PMID- 3287179 TI - Disputes delay development of leprosy vaccine for India. PMID- 3287180 TI - Structural and functional characterization of the short acidic transcriptional activation region of yeast GCN4 protein. AB - Derivatives of the yeast GCN4 transcription factor containing acidic regions of 35 to 40 amino acids fused directly to the DNA-binding domain are fully functional in vivo. High resolution deletion analysis and proteolytic mapping suggest that the activation region is a repeated structure composed of small units acting additively. Acidic character is a feature of the structural motif, possibly a dimer of alpha-helices from two GCN4 monomers, that may be important for interactions with the basic transcriptional machinery. PMID- 3287181 TI - Regulated expression and phosphorylation of a possible mammalian cell-cycle control protein. AB - A novel approach to the study of the control of the mammalian cell cycle was opened by the cloning of a human gene by complementation of a fission-yeast cdc2 cell-cycle mutant. We have investigated the behaviour of the RNA and protein products of this human gene, CDC2Hs, and its murine equivalent, CDC2Mm during serum starvation and re-feeding of cultured fibroblasts. In contrast to the pattern of wild-type cdc2+ expression in fission yeast previously described, the mammalian homologue displays variation in both RNA and protein levels during exit from and re-entry into the mitotic cycle. Like its yeast counterpart, however, the mammalian CDC2 protein (p34CDC2) becomes dephosphorylated upon shifting from exponential growth to quiescence, and rephosphorylated late in the G1 phase when cells are stimulated to re-enter the cycle. We propose that phosphorylation of p34CDC2 serves as a regulatory mechanism generally in eukaryotic cells, while transcriptional control of the CDC2 gene in higher eukaryotes may be relevant to long term processes such as senescence and differentiation. PMID- 3287182 TI - Monomeric insulins obtained by protein engineering and their medical implications. AB - The use of insulin as an injected therapeutic agent for the treatment of diabetes has been one of the outstanding successes of modern medicine. The therapy has, however, had its associated problems, not least because injection of insulin does not lead to normal diurnal concentrations of insulin in the blood. This is especially true at meal times when absorption from subcutaneous tissue is too slow to mimic the normal rapid increments of insulin in the blood. In the neutral solutions used for therapy, insulin is mostly assembled as zinc-containing hexamers and this self-association, which under normal physiological circumstances functions to facilitate proinsulin transport, conversion and intracellular storage, may limit the rate of absorption. We now report that it is possible, by single amino-acid substitutions, to make insulins which are essentially monomeric at pharmaceutical concentrations (0.6 mM) and which have largely preserved their biological activity. These monomeric insulins are absorbed two to three times faster after subcutaneous injection than the present rapid-acting insulins. They are therefore capable of giving diabetic patients a more physiological plasma insulin profile at the time of meal consumption. PMID- 3287183 TI - Hippocratic nails. PMID- 3287184 TI - What is the fragile X syndrome? PMID- 3287185 TI - Gull's disease. PMID- 3287186 TI - [Life expectancy of man in adulthood and old age]. PMID- 3287187 TI - [Difficult choices at the bedside: don't count on decision theory]. PMID- 3287188 TI - [Biocompatibility]. PMID- 3287189 TI - [HEPAR, an expert system for the diagnosis of liver and biliary disorders]. PMID- 3287190 TI - [The villi test (chorionic villi biopsy) in the 2d and 3d trimester of pregnancy]. PMID- 3287191 TI - [When is it whooping cough? Relation between laboratory diagnosis findings and symptoms]. PMID- 3287192 TI - [Immunoglobulin genes and T-cell receptor genes and the expression of immunological markers. II. Immunological diagnosis of malignant lymphatic diseases]. PMID- 3287193 TI - [Oral manifestations of HIV infection; preliminary experiences in 40 seropositive patients]. PMID- 3287194 TI - [Skin disorders due to the use of rubber gloves in health care]. PMID- 3287195 TI - [Anosognosia and anosodiaphoria in brain-damaged patients]. AB - Anosognosia and anosodiaphoria are terms that have frequently been used to cover a wide variety of different concepts. A review of the literature provides the point of departure for presentation of the methodological problems arising from the use of these terms. We then discuss the concept of anosognosia as a linguistic behavioural pattern arising from the patient's reaction to the "non accessibility" of a cerebral lesion. Anosognosia can thus be interpreted as behaviourally analogous to neglect. Anosodiaphoria is presented as a form of behaviour determined by the patient's attempt to come to terms with the consequences that a cerebral lesion has for his way of life. PMID- 3287196 TI - [Ultrasound study of disorders of coordination in tongue movement in swallowing]. AB - Ultrasound imaging of tongue movements permits real-time observation of swallowing and articulation without risk for the patient. The ultrasound images of the tongue motions were recorded on video-tape and then analyzed frame by frame. We were able to detect regular phases of tongue motion during normal swallowing. Clear deviations from normal motion patterns were found in a patient with anarthria, despite absence of swallowing difficulties in every day life. PMID- 3287197 TI - [Hypophyseal abscess and cerebral arteritis in a fatal course of pneumococcal meningitis]. AB - Even today uncomplicated courses of pneumococcal meningitis show relatively high fatality rates. Abscess formation leads to a drastic deterioration of prognosis; the same applies to the rarely observed occurrence of a cerebral arteritis. Up to 1985 only 50 cases of pituitary abscess had been described in the literature. This case report describes the signs and symptoms as well as the neuroradiological and post mortem findings on a patient who succumbed to a pneumococcal meningitis, complicated by formation of a pituitary abscess and cerebral arteritis. PMID- 3287198 TI - [Stereotaxic diagnosis and treatment of colloid cysts of the 3d ventricle. Apropos of 7 cases]. AB - The clinical and anatomical results of the treatment of 7 colloid cysts of third ventricle by stereotaxic aspiration are reported. A history of increased intracranial pressure was reported in all patients (4 females aged of 12, 16, 28, 38 years; 3 males aged of 36, 54, 59 years). A ventricular shunting device has been inserted in 4 patients. Pre-operative clinical findings were: signs of increased intracranial pressure (1 case), isolated memory disturbances (3 cases); motor weakness, memory disturbances and psychomotor slowness (2 cases); 1 of the 2 last cases had also thymic disturbances. Clinical examination was normal in 1 patient. CT-Scan revealed 5 hyperdense lesions, 3 with slight enhancement; 1 hypodensity encircled by an hyperdense ring without enhancement, 1 not enhancing isohypodensity. 6 colloid cysts were between the Foramens of Monro, 1 in the posterior third ventricle. Cyst volume ranged from 1.8 to 6.3 cc. (m: 3.4). Biventricular hydrocephalus was present in all but 1 patient. Stereotaxic aspiration of the cyst performed according to Talairach's system resulted in a release of C.S.F. circulation in all cases. 3 colloid cysts were aspirated completely, 4 were reduced to 3%, 11%, 12%, 33% of the initial volume. Post operatively 2 patients presented with a transient meningeal reaction, 1 with a transient "myoclonic" syndrome. In 1 "completely aspirated" case a control CT Scan showed, 5 years later, a small hyperdensity corresponding to 4% of the initial cyst volume. All patients lead a normal and useful life (Follow-up: 8-78 months, m: 45). Neurological examination is normal in 6 cases and shows a pre existent facial asymmetry in 1. Ours results suggest that stereotaxic investigation should be the first safe procedure in order to achieve both diagnosis and treatment of colloid cysts of third ventricle. PMID- 3287199 TI - [Cisterna megamagna. Dimensions and relations to cerebral atrophy. Clinical and x ray computed tomographic demonstration]. AB - Polaroids of 9,400 consecutive unselected computed tomography (CT) scans are reviewed and 31 cases with Mega Cisterna Magna (MCM) are detected. The incidence is 0.33% (31/9,400). Clinical and radiological data relating to these 31 cases shows that none of the patients presented neither any clinical sign of a posterior fossa space occupying lesion nor any radiological image such as hydrocephalus or forward displacement of the fourth ventricle. The dimensions of the cistern ranged as follows: width between 22.2-92.5 mm, depth between 22.2 37.0 mm, height between 26.0-39.0 mm. The authors propose 20 mm as the limit value of width and depth of a normal cisterna magna and 26 mm for its maximal height, these dimensions being the most frequently encountered ones of these 31 patients. The correlation between the magnitude of the cistern (the sum of the width and depth of the cistern: w + d) and the severity of cerebral atrophy (the sum of the maximum and minimum widths of the anterior horns of the lateral ventricles which is the most reliable atrophy index defined by Hirashima: a + b) is illustrated in figure 5. The authors conclude that Mega Cisterna Magna which has a constant incidence in routine CT examinations is predominantly a consequence of cerebral atrophy and does not have any specific clinical pathological correlate and does not require any form of treatment. PMID- 3287200 TI - [Immediate and severe epistaxis caused by traumatic rupture of the carotid siphon. Apropos of a case treated by intravascular approach]. AB - The authors report a recent case of massive and immediate epistaxis resulting from a rupture of the internal intracavernous carotid artery caused by closed head injury. The point out the unusualness and the extreme severity of such lesions. The pathogenesis of these epistaxis can be explained by an immediate arterial rupture proceeding from a sphenoidal fracture. The emergency bilateral carotid angiography states precisely the diagnosis and the level of the rupture, allowing in the same time the intravascular treatment by detachable balloon. PMID- 3287201 TI - [Bases of antibiotherapy in neuromeningeal infections]. AB - An early treatment and an adequate antimicrobial chemotherapy are major prognostic factors for bacterial meningitis, brain abscesses and related infections. The necessity of an early therapy requires to begin an empiric antibiotic treatment prior to obtain microbiological results. The principles that apply to empiric therapy of other types of infections are equally applicable to the treatment of central nervous system (CNS) infections and include: the capacity of achieving adequate levels of antibiotic in the CNS and for the brain (pharmacokinetic criteria), the knowledge of the most likely etiologic agents for central nervous system infections and their antibiotic susceptibility (bacteriological criteria). The main clinical types of CNS infection are reviewed for their usual etiologic agents, with a definition of an optimal "bacteriological deal" for each situation. Most studies emphasize the striking differences in the clinical features, etiologic agents and prognosis of spontaneously occurring (primary) meningitis, as opposed to post-traumatic or post-surgical, frequently Gram negative bacillary (secondary) meningitis and other CNS infections (brain abscesses and related infections). These studies, as our experience, suggest that the selection of an empiric therapy must be adapted for each clinical situation. Ampicillin still appears to be an ideal agent for empiric therapy for primary meningitis in older children and adults, in whom meningitis are usually caused by N. meningitidis and S. pneumoniae. In younger children (before 6 years), H. influenzae is more often implicated and the occurrence of beta lactamase mediated resistance to ampicillin in as high as 15% of isolates led to use a third generation cephalosporin as an empiric therapy. Neonatal meningitis, meningitis following trauma or surgery, brain abscess, subdural empyema, epidural abscess are caused by various etiologic agents including Streptococcus sp, Staphylococcus sp, Enterobacteriaceae, and for brain infections, anaerobic bacteria. Each situation led to specific recommendations by authors. Finally, miscellaneous aspects of therapy as the usefulness of intrathecal or intraventricular therapy, duration of treatment and place of the neuro-surgery during CNS infections are briefly reviewed. PMID- 3287202 TI - [Neurinoma of the trigeminal nerve. Excision by combined suboccipital and pteriono-temporal approach]. AB - The authors report a recent personal case of trigeminal neurinoma with a topographical extension both in the cerebello pontine angle and the middle cerebral fossa. This 33 year-old female suffered from progressive sensory disturbances of her right hemiface associated with a right fifth nerve motor deficit, a right VI nerve palsy and a tinnitus. CT scan and angiogram were evocative of a right hourglass trigeminal neurinoma. Two successive operative stage through suboccipital route and a pteriono-temporal extra and intradural approach allowed a complete removal of the tumour. A post-operative rhinorrhea dried up with 10 days. The patient complained with a right hemiface anesthesia and a palsy of the masseter muscles; the VI nerve palsy recovered within 3 months. From the review of the literature (118 cases) the authors summarize the anatomical, clinical and radiological features of these tumours and point out. The difficulty of their surgical removal that was only complete in half of cases. The high frequency of hourglass neurinomas explains that a single suboccipital or subtemporal approach--even with opening of the tentorium--only allowed 23 complete removal among the 58 published or quoted interventions. This justifies that in a majority of cases a combined approach must be preferred, using successively a suboccipital and an intradural subtemporal route, the latted giving access to the cavernous sinus in case of its invasion. PMID- 3287203 TI - Definition of Creutzfeldt-Jakob disease. PMID- 3287204 TI - Prolonged, progressive dementia with spongiform encephalopathy: a variant of Creutzfeldt-Jakob disease? AB - A 46-year-old female is described with prolonged, progressive dementia and a brain biopsy consistent with Creutzfeldt-Jakob disease (CJD). She had neither myoclonic jerks nor an electroencephalogram with periodic spikes and suppression. Five of her close relatives were also demented. The nosology of CJD was discussed in the light of this case in which histopathology was characteristic of spongiform encephalopathy but the clinical features were atypical. We concluded that it would be premature to expand the traditional diagnostic criteria to include such cases as having CJD but, at the same time, it would be prudent to handle tissue, linens and surgical instruments as if they were contaminated by the resistant agent of CJD. PMID- 3287205 TI - [Natural history of giant intracranial aneurysms]. AB - The outcome of a consecutive series of 28 patients with giant aneurysm who had been followed without surgery from one month to 12 years after the diagnosis was made, are presented with reviewing their radiological and clinical features. Symptoms and signs were directly or indirectly attributable to the intracranial mass effect and nine patients (32%) presented subarachnoid hemorrhage. Subarachnoid hemorrhage was frequently associated with intraventricular or intracerebral hemorrhage, a poor clinical grading at admission and a high mortality. Subarachnoid hemorrhage was most often recorded from the giant aneurysm at the supraclinoid portion of the internal carotid artery and the vertebro-basilar artery, but the rupture from the intracavernous giant aneurysm, completely thrombosed giant aneurysm and the fusiform type of giant aneurysm was rare. The mortality rate in 28 cases for the above follow up period was 46% (13 in 28 cases) and major morbidity occurred in 11% (3 in 28 cases). The above outcome of non operated giant aneurysm cases may justify the surgical management of the giant aneurysm, but as the intracavernous giant aneurysm and thrombosed giant aneurysm are relatively harmless, surgical indication should be carefully decided, especially in the older patients. PMID- 3287206 TI - [Intracranial neurinomas of the jugular foramen and hypoglossal canal]. AB - Intracranial neurinomas of the jugular foramen and the hypoglossal canal are relatively rare. Most reports have been of either single cases or of only two or three patients, and few large series exist in the literature. Although some of these tumors present palsies of the ninth, tenth, and eleventh cranial nerves as a jugular foramen syndrome, this is not always present. Unexpectedly, symptoms involving the eighth nerve are more frequently than those of ninth, tenth and eleventh nerves. This variability of clinical symptoms frequently leads to an initial misdiagnosis of glomus jugulare, acoustic or hypoglossal neurinoma. We report 2 cases of jugular foramen neurinomas and 2 cases of hypoglossal neurinomas. Our review of literature has tabulated 92 jugular foramen neurinomas and 34 hypoglossal neurinomas. These neurinomas had become considerably large in size by the time they were detected. So, we should endeavor, by clinical or neuroradiological finding to detect them at the early stage when they exert less influence on the brain. In this series we discuss clinical pictures of these neurinomas. PMID- 3287207 TI - [Acute epidural hematoma of the posterior fossa caused by forehead impact]. AB - A rare case of acute epidural hematoma of the posterior fossa caused by forehead impact is reported. This 36-year-old man fell from a truck and hit his face. He was conscious and was brought to our center 30 minutes after the injury. On admission, a contused wound of the right forehead was noticed. He was restless and had severe pain in the neck and upper extremities. Skull X-ray showed a linear fracture of the frontal bone and computed tomography (CT) scan was normal. He continued to be restless and sudden respiratory arrest and pupillary dilation occurred 10 hours after the admission. A CT scan revealed a lenticular high density area in the left posterior fossa which extended to the supratentorial region. The 4th ventricle was compressed and displaced to the right and also the quadrigeminal and ambient cisterns were not visualized at all. Immediate surgery disclosed a 30 g epidural hematoma of the left posterior fossa and the supratentorium and the clot was completely evacuated. The source of bleeding could not be identified. Opening of the dura revealed contusion in the occipital lobe. He died on the 17th postoperative day. The possible mechanism in the production of the posterior fossa hematoma in this case is discussed. PMID- 3287208 TI - Infantile familial encephalopathy with cerebral calcifications and leukodystrophy. AB - Two sets of siblings, in two different families, presenting with congenital and progressive neurological disorders, cerebral calcifications and leukodystrophy are reported. In the first family, the diagnosis of brain calcifications in two infants was based on skull X-rays; in the second family, ultrasound scans showed hyperechoic areas in the basal ganglia and periventricular white matter in both infants. Neuropathological studies confirmed the calcifications and revealed severe abnormalities of the white matter with GFAP positive gliosis. Electron micrographs showed large astrocytes with an increased amount of glial filaments. In the group of idiopathic non arteriosclerotic cerebral calcifications, these four cases may represent a separate entity with possible autosomal recessive inheritance. PMID- 3287209 TI - Gamma-aminobutyric acid and taurine antagonize the central effects of angiotensin II and renin on the intake of water and salt, and on blood pressure in rats. AB - Antagonism by neuro-amino acids of the central effects of angiotensin II and renin in rats was investigated. Angiotensin II (100 ng), injected into the preoptic area, stimulated the intake of water but not salt, to a lesser extent and with a shorter duration as compared with that induced by renin (5 mU), injected into the preoptic area. This angiotensin II-induced intake of water was markedly inhibited by [Sar1, Ile8]-angiotensin II, an angiotensin II receptor antagonist, but not by captopril, an angiotensin-converting enzyme inhibitor, previously administered through the same cannula. The angiotensin II-induced intake of water was also inhibited in a dose-dependent manner by gamma aminobutyric acid (GABA) (50-100 micrograms), muscimol, a GABA agonist, (100-200 ng), taurine (100-200 micrograms) and hypotaurine (100-200 micrograms), administered into the cerebroventricle and by GABA (5-10 micrograms), muscimol (10-20 ng) and taurine (10-20 micrograms) injected into the preoptic area in smaller doses. Renin (5 mU), injected into the preoptic area, elicited a marked increase in the intake of water and salt, which lasted for about 3 days. The effect of renin was inhibited by [Sar1, Ile8]-angiotensin II (10 micrograms) and was eliminated by captopril (25 micrograms) injected into the preoptic area. This effect of renin was not influenced by the peripheral administration of captopril. The effect of renin was also inhibited by GABA, muscimol or taurine injected into the cerebroventricle, in larger doses, or into the preoptic area in smaller doses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287210 TI - Brain stem hemorrhage: historical perspective. AB - Brain stem hemorrhage was first recorded in 1812. Its origin has been the subject of much study and experimentation. We review the studies that stress mechanical forces because dynamic axial distortion of the brain stem is a major factor in the physiology and pathology of the central nervous system. PMID- 3287211 TI - The critical first minutes after subarachnoid hemorrhage. AB - Six patients were observed during recurrent subarachnoid hemorrhage (SAH). Three each had an open skull and intact dura mater and demonstrated an extreme increase in intracranial pressure (ICP) that developed within 1 minute and then declined over several minutes. Three other patients were investigated with transcranial Doppler sonography before, during, and after recurrent bleeding, and their hemodynamics were studied. There is conclusive evidence that acute spontaneous SAH is often followed by an intracranial circulatory arrest lasting for several minutes and caused by a peak of ICP in the range of mean arterial levels. The mechanisms involved are discussed. There are strong indications that this temporary intracranial circulatory arrest promotes hemostasis, but may constitute a severe ischemic event. PMID- 3287212 TI - Computerized cortical surface electroencephalography after temporary middle cerebral artery occlusion in rabbits. AB - The sensitivity and regional specificity of intraoperative electroencephalographic (EEG) monitoring in cerebral ischemia was evaluated in a new experimental model of temporary focal cerebral ischemia in rabbits. EEG potentials were recorded directly from the cortical surface using a bipolar disc electrode grid and were analyzed by computer. Groups of 5 animals each underwent temporary occlusion of the left middle cerebral arterial trunk for 5, 10, 20, 30, 45, or 60 minutes. EEG data were recorded from the cortex proximal (temporal site) and distal (parasagittal site) to the middle cerebral arterial trunk during occlusion and 2 hours of reperfusion. EEG suppression was detected immediately after occlusion at the temporal site by analysis of power spectra in 29 of 30 rabbits (mean power, 32% of base line), by compressed spectral array (CSA) edge analysis in 23, and by analysis of the conventional EEG wave form in 24. Within 5 minutes after the start of occlusion, all 30 rabbits showed EEG power suppression and 26 showed decrease in the CSA edge frequency or in the routine EEG wave form. By the end of the occlusion period, EEG power at the temporal site had decreased to 20.5% of base line. At the parasagittal site, a lesser degree of EEG suppression was detected; 20 rabbits had an initial loss of EEG power (mean, 85.7% of base line), 13 had decrease in the CSA edge, and 7 had suppression of the EEG wave form. By the end of the occlusion period, spectral power at the parasagittal site had decreased in 25 of 30 rabbits to a mean of 86.9% of base line.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287213 TI - Surgical treatment of brain abscess. AB - The author reviews the methods of surgical treatment of brain abscess. All methods are grouped into the following six categories: tube drainage, marsupialization, the migration method of Kahn, tapping only, aspiration, and excision. At present, only two methods are used: aspiration and excision. Antibiotics and computed tomographic (CT) scanning play important roles in the surgical treatment of a brain abscess. The use of CT scanning is invaluable in the management of brain abscess for early and exact localization, assessment of the adequacy of operation, and sequential follow-up. PMID- 3287214 TI - Intradural herniated dorsal disc: case report and review of the literature. AB - A 67-year-old man with a 1 1/2-month history of spastic paraparesis caused by a dorsal intradural disc herniation underwent surgical treatment via a posterior approach. Dorsal herniated discs are rare, and intradural dorsal disc herniations are even more infrequent. Including this case, the medical literature reviewed describes only four such cases. PMID- 3287215 TI - Cerebellar hemangioblastoma symptomatic during pregnancy. AB - An 18-year-old woman presented during the 2nd month of her pregnancy with noncommunicating hydrocephalus due to a cerebellar hemangioblastoma. The tumor rapidly enlarged over a 12-day period after ventriculoperitoneal shunting, probably because of expansion of the vascular compartment. Serial computed tomography and magnetic resonance imaging observations support previous speculations in the literature that vascular engorgement of hemangioblastomas probably accounts for the rapid deterioration of some patients during pregnancy. PMID- 3287216 TI - [Usefulness of perineal and transrectal echotomography in the preoperative evaluation and follow-up of primary and recurrent tumors of the rectum. Our experience]. PMID- 3287217 TI - [Clinico-therapeutic guidelines in the treatment of carcinomas of the common bile ducts]. PMID- 3287218 TI - [Primary tumors of the small intestine. Retrospective study of 23 cases]. PMID- 3287219 TI - [Strangulated obturator hernia. Presentation of a case and review of the literature]. PMID- 3287221 TI - [Traumatic hemoperitoneum: diagnosis and surgical management]. PMID- 3287220 TI - [Post-traumatic diaphragmatic hernias with deferred symptomatology]. PMID- 3287222 TI - Otto Lanz, surgeon and art collector. AB - Otto Lanz (1865-1935) was educated in Switzerland, where he was trained in the surgical clinic of Theodore Kocher. In 1902, he was appointed as a professor of surgery in Amsterdam, remaining there until his death. He was wellknown for his surgery of the thyroid gland and for his studies on the vermiform appendix. He defined a point in acute appendicitis, to which his name has been eponymously attached (Lanz's point). His wide scope of interests is pictured, ranging from his invention of meshing a split-skin graft, to his antithyroid therapy, giving thyreotoxic patients the milk to drink of thyroidectomised goats. Apart from his professional achievements, he was a great connoisseur and passionate collector of Italian Renaissance art. Part of his collection was exhibited in the Rijksmuseum of Amsterdam, as perpetuated in the Lanz room until acquired for Hitler's proposed Fuhrermuseum during World War II. After the capitulation, the collection was returned to The Netherlands. PMID- 3287223 TI - The dry suture, forerunner of surgical adhesive tape. PMID- 3287224 TI - [Recent diagnostic and therapeutic findings on postmenopausal and senile osteoporosis]. AB - The incidence of osteoporosis in the West is considerable and its complications are such as to make it a common and disabling problem. Recent developments in the classification, pathogenesis and diagnosis of the disease are reported. Certain laboratory techniques have recently been developed that can provide adequate information about the degree of demineralisation present. Furthermore the accurate in vivo assessment of bone density is made possible by the development of double beam photon osteodensitometry that measures bone mineral content (BMC) with sensitivity and accuracy. On the treatment side, the various drugs available are reviewed with particular reference to estrogen, vitamin D, anabolisers (recently reassessed in radiogrammometric and densitometric studies) fluorides and calcitonin. Finally certain treatment protocols for post-menopausal and senile osteoporosis are proposed that should produce good results in a reasonably short space of time. PMID- 3287225 TI - [Presentation of a method of interpreting erythrocyte deformability]. AB - The physical principles of a method based on a haematic double filtration, according to Reid classic technique is explained. The aim is to determine a method for researching the characteristics of erythrocytic deformability, without changing the original medium, exoerythrocytic essential component of the membrane physiochemical quality and intraerythrocytic for the fast, active exchanges, after an evaluation of different techniques and instrumentation. A practical example for calculating the factor of correction, with reference to personal material, is made. This method has the advantage that it does not need the manipulation of the sample and does not delay the determination. PMID- 3287226 TI - [Prevention of thromboembolism in patients operated on for hip prosthesis]. AB - The latest research into the prevention of peri- and postoperative thromboembolic disease has found orthopaedic surgery patients to be most at risk. As the genesis of deep venous thrombosis (DVT) is due to haemodynamic, hemorheologic and parietal factors, various prophylactic measures have been considered in the past, measures which have not proved able to provide satisfactory protection in orthopaedics. The results obtained with Defibrotide in a random and controlled clinical study versus calcium heparin involving 211 patients of both sexes candidates to receive total hip arthroplasty and presenting at least one major thromboembolic risk factor are reported. The patients were assigned at random to one of the following treatments: 1) Defibrotide at a dose of 400 mg b.i.d. i.v. in 50 ml phleboclysis in 5 minutes (n = 108); 2) calcium heparin at a dose of 5000 IU t.i.d. subcutaneously (n = 103). The treatment began the day before operation and continued on average up to the eighth day for the Defibrotide group. With the control group it continued until discharge (usually on the 15th day) and at home for about three weeks until the completion of the physiotherapy cycle. In the 108 patients treated with Defibrotide only one case of DVT was reported and in none of these patients were symptoms or signs of pulmonary embolism encountered. In the group treated with calcium heparin 2 cases of clinically and radiologically diagnosed pulmonary embolism and 4 cases of DVT were observed. Although the differences were not statistically significant, the tendency favours Defibrotide. Statistically significant (p less than 0.01) was the difference in postoperative bleeding evaluated with particular attention in patients of advanced age. Further, in the Defibrotide group, scarring was considered excellent in 96% of cases while in the heparin group scarring was excellent in 85% (p less than 0.05). To conclude, the sure clinical effectiveness, tolerance, handiness and lack of interference with clotting functions make Defibrotide a really useful drug for the prevention of thromboembolic episodes in patients undergoing major orthopaedic surgery. PMID- 3287227 TI - [Pathology of the myocardium and coronary vessels in sudden cardiac death. A post mortem study of 130 cases]. AB - Autopsies were performed on 130 cases of sudden death (38 F, 92 M) i.e. death occurring in the space of a very few minutes in apparently healthy subjects, in order to examine the anatomopathological alterations to the heart. Varying degrees of coronary sclerosis were noted in 91.5%, thrombosis of one or more coronary vessels in 32.3%, acute histologically evident myocardial infarction in 54.6%. PMID- 3287228 TI - [Results of the use of topical diosmin (venosmine) in the treatment of acute hemorrhoid pathology]. AB - There is still much discussion about the pharmacological treatment of certain symptoms caused by haemorrhoids and their complications. In 1986 topical treatment with Diosmina ointment was used on 50 patients (33 males, 17 females) with grade 1, 2, 3 or 4 haemorrhoids featuring strangulation and thrombosis. Patients who had previously been given other treatment were excluded from the study. The efficacy of the treatment was assessed by a simple method previously used by others which involves scoring (0-3) the major symptoms of the condition (bleeding, oedema, erythema, pain, itching) according to severity. The drug was most effective on oedema and erythema, producing 75% and 73% improvements as assessed in three consecutive weekly visits. These results confirm the value of Diosmina in the topical treatment of acute haemorrhoids. In particular the treatment is very well tolerated and produces no unwanted side effects if properly used. PMID- 3287229 TI - [Expert systems in medical emergencies]. AB - Computers have already been introduced into the field of medical applications and many support systems have been developed. Recently expert or knowledge-based systems have been employed in some specific fields. A project for the creation of an expert system for use in toxicological emergencies is presented. This system is designed to give the physician continuous support and to employ computer formulae as similar as possible to medical reasoning. For this reason, medical knowledge was examined and the event graphs, frames and production rules to represent it were chosen. PMID- 3287230 TI - [Endometrial changes in the presence of a progesterone-releasing IUD. Cytological evaluation]. PMID- 3287231 TI - [Uterine myomatosis in pregnancy and the puerperium. Ultrasonographic study]. PMID- 3287232 TI - [Polyhydramnios and pregnancy. Review of 296 cases]. PMID- 3287233 TI - [Evaluation of the renal function in patients with ovarian carcinoma subjected to polychemotherapy including cisplatin or carboplatin]. PMID- 3287234 TI - [Immunoenzymatic study of cervical Chlamydia at an obstetrico-gynecological ambulatory service and treatment of the infection using erythromycin]. PMID- 3287235 TI - Legislation needs nurses' support. PMID- 3287236 TI - The management of nausea and vomiting in pregnancy. AB - The focus of this article is on the current research, theories and management strategies related to simple nausea and vomiting in pregnancy (NVP). Research related to the physiological, psychological and cultural factors associated with the expression of NVP are reviewed. The studies which have examined the effectiveness of non-pharmacological therapies in the treatment of NVP are presented. The results of these studies indicate that more rigorous experimental studies are necessary. However, preliminary findings can serve as a basis for the development of nursing approaches to the treatment of simple nausea and vomiting. The findings of these studies suggest research questions for future study. PMID- 3287237 TI - Opiate antagonists and rewarding brain stimulation. AB - This review examines the literature on the effects of opiate antagonists on brain stimulation (ICSS) reward. Antagonists should have predictable effects if endogenous opioids modulate ICSS. Naloxone is the antagonist most often used, and it has produced inconsistent results in some ICSS paradigms. When schedules of intermittent reinforcement are used, however, naloxone reliably reduces the rate of responding. It reverses the effects of opiate agonists on ICSS behavior, and it also attenuates the effects of psychomotor stimulants, such as amphetamine. The results produced by naloxone are consistent with a modulatory effect of endogenous opioid systems on reward, and suggest that the opiate and dopamine systems together exert significant control over ICSS. Further research is needed to characterize better the actions of the antagonists on ICSS behavior, and productive research directions are proposed. Data obtained in future studies might suggest how the endogenous opioid systems modulate both natural and brain stimulation reward. PMID- 3287238 TI - Cyclo(His-Pro): its distribution, origin and function in the human. AB - Cyclo(His-Pro), or histidyl-proline diketopiperazine, is a cyclic dipeptide endogenous to blood, cerebrospinal fluid (CSF), semen, brain, spinal cord, and gastrointestinal tract of humans. Although a part of cyclo(His-Pro) clearly appears to be derived from the limited proteolysis of thyrotropin-releasing hormone by Pyroglutamate aminopeptidase, the biosynthetic origin of the remainder of the peptide can only be speculated. The levels of this peptide in blood and CSF fluctuate in health and disease in a manner appropriate for a physiologically active endogenous molecule. PMID- 3287239 TI - Effects of stress on muscarinic mechanisms. AB - Hyperactivity of muscarinic mechanisms may be involved in the patho-physiology of depressive disorders and stress. The literature emphasizes the impact of stress on aminergic networks and muscarinic mechanisms are generally not accorded a significant role in the neurobiology of stress. However, experiments in man and animals indicate that acute and chronic stress activate central muscarinic mechanisms. The literature reporting these results is reviewed. PMID- 3287240 TI - Glucocorticoids and hypothalamic obesity. AB - Recent studies have demonstrated a role for adrenal glucocorticoid hormones in the hyperphagia and obesity which follow lesions of the ventromedial hypothalamus (VMH). Although VMH lesions elevate morning plasma corticosterone levels, it is concluded that this contributes little to the development of obesity. More importantly, animals with VMH lesions appear to be hyperresponsive to very low levels of circulating glucocorticoids. The overeating and obesity are both prevented and reversed by either complete adrenalectomy or complete hypophysectomy (i.e., resulting in plasma corticosterone levels of less than 1.0 microgram/dl) and restored by dosages of glucocorticoids that have no effect on feeding behavior and weight gain in nonlesioned adrenalectomized animals. Mineralocorticoid hormones have no effect on hypothalamic obesity. Judging by the time course of effects on feeding behavior in VMH-damaged mice of a single intracerebroventricular injection of a low dose of glucocorticoid, which has no effect when administered intraperitoneally, it is concluded that glucocorticoids exert their effect centrally in a permissive, rather than a regulatory, manner. Stimulation of the neighboring paraventricular nuclei (PVN) with norepinephrine or neuropeptide Y produces a rapid feeding response which is also abolished by adrenalectomy and restored with administration of glucocorticoids. However, it is unlikely that the PVN is the site at which glucocorticoids exert their effect in animals with VMH lesions, for PVN lesions or knife-cuts, or combination VMH-PVN lesions, also result in hyperphagia and obesity. It is concluded that adrenal glucocorticoid hormones exert their permissive effects on feeding behavior at brain sites other than the medial hypothalamus. The septo-hippocampal complex is suggested as a possible site. PMID- 3287241 TI - What the cerveau isole preparation tells us nowadays about sleep-wake mechanisms? AB - The intercollicular transected preparation opened a rich field for investigations of sleep-wake mechanisms. Initial results showed that brain stem ascending influences are essential for maintaining an activated cortex. It was subsequently shown that the forebrain also develops activating influences, since EEG desynchronization of the cortex reappears in the chronic cerveau isole preparation, and continuous or almost continuous theta rhythm is able to occur in the acute cerveau isole preparation. A brief "intermediate stage" of sleep occurs during natural sleep just prior to and after paradoxical sleep. It is characterized by cortical spindle bursts, hippocampal low frequency theta activity (two patterns of the acute cerveau isole preparation) and is accompanied by a very low thalamic transmission level, suggesting a cerveau isole-like state. The chronic cerveau isole preparation also demonstrates that the executive processes of paradoxical sleep are located in the lower brain stem, while the occurrence of this sleep stage seems to be modulated by forebrain structures. PMID- 3287242 TI - Dopamine-containing neurons in the mammalian central nervous system: electrophysiology and pharmacology. AB - A decade of research culminated in the late 1950's with the demonstration that dopamine was a chemical neurotransmitter within the mammalian brain. Since this time, dopaminergic neuronal systems have been extensively studied using numerous techniques. This paper will review the last 14 years of electrophysiological investigation on neurochemically identified dopamine-containing neurons in the central nervous system. This will include an examination of both the electrophysiological and pharmacological characteristics in these cells, as well as the resulting insights into the regulation of dopamine cell electrical activity which is derived from this work. PMID- 3287243 TI - [AIDS. Where to find assistance?]. PMID- 3287244 TI - The late Dr Thelma Becroft. PMID- 3287245 TI - Postmolar contraception. AB - Recent studies on the etiology and the cytogenetics of trophoblastic tumors suggest that hydatidiform mole and choriocarcinoma may be conditions with no causal relationship. With the advent of newer diagnostic methods which aid in the early diagnosis of pregnancy and help to differentiate it from abnormal pregnancy together with the increasing concern over the safety of use of the contraceptive measures following a hydatidiform mole, it is suggested that a period of postmolar contraception may no longer be necessary. The follow-up of these patients should include serial sonography in association with other currently available methods. Pregnancy should also be allowed to occur naturally if the patient so desires. PMID- 3287246 TI - Verrucous carcinoma of the female genital tract: a review. AB - The 102 cases of verrucous carcinoma of the female genital tract reported in the world literature have been reviewed. The difficulties in diagnosis of this tumor are discussed; correct diagnosis is heavily dependent on close collaboration between clinician and pathologist, and the provision to the latter of a sufficiently large biopsy specimen. Effective management requires surgical resection, which may at times need to be radical. Radiotherapy and chemotherapy are of doubtful value. PMID- 3287247 TI - Fetal cystic adenomatoid malformation of the lung: apparent improvement in utero. AB - Fetal cystic adenomatoid malformation is a rare pulmonary abnormality, usually involving only a part of the lung, that is characterized by excessive growth of the terminal respiratory elements. The natural history of this lesion and hence the prognosis after antenatal detection is still unclear. We report two cases of large cystic adenomatoid malformation, diagnosed prenatally, in which the size of the mass diminished visibly during the third trimester. Both fetuses had excellent outcomes after surgery. These findings suggest that when a cystic adenomatoid malformation is diagnosed antenatally, the initial impression concerning the size of the mass and final prognosis may not necessarily predict outcome, because there may be improvement during fetal life. PMID- 3287248 TI - Amniotic band syndrome in monozygotic twins: prenatal diagnosis and pathogenesis. AB - Amniotic band syndrome is a well-described disorder lacking a precise definition or a scientifically validated hypothesis of pathogenesis. The widely accepted "exogenous" theory suggests that early amniotic rupture leads to the formation of pathologic amniotic strands, which then induce nonanatomic fetal abnormalities. This paradigm appears to be challenged by observations that amniotic band syndrome occurs in monozygotic twin gestations. The exclusive development of amniotic band syndrome in monozygotic versus dizygotic twin gestations, the description of early amniotic rupture in one sac of a dizygotic twin gestation without subsequent fetal abnormalities, and the paradoxical observations of discordance in monoamniotic and concordance in diamniotic twin gestations, fail to support an "exogenous" etiology for amniotic band syndrome. PMID- 3287249 TI - Prefascial marsupialization of the pregnant uterus. AB - A case report is presented of a white woman, gravida 4, para 2, abortus 1, who experienced protrusion of a gravid uterus through the anterior rectus fascia. The uterus subsequently became entrapped and was reduced only after cesarean section at 34 weeks' gestation. PMID- 3287250 TI - Successful pregnancy after previous conservative treatment of an advanced cervical pregnancy. AB - Cervical pregnancy was diagnosed at 12 weeks' gestation in a young nulliparous woman presenting with vaginal bleeding. Initial treatment with methotrexate was unsuccessful. The patient was ultimately treated by internal iliac artery ligation, hysterotomy, and intracervical balloon tamponade. Nineteen months after surgery, the patient delivered a healthy infant at 36 weeks' gestation by cesarean section. PMID- 3287251 TI - Postcoital pneumoperitoneum. AB - Acute abdominal and shoulder pain in association with a pneumoperitoneum are common signs and symptoms of perforation of a hollow viscus. We report a case that describes the development of a postcoital pneumoperitoneum in an otherwise healthy postpartum patient. The literature is discussed, and supports this case as pneumoperitoneum in association with vigorous coital activity. PMID- 3287252 TI - Prenatal diagnosis of congestive heart failure in a fetus with a sacrococcygeal teratoma. AB - Two-dimensional Doppler echocardiography was used to diagnose congestive heart failure in a fetus with a large sacrococcygeal teratoma. Ultrasound performed for size-date inconsistency revealed a 27.5-week fetus with hydrops and a large solid and cystic mass in the sacral region. Fetal echocardiography showed dilated ventricles and a pericardial effusion; Doppler ultrasound demonstrated increased velocities and volume flows, along with tricuspid and mitral regurgitation. At delivery, the mass was bleeding actively, the amniotic fluid was markedly bloody, and the neonatal hematocrit was 10%. We postulate that intrauterine hemorrhage from the teratoma led to anemia and high-output cardiac failure confirmed by Doppler echocardiography, and suggest that all fetuses with sacrococcygeal teratomas be evaluated by two-dimensional Doppler echocardiography to detect the presence of congestive heart failure, in order to allow well-timed therapeutic interventions. PMID- 3287253 TI - Prenatal findings in a case of spondylocostal dysplasia type I (Jarcho-Levin syndrome). AB - We report the first prenatal identification using ultrasound of a fetus affected with spondylocostal dysplasia type I, or Jarcho-Levin syndrome, in a patient without a positive family history for this condition. The fetus was initially evaluated because of a low maternal serum alpha-fetoprotein determination. At 23 weeks, we visualized a shortened spine, disorganization of the vertebral bodies, posterior fusion of the ribs, and normal long-bone biometry. Termination of pregnancy was elected. All features identified with ultrasound were confirmed postnatally. The fetus was affected with Jarcho-Levin syndrome, a recessively inherited condition associated with a 25% recurrence rate. PMID- 3287254 TI - Fetal anomalies associated with an inversion duplication 13 chromosome. AB - We report the cytogenetics and pathology of a fetus with holoprosencephaly associated with an inversion duplication 13 chromosome. The pathology is compared with that found in cases of partial duplication (trisomy) and deficiency (monosomy) of chromosome 13 described in the literature. To our knowledge, this is the first time holoprosencephaly has been associated with this particular inversion duplication 13 chromosome. Careful pathology and complete chromosomal studies proved useful in counseling this couple. PMID- 3287255 TI - Morphologic replication of the mandible using computerized tomography for the fabrication of a subperiosteal implant. PMID- 3287256 TI - Bone scintigraphy of vascularized bone transfer in maxillofacial surgery. AB - Postoperative assessment of the viability of seven vascularized bone transfers was done in seven patients by means of radionuclide imaging within the first postoperative week. The results of a positive bone scan correlated with an uncomplicated union, with no frank failures. The two negative results both led to total failure, necessitating removal of the transferred bone. Radionuclide imaging in the first postoperative week after vascularized bone transfer appears to be a useful assessment of the anastomotic patency and the viability of the revascularized bone grafts. PMID- 3287257 TI - Clear cell sarcoma of the kidney: report of a case with mandibular metastasis simulating a benign myxomatous tumor. AB - The clear cell sarcoma of the kidney (CCSK) is one of the histologically unfavorable types of childhood renal tumors that has a propensity for osseous metastasis. We have presented the clinical and pathologic findings of the first well-documented case of a CCSK with mandibular metastasis, which was recognized approximately 18 months after the original diagnosis. Microscopically, the mandibular lesion had the features of a benign myxomatous neoplasm with the exception of occasional atypical spindle cells. Electron microscopic observation confirmed the undifferentiated nature of the neoplastic cells. It was concluded that the intensive chemotherapy that was administered to our patient very likely affected the histologic appearance of the mandibular metastasis as well as other recurrent lesions in the abdomen. Our review of the literature revealed only five previous examples of Wilms' tumor that had metastasized to the mandible. At least one of these earlier cases also represented a CCSK. PMID- 3287258 TI - Dyskeratosis congenita: report of a case and review of the literature. AB - A case of dyskeratosis congenita in a 10-year-old white boy is reported. The triad of oral leukoplakia, nail dystrophy, and skin pigmentation was present. Other associated anomalies included dysphagia and varied immunoglobulin levels, although there was no evidence of anemia, pancytopenia, and ocular involvement. Since it may be associated with future malignant change, dyskeratosis congenita should be considered in all cases in which an obscure white lesion exists in the mouth. PMID- 3287259 TI - A specialist institute looks to the future. AB - A specialized institute has unique problems relating to its responsibility for teaching, research and clinical care. In the 40 years of its existence it has played a considerable role in the development of the specialty in the United Kingdom, advancing knowledge in all fields--particularly head and neck oncology and audiological medicine. The threat to its associated specialist hospital and to its own future because of severe cuts may result in far-reaching decisions regarding its future role. PMID- 3287260 TI - [Andrology--1988]. PMID- 3287261 TI - [The role of percutaneous transhepatic puncture of the gallbladder, under ultrasonic guidance, in the therapy of acute cholecystitis]. PMID- 3287262 TI - [Immunomodulatory effect of synthetic peptides of IgG origin]. PMID- 3287264 TI - [Scoliosis screening in Bacs-Kiskun County using the Adams test and the moire technic]. PMID- 3287263 TI - [The use of the atopy score in the diagnosis of obstructive bronchitis]. PMID- 3287265 TI - [Torpid leg ulcer and amyloidosis]. PMID- 3287266 TI - [Experience in the care of 712 patients with naevus haemangiomatosus]. PMID- 3287267 TI - [Incidence of Hodgkin's disease in a patient with lymphoid leukemia]. PMID- 3287268 TI - [Corrections concerning the commemoration of Prof. Sebestyen]. PMID- 3287269 TI - [Wounds and wound treatment, prevention of tetanus]. AB - The care principles of injuries base on founded knowledge about the phases of wound healing, the causes of wound healing disturbances and the development of wound infections. The wound care includes the judgement of injuries, the surgical wound treatment and the aftercare. The wound evaluation with four categories makes a different therapeutic approach possible. The primary union is aspired to all non-infected wounds by direct wound closure. Suspicious infected and infected wounds are treated open after adequate wound excision. A secondary suture with a delayed primary wound closure is possible when the inflammation symptoms are recurrent. Other important aspects of wound care are a correct wound dressing, wound control and the checking for tetanus prophylaxis. PMID- 3287270 TI - [Soft tissue and bone injuries of the face]. AB - The major priority in treatment of combined soft tissue and bone injuries in the maxillofacial region is the primary reconstruction and fixation of the bony structures, with suturing of the soft tissue injuries only after this has been achieved. Facial injuries should be sutured without major excision of soft tissue and with thin, atraumatic and monophil suturing material. Various fixation systems are available for the bony structures of the face. Intraoral application of plates allows functionally stable fixation of maxillofacial fractures. Zygomatic, nasal and orbital fractures deserve special consideration. Only early reconstruction and fixation can prevent functional and aesthetic distortion in these cases, which cannot be corrected later. PMID- 3287271 TI - [First aid at the scene of the accident from the viewpoint of the trauma surgeon]. AB - A step-by-step therapy concept for prehospital care of the severely injured is presented. A schedule for effective organization of the rescue procedure is given, after which stress is placed on preservation of the vital functions. A therapy algorithm is explained, according to which the indications for intubation, ventilation and volume replacement depend on both physiological parameters (blood pressure, respiration frequency, Glasgow Coma Scale, capillary refill) and the type of injuries. Initial care of the injuries is discussed in some detail. Competent preclinical management of fractures and joint dislocations is a major topic. A flow chart for the selection of an adequate trauma center is proposed, which takes account of vital signs, the extent of the injuries, how the accident happened, and the force of the impact. PMID- 3287272 TI - [Principles of primary functional fracture treatment]. AB - The main characteristic feature of primary functional treatment of fractures is that all parts of the affected segment of the locomotor apparatus are essentially functional again within a week after the trauma has been sustained, even without any internal splinting. Stable cancellous bone compression, fractures that are stabilized by a pronounced muscular sheath and certain fractures affecting the shafts of the long tubular bones are all indications for application of this method, providing there is no concomitant high-grade soft tissue damage. Adjuvant analgesia is an important basis of the therapy; others are exercises under the supervision of a physiotherapist and the adaptation of supporting splints and cuffs. The primary functional treatment regimen has few complications, and when it is applied only in situations where it is genuinely indicated and is competently supervised, the clinical results are excellent. PMID- 3287273 TI - [Distal radius fracture]. AB - The treatment of fractures of the distal radius is in a state of flux, because the results of conservative treatment have so far been unsatisfactory in 20%-30% of cases. Instability resulting from dorsal compression, damaged ligaments (60%) and the presence of debris in the area of the metaphysis means that, while reduction is easy, retention is frequently difficult to achieve. Such fractures are reduced by using the ball of the little finger for extension while the ball of the thumb is positioned under the proximal fragment to provide support. A plaster cast based on the principle of three-point fixation is applied to immobilize the fractured part. The simplest surgical technique for unstable fractures of the distal radius is internal fixation with crossed Kirschner wires. For Smith's fractures [41], and especially those of type II (Thomas [44]), internal fixation with plates fixed to the volar bone surface is the procedure of choice. Comminuted fractures of the metaphysis and a tendency to shortening should be immobilized by external fixation. Early filling of the defect with cancellous bone leads to more rapid consolidation. In our own clinic we treated 409 cases of fracture of the distal radius in 2 years. The procedures applied were: conservative treatment in 39.6% of cases; internal fixation with wires in 55%; internal fixation with plates in 3.7%; and stabilization by means of external fixation in 1.7%. PMID- 3287274 TI - [Fracture treatment of the hand]. AB - Early mobilisation made possible by surgical stabilisation is considered to be the main pre-condition for complete restoration of function after trauma to the hand skeleton. Nevertheless, it should be borne in mind that exceptional capacity of the hand for adaptation may enable that even severely defective results (deviation of axis) can be functionally compensated. This article presents modalities of treatment approved by the author during more than 20 years of hand surgery. PMID- 3287275 TI - [Soft tissue injuries in the area of the hand]. AB - Soft tissue injuries to the hand are always a problem to the surgeon. A thorough examination and a precise preoperative diagnosis are the most important factors regarding forming a treatment concept. Blood supply, sensitivity and additional injuries are especially important parameters. The modern methods of plastic and reconstructive surgery involving tissue transfer and microvascular and even combined reconstruction methods, all offer multiple possibilities for reconstruction--even for problematic soft tissue injuries. The method of determining the urgency (Urgence differee) permits as even to offer patients methods that are normally only useful or successful in the hands of a specialist. Primary treatment can even take place in the first 48-72 h. If adequate operative treatment is performed by a plastic and reconstructive surgeon, the further corrective procedures that are often necessary can often also be avoided. PMID- 3287276 TI - [Injuries of the flexor and extensor tendons of the hand and forearm and their treatment]. AB - The general principles of treatment of injuries of the flexor and extensor tendons in the hand and distal forearm are mentioned. For the extensor tendons the different types of treatment performed for injuries in the different areas, the finger, the back of the hand, and the wrist, are briefly discussed. Knowledge recently acquired from experimental and clinical studies, especially that of the anatomy, the blood supply, the nutrient pathways, and the healing of the flexor tendons, is discussed, and its applications in our daily clinical work are shown. PMID- 3287277 TI - Genomic p53 gene immortalises. PMID- 3287278 TI - Immortalization of rat embryo fibroblasts by the cellular p53 oncogene. AB - Intact and rearranged p53 genes from Friend virus-induced erythroleukemic cell lines which code for proteins of 53- (p53) and 44-kDa (p44), respectively, were cloned into pUC18 and tested for their ability to immortalize rat embryo fibroblasts. The functional p53 gene from normal Balb/c mouse liver was also tested for immortalizing activity. Immortal cells were obtained with the three genes although the efficiency of immortalization by p44 was lower than that by p53. Expression of murine p53 and p44 in the established rat cell lines was confirmed by metabolic labeling and Western Blotting. Our results demonstrate that elevated expression of the mouse p53 gene, driven by its natural promoter and in the absence of strong heterologous promoters and/or enhancers, can efficiently immortalize early-passage rat embryo fibroblasts. p53-immortalized cells but not p44-immortalized cells could be morphologically transformed by secondary transfection with activated Ha-ras. Thus 5'-coding sequences of the p53 gene appear necessary for ras complementation but not for immortalization. PMID- 3287279 TI - Differential influence of adjacent normal cells on the proliferation of mammalian cells transformed by the viral oncogenes myc, ras and src. AB - We investigated the role of adjacent normal cells in the modulation of focal outgrowth of mammalian fibroblasts transformed by different viral oncogenes (myc, src and ras). NIH3T3 cells transformed by these three oncogenes were derived by transfection or infection and showed comparable cloning efficiencies in semi solid medium. However, upon replating in liquid medium a small number of transformed cells together with a vast excess of normal mouse embryo fibroblasts C3H10T1/2, ras- and src-transformed cells were able to overgrow the monolayer and formed distinct foci, whereas myc-transformed cells lacked this ability. Conditioned medium from normal cells did not affect the proliferation of myc transformed cells at clonal density. Addition of phorbol ester tumour promoters, either at the time of plating or as late as after one week, efficiently rescued focus formation by myc-transformed cells. In contrast, when myc-transformed cells were cultivated alone, their clone size and cloning efficiency were slightly reduced by the addition of tumour promoters. These results indicate that cell cell contacts between transformed cells and adjacent normal cells specifically inhibit the growth of myc- but not of ras- or src-transformed cells. The ability of tumour promoters and phospholipase-C to rescue the focus forming ability of myc-transformed cells is consistent with the possibility that activation of protein-kinase C is involved in the clonal expansion of 'suppressed' myc-bearing cells. PMID- 3287280 TI - Regional localization of the human c-rel locus using translocation chromosome analysis. AB - The human cellular homolog of v-rel, the transforming gene of reticuloendotheliosis virus, strain T, was previously localized to 2 cent-2p13 by a combination of somatic cell hybrid and in situ hybridization analyses. In this study, we use translocation chromosome analysis to refine c-rel's genetic assignment to 2p12-2p13. PMID- 3287281 TI - Impaired natural defence of beige (Chediak-Higashi syndrome) mice against tissue migrating larvae of Strongyloides ratti and its reconstitution by bone marrow cells. AB - The susceptibility of C57BL/6-bgJ/bgJ mice, which exhibit a murine counterpart of the Chediak-Higashi syndrome, to infection with Strongyloides ratti was examined. After a primary infection, the peak of the daily larval output in faeces (LPG) of bgJ/bgJ mice was approximately twice as high as that of their littermate bgJ/+mice. The total number of tissue migrating larvae recovered from bgJ/bgJ mice at 36 h after infection was also approximately twice as high as that from bgJ/+mice. However, after a primary infection, bgJ/bgJ mice could completely expel adult worms in the intestine by day 14. When an equal number of tissue migrating larvae obtained from the head of +/+ mice were implanted into bgJ/bgJ and bgJ/+mice, the magnitude and the kinetics of LPG were comparable between them, indicating that in both groups implanted larvae established in the intestine to become adult worms and then they were expelled by day 13. Thus, immune mechanisms involved in worm expulsion of bgJ/bgJ mice were comparable to those of bgJ/+mice. The higher susceptibility of bgJ/bgJ mice could be reduced to the level of bgJ/+mice by bone marrow grafting from bgJ/+mice 6 weeks prior to infection. Furthermore, when lethally irradiated bgJ/bgJ mice or bgJ/+mice were reconstituted with either type of bone marrow cells, the mice given bgJ/bgJ bone marrow cells showed higher susceptibility to infection with S. ratti regardless of the genotype of the recipients. These results indicate that the impaired natural defence of bgJ/bgJ mice is predetermined at the level of haemopoietic stem cells. PMID- 3287282 TI - Antibodies to Plasmodium falciparum gamete surface antigens in Papua New Guinea sera. AB - Sera from individuals living in malaria endemic areas of Papua New Guinea were tested for their effect on infectivity of Plasmodium falciparum gametocytes grown in culture to Anopheles freeborni mosquitoes. Consistent reduction of infectivity to less than 5% of control was observed with nine out of the 41 sera from the endemic area tested and also with three out of seven sera tested from individuals rarely exposed to malaria infection. Gamete surface antigens recognized by the sera were investigated by immunoprecipitation from 125I surface-labelled gametes extracted in SDS and Triton X-100. The main antigens recognized were of the same mol. wt (230, 48 and 45 kD) as those known to be targets of transmission-blocking monoclonal antibodies. A significant negative correlation was observed between the total ct/min immunoprecipitated from surface-labelled gametes by the sera and the average number of oocysts per gut observed in membrane feeding experiments with these sera. Spearmann's rank correlation coefficient indicated that suppression of infectivity correlated strongly with the presence of antibodies against the 230 kD protein; there was no significant correlation between suppression and antibodies to the 48/45 kD proteins. The antibody response to the different gamete surface antigens varied greatly in sera from the endemic areas suggesting that individuals respond differently to each gamete antigen. PMID- 3287283 TI - Expression of circumsporozoite proteins revealed in situ in the mosquito stages of Plasmodium berghei by the Lowicryl-immunogold technique. AB - A monoclonal antibody against the circumsporozoite proteins of the Plasmodium berghei sporozoite was used to trace the synthesis and expression of these proteins, via the Lowicryl immunogold technique, within the developing oocyst. The proteins were detected on the endoplasmic reticulum of the oocyst and were present in the sporozoite membranes at the point of their formation. PMID- 3287284 TI - Origins and organization of genetic diversity in natural populations of Trypanosoma brucei. AB - Experimental work has established that a sexual process can occur in African trypanosomes (Jenni, Marti, Schweizer, Betschart, Le Page, Wells, Tait, Paindavoine, Pays & Steinert, 1986; Paindavoine, Zampetti-Bosseler, Pays, Schweizer, Guyaux, Jenni & Steinert, 1986; Tait, personal communication). However, the role of the process in natural populations of trypanosomes is poorly understood. This paper considers what information can be gained from analyses of isoenzyme polymorphism. A cladistic approach is used to help determine whether trypanosome diversity could have been produced by mutation alone. When applied to three East African populations of Trypanosoma brucei it provides evidence that some diversity has arisen through a sexual process; this explains the variation observed within a locality and can account for the evolution of differences between localities. However, the extent to which genetic exchange currently operates is less clear. Analysis of genotype frequencies indicates that agreements with Hardy-Weinberg expectations can be obtained even if genetic exchange exerted no influence over genotype frequencies. Moreover, analysis of joint locus frequencies reveals disequilibrium between loci and that trypanosome populations may be lacking several genotype combinations. Thus, genetic exchange may not occur sufficiently frequently, or in such a way as to break up associations between loci. The relevance of these observations to the evolution of strain differences within T. brucei is discussed. PMID- 3287285 TI - Integrated control of ticks and tick-borne diseases of cattle in Africa. AB - The problems caused by tick and tick-borne diseases for livestock particularly cattle on the African continent are described and discussed. The control of ticks and tick-borne diseases must receive high priority in Africa with regard to both research and control application because of their widespread distribution in areas of high livestock potential and productivity. The conventional methods of tick and tick-borne disease control are discussed and are found to be inadequate in the conditions prevailing in Africa. Methods of integrated control are suggested and discussed in light of recent development in control methods and those still under development. Any one of these methods may not be adequate to control the problem on its own but when several of the methods are combined an economic and robust integrated control is likely to result. Encouragement is given to attempt this approach in Africa to solve what must be the largest animal health problem of livestock remaining in the world. PMID- 3287286 TI - The relative roles of the intestines and external surfaces in the nutrition of monogeneans, digeneans and nematodes. AB - Several major groups of parasitic helminths (Monogenea, Digenea and Nematoda) possess two surfaces that are potentially absorptive in nature. These are an external surface, a tegument in the platyhelminths and cuticle in the nematodes, and the intestine. This paper discusses the relative contributions of these absorptive surfaces in the nutrition of these parasitic helminths. There are many factors that determine the availability of, and a parasite's ability to absorb nutrients via either of these surfaces, and this review discusses individually some of the more important morphological, physiological and environmental factors affecting the potential nutritional roles of these surfaces. It is clear from such a summary of previous studies that the intestines and teguments (cuticles) of helminth parasites can each serve an important nutritional role. However, insufficient data make it impossible at this time to determine the relative nutritional roles of these surfaces in any single parasitic helminth. PMID- 3287287 TI - Biomembrane structure and function: recent studies and new techniques. AB - The consensus view of biomembrane structure is outlined. The present model is built upon a fluid lipid matrix, usually two molecules in length, into which the proteins are embedded. The lipid bilayer organization is discussed, such as their phase transition and fluid character and the effect of cholesterol upon the chain organization. The non-lamellar arrangement which some lipids adopt is described. The use of new physical techniques for obtaining information about the structure and dynamics of membrane proteins are described. These techniques include electron diffraction, electron microscopy and FTIR spectroscopy. Models of the structures of the Ca2+-ATPase and the glucose transporter from erythrocytes are shown, indicating the putative helices embedded in the lipid bilayer and the groups of amino acids in the aqueous environment. These models are based upon biochemical methods to obtain amino acid sequences using DNA cloning techniques. Finally, an experimental method using triplet probes is described for the study of the rotational dynamics of membrane proteins. Labelled monoclonal antibodies for studying the dynamics of the glucose transporter have been used. PMID- 3287288 TI - Excretory-secretory products of helminth parasites: effects on host immune responses. AB - Parasitic helminths excrete or secrete (ES) a variety of molecules into their mammalian hosts. The effects of these ES products on the host's immune responses are reviewed. Investigations into the source of antigenic or immunoregulatory ES products have identified the cuticular and tegumental surfaces of some nematodes and trematodes respectively as being important sources of ES products; other ES molecules are released through specialized excretory or secretory organs. It is proposed that the active shedding of surface antigens may serve as an important source of parasite antigens available to the immune system in a form in which they can be taken up and processed by antigen-presenting dendritic cells, macrophages and certain B cells for presentation to T helper cells. The ES products of nematodes, trematodes and cestodes contribute to immune evasion strategies of the parasites through mechanisms including shedding of surface bound ligands and cells, alteration of lymphocyte, macrophage and granulocyte functions and modulation of complement and other host inflammatory responses. Immunopathology may be induced by ES products as in the development of granulomas around entrapped schistosome eggs. In some host-parasite systems ES antigens may induce host-protective immune responses and this source of protective antigens has been utilized in the successful vaccination against helminth infections, particularly against infection with trichurid nematodes and the metacestode stage of cestode parasites. The use of ES antigens in immunodiagnosis of helminth infection is also briefly discussed. PMID- 3287289 TI - The interactions between drugs and the parasite surface. AB - The interrelationships between drugs and parasite surfaces are considered under the headings of (a) effects on membrane transport, (b) drug uptake mechanisms and (c) effects on surface morphology and function: praziquantel is discussed under a separate heading. The range of chemotherapeutic compounds that cause permeability changes and concomitant morphological disruption is discussed in terms of mode of drug action. Interpretation of the available data renders it difficult to identify the primary mode of action in the drugs considered. Drug uptake mechanisms are known for relatively few compounds; drug resistance as a function of drug acquisition is discussed. The role of the parasite surface as a specific drug target is argued. PMID- 3287290 TI - Molecular mechanisms involved in the transport of antibiotics into bacteria. AB - Many clinically useful antibacterial drugs have intracellular target sites. Therefore, in order to reach their targets, these compounds must be able to cross bacterial outer and cytoplasmic membranes. Considerable information is available on the mechanisms by which antibiotics cross bacterial membranes and, in many cases, it is now possible to define the molecular basis of their uptake. Passage of drugs across the outer membrane of Gram-negative bacteria can occur by diffusion through porin channels (e.g. beta-lactams and tetracyclines), by facilitated diffusion using specific carriers (e.g. albomycin), or by self promoted uptake (e.g. aminoglycosides and polymyxins). Transfer of antibiotics across the bacterial cytoplasmic membrane is usually mediated by active, carrier mediated, transport systems normally operating to transport essential solutes into the cell. For example, the antibiotic streptozotocin bears sufficient structural resemblance to N-acetyl-D-glucosamine to be transported by the phosphoenolpyruvate:phosphotransferase system, and D-cycloserine is recognized by the D-alanine, proton motive force dependent transport system. However, in some cases (e.g. tetracycline) although carrier-mediated transport is implied by the observation that drug uptake is energy dependent, the nature of the membrane carrier(s) responsible is unknown. Knowledge acquired from studies on bacterial peptide transport has been successfully used to deliver (or smuggle) amino acid mimetics disguised as peptides into the bacterial cell. These amino acid mimetics, although often poorly transported in their own right, are frequently potent inhibitors of bacterial peptidoglycan or lipopolysaccharide synthesis once they have gained access to the interior of the cell. PMID- 3287291 TI - Some general characteristics of the transport of nutrients and toxic compounds in yeasts and fungi. PMID- 3287292 TI - The Wellcome Trust lecture. Mechanisms of molecular trafficking in malaria. AB - The asexual stages of Plasmodium living within the erythrocyte result in growth related changes in the permeability properties of the red cell for substances such as glucose, amino acids, purine nucleosides, sodium, potassium, calcium, zinc, iron and several antimalarial drugs such as chloroquine, amodiaquine and mefloquine. In most cases such changes do not appear to be due to a modification in the affinity or specificity of red cell transporters; indeed, for most substances the membrane-associated transporters are either unaffected or are partially inactivated. In malaria-infected erythrocytes, where a striking increase in influx has been observed, it has been attributed to the insertion of parasite-encoded transporters into the red cell membrane or the formation of aqueous leaks and/or pores. Leak formation, in the vast majority of cases, does not appear to be dependent on the insertion of plasmodial proteins into the red cell membrane. However, since the data presently available are less than satisfactory for discriminating amongst the various possible transport mechanisms future studies will require painstaking efforts and carefully controlled conditions to discriminate amongst the various transport systems which are operational in the malaria-infected red cell and the parasite. PMID- 3287293 TI - Ontogenetic changes in helminth membrane function. AB - During their life-cycle many parasites experience a wide range of environments including free living and those provided by a variety of intermediate and final hosts. The nutritional requirements of parasites are met by physiological processes adapted to exploit the physicochemical characteristics provided by different hosts. In helminth parasites these adaptations are frequently expressed on the tegumentary surface. As an example of adaptations within the Trematoda, the control of monosaccharide transport in Proterometra sp. is described. Environmental sodium, although not directly involved in the uptake process, nevertheless regulates the expression of transport capabilities. In the Cestoda, the uptake of monosaccharides and amino acids is described for Hymenolepis diminuta. The metacestode of this tapeworm inhabits the blood system of an arthropod, and the adult the gut of a mammal. There are quantitative and qualitative differences in the amino acids and monosaccharides in these two environments and these are reflected in the transport mechanisms exhibited by the two forms of the life-cycle. In Echinococcus granulosus the transfer of amino acids, sugars and macromolecules across the membranes of hydatid cysts and protoscoleces is described. The major difference between these two stages in the life-cycle relates to the ability of hydatid cysts to absorb macromolecules, whereas protoscoleces are impermeable to these compounds. The potential for future work is emphasized. PMID- 3287294 TI - [Cis- and trans- mutations in genetic diseases]. AB - Whereas a great number of mutations located in the coding regions of genes have been described, genetic defects involving regulatory elements (cis-) or diffusible effectors controlling gene expression (trans-) are poorly known. Moreover, it appears that the structural defects of transcribed regions of genes have already delivered their "conceptual" message, whereas few studies of the consequences of one single gene defect on the expression of other genes and on in vivo functions are available. In the present communication, we wish to address the following issue: can we take advantage of Nature's experiments, ie. diseases, to extend our knowledge of the coordinate regulation of gene expression, via an original pathway, ie. the pathophysiological pathway? Can we select a few inborn or acquired metabolic diseases as models which could provide insight into as yet unknown factors involved in trans- regulation of gene expression? PMID- 3287295 TI - [Influence of the oxidation of lipid substrates on the neonatal production of glucose]. PMID- 3287296 TI - [Variations of the presynaptic inhibition of Ia fibers during voluntary movements in man]. AB - Presynaptic inhibition of Ia fibres can strongly reduce and even extinguish Ia excitatory postsynaptic potentials (e.p.s.p.). This phenomenon has been described in animal, but so far there was no method for studying presynaptic inhibition of Ia fibres in man. We have therefore firstly set up a method suitable to appreciate the amount of presynaptic inhibition of Ia fibres in man. Presynaptic inhibition is reduced for voluntary contractions, while it is enhanced for Ia fibres directed to the motoneurones innervating synergistic muscles not involved in the contraction. This control increases the motor contrast and very likely plays a role in the selectivity of movement. In the standing position, presynaptic inhibition of Ia fibres directed to soleus motoneurones is enhanced. This prevents development of an excessive soleus stretch reflex which might hinder forward progression during walking. PMID- 3287297 TI - [The receptor for the C3b fragment of complement, CR1, in pathology]. PMID- 3287298 TI - [Proteins C and S of coagulation: new markers of thrombotic risk in nephrotic syndromes?]. AB - Thromboembolic events remain one of the most serious complications in patients with nephrotic syndrome (NS). The natural anticoagulant system protein C-protein S was evaluated in patients with proteinuria and NS. Protein C levels were found to be normal or increased in NS. Protein C levels correlated positively with proteinuria, cholesterol and triglycerides and negatively with serum albumin. All of the 17 patients with NS exhibited urinary loss of protein C. Total protein S and C4BP were increased in mild and moderate forms of NS. Free protein S was identical in controls and NS patients. Nine of ten patients had urinary loss of protein S. No correlation was found between protein S and the various usual biologic parameters of NS. However, two patients with NS and thrombosis of the renal veins had an acquired deficit in either free protein S or protein C. Thus, in some patients, an acquired deficit in free protein S and/or protein C may contribute to the development of thrombotic complications in NS. PMID- 3287299 TI - [Contribution of monoclonal antibodies within the framework of urothelial tumors of the bladder]. AB - The advent of hybridoma technology has proved a major breakthrough in the field of tumor immunology and enables analysis at the molecular level of tumor heterogeneity. This approach seems particularly promising in urothelial tumors of the bladder and carries implications for diagnosis, prognosis and therapy of this disease. Two murine monoclonal antibodies (G4 and E7), obtained by xenogenic immunization of Balb/c mice with a human transitional carcinoma cell line (TCC) (647V) have proved especially useful. Use of a panel of monoclonal antibodies covering the entire spectrum of TCCs, most of which are already available, can be expected to result in significant modifications in the management of urothelial tumors. Advances in the field of monoclonal antibody technology may provide specific tools applicable to humans in vivo. PMID- 3287300 TI - [Anastomosis of the small intestine in a septic medium protected by a trellis of vicryl]. AB - An experimental study was carried out in rats to evaluate the outcome of small bowel anastomoses in the presence of peritonitis with and without protection by a vicryl mesh. One hundred and thirty rats were operated. 1) Thirty small bowel anastomoses were performed in a sterile environment to evaluate the morbidity and mortality due to the surgical procedure itself. All these animals had an uneventful course. 2) Forty anastomoses were done in a septic environment without protection. Twelve rats died immediately after the procedure. Six rats developed an anastomotic fistula and 22 had an uneventful course. 3) Sixty anastomoses were performed in a septic environment and protected by a vicryl mesh. Seventeen rats died immediately after the procedure. There were no anastomotic disruptions. Seventeen rats had an uneventful course, and 28 (46.7%) developed stenosis of the anastomosis. Protection of small bowel anastomoses by a vicryl mesh appears to effectively prevent disruptions and infections (no anastomotic fistulas or locoregional infections were recorded). However, the mesh is responsible for an intense inflammatory reaction, that often results in intestinal obstruction. PMID- 3287301 TI - [Study of endothelial markers of different clinical and hemodynamic types of angioma]. PMID- 3287302 TI - [Contribution of microradiography in search of calcifications of valvular bioprostheses]. AB - Implantation of a valvular bioprosthesis is one of the best treatments for valvular disease, particularly in children. Unfortunately, their use is limited as calcifications develop over time. Prevention of these calcifications is still an unresolved problem that is under study by Professor Carpentier and coworkers. These investigators have developed an experimental model in which accelerated development of calcifications occurs: fragments of porcine valves implanted under the skin of rats become calcified in a few days. Prior to implantation, the fragments are pretreated in an attempt to delay or prevent the development of calcifications. Two, four, six and eight months after implantation, the fragments are removed and calcifications are looked for using microradiography. Two hundred fragments have been studied. The material and technique used in our study are described. Results are semi-quantitative, based on the volume of calcifications. We conclude that microradiography is faster and more reliable than histology (the only technique used up till now) as it allows to study the entire fragments. PMID- 3287303 TI - [Indirect approach of stenosis of transplanted kidneys by Doppler echography]. AB - Pulsed Doppler ultrasound for the detection of rejection and renal artery stenoses involving transplanted kidneys was evaluated. Using mean velocity curves, the time interval between the ECG R wave and the onset of peak velocity was measured successively on the renal and ipsilateral iliac arteries and divided by the R-R interval. In 27 patients, a Doppler index defined as the ratio of the standardized renal artery and iliac artery time intervals, was determined and compared to angiographic data. The DI index failed to detect stenoses associated with rejection; conversely, in the absence of rejection, clear separation of patients without (n = 14, DI = 1.03 +/- 0.6) and with (n = 6, DI = 1.24 +/- 0.05) stenosis (t = 7.48, p less than 0.001) was achieved. Thus renal artery stenoses in transplant recipients can be detected by the comparative study of time intervals calculated for renal vessels and for the neighbouring iliac artery. PMID- 3287304 TI - [Videodensitometric analysis of venous digital angiography of the left ventricle: application to the measurement of the ventricular ejection fraction and volumes]. AB - Intravenous digital angiography of the left ventricle (LV) was submitted to videodensitometric analysis in order to measure the ejection fraction (EF) and ventricular volumes. The video-densitometric method was first validated using an experimental model consisting of latex balloons filled with contrast medium. The correlation for ejection fraction measurements was satisfactory (r = 0.9449), with less than 10% errors. For ventricular volumes, the correlation was also good (r = 0.97 and 0.92 with the Chapman and Dodge methods respectively), but marked variations across individuals were found. Digital videodensitometry thus appears to be a feasible and reliable method for ejection fraction and ventricular volume measurements. Further studies are needed to determine the accuracy of measurements of ventricular volumes. PMID- 3287305 TI - [Restatement and conception of an experimental battery of measurements of displacements in the three planes of a vertebral unit]. AB - The study of motions of a vertebral unit is difficult because of the great number of participating structures. Analysis in the three planes is required to obtain optimal visualization of the entire spectrum of criteria involved. Initially, we used comparators to achieve these measurements. However, the complexity and number of parameters quickly led us to switch to electronic sensors. At present, a completely automated test bench has been developed using an Orion data processing chain. Decoding and interpretating results nevertheless remains difficult in such tridimensional analyses. PMID- 3287306 TI - Comparative effects of insulin and refeeding on DNA synthesis, HMP shunt and cholesterogenesis in diabetic and fasted rats. AB - DNA synthesis, cholesterogenesis and the enzymes of the hexosemonophosphate (HMP) shunt pathway were investigated in liver of diabetic rats treated with insulin and in fasted/re-fed rats. Both insulin and refeeding were found to induce liver cell proliferation, accompanied by a remarkable increase in cholesterogenesis. An enhancement of glucose-6-phosphate dehydrogenase (G6PD) and 6-phosphogluconate dehydrogenase (G6PD) activities was also found in insulin-treated diabetic rats and in re-fed rats, supporting the concept that these two enzymes are involved in the proliferative process. Since insulin did not exert the same biochemical effects in a non replicating cell population, such as in insulin-treated normal rats, these studies provide new evidence of a close correlation between DNA, cholesterol synthesis and HMP shunt enzymes during cell proliferation. PMID- 3287307 TI - Loeffler's fibroplastic endocarditis. AB - The hypereosinophilia syndrome with cardiac involvement, as an incidental autopsy finding in a 50-yr-old male, is reported. A review of the literature on the clinical manifestations, pathologic findings, differential diagnosis, associated conditions, pathogenesis of the cardiac involvement, and the role of palliative treatment is presented. PMID- 3287308 TI - IgA nephropathy in relapsing polychondritis. AB - Relapsing polychondritis (RP) is a multisystem autoimmune disease characterized by the presence of antibodies to type II collagen. This collagen is found predominantly in cartilaginous tissues, vitreous humor, aorta and notochord. Involvement of the kidney is rare, only 7 cases having been recorded, and there is no type II collagen in glomeruli. Six of the previous cases had crescentic glomerulonephritis. We report here two cases of biopsy proven RP in which IgA nephropathy was seen, the first examples recorded. Both patients had hematuria and slight proteinuria, with mild impairment of renal function. The histological and immunofluorescence pattern on both biopsies was in keeping with IgA nephropathy. Both patients received steroids with diminution/disappearance of hematuria and proteinuria. In view of the potentially progressive nature of glomerular disease with RP, the renal status should be investigated in all patients with RP. PMID- 3287309 TI - Modern approach to the diagnosis and treatment of tuberculosis in children. AB - Tuberculosis in children remains an important infectious disease in the United States, with 1261 cases reported in 1985. The percentage of extrapulmonary manifestations is increasing. Advances in the diagnosis and treatment of tuberculosis in children have lagged behind those in adults owing to diminished familiarity with the disease and difficulty in performing clinical studies in children. Tuberculosis in the United States now occurs mainly in clusters of high risk people, such as the foreign born, Hispanics, blacks, Native Americans, and the impoverished. In general, the diagnosis of tuberculosis is epidemiologic, supported by the chest roentgenogram, skin test, and, most important, contact tracing. As the rate of drug-resistant tuberculosis increases, greater effort should be made to obtain cultures. New advances, such as DNA probes and serodiagnosis, may improve diagnostic accuracy, especially for extrapulmonary tuberculosis. Noncompliance is the major problem in treating tuberculosis, and greater effort should be directed toward novel treatment approaches in children, such as twice-weekly supervised therapy and shorter, more intense durations of therapy. PMID- 3287310 TI - Herpes simplex virus encephalitis in children. AB - Herpes simplex encephalitis (HSE) is an uncommon disease, yet 25 to 30 per cent of cases involve children. The initial clinical findings are nonspecific (fever, altered mental status), but most cases evolve to demonstrate focal neurologic signs and symptoms. The CSF is abnormal in over 90 per cent of cases. The EEG, CT, and MRI will further help in detecting focal encephalitis. The clinician caring for a child with focal encephalitis should institute broad-spectrum antimicrobial therapy plus acyclovir, pending definitive diagnosis by ancillary tests or brain biopsy, which is positive for HSE 33 to 55 per cent of the time and is diagnostic for other treatable conditions 10 to 20 per cent of the time. Acyclovir is the drug of choice for HSE and substantially reduces mortality and morbidity. The management of HSE in a child requires an experienced team of specialists and laboratory support in a tertiary intensive care setting. PMID- 3287311 TI - Cytotoxin-producing Escherichia coli and the hemolytic uremic syndrome. AB - Recently, a new class of diarrhea-associated Escherichia coli has been linked to the hemolytic uremic syndrome. The organisms included in this group produce cell damaging toxins (cytotoxins) related to Shigatoxin made by S. dysenteriae 1. The most common pathogen in this group is E. coli O157:H7. PMID- 3287312 TI - Hepatitis B serology--help in interpretation. AB - This review discusses the serologic markers of hepatitis B virus (HBV) infection. Interpretation of various serologic profiles is provided, and the importance of maternal screening for interruption of perinatal transmission of HBV infection is stressed. PMID- 3287313 TI - The rapid identification of group A beta-hemolytic streptococci in the upper respiratory tract. Current status. AB - Rapid detection of group A beta-hemolytic streptococcal antigen on throat swabs has become more popular in the management of patients with pharyngitis. Although the specificity of these commercially available kits usually has been satisfactory, the sensitivity has varied considerably. Currently most physicians accept a positive rapid test result but frequently require culture confirmation of a negative rapid antigen detection test on a throat swab. PMID- 3287314 TI - Candida: an increasingly important pathogen in the nursery. AB - Advances in neonatal care now permit the survival of very immature infants. Although candidiasis is not a new disease, the spectrum of clinical disease has greatly widened and the rate of invasive disease has increased significantly. This article reviews the history, microbiology, and epidemiology of candidal infections, both superficial and invasive. Particular attention is paid to the pathogenesis of and risk factors associated with the development of invasive disease, as well as its clinical manifestations, diagnosis, and treatment. PMID- 3287315 TI - Giardia lamblia. AB - Giardia is the most frequently identified enteric parasite in the United States, but much is not known about host-parasite interaction. Advances using immunodiagnostic techniques, endonuclease restriction analysis, surface-antigen detection methods, and measuring homologous and heterologous antibody responses are beginning to clarify the biology of Giardia. PMID- 3287316 TI - Central venous catheter infections. AB - When used wisely, central venous catheters are capable of providing vital circulatory access in any patient with a remarkably low risk of infection or major complication. Tunneled silicone catheters are the route of choice for long term or outpatient use, particularly for oncology or TPN patients; insertion of such a catheter should occur early in the hospitalization of a newly diagnosed patient on chemotherapy. The greatest experience has accrued with the cuffed silicone catheters (for example, Broviac), but the totally implantable devices (for instance, Port-a-cath) may become the device of choice in pediatric outpatients. For infants, small, percutaneously inserted noncuffed silicone catheters appear to offer the greatest safety. Among acute care patients, percutaneous plastic central venous catheters fulfill a vital role but represent an important source of infection. Scrupulous technique, the minimizing of manipulation, and a readiness to replace the catheter at any suggestion of trouble are important to achieving the best results. Within a given design, it is generally best to use the smallest diameter catheter capable of performing the desired tasks. However, on the basis of currently available data, there need be no hesitation to use a multilumen catheter if the care of the patient demands multiple access ports. The various silicone catheters can usually be left in place while infection is treated, although fungal and certain other infections are more likely to require catheter removal. Percutaneous plastic catheters should be removed or changed over a wire if infection is suspected; if tip culture of the removed catheter is positive, and the catheter was replaced over a wire, then the replacement catheter should be promptly removed. PMID- 3287317 TI - Methicillin-resistant Staphylococcus aureus: pediatric perspective. AB - Methicillin-resistant S. aureus has emerged as a nosocomial pathogen of major importance in pediatric patients. Infection occurs most often in hospitalized individuals with underlying predisposing medical conditions. Any body site may be involved, and bacteremia frequently occurs concomitantly. Vancomycin is the antibiotic of choice for serious MRSA infections; PRPs and cephalosporins generally are not effective. The likelihood of an adverse outcome of infection increases with the severity of an underlying condition and delay in institution of appropriate therapy. Infection control measures have met with only limited success in eradicating MRSA from the hospital environment. Methicillin-resistant S. aureus is likely to remain of considerable clinical significance to physicians caring for seriously ill children. PMID- 3287318 TI - Current concepts in the pathogenesis and management of brain abscesses in children. AB - Brain abscesses represent the most frequent intracranial suppurative process occurring in children. Improved bacteriologic techniques for isolating anaerobic microorganisms have shown that anaerobes play a major role in brain abscesses in conjunction with aerobic organisms such as alpha-streptococci. Computerized tomography has improved the diagnosis of brain abscesses and has changed the management in certain circumstances. Although surgical drainage still remains the definitive treatment modality, conservative medical management with serial CT scans has been successful. Still, the mortality and morbidity of brain abscesses remain substantial. PMID- 3287319 TI - Pulmonary late-phase allergic reactions. PMID- 3287320 TI - Neonatal group B streptococcal sepsis: effects of late treatment with dazmegrel. AB - Neonatal group B streptococcal (GBS) sepsis produces pulmonary arterial hypertension and hypoxemia that are preventable by pretreatment with the selective thromboxane A2 synthase inhibitor, dazmegrel. In the present experiment we administered dazmegrel (8 mg/kg) 2 h after the initiation of a 2 1/2 h infusion of 5 X 10(8) GBS/kg/h in ten 2- to 3-wk-old piglets. The multiple inert gas elimination technique was used to measure intrapulmonary shunt and alveolar ventilation to pulmonary perfusion mismatching. Thromboxane B2, the stable metabolite of thromboxane A2, and 6-keto-prostaglandin F1 alpha, the stable metabolite of prostacyclin, were assayed in arterial blood. Pulmonary arterial pressure increased immediately after initiation of the GBS infusion, rising from 12 +/- 2 to 34 +/- 4 torr (p less than 0.02); pulmonary vascular resistance increased by 400% (p less than 0.01). Arterial hypoxemia developed (p less than 0.02) in association with an increase in the low ventilation-perfusion ratio index but without a significant increase in intrapulmonary shunt. Thromboxane B2 levels increased 10-fold. Infusion of the carrier substance for dazmegrel after 2 h of GBS infusion produced no change in any variables. In contrast, infusion of the drug resulted in the return to pre-GBS infusion baseline values for both pulmonary arterial pressure and pulmonary vascular resistance. However, no improvement in arterial pO2 or in the low ventilation-perfusion ratio index occurred. Both pulmonary vascular resistance and pulmonary arterial pressure remained normal for 0.5 h after dazmegrel administration despite continued GBS infusion. Thromboxane B2 levels were decreased 30 min after dazmegrel (p less than 0.02), but remained greater than pre-GBS levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287321 TI - Effects of insulin and glucose concentrations on glucose utilization in fetal sheep. AB - Glucose and insulin clamp experiments were performed in vivo in chronically catheterized, late-gestation fetal lambs to quantify the effects of glucose and insulin on fetal glucose metabolism. Fetal glucose uptake from the placenta via the umbilical circulation (umbilical glucose uptake) was measured by application of the Fick principle, and fetal glucose utilization rate (GUR) was measured using [U-14C]glucose tracer. Fetal plasma insulin concentrations ranged from 2 to 119 microU.ml-1 and fetal blood glucose concentrations ranged from 7.3 to 62.6 mg.dl-1. GUR varied from 2.82 to 15.12 mg/min/kg and the exogenous glucose entry rate (umbilical glucose uptake + glucose infusion) varied from 2.46 to 13.95 mg/min/kg. The mean GUR [6.53 +/- 0.28 (SEM) mg/kg/min] was not different from the mean exogenous glucose entry rate [6.29 +/- 0.30 (SEM) mg/kg/min]. Multiple linear regression analysis on a glucose-by-insulin surface demonstrated a best fit model of fetal glucose utilization following the quadratic equation: GUR = 0.322 + [0.289 (glucose)] + [0.108 (insulin)] - [0.00319 (glucose)2] - [0.000673 (insulin)2], r = 0.883 (all terms significant at p less than 0.02). This model predicted a GURmax of 10.56 mg/min/kg at blood glucose concentration = 45.3 mg/dl and plasma insulin concentration = 80 microU/ml and Km values for blood glucose concentration and plasma insulin concentration of 20.6 mg/dl and 10 microU/ml, respectively. According to this model, the glucose and insulin effects were additive. Furthermore, change in GUR was not proportionate to change in glucose concentration, accounting for a decreasing metabolic clearance rate at higher glucose concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287322 TI - [Auxological study of children in the works of Janusz Korczak]. PMID- 3287323 TI - [Clinico-immunological characteristics of mixed intestinal infections in children]. PMID- 3287324 TI - 1988 directory of educational software for nursing. PMID- 3287325 TI - [Bone marrow transplantation--rapid development toward new indications]. PMID- 3287326 TI - Integration host factor (IHF) represses a Chlamydomonas chloroplast promoter in E. coli. AB - We show that in E. coli, a Chlamydomonas chloroplast promoter, PA, is repressed by Integration Host Factor (IHF). The himA 42 mutation, altering the alpha subunit of E. coli IHF, leads to over-accumulation of PA transcripts in vivo. This effect requires upstream chloroplast DNA sequences. DNAase I and methylation protection experiments show that IHF binds in vitro to a site within PA and band retardation shows that IHF inhibits formation of PA-E. coli RNA polymerase open complexes. We interpret these results, together with our previous deletion analyses, to mean that in E. coli, repression of PA by IHF minimally requires both binding of IHF to a site overlapping PA and binding of one or more additional proteins, perhaps including IHF itself, to sequences upstream of PA. PMID- 3287327 TI - cDNA and deduced amino acid sequence of 38 kDa-type acidic ribosomal protein A0 from Saccharomyces cerevisiae. PMID- 3287328 TI - cDNA and deduced amino acid sequence of acidic ribosomal protein A1 from Saccharomyces cerevisiae. PMID- 3287329 TI - cDNA and deduced amino acid sequence of acidic ribosomal protein A2 from Saccharomyces cerevisiae. PMID- 3287330 TI - Nucleotide sequence of rat renin cDNA. PMID- 3287331 TI - A rapid and convenient method for the preparation and storage of competent bacterial cells. PMID- 3287332 TI - Structure of a Saccharomyces cerevisiae gene encoding minor (AGY)tRNA(Ser). PMID- 3287333 TI - Nucleotide sequence of the 2-amino-3-ketobutyrate coenzyme A ligase (kbl) gene of E. coli. PMID- 3287334 TI - Complete nucleotide sequence and exon-intron boundaries of the 5' non-coding region of the mouse N-myc gene. PMID- 3287335 TI - Diethyl pyrocarbonate can detect a modified DNA structure induced by the binding of quinoxaline antibiotics. AB - The reactivity of the 160 bp tyrT DNA fragment towards diethyl pyrocarbonate (DEPC) has been investigated in the presence of bis-intercalating quinoxaline antibiotics and the synthetic depsipeptide TANDEM. At moderate concentrations of each ligand, specific purine residues (mainly adenosines) exhibit enhanced reactivity towards the probe, and several sites of enhancement appear to be related to the sequence selectivity of drug binding. Further experiments were performed with echinomycin at pH 5.5 and 4.6 to facilitate the protonation of cytosine required for formation of Hoogsteen GC base pairs. No significant increase in reactivity was observed under these conditions. Additionally, no protection of deoxyguanosine residues from methylation by dimethyl sulphate was observed in the presence of echinomycin. We conclude that the structural anomaly giving rise to drug-dependent enhanced DEPC reaction is not simply the formation of Hoogsteen base pairs adjacent to antibiotic binding sites. Nor is it due to a general unwinding of the double helix, since we show that conditions which are supposed to unwind the helix lead to a uniform increase in purine reactivity, regardless of the surrounding nucleotide sequence. PMID- 3287336 TI - Characterization of products derived from self-splicing of intron aI5 alpha which is located in the mitochondrial COX I gene of Saccharomyces cerevisiae. AB - We have characterized the in vitro self-splicing of intron aI5 alpha containing precursor RNA from the yeast mitochondrial gene coding for cytochrome oxidase subunit I. This intron follows the rules for group I self-splicing introns and all the characteristic products have been identified. In addition we have detected abnormal RNA products with features that indicate that the self-splicing behaviour of this intron is more complex. Two intron circles are formed by use of a major and minor intron-internal site for circle closure. A cryptic 5'-splice site located in the 3' exon results in guanosine nucleotide mediated opening at a position 30 nt downstream of the normal 3' splice site. The reactions can all be explained on the basis of the "splice guide" model proposed by Davies et al (1982 Nature 300 719-724). Although the sequence motifs at cyclization and splice sites occur more often in this intron, only some of them are allowed to interact with the internal guide sequence, suggesting that both primary structure and spatial folding of the RNA are involved in formation of productive reaction sites. PMID- 3287337 TI - DNA unwinding and inhibition of T4 DNA ligase by anthracyclines. AB - The ability to alter DNA tertiary structure of ten anthracycline derivatives whose antitumor potency is known was studied by an assay that makes use of nicked circular DNA and bacteriophage T4 DNA ligase. This assay allows the detection of tertiary structure alterations caused by DNA binding of both intercalating and non-intercalating drugs. The determination of these events can be obtained at different temperatures in the range of activity of DNA ligase. The results indicate that anthracyclines alter the DNA tertiary structure but this property does not correlate with their cytotoxic or antitumor activities. An additional interesting finding was that several anthracyclines inhibit T4 DNA ligase. The inhibition can be complete and is a cubic function of drug concentration. The inhibition of DNA ligase does not correlate with the ability of anthracyclines to alter the tertiary structure of DNA but is dependent from the presence of an amino group on the sugar ring. PMID- 3287338 TI - The effect on the function of the transcriptional activator NtrC from Klebsiella pneumoniae of mutations in the DNA-recognition helix. AB - We have constructed mutations in what we predict to be the DNA-recognition helix of Klebsiella pneumoniae NtrC, which regulates transcription from promoters under global nitrogen control. Mutations which disrupt the helix lead to complete loss of function. All point mutants tested were able to activate transcription from the sigma 54-dependent glnA promoter, but only those retaining some ability to recognise NtrC binding sites, as evidenced by their ability to repress the ntrB promoter and the upstream glnA promoter, were able to activate the nifL promoter. One mutant, which contained an amino acid substitution in the turn of the DNA binding motif as well as in the recognition helix, suppressed mutations in the NtrC binding sites upstream from the nifL promoter, but only if both sites bore equivalent transitions. This confirms that the DNA-binding motif for this class of transcriptional activator has been correctly identified and suggests that binding of NtrC can be cooperative. PMID- 3287339 TI - The complete nucleotide sequence of the arcaebacterial plasmid pHSB from Halobacterium, strain SB3. PMID- 3287340 TI - Improved hybridization conditions for DNA 'fingerprints' probed with M13. PMID- 3287341 TI - Nucleotide sequence of the gene coding for the large subunit of ribonucleotide reductase of Escherichia coli. Correction. PMID- 3287342 TI - S2 plasmid from cms-S-maize mitochondria potentially encodes a specific RNA polymerase. PMID- 3287343 TI - Re-using syringes safely. PMID- 3287344 TI - Development, testing, and application of the oral assessment guide. PMID- 3287345 TI - Comparison of the mixing and reinfusion methods of drawing blood from a Hickman catheter. PMID- 3287346 TI - [Connatal neuroblastoma IV-S. Clinical and therapeutic considerations on a case]. AB - The authors describe an original case of connatal neuroblastoma (stage IV-S), observed at birth, for the presence of subcutaneous nodules, in rapid expansion. Therapeutical approach is discussed (treatment or no treatment) on the base of literature data. PMID- 3287347 TI - [Retrocaval ureter in children: a rare form of obstructive uropathy]. AB - Retrocaval ureter is a rare anomaly, often misdiagnosed for years, presenting with sign of urinary infections and obstruction. Recognition of this anomaly is rare in childhood. We report a case of a 9 years old boy, who was successfully treated by ureteral section, excision of the retrocaval segment and uretero ureteral anastomosis. Current diagnostic procedures and different methods of treatment are reviewed. PMID- 3287348 TI - [Campylobacter pylori and gastroduodenal pathology in children]. AB - Since Warren and Marshall rediscovered in 1983 the presence of a spiral microorganism on the gastric mucosa, and named it Campylobacter Pylori (CP), its significance and characteristics have been largely studied. CP has fulfilled Koch's postulates, which need to proven before a microorganism can be said to cause a disease. The natural source of infection is unknown, but in human volunteer studies, ingestion of a suspension of CP was followed by the development of severe dyspepsia associated with colonization of gastric antrum and histologically proven gastritis B. CP is found overying the gastric epithelium, in the gastric crypts and in the mucus gel layer that protects it from gastric acid. There it causes infiltration of the mucosa by polymorphonuclear leucocytes and mononuclear cells, and mucin depletion. It is found in 60-70% of children with chronic active antral gastritis and can cause various lesions of upper intestinal tract, like esophagitis, duodenitis and gastric or duodenal ulcers. Several tests have been proposed to detect serum antibody against CP, but they are not yet commercially available. Breath test with C 13 or C 14-urea are promising, but up to now the diagnosis can be made only by upper G.I. endoscopy and antral biopsy. A pseudopolypoid antral gastritis seems to be the peculiar lesion caused by CP, but in children it is present only in 40% of cases. CP is easily seen in antral biopsies by Giemsa or Hematoxylin Eosin staining, or can be cultured in Skirrow's agar under microaerophilic conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287349 TI - [Vitamin E: physiology and pathology]. AB - The purpose of this report is to present an overview on vitamin E distribution, requirements, absorption and biochemical and nutritional aspects. A continuous interest in biochemical functions is recently developed and vitamin E certainly plays an important role throughout the body. The best known of its effects and still actively considered in recent years is the role as an important biological antioxidant. The red blood cell is an ideal model for studying the antioxidant role of vitamin E in cell membranes. Nutritional deprivation is a rare occurrence in developed countries. In prematurely delivered newborns the deficiency is due to marginal stores and to transient malabsorption but it can also be iatrogenic. In infants and adults vitamin E deficiency does occur in syndromes characterized by increased consumption or reduced absorption. Various gastrointestinal disorders induce, with steatorrhoea, marked alteration of vitamin E levels. Cystic fibrosis (CF), the commonest cause of pancreatic insufficiency during the first decades of life, is of particular interest. The fat malabsorption, often severe, may not well respond to pancreatic therapy and the hepatobiliary disease, increased in frequency with improved survival, induce a further reduction in intestinal bile salt concentration. Several manifestations have been attributed to vitamin E deficiency in CF and, although overt neurological complications seem to be relatively uncommon, it is recommended to maintain an adequate supplementation. PMID- 3287350 TI - [Periventricular leukomalacia in the newborn infant. Clinical and echographic diagnosis and follow-up]. AB - Periventricular leukomalacia (PVL) is defined as an ischemic lesion of the brain of the preterm infant, characterized by infarction of the deep white matter surrounding the external angle of the lateral ventricles, a watershed area lacking collateral circulation, representing a typical "border zone" of vascular supply. This lesion is considered the neuroanatomic basis of motor and sensory impairments, as spastic diplegia or quadriplegia, mental retardation, visual and auditory deficits. An early diagnosis and the study of the developmental sequence of PVL, are recently become possible by realtime ultrasound scanning. During a period of one year, from 2/1/1986 to 2/1/1987, 136 newborns hospitalized in the Division of neonatology of the Conegliano General Hospital, have been studied by serial ultrasound scans. The incidence of PVL in the whole group was of 2.9% (4 cases); the incidence increased to 5.6% in infants weighing less than or equal to 2.500 gr (median 1.800 gr), and was 12.5% in the newborns less than or equal to 35 weeks of gestational age (median 31.7 weeks g.e.). Females presented PVL in three cases, with a M/F ratio of 1:3. Cranial real-time ultrasound provided a practical and valuable tool for diagnosis and monitoring of PVL, for its accuracy and safety. The sequence of four stage in the evolution of PVL has been confirmed on ultrasound regular scanning: 1) initial echodensity at the external angle of the lateral ventricles, 2) mild normalisation, 3) gradual cavitation and development of cysts, 4) final development of ventriculomegaly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287351 TI - [Up-date on the etiopathogenesis of celiac disease]. AB - Wheat, oat, rye and barley flours are toxic for celiac patients. Prevalence and incidence of Celiac Disease (CD), quite variable from country to country, are very high in Austria (1 out of 476 born alive) and low in France (1 out of 41.667 born alive). This difference is probably due to its multifactorial genesis. In a multicentric Italian study, histocompatibility antigens of HLA complex II were typed in 460 CD children. DR3 was present in 63% of the cases (Relative Risk = RR: 6.8), DR7 in 67% (RR: 3.8) and DR3/DR7 in 22.5% (RR: 10.5), while in 7.7 of patients both antigens were absent. Therefore in a certain percentage of CD patients these risk antigens are absent, while in the normal population they can be present. The probability of CD increases when HLA DR3 and DR7 are present (but their absence cannot exclude the disease. The main etiological factor is gluten and its fractions (B, B1, B2, fraction 9 etc.). It seems that breast feeding can prevent or delay the onset of CD, while the age at gluten introduction does not modify the risk. Pathogenetic mechanisms are still under discussion: 3 theories are under investigation. 1) Enzymatic theory: a proteolytic enzyme for gluten digestion could be lacking. This theory is not yet proven, while Bruce et al. found in the jejunal mucosa of CD patients an elevation of a transglutaminase, which binds the gluten to enterocytes. Its level does not seem to vary with the diet. 2) Lectinic theory: the gluten bind the enterocyte membrane by a lectinic mechanism and damage it.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287352 TI - [Development of auditory evoked potentials of the brainstem in relation to age]. AB - In order to study the various changes which occur in the waveform, latency and amplitude of the auditory brainstem evoked response (BSER) as a function of age, the authors recorded the BSER from the scalp's surface of 20 newborns and 50 infants, 3 months, 6 months, 1 year and 3 years old as well as from 20 normal adults. The data obtained show that the most reliable waves during the first month of life are waves I, III, V, which is often present even when other vertex positive peaks are absent. The latencies of the various potential components decreased with maturation. Wave V, evoked by 90 dB sensation level clicks, changed in latency from 7, 12 msec at 1-4 weeks of age to 5,77 msec at 3 years of life. The auditory processes related to peripheral and central transmission were shown to mature at differential rates during the first period of life. By the 6th month, in fact, wave I latency had reached the adult value; in contrast, wave V latency did match that of the adult until approximately 1 year old. One obvious explanation for the age-related latency shift is progressive myelination of the auditory tract in infants, for this is know to occur. The authors conclude that the clinical application of this technique in paediatric patients couldn't provide reliable informations about auditory brain stem activity regardless of evaluation of the relationship between age and characteristics of BSER. PMID- 3287353 TI - [Beta 2 microglobulin in the diagnosis of reflux nephropathy in childhood]. AB - The authors determined beta 2 microglobulin plasmatic and urinary levels in 35 children aged 1 month-14 years; 25 of them were suffering from reflux nephropathy. The results of this study indicate that B2 microglobulin concentrations in plasma and urine can be useful parameters to the clinical diagnosis and evaluation of severity of reflux nephropathy. In presence of reduced glomerular filtration rate B2 microglobulin plasmatic levels resulted significantly out of the normal range (mean = 3318; s.d. = 1184) and proportional to the residual functionality degree (p 0.005); blood B2 microglobulin values demonstrated a higher specificity (76.2%) than creatine clearance. Moreover Bt (B2 microglobulin urinary level), Bs (B2 microglobulin excretion per minute corrected to surface area) and Bf (B- microglobulin excretory fraction) were shown to vary (p 0.025) in relation to the presence and the degree of tubulo interstitial damage. In particular, Bf values progressively impairing with the severity of the nephropathy, were shown to have a statistically good distribution and the best sensibility (95.2%) and specificity (77.8%) in detecting tubular damage. PMID- 3287354 TI - Ofloxacin: its pharmacology, pharmacokinetics, and potential for clinical application. AB - Ofloxacin is a 4-quinolone antibiotic with rapid bactericidal activity against a wide variety of organisms. Its proposed mechanism of activity is interference with DNA gyrase, an enzyme essential for the replication of bacterial DNA. In vitro activity of ofloxacin includes a variety of aerobic and anaerobic bacteria. Enteric gram-negative bacilli and cocci are generally sensitive to ofloxacin; nonaeruginosa strains of Pseudomonas are less so. Numerous bacterial pathogens of the gastrointestinal tract are also sensitive to the drug. Although its MIC values for gram-positive aerobic organisms are generally higher, ofloxacin's bactericidal activity against these organisms is considered by some to be adequate, and superior to that of most other fluoroquinolones. Ofloxacin is well absorbed after oral administration. Wide tissue and body fluid distribution is demonstrated. Urinary excretion is thought to be the primary route of elimination, with 80% of the dose recovered in the urine within 24 hours. The serum half-life ranges between 2.9 and 9 hours in a dose-dependent manner. Only modest accumulation is reported after multiple-dose administration. Clinical trials using daily dosages of 100-800 mg/day in single or divided doses have been reported in the treatment of a variety of conditions such as skin and soft tissue infections, tonsillitis, sexually transmitted disease, respiratory tract infections, cystitis, and complicated and uncomplicated urinary tract infections. English reports of these trials, however, are generally limited to abstract form, making evaluation of trial design difficult. Side effects most frequently encountered include gastrointestinal and central nervous system reactions. PMID- 3287355 TI - Time-dependent disposition of cyclosporine after pancreas transplantation, and application of chronopharmacokinetics to improve immunosuppression. AB - We studied the circadian influences on cyclosporine pharmacokinetics in five recipients of pancreatic allografts. Results from these patients demonstrate a slightly increased area under the concentration-time curve (p = 0.156) resulting from decreased apparent clearance during the resting (PM) versus activity (AM) period (p = 0.199). A significant delay in mean residence time was observed after the PM dose (p = 0.039), and the PM area under the moment curve was larger than the AM value (p = 0.063). We propose three chronopharmacokinetic dosing methods that alter either the PM dose administration time or redistribute the daily dose to produce equal exposure to cyclosporine during the active and resting periods. These trends and differences suggest that more sophisticated time-dependent cyclosporine dosing methods are needed to balance AM and PM drug exposure and thereby improve immunosuppression. PMID- 3287356 TI - Human infection with herpes zoster: etiology, pathophysiology, diagnosis, clinical course, and treatment. AB - Herpes zoster is a cutaneous vesicular eruption resulting from recrudescence of the chickenpox virus. It is mainly a disease of adults, with a predisposition for the elderly or immunocompromised. Although usually localized, the disease can disseminate to visceral organs. Diagnosis is often made based on the characteristic pattern of the lesion and clinical features. Tzanck smear, viral isolation, seroconversion, antibody titers, and monoclonal antibodies may further aid or confirm the diagnosis. Clinical features of herpes zoster may follow a progression through 3 stages, prodromal, acute, and chronic. The prodromal and acute phases seldom require more than symptomatic management. The chronic pain syndrome, postherpetic neuralgia (PHN), demands a more aggressive approach. Pharmacologic intervention, neuroaugmentation, and/or surgery may prevent or alleviate PHN, but universal response to any of these therapeutic approaches is unlikely. Tricyclic antidepressants remain the first choice in treating this pain syndrome. A trial of antiviral therapy may be warranted in patients with disseminated disease or in immunocompromised patients with localized disease. Of the antiviral agents, acyclovir is considered the drug of choice by most clinicians. PMID- 3287357 TI - Production of a biologically active variant form of recombinant human secretin. AB - A biologically active variant form of recombinant human secretin was produced using a gene fusion system designed to facilitate the purification of the protein. The fusion protein was recovered from the culture medium of Escherichia coli by IgG affinity chromatography, and recombinant secretin was released by cyanogen bromide treatment. A novel approach involving addition of a C-terminal Gly-Lys-Arg extension, was used to overcome the lack of amidation of recombinant proteins in Escherichia coli. The biological activity of the recombinant variant of secretin was at least 80% of the porcine secretin standard. PMID- 3287358 TI - Polygenic expression of gonadotropin-releasing hormone (GnRH) in human? AB - A non-mammalian lamprey-like gonadotropin-releasing hormone (lGnRH) has been detected in human hypothalami using a combination of immunocytochemistry, high performance liquid chromatography and radioimmunoassay. The hypothalamic distribution of immunopositive lGnRH neurons is similar to that observed for those containing the mammalian gonadotropin-releasing hormone (mGnRH), indicating a possible role for this newly identified peptide in the regulation of pituitary function. Our data suggest the existence of a separate gene for lamprey-like GnRH in humans. Confirmation of the exact nature and role of this newly detected form of GnRH will require future isolation and sequence analysis. The possibility that polygenic expression of a given peptide may be a common phenomenon even in higher mammals is discussed. PMID- 3287359 TI - Increases of neuropeptide Y-like immunoreactivity in plasma during insulin induced hypoglycemia in man. AB - Neuropeptide Y-like immunoreactivity (NPY-LI) in plasma during insulin-induced hypoglycemia was measured in 4 healthy male volunteers. Plasma NPY-LI increased from 167 +/- 11 pg/ml to 247 +/- 25 pg/ml 30 min after the administration of insulin (0.1 U/kg body weight IV), reached the maximum (296 +/- 6 pg/ml) 45 min after the insulin, and then decreased. These results suggest that NPY is released into the systemic circulation during insulin-induced hypoglycemia in man. PMID- 3287360 TI - Layered closure of lacerations. AB - The cause, depth, and location of a laceration are major determining factors in its treatment. In all cases, the wound must be completely cleansed with irrigation under pressure and then examined radiographically if necessary and debrided. Successful repair depends on understanding and using the principles of wound healing. The skin's greatest strength is in the dermal layer, and the best repair results when the entire depth of the dermis is accurately approximated to the entire depth of the opposite dermis. Accurate coaptation of the epidermis gives a polished effect to the repair but does not contribute to its strength. Fat and muscle do not support sutures. Full-thickness sutures may safely be used only on palmar and plantar surfaces. With an extensive laceration or one near a joint, a splint or sling may be needed. The wound should be examined a couple of days after suture placement for signs of infection. PMID- 3287361 TI - Repairing cuts and lacerations of the hand. AB - Cuts and lacerations of the hand require complete evaluation and care to ensure optimal healing. Contamination must be considered, and x-ray films should be taken to rule out the presence of foreign bodies, fractures, or joint injury in severe wounds. Irrigation and excision of nonviable tissue precede operative closure and graft placement. Puncture, gunshot, and bite wounds are left open to drain, and if necessary, tetanus and antibiotic prophylactic treatment is given. Appropriate immobilization and dressing with follow-up care are critical to the successful outcome of these injuries. PMID- 3287362 TI - Gestational diabetes. Ensuring optimal outcome for mother and child. AB - Traditional management recommendations for gestational diabetes are being questioned and are changing. Key components of revised plans of management are that all pregnant women should be screened for gestational diabetes, that stringent goals for blood glucose level are important for better outcome, that self-monitoring of blood glucose levels is essential, and that close attention should be paid to monitoring weight gain during pregnancy. Moreover, maintenance of ideal weight and yearly assessments for diabetes are important follow-up measures for the woman with gestational diabetes. PMID- 3287363 TI - [Detection of pathogens in bronchoalveolar lavage fluid in patients with pneumonias]. PMID- 3287364 TI - [Excess of proteases and functional deterioration in exogenous allergic alveolitis]. PMID- 3287365 TI - Prenatal ultrasound diagnosis of the Holt-Oram syndrome. AB - The Holt-Oram syndrome is an autosomal dominant disorder consisting of a congenital heart defect in combination with characteristic upper limb abnormalities. This report presents the ultrasonographic follow-up of two fetuses at risk for the Holt-Oram syndrome. In the first fetus, the existence of Holt Oram syndrome was suspected at 22 weeks of gestation; a ventricular septal defect, an atrial septal defect, and a minor skeletal defect were found. In the second fetus, no structural abnormalities were discovered until the 30th week, when a small atrial septal defect was detected. In both pregnancies, it was possible to exclude early in gestation the more severe forms of the Holt-Oram syndrome. PMID- 3287366 TI - Autosomal recessive polycystic kidney disease. Problems of prenatal diagnosis. AB - Autosomal recessive polycystic kidney disease (ARPKD) is characterized by different proportions of cystic dilated collecting ducts invariably associated with congenital hepatic fibrosis. Because of the nearly regular arrangement of nephrons and collecting ducts, disturbances have been postulated to act rather late on embryological grounds. Prenatal diagnoses seem to confirm this observation, as can be demonstrated in our cases and those reported in the literature. Increased echogenicity and renal enlargement are the main ultrasonographic signs of ARPKD; oligohydramnios is characteristic but not always present. Repeated sonographic measurements of the kidney length seem to be the most useful parameter. As differential diagnoses, autosomal dominant polycystic kidney disease as well as Meckel syndrome have to be taken into consideration. The prognosis of cases with oligohydramnios is usually poor. In genetic counselling, the possibility of prenatal diagnosis in the second trimester of pregnancy should be given with caution. PMID- 3287367 TI - Effect of peptide YY on insulin release stimulated by 2-deoxyglucose and neuropeptides in dogs. AB - Peptide YY (PYY) is a hormone released from gut after a meal. The objective of this study was to determine the effect of PYY on insulin release stimulated by either 2-deoxyglucose (2-DG) or neuropeptides in conscious dogs with gastric and duodenal fistulas. In control experiments dogs received either 2-DG (75 mg/kg i.v. bolus) or atropine (25 micrograms/kg bolus followed by 20 micrograms/kg/h i.v.) plus 2-DG (75 mg/kg i.v.) or bethanechol (80 micrograms/kg/h i.v.) or vasoactive intestinal peptide (VIP, 4 micrograms/kg i.v. bolus) or gastrin releasing peptide (GRP, 400 pmol/kg/h i.v.) or tetragastrin (G4, 100 micrograms/dog, i.v. bolus). On separate days, PYY was also infused intravenously in combination with one of the above stimulants. Given intravenously, PYY (200, 400 pmol/kg/h) significantly inhibited 2-DG stimulated-insulin secretion in a dose-dependent fashion. This inhibitory effect also existed in the presence of atropine. Peptide YY (400 pmol/kg/h) depressed the insulin levels in response to GRP or G4 but failed to inhibit bethanechol- and VIP-stimulated insulin release. After administration of the above stimulants, PYY did not modify the blood sugar concentrations. These results demonstrated that PYY might inhibit the cephalic phase of insulin release from dogs triggered by 2-DG and by the neuropeptides GRP and G4. Thus, PYY may play a negative feedback regulatory role on insulin release. PMID- 3287368 TI - Reduced pancreatic insulin is associated with retarded growth of the pancreas in young prediabetic BB rats. AB - The beta-cell function in the perfused pancreas, the total pancreatic insulin content, and the weights of pancreas, kidney, spleen, and total body fat were compared at the age of 30 and 45 days in diabetes-prone and body weight-matched diabetes-resistant male BB rats. These inbred rats had an incidence rate of diabetes at 90 days of age of 80 and 0%, respectively. At day 30, the pancreatic insulin content was reduced in the diabetes-prone (n = 10) rats to 15 micrograms (range 7.7-31.8) compared with 32 micrograms (range 23.3-52.9) in the diabetes resistant (n = 10) rats (p less than 0.01). Although the kinetics of insulin release in response to glucose was maintained, the amount of insulin released in the diabetes-prone rats was decreased (p less than 0.05) including the first peak (p less than 0.05). The weight of the spleen was less (p less than 0.05); whereas the weights of the pancreas, kidney, and total body fat did not differ from those observed in the diabetes-resistant control rats. At 45 days of age, the weight of the pancreas in the diabetes-prone rats (n = 8) was reduced to 159 mg (range 100 190) from 202 mg (range 185-214) (p less than 0.01). The body weight and body fat were identical to those observed in the diabetes-resistant controls (n = 8) and their kidney (p less than 0.05) and spleen (p less than 0.01) were larger. The insulin content was reduced to the same magnitude as the reduction of pancreatic weight. PMID- 3287369 TI - Clinical significance of ultrasonography, computed tomography, and biochemical tests in the rapid diagnosis of gallstone-related pancreatitis: a prospective study. AB - Real-time ultrasonography (US), computed tomography (CT), and biochemical tests were prospectively performed to detect gallstones in 88 consecutive patients immediately after the onset of an attack of acute pancreatitis. The sensitivity of biochemical tests was 84.6% when the patients had three or more positives of five parameters [including serum bilirubin, alkaline phosphatase (AP), gamma glutamyl transpeptidase (GGT), alanine transaminase (ALT), and alanine transaminase-aspartate transaminase (ALT-AST) ratio]. The sensitivity, specificity, and accuracy were 71.8, 98.0, and 86.4% for US, and 52.9%, 100%, and 79.5% for CT. The sensitivity, specificity, and accuracy were improved to 82.1, 100, and 93.2% by the combination of US and CT, and 94.9, 100, and 97.7% by the combination of US and biochemical tests. Adding CT to the combination of US and biochemical tests resulted in only a slight improvement in sensitivity and accuracy. In conclusion, a combination of US and biochemical tests can provide the best noninvasive method in rapidly detecting gallstones as an etiological factor in acute pancreatitis. Computed tomography is not cost-effective. A positive result of biochemical tests despite a negative finding in US calls for an intensive search for gallstones by further investigation with endoscopic retrograde cholangiography or repeated US examinations. PMID- 3287370 TI - Energetics of charge-charge interactions in proteins. AB - Electrostatic interactions between pairs of atoms in proteins are calculated with a model based on the linearized Poisson-Boltzmann equation. The equation is solved accurately by a method that takes into account the detailed shape of the protein. This paper presents applications to several systems. Experimental data for the interaction of ionized residues with an active site histidine in subtilisin BPN' allow the model to be tested, using various assumptions for the electrical properties of the protein and solvent. The electrostatic stabilization of the active site thiolate of rhodanese is analyzed, with attention to the influence of alpha-helices. Finally, relationships between electrostatic potential and charge-charge distance are reported for large and small globular proteins. The above results are compared with those of simpler electrostatic models, including Coulomb's law with both a distance-dependent dielectric constant (epsilon = R) and a fixed dielectric constant (epsilon = 2), and Tanford Kirkwood theory. The primary conclusions are as follows: 1) The Poisson-Boltzmann model agrees with the subtilisin data over a range of ionic strengths; 2) two alpha-helices generate a large potential in the active site of rhodanese; 3) epsilon = R overestimates weak electrostatic interactions but yields relatively good results for strong ones; 4) Tanford-Kirkwood theory is a useful approximation to detailed solutions of the linearized Poisson-Boltzmann equation in globular proteins; and 5) the modified Tanford-Kirkwood theory over-screens the measured electrostatic interactions in subtilisin. PMID- 3287371 TI - Conformational characteristics of the complete sequence of group A streptococcal M6 protein. AB - M protein is considered a virulence determinant on the streptococcal cell wall by virtue of its ability to allow the organism to resist attack by human neutrophils. The complete DNA sequence of the M6 gene from streptococcal strain D471 has allowed, for the first time, the study of the structural characteristics of the amino acid sequence of an entire M protein molecule. Predictive secondary structural analysis revealed that the majority of this fibrillar molecule exhibits strong alpha-helical potential and that, except for the ends, nonpolar residues in the central region of the molecule exhibit the 7-residue periodicity typical for coiled-coil proteins. Differences in this heptad pattern of nonpolar residues allow this central rod region to be divided into three subdomains which correlate essentially with the repeat regions A, B, and C/D in the M6 protein sequence. Alignment of the N-terminal half of the M6 sequence with PepM5, the N terminal half of the M5 protein, revealed that 42% of the amino acids were identical. The majority of the identities were "core" nonpolar residues of the heptad periodicity which are necessary for the maintenance of the coiled coil. Thus, conservation of structure in a sequence-variable region of these molecules may be biologically significant. Results suggest that serologically different M proteins may be built according to a basic scheme: an extended central coiled coil rod domain (which may vary in size among strains) flanked by functional end domains. PMID- 3287372 TI - Activation of ras oncogene in aflatoxin-induced rat liver carcinogenesis. AB - The presence of activated transforming genes was investigated in four primary aflatoxin-induced rat liver tumors in male Fischer rats, in two cell lines generated from such tumors, in an epithelial liver-derived nontransformed cell line, and in the latter cell line after transformation by aflatoxin B1 in vitro. When DNA extracted from these sources was transfected into NIH 3T3 cells, negative results were obtained from focus assays. Cotransfection of these DNA samples with a gene for resistance to G418, followed by selection for resistance to that antibiotic, and tumorigenicity testing in nude mice demonstrated DNA mediated transfer of the neoplastic phenotype in all cases except for DNA from the nontransformed cell line. DNA extracted from these primary nude mouse tumors used in a secondary round of transfection with NIH 3T3 cells gave positive results in focus assays, which were conserved through succeeding rounds of transfection. By use of appropriate radiolabeled probes, activated ras oncogenes were detected in all samples. N-ras activation was detected in three of the primary rat liver tumors and both hepatoma cell lines. Ki-ras activation was detected in one primary rat liver tumor, and Ha-ras activation was detected in the cell line transformed in vitro with activated aflatoxin B1. The activated Ki ras oncogene was further characterized by use of synthetic oligonucleotide probes and was shown to contain a G----A transition at the second nucleotide in codon 12. PMID- 3287373 TI - ATP-independent DNA strand transfer catalyzed by protein(s) from meiotic cells of the yeast Saccharomyces cerevisiae. AB - An activity that catalyzes the transfer of a strand from a duplex linear molecule of DNA to a complementary circular single strand can be detected in crude extracts from mitotic and meiotic cells of the yeast Saccharomyces cerevisiae by adding yeast single-stranded DNA binding proteins. This DNA strand-transfer activity increases greater than 15-fold during meiosis in MATa/MAT alpha diploids prior to the detection of a 100- to 1000-fold increase in homologous chromosomal recombination. No increase is observed in MATa/MATa or MAT alpha/MAT alpha cells, which do not undergo meiosis when shifted to meiotic medium, suggesting the activity is related to meiotic recombination. The activity is named strand transfer protein alpha (STP alpha) and has been extensively purified from the meiotic cells (6 hr after exposure to sporulation medium). The apparent molecular mass of STP alpha is 38 kDa under denaturing conditions. The DNA strand-transfer reaction catalyzed by STP alpha requires homologous single-stranded and double stranded DNA and Mg2+ but no nucleotide cofactor. Yeast single-stranded DNA binding proteins stimulate the reaction at least 10-fold. Among the products analyzed by electron microscopy were typical strand-exchange structures. PMID- 3287374 TI - Cloning and expression of JE, a gene inducible by platelet-derived growth factor and whose product has cytokine-like properties. AB - The platelet-derived growth factor-inducible gene JE has been widely used as a molecular marker for the cellular response to growth factors, antimitogenic agents, and other biological response modifiers; however, the structure of the JE gene and the nature of its encoded protein have not been previously described. We present here structural and regulatory features of the JE gene and its product that link it to a family of cytokines, including macrophage colony-stimulating factor, interferon alpha, interleukin 6 (also known as interferon beta 2, B-cell stimulatory factor 2, 26-kDa protein, and hybridoma/plasmacytoma growth factor), and interleukin 2. Just as T lymphocytes secrete interleukins as a component of their response to mitogens, it appears that fibroblasts secrete cytokines as a component of their response to platelet-derived growth factor. PMID- 3287375 TI - Insulin-stimulated microtubule-associated protein kinase is phosphorylated on tyrosine and threonine in vivo. AB - Exposure of 3T3-L1 cells to insulin stimulates a soluble, serine(threonine) specific protein kinase that phosphorylates microtubule-associated protein 2 (MAP 2) in vitro. The enzyme, termed MAP kinase, was isolated from insulin-treated or control cells radiolabeled with 32Pi. A 40-kDa phosphoprotein was found to elute in exact correspondence with enzymatic activity during hydrophobic interaction and gel filtration chromatography of extracts from cells stimulated with insulin. Both MAP kinase activity and the phosphoprotein were absent in fractions prepared from untreated cells. The 32P incorporated into the 40-kDa protein was stable during treatment with alkali. Phospho amino acid analysis confirmed that the radiolabel was primarily incorporated into phosphotyrosine and to a lesser extent phosphothreonine. In addition, MAP kinase was incompletely but specifically adsorbed by antibodies to phosphotyrosine. We conclude, based on these data and additional studies from this laboratory, that MAP kinase is phosphorylated on tyrosine in vivo. The data are consistent with the possibility that MAP kinase may be a substrate for the insulin receptor or another insulin-regulated tyrosine kinase. PMID- 3287376 TI - DNA polymerase I gene of Saccharomyces cerevisiae: nucleotide sequence, mapping of a temperature-sensitive mutation, and protein homology with other DNA polymerases. AB - A 5600-base pair segment spanning the coding region of the Saccharomyces cerevisiae DNA polymerase I gene was sequenced and found to contain an open reading frame of 1468 codons, corresponding to a polypeptide of Mr 166,794. A pol1 temperature-sensitive mutation, encoding a DNA-polymerase-primase complex with altered stability, has a single base-pair substitution that changes the glycine at position 493 to a positively charged arginine. Protein sequence comparison with other prokaryotic and eukaryotic DNA polymerases reveals three major regions of homology. This observation suggests that certain DNA polymerases might require the conservation of critical amino acid residues for activity. PMID- 3287377 TI - Mitogen and lymphokine stimulation of heat shock proteins in T lymphocytes. AB - We have examined the effects of phytohemagglutinin (PHA) and the polypeptide growth factor interleukin 2 (IL-2) on the synthesis of the 70- and 90-kDa heat shock proteins (HSP70 and HSP90, respectively) in human T lymphocytes. Resting T cells (G0) stimulated with PHA responded with a generalized increase in protein synthesis that included HSP70. Gel blot analysis indicated that steady-state levels of HSP70 mRNA were not specifically modulated by PHA. Synthesis of HSP90 protein, however, peaked very rapidly following PHA stimulation and decreased sharply after 1 hr. When IL-2-dependent human T cells, synchronized by IL-2 deprivation, were treated with IL-2, synthesis of HSP70 mRNA was increased as much as 15-fold. HSP70 and HSP90 protein synthesis increased significantly upon IL-2 stimulation of human T lymphocytes. Two distinct members of the ancient family of heat shock genes, HSP70 and HSP90, are shown to be stimulated at the activation and progression stages of lymphocyte mitogenesis, which suggests that genetic mechanisms evolved from primitive stress/adaptation responses may be conserved in mammalian cellular activation. PMID- 3287378 TI - Animal cell lysosomes rapidly exchange membrane proteins. AB - The lysosome has been chosen as a model to study the exchange of native membrane proteins within an organelle population. Heterologous lysosomes were brought together by vesicular stomatitis virus-mediated cell fusion. The distribution of lysosomal membrane protein was visualized by indirect immunofluorescence using species-specific monoclonal antibody. LAMP-2, a mouse lysosomal membrane protein, and HLAMP-B, a human lysosomal membrane protein, were found to transfer to Chinese hamster ovary cell sucrosomes (sucrose-swollen lysosomes). This transfer occurred in the presence of cycloheximide. The exchange of LAMP-2 and LIMP I, a rat lysosomal membrane protein, was observed between native lysosomes in a mouse (3T3)-rat (normal rat kidney) cell fusion. Extensive transfer/exchange was observed within 1.5-2 hr postfusion, which is consistent with the kinetics of endocytic content exchange between lysosomes. Both membrane protein and content transfer between lysosomes were inhibited by nocodazole, a disrupter of microtubules, as was endocytic delivery to sucrose-swollen lysosomes. In the presence of nocodazole, tubular lysosomes disappeared. Both tubular lysosomes and microtubules may be important for the transfer/exchange. The interspecies cell fusion/monoclonal antibody approach developed here should be readily applicable to determining if membrane protein exchange is a property of other organelles such as Golgi apparatus and mitochondria. PMID- 3287379 TI - Glucose stimulates proinsulin biosynthesis by a dose-dependent recruitment of pancreatic beta cells. AB - Glucose is a well-known stimulus of proinsulin biosynthesis. In purified beta cells, the sugar induces a 25-fold increase in the synthesis of insulin immunoreactive material over 60-min incubation. Autoradiographic analysis of the individual cells shows that this effect is achieved via dose-dependent recruitment of pancreatic beta cells to biosynthetic activity. Recruitment of beta cells is also seen in isolated islets exposed to glucose. The sigmoidal dose response curve for glucose-induced proinsulin biosynthesis thus reflects a heterogeneous responsiveness of pancreatic beta cells rather than a progressively increasing activity of functionally homogeneous cells. Dose-dependent recruitment of functionally diverse cells may be a ubiquitous mechanism in tissue function. PMID- 3287380 TI - Acquisition of transforming properties by FYN, a normal SRC-related human gene. AB - The SRC gene is the prototype for a family of closely related genes whose products have protein-tyrosine kinase activity. We recently described another member of this family, designated FYN, whose cDNA was isolated from normal human fibroblasts. To examine the possible role of FYN as an oncogene, we investigated the effects of FYN overexpression on NIH 3T3 cells. Our findings demonstrate that normal FYN overexpression induces morphologic transformation and anchorage independent growth. In addition, at relatively low frequency, FYN acquired properties of a dominant-acting oncogene capable of inducing the fully tumorigenic phenotype. Genetic changes associated with the conversion of normal FYN cDNA into a transforming gene with high focus-forming activity were localized to the carboxyl-terminal region of its translational product. PMID- 3287381 TI - Role for intracellular proteases in the processing and transport of class II HLA antigens. AB - Human B-lymphoblastoid cell lines (B-LCL) incubated with the protease inhibitor leupeptin accumulate complexes of class II HLA antigens with a series of Mr 21,000-23,000 basic proteins termed leupeptin-induced proteins (LIP). The appearance of class II antigen-associated LIP coincides with the disappearance of class II antigen-associated invariant (I) chain. Glycopeptides generated by in vitro proteolysis of LIP and I chain using Staphylococcus aureus V8 protease are identical as determined by electrophoresis in sodium dodecyl sulfate. These results suggest that LIP is a proteolytic product derived from the I chain and are consistent with the view that further in vivo proteolysis of LIP by a leupeptin-sensitive enzyme normally facilitates its release from class II antigens. Incubation of B-LCL with monensin, which traps class II antigens and associated I chain in the Golgi apparatus, or chloroquine, which neutralizes intracellular acidic compartments and inhibits I-chain dissociation, blocks the leupeptin-induced appearance of LIP. Treatment of LIP with endoglycosidases F and H shows that both of its N-linked oligosaccharides are in the complex form, indicating that proteolysis of class II antigen-associated I chain to generate LIP occurs in a late-Golgi or post-Golgi compartment. The compartment in which these proteolytic events occur may be identical to the site in macrophages and B lymphocytes where foreign antigens are processed and interact with class II HLA molecules. PMID- 3287382 TI - Anti-endothelial cell antibodies: detection and characterization in sera from patients with autoimmune hypoparathyroidism. AB - In a previous report, we described antibodies in autoimmune hypoparathyroidism (AHP) that are cytotoxic for cultured bovine parathyroid cells. In the present study, we show that sera from six AHP patients, but not from 26 patients with other autoimmune diseases or from 7 healthy subjects, react with bovine endothelial cells in culture (by flow cytometry and fluorescence microscopy) and in tissue sections (by immunohistology). We found uniformly that the immunoglobulin class reacting is IgM. Adsorption experiments showed that the antigenic determinants reacting with AHP sera were similar on bovine cultured endothelial cell membranes and in tissue sections of bovine parathyroid glands. The AHP sera also reacted with endothelial cells cultured from bovine adrenal medulla and pulmonary artery. Immunoblot analysis showed antibody binding to two major bands of 200 and 130 kDa solubilized from the membrane fraction of bovine parathyroid endothelial cells. Only one AHP serum consistently recognized endothelium-related structures on frozen sections of three different human parathyroid adenomas; two other sera reacted with one adenoma each; and three did not react with human adenomas. This indicates that human material is less suitable than bovine in detecting endothelium-related immune phenomena in AHP sera. The anti-endothelium IgM antibodies appear to be disease-specific but are not organ- or species-specific. The identification of endothelial cells as the target for antibodies in AHP raises the possibility that the endothelium subserves an important local function for endocrine epithelium. PMID- 3287383 TI - In vitro production of feline IgG: quantification by an enzyme-linked immunosorbent assay (ELISA). AB - We report here on the development of a sensitive and convenient enzyme-linked immunosorbent assay (ELISA) for feline IgG by using commercially available reagents and optimizing their concentrations. The reagents employed include goat anti-cat IgG antibody and alkaline phosphatase-conjugated goat anti-cat IgG antibody. The assay described is sensitive, reproducible, and highly specific for feline IgG. The assay was applied for the measurement of feline IgG synthesized and secreted in vitro by peripheral blood mononuclear cells cultured with or without a polyclonal B-cell activator. The amounts of secreted IgG in the supernatants measured by an ELISA correlated well with the numbers of IgG secreting cells which were induced upon stimulation with pokeweed mitogen and determined by a reverse hemolytic plaque assay. PMID- 3287384 TI - Histochemistry of ventricular heavy-chain myosins in cardiomyopathic Syrian hamsters treated with D-600. AB - Monoclonal antibodies (MAb) have been used to study the distribution of ventricular heavy-chain (HC) myosins in cardiomyopathic UM-X7.1 Syrian hamsters. The Ab were identified as alpha and beta anti-HC myosins because of their ability to cross-react with ventricular V1 and V3 myosins, respectively. Cryostat frozen sections from the midventricle region of normal and myopathic hearts were processed for demonstration of these isomyosins by indirect immunofluorescence. In myopathic hearts, there was a shift of predominant alpha myosin toward the beta isoform with the time course of the hamster cardiomyopathy. A D-600 treatment while preventing cardiac necrotic lesions had little or no effect on the beta isomyosin conversion. It is inferred that the isomyosin shift during the progression of the hamster cardiomyopathy is unrelated to the necrotizing process and merely reflects the hypokynetism of the cardiomyocytes. PMID- 3287385 TI - An immunocytochemical method for quantification of lung tissue fibronectin. AB - A technique to quantify tissue fibronectin was developed, using peroxidase antiperoxidase immunocytochemistry and automated scanning light microscopy. This technique was developed using isolated perfused rat lungs, some of which were subjected to acute oxidant lung injury. Both injured and control lungs were perfused with solutions containing heterologous fibronectin. The technique clearly demonstrated differences in the amount of tissue fibronectin in injured and noninjured lung as well as differences between lungs exposed to fibronectin and those not exposed. The described technique offers a reliable method for quantifying tissue fibronectin and is sensitive enough to detect differences in tissue fibronectin under experimental conditions of acute lung injury. PMID- 3287386 TI - Characterization of canine triiodothyronine (T3) autoantibodies and their effect on total T3 in canine serum. AB - A study of 3,5,3'-L-triiodothyronine autoantibody (T3 AA) in 18 dogs revealed an average apparent affinity constant for T3 of 2.24 +/- 1.78 X 10(10) M-1, an average T3 binding capacity of 639.3 +/- 666.5 ng/dl and a low thyroxine (T4) cross-reactivity (less than 1%) in all samples tested. A valid radioimmunoassay (RIA) procedure which involved heat treatment of samples for 1 hr at 70 degrees C and assay on Sephadex minicolumns was developed for measuring T3 in the presence of T3 AA. Total T3 was elevated (mean = 374.8 +/- 158.4 ng/dl) in samples in which T4 was in the normal canine range, but T3 was lower (mean = 96.1 +/- 63.3 ng/dl) in samples with T4 values in the hypothyroid range. For each sample the concentration of T3 not bound by T3 AA was calculated from the total T3 concentration, the affinity constant, and the binding capacity. In dogs with normal total T4 concentrations the average calculated T3 not bound by T3 AA was 147.2 +/- 144.4 ng/dl while in dogs with low total T4 the value was 15.7 +/- 26.3 ng/dl (normal canine range is 45-150 ng/dl). Canine samples containing T3 AA were compared to serum from three rabbits actively immunized against T3 to provide anti-T3 for commercial RIA. The rabbit T3-antisera had an average T3 affinity constant similar to those of the canine samples (1.57 X 10(10) M-1), but had average titer, T3 binding capacity, and total T3 values more than 10-fold higher. Our findings indicate that, in dogs with serum containing T3 AA and normal total T4 concentrations, a compensatory mechanism appears to exist to maintain non-T3 AA bound T3 within the range of normal total T3. This compensatory mechanism does not operate in those dogs with insufficient thyroid activity to maintain normal total T4 values. PMID- 3287387 TI - Long-term tamoxifen therapy to control or to prevent breast cancer: laboratory concept to clinical trials. AB - The successful evaluation of tamoxifen as an antiestrogenic therapy for advanced breast cancer in the early 1970's, has resulted in its availability in more than 70 countries around the world. Currently the drug development process is focusing attention upon long-term adjuvant therapy and the future prospect of chemosuppression. Progress at this stage, however, must be cautious. Trials conducted using women with stage I disease have a high proportion of women who may never have a recurrence. At this point, the risk is justified because the toxicity of tamoxifen is low and disease recurrence is invariably very difficult or impossible to control. Future studies in the general population must be carefully weighed to ensure that the hazards do not exceed the benefits. The pharmacology of tamoxifen seems to be a balance of estrogenic and antiestrogenic effects. Longer treatments with the drug must be carefully monitored. Uterine tissue should be examined to ensure that excessive stimulation does not occur. This is particularly true in the light of the recent report that a human uterine carcinoma, transplanted into athymic mice, can grow more rapidly during tamoxifen therapy (Satyaswaroop et al., 1984; Clark and Satyaswaroop, 1985). In fact, we have recently confirmed this observation in a collaborative study with Dr. Satyaswaroop. We have demonstrated that when athymic mice are transplanted in one axilla with an MCF-7 breast tumor and the human endometrial tumor in the other, tamoxifen causes the endometrial tumor to grow, but not the breast tumor. This again illustrates the target site specific effects of tamoxifen. If, in the long run, the estrogenic side effects of tamoxifen are too severe then there is a case for the development of a non-estrogenic antiestrogen. Clearly this may provide benefit for short term (1-2 years) therapy and avoid any estrogen-like stimulation of tumor growth. Similarly, the concern about antithrombin III depression will be avoided. On the negative side, however, the concerns about atherosclerosis and osteoporosis will again have to be addressed with a new generation of agents. PMID- 3287389 TI - The cellular response of human breast cancer to estrogen. PMID- 3287388 TI - Combination therapy with flutamide and [D-Trp6, des-Gly-NH2(10)]LHRH ethylamide in stage C and D prostate cancer: today's therapy of choice--rationale and 5-year clinical experience. PMID- 3287390 TI - From cell proliferation to differentiation: the steroid connection. PMID- 3287391 TI - Aromatase and aromatase inhibitors: from enzymology to selective chemotherapy. PMID- 3287392 TI - Estrogens and antiestrogens mediate contrasting transitions in estrogen receptor conformation which determine chromatin access: a review and synthesis of recent observations. AB - Our perspective is that the mechanisms separating the action of estrogen agonists and antagonists involve contrasting transitions in receptor conformation which determine receptor access to different chromatin regions. Although we have suggested that size related exclusion of receptor may provide one manner for determining chromatin access (Pavlik et al., 1985), additional mechanisms may also be involved. The most recent evidence from several laboratories supports this perspective and indicates that estrogen receptors associated with antiestrogens are competent with respect to activation and response elicitation. Thus, we believe that an important course for future effort will be to define chromatin interactions that are limited to estrogen receptors complexed with either agonist or antagonist. PMID- 3287393 TI - Polymers in cosmetic and pharmaceutical industries. PMID- 3287394 TI - Plasma factors influencing prostacyclin-like activity in patients with diabetic microangiopathy. AB - Plasma factors influencing PGI2-like activity in 19 patients with diabetes mellitus /Dm/ and 17 controls were studied through a comparison with the signs of retinal and glomerular angiopathy. The plasma PGI2 supporting activity /PSA/ was lower in 15 Dm cases than in the controls. Inhibitory activity against PGI2 production was detected in 6 patients. In the cases of more serious retinopathy associated with glomerulopathy, a significantly lower level of PSA was observed than in patients with mild retinopathy without glomerular diseases. The plasma concentrations of total and LDL-cholesterol were significantly higher, while the level of HDL-cholesterol was lower than in the controls. There was a positive correlation between PSA and HDL-cholesterol values and a negative correlation between PSA and LDL-cholesterol levels, which relates to an inhibitory effect of LDL and a protective role of HDL in PGI2 synthesis. PMID- 3287395 TI - Salutary effects of the prostacyclin analogue CG 4203 in lethal endotoxemia in rats. AB - In pentobarbitone anesthetized rats infusion of E. coli endotoxin (0.42 mg.kg 1.min-1 for 4 hours) produced 96% lethality within 6 hours. Transient decrease in mean arterial blood pressure, thrombocytopenia, leukopenia, loss of plasma fibrinogen, fibrin deposits in renal glomeruli, hemolysis and decrease in arterial oxygen tension and pH were observed. Infusion of the prostacyclin analogue CG 4203 (0.464 and 1.0 micrograms.kg-1.min-1 for 6 hours), starting concomitantly with the endotoxin infusion, improved the survival rate to 95 and 100%. Blood pressure during endotoxemia was slightly lower in CG 4203 treated rats than in vehicle controls. CG 4203 infusion marginally attenuated thrombocytopenia and obviously inhibited leukopenia, but did not effect fibrinogen consumption in endotoxemic rats. Incidence of glomerular fibrin deposits was dose dependently and significantly reduced by CG 4203. The lower dose reduced and the higher dose completely prevented the occurrence of hemolysis. Acidotic changes were not observed in CG 4203 treated endotoxin shocked rats. Also with treatment starting 1 hour after the onset of endotoxemia CG 4203 in the same doses significantly inhibited the endotoxin-induced lethality. As protective mechanisms against lethal rat endotoxemia the prostacyclin-like hemodynamic, fibrinolytic, rheological and membrane stabilizing properties of CG 4203 are discussed. PMID- 3287396 TI - [Psychopharmaceuticals and dreaming]. PMID- 3287397 TI - [Preparation and testing of polymer drugs]. PMID- 3287398 TI - In vitro studies on the antibacterial activity of phenoxyethanol in combination with lemon grass oil. AB - Lemon grass oil (LGO) has been reported to possess appreciable antibacterial activity especially against Grampositive bacteria. The effect of LGO on the antibacterial activity of phenoxyethanol was studied using MIC, growth inhibition, diffusion tests and bactericidal activity studies. Results showed appreciable increase in the activity of phenoxyethanol against Escherichia coli and Staphylococcus aureus when combined with 0.03% v/v LGO but not against Pseudomonas aeruginosa. The results show that the combined use of LGO and phenoxyethanol would increase the spectrum of activity of phenoxyethanol whose activity is mainly against Ps. aeruginosa. In addition, the combination reduced the effective concentration of both compounds necessary for activity. This would reduce any toxicological hazards as well as production costs. PMID- 3287399 TI - [Evaluation of retard drug forms with special reference to their therapeutic aspects]. AB - The useful development and application of controlled-release dosage forms is an important possibility to improve the pharmacotherapy of many diseases. However, according to the present social conditions of reproduction the introduction of a new drug has to be directed not only to a high therapeutic benefit but also to an increased social efficiency i.e., to an improvement of cost-benefit-relation. In the present study, therefore, the effect of using controlled-release dosage forms on the development of social efficiency is discussed. Basing on a comprehensive estimation of the therapeutic efficiency (therapeutic advantages and disadvantages) of controlled-release dosage forms the criteria of cost and benefit being of importance for a complex evaluation of efficiency are described. PMID- 3287400 TI - Lobotomy: a personal memoir. PMID- 3287401 TI - Peking Union Medical College: born-again elitism. PMID- 3287402 TI - Disease and death in Thomas Mann's fiction. PMID- 3287403 TI - Doctors in wartime: Johan Scharffenberg, prophet in his own country. PMID- 3287404 TI - Ludwig Aschoff (1866-1942): reminiscences. PMID- 3287405 TI - Three doctor-writers and how they heal. PMID- 3287406 TI - Restoration of masticatory function by microsurgically revascularized iliac crest bone grafts using enosseous implants. AB - Forty-one free osteomyocutaneous groin flaps were used for osteoplastic reconstruction of the mandible (n = 36) or maxilla (n = 5) following tumor resection or, less often, chronic osteomyelitis or traumatic bone loss. Nineteen grafts were transplanted into a preirradiated area. No total loss of a transplant or pseudoarthrosis was observed. Plates were used for graft fixation. Free grafting was necessary in two patients, who developed partial bone loss because of infection. Four patients showed partial loss of the skin part of the myocutaneous flap. Improvement of the preprosthetic situation was achieved by a total of 38 enosseous aluminium oxide implants into the vascularized bone grafts. All showed primary healing and successful integration in prosthetic rehabilitation, maximum follow-up time being 30 months. PMID- 3287407 TI - Altered spatial perception following harvest of a posterior auricular skin graft. AB - A 57-year-old man blind since an early age lost significant ability to orient himself in space regarding surrounding objects after his left ear was retropositioned to close a retroauricular full-thickness skin graft donor site. Release of the ear to its former position corrected the disability. We warn readers that long-time blind persons develop alternate methods to vision and a seemingly insignificant change of ear position may alter spatial orientation. PMID- 3287408 TI - A simple bone dust collector. AB - A new instrument for harvesting craniotome bone dust is described. This has been designed with the contours of the skull in mind and the ideal bone fragment size for satisfactory graft take. PMID- 3287409 TI - Lower eyelid reconstruction with tarsal flaps and grafts. PMID- 3287410 TI - Differential diagnosis of mental subnormality and abnormality: the contribution of psychometrics. AB - In a psychiatric population, cognitive abnormality impacts on intellectual functioning and is often misconstrued as subnormality, i.e., mental retardation. Standard IQ and neuropsychological tests contribute little to the differential diagnosis, which hinges on the question of developmental failure. A developmentally rooted psychometric battery, one that assesses conceptual, perceptual-motor, and social maturity, is proposed as an objective diagnostic method. Research confirms the validity of this approach for distinguishing between psychosis with severe functional vs. developmental impairment, even when matched for IQ. Diagnostic and treatment implications are discussed. PMID- 3287411 TI - Freud and fetishism: previously unpublished minutes of the Vienna Psychoanalytic Society. PMID- 3287412 TI - On the vicissitudes of Freud's early mothering. III: Freiberg, screen memories, and loss. AB - Utilizing clinical examples, I attempt to show that the memories Freud recalled on his return to his childhood home in adolescence screened the traumata he had suffered when he lost his Kinderfrau, then his playmates and the Freiberg countryside during his early childhood. PMID- 3287413 TI - Psychoendocrine aspects of mother-infant relationships in nonhuman primates. AB - Studies will be presented which examine the physiological and behavioral responses of squirrel monkeys and rhesus macaques following disruptions of mother infant relationships. Reliable increases in circulating levels of plasma cortisol occur following separation of the infant from its mother. The presence of familiar conspecifics during the time of separation reduces the pituitary-adrenal response, compared to that elicited by total isolation. Visual access to the mother during separation also ameliorates the plasma cortisol response. However, when infants are separated in the presence of unfamiliar conspecifics, the physiological response is exaggerated compared to animals which are totally isolated. The behavior expressed by the infant during separation, particularly separation-induced vocalizations, is not concordant with this physiological index of affect. The rate of vocalization produced when the infant has visual access to the mother was higher than when the infant was totally isolated. However, when allowed access to familiar conspecifics, the rate of vocalization was lower than during total isolation, with no vocalization produced while the separated infant was in the unfamiliar social group. The curvilinear relationship between vocalization and the physiological index of arousal has led to a revision of the traditional concept that separation-induced infant vocalization is reflective of distress. These data support the hypothesis that vocalizations may serve as a coping response that reduces the physiological indices of arousal. Social interaction with familiar cospecifics may serve as a non-vocal coping response (e.g., proximity contact to other monkeys) which also reduces the behavioral and physiological responses to maternal separation. PMID- 3287414 TI - Endocrine basis for the initiation, maintenance and termination of pregnancy in humans. AB - Channels of hormonal communication between the embryo and the mother are established early in the conceptual process. The preimplantation embryo exerts local uterine and systemic effects on the maternal organism to provide a suitable environment for embryonic development, to enable the development of a receptive endometrium for implantation, and to maintain corpus luteum function. In primates, implantation can be induced with progesterone alone if the proliferative effects of estrogens on the endometrium have already been achieved; estrogens may have a priming effect for progesterone on the endometrium, but it is not obligatory for implantation. Progesterone secretion from the corpus luteum is essential for the maintenance of early pregnancy until the placenta takes over the major role of steroidogenesis. This luteo-placental shift is completed at about the 50th day of human gestation. Withdrawal of progesterone effects by the administration of the competitive progesterone antagonist, RU 486, within 24 days after conception will terminate 85% of human pregnancies. Other nonsteroidal functions of the corpus luteum have been recently suggested. Relaxin and prorenin are peptides secreted by corpus luteum of pregnancy but their role remains putative at the present time. PMID- 3287415 TI - Lactation in humans. AB - Postpartum milk secretion is a hormonally regulated process that reflects the highly coordinated actions of endocrine, neuroendocrine, and behavioral mechanisms. Structural development of the mammary gland during pregnancy is stimulated primarily by estrogen, progesterone, and prolactin (PRL), the secretion of which is controlled directly or indirectly by the fetoplacental unit. Following parturition, PRL also plays an important role in initiating and sustaining milk secretion and suppressing the resumption of cyclic hypothalamic pituitary-ovarian function. Dynamic postpartum PRL secretion is in response to the neurogenic stimulus of suckling, which both acutely releases PRL and maintains the responsiveness of PRL regulatory pathways to subsequent nursing. The central control of PRL secretion at this time involves the integrated activities of inhibitory and stimulatory hypothalamic mechanisms. A major feature of lactation is the degree to which the entire process is controlled by the developing organism itself. PMID- 3287416 TI - Factors influencing maternal responsiveness in humans: usefulness of an animal model. AB - In this article we review some of the hormonal, sensory and experiential factors that regulate the onset and early maintenance of maternal responsiveness in rat and human mothers. We discuss data suggesting that, in humans, pregnancy is associated with changes in feelings and attitudes that may bear on adjustment to motherhood postpartum. Preliminary studies indicate that these changes are probably not hormonally mediated but are associated with a variety of psychosocial factors. Once women give birth, there is some suggestion that they undergo a period of elevated "responsiveness" which may be influenced by puerperal hormones and during which experiences with the newborn take on a special salience. Following the early postpartum period, a variety of factors influence maternal responsiveness, including the mother's affective state, her social relationships, and experiences caring for young. We discuss the relative contributions of psychological and physiological influences to maternal responsiveness at different stages of the maternity cycle. PMID- 3287417 TI - Neuroendocrine processes in the establishment of pregnancy and pseudopregnancy in rats. AB - Rats, like mice, hamsters and other small rodents, have a short, incomplete estrous cycle. They lack a spontaneous luteal phase, and the corpora lutea (CL) of the estrous cycle are short-lived and nonfunctional. The activation of the luteal phase in these incompletely cycling females depends on the neuroendocrine reflex provided by the male at the time of mating. In this article we review our research on the cervix-brain-pituitary-ovary interaction at the endocrine, neuroendocrine, neurotransmitter and behavioural levels, dealing with the chain of events initiated by the male and necessary for the establishment of the progestational state. PMID- 3287418 TI - Maternal communication of circadian phase to the developing mammal. AB - In rodents, an entrainable circadian clock begins oscillating prenatally in the hypothalamic suprachiasmatic nuclei (SCN). The maternal circadian system coordinates (entrains) the timing of the developing clock to the prevailing light dark cycle during both late fetal and early neonatal life. This maternal communication of circadian phase ensures that the developing animal is coordinated to the outside world until maturation of the normal pathway of light dark entrainment in adults, the retinohypothalamic pathway, permits direct photic entrainment through the neonatal eye. The mechanism of maternal communication of circadian phase remains to be determined, but the necessity of the maternal SCN in this communication has been demonstrated. Indirect lines of evidence suggest that a similar scheme occurs for the development of circadian rhythms in humans. PMID- 3287419 TI - Neuroendocrine basis of thermally regulated maternal responses to young in the rat. AB - Over the first two weeks postpartum there is a decline in the amount of time that the rat dam spends with her young, resulting from a decrease in the duration of each nest bout. The duration of each nest bout is limited by the rate of rise of maternal temperature when she huddles with her litter. This pattern of mother young contact is dependent on the dam's hormonal status, because adrenalectomised dams fail to show the expected decline in mother-young contact over time. Ovariectomy, on the other hand, does not have any effect on this behavior. Replacement therapy with glucocorticoids or placing the dam in a warm (25 degrees C) ambience reinstates the normal pattern of mother-litter contact in adrenalectomised-ovariectomised dams. These data suggest that the elevated level of serum glucocorticoids in lactating dams affects maternal behavior by increasing maternal heat load, thereby making the dam vulnerable to an acute rise in temperature when huddling with her young. Prolactin suppression also results in an increase in contact time between mother and young, but only in the second week postpartum. The effects of prolactin suppression are reversed by progesterone replacement or placing prolactin-suppressed females in a warm ambience. However, progesterone is ineffective in restoring the normal pattern of mother-litter contact in adrenalectomised females. These findings suggest that progesterone raises the thermal set point, thereby permitting the thermogenic effects of glucocorticoids to occur. PMID- 3287420 TI - Genital, olfactory, and endocrine interactions in the development of maternal behaviour in the parturient ewe. AB - This article reviews current understanding of the physiological control of maternal behaviour in parturient ewes. Estradiol is an important endocrine factor which stimulates maternal responsiveness, both in nonpregnant and in parturient ewes. However, its action depends on previous maternal experience, and other factors are also necessary for the rapid manifestation of maternal behaviour. Olfactory cues play a major role in the normal development of the mother-young relationship. Genital stimulation (GS) is a key factor influencing various aspects of maternal responsiveness in sheep. GS acts in synergy with peripheral hormones to induce the rapid onset of licking and immediate acceptance of a neonate at the udder in nonpregnant ewes. It also influences the attraction of amniotic fluid at parturition and reduces aggressive behaviour towards lambs. Deprivation of GS by peridural anesthesia disturbs maternal behaviour in parturient ewes, especially in primiparae. And, additional GS in postparturient ewes allows the formation of a new bond with an alien neonate in mothers which had already established a selective relationship with their own lambs. Some of these positive effects of GS are mediated through modifications of olfactory function (attraction of amniotic fluid, establishment of a selective bond), whereas this may not be the case for other effects (stimulation of licking, reduction of aggressive behaviour). Studies of the neural mechanisms involved will be necessary to specify the modes of action of GS. The first results suggest GS may act in at least two ways at the level of the brain. Stimulation of maternal behaviour could depend on the liberation of oxytocin within the brain, since intracerebroventricular injections of this hormone facilitate maternal responses. Also, GS can influence olfactory function through the activation of afferent noradrenergic pathways in the olfactory bulbs. Further studies need to be developed to specify the relationships between the various structures involved as well as the level at which estradiol exerts its facilitatory action. PMID- 3287421 TI - Mitral valve prolapse and panic disorder: a review of their relationship. AB - There has been considerable speculation about a possible relationship between panic disorder and mitral valve prolapse syndrome (MVP), although empirical results have been highly inconsistent. Some studies report low frequencies of 0 8%, others high frequencies of 24-35% "definite" MVP in panic patients (average across 17 studies: 18% of panic patients, 1% of normal controls). Elevated prevalences of MVP were also reported for generalized anxiety disorder, bipolar affective disorder, and anorexia nervosa. Studies of MVP patients generally failed to find elevated prevalence of panic compared to other cardiac patients or normal controls (averages across seven studies: 14%, 10%, and 8%, respectively). Inconsistent results may be due to widely different diagnostic criteria for MVP, low reliability of this diagnosis, inadequate control groups, "non-blind" ratings of panic or MVP, and sampling bias in both patient and control populations. These problems as well as the great variations in the published results preclude any final judgment. If there is concomitance between MVP and panic, it is small and primarily involves subjects with milder or reversible variants of MVP. At present it seems most justified, however, to assume co-morbidity in highly symptomatic individuals rather than a functional relationship. PMID- 3287422 TI - Acquired immune deficiency syndrome in childhood. PMID- 3287423 TI - Acid phosphatase activity in Nocardia brasiliensis and Nocardia asteroides. AB - Nocardia asteroides and N. brasiliensis strains were found to possess acid phosphatase activity. This enzyme was found to be cell-associated and its activity paralleled the cell mass increase seen during the Nocardia growth cycle. Of the strains tested, N. brasiliensis exhibited the highest enzymatic activity. Implications of these findings are related to current evidence which indicates that other microbial acid phosphatases may constitute potential pathogenic factors for humans. PMID- 3287424 TI - Complications inherent in scaling the basal rate of metabolism in mammals. AB - The scaling of the basal rate of metabolism in mammals is reexamined. Both the power and level of the scaling function are sensitive to various factors that interact with body mass and rate of metabolism, including the precision of temperature regulation, food habits, and activity level. This sensitivity implies that the rate of metabolism is a highly plastic character in the course of evolution. Consequently, the singular effect of mass on the rate of metabolism is most effectively analyzed in ecologically and physiologically uniform sets of species, rather than in taxonomically defined groups, which often are ecologically and physiologically diverse. Otherwise, all fitted curves for mammals integrate a variety of competing factors, thereby reflecting the species used and denying unique analytic significance to the power in scaling relations. Kleiber's eutherian curve may represent a relatively uniform set of data because all the species included were domesticated and because selection for high rates of production (and high rates of metabolism) occurred in the process of domestication. In the analysis of scaling relationships, the standard error of estimate (Sy.x) is a more valuable measure of the residual variation than is (1.0 r2) because r2 is a non-linear measure of the conformation of data to the relation and because Sy.x, unlike r2, is independent of the units used in the scaling relationship. At present the best estimate indicates that total rate of metabolism scales proportionally to approximately m0.60 at small masses (less than 300 g), as long as small species do not enter torpor, and scales proportionally to approximately m0.75 at large masses (greater than or equal to 300 g). Physiological properties other than metabolism are potentially sensitive to secondary factors, so their scaling functions also would be most clearly defined for physiologically uniform groups of species. This view suggests that insight into the significance of scaling relations can be obtained by examining the residual variation around a scaling function as well as by examining conformation to the function. PMID- 3287425 TI - Comparative ultraviolet action spectra (254-320 nm) of five "wild-type" eukaryotic microorganisms and Escherichia coli. AB - The action spectra of five eukaryotic organisms and the prokaryote, Escherichia coli, were examined over the wavelength range, 254-320 nm. Both the repair competent and three repair defective strains (E. coli, Caenorhabditis elegans, Saccharomyces) were examined. Tetrahymena pyriformis action spectra were performed with and without the excision repair inhibitor caffeine present. Others have observed that lethality, mutation, and the production of pyrimidine dimers show much the same wavelength dependence as DNA absorption. The results presented here demonstrate several action spectra which deviate from the DNA absorption spectra. Ultraviolet sensitization ratios (repair competent/repair defective) were also examined and were shown to change over the wavelength range. These findings suggest that DNA may not be the only important chromophore leading to cell death in the uv wavelength range studied. Since uv-B is of major importance in solar uv damage, these findings may also yield important implications for solar uv studies. PMID- 3287426 TI - Ergothioneine, histidine, and two naturally occurring histidine dipeptides as radioprotectors against gamma-irradiation inactivation of bacteriophages T4 and P22. AB - Bacteriophages P22, T4+, and T4os (osmotic shock-resistant mutant with altered capsids) were diluted in 0.85% NaCl and exposed to gamma irradiation (2.79 Gy/min) at room temperature (24 degrees C). T4+ was more sensitive to inactivation than was P22, and the T4os mutant was even more sensitive than T4+. Catalase exhibited a strong protective effect and superoxide dismutase a weaker protection, indicating that H2O2 or some product derived therefrom was predominant in causing inactivation of plaque formation. Low but significant (0.1 0.3 mM) reduced glutathione (GSH) enhanced phage inactivation, but a higher (1 mM) GSH concentration protected. A similar effect was found for the polyamine, spermidine. In contrast, 0.1 mM L-ergothioneine (2-thiol-L-histidine betaine) exhibited strong protection and 1 mM afforded essentially complete protection. L Ergothioneine is present in millimolar concentrations in some fungi and is conserved up to millimolar concentrations in critical tissues when consumed by man. L-Histidine and two histidine-containing dipeptides, carnosine and anserine, protected at a concentration of 1 mM, a level at which they are present in striated muscles of various animals. PMID- 3287427 TI - Potential applicability of nonclonogenic measurements to clinical oncology. AB - A number of assays are currently under evaluation for their potential usefulness in the selection of new chemotherapeutic agents or as predictive indicators for use in the design of optimal cancer treatment. Assays fall under the general categories of tumor cell survival, treatment-induced cellular damage, and determination of inherent tumor factors which includes tumor cell kinetics, tumor oxygenation, and measurement of specific biochemical systems. While technical advances to optimize these assays are continuing, possible inter- and intra-tumor cell variability to anticancer treatment modalities may complicate the interpretation and subsequent use of these assays. Regardless of their ultimate usefulness as clinical predictors, these assays will be extremely valuable in better characterizing and understanding the cell biology and biochemistry of human malignancies. PMID- 3287428 TI - The initial part of the survival curve: does it predict the outcome of fractionated radiotherapy? AB - The publication of a number of single-cell survival curves in vitro has stimulated radiobiologists and radiotherapists to analyze the survival characteristics of these curves for their ability to be predictive of the radioresponses of the tumors from which they were derived. Parameters of interest have been the steepness of the initial slope, the single-dose survival at 2 Gy, the mean inactivation dose, and the extrapolation number along with the D0 dose. An assessment of these correlations shows considerable overlap between the values of particular survival parameters even when tumors thought to be the most responsive are compared to those thought to be the least responsive. The importance of the full repair of sublethal damage in the analysis is noted, and a number of factors which may limit effective correlations between cell survival parameters and tumor response are discussed. PMID- 3287429 TI - Mechanisms of the radioprotective effect of cysteamine in Escherichia coli. AB - The values of the oxygen effect (m) and the maximal protective effect of cysteamine (DMF*) were estimated for four Escherichia coli strains: AB1157 (wild type), AB1886 (uvrA), AB2463 (recA), and p3478 (polA). A correlation made between DMF* and m as well as the kinetics of the increase of DMF with oxygen depletion showed that the protective effect of cysteamine is realized by three mechanisms: (i) anoxia achieved by oxygen reduction, with the DMF varying from 2.2 to 4.2 for different E. coli strains (this protection is the major contribution to the entire mechanism); (ii) lowering of the indirect radiation effect; i.e., for 50 mM cysteamine DMF does not exceed 1.1; and (iii) increase of the efficiency of enzymatic repair. The latter effect of cysteamine is registered only with the wild-type E. coli, the DMF being not less than 1.4. PMID- 3287430 TI - Serum copper concentration as an index of lung injury in rats exposed to hemithorax irradiation. AB - Serum copper concentration was evaluated as an index of lung injury (monitored by lung prostacyclin production) with respect to the effects of time, dose, dose fractionation, and penicillamine dose modification in rats irradiated to the right hemithorax. Both lung PGI2 production and serum Cu concentration increased with increasing 60Co gamma-ray dose in animals sacrificed 2 or 6 months postirradiation, and the highest values for both responses were observed at the latter autopsy time. At 2 months postirradiation, the elevations in lung PGI2 production and serum Cu concentration also were spared similarly when total radiation doses were delivered in five equal daily fractions as compared to single doses. Finally, the ability of D-penicillamine to ameliorate the radiation induced hyperproduction of PGI2 by rat lung was accompanied by an attenuation of the dose-dependent increase in serum Cu concentration at 2 months postirradiation in the drug-treated rats. In contrast, serum iron concentration was independent of time, dose, and penicillamine. At 2 months after irradiation, there also was a dose-dependent increase in lung hydroxyproline (collagen) content, the magnitude of which correlated closely with serum copper concentration in individual animals. Thus serum copper concentration is an accurate and minimally invasive index of lung injury in rats irradiated to the hemithorax and can predict lung hydroxyproline (collagen) content in individual irradiated rats. PMID- 3287431 TI - Imaging strategies for MR of the brain. AB - MR has emerged as the imaging modality of choice for the brain in patients presenting with seizures, chronic headaches, progressive neurologic deficits, ataxia, vertigo, hearing loss, visual loss, congenital abnormalities, signs of increased intracranial pressure, dementia, suspected multiple sclerosis, and in the vast majority of other elective neurologic problems. CT should currently be considered the primary imaging modality in patients with acute neurologic deficits (stroke), acute onset of severe headaches, and when fine bone detail is required. Acutely injured patients are more readily studied with CT. The vast majority of patients in whom CT is preferred are seen in emergent situations, frequently in hospital emergency rooms. The effects of trauma beyond the acute stage are best evaluated with MR. In the future, MR is likely to become the procedure of choice in even more clinical situations than at present. A summary of currently recommended primary imaging modalities in various clinical situations is provided in Table 1. PMID- 3287432 TI - Imaging strategies for MR of the spine. AB - Magnetic resonance (MR) imaging has rapidly evolved as a primary modality for evaluating the spine. Following routine radiographs, MR is currently the preferred examination in evaluating patients presenting with myelopathy, suspected congenital abnormalities, discitis/osteomyelitis, and myeloradiculopathy. It is becoming the examination of choice in evaluating patients with radiculopathy as well when fast-scan techniques are available. MR of the spine will prove increasingly important as the technology advances. It is likely that MR will replace myelography entirely for many indications. PMID- 3287433 TI - Magnetic resonance imaging in orbital diagnosis. AB - Today, computed tomography is the primary diagnostic imaging test in orbital disease. Magnetic resonance in some instances is complementary and in a few conditions superior to CT. The relationship between these two imaging modalities is evolving. PMID- 3287434 TI - MRI of the upper aerodigestive tract and neck. AB - The application of new technology has improved the ability of MR to image the upper aerodigestive tract and neck. Improved resolution along with inherent high tissue contrast and multiplanar capability now allow clear definition of detailed anatomic and pathologic tissue planes. MR currently rivals other imaging modalities in this region. At present, it is often better in demonstrating the depth of tumor infiltration and the presence of nodal metastasis. Initial studies also suggest that MR can effectively image postoperative sites and discriminate chronic fibrosis from recurrent tumor. Localization of abnormal parathyroid glands, particularly for re-exploration, is a promising technique. If the present limitations are recognized, such as identification of soft tissue calcification, MR can play an important role in the evaluation of the face and neck. With additional investigation and continued technologic improvements it is likely that this role will continue to increase. PMID- 3287435 TI - Chest applications of magnetic resonance imaging: an update. AB - Accumulated experience with MR applications in the chest has helped to define its role relative to other modalities. Technical advances improving image quality, newer fast scans, and cine methods are expanding the information available from MR. This discussion reviews the useful applications and limitations of MR in evaluating thoracic disorders. Physicians should be knowledgeable and selective in their utilization of this modality. PMID- 3287436 TI - Cardiovascular MRI: current role in patient management. AB - The role of cardiovascular MRI in patient management is still evolving. Its capability to demonstrate anatomy without risk has made it an important supplement to ultrasound and a replacement for CT and angiography in many settings. In vivo metabolic studies of congenital and acquired diseases may be the most important future developments. PMID- 3287437 TI - The role of MRI in diseases of the kidney. AB - The role of MRI in evaluating renal diseases has not yet been fully defined. Despite some inherent limitations due to motion and failure to confidently define calcifications, MRI can display normal and pathologic anatomy with great clarity. MRI is useful in the staging of renal carcinoma, especially in the evaluation of vascular invasion. Bulky tumors are best depicted with MRI, especially when the organ or origin is in question. Contrast agents, fast scan techniques, and spectroscopy hold great promise for the future. PMID- 3287438 TI - Imaging strategies for MRI of the pelvis. AB - Appropriate patient triage of pelvic diseases depends upon a problem-solving approach as outlined in this article. Whether MRI is chosen as an adjunct to US or CT or as the primary modality, as in the staging of malignancy, imaging strategies for pelvic MRI can be tailored to the organ of interest and to the clinical question being asked. PMID- 3287439 TI - Strategies for musculoskeletal magnetic resonance imaging. AB - There is a broad range of clinical applications for MRI in the diagnosis of musculoskeletal disease, and the emphasis in this article is on the evaluation of the joints and extremities. A discussion of basic principles, including radiofrequency coils, positioning, pulsing sequences, imaging planes, and technical parameters is followed by discussions of tailored approaches to the evaluation of mass lesions and joint pathology for specific regions of the musculoskeletal system. In the final section, consideration is given to the overall role of MRI in the diagnosis of musculoskeletal disorders with respect to other established imaging modalities. PMID- 3287440 TI - Nuclear magnetic resonance in the diagnosis of breast cancer. AB - We believe that the preponderance of evidence suggests that MRI is less accurate than conventional mammography in the diagnosis of primary cancer of the breast. Thus, it currently has no established place in algorithms for the evaluation of patients suspected of having breast cancer. MRI could be used to evaluate masses with mammographically smooth, well-defined margins, since high signal intensity (greater than fat) in a T2-weighted image is a highly specific indicator of benignancy in such lesions. However, most of these masses are cysts and can be reliably and less expensively identified as such by sonography. Nonetheless, MRI might be used to re-evaluate a smooth, well-defined mass if sonography has failed to identify the lesion as a cyst. MRI might be particularly useful in this regard if a lesion is difficult to evaluate by other modalities because it is located adjacent to the chest wall, is deep within a very large breast, or is obscured by a breast prosthesis. MRI with Gd-DTPA may be useful in evaluating radiographically dense breasts or in differentiating breast malignancies from irregular dysplastic or scar tissue. However, further investigation of this technique is needed. It has been hoped that in vivo measurement of T1 and T2 or in vivo NMR spectroscopy might improve the accuracy of noninvasive diagnosis of cancer of the breast. However, there is currently no credible evidence that in vivo measurements of relaxation times provide useful indexes for the diagnosis of breast cancer. In vivo NMR spectroscopy of nuclei other than P may ultimately provide reliable criteria for noninvasive diagnosis of breast cancer in humans, but the technique is currently in its infancy. PMID- 3287441 TI - MR imaging strategies in primary and metastatic malignancy. AB - This article gives the rationale of the indications for the use of MRI in the evaluation of primary and metastatic malignancies of the neck, chest, abdomen, male and female pelvis, and musculoskeletal system. The imaging protocols for each of these areas is also included. PMID- 3287442 TI - [Prognostic factors in breast cancer. Consequences for radiotherapy]. AB - Even today the therapeutic strategy in the treatment of breast cancer is governed by prognostic factors, such as the size and type of the tumor, histological grading, and the number of lymph node metastases. In addition to other criteria, a decision must also be made as to whether changes in the radiotherapy technique (dosage, means of boostering) might lead to better results in the treatment of carcinoma of the breast in patients in poor condition. Several studies indicate that the effectiveness of irradiation can be improved (even with respect to longterm results) by alterations in the technique and careful adaptation to the surgical procedure. PMID- 3287443 TI - [Current status of radiotherapy following ablative and breast-sparing treatment of breast cancer]. AB - After a total mastectomy in cases of a high risk of loco-regional recurrence the postoperative irradiation of the chest wall is indicated in the following situations: Inflammatory type of carcinoma, tumor stage T3-T4, extended multifocal and multicentric primary tumor. After radical axillary surgery even in patients with positive nodes irradiation is not necessary except in cases where all axillary nodes are involved or with invasion of the axillary tissue. The supra- and infraclavicular lymph drainage regions caudal to the operated area (clip) should be irradiated with 50 Gy providing both an enlarged or subtotal involvement can be diagnosed. The irradiation of the retrosternal lymph-drainage system with 45-50 Gy is indicated as follows: Medial or central tumor site, extensive involvement of the axillary nodes and advanced stages of the primary tumor (T2-T4). Axillary irradiation alone cannot serve as a substitute for surgery. After segmental mastectomy without postoperative radiotherapy a local failure rate of 30% is to be expected during a 5 year period. After surgery with adjuvant postoperative irradiation the local failure rate can be reduced to about 5%: 50-60 Gy should be applied. In case of an unfavourable histology an additional boost dose is recommended. The objective of breast cancer irradiation is to achieve freedom of loco-regional recurrence. The survival can be improved occasionally after local irradiation, theoretically improvement of survival can be achieved in 7-10% at the most. PMID- 3287445 TI - [Mass mammography screening. A means of reducing mortality in breast cancer?]. AB - The already high and still rising mortality rate for breast carcinoma continues to represent a serious problem, especially since neither surgical treatment nor radiotherapy has a significant influence on the prognosis of the disease. Mammography has made it possible to diagnose small and minute carcinomas of the breast before they become clinically symptomatic. Lymph node involvement is histologically confirmed in approximately 20% of breast carcinomas detected by mammography, as opposed to roughly 50% of the tumors diagnosed clinically. Further, in randomized studies mammoscreening was shown to reduce the mortality rates by 30% to 40%. Mammoscreening thus appears to be the only means of diminishing the mortality rate for breast carcinoma. PMID- 3287444 TI - [Value of sonography and computerized tomography in pelvic tumors in the female. Prospective comparative study of 132 surgically treated pelvic space-occupying lesions]. AB - Clinical examination, ultrasonography and computed sonography were compared in a prospective study to establish their relative value in the diagnosis of space occupying lesions in the female pelvis; 132 surgically excised lesions were examined with reference to the preoperative diagnoses made by all three methods. In the case of tumors of the ovary, the fallopian tubes and the corpus uteri, ultrasonography and computed tomography were found to yield information of approximately equal diagnostic value with reference to the site and extent of the tumor, the organ or organs affected and the consistency of the tumor. The two procedures were significantly more accurate than clinical examination, and to some extent they proved to complement each other. In contrast, computer tomography and ultrasonography proved to be inferior to clinical examination in the detection of tumors of the cervix. PMID- 3287446 TI - Cellular and cytokine immunotherapy of cancer. PMID- 3287448 TI - Adoptive immunotherapy in combination with chemotherapy for cancer treatment. PMID- 3287447 TI - Therapy of disseminated tumors by adoptive transfer of specifically immune T cells. PMID- 3287449 TI - Host-tumor interactions in immunosurveillance against cancer. PMID- 3287450 TI - Immunomodulation of neoplasia by interleukin 2. PMID- 3287451 TI - Nerve guidance: a role for bio-electric fields? PMID- 3287452 TI - Cellular localization and possible functions for brain histamine: recent progress. PMID- 3287453 TI - Pitfalls in the use of brain slices. AB - In vitro brain slices are the preparation of choice for the detailed examination of local circuit properties in mammalian brain. However it is the investigator's responsibility to verify that the circuits under investigation are indeed confined within the boundaries of the functional region of the slice used. The medium in which the slice is maintained is under the full control of the investigator. This places the burden on the investigator to ensure that: (1) the properties of the medium are fully under control; (2) the effects of the medium on the slice are known; (3) the conditions under which the slice is being maintained bear some reasonable relation to those it enjoys (or endures) in vivo. Generalizations to in vivo conditions must be made with caution. If at all possible, similar studies (perhaps less extensive, due to the greater technical difficulties) should be done in vivo to provide a basis for comparison. Investigators using drugs should be aware of, and respect, the basic pharmacological principles cited in the text. In particular, the substantial freedom the investigator has in defining the extracellular medium should not be abused. PMID- 3287454 TI - The auditory evoked potential in the rat--a review. PMID- 3287455 TI - Characteristics of the sympathetic preganglionic neuron and its synaptic input. PMID- 3287456 TI - Protective effects of CG-4203, a novel stable prostacyclin analog, in traumatic shock. AB - We studied the effects of CG-4203, a novel stable prostacyclin analog, in a severe model of traumatic shock in rats. Traumatic shock was produced by Noble Collip drum trauma and was characterized by marked hypotension, a 4- to 5-fold increase in plasma cathepsin D and myocardial depressant factor activities, and survival time of 95 +/- 15 minutes. Treatment with CG-4203 (100 ng/kg/min) significantly prolonged survival time to 194 +/- 20 min (p less than 0.002). Traumatized rats treated with CG-4203 exhibited significantly lower plasma activities of the lysosomal hydrolase cathepsin D (p less than 0.05). Furthermore, the plasma accumulation of myocardial depressant factor (MDF) activity was also significantly blunted in traumatized CG-4203 treated rats when compared with traumatized rats receiving only the vehicle (p less than 0.01). Our results suggest that a combination of membrane stabilizing and anti-proteolytic effects and inhibition of platelet aggregation may mediate the protective effects of CG-4203 in traumatic shock. PMID- 3287457 TI - The significance of prostacyclin produced by pregnant rat myometrium: the relationship between myometrial prostacyclin producing activity and passive stretch of myometrium by growing conceptus. AB - The present experiment was performed to elucidate the significance of prostacyclin (PGI2) produced by pregnant rat myometrium. PGI2-like substance producing activity of various portions of the uterus was measured at selected gestational stages by platelet bioassay; surface area per 1 gm of uterine wall enveloping one conceptus was calculated; and spontaneous contractility of myometrium of both conceptus and non-conceptus regions and the effects of authentic PGI2 on it were examined. PGI2-like substance producing activity increased with advancing pregnancy, but the activity varied according to area of the myometrium, being highest in the area where it was most greatly stretched by the growing conceptus and lowest where no conceptus was contained. Spontaneous contractility was reduced in regions with high PGI2 producing activity. Though authentic PGI2 generally exhibited a stimulatory effect, it had an inhibitory effect on Day 10 pregnant myometrium. From these results, it may be concluded that the producing activity of PGI2, which remarkably increases in the conceptus region with the advance of pregnancy, keeps the uterine wall relaxed, making the uterus adapt to the growth of the fetus. Passive myometrial stretch by the growing conceptus is thought to be one of factors which enhance myometrial PGI2 producing activity. PMID- 3287458 TI - Inhibition of the 5-lipoxygenase pathway with piriprost (U-60,257) protects normal primates from ozone-induced methacholine hyperresponsive small airways. AB - Weekly exposure to ozone in seven normal Rhesus monkeys led to induction of methacholine hypersensitive airways (RL increases 242 +/- 60% and Cdyn decreases 68 +/- 13% of baseline methacholine responses). It took 19 weeks to establish this hyperresponse that persisted for greater than 15 weeks once ozone was stopped. A second exposure led to similar response peaks in 6 weeks. At the peak of the second response, weekly 1% piriprost exposure before ozone led to a return to baseline that was not different between placebo and piriprost treated animals (9.4 +/- 1.0 and 4.3 +/- 2.9 weeks, placebo and treated, respectively P = 0.09 NS). A statistical difference in the mecholyl response in placebo and piriprost treated groups while on ozone was shown only in the Cdyn measurement (Cdyn% change 68 +/- 13 vs 24 +/- 14, placebo and piriprost, respectively P = 0.03). Off ozone (or return to baseline), a statistical difference could be detected both in RL and Cdyn (RL% changed 151 +/- 41 vs 31.1 +/- 49, P = 0.03, and for Cdyn 62.7 +/- 8 vs 9 +/- 10, P = 0.0006, placebo and piriprost, respectively). We conclude tha the primate provides a chronic model of airways reactivity in which the role of lipoxygenase is implicated because of the beneficial role of piriprost, and further that the ozone lesion is primarily in the smaller airways (possibly and alveolitis). PMID- 3287459 TI - Ciprostene, a stable prostacyclin analog, produces peripheral vasodilation, platelet inhibition and increased clot dissolution in the cat. AB - The effect of the stable prostacyclin analog ciprostene on hemodynamic parameters, platelet aggregation and clot dissolution was examined in the sodium pentobarbital anesthetized cat. Hemodynamic and platelet aggregation effects were measured in 5 cats following infusion of 5, 10, 20, 40 and 80 micrograms/kg/min of ciprostene. Drug was dissolved in Tyrode's buffer (pH 7.4) and all doses were infused for 20 minute intervals in ascending order. The hemodynamic data were consistent with peripheral vasodilation. The total peripheral resistance and mean aortic pressure decreased with increasing dose. No change in heart rate, cardiac index, or left ventricle dP/dt (contractility) was observed. All doses infused produced inhibition of ADP induced platelet aggregation. In vivo fibrinolytic activity was assessed with an aortic thrombus positioned at the bifurcation of the aorta. Five cats were infused with vehicle and 5 cats each were infused with 8 and 20 micrograms/kg/min ciprostene respectively. All infusions were via a 4F catheter positioned in the aorta proximal to the thrombus. Infusion time was 3 hours. Infusion of 8 micrograms/kg/min did not enhance dissolution of the aortic thrombus. However, the 20 micrograms/kg/min infusion significantly reduced the thrombus weight (mean = 13.2 mg) compared to vehicle (mean = 38.7 mg) (p less than 0.03). The results suggest that ciprostene is a potent vasodilator and platelet inhibitor with clot dissolution properties. PMID- 3287460 TI - [Letters of an emigrant. The psychoanalyst Clara Happel to her son Peter (1936 1945)]. PMID- 3287461 TI - [Instrumental research into the instrumental object]. PMID- 3287462 TI - [From the archives of psychoanalysis. Karl Landauer. Affective states and their development (affects, passions, temperament)]. PMID- 3287463 TI - [28th issue dedicated to the medical problems during the occupation under Hitler. On the 43d anniversary of the liberation of the Auschwitz-Birkenau concentration camp]. PMID- 3287464 TI - [At Sachsenhausen and Dachau 1939-1941]. PMID- 3287465 TI - [Participation of Cracow's Pomoc Zolnierzowi (Soldiers' Services) in aid to prisoners]. PMID- 3287466 TI - [In the hospital office during the first few years in the Auschwitz I concentration camp]. PMID- 3287467 TI - [Reminiscences of a physician-prisoner from Auschwitz]. PMID- 3287468 TI - [Women at the Auschwitz-Birkenau concentration camp]. PMID- 3287469 TI - [Dr. Antoni Goscinski]. PMID- 3287470 TI - [Preventive examinations of combatants. Evaluation]. PMID- 3287471 TI - [Stefan Malost]. PMID- 3287472 TI - [Dr. Tadeusz Snieszko]. PMID- 3287473 TI - [Dr. Jozef Kalisz]. PMID- 3287474 TI - [Dr. Mojzesz Pelc]. PMID- 3287475 TI - [Dr. Cyprian Sadowski "Skiba"]. PMID- 3287476 TI - [Dr. Zofia Gorka]. PMID- 3287477 TI - [On the 42d anniversary of the liberation of the Auschwitz-Birkenau concentration camp celebrated by the Cracow Medical Association]. PMID- 3287478 TI - [From the correspondence on the Auschwitz issues of Przeglad Lekarski (X)]. PMID- 3287479 TI - [Treatment of post-concentration camp asthenia]. PMID- 3287480 TI - [Medical topics on the occupation in Polish publications during 1987]. PMID- 3287481 TI - [Contents of preceding issues of "Przeglad Lekarski" (Medical Review) devoted to medical problems of the period of Nazi occupation]. PMID- 3287482 TI - [The Auschwitz dictionary (H). A model]. PMID- 3287483 TI - [The forgotten concentration camp in the center of Hamburg]. PMID- 3287484 TI - [Hospitals at Gablonz-Reinowits and Reichenau, branches of the Gross-Rosen concentration camp]. PMID- 3287485 TI - [Juveniles in the camp for displaced persons in Konstantynow Lodzki]. PMID- 3287486 TI - [Children in the institution in Herrnstadt]. PMID- 3287487 TI - [Sick prisoners in Dachau in the hands of the SS physician Rudolf Bracht]. PMID- 3287488 TI - [The SS physician Kurt Friedrich Plotner, experimenter at Dachau]. PMID- 3287489 TI - [Medico-sanitary problems of the Szczawnica Underground. Dr. Zbigniew Kolaczkowski]. PMID- 3287490 TI - [Reminiscences of a health service officer]. PMID- 3287491 TI - 75th anniversary of The Netherlands Cancer Institute. PMID- 3287492 TI - [High-resolution echography of the neck. Preoperative evaluation of lymph node metastases in patients with thyroid carcinoma]. AB - Twenty-six patients with papillary and 4 with medullary thyroid carcinoma were examined by HRUS before surgery in order to evaluate its accuracy in detecting lymph node metastasis (N) of the neck from thyroid carcinoma. All patients underwent total thyroidectomy and nodal dissection. HRUS was accurate in 73% of cases in N staging, while clinical staging was accurate in 60% of cases only. In 50% of patients HRUS provided with interesting additional information, such as disclosing lymphadenopathy in 8 patients with no clinical evidence, proving nodal involvement in 5 cases, and showing extranodal extension in 5 cases. HRUS allowed the observation of anechoic necrotic areas and microcalcified nodes. On the other hand, according to our results, HRUS cannot either discriminate metastatic from benign nodal involvement, or identify mediastinal adenopathy. False negatives are possible due to micrometastatic areas in normal size nodes. Nevertheless, HRUS proved to be a valuable aid to complete clinical examination of the neck, and a good guide for the surgeon during nodal neck dissection. PMID- 3287493 TI - [Echo-guided adrenal needle biopsy in the staging of lung tumors. Preliminary evaluation]. AB - In patients with lung tumors adrenal masses can represent metastases, hyperplasia, adenoma or other benign lesions, most of which can be asymptomatic. Although the sensibility of US and CT in the diagnosis of adrenal metastases is very high, their specificity is somehow less satisfactory. The risk of overstaging operable pulmonary tumors is therefore present. US-guided FNB can yield material enough for cytologic and, in some cases, histologic evaluation, thus offering a reliable solution to the clinical problem in selected cases. Our experience with US-guided percutaneous mono or bilateral FNB of adrenal masses with Chiba and/or Otto needles in 14 patients with pulmonary neoplasms is reported. The use of Otto needle is suggested in the largest adrenal masses or when histology of the primary neoplasm is unknown. Bilateral cytological FNB is suggested in borderline lesions. PMID- 3287494 TI - [Ultrasonics in the diagnosis of hyperplastic cholecystoses of focal and segmental extension type]. AB - The authors describe the sonographic (US) patterns of hyperplastic cholecystoses observed from January 1983 to April 1987 - 39 cases of focal extension and 12 of segmental extension--and confirm the higher sensibility of US versus oral cholecystography. Sonography (SG) allows a straight visualization of the gallbladder wall and its lesions, both in case of limited thickening of the wall (focal cholecystosis) and in case of more extensive thickening (segmental cholecystosis). To cholecystographic findings of focal lesions, SG gives additional information, adding a fundamental diagnostic element: the lack of acoustic shadowing distal to the nodular masses. Nonetheless, SG does not allow a discrimination between focal cholesterolosis and adenomyomatosis, except for particular cases, such as multiple nodular masses, and coexistence with the "comet tail" pattern--the latter due to parietal deposits of cholesterol. Furthermore, the differential diagnosis of focal cholecystoses includes some neoplasms of the gallbladder, and gallstones stuck to the wall, with no acoustic shadowing. In segmental cholecystoses, the direct evaluation of the entity and extension of the wall thickening remains a fundamental diagnostic element, even though such a morphologic detail is often integrated by the functional relieve of hypercontractility of the gallbladder wall after a fatty meal (both oral cholecystography and SG demonstrate it). PMID- 3287495 TI - [Diagnosis by imaging in renal and urinary tract malformations. Comparison of echography and traditional radiological studies]. AB - The diagnostic sensitivity of Ultrasound (US) was studied in 142 children with suspected kidney and urinary tract malformations. According to the clinical tests performed the patients underwent excretory urography (EU) and/or voiding cystouretrography (VCU); the results were compared to US findings. In the 75 patients with malformations, US proved to be extremely sensitive in abdominal renal ectopies, in "horseshoe" kidney, and in congenital obstructions of the ureteropelvic and vesico-ureteral junctions. US showed a higher sensitivity than EU in identifying multicystic kidney and in most cases of hypodysplasia. On the other hand, VCU was more accurate in vesico-ureteral reflux studies; US should thus be used in the follow-up of the patients undergoing medical therapy. EU must however be considered as the most important tool in the evaluation of early renal injuries and their possible development. PMID- 3287496 TI - [Dynamic ultrasonic hysteroscopy]. AB - An attempt was made to establish Dynamic Echohysteroscopy (DEHS) diagnostic criteria for the study of female genital apparatus, as recently proposed. DEHS consists of a pelvic ultrasonography during and following an injection of physiological solution in the uterine cavity. Since this technique does not use X rays, it has been proven useful to study female infertility. The authors have studied the normal and pathological aspects of 33 patients who underwent both DEHS and hysterosalpingography (HSG) (comparison diagnostic test). The results lead to the following conclusions: 1) DEHS can be considered a useful alternative to HSG, in the evaluation of uterine pathology; 2) in the evaluation of tubal pathology, DEHS has fewer diagnostic possibilities than HSG. Nevertheless, DEHS indirectly allows the patency of at least one tube. PMID- 3287498 TI - [Radiotherapy in T1 epidermoid carcinomas of the vocal cords]. AB - In the last years radiotherapy has become the methodology of choice in the treatment of initial T1a and T1b glottis neoplasias, the reason being-it is as successful in controlling the disease as demolition surgery, but it saves the phonation function. Our experience in the "O. Alberti" Institute of "Spedali Civili" di Brescia from January 1, 1970 to December 31, 1984 is here reported. Out of the total figure of 195 patients treated with radiotherapy, 154 were T1a, and 41 T1b. Global survival rate after 5 years is 76,25%. Loco-regional relapses were on the whole 28: 24 on T, and 4 on N. Saving therapy allowed the retrieval of 15 patients (62,5%) with relapse on T. The total dose administered (greater than 60 Gy or 60 less than Gy), TDF values (greater than 95 or less than 95 on minimum), and field dimensions (greater than 5 x 5 cm2 or less than 5 x 5 cm2) were considered, in order to evaluate the chance of relapse. The only statistical data concerning the significant difference between the two groups of patients irradiated with fields less than 5 x 5 cm2 and more than 5 x 5 cm2, both with a total dose of more than 60 Gy. In the group of patients irradiated with smaller fields, the percentage of relapses is lower. This is probably due to the fact that the patients had more superficial lesions. The treatment had no severe side effects, and never affected the quality of the voice. In order to obtain a high recovery-rate, in the meantime reducing side-effects and keeping a good phonation function, small fields and dose ranging between 64 and 68 Gray with 32-34 fractions, 5 per week, are thought to be the best. It is necessary, however, to watch out for penumbra and inaccuracy by immobilizing the patient with containing systems. PMID- 3287497 TI - [Radiotherapy in the treatment of carcinomas of the base of the tongue. Analysis of the literature and personal experience]. AB - Carcinoma of the base of the tongue is usually treated with radiation therapy. After a review of the literature, the findings are reported of 129 patients with squamous cell carcinoma of the base of the tongue treated in 1979-1983, with a minimum of a 3-year follow-up: 8 T1, 40 T2, 60 T3 and 21 T4 were found; only 48 cases were N0. Advanced stages (stage III and stage IV) were 83% of the total. External photon irradiation (Cobalt-60) was used in all cases; 33 patients underwent chemotherapy or surgery as additional treatment. The overall local control rate was 45.7%. Local control decreased as T stage advanced: T1 62.5%, T2 55%, T3 41.7% and T4 33.3%. The overall regional control rate for lymph nodes clinically palpable was 51.8%. The overall actuarial 5-year survival rate was 29.1%. The 5-year survival rate according to the N-staging varied from 37% for N0 stage to 17.4% for N3-stage. The majority of failures (92.8%) occurred within 2 years since the end of the therapy. Treatment complications, secondary carcinomas and causes of death are also discussed. Radiation therapy has proven to be effective for early-stage carcinoma of the base of the tongue; in more extensive lesions results are poor. Improved results could be obtained by optimal application of radiotherapeutic techniques. Knowledge of the various prognostic factors is essential to administer the therapeutic regimen for a given patient by the characteristics of his particular tumor. PMID- 3287499 TI - [Fistula of the second branchial cleft. Radiographic and echographic findings]. PMID- 3287500 TI - [Intrauterine echographic diagnosis of cystic adenomatoid malformations]. PMID- 3287501 TI - [Embolization of the splenic artery in cirrhotic patients with portal hypertension. Ultrasound results and follow-up]. AB - Over the last four years the authors performed transcatheter embolization of the splenic artery by Gianturco coils in 32 consecutive cirrhotic patients with portal hypertension, splenomegaly, cytopenia and gastro-esophageal varices endoscopically proved. This procedure was especially useful for treatment of splenomegaly and cytopenia because a constant reduction of spleen dimensions and increase in platelet count were registered. The effectiveness of transcatheter embolization and follow-up are based on clinic, hematologic and sonographic findings. We believe sonographic monitoring to be very useful both to evaluate splenomegaly and signs of portal hypertension and to reveal splenic complications (abscesses). We never registered severe complications. PMID- 3287502 TI - [Magnetic resonance study of renal function. Preliminary evaluation]. AB - The amount of functioning renal parenchyma can be estimated by MRI by considering the ratio between the mean intensities of cortical and medullar zones of the kidney. Fifty-six patients and 5 healthy volunteers were studied by MRI in our department. Scanning was performed with a superconductive magnet system operating at 0.5 Tesla. Pulse sequence was Spin-Echo with TR 300/TE 30 ms. The cortico medullary ratio (CMR) and differentiation (CMD) were standardized and related with creatine blood levels. CMR data ranged from 1.05 to 3.00, while CMD data ranged from 0.04 to 0.50. High values (good cortico-medullary contrast) were observed in subjects with normal renal function. Patients with renal diseases had low CMR and CMD, proportionally to the degree of renal failure, as proved by laboratory findings. Our preliminary study seems to demonstrate that MRI is an useful technique in the follow-up of patients with chronic renal disease. PMID- 3287503 TI - [A possible role of magnetic resonance in the follow-up of renal transplants]. AB - The authors discuss the possible role of Magnetic Resonance Imaging (MRI) in the follow-up of renal transplants. Its diagnostic accuracy is compared with Ultrasounds (US), which is considered the method of choice in postoperative monitoring of renal transplants. Thirty-two patients (transplant life ranging from 5 days to 37 months) were examined in the same day with both MRI and US. Sonographic evaluation is based on a group of signs related to renal alterations and unanimously ascertained; the identification of MR patterns of normally functioning kidney or renal rejection might give way to more extensive clinical applications of the method, with the advantages of multiplanarity and no X-ray use. MR diagnostic accuracy in the diagnosis of normally functioning transplant or renal rejection was 82.7% (vs. US: 68.9%); even though specificity was the same (84.6%). MRI had higher sensibility than US (82.25% vs. 656.25%). MRI is more sensitive in demonstrating renal pathology in transplanted kidneys, and its diagnostic accuracy is superior. Still, US must be considered the methodology of choice in instrumental research when there is a clinical suspicion of renal rejection, due to its sufficient diagnostic accuracy, to its being easy to perform in continuous follow-up, to its low cost and to the short execution time. MRI is nevertheless suggested in the follow-up of renal transplants both in questionable cases and when biopsy cannot be performed. PMID- 3287504 TI - [Ovarian dermoid cysts. Radiographic fat floating sign and CT diagnosis of chronic rupture]. AB - Unsuspected chronic rupture was discovered during surgical removal of a very large ovarian dermoid cyst. Abdomen X-ray, US and CT examinations were preoperatively performed. Standing X-ray projection of the abdomen allowed the appearing of a new radiographic finding of dermoid cyst, the "fat floating" as the equivalent of the "gravity dependent layering" in US and CT features. This radiographic sign appears as an horizontal line between two soft tissues of different opacity; it is caused by oily and sebaceous fluid floating over serous fluid and over intracystic debris. Literature was reviewed and radiographic findings in dermoid cysts were reconsidered; the sign of "fat floating" could enhance the diagnostic accuracy of abdomen X-ray. So when a pelvic or an abdominal-pelvic mass is discovered in a young woman, standing projection is required for abdomen X-ray. Rupture of a dermoid cyst may happen without notice and chronically; CT has been more accurate than US in evaluating rupture, in particular the peritoneal spread of oily pseudocyst. PMID- 3287505 TI - Early indicators of male reproductive toxicity. AB - Longitudinal data were analyzed for seminal characteristics of rhesus monkeys and beagles. The monkeys were exposed to DBCP; the beagles were exposed to acute or chronic whole body gamma irradiation. The semen was analyzed for volume and sperm concentration. Sperm were measured for percent motility, swimming speed, and head dimensions. Abnormalities of the sperm tail were also noted. All treatments resulted in measurable effects on the semen parameters. Sperm production, as evaluated by seminal sperm concentration or total sperm numbers in the ejaculate, was as informative of testicular toxicity as any other parameter or combination of parameters. A consistent finding was that changes in sperm output occurred concomitantly with changes in sperm motility. PMID- 3287506 TI - Postnatal effects of prenatal insult. AB - Exogenous agents may perturb development during the embryonic period and adversely affect the formation of organs. However, adverse effects on development are not limited to the embryonic period nor are the manifestations restricted solely to outright gross structural malformation, but may instead be expressed as a decrement or abberration of postnatal function. Susceptibility to altered development may extend well into the postnatal period. Studies of functional parameters in several organ systems have demonstrated the broad-based susceptibility, subtlety of expression and potential of long-lasting effects of altered development assessed by physiologic assays. Adverse effects on functional development, whether in the CNS, reproductive, gastrointestinal, genitourinary, respiratory, or immune systems, etc., merit continuing investigation. From the viewpoint of risk estimation and hazard detection, evaluations of postnatal functional parameters may be relevant for several reasons. First, such parameters may serve as low-dose triggers. Second, they may be useful as a focal point for epidemiological studies. Finally, a more thorough understanding of the degree and magnitude of such postnatal functional deficits is needed since an adverse maternal effect may be transient, considered acceptable, or unperceived, but the effect on the conceptus may be permanent and severe. The immune and respiratory systems are discussed as two examples of how subtle and protean adverse effects on functional development may be. PMID- 3287507 TI - Quantification of the genetic risk of environmental mutagens. AB - Screening methods are used for hazard identification. Assays for heritable mutations in mammals are used for the confirmation of short-term test results and for the quantification of the genetic risk. There are two main approaches in making genetic risk estimates. One of these, termed the direct method, expresses risk in terms of the expected frequency of genetic changes induced per unit dose. The other, referred to as the doubling dose method or the indirect method, expresses risk in relation to the observed incidence of genetic disorders now present in man. The indirect method uses experimental data only for the calculation of the doubling dose. The quality of the risk estimation depends on the assumption of persistence of the induced mutations and the ability to determine the current incidence of genetic diseases. The difficulties of improving the estimates of current incidences of genetic diseases or the persistence of the genes in the population led us to the development of an alternative method, the direct estimation of the genetic risk. The direct estimation uses experimental data for the induced frequency for dominant mutations in mice. For the verification of these quantifications one can use the data of Hiroshima and Nagasaki. According to the estimation with the direct method, one would expect less than 1 radiation-induced dominant cataract in 19,000 children with one or both parents exposed. The expected overall frequency of dominant mutations in the first generation would be 20-25, based on radiation induced dominant cataract mutations. It is estimated that 10 times more recessive than dominant mutations are induced. The same approaches can be used to determine the impact of chemical mutagens. PMID- 3287508 TI - Evaluation of developmental toxicity data: a discussion of some pertinent factors and a proposal. AB - There is currently no well-accepted standard method for evaluation of developmental toxicity data. This paper presents one approach to the evaluation of developmental toxicity data. We initially identify some pertinent factors that influence the interpretation of animal data and summarize the literature pertaining to these factors. Such factors include the quality and quantity of data and the relationship between maternal and developmental toxicity. We proceed with a discussion of quantitative assessment of data and propose schemes for qualitative and quantitative developmental hazard assessments. PMID- 3287509 TI - [Changes in S-adenosylmethionine metabolism in liver cirrhosis]. PMID- 3287510 TI - [Photochemotherapy. Usefulness of hematoporphyrin in the treatment of cancer by photoradiation]. PMID- 3287511 TI - [Lipid theory of atherosclerosis]. PMID- 3287512 TI - [Value of ultrasonography in the diagnosis of hepatic metastases]. PMID- 3287513 TI - [Gastric leiomyosarcomas: current radiological study]. PMID- 3287514 TI - [Liver disease caused by azathioprine: clinical case and review of the literature]. PMID- 3287515 TI - [Multiple hepatic hemangiomas associated with serous cysts of the liver]. PMID- 3287516 TI - [Choledochal cyst: another manifestation of fibropolycystic disease of the liver. Apropos of a case]. PMID- 3287517 TI - [Polycystic disease of the liver. Considerations on a case. Clinico-echographic study of the family]. PMID- 3287518 TI - [Diabetic autonomic neuropathy. Respiratory functional changes]. PMID- 3287519 TI - Some basic effects in cellular thermobiology. PMID- 3287520 TI - Interaction of hyperthermia and chemotherapy. PMID- 3287521 TI - Physiological effects of hyperthermia. PMID- 3287522 TI - Pathophysiology of tumors in hyperthermia. PMID- 3287523 TI - Aspects of metabolic change after hyperthermia. AB - Hyperthermia induces conformational changes of macromolecular structures. Such effects lead to a sudden inhibition of DNA, RNA and protein synthesis and a breakdown of membranes and of the cytoskeleton. These alterations can be very important for the mechanism of cell killing by hyperthermia. Furthermore hyperthermia induces a number of immediate metabolic changes by increasing metabolic rates. These alterations have been studied especially in intermediary metabolism like glycolysis, citrate cycle, lipid metabolism and oxidative phosphorylation. An increased turnover of ATP has been observed in cells and tissues during heating. These changes lead to a depletion of energy reservoirs. Also, disregulations occur at certain metabolic key points. Thus, the pathway of pyruvate into the citrate cycle via acetyl-CoA is apparently reduced in heated melanoma cells in vitro. The redox ratios of lactate/pyruvate, NADH/NAD+ and others are decreased. When the same melanoma cells are grown as a xenograft on nude mice the metabolic rates are also enhanced; however, the lactate/pyruvate ratio increases during a localized heating of the tumour. The extent of this effect is very variable in individual tumours and is apparently correlated with the blood flow. These alterations can be enhanced by glucose loading and can be used as an indicator of hypoxia within the tumour. Thus, the micromilieu can be modified by these metabolic effects in such a way that the thermosensitivity is increased. The data show that metabolic processes are directly and indirectly involved in cell killing by hyperthermia. PMID- 3287524 TI - Technical aspects of hyperthermia. PMID- 3287525 TI - Morphometric analysis of the endocrine pancreas in streptozotocin-diabetic rats kept on different dietary regimens. AB - The effects of different diets on the endocrine pancreas of streptozotocin diabetic rats were investigated by morphometry. Three dietary regimens were used over a period of 43 weeks: standard diet (SD), low carbohydrate-high protein diet (LC-HP), and low carbohydrate-high fat diet (LC-HF). Nondiabetic controls received standard diet. Volume density of the total endocrine tissue was significantly reduced in streptozotocin-diabetic rats kept on standard diet as compared to control rats. This reduction of endocrine tissue was significantly less in rats kept on LC-HP diet, whereas diabetic rats kept on LC-HF did not differ from diabetic rats on standard diet. In streptozotocin-diabetic rats volume density of B cells was drastically reduced, whereas volume densities of A, D and PP cells did not differ from nondiabetic controls. This decrease of B cells was partially prevented by LC-HP diet, but not by LC-HF diet. In nondiabetic control rats as in diabetic rats on standard diet most of the islets of Langerhans sized 500-6000 microns2. In contrast, diabetic rats on LC-HP diet revealed more endocrine tissue sized from 50 to 560 microns2 consisting of two to four endocrine cells, single cells, and small islets. The results suggest that LC HP diet may initiate reparation processes in the endocrine pancreas of streptozotocin-diabetic rats. PMID- 3287526 TI - Microbiological and serological studies on caprine pneumonias in Oman. AB - Eight of 10 typical cases of contagious caprine pleuro-pneumonia in Oman yielded strain F38-like mycoplasmas from the lungs in high titre, but no other mycoplasmas: both negative animals had been treated with tylosin shortly before death. Among 21 other lungs examined three of six cases of acute pneumonia yielded Mycoplasma ovipneumoniae; one also yielded M capricolum. M ovipneumoniae was also isolated from all eight cases of chronic pneumonia sampled from an abattoir, and from the lungs of three animals which died without overt signs of pneumonia. A single isolate of M arginini and three of unidentified mycoplasmas were also obtained from goats with and without pneumonia. Various bacterial species were isolated, none of which predominated. Antibodies to M mycoides subspecies capri (M m capri) and strain F38 were detected in sera from eight different sources. Assuming titres of 1 in 40 or more as positive in the indirect haemagglutination test used, 29 per cent of 422 serum samples had antibodies to M m capri alone, 2.6 per cent to strain F38 alone and 3.6 per cent to both organisms. These results confirm the presence of F38-like mycoplasmas in Oman, and indicate also widespread infection with M m capri. The role of the latter in caprine pneumonias in Oman requires elucidation. PMID- 3287527 TI - [Clinical pharmacology of drug interactions]. PMID- 3287528 TI - [Drug interactions with digitalis glycosides]. PMID- 3287529 TI - [Interaction of anti-arrhythmic drugs]. PMID- 3287531 TI - [Interaction among antithrombotics]. PMID- 3287530 TI - [Antihypertensive drug interactions]. PMID- 3287532 TI - [Lipid-lowering drugs and their drug interactions]. PMID- 3287533 TI - [A case of atypical coarctation of aorta with a chest aneurysm and ventricular septal defect]. PMID- 3287535 TI - Treatment of B-cell and T-cell lymphomas with monoclonal antibodies. PMID- 3287534 TI - Low dose aminophylline selectively increases upper airway motor activity in normals. AB - Because certain pharmacologic agents differentially influence upper airway and diaphragm motor activity, we postulated that the adenosine antagonist theophylline might preferentially increase alae nasi activity in human subjects. Using a double-blinded, randomized, placebo controlled design, we studied the effect of low dose aminophylline (1-2 mg/kg) on alae nasi and diaphragm surface electromyographic (EMG) activity. Seven healthy volunteers served as subjects for two trials on separate days. Subjects breathed from a close circuit while end tidal PCO2 was held constant in the eucapnic range. During each trial we recorded EMG signals from the alae nasi and diaphragm before and after intravenous infusion of either aminophylline or placebo. After the administration of aminophylline, the mean alae nasi EMG signal increased 87 +/- 31 (SD)% (P less than 0.005) while the mean diaphragmatic EMG signal did not change. There was no significant change in either the alae nasi or diaphragmatic EMG signal after placebo. There was no change in minute ventilation, tidal volume, or respiratory frequency after either aminophylline or placebo. We speculate that low dose aminophylline produces a selective increase in upper airway muscle activity through stimulation of the reticular activating system. PMID- 3287536 TI - Toxicity of monoclonal antibodies in the treatment of cancer. PMID- 3287538 TI - The current status and future applications of interleukin 2- and adoptive immunotherapy in cancer treatment. PMID- 3287537 TI - Tumor necrosis factor: current clinical status and implications for nursing management. PMID- 3287539 TI - IL-2: nursing applications in a developing science. PMID- 3287540 TI - Host defense mechanisms: an overview. PMID- 3287541 TI - [The development of the spine]. PMID- 3287542 TI - [From tick bite to Lyme disease: evolution of a clinical concept]. PMID- 3287543 TI - [Etiopathogenesis, physiopathology and general principles of therapy of type II diabetes]. PMID- 3287544 TI - [Ambulatory assessment of chronic bronchitis using a computerized questionnaire and pneumotachography with or without interruption of the air supply]. PMID- 3287545 TI - [Cardiovascular pharmacology of serotonin and its antagonists]. PMID- 3287546 TI - [Clinical profile of a new antihypertensive agents. Ketanserin]. PMID- 3287547 TI - Treatment of the torn anterior cruciate ligament. PMID- 3287549 TI - [A case from practice (104). Patient: Mr. A. M., born 1946]. PMID- 3287550 TI - [Pathophysiology of small intestine diseases]. PMID- 3287551 TI - [Crohn's disease of the small intestines. Pathological, clinical and therapeutic aspects]. PMID- 3287552 TI - [Functional diagnosis of the small bowel]. PMID- 3287548 TI - Exercise and the immune response. AB - A growing number of reports have become available which implicate infectious disease with reduced performance in athletes. The immune system consists of both nonspecific and specific components geared to control infections. Adaptive immunity functions through both antibody-mediated and cell-mediated compartments to establish and maintain long term immunity to infectious agents. Evidence is accumulating to support the view that physical exercise can lead to modification of the cells of the immune system. However, studies have often not been well designed to control exercise protocols when examining the effects of exercise on the immune system. Large numbers of peripheral blood lymphocytes are mobilised with exercise and in vitro tests indicate that temporarily these cells may not be capable of responding normally to mitogens. These reactions appear to be influenced by hormones to some degree and there are reports that the cells of the immune system are extremely active biochemically and may depend on products from muscles to maintain their activity. Specific populations within the circulating leucocyte pool vary significantly with exercise and there is some evidence that the T4/T8 lymphocyte ratio may become significantly reduced. This reduction in ratio may be related to the variable responses to T and B cell mitogens recorded in vitro which overall suggests that a temporary immune suppression may exist following certain training or performance schedules. It is argued that this may lead to a temporary susceptibility to infection and could result from overtraining. PMID- 3287553 TI - [Indications for long-term anticoagulant therapy]. PMID- 3287554 TI - [The child receiving a graft, the child donating the graft and their family, a year later]. PMID- 3287555 TI - [Campylobacter pylori, gastritis and gastroduodenal ulcer: more than just a combination]. PMID- 3287556 TI - [Algodystrophy in the child. Apropos of 2 cases and review of the literature]. PMID- 3287557 TI - [Paraclinical examinations in bone pathology: current information]. PMID- 3287558 TI - [Osteo-articular manifestations of hemochromatosis]. PMID- 3287559 TI - Prostatic abscess in the antibiotic era. AB - The clinical and bacteriologic features of 269 cases of prostatic abscess (PA) reported during the last 40 years were reviewed. In the pre-antibiotic era, PA not uncommonly had a dramatic presentation and frequently was caused by Neisseria gonorrhoeae. Currently, PA may be difficult to differentiate from prostatitis and other diseases of the lower urogenital tract. Prostatic enlargement is found in 75% of cases, whereas fever and urinary retention each occur in only one-third of cases. The organisms most frequently isolated from PA are Escherichia coli and other gram-negative bacilli; other isolates include Staphylococcus species and an expanding spectrum of bacteria and fungi. PA due to Staphylococcus species may also occur in neonates. Transrectal ultrasonography and computerized tomography are valuable methods for the preoperative diagnosis of PA. Although transurethral resection of the prostate is the most commonly used therapy for PA, transperineal aspiration of pus guided by transrectal ultrasonography appears to be promising. PMID- 3287560 TI - Occurrence and pathogenicity of the Streptococcus milleri group. AB - Streptococci of the milleri group are part of the normal flora of human mucous membranes. These streptococci have also been reported to be significant pathogens. Like other mucosal streptococci, they may cause infective endocarditis; unlike other mucosal streptococci, however, they have also been repeatedly associated (more frequently in men than in women) with serious suppurative infections. Evidence for the pathogenicity of the Streptococcus milleri group is scattered and mainly circumstantial. Although the organisms are found in a high proportion of certain suppurative infections, other bacteria are often present as well. Successful treatment of these infections with surgery and broad-spectrum antibiotics is not indicative of any specific etiology. Only a few attempts at the induction of experimental infections other than endocarditis have been effective. Further investigation is required to establish the pathogenicity and pathogenic mechanisms of the S. milleri group. PMID- 3287561 TI - Clinical disease spectrum and pathogenic factors associated with Plesiomonas shigelloides infections in humans. AB - Plesiomonas shigelloides is a gram-negative, facultatively anaerobic rod whose appropriate taxonomic position is presently under investigation. The isolation and identification of this microorganism in contaminated specimens (e.g., feces) by a clinical laboratory depend on the screening of gram-negative colonies for oxidase and indole positivity and the appropriate use of selective and differential agars. Plesiomonads have been associated with extraintestinal diseases (bacteremia, meningitis) on rare occasions; they have been recovered sporadically from patients presenting with acute gastroenteritis. Although case reports and epidemiologic data support a role for P. shigelloides in diarrheal disease, laboratory investigations have failed to identify an enteropathogenic mechanism in these bacteria consistently or to reveal an animal model that faithfully reproduces the disease. Moreover, studies with volunteers have failed to establish an etiologic relation between Plesiomonas and bacterial gastroenteritis. An accurate picture of the role of this bacterium in human disease must await future studies. PMID- 3287562 TI - Erysipelothrix rhusiopathiae endocarditis: microbiologic, epidemiologic, and clinical features of an occupational disease. AB - Ninety percent of the 49 reported cases of serious Erysipelothrix rhusiopathiae infection have been episodes of presumed or proved endocarditis. E. rhusiopathiae endocarditis correlates highly with occupation (farming, animal exposure), affects more males than females, exhibits a peculiar aortic valve tropism, displays a characteristic erysipeloid cutaneous lesion (in 40% of cases), and is associated with significant mortality (overall rate, 38%). Comparison with other unusual gram-positive rods causing endocarditis shows that E. rhusiopathiae resembles Listeria monocytogenes and Lactobacillus species in its propensity to involve structurally damaged but native left-sided valves. Unlike diphtheroid endocarditis, E. rhusiopathiae endocarditis has not involved prosthetic valves and is not associated with intravenous drug abuse, as is Bacillus species endocarditis. E. rhusiopathiae is exquisitely susceptible to penicillin but resistant to vancomycin. Since vancomycin is often employed in empiric therapy for presumed endocarditis, prompt microbiologic differentiation of E. rhusiopathiae from other gram-positive organisms is necessary to avoid delays in the initiation of appropriate antibiotic therapy. PMID- 3287563 TI - Haemophilus parainfluenzae infections in children, with the report of a unique case. AB - Haemophilus parainfluenzae, although a human commensal, is infrequently reported to be pathogenic. A child with a hepatic abscess caused by this organism was studied, and 54 other significant pediatric infections associated with H. parainfluenzae, as reported in the English-language literature, were reviewed. Meningitis and endocarditis were the most frequently reported infections and affected dissimilar populations of patients. Localized abscesses of the brain, skin, joints, and liver also occurred. Risk factors and antecedent illnesses were occasionally identified. The overall mortality rate was 11%, and the combined rates of morbidity and mortality totaled 38%. Difficulty in identifying H. parainfluenzae may have resulted in misdiagnosis of infections caused by this organism in the past. Antibiotic-resistant strains have emerged. Because H. parainfluenzae is ubiquitous and can cause serious disease in otherwise normal patients, it should be considered a pathogen, and its potential for causing pediatric illness should be more fully appreciated. PMID- 3287564 TI - Unusual infections associated with colorectal cancer. AB - Unusual infections associated with colorectal tumors may, in some instances, be the sole clue to the presence of a malignancy. The infections are either related to invasion of tissues or organs in close proximity to the tumor or secondary to distant seeding by transient bacteremia arising from necrotic tumors. Seven patients seen at one hospital over a 5-year period illustrate the clinical presentations of such infections. The infections identified in these seven patients include endocarditis, meningitis, nontraumatic gas gangrene, empyema, hepatic abscesses, retroperitoneal abscess, clostridial sepsis, and colovesical fistulae with urosepsis. A computer-assisted search of the English-language literature and cross-checks from other review articles identified other infections associated with colon cancer, which include nontraumatic crepitant cellulitis, suppurative thyroiditis, pericarditis, appendicitis, pulmonary microabscesses, septic arthritis, and fever of unknown origin. The clinical importance of these infections and their correlation with colorectal malignancies are reviewed. PMID- 3287565 TI - Role of empiric parenteral antibiotics prior to lumbar puncture in suspected bacterial meningitis: state of the art. AB - The performance of lumbar puncture (LP) in patients with suspected meningitis is often delayed if, for example, the clinical presentation suggests a need for prior computed tomographic (CT) scan or if patients are initially examined at settings with limited clinical facilities. The role of empiric parenteral antibiotic therapy prior to LP under these circumstances has not been critically analyzed. Review of the literature suggests that in cases of bacterial meningitis (1) the existing data are inadequate to assess the effect of a short delay of therapy on mortality and morbidity; (2) a short period of antibiotic therapy prior to LP does not change cerebrospinal fluid (CSF) white blood cell count, protein, or glucose; (3) the yield of CSF gram stain and culture may be somewhat reduced by a short period of antibiotic therapy, but these tests often remain positive; and (4) adjunctive tests, including blood cultures and CSF antigen tests, can often independently identify the bacterial meningopathogen. The available evidence suggests that if bacterial meningitis is suspected and LP must be delayed, intravenous antibiotics are warranted before CSF is obtained. PMID- 3287566 TI - Approaches to an understanding of pathogenetic mechanisms in AIDS. AB - AIDS, presumably caused by the human retrovirus, human immunodeficiency virus (HIV), is a disease with multiple pathologies, most of which are the consequence of a profound immunodeficiency. The first two sections of this review focus primarily on the normal development and function of the cells of the immune system and the known abnormalities that occur in this system in AIDS patients. Very little is known of the pathogenesis, in humans, of the four major clinical manifestations of AIDS--immunodeficiency, encephalopathy, Kaposi's sarcoma, and lymphoma. Because most pathologic studies derive from autopsy findings in terminal AIDS patients, it has been difficult to track the course of HIV infection from the time of initial contact with the virus through the evolution of the disease. Therefore, the final section of this review focuses on actual and potential animal models of AIDS and how such models might be valuable for studies on the pathogenesis of the disease, the development of relevant vaccines, and the testing of potential therapies. PMID- 3287568 TI - Nasal septal abscess due to Staphylococcus aureus in a patient with AIDS. AB - Nasal septal abscess is a potentially serious infection about which there has been little information in the infectious disease literature. A patient with acquired immunodeficiency syndrome who developed a nasal septal abscess was studied, and the literature about this infection was reviewed. PMID- 3287567 TI - Parotitis due to anaerobic bacteria. AB - Although Staphylococcus aureus remains the pathogen most commonly implicated in acute suppurative parotitis, the pathogenic role of gram-negative facultative anaerobic bacteria and strict anaerobic organisms in this disease is becoming increasingly recognized. This report describes a case of parotitis due to Bacteroides disiens in an elderly woman with Sjogren's syndrome. Literature reports on seven additional cases of suppurative parotitis due to anaerobic bacteria are reviewed. Initial therapy of acute suppurative parotitis should include coverage for S. aureus and, in a very ill patient, coverage of gram negative facultative organisms with antibiotics such as cloxacillin and an aminoglycoside. A failure to respond clinically to such a regimen or isolation of anaerobic bacteria should lead to the consideration of the addition of clindamycin or penicillin. PMID- 3287569 TI - Neonatal herpes simplex pneumonitis. AB - Four new cases of neonatal herpes pneumonia and five cases from the literature were assessed. Clinical presentations, laboratory abnormalities, and radiographic features were analyzed in an effort to establish helpful criteria for early institution of antiviral therapy. Any neonate who develops respiratory distress between the third and 14th days of life and has a chest radiograph that reveals prominent hilar with a central interstitial infiltrate is at high risk for herpes pneumonia. Antiviral therapy pending antigen detection and culture results should be strongly considered in any such patient when the etiology of pneumonitis is unknown and any of the following is found: (1) thrombocytopenia; (2) evidence of disseminated intravascular coagulation; (3) elevated values in liver function tests; (4) a positive result in a rapid screening test for herpes simplex virus; (5) lymphocytic pleocytosis of the cerebrospinal fluid; (6) development of vesicular skin lesions; or (7) further deterioration in clinical status during treatment with antibiotics. PMID- 3287570 TI - Malnutrition and overcrowding/intensive exposure in severe measles infection: review of community studies. AB - Most hospital studies of measles mortality suggest that high case fatality ratios are associated with malnutrition. However, no community study has documented this association. On the contrary, several community studies from Africa and Asia have found no relation between nutritional status and risk of severe or fatal measles. Instead, overcrowding and intensive exposure may be more important determinants of measles mortality. Clustering of several cases in the family and/or intensive exposure were associated with high measles mortality in community studies in West Africa, Bangladesh, and England. Thus sociocultural factors that concentrate many susceptible children in the home may increase the case-fatality ratio in measles. Conversely, this ratio will be lower when measles cases are dispersed. Siblings in rural areas, where long intervals separate epidemics, run a higher risk of contracting measles simultaneously than do their urban counterparts. Measles vaccination increases herd immunity and diminishes the clustering of several cases in a family. Vaccination may therefore reduce mortality even among unvaccinated children who contract measles. Crowding and intensive exposure may partly explain regional and historical variations in measles mortality; community studies suggest that mortality is high when a high proportion of measles patients have secondary cases (acquired through exposure at home). PMID- 3287571 TI - Epidemics and crowd-diseases: measles. By Major Greenwood, 1935. PMID- 3287572 TI - [The spleen: preserve or excise?]. PMID- 3287573 TI - [Usefulness of a computer algorithm in the diagnosis of acute abdominal pain of the right lower quadrant]. PMID- 3287575 TI - [Famotidine versus cimetidine in the treatment of non-complicated duodenal ulcer. A multicenter study]. PMID- 3287574 TI - [Lymphomatoid granulomatosis of the colon. Apropos of a case]. PMID- 3287576 TI - Zinc in human health and disease. AB - The importance of zinc in human health and disease has been reviewed by reporting data from the recent literature. The role of zinc in human nutrition, general health, skin diseases, acrodermatitis enteropathica, reproductive physiology and pathophysiology, pregnancy, non-insulin-dependent diabetes mellitus as well as atherosclerosis is discussed. The consequences of zinc deficiency and toxicity are also illustrated. PMID- 3287577 TI - Collagen ageing. An analysis of the visco-elastic behaviour of the tendons. PMID- 3287578 TI - [Isolated aneurysms of the iliac arteries]. AB - Isolated aneurysms of the iliac arteries are rare. They must be considered as a disease pattern of their own as against aneurysms of the abdominal aorta because of the specific anatomical conditions in the pelvis. The clinical symptomatology is determined by their localisation and topographical relationships within the pelvis; this can give rise to problems in differential diagnosis primary urological, neurological or gastrointestinal diseases. The prognosis is decisively determined by early and correct diagnosis because of the danger of rupture. Sonography, computed tomography and angiography are indispensable aids in preoperative planning. PMID- 3287580 TI - [Lymphography--farewell to a routine method in pretherapeutic staging?]. AB - In view of the steep decline in the number of lymphangiographies (LAG) performed, the authors try to correlate the relevance of this radiological staging method with that of computed tomography and the histological results of lymphadenectomy. The diagnostic accuracy of both methods (LAG and CT) is comparable (71.4% and 70.6%, respectively). In respect of specificity, CT is superior to LAG (this superiority is due to the method employed) to the tune of 88.2% for CT vs. 58.8% for LAG. If there is a large proportion of early tumour stages, CT is inferior to LAG with regard to sensitivity (52.6% and 63.2%, respectively). Lymphangiography can no longer be recommended in case of intrapelvic urological and gynaecological tumours. It is only indicated, as before, in staging diagnosis of seminomas of stage No of after CT and of Hodgkin's lymphomas of stage II B. In non-seminomas LAG is exclusively a service performed for the benefit of the surgeon wishing to have a contrast medium staining of the lymph nodes. In future, LAG can be offered only in centres having a sufficiently large group of oncological patients to look after. PMID- 3287579 TI - The value of lymphography in childhood solid tumours. AB - The lymphographic films of 40 children with solid tumours were re-evaluated to assess the value of lymphography. In 11 children the lymphographic findings were positive. In only one child with carcinoma of the small bowel the metastatic changes in a normal-sized lymph node were probably not demonstrable on ultrasound (US) or computed tomography (CT). In the most common childhood tumours the metastatic lymph nodes were enlarged and thus demonstrable on US or CT. Therefore we suggest that US or CT should be performed first, followed by lymphography in doubtful cases only. PMID- 3287581 TI - [Clinical aspects, radiology and differential diagnosis of stress fractures]. AB - Stress fractures result from bone stress in a rhythmical, repeated and subthreshold manner. Fatigue fractures and insufficiency fractures are considered. In the present paper clinical and radiological findings in stress fractures and problems of differential diagnosis are discussed. Typical locations and forms of manifestation are presented. PMID- 3287582 TI - [What purpose does the renin-angiotensin-aldosterone system serve in man?]. PMID- 3287583 TI - [The future of the renin-angiotensin system]. PMID- 3287585 TI - [Penicillin G and analogs. Current indications]. PMID- 3287584 TI - [Classification and place of penicillins among beta-lactam antibiotics. Structure. Mode of action. Pharmacokinetics]. PMID- 3287586 TI - [Aminopenicillins and ticarcillin. Current indications]. PMID- 3287587 TI - [Acylureidopenicillins, amidinopenicillins, clavams and beta-lactamase inhibitors]. PMID- 3287588 TI - [Side-effects of penicillins]. PMID- 3287589 TI - [Muscular manifestations in periodic disease]. AB - Between 1976 and 1983, the authors studied 50 new patients affected with periodic disease. 16 of them-mean age: 29-presented muscular manifestations. They may be grouped into two clinical aspects: muscular pain and contractures. The authors consider that these symptoms, first described in 1945, are an inherent part of the clinical picture of the disease. They discuss their relationship with periarteritis nodosa and remind the fact that their pathogenesis remains unknown. PMID- 3287590 TI - [From diffuse functional myalgias to primary fibromyalgias]. AB - Diffuse and chronic muscular pains, without any noticeable underlying anomaly, are a frequent cause for consultation. The origin of the pain was, at the beginning of the century, attributed to an inflammation of fascia, tendons, ligaments, subcutaneous tissues and even the muscle itself. Although this inflammatory etiology is not based on proven anatomical facts, some authors advocate an organic pathology of unknown origin and the terms of fibrositis or primary fibromuscular pain are used in the literature, especially the anglo-saxon literature, to describe such symptomatology. Clinical diagnostic criteria have been recently proposed in order to differentiate primary fibromuscular pain from functional diffuse muscular pains. The authors discuss the legitimacy of such distinction. PMID- 3287591 TI - A sensitive method to detect synthesis of the functional classical, alternative and terminal pathway of complement by cells cultured in vitro. AB - A new method used to study in vitro synthesis by human monocytes and alveolar macrophages of the essential complement components for the functional classical, alternative and terminal pathway is presented. The method is based on accumulation of major complements components on activators of the alternative (agarose beads) and classical (lgM-sensitized sheep erythrocytes; ElgM) pathway during co-culture with the phagocytes. There was a time-dependent increase in binding of labelled protein to the co-cultured activators, demonstrating de novo protein synthesis by the phagocytes. Moreover, there was a significant binding to the co-cultured agarose beads and ElgM of monoclonal anti-C3c, anti-C3g, polyclonal anti-C5-C9 and of two monoclonal antibodies (poly C9-MA and MCaEll) to a neoantigen of polymerized C9 present in the terminal complement complex (TCC). In addition, we found a significant binding of polyclonal anti-C4 antibodies to co-cultured ElgM. Incubation of the activators in human serum, subsequently revealed the same pattern of antibody binding. There was no binding of anti-S protein antibodies to the activators after incubation with serum or with the phagocytes. We thus conclude that mononuclear phagocyte-produced complement in the form of C3b, iC3b, and the TCC (C5b-9) was deposited on both activators, whereas C4b was detected on the ElgM. It is our hope that this method can be applied when studying complement biosynthesis by cells other than mononuclear phagocytes. PMID- 3287592 TI - Increased myocardial contractility during intravenous insulin infusion in type 1 (insulin-dependent) diabetic patients: an echocardiographic study. AB - On two occasions eight insulin-dependent diabetic patients were connected to an artificial beta-cell, and insulin was administered by continuous intravenous infusion at a rate of 2 mU/kg/min, producing a moderate hyperinsulinaemia (mean 116 microU/ml). At random, blood glucose was kept constant by concomitant glucose infusion, or allowed to decrease to a mean value of 5.3 mmol/l. M-mode echocardiography was performed before, at 90 and at 180 min of insulin infusion. Following the euglycaemic insulin infusion periods, the fractional shortening of the left ventricle increased from 38.2% to 41.0 and 40.2%, respectively (p less than 0.02). The diastolic diameter (pre-load) and end-systolic meridional wall stress (after-load) remained constant in this experiment. In contrast, no change in fractional shortening could be demonstrated during falling blood glucose, possibly because pre-load was altered to a significant degree during this experimental condition. In conclusion, concomitant infusion of insulin and glucose, producing an euglycaemic hyperinsulinaemia, is followed by increased myocardial contractility. PMID- 3287593 TI - Effects of fasting and glucose-insulin-potassium on glycogen contents in heart, skeletal muscle and liver. AB - The effect of intravenous infusion of glucose, insulin and potassium (GIK) on the glycogen contents of the heart, skeletal muscle and liver was investigated in rats. One group of animals received intravenous infusion of GIK continuously for 3 days, and two other groups of rats were given the same amount of saline intravenously. The animals receiving GIK, and a control group of the rats, were fasted for 8 h before sacrifice, while a second control group of animals was given free access to water and pellets until sacrifice. The heart, rectus femoris muscle and liver were then analysed for glycogen contents. It was found that fasting caused a depletion of glycogen in skeletal muscle and liver, while it did not cause any changes in myocardial glycogen which remained similar to that in the fed animals. Infusion of GIK prevented the depletion of glycogen in skeletal muscle and liver, but, unexpectedly, it did not cause any significant changes in myocardial glycogen content. PMID- 3287594 TI - Mononuclear phagocytes have the potential to synthesize the complete functional complement system. PMID- 3287595 TI - Characterization of a bovine thymic differentiation antigen analogous to CD1 in the human. AB - Three monoclonal antibodies (MoAb), TH97A, CC13, and CC14, define a thymic differentiation antigen in cattle. The antigen is expressed on 50-60% of bovine thymocytes, located mainly in the cortical areas, but is not expressed on peripheral blood mononuclear cells (PBMC). In cryostat sections of lymph node, the antibodies react with large dendritic-like cells in the paracortical regions. They also react with a proportion of the large 'frilly' cells in afferent lymph and with dendritic-like cells in the dermis. The antibodies apparently do not react with cells in the epidermis. Biochemical analysis of the antigen recognized by MoAb TH97A reveals two bands of 44 kDa and 12 kDa under reducing conditions. These polypeptides are distinct from bovine class I major histocompatibility complex molecules reactive with the MoAb w6/32. The tissue distribution of positive cells together with results of biochemical analyses indicate that the antigen recognized by these MoAb is the bovine analogue of the human CD1. PMID- 3287596 TI - Hormone receptors in human prostate cancer. AB - The relative success with which the response of breast cancer to endocrine therapy can be predicted by assay of female sex steroid receptors has led to attempts to use measurement of androgen receptors in neoplastic prostate tissue for predicting the success of anti-androgen therapy in prostate cancer. Hitherto hopes have not been fulfilled. Androgen receptors are present in almost all prostate samples, but with inhomogeneous distribution. No relationship was found between androgen receptor levels in needle aspirate and prognosis in prostatic carcinoma. Receptors for oestrogen, progestin and prolactin were also studied for identification of possible prognostic indicators. Progestin receptors appear to be present in prostatic tissue. Lack of consensus regarding prostatic oestrogen and prolactin receptors is due partly to their low (if any) concentrations and partly to differing methodology and interpretation of results. Oestrogen, progestin and prolactin receptors seem to lack prognostic significance in prostatic cancer. These findings and the high initial response rate of prostatic carcinoma to endocrine therapy indicate that further studies should focus on elucidating how such tumours become hormone-independent. PMID- 3287597 TI - Secretory function of the prostate gland. PMID- 3287598 TI - Estramustine-binding protein in rat and human prostate. AB - Estramustine phosphate, a nor-nitrogen mustard carbamate derivative of oestradiol 17 beta-phosphate, labelled with tritium in the oestradiol moiety, caused a higher concentration of radioactivity in rat prostate than did tritiated oestradiol-17 beta-phosphate or oestradiol-17 beta. Further studies in rat prostate demonstrated a protein that binds etramustine, the dephosphorylated metabolite of estramustine phosphate. The physical and chemical properties of this protein have been investigated, as has its presence in different organs of the rat and other species, including man. The finding of estramustine- binding protein in the human prostate gave rise to speculations concerning possible significance of estramustine phosphate's mechanism of action. The initial studies on estramustine-binding protein in rat and human prostate are briefly presented. PMID- 3287599 TI - Estramustine-binding protein--a marker for effect of therapy in prostatic carcinoma? AB - Estramustine-binding protein (EMBP) in human prostatic cancer before and after androgen-deprivation therapy was determined with an immunohistochemical technique. Although a rabbit polyclonal antiserum raised against rat EMBP was used, all the prostatic tumours displayed positive staining for EMBP. Staining was found exclusively in the cytoplasm of the epithelium, whereas nuclei, fibromuscular stroma and, in general, also lumina were negative. The staining intensity was higher in moderately and poorly differentiated, than in well differentiated tumours. EMBP immunostaining intensity decreased markedly from pretreatment levels in patients with remission, but returned to these levels when relapse occurred despite androgen withdrawal. Altered EMBP staining intensity was evident as early as 10 days after start of therapy in responding patients. EMBP may therefore be a marker of therapeutic response in human prostatic cancer. Provided that immunohistochemical measurements can be performed on fine-needle aspirates, EMBP analysis may be a direct and early means for predictive distinction between responding and non-responding patients. PMID- 3287600 TI - Influence of age, sodium status and ACE-inhibition on glomerular binding and responsiveness to angiotensin II in normotensive and spontaneously hypertensive rats. PMID- 3287601 TI - [Erythropoietin--the first hematologic hormone in clinical use]. AB - Recombinant human erythropoietin raises serum erythropoietin concentrations to adequate levels and restores the hematocrit to normal values in the vast majority of anemic, end stage renal disease patients undergoing regular hemodialysis. It can eliminate the need for transfusions and thus the risk of immunologic sensitization, infection and iron overload. Erythropoietin not only alters laboratory findings but improves the well being and performance of patients on hemodialysis as well. Side effects are minimal and neither antibodies nor resistance to the recombinant hormone have been observed so far. Along with the rise in hematocrit and blood viscosity some patients developed increased blood pressure and a few hypertensive encephalopathy, but after brief interruption of therapy erythropoietin treatment could be continued in combination with antihypertensive drugs. The pathophysiology of the increase in blood pressure, the risk of encephalopathy and the possibly somewhat higher risk of thrombosis remain to be elucidated. Nevertheless, the first recombinant hematopoietic hormone has passed its first clinical trials with success. PMID- 3287602 TI - [Benzodiazepine--practice and problems of its use]. AB - Benzodiazepines are the most frequently prescribed drugs in the Western world. About 3% of the adult Swiss population regularly use benzodiazepines for the treatment of anxiety states or for induction of sleep. All benzodiazepine agonists available exert qualitatively similar pharmacodynamic actions. They commonly activate central GABAergic neuroinhibition, thereby inducing anxiolysis, sedation/hypnosis, anticonvulsion and muscle relaxation. However, various derivatives differ in their physicochemical and pharmacokinetic properties such as lipophilicity, rate of gastrointestinal absorption, hepatic biotransformation and elimination half life. These differences among individual substances can be used clinically to optimize therapy for the individual patient. For example, the elimination half life greatly influences the frequency, intensity and type of adverse reactions such as hangover, rebound insomnia, development of tolerance and dependence as well as withdrawal symptoms. It is estimated that "low-dose dependency" develops in as many as 30 to 45% of chronically treated patients. Low dose dependency is mainly characterized by the appearance of withdrawal symptoms after cessation of therapy. Since management of the withdrawal state is difficult and especially troublesome for the patient it is best to prevent the development of benzodiazepine dependence by prescribing these drugs less and restricting them to short-term use (7-14 days). PMID- 3287603 TI - [Endoscopic therapy of acute upper gastrointestinal bleeding. A breakthrough in non-variceal bleeding?]. AB - Endoscopic therapy adds a new tool to the management of acute upper gastrointestinal hemorrhage. Endoscopic sclerotherapy being now a well established therapy for acute variceal bleeding, a simple and effective therapy for nonvariceal bleeding was missing. Recently coagulation therapy with laser, electric current or thermocouples has come into use, but injection therapy with hemostatic and sclerosing agents seems a simple, costeffective and relatively safe method. In uncontrolled trials the overall success rate in achieving hemostasis was over 90% and the need for emergency surgery was dramatically reduced. Injection therapy appears to be a major advance in the treatment of nonvariceal bleeding, especially in high risk patients. PMID- 3287604 TI - [Renal manifestations of sarcoidosis]. AB - Renal manifestations of sarcoidosis are rare. In addition to calcium nephropathy, granulomatous interstitial nephritis and glomerulo-nephritis (GN) account for most cases. The latter two manifestations are described in 4 patients and in a detailed review of the literature. In comparison to a nonselected population of sarcoidosis patients, granulomatous interstitial nephritis is found more frequently in male patients above 40 years of age; it is associated more frequently with other extrathoracic manifestations of sarcoidosis; and it causes renal insufficiency of varying degree, which is at least partially reversible with steroid therapy. Predominant findings are silent microhematuria, sterile pyuria, mild proteinuria and a variety of tubular functional disorders. Glomerulonephritis (39 observations) has been described with increasing frequency in sarcoidosis. Because of the well known immunological abnormalities of sarcoidosis, frequent association of sarcoidosis with GN could be expected but this association has not yet been proven statistically. Sarcoidosis-associated GN includes a variety of histological forms, viz. membranous, proliferative and sclerosing GN. Glomerulonephritis may appear before sarcoidosis. Conversely, both diseases may appear simultaneously, or GN may follow all other manifestations of sarcoidosis with a latency period of many years. PMID- 3287605 TI - [Frequent problems of non-steroidal antirheumatic agents in old age]. AB - The relationship between nonsteroidal antiinflammatory drugs (NSAID) and peptic lesions in the upper gastrointestinal tract remains unclear in many respects. Nevertheless, there is increasing evidence that the risk in patients over 65 years of age and particularly in women is higher than in younger individuals. Data suggest that compounds with long elimination half life increase the risk further. In patients at risk it is therefore advisable to start treatment with the lowest potentially effective dosage and to avoid compounds with long half lives as first line treatment. NSAID are today the most frequent cause of drug induced renal damage. The renal function disturbances induced by NSAID are largely due to inhibition of renal prostaglandin synthesis. In patients with underlying risk factors NSAID can cause acute renal failure, salt and water retention and hyperkalemia. Because of a progressive decline in renal function and alterations in water and electrolyte homeostasis with aging, elderly patients taking NSAID are particularly at risk of developing renal disease. PMID- 3287606 TI - [Indications and contra-indications for heart transplantation]. AB - Indication and contraindications for selection of patients for cardiac transplantation are given on the basis of 2 years' experience in evaluating a total of 65 patients, 30 of whom received heart transplant. Heart transplant must be considered in patients with: 1. Severe heart failure without response to maximal medical treatment. 2. End stage coronary artery disease where clinical heart surgery is no longer feasible. 3. Intractable malignant arrhythmia associated with pump failure. Heart transplant is contraindicated in: 1. Patients with extracardiac polymorbidity. 2. Cardiac low output with renal and hepatic impairment. 3. Compliance failure. 4. Increased pulmonary artery resistance. 5. Age over 60 years. PMID- 3287608 TI - [Phase contrast microscopy demonstration of glomerular erythrocytes in urine: practicable in ambulatory practice?]. AB - The use of phase-contrast microscopy in microhematuria, as proposed in 1979 by Birch and Fairley, renders morphological changes in red cells easily detectable and makes it possible to distinguish glomerular from non-glomerular bleeding. The aim of this study was to evaluate the practicability of this method as a routine laboratory test in ambulatory care. 60 patients with asymptomatic microhematuria (greater than or equal to 2 erythrocytes per high power field) were followed up over a one-year period. All patients were investigated by intravenous pyelography, ultrasound of urinary tract and three cytological examinations of the urine. The description of urine samples was done with phase-contrast microscopy by a first investigator at the beginning of the study and by a second after 12.8 months, blinded to clinical results and previous examinations. In 21 patients a definitive diagnosis was possible. In 18 patients the morphologic descriptions of the two investigators correlated with the clinical results. Only in two patients with established diagnosis there were differences between the urine description of the two investigators, and in one patient the interpretations of both investigators were wrong. These incorrect descriptions concerned patients with low-grade microhematuria. Thus, phase-contrast microscopy is a practicable method for the practitioner's use as a routine laboratory investigation. In low-grade microhematuria the method seems to be of minor value. PMID- 3287607 TI - [Relapsing polychondritis: a diversified disease picture]. AB - Relapsing polychondritis is a rare, at times fatal systemic disease involving inflammatory destruction mainly of cartilaginous structures. The sensory organs, respiratory tract, cardiovascular system and kidneys are most frequently involved. Based on the current state of knowledge it seems probable that relapsing polychondritis is an autoimmune disease. Early involvement of the respiratory tract and kidneys, anemia, arthritis and saddle-nose deformity are associated with poor prognosis. 2 cases of relapsing polychondritis (one with erosive symmetrical polyarthritis and the second with massive involvement of the respiratory tract) are presented. PMID- 3287609 TI - [Results and failures in extension bridges. A clinical and roentgenological follow-up study of free-end bridges]. PMID- 3287610 TI - [Fastening mechanisms. Fastening mechanisms on metal prostheses of adherent bridges--a position assessment]. PMID- 3287611 TI - [Preprosthetic orthodontics. 1. Theoretical bases]. PMID- 3287613 TI - [Fixed prosthetic rehabilitation]. PMID- 3287612 TI - [Complete prosthetic care in patients with endosseous implants. Diagnostic and therapeutic cooperation between surgeons and prosthetists]. PMID- 3287614 TI - Is c-myc protein directly involved in DNA replication? PMID- 3287615 TI - Measuring the accuracy of diagnostic systems. AB - Diagnostic systems of several kinds are used to distinguish between two classes of events, essentially "signals" and "noise". For them, analysis in terms of the "relative operating characteristic" of signal detection theory provides a precise and valid measure of diagnostic accuracy. It is the only measure available that is uninfluenced by decision biases and prior probabilities, and it places the performances of diverse systems on a common, easily interpreted scale. Representative values of this measure are reported here for systems in medical imaging, materials testing, weather forecasting, information retrieval, polygraph lie detection, and aptitude testing. Though the measure itself is sound, the values obtained from tests of diagnostic systems often require qualification because the test data on which they are based are of unsure quality. A common set of problems in testing is faced in all fields. How well these problems are handled, or can be handled in a given field, determines the degree of confidence that can be placed in a measured value of accuracy. Some fields fare much better than others. PMID- 3287616 TI - DNA damage and oxygen radical toxicity. AB - A major portion of the toxicity of hydrogen peroxide in Escherichia coli is attributed to DNA damage mediated by a Fenton reaction that generates active forms of hydroxyl radicals from hydrogen peroxide, DNA-bound iron, and a constant source of reducing equivalents. Kinetic peculiarities of DNA damage production by hydrogen peroxide in vivo can be reproduced by including DNA in an in vitro Fenton reaction system in which iron catalyzes the univalent reduction of hydrogen peroxide by the reduced form of nicotinamide adenine dinucleotide (NADH). To minimize the toxicity of oxygen radicals, the cell utilizes scavengers of these radicals and DNA repair enzymes. On the basis of observations with the model system, it is proposed that the cell may also decrease such toxicity by diminishing available NAD(P)H and by utilizing oxygen itself to scavenge active free radicals into superoxide, which is then destroyed by superoxide dismutase. PMID- 3287617 TI - Retroviruses. AB - First brought to scientific attention as infectious cancer-causing agents nearly 80 years ago, retroviruses are popular in contemporary biology for many reasons. (i) The virus life cycle includes several events--in particular, reverse transcription of the viral RNA genome into DNA, orderly integration of viral DNA into host chromosomes, and utilization of host mechanisms for gene expression in response to viral signals--which are broadly informative about eukaryotic cells and viruses. (ii) Retroviral oncogenesis usually depends on transduction or insertional activation of cellular genes, and isolation of those genes has provided the scientific community with many of the molecular components now implicated in the control of normal growth and in human cancer. (iii) Retroviruses include many important veterinary pathogens and two recently discovered human pathogens, the causative agents of the acquired immunodeficiency syndrome (AIDS) and adult T cell leukemia/lymphoma. (iv) Retroviruses are genetic vectors in nature and can be modified to serve as genetic vectors for both experimental and therapeutic purposes. (v) Insertion of retroviral DNA into host chromosomes can be used to mark cell lineages and to make developmental mutants. Progress in these and other areas of retrovirus-related biology has been enormous during the past two decades, but many practical and theoretical problems remain to be solved. PMID- 3287619 TI - Yeast: an experimental organism for modern biology. AB - The yeasts Saccharomyces cerevisiae and Schizosaccharomyces pombe have become popular and successful model systems for understanding eukaryotic biology at the cellular and molecular levels. The reasons for this success are experimental tractability, especially in applying classical and molecular genetic methods to associate genes with proteins and functions within the cell. PMID- 3287618 TI - Research on bacteria in the mainstream of biology. AB - The study of the genetics, biochemistry, and physiology of bacteria during the last 40 years has provided the concepts and methods for the study of cells of all types at the molecular level. Although much is already known about the mechanisms bacteria use to regulate the expression of their genes, a great deal more remains to be discovered that will have relevance to both prokaryotic and eukaryotic cells. Similarly, the study in bacteria of the transactions of DNA, of the synthesis and function of the cell membrane, of differentiation, and of the interaction with eukaryotic cells will undoubtedly produce results of general importance. The advantages of using bacteria for these studies include their simple noncompartmented structure, the accessibility of their genetic material, and the possibility of correlating the expression of a gene in the intact cell with its expression in a system composed of highly purified components. Finally, the comparative study of a wide variety of microorganisms may result in a better understanding of the evolution of prokaryotes and eukaryotes and lead to a comprehensive theory of cell biology. PMID- 3287620 TI - Xenopus laevis in developmental and molecular biology. AB - Xenopus laevis is a prime system for the study of embryogenesis in vertebrates. Both prelocalized information in the egg and inductive interactions between cells contribute to the ordered increase in complexity during development. Embryonic induction, discovered in amphibians, is being studied intensely in Xenopus; recent work suggests a role for growth factors in this process. Contributions of the Xenopus system to the analysis of ribosomal and 5S RNA genes, and the diverse and highly productive applications of the oocyte injection technology, are also summarized. PMID- 3287621 TI - The nematode Caenorhabditis elegans. AB - In Caenorhabditis elegans patterns of cell division, differentiation, and morphogenesis can be observed with single-cell resolution in intact, living animals. Mechanisms that determine behaviors of individual cells during development are being dissected by means of genetic, cell biological, and molecular approaches. PMID- 3287622 TI - Plants: novel developmental processes. AB - Plants represent a diverse group of organisms that have unique reproductive, developmental, and physiological processes. Although morphologically simple, plants have molecular genetic processes that are equivalent in complexity to those found in animals. Sophisticated gene transfer procedures, transposon mutagenesis in homologous and heterologous plants, and development of model organisms such as Arabidopsis permit almost any gene that is associated with an observable phenotype to be isolated and studied. These advances, coupled with general advances in molecular biology, now make it possible to dissect the molecular and cellular events responsible for controlling plant-specific processes. PMID- 3287623 TI - Transgenic animals. AB - The ability to introduce foreign genes into the germ line and the successful expression of the inserted gene in the organism have allowed the genetic manipulation of animals on an unprecedented scale. The information gained from the use of the transgenic technology is relevant to almost any aspect of modern biology including developmental gene regulation, the action of oncogenes, the immune system, and mammalian development. Because specific mutations can be introduced into transgenic mice, it becomes feasible to generate precise animal models for human genetic diseases and to begin a systematic genetic dissection of the mammalian genome. PMID- 3287624 TI - Primates. AB - Nonhuman primates demonstrate marked similarities to humans in almost all aspects of their anatomy, endocrinology, and physiology. These similarities underlie the value of these animals for appropriate studies in neurobiology, immunology, pathology, reproductive biology, teratology, neonatology, endocrinology, cardiology, and psychology. Investigations with nonhuman primates has made, and continues to make, significant contributions to biomedical and behavioral research. This review provides an overview of basic and applied studies for which primates are appropriate subjects and a summary of the advantages and problems of using nonhuman primates in research. PMID- 3287625 TI - The human as an experimental system in molecular genetics. AB - There are compelling reasons for choosing to develop the human as the highest order experimental system in genetics: an obvious social context that stirs interest, wide medical observation of the population that permits identification of an abundance of genetic defects, and our ability to perceive in the human subtle or complex variations that may not be observable in other species. Various lines of genetic inquiry that are based on research in other systems--cytogenetic analysis, biochemical studies, mapping of defective loci by linkage analysis in affected families, and in vitro techniques such as the creation of transgenic organisms--complement and enrich each other. New phenomena that would not have been predicted from investigations in other organisms have been found in humans, such as the discovery of the "giant" Duchenne muscular dystrophy gene and the identification of recessive cancer genes. Genetic research is yielding insights into human biology that are raising new possibilities for therapy and prevention of disease, as well as challenges to society in the form of ethical decisions about the appropriate application of genetic information. PMID- 3287626 TI - Genetic factors in intrauterine growth retardation. PMID- 3287627 TI - Maternal diseases associated with intrauterine growth retardation. PMID- 3287628 TI - Classification of intrauterine growth retardation. PMID- 3287629 TI - Ultrasound assessment of fetal growth and fetal measurements. PMID- 3287630 TI - The evaluation and interpretation of ultrasonic assessment of fetal growth. PMID- 3287631 TI - The use of Doppler ultrasound to assess intrauterine growth retardation in the fetus. PMID- 3287632 TI - Antepartum fetal assessment--newer techniques. PMID- 3287633 TI - Holistic health and the critique of Western medicine. AB - The holistic view of health has been accurately criticized in the literature for its individualistic, victim-blaming ideology that obscures the social origins of illness. The paper explains how the contrasting view of the body and illness provided by the holistic model can help to show how Western medicine reflects the capitalist system in which it is promoted. It shows how evaluation of holistic therapies is problematic insofar as it is based on the analytical, reductionist criteria of the Western model. It suggests that one reason why holistic practices are not more fully accepted by Western medicine may be the challenge they pose to the Western model, and to the commodification of health needs promoted by this model. PMID- 3287634 TI - The place of chiropractors in health care delivery: a case study of North Carolina. AB - Three perspectives on the place of DCs in the United States health care delivery system were derived from the social science literature; system status, cultural congruence, and utilization patterns. North Carolina was used as a case study site to examine these perspectives from a geographical point of view. It was found that DCs were located in smaller places than MDs. DC/population ratios were associated with white populations and higher incomes, but were not associated with those aged 18-64, rural populations, and religious groups that used touch in healing. DCs were located in more rural and lower income areas than were MDs. PMID- 3287635 TI - Pluralistic etiological systems in their social context: a Brazilian case study. In memory of James S. Coleman. AB - The main thesis of this paper is that multifactorial explanations of illness in medically pluralistic settings arise in distinctive interactional contexts. The first part is an overview of the anthropological literature on illness etiologies, specifically on the functions and nature of these etiological notions. The second part is a description of local notions of illness causation in Feira de Santana (Brazil) using an analytical model based upon a holistic view of culture which includes four closely interrelated domains: natural, socio economic, psychological and religious. This multifactorial nature of the etiological system is examined in light of: (a) the various sources that constitute the popular stock of etiological knowledge; (b) the different aspects of causality that can function as hierarchical levels in causal chains; (c) the process of the social production of etiological knowledge. The third part, an analysis of one informant's account of his illness, serves to illustrate the point developed in the first 2 parts. PMID- 3287637 TI - [Insulin injections]. PMID- 3287636 TI - Methodological issues in social support and social network research. AB - With the plethora of articles describing a relationship between social support and/or social network and health status, it was considered useful to take stock of the current status of research in this area, focusing on two critical methodological issues: clarity of definition, and validity and reliability of the measurement instruments. Of the 33 instruments reviewed only modest agreement was found in conceptual definition, and frequently the concepts were not defined or ill-defined. Of particular concern is the definitional confusion between social support and social network. Variables used to operationalize these concepts confirm this lack of specificity and ambiguity in definition. As for validity and reliability, many of the investigators reported no data on these issues; others provided information that only modestly supported the validity or reliability of their instrument. The conclusion of this assessment suggests the need to clarify the essential elements of social support and social networks in order to better distinguish between the behavioral (support) and structural (network) variables that may be affecting health status. A question is also raised as to the likelihood of a single questionnaire being designed that would accurately measure the perceptions of support or supportive behaviors in the variety of supportive research that will continue to be studied. Finally, more rigorous standards need to be used by investigators in establishing the validity and reliability of the instruments in order to improve their predictive utility. PMID- 3287638 TI - [The role of hypnosis, relaxation and sophrology in the treatment of pain]. PMID- 3287639 TI - Trachea-innominate artery fistula: retrospective comparison of treatment methods. AB - A fistula between the trachea and the innominate artery, a potentially fatal complication of tracheostomy, can be managed successfully. We have derived several guidelines from our experience with one such case and from a review of the 36 cases reported in the literature over the last decade. Diagnosis must be established before exsanguination occurs. Bronchoscopy and angiography are often nondiagnostic. Control of hemorrhage and a patent airway are the initial goals of treatment. Interruption of the innominate artery is the definitive treatment, with a low rebleeding rate (7%, 1/14 cases) and good long-term survival (64%, 9/14 cases). Maintenance of continuity of the innominate artery is contraindicated, because of a high rebleeding rate (60%, 6/10 cases) and poor long-term survival (10%, 1/10 cases). There is no convincing evidence that interruption of the innominate artery causes significant neurologic or vascular compromise. PMID- 3287640 TI - Treatment of keloids by single intraoperative perilesional injection of repository steroid. AB - Keloid management remains controversial, and recurrence and untoward side effects limit the use of many techniques. During a seven-year period, I surgically treated 19 children, aged 3 to 17 (mean 10.5 years), with a total of 28 keloids. After aseptic skin preparation, the interface between the keloid and normal skin or subcutaneous tissue was injected with betamethasone sodium phosphate and betamethasone acetate suspension (Celestone Soluspan). The lesion was excised, and the defect was closed with subcutaneous polyglycolic acid suture. No further therapy was given. There has been no dermal or subcutaneous atrophy, and there have been no recurrences after an average follow-up of 35.5 months (six months to nine years). The technique is simple and successful, and avoids the painful postoperative series of injections often advocated. PMID- 3287641 TI - Ganglions of the hand and wrist. AB - The ganglion is the most common soft tissue tumor of the hand and wrist, originating from the joint capsule or tendon sheath. Accurate diagnosis and proper treatment of these entities require a thorough knowledge of the anatomy of the wrist and hand as well as of the ganglion itself. Definitive therapy is based on total surgical removal of the cyst and its connections to the joint or tendon sheath. PMID- 3287642 TI - Treatment of asthma with glucocorticosteroids. AB - Glucocorticosteroids (GCS) are used to treat asthma that does not respond to accepted first-line therapy. Because they have potent anti-inflammatory properties, facilitate beta-adrenergic responsiveness, suppress the late-phase reaction and reduce secretion of mucus, GCS are indicated in the treatment of severe acute asthma and chronic asthma not responsive to beta-agonists and methylxanthines. They are also useful as a diagnostic tool to determine reversibility of airway obstruction in some patients with chronic obstructive pulmonary disease. Maximal antiasthmatic effect is achieved by prescribing daily divided doses of intermediate-acting systemic GCS and reducing the dosage to alternate days after the asthma has been controlled. Inhaled GCS have minimal systemic effects when used properly, and in selected cases may be as effective as the oral preparations. Improper use of these drugs may provoke side effects which are undesirable and dangerous. Proper patient education in the use of these drugs is necessary to avoid such severe adverse effects. PMID- 3287643 TI - Brickell vs Cartwright: confrontations in the antebellum medical literature. PMID- 3287644 TI - Unilateral lower extremity hypertrophic osteoarthropathy associated with aortic graft infection. AB - We have reported a case of unilateral lower extremity hypertrophic osteoarthropathy (HOA) associated with vascular graft infection, and have reviewed previous reports of this association. Knowledge of this association may lead to earlier diagnosis of graft infection in patients with clinical evidence of HOA. PMID- 3287645 TI - Pseudomonas paucimobilis empyema after cardiac transplantation. AB - Empyema caused by P paucimobilis and mouth flora occurred in a 56-year-old man two months after orthotopic cardiac transplantation. Successful treatment was accomplished with chest tube drainage and four weeks of intravenous cefazolin and clindamycin. PMID- 3287647 TI - [Public and private aid to evacuated hospitals in the Bashkir ASSR during the years of the war]. PMID- 3287646 TI - Campylobacter fetus endocarditis on a prosthetic heart valve. AB - Campylobacter fetus infection in man is rare. Few cases of Campylobacter endocarditis have been described, and none have been associated with a prosthetic heart valve. We have reported a case of Campylobacter fetus ssp fetus on a prosthetic mitral valve in a 48-year-old woman who was treated successfully with penicillin and streptomycin (and later with gentamicin). Replacement of the prosthetic valve was done because of stenosis and vegetations. Pathologic examination showed vegetations on a calcified prosthesis, but no bacteria were seen. PMID- 3287648 TI - [D.I. Pisarev and problems of public health]. PMID- 3287649 TI - [Contribution of N.N. Zinin to the development of physiological and medicinal chemistry]. PMID- 3287650 TI - Cholelithiasis in children. A report of 3 cases. AB - Three cases of gallstone in children with no apparent predisposing condition are reported. The importance of considering cholelithiasis in the child with abdominal pain is described and the use of ultrasonography in its efficient diagnosis is stressed. PMID- 3287651 TI - Worker fitness and risk evaluations. PMID- 3287652 TI - Worker fitness and risk evaluations in context. AB - The role of worker fitness and risk evaluations in society is described and the types of examinations and terminology used are defined, with emphasis on the commonly performed preplacement examination. PMID- 3287653 TI - Decision-making in worker fitness and risk evaluation. AB - The information needed to determine fitness or risk and to make employment recommendations and decisions is reviewed. Four key questions are discussed: What are the risks and demands of a specific job? Is the worker capable of performing the job? Would the job place the worker at increased risk? What should the clinician do when there is a likelihood of increased risk or decreased capabilities? PMID- 3287654 TI - Legal considerations in worker fitness evaluations. AB - Physicians performing worker fitness evaluations need to walk a very fine line. On the one hand, if they too-aggressively disqualify individuals, their actions may be illegal under handicap or other discrimination laws. On the other hand, if they are too lenient, the result may be injury or illness to the worker or even risks to public safety. Physicians must realize the unique nature of this type of medical examination and the close connection between law and medicine in this area. PMID- 3287655 TI - Job evaluation in worker fitness determination. AB - To assess work fitness on a placement exam requires detailed assessment of repetitive manual capabilities specific for the job, ability to withstand static loading of the back and other muscle groups in the working position, and tolerance of the heat and humidity conditions of the work environment. Less specific tests, such as aerobic capacity stress tests, grip strength, and back examination may not accurately reflect the demands of repetitive job activities and, therefore, may not satisfy the legal requirements of Title VII. Only occasionally will a job analysis lead to the establishment of a concrete capacity standard against which a potential worker's fitness or risk for injury can be measured in the physician's office. The most valuable contributions of a careful, quantitative job analysis are likely to be the identification of particular anatomic structures (e.g., joints and muscles) that will be subjected to high stress and a clear understanding of the job so that reasonable accommodation of the worker or modifications of the job and workplace can be considered. In summary, the following observations can be made: 1. Intensity of effort, continuous duration of effort, and frequency of repetition are the key factors for evaluating the physical demands on muscle groups during work. 2. Intensity of effort can be estimated by using psychophysical scaling techniques and by obtaining ratings from several people. 3. Timing the effort and recovery times for specific muscle groups during a task of interest can be used to quantify the possible fatigue. It will also provide information about ways to improve the task to bring it within the capabilities of more people. 4. Total workload is most easily evaluated by using estimation methods or lists of comparable jobs and then performing a time-weighted calculation of the full shift's work requirements. The workload should be related to the aerobic capacities of the active muscles. 5. Environmental heat and humidity reduce work capacity and must be factored into any assessment of job suitability. 6. Psychological and perceptual job demands should be assessed by defining the requirements for multiple-task performance or monitoring and by evaluating the environment for visual or auditory work. Accountability without control in the job should also be identified. 7. Many of the factors that make jobs difficult can be remedied without extensive cost to the employer. The job-evaluation techniques given in this chapter can help to identify the most effective ways to make changes in the job requirements.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3287656 TI - Cardiovascular conditions and worker fitness and risk. AB - Given that many cardiac events can be exacerbated by nonexertional (psychological or social) activities, it is very difficult to extrapolate directly from a negative stress test to absence of risk or to presence of potential disease. Therefore, in general, the best form of cardiovascular evaluation is direct observation by the clinician of the patient on the job, or careful review of AEM obtained while the person performs the job. These caveats apply equally to evaluation of the asymptomatic as well as the symptomatic individual. PMID- 3287657 TI - The evaluation of pulmonary fitness and risk. AB - In summary, medical evaluation for placement decisions must carefully consider the work requirements and the condition of the individual at the present time and in the future. In all situations, the right of the individual to a job must be balanced against the need to protect the potential worker against any adverse effects. Methods of accommodation of the respiratory-impaired worker must also be considered. As discussed elsewhere in this issue (Chapter 4), there are legal requirements for accommodation of the impaired worker. Accommodation may involve worksite modification, change in work schedule, or change in work practices. Specifically, if an individual cannot meet the exertion requirements of the job, it may be possible to modify them. For example, a punch press operator with chronic obstructive lung disease who is unable to carry the raw materials to the press once a day may be able to work if another worker carries the raw materials or if a suitable mechanical assist device is provided. Furthermore, proper workplace controls can decrease exposure levels; if there is no exposure to a toxic substance, then preexisting disease should not influence placement. In one very provocative study, McGrath demonstrated that with stringent environmental controls, persons with occupational asthma to trimellitic anhydride could continue working safely with this substance. Finally, many persons may be able to work on a part-time basis or during certain shifts. Medical evaluation for proper placement is not a single decision to be made on the basis of a one-time evaluation. An iterative approach may be employed, in which the worker's response to a particular placement may be monitored. In this way, individuals who develop adverse effects will be detected. Follow-up contact between the clinician and the worker in borderline situations should be encouraged both to detect any adverse reactions and to facilitate rapport such that the employee will feel comfortable in relating problems to the clinician. Thus, placement decisions must be made carefully with attention to the many factors involved. Ultimately, the physician must use the best available information when serving as an advisor to the potential employer and to the potential employee. PMID- 3287658 TI - Neurologic considerations in worker fitness evaluation. AB - This chapter focuses on neurological conditions that may seriously change work performance or risk, as well as considerations in neurological evaluation of the asymptomatic worker. PMID- 3287659 TI - Psychiatric conditions in worker fitness and risk evaluation. AB - This chapter has reviewed the specific techniques of measuring fitness for work in individuals with psychiatric impairment. The discussion also considered the estimate of risk associated with various specific conditions and diagnoses. The use of psychiatric measures in work-fitness estimation is warranted in the following situations: 1. applicants with known or suspect history of psychiatric disorder; 2. employees returning to work after an episode of emotional illness or substance abuse; 3. employees referred to the medical department by management for evaluation of performance decrement, absence, abrupt indebtedness, unusual behavior, etc.; and 4. individuals evaluated for high stress or high risk jobs. Applicants' evaluations begin with a thorough medical history, a physical examination, a mental status examination, and basic laboratory studies. The personal history must include a complete work history, with particular attention paid to job duration and reasons for leaving employment. The mental status may be extended by specialized scales, e.g., the Griffiths work behavior rating scale. Unless an applicant has evidence of cognitive dysfunction, the usual battery of psychometric tests will not be helpful. Instruments that measure self-concept and ego strength, e.g., the Stotsky-Weinberg Sentence Completion Test and Miskimins Self-Goal-Other Test, may assist in resolving difficult questions about work fitness, especially in people with a history of schizophrenia. When an employee returns to work after an episode of psychiatric illness, the major questions for the occupational physician are: Is this person capable of returning to his current job? If not, what type of work is he capable of performing? In this instance, the fitness evaluation must add management data about the job to medical data about the patient. The patient-job fit is the crucial issue. For example, a socially-isolated, withdrawn paranoid schizophrenic functioned adequately for years as a third-shift computer operator. The scale of his operational responsibilities allowed him to work alone most of the time, a work environment unsatisfactory to most people but quite suitable for him. To aid in maintaining patient compliance with the treating physician's regimen, the patient should be asked to authorize release of medical information about the illness and to allow continued contact between the occupational physician and the treating doctor. Regularly scheduled follow-up visits are very helpful in maintaining patients on the job. They should include a brief interval history, an abbreviated mental status, relevant laboratory data (e.g., urine chromatography), and support.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3287661 TI - Commentary: Survey research in Social Security. PMID- 3287660 TI - Reproductive fitness and risk. AB - Increased attention to issues related to reproductive fitness and risk are related to two factors: first, public and scientific concerns about the problem of human reproductive dysfunction and second, economic concerns. The author discusses reproductive fitness related to job tasks and reproductive risk, including clinical considerations, risk evaluation, and policy considerations. PMID- 3287662 TI - Income of the aged in 1962: first findings of the 1963 Survey of the Aged. By Lenore A. Epstein, March 1964. PMID- 3287663 TI - Status of lung transplantation. AB - Selected patients with terminal lung disease have been managed effectively by lung transplantation. Strict selection criteria for donors and recipients, attention to technical detail, and avoidance of perioperative corticosteroids increase the likelihood of success. The underlying pulmonary disease determines the appropriate procedure. Single-lung transplantation is most appropriate for patients with pulmonary fibrosis. Patients with emphysema or septic pulmonary disease who have adequate or recoverable cardiac function can be well served by double-lung transplantation. However, such patients are still treated in some centers by combined heart-lung transplantation. Patients with right-heart failure secondary to vascular or parenchymal pulmonary disease are best managed by combined heart-lung transplantation. Donor availability, airway healing, and diagnosis of rejection remain significant problems and are the focus of experimental and clinical investigation in many centers. PMID- 3287665 TI - Hepatic transplantation with perioperative and long term anticoagulation as treatment for Budd-Chiari syndrome. AB - Conventional medical and surgical management of Budd-Chiari syndrome is often unsuccessful. In this communication, we report the results of 19 hepatic transplants done for 17 patients suffering from Budd-Chiari syndrome. The first patient who had a transplant did not receive anticoagulant therapy during the postoperative period, and recurrent thrombosis of the hepatic veins in the newly transplanted liver rapidly developed. Sixteen patients who subsequently underwent transplantation were managed using a philosophy of early postoperative anticoagulant treatment when feasible. Using this approach, the cumulative proportion of patients surviving at one and three years was 88 per cent, and no recurrent hepatic vein thrombosis occurred during a mean follow-up period of 28.2 months. Forty-four per cent of the patients who were deliberately given anticoagulant medication experienced a hemorrhagic complication in the postoperative period, but there were no associated deaths. In spite of anticoagulant therapy, 31 per cent of the patients on anticoagulantion medication experienced a thrombotic complication that did not involve the hepatic veins; one early and one late death resulted, and a third patient required urgent retransplantation. Despite the difficulties in patient management, a carefully selected population of patients with hepatic failure secondary to Budd-Chiari syndrome appear to be well served by hepatic transplantation with early postoperative and long term anticoagulant therapy. PMID- 3287664 TI - Early experience with the total artificial heart as a bridge to cardiac transplantation. AB - There is no doubt that currently available biventricular pneumatic pulsatile devices placed orthotopically with transcutaneous drive lines can support life in patients who may then be successfully transplanted. For the most part, the world experience is with the Jarvik hearts. The current model of choice is the 70-cc device because it is smaller and may be implanted with less fear of "fit problems" than the 100-cc model. As Case 4 illustrates, a fit problem may cause a fatal outcome. But if special precautions in implantation are taken, these may be avoided (Case 6). The fears of excessive bleeding, hemolysis, embolism, and infection with the use of these devices are not as prohibitive as we suspected. Bleeding is always a threat in complex cardiac surgery with grafting. Hemolysis is not a problem if excessive transfusion can be avoided. Embolism and infection may be inevitable, but as our patient B.C. has proven, there is no need to rush immediately to transplantation. And if the implanted patient does not meet local transplant selection criteria, we have enough information now to recommend that they not be accepted for transplantation. Bleeding may be anticipated to be a major problem in any patient with dense reactive scar tissue. To avoid this, transplantation should be done within 3 weeks. We recommend patients who have previously been selected for orthotopic transplantation and begin an accelerated decompensation (our Cases 2 and 7) as the best candidates for temporary orthotopic mechanical support. In these patients, there is no question about whether recovery of the native heart is possible or whether a reversible myocardial insult is present. The plan to do an orthotopic transplant indicates that a cardiectomy is necessary. Case 5, who was in reasonable shape for transplantation, was also favorable. In cases of anticipated graft failure, early use of the Jarvik 7-70 is recommended. This type of device, when suitably placed, provides excellent control of the circulation. There is no requirement for intensive care of the native heart, since it is gone, along with toxic antiarrhythmic medications, risk of embolizing a mural thrombus, and the constant balancing of a univentricular device vis-a-vis the native heart. Further, if pulmonary edema is present with accompanying elevation in pulmonary vascular resistance, the biventricular device requires only an upward adjustment in right drive pressure. With a univentricular device one must worry not only about the pulmonary vascular resistance but also about the capacity of the right heart to pump at a normal output.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3287666 TI - A technique for controlling injuries of the iliac vein in the patient with trauma. AB - This has become our preferred way to control deep pelvic hypogastric vein injuries and we have found it to be particularly useful in the patient with multiple nonvascular injuries. It is rapid, entails little ongoing blood and allows for direct exposure of the injury. It minimizes the chances of creating additional iatrogenic injuries from blind clamping or dissection. Thus, this technique should not be used routinely but should be reserved for situations when attempts to obtain proximal and distal control are unsuccessful. PMID- 3287667 TI - Epidermoid tumors. Review of the literature. AB - Reports of epidermoid tumors from 1965 through 1986 were reviewed with emphasis on new and unusual findings. Clinical data considered were rapid onset, rare symptoms, size and rate of growth, and complications. Uncommon locations included multiple sites in one patient and the anterior fontanelle. The radiologic data from computed tomography were the main contributors to diagnosis. An immunohistochemical test disclosed that cells of craniopharyngiomas are keratin positive. Histologically benign epidermoids can behave as highly malignant tumors, and can become carcinomatous. Postoperative results for benign tumors were often excellent. Evidence was presented of the close relation among epidermoid and dermoid tumor, craniopharyngioma, ameloblastoma (adamantinoma), Rathke's cleft cyst, and aural cholesteatoma. PMID- 3287668 TI - "The profound proclamation of a young man" by Harvey Cushing. PMID- 3287670 TI - Selective stripping operation based on Doppler ultrasonic findings for primary varicose veins of the lower extremities. AB - In 337 limbs (208 patients) with primary varicose veins, Doppler ultrasound was used to detect reverse flow in the saphenous veins caused by manual compression of the calf. According to the extent of reverse flow in the saphenous trunks, varicosities of the long saphenous vein were classified into five types and the short saphenous vein, into four types. Two hundred five (66.3%) of 309 limbs with varicosities of the long saphenous vein had reverse flow in the entire saphenous trunk from the groin to the ankle. In varicosities of the short saphenous vein, 37 (52.9%) of 70 limbs showed reverse flow from the popliteal fossa to the ankle. The other limbs demonstrated reverse flow only in some segments of the saphenous veins. On the basis of these Doppler ultrasonic findings, selective stripping operations were performed on 80 limbs, in which only the segments with venous reverse flow were selectively removed. Postoperative plethysmographic measurement of the venous reflux volume and follow-up studies showed that results of the selective stripping operations were as satisfactory as those of the standard stripping operations (189 limbs) in which the entire saphenous vein was removed. Furthermore, the selective stripping operation was advantageous in reducing the incidence of nerve injury. PMID- 3287669 TI - [Induction of malignancies by radiotherapy: a retrospective study of 454 tumors]. AB - On the basis of 98 case reports compiled from the literature of the years 1902 to 1984, a retrospective study was conducted on 454 tumors developed after radiotherapy within the irradiation field. 226 patients (49.8%) were treated for a benign primary disease and 222 (49.6%) for a malignant primary disease. In six cases the primary diagnosis was unknown. The histologic investigation of the tumors showed sarcomas in 52% of the cases, carcinomas in 38%, and leukemias in 8.5%. Cerebral tumors were described in two cases. The average latency was 7.1 years in leukemia, 12.1 years in sarcomas, and 19 years in carcinomas. Carcinomas were preponderantly found after a focal dose up to 30 Gy, sarcomas after higher doses up to 70 Gy. In leukemia, a dose-effect correlation was not evident. The influence of surgery, chemotherapy, the age of the patients at the moment of radiotherapy, as well as the dignity of the primary disease on latency and histology of the radiogenic tumor was also investigated. PMID- 3287671 TI - Structural failure of a Greenfield filter. AB - A unique case is discussed in which a Greenfield filter failed structurally after less than 1 year in situ. In the absence of external trauma, two struts of the filter separated from the hub and migrated into the retroperitoneal tissues. A brief discussion of the complications of Greenfield filters concludes with a possible explanation of this particular problem. PMID- 3287673 TI - [Created with few resources but with a lot of enthusiasm]. PMID- 3287672 TI - [Background: Happy Birthday]. PMID- 3287674 TI - Synergistic inhibition of platelet aggregation by endothelium-derived relaxing factor and prostacyclin. AB - The anti-aggregatory effect of endothelium-derived relaxing factor (EDRF) on aggregation of washed, aspirin-treated platelets was compared with that of nitric oxide. Nitric oxide produced a dose-dependent inhibitory effect on PAF-induced aggregation: the antiaggregatory activity was unstable and was completely preventable by pretreating the platelets with haemoglobin (10 mumol/l). Bovine aortic endothelial cells (EC) were grown to confluence on microcarrier beads, pretreated with aspirin (1 mmol/l), and their addition to the platelet cuvette also caused a dose-dependent inhibition of aggregation induced by PAF, thrombin and A23187. The inhibitory effect of the EC on platelet aggregation was partly prevented in the presence of haemoglobin (10 mumol/l). Both nitric oxide and EC showed synergy with prostacyclin, in that the latter potentiated the anti aggregatory action of both these factors against PAF-induced platelet aggregation. Thus cultured endothelial cells release a non-prostanoid anti aggregatory factor, which, like nitric oxide, shows a synergistic interaction with prostacyclin and is blocked by haemoglobin. This anti-aggregatory factor has the characteristics of EDRF. PMID- 3287675 TI - A study of bleeding time in 120 long-term aspirin trial patients. AB - The bleeding time was measured in 120 patients participating in a longterm randomised double-blind trial of aspirin in thromboembolic prophylaxis (UK-TIA aspirin Study). In 70 patients taking aspirin 300 mg or 1,200 mg daily for a mean duration of 35 months the bleeding time averaged 228 seconds. In comparison with 30 patients randomised to placebo and not taking aspirin whose bleeding time averaged 217 seconds, there was no significant difference. Stratification of bleeding time estimation by duration of treatment suggested no significant trend in either placebo or aspirin groups over several years. These results suggest that the longterm trials of aspirin should be looked at again from the point of view of efficacy of treatment by time from randomisation. PMID- 3287676 TI - [Stereotaxic thalamotomy. Once more a therapeutic choice used in involuntary movement]. PMID- 3287677 TI - [Cytokines]. PMID- 3287678 TI - [Diagnosis of hip dysplasia in neonates. A comparative study between x-ray and ultrasonic examination]. PMID- 3287679 TI - [Intersuckling by cattle: a literature review]. AB - The literature on intersucking in cattle is reviewed. The following features are described: incidence, moments of appearance, relationship between herd mates, environmental factors (housing system, size of herd, area per animal, feeding places available, feed ration, nutrient deficiencies, housing and feeding practices during the rearing period), animal factors (genetic predisposition, social bonds, imitation), consequences (pathological changes, milk loss), and forms of symptomatic treatment (mechanical devices, surgery). It is concluded that rearing methods (bucket feeding of milk, early group housing) and genetic predisposition are likely to be the most important factors in the aetiology of intersucking in mature dairy cattle. As methods of symptomatic treatment are not successful in every case and are subject to ethical dispute, it is advisable not to treat intersucking cattle regardless of the symptomatic approach. This is the more important because there is clear evidence of genetic predisposition. The mode of inheritance is still unknown, but is likely to act through sucking motivation or drive at an early age. In problem herds more attention should be paid to rearing methods and selection of (A.I.) bulls. There also is a need for further research into the aetiology, particularly by longitudinal studies in which a large number of animals are studied from birth to first lactation. PMID- 3287680 TI - [Hygienic aspects of pig's head meat. 1. Obtaining and processing pigs' heads]. AB - Pigs's head meat is mainly obtained in specialised deboning plants and provides raw materials for the manufacture of meat products and snacks. Few data on hygiene in processing and production of pig's heads or on the bacteriological quality and tissue composition of pig's head meat have so far been published. The object of the present investigation was to supplement these data and to examine the extent to which this quality could be improved by Good Manufacturing Practices (GMP's). A total number of 11 slaughter-houses and 14 deboning plants were studied. Hygiene was assessed by two investigators on the basis of a check list. Temperatures of rooms, heads and head meat were measured. Twenty-one samples (7 x 3) were taken in each of nine deboning plants for bacteriological and histological examination. The investigations carried out in slaughter-houses showed that pig's heads were only washed in five out of eleven slaughter-houses. Cleansing and disinfection of the apparatus used in splitting the carcasses were omitted or merely carried out incidentally during slaughter. Assessment of hygiene in the deboning plants ranged from adequate to satisfactory in 13 out of 14 plants. The average aerobic colony count in Log N g-1 of pig's head meat was 6.7 +/- 0.7; this was 4.4 +/- 0.9 for counts of colony-forming units (CFU) of Enterobacteriaceae. Tonsils, mucous membranes, bone, hair and dirt were found to be present in 8, 13, 21, 39 and 9 per cent of the samples respectively. As a result of the manual cleavage of heads, relatively large bone particles (greater than 8 mm) were detected in the head meat. It is concluded that an improvement of the hygienic quality of pig's head meat can mainly be achieved by taking more care in obtaining pig's heads. PMID- 3287681 TI - Renal function following open heart surgery: the influence of postoperative artificial ventilation. AB - In order to detect changes in renal perfusion and function in the postoperative period of open heart surgery, a prospective study of 21 patients following open heart surgery was performed. Cardiac output, renal blood flow, glomerular filtration and renal function parameters were determined during intermittent positive pressure ventilation (IPPV), and during spontaneous ventilation (SV). During IPPV, renal perfusion was found to be substantially decreased. The glomerular filtration rate was also reduced, but to a lesser extent, implying that the changes were due to a selective increase in postglomerular vascular resistance. The clearances of urea and creatinine were decreased during IPPV, but the clearances of osmoles and potassium were higher. The reabsorption of sodium, potassium and osmoles were also decreased during IPPV, but not that of urea. These findings are consistent with the development of increased renal venous pressure during IPPV, caused by impeded venous return to the heart. In the low cardiac output range a cardiac index in excess of 0.5l/min/m2 during IPPV seems necessary to achieve the same renal perfusion as during SV. PMID- 3287682 TI - Resection of a heart tumor using autotransplantation. AB - A 38 year old male patient presented with a cardiac tumor. Echocardiography and visualization of the left atrium revealed a large myxoma. Surgical resection of the tumor was performed with the aid of cardiopulmonary bypass. The extensive size of the tumor base and its localisation at the posterior left atrial wall made a conventional approach impossible. Therefore radical resection of the tumor was undertaken using autotransplantation. After a routine postoperative course, the patient was discharged on the twenty seventh hospital day. PMID- 3287683 TI - [Current aspects of the laboratory diagnosis of acute leukemia in children]. AB - A review is given of recent developments in diagnosing leukemia. Acute megakaryoblastic leukemia has been in the past an unclassifiable leukemia, but with electronmicroscopy it has become classifiable. The recent description in the literature of myelodysplastic syndrome (pre-leukemia) has lead to earlier diagnosis. Immunephenotyping of early T-cel leukemia is now possible by showing a T-cel marker positivity present in the cytoplasm. Cytogenetics and molecular cytogenetics appear to become important. In the near future it will be shown whether these new methods, in combination with existing methods can help us determine existing heterogeneity at diagnosis or during the disease. PMID- 3287684 TI - [Biochemical and clinico-pharmacological aspects of antimetabolites in the treatment of leukemia]. AB - Methotrexate (MTX) and 6-mercaptopurine (6MP) have been used since 30 years in the maintenance treatment of acute lymphoblastic leukemia (ALL) of childhood. A synergistic effect of this combination was demonstrated in mouse and childhood leukemia. In this article an overview is given of our investigations, concerning the biochemical basis of this synergism. This synergism is caused by a selective inhibition of the purine de novo synthesis in malignant lymphoblasts by MTX, associated with an enhanced intracellular uptake of 6MP. Pharmacokinetic studies of MTX in various schemes of prophylactic central nervous system treatment in ALL are discussed. Treatment with 24-hr infusions of MTX in a dosage of 5 g/m2, as recommended in the new BFM-86/SNWLK ALL VII protocol, seems to be optimal. Pharmacokinetic studies of intravenous 6MP infusions demonstrated a good cerebral fluid penetration. Exploiting the synergistic action of the combination of MTX and 6MP may offer an improvement of the prophylactic central nervous systems treatment in ALL in the future, using intravenous administration of both MTX and 6MP. PMID- 3287685 TI - [Results of treatment of children with acute lymphatic leukemia (ALL) according to the ALL V protocol of the Netherlands Working Group on Leukemia in Children]. AB - The Dutch Childhood Leukemia Study Group performed a phase III study (Study ALL V) to evaluate the effectiveness of addition of rubidomycin to induction treatment with vincristine, prednisone and L-asparaginase in children (0-15 years) with standard risk acute lymphoblastic leukemia: WBC less than 50.10(9)/l, absence of mediastinal mass and/or cerebromeningeal leukemia. Furthermore, the influence of some initial patient- en disease-characteristics on the outcome was analysed. Between May 1979 and December 1982 240 patients entered into the study and were randomized into 2 groups: group A (n = 122) received induction treatment with vincristine, prednisone and L-asparaginase; group B (n = 118) received induction treatment with vincristine, prednisone, L-asparaginase and rubidomycin. All patients received cranial irradiation (doses adjusted to age) and intrathecal methotrexate, followed by maintenance treatment with 6-mercaptopurine and methotrexate for 5 weeks, alternated with vincristine and prednisone for 2 weeks, up to 24 months. Complete remission rate was 94% in both groups. Event-free survival at 5 years after diagnosis was higher in group B (62% +/- 4.6%) than in group A (54.2% +/- 4.6%) but the difference was not significant. A higher initial WBC, age greater than or equal to 10 years and a positive acid phosphatase reaction of the leukemic cells were unfavorable prognostic factors (p less than 0.01). Sex, FAB-morphology, immunophenotype and place of treatment (center or general hospital) were not significant factors. PMID- 3287686 TI - [Contribution of bone marrow transplantation to the treatment of children with leukemia]. AB - Bone marrow transplantation (BMT) is an intensive mode of treatment for acute leukemia of childhood. Indication are types and stages of leukemia with a poor prognosis following chemotherapy, such as acute nonlymphocytic leukemia (ANLL) in first complete remission (CR) of the disease, and acute lymphocytic leukemia (ALL) following relapse of the disease, in second CR. On the basis of our own experience and of analysis of published data it can be stated that allogeneic BMT, grafting bone marrow cells from a healthy HLA-identical sibling of the patient, has a long-term therapeutical effect which is superior to that of chemotherapy alone: in cases of ANLL, grafted in first CR, a long-term disease free survival of 55 to 67% was obtained, and in cases of ALL, grafted in second CR, this was between 38 and 64%. The potential effect of autologous BMT, i.e. with own bone marrow of the patient, sampled during CR of the disease, cannot yet be evaluated properly, because the follow-up period of this mode of treatment is too short. It is worth while to investigate the potential beneficial effect of autologous BMT, e.g. for children with ALL in second CR, who lack a HLA-identical donor. Also the potential contribution of bone marrow purging, e.g. for CALLA positive lymphocytes, should be investigated in relation to the relapse risk after autologous BMT for common ALL. PMID- 3287687 TI - [The infant with leukemia]. AB - Infant leukemia is rare and especially in newborn leukemoid reactions should be excluded by careful cytogenetic analysis before starting cytotoxic therapy. Infants have either acute lymphoblastic leukemia, monoblastic leukemia or acute undifferentiated leukemia. At present they have a bad outlook due to many coinciding unfavorable initial disease characteristics: high leukocyte count, liver and spleen enlargement, meningeal involvement, no expression of common ALL antigen, and a high frequency of pseudodiploid cells, that is with a translocation 4;II. The immaturity of organs and systems makes it difficult to treat these infants, and requires optimal supportive care. Therapeutic protocols for prospective clinical trials for leukemia in this age group are urgently needed. PMID- 3287688 TI - Fibronectin localization in the mouse embryo from the blastocyst stage to the egg cylinder stage in vitro. AB - Fibronectin has the characteristics of adhesiveness and cell migration promotion which may play important roles in embryo implantation. Using the direct and indirect immunofluorescence techniques, we found fibronectin on the blastocyst, and the trophoblast cells of the egg cylinder stage embryo, especially at the sites of cell spreading, as well as the inner cell mass. The results show that (i) fibronectin is used for the initial cell attachment to the plastic dish, and (ii) during the course of embryo growth in vitro, the trophoblast cells spread over the plastic dish in the area of cells which contain many granules of fibronectin. PMID- 3287689 TI - The hippocampus as a common target of neurotoxic agents. AB - The hippocampus (HPC) is in a strategic position to process information derived from the polymodal association areas of the neocortex and to redistribute it to cortical and subcortical regions involved in the modulation of complex behavioral processes. Several converging lines of evidence indicate that the HPC and its cholinergic input are an important neurobiological substrate for learning and memory processes. Destruction of the HPC proper, its afferent projections, and its cholinergic innervation, produces a persistent impairment in cognitive function. Since alterations in learning and memory are a common consequence of toxicant exposure it is possible that the HPC is an important target site for neurotoxicity. In fact, the HPC has been shown to be preferentially susceptible to a wide variety of toxic insults and disease states. For example, the HPC is damaged by a number of environmental toxicants (heavy metals and their alkyl derivatives), metabolic perturbations, neuroactive viruses, cerebrovascular insufficiency, and neurodegenerative diseases. The susceptibility of this structure to a broad spectrum of insults and its involvement in higher order cognitive processes makes it an important focal point for studies of behavioral and neurological toxicity. Neurobiological characteristics of the HPC that might make this structure uniquely susceptible to toxic insult are discussed. PMID- 3287690 TI - Mechanism of the neurotoxicity of 1-methyl-4-phenylpyridinium (MPP+), the toxic bioactivation product of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). AB - It is widely believed that the nigrostriatal toxicity of MPTP is due to its oxidation by brain monoamine oxidase first to MPDP+, and eventually to MPP+. Following uptake by the synaptic dopamine reuptake system, it is concentrated in the matrix of striatal mitochondria by an energy-dependent carrier, energized by the electrical gradient of the membrane. At the very high intramitochondrial concentrations thus reached, MPP+ combines with NADH dehydrogenase at a point distal to its iron-sulfur clusters but prior to the Q10 combining site. This leads to cessation of oxidative phosphorylation, ATP depletion, and cell death. Other pyridine derivatives act similarly on NADH dehydrogenase but they are not acutely toxic unless concentrated by the MPP+ carrier. PMID- 3287691 TI - The neurotoxicological aspects of the toxic oil syndrome (TOS) in Spain. AB - The pathomechanism of the Spanish mass oil poisoning, which affected more than 20,000 people in the spring of 1981 and has so far caused more than 500 deaths, has not yet been clarified. Subsequent to a toxic-allergic initial phase of the disease with fever as well as lung and skin manifestations, 10 to 20% of the patients, after passing through an interval of reduced symptoms, entered a second disease phase characterized by marked vasculitis and fibrosis in diverse organ systems. The most frequent manifestation type involved in this connection was a severe neuromyopathy with pronounced joint contractures and skin alterations. A survey of the disease course is presented on the basis of our own examinations at the Centro Especial Ramon y Cajal as well as morphological studies on nerve muscle and brain tissue, chemical analysis studies with oil samples from affected families and the literature available so far. PMID- 3287692 TI - The role of ultrastructural investigations in neurotoxicology. AB - The ways in which ultrastructural approaches have been applied to the investigation of xenobiotic-induced toxicity of the nervous system have been briefly reviewed. These approaches have been grouped in 3 broad areas, viz. morphology, function and composition. Firstly, morphological approaches permit the visualisation of changes in intercellular relationships, the identification of the subcellular target(s) of a xenobiotic substance and the discrimination between what may appear ostensibly to be identical cellular responses to one or more chemically distinct toxins. Secondly, functional approaches using, e.g. cytochemistry, ion precipitation, immunocytochemistry and autoradiography provide indications of metabolic state, the identity or the intra- or extracellular location of the "reactive species". Thirdly, those approaches, viz. electronprobe X-ray microanalysis and electron energy loss spectroscopy which provide information of the elemental composition of cells and tissues permit an assessment of the subcellular distribution and compartmentalisation of endogenous substances and toxic or therapeutic xenobiotics. In concert, ultrastructural approaches possess the ability to contribute unique information on the effects of exposure of cells of the nervous system to toxic substances and so direct further investigation towards an understanding of the mechanism of action. PMID- 3287693 TI - Immunochemical studies of acrylamide-associated neuropathology. AB - An immunohistochemical study on neurofilaments (NF) in the central and peripheral nervous systems of rats after repeated treatment with acrylamide was done by the avidin-biotin complex method using monoclonal anti-neurofilaments antibodies (68, 160 and 200 kD). Rats were given acrylamide (50 ml/kg) i.p. every day for 8 days. In the cerebrum, NF in perikarya of large nerve cells were weakly stained with all antibodies in both control and treated rats, with no differences between the 2 groups. In the cerebellum, NF of the Purkinje cells were slightly stained with all 3 antibodies. In the treated rats, a marked accumulation of NF in the distal part of the basket cell fibers was detected by 68 kD. In the molecular layer, some parallel fibers were also stained by 68 kD in the treated animals. In the spinal cord, all NF were stained, the staining being clearer in the lower part of the cord in the treated rats. In the peripheral nerve of the treated rats, many axons were segmentally swollen along the entire length of the nerve, especially, in the distal region. In muscle preparations of the treated rats, some neuro muscular junctions stained with 68 kD were also visible. PMID- 3287694 TI - Electrophysiological measures of visual and auditory function as indices of neurotoxicity. AB - The application of auditory and visual evoked potentials (VEP) to neurotoxicity testing of humans and animals is reviewed. VEPs elicited by flash, reversing checkerboard patterns, and sine wave grating are described. The flask evoked potential in rats is altered by exposure to many heavy metals, pesticides and solvents. The brainstem auditory evoked potential also appears to be sensitive to neurotoxic chemicals, but the evidence available is limited. The homology of auditory and visual evoked potentials in rats and humans is useful for cross species extrapolation in neurotoxicology research. PMID- 3287695 TI - Mechanisms of neurotoxicity and their relationship to behavioral changes. AB - In this review some of the evidence relating behavioral alterations induced by 2 neurotoxic chemicals, lead acetate and methyl mercury is presented with an attempt to relate these changes to the underlying neurobiological mechanisms. In the case of neonatal lead poisoning, the results of the early behavioral studies were confounded by excessive lead concentrations resulting in undernutrition of the pups. Subsequent studies in both rodents and monkeys have shown that blood lead concentrations comparable to those seen in children can induce behavioral alterations that may be related to hippocampal damage. In the case of methyl mercury which is a potent cytotoxic agent, prenatal exposure results in widespread cortical, and cerebellar alterations characterized by reduced myelination, delayed migration and loss of neurons. These morphological alterations are accompanied by permanent alterations in learning and memory as well as altered pharmacological sensitivity in catecholaminergic systems. Recommendations are made for better formulated behavioral and neurobiological assays in neurotoxicology in order to lead to a better understanding of the toxicity of chemicals. PMID- 3287696 TI - Effects on human performance from acute and chronic exposure to organic solvents: a short review. AB - The present short review deals with investigations of CNS-effects from acute and chronic exposure to some organic solvents and solvent mixtures, as measured by human performance. Some of the methodological problems in experimental and epidemiological investigations of effects from solvent exposure are discussed. Problem areas where further research is needed are indicated, and some methodological suggestions for future studies are presented. PMID- 3287697 TI - Detecting functional neurotoxicity in the course of safety evaluations with laboratory animals. AB - In the course of routinely performed subchronic toxicity studies with laboratory rodents, functional neurotoxicity, i.e. behavioral changes are usually noted first during the daily cage side observations of all animals. Observation and subsequent neurologic examination of a few key animals provide a primary tentative diagnosis. Additional automated testing might include: motor activity, startle response, hurdle stepping and maze behavior. Automated testing provides further refinement of the diagnosis and serves to determine the no observable effect level under conditions of blind testing. Behavioral changes should be assessed as early as possible after initiation of testing, i.e. during acute tests for mortality and the following subchronic range-finding studies. Subsequent subchronic organ toxicity studies are then carried out by following a valid experimental protocol for implementation of automated testing procedures and appropriate neuropathologic evaluation. PMID- 3287699 TI - Lack of genotoxicity with beta-carotene. AB - A literature review was conducted on adverse effects of carotenoids on human and animal development. The data suggest that beta-carotene administration prevented genetic damage caused by mutagens both in bacterial and cell culture systems, and that large doses of pure beta-carotene do not cause embryotoxicity in rodents. In addition, studies of individuals with congenitally high levels of plasma carotenoids and babies born carotenemic because of their mothers' intake of large amounts of carotenoid-containing foods during pregnancy reveal no abnormalities attributable to the carotenoid molecule. PMID- 3287698 TI - The formation of reactive intermediates in the MAO-catalyzed oxidation of the nigrostriatal toxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). AB - Oxidation of MPTP by monoamine oxidase (MAO), leading to the formation of reactive metabolites, is a critical step in the expression of the nigrostriatal toxicity of this molecule. A catalytic mechanism for the 2-electron oxidation of MPTP to MPDP+ and for the further 2-electron oxidation of MPDP+ to MPP+ is proposed, involving the formation of carbon-centered radical intermediates. These radical species appear to be involved in the mechanism-based inactivation of MAO by MPTP, possibly by generating 1,4-dihydropyridine adducts with the enzyme apoprotein or its coenzyme FAD. The pathways of metabolism of MPTP in brain and peripheral tissues and the active accumulation of metabolites of MPTP in dopaminergic neurons are discussed in terms of their possible contribution to the selective cytotoxicity of the compound. PMID- 3287700 TI - Transcranial Doppler ultrasonography during cardiopulmonary bypass in patients with severe carotid stenosis or occlusion. AB - Blood flow velocity of the middle cerebral artery was monitored during cardiopulmonary bypass procedures by means of transcranial Doppler ultrasonography. Our investigation was carried out in a group of 16 patients with severe carotid stenosis or occlusion and in a control group of 42 patients with no or stenosis of less than 50% local diameter reduction. After onset of cardiopulmonary bypass, both groups showed a short unstable phase followed by increased blood flow velocity (10% increase ipsilateral to the obstruction, 27% increase in the control group). Just before rewarming, blood flow velocity was still comparable to (control group -3%) or higher than (ipsilateral to obstructions +14%) prebypass values. Analysis of three patients with postoperative diffuse encephalopathy did not reveal reduced blood flow during cardiopulmonary bypass as a relevant factor. Two of the three showed luxury perfusion. Reduced perfusion due to carotid obstruction was not observed during cardiopulmonary bypass and therefore cannot be considered a significant risk factor for the development of intraoperative stroke. PMID- 3287701 TI - Effects of prostacyclin, indomethacin, and heparin on cerebral blood flow and platelet adhesion after multifocal ischemia of canine brain. AB - Seven anesthetized dogs treated with prostaglandin I2, indomethacin, and heparin were compared with 12 controls to test the hypothesis that the salutary effect of treatment on recovery of neuronal function and cerebral blood flow (CBF) after ischemia is coupled to the inhibition of platelet accumulation. In this model of right hemisphere multifocal ischemia, cortical somatosensory evoked response (CSER) amplitude, 14C autoradiographic blood flow, and 111In-labeled platelet accumulation were measured. The ratio of injured to noninjured hemispheric 111In activity (cpm/g) provided an index of platelet accumulation. Treatment improved CBF of the injured hemisphere compared with control after 4 hours of reperfusion (74 +/- 17 versus 53 +/- 13 ml/100 g/min, p less than 0.05), and it enhanced recovery of CSER amplitude (percent of baseline) after 1 hour of reperfusion compared with control (27.1 +/- 4.7% [treatment] versus 15.5 +/- 2.8% [control], p less than 0.05). However, the effect on CSER was not sustained after 4 hours of recovery. Despite these effects on CSER and CBF, treatment failed to inhibit 111In-labeled platelet accumulation in the injured hemisphere (1.7 +/- 0.3% [treatment] versus 1.5 +/- 0.1% [control], p greater than 0.05). Platelets may adhere to damaged endothelium despite aggressive platelet antiaggregant therapy. PMID- 3287702 TI - Assessment of interobserver variability in a Dutch multicenter study on acute ischemic stroke. AB - Quantitative assessment of patient data is a pertinent part of controlled clinical studies. When several centers are involved, the degree of agreement between different observers becomes important. Therefore, in addition to developing a multicenter study on acute ischemic stroke, we have estimated the interobserver agreement expressed in terms of kappa statistics. Twelve patients suffering from neurologic deficits due to acute ischemic stroke were examined by four investigators, and the results were assessed using the Mathew scale. Considerable interobserver variability was found. Agreement on items based on subjective information from the patient was low, and it is also possible that this information changes with time. It is advised that in the development of assessment scales, items with low interobserver agreement should be avoided. PMID- 3287704 TI - Problems in therapeutic drug monitoring: the dilemma of enantiomeric drugs in man. PMID- 3287703 TI - Pentoxifylline in acute nonhemorrhagic stroke. A randomized, placebo-controlled double-blind trial. AB - The efficacy and safety of pentoxifylline were assessed in 297 adult patients with ischemic stroke in a multicenter, double-blind, randomized and placebo controlled trial. Treatment was started within 12 hours after the stroke onset. Study medication was administered intravenously continuously (16 mg/kg/day, maximum 1,200 mg/day) for 3 days and per os (400 mg t.i.d.) for the remainder of 28 days. Demographic data were comparable, and functional impairment and mortality (pentoxifylline 12%, placebo 10%) were not different between the two groups. Neurologic deficit scores improved from baseline admission scores during the 4-week study in both groups but did not differ between groups at admission or throughout the study except during the first few days when the consciousness level (Days 1 and 2), motor function (Days 1 and 2), cranial nerve function (Days 1-4), and total neurologic deficit scores (Days 1 and 2) were better in the pentoxifylline group than in the placebo group, especially in a subset of patients with severe deficits at admission. Laboratory values and side effects were also comparable between groups. Our study indicates that pentoxifylline can be given safely in patients with acute ischemic stroke. Although pharmacologic effects were present during the first few days, the clinical benefits were small and not sustained. PMID- 3287705 TI - A model to account for the variation in cyclosporin binding to plasma lipids in transplant patients. AB - The usefulness of therapeutic monitoring for cyclosporin in transplant patients is still open to question due to variability of the data. One source of variability, the binding within plasma, was examined in renal transplant patients undergoing cyclosporin therapy. The fraction unbound varied between 0.04 and 0.13. A model based on physiochemical principles, involving concurrent partition of the drug between water, cholesterol, and triglyceride, was used to account for the variation in binding. Simulations using this model indicate that plasma cholesterol is a major factor contributing to the variability in fraction unbound and that the effect of triglyceride is less by a factor of four. PMID- 3287706 TI - Distribution of cyclosporin A between blood cells and plasma of cardiac and renal transplant recipients. AB - The relationship between blood cells and plasma concentrations of cyclosporin A (Cy A) determined by radioimmunoassay, was investigated in 12 heart and 12 kidney transplant recipients. The decision between a linear and nonlinear model was made according to a standardized residuals plot. We observed high blood cells-plasma concentration ratios in the two groups, indicating a high affinity of Cy A for blood cells. The distribution of Cy A between blood cells and plasma was ascribed to a nonlinear saturable model in the two groups. According to our results we have simulated the blood-plasma concentration ratio of Cy A as a function of plasma Cy A concentration and hematocrit. PMID- 3287707 TI - Partial characterization of endogenous digoxinlike substance in human urine. AB - Urinary samples were collected from individuals not taking cardiac glycosides. Aliquots of 30 ml were passed through preparative octadecylsilane-bonded phase columns and eluted in fractions by stepwise increasing concentrations of acetonitrile. Eluted fractions were analysed for their contents of endogenous digoxinlike substance (EDLS) by radioimmunoassay of digoxin and by a bioassay of cardiac glycosides, which measures the uptake of rubidium (86Rb) by erythrocytes as an index of Na+, K+-ATPase activity. In both assays, digoxinlike activity was found in several fractions, but the highest values were consistently measured in the fractions eluted with 40% acetonitrile. Greater amounts of EDLS were recovered from the urine of pregnant women than from the urine of men and nonpregnant women. PMID- 3287708 TI - A modified assay for cyclosporin in blood using solid-phase extraction with high performance liquid chromatography. AB - A modified procedure for measuring cyclosporin in whole blood by high-performance liquid chromatography is described and evaluated for clinical use. Sample preparation uses solid-phase extraction cartridges that can be reused. Life of the reverse-phase analytical column exceeds 1,000 injections at 70 degrees C. Cyclosporins A and D (internal standard) elute after 5.6 and 7.6 min, respectively. Calibration plots are linear from 50 ng/ml to at least 2,000 ng/ml. Within-day and between-day imprecision is less than 9% (coefficient of variation). Minimum measurable concentration is 50 ng/ml. PMID- 3287709 TI - [Electron immunocytochemistry of lymphocyte surface immunoglobulins in the bursa of Fabricius in the pre- and early postnatal ontogeny of chickens]. AB - The appearance and localization of surface immunoglobulins on B-lymphocytes of the bursa of Fabricius of developing chick embryos and chicks were studied by immuno-electron-cytochemical peroxidase-antiperoxidase (PAP) method. Ultrastructural characteristics of marked and unmarked lymphocytes of the bursa of Fabricius was shown. The increase in the density of reaction product on PAP complex in the course of lymphocytes differentiation was established. PMID- 3287710 TI - [The double anniversary of Johannes Evangelista Purkinje]. PMID- 3287711 TI - [Parathyroid cancer. A review and 4 case reports]. PMID- 3287712 TI - [Increased working capacity in insulin-dependent diabetics treated with insulin pumps. A controlled study]. PMID- 3287713 TI - [Gastric duplication. Gastrointestinal hemorrhage caused by gastric duplication]. PMID- 3287714 TI - [Heart function and heart disease in diabetes mellitus]. PMID- 3287715 TI - [Anaerobic bacterial pneumonia]. PMID- 3287716 TI - [The empty sella and empty sella syndrome]. PMID- 3287717 TI - [Common peroneal palsy. A clinical and electrophysiological review]. PMID- 3287718 TI - [The consequences of the introduction of ultrasound]. PMID- 3287719 TI - [Ultrasonically guided percutaneous drainage of intra-abdominal abscesses]. PMID- 3287720 TI - [Urethroplasty with a preputial patch in recurrent urethral stricture]. PMID- 3287721 TI - [Anesthesia and cigarette smoking]. PMID- 3287722 TI - [Bacteriological autopsy. The value of postmortem heart blood culture]. PMID- 3287723 TI - [Intraspinal migration of a pistol bullet]. PMID- 3287724 TI - [Mechanical bowel preparation prior to elective colorectal surgery]. PMID- 3287725 TI - [Orphenadrine and postoperative pain]. PMID- 3287726 TI - [Ion generator and asthmatic bronchitis/bronchial asthma. Evaluation of an ion generator in the treatment of recurrent asthmatic bronchitis and bronchial asthma]. PMID- 3287727 TI - [Evacuation of the colon prior to radiography. Is magnesium citrate an improvement?]. PMID- 3287729 TI - [Nephropathy of unknown origin. Uroradiological examination]. PMID- 3287728 TI - [Klebsiella pneumoniae as the cause of arthritis of the knee]. PMID- 3287730 TI - [Refractive surgery. A review of keratoplastic interventions]. PMID- 3287731 TI - [Peroperative ilio-inguinal block in children]. PMID- 3287732 TI - [Penile block in circumcision. Peroperative use as postoperative analgesia in children]. PMID- 3287733 TI - [Sublingual administration of flunitrazepam (Rohypnol) and lorazepam (Temesta) for premedication. A randomized double-blind study]. PMID- 3287734 TI - [Value of anticoagulant therapy in deep venous thrombosis in the lower limb in elderly, mobilized patients. A double-blind placebo controlled study with open therapeutic guidance]. PMID- 3287735 TI - [Fistula between the trachea and the innominate artery after tracheostomy]. PMID- 3287736 TI - Inferior colliculus and related descending pathways in rat. PMID- 3287737 TI - Norfenefrine in the treatment of female stress incontinence. A double-blind controlled trial. AB - Forty-four consecutive patients with genuine stress incontinence were treated with norfenefrine 15-30 mg t.i.d. in a 6-week, double-blind and parallel, placebo controlled study. Subjectively, 52% were improved and 26% became continent during norfenefrine treatment. Objectively (stress test), 30% became continent and the maximum urethral closure pressure increased 10% which was statistically significant. These results, however, were not statistically different from those of placebo treatment. Simultaneously, subjective and objective improvement was seen more often in patients given norfenefrine compared to placebo (p less than 0.1). In patients with most severe incontinence according to urodynamic criteria the effect of norfenefrine was statistically significantly better than placebo. A low incidence of side effects was observed and no differences between norfenefrine and placebo were found. It is concluded that norfenefrine may be of value in the treatment of female stress incontinence. PMID- 3287738 TI - [Urethro-adnexitis of the male and sexually transmissible pathogens. A report of experiences of the Giessen study group]. AB - In recent years, the improvement in microbiological diagnostic methods has caused the spectrum of infectious agents causing male urethroadnexitis to expand considerably. In addition to the well-known urinogenic enterobacteriae and enterococci and the sexually transmitted gonococci and trichomonads, Chlamydia trachomatis and Ureaplasma urealyticum must now be considered particularly important etiologic agents that are sexually transmitted. Their cell biology and epidemiology, our diagnostic procedures, and the criteria of etiologic classification of male urethroadnexitis are described in detail. The recently developed quinolone derivates offer new and promising therapeutic perspectives. PMID- 3287739 TI - [Stage-adapted pain therapy in advanced malignant urologic diseases]. AB - In advanced urological malignant diseases pain therapy is frequently of prime importance. Considerable progress in this area has led to the treatment of pain being taken on increasingly by specialized groups, in some cases without feedback to the urologist. In this situation it seems expedient for a urologist working in the field of oncology to be thoroughly informed of the present status of knowledge in modern pain treatment. The opportunities opened up by interdisciplinary team work directed by a urologist are pointed out, as are the requirements this imposes. The current chances of medicamentous cancer pain therapy and the treatment options in the fields of anaesthesiology, neurology and neurosurgery are touched upon with reference to the pathophysiology of chronic painful conditions. PMID- 3287740 TI - [Nongerminal, benign testicular tumors--report of experiences]. AB - Between 1983 and 1986 179 inguinal testicular explorations were performed. Testicular palpation and sonograms were carried out. 163 patients (91%) had malignant testicular tumours. 16 patients (9%) were found to have benign, nongerminal testicular tumours. When intraoperative frozen section diagnosed epidermoid cysts, the majority of these were enucleated, while the dermoid cysts and Leydig cell tumours were removed together with the testicle. The postoperative follow-up on all patients showed no evidence of local recurrence or metastases. PMID- 3287741 TI - Comparison of techniques for vesicourethral anastomosis: simple direct versus modified Vest traction sutures. AB - Radical retropubic prostatectomy has become a mainstay surgical procedure in the treatment of cancer of the prostate. There has been controversy, however, regarding the most appropriate method of vesicourethral reconstruction. We examined the records of 692 consecutive patients who underwent a radical retropubic prostatectomy from 1978 through 1984 at the Mayo Clinic. Of these, 416 patients underwent a modified Vest procedure, and in 276 patients a direct simple anastomosis was fashioned. In comparing these two methods, our review showed no substantial difference in complications, including the rate of urinary incontinence. PMID- 3287742 TI - Nondilated obstructive uropathy. AB - Four patients presented with severe renal failure secondary to urinary tract obstruction, yet ultrasonography and/or computed tomography revealed only minimal dilatation in 1 patient and no dilatation in the other three. Two patients had prostate cancer, one had bladder cancer, and one had retroperitoneal fibrosis. In all cases, relief of obstruction led to a dramatic improvement in renal function. These cases, and others in the literature, illustrate that in certain settings severe urinary tract obstruction may be present in the absence of dilatation and hence may be missed by noninvasive imaging techniques. Nondilated obstructive uropathy should be suspected in any elderly patient who presents with the acute onset of oliguria in the absence of an identifiable cause, especially if there is a previous history of malignancy in the pelvis. Left undiagnosed, this potentially reversible cause of renal failure can lead to end-stage renal disease. PMID- 3287743 TI - Management of ureteropelvic junction obstruction in neonate. AB - Fetal hydronephrosis demonstrated by maternal ultrasonography should lead to early investigation during the neonatal period. Postnatal confirmation of the diagnosis of ureteropelvic junction obstruction usually can be established by combining the radiologic modalities of ultrasound, diuretic isotope renal scan, and voiding cystourethrography. Rarely should intravenous urography, antegrade pyelography, or cystoscopy and retrograde pyelography be necessary. Findings of high-grade obstruction and/or significantly diminished function on the affected side(s) should prompt early neonatal reconstruction. Pyeloplasty was performed within the first month of life in 17 infants (20 kidneys) diagnosed as having significant ureteropelvic junction obstruction. Early reconstruction in the neonatal period can be performed successfully with minimal complications and a relatively brief period of hospitalization. This may ultimately achieve maximal preservation of renal function. PMID- 3287744 TI - Delayed retropubic urethroplasty of completely transected female membranous urethra. AB - Injuries to the female urethra, especially in childhood, are rarely seen with pelvic trauma. Complete transection of the membranous urethra was sustained by a ten-year-old girl in a car accident. A delayed retropubic urethroplasty after suprapubic cystostomy drainage was accomplished. The technique of the repair is described. Delayed repair in a female child is an excellent alternative to primary realignment if a primary repair cannot be accomplished. PMID- 3287745 TI - Page kidney phenomenon in kidney allograft following peritransplant lymphocele. AB - A case of kidney allograft dysfunction in a recipient with a prior lymphocele is described. We attribute it to a Page kidney phenomenon caused by a constrictive pericapsular fibrosis. Surgical exploration and excision of the fibrotic tissue were followed by the recovery of renal transplant function. To our knowledge, only 1 case of Page kidney in renal allograft due to peritransplant hematoma has been described in the literature. PMID- 3287746 TI - Relative merits of MRI, transrectal endosonography and CT in diagnosis and staging of carcinoma of prostate. AB - Magnetic resonance imaging (MRI) and transrectal sonography of 27 patients with biopsy-proved carcinoma of the prostate were performed to compare the sensitivity of these modalities to each other for diagnosis and to computed tomography (CT) for staging. Sonography was superior to MRI for the detection of intraglandular carcinoma and capsular disruption. MRI was superior to both sonography and CT for evaluating seminal vesicle invasion, and slightly better than CT for detecting lymphadenopathy. PMID- 3287747 TI - Aztreonam in treatment of intra-abdominal infections. AB - Aztreonam is a monobactam antibiotic with a broad antimicrobial spectrum against Gram-negative facultative bacteria. It possesses many of the characteristics of antibiotics that are useful for the treatment of intra-abdominal infections. While this drug is effective against the Gram-negative enteric bacilli usually encountered in intra-abdominal infections, it is not practical as a single agent since anaerobic bacteria are not susceptible to aztreonam. The use of aztreonam avoids the nephrotoxicity and ototoxicity associated with aminoglycoside antibiotics. Its pharmacokinetic parameters allow administration 3 or 4 times daily, and it is less expensive than many alternative agents. Studies comparing aztreonam to tobramycin in patients who also received clindamycin for acute appendicitis note similar rates of success in both antibiotic treatment groups. PMID- 3287748 TI - Role of aztreonam in lower respiratory tract infections. AB - Pneumonia caused by Gram-negative bacteria is a major cause of morbidity and mortality among hospitalized and immunocompromised patients. Most antibiotic regimens used to treat these pulmonary infections include aminoglycoside antibiotics. Since achievable serum and tissue levels of aminoglycosides are limited by dose-related nephrotoxicity and ototoxicity, alternative forms of antibiotic therapy would be desirable. Aztreonam, the first clinically available monobactam antibiotic, achieves high serum levels and adequate levels in bronchial secretions and lung parenchyma for efficacy against most Gram-negative pathogens implicated in nosocomial pneumonias. The results of early clinical trials comparing aztreonam with aminoglycosides for treatment of Gram-negative bacterial pneumonias indicate that this monobactam antibiotic is a safe, effective alternative to aminoglycoside therapy. PMID- 3287750 TI - Microbiology and pharmacology of aztreonam. AB - Aztreonam, the first monobactam antibiotic, represents a significant evolutionary advance in antimicrobial therapy. Aztreonam is stable in the presence of the hydrolytic beta-lactamase enzymes; as such, it is effective against most Gram negative aerobes, including Pseudomonas aeruginosa, Escherichia coli, Klebsiella, and Enterobacter. Due to its specific spectrum of activity, aztreonam does not disturb the normal Gram-positive and anaerobic intestinal flora. The safety profile of aztreonam is superior: unlike the aminoglycosides, aztreonam does not cause nephrotoxicity or ototoxicity, and no routine monitoring of serum levels is required with its use. The pharmacokinetics of aztreonam after intravenous infusion or intramuscular dosing are presented as well as the dosage adjustments for hemodialysis and chronic ambulatory peritoneal dialysis (CAPD). PMID- 3287749 TI - Role of aztreonam in urinary tract infections. AB - Bacterial colonization is the necessary first step in the etiology of all urinary tract infections. The hospital setting provides a pool of pathogenic bacteria which may lead to colonization in the hospitalized patient. The nosocomial infections which may follow and require treatment most often follow catheterization. Some host factors often lead to persistence of colonization and invasive symptomatic disease. These might include stone, caliceal diverticula, a hydronephrotic kidney, vesicoureteral reflux, bladder neck obstruction with residual urine, urethral diverticula, and infection of the prostate, as well as other disease states such as diabetes mellitus, cancer, or drug immunosuppression. Bacterial virulence must also be considered, but since normal host barriers are broken down by catheterization or instrumentation, usually avirulent bacteria are the more common cause of nosocomial urinary tract infections. Increasing bacterial resistance to antibiotics has been recognized among nosocomial infections. Thus, for a stringent trial, any new drug should be used to treat infections due to bacteria with multiple antibiotic resistance. The antibiotic must be active against the organisms, and early follow-up should evaluate both microbiologic and symptomatic cure. Late follow-up should show that there is no persistence of the original organism. New antibiotics should show some advantage over present antibiotics being used for treatment. Aztreonam offers an advantage over aminoglycosides in that it is neither ototoxic nor nephrotoxic. It appears to cause less antibiotic resistance in bacteria colonizing the intestine and therefore holds an advantage over most of the beta lactam antibiotics. In addition, aztreonam does not appear to be haptogenic and has shown little cross-allergenicity to either penicillins or cephalosporins. Worldwide trials of the drug suggest that aztreonam is as efficient, if not more so, than the third-generation cephalosporins, newer penicillin derivatives, and the aminoglycosides in the treatment of Pseudomonas and other bacteria causing nosocomial urinary tract infections. PMID- 3287751 TI - Tropical fish medicine. Fish cytology and hematology. AB - Cytology and hematology can provide valuable information during the evaluation of fish patients. Although more commonly practiced with larger species of fish, hematologic evaluation aids in the identification of diseases that have an effect on the cells in peripheral blood in the same manner as in mammalian and avian patients. Cytology provides clinical diagnostic support in the evaluation of the health status of even the smallest fish. PMID- 3287752 TI - Tropical fish medicine. Bacterial culture and evaluation of diseases of fish. AB - Bacteria are ubiquitous in nature. Fish are constantly exposed to bacteria, and usually only succumb to an infection after having been exposed to prolonged periods of stress. Before making a diagnosis of a bacterial disease, it is necessary to eliminate the possibility of environmental or parasitic problems. Environmental factors may act as stressors and can predispose a fish to bacterial disease while affecting the fish simultaneously. Clinical signs caused by the various bacterial pathogens are very similar. Therefore, to make a definitive bacterial diagnosis, it is necessary to culture and identify the organisms involved. PMID- 3287753 TI - An investigation of mastitis due to S agalactiae, S uberis and M smegmatis in a dairy herd. AB - Subclinical mastitis caused by streptococcal infections affected 27 of 83 cows in a commercial dairy herd. Between three and six weeks after intramammary treatment of these cows with cloxacillin, 16 (59 per cent) of the treated cows developed acute clinical mastitis associated with Mycobacterium smegmatis. None of the untreated cows was affected. Infected quarters were moderately hypertrophied and fine clots were present in the milk for three to four weeks. No cows showed systemic signs of illness. Studies carried out over 12 months showed that infected cows shed M smegmatis for three to four months and affected quarters remained hypertrophied in all but one cow after 12 months. The mean milk cell count of affected quarters fell slowly from 4,850,000/ml in the acute stage to 810,000/ml five months later and 620,000/ml 12 months later, suggesting that the organism persisted in the udder. The estimated mean loss in lactation yield for cows with M smegmatis mastitis was 10.8 per cent. Losses were greatest when the hind quarters were involved (mean 28 per cent for cows with both hind quarters affected). Ten of the 16 affected cows were ultimately culled owing to serious reductions in yield. PMID- 3287754 TI - Canine leishmaniasis. A review based on 95 cases in The Netherlands. AB - The clinically relevant aspects of canine leishmaniasis are reviewed. Included are data from 92 dogs imported from the Mediterranean basin and at least 2 autochthonous cases. New aspects on pathogenesis are presented, including evidence that canine leishmaniasis is an immune complex disease. Therapy with meglumine antimonate (Glucantime) is evaluated. The hazards of imported canine leishmaniasis for public health are discussed. PMID- 3287755 TI - Quantitative correlation of parasitological and serological techniques for the diagnosis of Trypanosoma congolense infection in cattle. AB - A comparison was made between serological and parasitological techniques for the diagnosis of bovine trypanosomiasis in Zambia. Overall sero-prevalence rates as determined by IFAT and ELISA were respectively 2.7-fold and 2.9-fold greater then the percentage of samples found positive with the dark ground/phase contrast buffy coat technique (DG). The results obtained by the two serological techniques were found to be closely correlated (94.2%) agreement) and titres obtained by ELISA tended to be slightly higher than those obtained by IFAT. Linear regression analysis of the results obtained by the IFAT and DG techniques revealed a highly significant correlation. This finding would permit the use of only one of the techniques in an epidemiological survey and to extrapolate the results from the regression line. PMID- 3287756 TI - Therapeutic efficacy of doxycycline hyclate in experimental Escherichia coli infection in broilers. AB - Treatment of experimentally induced colibacillosis in broilers with doxycycline hyclate through the drinking water was just effective at a dose of 200 mg/kg body weight (1000 ppm). The achieved therapeutic effects were similar to those of tetracycline at the same dose and of flumequine at a dose of 19 mg/kg body weight (100 ppm). PMID- 3287757 TI - The protective value of vaccine-induced neutralising antibody titres in swine fever. AB - The relationship between vaccine-induced antibody titres against swine fever virus (SFV), as measured by the neutralisation peroxidase-linked assay (NPLA), and protection against virus multiplication, excretion and transmission, disease and death was studied in 46 pigs. The pigs were housed individually and challenged intranasally with 100 pig ID50 of the virulent Brescia strain of SFV. In order to detect virus transmission, a swine fever (SF)-susceptible sentinel pig was placed in contact with the vaccinated animal 2 days after challenge. All 11 pigs with pre-challenge NPLA titres less than 12.5 responded to the challenge with fever, 8 out of 10 showed leucopenia, 7 transmitted virus to their contact and 3 died. Of the 9 animals with titres greater than or equal to 12.5 and less than 25, 8 developed fever, 6 out of 7 had leucopenia, 2 excreted and/or transmitted virus and all survived. Of the 12 pigs with pre-challenge titres greater than or equal to 25 and less than 50, 5 responded with fever, 6 out of 10 had leucopenia, 4 excreted virus and none died. Although all pigs with prechallenge titres greater than or equal to 50 showed a booster response, virus transmission was not observed, indicating that in the case of exposure such animals would not contribute towards the spread of field virus. From an epidemiological point of view, titres less than 32 were found inadequate. PMID- 3287758 TI - Detection of enterotoxigenic Escherichia coli in piggeries in Victoria by DNA hybridisation using K88, K99, LT, ST1 and ST2 probes. AB - Rectal swabs collected from piglets with diarrhoea from commercial pig farms were examined for the presence of enterotoxigenic Escherichia coli (ETEC) using DNA hybridisation methods. The probes specifically detected genes for the K88 and K99 fimbrial antigens and the heat-labile and heat-stable enterotoxins. DNA hybridisation methods detected more ETEC than could be detected by either enzyme linked immunosorbent assay (ELISA) or slide agglutination methods, and also offered the opportunity to test for fimbrial antigens and toxins concurrently. The DNA hybridization method was shown to be applicable to ETEC detection in mixed growths cultured directly from rectal swabs to filters. The method eliminates the need for toxin tests using animals and enables very large numbers of samples to be investigated. The use of toxin probes has revealed large numbers of ETEC with uncharacterized fimbrial antigens. PMID- 3287759 TI - [Virological research on appendicitis]. AB - Investigations were conducted on groups of subjects hospitalized in surgery services with a clinical diagnosis of acute or chronic appendicitis, to detect the presence of inframicrobial antibodies and antigens, as well as that of the C reactive protein in these patients as compared with a control group. The results of serological tests and of the examination of pieces of appendix are also presented. The obtained data are used as arguments for the theory of an inframicrobial infection part in some acute and chronic forms of appendicitis. PMID- 3287760 TI - [Moments in the history of ideas on the nature and origin of viruses]. PMID- 3287761 TI - [Role of carcinogenic factors in the external environment in the development of a hereditary predisposition to tumor growth (experimental data)]. PMID- 3287763 TI - [Immunomorphologic study of pepsinogens in stomach cancer]. AB - Pepsinogens were studied in histological specimens of gastric carcinoma by indirect immunoperoxidase method. They were identified in 14 out of 24 intestinal tumors and in 2 out of 6 mixed carcinomas, but none was found in any of 10 diffuse carcinomas. Pepsinogen C was found in all pepsinogen-positive tumors, pepsinogen A--in 11 of them, and an antigen common with swine pepsin--in 2 tumors only. The pepsinogens were also observed in metastases of pepsinogen-positive primary tumors. PMID- 3287762 TI - [Role of trace elements in the etiology and pathogenesis of tumor growth]. PMID- 3287764 TI - [Controversial problems in cancer immunology]. PMID- 3287765 TI - [On the criticism of antitumor immunity: arguments for and against]. PMID- 3287766 TI - Evaluation of three second-generation and three confirmatory assays for antibodies to human immunodeficiency virus. AB - The second-generation enzyme immunoassays (EIAs) for antibodies against human immunodeficiency virus (HIV) from three manufacturers (Abbott, Organon, Wellcome) and three anti-HIV confirmatory tests, i.e. Western Blot (WB, Biotech, Dupont), radioimmunoprecipitation assay (RIPA, CLB) and a competitive immunoassay (CIA, Abbott) were evaluated on a panel of 6,488 serum samples, which had previously been used for the comparison of seven first-generation EIAs. For the present study the panel was expanded with sequential serum samples from 12 individuals followed at 1- to 3-month intervals during seroconversion for anti-HIV. The second-generation EIAs and confirmatory tests were significantly more sensitive than the first-generation EIAs as was demonstrated by detection of 10- to 100 fold higher endpoint titers in anti-HIV-positive sera as well as by earlier detection of anti-HIV in 7-11 of the 12 subjects, who seroconverted. In all sera obtained during early HIV infection anti-gp 160/120env antibodies (WB, CIA) were found in addition to anti-p24 (WB, RIPA) and in serial twofold dilutions of these 'seroconversion samples' the new Abbott EIA and RIPA were significantly more sensitive than WB (p less than 0.05), whereas CIA and the new Organon EIA were significantly less sensitive than WB (p less than 0.05). The new Wellcome EIA was not statistically less sensitive than WB. The CIA was as sensitive as WB for antibodies to envelope proteins (gp41, gp160, gp120), but considerably less sensitive for core (p24) antibodies, as was shown in sera obtained during early as well as later clinical stages of HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287768 TI - [Influence of physicians born in Hungary on the development of medicine in Vienna]. AB - The curricula vitae of Hungarian-born eminent physicians who worked in Vienna primarily during the 19th century were compiled. The reason for doing so was the 150th anniversary of the foundation of the Society of Physicians in Budapest. PMID- 3287767 TI - [Clinical use of the artificial heart, indications and results]. AB - Clinical experience with the artificial heart now comprises 520 cases. 390 patients had to be supported mechanically when they could not be weaned off cardiopulmonary bypass. 177 (45%) subsequently had their assist devices removed and 100 (25.4%) were discharged. Good functional results were achieved, since 30 of 36 long-term survivors are in NYHA class I or II. 140 underwent two-stage cardiac transplantation. Of 63 patients implanted with a ventricular assist device (VAD) 71% were transplanted and 51% survived. A total artificial heart (TAH) was used in 77 cases, 81% were transplanted and 47% survived. Five patients received TAH implantations as a permanent replacement of the failing heart. Though the clinical courses were complicated by strokes and infections and the patients were tethered to bulky drive units, it was proven that the TAH may sustain human life for up to 622 days, much longer than so far achieved in animal experiments. Improvements of the atrial connectors and valve holding components and of the biocompatibility of the blood contacting surfaces should overcome the complication of thromboembolism. Fully implantable devices which are currently being developed will avoid the problem of drive-line infections and provide fuller mobility to the patient. PMID- 3287770 TI - [Combined antisecretory therapy in patients with duodenal ulcer]. AB - The ulcer healing effect of the combination of pirenzepine and cimetidine was compared to the cimetidine monotherapy in 60 duodenal ulcer patients, in whom previous cimetidine monotherapy (at the dose of 1000 mg/day for 4 weeks) had not produced any healing effect. The study was conducted in a prospective, double blind, random fashion. In 30 patients the cimetidine monotherapy was continued at the dose of 1000 mg/day. The other 30 patients received the combination of pirenzepine (75 mg/day) and cimetidine (400 mg at bedtime). Endoscopy was carried out before and after 4 weeks therapy. In the cimetidine group the ulcers have been cured in 12 cases. The cure rate was higher with the combination therapy: control endoscopy showed healed ulcers in 24 patients in this group. The difference between the two groups is statistically significant (chi 2-Test: 10.0, p less than 0.001). These results indicated a higher effectiveness of the pirenzepine-cimetidine combination in duodenal ulcer patients who had not previously responded to cimetidine alone. PMID- 3287769 TI - [Chronic invasive fibrous thyroiditis (Riedel struma). Case report with special reference to preoperative diagnosis]. AB - Chronic invasive fibrous thyroiditis (Riedel's struma) is a very rare disease of unknown aetiology mainly affecting middle-aged or old female patients. An aggressive fibrosis partly or totally replaces normal thyroid gland tissue. The gland becomes stony hard, is not displaceable and, characteristically, the fibrous tissue penetrates the capsule and infiltrates into surrounding structures such as muscles, vessels, nerves and even the trachea. Riedel's struma is often associated with fibrotic processes in other parts of the body. The preoperative differential diagnosis includes malignant tumours and fibrosing stages of Hashimoto's disease, as well as subacute thyroiditis de Quervain. This paper reports the case of a 60-year-old woman suffering from Riedel's struma and discusses differential diagnostic aspects with regard to preoperative investigation and pathohistology. PMID- 3287772 TI - Sociological and social anthropological approaches to food and eating. PMID- 3287771 TI - [Psychosexual disorders following genital operations in urology]. AB - Psychosexual and functional disorders following genital surgery can be understood within the context of general adaptation/maladaptation with severe illness and cancer. The psychodynamics and phases of psychic crises are described. Genital surgery injures sexual identity. The specific sexual consequences are psychosexual disorders such as avoidance, inappetence, specific anxieties, and functional disorders. As etiologic factors, unspecific psychogenic effects, more individual psychogenic symptomatology, and specific physical impairment of sexual functions overlap, in accordance to type of illness and surgery. These aspects are demonstrated by clinical problems. The consequences for psychological counselling and information of patients are discussed. PMID- 3287773 TI - Caries prevention with xylitol. A review of the scientific evidence. PMID- 3287774 TI - Nitrogen utilisation by ruminant animals. PMID- 3287775 TI - Opioid peptides from food (the exorphins). PMID- 3287776 TI - Selenium-related endemic diseases and the daily selenium requirement of humans. PMID- 3287777 TI - Metabolic fate of indeloxazine hydrochloride: alpha-glucoside formation in rats. AB - 1. After oral administration of indeloxazine hydrochloride ((+/-)-2-[(inden-7 yloxy)methyl]morpholine hydrochloride) to rats, two conjugates, which were labile to alpha-glucosidase hydrolysis but refractory to beta-glucosidase, were isolated from the urine. 2. Mass spectral and n.m.r. analyses confirmed that these conjugates were alpha-D-glucopyranosides of M-2 (trans-4-(2-morpholinylmethoxy) 1,2-indandiol) and M-3 (trans-6-[[(1,2-dihydroxy-4-indanyl)oxy]-methyl]-3 morpholinone). 3. These are probably the first examples of foreign compounds conjugated with glucose in the alpha-configuration. PMID- 3287778 TI - [Health care needs and health care organization for citizens of advanced age]. AB - In order to improve the health and well-being of the elderly, it is necessary to develop and assess care programs for the elderly within existing health and social services. An epidemiological approach in assessing the functional health and autonomy are described using the concepts of disability and handicap (according ICIDH). A design for estimating need and for identifying high-risk groups in a population survey are presented. PMID- 3287779 TI - [Differential use of psychotropic and nootropic drugs in cerebrovascular disorders]. PMID- 3287780 TI - [The sociology of coping with disease--questions, prerequisites, research approach and general practice significance]. AB - Coping is reflected on a social scientific view. Starting points: 1. the knowledge, that alone the kind and grade of disease not predistine the reactions, loads and quality of life of the patient and 2. the unknowledge about the fact, why patients "better" than other cope this critical living situation. Our position is, that social conditions and individual competences are important facts which determine the experience of chronic disease. The attention of sociological research is directed to a classical problem: What does social competences and social support mean for coping of disease? The article discuss theoretical foundations and it's empirical and practical transformation. It is a contribution of interdisciplinary cooperation between sociologists, psychologists and physicians to the problem of coping of chronical disease. PMID- 3287781 TI - [Serum vitamin A determinations and their value in determining vitamin A status]. AB - As demonstrated in the literature on vitamin A metabolism and homeostasis of retinol in serum, the concentration of retinol in serum is regulated very exactly if the liver stores are within the physiological range (20-300 micrograms/g liver). Therefore, the serum level indicates the status of vitamin A storage only if there is an extreme depletion or overconsumption of vitamin A. At marginal depletion, however, there is damage to peripheral tissue before changes in the vitamin A level in serum occur. At the beginning of hypervitaminosis A, changes in the level of vitamin A in serum also occur later. Therefore, the determination of vitamin A in serum gives no information on the adequacy of liver reserves for judging the necessity of a substitution. PMID- 3287782 TI - [Value of computerized tomography and ultrasonic diagnosis in acute pancreatitis]. AB - While the diagnosis of the acute pancreatitis is now as ever made clinically, the significance of ultrasound and computed tomography (CT) lies above all in the demonstration of morphologic changes and their extent. When the statements of the ultrasonic diagnosis are sufficient in easy stages of the acute pancreatitis and for the recognition of a more severe stage as well as for the control of the course, an evident assessment of the haemorrhagic necrotizing pancreatitis, in particular before operation, is possible only with the help of the CT. Only with its help we succeed in a comprehensive demonstration of the necroses, formations of abscesses, haemorrhages as well as of the ways of necrosis. The better availability and the riskless possibility of carrying out the ultrasonic diagnosis with altogether high evidence allow a narrow-meshed control of the course of the acute pancreatitis. PMID- 3287783 TI - [Local cutaneous amyloidoses. Report of 3 cases with lichen amyloidosus and 2 cases with nodular amyloidosis]. AB - We report on the clinical and histological features of lichen amyloidosus (3 cases) as well as localized nodular amyloidosis (2 cases: a man and a woman). Regarding lichen amyloidosus, our morphological and immunohistochemical findings suggest that amyloid is derived from keratinocytes. In nodular amyloidosis, the origin of amyloid may possibly be connected with plasma cells. PMID- 3287784 TI - [Sedimentation of nucleoids from rat thymus and spleen cells following whole-body irradiation]. AB - The sedimentation of nucleoids from thymic and splenic cells of rats was tested following total-body X-irradiation (TBI) with doses ranging from 24 to 1520 cGy. The principal results may be summarized as follows: 1) The nucleoid sedimentation of the cells was reduced immediately after TBI with doses of greater than or equal to 760 cGy. In the following postirradiation period, an enhancement of sedimentation rate has been observed which could be neutralized by addition of proteinase K to the nucleoid preparation. 2) When nucleoids were prepared 6 h after TBI with doses greater than or equal to 190 cGy, beside the main nucleoid band a smaller nucleoid fraction appeared in the ethidium bromide containing saccharose gradient. This fraction was of less sedimentability than the main nucleoid peak and could not be distinguished from pure, high molecular DNA. From the present results it is suggested that the reduction of the nucleoid sedimentation immediately following high doses of TBI is the result of primary (non-repaired) DNA lesions whereas the changes detectable some hours later are due to the secondary enzymatic changes connected with the interphase death of the cells. With respect to the detection of in vivo effects of X-irradiation, the nucleoid sedimentation has to be regarded much less sensitive than some biochemical and/or cytomorphological methods. PMID- 3287785 TI - Selective binding of amino acid residues to tRNA molecules detected by anticodon anticodon interactions. AB - Anticodon-anticodon pairing of complementary tRNA's has been studied by fluorescence temperature jump measurements in the presence of different ligands as an approach for the evaluation of ligand binding to tRNA. This procedure is particularly useful for ligands which do not show spectroscopic changes upon binding, but affect the pairing potential of anticodons. Addition of phenylalanine-, tyrosine- and tryptophan-amide leads to a substantial decrease of the tRNAPhe.tRNAGlu pairing constant Kp, whereas Kp remains almost unaffected by addition of leucine amide and increases upon addition of glycine amide. The effects observed for the aromatic amino acid amides can be described quantitatively by a site binding model with preferential binding of the amides to tRNAPhe. The binding constants evaluated according to this model (Phe-amide 120 M 1, Tyr-amide 160 M-1 and Trp-amide 580 M-1) are consistent with values obtained independently by fluorescence titrations with tRNAPhe. Selective binding of these amino acid residues to tRNAPhe is deduced from the observed concentration dependence which is not compatible with a corresponding binding process to tRNAGlu. Addition of glutamic acid diamide induces an increase of the tRNAPhe.tRNAGlu pairing constant, which is however equivalent to that observed for tRNAPhe.tRNALys pairing and thus does not demonstrate a selective binding to tRNAGlu. The pairing of tRNAPhe with tRNAGlu is strongly enhanced by addition of Mg2+ or spermine. Evaluation of the Mg2+ data by a site model leads to constants of 360 M-1 for the binding of Mg2+ to monomer tRNA and 3000 M-1 for the binding of Mg2+ to the tRNAPhe.tRNAGlu dimer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287786 TI - [Leukocyte obstruction (plugging) of the capillaries in vivo]. PMID- 3287787 TI - [Intravital microscopy: morphological, dynamic and functional aspects]. PMID- 3287788 TI - [General principles of the organization, functioning and regulation of the microcirculatory system of the liver]. PMID- 3287789 TI - [Immunodiagnosis of cutaneous leishmaniasis]. PMID- 3287790 TI - [Holographic homologies of biological motivation in the systems organization of behavioral acts]. PMID- 3287791 TI - [The creative course of P. K. Anokhin (on the 90th anniversary of his birth)]. PMID- 3287792 TI - [Reflection in the electrical activity of the brain of the activities of the mechanisms regulating the functional state]. AB - On the basis of analysis of the results of author's studies and literature data, theoretical notions are developed, according to which spatial-temporal organization of cortical biopotentials is a result of activity of nonspecific different level systems subtly regulating current alertness in conformity with needs of the actual and forthcoming activities. In the hierarchy of regulating systems, in conditions of alertness, nonspecific thalamic and midbrain system is leading. Activity of these regulation levels provides in alertness for formation and destruction of functional neuronal ensembles which realize elementary informational transformations. The role is emphasized of asynchronous processes in the central nervous system activity. PMID- 3287793 TI - [Cardiovascular diseases: a medical and social problem]. AB - Cardiovascular diseases are still the most important cause of death in industrialized countries. In spite of enormous progress regarding prevention, diagnostic and therapeutic procedures, coronary heart disease remains the most important cardiovascular cause for early invalidity, professional inactivity and premature death. The direct and indirect costs of cardiovascular diseases amount to 14.8% of total disease related costs. The future challenges are clear: this disease group is to a large extent preventable; efficient intervention models both on an individual and on a community level are available. Still, some more research on etiology, e.g. in relation to social class gradients is needed. In addition, the disease and its role within society and the health care structure should also be subject to research. PMID- 3287794 TI - [Clinical aspects and problems of pigeon breast and funnel chest]. AB - Chest wall protrusion and depression deformities, also known as funnel chest and pigeon chest, are nosologically a uniform entity. Our own histopathological studies revealed secondary changes, found likewise in arthroses, scolioses, aseptic osteonecroses and inflammatory processes, as well as changes found in so called primary collagenous diseases of unknown aetiology. Investigation of the collagen metabolism did not disclose differences from the normal II-type collagen either qualitatively or quantitatively. The aetiology of funnel chest and pigeon chest can be defined as follows: A hereditary disturbance of metabolism results in weakening of the wall of the parasternal cartilage, effecting a deformation secondary to mechanical strain by respiration and growth. Psychocosmetic reasons are recognised as indication for operation. In our opinion, the optimal age for operation is the second to the sixth year of life. During 20 years, 765 patients were operated on at our hospital without lethality. Postoperative complications were pneumothorax (4%), pneumonia (2%), after bleeding (2%) and disturbed wound healing (7%). Late results 5 years following surgery were excellent in 57%, good in 27%, satisfactory in 10% and unsatisfactory in 6% of the cases, thus adding up to 84% good results. PMID- 3287795 TI - [Hieronymus Cardanus (1501-1576): a forgotten pioneer of dentistry]. PMID- 3287796 TI - [Occlusal-periodontal loading is now quantitatively measurable: a new use of Periotest procedures]. PMID- 3287797 TI - [Terminology in plastic and reconstructive surgery]. AB - Precise definition is essential to diagnosis of diseases, therapeutic approaches, including surgical methods, and techniques. Terminological confusion may create insecurity among those seeking advice and may lead to erroneous consequences. The scope of Plastic and Reconstructive Surgery is outlined in this paper, and some major terms are interpreted. PMID- 3287798 TI - [New aspects of adequate postoperative prosthetic management following mastectomy]. AB - The availability of one unitised organ replacement model is no longer sufficient for adequate prosthetic care at any time. The first phase of a complex system of prosthetic care was completed by the development of "femi-Form", an epithesis master model, in 1982. Two more variants were introduced in 1986, "femi-Form S" and an interim prosthesis. The complex system of prosthetic care in its totality is considered to be an important step in public health. Great attention is given to it in the GDR for follow-up treatment in the context of tumour diseases. Manufacturers are expected to go to great lengths in developing adequate prosthetic devices for postoperative care. However, it is a challenge to the medical profession to speed up and generally support the introduction of this complex post-mastectomy system. PMID- 3287799 TI - [Surgical treatment of chronic ligament injuries of the knee joint]. AB - Treatment for median knee-joint instability with a case history long time back may occasionally be time-consuming and dissatisfactory to patient and doctor. Several synthetic materials and autologous grafts are used in surgical therapy. Some of the methods are described in this paper. In one of them use of autologous tissue is combined with its "dynamisation". PMID- 3287800 TI - [Tumor markers in gynecology. General review]. AB - Carcinoembryonic antigen (CEA) and alpha 1-fetoprotein (AFP) should like to be a part of the diagnostic tool of breast and ovarian cancer. HCG is an established specific tumor marker in the monitoring of trophoblastic tumors. The development of a specific HCG-beta-radioimmunoassay led off the possibility to determine the so called subclinical estimation of the tumor tissue. First clinical steps of tissue polypeptide antigen (TPA), cancer antigen 12-5 (CA-12-5), cancer antigen 15-3 (CA-15-3) and D-Dimer would be of great interest to study the correlation between serum concentrations and tumor mass. The following classification is showing other tumor markers in a general review, too dividing molecules produced from the tumor cell itself, so called tumor derived products, and on the other side tumor associated products accompanying the malignancy. PMID- 3287801 TI - From Pasteur to penicillin--the history of antibacterial chemotherapy. PMID- 3287802 TI - Detection of specific bacterial enzymes by high contrast metal chelate formation. Part II. Specific detection of Escherichia coli on multipoint-inoculated plates using 8-hydroxyquinoline-beta-D-glucuronide. AB - The use of 8-hydroxyquinoline-beta-D-glucuronide for the demonstration of beta glucuronidase activity within the family Enterobacteriaceae has been investigated. The compound has been shown to be an effective substrate for the bacterial enzyme and the Michaelis constant for the association has been determined. A multipoint-inoculated method was employed to test 400 routine clinical isolates including those of urinary and faecal origin. When grown on an agar-based medium containing the substrate together with a ferric salt, glucuronidase-positive organisms were revealed by intense black pigmentation located only in the colony mass. The only organism yielding positive results by this method was Escherichia coli. The shigellae tested were negative by this procedure. Of the total biochemically profiled E. coli organisms 80% were specifically visualised by the method. This contrasts with 97% positively obtained by a fluorescence procedure involving use of 4-methylumbelliferone-beta D-glucuronide but which also gives positive results with Shigella sonnei. A simple, cost-effective procedure involving use of both techniques for specific detection of E. coli is described. PMID- 3287803 TI - Is there an optimal methodology for the microbiological analysis of effluent in CAPD peritonitis? AB - The definition of CAPD peritonitis and reasons for negative effluent cultures are discussed. Based on published data, present-day recommendations for an optimal culture technique of CAPD effluents are given. PMID- 3287804 TI - [Effect of Propionibacterium granulosum KP-45 on the resistance to Listeria monocytogenes and Salmonella typhimurium infections]. AB - Killed bacterial cells of Propionibacterium granulosum KP-45 were found to be potent modifiers of non-specific resistance of mice against infection with either Listeria monocytogenes or Salmonella typhimurium. Injection of P. granulosum 7 days prior to infection resulted in marked splenomegaly. Disseminated acute inflammatory foci were found histologically in the liver. These mice were apparently less susceptible to infection, since definitely lower bacterial counts were determined. Simultaneous application of both P. granulosum KP-45 and L. monocytogenes resulted, however, in increased susceptibility of mice to infection, since definitely higher bacterial counts were found and the inflammatory reaction to infection was markedly enhanced. PMID- 3287806 TI - [Clostridia toxins]. PMID- 3287805 TI - Investigations on the binding of erythrogenic toxin A of Streptococcus pyogenes on human peripheral blood lymphocytes. II. Identification of toxin-binding lymphocytes and characterization of the receptor. AB - Gold complexes of erythrogenic toxin A (ETA) of Streptococcus pyogenes (strain NY 5) were bound to human lymphocytes that could be characterized as T cells by rosetting or labelling with OKT 3 antibody and anti-mouse-IgG-gold. Using OKT 4 and OKT 8 antibodies, respectively, it was demonstrated that binding of ETA was confined to the T helper/inducer cell subpopulation. Treatment of lymphocytes with neuraminidase enhanced the binding of ETA-gold, whereas trypsin treatment resulted in its reduction. Gangliosides of type II or type III and D-galactose only slightly decreased the ETA-gold binding. Preincubation of living lymphocytes with the mitogens concanavalin A or the Lens culinaris-lectin enhanced the binding of ETA-gold. PMID- 3287807 TI - [The detection of antibodies against influenza A viruses (H1N1, H3N2) in swine with the single radial hemolysis (SRH) and the hemagglutination inhibition (HAH) tests]. PMID- 3287808 TI - [History of Russian forensic psychiatry (forensic-psychiatric activities of the Sovestny (Conscience) Courts at the end of the 18th and first quarter of the 19th centuries)]. PMID- 3287809 TI - [Characteristics of the prevalence of multiple sclerosis (review of the literature)]. PMID- 3287811 TI - Intravenous streptokinase during acute myocardial infarction. A prospective open study. AB - To evaluate the efficacy of intravenous streptokinase in acute myocardial infarction (AMI) 108 patients received a high-dose (1.5 million units), short term infusion (60 minutes) within 6 hours after onset of symptoms, followed by anticoagulation. Before discharge a submaximal exercise test and a coronary arteriography were performed in 100 surviving patients. Sixty-seven patients had a patent infarct-related vessel. Clinical reocclusion occurred in 21 patients. Left ventricular function was slightly, but not significantly, better in patients with patent infarct-related vessels: ejection fraction 59.5 +/- 13% versus 57.4 +/- 13%. Additional procedures were performed in 20 patients: percutaneous transluminal coronary angioplasty (PTCA) in 8 and coronary artery bypass surgery (CABG) in 12. The results indicate that streptokinase applicated during a 6 hour time window is a potent thrombolytic agent in acute myocardial infarction with limited effect on global left ventricular function. Pre-discharge evaluation is necessary to screen patients for residual ischemia. PMID- 3287810 TI - Effect of penbutolol on circadian blood pressure, and renin, aldosterone and cortisol levels in patients with essential hypertension. AB - We investigated the effect of an orally administered, long-acting, beta adrenergic blocking agent, penbutolol, on the circadian rhythm of blood pressure (BP) and heart rate (HR), and plasma renin activity (PRA), aldosterone (PA) and cortisol (PC) levels in hospital patients with essential hypertension validated by a chronobiological inferential statistic method. After a wash-out period of three weeks, a group of 8 hypertensive patients (5 women and 3 men, 27 to 41 years old) underwent automatic BP and HR monitoring, and blood sampling for 24 hours in a hospital room before and after 4 weeks of treatment with penbutolol (40-mg tablet once a day at 9 a.m.). In basal conditions, a statistically significant mean circadian rhythm was demonstrated for HR, diastolic BP, PRA, PA, and PC. Systolic and diastolic BP were lowered by penbutolol, with only a minor decrease of HR. The treatment eliminated also the mean circadian rhythm of BP and HR. Penbutolol induced both a remarkable reduction of PRA with disappearance of the related circadian rhythm and a significant decrease in PA levels with maintenance of their circadian rhythmicity. The circadian secretory patterns of PC were similar before and after therapy. In conclusion, long-term treatment with penbutolol appears not only to set BP, PRA and PA values to lower levels, but also to decrease the within-day variation of BP, HR, and PRA. In addition, penbutolol does not influence the 24 h-secretion of PC. PMID- 3287812 TI - Haematological, physiological and survival data in a porcine model of adult respiratory distress syndrome induced by endotoxaemia. Effects of treatment with N-acetylcysteine. AB - The effects of N-acetylcysteine (NAC)--which is supposed to act as a free radical scavenger--were evaluated on lung function, haemodynamics and oxygen transport in a porcine model of pulmonary and cardiovascular failure induced by endotoxaemia. Three pigs, serving as controls, received NAC without endotoxin (E) for 6 h, and no notable physiological changes were found. Five pigs received a continuous infusion of E alone for 6 h and displayed a 90% decrease in leukocyte count and a 66% decrease in platelet count. Physiologically a four-fold increase in venous admixture (Qva/Qt), a nearly 2-3 fold increase in mean pulmonary arterial pressure (MPAP) and a progressive decline in cardiac output (Qt) of 60% were documented. Extravascular lung water (EVLW) increased 66%, mean arterial pressure (MAP) decreased 46% and oxygen delivery decreased 52%, leading to a metabolic acidosis. Three animals died during the observation period. Contrastingly, eight pigs, pretreated with NAC 150 mg.kg-1 which was continued at 20 mg.kg-1.h-1, showed a significantly attenuated response to E. Thus, leukocyte and platelet counts decreased 70% and 48%, respectively. Physiologically Qva/Qt increased 2.5 3 fold, MPAP increased 1.3-2 fold, and Qt decreased 32%. EVLW increased 27%, MAP decreased 27% and oxygen delivery decreased only 33% which kept the pH in the normal range. All animals survived the observation period, a significant difference from the E alone group. Thus, NAC significantly attenuated all monitored haematological and pathophysiological changes in the endotoxin model of ARDS in pigs. In addition to a reported free radical scavenger effect of NAC, our results support the assumption that NAC may counteract leukocyte and platelet aggregation in the lung thereby contributing to the beneficial outcome. PMID- 3287813 TI - Rectal v. intravenous administration of indomethacin in the treatment of renal colic. AB - Rectal administration of 100 mg indomethacin in solution had as good, and almost as rapid, an effect on renal colic as 50 mg given intravenously. Side effects were significantly fewer with the rectal than with the intravenous route. PMID- 3287814 TI - Beta-haemolytic streptococci in acute appendicitis. An ominous finding? AB - The significance of beta-haemolytic streptococci (BHS) in appendicitis was retrospectively studied. In one year 283 patients were operated on for appendicitis (perforated in 75 cases, gangrenous in 40). Peritoneal swab cultures were obtained in 93 cases. BHS was isolated from only six patients, four of whom had severe septic complications. Of the total patients, only five had such complications. The study indicated that isolation of BHS in appendicitis has ominous implications that call for vigilance against septic complications. PMID- 3287815 TI - Failure of single-dose metronidazole prophylaxis in colorectal surgery. No benefit from high dosage or combination with nalidixic acid. AB - In an open prospective study of postoperative infectious complications, patients undergoing elective colorectal surgery were randomly allocated to one of three groups receiving parenteral single-dose antimicrobial prophylaxis (1 g or 3 g metronidazole or 1 g metronidazole + 3 g nalidixic acid). Because of an unacceptably high rate of surgical infection in all three groups (36%, 29% and 39%, p greater than 0.1) among the first 103 evaluable patients, the study was discontinued. Nalidixic acid--though effective in in vitro tests of bacterial susceptibility--thus was found to be of little or no value as prophylaxis against Gram-negative infection. As the observed infection rate when metronidazole was given at the start of operation was seven-fold that previously found in the same department when 1 g metronidazole was administered 3-4 hours preoperatively (28/103 vs. 2/50, p less than 0.01), the timing of metronidazole prophylaxis was assumed to be potentially important for its ability to protect also against aerobic postoperative infection. PMID- 3287816 TI - Quality assurance measures in cytopathology. PMID- 3287817 TI - Quality control measures for cervical cytology laboratories. AB - The results of three quality control measures for evaluating a cytopathology laboratory's performance in the diagnosis of cervical abnormalities are presented. The sensitivities of cervical cytology were estimated to be 95.5% or 93.1% (using two different methods of analysis) for the detection of histologically diagnosed invasive squamous cell carcinoma of the cervix and 60% for the detection of adenocarcinoma and adenosquamous carcinoma of the cervix in 1983. The positive predictive values for a histologic diagnosis of neoplasia after cytologic reports of CIN III and invasive carcinoma were 92.5% and 99%, respectively. Repeatability of a negative cytologic result exceeded 98%. These results indicate that accurate cervical cytologic reporting can be achieved. Regular monitoring of the type described, which is both practical and reasonably comprehensive, is recommended for all laboratories. PMID- 3287818 TI - Predictive value of phenotypic cytologic characteristics in early dysplastic cervical lesions. AB - Four phenotypic cytologic parameters (koilocytotic changes, binucleation, multinucleation and the presence of metaplastic dysplastic cells) were evaluated in the initial cervical smears from 89 women who presented with slight or moderate dysplastic changes and had an adequate follow-up. The cases were divided in two groups according to their evolution: the 51 cases constituting group I showed persistence or progression of the lesions while the 38 cases in group II showed regression. Koilocytosis in 40% or more of the cells in a smear proved to have the greatest predictive value as an indicator of a lesion with less risk of progression. Multinucleation may have a similar value, but to a lesser degree. Binucleation and metaplastic dysplastic cells showed no statistical differences between persistence cases and regression cases. A fifth parameter, positivity to human papillomavirus capsid antigen by the immunoperoxidase technique, doubled its frequency in the regression group. The evaluation of these variables may provide a means of assessing the evolutionary potential of precursor cervical lesions, based on these lesions' cytologic phenotypic profiles. PMID- 3287819 TI - Fine needle aspiration cytology of neuroblastoma, including peripheral neuroectodermal tumor, with immunocytochemical and ultrastructural confirmation. AB - Eleven fine needle aspiration (FNA) biopsies were performed on seven children with neuroblastoma, including one patient with a congenital neuroblastoma and another with a peripheral neuroblastoma of the thoracopulmonary region. FNA cytology made the primary diagnosis of neuroblastoma in four of the seven cases. The other biopsies documented local recurrences and metastases to liver, lymph nodes, orbit and breast. The cytologic features included varying numbers of small primitive cells with scanty cytoplasm, poorly to well-formed pseudorosettes, cell processes, a fibrillary matrix and multinucleated ganglion cells. Five of the seven patients had electron microscopic (EM) examination of the FNA specimen, which in all cases confirmed the diagnosis. Batteries of immunoperoxidase stains were performed on all 11 aspirates with variable results. Staining for neuron specific enolase was positive in four of the five neoplasms tested, although strongly positive in only three of the cases. Staining for neurofilament markers was positive in only two of five tumors. Studies for cytokeratin markers (AE1/3), low-molecular-weight cytokeratin (35BH11), hematopoietic markers (T29/33), immunoglobulin light chains and myoglobin were negative. One case was positive for vimentin. This study attests to the value of FNA cytology in suggesting a correct diagnosis of either primary, recurrent or metastatic neuroblastoma in children. Selective use of immunoperoxidase stains and EM on the aspirates may be of value. PMID- 3287820 TI - Fine needle aspiration cytology of a cerebral ganglioglioma. Report of a case. AB - The fine needle aspiration (FNA) cytology of a rare central nervous system tumor, ganglioglioma, is described. The FNA cytologic diagnosis confirmed a radiologic suspicion of ganglioglioma detected by computerized tomography and intraoperative sonography, thus sparing the patient from a superior temporal gyrus resection, with attendant speech impairment. The cytologic distinction of this lesion from high-grade astrocytoma is important because of the more favorable prognosis in ganglioglioma. PMID- 3287821 TI - [Proteinuria in diabetes mellitus]. AB - A third of all Type 1 diabetic patients will develop proteinuria as a clinical sign of diabetic nephropathy. A 100-fold increase in relative mortality is observed in patients with persistent proteinuria. Proteinuria is preceded by a microproteinuric phase, which is reversible upon optimized metabolic control. Thereby, progression towards clinically manifest nephropathy can be delayed. Macroproteinuria and progressive renal insufficiency are not influenced by metabolic control, but by aggressive antihypertensive therapy. PMID- 3287822 TI - [Bacteriuria]. AB - Bacteriuria remains the most important sign of urinary tract infection. A standardization of the diagnosis and treatment of urinary tract infection requires a standard period of urine collection (4 hours), the correct collection of specimens, the determination of the number of bacteria by appropriate media (dipslide) and of urinary leucocytes. Test strips cannot replace the microscopy of the sediment. The therapeutic consequences result from the localization of the infection, the duration of treatment of cystitis is 1 to 4 days, of pyelonephritis 10 to 14 days. PMID- 3287823 TI - [Morphologic changes in urine erythrocytes in interference contrast microscopy as an indication of the source of microhematuria]. AB - According to Birch and Fairley (1, 2, 3) it is possible to differentiate glomerular from nonglomerular microhematuria by red cell morphology. Using an interference contrast microscope we examined urine sediments of 85 patients characterized by a microhematuria with more than 8000 red cells/ml urine. Examination of 31 patients with glomerular disease and 27 patients with nonglomerular disease yielded a correlation of 83.5 and 88% respectively between our results and the verified cause of microhematuria. In contrast red cell morphology did not prove any diagnostic favour in 27 patients with renal transplantation. PMID- 3287824 TI - Modern trends in anaesthesia. Premedication. PMID- 3287825 TI - Inhalation anaesthesia. PMID- 3287826 TI - Regional anaesthesia. PMID- 3287827 TI - Modern trends in anaesthesia. Muscle relaxation. PMID- 3287828 TI - Reversal agents in anaesthesia. PMID- 3287829 TI - Total intravenous anaesthesia--is there a future for midazolam? PMID- 3287830 TI - Immunohistochemical study on the endocrine pancreas of cattle with special reference to coexistence of serotonin and glucagon or bovine pancreatic polypeptide. AB - Bovine pancreatic endocrine cells were investigated by light microscopic immunohistochemistry. Serotonin-immunoreactive cells as well as insulin-, glucagon-, somatostatin-, bovine pancreatic polypeptide (BPP)-immunoreactive cells were detected in the pancreatic islets. Generally, insulin-immunoreactive cells were distributed throughout the islet and the others took peripheral location. Since the distribution and shape of serotonin-immunoreactive cells were very similar to glucagon- and BPP-immunoreactive cells, serial sections were restained by using the elution method. All glucagon- and BPP-immunoreactive cells also showed serotonin immunoreactivity but glucagon and BPP immunoreactivities were never observed to be colocalized in the same cell. A small number of serotonin-immunoreactive cells were observed that showed serotonin immunoreactivity only. PMID- 3287831 TI - The two- and three-dimensional structure of the microcirculation of the chick chorioallantoic membrane. AB - The chick chorioallantoic membrane (CAM) is a common model for studying biological processes, but descriptions of the CAM circulatory system and especially experimental preparations of the CAM in shell-less eggs are both scant and controversial. We studied the CAM structure and the three-dimensional spatial configuration of the CAM vessels using five methods: in vivo stereoscopic observations, whole-mount preparations, histological sections, corrosion cast microinjection techniques, and the reconstruction of a three-dimensional wax model. Our findings show that the CAM consists of a superficial two-dimensional layer composed of a network of a very dense capillary mesh, floating over and enclosing a deeper three-dimensional space in which medium and larger free floating vessels are seen to supply and drain the superficial layer. It is interesting to note that no tips or sprouts of blood vessels were observed during the development of the CAM vessels. In a shell-less egg preparation, the capillaries were found in the mesoderm layer of the CAM and not in or superficial to the ectoderm as is the case in the CAM of the intact egg which adheres to the shell membrane. PMID- 3287832 TI - Glial fibrillary acidic protein, vimentin and fibronectin in primary cultures of human glioma and fetal brain. AB - The expression of glial fibrillary acidic protein (GFAP), vimentin and fibronectin (Fn) was studied in cells cultured from human glioma and fetal brain by indirect immunofluorescence (IIF) microscopy and multiple labelling experiments. In the primary cultures a major part (20%-70%) of the cells usually displayed both GFAP and vimentin and the rest of the cells only vimentin. A prominent variation in GFAP and vimentin fluorescence intensity sometimes made interpretation of double IIF stainings difficult. However, occasional GFAP positive cells appeared vimentin negative in primary glioma cultures, whereas in fetal brain primary cultures cells that were preferentially GFAP positive also showed at least a weak vimentin immunoreactivity. Only a fraction of the cells, roughly corresponding to the GFAP-negative cells, were Fn positive in the primary cultures. As judged by double IIF, the GFAP-positive cells were usually Fn negative, while the Fn-positive cells were vimentin positive. This could also be demonstrated in triple IIF experiments. During serial subcultivation the amount of cells expressing GFAP decreased, while the number of Fn-positive cells increased. By the third to fourth passage GFAP positivity was usually lost, all cells expressed vimentin and most cells also Fn. The results of the present study demonstrate a general coexpression of GFAP and vimentin in cultured astroglial cells, in addition to cells expressing only vimentin. Interestingly, occasional glioma cells seem to contain GFAP as the only intermediate filament protein as detected by immunocytochemistry.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287833 TI - Lhermitte-Duclos disease. An immunohistochemical study of the cerebellar cortex. AB - Immunocytochemical studies were carried out on two previously reported autopsy cases of Lhermitte-Duclos disease. The unaffected cerebellar cortex adjacent to the lesions served as control. The findings supported the view, previously expressed by one of the authors, of a heterogeneous neuronal structure of the lesion, consisting of at least two cell types. No further light was thrown on the predominant medium-sized cells, believed to represent hypertrophic internal granular neurons. On the other hand the large cells shared a number of features with Purkinje cells. In particular they were recognized by the pan-T-cell antibody anti-Leu-4, were surrounded by axosomatic synapses visualized by the antisynaptic vesicle glycoprotein antibody SV2, and contained both non phosphorylated and phosphorylated neurofilament epitopes. It is suggested that these cells represent dysplastic Purkinje cells. The lesion therefore appears to be a complex hamartoma rather than a simple hypertrophy of the internal granular neurons. PMID- 3287834 TI - Neuropathology of Salla disease. AB - A neuropathological study was performed on two patients with Salla disease, one male and one female, from different families. They both died at the age of 41 years. Both patients showed increased excretion of free sialic acid in the urine, psychomotor retardation starting in the 1st year of life, ataxia and spasticity. Several family members of both families were affected with the same disease indicating the hereditary character of the disorder. The neuropathological investigation revealed strikingly similar changes in the two cases. Macroscopically the cerebral white matter was severely reduced. Histologically marked loss of axons and myelin sheaths was accompanied by pronounced astrocytic proliferation. The remaining axons frequently showed ovoid swellings surrounded by a myelin sheath. The reduction of the number of myelin sheaths seemed proportional to the numerical reduction of axons. Many cortical nerve cells displayed in relation to age an abnormal amount of lipofuscin. Neurofibrillary tangles were observed in nerve cells of the neo-cortex, nucleus basalis of Meynert and locus ceruleus. Cerebellum showed moderate loss of Purkinje cells. In the spinal cord axonal degeneration was observed in both ascending and descending tracts. PMID- 3287835 TI - A quantitative analysis of human astrocytosis. AB - The number of astrocytes in an atrophic human brain was counted with the aid of immunohistochemistry for glial fibrillary acidic protein. Microscopically, astrocytosis was remarkable in the cerebral neocortex and white matter. Taking the cortical atrophy into consideration, however, the total number of astrocytes in the cortical layers II-VI was not increased. The number of astrocytes in the white matter was not increased either. It is indicated that astrocytosis does not always mean hyperplasia (net increase of total number) of astrocytes. PMID- 3287836 TI - Apolipoproteins, dyslipoproteinaemia and premature coronary heart disease. PMID- 3287837 TI - Reduction of mortality in the Stockholm Ischaemic Heart Disease Secondary Prevention Study by combined treatment with clofibrate and nicotinic acid. AB - Consecutive survivors of a myocardial infarction from the Southern Hospital, below 70 years of age, were randomized into a Control group (n = 276) and a Treatment group (n = 279). The latter was openly prescribed the combination of clofibrate and nicotinic acid for serum lipid lowering. Each patient should remain in the study for 5 years and be seen regularly every 4 months at a special IHD outpatient clinic within the hospital. The concentration of serum cholesterol and triglyceride was lowered by 13% and 19%, respectively, in the Treatment group compared to the Control group. Total mortality was 82 cases in the Control group and 61 in the Treatment group, a 26% reduction (p less than 0.05). For patients above 60 years of age in the Treatment group the reduction in mortality was 28% (p less than 0.05). IHD mortality was reduced by 36% (p less than 0.01) in the Treatment group compared to the Control group. The beneficial effect of the serum lipid lowering treatment was related to the serum triglyceride concentration in two ways. First, it only occurred in patients with a triglyceride level greater than 1.5 mmol/l (n = 216). Secondly, it was most pronounced in the 44% of the treated patients who had a lowering of the serum triglyceride by 30% or more, and in this subgroup the reduction of IHD mortality was 60% (p less than 0.01). For serum cholesterol there were no such relations. The difference between serum triglycerides and cholesterol concerning these relations to the treatment outcome may be due to the fact that hypertriglyceridaemia was the most common hyperlipidaemia among our patients, occurring in 50%, while hypercholesterolaemia only occurred in 13%. Caution should be exercised in the interpretation of the results as the trial was not blind. However, the fact that the decrease in IHD deaths was directly related to the degree of serum triglyceride lowering indicates that it was the drug effect on serum lipids that was responsible for the beneficial effect of the treatment. PMID- 3287838 TI - Gastric inhibitory polypeptide in newly diagnosed ketotic type I (insulin dependent) diabetics. AB - Plasma concentrations of 5,000 daltons (5 kDa) immunoreactive gastric inhibitory polypeptide (IR-GIP) were measured before and up to 16 hours after the start of low-dose insulin treatment in newly diagnosed ketotic type I (insulin-dependent) diabetics. Nine patients were non-fasting. Before insulin treatment mean IR-GIP was 31 +/- 6 pmol/l (range 9-65 pmol/l). Four patients had IR-GIP concentrations in the normal fasting range (10-25 pmol/l), and nine patients had concentrations below 35 pmol/l. The remaining patients had IR-GIP concentrations in the normal postprandial range. A meal eaten after the start of insulin treatment caused an increase in IR-GIP in all patients. All patients had beta-cell function as estimated by plasma C-peptide. Individual changes in C-peptide were significantly correlated to changes in blood glucose both after the meal (r = 0.80, p less than 0.01) and during insulin treatment (r = 0.85 +/- 0.04). No correlation could be found between IR-GIP and blood glucose, C-peptide or insulin concentrations. Newly diagnosed ketotic type I diabetics have IR-GIP concentrations within the normal postprandial level. Hypoinsulinaemia, hyperglycaemia, and hyperketonaemia do not by themselves increase 5 kDa IR-GIP markedly above normal fasting levels. PMID- 3287839 TI - One or three weeks' treatment of acute pyelonephritis? A double-blind comparison, using a fixed combination of pivampicillin plus pivmecillinam. AB - The clinical and bacteriological effects of 1 and 3 weeks' pivampicillin plus pivmecillinam treatment were compared in a double-blind, randomized study of patients with acute pyelonephritis. Three weeks after the end of active treatment, clinical success was seen in 29 (91%) of the 32 patients on 1-week treatment, compared with 28 (97%) of the 29 patients treated for 3 weeks. Bacteriological success was seen in only nine (28%) patients in the 1-week group vs. 20 (69%) in the 3-week group (p = 0.004). This difference was mainly due to a large number of relapses of lower urinary tract infection in the 1-week group. Even in uncomplicated cases, the bacteriological result of the 1-week treatment was unsatisfactory. Side-effects were more common in the 3-week treatment group. In conclusion, 1-week treatment of patients with acute pyelonephritis is too short. Three weeks' treatment is effective in uncomplicated cases, but even longer treatment or low-dose prophylaxis is indicated in certain patients with predisposing factors. PMID- 3287840 TI - [The problem of psychiatric disorders associated with dependence on opiates and cocaine (review)]. PMID- 3287841 TI - Biological markers of cell proliferation and differentiation in human gastrointestinal diseases. PMID- 3287842 TI - Stromal involvement in malignant growth. PMID- 3287843 TI - Tumor clonality and its biological significance. PMID- 3287844 TI - Newborn macrosomy and cancer. PMID- 3287845 TI - Chemical carcinogenesis: from animal models to molecular models in one decade. AB - During the last decade, progress in chemical carcinogenesis research has been substantial, and understanding the cellular changes and molecular causes of initiation, promotion, and malignant conversion appears to be within reach. Cancer begins as a carcinogen-induced genetic change in a single cell. The interaction of a particular carcinogen with specific genetic sites results, in part, from selectivity of metabolically activated carcinogens for particular nucleosides or gene sequences. In turn, modification of the molecular structure at specific genetic loci will have tissue-specific and species-specific consequences dependent on the expression of a particular gene, its sequence, and the function of the gene product in the target cell. It is likely that inactivation of regulatory regions, genomic rearrangements, and point mutations in coding sequences all can result in an altered cell phenotype. The rasH gene (and perhaps other members of the ras gene family) appears to be a common target for coding sequence mutations in the initiation of carcinogenesis in several organ sites and species by specific carcinogens. Whatever genetic mechanisms are involved, an initiated cell phenotype common to many epithelial cell types is observed. Initiated cells have an altered program of terminal differentiation, are resistant to cytotoxic substances or show altered requirements for specific growth factors or nutrients. These cells would have a selective growth advantage in cytostatic or cytotoxic situations or under conditions favoring terminal differentiation. Tumor promoters, some acting through specific cellular receptors, produce a tissue environment conductive to the selective clonal outgrowth of the initiated cell population resulting in a clinically evident premalignant lesion. The tissue specificity for most promoters depends on the ability of a particular agent to produce the selective conditions required for the initiated phenotype of that organ. At the molecular level, phorbol ester tumor promoters bind to and activate protein kinase C and transduce signals through this second-messenger pathway. Heterogeneity in the species of protein kinase C molecule expressed by normal and initiated epidermal cells could account for the differential response pattern observed in these cell types during skin tumor promotion. Malignant conversion of benign tumors requires further genetic changes in the tumor cell. Such changes could result from inherent instability in the genome of initiated cells, from spontaneous mutations more likely to occur in the expanding population of proliferating benign tumor cells, or by additional exposure to exogenous genotoxic agents.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3287846 TI - Louvain rat immunocytomas. PMID- 3287847 TI - Oncogenes and the nature of malignancy. PMID- 3287848 TI - Plastic and cosmetic surgery of the face. By Adalbert G. Bettman, 1920. PMID- 3287849 TI - [Two cases of adrenal myelolipoma]. AB - Myelolipoma of the adrenal gland is a benign oligosymptomatic tumor composed of various proportions of fat and bone marrow elements. We report two operated cases found incidentally in a 76-year-old man and 49-year-old man. PMID- 3287850 TI - [A case of solitary metastasis of renal cell carcinoma to the thyroid gland]. AB - A case of solitary metastasis of renal cell carcinoma to the thyroid gland is reported. A 63-year-old-woman had been found to have an abnormal mass in the neck since April, 1986. She had a past history of right nephrectomy owing to right renal tumor 6 months earlier. Histological examination of the renal tumor revealed, common type, alveolar type, G1, INF alpha renal cell carcinoma. No metastasis was found on abdominal CT, chest tomography and bone scintigram at that time. Radical thyroidectomy was performed on June, 23, 1986. Histological examination by hematoxylin and eosin staining revealed metastasis of renal cell carcinoma, and immunohistochemical technique ruled out primary thyroid carcinoma. Postoperatively no other metastasis was found on head-chest-abdomen-CT, chest tomography or bone scintigram. Therefore no particular adjuvant therapy was performed. PMID- 3287851 TI - [Bladder carcinoma associated with hypercalcemia: report of 3 cases]. AB - Three cases of bladder carcinomas associated with hypercalcemia were presented. Case 1: A 43-year-old male was diagnosed as having bladder carcinoma 2 years ago and treated in another hospital by partial cystectomy with uretero-vesiconeostomy of the left side. On March 6, 1985, in our clinic, he received a total cystectomy with an ileal conduit for urinary bladder carcinoma. A 5-month post-operative clinical examination showed recurrence of the carcinoma with elevated serum Ca level (15.6 mg/dl). He was treated with eel-calcitonin, predonine, indomethacin, and furosemide, but died on August 23, 1985. Autopsy disclosed carcinoma of the urinary bladder (transitional cell cancer much greater than squamous cell cancer). Case 2: A 51-year-old male was diagnosed as having transitional carcinoma of the urinary bladder and was treated in our clinic by total cystectomy with cutaneous ureterostomy. Three months after the operation, he was readmitted with complaints of anorexia and disturbances of consciousness. His serum Ca level was elevated (17 mg/dl), and clinical examination showed recurrence of the carcinoma; bone scan revealed no metastasis. He was treated by radiotherapy with eel-calcitonin, predonine, indomethacin, and furosemide, but died on October 22, 1985. Autopsy disclosed carcinoma of the urinary bladder (squamous cell cancer). Case 3: A 72-year-old male was diagnosed as having a large urinary bladder tumor. An IVP showed a left non-functioning kidney. On admission, he complained of anorexia and confusion. His serum Ca level was elevated (13.8 mg/dl); bone scan revealed no metastasis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287852 TI - [A case of sigmoidovesical and ileovesical fistula with bladder papilloma complicating colonic diverticulitis]. AB - The clinical course of sigmoidovesical and ileovesical fistula due to rupture of colonic diverticulitis is reported. The patient, a 41-year-old male, who had been suffering from intestinocutaneous fistula for 16 months since drainage of abdominal abscess had chief complaints of cloudy urine and fecaluria. Cystoscopic examination revealed bladder papilloma land edema at the apex area of the bladder. Abscess and fistula were identified with transurethral ultrasonotomography and fistulography, respectively. Primary resection was performed after intravesical instillation of mitomycin-C and postoperative course was uneventful. Histological findings of the specimen revealed disappearance of bladder papilloma for the instillation therapy. Statistical analysis was made on 73 cases of sigmoidovesical fistula due to colonic diverticulitis reported in Japan including my own case. PMID- 3287853 TI - [Paraurethral leiomyoma in a female: report of a case]. AB - A 50-year-old female visited our clinic complaining of tumor formation in the external genitalia. The tumor was elastic hard upon palpation, 3 cm in diameter, and located in the right lateral side of the external urethral meatus. The paraurethral tumor was excised. Histopathological diagnosis was paraurethral leiomyoma. Female paraurethral leiomyoma is a rare benign tumor. There have been only 66 cases reported in the Japanese literature. We summarized these cases and studied their clinical features. PMID- 3287854 TI - [Transverse ectopia of the testis. A case report]. AB - A case of transverse ectopia of the right testis with left inguinal hernia is reported. A one-year-old-boy was admitted to our hospital with swelling of the left scrotal contents and right undescended testis. At operation, two testes were situated on the left side, one in the left scrotum and another in the left inguinal canal. Right transseptal orchiopexy was performed. Including our case, we discovered 73 cases of transverse ectopia of the testes in the Japanese literature. A brief discussion was made about the disease. PMID- 3287855 TI - [XYY syndrome: report of three cases]. AB - Three cases of XYY syndrome (YY syndrome) were experienced. Two cases had such rare associated anomalies as hypospadias and cryptorchism. Pathogenesis, incidence, clinical symptoms, gonadal function and fertility of the patients with XYY syndrome are briefly discussed. PMID- 3287856 TI - [The management of vesicoureteral reflux with neurogenic bladder due to spina bifida]. AB - Thirteen cases (20 ureters) of vesicoureteral reflux (VUR) associated with neurogenic bladder, treated with anti-reflux operation are reviewed. Twelve of the 13 cases had meningomyelocele and 1 had spina bifida occulta as an underlying disease. The type of neurogenic bladder was hypoactive detrusor-active sphincter in 11 patients and hypoactive detrusor-hypoactive sphincter in 2 patients. They were treated with an anti-reflux operation, 2 ureters by Politano-Leadbetter method and 18 ureters by Cohen method. The results were successful (success rate 85.0%). Therefore, we concluded that in neurogenic bladder patients especially with the hypoactive detrusor-active sphincter, the cause of their renal deterioration is mostly VUR. Thus we should examine such patients for VUR. On the other hand, when the renal deterioration of VUR patients cannot be improved by conservative treatment for example clean intermittent catheterization or indwelling catheter, we should perform an anti-reflux operation. PMID- 3287857 TI - [Immunohistochemistry of the human fetal mesonephros with anti-human N-myc protein antibody]. AB - Expression of a N-myc gene has been found in Wilms' tumor. N-myc protein, which is a N-myc gene product, can be detected using an anti-N-myc antibody. Paraffin sections of the fetal tissues at the seventh week of gestation were prepared for immunohistochemistry, stained by PAP method. The N-myc gene product was observed in the cells consisting of the mesonephric ductular wall. This result may suggest that Wilms' tumor is originated from the mesonephric tissue. PMID- 3287858 TI - [A case of renal pseudotumor]. AB - A case of renal pseudotumor in a 47-year old female is reported. She was admitted with the complaint of right flank pain. Intravenous pyelography showed filling defect in right renal pelvis and spreading deformity of calices with compression of infundibuli. Ultrasonography and computed tomography demonstrated round renal mass. Since possibility of hypovascular tumor was not completely ruled out by right selective renal angiography, subsequently performed, then right nephrectomy was done. Bisected specimen revealed mal position of renal lobe (lobar dysmorphism). Microscopic appearance showed normal renal parenchyma. The literature is also reviewed. PMID- 3287859 TI - [Retroperitoneal ganglioneuroma: report of 3 cases]. AB - We have experienced 3 cases of retroperitoneal ganglioneuroma. One case was in a 5-year-old boy with the chief complaint of abdominal mass. The preoperative diagnosis was neuroblastoma due to excessive urinary excretion of vanillylmandelic acid. The other two cases were in adults, 40 and 28 years old, and were found incidentally. All three cases were doing well without any clinical signs of recurrence almost 10 years, 5 years, and 6 months, postoperatively. The literature is reviewed briefly concerning some cases in children under 5 years of age whose ganglioneuromas were sometimes confused with neuroblastoma because of excessive catecholamines. PMID- 3287860 TI - [Venous hemangioma of the urethra: a case report]. AB - A case of urethral hemangioma in a 61-year-old female is reported. She had the complaint of urethral bleeding and difficulty on urination since November 2, 1986. Physical examination revealed a reddish colored, thumb-head sized tumor at the external urethral meatus. All laboratory tests revealed normal findings. At cystoscopy reddish mucosa was found at the distal urethra. With the preoperative diagnosis of urethral tumor, the tumor was removed en masse under spinal anesthesia. The tumor mass was 2.0 x 1.7 x 1.2 cm. The specimen was pathologically diagnosed as venous hemangioma of the urethra. The patient remains symptomless for 2 months after the operation. Six cases of urethral hemangioma including this case have been reported in the Japanese literature and are reviewed briefly. PMID- 3287861 TI - Inguinal lymphadenopathy simulating a false aneurysm on color-flow Doppler sonography. PMID- 3287862 TI - Sonography of the Achilles tendon and adjacent bursae. AB - Abnormalities of the Achilles tendon and adjacent bursae are common problems that may be difficult to diagnose clinically. Twenty patients with symptoms involving the Achilles tendon and 10 control subjects were evaluated with real-time sonography in order to explore the role of sonography in defining abnormalities of the tendon and adjacent bursae and in differentiating between conditions requiring surgery and those needing conservative therapy. Normal anatomic structures seen consistently included the Achilles tendon, the musculotendinous junction, the retrocalcaneal bursa, and the calcaneal tendon insertion site. The normal range of tendon thickness was 4-9 mm (mean, 6.2 mm). All patients had repeat sonograms after either clinical resolution (14 cases) or surgical intervention (six cases). Twelve of the symptomatic patients had abnormal findings. Partial ruptures of the Achilles tendon were reliably differentiated from other lesions. No evidence of tendon thickening was found in tendinitis. Tendon thickening was found only in cases of previous tendon rupture. The superficial tendo Achillis bursa was imaged only when inflamed. Sonography was found to differentiate reliably between conditions that require surgical intervention and those that will respond to conservative therapy. PMID- 3287863 TI - Multicystic dysplastic kidney and contralateral renal aplasia in a twin: diagnosis by prenatal sonography. PMID- 3287864 TI - Duodenal hematoma in child abuse: sonographic detection. PMID- 3287865 TI - Sonographically guided percutaneous biopsy of small (3 cm or less) masses. AB - Traditionally, sonographically guided percutaneous needle biopsy has been used for the biopsy of large, superficial, and cystic masses. Today, however, many think that small, solid masses also can be biopsied accurately. Real-time sonographically guided biopsies of 126 consecutive solid masses that were less than or equal to 3.0-cm in diameter (less than or equal to 1.0 cm, 24; 1.1-2.0 cm, 42; 2.1-3.0 cm, 60) were performed to diagnose primary or secondary neoplasm. These masses were located in a variety of anatomic regions (abdomen, 92; neck, 31; breast, two; extremity, one). Clear visualization of the biopsy needle was accomplished by continuous real-time monitoring of the needle's position, primarily by using linear, phased-array transducers, large-caliber needles (18- to 19-gauge, when possible), and an echogenic screw stylet inserted coaxially within the biopsy needle. The correct cytologic/histologic diagnosis was established in 91% of the masses (less than or equal to 1.0 cm, 79%; 1.1-2.0 cm, 88%; 2.1-3.0 cm, 98%). No complications other than mild, localized discomfort were encountered. Our experience suggests that sonographically guided biopsy is a highly accurate and safe procedure that can be used to establish the diagnosis in solid masses that are 3.0 cm or less in diameter if proper techniques are used to clearly visualize the biopsy needle. PMID- 3287866 TI - Doppler flow signature of the left renal vein. PMID- 3287867 TI - Roscoe Miller award. Fatty-meal sonography for evaluating patients with suspected partial common duct obstruction. AB - We evaluated the efficacy of fatty-meal sonography for identifying patients with partial common duct obstruction. The test consisted of initial control measurements of common duct diameter followed by repeated measurements every 15 min for 60 min after a fatty meal consisting of Lipomul (1.5 ml/lb). The rationale proposed for the fatty-meal test is that in the presence of partial common duct obstruction, fat-induced increases in bile flow related to increased circulating levels of cholecystokinin are associated with an increase in the diameter of the common duct. Initial analysis of our data indicated that a change in diameter of +/- 1 mm was within the range of measurement error or possibly physiologic variation. In 44 control subjects (24 without a gallbladder), the common duct diameter either remained unchanged, showed an insignificant change of +/- 1 mm, or decreased (greater than or equal to 2 mm). The common duct diameter never showed an increase of more than 1 mm. The results of fatty-meal sonography in 47 patients with suspected partial common duct obstruction were negative in all 28 true-negative cases (specificity, 100%) and were positive (common duct increased by greater than or equal to 2 mm) in 14 of 19 true-positive cases (sensitivity, 74%). Thus, in this study a positive test finding always indicated partial common duct obstruction. Of the true-positive cases, fatty-meal sonography correctly identified seven of eight patients with cryptic obstructive sphincter-of-Oddi dysfunction (stenosis or dyskinesia) and five of nine patients with commun duct stones. We conclude that fatty-meal sonography is a useful noninvasive screening test for evaluating patients with suspected partial common duct obstruction. PMID- 3287868 TI - Oral cholecystography vs gallbladder sonography: a prospective, blinded reappraisal. AB - In a prospective, blinded study of 205 patients, oral cholecystography (OCG) and sonography were compared in terms of how well each screened patients for gallbladder diseases. Among 23 patients who had pathologic confirmation of the diagnosis at cholecystectomy, OCG correctly diagnosed 20 cases (87%) while sonography diagnosed 18 (78%). Among 54 patients with an abnormal OCG and/or sonogram, OCG detected 47 (87%) while sonography detected 44 (81%). These small differences in detection rates were not statistically significant. On the basis of these results, we cannot conclude that either sonography or OCG has a diagnostic advantage in screening patients for gallbladder disease. The large numbers of false-negative examinations found on both sonography and OCG suggest that in a patient with persistent symptoms, the alternative study should be performed if the first examination is negative. PMID- 3287869 TI - Pneumatosis intestinalis after bone marrow transplantation. AB - The clinical and pathologic data in 18 patients in whom pneumatosis intestinalis developed after bone marrow transplantation were reviewed to determine the significance of this finding. The colon, predominantly the right side, was involved in 17 of the 18 cases. Pneumatosis intestinalis developed earlier in the 14 symptomatic patients than in the four asymptomatic patients. Symptoms included diarrhea (12 patients), abdominal pain (six patients), rectal bleeding (two patients), and abdominal distension (two patients). Factors contributing to the development of pneumatosis intestinalis included pretransplantation chemotherapy and radiotherapy, steroid therapy, infectious colitis, graft-versus-host disease, and septic shock. Intestinal disease contributed to the deaths of seven patients with pneumatosis intestinalis, necessitated right hemicolectomy in another patient, and resolved with conservative treatment in 10 patients. In summary, bone marrow transplant recipients with pneumatosis intestinalis may follow either a benign or fatal course, depending on the underlying condition of the patient. Clinical correlation is important in determining the significance of this finding. PMID- 3287870 TI - Transvaginal sonography: comparison with transabdominal sonography in the diagnosis of pelvic masses. AB - In a retrospective study, we compared transvaginal sonograms with transabdominal sonograms in 67 women referred for evaluation of palpable pelvic masses. The diagnoses included ovarian cyst (27), endometrioma (12), complex cyst (four), dermoid (three), infection (three), ovarian malignancy (two), and uterine fibroid (three). The final diagnosis was made surgically in 41 patients (61%) and by a combination of sonographic and clinical correlation in the remaining patients. More information about the internal architecture or anatomy of the mass was provided by the transvaginal images than by the transabdominal scans in 51 (76%) of the patients. Transabdominal sonography did not provide more diagnostic information in any of the patients examined. Transvaginal sonography was helpful in obese patients, in those with a large amount of bowel gas, and in those unable to achieve adequate bladder filling. Six simple cysts and four complex pelvic masses were identified solely on transvaginal sonograms. The results suggest that transvaginal sonography has considerable advantages over conventional transabdominal sonography in the evaluation of pelvic masses in women. PMID- 3287871 TI - Display of transvaginal and transrectal sonographic images. PMID- 3287872 TI - Long-term systemic hypertension in children after successful repair of coarctation of the aorta. AB - The mechanisms responsible for long-term hypertension in children after successful repair of coarctation of the aorta have not yet been determined. We measured plasma renin activity and aldosterone, adrenalin, and noradrenalin concentrations both under basal conditions and in response to standing and treadmill exercise in 24 normal normotensive children, 16 normotensive postcoarctectomy children, eight hypertensive postcoarctectomy children, and seven children with essential hypertension. Exercise-induced changes in plasma renin activity, aldosterone, adrenalin, and noradrenalin were comparable in the four groups in spite of a significantly greater increase in systolic blood pressure in the children with hypertension. In response to standing, the plasma concentration of noradrenalin increased significantly in normotensive but not in hypertensive children. Hyperresponse of blood pressure to exercise in hypertensive postcoarctectomy children and children with essential hypertension is not related to abnormalities in the sympathetic nervous system or the angiotensin-aldosterone axis. Hypertension could be related to primary baroreceptor alterations, to structural changes in the arterial wall, or both. Twenty percent of normotensive postcoarctectomy children had a blood pressure hyperresponse to exercise and an abnormal noradrenalin response to standing similar to that seen in the hypertensive children. Follow-up of children after coarctectomy may elucidate whether these two abnormalities are indicators of an increased risk of developing long-term recurrent hypertension. PMID- 3287873 TI - Propafenone: a new antiarrhythmic agent. PMID- 3287874 TI - Bone wax granuloma causing saphenous vein graft thrombosis. PMID- 3287875 TI - A campus on the move with Gerald L. Bepko. PMID- 3287876 TI - Distinguished Alumnus Award goes to Marsha Strong. PMID- 3287877 TI - Alumna close-up: Carol Haynes. PMID- 3287878 TI - Nose-only versus whole-body aerosol exposure for induction of upper respiratory infections of laboratory mice. AB - The effectiveness of two aerosol delivery systems, nose-only and whole-body, were compared using Swiss-Webster mice and two pathogens, Klebsiella pneumoniae and Venezuelan equine encephalitis (VEE) virus. With K. pneumoniae the median lethal dose (LD50) and the mean time to death correlated with the inhaled dose. An LD50 value of 335 colony forming units (cfu) for nose-only exposure was significantly less than the LD50 value of 3741 cfu obtained for whole-body exposure. The LD50 values obtained with VEE virus for nose-only exposure [8 plaque forming units (pfu)] and whole-body exposure (11 pfu) were similar to each other. Following a 10-min nose-only exposure, concentrations of K. pneumoniae approximating 10(4)/g were present after 24 hr in the upper respiratory tract (URT) and lungs. The numbers of bacteria reached a peak at 72 hr, when resolution of the infection began. Detectable levels of bacteria in the blood and tissues were delayed in mice given whole-body exposure, plus there was a decreased concentration of bacteria per gram of tissue. Major pathological lesions induced by K. pneumoniae were mild suppurative rhinitis and minimal suppurative bronchopneumonia. Viremia was greatest at 96 hr following aerosol exposure to VEE. Virus concentrations in the URT, lungs, cerebrum, spleen and mesenteric lymph nodes reached maximum titers earlier for mice exposed by nose-only than for mice exposed to whole-body aerosols.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287879 TI - Physiological guidelines for the design of manual lifting and lowering tasks: the state of the art. AB - The goal of many researchers and practitioners of occupational health and safety has been to design manual materials handling (MMH) tasks so as to reduce the frequency and severity of overexertion injuries usually associated with these types of tasks. Physiological limits with respect to the manual lifting and lowering aspects of MMH have been reviewed and evaluated. The information provided by different researchers has been presented in a concise manner that is easily accessed by designers and practitioners of MMH. Recommendations for future research in determining physiological limits of individuals engaged in manual lifting and lowering tasks and other aspects of MMH activities have been provided. PMID- 3287880 TI - Facial hair and respirator fit: a review of the literature. AB - The effect of facial hair on the quality of fit obtained while wearing a tight fitting respirator has been and continues to be a controversial subject. Many people hold strong opinions on both sides of the issue, but it is not opinion that is needed. Rather what is needed is quantitative study of the situation to determine precisely what effect facial hair has on respirator fit. The results of fourteen studies of the facial hair leakage question have been summarized. All but two of the fourteen studies found that in the presence of facial hair, face seal leakage increases from 20 times to 1000 times. In addition both intersubject and interrespirator face seal leakage variability increased when facial hair was present. In the other two studies, one completed with positive pressure SCBAs and the other completed in the workplace, no statistically significant leakage differences were found. PMID- 3287881 TI - Effect of diltiazem on myocardial infarct size estimated by enzyme release, serial thallium-201 single-photon emission computed tomography and radionuclide angiography. AB - Diltiazem is a calcium antagonist with demonstrated experimental cardioprotective effects. Its effects on myocardial infarct size were studied in 34 patients admitted within 6 hours after the first symptoms of acute myocardial infarction. These patients were randomized, double-blind to placebo or diltiazem (10-mg intravenous bolus followed by 15 mg/hr intravenous infusion during 72 hours, followed by 4 X 60 mg during 21 days). Myocardial infarct size was assessed by plasma creatine kinase and creatine kinase-MB indexes, perfusion defect scores using single-photon emission computed tomography with thallium-201 and left ventricular ejection fraction measured by radionuclide angiography. Tomographic and angiographic scanning was performed serially before randomization, after 48 hours and 21 days later. Groups were comparable in terms of age, sex, inclusion time and baseline infarct location and size. Results showed no difference in creatine kinase and creatine kinase-MB data between controls and treated patients, a significant decrease in the perfusion defect scores in the diltiazem group (+0.1 +/- 3.0 placebo vs -2.2 +/- 1.9 diltiazem, p less than 0.02) and a better ejection fraction recovery in the diltiazem group (-4.2 +/- 7.4 placebo vs +7.7 +/- 11.2 diltiazem, p less than 0.05). Myocardial infarct size estimates from perfusion defect scores and enzyme data were closely correlated. These preliminary results suggest that diltiazem may reduce ischemic injury in acute myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287882 TI - Long-term bepridil monotherapy for angina pectoris. AB - The long-term efficacy of bepridil as once-a-day monotherapy was studied in 19 men with stable angina pectoris. After 2 weeks of single-blind placebo therapy and a 12-week parallel placebo-controlled, dose-response study, each patient received open-label bepridil. After a dose-titration period of 3 months, patients received bepridil (100 to 400 mg once a day, mean 290 mg) for 24 months. The response to treatment was assessed by patient diaries and serial treadmill exercise testing 24 hours after dose administration, every 3 months. Only 2 patients were released from the study due to therapeutic failure. Compared with placebo, 3 months of bepridil therapy resulted in a significant reduction in the weekly frequency of angina from 10.3 +/- 9.1 to 1.8 +/- 3.5 (p less than 0.002) and nitroglycerin consumption from 5.0 +/- 5.4 to 1.4 +/- 2.3 (p less than 0.01). In addition, there was a simultaneous significant increase in the walking time to angina from 5.2 +/- 2.3 to 7.9 +/- 2.6 minutes (p less than 0.001) and total exercise time from 7.1 +/- 2.2 to 8.8 +/- 1.9 minutes (p less than 0.001). These favorable effects were sustained throughout the 24 months of the study. Although resting QTc interval was prolonged by 36 to 42 ms (p less than 0.001) during bepridil therapy, ventricular dysrhythmias were not observed immediately before or during exercise testing and were not manifested by symptoms. Neurologic and gastrointestinal side effects of mild to moderate severity were observed, but none required discontinuation of therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287883 TI - Hemodynamic profiles at rest and during supine exercise after orthotopic cardiac transplantation. AB - To characterize the spectrum of hemodynamic findings after orthotopic cardiac transplantation, 20 healthy heart transplant recipients with no evidence of cardiac dysfunction by noninvasive testing were studied for 1 to 51 months (mean 15) following surgery. After routine endomyocardial biopsy, right-sided heart pressures and thermodilution cardiac outputs were measured at rest (supine) and during symptom-limited, graded supine exercise. In addition, the effect of respiration on right atrial pressures and waveforms was determined at rest (supine, legs down), and after passive leg raising (volume loading). During exercise, striking increases of pulmonary artery, pulmonary artery wedge and right atrial pressures were seen. The mean pulmonary artery pressure rose 45% during the first stage of exercise (p less than 0.001) and by peak exercise it had increased 87% above resting values. The pulmonary artery wedge pressure increased significantly with passive leg elevation (p less than 0.001) and during the first stage of exercise rose 61% above baseline values. By peak exercise the mean pulmonary artery wedge pressure was more than double the resting value. Similarly, the right atrial mean pressure increased significantly (p less than 0.001) with passive leg elevation and nearly tripled at peak exercise. All values promptly returned to near baseline after exercise. The cardiac output increased 98% during exercise. During early exercise, the rise in cardiac output was mediated primarily by an increase in stroke volume. At rest, there was an abnormal response in right atrial mean pressure during slow deep inspiration in 7 individuals with legs down and in 12 after passive leg elevation (volume loading), including 4 of 10 patients studied beyond 1 year.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287884 TI - Contrast media-related complications during cardiac catheterization using Hexabrix or Renografin in high-risk patients. AB - Contrast media may lead to adverse reactions during cardiac catheterization. Hexabrix has less hemodynamic and electrophysiologic effects than Renografin-76. To assess relative complication rates using these agents, 82 patients with heart failure or "unstable" ischemic syndromes and undergoing catheterization were prospectively randomized to receive either Hexabrix or Renografin. Clinical diagnoses, hemodynamics before contrast media administration, left ventricular ejection fraction, case duration, contrast volume and cine film quality were similar in the 2 groups. The condition of 1 patient assigned to receive Renografin was deemed too unstable and Hexabrix was safely used. In the other patients, a total of 17 adverse reactions occurred (7 before administration of contrast and thus unrelated: 4 Hexabrix- and 3 Renografin-assigned patients, difference not significant). Three contrast-induced adverse reactions were considered minor (Hexabrix 2, Renografin 1, difference not significant). Severe adverse reactions requiring intervention, such as pulmonary edema and hypotension, were more frequent in patients who received Renografin (6 of 38, 16%) as compared with Hexabrix (1 of 43, 2%) (p less than 0.05). It is concluded that in high-risk patients undergoing cardiac catheterization, Hexabrix is tolerated better than Renografin and should be considered for routine use. PMID- 3287885 TI - "Microvascular angina" as a cause of chest pain with angiographically normal coronary arteries. PMID- 3287886 TI - Dissimilar systemic and local adverse effects of thrombolytic therapy. PMID- 3287887 TI - Antiischemic effects of a newly developed capsule containing 120 mg isosorbide dinitrate in sustained release form. PMID- 3287888 TI - Associations of HLA-A, B, DR antigens with primary disease in cardiac allograft recipients. PMID- 3287889 TI - Stone agers in the atomic age: lessons from the Paleolithic life-style for modern man. PMID- 3287890 TI - Raw cornstarch as an additional therapy in nesidioblastosis. AB - We report the successful use of raw cornstarch to maintain normoglycemia in two children with nesidioblastosis. Despite subtotal distal pancreatectomy both children required frequent daytime feedings and continuous nocturnal intragastric polycose administration to prevent symptomatic hypoglycemia. Raw cornstarch administration consistently maintained blood glucose levels in the normal range. Both children still need frequent daily feedings but no hypoglycemic episodes are reported. They have normal development and have maintained satisfactory growth during the 22 mo since initiation of treatment. PMID- 3287891 TI - Degree of starch gelatinization, digestion rate of starch in vitro, and metabolic response in rats. AB - Glycemic response after ingestion of starchy foods varies. Starch in many common ready-to-eat foods is only partly gelatinized. In view of this, the relationships among degree of starch gelatinization, in vitro digestion rate, and in vivo metabolic response in rats were studied. Wheat starch with different degrees of gelatinization was used in the experiments. Plasma glucose and insulin responses as well as the rate of in vitro hydrolysis with alpha-amylase were strongly correlated to the degree of starch gelatinization (r = 0.88, r = 0.90, and r = 0.96, respectively). Plasma glucose and insulin responses were also positively correlated to the rate of hydrolysis with alpha-amylase in vitro (r = 0.98 and r = 0.76, respectively). These results suggest that the degree of starch gelatinization is an important determinant both for the rate of starch hydrolysis in vitro and for the metabolic response in vivo. PMID- 3287892 TI - Metabolic differences between subjects whose blood pressure did or did not respond to oral calcium supplementation. AB - In a randomized, double-blind, placebo-controlled trial of a 1500 mg/d calcium supplement taken over a 12-wk period, the mean arterial pressure of normotensive adult males (n = 37) was modestly but significantly lowered as compared with a placebo group (n = 38). Within the Ca group only, responders (greater than or equal to 5 mm Hg decrease in mean arterial pressure, n = 14) were compared with nonresponders (less than 5 mm Hg decrease in mean arterial pressure, n = 23). The responders were older (p = 0.002) and exhibited higher mean arterial pressure (p = 0.00001), higher serum parathyroid hormone (p = 0.01), and lower serum total Ca (p = 0.001) at baseline. A stepwise discriminant function analysis revealed that mean arterial pressure and serum total Ca correctly classified 78.38% of the responders and nonresponders and, thus, were the most important determinants of blood pressure response to supplemental Ca. PMID- 3287893 TI - Methodologic considerations for investigating the diet-cancer link. AB - Evidence from human ecological studies and experimental animal studies suggest that a number of dietary factors may have a role in the etiology of cancers of various sites. When associations are examined within populations on the level of the individual, they often weaken or disappear. Although in some cases the suspect nutrient may have no real carcinogenic effect, it is proposed that there are at least three important methodologic problems that could prevent the observation of a true association between dietary factors and human cancer. First, diet assessment methods are inadequate to estimate true exposure with sufficient accuracy and precision especially over long periods. Second, use of retrospective diet assessment methods in case-control study designs can often introduce an important bias. Third, sufficient within-study-group contrasts are often lacking. These problems are discussed in interpreting recent cancer studies of diet, and recommendations are made for future research. PMID- 3287894 TI - Short-term changes in energy intake and serum insulin, neutral amino acids, and urinary catecholamine excretion in women. AB - The effect of short-term undereating (4.2 MJ [1000 kcal] for 4 d) followed by overeating (12.6 MJ [3000 kcal] for 2 d) on fasting and 2-h postprandial serum glucose, insulin, and neutral amino acids and on urinary free and total norepinephrine and dopamine excretion was studied in 12 normal women. Protein and sodium intake was constant throughout the study. Serum glucose concentration was not affected by diet but the serum total neutral amino acids (ie, sum of valine, leucine, isoleucine, and phenylalanine) tended to increase during undereating and decrease during overeating. Serum tryptophan concentration, relative to the remaining neutral amino acids, was consequently lower during undereating than overeating. The postprandial increase in serum insulin level was greater during overeating than undereating. Urinary free norepinephrine and total dopamine levels were also increased during overeating, suggesting both sympathetic and dopaminergic activation during overeating after undereating. PMID- 3287895 TI - Adolescent maternal weight gain and low birth weight: a multifactorial model. AB - Maternal weight gain is one of the most important independent predictors of infant birth weight and interacts with other maternal characteristics, including age, so that infant birth weight reaches a plateau at a higher level of maternal weight gain for young adolescents than for adults. It has been suggested that encouraging young adolescents to gain larger amounts of weight during pregnancy may be one way to decrease their risk of low-birth-weight deliveries. This recommendation may be premature because the mechanisms underlying the interaction between maternal age and weight gain are incompletely understood and may include such diverse factors as incomplete maternal growth, reproductive immaturity, diminished maternal body size, nutritional deficiencies, socioeconomic and behavioral factors, and maternal emotional stress. This review summarizes the literature on adolescent maternal weight gain and infant birth weight and discusses the importance of considering a multifactorial model in reformulating the weight-gain recommendations for pregnant adolescents. PMID- 3287896 TI - Gastrointestinal and cardiac response to low-calorie semistarvation diets. AB - Effects of low-calorie semistarvation diets on gastrointestinal and cardiac organ systems were studied. Male Sprague Dawley rats were divided into two groups, Group I, control (C) and Group II, semistarvation (SS), and maintained on a diet designed after low-calorie modified-fasting regimens in popular use. C animals consumed this diet ad libitum; SS animals received 23% of the total calories of C but the same ratio of calories from protein, carbohydrate, and fat and the same quantity and quality of all essential nutrients. Final weights of total body, heart, liver, and small intestine were lower in SS than in C animals. Protein depletion in SS compared with C animals was evident for heart, pancreas, and intestinal mucosa. Unless aggressively supplemented, low-calorie SS diets may deplete protein stores of the gastrointestinal organs of digestion and absorption and contribute to decrease in body nitrogen stores, specifically cardiac muscle. PMID- 3287898 TI - Glass ionomer cements in orthodontics--an update. AB - Because conventional bands continue to be used in clinical orthodontics, it is essential to evaluate new dental cements to establish their suitability as a cementing medium for orthodontic bands. This study was undertaken to determine the failure rate of bands cemented with a glass ionomer cement to premolar and molar teeth. The sample consisted of 100 consecutively completed cases. Stainless steel bands were cemented to premolar and molar teeth (799) with a glass ionomer cement (Ketac-Cem). The failure rate for the bands was 1.9%. This is significantly lower than the 5.1% recorded for bands cemented with a polycarboxylate cement reported in a previous study. PMID- 3287897 TI - Bonding orthodontic acrylic resin to enamel. AB - Bonded acrylic orthodontic appliances are a recent alternative to banded methods. However, the physical properties demonstrated by bonding adhesives at the acrylic enamel interphase have not been well documented. The purpose of this study was to use a laboratory testing model to evaluate the ultimate shear and tensile strengths and fracture sites of five bonding adhesives: unfilled (Bracketbond and Genie); filled (Unite, Excel, and Concise). One hundred bovine mandibular incisors were embedded in dental stone, labial surfaces ground flat for uniform acrylic-enamel adaptation, and stored in modified Fusyama's artificial saliva. Twenty 7-mm diameter acrylic cylinders were bonded in each group. Ten samples from each group were tested for shear strength and ten for tensile strength with an Instron testing machine. Bonding adhesive retained on the cylinder was measured by means of a Bioquant digitizer. Scanning electron microscopy was used to analyze fracture sites. The results showed that the percentage of bonding adhesive that remains on the acrylic surface after fracture is decreased by the addition of inorganic fillers to the adhesive and the use of separate liquid resin sealants, and is increased by the use of plastic bracket primers and bonding adhesives that are chemically similar to methylmethacrylate. Few significant differences in shear and tensile strengths were found among the bonding adhesives. Unfilled bonding adhesives cause less enamel damage and are indicated for clinical bonding of acrylic orthodontic appliances to enamel. PMID- 3287899 TI - Anna Hopkins Angle--"first lady" of orthodontics. PMID- 3287900 TI - Systemic complications of acute pancreatitis. AB - The multisystem involvement in acute pancreatitis (AP) is a reflection of the pancreatic gland's capacity to produce a number of potent vasoactive peptides, hormones, and enzymes. The various prognostic criteria are early evaluations of these metabolic derangements. The pathogenesis of hypocalcemia, long recognized as an indicator of severity of AP, is multifactorial. Imbalances of parathyroid hormone (PTH)-calcitonin, the interactions of glucagon, gastrin and other pancreatic hormones with PTH-calcitonin, the role of free fatty acids in binding serum calcium with albumin, and the translocation of calcium ion in muscles and liver, have been recently described but remain conflicting theories. Yet, the time-honored theory of calcium-soap formation enjoys wide acceptance. Hyperglycemia, hypoglycemia, and occasional ketoacidosis in acute pancreatitis have been studied thoroughly. The complex cause-and-effect relationship between hyperlipidemia with acute pancreatitis needs further study. The coagulation abnormalities seem to be initiated by activated trypsin, and their role in microvascular coagulation appears to form a unifying hypothesis for major organ dysfunction, but this requires further investigation. Adult respiratory distress syndrome may be the result of active enzymes that digest pulmonary surfactant and/or microvascular thrombosis. The depression of cardiac function and shock are suspected to be secondary to vasoactive peptides such as bradykinin, or myocardial depressant factor, whose structure has yet to be elucidated. The renin angiotensin alterations and renal complications in acute pancreatitis have received scant attention in the literature. The onset of moderate visual disturbances, or even blindness, in a patient with acute pancreatitis as a result of retinal vessel thrombosis is fortunately uncommon. Rare but interesting are the manifestations such as subcutaneous fat necrosis, arthralgia, and pancreatic encephalopathy. Despite the extensive literature on the complexities of the pathogenesis of complications of acute pancreatitis, there have been very few advances in the prevention and management of specific complications. It is hoped that further work on modification of enzymatic disturbances induced in acute pancreatitis will result in its effective treatment and prevention of serious complications. PMID- 3287901 TI - Arterial oxygen saturation during upper gastrointestinal endoscopy: influence of sedation and operator experience. AB - In order to compare the effects of Diazemuls and midazolam on arterial oxygen saturation during upper gastrointestinal endoscopy, 120 patients were randomly allocated to receive Diazemuls, midazolam, or normal saline. Endoscopy was performed by one consultant or one of four residents. Arterial oxygen saturation was monitored continuously during endoscopy by means of a Biox III pulse oximeter and ear probe. Oxygen saturation fell during endoscopy in all three groups, but no significant differences between the groups were detected at any stage of the procedure. When all groups were combined, there was significantly less desaturation when the consultant performed the endoscopy, and he was also significantly faster in carrying out endoscopy than the residents in each group. When an inexperienced resident was compared with one with at least 6 months of experience, there were significant differences in degree of desaturation, lowest value during endoscopy and tolerance score. It is suggested that the patient at risk of hypoxemia should, if possible, be endoscoped by an experienced endoscopist. PMID- 3287902 TI - Biliobiliary fistula: review of nine cases. AB - We have reviewed nine cases of biliobiliary fistula operated during 1983-85. Two of these patients also had a high hepatic duct stricture, an association not highlighted before. Eight of these patients had jaundice. A classical cholecystectomy in the presence of biliobiliary fistula entails grave risk to the integrity of the upper biliary tract. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography can detect these rare fistulae. It is proposed that all patients with cholelithiasis associated with jaundice be screened by sonography for evidence of biliobiliary fistula. They should then have an ERCP to detect and delineate the biliobiliary fistula. At surgery, all of these patients have a fused gall bladder with obliteration of the Calot's triangle. Both retrograde and antegrade cholecystectomy is hazardous in these cases. Instead, the gall bladder should be opened inferiorly and evacuated of all stones, followed by a partial cholecystectomy and common hepatic duct repair over a T-tube. In the presence of an associated high or low biliary stricture, a suitable bilioenteric anastomosis may be required. PMID- 3287903 TI - Survival of enteric pathogens in common beverages: an in vitro study. AB - This in vitro study was undertaken to determine the potential for survival of enteric pathogens in common drinking beverages. Three carbonated soft drinks, two alcoholic beverages, skim milk, and water were inoculated with Salmonella, Shigella, and enterotoxigenic Escherichia coli, and quantitative counts were performed over 2 days. Our studies showed poorest survival of all three organisms in wine, and greatest growth in milk and water. Beer and cola allowed survival of small numbers of Salmonella and E. coli at 48 h, whereas sour mix and diet cola were sterile by 48 h. Survival features may correlate with pH of the beverages. These observations may be useful in guiding travellers for appropriate beverage consumption while visiting areas endemic for "traveller's diarrhea." PMID- 3287904 TI - Rapidly progressive glomerulonephritis: classification, pathogenetic mechanisms, and therapy. AB - Immunopathologic studies over the past two decades have demonstrated that rapidly progressive glomerulonephritis (RPGN) can result from glomerular deposition of anti-GBM antibody, immune complexes, or from some as yet undefined mechanism that does not involve glomerular antibody deposition. The latter process may be cell mediated and resembles a small vessel vasculitis. Most cases of idiopathic RPGN are not accompanied by pathogenic glomerular immunoglobulin deposition. Recent experimental studies of immune mechanisms of glomerular injury have identified several new processes that can induce damage to the capillary wall sufficient to result in crescentic glomerulonephritis (GN). These include direct effects of anti-GBM antibody alone and of the complement C5b-9 (membrane attack) complex, nephritogenic effects of inflammatory effector cells that involve reactive oxygen species and glomerular halogenation, and injury mediated by sensitized lymphocytes independently of antibody deposition. Macrophages have been shown to participate in both intracapillary and extracapillary fibrin deposition and crescent formation as well as to mediate capillary wall damage. The role of resident glomerular cells and cell-cell interactions in glomerulonephritis is still under active investigation. Despite these several advances in understanding immune injury to the glomerulus, therapy for RPGN remains largely empiric. Although the prognosis in RPGN has clearly improved over time, no form of disease specific therapy has been clearly shown yet to be beneficial in a controlled study. Interpretation of the existing literature on therapy is complicated by the availability of only historical rather than concurrent controls, lack of attention to several variables known to affect disease outcome, and uncertainty regarding bias in favor of reporting positive results. Available data suggests that optimal outcomes may be achieved in anti-GBM nephritis by treatment with steroids, immunosuppression and plasma exchange, particularly when therapy is directed at patients with mild but rapidly progressive disease before oliguria or severe azotemia develop. Pulse steroids are probably the most cost-effective therapy for the idiopathic form of RPGN, but treatment with cytotoxic agents should be considered if clinical or histologic evidence of vasculitis is present. PMID- 3287905 TI - Renal functional reserve in live related kidney donors. AB - Renal function in 12 live kidney donors who had donated a kidney to a relative 3 to 10 years previously was studied. No clinically significant impairment of renal function was observed in the group. A significant rise in creatinine clearance (P = less than 0.01) occurred after a meat-protein load. When compared with 12 healthy controls with two kidneys, there was no significant difference in the percentage change in clearance after the meat load. In both groups there was an inverse correlation between the percentage change in creatinine clearance and the baseline creatinine clearance (P = less than 0.01), with no significant difference in the regression lines of the two groups. In conclusion, it appears that the single kidney responds appropriately to a meat-protein load and that there is no evidence from this study to suggest that hyperfiltration damaged the remaining kidney. PMID- 3287906 TI - Corporate influence on threshold limit values. AB - Investigations into the historical development of specific Threshold Limit Values (TLVs) for many substances have revealed serious shortcomings in the process followed by the American Conference of Governmental Industrial Hygienists. Unpublished corporate communications were important in developing TLVs for 104 substances; for 15 of these, the TLV documentation was based solely on such information. Efforts to obtain written copies of this unpublished material were mostly unsuccessful. Case studies on the TLV Committee's handling of lead and seven carcinogens illustrate various aspects of corporate influence and interaction with the committee. Corporate representatives listed officially as "consultants" since 1970 were given primary responsibility for developing TLVs on proprietary chemicals of the companies that employed them (Dow, DuPont). It is concluded that an ongoing international effort is needed to develop scientifically based guidelines to replace the TLVs in a climate of openness and without manipulation by vested interests. PMID- 3287907 TI - Analgesic efficacy of piroxicam in the treatment of postoperative pain. AB - Two randomized, double-blind, single-dose studies were conducted to assess the analgesic efficacy and safety of piroxicam for the treatment of moderate or severe postoperative pain. Study 1 evaluated the analgesic efficacy of piroxicam 20 mg compared with that of codeine sulfate 60 mg and placebo. A final patient population of 149 subjects rated pain intensity and pain relief at one half hour and one hour following treatment and then hourly for six hours, with a global assessment made at the completion of 24 hours. Piroxicam 20 mg was significantly more efficacious than placebo for all analgesic variables, including the sum of the pain intensity differences (SPID), total pain relief (TOTAL), percent SPID, duration of effect, and time to remedication. Codeine 60 mg was significantly superior to placebo for percent SPID and some hourly measures. Piroxicam 20 mg was significantly more effective than codeine 60 mg for percent SPID and a few hourly measures including time to remedication. Study 2 assessed the efficacy of piroxicam 20 mg or 40 mg compared with aspirin 648 mg and placebo. Sixty patients rated their pain intensity and relief hourly for 12 hours and at 24 hours after administration of study medication. Both doses of piroxicam were significantly more effective than placebo from Hours 2 to 12 for pain intensity difference (PID) and relief scores, as well as for SPID and TOTAL. Aspirin was significantly more effective than placebo from Hours 2 to 8 for relief and Hours 2 to 10 for PID as well as SPID and TOTAL. Piroxicam 40 mg was significantly more effective than aspirin 648 mg for SPID, TOTAL, and hourly measures beginning with Hour 6 through Hour 12. Piroxicam 20 mg was significantly better than aspirin for a few hourly measures: Hours 7 to 9 for relief and Hour 7 for PID. In addition, effects of piroxicam 20 mg had a significantly longer duration than aspirin. Similarly, piroxicam 20 mg had a significantly longer time to remedication compared with aspirin and placebo. The results of these studies provide evidence in support of the longer duration of analgesic efficacy of piroxicam compared with codeine or aspirin in patients with postoperative pain. PMID- 3287908 TI - Nonsteroidal anti-inflammatory drugs and changing attitudes toward dysmenorrhea. AB - Dysmenorrhea, which may be primary or secondary, is the occurrence of painful uterine cramps during menstruation. Until a decade ago, medical and social attitudes toward dysmenorrhea were shrouded with folklore, psychoanalytical profiles, or psychosomatic bases. In secondary dysmenorrhea, there is a visible pelvic lesion to account for the pain, whereas only a biochemical abnormality is responsible for primary dysmenorrhea. Recent advances in the biochemistry of prostaglandins and their role in the pathophysiology of primary dysmenorrhea and intrauterine device (IUD)-induced dysmenorrhea have now firmly established a rational basis for the disorder. In primary dysmenorrhea, menstrual prostaglandin release is significantly increased but can be readily suppressed to normal levels when nonsteroidal anti-inflammatory drugs (NSAIDs) capable of inhibiting cyclo oxygenase are given during menstruation. Many clinical trials (controlled and uncontrolled) have demonstrated the efficacy of NSAIDs such as the fenamates, indole-acetic acid derivatives, and arylpropionic acid derivatives in relieving primary dysmenorrhea as well as IUD-induced dysmenorrhea that is also due to elevated prostaglandin levels. With a few of these NSAIDs, it has been shown that the relief of pain is associated with a significant decrease in menstrual fluid prostaglandin levels. Cumulative data of clinical trials indicate that with the effective NSAIDs, 80 percent of patients with significant primary dysmenorrhea can be adequately relieved. Ongoing studies suggest that in some women, endometrial leukotriene, but not PGF2a production, is increased. With the official approval and availability of several effective NSAIDs for the specific treatment of primary dysmenorrhea in the United States, women who have primary dysmenorrhea have been greatly relieved and their productivity increased. Primary dysmenorrhea affects 50 percent of postpubescent women and absenteeism among the severe dysmenorrheics has been estimated to cause about 600 million lost working hours or 2 billion dollars annually. Thus, an effective, simple, and safe treatment of primary dysmenorrhea for two to three days during menstruation will not only have a positive economic impact but will also enhance the quality of life. The availability of effective dysmenorrhea therapy with NSAIDs has induced greater expectations of relief by the patient, as well as greater willingness to seek medical help, a more rational approach to patient management by physicians, changes in attitude toward women with primary dysmenorrhea, and the debunking of myths about dysmenorrhea that often have been perpetuated as fact.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3287909 TI - A double-blind, placebo-controlled study comparing three single-dose regimens of piroxicam with ibuprofen in patients with primary dysmenorrhea. AB - Sixty-eight women with primary dysmenorrhea were randomly assigned to one of five four-times-daily treatment groups for a minimum of three days and a maximum of five days. Three of the groups received different initial single-daily doses of piroxicam, which were followed on each treatment day with placebo for the second through fourth doses, namely, piroxicam 20 mg daily for five days (piroxicam 20 mg for five days); piroxicam 40 mg on Day 1, followed by piroxicam 20 mg on Days 2 through 5 (piroxicam 40 mg for one day); and piroxicam 40 mg on Days 1 and 2, followed by piroxicam 20 mg on Days 3 through 5 (piroxicam 40 mg for two days). The fourth group received ibuprofen 400 mg four times per day, and the fifth group received placebo four times per day. Patients determined the severity of overall discomfort and pelvic-abdominal pain at baseline and prior to each dose using a four-point numerical scale. Supplemental ibuprofen, 400 mg four times per day, was provided for those patients requiring additional pain relief. Patients also made a global determination of overall relief at the end of the study. At 24 hours, the results revealed that piroxicam 40 mg for two days, piroxicam 20 mg for five days, and ibuprofen provided significantly more relief of overall discomfort compared with placebo (p = 0.003, p = 0.018, and p = 0.026, respectively). All four active treatment groups also experienced significantly more relief of pelvic-abdominal pain compared with placebo: piroxicam 40 mg for two days followed by three days of 20 mg (p = 0.002), piroxicam 40 mg for one day followed by four days of 20 mg (p = 0.023), piroxicam 20 mg for five days (p = 0.012), and ibuprofen (p = 0.011). A significantly smaller percentage of patients treated with piroxicam 40 mg for two days required supplemental medication as compared with those treated with piroxicam 20 mg for five days (p = 0.035) and patients treated with placebo (p = 0.010). A greater amount of overall relief was obtained by patients treated with piroxicam 40 mg for two days compared with patients treated with piroxicam 40 mg for one day (p = 0.041) and placebo-treated patients (p = 0.001). It was concluded that single daily doses of piroxicam 20 mg and 40 mg were as effective as ibuprofen, 400 mg four times per day, for the relief of primary dysmenorrhea. PMID- 3287910 TI - Analgesic efficacy of piroxicam in postoperative dental pain. AB - The severity of postoperative dental pain can be variable depending on the type of procedure. Both centrally acting and peripherally acting analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and acetaminophen are used. NSAIDs are generally better suited to ambulatory outpatients. The most commonly used postoperative dental pain model includes patients who have undergone surgical removal of impacted third molar teeth. The analgesic efficacy of piroxicam in this pain model was studied both in the United States and in foreign centers. The foreign studies suggest that piroxicam at 20-mg doses produces analgesia in patients with postoperative dental pain. Seven single-dose, randomized, double-blind trials of 798 patients in the United States more clearly evaluated the efficacy of piroxicam. These studies used various doses of piroxicam (5, 10, 20, and 40 mg), aspirin 648 mg, and placebo. Safety results showed that a wide range of piroxicam doses were safe when administered in single doses. Although neither piroxicam 5 mg nor 10 mg produced clinically significant analgesia, 20-mg and 40-mg doses were significantly superior to placebo and both were comparable with aspirin 648 mg over the initial six hours. Piroxicam 20 mg and 40 mg, however, produced significantly longer durations of analgesia than aspirin 648 mg, and it appears that the analgesic effect of piroxicam may extend for up to 24 hours in a substantial proportion of patients. PMID- 3287911 TI - Piroxicam and naproxen in acute sports injuries. AB - The efficacy of piroxicam versus placebo was studied in a double-blind, randomized trial of 74 patients with traumatic injury of muscle, periosteum, bursa, or ankle joint. The piroxicam dosage was 40 mg once daily for two days and then 20 mg daily for an additional five days. Efficacy parameters were assessed at entry and at three, seven, and 14 days. At the Day 3 visit, there was a statistically significant improvement in the piroxicam group for pain at rest, pain on movement, pain on palpation, reduced muscle force, and general limitation of function. At the Day 7 visit, the difference was still significant for pain on palpation and reduced muscle force. Mean time required for full relief of symptoms was 7.5 days in the piroxicam group and 10.2 days in the placebo group. The anti-inflammatory effects of piroxicam and naproxen were then compared in 254 patients experiencing the same types of injuries mentioned above. The dosage of piroxicam was the same as in the comparison with placebo, whereas naproxen was given 500 mg twice daily; treatment in both groups lasted for five days. There was no difference in most parameters for pain, swelling, and function. There was a significant difference in favor of piroxicam for tenderness on palpation and time to complete relief of symptoms. PMID- 3287912 TI - Piroxicam in acute musculoskeletal disorders and sports injuries. AB - Approximately 20 percent of athletes have an acute or chronic injury related to their sport. In acute musculoskeletal disorders, inflammation is an important component of the symptomatology. Recent clinical studies are showing that nonsteroidal anti-inflammatory drugs (NSAIDs) can significantly reduce inflammation and help speed return to full function. In an international study, the efficacy and toleration of piroxicam were compared with that of indomethacin, naproxen, and aspirin in three multicenter, double-blind, parallel studies involving a total of 1,290 patients with acute sprains and tendinitis. The centers compared piroxicam 40 mg once daily for the first two days followed by 20 mg once daily for the remainder of the studies. This regimen was compared with either indomethacin, 50 mg three times per day for two days and 25 mg three times per day for the remainder of the treatment period; naproxen 500 mg twice daily for two days followed by 250 mg in the morning and 500 mg in the evening thereafter; or aspirin 4 g per day for the duration of the study. Treatment normally lasted 14 days; the minimal duration was seven days, with a maximum of 28 days. Overall assessment of efficacy was excellent or good in more than 80 percent of patients. Statistical differences were seen favoring piroxicam over aspirin (p less than 0.05) regarding reduction in tenderness and resumption of daily activities within 16 days (p less than 0.02). The study comparing piroxicam and naproxen showed a statistically significant difference in favor of piroxicam (p less than 0.025). There was no difference between piroxicam and indomethacin in the number of patients who were able to accomplish normal daily activity within 16 days. Furthermore, although efficacy was comparable among the NSAIDs, piroxicam was significantly better-tolerated than either naproxen or indomethacin. Piroxicam was also better-tolerated than aspirin, but a statistical difference was not reached. PMID- 3287913 TI - Insulin-mediated hypokalemia and paralysis in familial hypokalemic periodic paralysis. AB - To elucidate a potential role for insulin-mediated extra-renal potassium disposal in the clinical syndrome of hypokalemic periodic paralysis, an obese affected man was studied using the euglycemic insulin clamp, which, in normal and obese subjects, produces predictable, insulin dose-dependent declines in plasma potassium levels. During a 20 mU/m2/minute euglycemic clamp (insulin level, 88 microU/ml) procedure, while the patient with hypokalemic periodic paralysis demonstrated severe resistance to insulin-mediated glucose uptake (glucose uptake 50 percent of that of normal control subjects, n = 17), his plasma potassium declined to a degree similar to that seen in normal subjects. During a subsequent higher dose, 200 mU/m2/minute insulin infusion (insulin level, 914 microU/ml), plasma potassium declined to 2.5 meq/liter, a value significantly below that seen in normal (n = 19) (3.3 +/- 0.1 meq/liter) and obese (n = 6) (3.2 +/- 0.1 meq/liter) subjects. During this study, paralysis began in the patient's hand and forearm at the potassium nadir and lasted three hours, despite restoration of normokalemia 30 minutes after paralysis began. Glucose disposal rates during this high-dose insulin infusion were one-half that seen in lean control subjects (n = 19) and similar to those in obese control subjects. If these findings are representative of hypokalemic periodic paralysis and can be generalized to larger numbers of patients, they indicate several new features of this syndrome. The ability of insulin to induce hypokalemia is enhanced in this syndrome even in the presence of marked coexistent obesity-related resistance to the action of insulin to promote glucose utilization. Enhanced sensitivity of potassium uptake systems to activation by insulin (and other factors) may be a central feature of this syndrome. Additionally, paralytic hypokalemia can be induced during a euglycemic insulin clamp procedure, which could be utilized as a diagnostic test for this syndrome. PMID- 3287914 TI - Nephrotoxicity of continuous intravenous infusion of recombinant interleukin-2. AB - Adoptive immunotherapy with recombinant interleukin-2 has been complicated by significant nephrotoxicity of uncertain etiology. Creatinine clearance, effective renal plasma flow, plasma renin activity, aldosterone levels, and urinary prostaglandin excretion were evaluated in a 62-year-old man receiving continuous infusion recombinant interleukin-2. There was a marked decrease in the creatinine clearance and renal plasma flow, accompanied by an elevation in plasma renin activity and aldosterone level. Prostaglandin excretion also decreased, implying a direct effect on renal prostaglandin synthesis. The decrease in renal prostaglandin synthesis at a time of increased plasma renin activity may explain the reduction in renal function seen with recombinant interleukin-2 therapy. PMID- 3287915 TI - Infection in a patient with polycystic kidney and liver disease: noninvasive localization and treatment. PMID- 3287916 TI - Age-associated decline in cardiac allograft rejection. PMID- 3287917 TI - Risk factors for accelerated atherosclerosis in renal transplant recipients. AB - The factors responsible for atherosclerosis in renal transplant recipients are not known. In the present study, cardiovascular disease was investigated in 403 patients who received 464 kidney transplants during a 10-year period. Among those who had no clinical evidence of vascular disease at the time of transplantation, atherosclerotic complications developed in 15.8 percent during the post transplant follow-up period (46.1 +/- 36.2 months). Pre- and post-transplant vascular diseases were closely linked. However, after taking pre-transplant vascular disease into account, multivariate analysis showed that a number of known risk factors (age, sex, diabetes, cigarette smoking, hypertension, and serum cholesterol) were independently associated with post-transplant vascular disease. In addition, the number of acute rejection episodes (all treated with high doses of corticosteroids) was also independently linked to vascular disease. These results suggest that an increased prevalence of known risk factors, and events linked to allograft rejection, explain the high incidence of cardiovascular disease in renal transplant recipients. PMID- 3287918 TI - Measurements of peritoneal surface area in man and rat. AB - The peritoneal dialysis system is composed of unique membranes. To better understand the contribution of these membranes to peritoneal transport, the peritoneal surface areas were measured in human subjects and rats. PMID- 3287919 TI - Interactions between the blood-brain barrier and endogenous peptides: emerging clinical implications. AB - The effects of peptides on brain function suggest therapeutic and pathologic roles for these substances. Many peptides cross the blood-brain barrier (BBB) by transmembrane diffusion as a function of their lipid solubilities. Other peptides, such as the enkephalins, Tyr-MIF-1, vasopressin-related peptides, and peptide T-like peptides, are transported by carrier-mediated systems. Passage is influenced by aging, stress, lighting, drugs, amino acids, and neurotoxins. Disruption of the BBB results in complex changes in the blood and CSF levels of peptides. Peptides influence the passage of glucose, amino acids, and inorganic acids and may affect the integrity of the BBB. Peptide-BBB interactions have been suggested to play direct roles in dialysis dementia and maple syrup urine disease; they may be expected to be involved in other disorders of the CNS. PMID- 3287921 TI - Agnathia, holoprosencephaly, and situs inversus: report of a case. AB - We present the first documented case of agnathia-holoprosencephaly (an uncommon form of craniofacial anomaly) associated with situs inversus. This case may represent the concordance of multiple field complex anomalies, but the possibility of a major midline malformation (situs inversus) caused by a timed insult (environmental or genetic) which affects multiple structures and occurs concurrently with a major field defect during early embryogenesis cannot be excluded. PMID- 3287920 TI - Molecular mechanisms of autoimmunity. AB - Autoimmune diseases result from a combination of genetic susceptibility factors and exogenous influences such as infection or chemical (including drug) exposure. Germline DNA variations in genetic type as well as defects in antigen recognition acquired during thymic education of developing T-lymphocytes both contribute to impaired self: nonself discrimination and set the stage for later development of such diseases as myasthenia gravis, polymyositis, or systemic lupus erythematosus. In addition, drugs such as D-penicillamine, hydralazine, procainamide, or quinidine induce T-cell or B-cell changes which precipitate auto reactivity and cause drug-induced disease. Intervention in autoimmune diseases with prednisone, alkylating agents or the future use of more selective monoclonal antibody reagents may be life-saving in some of these disorders. PMID- 3287922 TI - Prenatal diagnosis of distal arthrogryposis. AB - We report the prenatal diagnosis of distal arthrogryposis type I by ultrasound at 18 wk gestation in a family with two other affected members (mother and sister of the fetus). The pregnancy was followed with serial ultrasounds, and the diagnosis was confirmed after birth. The clinical findings in all affected family members are described. A literature survey of prenatally diagnosed cases of multiple joint contractures is presented. These include cases with many different diagnoses. This is the first report of the prenatal diagnosis of distal arthrogryposis type I. It helps to illustrate the variability and prenatal natural history of the condition and the subtlety of the prenatal ultrasound findings. PMID- 3287923 TI - XK aprosencephaly and anencephaly in sibs. AB - Recent studies have suggested a causal and pathogenetic relationship between holoprosencephaly and anencephaly. In support of the proposed relationship we report a sibship that includes anencephalic male twins and a female infant with a severe form of alobar holoprosencephaly, radial aplasia, and oligodactyly. The upper limb and brain malformations are considered to represent aprosencephaly syndrome. The coexistence of anencephaly and aprosencephaly within a sibship suggests that XK aprosencephaly syndrome may be an autosomal recessive disorder. PMID- 3287924 TI - Tetraploidy in a 15-month-old girl. AB - We present a 15-month-old girl with tetraploidy and compare the manifestations with those of 3 previously reported liveborn infants with the same type of polyploidy. Common anomalies noted included micro-turricephaly, a prominent but narrow forehead, microphalmia or anophthalmia, limb anomaly, sacral meningomyelocele, and mental retardation. PMID- 3287925 TI - International Nosology of Heritable Disorders of Connective Tissue, Berlin, 1986. PMID- 3287926 TI - Renal ultrasound examination of parents in dominantly inherited renal adysplasia- a note of caution. PMID- 3287927 TI - From patients, with love. PMID- 3287928 TI - A national program for lowering high blood cholesterol. AB - The National Institutes of Health have begun a new National Cholesterol Education Program. This program is modeled on the 15-year-old National High Blood Pressure Education Program, which has played a major role in improving the detection and treatment of hypertension in this country. Similar success can be predicted for the National Cholesterol Education Program, given the similarity between these two risk factors--hypertension and cholesterol--in (1) the accumulated scientific evidence for the benefit of intervention, (2) the availability of classification and treatment guidelines, and (3) the approach to professional and public health education programs. The new National Cholesterol Education Program guidelines recommend that all adults undergo a blood cholesterol measurement at least once every 5 years. Patients with a level greater than 200 mg/dl (confirmed by a second measurement) should be advised to adopt a step 1 fat-controlled diet. Patients with a cholesterol level greater than 240 mg/dl are candidates for intensive treatment with step 2 diet and sometimes drugs, as are those in the 200 to 240 mg/dl range who are at especially high risk because they already have coronary heart disease or two other risk factors. However, drugs for lowering blood cholesterol levels should be used only when the indication has been confirmed by measurements of low-density lipoprotein cholesterol and as a supplement to continuing the dietary treatment. PMID- 3287929 TI - Role of lipoprotein lipase activity on lipoprotein metabolism and the fate of circulating triglycerides in pregnancy. AB - The mechanism that induces maternal hypertriglyceridemia in late normal pregnancy, and its physiologic significance are reviewed as a model of the effects of sex steroids on lipoprotein metabolism. In the pregnant rat, maternal carcass fat content progressively increases up to day 19 of gestation, then declines at day 21. The decline may be explained by the augmented lipolytic activity in adipose tissue that is seen in late pregnancy in the rat. This change causes maternal circulating free fatty acids and glycerol levels to rise. Although the liver is the main receptor organ for these metabolites, liver triglyceride content is reduced. Circulating triglycerides and very-low-density lipoprotein (VLDL)-triglyceride levels are highly augmented in the pregnant rat, indicating that liver-synthesized triglycerides are rapidly released into the circulation. Similar increments in circulating VLDL-triglycerides are seen in pregnant women during the third trimester of gestation. This increase is coincident with a decrease in plasma postheparin lipoprotein lipase activity, indicating a reduced removal of circulating triglycerides by maternal tissues or a redistribution in their use among the different tissues. During late gestation in the rat, tissue lipoprotein lipase activity varies in different directions; it decreases in adipose tissue, the liver, and to a smaller extent the heart, but increases in placental and mammary gland tissue. These changes play an important role in the fate of circulating triglycerides, which are diverted from uptake by adipose tissue to uptake by the mammary gland for milk synthesis, and probably by the placenta for hydrolysis and transfer of released nonesterified fatty acids to the fetus. After 24 hours of starvation, lipoprotein lipase activity in the liver greatly increases in the rat in late pregnancy; this change is not seen in virgin animals. This alteration is similar to that seen in liver triglyceride content and plasma ketone body concentration in the fasted pregnant rat. In the fasting condition during late gestation, heightened lipoprotein lipase activity is the proposed mechanism through which the liver becomes an acceptor of circulating triglycerides, allowing their use as ketogenic substrates, so that both maternal and fetal tissues may indirectly benefit from maternal hypertriglyceridemia. Changes in the magnitude and direction of lipoprotein lipase activity in different tissues during gestation actively contribute both to the development of hypertriglyceridemia and to the metabolic fate of circulating triglycerides.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3287930 TI - Lipids, clotting factors, and diabetes: endogenous risk factors for cardiovascular disease. AB - Theories of intimal injury leading to plaque formation include platelet adhesion and production of growth factors, hypercholesterolemia, smooth muscle cell proliferation, macrophage activity, defective utilization of low-density lipoproteins via deficient receptors, and deficiency in cellular lysosomal enzymes. High levels of low-density lipoproteins and intermediate-density lipoproteins, as well as their apoproteins, are strong risk factors for cardiovascular disease. The lowering of the cholesterol level has been shown to produce significant regression of atherosclerotic lesions. Data also suggest an interaction between lipids and platelets, although the role of coagulation disorders as an independent risk factor for atherosclerosis is difficult to assess. Although much of the data are controversial, there is evidence that platelet survival time is a strong predictor of severe vessel damage. In addition, some studies have reported decreased activity of antithrombin III with coronary artery disease, and there appears to be a direct correlation between fibrinogen and cholesterol levels. Finally, diabetes mellitus (both types I and II) is a significant independent risk factor for atherosclerosis. The risk is not related to the severity or duration of diabetes, and it appears to be greater in women than in men. PMID- 3287931 TI - Obesity, stress, and smoking: their role as cardiovascular risk factors in women. AB - Obesity, defined as an increase of 20% or more above desired weight, has been found to be an independent, albeit weak, risk factor for coronary heart disease in women and may increase the relative risk of other factors such as hypertension, diabetes mellitus, and elevated total serum cholesterol and low density lipoprotein-cholesterol. Type A personality and stress, on the other hand, appear to be moderate risk factors for coronary heart disease in women as well as in men. Approximately twice as many cardiovascular events occurred in type A women 35 to 64 years old as in type B women of the same age group. As expected, cigarette smoking is a major risk factor, primarily in young women. Women with smoking patterns similar to those of men experience similar rates of cardiovascular morbidity and mortality. In addition, smoking apparently acts synergistically with oral contraceptives and elevated total serum cholesterol to further increase risk. PMID- 3287932 TI - Women, work, and health: employment as a risk factor for coronary heart disease. AB - Employment as such does not appear to be a risk factor for coronary heart disease and may in fact have a beneficial effect on health. Although there is at present a paucity of reliable data, several key points emerge. In general, working women are in better health than homemakers or unemployed women. Single and married working women are apparently in better health than are divorced, separated, or widowed women. Among working women perception of control over the job environment may be a more important predictor of risk than level of job stress. Health appears to be compromised most among women who perceive little control over their lives. Although multiple social roles of wife, mother, and employee seem to enhance health, too much intensity in any one role may be detrimental. PMID- 3287933 TI - Oral contraceptives and coronary heart disease: modulation of glucose tolerance and plasma lipid risk factors by progestins. AB - Widespread use of oral contraceptive formulations by women throughout their reproductive life has given rise to concerns about the effects of oral contraceptives on risk factors for coronary heart disease. Oral contraceptive induced changes in both carbohydrate and lipoprotein risk factors may contribute to an increased risk of coronary heart disease. Carbohydrate and lipoprotein risk factors for coronary heart disease are reviewed, and oral contraceptive-induced changes in carbohydrate and lipoprotein metabolism, which may lead to altered risk status for coronary heart disease, are discussed. The importance of methodology in evaluating the results of studies assessing such oral contraceptive-induced changes is stressed. The role of progestins in influencing coronary heart disease risk factors is surveyed, and differences among progestins commonly used in oral contraceptive formulations are discussed. In addition, the effect of various combination oral contraceptives on risk factor status is outlined. Finally, the implications of available evidence for the selection of progestins for oral contraceptive formulations of the future are discussed. Current data indicate that medium- and low-fixed-dose oral contraceptive formulations containing estrogen/norethindrone acetate have less metabolic impact than do comparable levonorgestrel-containing formulations, including multiphasic formulations. Triphasic formulations may have less effect on coronary heart disease risk factors, although data are not yet conclusive. Novel progestins such as desogestrel may also have lesser effects on metabolic functions, but the reduced androgenicity of such compounds may expose women to an increased risk of estrogen-induced hypertriglyceridemia. PMID- 3287934 TI - Cardiovascular effects of endogenous and exogenous sex hormones over a woman's lifetime. AB - Natural fluctuations in concentrations of physiologic sex hormones over the course of a woman's lifetime affect lipoprotein levels; such effects may be compared with those induced by exogenous hormone therapy. During the progesterone dominated luteal phase of the menstrual cycle, high-density lipoprotein (HDL) concentrations do not fall, but low-density lipoprotein (LDL) concentrations usually decline. During pregnancy both estrogen and progesterone levels are extremely high; LDL concentration gradually increases to a maximum value at term of 50% above the nonpregnant level. Total HDL and HDL2 concentrations also increase, reaching a maximal 30% increase at 20 weeks' gestation. These physiological fluctuations have not been associated with increased arteriosclerosis. Oral contraceptives that combine C21 progestins and certain C19 progestin derivatives with estrogen have little or no effect on HDL2; however, those with a marked progestogenic or androgenic effect are more likely to lower HDL and HDL2. Increases in LDL concentration during oral contraceptive use are not consistently proportional to estrogen/progestin ratio and may reflect progestin androgenicity or a progestin-estrogen interaction. In postmenopausal women estrogen alone benefits lipoproteins, whereas cyclical administration of progestin with estrogen appears to lower HDL2-cholesterol proportionate to progestin dose. These exogenous hormone-induced changes are associated with the expected changes in arteriosclerosis risk when they have been looked for. In summary, estrogen-progestin regimens that do not affect LDL- and HDL2-cholesterol concentrations are most desirable in terms of long-term cardiovascular risk. PMID- 3287935 TI - Risks and mechanisms of cardiovascular events in users of oral contraceptives. AB - Three large British studies on the vascular effects of oral contraceptives have established that the risk of thromboembolic episodes, both venous and arterial, rises with increasing estrogen dose. Two of these studies have also demonstrated a dose-dependent relationship between the progestogenic component of oral contraceptives and the risk of arterial disease, though not of venous events. In men, high levels of factor VII coagulant activity, VIIC, and plasma fibrinogen are associated with an increased risk for ischemic heart disease. In view of the dose-dependent relationship between estrogen and these two clotting factors, especially VIIC, it is likely that the effects of oral contraceptive usage on the risk for thromboembolism are mediated substantially through the level of coagulability. The relationship between the progestogenic component of oral contraceptives and the risk for arterial disease is probably related, at least in part, to the effects of progestogens on blood pressure. PMID- 3287936 TI - Use of oral contraceptives in women of older reproductive age. AB - Evidence of increased risk for cardiovascular disease in oral contraceptive users of older reproductive age is based on early data involving formulations containing higher doses of estrogen and progestin than those in use today. In addition, early studies included patients who would not receive oral contraceptives with today's more stringent prescribing criteria. When these data were carefully analyzed, a significant increase in myocardial infarction was noted only in oral contraceptive users with concomitant risk factors for cardiovascular disease. Analysis of other studies also showed a significant increase in the incidence of cardiovascular disease and mortality only in oral contraceptive users older than age 35 years who smoked. A recent long-term cohort study of women without risk factors for cardiovascular disease who mainly used oral contraceptives containing less than or equal to 50 micrograms estrogen showed no increased risk of myocardial infarction or cerebrovascular accident with oral contraceptive use. Use of oral contraceptives containing less than 50 micrograms estrogen has not been shown to be associated with an increased risk of cardiovascular disease in healthy, nonsmoking women 35 to 45 years of age. PMID- 3287937 TI - Magnetic resonance imaging of nonmetallic orbital foreign bodies. AB - We studied a cadaver head model in which we inserted three orbital foreign bodies. We chose these foreign bodies because of their similarity to substances found in orbital trauma. Teflon and Lucite were used to represent synthetic materials, and dry pine was chosen as a type of organic material. Lucite is similar in radiographic density to plastics used in interior trim for automobiles and spectacle frames. While both orbital ultrasound and plain skull films failed to detect the foreign bodies consistently, both computed tomography and magnetic resonance imaging detected and localized the foreign bodies relatively well. Computed tomography was better in delineating shape and characterizing composition. PMID- 3287938 TI - Transient proliferative diabetic retinopathy during intensified insulin treatment. AB - Two women aged 22 and 19 years who had had diabetes for 11 and four years, respectively, developed proliferative retinopathy after five to seven months of significantly improved metabolic control. They were participants in two separate prospective studies including 97 insulin-dependent patients. At inclusion, one patient showed minimal background retinopathy and the other showed no retinopathy. Their level of glycosylated hemoglobin was initially high (14.3% and 17.5%) but within five to six months had fallen by 5.7% and 7.5%. The improved metabolic control was obtained by home blood glucose monitoring and insulin pump in the older patient and by home blood glucose monitoring only in the other. By maintaining near normoglycemia, regression of the proliferative retinopathy was achieved. Photocoagulation was not performed. After five and two years of follow up, respectively, only mild background retinopathy has been noted in both patients. We concluded that a significant lowering of blood glucose may provoke proliferative retinopathy and that sustained good metabolic control may reverse this retinopathy without photocoagulation. PMID- 3287939 TI - The effect of suture removal on postkeratoplasty astigmatism. AB - I followed up for a minimum of six months 439 eyes that had undergone corneal transplantation using a suturing technique consisting of eight interrupted 10-0 and a single, continuous, 16-bite 11-0 nylon suture. All sutures were removed from 188 eyes an average of 20 months after surgery. After suture removal, 64 corneas had an increase of astigmatism greater than 0.5 diopter, 79 eyes showed a decrease in astigmatism greater than 0.5 diopter, and 42 corneas had no change in astigmatism. The mean astigmatism before suture removal was 3.7 diopters, and the mean astigmatism after suture removal was 3.5 diopters. There was no apparent difference in postkeratoplasty astigmatism with donor corneal diameters 0.25 to 0.75 mm greater in diameter than the recipient diameters, or with different host diseases. The longer the sutures were left in place after surgery, the smaller the quantitative change in astigmatism after suture removal. The complications of this technique were no different from other currently used suture techniques. PMID- 3287940 TI - A study of race matching between donor and recipient in corneal transplantation. AB - We investigated the influence of a racial match or mismatch between the corneal donor and recipient on the risk of endothelial rejection and subsequent graft failure in 998 corneal transplant recipients. Actuarial survival analysis showed no significant difference in the cumulative risk of endothelial rejection between the 676 race-matched and 322 race-mismatched recipients. Recipients who had preoperative factors that placed them at a higher risk of endothelial rejection (n = 208) also were not subject to a higher incidence of endothelial rejection if they received race-mismatched tissue. Graft failure after endothelial rejection was not found to differ among race-matched or -mismatched groups. PMID- 3287941 TI - Mycobacterium fortuitum keratitis. AB - Two of four cases of Mycobacterium fortuitum keratitis occurred after corneal surgery with contact lens wear, one was associated with extended contact lens wear alone, and one occurred after a foreign body injury. All cases were characterized by pain, conjunctival hyperemia, stromal inflammation, and ulceration. Diagnosis was made by culture and acid-fast staining of corneal scrapings. On the basis of published experience with amikacin for the treatment of nonocular M. fortuitum infections, three patients were treated with topical amikacin. Two patients responded clinically, but histopathologic examination of a penetrating keratoplasty specimen in one of the two disclosed persistent infection. One patient was cured of early disease by debridement alone. Rapid diagnosis and absence of corticosteroid use were the two most important determinants of successful therapy. In advanced cases, infection may be cured and useful vision restored by penetrating keratoplasty. PMID- 3287942 TI - Toxic endothelial degeneration in ocular surface disease treated with topical medications containing benzalkonium chloride. AB - We examined a 56-year-old man with keratoconjunctivitis sicca and marked ocular surface disease in whom the prolonged frequent use of topical medications containing the preservative benzalkonium chloride was associated with corneal endothelial damage requiring corneal transplantation in one eye. The histopathologic findings on examination of the excised button were consistent with toxic endothelial disease. Postoperatively, the patient's symptoms continued until the preservative-containing medications were substituted with nonpreserved saline eyedrops. PMID- 3287943 TI - Use of an angiotensin converting enzyme inhibitor in ocular hypertension and primary open-angle glaucoma. AB - We studied the effects of a new topical angiotensin converting enzyme inhibitor, SCH 33861, in lowering intraocular pressure in 20 patients with ocular hypertension or primary open-angle glaucoma. In a double-masked, four-way crossover study with placebo and timolol, SCH 33861 was well tolerated and effective in lowering intraocular pressure. The magnitude of the drug's effect in lowering intraocular pressure was less than that of timolol 0.5%. PMID- 3287944 TI - The Leslie Dana Gold Medal. PMID- 3287945 TI - A new intra-anterior chamber iris suturing method. PMID- 3287946 TI - Changing utilization of donor corneas. PMID- 3287947 TI - Common systemic diseases in geriatric patients. AB - The elderly population will substantially increase by the year 2000, leading to an increased number of elderly patients in the optometric practice. The elderly differ substantially from other patient groups as aging is accompanied by many functional deficits. However, the majority of these decrements do not result in illness or disability. Disease states exist separately or are superimposed upon the already compromised body systems of the elderly. The average geriatric patient suffers from two or more chronic diseases. As primary care practitioners, optometrists should be familiar with the more prevalent diseases of the elderly and their impact upon performance during the vision examination. A review of the common diseases associated with aging is presented. PMID- 3287948 TI - Internalization and catabolism of insulin by an established renal cell line. AB - Proximal renal tubules are a key site of insulin metabolism. To explore the kinetics and metabolic requirements of insulin internalization and catabolism, we used the opossum kidney cell line, which has proximal tubular-like features and possesses insulin-specific receptors. Internalization was determined by separating membrane-bound insulin from intracellular insulin by exposure to an acidified medium. Internalization of membrane-bound insulin was rapid, and half maximal internalization occurred within 2.5 min. Degradation products did not accumulate in the cell but appeared in the medium after a delay of 5 min from the onset of internalization. In other experiments, addition of KCN (2 mM) or omission of glucose did not alter degradation, but KCN, combined with the omission of glucose, inhibited degradation by 64%. This was associated with a 240% increase in membrane-bound insulin and an 81% decrease in intracellular insulin. Accordingly, it appears that under these circumstances impaired degradation was a consequence of impaired internalization. In contrast, although 0.1 mM chloroquine, an endosomal-lysosomal inhibitor, also depressed degradation (by 57%), intracellular insulin increased fourfold, indicating failure of intracellular processing. We conclude that these cultured kidney cells rapidly internalize and degrade insulin and that internalization, a prerequisite for degradation, is dependent on energy that can be derived from anaerobic glycolysis or oxidative metabolism. Furthermore, the intracellular degradative processing of insulin by these cells involves a chloroquine-sensitive pathway. PMID- 3287949 TI - In vitro renal eicosanoid production during pregnancy in rabbits. AB - The low renal resistance to blood flow in the presence of an activated endogenous renin-angiotensin system in gravid animals may in part be mediated by the action of eicosanoids produced in situ. To evaluate intrarenal eicosanoid production during gestation in rabbits, we quantitated immunoreactive PGE2, 6-keto-PGF1 alpha (a stable metabolite of PGI2) and thromboxane B2 (a stable metabolite of thromboxane A2) in unextracted media after incubation of renal slices and isolated glomeruli. In cortical slices from nonpregnant and pregnant rabbits, PGE2 production (micrograms.g-1.30 min-1) was 0.04 +/- 0.005 and 0.08 +/- 0.01 (P less than 0.01) and 6 keto-PGF1 alpha was 0.03 +/- 0.01 and 0.06 +/- 0.01 (P less than 0.05), respectively. In papillary slices, PGE2 production was 14 +/- 2 and 21 +/- 2 (P less than 0.05) and 6 keto-PGF1 alpha was 4 +/- 1 and 5 +/- 1 (P greater than 0.05) for nonpregnant and pregnant rabbits, respectively. Thromboxane B2 production was unchanged during pregnancy in both cortex and papilla. Acute captopril administration to nonpregnant and to pregnant rabbits in vivo failed to alter in vitro renal slice eicosanoid production. Isolated glomeruli from nonpregnant and pregnant rabbits synthesized PGE2 at similar rates. Exogenous arachidonic acid increased PGE2 production (P less than 0.05), but angiotensin II had no effect on eicosanoid production in vitro. These data suggest that the net synthesis of vasodilator eicosanoids is enhanced during gestation in rabbits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287950 TI - Fatty acid-independent inhibition of hepatic ketone body production by insulin in humans. AB - To investigate whether elevated plasma insulin or glucagon concentrations are capable of modifying hepatic ketogenesis independently of plasma free fatty acid (FFA) concentrations, ketone body production was determined by [3 14C]acetoacetate infusions in overnight-fasted normal subjects during exogenous supply of FFA (Intralipid and heparin infusion). When plasma FFA concentrations were elevated from 0.73 +/- 0.07 to 1.53 +/- 0.16 mmol/l during low insulin concentrations (approximately equal to 13 microU/ml) in group A (n = 7), total ketone body production increased from 3.6 +/- 0.6 to 8.2 +/- 1.0 mumol.kg-1.min-1 (P less than 0.001). When plasma FFA were similarly elevated during raised plasma insulin concentrations (approximately equal to 110 microU/ml) in group B (n = 5), total ketone body production was only 3.8 +/- 0.8 mumol.kg-1.min-1 (P less than 0.01 vs. group A). Low plasma FFA and low insulin concentrations resulted in total ketone body production of 0.70 +/- 0.18 mumol.kg-1.min-1 in group C (n = 7; P less than 0.01 vs. groups A and B). Elevation of plasma glucagon during Intralipid infusion in group D (n = 7) failed to affect ketogenesis, but the beta hydroxybutyrate-to-acetoacetate concentration ratio decreased significantly (P less than 0.01). The data indicate that elevation of plasma insulin to high physiological concentrations restrains FFA-induced ketogenesis. PMID- 3287951 TI - Preservation of insulin effects on glucose production and proteolysis during fasting. AB - To determine whether fasting alters the ability of insulin to suppress endogenous glucose production or proteolysis, isotopic flux measurements of glucose, leucine, alpha-keto-isocaproate, and alanine were made in 13 normal volunteers after a 14-h (day 1) and an 84-h (day 4) fast. Using the "pancreatic clamp" technique, we achieved small increments in plasma insulin concentrations, as well as constant and identical plasma hormone and glucose concentrations, on both study days in seven subjects. The remaining six subjects were infused with saline and served as controls. Leucine rate of appearance (an index of proteolysis) was greater on day 4 than on day 1 (P less than 0.001), but decreased to equal values during the pancreatic clamp on each study day. During the pancreatic clamp, endogenous glucose production decreased to lesser (P less than 0.005) values on day 4 than on day 1. In conclusion, insulin suppresses proteolysis equally well before and after brief fasting, and endogenous glucose production is more completely suppressed by insulin after brief fasting than after an overnight fast. PMID- 3287952 TI - Glucagon, not insulin, may play a secondary role in defense against hypoglycemia during exercise. AB - The sympathochromaffin system, probably sympathetic neural norepinephrine, plays a primary role in the prevention of hypoglycemia during exercise in humans. Our previous data indicated that changes in pancreatic islet hormones are not normally critical but decrements in insulin, increments in glucagon, or both become critical when catecholamine actions are blocked pharmacologically. To distinguish between the role of insulin and that of glucagon in this secondary line of defense against hypoglycemia during exercise in humans, glucoregulation during moderate exercise (approximately 55% of maximum O2 consumption over 60 min) was studied in people who could not decrease insulin but could increase glucagon, i.e., patients with insulin-dependent diabetes mellitus (IDDM). While receiving constant intravenous infusions of regular insulin, in individualized doses shown to result in stable plasma glucose concentrations of approximately 95 mg/dl before exercise, patients with IDDM were studied under two conditions: 1) a control study (n = 13) and 2) an adrenergic blockade study (propranolol infusion, n = 8). In the control study, mean plasma glucose concentrations did not change (from 95 +/- 2 to 100 +/- 11 mg/dl) during exercise despite constant plasma free insulin levels. In the adrenergic blockade study plasma glucose declined (from 96 +/- 2 to 74 +/- 7 mg/dl, P less than 0.01) but stabilized; hypoglycemia did not occur. Exercise-associated increments in plasma glucagon were comparable in the two studies. These data confirm that decrements in insulin are not critical to the prevention of hypoglycemia during moderate exercise in humans and indicate that compensation for deficient catecholamine action does not require decrements in insulin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287953 TI - Role of gastric inhibitory polypeptide in postprandial hyperinsulinemia of obesity. AB - To assess the contribution of gastric inhibitory polypeptide (GIP) to the postprandial hyperinsulinemia of obesity, secretion rates of GIP (generated from kinetic analyses from infusions of porcine GIP) and insulin (from C-peptide applied to a validated kinetic model) to meals of 3 sizes were determined in 10 obese (5 male and 5 female) and 10 lean, sex- and age-matched healthy subjects. Although the postprandial secretion rates of GIP were greater in obese subjects (P = 0.03), postprandial concentrations of GIP were not. The latter may be explained by the greater volume of distribution of GIP in obese subjects (P = 0.036). Secretion rates and volume of distribution of GIP were correlated (r = 0.652, P less than 0.01). Despite excessive integrated postprandial (P = 0.010) insulin concentrations, insulin secretion was not significantly different between obese and lean subjects. We conclude that 1) although postprandial plasma GIP concentrations are normal, GIP secretion is increased in obesity, 2) the postprandial hyperinsulinemia of obesity is not due to excessive insulin secretion but is likely secondary to altered insulin clearance, and 3) GIP cannot account for the hyperinsulinemia of obesity through its insulinotropic action. PMID- 3287954 TI - Effects of a high-protein, low-carbohydrate diet on degradation of sucrase isomaltase in rat jejunoileum. AB - During the degradation of intestinal sucrase-isomaltase by pancreatic proteinases, degradation of sucrase-active site precedes that of the isomaltase active site in rats. In the present paper, we demonstrate that the extent of degradation of sucrase-isomaltase is altered by dietary manipulation in vivo. Adult rats were starved for 24 h and received either a standard diet (20 cal% protein, 55% carbohydrate) or an isocaloric high-protein, low-carbohydrate diet (70 cal% protein, 5% carbohydrate). Animals were killed 15 h after the refeeding. In rats fed a high-protein, low-carbohydrate diet, luminal trypsin activity was three times higher than controls, and sucrase activity in proximal ileum was significantly lower (P less than 0.001) than controls, whereas isomaltase activity was similar in both groups. In proximal jejunum, luminal trypsin activity was remarkably lower (P less than 0.01) than in proximal ileum in both groups; sucrase and isomaltase activity was similar in both groups. Crossed immunoelectrophoresis demonstrated that a degradation product of sucrase isomaltase, i.e., isomaltase monomer, was present in a larger amount in rats fed a high-protein, low-carbohydrate diet. In rats with bypassed pancreatic ducts, the amount of this degradation product was decreased and effect of a high protein, low-carbohydrate diet was abolished. Experiments with a sequential isolation of epithelial cells of proximal ileum revealed that sucrase activity was decreased along the entire height of the villus in animals fed a high protein, low-carbohydrate diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287955 TI - Psychoanalysis and Tibetan Buddhism as psychological techniques of liberation. PMID- 3287956 TI - Karen Horney and Heinz Kohut: theory and the repeat of history. PMID- 3287957 TI - The arthroscopic meniscal repair. Techniques and clinical experience. AB - Conservative meniscal repair should limit resection to only pathologic portions of the meniscus. The periphery of the meniscus is well vascularized, enabling healing of longitudinal tears. Sutures that perforate the meniscus vertically usually lead to stable healing. In arthroscopic meniscal surgery, isolated tears are sutured from within the joint, usually using techniques related to specially developed instrumentation. Our system uses three curved cannulas of various radii and a specific needle of 1.2 mm thickness, and can be operated by one hand while the joint is distracted with an AO/ASIF femoral distractor. In our series of 54 arthroscopic meniscal repairs, 42 (78%) healed without reinjury. Retears occurred in 12 patients, and were refixed again using the same techniques. Our experience has led us to conclude that the type of meniscal tear most suitable for arthroscopic repair is a vertical longitudinal lesion that involves the vascularized zone; abrading the synovial surfaces is helpful, as is positioning the sutures tightly together; the repair should be checked at 4 months by arthroscopy or by arthrogram; and a combination of nonabsorbable and resorbable sutures is most satisfactory. We believe that with experience arthroscopic meniscal repair becomes a less involved procedure than open repair, and that in the future such repair will be successfully extended to the more centrally located lesions. PMID- 3287958 TI - Myospherulosis in Japan. A report of two cases and an immunohistochemical investigation. AB - We report two cases of myospherulosis and offer review of the Japanese literature. Case 1 was a 41-year-old woman with cystic tumors under the fascia of the right major gluteal muscle. Case 2 was a 36-year-old man with subcutaneous cystic tumors in the right buttock. The characteristic saccular structures enclosing numerous small spherules were observed in the cysts. These spherules measured 5-7 micron in diameter and stained with Masson trichrome, Giemsa, Papanicolaou, and alizarin red S for hemoglobin. The myospherules also stained positively by the immunohistochemical method for hemoglobin. These findings support the contention that the spherules and parent bodies were derived from erythrocytes altered by foreign lipids or fat. PMID- 3287959 TI - T-cell-rich B-cell lymphoma. AB - Five cases of B-cell lymphoma are described in which the morphology and initial immunohistochemistry suggested a diagnosis of T-cell neoplasia. In four cases, the histological picture was that of an adult pleomorphic T-cell lymphoma; the fifth case was a lymphocytic lymphoma (CLL) with an accompanying T-cell lymphocytosis in the peripheral blood. Immunohistochemistry on both frozen and paraffin-embedded material showed that the cellular population in all five cases consisted mainly of T-cells; less than 10% of the cells stained as B-cells. However, immunoglobulin immunostaining combined with use of the new lineage related monoclonal antibodies reactive in paraffin section revealed that the B cells constituted the neoplastic population. Genetic analysis showed no evidence of clonality in the T-cells, nor was it able to detect rearrangement in the small number of clonal B-cells present. These cases represent a variety of B-cell neoplasia that mimicks T-cell lymphoma morphologically and immunologically. The vigorous T-cell reaction seen in such lymphomas means that the malignant population can be correctly identified only by careful examination of the immunohistochemical findings. PMID- 3287960 TI - Laminin and type IV collagen in different histological stages of Kaposi's sarcoma and other vascular lesions of blood vessel or lymphatic vessel origin. AB - Immunohistochemical staining was used to demonstrate basement membrane (BM) laminin and type IV collagen in eight cases of Kaposi's sarcoma (KS). These KS were not associated with AIDS and represented different histological stages of the disease: patch (three cases), plaque (one case), and nodule (four cases). Nine cases of benign angiogenic lesions, five of blood vessel origin, and four of lymphatic vessel origin were also studied. An early event in vascular proliferation at the patch stage of KS was an intersection of dermal collagen bundles and the appearance of granular BM material around this space. With the increase of amount and linear arrangement of BM material, well-defined capillaries were formed. Two types of capillary were found in KS lesions. One showed morphological features of blood capillaries, with a round lumen; thick, continuous BM, and occasional pericytes in the wall. The other included irregularly shaped vessels with thin, often disrupted BMs; thus these capillaries morphologically resembled lymphatic capillaries. BM staining also clearly revealed the vascular nature of the nodular lesions of KS, which were composed of a network of slit-like spaces surrounded by BMs. The solid tumor cell areas were sparse; they were composed of spindle-shaped cells surrounded by thin, interrupted basal laminae. By using antibodies against human laminin and human type IV collagen, it was also possible to demonstrate thin, widely disrupted BMs subendothelially in normal dermal lymphatic capillaries. Typically, the BMs in lymphangiomas and lymphangiectasias were continuous and more clearly defined. PMID- 3287961 TI - Papillary adenocarcinoma of rete testis. Autopsy findings, histochemistry, immunohistochemistry, ultrastructure, and clinical correlations. AB - Adenocarcinoma of the rete testis is a rare neoplasm that usually occurs in men after the age of 60 and carries a variable prognosis. We report an occurrence of this tumor in a 91-year-old man who had been treated for 2 years for an hydrocele. At the time of diagnosis, metastases were not evident; and the patient was treated with local radiotherapy. The diagnosis of papillary adenocarcinoma of the rete testis was made on the basis of: (a) a transition from normal rete testis to atypical and neoplastic rete epithelium; (b) exclusion of primary germinal and nongerminal testicular tumors and spread from distant sources; and (c) electron-microscopic findings, histochemical and immunological studies, and autopsy findings supporting the diagnosis. This is the first reported case of adenocarcinoma of the rete testis that includes documentation of the tumor's metastatic pattern. PMID- 3287962 TI - Cephalosporin antibiotics: molecules that respond to different needs. AB - Since the introduction of cephalothin in 1964, there has been a large number of cephalosporins synthesized and used clinically. Modification of the beta-acyl side chain has yielded compounds with stability against attack by plasmid and chromosomal beta-lactamases. The presence of methoxy groups at C-7 of the bicyclic cephalosporin nucleus has provided excellent activity against many anaerobic species. Changes in structure have also provided agents with extended half-lives, permitting twice a day dosing or single-dose prophylaxis. Cephalosporins clearly have come of age as agents to meet many different infectious needs. PMID- 3287963 TI - Antibiotics in surgery. An overview. AB - Antibiotic utilization in the surgical patient has the two unique features of preventive use in high-risk procedures and frequent use in suspected or documented polymicrobial infection. These two features have resulted in the search for agents with broader spectrums. Although numerous antibiotics or combinations of antibiotics can be shown to provide comparable results for both preventive and therapeutic indications, no superior choice has been identified in either area. Indeed, the search for broader spectrums of antibiotics may not further improve the identified results. If this is so, newer areas of exploration in antibiotic therapy in the surgical patient will need to focus on optimizing pharmacologic, toxic, and economic features while preserving comparability in clinical outcome. PMID- 3287964 TI - Cefotetan: a review of the microbiologic properties and antimicrobial spectrum. AB - Cefotetan (formerly ICI 156834 and YM09330) is a 7-methoxy cephalosporin possessing some advantageous antimicrobial spectrum, safety, and pharmacokinetic characteristics compared with other so-called second-generation cephalosporins. The published literature was reviewed and the cefotetan quantitative susceptibility testing data from nearly 31,000 isolates was tabulated. Against 15,769 enteric bacilli, cefotetan was observed to have a potency and spectrum more closely resembling a third-generation cephalosporin and markedly superior to cefoxitin. The mean of all MIC 90s reported for the Enterobacteriaceae ranged from 0.06 to 13 micrograms/ml except for citrobacter species, E. cloacae, Enterobacter species, and C. freundii. The mean MIC 50 for all 22 recorded species was in the susceptible range. Cefotetan was very effective against B. catarrhalis, H. influenzae, and pathogenic Neisseria species. However, cefotetan and cefoxitin were not active against Pseudomonas species, Acinetobacter species, and some rarely isolated species. Cefotetan was moderately active against the staphylococci (mean MIC 50, 7.6 to 26 micrograms/ml) and streptococci (mean MIC 50, 0.9 to 6.6 micrograms/ml). The coagulase-negative staphylococcus species generally had higher cefotetan and cefoxitin minimum inhibitory concentrations compared with the S. aureus isolates. Oxacillin-resistant staphylococci were resistant to cefotetan. The enterococci, JK group diphtheroids, Corynebacterium species, and L. monocytogenes isolates were resistant. A review of 4,751 strict anaerobes showed cefotetan to have a very comparable activity and spectrum to cefoxitin. The 1,291 B. fragilis strains had a mean MIC 50 and MIC 90 of 5.4 and 23 micrograms/ml, respectively. These values were slightly superior to cefoxitin when tested in parallel. More elevated minimum inhibitory concentrations were observed for other B. fragilis group species for cefoxitin and cefotetan. The mean cefotetan MIC 90 for all other anaerobic bacteria except the Eubacterium species and Lactobacillus species predict favorable clinical efficacy. The beta lactamase stability of cefotetan is very similar to that of other 7-methoxy cephalosporins. Cefotetan also inhibits Type Ia cephalosporinases with high enzyme affinity and is an inducer of these beta-lactamases, although cefotetan is not rapidly hydrolyzed. Synergy between cefotetan and numerous other antibiotics has been reported, but antagonism has also been occasionally observed. PMID- 3287965 TI - Criteria for in vitro susceptibility testing of cefotetan. Correlations with clinical and bacteriologic responses. AB - Standardized in vitro susceptibility testing criteria and quality-control guidelines for cefotetan have been well documented in the scientific literature. Cefotetan and cefoxitin differ in their in vitro spectrums of activity and cannot be used interchangeably for in vitro tests. In vitro susceptibility information failed to correlate with clinical or bacteriologic responses of treated patients when 314 anaerobic bacteria from 145 patients were evaluated. All cefotetan resistant anaerobic bacteria were eradicated by cefotetan therapy, and 93 percent of patients with resistant strains were clinically curved. Most members of the Bacteroides distasonis-ovatus-thetaiotaomicron group of pathogens were resistant in vitro, but only one strain persisted after cefotetan therapy for a 96.6 percent cure rate. There was better correlation when 2,336 aerobic bacteria from 1,630 infected body sites were considered. Microorganisms susceptible or moderately susceptible by in vitro tests were equally responsive to therapy (95 percent of patients clinically cured and 94 percent of isolates eradicated). However, strains that were resistant by in vitro test criteria were less likely to respond clinically. Development of resistance during therapy or superinfections (1.7 percent) were not found to be clinically important problems with cefotetan chemotherapy. PMID- 3287967 TI - Analysis of prothrombin time prolongation in North American cefotetan clinical trials: questions and answers. PMID- 3287966 TI - Impaired hemostasis caused by beta-lactam antibiotics. AB - Beta-lactam antibiotics can directly impair hemostasis by two separate nonimmune mechanisms. First, the NMTT-substituted cephalosporin drugs may cause hypoprothrombinemia by interfering with the hepatic activation of clotting factors II, VII, IX, and X. Second, the antipseudomonal penicillins may cause the bleeding time to be prolonged by interfering with platelet aggregation to physiologic agonists. In surgical patients who are malnourished, have impaired gastrointestinal function, or have renal failure, the potential for these adverse effects is increased. Serious bleeding requires treatment with fresh frozen plasma when hypoprothrombinemia is caused by NMTT-containing cephalosporins, since the prothrombin time returns to baseline relatively slowly after therapy with vitamin K. Hemorrhage caused by beta-lactam-induced platelet dysfunction must be treated with platelet concentrates, since new platelets sufficient to correct the defect do not enter the circulation for several days after treatment with the offending drug is discontinued. The more desirable approach is to prevent hypoprothrombinemia by giving vitamin K prophylaxis and to avoid beta lactams that impair platelet function in seriously ill patients at increased risk for bleeding. PMID- 3287968 TI - Newer cephalosporins: lessons to be learned from clinical trials in intraabdominal infections. AB - Recent clinical trials testing the efficacy of newer cephalosporins in intraabdominal infections lack a number of the study design criteria proposed by Solomkin et al. Nevertheless, these trials all support the use of these newer cephalosporins in the treatment of intraabdominal infections. These newer agents demonstrate increased in vitro antimicrobial activity against potential aerobic pathogens, which suggests that they may be used in combination with an antianaerobic drug in the treatment of intraabdominal infections. Therefore, agents including cefotaxime, cefoperazone, ceftazidime, cefuroxime, ceftriaxone, and aztreonam may be chosen in place of the standard aminoglycoside. Previous studies have demonstrated the necessity of both aerobic and anaerobic coverage in empiric therapy of intraabdominal infections. Cefotetan, ceftizoxime, cefoxitin, moxalactam, mezlocillin, and piperacillin all have in vitro activity against aerobes and anaerobes (including B. fragilis), thus, these agents have a potential as monotherapy for acute intraabdominal infections in otherwise healthy patients. Directed combination chemotherapy or perhaps imipenem alone is recommended for persistent peritonitis and intraabdominal infections in immunocompromised hosts. PMID- 3287969 TI - Overview of cephalosporin prophylaxis. AB - After an uncertain and highly controversial beginning, the use of antimicrobials for prophylaxis of surgical wound infection has evolved to represent state-of-the art management of the surgical patient. Although a truly ideal prophylactic antimicrobial does not exist, the cephalosporins, particularly those of the first generation, have emerged as the mainstay of prophylaxis in surgery. However, new pathogens and newly recognized problems have necessitated a comparative evaluation of a wide variety of antibiotic regimens. The choice of an appropriate antibiotic is complicated by the lack of an adequate experimental model of infection in clean and clean-contaminated surgical procedures. Moreover, clinical trials have proved to be an inefficient method of comparing antibiotic regimens, as important variations in risk factors for infection cannot be reliably controlled. Significant differences exist among cephalosporins and between the cephalosporins and other classes of antimicrobials in several clinically important parameters: antimicrobial spectrum, serum half-life, ease of administration, tissue penetrability, cost, and incidence of allergy and toxicity. New generations of cephalosporins and new classes of antibiotics have demonstrated the potential to out-perform the first-generation cephalosporins in many of these areas. Although the first-generation cephalosporins were essential in establishing the efficacy of antibiotic prophylaxis in surgery, there are no guarantees that this class of cephalosporin, or that any cephalosporin, for that matter, will continue to dominate the prophylactic arena. PMID- 3287970 TI - Multicenter clinical trials comparing cefotetan with moxalactam or cefoxitin as therapy for obstetric and gynecologic infections. AB - The clinical efficacy and safety of cefotetan was assessed in two multicenter clinical trials involving 335 evaluable patients hospitalized with obstetric and gynecologic infections. In Study I, cefotetan was compared with moxalactam and in Study II, cefotetan was compared with cefoxitin. The clinical response rate in Study I was 67 of 70 patients for cefotetan (96 percent) and 33 of 34 patients (97 percent) for moxalactam. In Study II, the clinical response rate was 138 of 147 patients in the cefotetan group (94 percent) and 76 of 84 patients in the cefoxitin group (91 percent). For the patients with bacteriologic response data, 196 of 205 cefotetan patients (96 percent), 23 of 24 moxalactam patients (96 percent), and 70 of 75 cefoxitin patients (93 percent) had a satisfactory bacteriologic response. Cefotetan was well tolerated and produced no major adverse reactions. The mean amount of cefotetan given was lower than that of moxalactam or cefoxitin. PMID- 3287971 TI - Cephalosporin therapy in intraabdominal infections. A multicenter randomized, comparative study of cefotetan, moxalactam, and cefoxitin. AB - Three broad-spectrum cephalosporins (cefotetan, moxalactam, and cefoxitin) proved effective in this randomized, prospective trial for treatment of 303 surgical patients with moderately severe regional peritonitis. PMID- 3287972 TI - Single-dose cefotetan versus multiple-dose cefoxitin as prophylaxis in colorectal surgery. AB - The safety and effectiveness of a single 2 g preoperative dose of cefotetan to reduce postoperative infectious complications after colorectal surgery was compared with multiple 2 g perioperative doses of cefoxitin in 289 patients enrolled in a multicenter trial; of the 239 evaluable patients, 164 received cefotetan and 75, cefoxitin. No statistically significant difference was detected in the successful clinical response rates for cefotetan and cefoxitin (88 percent and 92 percent, respectively). The difference in median increase in oral body temperature before and after the study (2.5 degrees F for cefotetan and 2 degrees F for cefoxitin) was statistically but not clinically significant (p = 0.03). Although nearly four times as many cefotetan patients as cefoxitin patients had surgery lasting 4 hours or more, the satisfactory bacteriologic response rates for cefotetan and cefoxitin were similar (88 percent and 93 percent, respectively). Nonobese patients and patients whose surgical procedures lasted less than 4 hours treated with either drug had significantly higher success rates (p less than 0.01). The incidence of major wound infection was approximately 8 percent for both treatment groups. Mean concentrations of cefotetan in plasma, specimens of colon, and subcutaneous fat were 128 +/- 61.8 micrograms/ml, 57.2 +/ 40.4 micrograms/g, and 26.8 +/- 19.4 micrograms/g, respectively. The incidence of adverse reactions was 12 percent for each group, and no reaction was considered treatment-related, including changes in results of clinical laboratory tests. A single 2 g preoperative dose of cefotetan was as safe and effective as multiple doses of cefoxitin in the reduction of postoperative wound infections after colorectal surgery. PMID- 3287973 TI - Multicenter open trial of cefotetan and cefoxitin in elective biliary surgery. AB - The present study was performed in two phases. In phase I, 112 patients were randomized to either 2 g cefotetan as a single prophylactic dose or 2 g cefoxitin every 6 hours for a maximum of 4 doses; phase II included 148 patients who were randomized to either 1 g cefotetan as a single dose or cefoxitin dosed as in phase I. The randomization was 2:1 cefotetan to cefoxitin in both phases. Nonevaluability rates were 10 percent for the cefotetan patients and 22 percent for the cefoxitin patients, the majority being due to dosing errors. Demographic characteristics demonstrated 88 percent to be female, 81 percent to be less than 65 years of age, and the average weight to be 165 lb. There were no differences in these characteristics among the groups. Common duct exploration was performed in 6 percent of the 2 g cefotetan patients, 9 percent in the 1 g cefotetan patients, and 13 percent in the 2 g cefoxitin patients. There were five clinical failures of prophylaxis: one wound infection in the 2 g cefotetan patients, one wound infection and one drain tract infection in the 1 g cefotetan patients, and one wound infection and one case of cholangitis in the 2 g cefoxitin patients. The clinical success rates were 98 percent in the 2 g cefotetan patients, 98 percent in the 1 g cefotetan patients, and 97 percent in the 2 g cefoxitin patients. PMID- 3287974 TI - Comparative effectiveness and safety of cefotetan and cefoxitin as prophylactic agents in patients undergoing abdominal or vaginal hysterectomy. AB - In a multicenter, randomized clinical trial, 282 women who underwent abdominal or vaginal hysterectomy were given a single preoperative 2 g dose of cefotetan (171 evaluable patients) or three perioperative 2 g doses of cefoxitin (84 evaluable patients) as antibiotic prophylaxis. A successful clinical response occurred in 92 percent of those receiving cefotetan and 90 percent of those receiving cefoxitin who underwent abdominal hysterectomy, and in 94 percent of those receiving cefotetan and 93 percent of those receiving cefoxitin who underwent vaginal hysterectomy. The incidence of vaginal cuff cellulitis was 3.4 percent and 5 percent for cefotetan and cefoxitin patients, respectively, who underwent abdominal hysterectomy, and 4.8 percent and 4.5 percent, respectively, for those who underwent vaginal hysterectomy. The incidence of major wound infection was 3.4 percent and 2.5 percent for cefotetan and cefoxitin, respectively, in the abdominal hysterectomy group. Postoperative changes in oral body temperature, duration of hospitalization, and postoperative grading of surgical wounds were similar. Both drugs were well tolerated. These results suggest that a single dose of cefotetan is equally effective and as safe as multiple-dose cefoxitin for prophylaxis in patients undergoing hysterectomy. PMID- 3287975 TI - Results of a multicenter comparative study of single-dose cefotetan and multiple dose cefoxitin as prophylaxis in patients undergoing cesarean section. AB - A study to compare the prophylactic efficacy of a single 2 g dose of cefotetan with multiple 2 g doses of cefoxitin in reducing the incidence of postcesarean section infection was evaluated in a multicenter trial of 269 women. No significant differences in clinical or bacteriologic response were detected between the two groups. A successful clinical response rate was achieved in 139 of 162 of the evaluable subjects given cefotetan (86 percent) and in 71 of 79 patients (90 percent) given cefoxitin. The respective satisfactory bacteriologic response rates were 91 percent (135 of 148 patients) and 93 percent (68 of 73 patients). The incidences of endometritis for cefotetan and cefoxitin (12 percent and 5 percent, respectively) and of postoperative wound infection (3 percent and 5 percent, respectively) were also not significantly different. Bactericidal levels of cefotetan were maintained in plasma in the immediate postpartum period. Both drugs were well tolerated. Single-dose prophylaxis with cefotetan was comparable to multiple doses of cefoxitin in reducing infectious morbidity in women undergoing cesarean section. PMID- 3287976 TI - A multicenter comparative study of cefotetan once daily and cefoxitin thrice daily for the treatment of infections of the skin and superficial soft tissue. AB - To compare the effectiveness of cefotetan administered at 2 g once a day with cefoxitin at 1 or 2 g three times a day in the treatment of hospitalized patients with skin and superficial soft tissue infections, 194 patients from eight centers were enrolled in an open, randomized trial. Most of the 104 evaluable patients in the cefotetan group and 50 in the cefoxitin group were young men with community acquired, moderate or severe cellulitis, or abscesses of the upper and lower extremities caused by Staphylococcus aureus, Streptococcus species, Escherichia coli, Proteus mirabilis, Bacteroides fragilis and other species of bacteroides, peptococcus species, and peptostreptococcus species. The mean duration of treatment was 7.5 days for cefotetan and 7.1 days for cefoxitin. A successful clinical response was achieved in 97 percent of the cefotetan patients and in 94 percent of the cefoxitin patients. Of the 88 and 39 bacteriologically evaluable patients in the cefotetan and cefoxitin groups, respectively, a satisfactory bacteriologic response occurred in 96 percent and 87 percent of the patients. No clinically significant changes in clinical laboratory determinations were noted. The incidence of adverse reactions in the cefotetan group (17 percent) was significantly different from that for the cefoxitin group (6 percent) (p less than 0.05); however, the incidence of treatment-related reactions was not significant and the events were mild. Discontinuation of therapy was necessary only in two patients in whom allergic-type reactions developed. A once-daily regimen of cefotetan was as effective as thrice-daily cefoxitin in this study in the treatment of primarily polymicrobial, moderate, or severe infections of the skin and superficial soft tissue. PMID- 3287977 TI - Delayed presentation of blunt splenic injury. AB - Eleven patients with delayed presentation of splenic injury after blunt abdominal trauma treated during a 10 year period have been described. They represented 24 percent of all patients treated for blunt splenic injury in our department in that time period. Ten patients required operative treatment and one was treated nonoperatively. There were no deaths. The value of computerized tomography and ultrasonography in the accurate preoperative assessment of splenic injury has been documented. In addition, the various diagnostic and therapeutic possibilities in blunt splenic trauma have been discussed. PMID- 3287978 TI - Stapling techniques for easy construction of an ileal J-pouch. AB - A technique for the extended use of GIA and EEA or ILS staplers in the easy construction of an ileal J-pouch and mucosal proctectomy has been described herein. The technique for construction of the J-pouch involves the almost exclusive multiple use of a GIA stapling device. The described mucosal proctectomy techniques use the EEA stapler for good traction and visualization for everted electrocautery suction mucosal dissection. With the use of these techniques, the integrity of the patient's tissue is preserved, suture lines are stronger, and the operating time is greatly reduced. PMID- 3287979 TI - Rehabilitation of the cancer patient. AB - Cancer patients often require extensive rehabilitation after treatment. Organization of a rehabilitation team and determination of its goals are a primary aim of such programs. Studies of job security and insurability demonstrate significant problems and biases toward the cancer patient. Discussion has been made of specific male and female sexual rehabilitation programs as well as programs directed at other physical disabilities secondary to head and neck or amputation surgery. Attention is drawn toward familiarizing the surgeon with these problems in order to enhance his treatment of the cancer patient. PMID- 3287980 TI - [The role of infection in abortion]. PMID- 3287981 TI - Comparative metabolic effects of chronic ethanol intake and undernutrition in pregnant rats and their fetuses. AB - Female rats receiving ethanol in the drinking water before and during gestation (ET) were compared to pair-fed animals (PF) and normal controls (C) fed ad libitum. On the 21st day of gestation the maternal body and liver weight, blood glucose, and plasma protein concentrations were lower in ET and PF animals as compared to C. In contrast to C or PF mothers, ET-fed mothers had higher circulating beta-hydroxybutyrate and triacyglyceride levels and beta-hydroxy butyrate/acetoacetate ratio. Liver triacylglycerides were increased whereas liver glycogen concentration was reduced in ET-fed animals. Only fetal body and liver weights and blood glucose were lower in both ET and PF than in C. Blood beta hydroxybutyrate was increased and liver glycogen was decreased only in ET fetuses. There were no differences among the groups in fetal circulating beta hydroxy-butyrate/acetoacetate ratio, plasma proteins, and triacylglycerides or liver triacyglyceride content. Results indicate that certain changes in ET mothers are specifically produced by the ethanol intake rather than undernutrition. Further, metabolic changes occurring in the fetus are influenced by the ethanol effects in the mother and these actions may be added to those directly produced by the ethanol crossing the placenta. However, the collaterals were three times more likely to report more drinking days than the patients; 40.4% (86/213) of the cohabiting contacts reported more drinking days compared to 12.7% (27/213) of the patients reporting more drinking days (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287982 TI - Validity of self-report in alcoholism research: results of a Veterans Administration Cooperative Study. AB - The validity of self-report in alcoholism treatment research is controversial. Our recently completed Veterans Administration Cooperative Study evaluating the efficacy of disulfiram treatment for alcoholism provided an opportunity to assess the validity of self-report. To assess treatment response, patients and household contacts were interviewed at seven scheduled points during the 1 year of follow up. Blood specimens also were obtained from the patients at these times and were analyzed for ethanol. Eighty-eight percent of the patient and/or collateral interviews were obtained at 6 months and 90% at 1 year. The mean number of blood and urine specimens collected per patient was 4.3 and 14.4, respectively. Outcome criteria included continuous abstinence during the year and total number of drinking days. Continuous abstinence: If we had had only the patients' self reports, we would have significantly underestimated the percentage of men who drank. By self-report 58.7% (355/605) relapsed whereas the combination of self report, collaterals' reports, and laboratory tests indicated that 72.4% (438/605) drank (p less than 0.001). Using Bayes' theorem, the conditional probability that a patient is continuously abstinent for 1 year when he so claims is 65%. Total drinking days: Of the 213 patient-collateral pairs each of whom provided all seven scheduled interviews, 46.9% (100/213) agreed on the total number of drinking days during the year.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3287983 TI - Effects of long-term ethanol inhalation on the immune and hematopoietic systems of the rat. AB - An inhalation method of ethanol administration was used to study the effects of 14 days of ethanol administration on the immune and hematopoietic systems of the rat. A decrease in cellularity was found in the spleen, thymus, and bone marrow of ethanol-treated rats. Although the red blood cell count, white blood cell count, and hemoglobin concentration were not significantly different between treatment and control groups, treatment with ethanol altered the relative proportion of lymphocytes and polymorphonuclear leukocytes in the peripheral blood. The granulocyte-macrophage progenitor cells in the bone marrow were unaffected by ethanol treatment, but a significant decline in the number of erythroid progenitor cells was noted in ethanol-treated rats. Splenic lymphocytes, although fewer in number in the ethanol-treated rats, showed no significant difference in ability to proliferate when stimulated by nonspecific mitogens. PMID- 3287984 TI - Depletion of hepatic glutathione by ethanol occurs independently of ethanol metabolism. AB - The mechanism of ethanol-induced depletion of hepatic glutathione (GSH) was studied in vivo and in isolated hepatocytes. Neither inhibition of ethanol metabolism with 4-methylpyrazole, nor a 10-fold elevation of acetaldehyde levels by inhibition of aldehyde dehydrogenase with cyanamide or disulfiram, affected the magnitude of the GSH depletion observed in vivo. The rate of intracellular GSH accumulation by isolated hepatocytes incubated with cysteine or methionine was not inhibited by the addition of 80 mM ethanol. A significantly decreased rate of GSH accumulation was, however, found in hepatocytes isolated from ethanol intoxicated animals. Neither the in vivo pretreatment with ethanol nor its in vitro addition to isolated hepatocytes affected the rate of GSH efflux. The results suggest that ethanol itself, rather than its metabolic products, causes depletion of liver GSH, and that events occurring in vivo are required for such an effect to be exerted. PMID- 3287985 TI - The HK/MBD questionnaire: replication and validation of distinct factors in a nonclinical sample. AB - Although Tarter et al.'s (1977) HK/MBD questionnaire has been found useful in subtyping populations of clinical alcoholics, its potential utility in nonclinical populations has yet to be determined. The current study examined the family history, personality, and substance use/abuse correlates of Tarter et al.'s HK/MBD questionnaire and factor analytically derived subscales (Alterman and McLellan, 1986) in a nonclinical sample of 580 young, adult males. In addition, a factor analysis of the HK/MBD questionnaire was undertaken to assess the extent to which the factor structure determined on a clinical alcoholic sample replicates in a nonclinical sample. Results indicated that each of the HK/MBD subscales showed relatively unique patterns of correlations with the various personality measures employed suggesting that they are measuring separate constructs. Perhaps of greatest importance, the HK/MBD items that appear to be of greatest relevance for understanding substance use/abuse are those related to antisocial behavior. Finally, the factor structure of the HK/MBD questionnaire in the nonclinical sample was found to be quite similar to the structure obtained in a clinical sample. These results demonstrate the multidimensional structure of the HK/MBD questionnaire and the utility of using the more homogeneous subscales in research with both clinical and nonclinical samples. PMID- 3287986 TI - Recent international reductions and increases in liver cirrhosis deaths. AB - This paper examines changes in liver cirrhosis death rates in 29 countries between 1974 and 1983 or the latest year available. Seven countries show a decline in death rates, six an increase, and the remaining 17 show no clear significant trends. Changes were more common among countries with high rates of alcohol consumption and high rates of liver cirrhosis deaths. Limited evidence for a widespread amelioration in liver cirrhosis seems to exist. PMID- 3287988 TI - P300 and the risk for alcoholism: family history, task difficulty, and gender. AB - P300 event-related brain potentials (ERPs) were obtained from 20 pairs of male and 20 pairs of female undergraduate subjects. One member of each pair reported having a father who was alcoholic (FHP), the other reported no known alcoholic biological relative (FHN). Pair members were matched on age, height, weight, grade point average, and personal drinking history. Three auditory tasks which differed in stimulus discrimination difficulty were presented to each subject. All tasks employed 20% target and 80% standard tones with the subject required to move their index finger whenever a target stimulus was detected. No significant differences in P300 amplitude or latency were obtained between the family history subject groups, although female FHP subjects tended to have smaller P300 amplitudes than their FHN counterparts. P300 amplitude decreased with increases in the amount of self-reported alcohol consumed for FHP subjects but significantly so only for the most difficult task situation. The results suggest that the relationship between the P300 ERP and the inheritability of alcoholism is not yet clear and may be subject to modulation by task requirements, population differences, and subject sex. PMID- 3287987 TI - Lack of prenatal testosterone surge in fetal rats exposed to alcohol: alterations in testicular morphology and physiology. AB - Pregnant Sprague-Dawley rats were administered a liquid alcohol diet (35% ethanol derived calories), a pair-fed isocaloric diet, or dry food pellets beginning on Day 14 of gestation and continuing until parturition. Testosterone levels in male fetuses were measured on Days 17 through 20 of gestation. The normal surge of testosterone on Days 18 and 19 was present in controls, but notably absent in male fetuses exposed to alcohol. Light microscopic examination of the testes at birth revealed a reduction in the number of leydig cells in the alcohol exposed group and the presence of a large number of vacuoles in the seminiferous tubules. In vitro studies of fetal testes at 18 and 22 days of gestation revealed that this in utero alcohol exposure regimen produced a marked insensitivity to rat LH (10 ng/ml) stimulation of testosterone secretion compared to controls. The response to ethanol (160 mg/dl) in alcohol exposed testes was characterized by a long-lasting suppression of testosterone compared to a large increase observed in control testes. No differences in anogenital distance were observed among the groups. Together, these data may explain some of the long-term feminizing and demasculinizing effects on reproductive and nonreproductive sexually dimorphic behaviors observed in adult males prenatally exposed to alcohol. PMID- 3287989 TI - Noninvasive estimation of blood alcohol concentrations: ethanol vapor above the eye. AB - The present study describes, in animals, a novel approach to the in vivo, noninvasive determination of alcohol in the body. The concentration of ethanol in vapor above the lacrimal fluid in the eye was analyzed in situ by the use of a fast (1-min) gas sensor method developed previously for biological liquids. After an oral dose of 1 g/kg to 11 animals, eye vapor measurements and blood samples were obtained over 4 hr. The correlation of 61 blood ethanol concentrations obtained by the two methods yielded a correlation coefficient of 0.92 and a slope of 0.99. The metabolic rates of ethanol determined by gas chromatographic analysis of blood and by ethanol eye vapor analysis are virtually identical. The data suggest that ethanol eye vapor analysis may be an attractive, noninvasive method for the determination of ethanol in animals. The method is not subject to false high readings due to alcohol in the buccal cavity and thus might constitute an alternative to breath analysis in the human. In a separate series, ethanol was determined by head space gas chromatography in samples of blood and lacrimal fluid while the animals were under ketamine anesthesia. The correlation of ethanol concentrations in blood and lacrimal fluid (r = 0.99) shows that ethanol is distributed in lacrimal fluid which comprises part of total body water. PMID- 3287990 TI - Prenatal alcohol exposure alters behavioral laterality of adult offspring in rats. AB - The effects of prenatal exposure to ethanol on side preference behavior were examined in adult Long Evans rats from three prenatal treatment groups: prenatal alcohol exposed (35% ethanol-derived calories, 35% EDC), nutritional control (0% ethanol-derived calories, 0% EDC) or standard control (lab chow, LC). Rats prenatally exposed to alcohol exhibited less side preference in a two-lever operant chamber while responding for food reward and alternated between the left and right levers more than either control group, which did not differ from each other. Although side preference increased over days of testing in the control groups, the 35% EDC subjects' side preference did not change with increased experience. When responding on a nonrewarded schedule (extinction), the three prenatal treatment groups did not differ in side preference. Alcohol-exposed offspring also displayed a marked difference in paw use compared to control subjects: while most of the control subjects used one paw preferentially, 35% EDC subjects used both paws together or alternated paws. Prenatal alcohol exposure appears to alter the normal development of behavioral laterality, and this altered development persists into adulthood. Prenatal alcohol exposure may also alter the functional interaction between intrinsic laterality and reward contingencies. PMID- 3287991 TI - Dose-additive inhibition of intake of ethanol by cholecystokinin and bombesin. AB - Cholecystokinin (CCK) and bombesin (BBS) are neuropeptides of the brain and gut which have been shown to inhibit intake of ethanol. CCK octapeptide and BBS tetradecapeptide were injected intraperitoneally in both single doses and combinations of doses to determine interactions of the two peptides in the control of consumption of ethanol. Water-deprived rats were given access to 5% w/v ethanol for 30 min, followed by a 30-min access to water, daily. One minute before presentation of ethanol, rats were injected with either saline or one of ten peptide solutions (three of CCK alone, three of BBS alone, and four combinations of both). Results from the injections of single peptides were used to determine predicted inhibitions of the peptide combinations, assuming perfect additivity of doses. None of the actual values of inhibition of intake of ethanol by peptide combinations differed significantly from its predicted additive value. Endogenous CCK-like and BBS-like peptides may suppress intake of ethanol by an additive mechanism of inhibition. PMID- 3287992 TI - Alterations in regional catecholamine content and turnover in the male rat brain in response to in utero ethanol exposure. AB - Fetal ethanol exposure is known to produce CNS abnormalities. The molecular basis for these manifestations observed in animals exposed to ethanol in utero may be explained by changes in regional catecholamine content and turnover. This study was designed to determine changes in catecholamine content and turnover in the cerebral cortex, cerebellum, medial basal hypothalamus, diencephalon, and septal area of male rats exposed to ethanol pre- and postnatally. Pregnant Sprague Dawley rats were exposed to either an ad libitum liquid diet containing 35% ethanol-derived calories, an isocalorically matched liquid diet, or a diet consisting of laboratory chow and water. Regional alterations in catecholamine content and turnover in each of the brain areas were observed on postnatal Day 18. A regional variability was demonstrated in the effect of in utero ethanol exposure on catecholamine content and turnover. The most dramatic effect was found in the dopaminergic neurons of the medial basal hypothalamus where in utero ethanol exposed offspring had a significantly reduced DA content and turnover when compared to pups from both isocalorically matched and chow-fed dams. These data indicate that the dopaminergic neurons of this particular brain region are susceptible to alteration by ethanol exposure during development and that this alteration cannot be explained by changes in nutrition alone. PMID- 3287993 TI - Long-term alcohol consumption reduces the number of neuronal nuclear pores. A morphometric study undertaken in CA3 hippocampal pyramids of rats. AB - A close relationship between the number of nuclear pores and the cellular protein synthesis activity is known to exist. Previous biochemical investigations lead to admit that the widespread neuronal alcohol-induced degenerative changes could depend on a decrease in the neuronal protein synthesis. The morphometric analysis made on the nuclear pore complexes of CA3 hippocampal pyramids of long-term alcohol-fed rats fully supports this attractive hypothesis, since it has been found a marked reduction in the number of pores per unit surface area of nuclear membrane, together with a reduction in their total number per nucleus. PMID- 3287994 TI - Reductions in liver cirrhosis mortality and morbidity in Canada: demographic differences and possible explanations. AB - In Canada, deaths from liver cirrhosis have declined by about 25% since 1974. To gain further insight into the nature of this decline, mortality rates for the years 1974-1984 and morbidity (hospital separation) rates for the years 1974-1980 were examined by age and sex and by province and sex. As well, survey data on drinking practices in Ontario were analyzed. Both mortality and morbidity declined over the time period involved, although variations over provinces, age groups, and sex were observed. The pattern of variations (largest declines in provinces with highest per capita alcohol consumption and in young to middle-aged males) strongly suggests decreased incidence of alcoholic liver cirrhosis. Among the factors which may be contributing to these declines are: the stabilization and small decreases in per capita consumption of alcohol; consumption pattern changes consistent with observed mortality and morbidity changes; expanded health promotion activities; and increases in the numbers of alcoholics receiving treatment. PMID- 3287995 TI - Alcohol P-450 oxygenase. PMID- 3287997 TI - Allergenic cross-reactivity of yeasts. AB - Yeast allergen extracts of Candida albicans, C. pseudotropicalis, C. krusei, C. parapsilosis, C. tropicalis, C. guilliermondi, C. humicola, C. norwegica, C. utilis, Cryptococcus albidus, Geotrichum candidum, Pityrosporon pachydermatis, P. ovale, Rhodotorula minuta, R. rubra, Saccharomyces cerevisiae, Torulopsis glabrata and Trichosporon cutaneum were investigated regarding their common allergenic properties. The enzyme immunoassay (EIA) using rabbit anti-Candida albicans antiserum showed remarkable immunological cross-reactivity only between the Candida species. However, there was a significant multiple sensitivity to the extracts of C. albicans, C. utilis, Cr. albidus, R. rubra and S. cerevisiae in skin prick testing in atopic patients, suggesting the possible presence of one or more common skin reactive allergens. PMID- 3287996 TI - A double-blind dose-response study of budesonide by inhalation in patients with bronchial asthma. AB - Budesonide by inhalation and placebo were tested in 18 patients with moderate chronic bronchial asthma. Three dose levels of budesonide were used (25, 100 and 400 micrograms q.i.d.) and the patients were to take two puffs q.i.d. in all periods. The active treatment was investigated using double-blind cross-over technique, and placebo at the end of the trial. The duration of each treatment period was 2 weeks. The study showed a high drop-out frequency while on placebo and that the PEF values were influenced in a dose-dependent way by budesonide. In spite of the double-blindness the patients had a tendency towards overuse of the trial aerosol on the lowest dose, but they used significantly less than prescribed during the period with the highest dose. No side effects were reported. PMID- 3287998 TI - Relationship of immediate and delayed hypersensitivity to nasopharyngeal and intestinal growth of Candida albicans in allergic subjects. AB - The growth of C. albicans yeast in the nasopharynx and in the anus as well as allergy symptoms were followed up for 8 months in 67 patients with bronchial asthma, allergic rhinitis and/or atopic eczema. 38 of the patients were skin prick test positive and 29 negative to C. albicans allergen extract. 32 of the patients had positive and 19 negative delayed skin reactions. The nasal, bronchial and skin symptoms of the yeast-sensitive allergic patients were not associated with the nasopharyngeal nor anal occurrence of C. albicans or other yeasts. The use of nasal or inhaled steroids had no effect on the occurrence of Candida in the nasopharynx. It was observed that immediate skin sensitivity had a positive correlation and the delayed sensitivity a negative correlation with the occurrence of C. albicans growth in nasopharynx and anus. These findings are in agreement with the concept that impaired cell-mediated immunity to C. albicans may lead to increased IgE response. This may explain the increased liability towards C. albicans nasopharyngeal and gastrointestinal "saprophytic" growth. PMID- 3288000 TI - Free radicals. Formation, function and potential relevance in anaesthesia. AB - Free radical species are ubiquitous in plant and animal life. This article describes briefly the formation of certain oxygen-centred free radicals which are essential for aerobic metabolism and host defences in humans. The mechanism of cytotoxicity of excess or inappropriate free radical production is described. The potential relevance of free radical tissue injury to the anaesthetist is illustrated using oxygen toxicity, adult respiratory distress syndrome and halothane hepatitis as examples. PMID- 3287999 TI - Transcutaneous electrical nerve stimulation after thoracotomy. Pain relief and peak expiratory flow rate--a trial of transcutaneous electrical nerve stimulation. AB - Forty patients scheduled to undergo thoracotomy were randomly allocated to receive either transcutaneous electrical nerve stimulation with intramuscular papaveretum (20 patients) or intramuscular papaveretum alone (20 patients) for postoperative pain relief. Total intramuscular analgesic requirements in the first 24 hours, time to satisfactory transfer to oral analgesia, antiemetic requirements and length of stay in hospital postoperatively were noted. Peak expiratory flow rate was compared pre- and postoperatively in the two groups. Use of nerve stimulation did not significantly alter the requirements for analgesia although there was a reduction in postoperative nausea and vomiting in the nerve stimulation group. There was no difference between the two groups with respect to changes in peak expiratory flow rate. PMID- 3288001 TI - Automated synthesis and sequence analysis of biological macromolecules. PMID- 3288002 TI - Rancidity and its measurement in edible oils and snack foods. A review. PMID- 3288003 TI - Measurement of sodium and potassium in clinical chemistry. A review. PMID- 3288005 TI - Alas, poor Trendelenburg and his position! A critique of its uses and effectiveness. PMID- 3288006 TI - Glucose homeostasis and insulin secretion during isoflurane anesthesia in humans. AB - The effect of isoflurane-air anesthesia on glucose tolerance in humans was investigated using two successive intravenous glucose tolerance tests (IVGTT). After a first IVGTT while awake, patients received a second IVGTT either while awake (group I), during anesthesia with isoflurane-air and pancuronium without surgical stimulation (group II), or during the same anesthetic technique but combined with surgery (group III). Isoflurane seemed to induce glucose intolerance (glucose disappearance rate K10-60 min = 1.628 +/- 0.462% min-1 [control] versus 1.086 +/- 0.920% min-1 [anesthesia], P less than 0.05) partly due to a decreased glucose induced insulin response. Growth hormone and norepinephrine levels were also increased during anesthesia. Epinephrine levels were lowered by isoflurane anesthesia. Although glucose intolerance was marked during surgery (K10-60 min = 0.892 +/- 0.286% min-1), the glucose-induced insulin response remained similar to that observed in patients in group II, while growth hormone, cortisol, epinephrine, and norepinephrine concentrations increased significantly. These known stress factors thus seemed to enhance glucose intolerance through a diminished response to insulin action and/or an enhanced hepatic glucose output, rather than by further impairing pancreatic insulin secretion. PMID- 3288004 TI - The epidermal permeability barrier. AB - The permeability barrier of the skin which prevents transcutaneous water loss and penetration of harmful drugs from the environment is localized in the horny layer of the epidermis. Multiple lipid bilayers obstructing the intercellular space of the stratum corneum fulfill this function. In contrast to cellular membranes consisting predominantly of phospholipids, these lamellae contain mostly ceramides, cholesterol and free fatty acids. The lamellae are derived from the contents of lamellar granules (LGs) which are synthesized in the viable epidermal layers by the keratinocytes. LGs display stacks of small disks each of which represents a flattened vesicle or liposome. Prior to terminal differentiation, the disks are exocytosed into the intercellular space and fused to form uninterrupted sheetlike lamellae. The singular lipid composition of LG-disks and of stratum corneum-lamellae reflects the multistage process of barrier formation. It also renders these structures well suited to provide for a barrier function. PMID- 3288007 TI - Topical anesthesia with lidocaine aerosol in the control of postoperative pain. AB - Postoperative pain was assessed in patients undergoing inguinal hernia repair. Ten patients received lidocaine aerosol in the surgical wound before skin closure, ten patients received placebo aerosol devoid of lidocaine, and ten patients were untreated. The lidocaine-treated group had significantly lower pain scores and meperidine requirements during the first postoperative day compared to the control groups. During the second day after surgery, these variables did not differ between groups. Wound anesthesia, assessed by palpation of the wound 24 h after surgery by a blinded investigator, was significantly more pronounced in the group treated with lidocaine aerosol than in the control groups. Similarly, in patients undergoing bilateral herniorraphy, wound pain following palpation was significantly reduced on the lidocaine-treated side compared to the untreated side. Patients in the group receiving lidocaine aerosol indicated less pain in connection with mobilization than untreated patients, but not compared to patients treated with placebo aerosol. Plasma substance P (SP) and beta-endorphin (BE) measured in lidocaine-treated patients and in untreated patients before and after drug administration showed no significant differences regarding SP, while BE was significantly increased 1 h after surgery in the untreated group. Plasma lidocaine concentrations were well below toxic levels. Results show that lidocaine aerosol used as topical anesthetic in the surgical wound is simple to use, and results in a long-lasting reduction of pain after a single administration. Moreover, postoperative mobilization is facilitated, and the requirement for postoperative analgesics is reduced. Wound healing was normal, and no adverse reactions to lidocaine were reported. PMID- 3288008 TI - Epidural anesthesia with fentanyl and lidocaine for cesarean section: maternal effects and neonatal outcome. PMID- 3288009 TI - pH-adjusted 2-chloroprocaine for epidural anesthesia in patients undergoing postpartum tubal ligation. PMID- 3288010 TI - [Multiple aneurysms of the visceral branches of the abdominal aorta. Apropos of a case and review of the literature]. PMID- 3288011 TI - [Paragangliomas of the carotid body]. PMID- 3288013 TI - Infection surveillance in cardiac transplantation. AB - Infections are a major cause of morbidity and mortality in cardiac transplantation. There is little information describing screening and prospective surveillance of heart recipients. We describe a surveillance program that was used for 35 patients, which screens and follows recipients through serologic, virologic, and immunologic parameters. Pretransplantation surveillance identified four (11.4%) patients whose skin tests with purified protein derivative (PPD) were positive, one patient with giardiasis, and seven (20%) recipients who were susceptible to cytomegalovirus (CMV). Twelve (34.3%) patients had CMV infections, only one of which was primary and involved a seropositive donor. The low rate of primary infection (14%) may result from our use of CMV-negative blood products. Seven (20%) recipients who were seronegative for toxoplasmosis received seropositive hearts, and disseminated toxoplasmosis developed in one of them. Eight (22.8%) patients had asymptomatic significant increases in Epstein-Barr virus antibody titers, without evidence of lymphoma. Fifteen (42.8%) recipients had at least one herpes simplex virus reactivation. Preventive, diagnostic, and early therapeutic interventions should occur as a result of infection surveillance, thus leading to a reduced risk of infection during the period after cardiac transplantation. PMID- 3288014 TI - Risk factors associated with a cluster of urinary tract infections in a geriatric unit caused by Klebsiella pneumoniae resistant to multiple antibiotics. PMID- 3288012 TI - [Simultaneous resection of the first rib and/or cervical rib and cervico-thoracic sympathectomy]. PMID- 3288015 TI - Evolutionary trends in carotid atherosclerotic plaques: results of a two-year follow-up study using an ultrasound imaging system. AB - A two-year follow-up on 118 atherosclerotic lesions of the extracranial carotid tract observed in 70 patients was carried out using real-time high-resolution echotomography. The following plaque characteristics were monitored: the echogenic patterns (soft, intermediate, hard, and mixed), the surface aspects, and the degree of stenosis. The aim of the study was to evaluate plaque evolution, in relation both to the degree of vessel stenosis produced and to the echostructural characteristics of the lesion. After two years 68% of the lesions remained unchanged while the degree of vessel stenosis increased in 32%; no case of regression was observed. Intrinsic factors appearing to condition an increase in degree of stenosis were "mixed" and "hard" echogenic pattern, an irregular lesion surface, and an initial degree of stenosis of more than 50%. A modification in the echogenic pattern, which generally tended to progress toward more highly reflecting echogenic levels was observed in 27% of the lesions studied. PMID- 3288017 TI - Congenital limb defects and prostheses before the seventeenth century. PMID- 3288016 TI - A controlled study on the effect of pentoxifylline and an ergot alkaloid derivative on regional cerebral blood flow in patients with chronic cerebrovascular disease. AB - Regional cerebral blood flow (rCBF) in 90 patients with CBF decreased due to vascular diseases was studied by using the xenon 133 inhalation technique and a 32-detector setup. Whereas 30 patients received their standard basic therapy only and were regarded as controls, 30 others received 3 x 2 mg/day of an ergot alkaloid (co-dergocrine mesylate), and 30 others received 3 x 400 mg pentoxifylline (slow-release formulation)/day orally. Therapy was performed for eight weeks and CBF measured before start of treatment, after a four-week treatment period, and at the end of the study. CBF did not change significantly in the control group; both the pentoxifylline and the ergot alkaloid group presented with a significant increase in the CBF. This positive effect was significantly more pronounced in the pentoxifylline group and affected more ischemic than other brain tissues. In addition, symptoms like sleep disturbances, vertigo, and tinnitus improved significantly during the pentoxifylline observation period. PMID- 3288018 TI - Management of infection following intra-abdominal trauma. AB - Intra-abdominal infections following abdominal trauma often involve the gastrointestinal aerobic and anaerobic bacterial flora. These organisms possess various virulence factors and exhibit potential synergy between them. The intra abdominal infection is biphasic, with the Enterobacteriaceae as the major pathogens in the peritonitis stage, and the Bacteroides fragilis group predominant in the abscess stage. Experiments with animals and experience in human beings support the need to use single or combined antimicrobial agent therapy that is effective against both Enterobacteriaceae and the B fragilis group. PMID- 3288019 TI - Likelihood ratios versus diagnostic weights. PMID- 3288020 TI - Antibodies to Borrelia burgdorferi in dogs in North Carolina. AB - An indirect immunofluorescence assay was used to detect antibodies against Borrelia burgdorferi in sera from 600 dogs in 1983 and 402 dogs in 1985. In 1983, the overall prevalence rate of dogs with B burgdorferi titers greater than or equal to 1:64 was 3.6%, whereas in 1985, the prevalence rate was 2.7%. An unexplainable higher seroprevalence was detected in 1 group of dogs tested in 1983. These dogs were from the southern coastal plains of North Carolina. In the dogs tested in 1985, this regional difference in sero-prevalence was not noticed. Statistical differences were not noticed (P greater than 0.05) between dogs from 2 sources or when gender was considered. Seemingly, the prevalence of anti-B burgdorferi antibodies in dogs in North Carolina was low. PMID- 3288021 TI - Hemodynamic and respiratory responses in halothane-anesthetized horses exposed to positive end-expiratory pressure alone and with dobutamine. AB - The influence of positive end-expiratory pressure (PEEP) on the alveolar-arterial O2 tension difference [P(A-a)O2], physiologic right-to-left shunt fraction, physiologic dead space-to-tidal volume ratio, and hemodynamic variables was studied in halothane-anesthetized horses maintained in dorsal recumbency during controlled ventilation. Dobutamine was used to minimize the adverse cardiovascular consequences of PEEP. Six adult horses were anesthetized, using xylazine (2.2 mg/kg of body weight, IM), guaifenesin (50 mg/kg, IV), thiamylal Na (4.4 mg/kg, IV), and halothane (1.5 to 2% inspired) in 100% O2. Mechanical ventilation was controlled to maintain arterial eucapnia for at least 45 minutes during base-line measurements. Hemodynamic and respiratory variables were determined every 15 minutes during equilibration. Each horse was subjected to 4 randomized treatments: 5 cm of H2O PEEP, 10 cm of H2O PEEP, 5 cm of H2O PEEP plus dobutamine (1 microgram/kg/min), and 10 cm of H2O PEEP plus dobutamine (1 microgram/kg/min). Each treatment lasted 15 minutes and immediately followed its predecessor. Although the magnitude of PEEP was randomized with and without dobutamine, PEEP without dobutamine always preceded PEEP with dobutamine. Differences in hemodynamic or respiratory variables among base-line measurements, 5 cm of H2O PEEP, or 10 cm of H2O PEEP were not significant (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288023 TI - Intrarectal ultrasonography in the staging and management of rectal tumors. AB - Intrarectal ultrasonography (IRUS) was used in the preoperative staging of 17 patients with rectal neoplasms. Fourteen patients had biopsy proven adenocarcinoma, and three others had large villous adenomas. Comparisons were made between clinical examination, IRUS staging and subsequent histopathologic staging. IRUS was performed with a Bruel and Kjaer radial scanner, type 1849, equipped with a 7.0 MHz transducer. IRUS accurately staged 3/3 rectal villous adenomas, and 11/13 rectal adenocarcinomas compared with histopathology. Clinical exam correctly staged all three villous tumors, and 6/9 carcinomas (24% of lesions were not palpable). IRUS correctly diagnosed the status of regional nodes in 88% of patients. IRUS is a highly accurate preoperative staging tool for rectal cancers both in delineating depth of bowel wall invasion and in assessing regional lymph nodes. It is easy to perform, safe, and well tolerated by the patients. IRUS has definitely arrived as the state of the art in evaluating rectal neoplasms and may impact heavily on surgical decision making for these neoplasms. PMID- 3288022 TI - Contribution of various host factors to resistance to experimentally induced bacterial endotoxemia in calves. AB - The reactions of 15 calves to IV administered bacterial lipopolysaccharide was investigated and was correlated with the capacity of 2 host defense mechanisms. The calves had a wide range of changes in clinical response, total WBC count, plasma lactate dehydrogenase (LD) activity, reaction to intradermally inoculated lipid A, and rectal temperature response. The early rectal temperature response of an individual calf was correlated with plasma LD activity, indicating a relationship between cell damage and fever. The concentration of antibody against lipid A at the time of lipopolysaccharide inoculation was negatively correlated with the rectal temperature changes recorded during endotoxemia, suggesting a protective ability of antibody. The capacity of a plasma inhibitor of lipopolysaccharide-mediated clotting of limulus amebocyte lysate was correlated with increases in plasma LD activity. Therefore, antibody to lipid A probably is involved in protection of cattle during endotoxemia, but the plasma lipopolysaccharide inhibitor actually may potentiate lipopolysaccharide toxicity. PMID- 3288024 TI - Therapeutic dilemmas in patients with symptomatic polycystic liver disease. AB - Most reports of the operative treatment of symptomatic polycystic liver disease (PCLD) are anecdotal or consist of only a small subset of patients in an institution's overall experience treating hepatic cysts. We have reviewed our experience with nine consecutive patients with symptomatic PCLD undergoing operative treatment from 1981 to 1987. Indications for operation include chronic abdominal pain (4 patients), cyst infection (2 patients), biliary obstruction (2 patients), inferior vena cava obstruction (2 patients), and symptomatic abdominal distention (2 patients). The average duration of symptoms leading to operation was 7.8 months. Three types of cystic disease were identified based on gross morphology: dominant cystic disease (3 patients), diffuse cystic disease (4 patients), and mixed cystic disease (2 patients). Operations to treat symptomatic PCLD included unroofing and external drainage of infected cysts (2 operations), simple unroofing (1 operation), cyst fenestration alone (4 operations) and fenestration combined with resection (3 operations). Treatment directed at principally dominant cysts (five patients) was associated with resolution of symptoms and low morbidity and mortality. Treatment directed at diffusely cystic disease (four patients) resulted in significant morbidity and mortality including three deaths. Successful surgical treatment of symptomatic patients with PCLD depends on accurate preoperative identification of patients with symptoms related to one or more dominant cysts. In this setting fenestration or simple unroofing of the dominant cyst is safe and effective treatment. By comparison, extensive fenestration with or without hepatic resection in patients with symptoms attributed to a diffusely cystic liver may be associated with unacceptable morbidity and mortality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288025 TI - [Enterotoxigenic Escherichia coli: description of a nosocomial diarrhea outbreak]. AB - A nosocomial diarrhea outbreak caused by Escherichia coli 0153: H45, which produces a thermostable enterotoxin, in five neonates admitted to the neonatology ward of the pediatric service of the Valencia University Hospital is described. The outbreak was discovered during a prospective study lasting eight months and aimed at evaluating the importance of Escherichia coli with enterotoxic capacity in acute infant diarrhea within our environment. The study involved conventional enterotoxigenicity tests applied both in vivo and in vitro. One of the patients, admitted with acute diarrhea was the source of the outbreak, with a possible person to person transmission. The diarrhea was slight to moderate. Emphasis is placed on the importance of this type of diarrhea in developed countries, and the problem is analyzed by reviewing its situation to the present. PMID- 3288026 TI - [Sebaceous nevus of Jadassohn associated with infantile spasms]. PMID- 3288027 TI - Why should internists be interested in interleukin-1? PMID- 3288028 TI - Campylobacter pylori antibodies in humans. AB - STUDY OBJECTIVE: To determine the diagnostic value of assays to measure serum antibodies to Campylobacter pylori, and to use these assays to determine the prevalence of C. pylori infection in a healthy population. DESIGN: A survey of patients having endoscopies for upper gastrointestinal symptoms, patients with other gastrointestinal illnesses, and healthy controls. SETTING: Outpatients attending endoscopy suites in two university-affiliated medical centers. PATIENTS: One hundred and twenty patients who had gastroduodenoscopies, 61 patients with lower intestinal illnesses, and 166 healthy controls. INTERVENTION: Assay to detect serum IgA, IgG, and IgM antibodies specific for C. pylori. MEASUREMENTS AND MAIN RESULTS: Absorption with other gram-negative pathogens showed that IgG and IgA assays, but not IgM assays, were specific for C. pylori. In patients in whom C. pylori had been isolated and who had gastritis diagnosed by histologic methods, significantly higher mean IgA and IgG levels were seen compared with patients without demonstrable C. pylori or gastritis. The sensitivity and specificity of a positive value in both IgA and IgG assays were more than 93%. Among healthy persons, IgG and IgA antibodies were rarely seen in patients less than 20 years old, but antibody prevalence progressed with age, reaching 50% in patients more than 60 years old. High IgA and IgG levels to C. pylori in five persons tested remained stable for more than 1 year, suggesting the organism persists for at least that period. In 61 patients with acute bacterial enteritis, acute pancreatitis, Crohn disease, or ulcerative colitis, prevalence of antibodies to C. pylori was consistent with age and unrelated to current disease. CONCLUSIONS: Campylobacter pylori infection, which is highly associated with active gastritis, may be diagnosed by serologic assay. Acquisition of infection begins in adult life, and prevalence increases with age. PMID- 3288030 TI - Clinical trials in congestive heart failure: why do studies report conflicting results? PMID- 3288029 TI - Combination drug therapy for familial combined hyperlipidemia. AB - STUDY OBJECTIVE: To compare the efficacy of gemfibrozil and colestipol with gemfibrozil and lovastatin in patients with familial combined hyperlipidemia. DESIGN: A prospective, randomized trial. SETTING: An outpatient clinical research center in a tertiary care center. PATIENTS: Seventeen patients with familial combined hyperlipidemia documented by studies of first-degree relatives; nine patients with type 2b hyperlipoproteinemia, and eight patients with type 4 hyperlipoproteinemia. INTERVENTIONS: Baseline lipid, lipoprotein, and apolipoprotein levels were obtained during control periods on diet alone and on gemfibrozil therapy. Patients then received gemfibrozil and colestipol or gemfibrozil and lovastatin in a randomized order. MEASUREMENTS AND MAIN RESULTS: In patients with type 2b hyperlipoproteinemia, gemfibrozil alone significantly reduced total cholesterol by 11%, and low density lipoprotein (LDL) apolipoprotein B by 18%, did not change LDL-cholesterol, and raised high density lipoprotein (HDL)-cholesterol levels by 26%. Addition of either colestipol or lovastatin reduced LDL-cholesterol levels by 17% and 25%, respectively, compared to gemfibrozil alone. However, colestipol mitigated the HDL-cholesterol raising effect of gemfibrozil and did not further reduce LDL-apolipoprotein B levels. In contrast, addition of lovastatin caused an additional reduction of LDL apolipoprotein B 19% compared with gemfibrozil alone. In patients with type 4 hyperlipoproteinemia, gemfibrozil alone reduced triglycerides by 40%, raised HDL cholesterol by 26%, and increased LDL-cholesterol levels by 29%. The addition of either colestipol or lovastatin reduced LDL-cholesterol levels by 34% and 33%, respectively (compared with gemfibrozil alone), but greater reductions of LDL apolipoprotein B (30% with lovastatin compared with 15% with colestipol, compared with gemfibrozil alone), and increases in HDL-cholesterol levels (8% increase with lovastatin compared with 10% decrease with colestipol, compared to gemfibrozil alone) were seen with the lovastatin combination. CONCLUSIONS: Although gemfibrozil with either colestipol or lovastatin favorably altered lipoprotein levels in patients with hypertriglyceridemia and familial combined hyperlipidemia, the combination of gemfibrozil and lovastatin appeared superior overall. PMID- 3288031 TI - Maximally reducing cardiovascular risk in the treatment of hypertension. AB - With the increasing recognition of relatively mild hypertension, asymptomatic patients are being started on life-long therapy with antihypertensive agents. Before the diagnosis is made or therapy instituted, elevated blood pressure must be verified. To provide maximal protection against premature cardiovascular disease and coronary disease, various non-drug therapies should be used that lower both blood pressure and other risk factors. Drugs should be chosen to provide maximal efficacy, long-term safety, and multifaceted convenience, providing the greatest protection with the least interference with quality of life. These goals can be best achieved by substituting commonly used drugs such as diuretics, central agonists, and beta-blockers with vasodilators, such as alpha-blockers, angiotensin-converting enzyme inhibitors, and calcium blockers. PMID- 3288032 TI - Brain amyloid and Alzheimer disease. AB - Clinicopathologic features of Alzheimer disease, the commonest cause of presenile or senile dementia, are presented. Several of the microscopic brain lesions found in patients with this dementia share the staining properties of amyloid and at least two of these lesions (senile plaque cores and amyloid angiopathy) are biochemically identical. Theories pertinent to the origins of brain amyloid and its role in the pathogenesis of Alzheimer disease are discussed in relation to theories of the cause of this dementia. Possible treatments for Alzheimer disease developed from our knowledge of brain amyloid processing and biochemistry are considered. PMID- 3288034 TI - National Study of Internal Medicine Manpower: XIII. The financing of internal medicine residency and fellowship training, 1985 to 1986. AB - Hospital revenue is the most important source for residency and fellowship stipends in internal medicine. Medicare is especially important for residency programs in voluntary hospitals and hospitals not closely affiliated with a medical school. In the last decade state and local government support and federal training grant support for residency stipends declined, whereas Veterans Administration support increased. Fellowship stipend sources are much more diverse; federal training grants, professional fees, foundations, medical school funds, and research grants contribute significantly. Medicare support appears to be focused on subspecialties particularly important to the elderly, including critical care, rheumatology, cardiology, hematology, gastroenterology, and nephrology. Geriatric medicine, however, receives substantial Veterans Administration support. With growing revenue constraints and increasing concerns about excess physicians we need to monitor the impact of government regulations and other factors on funds available for training internal medicine specialists. PMID- 3288033 TI - Diagnostic heterogeneity in clinical trials for congestive heart failure. AB - There are no uniform diagnostic criteria for congestive heart failure. To determine the pattern of diagnostic criteria used, reports of 51 randomized, double-blind, placebo-controlled, clinical drug trials published between 1977 and 1985 were reviewed. Only 23 (45%) of the trials specified objective diagnostic criteria beyond treatment history, clinical diagnosis, or functional class. Of these, there were two trials each for digoxin, hydralazine, amrinone, and metoprolol; for each pair, only one study showed therapy beneficial. Of the amrinone pair, the positive study required a lower ejection fraction (less than 30% compared with less than 45%) and selected patients with more clinical severity. Conversely, for metoprolol, the positive study specified a higher ejection fraction (less than 49% compared with less than 35%) and selected patients with clinically milder disease, suggesting that conflicting results may relate to differences in study population. Many studies of congestive heart failure are done without explicit diagnostic criteria. Criteria lack uniformity, and such discrepancies may explain conflicting results. PMID- 3288035 TI - Comprehensive functional assessment for elderly patients. Health and Public Policy Committee, American College of Physicians. PMID- 3288036 TI - Psychosocial stress, aging and cancer. PMID- 3288037 TI - Altered striatal dopaminergic and cholinergic reciprocal inhibitory control and motor behavioral decrements in senescence. PMID- 3288038 TI - Can opioids regulate hemopoietic differentiation? PMID- 3288039 TI - Tetrahydrobiopterin and biogenic amine metabolism in neuropsychiatry, immunology, and aging. AB - Tetrahydrobiopterin (BH4) is essential for biogenic amine synthesis, and alterations in its metabolism occur at birth (atypical PKU), in neuropsychiatric illnesses, and in aging. BH4 therapy has been attempted in atypical PKU and in neuropsychiatric illness with some success and may become more viable as more is learned about BH4 metabolism and ways are discovered to elevate brain BH4 levels. It is intriguing to consider that a genetic defect in BH4 biosynthesis occurring at birth might go unrecognized and contribute to altered biogenic amine metabolism that occurs in neuropsychiatric illness. Since there seems to be a sensitivity of BH4 metabolism to genetic alterations, it is possible that altered BH4 metabolism is involved in some of deleterious effects associated with the aging process. A link between genetic alterations in BH4 metabolism at birth and adult neuropsychiatric illness and aging remains to be established, although this seems plausible. The presence of BH4 and other pterins in cells of the immune system as well as the pineal gland and other neuroendocrine tissues suggests the potential for other functions of pterins. Hopefully, future research will uncover the full potential for the therapeutic use of BH4 in a variety of diseases as well as elucidating other potential roles for pterin molecules which are present in many different systems. PMID- 3288040 TI - Epidemiologic aspects of stress, aging, cancer and the immune system. PMID- 3288042 TI - Dysdifferentiation hypothesis of aging and cancer: a comparison with the membrane hypothesis of aging. AB - Our laboratories have been testing the basic concept that the age-dependent deterioration of the molecular components of living systems may be due in part to the biochemical effects of active oxygen species. The dysdifferentiation hypothesis of aging and cancer (DHAC) as well as the membrane hypothesis of aging (MHA) are discussed and compared to each other. These two hypotheses consider cellular mechanisms through which free radical-induced alterations may lead to the aging process. DHAC emphasizes the importance of the instability of the differentiated state of cells and how active oxygen species may interact with the genetic apparatus of cells, leading to improper gene regulation. The evidence supporting this hypothesis includes an age-dependent increase in the expression of specific genes that normally are expected to be repressed. Such evidence now includes the c-myc oncogene as well as an age-dependent decrease in the average methylation level of the entire genome in liver tissue of mice. The central concept of DHAC is that aging is a result of gene regulatory instability and that lifespan is governed by mechanisms acting to stabilize proper gene regulation. MHA is based on the concept that all cellular components are exposed to free radical attacks, and that the damaging efficiency of the radicals is density dependent. Compact structures like membranes are consequently more susceptible to damage than cytosolic components. In addition, the cell plasma membrane is exposed to another damaging effect called residual heat damage, which is due to the depolarization-induced discharge of the membrane during the action potential. MHA predicts that a key process of normal differentiation as well as aging is a continuous, age-dependent loss of the passive permeability of the cell membrane for potassium and probably also for water. This is due to a constant difference between the rates of damage and replacement of the membrane components and results in a gradual dehydration of the intracellular mass from the embryonic state to the aging state. The increasing intracellular density will eventually become rate-limiting for many different cellular functions, resulting in the cessation of growth and the beginning of aging. MHA also predicts an overall decrease of gene expression and protein turnover rate during aging. Pharmacological interventions on the cell membrane have supported the validity of MHA and have indicated specific mechanisms of how aging and dysdifferentiation may occur. PMID- 3288041 TI - Immune senescence contributes to the slow growth of tumors in elderly subjects. PMID- 3288043 TI - Restoration of in vivo humoral and cell-mediated immune responses in neonatally thymectomized and aged rats by means of lipid and protein fractions from the calf thymus. PMID- 3288044 TI - The therapeutic potential of lymphokines in neoplastic disease. PMID- 3288045 TI - Opioids: immunomodulators. A proposed role in cancer and aging. PMID- 3288046 TI - Neuroendocrine-thymus interactions: perspectives for intervention in aging. PMID- 3288048 TI - Actions of calcium on smooth muscle. Historical overview. PMID- 3288047 TI - A pituitary-thymus connection during aging. AB - Thymic involution is a normal consequence of aging. It has often been speculated that if this age-associated atrophy of the thymus gland could be prevented, the natural decline that occurs in a number of T-cell-mediated immune responses could be reversed. It has recently become clear that thymic involution can indeed be reversed by altering the hormonal environment of aged animals. These data support the concept of an active and functional pituitary-thymus axis. Since thymic reconstitution can result in restoration of some T-cell responses, it would appear that intrinsic defects which exist in T cells of aged animals can be at least partially reversed. This suggests that the aged environment plays a greater role in the decline of T-cell functions than has been previously recognized. Furthermore, phorbol esters and calcium ionophores can restore suppressed proliferative responses of T cells from aged rodents, so we speculate that intrinsic defects in T cells of aged subjects lie between the recognition system for antigen/lectin and intracellular transmission of this signal. PMID- 3288049 TI - Calcium and vascular myogenic tone. PMID- 3288050 TI - Calcium and activation of the release of endothelium-derived relaxing factor. AB - Indirect and direct experimental evidence demonstrates that both the entry of extracellular calcium and the liberation of calcium from intracellular stores can contribute to an increase in free cytoplasmic calcium concentration in endothelial cells, which seems to be an essential step in the synthesis and/or release of endothelium-derived relaxing factors(s). A variety of Ca2+ transport mechanisms may be involved in the regulation of cytoplasmic calcium in endothelial cells. Ca2+ entry may occur via voltage-operated Ca2+ channels. If they do exist, these channels may have characteristics different from those in underlying vascular smooth muscle cells. Sustained activation of the release of EDRF by various receptor agonists (e.g., acetylcholine, adenine nucleotides, and bradykinin) is also dependent on Ca2+ entry, but it is insensitive to organic Ca2+ channel antagonists. These findings indicate that, when used clinically in various cardiovascular diseases, organic calcium channel antagonists are not expected to interfere with endothelium-dependent relaxation evoked by endogenous vasoactive substances (e.g., ADP, serotonin). Since amiloride and its analogues blocked endothelium-dependent relaxations in different arterial preparations, Na+ transport and Na+/Ca2+ exchange were suggested to play a role in calcium dependent release of EDRF. The exact nature of Ca2+ transport mechanisms and also the calcium-sensitive cellular processes that lead to the synthesis/release of endothelium derived relaxing factor(s) remain to be determined. However, the available data suggest that calcium handling by the vascular smooth muscle and endothelial cells may be different, allowing potentially selective modulation of Ca2+ activation in these two cell types. PMID- 3288052 TI - Calcium transients in smooth muscle. PMID- 3288051 TI - The effect of calcium channel antagonists on peripheral neurones. PMID- 3288053 TI - Ca2+ antagonists and vascular disease. PMID- 3288054 TI - Calcium antagonists as antiatherogenic agents. AB - Pharmacological manipulations of calcium metabolism in animals fed high-fat diets may slow the progression of atherosclerosis. Agents with calcium-chelating (diphosphonic acid and thiophene carboxylic acid derivatives) or calcium-channel blocking properties (dihydropyridine derivatives, verapamil and its derivatives, diltiazem) have been demonstrated to suppress atherogenesis in rabbits and monkeys. The antiatherosclerotic effects appear to occur in the absence of hypolipidemic effects. The mechanisms of action of the structurally unrelated drugs remain to be elucidated. PMID- 3288055 TI - Pathophysiology of cardiomyocytes. AB - Isolated cardiomyocytes lend themselves very well to the quantification of pathological damage and to the determination of reversible versus irreversible changes. These single cells were used to study the cellular response to a variety of pathologic stimuli that impair structure and function. Degenerative alterations are accompanied by hyperactivation and irreversible rounding up of otherwise quiescent rod-shaped cells. Stereotypic degenerative changes and loss of sarcolemma-bound Ca2+ were seen during prolonged severe hypoxia, exposure to either depolarizing concentrations of potassium, veratrine, acylcarnitines, cationic amphiphiles, free-radical-generating systems, cardiac glycosides, or uncouplers of oxidative phosphorylation. Since the presence of extracellular Ca2+ is a prerequisite to obtain cell degeneration in most of these aggressive insults and since cellular Ca2+ overload parallels the damage, we studied the influence of representative compounds of the various subclasses of Ca2+ antagonists: verapamil, nifedipine, nicardipine, and diltiazem (Ca2+ blockers with high affinity for cardiac slow Ca2+ channels), cinnarizine, flunarizine, lidoflazine, and mioflazine (Ca2+ blockers with no affinity for cardiac slow Ca2+ channels). The non-slow-channel-blocking drugs were generally superior in protection against the imposed insults suggesting that prevention of Ca2+ overload is not correlated with slow channel blockade. For the latter group of drugs, other (hitherto not elucidated) mechanisms of membrane-drug interactions seem to be responsible for the preservation of Ca2+ homeostasis during the induction of pathological Ca2+ influx. PMID- 3288056 TI - A potential role of calcium ions in early ischemic and reperfusion arrhythmias. PMID- 3288057 TI - Brain ischemia as a target for Ca2+ entry blockers. PMID- 3288058 TI - Ischemic vasoconstriction and parenchymal brain pH. PMID- 3288059 TI - Historical overview. Calcium ion and contractile proteins. PMID- 3288060 TI - Control of cardiac arrhythmias by calcium antagonism. AB - In recent years calcium channel blockers have emerged as a new class of antiarrhythmic agents for the control of certain supraventricular and ventricular arrhythmias. Electrophysiologically, they are heterogeneous but their main action is mediated through a depressant effect on the slow calcium channel in cardiac muscle. In isolated muscle, their actions are modulated by their reflex actions and by their interaction with the autonomic nervous system due to the nonocompetitive adrenergic blocking actions that some of the compounds exhibit. The major agents exerting antiarrhythmic actions are verapamil, diltiazem, gallopamil, tiapamil, and bepridil; the dihydropyridines are devoid of significant electrophysiologic actions in vivo. Calcium antagonists prolong intranodal conduction time, lengthen the effective and functional refractory periods in the AV node, but exert little or no effect on atrial, ventricular, His Purkinje, or bypass tract conduction or refractoriness (except in the case of bepridil, which has additional electrophysiologic properties). These effects form the basis of the clinical antiarrhythmic effects of this class of agents. The most striking action is the predictable and prompt termination of reentrant supraventricular tachycardia by intravenous verapamil and diltiazem and the slowing of the ventricular response in atrial flutter and fibrillation. These agents may also be of value in the chronic control of ventricular response in atrial flutter and fibrillation; their role in multifocal atrial tachycardia and other ectopic tachycardias is less well defined. Calcium antagonists reverse ischemic ventricular arrhythmias due to coronary artery spasm but exert little or no action in the usual forms of sustained ventricular tachyarrhythmias associated with severe structural heart disease. They are poor suppressants of premature ventricular contractions. Recent data have established their role in exercise induced tachycardia occurring in the context of ischemic heart disease; they are also of value in ventricular tachycardia occurring in young subjects developing tachycardia with a right bundle branch block with left axis deviation morphology, an arrhythmia thought to be due to triggered automaticity. The role of calcium antagonists in reducing the incidence of sudden death in the survivors of acute myocardial infarction remains uncertain. PMID- 3288061 TI - Calcium antagonists in heart failure. PMID- 3288062 TI - Calcium antagonists and their potential for antihypertensive therapy. AB - Calcium antagonists are potent arterial vasodilators devoid of relevant chronic sympathetic reflex activation and sodium and volume retention. This favorable hemodynamic profile of action renders them suitable for monotherapy of hypertension where they act to reduce an enhanced, calcium-influx-dependent vasoconstrictor mechanism which may be brought about by altered smooth muscle cation handling and increased intracellular free calcium concentrations. Clinical studies have proved their efficacy, safety, and good tolerability alone or in combination with other drugs in uncomplicated hypertension where they are particularly effective in older and low-renin and possibly black patients. These properties and their efficacy in the treatment of severe and accelerated hypertension or hypertensive emergencies make them a valuable addition to already available drug therapy. PMID- 3288063 TI - Use of a calcium antagonist in aneurysmal subarachnoid hemorrhage. PMID- 3288064 TI - Clinical and experimental evidence for a role of calcium entry blockers in the treatment of migraine. PMID- 3288065 TI - Pharmacology of nimodipine. A review. AB - The major pharmacological findings with nimodipine reviewed in this chapter are summarized in TABLE 3. On the basis of these findings, the following conclusions appear to be justified: 1. Nimodipine is a 1,4-dihydropyridine with Ca2+ channel antagonist properties. It is more lipophilic than nifedipine and its distribution volume in the brain of rats is higher than that of nifedipine. 2. Nimodipine dilates cerebral vessels at considerably lower concentrations than required for dilatation of peripheral blood vessels. It can, therefore, improve cerebral blood flow at doses that do not reduce systemic arterial pressure. 3. Nimodipine inhibits 45Ca uptake into vascular smooth muscle and neuronal cells. 4. Nimodipine antagonized postischemic cerebral hypoperfusion in cats and prolonged life of stroke-prone spontaneously hypertensive (SH) rats at doses that have little if any effect on arterial blood pressure. 5. Nimodipine reduced neurological deficits in dogs and monkeys with global cerebral ischemia. In focal ischemia (MCA occlusion) nimodipine reduced infarct size and neurological deficits and normalized intracellular brain pH. 6. In addition to its cerebral vasodilator effect, nimodipine appears to have a direct neuronal action. The suggested evidence for the neuronal site of action of nimodipine includes: a. Presence of nimodipine binding sites in brain. b. Blockade by nimodipine of Ca2+ channels in single nerve cells and in endocrine cells under conditions of sustained depolarization. c. Interactions with centrally acting drugs. d. Effects on release of various neurotransmitters from neuronal tissue or endocrine cells. e. Demonstration of anticonvulsant action of nimodipine. f. Blockade of behavioral effects of Ca2+ channel agonists by calcium channel antagonists. PMID- 3288066 TI - The role of calcium channel blockers in reactive airway disease. PMID- 3288067 TI - Calcium antagonists and dysmenorrhea. PMID- 3288068 TI - Protection of liver by calcium entry blockers. PMID- 3288069 TI - Effects of calcium antagonists on renal function. PMID- 3288070 TI - Aspirin and secondary bleeding after traumatic hyphema. AB - A randomized, controlled study was conducted in 51 patients to investigate the effect of aspirin administration on traumatic hyphema. Aspirin tablets 500 mg tid were administered for seven days. Rebleeding was found in three of 23 eyes of patients who had received aspirin and in two of 28 eyes of control patients. This difference was not statistically significant (P = .405), proving that aspirin is not an important factor in rebleeding in patients with hyphema. PMID- 3288071 TI - [Fetal malformations detected by ultrasonics in a twin in multiple pregnancies. Medico-legal considerations on 4 cases]. PMID- 3288072 TI - [Non-immunologic hydrops fetalis]. PMID- 3288074 TI - Acquired ultrastructural alterations of respiratory cilia and clinical disease. A review. AB - Efficient cleansing of the upper and lower respiratory surfaces by the mucociliary apparatus is essential to health. Failure of the cleansing allows contaminants prolonged residence on the mucosal respiratory surfaces and thus penetration into the mucosa and possibly inauguration of disease. For some years, genetic ultrastructural ciliary alterations have been recognized, with symptoms dating from early life. It is only in recent years, however, that evidence has shown that ultrastructural ciliary alterations can be acquired later in life and that these alterations in turn lead to a deterioration of efficient ciliary cleansing. A discussion of the ultrastructure of the normal mammalian cilium will be given, as well as a listing of the genetic ciliary disease and their characteristic morphologic alterations. A more complete review will be made in regard to acquired ciliary defects, their cause, the ultrastructural changes, and the relation to clinical disease. PMID- 3288073 TI - [Fetal malformations detected by ultrasonics. Clinical and organizational considerations]. PMID- 3288075 TI - Effects of elevated intranasal temperature on subjective and objective findings in perennial rhinitis. AB - The effects of elevated intranasal temperature on symptoms and signs of perennial rhinitis were studied in 78 patients by a double-blind, randomized, placebo controlled clinical trial. Patients were subjected to two treatments separated by a 1-week interval. Each treatment consisted of three 30-minute sessions, during which the patient's intranasal temperature was raised by inhalation of saturated hot air (42 degrees C to 44 degrees C). Subjective response was recorded on a daily symptom score card during the week following treatment. Nasal patency was determined before and after treatment by measuring maximal nasal expiratory and inspiratory airflow and by measuring the area covered with vapor formed by the exhaled air on a plate. Highly reproducible results were obtained by using these three objective methods. Elevation of intranasal temperature resulted in amelioration of rhinitis symptoms and in objective evidence of increased nasal patency in a significant percentage of patients compared to the placebo-treated group. PMID- 3288076 TI - Effects of bacterial endotoxin on ciliary activity in the tubotympanum. AB - The discovery of endotoxin in effusion of otitis media with effusion (OME) has suggested the possibility that bacterial endotoxin may be involved in the pathogenesis and development of OME. In this study, we investigated the direct effects of lipopolysaccharide (LPS), possessing the major part of endotoxin activity, on the ciliary activity in the tubotympanum. The study shows that LPS deteriorates ciliary activity in a dose-response fashion and that even low levels can, with extended exposure, cause dysfunction of cilia. It can be postulated that endotoxin in middle ear effusions aggravates the condition of mucociliary dysfunction thus leading to chronic OME. PMID- 3288077 TI - Collagen components of bovine fetal and guinea pig cochlear bone and human stapes. AB - Collagenous components were isolated chemically from fetal bovine or guinea pig cochlear bone and human stapes after stapedectomy, and the purified protein was characterized by immunoblot assay and amino acid analysis. The results of this study suggest that these are mixtures of type I and type II collagens. The presence of type II collagen in the human stapes also was demonstrated by immunohistologic methods using monoclonal antibody. The presence of type II collagen in these tissues is significant, since it has been postulated as an autoantigen in autoimmune inner ear disease. PMID- 3288078 TI - [Herpetic stomatitis-gingivitis in children: controlled trial of acyclovir versus placebo]. PMID- 3288079 TI - Tattoo removal using precise shave excision and dermal overgrafting. AB - A method of tattoo removal using a precise partial thickness tangential excision of foreign body and dermis followed by dermal overgrafting with thin, split thickness skin grafts is presented. PMID- 3288080 TI - The brown recluse spider bite. AB - A review of the literature confirms that the brown recluse spider bite is a common and sometimes serious clinical entity. Local and systemic manifestations are extremely variable, thus complicating management of the bite. Pathophysiological studies in laboratory animals yield conflicting results and therapeutic recommendations because of technical and species-specific differences. Standard therapies include aggressive, early debridement as well as systemic and intralesional corticosteroids; however, well-controlled clinical studies to establish their efficacy have not been performed. Variable and unpredictable patient responses to the spider bite necessitate a conservative yet vigilant position in managing these bites. PMID- 3288081 TI - [Popliteal artery thromboses on an anatomical trap. Argument for the posterior approach]. PMID- 3288082 TI - Monoclonal antibody analysis of mononuclear cells in myopathies. IV: Cell mediated cytotoxicity and muscle fiber necrosis. AB - Cell-mediated muscle fiber injury occurs in inclusion body myositis (IBM), polymyositis (PM), and even in Duchenne dystrophy (DD). Most of the autoaggressive cells are T cells and macrophages, but some are killer/natural killer (K/NK) cells. We here compare the frequencies per 1,000 muscle fibers of endomysial K/NK cells of varying cytotoxicity with those of T cells and macrophages in 8 cases each of IBM, PM, and DD. Two-micrometer serial cryostat sections were analyzed. The Leu-4 marker, present on all T cells and some K/NK cells, and the Leu-7 and Leu-11 markers, present on K/NK cells, were localized by paired immunofluorescence. Macrophages were demonstrated by the acid phosphatase reaction. In IBM, PM and DD, the respective average cell counts per 1,000 muscle fibers were: Leu-4+7- cells (T cells not expressing a K/NK marker)--710, 530, and 59; Leu-4+7+ cells (K/NK cells of low K/NK cytotoxicity)--294, 163, and 13; Leu-4 7+ cells (K/NK cells of intermediate cytotoxicity)--32, 10, and 2; and macrophages--292, 251, and 38. Leu-11+ K/NK cells that have the highest killing activity were virtually absent in all cases. The data suggest a limited role for antigen and major histocompatibility complex unrestricted K/NK cells, as compared with antigen-specific and major histocompatibility complex-restricted T cells, in IBM and PM. Further, the findings cast doubt on the significance of either T cells or K/NK cells in mature muscle in DD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288083 TI - Fiber pathways of cortical areas mediating smooth pursuit eye movements in monkeys. AB - Recent studies in rhesus monkeys and human patients have increased our understanding of the role of various cortical regions in the generation of smooth pursuit eye movements. Little is known, though, about the cerebral white matter pathways mediating smooth pursuit. In this paper, we describe both the corticocortical and corticosubcortical projections from areas in the monkey brain known to be involved in smooth pursuit. The corticocortical pathways within one hemisphere consist of a sequence of arcuate fiber bundles interconnecting (1) striate cortex with an area in occipitoparietal cortex called the middle temporal (MT) area, (2) area MT with two areas in parietal cortex called the medial superior temporal (MST) and posterior parietal (PP) areas, and (3) area MST with area PP. An interhemispheric pathway interconnecting areas MT and MST consists of fibers sequentially passing through the tapetum, major forceps, and the splenium of the corpus callosum. The corticosubcortical pathway from area MST to the pontine nuclei and accessory optic system consists of fibers sequentially running through the internal sagittal stratum, the retrolenticular part of the internal sagittal stratum, and the cerebral peduncle. Based on the effects of lesions on pursuit eye movements, these corticocortical and corticosubcortical projections can be divided into sensory, motor, and attentional/spatial systems. Evidence from clinical studies suggests that homologous systems exist in the human cerebrum. PMID- 3288085 TI - Muscular contraction. PMID- 3288084 TI - Immunotherapy of multiple sclerosis. AB - Based on the assumption that multiple sclerosis is an autoimmune disease, a number of clinical trials designed to suppress the immune system or to restore immune balance in multiple sclerosis have been attempted. Depending on the disease category, the clinical goals of immunotherapy differ. Therapeutic goals include improving recovery from acute attacks, preventing or decreasing the number of relapses, and halting the disease in its progressive stage. The ultimate goal of multiple sclerosis therapy is the early treatment of patients in an attempt to halt the onset of progression. Specific strategies of immunotherapy include generation of a suppressor influence, removal of helper/inducer cells, manipulation of activated T cells, manipulation of class II major histocompatibility complex-bearing cells, alteration of lymphocyte traffic, extracorporeal removal of serum factors or cells, and manipulation of antigen specific cells. Present treatment modalities are beginning to show some efficacy of nonspecific immunosuppression, but these treatments are limited by their toxicities. As the immunotherapy of multiple sclerosis moves to the next stage in the coming years, patients at an earlier stage of their disease will have to be treated, nontoxic forms of therapy developed, clinical trials lengthened, and a laboratory monitor of the disease developed. Given the positive effects of immunotherapy seen thus far in the disease, it is possible that appropriate immunotherapeutic intervention may provide effective treatment for the disease in the future. PMID- 3288086 TI - Chloride transport in thick ascending limb, distal convolution, and collecting duct. PMID- 3288087 TI - Hormonal regulation of chloride transport in the proximal and distal nephron. PMID- 3288088 TI - Chloride transport and disorders of acid-base balance. PMID- 3288089 TI - Functional adaptations in hemoglobins from ectothermic vertebrates. PMID- 3288090 TI - The Bohr effect. PMID- 3288091 TI - CNS peptides and regulation of gastric acid secretion. PMID- 3288092 TI - Voltage dependence of the Na-K pump. AB - Present evidence demonstrates that the Na-K pump rate is voltage dependent, whereas early work was largely inconclusive. The I-V relationship has a positive slope over a wide voltage range, and the existence of a negative slope region is now doubtful. Monotonic voltage dependence is consistent with the reaction cycle containing a single voltage-dependent step. Recent measurements suggest that this voltage-dependent step occurs during Na translocation and may be deocclusion of Na+. In addition, two results suggest that K translocation is voltage insensitive: (a) large positive potentials appear to have no influence on Rb-Rb exchange or associated conformational transitions; and (b) transient currents associated with Na translocation appear to involve movement of a single charge, which is sufficient for a 3Na-2K cycle. The simplest interpretation is that the pump's cation binding sites supply two negative charges. Pre-steady-state measurements demonstrate that Na translocation precedes the pump cycle's rate limiting step, presumably K translocation. But, because K translocation seems voltage insensitive, the voltage dependence of the steady-state pump rate probably reflects that of the concentration of the intermediate entering this slow step. Further pump current and flux data (both transient and steady-state), carefully determined over a range of conditions, should increase our understanding of the voltage-dependent step(s) in the Na-K pump cycle. PMID- 3288093 TI - Site-directed mutagenesis and ion-gradient driven active transport: on the path of the proton. PMID- 3288094 TI - Effects of lipid environment on membrane transport: the human erythrocyte sugar transport protein/lipid bilayer system. PMID- 3288095 TI - Gene transfer techniques to study neuropeptide processing. PMID- 3288096 TI - Peptide alpha-amidation. PMID- 3288097 TI - Enzymes required for yeast prohormone processing. PMID- 3288098 TI - Tyrosine sulfation and the secretory pathway. AB - Tyrosine sulfation is a widespread posttranslational modification. Most tyrosine sulfated proteins identified so far are secretory, including several neuropeptides. Tyrosine sulfation occurs in the trans Golgi and is one of the last processing steps before proteins exit from the Golgi complex. The sulfation reaction is catalyzed by tyrosylprotein sulfotransferase, an integral membrane protein that recognizes tyrosine residues in exposed protein domains containing acidic amino acids. In the cases studied to date, tyrosine sulfation has been found to be irreversible, resulting in a life-long alteration in the phenotype of the secretory proteins. The biological role of tyrosine sulfation has so far been elucidated in only a few cases. The intracellular transport kinetics of a secretory protein and the biological activity of certain neuropeptides have been found to be affected by this modification. Future functional studies will be greatly facilitated by the use of chlorate, a sulfate analogue that has recently been found to be a potent and nontoxic inhibitor of sulfation in intact cells. PMID- 3288099 TI - Regulation of aldosterone secretion. AB - Regulation of aldosterone secretion is complex both in terms of the number of secretagogues that can influence its biosynthesis and the number of second messengers utilized by these secretagogues (Table 1, Figure 1). ACTH primarily acts via the adenylate cyclase system through a stimulatory G protein; however, there is evidence that at low concentration it may also activate calcium influx and phospholipase C in some species. The primary effect of AII is activation of phospholipase C, which increases both calcium release from intracellular stores and calcium flux across the cell membrane and activates protein kinase C. Potassium depolarizes the membrane, thereby activating calcium flow through voltage-dependent calcium channels. It also directly or indirectly causes release of calcium from intracellular binding sites. A small change in cAMP levels may also be involved in the sustained secretory response to potassium. Species variation in the regulation of aldosterone secretion probably exists; the control mechanisms in the human appear to be closer to those in the rat than to those in cow and sheep. How changes in dietary sodium and potassium modify aldosterone secretion and the adrenal's responsiveness to secretagogues remains unclear. Yet these effects may be of considerable importance, both in terms of understanding the overall regulation of aldosterone secretion and in resolving the discrepancies in the results obtained under different experimental conditions. PMID- 3288100 TI - Molecular aspects of hormone action in ovarian follicular development, ovulation, and luteinization. AB - As stated earlier, the mammalian ovary maintains the continuous development of follicles, but only a few are selected to ovulate and form corpora lutea. These processes are regulated primarily by the gonadotropins and involve specific, sequential changes in the function of theca cells and granulosa cells. Data from recent studies (summarized in Figure 3) show that specific genes are turned on or off at different stages of follicular growth in response to estradiol and different amounts of gonadotropins and cAMP. For example, mRNA for RII51 in granulosa cells and theca cells increases in association with small increased in cAMP but is markedly reduced by the LH surge and high cAMP. The content of mRNA for other kinase subunits, RI and C alpha, show little or no change during similar hormonal changes. In theca cells, mRNA for 17 alpha-hydroxylase increased and decreased in a manner similar to that for RII51. In contrast, levels of mRNA for P450scc increased only gradually in follicles but were markedly increased by the LH surge and high concentrations of cAMP and then appeared to be constitutively expressed in rat corpora lutea in a cAMP-independent manner. PGS and t-PA appear to follow yet another pattern: rapid induction by the LH surge followed by a rapid decline in association with ovulation. One major task for reproductive endocrinologists and molecular biologists now is to determine how low and high concentrations of cAMP act to turn on and turn off the expression of these specific genes at specific times during follicular maturation. A working model of the molecular events occurring in theca and granulosa cells of PO follicles is shown in Figure 4. LH acts on theca cells via cAMP ro regulate both P450scc and P450(17) alpha mRNA levels, leading to increased biosynthesis of androstenedione. The mechanisms by which cAMP acts in theca cells remain to be determined but appear to involve an increase in the content of RII51, P450scc, and P450(17) alpha. In granulosa cells, androstenedione is converted to estradiol by the aromatase P450 enzyme system. Estradiol, in turn, binds to estradiol receptors present in these cells and may thereby regulate gene expression. However, despite the presence of estradiol and estradiol receptors, little or no effect of estradiol is observed unless FSH acts via the FSH receptor to increase intracellular concentrations of cAMP. In a manner not yet understood, cAMP appears to enhance the actions of estradiol.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3288102 TI - Endocrine regulation and communicating functions of the Leydig cell. AB - Activation and regulation of Leydig cell function is exerted primarily by LH, which is secreted in pulses of high biological activity and interacts with membrane receptors. Other hormones and factors secreted by the Leydig cell or from the tubular compartment can influence Leydig cell differentiation and acute or chronic actions of LH on steroidogenesis. Conversely, hormones produced in the Leydig cell could modulate tubular function (e.g. beta-endorphin, oxcytocin). The LH receptor has been purified to homogeneity in sufficient quantities to allow its peptide sequence to be determined and its gene structure to be elucidated as well as functional reconstitution studies to be performed. The LH receptor subunit of Mr 90,000 can be phosphorylated by cAMP-dependent protein kinase. The native receptor appears to exist in the membrane as a dimer of identical subunits associated by noncovalent interactions. It is likely that receptor dimerization and further aggregation are necessary for signal transduction to occur, and receptor phosphorylation by one or more kinases may be involved in regulating gonadotropin action. Stimulation of the androgen pathway occurs mainly through a cAMP-mediated mechanism. The stimulatory event can be negatively influenced by the action of certain peptide hormones through the guanyl nucleotide inhibitory subunit of adenylate cyclase. Such an inhibitory action of angiotensin has further emphasized the importance of the cAMP pathway in the Leydig cell. The hormone also appears to facilitate androgen production by a cAMP-independent mechanism located at the plasma membrane or intracellular sites. A Ca2+ sensitive kinase system is present in the Leydig cell membranes. The presence of nM amounts of Ca2+ induces membrane phosphorylation of a protein Mr 45,000. Adenylate cyclase activation also is affected by Ca2+. Membrane phosphorylation may be a modifier of LH-stimulated adenylate cyclase activity and possibly other LH induced actions in the activated Leydig cell membrane. In the adult rat testis, the ability of Leydig cells to respond to sustained gonadotropic stimulation with increased androgen production is limited by the development of a refractory state associated with loss of LH receptors and steroidogenic enzymes. Gonadotropin induced steroidogenic lesions in adult rat testes include a late steroidogenic lesion at the site of conversion of progesterone to androgen and an early lesion before pregnenolone formation that leads to a decreased in vitro pregnenolone and testosterone response to hCG. PMID- 3288101 TI - Endocrine regulation of the corpus luteum. PMID- 3288103 TI - Medullary basal sympathetic tone. PMID- 3288104 TI - Pre- and postganglionic vasoconstrictor neurons: differentiation, types, and discharge properties. PMID- 3288105 TI - Electrophysiological properties of sympathetic preganglionic neurons. PMID- 3288106 TI - Peripheral sympathetic neural activity in conscious humans. PMID- 3288107 TI - Cardiovascular control in spinal man. PMID- 3288108 TI - Central coordination of respiratory and cardiovascular control in mammals. PMID- 3288109 TI - Central organization of sympathetic cardiovascular response to pain. AB - Figure 1 summarizes the pathways discussed in this review. Noxious and innocuous cardiac and somatic information converge on SRT neurons in the upper thoracic spinal cord; the third thoracic segment (T3) is shown in Figure 1. The SRT pathway and collaterals of the STT convey this information to the MRF (mainly RGC). This input is integrated with other inputs (eg. auditory and visual) by MRF neurons, some of which project to the spinal cord. RS motor neurons (dotted pathway) might mediate motor responses to cardiac pain, as well as motor responses associated with escape or alerting behavior. RS neurons (cross-hatched and clear pathways) can also modulate ascending traffic by altering activity of SRT and STT cells. Finally, RS neurons (dotted pathway) might modify sympathetic function via collaterals to IML or to interneurons, or MRF cells could project to medullary areas possessing neurons (solid pathway) that project directly to IML. The small figurines represent the heart (top), blood vessels (middle right) and muscle (bottom). PMID- 3288110 TI - Structural and chemical organization of the myenteric plexus. AB - The most striking characteristics of the myenteric plexus are the heterogeneity of its neuronal populations and the complexity of its organization. Myenteric neurons greatly differ in their morphological characteristics, projection patterns, and topographical arrangement within the ganglia. The discovery of histochemically distinct types of neurons together with the development of nerve tracing techniques and specific lesions have allowed a better understanding of the relationships of enteric neurons to specific target tissues. Consequently, these techniques have contributed significantly to our knowledge of the highly ordered organization of the ENS, which represents the anatomical substrate for the neural coordination and integration of the complex functions it subserves. The existence of different types of neurons that probably use different substances as transmitters may reflect on the existence of defined functional roles for each type of neurons. To date, only ACh, NE, and probably 5-HT seem to satisfy all the criteria necessary for establishing a neurotransmitter, although there is increasing evidence that some of the other substances, such as GABA, SP, and VIP, are enteric transmitters or modulators. The functional roles of the different types of neurons in the neural circuitry that regulates gastrointestinal functions remain to be elucidated. PMID- 3288111 TI - Chloride transport in the proximal renal tubule. AB - Our knowledge of chloride transport along the nephron has greatly expanded. Whereas for a long time it was assumed that chloride ions were reabsorbed entirely passively with sodium--the "mendicant" role of chloride, more recent studies suggest that several distinct reabsorptive transport mechanisms operate in parallel. Accordingly, a new model of proximal chloride transport has evolved that includes both active, transcellular as well as passive, intercellular transport pathways. Transcellular chloride reabsorption involves anion exchange mechanisms in both the luminal and peritubular cell membranes, processes that also depend on sodium, hydrogen, and bicarbonate ions. Chloride transport is thus intimately related to sodium and fluid transport as well as to cell acid-base metabolism. Unresolved problems concern the relative magnitude of transcellular and paracellular chloride transport and the details of luminal and basolateral chloride translocation steps. PMID- 3288112 TI - Comparison of two methods for determining in vitro postantibiotic effects of three antibiotics on Escherichia coli. AB - The postantibiotic effect (PAE) for 10 isolates of Escherichia coli was measured by two methods after 1 h of exposure to ampicillin, ciprofloxacin, or tobramycin. The reference method involved serial colony counting to determine growth after antibiotic exposure in relation to control growth. A spectrophotometric procedure was developed with the Abbott MS-2 research system. This method measured the time to detection of growth after exposure and compared this with the time for growth detection in control chambers having the same initial colony count. A reference curve of time to growth versus log initial CFU per milliliter was used to standardize control growth. PAE was determined after exposure to antibiotic at two and six times the MIC and with inocula ranging from 10(3) to 10(9) CFU/ml. There was a statistically significant correlation between PAE measured by the spectrophotometric and the reference methods, and the residuals about the regression line were normally distributed. The mean PAE determined by both methods was statistically different for tobramycin-exposed, but not for ampicillin- or ciprofloxacin-exposed, organisms. There was a concentration dependent PAE for ciprofloxacin and tobramycin. The PAEs for ciprofloxacin (151 min) and tobramycin (108 min) at concentrations six times the MIC were prolonged compared with those measured at two times the MIC (69 and 66 min, respectively). PAE was inversely related to the exposed inoculum for ciprofloxacin and tobramycin. The PAE for E. coli exposed to ampicillin was minimal and was not affected by either concentration or inoculum. The MS-2 method for determining PAE yields similar results, but is less laborious than the reference method. PMID- 3288113 TI - Stage-selective inhibition of rodent malaria by cyclosporine. AB - The relative susceptibility of different developmental stages of Plasmodium berghei to cyclosporine was investigated in vivo. Within 12 h of receiving a single 25-mg/kg (body weight) dose of cyclosporine, mice with patent P. berghei infections uniformly exhibited a rapid fall in asexual parasite stages. Initially, ring forms and mature schizonts disappeared. Subsequently, trophozoites disappeared between 21 and 24 h, whereas gametocytes persisted for 36 h. In contrast, when cyclosporine was administered to mice 1 day before inoculation (100 mg/kg) with P. berghei sporozoites and for 2 consecutive days after inoculation (25 mg/kg), infections developed normally. When mice with patent infections were placed on prolonged cyclosporine therapy (25 mg/kg per day), parasitemia initially disappeared but often recrudesced. Recrudescent parasites were frequently resistant to cyclosporine (Csr). The Csr phenotype remained stable after serial passage of parasites in mice and after transmission through Anopheles stephensi mosquitoes, in which the capacity to produce oocysts was reduced. When infections of untreated mice were initiated with equal numbers of Csr and cyclosporine-susceptible (Css) parasites and then carried through two serial cycles of mosquito-to-mouse transmission without cyclosporine treatment, the Csr phenotype was lost. The results indicate that cyclosporine selectively inhibits asexual blood stages of P. berghei and favors the emergence of Csr parasites with diminished infectivity for mosquitoes. PMID- 3288114 TI - Crystal and molecular structure of the antimalarial agent 4-(tert-butyl)-2-(tert butylaminomethyl)-6-(4-chlorophenyl)phenol dihydrogen phosphate (WR 194,965 phosphate). AB - WR 194,965 phosphate, a new antimalarial agent containing a biphenyl ring structure active against chloroquine-resistant Plasmodium falciparum, crystallized in ionic form with a positive charge on the quaternary nitrogen atom. The oxygen and nitrogen atoms of WR 194,965 were hydrogen bonded to the same phosphate group. The nitrogen atom was also hydrogen bonded to a second phosphate group. The phosphate ions formed discrete clusters of four phosphate moieties. The phosphate clusters contained fourfold inversion symmetry. The intramolecular N-O distance in WR 194,965 of 3.073 A (1 A = 0.1 nm) was close to the reported values for N-O distances in the active cinchona alkaloids and may be important for activity. A comparison of the crystalline structure of WR 194,965 with those of mefloquine and quinidine sulfate demonstrated that the regions of the three molecules in the vicinity of the aliphatic nitrogen atom and the oxygen atom superimpose. Much of the remainder of the WR 194,965 molecule spatially overlapped with the combined three-dimensional space defined by quinidine and mefloquine. The crystallographic parameters were: C21H29ClNO+.H2PO4-; Mr = 443.9; symmetry of unit cell, tetragonal; space group, I41/a; parameters of unit cell, a = b = 24.305 +/- 0.002 A, c = 17.556 +/- 0.003 A; V (volume of unit cell) = 10370.9 A3; Z (number of molecules per unit cell) = 16; Dx (calculated density) = 1.137 g cm-3; source of radiation, CuK alpha (lambda = 1.54178 A); mu (absorption coefficient) = 21.3 cm-1; F(000) (sum of atomic scattering factors at zero scattering angle) = 3,440; room temperature; final R = 8.2% for 2,508 reflections with [F0] greater than 3 sigma. PMID- 3288115 TI - Disposition of amopyroquin in rats and rabbits and in vitro activity against Plasmodium falciparum. AB - The disposition of amopyroquin was studied in rats after a single 50-mg/kg (body weight) oral dose of amopyroquin base. After a rapid absorption phase, the drug concentrations decreased in the plasma, with a terminal half-life of 14.5 h. The drug was widely distributed in the liver and lungs and, to a lesser extent, in the kidneys and spleen. In rabbits, the kinetic parameters were compared after a single 10-mg/kg dose of amopyroquin base through intravenous, intramuscular (i.m.), and oral routes. The similar bioavailability values (0.67 and 0.69) suggested that the drug could be used through i.m. or oral administration. Clearance and distribution volume did not differ significantly among the three modes of administration, and the terminal half-lives were 18.1 +/- 3.3, 23.9 +/- 6.7, and 25.7 +/- 5.4 h for intravenous, i.m., and oral routes, respectively. The ratio of concentrations in erythrocytes and plasma was about 5 in rats and rabbits. Three metabolites were detected in both animal species (one was tentatively identified as the primary amine derivative). The amopyroquin in vitro activity was tested against four chloroquine-susceptible and 11 chloroquine resistant African Plasmodium falciparum strains. For all isolates, the 50% inhibitory concentrations of amopyroquin were much lower than those of chloroquine and monodesethylamodiaquine. PMID- 3288116 TI - A look inside a bone bank. PMID- 3288117 TI - Pelviscopy. An endoscopic alternative to laparotomy. AB - Pelviscopy has positive aspects for the patient. The procedure reduces the amount of time the patient spends in surgery, the recovery period, and the amount of time the patient must be away from work. Much like other endoscopic procedures, pelviscopy incurs little or no bleeding, and reduces inflammatory tissue response. PMID- 3288118 TI - The nurse as circulator. Historical perspective, future possibilities. PMID- 3288119 TI - Factors promoting survival of bacteria in chlorinated water supplies. AB - Results of our experiments showed that the attachment of bacteria to surfaces provided the greatest increase in disinfection resistance. Attachment of unencapsulated Klebsiella pneumoniae grown in medium with high levels of nutrients to glass microscope slides afforded the microorganisms as much as a 150 fold increase in disinfection resistance. Other mechanisms which increased disinfection resistance included the age of the biofilm, bacterial encapsulation, and previous growth conditions (e.g., growth medium and growth temperature). These factors increased resistance to chlorine from 2- to 10-fold. The choice of disinfectant residual was shown to influence the type of resistance mechanism observed. Disinfection by free chlorine was affected by surfaces, age of the biofilm, encapsulation, and nutrient effects. Disinfection by monochloramine, however, was only affected by surfaces. Importantly, results showed that these resistance mechanisms were multiplicative (i.e., the resistance provided by one mechanism could be multiplied by the resistance provided by a second mechanism). PMID- 3288120 TI - Development of improved defined media for Clostridium botulinum serotypes A, B, and E. AB - The minimal nutritional growth requirements were determined for strains Okra B and Iwanai E, which are representatives of groups I and II, respectively, of Clostridium botulinum. These type B and E strains differed considerably in their nutrient requirements. The organic growth factors required in high concentrations by the Okra B strain (group I) were arginine and phenylalanine. Low concentrations (less than or equal to 0.1 g/liter) of eight amino acids (methionine, leucine, valine, isoleucine, glycine, histidine, tryptophan, and tyrosine) and of five vitamins (pyridoxamine, p-aminobenzoic acid, biotin, nicotinic acid, and thiamine) were also essential for biosynthesis. The 10 required amino acids could be replaced by intact protein of known composition by virtue of the bacterium's ability to synthesize proteases. Glucose or other carbohydrates were not essential for Okra B, although they did stimulate growth. Quantitatively, the most essential nutrients for Okra B were arginine and phenylalanine. In contrast, the nonproteolytic strain, Iwanai E (group II), did not require either arginine or phenylalanine. It required glucose or another carbohydrate energy source for growth and did not utilize arginine or intact protein as a substitute source of energy. Iwanai E utilized ammonia as a nitrogen source, although growth was stimulated significantly by organic nitrogenous nutrients, especially glutamate and asparagine. Iwanai E also required biosynthesis levels of seven amino acids (histidine, isoleucine, leucine, tryptophan, tyrosine, valine, and serine), adenine, and six vitamins (biotin, thiamine, pyridoxamine, folic acid, choline, and nicotinamide). Calcium pantothenate also stimulated growth. On the basis of the nutritional requirements, chemically defined minimal media have been constructed for C. botulinum serotypes A, B, E, and F (proteolytic).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288121 TI - Phenotypic and genotypic comparison of Escherichia coli from pristine tropical waters. AB - Nine fecal-coliform-positive strains were isolated from pristine sites in a tropical rain forest. These sites included nonpolluted rivers and water from bromeliads (epiphytes) which were 30 ft (ca. 910 cm) above the ground. Phenotypically, all of these isolates were identified as Escherichia coli. Their DNA was isolated and purified, and the base composition (G + C content) was determined and compared with that of E. coli B (ATCC 11303). The DNA from the environmental isolates was also hybridized to radiolabeled DNA from E. coli B. Eight strains had a DNA base composition similar to that of E. coli B and gave more than 75% homology with E. coli B. One strain had a different DNA base composition and a relatively low percentage of homology with the reference strain. The finding of E. coli in pristine tropical waters suggests that this bacterium could be a natural inhabitant in these environments and is not a reliable indicator of recent human fecal contamination in tropical waters. The indicators that are currently used in the tropics to test the biological quality of water should be reevaluated. PMID- 3288122 TI - Kinetic study on the interaction of Rhizopus chinensis aspartic protease with Streptomyces pepsin inhibitor (acetylpepstatin). AB - The fluorescence of tryptophan residues of Rhizopus chinensis aspartic protease was quenched about 25% upon binding with an inhibitor, Streptomyces pepsin inhibitor (acetylpepstatin). The kinetics of binding between the enzyme and the inhibitor was studied by the fluorescence stopped-flow method. The concentration dependence of apparent rate constants was consistent with a two-step mechanism involving a fast bimolecular association followed by a slow unimolecular process. The unimolecular process was interpreted to be a conversion from a transient intermediate to the final complex in which the inhibitor is tightly bound to the active site of the enzyme. Fluorescence quenching occurred essentially in the unimolecular process, which suggests microenvironmental transition around at least one tryptophan residue in the enzyme-substrate complex. PMID- 3288123 TI - Occlusive wound dressings. Why, when, which? PMID- 3288125 TI - HLA class I antigen (heavy and light chain) expression by Langerhans cells and keratinocytes of the normal human epidermis: ultrastructural quantitation using immunogold labelling procedure. AB - Using an immunogold labelling procedure, we quantified the density of major histocompatibility (MHC) class I antigens on the surface of Langerhans cells (LCs) and keratinocytes of the normal human epidermis. According to ultrastructural features, keratinocytes were divided into three subpopulations: stratum basalis (SBK), stratum spinosum (SSK), and stratum granulosum keratinocytes (SGK), and analyzed separately. For this purpose, three monoclonal antibodies (MCAs) were employed: an anti-HLA A,B,C, and anti-B2-microglobulin (B2 m), and a polymorphic anti-HLA A2 Aw69 MCA. Under electron microscopy, quantitative analysis demonstrated: (a) the presence of a high amount of HLA monomorphic determinants on SBK and SSK and moderate but significant labelling of SGK; (b) the very weak density of MHC class I antigens on the surface of epidermal LCs; (c) the expression, at an identical level, of the HLA heavy chain common determinant (HLA A,B,C), B2-m, and the alloantigen HLA A2 by all epidermal cells (ECs) apart from SGKs and LCs that presented far fewer HLA A2 sites than monomorphic determinants (B2-m and HLA A,B,C); (d) the absence of HLA class I on corneocytes and a moderate labelling of melanocytes. A knowledge of the precise quantitative distribution of HLA class I antigens among various cell subpopulations of the normal human epidermis would be very useful for the study and follow-up of cutaneous malignancies that are known to lose these molecules as well as for the understanding of immune responses, especially allospecific, that involve the skin. PMID- 3288124 TI - Malignant melanoma. Treatment with high-dose combination alkylating agent chemotherapy and autologous bone marrow support. AB - Nineteen patients with metastatic malignant melanoma were treated with 20 courses of high-dose combination alkylating agent chemotherapy and autologous bone marrow support. All 20 treatment courses were evaluable for toxic reactions and 17 of 20 courses were assessable for response. Twelve of the 20 courses were given at the phase 2 dose per square meter of cyclophosphamide (5.625 g), cisplatin (165 mg), and carmustine (600 mg). Marrow reconstitution occurred with a median time to recovery of 21 and 24 days for more than 500 neutrophils and more than 20,000 platelets, respectively. The overall response rate was 65%, with one patient achieving a complete response with chemotherapy alone. Ten additional patients achieved partial responses following chemotherapy, of which three were subsequently rendered disease free by surgical resection of single areas of residual tumor. Two of these patients are alive and disease free more than 22 months following chemotherapy and one remains relapse free. The median survival for responding patients was 15.2 months and 8.6 months for the entire group. PMID- 3288126 TI - Immunohistochemical localization of type V collagen in normal human skin. AB - Tissue distribution of type V collagen in normal human skin was studied using an indirect immunofluorescent technique to determine whether type V collagen is present in the interstitium or in the basement membrane. Type V collagen was isolated from the human placenta by pepsin digestion and was purified with fractioning salt precipitations. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) demonstrated that type V collagen contained alpha 1(V) and alpha 2(V) chains, but not the alpha 3(V) chain. Specificity of the rabbit antibodies to type V collagen was assessed using enzyme-linked immunosorbent assay (ELISA) and an immunoblotting method. Antibodies showed no cross-reactivity to other collagens, laminin, and fibronectin. With an indirect immunofluorescent technique, type V collagen was found to be widely distributed throughout the dermis. Intense fluorescent staining was noted in the papillary dermis and adnexal dermis surrounding hair follicles and eccrine glands. The basement membrane of the dermoepidermal junction, skin appendages, and capillaries was not stained. By indirect immunoperoxidase double staining, type V collagen was not found to be deposited on type IV collagen present in the basement membrane. Immunoelectron microscopic studies showed that type V collagen was not located in the basal lamina. These results suggest that type V collagen is distributed in the interstitium, but not in the basement membrane of normal human skin. PMID- 3288128 TI - Effect of lead on postnatal development of the bank vole (Clethrionomys glareolus). PMID- 3288127 TI - Phototoxicity of skin microorganisms tested with a new model. AB - A new standardized method for testing phototoxicity of chemicals against microorganisms is described. The inoculum size of the microorganism, application of test chemicals, prediffusion time, incubation time and incubation period are defined. Staphylococcus aureus, S. epidermidis, Candida albicans, and Pityrosporum orbiculare were studied. Both 8-methoxypsoralen and trimethylpsoralen were phototoxic against all microorganisms tested, while tetracycline and doxycycline were not phototoxic. C. albicans may be chosen for phototoxicity testing because it has been used earlier, it is easy to maintain in culture, it grows easily when tested, and its pathogenicity is low. The phototoxicity of S. aureus, S. epidermidis, Pseudomonas aeruginosa, Propionibacterium acnes, C. albicans, and P. orbiculare against each other were also investigated. Only P. orbiculare was inhibitory. It inhibited the growth of S. aureus, S. epidermidis, and Ps. aeruginosa - both in the dark and after irradiation. The growth inhibition was markedly enhanced after UVA irradiation, indicating phototoxicity. The phototoxic effect of P. orbiculare may play a role in the ecology of the human skin flora. PMID- 3288129 TI - Exposure assessment: input into risk assessment. AB - The validity of a risk assessment can be no better than that of the exposure assessment upon which it is based. The general paucity of relevant exposure data, combined with the limited appreciation by most risk assessors of the critical dimensions and metrics of exposure, often leads to an overreliance on exposure models of questionable validity. The problems of identifying and interpreting relevant metrics of exposure for epidemiologic studies and risk assessments are illustrated through the presentation of three case studies. The first examines the effects of ozone on respiratory mechanical function and demonstrates that the appropriate averaging time is greater than or equal to 6 hr, rather than 1 hr, as is implied by the current ambient air quality standard. The second case study examines the effects of sulfur oxides and particulate matter in ambient air on morbidity and mortality. It indicates that the effects are most closely associated with the acidity of the aerosol, providing a basis for an index of exposure more relevant than those currently used, i.e., sulfur dioxide and nonspecific gravimetric mass concentration of particulate matter. The third case study examines the effects of lead on blood pressure. It shows that blood lead in concentrations below 35 micrograms/dL correlates with blood pressure in both humans and animals independently of other known causal factors for blood pressure elevation. It also examines the variable relations between levels of lead in blood and in environmental media to illustrate the potential problems which can arise from the use of biological markers, such as lead in blood, as indices of exposure. PMID- 3288131 TI - The origin and early development of the Southern Surgical Association. PMID- 3288130 TI - Exposure registries. AB - Exposure registries are new tools for use as part of the public health response to toxic occupational and environmental exposures. These registries can help fill a gap that currently exists in the effective handling of problems following the revelation of an exposure situation. In the past, such a tool was lacking and potentially high-risk groups may not have received needed services. Recent legislation, however, has mandated the establishment of exposure registries. These registries can help provide the basis for a unified response to what historically has been described as a fragmented and ineffective approach to managing high-risk cohorts and assessing the impact of toxic substances. Certain exposure registries are now mandated by law (PL 96-510), and they have a place alongside other disease control and public health tools. Their establishment and use is not without problems, but the gain from them could be substantial. They fill a gap in the current public health response to problems of groups found to be at increased risk of exposure to toxic substances. PMID- 3288132 TI - Renaissance man of the Southern Surgical Association. PMID- 3288133 TI - The role of gynecologic surgeons in the Southern Surgical Association. PMID- 3288134 TI - Honorary fellows of the first century. PMID- 3288135 TI - Southern Surgical Association. The ninety-seven presidential addresses 1888-1987. PMID- 3288136 TI - Publication of the proceedings of the Southern Surgical Association. PMID- 3288137 TI - The collection and preservation of the archives of the Southern Surgical Association. PMID- 3288138 TI - Important risk factors of allograft survival in cadaveric renal transplantation. A study of 426 patients. AB - Multiple risk factors contribute to the allograft survival of patients who have cadaveric renal transplantation. A retrospective review of 19 such factors in 426 patients identified race, DR match, B + DR match, number of transplants, and preservation time to have a significant influence. The parametric analysis confirmed the effect to be primarily in the early phase, i.e., first 6 months. All patients received cyclosporine with other methods of immunosuppression resulting in an overall 1-year graft survival rate of 66%. The overall 1-year graft survival rate in the white race was 73% and in the black race was 57% (p = 0.002). Allograft survival and DR match showed white recipients with a 1 DR match to have 75% survival at 1 year compared with 57% in the black patient (p = 0.009). If HLA B + DR match was considered, the white recipient allograft survival increased to 76%, 84%, and 88% for 1, 2, and 3 match kidneys by parametric analysis. Patients receiving first grafts had better graft survival (68%) than those undergoing retransplantation (58%) (p = 0.05). Organ preservation less than 12 hours influenced allograft survival with a 78% 1-year survival rate compared with 63% for kidneys with 12-18 hours of preservation. Despite the benefits of B + DR typing, short preservation time, and first transplants to the white recipient, the allograft survival in the black recipient remained uninfluenced by these parameters. PMID- 3288139 TI - The surgical management of esophageal stricture in children. A century of progress. AB - Early in this century all procedures performed on the esophagus were accomplished through its lumen. Ingestion of caustics was common and resulted in dense strictures for which complicated and ingenious methods of dilation were advised. Because obstructions usually recurred, by-pass operations were devised with conduits of skin or segments of the gastrointestinal tract. Now, in contrast, when burns occur, intensive steroid therapy usually prevents all but localized areas of stricture. These areas, if short, can be treated with hydrostatic balloon dilation under fluoroscopic control. If longer or resistant to dilation, these strictures can be managed by incision and insertion of a colic patch with excellent long-term results. To a previous series of children who have had esophageal patch with a vascularized segment of colon, now added is an experience with a free segment of small intestine with vascular anastomosis to an artery and vein in the neck and another case of a free patch of pericardium to the esophageal stricture. PMID- 3288140 TI - Efficacy of retrograde coronary sinus cardioplegia in patients undergoing myocardial revascularization: a prospective randomized trial. AB - The efficacy of retrograde coronary sinus cardioplegia (RCSC) administered through the right atrium compared with aortic root cardioplegia (ARC) has not been examined critically in patients undergoing coronary artery bypass grafting (CABG). Twenty patients having elective CABG were randomized prospectively to receive cold blood ARC (Group I, 10 patients) or cold blood RCSC (Group II, 10 patients). Patient demographics were similar in both groups. Ventricular function was assessed preoperatively by radionuclide ventriculography and postoperatively by simultaneous hemodynamic and radionuclide ventriculographic studies with volume loading. There was no change in ejection fraction (EF) (preoperative versus postoperative value) in Group I (50 +/- 6% versus 53 +/- 6%) but in group II, at similar peak systolic pressure and similar left ventricular end-diastolic volume index (LVEDVI), LVEF improved significantly (49 +/- 6% versus 60 +/- 12%, p less than 0.05). Postoperative ventricular function (stroke work index versus EDVI) for the left ventricle and right ventricle were similar in both groups. Evaluation of postoperative LV systolic function (end-systolic blood pressure versus end-systolic volume index) and diastolic function (pulmonary capillary wedge pressure versus EDVI) were also similar in both groups. Retrograde coronary sinus cardioplegia is as effective as ARC for intraoperative myocardial protection, and provides excellent postoperative function in patients undergoing elective CABG. PMID- 3288141 TI - Technique of successful clinical double-lung transplantation. AB - Lung transplantation has become a successful method in the therapy for end-stage pulmonary disease. While single-lung transplantation provides benefit to patients with pulmonary fibrosis, bilateral lung transplants are required for septic or emphysematous lung disease. We describe the technique employed in 6 patients to transplant en bloc both lungs with the recipient heart left in place. The lungs are connected by a left atrial cuff, main pulmonary artery, and trachea. The completed implantation has a tracheal anastomosis securely wrapped in omentum, a left atrial anastomosis posterior to the heart, and a pulmonary artery anastomosis anteriorly. Airway ischemia resulted in the death of 1 patient. This procedure allows complete excision of all diseased pulmonary tissue, retention of the recipient's own heart, and separate excision of the donor heart for use in another recipient, thereby markedly increasing the supply of donor lungs for transplantation. PMID- 3288143 TI - The effect of arterial filtration on reduction of gaseous microemboli in the middle cerebral artery during cardiopulmonary bypass. AB - Noninvasive in vivo detection of gaseous microemboli in the middle cerebral artery, by transcranial Doppler ultrasound, was used to determine the effect of filtration in the arterial catheter using 25- and 40-microns filters and bubble oxygenators in patients undergoing cardiopulmonary bypass surgery. Eighteen patients undergoing coronary artery bypass surgery were studied using a closed cardiac (unvented heart) model. Group 1 patients (no filters) had the highest incidence of gaseous microemboli, as indicated by the ultrasound microemboli index, at both high and low oxygen flow rates. Group 2 patients (40-microns filters) had a significantly lower microemboli index, particularly at low oxygen flow rates (t = 4.9, p less than 0.001). The 25-microns group patients had the lowest values of all. No microemboli were detected at low oxygen flow rates, and microemboli were detected in only 0.1% of the samples at high oxygen flow rates. Additionally, observations on vented hearts in 3 patients undergoing cardiac valve surgery indicate that the origin of gaseous microemboli may be air trapped inside the heart. PMID- 3288142 TI - A comparison of solutions for lung preservation using pulmonary alveolar type II cell viability. AB - Many special solutions have been developed to protect the ischemic lung in preparation for transplantation. To determine an effective solution, we isolated pulmonary alveolar type II cells from rat lungs. These cells play an important role in sodium transport and the production of surfactant; thus, they are crucial to the respiratory physiology of the lung. In this study, we examined in vitro the effect of various solutions such as Collins' solution, Collins-Sacks solution, and glucose-insulin-potassium solution on alveolar type II cell viability. The cell viability was examined with a trypan blue dye exclusion test and [3H]thymidine uptake proliferation assay after 24 and 72 hours of incubation. The alveolar type II cells in the glucose-insulin-potassium solution had greater viability compared with cells cultured in either Collins' or Collins-Sacks solution. This study demonstrates that glucose-insulin-potassium solution has the least toxic effect on isolated alveolar type II cells compared with other preserving solutions. PMID- 3288144 TI - [Induced variability in Acremonium chrysogenum, a producer of neutral-alkaline proteases and peptidases]. AB - Lethal and mutagenic effects of N-nitrosomethyl biuret on the organism producing a complex of proteolytic enzymes i. e. Acremonium chrysogenum were studied. It was shown that methionine inhibited production of the protease complex in the induced prototrophic mutants. The selected mutants were classified according to the level of enzyme biosynthesis induction by methionine. PMID- 3288145 TI - [Conditions for immobilizing Streptomyces erythreus in a calcium alginate gel and the apparatus setup for the process]. AB - A laboratory unit for production of calcium alginate gel granules with immobilized microorganisms is described. It provides sterile production of particles from tens micrometers to 2 mm in diameter. Expediency of using biocatalysts in the form of fine granules is exemplified with a number of immobilized microorganisms. Conditions for immobilizing the erythromycin producing organism by its incorporation into the calcium alginate gel were studied. Viability of the actinomycete in the gel was shown by consumption of the nutrients and biosynthesis of the antibiotic. PMID- 3288146 TI - [Comparative study of apramycin-resistant microorganisms isolated from man and animals]. AB - Apramycin-modifying strains isolated from pigs with coli bacteriosis, from humans and hospital environment were studied comparatively. Production of enzymes modifying the aminoglycoside was estimated with the radioactive cofactor procedure. E. coli isolates from the animals were phenotypically resistant to apramycin and a number of other aminoglycosides. They produced acetyltransferase AAC(3)IV, phosphotransferase APH(3')(5"), APH(3") and other enzymes. Resistance of the strains to gentamicin was also conditioned by AAC(3)IV since these strains did not produce AAD(2") and AAC(6'). In the resistant strains of E. coli and their transconjugates there were detected plasmids with a relative molecular weight of 60-80 MD. Some of the belonged to the compatibility group I1, the others belonged to the compatibility group H1. Strains of S. marcescens, K. pneumoniae. K. oxytoca and S. aureus isolated from humans and hospital environment were sensitive to apramycin. Only isolates of P. aeruginosa were resistant to this antibiotic. However, all the isolates produced AAC(3)IV. Some of them additionally produced AAC(6'), an enzyme modifying amikacin, kanamycin and other antibiotics and not acetylating apramycin. Almost all the strains produced kanamycin- and streptomycin phosphotransferases. Possible coselection of strains resistant to apramycin and gentamicin using one of these aminoglycosides is discussed. PMID- 3288147 TI - [Combined use of mytilan and gentamycin in experimental infections ]. AB - It was shown that mytilan, a polysaccharide isolated from the mantle of Crenomytilus grayanus stimulated the host nonspecific resistance to infections. This was evident from the survival rate of the animals infected with lethal doses of E. coli and S. aureus. In addition, the combined use of gentamicin and mytilan in treatment of the infections caused by the above organisms enabled to increase the antibiotic therapy efficacy with using lower doses of both the antibiotic and the polysaccharide. PMID- 3288149 TI - [Effect of lytic enzymes on Staphylococcus and the possibilities of their combined use with antibiotics]. AB - Dependence of lytic enzyme preparation activity on temperature and time of Staphylococcus incubation with the preparation was shown. A decrease in the activity with an increase in the ionic strength of the incubation solutions and protective effect of salts on the staphylococcal cells were observed. Possible combined use of the preparation with antibiotics was studied. The enzymatic preparation inactivated penicillins and cephalosporins at the account of the ability of lytic endopeptidases to hydrolyze the peptide bond of the beta-lactam ring. However, its combined use with many other antibiotics such as novobiocin, lincomycin, rifampicin, gramicidin, polymyxin, oleandomycin, streptomycin, kanamycin, tetracycline and levomycetin is quite possible. PMID- 3288148 TI - [Immunoassay based on the direct measurement of fluorescence polarization in studying antibiotic pharmacokinetics]. PMID- 3288150 TI - [Changes in the degree of sensitivity to antibiotics of Shigella isolated from patients with dysentery in a city infectious disease hospital over the past 8 years]. AB - Changes in sensitivity of Shigella and in particular Shigella flexneri isolated from dysentery patients in a city infection hospital within 8 years i.e. from 1977 to 1985 were followed. It was shown that the changes were to the greater extent connected with preferable use of certain antibiotics in the hospital. PMID- 3288151 TI - [Azlocillin pharmacokinetics]. PMID- 3288152 TI - [Biological properties and antibiotic sensitivity of non-fermenting gram-negative bacteria]. PMID- 3288153 TI - [Classification and epidemiology of R plasmids of Enterobacteriaceae]. PMID- 3288154 TI - [Possibility of breeding of animals-producers of biologically active substances- by microinjection of cloned genes into the ovum]. PMID- 3288155 TI - [The methods of protoplast formation and transformation of Streptomyces strains]. AB - Factors influencing formation, regeneration and transformation of protoplasts in streptomyces are described. Conditions for formation and regeneration of protoplasts in 4 industrial strains producing the macrolide antibiotic tylosin were studied. It was demonstrated possible to apply the method for transformation of the S. lividans type culture to 3 industrial strains of S. griseus producing grisin, an antibiotic used as a feed additive. Potential increasing of the efficiency of protoplast transformation and transfection in various actinomycetous strains including industrial ones is discussed. The stimulating effect of lyposomes on transformation of protoplasts in S. lividans 66 with DNA of plasmids pVG101 and pIJ350 as well as transfection with DNA of phages SH10 and KS404 was shown. The tylosin resistance genes in S. fradiae strain B45 were cloned which enabled isolating the cluster of the genes participating in tylosin biosynthesis. PMID- 3288156 TI - Changing group A streptococci. The reappearance of streptococcal 'toxic shock'. PMID- 3288157 TI - Methodologic problems in exercise testing research. Are we solving them? AB - To evaluate the comparative effects of methodologic factors on the reported accuracies of two standard exercise tests, 56 publications comparing the exercise thallium scintigram with the coronary angiogram were analyzed for conformation to five methodologic standards. Analyzed were adequate definition of study group, avoidance of a limited challenge group, avoidance of workup bias, and blinded analysis of the coronary angiogram and myocardial scintigram. Study group characteristics and technical factors were also reviewed. Better conformation with methodologic standards was found than has been reported previously for treadmill exercise testing. Furthermore, study group characteristics and technical factors were better predictors of sensitivity and specificity than were methodologic deficiencies. Only workup bias and test blinding were significantly associated with test accuracy. The percentage of patients with previous myocardial infarction had the highest correlation and was independently and directly related to sensitivity and inversely related to specificity. PMID- 3288158 TI - Human immunodeficiency virus isolation studies and antibody testing. Household contacts and sexual partners of persons with hemophilia. AB - Virus isolation studies and human immunodeficiency virus (HIV) antibody testing were performed on 87 household contacts of 68 HIV antibody-positive hemophilic patients to determine the extent that HIV could be transmitted through heterosexual or through nonsexual, but intimate contact. Human immunodeficiency virus seropositivity was established for the 68 hemophiliacs by immunofluorescence method or enzyme-linked immunosorbent assay and confirmed by Western blot testing (for 66 patients). Fifty-one nonsexual contacts and 36 sexual partners of these hemophiliacs were tested for HIV antibody by immunofluorescence or enzyme-linked immunosorbent assay and Western blot. All sexual partners and all nonsexual household contacts were HIV antibody-negative, including six partners and nine parents of hemophiliacs from whom the virus had been isolated and seven parents and six partners of patients with AIDS. This study further demonstrates lack of transmission of HIV in intimate, but nonsexual settings, and suggests that heterosexual transmission, although well known to occur, may be relatively uncommon in hemophilic couples when the male and female partner have no other risk factors. It is hoped that intensive education and counseling programs will reduce exposure and maintain a low risk of heterosexual transmission. PMID- 3288159 TI - Age, sex, and race inequality in renal transplantation. AB - We calculated the chance of receiving a kidney transplant in the United States in 1983, and in the Midwest from 1979 through 1985, considering age, sex, and race. In the United States, 23,026 patients began long-term dialysis and 6112 (27%) received a kidney transplant. Transplant rates were 31% for men and 21% for women. White patients had a 30% rate and nonwhite patients a 20% rate. Patients less than 11 to 35 years old had an 85% rate vs a 3% rate for those older than 56 years. When race, age, and sex were analyzed together, nonwhite patients aged 21 to 45 years had only half the chance of receiving a transplant compared with white patients of the same age and sex. Women aged 46 to 60 years had less than half the chance of receiving a transplant when compared with men of the same age and race. These data show that there are age, sex, and race imbalances in the distribution of renal transplantation. We believe these imbalances only partially have a morally neutral biological, medical, social, and cultural explanation and that there should be a fairer distribution of kidney transplants. PMID- 3288160 TI - Renal function in patients with obstructive sleep apnea. Effects of nasal continuous positive airway pressure. AB - Patients with obstructive sleep apnea (OSA) often exhibit nocturnal polyuria, which disappears with nasal continuous positive airway pressure (CPAP) treatment. We measured water and electrolyte urinary excretion, creatinine and osmolal clearances, and water transport during sleep in 13 polygraphically monitored patients with OSA during two consecutive nights, either untreated or treated with nasal CPAP, and in eight normal subjects. Untreated patients with OSA had greater urinary flows and greater urinary sodium, chloride, and potassium excretions than did controls. Nasal CPAP treatment in patients with OSA resulted in a reduction in urinary flow and in sodium and chloride excretion, with a concomitant increase in sodium resorption. None of these effects was observed in CPAP-treated normal subjects. The only effect of nasal CPAP common to normal subjects and patients was a trend toward decreased glomerular filtration rate. PMID- 3288161 TI - 'Toxic strep syndrome'. A manifestation of group A streptococcal infection. AB - Three patients presented with multisystem disease that shared many of the features of toxic shock syndrome. Bacteriologic and serologic evidence strongly suggested that group A beta-hemolytic Streptococcus had caused the illnesses. Group A streptococcal infection may be an underdiagnosed cause of a toxic streptococcal syndrome, a syndrome of multisystem disease apparently mediated by toxins. PMID- 3288162 TI - The stress of residency. A review of the literature. AB - A review of empiric studies of the stresses of residency training and descriptions of intervention programs and mental health resource surveys published since 1980 indicated that inadequate sleep and fatigue are major stressors for residents, but they are only part of a more complex situation influenced by time demands, social support, and maturational factors. Other important stressful aspects of training appear to be those that interfere with social support. Increased anger, not depression, is emerging as the predominant mood change during residency, but the effects of any mood change on patient care have not been studied. Despite growing evidence of the need for change in training programs, especially attention to the affiliative needs of residents, few intervention programs have been reported. PMID- 3288163 TI - Pyomyositis in a patient with progressive systemic sclerosis. Case report and review of the literature. AB - Pyomyositis has become an increasingly recognized disease in temperate climates. A patient receiving chlorambucil for progressive systemic sclerosis, in whom streptococcal pyomyositis developed, is presented. Magnetic resonance imaging led to the early diagnosis. To our knowledge, this is the first case report of pyomyositis in a patient with scleroderma, and the first association with group G streptococcus infection in an adult. Connective tissue diseases and immunosuppression may emerge as risk factors for the development of this entity. PMID- 3288164 TI - [Skeletal findings in historical beheadings in the Bern canton]. AB - The skeleton of a decapitated buried in historical times (before 1798) is compared with the anatomical findings on cervical vertebrae from the last seven decapitated individuals on Bernese territory (19th century). PMID- 3288165 TI - Plasma monoamine metabolites in psychotic disorders. PMID- 3288166 TI - Genotoxicity assessment of the plasmacytomagenic agent pristane (2.6.10.14 tetramethylpentadecane) and four related alkanes by the SOS chromotest. AB - The most extensively studied model of plasmacytomagenesis is the induction of plasmacytomas in BALB/c mice by i.p. injections of mineral oil or, chemically more defined, by several branched alkanes such as pristane (2.6.10.14 tetramethylpentadecane), phytane (2.6.10.14-tetramethylhexadecane), and 7-n hexyloctadecane. The available evidence suggests that the primary biologic action of these plasmacytomagenic agents is to induce the formation of a chronic granulomatous tissue, the histological matrix of plasmacytoma development. However, certain genotoxic effects caused by the presence of these substances can not be ruled out a priori. Pristane, 2-methyldodecane, and 1.3-di-tert-butyl-5 methyl-cyclohexane as well as perhydroanthracene and hexahydrodibenzsuberane were proofed as potential genotoxic agents by the SOS chromotest, a quantitative bacterial colorimetric assay for genotoxins. The substances tested did not express any sign of genotoxicity, but exerted toxic effects to the E. coli tester strain. PMID- 3288167 TI - Targeting of cancer with radiolabeled antibodies. Prospects for imaging and therapy. AB - This article reviews the current status, including problems and some proposed solutions, of the targeting of cancer with radioactive antibodies for use in antibody imaging (radioimmunodetection) and radioimmunotherapy. The problems and results are similar for purified polyclonal and murine monoclonal antibodies. Foremost among the problems are the low accretion of antibody (0.01% to 0.001% of injected dose per gram) in tumor and the nonspecific deposition of radiometals that are more ideal for imaging or therapy after antibody conjugation. Despite these limitations, radioimmunodetection appears to be a safe and useful method, even at this early stage of development. Sensitivity, specificity, and accuracy rates of 80% to 90% have been achieved in some studies involving radioiodine labels and polyclonal or monoclonal antibodies, whereas lower percentages have been achieved with indium 111 or technetium Tc 99m radioconjugates. Even at a usual tumor resolution of 1.5 to 2.0 cm, occult cancers have been disclosed by radioimmunodetection when missed by traditional detection measures, including computed tomography and magnetic resonance imaging. Radioimmunotherapy is somewhat less developed as a treatment modality, but encouraging remissions have been observed, thus stimulating further active pursuit of this technology. These targeting results have been achieved with antibodies that are not truly cancer specific, but only exploit quantitative differences in antigen expression between tumor and adjacent normal tissues. Circulating target tumor antigens do not appear to prevent successful tumor targeting of the radioactive antibodies. PMID- 3288168 TI - Evaluating diagnostic performance of clinical tests by spreadsheet modeling. Bayesian analysis using Ri/Cj ratio as a unifying concept. AB - We present a general spreadsheet model for evaluating diagnostic performance of clinical tests. Our model depicts test results as an r X c matrix, with r possible test results and c possible clinical states. Analysis of this matrix is based on the Ri/Cj ratio, calculated as a number of subjects having a specified result Ri within a given clinical state Cj, divided by total subjects within this clinical state. From this model, we can identify three special cases: (1) a 2 X c matrix, with two possible test results of T+ or T-, over c possible clinical states; (2) an r X 2 matrix, with r possible test results, over two possible clinical states of D+ or D-; and (3) a 2 X 2 matrix, with two possible test results over two possible clinical states. Application of the Ri/Cj ratio to the r X c matrix provides a useful approach to graphic analysis of multiple test results over multiple clinical states. The Ri/Cj ratio also provides a general approach to Bayesian analysis, in which likelihood ratio, relative operating characteristic analysis, sensitivity, and specificity represent special cases or special applications. PMID- 3288169 TI - Radiohistology as a new diagnostic method for barium granuloma. AB - Barium granulomas are rare complications of the barium enema. They pose diagnostic problems to the gastroenterologist, who may suspect a carcinoma, and to the pathologist, who may have difficulty in determining the precise nature of the foreign body. From four cases we suggest a simple and quick diagnostic method: paraffin-block roentgenography. PMID- 3288170 TI - Xanthomatous bronchiolitis obliterans with cholesterol pneumonia. AB - Reported is an instance of bronchiolitis obliterans due to the accumulation of lipid-laden cells within bronchiolar walls and lumina. The bronchiolar lining had extensive squamous and goblet cell metaplasia with focal ulceration. Scattered foci of cholesterol pneumonia, composed of acicular crystals with an associated foamy lipid material and type II alveolar epithelial cell hyperplasia, were present. The patient had no history related to this unusual pulmonary disease, although preoperatively her serum cholesterol level was mildly elevated. She was treated with pulmonary and cardiac allotransplantation. PMID- 3288171 TI - Pathology in the 19th century at the University of California. PMID- 3288172 TI - Biofeedback and functional electric stimulation in stroke rehabilitation. AB - The study examined the efficacy of functional electric stimulation (FES) and biofeedback (BFB) treatment of gait dysfunction in patients with hemiplegia after stroke. These two therapeutic modalities were tested alone and in combination in a prospective, controlled, randomized trial. The authors hypothesized that in concurrent use, these two modalities would complement one another. Thirty-six hemiplegic patients undergoing rehabilitation after stroke were accepted for study and randomized into four groups to receive either control, FES, BFB, or combined therapies. Each patient received 30 minutes of treatment three times per week for six weeks, in addition to their general rehabilitation program. Quantitative gait analysis was performed biweekly on each subject during the experimental therapy and for four weeks afterward. Thirty-two subjects completed the study. Combined therapy with BFB and FES resulted in improvements in both knee and ankle minimum flexion angles during swing phase that were statistically significant with p = 0.05 and p = 0.02, respectively. Velocity of gait, cycle time, and symmetry of stance phases also improved. The length of time elapsed since the stroke did not prove to be a significant factor. PMID- 3288173 TI - Primary fibromyalgia syndrome and myofascial pain syndrome: clinical features and muscle pathology. AB - Primary fibromyalgia syndrome (PFS) is a common form of nonarticular rheumatism with diffuse musculoskeletal aching and stiffness at multiple sites and tender points at characteristic locations. Nonmusculoskeletal "systemic" symptoms, eg, fatigue, poor sleep, irritable bowel symptoms, and chronic headaches, are also common. Although PFS is similar to myofascial pain syndrome (MPS) in that both conditions cause muscle pain and tenderness, important differences exist. Unlike PFS, muscle pain in MPS is usually local or regional, accompanied by trigger points. Unlike tender points, trigger points produce a referral pain pattern specific to each muscle. Moreover, "systemic" features of PFS are usually absent in MPS. Common and important pathologic changes in muscle in PFS are moth-eaten appearance of Type I fiber by histochemistry, and myofibrillar lysis with glycogen and mitochondria deposition by electron microscopy; inflammatory changes are absent by light microscopy. Recent investigations have shown that PFS is a characteristic clinical entity. Further controlled studies are, however, essential to establish the pathologic changes in tender muscles in PFS. PMID- 3288175 TI - [Present-day pathological anatomy and prospects for its development in the 21st century]. AB - Scientific Societies of Pathologists from Socialist countries held three symposia to analyse recent developments and future trends in pathology. The author presents his state-of-the-art review at the third symposium (Berlin, 1987) based on international literature data and first-hand experience gained in the field of pathology for the last decades. Some negative tendencies are considered. It is stated, in particular, that the percentage of autopsies performed in those who died at hospitals and at home continues to decrease due to fading interest to autopsy results both from physicians and medical authorities. This can entail growing number of misdiagnoses, unassessed quality of medical aid in complicated cases, biased statistics, undetected infection during life, defects in medical training. Tendencies and tasks facing histopathology and cytological diagnosis are determined as follows: 1) purpose-specific introduction of new techniques and equipment 2) active promotion of interdisciplinary task-force groups of clinicians, pathologists, roentgenologists, etc. to verify diagnosis and develop new techniques 3) establishment of special reference centres 4) overall computerization 5) urgent need in additional skilled staff to satisfy growing technical requirements of molecular biology, genetics and tissue culture. Current research on pathology is believed unsatisfactory. The role of experimental pathology is underestimated. To improve the situation in fundamental pathological research, the author suggests large-scale perestroika involving additional investments and human resources, active participation of scientists, clinical pathologists and medical authorities. PMID- 3288174 TI - The genotoxicity of trenbolone, a synthetic steroid. AB - Trenbolone, a synthetic androgen is used as a growth promotant in animal husbandry. Because of its steroidal structure and properties it has been extensively evaluated in a series of in vitro and in vivo assays to assess its genotoxic and initiating properties. Both the parent molecule 17-beta-hydroxy trenbolone and its metabolite 17-alpha-hydroxy-trenbolone, produced only in cattle, have been tested. 17-beta-hydroxy-trenbolone was not genotoxic in the Ames Salmonella/microsome assay, cytogenetics assays in human lymphocytes and CHO cells, a micronucleus assay in CHO cells, a DNA repair synthesis assay in HeLa cells, mammalian cell mutation assays with CHO and V79 cells, the mouse micronucleus assay, rat bone marrow or spermatogonial cytogenetics assays or in a test for initiators in the rat. In the mouse lymphoma cell mutation assay with L 5178Y TK+/- cells, equivocal responses were obtained, particularly at highly toxic concentrations. With 17-alpha-hydroxy-trenbolone a weak positive response was obtained in the L5178Y Tk +/- assay, particularly at highly toxic concentrations. Negative results were obtained in the Ames Salmonella/microsome assay, the cytogenetics assays using both human lymphocytes in vitro and rat bone marrow in vivo, the DNA repair assay and in the CHO mammalian cell mutation assay. It was also negative in the in vivo test for initiators. From this extensive battery of data, and also taking into account published data on trenbolone, it is concluded that 17-alpha-hydroxytrenbolone and 17-beta-hydroxy trenbolone are devoid of genotoxic activity and are not initiators of cancer. PMID- 3288176 TI - [Clinico-morphological manifestations of Pseudomonas infection]. AB - Various aspects of Pseudomonas aeruginosa infection are covered in the review based on 48 topical Soviet and international publications. Pseudomonosis, caused by opportunistic gram-negative bacteria, is related to human infections often acquired in hospitals and occurs at many sites, the principal ones being respiratory and alimentary tracts. There are cases of severe sepsis. Morphologic signs presenting with alterative changes involve marked circulatory disorders about the necrotic tissue and torpid inflammation, are similar in children and adults. Typical are numerous bacterial colonies at the site of inflammation most pronounced at necrotic foci. PMID- 3288177 TI - [I. V. Davydovskii and the problems of general pathology]. PMID- 3288178 TI - [I. V. Davydovskii and the theory of sepsis and suppurative-resorptive fever]. PMID- 3288179 TI - [I. V. Davydovskii and the problems of infectious pathology]. PMID- 3288180 TI - [I. V. Davydovskii--the pedagogue]. PMID- 3288181 TI - [I. V. Davydovskii and contemporaneity]. PMID- 3288182 TI - [I. V. Davydovskii--pathologist-innovator--hospital prosector]. PMID- 3288183 TI - [Morphological diagnosis of abdominal cavity tumors using fine-needle aspiration biopsy controlled by ultrasound]. AB - Thin needle biopsy under ultrasound control was carried out in 142 patients. Cytologic evaluation (142 samples) was supplemented by histologic study in 111 cases. Morphologic assessment of the biopsy specimens proved sufficient for an adequate diagnosis in 93.6% of cases, represents an objective method of verification of ultrasound findings in primary and metastatic tumors of the peritoneum providing evidence for their tissue origin and histologic form. PMID- 3288184 TI - [Morphology of the lesser circulation during programmed hemodialysis and the transplantation of a human cadaveric kidney]. AB - The results of program-controlled hemodialysis (PCH) and cadaver kidney transplantation (CKT) were evaluated morphologically using 36 sections obtained from patients with end-stage chronic renal failure. For PCH-treated patients the findings indicated development of mixed secondary hypertension of the lungs associated with atherosclerotic involvement of the pulmonary artery and its branches, arteriolar rearrangements and visceral angiosclerosis. Morphologically, a successful CKT outcome resulted in late postoperative (in the time interval of 5 months--4.5 years) reduction of the signs typical for pulmonary vasculature affection with hypertension of the lesser circulation. This can suggest possibility of a reversible course of pulmonary hypertension in relevant patients. PMID- 3288185 TI - [Morphogenetic problems of dilated cardiomyopathy]. AB - A comprehensive histochemical, histoenzymatic, morphometric and ultrastructural evaluation of 27 autopsy and 22 biopsy specimens of the right ventricular endomyocardium, aimed at the study of dilatation cardiomyopathy, revealed alteration, compensatory and adaptation response in the cardiac muscle. The processes were recorded light-optically and ultrastructurally. Discussed are the mechanisms of the disease morphogenesis and ways of relevant therapeutic correction. PMID- 3288186 TI - [Use of lectins in pathomorphology: the results and prospects]. AB - Uses of lectin for diagnostic differentiation between neoplastic and nonneoplastic diseases and for other purposes in histopathologic investigations (in particular, to gain a better understanding of the pathogenesis of various diseases) are reviewed. Unresolved issues are discussed and prospects for further studies are outlined. PMID- 3288187 TI - [The role of age-related and adaptive changes in the vascular wall in atherogenesis in light of the theory of Academician I. V. Davydovskii on atherosclerosis]. AB - Aorta and coronary arteries (1053 and 386 cases, respectively) were evaluated in young persons. It is shown that atherosclerotic developments in the vessels are largely determined by hyperplastic involvement of the intima due to age-related vascular rearrangement and the hemodynamic factor. For aorta, these are represented by rhythmic structures which seem to give rise to the majority of the fibrous plaques. The findings are in consistence with I. V. Davydovsky's conceptions on age-related and adaptation changes in the vascular wall emerging during various human vital activities and supposed to underlie the development of atherosclerosis. PMID- 3288188 TI - [Preparation, quality testing and handling of MCT-containing fat emulsions]. PMID- 3288189 TI - [Effect of MCT-containing fat emulsions on postoperative protein metabolism]. PMID- 3288190 TI - [Plasma level of branched-chain amino and keto acids in healthy subjects after an intravenous dose of MCT/LCT or LCT]. PMID- 3288191 TI - [Elimination and utilization of infused medium-chain triglycerides]. PMID- 3288193 TI - Mesodermal determination genes: evidence from DNA methylation studies. PMID- 3288192 TI - Expression of human salivary protein genes. AB - Human proline-rich proteins (PRPs) are polymorphic, homologous in sequence, and linked in a cluster called the human salivary protein complex (SPC). Recently this complex was localized to human chromosome band 12p13.2 (Mamula et al., Cytogenet. Cell Genet. 39:279, 1985). We have isolated a PRP cDNA, EO27, from a human parotid gland library, identified it by DNA sequencing, and used it to study the molecular and cellular biology of PRP production. Cell-free translation and mRNA characterization with EO27 indicate that the numerous PRPs seen in saliva are produced from relatively few, large precursors, probably by posttranslational cleavage. This supports an hypothesis originally proposed by Friedman and Karn in 1977 (Am. J. Hum. Genet. 29:44 A; Biochem. Genet. 15:549) and later supported by biochemical studies (Karn et al., Biochem Genet. 17:1061, 1979) and molecular studies (Mamula et al., Fed. Proc. 43:1522, 1984; Maeda et al., J. Biol. Chem. 260:1123, 1985). EO27 was also used in this study to localize PRP mRNA production to the acinar cells of the parotid gland by in situ hybridization. PMID- 3288194 TI - The pivotal role of ferritin in cellular iron homeostasis. PMID- 3288195 TI - A family of closely related ATP-binding subunits from prokaryotic and eukaryotic cells. PMID- 3288196 TI - Genome mapping: some recent advances. PMID- 3288197 TI - Insulin-stimulated protein kinase activity in rat skeletal muscle that phosphorylates ribosomal protein S6. AB - Treatment of rats with a single high dose of insulin leads to rapid stimulation of cytosolic protein kinase activity in skeletal muscle that phosphorylates ribosomal protein S6. This stimulation is maximal within 15 minutes after insulin treatment, and the activity remains elevated for at least 90 minutes. The insulin stimulated protein kinase activity elutes as two peaks from DEAE-Sepharose. Peak I elutes at 0.04-0.06 M KCl and is stimulated by insulin approximately 1.4-fold above the control. Peak II elutes at 0.09-0.11 M KCl and is stimulated 2.8-fold above the control. The peak II activity, which is most strongly stimulated by insulin, is resolved from cyclic AMP-dependent protein kinase on DEAE-Sepharose and appears to be distinct from protein kinase C. These results represent a novel finding of the stimulation of S6 kinase activity by insulin in skeletal muscle tissue in vivo. PMID- 3288198 TI - Detection of a rabbit uteroglobin-like protein in human neonatal tracheobronchial washings. AB - Uteroglobin is a steroid hormone dependent, low molecular weight, secretory protein with many immunomodulatory properties. Immunomodulation by this protein may, at least in part, be related to its inhibitory effects on phospholipase A2 activity. Although uteroglobin is conclusively found in the rabbit, its presence in the human is controversial. Here, we present biochemical and immunological evidence for the detection of a uteroglobin-like protein in the wet epithelial living of the respiratory tract of human neonates. Because inhibition of phospholipase A2 may modulate tissue eicosanoid levels and since many eicosanoids (i.e. prostaglandins and leukotrienes etc.) are well known regulators of smooth muscle contractility, cellular migration and inflammatory processes, the discovery of this protein in the human respiratory tract may have important physiological implications. PMID- 3288199 TI - Localisation of the insulin-sensitive phosphatidylinositol glycan at the outer surface of the cell membrane. AB - A phosphatidylinositol-glycan has been implicated in the mechanism of action of insulin. Some of the actions of insulin may be mediated by the generation of the polar head group of this phosphatidylinositol-glycan. Localisation of the insulin sensitive phosphatidylinositol-glycan was investigated by reacting the glycophospholipid with the imidoester [1-14C]-isethionyl acetimidate. The present results indicate that most of the insulin-sensitive phosphatidylinositol-glycan is localized at the plasma membrane of rat liver, being 85% of the glycophospholipid present at the outer surface of the cell. These results suggest a paracrine action of insulin. PMID- 3288200 TI - Role of disulfide bonds in folding and secretion of human lysozyme in Saccharomyces cerevisiae. AB - We examined folding and secretion of human lysozyme using four mutants each lacking two cysteines expressed in a yeast secretion system. Our results have revealed that the formation of the disulfide bond Cys6/Cys128 in human lysozyme is a prerequisite for correct folding in vivo in yeast. Substitution of Ala for Cys77 and Cys95 gave eight-fold greater secretion of a molecule with almost the same specific activity as that of the native enzyme. Substitutions of the other cysteines gave molecules that were secreted at a lower rate and had lower specific activities than the native enzyme. These are the first findings that the individual disulfide bonds of human lysozyme have different functions in folding and secretion in vivo. PMID- 3288201 TI - Assay of a ribonuclease that preferentially hydrolyses mRNAs containing cytokine derived UA-rich instability sequences. AB - mRNA molecules encoding a number of inflammatory cytokines, as well as certain proto-oncogenes, contain a conserved UA-exclusive sequence in the 3' untranslated region that confers message instability in vivo. This sequence may comprise a critical regulatory element, governing the level of these mRNA molecules, and determining the efficiency with which they are translated. Through the use of a double-label RNAse assay, we have determined that lysates prepared from mouse macrophages selectively degrade mRNA molecules containing the 3' untranslated UA sequence found in the mRNA encoding human cachectin/TNF. The degree of instability is dependent upon the number of copies of inserted UA sequence present in the target mRNA molecule (a Xenopus beta-globin mRNA). mRNAs containing randomly generated UA sequences are more labile than unmodified globin mRNA, but less susceptible to degradation than mRNAs containing the authentic cachectin-derived sequence. mRNA molecules containing synthetic UG-exclusive sequences are normally stable or protected in vitro. The destruction of UA containing mRNA is inhibited by random adenylate/uridilate copolymers, but not by guanylate/uridilate copolymers. Boiling or proteinase K treatment destroys the selective nucleolytic activity of macrophage lysates. We propose that the nuclease measured here may serve to regulate cellular levels of mRNA molecules encoding cachectin, other inflammatory cytokines, and certain proto-oncogene products. PMID- 3288202 TI - Selective transcription of an insulin-regulated gene in nuclear extracts of rat hepatoma cells. AB - We have previously shown that when H4 hepatoma cells are pretreated with insulin, plant lectins, phorbol esters, or insulin mediator, the steady state concentration of gene 33 mRNA is markedly increased. The increase in gene 33 mRNA concentration with insulin is due to an increase in the transcription rate of this gene. In the present report we demonstrate that nuclear extracts prepared from H4 hepatoma cells pretreated with insulin exhibit enhanced transcription of gene 33 RNA from a DNA template containing the cap site and 1500 bp upstream of the 33 gene. This is a stable effect of insulin on the nuclear RNA polymerase II system since it is observed in frozen and thawed nuclear extracts as well as fresh nuclear extracts. PMID- 3288203 TI - Insulin action in early embryonic life: anti-insulin receptor antibodies retard chicken embryo growth but not muscle differentiation in vivo. AB - Insulin receptors are present in chicken embryos at day 2 of development and insulin stimulates embryonic growth and differentiation. Most important, anti insulin antibodies cause either death or developmental retardation in chicken embryos of that age. To determine if the embryo's endogenous insulin acts through its own receptor, we compared the effects of anti-insulin antibodies to the effects of anti-insulin receptor antibodies on growth and differentiation indexes in the chicken embryo. While the anti-insulin antibody caused a dose-dependent decrease in growth parameters like weight, total protein, DNA, RNA, total creatine kinase activity and a marker of differentiation, the creatine kinase-MB, the anti-insulin receptor antibody decreased all parameters except the creatine kinase-MB. Many, but not all, of the effects of insulin in early embryos, thus, are mediated through the insulin receptor. PMID- 3288204 TI - Conversion of 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha, 26-tetrol into 3 alpha, 7 alpha, 12 alpha-trihydroxy-5 beta-cholestanoic acid by rabbit liver mitochondria. AB - Rabbit liver mitochondria in the presence of NAD+ were found to catalyze the conversion of 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha, 26-tetrol into 3 alpha, 7 alpha, 12 alpha-trihydroxy-5 beta-cholestanoic acid. The peroxisomal fraction did not catalyze the reaction. Sonication of the mitochondria or dialysis overnight against a hypotonic buffer increased the rate of oxidation twofold. Most of the enzyme activity was recovered in the supernatant fraction after centrifugation at 100,000xg of sonicated mitochondria. 4-Heptylpyrazole, an inhibitor of cytosolic ethanol dehydrogenase, inhibited the mitochondrial formation of 3 alpha, 7 alpha, 12 alpha-trihydroxy-5 beta-cholestanoic acid by 70%. Disulfiram, an inhibitor of cytosolic acetaldehyde dehydrogenase, did not inhibit the reaction. The role of the mitochondrial dehydrogenase system in bile acid biosynthesis is discussed. PMID- 3288205 TI - Construction of immunogens for synthetic malaria vaccines. AB - The immunogenicity of a peptide consisting of eight repeats of the tetrapeptide sequence NANP (Asn-Ala-Asn-Pro) contained in the circumsporozoite protein of Plasmodium falciparum was investigated in mice under different modes of presentation. This peptide was able to produce biologically active antibodies when administered with adjuvant and linked to a protein carrier. However, a (NANP) peptide polymerized by carbodiimide was found to be immunogenic in the absence of protein carrier in H-2b mice. In contrast, the (NANP)8 peptide polymerized by glutaraldehyde was not immunogenic in the same strain. Furthermore, the efficacy of murabutide in saline, as an immunological adjuvant, was compared to the efficacy of Freund's complete adjuvant. PMID- 3288206 TI - Amino acid sequence of S-adenosyl-L-homocysteine hydrolase from Dictyostelium discoideum as deduced from the cDNA sequence. AB - S-Adenosyl-L-homocysteine hydrolase has been cloned from a lambda gt11 cDNA library prepared from Dictyostelium discoideum that had been starved for 3 hours. The sequence of the cloned cDNA was determined and the deduced amino acid sequence was compared to the amino acid sequence of rat AdoHcy hydrolase. When the sequences from the two species were aligned, 74% of the amino acids were in identical positions. If conservative changes were taken into account the homology was 84%. Because differences have been reported in the binding characteristics of NAD+ to the D. discoideum and rat AdoHcy hydrolases, changes in the amino acids of the putative NAD+-binding site were of particular interest. Six changes were observed in this region but the changes appeared to be in regions that are not critical to the three dimensional folding of the NAD+-binding site. PMID- 3288207 TI - Glycoproteins synthesized by cultured cardiac valve endothelial cells: unique absence of fibronectin production. AB - We have previously reported that cultured porcine cardiac valve endothelial cells released less fibronectin into the culture supernatant when compared to other porcine endothelial cells. In this report we compared the spectrum of glycoproteins synthesized by cardiac valve endothelial cells to glycoproteins synthesized by comparison endothelial cells derived from the ascending thoracic aorta. The cells were endogenously radiolabeled and extracted with detergent. Glycoproteins in the cell extracts were then isolated on wheat germ lectin agarose and compared using autoradiography following polyacrylamide gel electrophoresis. Fibronectin was identified by immunoblotting with specific antibody. The results showed that the outstanding difference between the endothelial cell types was the virtual absence of fibronectin in the cardiac valve endothelial cell extract. PMID- 3288208 TI - In vitro translation of rabbit lung Clara cell secretory protein mRNA. AB - The major secretory product of Clara cells is a low molecular weight protein (CCSP) whose extracellular function, at this time, is not known. The primary translation product of its mRNA is a protein with molecular weight approximately 1 kD greater than that of the native secreted protein (6.0 kD). The primary translation product is not detected in incubated lung tissue, only the secretory protein is found. The primary translation product is trypsin sensitive whereas the secretory protein is not. Cell free translation of the mRNA in the presence of microsomes results in cleavage of the signal peptide and the appearance of the lower molecular weight trypsin-resistant secretory protein. These data indicate that the low molecular weight Clara cell secretory protein is synthesized as a larger, trypsin sensitive, protein. Passage of the protein into the cisternae of the endoplasmic reticulum results in loss of the signal peptide and alterations to the tertiary structure of the protein rendering it trypsin insensitive. PMID- 3288209 TI - Effects of quinoline-containing antimalarials on the erythrocyte membrane and their significance to drug action on Plasmodium falciparum. AB - Quinoline-containing antimalarials are cationic amphiphiles which accumulate to high levels in lysosomes and are known to interact with membrane phospholipids. It was therefore hypothesized that they could exert their antimalarial effect by compromising the integrity of the parasite's acidic organelles. To test this hypothesis, the effects of chloroquine (CQ), quinine (Q) and mefloquine (MQ) on the osmotic stability of human red blood cells exposed to hypotonic solutions have been investigated. With CQ and Q stabilization was observed at pH 7.8 and destabilization at pH 5, indicating that destabilization is caused by the protonated forms of the drugs. With MQ the pH dependence was reversed, i.e. it destabilized at pH 7.8 and stabilized at pH 5, suggesting that destabilization is caused by the unprotonated drug. MQ caused cell lysis at the tenth millimolar range by a detergent effect. The possible destabilizing effect of drugs on the membranes of Plasmodium falciparum acidic organelles was investigated in metabolically-labelled parasites. We expected an increase in degradation of parasite proteins if drugs did indeed cause the release of acid hydrolases from destabilized organelles to the cytoplasm. No effect of drugs on parasite protein degradation could be observed, but protein synthesis was inhibited at therapeutic drug concentrations. These results imply that quinoline-containing antimalarials do not compromise the integrity of parasite acidic organelles, and that inhibition of protein synthesis results from a limited supply of essential amino acid(s) due to the demonstrable drug-mediated suppression of parasite digestion of host cell cytosol. PMID- 3288210 TI - Inhibition of pyruvate oxidation in rat islets by alpha-cyano-4-hydroxycinnamate. Differential effects on insulin secretion and inositol lipid metabolism. AB - The oxidation of 14C-pyruvate by isolated rat pancreatic islets was inhibited competitively and in a concentration-dependent manner by alpha-cyano-4 hydroxycinnamate. A similar, though less marked inhibition was observed of U-14C glucose oxidation, although oxidation of 1-14C-glucose was slightly enhanced in the presence of the drug. The rate of glycolysis, as estimated by the utilisation of 5-[3H]-glucose and levels of ATP in islets were unaffected by alpha-cyano-4 hydroxycinnamate. The inhibition of pyruvate oxidation by alpha-cyano-4 hydroxycinnamate was accompanied by an inhibition of insulin secretion in response to glucose, but not to a combination of Ba2+ and theophylline. In contrast, glucose-stimulated inositol lipid breakdown was not affected by the drug. Thus, mitochondrial oxidation of pyruvate appears to be a prerequisite for glucose-stimulated insulin secretion, but not enhanced inositol lipid metabolism. PMID- 3288211 TI - Hepatic carbohydrate metabolism in rats bred for alcohol preference. AB - The influence of ethanol on the carbohydrate metabolism was studied in two strains of rats: the AA strain with an inherited preference for alcohol and the ANA strain with an aversion to alcohol. In both strains, a single intraperitoneal dose of ethanol (1.5 g/kg body wt.) slightly increased the blood glucose concentration. In AA rats alcohol increased the rate of gluconeogenesis from alanine and had no effect on the liver glycogen stores, whereas in ANA rats the rate of gluconeogenesis remained unchanged and the glycogen stores decreased. It thus appears that the two rat strains maintain their blood glucose concentration by different mechanisms; the ANA rats utilise both glycogenolysis and gluconeogenesis but the AA rats only gluconeogenesis. PMID- 3288212 TI - Reduction of adipose tissue lipoprotein lipase activity as a result of in vivo administration of 2,3,7,8-tetrachlorodibenzo-p-dioxin to the guinea pig. AB - Within 1 hr of intraperitoneal administration of 1 microgram 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD)/kg, lipoprotein lipase (LPL) activity was reduced 38% from initial levels in the adipose tissue of the guinea pig. Maximal depression was observed after 2 days and persisted throughout the 10-day observation period. Oral administration of glucose restored LPL activity in TCDD treated animals after 1 day but only partially after 2 and 5 days, and had no effect after 10 days of exposure. Although initial (2-day) serum insulin levels were depressed, the inability of glucose to restore LPL activity after prolonged exposure was not due to malabsorption of glucose nor to changes in serum thyroxine or insulin concentration. TCDD also inhibited the lipolytic pathway in the adipocyte, but had no effect on hormone sensitive lipase (HSL). Since HSL and LPL are reciprocally regulated, it was concluded that TCDD acts on the adipocyte to uncouple HSL-LPL reciprocity as well as to reduce LPL production. PMID- 3288213 TI - Characterisation of theophylline metabolism by human liver microsomes. Inhibition and immunochemical studies. AB - Anti-human NADPH-cytochrome P-450 reductase inhibited all theophylline metabolic pathways confirming the involvement of cytochrome P-450 isozymes in the metabolism of theophylline. Tolbutamide, debrisoquine, mephenytoin, theobromine, phenylbutazone, sulphaphenazole and sulphinpyrazone did not inhibit theophylline metabolism by human liver microsomes. Verapamil and dextropropoxyphene were non selective competitive inhibitors of theophylline metabolism. Cimetidine and caffeine selectively inhibited the two demethylations as Ki values for these two pathways were lower than for the 8-hydroxylation pathway. The effects of nifedipine, propranolol and alpha-naphthoflavone were atypical. The degree of inhibition by propranolol reached a plateau, which was greater for the two demethylations than for the 8-hydroxylation. Alpha-naphthoflavone (ANF) at low concentrations inhibited the demethylations to a greater extent than the 8 hydroxylation. At higher concentrations ANF activated all pathways, with this effect being most marked for the 8-hydroxylation. Nifedipine inhibited the theophylline demethylations but not the 8-hydroxylation. In some livers the 8 hydroxylation was markedly activated. The results confirm that there are at least two distinct cytochrome P-450 isozymes involved in theophylline metabolism, one isozyme being involved with the demethylations and a different isozyme involved in the 8-hydroxylation pathway. Preliminary correlation studies suggest that the human orthologue to the rabbit polycyclic hydrocarbon inducible P-450 Form 4 may be involved in the N-demethylations of theophylline. PMID- 3288214 TI - Interactions of the E. coli single strand binding (SSB) protein with ss nucleic acids. Binding mode transitions and equilibrium binding studies. PMID- 3288215 TI - Dinucleoside oligophosphates--signal molecules? PMID- 3288216 TI - Interactions of antiviral agents with viral DNA synthesis. PMID- 3288217 TI - Directed one-dimensional diffusion of Escherichia coli RNA-polymerase, a mechanism to facilitate promoter location. PMID- 3288218 TI - DNA modifications by potential antitumour bisaziridinylquinones. PMID- 3288219 TI - A functional approach to the mapping of structural polymorphisms in superhelical DNA. PMID- 3288220 TI - The Bioelectromagnetics Research Laboratory, University of Washington: reflections on twenty-five years of research. PMID- 3288221 TI - Chronic exposure to ELF fields may induce depression. AB - Exposure to extremely-low-frequency (ELF) electric or magnetic fields has been postulated as a potentially contributing factor in depression. Epidemiologic studies have yielded positive correlations between magnetic- and/or electric field strengths in local environments and the incidence of depression-related suicide. Chronic exposure to ELF electric or magnetic fields can disrupt normal circadian rhythms in rat pineal serotonin-N-acetyltransferase activity as well as in serotonin and melatonin concentrations. Such disruptions in the circadian rhythmicity of pineal melatonin secretion have been associated with certain depressive disorders in human beings. In the rat, ELF fields may interfere with tonic aspects of neuronal input to the pineal gland, giving rise to what may be termed "functional pinealectomy." If long-term exposure to ELF fields causes pineal dysfunction in human beings as it does in the rat, such dysfunction may contribute to the onset of depression or may exacerbate existing depressive disorders. PMID- 3288222 TI - A long-term prospective study of the use of methotrexate in rheumatoid arthritis. Update after a mean of fifty-three months. AB - Twenty-five patients have completed a mean of 53 months of treatment with methotrexate (MTX) as part of a prospective study of the long-term safety and efficacy of the drug. Since the time of the last report (at a mean of 29 months), the mean dosage of MTX has increased from 12.4 mg/week to 14.6 mg/week, whereas the mean prednisone dosage has decreased from a baseline of 7.1 mg/day to 1.9 mg/day. A significant improvement from baseline in all clinical parameters tested was maintained, and response to therapy did not vary significantly between the assessment at 29 months and that at 53 months. Toxic reactions were as common during months 30-53 as during the first 29 months of the study, with patterns of toxic reactions remaining consistent within each patient. Radiologic evidence of disease progression was not seen before 24 months of MTX treatment, but after this time, it was observed in some patients. We conclude that many clinical features of long-term MTX therapy are distinctly different from what might have been expected after the short-term trials. PMID- 3288224 TI - Inside the national office. Governmental Affairs Department. PMID- 3288223 TI - The use of methotrexate in steroid-resistant systemic lupus erythematosus. AB - Although the use of methotrexate (MTX) is gaining acceptance in the treatment of several connective tissue diseases, there is little evidence of its therapeutic value in systemic lupus erythematosus (SLE). We examined the response to MTX in patients with steroid-resistant SLE in an open, unblinded study. Of 10 SLE patients treated with MTX (7.5 mg/weekly), 7 showed improvement. The other 3 stopped therapy because of lack of response or because of side effects. Improvements were noted within 3 months in responding patients. These promising observations suggest that controlled studies of MTX for the treatment of SLE are justified. PMID- 3288225 TI - Status report on undergraduate education in communication sciences and disorders. PMID- 3288226 TI - Interactions of triiodothyronine, insulin and dexamethasone on the binding of human LDL to rat hepatocytes in monolayer culture. AB - Rat hepatocytes were maintained for the first 24 h in culture in the presence of 10% (v/v) newborn calf serum and then for a further 16 h in serum-free medium containing 2 g bovine serum albumin per litre. The presence of 1-100 nM triiodothyronine (T3) in the second incubation significantly increased binding of human 125I-LDL to the LDL receptor. Unlike insulin, T3 was unable to reverse the decrease in binding brought about by dexamethasone. The increased binding to the LDL receptor produced by insulin and T3 was additive. We conclude that T3, insulin and glucocorticoids may play important roles in regulating plasma LDL concentrations by direct effect on LDL uptake by the liver. PMID- 3288227 TI - Testing a mechanism of control in human cholesterol metabolism: relation of arginine and glycine to insulin and glucagon. AB - Eight men were given 2 casein meals, one with and one without a supplement of arginine and glycine, to measure the effect on plasma amino acids, insulin and glucagon. Supplementation resulted in increased levels of plasma glucagon, glycine and arginine, a tendency to decreased insulin and significantly lower insulin/glucagon ratio, tryptophan and tyrosine. The data suggest that insulin and glucagon, which control cholesterol metabolism, respond to dietary and postprandial plasma amino acid levels of arginine and glycine. PMID- 3288228 TI - The impact of dental conditions on social functioning and the quality of life. PMID- 3288229 TI - A general overview of Mantel-Haenszel methods: applications and recent developments. PMID- 3288230 TI - Preventing cigarette smoking among school children. AB - Research to develop and ensure diffusion of smoking prevention programs must (a) be based on an appreciation of the social, psychological, and biological determinants at each stage in the onset process, (b) disentangle major interactions between program content, participant, provider, and setting factors as they determine impact, and (c) ensure both that diffusion is based on empirically grounded principles and that the process is monitored and its effectiveness evaluated. Sufficient evidence supports the tentative conclusion that social influence curricula can be efficacious--at least with some youth. However, we lack key information for diffusion, in particular concerning provider and setting factors. Thus, a cautious advance to diffusion research is recommended, noting that there is much we do not know, and that the public health need for applications must be balanced with continuing research to clarify for whom and under what circumstances current curricula work. At the same time, there should be strong continuing research to improve current interventions, especially for high risk populations. PMID- 3288231 TI - Viral vaccines and antivirals: current use and future prospects. AB - The evolution of viral vaccines from the time of Jennerian prophylaxis to today's recombinant technology has been a continuing story of success. From the relatively crude or "first generation" vaccines for smallpox, rabies, and yellow fever followed a second and third generation of improved or new viral vaccines. The application of techniques for attenuating, inactivating, and partially purifying candidate viruses yielded safe, effective vaccines against influenza, poliomyelitis, measles, mumps, and rubella. With the advent of effective national immunization programs in the United States and other areas of the world to promote wide scale use of these vaccines, we have seen a dramatic decrease in incidence of the viral infections of childhood. The new biotechnology serves as the cornerstone for a fourth generation of vaccines and has already provided a licensed recombinant yeast human hepatitis B vaccine. The prospects for a wide spectrum of new or improved vaccines are highly encouraging, not only because of the recent technical advances but also because vaccine development has been recognized as a priority area of research. Under the National Institute of Allergy and Infectious Diseases' Program for Accelerated Development of New Vaccines, support is being provided for developmental vaccine studies with hepatitis A and B, influenza A and B, rabies, rotavirus, varicella, and respiratory syncytial virus (53). The outlook for antivirals is equally optimistic. The same technologies that have provided greater insight into the genetics and molecular biology of viruses and hence the means to fashion subunit or even synthetic vaccines have yielded data that can be applied to successful development of targeted antiviral compounds. PMID- 3288232 TI - Early detection of cancer: an overview. PMID- 3288233 TI - Organic solvent neurotoxicity. PMID- 3288234 TI - A public health approach to the prevention of alcohol-related health problems. PMID- 3288235 TI - Hazards for health care workers. PMID- 3288236 TI - Health promotion and patient education benefits for employees. AB - One step that employers can take to assure that employees receive such education services is pursuing coverage of education as a separate service. For some time now, insurers have shown interest in patient education services (15-17, 61), but patient education "integral to care" is typically covered only as a part of the "per diem" in the case of hospitals or as part of the visit fee in the case of outpatient visits. Education for patients with diabetes is being covered experimentally as a separate service in at least 17 states. Physicians whose practice is composed largely of "cognitive services" rather than "procedures" are also interested in education as a reimbursable service. The same arguments as described in relation to coverage of risk reduction services generally apply to this case. Education programs for employees who are under medical care can improve their adherence to the recommended regimen and hence can improve the effectiveness of care. Education and counseling prior to surgical and other stressful procedures decrease stress and the need for pain medications, and they can shorten the length of hospital stays. Education is an important component of programs to substitute home care for hospital care or expensive outpatient care. Currently, however, a patient cannot rely on usual providers of medical care to offer adequate education. Reimbursement for patient education on a selected, experimental basis is probably warranted for chronic conditions requiring complex adjustments and regimens. Cases of asthma where there is a history of hospitalization or emergency room visits is an excellent possibility. The experience of covering diabetes education should be monitored to help resolve the debate. PMID- 3288238 TI - Health-related physical fitness in childhood: status and recommendations. PMID- 3288237 TI - Infant mortality in socially vulnerable populations. PMID- 3288239 TI - Models for exposure-time-response relationships with applications to cancer epidemiology. PMID- 3288240 TI - Health hazards of passive smoking. AB - "Environmental tobacco smoke" (ETS) is the term used to characterize tobacco combustion products inhaled by nonsmokers in the proximity of burning tobacco. Over 3800 compounds are in tobacco smoke, many of which are known carcinogens. Most ETS exposure is from sidestream smoke emitted from the burning tip of the cigarette. Sidestream smoke is hazardous because it contains high concentrations of ammonia, benzene, nicotine, carbon monoxide, and many carcinogens. Nonsmokers chronically exposed to ETS are believed to assume health risks similar to those of a light smoker. Children of parents who smoke have more respiratory infections, more hospitalizations for bronchitis and pneumonia, and a smaller rate of increase in lung function compared to children of parents who do not smoke, particularly during the first year of life. Among adults with preexisting health conditions such as allergies, chronic lung conditions, and angina, the symptoms of these conditions are exacerbated by exposure to ETS. The acute health effects among healthy adults include headaches, nausea, and irritation of the eyes and nasal mucous membranes. The evidence for a relationship between ETS and cancer at sites other than lung is insufficient to draw any positive conclusions. For lung cancer, studies have consistently shown an excess risk between 10% and 300%, with a summary relative risk of 1.3 (95% confidence interval = 1.1-1.5). A dose-response relation is suggested but difficult to assess completely. Histologic types of lung cancer are generally similar to those most closely associated with active smoking, although other histologic types have also been found. Both excess relative risks and the dose responses are underestimates of the true excess risk and of the range of dose-response effect. Although the temporal relationship between exposure and disease occurrence is established, many questions are unanswered. The findings are consistent with many known biologic effects of active smoking and are partially analogous to the biologic effects of direct smoke inhalation. As many as 5000 nonsmokers are estimated to die annually from lung cancer as a result of exposure to ETS. There is great potential for prevention of these premature deaths. The two major preventive actions are (a) eliminating the source by reducing the amount of direct smoking and (b) limiting the level of exposure by restricting where tobacco can be smoked. Specific preventive actions include smoking cessation, smoking prevention, restriction of advertising, increased taxation on tobacco, and adoption of stringent nonsmoking policies in the workplace, schools, and public places.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3288241 TI - Vaccines for parasitic diseases. PMID- 3288242 TI - Hunger in America. PMID- 3288243 TI - The AIDS epidemic: six years. PMID- 3288244 TI - Alcohol and residential, recreational, and occupational injuries: a review of the epidemiologic evidence. PMID- 3288245 TI - Effect of ice on bruising at cardiac catheter insertion sites (brachial approach). PMID- 3288246 TI - Management of spasticity. AB - The functional impairment due to spasticity must be carefully assessed before any treatment is considered. Therapeutic intervention is best individualized to a particular patient. Basic principles of treatment to ameliorate spastic hypertonia are: 1) avoid noxious stimuli and 2) provide frequent range of motion. Therapeutic exercise, cold or topical anesthesia may decrease reflex activity for short periods of time in order to facilitate minimal motor function. Casting and splinting techniques are extremely valuable to extend joint range diminished by hypertonicity. Baclofen, diazepam and dantrolene remain the three most commonly used pharmacologic agents in the treatment of spastic hypertonia. Baclofen is generally the drug of choice for spinal cord types of spasticity, while sodium dantrolene is the only agent which acts directly on muscle tissue. Phenytoin with chlorpromazine may be potentially useful if sedation does not limit their use. Tizanidine and ketazolam, not yet available in the United States, may be significant additions to the pharmacologic armamentarium. Intrathecal administration of antispastic medications allows high concentrations of drug near the site of action, which limits side effects. This form of treatment is the most exciting recent development in the treatment of spastic hypertonia. Peripheral electrical stimulation may have limited use in diminishing tone and facilitating paretic muscles. Dorsal column stimulation via electrodes within the spinal column was initially hailed as a therapeutic advance, but has subsequently been shown to be minimally effective. Phenol injections provide a valuable transition between short-term and long-term treatments and offer remediation of hypertonia in selected muscle groups. Tenotomies and tendon transfers offer significant benefit in carefully chosen patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288247 TI - Some new, simple and efficient stereological methods and their use in pathological research and diagnosis. AB - Stereology is a set of simple and efficient methods for quantitation of three dimensional microscopic structures which is specifically tuned to provide reliable data from sections. Within the last few years, a number of new methods has been developed which are of special interest to pathologists. Methods for estimating the volume, surface area and length of any structure are described in this review. The principles on which stereology is based and the necessary sampling procedures are described and illustrated with examples. The necessary equipment, the measurements, and the calculations are invariably simple and easy. PMID- 3288248 TI - Extracellular matrices in multicellular spheroids of human glioma origin: increased incorporation of proteoglycans and fibronectin as compared to monolayer cultures. AB - Tumor spheroids were cultured from five human glioma cell lines which differed considerably in their relative amount and composition of glycosaminoglycans (GAG), fibronectin and other extracellular matrix (ECM) components when grown as monolayer cultures. These differences were also evident when the cells were grown as spheroids. Under the 3-dimensional geometry of the spheroid system, there was, however, generally a more extensive ECM. Especially noteworthy was the presence of a small proteoglycan, probably a dermatan sulphate proteoglycan, in the ECM of the spheroids, but not in the monolayers. Noteworthy was also the appearance of fibronectin in spheroids which did not show any staining for fibronectin when grown as monolayer. The two spheroid types (U-87MG, U-105MG) with the most extensive matrix, and with the lowest proportion of hyaluronic acid (HA), had a low proliferation rate, whereas the three other spheroid types (U-118MG, U-138MG, U-251MG) with a less extensive ECM, and a relatively high production of HA had a much higher proliferation rate. These data provide further evidence for the usefulness of culturing cell lines as spheroids in the process of understanding important cell biological phenomena. PMID- 3288249 TI - Comparative analysis of two blood culture systems (Isolator and a 12-tube system) by cumulative differences in detection power at different times during incubation. AB - A lysis-centrifugation blood culture system (Isolator) and a conventional system (4 tubes of nutrient broth, 4 tubes of semisolid agar, and 4 tubes of thioglycollate agar) were compared after different lengths of incubation by cumulative scoring of differences in detection power. After the first half day of incubation, the Isolator system was already significantly faster in detecting isolates of clinical significance (15 vs. 4, P = 0.02). Maximum difference in first or only detection system was seen after two days of incubation and was based on an overall superior detection of Staphylococcus aureus (11 vs. 0, P = 0.001), and an earlier detection of Enterobacteriaceae (30 vs. 13, P = 0.01) in the Isolator system. On the contrary, the detection of Streptococcus pneumoniae was significantly inferior in the Isolator system (0 vs. 10, P = 0.002). The earlier finding of clinically significant microorganisms in the Isolator system certainly contributes to good patient-care. A drawback of the Isolator system was the finding of clinically insignificant coagulase-negative staphylococci in 11%, compared with 1% in the conventional system. This led to a considerable waste of time and materials in the laboratory. The comparison of the two blood culture systems, based on statistical analysis of cumulative differences in detection power, expressed as the earliest or only findings, gives the optimal information, and is in our opinion the clinically most relevant comparison. PMID- 3288250 TI - Dietary antigens: uptake and humoral immunity in man. AB - This thesis is based on 9 papers on the uptake of dietary antigens and on the humoral immune responses to dietary antigens, in healthy subjects and in patients with coeliac disease or atopic eczema. Work in experimental animals have indicated that dietary antigens are taken up in amounts, which are nutritionally insignificant, but may be of immunological importance. Local or systemic antibodies may retard the uptake, but in addition may increase the uptake of unrelated antigens. In humans the uptake of intact dietary antigen, free or in immune complexes, was reported in studies in healthy subjects and in patients with immune deficiency or atopy. We investigated the uptake of dietary antigen in 8 healthy subjects after a test meal, using ELISA methods and high performance liquid chromatography (HPLC) for the fractionation of serum samples. A significant finding was that ovalbumin (OA) was taken up as intact antigen or as a high MW immune complex constituent in all the 8 subjects. IgG was the only isotype demonstrable in the OA-containing aggregates, which were detected in particular in the subjects with high anti-OA antibody levels. The antigen was measurable in serum in up to 48 h after the meal. We studied with the same methods the uptake of OA and beta-lactoglobulin (BLG) in children with coeliac disease on a gluten-free diet and after gluten challenge, and in controls with a normal gut mucosa. Both OA and BLG was mostly present in high MW fractions of the sera, presumably as immune complexes. The levels of antigens in serum did not differ between the children with coeliac disease and the controls. However, in 4/5 coeliac children the uptake of both antigens was increased after gluten challenge, indicating increased antigen uptake in coeliac disease. Increased gut permeability has been suggested as a pathogenic factor in food allergy. At present, there is in this condition no direct evidence for altered uptake of dietary antigens. Dietary antigens have been detected in the mother's milk and may be important for the development of normal immunity to dietary antigens and in particular of cow's milk allergy in the infant. Antibodies to dietary antigens have previously been detected in a major proportion of healthy subjects. In a limited number of sera from normals, analysed by electrophoretic techniques, we detected antibodies to bovine serum albumin and OA predominantly in the IgG class. Interestingly, these antibodies were restricted to the IgG subclasses IgG1, IgG2 and IgG4.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3288252 TI - Are there limitations to shortening dialysis treatment? PMID- 3288251 TI - Effect of enterotoxigenic Escherichia coli heat stable toxin on intestinal lysosomal enzymes in the suckling rat. AB - A preliminary study on 9 suckling Wistar rats, which received E. coli stable toxin, and on 12 sham-operated controls showed that acid phosphatase, the marker enzyme for lysosome, was significantly increased in the infected group whereas alkaline phosphatase, glucose 6-phosphatase, succinic dehydrogenase, and proteinase, the marker enzymes for brush border, microsome, mitochondria, and the soluble fraction, respectively, remained unaffected. The results suggest that lysosome, the subcellular organelle responsible for intracellular digestion could be modified by E. coli stable toxin. In another set of experiments, where 7 infected suckling rats and 7 sham-operated controls were used, the maximal activities of lysosomal enzymes (released by Triton X-100) were found to be increased in the infected group confirming the results obtained in the preliminary experiment. The values of the ratio between maximal and basal activity (an expression of the degree of retention of enzymes to lysosome) of acid phosphatase and cathepsin D were also significantly increased, indicating that lysosomal membrane may also be stabilized during the infection. The increased activities of lysosomal enzymes and the increased lysosomal membrane stability suggest that intracellular digestion by lysosome could be increased during E. coli stable toxin infection. PMID- 3288253 TI - Present status of human cardiac allografts and prospects for xenografts. AB - Cardiac allotransplantation is no longer experimental. It is the standard by which all other methods of cardiac replacement must be judged. The dramatic improvement in survival and the quality of life of cardiac transplant recipients reflects many factors including refined criteria for patient and donor selection, as well as the clinical introduction of cyclosporine. Current contraindications to the procedure include: 1) age greater than 65 years, 2) active infection, 3) active malignant neoplastic disease, 4) recent pulmonary embolus or infarction, 5) irreversible renal or hepatic failure, and 6) fixed elevation of pulmonary vascular resistance. The introduction of cyclosporine has been accompanied by an increase in the 1 year survival. While the use of cyclosporine has not decreased the incidence of rejection episodes, it has dramatically decreased their severity. In addition, the incidence and severity of infectious complications, as well as the length of hospitalization, have been decreased with the introduction of cyclosporine. Despite the progress made, several problems remain in the management of transplant recipients. Chronic cyclosporine therapy has been associated with a disturbingly high incidence of hypertension and renal impairment, and a low, yet significant, incidence of malignant neoplasms. However, the most significant obstacle to successful clinical cardiac transplantation is the scarcity of donor organs. Many centers now report that the mortality rate for patients awaiting transplantation exceeds the mortality associated with the procedure itself. Donor scarcity has led to renewed interest in the development of mechanical cardiac devices and investigation into cross species transplantation (xenotransplantation). PMID- 3288254 TI - Acute respiratory failure. On how to injure healthy lungs (and prevent sick lungs from recovering). PMID- 3288255 TI - Single catheter veno-venous membrane lung bypass in the treatment of experimental ARDS. PMID- 3288256 TI - Neonatal ECMO. PMID- 3288257 TI - Continuous arteriovenous hemofiltration for acute renal failure. PMID- 3288258 TI - Evaluation of salmon calcitonin treatment in bone metastases from breast cancer- a controlled trial. AB - Salmon calcitonin 100 MRCU/day or a saline placebo were given in daily injections for at least three months to 49 patients with bone metastases from breast cancer in a randomized double-blind trial. All patients were normocalcemic, and most patients had stable or regressing disease at start of trial. No improvement in general performance or bone pain was detected as measured by a visual analogue scale, the daily duration of pain or consumption of analgetic drugs. Calcitonin had no effect on disease progression as judged by bone scans and radiographs. Calcitonin therapy did not affect serum calcium, alkaline phosphatase, bone gla protein, or the urinary excretion of calcium and hydroxyproline. Serum phosphate and magnesium decreased significantly during calcitonin treatment (p = 0.01, and 0.00005, respectively). It was concluded that salmon calcitonin in this dosage has no discernible effect on skeletal pain, general performance, bone metabolism or disease progression in patients with breast cancer metastatic to bone. A significant decrease in serum phosphate and magnesium probably indicated an effect of calcitonin on the renal excretion of these ions. PMID- 3288259 TI - 'An unusual fracture of a denture clasp due to contact with liquid mercury'. PMID- 3288260 TI - Pycnodysostosis. A review of reported dental abnormalities and a report of the dental findings in two cases. PMID- 3288261 TI - Impression materials. PMID- 3288262 TI - New non-invasive methods for measuring gastric emptying. PMID- 3288263 TI - Anaesthesia for isolated lung transplantation. AB - The anaesthetic management of a patient undergoing successful, left-sided orthotopic single lung transplantation is presented. Problems, specific to the operation, are featured and discussed. PMID- 3288264 TI - Sixty-five and going strong! British Journal of Anaesthesia reaches another landmark. PMID- 3288265 TI - The physics of lasers and implications for their use during airway surgery. PMID- 3288266 TI - Host defence mechanisms in the bladder. I. Role of mechanical factors. AB - This study evaluated the contribution of host defence mechanisms to bacterial clearance from the urinary bladder using an animal model in which rats were infected with Escherichia coli. Factors studied included the effect of hydration status, induced ultrastructural changes to the surface of the bladder mucosa, and the relevance of bacterial replication. Clearance was divided into two phases, primary (0-4 h), and secondary (4-24 h). Ninety-nine per cent of Escherichia coli 075 was cleared during the primary phase from normal, dehydrated and polyuric animals and 93% from anuric animals. Clearance was shown to be dependent on the presence of viable tissue. Bacterial numbers continued to decrease during the secondary phase in normal and dehydrated animals but increased in polyuric and anuric groups. No such rise occurred when rats were inoculated with Escherichia coli E/2/64, a non-replicating mutant. Evidence of ultrastructural changes to the bladder associated with impaired antibacterial properties was found in polyuric and anuric animals. Clearance of particulate matter (killed Candida albicans) however was unaffected by mucus disruption. The study has shown that the clearance of microorganisms from the bladder was unrelated to the voided volume, but is closely associated with the antibacterial activity of the mucosal surface. PMID- 3288267 TI - A monoclonal antibody (anti-L-35) which reacts with human osteoclasts and cells of the mononuclear phagocyte system. AB - The immunohistochemical reactivity of a monoclonal antibody, anti-L-35, on a wide range of tissues is described. Anti-L-35 showed a high specificity for known and presumptive cells of the mononuclear phagocyte system including monocytes, sinus histiocytes, tangible body macrophages, interdigitating reticulum cells, Kupffer cells, alveolar macrophages, microglia, synoviocytes and Langerhans cells. Anti-L 35 also stained osteoclasts in fetal and adult bone including osteoclast-like giant cells of the giant-cell tumour of bone. Anti-L-35 did not react with any other cell type in the tissues screened apart from renal proximal tubular epithelium and megakaryocytes. This study has shown that L-35 is not restricted to activated T-cells, as previously reported, and provides further immunohistochemical evidence that monocytes, macrophages and osteoclasts contain common cellular antigens. PMID- 3288268 TI - Effects of topical corticosteroid therapy on Langerhans cell antigen presenting function in human skin. AB - We have investigated the mechanisms by which topical corticosteroids modulate cutaneous immune reactions in man. Volunteers applied clobetasone butyrate 0.05% (Eumovate; EV), betamethasone valerate 0.1% (Betnovate; BV), clobetasol propionate 0.05% (Dermovate; DV), and control vehicles twice daily to forearm skin for 7 days. Steroid therapy significantly decreased the number of HLA-DR/T6 (CD1a) positive Langerhans cells (LCs) per mm2 in suction blister-derived epidermal sheets, expressed as a mean percentage of controls, as follows: EV 69.2%; BV 67.3%; DV 37.8%. LC antigen presenting capacity was determined in the allogeneic and autologous epidermal cell-lymphocyte reactions. The LC-dependent allostimulatory capacity of epidermal cells, expressed as a mean percentage of controls, was also significantly reduced by steroid therapy: EV 45.1%; BV 41.9%; DV 23.4%. Following therapy with clobetasol propionate 0.05%, the capacity of epidermal cells to present tetanus toxoid to, and to augment concanavalin A mediated lymphocyte stimulation of, autologous lymphocytes was reduced to 33.6% and 19.7% respectively of controls. Depression of epidermal cell allostimulatory capacity was not the result of a steroid-induced decrease in the production of epidermal cell-derived thymocyte activating factor (ETAF)/interleukin 1 by keratinocytes, since it could not be reversed by addition of exogenous interleukin 1. Indomethacin, added to block any potential prostaglandin synthesis during the culture period, did not restore the allostimulatory capacity of epidermal cells from steroid-treated sites. Addition of epidermal cells from DV treated sites depressed the capacity of control epidermal cells to stimulate lymphocytes in the allogeneic epidermal-lymphocyte reaction. Our results demonstrate that the anti-inflammatory action of topical corticosteroids in man is associated not only with a reduction in the number of HLA-DR/T6 positive LCs, but also with a marked decrease in Langerhans cell-dependent T lymphocyte activation. The effects of the different steroids on both of these parameters correlated with their potency as determined in the standard occlusive vasoconstrictor assay. Topical corticosteroids are widely used for the treatment of inflammatory skin disorders, and inhibit not only the elicitation phase, but also the induction phase, of allergic contact dermatitis reactions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3288269 TI - Obituary. Dr G. A. Grant Peterkin. PMID- 3288270 TI - Cytoskeleton organization of normal and neoplastic lymphocytes and lymphoid cell lines of T and B origin. AB - An anomalous organization of the cytoskeleton has been described in lymphocytes from chronic lymphatic leukaemia and in only few cell lines. We have now studied normal and neoplastic lymphocytes and lymphoid cell lines of both T and B lineage in order to detect morphological differences in the expression of microfilaments and intermediate filaments. Microfilaments appear to be well expressed by all the B cells, whereas a rich network of intermediate filaments is present in T cells and plasma cells. Most prominent changes occur in the latter system, which is almost lacking in cells of B chronic lymphatic and hairy cell leukaemia. Although the significance of the present findings is not yet clear, one might speculate that such alterations account for some of the aberrant functions and peculiar biologic properties of neoplastic lymphocytes. PMID- 3288271 TI - Differential phthalocyanine photosensitization of acute myeloblastic leukaemia progenitor cells: a potential purging technique for autologous bone marrow transplantation. AB - The potential value of sulphonated aluminium phthalocyanine (AISPc) as a purging agent for bone marrow autografts in acute myeloblastic leukaemia (AML) has been studied using in vitro clonogenic assays for normal (GM-CFC) and leukaemic (AML CFC) progenitor cells. In nine out of 13 cases, the leukaemic blasts were found to be highly sensitive to AISPc. In six of the sensitive cases clonogenic assays revealed that only 2 +/- 1% of AML progenitor cells survived AISPc treatment under conditions which permitted a GM-CFC recovery of 60 +/- 11%. AISPc photosensitization was also shown to selectively eliminate the leukaemic cell line K562 from an in vitro model of minimal residual disease. Thus photosensitization using AISPc may be an effective method of purging marrow autografts in some cases of AML. Evaluation of the sensitivity of AML clonogenic cells at diagnosis may identify those patients in whom AISPc photo-purging may be of benefit at the time of an autologous bone marrow transplant. PMID- 3288272 TI - TdT positive B-cell acute lymphoblastic leukaemia (B-ALL) without Burkitt characteristics. AB - The leukaemic cells in a 23-year-old man were small to medium-sized lymphoblasts with no cytoplasmic vacuoles and negative with PAS as well with peroxidase and acid phosphatase staining. Cytogenetic analysis showed -6, +12, -22, +mar (6p::22q), resulting in a trisomy 12 and monosomy of the long arm of chromosome 6. Immunological marker analysis revealed that the majority of the blasts was positive for terminal deoxynucleotidyl transferase (TdT) as well as surface membrane immunoglobulin (SmIg, mu, lambda), although B-ALL are supposed to be negative for TdT. The blasts were also positive for HLA-DR, CD9 (BA-2), CD10 (VIL A1) and CD24 (BA-1), but negative for the B-cell markers CD20 (B1) and Y29/55. Double immunofluorescence staining confirmed that almost all TdT+ cells were also positive for Sm mu, Sm lambda, HLA-DR and CD10. We thus made a diagnosis of TdT+ B-ALL without Burkitt characteristics. Since we could not detect SmIg+/TdT+ cells in bone marrow samples from adult healthy volunteers and from 10 children with ALL in complete remission, we conclude that TdT+ B-ALL cells may not have a normal counterpart in bone marrow or represent a malignant counterpart of a very rare cell in an intermediate differentiation stage between the pre-B-cell and the early B lymphocyte. PMID- 3288273 TI - Increased levels of platelet associated IgG in patients with thrombocytopenia are not confined to any particular size class of platelets. AB - Patients with immune thrombocytopenia have an increased percentage of microthrombocytes/platelet fragments and megathrombocytes. It has been suggested that increased levels of platelet associated IgG (PA-IgG) found in these patients might be related to the presence of this abnormal platelet size distribution. In this study we used flow cytometry to investigate the distribution of PA-IgG within a population of platelets and, in particular, we examined the relationship between platelet size and PA-IgG determined simultaneously on individual platelets. Platelet samples from 10 normals and 31 thrombocytopenic patients were studied. PA-IgG was estimated using immunofluorescent FITC anti-IgG antibody. Binding of FITC anti-IgG to the platelets was quantitated in the flow cytometer as relative mean fluorescence (RMF) which was calibrated against values (in fg/plt of FITC anti-IgG) obtained by spectrofluorometry after solubilization of the platelets. A high correlation (r = 0.89) was found between flow cytometric RMF value and spectrofluorometric FITC anti-IgG values. The flow cytometric studies showed that platelet samples with abnormally elevated levels of FITC anti IgG (greater than 1.7 fg/plt) not only have a higher percentage of platelets with elevated FITC anti-IgG, but that these platelets also have increased levels of FITC anti-IgG as compared to platelets from normal samples. Platelet size was measured by the amount of forward light scatter in the flow cytometer. A low but significant correlation (r = 0.33 +/- 0.12) was found between size (FALS) and fluorescent signals in samples with elevated FITC anti-IgG. The contribution of 10% of the smallest platelets by FALS and 10% of the largest platelets by FALS to the total levels of flow cytometer platelet fluorescence in these samples was only 4.4% and 19.4% respectively which was not higher than obtained with samples with normal levels of FITC anti-IgG. In conclusion, this study showed that increased levels of PA-IgG found among thrombocytopenic patients were not confined to any particular size class of platelets. PMID- 3288274 TI - Hand-arm vibration syndrome: a new clinical classification and an updated British standard guide for hand transmitted vibration. PMID- 3288275 TI - Is smallpox a hazard in church crypts? PMID- 3288276 TI - Familial uveal melanoma. AB - The cause of uveal melanoma is unknown. In a few cases, however, factors are found in association with the disease which may play some part in the aetiology. One such factor is inheritance. Twelve families have been reported with adequate documentation during the last century in which two or more members have had uveal melanomas. At least some of these may be the result of an inherited disorder. On available data inheritance is most likely autosomal dominant with partial expressivity or incomplete penetrance. This report describes two more families each of which have two members with uveal melanomas. PMID- 3288277 TI - Bilateral ocular disease as the initial presentation of malignant lymphoma. AB - Malignant lymphocytic lymphoma rarely involves the eye. In two patients we found ocular signs and symptoms as the initial presentation of systemic disease. In the first patient periorbital swelling and ptosis of one year's duration ultimately proved to be the result of malignant lymphoma. After resolution of swelling and ptosis with chemotherapy, the patient returned with diffuse iris involvement and uveitis with a hypopyon. In the second patient an acute change of refractive error proved to be the result of a lymphomatous deposit in the choroid. In both instances common symptoms were the initial manifestations of a diffuse malignant disease. PMID- 3288278 TI - Site-directed mutagenesis of the T4 endonuclease V gene: role of tyrosine-129 and -131 in pyrimidine dimer-specific binding. AB - T4 endonuclease V incises DNA at the sites of pyrimidine dimers through a two step mechanism. These breakage reactions are preceded by the scanning of nontarget DNA and binding to pyrimidine dimers. In analogy to the synthetic tripeptides Lys-Trp-Lys and Lys-Tyr-Lys, which have been shown to be capable of producing single-strand scissions in DNA containing apurinic sites, endonuclease V has the amino acid sequence Trp-Tyr-Lys-Tyr-Tyr (128-132). Site-directed mutagenesis of the endonuclease V gene, denV, was performed at the Tyr-129 and at the Tyr-129 and Tyr-131 positions in order to convert the Tyr residues to nonaromatic amino acids to test their role in dimer-specific binding. The UV survival of repair-deficient (uvrA recA) Escherichia coli cells harboring the denV N-129 construction was dramatically reduced relative to wild-type denV+ cells. The survival of denV N-129,131 cells was indistinguishable from that of the parental strain lacking the denV gene. The mutant endonuclease V proteins were then characterized with regard to (1) dimer-specific nicking activity, (2) apurinic nicking activity, and (3) binding affinity to UV-irradiated DNA. Dimer specific nicking activity and dimer-specific binding for both denV N-129 and N 129,131 were abolished, while apurinic-specific nicking was substantially retained in denV N-129,131 but was abolished in denV N-129. These results indicate that Tyr-129 and Tyr-131 positions of endonuclease V are at least important in pyrimidine dimer-specific binding and possibly nicking activity. PMID- 3288279 TI - Purification and organization of the gene 1 portal protein required for phage P22 DNA packaging. AB - The gene 1 protein of Salmonella bacteriophage P22 is located at the DNA packaging vertex of the mature particle. The protein is incorporated into the procapsid shell during shell assembly and is required for DNA packaging. The unassembled precursor form of the gene 1 protein has been purified from cells infected with mutants blocked in procapsid assembly. The purified 90,000-dalton protein was dimeric or monomeric; upon storage in the cold it formed 20S cyclic dodecamers. Computer filtering of negatively stained electron micrographs revealed 12 arms and knobs projecting from a central ring, with a 30-A channel at the center. Similar dodecameric rings were released from disrupted procapsid shells. These results indicate that the gene 1 protein is organized as a cyclic dodecamer within the procapsid shell and serves as the portal through which P22 DNA is threaded during DNA packaging. The presence of a 12-fold ring located at a 5-fold portal vertex appears to be a conserved structural theme of the DNA packaging apparatus of double-stranded DNA phages. PMID- 3288280 TI - Biosynthesis of lipid A in Escherichia coli: identification of UDP-3-O-[(R)-3 hydroxymyristoyl]-alpha-D-glucosamine as a precursor of UDP-N2,O3-bis[(R)-3 hydroxymyristoyl]-alpha-D-glucosamine. AB - The lipid A disaccharide of the Escherichia coli envelope is synthesized from the two fatty acylated glucosamine derivatives UDP-N2,O3-bis[(R)-3 hydroxytetradecanoyl]-alpha-D- glucosamine (UDP-2,3-diacyl-GlcN) and N2,O3 bis[(R)-3-hydroxytetradecanoyl]-alpha-D-glucosamine 1-phosphate (2,3-diacyl-GlcN 1-P) [Ray, B. L., Painter, G., & Raetz, C. R. H. (1984) J. Biol. Chem. 259, 4852 4859]. We have previously shown that UDP-2,3-diacyl-GlcN is generated in extracts of E. coli by fatty acylation of UDP-GlcNAc, giving UDP-3-O-[(R)-3 hydroxymyristoyl]-GlcNAc as the first intermediate, which is rapidly converted to UDP-2,3-diacyl-GlcN [Anderson, M. S., Bulawa, C. E., & Raetz, C. R. H. (1985) J. Biol. Chem. 260, 15536-15541; Anderson, M. S., & Raetz, C. R. H. (1987) J. Biol. Chem. 262, 5159-5169]. We now demonstrate a novel enzyme in the cytoplasmic fraction of E. coli, capable of deacetylating UDP-3-O-[(R)-3-hydroxymyristoyl] GlcNAc to form UDP-3-O-[(R)-3-hydroxymyristoyl]glucosamine. The covalent structure of the previously undescribed UDP-3-O-[(R)-3-hydroxymyristoyl] glucosamine intermediate was established by 1H NMR spectroscopy and fast atom bombardment mass spectrometry. This material can be made to accumulate in E. coli extracts upon incubation of UDP-3-O-[(R)-3- hydroxymyristoyl]-GlcNAc in the absence of the fatty acyl donor [(R)-3-hydroxymyristoyl]-acyl carrier protein. However, addition of the isolated deacetylation product [UDP-3-O-[(R)-3 hydroxymyristoyl] glucosamine] back to membrane-free extracts of E. coli in the presence of [(R)-3-hydroxymyristoyl]-acyl carrier protein results in rapid conversion of this compound into the more hydrophobic products UDP-2,3-diacyl GlcN, 2,3-diacyl-GlcN-1-P, and O-[2-amino-2-deoxy-N2,O3- bis[(R)-3 hydroxytetradecanoyl]-beta-D-glucopyranosyl]-(1----6)-2-amino- 2-deoxy-N2,O3 bis[(R)-3-hydroxytetradecanoyl]-alpha-D- glucopyranose 1-phosphate (tetra acyldisaccharide-1-P), demonstrating its competency as a precursor. In vitro incubations using [acetyl-3H]UDP-3-O-[(R)-3-hydroxymyristoyl]-GlcNAc confirmed release of the acetyl moiety in this system as acetate, not as some other acetyl derivative. The deacetylation reaction was inhibited by 1 mM N-ethylmaleimide, while the subsequent N-acylation reaction was not. Our observations provide strong evidence that UDP-3-O-[(R)-3-hydroxymyristoyl]glucosamine is a true intermediate in the biosynthesis of UDP-2,3-diacyl-GlcN and lipid A. PMID- 3288281 TI - The Mnt repressor of bacteriophage P22: role of C-terminal residues in operator binding and tetramer formation. AB - A set of C-terminal deletion mutants of the Mnt repressor of bacteriophage P22 has been constructed, and the corresponding truncated proteins have been purified. A truncated protein lacking the three C-terminal residues, Lys80-Thr81 Thr82, binds operator DNA with an affinity near wild type and has a normal tetrameric structure. Loss of the next residue, Lys79, causes a 600-fold decrease in operator affinity, but the truncated protein is still tetrameric. Further sequential deletions of Tyr78 and Leu77 cause modest decreases in operator affinity, but the truncated proteins are now dimeric. These results indicate that Lys79 is an important determinant of the high affinity of Mnt repressor for operator DNA and that Tyr78 is an important determinant of tetramer formation by Mnt repressor. PMID- 3288282 TI - NMR assignments of the four histidines of staphylococcal nuclease in native and denatured states. AB - NMR signals from all four histidine ring C epsilon protons and three of the four histidine C delta protons in the protein staphylococcal nuclease have been assigned by comparing spectra of the wild-type (Foggi strain) protein to spectra of three variants that each lack a different histidine residue. All proteins studied were cloned and overproduced in Escherichia coli. The NMR spectra of the three mutant proteins (H8R, H46Y, and H124L) used to make these assignments were similar to one another and to those of the wild type, except for signals from the mutated residues. The pKa values of those histidines conserved between the wild type and the mutants remained essentially unchanged. Multiple histidine C epsilon proton resonances due to non-native forms of nuclease were observed in both thermally induced and acid-induced unfolding. Residue-specific assignments of H epsilon protons in the thermally denatured forms of the mutant H46Y were obtained from connectivities to the native state by saturation transfer. PMID- 3288283 TI - Inactivation of Escherichia coli pyruvate formate-lyase by hypophosphite: evidence for a rate-limiting phosphorus-hydrogen bond cleavage. AB - Recently, Knappe and co-workers [Knappe, J., Neugebauer, F. A., Blaschkowski, H. P., & Ganzler, M. (1984) Proc. Natl. Acad. Sci. U.S.A. 81, 1332] have shown that the catalytically active form of pyruvate formate-lyase from Escherichia coli is associated with a protein-bound organic free radical which is quenched upon enzyme inactivation by oxygen or hypophosphite. Our interest in the chemical mechanism of this unusual enzymatic reaction has led us to investigate several key aspects of the inactivation of the lyase by hypophosphite and its relationship to the normal enzymatic reaction. We report here that the inactivation of both the free and acetylated forms of the lyase is subject to a primary kinetic isotope effect using [2H2]hypophosphite. This suggests that phosphorus-hydrogen bond cleavage is at least partially rate limiting during inactivation. In addition, the inactivated enzyme can be fully reactivated. We have also determined a Vmax/Km isotope effect of 3.6 +/- 0.7 for pyruvate formation from [2H]formate and acetyl coenzyme A. Thus, carbon-hydrogen bond cleavage is partially rate limiting in the normal reverse reaction. On the basis of our findings, the previous work of Knappe and co-workers, the likelihood that hypophosphite is a formate analogue, the known susceptibility of both hypophosphite and formate to homolysis, and a chemical precedent for homolytic cleavage of pyruvate, we offer a preliminary mechanistic proposal for the lyase reaction. PMID- 3288284 TI - Plasminogen activator activities in the developing rat prostate. AB - Plasminogen activator (PA) activities were measured in the rat prostatic complex and individual prostatic lobes during early postnatal and pubertal development and in sexually mature adult rats. There was no significant change in PA activity during postnatal prostate development. However, during sexual maturation with puberty, there was a decline in PA activity in the ventral (3-fold), dorsolateral (22-fold), and anterior (19-fold) prostate lobes when activity was expressed per unit protein. A decrease in activity of 25- and 11-fold was found for the dorsolateral and anterior lobes, respectively, when activity was expressed per unit DNA. There was no change in activity in the ventral lobe. The adult ventral prostate (and its secretion) have 3 broad bands of low molecular mass (approximately 23 and 26-32 kDa) plasminogen-independent protease activities. Proteases of these molecular sizes as well as an activity of 170 kDa were detected in the dorsolateral prostate. The former proteases in the ventral and dorsolateral lobes were first found at 21 days of age, whereas the 170 kDa protease was found in dorsolateral prostate immediately post-puberty (48 days). The low molecular mass plasminogen-independent proteases were also able to activate plasminogen (determined by zymography) and hence contribute to the total measured PA activity. Thus, at 21 days of age, the specific activity of plasminogen-dependent protease declined, since the total measured PA-specific activity did not change. Plasminogen-dependent activities in ventral, dorsolateral, and anterior prostate lobes of adult rats were found as doublets of approximately 57-59 kDa and 36-38 kDa.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288285 TI - Computer-assisted motor assessment of persons with disabilities to determine ability to use assistive devices. PMID- 3288286 TI - Compression of Holter ECG data. PMID- 3288287 TI - The ultrasound Doppler echocardiograph and personal computer: a clinical tool. PMID- 3288288 TI - Experimental analysis of nine tendon suture techniques. PMID- 3288289 TI - The enzymatic and mass spectrometric identification of 2-oxophytanic acid, a product of the peroxisomal oxidation of l-2-hydroxyphytanic acid. AB - A previously unreported metabolite of the mammalian phytanic acid breakdown pathway, 2-oxophytanic acid, was isolated and analysed by mass spectrometry. The metabolic origin of the 2-oxoacid is the oxidation by a rat kidney peroxisomal H2O2-generating oxidase of L-2-hydroxyphytanic acid, a well-established intermediate in phytanic acid alpha-oxidation. PMID- 3288290 TI - Molecular genetics of the HLA-D region component of inherited susceptibility to rheumatoid arthritis. PMID- 3288291 TI - Detection of anti-DNA antibodies: a comparison between two Farr assays, Crithidia luciliae and a human chromosomal substrate assay. AB - Four commercially available assays were compared with a 14C DNA Farr assay for their ability to detect anti-DNA antibodies in 119 sera from 109 patients with systemic lupus erythematosus (SLE) and 25 control sera. The 14C DNA Farr assay was the most sensitive and specific assay (SLE, 57% positive, controls, 0%). A commercial 125I DNA Farr assay was significantly less sensitive (SLE, 39% positive). The fluorescence human chromosomal preparation assay was as sensitive as the 14C DNA Farr assay (SLE, 58% positive) but less specific (controls, 8% positive). The immunofluorescence Crithidia luciliae assay was specific, but less sensitive (SLE, 37% positive) than the 14C DNA Farr assay. Adaptation of Crithidia to immunoperoxidase did not alter its sensitivity or performance. These results confirm that the 14C DNA Farr assay, locally refined and performed by experienced hands, is the most sensitive and specific assay for anti-DNA antibodies. The 125I DNA Farr was no more sensitive than the Crithidia assay but considerably more laborious. The human chromosomal preparation may be suitable as a rapid screening test for anti-DNA antibodies. PMID- 3288292 TI - Pulsed methylprednisolone in active early rheumatoid disease: a dose-ranging study. AB - A dose-ranging, double-blind study of pulsed methylprednisolone in 71 patients with active classical or definite RA is reported. Single pulses of 40 mg, 500 mg or 1 g were administered during a 24-h admission. All patients benefited transiently, but only in those who received 1 g was this prolonged beyond 3 weeks. Laboratory measurements showed no significant change in any group. Significantly more patients in the 1 g group felt the treatment worthwhile than in the other groups. The drop-out rates in the 40 mg and 500 mg groups differed significantly from that seen in the 1 g group and were such that statistical analysis beyond 3 weeks was difficult to interpret. Side-effects were mild. Three patients subsequently developed avascular necrosis, one in the 1 g and two in the 40 mg groups. The study suggests that single doses of MP below 1 g are not helpful in the management of acute RA. PMID- 3288293 TI - The effect of indomethacin on the psychomotor function of patients with rheumatic diseases. AB - We have compared the effect of single and multiple doses of indomethacin and placebo on objective measurements of psychomotor impairment in patients. Following a single 50 mg dose (n = 8), indomethacin produced psychomotor disturbance in only those patients who had no recent history of NSAID exposure. After multiple doses of indomethacin (25 and 50 mg tid for 5 days), significant psychomotor impairment was observed. We conclude that other NSAIDs may induce cross-tolerance to the psychomotor effects of indomethacin. Tachyphylaxis may develop to the psychomotor disturbance caused by indomethacin. PMID- 3288294 TI - The neuropathology of the acquired immune deficiency syndrome (AIDS). A review. AB - The nervous system has been involved in the majority (at least 75%), of cases of acquired immune deficiency syndrome (AIDS) examined postmortem, but the pathogenetic mechanisms involved are not well understood. The predominant pathological process is opportunistic infection secondary to the decrease of T helper (T4) cells and includes toxoplasmosis, encephalitis due to cytomegalovirus and progressive multifocal leucoencephalopathy. On the other hand, mycoses (mainly cryptococcosis) are relatively uncommon. Primary lymphomas are three times more common than secondary lymphoma spreading from other sites. Cerebral involvement by Kaposi sarcoma is metastatic, probably from primary foci in the lungs. Lesions due to the direct involvement of the nervous system by the human immune deficiency virus (HIV) include subacute encephalitis and vacuolar myelopathy. The former is reported with increasing frequency and is localized predominantly to the white matter in which multinucleated giant cells can be found. These are considered typical of AIDS and have been shown to contain HIV particles in their cytoplasm. AIDS lesions due to infectious agents do not always conform to the typical pattern of the uncomplicated disease and not uncommonly there is evidence of more than one infectious agent in the same area. Peripheral nervous system lesions in HIV infections, responsible for a variety of clinical symptoms, usually appear, in biopsy material, as nonspecific inflammatory in type. CMV inclusions and lymphomatous infiltrations of peripheral nerve have been reported in autopsy cases. PMID- 3288295 TI - Stage-specific cell-surface antigens of oligodendrocytes in the peripheral nervous system. Expression during development and regeneration and in myelin deficient mutants. AB - Monoclonal antibodies to stage-specific cell surface antigens of oligodendrocytes have been used to investigate the expression of antigens 05 through 011 in the peripheral nervous system of the mouse by immunohistology. In the adult sciatic nerve antigens 05 through 09 and 011 were diffusely positive. 010 antigen was not detectable in the peripheral nervous system at any age tested. During development antigens 05, 06 and 07 were first detectable at birth in tracts at the proximal part of the sciatic nerve. At day 2 the whole diameter of the nerve was positive for 05 antigen, while antigens 06 and 07 were detectable only in part of the nerve and antigens 08 and 09 were just about to appear. At day 4 antigen 011 was the last to appear. At day 7 all antigens were strongly detectable throughout the nerve. After transection of adult sciatic nerve expression of antigens 05 through 09 and 011 was studied at the proximal and distal ends of the cut. Three days after transection all antigens were fully detectable in the degenerating myelin and its debris. After 15 days residual debris was still distinctly positive, while Schwann cells in the bands of Bunger were antigen-negative. At approximately two weeks a connecting bridge between proximal and distal ends of the cut nerve had developed, but the 0 antigens were not detectable in this bridge until day 21. At day 42 all antigens were again fully detectable in the regenerating nerve. In hypomyelinating mouse mutants no difference to the normal control littermates was seen in staining pattern and intensity for jimpy and shiverer, while quaking showed an increase in staining intensity for 05 through 08 antigens. In trembler antigens 05, 06 and 07, but not 08, 09 and 011 appeared associated with non-myelin-forming Schwann cells, while the few recognizable myelin-forming Schwann cells expressed all antigens. These observations show that we have characterized 4 new monoclonal antibodies as further reagents to look at developmentally distinct steps in myelination of the peripheral nervous system. PMID- 3288296 TI - Genetically engineered antibody molecules: new tools for cancer therapy. PMID- 3288297 TI - Corporately managed health care and the new role of physicians. AB - The roles described are not all-inclusive, since a small proportion of physicians, as in times past, will continue to pursue diverse careers outside of an tangential to health care. Neither are the roles mutually exclusive, as physician-managers are also organizational employees, as independently contracting professionals may also be partly fee for service, as physician entrepreneurs may be fee for service practitioners or contracting professionals, and so forth. The point is, that as the delivery of health care becomes a more complex and formalized process, and as large organizations delivering and insuring health care become more predominant, the various roles of physicians are becoming more distinctly obvious. What are the implications of this trend toward greater internal segmentation of the medical profession? At this juncture, they are not entirely clear. It could mean that some groups of physicians will achieve higher status and more rewards than other groups, which might result in greater conflicts within the medical profession. Undoubtedly, the emergence of corporately managed health care and the development of new (and possibly divergent) roles for physicians confronts the medical profession and its members with the gnawing questions of who they really are and what do they really want to be? Ultimately, the greatest challenge may be in finding a common set of commitments and values which transcend our many different roles, and which provide physicians with a clear and continuing sense of ourselves as medical professionals. PMID- 3288298 TI - A critical appraisal of the role of proteolytic enzymes in cancer invasion: emphasis on tumor surface proteinases. PMID- 3288299 TI - Semantics and the chemotherapy of Hodgkin's disease--resistance is not relapse: alternative chemotherapy lacks effectiveness for disease not totally responsive to initial MOPP treatment. AB - Patients with advanced Hodgkin's disease not achieving a complete remission with initial MOPP therapy are significantly less responsive to adriamycin and nitrosourea-containing regimens than patients with relapsing disease following a complete remission with MOPP. Hodgkin's disease not responding completely to initial four-drug treatment represents resistant disease which, in most instances, may not be cured with existing alternative chemotherapy. These patients should receive innovative treatment. PMID- 3288300 TI - "Country needs more freedom". PMID- 3288301 TI - Computer software article 'has shortcomings'. PMID- 3288302 TI - Current perspectives on esthetic restorative dentistry. Part I. Porcelain laminates. PMID- 3288303 TI - Cosmetic imaging. A look into the future--now! PMID- 3288304 TI - Pain & helplessness in the anxious dental patient. A multifactorial approach. PMID- 3288305 TI - The symptom iceberg in dentistry. Treatment-seeking in relation to oral and facial pain. PMID- 3288306 TI - Potential problems associated with occupational exposure to nitrous oxide. PMID- 3288308 TI - A retirement scenario. PMID- 3288307 TI - Effective communication skills. A key to practice building. PMID- 3288309 TI - Effect of manipulative variables on porosity and microleakage of amalgam. PMID- 3288310 TI - Local anesthetics and sulphite sensitivity. PMID- 3288311 TI - Report on prosthetic joints, antibiotic prophylaxis and dental treatment. PMID- 3288312 TI - Treatment of the partially edentulous maxillary arch assisted by osseointegrated implants & magnets. PMID- 3288313 TI - Medical heroes and mitral prolapse. PMID- 3288314 TI - Evaluation of myocardial ischemia and infarction by nuclear magnetic resonance techniques. AB - Proton NMR imaging of myocardial ischemia without infarction requires the use of paramagnetic contrast agents. Even during the first few hours of infarction, imaging without contrast enhancement reveals only slight natural image contrast. Myocardial infarction, however, is much more readily detected during the first few days and weeks post coronary occlusion; this is due to a marked elevation in T2 during this time period. Chronic infarction, several months after the acute event, does not demonstrate altered signal intensity, but can be detected by visualizing myocardial wall thinning and aneurysm formation. Information regarding high energy phosphate metabolism can be acquired in vivo in ischemic animal preparations; preliminary data has demonstrated that it is possible to acquire similar information noninvasively in man. Development of this technique will eventually permit the study of pharmacological and mechanical interventions aimed at preserving myocardium in the ischemic heart. Exogenous labelling of myocardial tissue with carbon-13 permits the study of the effects of substrates on cellular metabolism. Ultimately, the technique of chemical shift imaging will provide a method of spatially resolving valuable metabolic information in the form of an NMR image. Eventually, with the gradual development of NMR technology, imaging and spectroscopy will become truly important clinical tools in the investigation of ischemic heart disease in man. PMID- 3288315 TI - In vitro stabilization of 6-methylsalicylic acid synthetase from Penicillium urticae. AB - In continuing studies of patulin biosynthesis, the first enzyme of the pathway, 6 methylsalicylic acid synthetase, was found to be far more labile than were the later enzymes of the pathway. Attempts were made to stabilize 6-methylsalicylic acid synthetase in vitro. The combined addition of the cofactor NADPH, the substrates acetyl-CoA and malonyl-CoA, the reducing agent dithiothreitol, and the proteinase inhibitor phenylmethylsulfonyl fluoride to cell-free extracts was found to prolong the half-life of the enzyme as much as 12-fold. This suggested that proteolysis and the conformational integrity of the enzyme may play an important role in controlling the duration of antibiotic biosynthesis in vivo. This was in agreement with the finding that the intracellular proteinase content of antibiotic-producing cells of Penicillium urticae rapidly increased just before the loss of 6-methylsalicylic acid synthetase content. These in vitro stabilization studies have provided some insight into the metabolic conditions that may stabilize these enzymes in vivo, and into possible ways of extending the life of these catalysts. PMID- 3288316 TI - Mutual antagonism among killer yeasts: competition between K1 and K2 killers and a novel cDNA-based K1-K2 killer strain of Saccharomyces cerevisiae. AB - Mutually antagonistic K1 and K2 killer strains compete when mixed and serially subcultured. At pH 4.6, where the K1 killer toxin is more stable in vitro, the K1 strain outcompeted the K2 strains at both 18 and 30 degrees C. At pH 4.0, closer to the in vitro pH optimum of the K2 killer toxin, the K1 strain again predominated at 18 degrees C, but at 30 degrees C the K2 strains became the sole cell type on subculture. To show more clearly that these results were dependent upon the respective killer toxins, control experiments were conducted with isogenic, nonkiller strains cured of the dsRNA-based killer virions. Such nonkiller strains were unable to compete with antagonistic killers under conditions where their isogenic killer parents could, strongly suggesting that the killer phenotype was important in these competitions. Double K1-K2 killer strains cannot stably exist, as their dsRNA genomes compete at a replicative level. Using recombinant DNA methodology, a stable K1-K2 killer strain was constructed. This strain outcompeted both K1 and K2 killers when serially subcultured under conditions where either the K1 or the K2 strains would normally predominate in mixed cultures. Such a double killer may be useful in commercial fermentations, where there is a risk of contamination by killer yeasts. PMID- 3288317 TI - Further characterization of Escherichia coli O153:H45, an ETEC serotype disseminated in Chile. AB - The newly described stable enterotoxin producing, enterotoxigenic Escherichia coli, serotype O153:H45, capable of expressing colonizing factor antigen I, is frequently isolated as a cause of diarrhea among Chilean children. Hybridization studies of five new strains confirmed previous results which indicated that the stable enterotoxin genes are contained in nonconjugative plasmids ranging in size from 81 to 87 kilobases. The strains expressed similar antibiotic resistance and metabolic properties but differed in their plasmid content. PMID- 3288318 TI - Epidemiology of osteoarthritis. AB - Although OA is recognized as the most common joint disorder, its pathogenesis is unclear and little is known about its natural history and progression. Epidemiologic studies have identified age as the strongest and most consistent correlate of OA, with distinct patterns of distribution by sex, ethnicity, and geographic location. There is growing consensus that OA represents a heterogeneous set of diseases that are affected by the interaction of multiple risk factors, producing a common pathway of disease; and that it is important to study multiple risk factors in association with generalized OA and site-specific subsets of OA. Two basic types of generalized OA are recognized, although it is quite possible that there are additional types of generalized OA. Genetic susceptibility, which implies some systemic factor of cartilage vulnerability, is thought to be the major risk factor for generalized OA. Mechanical factors associated with wear and tear on the joint have been the most important factors found in association with site-specific OA, although it is possible that systemic factors are also involved. Most likely there are multiple factors, such as genetic susceptibility; anatomic, biomechanical, and biochemical changes associated with aging; and exposure to various types of joint trauma and injury that are implicated in the etiology of OA. There is little known about progression of OA and the extent of the outcomes involved with progression of OA. Crucial to future epidemiologic research is the identification of homogeneous subsets of OA that facilitate standardized case definition, and research designs that incorporate multiple joints in one study and investigate the independent and interactive effects of multiple hypothesized risk factors. Cohort studies and longitudinal follow-up of persons with OA are needed in order to have a better understanding of the natural history of OA and its related outcomes. PMID- 3288319 TI - The biology of aging, with particular reference to the musculoskeletal system. AB - A broad assessment of the current status of knowledge of biologic gerontology is presented. The extent to which the aging phenotype is due to primary aging processes, or to lifestyle, or to disease processes is discussed. Particular emphasis is placed on the aging of the musculoskeletal system. Both bone and skeletal muscle are discussed within the framework of our current knowledge of aging. PMID- 3288320 TI - Approach to the diagnosis and management of musculoskeletal disease. AB - Musculoskeletal disease is not an inevitable consequence of aging. Complaints of musculoskeletal disease indicate disease. Differential diagnosis relies on clinical skills. Management is directed toward maintaining function. PMID- 3288321 TI - Osteoarthritis. AB - Osteoarthritis (OA, osteoarthrosis, degenerative joint disease) represents failure of the diarthrodial joint. It has numerous causes. As the heart may fail due to disease of the myocardium, endocardium, or epicardium, the joint may fail due to an abnormality in the articular cartilage, underlying bone, synovial membrane, supporting ligaments, or neuromuscular system. Primary (idiopathic) OA represents the most common form of the disease. It is usually monoarticular and tends to progress slowly. It most commonly involves the small joints of the hands, the hips, knees, spine, and the metatarsophalangeal joint of the great toe. PMID- 3288322 TI - Crystal-associated arthropathies. AB - Crystal-associated arthritis constitutes one of the best-understood inflammatory processes involving joints in humans. It affects mainly middle-aged or elderly individuals and is often seen in association with signs of degenerative joint disease. Articular manifestations of crystalline deposition disease not uncommonly are also the first presentation of reversible metabolic or endocrine disorders. This is an important field for clinicians because the diagnosis can be rapidly and precisely made by synovial fluid analysis. Furthermore, the acute manifestations can be controlled effectively with the administration of colchicine, nonsteroidal anti-inflammatory agents or intra-articular corticosteroid injections. The chronic manifestations of gouty arthritis are also successfully managed with long-term hypouricemic therapy. PMID- 3288323 TI - The spectrum of polymyalgia rheumatica. AB - Polymyalgia rheumatica and temporal arteritis are common syndromes of unknown cause that afflict older patients, the great majority of whom are white. Polymyalgia, which is seen more frequently, is a benign synovitis and can be differentiated from rheumatoid arthritis by the distribution of inflamed joints and by its rapid and complete response to small doses of prednisone. Temporal or giant cell arteritis occurs in approximately 20 per cent of patients with polymyalgia rheumatica and may present with either localized or systemic symptoms. Once the diagnosis is confirmed by temporal artery biopsy, patients should be treated with a large dose of prednisone for at least 1 month. The erythrocyte sedimentation rate is a useful test in suspecting the diagnosis initially, but is a poor gauge to tapering the steroid dose. PMID- 3288324 TI - Neoplastic associations of rheumatic diseases and rheumatic manifestations of cancer. AB - Associations between rheumatic diseases and malignant neoplasms are still inferential and based largely on epidemiologic data. Rheumatoid arthritis predisposes weakly to the occurrence of lymphoreticular neoplasms. This is more clearly true of Sjogren's disease, whether or not it is associated with RA. A subset of DM/PM which becomes manifest in close temporal proximity to a neoplasm may be a paraneoplastic reaction, but DM/PM, in general, does not predispose to neoplasia. Scleroderma in its early phase is associated with the development of breast cancer in women, and after a decade or longer, if pulmonary fibrosis has developed, with lung cancer. Of the drugs that have been used to treat these diseases, cyclophosphamide is most strongly implicated as a carcinogenic agent, particularly inducing lymphoreticular neoplasms and carcinoma of the bladder. Musculoskeletal symptoms that may be clues to the existence of cancer may either be caused by invasion of the neoplasm or be mediated by unidentified neurohumoral mechanisms. Except for multiple myeloma, primary neoplasms of skeletal tissues tend to occur under the age of 50 years. Metastatic disease occurs congruently with the age incidence of the primary neoplasm. Metastases may mimic mono- or oligoarticular arthritis if they happen to be periarticular or synovial. These metastases result most often from carcinoma of the lung or, in women, carcinoma of the breast. Hypertrophic pulmonary osteoarthropathy usually is due to carcinomas of the lung other than the small cell variety, and infrequently from other intrathoracic primary or secondary neoplasms. RA may be mimicked. Both skeletal metastases and HPOA are detected with greater sensitivity, but not specificity, by isotopic scanning techniques than by radiography. Of the other paraneoplastic musculoskeletal syndromes, neuromyopathy is the most frequent. It must be distinguished from cachexia, polymyositis, polymyalgia rheumatica, and the myasthenic syndrome. Both neuromyopathy and Eaton-Lambert (myasthenic) syndrome are predominantly associated with small cell carcinoma of the lung and both are best diagnosed by electromyography. Carcinomatous polyarthritis and the palmar fasciitis-arthritis syndrome occur with various neoplasms, although the latter appears to be particularly associated with ovarian carcinomas. The paraneoplastic arthritides test negatively for the rheumatoid factor, but no reliable positive immunochemical clues have as yet been identified. PMID- 3288325 TI - Orthopedic aspects of musculoskeletal disease in the lower extremities. AB - The elderly patient may be significantly benefited by careful evaluation and treatment of lower extremity disease. A great deal of emphasis must be given to preoperative planning to assure the most predictable outcome of any treatment program. Arthritis about the major joints has been revolutionized joint replacement surgery and fracture treatment has undergone many changes in the elderly. Most elderly patients can undergo surgical intervention. PMID- 3288326 TI - Joint infection, with consideration of underlying disease and sources of bacteremia in hematogenous infection. AB - Joint infection commonly results from hematogenous spread of infection from a distant site. Pre-existing joint disease increases the risk of joint infection during bacteremia. Most patients present with pain, swelling, heat, and limitation of motion of the affected joint, often with fever, but presentation may be atypical, especially in patients with rheumatoid arthritis, systemic corticosteroid therapy, or infected prosthetic joints. Diagnosis is best made by analysis and culture of synovial fluid. The infecting microorganism often provides a clue to remote infection or underlying disease, which may require special attention. Therapy consists of high-dose parenteral antibiotics and adequate drainage. Outcome depends on early diagnosis and appropriate therapy. PMID- 3288327 TI - Osteoporosis. AB - This article will review the pathogenesis of osteoporosis and the potential for prevention of the disorder, paying particular attention to estrogens. In addition, it will attempt to provide some rationale for identifying those who may be at risk from the disorder at a time when effective preventive therapy can be instituted, while also reviewing the results of treatment programs for the established disorder. PMID- 3288328 TI - Pharmacologic approaches to musculoskeletal disorders. AB - Pharmacologic considerations of musculoskeletal disease in the elderly involve an appreciation of the pathophysiology of aging as it alters host response to the particular drugs used for these disorders. Treatment of rheumatic conditions is often chronic. Pharmacologic studies of drug handling in the elderly versus the young are often short term and not appropriate to the answers required for sustained therapy in aging individuals with decremental organ system decline, dysfunction, and disease. Where inadequate information exists, the clinical therapist must proceed cautiously on a highly individualized basis in choice of agents, use of those agents at whatever particular dose, and monitoring to ensure safety. Such commitment requires the best of the art as well as the science of medicine. No less is required in the appropriate therapy of these disorders in our elderly population. PMID- 3288329 TI - A human model of gastric carcinogenesis. PMID- 3288330 TI - Depletion of adenosine diphosphate-ribosyl transferase activity in rat liver during exposure to N-2-acetylaminofluorene: effect of thiols. AB - The exposure of rats to a feeding regimen containing N-2-acetylaminofluorene (2AAF) causes an accumulation of lesions on liver DNA and a progressive impairment in DNA repair capacity. We used the in vivo experimental model of Teebor and Becker (Cancer Res., 31:1-3, 1971) with the carcinogen given to rats during four consecutive cycles, each one composed of 3 weeks of treatment and 1 week of recovery. The extent of DNA damage and repair was determined during each cycle by the alkaline elution technique. The results obtained showed that the number of alkalilabile sites in DNA is significantly enhanced after the first cycle and remains increased during following cycles. Since ADP-ribosyl transferase (ADPRT) is known to play a central role in the response to DNA damage, we investigated the effect of 2AAF on this enzyme during the carcinogenic process. The activity and the structure of ADPRT were analyzed using the activity gel and Western blot techniques. The catalytic band with a molecular weight of 116,000, clearly evident in liver extracts of control rats, was no longer detectable after one cycle of exposure to 2AAF returning progressively to an almost normal level within the last two cycles. When the aminothiol N-acetyl-L cysteine (NAC) was added to the 2AAF diet, the extent of DNA damage was drastically reduced, and DNA repair activity preserved for a longer period. In addition, the loss of ADPRT was not observed after the first cycle, but delayed to the end of the second, indicating that NAC exerts a protective effect on DNA and on ADPRT. Such effect was not evident when NAC was substituted by glutathione. The analysis of liver extracts on Western blot showed that the ADPRT immunoreactive band was almost undetectable after the first cycle suggesting that the loss in enzyme activity could be due to a block in de novo synthesis of the enzyme and not to an inhibition of its activity. PMID- 3288331 TI - Ethacrynic acid and piriprost as enhancers of cytotoxicity in drug resistant and sensitive cell lines. AB - Ethacrynic acid and piriprost (6,9-deepoxy-6,9-(phenylimino)-delta 6,8 prostaglandin I1) have been shown to potentiate the cytotoxic activity of chlorambucil in rat and human tumor cell lines. Walker 256 rat breast carcinoma cells (WS), with acquired resistance to nitrogen mustards (WR), and two human colon carcinoma cell lines, HT 29 and BE, were sensitized to chlorambucil when either ethacrynic acid or piriprost was administered at the same time as the alkylating agent. Both as single agents and in combination with chlorambucil, there was inhibition of glutathione S-transferase activity as measured with 1 chloro-2,4-dinitrobenzene as a substrate. A depletion in intracellular glutathione was also evident following ethacrynic acid alone or in combination with chlorambucil. Thus, diuretic plant phenols or prostaglandin analogues may have potential therapeutic utility in combination with alkylating agents. PMID- 3288332 TI - Estrogen-sensitive proliferation pattern of cloned Syrian hamster kidney tumor cells. AB - Estrogen-sensitive hamster kidney tumor cells H301 and their clonal derivatives were inhibited from proliferating in culture by charcoal-dextran (CD) stripped serum in a dose-dependent manner. Homologous serum was more potent an inhibitor than heterologous (human, bovine, equine) sera. Natural and synthetic estrogens failed to increase the proliferation rate of cells maintained in 2% CD Syrian hamster serum (SHS). At CDSHS concentrations above 2%, cell proliferation was significantly inhibited and estrogens completely reversed this inhibitory effect. Nonestrogenic steroids failed to overcome the serum inhibition. Two synthetic estrogens, moxestrol and 11 beta-chloromethylestradiol, were 10-fold more potent than estradiol in increasing cell proliferation yields; they were however, less potent than estradiol in inhibiting [3H]estradiol binding to intracellular estrophilins. d-Equilenin, a poor inducer of kidney tumors, was a weak estrogen in the "in culture" proliferation assay. Ethynylestradiol was highly estrogenic in culture while reports suggest that it is poor tumor inducer in the animal. Progestagens inhibit the growth of estrogen-induced kidney tumors; only promegestone partially blocked the proliferative effect of estradiol in cultures supplemented with 10% CDSHS. Charcoal-dextran stripped serum from animals bearing a diethylstillbestrol implant was as effective as the serum of untreated male hamsters in inhibiting the proliferation of B3H301 cells. These results are compatible with the following interpretations: (a) hamster serum contains a potent specific inhibitor of the proliferation of estrogen-sensitive cells (estrocolyone); (b) estrogens induce cell proliferation by neutralizing the effect of this serum-borne inhibitor; (c) the poor correlation between estrophilin binding and proliferative potency suggests no direct estrophilin involvement in the proliferative effect of estrogens on these cells; (d) the results obtained in this "in culture" model using estrogen (except ethynylestradiol) and other steroids are compatible with the results obtained in the animal; and (e) the tumorigenic process in Syrian hamster kidneys triggered by estrogens probably involves their direct interaction within these cells (shut off effect) in addition to the neutralization of the estrocolyone. PMID- 3288333 TI - Possible mechanism of inhibition of experimental pulmonary metastasis of mouse colon adenocarcinoma 26 sublines by a sialic acid: nucleoside conjugate. AB - As described previously (I. Kijima-Suda et al., Cancer Res., 46: 858-862, 1986), a sialyltransferase inhibitor, 5-fluoro-2',3'-isopropylidene-5'-O-(4-N-acetyl-2,4 dideoxy-3,6,7,8-tetra -O- acetyl-1-methoxycarbonyl-D-glycero-alpha-D galactooctapyranosyl)ur idine (KI-8110), inhibits pulmonary metastasis of murine colon adenocarcinoma 26 sublines of high (NL-17) and low (NL-44) metastatic potential. To investigate the mechanism of this inhibition, the effect of KI-8110 on the metastatic cascade, especially on the interaction between tumor cells and platelets which may play a crucial role in tumor cell metastasis, was examined. NL-17 cells induced irreversible platelet aggregation in heparinized human platelet-rich plasma in vitro. This activity was reduced by pretreatment of the tumor cells with KI-8110. Inhibition of aggregation was also induced by the treatment of tumor cells with neuraminidase or Limax flavus agglutinin, a lectin specific for sialic acid. Sialic acid, fucose, sialyllactose, and bovine submaxillary mucin inhibited this tumor cell-induced platelet aggregation, while galactose, mannose, lactose, alpha 1-acid glycoprotein, fetuin, and asialo-bovine submaxillary mucin did not. KI-8110 also inhibited platelet-derived growth factor dependent growth of NL-17 cells, but showed no effect on insulin or epidermal growth factor-dependent growth of the tumor cells. Platelet-derived growth factor induced phosphorylation of membrane protein was reduced by treatment of NL-17 cells with KI-8110. The same result was obtained in the neuraminidase-treated membrane fraction of NL-17 cells. These results suggest that KI-8110 inhibits experimental tumor cell metastasis by inhibiting the interaction between tumor cells and host platelets in at least two pathways, and this may be due to a reduction of sialic acid contents of the membrane surface of tumor cells. PMID- 3288334 TI - Effects of diabetes and sex steroid hormones on insulin receptor tyrosine kinase activity in R3230AC mammary adenocarcinomas. AB - Insulin binding and receptor tyrosine kinase activity were investigated in the insulin-responsive R3230AC mammary adenocarcinoma. Insulin receptors, partially purified by wheat germ agglutinin-agarose chromatography, displayed electrophoretic properties similar to those of normal tissues and demonstrated autophosphorylation of the beta subunit. Tyrosine kinase activity of tumor preparations was measured by incorporation of 32P from ATP into the synthetic polypeptide substrate glutamic acid80:tyrosine20. The Km (app) for ATP, 15 to 30 microM in tumors from ovariectomized or intact rats, appeared to be increased by 10(-7) M insulin in vitro, with the calculated Vmax increased by 3- to 5-fold; the Km (app) for glutamic acid80:tyrosine20 was 2 to 3 microM and insulin increased the Vmax by 25 to 50%. The effects of diabetes and insulin treatment and of various doses of estradiol, progesterone, estradiol plus progesterone, or tamoxifen on insulin binding, basal tyrosine kinase activity, and insulin inducible tyrosine kinase activity in vitro were studied in tumors from treated animals. Preparations from diabetic rats had elevated insulin binding and basal tyrosine kinase activity and displayed a striking dose-related increase in the ability for insulin induction of tyrosine kinase activity in vitro compared to intact animals; these effects of diabetes were prevented by administration of insulin. Over comparable doses, insulin growth factor 1 added in vitro induced tyrosine kinase activity minimally versus that seen for insulin. Treatment of rats with pharmacological doses of sex steroid hormones produced changes in insulin binding capacity and/or basal tyrosine kinase activity and, depending on dose, usually resulted in increased basal kinase activity relative to insulin binding. The insulin-inducible increase in tyrosine kinase activity in vitro was not altered by treatment with estradiol or estradiol plus progesterone in vivo, whereas high doses of progesterone attenuated the response. A consistent finding with increasing doses of sex steroids was an increase in the half-maximum dose or 50% maximum induction dose for insulin, implying reduced responsiveness. Tamoxifen administered to intact rats increased insulin binding and blunted the insulin-induced increase in tyrosine kinase in vitro; these effects were not seen in ovariectomized rats... PMID- 3288335 TI - Prolactin binding and localization in rat mammary tumor mast cells. AB - We found that prolactin is taken up by mast cells residing in prolactin dependent, 7,12-dimethylbenzanthracene-induced rat mammary tumors. Light and electron microscopic immunocytochemistry showed that mast cells concentrate prolactin in their cytoplasmic granules. No prolactin was found on mast cell surface membranes or in their nuclei. In primary cultures of tumor cells, mast cells were found mainly in the periphery of dome structures and these cells concentrated prolactin. When purified rat peritoneal mast cells were incubated with 125I-labeled prolactin, uptake was time, energy, and temperature dependent. Seventy % of accumulated prolactin was released intact from cytoplasmic granules by C48/80-induced degranulation. A mouse mastocytoma cell line also took up and released prolactin. These cells contained prolactin receptors (Kd = 4.5 nM) as determined in whole cells (approximately 3150 sites/cell) and in crude membranes (approximately 180 fmol/mg protein). We conclude that mast cells might significantly influence mammary tumor growth by accumulating and releasing prolactin within tumor tissue. PMID- 3288336 TI - Immunohistochemical comparison of Lea, monosialosyl Lea (CA 19-9), and disialosyl Lea antigens in human colorectal and pancreatic tissues. AB - The CA 19-9 antigen is a monosialosyl Lea blood group antigen which has been shown to be a useful tumor-associated antigen for the diagnosis of gastrointestinal cancers. Recently, a sialylated derivative of this antigen, disialosyl Lea, was isolated from a colon cancer liver metastasis and a monoclonal antibody (FH7) recognizing this novel determinant was developed. The present study simultaneously compared the expression of Lea, monosialosyl Lea, and disialosyl Lea antigens in a variety of nonmalignant, premalignant, and malignant tissues of the colorectum and pancreas with an aim toward elucidating whether disialosyl Lea is expressed as a tumor-associated antigen. In normal colonic mucosa, disialosyl Lea expression closely resembled Lea expression in overall frequency, segmental distribution, and cellular localization whereas monosialosyl Lea (CA 19-9) was essentially absent. Along the crypt axis, Lea was more often expressed in goblet cells of the upper crypt whereas disialosyl Lea was found in goblet cells along the entire crypt. Fetal colonic mucosa expressed all three antigens, as did most colorectal cancers regardless of location within the colon or degree of differentiation. The majority of hyperplastic polyps and practically all adenomatous polyps also expressed these three antigens, and in adenomas, antigen expression was independent of polyp size, villous morphology, or degree of dysplasia. In the normal pancreas, the three antigens were expressed on ductal, ductular and centroacinar cells of all specimens. The majority of pancreatic cancers expressed all three antigens. Thus, in the normal colon, the absence of monosialosyl Lea (CA 19-9) in the presence of disialosyl Lea suggests that an alpha 2,6 sialyltransferase is active, which results in the masking of CA 19-9 antigen expression. These results further support the concept that specific sialyltransferases play a role in regulating the expression of tumor-associated antigens. PMID- 3288337 TI - Workshop report from the Division of Research Grants, National Institutes of Health. Oxy radicals in carcinogenesis--a chemical pathology study section workshop. PMID- 3288338 TI - Comparative efficacy of antiepileptic drugs. PMID- 3288339 TI - Professor Hans Paulsen. PMID- 3288340 TI - Special issue in honour of Professor Hans Paulsen. PMID- 3288341 TI - Structural studies of glucorhamnans isolated from the lipopolysaccharides of reference strains for Serratia marcescens serogroups O4 and O7, and of an O14 strain. AB - Partially acetylated glucorhamnans have been isolated from the lipopolysaccharides of three strains of Serratia marcescens. The polymer from the reference strain (C.D.C. 864-57) for serogroup O4 has the disaccharide repeating unit shown below, in which acetylation at position 2 of the rhamnosyl residue is approximately 90% complete. Similar glucorhamnans from the reference strain (C.D.C. 843-57) for serogroup O7 and from a pigmented strain (NM) of serogroup O14 differ only in the configuration of the L-rhamnopyranosyl residue (beta) and the extent of O-acetylation (O7, almost stoichiometric; NM, 80-90%). Glucorhamnans of the second type have been isolated previously from the lipopolysaccharides of other strains of S. marcescens, including the reference strain for serogroup O6 and another pigmented O14 strain (N.C.T.C. 1377). In all cases, the lipopolysaccharide extracts also contained acidic glycans, but the glucorhamnans are believed to constitute the integral side-chains. (Formula: see text). PMID- 3288342 TI - The use of bacteriophage-mediated depolymerisation in the structural investigation of the capsular polysaccharide from Escherichia coli serotype K36. AB - The structure of the repeating unit of the capsular polysaccharide from Escherichia coli serotype K36 has been established from the results of spectroscopic and chemical analyses of (a) P1, the tetrasaccharide obtained on depolymerisation of the polysaccharide with a bacteriophage-borne endo galactosidase, (b) P1-alditol, and (c) the original polysaccharide. The repeating unit, which is identical to that reported for Klebsiella K57, has the following structure. (Formula: see text). PMID- 3288343 TI - Analysis by the reductive-cleavage method of linkage positions in a polysaccharide containing 4-linked D-glucopyranosyluronic residues. AB - The fate of 4-linked D-glucopyranosyluronic residues under reductive-cleavage conditions was investigated by using the Klebsiella aerogenes type 54 strain A3 capsular polysaccharide. Treatment of the fully methylated polysaccharide with triethylsilane and trimethylsilyl trifluoromethanesulfonate in dichloromethane, followed by in situ acetylation, yielded 1,5-anhydro-2,3,4,6-tetra-O-methyl-D glucitol, 3,4-di-O-acetyl-1,5-anhydro-2,6-di-O-methyl-D-glucitol, and 3-O-acetyl 1,5-anhydro-2,4-di-O-methyl-L-fucitol, as expected, but the expected product of reductive cleavage of the 4-linked D-glucopyranosyluronic residue, namely, methyl 3-O-acetyl-2,6-anhydro-4,5-di-O-methyl-L-gulonate, was not observed. Instead, methyl 2-O-acetyl-3,6-anhydro-4,5-di-O-methyl-L-gulonate (6) was identified as the sole product of reductive cleavage of the 4-linked D-glucopyranosyluronic residue. That compound 6 arose as a result of rearrangement during reductive cleavage rather than by reductive cleavage of a 5-linked D-glucofuranosyluronic residue, was established by reductive cleavage of the fully methylated polysaccharide following reduction of its ester groups with either lithium aluminum hydride or lithium aluminum deuteride. The products of the latter reductive cleavage were the same as before, except for the absence of 6 and the presence of 4,6-di-O-acetyl-1,5-anhydro-2,3-di-O-methyl-D-glucitol, or its 6,6 dideuterio isomer. Although the reductive-cleavage technique is suitable for the direct analysis of polysaccharides containing 4-linked D-glucopyranosyluronic residues, it does not establish whether the uronic residue is a 4-linked pyranoside or a 5-linked furanoside. The expected product is, however, derived from the 4-linked D-glucopyranosyluronic residue after sequential methylation, reduction of its ester group and reductive cleavage. PMID- 3288344 TI - [Micro-biochemical features of proteins from the islands of Langerhans isolated from normoglycemic rats with alloxan diabetes]. PMID- 3288345 TI - [The coat of arms of the Prague Guild of Surgeons]. PMID- 3288346 TI - Indications for the presence of two populations of serotonin-containing pinealocytes in the pineal complex of the golden hamster (Mesocricetus auratus). An immunohistochemical study. AB - Serotonin-like immunoreactivity was investigated in the pineal complex of the golden hamster by use of the indirect immunohistochemical technique. The superficial and deep portions of the pineal gland, and also the pineal stalk exhibited an intense cellular immunoreaction for serotonin. In addition, perivascular serotonin-immunoreactive nerve fibers were observed. Some serotonin immunoreactive processes of the pinealocytes terminated on the surface of the ventricular lumen in the pineal and suprapineal recesses, indicating a receptive or secretory function of these cells. Several serotonin-immunoreactive processes connected the deep pineal with the habenular area. One week after bilateral removal of both superior cervical ganglia the serotonin immunoreaction of the entire pineal complex was greatly decreased. However, some cells in the pineal complex, of which several exhibited a neuron-like morphology, remained intensively stained after ganglionectomy. This indicates that the indoleamine content of some cells in the pineal complex of the golden hamster is independent of the sympathetic innervation. PMID- 3288347 TI - Nerve growth factor-inducible, large external (NILE) glycoprotein in developing rat cerebral cells in culture. AB - Fetal rat cerebral cells underwent neuronal differentiation in culture. This process was accompanied by distinct changes in the cellular glycoprotein pattern. The incorporation of [3H]-fucose into two proteins of apparent molecular weights of 30,000 and 60,000 daltons was significantly decreased and specific developmental changes were observed in a group of glycoproteins with high molecular weights (150,000-250,000 dalton). By means of indirect immunoprecipitation one of them was identified as NILE gp (nerve growth factor inducible large external) glycoprotein (200,000 dalton), a marker of central and peripheral neurons. Its developmental expression on neurons of dissociated rat cerebral cultures was studied using the indirect immunofluorescence technique and compared to the fluorescent-labeling pattern of other neuronal markers. Neurons expressing NILE gp were detected as early as after one day in culture. No preferential staining of neurites versus cell bodies was observed. Two classes of NILE gp-positive cell-type, whereas the other group was represented by larger, more spindle-shaped neurons with a limited number of neuritic processes. In most cases one of these neuritic processes was preferentially labeled. Astroglia cells, as identified by immunolabeling with antisera against the glial acidic fibrillary protein, were observed to develop and mature after the first week in culture. NILE-positive neurons were found to be positioned in close association with glial cell processes. PMID- 3288348 TI - Expression of leucocyte antigens by cells from the metrial gland of the pregnant rat. AB - The function of the metrial gland of the rat, and particularly of its characteristic population of granulated cells, remains unknown. However, several lines of evidence suggest that the granulated cells may derive from lymphocytes, and play a role in the immunology of pregnancy. In this study, antigen expression by granulated and other cell populations from the metrial glands of rats at Days 13 and 14 of pregnancy was studied by an indirect immunoperoxidase method. Acetone-fixed frozen sections, and cytocentrifuge preparations of collagenase dispersed metrial gland tissue in which numbers of granulated cells had been increased by density-gradient centrifugation, were used. The primary antibodies used recognised, inter alia, B lymphocytes (MRC OX-3, MRC OX-6, MRC OX-12), T lymphocytes (MRC OX-8, W3/25, MRC OX-19), neutrophils (MRC OX-42) and cells of the monocyte/macrophage series (MRC OX-3, MRC OX-6, MRC OX-42, MRC OX-43). The majority of the granulated cells, including smaller, "immature" forms, were unlabelled by any of these antibodies. Some lymphocytes, and varying numbers of larger, non-granulated cells, were labelled by OX-6, OX-12, W3/25, OX-42 and OX 43. In addition to lymphocytes, labelled cells included neutrophils (OX-42), endothelial cells (OX-43), and probably some macrophages (OX-6, OX-43). OX-12, which recognises the kappa chain of rat IgG, labelled some large cells which may have been stromal cells. These findings do not support the concept that the granulated cells are derived from lymphocytes. PMID- 3288349 TI - Innervation of arteriovenous anastomoses in the brood patch of the domestic fowl. AB - The innervation of blood vessels in the brood patch (thoracic skin) of the domestic fowl was studied by use of the catecholamine fluorescence technique, acetylcholinesterase staining, and the immunoperoxidase technique for demonstration of vasoactive intestinal polypeptide (VIP). Large arteries and veins were sparsely innervated, whereas arteriovenous anastomoses (AVAs) were densely innervated by adrenergic, acetylcholinesterase-positive, and VIP immunoreactive nerve fibres. The rich supply of different vasomotor nerves to AVAs emphasizes the importance of these vascular shunts in regulating blood flow and, in turn, the transport of heat to the brood patch. Furthermore, the presence of VIP-immunoreactive nerve fibres in the vasculature of the brood patch suggests that VIP might be the mediator of the previously reported cold-induced vasodilatation. PMID- 3288350 TI - Lysosomes and pancreatic islet function. A quantitative estimation of crinophagy in the mouse pancreatic B-cell. AB - Ultrastructural studies of pancreatic islets have suggested that crinophagy provides a possible mechanism for intracellular degradation of insulin in the insulin-producing B-cells. In the present study, a quantitative estimation of crinophagy in mouse pancreatic islets was attempted by morphometric analysis of lysosomes containing immunoreactive insulin. Isolated islets were incubated in tissue culture for one week in 3.3, 5.5 or 28 mmol/l glucose. The lysosomes of the pancreatic B-cells were identified by morphological and enzyme-cytochemical criteria and divided into three subpopulations comprising primary lysosomes and insulin-positive or insulin-negative secondary lysosomes. Both the volume and numerical density of the primary lysosomes increased with increasing glucose concentration. The proportion of insulin-containing secondary lysosomes was highest at 5.5 and lowest at 3.3 mmol/l glucose. Insulin-negative secondary lysosomes predominated at 3.3 mmol/l glucose. Studies of the dose-response relationships of glucose-stimulated insulin biosynthesis and insulin secretion of the pancreatic islets showed that biosynthesis had an apparent Km-value for glucose of 7.0 mmol/l, whereas it was 14.5 mmol/l for secretion. The pronounced crinophagic activity at 5.5 mmol/l glucose may thus be explained by the difference in glucose sensitivity between insulin biosynthesis and secretion resulting in an intracellular accumulation of insulin-containing secretory granules. The predominance of insulin-negative secondary lysosomes at 3.3 mmol/l glucose may reflect an increased autophagy, whereas the predominance of primary lysosomes at 28 mmol/l glucose may reflect a generally low activity of intracellular degradative processes. PMID- 3288351 TI - Distribution of GABAergic perikarya and terminals in the centers of the higher auditory pathway of the chicken. AB - The distribution of presumed GABAergic neurons and axon terminals in nuclei of the higher auditory pathway of the chicken was investigated by immunocyto chemical methods employing antisera to the rate-limiting enzyme of GABA synthesis, glutamic acid decarboxylase, and to GABA. In the mesencephalic auditory center (MLD) about 20% of the cells reveal immunoreactivity. In contrast, the thalamic relay station nucleus ovoidalis is devoid of immunostained somata. This nucleus contains a high density of punctate immunoreactive structures presumed to be GABAergic axon terminals. In the auditory forebrain center field L and the auditory portions of the hyperstriatum ventrale, up to 8% of the cells were immunopositive. These neurons were significantly smaller than estimated from measurements of the overall cell population in these nuclei. From the two-dimensional arrangement of immunopositive neurons it is suggested that the GABAergic system in the avian auditory telencephalon consists of two separate groups of neurons: one subgroup mediating local inhibitory interactions, the other responsible for lateral inhibition between different frequency representations. PMID- 3288352 TI - Tying it all together: The Integrated Academic Information Management System being implemented at Maryland. AB - With the National Library of Medicine serving as the catalyst, the University of Maryland at Baltimore, Campus for the Professions, entered into a major initiative to integrate information management systems in support of the campus missions of education, research, and clinical care. Strategic planning initiated the integration process and continues in an iterative mode. In support of integration, changes were made in the campus organizational structure and in its technological infrastructure. Implementation involves transforming the Information Resources Management Division into an information utility on a phased and incremental basis. Collaboration with the Health Sciences Library is key to this transformation, as are numerous outreach activities. PMID- 3288353 TI - Medical linguistics: automated indexing into SNOMED. AB - This paper reviews the state of the art in processing medical language data. The area is divided into the topics: (1) morphologic analysis, (2) syntactic analysis, (3) semantic analysis, and (4) pragmatics. Additional attention is given to medical nomenclatures and classifications as the bases of (automated) indexing procedures which are required whenever medical information is formalized. These topics are completed by an evaluation of related data structures and methods used to organize language-based medical knowledge. PMID- 3288354 TI - Ultrastructural correlates of antimycotic treatment. PMID- 3288355 TI - Peptide transport in Candida albicans: implications for the development of antifungal agents. PMID- 3288356 TI - Epidemiology of coccidioidomycosis. AB - Coccidioides immitis naturally occurs in the soil and air of certain areas of the New World. These are generally arid to semiarid areas that have relatively modest rainfall, mild winters, and prolonged hot seasons. Coccidioidomycosis is usually a disease of human and nonhuman residents of these areas; but visitors may develop the disease after entering these areas and returning home long distances from the endemic areas. Inhalation (rarely percutaneous introduction) of arthroconidia of C. immitis leads to usually benign but occasionally severe and even fatal infection. Recovery from or asymptomatic infection leads to resistance to reinfection. Exposure to soil (dust) means that certain occupations are more likely to be exposed to C. immitis. Persistence of the organism in the soil means that infections will be encountered in the future, particularly as long as susceptible newcomers continue to enter endemic areas. Those who have been infected and recovered generally will be resistant to later infection, although exacerbation may occur as a result of superimposed immunosuppression. PMID- 3288357 TI - Immune response to Paracoccidioides brasiliensis in human and animal hosts. PMID- 3288358 TI - Morphogenetic transformation of fungi. PMID- 3288359 TI - Epidemiology of nosocomial fungal infections. PMID- 3288360 TI - Melanins and their importance in pathogenic fungi. PMID- 3288361 TI - Cytochrome P450 of fungi: primary target for azole antifungal agents. AB - Cytochromes of fungi are essentially similar to those of animals. Cytochromes of fungi constitute two electron transport systems occurring in mitochondria and the endoplasmic reticulum. The former system, called the respiratory chain, contributes to cellular respiration and ATP generation, whereas the later system, named the microsomal electron transport system, is responsible for biosynthesis of several cellular components. The oxidative metabolism of lanosterol, that is included in the biosynthetic pathway of ergosterol, is one of the important functions of the microsomal electron transport system, which is catalyzed by P450(14DM). Many azole antifungal agents avidly combine with P450(14DM) and inhibit the oxidative removal of C-32 (the 14 alpha-demethylation) of lanosterol. This inhibition causes depletion of ergosterol and accumulation of 14 methylsterols in the membrane of fungal cells. Such change in sterol composition disturbs membrane function and results in growth inhibition and death of the fungal cells. Accordingly, P450(14DM) is considered as the primary target for azole antifungal agents. Cytochrome P450, which mediates the 14 alpha demethylation of lanosterol, is also present in mammalian cells. Mammalian cells contain various species of cytochrome P450 which are responsible for many important cellular metabolic functions. If azole antifungal agents inhibit mammalian cytochrome P450 too, their systemic use may result in potentially significant adverse reactions. The high selectivity of azole antifungal agents for fungal P450(14DM) will be necessary for their systemic application. Binding ability of an azole antifungal agent to P450(14DM) is predominantly determined by the substituent at N-1 of the azole group, and the substituent must interact with the substrate site of the cytochrome. Extensive modification of the N-1 substituents and the screening of newly developed compounds with respect to the selectivity to fungal P450(14DM) with some conventional methods will be necessary. For this project, a biochemical understanding of cytochrome P450 and other cytochromes is important. PMID- 3288362 TI - Soluble polysaccharides of Cryptococcus neoformans. PMID- 3288363 TI - Tinea imbricata. PMID- 3288364 TI - Adhesion and association mechanisms of Candida albicans. PMID- 3288365 TI - Carumonam's in-vitro activity against gram-negative bacteria and its stability to their beta-lactamases. AB - The in vitro activity of the novel monobactam carumonam (RO17-2301) was evaluated on 311 gram-negative clinical isolates in comparison to aztreonam, cefotaxime, ceftazidime, cefotetan and ceftriaxone. Carumonam showed an antibacterial potency equal to or higher than any other reference compound; in particular it was the most effective against Proteus indole positive and Klebsiella sp. Its antipseudomonal activity was comparable to that of ceftazidime and it showed, together with aztreonam, the highest activity against the Citrobacter, Enterobacter and Escherichia coli isolates. The minimal inhibitory concentrations performed on permeability altered organisms indicated that carumonam has a penetration rate comparable to aztreonam and higher than cefotetan and ceftriaxone. Carumonam demonstrated excellent stability to chromosomal and plasmid-mediated beta-lactamases and that correlated with its antibacterial activity against the producing strains and inoculum size effect. PMID- 3288366 TI - A study of the antifungal activity of LY121019, a new echinocandin derivative. AB - LY121019 is a cyclic peptide antibiotic of the echinocandin group, which is characterized by strong anti-Candida activity (in particular against Candida albicans) as well as by low experimental toxicity. Its anti-Candida activity is thought to be due to an inhibition of the synthesis of beta-glucan, an essential cell wall polysaccharide. The different composition of culture media or the presence of animal serum did not show adverse effects on LY121019's anti-Candida activity and the addition of reducing compounds such as cysteine and hydroquinone did not manifest a negative influence. Analogously the anti-Candida activity was not influenced when C. albicans was grown under aeration. The activity of LY121019 was very high against the mycelial form of C. albicans even when this form was developed in the presence of animal serum. PMID- 3288368 TI - Lipid A and related compounds. XVII. Synthesis of 3-deoxy-D-manno-2-octulosonic acid (KDO)-(alpha 2----6)-D-glucosamine-4-phosphates, analogs of the biologically active moiety of lipopolysaccharide from Escherichia coli Re mutant. PMID- 3288367 TI - Radiation therapy and chemotherapy in the management of testicular seminoma: a review. AB - Since the early '50s, radiation therapy has been regarded as the mainstay of treatment for testicular seminoma. In the last decade, however, several reports claimed optimal control (about 80% of lasting complete remissions) of advanced disease with cisplatin-containing chemotherapy regimens, consequently questioning the opportunity of irradiation in bulky retroperitoneal presentation. The respective role of radiotherapy and chemotherapy in the management of advanced locoregional seminoma has been reviewed, in view of the fact that our data, previously unpublished, show a 10-year disease-free survival probability of 70% for 27 bulky stage II patients submitted to irradiation. On the grounds of currently available data, a prospective randomized trial of chemotherapy versus radiotherapy in stage II testicular seminoma seems justified, in order to identify the optimal treatment policy for this disease. PMID- 3288369 TI - Studies on the enzyme immunoassay of bio-active constituents contained in oriental medicinal drugs. IV. Enzyme immunoassay of glycyrrhetic acid. PMID- 3288370 TI - The contribution to medical work and nursing by the pioneer missionaries of the D.R.C. Mission in Nyasaland (Malawi) from 1889-1900. PMID- 3288372 TI - Immunoreactive pancreatic phospholipase A2 and catalytically active phospholipases A2 in serum from patients with acute pancreatitis. AB - Measuring the content of immunoreactive pancreatic phospholipase A2 (PLA2; EC 3.1.1.4) and the catalytic activity of PLA2 in serum samples from five patients with acute pancreatitis, we found no correlation between these two measurements overall. To test the specificity of the method for catalytic PLA2, we measured PLA2 activity in serum samples before and after immunoadsorption with an antiserum to human pancreatic PLA2. The results suggest the presence of at least two immunologically distinct PLA2 enzyme proteins in sera from these patients. One of the enzymes is pancreatic in origin and may exist in active, inactive, or inhibited form. The activity profile of the second PLA2 enzyme in serum during acute pancreatitis differs from that for other common pancreatic enzymes. In the present experiment, the catalytic activity was not removed by treatment with the anti-human pancreatic PLA2 antiserum. The source of this second PLA2 activity is unknown. Some samples contained increased activities of both PLA2 forms. PMID- 3288371 TI - Effects of insulin and dexamethasone on adenine nucleotide levels in cultured hepatocytes from adult rat. AB - Insulin and dexamethasone, usually added to culture media, play an important role in maintaining the survival of functional hepatocytes. Adenine nucleotide concentrations and energy charge values of cultured hepatocytes were determined to investigate the relationship between the beneficial effects of these hormones and the energy status of the cells. The results indicate that insulin and dexamethasone are essential in maintaining the metabolic competence of cultured hepatocytes and that this correlates with the absolute concentration of ATP rather than with the energy charge. PMID- 3288373 TI - Nucleotides, nucleosides, and oxypurines in human kidneys measured by use of reversed-phase high-performance liquid chromatography. AB - An HPLC technique is presented for determining adenine nucleotides and related substances in renal cortical tissue. Nineteen metabolic substances can be resolved in a single 25-min run, with use of a gradient-elution system. The mean intra-assay CV is 2.4%, the interassay CV 5%. The lower detection limit for substances commonly present in kidney tissue--such as ATP, ADP, AMP, GTP, GDP, GMP, IMP, inosine, adenosine, hypoxanthine, and xanthine--ranges from 0.6 to 3.6 mumol/L, corresponding to 18 and 107 pmol applied to the column. For reliable analysis, a specimen of renal cortex weighing at least 5 mg (wet weight), taken during donor nephrectomy, during cold storage of the kidney, and 1 h after the onset of reperfusion, can be used. The method presented provides a rapid, reproducible diagnostic tool for assessing the chemical energy status of human kidneys in renal surgery and transplantation. PMID- 3288374 TI - Monoclonal antibodies for radioimmunoassay of cyclosporine: a multicenter comparison of their performance with the Sandoz polyclonal radioimmunoassay kit. AB - The performance of a radioimmunoassay kit containing monoclonal specific and nonspecific antibodies to cyclosporine (Sandimmun-Kit; Sandoz Ltd., Basle, Switzerland) was compared with that of the original Sandoz polyclonal radioimmunoassay kit (Ciclosporin RIA-Kit). A total of 1320 blood and plasma samples from patients receiving cyclosporine after kidney, heart, liver, and bone marrow transplantation were analyzed at six centers. For blood samples the median result on using the specific assay was about 50% of the polyclonal assay result after kidney and bone-marrow transplantation, about 33% after heart and liver transplantation; comparable figures for plasma samples were 70 and 40%. The monoclonal nonspecific-antibody assay produced results 10% to 140% higher than polyclonal-assay results, depending on sample matrix and transplant indication; the largest difference was seen in samples from heart- and liver-transplant recipients. Evidently the specific-antibody assay provides a convenient alternative to high-performance liquid chromatography for specific measurement of the drug, but the role of the new nonspecific antibody, possessing an even broader spectrum of cross-reactivity with cyclosporine metabolites than the original polyclonal antiserum, has yet to be defined. PMID- 3288375 TI - Evaluation of a new strategy for detection of thyroid dysfunction in the routine laboratory. AB - We assessed the use of a new strategy for detecting thyroid disorders, utilizing a sensitive assay for concentrations of thyrotropin (TSH) and free thyroid hormone in serum as follow-up tests. Of 1279 patients who were not on thyroxin (T4) replacement treatment, 82% could be classified as euthyroid and would require no further tests. In patients who were on T4 replacement, 41% fell into the euthyroid category and would require no further tests. Using this strategy to replace our existing strategy of free thyroxin as a "first-line" test would reduce the proportion of patients who would require one or more follow-up tests from 49% to 24%. PMID- 3288376 TI - An enzyme immunoassay compared with a ligand-binding assay for measuring progesterone receptors in cytosols from breast cancers. AB - To assay progesterone receptor (PR), we compared Abbott's enzyme immunoassay (PR EIA) with a ligand-binding assay involving dextran-coated charcoal (PR-DCC), using cytosols prepared from 109 breast-cancer biopsies. Results by the two PR methods agreed well. Least-squares analysis produced a line of best fit having a slope of 0.88, an intercept on the PR-EIA axis of 16 fmol per milligram of protein, and a correlation coefficient (r2) of 0.87. To evaluate whether accurate PR-EIA measurements could be obtained on stored cytosols, we compared PR-EIA values for fresh cytosols with values for cytosols stored for various lengths of time up to 13 weeks. Agreement was excellent, especially when the samples showing very high binding (greater than 600 fmol per milligram of protein) were excluded. The lines of best fit after least-squares analyses of the remaining values had slopes between 1.0 and 1.1, intercepts less than 3 fmol/mg, and r2 all greater than 0.91. PMID- 3288377 TI - Neopterin and beta 2-microglobulin in serum of HIV-seropositive subjects during a two-year follow-up. PMID- 3288379 TI - Partial trisomy 20q due to paternal t(8;20) translocation. Case report and review of the literature. AB - In this report we present a malformed female newborn with partial trisomy 20q who was the unbalanced product of a paternal 8p/20q translocation (46,XY,t(8;20) (p23.1;q11]. PMID- 3288378 TI - Km mutant of acid alpha-glucosidase in a case of cardiomyopathy without signs of skeletal muscle involvement. AB - A male patient is reported with a mutation of acid alpha-glucosidase causing an altered Km toward natural substrates. Cardiac arrhythmia was found at 12 years of age, and he died of heart failure at 15 years. No skeletal muscle involvement was observed either clinically or histologically. Acid alpha-glucosidase activity in fibroblasts was moderately low (43% of the control mean) with normal Km for 4 methylumbelliferyl alpha-D-glucoside. The hydrolysis of glycogen was markedly decreased (14% of the control mean), and the Km for maltose was increased 4-fold and for glycogen 5-fold. The biosynthesis and the posttranslational processing of the mutant enzyme appeared normal, but the total amount of the enzyme was lower than normal. This mutant enzyme comigrated with normal acid alpha-glucosidase on starch gel electrophoresis, and not with the rare isozyme, acid alpha-glucosidase 2. A possible role of this mutant enzyme in the pathogenesis of this disease and the relationship to glycogenesis II are discussed. PMID- 3288380 TI - The melanocyte. Its structure, function, and subpopulations in skin, eyes, and hair. AB - I would like to stress that there seem to be three subpopulations of neural crest derived melanocytes in the body that can be functionally and morphologically distinguished: the cutaneous melanocytes, which continuously synthesize small melanosomes to be transferred to keratinocytes; the uveal melanocytes, which synthesize larger melanosomes for only a short while to be retained by this melanogenically dormant cell; and the hair melanocyte, which intermittently produces melanin either in a cyclic manner or as a periodic supply from a stem population. These three types of melanocytes synthesize melanin granules by an identical bipartite system. However, the control mechanism regulating the specific differentiation and postmelanin synthesis function of these cell types needs to be addressed in future research. PMID- 3288381 TI - Piebaldism, Waardenburg's syndrome, and related disorders. "Neural crest depigmentation syndromes"? AB - The striking parallel between the melanin pigmentary abnormalities of the hair and skin in piebaldism, Waardenburg's syndrome, piebaldism with deafness, and piebaldism or Waardenburg's syndrome with aganglionosis of the gut suggests that all these disorders belong to the same category. At present, the most logical way to link these syndromes is to consider them the results of defective development of the neural crest. The reason that in certain circumstances only melanoblasts are affected whereas in other situations other neural crest derivatives also are involved is not yet clear. In addition, some features, such as the upper limb abnormalities observed in Klein's syndrome, are not explained by a neural crest defect. Our knowledge of the interaction between the neural crest and neighboring structures closely related to it during embryonic life is limited. Some clues allowing us to better understand these complex syndromes combining depigmentation of hair and skin will come from future research in this field. PMID- 3288382 TI - Albinism. AB - Genetic abnormalities of the melanin pigment system in which the synthesis of melanin is reduced or absent are called albinism. The reduction in melanin synthesis can involve the skin, hair follicle, and eye, resulting in oculocutaneous albinism, or can be localized primarily to the eye, resulting in ocular albinism. Approximately 1 in 17,000 individuals in the United States has oculocutaneous albinism, and more than 1 per cent of the population are heterozygous for a gene producing albinism. PMID- 3288383 TI - Vitiligo and the Vogt-Koyanagi-Harada syndrome. AB - Vitiligo is a common acquired systemic disease that can be associated with several different autoimmune disorders. Besides the psychologically upsetting depigmentation of the skin that it causes, it can be associated with ocular abnormalities. There are three different theories regarding the etiology of vitiligo, none of which is entirely satisfactory. There are some valuable animal models for studying the disease, but they obviously have limitations in their application to the human disease. The melanocyte is present in other areas besides the skin, including the leptomeninges, the retinal pigment epithelium, the uveal tract, and the inner ear. Therefore, it is not surprising that whatever process destroys the melanocyte in the skin can also affect diverse tissues such as the eye, the ear, and the central nervous system. It is postulated that the Vogt-Koyanagi-Harada syndrome may be part of the systemic disease, vitiligo. PMID- 3288384 TI - Idiopathic guttate hypomelanosis. AB - Idiopathic guttate hypomelanosis is a common and frequently ignored dermatosis. It appears late in life and increases with aging. The studies so far reported do not support the hypothesis of a residual leukoderma following trauma, and the relation of IGH to chronic solar exposure has not yet been documented. However, the role of ultraviolet A and ultraviolet B in the pathogenesis of this dermatosis should be explored by more refined methods. Although it may be genetically modulated, a multifactorial etiology rather than a single cause is likely. An active depigmenting mechanism may underlie the melanocyte disturbance instead of a simple residual defect. Intralesional triamcinolone in very low concentrations with or without minigrafts of normally pigmented skin could be of some therapeutic value. PMID- 3288385 TI - Dysplastic nevi. Their significance and management. AB - Dysplastic nevi are found in a significant percentage of the population and are a sign that an individual with these nevi has a greater risk for developing a melanoma than do individuals without them. For patients with dysplastic nevi who also have two or more members of their primary family afflicted by melanomas, the risk of developing a melanoma is especially high. Guidelines for the care of patients with all forms of dysplastic nevi are outlined. PMID- 3288386 TI - Changes in hair color. AB - Hair color changes result not only from alterations of melanin production but also from changes in the hair structure itself, altering its optical properties. A variety of genetic, metabolic, nutritional, and acquired disorders result in hair color changes. When the underlying defect can be corrected, hair color usually returns to normal. The flag sign can occur as a result of nutritional insults or due to medications. Most drug-induced changes in hair color result in lighter hair color, although PABA and some chemotherapy regimens have darkened hair. Green hair due to exogenous copper may be associated with prior damage to the hair cuticle. Alopecia areata may selectively involve pigmented hairs. Regrowing white hairs have shown both keratinocyte and melanocyte abnormalities. Gray hair may temporarily darken after inflammatory processes, after electron beam-induced alopecia, and after some chemotherapy regimens. Much remains to be learned about the physiology of human graying. PMID- 3288387 TI - Pigmentary abnormalities of the nails with emphasis on systemic diseases. AB - The nails can change colors for many reasons. White bands called leukonychia are especially common. The shape of the white band, that is, concave or convex, indicates the site of injury. Color changes in the nails may also be a sign of a variety of cutaneous or systemic disorders. PMID- 3288388 TI - Chemical and pharmacologic agents that cause hyperpigmentation or hypopigmentation of the skin. AB - The list of chemicals and drugs that can result in alteration of skin color is slowly growing. Inflammatory processes can lead to either post-inflammatory hyperpigmentation or hypopigmentation. In non-inflammatory situations, chemical deposition can result in hyperpigmentation, whereas chemically induced destruction of melanocytes or their products may result in hypopigmentation. PMID- 3288389 TI - Survival of neurosurgery in changing legal and economic times. PMID- 3288390 TI - The future of carotid endarterectomy: a neurologist's point of view. PMID- 3288391 TI - The past, present, and future of extracranial to intracranial bypass surgery. PMID- 3288392 TI - The management of intracranial aneurysms--prospects for improvement. PMID- 3288393 TI - Spinal arteriovenous malformations. PMID- 3288394 TI - Somatosensory evoked potentials in neurosurgery. PMID- 3288395 TI - Neurosurgical horizons. PMID- 3288396 TI - The electrophysiological monitoring of motor pathways. PMID- 3288397 TI - Magnetic resonance imaging of spinal disorders. PMID- 3288399 TI - Presidential address: from Aequanimitas to Icarus. PMID- 3288398 TI - Intraoperative spinal ultrasonography. PMID- 3288400 TI - What constitutes spinal instability? PMID- 3288402 TI - Cervical spondylosis and syringomyelia: suboptimal results, incomplete treatment, and the role of intraoperative ultrasound. AB - The pathophysiology of cervical spondylotic myelopathy and syringomyelia is incompletely understood. Only 50-60% of the former group of patients and only 30 40% of the latter group of patients show long-term improvement. One possible cause for this might be continued anterior compression of the spinal cord in the former and incomplete drainage of the fluid-filled cavities in the latter. Intraoperative ultrasound imaging can be done in the operating room (4-6, 16-18) and can identify whether an adequate decompression has been done in patients with cervical spondylotic myelopathy and whether there has been complete drainage in shunting of patients with syringomyelia. Intraoperative ultrasound imaging aids the neurosurgeon in checking to see if he did what he set out to do. It is useful in operative procedures for cervical spondylotic myelopathy and syringomyelia. PMID- 3288401 TI - Stabilization procedures for thoracic and lumbar fractures. AB - New concepts regarding the biomechanics of spinal instability, new technology for spinal and neurodiagnostic imaging, further evolution of the role of neurological decompression, and the development of improved systems and techniques for achieving anatomical reconstruction and fixation of the spine continue to improve the care of patients suffering injuries of the thoracic and lumbar spine. This field of medicine is in rapid evolution, and newer improved methods will be forthcoming in the near future. An understanding of all of these developments as well as their limitations and potential complications is requisite if we are to optimize the functional capability of patients suffering these catastrophic injuries. PMID- 3288403 TI - Anterior approaches to lesions of the upper cervical spine. PMID- 3288405 TI - Surgical approaches to "inaccessible" brain tumors. PMID- 3288404 TI - Neurosurgical implications of the acquired immunodeficiency syndrome (AIDS). PMID- 3288406 TI - Monoclonal antibodies: their application in the diagnosis and management of CNS tumors. PMID- 3288408 TI - Spectrum of exposures for skull base tumors. PMID- 3288407 TI - Tumors of the cerebellopontine angle: combined management by neurological and otological surgeons. PMID- 3288409 TI - The diagnosis and treatment of orbital tumors. PMID- 3288410 TI - Surgery of masses affecting the third ventricular chamber: techniques and strategies. PMID- 3288411 TI - Tumors of the fourth ventricle: technical considerations in tumor surgery. PMID- 3288412 TI - The role of aggressive therapy for head injury: does it matter? PMID- 3288413 TI - Is ICP monitoring worthwhile? PMID- 3288414 TI - The devastated head injury patient. PMID- 3288415 TI - Controversies in medical management of head injury. PMID- 3288416 TI - Future therapy of head injury. PMID- 3288417 TI - The neurosurgeon and neurotrauma care system design. PMID- 3288418 TI - Nonoperative management of cervical spine injuries. PMID- 3288419 TI - Operative management of cervical spine injuries. PMID- 3288420 TI - Mechanisms and pathways of congenital infections. AB - Fetal and neonatal infections can occur at different times during pregnancy, from conception to birth. Infections that take place near the time of conception often destroy the zygote or embryo and only rarely leave definitive evidence. The mother can transmit the infection to her fetus through several routes, but the most likely routes are through ascending infections and through the blood. The inability of most agents to infect the early embryo probably depends largely on local barriers to the infectious agent, such as the zona pellucida. Some viruses, however, because of their systems for gene regulation of expression, can infect only embryos of certain developmental stages. Certain retroviruses can infect embryos, integrate into cellular DNA, and become part of the germline. After implantation, most infectious agents reach the fetus hematogenously. Organisms circulating in the mother reach and infect the placenta. They then may breach the placenta, gain access to the fetal circulation, and disseminate through the fetal body. Agents with particular tropisms infect particular organs and cause particular symptom complexes. The damage done by the organisms depends largely on the gestational age of the fetus at the time of the infection. The ability of the agent to infect or damage the fetus at all often depends on whether the mother is experiencing a primary infection or has previously mounted an effective immune response. Agents harm the fetus through direct destruction of parenchymal cells, through destruction of blood vessels and resulting infarction, through continued replication in fetal and neonatal tissues, through altering the growth parameters of various fetal tissues, and through provoking autoimmune responses. Infections that begin in the perinatal period usually infect the fetus by direct inoculation from infected foci in the birth canal or through direct contact with large amounts of infected maternal body fluids. Direct tissue destruction of the immediate sequelae of invasive infections usually causes the fetal damage from these perinatally acquired agents. The clinical features of the disease that begin in this period provide an opportunity for effective therapeutic intervention. Understanding the routes of fetal infection and the mechanisms underlying fetal damage from infection will help in devising strategies for preventing and treating congenital infections. PMID- 3288421 TI - HIV in pregnancy. AB - Human immunodeficiency virus is becoming increasingly common among childbearing women. Through federally recommended testing programs, obstetricians will soon be identifying pregnant women in their practices who are HIV infected. Hence obstetricians must be prepared to face the social, ethical, and medical dilemmas brought on by HIV infection in pregnancy. PMID- 3288422 TI - Maternal rubella and the congenital rubella syndrome. AB - The major goal of rubella immunization is the prevention of the congenital rubella syndrome. As many as 20 per cent of women in the reproductive age group in the United States continue to be susceptible to rubella despite the immunization programs currently in place. Intensified efforts are therefore needed to identify persons at risk for infection and to vaccinate them. Women who develop a rubella-like illness during pregnancy should have the diagnosis confirmed serologically because a diagnosis based on clinical criteria alone is unreliable and because of the serious implications of gestational rubella infection. The rubella virus can infect the fetus at any stage of pregnancy, but defects are rarely noted when this occurs after the 16th week of gestation. The most common abnormalities in the congenital rubella syndrome are hearing loss, mental retardation, cardiac malformations, and eye defects. Diabetes mellitus, thyroid disease, glaucoma, and other delayed manifestations of congenital rubella syndrome are common, thereby necessitating long-term followup of these patients. The detection of rubella-specific IgM antibodies in fetal blood is helpful in establishing the diagnosis prenatally and can aid in the management of pregnancies complicated by this infection. Susceptible women identified through screening during pregnancy should be immunized in the immediate postpartum or postabortion period. Although the live, attenuated rubella vaccine is contraindicated during pregnancy, pregnant women who are inadvertently immunized are not candidates for pregnancy termination because no defects consistent with congenital rubella have been reported to date in the offspring of other similarly vaccinated women. PMID- 3288424 TI - Gestational and congenital syphilis. AB - The frequency of congenital syphilis continues to increase throughout the United States during the 1980s. Untreated maternal infection can lead to stillbirth, premature labor, congenital infection, and neonatal death. Preventive measures, based on control of early syphilis in women, prenatal care, improved diagnosis and diligent followup, can help to decrease the incidence of congenital syphilis. The clinical presentation and recommended regimens for therapy of the gravida with syphilis and neonates with suspected congenital syphilis are reviewed. PMID- 3288425 TI - Management of tuberculosis in pregnancy and the newborn. AB - Tuberculosis in pregnant women and their offspring is a serious and sometimes life-threatening infection. A high index of suspicion is a prerequisite for proper diagnosis. Early detection is essential since treatment is successful in these patients. PMID- 3288423 TI - Uncommon virus infections of the mother, fetus, and newborn: influenza, mumps and measles. AB - The literature contains reports of epidemics of varying sizes, which in the aggregate suggest that congenital malformations are not attributable to maternal measles infection during pregnancy, that the incidence of prematurity may be somewhat higher among infected mothers, and that the incidence of abortion also may be somewhat higher. Before the introduction of measles vaccine in this country, the universality of childhood experience rendered adult infection a rare event. Gestational measles was thus uncommon. With the introduction of measles vaccine, these numbers can be expected to have decreased substantially. PMID- 3288426 TI - Perinatal infections with Chlamydia trachomatis. AB - Much has been relearned and learned anew about perinatal chlamydial infections during the past 10 to 15 years. The adverse effects of infection on pregnancy outcome have been suggested but not fully documented or explained. Epidemiologic, biologic, and immunologic correlates of risk for infection and complications of pregnancy due to C. trachomatis are not yet fully understood. Increased appreciation of the importance of this organism in pregnancy, coupled with more facile methods for diagnosing infection and with further research using modern molecular techniques, promises to add greatly to the completeness of our knowledge and to our eventual complete control of this infection in pregnancy. PMID- 3288427 TI - Parasites and pregnancy: the problems of malaria and toxoplasmosis. AB - Infections caused by parasites are common and not limited to the developing world. The spectrum of interactions between pregnancy and parasite infection ranges from minor discomfort to fetal death and are well illustrated by the problems of toxoplasmosis and malaria. PMID- 3288428 TI - Antibiotic therapy of the newborn. AB - The bacteria infecting newborn babies have changed over the last few decades and vary from place to place. Each neonatal unit must therefore make its own choice of antibiotics to attack the local pathogens. This choice must be reconsidered regularly because of the continuing change in pathogens, such as the recent problems encountered with Staphylococcus epidermidis. The newer beta-lactam antibiotics, especially the third-generation cephalosporins, are proving useful in the treatment of neonatal infections. PMID- 3288429 TI - Pulmonary hypertension and persistent fetal circulation in the newborn. AB - Despite these infants' very significant medical instabilities, which require vigorous therapeutic intervention, we have seen a population of infants with little in the way of persistent residual problems. Although many of their pulmonary complications persist after hospital discharge, most resolve within the first year of life. In addition, there are few neurodevelopmental disabilities encountered in such a high-risk population of children. PMID- 3288430 TI - Dipyridamole in the treatment of angina pectoris: a meta-analysis. AB - A meta-analysis was performed to reevaluate the efficacy of dipyridamole for prophylaxis of angina pectoris. We found 10 articles that reported 11 randomized control trials published between 1960 and 1970. Three trials found a statistically significant benefit for the drug vs placebo, four showed a positive trend, two found no difference, and two showed a slight trend favoring placebo. When the results of all 11 trials were combined, two different statistical methods showed a statistically significant benefit from the drug. These combined results must be interpreted cautiously because of excluded patients and other methodologic variations in the studies, as well as evidence from other studies that dipyridamole may aggravate angina. Nevertheless, we conclude that there is some evidence for efficacy of the drug and believe the question should be restudied in larger and better-designed trials. PMID- 3288431 TI - Discrepancy between first-dose converting enzyme inhibition at rest and subsequent inhibition during exercise in chronic heart failure. AB - Low-dose angiotensin-converting enzyme inhibition is thought to completely block the renin-angiotensin system. This study examined the hemodynamic and hormonal responses to initial low- and higher dose converting-enzyme inhibitor (lisinopril or captopril) at rest compared with the response during subsequent chronic therapy while treadmill exercise testing was performed in nine patients with chronic heart failure. At rest, similar changes in systemic arterial pressure, plasma renin activity, and plasma aldosterone concentration were found with initial low and higher doses. However, after at least 4 weeks of therapy, dose dependent increases in plasma renin activity and decreases in plasma aldosterone concentration were noted during exercise without significant differences in exercise systemic arterial pressure or heart rate. This discrepancy suggests that initial low-dose converting enzyme inhibition does completely block the enzyme, but higher dose therapy is required for complete blockade during subsequent exercise in chronic heart failure. PMID- 3288432 TI - Analgesic effect of picenadol, codeine, and placebo in patients with postoperative pain. AB - A double-blind, parallel study was conducted to evaluate the analgesic effect and safety of a single 25 mg oral dose of picenadol, a centrally acting analgesic, and to compare it with a 60 mg dose of codeine and a placebo in patients with postoperative pain. Two sites using similar protocols enrolled a total of 178 inpatients with postoperative pain. Pain intensity, relief, and adverse experiences were then measured for up to 6 hours after administration of the test medications. Both picenadol and codeine were significantly more effective than placebo in reducing pain intensity (mean sum of pain intensity difference scores: picenadol 5.21, codeine 5.19, and placebo 2.82) and increasing total relief (mean total pain relief: picenadol 10.21, codeine 11.07, and placebo 6.96). Adverse experience profiles were similar among the three treatment groups. PMID- 3288433 TI - Focal adhesions and cell-matrix interactions. AB - Focal adhesions are areas of cell surfaces where specializations of cytoskeletal, membrane and extracellular components combine to produce stable cell-matrix interactions. The morphology of these adhesions and the components identified in them are discussed together with possible mechanisms of their formation. PMID- 3288434 TI - A 3-year clinical trial to compare efficacy of dentifrices containing 1.14% and 0.76% sodium monofluorophosphate. AB - A 3-yr daily supervised toothbrushing study with a double blind design was conducted to evaluate the anticaries effectiveness of a 1.14% sodium monofluorophosphate (MFP) dentifrice (1500 ppm F) compared to a 0.76% MFP dentifrice (1000 ppm F). This study began with nearly 4000 children, primarily aged 8-11, in grades 3-5, residing in a nonfluoridated community in Florida. A total of 2415 children completed 3 yr of the study, representing 61% of the children who began the study. The results indicate a statistically significant (P less than 0.001) anticaries benefit was derived over a 3-yr period from the use of the higher fluoride dentifrice (1500 ppm F) when compared to the positive control (1000 ppm F). Percent reductions in mean dental caries increments were 20.9%, 22.1%, 21.8%, 24.3%, and 35.2% for DMFT, DFT, DMFS, DFS, and DFS Interproximal, respectively. PMID- 3288435 TI - Communicable Disease Report July to September 1987. PHLS Communicable Disease Surveillance Centre. PMID- 3288436 TI - Eukaryotic RNA polymerases. PMID- 3288438 TI - The challenge of self-mutilation: a review. AB - The challenge of self-mutilation among humans arises from the imprecision of much of the existing literature, as well as the countertransference such disturbing behavior mobilizes. Self-mutilation is defined as an individual's intentionally damaging a part of his or her own body apparently without a conscious intent to die. The importance of understanding this behavior is reflected in the frequency with which it is encountered among psychiatric patients, particularly those diagnosed with borderline personality disorder or schizophrenia. The distinguishing characteristics of dermal, ocular, and genital self-mutilation illustrate the diverse clinical settings in which mutilation arises. Numerous explanations with differing degrees of complexity and merit have been offered; yet, no clear consensus has emerged. Psychotherapy, behavior therapy, and chemotherapy, while controversial, remain the most compelling treatment options. Salient areas for further study include epidemiology both for specific groups and the general population, possible biologic bases for the behavior, and additional management options. PMID- 3288437 TI - Bipolar affective disorder and creativity: implications and clinical management. AB - Research on the relationship between creativity and mental illness is summarized, and studies documenting a relationship in writers between creativity and affective illness (particularly bipolar illness) are described. Writers have a high prevalence of affective illness, and both affective illness and creativity have increased frequency in their first-degree relatives. The clinical management of the creative individual is challenging. In general, creative individuals are most productive when their affective symptoms are under good control. PMID- 3288439 TI - Folie a deux. AB - A review of folie a deux or induced psychotic disorder (DSM-III-R) is provided. The author believes it to be a more frequent phenomenon than usually thought, especially when hospitalized patients are evaluated with their families. An argument is made for viewing it as a description of a relationship and possible influence between individuals who may have very different disease processes. This includes, in the secondary partner, a continuum from being very "impressionable" to having an autonomous and independent delusional disorder. A case report and suggestions for treatment are given. PMID- 3288440 TI - Thrombotic thrombocytopenic purpura. A review. AB - Thrombotic thrombocytopenic purpura (Moschcowitz's disease) is an uncommon, life threatening disorder of unknown cause. It consists of fluctuating symptoms including: haemolytic anemia, fever, thrombocytopenia, neurological and mental disturbances, and renal dysfunctions. The high mortality of this disease necessitates rapid diagnosis and immediate therapy. The clinical manifestations and diagnostic criteria are reviewed. A variety of theories have been proposed to explain its clinical and pathological manifestations, but the pathophysiology remains poorly understood. The present knowledge of the pathophysiology is discussed in detail. Failure to define the pathophysiology is a reason why there are no widely accepted therapeutic recommendations. The modes of therapy of the disease in relation to current understanding of its nature are discussed. The effect of exchange transfusions, plasma infusions, plasmapheresis and plasma exchange, corticosteroid therapy, immunosuppressive drugs, antiplatelet therapy and splenectomy on clinical course are reviewed. PMID- 3288441 TI - The cytology and biochemistry of pesticide microbiology. AB - Widespread use of pesticides has no doubt benefited human beings in one way or another. However, their side effects on various organisms, including nontarget organisms, are largely overlooked. In the recent past, several studies have been done to assess the effects of pesticides on nontarget organisms, including microorganisms. Although pesticide effects on growth parameters of microorganisms have been extensively reviewed, little attention has been paid regarding their cytological and biochemical aspects. Therefore, the present work is mainly concerned with the cytological and biochemical aspects of pesticide microbiology. The effects of pesticides on photosynthesis, respiration, proteins, and nucleic acids are reviewed. Attention is also paid to their effects on cell morphology and morphogenesis and their effect on cell constituents. PMID- 3288442 TI - Genetics of naphthalene catabolism in pseudomonads. AB - In pseudomonads, naphthalene is catabolized in a series of reactions to salicylic acid, which is further degraded via the catechol meta-cleavage, ortho-cleavage, or gentisic acid pathway to Krebs cycle intermediates. The naphthalene catabolic genes have been located on self-transmissible plasmids, in most cases, and implicated to have chromosomal locations in other cases. The best-studied naphthalene catabolic plasmid is NAH7. It carries two operons, one of which enables the host to utilize naphthalene and the other to utilize salicylate as a carbon and energy source. The product of another NAH7 gene, nahR, is required to turn on both operons in the presence of the inducer, salicylate. Several different naphthalene and salicylate catabolic plasmids have been shown to share sequence homology with NAH7. These plasmids can undergo structural alterations involving insertions and deletions during conjugations and changes in nutritional conditions. Available evidence suggests that salicylate catabolic plasmids can form from the naphthalene catabolic plasmids by structural alterations of the plasmid DNA. The gene organization and regulation, as well as the genetic instability of the naphthalene catabolic plasmids, are reminiscent of the TOL plasmids and suggest that the naphthalene catabolic plasmids and other catabolic plasmids may have evolved in a short period of time by acquiring and modifying preevolved gene clusters from host chromosomes or other plasmids. PMID- 3288443 TI - Neurophysiological approaches to the detection of early neurotoxicity in humans. AB - Various neurophysiological methods, including electroencephalography, electromyography, nerve conduction velocities, and evoked potential techniques, have been used to detect early signs of neurotoxicity in humans. These methods have been applied to groups of occupationally exposed workers and their referents in epidemiologic studies, to patients with suspected or proven diseases after long-term work in toxic environment, and to human subjects during or after experimental exposure. The main body of knowledge arises from epidemiologic studies of occupationally exposed subjects, and several chemicals widely used in industry have been shown to be neurotoxic. Of these, e.g., lead causing peripheral neuropathy, some solvents like carbon disulfide, n-hexane, and methyl n-butyl ketone also causing neuropathy and at times central nervous system effects as well as acryl amide have been studied using neurophysiological approaches. Several other solvents including toluene, xylene, and various mixtures of organic solvents have been suspected to be neurotoxic, and nervous system effects have been ascribed to those in several neurophysiological studies. Some studies have elucidated acute nervous system effects of ethyl alcohol or industrial solvents in experimental situations applying, for example, evoked potential techniques or electroencephalography. PMID- 3288444 TI - Roles of etheno-DNA adducts in tumorigenicity of olefins. AB - Cyclic DNA adducts bearing an "etheno" structure have been described to occur after interaction with metabolites of halogenated olefins. Extensive work has been published on adducts of vinyl chloride, both in vitro and in vivo. The major DNA adduct of vinyl chloride is 7-(2-oxoethyl)guanine, but an important minor adduct appears to be N2,3-ethenoguanine. Other etheno adducts, i.e., 1, N6 ethenoadenine and 3, N4-ethenocytosine, are readily formed with DNA, vinyl chloride, and a metabolizing system in vitro and with RNA in vivo, but usually are not detected as DNA adducts in vivo. Other compounds that have been studied with respect to possible formation of etheno DNA adducts are vinyl bromide (which is more or less completely analogous to vinyl chloride), acrylonitrile, vinyl acetate and vinyl carbamate. Proposals of possible structures of DNA adducts with an etheno structure have been promutagenic potential of these lesions which may lead to misincorporation of wrong DNA bases in newly synthesized DNA. PMID- 3288446 TI - Radiologic evaluation of esophageal dysphagia. AB - In patients with dysphagia, the radiographic examination evaluates both structural and functional abnormalities of the esophagus. Radiologic examination is more appropriate than endoscopy for initial screening of patients with dysphagia (Table 6). Endoscopy is more expensive, generally requires sedation, and is associated with a small but definite risk to the patient. Also, the endoscopic examination yields a poor evaluation of esophageal motor function and may fail to detect mucosal rings and peptic strictures, especially if smaller caliber instruments are used. The chief limitations of the radiographic examination are poor detection of mild cases of esophagitis and variable sensitivity and specificity in diagnosing esophageal motor disorders. PMID- 3288445 TI - Biosynthesis and biotransformation of glutathione S-conjugates to toxic metabolites. AB - The material presented in this review deals with the hypothesis that the nephrotoxicity of certain halogenated alkanes and alkenes is associated with hepatic biosynthesis of glutathione S-conjugates, which are further metabolized to the corresponding cysteine S-conjugates. Some glutathione or cysteine S conjugates may be direct-acting nephrotoxins, but most cysteine S-conjugates require bioactivation by renal, pyridoxal phosphate-dependent enzymes, such as cysteine conjugate beta-lyase (beta-lyase). The biosynthesis of glutathione S conjugates is catalyzed by both the cytosolic and the microsomal glutathione S transferases, although the latter enzyme is a better catalyst for the reaction of haloalkenes with glutathione. When glutathione S-conjugate formation yields sulfur mustards, as occurs with vicinal-dihaloethanes, the S-conjugates are direct-acting toxins. In contrast, the S-conjugates formed from fluoro- and chloroalkenes yield S-alkyl- or S-vinyl glutathione conjugates, respectively, which are metabolized to the corresponding cysteine S-conjugates by gamma glutamyltransferase and dipeptidases; inhibition of these enzymes blocks the toxicity of the glutathione S-conjugates. The cysteine S-conjugates must be metabolized by beta-lyase for the expression of toxicity; the beta-lyase inhibitor aminooxyacetic acid blocks the toxicity of cysteine S-conjugates, and the corresponding alpha-methyl cysteine S-conjugates, which cannot be metabolized by beta-lyase, are not toxic. Moreover, probenecid, an inhibitor of renal anion transport system, blocks the toxicity of cysteine S-conjugates, which cannot be metabolized by beta-lyase, are not toxic. Moreover, probenecid, an inhibitor of renal anion transport system, blocks the toxicity of cysteine S-conjugates. Homocysteine S-conjugates are also potent cyto- and nephrotoxins. The high renal content of gamma-glutamyltransferase and the renal anion transport system are probably determinants of kidney tissue as a target site. Biochemical studies indicate that renal mitochondrial dysfunction is produced by the cysteine S conjugates. Finally, some of the glutathione and cysteine conjugates are mutagenic in the Ames test, and reactive intermediates formed by the action of beta-lyase may contribute to the nephrocarcinogenicity of certain chloroalkenes. PMID- 3288447 TI - Image analysis applied to proliferating cells in malignant lymphoma. AB - This study describes a method for obtaining the distribution of a given cell type in histological sections, as revealed by a specific immunological marker. Two hundred fifty-six contiguous microscopic fields were analysed, and a cellular map was automatically constructed. The resulting images were stored on magnetic media for subsequent quantification and statistical tests. The method was applied to the analysis of 20 small cleaved-cell lymphomas in which the monoclonal antibody Ki-67 was used to mark proliferating cells. Clusters of proliferative cells were observed in both diffuse and nodular lymphomas. Cellularity and the percentage of marked cells were not significantly different in the two types of tumors. PMID- 3288449 TI - Volvulus of the cecum. Report of 26 cases and review of the literature. AB - The management of cecal volvulus is controversial. From 1971 to 1986, 26 patients with cecal volvulus were treated at Malmo General Hospital. Treatment and patient follow-up are presented, together with a review of 350 patients reported in the literature during the past 15 years. Anatomic background and types of volvulus are described. Simple detorsion is an alternative in high-risk patients without gangrene, but resection is the method of choice also when there is no gangrene present. PMID- 3288448 TI - Perianal Bowen's disease. AB - Thirty-three patients with perianal Bowen's disease were treated at the Cleveland Clinic Foundation from 1954 to 1986. Twenty-one patients were women and 12 were men, ranging in age from 30 to 69 years (mean, 48 years). Twenty patients (61 percent) presented with symptomatic perianal disease, while 13 patients (39 percent) were noted as having perianal Bowen's disease upon pathologic examination of routine hemorrhoidectomy specimens. Ten of the patients (30 percent) had prior histories of unrelated cancer. Twenty-seven patients were managed by wide local excision, three patients by simple excision, three patients by fulguration, and one patient by an abdominoperineal resection. During a follow up period averaging 3.7 years (range, 0.3 to 10 years), one patient developed a new invasive skin cancer while a second patient experienced a recurrence of perianal Bowen's disease. The characteristic gross appearance of this lesion and its failure to respond to conventional therapy should prompt the performance of a biopsy, which readily establishes the diagnosis. This experience confirms that wide local excision is adequate therapy for perianal Bowen's disease and that close clinical follow-up is necessary to identify disease recurrence or the development of a malignancy. PMID- 3288450 TI - The expression of carcinoma-associated antigens and blood-group-related antigens in rectal carcinoids. AB - The immunohistochemical expression of blood-group substances and carcinoma associated antigens were compared in rectal carcinoids and adenocarcinomas. Rectal carcinoid tumors, in contrast to rectal carcinomas, were consistently negative for CEA, gastrointestinal cancer antigen GICA (or CA 19-9), and carcinoma-associated antigen CA-50 (except in one case where less than 10 percent of the cells expressed CA-50). The carcinoids and rectal carcinomas extensively expressed blood-group substance A, B, and H, Lewis B antigen, and difucosylated carbohydrate antigens (DFCA). Thus, rectal carcinoids and adenocarcinomas possess both similar and different tumor antigen profiles. The occurrence of discrepant antigen determinants may be used in the differential diagnosis of these two types of tumors. The coexpression of blood-group substance A, B, and H, Lewis B antigen, and DFCA is consistent with the opinion that both rectal carcinomas and carcinoids have a common entoderm origin, but carcinoids are considered to rise from the endocrine-differentiated and the adenocarcinomas from the nonendocrine differentiated enterocytes. PMID- 3288451 TI - Treatment of desmoid tumors in Gardner's syndrome. Report of a case. AB - Aggressive desmoid tumors present difficult problems among patients with Gardner's syndrome. Recently, attention has been directed toward metabolic or hormonal manipulation of these tumors. A 21-year-old woman with Gardner's syndrome was admitted because of recurrent abdominal wall tumors. She was treated with nonsteroidal anti-inflammatory drugs, tamoxifen, and ascorbate for seven months. During this therapy, CT scan showed a gradual increase in size of the tumors. Subsequent resection of the abdominal tumors and the colon was performed. Although these three types of drugs were administered to prevent postoperative recurrence, an abdominal wall desmoid tumor that invaded the mesentery developed within nine months. The known treatments, that is, chemotherapy, irradiation, and surgical resection are discussed in view of this experience. PMID- 3288452 TI - What sequence of pathogenetic events leads to acute ulcerative colitis? AB - The etiology of ulcerative colitis remains unresolved despite new immunologic, biochemical, and microbiologic observations made in this disease. A sequence of pathogenetic events has been adduced from abnormalities reported from human and experimental colitis with the express purpose of establishing priority of factors that may lead to an attack of acute ulcerative colitis. The presence of undefined bacterial metabolites in the colonic lumen causing specific breakdown of fatty acid oxidation in colonic epithelial cells is proposed to be the initiating event of the disease process that leads to an immune response and eicosanoid response perpetuating epithelial cell damage. The proposals embody the thesis that primary metabolic damage to colonocytes determines the clinical and pathologic manifestations of ulcerative colitis. PMID- 3288453 TI - Antoine Lembert 1802-1851. Study on intestinal suture with a description of a new procedure for performing this surgical operation. 1826. PMID- 3288455 TI - The diagnosis of chlamydial infection in a cytology laboratory: ten months' experience using immunofluorescence with and without previous cytologic prediction. AB - A Chlamydia diagnostic service has been established as part of a cytology laboratory, combining prediction of possible infection by routine cytology with definitive testing by immunofluorescence. The first 10 mo of operation have had good clinician acceptance with 527 specimens submitted and 128 reported as positive (24.3%). Routine cytology was more accurate in predicting chlamydial infection than was clinical evaluation (32.8% of cytologically suspected cases were positive versus 20.2% of clinically suspected cases); however, both failed to identify many infected women. The patient selection for testing must be improved since only about 22% of infected women in our population were tested. Nevertheless, the service identified a large number of patients infected with an important sexually transmitted pathogen. Chlamydial diagnosis has become a major component of the laboratory's workload and has been cost-effective. PMID- 3288454 TI - Differences of liver membrane antibody frequency in alcoholic liver disease. Detection of IgG and IgA classes using radioimmunoassay. AB - The presence of liver membrane antibody in IgG and IgA was investigated by radioimmunoassay using isolated rabbit hepatocytes as target cells. This technique was more sensitive than the immunofluorescent method. IgG liver membrane antibodies were positive in 24% of patients with alcoholic liver disease. IgA liver membrane antibodies were detected in 58% of patients with alcoholic liver disease, whereas they were detected only in 21% of those with nonalcoholic liver disease, except for cases of autoimmune chronic active hepatitis. In alcoholic liver disease, IgA liver membrane antibodies were detected at a high frequency in a group of patients with alcoholic hepatitis and active cirrhosis (94%) as compared with that of fatty liver, hepatic fibrosis, and inactive cirrhosis (42%). These results suggest that alcoholic liver disease is characterized in part by a humoral immune response of IgA liver membrane antibodies. PMID- 3288456 TI - The potential value of imprint cytology in cytochemical localization of steroid hormone receptors in ovarian cancer. AB - Steroid hormone receptors were studied in 45 patients with primary, recurrent, or metastatic ovarian cancer in cryostat-frozen sections and imprint preparations. The ligands, 17 B-estradiol-6-carboxymethyloxine-bovine serum albumin fluorescein isothiocyanate (FITC-BSA estradiol) and hydroxyprogesteronehemisuccinate bovine serum albumin tetramethylrhodamine isothiocyanate (TMRITC-BSA progesterone) were used in the fluorescent cytochemical method. Results were compared with standard dextran-coated charcoal (DCC) biochemical assay. An overall significant correlation between biochemical values and cytochemical results was found. However, the imprint results were more sensitive and more specific than the frozen section results. A statistically significant difference (P less than 0.05) was observed between touch preparation material and frozen section specimens by the fluorescent method. PMID- 3288457 TI - Aspiration cytology and immunohistochemistry of an orbital aspergilloma. AB - The results of fine-needle aspiration (FNA) cytology combined with immunohistochemical staining of an orbital aspergilloma are presented. The cytologic findings included a tangled mass of hyphal elements and acute inflammation consistent with fungal disease. The slides were stained by the peroxidase-antiperoxidase method for Aspergillus sp. Positive staining confirmed the diagnosis of an orbital aspergilloma, and appropriate therapy was started. PMID- 3288458 TI - [Structural-functional organization of the Escherichia coli chromosome from immunoelectron microscopy data]. PMID- 3288459 TI - [Histone H1-specific proteinase is associated with the nuclear matrix and is activated by DNA-containing breaks or denatured sites]. PMID- 3288460 TI - [Stress bleeding and postoperative pneumonias in intensive care patients on ranitidine or pirenzepine]. AB - To prevent stress bleeding, 400 postoperative patients in intensive care but not expected to need long-term mechanical ventilation, were randomly given either 50 mg pirenzepine or 200 mg ranitidine daily intravenously for a mean of 3.9 days. Macroscopically visible bleeding was the criterion of stress bleeding. In addition, special attention was also paid to any signs of pneumonia. There was a significantly higher incidence of gastric pH values of less than 4 in the pirenzepine patients. Six episodes of bleeding occurred in the ranitidine group vs. three in the other. There was a significantly higher incidence of pneumonia among ventilated patients (18.0% vs. 2.7%). Among ventilated patients the pneumonia rate under ranitidine was 28.6% vs. 9.1% in the pirenzepine group (P less than 0.05). The probable cause of the higher pneumonia rate under ranitidine was the gastric colonization with gramnegative organisms. Pirenzepine assures an effective prophylaxis against stress bleeding at least as good as ranitidine. At the same time, the risk of lung infection is also lower with pirenzepine than ranitidine. PMID- 3288462 TI - [Diagnosis of amyloidosis]. PMID- 3288461 TI - [Exchange transfusion and (or) plasmapheresis: effective measures in severe tropical malaria?]. AB - A 42-year-old man was admitted to hospital with, previously wrongly diagnosed, fulminant falciparum malaria, 14 days after a two-week trip to Kenya. He had a high fever and was jaundiced, with severe anaemia and thrombocytopenia. He was given quinine intravenously and pyrimethamine/sulfadoxine (Fansidar) by mouth. He developed acute renal failure and increasingly severe cerebral symptoms, at times coma. An exchange transfusion and several plasmaphereses were, therefore, performed. The cerebral symptoms quickly abated during the exchange transfusion, but renal function failed to improve. Because of continuing fever, mefloquin (Lariam) and doxy-cycline (Vibramycin) were also administered. After several dialysis periods the patient improved gradually and was discharged after three weeks in generally good condition with normal renal function. PMID- 3288463 TI - [Therapy of amyloidosis]. PMID- 3288464 TI - [Goiter therapy with levothyroxine and iodide]. PMID- 3288465 TI - [Sonographic studies during drug treatment of diabetic gastroparesis]. AB - Ultrasound examination of ten insulin-dependent diabetics with neuropathic gastroparesis demonstrated that gastric motility can be increased by intravenous injection of both cisapride and metoclopramide (Paspertin) (P less than 0.05 to less than 0.0005). During a one-hour period of observation stimulation lasted longer after cisapride than metoclopramide, but there were no qualitative differences between them. Compared with healthy subjects the frequency of antral contractions was increased after both drugs (P less than 0.05 and less than 0.025, respectively). Intensity and speed of contraction was less in patients than in the control subjects, but this effect was significant only for speed of contraction 20 min after injection of the drugs (P less than 0.05). The results indicate that ultrasonography makes it possible to monitor drug treatment of abnormal gastric emptying in diabetics by measurement of both frequency and degree of antral contraction. PMID- 3288466 TI - [Gastric emptying disorders in diabetic gastroparesis]. PMID- 3288467 TI - Atenolol and sustained release nifedipine alone and in combination in hypertension. A randomised, double-blind, crossover study. AB - In this randomised, double-blind, crossover trial, the efficacy in hypertension of atenolol and nifedipine as single agents or in combination was compared. 81 patients with mild to moderate essential hypertension (sitting diastolic blood pressure 100-120 mm Hg, aged 20-70 years) from 6 outpatient clinics entered the study. By use of a Latin-square design, patients received, in randomised fashion, sustained release nifedipine 20mg twice daily, atenolol 50mg in the morning and then placebo in the evening, or sustained release nifedipine 20mg plus atenolol 50mg in the morning and then placebo in the evening. Each schedule was followed for 4 weeks. All treatments lowered systolic and diastolic blood pressure in the supine and standing positions compared with pretreatment values. The combination regimen significantly reduced supine and standing systolic (p less than 0.01 and p less than 0.001, respectively) and diastolic (p less than 0.001) blood pressure compared with nifedipine alone, and it also significantly reduced supine and standing systolic (p less than 0.01 and p less than 0.03, respectively) and diastolic (p less than 0.01) blood pressure compared with atenolol alone. Heart rate was significantly decreased by atenolol and the combination compared with nifedipine alone. 15 patients withdrew because of side effects: 9 during nifedipine treatment, 2 during atenolol treatment and 4 during combination treatment. Side effects were typical of those associated with nifedipine or atenolol. Flushes and hot sweats, which were frequent with nifedipine, were significantly less (p less than 0.001) with atenolol or the combination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288468 TI - Efficacy and tolerability of atenolol, nifedipine and their combination in the management of hypertension. AB - This randomised, double-blind, crossover study investigated the haemodynamic effects of a beta-blocker (atenolol 50mg) and a calcium antagonist (sustained release nifedipine 20mg) given either separately or in combination in 3 groups of patients with mild to moderate essential hypertension. Each treatment was administered twice daily. The fixed combination given twice daily for 4 weeks produced reductions in blood pressure which lasted for at least 12 hours after administration of the final dose. The control of blood pressure by the combination was superior to that achieved by its individual components. Side effects normally associated with nifedipine therapy were less frequent when it was administered with atenolol. Compliance with treatment was good, but it was best when the drugs were given together rather than separately. A fixed combination of atenolol and nifedipine may prove useful in treating hypertensive patients inadequately controlled on beta-blocker therapy alone. PMID- 3288470 TI - Ultrasound evolution and later outcome of infants with periventricular densities. AB - The evolution of ultrasound findings in 59 infants with transient periventricular densities is described and the neurodevelopmental outcome of 53 of these infants was compared with 92 of 107 infants with normal ultrasound scans, born during the same 24-month period. Four of the 53 infants with transient periventricular densities developed spastic diplegia and 24 developed transient dystonia, whereas only 8 of the 92 children with normal ultrasound scans demonstrated this finding (P less than 0.001). Persistence of the densities for more than 10 days and the presence of densities in the trigone were especially related with subsequent problems. Postmortem findings in two infants and MRI studies in six infants also suggested that transient periventricular densities represent the milder end of the spectrum of periventricular leukomalacia. PMID- 3288469 TI - Future approaches to the treatment of hypertension in the light of results from recent trials. AB - In this review approaches to the treatment of hypertension were appraised by considering data from recent trials. Two main questions were asked: at what level of blood pressure is treatment justified, and which drugs should be used? It is now well established that increases in both systolic and diastolic blood pressure are correlated with an increased risk of cardiovascular disease, heart attack or stroke. However, since patients are often asymptomatic, treatment must be justifiable in terms of reversing the risk of cardiovascular disease. The Australian Therapeutic Trial demonstrated that therapy was beneficial in patients whose diastolic pressure was at or above 95 mm Hg before treatment. Three recent large studies (EWPHE, IPPPSH and MRC) have provided interesting data on the level of blood pressure at which to start treatment and the most appropriate drugs to use. In one, treatment in the elderly, which raises particular concern, has been investigated. The MRC trial compared bendrofluazide with propranolol and showed a reduction in the incidence of stroke; however, to prevent 1 stroke, 850 patients would have to be treated for 1 year. Nevertheless, the benefits of therapy were clearly greater when diastolic blood pressure was at the upper end of the range 90-110 mmHg. Myocardial infarctions, which account for more deaths than stroke in mild to moderate hypertensives, do not appear to be reduced by treatment, whether or not this includes a beta-blocker. This is difficult to reconcile with the established 'cardioprotective' action of beta-blockers post-myocardial infarction. Other important factors affecting cardiovascular disease are governed by the patient's life-style, especially whether or not the patient smokes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288471 TI - Studies on the effect of tetrandrine on microtubules. II. Observation with immunofluorescence techniques. AB - Microtubules were purified by using two cycles of assembly and disassembly processes on fresh brain homogenates from 30 guinea pigs. The yield was about 60 mg. The effect of tetrandrine on tubulin was determined by spectrophotometric analysis and electron microscopy. In addition, we used the indirect immunofluorescent method including tubulin antibody to locate the presence of microtubules in 3T3 cells by fluorescence microscopy. The effects of colchicine and P204 were studied for comparison at the same time. The results showed that colchicine can effectively depolymerize microtubules, while tetrandrine showed aggregation, and in a different manner. The shape and structure of microtubules were definitely destroyed by colchicine, but were not affected by P204 which protected against the destructive effect of tetrandrine. This result indicated the safety of using a combination of P204 and tetrandrine in the treatment of silicosis. PMID- 3288472 TI - Neuroendocrine findings in anxiety disorders. AB - Anxiety disorders are newly defined syndromes in which inappropriate state anxiety is the sole or primary symptom. Hormonal manifestations of acute stress are usually minimal or absent in these disorders. A number of findings suggest receptor down-regulation or enzyme induction of sorts that would be expected to mute or dampen these responses. PMID- 3288473 TI - Premenstrual changes. Impaired hormonal homeostasis. AB - Premenstrual changes (PMCs) in mood and behavior are very prevalent. Nonetheless, their pathophysiology is still obscure and no proven treatment is yet available. Evaluation of the plethora of available data leads to the suggestion that PMCs may result from a temporary impairment of homeostasis among a multitude of systems. This impairment is triggered by a differential pace and magnitude of change-over-time in levels of several hormones and other substances during the luteal phase. PMID- 3288474 TI - Neuroendocrine aspects of suicidal behavior. AB - To assess biologic risk factors in suicidal behavior accurately, it is necessary to distinguish prospective from retrospective design. The former studies are more likely to elicit information concerning possible risk factors in suicide, whereas the latter may be better indicators of biologic traits. In both types of investigations, measures taken close to the suicide attempt are more likely to reflect the biologic state of the individual at the time of the behavior. Although the abnormalities present in suicidal individuals are not entirely clear, most evidence to date suggests an overactivity of the hypothalamic pituitary-adrenal axis and a dysregulation of both serotonin and adrenergic metabolism. These systems are interrelated. Both animal and human studies have established that a multivariate biologic approach is necessary to the understanding of the pathophysiology of suicide. PMID- 3288475 TI - Physiological differences in the elderly. Are they clinically important? PMID- 3288476 TI - Risk factor modification trials: implications for the elderly. AB - The scientific foundations for risk factor modification in the elderly are three fold: (1) data from long-term prospective population studies demonstrating significant independent relationships between established major risk factors- particularly blood pressure (systolic and diastolic), serum cholesterol, cigarette use, clinical diabetes--and risk of cardiovascular (CV) morbidity and mortality; (2) data from population studies on time trends of mass changes in major risk factors and parallel changes in CV mortality rates, including large sustained declines; (3) data from randomized controlled trials (RCTs). RCTs, the focus of this presentation, have been both unifactorial and multifactorial. The former include several trials of antihypertensive drug treatment, and of diet or drugs to lower serum cholesterol. When each of these two sets of unifactorial trials is considered in its totality, the positive nature of the findings is apparent. Among the antihypertensive drug trials, two--the Hypertension Detection and Follow-up Program in the U.S.A. and the study by the European Working Party on High Blood Pressure in the Elderly--involved older men and women, both with significantly favourable outcomes for their intensive treatment groups. Among the several trials on serum cholesterol reduction, the Los Angeles Veterans Administration domiciliary study involved elderly men, and showed significant reductions in incidence and mortality from atherosclerotic events in its fat modified diet group. Multifactorial trials have involved middle-aged men. Their findings are generally positive, particularly in regard to efficacy of life-style interventions to modify diet and smoking habits. Degree of efficacy is apparently related to degree of net change in risk factors in the intervention group compared to the control group. All these findings lend strong support to the judgment that risk factor modification, in the elderly as well as at younger ages, is useful for the prevention of the major adult CV diseases and for increasing longevity with health. PMID- 3288478 TI - The dementias of Parkinson's disease: prevalence, characteristics, neurobiology, and comparison with dementia of the Alzheimer type. AB - Overt dementia occurs in 40% of Parkinson's disease (PD) patients, but neuropsychological testing indicates that mental status changes are ubiquitous. The characteristics of the intellectual changes in PD are those of subcortical dementia and include impaired recall, visuospatial disturbances, executive deficits, bradyphrenia, and depression. Language function is largely uninvolved. These features contrast with the neuropsychological abnormalities of dementia of the Alzheimer type (DAT) where language and memory encoding are prominently affected and depression is rare. The dopaminergic deficit of PD is complicated in some patients by a cholinergic deficit and in others by DAT. Several dementia syndromes exist within PD, reflecting the superimposition of different types of pathologies and multiple neurotransmitter deficits. PMID- 3288477 TI - A double-blind study of bromocriptine and L-dopa in de novo Parkinson's disease. Short-term results. AB - The first phase of a longitudinal multicenter study comparing bromocriptine and L dopa (as Sinemet) as de novo therapy for Parkinson's disease using a double-blind randomized design has recently been completed. Over a period of 5.5 months, bromocriptine and L-dopa were equipotent in reducing functional and neurological disability. These observations complement and extend earlier studies and suggest a role for bromocriptine as de novo therapy of Parkinson's disease. PMID- 3288479 TI - A progress report on the New Zealand Multicentre Parkinson's disease trial. A comparison of low-dose treatment with bromocriptine or L-dopa. AB - A short-term and long-term prospective trial comparing 'low-dose' bromocriptine with L-dopa in the de novo treatment of Parkinson's disease began in 1983. One hundred and twenty-eight patients entered the trial by early 1987. One hundred and seven have remained on one drug. Statistical analysis indicates that a hundred patients in each treatment group will be necessary to avoid a type II statistical error in the comparison of these treatments. PMID- 3288480 TI - Furosemide-induced glucose intolerance in mice is associated with reduced insulin secretion. AB - The effect of furosemide on carbohydrate metabolism was studied in ob/ob mice. Intraperitoneal injection of a single dose of furosemide (200 mg/kg body weight) into fasted mice resulted in acute hyperglycaemia and two days after such a single dose, the mice showed fasting hyperglycaemia and glucose intolerance. Pancreatic islets from mice that had been injected with furosemide (200 mg/kg body weight) two days prior to the in vitro experiments showed increased basal (3 mmol/1 D-glucose) and decreased glucose-stimulated (20 mmol/1) insulin release. Islets from furosemide- or saline-injected animals showed no difference in islet insulin content. The results show that furosemide has both acute and long-term effects on carbohydrate metabolism in ob/ob mice. It is suggested that this, at least in part, is due to an effect on the pancreatic beta-cells. PMID- 3288481 TI - Release of prostacyclin from the dog saphenous vein by 5-hydroxytryptamine. AB - 5-Hydroxytryptamine (5-HT) stimulated the release of prostacyclin (PGI2) from strips of the dog saphenous vein. This stimulation was maintained after mechanical removal of the endothelium. The effect of 5-HT was mimicked by alpha methyl-5-hydroxytryptamine (alpha-CH3-5-HT) but not by 5-carboxamidotryptamine (5 CT) and it was inhibited by ritanserin. It is concluded that, in the dog saphenous vein, the stimulation of PGI2 release by 5-HT involves 5-HT2 receptors distinct from the '5-HT1-like' receptors that mediate contraction of the vessel. PMID- 3288482 TI - Histamine H1-receptor in endothelial and smooth muscle cells of guinea-pig aorta. AB - The location of histamine H1-receptors in the thoracic aorta of guinea-pigs was studied with a [3H]mepyramine binding assay. [3H]Mepyramine binding studies of whole and rubbed aortas, and of cultured endothelial and smooth muscle cells showed that the Kd values were all in the range 0.53-0.76 nM, but that the Bmax values were 19.1, 10.1, 63.3 and 11.6 fmol/mg protein, respectively. Thus, the whole aorta contained more H1-receptors than the rubbed one (free of endothelium), and cultured endothelial cells contained more H1-receptors than smooth muscle cells. These results indicate that more histamine H1-receptors were concentrated in the endothelial cells than in the smooth muscle cells in guinea pig aorta. PMID- 3288483 TI - Rapid interphase and metaphase assessment of specific chromosomal changes in neuroectodermal tumor cells by in situ hybridization with chemically modified DNA probes. AB - Repeated DNAs from the constitutive heterochromatin of human chromosomes 1 and 18 were used as probes in nonradioactive in situ hybridization experiments to define specific numerical and structural chromosome aberrations in three human glioma cell lines and one neuroblastoma cell line. The number of spots detected in interphase nuclei of these tumor cell lines and in normal diploid nuclei correlated well with metaphase counts of chromosomes specifically labeled by in situ hybridization. Rapid and reliable assessments of aneuploid chromosome numbers in tumor lines in double hybridization experiments were achieved, and rare cells with bizarre phenotype and chromosome constitution could be evaluated in a given tumor cell population. Even with suboptimal or rare chromosome spreads specific chromosome aberrations were delineated. As more extensive probe sets become available this approach will become increasingly powerful for uncovering various genetic alterations and their progression in tumor cells. PMID- 3288484 TI - Effect of anti-ER antibodies within the ER lumen of living cells. AB - We describe the production and partial characterization of 12 monoclonal antibodies raised against a preparation of endoplasmic reticulum membranes obtained from Xenopus laevis liver. Four of the antibodies cross-react with liver melanocytes; two of the antibodies recognize extracellular antigens, whilst the remaining six recognize antigens present in hepatocytes. The concentrations of these latter antigens increase markedly in livers stimulated by estrogen. Western blotting analysis revealed that the six anti-hepatocyte monoclonal antibodies recognize at least five different antigens whose molecular weights are 14K, 18K, 19K, 43K, and 125K. The possible functional involvement of the various antigens in the secretory pathway was investigated using Xenopus oocytes as a surrogate secretory system. The mRNAs coding for the monoclonal antibodies were injected into oocytes and the resulting immunoglobulin chains were translated and assembled into active anti-ER antibodies inside the lumen of the ER. The effect on secretion was then observed. Our data indicate that the binding of antibodies to most antigens of the endoplasmic reticulum membrane may result in a blockage of secretion. PMID- 3288485 TI - Altered accumulations of fibronectin are not dependent on fibronectin modifications during the differentiation of F-9 teratocarcinoma stem cells. AB - F-9 teratocarcinoma stem cells differentiate into parietal endoderm when monolayer cultures are treated with retinoic acid. This change in phenotype is accompanied by increased accumulation and altered organization of fibronectin deposits. Although both stem cells and treated cells synthesize and accumulate fibronectin, only the treated cells deposit a fibrillar array of the protein. We have monitored the accumulation of fibronectin in nontreated and treated F-9 cells with indirect immunofluorescence and have biochemically analyzed the fibronectin synthesized by each cell type with one- and two-dimensional acrylamide gels and peptide maps. Our data suggest that no differences exist between these fibronectins to account for the observed changes in accumulation. Thus, another mechanism may regulate the organization of matrix deposition. PMID- 3288486 TI - Lamin disassembly kinetics: a cell-free system with extracts from mitotic HeLa cells. AB - We describe a cell-free system in which a postribosomal supernatant from metaphase HeLa cells induces prophase-like changes in permeabilized HeLa cell populations as evidenced by the nuclear lamin disassembly and chromatin condensation. We have attempted to characterize the cell-free system with permeabilized HeLa cells. First, by extracting lamins with agents known to disrupt the noncovalent interactions in the supramolecular lamin aggregate in interphase using polyclonal and a newly established monoclonal anti-lamin Ab 2E3, uniform extraction of lamins was achieved with urea and deoxycholate whereas the cation Mg2+ and 2-mercaptoethanol had little effect on the disassembly of interphase lamins. Second, cytoplasmic extract from mitotic HeLa cells, synchronized by a nitrous oxide metaphase arrest, was tested. It had a differential effect on interphase lamin depolymerization. Nuclei in G1 phase of the cell cycle were more resistant against the mitotic extracts than cells in S and G2 phase. The results are discussed in terms of a possible inactivation of mitotic extracts by factors present in nuclei in early interphase. PMID- 3288487 TI - Localization of the regulatory subunit of cAMP-dependent protein kinase in Saccharomyces cerevisiae. AB - The subcellular distribution of the regulatory subunit of cAMP-dependent protein kinase in Saccharomyces cerevisiae cells was determined by subcellular fractionation and indirect immunofluorescence microscopy using the bcy1 mutant deficient in the regulatory subunit as control. The regulatory subunit of cAMP dependent protein kinase showing cAMP-binding activity was identified as a single protein of 50 kDa by photoaffinity labeling and immunoblotting. The regulatory subunit was concentrated in a nuclear fraction in addition to a cytoplasmic fraction. By comparison of the regulatory subunit distribution with the DNA localization, the area detected by the indirect immunofluorescence was identified as the nucleus. PMID- 3288488 TI - Myoblast-mediated fusion-injection: a new technique for introduction of macromolecules specifically into living skeletal muscle cells. AB - A new technique for the introduction of macromolecules specifically into living skeletal muscle cells has been developed by a modification of the red blood cell ghost-mediated fusion-injection technique [M. Furusawa (1980) Int. Rev. Cytol. 62, 29-67]. Fluorescein-labeled bovine serum albumin (FITC-BSA) was introduced into chicken skeletal muscle myoblasts by the human red blood cell-mediated fusion-injection method in the presence of polyethylene glycol. Myoblasts loaded with FITC-BSA were then purified by a fluorescence cell sorter and cocultured with myotubes. Specific cell fusion between myoblasts and myotubes occurred under normal culture conditions and BSA was successfully introduced into living myotubes. This technique may provide a new method not only for the study of a given macromolecule's function in living muscle cells but also for therapeutic purposes such as muscle-specific drug delivery. PMID- 3288489 TI - Plasmid content and protein I serovar of non-penicillinase-producing gonococci isolated in Munich. AB - One hundred and twenty-four strains of non-penicillinase-producing gonococci isolated in Munich in 1986 were characterized in terms of their plasmid content and protein I serovar. Eighty-two per cent of the strains belonged to serogroup 1 B with over half belonging to either serovar 1B-2 or 1B-3. Half of the 22 serogroup 1A strains belonged to serovar 1A-2. Nineteen strains (15.3%) were found to lack the 2.6 Md cryptic plasmid although seven of these strains contained the 24.4 Md conjugative plasmid. Nine of the 105 strains which harboured the cryptic plasmid also contained the conjugative plasmid. The 19 strains which lacked the cryptic plasmid comprised 10 different serovars, indicating the heterogeneous nature of this group of organisms. PMID- 3288490 TI - An appraisal of methods used in the examination of retail samples of cows milk. AB - The use of the methylene blue test for the examination of cows milk was investigated in an inter-laboratory survey. A poor relationship was found between results of these tests and total viable counts. Coliforms were detected in a large number of pasteurized milks, indicating frequent post-pasteurization contamination. No relationship was found between the results of the methylene blue test and the presence of coliforms. Results from this survey highlight the need for reappraisal of the methylene blue test as a statutory method for the examination of milk. A total viable count and coliform test are suggested for providing information regarding dairy hygiene and the quality of the product at the point of retail sale. PMID- 3288491 TI - Factors affecting the toxicity of rotting carcasses containing Clostridium botulinum type E. AB - Mice killed shortly after receiving c. 2000 spores of a type E strain of Clostridium botulinum per os were incubated at one of five chosen temperatures together with bottles of cooked meat medium seeded with a similar inoculum. After incubation the rotting carcasses were homogenized. Sterile membrane filtrates of the homogenates (10%, w/v) and pure cultures were then titrated for toxicity. Some of the main findings were confirmed with two further type E strains. Toxicity produced at 37 degrees C was poor in both carcasses and cultures (200 20,000 mouse intraperitoneal LD/g or ml). It was good in both systems at 30 and 23 degrees C, usually reaching 20,000-200,000 LD/g or ml, and in carcasses occasionally more; at 30 degrees C maximal toxicity was reached more quickly in carcasses than in cultures. Prolonged incubation (36-118 days) at 30 or 23 degrees C resulted in complete loss of toxicity in virtually all carcasses but not in cultures. At 16 degrees C the development of toxicity in carcasses was strikingly greater than in cultures. At 9 degrees C neither system produced more than slight toxicity after prolonged incubation. Trypsinization increased the toxicity of cultures but not usually of carcasses. Unfiltered carcass homogenate (10%, w/v) with maximal intraperitoneal toxicity was harmless for mice by mouth in doses of 0.25 ml. These findings differed in important respects from those made earlier with a type C strain. PMID- 3288492 TI - Genetic models in brain and behavior research, Part I. PMID- 3288493 TI - Genetic and pharmacological models of cholinergic supersensitivity and affective disorders. AB - Increased muscarinic sensitivity has been associated with altered hormonal states (hypothyroidism and hyperadrenocorticism), chronic administration of muscarinic antagonists or antidepressants with muscarinic actions, selective breeding for anticholinesterase sensitivity, and certain inbred strains of rats and mice. Thus, both genetic and environmental factors may influence muscarinic receptor sensitivity. The reasonably detailed studies on the selectively-bred rats have revealed that the Flinders Sensitive Line (FSL) rats weigh less, are less active, are more sensitive to muscarinic agonists and to stressors, and have higher concentrations of hippocampal and striatal muscarinic receptors than 'normal', or the selectively-bred, Flinders Resistant Line (FRL) rats. Thus, there are a number of parallels between FSL rats and depressed humans. The FSL rats may be the first animal model of depression to mimic the actual trait of depression, and not just the state. PMID- 3288495 TI - The locus ceruleus: a possible neural focus for genetic differences in emotionality. AB - The Maudsley Reactive and Non-Reactive strains have been developed as a model for the study of individual variations in stress-reactivity, and many differences in biobehavioral systems have been found between them. This review discusses limitations of the 'emotionality' construct in accounting for differences between the Maudsley strains and offers an alternative, theoretical approach. Amaral and Sinnamon have proposed that the locus ceruleus (LC) plays a stress-attenuating role in mediating behavioral, physiological and neuroendocrine response to prepotent, emergency-provoking stimuli and, building upon this formulation, it is proposed that the LC has been an important focus for gene action in the Maudsley model. It is suggested that the LC of the Non-Reactive strain is more strongly activated by stressful stimuli than the LC of Reactive rats, and is the basis of many of the behavioral and physiological differences between them. Behavioral and biochemical evidence consistent with this proposition is reviewed. Identification of the LC as a target for gene-action in the Maudsley model has an important advantage. It substitutes variations at a specific anatomic location in the brain for a loosely defined construct like emotionality, and the hypothesis is amenable to empirical tests by a variety of experimental approaches. PMID- 3288494 TI - Genetic and environmental influences on behavioral and neurochemical aspects of emotionality in rats. AB - Three pairings of rats (two derived from divergent, selective breeding and one from divergent environmental conditions) were compared with regard to behavioral and hormonal parameters. Striking differences were observed: results obtained in our own laboratory as well as those found in a review of the literature pointed to higher emotionality (e.g., increased defecation and corticosterone secretion, etc.) in Roman low-avoidance, Wistar-Kyoto and group-housed rats, as compared to their respective counterparts, Roman high-avoidance, spontaneously hypertensive, and individually housed Wistar rats. Concomitant receptor binding studies reviewed here (3H-diazepam- and 3H-imipramine-binding sites) have revealed, however, less consistent intrapair differences. PMID- 3288496 TI - Effects of multiple injections of luteinizing hormone-releasing hormone on the induction of pregnancy in androgenized female rats. AB - A study of the effect of cyclic (every 4 days) administration of gonadotropin releasing hormone on reproductive performance of the androgenized female rat was carried out. The responses measured were indirect indices of increased gonadotropin output; ovulation rate, uterine decidualization, mating and implantation. PMID- 3288497 TI - [Ethyl alcohol as an inducer and inhibitor of the hepatotoxicity of xenobiotics]. PMID- 3288498 TI - [Stages in the development of Soviet neuropharmacology]. PMID- 3288499 TI - Differential potency and trans-activation of normal and mutant T24 human H-ras1 gene promoters. AB - We have employed a short-term transfection assay system in which we monitored the transient expression of the chloramphenicol acetyltransferase (CAT) gene linked to the promoter region of the normal and mutant T24 H-ras1 gene or the human epsilon-globin gene in Chinese hamster lung (CHL) cells or cells derived from them which carry and express one or the other of the polyoma virus early genes. Our findings can be summarized as follows: (i) The mutant T24 H-ras1 promoter region behaves as a stronger promoter than the H-ras1 gene in all these types of cells as well as in rat 208F fibroblast cells. (ii) In CHL cells expressing the polyoma large T antigen the normal and mutant T24 Ha-ras1 promoters are not trans activated in these cells and only a 2.5-fold activation of the epsilon-globin promoter is observed. (iii) In cells expressing the polyoma middle T antigen both the normal and mutant H-ras1 are trans-activated whereas transcription from the epsilon-globin promoter is not affected when compared to the normal CHL cells. (iv) In cells expressing the polyoma small T antigen the normal and mutant H-ras1 as well as the epsilon-globin promoters are trans-activated. We suggest from these data that a tissue-specific element exists in the promoter region of the H ras1 gene and that the polyoma middle and small T antigens trigger the expression of proteins that trans-activate these promoters. PMID- 3288500 TI - Cloning and sequencing of spinach cDNA clones encoding the 20 kDa PS I polypeptide. AB - Apart from the 8 kDa subunit, which is of chloroplast origin, most of the small polypeptides of the PS I reaction center from higher plants are encoded in nuclear genes. We describe here the first nucleotide sequence of a nuclear component of this photosystem, the precursor of the 20 kDa protein. The deduced sequence of the large transit peptide (55-60 amino acids) is rich in serine/threonine residues and has a net positive charge, which are classical features of these precursors. The sequence itself is mainly hydrophilic, with no possibility of classical membrane-spanning alpha-helices; it exhibits an interesting stretch of five basic amino acids in close vicinity: Thr-Arg-Leu-Arg Ser-Lys-Tyr-Lys-Ile-Lys-Tyr. PMID- 3288501 TI - Evidence for the identity of anti-proteinase pulmonary protein CCSP and uteroglobin. AB - Purified Clara cell secretory protein (CCSP) from rabbit lung was analyzed by SDS gel electrophoresis, and immunoblotting with a specific anti-uteroglobin antibody as well as for its ability to bind [3H]progesterone. The results obtained indicate that proteins CCSP and uteroglobin are identical. PMID- 3288502 TI - Photosynthetic reaction centre of Chloroflexus aurantiacus. Primary structure of M-subunit. AB - The M-subunit primary structure of the reaction centre (RC) from Chloroflexus aurantiacus composed of 306 amino acid residues has been determined by parallel analysis of the protein and corresponding DNA. The blocked N-terminus as well as replacement of the essential histidine liganding Mg of an accessory bacteriochlorophyll in purple bacteria by leucine distinguishes the M-subunit of Chloroflexus RC from that of purple bacteria. PMID- 3288503 TI - Role of N-linked oligosaccharides attached to human renin expressed in COS cells. AB - One or both of two putative N-glycosylation sites (at asparagine-5 and -75) of human renin was eliminated by amino acid replacement of the asparagine residue with an alanine residue using site-directed mutagenesis. The three glycosylation deficient renins (Asn-5, Asn-75, Asn-5 and -75 mutants) were expressed in COS cells and secreted into the conditioned media. The secreted amounts of the three mutants were different from one another, although the mutant and wild-type renins had practically the same specific activity. An Asn-5 and -75 mutant which did not contain any glycosylation sites was unstable in the medium, suggesting that the N linked oligosaccharides play an important role in stabilization of human renin. PMID- 3288504 TI - Evidence that during very low density lipoprotein assembly in rat hepatocytes most of the triacylglycerol and phospholipid are packaged with apolipoprotein B in the Golgi complex. AB - Rat liver lipids were labelled by an intraportal injection of [3H]palmitic acid followed by isolation of rough and smooth endoplasmic reticulum or 'cis' or 'trans'-enriched Golgi fractions. The preparations were separated into membrane and contents and the apolipoprotein B of the content fractions was immunoprecipitated. More than 90% of the labelled triacylglycerol and phospholipid secreted into the blood immunoprecipitated with apolipoprotein B. Under the same experimental conditions 8, 12, 27 and 59% of the lipids of the rough, smooth, 'cis-Golgi' and 'trans-Golgi' contents, respectively, were immunoprecipitated. Thus, the 'trans-Golgi' region appears to be the major intracellular site of assembly of apolipoprotein B with triacylglycerol and phospholipid. PMID- 3288505 TI - [Stages in the development of fluorography]. PMID- 3288506 TI - [Reconstruction of facial defects by transplantation of a latissimus dorsi musculocutaneous flap by the microvascular method]. PMID- 3288507 TI - [The effect of selenium on the microhardness of molars in rats kept on a normal and protein-deficient diet]. PMID- 3288508 TI - [The effect of estrogen on episodic secretory patterns of luteinizing hormone releasing hormone (LHRH) and luteinizing hormone (LH) in hypergonadotropic hypogonadism]. AB - The secretory dynamics of plasma luteinizing hormone-releasing hormone (LHRH) and serum luteinizing hormone (LH) were studied in three hypogonadal women before and after chronic administration of mestranol. Blood samples were obtained through an indwelling iv line every 15 min over 3 hours, and plasma levels of LHRH and LH were measured by radioimmunoassay. LHRH and LH pulses were defined as rising from nadir to peak that exceed 2 times the intraassay coefficient of variation. All patients showed pulsatile LHRH and LH release before mestranol administration. The mean LH levels (89 +/- 20 mIU/ml) and pulse amplitude (33 +/- 14 mIU/ml) were significantly reduced after mestranol administration. On the other hand, the mean LHRH levels (1.87 +/- 0.49 pg/ml) and pulse amplitude (0.92 +/- 0.41 pg/ml) did not change significantly after mestranol administration. Pulse frequency (2 approximately 3 times/3 hrs) of LHRH and LH did not change after mestranol administration. These data show that the chronic administration of estrogen to such patients cause a decrease in mean LH levels and amplitude of LH pulse without a decrease of pulsatile LHRH secretions. These results suggest that the chronic negative feedback action of estrogen on episodic LH release in women may be at the level of the pituitary gland and estrogen may change the pituitary sensitivity to LHRH. PMID- 3288509 TI - [Influence of spironolactone on urinary prostaglandin E2 and kinin excretions in spontaneously hypertensive rats]. AB - Spironolactone was administered to spontaneously hypertensive rats (SHRs) in order to examine the urinary excretions of prostaglandin E2 (PGE2) and kinin. Thirteen SHRs were divided into 2 groups, and 0.1 ml of sesame oil was administered to one of 2 groups (spironolactone-untreated group) (n = 6) and 20 mg of spironolactone in 0.1 ml of sesame oil was administered to the other group (spironolactone-treated group) (n = 7) by the subcutaneous route for 10 days in succession, followed by the determination of body weight, blood pressure, urine volume, excretion levels of Na, K, kinin and PGE2 in 24-hour urine. Blood samples were drawn after these animals were killed by decapitation for determining plasma renin activity (PRA). In consequence, decreased blood pressure and increased urinary Na excretion were observed in the spironolactone-treated group. On the other hand, PGE2 excretion level in 24-hour urine markedly decreased immediately after administration of spironolactone (p less than 0.05) and was maintained at lower levels up to the end of experiment. However, 24-hour urinary kinin levels showed similar changes in the spironolactone-treated group and the untreated group with no significant difference between the two groups. These results indicate that spironolactone has a suppressive effect on urinary PGE2 excretion, the activity of which is not mediated by kinin production in the kidneys but produced by a direct action of spironolactone itself. PMID- 3288510 TI - Diagnosis and classification of the periodontal diseases. AB - A classification for gingivitis and periodontitis has been proposed based on clinical observations and immunologic parameters (summarized in Table 10). Overlapping clinical situations and exceptions to the rule certainly exist and pose challenges to clinicians during diagnosis, prognosis, and treatment planning. The clinical significance of making the diagnosis of either rapidly progressive periodontitis, juvenile, or prepubertal forms of periodontitis compared with adult periodontitis must be considered. A diagnosis of early-onset disease may (1) modify the periodontal treatment plan and may include the use of systemic antibiotics (for example, tetracyclines) or antiplaque agents (for example, sanguinarine, chlorhexidine); (2) modify the prosthetic treatment plan and require longer periods of monitoring before extensive replacement or splinting is initiated; (3) increase the frequency of periodontal recall appointments (at least four to six times during the first year or two following peridontal therapy); (4) implicate a genetic basis for the disease with the possibility of peridontal involvement of other family members; (5) influence decisions on prognosis; and (6) alert the clinician for potential future rapid periodontal breakdown. Future studies will further define and characterize all forms of periodontal diseases. Clinical, microbial, and immunologic information may permit inclusion of the relatively rare forms of periodontitis such as ANUG periodontitis and refractory periodontitis. Understanding the underlying biologic mechanisms of the pathogenesis of the periodontal diseases, coupled with clinical observations, will permit improved clinical investigations that ultimately will improve therapeutic approaches. PMID- 3288511 TI - Antimicrobial agents in the prevention and treatment of periodontal diseases. AB - It has been estimated that there are more than 400 diseases affecting the oral cavity. In terms of prevalence, however, the major public health problems are caries and periodontal disease. Although these two destructive entities are completely different in many respects, they share a common denominator: the initial lesions are brought about by an aggregate of bacteria known as plaque. This article discusses chemical control of plaque in the treatment of gingivitis and antimicrobial control of subgingival plaque in the treatment of periodontitis. The authors address the use of antibiotics in the treatment of localized juvenile periodontitis, the ideal properties of antiplaque agents, and adjunctive subgingival application of antimicrobial agents. PMID- 3288512 TI - The furcation problem. Current controversies and future directions. AB - Effective management of furcation regions affected by periodontal destruction includes accurate assessment of etiologic factors, careful diagnosis of furcation involvement, and an appropriate plan of therapy. Many forms of therapy have been advocated; most have been designed to allow adequate professional and personal removal of plaque from the furcation. All types of traditional therapy have disadvantages that must be carefully considered by the therapist and the patient. Newer treatment modalities attempt to regenerate periodontal attachment in the furcation. The techniques do not have sufficient controlled documentation at this time to warrant unqualified support, but they appear to be biologically feasible and hold considerable clinical promise. At this time, guidelines for management of a periodontally involved furcation region must stress application of the simplest therapy that is likely to provide clinical stability. Longitudinal data from carefully controlled clinical trials comparing therapy techniques are needed to refine our clinical judgment. PMID- 3288513 TI - The laterally positioned flap. AB - The laterally positioned flap has shown itself to be the most predictable and esthetically successful procedure in the treatment of mucogingival defects such as gingival/periodontal recessions and root exposures. It is of utmost importance that the biologic principles of wound healing, which have been discussed in the literature and this article, should be adhered to prior to, during, and after the surgical procedure. PMID- 3288514 TI - Regenerative and reconstructive periodontal plastic surgery. Mucogingival surgery. AB - Mucogingival surgery currently encompasses surgical management of many defects thought to be untreatable when the term mucogingival surgery was introduced in the 1950s. Mucogingival surgery has now expanded beyond the treatment of recession and problems associated with attached gingiva. Additionally, it would now include correction of ridge form, exposing unerupted teeth for orthodontic treatment, crown lengthening for esthetic purposes, and frenal surgery. With this in mind, mucogingival surgery has been redefined as "periodontal plastic surgery." PMID- 3288515 TI - Periodontal and prosthodontic treatment for patients with advanced periodontal disease. AB - This article describes prosthetic management of advanced periodontally involved dentitions. Overall prognosis and means of assessing scores to prospective abutment teeth are presented. Esthetic treatment and prognosis of surgically elongated dentitions is discussed, and a method to determine what the patient will look like after completion of treatment is presented. A specific approach using ceramometal restorations with modified long bevel and minimum gold collar and the use of electrosurgery for subgingival access is covered. PMID- 3288516 TI - Periodontal aspects of osseointegrated oral implants modum Branemark. AB - The osseointegration method developed by Branemark offers new perspectives in the rehabilitation of partial and total edentulism in cooperation with the prosthodontist or general practitioner. The success rates over 90 and even 95 per cent in the upper and lower jaws, respectively, have been confirmed by several teams on series of consecutive patients. Ongoing research will allow discrimination between those systems that really osseointegrate predictably and those that do this irregularly or only demonstrate a close bone apposition. There is an urgent need for follow-up studies on consecutive patients of 5 or preferably 10 years before unrestricted clinical applications are granted. There are attractive research perspectives offered by the osseointegration principle in the field of periodontology. Fundamental questions concerning bacterial colonization of hard surfaces in the oral cavity, epithelial downgrowth, ankylosis, and others can be addressed and extrapolated to the treatment of periodontal pathologies around teeth. PMID- 3288517 TI - Teaching periodontics. Past patterns and future prospects. AB - The article presents a brief history of the development of periodontal concepts and their data base. Because of the rapid change in periodontal science and knowledge, the author pleads for periodontal education based on "show, deliberate, choose, and do" in our dental curricula. PMID- 3288518 TI - Changing concepts in periodontics. AB - This article reflects long-term observations of a clinician in private practice. Significant changes have occurred in periodontology in the past 50 years, while basic principles of periodontics have remained firm. State of the art and predictions of the future of periodontal practice are based on experience gained in both a general practice and a practice limited to periodontics. PMID- 3288519 TI - In vitro acantholysis by captopril and thiopronine. AB - The possible acantholytic property of captopril and thiopronine has been investigated using in vitro tissue cultures. Normal human breast skin explants have been cultured in Hanks' balanced salt solution containing 40% normal inactivated human serum with the addition of L-cysteine, or reduced glutathione (GSH), or captopril, or thiopronine, at four different concentrations (1, 5, 10, 15 mM). Patterns of diffuse, mainly suprabasal acantholysis, with formation of bullae, were observed in the skin explants cultured with captopril or thiopronine at a 15-mM concentration after 5 days of culture; intraepidermal splits were present also at a 10-mM concentration. Focal acantholysis was seen in specimens cultured with L-cysteine or GSH at a 15-mM concentration. No lesions occurred in the samples treated with lower concentrations of the above substances, nor in controls. The results show a biochemical acantholytic potential of both captopril and thiopronine, resembling that of penicillamine in similar experimental conditions, and consonant with clinical observations of pemphigus induced by drugs containing thiol groups in their molecule (SH drugs). PMID- 3288520 TI - Tinea faciei caused by Microsporum canis in a newborn. AB - A case of tinea faciei caused by Microsporum canis in a 14-day-old infant is reported. The incubation period was seen to be 1 week. This was a familial infection which also affected the infant's grandmother and their pet cat and dog. Topical treatment with clotrimazole controlled the infection in the baby. A review of 14 cases (including our own) of dermatophytosis in newborn infants reported in the Japanese literature showed that newborn infants might be infected by several of these agents. PMID- 3288521 TI - Herpes gestationis in mother and erythemato-pustulous rash in the newborn with positive direct immunofluorescence. A transfer of the disease? AB - A 24-year-old secundigravida presented at 38 weeks of amenorrhea with typical cutaneous lesions of herpes gestationis. The newborn developed a skin rash 3 days after birth. The rash clinically resembled erythema toxicum neonatorum with dermal infiltrate of lymphocytes and eosinophilic polymorphonuclear cells forming a few intraepidermal pustules. The complement-binding antibody test for herpes gestationis factor was negative, but direct immunofluorescence study on this biopsy demonstrated a linear deposit of IgG and complement on the basement membrane zone. The possible transmission of the disease to the newborn is discussed. PMID- 3288522 TI - Localized nonscarring bullous pemphigoid of the vagina. AB - Here we report on a 60-year-old female patient suffering from multiple erosive inflammatory lesions of the vagina for 2 years. Subepidermal blister in the histological examination, deposits of IgG and C3 in the direct immunofluorescence studies and the basement membrane zone antibody titers between 80 and 320 have confirmed the diagnosis of bullous pemphigoid. The lesions responded to treatment with prednisolone and azathioprine fairly well. There have been no signs of scarring till now. PMID- 3288523 TI - Ketotifen in the young asthmatic--a double-blind placebo-controlled trial. AB - A double-blind placebo-controlled trial was carried out to assess the efficacy of ketotifen in the pre-school asthmatic. The trial period consisted of a 1-month run-in period followed by a 4-month treatment period. Symptom scores for asthma, rhinitis, eczema and, where possible, twice daily peak flow measurements (24 cases) were recorded on diary cards by the parents. All concomitant medication used in addition to the trial drug was noted. The only medication not allowed was disodium cromoglycate. A total of 37 children, 23 boys and 14 girls, mean age 4.1 years (range 1.3-5.9 years) completed the trial. They comprised 19 given ketotifen and 18 given placebo. All were atopic and had allergic rhinitis and 15 had eczema. Ketotifen dosage was 1 mg twice daily in the under 5-year-olds (23 cases) and 2 mg twice daily in the remainder. On analysing the results no significant benefit could be demonstrated for giving ketotifen in this group of patients. PMID- 3288524 TI - Efficacy and tolerance of naproxen instant suspension formulation: a post marketing survey. AB - A multi-centre uncontrolled clinical trial was performed in 42 Italian hospitals to evaluate the efficacy and tolerance of an instant suspension of naproxen, a well known anti-inflammatory drug. A total of 390 adults of all ages with musculoskeletal rheumatic diseases or minor traumatic injuries entered the trial. Patients received 500 mg naproxen instant suspension twice daily after meals, for 1-4 weeks. Assessment of signs and symptoms was made before starting the therapy, after 3 days and at the end of the treatment period. The drug produced a rapid and progressive relief of pain and articular symptoms in most patients and was equally effective in all the diagnostic sub-groups. The efficacy of treatment was 'excellent' or 'good' in about 85% of patients, 'moderate' in 10% and 'minimal' or 'absent' in about 5%. Almost 90% of patients had no side-effects; 5% were withdrawn because of unwanted effects. No correlation between incidence or intensity of side-effects and age of the patients or duration of therapy was observed. The complaints reported are common to other anti-rheumatic drugs, e.g. epigastric pain, pyrosis, nausea, vomiting and headache. In conclusion, naproxen instant suspension is highly effective and well tolerated. PMID- 3288525 TI - Single-dose clavulanate-potentiated amoxycillin versus three-dose cefotaxime in the prevention of wound infection following elective cholecystectomy: a prospective randomized study. AB - A prospective randomized study was carried out to evaluate the efficacy of clavulanate-potentiated amoxycillin with that of cefotaxime as prophylactic agents for the prevention of sepsis following elective cholecystectomy. One hundred patients were randomized into two treatment groups. In the first group, each patient received a single intravenous dose (1200 mg) of clavulanate potentiated amoxycillin 2 h before surgery. In the second group, patients were given intravenous cefotaxime, in three doses (2 g each) during surgery, and 6 and 12 h after their operation. No case of serious post-operative sepsis occurred in either group. Superficial wound infection occurred in 2% of patients receiving a single pre-operative dose of clavulanate-potentiated amoxycillin and in 6% of those given cefotaxime according to the three-dose regimen. PMID- 3288526 TI - Cell polarity in sea urchin embryos: reorientation of cells occurs quickly in aggregates. AB - Four apical components were used as markers for the apical end of the cell in studies centering on cell polarity in the early blastula stage of sea urchin embryos and in aggregates of cleavage stage cells. Cells were observed to maintain their polarity for several hours if dissociated and cultured in suspension. Orientation of cells in aggregates initially is random; however, within 3 hr the cells have reoriented so that their apical-basal axis corresponds to the correct inside-outside position in the aggregate. This reorientation occurs before formation of a basal lamina or a new hyalin layer in the aggregate, and appears to take place by a rotation or other movement of individual cells. The polarity within each cell is maintained during reorientation. An apical surface antigen is colocalized with concentrations of filamentous actin. Treatment of isolated cells with cytochalasin B causes the antigen to lose its apical position and eventually become distributed around the outside of the cell. Microtubules are visible radiating from two foci closely associated with the nucleus in untreated cells. Treatment of isolated cells with nocodazole leaves the apical cell surface marker and its associated actin undisturbed, but causes the nucleus to lose its apical position. Cytochalasin B and colchicine both prevent reorientation of cells in aggregates. Thus polarity appears to be a constant for the cells, and their reorientation in aggregates occurs prior to the polarized release of extraembryonic matrix and basal lamina. PMID- 3288527 TI - Molecular-genetic analysis and assessment of insulin action and pancreatic beta cell function. AB - Although the hereditary nature of non-insulin-dependent diabetes mellitus (NIDDM) is well recognized, the nature of the predisposing defect remains elusive. Individuals with a history of gestational diabetes had shown a reduced insulin sensitivity index (S1) in the absence of fasting hyperglycemia. To determine whether this finding could result from an inherited defect of the insulin receptor, an NIDDM pedigree was ascertained through a former gestational-diabetic proband. The proband, her siblings, and her first cousins were clinically characterized for insulin sensitivity with the minimal-model-based S1 from a modified glucose tolerance test. Islet function was characterized by the incremental insulin response to 5 g i.v. arginine at baseline and at a plasma glucose level of 500-600 mg/dl. Genetic studies included linkage analyses for the insulin gene and the insulin-receptor gene with DNA polymorphisms (restriction fragment-length polymorphisms, RFLPs) previously described. The pattern of inheritance in this large pedigree appeared to follow autosomal-dominant transmission. No defect in islet function was found, but as a group, third generation family members had an S1 that was significantly lower than that of weight-matched control individuals, suggesting an inherited defect in insulin action. Genetic studies showed no sharing of insulin gene, insulin-receptor-gene alleles among the diabetic individuals, or insulin-receptor alleles among third generation individuals with insulin insensitivity. The genetic analyses thus suggest that this pedigree has an inherited defect that is not linked to the insulin gene or the insulin-receptor gene. The diminished S1 may nonetheless suggest an inherited defect in insulin action. PMID- 3288528 TI - Effect of intensive diabetes treatment on low-density lipoprotein apolipoprotein B kinetics in type I diabetes. AB - The metabolism of low-density lipoprotein (LDL) was studied in six insulin dependent (type I) diabetic patients during a 7-wk period of conventional and intensive therapy with insulin. Plasma glucose and HbA1c were normalized, demonstrating the effectiveness of our intensive treatment program. Plasma lipoprotein profiles and LDL apolipoprotein B kinetic parameters were estimated during conventional and then during intensive therapy for each patient. Intensive therapy resulted in a significant reduction of plasma and LDL cholesterol and an increase in high-density lipoprotein (HDL) cholesterol. The lower LDL levels resulted from a decreased production of lipoprotein rather than an increased fractional catabolic rate. These results are consistent with our previous observations of very-low-density lipoprotein (VLDL) metabolism during intensive therapy. VLDL production is significantly reduced; thus, a decreased production of LDL supports the contention that intensive therapy with insulin in normolipemic type I diabetic patients reduces the production of lipoproteins containing apolipoprotein B rather than increasing the clearance, and therapy also increases HDL cholesterol. Both of these effects may be beneficial in reducing the risk for coronary heart disease in type I diabetes. PMID- 3288529 TI - Reversible impairment of glucose-induced insulin secretion in SHR/N-cp rats. Genetic model of type II diabetes. AB - The SHR/N-cp rat is a new genetically obese model for non-insulin-dependent diabetes mellitus. Expression of the diabetes is enhanced by a high-sucrose (54%) diet. After 4 wk on the diet, the cp/cp rats weigh significantly more than their +/? controls, have postprandial hyperglycemia (greater than 400 mg/dl), and are hyperinsulinemic, with immunoreactive insulin (IRI) levels 10- to 20-fold greater than controls. Total pancreatic IRI tends to be increased 1.6-fold in the cp/cp rats (although not significantly). There is no increase in pancreatic proinsulin content as a percent of total IRI. Studies of in vitro pancreatic function were carried out with the isolated nonrecirculating perfused pancreas method. The cp/cp rats (n = 10) showed impaired or absent IRI responses to 16.5 mM glucose, whereas +/? rats (n = 9) responded with classic biphasic curves. Comparison of insulin secreted in 20 min revealed a greater than 53% decrease in IRI secretion in cp/cp rats (P less than .05). A paradoxical hypersecretion of IRI at glucose concentrations of 0-2.7 mM was noted in cp/cp but not lean rats, i.e., 1.8 +/- 0.2 mU/min IRI in cp/cp rats vs. 0.04 +/- 0.007 mU/min in +/? rats. Perfusion of pancreases for 45 min with buffers containing no glucose resulted in restoration of a normal biphasic IRI response to 16.5 mM glucose in the cp/cp rats, whereas response in the lean rats was markedly reduced. Brisk IRI responses to 10 mM arginine in buffers with no glucose also occurred in cp/cp but not +/? rats. Glucagon secretion was relatively suppressed in the cp/cp rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288530 TI - Automated method for isolation of human pancreatic islets. AB - We describe an automated method for the isolation of human pancreatic islets. The procedure meets the following requirements: 1) minimal traumatic action on the islets, 2) continuous digestion in which the islets that are progressively liberated can be saved from further enzymatic action, 3) minimal human intervention in the digestion process, and 4) high yield and purity of the isolated islets. After purification on Ficoll gradients, an average of 164,600 islets/pancreas was obtained (2279 islets/g), with an average purity of 78.5% islets. The average volume and average insulin content of the final islet preparation were 348 mm3 and 93.4 U, respectively. The islets were morphologically intact with a normal degree of beta-granulation and responded to glucose stimulation with a fivefold increase of insulin secretion over basal levels. The procedure is now being used for the initiation of the second phase of clinical trials on human islet transplants. PMID- 3288531 TI - In vitro studies of insulin resistance in patients with lipoatrophic diabetes. Evidence for heterogeneous postbinding defects. AB - We studied the binding and action of insulin in cultured fibroblasts from six patients with lipoatrophic diabetes and marked in vivo insulin resistance and from seven control subjects. The binding of insulin was not altered, which corresponds well with studies with circulating erythrocytes. Similarly, the action of the hormone on amino acid uptake (estimated by active transport of aminoisobutyric acid) was comparable in patient and control cells. Conversely, studies concerning the effect of insulin on glucose transport (estimated by facilitated diffusion of 2-deoxyglucose) or glycogen synthesis (estimated by incorporation of glucose into cellular glycogen) revealed the presence of heterogeneous alterations among the different patient cell lines. However, although the nature of the defect(s) varied among the patients, alterations in glucose metabolism were present in all cases. These data suggest the presence of primary postbinding defects in glucose cellular pathways that give rise to insulin resistance in cells from lipoatrophic diabetic patients. PMID- 3288532 TI - Evidence for insulinotropic effect from rat parotid glands. AB - Previous observations have suggested that the salivary glands exercise a regulatory role on insulin secretion and/or glucose metabolism. We have challenged the issue by studying in unanesthetized, unrestrained rats the short- and long-term effect of selective sialoadenectomy on the animals' ability to meet an intra-arterial glucose challenge. Ten-minute intra-arterial glucose tolerance tests were carried out in chronically catheterized adult rats before and after sialoadenectomy. Eighty-five to 100 days postsurgery, the parotidectomized rats experienced a 45% reduction in plasma immunoreactive insulin output (P less than .001) compared with the sham-operated animals; the plasma glucose levels of the test subjects remained 19% higher (P less than .001) than those of the control group. In younger rats, similar observations were made; however, the difference in insulin and glucose responses between treatments was less than in the adult rats. Our findings suggest that the insulinotropic effect resides primarily with the parotids, and the role of the submandibular glands seems to be permissive at best. We hypothesize that parotidectomy deprives the beta-cells of a humoral principle that appears to be essential for optimizing the immediate insulin response to a glucose challenge. These results suggest that the insulinotropic effect of the parotids is of particular importance when aging changes insulin secretion and action. PMID- 3288533 TI - Autonomic and somatosensory nerve function after 2 years of continuous subcutaneous insulin infusion in type I diabetes. AB - Autonomic and somatosensory nerve function was studied in 24 insulin-dependent diabetic subjects (aged 29 +/- 7 yrs, diabetes duration 8 +/- 4 yr) randomly allocated to either continuous subcutaneous insulin infusion (CSII; n = 12) or unchanged conventional insulin therapy (CIT; n = 12). Measures of glycemic control and somatosensory and autonomic nerve function were comparable in the two groups at the start. Glycemic control was significantly improved in the CSII group throughout study, whereas it remained unchanged in the CIT group. In the CIT group, vibratory perception threshold (VPT) of the great toe and the medial malleolus deteriorated, as did heart rate variation (HRV) at rest, at deep breathing (.05 less than P less than .06), and at standing. In contrast, CSII patients retained their VPT and HRV. Comparison of nerve function alterations during the 2-yr trial showed better preservation in CSII than in CIT patients of VPT in the great toe (0.8 +/- 1.7 vs. -1.4 +/- 1.9 V, P less than .01) and the medial malleolus (1.5 +/- 2.9 vs. -1.4 +/- 1.8 V, P less than .05) and of HRV at rest (10 +/- 24 vs. -13 +/- 22 ms, P less than .05) and at standing (-0.01 +/- 0.13 vs. -0.15 +/- 0.16 ms, P less than .05). We conclude that intensified glycemic control can favorably influence parasympathetic and somatosensory nerve function in insulin-dependent diabetes mellitus. PMID- 3288534 TI - Circulating anti-immunoglobulin antibodies in recent-onset type I diabetic patients. AB - Human sera from 51 recent-onset insulin-dependent (type I) diabetic patients and 47 unrelated control subjects were screened for the possible presence of circulating factors reacting with several anti-pancreatic islet monoclonal antibodies (MoAb.ISL) in solid-phase radioimmunoassay methods (the original goal being the detection of anti-idiotypic islet cell antibodies and/or specific islet cell antigen-bearing immune complexes). MoAbs from the parental myeloma cell line and purified immunoglobulins (Igs) from different animal species were controls. Type I diabetic sera showed significantly increased binding to MoAb.ISL-coated wells compared with normal subjects (P less than .001). However, the same sera also tended to show a higher binding to the control (non-islet-related) MoAb. Sera from type I diabetic patients also reacted with horse, bovine, pig, rabbit, and goat IgG. Displacement of the binding has been obtained by F(ab')2 and/or Fc fragments of IgG. Evidence has been obtained regarding a similar reaction with human IgM. All the sera were negative when tested for rheumatoid factor by nephelometry. The circulating antibodies described have been proven to be different from islet cell autoantibodies. An anti-Ig antibody is thus present in the sera of recent-onset diabetic patients and represents an additional immunological phenomenon with possible physiopathological and clinical significance. PMID- 3288535 TI - Post-traumatic stress disorder following myocardial infarction. AB - The evaluation of Post-Traumatic Stress Disorder (PTSD) following myocardial infarction in four patients is described. The authors outline principles of the therapeutic interventions performed to alter the disorder and alleviate patients' incapacitation. Also discussed are the reasons that may be at the root of the omission of the diagnosis of PTSD for this patient population. PMID- 3288536 TI - Principles of screening applied to psychiatric disorders. AB - The morbidity and mortality caused by psychiatric illness is a significant public health problem. The use of a psychiatric screening questionnaire has been one strategy to improve the recognition and treatment of psychiatric disorders in general medical settings. This paper discusses how well psychiatric screening procedures fulfill criteria outlined by the World Health Organization for evaluating the utility of general medical screening efforts. Current research on the utility of screening for psychiatric disorders is reviewed, and the lack of data on the treatment of psychiatric disorders is identified in the general medical sector is emphasized. The randomized clinical trial is offered as the best method to test the efficacy of screening by eliminating various biases outlined in the paper. Quantitative concepts such as positive predictive value and receiver operator characteristic analysis are discussed. The need for more research on the efficacy of early treatment of psychiatric disorders is emphasized. PMID- 3288537 TI - [Rapid postradiation recovery of yeasts: the relationship to gamma-induced reciprocal mitotic recombination and gene conversion]. AB - gamma-induced reciprocal mitotic recombination and gene conversion have been studied under conditions inhibiting "rapid" postirradiation recovery of diploid yeast Saccharomyces cerevisiae. It turned out that, if the first postirradiation cell division occurs at higher KCl concentrations ("rapid" postirradiation recovery is inhibited), the frequency of mitotic reciprocal recombination within the gene ADE2-centromere region decreases. Keeping of irradiated cells (in the G1 phase of the cell division cycle) in water at 28 degrees C prior to plating on the selective agar containing 1.5 M KCl leads to smaller frequency of gene conversion lys2-25/lys2-22----Lys+, as compared with that for the cells immediately plated on the selective agar. Correlation has been found between the coefficient of gene conversion frequency decrease, due to postirradiation keeping in water, and "rapid" recovery efficiency. Interpretation of the data is based on the hypothesis that recombination repair of DNA double-strand breaks induced by ionizing radiation is responsible for "rapid" postirradiation recovery. PMID- 3288538 TI - [Transfer of hybrid plasmids pRP1.2::MINI-Mu into Agrobacterium and Rhizobium cells]. AB - The study is devoted to determination of bacteriophage Mu genome regions responsible for transfer limitation and instability of the plasmids in cells of strains of practically important microorganisms. With this aim in view, we determined the frequency of transfer into Agrobacterium tumefaciens and Rhizobium meliloti cells of plasmids with mini-Mu phages carrying previously constructed deletions of various lengths. Sharp decrease has been noted in the frequency of transfer into A. tumefaciens strain PG2592 of all the plasmids used, as compared with the initial plasmid pRP1.2 with no dependence on the availability of mini-Mu killing functions. This gives evidence that deletions in the mini-Mu utilized do not include the sites affected by the recipient' restriction system. As regards R. meliloti L5-30-M27, it appeared that the transfer of pRM30 plasmid carrying mini-Mu 5 with conserved killing functions (the ability for autonomous transposition) is of the same frequency as the transfer of pRP1.2. In this mini Mu, the region between the extreme HpAI sites in the right end is missing, this region being probably responsible for such low frequency of transfer into Rhizobium cells of Mu-containing plasmid. PMID- 3288539 TI - [Ploidy of a mutant Saccharomyces cerevisiae defective in homologous recombination]. AB - The ploidy of a mutant of Saccharomyces cerevisiae defective in recombination (Rec-) has been determined using tetrad analysis and flowing fluorometry. Evidence is obtained that the effect of the Rec- phenotype, i.e. the increase of the stability of plasmids with 2 mkm DNA ori replication in the yeast cirO cells is not the result of the diploidy in cells of the Rec- mutant developed in the process of transformation. PMID- 3288540 TI - Trans-acting protein factors and the regulation of eukaryotic transcription: lessons from studies on DNA tumor viruses. PMID- 3288541 TI - Specific binding of proteins from Rhizobium meliloti cell-free extracts containing NodD to DNA sequences upstream of inducible nodulation genes. AB - Nodulation (nod) genes in Rhizobium meliloti are transcriptionally induced by flavonoid signal molecules, such as luteolin, produced by its symbiotic host plant, alfalfa. This induction depends on expression of nodD. Upstream of three inducible nod gene clusters, nodABC, nodFE, and nodH, is a highly conserved sequence referred to as a 'nod box.' The upstream sequences have no other obvious similarity. We have found that DNA fragments containing the regions upstream of all three inducible transcripts show altered electrophoretic mobility when treated with R. meliloti extracts. The ability of the extracts to interact specifically with these DNAs correlated with the genetic dosage of nodD1 or nodD3 and with the presence and concentration of the nodD1 or nodD3 protein (NodD1 or NodD3) in the extracts. Antiserum specific to NodD was used to construct an immunoaffinity column that permitted a substantial purification of NodD1; this preparation of NodD1 also displayed specific binding to restriction fragments containing DNA sequences found upstream of inducible nod genes. In addition, NodD specific antiserum removed the specific DNA-binding activity from total Rhizobium cell extracts. The interaction of total extracts and of partially purified NodD protein with nod promoter sequences was competitive with an oligonucleotide representing the 3' 25-bp portion of the nod box. The interaction of R. meliloti extracts and NodD1 protein with nod gene upstream regions occurred independently of exposure of cells or extracts to flavone inducer. PMID- 3288543 TI - [Irritable bowel syndrome. Diagnosis and treatment]. PMID- 3288544 TI - [Ovarian stimulation in menopause. Placebo-controlled double-blind study of the effectiveness and tolerance of the splenic dialysate Solcosplen in climacteric complaints in the female]. PMID- 3288545 TI - Medicare support of medical education. PMID- 3288542 TI - [Food allergies. Allergic and pseudoallergic reactions and their practical significance]. PMID- 3288546 TI - The Veterans Administration and graduate medical education. PMID- 3288547 TI - Perspectives: a senator. PMID- 3288548 TI - Mitral valve prolapse and the anxiety disorders. AB - Confusing and contradictory results have emerged from studies of the relationship between anxiety disorders and mitral valve prolapse (MVP), a commonly occurring heart defect that has been associated with chest pain, palpitations, tachycardia, and arrhythmias. Patients with anxiety disorders, particularly panic attacks, appear to have an increased prevalence of MVP compared with control groups or the general population, although most individuals with MVP are asymptomatic. MVP does not appear to distinguish a subgroup of patients with panic disorder on the basis of vulnerability to panic attacks, symptom presentation, biological abnormalities, or treatment response. The authors review some current hypotheses about causal relationships between anxiety disorders and MVP, describe methods of diagnosing MVP and their shortcomings, and identify possible medical complications of MVP and ways to treat or prevent them. PMID- 3288549 TI - Providence gets exception to large city cutoff. PMID- 3288550 TI - Survey: Medicare A/R worsen again. PMID- 3288551 TI - Medicare HMOs hit by underpayment and slower growth. PMID- 3288552 TI - HHS malpractice offer could fall short of mark. PMID- 3288553 TI - Tumor invasion: a consequence of destructive and compositional matrix alterations. PMID- 3288554 TI - Intestinal mucin antigens in ulcerative colitis and their relationship with malignancy. AB - The expression of two intestinal mucin-associated antigens large intestine mucin antigen (LIMA) and small intestine mucin antigen (SIMA) were investigated by indirect immunoperoxidase staining of rectal mucosa from patients suffering from ulcerative colitis with (n = 6) and without (n = 31) associated carcinoma and in noncolitic controls (n = 40). The aim was to assess the relationship between antigen patterns and malignant change. SIMA, which is localised predominantly in the small intestine, is virtually undetectable in the normal adult colonic mucosa. However, this antigen is present in the foetal colon and colonic carcinoma. LIMA is expressed in normal colonic mucosa, but absent from the small intestine. LIMA staining patterns were not significantly different among the three groups. In contrast, expression of SIMA was significantly higher in the patients who had developed carcinoma (6/6) than in the noncancer group (7/71) (P less than 0.001). The presence of SIMA was also significantly related to areas of dysplasia compared to normal (P = .03) or inflammation (P less than .05), but it did not differ from mucosa showing "indefinite" atypia. The finding of 31% SIMA positive biopsies associated with severe inflammation in colitis with active disease, but no evidence of malignancy, is difficult to explain at the present stage. A followup study would be necessary to determine its significance. Perhaps the most important finding is the increased frequency of SIMA-positive foci in histologically normal mucosa in carcinoma patients compared with the noncancer group (P less than .001), suggesting a field change. These observations may be prove useful for the identification of patients who may be at risk of developing carcinoma. PMID- 3288555 TI - Polygenic control of quantitative antibody responsiveness: restrictions of the multispecific effect related to the selection antigen. AB - Among the differences observed between the various high (H) and low (L) antibody responder lines of mice resulting from distinct bidirectional selective breedings, one of the most puzzling is the variation in the "multispecific effect," i.e., in the modification of antibody responses to antigens unrelated to those used during the selection. The best examples are the H and L lines of selection IV, selected on the basis of responses to somatic antigen of Salmonella which do not differ in their antibody responses to sheep erythrocytes (SE). However, a wide range of variability is observed in the responses of (HIV X LIV)F2 hybrids to this antigen, and it was therefore hypothesized that distinct groups of genes might regulate antibody responses to SE and the somatic antigen. Indeed, a new selection (IV-A) for anti-SE responsiveness started from these (HIV X LIV)F2 successfully produced a high and a low anti-SE responder line. The results of selection IV-A and the variance analysis of (HIV-A X LIV-A)F2 hybrids are reported. They are roughly similar to those in selection I, also carried out for anti-SE responsiveness. In vivo attempts to identify the major regulatory mechanism which contributes to the interline difference indicate that the efficiency of macrophage accessory function has been modified in selection IV-A, as was observed in selection I, whereas this function did not differ in HIV and LIV lines. Probably in relation to the involvement of macrophage function there is a notable increase of the multispecific effect in selection IV-A when compared with selection IV. The results of selection IV-A demonstrate that responsiveness to heterologous erythrocytes and to somatic antigen of Salmonella are under separate polygenic control operating through distinct regulatory mechanisms. The choice of the selection antigen and immunization procedure is of major importance for defining the gene interaction operating in each selective breeding experiment and the extent of its multispecific effect. PMID- 3288556 TI - The role of electrophysiologic studies in pediatric cardiology: an overview. PMID- 3288557 TI - Advances in the treatment of cardiac dysrhythmias. PMID- 3288558 TI - Transcatheter therapy of cardiac defects in infants and children. PMID- 3288559 TI - Digitalis toxicity in infancy and childhood. PMID- 3288560 TI - Pharmacologic manipulation of the ductus arteriosus in the neonate: a physiologic basis and current state of the art. PMID- 3288562 TI - Is there a need to modify the "revised" Jones diagnostic criteria of acute rheumatic fever? PMID- 3288563 TI - Corporatization and the social transformation of doctoring. AB - Corporatization of health care is dramatically transforming the medical workplace and profoundly altering the everyday work of the doctor. In this article, the authors discuss recent changes in U.S. health care and their impact on doctoring, and outline the major theoretical explanations of the social transformation of medical work under advanced capitalism. The adequacy of the prevailing view of professionalism (Freidson's notion of professional dominance) is considered, and an alternative view, informed by recent changes, is offered. While the social transformation of doctoring is discussed with reference to recent U.S. experience, no country or health system can be considered immune. Indeed, U.S. experience may be instructive for doctors and health care researchers in other national settings as to what they may expect. PMID- 3288564 TI - Learned helplessness at work. AB - The development of theory and research on learned helplessness is reviewed and criticized on some points, e.g., for its reliance on artificial laboratory experiments. Some empirical findings are presented, indicating a connection between certain work characteristics and learned helplessness. Other research traditions have emphasized the importance of job qualifications, freedom of action, and development possibilities for well-being and health. There is, however, hardly and research on learned helplessness at work. Learned helplessness hypotheses should be tested on data from real life; if applied to work environment research, the theory of learned helplessness could generate important results. PMID- 3288561 TI - Infective endocarditis during infancy and childhood: current status. PMID- 3288565 TI - Medical metaphors of women's bodies: menstruation and menopause. AB - Implicit, underlying imagery in medical descriptions of menstruation and menopause is exposed, beginning with 19th century views. Contemporary medical texts and teaching reveal two fundamental assumptions about women's bodies. First, they assume that female reproductive organs are organized as if they form a hierarchical, bureaucratic organization under centralized control. Given this assumption, menopause comes to be described negatively, as a process involving breakdown of central control. Second, they assume that women's bodies are predominantly for the control. Second, they assume that women's bodies are predominantly for the purpose of production of desirable substances, primarily babies. Given this assumption, menstruation comes to be seen negatively, as a process involving failed production, waste products, and debris. Alternative imagery that works from our current understanding of physiology, but avoids denigration of women's bodies, is suggested. PMID- 3288566 TI - Corneal surgery II. PMID- 3288567 TI - Keratoprosthesis: past and present. PMID- 3288568 TI - Development and evaluation of refractive surgical procedures. PMID- 3288569 TI - Radial keratotomy. PMID- 3288570 TI - Epikeratophakia. PMID- 3288571 TI - Corrective surgery for astigmatism. PMID- 3288572 TI - [Dealing with therapeutic drugs]. PMID- 3288573 TI - [Bioequivalence of generic drugs]. PMID- 3288574 TI - [Reflections on the problem of the "critical period" in teratology]. PMID- 3288575 TI - [Drug prescriptions in pregnancy. Current status]. PMID- 3288576 TI - [Cleft hand and cleft foot abnormalities as a possible teratogenic side effect of the anthelmintic piperazine?]. PMID- 3288577 TI - [Position of the German Society of Internal Medicine on AIDS]. PMID- 3288578 TI - [Medical education in France]. PMID- 3288579 TI - [Treatment of hypertension today]. PMID- 3288580 TI - [Mild hypertension--a critical analysis of intervention studies]. PMID- 3288581 TI - [Hypertension and renal failure]. PMID- 3288582 TI - [Renovascular hypertension]. PMID- 3288583 TI - [Forms of adrenal hypertension]. PMID- 3288584 TI - [Hypertension and nutrition]. PMID- 3288585 TI - [Antihypertensive therapy and compliance. Effect of form of therapy and quality of life]. PMID- 3288586 TI - [A 35-year-old patient with polyarthritis and a stenosing colon tumor]. PMID- 3288587 TI - [Febrile diarrheal disease following extensive retroperitoneal lymphadenectomy]. PMID- 3288588 TI - [Severe deglutition disorders in a patient with a mediastinal space-occupying lesion]. PMID- 3288589 TI - [Leasing contracts in medical practices--what should be considered?]. PMID- 3288591 TI - Pyogenic liver abscess in pregnancy. AB - The first case of pyogenic liver abscess during pregnancy is described. Despite its rarity, this severe complication has to be considered when a febrile illness accompanied by upper abdominal pain and hepatomegaly occurs during pregnancy and puerperium. Diagnostic methods and treatment are suggested. PMID- 3288590 TI - Transient regional and migratory osteoporosis. A possible neural mechanism. AB - Transient osteoporosis of the hip is a rapidly developing painful osteoporosis of benign nature and as yet unexplained pathophysiology. We add 5 new cases of transient osteoporosis, 4 of which are regional and 1 migratory, to 70 cases abstracted from the literature. Our review of the literature confirmed that there are two major subgroups of transient osteoporosis: regional and migratory. Two of our cases exhibited abnormal neurological findings. A possible neural mechanism related to regional osteoporosis should be further explored by a meticulous neurological and electrophysiological workup of such patients. PMID- 3288592 TI - Giant mammary hamartoma--case report and review of the literature. AB - A case of giant mammary hamartoma is presented. Macroscopically the tumor resembled giant fibroadenoma and cystosarcoma phylloides. Histological criteria for diagnosis include encapsulation, preservation of lobular integrity and the presence of adipose tissue. The radiological picture is described and the differential diagnosis discussed. PMID- 3288593 TI - Early proteinuria and irreversible renal failure after kidney donation in a patient with a family history of renal disease. PMID- 3288595 TI - Hyperthyroid-induced chorea. Case report and review of the literature. PMID- 3288594 TI - Neurophysiological changes in the brain following central administration of immunomodulatory factors. PMID- 3288597 TI - [Clinico-immunological analysis of the significance of natural killer cells in skin diseases]. AB - Natural killer (NK) cells comprise a heterogeneous subpopulation of mononuclear cells with the capacity to spontaneously lyse neoplastic, virus-infected and special physiological cells. As such, they have been widely implicated in the regulation of immune function by secretion of several cell-specific substances. Measurement of NK-cell activity in vitro and identification of NK-cell subsets using multi-colour immunofluorescence and flow cytometry analysis are helpful techniques for the recognition of abnormalities in the NK-cell system. Experimental and clinical studies have shown that NK cells may play an important role in natural resistance to tumours in vivo, certain viruses and other microbial diseases. Defective NK activity has been described in various dermatological diseases, such as cancer, infections and autoimmune diseases. Recent data have shown that several kinds of therapy influence NK-cell activity. This review describes the relationship between NK cells and dermatological diseases as well as clinical treatment. PMID- 3288596 TI - Posttransfusion thrombocytopenia. PMID- 3288598 TI - [UV-A exposure of the human epidermis enhances the binding of antibodies to SSA/Ro in vitro]. AB - Normal and psoriatic skin specimens (n = 15) were processed to give 4-micron thick frozen sections and exposed to a single UV irradiation in vitro. We used monochromatic UV-B (313 nm) and UV-A (365 nm). The doses were as follows: 10(3)/10(4) J/m2 (UV-B) or 4.10(3)/8.10(4) J/m2 (UV-A). We investigated the effect on epidermal binding of antibodies to SSA/Ro using the indirect immunofluorescence technique. Untreated and UV-B-treated human skin failed to bind anti-SSA/Ro. UV-A exposure disclosed reticular or granular staining of epidermal nuclei and a perinuclear halo. The effect was nearly the same throughout the dosage range. The combination of UV-A and methoxsalen increased the intensity of staining. Normal and psoriatic skin behaved in the same way. PMID- 3288599 TI - [Congenital poikiloderma with verrucous hyperkeratosis. An unusual form of Thomson's syndrome?]. AB - A 50 year old male patient suffered from poikilodermatous skin since his 14th year of life. During the past 5 years hyperkeratotic plaques and squamous cell carcinomas developed, leading to metastases into lymph nodes and the lung and fatal outcome. To our knowledge, up to now 6 cases of congenital poikiloderma (Thomson-syndrome, Rothmund-Thomson-syndrome) in conjunction with verrucous hyperkeratosis and squamous cell carcinoma have been reported in the literature. PMID- 3288600 TI - Active immunization of heifers against luteinizing hormone-releasing hormone, human chorionic gonadotropin and bovine luteinizing hormone. AB - Seventy crossbred heifers were allotted randomly to 10 treatment groups. Treatments consisted of active immunization against ovalbumin (OV) conjugates of luteinizing hormone-releasing hormone (LHRH), human chorionic gonadotropin (hCG) and bovine luteinizing hormone (bLH) with each of three adjuvants. The adjuvants were complete Freund's adjuvant (CFA), M103(6) and 6VR6. Control animals were immunized against OV alone using CFA. Bulls were placed with the heifers following immunization to allow comparison of pregnancy rates between groups. Blood samples were collected weekly for 14 wk to determine antibody concentrations. Significant levels of circulating LH or LHRH antibodies were detected in heifers immunized with each of the hormone conjugates. Complete Freund's adjuvant was the most effective for stimulating antibody response to these antigens; however, M103 was equally effective when used with bLH or hCG conjugates. None of the heifers in the bLH-OV-CFA, bLH-OV-M103 or LHRH-OV-CFA immunization groups was pregnant at slaughter, whereas 71% of the OV-CFA control heifers were pregnant. Fertility suppression may be achieved in the bovine by active immunization against any of these three hormone conjugates. However, the duration of this study (8 wk after immunization) does not allow evaluation of the duration of effectiveness of each of the treatments. PMID- 3288601 TI - Influence of fasting and post-fast diet energy level on feed intake, feeding pattern and blood variables of lambs. AB - Trials were conducted to determine the influence of feed and water deprivation on feed intake, plasma glucose, free fatty acids (FFA), urea-N (PUN), serum insulin and growth hormone (GH) in lambs. In Trial 1, 12 Hampshire X Suffolk lambs (avg wt 30.5 kg) were deprived of feed and water for 0, 24, 48 or 72 h. During the first 8 d of realimentation, feed intake was depressed more (P less than .05) by longer periods of deprivation. In Trial 2, 12 crossbred lambs (avg wt 50 kg) were deprived of feed and water for 0 or 72 h. During the first 4 d of realimentation, feed intake was lower (P less than .05) in deprived than in fed lambs. The depressed feed intake could be detected within 30 min of feeding. In Trial 3, 12 crossbred lambs (avg wt 40 kg) were fasted for 0 or 72 h, and blood samples were obtained at -5, 30, 60, 120 and 180 min postprandial. On the 1st d of realimentation, lambs previously fasted had abnormal serum hormone patterns compared with nonfasted controls. On d 2 of realimentation, lambs previously fasted had higher (P less than .05) insulin, glucose and FFA than controls. On d 4 of realimentation, lambs previously fasted had higher insulin:GH ratios and lower PUN than controls. Results of these trials suggest that depriving lambs of feed and water for 72 h reduces subsequent feed intake for 4 d or more. Postprandial blood metabolite patterns are abnormal for a similar length of time. PMID- 3288602 TI - Digestibility and blood parameters in the preruminant calf fed a clotting or a nonclotting milk replacer. AB - Eight male Holstein calves 7 to 10 d of age were fed a milk replacer containing a skim milk powder subjected to low-temperature drying either with or without addition of an oxalate-NaOH buffer known to prevent curd formation. The calves were used in a completely randomized design to study the effect of milk clotting on digestibility and blood parameters. Plasma glucose and plasma insulin were similar (P greater than .05) for the clotting and the nonclotting milk replacers. For both treatments, concentrations of glucose and insulin reached a peak 2 h postfeeding (P less than .01). Plasma triglycerides were higher (P less than .01) postfeeding for the nonclotting than for the clotting milk replacer. Plasma essential amino acids and plasma urea were higher, whereas plasma calcium was lower, for the nonclotting milk (P less than .01). Digestibility of dry matter, protein and fat was similar (P greater than .05) between clotting and nonclotting milk. The dry matter content of feces was not affected by clotting (P greater than .05). The data are interpreted to indicate that clotting of the milk replacer modifies blood concentrations of triglycerides, essential amino acids and urea without changing the digestibility of the diet. PMID- 3288603 TI - The continuing problem of pneumococcal infection. PMID- 3288604 TI - Efficacy of amoxycillin/clavulanic acid in experimental Bacteroides fragilis/Escherichia coli mixed infections. AB - The efficacy of amoxycillin/clavulanic acid was compared with those of metronidazole, cefuroxime, metronidazole/ampicillin, metronidazole/gentamicin and metronidazole/cefuroxime, in experimental mixed infections produced in mice by subcutaneous inoculation of amoxycillin-resistant strains of Bacteroides fragilis and Escherichia coli. The combination of metronidazole/ampicillin failed to inhibit the growth of E. coli, and exerted only a transient effect on the numbers of Bact. fragilis in the groin abscesses. In contrast, amoxycillin/clavulanic acid prevented the development of the infection, eliminating both organisms. Metronidazole and cefuroxime, alone and in combination, were less effective than amoxycillin/clavulanic acid in inhibiting the growth of the infecting organisms. These results demonstrate the clinical potential of amoxycillin/clavulanic acid in prophylaxis, or in the therapy of mixed aerobe/anaerobe infections. PMID- 3288605 TI - Intraphagocytic activity of imipenem and piperacillin. PMID- 3288606 TI - Eradication of beta-haemolytic streptococci from the pharynx of healthy carriers with a single dose of ceftriaxone. PMID- 3288607 TI - Glucose uptake in rat soleus: effect of acute unloading and subsequent reloading. AB - The effect of acutely reduced weight bearing (unloading) on the in vitro uptake of 2-[1,2-3H]deoxy-D-glucose was studied in the soleus muscle by tail casting and suspending rats. After just 4 h, the uptake of 2-deoxy-D-glucose fell (-19%, P less than 0.01) and declined further after an additional 20 h of unloading. This diminution at 24 h was associated with slower oxidation of [14C]glucose and incorporation of [14C]glucose into glycogen. Unlike after 1 day, at 3 days of unloading basal uptake of 2-deoxy-D-glucose did not differ from control. Reloading of the soleus after 1 or 3 days of unloading increased uptake of 2 deoxy-D-glucose above control and returned it to normal within 6 h and 4 days, respectively. These effects of unloading and recovery were caused by local changes in the soleus, because the extensor digitorum longus from the same hindlimbs did not display any alterations in uptake of 2-deoxy-D-glucose or metabolism of glucose. This study demonstrates that alterations in contractile activity, brought about by unloading or recovery from unloading, can influence the regulation of glucose transport in the soleus. PMID- 3288608 TI - Bronchoconstrictor and antibronchoconstrictor properties of inhaled prostacyclin in asthma. AB - Prostacyclin (PGI2) is generated in appreciable amounts during allergic reactions in human lung tissue. To define its activity on human airways we have studied the effects of doubling concentrations of inhaled PGI2 and its hydrolysis product 6 oxoprostaglandin F1 alpha (6-oxo-PGF1 alpha) on specific airway conductance (sGaw), maximum expiratory flow at 30% vital capacity (Vmax30), forced expiratory volume in 1 s (FEV1), and static lung volumes in subjects with mild allergic asthma. In a second study the effect of inhaled PGI2 on bronchoconstriction provoked by increasing concentrations of inhaled prostaglandin (PG) D2 and methacholine was observed. Inhalation of PGI2 up to a concentration of 500 micrograms/ml had no significant effect on sGaw but produced a concentration related decrease in FEV1 and Vmax30 in all subjects. In two of four subjects inhalation of PGI2 also increased residual volume and decreased vital capacity but had no effect on total lung capacity. PGI2, but not 6-oxo-PGF1 alpha, protected against bronchoconstriction provoked by either PGD2 or methacholine whether airway caliber was measured as sGaw, FEV1, or Vmax30. The apparent disparity between the bronchoconstrictor and antibronchoconstrictor effects of PGI2 might be explained by its potent vasodilator effect in causing airway narrowing through mucosal engorgement and reducing the spasmogenic effects of other inhaled mediators by increasing their clearance from the airways. PMID- 3288609 TI - Gluconeogenic pathway in liver and muscle glycogen synthesis after exercise. AB - To determine whether prior exercise affects the pathways of liver and muscle glycogen synthesis, rested and postexercised rats fasted for 24 h were infused with glucose (200 mumol.min-1.kg-1 iv) containing [6-3H]glucose. Hyperglycemia was exaggerated in postexercised rats, but blood lactate levels were lower than in nonexercised rats. The percent of hepatic glycogen synthesized from the indirect pathway (via gluconeogenesis) did not differ between exercised (39%) and nonexercised (36%) rats. In red muscle, glycogen was synthesized entirely by the direct pathway (uptake and phosphorylation of plasma glucose) in both groups. However, only approximately 50% of glycogen was formed via the direct pathway in white muscle of exercised and nonexercised rats. Therefore prior exercise did not alter the pathways of tissue glycogen synthesis. To further study the incorporation of gluconeogenic precursors into muscle glycogen, exercised rats were infused with either saline, lactate (100 mumol.min-1.kg-1), or glucose (200 mumol.min-1.kg-1), containing [6-3H]glucose and [14C(U)]lactate. Plasma glucose was elevated one- to twofold and three- to fourfold by lactate and glucose infusion, respectively. Plasma lactate levels were elevated by about threefold during both glucose and lactate infusion. Glycogen was partially synthesized via an indirect pathway in white muscle and liver of glucose- or lactate-infused rats but not in saline-infused animals. Thus participation of an indirect pathway in white skeletal muscle glycogen synthesis required prolonged elevation of plasma lactate levels produced by nutritive support. PMID- 3288610 TI - Effect of normobaric hyperoxia on airways of normal subjects. AB - Airway responsiveness to inhaled cholinergic agonist during the early stage of pulmonary O2 toxicity was examined to determine whether normobaric hyperoxia alters airway function. Eight healthy nonsmoking males with moderate base-line methacholine responsiveness breathed normobaric O2 (greater than or equal to 95%) over 12 h and on another occasion breathed air in an identical protocol. Vital capacity, expiratory flow, airway responsiveness to methacholine, and respiratory symptoms were measured at 0, 4, 8, and 12 h while subjects breathed O2 and 12 h afterwards. After 12 h, forced vital capacity was significantly decreased with O2 breathing but not with air breathing. At 4, 8, or 12 h of exposure and 12 h after exposure, there was no difference in methacholine sensitivity or reactivity between O2 and air-exposure trials. The earliest manifestations of pulmonary normobaric O2 toxicity in normal adults include diminished vital capacity and the onset of respiratory symptoms, but early O2 toxicity does not produce altered responsiveness to inhaled methacholine. PMID- 3288611 TI - Psychopharmacology in child and adolescent psychiatry: a review of the past five years. PMID- 3288612 TI - Rumination disorder: differential diagnosis. PMID- 3288613 TI - Attention deficit disorder-hyperactivity and academic failure: which comes first and what should be treated? PMID- 3288614 TI - Adaptations of cognitive therapy for depressed adolescents. PMID- 3288616 TI - Misuse of midazolam. PMID- 3288615 TI - Pimozide treatment of the negative schizophrenic syndrome: an open trial. AB - Reports over the last 20 years suggest that pimozide, a neuroleptic of the diphenylbutylpiperidine (DPBP) group, might be helpful in the treatment of negative symptoms of schizophrenia, which are considered less responsive to standard neuroleptics than are positive symptoms. Research suggests that neuroleptic drugs of the DPBP group possess a unique property--potent calcium channel antagonism--which could explain their ability to relieve negative symptoms. Earlier reports, however, used measures not specifically designed to assess the negative syndrome. The Positive and Negative Syndrome Scale (PANSS) was developed and standardized to measure the negative syndrome in schizophrenia. The authors used the PANSS to study the effects of pimozide in a 6-week, open clinical trial with 10 neuroleptic-resistant schizophrenic inpatients who had prominent deficit features. Negative but not positive symptoms improved significantly, suggesting that the drug might target the negative profile. The authors discuss possible pharmacologic mechanisms for pimozide's potentially distinct clinical properties. PMID- 3288617 TI - Sequence and expression of mouse gamma-renin. AB - Mouse gamma-renin is a member of the group of serine proteases known as glandular kallikreins. These highly homologous proteins process a diverse range of growth factors and hormones to their biologically active form, usually by cleavage at a basic residue. gamma-Renin, however, cleaves at a Leu-Leu bond in a similar fashion to renin. We have identified and sequenced the gene and a cDNA encoding gamma-renin. The complete predicted amino acid sequence was determined, and residues that may be important in the unusual cleavage pattern exhibited by gamma renin are discussed. The nucleotide sequence enabled design of a gene-specific oligodeoxyribonucleotide which was used to determine in which mouse tissues gamma renin is expressed. PMID- 3288618 TI - Identification of a novel stress-inducible glycoprotein in Saccharomyces cerevisiae. I. Preliminary characterization. AB - We have identified a novel stress-inducible protein in Saccharomyces cerevisiae by pulse-labeling with [35S]methionine and two-dimensional gel analysis. The protein was characterized biochemically to gain further insight into mechanisms regulating the stress response. It has a Mr = 118,000 and exists in two forms of pI = 4.2 (p118A) and pI = 4.3 (p118B). p118A and p118B are modified by N glycosylation. Tunicamycin treatment revealed the presence of precursor proteins of Mr = 105,000, pI = 4.1 (p105A) and pI = 4.25 (p105B). The synthesis of p118A and p118B was almost completely shut off in cycling cells and was increased 11 fold following a mild heat shock. Both forms of p118 decayed in a biphasic manner under induced conditions. A tight correlation was observed in the kinetics of thermotolerance induction and p118A synthesis. Other forms of stress such as sulfur starvation which lead to arrest in the unbudded phase also resulted in enhanced synthesis of both p118A and p118B. However, in cell division cycle mutants blocked at various stages at the restrictive temperature, p118A and p118B had different synthetic patterns. Taken together, these data imply a role for induced p118 in proliferation arrest in the unbudded state. PMID- 3288619 TI - Identification of the reactive sulfhydryl groups of S-adenosylmethionine synthetase. AB - S-Adenosylmethionine synthetase from Escherichia coli is rapidly inactivated by N ethylmaleimide. In the presence of excess N-ethylmaleimide inactivation follows pseudo first-order kinetics, and loss of enzyme activity correlates with the incorporation of 2 eq of N-[ethyl-2-3H]maleimide/subunit. Preincubation of the enzyme with methionine and the ATP analog adenylylimidodiphosphate reduced the rate of N-ethylmaleimide incorporation more than 30-fold. Two N-[ethyl-2 3H]maleimide-labeled tryptic peptides were purified from the modified enzyme by reverse phase high performance liquid chromatography. The modified residues were identified as cysteine 90 and cysteine 240 by comparison of the amino acid compositions of these peptides with the protein sequence. These are the first residues to be implicated in the activity and/or structure of the enzyme. N Ethylmaleimide-modified S-adenosylmethionine synthetase exists mainly as a dimer in conditions where the native enzyme is a tetramer. Accumulation of the dimer parallels the loss of the enzyme activity. When an enzyme sample was partially inactivated, separation of tetrameric and dimeric enzyme forms by gel filtration revealed that the residual enzyme activity was solely present in the tetramer and N-[ethyl-2-3H] maleimide was present predominantly in the dimer. Gel filtration studies of the tetramer-dimer equilibrium for the native enzyme indicated that the dissociation constant between the tetramer and dimers is less than 6 x 10( 11) M. Similar studies for the N-ethylmaleimide-modified protein indicated that the dissociation constant of the tetramer is approximately 4 x 10(-4) M. Upon modification the strength of dimer-dimer interactions is diminished by at least 9 kcal/mol. PMID- 3288620 TI - Insulin-induced glycerolipid mediators and the stimulation of glucose transport in BC3H-1 myocytes. AB - We have previously demonstrated that insulin stimulates glycerolipid synthesis and phospholipid hydrolysis in BC3H-1 myocytes, resulting in the generation of membrane diacylglycerol, a known cellular mediator. This led us to the original proposal that diacylglycerol may contribute to the mediation of insulin action, especially stimulation of glucose transport. The fact that agents such as phenylephrine and phorbol esters, which increase or act as membrane diacylglycerols, are fully active in stimulating glucose transport in this tissue lent further support to this proposal. In this paper, we demonstrate that the diacylglycerol analogues PMA (4 beta-phorbol 12-myristate 13-acetate) and mezerein (both possessing 12 beta- and 13 alpha-O-linked substituents as well as a 4 beta-hydroxyl group) each increase the Vmax of the glucose transporter as does insulin. Diacylglycerol generated by the addition of phospholipase C also stimulates glucose uptake to a maximum which is equal and nonadditive to that of insulin, while addition of the narrowly active phosphatidylinositol-specific phospholipase C which generates the putative phosphoinositol-glycan mediator of Saltiel et al. (Saltiel, A., Fox, J., She Lin, P., and Cutrecasas, P. (1986) Science 233, 967-972) stimulates pyruvate dehydrogenase in these cells without any effect on glucose uptake. Pretreatment of the myocytes with PMA resulted in desensitization of subsequent glucose uptake to stimulation by phenylephrine, but had no effect on stimulation of glucose uptake by phospholipase C or by insulin, indicating that PMA pretreatment primarily desensitizes agonist-induced polyphosphoinositide hydrolysis which, as we have previously shown, is not involved in the insulin-induced generation of diacylglycerol. This was confirmed by the absence of intracellular Ca2+ mobilization during insulin administration, as measured by the sensitive fluorescent probe fura-2 in attached monolayer BC3H 1 myocytes. Furthermore, we have shown that insulin-generated diacylglycerol satisfies several criteria for a mediator of insulin action, including the demonstration that insulin-stimulated endogenous diacylglycerol generation is antecedent to glucose transport and has an identical insulin dose-response curve and moreover that the magnitude and time course of subsequent stimulation of glucose transport is reproduced by the addition of the simple exogenous diacylglyerol, dioctanoylglycerol, in the complete absence of the hormone. These results establish a central role for insulin-induced glycerolipid metabolism in mediating insulin-stimulated glucose transport in BC3H-1 myocytes. PMID- 3288621 TI - The expression in Escherichia coli of recombinant human platelet factor 4, a protein with immunoregulatory activity. AB - In order to establish more firmly the immunoregulatory effect of platelet factor 4 (PF4) and develop a means to provide material for possible clinical use, the nucleotide sequence for PF4 was synthesized utilizing a ligation strategy of six duplexes ranging from 27 to 43 base pairs in length. The individual oligodeoxynucleotides were synthesized on an automated system. The resultant gene segment (226 base pairs), which incorporated convenient HindIII and BamHI overhangs at the 5' and 3' ends, respectively, was cloned into the pIN-III-ompA-2 expression vector in Escherichia coli, affording a fusion protein of Mr = 8900 with 7 additional amino acids at the amino terminus and 4 at the carboxyl terminus and with aspartic acid rather than asparagine in position 47. The recombinant PF4 (rPF4) was purified by heparin-agarose affinity chromatography and reverse-phase high performance liquid chromatography. It reacted with a monoclonal mouse anti-human PF4 antibody on a Western blot and in an enzyme linked immunosorbent assay. The rPF4 protein exhibited an immunoregulatory effect like that of human PF4 in its ability to reverse concanavalin A-induced immunosuppression in BALB/c mice. PMID- 3288622 TI - The RNA N-glycosidase activity of ricin A-chain. The characteristics of the enzymatic activity of ricin A-chain with ribosomes and with rRNA. AB - Ricin A-chain cleaves the N-glycosidic bond at A-4324 in 28 S rRNA when intact rat ribosomes are the substrate. Cleavage occurs at a concentration of the toxin of 1 X 10(-10) M, and specificity for this single residue is retained when the concentration is as high as 3 X 10(-7) M. The apparent Michaelis constant (Km) for the reaction is 2.6 microM, and the turnover number (Kcat) is 1777 min-1. The same N-glycosidic bond is cleaved by ricin A-chain in naked 28 S rRNA, but at a greatly reduced rate. The Km value for this reaction is 5.8 microM. The results suggest that the A-chain has a similar affinity for 28 S rRNA in ribosomes and in the absence of ribosomal proteins. Ricin A-chain has no effect on 23 S rRNA in Escherichia coli ribosomes, however, the N-glycosidic bond at A-2600 in naked 23 S rRNA is cleaved by the toxin; this corresponds to the ricin site in eukaryotic 28 S rRNA. Since the Km value (3.3 microM) for the reaction with E. coli 23 S rRNA approximates that obtained with rat liver ribosomes, it is possible that E. coli ribosomal protein(s) protect this site against ricin attack in intact ribosomes. Ricin A-chain also acted on naked 16 S rRNA cleaving the N-glycosidic bond of adenine at position 1014. The results suggest that ricin A-chain recognizes a specific structure in rRNA, perhaps a loop and stem having the sequence GAGA in the loop. PMID- 3288623 TI - The stability of yeast invertase is not significantly influenced by glycosylation. AB - Yeast invertase exists in two different forms. The cytoplasmic enzyme is nonglycosylated, whereas the external invertase contains about 50% carbohydrate of the high mannose type. The protein moieties of both enzymes are identical. The two invertases have been used previously as a model system to investigate the influence of covalently linked carbohydrate chains on the stability of large glycoproteins, and controversial results were obtained. Here, we measured thermal and denaturant-induced unfolding by various probes, such as the loss of enzymatic activity, and by the changes in absorbance and fluorescence. The ranges of stability of the two invertases were found to be essentially identical, indicating that the presence of a high amount of carbohydrate does not significantly contribute to the stability of external invertase. Earlier findings that invertase is stabilized by glycosylation could not be confirmed. The stability of this glycoprotein is apparently determined by the specific interactions of the folded polypeptide chain. Unlike the glycosylated form, the carbohydrate-free invertase is prone to aggregation in the denatured state at high temperature and in a partially unfolded form in the presence of intermediate concentrations of guanidinium chloride. PMID- 3288624 TI - Effect of glycosylation on the mechanism of renaturation of invertase from yeast. AB - N-Glycosylation occurs cotranslationally as soon as the growing polypeptide chain enters the endoplasmic reticulum, before the final native-like folded state is reached. We examined the role of the carbohydrate chains in the mechanism of protein folding. The in vitro folding and association of yeast invertase are used as an experimental system. External invertase contains approximately 50% carbohydrate, whereas cytoplasmic invertase is not glycosylated. The functional native state of both proteins is a homodimer. At pH greater than or equal to 6.5 and at protein concentrations below 3 micrograms/ml, the kinetics of reactivation and the final yields are similar for the two invertases. For both proteins, reactivation is a sequential reaction with a lag phase at the beginning. The nonglycosylated protein tends to aggregate during reactivation at low pH and at protein concentrations above 3 micrograms/ml. After separation of inactive material, the renatured protein is indistinguishable from the original native state by a number of physicochemical and functional criteria. The results suggest that the carbohydrate moiety does not affect the mechanism of folding and association of invertase. However, glycosylation improves the solubility of unfolded or partially folded invertase molecules and hence leads to a suppression of irreversible aggregation. Such a protective effect may also be important for the in vivo maturation of nascent glycosylated protein chains. PMID- 3288625 TI - Stabilization of myc proto-oncogene proteins during Friend murine erythroleukemia cell differentiation. AB - A rapid and dramatic decrease in c-myc mRNA has been associated with the differentiation of a variety of cell types and may be a critical step in the maturation process. In this study, we have simultaneously measured steady-state c myc protein and c-myc mRNA levels in differentiating Friend murine erythroleukemia (MEL) cells. Northern blot analysis of poly(A+) RNA indicated a greater than 85% decrease in c-myc transcripts following a brief exposure to the inducing agents, dimethyl sulfoxide or hypoxanthine. The short half-life of the c myc protein (approximately 30 min) suggests that its level should fall in a similar fashion. Surprisingly, immunoblots of total cell proteins and immunoprecipitations of 35S-labeled protein revealed that c-myc protein levels remain approximately constant. This unexpected finding was accounted for in part by an increase in the c-myc protein half-life to 75-85 min. Immunoprecipitation of [35S]methionine-labeled proteins also demonstrated that the undifferentiated MEL cell synthesizes equal amounts of two c-myc-related proteins, p59 and p61. In contrast, MEL cell populations in the late stages of differentiation express predominantly the higher molecular weight species. This latter observation represents the first report of a temporal shift in the relative abundance of the two c-myc isoforms during cell differentiation. PMID- 3288626 TI - Studies on the mutator gene, mutT of Escherichia coli. Molecular cloning of the gene, purification of the gene product, and identification of a novel nucleoside triphosphatase. AB - The mutator gene, mutT, has been cloned into an expression vector and overproduced in Escherichia coli. The gene product has been purified to over 90% homogeneity as judged by gel electrophoresis and amino acid analysis. The amino acid composition of the protein and the sequence of the 20 amino acids of the N terminal region agree well with the nucleotide sequence of the gene reported by Akiyama et al. (Akiyama, M., Horiuchi, T., and Sekiguchi, M. (1987) Mol. Gen. Genet. 206, 9-16) and indicate that the first of the potential initiation codons (position 164) of the open reading frame in the PvuII fragment carrying the mutT gene is the site of initiation of translation of the 15,000-Da polypeptide. A novel nucleoside triphosphatase activity which has a preference for dGTP is associated with the purified protein, and preliminary experiments are consistent with the notion that the mutT gene product is the enzyme responsible for this activity. PMID- 3288627 TI - COOH-terminal processing of polypeptide D1 of the photosystem II reaction center of Scenedesmus obliquus is necessary for the assembly of the oxygen-evolving complex. AB - Mutant LF-1 of the green alga Scenedesmus obliquus has been described by Metz and co-workers (Metz, J. G., Pakrasi, H., Seibert, M., and Arntzen, C. J. (1986) FEBS Lett. 205, 269-274) to be inactive for light-driven oxygen evolution, despite a functional Photo-system II reaction center. A polypeptide, D1, implicated in the ligation of the primary photoreactants of photosystem II, was shown to migrate with an apparent higher molecular mass on LDS-PAGE in the mutant than in the wild type (WT) strain. We show here that polypeptide D1 is synthesized in a precursor form in Scenedesmus WT. Following synthesis and insertion into the thylakoid membrane, a 1.5-2-kDa oligopeptide is clipped off with a half-time of 1-2 min, yielding the mature 34-kDa form of the polypeptide. No processing of polypeptide D1 from mutant LF-1 was observed to take place. We show here that polypeptide D1 of LF-1 displays an identical proteolytic fingerprint pattern to the precursor D1 polypeptide of the wild-type strain. These both have molecular masses about 1.5-2 kDa higher than that of the mature WT polypeptide. A polyclonal antibody elicited by a synthetic oligopeptide (14-mer), predicted from the psbA gene nucleotide sequence to be homologous to the COOH terminus of the precursor D1 of spinach, cross-reacts only with D1 of mutant LF-1 and not with mature D1 of spinach, Chlamydomonas, or of Scenedesmus WT. This observation demonstrates that the greater molecular mass of polypeptide D1 from mutant LF-1 and of Scenedesmus WT precursor D1 is derived from a COOH-terminal extension. We conclude that the LF-1 mutant lacks the appropriate nuclear-encoded protease which processes polypeptide D1 at its COOH terminus from the precursor to the mature form. Such processing would appear to be a necessary step toward the stable incorporation of manganese into the oxygen-evolving site. PMID- 3288628 TI - Sequence of thioredoxin reductase from Escherichia coli. Relationship to other flavoprotein disulfide oxidoreductases. AB - The DNA sequence of the Escherichia coli gene encoding thioredoxin reductase has been determined. The predicted protein sequence agrees with an earlier determination of the 17 amino-terminal amino acids and with a fragment of the protein containing the redox-active half-cystines. Similarity between E. coli thioredoxin reductase and other flavoprotein disulfide oxidoreductases is quite limited, but three short segments, two of which are probably involved in FAD and NADPH binding, are highly conserved between thioredoxin reductase, glutathione reductase, dihydrolipoamide dehydrogenase, and mercuric reductase. PMID- 3288629 TI - Purification and characterization of C1, the catalytic subunit of Saccharomyces cerevisiae cAMP-dependent protein kinase encoded by TPK1. AB - In the yeast Saccharomyces cerevisiae, three genes TPK1, TPK2, and TPK3 encode catalytic subunits of cAMP-dependent protein kinase. We have purified and characterized the catalytic subunit, C1, encoded by the TPK1 gene. In order to purify C1 completely free of C2 and C3, a strain was constructed that contained only the TPK1 gene and genetic disruptions of the other two TPK genes. The cellular level of C1 was increased by expressing the genes for C1 (TPK1) and yeast regulatory subunit (BCY1) on multiple copy plasmids within this strain. Purification was accomplished by a two-column procedure in which holoenzyme was chromatographed on Sephacryl-200, then bound to an anti-regulatory subunit immunoaffinity column. Pure C1 was released from the antibody column by addition of cAMP. The protein migrated on a sodium dodecyl sulfate-polyacrylamide gel with an Mr of 52,000. Kinetic analysis showed that the apparent Km for ATP and Leu-Arg Arg-Ala-Ser-Leu-Gly was 33 and 101 microM, respectively. The kcat was determined to be 640 min-1. The protein weakly autophosphorylated, incorporating less than 0.1 mol of phosphate/mol of catalytic subunit. NH2-terminal sequencing revealed that the protein was blocked. PMID- 3288630 TI - Mutagenesis of the regulatory subunit of yeast cAMP-dependent protein kinase. Isolation of site-directed mutants with altered binding affinity for catalytic subunit. AB - Oligonucleotide-directed mutagenesis was used to produce mutants in the hinge region of the regulatory subunit (R) of the Saccharomyces cerevisiae cAMP dependent protein kinase. The mutant proteins were expressed in Escherichia coli, purified, urea treated to produce cAMP-free regulatory (R), and analyzed in vitro for catalytic (C) subunit inhibitory activity in the presence and absence of cAMP. When assayed in the absence of cAMP, wild type R dimer inhibited C with an IC50 of 40 nM. Replacement of amino acid residue Ser-145 (the autophosphorylation site of yeast R) with Ala or Gly produced mutants which were 2-10-fold better inhibitors of C, while replacement with Glu, Asp, Lys, or Thr produced mutants which were 2-5-fold worse inhibitors of C relative to wild type R. When assayed in the presence of cAMP, all R subunits had a decreased affinity for C subunit, with Ser-145 and Thr-145 undergoing autophosphorylation. These results suggest that the amino acid at position 145 of R contributes to R-C interaction and therefore influences the equilibrium of yeast protein kinase subunits in vitro. PMID- 3288631 TI - The yeast SEC53 gene encodes phosphomannomutase. AB - Yeast sec53 cells incubated at a restrictive temperature (37 degrees C) accumulate inactive and incompletely glycosylated forms of secretory proteins within the lumen of the endoplasmic reticulum. A defect in glycosylation of alpha factor precursor has been reproduced in vitro using membranes and cytosol isolated from sec53 mutant cells. Normal glycosylation is restored in reactions supplemented with a cytosolic fraction from wild type cells, with GDP-mannose, or with mannose 1-phosphate and GTP, but not with mannose 6-phosphate and GTP. This pattern of stimulation suggests that extracts of sec53 cells are deficient in phosphomannomutase activity or in the production of a precursor of mannose 1 phosphate. Several lines of evidence demonstrate that SEC53 encodes the yeast phosphomannomutase. Direct assay of soluble fractions from independent alleles of sec53 shows low to negligible phosphomannomutase, but nearly normal levels of phosphomannoisomerase activity. The residual phosphomannomutase activity in mutant cell lysates is thermolabile in proportion to the severity of the sec53 cell growth defect. Introduction of the SEC53 gene on a multicopy plasmid into sec53 or wild type yeast and into Salmonella typhimurium results in an increase in phosphomannomutase activity that correlates with elevated expression of the Sec53 protein. Finally, the Sec53 protein and phosphomannomutase activity cofractionate exactly in a 70-fold partial purification involving gel filtration and DEAE chromatography. The secretory defect in sec53 cells may now be explained by a deficit in GDP-mannose production. PMID- 3288632 TI - Role of aspartate 27 in the binding of methotrexate to dihydrofolate reductase from Escherichia coli. AB - Dihydrofolate reductase from wild-type Escherichia coli (WT-ECDHFR) and from a mutant enzyme in which aspartate 27 is replaced by asparagine have been compared with respect to the binding of the inhibitor methotrexate (MTX). Although the Asp27----Asn substitution causes only small changes in the association rate constants (kon) for the formation of binary and ternary (with NADPH) complexes, the dissociation rate constants for these complexes (koff) are increased for the mutant enzyme by factors of about 5- and 100-fold, respectively, at pH 7.65. In binding experiments, the initial MTX binary and ternary complexes of the mutant enzyme were found to undergo relatively rapid isomerization (kobs approximately 17 and 145 s-1, respectively). Although such rapid isomerization of complexes of WT-ECDHFR could not be detected in binding experiments, evidence of a slow isomerization (k = 4 x 10(-3) s-1) of the ternary WT-ECDHFR.MTX.NADPH complex was obtained from progress of inhibition experiments. This slow isomerization increases binding of MTX to WT-ECDHFR only 2.4-fold (much less than previously estimated). From presently available data, we could not determine the contribution of the rapid isomerization of complexes to the binding of MTX to the mutant enzyme. The Asp27----Asn substitution increases the overall dissociation constant (KD) 9-fold for the binary complex and 85-fold for the ternary complex. When it is also taken into account that a proton ultimately derived from the solvent must be added to MTX bound to the WT enzyme, but not to MTX bound to the mutant enzyme, these increases in KD for the mutant enzyme correspond to decreases in binding energy for MTX of 3.9 and 5.2 kcal/mol at pH 7.65 for the binary and ternary complexes, respectively. PMID- 3288633 TI - Vanadate down-regulates cell surface insulin and growth hormone receptors and inhibits insulin receptor degradation in cultured human lymphocytes. AB - Insulin is able to down-regulate its specific cell surface receptor in cultured human lymphocytes. The effect of vanadate, a known insulinomimetic agent, was examined to determine whether it could mimic insulin to down-regulate the insulin receptor. Exposure of cultured human lymphocytes (IM-9) to vanadate (0-200 microM) resulted in a time- and dose-dependent decrease in cell surface insulin receptors to 60% of control, while insulin (100 nM) down-regulated to 40%. The vanadate effect, in contrast to the rapid effect of insulin, was slow to develop (4-6 h). Surface receptor recovery after 18 h exposure was rapid after vanadate removal (20 min), but it required hours after insulin suggesting the presence of an intracellular (cryptic) pool of receptors after vanadate treatment. Insulin binding to Triton X-100-solubilized whole cells after 18 h treatment revealed that total cell receptors had decreased to 50% of control after insulin but increased to 120 and 189% of control after 100 and 200 microM vanadate, respectively. Furthermore, vanadate inhibited the insulin-mediated loss of total cell receptors from 50 to 28%. Removal of cell surface receptors by trypsin before cell solubilization revealed that 100 microM vanadate increased insulin binding to 321% of control indicating an accumulation of intracellular receptors. Labeling of cell surface proteins with Na125I and lactoperoxidase followed by immunoprecipitation of solubilized receptors with anti-receptor antibody after incubation for various times up to 20 h and quantitation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that, while insulin shortened t1/2 from 7.3 to 5.3 h, vanadate prolonged receptor t1/2 to 14 h. No effect of vanadate was detected on insulin receptor tyrosine kinase activity with up to 4 h incubation at the vanadate concentrations used in this study. Furthermore, human growth hormone surface receptors were similarly down-regulated by vanadate. We conclude that 1) vanadate has an apparent insulin-like effect to down-regulate cell surface insulin receptors in cultured human lymphocytes; 2) in contrast to insulin-induced down-regulation which is associated with receptor degradation vanadate causes an accumulation of intracellular (cryptic) receptors and inhibits insulin receptor degradation; and 3) these effects of vanadate may be exerted on other cell surface receptors. PMID- 3288634 TI - Generation of biologically active interleukin-1 beta by proteolytic cleavage of the inactive precursor. AB - Interleukin-1 beta (IL-1 beta) is derived from an inactive precursor by proteolytic cleavage. To study IL-1 beta processing, we expressed the precursor in Escherichia coli, partially purified it, and used it as a substrate for various potentially relevant protease preparations. The precursor alone was virtually inactive, but incubation with membranes from human monocytes or myeloid cell lines yielded a 500-fold increase in IL-1 bioactivity. Western blot analysis of the incubated material showed that the 31,000-Da precursor is broken down to three major products, ranging from 17,400 to about 19,000 Da. The most active of these products is the smallest one, and it co-migrates during electrophoresis with mature IL-1 beta. Four purified known proteases were also tested for their effect on precursor IL-1 beta, and none of these products co-migrated with the mature protein. Chymotrypsin and Staphylococcus aureus protease yielded slightly larger products, which were highly active. Elastase and trypsin yielded substantially larger products, and these had little IL-1 activity. The products of three of the known proteases were identified by NH2-terminal sequencing. These results show conclusively that proteolysis of precursor IL-1 beta generates biological activity and that the cleavage must occur close to the mature NH2 terminus. PMID- 3288635 TI - Extended polysialic acid chains (n greater than 55) in glycoproteins from human neuroblastoma cells. AB - Polysialic acid-containing glycoproteins consisting of extended chains of at least 55 sialyl residues (DP55, where DP represents degree of polymerization) are expressed on human neuroblastoma cells, CHP-134. The strategy used for detecting these unique carbohydrate structures was based on the use of two highly specific prokaryotic-derived enzyme systems and an anti-polysialosyl antibody (H.46). These probes were developed for the detection of polysialic acid on neural cell adhesion molecules (Troy, F. A., Hallenbeck, P. C., McCoy, R. D., and Vimr, E. R. (1987) Methods Enzymol. 138, 169-185). Proof for the presence of long chain multimers of sialic acid was based on two types of experiments which utilized: 1) a glycopeptide fraction of CHP-134 cells, labeled metabolically with D-[3H]GlcN and 2) a membrane fraction from CHP-134 cells which served as an exogenous acceptor of [14C] NeuNAc residues in an Escherichia coli K1 sialyltransferase assay. In vitro, this enzyme CMP-NeuNAc:poly-alpha-2,8-sialosyl sialyltransferase catalyzes the transfer of [14C]NeuNAc from CMP-[14C]NeuNAc to exogenous acceptors containing at least 3 sialyl residues. In the first series of experiments, endo-N acetylneuraminidase (Endo-N), a bacteriophage-derived enzyme specific for hydrolyzing poly-alpha-2,8-sialosyl chains containing a minimum of 5 sialyl residues was used. Limit Endo-N digestion of the 3H-glycopeptides from the [3H] GlcN-labeled cells released short [3H]sialyl oligomers [( 3H]DP1-6) which were degraded to [3H]NeuNAc by exosialidase. Partial Endo-N digestion released a series of [3H]sialyl oligomers extending up to DP55. The longer (DP20-55) and intermediate sized (DP10-20) oligomers were isolated and converted to short oligomers ((3H]DP1-6) by retreating with Endo-N, thus confirming their identity as homo-oligomers of alpha-2,8-linked [3H]NeuNAc residues. In the second series of experiments, a membrane fraction of CHP-134 cells was radiolabeled in vitro with [14C]NeuNAc by E. coli K1 sialyltransferase. The membrane fraction had a major portion of radioactivity that was high Mr and polydisperse (Mr 100,000 250,000) as demonstrated in sodium dodecyl sulfate-polyacrylamide gels. Using Western blotting, pre-existing material of similar size was shown to react with antibody H.46.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3288636 TI - Function of neutral endopeptidase on the cell membrane of human neutrophils. AB - Intact human neutrophils hydrolyzed N-formyl-Met-Leu-[3H]Phe (fMLP) and released Leu-[3H]Phe, cleaving 45-50% of the peptide within 20 min at 37 degrees C. The dipeptide after its release was then hydrolyzed to free amino acids by a dipeptidase (EC 3.4.13.11). This activity, present in plasma membrane-enriched fractions of neutrophil lysates, was also inhibited over 90% by phosphoramidon, an inhibitor of neutral endopeptidase (NEP, EC 3.4.24.11). Dithiothreitol and EDTA inhibited the activity to a comparable degree, suggesting the requirement for a heavy metal cofactor. Bestatin and amastatin, inhibitors of aminopeptidases (but not human kidney NEP), did not inhibit the rate of fMLP degradation but prevented the production of free phenylalanine and enhanced the accumulation of Leu-Phe. Of other inhibitors, alpha 1-antitrypsin and alpha 2-macroglobulin slightly enhanced the rate of fMLP hydrolysis by neutrophils, and others tested were ineffective. Rabbit antiserum to homogeneous human kidney NEP reacted specifically with a 100-kDa protein present in sodium dodecyl sulfate-solubilized neutrophils. The Mr of this protein was slightly larger than that of the kidney enzyme in sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The antiserum incubated with intact cells specifically inhibited the degradation of fMLP over 70%. First, we confirm that NEP present on the plasma membrane cleaves fMLP at the Met-Leu bond; then the dipeptide Leu-Phe is cleaved by a dipeptidase. Finally, inhibition of NEP completely blocks fMLP-mediated chemotaxis. Thus, the enzyme may play an important role in modulating chemotactic responses. PMID- 3288637 TI - A segment of the cartilage proteoglycan core protein has lectin-like activity. AB - A segment of 130 residues near the COOH terminus of the proteoglycan core protein derived from rat cartilage is highly homologous to the carbohydrate-recognition domain of the chicken hepatic lectin and other vertebrate carbohydrate-binding proteins. This portion of the protein has been expressed in an in vitro transcription and translation system and has been tested for its ability to interact with carbohydrates using affinity chromatography on immobilized sugars. A distinct specificity of the binding interaction is demonstrable, with fucose and galactose being the preferred ligands. However, the affinity of the expressed domain of the proteoglycan core protein is lower than that of the other known binding domains, since it elutes from the columns even in the presence of Ca2+. PMID- 3288638 TI - Repair of symptomatic aortic coarctation in the first three months of life. Early and late results after resection and end-to-end anastomosis and subclavian flap angioplasty. AB - During a 9 year period between January 1977 and December 1985, 98 consecutive infants under 3 months of age underwent surgical repair of symptomatic aortic coarctation. Resection and end-to-end anastomosis was performed in 73, subclavian flap angioplasty in 14, and other procedures in 11 patients. There were 20 (20.5%) early and 12 (12.5%) late deaths. No early deaths occurred in the isolated coarctation group. Associated complex cardiac malformations and age under 2 weeks at operation influenced significantly early and late outcome but not any particular surgical procedure. The survivors were followed from 6 months to 8 years and 8 months postoperatively. There were 16 (28%) re-coarctations among 56 survivors after end-to-end anastomosis requiring re-operation in 7 (12%) infants and 3 (30%) re-coarctations among 10 survivors after subclavian flap angioplasty requiring re-operation in 1 infant. After end-to-end anastomosis re coarctation as well as re-operation rate was markedly lower when an interrupted suture line for the entire anastomosis was used as compared to the group with a continuous suture line of the posterior aortic wall (21% vs. 33% re-coarctation rate and 4% vs. 18% re-operation rate respectively). From our results it is concluded that subclavian flap angioplasty for relief of aortic coarctation in early infancy is not superior to resection and end-to-end anastomosis. In the end to-end anastomosis group an interrupted suture line has a lower re-coarctation as well as re-operation rate as compared to a continuous suture line of the posterior aortic wall. PMID- 3288639 TI - Subclavian and innominate artery trauma: a recent experience with nine patients. AB - This report summarizes a recent 24-month experience with 9 patients who were treated for injuries to the innominate or subclavian arteries at a large urban hospital. All patients were male, age range was 17 to 47 years, and mean age was 29 years. The mechanism of injury included major arterial avulsions sustained during cancer operations at the base of the neck (2), blunt injuries secondary to motor vehicle accidents (2), stab wounds (1), and gunshot wounds (4). The vessels injured included the right subclavian artery (2), the innominate artery (1), and the left subclavian artery (6). Associated major venous injuries were seen in 4 cases (44%) and major non-vascular injuries in 5 cases (55%). Arterial exposure involved a variety of incisions, including left thoracotomy, median sternotomy, clavicular resection, or a combination of these. Arterial continuity was restored in all cases using primary repair (2), autogenous saphenous vein graft (6), or prosthetic graft (1). Venous injuries were treated by ligation (2) or lateral venorraphy (2). One patient died unexpectedly on the tenth postoperative day for an overall mortality of 11 percent. Three of the 8 survivors sustained nonfatal complications (38%). All 8 survivors had patent arterial repairs at the time of hospital discharge, and 5 of 8 survivors were available for follow-up with intravenous digital subtraction angiography (DSA), revealing arterial repair patency in all.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288640 TI - Effects of renal artery reconstruction on kidney perfusion and tubular function measured by new radionuclide techniques. AB - Therapeutic effects of renal artery reconstruction on kidney perfusion and function were studied in 36 patients using new methods for analyzing radionuclide studies. Effective renal plasma flow, glomerular filtration fraction and parameters indicating perfusion and tubular transport improved significantly in patients with postoperative normalization of blood pressure. Patients with a patent renal artery on angiogram but without normalization of blood pressure showed an improvement of parameters such as effective renal plasma flow, glomerular filtration fraction and tubular transport time, whereas the perfusion index remained unchanged. In the group with re-stenosis or re-occlusion all parameters deteriorated after surgery. Discriminant analysis of preoperative data showed that success of surgery could be predicted with high degree of certainty (65% for improvement and 92% for no improvement). The results indicate, that radionuclide methods and arteriography are complementary in the evaluation of the hemodynamic consequences of a renal artery stenosis. They also help to assess the effects of reconstructive surgery and to predict operative success. PMID- 3288641 TI - Is screening for vascular disease a valuable proposition? AB - The value of health screening among the general population has been well documented, with testing for hypertension, diabetes, and glaucoma now commonplace. It was the purpose of our study to determine the efficacy of a screening program for peripheral vascular disease and carotid artery disease using the noninvasive laboratory diagnostic tools. In the screening for peripheral disease, there were 496 participants with a mean age of 35 (range 17 to 63) years. All participants had an ankle:brachial index (ABI) of 0.95 or greater except one (0.47). Risk factors included smoking (350), history of cardiac disease (19), family history of vascular disease (204), and pain in the legs on walking (39). The risk factors could not be correlated with any objective vascular findings (abnormal ABIs). A Doppler ultrasound device, including an inflatable ankle cuff, was used to measure the ABI of the dorsalis pedis and posterior tibial vessels. Testing was performed on a volunteer basis after the participant completed a check-off sheet of risk factors. In screening for carotid artery disease 1338 women, whose average age was 31 years, had an less than 1% incidence of cardiac disease, and 803 men, whose average age was 40 years, had a 4% incidence. Less than 1% of the group had diabetes mellitus. All patients were asymptomatic referable to the extra-cranial vascular system. Two men of the 2141 persons tested had a lesion meriting further evaluation. The role of Health Fairs may be more effective as an educational resource than a diagnostic interventional tool.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288642 TI - Lumbar sympathectomy for severe lower limb ischaemia: results and analysis of factors influencing the outcome. AB - Sixty consecutive patients (66 legs) underwent surgical lumbar sympathectomy as the only therapy for severe lower limb ischaemia (pain at rest and/or frank gangrene) caused by arteriosclerosis in the period 1977 to 1982. After six months results were good, as defined by absence of pain at rest, healing of ischaemic lesions and no major amputation, in 48% of limbs and bad in all other limbs. Patients with rest pain only fared much better than those with gangrene: after six months a major amputation had to be performed in 14% and 45% respectively. The presence or absence of diabetes mellitus and palpable pulsations at knee level and the angiographic patterns were of no help in the prediction of the results of lumbar sympathectomy. Doppler ankle/arm indices did have predictive value, since in all limbs with Doppler indices lower than 0.30 a major amputation had to be performed. Lumbar sympathectomy still remains a useful procedure in the treatment of selected patients with severe lower limb ischaemia in which reconstructive surgery is not feasible. But it is only advocated in the presence of ankle/arm indices above 0.30 and in the absence of gangrenous lesions. PMID- 3288643 TI - Saphenous vein aneurysm following coronary artery bypass grafting. AB - Aneurysmal dilatation in a venous graft following coronary artery bypass grafting (CABG) is extremely rare. Recently, we performed a resection of aneurysm and redo CABG in two patients who developed aneurysmal changes in the graft, one after 1 year and 10 months and the other after 3 years and 11 months, and obtained good results. PMID- 3288644 TI - Posttranslational modification of ras proteins: detection of a modification prior to fatty acid acylation and cloning of a gene responsible for the modification. AB - Products of ras genes are synthesized as precursors in the cytosol and transported to the plasma membrane by a process which involves posttraslational modification by fatty acid. In this paper, we present evidence for the occurrence in the cytosol of an intermediate modification of ras proteins prior to the fatty acid acylation. The modification is detected by a slight shift in the mobility of the protein on SDS polyacrylamide gel. The fatty acid acylation does not contribute to this mobility shift. This modification is affected by the dprl mutation which has recently been shown to affect the processing of yeast RAS proteins. To further characterize the nature of the modification event, we have cloned DPR1 gene from the DNA of Saccharomyces cerevisiae. The gene is actively transcribed in yeast cells producing mRNA of approximately 1.6 kb. Genes related to the DRP1 appear to be present in a distantly related yeast, Schizosaccharomyces pombe as well as in guinea pig and human cells. PMID- 3288645 TI - Functional analysis of mitochondrial protein import in yeast. AB - In order to facilitate studies on protein localization to and sorting within yeast mitochondria, we have designed an experimental system that utilizes a new vector and a functional assay. The vector, which we call an LPS plasmid (for leader peptide substitution), employs a yeast COX5a gene (the structural gene for subunit Va of the inner membrane protein complex cytochrome c oxidase) as a convenient reporter for correct mitochondrial localization. Using in vitro mutagenesis, we have modified COX5a so that the DNA sequences encoding the wild type subunit Va leader peptide can be precisely deleted and replaced with a given test sequence. The substituted leader peptide can then be analyzed for its ability to direct subunit Va to the inner mitochondrial membrane (to target and sort) by complementation or other in vivo assays. In this study we have tested the ability of several heterologous sequences to function in this system. The results of these experiments indicate that a functional leader peptide is required to target subunit Va to mitochondria. In addition, leader peptides, or portions thereof, derived from proteins located in other mitochondrial compartments can also be used to properly localize this polypeptide. The results presented here also indicate that the information necessary to sort subunit Va to the inner mitochondrial membrane does not reside in the leader peptide but rather in the mature subunit Va sequence. PMID- 3288646 TI - Mechanism of induction of class I major histocompatibility antigen expression by murine leukemia virus. AB - Alterations in expression of major histocompatibility complex (MHC) antigens on tumor cells clearly correlate with the tumorgenicity and metastatic potential of those cells. These changes in the biological behavior of the tumor cells are presumably secondary to resulting changes in their susceptibility to immune recognition and destruction. Murine leukemia viruses (MuLV) exert regulatory effects on class I genes of the MHC locus. MuLV infection results in substantial increases in cell surface expression of all three class I MHC antigens. These viral effects on MHC antigen expression profoundly influence immune-mediated interaction with the infected cells, as assessed by cytotoxic T lymphocyte recognition and killing. Control of class I MHC and beta-2 microglobulin genes by MuLV takes place via a trans-acting molecular mechanism. MuLV controls expression of widely separated endogenous cellular MHC genes, transfected xenogeneic class I MHC genes, and unintegrated chimeric genes consisting of fragments of class I MHC genes linked to a bacterial reporter gene. These findings indicate that MuLV exerts its effects on MHC expression via a trans mechanism. The MuLV-responsive sequences on the MHC genes appear to lie within 1.2 kilobases upstream of the initiation codon for those genes. PMID- 3288647 TI - Characterization of yeast clathrin and anticlathrin heavy-chain monoclonal antibodies. AB - Clathrin-coated vesicles (CVs) were isolated from Saccharomyces cerevisiae by using procedures developed by Mueller and Branton [17]. Triskelions were purified from this material by extraction of CVs to release clathrin and by subsequent fractionation on Sepharose CL-4B. Triskelions were composed of approximately 180,000 Mr heavy chains and a single light-chain type of approximately 38,000 Mr and were able to undergo self-assembly into polyhedral cages. Trypsin digestion of such reassembled cages showed a peptide pattern very similar to that obtained for mammalian clathrin with two fragments of 125,000 and 110,000 Mr, which represent the major portion of the heavy-chain arm, and a polypeptide of approximately 43,000 Mr, which is the presumptive terminal domain. Eight monoclonal antibodies reacting with yeast clathrin heavy chains were produced. All eight bind to the major portion of the heavy-chain arm, and none bind to the terminal domain fragment. Peptide digestion experiments also indicated that at least three major regions on the arm are recognized by these antibodies. These will be useful in further structural and functional studies of clathrin from yeast. PMID- 3288648 TI - Increased content of chondroitin sulfate proteoglycan in human colorectal carcinoma metastases compared with the primary tumor as determined by an anti chondroitin-sulfate monoclonal antibody. AB - To determine if the amount of chondroitin sulfate proteoglycan (CSPG) in human colorectal tumor tissue correlates with the tumor's aggressiveness we immunochemically determined the CSPG levels in colorectal carcinomas at different stages. A total of 50 specimens--4 polyps, 15 stage B tumors, 9 stage C tumors, 12 stage D tumors, 7 liver metastases, and 3 lymph node metastases--were examined. Tumor tissues were extracted with 4 M guanidine hydrochloride containing protease inhibitors. The extracts were serially diluted and blotted onto nitrocellulose membranes. Reactivity of a chondroitin sulfate-specific mouse monoclonal antibody (CS-56) was determined by biotinylated goat antimouse Ig and avidin-biotin-peroxidase complex. After comparing tissues from tumors at different stages (classified by the presence or absence of metastasis), we could not find a positive or negative correlation between the amount of CSPG in primary colorectal carcinoma tissues and the tumor's metastatic potential. However, the metastatic foci in the liver or lymph node contained higher amounts of CSPG than the primary tumors did. Immunohistochemical staining of colon carcinoma tissue with CS-56 revealed that CSPG is predominantly localized in fibrotic portions in the tumor tissues. Two-year follow-up studies indicated that a high level of CSPG in primary tumors was not predictive of recurrence. PMID- 3288649 TI - Monoclonal antibodies to carbohydrate antigens in autologous bone marrow transplantation. AB - Normal and malignant myeloid cells express a highly immunogenic oligosaccharide, lacto-n-fucopentaose-III (LNF-III), that has been identified by numerous monoclonal antibodies (MoAb). We have been interested in the use of a particular monoclonal antibody to LNF-III, PM-81, in the treatment of patients with acute myelogenous leukemia using the antibody to treat bone marrow in vitro. Following in vitro treatment of bone marrow with PM-81 and another MoAb, AML-2-23, the remaining cells are used as an autograft in a patient treated with high-dose chemotherapy and radiotherapy. In order to enhance the ability of the MoAb to lyse leukemic cells in the remission bone marrow, we have explored the effect of neuraminidase treatment on leukemia cells. In this paper we describe that myeloid leukemia cells expressing low levels of LNF-III by immunofluorescence can be shown to have high levels of LNF-III after neuraminidase treatment. In addition, we show that normal bone marrow progenitor cells do not have cryptic LNF-III antigen, thus allowing the application of this finding to the clinical setting. Moreover, we have shown that leukemia colony-forming cells from one patient with acute myelogenous leukemia express cryptic LNF-III and that after exposure to neuraminidase there was an increased ability of PM-81 in the presence of complement to eliminate these colony forming cells. These data indicate that the LNF-III moiety is almost universally expressed on myeloid leukemia cells and their progenitors but not expressed on normal progenitors. Thus, it may be possible to enhance leukemia cell kill in vitro by neuraminidase treatment of bone marrow. PMID- 3288650 TI - Hyperinsulinemia and stromal luteinization of the ovaries in postmenopausal women with endometrial cancer. AB - Ovarian secretion of testosterone and androstenedione is increased in postmenopausal women with endometrial cancer, and insulin stimulates ovarian stromal androgen synthesis in vitro. We undertook this study to investigate whether women with endometrial cancer have increased serum immunoreactive insulin levels. Ten postmenopausal women with endometrial carcinoma and 10 postmenopausal women without cancer who matched the cancer patients in age, years since menopause, and percentage of ideal body weight were studied. The women with endometrial cancer had significantly higher fasting serum insulin levels than the normal women [mean, 187 +/- 26 (+/- SE) vs. 55 +/- 11 pmol/L; P less than 0.01]. The cancer patients had significantly higher insulin responses after glucose administration than normal women (sum of 1, 2, and 3 h postglucose values, 5545 +/- 1526 vs. 1444 +/- 156 pmol/L; P less than 0.02), even though their glucose responses were similar. Nests of luteinized cells, which were positive for testosterone by immunoperoxidase staining, were found in the ovarian stroma of 8 of the women with endometrial cancer, but in only 1 of those without cancer (P less than 0.01). Specific high affinity insulin receptors were demonstrable in the stroma of the postmenopausal ovaries. These results suggest that the frequency of stromal luteinization is increased in women with endometrial cancer and that insulin may play a role in the pathogenesis of this luteinization. PMID- 3288651 TI - Absence of the dawn phenomenon in normal subjects. AB - The existence of the dawn phenomenon, defined as an increase in plasma glucose levels and/or insulin requirements in the early morning hours, is well established in diabetic patients but remains controversial in normal subjects. To verify whether this phenomenon occurs in normal subjects, the nocturnal profiles in plasma glucose, insulin, and C-peptide levels; insulin to glucose ratio; and prehepatic insulin production were studied at short intervals (4 and 10 min) in 10 normal men. The first part of the night was characterized by a decrease in all values and the presence of 1 or 2 postprandial fluctuations, followed by a steady state until 0800 h. The individual profiles were frequently superimposable, with rapid 8- to 14-min oscillations. These results do not indicate the existence of a dawn phenomenon in normal subjects. PMID- 3288652 TI - Dose-response studies with biosynthetic human growth hormone (GH) in GH-deficient patients. AB - Increasing doses of biosynthetic human GH (R-hGH) were given sc to seven GH deficient patients for three consecutive 14-day periods (2, 4, and 6 IU/day at 2000 h), followed by 14 days of no GH therapy. At the end of each period each patient was hospitalized for frequent blood sampling from 2000 to 1100 h the following day. A dose-dependent increase in serum GH and serum insulin-like growth factor I (IGF-I) levels occurred. However, the time course of the serum IGF-I concentrations was different on the four occasions; there was a significant fall in the evening when no therapy was given (P less than 0.01), a significant increase after injections of 2 IU R-hGH, and constant levels during treatment with 4 and 6 IU R-hGH. Plasma glucose levels were within the normal range, with a significantly lower fasting level (at 0400 h) when no GH was given. Breakfast induced a plasma glucose rise when GH was administered, but no rise without GH, and a postprandial serum insulin response that was GH dose dependent. GH therapy increased serum FFA (P less than 0.05) and blood 3-hydroxybutyrate levels, but had no effect on blood alanine or lactate or serum triglyceride and cholesterol levels. We conclude that the serum IGF-I response to GH is dose dependent, and that a GH replacement dose of 2 IU/day (equalling 1.5 IU/m2.day) is insufficient to maintain normal diurnal serum IGF-I levels. Furthermore, a GH-independent diurnal variation in serum IGF-I in these patients is suggested. This GH preparation also has diabetogenic and lipolytic actions. PMID- 3288653 TI - Amphetamine, but not methylphenidate, predicts antidepressant efficacy. AB - Several researchers have explored the possibility that acute stimulant response may predict eventual improvement after specific antidepressants. This review analyzes the relationship between stimulant response and nonspecific antidepressant response. In five studies, amphetamine responders were found to eventually improve after antidepressant treatment in 85% of the cases, while nonresponders improved in 43% of the cases. In contrast, acute methylphenidate responders and nonresponders eventually improved on antidepressants at equivalent rates. Amphetamine sensitivity appears to be a trait (possibly pharmacodynamic) that is independent of depressive illness but predictive of tricyclic responsiveness. Other evidence has suggested that amphetamine and methylphenidate cause similar behavioral and symptomatic effects through distinct mechanisms of potential clinical relevance. The most effective method for administering an amphetamine challenge and its appropriate clinical use remain unclear. PMID- 3288654 TI - Effect of supplemental beta-carotene on luteinizing hormone released in response to gonadotropin-releasing hormone challenge in ovariectomized Holstein cows. AB - Thirteen lactating Holstein cows were assigned randomly to either a control or beta-carotene (600 mg/d) treatment group to determine the effect of long-term beta-carotene supplementation on releasable luteinizing hormone in response to gonadotropin-releasing hormone challenge. The experimental period was 28 wk. Milking was terminated at wk 16, ovariectomy performed at wk 20, and response to gonadotropin-releasing hormone determined at wk 27. Serum beta-carotene concentrations reflected dietary intake and were higher in the cows fed beta carotene after 2 wk of supplementation and remained higher for the duration of the trial. Feeding supplemental beta-carotene had no effect on circulating progesterone concentration, corpora lutea size or corpora lutea progesterone concentration, or basal concentrations of luteinizing hormone, frequency, and amplitude of luteinizing hormone pulses, or the release of luteinizing hormone in response to gonadotropin-releasing hormone. Thus, pituitary responsiveness to exogenous gonadotropin-releasing hormone was not affected by feeding supplemental beta-carotene. PMID- 3288655 TI - Effect of mastitis on proteolytic activity in bovine milk. AB - Proteolytic activity of milk was studied before, during, and after experimental induced mastitis. An inoculum of Streptococcus agalactiae was infused into one quarter of each udder of six cows to elicit an infection. Bacteriological cultures and SCC of milk were used to monitor infection status. Sodium dodecyl sulfate-PAGE was used to measure proteolytic activity of milk. Inhibitor 6-amino n-hexanoic acid was used to determine the relative proportion of plasmin and nonplasmin proteolytic activity of milk. Somatic cell count, total milk proteolytic activity, and nonplasmin proteolytic activity were higher in infected quarters than in quarters preinfection. After elimination of infections, SCC and nonplasmin proteolytic activity decreased to preinfection amounts. Total proteolytic activity of milk decreased after infections were cured but remained significantly higher than preinfection activity. This postinfection proteolytic activity in milk may be due to an increase in milk plasmin activity. Our data suggest that detrimental effects of mastitis on milk quality can continue after infection has been eliminated and milk SCC have returned to low values. PMID- 3288656 TI - Dental materials: 1986 literature review. Part 2. PMID- 3288657 TI - Smoking, saliva and salivation. PMID- 3288658 TI - The etched cast metal resin-bonded (Maryland) bridge: a clinical review. PMID- 3288660 TI - Gies award to Frank P Bowyer, Jr. PMID- 3288661 TI - Gies award to Lynden M. Kennedy. PMID- 3288659 TI - Head trauma in the child. AB - Head injury, either alone or in combination with multiple injuries, is common in children. Its pattern is different in children compared to adults, with diffuse cerebral swelling rather than localized hematoma being most common. The pathophysiology of pediatric head trauma is not yet clearly elucidated, but may be closely related to changes in the regulation of cerebral blood flow. The initial management and subsequent care of the child with severe brain injury are discussed from a multisystem viewpoint. The prognosis for children with severe head injury seems brighter than for adults, but there are not yet enough data to allow prediction of outcome in any individual case. Efforts to prevent, rather than treat, head injury in childhood are more likely to be beneficial. PMID- 3288662 TI - Gies award to Russell I. Todd. PMID- 3288663 TI - Honorary fellowship for Leon Singer. PMID- 3288664 TI - Award of merit to Jo Clark. PMID- 3288666 TI - The presidents. Lynden M. Kennedy 1974-1975. PMID- 3288665 TI - A treasury of dentistry. Dentist inventors. PMID- 3288667 TI - Central ossifying fibroma of the anterior maxilla: report of case. AB - Central ossifying fibromas are well-documented, benign lesions usually found on the mandible and posterior maxilla. These lesions are differentiated from other fibro-osseous proliferations by specific clinical, radiographic, and histopathological criteria. An unusual case involving the anterior maxilla is described, including a review of the diagnostic features of the lesion as well as a discussion of its relationship to other fibro-osseous lesions. PMID- 3288669 TI - Dentistry on stamps. PMID- 3288668 TI - Vertical extrusion using a removable orthodontic appliance. AB - Vertical extrusion is a useful adjunct to periodontal-restorative procedures, particularly in the anterior segment of the dentition in which esthetic appearance is a primary concern. In the case presented, a multidisciplinary approach was used to treat a tooth successfully with extensive subgingival destruction. Orthodontic and periodontic treatment, as part of an integrated treatment plan, resulted in preservation of esthetic appearance and establishment of sound tooth structure to allow for biologic width and restorative margins. PMID- 3288670 TI - Dentistry on stamps. PMID- 3288671 TI - The presidents. Robert B. Shira 1975-1976. PMID- 3288672 TI - Resolution of fused vertical molar root bridge abutment fracture: report of case. AB - Vertical root fractures involving apparently successful endodontic treatment with gutta-percha may be caused by hairline root fractures that existed before root canal therapy was performed. A root stripping technique was used to restore a strategically located tooth in a 70-year-old patient. Bruxism with occlusal trauma is proposed as a significant cause of hairline vertical root fractures. The commonly held view that these fractures arise from root canal condensation techniques appears more circumstantial than factual. PMID- 3288673 TI - Dentistry on stamps. PMID- 3288674 TI - The effect of sealants on dental caries: a review. AB - Many dentists are concerned that caries may progress if inadvertently sealed within a tooth by a pit and fissure sealant. Several research studies have been performed to determine whether this is an important concern. This report reviews the methods and results of those studies. PMID- 3288676 TI - Oxygen-derived free radicals and postischemic myocardial dysfunction ("stunned myocardium"). AB - Experimental studies have demonstrated that myocardium reperfused after reversible ischemia exhibits prolonged depression of contractile function ("stunning"), which is associated with various ultrastructural, biochemical, vascular and other functional abnormalities. Clinical observations suggest that stunning occurs in many situations (for example, rest and exercise-induced angina, myocardial infarction with early reperfusion, open heart surgery, transplantation) and thus may contribute significantly to morbidity among patients with coronary artery disease. In recent years an increasing number of studies have provided indirect evidence that postischemic myocardial dysfunction may be mediated in part by the generation of reactive oxygen species, such as superoxide radical (.O2-), hydrogen peroxide (H2O2) and hydroxyl radical (.OH). Thus, it has been shown that the recovery of the stunned myocardium is enhanced by agents that either scavenge oxygen metabolites, such as superoxide dismutase and catalase, N-2-mercaptopropionylglycine and dimethylthiourea, or prevent their generation, such as allopurinol, oxypurinol and desferrioxamine. More recent experiments utilizing electron paramagnetic resonance spectroscopy have directly demonstrated that reperfusion after a reversible ischemic episode is associated with a burst of free radical production. At present, the evidence supporting the free radical hypothesis is suggestive but not conclusive. Definitive demonstration of the role of oxy-radicals will require careful studies measuring the production of these species in conscious animal models of postischemic dysfunction. If confirmed, the free radical hypothesis will provide not only new important insights into the pathophysiology of ischemic injury, but also a rationale for developing clinically applicable interventions. PMID- 3288677 TI - Should digoxin be the drug of first choice after diuretics in chronic congestive heart failure? PMID- 3288675 TI - Sensitivity and specificity of assessing coronary bypass graft patency with ultrafast computed tomography: results of a multicenter study. AB - Because a significant number of all patients seen by cardiologists have had coronary bypass surgery, a relatively noninvasive method of assessing coronary bypass graft patency would be very helpful. Ultrafast computed tomography, by virtue of its rapid data acquisition time and reasonable spatial resolution, may be useful in this regard. To determine the sensitivity, specificity and predictive accuracy of this imaging modality as compared with cardiac catheterization, a multicenter study was undertaken. There were two parts to the study. Part I involved the evaluation of 179 grafts in 74 patients studied in the five participating centers between March 1985 and August 1986. Twenty-nine percent of these graft studies were found to be technically inadequate and were excluded before patency determinations began. The remaining group of 127 bypass grafts in 62 patients had studies adequate for interpretation. Fifty-one grafts were to the left anterior descending coronary artery or a diagonal branch, 37 to branches of the left circumflex artery and 28 to the right coronary artery or a posterior descending vessel; in addition, there were 11 internal mammary artery bypass grafts primarily into the left anterior descending or diagonal artery distribution. The sensitivity of detecting angiographically open grafts was 93.4%, the specificity of detecting angiographically closed grafts 88.9% and the predictive accuracy was 92.1%. A subsequent study (Part 2) was performed 9 months later to assess the ability to carry out technically adequate examinations. Of the 138 consecutive graft examinations (50 patients) included in this part of the study, 94.2% of the examinations were found to be technically adequate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288678 TI - Should asymptomatic ventricular arrhythmias in patients with congestive heart failure be treated with antiarrhythmic drugs? PMID- 3288679 TI - Doppler echocardiography for the diagnosis of acute cardiac allograft rejection. AB - To evaluate the changes in left ventricular filling associated with acute cardiac rejection, serial Doppler echocardiographic examinations were prospectively performed on the same day as endomyocardial biopsy in 55 consecutive patients who successfully underwent orthotopic transplantation and were free of a previous episode of rejection. On average, 8.6 Doppler studies per patient were performed within a 6 month period after transplantation. Recordings of mitral flow were made with pulsed Doppler and two-dimensional echocardiography from an apical four chamber view; isovolumic relaxation time, peak early mitral flow velocity and pressure half-time were measured. The patients were classified into two groups on the basis of the histopathologic findings: group I (25 patients with at least one episode of mild or moderate rejection) and group II (30 patients without rejection). In group I, rejection was associated with a significant decrease of isovolumic relaxation time (p less than 0.005) and especially pressure half-time (p less than 0.0005) with no change in heart rate and peak early mitral flow velocity. In group II, Doppler indexes remained unchanged. These changes were not associated with alterations in left ventricular systolic function assessed by echocardiography. Isovolumic relaxation time and pressure half-time both returned to values similar to baseline values after immunosuppressive therapy (p less than 0.05 and p less than 0.0005, respectively). With 20% decrease in pressure half time as a criterion for acute rejection, sensitivity was 88%, specificity 87% and positive predictive value 85%. Thus, Doppler echocardiographic evaluation of left ventricular diastolic function provides an excellent tool for early detection of acute rejection and noninvasive monitoring of the cardiac transplant recipient. PMID- 3288681 TI - Immunologic aspects of neurologic diseases. I. General responses and demyelinating diseases. PMID- 3288680 TI - Six month postoperative hemodynamics of the Hancock heterograft and the Bjork Shiley prosthesis: results of a Veterans Administration cooperative prospective randomized trial. AB - In a Veterans Administration Cooperative Study involving 13 medical centers, 575 patients undergoing single valve replacement were prospectively randomized to receive either the standard Bjork-Shiley prosthesis or the Hancock porcine heterograft (with a modified orifice for sizes 23 and smaller). The hemodynamic data in the 268 patients who underwent cardiac catheterization an average of 6 months (range 3 to 12) postoperatively are reported. Statistical analyses were performed on valve sizes 23, 25 and 27 in the aortic position, and 29, 31 and 33 in the mitral position. A wide variation was observed in mean pressure gradient and calculated orifice area in both valve types within all sizes in both the aortic and the mitral positions. In the aortic position, the Bjork-Shiley prosthesis tended to have a lower pressure gradient and larger calculated orifice area than the Hancock heterograft, but the differences in gradient between the two valve types were significant only in the larger-sized valves. The difference in calculated area between the two valve types was not significant within each valve size. In the mitral position, there were no differences in gradient and calculated orifice area between the two types of prostheses. The postoperative cardiac index, regurgitant volume, pulmonary artery systolic and mean pressures, left ventricular end-diastolic pressure, left ventricular ejection fraction and left ventricular end-diastolic volume index did not differ in patients receiving the Bjork-Shiley prosthesis from values in patients receiving the Hancock heterograft. Hence, the overall hemodynamic performance of both types of valves is remarkably similar. The choice between these two prostheses should, therefore, be governed not by the hemodynamic performance, but by other factors such as valve durability, risk of anticoagulation and incidence of valve-related complications. PMID- 3288682 TI - Adrenal function in children with bronchial asthma treated with beclomethasone dipropionate or budesonide. AB - The effect of inhaled beclomethasone dipropionate and budesonide on the adrenal function was studied in 30 children (aged 7 to 15 years) with mild bronchial asthma. The trial was designed as a prospective double-blind parallel study of the effect of stepwise increase of either beclomethasone dipropionate or budesonide from 200 micrograms through 400 micrograms, to 800 micrograms daily in three consecutive periods of 4 weeks. At the end of each period, the adrenal stress response was evaluated by measurements of serum cortisol and androstenedione during a short adrenocorticotropic hormone test. The unstimulated diurnal production of glucocorticosteroids was assessed by measurements of free cortisol in 24-hour urine samples. Free cortisol in urine was found a valid measure of the total diurnal excretion of cortisol metabolites, since it exhibited a good correlation to the fractional cortisol metabolites measured by gas chromatography. The adrenal response to adrenocorticotropic hormone stimulation was unaffected by treatment or dose. The unstimulated diurnal production of glucocorticosteroids demonstrated a highly significant dose-related suppression in response to the inhaled steroids. No significant difference was found between the two topical steroids (probability value 5.3%), and yet the suppression was apparent in the group of children treated with beclomethasone dipropionate but not in the group of children treated with budesonide. Further studies are desirable in order to ascertain whether budesonide offers an improved ratio between beneficial anti-inflammatory effect and unwanted systemic activity. PMID- 3288683 TI - Ketotifen inhibits the cutaneous but not the airway responses to platelet activating factor in man. AB - We studied the effect of ketotifen, an oral antiallergic and antihistaminic drug, on the airway and cutaneous responses to platelet-activating factor (PAF) in a double-blind, randomized, and crossover study in six normal subjects. Ketotifen (three doses of 2 mg taken during a 14-hour period before PAF) did not alter PAF induced bronchoconstriction and did not prevent the accompanying flushing and coughing. The transient neutropenia (74.5 +/- 4.8% fall; p less than 0.001) and rebound neutrophilia (104 +/- 55% rise) induced by PAF were not affected by ketotifen. On the day placebo was received, airway responsiveness to methacholine increased after PAF exposure with the concentration needed to cause a 40% fall in baseline partial expiratory flow rate (PC40), decreasing from 69.2 mg/ml (geometric standard error of the mean, 2.69) to 23.3 mg/ml (2.34) on day 3 (p less than 0.001). Ketotifen had no effect, because on the day ketotifen was administered, mean PC40 also decreased from 52.7 mg/ml (2.5) to 21.5 mg/ml (2.14) (p less than 0.01). In the skin, ketotifen reduced the flare area (from 8.05 +/- 3.60 to 1.14 +/- 0.29 cm2; p less than 0.05) and the wheal volume (from 0.068 +/- 0.010 to 0.045 +/- 0.008 cc; p = 0.02) induced by intradermal PAF (200 ng). Cutaneous responses to histamine (1 microgram) were significantly inhibited. Thus, the bronchoconstriction and bronchial hyperresponsiveness induced by PAF are not inhibited by ketotifen. Ketotifen inhibits PAF-induced wheal and flare in the skin, which is probably histamine dependent. The airway effects of PAF are unlikely to be mediated by histamine release. PMID- 3288684 TI - Effects of altered exposure chamber pressure on the breathing pattern of conscious rats in nose-only exposure tubes. AB - Rats exposed to inhaled toxicants while in plethysmographs having nose or neck seals may breathe against a negative pressure gradient during exposure. Breathing against negative pressure might affect the respiratory pattern and thus, the uptake or deposition of toxicant. The respiration of 10 conscious rats restrained in plethysmographic nose-only inhalation exposure tubes having a neck seal, was measured during breathing against ambient, negative and positive pressures (0 to +/- 7.5 cm H2O). Negative pressure increased respiratory frequency and reduced tidal volume, but minute volume was little changed. The estimated fraction of inspirate reaching the alveoli was reduced and inspiratory flow was increased. The magnitudes of these changes were small at typical exposure pressures, and the magnitudes of their effects on uptake and deposition would be expected to fall within the range of normal intersubject variability. Positive pressure tended to have effects opposite those of negative pressure. PMID- 3288685 TI - Cellular metabolism of arsenocholine. AB - The biotransformation of arsenocholine and arsenobetaine, which are organic arsenic compounds present in certain aquatic organisms, has been studied in vitro using synthetic reference substances. Incubation of arsenocholine with different liver cell fractions showed arsenocholine to be biotransformed only in presence of the mitochondrial fraction. The biotransformation products were arsenobetaine aldehyde, arsenobetaine, trimethylarsine oxide and trimethylarsine. Arsenobetaine was the major metabolite and it was formed via arsenobetaine aldehyde. Trimethylarsine oxide was formed via a side reaction from arsenobetaine aldehyde. Further reduction of trimethylarsine oxide, produced trimethylarsine. In vitro studies of arsenobetaine, did not show any formation of trimethylarsine oxide or trimethylarsine. Furthermore, cytotoxicity of arsenobetaine or arsenocholine in isolated hepatocytes was not observed. PMID- 3288686 TI - Mutagenicity and cytotoxicity of N-methyl-2-pyrrolidinone and 4 (methylamino)butanoic acid in the Salmonella/microsome assay. AB - The industrial solvent N-methyl-2-pyrrolidinone (NMP) and its hydrolysis product, 4-(methylamino)butanoic acid (N-MeGABA), were examined for mutagenicity and cytotoxicity in the Ames Salmonella/microsome assay. In order to detect a broad range of possible mutagenic endpoints, the following strains were used in the assay: base-pair substitution strains TA100, TA102 and TA104; frameshift strains TA97 and TA98; and repair proficient strains TA2638, UTH8413 and UTH8414. In the standard plate incorporation assay, six log-linear doses of each compound were tested; doses ranged from 0.01 to 1000 mumol/plate for NMP, and 0.01 to 316 mumol/plate for N-MeGABA. Neither compound was detectably mutagenic when tested in the presence and absence of metabolic activation by Aroclor-induced rat liver S9. NMP did show significant responses with strains TA102 and TA104 that were less than two-fold over background, but no clear dose-response relationships were evident. A preincubation modification of the assay was also performed, using strains TA98 and TA104. Mutagenic activity was not observed for NMP, while N MeGABA showed significant responses with TA104 but dose-related mutagenicity was not established. Preincubation testing revealed both NMP and N-MeGABA to be cytotoxic to the test population of Salmonella at the highest treatment doses. PMID- 3288687 TI - TCDD. PMID- 3288688 TI - An improved method for the purification of DNA-dependent RNA polymerase from Escherichia coli. AB - DNA-dependent RNA polymerase from Escherichia coli was purified further by elution through heparin-Sepharose CL-6B column after the enzyme was obtained, partially purified, using Burgess and Jendrisak's method [(1975)Biochemistry 14, 4634] The total yield of the pure protein was 10 mg from 50 g of E.coli cells. The method was found to be very reproducible and convenient. The enzyme preparation had 60% active molecules and the elongation rate of RNA synthesis by this enzyme was measured to be 11 bases/s over delta D111 T7 DNA. PMID- 3288689 TI - Effect of superior cervical ganglionectomy on insulin release by murine pancreas slices. AB - The effect of superior cervical ganglionectomy (SCGx) on basal and glucose stimulated insulin release in vitro was examined in pancreas slices of BALB/c mice subjected to surgery 14-96 h earlier. Fourteen or 20 h after SCGx a significant increase of insulin response to 11 mM glucose was detectable, while 96 h after SCGx a depression in response was found. Perifused pancreas slices obtained from mice subjected to SCGx 7 days earlier showed a decreased in vitro insulin response to glucose during both phases of insulin secretion. In sham operated mice, injection of the beta-adrenoceptor blocker propranolol or of the cholinergic muscarinic antagonist atropine decreased basal and glucose-stimulated insulin release, while the alpha-adrenoceptor blocker phenoxybenzamine did not affect it significantly. In mice subjected to SCGx 14 h earlier, propranolol treatment decreased basal insulin release and impaired the release elicited by glucose to values similar to those found in controls, phenoxybenzamine injection increased the basal and amplified the enhanced glucose-stimulated insulin release, and atropine injection, although unable to affect basal insulin release, impaired partially the amplification of response detectable after surgery. Our results support the existence of significant effects of SCG neurons on insulin release in mice. PMID- 3288690 TI - Changes in plasma catecholamines and plasma renin activity during hypotension in conscious rats with lesions of the nucleus tractus solitarii. AB - The purpose of the present study was to examine the effects of lesions of the nucleus tractus solitarii on the reflex control of sympathetic activity and renin release in the conscious rat. Two doses of the arteriolar vasodilator hydralazine (0.3 and 1 mg/kg, i.v.) were used to activate reflexively the sympathetic nervous system in nucleus tractus solitarii lesion and control rats. Administration of 1 mg/kg of hydralazine to the control rats caused mean arterial pressure to fall from 120 +/- 2 mm Hg to 84 +/- 2 mm Hg and elicited an 11.2-fold increase in plasma renin activity and a 2.7-fold increase in plasma norepinephrine concentration. Administration of 0.3 mg/kg of hydralazine caused the arterial pressure of the lesion group to fall from 118 +/- 3 mm Hg to a comparable value of 85 +/- 4 mmg Hg, but plasma renin activity and plasma norepinephrine concentration did not rise significantly. However, administration of 1 mg/kg of hydralazine to the lesion group caused arterial pressure to fall from 128 +/- 6 mm Hg to 64 +/- 2 mm Hg, in association with a 12.4-fold increase in plasma renin activity and a 1.6-fold elevation in plasma norepinephrine concentration. Atenolol, a beta 1-adrenoceptor antagonist, blocked 70% of the rise in plasma renin activity caused by 1 mg/kg of hydralazine in both groups of rats. In addition, prior renal denervation also markedly attenuated the rise in plasma renin activity caused by hydralazine in the lesion group. Finally, electrical stimulation of the vagus nerves, which caused a large vasodepressor response in the control group, failed to lower the arterial pressure of the lesion group. Based on these observations, we conclude that in the conscious rat (1) nucleus tractus solitarii lesions eliminate the arterial baroreflexes as well as the cardiopulmonary baroreflex, and (2) severe hypotension induces sympathetically mediated renin release in the apparent absence of arterial and cardiopulmonary baroreflex function. PMID- 3288692 TI - Foreign body migration in the hand. PMID- 3288691 TI - Axillary lymphadenopathy 17 years after digital silicone implants: study with x ray microanalysis. AB - Axillary lymphadenopathy developed in a patient with rheumatoid arthritis 17 years after the placing of Swanson implants in the hand. Foreign material in the lymph nodes was identified as silicone by energy-dispersive x-ray microanalysis. This emphasizes the long latent period that may be associated with this clinical phenomenon which may mimic other, more serious, diseases. PMID- 3288694 TI - Bibliography of the current world literature in hypertension. PMID- 3288693 TI - A retrospective study of patients' recall of respirator treatment. (1): Study design and basic findings. PMID- 3288695 TI - Effect of low versus conventional dose cyclopenthiazide on platelet intracellular calcium in mild essential hypertension. AB - Platelet free intracellular calcium levels were measured during a double-blind, placebo-controlled parallel study to investigate the antihypertensive activity of 50 micrograms, 125 micrograms, and 500 micrograms cyclopenthiazide, in mild essential hypertension. Cytosolic free calcium levels were significantly higher in established hypertensive patients (135 +/- 28 nmol/l, P less than 0.001) but not in borderline hypertensive patients (123 +/- 26 nmol/l) compared with normotensive controls (111 +/- 9 nmol/l). A positive correlation between platelet free calcium level and systolic and diastolic blood pressure was confirmed (n = 68; r = 0.309 P = 0.01; r = 0.405 P less than 0.001, respectively). The 125 micrograms and 500-microgram doses of cyclopenthiazide produced mean decrements in blood pressure of 18/10 mmHg and 23/8 mmHg, respectively, (P less than 0.05 for both), after 8 weeks of therapy. The 50-microgram dose displayed no useful antihypertensive activity. Platelet free calcium levels fell by a similar amount in the four groups. The fall in blood pressure produced by the 125 and 500 microgram doses of cyclopenthiazide did not correlate with changes in platelet [Ca2+]i (r = 0.166 systolic and r = 0.169 diastolic). These findings do not support the hypothesis that changes in platelet cytosolic calcium levels are determined by the same factors that control blood pressure. PMID- 3288696 TI - Role of granulocyte/macrophage colony-stimulating factor in the regulation of murine alveolar macrophage proliferation and differentiation. AB - Granulocyte/macrophage (GM)-CSF is one of the hemopoietic growth factors that stimulates neutrophilic granulocyte and macrophage production by bone marrow progenitor cells. In this study, the effect of GM-CSF on the growth and differentiation of murine pulmonary alveolar macrophages (PAM) was investigated. In the presence of GM-CSF, normal murine PAM were induced to proliferate and develop into macrophage colonies with a dose-response curve similar to that of bone marrow GM colony-forming cells. PAM also responded to CSF-1, a lineage restricted growth factor, but required much higher doses of CSF-1 and a longer incubation time for optimal colony formation. The proliferative response of PAM to CSF-1, however, was greatly enhanced by the concurrent addition of low doses of GM-CSF. In contrast, low doses of CSF-1 failed to potentiate the proliferative response of PAM to GM-CSF. Macrophages derived from GM-CSF cultures were rounder and less stretched and possessed less FcR-mediated phagocytic activity than cells produced in CSF-1 cultures. A study with hydrocortisone-induced monocytopenia showed that nearly one half of lung macrophages may be sustained by local proliferation of PAM without the continuous migration of blood monocytes. This study suggests that GM-CSF may play a major role in the production of PAM by two modes of action, 1) direct stimulation of cell proliferation and 2) enhancement of their responsiveness to CSF-1, thereby producing more mature and functionally competent macrophages. PMID- 3288697 TI - Increased resistance to non-MHC-restricted cytotoxicity related to HLA A, B expression. Direct demonstration using beta 2-microglobulin-transfected Daudi cells. AB - Experiments in several laboratories have shown that target susceptibility to NK and lymphokine-activated killer (LAK) cytotoxicity is inversely correlated with the target expression of HLA Class I molecules. We present the first direct evidence, obtained by gene transfection, that target cell HLA, A, B expression increases the resistance to the "so-called" non-MHC-restricted cytotoxicity. We have co-transfected, by electroporation, the human beta 2-microglobulin gene and the gene carrying the resistance to geneticin into Daudi cell line. Geneticin selection in culture followed by FACS sorting on the basis of strong positivity with the mAb W6/32 (which is specific for the HLA class I H chain associated to beta 2-microglobulin) have led to the establishment of a HLA+ Daudi cell line permanently expressing HLA A10, A11, and B17 molecules. Studies were performed in vitro to evaluate the susceptibility of these cells to either NK and LAK cytotoxicity. The HLA class I+ Daudi cells exhibit an increased resistance to killing by non-MHC-restricted killer cells (both NK and LAK) as compared with their HLA-Daudi counterpart. PMID- 3288700 TI - Propoxyphene. PMID- 3288698 TI - Recombinant tumor necrosis factor enhances macrophage destruction of Trypanosoma cruzi in the presence of bacterial endotoxin. AB - We examined in this work whether rTNF inhibits the capacity of Trypanosoma cruzi to multiply within murine macrophages or enhances the ability of the phagocytic host cells to destroy internalized parasites. We found that rTNF would not alter the fate of the trypanosomes within macrophages over a 48-h incubation period unless the latter cells were also treated with 1 ng/ml bacterial endotoxin (LPS). Treatment of macrophages with rTNF plus LPS, but not separate treatment with either rTNF or LPS, resulted in a significant decrease in the number of organisms per 100 macrophages with respect to values obtained with mock-treated macrophages. In addition, there was a significant reduction in the proportion of infected macrophages over the 48-h incubation period, indicating parasite clearance by the host cells. The combined effects of rTNF and LPS were seen when macrophages from CBA/J were used but not with LPS-insensitive macrophages from C3H/HeJ mice. Increased trypanosome killing by CBA/J macrophages treated with rTNF plus LPS was not seen when catalase was present in the culture medium, indicating a role for hydrogen peroxide in the cytotoxic effect. These results show that rTNF can affect the fate of T. cruzi within macrophages if LPS is present and point to destruction of internalized organisms rather than inhibition of parasite multiplication as the most likely explanation. PMID- 3288699 TI - Regulation of the immune response by sex hormones. I. In vitro effects of estradiol and testosterone on pokeweed mitogen-induced human B cell differentiation. AB - Sex hormones have been implicated in the pathogenesis of many autoimmune disorders, presumably through regulatory influences on the immune system. However, the mechanisms of sex steroid action on humoral and cellular immune responses are not precisely understood. In this study, the in vitro effects of physiologic concentrations of 17 beta-estradiol and testosterone on the Ag non specific differentiation of human PBMC were examined using optimal and sub optimal doses, respectively, of PWM. In cultures of PBMC from 14 normal donors (7 men and 7 women, aged 25 to 45 yr), 17 beta-estradiol (0.5 to 30 ng/ml) enhanced PWM-induced generation of PFC by 46% (p less than 0.01), whereas testosterone (10 to 300 ng/ml) inhibited PFC generation by a mean of 36% (p less than 0.001). The enhancing and suppressing effects of the sex steroids on PBMC occurred early inasmuch as estradiol and testosterone had to be added to the cultures at their initiation (6 and 24 h, respectively) in order to observe their influence. Moreover, deletion of the hormones from the cultures after as short a period as 12 h did not obviate their effects. There was no alteration of the kinetics of the response to PWM or an effect on the number of spontaneous PFC generated in vitro in the absence of PWM. In addition, there was no difference among men and women in response to either sex steroid, and within the female group, no variation was observed on different days of the menstrual cycle. These studies demonstrate direct immunoregulatory effects of specific sex steroids on human PBMC and support the idea that these hormones may have a role in the pathogenesis and treatment of some autoimmune disorders. PMID- 3288701 TI - Delayed cutaneous hypersensitivity reaction in breast cancer patients. PMID- 3288702 TI - [An experimental study of cancer therapy through the augmented foreign body reaction]. PMID- 3288703 TI - The apolipoprotein multigene family: biosynthesis, structure, structure-function relationships, and evolution. PMID- 3288704 TI - Osmoregulation of thirst. PMID- 3288705 TI - Thyrotrophin gene regulation. PMID- 3288706 TI - Evaluation of two acute cardiac ischemia decision-support tools in a rural family practice. AB - This study investigated the applicability in a primary care setting of two decision-support tools for evaluating the necessity of admitting patients with suspected acute cardiac ischemic disease to a cardiac intensive care unit. The heart disease predictive instrument (HDPI) of Pozen et al and the electrocardiogram scoring method of Brush et al were applied to records from all patients with cardiac-related diagnoses admitted to a family practice service. A retrospective review of medical records of all patients admitted with suspected acute ischemic heart disease to a rural community hospital family practice service was conducted. Of 147 patients identified, 108 were admitted primarily for suspected ischemia. Twenty-four myocardial infarctions occurred among these 108 patients (22.2 percent). Patients with HDPI probabilities of less than 50 percent were very unlikely to sustain infarction and in no case required intensive intervention for any problem not apparent at admission. Only 15 instances of the four types of complications that the instrument of Brush et al is designed to predict occurred; this incidence was too low to allow statistical testing. In summary, the heart disease predictive instrument reliably identified patients unlikely to require intensive care services in this population. Because of the low incidence of complications in this population, the instrument described by Brush et al was not found to be clinically useful. PMID- 3288707 TI - Drug treatment considerations for the hypertensive black patient. AB - In prior years the major differences noted between hypertension in black and white patients have been mostly epidemiological, with some suggestion that the differences were primarily quantitative and probably not qualitative. Recently, certain pathophysiological aberrations in hypertensive patients have been shown to be different in blacks and whites. Whether these differences are primary (genetic) or secondary has yet to be resolved. Nevertheless, certain racial differences may have therapeutic implications. Diuretics remain the mainstay of therapy for most hypertensive black patients. beta-Blockers and angiotensin converting enzyme (ACE) inhibitors have not shown great efficacy when used as monotherapy in black hypertensive patients. The combination of a diuretic with beta-blockers or ACE inhibitors, however, has been shown to abolish black-white differences in drug response. More recently, the calcium channel blockers have been shown to be potentially effective in black hypertensive patients. In spite of the effective drug therapy that is available for hypertensive patients in general, economic and social considerations continue to contribute to the low rate of detection, treatment, and control of hypertension in the black population. PMID- 3288708 TI - [Major malformation syndrome and apparently balanced chromosomal abnormality: holoprosencephaly and 5p; 12q translocation]. AB - Observation of holoprosencephaly associated to chromosomic aberration (balanced translocation 5p; 12q); genetic council may be difficult in case of familial translocation. PMID- 3288709 TI - Studies on a high molecular weight luteinizing hormone release stimulating factor of the ovine pineal gland. AB - Former work has shown that crude extracts of ovine pineal glands probably exert a stimulating activity on the release of gonadotropins of anterior pituitaries in vitro. By aqueous extraction followed by ultrafiltration through anisotropic membranes high Mr (above 100,000 daltons) fractions were obtained, which exhibit a stimulating effect on the levels of gonadotropins in the medium of either cultured pituitary cells or anterior hemipituitaries in short-term culture. Partial purification of a pineal luteinizing hormone release stimulating factor was accomplished by Sephadex G-150 filtration with a biopotency of 226 +/- 23 micrograms LH-RP-1 equivalents per mg protein and without an affinity for binding to anti-LHRH or anti-LH antibodies. The present data substantiate that high Mr forms, slightly heavier than authentic pituitary LH (Mr 23,000 daltons) and therefore not identical to the hypothalamic decapeptide LH-RH, represent ovine pineal factors which can increase the concentration of LH in the medium of cultured anterior pituitaries, but does not influence the secretion of prolactin in vitro. PMID- 3288710 TI - Response of pineal serotonin N-acetyltransferase activity in male guinea pigs exposed to light pulses at night. AB - Serotonin N-acetyltransferase (NAT), which is crucial for the formation of melatonin, undergoes a typical day/night rhythm in the pineal gland with low levels during daytime and high levels at night. Short pulses of light given at night have been shown to rapidly depress NAT activity in some species, but not in others, the reasons for this difference being unclear. As diurnality and nocturnality of the experimental animals may play a role and since diurnally active animals have been little investigated in this respect, in the present study the diurnally active guinea pig was investigated. Male guinea pigs kept under a lighting regimen of LD 12:12 (lights off at 1700 hrs) were killed between 1200 or 1300 hrs and between 0000 and 0200 hrs, at night in the dark or after exposure to 10 or 45 min of light. The results obtained show that the day/night difference of NAT activity is about 2-fold. 10 min or 45 min of light given at night significantly depress pineal NAT activity. Re-exposure to darkness for 1 hr of animals previously given light for 10 min leads to restoration of NAT activity. These findings together with data from the literature suggest that it does not appear to be the activity pattern (diurnality versus nocturnality) of an animal nor the amplitude of the day/night difference of pineal NAT activity that account for the suppressibility or non-suppressibility of pineal NAT activity by light at night. PMID- 3288711 TI - Parallel processing of short-term memory for sensitization in Aplysia. AB - How is the short-term memory for a single form of learning distributed among the various elements of a neuronal circuit? To answer this question, we examined the short-term memory for sensitization, using the siphon component of the defensive gill- and siphon-withdrawal reflex. We found that the memory for short-term sensitization is represented by at least four sites of circuit modification, each involving a different type of plasticity. These include (1) presynaptic facilitation of the sensory neuron connections onto both interneurons and motorneurons; (2) presynaptic inhibition at the connections of the L30 inhibitory neurons onto the excitatory interneuron L29; (3) posttetanic potentiation of the excitatory connections made by L29 onto a specific subclass of siphon motorneurons, the LFS cells; and (4) an increase in the tonic firing rate of the LFS siphon motor neurons, resulting in neuromuscular facilitation. Each of the heterosynaptic changes seems to involve a common modulatory transmitter and to utilize a common second messenger system. Moreover, each of these sites seems capable of encoding a different component of the short-term memory. Facilitation of the connections of sensory neurons should contribute to the increase in amplitude of the response; the disinhibition of the L29 interneurons and the posttetanic potentiation at L29 synapses should contribute to an increase in the duration of the response; and the increase in tonic firing of the LFS subclass of siphon motor neurons seems capable of contributing both to an increase in response amplitude and to changes in response topography. PMID- 3288712 TI - Van Harreveld 1904-1987. PMID- 3288713 TI - Spinal cord injury research in the Veterans Administration. PMID- 3288714 TI - The Donald Munro memorial lecture. PMID- 3288715 TI - Surgical management of spasticity and spasms in spinal cord injury: an overview. AB - Spasms and spasticity constitute a significant problem in spinal cord injured individuals. Surgical intervention may be indicated when spasms and spasticity cannot be satisfactorily controlled by medications and physical therapy. Surgical procedures carried out on the nervous system include neurotomy, rhizotomy, myelotomy, cordectomy and spinal cord stimulation. The various procedures and their indications will be discussed. PMID- 3288716 TI - Monoclonal antibodies specific for the different subunits of asymmetric acetylcholinesterase from chick muscle. AB - The asymmetric (20S) acetylcholinesterase (AChE, EC 3.1.1.7) from 1-day-old chick muscle, purified on a column on which was immobilised a monoclonal antibody (mAb) to chick brain AChE, was used to immunise mice. Eight mAbs against the muscle enzyme were hence isolated and characterised. Five antibodies (4A8, 1C1, 10B7, 7G8, and 8H11) recognise a 110-kilodalton (kDa) subunit with AChE catalytic activity, one antibody (7D11) recognises a 72-kDa subunit with pseudocholinesterase or butyrylcholinesterase (BuChE, EC 3.1.1.8) catalytic activity, and two antibodies (6B6 and 7D7) react with the 58-kDa collagenous tail unit. Those three polypeptides can be recognised together in the 20S enzyme used, which is a hybrid AChE/BuChE oligomer. Antibodies 6B6 and 7D7 are specific for asymmetric AChE. Four of the mAbs recognising the 110-kDa subunit were reactive with it in immunoblots. Sucrose density gradient analysis of the antibody-enzyme complexes showed that the anti-110-kDa subunit mAbs cross-link multiple 20S AChE molecules to form large aggregates. In contrast, there is only a 2-3S increase in the sedimentation constant with the mAbs specific for the 72-kDa or for the 58 kDa subunit, suggesting that those subunits are more inaccessible in the structure to intermolecular cross-linking. The 4A8, 10B7, 7D11, and 7D7 mAbs showed cross-reactivity to the corresponding enzyme from quail muscle; however, none of the eight mAbs reacted with either enzyme type from mammalian muscle or from Torpedo electric organ. All eight antibodies showed immunocytochemical localisation of the AChE form at the neuromuscular junctions of chicken twitch muscles. PMID- 3288717 TI - Parkinson's disease: an open label trial of pergolide in patients failing bromocriptine therapy. AB - Sixty-three patients with Parkinson's disease who failed bromocriptine therapy for various reasons were treated in an open-label trial of pergolide. The data were evaluated in a retrospective manner. Forty-six percent had a good response and tolerated the pergolide. A comparison of the outcomes regarding response and toxicity revealed that bromocriptine and pergolide act differently in individual patients. A trial of pergolide in Parkinsonian patients failing bromocriptine therapy may be therapeutically useful. PMID- 3288718 TI - A double-blind controlled trial of high dose methylprednisolone in patients with multiple sclerosis. PMID- 3288719 TI - Nursing strategies to improve compliance with life-style changes in a cardiac rehabilitation population. PMID- 3288720 TI - Fish oils in the prevention, treatment, and rehabilitation of coronary artery disease. PMID- 3288721 TI - Technologic advances in invasive pressure monitoring. PMID- 3288722 TI - Photoradiation therapy and its potential in the management of neurological tumors. AB - Photoradiation therapy is a form of local treatment that depends on the selective retention of a photosensitizer, such as hematoporphyrin derivative (HpD), by the tumor followed by treatment with light of an appropriate wavelength to activate the sensitizer in the tumor. The selective uptake of HpD by cerebral tumors has been demonstrated both in laboratory animal model studies and in clinical studies, and selective destruction of intracerebral tumors has been demonstrated in animal glioma models. The biological basis for photoradiation therapy and, in particular, the mechanisms for the selective uptake of the sensitizer into the tumor and the destruction of tumor with photoradiation therapy are discussed. Current evidence suggests that singlet oxygen is the major intermediary leading to cell damage, although other radicals such as hydrogen peroxide and hydroxyl radicals may be involved. Other studies suggest that the initial damage is to the blood vessels, and the tumor subsequently undergoes ischemic changes. Sixty-four patients treated with photoradiation therapy have been reported in the literature. The initial clinical studies were disappointing in their therapeutic effect but these studies often included treatment of recurrent gliomas and low doses of light were used. Technical advances, particularly in laser technology, have enabled more effective photoradiation therapy and the clinical trials are reviewed. PMID- 3288723 TI - High-dose barbiturate control of elevated intracranial pressure in patients with severe head injury. AB - In a five-center study, 73 patients with severe head injury and elevated intracranial pressure (ICP) were randomly assigned to receive either a regimen that included high-dose pentobarbital or one that was otherwise similar but did not include pentobarbital. The results indicated a 2:1 benefit for those treated with the drug with regard to ICP control. When patients were stratified by prerandomization cardiac complications, the advantage increased to 4:1. A multiple logistic model considering treatment and selected baseline variables indicated a significant positive treatment effect of barbiturates, a significant effect of time from injury to randomization, and an interaction of treatment with cardiovascular complications. However, of 925 patients potentially eligible for randomization, only 12% met ICP randomization criteria. The results support the hypothesis that high-dose pentobarbital is an effective adjunctive therapy, but that it is indicated in only a small subset of patients with severe head injury. PMID- 3288724 TI - CT-guided stereotaxic aspiration of colloid cysts. PMID- 3288725 TI - Prophylactic parenteral antibiotics in clean neurosurgical procedures: a review. AB - Clean surgical procedures carry a risk of postoperative wound infection that is less than 5% in most hospitals. The use of prophylactic antibiotic agents in clean neurosurgical cases is controversial, and the neurosurgical literature through 1980 contains no controlled clinical trials to study its effectiveness in such cases. A report of 1732 consecutive procedures without a single postoperative wound infection in patients receiving systemic gentamicin, vancomycin, and streptomycin irrigation fluids is often quoted by neurosurgeons; however, these results have not yet been duplicated by others. Since 1980, there have been several controlled trials that support the use in clean neurosurgical cases of prophylactic antibiotics, including the vancomycin/gentamicin/streptomycin regimen and the first-generation cephalosporins. A report in 1986 of 1602 cases without a primary wound infection supports the use of a single perioperative dose of cefazolin. A review of causative organisms in postoperative wound infections demonstrates the preponderance of Gram-positive pathogens. Therefore, when antibiotic prophylaxis is indicated, adequate Gram-positive bacterial coverage, including protection against Staphylococcus infection, is required. With consideration of the present data, the cost of antibiotic therapy, and the danger of drug toxicity, a short perioperative regimen of cefazolin as prophylaxis is preferred in clean neurosurgical cases. PMID- 3288726 TI - Rational decision making based on history: adult sore throats. AB - Primary care physicians are often required to make preliminary evaluations based only on the patient's history, especially during telephone encounters about sore throats. The authors studied adults with sore throats to determine whether patients can be stratified into higher and lower risks of strep throat by history alone. They first obtained data from 517 patients seen in an emergency room. Providers graded symptoms on a four-point scale (absent, mild, moderate, or severe). Initial analyses showed that prediction based on history should include three variables: fever, difficulty in swallowing, and cough. For ease of computation, these were consolidated into one score, "history" (= fever history + difficulty in swallowing - cough). This score was used to develop a model that predicts the probability of infection with group A beta-hemolytic streptococcus, and the model's performance was tested in two additional patient groups. The predictive accuracy of the "history" score was confirmed in all patient groups, despite differences in providers and disease prevalences. Primary care physicians may use this model to help them make decisions in situations such as telephone encounters without using additional data. PMID- 3288729 TI - Osler on probability. PMID- 3288728 TI - Distal deep vein thrombosis: what's the best treatment? PMID- 3288727 TI - Preoperative evaluation of pulmonary risk factors. PMID- 3288730 TI - An annotated bibliography for general internists. Substance abuse. PMID- 3288732 TI - The use of tracheotomy in oral and maxillofacial surgery. AB - Tracheotomy is discussed as a method of airway management required in various clinical situations. The anatomy and operative technique involved have been well established. This paper reviews additional aspects of the procedure: indications, complications, the physiologic effects on tracheolaryngeal function, and postoperative care. PMID- 3288731 TI - Cervicofacial necrotizing fasciitis: report of three cases and literature review. AB - Three cases of cervicofacial necrotizing fasciitis have been reported, two of dental etiology, and one the result of blunt and abrasive facial trauma. All cases responded well to aggressive surgical intervention in combination with broad spectrum antibiotic coverage and supportive medical therapy. The presence of increased vascularity in the head and neck region probably minimizes the amount of overlying soft tissue that must be excised during surgical management (in comparison to extremity and trunk necrotizing fasciitis cases). The key to successful management of such infections is early diagnosis of the disease process with prompt surgical and medical intervention. PMID- 3288733 TI - Congenital teratoid cyst of the floor of the mouth. PMID- 3288734 TI - The tuberculin skin test. PMID- 3288735 TI - Carcinoma in situ of the testis. PMID- 3288736 TI - Endodermal sinus (yolk sac) tumour of the liver. A case report and review of the literature. AB - A primary endodermal sinus tumour of the liver which developed in a 27-year-old woman is reported. The dimensions of the tumour were 11 x 11 x 9.5 cm. Most parts were friable, haemorrhagic, and necrotic. No metastasis was found, but one part of the tumour was invading the diaphragm directly. Histologically, the tumour had mainly a reticular pattern, and partly a solid pattern, and was characterized by the presence of Schiller-Duval bodies and intra- and extracellular hyaline globules. A small part of the tumour showed a polyvesicular vitelline pattern and glandular structures with enteric differentiation. Serum alpha-fetoprotein was very high (28,500 ng/ml), but carcinoembryonic antigen was within the normal range. Immunohistochemically, most of the tumour cells contained alpha fetoprotein and alpha-1-antitrypsin. Carcinoembryonic antigen and glutathione S transferase, which was recently proved to be a useful marker for colonic carcinoma, were detected only in the glandular part Four previously reported cases of primary endodermal sinus tumour of the liver are reviewed. PMID- 3288737 TI - Extraglomerular distribution of immunoreactive Goodpasture antigen. AB - The distribution of Goodpasture antigen (GA) was studied in a range of human tissues using indirect immunofluorescence and immunoperoxidase techniques. Frozen sections were stained using (1) a mouse monoclonal antibody (P1) raised against the autoantigenic component of human glomerular basement membrane, (2) autoantibodies eluted from the kidneys of patients with Goodpasture's syndrome, (3) antibodies eluted from the kidneys of a sheep with Steblay nephritis, and (4) mouse monoclonal and guinea pig polyclonal antibodies to human type IV collagen. The same pattern of staining was demonstrated using the eluted antibodies and monoclonal antibody P1. The presence of GA was confirmed in the lung and choroid plexus. GA was also detected in basement membranes at a number of previously unreported sites in the eye, thyroid, pituitary, adrenal, breast, and liver. GA was absent from other sites at which type IV collagen could be demonstrated. Direct immunofluorescence studies of tissue from a patient with Goodpasture's syndrome revealed deposition of IgG in the choroid plexus and eye, as well as in the kidney and lung. PMID- 3288738 TI - Field inversion gel electrophoretic separation of Cryptosporidium spp. chromosome sized DNA. AB - Chromosomal DNA from 5 isolates of Cryptosporidium parvum and 1 of C. baileyi were compared by field-inversion gel electrophoresis (FIGE). FIGE analyses of parasite DNA prepared from purified sporozoites versus intact oocysts showed no observable differences. Chromosomal DNA migration patterns of the 5 C. parvum isolates were indistinguishable, whereas similar but distinct differences were evident between C. baileyi and the isolates of C. parvum. Oocyst-reactive monoclonal antibodies differentiated oocysts of C. parvum from those of C. baileyi but were unable to distinguish oocysts of 1 isolate of C. parvum from another. PMID- 3288739 TI - Infection of Peruvian Aotus nancymai monkeys with different strains of Plasmodium falciparum, P. vivax, and P. malariae. AB - Aotus nancymai (karyotype I) monkeys from Peru were studied for their susceptibility to infection with Plasmodium falciparum, P. vivax, and P. malariae. Three strains of P. falciparum (Santa Lucia from El Salvador, Indochina I/CDC from Thailand, and Uganda Palo Alto) were inoculated into 38 monkeys. The results indicated that this species of Aotus monkey is highly susceptible to infection. The Uganda Palo Alto and the Santa Lucia strain parasites appear to be the most useful for immunologic and chemotherapeutic studies. Five strains of P. vivax (Chesson, ONG, Vietnam Palo Alto, Salvador I, and Honduran I/CDC) were inoculated into 28 monkeys. The Vietnam Palo Alto strain produced the highest level parasitemias ranging from 23,800 to 157,000/mm3. Mosquito infections were obtained with the ONG, Chesson, and Salvador I strains. Two out of 6 attempts to transmit P. vivax via sporozoite inoculation to splenectomized monkeys were successful with prepatent periods of 39 and 57 days. Five monkeys were infected with the Uganda I/CDC strain of P. malariae. Maximum parasitemias ranged from 10 to 5,390/mm3. PMID- 3288740 TI - In vitro cultivation of Herpetosoma trypanosomes on embryonic fibroblasts and in semidefined cell-free medium. AB - Microtus agrestis embryo fibroblasts (MAEF) support the survival and multiplication at 37 C of the mammalian multiplicative forms of the Herpetosoma trypanosomes Trypanosoma microti, T. evotomys, T. musculi, and T. lewisi passaged from cultures on Schneider's Drosophila medium and of T. grosi from Grace's medium. MAEF layers with parasites were maintained for a period of over 5 mo. A semidefined cell-free medium also supported the multiplication (at 37 C) of the mammalian forms of the same trypanosome species, passaged directly from Schneider's Drosophila medium or Grace's medium, without their prior culture on cell lines. Reproductive stages were observed in cultures; T. microti and T. evotomys produced nests of dividing amastigotes from which trypomastigotes developed in the medium supernatant. Trypanosoma lewisi, T. musculi, and T. grosi divided initially as epimastigotes, which then transformed to bloodstream trypomastigotes. Multiplication of trypomastigotes was also observed. These methods of reproduction are the same as those reported in the respective mammalian hosts. PMID- 3288741 TI - A comparison of Giardia microti and Spironucleus muris cysts in the vole: an immunocytochemical, light, and electron microscopic study. AB - We have shown that cysts of the genus Spironucleus share many common morphological features with Giardia cysts including: 2-4 nuclei, flagellar axonemes, a distinct cyst wall, and they even display the same immunostaining as Giardia cysts when labeled with antibodies specific for Giardia cyst wall. A direct comparison of Spironucleus muris and Giardia microti cysts have revealed that cysts of S. muris are significantly smaller than cysts of G. miroti. At the ultrastructural level, the cyst walls are similar in fibrillar appearance, but the width of the S. muris cyst wall is significantly less than that of G. microti. The cysts of S. muris also differ from G. microti in that they contain a striated rootlet fiber, flagellar sheath, and numerous glycogen rosettes. Characteristic features of Giardia include the adhesive disc and median body. Although the cysts of Spironucleus and Giardia are similar in appearance, these unique morphological features can be used to distinguish between the 2 protozoa and should be employed in the detection of Giardia cysts in water samples. PMID- 3288742 TI - Oral carriage of Candida albicans, ABO blood group and secretor status in healthy subjects. AB - ABO blood group and secretor status were determined in healthy subjects in relation to oral carriage of Candida albicans, using a mouthwash technique to identify carriers and non-carriers. Of 100 subjects studied, 32% carried Candida, the main species isolated being C. albicans (94% isolates). Carriage of C. albicans was significantly associated with blood group O (p less than 0.001) and independently, with non-secretion of blood group antigens (p less than 0.001), with the trend towards carriage being greatest in group O non-secretors. This suggests that in healthy subjects, blood group O and non-secretion of blood group antigens are separate and cumulative risk factors for oral carriage of C. albicans. PMID- 3288743 TI - Correlation between the sterol composition of membranes and morphology in Candida albicans. AB - The opportunistic pathogenic fungus Candida albicans was examined in three distinct morphological forms: yeast, mycelia, and stunted mycelia obtained by growing cells under mycelial-inducing conditions in the presence of ketoconazole at concentrations below the MIC. Comparison of the sterols of the parental strain with those from a mutant unable to produce mycelia, by TLC and GLC, showed no significant differences in sterol composition between the yeast and mycelial morphological forms. However, ketoconazole-treated cells possessed a lower ergosterol content and an increased amount of 14-methylated sterol precursors. The effect of ketoconazole on mycelial cells was quantitatively different from the effect on yeast cells in that the ratio of 4, 14-dimethylsterols to 4 methylsterols was significantly lower in the stunted mycelial morphological forms. A comparison of the effect of terbinafine on sterol biosynthesis and morphology suggests that the effect on ergosterol content is of greater importance than the increase in sterol precursors in determining cell shape. PMID- 3288744 TI - Management of ovarian cyst detected antenatally. AB - Ovarian cyst was diagnosed in nine fetuses by antenatal ultrasonographic examination. All deliveries were uncomplicated; two were delivered by cesarean section. The clinical condition in all cases was good. Five of the neonates with a large cyst (more than 5 cm in diameter) were managed surgically, while four were merely followed with repeated ultrasonic examinations. In three of the latter four infants, the cysts disappeared without clinical complications during the subsequent 12 months, and one has been followed for only 2 weeks. The treatment of neonatal ovarian cyst is controversial. Since small ovarian cysts are not clinically significant and may involute, conservative treatment after birth is possible. Repeated ultrasonographic examination may be used to follow small cysts in asymptomatic patients. However, surgical excision in the newborn period has been suggested for larger lesions and/or those with solid components inside the cyst before life-threatening complications occur. PMID- 3288745 TI - [Epilepsy. Reflections on the disease and its drugs]. PMID- 3288746 TI - Preparing young children for painful procedures. PMID- 3288747 TI - Attributions and depression: why is the literature so inconsistent? AB - A large body of literature examining the relations between depression and causal attributions has produced inconsistent findings. Many studies have clearly had inadequate statistical power, however, so that negative findings cannot be readily interpreted. In this review, statistical power was computed for all published analyses relating depression to attributions to any of the following: internal, stable, or global causes, or their composite, ability/character, effort/behavior, luck, or task difficulty. On average, the power of these analyses was very poor. For example, only 8 of the 87 analyses had a probability of .80 or better of detecting a small-medium true population effect (e.g., r = .20). Separating studies by levels of power helped to clarify the inconsistencies in the literature. Whereas across all published studies depression was fairly consistently related only to the composite of internal, stable, and global attributions, those few studies with fairly high power all reported significant relations of depression to stable and global attributions as well as to the composite. It is suggested that increased attention be paid to the power of statistical analyses in planning studies and in drawing conclusions from completed studies. PMID- 3288748 TI - [Change in gingival fluid pH during periodontal treatment: longitudinal study]. PMID- 3288749 TI - [Subgingival irrigation. Critical analysis of different experimental protocols]. PMID- 3288750 TI - [Periodontal disease. From gingivitis to periodontitis]. PMID- 3288751 TI - Companioning parents in perinatal decision making. PMID- 3288752 TI - Ethical considerations in contemporary reproductive technologies. PMID- 3288753 TI - Ultrastructural pathology of skeletal muscle in various rheumatic diseases. AB - Seventy-three muscle biopsies from patients with various rheumatic diseases were analyzed using immunofluorescence, light, and ultrastructural microscopy. Pathologic data were correlated with clinical variables of local muscle and systemic disease. Light and immunofluorescence findings were generally normal. Ultrastructure differed from normals, showing a spectrum of nonspecific changes. There were no disease specific pathologic features. Myofibrillar damage was the most common pathologic change, with atrophy or degeneration occurring in a majority of biopsies. Semiquantitative analysis showed a general correlation between the extent of pathologic change and muscle weakness. PMID- 3288754 TI - Review: systemic toxicity associated with the intravenous administration of colchicine--guidelines for use. AB - Published experiences with severe toxicity with intravenous colchicine have been reviewed. All reported cases reflect inappropriate use of the drug. Therapeutic rules for colchicine have been derived from this information: (1) Single intravenous doses should not exceed 2-3 mg, and cumulative total doses for an attack should not be more than 4-5 mg. (2) Patients should receive no more colchicine by any route for 7 days. (3) Colchicine doses must be reduced in the presence of renal or hepatic disease, and in the older patient with apparently normal renal function. (4) Intravenous colchicine doses should be half the size of oral ones. (5) Absolute contraindications to intravenous colchicine therapy for acute gout include combined renal and hepatic disease, creatinine clearances below 10 cc/min, and extrahepatic biliary obstruction. PMID- 3288755 TI - Polymyositis with myoglobinuria in pregnancy: a report and review of the literature. AB - A pregnant patient developed fulminant polymyositis with myoglobinuria after terbutaline and magnesium sulfate tocolysis. Her response to prednisone was dramatic. Rapid relapse occurred after inadvertent postcesarean dose reduction. Our patient again responded to increased prednisone. She and her twin babies are well. PMID- 3288756 TI - The 2 A resolution structure of the sulfate-binding protein involved in active transport in Salmonella typhimurium. AB - The crystal structure of the liganded form of the sulfate-binding protein, an initial receptor for active transport of sulfate in Salmonella typhimurium, has been solved and refined at 2.0 A resolution (1 A = 0.1 nm). The final model, which consists of 2422 non-hydrogen atoms, one sulfate substrate and 143 water molecules, yields a crystallographic R-factor of 14.0% for 16,959 reflections between 8 and 2 A. The structure deviates from ideal bond lengths and angle distances by 0.015 A and 0.037 A, respectively. The protein is ellipsoid with overall dimensions of 35 A x 35 A x 65 A and consists of two similar globular domains. The two domains are linked by three distinct peptide segments, which though widely separated in the amino acid sequence, are in close proximity in the tertiary structure. As these connecting segments are located near the periphery of the molecule, they further serve as the base or a "boundary" of the deep cleft formed between the two domains. Despite the unusual interdomain connectivity, both domains have similar supersecondary structure consisting of a central five stranded beta-pleated sheet sandwiched by alpha-helices on either side. The arrangement of the two domains gives rise to the ellipsoidal shape and to the cleft between the two domains wherein the sulfate substrate is found and completely engulfed. A discovery of considerable importance is that the sulfate substrate is tightly held in place primarily by seven hydrogen bonds, five of which are donated by main-chain peptide NH groups, another by a serine hydroxyl and the last by the indole NH moiety of a tryptophan side-chain; there are no positively charged residues, nor cations, nor water molecules within van der Waals' distance to the sulfate dianion. All the main-chain peptide units associated with the sulfate are in turn linked (via the peptide CO group) to arrays of hydrogen bonds. Three of these arrays are composed of alternating peptide units and hydrogen bonds within the solvent-exposed part of three alpha helices and two are linked to a histidine and an arginine residue. The sulfate binding protein bears strong similarity to the structures of four other periplasmic binding proteins solved in our laboratory which are specific for L arabinose, D-galactose/D-glucose, leucine/isoleucine/valine and leucine. The similarity includes the ellipsoidal shape and the two globular domain structures, each domain consisting of a central beta-pleated sheet flanked by alpha helices.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3288757 TI - Crystallization of human c-H-ras oncogene products. AB - There is compelling evidence that cancer develops as a consequence of genetic changes (probably multiple) in some members of a selected set of cellular genes. DNA isolated from a variety of tumors, but not normal tissues, possesses the ability to malignantly transform non-tumorigenic cells. Many oncogenes responsible for such transformation have been isolated from transformed cell lines and animal and human tumors induced spontaneously, by virus, by chemical, or by radiation. The most commonly found transforming genes isolated from human tumor cells by DNA transfection assay are the ras gene family (c-H-ras, c-K-ras and N-ras). We report crystallization of several human c-H-ras oncogene proteins. PMID- 3288758 TI - A suppressor of transcriptional activity is present upstream from the rat c-Ha ras promoter. AB - We report the presence of an element in the rat c-Ha-ras 5'-flanking region that has a suppressive effect on the promoter of this gene. Promoter activity was determined using constructs of different regions of the c-Ha-ras 5'-flanking region linked to the reporter gene chloramphenicol acetyl transferase (CAT) transfected into NIH-3T3 cells. The presence of the tract 400 base-pairs upstream from the promoter region reduced promoter activity tenfold. This suppressor element was effective in either orientation and was not produced by other DNA fragments of similar length. Transfection with different amounts of plasmid suggested that a trans-acting factor in limiting amounts was acting on the suppressor region. Gel-retardation assays demonstrated that a nuclear protein was present in 3T3 cells that specifically interacted with the 400-base fragment containing the suppressor element. PMID- 3288759 TI - Crystallization of the met repressor from Escherichia coli. AB - The met repressor from Escherichia coli has been crystallized in space group P21, with unit cell dimensions a = 35.6 A, b = 62.6 A, c = 44.5 A, beta = 102.4 degrees and one aporepressor dimer per asymmetric unit. Preliminary X-ray diffraction photographs show measurable intensities to beyond 1.5 A resolution, and the crystal form is ideally suited to high-resolution crystallographic analysis (1 A = 0.1 nm). PMID- 3288760 TI - Early events in murine erythroleukemia cells induced to differentiate. Accumulation and gene expression of the transformation-associated cellular protein p53. AB - Oncogenes may play a crucial role in the genetic program of cellular differentiation; even, probably, at a very early stage in this program, which can be described as pre-commitment. We have investigated the variation in, and the control level of, the accumulation of the transformation-associated cellular protein p53 in murine erythroleukemia cells induced to differentiate by hexamethylene bisacetamide. Using flow cytofluorimetry after double staining of the cells, we have found that p53 decreased from two hours after the input of the inducer, to reach a basal level of about 30% of the starting value. The stability of the protein was found to be affected neither by the inducer nor by the position of the cells in the cell cycle. Looking for the regulation mechanism of the p53 decay, we found that the mRNA started to decrease as early as half an hour after the hexamethylene bisacetamide was put in the culture medium, and that the transcription rate of the gene itself could not account for the observed down regulation of the mRNA, suggesting a post-transcriptional control for the mRNA accumulation. This control did not require the de-novo synthesis of a protein component, as shown by cycloheximide experiments, but seemed to be governed by the induced synthesis of an RNA molecule. Hypothetical models for such a regulation process are discussed in the light of recent reports on the metabolism of mRNA. PMID- 3288761 TI - Positions of S2, S13, S16, S17, S19 and S21 in the 30 S ribosomal subunit of Escherichia coli. AB - Neutron scattering distance data are presented for 33 protein pairs in the 30 S ribosomal subunit from Escherichia coli, along with the methods used for measuring distances between its exchangeable components. When combined with prior data, these new results permit the positioning of S2, S13, S16, S17, S19 and S21 in the 30 S ribosomal subunit, completing the mapping of its proteins by neutron scattering. Comparisons with other data suggest that the neutron map is a reliable guide to the quaternary structure of the 30 S subunit. PMID- 3288762 TI - Insulin and insulinlike growth factor receptors regulating neurite formation in cultured human neuroblastoma cells. AB - The functional role of brain insulin and insulinlike growth factor (IGF) receptors is being sought. Recently it has been found that these ligands are members of a newly identified family of neuritogenic polypeptides. We studied the relationship between 125I-insulin and 125I-IGF binding and their capacity to enhance neurite formation in cultured human neuroblastoma SH-SY5Y cells. The binding of 125I-insulin was temperature-dependent and heterogeneous. The Scatchard plot and dissociation rate were both consistent with the presence of two types of sites. There appeared to be about 900 high affinity sites per cell with a Kd of about 3 nM. This compared favorably with the half-maximal concentration of 4 nM for enhancement of neurite formation. The type I IGF sites were also present. Physiologic concentrations of insulin clearly enhanced neurite formation through the insulin sites, whereas physiologic concentrations of IGF-I and IGF-II enhanced through the IGF sites. Cross-occupancy of sites was observed at supraphysiologic concentrations, providing a reasonable explanation for the broad dose-response curves for these ligands. These results support the suggestion that one function of insulin and IGF receptors in neural tissues may be to modulate neurite formation. PMID- 3288763 TI - Distribution of glutamic acid decarboxylase and gamma-aminobutyric acid in the hypoglossal nucleus in the rat. AB - Immunocytochemistry was used to investigate the distribution of glutamic acid decarboxylase (GAD) and gamma-aminobutyric acid (GABA) in the hypoglossal nucleus (XII) of the adult rat. The distribution of GAD and GABA was found to be co extensive throughout XII. Although immunoreactivity was moderately dense in all regions, the intensity of staining was greatest in the ventral district of XII particularly ventromedially in the caudal half of the nucleus. Immunoreactive terminal-like profiles were observed around motoneuron somata and dendrites. There also was evidence of sparse mediolaterally-oriented densities of immunoreactivity at the junction of XII and the dorsal vagal nucleus and between dorsal and ventral districts of XII. In addition, neurons staining positive for GABA were found scattered within XII laterally and immediately outside of XII in and around the Nucleus of Roller. These observations suggest a complex, differential distribution of GABA in XII and are discussed in relation to tongue motor behavior. PMID- 3288764 TI - Methods for replacement of malaria vector populations. AB - The prospects are reviewed of replacement of malaria vector populations by harmless mosquito populations by means of: (i) ecologically competitive non vector species; (ii) natural selection due to the harmfulness of being infected; (iii) selection for insecticide resistance genes; (iv) meiotic drive; (v) negative heterosis; and (vi) hybrid dysgenesis. Serious difficulties exist with all of these approaches. At present 'dilution', i.e. release of insects carrying the desired genes without any system for forcing population replacement is the only available method. It avoids the disadvantage that, in constructing elaborate genetic 'packages', factors for low fitness may be irreversibly incorporated into them. It is debatable whether release of males only or both sexes should be attempted. PMID- 3288766 TI - The cephalosporin antimicrobial agents: a comprehensive review. PMID- 3288765 TI - The faecal coliform fingertip count: a potential method for evaluating the effectiveness of low cost water supply and sanitation initiatives. AB - A rapid and simple procedure for the enumeration of faecal coliform bacteria present on the fingertips is described. The distribution of individual faecal coliform fingertip counts within households has been compared with a number of variables related to the availability of water supply and sanitation facilities. This showed a strong association between the fingertip count and the possession of in-house water connections. It is proposed that this test might provide a reliable indication of the effectiveness of certain public health interventions. PMID- 3288767 TI - Pharmacotherapeutic aspects of medication of birds. AB - This review covers current knowledge of the pharmacodynamics and pharmacokinetics of drugs in avian species. Special attention has been paid to inter-species differences in relation to metabolic elimination, anatomy and physiology of the digestive and respiratory system, and differences in drug distribution. Intra species differences attributable to physicochemical aspects of the drug preparation and physiological conditions of the avian patient can also influence drug efficacy. The consequences of the choice of a particular method of drug administration on pharmacokinetics are also considered. PMID- 3288768 TI - Effect of induced synovial inflammation on pharmacokinetics and synovial concentration of sodium ampicillin and kanamycin sulfate after systemic administration in ponies. AB - Single doses of sodium ampicillin (10 mg/kg) and kanamycin sulfate (5 mg/kg) were administered intramuscularly (i.m.) separately, and then together, to five pony mares. The plasma antibiotic concentration-time curves were constructed. The pharmacokinetic parameters of the antibiotics given separately were not altered by concurrent administration. Four of the five pony mares were then given the i.m. kanamycin/ampicillin combination 4 h after acute synovitis and fever had been induced by injection of lipopolysaccharide into the left intercarpal joint. The plasma concentration-time curves and the synovial concentration-time curves of inflamed and normal joints were constructed. The Cmax of ampicillin in the lipopolysaccharide experiment was significantly higher than in the other experiments. The antibiotics entered the synovial fluid of the inflamed joints more quickly and attained higher concentrations than in the uninflamed joints. The ampicillin concentration exceeded 5 micrograms/ml in inflamed synovial fluid for some 2.5 h after injection, and kanamycin sulfate concentration exceeded 2 micrograms/ml for 7 h. PMID- 3288769 TI - Intrathoracic kidney: a case report with a review of the world literature. AB - We report a case of a right intrathoracic kidney and review the literature. The possible etiologies of intrathoracic kidneys are discussed. PMID- 3288770 TI - Intramural ganglia in the human urethra. AB - The urethras from five patients with a thoracic or cervical spinal cord lesion and one patient with carcinoma of the bladder were studied immunohistochemically for neuropeptide Y and vasoactive intestinal polypeptide. Autonomic ganglia, containing two to 21 nerve cell bodies, were found in the smooth and striated muscle regions of the intrinsic external urethral sphincter; they were present rarely in the distal urethra and were absent from the prostatic urethra. Neuropeptide Y immunoreactivity was observed in some of the nerve cell bodies (diameter 25 to 50 microns). Vasoactive intestinal polypeptide immunoreactivity was observed in small cells (diameter 15 to 25 microns.) in the urethral smooth muscle and in the walls of blood vessels that resembled small intensely fluorescent cells but may be nerve cell bodies. Both neuropeptide Y- and vasoactive intestinal polypeptide-immunoreactive nerve fibres were found in the smooth muscle and around blood vessels in the urethra of all patients. Both types of peptide-containing nerves were found associated with striated muscle of the intrinsic external urethral sphincter in patients with spinal cord injury, but only vasoactive intestinal polypeptide-immunoreactive nerves were found in the patient with carcinoma of the bladder in this region. The functions of the autonomic ganglia and vasoactive intestinal polypeptide- and neuropeptide Y immunoreactive nerves in the human urethra remain to be elucidated. PMID- 3288772 TI - Correction of intrinsic penile chordee with a ventral penile graft of fascia lata. AB - Chordee is an abnormal curvature of the penis detected on erection. Congenital or primary curvature of the penis without hypospadias is, however, rare. There are two kinds of primary curvatures; those associated with a normal corpus spongiosum and those with a hypoplastic spongiosum. Secondary curvatures associated with Peyronie's disease or periurethral fibrosis associated with urethral stricture are more common in adults. Four nonhuman primates had successful correction of artificially induced chordee with a graft of fascia lata. PMID- 3288771 TI - Primary tumors of the renal pelvis: evaluation of clinical and pathological features in a consecutive series of 10 years. AB - We operated on 36 patients for primary carcinoma of the renal pelvis between 1975 and 1984. The patients were evaluated for etiological factors, symptoms, diagnostic modalities, treatment, histological type and grade of dedifferentiation, presence of invasion, abnormalities in the urothelium adjacent to the tumor, abnormalities in the epithelium of the collecting tubules and patient survival. No etiological factors were found. The main symptom was hematuria. Diagnosis was made by excretory urography with tomography. Urine cytology examination was of no help in the diagnosis. The survival was high in patients with low grade tumors, tumors without invasion and tumors without coexisting atypia in the adjacent urothelium but it was poor in those with high grade tumors, tumors with invasion and tumors with atypia of the adjacent urothelium. PMID- 3288773 TI - Ultrasound diagnosis of ureteral stones: its usefulness with subsequent excretory urography. AB - The diagnostic accuracy of ultrasound scanning and excretory urography was compared in 157 patients with ureteral stones. Over-all, the diagnostic accuracy rates were 78.3 per cent for ultrasound scanning and 81.5 per cent for excretory urography. These rates were 83.2 and 85.0 per cent, respectively, in 107 cases of upper ureteral calculi, and 68.0 and 74.0 per cent, respectively, in 50 cases of lower ureteral stones. When the studies were combined the diagnostic accuracy rates increased to 98.1, 94.0 and 96.8 per cent for upper, lower and all stones, respectively. Ultrasound scanning is useful in the diagnosis of ureteral stones, especially in patients with ureteral colic. However, ultrasound combined with subsequent excretory urography is the most reliable method for the diagnosis of ureteral calculi. Bladder filling is a useful diagnostic aid for ultrasound scanning of lower ureteral calculi. PMID- 3288774 TI - Long-term efficacy of ureteral dilation for transplant ureteral stenosis. AB - Transluminal ureteral dilation was performed in 11 renal allograft recipients with transplant ureteral obstruction. Success was achieved in 5 patients (45 per cent) with a followup of 12 to 29 months (mean 19.6 months). All failures have been evident within 12 months of dilation. We conclude that ureteral dilation can provide long-term success in renal allograft recipients. However, continued close long-term monitoring of the anatomical and functional result is mandatory for patients treated in this manner. PMID- 3288775 TI - A controlled study of dimethyl sulfoxide in interstitial cystitis. AB - To evaluate the effectiveness of dimethyl sulfoxide in the treatment of patients with biopsies suggestive of interstitial cystitis, 33 patients underwent a controlled crossover trial. Patients were allocated randomly to receive 50 per cent dimethyl sulfoxide or placebo (saline). The medication was administered intravesically every 2 weeks for 2 sessions of 4 treatments each. Response was assessed urodynamically and symptomatically. Thirty women and 3 men (mean age 48 years and mean duration of symptoms 5.5 years) were entered into the study. No significant side effects to dimethyl sulfoxide were noted. When assessed subjectively, 53 per cent of dimethyl sulfoxide treated patients were markedly improved compared to 18 per cent of the placebo treated patients. Of the dimethyl sulfoxide group 93 per cent had objective improvement versus 35 per cent of the placebo group. Thus, dimethyl sulfoxide proved to be superior to placebo in the objective and subjective improvement of patients with interstitial cystitis. PMID- 3288776 TI - Computer-assisted learning and evaluation in medicine. AB - The use of the computer in medical education has been in evolutionary development since the early 1960s; its adoption, however, has been less widespread than the promise of the medium should warrant. Computer-assisted instruction enhances learning, allowing the student the discretion of content, time, place, and pace of instruction. Information conveyed can take several forms, some better suited to undergraduate medical education, others more applicable to graduate and continuing education. The use of the computer in certification and licensure could, within a decade, transform the way competence is assessed. Its greatest promise, however, may lie in providing pertinent information at the time when, and in the place where, patient care takes place. New developments in data storage and retrieval forecast applications that could not have been imagined even a year or two ago. PMID- 3288777 TI - [An autopsy case of esophageal cancer with brain metastasis]. AB - A rare case of esophageal cancer with brain metastasis is reported. A 54-year-old man complaining of dysphagia was admitted to our hospital. Endoscopic and radiographic examinations revealed an advanced esophageal cancer with supraclavicular lymph node metastasis. Five months later, muscle weakness of right upper extremities developed. A brain CT scan revealed a low density area with a ring enhancement in the left front parietal region. The patient developed right hemiplegia and delirium, and died seven months later. Autopsy findings showed a hematogenous metastasis of the left precentral gyrus, measuring 3.0 x 2.5 x 2.5 cm. PMID- 3288778 TI - [A case of squamous cell carcinoma of the breast]. AB - A case of squamous cell breast carcinoma is presented. The patient was 31-year old woman with a complaint of a right breast mass. The tumor was found to measure 7.0 x 8.0 cm without any inflammatory signs, and was associated with a bloody nipple discharge. Lymph-node metastases of the ipsilateral axillary and supraclavicular nodes were noted, and metastasis to the fifth lumbar vertebrae also was seen. Because of a diagnosis graded T4bN3M1, stage IV, an extended radical mastectomy was performed. Histologically, the major portion of this tumor consisted of a squamous cell carcinoma with a minimal component of adenocarcinoma and accompanying keratinization. The patient died of this cancer 5 months after the operation. PMID- 3288779 TI - [Colonic cancer; problems of early diagnosis. 1. Early diagnosis and the fecal occult blood test]. PMID- 3288780 TI - [Diagnosis of colonic diseases by CT X-ray and ultrasonics]. PMID- 3288781 TI - [Synthesis of peptide hormones by protein engineering--recent trends in research development]. PMID- 3288782 TI - Chylothorax and chylous ascites in a patient with uterine cancer. AB - A 63-year-old woman, who had undergone radical hysterectomy and radiation therapy for cervical cancer of the uterus three years previously, was found to have pleural effusion and ascites. A diagnosis of chylothorax and chylous ascites was made on the basis of these fluids' characteristics. She received medium-chain triglyceride (MCT) in her diet and intra-venous hyperalimentation to decrease the leakages of chyle into the pleural and peritoneal cavities, but she died of respiratory and renal failures after six months. At autopsy, metastases from the cervical cancer of the uterus to the lymph nodes in the mediastinum and around the abdominal aorta were proved histologically. Lymph node swelling due to metastasis had caused a rupture of the thoracic duct, leading to chylothorax and chylous ascites. The diagnosis, evaluation and therapeutic modalities of the condition are outlined and the literature reviewed. PMID- 3288783 TI - [Recent advance in diagnosis of liver diseases and aspects in future]. PMID- 3288784 TI - [Utility of ultrasound in hepatic diseases]. PMID- 3288785 TI - [Basic studies and the reference values of cancer associated antigen CA-50]. PMID- 3288786 TI - Reactions to vesical foreign bodies in two strains of rats. AB - Foreign bodies in the urinary tract induce uroliths. This study examined reactions to vesical foreign bodies in Brattleboro rats manifesting diabetes insipidus and Sprague-Dawley rats. A silk suture was placed in the bladder of these rats and the occurrence of vesical uroliths, stone composition, and mucosal morphology were examined. Sprague-Dawley rats readily formed bladder stones in addition to a urolith formed over the suture, but there was little evidence that Brattleboro rats developed similar stones. Stone composition was primarily ammonium magnesium phosphate. The mucosal reactive hyperplasia was pronounced in the Sprague-Dawley, but was negligible in the Brattleboro rats. In conclusion, vesical foreign bodies readily induced uroliths in Sprague-Dawley rats, but there was no similar evidence in Brattleboro rats. It is suggested that the excessive diuresis of the latter may play a major role for this resistance to form stones, but the precise mechanisms of it are complex and remain to be explored. PMID- 3288787 TI - [A plan for patient education in insulin therapy]. PMID- 3288788 TI - [History of nursing in Japan. 8. Pre-modern era. 8]. PMID- 3288789 TI - [History of nursing in Japan. 9. The modern era. 1]. PMID- 3288790 TI - [History of nursing in Japan. 10. The modern era. 2]. PMID- 3288791 TI - Calmodulin-dependent calcium signal transduction. AB - Calmodulin (CaM) is a ubiquitous, intracellular calcium-receptive protein. Biopharmacological studies using CaM antagonists suggest that CaM is involved in mechanisms of stimulus-induced cellular responses such as smooth muscle contraction, secretion of nonmuscle cells and cell proliferation. Results with these CaM antagonists, hydrophobic fluorescent probes, hydrophobic chromatography, and alternative activators of Ca2+, CaM-dependent enzyme revealed that calcium ion induces conformational changes in CaM that expose hydrophobic regions on the surface of the molecule, and these regions may act as sites of interaction with its target enzymes and CaM antagonists. Moreover, a similar molecular mechanism of calcium signal transduction was also observed with other calcium-modulated proteins such as troponin C and S100 protein. PMID- 3288792 TI - [In search of nursing roots in public health nursing in the wilderness of Hokkaido. 24. Public health nursing at land reclamation projects for half a century]. PMID- 3288793 TI - [History of public health nursing in Osaka. 7. Early days of public health clinics (7). Public health training before and during World War II]. PMID- 3288794 TI - [In search of nursing roots in public health nursing in the wilderness of Hokkaido. Final Section. Public health nurses who joined the pioneer farmers in negotiating with the federal and local governments]. PMID- 3288795 TI - [History of public health nursing in Osaka. Final Section. Early days of public health clinics (8). Public health nursing in Osaka during World War II]. PMID- 3288796 TI - [Current status of fetal diagnosis in Finland]. PMID- 3288797 TI - Early hospitals in Kansas from 1864 through World War I times. PMID- 3288798 TI - [Interpretation of maximum load tests in cardiological practice]. PMID- 3288799 TI - [Microcirculatory disorders in hypertension and coronary arteriosclerosis and their pharmacological correction]. PMID- 3288800 TI - [Current concepts of basal vascular tonus]. PMID- 3288801 TI - [The effectiveness of psychorelaxation therapy in patients with hypertension]. AB - A study of 117 patients with labile essential hypertension before as well as 6 weeks and 12 months after psychorelaxation treatment (PRT), making use of autogenous training, biological feedback or respiratory relaxation training techniques (the main group), and the control patients, exposed to no psychological effects and those on the so-called psychological placebo, demonstrated a significantly greater fall of systolic and diastolic arterial blood pressure, total peripheral resistance and hypertensive response to emotional stress, as well as better psychological adaptation, quality of life and working capacity in the main-group patients, as compared to the controls, by the end of the study. PMID- 3288802 TI - [Effect of myocardial ischemia on prostacyclin and thromboxane levels in arterial and coronary venous blood]. AB - Variations in arterial and venous blood prostacyclin and thromboxane were examined in 32 patients with coronary heart disease, neurocirculatory dystonia and the cardialgic syndrome, exposed to cardioselective stress as a result of the atrial stimulation test. Prostacyclin and thromboxane measurement in blood specimens obtained from the left ventricle and the coronary venous network may provide additional markers of myocardial ischemia in cases where diagnosis is otherwise difficult to make. PMID- 3288803 TI - [Individual differences and individual norms in automated preflight medical checkup]. AB - This paper describes the basic principles, methods and results of preflight automatic medical monitoring. Individual variations of statistic characteristics of the distribution of heart rate, blood pressure, oculomotor reaction time, pursuit reaction quality and other psychophysiological parameters were investigated. Group and individual norms were established. It was found that the sensitivity of group norms was 23 to 65% for different parameters and their prognostic value was 17 to 38%. It is important to assess statistic characteristics of the individual norm in order to identify individuals with latent prepathological and pathological states. Recommendations concerning the applicability of individual norms in early diagnosis, occupational psychological selection and control of operator's activities are given. PMID- 3288804 TI - [Metabolic aspects of readaptation after hypokinesia (based on experimental results with animals)]. AB - This review discusses changes in protein, carbohydrate and lipid metabolism of animals during their readaptation after exposure to hypokinesia of varying duration. It is concluded that at an early stage of readaptation anabolic reactions aimed at the recovery of the bulk of active muscle proteins and the amount of energy substrates are predominant. In this situation the synthesis of lipids and carbohydrates is prevailing over their utilization. It is postulated that during readaptation amino acids are used more actively to make up for energy expenditures, gluconeogenesis and lipid synthesis. In the course of readaptation wave-like metabolic changes occur, being sometimes greater than during hypokinesia. PMID- 3288806 TI - The extracellular matrix and neoplasia. PMID- 3288805 TI - [Effect of prolonged continuous external irradiation on humoral immunity indices of mice]. AB - Changes in the content and function of cell populations and subpopulations involved in the humoral response of mice to the thymus-dependent antigen were investigated. The effect was followed during a prolonged continuous exposure to 137Cs gamma-emitter (total dose--5 Gy and daily dose--12 cGy for 22 hours) and after its termination. The data obtained give evidence for a decrease of the pool of polypotent lymphocyte precursors (CFUs), stable moderate hypoplasia of central and peripheral organs of the immune system, distinct inhibition of antibody production at the expense of reduced activity of precursors of lymphocytes, B lymphocytes and T-helpers. In the remote postirradiation period residual radiation damage was seen in polypotent and committed precursors of lymphocytes and T-helpers which was responsible for the trend towards the decline of antibody production, hypoplasia in the spleen and lymph nodes being persistent. PMID- 3288807 TI - Cytology, immunopathology and flow cytometry in the diagnosis of pleural and peritoneal effusions. AB - There were 106 pleural and peritoneal effusions studied in order to investigate the contribution of immunocytochemistry and flow cytometry to routine cytologic diagnosis. A panel of antibodies (to cytokeratin, vimentin, human milk fat globule, epithelial membrane antigen and carcinoembryonic antigen) was applied to aceton-fixed slides, using immunoperoxydase and immunofluorescence methods. Flow cytometry was performed using a double labeling method, i.e., propidium iodide for DNA staining and keratin for labeling of epithelial cells. In this way DNA aneuploidy was more evident in the histograms when the fluid contained many reactive nonepithelial cells (lymphocytes). A designation of marker profiles was made for the three most frequently occurring diagnoses, i.e., reactive mesothelial proliferation (I), adenocarcinoma (II), and malignant mesothelioma (III). For the differentiation between adenocarcinoma and malignant mesothelioma, carcinoembryonic antigen was the most useful marker as 75% of the adenocarcinomas was carcinoembryonic antigen-positive and the malignant mesotheliomas were consistently negative. Furthermore, evident DNA-aneuploidy strongly supported the diagnosis of adenocarcinoma, as most malignant mesotheliomas were DNA-euploid, even though occasional DNA-aneuploidy was found in malignant mesotheliomas when different effusions from the same patient were examined. For the differentiation between reactive mesothelial cells and malignant mesothelioma human milk fat globule and/or epithelial membrane antigen, in this study proved to be most reliable, their presence strongly indicating malignancy. It is stressed that the method used (fixation, antibodies, washing procedures) can influence these findings. In 16 patients (17%) performing immunopathology and/or flow cytometry meant an important contribution to diagnosis. PMID- 3288808 TI - Respiratory effect on the blood volume of pulmonary capillaries. AB - We measured the density variations of aortic blood from rabbits ventilated by a positive end inspiratory pressure of 6 mmHg or a negative box pressure of the same magnitude. When calculated from the density variations, the fluctuations in blood volume of the pulmonary capillaries within one cycle as induced by an intermittent positive pressure ventilation were found to be similar to the ones induced by an intermittent negative pressure ventilation. Using these volumetric fluctuations as a means to assess the transpulmonary pressure and the transmural pressure across the pulmonary capillaries, we conclude that the switching of the ventilation method did not alter the cyclic fluctuations of these pressures. PMID- 3288809 TI - Pelvic exenteration for carcinoma of the cervix: analysis of 252 cases. AB - We present the results of 252 pelvic exenterations for primary and recurrent carcinoma of the cervix at the Hospital General de Mexico, a tertiary-care institution for the indigent. Emphasis is placed on the morbidity and mortality of the procedure in relation to patient selection. In underdeveloped countries, where early detection of cervical cancer is a rare event, pelvic exenteration must continue in the armamentarium of physicians; it can be associated with gains in the quality of life, with long-term survival, with effective rehabilitation, and possibly with cures. PMID- 3288811 TI - Odyssey of a sailor's diagnosis since 1795 AD. AB - In the year 1795, a British East Indiaman bound for China had a sick sailor on board who was diagnosed as having testis cancer by the ship's surgeon, who then treated him with an antiscorbutic diet, because scurvy was rampant among the sailors. He was completely cured of his cancer, as reported in the Edinburgh Medical and Surgical Journal by Livingstone in 1805. However, the sailor actually had scurvy and not testis cancer. This diagnostic error has been perpetuated in the medical literature until rectified by Shetty after 191 years. This is reconstructed account of the sailor's case history and the ship's journey as it actually took place in 1795 AD. PMID- 3288810 TI - Significant prolongation of segmental pancreatic allograft survival in two species. AB - A study was conducted to assess the suppression of segmental pancreatic allograft rejection by cyclosporine (CSA) alone in baboons and dogs, and subtotal marrow irradiation (TL1) alone and TL 1 in combination with CSA in baboons. Total pancreatectomy in the dog and primate provided a reliable diabetic model, induced an absolute deficiency of insulin and was uniformly lethal if not treated. Continuous administration of CSA in baboons resulted in modest allograft survival. As in baboons, dogs receiving CSA 25 mg/kg/d rendered moderate graft prolongation but a dose of 40 mg/kg/d resulted in significant graft survival (greater than 100 days) in 5 of 8 allograft recipients. Irradiation alone resulted in minimal baboon pancreatic allograft survival of 20 baboons receiving TL1 1,000 rad and CSA, 3 had graft survival greater than of 100 days. Of 15 baboons receiving TL1 800 rad and CSA, 6 had graft survival of greater than 100 days. In conclusion, CSA administration in dogs and TL1 in combination with CSA in baboons resulted in highly significant segmental pancreatic allograft survival. PMID- 3288812 TI - Postoperative radiation as adjuvant treatment for carcinoma of the oral cavity, larynx, and pharynx: preliminary report of a prospective randomized trial. AB - A prospective randomized trial was performed in patients with advanced squamous cell carcinomas (SCC) of the oral cavity, larynx, and pharynx to examine the effect of adjuvant postoperative radiation therapy on locoregional recurrence and survival following "curative" resection. Fifty-one patients with stage III or IV SCC treated from 1981 through 1984 were randomized to receive either surgery alone (n = 27) or surgery with postoperative radiation (n = 24). Five patients were excluded from the study after randomization because of ineligibility or protocol violations. Overall recurrence rates of 55.6% and 36.8% were noted in the surgery and surgery with adjuvant radiotherapy arms, respectively (p = NS). This trend towards a higher recurrence rate in the surgery only arm was in part due to the development of lymph node metastases in the contralateral, nonoperated neck. Thus far, no significant differences in either locoregional or overall survival have been noted between the two treatment arms. In this preliminary analysis, adjuvant postoperative radiotherapy does not appear to improve disease free or overall survival. PMID- 3288813 TI - Identification of synchronous esophageal tumors in patients with head and neck cancer. AB - Patients with a primary head and neck neoplasm are at risk for additional malignancies of the upper aerodigestive tract, which may be asymptomatic. This phenomenon may reflect the regional carcinogenic influence of alcohol and tobacco abuse. A review of the recent literature documents the value of performing laryngoscopy, bronchoscopy, and esophagoscopy on all patients being staged for head and neck tumors to identify second synchronous cancers, the presence of which may significantly alter the treatment plan. PMID- 3288814 TI - Ring chromosomes in chronic myelogenous leukemia: an ominous finding. AB - Two cases of Philadelphia chromosome positive chronic myelogenous leukemia (CML) demonstrated ring chromosomes. The appearance of the ring coincided with evolution from the stable to the aggressive phase. A literature search yielded six other cases of ring chromosomes in CML; all were in or were entering the aggressive phase of the disease. Thus, as is the case with acute nonlymphocytic leukemia, in CML the finding of an acquired ring chromosome is associated with a poor prognosis. PMID- 3288815 TI - The Ha-ras polymorphism in myelodysplasia and acute myeloid leukaemia. AB - We have assessed the possibility that rare allelic variants of the c-Ha-ras-1 locus may be linked to a susceptibility to malignancy [1]. c-Ha-ras-1 genotypes were scored in 41 patients with myelodysplasia (MDS), 51 patients with acute myeloid leukaemia (AML) and 52 normal subjects. The incidence of rare alleles in the MDS patients was 4.8% and in AML an incidence of 15.7% was found. No rare alleles were found in the normal subjects. We conclude that rare alleles in MDS are not a common predisposing factor. PMID- 3288816 TI - Induction of proliferation of acute myeloblastic leukemia (AML) cells with hemopoietic growth factors. AB - Like their normal counterparts, leukemic blasts have recently been shown to respond to hemopoietic growth factors in both suspension culture and in semisolid media. In the present study, we have evaluated the proliferative response of 35 AML cases to colony-stimulating factors (CSFs) containing conditioned media derived from the human cell lines GCT, 5637, MO and MG U87, and to human recombinant IL-1 (rh-IL1), IL-3 (rhIL-3), GM-CSF (rhGM-CSF) and G-CSF (rhG-CSF). In the great majority of cases, an increase of 3H-thymidine (3H-TdR) uptake was obtained in response to at least one conditioned medium. The labeling index (LI) and the growth fraction (GF), evaluated in a restricted group of cases, were also increased by the growth factors, suggesting that they act by recruiting leukemic cells in cycle from the resting compartment. The ability of blast populations to form colonies was also studied. Conditioned media were found to induce or significantly increase the clonogenic capacity in 20 cases out of 22. The response of leukemic cells to human recombinant CSFs and rhIL-1, used alone or in combination, was also assayed. The results, in agreement with those obtained with conditioned media, show that each leukemic case displays a different pattern of response to CSFs, and that optimal growth conditions must be individually assessed. The possibility of increasing the fraction of cycling cells in AML populations may represent a way to render them more sensitive to cytostatic agents, with a view to new therapeutic strategies. PMID- 3288817 TI - Hypomagnesemia-induced cardiomyopathy. AB - Magnesium is the fourth most abundant cation in the body and the second most plentiful intracellularly. Magnesium is crucial to mitochondrial integrity, oxidative phosphorylation, protein synthesis, nucleic acid stability, membrane permeability, and neuro-muscular excitability. In addition, magnesium deficiency induces other electrolyte disturbances including hypocalcemia, hypokalemia, and hypophosphatemia. Because it is not routinely measured, many physicians fail to remember the significance of this element. Reported here is a patient with bulimia who presented with a magnesium deficiency which resulted in her refractory and eventually fatal cardiomyopathy. The cardiac pathophysiology of hypomagnesemia, hypokalemia, hypocalcemia and hypophosphatemia is reviewed and correlated with the clinical and pathological findings. PMID- 3288818 TI - The effect of self-care interventions on the use of medical service within a Medicare population. AB - To determine the effect of a self-care communication-based health education program on ambulatory care utilization, a prospective, randomized, controlled trial was conducted with a Medicare population within a health maintenance organization. A statistically significant decrease of 15% in total medical visits was found in the experimental group as compared with a control. Although not evident in the control, a statistically significant decrease in the ratio of follow-up visits from pre-entry to postentry was realized in the experimental group. Medical-visit decreases resulted in a savings of $36.65 per household in the experimental group for a benefit-cost ratio of 2.19 saved for every dollar spent on intervention. These results demonstrate that a health education program can reduce utilization while having no known negative impact on the quality of health. PMID- 3288819 TI - In memoriam. Solomon Jacob Axelrod, MD, MPH, September 25, 1912-September 21, 1987. PMID- 3288820 TI - The classification of 5-hydroxytryptamine receptors. PMID- 3288821 TI - Pyrido[1,2-alpha]pyrimidines; new chemical entities in medicinal chemistry. PMID- 3288823 TI - Stereochemical implications of hybrid and pseudo-hybrid drugs. Part III. PMID- 3288822 TI - Indole alkaloids in medicine. PMID- 3288824 TI - [A new stereotaxic instrument makes punctures guided by computer tomography easier]. PMID- 3288825 TI - [Epidemiology at a smelter (I). The Ronnskar case: history, occupational environment, increased mortality]. PMID- 3288826 TI - [Epidemiology at a smelter (II). The Ronnskar case: how was it then?]. PMID- 3288827 TI - [Epidemiology at a smelter (III). The Ronnskar case: methodological aspects]. PMID- 3288828 TI - [Intravenously stimulated insulin reserve of the pancreas following experimental pancreatic duct ligation in the swine--studies 2, 4 and about 60 days following ligation]. AB - After pancreatic duct ligation (PDL) intravenous glucose tolerance tests (i.v. GTT) were performed in 12 pigs. The release of insulin and the corresponding blood sugar levels were controlled, the pancreata were examined histologically and immunohistochemically. In spite of a reduced number of beta-cells no reduction of glucose tolerance could be shown 60 days after PDL. Two days after the i.v. GTT showed an increased release of insulin corresponding with lowered blood sugar levels. This phenomenon is explained as a stimulated state of the beta-cell in the phase of interstitial edema. PMID- 3288831 TI - Functional analysis of different sequence elements in the Escherichia coli galactose operon P2 promoter. AB - Starting with a DNA fragment containing the galactose operon P2 promoter, we made a series of deletions that progressively replaced DNA sequences upstream of the transcription startpoint and determined their effects on P2 activity. The results show that specific sequences upstream of -32 are not important. Removal of the sequence 5'-CACA-3' from -32 to -28 reduces P2 activity by 50%: longer deletions to -16 further reduce activity but do not remove the information specifying the transcription startpoint. DNA sequences between -32 and -16 at gal P2 assist the isomerization of RNA polymerase from closed to open complexes rather than contributing to the initial binding of RNA polymerase. The activity of gal P2 in the absence of -35 region sequences is dependent on the sequence TG just upstream of the -10 hexamer, TATACT: a mutation at -14 changing the TG sequence to TT totally inactivates P2. However, P2 activity can be restored if the consensus -35 region sequence TTGACA is cloned 17 bp upstream of the -10 hexamer. Thus, for transcription initiation, the -10 hexamer, TATACT, must 'cooperate' with upstream sequences that may be located either around -35 or -14. PMID- 3288830 TI - Surgical management of peritoneal carcinosis: diagnosis, prevention and treatment. AB - Gastrointestinal and ovarian malignancies frequently recur with metastatic disease limited to the abdominal cavity. Due to full thickness penetration of tumor through bowel wall, spillage of tumor from lymphatic channels by surgical trauma or perforation of the tumor through the ovarian capsule, tumor cells are disseminated throughout the peritoneal surfaces either prior to or at the time of surgical removal of the primary tumor. In the past, diagnosis of recurrent cancer was difficult because no sensitive diagnostic test was available by which to image a small tumor volume present on peritoneal surfaces. Computerized tomography with intraperitoneal infusion of contrast can demonstrate tumor nodules not otherwise detectable. Intraperitoneal installation of I-131 labeled monoclonal antibody has allowed visualization of mucinous tumor on peritoneal surfaces not seen by any other radiologic test. Intraperitoneal chemotherapy has been shown to provide palliation in patients with small volume disease confined to peritoneal surfaces. Because of limited penetration of chemotherapy into large tumor nodules this treatment strategy has not been effective for bulky intraabdominal recurrent cancer. Cytoreductive surgery utilizing high voltage electrocautery and CO2 laser evaporation of tumor can make patients relatively disease free. These surgical technologies combined with postoperative intraperitoneal chemotherapy have been shown to be of benefit for selected patients with recurrent intraabdominal cancer. The wider application of these intraperitoneal chemotherapy treatments for patients in an adjuvant setting may be of value in preventing the occurrence of peritoneal carcinosis and in improving survival. PMID- 3288832 TI - Defective Escherichia coli signal peptides function in yeast. AB - To investigate structural characteristics important for eukaryotic signal peptide function in vivo, a hybrid gene with interchangeable signal peptides was cloned into yeast. The hybrid gene encoded nine residues from the amino terminus of the major Escherichia coli lipoprotein, attached to the amino terminus of the entire mature E. coli beta-lactamase sequence. To this sequence were attached sequences encoding the nonmutant E. coli lipoprotein signal peptide, or lipoprotein signal peptide mutants lacking an amino-terminal cationic charge, with shortened hydrophobic core, with altered potential helicity, or with an altered signal peptide cleavage site. These signal-peptide mutants exhibited altered processing and secretion in E. coli. Using the GAL10 promoter, production of all hybrid proteins was induced to constitute 4-5% of the total yeast protein. Hybrid proteins with mutant signal peptides that show altered processing and secretion in E. coli, were processed and translocated to a similar degree as the non-mutant hybrid protein in yeast (approximately 36% of the total hybrid protein). Both non mutant and mutant signal peptides appeared to be removed at the same unique site between cysteine 21 and serine 22, one residue from the E. coli signal peptidase II processing site. The mature lipo-beta-lactamase was translocated across the cytoplasmic membrane into the yeast periplasm. Thus the protein secretion apparatus in yeast recognizes the lipoprotein signal sequence in vivo but displays a specificity towards altered signal sequences which differs from that of E. coli. PMID- 3288829 TI - [Clinical aspects and therapy of Merkel cell tumor--report of 4 personal cases and review of the literature]. AB - Four cases of Merkel cell tumor located in the face or on the trunk are presented. In a literature review 339 cases were found and analysed. The Merkel cell tumor is a neuroendocrine tumor of the skin derived from the Merkel cells. It is located most often in the face and neck area. Typically, it is an exophytic node, has a red-blue color and measures 25 mm in diameter on the average. Since it is metastasizing it is a malignant tumor. Regional node metastases were found in 27%, local recurrences occur in 51%, and distant metastases were seen in 32% of the cases. The best therapy is excision with wide margins as is the rule for a malignant skin tumor. While the tumor reacts to radiotherapy, chemotherapy seems to be of no help. PMID- 3288833 TI - A replication region of the IncHI plasmid, R27, is highly homologous with the RepFIA replicon of F. AB - A region of the IncHI plasmid R27 has been found to share very close nucleotide sequence homology with the RepFIA replicon of F. This region has been located on a 1.6 kb segment of R27 plasmid DNA, and corresponds to ori-2 and the E gene of F. The incC repeat sequence region shows reduced homology, with the F repeats being an imperfect subset of a larger repeated sequence found in R27. The E gene homologue of R27 is able to initiate replication from the F ori-2 sequence and to repress the E gene promoter of F. The results are consistent with the observed incompatibility behaviour of R27, and have a bearing on the specificity of interaction of E protein with its DNA-binding sites. PMID- 3288834 TI - The continuing search for an in vivo mutagen which is non-genotoxic in vitro- response to Tweats and Gatehouse. PMID- 3288835 TI - Studies upon the genetic effects of environmental chemicals: the coordinated research programme of the European Economic Community. AB - The objectives of the European Economic Community's Environmental Research and Development Programmes are to provide a scientific basis for current environmental policy and future environmental management. This paper reviews the work and achievements of the studies carried out by the collaborating laboratories during the period 1981-1985 of the 3rd Programme within the research area 'The Genetic Effects of Environmental Chemicals'. Research efforts supported by the programme may be divided into (i) those involving the validation of current genotoxicity assays and the evaluation of their use in community regulatory activities such as the classification and labelling of chemicals, (ii) those involving the characterization of the metabolic and genotoxic profile of specific chemicals and (iii) those involving the development of new technologies suitable for the hazard identification and risk evaluation of genotoxins. Validation studies have included those of the host mediated assay (and its various modifications), unscheduled DNA synthesis assays and a variety of Drosophila genotoxicity assays. New developments include assays for the detection of chromosome aneuploidy, protocols for cell transformation studies, the detection and quantification of genotoxic lesions, techniques for the study of transplacental genotoxicity, assays for the detection of genotoxic activity in the liver and in germ cells and monitoring techniques for the assessment of both environmental quality and genotoxin exposure in individuals and in populations. The coordination of research effort, such as that described here provides an effective mechanism for the concentration of research on specific problems, for the rapid dissemination of experimental data and the transfer of technology within the European Community. PMID- 3288836 TI - Genotoxicity of 2-nitropropane and 1-nitropropane in Salmonella typhimurium and human lymphocytes. AB - A 10- and 12-fold increase of revertant numbers could be demonstrated for 2 nitropropane (2-NP of greater than 99% purity) tested in the preincubation assay with Salmonella typhimurium strains TA 100 and TA 98 in the presence and absence of S9 mix. In the nitroreductase-deficient strains TA 100NR and TA 98NR, 2-NP was less mutagenic than in the parent strains. In human lymphocytes the induction of a weak clastogenic effect and of sister chromatid exchanges required exogenous metabolic activation. No significant mutagenic or cytogenetic response was found with 1-nitropropane of 97% purity in S. typhimurium or human lymphocytes. PMID- 3288837 TI - Chloroprene and isoprene: cytogenetic studies in mice. AB - Groups of male B6C3F1 mice (n = 15) were exposed for 6 h per day to ambient air, to chloroprene (12, 32, 80, 200 p.p.m.) or to isoprene (438, 1750 and 7000 p.p.m.) on 12 days. These compounds are the 2-chloro and the 2-methyl analogues, respectively, of 1,3-butadiene, a genotoxic and carcinogenic chemical in B6C3F1 mice. Exposure to chloroprene resulted in a 100% incidence of mortality among the mice exposed to 200 p.p.m. At concentrations of 80 p.p.m. and below, chloroprene neither induced a significant increase in chromosomal aberrations (CA), sister chromatid exchanges (SCE) or micronucleated erythrocytes, nor significantly altered the rate of erythropoiesis or of bone marrow cellular proliferation kinetics. However, the mitotic index (MI) in the bone marrow of chloroprene exposed mice was significantly increased. Under similar conditions, exposure to isoprene induced significant increases at all concentrations in the frequency of SCE in bone marrow cells and in the levels of micronucleated polychromatic erythrocytes (PCE) and of micronucleated normochromatic erythrocytes in peripheral blood. In addition, a significant lengthening of the bone marrow average generation time and a significant decrease in the percentage of circulating PCE was detected. However, exposure to isoprene did not induce in bone marrow a significant increase in the frequency of CA nor did the exposure significantly alter the MI. The dose-response curves for SCE and micronuclei induction were non-linear, appearing to saturate at 438 and 1750 p.p.m., respectively. These results suggest that, similarly to butadiene, inhaled isoprene can be expected to induce tumors at multiple sites in B6C3F1 mice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288838 TI - Cell killing and mutagenesis by alkylating agents and UV irradiation in wild-type and deoxycytidine-kinase-deficient Friend murine leukaemia cells. AB - Wild-type (clone 707) Friend murine leukaemia cells were compared with two ara-C resistant subclones in terms of sensitivity to cell killing and mutagenesis to 6 thioguanine resistance following treatment with ethyl methane sulphonate, methyl methane sulphonate and UV irradiation. The ara-C-resistant subclones, 707DKE and 707DK48, had respective deoxycytidine kinase activities of 6.7 and 5.4% the values found in wild-type cells. No clear pattern of altered sensitivity to cell killing or mutagenesis emerged between the wild-type cells and the ara-C resistant subclones. These results do not provide evidence for a role of deoxycytidine kinase in determining sensitivity to mutagenic agents in the Friend cell line. PMID- 3288839 TI - Enhanced reactivation and mutagenesis of UV-irradiated adenovirus in normal human fibroblasts. AB - UV-enhanced reactivation (UVER) and UV-enhanced mutagenesis (UVEM) for two adenovirus temperature-sensitive mutants (Ad5ts35 and Ad5ts125) were examined following the infection of normal human fibroblasts. Fibroblast monolayers were either UV-irradiated or left non-irradiated and subsequently infected with either non-irradiated or UV-irradiated virus. After incubation of the infected cultures at the permissive temperature, the induction of wild-type revertants in the viral progeny was determined by plaquing at the permissive (33 degrees C) and the non permissive (39 degrees C) temperatures on human HeLa or KB cells. UV-irradiation of the virus alone resulted in a dose-dependent increase in the UV-induced reversion frequency (RF) of viral progeny and a dose-dependent exponential decrease in progeny survival, when infecting non-irradiated cells. Analysis of the slopes of the UV-induced reversion curves suggested that 2.5 +/- 0.3 and 2.4 +/- 0.5 'hits' were required to produce a targeted reversion event among the viral progeny of Ad5ts36 and Ad5ts125 respectively. UV-irradiation of cells 24 h prior to infection resulted in a significant increase in progeny survival for UV irradiated virus (UVER factor = 3.4 +/- 0.8) concomitant with a significant increase in RF for UV-irradiated virus (targeted increase = 1.9 +/- 0.3). The UV induced RF per lethal hit to the virus was also significantly greater in UV irradiated compared with non-irradiated cells. These results are consistent with the existence of a UV-inducible error-prone DNA repair mechanism in normal human cells. PMID- 3288840 TI - Adaptive response to simple alkylating agents in the phototrophic bacteria Rhodobacter capsulatus and R.sphaeroides. AB - The presence of an adaptive response to low doses of alkylating chemicals in the phototrophic bacteria Rhodobacter sphaeroides and R.capsulatus has been studied. Results obtained show that both strains display this repair response against the challenge doses of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), when they are pretreated with low doses of this compound for 120 min. The adaptive response of both R.sphaeroides and R.capsulatus induced an increase of cell survival and a decrease of mutagenesis in the MNNG-pretreated cells. Furthermore, the MNNG induced adaptive repair also gives protection to diethylsulphate and ethylmethanesulphonate in both phototrophic bacteria. Finally, the MNNG-promoted adaptive response is sensitive to inhibitors of protein synthesis such as chloramphenicol, indicating that this DNA repair mechanism needs protein synthesis in R.sphaeroides and R.capsulatus, in a way similar to that which occurs in Escherichia coli. PMID- 3288841 TI - The bacterial mutagenicity of synthetic all-trans fecapentaene-12 changes when assayed under anaerobic conditions. AB - Fecapentaenes are potent mutagens produced in the anaerobic environment of the human colon. The aim of this study was to determine the effect of anaerobic conditions on the bacterial mutagenicity of all-trans fecapentaene-12, a synthetic fecapentaene. Fecapentaene-12 was tested aerobically and anaerobically at doses from 0.25 to 4 micrograms/plate in agar-overlay assays with Salmonella typhimurium TA98 and TA100 and Escherichia coli WP2uvrA(pKM101), and 0.01 to 2 micrograms/ml in fluctuation test with TA100. In agar-overlay tests, fecapentaene 12 was less mutagenic to the frameshift mutant TA98 under aerobic conditions than under anaerobic conditions (average slopes of 3.8 and 31.6 revertants/micrograms respectively). Aerobic assays using TA100 and E. coli WP2uvrA-(pKM101) gave respective slopes of 62.9 and 167.6. Anaerobic assays with these base substitution mutants gave negative results under conditions in which positive controls were mutagenic. However, the numbers of spontaneous revertants in these anaerobic assays were substantially lower than normal. Microtitre fluctuation tests, known to perform equally well under both aerobic and anaerobic conditions, were conducted with TA100 to confirm that the activity of fecapentaene-12 as a base-substitution mutagen was attenuated under anaerobic conditions. Replicate aerobic assays gave an average slope (revertants/well/microgram) of 0.41, compared with 0.056 for anaerobic assays--a greater than 7-fold difference. There was no significant difference in slope between aerobic and anaerobic positive controls. Thus, fecapentaene-12 may have two distinct modes of action, acting as a base-substitution mutagen and as a frameshift mutagen. Anaerobic conditions suppress the base-substitution activity but not the frameshift activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288842 TI - Procarbazine is a potent mutagen at the heterozygous thymidine kinase (tk +/-) locus of mouse lymphoma assay. AB - Procarbazine (Natulan) is a potent inducer of gene mutations at the heterozygous tk +/- locus in L5178Y mouse lymphoma cells in the presence of Aroclor-induced rat liver S9 metabolic activation (approximately 10(-3) mutant frequency at 10 micrograms/ml) while exerting a far weaker effect in the absence of S9. This mutagenicity is fairly robust with respect to the quantitative composition of the S9 mix and to variations in mouse lymphoma assay protocols (soft agar cloning versus 'microwell' assays). The high proportion of small colony tk -/- mutants induced by procarbazine together with the far weaker mutagenic response at the hemizygous hgprt locus in these same cells is interpreted in terms of a chromosomal or multi-gene mutational mechanism. Although procarbazine is clastogenic in vivo, it does not appear to be so under standard protocols using cultured human lymphocytes (+/- S9). It is not yet clear why this should be so, especially in light of its apparent clastogenicity in mouse lymphoma cells. PMID- 3288843 TI - The short-term test activity profile for procarbazine hydrochloride. PMID- 3288844 TI - Further debate of testing strategies. PMID- 3288845 TI - Treatment of climacteric complaints with Org OD 14: a comparative study with oestradiol valerate and placebo. AB - Org OD 14 (7 alpha,17 alpha-17-hydroxy-7-methyl-19-norpregn-5(10)-en-20-yn-3-one) is a steroid possessing mixed hormonal activity, which in earlier studies has been shown to alleviate climacteric complaints and to prevent post-menopausal osteoporosis without affecting the endometrium. The effects of Org OD 14 on climacteric complaints were compared with those of oestradiol valerate (E2V) and placebo in a randomized, double-blind, cross-over study in 20 women who had been oophorectomized and hysterectomized 3-6 yr earlier as part of their treatment for cervical cancer. Each patient was treated orally for a total period of 18 wk, comprising 6 wk on each preparation. Capsules of identical appearance were given; these contained either 2.5 mg Org OD 14, 2 mg E2V or placebo. The patients' scores for symptoms and mood items on standardized rating scales were recorded at the end of each 6-wk treatment period (i.e. on days 43, 85 and 127). There were no differences between the effects of Org OD 14 and E2V on symptoms and mood items, while both compounds were more effective than placebo. Our findings confirmed that Org OD 14 is effective in ameliorating oestrogen deficiency symptoms in climacteric women. PMID- 3288846 TI - Blood pressure during oestrogen/progestogen substitution therapy in healthy post menopausal women. AB - In order to explore the long-term effect of hormone (17 beta-oestradiol) substitution therapy on blood pressure in healthy post-menopausal women, we reviewed the data from five long-term (1-2 yr), double-blind, placebo-controlled studies carried out in our department over the last decade. Three of the studies related to early post-menopausal women (mean age 50 in all three cases) and two involved later post-menopausal women (mean ages 64 and 70, respectively). The systolic blood pressure values during hormonal substitution therapy showed no change in relation to those recorded during placebo administration, whereas the diastolic blood pressure fell slightly in all five studies. However, in that based on the oldest subjects, the results were not statistically significant. It was therefore concluded that hormone substitution therapy with 17 beta-oestradiol has no adverse effect on blood pressure, and may even have a beneficial action. PMID- 3288847 TI - Frederick W. Bryant, MD--new MSMS president. PMID- 3288848 TI - Acupuncture and labour--a summary of results. PMID- 3288850 TI - Malignant melanoma: a clinical perspective. PMID- 3288849 TI - Osteoporosis: the role of calcium intake and supplementation. AB - The role of calcium in age-related bone loss still is controversial. However, evidence is accumulating to support the hypothesis that an adequate calcium intake early in life, because of its relationship to peak bone mass, may be of greater importance than is the calcium intake in later life. Calcium intake would appear to be declining with age due to the changing food habits that are associated with social and technological change. This is explained partly by the increasing concern about obesity in Western society, with the trend for women to restrict their energy intake, rather than to increase their energy expenditure, to control weight. Thus, low energy intakes and the avoidance of dairy foods have contributed to the declining intakes of calcium and other minerals. Health educational programmes, which are designed to prevent osteoporosis and which identify women who are most at risk of the disease, should provide sensible nutritional advice on an adequate calcium intake and regular weight-bearing exercise among other life-style changes. PMID- 3288851 TI - Control of malaria in "tropical-paradise" hideaways. PMID- 3288852 TI - [Cytokines. Basic research as the basis for therapeutic innovations]. PMID- 3288853 TI - The application of a two-stage design for clinical trials in patients with recurrent head and neck cancer. AB - Cytotoxic chemotherapy produces modest benefits for patients with recurrent and metastatic squamous cell carcinoma of the head and neck (SCCHN). Prospective randomized clinical trials have failed to demonstrate unequivocal superiority of aggressive multidrug regimens over single agents. Despite this, phase II trials frequently result in encouraging preliminary observations that compare favorably to historical single-agent data. While providing for a useful method of screening for anti-tumor activity, phase II studies have limited use in determining the relative value of a new treatment program. Results of phase II studies are considerably influenced by patient selection factors and criteria used to establish therapeutic benefits (responses). Furthermore, estimations of true levels of efficacy (response rates) are dependent on sample sizes, which are usually limited in such trials. We propose that newly developed combinations containing at least one known active agent in this disease should be tested in a controlled setting after their toxicity pattern has been well established. The conduct of the usual phase II study in these situations will probably not provide useful new information, since responses are likely to be observed. We describe a two-stage design applied to terminate a trial if at the first stage there is no evidence of improvement over the control arm. This method allows for early termination of studies involving relatively inefficient treatment regimens and, at the same time, continuation of those with a high likelihood to result in significant therapeutic improvements over a control arm. Loss of power is negligible and sample sizes can be reduced significantly. The rationale behind this method and its simplicity are attractive features for a widespread application for new drug development strategies in this and other diseases. PMID- 3288854 TI - Diagnosis of neuroblastoma metastasis in bone marrow with a panel of monoclonal antibodies. AB - Neuroblastoma, along with rhabdomyosarcoma, Ewing's sarcoma, and acute lymphoblastic leukemia/lymphoma, is one of the small, round-cell tumors of childhood. All of these malignancies show a propensity to metastasize to bone marrow. Occasionally when the clinical picture is unclear and the tumor is particularly anaplastic, it can be difficult to arrive at a diagnosis by conventional histological and biochemical procedures. In the present study, a panel of nine monoclonal antibodies was used to undertake a detailed analysis of seven bone marrows contaminated with tumor cells: six cases of stage IV neuroblastoma, and one case of stage IV-S neuroblastoma. The antibody profiles obtained were compared with those deduced from the studies of over 20 marrows from patients with acute lymphoblastic leukemia. A comparison of these data with those obtained from the studies of rhabdomyosarcoma and Ewing's sarcoma cell lines and tissues suggests that when high levels of tumor cells are present in the marrow, it is possible to obtain a confident diagnosis of either neuroblastoma or acute lymphoblastic leukemia. In addition, the immunocytological identification of neuroblasts in bone marrow enables accurate staging without histological examination. PMID- 3288855 TI - [Diagnostic and therapeutic considerations on the "diabetic foot"]. PMID- 3288856 TI - [Ethical conflicts in experimental medicine]. PMID- 3288858 TI - Neuroendocrine findings in the schizophrenias. AB - A host of abnormalities have been found in responses to neuroendocrine challenges in the schizophrenias. Some, such as dexamethasone suppression, may be associated with pharmacokinetic differences in the handling of agonists or may represent a contamination of a schizophrenic population by patients with affective disorders. Other abnormalities, such as the growth hormone response to thyrotropin-releasing hormone and to luteinizing hormone-releasing hormone in adolescents but not in adults, may reflect developmental changes interacting with disease processes. Still other abnormalities may be more directly reflective of different disease processes: a rapidly neuroleptic-responsive and good-prognosis psychotic disorder appears to be associated with blunted thyrotropin response to thyrotropin releasing hormone and a blunted growth hormone response to apomorphine; a relatively drug-responsive psychotic disorder whose response requires several weeks of neuroleptic treatment appears to be associated with an excessive growth hormone response to apomorphine. The neuroendocrine windows for viewing brain function in the schizophrenias still permit indistinct images of the processes that modulate their release. Nevertheless, the images may provide important clues to the biopathology underlying these diseases. PMID- 3288857 TI - Effect of EDRF release from freshly harvested endothelial cells on the coronary circulation of the isolated working rabbit heart. AB - Vascular relaxation in rabbit aortic preparations by acetylcholine is endothelium dependent. Because of the short half-life of the endothelium-derived relaxing factor(s) (EDRF), a constant source of this material is necessary to study its effect in perfused hearts or hearts in situ (reported half-life 6-50 sec). To investigate the effect of EDRF(s) on the large coronary arteries and the resistance vessels of the isolated working rabbit heart, freshly harvested porcine endothelial cells were used. The cells were stimulated with acetylcholine to produce EDRF(s). To extend the half-life of EDRF, superoxide dismutase was added to the cell suspension. Left atrial infusion of these cells increased coronary flow and reduced total coronary resistance. No significant effect on the diameter of the endothelium-deprived obtuse marginal coronary artery was noted. The vasoconstrictor effect on resistance vessels of topically applied histamine was significantly reduced during the infusion of activated endothelial cells. It can be concluded that EDRF(s) released from freshly harvested endothelial cells increases coronary flow and diminishes total coronary vascular resistance in the working heart. In this preparation coronary arterioles are more sensitive to EDRF(s) than large coronary arteries. EDRF may contribute to the regulation of regional myocardial flow. PMID- 3288859 TI - Premenstrual changes. Impaired hormonal homeostasis. AB - Premenstrual changes (PMCs) in mood and behavior are very prevalent. Nonetheless, their pathophysiology is still obscure and no proven treatment is yet available. Evaluation of the plethora of available data leads to the suggestion that PMCs may result from a temporary impairment of homeostasis among a multitude of systems. This impairment is triggered by a differential pace and magnitude of change-over-time in levels of several hormones and other substances during the luteal phase. PMID- 3288860 TI - The endocrinology of anorexia nervosa and bulimia nervosa. AB - Considerable evidence exists of hypothalamic dysfunction in patients with anorexia nervosa and bulimia nervosa. This dysfunction is reflected in disturbances of endocrine function including abnormalities of gonadotropin, growth hormone, and corticotropin-releasing hormone secretion. Whereas these disturbances are generally reversed with nutritional rehabilitation and weight restoration, it is not evident to what extent nutritional factors are the primary etiology or whether they unmask an otherwise existing but compensated central disturbance. Similarly, endocrine disturbances may be a final common pathway in which disturbances of diet, weight, activity, stress, and mood as well as hypothalamic dysfunction are expressed. PMID- 3288861 TI - Neuroendocrine aspects of suicidal behavior. AB - To assess biologic risk factors in suicidal behavior accurately, it is necessary to distinguish prospective from retrospective designs. The former studies are more likely to elicit information concerning possible risk factors in suicide, whereas the latter may be better indicators of biologic traits. In both types of investigations, measures taken close to the suicide attempt are more likely to reflect the biologic state of the individual at the time of the behavior. Although the abnormalities present in suicidal individuals are not entirely clear, most evidence to date suggests an overactivity of the hypothalamic pituitary-adrenal axis and a dysregulation of both serotonin and adrenergic metabolism. These systems are interrelated. Both animal and human studies have established that a multivariate biologic approach is necessary to the understanding of the pathophysiology of suicide. PMID- 3288862 TI - High-level expression of c-H-ras1 fails to fully transform rat-1 cells. AB - Rat-1 cells were transfected with plasmids encoding normal (Gly-12), nonactivated (Pro-12), and activated (Val-12 and Ile-12) p21H-ras in the presence of an amplifiable dihydrofolate reductase marker. The introduced DNA was amplified by selection in methotrexate to establish the relationship between p21H-ras expression and various hallmarks of cellular transformation. The maximum level of p21H-ras (Gly-12) consistent with cell viability was approximately 0.13% of total cell protein (approximately 60,000 molecules per cell); this is 44-fold greater than the level of the endogenous protein. The maximum tolerated level of a second nontransforming form of p21H-ras (pro-12) was about half of this. Amplification in Rat-1 cells of H-ras genes encoding the highly oncogenic Val-12 and Ile-12 forms of p21H-ras could not be achieved by methotrexate selection, providing strong evidence that synthesis of activated p21H-ras above a certain threshold (about 0.02% of total protein) in Rat-1 cells is incompatible with cell viability. Individual cell lines were isolated and their morphology, anchorage independent growth, tumorigenicity, and response to and production of growth factors were studied. We report that cell lines expressing near-maximum tolerated levels of either the normal or pro-12 form of p21H-ras were not as transformed as cells expressing much more modest levels of the highly oncogenic (Val-12) form, suggesting that the complete elaboration of the transformed phenotype by ras depends, at least in part, on mutations that distinguish the cellular and viral proteins. We found that cells expressing elevated levels of the normal p21(H-ras) could be fully transformed by the activated (Val-12) form and that such cells continued to overexpress p21(H-ras) (Gly-12), arguing against a role for normal ras genes in suppression of the oncogenic potential of their mutationally activated counterparts. PMID- 3288863 TI - Expression of the human beta-globin gene after retroviral transfer into murine erythroleukemia cells and human BFU-E cells. AB - Replication-defective amphotropic retrovirus vectors containing either the human beta-globin gene with introns or an intronless beta-globin minigene were constructed and used to study beta-globin expression following gene transfer into hematopoietic cells. The beta-globin genes were marked by introducing a 6-base pair insertion into the region corresponding to the 5' untranslated region of the beta-globin mRNA to allow detection of RNA encoded by the new gene in human cells expressing normal human beta-globin RNA. Introduction of a virus containing the beta-globin gene with introns into murine erythroleukemia cells resulted in inducible expression of human beta-globin RNA and protein, while the viruses containing the minigene were inactive. The introduced human beta-globin gene was 6 to 110% as active as the endogenous mouse beta maj-globin genes in six randomly chosen cell clones. Introduction of the viruses into human BFU-E cells, followed by analysis of marked and unmarked globin RNAs in differentiated erythroid colonies, revealed that the introduced beta-globin gene was about 5% as active as the endogenous genes in these normal human erythroid cells and that again the minigene was inactive. These data are discussed in terms of the potential treatment of genetic disease by gene therapy. PMID- 3288864 TI - Detection of toxigenic Escherichia coli using biotin-labelled DNA probes following enzymatic amplification of the heat labile toxin gene. AB - Several types of DNA probes labelled with biotin were compared for their sensitivity to detect the heat labile toxin (LT) gene in toxigenic Escherichia coli. In addition, a procedure was developed for enzymatically amplifying LT gene sequences in toxigenic E. coli. Probes were labelled with biotinylated nucleotides by either nick translation; 3' tailing; primer extension of probe DNA cloned into bacteriophage M13; sandwich hybridization; or oligolabelling of isolated DNA fragments. A single stranded probe consisting of a DNA fragment from the LT gene cloned into the bacteriophage M13mp18 and detected by hybridization to oligolabelled biotinylated M13mp18 RF DNA in a sandwich hybridization was able to detect as little as 10 pg of toxin gene DNA. Cloned LT gene DNA was serially diluted and amplified enzymatically using synthetic oligonucleotide primers. Amplified DNA was detected using biotin-labelled M13-based probes. As little as 1 fg of LT DNA could be amplified to detectable levels by this method. Experiments with LT+ bacteria resulted in the detection of as few as 1000 bacteria. The combination of enzymatic amplification coupled with M13-based DNA probes provides a highly sensitive tool for detecting pathogenic microorganisms. PMID- 3288865 TI - In situ hybridization with complementary synthetic oligonucleotide and immunocytochemistry: a combination of methods to study transcription and secretion of oxytocin by hypothalamic neurons. AB - We have constructed an icosameric, anti-sense oligodeoxyribonucleotide probe derived from the published sequence of rat oxytocin gene precursor that was used for in situ hybridization, combined with immunostaining, to characterize the biosynthetic and secretory activity of hypothalamic oxytocin neurons. The population of hybridized neurons overlapped with the pattern of oxytocin immunoreactive cells, except for a fraction of these cells which remained unhybridized. A number of hybridized neurons remained unstained. The differential proportion of hybridized and immunostained neurons are interpreted as differences in secretory turnover of endocrine neurons. PMID- 3288866 TI - Prevention of necrotizing enterocolitis in low-birth-weight infants by IgA-IgG feeding. AB - In a randomized clinical trial, we evaluated the efficacy of an oral immunoglobulin preparation (73 percent IgA and 26 percent IgG) in reducing the incidence of necrotizing enterocolitis in infants of low birth weight for whom breast milk from their mothers was not available. A total of 434 infants weighing between 800 and 2000 g were eligible for entry in the study. Of these, 255 were withdrawn - 234 during the first week of the study because breast milk from their mothers became available (123 in the treatment group and 111 in the control group), and 21 because of violations of protocol or because breast milk became available after the first week. The duration of follow-up was 28 days. Among the infants for whom breast milk did not become available during the study, there were no cases of necrotizing enterocolitis among the 88 receiving oral IgA-IgG, as compared with six cases among the 91 control infants (P = 0.0143). Of the infants withdrawn from the study, two assigned to the control group had necrotizing enterocolitis. We conclude that the oral administration of IgA-IgG may prevent the development of necrotizing enterocolitis in low-birth-weight infants. PMID- 3288867 TI - HMG-CoA reductase inhibitors for treatment of hypercholesterolemia. PMID- 3288868 TI - The crisis in clinical cancer research. Third-party insurance and investigational therapy. PMID- 3288869 TI - Granulocyte-macrophage colony-stimulating factor and myelodysplastic syndromes. PMID- 3288870 TI - Transplantation and the Medicare end-stage renal disease program. PMID- 3288871 TI - Prophylactic sclerotherapy before the first episode of variceal hemorrhage in patients with cirrhosis. AB - The value of sclerotherapy as prophylaxis against the first episode of variceal hemorrhage has not been established. Therefore, we randomly assigned 133 patients with cirrhosis of the liver (of alcoholic origin in 66 percent), esophageal varices, and no previous intestinal bleeding to either prophylactic sclerotherapy (n = 68) or no prophylaxis (n = 65). The groups were comparable in hepatic function, endoscopic findings, and the pathogenesis of cirrhosis. All patients who subsequently had a first episode of variceal hemorrhage received sclerotherapy whenever possible. During a median follow-up of 22 months, variceal hemorrhage occurred in 28 percent of the patients receiving sclerotherapy and 37 percent of the controls (P = 0.3). Thirty-five percent of the sclerotherapy group and 46 percent of the control group died. The survival curves (Kaplan-Meier) of both groups were similar (P = 0.2). However, among patients with alcoholic and moderately decompensated cirrhosis (Child-Pugh group B), survival was significantly higher in those receiving sclerotherapy, although the risk of bleeding was only marginally reduced by this procedure. We conclude that prophylactic sclerotherapy does not significantly reduce the risk of bleeding from esophageal varices, but that a subgroup of patients with esophageal varices and moderately decompensated alcoholic cirrhosis may benefit from prophylactic sclerotherapy because of factors not solely attributable to prevention of an initial episode of variceal bleeding. PMID- 3288872 TI - Serum cyclosporine concentration and risk of acute graft-versus-host disease after allogeneic marrow transplantation. AB - To determine the relation between the serum cyclosporine concentration and the risk of acute graft-versus-host disease (GVHD), we studied 179 recipients of bone marrow grafts from HLA-identical sibling donors who received prophylaxis with cyclosporine, either by itself or combined with methotrexate. Cyclosporine was given either orally or intravenously at full doses from the day before transplantation until day 50; it was then tapered off and discontinued on day 180. Trough concentrations of serum cyclosporine were measured by radioimmunoassay. The relation between patients' characteristics and the risk of acute GVHD was analyzed with a relative-risk regression model. In 66 patients (37 percent), grades II to IV of acute GVHD developed 7 to 66 days (median, 13) after transplantation. The trough cyclosporine concentration for a given week was significantly associated with the risk that acute GVHD would develop during the following week. The relative risks were 0.7 (i.e., there was a 30 percent reduction in risk) for every increase of 100 ng per milliliter in cyclosporine concentration and 1.0, 0.60, and 0.20 for concentrations of less than 100, 100 to 199, and 200 or more ng per milliliter, respectively (P less than 0.01). A patient's age, prophylaxis regimen, and year of transplantation also influenced the risk of acute GVHD significantly. These data indicate that low cyclosporine concentrations can be a cause of treatment failure and that concentrations should be monitored in recipients of marrow transplants. PMID- 3288873 TI - Pediatric surgery. PMID- 3288874 TI - Comparison of nutrition habits in Potsdam two centuries ago with modern developments. AB - Nutrition habits in the 18th century are described using as examples a menu of the Prussian King, the weekly menu in the Potsdam military orphanage, and the daily ration for a soldier of the Prussian army. Due to the social and scientific progress the quality of nutrition has improved in many respects. Compared to past times there are today no deficiencies in energy and essential nutrients, if knowledge and behavior are in accord. Full employment, high purchasing power and stable prices for basic food are the premises for good nutrition. The wide-spread desire for a nutrition of high hedonic value connected with a broad food choice has nutritional advantages, but as well the potential disadvantage of overnutrition. The hygienic quality of food has probably never been as high as today. PMID- 3288875 TI - Just what did the nurse do? PMID- 3288876 TI - Groote Schuur Hospital celebrates fifty years. PMID- 3288877 TI - Connections with the past. Finally, some answers. PMID- 3288878 TI - Legislative issues. A time for action. PMID- 3288879 TI - Political activism: our heritage (Florence Nightingale). PMID- 3288880 TI - [The clinical importance of insulin antibodies]. PMID- 3288881 TI - [Echography in the diagnosis of epiphysiolysis of the proximal humerus in a newborn infant]. PMID- 3288882 TI - [A dreaded complication of infectious endocarditis: intracranial mycotic aneurysms]. PMID- 3288883 TI - [Is medicine a scientific education?]. PMID- 3288884 TI - Disinfectants in dialysis: dangers, drawbacks and disinformation. PMID- 3288885 TI - The case for oxygen free radicals in the pathogenesis of ischemic acute renal failure. AB - One of the more glaring paradoxes of ischemic acute renal failure is that such injury appears to be worse in the kidney as opposed to other organs, even though the kidney is the best oxygenated. An answer can be deduced from the anatomical and physiological background, together with a reappraisal of the role of medullary vascular damage and recent evidence of the importance of the postischemic component of ischemic injury, which is mediated by oxygen free radicals. As far as oxygenation is concerned, the kidney's Achilles heel is the tubules of the outer strip of the outer medulla, which are also those that have the most metabolic activity. It is here that ischemic injury begins, and is maintained and exacerbated in the postischemic stage by the free radicals. These are produced by the kidney in large quantities, since it has all the necessary chemical ingredients available. It is therefore readily understandable why the kidney, being the best oxygenated organ, is so sensitive to an ischemic insult, since the damage caused in the postischemic stage is increased the greater the amount of oxygen brought in by reperfusion. PMID- 3288886 TI - Metabolic and hormonal assessment of patients on maintenance hemodialysis for 10 years or more and their importance in long-term survival. AB - We studied metabolic and hormonal patterns in 11 patients on hemodialysis for over 10 years (group A) to determine whether some metabolic abnormalities worsen with long-term dialysis or whether a particular endocrine-metabolic pattern discriminates long-term hemodialysis survivors. Data were compared to those of 14 subjects of similar age and sex on dialysis for 1-3 years (group B) and to those measured in the same patients during the 1st year of dialytic treatment. As to glucose metabolism, group A showed elevation of fasting plasma glucose and a decrease of glucose constant decay (K) and insulin production (IIG) values as compared to the 1st year of dialysis. No difference was found between group A now and group B. However in the 1st year of dialysis group A showed significantly higher K values than group B. As regards lipid metabolism, group A presented higher alpha-lipoprotein values and high-density lipoprotein cholesterol/cholesterol, high-density lipoprotein-cholesterol/apoprotein A, and apoprotein A/apoprotein B ratios, while low-density lipoprotein-cholesterol and apoprotein B values and beta/alpha-lipoprotein ratio were lower. These data demonstrate less vascular risk in group A. We explain these results as depending on natural selection. Multivariate analysis of survival confirmed that survival in hemodialysis patients is influenced negatively by glucose and lipid metabolism abnormalities. As to Ca-P metabolism, group A showed higher carboxy-terminal parathyroid hormone and alkaline phosphatase values than group B. However, these data may be superimposed to those determined in the same patients in 1981, when we began the regular use of 1 alpha,25-(OH)2-vitamin D3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288887 TI - Renal handling of beta-2-microglobulin in neonates treated with gentamicin. AB - Increased levels of urinary beta 2-microglobulin (beta 2M) have been used as a marker of proximal tubular dysfunction in human neonates. To assess the value of beta 2M in the detection of early stages of tubular damage caused by gentamicin, renal handling of beta 2M was studied sequentially in 18 gentamicin-treated neonates with idiopathic respiratory distress syndrome (mean birth weight 1,781 g, mean gestational age 33.7 weeks) during the first 7 days of life. These data were compared with those obtained from 10 control infants matched for gestational and postnatal ages. In addition, follow-up studies of renal function were conducted in 14 of 18 study infants 1 week after termination of therapy, on day 14 postpartum. The (+/- SD) fractional tubular excretion of beta 2M (FE beta 2M) tended to decrease significantly in the control infants from 10.3 +/- 1% on day 1 to 6.5 +/- 0.8% on day 7 postpartum (p less than 0.05). In infants treated with gentamicin, the mean FE beta 2M rose from 10.5 +/- 2% on day 1 to 17.1 +/- 1% on day 7 (p less than 0.01), followed by a decrease to 8.2 +/- 0.5% over the next 7 days (p less than 0.001). Compared with the control infants, values for the infants receiving gentamicin were significantly higher on postpartum days 3,5, and 7 (p less than 0.001). No significant differences in serum creatinine, creatinine clearance, or fractional tubular excretion of sodium were observed between the two groups during the study period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288888 TI - Renal, major histocompatibility complex antigens and cellular components in rapidly progressive glomerulonephritis identified by monoclonal antibodies. AB - Identification of crescent-forming cells in rapidly progressive glomerulonephritis (RPGN) is very difficult, and controversial results on the participation of different epithelia as well as of monocytes have been reported. In the present study different monoclonal antibodies were used to analyze cellular infiltrates of crescents and the interstitium as well as the distribution of well-defined renal antigens and major histocompatibility complex (MHC) encoded antigens along the human nephron in cryostat sections of renal biopsies from patients with RPGN. The results demonstrate that monocytes/macrophages infiltrate Bowman's space and that cellular components of crescents present with phenotypes of parietal glomerular and proximal tubular cells. T lymphocytes are significantly found in glomeruli and also in interstitium with predominance for CD4+ lymphocytes. Reduction of MHC class-II antigens within diseased glomeruli correlates with changes in renal antigen expression. Tubular cells, however, often presented an abnormal expression of MHC class-II antigens. Differences of renal and MHC-encoded antigen expression may be due to rapid regeneration episodes of renal parenchymal cells in RPGN. PMID- 3288889 TI - Bilateral nephrectomy and dialysis as an option for patients with bilateral renal cancer. AB - Six patients who underwent bilateral nephrectomy for renal carcinoma were placed on maintenance dialysis; of these, 1 patient had a renal transplant. A 5-year 44% survival of these patients was observed. We feel that radical nephrectomy followed by chronic dialysis is a reasonable alternative and offers a fair prognosis to patients with bilateral renal cancer in which partial nephrectomy is not possible. PMID- 3288890 TI - Uremia and the control of protein metabolism. PMID- 3288891 TI - Pathogenesis of cerebral atrophy in uraemia. State of the art. AB - This paper discusses the possible pathogenesis of the cerebral atrophy (CA) observed in a large percentage of uraemic patients, taking the form of prevalently cortical damage (cortical atrophy) and/or subcortical enlargement of ventricular cavities (subcortical atrophy). This central nervous system pathology seems to share very little either with the better known 'dialysis encephalopathy' or with the 'acute encephalopathy syndrome', even though sporadic cases of both these forms have shown concomitant CA. Histopathologically it offers the picture of loss of neurons and nerve fibres and can thus be compared with uraemic peripheral nervous system damage. CA is unquestionably important because of its implications in terms of impairment of superior cortical functions, just as in CA of non-uraemic aetiology. A first aetiopathogenic hypothesis might include endogenous uraemic intoxication to the nerve tissue, believed responsible for peripheral uraemic neuropathy, but other possibilities merit consideration: vascular calcification secondary to hyperparathyroidism, blood lipid disorders, and systemic hypertension--factors that contribute to impairing the brain vasculature, with cascade effects on brain tissue oxygenation, neuronal metabolism, and energy exchanges. Tissue oxygenation is already jeopardized in the uraemic patient by the concomitant chronic anaemia and by cardiac insufficiency in cases with hypertensive heart disease. In dialysis patients with volume-dependent hypertension the brain may be further damaged by abrupt pressure changes produced by dialytic ultrafiltration; these constitute a severe challenge to cerebral blood flow autoregulation. Cyclic variations of brain tissue hydration connected with regular dialysis treatment may have adverse effects on neurotransmitter functions, particularly those mediated by neuropeptidergic systems. Chronic intoxication may result from oral Al(OH)3 of phosphorus chelating agents: in animal studies and clinical observations in non-uraemic populations the neurotoxic potential of Al is indicated by a significant correlation between histological neuronal damage, impaired function, and Al concentration in brain tissues. In addition, a concausal role of malnutrition in central nervous system damage in the uraemic patient cannot be overlooked, since malnutrition is known to give rise to functional and structural alterations in non-uraemic human pathology. In the light of these clinical observations and experimental findings, it would appear that the prevention of CA in uraemia is today feasible. PMID- 3288892 TI - Special issue in memory of Dr. Arthur Cherkin. PMID- 3288893 TI - Effect of aging on the blood-brain barrier. AB - Aging is commonly associated with progressive deterioration in central nervous system (CNS) function. Nutritional factors or environmental toxins have important effects on CNS degenerative changes. The blood-brain barrier (BBB) is a major modulator of nutrient delivery to the CNS. The tight junctions and the paucity of pinocytosis or fenestrations in brain capillary endothelium act as an effective barrier between the CNS and the circulating toxic agents. Senescence is associated with significant, though often subtle, changes in BBB. Conditions which are commonly associated with aging, such as hypertension and cerebrovascular ischemia, aggravate the age-related alterations in BBB function. The histologic changes in brain vasculature with aging is region selective and species specific. The common age-related histologic changes include loss of capillary endothelial cells, elongation of the remaining endothelial cells, and decreased capillary diameter in rat cortex, but not in the monkey or human cortex, and a decrease in the number of mitochondria in endothelial cells of the brain capillaries in the monkey but not in the rat. The age-related alterations in BBB transport function include a decrease in BBB choline transport with aging and decreased brain glucose influx. The BBB neutral amino acid transport appears to be unaltered in the aged mice. Most of the studies reported so far have failed to show a significant age-related alteration in BBB permeability to water-soluble substances and high molecular weight solutes in the absence of neurological disease. A more profound change in BBB permeability appears to be associated with Alzheimer's disease. Immunohistological studies have demonstrated the presence of serum proteins in the cerebrovascular amyloid in patients with Alzheimer's disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3288895 TI - Cognitive and brain imaging measures of Alzheimer's disease. AB - Diagnosis of Alzheimer's disease (AD) during life relies upon clinical and neurobehavioral symptoms but is presumptive without microscopic verification of neuropathology. Studies in this review observed considerable heterogeneity in AD symptoms and did not agree on how to detect the earliest symptoms. Problems exist in diagnosis. Differences in symptoms and diagnosis result from how AD is defined neurobehaviorally and on the model used for description. The studies reviewed have been considered under three basic models: A severity (staging) model; a heterogeneity (subtyping) model; and an information processing model. Differences in model intent have resulted in differences in disease description. Brain imaging measures have not invalidated models but add the neural substrate needed to examine correlation of measures within each model. PMID- 3288894 TI - How should one study brain adrenergic receptors in aging? AB - Contradictory findings and lack of definitive information regarding adrenergic receptors in aging results in part from problems related to the methodology that has been used to study this question. Limitations of available techniques and new biochemical, molecular biological, and physiological methods that may prove particularly helpful for future studies are discussed. PMID- 3288896 TI - [Arteriosclerosis risk factors and the evaluation of Doppler recording of carotid blood flow in patients with a history of ischemic stroke]. AB - The authors analysed control ultrasonographic examination of the carotid arteries based on Doppler's phenomenon at least six months after ischaemic stroke in 40 patients of the Department of Neurology, Medical Academy in Wroclaw. The examination was done using a Polish UDP-20 flowmeter. In more than one half of the patients (57.5%) the carotid blood flow was worsened. The predominating risk factor in the group with worsening was abnormal serum lipid pattern (hyperlipidaemia and/or low HDL values). In this group also more frequent presence of two or more risk factors was observed (69.9%). The usefulness was demonstrated of monitoring of the conditions of the carotid arteries in patients after ischaemic stroke using this method. PMID- 3288897 TI - [The use of the method of multimodal evoked potentials in occupational medicine]. PMID- 3288898 TI - Correlations among intracranial pulsatility, intracranial hemodynamics, and transcranial Doppler wave form: literature review and hypothesis for future studies. AB - In the present work, the major correlations among cerebrospinal fluid (CSF) pulsatility, cerebral hemodynamic changes, the action of mechanisms regulating cerebral blood flow and cerebral blood volume, and the main aspects of the intracranial basal artery transcranial Doppler wave form are critically examined. CSF pulsatility is a consequence of rigidity of the craniospinal compartment and the pulsating changes in cerebral blood volume. At low and medium intracranial pressures (ICPs), changes in CSF pulsatility are mainly the result of changes in craniospinal elastance. During severe intracranial hypertension, however, CSF pulse pressure reflects an abrupt increase in cerebrovascular (i.e., cerebral vessel) compliance. The mechanisms controlling cerebral blood flow and cerebral blood volume affect CSF pulsatility through both an alteration in craniospinal blood volume and a change in vascular wall pulsatility. Examination of the main parameters of the Doppler velocity pattern (maximal systolic blood velocity, diastolic blood velocity, and peak to peak pulsatility index) in cerebral basal arteries reveals a significant alteration in the velocity wave form during severe ICP increase (above 60 mm Hg). During moderate ICP increase, when cerebral regulatory mechanisms are effective, the Doppler velocity pattern is not significantly affected by ICP changes. PMID- 3288899 TI - Value of transcranial Doppler examination in the diagnosis of cerebral vasospasm after subarachnoid hemorrhage. AB - In 21 patients with subarachnoid hemorrhage secondary to ruptured intracranial aneurysms, we performed serial neurological evaluations, transcranial Doppler examinations, and cerebral blood flow (CBF) determinations. We classified 8 patients as having vasospasm (delayed neurological deterioration, appropriate reduction of CBF) and 13 patients as having no spasm on the basis of this information. Transcranial Doppler flow velocities in the middle cerebral artery and the anterior cerebral artery were significantly elevated for the group with vasospasm on posthemorrhage Days 4 through 12. Elevation of transcranial Doppler velocities preceded clinical signs of cerebral ischemia. The maximal transcranial Doppler flow velocities achieved were compared on the basis of the extent of clot on early computed tomographic (CT) scans. The mean anterior cerebral artery flow velocities were significantly different between CT Grades II and III. The initial transcranial Doppler flow velocities were compared on the basis of the patient's Hunt and Hess grade upon admission. The flow velocities for Grade V patients were significantly lower than those for Grade IV patients. Transcranial Doppler flow velocities were compared with arteriographically observed anterior cerebral artery and middle cerebral artery radii in 12 instances. The correlation was poor, but the data should be interpreted cautiously in view of the small number of arteriograms. We conclude that transcranial Doppler examination has considerable potential in the early diagnosis of delayed ischemic neurological deficit (clinical vasospasm) in patients with subarachnoid hemorrhage. PMID- 3288901 TI - Intrasphenoidal encephalocele: report of a case. AB - The diagnosis of intrasphenoidal encephalocele may be difficult because of its rarity and its nonspecific signs and symptoms. The authors report a patient with intrasphenoidal encephalocele who was operated on by the transsphenoidal approach with a good result. They also review five reported cases, with discussion of their clinical characteristics and operative indications. PMID- 3288900 TI - Middle cerebral artery aneurysm due to Nocardia asteroides: case report of aneurysm excision and extracranial-intracranial bypass. AB - Nocardia asteroides is an uncommon human pathogen typically encountered in immunocompromised patients. Primary central nervous system (CNS) nocardiosis is rare and usually manifests as cerebritis or abscesses. The case of a young woman who presented with CNS Nocardia abscesses complicated by an infective middle cerebral artery aneurysm is reported. Treatment, which included abscess aspiration, aneurysm excision, and end-to-end extracranial to intracranial bypass and prolonged antibiotic therapy, resulted in an excellent outcome. This case and the management of CNS nocardiosis are reviewed. PMID- 3288902 TI - William Sharpe, M.D.--neurosurgeon/entrepreneur. PMID- 3288903 TI - Local effector functions of capsaicin-sensitive sensory nerve endings: involvement of tachykinins, calcitonin gene-related peptide and other neuropeptides. PMID- 3288904 TI - Characterization of ependymal cells in hypothalamic and choroidal primary cultures. AB - Long-term primary cultures derived from fetal mouse or rat hypothalamus and choroid plexus were obtained in serum-supplemented and chemically defined media. In order to identify and characterize cell types growing in our cultures, we used morphological features provided by phase-contrast, scanning and transmission electron microscopy. Immunological criteria were recognized, using antibodies against intermediate filament proteins (vimentin, gliofibrillar acid protein, cytokeratin, desmin, neurofilament proteins), actin, myosin, ciliary rootlets, laminin and fibronectin in single or double immunostaining, and monoclonal antibodies known to detect epitopes of ependymal or endothelial cells. Minor cell types such as astrocytes, fibroblasts and endothelial cells were distinguished. Ependymal cells, which exceeded 75% of the cultured cells, were identified by their cell shape and epithelial organization revealed by phase-contrast and transmission electron microscopy, by their apical differentiation evidenced by scanning and transmission electron microscopy, and by certain molecular markers (e.g. gliofibrillar acid or ciliary rootlet proteins) detected by immunofluorescence. Four ependymal cell types were recognized: choroidal ependymocytes, ciliated and unciliated ependymal cells, and tanycytes. All these cultured ependymal cell types showed a remarkable resemblance to in vivo ependymocytes, in terms of marker expression and ultrastructural features. PMID- 3288905 TI - [Computerized tomographic evaluation of latero-cervical lymphatic metastasis of carcinoma of the larynx. Personal experience in 170 cases]. AB - CT can be considered the most reliable technique in detecting nodal metastases of the cervical district. The Authors have studied 170 patients with laryngeal cancer (104 N0, 21 N1, 21 N2 and 24 N3 clinically) with CT of the cervical region during infusion of contrast material. All patients underwent radical neck dissection with pathological examination of the nodes. CT diagnosis and pathological findings were correlated. Our findings show that CT has an overall accuracy of 91.8% (100% in groups N2 and N3) and fed false positives and false negatives. PMID- 3288906 TI - [Endoscopic treatment of upper digestive hemorrhages]. AB - The main aspects of endoscopic haemostasis treatment of severe haemorrhages of the upper digestive tract are analysed with particular emphasis on the techniques employed and the results obtainable. PMID- 3288908 TI - [Human immunoglobulins]. PMID- 3288907 TI - [Primary intestinal lymphomas. Review of the literature apropos of a clinical case]. AB - A rare case of primary lymphoma of the bowel in a 26 year old woman is reported and the complex problems of diagnosis and treatment are examined. The importance of establishing the primary or secondary nature of this tumour of the small bowel is emphasised. This is because primary intestinal tumours require the most radical treatment possible even in advanced stages of the disease in order to avoid complications and to identify the areas involved in the proliferative process. Finally the importance of continuing surgery with drug and radiation treatment in order to improve prognosis is emphasised. PMID- 3288910 TI - New functional tests of vitamin E status in humans. PMID- 3288911 TI - Pairing sweet tastes and food consumption affects food preferences. PMID- 3288909 TI - Effects of triglyceride structure on lipid metabolism. PMID- 3288912 TI - Role of sodium vs sodium chloride in hypertension. PMID- 3288913 TI - The Lancet, Volume i, 1957: Prediction of serum-cholesterol responses of man to changes in fats in the diet. By Ancel Keys, Joseph T. Anderson, Francisco Grande. PMID- 3288914 TI - Lymphocytic interstitial pneumonitis in adult HIV infection. PMID- 3288915 TI - Saccharomyces fungemia in a patient with AIDS. PMID- 3288916 TI - The use of ultrasound in the diagnosis of congenital pyloric stenosis. AB - Thirty-six infants with pyloric stenosis were studied preoperatively by ultrasound and compared with a control group of 24 normal infants aged one month. Measurement of pyloric muscle diameter and muscle wall thickness was significantly different for each measure between groups and they had a nonoverlapping distribution. Ultrasound has a clear place in the diagnosis of pyloric stenosis. PMID- 3288917 TI - Maori health in the mid-nineteenth century. PMID- 3288918 TI - Saving the Maoris: Dr Thomas Hodgkin as a physician and social reformer. PMID- 3288919 TI - Problems of organ transplantation. PMID- 3288920 TI - New Zealand Medical Association 1886-1986. Centennial meeting. Auckland, 17-21 May 1987. Proceedings. PMID- 3288921 TI - New Zealand and its doctors, 1840s-1980s. PMID- 3288922 TI - Patients, relatives, doctors: their expectations and viewpoints. PMID- 3288923 TI - The nursing profession and the health service. PMID- 3288924 TI - The future of medicine from a medicolegal viewpoint. PMID- 3288925 TI - General practice. PMID- 3288926 TI - New Zealand futures trust visit to New Zealand. Australasia revisited--towards the transTasman federation. PMID- 3288927 TI - Birth asphyxia: does the Apgar score have diagnostic value? AB - The current literature was reviewed to evaluate the Apgar score as a diagnostic test for the presence of asphyxia. Several studies were examined and the sensitivity, specificity, and predictive values of the Apgar scores calculated. Using an umbilical cord arterial pH below 7.2 as evidence of asphyxia, the one minute Apgar score showed poor sensitivity as a marker of asphyxia. Therefore, we discourage reference to the term "asphyxia" when Apgar scores alone are used as supportive evidence. PMID- 3288928 TI - Ultrasound diagnosis of defects in the scarred lower uterine segment during pregnancy. PMID- 3288929 TI - Influence of short-term indomethacin therapy on fetal urine output. AB - Eight pregnancies ranging from 27-32 weeks' gestation were treated for preterm labor with oral indomethacin. The dosage regimen was 25 mg every four hours in four patients and 25 mg every six hours in the other four patients. The maximum duration of indomethacin therapy was 72 hours. In three patients, fetal ductus arteriosus constriction mandated discontinuation of indomethacin at 24 hours. Sonographic assessment of hourly fetal urine output was performed before therapy, at multiple regular intervals during therapy, and 24 hours after the last dose of indomethacin. A dramatic decline was noted from the mean baseline fetal urine output of 11.2 mL/hour. The mean fetal urine output at five, 12, and 24 hours during therapy was 2.2, 1.8, and 1.8 mL/hour, respectively (P less than .05). Twenty-four hours after completion of indomethacin therapy, the mean fetal urine output was 13.5 mL/hour. Poor correlation (r = 0.14, P less than .05) was noted between maternal serum indomethacin levels and hourly fetal urine output. This significant decline in urine output is consistent with other results in neonatal and adult animals and humans. Furthermore, it implies a role for prostaglandins in controlling urine output during fetal life. PMID- 3288930 TI - External cephalic version with tocolysis: factors associated with success. AB - Data were collected prospectively on factors that might affect the success or failure of external cephalic version, using a protocol including fetal monitoring, ultrasound, tocolysis, and external version after 37 weeks' gestation. Patients were accepted into the protocol whether or not risk factors for failure were present. Sixty-seven patients were admitted to the study and 40 (60%) underwent successful version. Using chi 2 analysis, we found that failure of external version was significantly associated with obesity, descent of the breech into the pelvis, decreased fluid, and fetal back positioned posteriorly. Thirteen women were in active labor; this had no effect on the success rate providing that descent had not occurred. Two factors, descent of the breech into the pelvis and posterior position of the fetal back, had an independent effect on success after controlling for other variables. PMID- 3288931 TI - Lichen planus of the vulva. AB - Lichen planus is an uncommon cutaneous disease that can affect the vulva. Vulvar pruritus and pain are common symptoms in patients with genital involvement. Examination reveals an erythematous, friable vestibule with adherent exudate. Marked resorption of the labia minor and atrophy may occur in time. Diagnosis is based on associated clinical findings involving the oral mucosa and/or the skin and on vulvar biopsy. PMID- 3288932 TI - Estimation of nongravid uterine volume based on a nomogram of gravid uterine volume: its value in gynecologic uterine abnormalities. AB - To facilitate accurate and standard methods of reporting pathologic uterine corpus enlargement, we constructed a nomogram using the gravid uterine corpus volumes from five to 20 weeks' gestation in 186 patients. The volume was calculated by measuring the maximum length and anteroposterior and transverse diameters of the uterine corpus, and using the formula for the volume of a prolate ellipsoid: V = 0.52 X (L X AP X T). Clinicians can use the nomogram for better understanding in assessing uterine volume. PMID- 3288933 TI - Comment to the article 'Effects of L-timolol, D-timolol, haloperidol and domperidone on rabbit retinal blood flow measured with laser Doppler method'. PMID- 3288934 TI - Incidence and mechanism of failure of cemented acetabular component in total hip arthroplasty. AB - Clinical results today seem to suggest that acrylic cement is crucial in producing immediate and reproducible results of pain-free joints following total hip replacement. Proper application by the use of contemporary techniques may be suitable in most conditions requiring hip replacement. The incidence of acetabular failure in a specific group of patients at risk may warrant experimentation by the use of a noncemented system. The mechanism of failure of low-friction arthroplasty may be multifaceted, but our experience indicates that the mechanisms of failure of the acetabulum have been due to excessive deepening and expansion of the acetabulum, once thought to be fundamental to the procedure. A rudimentary technique of cement pressurization, both in the femur and in the acetabulum, also may have played a part in late failures of this procedure. Early demarcation at the cement-bone interface was prevalent in young and active or heavy individuals. Demarcation and loosening were time-dependent phenomena. Demarcation and loosening also appeared with the aging process and increased osteopenia. A higher incidence of loosening also was observed in young and light weight individuals, with presumably increased elasticity of the pelvic bone. PMID- 3288935 TI - Long-term results of cemented total knee arthroplasty. AB - Excellent long-term results recently have been reported for cemented total knee arthroplasties. This success results from well-established principles of surgical technique, implant materials, and prosthetic design. These are described in their historical context. PMID- 3288936 TI - Effect of modern cement technique on acetabular fixation total hip arthroplasty. A retrospective study in matched pairs. AB - The modern cement technique has significantly reduced the bone-cement interface radiolucency and, therefore, it is suggested that the results of the cemented socket with this technique should be the basis for comparison with other methods of fixation. PMID- 3288937 TI - Pathologic studies of total joint replacement. AB - Articular endoprostheses are, in effect, foreign bodies designed to re-establish functioning articulations and are, therefore, capable of eliciting a local or systemic response to their presence. This article discusses the body's reactions to foreign bodies in general, and to endoprostheses in particular, and attempts to place those reactions into perspective regarding survival and failure of articular endoprostheses. The effects of size, shape, and composition of the materials used in the prosthetic components, and the mechanical factors acting on them to produce debris, are presented. PMID- 3288938 TI - Wear and loosening of the socket in the Charnley low-friction arthroplasty. AB - In the Charnley low-friction arthroplasty, wear of the HDP socket and the dimensional changes resulting from it are more important than the tissue response to wear debris. Study of wear and the related mechanical factors is likely to be more rewarding than the search for alternative methods of fixation. PMID- 3288939 TI - Acetabular cup wear in total hip arthroplasty. AB - Clinical, pathologic, radiographic, and biomechanical factors of 10 severely worn retrieved Charnley acetabular cups were examined to determine whether these factors influenced cup wear. Change in cup thickness was found to be linear with time. It was found that the actual change in cup thickness was not significantly different from the radiographic change in cup thickness. No correlation was found with the other clinical or radiographic factors. PMID- 3288940 TI - Biobehavioral factors in cancer pain. AB - Despite the presence of pathology in cancer pain, the pain experience in adult cancer patients cannot be totally explained by the extent of such pathology. Unlike chronic benign pain very little research on the role of biobehavioral factors has been conducted to help explain this paradox. The literature on the role of biobehavioral factors in the cancer pain experience is reviewed. A brief review of epidemiology and pathophysiology is presented. Following this, the biobehavioral literature was organized according to research on psychological characteristics and environmental factors. Research addressing affective, cognitive, behavioral and physiological reactions to pain was also discussed. Despite the paucity of studies, the review suggested the following: (1) personality factors do not appear to play a consistent role in the modulation of pain in cancer patients; (2) the work on environmental influences on cancer pain indicate a weak association between such factors as social network and pain intensity; (3) studies on affective state indicate minimal relationships to pain, and lastly, (4) studies on cognitive responses to pain in cancer patients and their influence on the pain experience have not been conducted. To date, in the areas where biobehavioral factors have been investigated, the findings appear modest. However, many potential variables, e.g., self-esteem, the role of family, the role of models, past or current work environments, social learning factors and responses to pain such as fear, somatization and reattribution have not been explored with cancer patients. While the influence of biobehavioral factors in adult cancer pain appear to be relatively modest, the literature is not extensive. Increased efforts at more precisely determining the input of such factors in cancer pain are warranted, particularly given the role of such variables in other recurrent and chronic pain states. PMID- 3288941 TI - Sources of variability in the sensation of pain. PMID- 3288943 TI - Long range planning--who has the time? PMID- 3288942 TI - The efficacy of hypnosis- and relaxation-induced analgesia on two dimensions of pain for cold pressor and electrical tooth pulp stimulation. AB - This study evaluated the efficacy of hypnosis- and relaxation-induced suggestions for analgesia for reducing the strength and unpleasantness dimensions of pain evoked by noxious tooth pulp stimulation and by cold pressor stimulation. The Tellegen Absorption Questionnaire was used to assess hypnotic susceptibility for 28 subjects in order to match treatment groups according to sex and susceptibility scores. Tooth pulp stimulation consisted of a 1 sec train of 1 msec pulses at a frequency of 100 Hz, applied at 20 sec intervals to the central incisor. Six stimuli, selected between subject's pain and tolerance thresholds, were presented 3 times each in random order. Cold pressor stimulation consisted of forearm immersion in a circulating water bath maintained at 0-1 degrees C. Subjects made threshold determinations of pain and tolerance and used Visual Analogue Scales to rate the strength and the unpleasantness of both noxious stimuli before and after receiving either hypnosis- or relaxation-induced analgesia. There were no significant differences in pain reductions between hypnosis- and relaxation-induced interventions. However, the percent reduction in both strength and unpleasantness varied significantly as a function of the type of pain. Both hypnosis and relaxation significantly reduced the strength and the unpleasantness of tooth pulp stimulation, but only the unpleasantness dimension of cold pressor pain. The pain reductions were not correlated with subjects' hypnotic susceptibility levels. The results indicate that the extent and the quality of the analgesia produced by these cognitive-based therapies vary not only according to subjects' characteristics and the efficacy of the intervention, but also according to the nature of the noxious stimuli. Tooth pulp and cold pressor stimulation represent qualitatively different stimuli with respect to both the type of nerves activated and the mode of stimulus application. Discrete, randomly presented levels of noxious electrical stimulation to the teeth activate predominantly small fibers and produce brief pain sensations that vary unpredictably in intensity. In contrast, continuous cold stimulation to the forearm activates a variety of nociceptive and non-nociceptive fibers and produces progressive cold and pain sensations with a predictable increase in intensity from cold sensations to paresthesia and severe pain. PMID- 3288944 TI - Periodic breathing: quantitative analysis and clinical description. PMID- 3288945 TI - Echovirus infections of newborn infants. PMID- 3288946 TI - Single dose antibiotic therapy is not as effective as conventional regimens for management of acute urinary tract infections in children. AB - One hundred thirty-two children with acute urinary tract infection were randomly assigned to receive trimethoprim-sulfamethoxazole in one dose, two doses daily for 3 days or two doses daily for 7 days. The patient characteristics, etiologic agents and frequency of roentgenologic abnormalities were similar for the three treatment groups. There was no significant difference in bacteriologic cure rates for the single dose regimen (93%) and multidose regimens (96%). The difference in rates of recurrent urinary tract infection between the single dose (20.5%) and 3 day (5.6%) and 7-day (8%) regimens was statistically significant (P = 0.033). A single dose of trimethoprim-sulfamethoxazole is inadequate treatment for infants and children with acute urinary tract infection. PMID- 3288947 TI - Aztreonam: review of the clinical experience and potential uses in pediatrics. PMID- 3288948 TI - Acute focal bacterial nephritis: diverse clinical presentations in pediatric patients. PMID- 3288949 TI - Disseminated neonatal aspergillosis: report of a fatal case and analysis of risk factors. PMID- 3288950 TI - Hepatic abscesses in a child caused by Fusobacterium necrophorum. PMID- 3288951 TI - Oxybutynin efficacy in the treatment of primary enuresis. AB - The effectiveness of oxybutynin in the treatment of primary enuresis was evaluated in a double-blind study. A total of 30 children (25 boys, five girls), at least 6 years of age, with primary enuresis and no daytime incontinence or history of other urinary tract problems were selected at random from an enuresis clinic population. The study was explained to the families and they were told how to keep records of nocturnal bed-wetting episodes and side effects. The patients were treated with a 10 mg of oxybutynin at suppertime for 28 days. Before or after the treatment period, all children received an identical placebo for 4 weeks. Two-sided paired t tests were used to compare frequency of nocturnal enuresis. Frequency during the drug regimen did not differ significantly from that during the placebo study. There were no differences in findings between boys and girls or between children who had previously taken imipramine and those who had not. The study showed no evidence that oxybutynin is effective in treating primary enuresis. PMID- 3288952 TI - Esophageal motor abnormalities in children and adolescents with scleroderma and mixed connective tissue disease. AB - To determine the frequency and nature of esophageal motor abnormalities in children and adolescents with scleroderma syndromes and mixed connective tissue disease, esophageal manometry was performed on seven patients with progressive systemic sclerosis, four patients with mixed connective tissue disease, and two patients with linear scleroderma. A total of 73% of patients with progressive systemic sclerosis and mixed connective tissue disease had symptoms of esophageal dysfunction. A significant association between the presence of Raynaud phenomenon and esophageal symptoms was noted. Esophageal motor abnormalities were detected in 73% of patients with progressive systemic sclerosis and mixed connective tissue disease; these abnormalities were characterized by decreased lower esophageal sphincter pressure and abnormal peristalsis in the distal two thirds of the esophageal body. They resemble those described among adults with progressive systemic sclerosis and mixed connective tissue disease but were not related to disease duration or to the presence of Raynaud phenomenon. Patients with linear scleroderma did not have esophageal symptoms and demonstrated only nonspecific motor abnormalities that did not worsen during several years of follow-up. PMID- 3288953 TI - Systolic or diastolic blood pressure significance. PMID- 3288954 TI - Fire-setting behavior in individuals with Klinefelter syndrome. PMID- 3288955 TI - Odontoid fracture in a child occupying a child restraint seat. PMID- 3288956 TI - American Academy of Pediatrics: Directory of overseas service opportunities for pediatricians. PMID- 3288957 TI - Blood pressure in obese adolescents: effect of weight loss. AB - The BP distribution of a group of 72 obese adolescents was determined both before and after weight loss. Weight loss was produced by a program of caloric restriction and behavior change alone (n = 26) or with a combination of caloric restriction, behavior change, and exercise (n = 25). It was demonstrated that obese adolescents have a BP distribution that is skewed 1 SD to the right of normal (P less than .01), and that with weight loss this distribution was no longer different from that of the general population. It was also shown that a weight loss program that incorporates exercise and caloric restriction produces the most desirable effect on BP reduction (ie, greatest decrease in resting systolic BP and greatest decrease in exercise diastolic and mean BP). Finally, it was demonstrated that obese adolescents have structural changes present in the forearm resistance vessels and that these structural changes are reversed to the greatest extent in the weight loss program that includes exercise. PMID- 3288958 TI - Renal function correlates of postnatal diuresis in preterm infants. AB - A characteristic pattern of fluid homeostasis occurs in the first week of life in many preterm infants. Initially, urine output is low independent of fluid intake, subsequently a diuresis occurs, and finally urine output begins to vary with intake. Renal clearance measurements were made during each of these three phases to elucidate the renal mechanisms involved. Periods during which the ratio of urine output to fluid intake was greater than or equal to 1 and urine output was greater than or equal to 3 mL/kg/h were defined as diuretic. Of 22 preterm infants studied from 12 to 120 hours of age, 17 had at least one period of diuresis. In these infants, urine output, fluid intake rate, output to intake ratio, glomerular filtration rate, and fractional sodium excretion were lowest at 12 to 24 hours of age. During diuresis, urine output tripled without a significant change in fluid intake so that output to intake increased to levels exceeding unity. Diuresis was associated with significant increases in glomerular filtration rate and fractional sodium excretion. By 108 to 120 hours of age, urine output decreased despite an increase in fluid intake. This was accompanied by a decrease in glomerular filtration rate. These results suggest that the initial antidiuretic phase is the result of a low fractional sodium excretion in the face of a low glomerular filtration rate. Subsequently, diuresis and natriuresis occur as a result of abrupt, nonmaturational increases in glomerular filtration rate and fractional sodium excretion. With cessation of diuresis, glomerular filtration rate and fractional sodium excretion decrease and water and electrolyte output begin to vary appropriately with intake. PMID- 3288959 TI - Intraparenchymal cerebral cysticercosis in children: diagnosis and treatment. AB - Cerebral cysticercosis is being diagnosed with increasing frequency in children in the United States. A total of 52 patients with intraparenchymal cerebral cysticercosis, 21 months to 20 years of age, were observed for 2 to 72 months. Actively inflamed acute lesions, with or without coexisting chronic calcified lesions, were seen in 42 patients. Solitary lesions were seen in 39 patients, multiple lesions in 13. Chronic inactive calcified lesions were seen in ten children. A total of 51 patients had seizures that were either partial or partial with secondary generalization. Patients were treated with anticonvulsants. Praziquantel was not used. All active lesions resolved completely or with punctate calcification in 2 to 9 months, according to radiographic findings. Seizures were easily controlled. Patients were gradually weaned from anticonvulsants and in 60% no seizures recurred. Prognosis was generally good. Characteristics of the CT scans are detailed. PMID- 3288960 TI - Vesicoureteral reflux in the primate. IV. Infection as cause of prolonged high grade reflux. AB - High-grade reflux commonly lasts longer than moderate reflux, which disappears with maturation of the ureterovesical junction. It is known that ureteral function is affected by urinary tract infection from studies in experimental animals, as well as through clinical findings in patients with upper tract infection. Whether infection might affect the ability of the ureter to prolong high-grade reflux was questioned. This observation might explain why high-grade reflux does not disappear as rapidly as moderate reflux in children with recurrent urinary tract infections. Vesicoureteral reflux was produced surgically in combination with bladder neck obstruction using infant monkeys. The reflux thus produced was high grade with ureteral dilation and caliectasis. In the group of animals in which the bladder neck obstruction was relieved surgically, the reflux rapidly disappeared. In the other group, a bladder infection was produced with Escherichia coli at the time of release of the bladder neck obstruction. The reflux lasted significantly longer, an average of 18 months. Therefore, it appears that treatment of urinary tract infection rather than vesicoureteral reflux is the most important therapy. PMID- 3288961 TI - Levy-Hollister syndrome. AB - The Levy-Hollister syndrome is an autosomal dominant disorder characterized by lacrimal malformations, simple cup-shaped ears, hearing loss, hypodontia and enamel dysplasia, and upper limb malformations. Renal anomalies have been noted variably. Two families with this disorder have been described previously. Recently, a third family with the Levy-Hollister syndrome was evaluated. Unusual features present in this family included bilateral nasolacrimal duct fistulas, radial aplasia, and unusual dermal ridge patterns. Early recognition of this disorder should prompt investigation for renal anomalies and/or hearing loss. It should also lead to consideration of surgical attempts to correct the lacrimal abnormalities or conductive hearing loss, thereby reducing the long-term morbidity in affected patients. PMID- 3288962 TI - [The Pediatrics School of the I Moscow Medical Institute]. PMID- 3288963 TI - [Modern methods of medical informatics in pediatric science and practice]. PMID- 3288964 TI - [The paths of development of maternal and child welfare in the USSR]. PMID- 3288965 TI - Network for nursing research. PMID- 3288966 TI - [Tumors of the adrenal cortex--a retrospective multicenter study of a rare tumor]. PMID- 3288967 TI - [Accidentally discovered adrenal tumors--etiology, examination and treatment]. PMID- 3288968 TI - [Increased significance of direct immunofluorescence examination in dermatopathology]. PMID- 3288969 TI - Synthesis of a gene for the HIV transactivator protein TAT by a novel single stranded approach involving in vivo gap repair. AB - The synthesis of a gene for the HIV TAT protein is described using a novel approach that capitalises on the ability to synthesise oligonucleotides of greater than 100 bp in length. It involves the synthesis of large oligomers covering one strand of the desired gene in its entirety and the use of small complementary bridging and adapter oligonucleotides to direct the assembly and cloning of the large oligomers. After ligation to the cloning vector the partially single stranded intermediate is transformed directly into the recipient bacterial host where the plasmid is repaired. The synthetic tat gene has been expressed in HeLa cells and is shown to trans-activate TAR+ but not TAR- HIV LTR CAT constructs. PMID- 3288970 TI - Bacteriophage T7 late promoters with point mutations: quantitative footprinting and in vivo expression. PMID- 3288971 TI - Integration host factor of Escherichia coli regulates early- and repressor transcription of bacteriophage Mu by two different mechanisms. AB - Integration host factor (IHF) of E. coli positively regulates both early and repressor transcription of bacteriophage Mu. In this paper we show that although binding of IHF to the same binding site is responsible for both types of transcription regulation, the mechanisms by which these regulations occur are different: Activation of transcription from the early promoter (Pe) requires a helix-dependent orientation of IHF- and RNA polymerase binding sites on the DNA helix with a limited distance between both sites. Activation of repressor transcription shows no helix dependency between promoter and IHF binding site and the distance between both sites can be enlarged at least by 100 base pairs without affecting the positive control. A possible mechanism for both types of transcription stimulation will be discussed. PMID- 3288972 TI - Sequence analysis of a yeast genomic DNA fragment sharing homology with the human c-myc gene. PMID- 3288973 TI - Recruit and retain. Looking to the past. PMID- 3288974 TI - A medicolegal review of playground equipment injuries in children. PMID- 3288975 TI - Late-onset depression. AB - Clinical and biologic studies of geriatric depression are reviewed to evaluate the role of age of onset as a distinguishing parameter. The findings suggest that late-onset depressives have a different presentation, more frequent relapses, and a greater association with medical disorders, dementia, and aging-related biologic changes than early-onset geriatric depressives. Careful clinical evaluation and follow-up of late-onset depressives are suggested. Longitudinal investigations of geriatric depressed patients are needed in order to study the frequency and time of occurrence of various clinical outcomes and identify predictors of outcome in late- and early-onset geriatric depression. PMID- 3288976 TI - Late-onset bipolar disorder. AB - Mania in old age is not as rare as it was once thought to be. It may constitute up to 5 per cent of admissions in the psychogeriatric department. The clinical picture, for the most part, seems to correspond with mania in younger patients, although some patients may have atypical presentations. Secondary mania should be excluded first, before a firm diagnosis of primary affective disorder is made. The prognosis and treatment of late onset mania do not seem to differ appreciably from those in younger patients. PMID- 3288977 TI - Poststroke depression and psychosis. AB - Stroke is capable of producing a varied spectrum of neurobehavioral syndromes that may come to the attention of the mental health professional evaluating psychiatric symptoms in elderly individuals. The neurobehavioral effects may include affective or psychotic symptoms and may occur immediately after the stroke or months to years later. The presence of underlying (or pre-existing) brain disease may have an adverse effect on the resolution of the neuropsychiatric symptoms. Although there are no treatment response studies in the area of psychosis following stroke, the response of poststroke depression to antidepressants makes attempted pharmacologic treatment of symptoms justified. PMID- 3288978 TI - The late-onset psychoses. Possible risk factors. AB - Schizophrenia and depressive illness can manifest for the first time in late life. Similarities to the early-life forms of the illnesses appear to outweigh the differences. Disparities in symptoms and risk factors in the elderly likely stem from biologic and social changes that are part of the aging process. PMID- 3288979 TI - Intracranial mass lesions associated with late-onset psychosis and depression. AB - Tumors and other mass lesions of the brain may present with symptoms resembling psychosis or depression or with features of delusions, hallucinations, mania, or catatonia. There is an over-representation of tumors affecting the frontal lobe, temporal lobe, and diencephalon in patients with these manifestations. Neurologic symptoms and signs may be helpful in making an early diagnosis of the tumor. Patients with late-onset psychosis, unusual histories of depression, and those with focal neurologic findings associated with psychotic disorders should undergo computerized tomographic (CT) scanning to exclude a focal brain lesion. PMID- 3288980 TI - Late-life psychosis and modern neuroimaging. AB - A historical review of the literature on late-life psychosis (LLP) is presented with special emphasis on the relationship of structural and metabolic brain disease to this condition. The study of this patient population with modern neuroimaging is described. With the use of magnetic resonance imaging (MRI), single photon computerized emission tomography (SPECT), and computerized EEG, the authors estimate that approximately 50 to 60 per cent of cases will have structural or metabolic brain disease as a significant contributing factor to their psychosis. In their experience, silent vascular disease is seen in approximately one quarter of all cases. A logical clinical approach to these patients is presented. PMID- 3288981 TI - Neuropsychology of late-life psychoses. AB - The number of published neuropsychological studies of older psychiatric patients have been few. Moreover, almost nothing is known about the neuropsychological status of older individuals who develop psychotic symptoms for the first time later in life. Because of the spectrum of possible diagnostic considerations, careful diagnostic evaluations are of critical importance. Such evaluations should include comprehensive history-taking (using several sources), in addition to medical, psychiatric, neurologic, neuroimaging, and neuropsychological assessments. As the number of older individuals in our population grows, we will be increasingly faced with neuropsychiatric disorders that may arise de novo in the elderly. Multimodal and longitudinal investigations of older patients who develop psychotic or depressive symptoms are needed. PMID- 3288982 TI - Depression in the aged. An overview. AB - Depression in the aged is common and associated with substantial medical and social morbidity and mortality. It is often missed or misdiagnosed because of masked or somatic symptoms, delusions, and pseudodementia. At any given time, about 2 per cent of the elderly have major depression and a third to a half of older psychiatric inpatients and outpatients have mood disorders. Aged depressives have more somatization, hypochondriasis, anxiety, retardation, and delusionality but less guilt, loss of libido, and family history of depression than young ones. Both the illnesses common in the elderly and the medicines used to treat them may be etiologically connected with depression. After precipitating causes are remedied, remaining symptoms respond to antidepressant treatment. Medication doses are much lower and side effects more troublesome. ECT or concomitant antipsychotic medication are more likely to be indicated. PMID- 3288983 TI - Infantile myofibromatosis: a review of clinicopathology with perspectives on new treatment choices. AB - The fibromatoses are a heterogeneous group of disorders characterized by proliferation of fibroblasts. Infantile myofibromatosis is a variant that is distinctive because of its multicentric origin, appearance at birth, and cellular composition, which is predominantly myofibroblasts. We treated a patient with infantile myofibromatosis with the interesting clinical presentation of a linear lesion involving the left arm and shoulder, and aggressive hepatomegaly with jaundice secondary to fibroblastic infiltration of the common bile duct and gallbladder. Diagnosis was confirmed histologically and ultrastructurally. Excision of the cutaneous lesion was facilitated by tissue expansion of uninvolved regional tissue. PMID- 3288984 TI - Structure of chloramphenicol acetyltransferase at 1.75-A resolution. AB - Chloramphenicol acetyltransferase [acetyl-CoA:chloramphenicol O3 acetyltransferase; EC 2.3.1.28] is the enzyme responsible for high-level bacterial resistance to the antibiotic chloramphenicol. It catalyzes the transfer of an acetyl group from acetyl CoA to the primary hydroxyl of chloramphenicol. The x-ray crystallographic structure of the type III variant enzyme from Escherichia coli has been determined and refined at 1.75-A resolution. The enzyme is a trimer of identical subunits with a distinctive protein fold. Structure of the trimer is stabilized by a beta-pleated sheet that extends from one subunit to the next. The active site is located at the subunit interface, and the binding sites for both chloramphenicol and CoA have been characterized. Substrate binding is unusual in that the two substrates approach the active site via clefts on opposite molecular "sides." A histidine residue previously implicated in catalysis is appropriately positioned to act as a general base catalyst in the reaction. PMID- 3288985 TI - Aspartic acid substitutions affect proton translocation by bacteriorhodopsin. AB - We have substituted each of the aspartic acid residues in bacteriorhodopsin to determine their possible role in proton translocation by this protein. The aspartic acid residues were replaced by asparagines; in addition, Asp-85, -96, 115, and -112 were changed to glutamic acid and Asp-212 was also replaced by alanine. The mutant bacteriorhodopsin genes were expressed in Escherichia coli and the proteins were purified. The mutant proteins all regenerated bacteriorhodopsin-like chromophores when treated with a detergent-phospholipid mixture and retinal. However, the rates of regeneration of the chromophores and their lambda max varied widely. No support was obtained for the external point charge model for the opsin shift. The Asp-85----Asn mutant showed not detectable proton pumping, the Asp-96----Asn and Asp-212----Glu mutants showed less than 10% and the Asp-115----Glu mutant showed approximately equal to 30% of the normal proton pumping. The implications of these findings for possible mechanisms of proton translocation by bacteriorhodopsin are discussed. PMID- 3288986 TI - Mutant 16S ribosomal RNA: a codon-specific translational suppressor. AB - We have isolated an unusual codon-specific translational suppressor in Escherichia coli. The suppressor resulted from a spontaneous mutation in a chromosomal gene during a selection for suppressors of the auxotrophic nonsense mutation trpA(UGA211). The suppressor allows readthrough of UGA mutations at two positions in trpA and at two sites in bacteriophage T4. It does not, however, suppress amber (UAG) or ochre (UAA) mutations that were tested in both genomes, some of which were at the same positions as the suppressible UGA mutations. The suppressor also does not allow mistranslation of the UGA-related trpA missense mutations UGG at positions 211 and 234, AGA at 211 and 234, CGA at 211, or UGU and UGC at 234. The suppressor mutation was mapped by genetic procedures to position 89 on the E. coli genetic map. Localization of the suppressor mutation to rrnB was achieved by cloning it in the low-copy-number plasmid pEJM007 by in vivo recombination from the chromosome. Recloning in bacteriophage M13 and subsequent DNA sequence analysis allowed the identification of the suppressor mutation as a deletion of the cytidylic acid residue at nucleotide position 1054 of the 16S ribosomal RNA. The mutant EcoRI-Xba I fragment from the suppressor gene was recloned, from M13, in an otherwise wild-type rrnB in the plasmid pEJM007, and UGA suppression was examined. The UGA-suppressing activity of the reconstructed suppressor-containing pEJM007 was indistinguishable from that of the original recombinant suppressor-containing plasmid. This result demonstrates that the C1054 deletion in 16S rRNA is both necessary and sufficient for UGA suppression. The existence of this mutant suggests an important role for rRNA in codon recognition, at least for accurate polypeptide chain termination. PMID- 3288987 TI - A beta-cell-specific protein binds to the two major regulatory sequences of the insulin gene enhancer. AB - The selective transcription of the Rat insulin 1 gene is mainly dependent on a beta-cell-specific enhancer element located in the 5' flanking DNA. In analogy to many other viral and cellular enhancers, the insulin enhancer has been shown to be of a mosaic structure and the cis-acting elements of importance for the enhancer activity have been defined. Two short sequences are of crucial importance for the enhancer activity since mutation of either sequence leads to a decrease in activity (by a factor of approximately 10), and the double mutant eliminates all enhancer activity. This study shows that these two major cis acting elements interact with beta-cell-specific proteins. These two enhancer modules carry an 8-base-pair homology and compete with each other for protein binding, suggesting that they interact with the same protein, designated insulin enhancer binding factor 1 (IEF 1). Since mutation of these sequences eliminates the enhancer activity and protein binding, we propose that IEF 1 is the key regulator controlling the selective activity of the insulin gene enhancer. PMID- 3288990 TI - Use of site-directed mutagenesis to elucidate the role of arginine-166 in the catalytic mechanism of alkaline phosphatase. AB - The guanidinium group of arginine-166 has been postulated to act as an electrophilic species during phosphorylation of alkaline phosphatase. Its role could be either to stabilize the developing negative charge on the oxygen of the leaving group or the pentacoordinate transition state or to help bind the -PO2-3 group. We have produced via site-directed mutagenesis two Escherichia coli alkaline phosphatase mutants (lysine-166 and glutamine-166) to test whether the guanidinium group plays a critical role in catalysis. Comparative kinetic characterization of the lysine-166 and glutamine-166 mutants indicates that the charge at residue 166 is not required for the hydrolysis of phosphate monoesters. Small decreases in kcat are observed for both the lysine and glutamine mutants, relative to the wild-type enzyme, but the value for the uncharged glutamine mutant is only one-third that of lysine. Thus, the stabilizing effect of the positively charged guanidinium group does not appear to play a major role in the rate-limiting step for substrate hydrolysis. A significant effect on the Km value is seen only for the glutamine mutant. PMID- 3288989 TI - Malignant transformation by ras and other oncogenes produces common alterations in inositol phospholipid signaling pathways. AB - The role of ras proteins in signal transduction was assessed by studying inositol phospholipid metabolism and inositol phospholipid-mediated cellular responsiveness to agonists in cells transformed by ras and other oncogenes. Specific alterations were observed in the inositol phospholipid cycle of ras transformed fibroblasts, but similar changes were also produced by spontaneous transformation or transformation mediated by either membrane-associated oncogenes, such as src, met, or trk, or cytoplasmic oncogenes, mos and raf; the nuclear oncogenes fos and myc did not produce these changes. The alterations included (i) stimulation of phospholipase A2 activity as indicated by elevated levels of glycerophosphoinositol and nonesterified arachidonic acid and (ii) specific uncoupling between surface receptor-mediated stimulation by platelet derived growth factor, bombesin, or serum and activation of intracellular phospholipase C. These findings suggest the existence of common biochemical pathways for transformation by cytoplasmic and membrane-associated oncogenes and are not consistent with the hypothesis that 21-kDa ras proteins (p21) are direct or distinct regulatory elements of phospholipase C or phospholipase A2 in inositol phospholipid signal transduction pathways. PMID- 3288988 TI - Codon choice and gene expression: synonymous codons differ in their ability to direct aminoacylated-transfer RNA binding to ribosomes in vitro. AB - Phe-tRNA (anticodon GAA)--polypeptide-chain elongation factor Tu-GTP ternary complexes react faster with ribosomes programmed with UUC codons than with ribosomes programmed with UUU codons. A similar preference is shown by Leu-tRNA2 (anticodon GAG) complexes, which react faster with ribosomes programmed with CUC than with those programmed with CUU. The difference is seen in the rate of ternary-complex binding to the ribosome; no differences are seen in peptide-bond formation. Highly expressed mRNAs in Escherichia coli favor codons terminating in cytosine rather than uracil when both codons are read by a single tRNA with an anticodon beginning with guanine. The results suggest that intrinsic differences between the efficiencies of synonymous codons play an important role in modulating gene expression in E. coli. PMID- 3288991 TI - NIH-3T3 cells transformed by the EJ-ras oncogene exhibit reduced platelet-derived growth factor-mediated Ca2+ mobilization. AB - NIH-3T3 cells transformed by the EJ-ras oncogene synthesize only 10-15% as much inositol 1,4,5-trisphosphate (InsP3) as control cells after stimulation with platelet-derived growth factor (PDGF). This is despite the fact that the basal (unstimulated) levels of InsP3 synthesized in control and EJ-ras-transformed cells are not significantly different. Using the fluorescent indicator fura-2 and digital-imaging techniques, we have visualized and quantified changes in intracellular Ca2+ concentrations in control and EJ-ras-transformed NIH-3T3 cells in response to PDGF. Within 3 min after exposure of control cells to PDGF, intracellular Ca2+ levels are increased 3- to 9-fold, paralleling the increase in InsP3. In contrast, the majority (greater than 90%) of the EJ-ras-transformed cells show no increase in Ca2+ levels after PDGF exposure and the few that did respond exhibited only a small transient increase. Pronounced differences in the intracellular localization of Ca2+ increases in control and the responding EJ-ras transformed cells were also observed. Despite the inhibition of InsP3 synthesis and subsequent Ca2+ mobilization, the EJ-ras-transformed cells respond mitogenically to PDGF. These data do not support the hypothesis that the EJ-ras gene product (p21) stimulates a phosphatidylinositol 4,5-bisphosphate-specific phospholipase C in NIH-3T3 cells; instead they suggest that the EJ-ras p21 may uncouple the PDGF receptor from phospholipase C resulting in inhibition of PDGF stimulated activity of phospholipase C, InsP3 synthesis, and Ca2+ mobilization. PMID- 3288992 TI - Analysis in serum-free culture of the targets of recombinant human hemopoietic growth factors: interleukin 3 and granulocyte/macrophage-colony-stimulating factor are specific for early developmental stages. AB - We have used a serum-free culture system for enriched human hemopoietic progenitors to analyze the developmental stages and lineage specificities of the human hemopoietic colony-stimulating factors. None of the individual factors alone efficiently supported hemopoietic colony formation. Neither interleukin 3 nor granulocyte/macrophage-colony-stimulating factor alone or in combination effectively supported proliferation of progenitor cells. However, when combined with granulocyte-colony-stimulating factor or erythropoietin, these factors yielded neutrophil colonies or erythroid bursts, respectively. Serial observations of interleukin 3-supported cultures revealed sequential emergence and subsequent degeneration of clusters of cells. These observations suggest that the primary targets of interleukin 3 and granulocyte/macrophage-colony stimulating factor are multipotent progenitors at the early stages of development rather than cells in the terminal process of maturation. PMID- 3288993 TI - DNA base sequence changes and sequence specificity of bromodeoxyuridine-induced mutations in mammalian cells. AB - By using a shuttle vector system developed in our laboratory, we have carried out studies on the molecular mechanism by which 5-bromodeoxyuridine (BrdUrd) induces mutations in mammalian cells. The target for mutagenesis in these studies was the Escherichia coli gpt gene that was contained within a retroviral shuttle vector and integrated into chromosomal DNA in mouse A9 cells. Shuttle vector-transformed cells expressing the gpt gene were mutagenized with BrdUrd and cells with mutations in the gpt gene were selected. Shuttle vector sequences were recovered from the mutant cells, and the base sequence of the mutant gpt genes was determined. The great majority of the BrdUrd-induced mutations involving single base changes were found to be G.C----A.T transitions. We have shown that mutagenesis by BrdUrd depends upon perturbation of deoxycytidine metabolism. Thus, the current results suggest that BrdUrd mutagenesis involves mispairing and misincorporation of BrdUrd opposite guanine in DNA, driven by nucleotide pool perturbation caused by BrdUrd and the resulting imbalanced supply of triphosphates available for DNA synthesis. The results also revealed a very high degree of sequence specificity for the BrdUrd mutagenesis. BrdUrd-induced G.C--- A.T transitions occurred almost exclusively in sequences with two adjacent guanine residues. Furthermore, in approximately equal to 90% of the cases, the guanine residue involved in mutation was the one in the more 3' position. PMID- 3288994 TI - Site-specific binding of viral plus single-stranded RNA to replicase-containing open virus-like particles of yeast. AB - X double-stranded RNA is a deletion mutant of L-A double-stranded RNA and is encapsidated in viral particles by the L-A-encoded major coat protein. X double stranded RNA has all the cis sites necessary to be transcribed, encapsidated, and replicated. We have cloned X double-stranded RNA and sequenced it. The complete X double-stranded RNA sequence deduced indicates that the first 25 bases of the X plus-strand 5' end originated from the 5' end of the L-A plus strand and that most, if not all, of the rest comes from the 3' end of the L-A plus strand. The X plus strand made by X double-stranded RNA-containing virus-like particles binds specifically to empty open virus-like particles and is converted by these particles to X double-stranded RNA. RNA transcripts of the X complementary DNA clones and deletion derivatives thereof were made in vitro by T7 and T3 RNA polymerases and tested for specific binding to the virus-like particles. The results suggest that the binding is due to the sequence UUUGGCCAGG, 370 bases upstream from the X plus-strand 3' end. This sequence is also present in the M1 plus strand 140 bases from its 3' end. PMID- 3288995 TI - Dominant negative protein kinase mutations that confer a G1 arrest phenotype. AB - The CDC28 gene of Saccharomyces cerevisiae encodes a protein kinase that is required for passage through the G1 phase of the cell cycle. We have used an inducible promoter fused to the CDC28 coding sequence to isolate conditionally dominant mutant alleles of CDC28. Overexpression of these dominant alleles causes arrest in the G1 phase of the cell cycle but permits the distinctive asymmetric growth that is characteristic of recessive temperature-sensitive cdc28 mutants. The dominant alleles encode products with no detectable protein kinase activity, and their phenotypic effects can be suppressed by simultaneous overproduction of the wild-type protein. DNA sequence analysis showed that the mutant site in at least one of the dominant alleles is in a residue that is highly conserved among protein kinases. These properties are best understood if the dominant mutation results in the catalytic inactivation of the protein kinase but still allows the binding of another component needed for CDC28 function. By this model, high levels of the mutant protein arrest cell division by denying the wild-type protein access to this other component. Suppressors that may encode this other component have been isolated on high-copy-number plasmids. PMID- 3288997 TI - Drug update: the insulins. PMID- 3288996 TI - Immunological identification of a high molecular weight protein as a candidate for the product of the Duchenne muscular dystrophy gene. AB - An oligopeptide was synthesized based on translation of the nucleotide sequence of the putative exon region of clone pERT87-25 from the gene for Duchenne muscular dystrophy. Immunization of rabbits with this oligopeptide induced the formation of antibodies directed against a protein present in human, rat, and rabbit skeletal muscle. This protein, which is missing in the skeletal muscle of two patients with Duchenne muscular dystrophy, has a molecular mass of approximately equal to 320-420 kDa and is clearly different from the putative Duchenne muscular dystrophy-related protein nebulin. The data suggest that this 320- to 420-kDa protein is produced by the Duchenne muscular dystrophy gene. PMID- 3288998 TI - Primary site of the huge increase in resistance upon inhibition of gastric acid secretion with hypotonic secretory solution. AB - In summary, in this paper previous as well as some new results are presented for analysis. It has been shown for the in vitro frog gastric mucosa, with secretory solutions hypotonic relative to the nutrient solution, that inhibition of acid secretion produces a large increase in the transmucosal resistance, Rt. We have shown on the basis of electrophysiological findings that the large increase in Rt is due to an increase in the resistance of the pit and tubular lumina and that the primary factor in this increase is a decrease in luminal area. We have shown that the low transmucosal resistance of the fundus (the acid-secreting portion of the stomach) under standard conditions is due to a low resistance of the lumen tubular (acid-secreting) cell pathway and that the parallel pathways have high resistances. The latter conclusion is important in deciding among the various models for the mechanism of acid secretion. The histological findings are qualitatively predicted by the electrophysiological results. The limitations of present histological techniques for a quantitative determination of the area of the lumina have also been discussed. PMID- 3288999 TI - Characteristics and regulation of active transport in lungs from young and aged mammals. AB - From the data presented here, it appears that the ability to stimulate solute (and water) clearance from the alveolar spaces may decrease with aging. This implies that the management of elderly patients with respiratory diseases or complications may necessitate a different approach than that useful in younger patients. Many of the active transport mechanisms well-characterized in other epithelia now seem to be important for maintaining the alveolar air spaces in their normally "dry" condition in the lungs of fetal and young, sexually mature mammals. In situations in which excess fluid is present in the air spaces of the lung, it is likely that the normal regulation of these active transport processes may play a major processes may play a major role in alveolar fluid clearance. Various exogenous agents may be helpful in stimulating the active solute and water reabsorption from air space to vascular space in both fetal and young sexually mature mammals. Further studies on the effects of aging on the characteristics and regulation of lung fluid balance are still needed. PMID- 3289000 TI - Efficacy of nicotine chewing gum: a review. PMID- 3289001 TI - Dose and nicotine dependence as determinants of nicotine gum efficacy. PMID- 3289002 TI - Conceptual basis of replacement therapies for chemical dependence. PMID- 3289003 TI - Nicotine replacement as sole therapy or as adjunct. PMID- 3289004 TI - Smoking relapse: the role of pharmacological and behavioral factors. PMID- 3289005 TI - Toxicity of nicotine: implications with regard to nicotine replacement therapy. PMID- 3289006 TI - Safety of nicotine-containing gum. PMID- 3289007 TI - Nicotine: a dependence-producing substance. PMID- 3289008 TI - Dependence potential and abuse liability of nicotine replacement therapies. PMID- 3289009 TI - Nicotine replacement: an overview. PMID- 3289010 TI - Pharmacologic basis for nicotine replacement. PMID- 3289012 TI - Is bronchial hyperresponsiveness in humans a smooth muscle abnormality? PMID- 3289011 TI - Nicotine replacement: the role of blood nicotine levels, their rate of change, and nicotine tolerance. PMID- 3289013 TI - Heat and water loss from the airways as a provoking stimulus for asthma. PMID- 3289014 TI - Non-pharmacological modulators of airway responsiveness. PMID- 3289015 TI - Role of eicosanoids in airway smooth muscle tone. PMID- 3289016 TI - The role of PAF in altered airway responsiveness. PMID- 3289017 TI - Immunological mediators. AB - As a central mediator of inflammation, cachectin is an isolated target for pharmacotherapeutic intervention. It has been demonstrated that mice treated with a polyclonal antiserum directed against mouse cachectin become resistant to the lethal effect of lipopolysaccharide. Thus, it would seem possible that neutralizing monoclonal antibodies directed against human cachectin may prove to be useful in the treatment of sepsis and septic shock, particularly in its early stages. Once it becomes possible in vivo to quantify cellular activation and production of these cytokines, the development of septic and possibly traumatic shock will be easier to monitor and more rational therapeutic approaches will be found. PMID- 3289018 TI - The splanchnic organs as the source of toxic mediators in shock. AB - The splanchnic organs, and especially the pancreas and the small intestine, are susceptible to injury during ischemia and shock and the following reperfusion. This particular tissue injury is associated with a release of cardiotoxic and other toxic mediators which further aggravate the shock condition, leading to further tissue injury etc. Thereby a vicious circle is created, which is likely to contribute to collapse and death. PMID- 3289020 TI - Mechanisms of non-penetrating head injury. PMID- 3289019 TI - Cerebral circulation in hypoxia and ischemia. AB - In conclusion our results clearly suggest that vital functions of the brain, in spite of its well developed autoregulation are impaired during prolonged hypovolemic conditions. Regional cerebral blood flow measured by the 133Xe clearance and 14C-antipyrine autoradiographic techniques demonstrated a progressive reduction in CBF, with the development of patchy and circumscribed ischemic areas during hemorrhagic shock which persisted after reinfusion. The regional distribution of the underperfused regions cannot be explained solely in terms of boundary zones between the main distribution fields of major cerebral arteries. Our results suggest the involvement of the sympathetic nervous system in the impairment of cerebral microcirculation during hemorrhagic shock. The patchy focal brain damage could be the background of the functional impairment. The focal appearances suggests that, in addition to generalized (blood borne) changes, local factors play an important role in the production of ischemic areas in the brain. Afferent neural nociceptive input to the brain seems to be elevated during shock. It may be presumed that this leads to increased tissue metabolism and the accumulation of metabolites. The low flow combined with elevated neuronal activity and cellular metabolism produces an imbalance between oxygen delivery and oxygen utilization. The local nature of afferent activation of the CNS can explain the regional impairment in the brain tissue. Nociceptive afferent stimulation increases, while denervation of the carotid sinus or transsection of the vagus or spinal afferent pathways decreases the sensitivity to shock. We have presented further evidence that stimulation of the C-fibres of the sciatic nerve reduced local cerebral blood flow and the tissue PO2 in the n. VPL thalami and VM hypothalami in cardiovascularly restricted (stabilized blood pressure) animals. Concerning the subcellular events that may lead to neuronal death during hemorrhagic shock, we believe that the depletion of high energy phosphates initiates those complex changes which result in the loss of the viability of the affected cells. In this process the increase of free calcium in the cytosol probably plays a crucial role. PMID- 3289021 TI - The pharmacological basis for the treatment of brain ischemia and hypoxia. PMID- 3289022 TI - Organ specific metabolic changes in shock. PMID- 3289023 TI - Cardiovascular reflex function after injury. PMID- 3289025 TI - Metabolic and immunologic alterations of sepsis in the elderly. PMID- 3289024 TI - Neonatal sepsis: metabolic and hormonal considerations. PMID- 3289026 TI - Hypermetabolism/organ failure: the role of the activated macrophage as a metabolic regulator. AB - Multiple organ failure continues as the main cause of death after burns, trauma and sepsis. This clinical syndrome represents the transition from a hypermetabolic response to injury to a setting of clinical organ failures and death. Risk factors include: perfusion deficits, persistent foci of dead or injured tissue, an uncontrolled focus of infection, the presence of the respiratory distress syndrome, persistent hypermetabolism, and preexisting fibrotic liver disease. Once in the organ failure syndrome, most treatment modalities become progressively ineffective, including: ventilation, antibiotics, nutrition, and surgery. The best treatment remains prevention with rapid control of the source and restoration of oxygen transport. The response to injury involves alterations in physiology and in the metabolism of carbohydrate, fat and amino acids. These changes seem to reflect the modulation of the end-organs by the mediator systems activated in response to the stress stimulus. The transition from hypermetabolism to organ failure appears to reflect the clinical appearance of liver failure. It is currently hypothesized that this liver failure represents a state of regulatory dysfunction induced by the activated hepatic macrophage, the Kupffer cell. This same process may also influence metabolic failure in other organs where this cell-cell regulation can occur, e.g. kidney, lung. The activation of these macrophages is hypothesized to represent the final stage of a series of continuous stimulating events, eg. hypoxia, endotoxin, bacteria, and gut translocated toxins. The precise monokine(s) responsible are not yet completely characterized. Treatment consists of the modalities outlined above and the employment of aggressive metabolic (nutritional) support. PMID- 3289027 TI - Aspects of central and peripheral adrenergic mechanisms in experimental shock. PMID- 3289028 TI - Glucagon: a potentially important hormone in circulatory shock. PMID- 3289029 TI - Cellular aspects of shock, sepsis and burns: mechanisms of cell injury. PMID- 3289031 TI - Glucoregulatory effects of interleukin-1: implications to the carbohydrate dyshomeostasis of septic shock. PMID- 3289030 TI - Quantitative ultrastructure of skeletal and cardiac muscle in hyperdynamic sepsis. PMID- 3289032 TI - Murine monoclonal antibody directed against lipopolysaccharide (LPS) inhibits Kupffer cell activation by endotoxin in vitro. PMID- 3289033 TI - Tissue mechanisms of postinjury hypermetabolism. PMID- 3289034 TI - Design and conduct of clinical trials: development of a clinical study based on animal data. AB - There are numerous animal research studies documenting the effectiveness of corticosteroid and antibiotic therapy in E. coli-induced shock. Findings from other reports show equally effective treatment of shock induced by endotoxin, using corticosteroid without antibiotics. Early treatment using pharmacologic doses of corticosteroid is very effective in several species of animals in preventing or ameliorating the pathophysiologic changes induced by E. coli or endotoxin, and enhancing the probability of permanent survival (more than 7 days). This form of treatment given acutely (first 12 hours) produces no observable detrimental effects in animal models. It was considered of extreme importance to determine if this particular therapy had successful human application. Results from previous clinical studies evaluating the effectiveness of corticosteroid in severe sepsis/septic shock were in marked conflict. We accepted the challenge to design a clinical study to determine if there were human subgroup populations with severe sepsis who responded similarly to the animal treated with corticosteroid. PMID- 3289035 TI - General statistical design considerations of randomized clinical trials. AB - Randomized clinical trials are the most objective method for evaluating new therapies, but they are subject to the same biases as nonrandomized studies unless the principles of statistical design are observed at the planning stage. Estimation of sample size also requires early careful consideration, since studies of inadequate size will not have sufficient statistical power to detect meaningful treatment differences. For ethical reasons, interim data monitoring procedures should be used to detect early treatment responses that may lead to alteration or interruption of the planned study to give patients early benefit from a superior treatment or diminish their risk from ineffective or harmful treatment. Additional important aspects of clinical trial design that were not addressed in this report include: definition of study objectives and endpoints, description of data to be collected, details of the treatment regimens, informed consent and plans for data analysis. The science of clinical trial design is complex; only some of the key statistical issues have been addressed briefly in this report. PMID- 3289036 TI - Mechanisms of cell injury in low-flow, normal-flow and no-flow anoxia. PMID- 3289037 TI - Design and conduct of clinical trials in systemic sepsis. Critical analysis of VA Cooperative Study No. 209. PMID- 3289038 TI - Development of VA clinical trials, Cooperative Study 209 in perspective, dilemmas of the clinical trial. PMID- 3289039 TI - Vasoactive humoral mediators and the splanchnic circulation in shock. PMID- 3289040 TI - T lymphocyte-dependent mechanisms of fibrosis. PMID- 3289041 TI - Metabolic cooperativity within wounded tissue: hormone-nutrient interactions. PMID- 3289042 TI - Carbohydrate and energy metabolism in healing wounds. PMID- 3289043 TI - Molecular regulation of growth control: implications for wound healing. PMID- 3289044 TI - Effect of various types of injury on proteolysis in normal muscle. PMID- 3289045 TI - The role of connective tissue matrix in wound healing. PMID- 3289046 TI - Role of fibronectin in epithelialization and wound healing. PMID- 3289047 TI - The use of platelet derived wound healing formula in human clinical trials. PMID- 3289048 TI - Mechanisms of accelerated wound repair using epidermal growth factor and basic fibroblast growth factor. PMID- 3289049 TI - Acetylcholine and brain aging. PMID- 3289050 TI - [Solubility and rate of dissolution in lipoid vehicles]. PMID- 3289051 TI - Functional mechanisms of temperature regulation, adaptation and fever: complementary system theoretical and experimental evidence. PMID- 3289053 TI - Importance of the thiol disulfide status of microtubule proteins for antimitotic drug action. PMID- 3289052 TI - Age and diet effects on drug action. PMID- 3289054 TI - Effects of cancer disease on the metabolism of anticancer agents. PMID- 3289055 TI - Effects of methionine and other sulfur compounds on drug conjugations. PMID- 3289056 TI - 1987 Douglas Lea memorial lecture. Particle dosimetry in bone and the toxicity of bone-seeking radionuclides. AB - Consideration is given to the tissues at risk in bone and a Monte Carlo method is described which determines the absorbed dose to endosteal tissues and marrow in trabecular bone. The method synthesizes random tracks through the trabecular structures that deposit energy along a path through any given trabecular cavity. The path lengths through the trabeculae and marrow cavities are measured with a bone-scanning microscope and other bone data, such as trabecular surface areas, can also be derived. Results are given for human bones and for bones of the beagle, miniature pig and rhesus monkey. They show that, for the same radionuclide concentration, the doses to endosteal tissues and bone marrow are several times greater in animal than in human bone, and that higher doses in human bone from the Ca and Sr radionuclides are obtained if the initial deposition on bone surfaces is allowed for. Other studies show that the occurrence of osteosarcoma in the human long bones correlates well with trabecular surface area and also that, unlike the case of beta-particles from 90Sr+90Y, leukaemia is not a significant consequence of the alpha-particle doses from 226Ra in human bone or from 226Ra, 239Pu and other alpha emitters in beagle bone. PMID- 3289057 TI - Membrane damage and recovery associated with growth delay induced by near-UV radiation in Escherichia coli K-12. PMID- 3289058 TI - Inactivation and mutation induction to 6-thioguanine resistance in V79 hamster fibroblasts by simulated sunlight. PMID- 3289059 TI - The American Board of Plastic Surgery: in pursuit of excellence. PMID- 3289060 TI - The fall of Asklepios: medicine, morality, and money. PMID- 3289062 TI - The American Board of Plastic Surgery, 1937-1987. PMID- 3289061 TI - Venous air embolism during a craniofacial procedure. AB - The possibility of venous air embolism exists whenever the craniofacial operative field is above the level of the heart. Craniotomy with the high-torque craniotome is hypothesized to have produced venous air embolism in the patient described in this report. The diagnosis of venous air embolism is determined by transesophageal Doppler probe, transesophageal echocardiogram or external echocardiogram, and end-tidal N2 and CO2 determinations. Treatment includes control of the air entry sites, aspiration of air from the right atrium via a catheter placed prior to operation, and discontinuing nitrous oxide. If these measures are unsuccessful, the operative field should be transposed below heart level and the procedure terminated. In the event of significant hemodynamic compromise, closed cardiac massage should be tried; if that fails, open cardiac massage and direct aspiration are necessary. The true incidence of venous air embolism in craniofacial operations may be much higher than previously suspected. We therefore recommend placement of appropriate monitoring equipment to detect intracardiac air in those major craniofacial procedures in which there is a potential for intravascular air ingress. PMID- 3289063 TI - Polyvinylchloride for increasing take of skin grafts. PMID- 3289064 TI - Staples to secure skin grafts. PMID- 3289065 TI - Sir A. Michael Wood, 1919-1987. PMID- 3289066 TI - Surgical correction of hemifacial microsomia in the growing child. AB - This is a follow-up study of 20 children who had surgical correction of hemifacial microsomia in an effort to improve facial growth and minimize secondary distortion. In group 1 (skeletal types I and IIA), 10 children underwent elongation and lengthening of the mandible. In group 2 (skeletal types IIB and III), 10 children had total construction of a new temporomandibular joint and mandibular ramus with rib grafts and costochondral junction. In both groups, an open bite was created on the affected side to provide space for tooth eruption and downward growth of the middle face. The mean follow-up was 50.9 months (18 to 117 months) in group 1 and 45 months (18 to 50 months) in group 2. Analysis of our early results showed that all patients have had downward growth of the midface on the affected side. All five patients in group 1, followed to complete closure of the surgically created open bite, have maintained a level occlusal plane. In group 2, the one patient followed to completion of facial growth continues to have a level occlusal plane and facial symmetry. Appropriately timed mandibular construction and/or elongation in children with hemifacial microsomia is safe and effective. There is a decrease in secondary deformity on the affected side, and the eventual overall facial growth is optimized. Some group 2 children will need secondary elongation and augmentation of the mandible. Nevertheless, this study demonstrates that early mandibular correction may obviate the need for maxillary and orbital procedures in adulthood. PMID- 3289067 TI - Clinical application of autologous cultured epithelia for the treatment of burn wounds and burn scars. AB - This report presents our experience with autologous cultured human epithelia grafting on burn wounds, burn scars, and skin-graft donor sites in seven patients. Dispersed epidermal cells were cultured with 3T3 cells treated with mitomycin C. After 2 to 3 weeks, cultured epithelia (total 350 to 2250 cm2) were grafted to the wound. The results showed that cultured epithelia grafts did not take so completely compared to the meshed skin grafts used for the coverage of burn wounds. However, cultured grafts placed on aseptic wounds adhered well and showed good appearance. In the histologic findings, normal differentiation of epidermal cells was found. Cultured grafts were bordered from subepidermal granulative tissue with basement membrane. A rete ridge and the adnexal structures were absent in the specimens that adhered to the burn wounds. However, in the specimens that took on abraded wounds, a gently sloping rete ridge and elastic fibers were seen. The histologic findings showed structures resembling normal skin. PMID- 3289068 TI - [Correlation of physical and psychological aspects in alcohol and drug dependence]. AB - Dependence to alcohol and drug must be consistently viewed as the consequence of a combination of physical and psychological elements. This is substantiated both philosophically and by taking issue with dualist concepts as well as those which absolutize the psychological aspect. The medical definition of dependence as an illness should be adhered to, whilst at the same time recognizing that psychological and social factors play a determining role. PMID- 3289069 TI - [The French mental health law of 1938]. AB - Prehistory, attendant circumstances, and consequences are scrutinised on the occasion of the 150th anniversary of the first wide-ranging law on the treatment of the feeble-minded in France, forerunner of all subsequent laws on the matter. PMID- 3289070 TI - Relative contribution of specific and nonspecific treatment effects: meta analysis of placebo-controlled behavior therapy research. PMID- 3289072 TI - Reconceptualizing arousal: psychobiological states in motor performance. PMID- 3289071 TI - The relation of empathy to aggressive and externalizing/antisocial behavior. PMID- 3289073 TI - Motion artifacts in brain and spine MR. AB - As a result of the effects of cerebrospinal fluid and blood motion, motion artifacts are common in brain and spine MR imaging. These artifacts, which are most common on T2-weighted spin-echo sequences, show up as streaking and ghosting in the phase-encoding (PE) direction (PE artifacts) and as loss of signal from flowing material (flow void). A review of the physical and physiologic causes of these artifacts and a review and explanation of several techniques that are useful in reducing or eliminating them are presented in this article. PMID- 3289074 TI - Common congenital brain anomalies. AB - Craniocerebral malformations remain enigmas to many radiologists because their pathogeneses are obscure, noninvasive imaging modalities could not display them in detail until recently, and concise classifications have been lacking. In this article the MRI findings of the most common congenital brain malformations are presented with an emphasis on the characteristic features of each malformation and the clinical symptoms and course. PMID- 3289075 TI - Magnetic resonance imaging of intracranial hemorrhage. AB - The appearance and evolution of intracranial hemorrhage as detected by magnetic resonance (MR) imaging is complex. This article outlines the underlying physiology of hemorrhagic masses in order to explain their complex appearance. The MR appearance of intraparenchymal (benign and neoplastic) and extraparenchymal intracranial hemorrhage is described. PMID- 3289076 TI - Intracranial vascular malformations and aneurysms. Current imaging applications. AB - Cerebral angiography traditionally has been the mainstay of diagnosis in the evaluation of intracranial vascular malformations and, in fact, continues to be the definitive modality for the study of these lesions. However, recent advances in magnetic resonance imaging have resulted in exquisitely detailed noninvasive characterization of intracranial vascular pathology, so that assessment of the lesion itself as well as the associated intracerebral pathology can often be made on anatomic, temporal, and histopathophysiologic bases. This article discusses current imaging techniques in the diagnosis of intracranial vascular malformations and aneurysms. PMID- 3289077 TI - The magnetic resonance imaging of infections and inflammatory diseases. AB - The MR features of inflammatory lesions of the central nervous system are reviewed in this article, and the sensitivity and specificity of MR and CT in the detection of these lesions are compared. The advent of CT dramatically improved the morbidity and mortality of inflammatory disease by facilitating earlier and more accurate diagnosis which, in turn, produced more timely medical and surgical intervention. The efficacy of MR in the evaluation of inflammatory lesions must, therefore, be compared to CT in order to accurately asses its role. PMID- 3289078 TI - MR contrast enhancement of intracranial lesions with Gd-DTPA. AB - Gd-DTPA is a paramagnetic contrast agent for MR that produces enhancement of lesions on T1-weighted images. Since it does not cross the intact blood-brain barrier (BBB), Gd-DTPA enhances only those pathologic processes that are associated with breakdown of the BBB and structures or lesions that are devoid of a BBB. Gd-DTPA improves conspicuity, helps characterize and delineate the extent of lesions, and increases the sensitivity for detection of cerebral abnormalities. PMID- 3289079 TI - [Current problems in osteoporosis from the clinical and radiologic viewpoints]. AB - Osteoporosis is a disease leading to enhanced fragility of bone in association with minimal trauma. This is because of thinning and rarefaction of spongy and cortical bone. Initially, osteoporosis is often only detectable in the spine; later, peripheral cortical bone is also affected. Osteoporosis mainly is a problem associated with postmenopausal bone loss (PMO). With the increasing use of technique evaluating bone density, non-PMO-associated osteoporosis can be increasingly detected. In early menopause, estrogen substitution prevents further bone loss; in severe cases strategies to increase bone mass are under investigation and are very effective in the patients tested so far. Radiological methods are of value to diagnose osteoporosis and monitor the efficacy of treatment. Density measurement of trabecular and cortical spinal bone with computed tomography seems to be the technique of choice. Peripheral measurements must still prove their value, however. The advantage of quantitative CT is its capacity, selectively and reproducibly, to determine distinct bone structures like cortical or trabecular bone. Normal lateral X-ray films of the spine are essential to assess vertebral deforming events and exclude further wedging during therapeutic trials. PMID- 3289080 TI - [Comparative bone density measurements in healthy women and women with osteoporosis]. AB - To compare methods of noninvasive measurement of bone mineral content, 40 healthy early postmenopausal women and 68 postmenopausal women with osteoporosis were studied. The methods included mono- and dual-energy quantitative computed tomography (QCT) and dual-photon absorptiometry (DPA) of the lumbar spine, single photon absorptiometry (SPA) of the distal third of the radius, and combined cortical thickness (CCT) of the second metacarpal shaft. Lateral thoracolumbar radiographic studies were performed and the spinal fracture index calculated. There was good correlation between QCT and DPA methods in early postmenopausal women and moderate correlation in postmenopausal osteoporotic women. Correlations between spinal measurements (QCT or DPA) and appendicular cortical measurements (SPA or CCT) were moderate in healthy women and poor in osteoporotic women. Measurements resulting from one method were not predictive of measurements obtained by another method for individual patients. The strongest correlation with severity of vertebral fracture was provided by QCT and the weakest by SPA. There was good correlation between single- and dual-energy QCT results. Osteoporotic women and younger healthy women can be distinguished by the measurement of spinal trabecular bone density using QCT, and this method is more sensitive than the measurement of spinal integral bone by DPA or of appendicular cortical bone by SPA or CCT. PMID- 3289081 TI - [Quantitative determination of bone mineral content by double-spectrum computer tomography]. PMID- 3289082 TI - [New developments in bone density measurement by quantitative computer tomography]. AB - The standard procedure in bone mineral measurements of the lumbar spine with QCT is presented in detail and analyzed with respect to the steps that may influence the accuracy and precision of the measurement. As new technical and methodological approaches, we present an improved implementation of dual energy CT and algorithms for automated determination of the CT slice and the evaluation region of interest. Dual energy methods provide greater accuracy; the automated algorithms relieve the operator of a tedious task and ensure greater precision. With respect to the clinical requirement to determine changes in bone mineral density as reliably and as early as possible, the precision increasing measures are considered more important. They also constitute a new methodological concept in radiology. Dual energy CT is only recommended for basic studies at this time. PMID- 3289083 TI - [Nuclear medicine methods for the determination of bone mineral content]. AB - Osteoporosis is becoming recognized as a major social and economical health problem. Bone mineral content (BMC) depends on many hormonal and metabolic factors. The pathophysiological mechanism of the loss of bone mass is still unclear. For preventive diagnosis and treatment of osteoporosis, quantitative technology is required that will measure BMC with high precision and reproducibility. Nuclear medical methods permit the BMC of the appendicular skeleton to be measured by single photon absorptiometry. Whole-body BMC, as well as spine and femur BMC, can be measured by dual photon absorptiometry. The results from both procedures are reasonably precise and correlate well with the ash weight of isolated bone. The radiation exposure level in both SPA and DPA is low. SPA and DPA may be used for cost-effective screening of high-risk patients to predict the likelihood of future fractures and control osteoporosis therapy. PMID- 3289084 TI - Feasibility of high-resolution, intravascular ultrasonic imaging catheters. AB - A small-aperture, prototype ultrasonic imaging system, typical of the size necessary to be embedded in a catheter, was developed to evaluate the feasibility of intravascular ultrasonic imaging catheters (UICs). The evaluation included in vitro imaging of postmortem samples of human femoral and iliac arteries with the UIC prototype and a high-resolution magnetic resonance (MR) proton imager. Excellent correlations between results from the UIC images, MR images, and tissue specimens were demonstrated. Although the current prototype is too large to be useful in examination of smaller vessels such as coronary arteries, the signal-to noise ratio and resolution obtained indicate that imaging with intravascular UICs is feasible and may have significant diagnostic value. PMID- 3289085 TI - Suspected leaking abdominal aortic aneurysm: use of sonography in the emergency room. AB - To determine the value of sonography in the emergent evaluation of suspected leaking abdominal aortic aneurysms, the authors examined 60 patients in the emergency department using sonography and a protocol involving advance radio notification from the ambulance; arrival of sonographic personnel and equipment in the triage room before patient arrival; and, during other triage activities, rapid sonographic evaluation of the aorta for aneurysm and of the paraaortic region for extraluminal blood. Sonographic findings were correlated with surgical results and clinical outcome. When performed under these circumstances, sonography was accurate in demonstrating presence or absence of aneurysm (98%), but its sensitivity for extraluminal blood was poor (4%). A combination of sonographic confirmation of aneurysm, abdominal pain, and unstable hemodynamic condition resulted in the correct decision to perform emergent surgery in 21 of 22 patients (95%). An abbreviated sonographic examination done in the emergency room can provide accurate, useful information about the presence of aneurysm; this procedure does not significantly delay triage of these patients. PMID- 3289086 TI - Retroperitoneal and pelvic hemangiopericytomas: clinical, radiologic, and pathologic correlation. AB - Seventeen cases of hemangiopericytoma of the retroperitoneum were retrospectively analyzed for demographic, morphologic, and radiologic features. These tumors were found in all age groups (2 months to 72 years) and occurred in similar numbers of male and female patients. The tumors tended to be large (11 were greater than 8 cm), were well encapsulated, and occurred less frequently in the pelvic retroperitoneal space (six cases) than in abdominal retroperitoneum (11 cases). All tumors were bulky enough to displace part of the gastrointestinal tract, with only two being inoperable. The most distinctive radiologic feature was hypervascularity (found on 11 of 11 angiograms). Other nondiscriminating radiologic features included well-defined margins and necrosis, with nondistinctive amorphous calcification identified in one case. Angiographic or computed tomographic demonstration of hypervascularity in a retroperitoneal tumor is more suggestive of hemangiopericytoma than of a liposarcoma or malignant fibrous histiocytoma, two of the more common tumors of this region. PMID- 3289087 TI - Intussusception in infants and children: diagnosis and therapy. AB - Intussusception represents the most common abdominal emergency of early childhood. Despite its prevalence, there is controversy concerning diagnosis and therapy. The authors discuss their approach to the diagnosis of suspected intussusception and the radiologist's role in therapy. PMID- 3289088 TI - Cerebral hemodynamics in infants undergoing extracorporeal membrane oxygenation: further observations. AB - Intracranial Doppler ultrasonographic examinations were performed on 64 infants treated with extracorporeal membrane oxygenation (ECMO). Serial studies were performed on the anterior cerebral artery in 55 infants before and during ECMO bypass, and on the middle cerebral arteries (MCAs) and internal carotid arteries (ICAs) on an additional nine infants. The onset of ECMO was associated with changes in character of pulsatile flow, direction of flow, and mean blood-flow velocity. Pulsatility decreased in all patients, and mean blood-flow velocity increased in 73% of patients (mean change from baseline, 87%). Despite retrograde flow in the right ICA in five of nine infants, antegrade flow to the right MCA was preserved in all cases. We found no correlation between alterations in mean blood-flow velocity and overall mortality, frequency of intracranial hemorrhage, and neuro-developmental outcome. These data suggest that wide variations in cerebral blood flow occur with ECMO therapy, and that these changes appear to be well tolerated. PMID- 3289089 TI - Imaging of degenerative disk disease. PMID- 3289090 TI - Testicular cysts: differentiation with US and clinical findings. AB - In 34 of 847 patients (4%), testicular cysts were discovered with high-resolution ultrasound (US). Sixteen had a cystic testicular tumor, and US images showed multiple cysts and solid tumor portions in 12 of these 16 (75%). Eighteen patients had nonneoplastic cysts: Five had cysts of the tunica albuginea, and 13 had intratesticular cysts. All tunica albuginea cysts were palpable as small masses, and only US images showed that the masses were cystic. None of the 13 intratesticular cysts was palpable; all were accidentally discovered with US, which showed that 12 were single cysts with a marginal location (92%). On histologic studies, the nonneoplastic cysts were related to the spermatic ducts (rete testis, efferent ductules) and frequently appeared as postinflammatory alterations. Only five patients with intratesticular cysts were followed up with US, and no changes occurred. The combination of clinical and US findings facilitated the differentiation between nonneoplastic and neoplastic testicular cysts. PMID- 3289091 TI - Small arteries in peripheral lymph nodes: a specific US sign of lymphomatous involvement. AB - Fifty-seven patients with palpably enlarged peripheral lymph nodes underwent detailed ultrasonographic (US) examination with a 5.0-MHz and a 7.5-MHz probe. In 32 of 36 patients with malignant lymphoma (12 with Hodgkin disease, 24 with non Hodgkin lymphoma) US showed a hypoechoic mass with a centrally located tubular structure. Pathologic examination showed that this structure correlated with small intact arterial vessels encased by confluent lymphomatous masses. This sonographic finding was not seen in patients with carcinomatous metastatic lesions to the lymph nodes (nine patients) or benign lymphadenitis (12 patients). The detection with US of small arteries within enlarged lymph nodes may indicate nodal infiltration by malignant lymphoma. PMID- 3289092 TI - Deep venous thrombosis: is contrast venography still the diagnostic "gold standard"? PMID- 3289093 TI - Perioperative US. PMID- 3289094 TI - Percutaneous cholecystostomy: diagnostic and therapeutic efficacy. AB - Percutaneous cholecystostomy was performed in 32 patients for treatment of suspected cholecystitis (16 patients), decompression of biliary obstruction (six patients), or performance of diagnostic cholangiography (ten patients). The gallbladder was successfully catheterized in 32 of 32 patients (100%), and therapeutic or diagnostic benefit was achieved in 29 of 32 patients (91%). There were no major complications and no procedure-related deaths. There were four minor complications. In the 14 patients with severe cholecystitis there was substantial clinical improvement in 13. Five patients underwent catheter withdrawal after stabilization or long-term drainage. In biliary obstruction, hyperbilirubinemia was successfully treated with percutaneous cholecystostomy in five of six patients, and associated cholangitis was successfully treated in four of four. Ten patients underwent transcholecystic cholangiography; diagnostic visualization was achieved in all, including seven who underwent percutaneous cholecystostomy-assisted transhepatic biliary drainage. Percutaneous cholecystostomy is a safe and effective procedure in diagnosis and treatment of biliary tract problems. PMID- 3289095 TI - Carcinoma of the breast: detection with MR imaging versus xeromammography. AB - Detectability of breast cancer with magnetic resonance (MR) imaging versus xeromammography was quantitatively compared. MR images were obtained of breasts of 120 women who underwent xeromammography. T1 values were determined for masses larger than 2 cm. Cancer was histologically confirmed in 39 breasts and was considered excluded from 81 due to results of biopsy, cyst aspiration, or sonography or absence of change in xeromammographic findings over time. Images were blindly interpreted by three observers, and results were expressed as receiver operating characteristic curves. Detectability of breast cancer was substantially better with xeromammography than with MR imaging for all observers (P less than .03, 10(-6), and .001). On MR images, spiculation of a mass, distorted architecture, skin thickening, and nipple or skin retraction were specific but relatively insensitive indicators of cancer. Masses with smooth, distinct margins and signal intensity greater than that of fat on T2-weighted images were always benign. Other findings and T1 values were not diagnostically useful. The authors conclude that xeromammography is superior to MR imaging in detection of breast cancer. PMID- 3289096 TI - One-shot dual-energy subtraction chest imaging with computed radiography: clinical evaluation of film images. AB - A clinical evaluation of one-shot dual-energy subtraction chest imaging by means of computed radiography (CR) with imaging plates was carried out in a comparison with the original plain CR images. In analyses of chest images of 140 patients, new information, not detected on the original plain CR images, was obtained on subtraction images in 21 patients (15%). Receiver operating characteristic curve studies also verified the superiority of CR subtraction over the original plain CR images for the detection of pulmonary nodules, calcification in a nodule, and rib lesions. Subtraction images complemented the original plain images. PMID- 3289097 TI - Improved prediction of intrauterine growth retardation with use of multiple parameters. AB - Several sonographic parameters have been proposed for predicting intrauterine growth retardation (IUGR), but each has been shown to have a low positive predictive value. To predict IUGR more reliably, the authors developed a multiparameter approach based on sonographic and clinical data from 62 fetuses with IUGR and 91 normal fetuses. Logistic regression analysis revealed that the combination of sonographically estimated fetal weight, amniotic fluid volume, and maternal blood pressure status best correlates with the presence or absence of IUGR and produced an IUGR scoring system based on these three parameters. The scoring system, which has a range of 0-100, was tested on a second set of fetuses (47 with IUGR, 81 normal) to determine its performance characteristics. An IUGR score below 50 virtually excludes the diagnosis of IUGR (0.9% likelihood of IUGR, or negative predictive value of 99.1%). A score above 75 allows confident diagnosis of IUGR (positive predictive value, 82%). A score of 50-75 is equivocal, in that it is associated with an intermediate (24%) likelihood of IUGR. The IUGR score is a practical tool that can be easily used in any ultrasound facility. PMID- 3289099 TI - The diaphragm: anatomic, pathologic, and radiologic considerations. AB - The diaphragm, by virtue of its complex anatomy and multiple ligamentous connections to both thoracic and abdominal structures, is more than a simple partition between the chest and abdomen. Cross sectional images of the diaphragm and peridiaphragmatic processes can be confusing unless the radiologist is aware of the normal structure of the diaphragm, its attachments to the body wall, and the multiple ligaments that attach to the diaphragm. PMID- 3289098 TI - Contrast venography: reassessment of its role. AB - To compare contrast venography with noninvasive methods, 353 patients clinically suspected of having deep venous thrombosis were examined with venography and independently with combined Doppler flow sounds and plethysmography. Noninvasive examinations had a sensitivity of 96% and a specificity of 90%. Positive noninvasive tests had a 94% predictive value, and negative noninvasive tests had a 93% predictive value. The overall accuracy of the noninvasive tests was 94% (331 of 353) compared with venography. Since venography itself may be subject to misinterpretation, noninvasive examinations should be the preferred initial method for diagnosing deep venous thrombosis. Venography should be reserved for situations that require additional diagnostic confirmation. PMID- 3289100 TI - Carotid duplex sonography: a multicenter recommendation for standardized imaging and Doppler criteria. AB - A complex duplex carotid evaluation involves high resolution imaging and characterization of the carotid plaque as well as quantitative Doppler spectral analysis to determine the presence and degree of flow restriction. Each of the components of the examination is essential to evaluate the carotid arteries adequately for the presence of disease. Both of these components should be assimilated into a final report that can be used to determine who is at risk for embolic as well as flow restrictive disease. By carefully following the reporting system described in this paper, an accurate and reproducible means of evaluating the carotid arteries can be achieved that permits comparison of studies. In addition, this will allow accurate communications among institutions and help to insure a better understanding of the etiology and pathogenesis of atherosclerotic carotid artery disease. PMID- 3289101 TI - Treatment planning with external beams. Introduction and historical overview. AB - In this first of a series of articles on Radiation Treatment Planning based on the Basic Physics Symposium of the American Association of Physicists in Medicine at the 73rd Annual meeting of the RSNA, an attempt has been made to provide a broad overview of the process of designing an optimal radiation therapy regimen. The essentials of treatment planning have been identified and essential terms have been defined. Variables to be selected have been identified and constraints in choosing treatment plans have been noted. The effect of combining multiple beams to achieve the most advantageous distribution of radiation dose within the patient has been discussed and the vital importance of appropriate quality control has been emphasized. Future articles will consider specific aspects of this discipline in detail. PMID- 3289103 TI - An improved method for isolating Ca2+-resistant myocytes from the adult rat heart. AB - Maintaining viability in cardiac myocytes isolated from adult rats using collagenase is difficult in Ca-containing media due to cell damage that occurs on reintroduction of Ca after perfusing the heart with the Ca-free medium needed to isolate myocytes with collagenase. Recently it has been proposed that Ca-free perfusion of isolated rabbit interventricular septa leads to cellular Na overload which, on reintroducing Ca, produces influx of toxic concentrations of Ca due to the Na/Ca exchange mechanism in the sarcolemma. We have found that replacing a portion of the 118 mM NaCl in the Ca-free perfusion medium with 69 mM LiCl dramatically increased the proportion of Ca-tolerant cardiac myocytes isolated from adult male rats with collagenase. Myocyte viability was maintained over a four hour period of incubation at 37 degrees C in 1 mM Ca. PMID- 3289102 TI - Ultrasound case of the day. Small bowel intussusception. PMID- 3289104 TI - In memoriam Sven Lofgren (1910-1978). PMID- 3289105 TI - Measures of stress and related constructs: a guide for research and clinical practice. PMID- 3289106 TI - [Cerebro-meningeal hemorrhages caused by rupture of intracranial arterial aneurysms]. PMID- 3289107 TI - [Description of an intervention]. PMID- 3289108 TI - [Music in the hospital]. PMID- 3289109 TI - [Neurological manifestations of alveolar echinococcosis]. AB - Among 78 cases of alveolar echinococcosis reported in Lorraine, France, 5 had neurologic complications which in 3 cases revealed the disease. Results of parasitic tests are discussed and emphasis is placed on differences between this disease and hydatidosis. Encephalic localizations (3 cases) were multiple making neurosurgery impossible. The outcome was fatal in 2 cases: 1 month after the initial neurologic signs in the absence of treatment (case 1) and 4 months after treatment with flubendazole (case 2). This drug was however effective in the 3rd case (hepatic, pulmonary and cerebral form) with follow-up now at 4 years. Epidemiologic, histopathologic, clinical, diagnostic characteristics and course of these encephalic localizations are reviewed. Spinal localizations (2 cases) presented with a picture of spinal cord compression. After laminectomy and flubendazole, the course was marked by relapse with death in one case and a satisfactory neurologic course with a 4 year follow-up in the other one. PMID- 3289110 TI - [Dystonia in the child]. AB - A classification of child dystonias is proposed as a guide to etiological diagnosis. The analysis of symptoms and signs provides a distinction between dystonia and other involuntary movements: dystonia is a tonic involuntary movement which appears during voluntary activity as a slow and involuntary movement. Two groups of child dystonic syndromes can be distinguished: 1) dystonic syndromes where dystonia is the main neurologic abnormality; they result mainly from toxic and anoxic disorders and from torsion dystonia; 2) dystonic syndromes with associated dystonia and intellectual impairment; they are often familial neurometabolic disorders. Analysis of child dystonias show some common features: a long interval between the causative brain lesion and the onset of dystonia is possible, and may last several years. In neuro-metabolic disorders also dystonia appears after the first year of life, when psycho-motor impairment has already appeared. Etiologic investigations can provide a diagnosis and sometimes a treatment in several varieties of dystonia, e. g. L-Dopa in torsion dystonia, correction of metabolic disturbance in Wilson disease or glutaric aciduria. Genetic counselling should be provided. PMID- 3289111 TI - Histologic changes in the gastroduodenal mucosa after long-term medical treatment with cimetidine or parietal cell vagotomy in patients with juxtapyloric ulcer disease. AB - Biopsy specimens were collected during endoscopy from pre-established sites in the corpus (n = 60), antrum (n = 53), and the duodenal bulb (n = 54) from the same patient before and 2-3 years after parietal cell vagotomy (PVC) or after a similar period of treatment with cimetidine. There was a significant increase in scores of chronic body gastritis after PCV (p less than 0.001) even in comparison with the cimetidine group (p less than 0.01), for which the scores of chronic body gastritis remained essentially unchanged. The scores of chronic antral gastritis and the incidence of intestinal metaplasia of the antrum increased significantly (p less than 0.05) in both the PCV and the cimetidine groups when the two treatment groups were analyzed together. The degree of polymorphonuclear infiltration in the body and antral mucosa, the incidence and severity of duodenitis, and the incidence of gastric metaplasia in the duodenal cap were unaffected by the treatment. In contrast to maintenance treatment with cimetidine PCV seems to accelerate the development of chronic body gastritis. The kappa statistics, as indicator of the reproducibility of histopathologic scoring, were acceptable. PMID- 3289113 TI - Olsalazine does not increase the bile acid losses in subjects with a permanent ileostomy. AB - Olsalazine is a novel compound presently under development for the treatment of ulcerative colitis. Olsalazine sometimes causes diarrhoea; one of the possible explanations could be an increased load of bile acids in the colon. Bile acid ileostomy output was therefore measured enzymatically and after oral administration of tauro-23-[75Se]selena-25-homocholic acid (SeHCAT) in eight subjects during intake of placebo or olsalazine. The bile acid output showed great individual variations during both treatment periods, but there was no indication that olsalazine interfered with bile acid handling in the terminal ileum. PMID- 3289112 TI - Immunoperoxidase localization of apolipoprotein D in human enterocytes and hepatocytes. AB - In this study we prepared a pure apolipoprotein D and obtained a specific antiserum to it. The purified apolipoprotein D migrated as a single band of Mr = 29,000 but appeared as five isoforms on isoelectrofocusing. The antiserum did not cross-react with other apolipoproteins. Immunoenzymatic staining revealed the presence of apolipoprotein D in the perinuclear area of the cytoplasm of isolated normal hepatocytes and HepG2 cells. Apolipoprotein D was also localized in intestinal epithelium and in liver cells. The intracellular distribution of apolipoprotein D was similar to that of apolipoprotein B. Our results indicated that apolipoprotein D, like many other circulating apolipoproteins, is synthesized in enterocytes and hepatocytes. PMID- 3289114 TI - [Campylobacter pylori: cause of gastritis and ulcer disease?]. AB - Several studies have shown a striking association between the presence of Campylobacter pylori (C.p) in the gastric mucosa and histologically confirmed gastritis and ulcer disease. The microorganism has been found in up to 90% of patients with active chronic antral (type B) gastric ulcer, and in up to 70% of patients with duodenal ulcer. Voluntary ingestion of C.p. by two persons and two epidemic occurrences after apparent C.p. contamination of stomach probes, with demonstration of the bacterium in the mucosa, have shown that C.p. can induce acute gastritis; in one volunteer the acute gastritis progressed to the active chronic form. Eradication of C.p. by antibacterial treatment is associated with resolution of gastritis. Relapse of peptic ulcer is closely related to infection by C.p. The microorganism has important virulence factors allowing it to select an ecological niche below the mucus layer on the gastric mucosa. C.p. exhibits strong mucolytic activity through proteases which could damage the mucus barrier and therefore increase susceptibility to development of gastritis and peptic ulcers; however, the pathogenic impact of C.p. remains unknown. C.p. is diagnosed by histological or microbiological examination of gastric biopsy specimens or by serological techniques. Bismuth salts alone or in combination with antibiotics are effective against C.p., but the efficacy of antimicrobial treatment of gastritis and ulcer disease associated with C.p. has still to be proven by large double-blind placebo-controlled trials. The hitherto published findings do not allow definite evaluation of the pathogenetic significance of C.p. in gastritis and ulcer disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289115 TI - Aspects of a cognitive neuroscience of mental imagery. AB - Although objects in visual mental images may seem to appear all of a piece, when the time to form images is measured this introspection is revealed to be incorrect; objects in images are constructed a part at a time. Studies with split brain patients and normal subjects reveal that two classes of processes are used to form images--ones that activate stored memories of the appearances of parts and ones that arrange parts into the proper configuration. Some of the processes used to arrange parts are more effective in the left cerebral hemisphere and some are more effective in the right cerebral hemisphere; the notion that mental images are the product of right hemisphere activity is an oversimplification. PMID- 3289116 TI - Localization of cognitive operations in the human brain. AB - The human brain localizes mental operations of the kind posited by cognitive theories. These local computations are integrated in the performance of cognitive tasks such as reading. To support this general hypothesis, new data from neural imaging studies of word reading are related to results of studies on normal subjects and patients with lesions. Further support comes from studies in mental imagery, timing, and memory. PMID- 3289117 TI - The leucine zipper: a hypothetical structure common to a new class of DNA binding proteins. AB - A 30-amino-acid segment of C/EBP, a newly discovered enhancer binding protein, shares notable sequence similarity with a segment of the cellular Myc transforming protein. Display of these respective amino acid sequences on an idealized alpha helix revealed a periodic repetition of leucine residues at every seventh position over a distance covering eight helical turns. The periodic array of at least four leucines was also noted in the sequences of the Fos and Jun transforming proteins, as well as that of the yeast gene regulatory protein, GCN4. The polypeptide segments containing these periodic arrays of leucine residues are proposed to exist in an alpha-helical conformation, and the leucine side chains extending from one alpha helix interdigitate with those displayed from a similar alpha helix of a second polypeptide, facilitating dimerization. This hypothetical structure is referred to as the "leucine zipper," and it may represent a characteristic property of a new category of DNA binding proteins. PMID- 3289119 TI - Production of stable rabbit-mouse hybridomas that secrete rabbit mAb of defined specificity. AB - Inclusion of normal rabbit serum (NRS) in culture medium after interspecific fusion of hyperimmunized rabbit spleen cells with murine SP2/0 myeloma cells produced 271 rabbit-mouse hybridomas (RMHs) that secreted rabbit immunoglobulin against group A Streptococcus (GAS). Continued use of NRS-supplemented medium during cloning yielded stabilized monoclonal RMH lines that have secreted GAS specific rabbit antibody at concentrations similar to murine hybridomas (3 to 8 micrograms per 10(6) cells per 24 hours), for over 4 months of culture in vitro. The use of NRS as a medium supplement during initial culture, cloning, and stabilization of RMHs enables production of considerably more specific rabbit monoclonal antibody (mAb)-secreting RMHs than have previously been reported. PMID- 3289118 TI - Astrocyte mitogen inhibitor related to epidermal growth factor receptor. AB - Epidermal growth factor (EGF) is a well-characterized polypeptide hormone with diverse biological activities, including stimulation of astrocyte division. A soluble astrocyte mitogen inhibitor, immunologically related to the EGF receptor, is present in rat brain. Injury to the brain causes a time-dependent reduction in the levels of this inhibitor and the concomitant appearance of EGF receptor on the astrocyte surface. Intracerebral injection of antibody capable of binding the inhibitor caused the appearance of numerous reactive astrocytes. EGF receptor related inhibitors may play a key role in the control of glial cell division in both normal and injured brain. PMID- 3289120 TI - Amplification of c-erbB-2 and aggressive human breast tumors? PMID- 3289121 TI - Lung cancer. Issue dedicated to Mary Jean O'Leary Matthews. PMID- 3289122 TI - Lung cancer biology. AB - Advances in the understanding of the biology of lung cancer have progressed rapidly over the past decade while treatment results have remained essentially unchanged. It is clear that the knowledge of the heterogeneity of lung cancer cell types in respect of growth properties, biomarker expression, oncogene expression, and antigen expression needs to be applied in the clinic; and their role in predicting response to cytotoxic therapy and survival needs prospective evaluation. In addition the application of cell lines in screening for tumor specific cytotoxic agents should provide for a more rational approach for drug selection in future clinical trials. Finally the development of magnetic resonance spectroscopy may also play a role both in further understanding the biology of lung cancer, and in the clinical assessment of tumor sensitivity in vivo. More recent data using DNA probes specific for the cytogenetic deletion on chromosome 3, previously identified in only SCLC, suggests that this deletion 3p 14-23 is common to most, if not all, cell types of lung cancer. This adds further to the hypothesis that a common stem cell exists from which all histologic types of lung cancer arise. PMID- 3289123 TI - Molecular genetics of lung cancer. PMID- 3289124 TI - [History of the concept of schizophrenia]. PMID- 3289125 TI - Cancer of the ovary. The Johannesburg Hospital experience. AB - Experience with 100 patients with epithelial ovarian cancer, who underwent primary definitive surgery at Johannesburg Hospital between 1 January 1979 and 31 July 1987, is presented and the absolute 4-year survival figures are compared with those from 1977. For patients with advanced disease (stages III and IV) the 4-year survival rate has improved from 4.4% to 42% (P = 0.001). Reasons for this substantial progress are outlined. Fifty per cent of the patients had nonspecific gastro-intestinal symptoms at the time of diagnosis and 20% had previously undergone hysterectomy. A case is made for prophylactic oophorectomy at the time of hysterectomy. PMID- 3289126 TI - Occurrence of Clostridium tetani in soil and horses. AB - The annual incidence of tetanus in the RSA is up to 300 cases with more than 50% of these coming from Natal/KwaZulu. The condition of playing fields and the excretion of Clostridium tetani by horses was therefore investigated. The overall contamination rate of soils in the Durban area is lower than that of published data from other parts of the world, for instance 28% for Durban in comparison with 31-42% for Japan and Quebec. A rugby field in the Transvaal showed 40% contamination and a pasture used for horses for more than 20 years 65%. No case of human or equine tetanus has ever been reported from either the playing field or the pasture. A permanent carrier state in horses could not be established; the organisms were only excreted for 3-4 days. At any one time only 2 out of 27 horses in a stable were excreting C. tetani. Only 7 of 118 faeces samples were positive over a period of 4 months (5-9%). PMID- 3289127 TI - In vitro cultivation of southern African strains of Plasmodium falciparum and gametocytogenesis. AB - Sixteen southern African isolates of Plasmodium falciparum were successfully established and maintained in gassed tissue culture flasks which were either held in a static position or shaken. Shaken cultures yielded 48-hour growth rates ranging from 3.9-fold to 9.5-fold and peak parasitaemias ranging from 9% to 27%. Growth rates in static flasks were lower, ranging from 1.8-fold to 4.2-fold every 48 hours with peak parasitaemias ranging from 4% to 12%. Four of the established isolates were treated so as to promote gametocytogenesis and the rate of gametocyte production was found to be high. The mean percentage gametocytes by day 20-25 was 4.2% of erythrocytes, which represented approximately 50% of total parasites. PMID- 3289128 TI - Pancreatic transplantation in a patient with severe insulin resistance. A case report. AB - A 22-year-old white woman with insulin-dependent diabetes mellitus of 20 years' duration and advanced secondary complications underwent pancreatic transplantation for severe insulin resistance and rapidly progressive nephropathy. Resistance to all forms and strengths of subcutaneously administered insulin had necessitated almost permanent hospitalisation for the previous 10 years. Short-term improvement of the endocrine and metabolic status was achieved by initial segmental and subsequent whole pancreatic transplantation. PMID- 3289129 TI - Double malarial infections. PMID- 3289130 TI - [Acute lymphoblastic leukemia, hand-mirror variant. Immunologic phenotype and ultrastructural study]. PMID- 3289131 TI - Post Nissen syndrome. AB - The Nissen fundoplication is the most common anti-reflux operation performed. Gas bloat and inability to vomit after repair may be severe, but infrequently require reoperation; in contrast, other complications can be very debilitating or life threatening. One hundred and sixteen patients who required reoperation for serious complications after Nissen repair are presented and classified according to the cause of the failed repair. Nissen complications resulted in recurrent reflux (86 per cent), severe dysphagia (60 per cent), esophageal dysmotility (48 per cent) and gastric perforation and fistualization (5 per cent). The "classic" Nissen fundoplication involves a blind 360 degree wrap, which includes the acid producing parietal cell mass. The resulting pouch drains poorly and is, therefore, subject to gastric ulceration. Reoperation at our institution, using principally the Hill antireflux procedure, gave excellent or good results in 86 per cent, fair in 9 per cent and poor in 5 per cent. Three operative deaths (2.6 per cent) and one late death (0.9 per cent) occurred. PMID- 3289132 TI - Early secondary suture versus healing by second intention of incisional abscesses. AB - A controlled trial was set up to compare the treatment of wound abscesses, occurring after laparotomy, with either early secondary suture combined with cefuroxime and metronidazole given intravenously or by healing by second intention. The secondary suture was performed two days after wound drainage and resulted in a significant reduction (p less than 0.01) in healing time without complications. No reinfections occurred. PMID- 3289133 TI - Results of radical dissection of the groin in patients with stage II melanoma and histologically proved metastases of the iliac or obturator lymph nodes, or both. AB - In order to determine the value of the pelvic part of the radical dissection of the groin, the histories of 23 patients with Stage II (UICC) melanoma with histologically proved metastases of the iliac or obturator lymph nodes, or both, were studied. Histologically proved primary melanomas were found in 19 patients, 18 were localized on the leg and one on the trunk. In four patients, the primary melanoma was unknown. Seven patients had received adjuvant radiotherapy. The time between node dissection and the moment of analysis was two years for 17 patients, five years for 11 patients and ten years for ten patients. Calculated actuarially, 42 per cent of the patients were still without distant metastasis after two years and 32 per cent after five and ten years. At the time of the analysis, ten patients were alive, nine without evidence of disease and three having survived for more than five years. Remarkably, the primary tumor of all three patients was "unknown" and they had all had adjuvant radiotherapy. In pooling the data of this series with those from the literature, it appears that, of 78 patients with Stage II melanoma and deep node involvement, 12 had a disease free survival time of more than five years after therapeutic radical groin dissection. Involvement of deep nodes does not always seem to equate with systemic disease. We think that, when there is an indication for a therapeutic groin dissection, an en bloc superficial and deep lymph node dissection is warranted. PMID- 3289134 TI - Interposition spiral saphenous vein graft bypass in bilateral simultaneous radical neck dissection. AB - We advocate the use of the spiral saphenous vein bypass of the IJV when bilateral radical neck dissections are performed with the sacrifice of both IJV. The technique we have described herein is uniformly successful in this setting and associated with only 30 minutes to one hour of increased operative time. This bypass will decrease the postoperative facial edema and associated complications and allow the patient to go on to radiation and chemotherapy in an expeditious and safe manner. PMID- 3289136 TI - [Psychosocial problems in managing the cancer patient in medical practice]. PMID- 3289135 TI - Goblet cell carcinoids of the appendix. AB - A review of goblet cell carcinoid of the appendix was undertaken. This interesting tumor appears to lie somewhere between an ordinary carcinoid and a well differentiated adenocarcinoma of the appendix in regard to its biologic behavior. The histologic features of the goblet cell carcinoid of the appendix are distinctive enough to facilitate a diagnosis, although the histogenesis remains controversial and unsettled. The prognosis is generally good in a patient treated by simple appendectomy, the treatment of choice in the majority of patients. PMID- 3289137 TI - [Crohn disease or non-Hodgkin's malignant T cell lymphoma? A diagnostic problem evaluated by gene technology DNA analysis]. PMID- 3289138 TI - Endoscopic diagnosis and treatment of Dieulafoy's ulcer. AB - Dieulafoy's ulcer often develops unmanageable severe gastrointestinal hemorrhage and sometimes takes a fatal course. In the past surgical operations were considered to be the only life-saving measure for this lesion. Since 1979, 46 lesions of Dieulafoy's ulcer in 45 cases with active bleeding from exposed blood vessels were treated during emergency endoscopy by the hemostatic method of pure ethanol injection. Transient hemostasis was obtained in all cases. Rebleeding occurred in 5 cases (11%) and pure ethanol injection was performed again. Hemostasis was obtained in all cases, but one case again had rebleeding due to an overlooked Dieulafoy's ulcer located in the gastric fundus. Emergent surgical operation was performed in this case. No case required elective surgery and no deaths were attributed to bleeding. Our method achieved complete hemostasis at a rate of 98% (44 cases) for Dieulafoy's ulcer. The pure ethanol injection method is one of the most effective hemostatic methods for the Dieulafoy's ulcer. PMID- 3289140 TI - Role of calcium in suppression of glucagon release from isolated diabetic rat pancreata. AB - To investigate the role of extracellular Ca2+ (Ca2+) in suppression of glucagon release in diabetic animals, pancreata were isolated from streptozotocin-diabetic rats and perfused with a 15 mM glucose solution containing one of the following: (1) Ca2+ 2.1 mM and insulin 22 microU/ml, (2) Ca2+ 2.1 mM and insulin 110 microU/ml, (3) Ca2+ 2.1 mM and insulin (-) or (4) Ca2+ 0.2 mM and insulin 110 microU/ml. Although perfusion with 22 microU/ml of insulin did not alter glucagon release, perfusion with 110 microU/ml of insulin in the presence of Ca2+ and glucose significantly reduced the release of glucagon from 1.9 +/- 0.3 ng/min to 1.2 +/- 0.3 ng/min for the first 3 min. The absence of insulin enhanced glucagon release from the baseline level of 1.0 +/- 0.1 ng/min to 1.6 +/- 0.3 ng/min at 11 min and to 1.4 +/- 0.2 ng/min at 21 min. Deprivation of Ca2+ in the perfusate also enhanced glucagon release from the baseline level of 0.8 +/- 0.1 ng/min to 1.2 +/- 0.3 ng/min for the first 4 min. It is concluded that insulin suppresses glucagon release and Ca2+ is needed for the suppression of glucagon release in the presence of both insulin and glucose in streptozotocin-diabetic rat pancreata. PMID- 3289139 TI - Comparative analysis of lymphocyte phenotypes between carriers of human immunodeficiency virus (HIV) and adult patients with primary immunodeficiency using two-color immunofluorescence flow cytometry. AB - A variety of phenotypic abnormalities of peripheral blood lymphocytes from 8 HIV carriers (HIVC), 6 patients with common variable immunodeficiency disease (CVID), and 13 patients with selective immunoglobulin deficiency (SIgD) were compared using two-color flow cytometry. There was a close resemblance in phenotypic abnormalities between HIVC and the patients with CVID; i.e., increases in CD8+CD11-, Leu7+CD16- and CD3+DR+ cells, and decreases in CD4+Leu8+, CD4+Leu8-, Leu7+CD16+ and Leu7-CD16+ cells. The increase in CD3+DR+ cells was due to an increase in CD8+DR+ cells. The CD4/CD8 ratio was inverted in both groups. A strong correlation coefficient (CC) was found only between the CD4/CD8 ratio and CD4+Leu8+ cells in HIVC, while CC was also high between the CD4/CD8 ratio and CD8+CD11- cells in CVID. The phenotypic abnormalities of the patients with SIgD were various and no significant difference was found against the control, except for an increase in CD4+Leu8+ cells and a decrease in CD4+Leu8- cells, which suggests heterogeneity of immunological deficits in this group. In severe immunodeficiency, ineffective killer cells appeared to be induced as a result of an adaptive change involved in recurrent or persistent viral infections, and Leu8 molecule may be concerned in the susceptibility of CD4+ cells to HIV. PMID- 3289142 TI - Kinetics of drug effects in man. AB - This review describes general principles that contribute to the understanding of the relationship between drug concentrations and pharmacological effects. In particular, attention is given to drugs that exert direct and reversible pharmacological responses. First of all, the relationship between measured (total) concentration and effective concentration should be considered. The effect kinetics can often be described by rather simple principles, giving important information for interpretation of drug-monitoring data. In other situations, the application of new approaches in pharmacokinetic--pharmacodynamic modeling turns out to provide valuable insight for the interpretation of more complicated concentration--effect relationships that would not otherwise have been recognized. PMID- 3289141 TI - [Computed tomography in the diagnosis of maxillofacial diseases]. PMID- 3289143 TI - Problems in therapeutic drug monitoring: free drug level monitoring. AB - Historically, it has been assumed that only free drug concentration is the pharmacologically active species. This article reviews the theoretical pharmacological and pharmacokinetic justifications for monitoring free drug levels. The determinants likely to influence plasma protein binding and the free concentrations of drugs are delineated. The different methods which can be used for determining free drug level are presented. Their advantages and drawbacks as well as their reliability and suitability for routine clinical practice are discussed. Currently, antiepileptic drugs such as valproic acid, phenytoin, carbamazepine and a few antiarrhythmic drugs meet the theoretical criteria justifying free drug level monitoring. Conditions causing alteration in free concentrations of these drugs are reported. But, for all these drugs, there is a considerable lack of data establishing the correlations between therapeutic or toxic response and free concentration. Presently, our capability to interpret correctly the free drug level data is still limited. In the future, much more effort must be devoted in order to provide sufficient information on the clinical relevance of free drug concentration. PMID- 3289144 TI - Auxiliary heterotopic liver transplantation. PMID- 3289146 TI - Cyclosporine's effect on canine pancreatic endocrine function. AB - This study was designed to investigate the mechanism, and reversibility, of glucose intolerance following the acute administration of cyclosporine (CsA) in a canine model. Three groups underwent a baseline intravenous glucose tolerance test (IVGTT; 0.5 g/kg of glucose), with simultaneous insulin determinations. In groups A and B, repeat IVGTTs were performed, at three-day intervals, after 2, 4, and 6 mg/kg of intravenous CsA + solvent (group A; n = 8), or the solvent alone (group B; n = 5). Repeat IVGTTs were performed in group A, 24 and 72 hr after the last CsA infusion. In group C (n = 5), IVGTTs were performed, 4, 24, 48, and 72 hr after oral CsA (12.5 mg/kg). In each group, the rate of glucose clearance (k value,--per cent min), and basal-to-peak insulin difference (uU/ml), for each IVGTT were compared with the baseline results. In group A, the basal-to-peak insulin difference was significantly lower than baseline (81.9 +/- 13.6) after 2 mg/kg (27.3 +/- 3.1; P less than 0.005), 4 mg/kg (22.7 +/- 3.7; P less than 0.001); and 6 mg/kg (16.8 +/- 3.2; P less than 0.001) of CsA, and returned to baseline within 24 hr (81.4 +/- 3.7). Corresponding K values were also significantly different in group A. In group B, there were no significant differences in these parameters from controls, at the equivalent doses of the solvent alone. At 4 hr after oral CsA (group C), there was a reduction in the basal-to-peak insulin difference (37.2 +/- 9.1 vs. 22.5 +/- 4.1) and K values ( 3.20 +/- 0.4 vs. -1.96 +/- 0.3), with the change in K values being statistically significant (P less than 0.05). A return to baseline levels was present at 24 h. This study demonstrates that, in the canine model, therapeutic doses of intravenous and oral CsA acutely impair glucose regulation. This acute effect is secondary to decreased peripheral insulin levels, is reversible at 24 h, and is not evident with CsA solvent alone. The mechanism of decreased insulin secretion following CsA administration requires further elucidation. PMID- 3289145 TI - Adenine nucleotide tissue concentrations and liver allograft viability after cold preservation and warm ischemia. AB - The relation between adenine nucleotide liver concentrations and the viability of liver allografts after cold preservation and warm ischemia was studied. A rat model was used with storage times defined in terms of allograft viability. Livers were excised and stored for 4 hr at 4 degrees C or 1 hr at 37 degrees C (viable if transplanted) or for 8 hr at 4 degrees C or 2 hr at 37 degrees C (not viable if transplanted) in a solution containing 0.9% NaCl and 2 mM CaCl2. Adenine nucleotide, malondialdehyde, and glutathione concentrations were measured in liver biopsies at the end of the storage periods and in control livers. During cold preservation, ATP concentrations decline, but degradation is largely halted at AMP, and this is independent of the length of storage or viability of the allograft. Graft failure is not due to lack of availability of intramitochondrial substrate (AMP) for rephosphorylation to adenosine triphosphate (ATP), nor is it likely that provision of such substrate will be helpful. On the other hand, with warm ischemia, degradation to inosine, hypoxanthine and xanthine occurs and nonviable livers develop higher levels of xanthine than viable ones; in fact, xanthine concentrations provide 100% discrimination between viable and nonviable warm preserved livers. Malondialdehyde concentrations were also significantly greater in the warm preserved nonviable livers, indicating that some lipid peroxidation may occur even before reperfusion of allografts. Glutathione concentrations were similar in all experimental groups. PMID- 3289147 TI - Effects of perfusion pressure during flushing on the viability of the procured liver using noninvasive fluorometry. AB - The influence of perfusion pressure and flow rate on hepatic cellular viability was investigated in the procured liver using noninvasive pyridine nucleotide fluorometry, in relation to other metabolic indices such as nicotinamide adenine dinucleotide (NAD) concentration, adenine nucleotides, tissue ketone bodies, and mitochondrial phosphorylative activity. Rat liver was perfused at a controlled flow rate through the portal vein with a nonrecirculating open-end-design perfusion system driven by a roller pump using cooled oxygenized Euro-Collins' solution. The maximum pressures (mean pressure in parentheses) of experimental groups were 8 (5) mmHg, 15 (9) mmHg, 40 (25) mmHg, 80 (50) mmHg, 120 (73) mmHg, 240 (152) mmHg. The amplitude between oxidation and reduction levels (RxA) in the fluorometric trace, and the gradient or velocity of the trace curve from oxidation to reduction (RxV) were determined by the measurement of fluorescence from NAD phosphate, reduced form (NADPH) using a new fluorometric device. Other metabolic indices were measured after attainment of a fully oxygenated state. RxA decreased in accordance with the increase of pressure. Similar results were obtained in the changes of NAD concentration, total adenine nucleotides, and total tissue ketone bodies, possibly due to the wash-out of these metabolites. RxV decreased in inverse proportion to the increase of pressure. There were close positive correlations between RxV and tissue ketone body ratio (acetoacetate/3 hydroxybutyrate) (r = 0.793, less than 0.01), RxV and respiratory control ratio in isolated mitochondria (r = 0.617, P less than 0.05), RxV and state 3 respiration (r = 0.792, P less than 0.01), and RxV and phosphorylation rate (r = 0.833, P less than 0.01). These results suggest that perfusion pressure and flow rate can easily deteriorate the energy metabolism of the procured liver, and that the gravity-induced hydrostatic pressure presently used in procurement perfusion should be reevaluated on the basis of energy metabolism. PMID- 3289148 TI - Induction of antiidiotypic antibodies to donor HLA-A2 following blood transfusions in a highly sensitized HLA-A2+ recipient. AB - A patient (HLA-A2,3; B35,60) with end-stage renal disease and a high level of pretransfusion (t0) anti-HLA cytotoxic antibodies (60% positive to a random panel), but lacking cytotoxic antibodies against her HLA haploidentical sister (HLA-A2,3; B35,44), received 3 donor-specific transfusions (DST) from the latter: 200 cc fresh whole blood at biweekly intervals, while being treated with azathioprine (AZA, 1 mg/kg/day). Her serum remained negative for antidonor antibodies both by standard cytotoxicity assay and by immunofluorescence flow cytometry after DST + AZA treatment, and she experienced no acute rejection episodes following donor kidney transplantation. Microcytotoxicity inhibition tests were performed using standard HLA-typing sera as a source of Ab-1, and pre- and posttransfusion sera were added to serial dilutions of Ab-1 to test for the presence of Ab-2 (antiidiotype) to donor HLA class I specificities. Although both pre- and posttransfusion sera inhibited cytotoxicity toward HLA-A2 antigens expressed on recipient target cells, only posttransfusion serum was found to inhibit cytotoxicity against the HLA-A2 antigens expressed on donor target cells. Absorption of soluble HLA class I antigens present in pre- or posttransfusion sera removed the inhibition of cytotoxicity toward recipient HLA-A2 but did not affect the inhibition of cytotoxicity toward donor HLA-A2 by posttransfusion sera. The F(ab')2 fragment of the IgG fraction of posttransfusion sera contained the inhibitory activity, suggesting induction of Ab-2 toward idiotypes specific for donor HLA-A2 antigens encoded on the unshared haplotype. PMID- 3289149 TI - HLA-DR2, a marker for class I antigen sensitization. AB - After analysis of 423 hemodialysis patients in a transfusion program and 461 cadaver-donor renal transplants, we found that HLA-DR2 frequency was significantly higher in the responder (36%) than in the nonresponder patient group (19%), according to the percentage of PRA (panel reactive antibodies). Among DR2+ patients, the percentage of hypersensitized patients was twice that of DR2- patients. Graft survival curves in cadaver-donor renal transplants indicated a significantly lower survival when recipients were DR2+, even in recipient-donor pairs identical for class II antigens but mismatched for class I antigens. The prognostic probability of low response to transfusions by a stepwise logistic regression analysis showed the influence of sex and DR2 phenotype. By multivariant discriminant analysis, we found that the DR2 phenotype was one of the most influential transfusion sensitization risk factors. Our preliminary conclusion is that DR2 can be related to immune responsiveness to class I antigens. PMID- 3289150 TI - ABO compatibility and acute graft-versus-host disease following allogeneic bone marrow transplantation. AB - If ABO antigens/antibodies play any role in the pathogenesis of acute graft versus-host disease (GVHD), one would expect the highest incidence of GVHD in recipients of minor ABO-mismatched grafts, followed by ABO-matched grafts, and the lowest incidence in major ABO-mismatched transplants. To test this hypothesis 174 patients receiving an HLA-identical allogeneic bone marrow transplant (BMT) for aplastic anemia (n = 32) or leukemia (n = 142) were analyzed for factors associated with acute GVHD. Variables analyzed included diagnosis, sex, age, blood group of donor and recipient, ABO compatibility, Rhesus compatibility, sex compatibility, number of bone marrow cells given at BMT, year of transplant, day of engraftment, and GVHD prophylaxis. We first carried out an exploratory contingency table analysis: minor ABO incompatibility was associated with a significantly higher risk of severe acute GVHD when compared with ABO-matched and major-ABO mismatched pairs (P = 0.003): 14/9, 57/67, and 5/22 patients developed, respectively, 0-I/II-IV acute GVHD in ABO major-mismatched, matched, and minor mismatched pairs. Donors of group 0, (P = 0.06), older recipient's age (P = 0.08), fast engraftment (P = 0.03), and older donor's age (0.08) were also associated with a higher risk of GVHD. Recipient's ABO group, diagnosis, year of transplant, Rhesus group of donor or recipient, Rhesus compatibility, sex of donor or recipient, sex compatibility, and type of GVHD prophylaxis were not predictive of GVHD. A Cox multifactorial proportional hazards analysis confirmed that ABO matching was the single most significant factor associated with GVHD (P = 0.006). The cumulative incidence of GVHD grade II+ was 39%, 54%, and 82% for ABO major-mismatched, matched, and minor-mismatched pairs (P = 0.01). This study suggests that ABO antigens may play a role in the development of acute GVHD. PMID- 3289151 TI - Unimpaired first-set and second-set skin graft rejection in agammaglobulinemic mice. AB - B cell and antibody-deprived B10.BR chronically suppressed by rabbit antimouse IgM serum rejected first-set allogeneic skin grafts as rapidly as control mice. We confirmed this finding using BALB/c mice born from B cell-deprived mothers and chronically treated with anti-IgM antibodies. Such mice had previously been shown to be agammaglobulinemic except for the suppressing monoclonal rat antimouse IgM antibody in their serum. These results indicate that in mice neither first nor accelerated second-set skin graft rejection reactions depend upon preexisting natural or specifically induced antibodies. PMID- 3289152 TI - Prevention of alloantibody formation after skin grafting without prolongation of graft survival by anti-L3T4 in vivo. AB - Treatment of mice in vivo with monoclonal antibodies against the L3T4 antigen (CD4 in human beings) has been shown to suppress the humoral response to several foreign antigens and to prolong the survival of allografts in some cases. Experiments were therefore performed to test whether anti-L3T4 antibody treatment would suppress alloantibody production after skin transplantation. Monoclonal anti-L3T4 antibody (GK1.5) was administered to C57BL/6 (B6) mice prior to BALB/c skin grafting. The production of B6 anti-BALB/c alloantibody was then tested after graft rejection. The results showed that: (1) graft survival of BALB/c skin on B6 mice was not substantially prolonged by anti-L3T4 treatment; (2) graft survival was significantly prolonged if mice were treated with both anti-L3T4 and anti-Lyt2 antibody; (3) the production of alloantibody following grafting was decreased by anti-L3T4 treatment and was completely eliminated if thymectomy was also performed; (4) thymectomy prolonged the effectiveness of the anti-L3T4 treatment; (5) tolerance to alloantigens presented at the time of anti-L3T4 treatment was not achieved; and (6) well-established cytotoxic antibody titers rose to higher levels after secondary grafting even with concurrent anti-L3T4 treatment, while weak antibody titers remained stable or decreased. These results indicate that L3T4+ cells are essential in providing the "help" necessary for generating humoral responses to alloantigens but that elimination of these L3T4+ cells still allows the generation of help for cell-mediated immunity. The data also suggest that class I antigens must be presented on class II molecules in order to elicit an antibody response. PMID- 3289153 TI - Induction of donor-specific unresponsiveness to rat cardiac allograft by donor leukocytes and cyclosporine. AB - Many recent reports have emphasized the importance of donor antigens in the induction of allograft tolerance. This study examines the effect of pretransplant infusion of 10(8) donor leukocytes (DL) combined with peritransplant cyclosporine (CsA) on W/F cardiac allograft survival in Lewis rats. Peritransplant recipient treatment consisted of CsA 20 mg/kg given i.m. on days 0, +1, and +2 relative to heart transplantation. Lewis recipients, 5-8 per group, were pretreated with 10(8) DL with or without peritransplant CsA. A single DL transfusion on day -3 or day -7 prior to transplantation significantly prolonged the mean survival time (MST) of W/F hearts from 7.0 +/- 0.9 days in controls to 12.2 +/- 4.5 days and 12.4 +/- 1.0 days (P less than 0.01), respectively. Two DL infusions on days -7 and -3 or on days -14 and -7 prolonged the MST to 10.6 +/- 1.3 days (P less than 0.02) and 16.4 +/- 2.8 days (P less than 0.001), respectively. The administration of peritransplant CsA alone significantly prolonged W/F heart allograft survival to 43.1 +/- 2.7 days. When pretransplant DL transfusion on day -3 was combined with CsA treatment, 4/8 animals maintained their grafts indefinitely (greater than 100 days). Similarly, DL infusion on day -7 with peritransplant CsA led to indefinite graft survival in 3/5 animals. Administration of DL on days -7 and -3 combined with CsA resulted in indefinite graft survival (greater than 100 days) in 4/6 animals. Transfusion of DL on day -3 alone or in combination with peritransplant CsA, had no effect on a third-party (ACI) heart allograft survival prolongation compared with appropriate controls. To define the underlying mechanisms responsible for donor-specific unresponsiveness in this model, pooled sera and unseparated spleen cells were passively transferred from recipients of long-term cardiac allografts to syngeneic rats receiving donor-type (W/F) or third-party (ACI) cardiac allografts. Transfer of serum (1 ml on days 0, and 1, 0.5 ml on days +2, +3, and +4) from ungrafted recipients of DL on days -14 and -7 led to significant donor graft survival of 9.8 +/- 0.4 days (P less than 0.02) in unmodified hosts. Similarly, passive transfer of serum obtained at 20 and 100 days after transplantation significantly prolonged the MST of donor-type hearts in syngeneic untreated hosts to 11.3 +/- 0.8 and 10.0 +/- 1.1 days, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3289154 TI - Splenic artery aneurysm rupture following orthotopic liver transplantation. PMID- 3289156 TI - Cyclosporine and pregnancy. PMID- 3289155 TI - 31P nuclear magnetic resonance evaluation of intermittent perfusion as a method of liver preservation. PMID- 3289157 TI - Timing of renal transplantation in the management of pyridoxine-resistant type I primary hyperoxaluria. PMID- 3289158 TI - Evidence that donor spleen cells administered through the portal vein prolong the survival of cardiac allografts in rats. PMID- 3289159 TI - Orthotopic liver transplantation in the rat. A simplified technique using the cuff method for suprahepatic vena cava anastomosis. PMID- 3289160 TI - Appendicitis in a transplant patient. PMID- 3289161 TI - Fourteenth congress of the Scandinavian Transplantation Society. Oslo, May 7-9, 1987. Proceedings. PMID- 3289162 TI - Kidney graft survival in sensitized, cyclosporine A-treated recipients in Scandiatransplant. PMID- 3289163 TI - HLA-DR mismatch and histologically evaluated rejection episodes in cardiac transplants can be correlated. PMID- 3289164 TI - Transplantation with kidney grafts from living donors mismatched for two haplotypes. PMID- 3289166 TI - Direct lymphocyte-mediated cytotoxicity: four cases of renal allograft rejection. PMID- 3289165 TI - Transfusion interval: a risk factor in renal transplantation? PMID- 3289167 TI - Serum interleukin 2 activity in renal graft recipients. PMID- 3289168 TI - Immunologic monitoring of rabbit antithymocyte globulin-treated transplant recipients: a comparison of serial E-RFC and immunomagnetic quantitation of CD2+ cells. PMID- 3289169 TI - Increasing incidence of Pneumocystis carinii pneumonia in renal transplant patients. PMID- 3289170 TI - The clinical significance of serum C-reactive protein after renal transplantation. PMID- 3289172 TI - The biopty biopsy technique: a major advance in the monitoring of renal transplant recipients. PMID- 3289171 TI - Effects on renal function of combined treatment with trimethoprim and cyclosporine A in kidney transplant patients. PMID- 3289173 TI - Macrophages and C3-deposition in early biopsies as a sign of poor prognosis in human kidney graft rejection. AB - Clinical characteristics such as retransplantation, cytotoxic antibodies, no or delayed graft onset, or early anuria seem to be important factors to define this group of patients. If early biopsies show intravascular presence of macrophages in venulae or capillaries usually combined with a C3-deposition in glomular capillary walls, the prognosis of graft outcome seems to be poor even with rather heavy antirejection therapy. PMID- 3289174 TI - Diagnostic value of peripheral plasma renin response to a single dose of captopril in suspected renal transplant artery stenosis. PMID- 3289176 TI - Appearance of basic glutathione transferase in the urine during tubular complications in renal transplant recipients. PMID- 3289175 TI - Magnetic resonance imaging of kidney and pancreatic transplants. PMID- 3289177 TI - Renal replacement therapy in patients over 60 years of age. PMID- 3289178 TI - Cyclosporine A does not increase the frequency of thromboembolic events. PMID- 3289180 TI - Cold ischemia time and renal allograft function in cyclosporine-treated patients. PMID- 3289179 TI - Primary nonfunction after renal transplantation: a prospective multifactorial analysis of possible causes in 106 consecutive transplants. PMID- 3289181 TI - Influence of early cyclosporine dosage and plasma and whole blood levels on acute rejections in cadaveric renal allograft recipients. PMID- 3289182 TI - Early acute kidney allograft rejection in patients with triple-drug immunosuppressive treatment. PMID- 3289183 TI - Use of monoclonal antibodies to T cells (OKT3) for treatment of acute cellular rejection after renal transplantation. PMID- 3289184 TI - Reversal of kidney transplant rejection after plasmalymphocytapheresis. PMID- 3289185 TI - Renal or combined renal/pancreatic transplantation for diabetic end-stage renal disease? PMID- 3289186 TI - Pancreas transplantation: curative therapeutic approach to diabetic microangiopathy? PMID- 3289187 TI - Pancreatic transplantation in diabetics with preuremic nephropathy. PMID- 3289188 TI - Metabolic effects of living related pancreatic graft donation. PMID- 3289189 TI - Patient decision-making for pancreatic transplantation. PMID- 3289190 TI - Allogeneic bone marrow transplantation in children at Huddinge Hospital. PMID- 3289191 TI - Low incidence of severe acute and chronic graft-versus-host disease as a result of prolonged cyclosporine prophylaxis and early aggressive treatment with corticosteroids. PMID- 3289193 TI - Repopulation of T, B, and natural killer-like cells in the blood and marrow after purged autologous bone marrow transplantation. PMID- 3289192 TI - Serologic surveillance for evidence of deep disseminating fungal infections in bone marrow transplantation recipients. PMID- 3289194 TI - Inflammatory cells in acute pig liver allograft rejection. PMID- 3289195 TI - Cell-mediated lympholysis activity between inbred rat strains in experimental heart transplantation. PMID- 3289196 TI - Morphologic and immunohistochemical changes in antithymocyte globulin-induced permanently surviving rat cardiac allografts. PMID- 3289197 TI - Establishment and characterization of a U937-B cell line hybridoma expressing HLA class II molecules. PMID- 3289198 TI - Ureteral obstruction of a renal allograft secondary to Candida krusei. PMID- 3289199 TI - Recurrent hemolytic syndrome after renal transplantation. PMID- 3289200 TI - Cyclosporine as an immunosuppressive agent for autoimmune disease: theoretical concepts and therapeutic strategies. PMID- 3289201 TI - The use of cyclosporine in ocular inflammatory disorders. PMID- 3289202 TI - Comparison of the efficacy of unilateral, bilateral, and oral cyclosporine in experimental immunogenic uveitis in rabbits. PMID- 3289203 TI - Cyclosporine trials in diabetes: updated results of the French experience. PMID- 3289204 TI - Effects of immunosuppression with cyclosporine in insulin-dependent diabetes mellitus of recent onset: the Canadian open study at 44 months. PMID- 3289205 TI - The effect of cyclosporine A on humoral and cellular immunity in insulin dependent (type I) diabetes mellitus. PMID- 3289206 TI - Immunopharmacological treatment in myasthenia gravis. PMID- 3289208 TI - Cyclosporine in nephrotic syndrome. PMID- 3289207 TI - Cyclosporine: therapeutic effects in rheumatic diseases. PMID- 3289209 TI - Is cyclosporine effective in preventing recurrence of immune-mediated glomerular disease after renal transplantation? PMID- 3289210 TI - Current concepts of autoimmune disease. AB - Our concepts of autoimmune disease have evolved with our changing understanding of the immune response. In recent years, clonal deletion theories have gradually given way to more dynamic views of the regulation of anti-self immune reactions. It is now clear that self-reactive B cells and some self-reactive T cells persist in the body, and there is every reason to believe that antigen-presenting cells are fully capable of presenting self-antigens in the same manner as foreign antigens. The critical event in the induction of autoimmune disease, therefore, is the quantitative balance of active suppression v the induction of self reactive help. This help provided a helper T cell response requires that the self antigens be presented in the context of self-MHC with sufficient affinity and avidity. The antireaction must be potent enough to overcome the totality of suppressive factors, including specific and non-specific suppressor T cells and anti-idiotypic or anti-T-cell-receptor responses. PMID- 3289211 TI - Low-dose cyclosporine effective in severe psoriasis: a double-blind study. PMID- 3289212 TI - Serum creatinine levels two years later: follow-up of a placebo-controlled trial of cyclosporine in rheumatoid patients. PMID- 3289214 TI - Necrotizing lymphadenitis. Case report and review of the literature. AB - A 22-year-old Jordanian woman with enlarged cervical lymph nodes proved histologically to be suffering from necrotizing lymphadenitis; she recovered spontaneously. She had remained in good health at four years follow up. This is the first case reported from Jordan. The clinical picture, etiology, histopathology, course and differential diagnosis of the disorder are discussed. PMID- 3289213 TI - Tumoral calcinosis: case reports from Saudi Arabia with a review of the literature. AB - Tumoral calcinosis is a rare disease mainly reported among blacks, especially from the tropical and sub-tropical regions of Africa. Hitherto, no reports of this disease entity have been reported from North Africa and the Arab Peninsula. This paper is therefore the first documentation of tumoral calcinosis in nine patients from the Arabian Peninsula; seven of whom are Saudis and two Yemenis. Peculiar osseous and joint changes co-existed in one of the cases. Moreover, there was a high incidence in the feet, in 75% of cases. One of the lesions was quite extensive. Reason for these changes are suggested. PMID- 3289215 TI - Concurrent chloroquine and Fansidar resistance of Plasmodium falciparum: an imported case from Gabon. AB - A case of concurrent chloroquine and Fandisar resistance is described in a traveller returning from Gabon. Mefloquine therapy resulted in clinical cure. PMID- 3289216 TI - [Anti-cardiolipin antibodies]. PMID- 3289217 TI - [Rapid diagnosis of acute respiratory tract infections in general practice]. PMID- 3289218 TI - [Biosynthetic insulin. A treatment method in diabetic lipoatrophy]. PMID- 3289219 TI - [Ovarian cysts assessed by ultrasound and cytology]. PMID- 3289220 TI - [Can it be proved that antihypertensive treatment has any benefits?]. PMID- 3289221 TI - Estimation of the renal weight by routine echographic measurements. PMID- 3289222 TI - Factors affecting the continuous wave Doppler spectrum for the diagnosis of carotid arterial disease. AB - Spectral analysis of continuous wave (CW) Doppler signals is used for the diagnosis of carotid arterial disease. Previous clinical and in vitro studies have documented that the peak Doppler frequency is increased in recordings made directly over a stenosis and that spectral broadening is observed beyond a stenosis in the region of disturbed flow. However, certain hemodynamic and technical factors can effect the Doppler spectrum and in particular cause spectral broadening although they are not related to the severity of the arterial stenosis. In this in vitro study, Doppler spectra were quantified by (1) measurements of the peak, mean and mode frequencies, and (2) measurements that quantify changes in the shape of the spectra and thus can potentially detect the presence of spectral broadening. The latter measurements included the spectral broadening index (SBI), coefficient of variation (CV), coefficient of skewedness (CS), and coefficient of kurtosis (CK). Using straight tubes without a bifurcation in a steady flow model, we found that the peak frequency and the extent of spectral broadening were dependent upon the severity of the stenosis, the relation of the recording site to the stenosis or bulb, and the flow rate. Comparison of the severity of Doppler spectral broadening from bulb and stenosis recordings allowed us to conclude that any observed changes in spectral broadening measurements are probably due to a significant stenosis and not to the presence of a normal bulb. If the tube is not completely insonated by the CW Doppler beam, an error of between 4 and 35% can be read in the spectral broadening measurements. The peak frequency, mean frequency, and SBI are not altered significantly by the automatic gain control or dynamic range and noise level settings usually chosen by the spectrum analyzer. Because of the variability of individual Doppler spectra, one should be cautious about deriving quantitative data from one individual spectrum. The results of quantitative analysis of the amplitude spectrum are different from the power spectrum. In conclusion, this in vitro study identified several hemodynamic and technical factors that affect the CW Doppler spectrum; however, in the clinical setting, their influence on quantitative measurements of the extent of spectral broadening likely can be minimized by a skilled technologist who uses a standardized technique. PMID- 3289224 TI - Bibliography of biomedical ultrasound. No. 73. PMID- 3289223 TI - Age dependence of the flow velocity in the basal cerebral arteries--a transcranial Doppler ultrasound study. AB - The age dependence of the blood flow velocities of the middle, anterior, and posterior cerebral arteries measured by the transcranial Doppler method is discussed and compared with the velocity values in the internal carotid artery. A number of 535 patients without neurological deficits but with a previous neurological event were examined. Flow velocities decrease in all examined vessels with increasing age. This is in accordance with cerebral blood flow measurements by Xenon inhalation techniques. The reasons of the decrease and its consequences on the vasospasm in patients suffering from subarachnoidal hemorrhage are discussed. PMID- 3289225 TI - Control of bleeding in upper urinary tract and retroperitoneal surgery. AB - Surgery of the upper urinary tract and the retroperitoneal spaces is a constant invitation to potentially serious bleeding. An adequate well-organized exposure of the pathologic condition involved, detailed knowledge of the regional anatomy and its variations, careful gentle dissection of the major vessels, and a calm disposition of the surgeon are the critical factors in preventing intraoperative hemorrhage. Unexpected bleeding is at times unavoidable, and the urologic surgeon should have a well-prepared method for managing hemorrhage during each procedure. Temporary control with gauze packs, sponge sticks, or the surgeon's finger should be the initial step in the control of serious hemorrhage, and this will virtually stop most bleeding. The subsequent period should be used to communicate with the anesthesiologist, who must replace the blood already lost and forewarn the blood bank of future needs. The surgeon is obligated to improve exposure of the bleeding site, dissect out the vessel involved, obtain any additional necessary lighting and suction equipment, and call for a colleague to help secure the vascular rent while applying continued proximal and distal tamponade. Because serious intra-operative hemorrhage can be encountered by even the most skilled surgeon, consultation with an experienced colleague should be looked on as an integral part of the armamentarium for the optimal care of the urologic patient. PMID- 3289226 TI - Complications of extracorporeal shock-wave lithotripsy and percutaneous nephrolithotomy. AB - The serious complications of ESWL associated with the Dornier HM-3 lithotripter are well known. It is incumbent on operators to recognize these problems and, when possible, to anticipate them and utilize a treatment plan that will minimize their occurrence. Appropriate use of percutaneous techniques, double-J stents, and ureteroscopy and aggressive use of antibiotics can minimize the serious complications associated with ESWL. It will be of interest to see whether newer generation lithotripters will produce an incidence of complications similar to that of the Dornier HM-3 or whether unique problems will call for new strategies. We have described the clinically important complications of ESWL and percutaneous nephrolithotomy. At this time, these modalities should be looked on as complementary procedures. Each has specific indications, and, when used appropriately, often in concert, both will provide safe, effective treatment for patients with renal calculus disease. PMID- 3289228 TI - [Differential diagnosis in the need for nursing care]. PMID- 3289227 TI - Management of bowel and urinary tract complications after urinary diversion. AB - Fortunately, the incidence of serious bowel and conduit problems in the immediate postoperative period and within the first year after diversion is low (5 to 10 per cent). The ileal or colon conduit still serves as the standard method of urinary diversion in adults with pelvic malignancy. Prevention of these complications should truly begin in the preoperative period, and careful judgement should be used postoperatively so that no therapeutic option is undertaken too early. The goal in managing these complications is the preservation of renal function, the maintenance of longest possible amount of functioning bowel, and the absence of indwelling stents and tubes. Patience is needed, along with the maintenance of drainage, adequate nutrition, observation for and treatment of sepsis, and a careful delineation of the anatomic defects. These patients, with their high reoperative mortality rate (approximately 50 per cent), present one of the most intriguing and complicated challenges to the urologist. Using the principles outlined here, we have had only one death in 22 consecutive patients referred to the Lahey Clinic for the management of complex bowel and urinary tract complications following urinary diversion. PMID- 3289229 TI - [Expert assessment in continuing specialist education]. PMID- 3289231 TI - [Removal of a pigmented tumor from the forehead and replacing the defect with a flap from the dorsum of the foot]. PMID- 3289230 TI - [Alzheimer's disease]. PMID- 3289232 TI - [Is safe ligation of major arteries possible in patients with chronic terminal renal failure?]. PMID- 3289233 TI - [Prevention of bronchial fistula and empyema after resection and removal of the lung]. AB - Pulmonectomies in 231 patients and resections of a lung in 320 patients were followed by the development of bronchial fistulas in 33 patients (5.9%): after pneumonectomy--in 17 patients (7.3%) and after lobe- and bilobectomy in 16 patients (5%). Empyema of the pleura was noted in 20 patients (3.6%): in 12 patients (5.2%) and 8 patients (2.5%) correspondingly. Seventeen of 53 patients with these complications died. The use of a manual method of suturing the bronchus without a stump with the local application of fibrinogen, complex bronchological sanitation and intraoperative bronchofibroscopy (drainage of the pleural cavity after pneumonectomy with the following filling of the cavity with an antiseptic solution and formation of the selective pneumoperitoneum) allowed to decrease the incidence of bronchial fistulas in 102 patients to 2.9%, and empyema of the pleura--to 1.9%. PMID- 3289234 TI - [Prevention of reflux esophagitis after gastrectomy by the Hofmeister-Finsterer method]. AB - The work generalizes results of diagnostics, prophylactics and treatment of reflux-esophagitis in 174 patients with resection of the stomach by the method of Hofmeister--Finsterer. The preventive use of antireflux operations (frontal crurorrhaphy and fundoesophagophrenorrhaphy) proved to be effective. Resection of the stomach in combination with hiatoplasty was followed by a less amount of reflux-esophagitis (from 48% to 10%) in the remote postoperative period. PMID- 3289235 TI - [Repeat operations after surgical interventions in perforated gastroduodenal ulcers]. AB - Indications to reoperations and conditions of performing them are analyzed on the basis of an experience with 188 reoperations. Principles of choice of the method of reoperations are given which depend on the defects of the primary operations. PMID- 3289236 TI - [Clinico-instrumental methods in the diagnosis and treatment of acute pancreatitis]. AB - Under analysis were diagnostic possibilities of clinico-instrumental methods in examination of 397 patients with acute pancreatitis. The integral method of examination included a general rentgenological examination, angiography, laparoscopy as well as echography and computer tomography. The reliable diagnostics of acute pancreatitis is known to be very complicated and requires a skillful combination of various research methods. The most rational scheme of the examination of patients suspected for acute pancreatitis is proposed. PMID- 3289237 TI - [Angiotensometry in intra-abdominal resection of the rectum and sigmoid in cancer]. AB - The transilluminative occlusive angiotensometry was used for the determination of viability of the sutured segments of the colon in 93 intraabdominal resection for carcinoma. The use of angiotensometry has reduced the incompetence of anastomosis sutures in intraabdominal resections of the rectum and sigmoid colon from 13.6% to 8.6%. PMID- 3289238 TI - [Treatment of rectal fistula]. AB - New methods of operations for high extrasphincter fistulas of the rectum have been developed consisting in dissection of the sphincter passage from the side of perineum to its inner opening and closure of the opening from the side of the intestinal lumen with a flap of wide femoral fascia or bioelastic material with the help of medical glue MK-7. PMID- 3289240 TI - [Migrating foreign body in the abdominal cavity]. PMID- 3289239 TI - [Surgical tactics in anaerobic non-clostridial peritonitis]. AB - Under observation there were 128 patients with neclostridial peritonitis (NP) which made up 19.3% of the total number of patients with peritonitis. In spreaded NP when the source of NP was successfully eliminated and fibrinous layers on the peritoneum the laparotomy wound was tightly sutured up to the aponeurosis (included), primary delayed sutures were put on the skin. When it was impossible to completely remove all the fibrin from the peritoneum, the wound was sutured through all the layers, the sutures were tied in bows followed by numerous revisions of the abdominal cavity. Laparotomy was performed in postoperative NP with phlegmons of the abdominal cavity. The use of the tactics described allowed lethality to be reduced from 39.4% to 13.7%. PMID- 3289241 TI - [Treatment of fissure in ano]. PMID- 3289242 TI - Cerebrospinal fluid. AB - It is hoped that we have demonstrated that collection, handling, and limited analysis of CSF samples from the dog and cat are relatively simple. No special equipment or handling is required, and the procedures are within the capabilities of any veterinarian interested in performing them. In addition, although this article was not intended to present a detailed discussion on the interpretation of the analysis of CSF, we have demonstrated some very practical interpretations to the various aspects of a routine CSF analysis. When combined with a signalment, complete history, and thorough general physical and neurologic examination, CSF analysis can prove invaluable in the workup of an animal with a neurologic disorder. Relatively simple laboratory procedures can be helpful in differentiating peripheral blood contamination from true intrathecal hemorrhage, in identifying an active inflammatory process, in potentially characterizing an etiologic agent, and, on rare occasions, in identifying primary or metastatic neoplastic disease involving the CNS. In many cases, the above is not directly possible, because the changes observed in our routine analysis are nonspecific. Yet, documenting and following these "nonspecific" alterations are helpful in determining if there is progression or regression of the disease process. In turn, these changes or lack of changes are helpful in identifying if the proper therapy has been instituted and if additional or different therapy is required. PMID- 3289243 TI - Neuroradiology. AB - Neuroradiographs are an invaluable part of the diagnostic plan in most cases involving nervous system dysfunction in companion animals. High MAS, low KvP techniques used on standard radiographic equipment available in most veterinary practices will provide good-quality neuroradiographs of the skull and spine. Proper positioning of the animal, which necessitates use of general anesthesia, is required to obtain neuroradiographs of good diagnostic quality. A working knowledge of the normal anatomy of the skull and spine is required to make correct interpretations of the neuroradiographs. PMID- 3289244 TI - Neurogenic disorders of micturition. AB - Anatomic considerations of micturition are reviewed as well as the effects of lesions at various levels on the urinary system as a whole. Proper diagnostic approach, interpretation of results, and recommendations for therapy are outlined to aid the practitioner in handling neurogenic disorders of micturition. PMID- 3289245 TI - Acute injury to the central nervous system. AB - Central nervous system (CNS) trauma is divided into brain and spinal cord injury. A basic understanding of the pathophysiology of CNS trauma helps the practitioner more accurately evaluate, treat, and prognose cases of CNS trauma. The progressive nature of CNS injuries and the contribution of microvascular ischemic are explored. PMID- 3289246 TI - Fibrocartilaginous embolism. AB - Fibrocartilaginous embolism (FCE) is an acute myelopathy that affects primarily dogs and human beings, and occasionally other mammalian species. It is frequently associated with trauma or vigorous exercise; in dogs it tends to affect mature non-chondrodystrophoid and giant breeds. Signs are acute and frequently indicate a very lateralized or focal lesion within the spinal cord, with resultant disparities in sensory and motor function. Lower motor neuron disease is common and hyperesthesia is unusual. The primary differential diagnoses are concussive trauma and intervertebral disc herniation, but the acute onset of strongly lateralizing spinal cord deficits without hyperesthesia in a breed at risk is strongly suggestive of the FCE syndrome. Attention must be given to other systemic diseases that might also give rise to emboli in the absence of FCE. Diagnosis is based on history, clinical signs, and elimination of other differential diagnoses. Treatment is largely supportive, although high doses of methylprednisolone may be beneficial early in the course of the disease. Affected patients may make a functional recovery if deep pain sensation is preserved and there are not complete lower motor neuron signs in affected limbs or sphincters. PMID- 3289247 TI - Selected neurotoxins. AB - The small animal practitioner is faced with an infinite number of potential toxins in our modern environment. Unapproved usage of drugs and insecticides requires the practitioner to keep informed about the development of new toxic syndromes. Recreational drug toxicosis in animals is still seen with some frequency in clinical practice and should not be overlooked, even when the owner denies the possible exposure. In this article, we have discussed a few of the more common and newer neurotoxicities seen in clinical practice today. Neurologic toxicities are complex, but treatment can be rewarding if early diagnosis is made and aggressive therapy is instituted. The practitioner will find it worthwhile to establish contact with a toxicologist or poison information center for additional support when necessary. PMID- 3289248 TI - Inflammatory disease of the central nervous system. AB - Inflammatory diseases involving the central nervous system can be difficult to diagnose and frustrating to treat. The clinician can maximize successful treatment of these patients by recognizing the clinical signs in the early stages of disease, following a logical diagnostic plan to identify the specific etiologic agent involved, and formulating an appropriate and aggressive therapeutic plan. Treatment will not always be successful owing to lack of effective treatments and irreversible neurologic damage. PMID- 3289249 TI - Disorders of the vestibular system. AB - Disorders of the vestibular system are common in veterinary practice and result in a clinical syndrome characterized by head tilt, asymmetric ataxia, and nystagmus. These signs may occur with lesions involving the peripheral or central vestibular structures. Careful neurologic evaluation of the animal and knowledge of surrounding neuroanatomic structures and their functions enable the clinician to differentiate between peripheral and central disorders. Conditions resulting in peripheral vestibular symptoms include idiopathic syndromes, otitis interna, trauma, neoplasia, drug-induced ototoxicity, and congenital disorders. Radiographs of the petrous temporal bone and tympanic bulla and examination of the tympanic membrane are useful in determining the specific etiology. Central vestibular dysfunction may result from inflammatory CNS diseases, neoplasia, trauma, thiamine deficiency, and storage diseases. Cerebrospinal fluid analysis, skull radiographs, and computed tomography are diagnostic tests useful in animals with central vestibular symptoms. Once the etiology is identified, specific therapy may be provided and a more accurate prognosis can be determined. PMID- 3289251 TI - Lumbosacral stenosis and injury of the cauda equina. AB - Idiopathic (congenital) L/S stenosis, acquired (degenerative) L/S stenosis, and traumatic injury to the vertebral column caudal to L6 often produce signs of neurologic dysfunction attributed to compression, displacement, entrapment, or trauma of the cauda equina. Clinical signs vary from animal to animal and depend upon which roots of the cauda equina are involved and the nature of the compromise. An understanding of the anatomy of the area and an appreciation for the functional relationship between the cauda equina and structures innervated are essential for accurate evaluation, workup, diagnosis, treatment, and outcome. PMID- 3289250 TI - Disc-associated wobbler syndrome in the Doberman pinscher. AB - Disc-associated wobbler syndrome is a subset of the diverse canine wobbler complex. Disc-associated wobbler disease can occur in many large-breed dogs but the vast majority are middle-aged Doberman Pinschers. Dorsal annulus hypertrophy and protrusion is the hallmark lesion with variable association of dorsal ligamentum flavum hypertrophy and bony malformations. Chronic caudal cervical spinal cord compression results in the clinical signs. Instability, primary disc degeneration, and conformational etiologies have been incriminated. The clinical course usually entails chronic progressive paraparesis to tetraparesis with insidious onset. Acute onset or exacerbations are less common. Diagnosis is based upon history, neurologic examination, and radiography/myelography. Long-term conservative therapy is only palliative and usually leads to the demise of the animal. Surgical therapy offers the potential of a cure but at significant risk of morbidity and mortality. Surgical treatment consists primarily of decompressive techniques with or without stabilization. The numerous surgical techniques utilized highlight the variability of the lesions and the lack of universal acceptance of any one technique. Decompression is accomplished by surgical access to the vertebral canal to physically remove the abnormal ligament and/or bony material. Alternatively, distraction combined with fusion of the vertebrae adjacent to the offending disc may reduce the hypertrophied/prolapsed dorsal annulus. Regardless of the procedure, postoperative management may be fraught with complications that require special considerations. PMID- 3289252 TI - Neurology of the geriatric patient. AB - Owing to improvements in health care, more animals are living to advanced ages. Many abnormal neurologic conditions can affect these patients, but those most commonly associated with advancing years include degenerative, neoplastic, and idiopathic processes. An understanding of the "normal" age-related changes seen on a neurologic examination must be kept in mind when evaluating geriatric patients. Special care and consideration of the patient and client are often required in managing these cases, especially because treatment protocols are often unsuccessful or do not exist, resulting in a prognosis that is often poor at best. PMID- 3289253 TI - Progress in controlling mastitis in England and Wales. AB - Mastitis in England and Wales has been controlled over the past 20 years while the average size of dairy herds has doubled to 65 cows. The incidence of clinical mastitis has been reduced from approximately 120 to 150 cases per 100 cows to less than 50 cases. The limited data on the prevalence of subclinical mastitis indicate that it has been reduced from over 50 per cent of cows infected to less than half this level. The application of the major mastitis control measures on the farm has doubled over the period 1973 to 1983 and had reached 66 to 90 per cent for individual measures by 1983. The national mean cell count in milk has been reduced from 573,000 to 352,000 cells/ml between 1971 and 1986, and the proportion of herds having annual mean cell counts below 300,000 cells/ml has increased from 15.7 per cent to 40.7 per cent in the last eight years. PMID- 3289255 TI - Salmonella enteritidis infection in broiler chickens. PMID- 3289254 TI - Acupuncture analgesia: a review. AB - Acupuncture analgesia works by stimulating large myelinated nerve fibres which conduct the stimulus to the spinal cord and higher centres. The ascending pain impulses are blocked by a complicated interaction in which serotonin, endorphins, encephalin, norepinephrine and substance P all play important roles. The practical applications of acupuncture in small animal practice are limited and require the cooperation of the owner and the animal. It is useful especially in caesarian sections, in patients with high risk conditions such as gastric torsion and as a post-surgical analgesic. It can also be used to advantage in combination with conventional anaesthetic agents. PMID- 3289256 TI - Fructooligosaccharides: a review. AB - Fructooligosaccharides are naturally occurring compounds that have been reported in a variety of plants. Neosugar is a fructooligosaccharide mixture of 1F-(1-beta fructofuranosyl)-sucrose polymers which is produced on a commercial scale from sucrose using a fungal fructosyltransferase. The resulting product is 0.4 to 0.6 times as sweet as sugar and is resistant to digestion by mammalian alpha-amylase, sucrase and maltase. Although Neosugar is non-digestible in humans, it is selectively utilized by bifidobacteria. Neosugar has been examined extensively in human and animal studies which indicate a lack of toxicity, carcinogenicity and genotoxic effects. Neosugar is used as a feed additive for poultry and swine in Japan and has been approved in foods as a raw material. Additional studies in progress in the US suggest that it could provide an economic alternative as an additive to poultry and swine feed. PMID- 3289257 TI - 1988 Directory of Diplomates. PMID- 3289258 TI - [Prospects of the use of thymus preparations in the prevention of cancer]. PMID- 3289259 TI - [Current possibilities and problems in the rehabilitation of patients with breast cancer]. PMID- 3289260 TI - [Lymphoid cell infiltration of malignant epithelial tumors in humans]. AB - 210 malignant tumors of different sites were studied by morphohistochemical, ultrastructural and stereometric means. Lymphoid cell infiltration was shown to be a morphologic manifestation of immune antitumor reactions. Neoplasms may show very high levels of lymphoid cell infiltration. However, the level of the said cells in the parenchyma and degree of cytotoxic effect on cancer cells are insufficient for antitumor effect to come about. Such factors as parenchyma/stroma ratio, degree of cell differentiation and stage of tumor may influence the level and pattern of infiltration. PMID- 3289261 TI - [Humoral and cellular factors of immunity in mice with hepatoma 22A]. AB - Levels of hepatic autoantigens, anti-hepatic antibodies and immune complexes in sera of C3HA mice bearing syngeneic weakly-immunogenic hepatoma 22a were measured. The level of autoantigens increased during tumor growth, while autoantibodies were not identified at all stages. Circulating immune complexes were shown to bind heterologous complement at early stages of hepatoma growth, but later they did not. Bound immune complexes were identified in the kidney by means of immunofluorescence. Blastogenic reaction of normal splenic cells did not change when cells were cultivated with serum of tumor-bearing mice obtained throughout tumor growth. The proliferative activity of tumor-bearers' lymphocytes decreased during cultivation with serum taken at the terminal stages of tumor growth only. However, there was no correlation with the presence of free hepatic antigen and immune complexes in sera of hepatoma-bearing mice. PMID- 3289262 TI - [Prof. L. M. Ratner]. PMID- 3289263 TI - [Organization of medical treatment of patients with infectious disease in the Ukraine in the pre-revolution period]. PMID- 3289264 TI - [The role of various risk factors in the development of arteriosclerosis of arteries of the brain stem]. PMID- 3289265 TI - [Diabetic neuropathy of the heart (review of the literature)]. PMID- 3289267 TI - [Drug treatment of patients with pyelonephritis (review of the literature)]. PMID- 3289266 TI - [Changes in the hormone system in patients with acute and chronic pneumonia]. PMID- 3289268 TI - [Effectiveness of the pathogenetic treatment of patients with acute glomerulonephritis]. PMID- 3289269 TI - [Doppler ultrasonography in the diagnosis of the initial symptoms of dyscirculatory encephalopathy in elderly patients]. PMID- 3289270 TI - Distribution coefficient, a convenient term for the relation of predictable physico-chemical properties to metabolic processes. AB - 1. The consequences of metabolic transformation on lipophilicity have been considered using the terms log P (partition coefficient) and log D (distribution coefficient). 2. Transformations which result in no change in the degree of ionisation can be readily predicted by the use of fragmental constants and log P. 3. If metabolism alters the degree of ionization then the distribution coefficient, log D, at physiological pH is a more appropriate term to use. Intuitive empirical observations may be incorrect and lead to false assumptions about the lipophilicity or water solubility of metabolites. 4. Metabolism may form zwitterionic molecules. These metabolites need special consideration since their penetration into lipid phases may be greater than expected. PMID- 3289271 TI - [The role of the kidney in the pathogenesis of hypertension]. AB - Neither a temporary increase in salt intake nor the activation of endogenous vasoconstrictor hormones alone will cause a rise in blood pressure in healthy subjects. High blood pressure rather results from an augmented product of cardiac output and peripheral vascular resistance, which also requires defective baroreceptor function. Experimental and clinical evidence from renal transplantation suggests that high blood pressure may be transmitted by the kidney. Morphological or functional inability of the kidney to adequately eliminate excessive salt, as in renoparenchymal hypertension, or with enhanced renal adrenergic activity in the presence of high salt intake, may induce initially salt- and volume-dependent hypertension with increased cardiac output and normal peripheral vascular resistance. In the case of reduced nephron population, this first stage was shown to be followed by a normalization of cardiac output, but a simultaneous rise in peripheral vascular resistance, including decreased compliance of the venous capacitance vessels. What are the underlying mechanisms which convert volume-dependent hypertension into high resistance hypertension without necessarily reducing central blood volume? Increased central blood volume, which may stimulate the secretion of an endogenous Na-K-ATPase inhibitor or other endogenous factors, may cause decreased transmembranous sodium transport, resulting in elevated intracellular concentrations of sodium and calcium with enhanced responsiveness of the vascular smooth muscle cell to vasoconstrictor hormones. Since increased central blood volume also decreases baroreceptor sensitivity, the disturbed interplay of cardiac output and peripheral vascular resistance will result in high blood pressure. PMID- 3289272 TI - [Aggressive mediastinal fibrosis, a rare cause of superior vena cava obstruction- case report and review of the literature]. AB - An aggressive mediastinal fibrosis was found to be a cause of superior vena caval obstruction in 1 to 2% of patients. Symptoms can be discrete for a long time, but the progressing disease can cause many symptoms. A 56-year-old man who, for half a year, suffered from thoracic pain during deep inspiration, and then rapidly developed superior vena caval obstruction caused by aggressive mediastinal fibrosis is discussed. The operative treatment consisted in complete replacement of the superior vena cava. PMID- 3289273 TI - [Biochemical parameters of wound healing and their relation to aging]. AB - Today old age represents no contraindication to operative treatment. The age dependence of normal coagulation, immunological system and connective tissue components is described with respect to the course of wound healing. Possible misinterpretations that may occur, if preoperative values do not exist and the subsequent course is not observed, are pointed out. PMID- 3289274 TI - [Complications following autologous bone transplantation at the site of removal]. AB - Between April 1978 and December 1983, 206 operations to obtain autologous bone were performed in the Orthopedic Department of Barmbek General Hospital. In 1985, 125 patients were analyzed by means of a detailed questionnaire and a clinical examination. A total of 55.2% of the 125 patients were free of complaints following removal of bone. In 37.6% there were slight to moderate, and in 7.2% severe to extremely severe complications. The most common type of complaint was persistent postoperative pain (40%). Neural damage, i.e., hypesthesia and dysesthesia, was observed in 21.6% of the cases. An increased postoperative tendency to swelling was seen in 12.8% of the 125 patients. There was also one case of fracture of the shaft of the tibia in the area where bone had been removed. Other complications were rare. All in all, the postoperative complications following removal of a chip from the shin were the most serious. Complaints due to removal from the posterior iliac crest were considerably less severe. The least problematic courses were those after removal from the anterior iliac crest. Removal of coritcospongious chips from the tibia should be avoided if at all possible. The removal site of choice is the anterior iliac crest, unless the posterior crest has to be preferred because of the surgical technique employed. PMID- 3289275 TI - [Value of heterologous bone transplants in the surgical therapy of habitual shoulder dislocation]. AB - 45 heterologous bone grafts of "Kiel Bone" were radiologically examined after operative treatment of recurrent shoulder dislocation in the technique of M. Lange. The postoperative period differed between 1 and 17 years. Bony consolidation was achieved in 80% of the cases. Signs of resorption were postoperatively found in 14 cases. Five of them consolidated secondaryly. The results of our study show the usefulness of "Kiel Bone" in the treatment of recurrent shoulder dislocation. It should not be used as a bone graft in cases which require quick an secure consolidation. In these cases autologous bone grafts are superior. PMID- 3289277 TI - [Sensitivity and specificity of the passive hemagglutination reaction with erythrocyte diagnostic agents made from cultured and pathogenic Treponema pallidum]. PMID- 3289276 TI - [Preoperative skin disinfection in interventions on the hip joint]. AB - Gram-positive cocci in particular, mainly Staphylococcus aureus and Staphylococcus epidermis, can be identified on patients' skin as facultative causes of wound bed infection. Disinfection the evening prior to surgery causes a statistically significant reduction in the number of skin organisms. The only explanation of the increase in the number of such organisms in isolated patients following disinfection the evening prior to surgery, and also after preoperative disinfection, is recontamination of the disinfected skin areas. Covering them with sterile surgical trousers and adhesive foils does not provide sure protection from recontamination. Studies of this kind may enable specific hospitals to establish a perioperative antibiotic prophylaxis for their own spectrum of micro-organisms. PMID- 3289278 TI - [Case of lepromatous leprosy]. PMID- 3289279 TI - [75th anniversary of the Department of Skin and Venereal Diseases of the Pirogov II Moscow Medical Institute]. PMID- 3289280 TI - The importance of metallic elements in wine. A literature survey. AB - A review of the current literature concerning the role played by metallic elements present in wine is presented. The aim is to show the importance of these elements in the entire wine-making process, mainly through their influence on the organoleptic properties of wine. The study takes into consideration the individual stages of the process such as fertilization, fermentation and aging and also deals with other interesting aspects related to hygiene and dietetic properties, as well as the possibility of differentiating wines according to their metal contents. PMID- 3289281 TI - [Analysis of prosthetic performance from 1980 to 1985 of the clinical-prosthetics and technical-prosthetics time period and the specific application of the dental technician]. PMID- 3289282 TI - [From the "cracknel-teeth" up to individual relief of the mastication surface]. PMID- 3289283 TI - [Interchangeable system of "articulator-plaster-key-fixing" in model casting technics]. PMID- 3289284 TI - [Acidifying device for precious alloys for use in dental technology]. PMID- 3289285 TI - Enterohemolysin, a new type of hemolysin produced by some strains of enteropathogenic E. coli (EPEC). AB - 42 Escherichia coli O26 strains which had been isolated at geographically different places and over a long time period were examined for hemolysin synthesis. 17 of these were found to be hemolysin-negative, nine strains were found to produce plasmid encoded alpha-hemolysin and 16 strains were shown to produce a phenotypically different hemolysin. This new type of hemolysin was called enterohemolysin and found to be genetically and immunologically non related with the already described E. coli alpha-hemolysin. Enterohemolytic E. coli were not found in feces of 200 healthy infants under the age of two years. However, four E. coli O111 strains, one O121:H- and one O25:K5:H- strain, all from infants with diarrhoea were also enterohemolysin producers. PMID- 3289286 TI - [Research on the molecular mechanisms of the pathogenesis of myodystrophies and the systematic approach to the study of human proteins (a review)]. PMID- 3289287 TI - [Ocular symptoms of myasthenia (a review)]. PMID- 3289289 TI - [Hysterical psychopathy. The typological aspects (a review of the foreign literature)]. PMID- 3289288 TI - [Metabolism of steroid sex hormones in different physiological and pathological states of the skeletal muscles]. PMID- 3289291 TI - [Dynamics of clinical hormonal indices in patients with reactive depressions]. AB - Using radioimmunoassay the authors studied the patterns of plasma levels of cortisol, insulin, triiodothyronine, and thyroxine in patients with acute and protracted reactive depressions. The patients had higher cortisol levels and lower immunoreactivity of the other three hormones as compared to a group of healthy donors. Patients with acute depressions had higher values of cortisol than those with protracted ones. The treatment tended to normalize the hormonal parameters which was parallelled by positive clinical dynamics. Patients with protracted reactive depressions were more resistant to the conducted therapy. Concentrations of plasma hormones (with the exception of insulin) at the end of the treatment remained altered as compared to those in healthy subjects. PMID- 3289290 TI - [Characteristics of cerebral blood flow in children with cerebral palsy during the dynamics of treatment]. AB - Using methods of circulatory radioencephalography and encephaloscintigraphy the authors identified changes in the parameters of the cerebral blood flow (CBF) in 103 patients with childhood cerebral paralysis. Depending on predominant disorders of the CBF in the microcirculatory, arterial or venous systems, vasoactive drugs administered for hemodynamic correction were used differentially. PMID- 3289292 TI - Insulin/C-peptide response to intravenous glucagon. A dose-response study in normal and non-insulin-dependent diabetic subjects. AB - The C-peptide and insulin secretory responses to increasing doses of iv glucagon (1, 2, 5, 10 micrograms/kg body weight and 1 mg (only diabetics] were investigated in six lean non-insulin-dependent diabetic patients and six normal subjects, matched for body weight and fasting blood glucose concentrations. A well defined relationship between glucagon dose and the C-peptide/insulin response was observed in both groups. The course of the dose-response curves was significantly different in diabetics. The maximal obtainable C-peptide response (E-max) was reduced to 53% of the response in normal subjects (P = 0.037), and the insulin response was reduced to 52% (P = 0.014). E-max was reached in diabetics with only 10 micrograms/kg of glucagon, whereas higher doses seem to be needed in the control group. However, the glucagon dose causing 50% of E-max (ED50) was not significantly higher. Thus, the widely accepted use of 1 mg of glucagon to test residual beta cell function secures a maximal response of both insulin and C-peptide in non-insulin-dependent diabetic subjects. In addition, our data support the theory that beta cell deficiency is a basic feature of non insulin-dependent diabetes. PMID- 3289293 TI - Reduction of urinary albumin excretion after 4 years of continuous subcutaneous insulin infusion in insulin-dependent diabetes mellitus. The Oslo Study. AB - Urinary albumin was studied in 45 patients with insulin-dependent diabetes in a 4 year prospective randomized trial, comparing continuous sc insulin infusion (CSII), multiple insulin injections, and conventional treatment with twice daily injections. Strict blood glucose control was obtained with CSII and multiple injections, better than with conventional treatment (2P less than 0.01): mean glycosylated haemoglobin (% HbA1 +/- SEM) after 4 years: CSII 9.0 +/- 0.4%; multiple injections 9.4 +/- 0.4%; conventional treatment 10.5 +/- 0.5. A total of 696 24-h urine specimens were collected. After 4 years of CSII from the time of randomization, urinary albumin excretion was reduced (26 +/- 5 to 16 +/- 4 mg/24 h, mean +/- SEM, 2P less than 0.01), when compared with conventional treatment (2P = 0.01), when compared with conventional treatment (2P = 0.01) where no change was observed (21 +/- 4 to 22 +/- 6 mg/24 h, n.s.). The reduction observed during multiple injection treatment was not significant (17 +/- 3 to 14 +/- 3 mg/24 h). Long-term near-normoglycaemia may influence the mechanisms leading to albuminuria in diabetes, if introduced at an early stage of the disease. PMID- 3289294 TI - Effects of corticotropin-releasing hormone on insulin and glucagon secretion in mice. AB - Besides in the brain, corticotropin-releasing hormone occurs in the pancreas. Therefore, its effects on plasma levels of insulin and glucagon were investigated in vivo in the mouse. At 2 min after CRH injection (0.5-8.0 nmol/kg), plasma insulin was lowered: by 4.0 nmol/kg from 38 +/- 4 to 28 +/- 2 mU/l (P less than 0.05). Plasma insulin was lowered also at 6 min, whereas at 10 min, plasma insulin levels were elevated (P less than 0.05). Plasma glucagon levels were slightly lowered (P less than 0.05) at 10 min after CRH injection, whereas plasma glucose was slightly elevated (P less than 0.05) at 6 min after injection but not at 2 or 10 min. The effects of CRH on the plasma insulin and glucagon response to iv injections of half-maximal dose levels of glucose (2.8 mmol/kg) or the cholinergic agonist carbachol (0.16 mumol/kg) were also investigated. CRH, 4.0 nmol/kg, however, could not influence the plasma insulin or glucagon levels after the iv injection of either glucose or carbachol. Thus, CRH slightly affects basal plasma levels of insulin and glucagon in mice. In contrast, stimulated insulin and glucagon secretions are not affected by CRH. Peripheral CRH may therefore be of slight importance for the regulation of basal plasma levels of insulin and glucagon in the mouse. PMID- 3289295 TI - No effect of superoxide dismutase on spontaneous development of diabetes in db/db mice. AB - B-cells have previously been shown to be very susceptible to damage induced by superoxide radicals, and protection against such damage has been achieved both in vitro and in vivo with superoxide dismutase. During maturation, db/db mice develop diabetes and accumulation of potentially superoxide radical-producing leucocytes can be demonstrated in the islets during the process. To test for the possibility that superoxide radical-induced damage contributes to the development of diabetes, db/db mice were given daily ip injections of 200 mg/kg polyethylene glycol-substituted CuZn superoxide dismutase. No effect of the treatment could be demonstrated. PMID- 3289296 TI - Effects of neuromedin B, gastrin-releasing peptide-10 and their fragment peptides on secretion of gastrointestinal and pancreatic hormones in dogs. AB - The effects of neuromedin B (NMB), gastrin-releasing peptide (GRP)-10 and their C terminal fragment peptides on the pancreatic and gastrointestinal hormone release were studied in dogs. Intravenous bolus injections of NMB and GRP-10 (4.5 nmol/kg) into conscious dogs elicited a sharp and statistically significant rise in plasma gastrin and insulin levels, but only GRP-10 brought on a significant rise in the plasma glucagon and enteroglucagon levels. The degree of stimulation of gastrin and insulin secretion by NMB and GRP-10 was dose-dependent. With a dose of 4.5 nmol/kg, the minimum size of C-terminal fragment peptides of NMB and GRP-10 to stimulate gastrin secretion was NMB and GRP-10, respectively. Both NMB and GRP-10 (0.1-100 nmol/l) stimulated insulin release from the isolated canine pancreas. The glucagon release was stimulated by 10 and 100 nmol/l GRP-10 and was not stimulated by the same doses of NMB. The somatostatin release was not influenced by either peptide. It is concluded that 1) NMB and GRP-10 can stimulate gastrin and pancreatic hormone secretion, and the latter effect may be mainly due to a direct action on the islet cells; 2) the stimulatory effect of GRP-10 is stronger than that of NMB. The difference in the minimal active fragment between NMB and GRP-10 suggests that the amino acid of position 3 - NMB (Leu) and GRP-10 (His) - may play an important role in their biological activity. PMID- 3289298 TI - Interleukin-1 potentiates glucose stimulated insulin release in the isolated perfused pancreas. AB - The acute effects of recombinant human interleukin-1 beta (rIL-1) on basal and glucose-stimulated insulin release were investigated in the isolated perfused pancreas. At a concentration of 20 micrograms/l rIL-1 had no effect on basal insulin release, but increased the total amount of insulin released during first and second phase insulin release in response to 20 mmol/l D-glucose in the rat pancreas (P less than 0.05). In addition, 26 micrograms/l of rIL-1 potentiated insulin release in response to square wave infusions of stimulatory concentrations of glucose (11 mmol/l) in the porcine pancreas. We hypothesize that IL-1 in the systemic circulation may affect B cell function in vivo. PMID- 3289297 TI - Demonstration of gonadotropin-induced plasma renin activity in human internal spermatic vein. AB - In order to investigate the secretion of renin from the Leydig cells of human testis, plasma renin activity (PRA) in left internal spermatic vein (ISV) and cubital vein (CV) was measured at the time of surgical repair of varicocele in 19 patients aged from 21 to 39 years. Ten of them were given a single im administration of hCG (10,000 IU/m2) 4 days before the operation, whereas the remaining nine were not treated. Although mean PRA levels in CV in treated and non-treated groups were similar (1.25 +/- 0.45 and 1.14 +/- 0.38 nmol/l per h, respectively), mean PRA level of ISV in the treated group (3.52 +/- 0.76 nmol/l per h) was significantly higher than that in the non-treated group (1.30 +/- 0.32 nmol/l per h) (P less than 0.01); serum testosterone levels in the same ISV were also much higher in the treated than in non-treated group (P less than 0.001). These data show the following results; 1) under basal conditions, no release of renin from Leydig cells into testicular blood flow could be observed; 2) after treatment with hCG, the secretion of renin into the ISV seemed to be demonstrable. The present results suggest for the first time the secretion of hCG induced renin from the human testis in vivo. PMID- 3289299 TI - Ultrastructural evidence for oxytocin in the rat anterior pituitary gland. AB - OT is synthetized in the hypothalamus. These neurons project to the posterior lobe of the pituitary and the external zone of the median eminence. In order to localize OT in the male rat anterior pituitary we have used immunocytochemistry on ultra-thin sections in target cell(s) obtained by cryoultramicrotomy. OT-like immunoreactivity was observed in lactotropes only. No immunoreactivity was observed in gonadotropes, somatotropes, corticotropes or thyrotropes. In lactotropes, immunoreactivity was localized at the plasma membrane level, in the cytoplasmic matrix and around the secretory granules, but not in the other organelles, and in the nucleus. No reaction was observed by using either non immune serum or anti-OT serum incubated with OT. No modification of OT-like immunoreactivity was observed by using anti-OT serum incubated with heterologous peptides. These results 1) provide immunocytological evidence for the presence of OT in the anterior pituitary gland; 2) indicate the presence of this peptide in one particular cell type, and 3) support the hypothesis that OT could have a direct participation in the regulation of the PRL release. PMID- 3289300 TI - The effect of pirenzepine on growth hormone and blood glucose levels in type I diabetes mellitus. A controlled study in patients on basal bolus insulin treatment. AB - Increased GH levels in Type I diabetes mellitus have been implicated in the pathogenesis of metabolic complications such as the so-called dawn phenomenon. GH secretion is under control of cholinergic mechanisms. In 21 Type I diabetic patients the effect of oral administration of the anticholinergic drug pirenzepine in addition to intensive insulin therapy on GH and blood glucose levels was studied. At 21.30, 08.00 and 12.00 h, all patients received in random order 50 mg of pirenzepine or placebo po. Blood for determination of GH, blood glucose, cortisol and C-peptide levels were obtained at 3-h intervals. Serum levels of plasma glucose and GH were significantly lower under pirenzepine than under placebo (P less than 0.05 and P less than 0.01, respectively). Serum levels of cortisol, free insulin and C-peptide were comparable on the test and the control day. Our data indicate that in Type I diabetes mellitus the anticholinergic drug pirenzepine is effective in decreasing both GH and blood glucose levels. PMID- 3289301 TI - Insulin-like growth factors in the Gottinger miniature-pig. AB - IGF I was determined by a radioimmunoassay and IGF II by a radioreceptorassay in 20 Gottinger miniature (mini)-pigs and 13 domestic pigs of different weight and age. Immunoreactive IGF I serum levels of mini-pigs were similar to those of domestic pigs in corresponding age-classes (150-250 and 100-270 micrograms/l, respectively). No differences were detectable between receptor-reactive IGF II serum levels in mini-pigs (150-200 micrograms/l) and domestic pigs (110-270 micrograms/l) nor did the biological insulin-like activities (measured in the rat fat cell assay) differ in mini- and domestic pigs (81-100 and 71-98 mU insulin/l, respectively). IGF I and IGF II decreased drastically after hypophysectomy in one of the mini-pigs. Intravenous bolus injections of 30 micrograms/kg of recombinant human IGF I in 4 mini-pigs caused a similar degree of hypoglycemia (nadir of blood glucose 1.33 +/- 0.61 mmol/l) as 0.15 IU insulin/kg, followed by a sharp growth hormone peak. We conclude that the marked difference between mini- and domestic pigs regarding body size is unrelated to serum levels of IGF I and II, a lack of response of tissues to IGF I or a reduced growth hormone secretory capacity in the mini-pig. PMID- 3289302 TI - The influence of pulsatile GnRH administration to the ovariectomized rat on the pituitary response to GnRH and the occurrence of spontaneous LH pulses. AB - Otherwise untreated adult ovariectomized rats were given pulses of GnRH (5 ng/100 g body weight iv) once every 60 or 120 min for 24 or 96 h. On the first and last day of the experiment plasma LH was estimated during the administration of GnRH pulses. Endogenous LH pulses between exogenously generated LH pulses were observed in nearly all animals on both the first and the last day, without any change in nadir and amplitude values. Shortly after an injection of GnRH, the spontaneous LH pulses were fewer than expected. The number of these pulses, however, increased again with time after the injections. The response to exogenous GnRH was reduced on the last day of the experiment. However, not all GnRH injections led to LH pulses. Most injections which did not result in an LH pulse appeared to be given within 15 min after a preceding endogenous LH pulse. The results obtained are in agreement with the hypothesis of an acute short lasting desensitization of the pituitary gland caused by exogenous as well as endogenous pulses of GnRH. PMID- 3289303 TI - Vasoactive intestinal peptide stimulates gonadotropin-releasing hormone release from rat hypothalamus in vitro. AB - The effects of vasoactive intestinal peptide (VIP) on the releases of LH and GnRH were examined in a sequential double chamber perifusion system by perfusing the medio-basal hypothalamus and/or pituitary excised from normal female rats in diestrus or ovariectomized rats. When the medio-basal hypothalamus and pituitary from normal rats in series were perifused with VIP (10(-6) mol/l), the concentration of LH in the efflux was increased by 59-181% above that before the injection (P less than 0.05), VIP having a dose-dependent effect. VIP had no effect on LH release from the pituitary perifused alone. Infusion of VIP at 10( 6) mol/l induced a significant release (84-159% increase, P less than 0.05) of GnRH from the medio-basal hypothalamus. Infusion of 10(-6) mol/l VIP induced a significant release (41-99% increase, P less than 0.05) of LH in ovariectomized rats. These findings suggest that VIP induces GnRH release from the medio-basal hypothalamus, resulting in LH release from the pituitary, and that this process does not require ovarian estrogen. PMID- 3289304 TI - Immediate and time-dependent effects of glucose on insulin release: differential calcium requirements. AB - Glucose regulates insulin release in a complex manner; apart from its acute secretory action it induces time-dependent effects which modulate subsequent islet responses. The Ca2+ sensitivities of the diverse secretory events generated by glucose were investigated in the perfused rat pancreas. First- and second phase insulin responses to 16.7 mmol/l glucose were obliterated in the presence of 5 mmol/l EgTA; threshold Ca2+ concentrations for significant responses were 0.25 mmol/l for second-phase, and 'O' (no Ca2+ added, approx 20 mumol/l) for first-phase release (both around 10% of control). The apparent Km of the Ca2+ dependencies were 0.6 mmol/l for first-phase, and 1.25 mmol/l for second-phase release. Time-dependent potentiation was demonstrated by subjecting the pancreas to two 40-min 16.7 mmol/l glucose stimuli separated by a 30-min rest period; this amplified the first-phase response to the second stimulus 2.5 +/- 0.9-fold. Also the generation of potentiation was Ca2+ dependent, with characteristics similar to those of the acute second-phase insulin response (apparent Km approximately 1.0 mmol/l Ca2+). In contrast, the amplified first-phase response to the second glucose pulse retained its high sensitivity to Ca2+, thus resembling the unprimed first-phase. The inhibitory message of glucose was demonstrated by applying two sequential 5-min pulses of 8.3 mmol/l glucose: the insulin response to the second stimulus was reduced by 43 +/- 9%. Addition of EgTA to the first glucose pulse had no effect on the inhibition of the second insulin response. Thus: 1. Despite its high sensitivity to Ca2+, also first-phase release is fully dependent on extracellular Ca2+.2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289305 TI - From molecular mechanisms to behavior. PMID- 3289306 TI - Sonography of popliteal masses. AB - Sonography of the popliteal space was performed in 28 patients with a history of a popliteal mass, verified by physical examination in all but 7 patients. The final diagnosis was established by needle biopsy or surgery. Three main types of lesions were found sonographically. A thin-walled echo-free cyst was present in 16 patients. The diagnosis in all of these cases was Baker's cyst. Two patients had a mixed cystic and solid lesion, which was found to be a Baker's cyst, with a loose body in 1 case and a soft-tissue sarcoma with hematoma in the other. Three patients showed solid lesions subsequently diagnosed as an old rupture of the semimembranosus muscle, lipoma, and soft tissue sarcoma. Sonography was normal in the 7 patients without clinical evidence of a popliteal mass. Sonography of popliteal masses is useful to distinguish benign cysts from other lesions. PMID- 3289307 TI - Acetabular fracture causing hip joint tamponade. A case report. AB - An 81-year-old woman had severe hip pain after a fall. Radiography was normal, but computed tomography and sonography showed a minor, displaced acetabular fracture and hemarthrosis. Aspiration of 15 ml of blood reduced the intracapsular pressure in the neutral position from 30 kPa to atmospheric pressure with relief of pain and increased joint motion. This case confirms that acetabular fracture may escape radiographic diagnosis and cause hip joint tamponade. Aspiration should be considered as a palliative and possibly therapeutic measure. PMID- 3289309 TI - Determinants of adolescent obesity: a comparison with anorexia nervosa. AB - This report investigates childhood and adolescent obesity through a comparison with anorexia nervosa, an eating disorder typically associated with the opposite end of the eating behavior spectrum. Many similarities in the etiologies of the two conditions are discussed, particularly with regard to the influence of family interactional patterns. More specifically, it appears that the families of both anorexics and the obese are characterized by overprotectiveness and enmeshment, resulting in a poor sense of identity and effectiveness. Such children, usually compliant and dependent in childhood, misuse the eating function in an attempt to assert their independence and gain control of their lives in adolescence. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III R), anorexia nervosa, but not obesity, meets the definition of an eating disorder. Although it appears that DSM-III-R is accurate in not classifying obesity as an eating disorder, it is important to keep the etiological similarities of the two conditions in mind when treating obesity. PMID- 3289308 TI - The travails of 19th-century urban youth as a precondition to the invention of modern adolescence. AB - One of the factors leading up to the "invention" of modern adolescence was what reformers saw as the corruption of youth by the city. It was the plight of these youth--all too visible to reformers, intellectuals, opinion makers, and trend setters--which set the stage for a child-saving movement during the last century aimed at taking youth off the streets, putting them in schools, stretching out the home-leaving age from 14 to 18, and in general, prolonging a developmental period. PMID- 3289310 TI - Delinquency: the learning disabled students reaction to academic school failure? AB - Support for the relationship between academic performance and delinquency is offered. Additionally a review is provided describing the learning disabled male adolescent as the target population for experimental research. PMID- 3289311 TI - High points in the physiology of extreme altitude. PMID- 3289312 TI - Circulatory adjustments to anemic hypoxia. PMID- 3289313 TI - Red cell properties and optimal oxygen transport. PMID- 3289314 TI - Matching O2 delivery to O2 demand in muscle: I. Adaptive variation. PMID- 3289315 TI - Matching O2 delivery to O2 demand in muscle: II. Allometric variation in energy demand. PMID- 3289316 TI - The relationship of tissue oxygenation to cellular bioenergetics. PMID- 3289317 TI - Pulmonary diffusing capacity and alveolar-capillary equilibration. PMID- 3289318 TI - Skeletal muscle mitochondria: the aerobic gate? AB - At an animal's maximum aerobic capacity (VO2max), the O2 flowing through the respiratory system is consumed by a functionally exclusive sink, skeletal muscle mitochondria. Thus, O2 consumption will never exceed the muscles O2 demand. If the system is ideally designed, structures upstream to the skeletal muscle O2 sink must be built to insure adequate O2 delivery to the working muscle. There are a number of structure-function solutions available to supply the demanded O2 to the muscle; these have been found to vary, often ontogenetically, with hypoxia, training, etc. But there is one relationship that is invariant: Total O2 uptake can be predicted by the total (active) skeletal muscle mitochondrial volume. In aerobic and sedentary animals, across a range of body sizes, maximum (in vivo) mitochondrial O2 consumption is constant among mammals (at approximately 2000 O2 molecules per square micron of inner mitochondrial membrane per second). Because the volume of mitochondria is one of the most plastic of all respiratory structures, we interpret this relationship as suggesting that skeletal muscle mitochondria alone sets the demand for O2 and, thus, the volume of skeletal muscle mitochondria dictates an animal's maximum aerobic capacity. PMID- 3289319 TI - Breathing during exercise: demands, regulation, limitations. AB - In humans alveolar ventilation (VA) is adjusted almost perfectly to the metabolic demands of mild and moderate exercise. For example, in exercise transitions and in the steady state, PaCO2 rarely deviates by more than 1 to 3 mmHg from the value at rest. This near-homeostasis contrasts to most other mammalian species; equines for example, demonstrate a progressive hypocapnia and alkalosis as exercise intensity is increased to moderate levels. In equines, the control systems seem programmed for a specific hyperventilation that contributes to maintenance of PaO2 homeostasis. Generally, during heavy exercise all species hyperventilate creating hypocapnia, increased PAO2, widened A-a O2 gradient, and PaO2 homeostasis. The origin of the metabolic ventilatory stimulus remains controversial. Evidence exists for: a) "neural" mediation, either central command or peripheral afferent in nature; and b) "humoral" mediation with an intra thoracic metabolite receptor being a possibility. The mechanism of the species differences in hyperventilation during exercise does not appear to be due to species variation in chemoreceptor "fine tuning". Contrary to traditional thinking, recent findings suggest that the hyperventilation during heavy exercise might not be mediated by lactacidosis stimulation of chemoreceptors. The increase in VA during exercise is achieved efficiently in that airway diameter is modulated and the pattern of breathing and the recruitment of respiratory muscles are set to minimize the O2 cost of breathing. It has been postulated that mechanoreceptors in airways, lung parenchyma and the chest wall are important to efficient breathing. Their role and contribution to the exercise hyperpnea has been shown by reductions in respiratory neural output within breath when respiratory impedance is reduced via helium breathing. Hilar nerve afferents do not appear to be critical to this response. However, carotid chemoreceptors appear essential for "fine tuning" of VA when respiratory impedance is reduced. In most healthy exercising mammals, the efficiency component of the exercise stimulus does not compromise VA. There are two known major exceptions. One is the extremely fit human athlete during very high workloads when atypically there is minimal or no hyperventilation resulting in arterial hypoxemia. That indeed the high O2 cost of breathing compromises VA is indicated by hyperventilation and alleviation of hypoxemia with resistance unloading through helium breathing. A second example of a compromise of VA is that of a galloping racehorse at very high workloads.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3289320 TI - Problems with the hyperventilatory response to exercise and hypoxia. PMID- 3289322 TI - Convection, diffusion and their interaction in the bronchial tree. AB - The bronchial tree is an asymmetric multi-generation conduit for air to pass through. Breathing is a time-varying, cyclic process. Therefore, gas transport in the bronchial tree during breathing is a problem with both spatial and temporal complexities. However, it is possible to gain a fair understanding of this complex process by examining the roles of bulk convection, molecular diffusion and the various modes of their interaction. Convection brings the inspired gas into the peripheral region of the lung and removes the mixed inspired-resident gas from the lung. During the post-inspiratory and post-expiratory pauses and in the very distal regions of the lung, molecular diffusion alone is responsible for the mixing process. Convection and diffusion together are responsible for establishing a quasi-steady front of the inspired gas in the peripheral lung region. The position of the front depends on lung volume, tidal volume, inspiratory flow-rate as well as diffusivity of the inspired gas. Taylor-type dispersion, while certainly existing in the lung, and despite its gas mixing potentials, is of questionable effectiveness in the overall gas transport process in the bronchial tree. The various modes of interaction between convection and diffusion are likely to improve gas mixing in the bronchial tree and have an effect on the phase II of the single-breath washout curve. PMID- 3289321 TI - Regulation of the acid-base balance during prolonged hypoxia: effects of respiratory and non-respiratory acidosis. PMID- 3289323 TI - Comparative physiology of oxygen transfer in lungs. PMID- 3289324 TI - Limitations to the efficiency of pulmonary gas exchange during exercise in man. PMID- 3289325 TI - Distribution of skeletal muscle blood flow during locomotory exercise. PMID- 3289326 TI - Physiology of lipoteichoic acids in bacteria. PMID- 3289327 TI - Exoerythrocytic development of malarial parasites. PMID- 3289328 TI - Parasites and complement. PMID- 3289329 TI - Chemical communication in helminths. PMID- 3289330 TI - The nature, extent and significance of variation within the genus Echinococcus. PMID- 3289331 TI - Cryptosporidiosis in perspective. AB - In this review I have examined the vast literature which has accumulated on Cryptosporidium, particularly in the past 3 years, in an attempt to highlight areas in which progress has been made in relation to the organism and the disease, and to indicate areas in which knowledge is still lacking. Since 1982, a global effort by scientists and clinicians has been directed towards determining the nature of the disease in humans and the relative contribution of cryptosporidiosis to gastroenteritis. From published data, the incidence of diarrhoea is 1-5% in most developed countries, and 4-7% in less developed countries, when measured throughout the year and in all age groups. The frequency of cryptosporidiosis is highest in children aged between 6 months and 3 years, and in particular locations (e.g., day-care centres) and at particular times of the year. Although susceptibility to infection is life-long, one suspects that the lower prevalence among older children and adults is due to immunity acquired from frequent exposure. Other important factors contributing to higher prevalence are the season--it is more frequent in a wet, warm climate--association with travel to particular destinations, poor hygiene, intimate contact with certain animals, and congregation of large numbers of young previously unexposed children in day-care centres. The association between cryptosporidiosis and giardiasis presumably results from the existence of a common source of infection. The immune status of the host appears to be a major determinant of whether the infection is self-limiting or persistent. It is clear that both branches of the immune system are required for complete recovery, since T-lymphocyte dysfunction or hypogammaglobulinaemia can both lead to persistent illness. Chronic diarrhoea and malabsorption attributed to cryptosporidiosis also occur in the absence of evidence of immune defect. The importance of respiratory tract infection in humans, other than in the terminal stages of chronic illness, requires investigation. The infection has now been identified in all classes of vertebrates; it has been observed in all domestic animals including pets, and a wide range of wildlife including birds. Cryptosporidiosis seems to cause diarrhoea in young ruminants, less frequently in pets. In birds the parasite has been observed in the gastrointestinal tract, without ill effect, and in the respiratory tract, in which clinical symptoms of variable severity have been described. The mucosal response of the gastrointestinal tract to infection appears to vary among mammals and may be the key to the variable clinical manifestations observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3289332 TI - Reliability diagnosis of FAST in allergic rhinitis. Correlation with RAST, nasal provocation and prick test. AB - Not much data is available on the reliability diagnosis of IgE FAST, in comparison with other "in vitro" and "in vivo" techniques. The motive of this study was to evaluate FAST sensitivity in patients with rhinitic allergies, comparing it with RAST and the prick test. Thirty-four patients, monosensitized in 11 cases for pollen, in 16 for mites and in 7 for moulds were studied. Ten patients with negative nasal provocation were used for the control group. In a total of 133 sera, there was class concordance between FAST and prick test in 59.39% of the cases, with a r = +0.41 and p less than 0.001 correlation coefficient. Corcordance of FAST and RAST for a total of 135 sera was 65.18%. Concordance in those who had nasal positive provocation was 87.65% for FAST, 75.04% for RAST and 92.85% for prick. From our experience with FAST, in patients with allergic rhinitis for the pneumoallergens evaluated, we conclude that this test constitutes an alternative "in vitro" diagnosis in the cases indicated. We found that its advantages were its low cost in the way of human and economical resources, its greater reliability in comparison with RAST, its simple administration and it being harmiess. PMID- 3289333 TI - Total and specific IgE levels in human hydatid disease determined by enzyme immunoassay. I. Preoperative levels. AB - The levels of total IgE and specific IgE in preoperative sera from 29 adult patients with surgically confirmed hydatidosis were studied by means of enzyme immunoassay. Sera from 88 healthy donors were likewise studied. Findings showed that in the majority of the hydatidosis cases there was an increase of specific IgE and total IgE although individual variance was significant. Determination of total IgE as the only serological diagnostic test is not valid, since 27.5% of patients showed a total IgE level within normal values. Moreover, the determination of specific IgE has more diagnostic value than that of total IgE although it must be taken into account that in 7% of human hydatidosis cases there are no detectable levels of anti-Echinococcus IgE. PMID- 3289335 TI - Back to the fork in the road. Interview by William H. McDonald. PMID- 3289336 TI - Orthostatic hypotension. AB - Orthostatic hypotension is a potentially debilitating condition in the elderly. It may be associated with aging, drug therapy or underlying disease. Pathophysiologic mechanisms can be classified as vasovagal, sympathicotonic and asympathicotonic (autonomic nervous system disease). Only a detailed history will uncover the disorder in some patients. When conservative measures fail, fludrocortisone is a generally helpful drug that induces volume expansion. PMID- 3289334 TI - Cockroach asthma: case report and literature review. AB - Among the different antigens, insects play an important role in the induction of allergic reactions. We report on a 12-year-old boy with family history of atopy, who developed symptoms of rhinitis and perennial asthma since the age of 5. Patient's symptomatology increased during pollination and kept close relationship to domestic antigens. A skin and inhalation test with an extract of domestic dust was positive. An investigation about potential allergens was initiated and the patient mentioned that was a significant amount of cockroaches at his home. Skin tests, RAST and bronchial provocative tests with a cockroach extract gave positive results. Bronchial provocative tests with a cockroach extract gave immediate and late responses, as has been evidenced by different authors. Immunotherapy has been successfully employed, partly due to the difficulties inherent to an efficient way of preventing insect contact. Improvement of symptomatology correlates well with blocking antibody production and the reduction in white cell sensitivity to the antigenic system. Finally, the potential relevance of cockroach hypersensitivity in our country be underlined. Cockroach sensitivity should be considered in every patient with perennial asthma, in which the usual allergens have been excluded. PMID- 3289337 TI - Scuba diving injuries. AB - Scuba diving has become increasingly popular, and family physicians may encounter patients who have been injured in a dive. Manifestations of diving injuries may not occur until 12 hours or more after a dive. Initial treatment, based on knowledge of the pathophysiology of decompression sickness, lung expansion injuries and ear barotrauma, may prevent severe and permanent sequelae. Decompression sickness and air embolism are medical emergencies. PMID- 3289338 TI - Sclerotherapy for esophageal varices. AB - Sclerotherapy is an effective early treatment for bleeding esophageal varices. The procedure can be performed without general anesthesia and can be used to stabilize the situation until a decision is reached regarding long-term therapy. Sclerotherapy has a failure rate of up to 30 percent. Portacaval shunt is recommended if either acute or long-term sclerotherapy fails. Prophylactic sclerotherapy is not recommended. PMID- 3289339 TI - Hyperthermic syndromes. AB - Heat stroke victims lack thermoregulatory control. Treatment includes immediate cooling, circulatory support and monitoring for secondary complications. Neuroleptic malignant syndrome is a complication of neuroleptic drug therapy; skeletal muscle hypertonicity helps distinguish this entity from heat stroke. Malignant hyperthermia should be considered in any patient who is under physiologic or anesthetic stress and develops hyperthermia plus skeletal muscle rigidity, tachypnea, hypoxia, tachycardia and hyperkalemia. PMID- 3289340 TI - Vaginal birth after cesarean delivery. AB - The safety of vaginal birth after cesarean (VBAC) delivery has been documented. Fetal and neonatal morbidity is not increased, and the mortality rate is less than one in 2,000 deliveries. Maternal morbidity and mortality rates for VBAC delivery are significantly lower than those for repeat cesarean section. Family physicians should inform patients about the option of VBAC delivery and should support the provision of this service at hospitals with appropriate facilities. PMID- 3289341 TI - The diagnosis of alcoholism. AB - Alcoholism is underdiagnosed by many physicians, for various reasons. The physician may feel that alcoholism is a weakness rather than an illness or may believe that alcoholics differ in appearance from other patients. Patients and family members frequently deny the problem, and some physicians are reluctant to diagnose a disorder they do not know how to treat. Diagnosis depends mainly on the medical, social and psychologic histories. Questionnaires are useful for routine screening of patients. PMID- 3289342 TI - The young child with fever. PMID- 3289344 TI - Tick-borne diseases. AB - Tick-borne diseases have their peak incidence in the spring and summer. The different infections caused by tick vectors have certain geographic locations and unique clinical presentations. The most common tick-transmitted infection is Lyme disease. Early diagnosis of tick-borne disease is essential so that effective and, in some cases, lifesaving antibiotic therapy can be instituted. Preventive measures are simple. PMID- 3289343 TI - Erythropoietin for the anemia of chronic renal failure. PMID- 3289345 TI - Role of calcium antagonists as initial pharmacologic monotherapy for systemic hypertension in patients over 60 years of age. AB - Hypertension is most prevalent in older patients and is associated with increasing morbidity and mortality with age. The ability of antihypertensive treatment to reduce these complications in the elderly is now well established. However, several aspects of the treatment of hypertension are being evaluated. In particular, there is a growing trend to avoid individualizing the choice of medication. This is of particular concern in older patients who may differ in the pathophysiology of their hypertension, in their accompanying medical conditions, and in how they may respond to antihypertensive drugs. In addition, elderly hypertensives are often taking a number of medications in addition to antihypertensive drugs. This, along with the fact that the elderly often metabolize drugs more slowly, makes this group particularly susceptible to drug drug interactions and pharmacologically induced toxic side effects. Considering these points, it appears that the calcium channel blockers are attractive antihypertensive agents for the elderly population. PMID- 3289346 TI - Sexual dysfunction with aging and systemic hypertension. AB - The incidence of sexual dysfunction increases with age and in the presence of systemic hypertension. An interplay between endocrine, neurologic and vascular systems mediates normal male sexual function. Androgens primarily regulate libido and maintenance of genital tissue, while the autonomic nervous system and arterial blood flow play key roles in the physiology of the male sexual response, particularly penile erection. Vascular disease related to hypertension, diabetes mellitus and atherosclerosis may be the main factor contributing to the sexual dysfunction that occurs with aging. Hormonal alterations probably play less of a role. The importance of neurologic abnormalities remains to be determined. Although specific diagnostic testing can be useful in defining abnormalities in each of these systems, treatment of sexual dysfunction in the setting of hypertension in the elderly patient remains a challenge. PMID- 3289347 TI - Psychological perspectives of sex and aging. AB - Older patients have many assaults on their sexuality. Our culture often discourages sexual interest in older persons. Changes in sexual physiology and the effects of chronic illness and medications can further contribute to negative expectations and can impair sexual performance. The emotional and relational stresses of aging can lead to depression, thus further compounding sexual slowdown. Failure to appreciate psychological factors can result in inappropriate treatment by the physician and actually add to the patient's distress. This report considers the mind/body relationship in sexual performance and offers guidance to the physician in the diagnosis of physical and emotional factors affecting the older person's sexual life. PMID- 3289348 TI - Sexual dysfunction in the diabetic patient with hypertension. AB - The prevalence of diabetes mellitus and hypertension in the United States is increasing partly because of the incidence of these diseases in the growing geriatric population. Diabetes and hypertension have been associated with sexual dysfunction in both men and women. Neuropathy, vascular insufficiency and psychological problems have been implicated in impotence, impaired ejaculation and decreased libido in men and in decreased vaginal lubrication, orgasmic dysfunction and decreased libido in women. Several investigations of women with diabetes suggest fewer reports of sexual dysfunction than have been reported by diabetic men. However, there have been few evaluations of sexual dysfunction in women and no standard methods for assessment. Antihypertensive agents, especially diuretics, sympathetic inhibitors and beta-blocking agents have been associated with sexual dysfunction due to autonomic and hormonal effects. An estimated 40 to 80% of diabetic hypertensives have reported sexual dysfunction in several investigations. Clearly, the diabetic hypertensive patient should be evaluated for sexual dysfunction, and appropriate therapy, including changes in medication or referral for sex counseling, should become routine in clinical care. PMID- 3289349 TI - Systemic hypertension in diabetes mellitus. AB - Hypertension occurs more frequently in diabetics and markedly exacerbates the vascular morbidity and mortality resulting from this metabolic disorder. However, the etiology of hypertension in diabetics remains poorly understood. Like aging persons, diabetics have increased systemic resistance and a probable reduction in baroreceptor sensitivity. They also have an expanded total body sodium pool and a tendency to lower levels of plasma renin activity. Some of these factors suggest that a subtle calcium deficiency could also be of etiologic importance. PMID- 3289350 TI - Profile of systemic hypertension in black patients. AB - Hypertension extracts a huge toll from the black community in terms of excess morbidity and mortality. The black hypertensive is more likely to die from the disease and to have stroke, end-stage renal disease or heart failure. Furthermore, contrary to previous beliefs, blacks are at least as likely to have coronary artery disease as whites. Although substantial overlap occurs, the black hypertensive is more likely to be volume-expanded, to have a lower plasma renin level, and to be classified, as salt-sensitive than is the white hypertensive. Decreased dietary potassium and calcium intake, altered intra-cellular handling of sodium and calcium, and psychosocial factors have also been implicated in the pathophysiology of hypertension in blacks. PMID- 3289351 TI - Pharmacologic management of systemic hypertension in blacks. AB - This article contrasts the characteristics of essential hypertension found in the black population with that seen in the nonblack population. Socioeconomic and pathophysiologic factors are discussed. Different pharmacologic classes of drugs are compared for their effectiveness in treating the black hypertensive patient. Because black hypertensives tend to have salt-sensitive, low-renin hypertension coupled with decreased cardiac output and high peripheral vascular resistance, an ideal antihypertensive should have natriuretic effects but also the physiologic capability of reducing vascular resistance. Such an ideal hypertensive drug would be able to lower systemic blood pressure while improving organ perfusion and function. PMID- 3289352 TI - Metabolic changes with antihypertensive therapy of the salt-sensitive patient. AB - Recent evidence suggests that metabolic changes that occur with antihypertensive agents may influence cardiovascular risk. Diuretic therapy is particularly appropriate for the salt-sensitive hypertensive patient. However, diuretic induced electrolyte abnormalities may lead to ventricular arrhythmias, even in patients with uncomplicated essential hypertension. Antihypertensive drugs may change circulating lipoprotein levels, which may influence the development of atherosclerosis. Therefore, serum cholesterol and triglyceride levels should be monitored when antihypertensive drugs are administered that can cause hyperlipidemia. Weight reduction and diet therapy should be used because these may have a greater effect on reducing hyperlipidemia, though choice of antihypertensive agents is important. In addition, glucose tolerance may worsen with thiazide therapy, perhaps because newer evidence suggests that insulin resistance is common in essential hypertension. This glucose intolerance may be corrected with potassium repletion or substitution of bumetanide for thiazide. The calcium antagonists may be substituted for diuretic therapy, or other classes of antihypertensive drugs may be used with a reduced dose of diuretic drug if these metabolic changes persist. Thus, attention to metabolic changes may be as important as blood pressure reduction in treatment of the salt-sensitive hypertensive patient. PMID- 3289353 TI - Physiologic and hemodynamic considerations in blood pressure control while maintaining organ perfusion. AB - Essential hypertension remains a significant contributor to mortality, despite treatments effective in decreasing blood pressure. A major reason mortality remains high may be that the conventional stepped-care approach does not always reduce blood pressure in a physiologic manner, which may result in metabolic derangements and elicitation of undesirable reflex mechanisms. Use of the stepped care approach does not take into account fundamental hemodynamic differences associated with a hypertensive patient's age, race and weight. A nonphysiologic approach in the use of antihypertensive agents may be associated with progression of left ventricular hypertrophy, metabolic derangements, arrhythmias, sudden death, and increased atherosclerotic and nephrosclerotic complications. Considerations of the alterations in cardiovascular structure that can occur in light of the activity of the renin-angiotensin system, the sympathetic nervous system and transcellular calcium flux are discussed as to how they affect long term survival. PMID- 3289354 TI - Salt sensitivity and systemic hypertension in the elderly. AB - Aging in industrialized societies is accompanied by increases in the incidence and prevalence of hypertension, with a disproportionately greater increase occurring among aging blacks than among aging whites. This geriatric hypertension is generally of a salt-sensitive nature with a disproportionate frequency of isolated systolic hypertension. Although salt-taste acuity declines with age, salt sensitivity among the elderly does not appear to result from a compensatory increase in salt intake. Rather, age-related increases in salt sensitivity result, in part, from a reduced ability to appropriately excrete a salt load, which is due to a decline in renal function and to a reduced generation of natriuretic substances such as prostaglandin E2 and dopamine. Age-associated declines in the activity of membrane sodium/potassium-adenosine triphosphatase (Na/K-ATPase) may also contribute to geriatric hypertension because this results in increased intracellular sodium that may cause reduced sodium-calcium exchange and thereby increase intracellular calcium and vascular resistance. Reductions in cellular calcium efflux due to reduced calcium-ATPase activity may similarly cause an increase in intracellular calcium and vascular resistance. Increasing dietary calcium intake may represent an effective nonpharmacologic treatment for some salt-sensitive persons because it appears to reduce intracellular calcium by (1) suppressing parathyroid hormone-mediated calcium influx, (2) increasing Na/K ATPase activity, and (3) reducing intravascular volume due to calcium-induced natriuresis. PMID- 3289355 TI - Value of the ST-T segment in lead V4R in inferior wall acute myocardial infarction to predict the site of coronary arterial occlusion. PMID- 3289356 TI - The origin of specious. PMID- 3289357 TI - Comparison of intravenous anisoylated plasminogen streptokinase activator complex and intracoronary streptokinase in acute myocardial infarction. AB - Coronary angiography was used to compare the efficacy of anisoylated plasminogen streptokinase activator complex (APSAC) administered intravenously and streptokinase given by intracoronary infusion in inducing reperfusion in patients with a proven acute myocardial infarction. Forty-two patients received 30 U of APSAC intravenously over 5 minutes and 43 patients received 250,000 IU of streptokinase given via intracoronary infusion over 90 minutes, after occlusion of the infarct-related vessel was demonstrated by angiography. Reperfusion was achieved in 23 (64%) of 36 patients (mean time to reperfusion 46 minutes) treated with APSAC and 25 (67%) of 37 patients (mean time to reperfusion 45 minutes) treated with intracoronary streptokinase, who were angiographically evaluated 90 minutes after the start of treatment. Twenty-four hours after treatment, reocclusion had occurred in 1 (5%) of 22 patients in the APSAC group and in 3 (13%) of 23 patients in the streptokinase group. No major bleeding was observed in either treatment group despite a similar systemic lytic state that lasted for up to 48 hours. Two patients treated with APSAC died after severe left ventricular failure unrelated to therapy. The results indicate that APSAC given intravenously is as effective as streptokinase given intracoronary in producing thrombolysis in acute myocardial infarction. The major advantages of APSAC are its rapid and convenient administration by a single intravenous injection, the low rate of arterial reocclusion and good patient tolerance. PMID- 3289358 TI - Basic and clinical radiation physics. PMID- 3289360 TI - Tumor biology. PMID- 3289359 TI - Basic radiobiology. AB - Experimental studies of the biological effects of radiation were started soon after the discoveries of x-rays in 1895, but there is still much that is not known. This article includes some research objectives that are essentially pragmatic in nature, intended to support and improve the current practice of radiotherapy, but the central thrust is the understanding of the mechanisms involved in the biological effects of radiation at the cellular and molecular levels. The article was written by a consortium of scientists and suffers inevitably from the drawback that writing styles are inconsistent, and coverage is not uniform. However, it benefits from the enormous advantage that it reflects the accumulated wisdom and judgment of more than a dozen scientists who, in their own areas of expertise, are recognized as being at the cutting edge of radiation research. The niceties of style and syntax are sacrificed in favor of the quality of the science and the maturity of judgment. The study of DNA damage as a mechanism for cell injury in early- and late-responding tissues, as well as a comparison of DNA damage that leads to lethality, as opposed to transformation and mutagenesis, are key items. The study of cell lethality with cells in culture led to the identification of repair, both sublethal and potentially lethal, as well as the dose-rate effect, and has had a considerable impact on radiotherapy. Future studies should focus on understanding the factors that determine radiosensitivity/radioresistance. A variety of approaches are available, including the study of genetically deficient cell lines from cancer-prone individuals. A parallel approach is the application of the techniques of molecular biology to clone the repair genes in mammalian cells, and to understand genetic defects that alter gene regulation, or to regulate biochemical factors in the cell. Substantial progress has been made in developing in vitro assays for mutagenesis, particularly using hybrids of rodent and human cells. Better methods are needed to study the effects of mutation on gene expression, and sensitive systems are needed that can detect low doses of radiation. Assays of oncogenic transformation, the in vitro counterpart of carcinogenesis, have been used to investigate the oncogenic potential of various types of radiation and chemotherapy agents. Key topics in future will include the investigation of supra additivity between different agents, the identification and characterization of oncogenes that may be activated by radiation, the development of quantitative assays based on human cells, and further studies involving cell-to-cell communication.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289361 TI - Predictive assays of tumor radiocurability. PMID- 3289362 TI - Chemical modification of radiation and chemotherapy. PMID- 3289363 TI - Combined modality therapy using cytotoxic agents and radiation therapy. PMID- 3289364 TI - Dose fractionation and volume effects in normal tissues and tumors. PMID- 3289365 TI - Brachytherapy. PMID- 3289366 TI - Immunosuppressive techniques using radiation. PMID- 3289367 TI - Biological and clinical aspects of hyperthermia in cancer therapy. PMID- 3289368 TI - Radiation therapy and surgery. PMID- 3289369 TI - Applications of data bases and AI/expert systems in radiation therapy. PMID- 3289371 TI - Luteinizing hormone releasing hormone and human behavior. PMID- 3289370 TI - Oncologic imaging: state of the art and research priorities. PMID- 3289372 TI - Perinatal risk factors for the development of extensive cystic leukomalacia. AB - Seventeen infants with extensive cystic leukomalacia without associated intraventricular hemorrhages were compared with 34 infants with normal cranial ultrasound findings and 34 infants with large intraventricular hemorrhages to establish whether different risk factors could be elicited for these lesions. Adverse obstetric factors that were associated with extensive leukomalacia were the place of birth (outborn [ie, not born at our hospital but transferred here after delivery]) and the need for emergency cesarean section. Neonatal risk factors, with the exception of gestational age, were equally distributed between the infants with the two types of lesions. The results of this study suggest that extensive cystic leukomalacia and large hemorrhages have similar predisposing factors, but the type of lesion that develops depends on the maturity of the infant. PMID- 3289373 TI - Case management and quality assurance to improve care of inner-city children with asthma. AB - Case management and quality assurance techniques were used in a program designed to improve the process and outcomes of care for inner-city children with asthma. The program had three major elements: assessment of the care of individual patients and feedback to their primary care providers, periodic contact with parents, and provision of educational materials about asthma to parents. Telephone interviews with parents were used to assess knowledge of home asthma care and the type of care prescribed by the child's physician. Medicaid and hospital records were used to measure acute care utilization. Eighty-eight children (aged 0 to 5 years) who had made more than two emergency room visits for asthma were recruited by telephone. Fifty-six prescribing errors were identified, 24 being failure to prescribe an additional drug for short-term use by children receiving continuous therapy. Acute care use dropped 50% compared with a control period. This type of program is feasible but may require in-person recruiting to reach high-risk families without telephones. PMID- 3289374 TI - Rapidly progressive IgA nephropathy. AB - Five children had rapidly progressive glomerulonephritis, determined by biopsy specimen and terminating in end-stage renal disease. All had mesangial deposition of IgA and C3 in the pattern typically seen with IgA nephropathy (Berger's disease). These children ranged in age from 7 to 13 years; four were boys. Severe hypertension was present in all, and three had a nephrotic syndrome. Other than hypertension and findings related to renal insufficiency or nephrotic syndrome, no clinical or laboratory finding was a consistent marker distinguishing these patients from those with uncomplicated IgA nephropathy, and no therapy proved useful in halting the rapid decline in renal function. The disease has not recurred in the kidney transplant of any of the five children. PMID- 3289375 TI - Multiple pterygium syndrome. An overview. AB - The longitudinal course of two sisters with multiple pterygium syndrome is reported. The findings in these siblings are compared with those of 27 children described in the medical literature. The longitudinal course of short stature, scoliosis, talipes equinovarus, pterygia, hearing loss, and pubertal and intellectual development in this syndrome is described. Recommendations are made for a multidisciplinary approach to individuals with multiple pterygium syndrome, which includes the services of a primary care physician, orthopedist, physical therapist, and plastic surgeon. PMID- 3289377 TI - In memoriam Theodore Joslyn Curphey, M.D. PMID- 3289376 TI - Spinocerebral faecal migration in a shotgun injury. AB - Migration of foreign material within the subarachnoid space is a rare event, seldom reported in the medical literature. We report a unique case in which spinocerebral migration of faecal material occurred as a direct consequence of a shotgun injury to the pelvis. PMID- 3289378 TI - Arthritic manifestations of inflammatory bowel disease. AB - Rheumatologic conditions associated with inflammatory bowel disease may be divided into four clinical categories. First, a unique form of peripheral arthritis occurs in 15-20% of patients with inflammatory bowel disease. The incidence is higher in Crohn's disease than in ulcerative colitis. This is a self limited, nondeforming, seronegative arthritis that waxes and wanes with bowel flares. It characteristically involves knees and ankles. Persistent erosive monoarthritis is described. Second, spondylitis clinically and radiographically indistinguishable from idiopathic ankylosing spondylitis occurs in 3-6% of patients with inflammatory bowel disease. HLA-B27 positivity occurs in 53-75% of cases, fewer than in idiopathic spondylitis. Third, a bilateral, symmetrical sacroiliitis is seen in 4-18% of patients. This may not progress to clinical spondylitis. The fourth category encompasses rheumatologic complications of inflammatory bowel disease. These include granulomas of bones and joints, granulomatous vasculitis, clubbing, periostitis, amyloidosis, osteoporosis, osteomalacia, septic arthritis, and complications of corticosteroid therapy. PMID- 3289379 TI - Failure of a cytoprotective dose of Arbacet to heal acute gastric ulcers. AB - Twenty outpatients with an endoscopic diagnosis of gastric ulcer were evaluated for 6 wk in a randomized, double-blind trial comparing 15(R)-15-methyl prostaglandin E2 (Arbacet) (10 micrograms, 0.5 h before each meal and at bedtime) with placebo. Endoscopy was performed at 3 wk and 6 wk during the study period. Five of nine patients (56%) taking Arbacet and seven of 11 patients (64%) in the placebo group had complete healing of their gastric ulcer. Healing occurred in four patients from the Arbacet group and three patients in the placebo group at 3 wk. A cytoprotective dose of Arbacet (40 micrograms daily) is not significantly better than placebo in healing gastric ulcers. PMID- 3289380 TI - Hepatic amyloidosis presenting as severe intrahepatic cholestasis: a case report and review of the literature. AB - Although hepatic involvement is common in all forms of amyloidosis, jaundice is infrequent and usually mild. We report a case of a 74-yr-old man with severe intrahepatic cholestasis and hepatic amyloid. The topography of amyloid deposition was unusual, in that deposits were confined predominantly to the portal tract. They appeared as a dense eosinophilic infiltrate that stained with congo red. A review of the English-language literature revealed only 18 prior patients with hepatic amyloid associated with severe intrahepatic cholestasis. The histology of only one of these patients showed a similar distribution of amyloid deposits. PMID- 3289381 TI - Inferior vena caval and right atrial thrombosis complicating an amebic hepatic abscess. AB - We describe a 50-yr-old black laborer who presented with right lower chest pain, weight loss, and pedal edema. Ultrasonography and computed tomograms showed a large abscess cavity in the right lobe of the liver which extended very close to the inferior vena cava. The lumen of the adjacent inferior vena cava was partially occluded by thrombus, which could be traced up into the cavity of the right atrium. The hepatic veins were normally patent. Sterile blood-stained pus was aspirated from the abscess. Antibodies against Entamoeba histolytica were present in high titer in the patient's serum. Although propagation of hepatocellular carcinoma into the inferior vena cava and even up into the right atrium is well recognized, inferior vena caval thrombosis extending up into the right atrium has not hitherto been reported as a complication of amebic hepatic abscess. PMID- 3289382 TI - Solid and papillary neoplasm of the pancreas: a report of an unusual pattern of calcification. AB - Solid and papillary neoplasms of the pancreas are very rare and occur predominantly in young women. Calcifications in the neoplasms are rarely observed radiologically. We report a case of a 48-yr-old female with this neoplasm containing prominent calcifications on the wall. PMID- 3289383 TI - Re: "Effects of passive smoking in the Multiple Risk Factor Intervention Trial". PMID- 3289384 TI - Stress symptomatology among Vietnam veterans. Analysis of the Veterans Administration Survey of Veterans. II. AB - In 1979, the US Veterans Administration conducted a health survey of 11,230 veterans. The present analysis of these data focuses on the association between Vietnam service and combat experience with eight post-traumatic stress disorder symptoms among the 1,787 Vietnam era veterans who entered military service between 1965 and 1975. The advantages of this study are that it includes a large random sample selected from the total US population, had a high interview response rate (93%), and collected data prior to the recent public controversy surrounding the issue of the health effects of possible exposure of Vietnam veterans to Agent Orange. After adjustment for the potential confounding effects of military service and demographic factors, the level of combat exposure was significantly associated with all eight symptoms of post-traumatic stress disorder in a dose response pattern. For seven of the eight symptoms, a twofold increase in the factor-adjusted prevalence odds ratio was observed when non Vietnam service veterans were compared with Vietnam veterans who experienced the most intense combat experience. Being younger, less well educated, or nonwhite at the time of military service are factors which independently further increased the probability of stress symptoms. PMID- 3289385 TI - Molecular basis of alpha-1-antitrypsin deficiency. AB - Alpha-1-antitrypsin (A1AT) deficiency is an autosomal hereditary disorder associated with a major reduction in serum A1AT levels. Clinically, A1AT deficiency is associated with emphysema in adults and, less commonly, liver disease in neonates. A1AT is a 52-kDa, 394-amino acid, single-chain glycoprotein normally present in serum at 150 to 350 mg/dl. The A1AT gene, composed of seven exons dispersed over 12 kb of chromosomal segment 14q31-32.3, is expressed in hepatocytes and mononuclear phagocytes. The A1AT protein, a member of the class of protease inhibitor proteins known as serpins (serine protease inhibitors), is a globular molecule composed of nine alpha-helices and three beta-pleated sheets. The major function of A1AT is to inhibit neutrophil elastase; A1AT does so through an active site centered around Met358 contained within an external stressed loop on the surface of the molecule. A1AT is a highly pleomorphic protein with greater than 75 variants determined at the protein and/or gene level. These variants can be categorized into four groups according to their serum A1AT level and function: normal, deficient, dysfunctional, and absent. There are two important salt bridges within the A1AT molecule (Glu342-Lys290; Glu263-Lys387); a mutation in the A1AT gene causing disruption of either salt bridge causes distinct molecular pathology resulting in reduced serum A1AT levels. Clinically relevant variants can be distinguished by a combination of isoelectric focusing of serum, restriction fragment length analysis of genomic DNA, oligonucleotide probes, and direct sequencing of the variant A1AT genes. PMID- 3289386 TI - Natural history of alpha-1-protease inhibitor deficiency. AB - Alpha-1-protease inhibitor (A1PI) exists in over 30 biochemical variants (the Pi system), inherited as autosomal codominant alleles. Homozygotes of Pi type Z have only 10 to 20 percent of the normal serum A1PI concentration and have a high risk of developing pulmonary emphysema. A1PI is an inactivator of polymorph lysosomal elastase, the unopposed action of which may damage the lung. Cigarette smoking is an important additional risk factor. Neonatal hepatitis occurs in 10 to 20 percent of Pi type Z persons, and cirrhosis develops in a number of them in later childhood or in adult life. In heterozygotes of Pi type MZ, pulmonary or hepatic disease may also develop, though they are at lesser risk than type Z homozygotes. Specific A1PI replacement therapy derived from human plasma is now available and has been administered to Pi type Z patients by weekly intravenous infusion without adverse effects. A controlled clinical trial would be desirable, though this would be attended by organizational and economic problems. PMID- 3289387 TI - Alpha-1-antitrypsin augmentation therapy for alpha-1-antitrypsin deficiency. AB - Alpha-1-antitrypsin (A1AT) deficiency is a genetic disorder characterized by low serum levels of A1AT and a high risk for the development of emphysema. A1AT is the principal inhibitor of neutrophil elastase, such that a deficiency of A1AT results in insufficient anti-elastase protection in the lower respiratory tract, thus allowing neutrophil elastase to destroy alveolar structures. The goal of A1AT augmentation therapy in A1AT deficiency is to raise lung A1AT levels and anti-neutrophil elastase capacity to levels that will provide adequate protection against neutrophil elastase, thereby preventing the lung from further elastase mediated degradation. Studies with intravenous administration of human A1AT (60 mg/kg at weekly intervals) demonstrate that serum A1AT levels increased from an average 33 +/- 8 mg/dl pre-infusion to a steady-state trough level of 117 +/- 4 mg/dl, well above the projected threshold protective serum level of A1AT. The infused A1AT diffused into the lung and significantly augmented the epithelial lining fluid A1AT levels, rising from an average 0.44 +/- 0.16 microM (pre infusion) to 2.62 +/- 1.29 microM at the nadir level just prior to the next infusion. Of critical importance is the fact that the A1AT that diffused into the lung was active as an inhibitor or neutrophil elastase, resulting in significant augmentation of epithelial lining fluid anti-neutrophil elastase capacity and normalization of the lung anti-elastase protection. In the over 800 weekly infusions administered, no significant adverse reactions have occurred. These findings demonstrate that long-term augmentation therapy with weekly infusions of A1AT is a rational, safe, and biochemically effective therapy for A1AT deficiency. PMID- 3289388 TI - Replacement therapy for alpha-1-protease inhibitor deficiency in PiZ subjects with chronic obstructive lung disease. AB - In a six-month multicenter feasibility and safety study, 20 patients, who all had a congenital deficiency of alpha-1-protease inhibitor (A1PI) of the PiZ phenotype accompanied by a chronic obstructive lung disease, were treated with human-plasma derived A1PI. A weekly dose of 60 mg/kg, administered intravenously, was shown to be sufficient to maintain patient serum levels above the threshold limit of 35 percent, the serum level of healthy persons of the MZ phenotype. This is supposed to be the minimal effective level for protection against the elastolytic attack of the lung and, therefore, satisfies one of the most important criteria of feasibility of long-term replacement therapy. The global concentration in serum or bronchiolar lavage fluid A1PI including active and inactivated A1PI was measured immunologically by rate nephelometry and radial immunodiffusion. The functional activity of A1PI, expressed as free inhibitor activity against trypsin and leukocyte elastase, confirmed that the infused A1PI remained mostly in its active form in the circulation. Reported adverse reactions were moderate and did not require alteration to the schedule of the infusions and/or the dose and rate of administration. Antibodies to A1PI as measured by the Ouchterlony method did not develop. Laboratory and physical signs of possible hepatitis virus contamination were not observed. The long-term replacement therapy, therefore, appears to be safe. PMID- 3289389 TI - Computer consult: animated learning. PMID- 3289390 TI - Building a better primary care bookshelf. PMID- 3289391 TI - Nursing in the Civil War. PMID- 3289392 TI - Misdiagnoses in obstetric and gynecologic ultrasound examinations: causes and possible solutions. AB - Two small series of cases documenting ultrasound misdiagnoses are presented. The first concerns obstetric ultrasound misdiagnoses originating in the private offices of physicians. The second concerns gynecologic ultrasound misdiagnoses originating in a level II medical center. A dichotomy exists in the use of diagnostic ultrasound examination in the practice of obstetrics and gynecology. The dichotomy is a serious defect in our specialty that needs urgent addressing. The institutional problem can be partially resolved by furnishing the sonographer with the referred patient's history and physical findings. The problem of the ultrasound machine in the office of a private physician is much more complex. It may require government intervention and strict licensing measures for resolution. PMID- 3289393 TI - Preoperative localization of androgen-secreting tumors: clinical, endocrinologic, and radiologic evaluation of ten patients. AB - A series of 10 patients with benign androgen-secreting neoplasms is presented. Nine tumors were ovarian, and one adrenal. In an attempt to correctly diagnose the presence of tumor and to accurately localize the lesion to a specific gland, steroid hormones in peripheral, ovarian, and adrenal vein serum were analyzed by radioimmunoassay. Little correlation was made in this series with those levels of testosterone (greater than 2 ng/ml) or dehydroepiandrosterone sulfate (greater than 7000 ng/ml) that have been widely used to predict the presence of such tumors. Peripheral testosterone levels were less than 2 ng/ml in 50% of our patients, and the dehydroepiandrosterone sulfate level was greater than 7000 ng/ml in only a single patient with an ovarian lipoid cell tumor. Pelvic ultrasonography was found to be of limited value in evaluating nonpalpable tumor because of the small size (less than 2 cm3) of the majority of these neoplasms. The use of selective retrograde venous catheterization to demonstrate significant effluent-peripheral vein androgen gradients served to accurately localize androgen-secreting tumors in all six patients in which it was used. Our data emphasize the potential pitfalls that exist in the preoperative evaluation of patients with these fascinating neoplasms and the importance of a high degree of suspicion on the part of the physician caring for these women. PMID- 3289394 TI - Antepartum external cephalic version with tocolysis: a study of term singleton breech presentations. AB - External version with the use of tocolysis is cost-effective and leads to lower perinatal morbidity and a lower cesarean section rate. A study was undertaken to see if version was being practiced in a nonteaching community hospital. One hundred twenty-one breech presentations occurring at 36 or more completed weeks of gestation were reviewed from July 1, 1985 to June 30, 1986. Successful version occurred in 60% of 65 patients; 77% of patients with a successful version delivered vaginally. Six of the remaining 56 patients, who did not undergo attempted version, delivered vaginally with breech presentation. At least 21 patients who delivered by elective cesarean section would have been candidates for external version with tocolysis. Seventeen patients had a cesarean section because a breech presentation was diagnosed in labor. PMID- 3289395 TI - The Zavanelli maneuver extended: progression of a revolutionary concept. AB - Since description of the Zavanelli maneuver in 1984, 15 additional cases have come to light in which partially born but vaginally undeliverable fetuses have been returned to the vagina and subsequently extracted by cesarean section. Ten presentations were vertex, five breech. Half or more of each fetus had been delivered before vaginal reinsertion in eight of the 15. With one exception, all fetuses survived. There were no instances of fetal or maternal trauma. These cases represent a natural and progressive extension of the revolutionary concept behind the Zavanelli maneuver. Contrary to the age-old dicta, the process of vaginal birth, once initiated, does not have to proceed inexorably to completion with either life or death for the fetus in the balance. These cases demonstrate that delivery can be reversed at essentially any moment with excellent potential for fetal survival and relatively insignificant maternal risk. PMID- 3289396 TI - Investigating unexplained infertility. AB - In an attempt to reduce the number of couples whose basic infertility evaluation fails to reveal any abnormality, 57 couples with the diagnosis of unexplained infertility were further investigated by ultrasound monitoring for folliculogenesis, sperm antibody testing, hamster egg penetration assay, and major histocompatibility (human leukocyte antigen) typing. The use of these techniques allowed the diagnosis of luteinized unruptured follicle in 5% (three patients), sperm antibodies in 5% (three patients), low sperm penetration in 11% (six patients), and human leukocyte antigen-B locus homozygosity in 37% (21 couples). When the incidence of B locus homozygosity among the 57 couples with unexplained infertility was compared with that in 51 fertile couples, the difference was significant at p = 0.025. Thus by adding the diagnostic tools of ultrasound monitoring of folliculogenesis, sperm antibody testing, hamster egg penetration assay, and major histocompatibility antigen typing, the diagnosis of unexplained infertility can be reduced by 60%. PMID- 3289397 TI - The relationship between labor and route of delivery in the preterm infant. AB - The purpose of this prospective study was to evaluate the effects of the active phase of labor and route of delivery on the frequency of germinal layer/intraventricular hemorrhage in 89 infants with ultrasound-estimated fetal weights less than or equal to 1750 gm. Twenty-eight infants (31.5%) had germinal layer/intraventricular hemorrhage within 1 hour after birth and an additional 15 infants (17%) had germinal layer/intraventricular hemorrhage beyond 1 hour after birth. Infants with germinal layer/intraventricular hemorrhage had a significantly lower gestational age (p less than 0.003) and birth weight (p less than 0.007). Germinal layer/intraventricular hemorrhage within 1 hour after delivery was increased in the infants of women who experienced the active phase of labor regardless of the route of delivery. However, the incidence of germinal layer/intraventricular hemorrhage beyond 1 hour after delivery and the overall incidence were similar in the vaginal delivery and cesarean delivery groups. In addition, there was an increased incidence of progression to grades III and IV hemorrhage regardless of route of delivery in the infants whose mothers experienced the active phase of labor. PMID- 3289399 TI - The American Board of Obstetrics and Gynecology, Inc. Board certification. PMID- 3289398 TI - Outpatient cervical ripening with prostaglandin E2 gel in uncomplicated postdate pregnancies. AB - A double-blind, placebo-controlled, prospective investigation was undertaken to determine whether the outpatient administration of prostaglandin E2 gel was helpful for ripening the cervix in postdate pregnancies. One hundred eighteen women with an uncomplicated pregnancy at or beyond 42 weeks' gestation with an unripe cervix (Bishop score less than or equal to 5) were randomly administered a single dose of gel containing either 2.5 mg prostaglandin E2 (n = 55) or a placebo (n = 63) before induction of labor with Pitocin. No side effects were detected in these healthy mothers and fetuses. A distinct change in Bishop score after 12 hours occurred more often in the prostaglandin E2 than in the placebo group (42% versus 6%, p less than 0.0001). Forty-four women (80%) who had received prostaglandin E2 were admitted in early labor; they required little or no oxytocin for augmentation. The duration of labor and maximum dose of oxytocin infused were significantly decreased in the prostaglandin E2 group, and forceps delivery or primary cesarean sections were performed less often when prostaglandin E2 was used (24% versus 44%, p less than 0.05). The outpatient administration of a single dose of prostaglandin E2 gel is safe in the uncomplicated postdate pregnancy and was found to significantly change the unripe cervix, enhance the onset of labor, minimize the need for oxytocin administration, and encourage a spontaneous vaginal delivery. PMID- 3289401 TI - Neurohormonal regulation of renal function during development. AB - This review summarizes current understanding of fetal renal physiology and considers the role of the neuroadrenergic system and renin-angiotensin system in controlling renal hemodynamics and function during development. Recent evidence suggests that renal innervation appears early during fetal life but is not an important modulator of renal hemodynamics and function during resting conditions in immature animals. It has also been observed that the renal hemodynamic response to renal nerve stimulation (RNS) is less in fetal and newborn animals than in adults. But contrary to previous findings in adult animals, RNS during alpha-adrenoceptor antagonism produces renal vasodilation in fetal and newborn sheep, but not in adult ewes. The role of the renin-angiotensin system (RAS) in modulating renal hemodynamics and function during prenatal and postnatal maturation is discussed. It is suggested that the RAS plays an important role in regulating blood pressure early during fetal life, whereas its influence on renal hemodynamics and function appears later during development. PMID- 3289400 TI - Immunohistochemical confirmation of Creutzfeldt-Jakob disease with a long clinical course with amyloid plaque core antibodies. AB - Amyloid plaques have been found in the brains of some patients with Creutzfeldt Jakob disease (CJD) and all patients with Gerstmann-Straussler syndrome (GSS). We examined paraffin sections from 45 patients with CJD or GSS and from 51 patients with other neurologic diseases, using an antiserum against GSS amyloid plaque cores. The GSS amyloid plaque core antiserum revealed not only birefringent amyloid plaques but also small plaques that cannot be detected by the staining with Congo red dye. Positive immunolabeling was demonstrated in 59% of 34 Japanese patients with CJD, in 100% of 11 patients with GSS, and in none with other neurologic diseases. All cases of CJD of short duration (less than 11 months) were evaluated as being negative, and 95% of 21 long survivors (over 12 months) were positive. This immunohistochemical approach revealed that amyloid plaque is a hallmark of CJD with a long clinical course. PMID- 3289402 TI - Influence of flow rate and perfused load on insulin absorption in isolated proximal tubules. AB - The effect of flow rate and perfused load on insulin absorption was studied in isolated proximal rabbit tubules. In one series of experiments tubules were perfused for 30 min with 125I-[A14]insulin at 3.6 ng/ml and at flow rates varying between 2.2 and 43.3 nl/min, thus varying both flow rate and the perfused load. In a second series of experiments the tubules were exposed to increasing loads of insulin at a fixed flow rate of 15 nl/min. In a third series of experiments two groups of tubules were exposed to identical perfused loads at two different flow rates. The results showed that absorption is linearly correlated with the perfused load in the ranges of flow rates and concentrations examined. The perfused load determined the magnitude by which the insulin was reabsorbed, whereas the flow rate determined the efficiency (fractional absorption) by which the protein was reabsorbed. At flow rates less than 5 nl/min the fractional absorption was greater than 65%, and at flow rates greater than 30 nl/min fractional absorption was less than 40%. Thus, there is an inverse relationship between flow rate and fractional absorption. The described effects of changes in flow rate and perfused load are suggested to be caused by concomitant changes in the mean luminal concentration. PMID- 3289403 TI - Radio-frequency vs. electrolytic VMH lesions: differential effects on plasma hormones. AB - Electrolytic lesions of the ventromedial hypothalamus (VMH) result in marked hyperphagia and obesity, but several studies have found the excess food intake and weight gain to be greatly reduced when lesions are produced by electrocauterization with radio-frequency current. Unlike electrolytic lesions, radio-frequency lesions leave few or no deposits of metallic ions that can potentially stimulate adjacent tissue. In the present experiment, weight gain and several endocrine responses previously associated with the VMH syndrome were compared in female rats given either electrolytic, radio-frequency, or sham VMH lesions. Both groups with VMH lesions became obese, but rats with radio-frequency lesions displayed only 63.2% of the weight gain of animals with irritative lesions (120.0 vs. 189.8 g in 20 days). Only rats with electrolytic lesions displayed elevated plasma insulin levels during an initial period of food restriction, but both groups with lesions were hyperinsulinemic when allowed to overeat. Plasma growth hormone levels were decreased by electrolytic lesions but unaffected by radio-frequency lesions. Morning corticosterone levels were elevated in both VMH groups, but only the rats with electrolytic lesions were found to have elevations in plasma adrenocorticotropin. It is concluded that some of the endocrine dysfunctions resulting from electrolytic VMH lesions are due to irritative stimulation rather than to tissue ablation. PMID- 3289404 TI - The DSM-III-R personality disorders: an overview. AB - The revision of DSM-III (DSM-III-R) includes substantial changes in the axis II personality disorders. The authors present and critically review these revisions and suggest directions for further research. The issues discussed include the multiaxial system, the use of a categorical rather than a dimensional format, the change from monothetic to polythetic criteria sets, the reduction in overlap among criteria sets, the decrease in the amount of unnecessary inferential clinical judgment required to make diagnoses, and the addition of two new personality disorders in an appendix. The criteria sets for many of the DSM-III personality disorders were also substantially revised in DSM-III-R. Changes in each of these are discussed in turn. PMID- 3289406 TI - AIDS controversies in the mirror of history. PMID- 3289405 TI - Psychoanalysis and multiple personality. PMID- 3289407 TI - Clomipramine for obsessive-compulsive symptoms. PMID- 3289408 TI - Idiopathic cardiomyopathy and panic disorder in cardiac transplant candidates. PMID- 3289409 TI - Sensitivity and specificity of clinical case definitions for pertussis. AB - We evaluated the diagnostic performance of 15 clinical case definitions for pertussis in 233 patients who developed acute respiratory illness during community outbreaks in Wisconsin and Delaware. Using results from culture (Regan Lowe media) and serology (Ig-class-specific ELISA) as diagnostic standards, cough for greater than or equal to 14 days was both sensitive (84 per cent-92 per cent) and specific (63 percent-90 per cent) in identifying patients with pertussis. This definition may be useful in monitoring pertussis outbreaks and for investigating contacts of culture-positive cases. PMID- 3289410 TI - Autoimmune etiology in premature ovarian failure. PMID- 3289411 TI - Preterm birth and infection: pathogenic possibilities. AB - Preterm delivery remains the preeminent problem in perinatal care worldwide. Recent data suggest that cervical/vaginal microflora, and/or the inflammatory responses they engender, produce factors which can cause or predispose to preterm labor and rupture of membranes. Microorganisms mediating such processes may not be "recognized pathogens" and are often considered normal flora. These microorganisms may act singly, additively, or synergistically with host factors released during an induced inflammatory response. Both qualitative and quantitative aspects of cervical/vaginal microflora are likely important. Multiple cervical/vaginal microorganisms produce IgA proteases, neuraminidases, and mucinases which may facilitate passage of these and other agents past cervical barriers and into the lower uterine segment. Multiple microflora also produce phospholipases A2 and C, each of which can locally augment production of eicosanoids within the uterus which are important in cervical ripening and labor. Similar microflora produce various proteases, including collagenase, which can focally weaken the amniochorion and predispose to premature rupture of membranes and cervical ripening. Intrauterine microorganisms induce inflammatory reaction and may engender local release of similar proteases, phospholipases, oxygen radicals, as well as platelet activating factor (PAF), and lymphokines which can also initiate or further potentiate labor-inducing mechanisms. Roles for uteroplacental or systemic release of tumor necrosis factor (TNF) and various interferons are beginning to be understood. Recognition of microbe-induced pathogenesis of some cases of preterm birth offers the hope of specific treatment and prophylaxis. In recent studies, administration of erythromycin and tocolytic agents was associated with an improved outcome in selected women. "Just why so many gravidas go into labor prematurely and hence give birth to infants who often are unable to cope with extrauterine conditions is one of the great unsolved problems of obstetrics." PMID- 3289412 TI - [Problems in anesthesia of drug addicts]. AB - This review attempts to provide an inside view of the current state of knowledge on the anesthetic management of the drug addict intra- and postoperatively. The summary of the numerous publications on this subject demonstrates that neither a unanimous opinion nor a uniform anesthetic procedure exists. The choice of procedure depends on the medical history as well as the physical and psychological status of the patient. PMID- 3289413 TI - [Models and methods in animal experiments in resuscitation]. AB - Various animals models and several different methods are used in cardiopulmonary resuscitation (CPR) research. The animals used most frequently are dogs and pigs, but in each species thorax configurations, which might be an important factor in the mechanism of blood flow during CPR, are at great variance. The influence of anesthetics on cardiopulmonary and cerebral functions during and following resuscitation are largely unknown, and accordingly there is great variance in the techniques employed by individual researchers. The experimental design chosen with regard to the effect of heparin and epinephrine, induction, form, and duration of cardiac arrest as well as duration of CPR is often very different; comparisons are therefore difficult to make. During CPR ventilation is monitored using ventilatory pressure, frequency, tidal volume, and arterial blood gases. Thorax compressions are characterized by frequency, direction (sagittal, transversal), technique (mechanical, manual), relationship of time between compression and relaxation (50:50, 40:60), and depth of compression (power used, esophageal pressure, arterial blood pressure). Effects of CPR techniques are demonstrated during CPR by cardiovascular parameters. In addition to recording of blood pressure and blood flow, examination of regional perfusion rates using radioactive microsphere techniques is common. 24-h surveillance and extensive neurological tests are carried out during recovery following CPR. PMID- 3289414 TI - Determination of interchain crosslinkages in insulin B-chain dimers by fast atom bombardment mass spectrometry. AB - New methodology for identifying and locating crosslinkages in peptides is described. Pepsin is used to cleave insulin and B-chain dimers of insulin into fragments under conditions which retain the original peptide crosslinkages. After partial separation by HPLC, the peptides are analyzed by fast atom bombardment mass spectrometry (FABMS) to determine their molecular weights. The molecular weights of peptide fragments expected from the pepsin digests of human insulin and related model compounds are calculated from the amino acid sequence of the intact peptide. Digestion products are identified by matching their molecular weights, as determined by FABMS, with calculated molecular weights. Locations of interchain crosslinkages are deduced after the peptide fragments have been assigned to specific segments of the parent peptide. The validity of the method has been established by correctly identifying structurally important products in the pepsin digests of model compounds such as human, bovine, and porcine insulins. Procedures developed with the model compounds were used to identify crosslinkages in peptides of unknown structure isolated from an insulin A-chain/B chain combination reaction mixture. Evidence is presented for formation of three different types of crosslinkages, disulfide, lanthionine, and sulfoxide. PMID- 3289415 TI - Immunoblotting of hydrophobic integral membrane proteins. AB - For diagnosis and research purposes it is frequently desirable to measure by immunoblotting small amounts of proteins in complex mixtures such as tissue biopsy homogenates. Standard immunoblot procedures that give excellent results for soluble proteins unexpectedly gave low and irreproducible signals with some hydrophobic membrane proteins. We found that this was due to inefficient electrophoretic transfer to nitrocellulose, which could be corrected by modification of the transblot buffer. Hydrophobic integral membrane proteins of peroxisomes as well as other rat and human liver proteins were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transferred to nitrocellulose filters. The nitrocellulose-bound proteins were detected both by staining and by immunoblotting with an antiserum against the 22-kDa integral membrane protein of peroxisomes plus 125I-labeled protein A. A modified transblot buffer with 0.7 M glycine and 25 mM Tris (pH 7.7) but no methanol allowed use of a much shorter transfer time and strikingly improved the electrophoretic transfer of membrane proteins such that a peroxisomal integral membrane protein could be easily detected in human liver biopsy homogenates. PMID- 3289417 TI - Improving the efficacy of a CPAP system during one-lung anesthesia. PMID- 3289416 TI - Human intervertebral disc: structure and function. AB - This review begins with a brief introduction in which the development, blood supply and innervation of the intervertebral disc is considered, particularly as these may influence the following sections on structure and function. The three regions within the disc--that is, the nucleus pulposus, annulus fibrosus, and cartilage end plates--are considered in some detail. There appears to be no distinct border between the central nucleus pulposus and the outer annulus fibrosus, the main difference being in their fibrous structure. The fluid space is important in the nutrition of the disc, showing plastic deformation and recovery characteristics. The structural elements, both macroscopically and microscopically, together with the biochemical elements, are intimately related to function. The intervertebral disc should not be though of as a homogeneous and static structure; it has a heterogeneous composition and responds dynamically to applied loads. Neither should it be considered as an isolated structure because it interacts with the vertebral bodies, together constituting the vertebral unit. Furthermore, changes within the disc can, and do, have dramatic effects on vertebral column kinematics. The intervertebral disc is not inactive; it is capable of self-maintenance; in injury it can repair itself and has considerable regenerative properties. PMID- 3289418 TI - Neuroimmunoallergic inflammation: new pathogenetic concepts and future perspectives of immediate and late allergic reactions. Part II. PMID- 3289419 TI - Determination of theophylline concentrations by AccuLevel. AB - Determination of theophylline concentrations in 29 paired venous samples by AccuLevel and EMIT disclosed excellent correlation. Evaluation of precision of AccuLevel by 20 replicate analyses disclosed a coefficient of variation of 3.5%. AccuLevel is an accurate, precise, rapid method of determination of theophylline concentrations in whole blood. PMID- 3289421 TI - Delayed-type allergy to various insulin preparations. PMID- 3289420 TI - Impact of AccuLevel on treatment of acute asthma. AB - Study of the impact of rapid availability of theophylline concentrations on emergency treatment of acute asthma disclosed use of AccuLevel in 50 children significantly shortened the time required to reach concentrations of at least 10 micrograms/mL and shortened time spent in the emergency room as compared with 50 children in whom serum concentrations were measured only by EMIT. PMID- 3289422 TI - Payor mix of trauma patients at a rural-metropolitan regional trauma center: a three-year experience. AB - The development of a statewide trauma system will depend on designation of community hospitals as trauma centers. The financial impact of such designation will be a prime concern. The payor mix of trauma patients will be one of the deciding factors as to whether hospitals will agree to accept designation. A three-year review of payor class on discharge for 2,605 trauma and 55,041 nontrauma admissions to a nonuniversity teaching hospital is presented. Sixty four percent of all trauma admissions had third-party payor insurance coverage, compared with 72% of all nontrauma admissions (P less than .00001). Twenty-seven percent of trauma admissions were for penetrating injury. Sixty-eight percent of patients admitted for blunt trauma had third-party coverage, while 50% of those admitted for penetrating trauma had third-party coverage. Total commercial insurance coverage was higher for trauma patients than for nontrauma admissions. The payor class mix for trauma patients presented may be representative of similar institutions in a similar geographic setting and may offer assistance to hospitals considering the financial impact of trauma center designation. PMID- 3289423 TI - An emergency physician's guide to prosthetic heart valves: valve-related complications. AB - Serious valve-related complications that occur in patients with prosthetic valves have been discussed. The emergency physician's role primarily is to recognize the high probability that one of these serious complications exists and hospitalize the patient so that rapid definitive diagnoses and therapeutic decisions are not delayed. PMID- 3289424 TI - Emphysematous pyelonephritis: an emergency indication for the plain abdominal radiograph. AB - We report the case of a 59-year-old diabetic woman with emphysematous pyelonephritis. The patient presented with nausea, vomiting, and right flank pain of three days duration. The diagnosis was established by a plain abdominal radiograph in the emergency department. Aggressive rehydration, control of diabetes, broad-spectrum antibiotic therapy, and early right nephrectomy resulted in rapid clinical improvement. Emphysematous pyelonephritis is rare and often fatal. Survival depends on early diagnosis and aggressive combined medical and surgical management. PMID- 3289425 TI - Toxic shock syndrome following diagnostic peritoneal lavage. AB - We report the case of a 15-year-old girl who developed high fever, syncope, abdominal pain, nausea and vomiting, myalgia, pharyngitis, and a desquamating rash eight days after a diagnostic peritoneal lavage. The diagnostic peritoneal lavage wound was erythematous and tender. Incision of the site yielded 10 mL of exudate that cultured Staphylococcus aureus. The patient was treated with a first generation cephalosporin and recovered without sequelae. To our knowledge, this is the first reported case of toxic shock syndrome following diagnostic peritoneal lavage. PMID- 3289426 TI - Alkaline chemical burn to the face requiring full-thickness skin grafting. AB - A case of a patient with an alkaline chemical burn to the face from the misuse of the aerosol form of an oven cleaner is presented. The low concentration of sodium hydroxide and lack of early pain delayed the patient's presentation to the emergency department for two hours. After this delay in seeking treatment, continuous irrigation in the ED did little to modify the pH of the patient's injured skin. Thus, she developed a full-thickness alkaline burn that eventually required skin grafting. PMID- 3289427 TI - Psychotherapeutic services for ethnic minorities. Two decades of research findings. PMID- 3289428 TI - Use of polyethylene glycol-modified uricase (PEG-uricase) to treat hyperuricemia in a patient with non-Hodgkin lymphoma. AB - Modification by covalent attachment of monomethoxypolyethylene glycol (PEG) can reduce the immunogenicity and prolong the circulating life of injected enzymes, making their use as therapeutic agents feasible. We report the first clinical use of PEG-modified Arthrobacter protoformiae uricase (PEG-uricase) to treat hyperuricemia in a patient with non-Hodgkin lymphoma and renal insufficiency who was allergic to allopurinol. Two intramuscular injections totaling 3 U/kg body weight during the first 30 hours of treatment lowered the plasma urate level from 910 to 190 mumol/L (15.3 to 3.2 mg/dL), after which a dose of 2 U/kg every 5 to 6 days maintained the plasma urate level at 540 mumol/L (9 mg/dL) or lower. After the injection of PEG-uricase, uricase activity appeared in plasma rapidly, peaking within 24 hours and persisting for approximately 5 days; an inverse relation between plasma uricase activity and plasma urate concentration was noted. The agent was nontoxic and well tolerated. No antibody to either PEG uricase or unmodified uricase developed over a 3-week period, during which four doses of PEG-uricase were administered. Because of its long circulating life, PEG uricase is probably a more effective hypouricemic agent than unmodified uricase, which has previously had limited use. As an adjunct to cytolytic therapy for hematologic malignancies when protection from hyperuricemia is needed rapidly, PEG-uricase deserves further study. PMID- 3289429 TI - Recurrent cystitis and bladder mass in two adults with chronic granulomatous disease. AB - Two men, aged 23 and 20 years, with recurrent episodes of severe cystitis and X linked chronic granulomatous disease were studied. Ultrasonography showed large discrete bladder masses that mimicked bladder carcinoma in both patients. Urine and bladder biopsy cultures were negative and histopathologic findings were consistent with chronic inflammation. One patient improved with symptomatic therapy on two occasions; the other patient required prolonged intravenous antibiotic therapy before fever and dysuria resolved. The possible mechanisms by which such inflammatory bladder masses might arise are discussed and eight previously reported cases of chronic granulomatous disease with cystitis are reviewed. From this clinical experience, we recommend prolonged antibiotic therapy. In patients who fail to respond to antibiotic therapy, steroids may be cautiously administered. PMID- 3289430 TI - Doppler echocardiography for assessing left ventricular diastolic function. AB - During the last 2 years, the use of pulsed Doppler echocardiography for assessing left ventricular diastolic function has received increased attention. This method is based on measurements derived from a waveform that reflects the velocity of blood flow through the mitral valve during ventricular filling. The technique is particularly attractive because it is noninvasive and relatively simple. Technically satisfactory recordings can be obtained in most patients. In a relatively short period, numerous studies using the Doppler technique to assess diastolic function in children and adults with cardiac disease have been published. This review appraises the current status of applications of Doppler echocardiography and critically examines the strengths, limitations, and ultimate potentials of this new method. PMID- 3289431 TI - Neutrophils and host defense. AB - Neutrophils, the predominant phagocytes of circulating blood, are the first cells to arrive at sites of infection. Although neutropenia has long been recognized to predispose to infection, recently other syndromes marked by frequent infections have been shown to be caused by an underlying neutrophil dysfunction. Efforts to define the molecular pathology of such disorders have helped delineate the molecular basis of normal neutrophil function. Advances have been made in defining the roles of the neutrophil's varied receptors in recognition, movement, and adhesive phenomena. Progress in establishing the pathogenesis of chronic granulomatous disease has provided important insights into the enzymatic machinery that normal neutrophils use to produce antimicrobial oxidants. The identification and precise characterization of antimicrobial components, such as defensins, have outlined the potential roles of "natural antibiotics" in neutrophil-mediated host-defense functions. These areas of neutrophil function will be reviewed and placed in a clinical context to guide physicians in evaluating children and adults with frequent or unusual infections. PMID- 3289432 TI - The treatment of chronic type B viral hepatitis. PMID- 3289434 TI - Acetylcholine nicotinic receptor: a key molecule for the pathogenesis of myasthenia gravis. PMID- 3289435 TI - Thyrotropin regulation of thyroid cell functions: mechanisms and relationship to thyroid disease. PMID- 3289433 TI - Prednisone withdrawal followed by recombinant alpha interferon in the treatment of chronic type B hepatitis. A randomized, controlled trial. AB - STUDY OBJECTIVE: To determine the efficacy of a short course of prednisone followed by recombinant interferon treatment in patients with chronic type B hepatitis. DESIGN: Randomized, controlled trial with a 5-month treatment phase and a 9-month observation period after treatment. SETTING: Two referral-based university-affiliated medical centers. PATIENTS: Thirty-nine clinically stable patients with chronic type B hepatitis, all of whom were positive for hepatitis B antigen, hepatitis B virus-associated-DNA (HBV-DNA), and DNA polymerase for at least 6 months before entry. Patients included 20 heterosexuals and 19 male homosexuals. INTERVENTIONS: Eighteen patients were treated with a 6-week tapered regimen of prednisone, followed by 90 days treatment with recombinant interferon alpha-2b; 21 patients were untreated controls. Paired liver biopsy specimens of 27 patients (pretreatment and 9 months after treatment) were blindly evaluated. MEASUREMENTS AND MAIN RESULTS: Nine treated patients had a sustained loss of HBV DNA. In addition, eight treated patients lost hepatitis B e antigen and four became negative for hepatitis B surface antigen (HBsAg). When compared with controls the differences were statistically significant for clearance of HBV-DNA and HBsAg (P = 0.035 and 0.037, respectively). Treated patients who had a sustained loss of HBV-DNA had higher initial alanine aminotransferase lower initial DNA and DNA polymerase levels, and were more frequently heterosexual. Patients who responded to treatment with the disappearance of hepatitis B e antigen and HBV-DNA had normal liver function tests and markedly improved liver histology during follow-up. CONCLUSIONS: The immunologic priming provided by a short course of prednisone used with alpha interferon may be an effective treatment for selected patients with chronic type B hepatitis. PMID- 3289436 TI - Role of cell surface receptors in the regulation of non adaptive immune response by the large granular lymphocytes. PMID- 3289437 TI - Processes of peripheral nerve and neuromuscular repair. PMID- 3289439 TI - Tumor promotion and signal transduction mechanisms. PMID- 3289441 TI - Protein-lipid interactions. PMID- 3289440 TI - Structure and function of gangliosides. PMID- 3289438 TI - Dietary lipids and pathology of nervous system membranes. PMID- 3289442 TI - Spectroscopic studies on the membrane lipids of mammalian cells. PMID- 3289443 TI - Membrane fusion in exo-endocytosis: sorting of vesicle and plasma membrane components. PMID- 3289444 TI - Membrane fusion: studies with model systems. PMID- 3289445 TI - Glycoproteins of envelope viruses as a model for studying cell fusion processes. PMID- 3289446 TI - Recognition and destruction of tumor cells by natural killer cells. PMID- 3289447 TI - Membrane mediated cell-cell interactions during gametogenesis. PMID- 3289448 TI - Dynamics of biological membranes. PMID- 3289449 TI - Physiology of hard tissues in comparison with the solubility of synthetic calcium phosphates. AB - On the basis of the composition of the mineral in bone and the saturation level of blood plasma, with respect to slightly soluble calcium phosphates, it is shown that normal tissue fluids are not supersaturated with whole bone but with the minerals of dead bone. The phase controlling solubility in living bone is octocalcium phosphate, and the presence of this phase could regulate the calcium phosphate concentrations of the body fluids by a simple physicochemical equilibrium. It is explained how parathyroid hormone and calcitonine can act on osteocytes in such a way that shifts occur in this physicochemical equilibrium. It is also explained how the mineral of bone is affected by the activity of osteoclasts and osteoblasts during bone turnover. From this knowledge about the physiology of bone mineral, it is possible to predict the behavior of calcium phosphate bioceramics implanted in the body once their true solubility limits are known. Solubility studies have been carried out on hydroxyapatite, oxyhydroxyapatite, octocalcium phosphate, brushite, beta-tertiary calcium phosphate, and magnesium whitlockite. These studies indicate that the resorbabilities for implants of these materials are in the following order: magnesium whitlockite less than hydroxyapatite less than oxyhydroxyapatite less than beta-tertiary calcium phosphate. This order is consistent with data from implant studies now available in the literature. PMID- 3289450 TI - Ceramics in composites. Review and current status. PMID- 3289451 TI - Interfacial behavior of bulk bioactive glass and fiber-reinforced bioactive glass dental root implants. PMID- 3289452 TI - Coatings of ceramics on metals. AB - An improved understanding of the complexity of the chemical bond theory as it applies to multiphase alloys is developing. A better understanding of compatibility of alloy and ceramic during refiring schedules based upon leucite phase transformations and the ramifications for porcelain failure is emerging. It may also be possible to use other high-expansion glass-ceramic compositions for coating metals. The limitations of bond test methods have been identified. Future bond test methods should aim to make use of fracture toughness theory. Ideally, it should be possible to specify ceramic-to-metal interfacial fracture toughness as a percentage of the fracture toughness of the ceramic interface material. Wet chemical methods have the potential to produce a number of innovative advances in new ceramic and glass biomaterials. These systems may provide a useful method for initial ceramic precoats on metals. PMID- 3289453 TI - Surface activities of bioactive glass, aluminum oxide, and titanium in a living environment. PMID- 3289454 TI - Epithelial attachment to ceramic dental implants. PMID- 3289455 TI - Function of neuropeptides in the central nervous system. PMID- 3289457 TI - Use of implantable pump systems for intraarterial, intraventricular and intratumoral treatment of malignant brain tumors. PMID- 3289456 TI - Intracerebroventricular administration of morphine for control of irreducible cancer pain. PMID- 3289458 TI - Intratumoral chemotherapy with multiple sources. PMID- 3289459 TI - A new implantable drug delivery system for patient-controlled analgesia. PMID- 3289460 TI - MiniMed Technologies Programmable Implantable Infusion System. PMID- 3289461 TI - Medtronic SynchroMed drug administration system. PMID- 3289462 TI - Cerebrospinal fluid circulation and the blood-brain barrier. PMID- 3289463 TI - Audit of therapeutic drug monitoring. PMID- 3289464 TI - A practical approach to the investigation of amino acid disorders. AB - We have, in this paper, highlighted some of the common problems in amino acid analysis in our experience and listed the possible causes for increases in specific amino acids in urine--together with guidance on appropriate follow-up investigations. PMID- 3289465 TI - HbA1 in the diagnosis of factitious remission of diabetes. AB - A case of factitious remission of type I diabetes in an adolescent girl is reported. The clue to diagnosis came from an inconsistency between clinic blood glucose levels and the corresponding values of glycosylated haemoglobin. Investigations of 24 h hormone and metabolite profiles demonstrated discrepancies between insulin dose, endogenous insulin production and free insulin levels which provided confirmatory evidence of surreptitious self-administration of insulin by the patient. PMID- 3289466 TI - Review of selected bacterial enterotoxins and their role in gastroenteritis. AB - The study of enterotoxins began in earnest approximately 30 years ago with characterization of the cholera toxin. So far, more enterotoxins have been associated with Gram-negative rather than Gram-positive bacteria. These substances can be roughly divided into the cytotonic variety, which primarily interfere with intestinal cell metabolism, and those which are cytotoxic, responsible for cell destruction. Most cytotonic enterotoxins activate cyclic adenosine monophosphate (cAMP) or cyclic guanosine monophosphate (cGMP) producing watery diarrhea, resulting from fluid and electrolyte flux. This typically results after binding to a toxin-specific receptor site on the small intestinal epithelium. Cytotoxic enterotoxins may interfere with protein synthesis in cells of the colonic epithelium and cause bloody, sometimes fatal dysentery. As more enterotoxins are discovered, it is becoming apparent that such variables as anatomic site and mode of action may not, in fact, be definitive criteria for classifying these substances. As a result, no universally acceptable classification scheme has yet been devised. Moreover, the biochemical and physiological characteristics of many enterotoxins and their role in gastroenteritis and other disorders remain speculative. PMID- 3289467 TI - Urine screening: an alternative to urine cultures. AB - Urine cultures represent one of the most commonly submitted specimens to a microbiology laboratory. In an attempt to manage effectively this type of specimen, Bac-T-Screen (BTS), nitrate and leukoestrase test were performed on all clean catch urine specimens sent for culture. Three hundred and four specimens were screened by these methods. The BTS, by itself, had the highest sensitivity, and specificity (92 percent and 81 percent, respectively) and the lowest false negative rate (9.8 percent) of the three tests. A combination BTS/leukoestrase test increased specificity (99 percent), but the sensitivity was only 73 percent. PMID- 3289468 TI - Toxicological quandary of the use of bis (2-diethylhexyl) phthalate (DEHP) as a plasticizer for blood bags. AB - Plastic bags are very useful containers for the storage of blood and blood products since they are relatively transparent, hard to break, can be sealed aseptically with a radio-frequency current, and can be centrifuged for the isolation of blood components. In order to make the plastic more flexible, various agents are added, of which the most common is di- (2-ethylhexyl) phthalate (DEHP). This plasticizer has been found to leach from the plastic into the blood components during the storage period. Some animal studies have shown that this chemical can produce cancers and various tissue abnormalities. The human data from multi-transfused patients do not clearly indicate any specific damage: however, because of the animal studies, work has been carried out to find a non-leachable plasticizer. Several have been found: unfortunately, when survival studies are done, the red cell life span of the stored blood is decreased. Current work seems to indicate that DEHP has a membrane stabilizing function that prolongs the storage time of the red cell. Therefore, there currently is a trade off between plasticizer presence and red cell life span that must be considered when designing new blood storage bags. PMID- 3289469 TI - Dermatological manifestations of toxic agents. AB - A great variety of cutaneous disorders can be seen as reactions to toxic substances. To limit the extent of this review, cutaneous manifestations known to have an immunological mechanism are simply listed with pertinent references. The report has been focused to cover the cutaneous manifestations of toxic agents of non-immunological and unknown mechanisms. Entities discussed include acne, alopecia, dermatitis caused by spider bites, pityriasis rosea, and chemically induced scleroderma. PMID- 3289471 TI - Teratogens and teratogenesis: general principles of clinical teratology. AB - Numerous factors hinder our ability to recognize fully human teratogens. Among these are the limitations of animal and epidemiologic studies, the lack of understanding of the mechanisms of action of most teratogens, and the variability in expression of the clinical manifestation. Dose and timing of exposure, interactions with other environmental agents, and host susceptibility influence this variable expressivity. Recent studies suggest the genetic constitution of the mother and the fetus play a central role in the teratogenic response. Techniques currently being developed may help in a near future to identify susceptible individuals and to prevent specific types of drug-induced birth defects. PMID- 3289470 TI - Art in relation to lead poisoning. AB - Lead poisoning is an ancient and modern problem. Since many artists have had exposure to lead, it is appropriate to use some of their works as a vehicle to depict the symptoms of the variable syndromes associated with lead exposure. PMID- 3289472 TI - Perils of mercury. AB - The historical items pertaining to mercury are outlined, and its toxicity and former medicinal uses are discussed. The diversity of the toxic effects by the different forms of mercury as well as the routes of administration are illustrated in three case reports. The importance of diaphoresis in the treatment of mercury poisoning as well as the status of the use of chelating agents are reviewed. The need for the surveillance of mercury and the prevention of exposure to mercury from environmental and dietary sources are emphasized. The importance of excluding mercury toxicity in patients with psychiatric and neurological disorders is stressed. PMID- 3289473 TI - [Value of the inflammatory reaction after intravesical injection of BCG into the bladder]. AB - 55 patients with bladder tumours were treated by intravesical BCG. Histological study of the biopsies performed 9 weeks after the initial treatment revealed an intense inflammatory reaction in 10 cases. This intense inflammatory reaction was more frequent in patients who had never been treated previously and in patients who subsequently relapsed. The interpretation of these results needs to be confirmed by a study of the cell sub-populations which constitute this inflammatory infiltrate. PMID- 3289475 TI - [Surgical castration for cancer of the prostate. A simplified technic]. AB - We describe a simplified technique for surgical castration in patients with carcinoma of the prostate consisting mainly in crushing the epididymis between two kelly forceps and then removing the entire testis. The epididymis is then gathered into a mass and sutured using a hemostatic stitch. Fifty-five castrations for carcinoma of the prostate were performed using this simplified technique, with a low morbidity rate: moderate hematoma of the scrotum that did not require reoperation, and two mild superficial wound infections. Surgical castration for carcinoma of the prostate is a simple procedure. At present this treatment involves the lowest costs and ensures optimal patient compliance. PMID- 3289474 TI - [Clear cell epithelioma of the kidney in a child. Apropos of a case]. AB - The authors report a case of renal hypernephroma in a child. This is an uncommon tumour which is very rarely diagnosed preoperatively. Its treatment is exclusively surgical. As in adults, the prognosis depends on the stage of the tumour at the time of discovery. PMID- 3289476 TI - [Liposarcoma of the spermatic cord]. AB - We review a new case of spermatic cord liposarcoma followed over a period of two years. After simple excision and 50 grays of radiotherapy had a local recurrence one year later; the patient a wide radical orchiectomy was then performed. A review of the literature illustrates the various clinicopathological data and their prognosis. The various treatments described are also analysed. PMID- 3289477 TI - [A rare diagnosis of an intrascrotal tumor: polyorchidism]. AB - The authors report a new case of polyorchidism and review the literature. They discuss the different anatomo-clinical forms and the therapy of this rare anomaly. PMID- 3289478 TI - [Ultrasonographic concept of the central prostate. Value of the endorectal approach]. AB - In view of the difficulties involved in tissue characterisation of prostatic lesions by suprapubic and transrectal ultrasonography, the authors propose the concept of the central prostate in order to improve the possibility of histological diagnosis based on a topographical approach to ultrasound modifications. When the lesions are selectively situated in the central prostate, with clear distinction between the central prostate and the peripheral prostate, there is a low probability of a neoplastic lesion. However, the histological diagnosis must be extremely cautious and when a suspicious lesion is detected on ultrasonography, ultrasound guided aspiration biopsy may be required. PMID- 3289479 TI - [Use of the laser in urology]. AB - The usage of laser therapy in urology is based upon thermal effects that lead to tissue destruction by coagulation necrosis and volatilization. The endoscopic treatment of bladder tumors has been its most important utilization. The authors report their experience with 681 bladder tumors in 198 patients and present the technical details of laser therapy, the indications and the results. The recurrence rate at the previously treated tumor area was found to be rather improved: 0.75/100 months/patient for stage pTa and 0.92/100 months/patient for stage pT1. Other utilizations for laser therapy exist: upper tract urothelial tumors mainly in selected cases as solitary kidney; urethral localizations of urothelial tumors and condylomata acuminata; urethral stenosis, as a complement of optical urethrotomy; hemorrhagic cystitis after radiotherapy and some forms of chemotherapy. The pulsed dye laser may become an important advance in endoscopic treatment of ureteral calculi. PMID- 3289480 TI - [Treatment of mycotic aneurysms after renal transplantation]. AB - The authors report two cases of aneurysm in renal transplantation: one after removal of the transplant and the other with the transplant in place. In both cases, repair was preceded by excision of the aneurysm and consisted of interposition of an inverted autologous vein graft. PMID- 3289482 TI - Pharmacologic modulation of erythropoietin production. AB - A model for the regulation of erythropoietin production has been presented. This model proposes that a primary O2-sensing reaction in the kidney is initiated by a decrease in ambient PO2, a rapid decrease in gas exchange in the lung, a diminished oxygen-carrying capacity of hemoglobin, a molecular deprivation of oxygen, or a decrease in renal blood flow. It is proposed that the primary oxygen sensing reaction may trigger the release of several mediators that stimulate adenylate cyclase through a receptor-activated stimulation of a G protein in the renal cell membrane. Some of the agents that are thought to be released during hypoxia, which may trigger this cascade, are adenosine (A2 activation), eicosanoids (PGE2, PGI2, and 6-keto PGE1), oxygen-free radicals (superoxide and H2O2), and catecholamines with beta-2 adrenergic receptor agonist properties. The activation of adenylate cyclase generates cyclic AMP, which activates protein kinase A, leading to the production of a phosphoprotein that, in turn, activates a nuclear protein involved in transcription and/or translation for erythropoietin biosynthesis and/or secretion. A second part of this model concerns the effect of hypoxia on a renal cell membrane phosphodiesterase and the generation of inositol triphosphate and diacylglycerol. Diacylglycerol may interact with diacylglycerol lipase to generate arachidonic acid, which, together with arachidonic acid generated by the interaction of phospholipase A2 on membrane phospholipids, produces eicosanoids. Eicosanoids may play a secondary role in Ep production/secretion. The model further proposes that calcium levels in both renal and liver cells may be important in regulating erythropoietin biosynthesis and/or secretion. It is proposed that an increase in intracellular calcium leads to the inhibition of erythropoietin biosynthesis and/or secretion and a decrease in intracellular calcium increases erythropoietin production. The specific mechanism by which calcium regulates erythropoietin biosynthesis and secretion is not well understood. However, a good correlation is seen with several agents that decrease intracellular calcium and increase erythropoietin production as well as with other agents that increase intracellular calcium and decrease erythropoietin production. When inositol triphosphate levels are increased, an increase in the mobilization of intracellular calcium from the endoplasmic reticulum or another intracellular pool occurs. This increased intracellular calcium probably activates a calcium calmodulin kinase and produces a phosphoprotein that inhibits erythropoietin production/secretion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3289481 TI - An unexpected life in research. PMID- 3289484 TI - Host biochemical defense mechanisms against prooxidants. PMID- 3289483 TI - Neuromodulatory actions of peptides. PMID- 3289485 TI - Chemotherapy of leprosy. PMID- 3289486 TI - Endogenous anorectic agents--satietins. PMID- 3289487 TI - Recent advances in blood-brain barrier transport. AB - In summary, recent studies over the last ten years have concentrated on what the blood-brain barrier does rather than what it is. This focus has changed the concept of this important membrane from a passive, relatively immutable structure to a dynamic interface between blood and brain. Further understanding of the molecular cell physiology of the brain capillary endothelium will undoubtedly lead to new insights into both drug action at the BBB and drug delivery through this barrier. PMID- 3289488 TI - Arterial wall changes in chronic cerebrovasospasm: in vitro and in vivo pharmacological evidence. PMID- 3289489 TI - Drug nephrotoxicity. PMID- 3289490 TI - The immunologic and metabolic basis of drug hypersensitivities. PMID- 3289491 TI - Serotonin and vascular responses. PMID- 3289492 TI - Molecular pharmacologic approaches to the treatment of AIDS. PMID- 3289493 TI - Endogenous ligands for high-affinity recognition sites of psychotropic drugs. PMID- 3289494 TI - Advances in cardiac cellular electrophysiology: implications for automaticity and therapeutics. PMID- 3289495 TI - Chloramphenicol: relation of structure to activity and toxicity. PMID- 3289496 TI - [Boron-neutron capture therapy in brain tumors and other cancers--a radiosurgery]. AB - If a certain means enables a selective loading of tumor cells with a stable isotope of boron-10, the tumor tissue can be selectively destroyed when the tumor containing organ is exposed to slow neutron beams as the result of intracellular heavy particle radiations which arise from boron-10 atoms in the neutron capture reactions. An early clinical trial in the U.S.A. was discontinued after the 1953 1961 series, but the clinical trial resumed in Japan in 1968 has so far treated almost 90 patients with malignant brain tumors. The longest surviving patient has lived 16 years, and two others have lived 10 years. A median survival of 2 years was obtained with 12 patients with grade III - IV gliomas which had been within 6 cm from the cortical surface. This success has caused a reassessment of this therapy throughout the world, and there is an internationally concerted effort is going on in most countries with advanced technology. Application of this therapy to other incurable cancers, such as those of the liver, pancreas, skin and even of the bone-marrow is being sought. PMID- 3289497 TI - [Radiofrequency hyperthermia in malignant brain tumors: clinical trials]. AB - Local hyperthermia using 13.56-MHz radiofrequency (RF) capacitive heating was evaluated in 19 patients with malignant brain tumor. Intraoperative heating was performed in 4 patients. RF applicators were placed on the cerebral convexity and medial surface with the tumor between them. RF power was controlled so as to maintain the brain temperature below 40 degrees C. Under these conditions, the highest temperature of each tumor varied from 44 to 52 degrees C. After heating alone for about 60 min, 3 tumors showed regression on CT scan. Extracranial heating was performed in 15 patients with cerebral glioblastoma. RF applicators were placed on the scalp and applied to diametrically opposite sides of the tumor after bilateral craniectomy not smaller than the size of the applicator. The heating was performed for about 60 min at each session and repeated twice a week for a total of 4 to 10 times in combination with radiation and ACNU-chemotherapy. The brain temperatures were maintained below 42 degrees C. The highest temperatures of the tumor varied from 42 to 46 degrees C. Seven of 13 evaluable tumors on CT scan showed regression after the treatment. Low-density lesions appeared transiently in the brains of 2 patients, located in the RF field. In conclusion, RF capacitive heating can be applied to human malignant cerebral tumors. PMID- 3289498 TI - [Endoscopic treatment of early upper gastrointestinal carcinoma--high-frequency current polypectomy, laser, and microwave coagulation procedures]. AB - The authors have been treating early gastric carcinoma endoscopically by high frequency-current polypectomy since 1976, by microwave coagulation since 1982, and by laser coagulation since 1983. In order to achieve absolute curability of early carcinoma, we recommend that polypectomy be performed first, whenever possible. The reason for this is that the resected polypectomised tissue enables a decision to be made as to whether further treatment is necessary, after histopathological examination of the specimen. Otherwise, cases in which snaring is impossible, such as flat or depressed carcinomas of markedly small or large size, should be treated by microwave and/or laser coagulation. In total, we have experienced 92 lesions (83 cases) of early gastric carcinoma treated by all of above 3 methods, and we currently have 5 cases showing more than 5-year survival. Among these, type II a early carcinomas less than 10mm in diameter accounted for the majority; on the other hand, there were 11 type II c cases, also with tumors less than 10mm in diameter. Referring to our surgical data, type II c (without ulcer nor lymph node metastases) less than 5mm in size is limited to the mucosa in 100% of cases, and of 6-10mm in size in 85%. We therefore propose that type II c tumors less than 10mm in size should be treated endoscopically, as well as type II a tumors of the same size. In order to determine the depth of carcinomatous invasion, endoscopic ultrasonography (EUS) is effective. The diagnostic accuracy for Ul(-) early carcinoma is almost 100%, but for Ul(+) cases EUS is not so accurate. Further studies and improvements of EUS are thus needed. PMID- 3289499 TI - [Endoscopic resection with local injection of hypertonic saline epinephrine for the treatment of early gastric cancer]. AB - We have developed a new method of endoscopic resection of early gastric carcinomas and other tumors. Characteristics of the new method are summarized as follows. 1. In order to prevent bleeding after endoscopic resection of the tumors, local injection of hypertonic saline epine phrine (HSE) solution was applied to the lesion. Even a depressed lesion like II c type early gastric carcinoma was artificially protruded by local injection of HSE solution. 2. Instead of a single fiberscope, double fiberscopes were employed simultaneously for endoscopic resection of the lesion. 3. Prior to resection of the lesion by high frequency current snare method, incision of the mucosa along the marking line around the lesion performed, enabling the area to be resected precisely. 4. Because tissue damage is mild, resected materials removed are suitable for pathological study. Endoscopic resection was performed on a total of 113 cases in early gastric carcinomas; 103 cases among them (91.2%) were curative resections. Ten cases of the rest underwent surgical gastrectomy for the endoscopic non curative resections. Rate of five-year survival in 103 cases was 85.2%. Endoscopic resection by our method seems to be effective for the treatment of early gastric carcinomas in any lymph node metastasis and in patients at high surgical risk. PMID- 3289500 TI - [Drug delivery systems]. AB - Progress in drug delivery system (DDS) is described. Definition, type and merit of each DDS are discussed. The, most important subject of DDS is in cancer treatment, and various methods of cancer treatment using DDS have been studied. In addition to the cancer treatment, DDS is employed for the treatment of other diseases, and some of the DDS seem more useful than that in cancer treatment, which will be also available against cancer in the future. PMID- 3289501 TI - [Recent advances in the treatment of choriocarcinoma]. AB - Recent advances in intensive care procedures have improved the therapeutic results of choriocarcinoma treatment. The mortality of patients with choriocarcinoma, which was 100% in 1958, has gradually decreased, and finally fell to about 10% in 1983. These favorable results have been mainly due to the progress made in chemotherapy, including combined administration of methotrexate and actinomycin-D. However, recent progress has been chiefly dependent on intensive care procedures, involving so-called multidisciplinary treatment, including surgical treatment for pulmonary or intracranial metastatic foci and whole-brain irradiation. When the treatment results for choriocarcinoma were compared between metastatic and non-metastatic cases, the mortality, which had decreased for both groups with time, had already reached 0% in non-metastatic cases, although it was still about 20% in metastatic cases. These results have made it clear that the most important aspect is how to treat choriocarcinoma metastatic foci. With the goal of finding some form of treatment that will help to attain complete cure of choriocarcinoma, we present here details of recent progress made in choriocarcinoma treatment. PMID- 3289502 TI - [Clinical study on the effect of adjuvant immunochemotherapy using OK-432 and 5 FU in pharyngeal and laryngeal cancers]. AB - A randomized controlled trial was carried out on 38 pharyngeal and 59 laryngeal previously untreated cancers to evaluate the effects of adjuvant immunochemotherapy using 5-FU with and without OK-432. After each fundamental therapy, 5-FU was given orally at a dose of 200-300 mg/day for more than a year. OK-432 was intracutaneously administered at a dose of 5KE once a week for more than a year. Three-year survival rates and disease-free intervals were estimated for the two groups. In cases of pharyngeal cancer, the 3-year survival rate was 58% in both groups and the disease-free interval rates for up to 3 years after the fundamental therapy was 49% in the OK-432 + 5-FU group and 52% in the 5-FU group. These results showed no statistically significant difference. In laryngeal cancers, the 3-year survival rate was 96% in the OK-432 + 5-FU group and 82% in the 5-FU group. These results also showed no statistically significant difference. The disease-free interval rates were 87% in the OK-432 + 5-FU group and 64% in the 5-FU group, revealing a statistically significant difference (p less than 0.1). This suggests that OK-432 is more effective in producing a higher survival rate in cases of laryngeal cancer. PMID- 3289503 TI - [The minimization method in a medium size clinical trial. Study of immunochemotherapy with PSK in gastric cancer]. AB - One of the objectives of randomization is to balance the number of patients in each level and combination of levels of prognostic factors. However, as the number of possible prognostic factors increases, some imbalance may occur and make the results of the analysis less interpretable. In order to balance the marginal distribution of each factor and to facilitate more interpretable trial results, the "minimization method" reported by Pocock was applied in our multi center immunochemotherapy clinical trial. Balancing in every institution was achieved by using Zelen's prespecified value d = 3 for replacing provisional assignment in the individual institution. Nonmetric principal component analysis in S, N factors which were used in minimization process showed good equilibration between groups. Also, in uncontrolled background factors, such as cancer pathology or Borrmann types, acceptable balance was obtained spontaneously at the end of the trial. PMID- 3289504 TI - [Pharmacokinetics of carboplatin (CBDCA) and tissue concentration of platinum in gynecologic organs]. AB - A pharmacokinetics and platinum concentration in the gynecologic organs were measured following the intravenous drip infusion of 375 mg/m2 of CBDCA. Total platinum (TP) in plasma decreased biphasically and free platinum (FP) was almost monophasically eliminated. The t 1/2 of FP was about 51 min. and the percentage of FP out of TP at four hours after administration was more than 92%, which was much higher proportion compared with that of cisplatin (CDDP). A cumulative excretion of platinum in the urine within 24 hours was 69%. The platinum concentration in the benign part of portio and endocervix were higher than that of malignant portion, although there were no significant differences in other pelvic organs such as ovary and tubes. However, pelvic lymph-nodes showed less platinum concentration both in metastatic and non-metastatic tissues. Platinum concentration in the tissue did not change significantly with lapse of time. Bone marrow suppression was observed especially in the patients who had received chemotherapy or radiotherapy. No renal toxicity was observed even without any hydration and gastro-intestinal toxicity was much milder than that of CDDP. PMID- 3289505 TI - [Adriamycin]. PMID- 3289506 TI - Progress of renal dysfunction in inhabitants environmentally exposed to cadmium. AB - The reversibility of beta 2-microglobulinuria, glucosuria, and aminoaciduria was examined in 74 inhabitants (32 males and 42 females) over 50 yr of age, who lived in a cadmium-polluted area. The subjects participated in two examinations conducted just after the cessation of cadmium exposure and 5 yr later. All urinary parameters did not show reversible changes. During the 5 yr the geometric mean concentrations of beta 2-microglobulinuria, glucosuria, and aminoaciduria indicated significant increases in excretion. In cases where greater than 1,000 micrograms/g creatinine of beta 2-microglobulinuria was observed (at the time cadmium exposure ended), almost all individuals exposed to cadmium showed deterioration of beta 2-microglobulinuria, whereas in the case of less than 1,000 micrograms/g creatinine of beta 2-microglobulinuria, no significant changes were observed. The present study indicates that cadmium-induced renal dysfunction in individuals environmentally exposed to cadmium is irreversible. PMID- 3289508 TI - [Recurrent urinary infections in kidney transplantation]. PMID- 3289507 TI - Airway responses to 2.0 ppm nitrogen dioxide in normal subjects. AB - Nitrogen dioxide (NO2) is a common indoor air pollutant. To characterize the acute respiratory responses to this gas, 18 nonsmoking normal subjects (mean age +/- standard deviation [SD] = 25 +/- 4 yr) were exposed to filtered air or 2 ppm NO2 gas for 1 hr in a 30-m3 environmental chamber on different days, typically 1 wk apart, in a double-blind randomized fashion. Lung function tests included forced vital capacity, forced expiratory volume in one second, partial expiratory flow at 40% of vital capacity (Vp40), functional residual capacity, and specific airway conductance, and were measured before and after exposure. Airway reactivity to methacholine inhalation was determined within 45 min of each exposure. The dose of methacholine in mg/ml to cause a 40% decrease in specific airway conductance (PD40) was measured. Airway reactivity to methacholine aerosol increased significantly after NO2, which is shown by a decrease in the concentration of methacholine; PD40 (AIR) = 101 +/- 44, PD40 (NO2) = 81 +/- 45 mg/ml, p = .003. No significant changes were noted in the lung function tests after NO2 exposure. These findings indicate that normal nonsmokers exposed to 2.0 ppm NO2 for 1 hr develop an increase in airway reactivity to methacholine aerosol, which is not associated with changes in lung volumes, flow rates, or respiratory symptoms. PMID- 3289509 TI - [Synchronous bilateral renal adenocarcinoma]. PMID- 3289510 TI - [Sarcomatoid renal carcinoma. Cytological study using fine-needle puncture aspiration, optical microscopy and immunohistochemistry]. PMID- 3289511 TI - A double blind, placebo controlled trial of intravenous methylprednisolone in systemic lupus erythematosus. AB - A double blind, placebo controlled trial was performed in 25 patients to study the use of intravenous methylprednisolone (IVMP) in the treatment of active systemic lupus erythematosus (SLE). The trial examined the additive effect of IVMP on a background of conventional oral steroid treatment. Patients were followed up for six months. The results showed a trend towards more consistent overall improvement in the first two weeks after IVMP administration compared with placebo, but this difference was not maintained at one month or subsequently. They also suggested a quicker resolution of hypocomplementaemia in the treatment group. Other parameters of disease activity showed no difference. Side effects were generally mild and were similar in incidence between the two groups. Thus it is concluded that IVMP may improve initial suppression of active lupus in some patients when added to conventional oral steroid treatment, but that this additional benefit is not maintained; IVMP is, however, a relatively safe treatment when used in this way. PMID- 3289512 TI - Impending sudden cardiac death: treatment with myocardial revascularization and the automatic implantable cardioverter defibrillator. PMID- 3289513 TI - Circumferential intimal tear causing obstruction of the aortic arch: an unusual complication of aortic dissection. AB - A 66-year-old man was first seen because of occlusive disease of the aortic arch vessels secondary to a Type I aortic dissection. At operation, circumferential detachment of the intima was found with intussusception of this flap into the descending aorta causing obliteration of the arch vessels. There has been only one previous report of circumferential intimal intussusception complicating aortic dissection. PMID- 3289514 TI - The importance of two-dimensional echocardiography in the location of a bullet embolus to the right ventricle. AB - Bullets which enter a sufficiently large vein may embolize to the right ventricle. This finding is usually determined after the bullet has been removed from the heart. A chest x-ray study cannot, however, differentiate with certainty between localization in the right ventricular cavity, the right ventricular wall, or the pericardium. We recommend echocardiography to document bullet localization in the right ventricular cavity prior to surgical removal. PMID- 3289515 TI - Coronary artery spasm following coronary artery surgery. AB - Coronary artery spasm during the early postoperative period following cardiopulmonary bypass for coronary artery surgery can be an unrecognized cause of sudden, severe cardiopulmonary collapse. The literature regarding perioperative coronary artery spasm is reviewed, and methods of prevention, diagnosis, and treatment are suggested. Preoperative angina at rest appears to be an important identifying factor in patients who experience postoperative coronary spasm. Anatomically, the presence of a relatively normal, dominant right coronary may also indicate increased risk for early post-coronary bypass spasm. Acute hypotension is often the first sign of coronary artery spasm, and conventional treatment methods may only worsen the vasospastic reaction. Peripheral intravenous nitroglycerin infusion has often been unsuccessful treatment while intragraft or intracoronary nitroglycerin injection or administration of calcium channel-blocking drugs, or both, has proven to be effective in reversing the coronary artery spasm and ventricular dysfunction. Reluctance to use vasodilating agents must be overcome, even in the face of hypotension, when evidence of spasm is present. PMID- 3289516 TI - Transposition of the great arteries. PMID- 3289518 TI - Operative management of chest wall deformities in children: unique contributions of Southern thoracic surgeons. PMID- 3289517 TI - Surgical management of lung cancer with solitary cerebral metastasis. AB - Between 1964 and 1986, 19 patients underwent resection of both a primary lung cancer and the associated brain metastasis. One patient underwent resection of 2 separate primary lung cancers and the associated metastases. The 12 men and 7 women ranged in age from 42 to 67 years (mean, 54.6 years). The cell type was adenocarcinoma in 12 tumors, squamous or adenosquamous cell in 5, large cell undifferentiated or anaplastic in 2, and malignant carcinoid in 1 tumor. The types of resection were as follows: lobectomy for 12 neoplasms, pneumonectomy for 5, bilobectomy for 2, and wedge resection for 1 neoplasm. Radiotherapy to the brain was given in connection with sixteen of the twenty craniotomies. The patient with 2 separate primary neoplasms survived 19 years before dying 5 months after the second craniotomy. The mean survival is 8.0 +/- 2.1 years (+/- the standard error), and the median survival is 1.67 years. Survival at 1 year was 65 +/- 10.7% and at 5 years, 45 +/- 11.1%. On univariate analysis, the following factors were found to correlate significantly with longer survival: a lung tumor in Stage I or II; negative mediastinal nodes; curative rather than palliative resection of the lung tumor; and age younger than 55 years. However, on multivariate analysis, only curative resection was a significant factor (p less than 0.01). We believe these results justify continued application of this combined surgical approach to patients having limited-stage lung cancer with a solitary brain metastasis. PMID- 3289520 TI - Intractable hemolysis caused by perivalvular leakage following mitral valve replacement with St. Jude Medical prosthesis. AB - Nine patients with intractable hemolysis caused by perivalvular leakage following mitral valve replacement with a St. Jude Medical prosthesis are presented. All patients had dark-colored hemoglobinuria, which appeared from 1 day to 44 days after the operation, with moderate or severe hepatorenal insufficiency. One patient died of multiorgan failure. The other 8 patients underwent reoperation, and all survived. Reoperation revealed that all leakages were tiny and had no adverse effect on hemodynamics. In all the patients having reoperation, hemoglobinuria disappeared immediately after the procedure. Surface-scanning electron microscopy of the sewing cuff of the St. Jude Medical prosthesis revealed the rough surface structure of the sewing ring. Because of this irregular, shaggy surface structure, greater shearing forces against erythrocytes can be generated when there is perivalvular leakage. PMID- 3289519 TI - The risks and benefits of thrombolytic therapy in acute aortic and mitral prosthetic valve dysfunction: report of a case and review of the literature. AB - A patient with acute thrombosis of a St. Jude mitral prosthesis was treated with streptokinase with initial success. Subsequent recurrent thrombosis and embolism prompted operative revision. Because the use of thrombolytic agents in this setting is somewhat controversial, we searched the literature for all reports of aortic or mitral prosthetic valve dysfunction treated this way. The cases of 58 patients treated 62 times were reviewed for efficacy of therapy and morbidity. Thrombolytic therapy may be useful in patients with prosthetic valve thrombosis causing critical hemodynamic compromise. It is frequently the only treatment needed. Further, it may help reduce operative risk for those patients in whom complete resolution is not possible. The incidence of systemic embolism is 18%, however, neurological events are usually limited and transient. PMID- 3289521 TI - Malaria. A city hospital experience. AB - We reviewed the charts of 24 patients with malaria seen at the Queens Hospital Center, Jamaica, NY, over the past five years. Twenty-three patients were foreign citizens. Eighteen patients were infected with Plasmodium vivax and six with Plasmodium falciparum. Malaria was suspected on admission in 19 of the 23 hospitalized patients. Five patients were admitted with unrelated diagnoses, and four of these experienced diagnostic delay. All diagnoses were confirmed with thin blood smears. Twenty-one patients were febrile, and 18 patients had prominent gastrointestinal tract symptoms. Serum glucose level was increased in nine patients, and hypoglycemia occurred in one. Four patients also had intestinal parasites. Malaria should be suspected in travelers with gastrointestinal tract symptoms, and patients with malaria may have other parasitic infections. Most patients with P vivax infections can be treated as outpatients, since the course is usually uncomplicated. PMID- 3289522 TI - Hypothermia and blood pH. A review. AB - Management of the hypothermic patient concerns physicians in many specialties. Accidental hypothermia is commonly encountered in the emergency and operating rooms and in the adult and neonatal intensive care units. Intentional induction of hypothermia is used routinely in cardiac surgery to reduce total body metabolism and oxygen consumption, which is beneficial when an increased tolerance to ischemia is required, such as during total circulatory arrest. Hypothermia is associated with such complications as acidosis, impaired myocardial function, altered blood clotting, decreased kidney and liver function, and intracellular swelling. This review summarizes the laboratory, theoretical, and clinical evidence that the management of blood pH during hypothermia may alter the appearance or magnitude of these deleterious effects. PMID- 3289523 TI - Double-blind comparison of alprazolam, diazepam, and placebo for the treatment of negative schizophrenic symptoms. AB - Fifty-five schizophrenic outpatients with negative symptoms were treated for up to six weeks by the addition of alprazolam (mean dose, 4.2 mg/d), diazepam (mean dose, 40.4 mg/d), or placebo to their ongoing neuroleptic treatment. A repeated measures analysis of variance with baseline measurements entered as covariates indicated the presence of a significant time X drug interaction effect for the weekly Brief Psychiatric Rating Scale (BPRS) withdrawal/retardation subfactor scores. During the initial weeks of the study, the alprazolam-treated group had lower scores, while the diazepam-treated group had higher scores than the placebo treated group. However, an end point analysis performed on the final BPRS withdrawal/retardation subfactor scores showed no significant differences among the three groups, nor were beneficial effects observed on any of the BPRS subfactor scores that assess positive symptoms. Plasma alprazolam levels were maintained throughout the study and ranged from 20 to 100 ng/mL. These results suggest that alprazolam had no sustained significant effect on negative schizophrenic symptoms. PMID- 3289524 TI - Alprazolam augmentation of the antipsychotic effects of fluphenazine in schizophrenic patients. Preliminary results. AB - Alprazolam was added, under double-blind conditions, to stable fluphenazine hydrochloride regimens in 12 symptomatic, chronically ill inpatients with schizophrenia. The addition of alprazolam was associated with significant, albeit modest, reductions in global psychosis, thought disorder, and paranoia ratings, with a return to pretreatment levels on discontinuation of alprazolam treatment. Improvement in "negative symptoms" such as emotional withdrawal paralleled the changes in "positive symptoms" but did not, in itself, reach statistical significance. There were no significant changes in group mean plasma levels of homovanillic acid or 3-methoxy-4-hydroxyphenylglycol during alprazolam treatment, although group mean serum cortisol levels were significantly decreased by alprazolam treatment. Patients who responded favorably to alprazolam treatment were significantly more psychotic or anxious before treatment, were older, showed significant alprazolam-associated reductions in plasma levels of homovanillic acid, and had significantly more prominent prefrontal cortex atrophy on computed tomographic scans than patients in whom alprazolam was without therapeutic effect. These preliminary data, based on a small sample, suggest that some patients with schizophrenia who are only partially responsive to standard neuroleptic treatment may benefit from the addition of triazolobenzodiazepines, such as alprazolam. PMID- 3289525 TI - Request for retraction. PMID- 3289527 TI - Transient osteoporosis of the hip in the first trimester of pregnancy. A case report and review of Japanese literature. AB - A patient with transient osteoporosis of the hip in her first trimester of pregnancy is reported in this study. Rapid symptomatic improvement after artificial abortion was observed. These findings exclude pressure on the obturator nerve, Sudeck's osteodystrophy, venous obstruction, and excessive demand of proteins and calcium in the etiology of this condition. Rather it is here suggested that chemical or hormonal factors related to pregnancy play an important role in the etiology. PMID- 3289526 TI - Proven and nonproven facts in knee arthroplasty. Results with the semiconstrained GSB-prosthesis. AB - The great number of knee-replacement systems makes a comparative study difficult. Even more confusing are the different criteria used for the evaluation of the results. After a critical review of what can be taken as proven facts, our own experience with the semiconstrained GSB-III knee prosthesis is critically analyzed. The survivorship method is used, presenting the cumulative success rate and analyzing the reasons for the failure rates. We feel that all authors presenting results of knee arthroplasty should adopt this method, using the same or at least comparable evaluation sheets (for instance, that of ERASS). Moreover, more attention should be given to bone dynamics in a prospective study using modern technology (CT densitometry). This will help to detect possible factors responsible for the failure of knee arthroplasty and possibly to prevent failure with medication. PMID- 3289528 TI - Efficacy of directed percutaneous fine-needle aspiration cytology in the diagnosis of intra-abdominal masses. AB - Directed percutaneous fine-needle aspiration (FNA) cytology was performed on 113 patients with intra-abdominal masses. The 47 male and 56 female patients had a median age of 56 years (range, 17 to 83 years). Computed tomography (CT) was used to localize the needle in 90 cases, and ultrasonography was used in the remaining 24 cases. The predominant sites aspirated were the liver (n = 40), pancreas (n = 23), and pelvis (n = 14). Seventy-eight of the 113 patients had a malignant neoplasm. Fine-needle aspiration cytology correctly identified 63 (88%) of the 78 cases. There were no false-positive studies. Computed tomography and UTZ ultrasonography were equally sensitive in detecting malignant neoplasms. In 38 patients with a history of previously treated malignant neoplasm, percutaneous aspiration cytology confirmed the presence of recurrent disease in 24 (75%) of 32 patients. Results of aspiration cytology obviated the need for a diagnostic laparotomy in 51 (65%) of the 78 patients with a malignant neoplasm. There was no serious morbidity or mortality associated with the procedure. We conclude that CT/ultrasonography-directed percutaneous FNA cytology is the procedure of choice in the workup of patients with intra-abdominal masses. The specificity is 100% and sensitivity is 90%. It is particularly useful in patients with extensive disease that would not be palliated by operation. PMID- 3289529 TI - Pneumocystis carinii pneumonia in renal transplant recipients. PMID- 3289530 TI - The face of nursing: portrayed in picture postcards. PMID- 3289531 TI - Effect of oral Escherichia coli inoculation on performance of young turkeys. AB - A strain of Escherichia coli isolated from the yolk sac of stunted turkey poults was administered orally to day-old large white poults. Poults were inoculated with either 0.1 ml of sterile broth or 0.1 ml of a 10(-2) dilution of a 24-hr E. coli culture containing 3.4 x 10(8) viable bacteria per ml. Two levels of dietary protein (28 or 22%) were fed from 1 day to 3 weeks of age. Following E. coli inoculation of 3.4 x 10(5) viable bacteria at day one, body weight gain and feed consumption from 0 to 3 weeks of age were numerically increased 4.5 and 2.1%, respectively, and feed efficiency was significantly increased 2.4%. E. coli had a greater effect on performance of poults fed the 28% protein diet than on poults fed the 22% protein diet. Metabolism studies, conducted from 7 to 10 and from 17 to 20 days postinoculation, showed no significant changes in the measurements of nutrient utilization due to E. coli other than a 17% increase in nitrogen retention from 17 to 20 days by those poults fed the 28% protein diet. PMID- 3289532 TI - Diagnosis of chlamydial infection in pet birds: comparison of cloacal-swab culture and peroxidase-antiperoxidase methods. AB - Cloacal swabs were examined using a peroxidase-antiperoxidase (PAP) method that employs a monoclonal antibody to chlamydiae. The specificity and sensitivity of cloacal-swab PAP examination and the prevalence of chlamydiosis were calculated using both culture and tissue PAP evaluation as standards. The prevalence of chlamydial infections was 9.3% as determined by culture and 46.3% as judged by tissue PAP evaluation. Cloacal-swab PAP examination yielded a sensitivity of 71.4% and specificity of 85.5% when compared with culture results and a sensitivity of 81% and specificity of 85.7% compared with tissue PAP results. Culture had a sensitivity of 47.4% and specificity of 100% compared with tissue PAP results. Similarly, the efficiency of cloacal-swab PAP test was about 84% compared with culture results and tissue PAP. The efficiency of culture compared with tissue PAP was 73.1%. PMID- 3289533 TI - Species-related differences in the incidence of gram-negative bacteria isolated from the cloaca of clinically normal psittacine birds. AB - Cloacal swabs from 506 clinically normal psittacine birds of 22 species were aerobically cultured for bacteria and yeasts. In 45 (9%) samples, no microbial organisms were recovered. Gram-positive bacteria were recovered from 474 (91%) samples. The incidences of gram-negative bacteria and yeasts were: Escherichia coli 157 (31%), Enterobacter sp. 21 (4%), Klebsiella sp. 3 (0.6%), Pseudomonas sp. 4 (0.8%), and yeasts 26 (5%). Differences were noted in the recovery rate of E. coli among the various species of birds cultured. Escherichia coli was recovered from 101 of 168 cockatoos (60%) of the genus Cacatua but from only 18% of 338 non-Cacatua species. As all birds were housed in the same facility under similar conditions, this difference in the incidence rate of E. coli cannot be explained on the basis of differences in husbandry or diet alone. PMID- 3289534 TI - Assembly of M13 and M13am8H1R1 procoat protein into microsomes is stimulated by rabbit reticulocyte lysate and ATP. AB - Processing of M13 procoat protein to transmembrane coat protein by dog pancreas microsomes is stimulated by a component of rabbit reticulocyte lysate and ATP. We asked whether this ATP-dependent reaction, involved in membrane assembly of procoat protein in the eukaryotic system, is related to the membrane potential dependent reaction observed for the membrane assembly of procoat protein in E. coli. Specifically, we asked if a mutant procoat protein which had been previously shown to be independent of the membrane potential with respect to its assembly in E. coli (M13am8H1R1 procoat protein) shows a stimulation by reticulocyte lysate and ATP in its assembly into microsomes. Since the mutant procoat protein behaved exactly as the wild type procoat protein in the eukaryotic in vitro system, we propose that the ATP-dependent reaction observed for the eukaryotic system does not substitute for the membrane potential dependent reaction in the prokaryotic system. PMID- 3289536 TI - Detection of a lag phase in gonadotropin-releasing hormone stimulated synthesis of lutropin peptide chains in cultured rat anterior pituitary cells. AB - We have studied the time course (0-5h) of the stimulatory effect of the hypothalamic gonadotropin-releasing hormone (GnRH) on the biosynthesis of lutropin (LH) polypeptide chains, as measured by the incorporation of [35S] methionine into proteins synthesized in cultured rat anterior pituitary cells in the absence or presence of 10nM GnRH. Labeled polypeptides, immunologically related to LH subunits alpha and beta, were isolated by specific immunoprecipitation, analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, then revealed by fluorography and quantified by counting the excised bands. This methodology allowed us to detect the radioactivity incorporated into LH subunits after less than 15 min of incubation. During first 1h of the time-course the quantity of [35S]Met incorporated into both alpha and LH beta subunits was not increased by the presence of GnRH in the incubation medium. A significant increase in the incorporation of radioactivity into LH subunits was observed after 2h of GnRH treatment. However, the increase in LH release into the medium in response to GnRH, as measured by RIA, was immediate. These data demonstrate that GnRH-stimulated synthesis of LH polypeptide chains occurs after a lag of approximately 1h and involves mechanisms different from those governing the stimulation of LH release. PMID- 3289535 TI - Insulin resistance by unprocessed insulin proreceptors point mutation at the cleavage site. AB - Failure to cleave the interconnecting site between alpha- and beta-subunit produced insulin proreceptors in the plasma membranes which had markedly low affinity to insulin, leading to extreme insulin resistance in a patient. We performed cDNA sequence analysis of the cleavage site of the insulin proreceptor from the patient. Polymerase chain reaction was used to obtain large amount of cDNA coding for the region including the interconnecting site. A thermostable DNA polymerase, Taq polymerase, successfully produced enough amount of cDNA of the region to be sequenced. The results showed AGG (Arg) to AGT (Ser) point mutation, resulting in the change of interconnecting sequence of the two subunits from -Arg Lys-Arg-Arg- to -Arg-Lys-Arg-Ser-. These results suggest that the tertial structure change of the cleavage site leads to production of unprocessed insulin proreceptors. PMID- 3289537 TI - Thrombospondin is present in articular cartilage and is synthesized by articular chondrocytes. AB - Thrombospondin, a multifunctional adhesive glycoprotein originally identified in platelets, was isolated and identified from an extract of ovine articular cartilage. Immunoreactive material from a cartilage extract comigrated on gel electrophoresis with purified human platelet thrombospondin. When articular chondrocytes were cultured in the presence of 35S-methionine, metabolically labeled thrombospondin was immunoprecipitated from the culture medium and cell layer extract. These results demonstrate that thrombospondin is present in articular cartilage and is synthesized by articular chondrocytes. PMID- 3289538 TI - Mutant isolation and cloning of the gene encoding protease VII from Escherichia coli. AB - A mutant of Escherichia coli lacking protease VII, the outer membrane-associated protease which specifically cleaves paired basic residues (1), was isolated by using N-methyl-N'-nitro-N-nitrosoguanidine treatment. The mutant exhibited no significant change as for its growth rate and microscopic feature compared with wild cells. The gene encoding protease VII was cloned by using complementation analysis of protease VII (-) mutation. The minicell experiment showed that the gene encoded a putative precursor protein of 38,000 Mr which was processed into a protein of 36,000 Mr suggesting the presence of a signal peptide on the putative precursor. PMID- 3289539 TI - L-leucine and its analogue: specific inhibitors for S-benzyl-L-cysteine-p nitroanilide-hydrolyzing enzyme in Escherichia coli B. AB - An enzyme that catalyzes hydrolysis of S-benzyl-L-cysteine-p-nitroanilide was purified from E. coli B. The enzyme was a monomer with a molecular weight of 82,000. In addition to L-cysteinylglycine, the enzyme hydrolyzed various glycine containing dipeptides most efficiently at pH 7.0. The enzyme required no metal ions for activity and was specifically inhibited by L-leucine and its analogue with free carboxyl group at the physiological concentrations. PMID- 3289540 TI - In vivo phosphorylation of isocitrate lyase from Escherichia coli D5H3G7. AB - This report describes the in vivo phosphorylation of isocitrate lyase and examines the possible consequences to the control of the Kreb's cycle and glyoxylate bypass. NADP-specific isocitrate dehydrogenase from E. coli was the first bacterial protein whose enzymic activity was shown to be modulated by reversible phosphorylation. This enzyme has been thought to be solely responsible for the partitioning of isocitrate between the Kreb's cycle and glyoxylate bypass. No studies to date have examined the possible role of isocitrate lyase in controlling this flux. PMID- 3289541 TI - Specific inhibition of aspartase by S-2,3-dicarboxyaziridine. AB - Aspartase of Escherichia coli was inhibited in a competitive manner by S-2,3 dicarboxyazirdine (DCAZ), an antibacterial substance against Aeromonas salmonesida. The inhibition constant (Ki) was 55 microM, which was as low as less than one tenth that of the Km value for the substrate, L-aspartate. In view of the fact that both aspartase and fumarase (J. Greenhut et al. (1985) J. Biol. Chem. 260, 6684-6686) were inhibited by DCAZ in competitive manners, common features of the reaction mechanism of the two enzymes were discussed. PMID- 3289542 TI - Partial characterization of a nuclear proteolytic activity from fertilized sea urchin eggs. AB - The nuclei from fertilized sea urchin eggs, obtained 80 min after fertilization, contains a neutral proteolytic activity. Optimal action on casein was observed at pH 7-8 and a Km value of 1.2 mg/ml was determined for this substrate. The proteolytic activity was stimulated 1.5 fold by the addition of 3 M urea and decreased at higher urea concentrations. NaCl and CaCl2 were inhibitory whereas MgCl2 increased the enzyme activity. Isolated histones from sea urchin sperms, and especially histones H1, H2A, H2B and H3, were degraded by the nuclear activity. A partial inhibition of histones degradation was caused by sodium bisulfite and NaCl. The proteolytic activity was found associated to the chromatin of fertilized sea urchin eggs. PMID- 3289543 TI - [Physico-chemical and immunochemical characteristics of oncoprecipitins of crustacin and cyprein specifically reacting with carcinoembryonic antigen]. AB - Crustacin from Pagurus prideauxii and cyprein from Cyprea caputserpentis have been shown to be glycoproteins with molecular masses 36 +/- 1 and 44 +/- 1.4 kDa, containing 3 and 18% of carbohydrates, respectively. Their amino acid and monosaccharide composition have been determined. Crustacin or cyprein interact with CEA more specifically than carbohydrate-containing polymers with lectins. Carbohydrates unspecifically inhibit this interaction at rather high concentrations. Association constants of CEA-crustacin and CEA-cyprein complexes are 0.6.10(8) M-1, respectively. Besides, ELISA showed that antibodies against CEA bind antibodies to crustacin and cyprein. PMID- 3289544 TI - [Synthesis and antiaggregation activity of prostacyclin analogs. 1. Bicyclo [3.2.0] heptane analogs]. AB - Bicyclo[3.2.0]heptane analogues of prostacyclin were synthesized starting from 2,3-epoxy-bicyclo[3.2.0]heptane-6-one ethylene ketale by means of alkynydlithium BF3-reagents and Wittig reaction. The regioselectivity of the oxirane ring opening reaction is 3:2 and stereoselectivity of Wittig olefinization is 1:1. The synthesised compounds were identified by 13C NMR spectra. The antiaggregative activity of the prostacyclin analogues on rabbit blood platelets was 10(-3)-10( 4) of the activity of PGE1, the isomers with (E)-double bond in alpha-chain being by an order more active that the (Z)-isomers. Elongation of the alpha- and omega side chain by one carbon atom gives 2-4 fold increase of the activity. Bicyclo[3.2.0]heptane analogues of prostacyclin represent-simple and readily obtainable models for elucidation of structure-activity relationship among prostacyclin analogues. PMID- 3289545 TI - [Affinity modification of Escherichia coli ribosomes with 2',3'-O-[4-(N-2 chloroethyl)-N-methylamino]-benzylidene derivative of AUGU3 in the 70S initiation complexes]. AB - Affinity labelling of the Escherichia coli ribosomes with the 2',3'-O-[4-(N-(2 chloroethyl)-N-methylamino]benzylidene derivative of AUGU3(AUGU3[14C]CHRCl) has been studied within 70S initiation complexes ribosome.AUGU3[14C]CHRCl.fMet tRNA(Metf) and binary complex ribosome.AUGU3[14C]CHRCl. Various ways of the 70S initiation complex formation resulted in differently labelled products. Proteins S5, S7, S9, L1, L16 were thus identified as cross-linked with AUGU3[14C]CHRCl within an initiation complex obtained in the presence of initiation factors IF-1, IF-2, IF-3, whereas only proteins S5 and S7 were cross-linked within the complex obtained with the sole factor IF-2. Proteins S1, S3, L1 and L33 were labelled within the initiation complex obtained nonenzymatically but only protein S1 within the binary complex. In all complexes formed with use of initiation factors labelling of IF-2 factor was invariably observed. PMID- 3289546 TI - [Immune electron microscope localization of RNA-polymerase on the Escherichia coli chromosome using monoclonal antibodies against the beta-subunit]. AB - Possibility of the immunoelectron microscopic visualization of RNA polymerase on the Escherichia coli chromosome with monoclonal antibodies against the beta subunit labelled by [protein A.gold] complex was demonstrated. Using this method RNA polymerase molecules were revealed within nucleoid as well as on the membrane free chromosome. PMID- 3289547 TI - [Cloning, expression and structure of the functionally active shortened lon gene in Escherichia coli]. AB - Lon gene of E. coli has been cloned into the plasmid pBR327. Full nucleotide sequence of the gene has been established. It was shown that the cloned gene does not possess the terminal codon and is somewhat shortened. Nevertheless it retains full phenotypic activity and expresses the C-end modified La proteinase which retains ATP-dependent proteolytic activity. PMID- 3289548 TI - Use of T cell cloning to detect in vivo mutations induced by cyclophosphamide. AB - By cloning T cells, mutations at the hypoxanthine-guanine phosphoribosyltransferase locus were quantified in peripheral blood lymphocytes of 12 patients with connective tissue diseases receiving long-term cyclophosphamide. Frequency of mutation was higher than in control subjects and was related to the duration of therapy; therefore, some cells with mutations are long-lived, and these cells accumulate in the peripheral circulation. Mutation frequency was also independently related to age. The results indicate that even low doses of cyclophosphamide are mutagenic and may explain, in part, why these patients are at risk of drug-induced malignancy. PMID- 3289549 TI - Costochondral involvement in systemic candidiasis in heroin addicts: clinical, scintigraphic, and histologic features in 26 patients. AB - We studied the clinical, scintigraphic, and histopathologic characteristics of 26 intravenous drug abusers with costochondral involvement secondary to systemic infection with Candida albicans. The clinical findings were of a mass appearing in the anterior region of the thorax. In general, signs of inflammation were absent. Histopathologic study of this costochondral mass in 12 patients showed perichondritis in 100% and myositis in 87%, with secondary involvement of cartilage in 43% and of bone in 75%. Results of bone scintigrams using 99mTc methylene diphosphonate were positive in only 7 of 15 patients (47%), with a correlation between positive uptake and osteitis. Gallium scintigraphy findings were positive in 9 of 10 patients (90%). The greater sensitivity of 67Ga was probably because the invariably present pericartilaginous inflammatory mass was not always accompanied by secondary cartilage and bone involvement. PMID- 3289551 TI - Purification of proteins produced by biotechnological process. AB - Proteins maintain functions important to life. Faulty functioning or deficiency gives rise to pathological reactions. These proteins can now be produced, using the methods of recombinant DNA technology and administered to patients for replacement therapy. Many proteins as active ingredients are already available for use as immunomodulators, agents for tumour treatment, plasma proteins and hormones. They are in various stages of development, ranging from cloning of the producing cells to marketing of the finished products. Since the active substances are proteins synthesized by recombinant cells, their purification presents a particular challenge to protein chemists. Purification of recombinant DNA-derived proteins intended for human use is an essential part of the biotechnical process. It starts immediately after the fermentation of the host cell. The characteristics of the protein determine which microorganisms or cell cultures are used and this in turn defines the first purification step. The microorganisms are disrupted, and the insoluble protein, desposited in "inclusion bodies" has to be renatured, or the proteins secreted by cells and have to be concentrated. The subsequent strategy for purification of the protein does not depend on the fermentation process but is entirely determined by the physiochemical properties of the proteins. The goal of the first purification step is to isolate as fast and quantitatively as possible the recombinant protein from the culture filtrate, in order to minimize potential changes brought about by proteases or glycosidases. Immunoaffinity or ligand-affinity chromatography is used preferentially for this purpose. The concentration of protein and buffer changes are carried out by precipitation followed by reconstitution or, preferably, by dialysis and ultrafiltration/diafiltration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289550 TI - Comparison of the short-acting benzodiazepines midazolam and triazolam with placebo. AB - The hypnotic effect of midazolam (Dormicum, 15 mg) and triazolam (0.5 mg) were compared with each other and with a placebo. Their effects on the quality of dreams and of morning awaking were also evaluated. 30 out-patients were included in a double-blind cross-over study for a period of 11 consecutive nights in which the order of the drugs was randomized according to the Latin squares method. The active substances and the placebo were each administered in 3-night blocks separated from each other by an intercalary placebo night. On waking each morning the patients answered a questionnaire concerning the previous night. Some of the responses were recorded on a visual analogue scale. Midazolam and triazolam significantly decreased the latency of onset of sleep and the number of nocturnal and premature morning awakenings. The patients' overall impression of their night was better under the active drugs than under placebo. However, there were no differences between placebo and the benzodiazepines as far as side effects or the quality of dreams and of morning awakening were concerned. The two drugs had an identical effect on sleep latency, but under midazolam the patients woke more frequently during the night and slightly earlier in the morning, suggesting that the duration of action is shorter. The intercalary placebo nights were better after 3 nights of placebo than after 3 nights of benzodiazepine. This rebound effect was more marked after triazolam than after midazolam. In conclusion the two benzodiazepines were both effective and well tolerated but midazolam is slightly shorter acting and has slightly less rebound effect than triazolam. PMID- 3289552 TI - Educational resources on AIDS. PMID- 3289553 TI - Sonographic diagnosis of agenesis of the corpus callosum in the fetus and newborn infant. AB - The sonographic findings in nine cases of agenesis of the corpus callosum examined before and after birth are reported. Agenesis of the corpus callosum was suspected in utero due to a typical configuration of the lateral ventricles, which included enlargement of the atria and occipital horns and marked separation of the bodies. In three cases pregnancy was terminated because of severe associated anomalies. In the remaining six cases postnatal ultrasound examination allowed a certain diagnosis by demonstrating the abnormal configuration of the lateral ventricles, varying degrees of enlargement, and upward displacement of the third ventricle and absence of the corpus callosum. PMID- 3289554 TI - Sonographic findings in a case of cloverleaf skull deformity and prune belly. AB - A rare case of cloverleaf skull is reported that was not diagnosed in utero. The case is more unusual because it was not associated with hydrocephalus and was associated with prune belly. PMID- 3289555 TI - Antepartum fetal heart rate characteristics in cases of premature rupture of membranes. AB - The present retrospective study investigates the effect of premature rupture of membranes on fetal neurocardiac maturation as reflected by the fetal heart rate (FHR) pattern. The FHR tracings of 41 cases involving premature rupture of membranes of at least 48 hours' duration at 24 to 37 weeks' of gestation were studied. Fifty-two cases of normal pregnancy who were matched for gestational age served as controls. The results demonstrate similar baseline FHR and variability in the study and control group. The incidence of FHR accelerations of 15 beats/min was significantly greater in cases of premature rupture of membranes, and their onset was detected at an earlier gestational age. In addition, the mean amplitude of FHR accelerations was significantly greater in the study group compared with the control group. As a result, patients with premature rupture of membranes have a reactive nonstress test at an earlier gestational age than do control patients. These findings support the concept that premature rupture of membranes causes accelerated neurocardiac fetal maturation, as reflected by FHR pattern, possibly by inducing a stressful intrauterine environment. PMID- 3289556 TI - Percutaneous fetal umbilical blood sampling: procedure safety and normal fetal hematologic indices. AB - Percutaneous umbilical blood sampling allows direct access to the fetal circulation. We describe our experience with the procedure in the first 100 patients whose fetuses were at risk for hemolytic anemia, chromosomal abnormalities, coagulopathy, or intrauterine infection. Hematologic indices, including hemoglobin, hematocrit, red blood cell count, white blood cell count, and platelet count, were analyzed from 50 of the fetuses who were normal at delivery. Normal values and gestational age regression curves (from 17 to 37 weeks' gestation) are presented. The technique and complications of the procedure are described. Percutaneous umbilical blood sampling affords useful information in prenatal diagnosis and entails a low rate of complications. PMID- 3289558 TI - Routine preoperative ultrasonography and cesarean section. AB - This prospective investigation was undertaken to determine whether routine ultrasound visualization of the gravid uterus shortly before cesarean section would provide useful information in determining the site for uterine incision. Complete data were gathered on 124 pregnancies using a portable real-time ultrasound machine. Determination of the placenta and umbilical cord locations, fetal presentation, and amniotic fluid volume were reliable. Compared with a matched group without ultrasonic visualization, the eventual site for uterine incision and morbidity to the mother and fetus were not significantly different. Although routine visualization of the intrauterine contents before surgery is not necessary, worthwhile information may be gained in select cases to confirm a previously suspected noncephalically presenting fetus or a low anterior placenta. PMID- 3289557 TI - Course and predictive value of fetal heart rate parameters. AB - The present study concerns the developmental character of the fetal heart rate (FHR) pattern and the implications of predicting the perinatal outcome. Data from 443 patients undergoing 2193 nonstress tests were analyzed retrospectively. We found a significant increase of accelerations more than 15 beats/min, of accelerations associated with fetal movements, of fetal movements registered by the tocotransducer, the frequency of oscillations, and of the Fischer score values throughout gestation. The number of short FHR decreases and the mean baseline level declined throughout gestation. A long duration of absent or reduced baseline variability registered even 6 weeks before delivery was associated with low Apgar score values. Late decelerations and contractions registered early in pregnancy were also correlated to a poor outcome. Tachycardia and a low number of accelerations were only correlated to a poor perinatal outcome shortly before the delivery. Fetal movements not associated with FHR accelerations were an early indicator of a poor neonatal outcome. Scoring systems did not generally improve the predictive value of FHR patterns. PMID- 3289559 TI - [Location, structure and mechanism of action of peripheral arterial chemoreceptors]. PMID- 3289560 TI - [Free radicals and their significance for intensive care]. PMID- 3289561 TI - Red nucleus: past and future. AB - The red nucleus has greatly interested scientists for almost a century. This can be explained by the fact that problems of general interest are encountered when studying this nucleus. Some of them are outlined in this paper, such as the phylogenetic evolution of the rubrospinal tract, the respective roles of the rubrospinal and pyramidal tracts in the execution of various types of movements, and the respective roles of these two tracts in movement automatization. PMID- 3289562 TI - Evolution of the red nucleus and rubrospinal tract. AB - A red nucleus, defined by its relative position in the tegmentum mesencephali, its contralateral rubrospinal or rubrobulbar projections and by crossed cerebellar afferents, is found in terrestrial vertebrates and certain rays. A crossed rubrospinal tract occurs in anurans, limbed urodeles and reptiles, birds and mammals, but is apparently absent in boid snakes, caecilians and sharks. A distinct rubrospinal tract is found in certain rays which use their enlarged pectoral fins for locomotion. A crossed tegmentospinal tract, possibly a rubrospinal tract, is found in lungfishes. Although evidence was presented for a rubrospinal tract in more advanced snakes, the available experimental data in lower vertebrates suggest that the presence of a rubrospinal tract is related to the presence of limbs or limb-like structures. In the connectivity of the red nucleus in terrestrial vertebrates, 'levels' of complexity can be distinguished, paralleled by the development of the cerebellum. These 'grades of organization' are probably related to the type of motor performance the particular terrestrial vertebrates are capable of. PMID- 3289563 TI - Target cells of rubrospinal tract fibres within the lumbar spinal cord. AB - This short review concerns the problem of how the red nucleus contributes to the initiation and execution of movements. However, it deals with only one aspect of this problem, and focuses on the question of which intrinsic spinal interneuronal networks are used by neurones in the red nucleus to induce movements. The evidence is reviewed that neurones in the red nucleus have access to interneurones with a great variety of functions, excitatory as well as inhibitory. These interneurones are interposed in a number of different spinal reflex pathways, and include both the first and last order interneurones of these pathways. Through them different sets of motoneurones may be affected. All types of interneurones involved are also used by other descending systems, e.g. by cortico- and/or reticulospinal systems, and integrate descending commands with information from various peripheral receptors. PMID- 3289564 TI - Characteristics and applications of adsorbents for pyrogen removal. AB - Characteristics and applications of immobilized histidine and immobilized histamine for pyrogen removal were investigated. Immobilized histidine showed a high affinity for pyrogen at low ionic strength and over a wide pH range. The adsorption capacity was 0.53 mg of lipopolysaccharide per milliliter of the adsorbent. The apparent dissociation constant was 1.57 X 10(-9) M. The adsorption of pyrogen to immobilized histidine decreased with increasing ionic strength, but pyrogen could be adsorbed even at ionic strengths of gamma/2 = 0.05-0.1, at which other substances were little adsorbed; that is, specific adsorption of pyrogen was observed. The adsorption of pyrogen could be increased at ionic strengths of gamma/2 = 0.05-0.1 by using a lower flow rate or a longer column length. Immobilized histidine and immobilized histamine could be used for the removal of natural pyrogens contaminating various useful low-molecular-weight compounds as well as high-molecular-weight compounds such as proteins. PMID- 3289565 TI - Multistep reactions with immobilized microorganisms. AB - This review presents some examples of new semicontinuous and continuous processes for product formation and for degradation of xenobiotics with immobilized microorganisms. A semicontinuous process for glycerol formation with Saccharomyces cerevisiae cells, adsorbed on sintered glass, and a continuous production of citric acid with Aspergillus niger, entrapped in calcium alginate, are given as examples of the production of primary metabolites. The production of ergot alkaloids with entrapped Claviceps purpurea demonstrates the possibilities of production of secondary metabolites. The continuous degradation of phenolic substances and that of 4-chlorophenol by entrapped and adsorbed microorganisms are given as examples of the possibility of a continuous degradation of xenobiotics by immobilized microorganisms. The continuous degradation of these substances was successful not only in artificial solutions but also in sterile and nonsterile wastewater. PMID- 3289566 TI - Before and after. PMID- 3289567 TI - Normal, autoimmune, and malignant CD5+ B cells: the Ly-1 B lineage? PMID- 3289568 TI - Melanoma antigens: immunological and biological characterization and clinical significance. PMID- 3289569 TI - The developmental biology of T lymphocytes. PMID- 3289570 TI - Role of the major histocompatibility complex class I antigens in tumor growth and metastasis. PMID- 3289571 TI - The immunoglobulin superfamily--domains for cell surface recognition. PMID- 3289572 TI - Lymphotoxin. AB - LT was one of the first lymphokines to be described and has been one of the most difficult to fit into a conceptual framework. Now, 20 years after its discovery, its structure, genetic organization, and linkage are well understood in mouse and human, and insight has been gained into its biological role. It is a T cell derived glycoprotein of 25 kd coded by a gene within the MHC. It is somewhat (35%) structurally homologous to the macrophage product TNF. The genes for LT and TNF are tightly linked, and the proteins share most biological activities and compete for the same cell surface receptor. LT is induced in an antigen-specific MHC restricted fashion from class I and class II restricted T cells. Viral infection is also associated with LT production by lymphoid cells. LT has several effects on target cells including killing, growth stimulation, and induction of differentiation. The mechanism of LT's effects involves receptor binding and internalization and several sequelae including changes in prostaglandins and chromosome integrity. LT probably plays several biological roles. It can contribute to immunoregulation, defense against viruses, parasitic infections, and rejection of tumors. Understanding LT's role in the pathogenesis of diseases of autoimmunity and immune dysregulation will be the key to devising effective regimens for prophylaxis and treatment. PMID- 3289573 TI - Unique tumor-specific antigens. PMID- 3289574 TI - Molecular regulation of B lymphocyte response. PMID- 3289575 TI - Kinin formation: mechanisms and role in inflammatory disorders. AB - Although considerable progress has been made in elucidating the molecular events occurring during kinin generation by both the plasma kinin-forming system and the tissue kallikrein system, it is only in recent years that we have come to appreciate their potential role in inflammation in a wide variety of diseases. The importance of the tissue kallikrein system depends upon secretion of the active form of the requisite enzyme in the presence of a source of kininogen. Since tissue kallikreins are widely distributed in tissues, and since lymph and interstitial fluid contains kininogen (271), a local milieu for potential kinin formation is always present. The plasma system will be activated secondary to inflammation initiated by some other process. There may be endothelial or epithelial damage exposing connective tissue. Plasma leakage caused by release of some other permeability factor (including kinin made by tissue kallikrein) would thus lead to activation of the plasma cascade in many forms of inflammation. As with all mediators, however, the contribution of kinins to an inflammatory response can only be definitively evaluated if their actions can be selectively antagonized. Competitive receptor antagonists have recently been synthesized (228) and will, we hope, soon be available for administration to humans. Should these compounds prove effective in vivo, they could be used in conjunction with currently available assays for kallikreins, kininogens, kinins, and their various inactivated or degraded products, to provide new insights into the role of these systems in the pathogeneses of inflammatory diseases. PMID- 3289576 TI - IgE-binding factors and regulation of the IgE antibody response. AB - In rodents, IgE-bF are derived from a subset of T cells that bear Fc epsilon R or Fc gamma R, or both, and selectively enhance or suppress the IgE response. IgE-PF and IgE-SF may share a common structural gene, therefore a common polypeptide chain, and their biologic activities are decided by post-translational glycosylation process. Under physiological conditions, this process is controlled by two lymphokines, i.e. GEF and GIF. The same principle probably applies to human T cell-derived IgE-bF. In both rodent and human lymphocytes, Fc epsilon RII on B cells are degraded, and their fragments are released from the cells. The fragments of Fc epsilon RII on human B cells represent the carboxy terminal half of the receptor molecules and have affinity for IgE. In contrast, the fragment of Fc epsilon R in mouse B cells does not have an affinity for IgE. Thus, "IgE-bF" are derived from both T cells and B cells in humans, but only from T cells in rodents. The formation of T cell-derived IgE-bF was induced by interferons, while biosynthesis of Fc epsilon R in B cells and the formation of their fragments were enhanced by IL-4. IgE-bF are also formed by a subset of antigen-primed T cells upon cognate interaction with antigen-pulsed syngeneic macrophages. These antigen primed T cells constitutively secrete either GEF or GIF, having no affinity for homologous antigen. Upon antigenic stimulation, however, GEF and GIF formed by the cells had affinity for the antigen. The antigen-specific GEF enhanced the antibody response, and antigen-specific GIF suppressed the antibody response, both in carrier specific manner. The possible relationship between antigen specific GEF and antigen-specific TaF, and that between antigen-specific GIF and antigen-specific TsF both require further studies. Nonspecific GIF not only switches T cells from the formation of IgE-PF to the formation of IgE-SF, it also facilitates the generation of antigen-specific suppressor T cells which produce antigen-specific GIF upon antigenic stimulation. Propagation of antigen-primed T cells in the presence of GIF also facilitate the generation of antigen-specific suppressor T cells in vitro. If the same procedures would be effective for human T cells of allergic patients, it would be possible to generate antigen-specific suppressor T cells from their T cell population in vitro and to establish T cell hybridomas that produce allergen-specific GIF(TsF).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3289577 TI - Nonprecipitating asymmetric antibodies. PMID- 3289578 TI - Prospects for gene therapy for immunodeficiency diseases. PMID- 3289579 TI - C1 inhibitor and hereditary angioneurotic edema. PMID- 3289580 TI - The T cell receptor/CD3 complex: a dynamic protein ensemble. PMID- 3289581 TI - Repair of nasal septal perforation utilizing the midface degloving technique. AB - A technique utilizing the midfacial degloving approach in the repair of nasal septal perforations in 24 patients is reported. The midface degloving approach was limited to patients with septal perforations greater than 3 cm and failed prior attempts at surgical closure. Bilateral posteriorly based unipedicled flaps were utilized in the septal closure. Complete closure was accomplished in 75% (18/24) of cases, with a follow-up of one to three years. Complications included reperforation in 25% (6/24) of cases and partial vestibular stenosis in 20% (5/24) of cases. A modification of our technique, relining the nasal floor with postauricular full-thickness skin grafts, has alleviated vestibular stenosis. PMID- 3289582 TI - Postrhinoplasty epistaxis. Role of vitamin E? AB - Postrhinoplasty epistaxis occurred in two patients, both of whom were found to be ingesting megadoses of vitamin E. The rate of vitamin E consumption in a population of 100 uncomplicated nasal operations during this same period was 16%. A review of the medical literature on vitamin E found recent evidence demonstrating a marked decrease in platelet adhesiveness with megadose ingestion of vitamin E. It is concluded that this should be avoided in the perioperative period. PMID- 3289583 TI - A randomized clinical trial of topical gentamicin after tympanostomy tube placement. AB - Purulent otorrhea is the most common complication of tympanostomy with tube placement. Some authors report an incidence of over 30%. We have evaluated topical gentamicin solution for prophylaxis in a controlled, randomized, prospective clinical trial. Nine patients of the 102 in the study developed otorrhea in the first two postoperative weeks. All nine were in the control group of 46. The 56 patients receiving prophylactic gentamicin had no cases of purulent otorrhea. Several other characteristics of the patients and the procedures were examined as possible risk factors for otorrhea. None were statistically significant, but the younger patients had a higher rate of infection. We recognize the theoretical risk of ototoxicity, but conclude that instillation of topical gentamicin is an effective prophylactic technique for preventing purulent otorrhea after tympanostomy. PMID- 3289584 TI - Pathologic quiz case 1. Intense foreign body with abnormal polarizable material in the soft tissue. PMID- 3289587 TI - Contribution of new cryomethods to a better knowledge of bacterial anatomy. AB - Electron microscopy has largely contributed to the study of bacterial anatomy. However, as varied alterations can occur during cell preparation, at the level of cell structure and at the molecular level, it is difficult to know to what extent electron micrographs correspond to the true appearance of the living state. The recent development of cryomethods which avoid some of the alterations which may occur during conventional fixation and embedding procedures, has shed new light on bacterial anatomy. These have definitively proved that mesosomes do not exist, but are artefactual structures induced by the fixative. New features of the bacterial "nucleus" relating to its shape and fine structure appeared in thin sections of Gram-positive and Gram-negative bacteria prepared by cryosubstitution. New information has also been obtained on the cell wall structure of different bacterial species. PMID- 3289585 TI - Identification of a developmentally modulated, intermediate filament associated protein in the chick embryo. AB - We report here the detection of a high molecular weight (greater than 400,000) cytoskeletal protein in the myogenic and neural tube derived structures of the chick embryo using a monoclonal antibody, F51H2. Immunohistological analysis reveals that this protein is concentrated in the myotome part of the somites, in the heart primordium, and in the neural tube at the end of the 2nd day of incubation. In cultured fibroblasts, the antibody appeared to decorate a filamentous network, although immunoreactivity was not detected on mesenchymal cells in situ. This network was also observed in cultured myoblasts where it has been demonstrated to be coincident to that of desmin. In colchicine-treated cells the immunoreactivity coincided with the perinuclear cap formed by the collapse of intermediate filaments (IFs). Immunoblot experiments confirmed the early distribution of F51H2 antigen in muscle and nerve tissues and its concentration in a salt-resistant IF-rich fraction of muscle tissues. In addition, there is a progressive loss of immunoreactivity during development. The immunoreactive band on sodium dodecyl sulfate gels was faint in tissues from newly hatched chickens and absent in adult tissues. It is suggested that the monoclonal antibody observed herein reacts with an embryo specific high molecular weight protein that is associated with IFs. PMID- 3289589 TI - Of birds and B1: the story of beriberi. PMID- 3289588 TI - The centenary of the "Annales de l'Institut Pasteur". PMID- 3289586 TI - High-cell density fermentation studies of recombinant Escherichia coli strains expressing human interleukin-1 beta. AB - A high-productivity process has been developed for the production of mature human interleukin-1 beta (IL-1 beta) from recombinant Escherichia coli strains. Conditions were found that allow high IL-1 beta expression levels in high cell density cultures. Improved fed-batch fermentation strategies are described which include maintenance of glucose and acetate concentrations below 1 g/l and sparging the fermentor with an O2-enriched air supply. Using the E. coli tryptophan promoter control of transcription, a 2.2 g/l production level of IL-1 beta was achieved in E. coli B at cell densities of 55 g dry weight per litre. Another genetic construction involving the bacteriophage lambda cIts-PR expression cassette allowed a similar IL-1 beta production level (1.9 g/l) in E. coli E103S, albeit at a lower cell density (30 g/l). A simplified procedure allowing the purification of fully active IL-1 beta is also presented. PMID- 3289591 TI - The plague pandemics and the discovery of the plague bacillus. PMID- 3289590 TI - Family planning as a priority for maternal and child health. PMID- 3289592 TI - Redundant dentist. PMID- 3289593 TI - Dental amalgam. PMID- 3289594 TI - Tobacco smoking and oral health. PMID- 3289595 TI - 'The pawn in the gambit'. PMID- 3289596 TI - 'The effect on microleakage of interchanging denture adhesives in two composite resin systems in vitro'. PMID- 3289597 TI - Glass-ionomer cements. PMID- 3289598 TI - Atenolol-nifedipine combinations compared to atenolol alone in hypertension: efficacy and tolerability. AB - 1. In a double-blind, randomised, three-way-crossover study, 25 patients with sitting diastolic blood pressure between 95 and 120 mm Hg (Phase V) after 4 weeks' run-in on atenolol 50 mg twice daily, received atenolol 50 mg twice daily alone, atenolol 50 mg plus nifedipine 20 mg each twice daily and atenolol 50 mg plus nifedipine 40 mg each twice daily in three treatment periods each lasting 4 weeks. 'Washout' periods were not included. 2. The two combination treatment regimes lowered the 12 h post-dose blood pressure more effectively than did atenolol alone, but the high dose nifedipine combination was no more effective than the low dose nifedipine combination. Sitting systolic BP (+/- s.e. mean) at the end of each period was 174 +/- 5 mm Hg after the atenolol run-in, 170 +/- 5 mm Hg with atenolol alone, 156 +/- 5 mm Hg with the low dose combination and 158 +/- 4 mm Hg with the high dose combination. Corresponding diastolic BP readings were 106 +/- 2 mm Hg, 106 +/- 2 mm Hg, 97 +/- 2 mm Hg and 99 +/- 2 mm Hg respectively. 3. Side-effects tended to occur less commonly with the low dose of the fixed combination than with atenolol alone. An increased number of side effects occurred with the 40 mg twice daily doses of nifedipine, particularly flushing/erythema, oedema of the ankles/feet, and a hot feeling in the legs. These differences did not reach significance. 4. Overall compliance was good (98 +/- 0.7 s.e. mean %) and was similar within the different treatment regimes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289599 TI - Effectiveness and tolerability of CV-3988, a selective PAF antagonist, after intravenous administration to man. AB - 1. The efficacy and tolerability of CV-3988, a selective PAF antagonist with structural analogies with PAF, were studied after intravenous infusion in man. 2. The compound, in doses from 750 to 2,000 micrograms kg-1, significantly reduced platelet sensitivity for PAF. The threshold aggregating concentration (TAC) of PAF, expressed in % of the mean predosing value, increased in a dose dependent manner reaching 356 +/- 162% of the basal TAC at the end and 266 +/- 123% of the basal TAC 4 h after infusion of the highest dose. The TAC of PAF returned to the basal value within 24 h after the end of the infusion. 3. CV-3988 did not cause major side effects nor changes in blood pressure, pulse and respiratory rate. However, small but clinically insignificant changes in plasma haemoglobin and serum haptoglobin were seen at the end and 4 h after the end of the infusion, indicating a slight haemolysis. 4. Our results indicate that, when adequate infusion volumes and infusion rates are used, CV-3988 can safely be administered to man and should be useful in elucidating the role of PAF in disease. PMID- 3289602 TI - Rheological consequences of erythrocyte dehydration. PMID- 3289600 TI - The immunocytochemical localisation and distribution of cytochrome P-450 in normal human hepatic and extrahepatic tissues with a monoclonal antibody to human cytochrome P-450. AB - 1. The localisation and distribution of cytochrome P-450 in human tissues has been studied by immunocytochemistry using a monoclonal antibody to a major form of human hepatic cytochrome P-450, P-450hA7, which is closely related to cytochromes P-450 HLp and P-450NF. 2. Strong immunoreactivity was identified in hepatocytes, columnar absorptive epithelial cells of the small intestine, polymorphonuclear leucocytes and their precursors in the bone marrow, and in mast cells. 3. Weak immunoreactivity was present in the proximal tubules of the kidney, pancreatic acini, gall bladder epithelium, squamous epithelium and sebaceous glands of the skin, interstitial cells of the testis and luteal cells of the ovary. 4. Immunoreactivity could not be demonstrated in the adrenal gland, placenta, colonic epithelium and alveolar type II cells and Clara cells of the lung. PMID- 3289601 TI - Pharmacokinetics of chloroquine in Thais: plasma and red-cell concentrations following an intravenous infusion to healthy subjects and patients with Plasmodium vivax malaria. AB - 1. Chloroquine diphosphate (15 mg base kg-1) was given by constant rate intravenous infusion to two groups of Thai subjects. Eleven were patients with malaria (10 with Plasmodium vivax and one case with Plasmodium malariae) and 10 were healthy normal volunteers. 2. Plasma and packed red-cell concentrations of chloroquine, electrocardiographic intervals, arterial blood pressure and pulse were measured at frequent intervals. 3. Peak plasma concentrations at the end of the infusion ranged from 979 to 2,900 ng ml-1 in the malaria patients. In the group of healthy subjects the range was 550-2,200 ng ml-1. Values for terminal elimination rate constant, (lambda z) plasma clearance (CL), initial volume of distribution (V1) and volume of distribution at steady state (Vss) were calculated. For the healthy subjects, mean estimates of these parameters were lambda z = 0.062 +/- 0.030 day-1, CL = 597 +/- 238 ml min-1, V1 = 0.66 +/- 0.71 l kg-1 and Vss = 132 +/- 50 l.kg-1 For the group of malaria patients, the corresponding values were lambda z = 0.055 +/- 0.032 day-1, CL = 535 +/- 246 ml min-1, V1 = 0.74 +/- 0.75 l kg-1 and Vss = 136 +/- 64 l kg-1 There was no statistically significant difference in the estimates for any parameter between groups (P less than or equal to 0.05). 4. Chloroquine concentrations in packed red blood cells consistently exceeded those in plasma and showed no consistent change with time throughout the period of study in either group. The median value for the red cell to plasma ratio was between 3 and 4 in each group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289603 TI - Improvement in rejection, engraftment rate and survival without increase in graft versus-host disease by high marrow cell dose in patients transplanted for aplastic anaemia. AB - Two hundred and fifty-two consecutive patients with severe aplastic anaemia were conditioned by cyclophosphamide and given marrow transplants from HLA-identical siblings or parents. The results were analysed to examine the influence of marrow cell dose on graft rejection, speed of engraftment, survival and acute and chronic graft-versus-host disease (GVHD). Sixty patients received a corrected marrow cell dose below 2.2 x 10(8) nucleated cells per kg body weight, 73 patients between 2.2 and 3.2 x 10(8) cells/kg, 60 patients between 3.3 and 4.2 x 10(8) cells/kg, and 59 patients more than 4.2 x 10(8) cells/kg. The significant association between high marrow cell dose and low risk of graft rejection previously reported was confirmed. In addition, high marrow cell dose resulted in small but statistically significant reductions in time to granulocyte and platelet recoveries in patients with sustained engraftment. High marrow cell dose was also associated with a significant improvement in patient survival, a result solely due to the reduction in the incidence of graft rejection. Neither acute nor chronic GVHD were influenced by marrow cell dose. We conclude that the maximum marrow cell dose should be transplanted in patients with severe aplastic anaemia. Maximum marrow cell doses are likely to decrease the incidence of graft rejection, shorten the time to engraftment thereby decreasing the need for blood products and antibiotic support, and improve overall patient survival. PMID- 3289604 TI - Bone marrow transplantation for myelodysplastic syndromes. AB - Eight patients with myelodysplastic syndromes (MDS) were treated with bone marrow transplantation (BMT). Median age was 34.5 years and ranged between 3 and 45. FAB diagnosis was refractory anaemia (RA) in three, RA with excess of blasts (RAEB) in four and RAEB in transformation (RAEB-t) in one case. Four patients were prepared with cyclophosphamide and total body irradiation whilst the other four received busulphan and cyclophosphamide. Engraftment was documented in seven of eight patients. Two patients died from complications related to the procedure. One had early veno-occlusive disease of the liver whilst the other died 46 months after BMT from pulmonary fibrosis. One patient died from recurrent disease 11 months after BMT. Five patients are alive and in complete remission 9-35 months post-transplantation. Four of these patients have a Karnofsky score greater than or equal to 90%. These results suggest that BMT can induce prolonged disease-free survival in patients under 50 years of age. If a compatible donor is available, marrow transplantation should be seriously considered in the treatment of MDS. PMID- 3289605 TI - A comparative study of combination chemotherapy versus marrow transplant in first remission in adult acute lymphoblastic leukaemia. AB - The results of conventional chemotherapy in adult acute lymphoblastic leukaemia (ALL) have not improved substantially in recent years. The present study is based on a flexible policy of marrow transplantation (allograft and autograft without marrow purging) in first remission compared with a group treated with standard maintenance therapy after a common induction sequence. The actuarial disease free survival (DFS) and actuarial overall survival (OS) at 3 years for autologous marrow grafted patients was 30% and 65% respectively. The allogeneic transplant group had DFS of 30% and OS at 3 years of 38% compared with DFS (12%) and OS (12%) for patients on 6-mercaptopurine and methotrexate maintenance. The actuarial disease free survival calculations include patients on protocol not entering remission, therefore, giving the worst possible result. We conclude that high dose chemo/radiotherapy with autologous marrow rescue in first remission followed by no maintenance provides better results in terms of overall survival and quality of life than standard ALL maintenance in adult patients. Results for allogeneic transplant in ALL are less good in terms of duration and quality of survival and the majority of deaths are related to causes other than leukaemic relapse. PMID- 3289606 TI - Childhood monosomy 7 revisited. AB - Monosomy 7 is found in acute myeloid leukaemia (AML) and myelodysplasia and is characteristic of a rare chronic myeloproliferative disease (MPD) of young children. We have seen 16 children with monosomy 7. Their clinical features and response to treatment are discussed. Monosomy 7 diseases appear to have a particularly poor prognosis. The AML is often resistant to treatment and relapse is common. Children with chronic MPD die of bone marrow failure or evolve to AML or myelofibrosis. We have treated these children intensively with combination chemotherapy and allogeneic bone marrow transplantation. Four children with MPD received supportive care and low dose chemotherapy alone. They all died, surviving between 4 months and 4 years. Six children with MPD received intensive chemotherapy: three remitted, one relapsing after 9 months, the others remaining in remission at 18 months and 3 years. One child with MPD has undergone successful BMT and survives 7 1/2 years after presentation. Remission was achieved in three of four cases of AML. They all relapsed within 9 months. Bone marrow transplantation was successful in one child with myelofibrosis. Intensive chemotherapy and early bone marrow transplantation is likely to offer these children their best chance of survival. PMID- 3289607 TI - Biochemical markers in multiple myeloma: a multivariate analysis. AB - The analysis of individual biochemical and clinical variables in 121 patients with multiple myeloma showed that serum beta 2-microglobulin (S-beta 2m) had the most significant relation to survival. Other variables such as serum thymidine kinase (S-TK), serum lactate dehydrogenase (S-LDH), S-creatinine, haemoglobin (Hb), ESR, S-albumin, age and clinical stage were also significant. No such relationship was found with M-component, presence of light chains in urine, type of secreted immunoglobulin or S-calcium. The exclusion of clinical stage in the first multivariate analysis resulted in a model consisting of S-beta 2m, age and S-TK, none of the other variables gave additional information. When in the second multivariate analysis the basic variables involved in staging procedure were excluded and clinical stage included, stage III, but not stage II, was found to give additional information to the model described above. Individual analysis of the variables showed that Hb had the most significant relation to effect of initial therapy. Other significant variables were S-TK, S-beta 2m and age. When using the multivariate approach, Hb alone was found to contain all the relevant information. PMID- 3289608 TI - Is treatment needed for mild impairment of glucose tolerance in pregnancy? A randomized controlled trial. PMID- 3289609 TI - The effects of differing acid concentrations, techniques and etch time on the etch pattern of enamel of erupted and unerupted human teeth examined using the scanning electron microscope. AB - The effects of varying acid concentration, etch time and agitation, on the etch properties of enamel from unerupted and erupted human teeth, were examined using the scanning electron microscope. Results showed that whilst there are differences in behaviour between erupted and unerupted enamel when conditions are varied, under most circumstances unerupted enamel will behave in a similar manner to erupted enamel. With low acid concentration both the duration of etch and agitation seem to be important factors in producing a roughened surface. It is suggested that the manufacturers' recommendations be more precise for a new low acid concentration orthodontic bonding package. PMID- 3289610 TI - Multistrand wire retainers: an indirect technique. AB - A method is described for bonding multistrand retainers indirectly, using a silicone locating splint and visible light curing adhesive. This technique permits construction of the retainer in the laboratory and eliminates the problem of positioning flexible wires in the mouth. PMID- 3289611 TI - Negative cooperativity within individual tetramers of Escherichia coli single strand binding protein is responsible for the transition between the (SSB)35 and (SSB)56 DNA binding modes. AB - We have examined the binding of the oligonucleotide dT (pT)34 to the Escherichia coli SSB protein as a function of NaCl and MgCl2 concentration (25 degrees C, pH 8.1) by monitoring the quenching of the intrinsic protein fluorescence. We find two binding sites for dT(pT)34 per single strand binding (SSB) protein tetramer, with each site possessing widely different affinities depending on the salt concentration. At 200 mM NaCl, we observe nearly stoichiometric binding of dT(pT)34 to both binding sites within the SSB tetramer, although a difference in the affinities is still apparent. However, when the NaCl concentration is lowered, the overall affinity of dT(pT)34 for the second site on the SSB tetramer decreases dramatically. At 1.5 mM NaCl, only a single molecule of dT(pT)34 can bind per SSB tetramer, even with a 10-fold molar excess of dT(pT)34. MgCl2 is effective at 100-fold lower concentrations than NaCl in promoting the binding of the second molecule of dT(pT)34. This binding behavior reflects an intrinsic property of the SSb tetramer, since it is also observed upon binding of smaller oligonucleotides, and the simplest explanation is that a salt-dependent negative cooperativity exists between DNA binding sites within the SSB tetramer. This phenomenon is also responsible for the transition between the two SSB-single strand (ss) polynucleotide binding modes that cover 35 and 56 nucleotides per tetramer [Bujalowski, W., & Lohman, T. M. (1986) Biochemistry 25, 7799-7802]. Extreme negative cooperativity stabilizes the (SSB)35 binding mode, in which the SSB tetramer binds tightly to ss DNA with only two of its subunits while the other two subunits remain unligated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289612 TI - Base cleavage specificity of angiogenin with Saccharomyces cerevisiae and Escherichia coli 5S RNAs. AB - The base cleavage specificity of angiogenin toward naturally occurring polyribonucleotides has been determined by using rapid RNA sequencing technology. With 5S RNAs from Saccharomyces cerevisiae and Escherichia coli, angiogenin cleaves phosphodiester bonds exclusively at cytidylic or uridylic residues, preferably when the pyrimidines are followed by adenine. However, not all of the existent pyrimidine bonds in the 5S RNAs are cleaved, likely owing to elements of structure in the substrate. Despite the high degree of sequence homology between angiogenin and ribonuclease A (RNase A), which includes all three catalytic as well as substrate binding residues, the cleavage patterns with natural RNAs are unique to each enzyme. Angiogenin significantly hydrolyzes certain bonds that are not appreciably attacked by RNase A and vice versa. The different cleavage specificities of angiogenin and RNase A may account for the fact that the former is angiogenic while the latter is not. PMID- 3289613 TI - Steric course of the hydration of D-gluco-octenitol catalyzed by alpha glucosidases and by trehalase. AB - Crystalline Aspergillus niger alpha-glucosidase and highly purified preparations of rice alpha-glucosidase II and Trichoderma reesei trehalase were found to catalyze the hydration of [2-(2)H]-D-gluco-octenitol, i.e., (Z)-3,7-anhydro-1,2 dideoxy-[2-2H]-D-gluco-oct-2-enitol, to yield 1,2-dideoxy-[2-2H]-D-gluco octulose. In each case, the stereochemistry of the reaction was elucidated by examining the newly formed centers of asymmetry at C-2 and C-3 of the hydration product. The C-1 to C-3 fragment of each isolated [2-2H]-D-gluco-octulose product was recovered as [2-2H]propionic acid and identified by its positive optical rotatory dispersion as the S isomer, showing that each enzyme had protonated the octenitol (at C-2) from above its re face. 1H NMR spectra of enzyme/D-gluco octenitol digests in D2O showed that the alpha-anomer of [2-2H]-D-gluco-octulose was exclusively produced by each alpha-glucosidase, whereas the beta-anomer was formed by action of the trehalase. The trans hydration catalyzed by the alpha glucosidases was found to be very strongly inhibited by the substrate; the cis hydration reaction catalyzed by the trehalase showed no such inhibition. Special importance is attached to the finding that in hydrating octenitol each enzyme creates a product of the same anomeric form as in hydrolyzing an alpha-D glucosidic substrate. This result adds substantially to the growing evidence that individual glycosylases create the configuration of their reaction products by a means that is independent of donor substrate configuration, that is, by a means other than "retaining" or "inverting" substrate configuration. PMID- 3289614 TI - Cytoplasmic membrane is the target organelle for transition metal mediated damage induced by paraquat in Escherichia coli. AB - Bacterial survival indicates that copper or iron is an essential mediator in paraquat toxicity in Escherichia coli [Kohen, R., & Chevion, M. (1985) Free Radical Res. Commun. 1, 79-88; Korbashi, P., Kohen, R., Katzhendler, J., & Chevion, M. (1986) J. Biol. Chem. 261, 12472-12476]. In this study we have identified the cytoplasmic membrane as a target organelle in metal-mediated paraquat toxicity and have demonstrated the complete correlation of the membrane damage with the levels of adventitious copper (or iron). The extent of membrane damage was related by use of four parameters: (a) the level of cellular ATP, (b) the level of cellular potassium, (c) the cellular capacity to accumulate and retain radiolabeled leucine, and (d) the cellular integrity as reflected by transmission electron microscopy (TEM). Exposure of bacterial cells to a combination of paraquat and copper caused a marked decline in parameters a, b, and c. This decline was found to occur in parallel with, or even to precede, the sharp loss of survival of E. coli under the same conditions. Likewise, TEM micrographs clearly indicated alterations in cellular structure that possibly reflect sites of detachment of the cytoplasmic membrane from the bacterial capsule. In contradistinction, copper alone or paraquat alone could not bring about similar changes in cellular structure. These findings are in accord with the suggested site-specific metal-mediated Haber-Weiss mechanism for paraquat toxicity and support our notion that specific chelators of transition metals could reduce or prevent the biological deleterious effects of this herbicide. PMID- 3289615 TI - A soluble enzyme activity that attaches free diaminopimelic acid to bdelloplast peptidoglycan. AB - An enzyme activity, responsible for the attachment of diaminopimelic acid (DAP) to bdelloplast wall peptidoglycan, was studied in an in vitro, cell-free system. Most of the activity was found in the high-speed (20000g) supernatant fraction of homogenates of bdelloplasts prepared from a culture of the intracellular bacterium Bdellovibrio bacteriovorus 109J, growing synchronously within cells of Escherichia coli. Peptidoglycan preparations obtained either from E. coli ML35 or from the walls of bdelloplasts synchronously cultured for 40 or 90 min served as the acceptors in this reaction, whereas cell wall or peptidoglycan preparations obtained from Gram-positive bacteria could not function as acceptors of DAP. The attachment activity had an apparent Km value for DAP of 10 microM; for bdelloplast peptidoglycan, it was approximately 0.43 mg/mL, which is 13 microM with respect to peptidoglycan disaccharide peptide units. DAP attachment was partially inhibited by the structural analogues lanthionine, L-ornithine, beta aminobutyric acid, and D-serine, as well as the cell wall synthesis inhibitors penicillin G, ampicillin, and cephalexin. This enzyme activity is present only during the intracellular stage of the bdellovibrio's developmental growth cycle and may serve a stage-specific function of biochemically modifying the cell in which it grows. PMID- 3289617 TI - The influence of tetraphenylborates (hydrophobic anions) on yeast cell electro rotation. AB - The action of a series of tetraphenylborate ion (TPB) derivatives on yeast cells was studied by electro-rotation of the pre-treated cells. TPB derivatives in which all four phenyl groups were substituted with fluorine, chlorine or trifluoromethyl were much more toxic than the unsubstituted compound, the effect increasing dramatically with increasing size of substituents. These observations suggest that the toxicity of these hydrophobic ions is determined mainly by their size and possibly also by the chemical inductivity of their substituent groups. The order of the toxicities of these ions was in fair agreement with literature values for their translocation rates across artificial bilayers. Incubation times of 3 h were used as standard, longer incubations (up to 48 h) showed that the number of cells affected by low doses of TPB increased with the logarithm of time after the first hour of incubation. Although measurements of the percentage of cells showing co-field rotation showed that controls were not adversely affected by incubations as long as 9 h, rotation spectra showed that some cells suffer loss of internal conductivity during extended incubations. Decrease of the pH of the incubation medium, or inclusion of high concentrations of NaCl or KCl, potentiated the effects of these hydrophobic ions. The toxicity developed slowly, and the sensitivity of the assay was only very weakly dependent on the cell suspension density. PMID- 3289619 TI - Eukaryotic DNA polymerase-primase: structure, mechanism and function. PMID- 3289616 TI - ATP-stimulated hydrolysis of GTP by RecA protein: kinetic consequences of cooperative RecA protein-ATP interactions. AB - The cooperativity of the single-stranded DNA dependent nucleoside triphosphatase activity of the recA protein was investigated by examining the influence of a good substrate (ATP) on the hydrolysis of a poor substrate (GTP). At pH 7.5 and 37 degrees C, both ATP and GTP are hydrolyzed with a turnover number of 17.5 min 1. The S0.5 for GTP (750 microM), however, is nearly 20-fold higher than the S0.5 for ATP (45 microM). Low concentrations of ATP activate the GTPase activity of the recA protein by lowering the S0.5 for GTP; in the presence of 50 microM ATP, the S0.5 for GTP is reduced from 750 microM to 200 microM. Concentrations of ATP greater than 50 microM result in competitive inhibition of the ATP-activated GTPase activity. Although GTP is a substrate for hydrolysis, it will not substitute for ATP as a high-energy cofactor in the standard recA protein promoted three-strand exchange reaction. To account for these results, a minimal kinetic model is presented in which ATP binding induces specific conformational changes in the recA protein that do not occur with GTP binding. PMID- 3289620 TI - Interdomain cleavage of plasma fibronectin by zinc-metalloproteinase from Serratia marcescens. AB - Limited proteolysis of porcine plasma fibronectin by the 56 kDa proteinase (56K proteinase) (EC 3.4.24.4) from Serratia marcescens released six polypeptides: a 27 kDa peptide, the heparin-binding domain which comprises the NH2-terminal end; a 50 kDa peptide, a mid-molecule that mediates binding to gelatin or collagen; a 160 kDa peptide, that contained the heparin-binding domain with cell-spreading activity; and a 140 and a 20 kDa peptide which released from the 160 kDa peptide. Each fragment was purified and characterized by its chemical and biological properties, and it was found that they were respectively different domains. Both the 160 and the 140 kDa peptide contained one cysteine per mole of peptide. The 160 kDa peptides were connected by a 6 kDa peptide, which was present at the COOH terminal end of the molecule and was biologically inactive. Only 6 kDa peptide contained a disulfide bond and produced 3 kDa peptide after reduction, whereas other fragments did not change with or without reduction on SDS-polyacrylamide gel electrophoresis. NH2-terminal sequence analyses of the released peptides showed that the 56K proteinase cleaved the fibronectin between the Arg-Thr (located at two different sites), Leu-Ser and Gln-Glu bonds. Out of 118 Arg residues, there are nine sequences containing Arg-Thr, and two of them near or at an interdomain location (at Arg 259 and 2239) were cleaved. Out of 124 Leu residues, there are 11 Leu-Ser sequences and only one, at 687, was cleaved. The above fragments with functional domain activity could be aligned according to the previously reported amino-acid sequence of human or bovine plasma fibronectin. The treatment of fibroblast cells by the 56K proteinase resulted in loss of morphological integrity and extracellular matrix. PMID- 3289618 TI - Transcriptional and posttranscriptional regulation of malic enzyme synthesis by insulin and triiodothyronine. AB - To investigate the transcriptional and posttranscriptional regulation of malate dehydrogenase (EC 1.1.1.40) induction by insulin, the transcriptional rate, mRNA concentration and enzyme induction of malic enzyme were compared in livers of normal and diabetic rats fed a high-carbohydrate diet. When rats were fed the diet for 4 days, the enzyme induction and mRNA concentration in livers of diabetic rats were only about 10% and 39%, respectively, of the values of normal rats, and the transcriptional rate was about 64%. Insulin treatment restored the transcriptional rate and mRNA concentration in 8 h and the enzyme induction in 4 days. Thus, it is suggested that insulin is involved in malic enzyme transcription of the gene and also possibly in the translation of the cytoplasm. On the other hand, by giving triiodothyronine treatment, the transcriptional rate and mRNA concentration were increased about twice and the enzyme induction, about 10-times in the diabetic animals. Triiodothyronine appears to stimulate malic enzyme transcription and possibly post-transcriptional steps even at a very low insulin level. PMID- 3289621 TI - Isolation of alveolar type II cells from fetal rat lung by differential adherence in monolayer culture. AB - Type II alveolar epithelial cells were isolated from fetal rat lung by differential adherence in monolayer culture. The preparation had a high degree of purity, as assessed by phase contrast microscopy and immunocytochemistry. Purity, based on reactivity with specific anti-adult lung serum (SAALS), which recognizes only type II cells, was 91% for cells isolated from 19-day fetal lungs and 79% for cells isolated from 21-day fetal lungs. The lower purity of type II cells in cultures derived from 1-day postnatal rat lungs (51% cells reactive with SAALS) is probably due to a lower tendency of the type II cells from neonatal rats to adhere to culture dishes than of type II cells from fetal rats. Type II cells isolated from 21-day fetal lungs contained a higher percentage phosphatidylglycerol and incorporated [Me-3H]choline faster into phosphatidylcholine (PC) than type II cells isolated from 19-day fetal lungs. Moreover, in cell preparations derived from lungs at fetal day 21, a higher percentage of epithelial cells contained lamellar bodies than in preparations derived from lungs at fetal day 19. The observation of these differences in the stage of maturation indicates that these differences, which are typical features of the original material, are not obliterated by differentiation during the culture. Type II cells isolated according to the present procedure were capable of synthesizing PC with a high percentage of the disaturated species. This method for the isolation of fetal type II cells may be a useful tool in studies concerning surfactant synthesis and its regulation in the fetal lung. PMID- 3289622 TI - Fatty acid chain-shortening activity in the pulmonary type II cell. AB - Type II cells obtained from fetal rabbit lung tissue in culture were incubated with [14C]palmitic and [14C]stearic acids labeled at either the carboxyl or the terminal methyl groups. Significant chain shortening of [18-14C]stearic acid to radiolabeled palmitic acid was observed, with little chain shortening of palmitic acid to myristic acid. Incorporation of 14C into palmitic acid by beta-oxidation followed by de novo fatty acid biosynthesis was not detectable under the same experimental conditions. The palmitic acid supplied by chain shortening was preferentially incorporated into phosphatidylcholine instead of other lipids. Fatty acid chain-shortening activity in the type II cell appears to be capable of increasing the amount and relative proportion of palmitic acid available for phosphatidylcholine biosynthesis. PMID- 3289623 TI - [The function of the counting of time as the basis for the individual adaptive activity of the nervous system]. AB - An important role of time factor in adaptive process of organisms is shown on the basis of great literary material. The time perception is a result of the interrelationship of the so-called "biological clock" and learning during the whole ontogenesis. The hypothetical mechanisms of time perception are discussed. In own experiments the authors revealed more distinct expressiveness of high frequency components in electroencephalogram spectrum and less expressiveness of low-frequency components in subjects underestimating time intervals compared with subjects overestimating them. A conception on the role of individual characteristics of nervous system in time perception is developed. PMID- 3289624 TI - [Learning and memory: neurophysiological mechanisms]. AB - The analytical review of study of neurophysiological basis in different kinds of learning and memory in animal and human is given. The main attention is paid to the consideration of systemic and neuronal levels of habituation and conditioned reflexes. A conception on the brain functional state as the main mechanisms of learning and distributed multicomponent engram corresponding to the integrative process peculiarities is developed. PMID- 3289625 TI - [Characteristics of learning in ontogeny]. AB - The rate of learning in young animals and in adults is different, it is higher in ontogenesis. The mechanism of learning in young animals is also different. In the ontogenesis it is similar to imprinting. Probably the mechanisms of the infantile amnesia develops according to the model of dissociated when the association is a certain chemical composition of brain which is typical of this age level. The information more important from the biological point of view is less dissipated and better restored that testifies the low effectiveness of reproductive system and not low memory trace consolidation. The difficulties in extinction and differentiation in experiments with rats are connected with reflex automatisation but not with the deficit in inhibition. PMID- 3289627 TI - [The difference between rheumatoid factors and normal immunoglobulins disclosed by a monomolecular layer technic]. AB - 20 rheumatoid factors of two classes, namely IgG and IgM, were isolated from the serum of 11 patients with rheumatoid arthritis. The method of monolayer analysis revealed that these proteins differ from normal ones either by the instability of their native structure, or by their anomalous hydrophilic properties. Dialysis resulted in partial or complete restoration of normal properties in the majority of samples studied. It has been concluded that at least some of the rheumatoid factors are complex structures that contain, beside IgG and IgM molecules, also certain smaller molecules. PMID- 3289626 TI - [Structural bases of the plasticity of the nervous system]. AB - The present state of morphological study of variability in the nervous elements under conditions of adaptive change under the influence of afferent effects, age changes during different periods of ontogenesis, under conditions of de- and regeneration of synapses have been considered. A question on correlation between structure and the function of synapses during the change has been analysed. The tasks of subsequent study of this problem have been outlined. PMID- 3289628 TI - [Mitogenic effect of Legionella pneumophila: the ratio of proliferating T- and B cells changes after immunization]. AB - The splenic lymphocyte proliferative response of guinea-pigs immunized with L. pneumophila antigen (ALP) was studied. The immune animals were shown to express enhanced reactivity in response to E. coli lipopolysaccharide, as compared to the controls, while the response to concanavalin A was markedly decreased. After 3 days in the culture ALP induced a significant nonspecific lymphocyte transformation that was expressed to a similar degree in both experimental and control group. However, after a 5-day incubation ALP induced a specific proliferative response of the immunized guinea-pig splenocytes. The experiments on fractionation by passing through the column with nylon wool revealed that T cells are activated in non-immunized guinea-pigs. The results obtained prove that T cells mediate the immune response to ALP in guinea-pigs. PMID- 3289629 TI - [A method of detecting demyelinated nerve tissue in experimental allergic encephalomyelitis]. AB - A method of rapid pathomorphological diagnosis of demyelinization with a simultaneous detection of cell elements in the nervous tissue has been described. The method tested on the model of experimental allergic encephalomyelitis (EAE) is a modified method of Marchi with subsequent staining of histological sections with toluidine blue. Due to a shorter period of nervous tissue exposure to potassium bichromate and osmium acid solutions (from 6-8 weeks to 5 days) the cells preserve their ability to uptake the dye and the endurance of histological sections increases. Their thickness (2-3 microns) makes it possible to examine them in immersion magnification of the light microscope. Using the above method, we succeeded in revealing hematogenic and glial elements in demyelinating foci in the central nervous system of animals with EAE. The method described can be used for studying pathomorphology of multiple sclerosis and other demyelinating diseases in humans and their experimental models, as well as for the express diagnosis of demyelinization in pathoanatomical practice. PMID- 3289630 TI - [Heterogeneity of basal membranes in human tissues detected by monoclonal antibodies to laminin and entactin]. AB - The distribution of basal membrane glycoproteins, laminin and entactin, was studied immunohistochemically by peroxidase-antiperoxidase technique in different adult human organs: kidneys, liver, heart, skin, spleen and ileum. Monoclonal antibody against entactin (ELM2) reacted with all basal membranes. Monoclonal antibody against laminin (LT3.1), however, did not react with basal membranes of arterial smooth muscle cells, or with endothelial basal membranes of renal and hepatic sinusoid endothelium. Thus, LT3.1 antibody has revealed basal membrane heterogeneity by laminin. The possible immunochemical heterogeneity of basal membranes by entactin is also discussed. PMID- 3289631 TI - [Identification of Salmonella enterotoxin by coagglutination reaction]. AB - It has been shown that the intensity of enterotoxin production by various strains of Salmonella is different (it ranges from + to +). Thus, in addition to adhesive properties and skin permeability factors, the ability of various Salmonella strains to produce enterotoxin is one of the pathogenic factors of these microorganisms. Further biological characteristics of the infective agents will promote the detection of epidemiologically significant types of microorganisms during outbreaks of toxicoinfections. PMID- 3289632 TI - Clinical pharmacodynamics of anticancer drugs: a basis for extending the concept of dose-intensity. AB - The studies reviewed herein support the precept that "systemic dose-intensity" (i.e., systemic exposure) may be more informative than "administered dose intensity" for certain anticancer drugs. This does not mean that the administered dose-intensity should be ignored; in fact these data indicate the importance of documenting and assessing administered dose-intensity as an initial step toward identifying those situations where systemic dose-intensity may be most important. The studies described in this review were selected as representative examples of successful clinical pharmacodynamic studies; other published examples include vincristine AUC versus severity of neurotoxicity, etoposide systemic exposure versus leukopenia, red cell concentration of mercaptopurine metabolites versus neutropenia in children with ALL, and ARA-CTP retention in leukemic blasts versus clinical response in acute non-lymphocytic leukemia. As is the case with other types of clinical trials in cancer patients, there are also examples of negative pharmacodynamic studies (i.e., no relationship found between concentration and effects). There are several possible reasons for such negative findings, including the lack of such a relationship for some drugs, measuring the inappropriate drug moiety (e.g., failure to measure all active metabolites), measuring drug concentrations in the wrong biological fluid, evaluating systemic exposure over too narrow a range (i.e., all patients have either sub- or supra therapeutic systemic exposure), selecting inappropriate sampling times or pharmacokinetic parameters, inadequately assessing drug toxicity or response, or simply studying an inadequate number of patients or patients with drug-resistant cancers. Therefore, negative findings in some pharmacodynamic studies should not deter the investigation of other drugs and/or other malignant diseases, just as negative therapeutic trials do not preclude subsequent clinical trials in oncology. Also, finding a relation between systemic exposure and drug toxicity, in the absence of a clear relation to antitumor effects, is potentially of great clinical utility. Such data should allow more objective escalation of drug dosages in individual patients, to ensure maximum dose-intensity while avoiding host toxicity. Obviously, if such dose escalation could be guided by more easily measured patient characteristics (e.g., age, weight, CrCl, shoe size, etc.), then using drug concentrations in individual patients might be obviated.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3289633 TI - Acute lymphoblastic leukemia in adult identical twins. AB - The development of acute lymphoblastic leukemia (c-ALL) in identical twins is reported. The first born had ALL in 1982 and bone marrow transplantation was performed in first complete remission (CR) from his healthy twin-brother the same year. The bone marrow donor developed ALL in 1985; he received an autologous bone marrow transplantation in first CR in 1986. Unfortunately, both patients relapsed in 1986. Cytogenetic studies of the first born revealed multiple chromosomal abnormalities and a marker chromosome whereas the second patient had a Philadelphia chromosome. Genetic reasons or exposure to leukemogenic agents may be responsible for the onset of these leukemias. PMID- 3289634 TI - Effects of tamoxifen and 4-hydroxytamoxifen on synchronized cultures of the human breast cancer cell line MCF-7. AB - The effect of antiestrogens on cultures of synchronized MCF-7 human breast cancer cells was studied. Cultures were synchronized by an eighteen hour block with 1.5 mM hydroxyurea. Tamoxifen or 4-hydroxytamoxifen was added at various times following removal of the hydroxyurea block and the cell number and rate of incorporation of 3H-thymidine by the cultures were followed for 48 hours through two waves of DNA synthesis. Antiestrogens added when hydroxyurea was removed inhibited only the second wave of DNA synthesis. Inhibition of the second wave only occurred if the antiestrogen was added before or at about the time of mitosis. To determine whether antiestrogen had to be present before mitosis in order to block the next round of DNA synthesis, cells in mitosis were selected by shaking them loose. The subsequent division of these cells was followed to determine the effect of treating them with antiestrogens before, after, or both before and after mitosis. The addition of antiestrogens at the time of mitosis proved sufficient to block the next round of cell division. Thus antiestrogens are cell cycle specific agents and appear to act at a point early in G1 to block the next round of DNA synthesis and cell division. PMID- 3289635 TI - Autologous bone marrow transplantation in breast cancer. A panel discussion. PMID- 3289637 TI - Central control of human gastrointestinal function. PMID- 3289636 TI - Intrinsic control of the gut. AB - In most mammals (except ruminants) activity in the gastrointestinal (GI) tract depends upon the condition or state of the animal, namely, fasted or fed. The fasted state is characterized by a caudally migrating, cycling motor complex, showing periods of intense contractile and secretory activity alternating with periods of quiescence. Although the mechanisms involved in the transition from the fasted to the fed state are not fully understood it seems likely that both states utilize intrinsically located neural control mechanisms and common neuronal pathways to the effector tissues. We have commented on the reported properties of the myenteric neurones and their projections to the muscle layers. The data suggests that there are both cholinergic and non-cholinergic excitatory motor neurones supplying the muscle layers. In the guinea-pig, at least, the projections of the neurones to the circular muscle layer run for relatively short distances in oral-aboral axis of the gut. The non-cholinergic excitatory transmitter substance may be Substance P or a similar tachykinin. Other excitatory nerves may well be present. There are at least two mechanisms used by non-cholinergic non-adrenergic inhibitory nerves supplying the muscle layers. In the guinea-pig ileum, there are at least two distinct projections of inhibitory motor neurones; both have aborally directed projections. The first of these is relatively short and the other long (greater than 10 mm). Individual myenteric neurones appear to contain unique and perhaps identifying groups of peptides. The functional role of many of these peptides, either within the myenteric plexus or their projections to the muscle layers, remains to be elucidated. The projections of the neurones of the submucous plexus run primarily to the mucosa. Both cholinergic and non-cholinergic secretomotor neurones appear to be present. The activation of local neural reflexes, which results in secretomotor activity, may involve submucous sensory neurones containing acetylcholine and Substance P together with cholinergic interneurones. Projections from the myenteric to the submucous plexus are likely to be involved in the coordination of intestinal movement and secretomotor activity. A simplified schematic diagram of some of the neuronal circuitry of the submucous plexus has been developed and includes the findings from immunocytochemical and electrophysiological studies. PMID- 3289638 TI - The neurophysiology of vomiting. AB - Nausea and vomiting can be induced by a wide variety of stimuli such as pregnancy, space travel, raised intracranial pressure, radiation and cytotoxic drugs. The mechanisms by which all these diverse stimuli culminate in a final common act is unknown. From studies in the 1950s a model of the emetic reflex emerged consisting of a chemoreceptor trigger zone in the area postrema and a vomiting centre in the brain stem. This concept has been reviewed and revised in the light of recent studies. Many discussions of emesis involve detailed descriptions of the gastrointestinal events associated with the act of vomiting only-nausea and retching receiving little attention. Here we have tried to give a broader view by considering the neurophysiology of such events and have included nausea and retching, phenomena that are usually inseparable from vomiting. The possible biological function of these events is also discussed. The involvement of visceral systems (such as the heart, airways and gut) is included, and particular attention is paid to vagal mechanisms underlying the changes in gut motor activity. Emesis has long been thought to be organized by a 'vomiting centre'; the possibility that this vomiting centre could be the parvocellular reticular formation is reviewed, as is the concept that the 'centre' is larger than an anatomically defined single group of cells. The mechanism of action of two clinically relevant emetic stimuli--radiation and cytotoxic drugs-is considered in detail. Recent studies of the antiemetic properties of novel 5-HT-3 receptor antagonists against radiation and cytotoxic drug-induced vomiting are discussed; these studies suggest that important advances will be made in the treatment of emesis induced by these and other related agents. PMID- 3289639 TI - Control of eating behaviour. PMID- 3289640 TI - Neural mechanisms in disorders of defaecation. PMID- 3289641 TI - Pseudo-obstruction syndromes. AB - Chronic intestinal pseudo-obstruction (CIP) is a clinical syndrome characterized by symptoms and signs of intestinal occlusion, in absence of any mechanical obstruction of the gut lumen. It causes impaired transit of intestinal contents and is determined by abnormalities of motor activity. The term CIP is used to indicate a heterogeneous group of disorders with many different pathogenic mechanisms. The defect in the regulation of intestinal transit can be at any level of motility control. Two main types of CIP are recognized, termed respectively myogenic (when smooth muscle cells are affected) and neurogenic (caused by abnormalities of extrinsic and/or intrinsic nervous supplies). Both types may be secondary to a variety of recognizable diseases or idiopathic. In myogenic CIP, intestinal transit is impaired because of lack of propulsive strength; in the neurogenic form, contractions are powerful but not sufficiently co-ordinated to propel intestinal contents aborally in an organized fashion. CIP belongs to the large and loosely defined group of digestive functional disorders. These disorders probably share common pathogenic mechanisms but with different expressiveness. The reasons why only some patients present recurrent symptomatological bouts resembling mechanical occlusion has not been clarified. This aspect is of great clinical relevance and deserves attention, as CIP patients, unlike other patients with severe functional disorders, may undergo repeated, useless and potentially dangerous operations. The diagnosis of CIP may be suggested by clinical features and is based on radiological, endoscopic, manometric, and histological findings. Recent technological improvements facilitate the recognition of this intriguing syndrome. In particular, manometric recording of the small bowel motility, which has long been considered an important research technique, can now also be regarded as a useful diagnostic tool. PMID- 3289642 TI - The neural control of pelvic viscera. PMID- 3289643 TI - [Comparison between single-dose and hyperfractionated total-body irradiation for the conditioning of allogenic grafts of the bone marrow. A retrospective study of 54 patients with malignant hematologic diseases]. AB - The present study is a retrospective analysis of 54 patients with hematological malignancies who were treated by total body irradiation (TBI) and allogenic bone marrow transplantation from 1982-1986. Patients were not randomly assigned to receive either single dose total body irradiation (STBI) (10 Gy x 1-4 cGy/min lung dose 8 Gy) or hyperfractionated total body irradiation (HTBI) (1,20 Gy x 11 3 fractions/day-lung dose 9 Gy). Thirty one patients received STBI and 23 a HTBI regimen. Despite the presence of a large proportion of patients with a high risk of leukemic relapse in the HTBI group, the incidence of relapse did not differ significantly in the two groups: STBI (16%), HTBI (21%). Lung and liver toxicity were predominant in the STBI group. Interstitial pneumonitis occurred in 45% of the STBI patients versus 13% in the HTBI group. This difference remains significant when adjusted to the incidence of graft versus host disease (GVHD) in the two groups. Three cases of veino-occlusive disease were observed (10%), but only in the STBI group. Even when differences in age and the frequency of GVHD are considered in the two groups, these findings suggest that HTBI is at least as effective as STBI and that toxicity is reduced with this schedule. PMID- 3289645 TI - The effect of a relaxation technique on coronary risk factors. AB - This study examined the effect of a relaxation technique on plasma lipids, weight, blood pressure, and blood glucose. Sixteen outpatient males were randomly assigned to control or experimental groups. The experimental group was taught a relaxation technique that they used throughout the study. The control group was started in a reading program. Subjects were followed by a nurse practitioner and dietitian for eight weeks. Results revealed a significant reduction in systolic blood pressure and a marginally significant reduction in low density lipoprotein (LDL) cholesterol in the experimental group. Both control and experimental groups self-reported high compliance with diet and adherence to prescribed intervention. State anxiety was found to be inversely related to changes in total cholesterol and LDL cholesterol. PMID- 3289644 TI - [Neonatal carcinoma. Review of the literature apropos of a case]. AB - A cortical adrenal carcinoma arising during the neonatal period and associated with virilization recurred after an initial excision and is in complete remission after a follow-up period of 10 years. The authors have performed a review of the medical literature which has yielded 56 neonatal carcinomas including this one. More than half of these cases concerned the thyroid gland (15 cases) and the adrenal cortex (14 cases). These were followed by malignant melanomas (12 cases), carcinomas of the parotid gland (6 cases), oropharyngeal region (3 cases), adrenal medulla (2 cases) and stomach, liver, breast and cutaneous sweat gland (one case each). Six tumors were associated with congenital malformations which included Beckwith-Wiedeman's syndrome; 4 tumors arose from preexisting tissue lesions; in one case, oral contraceptives were taken during pregnancy. The main treatment of neonatal carcinomas is surgery. Local recurrences (7 cases) do not markedly affect the outcome, whereas metastases (12 cases) have a very unfavorable prognosis. Superficial tumors are diagnosed earlier and more frequently cured. Out of 44 cases for which the outcome is known, only 18 children survived. PMID- 3289647 TI - Bacteriophage endoglycanases and desorption chemical ionization mass spectrometry (DCI-MS) to sequence bacterial antigens. PMID- 3289646 TI - Determination of atrazine residues in water and soil by enzyme immunoassay. PMID- 3289649 TI - The ABL oncogene in human leukemias. AB - The ABL proto-oncogene on the Philadelphia chromosome is 'activated' by its translocation in a manner similar to its activation by the murine Abelson leukemia virus--with the formation of a fusion protein with a new N-terminus and enhanced tyrosine kinase activity. Study of this BCR-ABL fusion gene has led to the development of molecular probes which are beginning to play an important role in the diagnosis and clinical management of chronic myelogenous leukemia, and may ultimately lead to better understanding of the biology of the disease. The role of ABL on the Philadelphia chromosome in acute lymphoblastic leukemia is only now beginning to be understood, but is likely to be similar, and a new ABL species has already been identified by several groups. It is likely that this protein is the product of a fusion gene, as it is in chronic myelogenous leukemia, but definitive proof awaits molecular cloning of the translocation breakpoint. Aside from its activation by the Ph1 chromosome, ABL has not been found to have a role in any other human cancer. PMID- 3289648 TI - Alprazolam versus chlormethiazole in acute alcohol withdrawal. PMID- 3289651 TI - Inherited factors in thrombosis. AB - Patients with inherited defects or abnormalities that impair the naturally occurring anticoagulant and fibrinolytic systems are at risk of developing venous and, more rarely, arterial thromboembolism. The prevalence of inherited thrombophilia in the general population is higher than that of inherited bleeding disorders (ca. 1 in 7500 vs 1 in 20,000). Low levels or dysfunctional forms of antithrombin III, protein C and protein S and abnormal fibrinogens are the most frequent and well-established inherited causes for thrombosis. Less frequent and/or less established causes are low heparin cofactor II and plasminogen and high levels of plasminogen activator inhibitor and histidine-rich glycoprotein. The pathophysiology, genetic and clinical aspects and laboratory diagnosis of inherited thrombotic disorders are reviewed and an approach to prophylaxis and therapy is outlined. PMID- 3289650 TI - Congenital platelet disorders. AB - Congenital platelet disorders include thrombocytopathies and thrombocytopenias, which often occur in association. Thrombocytopathies constitute a model for exploring platelet physiology at the molecular level: adhesion, activation, release phenomena, aggregation. Further advances in understanding thrombocytopenias now require studies of medullary physiology. A better knowledge of these disorders is necessary to improve their management. PMID- 3289652 TI - Methyldopa-induced autoantibodies against red blood cells. AB - Methyldopa therapy results in the formation of red cell autoantibodies in 10-20% of patients taking the drug for longer than 4 months. These red cell antibodies are true autoantibodies, that is they are directed against an autoantigen on the red blood cell membrane and not against the drug or against a drug-altered antigen. The target membrane antigen is usually within the Rhesus system, although often the antibody specificity cannot be defined. Red cell antibody is usually detectable in the patient's sera as well as on the red cells. The autoantibody is usually a warm reacting IgG antibody. Most patients who develop these autoantibodies do not go on to develop hemolytic anemia in spite of high titres of antibodies on their red cells. In addition, these patients do not tend to develop hemolysis if methyldopa therapy is continued. Rarely patients develop hemolytic anemia which can be severe. Differences in antibody characteristics, including subclass restriction, complement-binding ability, or titre do not explain why some patients with autoantibody hemolyze while most do not. One group of investigators found that hemolyzing patients had IgM on their red cells while those who did not had IgG only. But while this observation could explain why some patients (IgM-sensitized red cells) hemolyze, it does not explain why most patients with IgG-sensitized red cells do not hemolyze. Why the autoantibody forms is not known but some investigators have proposed that the drug may directly affect B or T cells with resulting impairment of immune tolerance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289653 TI - Iron status and cellular immune competence. AB - There is increasing evidence that both iron overload and iron deficiency are associated with significant abnormalities of immune function. In diseases associated with iron overload there is increased susceptibility to both infection and neoplasia. The precise mechanisms are still being unravelled but iron overload has been shown to impair antigen-specific immune responses and to reduce the number of functional helper precursor cells. Similarly, iron in vitro in concentrations reported to be present in the serum of patients with iron overload impairs the generation of cytotoxic T-cells, enhances suppressor T-cell activity and reduces the proliferative capacity of helper T-cells. The predominant tumor seen in iron overload is primary hepatocellular carcinoma; however other aetiological factors appear to be involved in addition to iron overload, especially hepatic cirrhosis. Nevertheless, primary liver cancer occurs much more frequently in hemochromatosis than in other forms of cirrhosis. Iron deficiency is associated with an altered response to infection but the relationship is again a complex one. The cellular mechanisms involved have yet to be clearly defined, although impaired T and B cell function have been demonstrated. PMID- 3289654 TI - What are killer cells and what do they do? AB - Cytotoxic effector function of the immune system is mediated predominantly by killer cells and with the exception of complement-mediated lysis all forms of immune-directed cell death are attributable to these cells. The heterogeneous collection of cells with cytotoxic properties ranges from the phylogenetically primitive granulocyte and natural killer (NK) cell lineages to the more complex and versatile macrophage and antigen-specific cytotoxic T lymphocyte. Most killer cells are capable of the dual functions of cytotoxicity and immunoregulation. Granulocytes, macrophages and NK cells constitute an effective 'first line' cellular defence against invasive microbial pathogens and emerging malignancies. Through direct cytotoxicity or by the secretion of cytokines, NK cells also prevent overproliferation of precursor cell populations, thereby exerting a more discriminating control over antigen-specific T and B cell responses. The ultimate refinement of the killer cell is the cytotoxic T cell which is directed by an antigen receptor comparable in specificity and diversity to the immunoglobulin molecule. The mechanisms underlying the initial interaction between killer cell and target and the subsequent lytic event are imperfectly understood. Although many cytokines with lytic properties have been identified and in some cases cloned, their relative importance and intricate interactions with other components of the immune system are still largely unknown. In addition to the prevention of infection and malignancy, killer cells of all lineages are important in the pathogenesis of human disease. Of particular interest is the role of macrophages, NK cells and cytotoxic T cells in autoimmunity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289655 TI - Gaucher disease. AB - Gaucher disease is a glycolipid storage disorder characterized by accumulation of glucocerebroside in the liver, spleen, and bones, and caused by a deficiency of glucocerebrosidase. Glucocerebrosidase cDNA has been cloned and sequenced, and much has been learned about the synthesis and processing of this enzyme. Inherited as an autosomal recessive disorder, Gaucher Disease is relatively common among Ashkenazi Jews. In its most common form, designated Type 1 or adult type of Gaucher disease, the central nervous system is spared. Several organ systems may be involved, including not only the hematopoietic tissues and bones, but also the lungs. Diagnosis can be achieved without marrow examination by estimating the glucocerebrosidase (beta-glucosidase) activity of the peripheral blood leukocytes. Currently available conventional therapy is purely symptomatic in nature, including orthopedic procedures and splenectomy. On an experimental basis, splenectomy may be partial instead of total. Because the disease is due to an abnormality of the monocyte-macrophage system, cells that arise from the hematopoietic stem cell, and because the central nervous system is spared it has been considered a very suitable candidate for experimental therapeutic intervention. Bone marrow transplantation has been attended with limited success, enzyme therapy has not yet been successful, and studies utilizing gene transfer are underway. PMID- 3289657 TI - The many facets of adolescent drinking. PMID- 3289656 TI - Mixed acute leukaemias. AB - In recent years immunophenotyping and analysis of clonal rearrangement of immunoglobulin and T-cell antigen receptor genes have proved valuable for the diagnosis and classification of leukaemia. These techniques aid in the assignment of cell lineage in cases of acute leukaemia in which the standard FAB criteria of morphology and cytochemistry do not reveal clear lymphoid or myeloid phenotype. These new techniques have also revealed that the leukaemic blasts in a sizable minority of otherwise typical cases of acute leukaemia express 'inappropriate' lineage-associated markers and have been termed mixed acute leukaemias. The spectrum of characteristics encompassed by mixed acute leukaemias ranges from fairly common cases expressing one or two inappropriate markers to the more extreme, rare cases of acute leukaemia termed 'hybrid' in which a truly scrambled picture is seen. A subgroup of these mixed cases have two distinct populations of blasts, e.g. one lymphoid and the other myeloid. These observations raise a number of issues about the cell of origin of these leukaemias and about the mechanisms controlling the developmental regulation of expression of different lineage-associated markers. In addition, accumulating evidence suggests that inappropriate expression of markers may identify sub-groups of both acute myeloid and lymphoblastic leukaemia with an inferior prognosis. PMID- 3289658 TI - Tenth anniversary of smallpox eradication. PMID- 3289659 TI - Alzheimer's disease. AB - The current knowledge of the neuropathology, neurochemistry and genetics of Alzheimer's disease is reviewed. The hallmarks of neuropathology, namely neuritic plaques and neurofibrillary tangles, are described. The search for the aetiological agent(s) and a therapeutic strategy are briefly described and the location of a genetic locus for Alzheimer's disease on chromosome 21 is discussed. Future directions for research are suggested. PMID- 3289660 TI - Surgical treatment of chronic pancreatitis. AB - Surgery for chronic pancreatitis is indicated in patients with intractable pain, major complications, or possible underlying malignancy. The options include various resections or pancreatic ductal drainage procedures. Drainage has the benefit of low mortality and morbidity, but is often unsuitable for patients with diffuse disease. Careful follow-up and symptomatic assessment are necessary, and as many as 50% of these difficult patients may have persistent symptoms despite surgery. Careful selection of the patient and the procedure is essential for success. PMID- 3289661 TI - Lithotripsy. AB - In the last few years dramatic changes have occurred in the surgical treatment of stones in the upper urinary tract. Ninety-five per cent of all stones that previously necessitated open surgery are now amenable to less invasive techniques. Percutaneous nephrolithotomy (PCNL), developed in the early 1980s, has been complemented by extracorporeal shock wave lithotripsy (ESWL) and ureterorenoscopy (URS). This article traces the history of ESWL, defines its place in the management of patients with upper urinary tract stones, and looks forward to further advances. PMID- 3289662 TI - Clinicians' guide to antibiotics. Chloramphenicol. AB - Chloramphenicol, despite its well-recognized toxic side effects, is a cheap and useful antibiotic in the management of meningitis, typhoid, brain abscess and severe Haemophilus influenza infections. Where possible, drug levels should be monitored. PMID- 3289664 TI - Thumb reconstruction by the posterior interosseous osteocutaneous flap. AB - An island osteo-fasciocutaneous flap, based on the posterior interosseous vessels, is described for thumb reconstruction. The artery supplies the fascial plexus of the posterior forearm as well as the superficial and deep extensor muscles. A vascularised bone segment of the upper third of the ulna can be harvested, including a cuff of the extensor pollicis longus muscle. The flap was used successfully in two clinical cases. PMID- 3289663 TI - The true pioneer of less radical mastectomy (G. Keynes) PMID- 3289665 TI - Changes in area and thickness of expanded and unexpanded axial pattern skin flaps in pigs. AB - The pig buttock flap model was used firstly, to compare changes in expanded axial skin flap area with control flaps prior to flap elevation and 3 or 4 months post flap inset and, secondly, to compare the thickness of expanded and control flaps at elevation and for 3 to 6 months post-flap inset. Following 5 weeks' expansion and prior to elevation, the expanded tissue had gained a significant 63.3% mean increase in area compared with the control tissue (p less than 0.01). Immediately post elevation and inset, the expanded flaps were still significantly larger than the control flaps by a mean 29.8% (p less than 0.01) but had lost 56% of the original area gained. Little change in area occurred in the 3 months post-flap inset as the expanded flaps were still a mean 23.4% larger than the control (p less than 0.01). Dermal and cellular non-keratinised epidermal layers thickened markedly in expanded skin compared to control skin. Following elevation and inset of the flaps, both dermis and epidermis thickened in expanded and control flaps. PMID- 3289667 TI - Silicone gel sheet tie-over for skin graft on the eyelid following release of scar contracture. AB - A simple tie-over dressing using a silicone gel sheet gives firm fixation and allows direct inspection of the underlying grafted skin. Moreover, if haematoma or any complication is recognised, the sheet can be easily removed and reapplied. PMID- 3289666 TI - Comparative viability of expanded and unexpanded axial pattern skin flaps in pigs. AB - A comparison of viable areas of axial pattern flaps post inset was made between expanded and non-expanded pig buttock island flaps. The deep circumflex iliac artery and vein supply approximately the proximal 14 x 10 cm area of this flap. Larger flaps were raised on expanded and control sides of eight pigs to determine if expansion increased the area of survival. In six of eight pigs whose initial tissue expansion did not create more than approximately a 50% increase in skin area, the expanded flaps had a statistically significant increase in viable skin area (proportionally) 10 days post inset than their control flaps (p less than 0.05). Two other pigs did not conform to this pattern. Their initial tissue expansion was greater than 50%, and the resulting area of flap viability was proportionally less in expanded flaps than the control flaps. PMID- 3289668 TI - An improved design for the skin graft board. AB - A modified design is described for the skin graft board, which improves its performance when used in conjunction with the skin graft knife. PMID- 3289669 TI - History of the British Association of Plastic Surgeons. PMID- 3289670 TI - Sonomammography in benign breast disease. AB - An assessment is made of direct-contact B-scan sonomammography in 480 patients with clinically benign breast disease, of whom 121 underwent biopsy. In eight patients, ultrasound was normal when histology showed diffuse benign disease, and in four patients, ultrasound gave a benign result when histology showed malignancy. In 25 patients, attenuating shadow led to biopsy for a false positive diagnosis of carcinoma. Ultrasound can be used to avert unnecessary biopsy either by excluding a focal mass or by revealing clinically unsuspected malignancy when X-ray mammography shows moderate or marked density in patients complaining of a breast lump or nodularity. PMID- 3289672 TI - Threshold subtraction in radionuclide imaging. PMID- 3289671 TI - Ultrasound diagnosis of Ascaris lumbricoides in the pancreatic duct: the "four lines" sign. PMID- 3289673 TI - Tumours of the renal pelvis and ureter. Observations in 170 patients. AB - A study was made of 170 patients with renal pelvis or ureteric tumours, 160 of whom underwent surgery between 1948 and 1981. The most important aetiological factor was chronic phenacetin abuse: 21.7% of 83 patients with renal pelvis tumours and 11.4% of those with ureteric tumours gave a history of phenacetin abuse. The latency periods ranged from 24 to 26 years. This is the first report of a relationship between abuse of analgesics and urothelial tumours from the Federal Republic of Germany. PMID- 3289674 TI - Diagnosis and management of lymphoceles after renal transplantation. AB - Eighteen lymphoceles developed after 199 renal transplantations, 11 being asymptomatic. Ultrasound was the most sensitive method of detection. Seven lymphoceles were symptomatic, pelvic mass and decreased renal function being the most frequent signs. Five lymphoceles were successfully treated by instillation of iodate povidone into the lymphatic cavity; there were no complications or recurrences. This is a simple, safe and inexpensive method for the treatment of lymphoceles after renal transplantation. PMID- 3289675 TI - Terodiline, emepronium bromide or placebo for treatment of female detrusor overactivity? A randomised, double-blind, cross-over study. AB - In a randomised, double-blind study, 20 women with idiopathic detrusor instability and associated symptoms were treated with terodiline 25 mg bd, placebo, and emepronium bromide 200 mg tds--each drug being given for 3 weeks with placebo as wash-out period before cross-over. The results were evaluated according to drug preference, frequency charts and elimination of detrusor instability on cystometry. Serum levels of both drugs were monitored as control of tablet intake. The preference for terodiline to placebo was statistically significant: 14/3 women (P less than 0.05), and the majority of women (12/4) preferred terodiline to emepronium. Terodiline also gave a small but significant reduction in 24 h micturition frequency and eliminated detrusor instability in almost 50% of the patients (P less than 0.05). Side effects were frequent but mild in all three treatment periods. It was concluded that terodiline offers an alternative in the treatment of female detrusor instability. PMID- 3289676 TI - Benefits of combination therapy with flutamide in patients relapsing after castration. AB - Two hundred and nine patients with biopsy-proven stage D2 prostatic carcinoma showing disease progression after orchiectomy or treatment with DES (stilboestrol) or an LHRH agonist alone received combination therapy with the pure antiandrogen flutamide. In patients treated with DES, the oestrogen was replaced by the LHRH agonist [D-Trp6]LHRH ethylamide. The objective response to therapy was assessed according to the criteria of the US NPCP. Thirteen patients had a complete response to treatment, while partial and stable responses were achieved in 20 and 39 patients respectively (total objective response rate of 34.5%). The mean duration of response was 24 months. In the non-responders the median survival was 8.1 months with a 17% probability of survival at 2 years; the probabilities of survival at 2 years of the patients who showed partial and stable responses were 87 and 67% respectively. All patients who achieved a complete response are still alive. Combination therapy with Flutamide and castration (surgical or LHRH agonist) appears to be the treatment of choice for prostate cancer patients in relapse after standard endocrine therapy. PMID- 3289677 TI - Clinical versus ultrasonographic evaluation of scrotal disorders. AB - Clinical and ultrasonographic examinations of scrotal disorders were compared in 166 patients in order to determine their ability to distinguish between those diseases requiring surgery and those requiring clinical follow-up only. Ultrasound examinations were efficient in discriminating between normal and pathological findings. Extra-testicular lesions were readily differentiated from testicular ones. Although both clinical and ultrasonographic examinations had high sensitivity (90%) in detecting testicular cancer, the number of false positive findings was smaller after ultrasound examination. This gave a predictive value of a positive test of 53% after ultrasound examination but only 33% after clinical examination. Ultrasound examination may, therefore, reduce the number of surgical explorations in the scrotum and should be performed in patients with suspected testicular pathology based on history and palpatory findings. PMID- 3289678 TI - Bullous pemphigoid associated with renal carcinoma. PMID- 3289679 TI - Intravesical migration of Lippes loop with stone formation. PMID- 3289680 TI - Recommended techniques in small animal anaesthesia. IV. Anaesthesia and cardiac disease. PMID- 3289681 TI - After effects of the Chernobyl accident. PMID- 3289683 TI - Expression of ETS proto-oncogenes in astrocytes in human cortex. AB - In order to investigate a possible function of ETS proto-oncogenes in human brain, we incubated a polyclonal antibody raised against the viral region of E26 homologous to ETS1 and ETS2 with human brain frontal cortex sections. Our results show that this antibody decorates astrocytes but not neurons. By using astrocytomas of different grades as a source of astrocytes, we demonstrate the presence of ETS1 and ETS2 messenger RNAs and proteins. This leads to the idea that ETS genes are expressed in cells with dividing potentialities in human cortex and that they could provide a new marker for glial cells. Recently, a microduplication on chromosome 21 including ETS2 locus was described in karyotypically 'normal' Down's syndrome and suspected in Alzheimer's disease; when testing Alzheimer's disease-affected brain cortex sections, no obvious difference was observed with the technique used. PMID- 3289682 TI - Clinical concepts of Duchenne muscular dystrophy. The impact of molecular genetics. AB - Molecular genetics has transformed clinical concepts of Duchenne muscular dystrophy (DMD) in several different ways. (1) The disease can now be defined as a myopathy due to mutation at Xp21, a specific locus on the short arm of the X chromosome. (2) As a consequence of that discovery, any myopathy due to mutation at Xp21 should be a variant of DMD and should affect the same gene product. Moreover, any myopathy due to mutation at a location other than Xp21 should affect some other gene product. (3) For these reasons, DNA analysis is now needed for clinical diagnosis of muscle disease. (4) Xp21 myopathies may be mild or severe, may occur in females even though X-linked, and may be manifest only by high serum levels of creatine kinase. (5) Mental retardation is not consistently related to diseases that are encoded at Xp21. The association of mental retardation with DMD may be due to mutation in a separate gene near that for DMD. Concepts may soon be altered again as we learn about the affected gene product (dystrophin) and its role in these diseases. PMID- 3289684 TI - Localization of calcitonin gene-related peptide in the vestibular end-organs in the rat: an immunohistochemical study. AB - The present immunocytochemical study has demonstrated the presence of a dense fiber plexus containing calcitonin gene-related peptide (CGRP) in the vestibular end-organs in the rat. These fibers appear to originate from the central nervous system. PMID- 3289685 TI - Functional influence of areas 17, 18, and 19 on lateral suprasylvian cortex in kittens and adult cats: implications for compensation following early visual cortex damage. AB - The aim of the present study was to investigate the mechanisms of physiological compensation that is seen in the posteromedial lateral suprasylvian (PMLS) cortex of cats that received visual cortex (areas 17, 18, and 19) damage early in life. The strategy was to compare the response properties of PMLS neurons just after visual cortex damage (before any compensation has occurred) with the properties of PMLS neurons in normal cats and cats with long-standing visual cortex damage. Fourteen animals (aged 8 weeks, 18 weeks, 26 weeks, or adult) received a unilateral visual cortex lesion and recordings were made from ipsilateral PMLS cortex within about 24 h. An additional 4 adult cats were studied within either 24 or 3 h of a bilateral visual cortex lesion. Results from these animals were compared with results from normal cats and cats with long-standing visual cortex damage studied previously in this laboratory. At all ages studied, an acute visual cortex lesion reduced the percentage of direction-sensitive cells in PMLS cortex from nearly 80% in normal cats to about 20% after the lesion. In 8- and 18 week-old kittens, nearly all of the remaining PMLS cells responded best to stimulus movement but were not direction sensitive. In 26-week-old and adult cats, the remaining cells were divided between those that responded to movement without a directional preference and those that responded as well to stationary flashed stimuli as to moving stimuli. The presence of receptive-field surround inhibition was not affected significantly by an acute lesion at any age. In addition, few PMLS cells were orientation selective to elongated slits of light in cats with an acute lesion, just as in normal cats. The ocular dominance distributions of PMLS neurons also were normal following an acute visual cortex lesion at all ages studied. These results suggest that the influences of areas 17, 18, and 19 on the response properties of PMLS neurons are the same when the properties first reach maturity as in adult cats. The results also suggest that the mechanisms of physiological compensation for an early visual cortex lesion differ for different response properties. Compensation of direction sensitivity and orientation selectivity (an anomalous property) develops de novo after the early lesion. In contrast, compensation of ocular dominance appears to be due to the maintenance of a preexisting property that is present immediately after the lesion. Thus, plasticity after early visual cortex damage represents multiple developmental changes in the remaining visual pathways. PMID- 3289686 TI - Animal models of Alzheimer's disease: experimental cholinergic denervation. AB - Several animal models of AD have been developed, based upon the consistent finding of a presynaptic cholinergic deficit in AD. Significant cell loss in the NBM, the primary cortical cholinergic afferent, has been reported in AD. Lesions of the corresponding nuclei in the rodent and primate produce a persistent cholinergic deficit, but no consistent change in other neurotransmitter systems. Significant mnestic and cerebral metabolic deficits are observed acutely after lesion, which are responsive to pharmacological reversal and recover over time. Administration of AF64A produces similar mnestic and cholinergic deficits as NBM lesion, but these effects may be less responsive to pharmacological reversal. Administration of scopolamine, a muscarinic receptor antagonist, produces transient receptor blockade, mnestic deficits and deficits in cerebral metabolism, which can be reversed with a variety of pharmacological agents. The primary dissociations between these models and the deficits in AD are the lack of pharmacological response and recovery of function in AD patients and the presence of non-cholinergic neurochemical and cytoskeletal abnormalities. Future research should focus upon the systematic production and analysis of non-cholinergic neurotransmitter and cytoskeletal abnormalities to determine the contribution of these factors to the pathology seen in AD and the production of deficit in aged animals, which may more closely approximate the deficits in AD. The analysis of factors involved in recovery of function and pharmacological response in animal models may provide insight into potential treatment approaches to AD. PMID- 3289687 TI - 'Hidden lamination' in the dorsal lateral geniculate nucleus: the functional organization of this thalamic region in the rat. AB - The cyto-and myeloarchitecture of the rat's dorsal lateral geniculate nucleus (dLGN) display none of the laminar features characteristic of this thalamic region in carnivores and primates. Despite this, the rodent's nucleus contains a segregation of functionally and ocularly distinct afferents--organizational properties manifested in the prominent lamination of these other mammalian forms. The rat's dLGN can be divided into two main regions: an inner core and an outer shell. The inner core contains two ocular laminae receiving direct retinotopic projections from the contralateral nasal and ipsilateral temporal retinae, mapping the contralateral visual hemifield. The outer shell receives a retinotopic projection from the complete contralateral retina only, the representation of the ipsilateral hemifield being extremely compressed at the medial edge of this lamina. The retinotopic maps in these three ocular laminae (contra, ipsi, contra) are in conjugate register, so that lines of projection course rostro-ventro-medially from the optic tract at the thalamic surface through these laminae. Three morphologically distinct retinal ganglion cell types project to the dLGN, and the axons of these ganglion cells are partially segregated within the optic tract in anticipation of their segregation within the nucleus, where they terminate at distinct locations along the lines of projection. Type I and III cells terminate in the inner core of the nucleus, while type II and III cells terminate in the outer shell. The outer shell also receives a direct projection from the superior colliculus. These characteristics of the afferent termination within the rat's dLGN support the view of a general mammalian plan for the organization of this thalamic region, and provide a basis for further experimentation to test speculations about potentially homologous subdivisions of this nucleus. Conclusions regarding functionally analogous pathways are proposed with less confidence, due to the paucity of definitive evidence for physiologically distinct cell classes. The type I cells in the rat's retina are the likely homologues of the cat's alpha-cell. Geniculocortical relay cells driven by them have properties similar to the cat's Y-cell. The inner core of the nucleus then may transmit information of a Y-like nature onto striate cortex. The outer shell of the rat's nucleus, a portion of which receives collicular as well as retinal innervation, may convey W-like information onto striate cortex. The rat's retinogeniculate projection appears to be lacking a beta-cell-like pathway that may subserve X-cell function altogether. PMID- 3289688 TI - Complex sound analysis (frequency resolution, filtering and spectral integration) by single units of the inferior colliculus of the cat. AB - The central nucleus of the inferior colliculus (ICC) is a center of convergence of brainstem input and is critical for auditory information processing. Here, the analysis of complex sound spectra by single neurons in the ICC is investigated. Several measures of frequency resolution (excitatory/inhibitory tuning curves, effective bandwidths, critical ratio bands, critical bands derived using narrowband masking and two-tone separation paradigms) have been obtained from the responses of these neurons at sound pressure levels (SPL) up to 80 dB above the units' response thresholds (nearly 110 dB SPL). Among our results are the following: (1) Narrowband masking measures of critical bands from ICC neurons closely parallel behavioral measures using the same stimulus paradigm. (2) Frequency resolution power as measured by critical bandwidths varies little as a function of stimulus intensity. (3) Tuning curves of ICC neurons provide no simple basis for predicting the frequency filtering of the same neurons excited by complex sound spectra. (4) There is a frequency dependence of all measures of frequency resolution similar to that found in psychophysical determinations of critical bandwidths. That is, spatial frequency resolution in the cochlea is the origin for the resolution found in the ICC and in behavioral tests. (5) Lateral inhibition at the level of the ICC clearly plays a role in frequency resolution. (6) Frequency resolution is encoded by response rate changes of ICC neurons and is independent of tone response threshold, response latency, spontaneous activity, tone response type, binaural response type. It is concluded that spectral analysis of sound is established by processes, including lateral inhibition, independent of other basic response properties of neurons at the level of the ICC. PMID- 3289689 TI - Brain macrophages: questions of origin and interrelationship. AB - Brain tissue appears to contain several distinct types of macrophages. An effort is made here to present a description of the complete cohort of macrophages and sources of phagocytic activity in this tissue. Initially, the criteria and methods used for the identification of tissue macrophages in general are considered. These include some morphological and ultrastructural features, assessment of phagocytic activity, and histochemistry for intracellular and surface components. Each of these methods or criteria has certain advantages but also associated problems and limitations; all have been applied in various instances to brain tissue. In a final analysis, the most reliable means of identification of tissue macrophages involves a combination of all of these approaches. The identification and characterization of macrophages have been rendered extremely confusing in the brain because of so many different sources of these cells, both intrinsic and blood-derived. The classes of macrophages or phagocytic cells in brain tissue are microglia, supraependymal cells, epiplexus cells, meningeal macrophages, pericytes, and direct blood-derived macrophages. The morphology, location, and functional properties of each of these classes is described. In an overall view, brain tissue is very well protected by intrinsic macrophages, and the locations and distribution of these cells are consistent with other tissues. Finally, in a consideration of origin and interrelationship, the idea is presented that the most likely source for all or most brain macrophages is monocytic blood cells. The latter cells appear to migrate into the tissue from several sites during embryogenesis and may continue to enter, at least from blood vessels, in the adult state. PMID- 3289690 TI - Examination of the horse with colic. AB - The purpose of this detailed description of the clinical examination of the colic patient is to arrive at a specific diagnosis. However, this is hardly ever possible, but the practitioner should be in the position to establish the suspicion of an intestinal obstruction or to rule out its presence during the course of the development. Single clinical findings should not be interpreted in isolation but in relation to one another, so that a false diagnosis is not made. All clinical findings should be documented, so that when repeated examinations are carried out, findings can be compared with one another. This is also important in the evaluation of the cause of the condition; also, it will be easier to discern the results of therapy. PMID- 3289691 TI - Recognition and treatment of endotoxemia. AB - Endotoxemia occurs secondary to several diseases that disrupt the mucosal barrier to bacteria or their toxins. The effects of endotoxemia are varied and are mediated by a wide variety of proinflammatory substances. Although evidence certainly exists to incriminate the cyclooxygenase-derived products of arachidonic acid in the early responses to endotoxemia, various other mediators must also be considered. Treatment presently involves fluid replacement, correction of acid-base abnormalities, augmentation of cardiovascular function, and inhibition of cyclooxygenase activity. PMID- 3289692 TI - Recognition and management of disseminated intravascular coagulation in horses. AB - This article reviews normal hemostasis in order to provide the reader with the basis for understanding the pathogenesis and manifestations (both clinical and laboratory) of disseminated intravascular coagulation (DIC) in horses. DIC is subsequently discussed. The diagnosis and treatment of DIC in horses are also described. PMID- 3289693 TI - Prevention and management of peritonitis in horses. AB - Peritonitis and adhesions in the horse are best managed through prevention. Perioperative antimicrobial therapy, nonsteroidal anti-inflammatory therapy, experienced personnel, and good surgical techniques should minimize complications after surgery. Despite preventative measures, some horses still develop peritonitis after surgery. Immediate, intensive treatment is necessary to enhance their chances for survival. PMID- 3289694 TI - Alternative diagnoses in the colic patient. AB - Despite clinical signs compatible with obstruction or ischemia of the gastrointestinal tract, the clinician occasionally is unable to identify a gastrointestinal cause for colic. In this article, disorders not originating from obstruction or ischemia of the gastrointestinal tract but causing real or apparent abdominal pain are presented as alternative causes of colic. In addition, colic of gastrointestinal origin may be the primary inciting factor or a secondary complication of an alternative disorder, causing colic-like signs. Recognition of alternative diagnoses relies on a thorough and consistent approach to the clinical assessment of the equine colic patient and helps to ensure appropriate patient management. PMID- 3289695 TI - Initial treatment of colic. AB - This article discusses some of the rationales for the medical management of colic during the initial treatment period. The issue of colic pain control and the masking of clinical signs that may indicate severe gastrointestinal disease is addressed. Therapeutic considerations related to dehydration, metabolic imbalances, hemostatic disorders, antimicrobial therapy, fecal consistency, gastrointestinal decompression, and regulation of intestinal motility are reviewed. PMID- 3289696 TI - Decision for surgery. AB - Based on the clinical impression and the current knowledge of the clinical variables (rectal examination, abdominal distention, abdominal fluid, intractable pain) most likely to differentiate between medical and surgical cases, three decision trees are provided as a guide to making the management decision in a horse with abdominal pain. Prior elimination of horses with limited life expectancy because of age or function or where financial constraints are present is understood. It must be emphasized that most of the information presently available originates from referral centers where the prevalence of surgical candidates is much higher than in general practice. This would influence the accuracy of the clinician in identifying horses with a surgical lesion or estimating survival (positive predictive value). PMID- 3289698 TI - Intensive care of the patient after abdominal surgery. AB - After surgical correction of the underlying abdominal disorder, careful postoperative care is the most important factor resulting in increased survival rates. Intensive care of the postoperative patient can be done practically and economically. PMID- 3289697 TI - Anesthetic considerations for emergency equine abdominal surgery. AB - The physiologic changes that take place in horses presented for emergency abdominal surgery and the effects of these changes on the horse's anesthetic management are discussed. PMID- 3289699 TI - Recognition and management of ileus. AB - Ileus may occur in horses of all ages secondarily to drug administration, colic, exhaustion, peritonitis, or metabolic disorders. Ileus most commonly occurs following abdominal surgery for colic and is a significant cause of postoperative mortality in these horses. The most common clinical signs of ileus are decreased or absent intestinal sounds and gastric reflux. Ileus is treated by eliminating the initiating causes, correcting metabolic imbalances, decompressing distended bowel, providing analgesia, stimulating motility with drugs, and regulating exercise and feed and water intake. PMID- 3289701 TI - Interactive videodisc production in a university environment. PMID- 3289700 TI - Integration of computerized assessment screens into psychomotor skill modules at a school of nursing. PMID- 3289702 TI - Computers in nursing education. Where is the educational perspective? PMID- 3289703 TI - Insulin and the resting potential of hypoxic substrate-deprived myocardium. AB - Insulin stimulates ionic transport by the sodium pump and induces hyperpolarization in skeletal and cardiac muscle among other cells. The insulin induced hyperpolarization in most cases can be inhibited by exposure to cardiac glycosides or metabolic inhibition. However, extracellular accumulation of K ions leaking from hypoxic cells in superfused preparations may distort the effects of insulin on the resting potential. We used standard microelectrode techniques and perfused rabbit hearts submitted to hypoxia and substrate deprivation to reinvestigate the effects of insulin (6.4 nM) on the membrane potential. The membrane depolarized by about 6 mV and the action potential was reduced to a sharp spike without overshoot. Insulin restored the resting potential to control values but did not change the action potential configuration substantially. The insulin-induced repolarization was not due to reuptake of potassium as revealed by spectrophotometric determinations of myocardial K content. In addition, the diffusion component of the resting potential measured after inhibition of the sodium pump with 10(-4) M ouabain was not modified by insulin. Our results suggest that an increase in the contribution of electrogenic Na extrusion to the resting potential underlies the repolarizing effect of insulin of hypoxic substrate-deprived myocardium. PMID- 3289704 TI - Idiopathic Parkinson's disease: revised concepts of cognitive and affective status. AB - Assumptions regarding increased risk of dementia in Parkinson's disease and of depression mimicking the endogenous form are reviewed and challenged from the perspectives of recent findings in both the neuropsychological and anatomical domains. Evidence suggests that depression, while frequent, behaviourally resembles the reactive variety and that selective impairment of cognitive functions considered to depend upon the integrity of the frontal lobes accompanies this disorder. In this regard, it is speculated that the cognitive alterations seen in non-demented parkinson patients are the consequences of dysfunction of the caudate nucleus which contributes significantly to the normal activities processed through the frontostriate "complex loop". PMID- 3289705 TI - Jakob-Creutzfeldt disease associated with Wernicke encephalopathy. AB - Wernicke disease (WD) is a complication of alcoholism and malnutrition and usually presents acutely and is characterized by disturbances of consciousness, paralysis of the external ocular muscles, and ataxia. The disease results from deficiency of vitamin B 1, or thiamine, an essential coenzyme in intermediate carbohydrate metabolism. On the other hand, Jakob-Creutzfeldt disease (J-C) results from infection with an unconventional agent with a long incubation period and is characterized by a rapidly progressive dementia and histologically by a spongiform encephalopathy associated with neuronal destruction and pronounced astrogliosis. Combination of both diseases has not been reported in the literature previously and their relationship is uncertain. We present 3 cases with this interesting association and consider their relationship. PMID- 3289706 TI - Magnetic resonance imaging of meningio-angiomatosis. AB - We report the case of a patient with meningio-angiomatosis, a rare disorder of the cerebral cortex often associated with Von Recklinghausen's neurofibromatosis. Previous reports have described a variety of radiological findings but in general they have been of little value in the diagnosis of this disorder. We describe the magnetic resonance image, which identified a well-defined lesion. The imaging techniques are reviewed. PMID- 3289707 TI - In memoriam: William Strathearn Keith (1902-1987). PMID- 3289708 TI - Novel uses of EMG to study normal and disordered motor control. AB - The electromyogram (EMG) is unique in that it gives the output of a single class of neurons, a-motoneurons, in a way that can be readily recorded and studied in normal subjects as well as in patients with a variety of disorders. Although the EMG has been used for many years, new applications continue to be found. This paper reviews in succession four recent approaches to EMG recording that have provided insight into the function of the normal and the disordered nervous system. PMID- 3289709 TI - Mechanisms of action of neural grafts in the limbic system. AB - This review summarizes the range of possible mechanisms of action of neuronal grafts in the central nervous system. It aims to illustrate the capacity and limitations of the transplanted tissue in the promotion of neurological recovery after experimental surgical insults. PMID- 3289711 TI - House dust mite and dust control. PMID- 3289710 TI - Liver transplantation: current concepts. AB - In this decade liver transplantation has been established as the preferred treatment for children and adults with irreversible end-stage liver disease. Biliary atresia in children and nonalcoholic cirrhosis in adults are the most common indications for the procedure. Transplantation currently plays only a minor role in the treatment of hepatic malignant disease. Blood group compatibility between donor and recipient is preferred, but histocompatibility matching (tissue typing) currently has no significant role in the selection of recipients. Approximately 70% of recipients survive for 1 year, and these patients have an excellent prospect of long-term survival. The emerging evidence indicates that the quality of life and rehabilitation of most liver recipients are good. The current success of liver transplantation can be attributed to critical selection of recipients, modern anesthetic and surgical techniques, improved perioperative care, accurate diagnosis of rejection and superior immunosuppression with cyclosporine. PMID- 3289714 TI - Clinical nurse specialization: an annotated bibliography--research on the role. PMID- 3289712 TI - Environmental control of the home. PMID- 3289715 TI - Clinical nurse specialization: an annotated bibliography--organizational structure. PMID- 3289713 TI - Building-related illness. A review of available scientific data. AB - The allergist-immunologist is ideally trained to play a critical role in the recognition and evaluation of patients with building-related illness. The practitioners of this subspecialty should also take an active role in critical studies that will expand the knowledge base in this whole area, and collaborate as well with colleagues in toxicology and industrial hygiene to develop accurate and sensitive measures of implicated pollutants, irritants, and allergens. The role of multiple low level pollutants on healthy workers must be assessed in an objective fashion. Methods to evaluate and enforce regulations on building ventilation should be developed and widely applied. It is only in this fashion that an expanding population of office workers can be assured a suitable work environment as we emerge from the age of the industrial blue collar worker to the technical, office-based white collar worker. PMID- 3289716 TI - Therapeutic community: a Canadian update. AB - Therapeutic Community is forty years old. This paper describes its origins and reviews the more important contributions in the English speaking literature of the last decade. There have been few contributions from Canadians in spite of an upsurge of interest in Group Psychotherapy in the last few years. Some experiences in Toronto are reported. PMID- 3289717 TI - A double blind comparison of alprazolam and amitriptyline hydrochloride in the treatment of nonpsychotic depression. AB - In a six week, double-blind, parallel study of alprazolam and amitriptyline hydrochloride in 130 outpatients suffering from moderate to severe nonpsychotic depression, alprazolam was as effective as amitriptyline hydrochloride in relieving depressive symptoms and significantly more effective in relieving symptoms of anxiety and somatization. Alprazolam showed an earlier onset of activity in most measurements of efficacy and produced fewer side effects than amitriptyline hydrochloride. Anticholinergic side effects were reported more frequently by patients taking amitriptyline hydrochloride, while drowsiness was reported more frequently by patients taking alprazolam. At the end of the study, the average daily doses were 2.4 mg alprazolam and 135 mg amitriptyline hydrochloride. The Hamilton Psychiatric Rating Scale for Depression, Hamilton Anxiety Rating Scale, Physician's Global Impressions, Patients' Global Impressions, Hopkins Self-Rating Symptom Scale, and Symptom and Side Effects Checklist were evaluated at the end of weeks 1, 2, 3 and 6 to determine and compare the efficacy and safety of the two study drugs. PMID- 3289718 TI - Psychiatric consultation in a general hospital. AB - The psychiatrist's role in the therapeutic management of a wide range of hospitalized persons is now recognized. This study investigated the extent and the pattern of consultations among the medical specialties (medicine, surgery, obstetrics/gynecology, family practice, pediatrics and psychiatry) in a large teaching hospital over a one year period. Among the specialties consultations were requested most often from within the same specialty; for example, medicine sought 64.4% consults from medicine. The proportion of patients with an associated psychiatric diagnosis in each of the specialties ranged from 2 to 21%. Psychiatric consultations on these patients ranged from 5 to 13 per hundred (medicine = 12, surgery = 8.9, family practice = 13.2 and pediatrics = 5). Consultations rates reported in previous studies were also reviewed. Factors that may contribute to the generally low rate of psychiatric consultation and the implications for providing better care are then discussed. PMID- 3289719 TI - The psychiatrist's role in determining competency to consent in the general hospital. AB - In the general hospital, consultation-liaison psychiatrists are frequently consulted regarding issues of competency to consent to medical and surgical procedures and treatments. It is necessary that psychiatrists practicing in this setting have a thorough awareness of both the legal aspects of competency and consent and the clinical situations which can arise. In this paper we discuss the legal basis for consent and various definitions proposed for mental competency to consent to treatment. We describe a number of typical situations which lead to psychiatric consultation and suggest an appropriate approach to their resolution. PMID- 3289720 TI - Research in consultation-liaison psychiatry: the Toronto General Hospital experience. AB - Research that has developed in association with the consultation-liaison service at the Toronto General Hospital is reviewed in this paper. The value of systematic investigation in the consultation-liaison setting is addressed. Such approaches may be necessary to establish consultation-liaison psychiatry as a theoretical discipline which can advance knowledge in addition to enhancing patient care. PMID- 3289721 TI - Alcohol and drug problems: a challenge to consultation-liaison psychiatry. AB - Although alcohol and drug problems are prevalent in the population at large and among patients in general hospitals, they have not been a major concern of consultation-liaison psychiatry. A setting in which all psychiatric consultations are directed to such problems, the Clinical Institute of the Addiction Research Foundation, is described, and parameters of its consultation experience are explored. It is suggested that dealing with alcohol and drug problems should become an integral aspect of consultation-liaison psychiatry. Such a development may prove to be especially fruitful in teaching a comprehensive approach to patient care. PMID- 3289722 TI - Psychiatric consultation-liaison services to an obstetrics and gynecology department. AB - This paper describes the psychiatric consultation-liaison services provided to an Obstetrics and Gynecology Department. Clinical services are provided both by program consultation and by individual inpatient and outpatient referral. Clinical problems in obstetrics and gynecology that result in psychiatric referral are discussed. Research interests which play an important role in the program are described. Educational activities are directed toward ward and clinic staff, undergraduate medical students, residents and the practising specialist. The combination of well articulated consumer requests, interested gynecologists and obstetricians, broadened gynecology residency training objectives, and greater involvement of consultation-liaison psychiatrists suggests a promising future for psychosomatic obstetrics and gynecology. PMID- 3289723 TI - Psychosis and positron tomography. AB - The new technology of positron emission tomography (PET) offers hope in developing objective biological indices and correlates of various psychotic states, including schizophrenia. PET is of the order of a million to a billion times more sensitive than MRI (magnetic resonance imaging) and is now successfully measuring the densities of various brain neurotransmitter receptors in health and disease. PET data in schizophrenia patients confirm that delusions and hallucinations are controlled by neuroleptics when the D2 dopamine receptors are specifically blocked. D1 receptors are not involved. The elevation of D2 receptors as a possible basis for psychotic symptoms needs additional investigation because of technical difficulties which need to be resolved. The rapid development of PET indicates its promise for differential diagnosis as well as its value in treating the psychoses. PMID- 3289724 TI - Optically clear and vacuolated nuclei. Two useful signs for the transoperative diagnosis of papillary carcinoma of the thyroid. AB - Ground glass nuclei and Orphan Annie Eye nuclei are currently accepted as the most useful signs for the diagnosis of papillary carcinoma of the thyroid. The nuclear appearance, however, is not used in transoperative studies because the general opinion is that they are only found in permanent sections. To compare the nuclear aspect of the permanent with frozen sections and imprints, a prospective double-blind study of 48 transoperative thyroid specimens was performed. The results show that the nuclei are similar when examined by the three techniques. PMID- 3289725 TI - Melanocytic schwannoma. AB - The clinical, histopathologic, immunohistochemical, and electron microscopic findings of two cases of melanocytic schwannoma are reported. One case, which occurred in the parotid gland, is believed to be the first reported in this location. The other case was located in the sacral spinal region. A review of the clinical and pathologic features of 32 previously reported cases is presented. The recurrence rate was 24%. Those tumors that were incompletely excised and/or located in the cranial nerves had the worst prognosis. PMID- 3289726 TI - Acute neurologic dysfunction after high-dose etoposide therapy for malignant glioma. AB - Etoposide (VP-16-213) has been used in the treatment of many solid tumors and hematologic malignancies. When used in high doses and in conjunction with autologous bone marrow transplantation, this agent has activity against several treatment-resistant cancers including malignant glioma. In six of eight patients (75%) who we treated for recurrent or resistant glioma, sudden severe neurologic deterioration occurred. This developed a median of 9 days after initiation of high-dose etoposide therapy. Significant clinical manifestations have included confusion, papilledema, somnolence, exacerbation of motor deficits, and sharp increase in seizure activity. These abnormalities resolved rapidly after initiation of high-dose intravenous dexamethasone therapy. In all patients, computerized tomographic (CT) brain scans demonstrated stability in tumor size and peritumor edema when compared with pretransplant scans. This complication appears to represent a significant new toxicity of high-dose etoposide therapy for malignant glioma. PMID- 3289727 TI - Thorotrast-associated gliosarcoma. Including comments on thorotrast use and review of sequelae with particular reference to lesions of the central nervous system. AB - The occurrence of a glioblastoma with sarcoma, a gliosarcoma, in the left frontal temporal area of a 49-year-old woman with a history of Thorotrast exposure, is described. Thorotrast-laden histiocytes and free Thorotrast material were found in both components of the tumor. An overlying, adherent dural cranial lesion was found to contain massive deposits of Thorotrast embedded in a dense fibrotic and sclerotic stroma with focal calcification. These features are typical of "Thorotrastoma." Thorotrast stains greenish-brown with hematoxylin and eosin and appears as refractile granular particles of relatively uniform size either within histiocytes or as free material. The radioactivity of the deposits was confirmed through the use of a scintillation counter, and 232 thorium was definitively identified though the use of scanning electron microscopy with energy-dispersive X-ray analysis. Immunohistochemical studies of the tumor demonstrated glial fibrillary acid protein (GFAP) immunoreactivity in areas of glioma and focal vimentin and actin immunoreactivity in areas of sarcoma. Thorotrast-associated lesions of the central nervous system (CNS) are infrequently reported, and a Thorotrast-associated gliosarcoma has not yet been reported. The use of Thorotrast, its radiobiology, and sequelae are reviewed with particular emphasis on lesions occurring in the CNS. PMID- 3289728 TI - Human squamous cell carcinoma lines express oncofetal 44-kD polypeptide defined by monoclonal antibody to mouse fetus. AB - Most primary human carcinomas uniformly express an oncofetal epitope which has not been demonstrated previously in established human carcinoma cell lines. We successfully derived several low-passage cell lines of human squamous cell carcinoma (SCC) from head and neck tumors using an in vitro adaptation procedure, characterized these lines, and examined them for expression of a 44-kilodalton (kD) polypeptide (PP) oncofetal antigen (OFA) at the cell surface. Newly established an in vitro-passaged SCC cells retained characteristic microvilli, numerous desmosomes and tonofilaments, abundant rough endoplasmic reticulum, osmophilic keratohyaline granules, and other features of the primary SCC cells. These new cell lines and two long-term, established SCC lines (FaDu and Detroit 562) displayed OFA at the cell surface, as determined by flow cytometry using monoclonal antibody (MoAb) 115. While the FaDu and Detroit 562 lines exhibited aneuploidy during flow cytometric analysis, the new, low-passage SCC lines that we developed remained diploid as were the primary SCC cells from which they were derived. We propose that the expression of a 44-kD OFA is a common feature of human SCC. This marker may prove useful in the detection and treatment of these tumors. PMID- 3289729 TI - Immunocytochemical detection of progesterone receptor in breast cancer with monoclonal antibody. Relation to biochemical assay, disease-free survival, and clinical endocrine response. AB - A new immunocytochemical assay for progesterone receptor (PgR-ICA) employing the monoclonal antibody JZB 39 was used to study tumors from two series of patients with breast cancer. In Series 1 assay results were in agreement with those of biochemistry in 76% of 338 cases (P less than 0.001) and in 54% of 101 cases in Series 2 (P less than 0.001). Agreement was better in Series 1 because it included fresher, previously untouched specimens. There were 70 patients in Series 1 with known clinical endocrine response. A negative assay correlated with disease progression in 45 of 57 patients, significantly better than with biochemistry (P = 0.013). In comparing 39 women with rapid disease progression with 39 free of disease at 5.1 years, those with PgR-ICA-positive tumors were over four times more likely to remain disease-free than those with negative results (P = 0.007). Product moment life-table analysis of 79 patients from Series 2 showed a significantly better cumulative survival for those with PgR-ICA positive tumors (P = 0.047). These findings indicate that PgR-ICA should be of value in planning therapy and predicting disease course in breast cancer patients. PMID- 3289731 TI - The computer and stereotactic surgery in neurological surgery. AB - The technical aspects, current uses, and future clinical applications of stereotactic surgery and three-dimensional imaging in neurological surgery are reviewed. PMID- 3289730 TI - The planning of orthopaedic reconstructive surgery using computer-aided simulation and design. AB - Three-dimensional reconstructions from computed tomographic (CT) images are currently being used clinically in a wide variety of orthopaedic surgical applications. The computer may be used to select the optimum standard artificial joint replacement or to design a custom artificial joint replacement for a particular patient. Where large bony defects exist, the computer may be used to design bone allografts for joint reconstruction and to manufacture models of the bones for use in planning the surgery. In cases where osteotomies are performed to improve the mechanics of the joint, each proposed osteotomy may be simulated on the computer to identify the surgical plan that will optimally normalize the diseased joint. PMID- 3289732 TI - Computed tomography of the masticatory system--a review. AB - Computed tomography (CT) is a practical method for evaluating the masticatory system, since it shows the bone structures and soft tissues at the same time. It enables one to measure the densities and dimensions of various tissues. All parts of the temporomandibular joint (TMJ), condylar process, mandibular fossa and disc and the main masticatory muscles are well demonstrated by CT in projections which are not possible with other radiological methods. PMID- 3289733 TI - Acute lymphocytic leukemia with 9p anomalies. A report of four additional cases and review of the literature. AB - Childhood acute lymphocytic leukemia (ALL) with partial deletion of the short arm of chromosome 9 (9p-), particularly in the p21-22 region, associated with bulky disease, has been regarded as a possible subgroup of ALL. We have reviewed clinical and cytologic data in 128 cases of ALL (childhood and adult). Four of them had 9p anomalies. Two patients had a deletion in the 9p21 region associated with another deletion (9p13----pter) in one case and with t(1;19)(q21;p13) in the second patient. A third patient had a t(9;14)(p21;q12) balanced translocation associated with 14q22----qter deletion; the last patient showed a t(5;9)(p14;q21) unbalanced translocation also associated with 14q deletion. All four patients had lymphomatous ALL, but immunophenotype was non-T, in the four cases, (non-T, non-B in two patients and common ALL in the two remaining cases). Acute lymphocytic leukemia with 9p anomalies appears relatively frequently and is usually associated with poor prognostic features (i.e., bulk disease and high leukocyte counts) but does not seem restricted to childhood and T-cell lineage. PMID- 3289734 TI - Ribonucleotide reductase activity and growth of glutathione-depleted mouse leukemia L1210 cells in vitro. AB - L1210 cells treated with L-buthionine-(S/R)-sulfoximine (BSO) had glutathione (GSH) and non-protein thiol levels only 15% that of control. These GSH-depleted cells grew as well as the control L1210 cells and there was no decrease in ribonucleotide reductase activity in situ as measured by the conversion of [14C]cytidine to deoxytidine nucleotides and incorporation into DNA. Further, when these BSO-stressed cells were treated with hydroxyurea or IMPY, there was no potentiation of the inhibition caused by hydroxyurea or IMPY alone. These data indicate that the glutathione/glutaredoxin system of ribonucleotide reductase is not the sole carrier of reducing equivalents from NADPH for the reduction of the 2'-position of the corresponding ribonucleoside 5'-diphosphate; and that glutathione is not critical in regenerating the tyrosyl free-radical on the M2 subunit which is destroyed by the hydroxyurea or 2,3-dihydro-1H-pyrazolo-[2,3 alpha]imidazole (IMPY) treatment. PMID- 3289735 TI - Promotive effect of 4,4'-methylenebis(N,N-dimethyl)benzenamine on N-bis(2 hydroxypropyl)nitrosamine-induced thyroid tumors in Wistar rats. AB - The promotive effect of 4,4'-methylenebis(N,N-dimethyl)benzenamine (MDBA) on 2 stage thyroid tumorigenesis induced by N-bis(2-hydroxypropyl)nitrosamine (DHPN) in Wistar male rats was investigated. Animals were given i.p. injections of DHPN, and then a basal diet containing 0.0375% MDBA for 19 weeks. In addition, localization of the thyroid-stimulating hormone (TSH) in the pituitary gland was investigated. Levels of TSH and T4 in serum were measured by radioimmunoassay (RIA). The addition of MDBA to the diet significantly increased the incidence and numbers of preneoplastic lesion (focal hyperplasia), adenoma and carcinoma of the thyroid. TSH was usually localized in the thyroidectomy-cell in the anterior lobe of the pituitary gland, and the number of TSH-positive cells increased in the group treated with MDBA. Mean circulating levels of TSH were elevated in all MDBA treated groups, and mean T4 levels in groups treated with MDBA were significantly lower different (P less than 0.05) than those in control groups. PMID- 3289736 TI - Adjuvant chemotherapy in breast cancer. A review of the literature. PMID- 3289737 TI - Antiidiotype antibodies in cancer patients receiving monoclonal antibody to carcinoembryonic antigen. AB - The initial 10 patients of a Phase I clinical trial involving multiple injections of murine monoclonal anti-carcinoembryonic antigen (CEA) antibody, NP-2, were studied for the presence in their sera of antiidiotypic antibody. Most patients had advanced gastrointestinal adenocarcinoma and received 1 mg/m2 monoclonal antibody three times weekly, or once a week, resulting in five to 13 injections over 12 to 240 days. Antiidiotype antibody was detected with a blocking radioimmunoassay using [125I]NP-2-F(ab')2 binding to CEA-coated microwells and [125I]NP-4-F(ab')2 as a control antibody. Five out of 10 patients demonstrated 65 96% inhibition of NP-2 binding at 1/20 dilution of serum compared to NP-2 binding in the presence of pretreatment sera. The inhibitory activity was preserved after adsorption over a polyclonal mouse IgG immunoadsorbent whereas exposure to a NP-2 affinity column completely depleted the activity. Specificity testing, including the blocking effect of patient sera on the control antibody NP-4, and interference by the possible presence of circulating NP-2, circulating CEA, and human anti-CEA activity, confirmed that the inhibition observed was specific for NP-2 and was caused by an agent with CEA-like characteristics. Longitudinal studies demonstrated that elevated titers of antiidiotypic antibody appeared later in the course of immunization than did antibody against mouse immunoglobulin. These studies indicate that patients can be sensitized to the idiotype (anti-combining site and/or combining site-related) of monoclonal antibodies to CEA following multiple infusions. PMID- 3289738 TI - Induction of carcinoembryonic antigen secretion and modulation of protein secretion/expression and fibronectin/laminin expression in human colon carcinoma cells by transforming growth factor-beta. AB - We have recently reported that TGF-beta induces a response similar to that of planar polar differentiation promoters in human colon carcinoma MOSER cells. N,N Dimethylformamide and TGF-beta had similar effects on MOSER cells with respect to reversible inhibition of growth (both in monolayer culture and semisolid medium), induction of fibronectin expression and the induction of morphological alterations (Cancer Res., 47:2950-2954, 1987). Since the expression of carcinoembryonic antigen (CEA) has been reported to be modulated by planar polar compounds that promote differentiation in colon carcinomas, we addressed the issue of whether the differentiation-like effects of TGF-beta on these cells would also encompass modulation of CEA expression in the MOSER cells. The biological modulating effects of TGF-beta on extracellular matrix glycoprotein expression and the expression and secretion of cellular proteins were also studied in view of the reported modulating effects of this growth factor on untransformed, noncolonic cells. In this communication we report that TGF-beta induced the synthesis of fibronectin and laminin but not collagen IV. TGF-beta also induced CEA secretion in a dose-dependent manner. Elevated CEA secretion was detected following 48 h of TGF-beta treatment and a 16-fold increase in CEA secretion was observed following 7 days of treatment. The cells were committed to secrete CEA following one dose of TGF-beta treatment. The enhanced expression of four cellular proteins (Mr 42,000, Mr 48,000, Mr 52,000, and Mr 55,000) and the enhanced secretion of three proteins (Mr 66,000, Mr 200,000, and Mr 400,000) were also induced. Some of these protein alterations were detected as early as 6-24 h following TGF-beta treatment. It is concluded that TGF-beta modulated the production and secretion of CEA, the synthesis of fibronectin and laminin, and the expression and secretion of several cellular proteins in the colon carcinoma MOSER cells. To our knowledge, this is the first report on the modulation of CEA and laminin by TGF-beta in tissue-cultured cells, and is the first report on the modulation of cellular proteins by this growth factor in human colon carcinoma cells. PMID- 3289739 TI - Differential responsiveness of human breast cancer cell lines MCF-7 and T47D to growth factors and 17 beta-estradiol. AB - A completely serum-free assay method has been used to compare the mitogenic activities of polypeptide growth factors and estrogens with MCF-7 and T47D human breast cancer cells in culture. The lines were maintained in a viable, slowly dividing condition in Ham's F12 and Dulbecco's modified Eagle's medium (1:1) supplemented with sodium bicarbonate (2.2 g/liter), 15 mM 4-(2-hydroxyethyl)-1 piperazineethane-sulfonic acid, human transferrin (10 micrograms/ml), and bovine serum albumin (200 micrograms/ml) (designated Tf/BSA). This medium allowed the assay of mitogenic activities as measured by multiple rounds of cell division and permitted comparisons of the biological potencies of growth factors within functional families as well as of dissimilar mitogens. Insulin-like growth factor I (IGF-I) was the most potent mitogen studied, showing ED50 values of 160 pg/ml and 1.7 ng/ml with the MCF-7 and T47D cells, respectively. Insulin-like growth factor II and insulin were less active, with ED50 values of 0.55 and 1.2 ng/ml with MCF-7 cells and 4.3 and 10 ng/ml with the T47D cell line, respectively. Mitogens sharing epidermal growth factor-like functional properties had ED50 values from 35 pg/ml to 2.5 ng/ml, while transforming growth factor type beta and platelet-derived growth factor had no detectable stimulatory effects. Basic fibroblast growth factor had ED50 values of 0.42 ng/ml and 3.7 ng/ml for the MCF 7 and T47D cells, respectively, while acidic fibroblast growth factor was nearly inactive. In phenol red-free Tf/BSA, 17 beta-estradiol caused a 60% increase in MCF-7 cell numbers over controls in 8 days while having no effect on growth of the T47D cell line. From MCF-7 conditioned Tf/BSA medium, IGF-I was identified by biological activity, by radioimmunoassay (approximately equal to 2 pg/ml) and by estimation of molecular weight (8,000) under dissociating conditions. The concentration of IGF-I was not affected by 17 beta-estradiol treatment. The data indicate that induction of acid stable, low molecular weight autocrine growth factors involved more regulation than defined by estrogens alone. The minimal effects of 17 beta-estradiol in Tf/BSA opened several possibilities including the putative roles of other serum-borne hormones, growth factors and regulators in autocrine growth factor induction. PMID- 3289741 TI - Note re: December 1967 cover of Cancer Research. PMID- 3289740 TI - Selective inhibition of human ribosomal gene transcription by the morpholinyl anthracyclines cyanomorpholinyl- and morpholinyldoxorubicin. AB - Upon incubation of cultured mammalian cells with the new anthracycline analogues cyanomorpholinyldoxorubicin and morpholinyldoxorubicin, nucleoli irreversibly segregate into their substructures which form individual portions of the nucleolar mass and characteristic electron-dense components adjacent to the nucleolonema; these changes in nucleolar ultrastructure are similar to those produced by actinomycin D (AMD). In the present study we have examined the effects of anthracycline analogues on RNA synthesis, localization of RNA polymerase I in situ, and activity of RNA polymerases in vitro, and compared these effects with those of the parent compound doxorubicin (DOX) and AMD. The results show that, following treatment with cyanomorpholinyldoxorubicin, morpholinyldoxorubicin, and AMD, but not DOX, RNA polymerase I-containing transcription complexes were reduced, reflecting the transcriptional activity of the rRNA genes. The residual RNA polymerase-containing entities were redistributed into cap-like aggregates at the nucleolar periphery. Within 30 min of exposure to cyanomorpholinyldoxorubicin, morpholinyldoxorubicin, and AMD, but not DOX, a 75-90% inhibition of RNA polymerase I activity in situ and in vitro was observed. At this early time there was no significant inhibition of nucleoplasmic RNA labeling in situ or RNA polymerases II and III activities in vitro. At later times following reincubation in drug-free medium, inhibition of all three polymerases was observed. Impairment of RNA synthesis appeared to result from drug interaction with the DNA template rather than an interaction with RNA polymerase I itself. We conclude that the morpholinyl derivatives of DOX are preferential inhibitors of ribosomal gene transcription and that they may have a mechanism of action similar to that of AMD on rRNA synthesis. PMID- 3289742 TI - The role of the orthopaedic surgeon in the treatment of bone pain. PMID- 3289743 TI - Neurological mechanisms in cancer pain. PMID- 3289744 TI - Scientific and clinical aspects of radiotherapy in the relief of bone pain. AB - Radiotherapy is highly effective in relieving metastatic bone pain. The mechanism of action remains unclear, and tumour shrinkage may be relatively unimportant in producing analgesia. Various techniques of localized external beam therapy are in use with no consistent advantage seen for either high doses or multiple fractions. For scattered painful metastases, wide-field hemibody irradiation or the systemic administration of radioisotopes are effective but may be associated with greater toxicity than localized irradiation. PMID- 3289746 TI - A new stable epithelial cell line (RK-L) from normal rat kidney. AB - A stable epithelial cell line has been established from the kidneys of a normal Sprague-Dawley rat. This line, termed RK-L, has a high proliferative capacity (minimal doubling time 12.3 h) and can be grown in medium containing 1% fetal bovine serum. Thus far, the line has been carried through more than 60 serial passages. The RK-L cells were found to display similarities with kidney tubule cells. Using light microscopy, confluent cultures were seen as pavement-like monolayers forming domes, which are thought to result from transepithelial fluid transport. Electron microscopy revealed polarized cells that had microvilli on the apical surface, junction complexes in the apical part of the lateral cell membrane, and a basal lamina-like layer. Pinocytotic activity was indicated by infoldings of the apical plasma membrane and the formation of vesicles. The RK-L line should prove useful for investigations of kidney tubule transport mechanisms. PMID- 3289745 TI - Scintigraphic detection in mice of inflammatory lesions and tumours by an indium labelled monoclonal antibody directed against Mac-1 antigen. AB - The monoclonal antibody, 3A33, directed against Mac-1 antigen which is expressed essentially on macrophages and polymorphonuclear cells, was injected i.v. into mice, as part of an attempt to visualize inflammatory lesions and tumours by external scintigraphy. The monoclonal antibody, a rat IgG2a, was conjugated with a bifunctional chelating agent, diethylenetriaminepentaacetic acid at a 1:1 molecular ratio and complexed with 111-indium, a procedure which apparently did not alter its binding to peritoneal macrophages and provided relatively stable cell labelling. An unrelated rat IgG2a of unknown specificity radiolabelled in the same manner as 3A33 served as a control. The uptake of i.v. injected 3A33 by peritoneal macrophages was up to 50 times that of unrelated IgG2a. After i.v. inoculation, the antibody accumulated in the liver, spleen, lung, in foot-pad inflammatory reactions induced by injection of Freund's adjuvant and in experimentally grafted tumours. The 3A33: non-specific IgG2a uptake ratio in inflammatory lesions and tumours, however, was much lower than for peritoneal macrophages and was generally close to 2. This was sufficient to obtain scintigraphic images of inflammations and tumours. The images obtained after injection of 3A33 were clearly of better quality than those given by the non specific immunoglobulin. They could be improved by subtraction of the vascular images obtained after injection of 99m-technetium serum albumin. The labelling of Mac-1-positive blood mononuclear cells by in vitro incubation with radioactive 3A33 was not intense enough to allow scintigraphic imaging after in vivo re infusion but seemed more selective than the injection of whole antibody in detecting inflammatory reactions. These results seem interesting in view of the potential human application to the detection inflammatory lesions and the appreciation of tumour inflammatory components. Possible improvements in the technique are discussed. PMID- 3289747 TI - [An epidemiological survey of filarial chyluria]. PMID- 3289748 TI - [An investigation on secondary attack rate in families and environment contamination of bacillary dysentery in urban and rural areas]. PMID- 3289749 TI - [A preliminary observation on the bactericidal effect of chlorinated trisodium phosphate]. PMID- 3289751 TI - [Cryptosporidiosis: a new parasitic zoonosis]. PMID- 3289750 TI - [Epidemic Shiga bacillus dysentery in China]. PMID- 3289752 TI - Newer emergency reperfusion techniques in acute myocardial infarction. AB - We have given an overview of the management of the acute myocardial infarction patient utilizing the aggressive reperfusion techniques available today. Anatomic reperfusion rates have been over 95% with the combined methods described. The remaining problems technically are those of earlier reperfusion, methods to enhance myocardial recovery after ischemia, and prevention of restenosis or reocclusion. The use of laser methodology, coronary sinus retroperfusion, partial left heart bypass, and other innovative strategies may improve these results. The introduction of tissue plasminogen activator will affect our approach and will profoundly alter society's expectations of therapeutic success. Still, patients will die from acute myocardial infarction and its complications. The search for a prevention must, therefore, not be overshadowed by our current enthusiasm for reperfusion techniques. Hopefully, our current approach will become a historical footnote as breakthroughs in preventive strategies occur. PMID- 3289753 TI - The yeast cell-type-specific repressor alpha 2 acts cooperatively with a non-cell type-specific protein. AB - The yeast alpha 2 protein is a cell-type-specific transcriptional repressor. It acts by binding to an operator located upstream of each of its target genes. In this paper, we describe a protein (GRM) that is present in all cell types and binds cooperatively with alpha 2 resulting in an unusual arrangement of the two proteins at the operator. A dimer of alpha 2 occupies the two ends of the operator and straddles the GRM protein, which binds to the center of the operator. Using mutant operators, we show that the recognition sequences for both GRM and alpha 2 are required for repression of a test promoter in vivo. Finally, we deduce that the GRM/alpha 2 cooperativity is mediated through a protein protein interaction between GRM and the N-terminal domain of alpha 2. This conclusion follows from the observation that the isolated C-terminal domain of alpha 2 can co-occupy the operator with GRM but does not bind cooperatively with GRM. PMID- 3289754 TI - Background to bicoid. PMID- 3289755 TI - Activation of cdc2 protein kinase during mitosis in human cells: cell cycle dependent phosphorylation and subunit rearrangement. AB - HeLa cell p34, homolog of the yeast cdc2+/CDC28 protein kinase, has been investigated. p34 was phosphorylated at two or more sites and existed in a complex with p13, the previously identified homolog of the suc1+ gene product of S. pombe. A fraction of the most highly phosphorylated form of p34 was also associated with p62, a newly identified protein that became phosphorylated in vitro. The phosphorylation state of p34, its association with p62, and the protein kinase activity of the complex were each subject to cell cycle regulation. In newly born cells early in G1, p34 was unphosphorylated, not associated with p62, and inactive as a protein kinase. Each of these conditions was reversed in G2 and the p34/p62 complex was maximally active as a protein kinase, with respect to both endogenous and exogenous substrates, during mitotic metaphase. p34 may act to regulate the G2/M transition in HeLa cells. PMID- 3289756 TI - The microtubule-dependent formation of a tubulovesicular network with characteristics of the ER from cultured cell extracts. AB - The formation of a dynamic tubulovesicular membrane network that resembles the endoplasmic reticulum (ER) has been observed in extracts of cultured chick embryo fibroblasts (CEF cells) using video-enhanced differential interference contrast microscopy. Initially, membranes in the CEF extracts appeared amorphous and aggregated, but with time, membrane tubules moved out along stationary microtubules. The membrane tubules formed new branches on intersecting microtubules and fused with other branches to form a network of interconnected polygons. The tubulovesicular network was solubilized by detergent and took on a beaded morphology in a hypotonic buffer. Formation of the tubulovesicular network required ATP and microtubules. The network did not contain elements of the plasma membrane, Golgi apparatus, or mitochondria but could be labeled with ER markers. We suggest that the tubulovesicular network contains components from the ER and is formed by membrane associated motors moving upon microtubules in a process we call microtubule-dependent tethering. PMID- 3289758 TI - Distribution of actin filaments in human malignant keratinocytes. AB - Distribution of actin filaments in human malignant keratinocytes was examined by immunofluorescence staining. The primary cultures were obtained from a squamous cell carcinoma, a basal cell carcinoma, and Bowen's disease. Rhodamine-phalloidin staining revealed that actin filaments were occasionally organized to form stress fibers, many short bundles with a ripple appearance, and regular arrays of actin patches. Some of these structures appeared in untransformed keratinocytes as a result of a brief exposure to a tumor promotor, TPA. These findings suggest that regulation of actin functions is involved in neoplastic processes from the very early stages and that alteration is persistent in neoplastic cells. PMID- 3289759 TI - Targeting of antiviral drugs bound to protein carriers. AB - The value of antiviral drugs would be improved by their selective delivery into infected cells. This goal can be achieved by conjugating the drug to a protein which is taken up specifically by the cells where the virus grows. Conjugates will be pharmacologically effective in these cells if the bond linking the drug to the carrier does not suppress the activity of the drug or if the bond is broken down with consequent intracellular release of the drug. Experiments on this approach to antiviral chemotherapy have been directed mainly at selectively delivering antiviral agents into hepatocytes in order to increase their chemotherapeutic index in the treatment of chronic hepatitis B. PMID- 3289757 TI - Viability maintenance of mammary epithelial cells in vitro. AB - Mammary epithelial cells were isolated from mice lactating for 6 to 10 days and incubated in plastic culture dishes for 10 days. Viability of the cells was tested daily for 8 different treatment regimens including control (Minimum Essential Medium and antibiotics). Tested in cultures were horse serum, a collagen gel matrix, the lactogenic hormones prolactin, insulin, cortisol and all combinations of the above. Effectiveness of treatment was compared each day using the Duncan's New Multiple Range Test (DNMRT) and over the entire 10 day experimental period using regression analysis. After 1 day the collagen gel matrix was the most effective treatment followed by lactogenic hormones and horse serum. On days 2, 4 and 5, horse serum alone was the best treatment while day 3 demonstrated a slight superiority for hormones only. By day 6, and until day 10, a combination of horse serum and hormones maintained viability most successfully. The second and third most effective treatments during this portion of the experimental period were a combination of all three components and hormones alone, respectively. These data support the concept of complex support for mammary epithelial cell viability by a collagen gel matrix accompanied by three known hormones and unknown factors in horse serum. PMID- 3289760 TI - [Experience with the conservative treatment of incontinence using the anticholinergic agent propiverin (Mictonorm)]. PMID- 3289761 TI - [Czech gynecologists and obstetricians as authors]. PMID- 3289762 TI - Regulation of isoleucine-valine biosynthesis in Saccharomyces cerevisiae. AB - The threonine deaminase gene (ILV1) of Saccharomyces cerevisiae has been designated "multifunctional" since Bollon (1974) indicated its involvement both in the catalysis of the first step in isoleucine biosynthesis and in the regulation of the isoleucine-valine pathway. Its role in regulation is characterized by a decrease in the activity of the five isoleucine-valine enzymes when cells are grown in the presence of the three branched-chain amino acids, isoleucine, valine and leucine (multivalent repression). We have demonstrated that the regulation of AHA reductoisomerase (encoded by ILV5) and branched-chain amino acid transaminase is unaffected by the deletion of ILV1, subsequently revealing that the two enzymes can be regulated in the absence of threonine deaminase. Both threonine deaminase activity and ILV1 mRNA levels increase in mutants (gcd2 and gcd3) having constitutively depressed levels of enzymes under the general control of amino acid biosynthesis, as well as in response to starvation for tryptophan and branched-chain amino acid imbalance. Thus, the ILV1 gene is under general amino acid control, as is the case for both the ILV5 and the transaminase gene. Multivalent repression of reductoisomerase and transaminase can be observed in mutants defective in general control (gcn and gcd), whereas this is not the case for threonine deaminase. Our analysis suggests that repression effected by general control is not complete in minimal medium. Amino acid dependent regulation of threonine deaminase is only through general control, while the branched-chain amino acid repression of AHA reducto isomerase and the transaminase is caused both by general control and an amino acid-specific regulation. PMID- 3289763 TI - [Diagnosis of autonomic neuropathies using microcomputer evaluation of inter reflex functions]. PMID- 3289764 TI - Nurses' contributions during the Vietnam effort. PMID- 3289765 TI - [Effect of Salvia miltiorrhiza on the survival time of a heart allograft in experimental animals]. PMID- 3289766 TI - [Tripterygium wilfordii on prolonging the survival time of myocardial allografts in mice]. PMID- 3289767 TI - [Research on treating and preventing decreased intelligence in the aged with traditional Chinese medicine]. PMID- 3289768 TI - A comparative study of continuous and intermittent epidural analgesia for labour and delivery. AB - This study compares a continuous infusion technique with intermittent "top-up" doses using 0.25 per cent bupivacaine for epidural analgesia for labour and delivery in healthy primiparous patients. Sixty women were randomized into two groups, A (continuous) and B (intermittent). Twenty-eight patients in Group A and 29 in Group B completed the study. We compared the groups with regard to satisfaction with pain relief for both labour and delivery as measured by a Visual Analogue Scale on five occasions during and after parturition. There was no difference between groups at any of the five stages. The difference in pain scores before the epidural and after the epidural was significant for both groups (p less than 0.001). The incidence of missed segments, degrees of motor block, height of sensory block, length of labour and fetal outcome were similar in both groups. Plasma bupivacaine levels were measured in six patients in each group. Mothers in Group A received more drug than those in Group B (p less than 0.01) but plasma bupivacaine levels remained low in the mother and the umbilical cord samples in the sub-set from this group. More women in Group A required outlet forceps (p less than 0.05) whereas mid-forceps and Caesarean section rates were similar in the two groups. Fewer mothers in the infusion group had spontaneous vaginal delivery. We conclude that infusion techniques are as effective as intermittent top-up epidurals and are well received by mothers in labour. PMID- 3289769 TI - A comparative study of patient controlled epidural analgesia (PCEA) and continuous infusion epidural analgesia (CIEA) during labour. AB - In a randomised, single-blinded, placebo-controlled study, 27 parturients in labour receiving epidural 0.125 per cent bupivacaine, were assessed to evaluate the efficacy of patient-controlled epidural analgesia (PCEA) compared with continuous infusion epidural analgesia (CIEA). Group A (n = 14) received a background infusion of 4 ml.hr-1 0.125 per cent bupivacaine, with further 4 ml aliquots, self-administered, as required (up to 16 ml.hr-1). Group B (n = 11) received a continuous infusion of 12 ml.hr-1 through the same PCA apparatus, but with the demand-button deactivated. Both groups were similar in respect to age, height, weight, duration and outcome of labour, birthweight and neonatal Apgar scores. Patients in Group A (PCEA) received significantly less local anaesthetic than those in Group B (11.2 vs 15.2 mg.hr-1). Pain relief was similar in both groups. Patients expressed overall satisfaction with PCEA, appreciating control over their own pain relief and less reliance on medical staff. PCEA is a safe, effective means of providing optimal analgesia during labour, with minimal local anaesthetic requirement. PMID- 3289770 TI - Myalgia in outpatient surgery: comparison of atracurium and succinylcholine. AB - We studied 60 outpatients randomly divided into two groups. Anesthesia was induced with fentanyl 1.5 micrograms.kg-1 plus thiopentone 5-7 mg.kg-1. Patients in Group I were intubated with the aid of succinylcholine 1.5 mg.kg-1 after pre treatment with d-tubocurarine 0.05 mg.kg-1. Group II received atracurium 350 micrograms.kg-1 three minutes after a priming dose of 50 micrograms.kg-1. Anesthesia was maintained with isoflurane 1-2 per cent in a mixture of nitrous oxide 60 per cent and oxygen 40 per cent. No supplemental doses of fentanyl or atracurium were given. Intubation conditions were satisfactory for all patients in both groups. There was no significant difference in intubation score between the two groups. The incidence of myalgia was 76 per cent in the succinylcholine group compared to 23 per cent in the atracurium group (p less than 0.005). Fifty per cent of the patients in the succinylcholine group had myalgia necessitating bed rest or analgesics compared to 23 per cent in the atracurium group (p less than 0.05). We conclude that atracurium is a suitable neuromuscular relaxant for outpatient surgery and that myalgia is a major morbidity factor in this population that can be reduced by the use of atracurium instead of succinylcholine. PMID- 3289771 TI - Cyclosporine-pancuronium interaction in a patient with a renal allograft. AB - A case is described of a 54-year-old 55 kg patient who presented for clipping of a middle cerebral aneurysm two years after a successful renal allograft. Immunosuppression was maintained with azathioprine 100 mg daily, cyclosporine 300 mg daily and prednisone 10 mg daily. The patient had chronic hypertension controlled with nifedipine 40 mg daily and furosemide 20 mg daily. The cyclosporine level taken on the morning of surgery was 166 micrograms.L-1. Induction of anaesthesia consisted of fentanyl 350 micrograms, thiopentone 125 mg and pancuronium 5.5 mg. Anaesthesia was maintained with nitrous oxide 70 per cent in oxygen and isoflurane 0.5-1.5 per cent. No additional doses of pancuronium were given during the four hour surgical procedure. At the end of surgery, four twitches were present with train-of-four stimulation, but evidence of residual muscle paralysis was present. Residual neuromuscular blockade was reversed with atropine 1.2 mg and neostigmine 2.5 mg. Residual paralysis was present in the Recovery Room and edrophonium 10 mg was given prior to extubation. Clinical testing demonstrated adequate reversal of neuromuscular blockade. Twenty minutes following extubation, increasing respiratory distress was noted. There was clinical evidence of muscle paralysis. The patient was re-intubated. It is proposed that cyclosporine potentiated the pancuronium blockade producing prolonged neuromuscular relaxation resulting in residual paralysis following surgery. The potential interactions of cyclosporine and muscle relaxants deserve further study. PMID- 3289772 TI - Mechanisms of anaesthesia: a mystery. PMID- 3289773 TI - Surgical anaesthesia for the pregnant patient. PMID- 3289774 TI - Controversies in paediatric anaesthesia. PMID- 3289775 TI - Paediatric and neonatal intensive care. PMID- 3289776 TI - Predicting outcome in critical care. PMID- 3289777 TI - Spinal anaesthesia. PMID- 3289778 TI - Control of breathing: effects of analgesic, anaesthetic and neuromuscular blocking drugs. PMID- 3289779 TI - The contribution of pharmacokinetics and pharmacodynamics to clinical anaesthesia care. PMID- 3289780 TI - Onset of action of relaxants. PMID- 3289781 TI - Anaesthesia for the patient with cardiac disease. AB - I have tried to summarize experimental work in human and animal models. This work is complex and difficult to interpret. Clinicians should not take isolated experimental studies and jump to conclusions about clinical use of anaesthetics. Experimenters should not arrive at sweeping conclusions based on a particular experimental study performed under some or other carefully or not so carefully controlled conditions. Editorialists, such as Becker in a recent issue of Anesthesiology, should not conclude that an anaesthetic is "dangerous," based on these kinds of studies. It is especially invalid to use the term "dangerous" unless the author is willing to present us with a viable, experimentally proven, safer alternative. To tell us that isoflurane is "dangerous" implies that we should switch to some unspecified other agent. What conclusions can be arrived at based on these studies? (1) It is possible to produce coronary steal, in dogs, at constant coronary flow, with isoflurane at 41 mmHg perfusion pressure. The comparison between halothane and isoflurane is suspect because is was performed at two markedly different coronary perfusion pressures. (2) Myocardial ischaemia can be induced in humans with coronary artery disease when hypotension and tachycardia is permitted during isoflurane anaesthesia. During these conditions, relative preservation of coronary blood flow greater than that which would be expected because of measured or calculated demand has been interpreted as meaning that the mechanism was that of coronary steal. I am not convinced that this mechanism needs to be invoked here, but we can conclude from these studies that if hypotension and tachycardia are allowed to occur in patients with coronary artery disease, ischaemia is possible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289782 TI - The preneoplastic state in mouse mammary tumorigenesis. PMID- 3289784 TI - [Studies on the diagnosis of human filariasis by indirect fluorescent antibody test and immunoenzymatic staining technic with homologous and heterologous adult filarial antigens]. PMID- 3289783 TI - Rates of glycolysis and glycogenolysis during ischemia in glucose-insulin potassium-treated perfused hearts: A 13C, 31P nuclear magnetic resonance study. AB - The effects of 11.7 mM glucose, insulin, and potassium (GIK) on metabolism during ischemia were investigated in the perfused guinea pig heart using magnetic resonance spectroscopy. Intracellular metabolites, primarily glycogen and glutamate, were labeled with 13C by addition of [1-13C]glucose to the perfusate during a normoxic, preischemic period. 13C and 31P NMR spectroscopy was used to observe the metabolism of 13C-labeled metabolites simultaneously with high-energy phosphorus metabolites and pH. The extent of acidosis and the rate and amount of labeled lactate accumulation during ischemia were the same in control (3 mM glucose + insulin) and GIK-treated hearts. In contrast, the rate of labeled glycogen mobilization during ischemia in GIK-treated hearts was one third the rate observed in control hearts. These observations suggest that GIK decreased the rate of glycogenolysis during ischemia without affecting the rate of glycolysis. We propose that glucose contributed as a glycolytic substrate to a greater extent during ischemia in GIK-treated hearts than in hearts perfused with 3 mM glucose and insulin. The glycogen-sparing effect of GIK demonstrated in these studies could delay the onset of ischemic damage in a clinical setting by prolonging the availability of glycolytic substrate necessary for production of high-energy phosphate. PMID- 3289785 TI - [Clinical study on the treatment of malaria with artemether and artesunate]. PMID- 3289786 TI - [Detection of antibodies to vivax-malaria by ELISA using in vitro cultured erythrocytic Plasmodium cynomolgi as antigen]. PMID- 3289787 TI - [Determination of minimum effective concentration and proposed dosage regimen of pyronaridine in the treatment of malaria]. PMID- 3289788 TI - [The receptor role of glycophorin A during the invasion of human erythrocytes by Plasmodium falciparum]. PMID- 3289789 TI - [Experience in the consolidation measures in the final stage of malaria eradication in Daxin County, Guangxi]. PMID- 3289790 TI - Morning increase in platelet aggregability. Association with assumption of the upright posture. AB - The frequencies of onset of myocardial infarction and sudden cardiac death are increased between 6 AM and 12 noon. Platelet aggregability, which may play a role in the cause of these disorders, has been observed to increase after the normal morning activities of awakening, arising, and ambulating. To determine which morning activity or activities are responsible for this aggregability increase, we measured platelet aggregation in 16 normal subjects on a control day of delayed arising (i.e., subjects remained supine until 12:30 PM) and on a day in which normal morning activities were divided into three isolated components of awakening (8 AM), assumption of upright posture (9:30 AM), and ambulating (11 AM). Blood samples to assess platelet aggregability were drawn at 8 AM before activity and 90 minutes after the initiation of each activity (i.e., at 9:30 AM, 11 AM, and 12:30 PM). For the group, in vitro platelet responsiveness to adenosine diphosphate and epinephrine increased only after assumption of the upright posture. The lowest concentration of agonist required to produce biphasic platelet aggregation decreased (aggregability increased) between 9:30 and 11 AM (90 minutes after assumption of the upright posture) from 3.3 +/- 0.3 to 2.4 +/- 0.2 microM for adenosine diphosphate (p less than 0.05) and from 2.1 +/- 0.5 to 1.0 +/- 0.4 microM for epinephrine (p less than 0.05). During the same interval, plasma epinephrine increased from 34 +/- 7 to 55 +/- 9 pg/ml (p less than 0.05), and plasma norepinephrine increased from 169 +/- 19 to 298 +/- 25 pg/ml (p less than 0.01). There was no significant change in aggregability or catecholamine concentrations on the control day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289792 TI - IV digital subtraction angiography and coronary disease: fact of fancy. PMID- 3289793 TI - Nonalcoholic fatty liver. Structural and clinical implications. PMID- 3289791 TI - Long-term vasodilator therapy of chronic aortic insufficiency. A randomized double-blinded, placebo-controlled clinical trial. AB - Although vasodilator drugs acutely reduce regurgitation and improve cardiac performance in aortic insufficiency, their long-term effects on left ventricular size and function are uncertain. Consequently, we performed a double-blinded, placebo-controlled trial using hydralazine in 80 minimally symptomatic patients who had clinically stable, moderate-to-severe aortic insufficiency. Patients randomized to hydralazine displayed a progressive reduction in left ventricular end-diastolic volume index (LVEDVI) measured by radionuclide angiography, the predetermined end point of the study. At 24 months, mean LVEDVI had been reduced by 30 +/- 38 ml/m2, an 18% reduction from baseline. In contrast, LVEDVI changed minimally in patients randomized to placebo, and the intergroup differences over time were statistically significant (p less than 0.03). The hydralazine group also experienced reductions in left ventricular end-systolic volume index and increases in ejection fraction that were significantly different (both p less than 0.01) from changes in placebo-treated patients. These findings show that long-term treatment with hydralazine reduces the volume overload in aortic insufficiency and suggest that such therapy may have a beneficial effect on the natural history of the disease. PMID- 3289795 TI - Glutamate dehydrogenase: biochemical and clinical aspects of an interesting enzyme. AB - The molecular properties and possible metabolic functions of glutamate dehydrogenase (GLDH-EC 1.4.1.3) are described. The distribution of this enzyme in the body and particularly in the liver are outlined. The significance of these properties for GLDH release into the extracellular space, for the distribution and elimination of the enzyme and, foremost, for the assay of GLDH as a diagnostic indicator of hepatic and biliary disease are shown. Analytical methods are reviewed. PMID- 3289794 TI - Ependymoma of the spinal cord and cauda equina: a review. PMID- 3289796 TI - Clinical biochemistry of peroxisomal disorders. AB - Peroxisomes have been shown to participate in a variety of pathological processes. Peroxisomal anomalities are central features of Zellweger's cerebro hepato-renal syndrome, neonatal adrenoleukodystrophy, infantile Refsum's disease and several other genetic metabolic disorders (pseudo-Zellweger syndrome, Leber congenital amaurosis, cerebrotendinous xanthomatosis, rhizomelic chondrodysplasia punctata). In disorders with general loss of peroxisomal functions (Zellweger syndrome, neonatal adrenoleukodystrophy, infantile Refsum's disease) an accumulation of very long-chain fatty acids and pathological bile acids are found. Patients have a defective synthesis of plasmalogens and show increased excretion of dicarboxylic acids of medium chain length and of pipecolic acid in the urine. These anomalities which are due to the lack of peroxisomal enzymes, supply the basis for clinical laboratory tests. The study of these peroxisomal disorders has presented valuable information on the normal function of peroxisomes. PMID- 3289797 TI - Effect of insulin on globin synthesis in human reticulocytes. PMID- 3289798 TI - Enzyme immunoassay of cortisol in human plasma using penicillinase as label. AB - An enzyme immunoassay for cortisol in human plasma using an antiserum raised against cortisol-3-O-carboxy-methyloxime bovine serum albumin and cortisol-21 hemisuccinate conjugated to penicillinase as tracer is described. Although employing immunoassay plates for separation of antigen-antibody complex from the free components was less time consuming, the slope and sensitivity of the standard curve were improved by the addition of goat anti-rabbit gamma globulin for precipitating the complex. There was good correlation between radioimmunoassay and enzyme immunoassay results obtained for cortisol levels present in normal human plasma. PMID- 3289799 TI - A new and rapid immunochemiluminometric assay for the measurement of Tamm Horsfall glycoprotein. AB - Tamm-Horsfall glycoprotein was purified to apparent homogeneity from human urine by repeated precipitation with 0.58 mol/l NaCl and gel permeation chromatography under dissociating conditions on Bio-Gel A1.5M. The protein was found to consist of a single polypeptide chain of Mr 100,000 under non-reducing conditions and Mr 75,000 under reducing conditions. Antibodies to Tamm-Horsfall glycoprotein were raised in rabbits and subsequently purified by affinity chromatography using the glycoprotein linked to Sepharose 4B. The specificity of these antibodies was confirmed by Western blotting and by indirect immunofluorescence staining of human kidney tissue. The purified antibodies were labelled with 4-(2 succinimidyloxycarbonylethyl)phenyl-10-methyl-9-acridinium carboxylate fluorosulphonate, an acridinium ester, to a specific activity of 6 X 10(5) photon counts/ng of protein, and used to establish a two-site immunochemiluminometric assay for the measurement of Tamm-Horsfall glycoprotein in serum and urine. The bound and the free fractions were separated by a second antibody to Tamm-Horsfall glycoprotein linked to paramagnetic particles. The bound antibodies were quantified by chemiluminescence. The assay had a sensitivity of detection of 2 ng/ml and a working range, as determined by inter-assay precision profiles, of 30 500 ng/ml. The range in serum samples from volunteers with normal renal function (n = 92) was 74-520 ng/ml and the mean 24-h excretion rate in healthy subjects (n = 32) was 70 +/- 26 mg. PMID- 3289800 TI - The immune response to the cell wall of Mycobacterium bovis BCG. AB - Mice were immunized with the cell wall of BCG suspended in an oil-in-saline emulsion, and examined against time for the emergence of T cell-mediated acquired immunity. Evidence is presented that shows that levels of acquired resistance expressed in these animals over the first month following inoculation, and which enabled them to substantially resist an intravenous challenge infection with Mycobacterium tuberculosis, were completely nonspecific in nature, in that they were equally well expressed in normal and T cell-deficient mice, and were present at a time when no protective T cell activity could be passively transferred from the inoculated host. Paradoxically, in contrast, weak but statistically significant protective immunity could be detected in the spleens of CW-immunized mice approximately 3 months after inoculation, at a time when the donor animals were devoid of resistance to rechallenge. Finally, evidence is presented that shows that the CW material, if given subcutaneously, is highly immunogenic for the generation of delayed-type hypersensitivity effector T cells; however, these cells do not themselves contribute to protective immunity. PMID- 3289801 TI - Antigens of Mycobacterium leprae identified by immunoprecipitation with sera from leprosy and tuberculosis patients. AB - Mycobacterial antigens which react with human B lymphocytes were investigated by immunoprecipitation of radiolabelled sonicates of Mycobacterium leprae and M. bovis (BCG) with sera from patients with leprosy and tuberculosis in the presence of Staphylococcus aureus. SDS-PAGE analysis of the immunoprecipitates demonstrated that dense bands of Mr 12,000 (12K), 15K, 27K, 32-33K, 36K and 48K were the major antigens of M. leprae recognized by antibodies in lepromatous leprosy sera. Of these, only the 15-16K band reacted significantly with sera from patients with tuberculoid leprosy and tuberculosis. Other antigens including the T cell immunogens of Mr 18K and 70K reacted with some of the BL/LL sera tested. There were differences in the pattern of antigens precipitated from BCG sonicate by leprosy sera with the 65K antigen and a high molecular weight band (greater than 94K) being readily detected. These results differ in part to these obtained by probing immunoblots of M. leprae sonicate with leprosy sera. Factors contributing to these differences are discussed. PMID- 3289802 TI - Lack of relation between expression of HLA-DR and secretory component (SC) in follicle-associated epithelium of human Peyer's patches. AB - Follicle-associated epithelium (FAE) of normal human Peyer's patches (PP) was studied with regard to expression of HLA-DR determinants and secretory component (SC); the latter acts as a receptor for polymeric immunoglobulins (pIg). Putative M cells were identified in FAE by lack of a brush border with alkaline phosphatase. These cells were virtually negative for HLA-DR whereas the remaining FAE was strongly positive like villous epithelium. Conversely, the complete FAE showed no SC expression and was negative for IgA. These findings suggested that the FAE (including the M cells) does not participate in SC-mediated transport of pIgA, which in the gut mainly takes place through columnar crypt cells. The FAE (excepting the M cells) may be involved in an MHC class II-restricted antigen presenting function as recently suggested for villous epithelium. The role of M cells may hence be limited to uptake and transport of luminal antigens. PMID- 3289804 TI - Plasma exchange and immunosuppression in rapidly progressive glomerulonephritis: a controlled, multi-center study. AB - In a randomized study of 26 patients with histologically confirmed rapidly progressive crescentic glomerulonephritis, 12 patients were treated with immunosuppressants alone (corticosteroids, cyclophosphamide and azathioprine) while the other 14 patients received not only the identical immunosuppressive treatment but also plasma exchange therapy for four weeks. No statistically significant difference was found between the two groups. After 8 weeks, 73% and 69% of the patients in each respective group showed recompensation of renal function; serum creatinine fell from initially 7.0 and 6.2 mg/dl mean to 2.7 and 2.3 mg/dl mean, and under continued immunosuppression did not rise in the following months. Thus, in non-autoantibody induced rapidly progressive glomerulonephritis, kidney function could be improved substantially by immunosuppressive therapy, but an advantage of supplementary plasma exchange could not be shown. PMID- 3289803 TI - Nephritogenicity and immunocytochemical localization of the 70-kilodalton glycoprotein subunit (gp70) of Heymann antigen. AB - Heymann nephritis (HN) is an experimentally induced glomerulonephropathy of the rat characterized by subepithelial immune deposits and proteinuria. Immunization with a complex multimeric glycoprotein, gp600, comprising four subunits gp330, gp140, gp110, and gp70 has been shown to induce the complete form of the disease including proteinuria. Examination of three different batches of heterologous anti-gp600 antisera by immunoblot technique showed that the reactivity toward gp70 was dominant and common to all three antisera. gp70 was isolated from Triton X-100-solubilized Fx1A by lectin Lens culinaris affinity chromatography, and the purity was confirmed by SDS-PAGE. Ten rats were actively immunized with 200 micrograms of gp70. All 10 animals developed circulating brush border antibody and typical granular IgG deposits in the glomerulus but only 1/10 animals developed abnormal proteinuria. A potent antiserum against gp70 was prepared in the rabbit. It reacted strongly to the glomerular capillary wall and the proximal tubular brush border by immunofluorescence. By Protein A immunogold technique using anti-gp70, gold particles were found associated with the glomerular basement membrane (GBM)-endothelial region. By immunoblot analysis of rat GBM using the same anti-gp70 antiserum, a 70-kDa cross-reactive antigen was demonstrated in GBM preparations. These results show that the smallest subunit, gp70 of the complete HN antigen, gp600/Fx1A can independently induce the lesion of HN, but without proteinuria. The presence of gp70 on the endothelial side of the GBM is consistent with a role for in situ antigen-antibody reactions at sites other than the subepithelial region in the pathogenesis of HN. PMID- 3289805 TI - Is there any tubular secretion of protein? AB - Immunohistological investigations performed with the PAP method on tubular casts in the thick Henle loops and in the distal convoluted tubules led to the following results. 1) In control kidneys, casts consisting of sIgA and IgM occur, mostly isolated, in 30% and 20%, respectively, of cases. On the other hand IgG casts, likewise isolated, are only observed in 7% of cases. 2) In the case of mesangioproliferative glomerulonephritis of the IgA and non-IgA nephritis type, casts consisting of sIgA and IgM are observed more often than in control kidneys, especially when the serum creatinine concentration exceeds 1.3 mg%; i.e., the glomerular filtration is reduced. 3) In kidneys with inflammatory and non inflammatory glomerular diseases which had led to nephrotic syndrome, casts consisting of sIgA and IgM are not observed more often than in kidneys with glomerulonephritides which had not been accompanied by nephrotic syndrome. 4) In kidneys with severe impairment of the excretory function (rapidly-progressive glomerulonephritis, primary malignant nephrosclerosis, acute renal failure) casts consisting of sIgA and IgM are observed more often than in controls but not more often than in IgA and non-IgA nephritides with increased serum creatinine concentration. 5) In kidneys which had become aglomerular as a result of scarring of the glomeruli, with atrophic proximal tubules and preserved epithelia of the ascending loop of Henle, casts consisting of sIgA and IgM as well as secretory component occur in a large quantity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289806 TI - Renal histology of mucocutaneous lymph node syndrome (Kawasaki disease). AB - Renal involvement is well described in patients with mucocutaneous lymph node syndrome (MCLNS), or Kawasaki disease and is manifested by mild azotemia, hematuria, pyuria or cylinduria, and more often, proteinuria. Renal morphology during the acute stages of the illness has never been reported. In this paper we describe the renal histopathologic changes in a child with MCLNS. The glomerular histopathologic findings suggest immune complex damage to the kidney as a possible mechanism of nephrotoxicity in MCLNS. Presence of kidney lesions, which speak in favor of the injurious role of immune complexes in MLCNS may be relevant to the understanding of the pathogenesis of the vascular lesions that are characteristic of this disease. PMID- 3289807 TI - Is serum creatinine a reliable expression of an adequate cyclosporine immunosuppression? AB - In 13 renal transplant patients with an excellent graft function, but concomitant abnormal T6 CsA plasma levels (CsA plasma level, 6 hours after oral administration of the drug), dose adjustments of CsA were performed until a normal T6 was achieved. A significant decrease of serum creatinine values was obtained after dose modification. Prophylactic monitoring of CsA immunosuppression by T6 could be a means of avoiding nephrotoxicity or undertreatment in patients with acceptable serum creatinine levels and unsuspected drug related renal dysfunction. PMID- 3289808 TI - Sensitivity and specificity of programmed atrial stimulation for induction of supraventricular tachycardias. AB - The sensitivity and specificity of two programmed atrial stimulation protocols were studied in 92 consecutive patients undergoing electrophysiologic studies both with (35 patients) and without (57 patients) clinical supraventricular arrhythmias. Protocol I (P I) consisted of incremental atrial pacing to 2:1 atrioventricular (AV) block and a single atrial extrastimulus scanned by 10 ms decrements through diastole to the atrial effective refractory period at a single drive-cycle length. Protocol II (P II) included a second atrial extrastimulus scanned by 10 ms decrements through diastole at a single drive-cycle length with the first extrastimulus set 20 ms from the atrial effective refractory period. Rapid atrial pacing at cycle lengths of 350, 300, and 250 ms was then performed with P II. P I was employed in all patients while P II was studied in the final 48 patients only. Of the 35 patients with clinical atrial arrhythmias, 26 (74%) of their arrhythmias were induced with either P I (18/35; sensitivity = 51%) and/or P II (12/17; sensitivity = 71%). Of the 57 patients without clinical atrial arrhythmias (control group), atrial arrhythmias were induced in 11 (19%), 3 with P I (specificity 95%, 54/57) and 8 with P II (specificity 74%, 23/31). The sensitivity of P II was higher (71%), but its specificity was lower (74%) than P I (51% and 95%, respectively; p less than 0.05). The positive predictive value of P II was lower (60%) than that of P I (86%) (p less than 0.05), but the negative predictive value (82%) and predictive accuracy (73%) were comparable to those of P I (76% and 78%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289809 TI - William Osler. PMID- 3289810 TI - Symposium: Advances in Switzerland: A tribute to Maurice E. Muller. PMID- 3289811 TI - Early temporary porosis of bone induced by internal fixation implants. A reaction to necrosis, not to stress protection? AB - Stabilization of the fracture using implants requires contact surfaces between implant and bone. Such contact has been observed to induce bone porosis first seen at one month after surgery. Bone loss in the vicinity of implants has hitherto been explained as being induced by mechanical unloading of the bone (stress protection). Experiments in sheep, dogs, and rabbits combining intravital staining of blood circulation and polychrome fluorescent labeling of bone remodeling leads to the conclusion that early bone porosis in the vicinity of the implants is the result of internal remodeling of cortical bone and is induced by necrosis rather than by unloading. This theory is favored by the evidence that (1) the bone porosis is of a temporary nature, an intermediate stage in internal bone remodeling; (2) the pattern of the remodeling zone is closely related to that of the disturbed circulation, and not to that of unloading; (3) plastic plates may produce more porosis than steel plates; and (4) improved blood circulation using modified plates resulted in reduced porosis. The clinical relevance of these findings is related first to the temporary weakening of the bone, and second to the possibility of sequestration. Sequestration may be the result of intensified remodeling activity in the presence of inflammation or infection. PMID- 3289812 TI - The influence of diabetes mellitus on the healing of closed fractures. AB - Thirty-one closed fractures of the lower extremity in diabetics were retrospectively reviewed to determine healing times. There was a prolonged union time overall (163% of expected) and in both insulin and oral hypoglycemic controlled diabetics (157% and 176% of expected). Displaced fractures showed a prolonged union time, while nondisplaced fractures healed in the normal time period (187% and 96% of expected). Fractures treated by open reduction had a more prolonged healing time than those treated by closed reduction (186% and 142% of expected), but this was primarily related to displacement. Sex and age had no effect on union time. The known effects of diabetes mellitus on bone and mineral metabolism in both experimental animals and humans may explain these prolonged union times. PMID- 3289813 TI - The synovial response to intraarticular cobalt-chrome wear particles. AB - The intraarticular effects of alloy wear particles similar in size to those present in the tissues around loose total joint prostheses were studied in rat knee joints injected with laboratory-prepared particulate cobalt-chrome. The particles induced rapid proliferation of macrophages and focal degeneration of synovial tissues similar to the response seen in the articular tissues around loose total joint prostheses in humans. Bacteriologic tests excluded infection as a factor. Wear particles may contribute to the changes in the tissues around total joint prostheses and may contribute to bone resorption resulting in prosthetic loosening. Experiments on animals provide useful information about the biocompatibility of materials used in the manufacture of total joint prostheses. PMID- 3289815 TI - Fat embolism. A perspective. AB - The importance of fat embolism as a complication of bony trauma has been recognized for over 100 years. During this time there have been short bursts of rapid progress in knowledge and understanding of the problem separated by periods of confusion and misunderstandings. Presently, as a result of improvements in technology, new information has been derived to reduce significantly the morbidity and mortality of fat embolism. PMID- 3289814 TI - The effects of bulk versus particulate polymethylmethacrylate on bone. AB - Twenty-one mature New Zealand white female rabbits were allocated into three groups of seven rabbits. Group I received a bolus of doughy Simplex polymethylmethacrylate (PMMA) cement injected into the proximal tibia through a drill hole. Group II received a preformed, cooled, bulk PMMA pellet. Group III had particulate PMMA powder implanted. The operated, but nonimplanted, left tibiae served as controls. Animals were killed after four months. Histologically, both Group I and Group II demonstrated a thin, fibrous tissue membrane at the implant interface. Particulate PMMA (Group III) stimulated a much thicker, florid, foreign body reaction composed of histiocytes and giant cells. The foreign body response to particulate acrylic cement was similar to that seen in failed cemented joint replacement arthroplasty in humans. PMID- 3289816 TI - Arthrotomy and resection of the hip; posterior method. By Dr. Theodor Kocher, 1911. PMID- 3289818 TI - Hepatic imaging in diffuse liver disease. AB - An analysis of hepatic imaging (liver-spleen scintigraphy, ultrasonography, and computed tomography) was performed in 91 patients prospectively referred for percutaneous liver biopsy for suspected chronic liver disease. Hepatic imaging was performed in 51 of 91 patients (56%). Of these 51 patients, 42 (82%) underwent radionuclide imaging, whereas only seven (14%) underwent ultrasonography and only two (4%) underwent computed tomography performed. Scintigraphy revealed evidence of diffuse liver disease in 40 of 42 patients (95%) vs 0 of 7 patients (0%) for ultrasonography (P less than 0.0001). The frequency of imaging varied significantly by prebiopsy presumptive diagnosis, but this pattern was primarily a reflection of patient age. Imaging was performed in 76% of patients over 50 years of age vs 37% of patients below this age (P less than 0.001). In the hospital, scintigraphy is still prominently used as a screening tool before referral for percutaneous liver biopsy. Justification of this use involves multiple reasons beyond simply a diagnosis. PMID- 3289817 TI - Recurrent hemolytic uremic syndrome in a renal transplant recipient. AB - This case report presents clinical, scintigraphic, duplex sonographic, and biopsy findings in a 23-year-old female renal allograft (RAG) recipient, who had transplantation for chronic renal failure secondary to hemolytic uremic syndrome (HUS). She demonstrated acute and rapidly progressing RAG failure at 7 weeks after transplantation. PMID- 3289820 TI - Lung uptake of technetium-99m phosphate compounds after liver transplantation. AB - Pulmonary calcification can be detected easily using Tc-99m phosphate compounds. Lung uptake of Tc-99m bone imaging agents was observed in two patients after liver transplantation. Transient hypercalcemia due to calcium infusion during hepatic transplantation may be responsible for the pulmonary calcification. PMID- 3289819 TI - Bone imaging in the assessment of en bloc osteocutaneous autotransplantation. AB - A patient is presented who sustained an avulsed portion of the mandible and all soft tissues of the floor of the oral cavity, requiring an autogenous en bloc transplant to replace the avulsed tissues. The clinical role of bone imaging in assessing the patency of the microvasculature and viability of the vascularized osteocutaneous graft is discussed, and the criticality of the time of image acquisition in prognosticating the success of the transplantation is emphasized. PMID- 3289821 TI - An unusual case of a false-positive iodine-131 whole body scan in a patient with papillary thyroid cancer. AB - A false-positive I-131 whole body scan (WBS) for lung uptake in a patient with papillary thyroid cancer, with replacement of his infiltrated esophagus with a left colon graft, is presented. The I-131 image, seen in the upper right lung field, was due to the contaminated colon graft lacking normal peristaltic movements, which was located in the right paramediastinal region. This finding was demonstrated by imaging the upper digestive tract with orally administered Tc 99m DTPA and by a barium x-ray. PMID- 3289822 TI - A target lesion of the thyroid. PMID- 3289823 TI - Colorado Medical Society, Physician's directory 1988. PMID- 3289824 TI - Aminoglycosides: a reassessment of their therapeutic role. PMID- 3289825 TI - First case of subcutaneous zygomycosis caused by Saksenaea vasiformis in India. AB - The first case of subcutaneous zygomycotic infection caused by Saksenaea vasiformis in a rice mill worker from India is described. The infection, confined to the man's left foot, showed multiple draining sinuses, inflammation, and intermittent low-grade fever following a crushing injury when a log fell on his foot. Histopathologic examination of two biopsy specimens, taken at 3-wk intervals, revealed the presence of broad, sparsely septate, branched, hyaline hyphae characteristic of a zygomycete. When they were grown on a nutritionally deficient medium, two cultures isolated from the biopsied tissues formed numerous, vase-shaped sporangia typical of S. vasiformis. Necrosis of the affected area led to amputation of the fore part of the foot. A split thickness graft was well accepted, and treatment with potassium iodide, following the graft, cured the infection. PMID- 3289826 TI - Differing complement-mediated opsonic activity of rabbit interstitial fluids from autologous serum. AB - Lack of appropriate methods for withdrawing extravascular or interstitial fluid from an animal host has limited in vitro study on the role of complement in the local defence of the extravascular space. In the present study, we obtained fluids from membrane diffusion chambers (porosity 0.22 micron) implanted into the kidneys, peritoneal cavity and soft tissues in rabbits. The complement-mediated opsonic activity (CMOA) of these fluids for Staphylococcus aureus ATCC 502A and Escherichia coli 01 was then compared to that of autologous sera. Soft tissue and renal interstitial fluids were as opsonic for E. coli as autologous sera but were however, poor opsonins for S. aureus. The peritoneal fluid was marginally effective in opsonization of both bacterial strains. While chelation of the fluids with MgEGTA (to block the classical pathway) did not diminish CMOA for E. coli, it reduced the CMOA for S. aureus by half. Conversely, heat-inactivation of the fluids and serum eliminated the opsonic activity for E. coli but only decreased the opsonic activity for S. aureus by half. Following a 24 h in vivo growth of E. coli in the implanted chambers, the CMOA was drastically reduced. Concomitant to the reduction in functional complement in the fluids, E. coli recovered from the chambers were found coated, though not maximally, with C3b as evidenced by studies with fluorescent antibody. The differences in opsonic content of extravascular fluids observed here might explain why certain sites of the body may be more vulnerable to attack by some bacterial species which are not effectively opsonized and therefore phagocytized. PMID- 3289827 TI - Colon cancer bearing rats produce a lymphokine which induces macrophage migration inhibition (MIF) in vitro. AB - We studied a series of 40 rats at various stages of colorectal carcinoma, as induced by N-methyl-N-nitro-Nitrosoguanidine. Lymphokine containing supernatants were obtained simultaneously from splenic and peripheral lymphocytes, after exposure to rat colon cancer antigen in vitro. The lymphokine was found capable of performing Macrophage Migration Inhibition (MIF) when obtained from rats with: carcinoma through serosa, carcinoma of submucosa, carcinoma of the mucosa and carcinoma in situ. All control rats were free of cancer and were MIF negative. The MIF response in this study was evaluated as a marker of chemically induced colorectal carcinoma in rats in order to better understand the lymphocyte response to tumor progression from atypia to adenocarcinoma of the colon. PMID- 3289828 TI - A simple computer program for insulin dose adjustment in diabetic patients. AB - A program is described for the adjustment of insulin dose in diabetic patients. The program is written in BASIC and runs on a Casio FX-770P portable computer. On the basis of the maximum daily dose variation allowed, seven twice-daily glucose determinations and the previous insulin dose, the program generated 'cautious' and 'normal' insulin dose adjustment for 66 patients which correlated well with the judgements made by four expert diabetologists. PMID- 3289829 TI - Cognitive therapy of depression: a means of crisis intervention. PMID- 3289830 TI - Controlled-release naproxen compared with isoxicam in patients with osteoarthritis. AB - The therapeutic efficacy and tolerability of a new controlled-release 1000 mg tablet of naproxen (naproxen CR) were compared with 200 mg isoxicam in 100 out patients with osteoarthritis. Medications were administered once daily for 4 weeks in a controlled, randomized, double-blind, parallel trial. Patients were assessed for duration of stiffness, global pain, pain in the worst affected joint, night pain, pain on full passive movement, and pain on selected activity. No statistically significant differences were found between naproxen CR and isoxicam for any of the efficacy variables. Only 3 patients (2 with naproxen CR, 1 with isoxicam) reported adverse events, all mild to moderate; no patient withdrew from the study. At the conclusion of the study, patients and physician evaluated therapeutic response independently; both drugs provided steady improvement as judged by patients and physician. Both physician and patients evaluated naproxen CR as very good or good for 36 (72%) patients, and isoxicam as good or very good for 35 (73%) patients. Naproxen CR and isoxicam proved equally effective and well-tolerated for the treatment of osteoarthritis in this study. PMID- 3289832 TI - Ultrasonography of Pancoast tumor. AB - Eleven patients with Pancoast tumor, who failed to yield diagnostic materials by conventional sputum cytology and fiberoptic bronchoscopy, were studied by real time linear-array and sector ultrasonography. The sector scanner through the supraclavicular approach adequately visualized the external profile and the internal texture of the lesions in all 11 patients, which is a significant improvement (p less than 0.05) over what can be accomplished with linear-array scanner through the intercostal approach. All patients received percutaneous transthoracic aspiration under ultrasound guidance. Positive cytologic diagnosis was established in ten of the 11 patients (91 percent). Additional biopsies performed in seven patients under similar ultrasonic guidance also provided concordant results. No complications were observed in this series. This study has clearly shown that ultrasound-guided aspiration biopsy can be a safe and useful means for obtaining materials for pathologic confirmation of Pancoast tumor. It may also assist in defining the tumor extension to pleura and adjacent structures. PMID- 3289833 TI - Acquired immune deficiency syndrome and the lung. PMID- 3289831 TI - A double-blind comparison of two lormetazepam doses in elderly insomniacs. AB - The relative efficacy and tolerability of two lormetazepam doses, 0.5 mg and 1.0 mg, were compared in 145 elderly insomniacs in a double-blind, multi-centre study. On entry, data were recorded on the patient characteristics and sleep pattern, and patients were allocated at random to receive treatment with either 0.5 mg or 1.0 lormetazepam per night for 7 nights. Details were recorded daily in a diary by patients on sleep latency, the number of night-time awakenings, time of morning awakening, and whether they awoke refreshed. A record was also kept of any adverse effects of treatment. At the end of the study period, an overall assessment was made by the physician of the patients' response to treatment. The results showed that patients in both dose groups improved significantly (p = 0.001) in the three principal efficacy measures, but there were no apparent trends in the time when patients awakened in the morning. The only evidence of a difference in response to the two doses was that significantly (p less than 0.01) more patients on the larger dose were given a global rating of 'much improved' by the physician. Five patients withdrew from the study; 2 because of lack of efficacy, 2 because of side-effects, and 1 because of a suspected myocardial infarction not related to therapy. Only 6% of patients (4 on each dosage) reported adverse effects, most frequently related to carry-over sedation, i.e. drowsiness, sleepiness, muzzy head. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289834 TI - Basic mechanisms of asthma. Role of inflammation. AB - It is now recognized that the basic reason for airway obstruction in asthma is chronic airway inflammation. The hyperresponsiveness and "bronchospasm" are, in part at least, a consequence of the inflammation. Optimum patient care needs to focus on preventing inflammation when possible and using anti-inflammatory drugs when prevention is not possible. When chronic asthma is mild, aerosol glucocorticoids or cromolyn suffice. Acute exacerbations that do not respond fully to bronchodilator drugs usually should be treated by a course of oral glucocorticoids. A few patients with severe disease require oral glucocorticoid therapy indefinitely. PMID- 3289835 TI - Hidden allergic factors in the etiology of asthma. AB - Increasing evidence from case control surveys, population studies and allergen avoidance studies suggest inhalant allergy plays an important role in the etiology of asthma. Recent studies in hospital emergency rooms have compared the prevalence of serum IgE antibodies to common allergens (mite, cat, cockroach, rye grass and ragweed pollen) in patients admitted with acute asthma attacks and in unselected age-matched control subjects. These studies, carried out in central Virginia and northern California, showed a highly increased prevalence of IgE antibodies to inhaled allergens among asthmatic patients, and suggest that the development of allergen specific IgE antibody responses is a major risk factor for emergency room admission with asthma. Presentation at the emergency room appeared to be related to patients' exposure to specific allergens: in central Virginia, in the fall, dust mite was the predominant allergy, whereas in northern California, in May-June, most asthmatic patients (greater than 90 percent) were allergic to rye grass. New immunoassay technology, based on the use of monoclonl antibodies, has been developed to measure the quantities of "indoor" allergens (mite, cat, cockroach) in asthmatic patients' houses. It is now possible to propose tentative levels of mite allergens which should be considered both as a risk for IgE antibody sensitization (2micrograms allergen/g dust) and as a risk for acute asthma attacks (10micrograms allergen/g dust). Future management of asthma will require analysis of indoor allergens and the development of efficient allergen avoidance procedures. Further research is necessary to investigate the relationship between airborne allergen levels, particle size and the precipitation of asthma attacks and also to investigate immunologic mechanisms which may cause bronchial hyperreactivity. PMID- 3289836 TI - Clearance of aerosolized 99mTc-diethylenetriaminepentacetate before and after smoke inhalation. AB - The pulmonary clearance of aerosolized 99mTc-diethylenetriaminepentacetate (DTPA) was studied in mongrel dogs immediately after exposure to wood smoke to see if a sensitive, objective way of assessing the degree of pulmonary injury might be found. Animals were studied in four groups as follows: control, following five minutes, two minutes, and 15 seconds of smoke exposure. Chest roentgenograms and 133Xe scans were taken before and after smoke exposure. The DTPA clearance was more sensitive in detecting injury than either of these imaging techniques. The DTPA clearance rates increased in a dose responsive way following smoke inhalation: 2.4 percent and 12.1 percent excreted per minute for control animals and those exposed to five minutes of smoke, respectively. Seven patients in a clinical trial of DTPA following smoke exposure are described; their DTPA clearance rates were all normal, although five were active cigarette smokers. Despite encouraging results in animal experiments, DTPA clearance studies may be of little practical value in the clinical setting of acute inhalation injury. PMID- 3289837 TI - Utility of immediate postlobectomy fiberoptic bronchoscopy in preventing atelectasis. AB - In a prospective randomized trial, we examined the value of routine postlobectomy fiberoptic bronchoscopy (FOB) in preventing postoperative atelectasis. Twenty patients who underwent lobectomy were randomly assigned to either chest physical therapy alone (group 1) or immediate bronchoscopy (group 2). Both group 1 and group 2 were placed on a standard physical therapy regimen consisting of aerosol bronchodilator therapy, chest percussion, and incentive spirometry. It was concluded that routine postlobectomy bronchoscopy offers no advantage over the usual physical therapy measures in preventing the development of postoperative atelectasis. PMID- 3289838 TI - Small-vessel disease, coronary artery vasodilator reserve, and diabetic cardiomyopathy. PMID- 3289839 TI - Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. AB - Although obstructive sleep apnea (OSA) has been studied in detail for over a decade, the mortality of this disorder is unclear. We calculated cumulative survival in 385 male OSA patients. We found that those with an apnea index (AI) greater than 20 had a much greater mortality than those with AI = less than 20. The probability of cumulative eight-year survival was .96 +/- 0.02 (SE) for AI = less than 20 vs. 63 +/- 0.17 for AI greater than 20 (p less than .05). This difference in mortality related to AI was particularly true in the patients less than 50 years of age in whom mortality from other causes is not common. None of the patients treated with tracheostomy or nasal CPAP died. Eight of the patients treated with uvulopalatopharyngoplasty (UPPP) died and the cumulative survival of the UPPP-alone treated group was not different from the survival curve of untreated OSA patients with an apnea index of greater than 20. We conclude that OSA patients with an apnea index of greater than 20 have a greater mortality than those below 20 and that UPPP patients be restudied after therapy. If the latter patients are found not to have marked amelioration of their AI, then they should be treated by nasal CPAP or tracheostomy. PMID- 3289840 TI - Sociometric status and peer group dynamics. PMID- 3289841 TI - Paternal absence and sex-role development: a meta-analysis. AB - A meta-analysis was based on every available study that has compared father present and father-absent children on a measure of sex typing. 67 studies produced 222 estimates of effect size. Owing to the inappropriateness of conventional statistics, Hedges's approach to meta-analysis was employed. Results show that published studies produced larger estimates of effect size than dissertations and conference papers. Effect-size estimates based on clinical and incarcerated samples were significantly different from those based on more typical samples. Generalizable differences between father-present and father absent females were conspicuously absent. Preschool father-absent boys were shown to make less stereotypical choices of toys and activities when compared to father present age-mates. When compared to father-present boys, older father-absent boys were more stereotypical in their overt behavior, particularly in terms of aggression. Discussion focused on interpretation of the results within a multidimensional conception of sex role. PMID- 3289842 TI - [Changes in diagnosis and indications in gallstone surgery]. PMID- 3289843 TI - [Current status of litholysis and lithotripsy of gallstones]. PMID- 3289845 TI - [Current status of intraoperative radiotherapy]. PMID- 3289844 TI - [Interdisciplinary procedure in complicated gallstone disease]. PMID- 3289846 TI - [Regional chemotherapy of liver tumors--analysis of status]. PMID- 3289847 TI - [Perioperative chemotherapy in gastrointestinal cancer]. PMID- 3289848 TI - [Surgical therapy of gallbladder cancer]. AB - Because of the normally far advanced tumor stages of carcinomas of the gallbladder, the resection rate in the literature varies from 10 to 30 percent. Our own curative resection rate was 19% in a series of 89 patients between 1969 and 1985 first treated in our hospital. The palliative resection rate was 29%, in 10% we performed a palliative operation and in 36% an explorative laparotomy. The curative resected gallbladder carcinomas were mainly stage I and II tumors, incidentally found at operation or histopathological examination. Has the gallbladder carcinoma invaded perimuscular connective tissue, an extended operation with resection of the segments IVb and V of the liver and lymphnode dissection must be recommended. Stage III and IV carcinomas of the gallbladder with infiltration of the liver can be curatively operated organ-saving in using en-bloc resection of the gallbladder with the adjacent segments IVb and V, or IVb and VI and with lymphnode dissection of the hepatoduodenal ligament. The observed five-year-survival rate (Cutler and Ederer) including lethality of the curative resected carcinoma of the gallbladder is 56.3 +/- 25.2%. PMID- 3289849 TI - [Surgical therapy of chest wall tumors]. AB - Tumors of the chest wall may occur as both primary and secondary tumors. Diagnosis is established by clinical examination, conventional and/or computed tomography. In most cases of chest wall tumors resection is the treatment of choice. It should be performed with a safe distance to the tumor, if necessary with bloc resection of another intrathoracic part or adjacent tissues. For skeletal reconstruction non-absorbable and absorbable mesh is available; even complete replacement of the sternum is possible. Large full thickness defects can be covered with sliding flaps or myocutaneous flaps from adjacent locations. PMID- 3289850 TI - [Preoperative nonspecific immunostimulation with Propionibacterium granulosum KP 45 in patients with colorectal cancer. A prospective randomized study]. AB - The effect of preoperative unspecific immunomodulation with Propionibacterium granulosum KP-45 (P.g.) on postoperative complications and patient survival was evaluated in a prospectively randomized trial in patients with colorectal tumor resection. Patients of the therapy group (n = 51) received at least 3 days before operation an infusion of 10 mg P.g., patients of the control group (n = 49) were not treated at all. The wound infection rate and the number of re-explorations were significantly lower in the therapy group, however, patient survival and tumor recurrence rates were not positively affected by this P.g. pre-treatment. PMID- 3289851 TI - [Cystojejunostomy without entero-entero-anastomosis. Simplified surgical procedure in pancreatic pseudocyst]. PMID- 3289853 TI - [Fasciocutaneous VY flap for covering decubitus ulcers]. PMID- 3289852 TI - [Pedicled jejunum transplant--a possibility for partial bile duct replacement]. PMID- 3289854 TI - [Nobel Prize winners in surgical medicine]. PMID- 3289855 TI - [Anaerobic infections of the female genital tract and their treatment]. PMID- 3289856 TI - Two major components of synaptonemal complexes are specific for meiotic prophase nuclei. AB - Monoclonal antibody II52F10 was elicited against purified synaptonemal complexes (SCs); it recognizes two major components of the lateral elements of SCs, namely an Mr = 30,000 and an Mr = 33,000 protein. We studied the distribution of the antigens of II52F10 within tissues and cells of the male rat by immunoblot analysis and immunocytochemical techniques. Nuclear proteins from various cell types, including spermatogonia and spermatids, did not react with antibody II52F10 on immunoblots; the same holds for proteins from isolated mitotic chromosomes. As expected, an Mr = 30,000 and an Mr = 33,000 protein from spermatocyte nuclei did react with the antibody. In cryostat sections of liver, brain, muscle and gut we could not detect any reaction with II52F10. In the testis the reaction was confined to SCs or SC fragments. Partly on the basis of indirect evidence we identified the antigen-containing cells as zygotene up to and including post-diffuse diplotene spermatocytes. The persistence of some antigen-containing fragments in the earliest stages of spermatids could not be excluded. We conclude that the lateral elements (LEs) of SCs are not assembled by rearrangement of pre-existing components of the nucleus: at least two of their major components are newly synthesized, presumably during zygotene. Furthermore we conclude partly from indirect evidence that the major components of the LEs of SCs are not involved in the chromosome condensation processes that take place during the earliest stages of meiotic prophase. PMID- 3289858 TI - [Mitral valve prolapse]. PMID- 3289857 TI - [Chronic granulocytic leukemia and HLA]. PMID- 3289859 TI - Population pharmacokinetics of gentamicin in neonates. AB - The influence of a number of clinical characteristics on the population pharmacokinetics of gentamicin were examined using routine drug-monitoring data from a group of 113 neonates. The data were analyzed using the programme NONMEM. Clearance was 0.053 litres.h-1.kg-1 and was reduced in neonates with postconceptional age less than or equal to 34 weeks (X 0.83) and 5-min Apgar score less than 7 (X 0.82). Volume of distribution was 0.47 litres.kg-1. These population mean parameter estimates were used to generate dosage regimens to achieve concentrations within the therapeutic range. PMID- 3289860 TI - Postprandial exercise in type I diabetic patients on multiple daily insulin injection regimen. AB - This study shows the influence on plasma glucose concentrations of 45 min of mild exercise (48 +/- 4% of maximum aerobic capacity) performed 180 min after breakfast and 195 min after a subcutaneous injection of regular insulin by six type I (insulin-dependent) diabetic patients on a three-daily insulin injection regimen (regular insulin before breakfast and lunch, regular + intermediate insulin before supper). It has been observed that such exercise does not induce a large plasma glucose decrease. Actually, plasma glucose concentrations were 99 +/ 18 mg/dl before exercise, reached a nadir of 78 +/- 17 mg/dl at 35 min, and were 81 +/- 15 mg/dl at the end of exercise. During the control study at rest, in the same 45-min time interval, plasma glucose decreased from 146 +/- 31 to 128 +/- 31 mg/dl. In the exercise study, one patient began exercising while hypoglycemic, and another patient developed asymptomatic hypoglycemia during exercise. In the control study at rest, one patient showed hypoglycemic glucose concentrations. Throughout the exercise study, plasma free-insulin concentrations decreased (from 32 +/- 5 to 20 +/- 4 microU/ml) as a result of the pharmacokinetics of subcutaneously injected insulin. PMID- 3289861 TI - Randomized controlled trial of topical hyperbaric oxygen for treatment of diabetic foot ulcers. AB - The effect of 2 wk of topical hyperbaric oxygen (THO) treatment on the healing of diabetic foot ulcers without associated gangrene was evaluated in a prospective, controlled, and randomized manner in 28 patients. There were 12 patients in the THO group (group 1) and 16 in the control group (group 2). Clinical management of the two patient groups was similar except for THO treatment in the group 1 patients. Clinical parameters, including age, sex, baseline fasting serum glucose levels, duration of diabetes mellitus, duration of foot ulcers, presence of peripheral neuropathy or arterial insufficiency, and evidence of osteomyelitis as determined by radiographs and/or radionuclide scans, were comparable in both groups of patients. No statistical differences (Student's t test) were seen in the number of microorganisms isolated from curettage cultures of the base of the ulcer at days 0, 7, and 14 of the study between groups 1 and 2. In contrast to previous studies, there was a paucity of anaerobic microorganisms isolated from these foot ulcers without associated gangrenous changes. Ulcer areas were estimated by multiplying the maximum width by the maximum length in millimeters at days 0, 7, and 14. Analysis of variance and Student's t test revealed progressive significant reductions in the ulcer areas in both groups when days 0, 7, and 14 were compared and in ulcer depths in both groups when days 0 and 14 were compared. However, such ulcer size changes did not differ statistically between the control and THO groups. A trend toward slower healing was observed in the THO group. Healing of diabetic foot ulcers was not accelerated by THO in this study. PMID- 3289862 TI - Type II diabetes mellitus. Interface between clinical and epidemiological investigation. AB - The field of cardiovascular disease and atherosclerosis has been enriched by a fruitful interplay between basic and clinical scientists and epidemiologists. Such interaction has been less highly developed in the field of diabetes. I present an epidemiological perspective on certain problems in type II (non insulin-dependent) diabetes research and point out some potentially useful directions for future interdisciplinary efforts involving both basic and clinical scientists and epidemiologists. Early research on diabetes has been marred by variable case definitions. The demonstration in numerous epidemiological studies that plasma glucose has a bimodal distribution in populations has contributed to the widely accepted National Diabetes Data Group (NDDG) and the nearly identical World Health Organization (WHO) definitions of diabetes. This development has markedly ameliorated many of the difficulties resulting from variable case definitions. Appreciation of the phenomenon of bimodality has also contributed to a better understanding of impaired glucose tolerance. Many studies on the pathogenesis of type II diabetes take the form of case-control (i.e., cross sectional) studies. The weaknesses of this research design are well known to epidemiologists. Prospective studies, a much stronger research design for inferring causal relationships, are much less common in the field of diabetes than in the field of cardiovascular disease and atherosclerosis. Recently, however, two prospective studies have helped define the role of serum insulin levels and insulin resistance as diabetes risk factors. These studies were carried out in small, relatively isolated populations, and there is a great need to replicate these findings in larger, more representative populations and to further evaluate the relative role of insulin secretion and insulin resistance as diabetes risk factors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289863 TI - Polyunsaturated and saturated fat, cholesterol, and fatty acid supplementation. AB - Almost all of risk factors for arteriosclerosis and coronary heart disease identified in population studies are overrepresented in diabetes. Of these risk factors, plasma lipids and lipoproteins are the target for altered dietary habits, particularly regarding fat. Such an alteration must be qualified with an understanding of the relationship between diabetes mellitus and lipoprotein metabolism and evidence of a favorable outcome of a fat-modified diet on this relationship. In seeking a revision of the current dietary fat recommendations of the American Diabetes Association, we have addressed five major questions. Is the serum lipid or lipoprotein concentration in diabetes different from that of the nondiabetic population? Are the familial or genetic forms of hyperlipidemia coinherited and/or overrepresented in diabetic subjects? What is the mechanism of the lipid/lipoprotein disorder in diabetes, and to what extent could it be related to the diabetic metabolic milieu? What is the effect of antidiabetic treatment on plasma lipids and lipoprotein metabolism? What evidence is there that a modified-fat diet could exert favorable benefits over and above what could be achieved by optimal antidiabetic therapy? This article outlines the revised dietary fat recommendations of the American Diabetes Association Nutrition Task Force and their rationale. PMID- 3289864 TI - Evaluation of protein in dietary management of diabetes mellitus. AB - Establishing appropriate recommendations for protein intake in the management of diabetes requires examination of the role that dietary protein plays in overall health, in the control of diabetes, and in the risks to health posed by diabetes. Achieving metabolic control and delaying and/or preventing diabetic complications have previously been established as primary goals for the dietary management of diabetes. Although the primary function of dietary protein is for growth and tissue maintenance, dietary protein may play a role in the regulation of glucose metabolism and in the development of diabetic renal complications. Approximately half of protein intake is considered to be available as glucose. Dietary composition also affects secretion of insulin and counterregulatory hormones. One third of individuals with insulin-dependent diabetes and one-fifth of those with non-insulin-dependent diabetes develop nephropathy within 15 yr after the diagnosis of diabetes. High protein intake and hyperglycemia can increase the glomerular filtration rate and the work load of the kidney. There is growing evidence from clinical studies that the progression of renal disease is delayed by early protein restriction. More studies are needed to assess early risk of diabetic nephropathy and to determine whether protein restriction alters the course of diabetic nephropathy. A dietary intake of between 12 and 20% protein provides flexibility in food selection but exceeds actual needs. The adult Recommended Dietary Allowance of 0.8 g/kg body wt should provide guidance for determining desired protein intake for individuals with diabetes. PMID- 3289865 TI - Use of alternative sweeteners in diabetic diet. AB - Alternative sweeteners are widely advocated and used. However, there is insufficient scientific information to determine whether alternative sweeteners aer of value in the management of diabetes, either in improving dietary adherence or in contributing to the achievement or maintenance of a lower body weight. Each of the available sweeteners has advantages and disadvantages; no one is preferred. Recommendations about alternative-sweetener use should be tailored to the specific dietary and life-style patterns of the individual. PMID- 3289866 TI - Dietary considerations for obese diabetic subjects. AB - Individuals with an upper-body form of obesity show greater associations with higher glucose excursions, exacerbated insulin resistance, increased abnormality of lipoprotein profile, and higher cardiovascular risk. Individuals with obesity and diabetes are at great risk for cardiovascular disease. Weight reduction and improvement in blood glucose control through dietary interventions for the obese person with non-insulin-dependent diabetes mellitus (NIDDM) hold the greatest potential for reducing morbidity and mortality. The relative merits of different weight-reduction programs are unclear, but regimens should be nutritionally complete, easy to follow, and include a program for maintaining the reduced weight level. Improvement in insulin action and the possibility of slowing development of clinical nephropathy or end-stage renal disease in NIDDM through weight loss have been found. Very low calorie diets, when used with medical supervision, may lead to significant weight loss, improved metabolic status, and even reduction or elimination of the need for oral hypoglycemic agents or insulin; however, further studies are needed to examine possible negative outcomes in people with NIDDM before very low calorie diets can be recommended. The causes of obesity and its connection with diabetes are unclear, but even modest calorie restriction may be beneficial to obese diabetic patients because of the positive effects on blood glucose levels and requirements for insulin and oral antidiabetic agents. PMID- 3289867 TI - Diet therapy for minority patients with diabetes. AB - Diet therapy for minority diabetic patients must be directed to NIDDM, the most prominent form of diabetes in minority populations. Diet programs must be tailored to the cultural framework, and traditional foods with desirable characteristics can be encouraged. To teach patients about diet, educators must use educational techniques appropriate to culture and literacy of the patient and family. Single-concept messages such as "eat less fat" or "eat less food" promote learning and minimize failure. Nutrition information can be divided into sequenced manageable steps that can then be individualized to the patient's setting. No single set of exchange lists will suffice for all minority groups, nor are exchange lists themselves appropriate for all situations. To meet the needs of minority patients, nutrition educators must use a variety of tools and techniques relating to the foods of a particular ethnic group. Sound education strategies and simplified materials for NIDDM patients should also be employed. PMID- 3289868 TI - Pediatric, adolescent, and young-adult nutrition issues in IDDM. AB - Although insulin is life sustaining for patients with insulin-dependent diabetes mellitus (IDDM), the meal plan is of critical importance for avoiding hyperglycemia, preventing hypoglycemia, and maintaining metabolic balance. Consistency, timing, composition, and caloric content of food intake and physical activity, age, sex, growth, and pubertal status alter meal-plan needs. Self monitoring of blood glucose should be used to individualize the meal plan. The general American Diabetes Association recommendations suggest that 50-65% of total calories be from carbohydrates from foods with a lower glycemic index and/or high fiber content. Protein should contribute 12-20% of total calories and fat less than 30%, with less than 10% saturated fat and less than 300 mg/day cholesterol. More severe fat restriction should be considered in individuals with persistent lipid abnormalities when compared with sex- and age-adjusted values. Calories should be sufficient for growth and development, with growth data obtained several times a year and plotted on standardized weight, height, and velocity charts. Blood pressure should be similarly plotted on age- and sex standardized curves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289869 TI - Role and management of exercise in diabetes mellitus. AB - As more is understood about the physiology of exercise, in both normal and diabetic subjects, its role in the treatment of diabetes is becoming better defined. Whereas people with diabetes may derive many benefits from regular physical exercise, there are also several hazards that make exercise difficult to manage. In type I (insulin-dependent) diabetes, there are risks of hypoglycemia during or after exercise or of worsening metabolic control if insulin deficiency is present. Type II (non-insulin-dependent) diabetic patients treated with sulfonylureas are also at some increased risk of developing hypoglycemia during or after exercise, although this poses less of a problem than with insulin treatment. In individuals treated by diet alone, regulation of blood glucose during exercise is usually not a significant problem and exercise can be used as an adjunct to diet to achieve weight loss and improved insulin sensitivity. When obese type II diabetic patients are treated with very low calorie diets, adequate amounts of carbohydrate must be provided to ensure maintenance of normal muscle glycogen content, particularly if individuals wish to participate in high intensity exercise that places a heavy workload on specific muscle groups. On the other hand, moderate-intensity exercise such as vigorous walking can be tolerated by individuals on very low calorie, carbohydrate-restricted diets after an appropriate period of adaptation. A number of strategies can be employed to avoid hypoglycemia in type I diabetic patients, and both type I and II diabetic patients should be examined carefully for long-term complications of their disease, which may be made worse by exercise. These considerations have led many diabetologists to consider exercise beneficial in the management of diabetes for some individuals but not recommended for everyone as a necessary part of diabetes treatment as in the past. The goals should be to teach patients to incorporate exercise into their daily lives if they wish and to develop strategies to avoid the complications of exercise. The rationale for the use of exercise as part of the treatment program in type II diabetes is much more clear than for type I diabetes; regular exercise may be prescribed as an adjunct to caloric restriction for weight reduction and as a means to improve insulin sensitivity in the obese insulin-resistant individual. PMID- 3289870 TI - The ambulatory insulin program: initiating insulin therapy in an outpatient setting. PMID- 3289871 TI - Nabumetone (Relifex)--another NSAID. PMID- 3289872 TI - The treatment of mild hypertension. PMID- 3289873 TI - [The spectrum of Lyme borreliosis from the dermatologic viewpoint]. AB - Erythema chronicum migrans, lymphadenosis benigna cutis and acrodermatitis chronica atrophicans represent the dermatological manifestations of the multi organ disease Lyme borreliosis. Koch's requirements of evidence for an infectious disease, demonstration of the bacterium, transfer, and culture have proven Borrelia burgdorferi to be the causative agent of the above mentioned skin diseases. This justifies a penicillin therapy, that has been administered in Europe empirically for the last 30 years. Correct and prompt diagnosis is important since delayed treatment is less effective, presumably because the spirochete becomes sequestered in immune-privileged sites. Recent observations in several laboratories that antibody titers to Borrelia burgdorferi are also elevated in several other skin diseases and that the spirochete can be detected in tissue sections of different organs may imply extension of the dermatological spectrum of Lyme disease. The significance of these findings in such heterogeneous diseases as morphea, lichen sclerosus et atrophicans, etc. however awaits final examination. PMID- 3289874 TI - [Hemodynamic effects of different antihypertensive combinations]. AB - The haemodynamic effects of combinations of antihypertensive drugs were tested in an open trial on 15 patients with essential arterial hypertension. The following combinations were used: Piretanid/Captopril, Piretanid/Urapidil and Acebutolol/Piretanid. All three combinations significantly lowered arterial pressure at rest and on exercise. Both Piretanid/Captopril and Piretanid/Urapidil reduced the arterial pressure exclusively by reduction of the peripheral resistance, while cardiac output rose. On the other hand, Acebutolol/Piretanid reduced the blood pressure through reduction of cardiac output, less so by lowering the peripheral resistance. Mean pulmonary arterial pressure, as a measure of left-ventricular filling pressure, fell under Piretanid/Captopril and Piretanid/Urapidil, remaining high under Acebutolol/Piretanid. Thus the combinations of Piretanid/Captopril and Piretanid/Urapidil are most likely to fulfill the demands to be placed on an "ideal" antihypertensive treatment. PMID- 3289875 TI - [Allergy to human insulin. Case reports on 3 patients]. AB - Allergy against human insulin was demonstrated in three diabetics who had not previously been treated with animal-derived insulin. In all three patients the allergy developed within a few weeks or months of starting insulin treatment. The diagnosis was confirmed by intracutaneous tests and determination of insulin specific IgE antibodies. Desensitisation was necessary in one patient, in the other two the allergic symptoms were successfully treated by local measures. Two of the patients are at present well controlled on human insulin, while the third is still undergoing desensitisation. Such cases of primary allergy against human insulin have not previously been reported in the German medical literature. PMID- 3289876 TI - [Dorso-cranial liver resection with hepato-atrial anastomosis. An alternative to liver transplantation or the surgical procedure of choice in Budd-Chiari syndrome?]. AB - Surgery was required for a 23-year-old woman with rapidly progressive reduction in liver function and treatment-resistant ascites due to Budd-Chiari syndrome. A dorsocranial liver resection with hepatoatrial anastomosis was performed. The postoperative course has been satisfactory, demonstrating that this method should be seriously considered in the treatment of Budd-Chiari syndrome. PMID- 3289877 TI - [Hyposensitization in allergic diseases?]. PMID- 3289878 TI - [Dipyridamole-201thallium perfusion scintigraphy in coronary diseases]. PMID- 3289879 TI - [Inhalation anesthetics today]. PMID- 3289880 TI - [Hans Popper]. PMID- 3289881 TI - [Diagnosis of diabetic neuropathies]. PMID- 3289882 TI - [Therapy of diabetic polyneuropathy]. PMID- 3289884 TI - [Differences in the effectiveness of levothyroxine preparations]. PMID- 3289883 TI - [Enzyme substitution in the treatment of pain in chronic pancreatitis. Significance of feedback regulation in pancreatic secretion]. PMID- 3289885 TI - [Testing of a reflection photometer for the determination of enzymes and metabolites in the blood plasma of racehorses]. PMID- 3289887 TI - [Narasin poisoning in turkeys]. PMID- 3289886 TI - An enzyme-linked immunosorbent assay (ELISA) for detection of antibodies against swine fever virus using horseradish-peroxidase-protein-A as conjugate. PMID- 3289888 TI - [Pregnancy detection in Asian and African elephants]. PMID- 3289889 TI - [Etiologic and pathomorphologic parallels in chlamydial abortion in sheep]. PMID- 3289890 TI - [Clinical aspect and treatment of respiratory distress syndrome in newborn calves]. PMID- 3289891 TI - Temporal arteritis. PMID- 3289892 TI - The Endocrine Society: origin, organization, and institutions. PMID- 3289893 TI - Altered differentiated cell surface properties of transformed (RINm5F) compared with native adult rat pancreatic B cells. AB - RINm5F cells, a line derived from a rat insulinoma, are frequently used as a model for studying pancreatic B cell structure and function. These transformed cells are known, however, to be different from native B cells in a number of biochemical respects. We have now compared the surface features of RIN cells and native B cells in two different ways: 1) Dispersed cells from islet obtained from adult rats can reassociate spontaneously in culture to form aggregates (pseudoislets) with cellular organization similar to that of intact native islets (a central B cell core surrounded by a discontinuous mantle of non-B cells). Native islet cells and RIN cells were mixed together and allowed to reaggregate. Examination by immunocytochemistry and transmission electron microscopy showed that the aggregates contained all cell types present in the original mixed cell suspension (native B- and non-B cells, and RIN cells). The native B cells were centrally located, surrounded by zones of non-B cells, as in islets. The RIN cells, however, were restricted to the periphery and as such not recognized as native B cells. 2) R2D6, a monoclonal antibody, binds selectively to a ganglioside on the surface of islet B, but not non-B, cells. The role of this ganglioside is not known. RIN cells were incubated with R2D6 followed by a fluorescently labeled second antibody. Analysis by flow cytofluorometry indicated that the monoclonal antibody had bound (stained) only 3-15% of the RIN cells. These R2D6 positive cells were sorted from R2D6 negative cells and subsequently shown to have a lower DNA content. Expression of the R2D6 target ganglioside on RIN cells thus appears to be cell cycle dependent. Based on two different criteria, RINm5F cells do not therefore share surface features in common with native B cells. The cell cycle dependent expression of a B cell surface antigen by the RIN cells might, however, be a useful model for studying the regulation of ganglioside turnover. PMID- 3289895 TI - Transcriptional regulation of a rat hepatoma gene by insulin and protein kinase C. AB - Both insulin and phorbol esters rapidly stimulated the cytoplasmic accumulation of a specific mRNA (designated p33) in a time- and dose-dependent manner in serum deprived rat H4 hepatoma cells. When cells were pretreated with phorbol esters to produce a deficiency in protein kinase-C, the ability of further phorbol ester addition to stimulate p33 mRNA accumulation was abolished. However, after pretreatment of H4 cells with phorbol esters, insulin still induced cellular p33 mRNA concentrations, but to a lesser degree. The primary effect of phorbol esters was to increase transcription of the p33 gene, and this was abolished after pretreatment with phorbol esters. In previous work, insulin was shown to stimulate p33 gene transcription, but this effect was insufficient to account for the level of insulin-induced p33 mRNA production. The transcriptional effect of insulin was further reduced by phorbol ester pretreatment. Insulin must, therefore, regulate p33 gene expression by at least two pathways, at least one of which may be modulated by protein kinase-C. PMID- 3289894 TI - Effect of baroreceptor denervation on the inhibition of renin release by vasopressin. AB - Previous studies have suggested that the inhibition of renin secretion by acute administration of vasopressin in conscious dogs results from a reflex reduction in renal nerve activity. In the present investigation, this hypothesis was tested by studying the effect of total baroreceptor denervation or selective low pressure baroreceptor denervation on the suppression of PRA by vasopressin in conscious, chronically prepared dogs. In eight sham-operated dogs, a 45-min infusion of vasopressin (2.0 ng/kg.min, iv) decreased PRA from 10.5 +/- 1.9 to 5.9 +/- 1.0 ng/ml.3 h (P less than 0.01). Mean arterial pressure did not change (110 +/- 10 to 107 +/- 7 mm Hg), but heart rate decreased from 84 +/- 9 to 69 +/- 8 beats/min (P less than 0.05). In contrast, vasopressin infusion failed to significantly decrease PRA in seven sinoaortic/cardiac denervated dogs (9.5 +/- 1.7 to 7.4 +/- 2.0 ng/ml.3 h), although decreases did occur in three of the dogs. Mean arterial pressure increased from 104 +/- 5 to 125 +/- 6 mm Hg (P less than 0.01), but heart rate did not change (112 +/- 4 to 107 +/- 5 beats/min). When renal perfusion pressure was maintained at the preinfusion level in three sinoaortic/cardiac denervated dogs, vasopressin infusion failed to decrease PRA (2.3 +/- 0.6 to 2.4 +/- 0.6 ng/ml.3 h). In six cardiac denervated dogs, vasopressin infusion decreased PRA from 5.3 to 0.9 to 3.1 +/- 0.7 ng/ml.3 h (P less than 0.01). Results obtained with two lower doses of vasopressin (0.5 and 1.0 ng/kg.min) were generally similar to the responses observed during infusion at 2.0 ng/kg.min. Angiotensin II (5.0 ng/kg.min) suppressed PRA in all groups of dogs. These experiments demonstrate that the inhibition of renin secretion by acute administration of vasopressin in conscious dogs is prevented by total baroreceptor denervation, but not by denervation of the low pressure baroreceptors alone. These results suggest that the suppression of renin release by vasopressin is a reflex response resulting from activation of the high pressure baroreceptors. PMID- 3289896 TI - Peripheral insulin release after pancreatic resection: the effect of decreased beta-cell mass with systemic or portal drainage. AB - Surgical alteration of the pancreas can result in several anatomic alterations which may affect insulin release. We evaluated the effects of resection, systemic drainage, and autotransplantation of the canine pancreas on peripheral insulin levels and glucose disposal as measured by iv glucose tolerance tests (IVGTT) and a steady state hyperglycemic challenge (clamp). Proximal pancreatectomy (PPx) with reduced beta-cell mass and intact portal drainage resulted in a modestly elevated fasting glucose level and increased integrated glucose response to IVGTT. Compared to preoperative normals, basal insulin was unchanged from preoperative controls; however, peak insulin and integrated insulin response to IVGTT were decreased in PPx animals. Splenocaval drainage or autotransplantation of the distal pancreas resulted in normalization of the severely altered insulin response and fasting glucose levels. K values were significantly reduced after all three procedures. Clamp studies confirmed the basal glucose and insulin findings of the IVGTT. During the clamp, PPx animals had peripheral insulin values approximately 50% of normal controls, while autotransplantation and splenocaval drainage animals had insulin values that approximate normal controls. All three postsurgical groups had blunted insulin levels during stable hyperglycemia. Glucose utilization rates were severely decreased in all three groups. Reduction of beta-cell mass with intact portal drainage resulted in reduced insulin response to glucose challenge by either IVGTT or clamp. Systemic drainage of this same reduced beta-cell mass resulted in peripheral insulin levels comparable to normal controls. Denervation (autotransplantation) had little additive effect. All three groups demonstrated severely decreased rates of glucose disappearance as measured by both IVGTT and clamp studies. Therefore, reduction in beta-cell mass, drained systemically or portally, results in altered glucose disposal regardless of the peripheral insulin levels. PMID- 3289897 TI - Insulin synthesis by isolated rabbit neurons. AB - Insulin has been identified in the central nervous system of a number of vertebrate species, but the site of synthesis as yet remains unresolved. Two previous studies reported the presence of insulin mRNA in neural tissue, but related efforts to confirm and better localize the cellular origin of the hormone have yielded equivocal results. In the present study we have attempted to clarify this issue by employing both immunocytochemistry and in situ hybridization on isolated enriched cultures of rabbit brain neurons and glia. Our data show that a subset (3-5%) of neurons is positively immunoreactive for insulin, but all of the glial cells are negative. The level of staining intensity can be increased by preincubating the neurons with monensin (a Na+ ionophore that prevents cell secretory activity), but not the fraction of positive cells. Similarly, in situ hybridization reveals the presence of mRNA in 3-5% of neurons, but no such signal is detected in glia. Thus, our data not only confirm previous reports of insulin in the central nervous system, but, more importantly, indicate that the synthesis of the hormone is local and apparently confined to a subset of neurons. PMID- 3289898 TI - Hormone ontogeny in the ovine fetus: XXI. The effect of insulin-like growth factor-I on plasma fetal growth hormone, insulin and glucose concentrations. AB - We infused intravenously recombinant human Insulin-like Growth Factor-I (IGF-I; 1 microgram/kg/min for 120 minutes after an acute dose of 25 micrograms/kg) into chronically catheterized ovine fetuses (124-132 days gestation) to study its effect on the secretion of fetal ovine Growth Hormone (oGH). In all IGF-I infused fetuses, oGH concentrations fell during the infusion. The maximal change in the concentration of oGH (mean +/- SEM) was -54 +/- 10 ng/ml in contrast to +7 +/- 6 ng/ml in saline controls (p less than 0.005), a decrease of 33 +/- 4% (controls: +6 +/- 5%; p less than 0.005). By 60 minutes after the infusion of IGF-I was completed, the concentration of plasma oGH was comparable to control and pre infusion values. In IGF-I infused fetuses, the mean concentration of insulin also decreased (p less than 0.02), whereas glucose levels remained unaltered. The results suggest that the lack of inhibitory feedback by the relatively low levels of circulating IGF-I is one factor in the hypersecretion of GH by the fetus. PMID- 3289899 TI - Crohn's disease in the esophagus--report of a case. AB - A case of esophageal Crohn's disease is described. Crohn's lesion was observed in the lower esophagus, and sarcoid-like granulomas were found in the biopsied specimen. A clinical consideration of this phenomenon is presented. PMID- 3289900 TI - Transendoscopic Doppler ultrasound: usefulness for diagnosis and treatment of vascular malformations. AB - Vascular malformations of the GI tract can be treated by thermal methods, including the YAG laser. The diagnosis of these lesions is not always easy, and it is difficult to evaluate the completeness of therapy of these lesions. We investigated the value of Doppler ultrasound in this respect. The TVD-1 (Key Med) transendoscopic vascular detector using the 2.5 mm diameter probe emitting at 7 MHz, was used through standard endoscopes. Outputs were monitored through a loudspeaker, and imaged on an oscilloscope, or recorded on a mingograph. Diagnostic usefulness was studied in 64 vascular lesions, 36 in the colon and 28 in the upper GI tract in ten patients. A Doppler signal was detected in 75% of the lesions, including all lesions larger than 5 mm in diameter. Forty-five lesions in 13 patients were studied before and immediately after laser therapy. Three out of five patients in whom Doppler-positive lesions persisted after laser treatment rebled, as compared with 2 out of 8 patients with Doppler-negativity. Disappearance of the signal, however, may be transient, and is probably due to laser-induced edema. These results suggest that endoscopic Doppler ultrasound may have a role in the diagnosis and treatment of vascular anomalies of the GI tract, and should stimulate further research. PMID- 3289901 TI - Experimental evaluation of surfactants for replacement therapy. PMID- 3289902 TI - Effect of lung airway branching pattern and gas composition on particle deposition. I. Background and literature review. AB - This paper reviews (1) the influence of airflow and particle motion on particle deposition within human lung airways, (2) the effects of carrier gas properties on mass transport in lung airways, and (3) the differences in particle deposition patterns and efficiencies between humans and experimental animals. The primary purpose of this review of general principles and available literature is to identify critical factors affecting the dosimetry of inhaled toxicants. Special attention is paid to studies utilizing gases of varying composition, which illuminate the role of flow profiles and turbulence in gas and particle penetration, and to studies of the effects of interspecies differences in airway branching patterns on particle deposition patterns within the airways. PMID- 3289903 TI - Proliferative lesions in the male reproductive system of F344 rats and B6C3F1 mice: incidence and classification. AB - The incidences of all primary neoplasms in the testes and accessory reproductive organs of 51,230 male Fischer 344 (F344) rats and 46,752 male B6C3F1 mice were obtained from the pathology data base of more than 300 long-term toxicity/carcinogenicity studies performed for the National Toxicology Program. The overall incidence of reproductive system neoplasms in male F344 rats was 81.5%. The most common neoplasms were interstitial cell adenoma of the testis (76.6%), adenoma/carcinoma of the preputial glands (2.9%), mesothelioma of the tunica vaginalis (1.5%), and adenoma of the prostate gland (0.3%). The combined incidence (0.1%) of 59 other rare neoplasms consisted of 18 different types that occurred with a frequency of 4 or less. In contrast to the rats, male B6C3F1 mice had a low overall incidence (0.6%) of neoplasms in reproductive organs. The most common neoplasm was the interstitial cell adenoma (0.4%). Thirty additional types of neoplasms were identified. Each of these uncommon neoplasms occurred at a frequency of 12 or less with an overall combined incidence of 0.2%. Morphological features are described for neoplasms in the rat and mouse, and criteria are presented for differentiation of testicular interstitial cell adenoma, prostatic adenoma, and mesothelioma from hyperplastic changes. PMID- 3289904 TI - Hemodynamic response to carbon monoxide. AB - Historically, and at present, carbon monoxide is a major gaseous poison responsible for widespread morbidity and mortality. From threshold to maximal nonlethal levels, a variety of cardiovascular changes occur, both immediately and in the long term, whose homeostatic function it is to renormalize tissue oxygen delivery. However, notwithstanding numerous studies over the past century, the literature remains equivocal regarding the hemodynamic responses in animals and humans, although CO hypoxia is clearly different in several respects from hypoxic hypoxia. Factors complicating interpretation of experimental findings include species, CO dose level and rate, route of CO delivery, duration, level of exertion, state of consciousness, and anesthetic agent used. For example, tachycardia is commonly observed, although bradycardia also can result from myocardial and/or central nervous system (CNS) hypoxemia at high carboxyhemoglobin (COHb) saturations, as can electrocardiographic abnormalities. Augmented cardiac output usually observed with moderate COHb may be compromised in more severe poisoning for the same reasons, such that regional or global ischemia result. The hypotension usually seen in most animal studies is thought to be a primary cause of CNS damage resulting from acute CO poisoning, yet the exact mechanism(s) remains unproven in both animals and humans, as does the way in which CO produces hypotension. This review briefly summarizes the literature relevant to the short- and long-term hemodynamic responses reported in animals and humans. It concludes by presenting an overview using data from a single species in which the most complete work has been done to date. PMID- 3289905 TI - Lesions of testis and epididymis associated with prenatal diethylstilbestrol exposure. AB - Cryptorchidism and retention of Mullerian duct structures occur with high frequency among the male offspring of CD-1 mice treated with 100 micrograms diethylstilbestrol/kg body weight on days 9 through 16 of pregnancy. Hyperplasia of the rete testis and Mullerian duct structures were found in many of the DES treated male mice, as was a low but significant number of reproductive tract neoplasms. PMID- 3289906 TI - Male reproductive toxicology: comparison of the human to animal models. AB - The human male is of relatively low fertility and thus may be at greater risk from reproductive toxicants than are males of the common laboratory animal model species. Lack of knowledge of the physiological differences that contribute to interspecies variation between man and animals can prevent the effective application of animal data to the assessment of human reproductive risk. Evaluation of spermatogenesis from testicular histology, while uncommon, can provide valuable information about human reproductive risk. The measurement of sperm count or concentration has long been the most feasible approach for human semen evaluation, but may be an insensitive indicator of reproductive function because of high sample-to-sample variability. Interspecies extrapolation factors can be calculated by comparing the reduction in sperm count in humans and test species after exposure to drugs or chemicals. These factors can provide a realistic assessment of relative risk, provided that the sperm are counted at the appropriate time after exposure. However, the degree to which extrapolation factors derived for one agent, and only from sperm counts, can be generalized is not known. Monitoring of sperm motility and morphology parameters is also a common means of evaluating human semen quality, but these techniques are also hampered by the relatively high interindividual and intersample variability. Computer-assisted and morphometric approaches show promise of decreasing the subjective nature of these evaluations and increasing their value in risk assessment procedures. Improvements in predicting human reproductive risk can be expected to come from increased knowledge about reproductive mechanisms in man and animals, together with the utilization of objective measures of cellular indicators of male reproductive function. PMID- 3289907 TI - Issues and current applications of interspecies extrapolation of carcinogenic potency as a component of risk assessment. AB - The Life Sciences Research Office (LSRO) of the Federation of American Societies for Experimental Biology (FASEB) is conducting this symposium under contract with the Center for Food Safety and Applied Nutrition (CFSAN) of the Food and Drug Administration (FDA). The FDA has requested information on the strengths and weaknesses of current interspecies extrapolation methods using metabolic and pharmacokinetic data, identity of data for these methods, bases for choice of extrapolation method and selection of data base, validity and uniformity of interspecies extrapolation from target organ data, and nature and completeness of supporting data. Definitions and basic concepts of dose scaling are addressed and questions regarding appropriate units of measurement (e.g., mg/kg body weight, mg/m3 respired air, mg/m2 surface area) are raised. The use of DNA damage as a marker or end point upon which to scale carcinogenic potency is considered. Genotoxic mechanisms of carcinogenesis are emphasized because the roles of DNA adducts and DNA repair processes in initiation and promotion are much better defined than the mechanism for nongenotoxic carcinogenesis. The problems encountered in evaluating the human carcinogenicity of trichloroethylene are reviewed. The broad objectives of the symposium are discussed and the development of a structured format for the presentation of invited papers is presented. PMID- 3289908 TI - Comparative biology of test species. AB - This paper assesses the capacity of animal models to predict human response to carcinogenic agents with consideration for the heterogeneity of humans. It is widely accepted that human susceptibility to toxic substances, including carcinogens, is highly variable. Conventional rodent models are usually highly inbred and valued for their ability to display characteristic homogeneity. Current practice assumes that the homogeneity of response to toxic agents, including carcinogens, in the rodent model will be representative of humans. The issue then becomes, To which of the broad spectrum of human responses are specific animal models likely to be related? This paper examines the extent of human heterogeneity over a broad range of biochemical characteristics (e.g., aryl hydrocarbon hydroxylase activity, epoxide hydrase activity, beta-glucuronidase activity, debrisoquine hydroxylation, DNA-adduct formation) with emphasis on those biochemical characteristics that affect responses to carcinogens. Examples are presented to compare the heterogeneity of selected animal models for these biochemical characteristics as they relate to the spectrum of human responses noted above. The paper presents a theoretical perspective for determining to which part of the human population response spectrum common animal models are most likely to be extrapolated. PMID- 3289909 TI - Absorption and distribution of xenobiotics. AB - Extrapolation of pharmacokinetic data between species has been simplified by the advent of more sensitive methods of analysis of chemicals in body tissues and by the capability of inexpensive computers to perform complex calculations. These new methods enable investigators to observe the rates at which target tissues reach equilibrium in different species and to develop mathematical models of these processes. The evaluation of physiological pharmacokinetics from classical or compartmental kinetics is improving the ability to project the long-term behavior of chemicals in body fluids and organs based on independently derived physical, chemical, and physiological constants obtained from simple chemical reactions, tissue culture experiments, or short-term animal studies. Accurate prediction of chemical behavior by such models gives support to hypothetical mechanisms of distribution and accumulation, while significant deviations from predicted behavior signal the existence of previously unsuspected pathways. These techniques permit the simulation of the impact of linear, nonlinear, and saturation kinetics on chemical behavior; the prediction of integrated tissue exposure; and the mapping of the sequence of alternate metabolic pathways that lead to toxicity or detoxification. The discussion will identify the research needs for improving extrapolations between species. PMID- 3289910 TI - Interspecies comparisons of tissue DNA damage, repair, fixation, and replication. AB - The many anatomical, physiological, and biochemical differences among various mammalian species make it difficult to extrapolate carcinogenic potency data from animals to humans. The process is further complicated by the multistep origin of most malignant tumors in animals and humans due to the interaction of target cells with both endogenous and exogenous factors. Species differences in these aspects of carcinogenesis must also be considered when attempting to evaluate the carcinogenic risks of chemicals to humans. Cancer development in animals involves at least three distinct stages: initiation, promotion, and progression. Intra- and interspecies differences in susceptibility to carcinogenesis may be related to any one or a combination of these stages. Variation in species susceptibility to tumor initiation may result from differences in the abilities of various species to metabolize a potential carcinogen to an ultimate carcinogenic form and/or to detoxify the carcinogen. Most comparative studies among species have only revealed subtle differences in metabolism. DNA adducts from several activated carcinogens have been found to be the same in a number of tissues from various species, including humans. Capacity for DNA repair is apparently a critical factor in the initiation of carcinogenesis in target cells of different species but is less critical among mice that differ in susceptibility to two stage carcinogenesis of the skin and liver. Susceptibility variations among stocks and strains to such carcinogenesis appear to be related to alterations in tumor promotion. Additional comparative studies are critically needed on all aspects of carcinogenesis to permit effective extrapolation of carcinogenic potency data from animals to humans. PMID- 3289911 TI - Comparative histopathology of the development of selected neoplasms of the liver, pancreas, and urinary bladder in rodents. AB - The valid extrapolation of carcinogenesis data from one species to another depends, in part, on strong similarities of the metabolic and cellular mechanisms involved in the carcinogenic process and similarities in the nature and behavior of the various lesions that appear during the development of neoplasia between the species involved. Although there are many biological differences between the various rodent species used in carcinogenesis research, there are more similarities, in keeping with the surprising unity of basic cellular and tissue organization and function that is evident throughout biological systems at every level of evolutionary development. An understanding of intraspecies similarities and differences, especially as these modify the morphologic responses of the host to carcinogenic chemicals, is of central importance if carcinogenesis data from one species are to be used to predict carcinogenic risk in another. In this manuscript the histopathology of the various lesions that appear during chemically induced cancer of the liver, pancreas, and bladder in several rodent species has been selected to compare and contrast similarities and differences that exist among them and among the spontaneous premalignant lesions and carcinomas of these organs in humans. PMID- 3289912 TI - Needs for biological risk assessment in interspecies extrapolation. AB - This paper suggests that not all chemicals shown to be carcinogenic in animals may exert this effect in humans exposed to much lower amounts of the chemical. It is possible that agents which differ in their effects in humans and animals may be identified through the application of Biological Risk Assessment to the experimental results. Chemicals tested in systems in which untreated animals develop high background yields of tumors or in which high-dose toxicity may be a critical factor in the induction of carcinogenesis are suggested as candidates requiring very careful consideration before their carcinogenicity in humans is assumed. PMID- 3289913 TI - Opportunities for improving techniques for interspecies extrapolation in the risk assessment process. AB - Quantitative estimates of human carcinogenic risk from chemical exposure are currently derived primarily from linearized multistage model analyses of the tumor response as observed in chronic laboratory animal bioassays versus administered dose. The numerous ad hoc assumptions that provide a rationale for this generic approach to carcinogenic risk assessment can only be evaluated critically when mechanistic data directly relevant to the low-dose and interspecies extrapolation problems are available. Clear needs exist to develop such ancillary data bases and the means for explicitly incorporating them into the risk estimation process. Target site dosimetry provides one useful organizing concept. Physiological response modeling can account systematically for interspecies variations in the distribution and disposition of chemicals in relation to external measures of exposure. Direct measurements of interactions of chemicals and their metabolites with specific target macromolecules can provide sensitive and biologically meaningful exposure indices. Alternatively, quantitation of toxic effects such as altered cell regulation and differentiation can serve the same purpose. Virus and oncogene activation, DNA damage and repair, and enhanced cell proliferation provide additional biological markers of exposure. They may also comprise critical elements of the carcinogenic process. Identification of the actual mechanisms involved should eventually lead to the development of risk assessment models that adequately reflect the unique biological and toxicological characteristics of different species-chemical combinations. PMID- 3289915 TI - Health promotion--science or ideology? AB - This article is the author's American Psychological Association Division 38 Presidential Address, which was delivered at the 1987 APA meetings. It challenges health psychologists to be wary of becoming zealots in health promotion activities without continuing to recognize that health promotion programs should be anchored in sound science. This is discussed in terms of the biomedical research support for a recommended health practice or in terms of the psycho socio-behavioral research support for techniques applied or advocated in intervention programs. To illustrate this problem in health promotion, the research foundations for recommendations of cholesterol control programs and the "Say No to Drugs" campaigns are explored. Other concerns relating to the appropriate role for the health psychologist in health promotion activities are also discussed. PMID- 3289914 TI - Body fat in normal adults estimated by oxygen-18- and deuterium-dilution and by anthropometry: a comparison. AB - We estimated body fat in 20 normal adults (10 males and 10 females) from 18O- and 2H-dilution spaces and from the equations of Durnin & Womersley and Pollock, Schmidt & Jackson based on skinfold thickness measurements. Differences between methods for body fat estimation were found to be sex-dependent: subsequent analyses indicated significant differences between methods within each sex. Regardless of sex, the highest fat estimates were obtained with the 18O-dilution method, followed by those obtained with the 2H-dilution method or the Durnin & Womersley equation. The lowest fat estimates were obtained using the Pollock, Schmidt & Jackson equation. The 18O-dilution method and the Durnin & Wormersley anthropometric method are both suitable and appropriate for body fat estimation in adults studied under field conditions. PMID- 3289916 TI - Psychosocial models of the role of social support in the etiology of physical disease. AB - Although there has been a substantial effort to establish the beneficial effects of social support on health and well-being, relatively little work has focused on how social support influences physical health. This article outlines possible mechanisms through which support systems may influence the etiology of physical disease. I begin by reviewing research on the relations between social support and morbidity and between social support and mortality. I distinguish between various conceptualizations of social support used in the existing literature and provide alternative explanations of how each of these conceptualizations of the social environment could influence the etiology of physical disease. In each case, I address the psychological mediators (e.g., health relevant cognitions, affect, and health behaviors) as well as biologic links (e.g., neuroendocrine links to immune and cardiovascular function). I conclude by proposing conceptual and methodological guidelines for future research in this area, highlighting the unique contributions psychologists can make to this inherently interdisciplinary endeavor. PMID- 3289918 TI - Isolation and characterization of porcine diazepam-binding inhibitor, a polypeptide not only of cerebral occurrence but also common in intestinal tissues and with effects on regulation of insulin release. AB - The polypeptide DBI (diazepam-binding inhibitor) has been purified from the porcine upper intestine, where it is abundant. Porcine mature DBI is composed of 86 amino acid residues and has a blocked N-terminus. The primary structure, the first DBI structure determined at the protein level, differs from those indirectly deduced for human and rat DBI at 11 and 17 positions, respectively. In total, the three mammalian DBIs differ at 22 positions but have exactly identical C-terminal 11-residue segments, highly charged and ending with C-terminal isoleucine. The porcine DBI inhibits both the early and the late phase of glucose induced insulin release from the isolated perfused rat pancreas. Thus, the results identify by direct analysis the presence of DBI at a non-cerebral localization (gut), establish a novel structural form (porcine) and demonstrate a novel bioactivity (on insulin release). These aspects are of special interest in relation to the conserved segments, including the one at the C-terminal end, which may constitute functionally important parts of the polypeptide. It is possible that DBI belongs to a new family of gut polypeptides which inhibit glucose-mediated insulin release by hormonal and/or neurocrine mechanisms. PMID- 3289917 TI - Interlaboratory studies with the Chinese hamster V79 cell metabolic cooperation assay to detect tumor-promoting agents. AB - Three laboratories participated in an interlaboratory study to evaluate the usefulness of the Chinese hamster V79 cell metabolic cooperation assay to predict the tumor-promoting activity of selected chemicals. Twenty-three chemicals of different chemical structures (phorbol esters, barbiturates, phenols, artificial sweeteners, alkanes, and peroxides) were chosen for testing based on in vivo promotion activities, as reported in the literature. Assay protocols and materials were standardized, and the chemicals were coded to facilitate unbiased evaluation. A chemical was tested only once in each laboratory, with one of the three laboratories testing only 15 out of 23 chemicals. Dunnett's test was used for statistical analysis, and differences between treated- and control-cell responses were analyzed at P less than or equal to .01. Chemicals were scored as positive (at least two concentration levels statistically different than control), equivocal (only one concentration statistically different), or negative. For 15 chemicals tested in all three laboratories, there was complete agreement among the laboratories for nine chemicals. For the 23 chemicals tested in only two laboratories, there was agreement on 16 chemicals. With the exception of the peroxides and alkanes, the metabolic cooperation data were in general agreement with in vivo data. However, an overall evaluation of the V79 cell system for predicting in vivo promotion activity was difficult because of the organ specificity of certain chemicals and/or the limited number of adequately tested nonpromoting chemicals. PMID- 3289919 TI - Electron transfer between the hydrogenase from Desulfovibrio vulgaris (Hildenborough) and viologens. 1. Investigations by cyclic voltammetry. AB - The electron transfer kinetics between the hydrogenase from Desulvovibrio vulgaris (strain Hildenborough) and three different viologen mediators has been investigated by cyclic voltammetry. The mediators methyl viologen, di(n aminopropyl) viologen and propyl viologen sulfonate differ in redox potential and in net charge. Dependent on the pH both the one- and two-electron-reduced forms or only the two-electron-reduced form of the viologens are effective in electron exchange with hydrogenase. Calculations of the second-order rate constant k for the reaction between reduced viologen and hydrogenase are based on the theory of the simplest electrocatalytic mechanism. Values for k are in the range of 10(6) 10(7) M-1 s-1 and increase in the direction propyl viologen sulfonate----methyl viologen----di(n-aminopropyl) viologen. An explanation is based on electrostatic interactions. It is proposed that the electron transfer reaction is the rate determining step in the catalytic mechanism. PMID- 3289920 TI - Electron transfer between the hydrogenase from Desulfovibrio vulgaris (Hildenborough) and viologens. 2. Investigations by chronoamperometry. AB - The electron transfer kinetics between the hydrogenase from Desulfovibrio vulgaris (strain Hildenborough) and the mediators methyl viologen, di-(n aminopropyl) viologen and propyl viologen sulfonate have been investigated by chronoamperometry. Second-order rate constants were calculated on basis of the theory for a simple catalytic mechanism and are compared with the results obtained before by cyclic voltammetry (preceding paper in this journal). From the ionic-strength dependence and the observed differences in the rate constants for the differently charged viologens, the existence of an electrostatic interaction between mediator and a negatively charged part of the protein is confirmed. Chronoamperometry (computer-controlled) was found to possess advantages over cyclic voltammetry in the determination of homogeneous rate constants (faster, more accurate, and better reproducibility). PMID- 3289922 TI - Kinetic and spectral studies on the redox forms of methanol dehydrogenase from Hyphomicrobium X. AB - Several reaction rate constants in the catalytic cycle of methanol dehydrogenase (EC 1.1.99.8) in vitro were determined with stopped-flow spectrophotometry. The studies revealed that the high pH required for adequate activity of the enzyme is related to the strong pH dependency of the oxidation rates of the reduced and semiquinone enzyme forms, MDHred and MDHsem, with the artificial electron acceptor Wurster's blue. The rate-limiting step in the catalytic cycle is associated with the conversion of oxidized enzyme-substrate complex (MDHox.S) into reduced enzyme (MDHred) and product. The effect of activator (ammonium salts) was also confined to this step, but even saturating concentrations were unable to remove the limitation completely. Making use of the large deuterium isotope effect associated with substrate oxidation in the absence of activator, the transient MDHox.C2H3OH complex could be isolated and its slow decomposition into MDHred and formaldehyde could be demonstrated. Further evidence is presented to support the view that the different absorption spectra observed originate from genuine redox forms of methanol dehydrogenase with different redox states of the cofactor PQQ and not from enzyme-electron acceptor complexes. The results confirm and extend our original view on the mechanism of action and contradict the mechanism proposed by others [Parkes, C. & Abeles, R. H. (1984) Biochemistry 23, 6355-6363]. PMID- 3289923 TI - Immunoelectron microscopic localisation of ribosomal proteins from Bacillus stearothermophilus that are homologous to Escherichia coli L1, L6, L23 and L29. AB - The locations of proteins BL1, BL6, BL23 and BL29 from Bacillus stearothermophilus have been determined on the ribosomal surface by immunoelectron microscopy. All four proteins were localized in the same region of the 50S subunit as their homologous counterparts from Escherichia coli, indicating that the ribosomal architecture is the same in both species. This finding is of great importance as it allows structural data obtained on ribosomes from either organism to be incorporated into a unique ribosome model. PMID- 3289921 TI - Study of the coinduction by fatty acids of catalase A and acyl-CoA oxidase in standard and mutant Saccharomyces cerevisiae strains. AB - Evidence is presented that Saccharomyces cerevisiae can metabolize fatty acids via the inducible peroxisomal beta-oxidation pathway even when these acids are not the sole carbon source. The fatty acids of chain length of C10-C18 induce acyl-CoA oxidase simultaneously with catalase A but have no effect on catalase T and acyl-CoA dehydrogenase. The coinduction of both acyl-CoA oxidase and catalase A is recorded in strains with both active catalase A and T or displaying only catalase A activity. In mutants lacking catalase A, the induction of acyl-CoA oxidase is observed without a concomitant increase in catalase activity. After centrifugation in a linear Ficoll gradient of the particulate fraction from the cells grown on ethanol and oleate the activity of acyl-CoA oxidase cosediments with catalase A. The relationship of catalase A to acyl-CoA oxidase is discussed. PMID- 3289924 TI - Orbital and intracranial haemangiopericytoma. Case report with a short review. AB - A case of haemangiopericytoma (HPC) in a 50-year-old male occurring in the orbit and the adjoining anterior and middle cranial fossa, studied by ultrasound, angiography and computed tomographic scans, is presented. A short review of the radiological features is given. This is the first case of this rare tumor studied by all the three aforementioned radiodiagnostic modalities; and one of the few reports of its computed tomographic (CT) appearances in the literature. The marked and persistent enhancement of this tumour with the polycyclic nature of its well-defined margins as seen on CT is emphasized. It is suggested that dynamic scanning may assist in differentiating this tumour from meningioma with which it is often confused. PMID- 3289925 TI - Schwannoma of the lesser omentum. AB - A case of solitary benign schwannoma of the omentum is detected by CT, ultrasonography and angiography, as a solid mass containing cystic regions. PMID- 3289926 TI - Seminal vesicle cyst and ipsilateral renal agenesis. Case report. AB - Cysts of the seminal vesicles are rare, and associated anomalies of the ipsilateral kidney are frequent. We report a case of a monolocular cystic mass in the seminal vesicle bed in a young male with recurrent epididymitis, with emphasis on the ultrasonographic and CT features. The embryological background is briefly mentioned. PMID- 3289927 TI - Multiple imaging modalities in a case of hibernoma. AB - Hibernoma is a rare hypervascular benign tumour that originate from brown fat. A case of hibernoma of the thigh, examined by xeroradiography, ultrasound, CT and angiography, is reported. The characteristics of this tumour are considered. PMID- 3289928 TI - Value of ultrasonography in preoperative diagnosis of rotator cuff tears and postoperative follow-up. AB - Four hundred and six patients presenting with shoulder pain underwent bilateral shoulder ultrasonography. Rotator cuff lesions were diagnosed in 197 patients. In 155 of the 308 patients who had additional arthrographic examinations, the arthrogram documented rotator cuff tears. Sixty-eight patients underwent surgery. There was good correlation between the ultrasonographic and arthrographic findings as well as the surgical results, with a sensitivity of 91% for each examination technique. Thirty-six postoperative patients were studied ultrasonographically; a minor to marked increase in rotator cuff echogenicity was demonstrated in them all. Its high predictive value makes ultrasonography the method of choice in diagnosing rotator cuff tears. Based on the evaluation of particular criteria, rotator cuff tears (greater than 1 cm) are commonly documented by ultrasonography. Only in patients with indeterminate or negative ultrasonograms in whom there is a high index of clinical suspicion, should arthrography be performed as a complementary imaging test. In postoperative follow-up the degree of scar formation at the reinsertion of the tendon is adequately documented by ultrasonography. PMID- 3289930 TI - The Belgian Heart Disease Prevention Project: 10-year mortality follow-up. AB - The Belgian Heart Disease Prevention Project was a controlled, randomized multifactorial intervention trial in middle-aged men which lasted 6 years. Significant net differences between intervention and control groups were observed in change in risk profile, in total mortality and in CHD incidence. The net difference in risk profile change was greatest at two years, intermediate at four years and minimal at six years. Total and cause-specific mortality rates were systematically followed from the 6th to the 10th year. Follow-up at 10 years was 99.3% complete. The differences between intervention and control groups in total, coronary and cardiovascular mortality reduced from the 6th to the 10th year. The results suggest that changes in risk profile are rapidly followed by changes in cardiovascular mortality, but this applies in both directions. Thus risk reduction should be maintained in order to achieve a long-lasting preventive effect. PMID- 3289929 TI - Iopamidol 150 in intra-arterial digital angiography of the peripheral vasculature: a comparative study. AB - The results of a comparative double-blind clinical trial involving peripheral intra-arterial DSA performed with low iodine iopamidol concentrations (150 and 200 mg. I/ml.) are reported. Forty-six patients were examined for vital signs, local (heat and pain sensations) and systemic reactions and monitored throughout the procedure. No untoward effect was observed apart from mild local reactions, which on the other hand did not produce any movement artifacts. Image quality was good to optimal in 98% of the cases. In no case were higher concentrations of contrast medium (cm) needed. No significant differences between the two concentrations of cm used were observed with respect to either contrast ability or tolerability. PMID- 3289931 TI - A comparison of digoxin, diltiazem and their combination in the treatment of atrial fibrillation. AB - Fourteen patients (four females) with chronic atrial fibrillation were entered into a randomized, double-blind crossover study to compare the effects of treatment with diltiazem alone, digoxin alone, and a combination of diltiazem plus digoxin. The dose of digoxin was adjusted so as to achieve serum concentrations within the range 1.3-2.6 nmol l-1 between six and eight hours after dosing. Four patients were withdrawn from the study; three patients experienced side effects while taking diltiazem and one reverted to sinus rhythm while taking digoxin. Among the remaining 10 patients, mean heart rates were significantly lower during treatment with the combination of digoxin and diltiazem than with digoxin alone both at rest, after exercise and during ambulatory ECG monitoring. Post-exercise heart rates were reduced by 15% with combination therapy when compared with digoxin alone (151.9 vs. 128.1 bpm), but there was no evidence that this reduction in ventricular rate was associated with improved exercise tolerance. The results suggest that further reduction of the rapid ventricular rates seen in digitalized patients with AF by the use of diltiazem does not appear to be of benefit in the majority of patients. PMID- 3289933 TI - Some controversial aspects of cervical cancer precursors. PMID- 3289932 TI - Disopyramide in the maintenance of sinus rhythm after electroconversion of atrial fibrillation. A placebo-controlled one-year follow-up study. AB - In this multicentre study, 90 patients who left hospital in sinus rhythm after electroconversion of atrial fibrillation were randomized to double-blind treatment with either disopyramide (n = 44) or placebo (n = 46). The groups were comparable regarding age and sex distribution, duration of atrial fibrillation, heart volume and NYHA-classification. Life-table analysis was used to estimate the percentage of patients still in sinus rhythm and tolerating treatment at control visits after 1, 3, 6, 9 and 12 months. After 1 month there was already a significant difference (P less than 0.01) between the two groups (disopyramide 70%, placebo 39%), a difference that was still remaining after 12 months (disopyramide 54%, placebo 30%). Twenty-four patients, all relapsing to atrial fibrillation before six months on placebo, were converted to sinus rhythm once again. They were then treated with disopyramide in an open manner and after 12 months 37% were still in sinus rhythm. From the results of this study, disopyramide seems to be a useful drug in maintaining sinus rhythm after electroconversion of atrial fibrillation. PMID- 3289934 TI - Comparison of the diagnostic value of sonography and rectal examination in cancer of the prostate. AB - The value of endorectal sonography for the diagnosis of prostatic cancer was established after retrospective interpretation of sonographic findings in 213 patients, without prior knowledge of either the clinical or pathological data. Endorectal sonography was performed by the authors with a mechanical sectorial high frequency (7.5 MHz) probe. A pathology report (73 biopsies, 52 TUR, 7 suprapubic adenomectomy specimens) was available from 132 patients: 25 pathological examinations were interpreted as normal; 41 adenomas; 24 prostatitis or fibrosis, and 42 cancers (5 clinical stage T0, 22 T1, 2 T2 and 13 T3). Specificity for the diagnosis of cancer was 65 or 81%, respectively, according to the normality reference considered, i.e. either the group of patients having a normal pathological control (90 patients) or the same group plus another group of patients with a normal rectal examination (171 patients). The sensitivity for the diagnosis of cancer was only 48%. 43% of cancers were falsely interpreted as prostatitis or adenomas and 9% as normal (2 T0 and 2 T1). The large proportion of local stages without capsular involvement (29 of 42) is partly responsible for this lack of sensitivity. Rectal examination and sonography are complementary techniques. In the same study, rectal examination had a 48% specificity and a 92% sensitivity. PMID- 3289936 TI - Transitional cell carcinoma of the bladder in children under ten years of age. A case report. PMID- 3289935 TI - Intravesical chemoresection with 4'-epi-doxorubicin in patients with superficial bladder tumors. AB - The authors report the preliminary data concerning a multicentric study on ablative effects of 4'-epi-doxorubicin (EPR) on superficial bladder cancer. Forty six patients affected by multiple transitional cell superficial bladder carcinoma were treated by transurethral resection of all but one tumor, left as a marker lesion. Subsequently, an intensive local treatment with EPR and 3-month control cystoscopies with biopsies were performed. In the 47% of cases the control cystoscopy and pathology assessed the complete disappearance of marker lesions without any new occurrence whereas it is interesting to observe that the breakdown of the complete remissions into primary (67%) versus recurrent (37%) and in intravesical unpretreated (55%) versus pretreated (31%) showed important differences. It may be concluded that EPR shows a real activity against transitional cell superficial bladder carcinoma. PMID- 3289937 TI - Serum levels and urinary excretion of beta-2-microglobulin in patients with urinary bladder carcinoma. AB - The levels of beta 2-microglobulin in urine and serum were determined in 34 patients with urinary bladder carcinoma. In 22 patients (64%) serum beta 2 microglobulin was elevated and in 11 patients (32%) urinary excretion of the protein was increased. It was also found that all but 1 patient with elevated serum beta 2-microglobulin or urinary beta 2-microglobulin had WHO grade-II or grade-III tumors. In contrast, all patients with grade-I tumors, except 1, displayed normal levels of urine and serum beta 2-microglobulin. PMID- 3289938 TI - Lymphocyte subsets and macrophages in the male genital tract in health and disease. A monoclonal antibody-based study. AB - The crucial role of the immune system in the defence against infection and malignancy and its intimate involvement in the pathogenesis of a wide variety of chronic diseases is well established. Although the male genital tract is particularly vulnerable to infection, malignancies and autoimmune disorders which may lead to infertility, our knowledge of the distribution of cells of the immune system in the genital tract is limited. We have therefore investigated this matter using monoclonal antibodies to lymphocyte subsets, macrophages and HLA-DR antigens. These studies have revealed a consistent pattern of distribution of the cells of the immune system within the tissues of the male genital tract. Of special interest were the predominance of the T-suppressor/cytotoxic cells in the lining epithelium of the genital tract, the demonstration of macrophages in testicular tissues and the preferential expression of HLA-DR antigens on the lining epithelium. Profound changes in this pattern were noted in clinical specimens examined. These observations throw light both on normal immune homeostatic mechanisms within the male genital tract and the pathogenicity and aetiology of certain genital tract disorders and highlight the potential value of further studies in this area. PMID- 3289939 TI - Endoscopic biopsies for quantitative nerve density evaluation of the urinary bladder. AB - Nerve density in the lamina propria from endoscopic and open bladder biopsies is compared in normal and pathologic urinary bladders. A semiquantitative appreciation of nerve density is obtained by counting the fibers in a number of high power fields after S100 staining. Nerve density scoring on endoscopic biopsies is reliable and reproducible and can be applied in the assessment of neurogenic and nonneurogenic bladder disorders. PMID- 3289940 TI - Paratesticular rhabdomyosarcoma in adolescents. AB - Paratesticular rhabdomyosarcoma is a rare tumour which occurs mostly in children and adolescents. Unlike other paratesticular sarcomas, it is associated with a much poorer prognosis. Therefore a multidisciplinary approach in the management of this condition is advocated in an effort to improve the results of treatment. In this paper we report the first 2 cases managed at this hospital. PMID- 3289941 TI - Relationship between radioligand binding assay, immunoenzyme assay and immunohistochemical assay for estrogen receptors in human breast cancer and association with tumor differentiation. AB - We have studied the merit of a new enzyme immunoassay (EIA) in relation to the results obtained with a conventional dextran-coated charcoal assay (DCC) of estrogen receptors (ER) in cytosols and nuclear extracts of human breast cancer tissue. The results of the two assays were related to cytosolic progesterone receptor content (PgR), semiquantified ER content in formalin-fixed paraffin embedded tissue specimens and tumor differentiation. The EIA was found stable at low cytosol protein concentrations (0.5 mg/ml). The EIA and DCC assays were highly correlated both in cytosols (r = 0.92, n = 57) and nuclear extracts (r = 0.82, n = 25), but the EIA slightly overestimated the ER values in both ER fractions. A significant correlation between ER in nuclear (ER(N] and cytosolic (ER(C] fractions was established with both assays (DCC: r = 0.90, n = 56; EIA: r = 0.83, n = 24). A qualitative relationship was established between PgR and ER fractions as determined with both assays, the best quantitative association was between PgR and ER(N(DCC] (r = 0.58, n = 34, P less than 0.001). A significant qualitative and quantitative relationship was found between semiquantified ER content in formalin-fixed, paraffin-embedded tissue and ER(C(DCC] (r = 0.88), ER(N(DCC] (r = 0.86], ER(C(EIA] (r = 0.60), ER(N(CIA] (r = 0.64) and PgR (r = 0.65). Finally, we found tumor differentiation to be significantly associated with ER content as determined with all assays except for ER(N(EIA]. We recommend the use of the DCC assay for routine analysis of ER until the clinical correlation of EIA results has been established. PMID- 3289942 TI - Ifosfamide and VP-16213 combination chemotherapy combined with ablative chemotherapy and autologous marrow transplantation as salvage treatment for malignant lymphoma. AB - Eighteen patients with high-grade malignant lymphoma were treated with ifosfamide VP16213 combinations after failing to respond completely or after relapsing on CHOP-like therapy. Responders to the salvage therapy were subsequently treated with ablative chemotherapy (BCNU, VP-16213, Ara-C and melfalan) and autografted. Of these 18 patients six were in relapse, six were partial responders and six failed CHOP-like therapy. There were two complete remissions and seven partial responses to the ifosfamide-VP-16213 combinations. Of them, eight patients were transplanted, together with one non-responder. Four of these nine patients were disease-free survivors 18-34 months after autografting. There were two early deaths: one before and one during the autografting procedure. Using one of the best salvage therapy combinations followed by high-dose chemotherapy and autografting is feasible. The results in this pilot study suggest that an appreciable number of patients may be cured by this procedure. PMID- 3289943 TI - Pharmacology of adriamycin: the message to the clinician. AB - In attempting to describe the human pharmacology of ADR, one is aware of the gaps in our knowledge and shortcomings of the available data. Nevertheless, such information is essential if we are ever to be able to convert rationally in vitro observations into clinical pharmacologic effect or, as is more often the case, explain why the desired effect has not been produced. Clinical pharmacokinetic studies to-date suggest that there is a clear relationship between ADR blood levels and toxicity. No such relationship between ADR blood levels and therapeutic response has been shown. The 7-deoxyaglycone tissue metabolites of ADR, which also appear in blood, may be more closely related to ADR cardiotoxicity and therefore may provide a better pharmacokinetic marker of its development. It appears that the only accurate pharmacokinetic indicator of response is the level of drug in the tumour itself. PMID- 3289944 TI - 'Petite' mutagenesis by anticancer drugs in Saccharomyces cerevisiae. AB - The mitochondria of cancer cells are potential targets for chemotherapy. Drugs which primarily affect mitochondrial DNA can be screened using a 'petite' mutagenesis assay in Saccharomyces cerevisiae. We have used this approach to estimate the antimitochondrial effects of a range of current clinical and experimental antitumour drugs with varying modes of action. Of agents currently in the clinic, the antimetabolites 5-fluorouracil and methotrexate were extremely effective in inducing this respiratory defect, providing cells were growing during treatment. Adriamycin, BCNU, bleomycin, methyl CCNU, cis-platinum, chlorambucil, daunomycin, nitracine, nitrogen mustard and hycanthone were also weakly effective 'petite' mutagens, in either growing or non-growing conditions. None of the currently used agents but some experimental drugs induced high numbers of 'petite' mutants during growing or non-growing conditions. To date, where such agents have been tested clinically, they have proved either ineffective or very toxic. It is possible that antimitochondrial effects on non proliferating cellular tissues such as the heart might cause unacceptable toxicity and preclude the clinical use of such agents. For those agents effective against proliferating cells, the mitochondria could be an important target for chemotherapy in some cell types. This type of drug appears relatively uncommon in the clinic at present. The 'petite' mutagenesis assay could be more widely used as a screen to optimize this property in development of analogues of current clinical agents, or in developing new types of anticancer drug. PMID- 3289945 TI - Combination therapy with flutamide and [D-Trp6]LHRH ethylamide for stage C prostatic carcinoma. AB - Sixty-seven previously untreated patients presenting with clinical stage C prostatic carcinoma with no evidence of distant metastases received combination therapy using the antiandrogen Flutamide and the LHRH agonist [D-Trp6]LHRH ethylamide for an average duration of treatment of 23.5 months. Only five patients have so far shown treatment failure with 91.8% of the patients still in remission at 2 years. Three patients have died from prostate cancer while three have died from other causes, 93.5% of the patients being alive at 2 years. Local control was achieved rapidly in all except one patient. Urinary obstruction and hydronephrosis were corrected in all cases. When comparing to recent data obtained after single endocrine therapy (orchiectomy or estrogens), or radiotherapy, the rate of treatment failure at 2 years is 3.5-fold lower after combination therapy (8.2%) than monotherapy (28.4%). The death rate at 2 years following start of the combination therapy is 6.5% while it is on average 22.2% (3.4-fold higher) in the studies using monotherapy (orchiectomy or estrogens) or radiotherapy. The present data suggest that treatment of prostate cancer with combination therapy before clinical evidence of dissemination of the disease permits a better response which is possibly explained, at least in part, by the lower degree of dedifferentiation and heterogeneity of the tumors. PMID- 3289946 TI - Validation of a quality of life questionnaire for use in clinical trials for treatment of patients with inoperable lung cancer. AB - In order to assess the quality of life of patients with inoperable lung cancer, a questionnaire for patient self-administration with 29 variables was designed including the following subjects: psychosocial well-being, medical side-effects, activities of daily living and physical performance. The questionnaire was validated by using a semistructured interview. Thirty-one patients treated for inoperable lung cancer with either radiotherapy (42%), chemotherapy (42%) or a combination of these two treatment modalities (16%) were included in the study. The multitrait-multimethod matrix (MTMM) was used in the analysis of the construct validity. The present validation study showed a high degree of validity for the majority of the items studied. Some of the items showed a low degree of validity, and are subject to future analysis in large scale studies. PMID- 3289949 TI - Influence of age on the pharmacokinetics of ceftazidime in acutely ill, adult patients. AB - The single and multiple i.v. dose pharmacokinetics of ceftazidime were investigated in 37 acutely ill patients with normal age-related glomerular function. Distribution was rapid with similar t1/2 alpha at all ages. Compared to the younger patients, elderly subjects had lower total and renal clearances and reduced urinary recovery. Ceftazidime clearance was closely correlated with glomerular function. The t1/2 beta was approximately 2 h in young and middle-aged patients, 2.73 h in patients aged 60-79 years, and 3.54 h in those above 80 years. The AUC was more than doubled in the oldest patients compared to individuals younger than 40 years. Vss did not change with advancing age, but was larger than previously reported in healthy volunteers. Elimination variables were not altered during multiple dosing, but a small but significant increase in AUC was detected in the elderly. Dose reduction by 50% in patients more than 70 years old is suggested. PMID- 3289948 TI - A comparison of treatment with metformin and gliclazide in patients with non insulin-dependent diabetes. AB - Twenty-seven obese non-insulin-dependent diabetic patients, treated with dietary carbohydrate restriction and metformin, were recruited from the diabetic outpatient clinic and entered into an open crossover study with gliclazide. Twenty-one patients completed the study. During three months observation on metformin, the mean weight of the group fell by 1.0 kg with 14 patients losing a mean of 1.8 kg with 14 patients losing a mean of 1.8 kg, 3 remaining unchanged and 4 gaining a mean weight of 1.1 kg. Over the subsequent three months on gliclazide, the mean weight of the group rose by 1.4 kg with 16 patients gaining a mean of 2.2 kg, two remaining unchanged and 3 losing a mean of 2.0 kg. In addition, 10 patients were heavier after gliclazide than at the time of recruitment (mean 2.6 kg), 3 were unchanged and 8 had lost weight since commencing the trial (mean 2.1 kg), mostly due to greater loss on metformin than gain on gliclazide. Glycaemic control did not improve significantly during the observed period on metformin but lower concentrations of fasting glucose and total glycosylated haemoglobin were achieved with gliclazide. Mean plasma insulin concentration was significantly higher and mean serum lactate was significantly lower during treatment with gliclazide. In conclusion, gliclazide does not support weight loss in obese non-insulin-dependent diabetic patients to the same extent as metformin but the difference between the two drugs is small. Gliclazide is a suitable oral hypoglycaemic agent for use in the obese diabetic who cannot be controlled by diet alone. PMID- 3289947 TI - A comparison of felodipine and propranolol as additions to hydrochlorothiazide in the treatment of hypertension. AB - Eighty one patients with uncomplicated hypertension who required additional antihypertensive medication (diastolic Phase V [dBP] greater than or equal to 95 mm Hg) after 4 weeks treatment with hydrochlorothiazide (HCTZ) 25 mg o.m. were randomized to receive felodipine 5 mg b.i.d. (n = 40) or propranolol (n = 41) 80 mg b.i.d. in addition to HCTZ 25 mg o.m. If the dBP measured about 12 h post-dose was not less than or equal to 90 mm Hg after 4 weeks, the dose of felodipine or propranolol was doubled. The double blind trial period was 8 weeks for all patients. Over the 8 week period, felodipine reduced the seated dBP from 100 to 83 mm Hg and propranolol from 101 to 86 mm Hg. The attained seated dBPs were significantly different in the two groups. About one third of patients in each group received the high dose of second-line therapy. After 8 weeks 91% of patients receiving HCTZ+felodipine and 84% receiving HCTZ+propranolol had a dBP less than or equal to 90 mm Hg. Both regimens were well-tolerated with an equal incidence but different pattern of adverse events (felodipine: flushing, headache and peripheral oedema; propranolol: dyspepsia, fatigue and vasospasm). In this 8 week study, felodipine and propranolol were safe and effective second-line antihypertensive drugs when added to hydrochlorothiazide. At the doses selected, felodipine was at least as effective as propranolol. PMID- 3289952 TI - Quantification of the progenitors for thymic T cells in various organs. AB - Partial characterization and frequency determination of the progenitors for thymic T cells in various organs were made by transferring cells directly into the thymus (intrathymically, i.t.). B10. Thy-1.1 (H-2b, Thy-1.1) mice were used as the donor, and C57BL/6 (H-2b, Thy-1.2) mice that had been whole body irradiated with 800 rads and reconstituted with 10(7) syngeneic (B6) bone marrow (BM) cells were used as the recipient. BM cells, spleen cells and thymus cells from young adults and fetal liver cells (day 14 of gestation) were treated with anti-Thy-1.1 antibody plus complement, and transferred i.t. The generation of Thy 1.1+ donor type cells in the recipient's thymus was investigated by using flow cytometry. From the time course of generation, it was shown that the progenitor cells in the thymus were distinct from those in other organs. After the transfer of thymic non-T cells, donor-type cells began to generate on the 4th day, the proportion of donor-type T cells increased quickly thereafter, and the progenitors in this organ ceased to produce T cells by day 21. On the other hand, a latent period of about 10 days was required for progenitor cells in the BM, spleen or fetal liver to generate T cells, and T cell producing-activity of the progenitor cells in these organs lasted as long as 7 weeks. The frequency of progenitor cells was analyzed by transferring serial dilutions of anti-Thy-1.1 plus complement-treated cells i.t. and investigating the generation of donor-type T cells in the recipient's thymus on day 11 in the case transferred with thymic cells and on day 21 in other cases. The proportion of negative recipients which did not contain detectable levels of donor-type cells was plotted on a logarithmic scale against the number of cells transferred on a linear scale. The progenitor cell frequencies in BM, spleen, thymus and fetal liver were estimated to be 12.5 x 10(-5), 6.25 x 10(-5), 0.22 x 10(-5) and 0.14 x 10(-5), respectively. The reliability of the frequency determination was supported by the finding that when a limited number (10(3)) of a 1:1 mixture of BM cells from two mutually identifiable donors was transferred i.t., most of the recipients were negative for donor-type T cells and 3 out of 4 positive recipients were seeded by progenitor cells of a single donor. PMID- 3289951 TI - "Radioresistant" intrathymic T cell precursors express T cell receptor C gamma 4- and C delta-specific gene messages. AB - We have studied the expression and sequences of T cell receptor gamma and delta chain gene messages in intrathymic T cell precursors of mice irradiated with 600 rads. On day 7 after irradiation a high level of expression of gamma and delta chain messages was detected in thymocytes which were composed of a relatively high proportion of CD3+CD4-CD8- thymocytes. During further development of the precursors from day 7 to day 14 after irradiation, gamma and delta chain messages fell to low levels and alpha and beta mRNA levels increased. Nucleotide sequence analysis of 14 gamma and 10 delta chain complementary DNA (cDNA) in the thymocytes on day 7 revealed that there were 7 functional gamma chain transcripts composed of V gamma 2-J gamma 2-C gamma 2 or V gamma 1-J gamma 4-C gamma 4 gene segments, and only 1 functional delta chain transcript composed of the V delta M23-D delta 1-D delta 2-J delta 1-C delta gene segments. The repertoire of gamma chain and delta chain genes used in "radioresistant" intrathymic T cell precursors of adult mice appears to be limited. PMID- 3289950 TI - Comparative pharmacokinetics of ceftazidime in young, healthy and elderly, acutely ill males. AB - The pharmacokinetics of ceftazidime have been investigated after single and multiple i.v. doses in 9 young healthy male volunteers and 15 elderly male patients with acute bacterial infections. All subjects had normal, age-correlated glomerular function. Distribution and elimination in young volunteers were unaffected by posture and were similar to what has been reported earlier. In contrast, elderly patients had longer t1/2 beta (3.1 vs 1.9 h), larger AUC (414.0 vs 276.6 h.mg/l), lower total and renal clearances, reduced urinary recovery over 12 h and enlarged Vss. Total serum clearance of ceftazidime was closely correlated with the 51Cr-EDTA clearance. There was no significant change in 51Cr EDTA clearance after seven days of treatment. A reduction in the dose of beta lactam antibiotics eliminated by the kidney is advisable in elderly patients with an acute bacterial infection. PMID- 3289953 TI - Lack of effect of captopril on preglomerular renal microvascular prostanoid biosynthesis. AB - Extensive research has focused on the mechanisms by which converting enzyme inhibitors, such as captopril, lower the systemic blood pressure. In addition to inhibiting the conversion of angiotensin I to angiotensin II, these agents have been proposed to influence other systems which might affect vascular resistance including the kinins and the prostanoids. This study was designed to evaluate whether captopril has any direct effect to increase the synthesis of endogenous vasodilator prostanoids in either freshly isolated rabbit renal preglomerular microvessels or in endothelial cells derived from them. The results indicate that captopril, in a variety of doses, had no effect on the synthesis of either prostacyclin or PGE2 by renal preglomerular microvessels. Bradykinin, on the other hand, increased prostanoid production significantly in the same tissue preparations. Finally, captopril had no effect in altering bradykinin-induced increases in renovascular prostanoid biosynthesis. Thus, captopril appears to have no ability to enhance the production of vasodilator prostanoids in rabbit renal preglomerular resistance vessels. These data question the role of prostanoid-related mechanisms in the non-renin-related antihypertensive actions of captopril. PMID- 3289954 TI - Immunochemical analysis of extracellular matrix during embryonic lens development of the Cat Fraser mouse. AB - We have characterized the extracellular matrix present during early mouse-lens morphogenesis in Swiss and Cat Fraser mutant mice which produces a thicker capsule. In the two mouse strains, laminin was first detected when the optic vesicle and the head ectoderm are closely associated. At day 10, staining for laminin and fibronectin is especially concentrated at the border of the lens pit. At this stage, type IV collagen and proteoheparan sulphate have a similar distribution to laminin and fibronectin. In the two mouse strains, no major differences were observed in the intensity and the distribution of fluorescent basement-membrane components. This suggests that the overall increase in capsule thickness of the Cat Fraser mutant is more related to an increased cellular synthesis of capsule than to an abnormal distribution of one or more basement membrane macromolecules. PMID- 3289955 TI - Detection of ocular mucus in normal human conjunctiva and conjunctiva from patients with cicatricial pemphigoid using lectin probes and histochemical techniques. AB - Conjunctival biopsies from patients with cicatricial pemphigoid affecting the conjunctiva and patients undergoing cataract surgery (normal conjunctiva) were snap-frozen, cryostat sectioned and incubated with fluorescein-conjugated lectins; peanut agglutinin (PNA), Helix pomatia agglutinin (HPA), soybean agglutinin (SBA), wheat germ agglutinin (WGA) and succinylated wheat germ agglutinin (S-WGA). Controls consisted of preincubating the lectins with the appropriate blocking sugars before applying the lectins to the sections. PNA and HPA stained the mucus granules contained in the conjunctival goblet cells but did not stain mucus or glycocalyx at the ocular surface distal to the goblet cells. Native WGA and S-WGA had high affinities for conjunctival goblet cells and the apical epithelial cell layers. Native WGA stained mucus and glycocalyx at the ocular surface. This staining of the ocular surface by WGA was confirmed at the transmission electron microscopic level using WGA conjugated to ferritin. Cicatricial pemphigoid patients in this study had reduced numbers of goblet cells; however, those goblet cells which were observed in cicatricial pemphigoid conjunctiva stained positively with HPA, PNA, WGA, and SWGA as did goblet cells in normal conjunctiva. PMID- 3289956 TI - Protease activities in cultured beef lens epithelial cells peak and then decline upon progressive passage. AB - Beef lens cells in culture are readily obtained and provide many opportunities to study phenomena related to cell differentiation and maturation, environmental stress, disease, and perhaps mechanisms of transformation. Although altered rates of proteolysis are known to accompany these phenomena, the proteolytic activities available in cultured beef lens epithelial cells have not been documented. In this work are documented the specific activities, based on protein and DNA content, of neutral exo- and endopeptidase, cathepsins B- and D-like enzymes and acid phosphatase in lens epithelial cortical and core tissue and in cultured epithelial cells at passages 1-43. Maximal activity of each protease occurs almost routinely at passage 5 or 9, reaching values of approx. 1400-, 0.77-, 4520 nmol min-1 per mg protein for neutral exopeptidase (passage 5), neutral endopeptidase (passage 5) and cathepsin B (passage 5) respectively, and 7.1 micrograms trichloroacetic acid soluble peptide min-1 per mg protein for cathepsin D (passage 15). On a microgram-1 DNA basis, the maximal specific activities for the same enzymes were 48 (passage 5), 0.03 (passage 5), 283 (passage 9), and 0.5 (passage 9) respectively. In subsequent passages, the specific activities declined to values which were similar to or lower than the specific activities observed for these proteases in lens epithelial tissue. PMID- 3289957 TI - Growth of pure cultures of retinal pigment epithelial cells using chorioretinal biopsies from the pig. PMID- 3289959 TI - Abstracts. Seventeenth annual meeting, International Society for Experimental Hematology. 21-25 August, 1988, Houston, Texas, USA. PMID- 3289958 TI - Aging of the extracellular matrix and its pathology. AB - Recent concepts on the mechanisms of aging of extracellular matrix (EM) are reviewed as well as its involvement in age-associated diseases. Cell differentiation, histogenesis and organogenesis can be analyzed in terms of the program of the biosynthesis of EM macromolecules during development, maturation and aging. The most important biological role of EM is the integration of cells in tissues, of tissues in organs and of organs in the whole organism. EM can directly influence cell behavior through the contact between EM and the genome mediated by structural glycoproteins (fibronectin, laminin, elastonectin, etc.) interacting with other EM macromolecules (collagen, proteoglycans, elastin) and the cytoskeleton by trans-membrane receptors (integrins). Most age-associated diseases exhibit a deviation (qualitative or quantitative) from the normal program of EM biosynthesis. Three examples are analyzed in some detail: atherosclerosis, diabetes and malignant tumors. The degradation of elastic fibers catalyzed by cellular elastase-type enzymes is observed in atherosclerosis and also in emphysema and skin aging. Several of these enzymes were isolated and characterized from platelets, fibroblasts, smooth muscle cells and lipoproteins. The biosynthesis of some of them increases with age and facilitates cell migration. Plasma fibronectin increases with age exponentially. This increase is absent or strongly attenuated in diabetes and some cancers. Tissue fibronectin increases in diabetes, Werner syndrome and in the peritumoral desmoplastic reaction while most tumor cells can no more retain fibronectin on their membrane facilitating their movement in the organism. These examples demonstrate the importance of the study of cell matrix interactions for gerontology. PMID- 3289960 TI - Assessment of dyspnoea. PMID- 3289961 TI - Respiratory response to histamine- and methylcholine-induced bronchospasm in nonsmokers and asymptomatic smokers. AB - The respiratory response to bronchospasms of the same magnitude induced by inhalation of histamine or methylcholine was measured non-invasively, using bellow pneumographs, in nonsmokers and asymptomatic smokers. In each subject, tidal volume (VT), breathing frequency (f) and inspiratory time (TI) were obtained on two different days, in a randomized crossover fashion, with the following sequence: basal conditions, after inhalation of buffered saline as a control and after histamine or methylcholine inhalation. Basal and control conditions did not differ from each other and were the same for both groups. The respiratory responses to both bronchoconstrictors did not differ from each other and were also the same in both groups: VT increased, f and TI remained unchanged. Thus, VT/TI, an index of respiratory drive, also increased. In nonsmokers the increased VT/TI and the associated increase in minute ventilation were both correlated to the decrease in FEV1. These correlations were not found in smokers. Although they have different effects on airway irritant receptors, inhaled histamine and methylcholine induce the same respiratory response in nonsmokers and smokers. Thus, the presumed smoking-related changes in airway mucosa permeability do not seem to influence the direct stimulating effect of histamine on these endings. The absence of correlation between FEV1 and VT/TI changes in smokers suggest that smoking might affect the respiratory drive in acute drug induced bronchospasm. PMID- 3289962 TI - Mecholyl aerosolized in the surrounding lung increases the resistance of the collateral pathways. AB - Collateral ventilation allows gas exchange in pulmonary units distal to an airway obstruction. Regional control of this airflow may be possible because smooth muscle exists in the wall of collateral pathways. Evidence of an intrasegmental cholinergic control of these pathways has been previously shown. We performed this study to investigate the possible control of collateral ventilation by cholinergic receptors situated in the surrounding lung. By using the wedged catheter technique, we measured collateral resistance before and after aerosolization of methacholine in the lung surrounding the wedged segment: both collateral resistance and the time constant for collateral ventilation increased, providing that a cholinergic stimulation in the surrounding lung can influence collateral pathways. Fast and complete reversibility was obtained after isoproterenol or atropine injection. Collateral obstruction would seem to be due, therefore, to a muscular spasm. The effective compliance of the wedged segment decreased during the spasm induced by mecholyl in the surrounding lung, and could be attributed to an increased interdependence of this segment with surrounding segments. This effect was immediately reversed by intravenous bronchodilators. We conclude that cholinergic receptors on the smooth muscles of the external collateral channels can control collateral ventilation. PMID- 3289963 TI - Occupational asthma due to isocyanates. AB - 162 subjects who had been exposed to isocyanates, who had developed symptoms during the exposure period, or in the evening or night and, therefore, had a history compatible with isocyanate-induced asthma, were studied with inhalation challenge testing to isocyanates (toluene diisocyanate and methylene diphenyl diisocyanate) and methacholine, because they were suspected of having occupational asthma. None of these subjects had symptomatic asthma before employment. The diagnosis of occupational asthma was delayed (duration of symptoms before diagnosis: 3.9 +/- 0.4 yrs). Isocyanate-asthma documented by a positive inhalation challenge to isocyanates was present in 57.4% of the subjects. A higher degree of airway responsiveness to methacholine was present in subjects with a positive isocyanate inhalation challenge compared to subjects with a negative challenge (Gmean and GESM: 0.407 (1.14) vs 0.942 (1.14) mg). The majority of the subjects complained of shortness of breath and cough. The low proportion of atopic subjects (21.5%) and of smokers (7.5%), and the high proportion of subjects with the late component in the asthmatic reaction (71%) appear to be common features in this disease. PMID- 3289964 TI - Dyspnoea: assessment and pharmacological manipulation. PMID- 3289965 TI - Amino acid sequence template useful for alpha-helix-turn-alpha-helix prediction. AB - Necessary stereochemical requirements for an amino acid sequence segment to fold into an alpha-helix-turn-alpha-helix supersecondary structure are presented in sequence template form. The usefulness of the template is illustrated by alpha helix-turn-alpha-helix predictions consistent with experimental data from the large T antigens of two polyoma viruses, simian virus 40 (segment 143-165) and mouse polyoma virus (segment 297-319), and the yeast transcription activator GCN4 (segment 256-278). PMID- 3289966 TI - Antibodies against basic fibroblast growth factor inhibit the autocrine growth of pulmonary artery endothelial cells. AB - Anti-recombinant human basic fibroblast growth factor (rbFGF) antibodies efficiently inhibited the basal proliferation of bovine pulmonary artery endothelial (BAE) cells. The cell-free extract of BAE cells stimulated the proliferation of bovine capillary endothelial cells and this activity was completely abolished by the antibodies. Furthermore, on heparin HPLC the activity was eluted at exactly the same retention time as that for authentic pituitary bFGF. These observations directly indicate that the BAE cells produce bFGF that stimulates their own basal growth by binding to specific receptors expressed on the cell surface. PMID- 3289967 TI - Subunit-specific phosphorylation of pyruvate kinase in medullary thyroid carcinomas of the rat. AB - Pyruvate kinase from anaplastic medullary thyroid carcinomas contains predominantly K-type subunits, whereas pyruvate kinase from differentiated medullary thyroid carcinomas consist of M- and K-type subunits in about equal proportion. In order to analyse the incorporation of phosphate in the respective isozymes after endogenous phosphorylation of cytosolic extracts with [32P]ATP, homotetrameric isozymes as well as heterotetrameric hybrids of differentiated tumors were resolved by affinity chromatography on Blue-Sepharose CL-6B and, if necessary, further purified by immunoprecipitation. SDS-polyacrylamide gel electrophoresis of purified isozymes and subsequent autoradiography showed the incorporation of phosphate in the K4-type isozymes, but not in the other isozymes. The phosphorylation appeared to be cAMP-independent and occurred on a serine residue. PMID- 3289969 TI - Insulin-like growth factor 1 and insulin reduce epidermal growth factor binding to Swiss 3T3 cells by an indirect mechanism that is apparently independent of protein kinase C. AB - Insulin-like growth factor 1 and insulin reduced the binding of 125I-labelled epidermal growth factor (125I-EGF) to Swiss 3T3 cells by 15-20% at 37 degrees C, but not at 4 degrees C. Scatchard analysis indicated that IGF-1 and insulin affected the higher-affinity component of EGF binding, an effect previously associated with the activation of protein kinase C. However, the inhibition of 125I-EGF binding by IGF-1 and insulin was increased, not reduced, when the cells were treated with high concentrations of phorbol esters to down-modulate protein kinase C. We suggest that IGF-1 and insulin activate a protein kinase with similar or overlapping specificity to that of protein kinase C. PMID- 3289968 TI - Activation of c-Ki-ras coexists with c-myc amplification in cells from a nude mouse tumor induced by the human breast carcinoma cell line SW 613-S. AB - In vitro transfection experiments have shown that cooperation between two different oncogenes can confer a fully malignant phenotype to primary rodent cells. We have previously reported that SW 613-Tul cells, derived from a tumor induced in a nude mouse by the human breast carcinoma cell line SW 613-S, showed a 30-fold amplification of the c-myc gene. In the present work, we show that these cells also harbor an activated c-Ki-ras gene capable of inducing the formation of foci upon transfection of NIH 3T3 cells with SW 613-Tul genomic DNA. Our results suggest that both the c-myc and c-Ki-ras oncogenes, activated by two different mechanisms, may cooperate in the full expression of the tumorigenic phenotype of SW 613-Tul cells. PMID- 3289970 TI - Protein NMR resonance assignment by isotropic mixing experiments on random fractionally deuterated samples. AB - The 108-residue protein E. coli thioredoxin has been uniformly enriched to 50% with deuterium at all carbon-bound hydrogen positions. Isotropic mixing (i.e. TOCSY) experiments have been conducted for both the deuterated and natural abundance samples. Using a 54 ms mixing time correlation peaks can be seen for all four protons on the benzenoid ring of tryptophan in both samples. The deuteration results in an average decrease in cross-sectional area of a factor of 2-3 for the TOCSY cross-peaks. The cross-peak intensities for the deuterated sample systematically decrease as a function of the number of protons involved in the transfer process thus overcoming a common ambiguity in the TOCSY experiment. PMID- 3289971 TI - Degradation of epidermal growth factor receptors by cathepsin L-like protease: inhibition of the degradation by c-Ha-ras gene products. AB - Extract of NIH3T3 mouse fibroblasts contains a protease which can cleave epidermal growth factor receptor (EGF receptor). This protease was tentatively named cathepsin X and purified to near homogeneity. The characteristics of cathepsin X were similar to those of cathepsin L and the proteolytic activity of cathepsin X was inhibited by c-Ha-ras gene products. PMID- 3289972 TI - 31P NMR investigations on free and enzyme bound thiamine pyrophosphate. AB - Pyruvate decarboxylase (PDC) contains thiamine pyrophosphate (TPP) and Mg2+ as cofactors. 31P NMR studies with PDC in the presence of added Mn2+ reveal the pyrophosphate moiety of TPP to be a nonaccessible area for the external Mn2+ and thus proving the Mg-P-complex (taking part in the binding of the coenzyme to the protein) to be a nonaccessible area for the medium. Glyoxylic acid, acting as an inhibitor of PDC by forming a noncleavable bond with the catalytic center of TPP causes a steric immobilization of the coenzyme indicated by a line broadening of the pyrophosphate moiety. PMID- 3289973 TI - Automated Sanger dideoxy sequencing reaction protocol. AB - The protocol for Sanger dideoxy chain termination reactions in DNA sequencing is tedious and prone to errors due to the repetitive character of the pipetting steps. An industrial robot, with the addition of a few simple parts, was programmed to automate the dideoxy sequencing reactions. The system is set up in a short time for routine operation and it is faster and more reliable than a human operator. It is flexible and allows variations and optimization of the standard procedure. Disposable microtiter plates at a controlled temperature are used. In one reaction cycle (about 50 min) up to 48 templates are processed. Up to 450 bases were resolved in automated DNA sequencing on samples prepared by the robot. The protocol is applicable to fluorescent as well as to radioactive labeling. PMID- 3289974 TI - Index of Biochemical Reviews 1987. PMID- 3289975 TI - The diagnosis of luteal phase deficiency: a critical review. AB - Luteal phase deficiency is an ovulatory dysfunction problem that is subtle but real. It may be the most common ovulatory problem in women. Luteal phase deficiency has been clearly demonstrated in the research setting (1) in spontaneous cycles, (2) when follicular maturation has been impeded, and (3) when luteotrophic influences have been suppressed. The diagnosis of LPD in the clinical setting remains problematic and controversial primarily because there is no practical diagnostic method that has been validated. This article has reviewed the methods that have been used to diagnose LPD. BBT charts are insensitive; these charts reliably diagnose LPD only when there are persistent short luteal phases. There is disagreement whether ovarian follicular size, as determined by ultrasonography, is decreased in LPD; however, ultrasonographic diagnosis of LPD would require daily scans through ovulation, which makes this approach impractical. Mild hyperprolactinemia is a probable cause of LPD in a minority of patients; a physician should obtain a PRL level in LPD women with the realization that there is considerable sampling variability. Determination of serum gonadotropin levels (LH or FSH or both) is not practical for the clinical diagnosis of LPD. Random serum P levels, whether single or multiple, are not helpful in the diagnosis of LPD in individual patients. The secretory pattern of P results in such wide confidence limits that P samples from individuals cannot be compared to normal in a useful manner. Most of the controversy about the diagnosis of LPD has centered around the use of individual serum P levels. The timed endometrial biopsy relies on the endometrium as a bioassay of P over time. The endometrial biopsy has not been carefully validated in terms of its sensitivity or accuracy for the diagnosis of LPD. However, it remains the best current method for the diagnosis of LPD when the standard guidelines for its use are followed. As opposed to the other tests for LPD, awareness of the usefulness of the biopsy has increased as we have learned more about CL physiology. No current research method for the diagnosis of LPD appears to be a practical method that could be applied in the clinical setting. Specific secretory proteins from the endometrium and methods to measure hormone secretion that circumvent the secretory pattern hold promise for improved methods to diagnose LPD in the future. PMID- 3289976 TI - A new method of histologic dating of human endometrium in the luteal phase. AB - Morphometric analysis was performed on 70 endometrial biopsy specimens collected from a population of fertile women. Of the 17 morphometric measurements that were performed on each endometrial biopsy, only 5 were required to achieve a highly significant correlation with chronologic dating based on luteinizing hormone surge (R = 0.99). The result of histologic dating, based on morphometric analysis of endometrial biopsies collected from a separate, unbiased population, correlated strongly and significantly with chronologic dating (r = 0.98, P less than 0.0001). The correlation was better than that achieved when histologic dating was performed according to the conventional dating criteria (r = 0.88, P less than 0.001). PMID- 3289977 TI - Cardiac Doppler echocardiography principles and applications. PMID- 3289978 TI - Immunohistological evaluation of endothelial markers and basement membrane components in port-wine stains. AB - As shown by an immunohistological study, the endothelial cells in the lesions of port-wine stains (PWSs), investigated for factor VIII-related antigen and Ulex europaeus agglutinin I lectin, were found to be swollen or flattened corresponding to mild or pronounced dilatation of vessels, respectively. Furthermore, dilated vessels in the lesional skin exhibited a broader staining for type IV collagen, laminin and fibronectin, which, however, was not considered to be of primary pathogenetic importance for vessel dilatation in PWSs. As concluded from the number of vessels, no vascular proliferation occurred, which indicates that PWS is not a true hemangioma but a special clinical type of telangiectasia. PMID- 3289979 TI - Chicken mucin-cross-reactive antigen. AB - We have previously described a chicken heterophile antigenic determinant (CHAD-1) shared by Mycobacterium smegmatis and chicken tissues. We then demonstrated that CHAD-1 is present on several chicken glycoproteins and that its immunoreactive domains are highly branched asparagine-linked oligosaccharides terminating in N acetylglucosamine residues. In the present study, we have shown that CHAD-1 is also expressed by mucin purified to homogeneity from a soluble mucus of chicken intestine. Another antigen found on chicken mucin is a chicken mucin-cross reactive antigen (CMCRA). Antisera to this antigen were produced by immunization of rabbits with an enriched preparation of CHAD-1 isolated from the bursa of Fabricius. These antisera were absorbed with Mycobacterium smegmatis (to block the anti-CHAD-1 antibody) and with chicken serum, and then used for immunoperoxidase staining of chicken tissue sections for CMCRA. The latter antigen was detected in most medullary cells of the bursa, in epithelial cells and Hassal's corpuscles of the thymus, and in mucus-producing cells of the intestine, esophagus, trachea, and bronchi. Using Western immunoblot analysis, we demonstrated that CMCRA is expressed by a number of polypeptides extracted from bursal lymphoid cells. These polypeptides could not be detected in extracts of thymus, spleen, peripheral blood or bone marrow mononuclear cells. PMID- 3289980 TI - Direct immunofluorescence for Chlamydia trachomatis on urogenital smears for epidemiological purposes. AB - A population of 197 asymptomatic women, attending an out-patient department for birth-control advice, was screened for urogenital infection with Chlamydia trachomatis by direct immunofluorescence on cervical and urethral smears. A blood sample was obtained for chlamydial serology and demographic, behavioural and clinical data were recorded. Eleven (5.5%) women had a chlamydial infection. Chlamydial infection, as diagnosed with direct immunofluorescence, correlated with a history of sexually transmitted disease (p less than 0.01), promiscuity (p less than 0.01), use of oral contraceptives (p less than 0.02) and high chlamydial antibody titres (p less than 0.01). These last also correlated with a history of sexually transmitted disease (p less than 0.02) and promiscuity (p less than 0.02). These results, obtained with direct immunofluorescence, are indistinguishable from those obtained previously with chlamydial culture. Direct immunofluorescence on urogenital smears seems a valuable tool for epidemiological investigation. Our data also support the hypothesis that oral contraceptive use is correlated with chlamydial infection because of increased cervical susceptibility to infection and not because of a sampling bias towards oral contraceptive users. PMID- 3289981 TI - Intravenous glucose tolerance test in gestational diabetes and pregnancy: 'manual' versus computerized assessment. AB - In order to assess the reliability of 'manual' versus computerized interpretation of the intravenous glucose tolerance test (IVGTT), fifty-five women, aged 19 to 41, underwent an IVGTT. Fifteen subjects had overt diabetes mellitus, sixteen were evaluated for gestational diabetes and twenty-four were healthy controls, fourteen of whom were pregnant. Each IVGTT was analysed by two trained physicians independently and by a simple computerized program, and the k' values obtained were compared, using the Student t-test for paired data. Significant difference (p less than 0.005) was found comparing either the 'manual' assessments or the 'manual' versus computer calculations. It is concluded that the IVGTT test must be interpreted using a simple computerized program, especially in borderline cases of pregnancy where the traditional 'manual' analysis might result in misclassification or misdiagnosis of the patient. PMID- 3289982 TI - IUDs--a new look. PMID- 3289983 TI - Germinal vesicle components are not required for the cell-cycle oscillator of the early starfish embryo. AB - We show that certain events of the cell cycle can still occur in starfish oocytes or fertilized eggs from which the germinal vesicle (the prominent nucleus of prophase-arrested oocytes) has been removed before the induction of meiotic maturation. Two meiotic asters develop following hormonal induction of meiotic maturation in these enucleated oocytes. The asters then divide to form a transient tetrapolar figure. When enucleated oocytes are fertilized, the sperm centrosome duplicates at the times corresponding to each cleavage in control nucleated embryos. Periodic changes in the organization of the asters and in the morphology of the cell surface also occur in synchrony with controls. Decondensation of the sperm nucleus, spindle formation, and cleavage do not occur when enucleated oocytes are fertilized. Ultimately the number of asters increases to approximately 520 (about 2(9] before the pseudo-embryo arrests and cytolyzes. Fertilized eggs from which both pronuclei but not the sperm aster have been removed undergo nine cleavages and then cease cell division. The cessation of division may be related to the events that cause the midblastula transition after seven cleavages in normal nucleated embryos. PMID- 3289984 TI - A gradient of responsiveness to the growth-promoting activity of ZPA (zone of polarizing activity) in the chick limb bud. AB - Limb bud mesoderm of stage 22-23 embryos was dissected into four pieces along the anteroposterior axis and dissociated cells of each region were separately cultured under various conditions. When the cells were cultured in medium containing 0.1% fetal calf serum (serum-poor medium) only a slight increase in cell number occurred in the cultures of all four regions. However, when the cells were cultured in medium containing 10% FCS, only cells of two central regions proliferated rapidly, and no growth promotion was observed in cells in the most anterior and posterior regions. Using the serum-poor medium, we examined the growth-promoting effects of cocultured limb bud fragments and of some growth factors on the cells of four regions. Anterior, distal, and proximal fragments promoted cell proliferation and their promotive effect on the cells of each region was equal. On the other hand, posterior fragments (containing ZPA) showed stronger promotive effects on preaxial cells than on postaxial cells. For comparison with the growth-promotive effect of the posterior fragment, fibroblast growth factor (FGF), epidermal growth factor (EGF), insulin, and retinoic acid were tested in cell culture. FGF showed position-dependent growth promotion, while EGF and insulin promoted growth in the cells of all four regions to a similar degree. Retinoic acid showed no effect on cell growth at low concentrations, and was rather toxic at high concentrations. These results suggest that the cells of the posterior region secrete an FGF-like growth factor(s), which controls normal limb development and experimental duplicate formation. PMID- 3289986 TI - Synthesis and localization of plasma proteins in the developing human brain. Integrity of the fetal blood-brain barrier to endogenous proteins of hepatic origin. AB - The distribution and possible origins of plasma proteins in the human embryonic and fetal brain at different stages of development have been investigated by a combination of isolation and translation of mRNAs and immunocytochemistry using specific antisera. As many as 23 plasma-like proteins have been identified using immunocytochemical methods at the light microscopical level. The presence of mRNAs for 13 of the immunocytochemically positive plasma proteins was demonstrated by in vitro and in ovo translation followed by crossed immunoelectrophoresis and autoradiography; this indicates in situ synthesis of these proteins (e.g., alpha-fetoprotein, alpha 1-antitrypsin, GC-globulin, alpha 2-macroglobulin, pseudocholinesterase, and transferrin) in some brain regions. The regional distribution of some proteins and the absence of some mRNAs suggest that the presence of certain plasma proteins in developing brain may be accounted for by uptake from csf or via nerve processes extending beyond the blood-brain barrier. In several cases, specific proteins appear to be associated with defined cell types, e.g., alpha-fetoprotein, GC-globulin, and ceruloplasmin with neurons, alpha 2-macroglobulin with endothelial cells, and ferritin with glial cells. Some proteins were associated with two or three cell types, e.g., alpha 1-antitrypsin with neurons and glia, and transferrin and alpha 2HS-glycoprotein with neurons, glia, and endothelial cells. Comparison of the expression of mRNAs from fetal brain and liver injected into Xenopus oocytes showed that a few proteins (transferrin and ceruloplasmin) were secreted when liver mRNA was injected, but not when brain mRNA was injected. This suggests that there may be an important difference in the structure and/or processing of these proteins in the brain which may reflect a function different from that associated with them when they originate from the liver. Staining was generally intracellular rather than extracellular; plasma proteins were not associated with the areas immediately around blood vessels although there was a strong immunoprecipitation for each protein within the lumen of cerebral blood vessels. These immunocytochemical findings together with the identification of mRNAs for a large number of plasma proteins in immature brain are discussed in relation to animal experimental work which suggests that the blood-brain barrier to protein is present even at very early stages of brain development. PMID- 3289985 TI - A transient array of parallel microtubules in frog eggs: potential tracks for a cytoplasmic rotation that specifies the dorso-ventral axis. AB - The dorsoventral axis of the frog embryo is specified by a rotation of the egg cytoplasm relative to the cortex. When eggs undergoing the cortical/cytoplasmic rotation were examined by immunocytochemistry and electron microscopy, an extensive array of parallel microtubules was found covering the vegetal hemisphere of the egg. The microtubules were 1-3 microns deep from the plasma membrane and were aligned parallel to the direction of rotation. They formed at the start of rotation and disappeared at its completion. Colchicine and uv irradiation, inhibitors of the rotation, prevented the formation of the parallel microtubules. Based on these properties, we suggest that the parallel microtubules serve as tracks for the cortical/cytoplasmic rotation which specifies the dorsoventral axis of the embryo. PMID- 3289987 TI - The modulation of cell adhesion molecule expression and intercellular junction formation in the developing avian inner ear. AB - The cells that constitute the membranous labyrinth in the vertebrate inner ear are all derived from a single embryonic source, namely, the otocyst. The mature inner ear epithelia contain different regions with highly differentiated cells, displaying a highly specialized cytoarchitecture. The present study was designed to determine the presence of adherens-type intercellular junctions in this tissue and study the expression of cell adhesion molecules (CAMs) associated with these junctions, namely, A-CAM and L-CAM, in the developing avian inner ear epithelia. The results presented here show that throughout the early otocyst, A-CAM is coexpressed with L-CAM. The formation of asymmetries between sensory and nonsensory areas in the epithelium is accompanied by the modulation of CAMs expression and the assembly of intercellular junctional complexes. A-CAM and L CAM display reciprocal expression patterns, the former being expressed mostly in the mosaic sensory epithelium, while L-CAM becomes conspicuous in the nonsensory areas but its expression in the sensory region is markedly reduced. Adherens-type junctions and numerous desmosomes are found in the junctional complexes of early otocyst cells. The former persist to maturity of the various inner ear epithelia, whereas desmosomes disappear from junctional complexes of hair cells but remain in the intercellular junctional complexes of all other cell types in the membranous labyrinth. Thus, adherens type intercellular junctions comprise the only defined cytoskeleton-bound junction in mature hair cells. A-CAM-positive cells are also found in the region of the acoustic ganglion in early developmental stages but not in the mature neural elements. PMID- 3289988 TI - Cytoimmunofluorescent localization of severin in Dictyostelium amoebae. AB - Severin is a 40-kDa Ca2+-activated protein from Dictyostelium that rapidly fragments and disassembles actin filaments in vitro (S.S. Brown, K. Yamamoto, and J.A. Spudich, J. Cell Biol. 93, 205-210, 1982; and K. Yamamoto, J.D. Pardee, J. Reidler, L. Stryer, and J.A. Spudich. J. Cell Biol. 95, 711-719, 1982). To determine if severin is colocalized with actin filaments in vivo, we have used the agar-overlay technique of S. Yumura, H. Mori, and Y. Fukui (J. Cell Biol. 99, 894-899, 1984) to examine the intracellular locations of severin and F-actin in vegetative Dictyostelium amoebae. In rounded cells taken from suspension culture severin colocalized with F-actin at cortical edges while maintaining an endoplasmic presence. Both severin and F-actin were present throughout nascent pseudopods of motile cells, while severin appeared concentrated at the leading edge of fully developed pseudopods. Amoebae feeding on a bacterial lawn formed large phagocytic vesicles that were surrounded by an extensive cell cortex rich in severin. Streaming cells entering aggregates during the Dictyostelium developmental cycle showed severin staining throughout the cytoplasm with F-actin at the cortex. The preferential localization of severin in cytoplasmic regions of vegetative cells undergoing extensive actin cytoskeletal rearrangement prompts consideration of a role for severin-mediated disruption of actin filament networks during pseudopod extension and phagocytosis. PMID- 3289989 TI - Lilly lecture 1987. The triumvirate: beta-cell, muscle, liver. A collusion responsible for NIDDM. PMID- 3289990 TI - Influence of circulating epinephrine on absorption of subcutaneously injected insulin. AB - Effects of epinephrine (Epi) infusion on the absorption of subcutaneously injected 125I-labeled soluble human insulin (10 U) from the thigh or the abdomen were studied in 16 healthy subjects and from the thigh in 10 insulin-dependent diabetic (IDDM) patients. Epi was infused at 0.3 (high dose) or 0.1 (low dose; healthy subjects) nmol.kg-1.min-1 i.v., resulting in arterial plasma Epi levels of approximately 6 and 2 nM, respectively. Saline was infused on a control day. Insulin absorption was measured as disappearance of radioactivity from the injection site and as appearance of plasma immunoreactive insulin (IRI). Adipose tissue blood flow was measured with the 133Xe clearance technique. First-order disappearance rate constants of 125I from the thigh depot decreased approximately 40-50% during the high dose of Epi compared with control (P less than .001). The corresponding decrease from the abdominal depot was approximately 40% (P less than .001), whereas no significant change was found during the low Epi dose. IRI fell compared with control in all groups at the high Epi dose. The Epi-induced depression of insulin absorption occurred despite unaltered or even slightly increased subcutaneous blood flow. The results indicate that circulating Epi at levels seen during moderate physical stress depresses the absorption of soluble insulin from subcutaneous injection sites to an extent that might be important for glycemic control in IDDM patients. Furthermore, dissociation is found between changes in insulin absorption and subcutaneous blood flow during Epi infusion, suggesting that factors other than blood flow may also influence the absorption of subcutaneously injected insulin. PMID- 3289991 TI - Genetic analysis of glucose tolerance in inbred mouse strains. Evidence for polygenic control. AB - To determine genetic factors involved in diabetes susceptibility in inbred strains of mice, we initially evaluated differences in fed plasma glucose and insulin concentrations among six strains (AKR/J, C3H/HeJ, C57BL/6J, C57L/J, DBA/2J, and SWR/J). There was considerable variation in fed plasma glucose concentration, with C3H/HeJ mice the most glucose tolerant (174 +/- 7 mg/dl) and C57BL/6J mice the least glucose tolerant (252 +/- 7 mg/dl, P less than .0001 vs. C3H/HeJ mice). Glycosylated hemoglobin of C57BL/6J mice (4.0 +/- 0.06%) was also higher than that of C3H/HeJ mice (3.52 +/- 0.06%, P less than .0001). The fed plasma insulin concentration did not differ between these two strains. Glucose tolerance was further evaluated in overnight-fasted C3H/HeJ and C57BL/6J mice by an intraperitoneal glucose tolerance test (IPGTT). Although fasting plasma glucose did not differ, the most remarkable difference in plasma glucose during IPGTT between C57BL/6J and C3H/HeJ mice was noted at 30 min (489 +/- 29 vs. 227 +/- 20 mg/dl, P less than .001). To determine the number of genes involved in the phenotypic difference in glucose tolerance, C57BL/6J males were crossed with C3H/HeJ females (F1, C3H/HeJ X C57BL/6J), and the F1 hybrid females were backcrossed with C57BL/6J males (backcrossed, F1 X C57BL/6J). Plasma glucose after 30 min on IPGTT was 219 +/- 8 (n = 21), 456 +/- 18 (n = 23), and 292 +/- 13 (n = 23) mg/dl for C3H/HeJ, C57BL/6J, and F1 mice, respectively (P less than .001 for all comparisons).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289992 TI - Reduction of glycemic potentiation. Sensitive indicator of beta-cell loss in partially pancreatectomized dogs. AB - To determine which test of islet function is the most sensitive indicator of subclinical beta-cell loss, we studied six conscious dogs before and 1 and 6 wk after removal of the splenic and uncinate lobes [64 +/- 2% pancreatectomy (PX)]. To assess hyperglycemic potentiation, acute insulin secretory responses (AIR) to 5 g i.v. arginine were measured at the fasting plasma glucose (FPG) level after PG was clamped at approximately 250 mg/dl and after PG was clamped at a maximally potentiating level of 550-650 mg/dl. FPG levels were unaffected by PX (112 +/- 4 mg/dl pre-PX vs. 115 +/- 5 mg/dl 6 wk after PX, P NS). Similarly, basal insulin levels remained constant after PX (11 +/- 2 microU/ml pre-PX vs. 11 +/- 1 microU/ml 6 wk after PX, P NS). The AIR to 300 mg/kg i.v. glucose decreased slightly from 42 +/- 9 microU/ml pre-PX to 32 +/- 5 microU/ml 6 wk after PX (P NS), and thus the beta-cell loss was underestimated. In contrast, insulin responses to arginine declined markedly after PX. The AIR to arginine obtained at FPG levels declined from 23 +/- 3 microU/ml pre-PX to 13 +/- 2 microU/ml 6 wk after PX (P = .04). The AIR to arginine obtained at PG levels of approximately 250 mg/dl declined even more, from a pre-PX value of 56 +/- 7 microU/ml to 21 +/- 4 microU/ml 6 wk after PX (P = .02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289993 TI - Insulin action and insulin secretion in identical twins with MODY. Evidence for defects in both insulin action and secretion. AB - To evaluate the pathogenetic mechanisms responsible for development of diabetes in the genetically inherited disease maturity-onset diabetes of the young (MODY), we have investigated a pair of identical twins (19 yr old) from a MODY family. One twin had nondiabetic fasting plasma glucose values but impaired glucose tolerance (IGT), whereas the other suffered from frank diabetes (fasting plasma glucose 12.5 mM). Differences in insulin secretion pattern and/or insulin action between the twins is supposed to be responsible for development of hyperglycemia in MODY. On the other hand, identical defects in insulin secretion and action in the twins may point to the primary genetic defect in MODY. Therefore, our aim was to investigate insulin secretion and insulin action in the twins to find these differences and similarities. We found that fasting plasma insulin and C-peptide values were slightly increased in the twins, whereas the responses of insulin and C-peptide to oral glucose tolerance tests (OGTT) and meals were similar in the twins and within normal range. The insulin responses to OGTT were, however, lower than expected from the glucose values, indicating a beta-cell defect. Despite elevated plasma insulin levels, basal hepatic glucose output (HGO) was normal in the IGT twin but increased by 75% in the diabetic twin. The maximally inhibitory effect of insulin on HGO, when estimated at euglycemia, was normal in the IGT twin but reduced by 60% in the diabetic twin. Furthermore, the maximal insulin mediated glucose uptake in peripheral tissues was reduced by 40% in the diabetic twin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289994 TI - Physiological importance of deficiency in early prandial insulin secretion in non insulin-dependent diabetes. AB - Patients with non-insulin-dependent diabetes mellitus (NIDDM) have a deficiency in early prandial insulin secretion. To determine the contribution of this early deficiency to prandial hyperglycemia, exogenous intravenous insulin (1.8 U over 30 min) was delivered to eight NIDDM subjects in a profile designed to simulate the normal initial rise in insulin levels. The same dose of insulin was also administered 1) in the same profile but delayed by 30 min and 2) as a constant infusion over 180 min. Augmentation of the early insulin response caused a 33 +/- 4% reduction in the glycemic response to a mixed meal (P less than .005); the peak blood glucose increment above baseline was reduced by 1.4 mM (P less than .005) to an increment identical to nondiabetic subjects (3.3 +/- 0.3 vs. 3.2 +/- 0.2 mM), and blood glucose levels were still 0.9 mM lower after 180 min (P less than .05). In contrast, the delayed profile or constant infusion did not significantly alter the glycemic response to the meal. Early insulin augmentation resulted in elevated peripheral insulin levels initially (peak level 81 +/- 11 mU/L), but subsequent insulin and C-peptide levels were lower than in the control study (at 180 min after the meal, 22 +/- 5 vs. 33 +/- 8 mU/L, P less than .05, and 4.0 +/- 0.5 vs. 5.3 +/- 0.6 micrograms/L, P less than .02, respectively). Early insulin delivery caused free-fatty acid (FFA) levels to fall at a faster rate after the meal and also attenuated the initial rise in glucagon levels typical of NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3289995 TI - Role of gluconeogenesis in sustaining glucose production during hypoglycemia caused by continuous insulin infusion in conscious dogs. AB - The roles of glycogenolysis and gluconeogenesis in sustaining glucose production during insulin-induced hypoglycemia were assessed in overnight-fasted conscious dogs. Insulin was infused intraportally for 3 h at 5 mU.kg-1.min-1 in five animals, and glycogenolysis and gluconeogenesis were measured by using a combination of tracer [( 3-3H]glucose and [U-14C]alanine) and hepatic arteriovenous difference techniques. In response to the elevated insulin level (263 +/- 39 microU/ml), plasma glucose level fell (41 +/- 3 mg/dl), and levels of the counterregulatory hormones glucagon, epinephrine, norepinephrine, and cortisol increased (91 +/- 29 to 271 +/- 55 pg/ml, 83 +/- 26 to 2356 +/- 632 pg/ml, 128 +/- 31 to 596 +/- 81 pg/ml, and 1.5 +/- 0.4 to 11.1 +/- 1.0 micrograms/dl, respectively; for all, P less than .05). Glucose production fell initially and then doubled (3.1 +/- 0.3 to 6.1 +/- 0.5 mg.kg-1.min-1; P less than .05) by 60 min. Net hepatic gluconeogenic precursor uptake increased approximately eightfold by the end of the hypoglycemic period. By the same time, the efficiency with which the liver converted the gluconeogenic precursors to glucose rose twofold. Five control experiments in which euglycemia was maintained by glucose infusion during insulin administration (5.0 mU.kg-1.min-1) provided baseline data. Glycogenolysis accounted for 69-88% of glucose production during the 1st h of hypoglycemia, whereas gluconeogenesis accounted for 48-88% of glucose production during the 3rd h of hypoglycemia. These data suggest that gluconeogenesis is the key process for the normal counterregulatory response to prolonged and marked hypoglycemia. PMID- 3289996 TI - Maintenance of high-energy brain phosphorous compounds during insulin-induced hypoglycemia in men. 31P nuclear magnetic resonance spectroscopy study. AB - 31P nuclear magnetic resonance (NMR) spectroscopy allows noninvasive studies of cerebral energy-rich phosphorous compounds in humans. In an attempt to characterize the relationship between peripheral blood glucose concentrations and whole-brain phosphate metabolism during insulin-induced hypoglycemia, 31P NMR spectra were obtained before and after intravenous injection of insulin (0.15 IU/kg body wt) in six men. Compared with prehypoglycemic measurements, no significant changes were found in brain content of Pi, sugar phosphates, phosphocreatine, phosphodiesters, and ATP, and brain pH remained constant during the experiment. These results show that the integrated brain profile of energy rich phosphorous compounds is unaffected by experimental insulin-induced hypoglycemia in humans. PMID- 3289997 TI - Increased hypothalamic neuropeptide Y concentrations in diabetic rat. AB - Central and lateral hypothalamic concentrations of 10 regulatory peptides were measured by radioimmunoassay in streptozocin-induced diabetic (STZ-D) and matched control rats between 1 day and 14 wk after diabetes induction. After 2 wk, both central and lateral hypothalamic neuropeptide Y (NPY) concentrations in STZ-D rats were consistently higher than those found in control rats, with significant 30-50% increases at 4 wk in the central hypothalamus, and at 6 and 14 wk in both central and lateral hypothalamus. Immunocytochemical studies in 4- and 6-wk STZ-D animals showed the appearance of intensely NPY-positive swollen cell bodies in the supraoptic nucleus and a subjective increase in NPY staining of medial hypothalamic nerve fibers. Central hypothalamic concentrations of three other peptides were significantly greater in STZ-D animals than those in control animals at single points (neurotensin, 1 day; calcitonin gene-related peptide, 2 wk; neurokinin, 4 wk). Hypothalamic concentrations of the other six peptides examined (bombesin, galanin, neuromedin B, substance P, somatostatin, and vasoactive intestinal peptide) did not differ significantly between STZ-D and control groups at any time. However, galanin immunostaining in the supraoptic and magnocellular paraventricular nuclei was strikingly concentrated in a reduced number of distended cell bodies. Hypothalamic peptide changes in STZ-D could be related to metabolic disturbance, changes in energy and water balance, altered pituitary function, or other factors. Persistently elevated concentrations of NPY, a very potent central stimulant of eating and drinking, may mediate the hyperphagia and polydipsia characteristic of STZ-D. PMID- 3289999 TI - Reduced in vivo biological activity of in vitro glycosylated insulin. AB - We evaluated the in vivo biological activity of in vitro extensively glycosylated insulin (GI) with the euglycemic-hyperinsulinemic glucose-clamp technique in postabsorptive nondiabetic subjects. Insulin-mediated glucose disposal was approximately 30% lower (P less than .03) with GI (9.2 +/- 1.2 mg.kg-1.min-1, mean +/- SE) than with the nonglycosylated hormone (12.6 +/- 0.7 mg.kg-1.min-1) at comparable plasma insulin concentrations (approximately 90 microU/ml). Binding of GI to a specific receptor on circulating cells (erythrocytes and monocytes) was normal. We conclude that in vitro extensive glycosylation of insulin reduces its biological activity in vivo, as reflected by insulin-mediated glucose disposal, probably at a postreceptor level. PMID- 3289998 TI - Taste-induced changes in plasma insulin and glucose turnover in lean and genetically obese rats. AB - Cephalic-phase insulin release (CPIR) and the changes in glucose turnover induced by saccharin ingestion were studied in freely moving lean and genetically obese fa/fa rats equipped with chronic catheters for blood sampling. Six-hour-fasted lean and obese rats were trained to drink 1 ml sodium saccharin (0.15%) or 1 ml glucose (70%), and blood samples were taken before and after the stimuli. As early as 1-1.5 min poststimulus, there was a significant increase in CPIR in lean and obese rats. The amplitude of the CPIR induced either by saccharin or by glucose in the obese rats was significantly higher than it was in the lean rats. The effect of saccharin ingestion on the hepatic glucose production (HGP) and the rate of glucose disappearance (Rd) was studied in 6-h-fasted lean and obese rats, under non-steady-state conditions, according to a method previously validated. Saccharin ingestion produced a significant increase in HGP and Rd in lean and obese rats compared with basal values. The saccharin-induced increments in HGP and Rd were higher in the obese than in the lean animals. We conclude that saccharin (through taste) appears to elicit parasympathetic (insulin release) and sympathetic (HGP increase) reflexes in lean and obese rats. These taste-induced changes in plasma insulin and glucose turnover are exaggerated in the obese rats and may participate in obesity and in insulin resistance of the overall syndrome. PMID- 3290000 TI - Two-color flow cytometry analysis of activated T-lymphocyte subsets in type I diabetes mellitus. AB - We addressed the question of whether newly diagnosed type I (insulin-dependent) diabetes mellitus patients showed an increased number of DR (la+) T-lymphocytes compared with nondiabetic siblings and normal control subjects. Two-color flow cytometry measurements of peripheral-blood lymphocytes showed a slight but statistically significant increase in DR+ T-lymphocytes in diabetic subjects as well as the nondiabetic sibling control compared with the normal control subjects. This difference was not present in long-term-diabetic subjects. Thus, in addition to minor changes in this lymphocyte subset in peripheral blood, the sibling data demonstrate a lack of specificity for the disease; therefore, these measurements are probably of limited diagnostic usefulness. PMID- 3290001 TI - Effect of bacitracin on binding and processing of insulin by established renal cell line. AB - The effect of bacitracin on the binding and processing of 125I-labeled insulin was studied in a proximal tubular epithelium-like opossum kidney cell line. This cultured cell line handles insulin in a manner comparable to the in vivo situation, which requires membrane binding, internalization, and intracellular degradation. The addition of bacitracin inhibited insulin degradation significantly and delayed the time of appearance of products in the medium (22 min) compared with control cells (14 min). Maximum total cell-associated radioactivity increased from 1.5 +/- 0.19% in the control cells to 2.5 +/- 0.17% in the treated cells. Separation of cell membrane from internalized radioactivity was achieved by acid washing and showed no change in membrane-bound radioactivity or rate of internalization, but a significant increase in intracellular radioactivity was noted. Gel-filtration chromatography revealed that this was due to an accumulation of chromatographically intact insulin. Accordingly, we conclude that bacitracin inhibits insulin degradation in cultured kidney cells by perturbing the intracellular processing of insulin, not by altering the binding or internalization of the hormone or by inhibiting the release of small degradation products. Because of the multiple actions of this agent, the exact site in these kidney cells at which intracellular degradation is inhibited remains to be established. However, in contrast to studies with lysosomes isolated from cells of other tissues, this study showed that when lysosomes isolated from rat renal cortex were exposed to bacitracin, insulin degradation was inhibited markedly (81%). PMID- 3290002 TI - Adenosine is required for myocardial insulin responsiveness in vivo. AB - The adenosine-receptor antagonist 8-phenyltheophylline (8-PTH) was used to study the role of endogenous adenosine in modulating insulin-stimulated myocardial glucose uptake (MGU) in vivo. Dogs were surgically instrumented under pentobarbital sodium anesthesia to measure hemodynamics and obtain blood samples for determinations of oxygen and glucose concentrations. Myocardial uptake of these substances was calculated as the product of the appropriate arterial coronary sinus differences and circumflex blood flow. The response to insulin was determined with the hyperinsulinemic-euglycemic clamp technique. During insulin infusion, MGU increased from 3.12 +/- 0.8 to 9.20 +/- 1.8 mg/min (mean +/- SE). In contrast, insulin failed to increase MGU when 8-PTH was being infused into the circumflex artery. These results demonstrate that some degree of adenosine receptor-mediated activity is required for insulin to stimulate myocardial glucose uptake. It is suggested that the presence of adenosine at its receptor may be an important factor during conditions in which myocardial insulin resistance may develop. PMID- 3290003 TI - Report and recommendations of the San Antonio conference on diabetic neuropathy. Consensus statement. PMID- 3290004 TI - Use of in vitro DNA amplification to screen family members for an insulin gene mutation. AB - The DNA polymerase chain reaction can be a powerful tool for amplifying selected segments of genomic DNA for investigation of point mutations that are inaccessible via classic restriction-fragment-length polymorphism analysis. We have applied this method to an analysis of the incidence of heterozygosity for the mutant insulin allele insulin Wakayama (A3 Val----Leu) in two unrelated Japanese families having the hyperinsulinemic mutant insulin syndrome. The results indicate that this method is simple, sensitive, and accurate and should be useful for screening larger (diabetic) populations to detect single-base substitutions in the insulin gene that lead to either altered (pro)insulin structure and/or insulin production. PMID- 3290005 TI - Inhibition of insulin release in vitro mediated by mononuclear cells from diabetic patients treated with cyclosporin A or placebo. AB - Anti-beta-cell-specific cell-mediated immunity was studied over a 12-mo period in 65 recently diagnosed diabetic patients randomly receiving either cyclosporin or placebo. Anti-beta-cell cellular immunity was assessed by an in vitro test based on the inhibition of insulin release from cultured rat islet cells by patients' mononuclear cells. This beta-cell-suppressive effect disappeared in cyclosporin A treated patients within 1 mo and did not reappear during 12 mo of follow-up. Conversely, the suppressive effect persisted unchanged in placebo-treated patients during 12 mo of follow-up. These changes were predictive neither of cyclosporin A-induced remission nor of relapses. Results of the insulin-release inhibition test were not correlated to islet cell autoantibodies or HLA phenotype. PMID- 3290006 TI - Glucose transport is rate limiting for skeletal muscle glucose metabolism in normal and STZ-induced diabetic rats. AB - To test the hypothesis that glucose transport is rate limiting for skeletal muscle glucose metabolism, intracellular free glucose was measured in in situ abdominal wall muscle and liver that were rapidly freeze-clamped and removed from normal and streptozocin-induced diabetic (STZ-D) Sprague-Dawley rats exposed to different concentrations of serum insulin and glucose achieved by 90-min glucose clamps. Three groups of anesthetized normal (n = 17) and three groups of STZ-D (n = 19) animals were studied. In each group, infusions were adjusted to expose rats to basal, euglycemic-hyperinsulinemic, and hyperglycemic-hyperinsulinemic conditions. Final steady-state serum glucose and insulin concentrations (mean +/- SE) achieved in the six groups ranged from 112 +/- 2 to 467 +/- 26 mg/dl and from 5.8 +/- 1.9 to 3644 +/- 116 microU/ml, respectively. Intracellular free-glucose content of all tissue was calculated from total tissue glucose content minus the contribution of glucose in extracellular water estimated with [14C]inulin. Intracellular free glucose was not detected in muscle of any of the experimental groups. However, intracellular free glucose was detected in liver from all normal and STZ-D rats, and the calculated intracellular concentrations of free glucose correlated with serum glucose concentrations (r = .68, P less than .001). We conclude that intracellular free glucose does not accumulate, regardless of glucose or insulin concentration, in normal skeletal muscle and muscle made insulin resistant (by STZ-D), suggesting that glucose transport remains rate limiting. PMID- 3290007 TI - Effect of intensive insulin therapy on glycemic thresholds for counterregulatory hormone release. AB - To evaluate the effect of strict glycemic control of insulin-dependent diabetes mellitus (IDDM) on the plasma glucose threshold initiating counterregulatory hormone responses to hypoglycemia, we used the glucose clamp technique to produce a standardized gradual glucose decline from 90 to 40 mg/dl in seven young IDDM patients before and after 2-6 mo of intensified insulin therapy. Before intensive therapy [hemoglobin A1 (HbA1) 9.6 +/- 1.1%], epinephrine responses were triggered at a higher plasma glucose level (67 +/- 4 mg/dl) than in normal control subjects (56 +/- 1 mg/dl, P less than .05), and clinical symptoms of hypoglycemia appeared at glucose levels of 50-60 mg/dl. After intensive therapy (HbA1 7.1 +/- 0.7%), the glucose threshold for epinephrine release consistently declined to values (46 +/- 2 mg/dl) below normal (P less than .01). Furthermore, epinephrine concentrations were markedly reduced at each hypoglycemic level, and a greater hypoglycemic stimulus was required to elicit symptoms. The glucose threshold stimulating release of growth hormone also significantly declined after intensive therapy. We conclude that strict glycemic control of IDDM lowers the plasma glucose level required to generate epinephrine release during hypoglycemia. This may diminish patient recognition of moderate hypoglycemia and increase the risk of severe hypoglycemia in intensively treated IDDM. PMID- 3290008 TI - Increased dye coupling in pancreatic islets from rats in late-term pregnancy. AB - Our previous studies have suggested that elevated lactogen, increased glucose stimulated insulin secretion, and increased beta-cell coupling are associated. To determine whether this association occurs under conditions of physiologically increased lactogen, we have studied the extent of dye coupling in rat islets during the later stage of pregnancy. These animals have high plasma lactogen levels in the form of placental lactogen, increased plasma insulin, and decreased plasma glucose. The fluorescent tracer, Lucifer yellow CH, was microinjected into central cells of islets from both pregnant and virgin rats, and the extent of transfer was quantitated by determining the projected area of dye spread. Two area measurements were made for each injection, one around the entire discernible fluorescent region ("outer") and another around the distinct brighter region of cells surrounding the injected cell ("inner"). Pregnancy increased dye transfer, as determined by both measurements. The outer area of dye transfer was 9047 +/- 775 microns2 for the islets from pregnant rats and 4699 +/- 391 microns2 for the islets from virgin rats (P less than .001). Similarly, pregnancy increased the inner area of dye transfer, 1447 +/- 161 microns2 for the islets from pregnant rats and 795 +/- 80 microns2 for the islets from virgin rats (P less than .001). These results support the hypothesis that elevated lactogen, increased glucose stimulated insulin secretion, and increased beta-cell dye coupling are associated under physiological conditions. The study indicates that enhanced beta-cell coupling is part of the structural and functional adaptation that the islets undergo during a subject's pregnancy and demonstrates that the extent of beta cell coupling is regulated by a physiological condition. PMID- 3290009 TI - Functional characteristics of rat pancreatic islets maintained in culture after exposure to human interleukin 1. AB - Recent observations suggest a role for interleukin 1 beta (IL-1) in the autoimmune beta-cell destruction observed in type I (insulin-dependent) diabetes mellitus. We investigated the acute and long-term effects of IL-1 on pancreatic beta-cell function in vitro. Rat pancreatic islets were isolated and kept in tissue culture for 5 days. The islets were subsequently transferred to media containing RPMI-1640 plus 1% human serum with or without human recombinant IL-1 beta (300 pM) and cultured for another 48 h. The islets were examined either immediately after IL-1 exposure (day 0) or after an additional 6-day culture period without IL-1. On day 0, IL-1 was found to totally inhibit glucose stimulated insulin release, partially inhibit glucose oxidation, and induce a decrease in islet DNA content. However, these islets were able to release insulin after stimulation with glucose plus theophylline, although the absolute rate of insulin secretion was lower than that of the control group. After 6 days in culture, the insulin-secretory response to glucose and the glucose oxidation rates of the IL-1-pretreated islets were completely restored, but there remained a reduced islet DNA content. We conclude that IL-1 is cytotoxic to islet beta cells. However, surviving beta-cells are able to recover their functional capacity after a period of inhibited function. PMID- 3290010 TI - Prospective study of predictors of beta-cell survival in type I diabetes. AB - We conducted a prospective study to describe the course of the pancreatic beta cell function from the time of clinical diagnosis of insulin-dependent (type I) diabetes to determine whether DR type, presence of islet cell antibodies (ICA), presence of insulin antibodies (IA), age at onset, and sex could help in the prediction of residual endogenous insulin secretion. A cohort of 68 children was followed for 18 mo after diagnosis of type I diabetes. The outcome variables selected for analysis were 1) serum C-peptide peak concentration after a Sustacal meal, 2) time of disappearance of the serum C-peptide response, and 3) time after diagnosis at which the maximal serum C-peptide response was observed. After institution of insulin therapy, serum C-peptide peak concentrations rose temporarily for 1-6 mo and declined thereafter. Multivariate analysis of the data showed that DR type (P = .2488) and presence of IA (P = .1604) had no effect on serum C-peptide over time, but sex (P = .0146), age at onset (P = .0002), and presence of ICA (P = .0147) significantly contributed to the variation of serum C peptide over time. Furthermore, age at onset, presence of ICA, and sex were also the only significant predictors of the time of disappearance of the beta-cell function. The relative risks of beta-cell-function disappearance were 0.87 (P = .0015), 9.43 (P = .0181), and 2.25 (P = .0468), respectively. In conclusion, there are distinct variations in the natural course of the beta-cell function in type I diabetes. beta-Cell-function survival is significantly shortened the younger the subject is at disease onset, if ICA are present at diagnosis, and if the subject is male. PMID- 3290011 TI - Effect of chronic diabetes on myocardial fuel metabolism and insulin sensitivity. AB - To assess the effect of chronic insulin-deficient diabetes on myocardial fuel substrate metabolism in vivo, we measured the myocardial balance of glucose, free fatty acids (FFAs), and amino acids in nine postabsorptive conscious dogs 4-6 wk after treatment with streptozocin. The acute effect of insulin on the myocardial balance of these same substrates was measured in six dogs by use of the euglycemic insulin clamp technique. To further examine the effect of insulin on heart amino acid balance, we studied three additional dogs given a constant infusion of amino acids during the insulin clamp to blunt the insulin-induced hypoaminoacidemia. In these dogs, the fasting plasma glucose concentration was markedly elevated (258 +/- 3 mg/dl). In the basal period, there was no significant glucose uptake by the heart [arterial vs. coronary sinus concentration difference (delta) = 1.0 +/- 2.0 mg/dl]; furthermore, physiologic hyperinsulinemia did not stimulate glucose uptake (delta = 2.0 +/- 2.5 mg/dl). Postabsorptively, arterial FFAs were elevated (1550 +/- 320 microM) in diabetic animals, and there was a significant net extraction of FFAs by the heart (net uptake 26 +/- 9 mumol/min; extraction ratio 30 +/- 8%). During the insulin clamp, arterial FFAs declined (645 +/- 240 microM), as did heart FFA uptake (11 +/- 6 mumol/min), and the net extraction ratio for FFAs was unchanged (30 +/- 7%). Similarly, the arterial branched-chain amino acid (BCAA) concentration was elevated in the postabsorptive state, and there was a significant myocardial uptake of these amino acids and of alanine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290013 TI - Short-latency cortical somatosensory evoked responses of preterm infants with ultrasound abnormality of the brain. AB - Somatosensory evoked response (SER) testing was carried out on 30 neonates with abnormality of the brain diagnosed by ultrasound, and the results were compared with previously defined normal ranges. The N1 peak latencies of the cortical SER were significantly different from normal, but peripheral nerve conduction velocities were not. Early neurological follow-up of these infants suggests that the cortical SER shows good correlation with neurological and developmental outcome, and may provide useful additional diagnostic information to cranial ultrasound for these high-risk infants. PMID- 3290012 TI - Glyceraldehyde phosphate and methyl esters of succinic acid. Two "new" potent insulin secretagogues. AB - We discovered that two physiologically occurring metabolic intermediates, glyceraldehyde phosphate and succinate, are potent insulin secretagogues. No other glycolytic intermediate besides glyceraldehyde phosphate was insulinotropic. Succinate, when added to islets as either its monomethyl or dimethyl ester to increase its cellular permeability, was also insulinotropic. In islets, as in other cell types, these esters are apparently hydrolyzed intracellularly to succinate. Unesterified succinate and other unesterified citric acid-cycle intermediates did not stimulate insulin release. Initiation of insulin release by esters of succinate suggests that mitochondrial metabolism alone is sufficient to initiate and support insulin release. However, this is specific for succinate in that esters of fumarate, pyruvate, and citrate were not insulinotropic. PMID- 3290014 TI - Bilateral striatal lesions. PMID- 3290015 TI - The fragile-X syndrome. AB - The variability in behavioral manifestations of the fragile-X syndrome and the lack of a well-defined psychological profile require the attention of behavioral geneticists and other behavioral scientists. The association with autism suggests that the fra(X) may be responsible for a genetic subtype of autism. While the fragile-X syndrome is considered an X-linked disorder, several aspects of observed transmission patterns do not follow those of classical X-linked inheritance. In particular, the finding of genetic transmission via intellectually normal males is surprising and has important implications for genetic counseling, as well as for genetic models of the fragile-X syndrome. Reports on folic acid treatment are encouraging, but not conclusive. The mechanisms involved in the association between the fra(X) chromosome and its particular phenotype are still unknown. Current investigations applying advanced techniques in molecular biology are likely to provide insight into this unique genetic disorder. PMID- 3290016 TI - Nasal obstruction in childhood: the obstructive sleep apnoea syndrome. PMID- 3290017 TI - Prospective analysis of islet cell antibodies in children with type 1 (insulin dependent) diabetes. AB - The prevalence of islet cell antibodies in children with Type 1 (insulin dependent) diabetes was determined in a cohort of 678 children. The natural course of islet cell antibodies was followed in 375 children at 1 year, 252 and 135 children after 2 and 3 years respectively. Islet cell antibodies were determined by indirect immunofluorescence on cryostat sections of human pancreas. At diagnosis of diabetes 85% of the children had detectable islet cell antibodies (mean titre 10.4). After 3 years 62% of the children were still islet cell antibody positive (mean titre 2.9) indicating a greater persistence of islet cell antibodies than described in earlier studies. In this large cohort a significant correlation between islet cell antibody prevalence or persistence and sex, age or HLA-DR type was not observed except for a faster loss of islet cell antibodies in very young boys and in patients lacking HLA-DR types 3 and 4. Complement fixing islet cell antibodies correlated with high titre islet cell antibodies. Greater persistence of islet cell antibodies was seen for cases with high antibody titre and in children with diagnosis of diabetes during the first half of the year. PMID- 3290019 TI - Absence of glucopenic inhibition of the insulin response to arginine at the onset of diabetes in BB/W rats. AB - To determine if the inhibiting effect of glucopenia on arginine-stimulated insulin secretion is impaired at the onset of autoimmune diabetes, the insulin response to arginine was studied at 5.6 and 2.8 mmol/l glucose in perfused pancreata isolated from BB/W rats on the first day of diabetes and from age matched diabetes-prone BB/W rats without diabetes. During glucopenia the baseline insulin secretion was reduced by more than 80% in both groups. However, the arginine-stimulated insulin response in the diabetic group was only 16.5% lower during glucopenia compared to 79.1% lower in the nondiabetic controls. Also, enhancement of the arginine-stimulated glucagon response by glucopenia was modest compared to controls. The results indicated that at the onset of this form of autoimmune diabetes the surviving B cells are, for unknown reasons, hyperresponsive to arginine and that, in contrast to the controls, this response is not inhibited by glucopenia. PMID- 3290018 TI - Diabetic neuropathy in the upper limb and the effect of twelve months sorbinil treatment. AB - Clinical and neurophysiological studies were undertaken, with particular reference to the arms, in 39 patients with diabetic neuropathy. The effects of an aldose reductase inhibitor, sorbinil, on neuropathy in these patients were studied in a 12 month double blind placebo controlled trial. Neurophysiological measurements, particularly of sensory amplitude, were considerably more sensitive than measurements of temperature and vibration sensation and remain of fundamental importance in measuring diabetic neuropathy at an early and potentially reversible stage. There was no significantly beneficial effect of sorbinil on clinical or neurophysiological measurements of nerve function in patients with established diabetic neuropathy. These results indicate that neurophysiological techniques are necessary, in conjunction with clinical measurements, for the assessment of 'early' diabetic neuropathy and that aldose reductase inhibitors are not effective in the treatment of established diabetic neuropathy. PMID- 3290020 TI - [Diagnostic and therapeutic use of the artificial endocrine pancreas in hypoglycemia]. PMID- 3290021 TI - [Importance of nuclear medicine in the diagnosis and prognosis of acute myocardial infarct]. PMID- 3290022 TI - [Creatinine]. PMID- 3290023 TI - [Update on cancer radiotherapy]. PMID- 3290024 TI - Regulation of the mitochondrial adenine nucleotide pool size in liver: mechanism and metabolic role. AB - The ATP-Mg/Pi carrier in liver mitochondria can catalyze the exchange of ATP-Mg on one side of the inner membrane for Pi on the other. This mechanism allows for net uptake or release of ATP-Mg from mitochondria and thus regulates the matrix ATP + ADP + AMP pool size. In isolated mitochondria, carrier activity is stimulated by submicromolar concentrations of calcium, suggesting that calcium may regulate transport rates in vivo. Whenever the carrier is active, the direction of any net changes in the matrix adenine nucleotide pool size is determined mainly by the extent to which the prevailing ATP-Mg concentration gradient deviates from an equilibrium related to delta pH through the phosphate concentration gradient. Thus it seems that in the cell, energy status (reflected by ATP:ADP ratios in the cytoplasm and matrix) determines whether calcium mediated hormone activation of the carrier will produce an increase or a decrease in the matrix adenine nucleotide content. Consequent variations in the absolute concentrations of ATP, ADP, and AMP in the matrix may contribute to the selective regulation of those metabolic activities in the cell that have adenine nucleotide dependent steps localized to the mitochondrial compartment (gluconeogenesis, urea synthesis, mitochondrial biogenesis, and even oxidative phosphorylation). PMID- 3290025 TI - Heme oxygenase: function, multiplicity, regulatory mechanisms, and clinical applications. AB - In biological systems oxidation of heme is carried out by two isozymes of the microsomal heme oxygenase, HO-1 and HO-2. HO-1 is the commonly known heme oxygenase, the activity of which can be induced by up to 100-fold in response to a wide variety of stimuli (metals, heme, hormones, etc.). HO-2 was only recently discovered, and the isozyme appears to be uninducible. The two forms are products of two different genes and differ in their tissue expression. The primary structure of HO-1 and an HO-2 fragment of 91 amino acid residues show only 58% homology, but share a region with 100% secondary structure homology. This region is believed to be the catalytic site. Most likely, HO-1 gene is regulated in the same manner as metallothione in the gene. HO-1 has a heat shock regulatory element, and possibly many promoter elements, which bind to respective inducers and cause transcription of the gene. In vivo induction of HO-1 activity in the liver is accompanied by decreases in the total P-450 levels and, in a reconstituted system, cytochrome P-450b heme can be quantitatively converted to biliverdin by HO-1 and HO-2. The enzyme activity is inhibited in vivo for extended periods subsequent to binding of Zn- and Sn- protoporphyrins. This property appears useful for the suppression of bilirubin production. The metalloporphyrins, however, are not innocuous and cause major disruptions in cellular metabolism. In this review recent findings on heme oxygenase are highlighted. PMID- 3290026 TI - Dissociation of immune capacity from nutritional status by triiodothyronine supplements in severe protein deficiency. AB - Weanling mice were fed ad libitum from age 23 to 37 days either an 18 or an 0.6% protein diet. Half the animals in each dietary group received supplemental triiodothyronine (T3, 0.2 mg/kg diet). T3 increased the primary in vivo antibody response of protein-deficient mice to sheep red blood cells, as measured by both splenic plaque-forming cells (PFC) per 10(6) nucleated spleen cells and serum hemagglutinin titers. T3 also increased PFC/spleen in well-nourished mice. The effect on protein-deficient animals was achieved although nutritional status in these animals, as estimated by weight loss and carcass composition, was further impaired by T3 supplementation. These results support the hypothesis that immune functions can be improved independently of nutritional status in severe (wasting) malnutrition. Insofar as T3 was effective in a model of malnutrition that does not reduce serum total or free T3 levels, the phenomenon appears to represent a pharmacological action of the hormone. PMID- 3290027 TI - [Arrhythmogenic right ventricular dysplasia. Study of a selected population]. AB - 268 patients (pts) aged between 4 and 63 (average block 33.6) years were examined in an effort to detect structural and/or wall motion abnormalities of the right ventricle, consistent with a diagnosis of Arrhythmogenic Right Ventricular Dysplasia (ARVD). The patients included in this study had some of these features: 1) sudden juvenile death (age less than 35 years) due to heart disease; 2) relatives of pts died suddenly of pathologically proven ARVD; 3) pts with ventricular arrhythmias grade Lown greater than 3, and with QRS morphology mainly of left bundle branch block; 4) pts between the ages of 18 and 40, with negative T waves beyond V2; 5) pts with ventricular arrhythmias of left bundle branch block morphology, and grade Lown greater than 1, and negative T waves beyond V1. ARVD was recognized in 108 living and 18 deceased pts. Our data confirm that ARVD is a wide spectrum disease, going from the classical form described by Marcus and Fontaine to concealed forms characterized mainly by premature ventricular complexes. PMID- 3290028 TI - [Papillomatosis of the mitral valve as an unusual cause of myocardial ischemia. Description of a case and review of the literature]. AB - Papilloma is a rare primary heart tumour; only 75 cases have been reported and most were casual findings at autopsy. We describe another case of this tumour in a 9 years girl. The neoformation had produced a picture of angina pectoris, followed by death due to an occluded left coronary orifice. To our knowledge, this is the first report of this type of tumour with electrocardiographic documentation. PMID- 3290029 TI - [Pit cell]. PMID- 3290030 TI - [Computerized systems for the analysis of signals of digestive motility]. PMID- 3290031 TI - [Digestive endosonography in 1988. Principles and trends]. PMID- 3290032 TI - [Severe digestive vasculitis: value of bolus of cyclophosphamide]. PMID- 3290033 TI - Gastric wall thickness in normal and neoplastic subjects: a prospective study performed by abdominal ultrasound. AB - Gastric wall thickness (body-antrum) was blind measured prospectively by real time ultrasound in 58 patients (30 with gastric cancer and 28 healthy) who had previously undergone endoscopy. Gastric wall thickness on the average measured 15.933 +/- 4.471 mm in the neoplastic patients and 5.107 +/- 1.100 mm in the normal subjects. Seven millimeters was the highest value found in the normal subjects (4 cases) and the minimum value found in the neoplastic patients (1 case). Knowing the normal gastric wall thickness value on a standard ultrasound examination of the upper abdomen is useful, as ultrasound is often performed as a screening or first-step procedure, in order to address the patients with higher values toward more specific techniques. PMID- 3290034 TI - Glucagon-induced small bowel air reflux: degrading effects on double-contrast colon examination. AB - Glucagon-induced small bowel air reflux and its effect on the diagnostic quality of the double-contrast barium enema examination was prospectively evaluated in 103 patients. These were randomly assigned to receive 0.5 mg intravenous glucagon (50 patients) or to a control group without such medication (53 patients). The group receiving glucagon demonstrated an increased amount of small bowel air and a greater magnitude of change in its volume secondary to reflux, as well as degradation in the quality of barium enema study when compared to the nonglucagon group. No significant improvement in visualization of the appendix after glucagon was observed. We conclude that routine administration of glucagon during double contrast enema would degrade the quality of examination primarily because it promotes retrograde reflux of air into the small intestine. PMID- 3290035 TI - Intussusception secondary to squamous carcinoma of the lung. AB - This report describes unusual radiologic and pathologic findings in a patient with multiple small bowel metastases from squamous cell carcinoma of the lung. The diagnostic work-up revealed a large, pleural-based, right lung mass, a large left adrenal mass, two ulcerated small bowel masses, and a unique giant peduncular mass that caused intermittent intussusception. A pertinent review of the literature is presented. PMID- 3290036 TI - Obstructive jaundice from open vessel clip. AB - Obstructive jaundice occurred 3 years after cholecystectomy in a 49-year-old man. At surgery a large stone was discovered in the common bile duct. Pathologic examination showed that the stone had formed around an open vessel clip. Migration of an open vessel clip to the biliary system with subsequent stone formation has not been reported previously. PMID- 3290037 TI - Intraluminal papillary carcinoma of the gallbladder: prognostic value of computed tomography and sonography. AB - Twenty-seven consecutive cases with a prospective diagnosis of cancer of the gallbladder were analyzed to clarify the computed tomographic (CT) and ultrasonographic features, behavior, and prognosis of intraluminal papillary carcinoma (n = 7) of the organ. With CT and ultrasonography, these intraluminal carcinomas were further classified into 3 subtypes: single polyp, multiple polyp, and jam-packed gallbladder. Preoperative diagnosis, evaluation of local invasiveness, and detection of metastatic lesions were reliably done. Carcinomas of this type were locally less invasive, less frequently metastasized, and resulted in a longer survival than the other massive and thickened-wall carcinomas. PMID- 3290038 TI - Splenosis: ultrasound and CT findings in a case complicated by an intraperitoneal implant traumatic hematoma. AB - A case of intraperitoneal splenosis, found incidentally at ultrasound examination in a 35-year-old man, is reported. The diagnosis, suspected on the basis of computed tomographic (CT) and radionuclide studies, was established by surgery. Three years later, after direct trauma, ultrasound and CT studies revealed a surgically proven splenosis implant hematoma. The contribution of radiologic examinations in the diagnosis of splenosis is emphasized. PMID- 3290039 TI - Ubiquitous expression of HLA-DR antigens on human small intestinal epithelium. AB - To clarify the frequency of the expression of HLA-DR antigens on the human small intestinal epithelium and the variation of such expression, 43 specimens (duodenum 16, jejunum 8, ileum 19; histologically normal 33, pathologic lesions 10) were studied for HLA-DR expression by indirect immunoperoxidase staining using monoclonal antibodies against HLA-DR antigens. All specimens reacted with anti-HLA-DR antibodies with minor variations. Most specimens showed decreasing intensity from the top of the villi toward the base of the villi and no staining in the crypt. In about half of the specimens, clear peripheral and cytoplasmic staining of the epithelial cells was observed. In some cases, the staining of the apical portion of the epithelium was patchy. The expression was unrelated to the lymph follicle. This ubiquitous expression of HLA-DR antigens on the small intestinal epithelium presents a striking contrast to an absence of the antigens on the normal large intestinal epithelium. A preliminary study on the pathologic lesions demonstrated the following changes in the expression of HLA-DR antigens; appearance of HLA-DR antigens on the crypt epithelium in Crohn's disease, loss of HLA-DR antigens on the epithelium covering the area of cell infiltration in macroglobulinemia and covering adenoma in familial polyposis coli. PMID- 3290040 TI - Chronic calcific pancreatitis: clinical profile in northern India. AB - Twenty three patients with chronic calcific pancreatitis of the tropics in Northern India were prospectively studied. All had pancreatic calcification and ERCP changes typical of chronic pancreatitis, the most predominant being ductal dilatation which was detected in all patients by both ERCP and by ultrasonography. Pain was present in 19 (83%) patients and diabetes in 11 (48%) patients. Exocrine pancreatic dysfunction was uncommon, steatorrhoea being present in only 9% of patients. Ten of the 11 patients with diabetes required insulin for control and one case was able to be controlled by an oral antidiabetic agent. Two patients developed ketoacidosis during acute episodes of pancreatitis, 3 patients had peripheral neuropathy and one patient had visual changes. Recurrent severe pain was the reason for operation in 7 patients. All had a lateral pancreaticojejunostomy. In order to obtain an objective assessment of pain, a scoring system was developed to grade its severity according to its intensity, frequency and consequences. Six patients who preoperatively had a pain score of 15 or more (out of a maximum score of 24) attained significant relief after the surgery. We feel this scoring system may provide an easy objective assessment of pain in the subsequent follow-up of these patients. PMID- 3290041 TI - [Transit time of the maturing granulocytic cell of the bone marrow]. PMID- 3290043 TI - [Mycotic complications in hemoblastoses]. PMID- 3290044 TI - [Familial multiple myeloma]. PMID- 3290042 TI - [The role of endocrine pancreas function in regulating thrombocytopoiesis]. PMID- 3290045 TI - [A method for the immunocytochemical detection of lactoferrin in human neutrophils]. PMID- 3290046 TI - The endocrine cells in the gut of Mugil saliens Risso, 1810 (Teleostei): an immunocytochemical and ultrastructural study. AB - The endocrine cells in the gut of Mugil saliens Risso, 1810 (leaping grey mullet) were investigated by immunocytochemical and electron microscopic techniques. Gastrin-, glucagon-, and somatostatin-immunoreactive cells were identified in the cardiac and cecal stomach regions, located mainly in the lower part of the gastric folds and in the upper part of the glands. Substance P-, somatostatin-, and pancreatic polypeptide (PP)-immunoreactive cells were found between epithelial cells in the pyloric stomach region. Gastrin-, cholecystokinin (CCK)-, gastric inhibitory polypeptide (GIP)-, substance P-, Met-enkephalin- and PP immunoreactive cells were observed throughout the intestine while only the last three of these appeared in the posterior intestine. Nine types of gastroenteroendocrine cells were ultrastructurally characterized; some of them were related to the cell types immunocytochemically identified. PMID- 3290047 TI - A comparison of endocrine pancreatic tissue in adults of four species of lampreys in British Columbia: a morphological and immunohistochemical study. AB - Histological techniques and immunohistochemistry with antisera against insulin and somatostatin were used in a study of the identification and the distribution of endocrine pancreatic tissue in adults of four species of lampreys in British Columbia. The fine structure of the pancreatic cells of one of the species was also examined. The four species (Lampetra ayresi, Lampetra tridentata, Lampetra macrostoma, and Lampetra richardsoni) all possess cranial and caudal pancreatic masses and an intervening intermediate cord, but there are variations in amount and deposition of the pancreatic tissue with respect to the alimentary canal and the liver which appear to be species specific. There is also some variation in the distribution of pancreatic tissue between L. richardsoni of different stream populations. A newly identified parasitic variety of L. richardsoni in Morrison Creek, called L. richardsoni var. marifuga, usually has no cranial pancreas but has an extensive intermediate cord. The distribution of pancreatic tissue in these lampreys is of relevance to taxonomy and to variations in development of the endocrine pancreas during lamprey metamorphosis. The pancreatic tissue of all species and var. marifuga is composed of cells which are immunoreactive to either insulin or somatostatin antisera. The fine structure of cells from the cranial and caudal pancreatic tissue from L. ayresi does not vary with saltwater and freshwater acclimation. Insulin-containing B cells and somatostatin-containing D cells are present in equal numbers in both pancreatic regions and the cells each have characteristic cytoplasmic granules. A third cell type is most abundant in the cranial pancreas but it is of unknown function. PMID- 3290048 TI - The story of elderly care. Geriatrics era to modern times. PMID- 3290049 TI - From DNA to form: the achaete-scute complex. PMID- 3290050 TI - SCH9, a gene of Saccharomyces cerevisiae that encodes a protein distinct from, but functionally and structurally related to, cAMP-dependent protein kinase catalytic subunits. AB - A new gene, SCH9, was isolated from Saccharomyces cerevisiae by its ability to complement a cdc25ts mutation. Sequence analysis indicates that it encodes a 90,000-dalton protein with a carboxy-terminal domain homologous to yeast and mammalian cAMP-dependent protein kinase catalytic subunits. In addition to suppressing loss of CDC25 function, multicopy plasmids containing SCH9 suppress the growth defects of strains lacking the RAS genes, the CYR1 gene, which encodes adenylyl cyclase, and the TPK genes, which encode the cAMP-dependent protein kinase catalytic subunits. Cells lacking SCH9 grow slowly and have a prolonged G1 phase of the cell cycle. This defect is suppressed by activation of the cAMP effector pathway. We propose that SCH9 encodes a protein kinase that is part of a growth control pathway which is at least partially redundant with the cAMP pathway. PMID- 3290052 TI - Promoter vectors with restriction-site banks. AB - New vectors harboring the promoter for the chloramphenicol acetyl transferase gene (cat promoter) have been constructed. These vectors are all derived from pJRD184 [Heusterspreute et al., Gene 39 (1985) 299-304], which contains a restriction-site bank. The cat promoter has been inserted at various positions and in reverse orientations so that almost all the restriction sites originally present on JRD184 can be used in cloning experiments. The expression of the aceK gene of Escherichia coli cloned under the control of the cat promoter has been tested. A large increase in the synthesis of the isocitrate dehydrogenase kinase, the aceK gene product, has demonstrated the efficiency of the newly constructed vectors. PMID- 3290051 TI - Efficient secretion of two fungal cellobiohydrolases by Saccharomyces cerevisiae. AB - Two different cellobiohydrolases, CBHI and CBHII, of the filamentous fungus Trichoderma reesei both hydrolyse highly crystalline cellulose. Cellulolytic strains of the yeast Saccharomyces cerevisiae were constructed by transferring cDNAs coding for these enzymes into yeast on an expression plasmid. These cellulolytic yeasts were able to secrete efficiently the large, heterologous proteins to the culture medium. The recombinant cellulases were observed to be heterogeneous in Mr due, at least partly, to variable N-glycosylation. Recombinant CBHII was able to bind to crystalline cellulose, although slightly less efficiently than the native enzyme. Both of the two recombinant cellulases were able to degrade amorphous cellulose. In a fermenter cultivation, around 100 micrograms/ml of CBHII was secreted into the yeast growth medium. PMID- 3290053 TI - Isolation and characterization of a beta-tubulin gene from Candida albicans. AB - We report the isolation and nucleotide sequence determination of a beta-tubulin gene (TUB2) from the pathogenic dimorphic fungus Candida albicans. Nucleotide sequence analysis revealed that TUB2 encodes a protein of 449 amino acids (aa) with considerable sequence homology to beta-tubulins isolated from other fungal species. The nucleotide sequence of the C. albicans gene is 70% homologous to that of the Saccharomyces cerevisiae gene. The coding region for the C. albicans beta-tubulin gene is interrupted by two introns. The first intron occurs after the 4th aa and the second intron occurs after the 13th aa. A comparison with other fungal beta-tubulin genes indicates that the intron locations are highly conserved. Codon usage in the C. albicans TUB2 gene is nonrandom, as has been observed for other fungal beta-tubulin genes. The C. albicans TUB2 gene is transcribed to yield a 1.8-kb mRNA species. On the basis of genomic Southern-blot analysis, we conclude that C. albicans most likely possesses a single beta tubulin gene. PMID- 3290054 TI - Cloning of a phosphinothricin N-acetyltransferase gene from Streptomyces viridochromogenes Tu494 and its expression in Streptomyces lividans and Escherichia coli. AB - Phosphinothricin-tripeptide (Ptt), also known as bialaphos, contains phosphinothricin (Pt), a potent inhibitor of glutamine synthetase. A 4.0-kb Bam HI fragment coding for Ptt resistance was cloned in Streptomyces lividans TK23. The fragment was isolated from a Ptt-resistant mutant of Streptomyces viridochromogenes Tu494. Subcloning experiments revealed that Ptt resistance can be assigned to a 0.8-kb Bg/II fragment. This fragment was shown to include the Ptt-resistance promoter. Subcloning this fragment downstream from the lacZ promoter conferred Ptt resistance to Escherichia coli JM83 in one of the two possible orientations. Biochemical investigations revealed that the Bg/II fragment codes for a Pt N-acetyltransferase. PMID- 3290056 TI - Cardiac disorders: a guide to assessing risk in the elderly. AB - Coronary artery disease can have various clinical manifestations, from the presence of "silent" ischemia to the occurrence of an acute myocardial infarction and congestive myopathy. At each point in the clinical manifestation of coronary artery disease, the practitioner has an evolving number of techniques available to guide decisions regarding prognosis and therapy. Guidelines exist for defining which patients with "silent" ischemia need further evaluation. The clinically manifested occurrence of angina pectoris is commonly encountered in the elderly. Prognostic stratification can occur using both invasive and non-invasive techniques. Even patients with unstable angina have different outcomes depending upon clinical presentation and therapeutic management. Finally, a large pool of patients who survive an acute myocardial infarction have a varied prognosis depending upon certain risk markers as documented with widely available non invasive testing. This article summarizes the evaluations and decisions the physician can make regarding patients who present with the various manifestations of coronary artery disease and provides a summary of recent data supporting decisions regarding prognosis and therapy. PMID- 3290055 TI - Analysis of the functional domains of biosynthetic threonine deaminase by comparison of the amino acid sequences of three wild-type alleles to the amino acid sequence of biodegradative threonine deaminase. AB - The nucleotide sequence of the gene, ilvA, for biosynthetic threonine deaminase (Tda) from Salmonella typhimurium was determined. The deduced amino acid sequence was compared with the deduced amino acid sequences of the biosynthetic Tda from Escherichia coli K-12 (ilvA) and Saccharomyces cerevisiae (ILV1) and the biodegradative Tda from E. coli K-12 (tdc). The comparison indicated the presence of two types of blocks of homologous amino acids. The first type of homology is in the N-terminal portion of all four isozymes of Tda and probably indicates amino acids involved in catalysis. The second type of homology is found in the C terminal portion of the three biosynthetic isozymes and presumably is involved in either (i) the binding or interaction of the allosteric effector isoleucine with the enzyme, or (ii) subunit interactions. The sites of amino acid changes of two E. coli K-12 ilvA alleles with altered response to isoleucine are consistent with the conclusion that the C-terminal portion of biosynthetic Tda is involved in allosteric regulation. PMID- 3290057 TI - Post-stroke management concerns and outcomes. AB - In the United States alone, there are 1.7 million stroke survivors at any given time, 75% between the age of 55 and 84 years, thereby posing a formidable rehabilitation task. In order to reduce short-term mortality from strokes, management should focus on improved pre-stroke status of high-risk patients and on improved recognition and therapy of medical complications of stroke during the first 3 weeks. Long-term recovery from stroke can be facilitated by skilled rehabilitation and augmented by treatment of depression and other emotional problems. Newer experimental therapies instituted during the first hours after stroke may also prove to accelerate recovery over the first 3 months after stroke. PMID- 3290059 TI - Relief of emotional symptoms in elderly patients with terminal cancer. AB - Effective palliative care is one of the most valuable skills a physician may acquire. It involves not only control of physical symptoms, but relief of emotional symptoms. Relief of emotional symptoms requires truth telling in a context of supportive, skillful communication. Important communication skills include empathy, legitimation, support, partnership, and respect. Using these skills and the development of a limited treatment plan, along with pharmacological intervention, when necessary, to treat anxiety, depression, and confusion, may provide a significant measure of relief for the suffering that often accompanies terminal cancer. PMID- 3290058 TI - UTIs and two new antibiotics in the elderly. AB - Of the new antimicrobials available for the treatment of urinary tract infections (UTIs), aztreonam and imipenem/cilastatin represent two structurally unique, but distinct, classes of beta-lactam antibiotics. Aztreonam has a directed spectrum of activity covering gram-negative bacilli usually associated with UTIs. In comparative clinical trials of patients with complicated UTIs, aztreonam is well tolerated and is as effective as conventional control regimens, including aminoglycosides. On the other hand, the antimicrobial spectrum of imipenem/cilastatin includes not only gram-negative bacilli but also gram positive cocci and anaerobes. As such, this broad-spectrum antibiotic should be reserved for the treatment of mixed infections. PMID- 3290060 TI - Geriatric rheumatology: safe use of potentially toxic antirheumatics. AB - Despite what is known about pharmacokinetics in the elderly, there is little information regarding the relationship between age and disease-modifying antirheumatic agents or immunosuppressive drugs. Musculoskeletal diseases are common in the aging population, and the therapeutic use of potentially toxic pharmacologic agents, including immunosuppressives, is prevalent. A number of factors influence the potential for toxicity in this age group, including polypharmacy and age-related physiologic change. An overview of clinical pharmacologic factors in the elderly is presented, and available information on efficacy and toxicity of disease-modifying antirheumatics and immunosuppressives is reviewed. PMID- 3290061 TI - Peculiarities of the effect of hormones and transmitters during aging: modulation of changes in dopaminergic action. AB - Loss of motor control is an important functional manifestation of aging. This dysfunction appears to be at least partially due to loss of striatal dopamine receptors. We have examined the possible mechanisms by which such a deterioration occurs as well as possible manipulations to delay and/or reverse these impairments. PMID- 3290062 TI - Ca2+ release from mitochondria induced by prooxidants. AB - A variety of chemically different prooxidants causes Ca2+ release from mitochondria. The prooxidant-induced Ca2+ release occurs from intact mitochondria via a route which is physiologically relevant and may be regulated by protein ADP ribosylation. When the released Ca2+ is excessively cycled by mitochondria they are damaged. This leads to uncoupling, a decreased ATP supply, and a decreased ability of mitochondria to retain Ca2+. Excessive Ca2+ cycling by mitochondria will deprive cells of ATP. As a result, Ca2+ ATPases of the endoplasmic (sarcoplasmic) reticulum and the plasma membrane are stopped. The rising cytosolic Ca2+ level cannot be counterbalanced due to damage of mitochondria which, under normoxic conditions, act as safety device against increased cytosolic Ca2+. It is proposed that prooxidants are toxic because they impair the ability of mitochondria to retain Ca2+. PMID- 3290064 TI - [Endovascular methods of treating patent ductus arteriosus]. PMID- 3290063 TI - Lipid peroxidation in tumour cells. AB - Several studies point to the existence of a disturbance in the metabolism of the reactive species of oxygen in cancer cells. Based on this evidence, and in particular on a characteristic behaviour of tumour membrane lipids, namely their growth-related resistance to oxy-radical-induced peroxidation, a sequence of events is outlined that could hypothetically drive the transformed cell to an uncontrolled proliferation. The proposed scheme is also conceived as a framework for further in vivo investigations of the complex biological phenomena of tumour cell growth and invasion in more integrated and kinetically controlled cellular systems. PMID- 3290065 TI - [Current views on the surgical treatment of spontaneous pneumothorax in bullous pulmonary emphysema]. PMID- 3290066 TI - Biliary obstruction is best managed by endoscopists. PMID- 3290067 TI - Bleeding from multifocal heterotopic gastric mucosa in the colon controlled by an H2 antagonist. AB - The sixth documented case of heterotopic gastric mucosa in the large bowel proximal to the rectum is described in a two year old girl with a neural tube defect and recurrent rectal bleeding. Unusual in itself, this case is unique in that the rectal bleeding has been controlled with an H2 receptor antagonist. PMID- 3290069 TI - [Effects of bands and brackets on the marginal periodontium]. PMID- 3290070 TI - [The bracket adhesion technic when using a shorter etching time. Clinical results]. PMID- 3290072 TI - [Efficiency factors in psychotherapy--specific and nonspecific influences]. AB - The effectiveness of psychotherapy is discussed especially concerning the problem of specific versus unspecific factors and their possible interdependence. After a critical review of the results of the evaluation research some important paradigmatic papers on the differential operation of psychotherapeutic methods were evaluated. As there are no doubts that psychotherapy is effective in general even if it was performed by untrained therapist the impact of the specific and the unspecific factors has been investigated. As a result there was no convincing proof for the efficiency of specific factors in psychotherapy. As a consequence the unspecific factors have to be considered as highly effective in psychotherapy. Some models of the relationship factors were demonstrated and discussed. PMID- 3290068 TI - Acalculous disease of the gall bladder. PMID- 3290073 TI - [Recent advances in patient monitoring in anesthesia]. PMID- 3290071 TI - [Karl Wilmanns (1873-1945)--a biobibliographic view of a psychiatric era]. AB - The Heidelberg University school of psychiatry was mainly shaped by the personality of Emil Kraepelin (1876-1926) who won world-wide recognition at the end of the 19th century during the discussions on "dementia praecox". It was his personality that made Heidelberg a fulcrum of a growing new scientific self assurance that had no precedent in clinical psychiatry which no longer needed the disciplines of neuropathology and neurophysiology as pillars of support to gain recognition among the experts. Although the scientific achievements of Wilmanns cannot be rated as highly as those of E. Kraepelin and K. Jaspers, it is a fact that the period between 1918 and 1933 during which the Department of Psychiatry of the University of Heidelberg as represented by the University Hospital of Psychiatry, was headed by Karl Wilmanns, was the most fruitful period of the "Heidelberg School". 1933 was not only a political but also a psychiatric turning point. Karl Wilmanns was one of the first of the well-known university teachers who was dismissed from office for political reasons. With his exit the Heidelberg School came to an end, and with it the discipline of psychopathology as a fundamental part of psychiatry- which had been the true progeny of that school. The references outline the influence of biological though on the "zeitgeist" of psychiatry. The contradictions, inhumanity and seduction of this line of thinking were not sufficiently recognised in all their aspects and consequences even by critical minds such as that of K. Wilmanns. PMID- 3290074 TI - [Finger temperature changes during exercise as related to exercise intensity]. AB - An approach was made to assess individual exercise tolerance using finger vasoconstrictive response as a marker for exercise intensity. Finger temperature (FIT) monitoring was used as an averaged flow sensor and was validated by finger plethysmography and laser-Doppler flowmetry. Progressive multi-stage intermittent exercise protocol (3-minute exercise period alternating with 3-minute rest period) was used to permit stable FIT values before each exercise stage. Anaerobic threshold (AT) was determined by respiratory measurements. Mean room temperature was 25.4 +/- 1.6 degrees C. The general pattern of FIT during 3 minute exercise period was as follows: at the mild exercise stage FIT decreased initially, only to rise at the latter half of exercise. As the exercise stage progressed FIT decreased throughout, and at the stage of maximal effort FIT decrease linearly (LiD). FIT decrease was abolished by the nerve block. Four groups of subjects (48 in total) were studied using the above-described exercise protocol. Group I; 6 athletes, II; 16 normal subjects, III; 8 mild cardiac and IV: 15 moderate to severe cardiac patients. Mean maximal oxygen consumption (ml/kg/min) was 70, 47, 31 and 15, and mean HR (b/min) was 188, 195, 165 and 142, respectively in group I, II, III, IV. LiD was observed in greater than 80% of all cases at the work load above 90% of peak oxygen consumption, and approximately 1.6-fold of AT in group I, II and III and 1.3-fold of AT in group IV. Correlation between plasma norepinephrine and FIT decrease was observed in normal subjects. In conclusion, FIT monitoring during treadmill exercise using intermittent protocol uncovered a work load dependent progressive vasoconstrictive response. And a linear decrease of FIT indicated an approaching maximal work load for the individual subject. PMID- 3290075 TI - The insulin receptor in circulating cells, with special reference to the red blood cells. Its characteristics in some disease states (obesity and diabetes mellitus). PMID- 3290076 TI - Selective potentiation of 5-methyl-2-(1-methylcyclohexyl)-4-oxazoleacetic acid (AD-4610) on glucose-induced insulin secretion. AB - In the perfused pancreas from normal SD rats, AD-4610 (0.01-0.1 mM) potentiated biphasic insulin secretion induced by 7.5 mM of glucose. The concentration response curve of insulin secretion to glucose was shifted leftwards with AD-4610 (0.1 mM) without altering either the threshold concentration of glucose to induce insulin secretion or the maximal insulin response to glucose, indicating increased sensitivity of the pancreatic B-cells to glucose. On the other hand, AD 4610 was 10-fold less effective in altering insulin secretion induced by arginine and glyceraldehyde. The effect of AD-4610 on insulin secretion and glucose metabolism was compared with that of tolbutamide in vivo. AD-4610 (100 mg/kg) potentiated insulin secretion induced by an intravenous glucose load, and also accelerated glucose metabolism without altering basal insulin secretion in normal rats. On the other hand, tolbutamide (20 mg/kg) increased basal insulin secretion, but slightly decreased glucose-induced insulin secretion. In yellow KK mice with hyperglycemia, AD-4610 (10-100 mg/kg) had a dose-dependent hypoglycemic action, but tolbutamide did not. Thus, AD-4610 stimulated insulin secretion in a glucose-dependent fashion and enhanced glucose metabolism in vivo. These results suggest that AD-4610 selectively potentiates glucose-induced insulin secretion by increasing the sensitivity of pancreatic B-cells to glucose and may be useful for treating human NIDDM through a different mechanism than that of tolbutamide. PMID- 3290077 TI - Infusion of nicotinic acid stimulates leucine oxidation and inhibits protein synthesis in pigs before and during a meal. AB - Leucine metabolism was measured isotopically in immature female pigs to assess the effect of acute infusions of nicotinic acid (NA) on leucine kinetics in both the fed and fasting states. After an overnight fast, immature pigs were infused with 3H-alpha-ketoisocaproate (KIC) and 14C-leucine. After a 2-hour equilibration period, an infusion of either saline or 0.4 mg/kg.min of NA was begun. NA caused a decrease in plasma glucose and an increase in plasma glucagon. During the fasting period, NA increased KIC oxidation 2-fold over controls. After feeding, plasma free fatty acids (FFA) in both groups were equivalent, but KIC oxidation was still approximately 80% higher in NA-infused animals. In addition, NA stimulated proteolysis and inhibited protein synthesis during the meal. Because plasma FFA concentrations were equal during the fed period, it is unlikely that changes in FFA concentrations are responsible for the changes in leucine metabolism observal during NA infusion. PMID- 3290078 TI - Beta 2-sympathomimetic activation as a cause of posthypoglycemic glucose intolerance. AB - Posthypoglycemic glucose intolerance is related to counter-regulatory hormones. We have tested the role of the beta 2-sympathomimetic activity of the catecholamines in healthy volunteers. beta 2-stimulation with fenoterol for 25 minutes caused glucose intolerance and insulin resistance for 4 hours. This suggests that the beta 2-sympathomimetic activity induces glucose intolerance after an episode of hypoglycemia. PMID- 3290079 TI - Hormone responsiveness of collagenase-isolated rat islets is markedly increased by short-term maintenance in tissue culture. PMID- 3290081 TI - Medicare shapes the nation's health care system. PMID- 3290080 TI - Insulin sensitivity in subacute experimental T3 hyperthyroidism in man. PMID- 3290083 TI - FY 1989 PPS rules affect outliers, labor costs. PMID- 3290082 TI - Part B reform must address quantity and quality. PMID- 3290085 TI - Fear of failure and what hospitals did about it. PMID- 3290084 TI - Inspector General weighs advice on fraud and abuse. PMID- 3290086 TI - Congress could close Bethesda appeal window. PMID- 3290087 TI - Suppliers help hospitals 'sell' care to payers. PMID- 3290088 TI - Catastrophic care plan nets little for multis. PMID- 3290089 TI - Plan today for tomorrow's workforce needs. PMID- 3290090 TI - Practical problems of diagnosing trichomoniasis in women. AB - Analysis of eight groups of data collected at varying intervals during a period of seven years showed fluctuations in the sensitivity of tests to diagnose trichomoniasis in women. The best results were obtained from fresh, correctly prepared Diamond's medium, Feinberg-Whittington's medium, and modified Squires and McFadzean's medium (which showed 82% to 94% relative sensitivity). Poor results were identified consistently in commercially prepared Bushby medium from one source (40% relative sensitivity) and in a batch of commercially prepared Squires and McFadzean's medium from which chloramphenicol had been omitted (23% relative sensitivity). Examination of wet film, culture, and exfoliative cytology stained by Papanicolaou's method were shown to be indispensable for auditing the performance of each test and to maintain the quality of a diagnostic service. PMID- 3290091 TI - Does lactobacillus vaccine for trichomoniasis, Solco Trichovac, induce antibody reactive with Trichomonas vaginalis? AB - Solco Trichovac is a vaccine of Lactobacillus acidophilus developed for treating trichomoniasis. The efficacy of the vaccine is reportedly due to cross reacting antibody being produced in people immunised with the lactobacillus bacteria. Several techniques, including enzyme linked immunosorbent, indirect immunofluorescence, immunoblot, and radioimmunoprecipitation assays were used to assess the extent of antigenic cross reactivity between Lactobacillus acidophilus and Trichomonas vaginalis. Data show a lack of antigenic relatedness between the Solco Trichovac lactobacilli and several strains of T vaginalis. Furthermore, antiserum to L acidophilus failed to inhibit trichomonad cytadherence or host cell killing, as is suggested by the producers of the Solco Trichovac vaccine. PMID- 3290092 TI - Sex and cervical cancer. PMID- 3290094 TI - Proliferation of thymocytes in relation to T-cell receptor beta-chain expression. AB - During proliferation and differentiation of maturing thymocytes, T-cell receptor beta-chain products are first expressed in the cytoplasm. Only subsequently are they expressed on the cell surface, presumably as part of the alpha beta/CD3 receptor complex. This study uses double immunofluorescence labelling to identify these cytoplasmic and surface phases separately in relationship to cell-cycle parameters. The use of a mitotic arrest agent and tritiated thymidine autoradiography both show that cells with cytoplasmic beta-chains are in cell cycle, whereas cells with surface beta-chains are cycling slowly, if at all. PMID- 3290095 TI - The T-cell receptor for antigen. AB - There are two important questions concerning the T-cell antigen receptor. Firstly, what is the structural basis of major histocompatibility complex (MHC) restricted recognition? Secondly, what is the origin of tolerance to self-MHC and the 'learning' of MHC-restricted recognition during thymus development? These central questions are discussed here in the context of our current knowledge of the structures of the genes encoding T-cell receptor proteins, their expression during thymocyte development and the mechanisms by which the T-cell receptor repertoire is generated. PMID- 3290093 TI - A role for mature B cells in bone marrow transplantation. AB - The proliferative potential of membrane Ig (mIg)-bearing B lymphocytes was assessed in an adoptive transfer system based on the use of non-inbred rabbits matched for major histocompatibility (MHC) antigens and mismatched for immunoglobulin (Ig) allotypes. Cell suspensions made from spleens (SP), mesenteric lymph nodes (LN), or bone marrow (BM) of allotype b4b5 rabbits were deprived of B cells with mIg of the b4 type by adherence to plastic dishes coated with affinity-purified anti-b4. When such b4-depleted cell populations were injected into newborn hosts of allotype b6b6, stable and lasting chimerism promptly resulted, in which donor-derived products were almost entirely of the b5 allotype. Chimeras formed by transfer of unfractionated cells from b4b5 donors, on the other hand, exhibited a predominance of the b4 allotype, as seen in the living donors. BM but not SP or LN contained precursors capable of differentiating into mIg+ lymphocytes in culture, but no evidence was obtained for engraftment and differentiation by such B-cell precursors or more primitive stem cells in vivo. These studies suggest a potentially significant role for mature B cells in reconstituting the immune system of human transplant recipients. PMID- 3290096 TI - Molecular genetics of the MHC. AB - Although some gaps remain, the major histocompatibility complex (MHC) has now been mapped in considerable detail in both humans and mice. From the results of DNA cloning and sequencing, there is now a detailed knowledge of which genes are expressed and the composition of the proteins encoded by them, as well as the structural basis of the polymorphism. The problem that can now be addressed is how the sequences of the polymorphic domains relate to the function of HLA molecules and to the diseases associated with the MHC. PMID- 3290097 TI - Structure-function relationships of MHC class II molecules. PMID- 3290098 TI - Antigen recognition by B cells: antibody-antigen interactions at the atomic level. AB - Despite the wealth of information concerning the structure of the antibody combining site and the interactions involved in the binding of small molecule haptens, there is considerable debate about the way in which antibodies recognize and bind to the surfaces of foreign proteins. Two recent crystallographic analyses of antibody molecules complexed with protein antigens have provided the first glimpses of the nature of this interaction at the atomic level. PMID- 3290099 TI - Transmembrane signalling by B-lymphocyte receptors. AB - The responses of B cells to specific antigens are modulated by secondary signals delivered by a variety of cell surface receptors. Besides surface immunoglobulins, these include class II MHC antigens, Fc and C3 receptors, in addition to those for various lymphokines. The current knowledge of the second messengers used by various receptors and their roles in B-cell activation are discussed here. PMID- 3290100 TI - Lymphokines and interleukins. AB - The application of recombinant DNA technology to the investigation of lymphokines has provided homogeneous material for experimentation. The general biochemical and biological properties of these lymphokines are reviewed here. The available information suggests that lymphokines have diverse and synergistic effects on multiple target cells and organs. The biological significance of these effects is discussed. PMID- 3290102 TI - T-cell differentiation and effector functions. AB - T cells and their subpopulations have many different functions important for (i) the regulation of immune responses through the release of antigen non-specific lymphokines and (ii) as effector cells to rid the host of intracellular pathogens, be they bacteria, parasites or viruses. In this short summary only a few features of T-cell function can be summarized, and studies in virus infection will serve as illustrations. PMID- 3290101 TI - The T-cell repertoire. PMID- 3290103 TI - Altered excretion of prostaglandin and thromboxane metabolites in pregnancy induced hypertension. AB - The renal and systemic metabolites (the latter as 2,3-dinor derivatives) of prostacyclin and thromboxane A2 were measured, along with renal prostaglandin E2 and kallikrein, in the urine of 15 patients with pregnancy-induced hypertension, 15 normotensive pregnant women matched for both age and gestational age, and 15 normotensive nonpregnant control women. Urinary excretion of all prostaglandin and thromboxane metabolites studied proved significantly higher in normotensive pregnant women than in controls. Prostaglandin E2, 6-keto-prostaglandin F1 alpha, and 2,3-dinor-6-keto-prostaglandin F1 alpha were significantly lower in pregnancy induced hypertensive women than in normotensive pregnant women, whereas thromboxane B2 and 2,3-dinor-thromboxane B2 showed no significant differences in the two groups. A significant negative correlation (r = -0.636, p less than 0.01) was found between urinary 2,3-dinor-6-keto-prostaglandin F1 alpha and mean blood pressure in the two groups of pregnant women taken as a whole. These data indicate that, in pregnancy-induced hypertension, there is an imbalance between vasodilator and vasoconstrictor factors, not only in the kidneys, but also at the systemic vascular level. This imbalance, which may in itself produce vasoconstriction, may also potentiate the hypertensive effect of catecholamines and angiotensin II. PMID- 3290104 TI - Heparin-inhibitable basement membrane-binding protein of Streptococcus pyogenes. AB - Solubilized surface proteins of Streptococcus pyogenes serotype M6 were found by indirect immunofluorescence assays to bind selectively to proteoglycan-containing regions of basement membranes of kidney and cardiac muscle in vitro. Epithelial, endothelial, and interstitial cells were unstained. Binding of streptococcal protein to basement membranes was competitively inhibited by heparin and, to a lesser extent, by heparan sulfate. Weak inhibition was also observed with other glycosaminoglycans, including dermatan sulfate, chondroitin sulfate, and hyaluronic acid. Type IV collagen, gelatin, serum fibronectin, glucuronic acid, and a selection of monosaccharides had no significant effects on binding. The heparin-inhibitable basement membrane-binding protein was purified by affinity chromatography on heparin-Sepharose 6-B. Polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate and urea dissociated the affinity-purified protein into two polypeptides of 9,000 and 15,000 mrs. Chemical analyses revealed that the purified protein was devoid of cysteine, amino and neutral sugars, and phosphate. Thus, the polypeptides are not glycosylated or complexed with trace amounts of lipoteichoic acid or polysaccharide. Binding of purified protein to tissue was determined by direct radioassay and indirect immunofluorescence and was inhibitable by heparin. Although the in vivo effects of this streptococcal component remain to be determined, its deposition on basement membranes in vitro supports the hypothesis that it contributes to the pathogenesis of poststreptococcal glomerulonephritis or acute rheumatic fever. PMID- 3290105 TI - Interaction between human natural anti-alpha-galactosyl immunoglobulin G and bacteria of the human flora. AB - Anti-alpha-galactosyl immunoglobulin G (anti-Gal) is a natural antibody present in unusually high amounts in human sera. It constitutes as much as 1% of circulating immunoglobulin G in humans and displays a distinct specificity for the carbohydrate epitope galactosyl alpha(1----3) galactosyl (Gal alpha 1--- 3Gal). Recently, it has been suggested by various investigators that anti-Gal may be related to some autoimmune phenomena, since marked elevation of its titer was found in sera of patients with autoimmune thyroid disorders, rheumatoid arthritis, glomerulonephritis, and Chagas' disease. In view of the ubiquitous presence of anti-Gal in high titers in humans, throughout life, we hypothesized that, analogous with synthesis of anti-blood group antibodies against bacterial antigens, bacteria within normal intestinal flora may provide constant antigenic stimulation for the synthesis of anti-Gal. This hypothesis would imply that anti Gal may bind to a variety of bacterial strains of human flora. In the present study, the interaction between affinity chromatography-purified anti-Gal and various bacterial strains was studied. By the use of a direct immunostaining assay and an enzyme-linked immunosorbent assay, anti-Gal was found to interact with a variety of Escherichia coli, Klebsiella, and Salmonella strains, some of which were isolates from normal stool. Furthermore, the anti-Gal-binding sites in some strains were found to be present on the carbohydrate portion of bacterial lipopolysaccharides. It is thus suggested that Gal alpha 1----3Gal epitopes in the outer membranes of normal flora enterobacteria may provide a continuous source for antigenic stimulation. Since there is no immune tolerance to the Gal alpha 1----3Gal carbohydrate structure in humans, anti-Gal seems to be constantly produced in response to these enterobacteria. In addition, bacteria which express Gal alpha----3Gal epitopes and which may adhere to various cells mediated binding of anti-Gal to human cell lines. These findings raise the possibility that anti Gal may damage normal human tissues via inflammatory processes facilitated by bacterial Gal alpha 1----3Gal epitopes. PMID- 3290106 TI - Comparison of the carbohydrate-binding specificities of cholera toxin and Escherichia coli heat-labile enterotoxins LTh-I, LT-IIa, and LT-IIb. AB - The heat-labile enterotoxins of Vibrio cholerae and Escherichia coli are related in structure and function. They are oligomers consisting of A and B polypeptide subunits. They bind to gangliosides, and they activate adenylate cyclase. The toxins form two antigenically distinct groups; members of each group cross-react but are not necessarily identical. Serogroup I includes cholera toxin (CT) and type I heat-labile enterotoxin (LT-I) of E. coli. LTh-I and LTp-I are antigenic variants of LT-I produced by strains of E. coli from humans and pigs, respectively. Serogroup II contains the type II heat-labile enterotoxin (LT-II) of E. coli. Two antigenic variants designated LT-IIa and LT-IIb have been described. The binding of CT, LTh-I, LT-IIa, and LT-IIb to gangliosides was analyzed by immunostaining thin-layer chromatograms and by solid-phase radioimmunoassay. The four toxins have different glycolipid-binding specificities. LTh-I and CT bind strongly to ganglioside GM1 and less strongly to ganglioside GD1b. However, LTh-I, unlike CT, also binds weakly to GM2 and asialo GM1. LTh-I, like CT, probably binds to the terminal sugar sequence Gal beta 1 3GalNAc beta 1-4(NeuAc alpha 2-3)Gal . . ., where GalNAc is N-acetylgalactosamine and NeuAc is N-acetylneuraminic acid. LT-IIa probably binds to the same sugar sequence to which CT and LTh-I bind, with the additional contribution to binding of a second NeuAc as in GD1b and GD2. Also, LT-IIa must bind the Gal beta 1 3GalNAc . . . sequence in such a way that its binding is relatively unaffected by attachment of NeuAc to the terminal galactose residue as in GD1a, GT1b, and GQ1b. LT-IIb probably binds to the terminal sugar sequence NeuAc alpha 2-3Gal beta 1 4GalNAc . . ., as it binds to gangliosides GD1a and GT1b but not to GM1. PMID- 3290107 TI - Histologic, immunofluorescence, and electron microscopic study of infectious process in mouse lung after intranasal challenge with Coxiella burnetii. AB - A histologic, immunofluorescence, and electron microscopic study of the intracellular parasitism of Coxiella burnetii (the Q fever agent) in mouse lungs after intranasal challenge was undertaken. It was shown that this microorganism invades type I and, rarely, type II pneumocytes as well as pulmonary fibroblasts and histiocytes. The infectious process can be described as a focal intra alveolar inflammation with the macrophages prevailing in the exudate. It is self limited, with a complete resolution. The inflammation is associated with atelectases and with increased secretory activity by type II pneumocytes. Alveolar macrophages and granulocytes degrade C. burnetii. This degradation is followed by damage to and eventual disintegration of some macrophages and by damage to some bacterium-free pneumocytes and vascular endothelial cells in the vicinity of macrophages degrading organisms. The cell damage might be caused by lipopolysaccharide released from degraded organisms. The infectious process is also associated with the influx of T cells in the pneumonic foci, T-cell attachment to the macrophages degrading organisms, and fusion of some macrophages. These are considered a morphologic expression of cell-mediated immunity involved in the infectious process. PMID- 3290108 TI - Association of electrophoretic karyotype of Candida stellatoidea with virulence for mice. AB - Seven isolates of Candida stellatoidea were studied for their electrophoretic karyotype, virulence for mice, sensitivity to UV radiation, growth rate in vitro, reaction on cycloheximide-indicator medium, and proteinase activity. The isolates exhibited one of two distinct electrophoretic karyotypes as determined by orthogonal field alternating gel electrophoresis (OFAGE). Four isolates, including the type culture of C. stellatoidea, belonged to electrophoretic karyotype type I by OFAGE, showing eight to nine bands of which at least two bands were less than 1,000 kilobases in size as estimated by comparison with the DNA bands of Saccharomyces cerevisiae. These isolates failed to produce fatal infection in mice within 20 days when 5 X 10(5) cells were injected intravenously. The yeasts were cleared from the kidneys of two of three mice tested by day 30. Type I showed proteinase activity on bovine serum albumin agar at pH 3.8 and produced a negative reaction on cycloheximide-bromcresol green medium within 48 h. The three grouped in type II by OFAGE showed banding patterns similar to those of a well-characterized isolate of Candida albicans. The isolates of type II had an electrophoretic karyotype of six to seven bands approximately 1,200 kilobases or greater in size. All three type II isolates were highly virulent for mice, producing fatality curves similar to those of a previously studied C. albicans isolate. From 80 to 90% of the mice injected with 5 X 10(5) cells intravenously died within 20 days. The type II isolates produced a positive reaction on cycloheximide-bromcresol green agar and showed no proteinase activity on bovine serum albumin agar at the low pH. In addition, the type II isolates grew faster and were significantly more resistant to UV irradiation than the type I isolates. These results indicated that type II, but not type I, isolates can be considered simply as sucrose-negative C. albicans. PMID- 3290109 TI - Boosting of transmission-blocking immunity during natural Plasmodium vivax infections in humans depends upon frequent reinfection. AB - The infectivity to mosquitoes of 31 acute Plasmodium vivax patients was measured by permitting mosquitoes to feed directly on the patients. The infectivity of these patients correlated closely with titers of antibodies in their serum as measured by indirect immunofluorescence against air-dried female gametes of P. vivax. Infectivity by direct feeding was also closely parallel to the transmission-blocking activity of the sera of patients as measured by the suppression of infectivity of parasitized blood by autologous serum relative to normal (nonmalarial) human serum when fed to mosquitoes through a membrane. These results are consistent with serum antibodies in human P. vivax infections as major factors determining the infectivity of an infected individual to mosquitoes. It was further noted that individuals having a second attack of P. vivax within less than 4 months were considerably less infectious to mosquitoes than first-attack patients were. This "boosting" of transmission-blocking immunity was much less if longer intervals intervened between attacks. We discuss the immunological implications and possible epidemiological significance of this short-term boosting of transmission-blocking immunity by successive P. vivax infections. PMID- 3290110 TI - Pathogen specificity of Treponema pallidum subsp. pallidum integral membrane proteins identified by phase partitioning with Triton X-114. AB - The antigenically conserved proteins of Treponema pallidum subsp. pallidum and four nonpathogenic cultivatable treponemes were investigated by phase partitioning with the nonionic detergent Triton X-114 and immunoblot analysis. None of the T. pallidum integral membrane proteins identified by phase partitioning (detergent-phase proteins) appeared to be antigenically related to proteins of the nonpathogens. Protease-resistant material similar to lipopolysaccharide was identified in the detergent phase from T. phagedenis biotype Reiter but was not detected in T. pallidum. PMID- 3290111 TI - Analysis of macromolecular ethylene oxide adducts. AB - Ethylene oxide is a carcinogenic compound which is also an ethylene metabolite. Ethylene oxide forms macromolecular adducts with proteins and nucleic acids. Targets in proteins are the amino acids cysteine, histidine and valine (if N terminal, as in hemoglobin). The major DNA adduct is 7-(2-hydroxyethyl)-guanine. Methods for detection of this adduct include radiolabelling and GC-MS. The sensitivity of current GC/MS methods can be improved by selective enrichment of adducts from DNA samples. Studies in this direction are presently being performed. PMID- 3290113 TI - Occlusion as the cause of undiagnosed pain. AB - The teeth provide precise skeleto-motor influences for the stomatognathic system. This unique guidance mechanism characterizes each individual's chewing pattern. It controls the activity of jaw muscles to ensure that appropriate tooth contacts within the limits of existing tooth relationships occur at the end of each chewing cycle. This acts as a means of re-setting the neuromuscular system in anticipation of the next jaw opening movement. The absence of stable centric occlusion at the end point of each chewing cycle alters neuromuscular co ordination and predisposes to muscle dysfunction. Tooth and jaw or craniomandibular relationships are associated with craniocervical relationships and especially tongue posture. This is also directly influenced by the need for airway maintenance as the predominant influence on tongue-muscle function. The susceptibility to pain and dysfunction is further influenced by individual stereognathic sensitivity or the variable awareness of tooth contour and tooth contacts. These special features are present within the framework of the psycho physiological and psycho-social significance of the face and mouth, which directly bears on the individual response to and appreciation of pain and dysfunction. Tooth guidance also influences condyle-disc function. Anterior and posterior teeth provide primary and secondary lateral guidance in function, directing the jaw into centric occlusion. If this guidance tends to direct the jaw posteriorly along distal, rather than mesial tooth inclines, it restricts the antero-posterior 'function' of jaw movement at tooth contact. This predisposes to condyle-disc dysfunction and the development of internal derangements, by increasing the likelihood of the posterior thick band of the disc being displaced anteriorly and the condyle posteriorly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290112 TI - Commuting--a further stress factor for working people: evidence from the European Community. I. A review. AB - About 100 million workers in the European Community commute to and from work daily. A review of the available data shows that commuting has increased in recent decades as rising car ownership has produced a more dispersed pattern of residential and job locations. In general, average commuting durations are falling, although average commuting distances are increasing as a result of faster commuting modes. However, the number of very long duration journeys have also increased, albeit from a small level. Up to now most research has focused on transport and land use issues, while very few studies have dealt with its impact on health, safety and social life of the workers. The available data indicate commuting to be a stress factor not only because of transport modes, but also by its interference with living and working conditions: namely, reduction of time available for discretionary leisure activities and increased absenteeism at workplace. Long-term effects on health have not been adequately investigated. Well integrated policies and strategies concerning the different aspects of this problem (transport, health, work organization, residential planning) must be developed both at the local and international levels to facilitate adequate solutions for this stressful condition. PMID- 3290114 TI - Federation Dentaire Internationale. Member associations. PMID- 3290115 TI - Occlusal harmony and disharmony: frauds in clinical dentistry? AB - In defining the principles of occlusal function it is possible to demonstrate how firmly the number, the placement and the distribution of occlusal contacts control muscle activity and joint function during biting and chewing. This control implies that the intercuspal position is determined by positive feedback, that is by afferent activity that varies with occlusal stability. Conventional dental treatment involving occlusal surfaces alters this input and consequently alters the coordination of the muscles of mastication and the function of the temporomandibular joints. To assess and direct this input properly, quantitative parameters of electromyography and kinesiography are needed. Terms such as harmony and disharmony are irrelevant and must be abandoned. PMID- 3290116 TI - Anesthetic techniques for the elderly outpatient. PMID- 3290117 TI - Management of acute oliguria in the elderly patient. PMID- 3290118 TI - Anesthesia in the geriatric patient. Indications for invasive monitoring. PMID- 3290119 TI - Hypothermia in the elderly. PMID- 3290120 TI - Perioperative management of patient with chronic obstructive pulmonary disease. AB - There have been many changes in the prevention and therapy of postoperative pulmonary complications in the patient with COPD. Attention to patient analgesia and maintaining lung volumes are the keys to prevention. Recent advances in the therapy of bronchospasm are decreasing side effects and increasing success. PMID- 3290121 TI - The autonomic nervous system and geriatric anesthesia. AB - Patients subjected to surgery and anesthesia must rely on autonomic mechanisms to maintain homeostasis and adequate organ perfusion. In the elderly, many of these mechanisms are limited in the strength, the rapidity, and the range in which they can compensate for physiological stresses and trespass. Anesthesiologists rely on predictable results from manipulation of the ANS and its effector organs, but aging in itself seems to alter the responses to these pharmacological manipulations. The diseases and medications that often accompany old age are further confounding factors. Some of the changes found with age seem to arise from the ANS itself, while some more likely originate in structural alterations of the cardiovascular system. Although both basic and clinical research reports are rife with contradictions, a knowledge of ANS aging should help us to anticipate the particular responses and requirements of our older patients. PMID- 3290122 TI - Neuromuscular blocking agents in geriatric anesthesia. PMID- 3290123 TI - Perioperative care of the hemodynamically unstable geriatric patient. AB - The perioperative management of the geriatric patient with critical illness is a challenge for even the most skilled anesthesiologist. Careful preoperative assessment and preparation are essential. Optimal therapy requires application of appropriate monitoring, accurate interpretation of hemodynamic data, and appropriate selection and administration of anesthetics and therapeutic interventions. The hemodynamic compromise of critical illness is compounded by underlying pathophysiology in the aged. These factors lend a complexity to the treatment of the geriatric patient with hemodynamic instability that necessitates the anesthesiologist's implementation of the most current technological and pharmacological modalities in the operating room and intensive care unit. PMID- 3290124 TI - Conceptual analysis of validation therapy. AB - The present article examines the conceptual aspects of Validation Therapy. Validation Therapy is a humanistic approach used to give disoriented old-old people, eighty years and older, an opportunity to resolve their life's unfinished conflicts by encouraging them to express their feelings. This approach emphasizes the relationship between the old-old person and the caregiver by focusing on empathy, acceptance, and acknowledgment. Four stages of disorientation, ranging from mild to severe, are described on the basis of emotional and physical characteristics. The theoretical assumptions and underlying principals of Validation Therapy are discussed. Finally, research studies are outlined to evaluate the effectiveness of Validation Therapy. It is concluded that although Validation Therapy is a well-formulated, alternative approach to helping disoriented individuals, further research is needed to determine its validity. PMID- 3290125 TI - Social dimensions of mental illness among rural elderly populations. AB - Despite growing concern with rural elderly populations, little attention has focused on their mental health, ways it may correlate with physical health, or how rural mental health patterns compare to urban. Popular wisdom contends that elderly people in general, and rural elderly persons in particular, are at increased risk for mental illness. This article examines these questions. A review of available literature suggests that elderly people may be at only slightly greater risk of mental illness than the population at large, though there are some indications that rates of depression may be somewhat higher among the elderly population. Much of this same literature implies that objective environmental conditions play a significant role in the incidence of depression. Analysis of data gathered in a statewide random poll (N = 743) indicates that while physical health tends to be poorer among rural populations, when health is held constant there is actually an inverse relationship between age and depression. Therefore, rural elderly persons are no more likely to be depressed than their urban counterparts despite harsher living conditions. Both conceptual and policy implications are discussed. PMID- 3290128 TI - Metanalysis: a new scientific endeavor. PMID- 3290127 TI - The correction of ultrasonic image analysis features for their depth dependence. AB - Ultrasound has long been used for clinical imaging purposes and for estimating the properties of tissues. More recently image analysis techniques have been used for quantifying the image's texture. These techniques have had limited success due primarily to the dependence of the texture measures on the depth of the sample volume. A simple algorithm has been developed for deriving a correction for this effect; its efficacy is demonstrated on placental data. PMID- 3290126 TI - Microcomputer application of Bayesean probability testing for the identification of bacteria. AB - A computer program (BACTID) is described which facilitates the identification of bacteria based on a priori data and Bayesean probability testing. The program is not limited to a specific format, has a short execution time, can be easily applied to a variety of situations, and can be run on almost any microcomputer system operating under either 8-bit CP/M or 16-bit MS-DOS/PC-DOS. Additionally, BACTID (1) is not limited to one type of computer (hardware independent), (2) is not limited by size of the computer's random access (RAM independent), (3) can recognize various data bases matrices (format independent), (4) is able to compensate for missing data and (5) allows for various methods of data entry. The efficacy of the program was checked against a commercially available test system and a 99.34% agreement was obtained. Also, the execution time for a 46 x 21 element data matrix was as little as 3.5 s. These results show that microcomputer identification programs are not only viable alternatives to code book registers, but also offer flexibility which is not found in commercial systems. PMID- 3290129 TI - A review of epidemiological studies of the health effects of living near or working with electricity generation and transmission equipment. AB - In the last ten years there has been increasing concern that the extremely low frequency (ELF), non-ionising electromagnetic fields emitted by electrical installations and equipment using alternating current at 50-60 Hertz might have long-term effects on health. Studies of the association between disease and residence near installations transmitting or generating electricity and studies of the health of workers in the electrical industry are reviewed. Most of the investigations relate to cancer, although other conditions such as outcome of pregnancy have been studied. The most consistent finding is that electrical workers appear to be at increased risk of leukaemia, especially acute myeloid leukaemia. The effect is small. Combining the results of eleven separate investigations suggests an 18% increase in the risk of leukaemia (RR = 1.18, 95% confidence interval (CI) 1.09-1.29) which is partly or wholly due to a 46% increase in the risk of acute myeloid leukaemia (RR = 1.46, 95% CI 1.27-1.65). It is not clear whether this increase is specific to certain types of work within the electrical industry. Nor is it possible to determine from the available data if the increase in leukaemia is due to electromagnetic fields or to other factors to which electrical workers are exposed. There is no clear association between cancer risk and residence near sources transmitting electricity, although some data suggest that there may be small increases in leukaemia in those living very close to the sources. The relationship between adverse outcome of pregnancy and exposure to sources of ELF electromagnetic fields needs further investigation. Studies of the possible effects of ELF electromagnetic fields on health are hampered by problems in measuring exposure and by the ubiquity of exposure in the community. PMID- 3290130 TI - Ethnic factors in multiple sclerosis: a review and critique of the epidemiological literature. AB - A review of the international epidemiological literature is undertaken with the view of identifying the main demographic and sociocultural features of MS as they apply to ethnic groups. Ethnic groups are differentiated principally in terms of three variables: race, religion, and nationality. Although MS is present in the three principal racial groups in the world (white, oriental, and black), it tends to be unequally distributed. Four hypotheses are formulated regarding the unequal susceptibility of the races to MS. Hypothesis 1. Whereas the highest MS rates are found in regions of the world inhabited largely by white populations, the lowest rates tend to be found in those areas where non-whites live. Hypothesis 2. Racially different groups living in the same geographical area tend to have different MS rates, although there is tendency for whites to experience MS more often than non-whites. The data associated with hypotheses 1 and 2 support a uniformly higher and lower risk for MS among respectively whites and non-whites. If these findings are valid, these studies indicate that racial (genetic) factors may play an important role in the distribution of this disease. Hypothesis 3. Data from this hypothesis confirm the proposition that the risk of MS among white and non-white populations tends to be variable, with variability in susceptibility being especially prominent among whites. Hypothesis 4. The prevalence data, plus the geographical distributions, in the US serve to support the firmly established interpretation that prevalence in all three racial groups tends to increase in frequency with increasing geographical latitude.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290131 TI - Estimation of body fat from ultrasound measures of subcutaneous fat and circumferences in obese women. AB - Body density and body fat are commonly estimated from measures of subcutaneous adipose tissue taken with skinfold calipers at specific body sites. In obese individuals, factors such as compression and inability to palpate tissues hinder the accurate measurement of skinfolds. Thus, the use of skinfold caliper measurements may yield spurious body density values. Previous research indicated that in obese persons, subcutaneous adipose tissue thickness measured by ultrasound gave more accurate predictions of body density, determined by hydrostatic weighing, than did caliper measurements. The present study compared ultrasound with circumference readings in estimating the body density of 31 white, obese women. Subcutaneous adipose tissue was measured at six body sites with an ADR model 2130 ultrasound real-time scanner. A calibrated fiberglass tape was used to take circumferences at ten body sites. Body density was computed from hydrostatic weighing using the Goldman/Buskirk formula, and percentage body fat, from the Siri equation. Mean (+/- s.d.) body density was 1.002 (+/- 0.015) g/ml, percentage body fat, 44.0 (+/- 7.5) and body mass index, 32.3 (+/- 4.5). The best prediction of body density, as determined by hydrostatic weighing, was with biceps and mid-thigh sites for ultrasound (r2 = 0.569). The combination of age, wrist, waist and upper thigh sites gave the best prediction for circumferences (r2 = 0.752). For the obese women in this study, circumference measurements provided a better estimation of body density and hence, body fat, than did ultrasound measures. A possible explanation to account for the difference is that circumference measures reflect both internal and subcutaneous adipose tissue, while only subcutaneous adipose tissue is measured with ultrasound. PMID- 3290132 TI - Exogenous insulin therapy slows weight loss in type 2 diabetic patients. AB - The impact of exogenous insulin therapy on the ability of obese, noninsulin dependent diabetic patients to lose weight was studied. Weight loss data from seven insulin-requiring type 2 diabetic patients, 11 sulfonylurea-treated type 2 diabetic patients and 12 non-diabetic controls on very-low-calorie diets were analyzed. Upon starting the diet, insulin doses were reduced by 50 percent and given once daily as intermediate-acting insulin. Doses were adjusted to maintain capillary blood glucoses between 6.7 and 10 mM. Sulfonylureas were stopped upon initiation of the diet. Patients were seen weekly for determination of their dietary compliance, medical status, glucose control, activity level and amount of weight loss. The insulin-treated subjects lost significantly less weight per week, whether expressed as kilograms, change in body mass index or percent of initial body weight lost. Treatment of obese type 2 diabetic patients with insulin retards their ability to lose weight independent of caloric intake. PMID- 3290133 TI - Effect of a three-day interruption of exercise-training on resting metabolic rate and glucose-induced thermogenesis in training individuals. AB - Exercise-training has been shown to influence resting components of energy expenditure in lean and obese individuals. Moreover, experimental data suggest that the effect of training on these components could represent an acute effect of exercise. In this regard, the present study was undertaken to determine whether resting metabolic rate (RMR) and glucose-induced thermogenesis (GIT) could be modified depending on the delay elapsing between the last exercise session of a training program and calorimetric measurements. Eight trained individuals were tested 16 h after a 90-min exercise bout and following a 3-day interruption of training. A significant decrease in RMR (-6.6 percent, P less than 0.05) was observed in response to exercise cessation. On the other hand, an increased GIT was noted following the 3-day rest period and this effect was also statistically significant. These results show that short-term interruption of training can affect substantially RMR and GIT in trained individuals, indicating that the time elapsing since the last exercise session must be taken into account in the interpretation of the effects of physical training on both these parameters. PMID- 3290134 TI - Insulin and thermogenesis. AB - The evidence reviewed here indicates that insulin can increase sympathetically mediated thermogenesis, probably via its central actions. However, since hypoglycaemia appears to inhibit thermogenesis, the interpretation of data and design of the experiments to study this phenomenon are highly problematic and further confounded by marked changes in insulin sensitivity. This review has purposely concentrated on work performed on experimental animals without directly referring to man. This is because of the very limited number of studies carried out in man, and the fact that difficulties of interpretation discussed above are multiplied many-fold by the limitations of human studies. The evidence to support a role for DIT in energy balance regulation and the importance of brown fat in man has been reviewed elsewhere. A limited number of studies have reported increases in metabolic rate in human subjects infused with glucose and insulin. This response is partially inhibited by the beta-adrenergic antagonist propranolol, and the effects diminished in some grossly obese subjects (e.g. Pima Indians). Landsberg has recently presented and discussed data which indicate that insulin can stimulate thermogenesis in man, and concluded that 'insulin is a major signal that relates dietary intake to sympathetic activity'. PMID- 3290135 TI - Pain and sensory symptoms in Parkinson's disease. PMID- 3290136 TI - Neuroimmunomodulation: potentiation of delayed hypersensitivity and antibody production by chronic electrical stimulation of the rat brain. AB - This study deals with the structural and functional correlates of the immunoneuroendocrine interconnections, and explores the effects of localized brain stimulation on immune response. Bilateral symmetrical electrodes were placed in the dorsomedial nucleus, ventromedial nucleus and posterior area of the hypothalamus, and in the sensorimotor cerebral cortex of the rat brain. Electrical stimulations were applied for 39 consecutive days, 10 days before and 29 days after single immunization. In sham-stimulated rats, electrodes were lowered into the hypothalamic areas and sensorimotor cortex without passing any current. Animals with electrodes were divided post mortem into groups according to the histological location of the electrode tips. Intact rats served as additional controls. All animals were immunized with bovine serum albumin in complete Freund's adjuvant and tested for immune reactions 7, 14, 21, and 28 days after immunization. The most significant finding was the potentiated delayed skin hypersensitivity and, to a lesser extent, antibody production to bovine serum albumin in rats with stimulated dorsomedial hypothalamus and sensorimotor cortex. On days 21 and 28, skin reactions increased in rats with stimulated posterior hypothalamus. These immune effects could not be obtained when the stimulation was applied to the hypothalamic ventromedial nucleus. Several pathways of the immunoneuroendocrine interplay are suggested. PMID- 3290137 TI - Neuroimmunomodulation: some recent views and findings. PMID- 3290138 TI - The cortex regulates the immune system and the activities of a T-cell specific immunopotentiator. AB - Evidence has accumulated to demonstrate important bidirectional communications between the nervous and immune systems. The anatomic pathways of communication include the commitment of different midbrain areas to regulation of immunologic functions. Neuropeptides appear as critical mediators of neuroregulation of function of diverse immunocompetent cells. Biochemicals secreted by immunocompetent cells mediate the effects of the immune system on the nervous system. We provide suggestive evidence that the above summarized effects are under a lateralized control of the neocortex. Furthermore, the neocortex has a lateralized influence on the immunopotentiating effects of sodium diethyl dithiocarbamate (imuthiol), which compound selectively increases T-cell numbers and activities, and acts on cholaminergic pathways. Thus, a major hemispheric asymmetry in the response to a drug is revealed. These results point to an important influence of neocortex on number and function of immunocompetent cells, which role can be modified by pharmacologic agents. PMID- 3290139 TI - Bilateral electrodermal asymmetry: past hopes and future prospects. AB - In the present paper, I have reviewed data and evidence concerning bilateral electrodermal (EDA) recordings and hemispheric asymmetry. Nine papers published between 1982 and 1986 are evaluated together with the 51 papers reviewed in the prior Hugdahl (1984) paper. The overall impression of the data is skepticism concerning what bilateral differences imply. This does, however, not imply that EDA is a less relevant index of hemispheric asymmetry compared to other psychophysiological measures. The important aspect of psychophysiological laterality research is not the use of different dependent measures, but the design and manipulation of the independent variables. Thus, increased responding to a verbal stimulus initially projected only to the left as compared to the right hemisphere may be as instructive concerning conclusions about asymmetry as bilateral differences to a stimulus presented to both hemispheres simultaneously. PMID- 3290140 TI - EEG measures of cerebral asymmetry: conceptual and methodological issues. AB - An overview of the use of EEG to assess hemispheric differences in cognitive and affective processes is presented. Some of the advantages of using EEG to assess asymmetric hemispheric differences in the study of complex mental activity are described. Following this brief introduction, two conceptual issues which are central to studies of EEG asymmetries are introduced: (1) the distinction between hemispheric specialization and activation, and (2) the importance of rostral caudal differences for the understanding of both specialization and activation. Three methodological issues in the use of EEG to assess hemispheric differences are then presented: (1) the use of asymmetry metrics, (2) muscle artifact, and (3) appropriate reference electrode location. Finally, some empirical examples of using EEG to assess affective and cognitive processes which illustrate these conceptual and methodological issues are described. PMID- 3290141 TI - The use of event-related potentials in the study of brain asymmetries. AB - The utility of event-related brain potentials (ERPs) in the study of hemispheric specialization is discussed in the context of three experimental cases: the application of motor potentials to the "continuous flow" model of human information processing, investigations of the role of early experience in cerebral organization, and hemispheric asymmetries in phonemic recoding during reading. The importance of the electrical reference in ERP records is stressed. PMID- 3290142 TI - Law, professional ethics and the problem of conflict with personal values. AB - There are, on occasions, instances in which a nurse may not agree with a given medical order of prescribed treatment. This is particularly likely in cases involving the use of extraordinary means of life-saving treatments on chronically or terminally ill patients. In such instances, the nurse may either (1) refuse to carry out the given medical order(s) or (2) refuse/decline to care for the patient in question (e.g. the nurse may instead request to be assigned a different patient in an attempt to avoid a personal dilemma). In cases where medical orders stand to violate the law, a nurse's refusal to carry out the medical order(s) in question might be seen to be fully justified; where medical orders violate nothing more than a philosophical or personal sense of right and wrong, however, justification for refusing to carry out such orders may not seem so defensible. This paper will critically examine the questions of when, if ever, a nurse might be justified on other than legal grounds (given the sometimes inappropriate and inadequate nature of law) to either (1) refuse to carry out a doctor's orders or (2) refuse/decline to care for a given patient. These questions will be discussed in relation to a real life scenario. PMID- 3290143 TI - The norms and values held by three groups of nurses concerning psychosocial nursing practice. AB - Research findings indicate that nurses often fail to provide patients with supportive psychosocial nursing care. The reasons for this and the norms and values on which nursing practice is predicated are unknown. The norms and values of three similar groups of nurses concerning psychosocial nursing care were inferred from observation and analysis of the nurses' interactions with each other, with other hospital personnel and with patients. Each group was observed for 5-7 weeks while working on one of three selected medical floors in the same hospital. Each group of nurses had norms and values which were discernable in typical behavior patterns, characteristics, explicit and implicit expectations, orientations, beliefs and attitudes. Two head nurses greatly influenced selection and enforcement of their groups' norms and values. The third group had not developed work-oriented norms and values. Nurses did not usually collaborate with other health-care professionals in the interests of their patients. The head nurses performed this function for each group. All nurses demonstrated knowledge of psychosocial nursing concepts but patient care was usually limited to physical nursing care, giving medications and meeting patients' verbally expressed requests for assistance. Nurses did not respond to or seem to notice patients' non-verbal or incoherent distress. They referred patients who exhibited disruptive behavior to other health professionals without delay. Patients who did not require physical nursing care had little opportunity for interaction with nurses. All three groups had work schedules which facilitated the typical style of nurse-patient interaction on each unit. These interactions were: cool, efficient and rushed on one unit; casual, warm and somewhat superficial on the second unit; brusque and business-like on the third unit. Nurses used social/moral assessment of patients which was facilitated by nurses telling each other anecdotes concerning patients. These anecdotes facilitated one group's typical humane, and two groups' typical dehumanizing nurse-patient interactions. The researcher concluded that group dynamics require consideration when planning nursing care delivery systems and that nurses need to develop pragmatic, supportive, psychosocial nursing interventions. PMID- 3290144 TI - Megavitamin therapy with pyridoxine. PMID- 3290145 TI - Nursing in the 40 years of the World Health Organization. AB - In the celebration of the 40 years of the World Health Organization's existence, the International Council of Nurses, spokesman for the world's nurses, wants to be present with the enthusiasm of a friend, with the pride to be an associate in providing health care and with due respect of the professionals who recognize the leading role and authority of WHO in the health field. PMID- 3290146 TI - The nurse of tomorrow. AB - Even since 1950, the seventh of April has been celebrated as World Health Day, because it marks the date in 1948 when WHO was founded. Each year a theme related to international public health has been chosen for World Health Day, with an appropriate slogan. This year the slogan is "Health for all--all for health." In 1954, "The nurse--pioneer of health" was selected as the slogan "to", in the words of former WHO Director-General Marcolino Candau, "bring about a clearer realization of the fundamental importance of the nurse's work for the health of the world." At the time Dr Candau took the opportunity to acknowledge "the valuable support and cooperation which WHO has consistently received from the ICN both before and since its admission into official relationship." To promote the nursing theme in 1954, material was prepared by the WHO for distribution to organizations and media around the world. Included in its kit was the following article by Daisy Bridges, ICN Executive Secretary 1948-61. Written 35 years ago, when ICN had already been in existence for over a half century, this article aptly expresses an ICN philosophy that remains unchanged and illustrates how ICN since its inception in 1899 has been working toward developing a nursing profession that can, with other health disciplines, not only help care for the sick, prevent disease and promote health but share in the planning of such a service and take the responsibility for its own professional contribution. PMID- 3290147 TI - The place of echography in percutaneous nephrostomy and nephrostolithotomy. AB - The advantages and limits of echography in the performance of percutaneous nephrostomy and nephrostolithotomy are described, based on our own cases. PMID- 3290148 TI - Relation of renal thromboxane A2 production to urine flow, electrolyte excretion and plasma renin activity in control state and drug induced hypotension. AB - The functional importance of renal TxB2 generation in the maintenance of elevated arterial blood pressure in essential hypertension was followed in 22 patients, using the method of sustained blood pressure decrease by i.v. sodium nitroprusside infusion. Linear correlation between urinary excretion of TxB2, urine flow, and sodium excretion could be established in both control and hypotensive periods. Presumably, changes in urinary excretion of TxB2 reflect a secondary intrarenal counterregulatory response. PMID- 3290149 TI - Diagnostic imaging in clinical cancer management: brain metastases. PMID- 3290151 TI - Detection of colonic polyps on single-contrast barium enema study: emphasis on the elderly. PMID- 3290150 TI - Effect of lumbar puncture on flow of cerebrospinal fluid. AB - The rate at which isotopes descend from the cisterna magna to the lumbar subarachnoid space is highly variable. In monkeys, with and without previous lumbar puncture, transit time was measured. In animals with a previous lumbar puncture, transit times were 10 to 120 minutes; in monkeys without a previous lumbar puncture, transit times were 120 to 180 minutes. In experimental studies of cerebrospinal fluid circulation, the effect of lumbar puncture must be controlled. PMID- 3290152 TI - Vancomycin: specialized niche for a narrow-spectrum antibiotic. PMID- 3290153 TI - The clonogenic assay in perspective. PMID- 3290154 TI - Clinical use of ciprofloxacin: an interesting new oral antibiotic. PMID- 3290155 TI - The first heart transplant operation in Hawaii and the prophylactic use of monoclonal antibodies (OKT3): a case report. PMID- 3290156 TI - Naproxen sodium for muscle contraction headache treatment. PMID- 3290157 TI - Prolonged vasospasm in migraine detected by noninvasive transcranial Doppler ultrasound. PMID- 3290159 TI - Effectiveness of salmon calcitonin nasal spray preparation in migraine treatment. PMID- 3290158 TI - The psychological treatment of recurrent headache in adolescents--short-term outcome and its prediction. PMID- 3290160 TI - Prospective payment for capital: an examination of current issues. AB - Congress has suggested that a prospective payment system for capital should permit the continuation of cost-based reimbursement for certain projects. A study was conducted to examine the components of the capital planning process used by eight hospitals and the effect of this process on completion of capital projects. PMID- 3290161 TI - [Rational diagnosis in phlebologic practice]. AB - Venous diseases are of extraordinary sociomedical and socioeconomic relevance. They are a daily problem in general practice and require careful diagnostic clarification and exact definition with regard to differential diagnosis. In the diagnosis of important venous diseases Doppler sonography must always be carried out after the case history has been taken and a physical examination has been performed. It allows a relatively fast, functionally orientated and differentiated assessment of all venous diseases of the lower and upper extremities and does not involve any risk. At present, it cannot be replaced by any other method either in general or in clinical practice, and also serves as an indication for phlebography for example. Duplex sonography can supplement Doppler ultrasonography significantly, but this examination is still very expensive. There are fundamental sources of error in photoplethysmography and this technique has considerable limitations. It never can replace Doppler ultrasonography. Its only well-founded application - besides a general determination of a more pronounced venous transport disturbance - is to test the haemodynamic effect of eliminating important venous insufficiency points as preparation for invasive forms of therapy. The kind of examination shown here offers the best prerequisites for rational diagnosis in phlebological practice. PMID- 3290162 TI - [The CO2 laser in dermatotherapy--use and indications]. AB - Due to the high absorption of infrared light in water the CO2 laser (lambda = 10,600 nm) is suitable for cutting and vaporizing tissue. The ablation of pathological tissue by means of the CO2 laser can be exactly controlled. The treated area is usually dry and clear since blood and lymph vessels up to a diameter of 1 mm are sealed. Postoperative swelling and pain are reduced compared with electrosurgery. Important and frequent indications for CO2 laser application are HPV papillomas (condylomata acuminata, common warts, bowenoid papules) and the removal of tattoos. The CO2 laser is also suitable for the removal of benign and disseminated lesions such as angiofibromas, syringomas, trichoepitheliomas, epidermal nevi etc. Lesions of the oral mucosa (leukoplakias, mucosal warts) can be removed by means of the CO2 laser. Additionally, the treatment of vascular lesions (nevi flammei, lymphangiomas, telangiectasias) has been described, although the CO2 laser does not operate in a vessel-specific manner. As this review article demonstrates, the CO2 laser has a broad range of applications and represents an enrichment of dermatotherapy. PMID- 3290163 TI - [Ichthyosiform scaling in alpha-1,4-glucosidase deficiency]. AB - In two patients suffering from infantile and juvenile types of alpha-1,4 glucosidase deficiency (Pompe's disease, glycogen storage disease types 2a and 2b) with typical lysosomal glycogen storage, widespread dry "ichthyosiform" scaling skin was observed. The clinical and microscopical findings resembled those of ichthyosis vulgaris. Even in the cytoplasm of keratinocytes vacuolar glycogen accumulation was demonstrated, suggesting a correlation between this pathological storage process and the symptom of "scaling". Therefore, ichthyosiform scaling conditions should be investigated not only for disorders of lipid metabolism but also for a possible disturbance of the carbohydrate digesting enzymes. PMID- 3290164 TI - [Diagnosis and therapy of deep phlebothrombosis of the lower limbs]. PMID- 3290165 TI - [Complex injuries of the lower limbs. An introductory study]. PMID- 3290166 TI - [Complex injuries of the lower limbs. Bone problems and reconstruction of diaphyseal defects]. PMID- 3290167 TI - Radiation therapy and conservation surgery for primary and recurrent carcinoma of the vulva: report of 40 patients and a review of the literature. AB - Forty patients with histologically confirmed primary or recurrent vulvar carcinoma were treated with radiation therapy for loco-regional disease. Nineteen of the patients with primary tumors received postoperative radiotherapy (5000 cGy in 6 weeks). Fifteen of the 19 exhibited local tumor control. Five patients with Stage III or IV disease were managed with radiotherapy alone. Four had a complete response with two currently NED. Two patients who received preoperative radiotherapy with local excision are also currently free of disease. The 4-year NED survival for the study population is 100%, 28%, 50%, 0% and 10% for Stage I, II, III, IV and recurrent tumors respectively. The poor results obtained in Stage II tumors is likely due to selection criteria since four of seven patients developed distant metastases. Two of the 14 patients treated for recurrent disease remain NED after local excision of their tumors prior to irradiation. Even though the number of patients is small no dose response for subclinical disease could be found between 4500 and 7000 cGy. Treatment morbidity was acceptable with two patients developing severe long-term complications requiring surgical intervention. PMID- 3290168 TI - Immunosuppression prior to marrow transplantation for sensitized aplastic anemia patients: comparison of TLI with TBI. AB - From May 1980 through July 1986, 26 patients with severe aplastic anemia, sensitized with multiple transfusions of blood products, were treated on either of two immunosuppressive regimens in preparation for bone marrow transplantation from a matched donor. There were 10 patients treated with total body irradiation (TBI), 200 cGy/fraction X 4 daily fractions (800 cGy total dose), followed by cyclophosphamide, 60 mg/kg/d X 2 d. An additional 16 patients were treated with total lymphoid irradiation (TLI) [or, if they were infants, a modified TLI or thoracoabdominal irradiation (TAI)], 100 cGy/fraction, 3 fractions/d X 2 d (600 cGy total dose), followed by cyclophosphamide, 40 mg/kg/d X 4 d. The extent of immunosuppression was similar in both groups as measured by peripheral blood lymphocyte depression at the completion of the course of irradiation (5% of initial concentration for TBI and 24% for TLI), neutrophil engraftment (10/10 for TBI and 15/16 for TLI), and time to neutrophil engraftment (median of 22 d for TBI and 17 d for TLI). Marrow and peripheral blood cytogenetic analysis for assessment of percent donor cells was also compared in those patients in whom it was available. 2/2 patients studied with TBI had 100% donor cells, whereas 6/11 with TLI had 100% donor cells. Of the five who did not, three were stable mixed chimeras with greater than or equal to 70% donor cells, one became a mixed chimera with about 50% donor cells, but became aplastic again after Cyclosporine A cessation 5 mo post-transplant, and the fifth reverted to all host cells by d. 18 post-transplant. Overall actuarial survival at 2 years was 56% in the TLI group compared with 30% in the TBI group although this was not statistically significant. No survival decrement has been seen after 2 years in either group. There was less long-term morbidity in the TLI group compared with TBI although the numbers of surviving patients are small. With no difference in engraftment or survival, it is suggested that, for sensitized severe aplastic anemia patients, who are to receive a non-T cell-depleted marrow from a matched donor, prudent cytoreduction should include a fractionated, moderate dose irradiation regimen with maximum organ sparing, that is either TLI or TAI. PMID- 3290169 TI - Effects of accelerated fractionation on radiation injury of the small intestine: a new rat model. AB - The present study assessed the influence of shortening the overall treatment time (accelerated fractionation) on radiation injury of the small intestine. A rat model which allowed repeated irradiation of a localized segment of small intestine was developed. Young adult male Sprague-Dawley rats were orchiectomized, and a loop of the distal ileum was transposed to the left part of the scrotum. The intestinal segment was irradiated with a total dose of 56 Gy, given in 20 fractions, the total treatment time being either 26, 12, or 7 days (i.e. 1, 2, or 3 fractions per day). Radiation injury was assessed by histopathologic examination at 6 hr and at 2 weeks after the last irradiation. The surgical procedure was without complications. Shortening the overall treatment time by giving more than one radiation dose per day resulted in markedly increased injury both at 6 hr and at 2 weeks. It is concluded that accelerated fractionation results in increased radiation injury of the intestine when compared with standard fractionation. Because there may be a relationship between early and late effects in the intestine, our results also indicate that increased late radiation enteropathy may result from accelerated fractionation. PMID- 3290170 TI - Hermann Holthusen. PMID- 3290171 TI - A new stereotactic X-ray knife. AB - For many years, the irradiation of small volumes of tissue in the brain to necrotizing doses has been investigated as a "non-invasive" alternative to neurosurgery. We propose a new system in which a precisely machined helmet serves as a multi-port focussed X-ray collimator when it is itself irradiated by a conventional medical linear accelerator run in the electron mode. When the collimator is attached to a stereotactic frame, the geometric accuracy of delivering small radiation fields to the brain is limited primarily by the accuracy of the stereotactic localization, and is relatively independent of the positional stability of the accelerator. Field sizes as small as two millimeters are readily achievable. The problem of low dose rate associated with these small fields is overcome by the use of high electron beam currents. PMID- 3290172 TI - Epididymal markers in human infertility. AB - Alpha-glucosidase, glycerophosphocholine, and L-carnitine were measured in sperm free seminal plasma to determine whether these markers reflected the epididymal function of men attending an infertility clinic. The putative markers correlated well with each other (r = 0.66 to 0.70) and in 92% of 283 cases were accurate in categorizing semen as containing normal or subnormal amounts of markers. Glucosidase was considered the best index of epididymal function and was used for a further 306 samples. The ejaculate content of epididymal markers was correlated with testicular volume and serum testosterone below values of 30 ml and 30 nmol/l, respectively. Markers were also correlated with the concentration and motility of spermatozoa in semen. Seventy-one of 425 patients (17%) displayed subnormal epididymal secretions, mainly in association with hypogonadism (Klinefelter syndrome, Kallman syndrome, idiopathic hypogonadotropic hypogonadism) but also in cases of obstructed ducts, maldescended testicles, and local irradiation following hemicastration. Because azoospermic patients had reduced epididymal markers with both high and low FSH levels and a large proportion of men with reduced glucosidase and normal FSH suffered from testicular failure, it is suggested that other indices of testicular function are required for correct interpretation of reduced epididymal markers. Thirteen patients (3%) had low markers for which no cause was apparent; these may be cases of infertility due to isolated epididymal dysfunction. PMID- 3290173 TI - Terpentecin, an inhibitor of DNA synthesis. AB - Terpentecin at a concentration of 0.78 microgram/ml decreased the number of viable cells of Escherichia coli NIHJ to less than one thousandth the starting number in an hour when added to an exponentially growing culture in a nutrient broth. During this time, the turbidity of the cell suspension kept increasing as fast as the control. Microscopic inspection of the cells exposed to terpentecin under these conditions revealed that the cells were elongated. Terpentecin at a concentration of 6.25 micrograms/ml inhibited incorporation of [14C]thymidine into the acid-insoluble material of cells of E. coli NIHJ by 70% in 30 minutes in contrast to little or no inhibition of the incorporation of [14C]uridine or [14C]leucine. Under similar conditions, terpentecin did not inhibit either membrane transport (uptake) of [14C]thymidine into the cells or the metabolic conversion of the precursor into various cellular acid-soluble components. Terpentecin at a higher concentration (70 micrograms/ml) inhibited by 40% in 30 minutes the incorporation of [methyl-3H]thymidine triphosphate into the DNA fraction of toluene-treated cells of E. coli JE6296 (pol A-). Terpentecin showed stronger antibacterial activities against Bacillus subtilis M45T (rec-) and E. coli BE1121 (rec A-) than against their corresponding wild type strains. However, terpentecin showed no mutagenicity by the Ames test with Salmonella typhimurium strains TA100, TA98, TA92, TA1538, TA1537 and TA1535, and with E. coli WP2 (uvr A). Terpentecin at a lower concentration (0.07 micrograms/ml) inhibited growth in vitro of mouse leukemia L1210 cells by 50%. With the mammalian cells again the incorporation of [14C]thymidine into the acid-insoluble cell material was inhibited more strongly than incorporation of [14C]uridine and [14C]leucine. There was no sign of mutagenicity by the micronucleus test using mice. PMID- 3290174 TI - Effects of lincomycin on synthesis of TEM beta-lactamase by Escherichia coli. AB - Sub-inhibitory concentrations of lincomycin slightly inhibit growth of Escherichia coli carrying plasmid RP4 and cause a 2-fold increase in TEM-2 beta lactamase. To analyze this effect, cultures were pulse-labeled with [3H]leucine, chased with non-radioactive leucine and immunoprecipitated with anti-beta lactamase antiserum. The synthesis rate of beta-lactamase was two times higher in inhibited cultures than in control cultures. No significant decrease of labeled enzyme occurred during the 30 minutes chase, indicating no degradation of beta lactamase. The rate of maturation of pre-beta-lactamase was determined by measuring the decrease in the amount of pre-beta-lactamase after a 1-minute labeling interval. There was no significant difference between the control and lincomycin-treated cultures, indicating that posttranslational translocation is not involved in the stimulation. Both plasmid encoded and chromosomally encoded TEM-1 beta-lactamase increased in the presence of lincomycin. The effects of other protein synthesis inhibitors on the synthesis of TEM-1 beta-lactamase were examined. The stimulation of beta-lactamase synthesis by lincomycin appears to be specific for macrolide and related antibiotics and is not a general phenomenon resulting from partial inhibition of protein synthesis. PMID- 3290175 TI - Calbindin (CaBP 28 kDa) localization in the peripheral vestibular system of various vertebrates. AB - Previous reports on calbindin, a 28 kDa vitamin D-induced calcium-binding protein, located in the mammalian peripheral vestibular system indicated that it is specifically distributed and postulated that it could play a role in the electrophysiological functioning of the sensory cells. This immunocytochemical investigation of the distribution of calbindin in the vestibular system of various vertebrates: fishes (goldfish and sea-perch), amphibia (frog), birds (chicken) and mammals (mouse, cat and baboon), was performed to verify these observations. In the vestibular ganglion, only a few neurons were faintly immunoreactive in the fishes and the frog, while the staining was more intense but still not present in all neurons of the chicken, the mouse and the cat. All the neurons were immunoreactive in the baboon. No immunoreactivity was observed in the sensory epithelia of the fishes. All hair cells were strongly immunoreactive in the frog. In the other species, most of the hair cells in the cristae were immunostained except those situated in the peripheral areas. In the maculae, the hair cells of the striola were either the only ones stained or were more intensely stained or were more intensely stained than the others. The localization of calbindin in specific cellular types and its increasing abundance from the fishes to the mammals suggest that calbindin is associated with the capacity of sensory and nerve cells to analyze precise mechanical or biochemical stimulations. PMID- 3290176 TI - Nursing, therapy, and social control: feminist science and systems-based family therapy. PMID- 3290177 TI - The problem of professional autonomy in nursing. PMID- 3290178 TI - Growth and formation of toxin by Clostridium botulinum in peeled, inoculated, vacuum-packed potatoes after a double pasteurization and storage at 25 degrees C. AB - A process that claims to use a double pasteurization to produce vacuum-packed potatoes for storage at ambient temperature has been evaluated. After the first pasteurization, potatoes are vacuum-packed and stored at 25 degrees-35 degrees C for up to 24 h, which is intended to allow germination of bacterial spores, and are then pasteurized again. When potatoes were inoculated with spores of Clostridium botulinum and subjected to this double-pasteurization process a high proportion of spores remained viable and resulted in growth and formation of toxin within 5-9 d at 25 degrees C. To provide an appropriate reduction in the risk o survival and growth of Cl. botulinum, peeled, vacuum-packed potatoes for storage at ambient temperature should be given a heat treatment equivalent to an F(0)3 process. If they are not given such a heat treatment they should be stored at a temperature below 4 degrees C. PMID- 3290179 TI - Infections by gram-positive bacteria: an overview. AB - Staphylococcus aureus, which has exceptional ability to cause disease in man, has responded to the introductions of antimicrobial agents by the selection and emergence of antibiotic-resistant strains. There have been cyclical changes in the prevalence of these strains in nosocomial infections. Other Gram-positive species that give rise to concern, for related reasons, are Staph. epidermidis and other coagulase-negative staphylococci, Streptococcus faecalis and the JK group of corynebacteria. These problems are discussed to provide a background for the contributions that follow. PMID- 3290180 TI - Osteomyelitis: options for diagnosis and management. AB - The bacterial aetiology of osteomyelitis is best determined by bone biopsy under radiographic control. While Staphylococcus aureus is still the most common cause of osteomyelitis, Gram-negative bacteria occur more frequently than they did in the past. The prognosis of antibiotic treatment is made worse by chronic infection and by underlying conditions, such as diabetes mellitus or peripheral vascular disease. Treatment for six weeks with single broad-spectrum antimicrobial agents can give success rates similar to those obtained with combination therapy, including aminoglycosides, and with less toxicity. Newer diagnostic methods (radionuclide scans and radiographic techniques) and treatment options (antibiotic-containing acrylic beads and microvascular grafts) may offer improved management if used discriminatingly. PMID- 3290181 TI - New considerations in the pathogenesis of coagulase-negative staphylococcal foreign body infections. AB - Coagulase-negative staphylococci are the predominant cause of foreign body infections. The pathogenesis is related to the ability of these staphylococci to adhere to and grow on polymer surfaces and to produce an extracellular slime substance. The exact chemical nature of this extracellular slime substance is still not known, although there is some evidence that it may be a complex glycoconjugate. On the basis of in-vitro and animal data, the extracellular slime substance seems to interfere with various host-protective mechanisms and with the action of antistaphylococcal antibiotics. These factors can explain several clinical characteristics of coagulase-negative staphylococcal foreign body infections. PMID- 3290182 TI - Gram-positive infections in granulocytopenic patients: an important issue? AB - Gram-positive pathogens have become a common cause of bacteraemia in granulocytopenic cancer patients. This has been partially attributed to the use of central intravenous devices such as Hickman catheters; mucositis secondary to intensive antineoplastic chemotherapy or herpes infections may also be the source, especially for streptococci, whereas the skin is most probably the source for Staphylococcus epidermidis. Antimicrobial prophylaxis recommended mainly with the aim of reducing the incidence of Gram-negative bacillary infections may also play a significant role. The rate of response of documented infections caused by Gram-positive cocci to 'standard' empirical therapy (which has been mainly directed against Gram-negative bacilli) has been unsatisfactory although the lethality reported has been low. These results raise an important question, whether or not a specific anti-Gram-positive antibiotic such as vancomycin, should be added to the empirical regimen. A recent study suggested that empirical vancomycin provided no benefit since the mortality due to Gram-positive infections was low and a favourable outcome was obtained by adding a specific antibiotic after bacteriological documentation. However, others have shown that empirical use of vancomycin was associated with a more rapid resolution of fever. Vancomycin has been associated with an excess rate of side-effects and is difficult to administer. Another important question is whether or not antimicrobial prophylaxis for gut decontamination should include anti-Gram positive cover. Recent studies have confirmed that Gram-negative bacillary bacteraemia may be prevented by oral gut decontamination but not bacteraemia due to Gram-positive bacteria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290183 TI - Gram-positive bacteria: spread and antimicrobial resistance in university and community hospitals in the USA. AB - Gram-positive bacteria have become more important as a source of both community and nosocomial infection in the United States during the past few years. In part, this has been due to the increasing prevalence of resistance of some of these organisms to commonly-employed antimicrobials. Initially, such resistance was seen primarily in university and referral hospitals. Spread of resistant strains to the community hospital recently has become prominent for many of these organisms. Exemplifying these trends are methicillin-resistance in Staphylococcus aureus, vancomycin-resistance in coagulase-negative staphylococci, relative resistance to penicillin among pneumococci, aminoglycoside-resistance in viridans streptococci, and resistance to both beta-lactams and aminoglycosides in enterococci. These developments highlight the importance of the Gram-positive cocci in today's clinical practice in the USA. The need to define and deal with these trends is emphasized by the speed with which the changes have developed in both university and community hospitals. PMID- 3290184 TI - Trends in the epidemiology and antibiotic resistance of clinical Staphylococcus strains in Italy--a review. AB - This review analyses the current Italian problem of clinical Staphylococcus isolates and trends in their antibiotic resistance. Most information has come from two recent nationwide collaborative studies. Some data have also been derived from particular experiences in individual laboratories. S. aureus was predominant among Staphylococcus isolates from most clinical sources. S. epidermidis predominated in strains isolated from artificial devices, blood, and cerebrospinal fluid. S. saprophyticus was isolated with greater frequency from outpatients than from inpatients, predominantly from urinary specimens. In spite of marked laboratory-to-laboratory and geographical variations, greater staphylococcal resistance to methicillin and most other antibiotics was noted. Overall, among clinical Staphylococcus strains isolated in Italy, more than a third of organisms from inpatients and more than a fifth of those from outpatients currently proved to be resistant to methicillin. The incidence of methicillin resistance was generally lower in Southern Italy than in the rest of the country, occurred at a twofold higher rate in isolates from inpatients than from outpatients, and was generally higher among isolates from intensive care units than from other hospital departments. There was increasing involvement of coagulase-negative staphylococci in human infections which made up about half of all clinical Staphylococcus isolates. Coagulase-negative staphylococci were more frequent than S. aureus in specimens from intensive care and surgical wards, and also were more resistant to many antibiotics including methicillin. PMID- 3290185 TI - Microbiological and clinical aspects of aspiration pneumonia. AB - Aspiration pneumonia is characterized by a pneumonitis in a dependent segment of the lung with typical necrosis or abscess-formation in the parenchyma. Observed aspiration or predisposition to aspiration, cavitation or abscess formation, with or without empyema fluid and isolation of distinctive micro-organisms are important clues to the diagnosis. Diagnostic procedures to collect anaerobic uncontaminated secretions are transtracheal aspiration, blood cultures, pleural fluid aspiration, fibreoptic bronchoscopic protected investigations and percutaneous transthoracic aspiration. Leading pathogens in more than 90% are anaerobic bacteria, mostly species of Bacteroides, Fusobacterium, Peptococcus and Peptostreptococcus; aerobic bacteria include Staphylococcus aureus and Gram negative bacilli, mainly Klebsiella spp. and Pseudomonas aeruginosa. Treatment depends on bacteriological results; penicillin G and clindamycin are the most useful antibiotics against anaerobes and should be administered over a long period of time (4-12 weeks), adjusted to the clinical course of the individual patient. PMID- 3290186 TI - The development of antimicrobial resistance in staphylococci. AB - Staphylococci are among the most important aetiological agents of both community- and hospital-acquired infections. Staphylococcus aureus isolates resistant to penicillin because they produced beta-lactamase were isolated soon after the introduction of penicillin as a therapeutic agent. The production of beta lactamase was mediated by a plasmid. The incidence of penicillin resistance in S. aureus increased during the succeeding decades until most clinical isolates were resistant to penicillin. During the 1940s and 1950s resistance to other antimicrobial agents was also demonstrated, usually in combination with penicillin resistance, thus creating multi-resistant strains. Methicillin, a penicillin that was essentially resistant to staphylococcal beta-lactamase, was introduced into clinical use in the early 1960s and this alleviated much of the problem of antimicrobial resistance in S. aureus, but methicillin-resistant strains were soon isolated. Although methicillin-resistant staphylococci had been a nosocomial problem in Europe in the 1960s and early-1970s, it was not until the mid-1970s that they became a problem in the United States. Since then the incidence of methicillin-resistant S. aureus has steadily increased. The methicillin-resistant S. aureus strains are usually multi-resistant including the beta-lactams and one or more of the following: aminoglycosides, macrolides, lincosamides, tetracyclines (usually not minocycline), and chloramphenicol. The methicillin-resistant S. aureus are generally susceptible to vancomycin, teicoplanin, rifampicin, coumermycin, minocycline, the quinolones, and sulphamethoxazole-trimethoprim. The coagulase-negative staphylococci are also important aetiological agents of nosocomial infections and the incidence of these infections has increased in recent years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290187 TI - Antibiotic therapy of nonenterococcal streptococcal and staphylococcal endocarditis: current regimens and some future considerations. AB - Regimens for endocarditis caused by these bacteria are generally based on high dosage of a beta-lactam antibiotic, penicillin in the case of streptococci and a penicillinase-resistant penicillin for Staphylococcus aureus, with vancomycin substituted for beta-lactam resistant staphylococci, including coagulase-negative staphylococci. The addition of other antimicrobial agents, such as aminoglycosides (or, in the case of staphylococci, sodium fusidate or rifampicin) may increase bactericidal efficiency, or allow shorter courses, but problems of toxicity or emergence of resistance may occur. Optimal regimens are discussed, and newer agents of possible usefulness are reviewed. PMID- 3290188 TI - In vitro analytical system for determining the ability of antibiotics at residue levels to select for resistance in bacteria. AB - An analytical procedure, based on the concept that exposure of bacteria to antibiotics will result in the selection of a resistant population, was developed. Two strains of enteric bacteria, Escherichia coli CS-1 and Enterobacter cloacae B520, which are sensitive to a wide variety of antibiotics, were used as the test organisms. E. coli CS-1 were exposed to 1.00 micrograms antibiotic or antimicrobial/mL; E. cloacae B520 were exposed to 0.01, 0.10, 0.50, 1.00, and 5.00 micrograms/mL. Both organisms developed increased resistance to other antibiotics after exposure to chlortetracycline and oxytetracycline, as measured by the minimum inhibitory concentration (MIC). E. cloacae B520 showed increased resistance to ampicillin, oxytetracycline, and chloramphenicol after exposure to levels as low as 0.10 microgram/mL. Exposure to streptomycin, sulfamethazine, tylosin, bacitracin, flavomycin, virginiamycin, and monensin at levels of 1.00 microgram/mL did not increase the MIC. Exposure to 5.00 micrograms streptomycin, sulfamethazine, tylosin, and monensin/mL increased the MIC of E. cloacae to one of the antibiotic markers. These increased MICs exceeded the 95% confidence limits of the MIC values of the unexposed organisms. PMID- 3290189 TI - Method to determine effect of antibiotics at residue levels on R-factor transfer. AB - An analytical system was developed which can assess the ability of antibiotic/antimicrobial residues (0.01-1.00 ppm) to affect the conjugal transfer of resistance among the Enterobacteriaceae. The donor strain, Escherichia coli RP 4 (Amr Tcr Nmr Kmr Lac+), and recipient strain, E. coli Sc-8632 (Smr Lac-), were incubated together in a 1:9 donor:recipient ratio for 18 h with gentle shaking (50 rpm) in brain heart infusion broth in the presence of residue levels of antibiotics. The mating cultures were serially diluted and spread-plated onto MacConkey agar containing 25 micrograms streptomycin/mL to select the total recipient population of sensitive E. coli Sc-8632 and transconjugants. After an 18 h incubation at 37 degrees C, the plates were replicated onto MacConkey agar containing 25 micrograms ampicillin/mL to select the ampicillin-resistant transconjugant population. Repeatability was good; the average transfer was 51.8%, with a coefficient of variation of 9.3%. Residue levels of tylosin (0.10 and 1.00 ppm) increased the transfer of the ampicillin marker beyond the 95% confidence limits. Oxytetracycline, bacitracin, streptomycin, penicillin, and virginiamycin did not increase the percent transfer. Oxytetracycline at 0.01 ppm decreased the percent transfer. In general, residue levels of antibiotics (0.01 1.00 ppm) did not affect the conjugal transfer of antibiotic resistance. PMID- 3290190 TI - Evaluation of abbreviated enzyme immunoassay method for detection of Salmonella in low-moisture foods. AB - A modified enzyme immunoassay method (EIA) utilizing an 18 h pre-enrichment, a 6 8 h selective enrichment, and a 14 h M-broth post-enrichment is compared to the standard culture method (AOAC/BAM) on selected low-moisture foods. Tested samples included 238 inoculated, 30 naturally contaminated, and 30 uninoculated foods. By EIA, 235 samples were positive (optical densities greater than 0.2 at 405 nm), 233 of which were confirmed culturally. By the culture methods, 221 samples were positive. The EIA method was more productive in detecting salmonellae in inoculated samples of dry cheese powder, chocolate, and nonfat dry milk, whereas the culture method gave better recovery from naturally contaminated meat and bone meal. The modified EIA could be completed in 40 h and required no centrifugation. PMID- 3290191 TI - Crystalline surface layers in procaryotes. PMID- 3290192 TI - Ancient heat shock gene is dispensable. AB - Hsp83 is a major eucaryotic heat shock protein and one of the most conserved proteins known. We have isolated an Escherichia coli gene homologous to eucaryotic Hsp83 and used it to construct a deletion mutation. The E. coli mutant was viable but had a slight growth disadvantage that increased with temperature. PMID- 3290193 TI - Expression of double-stranded-RNA-specific RNase III of Escherichia coli is lethal to Saccharomyces cerevisiae. AB - The gene for the double-stranded RNA (dsRNA)-specific RNase III of Escherichia coli was expressed in Saccharomyces cerevisiae to examine the effects of this RNase activity on the yeast. Induction of the RNase III gene was found to cause abnormal cell morphology and cell death. Whereas double-stranded killer RNA is degraded by RNase III in vitro, killer RNA, rRNA, and some mRNAs were found to be stable in vivo after induction of RNase III. Variants selected for resistance to RNase III induction were isolated at a frequency of 4 X 10(-5) to 5 X 10(-5). Ten percent of these resistant strains had concomitantly lost the capacity to produce killer toxin and M dsRNA while retaining L dsRNA. The genetic alteration leading to RNase resistance was localized within the RNase III-coding region but not in the yeast chromosome. These results indicate that S. cerevisiae contains some essential RNA which is susceptible to E. coli RNase III. PMID- 3290194 TI - Noncoordinate translation-level regulation of ribosomal and nonribosomal protein genes in the Escherichia coli trmD operon. AB - The trmD operon of Escherichia coli contains the genes for the ribosomal protein S16, a 21-kilodalton polypeptide of unknown function, the tRNA(1 methylguanosine)methyltransferase, and the ribosomal protein L19, in that order. As reported elsewhere, the operon is transcribed as a single polycistronic mRNA species, and there is no significant difference in the steady-state amounts of different parts of the mRNA (A.S. Bystrom, A. von Gabain, and G.R. Bjork, submitted for publication). Furthermore, accumulation of all parts of the transcript is altered in a stringently controlled manner upon starvation for valyl-tRNA. Here we show that the rate of synthesis of the trmD operon proteins increased with increasing growth rate and that the amount in steady state, at a specific growth rate (k = 1.0), of the tRNA(1-methylguanosine)methyltransferase was 260 molecules per gene copy, which is about 40 times lower than the amount of the two ribosomal proteins, whereas the 21-kilodalton protein was synthesized to the amount of about 850 molecules per gene copy. The lower steady-state amount of the two nonribosomal proteins was not due to a higher turnover rate. Synthesis of the 21-kilodalton and TrmD proteins responded differently from that of the two ribosomal proteins during conditions which provoked amino acid starvation, although accumulation of the entire mRNA molecule responds similarly to the rate of synthesis of the two ribosomal proteins. We conclude that the observed differential and noncoordinate expression is achieved by regulation at the level of mRNA translation. PMID- 3290195 TI - Effect of extreme salt concentrations on the physiology and biochemistry of Halobacteroides acetoethylicus. AB - Halobacteroides acetoethylicus grew in media with 6 to 20% NaCl and displayed optimal growth at 10% NaCl. When grown in medium with an [NaCl] of 1.7 M, the internal cytoplasmic [Na+] and [Cl-] were 0.92 and 1.2 M, respectively, while K+ and Mg2+ concentrations in cells were 0.24 and 0.02 M, respectively. Intracellular [Na+] was fourfold higher than intracellular [K+]. Since Na+ and Cl ions were not excluded from the cell, the influence of high salt concentrations on key enzyme activities was investigated in crude cell extracts. Activities greater than 60% of the maximal activity of the following key catabolic enzymes occurred at the following [NaCl] ranges: glyceraldehyde-3-phosphate dehydrogenase, 1 to 2 M; alcohol dehydrogenase (NAD linked), 2 to 4 M; pyruvate dehydrogenase, 0.5 to 1 M; and hydrogenase (methyl viologen linked), 0.5 to 3 M. These studies support the hypothesis that obligately halophilic, anaerobic eubacteria adapt to extreme salt concentrations differently than do halophilic, aerobic eubacteria, because they do not produce osmoregulants or exclude Cl-. This study also demonstrated that these halophilic, anaerobic eubacteria have a physiological similarity to archaebacterial halophiles, since Na+ and Cl- are present in high concentrations and are required for enzymatic activity. PMID- 3290196 TI - Adjustment of polyamine contents in Escherichia coli. AB - Adjustment of polyamine contents in Escherichia coli was studied with strains of Escherichia coli producing normal (DR112) and excessive amounts of ornithine decarboxylase [DR112(pODC)] or S-adenosylmethionine decarboxylase [DR112(pSAMDC)]. Although DR112(pODC) produced approximately 70 times more ornithine decarboxylase than DR112 did, the amounts of polyamines in the cells of both strains did not change significantly. The amounts of polyamines in DR112(pODC) were adjusted by excretion of excessive amounts of putrescine to the medium. When ornithine was deficient in cells, polyamine contents in DR112(pODC) were much higher than those in DR112, although polyamine contents were low in both strains. This indicates that large amounts of ornithine decarboxylase increased the utilization of ornithine for putrescine synthesis. During ornithine deficiency, strain DR112 produced 3.4 times more ornithine decarboxylase. Strain DR112(pSAMDC) produced seven times more S-adenosylmethionine decarboxylase than DR112 did. In DR112(pSAMDC) an increase (40%) in spermidine content, a decrease (35%) in putrescine content, and no significant excretion of putrescine and spermidine were observed. The amount of ornithine decarboxylase in DR112(pSAMDC) was approximately 30% less than that in DR112. In addition, S-adenosylmethionine decarboxylase activity was strongly inhibited by spermidine. A possible regulatory mechanism to maintain polyamine contents in Escherichia coli is discussed based on the results. PMID- 3290197 TI - Osmotic control of glycine betaine biosynthesis and degradation in Rhizobium meliloti. AB - Intracellular accumulation of glycine betaine has been shown to confer an enhanced level of osmotic stress tolerance in Rhizobium meliloti. In this study, we used a physiological approach to investigate the mechanism by which glycine betaine is accumulated in osmotically stressed R. meliloti. Results from growth experiments, 14C labeling of intermediates, and enzyme activity assays are presented. The results provide evidence for the pathway of biosynthesis and degradation of glycine betaine and the osmotic effects on this pathway. High osmolarity in the medium decreased the activities of the enzymes involved in the degradation of glycine betaine but not those of enzymes that lead to its biosynthesis from choline. Thus, the concentration of the osmoprotectant glycine betaine is increased in stressed cells. This report demonstrates the ability of the osmolarity of the growth medium to regulate the use of glycine betaine as a carbon and nitrogen source or as an osmoprotectant. The mechanisms of osmoregulation in R. meliloti and Escherichia coli are compared. PMID- 3290199 TI - Minimal region necessary for autonomous replication of pTAR. AB - The native 44-kilobase-pair plasmid pTAR, discovered in a grapevine strain of Agrobacterium tumefaciens, contains a single origin of DNA replication confined to a 1.0-kilobase-pair region of the macromolecule. This region (ori) confers functions sufficient for replication in Agrobacterium and Rhizobium species but not in Pseudomonas solanacearum, Pseudomonas glumae, Pseudomonas syringae pv. savastanoi, Xanthomonas campestris pv. campestris, and Escherichia coli. ori contains a repA gene that encodes a 28,000-dalton protein required for replication. Nucleotide sequencing of repA and its promoter region revealed four 8-base-pair palindromic repeats upstream of the repA coding region. Deletion of these repeats alters repA expression and plasmid copy number. Downstream of repA are three additional repeats in a region essential for replication. A locus responsible for plasmid partitioning (parA) and a putative second locus regulating plasmid copy number are part of the origin region and are required for stable plasmid maintenance. PMID- 3290198 TI - DNA sequences of the cysK regions of Salmonella typhimurium and Escherichia coli and linkage of the cysK regions to ptsH. AB - Nucleotide sequences of the cysK regions of Salmonella typhimurium and Escherichia coli have been determined. A total of 3,812 and 2,595 nucleotides were sequenced from S. typhimurium and E. coli, respectively. Open reading frames of 323 codons were found in both species and were identified as those of cysK by comparison of deduced amino acid sequences with amino- and carboxyl-terminal amino acid analyses of the S. typhimurium cysK gene product O-acetylserine (thiol)-lyase A. The two cysK DNA sequences were 85% identical, and the deduced amino acid sequences were 96% identical. The major transcription initiation sites for cysK were found to be virtually identical in the two organisms, by using primer extension and S1 nuclease protection techniques. The -35 region corresponding to the major transcription start site was TTCCCC in S. typhimurium and TTCCGC in E. coli. The deviation of these sequences from the consensus sequence TTGACA may reflect the fact that cysK is subject to positive control and requires the cysB regulatory protein for expression. Sequences downstream of cysK were found to include ptsH and a portion of ptsI, thus establishing the exact relationship of cysK with these two genes. A 290-codon open reading frame, which may represent the cysZ gene, was identified upstream of cysK. PMID- 3290200 TI - Molecular characterization of the hemolysin determinant of Serratia marcescens. AB - The nucleotide sequence of a 7.3-kilobase-pair fragment of DNA encoding a hemolytic activity from Serratia marcescens was determined. Two large open reading frames were identified, designated shlA (Serratia hemolysin) and shlB, capable of encoding polypeptides of 165, 056 and 61,897 molecular weight, respectively. Both reading frames were expressed in vivo. The shlB gene product was localized to the outer membrane of Escherichia coli cells harboring the S. marcescens hemolysin determinant. Consistent with this location, a signallike sequence was identified at the N terminus of the polypeptide predicted from the nucleotide sequence of the shlB gene. Hyperexpression of the shlB locus permitted the identification of two shlB-encoded polypeptides of 65,000 and 62,000 molecular weight, respectively. Determination of the N-terminal amino acid sequence of the purified 62,000-molecular-weight protein confirmed that it was the mature form of the ShlB protein initially synthesized as a precursor (65,000 molecular-weight protein). By using polyclonal antisera raised against the purified proteins, ShlA and ShlB were identified in the outer membrane of S. marcescens. The shlA gene product was shown to interact with erythrocyte membranes, confirming it as the hemolysin proper. Both hemolysis and the interaction of ShlA with erythrocyte membranes did, however, require the ShlB function. Progressive deletion of the C terminus of the ShlA protein gradually reduced hemolytic activity until 37% of the amino acids had been removed. Elimination of 54% of the amino acids produced a nonhemolytic protein which, however, was still capable of associating with erythrocyte membranes. PMID- 3290201 TI - Colicin E8, a DNase which indicates an evolutionary relationship between colicins E2 and E3. AB - Colicin E8-J and its immunity protein were characterized with regard to their activities and gene structures. Colicin E8 is a complex of proteins A and B; protein A (the naked E8) exhibits an apparently nonspecific DNase activity that is inhibited by protein B (the immunity protein), as in the case of colicin E2. The nucleotide sequence of the downstream half of the colicin operon of ColE8-J was determined to be highly homologous to that of ColE2-P9, with the exception of the hot spot region of the 3'-terminal segment of the colicin gene and the adjacent immunity gene. The immE2-like gene of ColE3-CA38 was, as assumed previously, extensively homologous to the immE8 gene of ColE8-J, and thus, ColE8 J was shown to be situated between ColE2-P9 and ColE3-CA38 in the evolution of the E-group Col plasmids. PMID- 3290203 TI - Construction of a fol mutant strain of Escherichia coli for use in dihydrofolate reductase mutagenesis experiments. AB - A strain of Escherichia coli with the fol gene deleted and a kan gene inserted in its place was created for use in cloning and isolation of mutant dihydrofolate reductase. Southern blot analysis and dihydrofolate reductase enzyme assays confirmed the delta fol::kan genotype. A thyA mutation accompanied the fol deletion and is required for survival of a dihydrofolate reductase-deficient strain. PMID- 3290202 TI - Construction of an Escherichia coli K-12 ada deletion by gene replacement in a recD strain reveals a second methyltransferase that repairs alkylated DNA. AB - We constructed an ada deletion by gene replacement in a recD1014 strain of Escherichia coli. Characterization of a delta ada-25 recD+ strain revealed the presence of a second DNA methyltransferase activity in E. coli K-12 which transfers a methyl group from methylated DNA to a protein with a molecular weight of 18,000 to 20,000. PMID- 3290205 TI - Crystals of a trypsin-modified alkaline phosphatase. Preliminary crystallographic characterization. AB - Trypsin-modified alkaline phosphatase from Escherichia coli has been crystallized in a form distinct from the two known crystal forms of the native enzyme. The large well diffracting crystals belong to the orthorhombic space group P2(1)2(1)2(1), possess unit cell dimensions a = 56.0 A, b = 136.0 A, c = 283.9 A with 2 dimers per asymmetric unit, and are suitable for high resolution x-ray crystallographic studies. The observed structural and functional differences between the native and modified molecules are a result of peptide bond cleavage at Arg10-Ala11 with loss of the NH2-terminal decapeptide in both subunits of the dimer. PMID- 3290204 TI - Construction of a minimum-size functional flagellin of Escherichia coli. AB - Various deletions were introduced into the central region of Escherichia coli flagellin (497 residues) without destroying its ability to form flagellar filaments. The smallest flagellin retained only the N-terminal 193 residues and the C-terminal 117 residues, which are suggested to be the domains essential for filament formation. PMID- 3290206 TI - COOH-terminal requirements for the correct processing of a phosphatidylinositol glycan anchored membrane protein. AB - Placental alkaline phosphatase (PLAP) is anchored to the plasma membrane by a phosphatidylinositol-glycan (PI-G) moiety. During processing of nascent PLAP, a 29-residue COOH-terminal peptide is cleaved out and the PI-G moiety is attached to the newly created COOH terminus of the mature protein. To investigate the structural requirements of the COOH terminus of the nascent protein for PI-G tailing and anchoring to the plasma membrane, we have transfected COS cells with wild type and mutant forms of cDNA encoding human prepro-PLAP. Utilizing a series of COOH-terminal deletion mutants of prepro-PLAP, it was found that to be PI-G tailed the newly synthesized protein must possess an uncharged, predominantly hydrophobic amino acid sequence of a minimal length in the COOH-terminal peptide. While forms of prepro-PLAP with 17 consecutive hydrophobic residues in the terminal sequence yielded PI-G-tailed and membrane-bound products, prepro-PLAP mutants with 13 or fewer of such residues yielded hydrophilic proteins that were no longer PI-G-tailed but efficiently secreted into the medium. Studies using cassette mutants demonstrated that the precise amino sequence of the COOH terminal region could be altered as long as minimal hydrophobicity and length was maintained. PMID- 3290207 TI - Localization of the carboxyl terminus of Band 3 to the cytoplasmic side of the erythrocyte membrane using antibodies raised against a synthetic peptide. AB - Polyclonal antibodies were raised in rabbits against a synthetic peptide which corresponds to the 12-amino acid carboxyl-terminal sequence of murine erythrocyte Band 3. Immunoblots of ghost membrane proteins showed that the antibody specifically recognized murine or rat Band 3 but not human or canine Band 3. The antibody also bound to murine ghost membranes applied directly to nitrocellulose but not to human ghost membranes. This shows that the carboxyl terminus of Band 3 is available for antibody binding in ghost membranes and that the carboxyl terminal sequences of human and mouse Band 3 are not identical. The specificity of the antibody for the carboxyl terminus of Band 3 was confirmed by the loss of antibody binding after digestion of detergent-solubilized ghost membrane proteins with carboxypeptidase Y. In addition, carboxyl-terminal fragments of Band 3 generated by protease treatment of cells or ghost membranes were positive on immunoblots while amino-terminal fragments were negative. In contrast, protease treated stripped ghost membranes did not contain a carboxyl-terminal fragment of Band 3 that was detectable on immunoblots. The carboxyl terminus of Band 3 was localized to the cytoplasmic side of the erythrocyte membrane since antibody binding as determined by immunofluorescence occurred in ghosts and permeabilized cells but not in intact cells. In addition, competition studies using enzyme linked immunosorbent assays and immunoblots showed that cells and resealed ghosts competed poorly for antibody compared to ghost membranes, inside-out vesicles, or albumin-conjugated peptide. PMID- 3290208 TI - Two distinct classes of carbohydrate-recognition domains in animal lectins. PMID- 3290209 TI - Estrogen-induced post-transcriptional modulation of c-myc proto-oncogene expression in human breast cancer cells. AB - The effects of estradiol (E2) on c-myc proto-oncogene expression were studied in the estrogen receptor (ER)-positive human breast cancer cell line, MCF-7. A biphasic modulation in c-myc mRNA levels occurs during the first 24 h of E2 (1 nM) exposure and in the absence of changes in MCF-7 culture growth, with transcript levels rising 4-6-fold within 1 h, returning to near base-line level after 3-6 h, and increasing again after 24 h of exposure. In contrast, the growth inhibiting antiestrogen, tamoxifen (1 microM), reduces c-myc to 20% of the pretreatment level within 3-6 h of exposure, and this early decline is followed by a gradual return toward base-line level after continuous 72-h treatment. In ER negative cells there is no change in c-myc expression following E2 exposure. MCF 7 nuclear runon assays show that c-myc transcription rates remain unchanged from base line for 24 h after E2 administration; as well, cycloheximide inhibition of protein synthesis superinduces c-myc expression and prevents E2 modulation of transcript levels. These results indicate that post-transcriptional modulation of c-myc by E2 is mediated by a labile degradative protein or otherwise dependent on active protein synthesis. We also developed MCF/nm and MCF/dm sublines by transfecting normal cells with human c-myc exons 2-3, transcriptionally driven by a retroviral long terminal repeat. Expression of the transfected c-myc genes in these sublines remains constant and elevated 10-fold, while transcript levels from the endogenous proto-oncogene continue to be modulated by E2. These findings suggest that in ER-positive breast cancer cells, E2 can modulate c-myc mRNA levels by a post-transcriptional mechanism that depends on gene sequences upstream from c-myc exon 2. PMID- 3290210 TI - Structure and bactericidal activity of an antibiotic dodecapeptide purified from bovine neutrophils. AB - Cytoplasmic granules of neutrophils store a variety of cationic polypeptides, which exert in vitro a potent antibacterial action and are potentially involved in host defense mechanisms. From an acid extract of bovine neutrophil granules we have purified over 2,000-fold a dodecapeptide exhibiting bactericidal activity against both Escherichia coli and Staphylococcus aureus at 10(-7)-10(-5) M concentration. The purification procedure involved only two steps of ion-exchange and reversed-phase chromatography. The peptide, named bactenecin, has the amino acid sequence, Arg-Leu-Cys-Arg-Ile-Val-Val-Ile-Arg-Val-Cys-Arg, maintained in a cyclic structure by a disulfide bond between the two cysteine residues. Computer modeling of the dodecapeptide resulted in a conformation in which the chain adopts an antiparallel extended structure forming a gamma turn at residue 7. PMID- 3290211 TI - Kinetic evidence for a critical rate of protein synthesis in the Saccharomyces cerevisiae yeast cell cycle. AB - The kinetics of cell cycle initiation were measured at pH 2.7 for cells that had been arrested at the "start" step of cell division with the polypeptide pheromone alpha-factor. Cell cycle initiation was induced by the removal of alpha-factor. The rate at which cells completed start was identical to the rate of subsequent bud emergence. After short times of prearrest with alpha-factor (e.g. 5.2 h), the kinetics of bud emergence were biphasic, indicative of two subpopulations of cells that differed by greater than 10-fold in their rates of cell cycle initiation. The subpopulation that exhibited a slow rate of cell cycle initiation is comprised of cells that resided in G1 prior to start at the time of removal of alpha-factor, whereas the subpopulation that initiated the cell cycle rapidly is comprised of cells that had reached and become blocked at start. A critical concentration of cycloheximide was found to reintroduce slow budding cells into a population of 100% fast budding cells, suggesting that the two subpopulations differ with respect to attainment of a critical rate of protein synthesis that is necessary for the performance of start. Cycloheximide and an increase in the time of prearrest with alpha-factor had opposite effects on both the partitioning of cells between the two subpopulations and the net rate of protein synthesis per cell, consistent with this conclusion. Cell cycle initiation by the subpopulation of fast budding cells required protein synthesis even though the critical rate of protein synthesis had been achieved during arrest. It is concluded that alpha factor inhibits the synthesis of and/or inactivates specific proteins that are required for the performance of start, but alpha-factor does not prevent attainment of the critical rate of protein synthesis. PMID- 3290212 TI - Interaction of monoclonal antibodies with alpha-bungarotoxin and (-)-nicotine binding sites in goldfish brain. Identification of putative nicotinic acetylcholine receptor subtypes. AB - Monoclonal antibodies raised against the nicotinic acetylcholine receptor of Electrophorus electricus electroplaque have been used as probes to characterize putative nicotinic acetylcholine receptors in goldfish brain. One monoclonal antibody (mAb), mAb 47, recognized a protein which binds both (-)-[3H]nicotine and 125I-alpha-bungarotoxin with high affinity. Another monoclonal antibody (mAb 172) recognized a protein which binds (-)-[3H]nicotine but not 125I-alpha bungarotoxin. Both antibodies precipitated a protein(s) (biosynthetically labeled with [35S]methionine) in the absence, but not in the presence, of excess purified nicotinic acetylcholine receptor from Torpedo nobiliana. The dilution of mAb 47 that precipitated half of the maximum amount of 125I-alpha-bungarotoxin binding protein was the same as that which precipitated half of the maximum amount of (-) [3H]nicotine binding activity. When used in combination, the two antibodies precipitated more (-)-[3H]nicotine radioactivity than either antibody alone. The (-)-[3H]nicotine and 125I-alpha-bungarotoxin binding component-mAb complexes were characterized by sucrose density centrifugation. In the presence of either mAb 172 or 47, the (-)-[3H] nicotine binding component migrated further into the gradient, but only mAb 47 shifted the 125I-alpha-bungarotoxin peak. Incubation of solubilized brain extract with alpha-bungarotoxin-coupled Sepharose reduced the amount of (-)-[3H]nicotine radioactivity precipitated by mAb 47 but not by mAb 172. These data suggest that the antibodies may recognize distinct subtypes of ( )-nicotine binding sites in goldfish brain, one subtype which binds both 125I alpha-bungarotoxin and (-)-[3H]nicotine and a second subtype which binds only (-) [3H] nicotine. PMID- 3290213 TI - Conformational changes in the chicken receptor for endocytosis of glycoproteins. Modulation of ligand-binding activity by Ca2+ and pH. AB - Limited proteolysis, gel filtration, and circular dichroism have been used to identify at least three distinct conformational states of a proteolytic fragment containing the ligand-binding domain of the chicken receptor for endocytosis of glycoproteins. Differences in the ligand-binding activity of intact receptor brought about by changing Ca2+ concentrations and pH values can be correlated with different physical states of the binding domain present under similar conditions. An active, ligand-binding state can be detected at either pH 7.8 or 5.4, but 10-fold higher concentrations of Ca2+ are required to stabilize this state at the lower pH. In all cases, the dependence on Ca2+ concentration is second-order, suggesting that two Ca2+ ions are bound to each domain. These studies demonstrate an interdependence between the effects of Ca2+ concentration and pH on both ligand-binding activity and receptor conformation, which is important to consider when describing the binding and dissociation of ligand during endocytosis. PMID- 3290214 TI - Purification and characterization of a peptidoglycan-associated lipoprotein from Haemophilus influenzae. AB - We have purified to homogeneity a peptidoglycan-associated protein from Haemophilus influenzae. Our purification process used differential extraction of cell envelopes with nondenaturing detergents. Solubilization of this protein was accomplished by heating a peptidoglycan-enriched subcellular fraction in the presence of one of several nondenaturing detergents at 55-60 degrees C. The purified protein migrated as a single band, with a Mr approximately 15,000, following sodium dodecyl sulfate-polyacrylamide gel electrophoresis. This protein contains covalently linked fatty acids, is rich in tyrosine, but lacks methionine and tryptophan. Amino acid analysis also revealed the presence of glycerylcysteine, which has been shown to be the site of fatty acylation in other bacterial lipoproteins. Over 87% of the primary structure has been determined by sequencing high pressure liquid chromatography purified fragments derived from several endoproteinase digests. This protein belongs to a family of proteins, known as peptidoglycan associated lipoproteins, which appear to be components of the outer membranes of most Gram-negative bacteria. PMID- 3290215 TI - Disulfide linkage of the zeta and eta chains of the T cell receptor. Possible identification of two structural classes of receptors. AB - The T cell antigen receptor (TCR) is a multisubunit membrane complex. It consists of two disulfide-linked polymorphic chains (either alpha-beta or gamma-delta heterodimers) which are noncovalently linked to five invariant chains. The CD3 gamma and CD3-delta chains bear N-linked carbohydrates and the CD3-epsilon and zeta chains are nongly-cosylated. Further analysis of the zeta chain in murine T cells demonstrates that it can exist as either a homodimer or disulfide linked to an additional protein with an apparent Mr of 22,000. The partial peptide map of this 22-kDa protein is different than zeta and all of the CD3 components. Like zeta, it has no apparent N-linked carbohydrate chains. We have chosen to refer to this subunit as the eta chain of the TCR. Ninety percent of zeta in cloned and nonclonal populations of T cells exist as a homodimer, and the remainder is found linked to the eta chain. The tight regulation of the zeta-zeta to zeta-eta ratio suggests an important functional role for these structural components of the TCR. PMID- 3290216 TI - Characterization of the binding of alpha-bungarotoxin to bacterially expressed cholinergic binding sites. AB - Bacterially expressed cDNA fragments of the alpha-subunit of the nicotinic acetylcholine receptor previously have been shown to bind alpha-bungarotoxin (Gershoni, J. M. (1987) Proc. Natl. Acad. Sci. U. S. A. 84, 4318-4321). Here, a novel system has been developed in which totally synthetic alpha-bungarotoxin binding sites are expressed in Escherichia coli transformants. The amino acid sequences, alpha 184-200 and alpha 184-196 of the Torpedo californica alpha subunit of the nicotinic acetylcholine receptor were expressed as trpE fusion proteins via the expression vector pATH2 and a method for the enrichment of these fusion proteins is described. Quantitative analysis of toxin binding to the recombinant binding sites demonstrates that they bind toxin with affinities of KD = 2.5 X 10(-7) and 4.7 X 10(-6) M, respectively. Furthermore, the pharmacological profile of alpha 184-200 qualitatively reflects that of the intact receptor. These data not only indicate that the area of alpha 184-200 is an essential element of the cholinergic binding site but that residues alpha 197-200 contribute a point of contact between the receptor and alpha-bungarotoxin. PMID- 3290217 TI - Regulation of H2a-specific proteolysis by the histone H3:H4 tetramer. AB - We have studied the limited cleavage of H2a in the H2a:H2b histone dimer by the H2a-specific protease under physiological conditions (neutral pH, 0.1 M NaCl) using a variety of histone-DNA reconstitutes as substrates and/or regulators of the partially purified enzyme. Under these conditions the protease cleaves H2a in "native" dimer-DNA reconstitutes but not in "native" octamer-DNA reconstitutes. Treatment of the enzyme with saturating amounts of H3:H4 tetramer-DNA prior to addition of dimer-DNA substrate results in complete inhibition of H2a-specific proteolysis. Sucrose gradient sedimentation experiments indicate that the protease binds reversibly to tetramer-DNA and that this leads to the reversible inhibition of enzymatic activity. Using three different tetramer-DNA complexes, we found native tetramer-DNA to be a more effective inhibitor than either trypsin treated tetramer-DNA or acetylated tetramer-DNA. We conclude that under physiological conditions, the H2a-specific protease binds primarily to the highly basic amino-terminal domain of the H3:H4 tetramer, and this binding lowers the effective concentration of enzyme available to cleave H2a. Although no cleaved H2a is produced when protease is mixed with native octamer-DNA, incubation of the enzyme with acetylated octamer-DNA results in H2a-specific proteolysis. This is the first demonstration that the H2a-specific protease activity can be modulated by a physiologically relevant process (e.g. histone acetylation). We propose that the sequestered protease may be functionally regulated in vivo through reversible post-translational modifications to the NH2-terminal domains of the histone H3:H4 tetramer. PMID- 3290219 TI - Artificial intelligence systems (expert systems) as diagnostic consultants for the cytologic and histologic diagnosis of cancer. Report from the Second International Conference, March 13-15, 1988, Chicago, Illinois. PMID- 3290218 TI - Early processing of prothrombin and factor X by the vitamin K-dependent carboxylase. AB - Binding interactions between the membrane-associated vitamin K-dependent carboxylase and its prothrombin and factor X substrates have been investigated in liver microsomes. Both substrates are firmly attached to microsomal membrane fragments which also harbor the carboxylase. In vitro 14CO2 gamma-carboxylation of these substrates, triggered by reduced vitamin K1H2, resulted in release of 14C-labeled prothrombin precursors from the membrane fragments, but no release of 14C-labeled factor X precursors could be demonstrated, which suggested a difference in early processing of these substrates by the carboxylase. Warfarin treatment of rats resulted in a 3-fold increase in the membrane concentration of factor X antigens and a 20-fold increase in 14C gamma-carboxylation of the membrane pool of factor X carboxylase substrates. There was a dose-response relationship between the amount of drug administered to the rats and 14C labeling of the membrane pool of factor X carboxylase substrates. On the other hand, the membrane concentration of prothrombin antigens did not increase in response to the drug, and 14CO2 gamma-carboxylation of the membrane pool of prothrombin carboxylase substrates was the same in warfarin and saline-treated rats. The results demonstrate significant differences in the interaction between the carboxylase and its prothrombin and factor X substrates. It appears that the different interactions result from binding of the prothrombin and the factor X precursors to separate microsomal membrane proteins that are involved in the gamma-carboxylation reaction. Warfarin appears to induce the factor X precursor specific but not the prothrombin precursor-specific binding proteins, which suggests a new mechanism for the action of warfarin. These binding proteins may be under different genetic control. Treatment of the prothrombin and the factor X carboxylase substrates with endonuclease H showed that the rat prothrombin and the human factor X carboxylase substrates are high mannose glycoproteins. The human prothrombin and the rat factor X carboxylase substrates did not, on the other hand, change their migration in sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels after endonuclease H treatment. The data demonstrate differences in the glycoprotein nature of the rat and the human carboxylase substrates. PMID- 3290220 TI - Signal and membrane anchor functions overlap in the type II membrane protein I gamma CAT. AB - I gamma CAT is a hybrid protein that inserts into the membrane of the endoplasmic reticulum as a type II membrane protein. These proteins span the membrane once and expose the NH2-terminal end on the cytoplasmic side and the COOH terminus on the exoplasmic side. I gamma CAT has a single hydrophobic segment of 30 amino acid residues that functions as a signal for membrane insertion and anchoring. The signal-anchor region in I gamma CAT was analyzed by deletion mutagenesis from its COOH-terminal end (delta C mutants). The results show that the 13 amino acid residues on the amino-terminal side of the hydrophobic segment are not sufficient for membrane insertion and translocation. Mutant proteins with at least 16 of the hydrophobic residues are inserted into the membrane, glycosylated, and partially proteolytically processed by a microsomal protease (signal peptidase). The degree of processing varies between different delta C mutants. Mutant proteins retaining 20 or more of the hydrophobic amino acid residues can span the membrane like the parent I gamma CAT protein and are not proteolytically processed. Our data suggest that in the type II membrane protein I gamma CAT, the signals for membrane insertion and anchoring are overlapping and that hydrophilic amino acid residues at the COOH-terminal end of the hydrophobic segment can influence cleavage by signal peptidase. From this and previous work, we conclude that the function of the signal-anchor sequence in I gamma CAT is determined by three segments: a positively charged NH2 terminus, a hydrophobic core of at least 16 amino acid residues, and the COOH-terminal flanking hydrophilic segment. PMID- 3290221 TI - A novel marker glycoprotein for the microvillus membrane of surface colonocytes of rat large intestine and its presence in small-intestinal crypt cells. AB - Murine mAbs were produced against purified microvillus membranes of rat colonocytes in order to establish a marker protein for this membrane. The majority of antibodies binding to the colonic microvillus membrane recognized a single protein with a mean apparent Mr of 120 kD in both proximal and distal colon samples. The antigen is membrane bound as probed by phase-partitioning studies using Triton X-114 and by the sodium carbonate extraction procedure and is extensively glycosylated as assessed by endoglycosidase F digestion. Localization studies in adult rats by light and electron microscopy revealed the microvillus membrane of surface colonocytes as the principal site of the immunoreaction. The antigen was not detectable in kidney or liver by immunoprecipitation but was present in the small intestine, where it was predominantly confined to the apical membrane of crypt cells and much less to the microvillus membrane of differentiated enterocytes. During fetal development, the antigen appears first in the colon at day 15 and 1-2 d later in the small intestine. In both segments, it initially covers the whole luminal surface but an adult-like localization pattern develops soon after birth. The antibodies were also used to develop a radiometric assay for the quantification of the antigen in subcellular fractions of colonocytes in order to assess the validity of a previously developed method for the purification of colonic brush-border membranes (Stieger, B., A. Marxer, and H.P. Hauri. 1986. J. Membr. Biol. 91:19 31.). The results suggest that we have identified a valuable marker glycoprotein for the colonic microvillus membrane, which in adult rats may also serve as a marker for early differentiation of enterocyte progenitor cells in small intestinal crypt cells. PMID- 3290222 TI - Regulation of actin microfilament integrity in living nonmuscle cells by the cAMP dependent protein kinase and the myosin light chain kinase. AB - Microinjection of the catalytic subunit of cAMP-dependent protein kinase (A kinase) into living fibroblasts or the treatment of these cells with agents that elevate the intracellular cAMP level caused marked alterations in cell morphology including a rounded phenotype and a complete loss of actin microfilament bundles. These effects were transient and fully reversible. Two-dimensional gel electrophoresis was used to analyze the changes in phosphoproteins from cells injected with A-kinase. These experiments showed that accompanying the disassembly of actin microfilaments, phosphorylation of myosin light chain kinase (MLCK) increased and concomitantly, the phosphorylation of myosin P-light chain decreased. Moreover, inhibiting MLCK activity via microinjection of affinity purified antibodies specific to native MLCK caused a complete loss of microfilament bundle integrity and a decrease in myosin P-light chain phosphorylation, similar to that seen after injection of A-kinase. These data support the idea that A-kinase may regulate microfilament integrity through the phosphorylation and inhibition of MLCK activity in nonmuscle cells. PMID- 3290223 TI - Diverse effects of beta-tubulin mutations on microtubule formation and function. AB - We have used in vitro mutagenesis and gene replacement to construct five new cold sensitive mutations in TUB2, the sole gene encoding beta-tubulin in the yeast Saccharomyces cerevisiae. These and one previously isolated tub2 mutant display diverse phenotypes that have allowed us to define the functions of yeast microtubules in vivo. At the restrictive temperature, all of the tub2 mutations inhibit chromosome segregation and block the mitotic cell cycle. However, different microtubule arrays are present in these arrested cells depending on the tub2 allele. One mutant (tub2-401) contains no detectable microtubules, two (tub2 403 and tub2-405) contain greatly diminished levels of both nuclear and cytoplasmic microtubules, one (tub2-104) contains predominantly nuclear microtubules, one (tub2-402) contains predominantly cytoplasmic microtubules, and one (tub2-404) contains prominent nuclear and cytoplasmic microtubule arrays. Using these mutants we demonstrate here that cytoplasmic microtubules are necessary for nuclear migration during the mitotic cell cycle and for nuclear migration and fusion during conjugation; only those mutants that possess cytoplasmic microtubules are able to perform these functions. We also show that microtubules are not required for secretory vesicle transport in yeast; bud growth and invertase secretion occur in cells which contain no microtubules. PMID- 3290224 TI - Generation of antisera that discriminate among mammalian alpha-tubulins: introduction of specialized isotypes into cultured cells results in their coassembly without disruption of normal microtubule function. AB - To assay the functional significance of the multiple but closely related alpha tubulin polypeptides that are expressed in mammalian cells, we generated three specific immune sera, each of which uniquely recognizes a distinct alpha-tubulin isotype. All three isotypes are expressed in a tissue-restricted manner: one (M alpha 3/7) only in mature testis, one (M alpha 4) mainly in muscle and brain, and the third (M alpha 6) in several tissues at a very low level. A fourth specific antiserum was also generated that distinguishes between the tyrosinated and nontyrosinated form of a single alpha-tubulin isotype. Because individual tubulin isotypes cannot be purified biochemically, these sera were raised using cloned fusion proteins purified from host Escherichia coli cells. To suppress the immune response to shared epitopes, animals were first rendered tolerant to fusion proteins encoding all but one of the known mammalian alpha-tubulin isotypes. Subsequent challenge with the remaining fusion protein then resulted in the elicitation of an immune response to unique epitopes. Three criteria were used to establish the specificity of the resulting sera: (a) their ability to discriminate among cloned fusion proteins representing all the known mammalian alpha-tubulin isotypes; (b) their ability to uniquely detect alpha-tubulin in whole extracts of tissues; and (c) their capacity to stain microtubules in fixed preparations of cells transfected with sequences encoding the corresponding isotype. The transfection experiments served to demonstrate (a) the coassembly of M alpha 3/7, M alpha 4, and M alpha 6 into both interphase and spindle microtubules in HeLa cells and NIH 3T3 cells, and (b) that the M alpha 4 isotype, which is unique among mammalian alpha-tubulins in that it lacks an encoded carboxy-terminal tyrosine residue, behaves like other alpha-tubulin isotypes with respect to the cycle of tyrosination/detyrosination that occurs in most cultured cells. PMID- 3290225 TI - Complex regulation and functional versatility of mammalian alpha- and beta tubulin isotypes during the differentiation of testis and muscle cells. AB - In the accompanying paper (Gu, W., S. A. Lewis, and N. J. Cowan. 1988. J. Cell Biol. 106: 2011-2022), we report the generation of three antisera, each of which uniquely recognizes a different mammalian alpha-tubulin isotype, plus a fourth antibody that distinguishes between microtubules containing the tyrosinated and nontyrosinated form of the only known mammalian alpha-tubulin gene product that lacks an encoded carboxy-terminal tyrosine residue. These sera, together with five sera we raised that distinguish among the known mammalian beta-tubulin isotypes, have been used to study patterns of tubulin isotype-specific expression in muscle and testis, two tissues in which characteristic developmental changes are accompanied by dramatic rearrangements in microtubule structures. As in the case of cells in culture, there is no evidence to suggest that there is subcellular sorting of different tubulin isotypes among different kinds of microtubule, even in a cell type (the developing spermatid) that simultaneously contains such functionally distinct structures as the manchette and the flagellum. On the other hand, the patterns of expression of the various tubulin isotypes show marked and distinctive differences in different cell types and, in at least one case, evidence is presented for regulation at the translational or posttranslational level. The significance of these observations is discussed in terms of the existence of the mammalian alpha- and beta-tubulin multigene families. PMID- 3290227 TI - [Sexual function and aortoiliac reconstructive surgery]. AB - In this study of 52 patients aged between 32 and 60 years, maintenance or restoration of sexual function during aorto-iliac surgery represented a usually non-priority but certainly desirable objective. Aspects studied were: place of crossed bypass and of endarterectomy-type of aorto-prosthesis anastomosis: end-to end or end-to-side - routine or non-routine reimplantation of a hypogastric artery. Results in this series showed a lack of advantage from the sexual point of view for end-to-side over end-to-end surgery; hypogastric reimplantation offers a supplementary guarantee of efficacy but should not be performed routinely; crossed bypass operations are certainly interesting solutions in young patients. Endarterectomy should not be rejected as a matter of principle but with respect to sexual function its indications should be reserved for cases not requiring extensive dissection of arterial axes. PMID- 3290226 TI - Mitosis-inducing factors are present in a latent form during interphase in the Xenopus embryo. AB - During the conversion to the mitotic state, higher eukaryotic cells activate a cascade of reactions which result in the disintegration of the nuclear envelope, the condensation of the DNA into chromosomes, and the reorganization of the cytoskeleton. In Xenopus, the induction of the mitotic state appears to be under the control of a cytoplasmic factor(s) known as mitosis-promoting factor or MPF. We have developed a rapid and highly sensitive version of an in vitro assay for MPF. The assay uses reconstituted nuclei in interphase cytoplasm from activated Xenopus eggs. The MPF-induced conversion from interphase to mitosis is conveniently monitored by the visual observation of the loss of the nuclear envelope from the substrate nuclei. At near saturating concentrations of MPF, nuclear breakdown requires 20-30 min. Preincubation experiments have revealed that the action of MPF requires only a few minutes and that the disassembly process itself takes up the remainder of the incubation period. Using this cell free system, we have investigated the observation that protein synthesis is required for the progression through each successive mitotic cycle in the developing Xenopus embryo. A simple explanation for this finding would be that MPF is degraded after each mitosis and then resynthesized before the next mitotic cycle. However, using in vitro reactivation experiments, we have found that MPF is present in a latent, inactive form during interphase. These results suggest that the block in the cell cycle induced by inhibitors of protein synthesis is due to the lack of production of an activator of MPF. PMID- 3290228 TI - [Spontaneous regression of pulmonary metastasis of cancer of the kidney. Apropos of a case occurring after the irradiation of a pelvic metastasis. Review of the literature]. AB - Spontaneous regression of metastases from cancer of kidney is an exceptional event, original but non-specific to this neoplasm. Observed principally in secondary pulmonary localizations this phenomenon occurs most frequently after nephrectomy. A personal case is presented of regression of pulmonary images considered as being metastatic after irradiation of a pelvic metastasis from renal adenocarcinoma, and a literature review carried out. The various pathogenic hypotheses are discussed and the place of nephrectomy for metastatic renal cancer (Robson's stage IV) debated. PMID- 3290229 TI - [Intraperitoneal textiloma. Apropos of 5 cases]. AB - Five cases of foreign textile bodies left in the peritoneal cavity are reviewed the corpus delictus was an abdominal field packing in 4 cases (in 1 case 2 packings were involved), and in one case a compress. The 5th patient, operated upon in the department, presented a delayed pseudo-tumoral picture after a course of 4 years. The 4 cases referred from another department presented signs of sepsis identified at an early stage. Etiologic, clinical, diagnostic and prophylactic aspects are reviewed. PMID- 3290231 TI - [Trans-sutural anastomosis. A technical procedure which facilitates the low colorectal anastomosis]. AB - How colorectal anastomosis using a circular suture forceps introduced transanally can be considerably facilitated by the "trans-sutural" anastomosis technique, this avoiding the sometimes difficult operative phase of the distal bursa and allowing reduction of septic phase and performance of anastomosis of surfaces of identical caliber. Crossing of clipping lines, of linear and circular shape, resulting from use of this method lacks any inconveniences. Results are reported in 66 patients treated in this way, confirming the reliability of this type of anastomosis. PMID- 3290230 TI - [Multiple hydatid cyst of the liver: indication for a conservative treatment in uncomplicated univesicular localizations. Apropos of 19 cases]. AB - Results are reported of treatment of multiple hydatid cysts of liver in 19 patients (63 cysts) between 1981 and 1985. The relative frequency and severity of forms of multiple localization are emphasized as well as particular features related to extra-hepatic abdominal localizations. Diagnosis is assisted by ultrasound and particularly CT scan imaging in multiple forms. Since surgical excision remains the only potentially curative treatment for hydatid cyst, conservative therapy by puncture-sterilization and aspiration, with or without combined medical treatment, can be proposed when certain localizations make conventional surgery difficult and dangerous for vital prognosis. PMID- 3290232 TI - Direct separation of drug enantiomers by high-performance liquid chromatography with chiral stationary phases. AB - The development of chiral stationary phases for HPLC has resulted in renewed interest in methods for the separation of drug enantiomers. This paper provides a brief overview of some of the more recent approaches to the direct resolution of drug enantiomers by HPLC with particular emphasis on their quantification in biological fluids. PMID- 3290233 TI - Test-of-cure stool cultures for traveler's diarrhea. AB - Whether enteropathogens were eradicated or persisted in test-of-cure stool cultures from 251 patients with traveler's diarrhea, the durations of diarrhea were similar within the antimicrobial agent-treated (32 versus 33 h) and placebo treated (82 versus 96 h) groups. Routine test-of-cure stool cultures can be useful for evaluating treatment failures and for assessing asymptomatic carriage of enteropathogens after treatment, but they are not mandated in the design of placebo-controlled antimicrobial treatment trials in traveler's diarrhea when the focus of the trial is clinical efficacy. PMID- 3290234 TI - Laboratory findings in four cases of adult botulism suggest colonization of the intestinal tract. AB - There was laboratory evidence of intestinal colonization in four cases of adult botulism confirmed by the Centers for Disease Control. No performed toxin was detected in available foods, but Clostridium botulinum was isolated from foods in two instances. Botulinal toxin was detected in the sera of all four patients, in one case at 47 days after ingestion of suspected food. C. botulinum was demonstrated in the stool of all four patients and persisted for 119 days after the onset of illness in one patient. Two patients had surgical alterations of the gastrointestinal tract, which may have promoted the colonization. The apparent lack of ingestion of performed toxin in these cases and the persistence of botulinal toxin or C. botulinum, or both, for long periods in three of the patients suggest that colonization of the intestinal tract occurred. PMID- 3290235 TI - Rapid characterization of oral and nonoral pigmented Bacteroides species with the ATB Anaerobes ID system. AB - The ATB Anaerobes ID system (API SYSTEM, La Balme Les Grottes, France) was evaluated for its ability to differentiate between species of the pigmented Bacteroides group. This identification system is based on the degradation of chromogenic substrates in combination with sugar fermentation reactions. The results showed that the ATB system can be useful for differentiation between the 10 pigmented Bacteroides species. However, additional tests may be necessary. PMID- 3290236 TI - Homogeneous liposome lysis assay for determination of anti-streptolysin O antibody titer in serum. AB - We developed a liposome lysis assay for determining anti-streptolysin O antibodies (ASO) in human sera involving the use of carboxyfluorescein-entrapped multilamellar liposomes. This assay system was based on the inhibition of streptolysin O-induced liposome lysis by ASO. Briefly, after incubation of a given amount of streptolysin O with ASO for 30 min at 37 degrees C, carboxyfluorescein-entrapped liposomes composed of egg yolk phosphatidylcholine and cholesterol in a molar ratio of 1:1 were added to the mixture to determine the residual streptolysin O activity. Liposome lysis, detected as carboxyfluorescein release from the liposomes, was inversely proportional to the ASO titer. The results of within-run and between-run precision studies indicated that the liposome lysis assay is accurate and gives reproducible data. Bilirubin, hemoglobin, and triglycerides did not interfere with the liposome lysis assay. The ASO titers of 100 patient sera, evaluated by our new method and the Rantz Randall method, showed good correlation. PMID- 3290237 TI - Detection of an immunoglobulin M response in the elderly for early diagnosis of respiratory syncytial virus infection. AB - The indirect fluorescent-antibody technique was compared with indirect and mu capture enzyme-linked immunosorbent assays for the detection of respiratory syncytial virus (RSV) immunoglobulin M (IgM) in the elderly. Sera from 47 patients (mean age, 70 years) with acute lower respiratory tract infections caused by RSV were investigated. Specific IgM was detected in 81% (38 of 47) of the patients. The fluorescent-antibody technique, which gave 70% positive results, proved to be the most sensitive of the three methods. An IgM response was seldom seen in sera from the elderly within the first week of disease, but was present in 85% of sera (33 of 39) collected between days 11 and 30 of disease. In some patients it persisted for more than 6 weeks. Detection of IgM was found to be a useful tool for the diagnosis of RSV infections in elderly patients. PMID- 3290238 TI - Variation of electrophoretic karyotypes among clinical isolates of Candida albicans. AB - Orthogonal-field-alternation gel electrophoresis was used to compare clinical isolates of Candida albicans by resolving chromosome-sized DNA molecules into an electrophoretic karyotype. Seven to nine bands were observed among isolates recovered from 17 patients. In addition, 14 distinct electrophoretic patterns were noted among the isolates from these patients. In a given individual, isolates were likely to have identical electrophoretic patterns. Therefore, the electrophoretic karyotype patterns demonstrated by orthogonal-field-alternation gel electrophoresis can be used to designate a strain for epidemiologic studies. PMID- 3290239 TI - The urinary bladder, a consistent source of Borrelia burgdorferi in experimentally infected white-footed mice (Peromyscus leucopus). AB - White-footed mice, Peromyscus leucopus, were experimentally infected in the laboratory with Borrelia burgdorferi, the causative agent of Lyme disease. After mice were infected by intraperitoneal or subcutaneous inoculation or by tick bite, attempts were made to culture spirochetes from the urinary bladder, spleen, kidney, blood, and urine. Spirochetes were most frequently isolated from the bladder (94%), followed by the kidney (75%), spleen (61%), and blood (13%). No spirochetes were isolated from the urine. Tissue sectioning and immunofluorescence staining of the urinary bladder demonstrated spirochetes within the bladder wall. The results demonstrate that cultivation of the urinary bladder is very effective at isolating B. burgdorferi from experimentally infected white-footed mice and that culturing this organ may be productive when surveying wild rodents for infection with this spirochete. PMID- 3290240 TI - Antigen(s) responsible for immunoglobulin G responses specific for the acute stage of Toxoplasma infection in humans. AB - An agglutination test for immunoglobulin G (IgG) Toxoplasma antibodies with acetone-fixed tachyzoites (AC antigens; AC agglutination test) was positive only with sera from patients during the acute stage of their infection. In contrast, when the test was performed with Formalin-fixed tachyzoites (HS antigens; HS agglutination test), positive results were obtained during both the acute and chronic (latent) stages of the infection. Studies were performed to define the antigen(s) of T. gondii which are detected by IgG antibodies present only during the acute stage of the infection. Sera of mice immunized with AC antigens recognized predominantly 10 antigens of tachyzoites by immunoblot analysis. Sera from individuals with the acute but not chronic infection reacted strongly with these same 10 antigens in immunoblots. Sera of mice immunized with HS antigens recognized more Toxoplasma antigens on immunoblots than did mouse AC antibodies. Absorption of the latter with HS antigens removed detectable reactivity of AC antibodies in immunoblots and in the AC and HS agglutination tests, suggesting that AC antigens are a selected portion of HS antigens. AC antigens were specific for tachyzoites in that AC antibodies reacted with the cell membranes of both forms of the organism in an indirect fluorescent-antibody test. Tachyzoite specific antigen(s) appear to be useful in differentiating between the acute and chronic stages of Toxoplasma infection through their detection by IgG antibodies. PMID- 3290241 TI - Characterization of enteroinvasive Escherichia coli strains isolated from children with diarrhea in Chile. AB - Analysis of stool samples from 912 cases of diarrhea among Chilean infants and 1,112 controls resulted in the isolation of 17 enteroinvasive Escherichia coli (EIEC) strains from diarrhea cases (1.9%) and 3 EIEC from the asymptomatic controls (0.3%). Biochemical analysis of the 20 isolates showed variability among them. However, the majority were lysine decarboxylase negative and nonmotile and utilized sodium acetate. The strains belonged to the O groups 28ac, 124, 143, or 144 or were untypable with the antisera used. Most of them had conjugative plasmids which mediated multiple antibiotic resistance. There was a strong correlation in this group of strains between a positive Sereny test, the presence of a plasmid of 120 megadaltons, and hybridization with the invasiveness probe, an HindIII fragment derived from the plasmid pPS15A. The isolates had a wide range of plasmid profiles. Bioassays and colony and Southern hybridization tests with iron uptake DNA probes indicated that 80% of the EIEC strains produced aerobactin and expressed its receptor, the genes for which are known to be chromosomally located. PMID- 3290243 TI - Detection of respiratory syncytial virus antigen in nasopharyngeal secretions by Abbott Diagnostics enzyme immunoassay. AB - We compared a rapid respiratory syncytial virus (RSV) antigen enzyme immunoassay (EIA) (Abbott Diagnostics, North Chicago, Ill.) with virus culture and with the indirect fluorescent-antibody test (FAT) by using nasopharyngeal washings from children with suspected RSV pneumonia or bronchiolitis. Fresh washings were used in all three tests. Specimens were inoculated into HEp-2 cells and human embryonic lung fibroblasts and observed for cytopathic effect. Cells in the centrifuged sediments of the nasal washes were examined for typical cytoplasmic fluorescence of RSV by FAT. The EIA cutoff was an optical density (OD) at 492 nm that was greater than the mean OD of the negative controls plus 0.1. An OD within +20% of the cutoff was considered borderline, and these specimens were retested. Of 289 specimens, 118 (41%) were positive by culture, 150 (52%) were positive by FAT, and 154 (53%) were positive by EIA. Eight borderline EIAs were all negative when the specimens were retested after storage at -70 degrees C. Of 17 specimens positive by EIA but negative by culture and FAT, 9 were blocked in a competitive EIA, indicating that they were true-positives and that the culture and FAT were falsely negative. The sensitivity, specificity, and predictive value (positive) of the EIA versus culture, FAT, or blocking assay were 90, 94, and 95%, respectively. We conclude that the Abbott RSV antigen EIA is highly sensitive and specific. PMID- 3290242 TI - Comparison of two GM1-erythrocyte assays to detect heat-labile Escherichia coli enterotoxin in stool specimens. AB - Two erythrocyte immunoassay techniques to detect the presence of Escherichia coli heat-labile enterotoxin (LTh) in stool supernatants and cell-free culture supernatants were compared. In the competitive assay, GM1 ganglioside was coated onto V-shaped-well microdilution plates and enterotoxin was coupled to sheep erythrocytes. As little as 0.8 ng of LTh per ml was detected by this method, which was based on the competition between the LTh of the test sample and the sensitized erythrocytes. The second assay made use of chimera antibody prepared by coupling polyclonal anti-LTh antibody to a monoclonal antibody specific for sheep erythrocytes. In this case, LTh, which was specifically bound to a GM1 ganglioside-coated plate, was detected by successively adding the chimera antibody and sheep erythrocytes. The limit of detection of the chimera antibody erythrocyte immunoassay was 0.2 ng/ml. Stool samples were collected from 167 infants hospitalized for diarrhea in the hospital of Noumea, New Caledonia. False negative reactions due to proteases present in the stool samples were avoided by the addition of phenylmethylsulfonyl fluoride. PMID- 3290244 TI - Biophysical optima for metabolism of Mycobacterium leprae. AB - The metabolic response of freshly harvested, nude-mouse-derived Mycobacterium leprae to biophysical parameters was studied to facilitate an understanding of axenic culture requirements. Quantitation of intracellular ATP and the rate of [U 14C]palmitic acid incorporation into phenolic glycolipid I (PGL-I) were used as metabolic indicators after axenic incubation in modified Dubos medium under various biophysical conditions. PGL-I synthesis was optimal at 33 degrees C, whereas ATP was optimally maintained at less than or equal to 33 degrees C. Both metabolic indices showed sharp reductions at 37 degrees C. After 5 days of incubation, PGL-I synthesis and ATP maintenance showed pH optima of 5.1 to 5.6, with the higher value appearing optimal for ATP maintenance after extended incubation. Metabolic activity was negatively affected by strong reducing agents, and ATP maintenance was optimal when the gaseous environment was maintained at 2.5 to 10% oxygen. The results may partially explain the failure to cultivate the leprosy bacillus in vitro. PMID- 3290245 TI - Suggestion to supplement Shigella flexneri classification scheme with the subserovar Shigella flexneri 4c: phenotypic characteristics of strains. AB - A new serovar of Shigella flexneri has been isolated with increasing frequency in the USSR. It has the antigenic formula IV:7,8. We suggest that it be incorporated into the classification scheme as S. flexneri subserovar 4c. The 212 strains of this proposed subserovar examined to date display biochemical and serological properties typical of the species, are sensitive to the genus-specific bacteriophage, and cause keratoconjunctivitis in the Sereny test. PMID- 3290246 TI - Occurrence of respiratory syncytial virus subgroup A and B strains in Japan, 1980 to 1987. AB - The subgroup characteristics of 71 strains of respiratory syncytial virus (RSV) isolated in Sapporo, Japan, during 5 epidemic years from 1980 to 1987 were determined by the use of 17 monoclonal antibodies (MAbs) raised against the RSV Long strain, which is now recognized as the prototype subgroup A strain. Nine of these MAbs immunoprecipitated the fusion protein (F), five immunoprecipitated the large glycoprotein (G), two immunoprecipitated the nucleoprotein (NP), and one immunoprecipitated the phosphoprotein (P). Based on the pattern of reaction of these MAbs to RSV isolates in an indirect immunofluorescence assay, we were able to distinguish two different subgroups. Subgroup A strains reacted to all 17 MAbs. Subgroup B strains reacted to none of the anti-G MAbs, eight of the nine anti-F MAbs, and all anti-NP and anti-P MAbs. Subgroup A included 38 (53.5%) isolates from every epidemic year. Subgroup B included 32 (45.1%) strains isolated in the last 4 epidemic years. One virus strain with an intermediate character of reactivity was isolated in 1983. From the first epidemic year, six subgroup A strains and no B strains were isolated. During the next three annual epidemics, subgroup B strains were predominantly isolated, i.e., 8 of 13, 10 of 13, and 13 of 17 strains. However, in the last epidemic year only one strain of 22 isolates belonged to subgroup B, and the remainder belonged to subgroup A. This variability of dominance in the occurrence of different RSV subgroup strains may suggest a possible role of the subgroup-specific immune response in RSV epidemics. PMID- 3290247 TI - Modified Thayer-Martin medium for recovery of Nocardia species from contaminated specimens. AB - Specimens submitted for isolation of Nocardia species are frequently contaminated with other bacteria. Although decontamination with sodium hydroxide or benzalkonium chloride can remove these bacteria, this treatment is also toxic for Nocardia species. We demonstrate that modified Thayer-Martin medium can be used for selective isolation of Nocardia species. PMID- 3290248 TI - Comparison of three methods for recovery of Mycobacterium avium complex from blood specimens. AB - Three methods were used for the recovery of mycobacteria from blood specimens obtained from acquired immunodeficiency syndrome patients: (i) inoculation of 7H11 agar plates with a concentrated specimen, (ii) inoculation of 7H12 BACTEC vials with a concentrated specimen, and (iii) inoculation of 7H13 BACTEC vials with a nonconcentrated specimen. In this study, we examined 255 specimens and obtained positive mycobacterial growth in 47 of them. Among these 47 cultures, 40 were found to be positive by all three methods, and the total recovery rates in relation to these culture-positive specimens were 94% for method 1, 89% for method 2, and 96% for method 3. The advantages and disadvantages of these three methods are discussed. PMID- 3290249 TI - Lowering cholesterol, 1988. Rationale, mechanisms, and means. PMID- 3290250 TI - Physiological role for cholecystokinin in reducing postprandial hyperglycemia in humans. AB - It is known that the ingestion of glucose alone causes a greater increase in plasma glucose levels than ingestion of the same amount of glucose given with other nutrients. Since physiological plasma concentrations of cholecystokinin (CCK) prolong gastric emptying, it is proposed that after a meal, CCK may modify plasma glucose levels by delaying glucose delivery to the duodenum. To evaluate the effect of CCK on oral glucose tolerance, plasma CCK, insulin, and glucose levels and gastric emptying rates were measured in eight normal males before and after the ingestion of 60 g glucose with the simultaneous infusion of either saline or one of two doses of CCK-8 (12 or 24 pmol/kg per h). Gastric emptying rates were measured by gamma camera scintigraphy of technetium 99m sulfur colloid and plasma CCK levels were measured by a sensitive and specific bioassay. Basal CCK levels averaged 1.0 +/- 0.1 pM (mean +/- SEM, n = 8) and increased to 7.1 +/- 1.1 pM after a mixed liquid meal. After glucose ingestion, but without CCK infusion, CCK levels did not change from basal, and the gastric emptying t1/2 was 68 +/- 3 min. Plasma glucose levels increased from basal levels of 91 +/- 3.9 mg/dl to peak levels of 162 +/- 11 mg/dl and insulin levels increased from 10.7 +/- 1.8 microU/ml to peak levels of 58 +/- 11 microU/ml. After glucose ingestion, with CCK infused at 24 pmol/kg per h, plasma CCK levels increased to 8 pM and the gastric emptying t1/2 increased to 148 +/- 16 min. In concert with this delay in gastric emptying, peak glucose levels rose to only 129 +/- 17 mg% and peak insulin levels rose to only 24.2 +/- 4.2 microU/ml. With CCK at 12 pmol/kg per h, similar but less dramatic changes were seen. To demonstrate that endogenous CCK could modify the plasma glucose and insulin responses to oral glucose, oral glucose was given with 50 g of lipid containing long-chain triglycerides. This lipid increased peak CCK levels to 3.7 +/- 0.9 pM. Concomitant with this rise in CCK was a delay in gastric emptying and a lowering of plasma glucose and insulin values. To confirm that CCK reduced hyperglycemia by its effect on gastric motility, 36 g glucose was perfused directly into the duodenum through a nasal duodenal feeding tube in four subjects. With duodenal perfusion of glucose, there was no change in plasma CCK levels, but plasma glucose levels increased from basal levels of 93+/-5 to 148+/-6 mg/dl and insulin levels rose from 10.6+/-3.5 to 29.5+/-5.2 microU/ml. When CCK was infused at 24 pmol/kg per h, neither the plasma glucose nor insulin responses to the duodenal administration of glucose were modified. Thus we conclude that CCK, in physiological concentrations, delays gastric emptying, slows the delivery of glucose to the duodenum, and reduces postprandial hyperglycemia. These data indicate, therefore, that CCK has a significant role in regulating glucose homeostasis in human. PMID- 3290251 TI - Effects of decreasing the frequency of gonadotropin-releasing hormone stimulation on gonadotropin secretion in gonadotropin-releasing hormone-deficient men and perifused rat pituitary cells. AB - The effects of decreasing the frequency of pulsatile gonadotropin-releasing hormone (GnRH) stimulation on pituitary responsiveness were studied in (a) men with isolated GnRH deficiency who had achieved normal sex steroid levels during prior long-term pulsatile GnRH replacement and (b) perifused dispersed pituitary cells from male rats in the absence of sex steroids. In three groups of four GnRH deficient men, the frequency of GnRH stimulation was decreased at weekly intervals from (a) every 2-3-4 h (group I), (b) every 2-8 h without testosterone replacement (group II), or (c) every 2-8 h with testosterone replacement (group III). In three groups of three columns of perifused dispersed pituitary cells, pulses of GnRH were administered every 2, 4, or 8 h. In groups I and II, mean area under the luteinizing hormone (LH) curve increased (P less than 0.025) and serum testosterone levels fell (P less than 0.035) as the frequency of GnRH stimulation was decreased. In group III, the area under the LH curve also increased (P less than 0.01) although serum testosterone levels were constant, thereby demonstrating that the increase in pituitary responsiveness to slow frequencies of GnRH stimulation occurs independently of changes in the sex steroid hormonal milieu. The area under the LH curve also increased in the perifused dispersed rat pituitary cells when the frequency of GnRH administration was decreased to every 8 h (P less than 0.05), thus demonstrating that the enhanced pituitary responsiveness to slow frequencies of GnRH stimulation is maintained even in the complete absence of gonadal steroids. Nadir LH levels fell in all three groups (P less than 0.01) as the frequency of GnRH stimulation was decreased. In contrast, mean peak LH levels, the rate of LH rise, and the rate of endogenous LH decay were constant as the frequency of GnRH stimulation was decreased. Finally, as the GnRH interpulse interval increased, mean LH levels fell, and mean follicle-stimulating hormone levels were stable or fell. These results indicate that (a) pituitary responsiveness to GnRH increases at slower frequencies of GnRH stimulation in models both in vivo and in vitro, (b) these changes in pituitary responsiveness occur independently of changes in gonadal steroid secretion, and (c) the increases in LH pulse amplitude and area under the curve at slow frequencies of GnRH stimulation are due to decreases in nadir, but not peak, LH levels. Slowing of the frequency of GnRH secretion may be an important independent variable in the control of pituitary gonadotropin secretion. PMID- 3290253 TI - Effect of bone marrow transplantation on enzyme levels and clinical course in the neurologically affected twitcher mouse. AB - The effect of allogeneic bone marrow transplantation (BMT) was investigated in the neurologically affected twitcher mouse, a model for human Krabbe's disease. Twitcher mice have a hereditary deficiency of the lysosomal enzyme galactosylceramidase, which causes growth delay, tremor, and paralysis of the hind legs. Death occurs at 30-40 d of age. After BMT galactosylceramidase activity increased to donor levels in hemopoietic organs. In lung, heart, and liver, galactosylceramidase activity rose to levels intermediate between those of twitcher and normal mice. Increased galactosylceramidase activity in liver parenchymal cells indicated uptake of the donor enzyme by recipient cells of nonhemopoietic origin. Enzyme activity also increased in kidney tissue. BMT resulted in a gradual increase in galactosylceramidase activity in the central nervous system to 15% of normal donor levels. A 5-6-fold increase in galactosylceramidase activity was found in the peripheral nervous system. This increase in enzyme activity was accompanied by a partial alleviation of neurological symptoms. In particular, paralysis of the hind legs was prevented by BMT. BMT led to a modest restoration of growth and prolonged survival. In several cases, the mice survived for more than 100 d, but eventually all animals died with severe neurological disease. PMID- 3290252 TI - Regulation of glucose turnover during exercise in pancreatectomized, totally insulin-deficient dogs. Effects of beta-adrenergic blockade. AB - To examine whether glucose metabolic clearance increases and whether catecholamines influence glucose turnover during exercise in total insulin deficiency, 24-h fasted and insulin-deprived pancreatectomized dogs were studied before and during exercise (60 min; 100 m/min; 10% slope) with (n = 8) and without (n = 8) propranolol infusion (PI, 5 micrograms/kg-min). Exercise with or without PI was accompanied by four and fivefold increments in norepinephrine and epinephrine respectively, while glucagon (extrapancreatic) fell slightly. Basal plasma glucose and FFA concentrations and rates of tracer-determined (3[3H]glucose) hepatic glucose production (Ra) and total glucose clearance (including urinary glucose loss) were 459 +/- 24 mg/dl, 1.7 +/- 0.5 mmol/liter, 7.8 +/- 0.9 mg/kg-min and 1.6 +/- 0.1 ml/kg-min, respectively. When corrected for urinary glucose excretion, basal glucose metabolic clearance rate (MCR) was 0.7 +/- 0.1 mg/kg-min and rose twofold (P less than 0.0001) during exercise. Despite lower lactate (3.3 +/- 0.6 vs. 6.6 +/- 1.3 mmol/liter; P less than 0.005) and FFA levels (1.1 +/- 0.2 vs. 2.2 +/- 0.2 mmol/liter; P less than 0.0001) with PI, PI failed to influence MCR during exercise. Ra rose by 3.7 +/- 1.7 mg/kg-min during exercise (P less than 0.02) while with PI the increase was only 1.9 +/- 0.7 mg/kg min (P less than 0.002). Glucose levels remained unchanged during exercise alone but fell slightly with PI (P less than 0.0001). Therefore, in total insulin deficiency, MCR increases marginally with exercise (13% of normal); the beta adrenergic effects of catecholamines that stimulate both FFA mobilization and muscle glycogenolysis do not regulate muscle glucose uptake. The exercise-induced rise in hepatic glucose production does not require an increase in glucagon levels, but is mediated partially by catecholamines. Present and previous data in normal and alloxan-diabetic dogs, suggest that (a) in total insulin deficiency, control of hepatic glucose production during exercise is shifted from glucagon to catecholamines and that this may involve catecholamine-induced mobilization of peripheral substrates for gluconeogenesis and/or hepatic insensitivity to glucagon, and (b) insulin is not essential for a small exercise-induced increase in muscle glucose uptake, but normal insulin levels are required for the full response. Furthermore, the catecholamines appear to regulate muscle glucose uptake during exercise only when sufficient insulin is available to prevent markedly elevated FFA levels. We speculate that the main role of insulin is not to regulate glucose uptake by the contracting muscle directly, but to restrain lipolysis and thereby also FFA oxidation in the muscle. PMID- 3290254 TI - 1,25-Dihydroxyvitamin D3 modulates the expression of a lymphokine (granulocyte macrophage colony-stimulating factor) posttranscriptionally. AB - We recently showed that 1,25(OH)2D3 sensitively inhibited the expression of granulocyte-macrophage colony-stimulating factor (GM-CSF) in normal human mitogen activated peripheral blood lymphocytes and in the human T lymphotropic virus I immortalized T cell line known as S-LB1 at the levels of both mRNA and protein. Using S-LB1 cells as a model system the present paper identifies at least in part the mechanisms by which 1,25(OH)2D3 regulates the expression of GM-CSF. Time course studies demonstrated that by 6 and 48 h of exposure of S-LB1 cells to 1,25(OH)2D3 (10(-8) M) the GM-CSF mRNA levels were reduced by 50 and 90%, respectively. Studies using cycloheximide as a protein synthesis inhibitor showed that the inhibitory action of 1,25(OH)2D3 on GM-CSF expression was dependent on new protein synthesis. In vitro nuclear run-on assays demonstrated that 1,25(OH)2D3 (10(-8) M) did not change the rate of transcription of the GM-CSF gene. The t1/2 of GM-CSF mRNA, however, was profoundly reduced by 1,25(OH)2D3 when transcription was blocked by actinomycin D compared with the half-life of GM CSF in the presence of actinomycin D alone (t1/2, less than 0.5 and 4 h, respectively). Taken together, these results demonstrate that 1,25(OH)2D3 regulates expression of the lymphokine GM-CSF posttranscriptionally by influencing the stability of GM-CSF mRNA. PMID- 3290256 TI - Impaired cardiac muscarinic receptor function in dogs with heart failure. AB - Prior physiological studies have suggested that parasympathetic control is altered in heart failure. The goal of our studies was to investigate the influence of heart failure on the muscarinic receptor, and its coupling to adenylate cyclase. Ligand binding studies using [3H]quinuclidinyl benzilate and enriched left ventricular (LV) sarcolemma, demonstrated that muscarinic receptor density in heart failure declined 36% from a control of 5.6 +/- 0.6 pmol/mg, with no change in antagonist affinity. However, agonist competition studies with both carbachol and oxotremorine showed that it was a loss of high affinity agonist binding sites in the sarcolemma from failing LV that accounted for this difference. The functional efficacy of the muscarinic receptor was also examined. When 1 microM methacholine was added to 0.1 mM GTP and 0.1 mM isoproterenol, adenylate cyclase stimulated activity was inhibited by 15% in normal LV but only 5% in LV sarcolemma from animals with heart failure even when the reduced adenylate cyclase in these heart failure animals was taken into account. Even at 100-fold greater concentrations of methacholine, significantly less inhibition of adenylate cyclase activity was observed in LV failure as compared with normal LV sarcolemma. Levels of the GTP-inhibitory protein known to couple the muscarinic receptor to adenylate cyclase, as measured with pertussis toxin labeling, were not depressed in LV failure. Thus, the inhibitory pathway regulating LV adenylate cyclase activity is defective in heart failure. The decrease in muscarinic receptor density, and in particular the specific loss of the high affinity agonist binding component of this receptor population, appears to be the major factor underlying this abnormality. PMID- 3290255 TI - Modulation of the in vitro candidacidal activity of human neutrophil defensins by target cell metabolism and divalent cations. AB - We tested the in vitro susceptibility of Candida albicans to three defensins from human neutrophilic granulocytes (HNP-1, 2, and 3), a homologous defensin from rabbit leukocytes (NP-1), and four unrelated cationic peptides. Although the primary amino acid sequences of HNP-1, 2, and 3 are identical except for a single amino-terminal amino acid alteration, HNP-1 and HNP-2 killed C. albicans but HNP 3 did not. C. albicans blastoconidia were protected from HNP-1 when incubations were performed in the absence of oxygen or in the presence of inhibitors that blocked both of its mitochondrial respiratory pathways. Neither anaerobiosis nor mitochondrial inhibitors substantially protected C. albicans exposed to NP-1, poly-L-arginine, poly-L-lysine, or mellitin. Human neutrophilic granulocyte defensin-mediated candidacidal activity was inhibited by both Mg2+ and Ca2+, and was unaffected by Fe2+. In contrast, Fe2+ inhibited the candidacidal activity of NP-1 and all of the model cationic peptides, whereas Mg2+ inhibited none of them. These data demonstrate that susceptibility of C. albicans to human defensins depends both on the ionic environment and on the metabolic state of the target cell. The latter finding suggests that leukocyte-mediated microbicidal mechanisms may manifest oxygen dependence for reasons unrelated to the production of reactive oxygen intermediates by the leukocyte. PMID- 3290257 TI - Mild type II diabetes markedly increases glucose cycling in the postabsorptive state and during glucose infusion irrespective of obesity. AB - Glucose cycling (GC; G in equilibrium G6P) equals 14% of glucose production in postabsorptive man. Our aim was to determine glucose cycling in six lean and six overweight mild type II diabetics (fasting glycemia: 139 +/- 10 and 152 +/- 7 mg/dl), in postabsorptive state (PA) and during glucose infusion (2 mg/kg per min). 14 control subjects were weight and age matched. GC is a function of the enzyme that catalyzes the reaction opposite the net flux and is the difference between hepatic total glucose output (HTGO) (2-[3H]glucose) and hepatic glucose production (HGP) (6-[3H]-glucose). Postabsorptively, GC is a function of glucokinase. With glucose infusion the flux is reversed (net glucose uptake), and GC is a function of glucose 6-phosphatase. In PA, GC was increased by 100% in lean (from 0.25 +/- 0.07 to 0.43 +/- .08 mg/kg per min) and obese (from 0.22 +/- 0.05 to 0.50 +/- 0.07) diabetics. HGP and HTGO increased in lean and obese diabetics by 41 and 33%. Glucose infusion suppressed apparent phosphatase activity and gluconeogenesis much less in diabetics than controls, resulting in marked enhancement (400%) in HTGO and HGP, GC remained increased by 100%. Although the absolute responses of C-peptide and insulin were comparable to those of control subjects, they were inappropriate for hyperglycemia. Peripheral insulin resistance relates to decreased metabolic glucose clearance (MCR) and inadequate increase of uptake during glucose infusion. We conclude that increases in HGP and HTGO and a decrease of MCR are characteristic features of mild type II diabetes and are more pronounced during glucose infusion. There is also an increase in hepatic GC, a stopgap that controls changes from glucose production to uptake. Postabsorptively, this limits the increase of HGP and glycemia. In contrast, during glucose infusion, increased GC decreases hepatic glucose uptake and thus contributes to hyperglycemia. Obesity per se did not affect GC. An increase in glucose cycling and turnover indicate hepatic insulin resistance that is observed in addition to peripheral resistance. It is hypothesized that in pathogenesis of type II diabetes, augmented activity of glucose-6-phosphatase and kinase may be of importance. PMID- 3290260 TI - Intra-arterial infusion catheters with implantable injection chambers in maxillo facial oncology. AB - An intra-arterial chemotherapy procedure in patients with malignant tumours in the oral and maxillo-facial region which, from the vascular point of view, can be dependent on the external carotid artery and/or its branches is presented. Particularly for the prevention of catheter infection, obstruction, etc., a subcutaneous pouch, connected to the infusion catheter, is implanted subcutaneously in the submastoid region. PMID- 3290258 TI - Desensitization of the insulin receptor by antireceptor antibodies in vivo is blocked by treatment of mice with beta-adrenergic agonists. AB - In previous studies we reported that immunization of mice with ungulate insulins induced the development of antiinsulin antibodies, which include an idiotype that appeared to recognize the part of the insulin molecule recognized by the hormone receptor. The antiinsulin antibodies of this idiotype were replaced spontaneously by antiidiotypic antibodies. The antiidiotypic antibodies, which persisted for about 14 d, mimicked insulin and functioned as antibodies to the insulin receptor. They induced down regulation, desensitization and refractoriness of the insulin receptor and disturbances in glucose homeostasis in vivo (Shechter, Y., D. Elias, R. Maron, and I.R. Cohen., 1984; Elias, D., R. Maron, I.R. Cohen, and Y. Shechter. 1984, J. Biol. Chem. 259: 6411-6419). We now report that effects of the antiidiotypic antibodies on the insulin receptor effector system can be modified pharmacologically. Administration of the beta-adrenergic agonist isoproterenol during the period of insulin resistance (days 26-40 after primary immunization), largely restored fat cell responsiveness to insulin, and eliminated the appearance of fasting hyperglycemia. This restoration appeared to be caused by inhibition of both insulin receptor desensitization and refractoriness. In contrast, down regulation of insulin receptors was not reversed by isoproterenol treatment in vivo. The effects of treatment with isoproterenol persisted for 2-4 d after termination of treatment. The beta antagonist, propranolol and more so, the beta 1a-antagonist metoprolol, specifically blocked the effect of isoproterenol at a molar ratio of 3-10:1. Oral administration of the cAMP phosphodiesterase inhibitor, aminophylline, was also effective in inhibiting the development of desensitization in fat cells. These results indicate that treatment with beta 1-adrenergic agonists in vivo, or other agents that elevate cellular cAMP levels, can inhibit the development of the "postbinding" defects induced by insulin-mimicking, antireceptor antibodies. These observations have both basic and clinical implications. PMID- 3290259 TI - Herpes gestationis autoantibodies recognize a 180-kD human epidermal antigen. AB - Herpes gestationis (HG) is a putative autoimmune bullous dermatosis of pregnancy which shares many findings with bullous pemphigoid (BP), a disease of the elderly. This study identifies for the first time the antigen detected by HG autoantibodies and compares it with that recognized by BP autoantibodies. Sera from 16 HG and 17 BP patients, and from normal pregnant women were evaluated by immunofluorescent (IF) studies and immunoblotted against human epidermal extracts. 89% of HG sera with circulating antibodies by IF recognized a 180-kD protein by immunoblotting. 71% of BP sera recognized a 240-kD band, but 47% detected a 180-kD protein that comigrated with the antigen detected by HG sera. None of the control sera recognized any specific bands. These findings suggest that the 180-kD epidermal protein may be the antigen detected by the HG factor and they also define immunologic similarities between HG and BP. PMID- 3290261 TI - Titanium-coated hollow screw and reconstruction plate system (THORP) in mandibular reconstruction. AB - Clinical results are presented which have been obtained from mandibular reconstruction with the Titanium-coated Hollow Screw and Reconstruction-Plate system (THORP) in 7 selected patients. In 3 of the patients primary bone grafting was performed with simultaneous implantation of titanium fixtures for dental reconstruction. The reconstruction-plates have shown excellent functional stability with no failures, such as loosening of screws, within an observation period up to 2 1/2 years. The system was submitted to immediate full functional loading despite the limited number of 2-3 fixation screws for each end of the plate. Among several technical advantages of the system are the possibility of lingual plate application and reconstruction with a three-dimensionally free, adjustable condylar prosthesis. PMID- 3290262 TI - The incidence, multiple presentation and recurrence of aggressive cysts of the jaws. AB - The incidence, multiple presentation and recurrence rate of aggressive cysts of the jaws is discussed, based on a study of 677 cysts in 651 patients. Cysts that are considered aggressive include: cysts in which carcinoma develops, unicystic ameloblastoma, keratocysts and calcifying odontogenic cysts. Based on literature studies and on our own material, the incidence and multiplicity of these lesions is calculated. Recommendations for treatment include careful preoperative assessment and treatment of suspicious lesions with excision of the overlying mucosa and fixation of the defect with Carnoy's solution. The cyst in which carcinoma develops should be treated as a true malignancy i.e. by resection. Long term follow-up is necessary to eliminate the possibility of recurrence. PMID- 3290263 TI - Amiloride prevents amphotericin B related hypokalaemia in neutropenic patients. AB - Twenty neutropenic patients with various haematological disorders were randomised prospectively to receive either intravenous amphotericin B alone or amphotericin B and oral amiloride 5 mg twice a day for treatment of confirmed or suspected fungal infection. Patients receiving amiloride had a significantly higher plasma potassium (p less than 0.01), a significantly lower urinary potassium loss (p less than 0.01), and required significantly less potassium chloride supplementation to maintain their plasma potassium within the normal range (p less than 0.001). Amiloride was well tolerated, had no clinically important side effects, and provided effective control of plasma potassium in patients treated with amphotericin B. PMID- 3290265 TI - Polybrene technique for red cell antibody screening using microplates. AB - The manual polybrene technique was adapted as a microplate test for antibody screening to determine its sensitivity and specificity and compared with conventional tube testing using various antibodies and serologically inert sera. Equivalent results were obtained for both techniques and it is concluded that this adaptation of the polybrene technique is useful in pretransfusion testing. PMID- 3290264 TI - Histological lesions associated with cyclosporin: incidence and reversibility in one year old kidney transplants. AB - To determine the type and reversibility of the long term effects of cyclosporin A, biopsy specimens were taken from 20 recipients of kidney allografts, twelve months after transplantation, and three months later, during which time azathioprine was substituted for cyclosporin A. Arteriolar IgM and complement deposits and tubular isometric vacuolisation associated with cyclosporin A treatment significantly regressed after stopping this drug one year after transplantation. Conversion to azathioprine was accompanied by an increase in mononuclear cell infiltrates and tubulitis despite an evident improvement in renal function. Nephrotoxicity as a result of cyclosporin A is common but can be reversed--at least partially. PMID- 3290266 TI - Techniques for obtaining differential cell counts from bone marrow trephine biopsy specimens. AB - Differential cell counts were performed on 200 paired bone marrow aspirates and trephine biopsy specimens to compare the distribution of cell types. Relatively more immature myeloid cells were found in the trephine biopsy specimens and relatively more polymorphs and lymphocytes in the aspirates. Two methods for sampling areas of the trephine biopsy specimens for counting were assessed, and the differences between aspirates and trephine specimens were found to be more consistent when the second, more extensive, sampling method was used. This method also permitted quantitation of some features of bone marrow topography and provided information that would not normally be obtainable from aspirated material. The techniques were easy to apply and took relatively little time to perform. They could offer useful information in the study of bone marrow disorders, particularly those such as myelodysplastic syndromes in which disturbances of marrow architecture are prominent. PMID- 3290267 TI - Immunocytochemical detection of tumours of neuroectodermal origin. AB - Immunocytochemical methods were applied to bone marrow aspirate and cerebrospinal fluid specimens to show cellular reactivity with the monoclonal antibody UJ13A, which recognises an antigen expressed by cells of neuroectodermal origin. The antigen remained stable after air drying and appropriate fixation. In five patients with various neuroectodermal tumours the diagnostic advantages of these techniques were clear; they can be performed even when only very small amounts of diagnostic material are available. PMID- 3290268 TI - Microwave irradiation of human brain tissue: production of microscopic slides within one day. AB - A three step method using microwave irradiation enabled microscopic slides of human brain tissue to be obtained within one working day: steps 1 and 2 hardened and solidified brain tissue; step 3 completed formalin fixation. The efficacy and precision of the method was compared with slides of conventionally processed brain tissue that had been fixed in formalin for six weeks. The microscopic quality of the sections was excellent with good presentation of brain tissue and equalled that of conventionally processed slides. PMID- 3290269 TI - Increased isolation of anaerobes at low cost. PMID- 3290270 TI - Clinical interface of blood transfusion. PMID- 3290272 TI - Automated screening of blood cultures with the Malthus microbiological growth analyser. AB - A total of 3347 blood cultures from patients in all hospital wards were examined on a Malthus microbiological growth analyser and by a conventional system. There was no significant difference in the total numbers of positive cultures of clinical importance between the two systems (p greater than 0.05). Staphylococcus aureus, however, was isolated more often by the conventional method (p less than 0.05). Failure of the automatic detection routine limited the potential of the Malthus system for earlier detection of positive cultures. Daily visual examination of Malthus curves and subculture of bottles not promptly attached to the apparatus were necessary to avoid missing some positive cultures. False positive rates were 13% for the Malthus system and 2% for the conventional system. The contamination rate was considerably lower in the Malthus system (p less than 0.001). Further development would be necessary for the apparatus to be acceptable for routine screening of blood cultures. PMID- 3290271 TI - Blood cultures: where do we stand? PMID- 3290273 TI - Comparison of conventional and single bottle system for blood cultures. AB - A single bottle blood culture system (Oxoid Signal system) was compared with a conventional two bottle subculturing system. A total of 2016 routine blood samples yielded 186 (9%) clinically important isolates. Of these, 40 (21%) were isolated only in the Oxoid system and 30 (17%) only in the conventional system. One hundred and sixteen (62%) were isolated from both systems. Volume of blood was not significantly associated with the rate of detection but was significantly associated with the speed of detection. A continuation of the study with a Signal bottle and single conventional bottle confirmed initial results of the increased isolation rate using two systems. The Oxoid single bottle blood culture system was at least comparable with a conventional system in terms of rate of detection of organisms and was superior in terms of speed of detection. PMID- 3290275 TI - Comparison between Bactec and Oxoid blood culture systems in a neonatal intensive care unit. PMID- 3290274 TI - Evaluation of use of Signal system of blood culture in paediatrics. AB - A new method of blood culture, the Signal system (Oxoid), was assessed in paediatric practice. Isolation rates of pathogens, frequency of contamination (false positive results), and time taken to detect positive cultures were analysed. Four hundred and seventy nine organisms were isolated from 457 of 3000 cultures collected, of which 283 organisms were considered to be clinically important. The overall rate of positive cultures was 15.2%, and clinically important organisms were isolated from 9.1%, giving an overall contamination rate of 6.1%. The rate of contamination with Gram positive bacilli was 1.1% and coagulase negative staphylococci 4.2%. Over 51.6% of all isolates were detected within 24 hours, 81% within 48 hours, and 86% within three days: 91.1% of clinically important organisms were isolated within three days. Unimportant organisms tended to give a delayed signal, although this sometimes occurred with Candida spp, Klebsiella spp, Pseudomonas spp and a small number of other such organisms. Four hundred and forty nine of the 457 positive cultures gave a visible signal. Six of seven isolates of Haemophilus influenzae failed to give a signal, as did two coagulase negative staphylococci. The Signal system is a convenient and cost effective method of blood culture. PMID- 3290277 TI - Treatment of periodontal furcation defects. (II). Bone regeneration in mandibular class II defects. AB - A total of 30 mandibular, buccal class II furcation defects were treated in 22 subjects using a regenerative surgical therapy that included citric acid root conditioning and coronally positioned flaps secured by crown-attached sutures. In addition, grafts of freeze-dried, decalcified allogenic bone were placed in 16 of the 30 defects. The effect of the therapies was evaluated from a series of soft and hard tissue measurements. These measurements demonstrated notable improvement 12 months following therapy. On the average, 67% of the defect volume became filled with bone. 43% of treated defects were completely closed by bone fill. No difference was observed between defects treated with and without bone grafts. PMID- 3290276 TI - Treatment of periodontal furcation defects. (I). Review of the literature and description of a regenerative surgical technique. AB - This report provides an abbreviated review of the literature on treatment and prognosis of periodontal furcation lesions. In addition, it describes a surgical technique designed to accomplish bone regeneration in class II furcation defects, together with the rationale for the development of this procedure. Results of treatment of 30 defects with this technique are presented in a subsequent report. PMID- 3290278 TI - Routine immunofluorescence for pruritic urticarial papules and plaques of pregnancy. PMID- 3290279 TI - Temperature-dependent skin disorders. AB - The skin is important in preserving homeostasis between man and his environment. One main role of the skin is in thermoregulation, where cutaneous blood flow, and hence skin temperature, vary widely in order to help preserve core body temperature. Under extreme conditions, frostbite or burns may occur. Prolonged exposure to moderate degrees of heat or cold can result in erythema ab igne and chilblains. Temperature plays a direct role in some of the physical urticarias and is one of several important pathogenic factors in conditions such as Raynaud's syndrome, cold panniculitis, and cryoglobulinemia. These and other temperature-dependent skin disorders are reviewed. PMID- 3290280 TI - Determination of sex steroid receptor in human basal cell carcinoma. AB - The role of estrogens in the development of skin cancer is controversial. Sex steroids have a profound effect on the epidermis and epidermal appendages. Estradiol in pharmacologic doses has been reported to stimulate basal cell carcinoma in an animal model. Sex hormones act by means of a specific protein receptor. In this study we used a specific, highly sensitive monoclonal antibody to evaluate sex steroid receptors in human basal cell carcinoma. No estrogen or progesterone receptor protein was detected in the basal cell tumor, despite clear positive control tissues. We conclude that these sex steroid receptors are not present in significant amounts to mediate a direct effect in basal carcinoma. PMID- 3290281 TI - Cutaneous manifestations of the acquired immunodeficiency syndrome in children. AB - The acquired immunodeficiency syndrome (AIDS) in children is now known to be a clinical entity separate and distinct from AIDS in adults. In this article we present a review of the recent literature describing the history, definitions, epidemiology, differential diagnosis, and immunologic and clinical features of pediatric AIDS. Special emphasis is placed on the cutaneous manifestations of human immunodeficiency virus infection in children, which, to date, have not been the subject of a comprehensive review. PMID- 3290283 TI - Herpes gestationis and ritodrine. PMID- 3290282 TI - Papillary eccrine adenoma. A light microscopic and immunohistochemical study. AB - The papillary eccrine adenoma is a rare benign sweat gland neoplasm characterized by a potentially locally aggressive clinical course. The light microscopic findings in two cases of this unusual neoplasm are discussed, with emphasis on the differential diagnosis of this tumor from other benign and malignant sweat gland neoplasms. Immunohistochemistry studies directed against various epithelial antigens were also performed. Immunoperoxidase stains positive for carcinoembryonic antigen, S-100 protein, and epithelial membrane antigen strongly support the hypothesis that this unusual neoplasm differentiates toward the eccrine secretory coil. PMID- 3290284 TI - Chemexfoliation: indications and cautions. PMID- 3290285 TI - Felix Pinkus, M.D. (1868-1947). PMID- 3290286 TI - Pemphigus. AB - The term pemphigus refers to a group of autoimmune intraepidermal blistering diseases of the skin and mucous membranes. Several clinical variants of pemphigus are recognized. The major histologic feature of all variants is acantholysis, the disruption of normal cell-to-cell adhesion, which leads to intraepidermal blister formation. Most patients with pemphigus demonstrate IgG autoantibodies directed against an antigen located on the surface of keratinocytes. Although the stimulus for autoantibody production is unknown, several mechanisms have been proposed to explain the pathogenesis of acantholysis. One popular model proposes that pemphigus antibodies induce acantholysis through local stimulation of the plasminogen-plasmin system. Another model proposes that pemphigus antibodies fix complement and thereby alter cell membrane integrity to produce acantholysis. Prior to the availability of corticosteroids, pemphigus vulgaris was commonly fatal. Treatment with glucocorticosteroids has drastically improved the prognosis. Immunosuppressive agents and plasmapheresis have been used successfully in some patients with severe disease. PMID- 3290287 TI - Use of an autologous antigen in the serologic testing of patients with erythema migrans of Lyme disease. AB - We attempted to detect an early rise in antibody titers to Borrelia burgdorferi in the serum of patients with erythema migrans of Lyme disease by utilizing B. burgdorferi isolates obtained from patients' own skin lesions instead of the B31 reference strain. B. burgdorferi was isolated from nine of 23 skin biopsy specimens submitted for culture. Elevated antibody titers were not detected in any of the 23 acute serum samples by immunofluorescence assay. The antigens derived from patient isolates were no more effective than the reference strain in detecting antibodies in patients with early Lyme disease. PMID- 3290288 TI - Sinus histiocytosis with massive lymphadenopathy. Case report and review of a multisystemic disease with cutaneous infiltrates. AB - A report of a patient with the rare syndrome of sinus histiocytosis with massive lymphadenopathy is presented here. This patient is unusual in several respects, including his longevity after diagnosis, the presence of a benign monoclonal gammopathy, and the characterization of his cutaneous infiltrates by immunofluorescent monoclonal antibody markers. A review of the literature on sinus histiocytosis with massive lymphadenopathy, with particular emphasis on cutaneous manifestations, is given. PMID- 3290289 TI - Peyton E. Weary, M.D., elected to leadership position in the American Board of Medical Specialties. PMID- 3290290 TI - Treatment of leg ulcers with cultured epithelial grafts. PMID- 3290291 TI - The legacy of Abraham Buschke. PMID- 3290292 TI - Immunologic mechanisms in psoriasis. AB - This review presents evidence for the immunopathogenesis of psoriasis. T lymphocytes with human lymphocyte antigen (HLA)-DR molecules and receptors for interleukin 2 were found in the dermis of psoriatic plaques, suggesting the presence of activated T cells in these lesions. Keratinocytes in active plaques demonstrated HLA-DR molecules on their surfaces. These immunologic abnormalities were reversible with medical therapy. Keratinocyte HLA-DR expression was associated with an increased incidence of psoriatic arthritis. We propose that HLA-DR + keratinocytes and Langerhans cells in plaques could activate dermal T cells directly in an autologous mixed leucocyte/epithelial cell reaction. Alternatively, they could present an unknown autologous or exogenous antigen to T lymphocytes. T cell activation would then lead to the release of mediators of inflammation, and possibly of epidermal growth factors. This hypothesis also provides an explanation for the chronicity of psoriasis. Most of the therapies used to treat psoriasis suppress cellular immune function and inflammation. These include ultraviolet irradiation, cyclosporine, corticosteroids, methotrexate, anthralin, and retinoids. PMID- 3290293 TI - Storage stability and some nutritional aspects of milk powders and ultra high temperature products at high ambient temperatures. PMID- 3290294 TI - Partial purification and characterization of an extracellular proteinase from Aeromonas hydrophila strain A4. AB - An extracellular metalloproteinase from Aeromonas hydrophila strain A4, isolated from milk, was purified by a factor of 300 by chromatography on DEAE-cellulose and Sephadex G-150. The enzyme had a mol. wt of 43,000 and contained 2 g atom Ca/mol. It was active over a pH range 4.8-9.5 and had optimum activity on casein at pH 7.0 with Km = 0.17 mM. It was strongly inactivated by metal chelators and the apoenzyme was fully reactivated with Ca2+, Mn2+ or Co2+. Heavy metal ions such as Ag+, Hg2+, Fe2+, Zn2+, Cd2+, Ni2+ and Cu2+ totally or partly inactivated the enzymic activity at 5 mM concentration. The enzyme was not inactivated by diisopropylfluorophosphate, soyabean trypsin inhibitor or sulphydryl group reagents. It was optimally active at 45 degrees C; above 50 degrees C activity declined rapidly, but significant activity persisted at 4 degrees C. It was heat labile in phosphate or Tris-maleate buffer but exogenous Ca2+ afforded protection. PMID- 3290295 TI - Adolescent mental health in China. AB - Adolescent Mental Health in China is the responsibility of the wider society and is supported by social, educational and health care resources. With limited facilities, China emphasizes community mental health care, with prevention and health promotion as priorities. Mental health is considered in the context of an orderly socialist society with stable family life supported by the state. Society is currently influenced by a mixture of Communist ideology, ancient tradition and newer Western approaches. Difficulties in reconciling these factors are affecting the attitudes and behaviour of China's youth. PMID- 3290296 TI - Adolescents' mental health and the Greek family: preventive aspects. AB - Preventive mental health measures can be properly planned only if the various factors leading to the adolescent's personality structure are extensively investigated. Starting with the specific attitudes of a couple towards genetic counselling, the disadvantages of urbanization and of the dissolution of the traditional extended family are discussed with regard to their effect on the younger members. Data are produced concerning the child-rearing practices of Greek in comparison to American parents and their effect on the adolescent's emotional life. Extreme dependence on the family, pressure for school achievements, lack of sexual education, etc. are characteristic of the stresses a Greek adolescent undergoes. Socio-cultural conditions, like immigration, adoption, etc. are shown to have a different psychological effect on an adolescent in Greece than in America. Specific stresses regarding the adolescent's future, like preparing for university entrance examinations, are discussed and preventive measures are proposed. PMID- 3290298 TI - Utilization of a natural tooth in acid-etch bridging. AB - This report reviews nine cases where despite the wide range of treatments applied to the dentition after a traumatic episode, tooth loss was inevitable and the crown of the damaged tooth was used as a pontic for an immediate bridge. Advantages and disadvantages are reviewed. PMID- 3290299 TI - A clinical investigation of a high-level fluoride dentifrice. PMID- 3290297 TI - Oral health in children treated with bone marrow transplantation: a one-year follow-up. PMID- 3290300 TI - The role of coping in children's adjustment to the dental visit. PMID- 3290301 TI - Dentistry for the elderly: a review and an assessment of the future. PMID- 3290302 TI - 'Mercury poisoning' from dental amalgam--an evaluation of the evidence. PMID- 3290303 TI - The neurobiology of craving: implications for the understanding and treatment of addiction. PMID- 3290304 TI - Relevance of cue reactivity to understanding alcohol and smoking relapse. PMID- 3290305 TI - The role of genetics in the pathogenesis of alcoholism. PMID- 3290306 TI - A motivational model of alcohol use. PMID- 3290307 TI - References to contemporary papers on acoustics. PMID- 3290308 TI - Treating dental problems. PMID- 3290309 TI - A new look for your smile. PMID- 3290310 TI - Iron nutrition and absorption: dietary factors which impact iron bioavailability. AB - Iron deficiency is widely observed worldwide, yet, paradoxically, iron is the most plentiful heavy metal in the earth's crust. Although absorption of iron from the gastrointestinal tract is strictly controlled, excretion is limited to iron lost from exfoliation of skin and gastrointestinal cells, customary and abnormal blood loss, and menses. Individuals highly vulnerable to iron deficiency have high iron needs, as during growth or pregnancy; high iron loss, as during marked hemorrhage or excessive and/or frequent menstrual losses; or diets with low iron content or bioavailability. Food iron is classified as heme or nonheme. Approximately half of the iron in meat, fish, and poultry is heme iron. Depending on an individual's iron stores, 15% to 35% of heme iron is absorbed. Food contains more nonheme iron and, thus, it makes the larger contribution to the body's iron pool despite its lower absorption rate of 2% to 20%. Absorption of nonheme iron is markedly influenced by the levels of iron stores and by concomitantly consumed dietary components. Enhancing factors, such as ascorbic acid and meat/fish/poultry, may increase nonheme iron bioavailability fourfold. PMID- 3290311 TI - Nutrition care of AIDS patients. AB - Often the complications of the acquired immunodeficiency syndrome (AIDS) have a negative impact on nutritional status. Weight loss and protein depletion are commonly seen among the AIDS population. Though the relationship between disease progression and nutritional status has not been established, maintaining good nutritional status may support response to treatment of opportunistic infections and improve patient strength and comfort. Increased nutrient needs, decreased nutrient intake, and impaired nutrient absorption contribute to malnutrition in AIDS patients. Causes of decreased nutrient intake and absorption may be poor appetite, oral and esophageal pain, mechanical problems with eating, and gastrointestinal complications (diarrhea and malabsorption). Causes of these impediments to maintaining nutritional status are discussed, and suggestions to overcome them are given. Dietitians working with AIDS patients need to understand how the complications of the disease might affect nutritional status so that strategies for nutrition treatment can be developed. Nutrition care of AIDS patients requires that dietitians and their support personnel provide supportive, nonjudgmental care. The patients should be included in decision making regarding their nutrition care. Caring for AIDS patients in the community and through home care agencies represents an area in need of the expertise of a dietetics professional. PMID- 3290312 TI - Depot neuroleptics in the treatment of behavioral disorders in patients with Alzheimer's disease. PMID- 3290314 TI - [Surgical treatment of lagophthalmos]. PMID- 3290313 TI - Illness behavior in the aged. Implications for clinicians. AB - A better understanding of the processes through which elderly individuals perceive, evaluate, and act on symptoms will enable physicians to respond more appropriately to the needs of older patients. This paper reviews existing evidence on how the experience of chronic disease and the atypical presentation of symptoms influence symptom recognition and reporting among elderly individuals. A discussion of research on health perceptions suggests that some elderly may inappropriately deny illness and delay seeking medical care, while others with overly negative health perceptions may make excessive physician visits. An overview is presented of the process by which elderly individuals come to seek care from their physicians, combining evidence from the diverse literatures on chronic illness, atypical presentation of disease, and health perceptions. We conclude by discussing the practical implications of this information for clinicians working with the elderly. PMID- 3290315 TI - Genetic specification of life span: processes, problems, and potentials. PMID- 3290316 TI - The aging of Asia. AB - This article reviews some of the demographic characteristics of population aging and the elderly populations in 14 Asian countries: health and life expectancy; sex ratio, marital status, and living arrangements; and rural versus urban residence, labor force participation, retirement, and income. It also focuses on current programs for the elderly populations in Asia and discusses three general issues of importance in the development of aging policies: (a) to what extent should the West be used as a model; (b) what should be the role of the family versus the government in caring for elderly people who cannot care for themselves; and (c) should eligibility for programs be based on age or need? PMID- 3290317 TI - [The wanderings of Jules Cloquet and Gustave Flaubert]. AB - This is the story of a picaresque journey in France and in Corsica of Jules Cloquet (1790-1883), the French anatomist who described the well-known Cloquet's node and of Gustave Flaubert (1821-1880), the famous author of "Madame Bovary" and of many others novels. They were two vagabonds, Cloquet watching with slackness the young womanizering Flaubert. At 64 years of age, the lazy and meddlesome Cloquet stopped operating and writing. Surrounded by honors, he died at the age of 93, leaving his eponym to the Cloquet's node. PMID- 3290318 TI - [Specific immune relationships among the mother, the fetus and the trophoblast. Present-day aspects]. AB - Studying the literature, which is becoming larger and larger, the authors note that there is increasing understanding about the immune response that allows a harmonious development of the feto-placental unit. After the recognition of certain trophoblastic antigens there followed the activation of lymphocytes which synthesize substances favourable to trophoblastic growth. At the same time protective mechanisms which inhibit the generation and activation of immunological factors which are normally found when allografts are rejected, were recognized. Also recognized were other systems able to suppress aggressive features that can become active during pregnancy. PMID- 3290319 TI - [Retrocervical cystic hygroma. Ultrasonic diagnosis. Apropos of 5 cases]. AB - The authors report five ultrasonic imaging between 13 and 32 weeks of gestation. All of them have an hydrops fetalis and an aspect of like masses located in the nuchal region. A cystic retrocervical hygroma was confirmed at autopsy examination in three cases. The diagnosis of cystic hygroma remains inaccurate in the other two cases in the lack of the radiographic and anatomical verification. A review of the literature was made up to define the diagnostic aspects of the hygroma colli, their histological aspects and the mains etiological factors. PMID- 3290320 TI - [Neonatal cystic leukomalacia. Perinatal case histories of 30 survivors]. AB - In 30 surviving neonates, close prolonged ultrasonographic brain studies demonstrated cystic periventricular leucomalacias (CPVL) of varying degree (11 minor forms, 12 moderate forms, 7 severe forms). Clinical histories were reviewed for each case. There were 18 boys, 4 twins, 2 small-for-dates. Mean gestational age was 31 +/- 2 weeks, mean birthweight was 1532 +/- 356 g. No pregnancy was normal, but prenatal events were of a common occurrence in 26/30 cases (premature labor, toxaemia, twins...). Immediate perinatal events included cord difficulties in 5 cases (3 tight cords around the neck, 1 prolapse, 1 case where loose cord around the neck came down with the head), abruptio placentae (2), acute fetal distress (10, of which 8 were severe), Apgar scores 0-1 (9, of which 7 occurred after fetal distress and 2 were unexpected). In four cases, CPVL were of antenatal origin (already in the cystic stage on days 1-2). In 2 cases, CPVL occurred postnatally (infective shock on day 1 and day 46). Plausible mechanisms for anoxic-ischaemic lesions could only be found in 13 cases and remained unknown in the other 17. However, clinical histories suggested the following; cumulative minor events might become as damaging as single major events; "minor" fetal distresses should be scrutinized; pregnant women should be taught not to wait until late to arrive at hospital because this results in non-monitored delivery. No obvious relationship was found between the severity of known events and the degree of CPVL, but a number of pre- and perinatal periods were poorly monitored. The legal importance of early ultrasonographic studies was stressed. PMID- 3290321 TI - [Vaginal hysterectomy of the non-prolapsed uterus]. PMID- 3290322 TI - Competition among health insurers, revisited. AB - This paper updates our 1977 study of health insurance competition. We find that insurers are now far more willing to compete by controlling costs. Large consumer copayments and insurer utilization controls, once deemed politically infeasible, have become commonplace. HMOs and especially PPOs are booming. Blue Shield and Blue Cross market share and market power are declining. We discuss why the insurance market has changed and conclude with thoughts on the future. PMID- 3290323 TI - Health insurance without provider influence: the limits of cost containment. AB - In our previous paper, we showed that market forces can play a significant role in controlling health care costs and that a considerable amount of cost containment effort was pursued by third-party insurers in Oregon in the 1930s and 1940s. Although physicians were able to thwart this cost-control effort, a 1986 Supreme Court decision, FTC v. Indiana Federation of Dentists, found that a boycott of insurers by dentists violated Section 5 of the Federal Trade Commission Act. Further investigation of recent developments, including the recent Wickline v. California decision, indicates that the primary barriers to cost containment today are not obstructive tactics by providers or provider controlled health insurance plans. Rather, the primary barriers are increases in the development and diffusion of new technology and society's apparent preference for paying for new tests and procedures regardless of economic efficiency. PMID- 3290324 TI - The use of sublingual nifedipine in a patient with a clonidine overdose. AB - We report the case of a 46-year-old woman who took approximately 8 mg of clonidine in a suicidal gesture. She arrived in the emergency department 45 min after the overdose with severe hypertension and an altered mental status. Nitroprusside, which is the drug of choice for treating this "paradoxical hypertension," was not readily available. The patient was treated with a total of 20 mg of nifedipine sublingually. This resulted in a rapid decline in her blood pressure and an improvement in her mental status. We review the toxicology of clonidine overdose and discuss its treatment. PMID- 3290325 TI - Assessment of suicide potential by nonpsychiatrists using the SAD PERSONS score. AB - We were unable to validate the predictive ability of a previously described mneumonic (SAD PERSONS score, SPS) for determining the need for hospitalization of patients who have expressed suicidal ideation or behavior. After reviewing published studies on the subject, we arrived at a modification of this scale (MSPS). The MSPS obtained by nonpsychiatric and psychiatric house staff was compared and correlated with patient disposition for 100 consecutive adult patients presenting to the Harbor-UCLA Medical Center emergency department for the assessment of suicidal behavior. We were unable to correlate the MSPS with patient disposition. However, four criteria were found to correlate with the need for hospitalization (P less than .001). After weighting the MSPS, giving two points for each of these four criteria, and one point for each of the other six, we found that a score of greater than or equal to 6 had a sensitivity of 94% and a specificity of 71% in identifying need for hospitalization. A score of less than or equal to 5 had a negative predictive value for hospitalization of 95%. When two nonsuicidal patients, admitted for situational reasons only, were eliminated, a score of greater than or equal to 6 had a 100% sensitivity and a score of less than or equal to 5 had a 100% negative predictive value in identifying patients requiring hospitalization. Subsequent use of the weighted MSPS for an additional 82 patients confirmed these results. Follow-up of 97.5% (116/119) of all patients discharged from the emergency department at 6 to 12 months found no mortalities. Using a weighted MSPS, nonpsychiatrists can quickly and easily obtain the objective information necessary to make an initial assessment of suicidality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290326 TI - Medical museum notes (Dr. Frank B. Wynn, Abraham Lincoln). PMID- 3290327 TI - Evaluation of the uterine cervix for cancer. PMID- 3290328 TI - Medicine's lighter moments. PMID- 3290329 TI - Examining new solutions for Medicare funding. PMID- 3290330 TI - Immunocytochemical localization of actin in epithelial cells of rat small intestine by light and electron microscopy. AB - We used post-embedding immunocytochemical techniques and affinity-purified anti actin antibody to evaluate localization of actin in epithelial cells of small intestine by fluorescence and electron microscopy. Small intestine was fixed with 2% formaldehyde-0.1% glutaraldehyde and embedded in Lowicryl K4M. One-micron or thin sections were stained with antibody followed by rhodamine- or colloidal gold labeled goat anti-rabbit IgG, respectively. Label was present overlying microvilli, the apical terminal web, and the cytoplasm directly adjacent to occluding and intermediate junctions. Label was associated with outer mitochondrial membranes of all cells and the supranuclear Golgi region of goblet cells. Lateral cytoplasmic interdigitations between mature cells and subplasmalemmal filaments next to intrusive cells were densely labeled. The cytoplasm adjacent to unplicated domains of lateral membrane was focally labeled. Label was prominent over organized filament bundles within the subplasmalemmal web at the base of mature cells, whereas there was focal labeling of the cytoplasm adjacent to the basal membrane of undifferentiated cells. Basolateral epithelial cell processes were labeled. Label was focally present overlying the cellular ground substance. Our results demonstrate that actin is distributed in a distinctive fashion within intestinal epithelial cells. This distribution suggests that in addition to its function as a structural protein, actin may participate in regulation of epithelial tight junction permeability, in motile processes including migration of cells from the crypt to the villus tip, in accommodation of intrusive intraepithelial cells and in adhesion of cells to one another and to their substratum. PMID- 3290331 TI - Immunohistochemical localization of cellCAM 105 in rat tissues: appearance in epithelia, platelets, and granulocytes. AB - CellCAM 105 is an integral membrane glycoprotein, with apparent Mr 105,000, which has been purified from rat liver plasma membranes. It consists of two structurally similar, highly glycosylated polypeptide chains and is involved in cell-cell adhesion of adult rat hepatocytes in vitro. In this communication we report on the distribution and cell surface location of cellCAM 105 in rat tissues, obtained by using highly sensitive immunodetection systems based on complex formation between biotinylated antibodies, biotinylated peroxidase and avidin, or on antibodies coupled to alkaline phosphatase. CellCAM was found in many organs and organ systems, including liver, kidney, blood, blood vessels, glands, respiratory system, and gastrointestinal tract. It was mainly localized to epithelial structures but showed a varying cell surface distribution. In some cell types it was predominantly localized to cell-cell contact areas. In other cell types the highest concentrations were seen in brush-border areas containing densely packed microvilli. In addition to epithelial structures, cellCAM 105 was found in rat platelets, where it became strongly expressed on the cell surfaces after activation with ADP or collagen, suggesting that it might be involved in platelet adhesion and/or aggregation mechanisms. Granulocytes also contained cellCAM 105. By SDS-PAGE/immunoblotting, significant differences were found in the apparent Mr values of cellCAM 105 in different tissues. The collected data suggest that cellCAM 105 participates in several different cell surface membrane interactions, of which the common denominator might be membrane-membrane binding. PMID- 3290332 TI - Antibodies to mouse lung capillary endothelium. AB - We are interested in developing monoclonal antibodies (MoAbs) that recognize specific cell types in the lung of BALB/c mice. Normal mouse lung homogenate was used to immunize F344 rats and hybridomas were produced by fusion of rat spleen cells with mouse myeloma SP 2/0. Two hybridomas were selected which produced MoAbs active in immunohistochemistry of lung cells. MoAb 273-34A and 411-201B both show extensive peroxidase staining of capillary endothelial cells within alveolar walls of lungs at the light microscopic level. To demonstrate cell specificity, immunoelectron microscopy with gold-labeled antibody was performed. Lightly fixed lungs were frozen and thin-sectioned before staining with MoAb and 5-nm gold particles coupled to secondary antibody. Quantitative analyses of these cryosections show that both antibodies, used at optimal concentrations, are specific for binding to capillary endothelial cells. More than 95% of the gold particles are associated with capillary endothelial cells on the thin side of the alveolar wall. When capillaries adjoined thick septa containing interstitial cells, about two thirds of the gold particles were associated with endothelial cells and about one quarter with interstitial cells. These MoAbs should be useful in studying the role of endothelial cells in toxic lung injury. PMID- 3290333 TI - Immunocytochemical localization of cathepsins B, H, and their endogenous inhibitor, cystatin beta, in islet endocrine cells of rat pancreas. AB - To determine the characteristics of lysosomes in rat islet endocrine cells, we examined the precise localization of cathepsins B, H, and L and their specific inhibitors, cystatins alpha and beta, using immunocytochemical techniques. By use of serial semi-thin sections, we detected immunoreactivity for cathepsin B in insulin-, glucagon-, somatostatin-, and pancreatic polypeptide-positive (PP) cells. Strong immunoreactivity for cathepsin H was seen in A-cells and weak immunoreactivity in PP cells, but none in others. Immunodeposits for cystatin beta were demonstrated in B-cells. Brief dipping of thin sections in 1% sodium methoxide before the following immunocytochemical reaction enhanced specific deposits of immunogold particles on the target organelles. Use of a double immunostaining technique showed co-localization of insulin with cystatin beta in many secretory granules. This suggests that cystatin beta may regulate converting enzymes participating in the maturation process of insulin. By use of an immunogold technique, heterogeneous localization of cathepsins B and H in lysosomes was also found among islet cells at the light microscopic level. This may be due to the difference in peptides degraded in lysosomes among the cells. PMID- 3290335 TI - Immunocytochemical localization of myosin in rabbit liver cell. AB - It has been established that the liver cell possesses its own myosin which resembles other non-muscle myosins in subunit composition and in its dependence of actin-activated Mg2+-ATPase activity on light chain phosphorylation (Ueno T, Sekine T: Biochem Int, 1987;15:1205). We have raised a specific antibody against rabbit liver cell myosin. Immunoblot analysis has shown that the purified antibody reacts only with the heavy chain of liver cell myosin. The antibody did not react with rabbit skeletal muscle myosin or with smooth muscle myosin extracted from rabbit intestinal wall. Cryostat liver sections analyzed by indirect immunofluorescence microscopy showed a characteristic polygonal staining pattern, indicating that myosin is concentrated close to the plasma membrane, particularly in the region of bile canaliculi. Myosin therefore appears to be localized in the area where actin filaments are also abundant. PMID- 3290334 TI - Improvement of immunofluorescence for diagnosis of AIDS using laser microscopy. AB - One of the most commonly used methods for demonstration of HIV antibodies is indirect immunofluorescence employing HIV-infected, CD4-positive lymphoid cell lines as antigenic substrate. Immunofluorescence with conventional optic equipment is reported to be slightly less sensitive than enzyme-linked immunoassay (ELISA). We have developed an immunofluorescence microscope which is equipped with an argon laser that has the advantages of much brighter fluorescence than conventional techniques, the prevention of fluorescence bleaching, and the possibility of distinguishing specific from nonspecific staining by comparative analysis of the kinetics of the bleaching curves. This microscope has now been used for demonstration of HIV antibodies in indirect immunofluorescence tests on the H9 lymphoid cell line, which is highly efficient in expressing HIV after infection. Titers of ELISA and Western blot-verified HIV positive patients and appropriate normal controls were compared using four types of microscopic equipment, including the laser immunofluorescence microscope. The latter afforded significantly higher titers than those obtained with conventional immunofluorescence microscopes, and also made possible the distinction between specific and nonspecific staining. PMID- 3290336 TI - [Commemorative calendar of neuroscience for 1988]. PMID- 3290338 TI - Bibliography of the current world literature in hypertension. PMID- 3290337 TI - Cathepsin B immunoreactivity is widely distributed in the rat brain. AB - The cellular localization and regional distribution of cathepsin B within rat CNS was revealed by immunohistochemistry using a monospecific antiserum. Cathepsin B protein was found to be widely but unevenly distributed throughout rat brain. Neurons were always cathepsin B immunoreactive. Glial elements were only occasionally immunostained. The distribution of the enzyme resembles largely that of cathepsin D. PMID- 3290339 TI - Hypertension and cerebrovascular disease--the Japanese experience. PMID- 3290340 TI - Amplification of IL-2-driven T cell proliferation by recombinant human IL-3 and granulocyte-macrophage colony-stimulating factor. AB - Two recombinant human preparations of CSF, namely granulocyte-macrophage-CSF (GM CSF) and IL-3 (multi-CSF), were tested for their ability to stimulate the growth of human freshly separated and in vitro activated lymphocytes. Both CSF independently induced short term proliferation in unfractionated PBL and lectin stimulated T cells. Despite the great variability among different donors in the magnitude of lymphocyte response to the two growth factors, IL-3 at suboptimal concentrations (10 U/ml) consistently induced a higher proliferative response than did GM-CSF at suboptimal concentrations (5 ng/ml) in all of the preparations tested. When used in combination with IL-2, GM-CSF and, especially, IL-3 significantly potentiated the proliferative responses induced by IL-2 in both unstimulated and mitogen-activated lymphocytes. Dose-response curves using increasing concentrations of IL-2 and IL-3 and isobologram analysis of these interactions revealed a clear synergy of action between the two growth factors in inducing proliferation of unfractionated PBL, purified T cells, mitogen-activated lymphocytes, and alloantigen-stimulated T cells. In addition to enhancing the short term responsiveness to IL-2, GM-CSF and, especially, IL-3 drastically potentiated the long term growth of non-activated human lymphocytes and of lectin or Ag-activated T cells in the presence of IL-2. Immunofluorescence analysis indicated a higher expression of activation Ag (anti-Tac receptors and HLA class II Ag) in cultures incubated in the presence of IL-3 either alone or in conjunction with IL-2. The overall data indicate that human GM-CSF and IL-3 can support the growth of cells within the lymphoid lineage and exert potent amplifying effects on IL-2-induced T cell growth in vitro. PMID- 3290341 TI - Induction of monocyte migration by recombinant macrophage colony-stimulating factor. AB - Human recombinant macrophage-CSF (M-CSF) induced migration across polycarbonate or nitrocellulose filters of human peripheral blood monocytes. Checkerboard analysis of M-CSF-induced migration, performed by seeding different cytokine concentrations above and below the filter, revealed that the locomotory response involved chemotaxis, though some gradient-independent augmentation of migration occurred. Polymixin B did not affect M-CSF chemotaxis and M-CSF was active on monocytes from the LPS-unresponsive mouse strain C3H/HeJ. These findings rule out a contribution of minute endotoxin contamination, below the sensitivity of the Limulus assay, in M-CSF chemotaxis. Rabbit anti-M-CSF antibodies inhibited the chemotactic activity of recombinant M-CSF, thus further indicating that the M-CSF molecule was indeed responsible for chemotaxis. M-CSF preparations encoded by 224 or 522 amino acid cDNA clones were equally effective in inducing monocyte migration. Recombinant M-CSF did not elicit a migratory response in large granular lymphocytes and in endothelial cells under conditions in which appropriate reference attractants were active. A modest stimulation of migration of polymorphonuclear leukocytes, inhibitable by antibodies, was observed at high cytokine concentrations (10 to 100 times higher than those required for monocyte locomotion). The maximal polymorphonuclear leukocytes response evoked by M-CSF was small compared to that evoked by reference chemoattractants or to that evoked by the same cytokine in monocytes. Hence, M-CSF is a potent chemoattractant for mononuclear phagocytes and exerts its action preferentially on cells of the monocyte-macrophage lineage. M-CSF, produced locally by activated macrophages, may play a role in the selective recruitment from the blood compartment of mononuclear phagocytes to amplify resistance against certain noxious agents. PMID- 3290342 TI - C1q enhances the phagocytosis of Cryptococcus neoformans blastospores by human monocytes. AB - We investigated whether C1q, a subunit of the first component of C, could modulate human peripheral blood monocyte-mediated phagocytosis of Cryptococcus neoformans (CN). Adherence of monocytes to C1q-coated surfaces induced a significant enhancement of ingestion of CN blastospores that had been opsonized with specific anticapsular IgG (IgG-CN). Additionally, C1q enhanced the monocyte mediated phagocytosis of CN opsonized with C (CN-absorbed, nonimmune, normal human serum; C-CN). Ingestion of IgG- and C-CN by control and C1q-stimulated monocytes was maximal by 1 h of incubation. The monocyte-mediated enhancement of phagocytosis caused by C1q was paralleled by a proportionate increase in fungicidal activity, an effect which was maximal by 3 h of incubation. Human serum albumin-adherent, control monocytes exhibited only a low level of killing after 3 h of incubation. C1q enhancement was blocked by preincubation of the surfaces with a goat, polyclonal F(ab')2 anti-C1q. This study describes a new cellular function for the cell surface C1q receptor: the enhancement of phagocytosis of a pathogenic organism by monocytes. PMID- 3290343 TI - Characterization of the pattern of inflammatory cell influx and cytokine production during the murine host response to Listeria monocytogenes. AB - To examine the physiologic mechanisms responsible for enhanced antibacterial activity during infection with Listeria monocytogenes (LM), we developed an in vitro assay for quantifying leukocyte anti-listerial activity (LAA) in spleen and bone marrow. When LAA was serially measured in C57B1/6 (B6) mice infected i.v. with LM, two distinct phases of response were observed. Splenic LAA increased four- to fivefold during the first 2 days after i.v. infusion of LM (from 2.4 +/- 1.8 U/spleen before infection to 11.8 +/- 2.4, p less than 0.01), dropped significantly on days 3 to 4, and increased again to similar levels from days 5 to 7. A fall in bone marrow activity from the 3.5 +/- 1.5 to 1.6 +/- 0.7 U/mouse (two femurs) coincided with the initial rise in splenocyte activity, and was followed by a gradual return to base line. Bacterial containment in vivo correlated well with splenic LAA in vitro. Carbonyl iron pretreatment of cells from both normal and LM-infected animals ablated LAA, suggesting the effectors were phagocytic. LAA in normal spleens was unaffected by 400 rad; LAA of normal marrow as well as splenocyte and marrow cell suspensions obtained 2 days after LM infection was markedly reduced by this dose of irradiation. Quantitative studies of spleen composition revealed a 10-fold increase in polymorphonuclear neutrophils between day 0 and day 2 followed by a marked decrease on day 3; this pattern closely resembled the changes in LAA observed during the same period. In contrast, splenic macrophage number did not increase from base line until after day 3. To look for evidence of changes in the efficiency of bacterial killing by phagocytes during infection, we calculated LAA/splenic phagocyte. The efficiency of killing increased threefold over base line within 1 day after LM infusion but we detected no additional increases later in infection. Because cytokines may have mediated some or all of the changes observed, we measured the capacity of splenocytes obtained at various times after infection to produce IL-2, TNF, and IFN-gamma in vitro. TNF activity increased in parallel with the first and second LAA peaks, whereas increases in IL-2 and IFN-gamma activity were associated only with the second.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3290344 TI - Epithelial and neural localization and heparin binding of the cell-substratum adhesion molecule, epinectin. AB - Epinectin, a cell-substratum adhesion promoting molecule, was first isolated from the extracellular matrix of A431 human squamous carcinoma cells. In order to determine the biologic significance of epinectin, we determined the distribution of epinectin in various rat epithelial tissues by indirect immunofluorescence microscopy. Polyclonal antibodies to epinectin stained basal cells and basilar regions of skin, urinary bladder, and vagina. There was predominantly cytoplasmic staining along with amorphous extracellular staining. Strong staining was also noted in sebaceous glands and hair follicles. The immunoreactivity for epinectin in the skin was distinct from that for fibronectin, laminin, and type IV collagen. Antibodies to epinectin also stained subpopulations of neurons in the cerebrum and cerebellum. Epinectin antibodies strongly stained the cytoplasm of some pineal cells and cells of the pars intermedia of the pituitary. The distribution of epinectin suggests a role not only in epithelial cell-substratum adhesion, but in neuronal cell function. Heparan sulfate is known to be involved in the binding of several adhesion promoting molecules to cell surfaces. In order to assess the mechanism of adhesion of epinectin to cells, we measured the binding of 3H-heparin to epinectin. Binding of 3H-heparin was concentration dependent and inhibitable with cold heparin. PMID- 3290345 TI - Laboratory tests in the diagnosis of the chronic pancreatic diseases. Part 6. Differentiation between chronic pancreatitis and pancreatic cancer. PMID- 3290346 TI - Response of tumours to hyperglycaemia: characterization, significance and role in hyperthermia. AB - The response of both neoplastic and surrounding normal tissue to hyperthermia is influenced by a number of physical, physiological, biological and immunological factors. Two physiological factors that play an important role are blood flow and pH. Temperature distributions within neoplastic and surrounding normal tissue during hyperthermia are influenced by convective heat transfer between the blood and tissue bed. A number of in vitro studies have illustrated that lowering media pH sensitizes cells to hyperthermia. It has been suggested that pharmacological agents could be used in conjunction with hyperthermia treatment to improve cancer treatment if these agents decrease tumour blood flow and/or decrease tumour pH. One agent that has been studied extensively for this purpose is glucose. The objective of this paper is to review the results on the effect of hyperglycaemia on normal and tumour tissue blood flow and pH and its role in hyperthermia. After a brief discussion of the role of tumour pH and blood flow in hyperthermia treatment, data available in the literature on the effect of hyperglycaemia on normal and tumour tissue blood flow and pH are reviewed. Finally, the role of hyperglycaemia in hyperthermia treatment is discussed, and various studies involving the combined treatment are summarized. Key unanswered questions and directions for future research are pointed out. PMID- 3290347 TI - Temperature elevation at muscle-bone interface during scanned, focused ultrasound hyperthermia. AB - The effect of a muscle-bone interface on the temperature distribution during scanned, focused ultrasound hyperthermia was studied in vivo in dogs' thighs. The detailed temperature maps showed a sharp temperature maximum at the interface. The magnitude of the temperature elevation was between two and four times as large as obtained in resting muscle with similar intensities. The muscle tissue close to the bone could be heated to a therapeutic temperature level without overheating the bone when higher frequency or multiple-focused beams were used. The results showed that bone pain associated with ultrasound hyperthermia treatments is probably caused by extreme temperatures in bone, which can be avoided by sonicating the tumour in such a manner that the intensities at the bone surface are low enough so as not to cause large temperature elevations. Therefore, treatment planning which takes into account the location of bones is necessary for successful, clinical utilization of scanned, focused ultrasound hyperthermia. PMID- 3290348 TI - Laser Doppler flowmetry in subepidermal tumours and in normal skin of rats during localized ultrasound hyperthermia. AB - Laser Doppler flowmetry has been applied to normal skin and to subepidermal tumours during localized ultrasound hyperthermia in the rat. In normal skin, 40 degrees C hyperthermia only induced a marginal increase in the red blood cell flux. Significant increases occurred after 20 min at 42 degrees C and after 4 min at 44 degrees C. During 44 degrees C hyperthermia maximum fluxes were reached after 24 min. Thereafter, the flow declined and finally approached preheating values. In contrast, in subepidermal tumours 40 degrees C hyperthermia on the average induced a slight decrease of the flux. During 42 degrees C hyperthermia a significant flow decrease was found after 40 min of heating. Following a transient increase in the laser Doppler flow during the heating-up period, 44 degrees C hyperthermia led to a significant impairment of the flux after 24 min. A total shutdown of RBC flux was observed in about 30 per cent of the tumours at 44 degrees C. Upon elevated tissue temperatures, pronounced inter-tumour variabilities in the time- and temperature-dependent changes of RBC flux were observed. Rhythmic oscillations of the RBC flux were found in some subepidermal tumours (0.40 +/- 0.05 cycles/min). Upon heating, these periodic flow variations slowed down significantly (0.20 +/- 0.04 cycles/min), whereas in normal skin the frequency of the flow fluctuations increased. PMID- 3290349 TI - Protection against heat-induced cell killing by alanine. AB - When L-alanine was added either to full growth medium or to Hanks' balanced salt solution (HBSS) prior to hyperthermia, survival of heated cells was significantly increased in a concentration-dependent manner. Maximal heat protection was not immediate, but required at least 1 h at 37 degrees C incubation prior to heating. Heat protection was principally reflected in an increased Dq on the 45 degrees C survival curve; for example, with 100 mM L-alanine, the Dq increased from approximately equal to 20 (control) to 30 min at 45 degrees C. Hyperthermia of 1 h at temperatures between 42 degrees C and 45 degrees C indicated that 100 mM alanine had shifted the isotoxic temperature by 0.5 degrees C. Comparable heat protection was also observed with D-alanine and amino acid dimers, such as alanyl alanine or alanyl-leucine. Leucine at similar concentrations by itself, without alanine, did not protect cells against heat killing, but increased cellular heat sensitivity. The data suggest that heat protection by alanine does not require incorporation of alanine into cellular protein, but is mediated by the free amino acid. PMID- 3290350 TI - Chemical modification of tumour blood flow. AB - The preferential modification of tumour blood flow with chemical agents has been extensively investigated for the purpose of improving the treatment of tumours with ionizing radiation, chemicals and hyperthermia. In this paper I have utilized representative vasoactive drugs to demonstrate the various mechanisms via which tumour haemodynamics can be modified selectively. Chemicals which alter tumour blood flow by changing blood viscosity are also discussed. Of particular interest are the calcium entry blockers, flunarizine and verapamil, which have been shown to increase tumour blood flow, tumour oxygenation, tumour radiation sensitivity and the cytotoxicity of chemotherapeutic agents. These encouraging research results provide compelling evidence that these two drugs may prove to be useful adjuvants for radiation therapy. PMID- 3290351 TI - [The effect of free radical scavengers during heart transplantation]. PMID- 3290352 TI - [A case of neurinoma originating from the left vagus nerve in the antero-superior mediastinum]. PMID- 3290353 TI - [Successful reconstruction of a carinal disruption immediately after blunt chest trauma]. PMID- 3290354 TI - [Coarctation of the aorta with right aortic arch]. PMID- 3290355 TI - [Mixed type (IB + III) total anomalous pulmonary venous drainage--a successful correction in a 9-month-old infant]. PMID- 3290357 TI - Distal bypass with the saphenous vein in situ. Technical aspects and early results. AB - The in situ saphenous vein graft has theoretical advantages, e.g. preservation of vasa vasorum and normally functioning endothelium, over the reversed vein graft and has gained popularity in recent years. Forty-three patients underwent 45 distal in situ saphenous vein bypasses for limb salvage during a 15-month period. The Hall valve stripper was found to be superior to the Mill valvulotome for valve incision. Intraarterial digital subtraction angiography (DSA) was a useful tool for perioperative anastomosis and graft evaluation. The incidence of early graft failure, 8/45 (18%), was mostly due to identifiable causes, mainly small caliber veins (less than 2.5 mm diameter). The cumulative patency rate of 77% remained stable during the follow-up period of 15 months. Perioperative mortality was zero. The main technical advantage with the in situ method is the reduced size disparity at the anastomotic sites. The in situ technique allowed the successful use of veins as small as 2.5 mm in diameter which resulted in a vein utilization rate of 95%. This rendered long distal bypasses possible in patients who could not have been reconstructed with the reversed vein technique. PMID- 3290356 TI - Effect of long-term ketanserin treatment on 5-HT levels, platelet aggregation and peripheral circulation in patients with Raynaud's phenomenon. A double-blind, placebo-controlled cross-over study. AB - The long-term effects of the serotonergic (5-hydroxy-tryptamine, 5-HT) receptor antagonist, ketanserin, on 5-HT levels in whole blood, platelet aggregation and peripheral circulation were investigated in a double-blind placebo-controlled cross-over study. In 13 patients with Raynaud's phenomenon, 5-HT and catecholamine levels in whole blood were determined and platelet aggregation assayed after addition of ADP, collagen and 5-HT. Peripheral circulation was evaluated with fingertip temperatures and finger plethysmography before and after local cooling, with measurements repeated after indirect sympathetic blockade by body warming and after alcohol. Patients' symptoms were continuously registered in an individual diary. All measurements were performed 8 to 12 hours after the last drug intake. Five of seven scleroderma patients reported beneficial effects of ketanserin treatment and all six patients with primary Raynaud's phenomenon reported less severe and shorter cold-induced attacks. 5-HT levels in whole blood were significantly reduced after 5 weeks of ketanserin treatment (p less than 0.001) with a tendency for persistence of this reduction after halting of the medication (a "carry-over" effect). Platelet aggregation velocity induced by ADP, collagen and 5-HT was unaffected after ketanserin treatment. The diastolic blood pressure in these patients was decreased from 77.5 mmHg to 71.0 mmHg (p less than 0.001) after ketanserin, but the finger systolic blood pressure (FSBP) was unchanged. After sympathetic blockade by body warming, patients with ketanserin treatment had a paradoxical reduction in both FSBP and finger-tip temperatures, which makes a supposed alpha-receptor-blocking effect of ketanserin less likely. The reduced 5-HT levels in whole blood may explain the subjective favourable effect on patients with Raynaud's phenomenon. PMID- 3290358 TI - Patients with reversible ischemic neurological deficit (RIND) have less severe carotid artery lesions than those with transient ischemic attack (TIA) evaluated by duplex ultrasound. AB - Fifteen patients with amaurosis fugax (AF), 37 with hemispheric TIA and 35 with reversible ischemic neurological deficit (RIND) were examined in the extracranial carotid arteries by duplex ultrasound within two months from symptoms. The most advanced atherosclerotic lesions were found among AF followed by hemispheric TIA. These two groups differed significantly from RIND which showed less advanced lesions, both on the symptomatic and asymptomatic side. Among RIND patients lesions showing 50% stenosis or more were seldom seen. Similar differences between the three groups were found after angiography of a subgroup. The hemispheric TIA group showed cholesterol, triglycerides and creatinine compared to AF and RIND. Previous atherosclerotic cardiovascular diseases were more often found among AF and hemispheric TIA than among RIND. It is suggested that TIAs, including AF, and RIND should be regarded as separate entities from a pathophysiological and clinical point of view. PMID- 3290359 TI - Digital subtraction angiography versus standard contrast arteriography in evaluation of peripheral vascular disease. AB - Fifteen patients with lower limb ischemic disease were preoperatively assessed with both intravenous or intra-arterial digital subtraction angiography (DSA), and standard contrast angiography (SCA). The images were reviewed and the operative strategies, based on the clinical data and each of SCA and DSA, were compared. SCA provided more information than DSA in two patients, one of which had an incomplete DSA investigation. DSA provided more information than SCA in three patients. The distal crural vessels were better visualized with DSA in one patient, and popliteal lesions were demonstrated as being more severe using DSA than with SCA in two patients. The level of the distal anastomosis of the proposed bypass was lowered to below the knee as a result of DSA in these two patients. We conclude that comparable information is obtained using SCA or DSA, and that DSA, in particular the intraarterial technique, is a satisfactory alternative to SCA in preoperative evaluation of patients with lower limb ischemic disease. PMID- 3290360 TI - Histopathological characterization of carotid plaques echotomography. AB - The positive correlation between cerebral ischemia and carotid atherosclerosis of extracranial tract has been well established. The reliability of echotomography as diagnostic and prognostic tool in the evaluation of the carotid atherosclerotic lesions is now intensively investigated. Most of the attention has been payed to the accuracy in the determination of the carotid stenosis. A percentage of cerebrovascular accidents do not correlate to the vascular stenosis but to the other modifications induced by the atherosclerotic plaque, such as the release of emboli, acute stenosis for intraplaque haemorrhage or thrombosis. Thus the evaluation of the composition of the plaque may represent a good prognostic tool. In the present study, fifty-two carotid obtained at surgery from patients, who preoperatively underwent ultrasonographic scanning of both carotid arteries, were examined by histological methods. In calcified tissues a significant correlation between findings obtained with both techniques was observed. In the complicated plaques atheromasic gruel, intraplaque haemorrhages and thrombosis could not be discriminated by echotomography. PMID- 3290361 TI - [Enzyme immunological measurement of estrogen receptors in the human endometrium by the use of monoclonal antibody]. AB - The concentrations of cytosol (ERc), nuclear (ERn), and total (ERc+n) estrogen receptors were determined by Enzyme Immunoassay using Monoclonal Antibody, in normal endometrium freshly obtained from 13 cases, and were compared with those determined by a conventional ligand binding assay on LH-20 (LH-20 assay). There was good correlation between EIA and LH-20 values. The correlation coefficients for ERc, ERn and ERc+n were 0.960, 0.980 and 0.950, respectively. Regression lines were as follows; Ec = 1.22Lc-4.07, En = 1.18Ln+37.7 and Ec+n = 1.27 Lc+n 158.4. These results clearly demonstrate the applicability of the ER-EIA for the determination of estrogen receptors in the endometrium. Particularly for clinical laboratory purposes, the enzyme immunoassay has some advantages over the conventional binding assay in terms of non-radioactivity and simple procedure. PMID- 3290362 TI - [Studies on the cardiotocograms recorded by a new system with 1 MHz ultrasound and autocorrelation heart rate meter]. AB - Improved FHR records were obtained by the use of a new 1 MHz ultrasound transducer and autocorrelation heart rate meter. The results were compared with conventional 2.5 MHz continuous wave ultrasound device. The rate of the loss of FHR recording was 0 to 6.6% (2.8 +/- 2.1%) in the new device, and it was 2.1 to 23.5% (8.7 +/- 6.2%) in the old one. The loss of FHR record in the 2nd stage of labor was 3.2% when 1 MHz ultrasound and new device were used, and it was 2.0% with direct fetal ECG signal using scalp electrode and the same device. More clear record was obtained with use of ultrasound at a crowning of fetal head than that of direct fetal ECG. In the use of 1 MHz ultrasound, 51% cases in 55 patients showed undisturbed FHR record 1 minute before delivery of the fetus. Slightly noisy but analysable FHR record was obtained in 36%. Hence, the FHR records were clearly evaluated until 1 minute before delivery of the infant in 87% of the cases. Maternal heart rate signal was mixed with FHR in 2 cases in routine intrapartum ultrasonic FHR monitoring. However, the maternal signal disappeared after moving the transducer to other position where fatal heart beat was more clearly detected. PMID- 3290363 TI - [Clinical management of IUGR fetus]. PMID- 3290364 TI - [Role of epidermal growth factor in reproduction]. PMID- 3290365 TI - Mallet finger. PMID- 3290366 TI - Treatment of post-traumatic contracture of the hand. PMID- 3290367 TI - The dorsal occult ganglion of the wrist and ultrasonography. AB - In five cases of suspected occult ganglion on the back of the wrist, an ultrasonographic examination was performed. This revealed a small hypoechogenic area on the dorsal aspect between the scaphoid and the lunate or just dorsal to the lunate. Exploration of this area in three cases confirmed the presence of an occult ganglion. In the other two cases, further aspiration revealed traces of mucinous jelly at the tip of the needle. PMID- 3290368 TI - Treatment of ganglia by a thread technique. AB - Seventy ganglia of the wrist have been treated by a new method whereby two sutures are passed through the ganglion, at right angles to each other, and each is tied in a loop. At intervals thereafter, the contents of the ganglion are expelled by massage. Only three recurrences occurred in 62 patients followed-up. This compares well with the results of surgical excision and avoids the complications of operation and anaesthetic. PMID- 3290369 TI - An unusual subcutaneous neck lump. PMID- 3290370 TI - Scrofula revisited. AB - Mycobacterial cervical lymphadenitis, or scrofula, is a disease dating back thousands of years. In spite of modern treatment and public health measures, scrofula persists but is infrequently seen. Five patients with cervical tuberculous lymphadenitis as a sole presentation have been seen in our department in the last 10 years. The clinical presentation and current methods of diagnosis and treatment are described. A short historical review is given. PMID- 3290371 TI - Risk management for hazardous chemicals. Adverse health consequences of their use and the limitations of traditional control standards. PMID- 3290372 TI - A review of the validity and efficacy of the Health Risk Appraisal instrument. AB - The Health Risk Appraisal instrument links life-style factors with the probability of death by comparing an individual's profile to national averages. The result, usually generated by computer, is used to counsel the individual to modify risk factors that could lead to disease. This paper reviews the validity of the Health Risk Appraisal, its reliability, and its effect on health behavior. While the results of observational studies support the efficacy of the Health Risk Appraisal, more controlled studies have not been able to demonstrate a strong effect. Methodological problems are briefly discussed. Although there are valid criticisms leveled at the procedure, the Health Risk Appraisal has become quite popular as a health education tool and may represent the future in preventive care. PMID- 3290373 TI - Thermographic imaging of myofascial trigger points. AB - Thermographic findings in two patients suffering from myofascial trigger points are presented. These are shown as discrete foci of increased thermal emission, with corresponding areas of diffuse hyperthermia. These thermal findings correlate highly with the classic locations of specific trigger points and their areas of pain referral, respectively, as described in literature. Not only do these cases describe a thermal pattern that varies somewhat from previous reports, but they also illustrate the previously unreported imaging of areas of pain referral from specific trigger points. PMID- 3290374 TI - A critical look at the subluxation hypothesis. AB - Historically, manipulation has been applied to manage spinal and extremity joint lesions that produce pain. The cause of this local or referred joint pain often has been attributed to subluxation or partial dislocation. This paper looks at the historical roots of the subluxation hypothesis, and reviews the literature to see if any valid research exists supporting the hypothesis that slight subluxations correlate with local or referred pain or is a cause of fixation. Also examined is whether proof exists that manipulation reduces subluxation. Associations between subluxation and the manipulable lesion are outlined, and suggestions for use of the word subluxation are addressed. The term somatic dysfunction is forwarded as an appropriate descriptive diagnosis of the manipulable lesion. PMID- 3290375 TI - Short leg correction: a clinical trial of radiographic vs. nonradiographic procedures. PMID- 3290376 TI - Efficacy of various methods of sterilization of acupuncture needles. AB - The iatrogenic transmission of hepatitis B virus by inadequately sterilized acupuncture needles recently has been reported. Because some licensed chiropractors use acupuncture as a therapeutic modality, we have evaluated sterilization methods for these needles, which would be adaptable for use in a chiropractic office. Dry heat, boiling water, pressurized steam, sodium hypochlorite, and 70% alcohol were compared with a glass bead dry heat sterilizer originally developed for dental instruments. Presterilized acupuncture needles were contaminated with Bacillus stearothermophilus, Escherichia coli or Staphylococcus epidermidis and sterilized for intervals ranging from 5 sec to 30 min. The needles were then cultured to determine the efficacy of the sterilization regimen. Seventy percent alcohol was ineffective as a sterilization method. In terms of both time and convenience, the glass bead apparatus was the most efficient of the remaining methods tested. B. stearothermophilus contaminated acupuncture needles were sterilized within 10 sec of exposure to preheated glass beads. Less than 10 sec exposure killed E. coli and S. epidermidis. A significant advantage of the glass bead sterilizer over the other methods was the absence of physical damage to the needles. PMID- 3290377 TI - Static and dynamic components of the chiropractic subluxation complex: a literature review. AB - Intervertebral dysfunction refers to a biomechanical fault which is abnormal in both its dynamic and static components. A subluxation may be considered as being fixated and also slightly malpositioned in one or more axes of rotation. Subluxation may be considered as one component of a complex or syndrome of intervertebral dyskinesia, dysarthrosis or dysfunction. The biochemical and histological components explain some of the pain mechanisms, tissue changes and residual effects of acute and chronic intervertebral fixation and the need for repeated spinal manipulations and prolonged care. Interexaminer reliability studies indicate that a standard method of motion palpation is quite feasible and accurate. X-ray evidence of dyskinesia shows promise as a means of documenting subluxation fixations. PMID- 3290378 TI - Gastroduodenal intussusception: a case report and literature review. PMID- 3290379 TI - Lymphocyte subsets show marked differences in their distribution between blood and the afferent and efferent lymph of peripheral lymph nodes. AB - The surface phenotypes (CD1, CD4, CD5, CD8, SBU-T19, MHC class I, MHC class II, and sIg) of cells in blood, lymph nodes, and lymph were determined to examine simultaneously the distribution of lymphocyte subsets circulating in blood, afferent lymph, and efferent lymph of a peripheral lymph node. Marked differences in the percentage of certain lymphocyte subsets were apparent within the compartments examined, suggesting that lymphocyte subsets leave the blood with differing efficiencies. Lymphocyte subsets also appeared to be extracted from the blood at different rates by lymph node as opposed to subcutaneous vascular endothelium. Endothelial cells in different vascular beds may express different numbers of molecules complementary to a set of migration-related cell surface molecules specific for each lymphocyte subset. Accordingly, the vascular endothelium would be the key factor in regulating nonrandom cell migration. PMID- 3290380 TI - Expression of genetically determined diabetes and insulitis in the nonobese diabetic (NOD) mouse at the level of bone marrow-derived cells. Transfer of diabetes and insulitis to nondiabetic (NOD X B10) F1 mice with bone marrow cells from NOD mice. AB - The development of autoimmune diabetes in the nonobese diabetic (NOD) mouse is controlled by at least three recessive loci, including one linked to the MHC. To determine whether any of these genetic loci exert their effects via the immune system, radiation bone marrow chimeras were constructed in which (NOD X B10)F1 irradiated recipients were reconstituted with NOD bone marrow cells. Unmanipulated (NOD X B10)F1 mice, or irradiated F1 mice reconstituted with F1 or B10 bone marrow, did not display insulitis or diabetes. In contrast, insulitis was observed in a majority of the NOD----F1 chimeras and diabetes developed in 21% of the mice. These data demonstrate that expression of the diabetic phenotype in the NOD mouse is dependent on NOD-derived hematopoietic stem cells. Diabetogenic genes in the NOD mouse do not appear to function at the level of the insulin-producing beta cells since NOD----F1 chimeras not only developed insulitis and diabetes but also rejected beta cells within pancreas transplants from newborn B10 mice. These data suggest that the beta cells of the NOD mouse do not express a unique antigenic determinant that is the target of the autoimmune response. PMID- 3290381 TI - The dynamics of granuloma formation in experimental visceral leishmaniasis. AB - We have examined the temporal sequence of events leading to the formation of hepatic granulomas after the intravenous injection of L. donovani amastigotes into BALB/c mice. Parasite ingestion by permissive Kupffer cells (KC) occurred promptly, and local KC aggregations were the foci about which granulomas were subsequently formed. Infected KC were recognized by the uptake of colloidal carbon and the expression of the macrophage-specific antigen recognized by F4/80 mAb. Peroxidase-positive granulocytes migrated rapidly and were followed by monocytes and L3T4+ T cells that enclosed the infected KC. Thereafter, Ly-2+ T cells were prominent members of the granulomatous lymphoid population. Parasites multiplied until 4 wk, and then a prompt reduction in infected cells occurred. This was associated with a sharp decline in the L3T4+ T cells of the granulomas and the maintenance of the Ly-2+ subset. In comparison, athymic nu/nu mice developed smaller, more slowly appearing granulomas that contained granulocytes and monocytes and exhibited progressive parasite replication. Upon rechallenge, the entire process was completed in 2 wk, and infected KC in the euthymic mice were never observed. We hypothesize that the effectiveness of the granulomatous response requires the destruction of parasitized host cells (KC), in a lymphokine rich environment. We further suggest that the Ly-2+ T cell serves as an important effector cell in this process, either by direct cytotoxicity or by supporting the cytotoxic potential of other cell types in the granuloma. PMID- 3290382 TI - Cloning and characterization of a cDNA for murine macrophage inflammatory protein (MIP), a novel monokine with inflammatory and chemokinetic properties. AB - In the course of studies on cachectin/TNF being conducted in our laboratory, a novel macrophage product has been detected and characterized. Termed macrophage inflammatory protein or MIP, this protein appears to be an endogenous mediator of the inflammatory events induced by endotoxin. A cDNA cloned probe for this protein has been isolated from a lambda gt10 phage library prepared from poly(A)+ RNA obtained of endotoxin-induced RAW264.7 cells. The sequence codes for a 92 amino acid-long polypeptide, of which 69 amino acids correspond to the mature product. The sequence predicts a molecular weight of 7,889 and structural analysis of the protein indicates a characteristic signal sequence alpha-helix and a hydrophobic core. Sequence data also confirm no sequence similarity to any other protein listed in the Dayhoff data base. PMID- 3290383 TI - Passive acquired mucosal immunity to group A streptococci by secretory immunoglobulin A. AB - We present a model in which animals are passively immunized at a mucosal site, allowing one to evaluate immunological protection at the mucosal level only. Affinity-purified, anti-M protein sIgA administered intranasally protected mice against systemic infection after intranasal challenge with group A streptococci. In contrast, anti-M protein serum Ig administered intranasally was not protective at this site, although it neutralized the antiphagocytic property of M protein and promoted phagocytosis. Protection by sIgA occurred despite the lower immunoreactivity of sIgA to purified M protein compared with serum Ig. The data suggest that sIgA can protect at the mucosa and may preclude the need for opsonic IgG in preventing streptococcal infection. PMID- 3290384 TI - Interleukin 1 potentiates the lethal effect of tumor necrosis factor alpha/cachectin in mice. AB - Human rIL-1 alpha and human rIL-1 beta were examined for their ability to potentiate the lethal and hypothermic effects of mouse rTNF-alpha in mice. The LD50 of rTNF-alpha was 1.5 micrograms/mouse, whereas the LD50 of rTNF-alpha was reduced to 0.4 micrograms/mouse and 0.5 micrograms/mouse when rTNF-alpha was administered in combination with a nonlethal dose of rIL-1 alpha or rIL-1 beta, respectively. A similar rTNF-alpha enhancing effect of the rIL-1 was observed on the temperature response. The results show that the rIL-1 markedly potentiate the effects of rTNF-alpha on lethality and temperature in mice, and support our suggestion that TNF-alpha and IL-1 may have synergistic lethal effect in human septic shock. PMID- 3290385 TI - (NZW x BXSB)F1 mouse. A new animal model of idiopathic thrombocytopenic purpura. AB - A decrease in thrombocyte count was observed in (NZW x BXSB)F1 (W/B F1) mice at the age of greater than 5 mo, whereas megakaryocyte counts were found to increase in such mice. FACS analyses revealed the presence of both platelet-associated antibodies (PAA) and circulating antiplatelet antibodies. There is a correlation between the presence of these antibodies and the degree of thrombocytopenia. The transplantation of normal bone marrow cells from BALB/c nu/nu mice to W/B F1 mice was found to have preventative and curative effects on thrombocytopenia; the mice showed normal platelet counts and no evidence of circulating antiplatelet antibodies. These results indicate that thrombocytopenia in W/B F1 mice is due to the presence of antibodies to platelets. We therefore think that W/B F1 mice serve as a useful animal model of idiopathic thrombocytopenic purpura (ITP) not only for elucidating the mechanism of the development of antiplatelet antibodies, but also for characterizing autoantibodies to platelets. PMID- 3290387 TI - Formation of flagella during interphase in secondary spermatocytes from Xenopus laevis in vitro. AB - In cell culture, single motile flagella, 1 micron in length, were observed to grow from secondary spermatocytes of Xenopus laevis within 2-3 hours after telophase I, at 22 degrees C. About 90% of the secondary spermatocytes formed flagella as observed by phase-contrast microscopy. The flagella grew up to 2-6 microns in length during interphase II, which lasted about 18 hours. The presence of the "9 + 2" microtubular structure of the flagellar axonemes of secondary spermatocytes was confirmed by electron microscopy. When chromosomal condensation began (prophase II), the flagella were resorbed into the cells and, after the second meiotic division, a flagellum was formed again by each of the round spermatids. Thus, there appears to be a close relationship between the meiotic division cycle and the formation of flagella. The possible contribution of Sertoli cells to the formation of flagella in secondary spermatocytes was examined by reducing the number of Sertoli cells to less than ten per culture. Under these conditions, flagella formed in secondary spermatocytes with very high efficiency. It is very likely that secondary spermatocytes form flagella in vivo, since the secondary spermatocytes were observed to have flagella immediately after dissociation of the testes. PMID- 3290386 TI - Cardiovascular effects of prostaglandin I2 and prostaglandin F2 alpha in the unanesthetized bullfrog, Rana catesbeiana. AB - The cardiovascular effects of prostaglandin (PG)I2 and PGF2 alpha were compared in the unanesthetized American bullfrog (Rana catesbeiana). Control mean arterial pressure (MAP) and heart rate (HR) were 25.7 +/- 1.1 mm Hg and 35.1 +/- 1.1 beats/min, respectively. Intravenous injections of PGI2 decreased MAP and increased HR in a dose-dependent fashion over the range of concentrations tested (0.03, 0.3, 3, and 10 micrograms/kg-body weight [bw]. Neither atropine (1 mg/kg bw) nor verapamil (1 mg/kg-bw) treatment altered the MAP or HR responses to PGI2 (3 micrograms/kg-bw). However, propranolol (5 mg/kg-bw) significantly blunted the hypotensive effects without affecting the increase in HR. Prostaglandin F2 alpha (tested at 0.3, 3, 30, and 100 micrograms/kg-bw) increased both MAP and HR. Mean arterial pressure increased with concentrations greater than 0.3 microgram/kg-bw and reached peak effects at 30 micrograms/kg-bw. Prostaglandin F2 alpha increased HR at doses greater than 0.3 microgram/kg-bw. Neither the pressor nor positive chronotropic effects of PGF2 alpha (30 micrograms/kg-bw) were affected by atropine or propranolol. However, verapamil significantly attenuated the pressor effects without affecting the increase in HR. These results demonstrate that both prostaglandins have qualitatively similar effects on HR, but opposite effects on MAP. Prostaglandin I2 is a hypotensive prostaglandin, while PGF2 alpha is hypertensive. The pressor effects of PGF2 alpha are partially dependent on calcium influx. The positive chronotropic effects of both prostaglandins are independent of the autonomic nervous system, suggesting a different mechanism of action. PMID- 3290389 TI - An examination of a contaminated seminal stain using absorption-elution and enzyme-linked immunosorbent assay (ELISA). AB - A semen stain, apparently contaminated with a detergent cleanser, was received for examination. The contamination interfered with the normal biochemical reactions of such stains. Treatment of the sample enabled ABO groups to be determined. PMID- 3290388 TI - An improved method for the histological preparation of single hairs and dust samples--morphological and immunological examination. AB - An improved method of the serological and morphological investigation of human hair is reported. The hair was firmly fixed onto a microscopic slide with cellophane tape and observed microscopically to confirm the cuticula images and the presence of the medulla. A piece of the hair containing the medulla was dissected, embedded in paraffin, and a cross section of this hair was prepared. By treating the sample with immunohistochemistry (biotin-antibiotin ABC technique), the blood type of the hair was confirmed definitively. Dust containing shaved beard can be examined in the same way. PMID- 3290391 TI - Coercion and socialized medicine. PMID- 3290390 TI - Delayed traumatic intracerebral hematoma (DTICH) and the determination of the manner of death. A case report and review of the literature. AB - The concept of a traumatic incident resulting in death when there has been a prolonged interval between the two events raises questions for medical examiners. A case is presented in which a 33-year-old man was found dead in his locked home. Although there was no evidence of foul play at the scene, the death was subsequently found to be directly related to an episode of head trauma sustained in an altercation approximately 1 1/2 months before. The fatal lesion was a large intraparenchymal hematoma in the right frontal lobe of the brain which had developed in an area of contusion identified by computerized tomography (CT) scan while he was hospitalized following the trauma. The literature regarding delayed traumatic intracerebral hematoma (DTICH) is reviewed and its relevance to cases coming under the jurisdiction of a medical examiner is discussed. PMID- 3290392 TI - Cholesterol and coronary atherosclerosis. PMID- 3290394 TI - In memoriam Herbert Barden, Ph.D. (1927-1987). PMID- 3290393 TI - Pharmacologic treatment of hypercholesterolemia. PMID- 3290397 TI - Cervical cancer in nuns and prostitutes: a plea for scientific continence. PMID- 3290398 TI - The International Agranulocytosis and Aplastic Anemia Study (IAAAS) PMID- 3290396 TI - Serum cholesterol and risk of cancer in a cohort of 39,000 men and women. AB - Serum cholesterol concentration was studied for its prediction of cancer in 39,268 men and women aged 15-99 years and initially free from cancer. During a median follow-up of 10 years 1381 cancer cases were diagnosed. Serum cholesterol level was inversely associated with cancer incidence among non-smokers. Age adjusted relative risks of cancer in quintiles of serum cholesterol were in male non-smokers 1.0, 0.81, 0.73, 0.69, and 0.46 and in female non-smokers 1.0, 0.75, 0.84, 0.78, and 0.70. The associations were not found to be confounded by serum vitamins A or E, serum selenium or several other factors. The association between serum cholesterol level and risk of cancer varied from strongly negative to slightly positive according to subpopulation and site of cancer. The strongest negative associations were found to appear during the first years of follow-up, especially for rapidly developing cancers. Thus the increased occurrence of cancer at low cholesterol levels seems mainly to be due to preclinical cancer. PMID- 3290395 TI - The role of clinical neuropsychology in the neurological diagnosis of Alzheimer's disease. AB - This survey on the early diagnosis of Alzheimer's disease (AD) reinstates the role of clinical neuropsychology in describing the cognitive status of AD and its evolution. The role of clinical neuropsychology is restricted to the clinical diagnosis of organic mental deterioration and its contribution to the diagnosis of AD is separate from that of neurology and neuroradiology. The frequency of a single neuropsychological disturbance in early AD patients is illustrated by our own observations. PMID- 3290399 TI - Hyperlipidemia after heart transplantation. AB - Because hyperlipidemia may be a factor in the development of late graft atherosclerosis after heart transplantation, we have studied serum lipid levels in patients during the first year after transplantation. Serum cholesterol and triglyceride levels were measured in the preoperative period and at regular intervals up to 12 months after transplantation in 22 consecutive heart transplant recipients. Patients were divided into two groups: group 1 included 10 patients with underlying ischemic heart disease, and group 2 had 12 patients with underlying idiopathic dilated or valvular cardiomyopathy. Mean serum cholesterol concentrations in both groups increased substantially after operation and peaked at 3 months (respective rises of 35% and 30%). By 12 months after transplantation 50% of group 1 and 33% of group 2 manifested a significant degree of hypercholesterolemia (plasma cholesterol greater than 6.5 mmol/L, 250 mg/100 ml). Mean serum triglyceride concentrations increased in both groups during the latter part of the first year (respective increases of 44% and 13%). At 12 months only 10% of group 1 and 8% of group 2 manifested a significant degree of hypertriglyceridemia (plasma triglycerides greater than 3.0 mmol/L, 265 mg/100 ml). Over the first postoperative year there was a progressive increase in body weight, and this correlated highly with the increase in serum lipid levels (r = 0.90 for serum cholesterol and r = 0.84 for serum triglycerides). The role of conventional risk factors including hypercholesterolemia in the development of graft atherosclerosis remains uncertain, but until their role is defined, further strenuous efforts at weight control as a means of preventing or managing hyperlipidemia need to be explored. PMID- 3290400 TI - Heterotopic heart transplantation: electrophysiologic changes during acute rejection. AB - To identify electrophysiologic (EP) measurements sensitive to heart transplant rejection, heterotopic thoracic heart transplantation was performed in 11 dogs. Endocardial biopsies were performed daily for up to 9 days, and the severity of rejection was classified as mild, moderate, or severe. Late diastolic thresholds; refractory periods of the left ventricle and right atrium; and conduction times from the right atrium to left atrium, left ventricle to right ventricle, and right atrium to right ventricle were measured daily in transplanted and recipient hearts. The amplitude of the left atrium and right ventricular electrograms was recorded daily. In the recipient hearts no significant EP changes were observed after the second postoperative day. Left ventricular and right atrial refractory periods in both hearts did not change. In the transplanted hearts the conduction times of the right and left atria (but not the conduction time of the left to right ventricles) and right atrium to right ventricle identified moderate rejection; right atrial diastolic threshold was a marker only for severe rejection. Amplitudes of the left atrial and right ventricular electrograms decrease significantly only with severe rejection. At postmortem histologic evidence for rejection was greater in the atria than the ventricles. EP changes in the atria and atrioventricular conduction are more sensitive indicators of acute rejection than ventricular EP changes and correlate with the histologic grade of rejection. None of the measurements evaluated, however, was shown to be a sensitive marker of mild rejection. PMID- 3290401 TI - The heterotopic right heart assist transplantation. AB - Heterotopic heart transplantation has been utilized experimentally and clinically to assist the recipient heart in maintaining either the systemic circulation alone or both the systemic and pulmonary circulations. We describe a model in which the heterotopic heart transplantation is utilized to supply the pulmonary circulation while the recipient heart acts as the systemic ventricle. This procedure might be used for selected patients with complex congenital heart disease. The method we have used in five dogs (16.5 to 23.5 kg) consists of preparation of the donor heart by excision after cardioplegic arrest, ligation of the venae cavae, anastomosis of the donor pulmonary artery (PA) to the donor left atrial appendage, and insertion of a left ventricular (LV) apical Dacron graft connected to a valved aortic allograft. Implantation in the recipient consists of anastomosis of the donor left atrium to the recipient right atrium, anastomosis of the LV apical conduit to the recipient main PA, and anastomosis of the donor aorta to the recipient ascending aorta to supply oxygenated blood to the donor coronary circulation. The recipient right ventricle (RV) in the experimental model is inactivated by inducing tricuspid regurgitation and by ligating the proximal PA. Early survival (3 hours) with stable hemodynamic measurements was obtained in all dogs, with the recipient RV excluded from the circulation and with the donor LV pumping the total systemic venous return to the PA. Pulmonary blood flow was maintained even when the ventricular pressure was raised to systemic levels by narrowing the conduit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290403 TI - Myocardial energy metabolism in preserved heart: comparison of simple storage and hypothermic perfusion. AB - Isolated canine hearts were preserved for 24 hours by either simple hypothermic storage in Collins' M solution (group 1, n = 7) or hypothermic perfusion with oxygenated modified Krebs solution (group 2, n = 7), followed in both cases by reperfusion with cross circulation. Myocardial biopsies taken consecutively during preservation and after reperfusion were analyzed for high energy phosphates (adenosine triphosphate [ATP], adenosine diphosphate [ADP], adenosine monophosphate [AMP], and creatine phosphate), their catabolites (inosine), and lactate. In group 1, ATP decreased from 23.7 +/- 2.8 mumol/gm dry weight (mean +/ standard deviation) at 0 hours to 5.6 +/- 2.8 mumol/gm dry weight at the end of preservation. Creatine phosphate decreased and lactate increased significantly during 24 hours of preservation. The consumption rate of ATP appeared to have decreased after 18 hours of preservation. In group 2, ATP, creatine phosphate, and lactate remained at control levels during preservation. Coronary vascular resistance, however, increased significantly. After reperfusion functional measurements of the hearts in both groups did not vary significantly, despite the difference in myocardial ATP content (11.2 +/- 4.9 mumol/gm dry weight in group 1 and 17.9 +/- 3.9 mumol/gm dry weight in group 2; p less than 0.05). Simple hypothermic storage manifested a limitation in terms of energy store compared with hypothermic perfusion, whereas the latter appeared to have a risk of possible myocardial damage caused by the perfusion itself. PMID- 3290402 TI - Acute vascular rejection involving the major coronary arteries of a cardiac allograft. AB - A case of acute vascular rejection occurring in a cardiac allograft is presented. The rejection was characterized by prominent lymphocytic infiltration of the major coronary arteries in a pattern similar to that observed in acute vascular rejection occurring in renal allografts. Additionally, there was electron microscopic evidence of endothelial damage of smaller vessels. In addition to routine light microscopic evaluation of heart biopsies obtained in this case, immunofluorescent staining of biopsies for IgG, IgM, C3, Clq, fibrinogen, T cells, B cells, and Ia human leukocyte antigen (HLA-DR) was also performed. These studies suggest that antibodies may have been important in the terminal rejection episode described in this case. Furthermore, immunofluorescent staining detected continuing endothelial cell damage, reflected as Ia antigen positivity of allograft blood vessels, despite apparent improvement of rejection as judged by light microscopy. PMID- 3290405 TI - Psychopathology in heart transplant candidates. AB - Psychodiagnostic data are reported on 69 heart transplant candidates. Twenty seven patients actually received a transplantation. A high prevalence of anxiety and depression appeared related to their desperate cardiac status. Distressful symptoms did not predict postoperative psychiatric complications. Reduced coping skills as reflected by diagnoses of personality disorders or organic mental impairment were associated with many behavioral problems capable of jeopardizing survival. Psychiatric input is necessary for, and was helpful in, the management of these patients. PMID- 3290404 TI - Electrophysiologic assessment of the transplanted canine heart: correspondence to histopathologic findings in acute rejection. AB - This study was undertaken to electrophysiologically find signs of rejection after heart transplantation. A donor heart with a created atrial septal defect was implanted in the retroperitoneal space by anastomosing the thoracic aorta and left pulmonary artery of the donor heart to the abdominal aorta and inferior vena cava of the recipient heart, respectively. Endocardial leads were set up in the right atrium in the vicinity of the bundle of His and in the right ventricle. Cyclosporine (10 to 18 mg/kg/day, continuously) and prednisolone (1.0 mg/kg/day, for the first 4 days) were given orally. Electrophysiologic examinations were performed 1 to 4 days (control data) after the transplantation and were compared with data obtained 5 to 21 days after operation on 12 mongrel dogs. Finally, histopathology of the donor heart was studied. Results showed that the effective refractory period (ERP) of the atrioventricular conduction system was prolonged in six animals from 120 +/- 25 to 192 +/- 35 msec (p less than 0.02) on average. The ERP of the ventricle was shortened in four dogs from 153 +/- 36 to 123 +/- 17 msec (p less than 0.05). Specimens disclosed mononuclear cell infiltration in the atrioventricular node, the bundle of His, and the right and left bundle branches in eight of 12 cases and mild to moderate myocyte damage with cell infiltration in the ventricular septum of the same eight hearts. The ERP of the atrioventricular conduction system showed no change in four cases without mononuclear cell infiltration in the conduction system. These results suggested the feasibility of electrophysiologic monitoring as a means for detecting acute rejection in the prenecrotic stage in transplanted hearts. PMID- 3290406 TI - Multiple ex vivo organ preservation with warm whole blood. AB - To determine the feasibility of en bloc removal of the heart, lungs, liver, kidneys, and pancreas for preservation with warm blood autoperfusion, organs from 34 dogs were preserved ex vivo for periods of between 3 and 22 hours. The lungs were ventilated with a Bird Mark 7 respirator, and the heart served as the pump to perfuse all organs of the multiple organ block. In the first group of 28 animals, surgical and pharmacologic techniques were developed to permit management of the ex vivo model. The last six experiments were conducted in a standardized fashion for a period of 6 hours and evaluated on the basis of hemodynamic, biochemical, and pathologic measurements. In this group the pH level remained stable and blood gas levels remained within normal limits for inspired oxygen of 0.2. Serum and urine electrolyte levels were easily maintained within normal limits. Serum enzyme values were elevated initially after operation, and this increase persisted throughout the preservation period in most animals. Continuing refinements in surgical technique, pharmacologic management, and chamber development resulted in a dramatic reduction of the edema and organ damage seen on pathologic studies of the initial experiments. The presence of focal lymphatic congestion, however, was noted even in the animals in group II and may have been related to ligation of major lymphatic channels or to endothelial loss. These changes could contribute to the development of the pathologic changes seen in irreversible shock. Preservation of the multiple organ block by warm autoperfusion is an important step in understanding the physiology of organ preservation and has potential for permitting prolonged organ preservation. Studies are continuing to further analyze this model and prolong the time of preservation. Final assessment of the model will be transplantation of the preserved organs and evaluation of function after implantation. PMID- 3290407 TI - Effects of cyclosporine and antibody adsorption on pig cardiac xenograft survival in the baboon. AB - The problem of donor heart supply would be solved if hearts could be transplanted from readily available animals such as the pig or sheep. We have investigated heterotopic heart transplantation (in the neck) with the pig as donor and baboon as recipient. Five experimental groups were studied. Control hearts (group 1, n = 4) were rejected within 4 minutes to 8 hours. Splenectomy done before transplantation (group 2, n = 3) did not extend survival significantly (30 minutes to 8 hours). Donor heart survival in baboons receiving immunosuppressive therapy of cyclosporine and methylprednisolone (group 3, n = 5) was from 15 to 75 minutes only in four animals and for 5 days in one animal. Anti-pig antibody adsorption from baboon blood by pretransplant donor-specific kidney hemoperfusion (group 4, n = 7) resulted in cardiac function for 6 to 12 hours in three cases and from 4 to 5 days in four cases (p less than 0.02). A combination of pretransplant antibody adsorption and immunosuppression (group 5, n = 4) resulted in graft survival of 8 to 20 hours in three cases and of 4 days in one case (p less than 0.03). Histopathologic features of vascular (hyperacute) rejection were seen in all hearts except one (the 5-day survivor in group 3). Pretransplant adsorption of antibody clearly prolonged survival of discordant cardiac xenografts in some cases. Further exploration of this technique appears justified. PMID- 3290408 TI - First experiences with resin-bonded bridges and splints--a cross-sectional retrospective study, Part II. AB - This second report establishes that the success of treatment with resin-bonded bridges was dependent upon many factors. Factors controlled by the clinician, such as case selection and treatment planning greatly influence the clinical success. It was possible to show that framework preparation and the amount of available enamel were significant factors, whereas isolation technique, type of retention mechanism and type of adhesive used were of less importance. Longitudinal studies are needed to confirm these observations. Seventeen clinicians placed 496 resin-bonded bridges and splints with different retention mechanisms and bonding agents. These reconstructions were examined in regard to the failure rate and in regard to reattachment problems. Ninety-seven per cent of the bridges and 90% of the splints were still in place after 1 year. For bridges and splints a 90% success rate was ascertained after 2 years. PMID- 3290409 TI - Mandibular function and dysfunction in complete denture wearers--a literature review. PMID- 3290410 TI - Fixed restorations produced by commercial dental laboratories in Vancouver and Geneva. AB - A survey of commercial dental laboratories in Geneva and Vancouver has been carried out using both questionnaires and telephone enquiries. It was concerned with the types of fixed prostheses constructed and the impact of recent technical developments. The results of the study revealed that cosmetic factors played a major role in deciding the use of new techniques. Porcelain was used on the occlusal surface of most restorations and metal margins were preferred on PFM crowns. Precious and base alloys were used frequently to cast PFM protheses in Vancouver, whereas semi-precious alloys were favoured in Geneva. Most of the laboratories used precious alloys for all-metal restorations. PMID- 3290411 TI - The pathology of mycotoxins. PMID- 3290412 TI - Growth and development of adipose tissue. PMID- 3290413 TI - An individual double-blind crossover trial for assessing methylphenidate response in children with attention deficit disorder. AB - To obtain more objective data on response to therapy and to overcome parents', teachers', psychologists', and physicians' concerns about potential overuse, I instituted individual double-blind crossover trials of methylphenidate for children with attention deficit disorder (ADD). Each child is given 0.3 mg/kg/dose twice daily for 2 weeks and placebo for 2 weeks in random order and in double-blind fashion. Parents and teachers record observations of behavior and academic performance. Analysis of 70 trials and follow-up clinical data demonstrated that (1) 51 children showed improvement in one of the 2-week periods and that period corresponded with methylphenidate therapy in 48 (69%); (2) 6 of the 22 who did not respond to methylphenidate experienced worsening of function while taking the drug; (3) history and physical findings were not helpful in predicting methylphenidate response; (4) there were no serious side effects during the trial; and (5) all but three of the responders took methylphenidate for at least 1 year with sustained improvement in behavioral function, academic function, or both. Individual double-blind crossover trials can be used in an office setting to identify objectively which children with ADD respond to treatment with methylphenidate. Because the trial demonstrates to parents, teachers, psychologists, and physicians that methylphenidate is or is not beneficial to a particular child, this clinical tool is associated with a high level of confidence that the drug is being appropriately prescribed. PMID- 3290414 TI - Inborn errors of metabolism and Reye syndrome: differential diagnosis. PMID- 3290416 TI - Effects of cell recycle on microbial cell viability and metabolism. PMID- 3290415 TI - Budd-Chiari syndrome in children: report of 22 cases. AB - Clinical, radiologic, and histologic features in 22 children with Budd-Chiari syndrome are reported. Three children had acute refractory ascites; all the others had hepatomegaly, which was detected either fortuitously or because of abdominal pain or distention. Results of liver function tests were normal or only moderately abnormal. In most cases a combination of ultrasonography and needle liver biopsy pointed to the diagnosis of Budd-Chiari syndrome, which was confirmed by angiography. Eighteen children underwent surgery involving various techniques, depending on the degree of patency of the inferior vena cava. Five children died postoperatively. Histologic studies of the liver, carried out in 12 of the surviving children, showed disappearance or regression of centrilobular hemorrhagic infiltration. Half of the surviving surgical patients are now free of complications after a follow-up of 7 months to 7 years; the others have either secondary thrombosis of the inferior vena cava or stenosis of the shunt or have experienced late pulmonary complications. Our results suggest that (1) Budd Chiari syndrome must be considered a possible diagnosis in children with firm hepatomegaly and normal or near normal liver function, (2) surgery provides good results in many instances, and (3) the possibility of late complications requires careful follow-up. PMID- 3290417 TI - Chronic intestinal pseudo-obstruction syndrome in pediatrics. Results of a national survey by members of the North American Society of Pediatric Gastroenterology and Nutrition. AB - A total of 87 cases of chronic intestinal pseudo-obstruction were identified as fitting the criteria for the syndrome. Five families, three with autosomal dominant inheritance, accounted for 15 cases. The remainder were single cases in families, indicating either autosomal recessive inheritance, spontaneous mutation, or acquired disease. Of the 87 patients, 47 were male; 19 patients were symptomatic at birth and 37 (43%) within the first month of life; 64% were diagnosed by the first year of age and the remainder were diagnosed by 18 years of age. Patients currently range in age from 3 months to 24 years. Abdominal distension in 70, vomiting in 50, and constipation in 50 of the 87 cases were the three commonest presenting symptoms. Diarrhea and failure to thrive were present in 20 cases. Urinary tract infection and failure to void were present in 10 cases. Diagnosis was established by clinical presentation, radiographic studies, and at exploratory laparotomy. Esophageal motility was abnormal in 14 patients. Anal manometric studies were done in 16 and showed normal recto-anal inhibitory reflex in all but one. Only 34 patients had biopsy studies as part of their evaluation and, of these, only 12 were full-thickness. Abnormal plexuses were found in eight and degeneration of smooth muscles in four. There was little or no benefit from the use of any medication to promote motility. One patient with intractable pseudo-obstruction benefited from a subtotal enterectomy. Of those patients not lost to follow-up, 31.4% died; 43% of these deaths occurred within the first 6 months from complications of total parenteral nutrition. One infant had a complete spontaneous remission by 1 year of age, with normalization of radiographic findings; another had partial remission by 6 months of age. PMID- 3290418 TI - Ultrasound guided percutaneous cholecystocholangiography for early differentiation of cholestatic liver disease in infants. AB - Direct visualization of the extrahepatic biliary tree is difficult in infants and young children without resorting to an intraoperative cholangiogram. Small size and lack of dilated intrahepatic ducts especially in infants with cholestatic jaundice often preclude using the techniques of percutaneous transhepatic cholangiography or endoscopic retrograde cholangiopancreatography. We studied the feasibility of ultrasound-guided percutaneous cholecystocholangiography (US guided PCC) in differentiating extrahepatic from intrahepatic causes of cholestatic jaundice in four infants. Clinical, laboratory, radiographic, and histologic criteria had not conclusively excluded extrahepatic obstruction prior to the use of this technique. Four infants, between 4 and 10 weeks of age, were studied without complications. In one patient, biliary atresia was diagnosed at 4 weeks of age; in another, aspirated bile was cultured leading to a specific diagnosis of bacterial cholangitis; and, in two others, intrahepatic cholestasis was confirmed by the demonstrated patency of the extrahepatic biliary tree. In infants and young children in whom a gallbladder lumen can be seen, US-guided PCC offers a potential rapid, nonoperative means of differentiating intrahepatic and extrahepatic causes of cholestatic jaundice, defining the anatomy of the extrahepatic biliary tree, and directly sampling gallbladder bile. PMID- 3290420 TI - "Natural highs" in an historical and biological context. PMID- 3290419 TI - Cholesterol ester storage disease: clinical, biochemical, and pathological studies of four new cases. AB - Cholesterol ester storage disease (CESD) is infrequent in children. Four new cases in two nonrelated families are presented. Acid lipase deficiency in the leukocytes of the patients and reduced activity (50%) in those of parents were demonstrated. Clinical manifestations varied from neonatal cholestasis to asymptomatic hepatomegaly. Hepatic histology showed lipid vacuoles and cholesterol ester storage in hepatocytes and Kupffer cells. Increased levels of cholesterol and hepatomegaly were the first findings. There is as yet no specific treatment for CESD; however, the early detection of cases would make possible the timely control of complications. PMID- 3290421 TI - A places-rated almanac for pediatric psychology. PMID- 3290422 TI - Measuring the severity of surgical stress in newborn infants. AB - Measurement of the severity of surgery would greatly facilitate the design and interpretation of studies in neonates undergoing surgery. A scoring method, based on the amount of blood loss, superficial dissection, and visceral trauma, the site and duration of surgery, cardiac surgical factors, and associated stress factors for surgical neonates, was formulated and applied to 94 neonates undergoing surgery. Perioperative management was standardized for all patients and hormonal-metabolic variables were measured in blood samples drawn preoperatively at the end of the operation, and at six, 12, and 24 hours after operation. The stress scores were correlated significantly with the plasma epinephrine (P less than .0001), norepinephrine (P less than .0001), insulin (P less than .001), glucagon (P less than .005), and cortisol (P less than .02) responses, and with changes in blood glucose (P less than .0001), lactate (P less than .0001), pyruvate (P less than .0001), and alanine (P less than .005) during and after operation. Discriminant function analysis was used for further validation and this scoring method was found to predict accurately the severity of surgical stress in 89.4% cases. Discrepancies in the remaining cases were found to be related to specific clinical factors. On comparison of the hormonal and metabolic responses of neonates in the minor (N = 71), moderate (N = 12), and severe (N = 11) stress groups, increasing severity of surgical stress was found to be associated with greater and more prolonged changes in plasma catecholamines, blood glucose, and gluconeogenic substrates during and after operation. Clinical outcome following operation was also significantly different between the three stress groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290423 TI - Fetal ovarian cysts: a report of five cases. AB - Large fetal ovarian cysts are rare; however, widespread use of antenatal ultrasound examination has led to an increased detection rate and surgical removal. A case presenting with bowel obstruction is described along with four other cases that presented in the last 24 years. Previously reported series are reviewed and compared. It is stressed that complications are very rare and hasty surgical management of cases detected by ultrasound scanning is not warranted. PMID- 3290424 TI - Acute suppurative thyroiditis caused by Eikenella corrodens. AB - Eikenella corrodens is a slow-growing facultative anaerobe present in the normal oral flora. Two children have been described with acute suppurative thyroiditis with E corrodens as the major pathogen. Staphylococci are the most frequently identified pathogens in acute suppurative thyroiditis. Penicillin or ampicillin are the drugs of choice for infections caused by E corrodens. Anatomic defects should be searched for in children with acute suppurative thyroiditis. PMID- 3290425 TI - Childhood tracheobronchial mucoepidermoid carcinoma: a case report and review of the literature. AB - Mucoepidermoid carcinoma of the lung presenting in childhood is an uncommon neoplasm. Symptoms of progressive bronchial obstruction proceed the recognition of this lesion. The well-confined local growth and minimal metastatic potential of childhood mucoepidermoid carcinoma make local resection with maximum conservation of pulmonary parenchyma the recommended operative treatment. Adequate surgical resection precludes the need for further radiation therapy or chemotherapy. This report details the presentation and treatment of a child with this rare tumor and reviews the present literature experience with childhood mucoepidermoid carcinoma. PMID- 3290426 TI - Intussusception in Henoch-Schonlein purpura: diagnosis with ultrasound. PMID- 3290427 TI - Six-month effects of a sanguinarine dentifrice on plaque and gingivitis. AB - A six-month, double-blind clinical trial was conducted to determine the effectiveness of a sanguinarine-containing dentifrice in reducing plaque and gingival inflammation. One hundred twenty adult volunteers were randomly assigned to a control or experimental group. The test dentifrice contained 750 mcg/g of sanguinaria extract. A dentifrice of similar composition without sanguinarine was used as the placebo. Plaque and gingival inflammation scores were recorded for four surfaces on each of 12 index teeth at baseline, one-, three, and six-months. Matched pair t-test analyses showed no significant differences between experimental and control groups for mean six-month changes in plaque and gingival inflammation scores in analyses using all 48 sites per subject or in analyses of only the 24 interproximal sites. No long-term reduction was demonstrated in plaque or gingival inflammation with the use of a sanguinarine-containing dentifrice. PMID- 3290428 TI - Intragingival occurrence of Actinobacillus actinomycetemcomitans and Bacteroides gingivalis in active destructive periodontal lesions. AB - A total of six active and six nonactive sites from six untreated periodontitis patients were examined for intragingival presence of Actinobacillus actinomycetemcomitans and Bacteroides gingivalis. The active destructive periodontal disease was determined by the "tolerance method." The method of immunoperoxidase was used in the identification of intragingival microorganisms in active and nonactive periodontal sites. Light microscopic sections of gingival tissues consecutive to those with gram stain, revealing presence of bacteria (substantiated by electron microscopy), were stained with peroxidase-labeled antibodies against A. actinomycetemcomitans and B. gingivalis. B. gingivalis was found to be significantly elevated in the connective tissue of active sites when compared to nonactive sites. A statistically significant border-line difference was found between active and nonactive sites in the connective tissue invaded by A. actinomycetemcomitans. Our findings plus the well established periodontopathic potential of A. actinomycetemcomitans and B. gingivalis support the concept that these bacteria are important invasive pathogenic agents in periodontitis. PMID- 3290429 TI - Osseointegrated oral implants. A Swedish multicenter study of 8139 consecutively inserted Nobelpharma implants. AB - Fourteen Swedish teams outside the University of Gothenburg, each with minimally three years' experience in the Nobelpharma osseointegrated implant participated in a retrospective multiclinic study. The total number of consecutively inserted implants at the 14 clinics was 8139. The outcome of every implant was reported and all implant failures, irrespective of when they occurred, were published. The success criteria included absence of implant mobility, absence of radiolucent zones on x-rays, and an annual bone loss after the first year of less than 0.2 mm. In the mandible 334 implants were followed for five to eight years, with only three failures, for a success rate of 99.1%. In the maxilla 106 implants were followed for five to seven years, with a success rate of 84.9%. In irradiated and grafted mandibles, 56 implants were inserted and none was lost during a follow-up of up to five years. In the irradiated maxilla there were 16 implants inserted with three reported failures and in the grafted upper jaw 71 implants were inserted with 12 failures. The proportions of mandibular and maxillary sleeping implants were 0.8 and 0.3%, of patient drop-out implants 0.3 and 0.6%, and of patient death implants 0.9 and 1.2%, respectively. It was concluded that the osseointegrated implant, if inserted according to the guidelines of Branemark, results in a very high degree of clinical success, thereby meeting any published oral implant success criteria. PMID- 3290430 TI - Clinical and microbiologic effects of local tetracycline irrigation on periodontitis. AB - This investigation was conducted on seven individuals referred for treatment of moderate adult periodontitis. Twenty-eight sites with an average probing depth of 5.6 +/- 0.9 mm were evaluated. One tooth per jaw quadrant was randomly assigned to receive one of the following treatments: (I) no treatment, i.e., control; (II) saline irrigation; (III) tetracycline irrigation and (IV) scaling and root planing (SC/RP). A plaque control program was instituted one week prior to the experimental period and reinforced throughout the eight-week study. Irrigation was performed every 48 hours during the first two weeks of the experiment for Groups II and III, and the single treatment of SC/RP was carried out immediately following the baseline examination for Group IV. Clinical and microbiologic changes were monitored every two weeks using plaque and gingival indices, gingival fluid flow, probing depths, bleeding on probing and dark-field microscopic examination of the subgingival microbial flora. The tetracycline and SC/RP treatment modalities resulted in statistically significant clinical and microbiological improvements when compared with the control. Tetracycline irrigation alone and SC/RP alone had a similar effect in changing the subgingival microflora from one associated with disease to one associated with health. Thus, these treatment modalities are effective methods of producing statistically significant alterations in the subgingival microflora. The property of substantivity may contribute to the sustained duration of the effect of locally delivered tetracycline. PMID- 3290431 TI - Periodontal therapy. A summary status report 1987-1988. PMID- 3290432 TI - Giant cell fibroma. A case presentation and review. AB - The giant cell fibroma should be of special interest to the periodontist as its primary site of occurrence is on the gingival tissue. A case report of a large giant cell fibroma is followed by a review of this interesting oral tumor, including the controversy surrounding its classification as a separate entity. PMID- 3290433 TI - [Ultramicro analysis of bioactive substances: an approach based on the development of highly selective fluorogenic reagents]. PMID- 3290434 TI - Diffuse idiopathic skeletal hyperostosis. A case report. PMID- 3290435 TI - Two feet-one hand syndrome. PMID- 3290436 TI - Care for the care-giver. PMID- 3290438 TI - Distraction: a nursing intervention to decrease procedural distress in preschool and early school-age children with cancer. PMID- 3290437 TI - Development of an educational handbook: preparing the pediatric patient and family for pre-bone marrow transplant procedures and consults. PMID- 3290439 TI - Stomatitis in the pediatric bone marrow transplant patient. PMID- 3290440 TI - Educational preparation for the nursing staff on a combined pediatric/adult bone marrow transplant unit. PMID- 3290441 TI - Management of skin care complications in pediatric bone marrow transplant patients: a nursing challenge. PMID- 3290442 TI - Relaxation techniques in children with cancer: the nurse's role. PMID- 3290443 TI - [1H-NMR studies on the water structure in biological system]. PMID- 3290444 TI - Implant dentistry: a solution to the problem of malaligned fixtures with tissue integrated prostheses. PMID- 3290445 TI - Correction of the posterior palatal seal by using a visible light-cured resin: a clinical report. AB - This article presents a technique for correcting an inadequate posterior palatal seal using a visible light-cured resin. The procedure is accomplished conveniently at chairside instead of depriving the patient of the denture for a laboratory correction. PMID- 3290446 TI - Removal of parallel prefabricated posts: a clinical report. AB - The serrations on some parallel and vented prefabricated posts are continuous spirals. Occasionally removal is indicated. If attempts to loosen the post by mechanical vibration fail, the embedded portion may be removed by turning. Careful examination of the radiograph and the exposed portion of the post is needed to determine the proper direction of torque. PMID- 3290448 TI - A four-year clinical evaluation of resin-bonded fixed partial dentures. AB - A total of 58 resin-bonded fixed partial dentures seated in 47 patients were examined for periods of 2 to 51 months. During the evaluation period, 10 prostheses (17.2%) became dislodged. Six restorations (10.3%) were successfully rebonded and four (6.9%) were remade. Six anterior and four posterior restorations were dislodged. Six mandibular and four maxillary prostheses became debonded. One restoration containing more than one pontic was dislodged. PMID- 3290447 TI - A comparison of the marginal fit of three cast ceramic crown systems. AB - The conclusions were: 1. The Cerestore crown system produced an impressive marginal fit without technique sensitivity. However, irregularities on the crown margin due to the porosities of the fired core were noted. 2. The Dicor castable ceramic crown system in this study produced rounded marginal openings because of the shrinkage during ceramming, the treatment of the surface texture after ceramming, and damage from air abrasives. 3. The Ceplatec crown system produced a suitable marginal fit when the distortion of the foil coping during porcelain firing was controlled. The quality of the margin was ultimately determined by the skill of the technician. PMID- 3290449 TI - The restoration of endodontically treated teeth: an update. PMID- 3290450 TI - Multiple cast post and cores for anterior teeth: rationale and technique. PMID- 3290451 TI - Effect of contaminants on the adhesion of light-bodied silicones to putty silicones in putty-wash impression technique. AB - This study was concerned with the adhesion of a light-bodied silicone to a putty silicone in a putty-wash impression technique when the preliminary putty impression was contaminated with human saliva or residues from acrylic resins used in the fabrication of provisional restorations by direct technique. Data indicated that condensation and addition silicones differed in their susceptibility toward the tested contaminants. Salivary contamination and chemical residues from the autopolymerizing acrylic resins weakened the bond strength and caused adhesive failure dependent upon the type of silicone impression material used. PMID- 3290452 TI - Shear bond strengths and scanning electron microscope evaluation of three different retentive methods for resin-bonded retainers. PMID- 3290454 TI - Three-year findings of a multiclinical trial for a posterior composite. PMID- 3290455 TI - A laboratory evaluation of rebond strengths of solid retainers of the acid-etched fixed partial denture. PMID- 3290453 TI - Continuous brushing acid-etch technique and microleakage of class V composite restorations. PMID- 3290456 TI - The effect of resilient layer and occlusal reactive complete dentures on the residual alveolar ridge. AB - A technique for making resilient layer and occlusal reactive dentures was proposed. A radiographic and clinical evaluation of the effect of these dentures on the residual ridges of 17 subjects was done. The results showed that the rate of ridge reduction with these dentures was significantly less than that with conventional dentures. Therefore, the resilient layer principle is a promising clinical modality. PMID- 3290457 TI - Simple application of anterior jig or leaf gauge in routine clinical practice. AB - Utilization of either of the two described methods by dentists is recommended as a simple means to routinely record or provide centric relation closures. The leaf gauge (1 to 6 mm thick) can be made from plastic or x-ray film or it can be purchased. The anterior acrylic resin jig can be made in a few minutes directly in the mouth by the dentist or an assistant or by a technician using mounted casts. Both methods avoid adaptive mandibular closure patterns and dentist-guided jaw closure as well as other commonly unrecognized errors in assessing occlusal contacts. PMID- 3290458 TI - An overview of infection control in dental practice. AB - Although it is not possible to cover all of the ramifications of infection control in prosthodontics, currently available information may be summarized as follows: 1. All dental disciplines must be concerned with the dangers involved in the spread of certain infectious diseases. 2. Prosthodontists and their ancillary personnel may be exposed to certain diseases predominantly found in adult patients, such as hepatitis B and tuberculosis. 3. Dentists must ensure that at least six basic infection control procedures are observed when treating patients. 4. Additional control procedures should be observed in the fabrication and handling of impressions and dental prosthesis. 5. Dental offices and commercial laboratories should work closely together to coordinate control of potential cross-infection between the two disciplines. The control of infectious diseases in prosthodontics is not difficult. It requires the expenditure of a little time, a little money, and most important, a great deal of discipline. The rewards are well worth the additional effort and could even be lifesaving. PMID- 3290459 TI - A modified box seat technique for removable dies. PMID- 3290460 TI - An aid to finishing complete and removable prostheses. PMID- 3290461 TI - Use of a stabilized record base in osseointegration. PMID- 3290462 TI - A new ring clasp design. PMID- 3290463 TI - An aid for swing-lock partial denture removal. PMID- 3290464 TI - Significance of abutment tooth angle of gingival convergence on removable partial denture retention. PMID- 3290465 TI - Wandering: causes, consequences, and care. PMID- 3290466 TI - [Ultrasonoendoscopy: its indications in esophageal and gastric pathology]. AB - Endoscopic ultrasonography (EUS), which uses a high sonographic frequency (7.5 mHz) is a recently developed diagnostic tool that enables detailed analysis of the digestive wall and visualization of adjacent structures, like the posterior mediastinum through the esophagus. Thus, EUS may provide accurate documentation of the extent of esophagogastric malignancies, and of the adjacent lymph-node involvement. From now, results in preoperative staging compare favourably with CT scan. EUS provides also helpful complementary informations for the diagnosis of giant fold gastropathies or submucosal (or extrinsic) abnormalities. Moreover it may be usefull for the post-therapeutic follow-up of cancers, ulcers or varices. PMID- 3290467 TI - [Ultrasonography and x-ray computed tomography in the diagnosis of intra abdominal textiloma. Apropos of 12 cases]. AB - Feared by every surgeon, retained surgical sponges (or gossypiboma) are rare iatrogenic entities. Ultrasonography and computed tomography are very valuable, providing an immediate answer in the majority of cases. We report 12 cases of intra-abdominal retained surgical swabs. The ultrasonic pattern was made whether of a large poorly echogenic mass with a hyper-echogenic center and sharply delineated posterior acoustic shadow (7 cases) or of a large acoustic shadow posterior to a solitary highly echogenic area (4 cases). Computed tomography demonstrated whether large peripherally enhanced cystic mass associated with serpiginous or spongiform central area (5 cases) or heterogeneous abscess-like fluid mass. PMID- 3290469 TI - [Retro-aortic left brachiocephalic venous trunk. A rare anomaly: 2 cases]. AB - Two cases of a rare anomaly of the trajectory of the left brachiocephalic venous trunk were detected by CT scan imaging. In both patients the trunk passed under the aortic arch before emptying into the superior vena cava. One patient presented, in addition, a complex anomaly of the aortic arch. PMID- 3290468 TI - [Ascaris in bile ducts. Value of ultrasonic diagnosis]. AB - Results of ultrasound imaging in 4 cases of ascaris migration into biliary tract are described. Certain aspects are typical of the nematode in the biliary ducts: triple line image, spaghetti appearance, mobility of image. Other important diagnostic ultrasound features are the labile and changing character of direct and indirect signs of the parasitic wandering of the worm. These findings provide ultrasonography with advantages over other methods of biliary tract exploration, less reproducible and heavier. PMID- 3290470 TI - Interaction of the D1 receptor antagonist SCH 23390 with the central 5-HT system: radioligand binding studies, measurements of biochemical parameters and effects on L-5-HTP syndrome. AB - The interaction of SCH 23390 with dopamine (DA) and serotonin (5-HT) systems has been examined in vivo and in vitro. Like selective 5-HT2 blockers, SCH 23390 inhibited in vivo [3H]spiperone binding in the rat frontal cortex (ID50: 1.5 mg/kg) without interacting at D2 sites. SCH 23390 was equipotent to cinanserin and methysergide. In vitro, SCH 23390 inhibited [3H]ketanserin binding to 5-HT2 sites (IC50 = 30 nM). Biochemical parameters linked to DA and 5-HT were not changed excepted in striatum where SCH 23390 increased HVA and DOPAC. In the L-5 HTP syndrome model, SCH 23390 clearly showed antagonism of 5-HT2 receptors. SCH 23390 had weak affinity for 5-HT1B (IC50 = 0.5 microM), 5-HT1A (IC50 = 2.6 microM) and alpha 1-adrenergic receptors (IC50 = 4.4 microM). PMID- 3290471 TI - Neural regulation of properties of the nicotinic acetylcholine receptor. AB - During nerve-muscle synapse formation, acetylcholine receptors become localized and modified to allow efficient transfer of information from nerve to muscle. In this paper we summarize our studies on two aspects of receptor modulation--their concentration at synaptic sites and their ability to desensitize in response to prolonged application of agonist. We demonstrate that receptor localization is a complex event which extensively reorganizes the structure of the junctional region. This allows the subsequent influences of contraction to be exerted differently in junctional and extrajunctional regions. We indicate that increases in muscle cell Ca2+ appear to mediate some of the effects of muscle contraction and suggest how regulation of Ca2+ levels may specify junctional and extrajunctional differences. Finally, we discuss the role of receptor phosphorylation in determining the rate of desensitization. PMID- 3290473 TI - Functional correlates of serotonin 5-HT1 recognition sites. AB - A short overview is given of the evidence supporting the existence of subtypes of 5-HT1 receptors. As 5-HT1 receptors were first described using radioligand binding studies, a brief description of 5-HT1A, 5-HT1B, 5-HT1C and 5-HT1D receptor binding is given. Then, recent data obtained in biochemical, electrophysiological, behavioural and other functional studies is compared to results obtained in radioligand binding studies. The paper shows that functional correlates do indeed exist for subtypes of 5-HT1 recognition sites; moreover, these are markedly different from the effects mediated by 5-HT2 (5-HT D) or 5-HT3 (5-HT M) receptors. PMID- 3290472 TI - Nervous system-immune system interactions: an overview. AB - Links between the nervous and immune systems are suggested by the behavioural conditioning of immunosuppression, the effects of brain lesions and stress on immune responses, and physiological and chemical changes in the brain during immune responses. These links probably include glucocorticoids secreted from the adrenal gland, catecholamines and neuropeptides secreted by sympathetic terminals and the adrenal medulla, certain pituitary hormones, and polypeptides produced by cells of the immune system. The effect of glucocorticoids is not exclusively immunosuppressive, nor is it adequate to explain all the effects of stress. In vitro endogenous opiates facilitate lymphocyte proliferation and natural killer (NK) cell activity, but in vivo opiates appear to inhibit immune responses and impair tumour rejection. Increases of circulating glucocorticoids after infection and an apparent activation of cerebral catecholaminergic cells indicate that challenges to the immune system are interpreted physiologically as stressors. Moreover, they suggest that the brain may be able to monitor the progress of immune responses. Certain protein factors produced by the thymus gland (thymosins) may be able to counter stress-induced deficits in immunological responses. PMID- 3290474 TI - Microwave sterilization of Candida on underwear fabric. A preliminary report. AB - Candida-contaminated underwear might not be sterilized by ordinary laundering. The effectiveness of microwaving against Candida albicans on fabric was therefore determined. Swatches of Candida-impregnated cotton underpants fabric were subjected to domestic microwaving at the high setting for up to 30 minutes. If the fabric was microwaved dry, the Candida organisms survived. If the fabric was moistened, sterilization occurred within five minutes. Microwaving wet, freshly laundered cotton underpants should sterilize residual Candida and reduce the risk of reinfection. PMID- 3290475 TI - Adhesion formation and prevention after peritoneal injury and repair in the rabbit. AB - Fifteen rabbits were used to assess peritoneal healing and adhesion formation after suturing and stapling peritoneal edges or excising, cauterizing and abrading areas of peritoneum. Two weeks after peritoneal injury, the amount of adhesions formation was noted. Resection of peritoneal tissue with natural rehealing was preferable to reapproximation of free peritoneal edges with either staples or sutures. PMID- 3290476 TI - Perinatal group B streptococcal infections across intact amniotic membranes. AB - We reviewed the perinatal mortality due to group B streptococcal infection over a three-year period at a tertiary center. In 6 of 16 perinatal deaths due to group B Streptococcus, representing a range of gestational ages, infection occurred with the membranes intact. A review of reports from the obstetric and pediatric literature revealed that 10-50% of group B streptococcal infections occur in this manner. Several investigators of both animals and humans have demonstrated the pathophysiology of an ascending transamniotic infection. The current series emphasized this mode of infection in group B streptococcal disease. PMID- 3290477 TI - The prevalence of positive test results for Chlamydia trachomatis by direct smear for fluorescent antibodies in a south Texas family planning population. AB - Chlamydia trachomatis is a major human genital pathogen implicated as a leading cause of involuntary infertility in women. To assess the prevalence of results positive for C trachomatis by a direct immunofluorescent test in a family planning population, mass screening of all patients attending five urban family planning clinics was conducted for a two-month period. The objectives of this study were to assess the prevalence of positive C trachomatis test results in this population and to evaluate the commonly accepted demographic/behavioral risk factors reported in previous studies. A total of 2,761 subjects were tested using the MicroTrak collection kit. The subjects ranged in age from 12 to 69 years. The overall rate of positive test results was 10.5%. Significant associations between C trachomatis test results and the following variables were observed: race/ethnicity, age, marital status, existence of multiple partners and positive gonorrhea tests. Chlamydial infection was not significantly associated with income, pregnancy, current contraceptive method or age at first intercourse. While the results of the study indicated both agreement and disagreement with other clinical investigations, the fact that 10.5% of a largely asymptomatic population exhibited chlamydial infection has major implications for the management of women's reproductive health care. PMID- 3290478 TI - Evolution of polycystic ovaries in a girl with delayed menarche. A case report. AB - A 17-year-old girl had delayed growth secondary to low birth weight. Although she entered puberty at 12.5 years, she had delayed menarche. She underwent serial ovarian ultrasound scans, and a change in ovarian morphology was observed, from a normal multicystic appearance to one typical of polycystic ovaries (PCOs). We hypothesize that normal ovarian morphology may change to PCOs during the peripubertal period because of a change in the endocrine milieu. PMID- 3290479 TI - Pregnancy after gamete intrafallopian transfer in a woman with primary infertility and in utero exposure to diethylstilbestrol. A case report. AB - In utero exposure to diethylstilbestrol (DES) has an adverse effect on reproductive performance and may be associated with infertility. Gamete intrafallopian transfer (GIFT) is a new reproductive technique that has been advocated as an alternative to in vitro fertilization in women with at least one normally functioning fallopian tube. The process involves the translaparoscopic placement of oocytes and sperm into the fallopian tube. The technique has been successful in treating infertility due to endometriosis, male factors and immunologic factors as well as unexplained infertility. We accomplished the first successful GIFT procedure in a woman with significant uterine effects from prenatal DES exposure. This technique may prove to be an effective treatment for infertile women with DES exposure who have no adequate explanation for their infertility. PMID- 3290480 TI - Psychotherapy is effective. PMID- 3290481 TI - Evaluation of a tubeless pancreatic function test in patients with steatorrhoea in a district general hospital. AB - The Pancreolauryl Test (PLT), a tubeless pancreatic function test, has been evaluated in an unselected series of outpatients with steatorrhoea presenting to a district general hospital (DGH). This is the first study of the PLT in a DGH, involving an unselected series of patients and not those from secondary or tertiary referral hospitals. Health controls (n = 15) and patients with self limiting diarrhoea (n = 8) had normal urinary excretion indices (greater than or equal to 30). Coeliac disease (n = 13) and small bowel bacterial overgrowth (n = 12) were the commonest causes of steatorrhoea and there were no false-positive results in these patients. The mean urinary excretion index in patients with untreated coeliac disease (mean index = 38%) was lower than in healthy controls (n = 15, mean index = 53%; P less than 0.05 greater than 0.02). No patient with proven pancreatic steatorrhoea had a normal PLT result, confirming the high negative predictive value found by others. Low results in patients with steatorrhoea following gastric surgery indicate poor mixing of food with pancreatic juices. The PLT proved to be a simple, inexpensive and noninvasive outpatient screening test suitable for use in a DGH to exclude a pancreatic origin of steatorrhoea. PMID- 3290483 TI - The eye and inherited metabolic disease: a review. PMID- 3290482 TI - Iron added to flour: is it nutritionally beneficial? Discussion paper. PMID- 3290485 TI - Conformationally constrained renin inhibitory peptides: gamma-lactam-bridged dipeptide isostere as conformational restriction. AB - A model of the conformation of the enzyme-bound inhibitor of human renin suggested the possibility of a gamma-lactam conformational restriction at the P2 P3 site. Synthetic routes to these gamma-lactam dipeptide isosteres and their incorporation into potential renin inhibitors are described. Peptide VIa,b with a gamma-lactam conformational constraint and a hydroxyethylene isostere at the cleavage site inhibited human plasma renin with an IC50 value of 6.5 nM. The flexibility of these syntheses should make available a number of potential enzyme inhibitors with this structural feature for the study of enzyme-bound conformers. PMID- 3290484 TI - Oxidants, oxidant drugs, and malaria. PMID- 3290486 TI - Synthesis and renin inhibitory activity of angiotensinogen analogues having dehydrostatine, Leu psi [CH2S]Val, or Leu psi [CH2SO]Val at the P1-P1' cleavage site. AB - The synthesis and in vitro renin inhibitory potencies of angiotensinogen (ANG) analogues having amide (CONH) bond replacements at P1-P1', the Leu-Val cleavage site, corresponding to Leu psi[CH2SO]Val, and the trans olefinic analogue of statine (Sta), 4(S)-amino-6-methyl-2(E)-heptenoic acid (dehydrostatine, Dhs), are reported. These are compared to P1-P1' Leu psi[CH2NH]Val-, Sta-, or Phe-Phe substituted analogues of the same template. The Dhs pseudodipeptide was found to be an adequate mimic of a trans CONH bond and gave a peptide, H-Pro-His-Pro-Phe His-Dhs-Ile-His-D-Lys-OH, approximately equal in potency to a Phe-Phe-containing inhibitor, but 200-fold less potent than its Sta-substituted congener. That the enhanced potency of the Sta-containing peptide most likely depends on hydrogen bonding as well as tetrahedral geometry is indicated by the 50-100-fold lower potency of the tetrahedral Leu psi[CH2S]Val and Leu psi[CH2SO]Val analogues as compared to the Leu psi[CH2NH]Val-containing congener. PMID- 3290487 TI - The hypothetical active site lattice. An approach to modelling active sites from data on inhibitor molecules. AB - Microcomputer-assisted methods are described that allow the mathematical construction of a hypothetical active site lattice (HASL) which can model enzyme inhibitor interactions and provides predictive structure-activity relationships for a set of competitive inhibitors. The inhibitor set can be structurally dissimilar, including acyclic and cyclic moieties normally refractory to classical parameter-based quantitative structure-activity relationship strategies. With use of three-dimensional Cartesian coordinates representing energy-minimized inhibitor conformations, a four-dimensional space-filling description is generated, wherein the fourth dimension can be a user-selected physiochemical property such as hydrophobicity or electron density. The multidimensional lattices thus generated are used to quantitatively compare molecules to one another. Composite lattices of more than one molecule are merged with binding data to form a HASL capable of predicting inhibitor binding and relative orientation. Details of the algorithms and assumptions utilized are illustrated for competitive inhibitors of yeast glyoxalase-I and E. coli dihydrofolate reductase. PMID- 3290489 TI - Are double translocations double trouble? AB - Double translocation heterozygotes are rare, but need not necessarily pose more of a counselling problem than single reciprocal translocation heterozygotes. Nine cases of double translocation are presented, together with a review of the few reports published to date. An attempt is made to provide simple counselling guidelines in the assessment of the risk of producing a liveborn abnormal child. This is not based on theoretical considerations of segregation patterns, but extrapolated from what is known empirically about the viable segregation patterns in carriers of single reciprocal translocations. It assumes that there is no interference with the independent assortment of the two separate exchanges, unless a common participating chromosome is involved. The possibility of an interchromosomal effect has not been taken into consideration. PMID- 3290490 TI - Complete absence of external genitalia in limb-body wall complex: two cases. AB - Two neonates with limb-body wall complex (LBWC) and complete absence of the external genitalia are presented. Our patients are the sixth and seventh cases of complete absence of the external genitalia recorded in English publications and the first two cases associated with LBWC. The incidence of complete absence of the external genitalia in our newborn population during a period of 12 years (1975 to 1986) was one case per 13 420 births. PMID- 3290491 TI - The Coffin-Lowry syndrome. PMID- 3290492 TI - Prospective addition of beta-lactamase to blood culture medium. AB - The value of adding beta-lactamase to bottles of blood-culture medium before their distribution to wards was investigated. Significantly more bottles containing beta-lactamase were culture-positive than those without (p less than 0.002). In another series, when the enzyme was added to both bottles in each set there was no significant difference in isolation rates between the two bottles. The groups of organisms which were isolated more readily when beta-lactamase was present were staphylococci and streptococci. Storage of beta-lactamase (Genzyme broad-spectrum mixture) in blood-culture medium at room temperature resulted in rapid loss of cephalosporinase activity, whereas little decline in penicillinase activity was noted over a period of 118 days. PMID- 3290493 TI - Competitive enzyme-linked immunosorbent assay for Treponema pallidum antibodies. AB - A competitive enzyme-linked Treponema pallidum immunosorbent assay (CETPIA) was compared with the standard serological tests for syphilis. Of 3081 serum samples submitted, 2883 gave negative results in the CETPIA and the routine screening tests. Positive results were obtained in the CETPIA and in one or more of the specific treponemal tests with 115 samples. Discrepancies in the results of the CETPIA and standard serological tests were found with 83 serum samples, most of these were attributed to biological false positive reactions in the Venereal Disease Research Laboratory (VDRL) test. CETPIA may have a role in the serological diagnosis of syphilis. PMID- 3290494 TI - Vero cytotoxin-producing strains of Escherichia coli. PMID- 3290495 TI - Trophoblast concept as applied to therian mammals. AB - Available evidence provides little support for a recent proposal that the term "trophoblast" be applied solely to eutherian mammals. Arguments for such a restricted usage are based on a dichotomous interpretation of therian reproduction that underestimates the developmental, structural, and functional diversity of trophoblastic tissues occurring within the infraclass Eutherian. The occurrence of developmental patterns that are phenotypically intermediate between those of commonly studied eutherians and metatherians suggests that blastocyst development is not fundamentally different in marsupials and eutherians. The trophoblast of marsupials accomplishes most or all of the major functions of the eutherian trophoblast, including maternal-fetal physiological exchange, implantation, contribution to placental membranes, steroid metabolism, and possibly, immunological protection of the conceptus. Furthermore, application of the term "trophoblast" to marsupials is consistent with present and past usage, as well as with the original definition and etymological derivation of the term. Therefore, we recommend that the term "trophoblast" continue to be applied in a functional-morphological sense to the appropriate extraembryonic tissues of marsupials. Such use of functional (rather than taxonomic) criteria for application of this term avoids biasing interpretations of mammalian reproductive evolution. PMID- 3290488 TI - Genetic markers on chromosome 7. AB - Chromosome 7 is frequently associated with chromosome aberrations, rearrangements, and deletions. It also contains many important genes, gene families, and disease loci. This brief review attempts to summarise these and other interesting aspects of chromosome 7. With the rapid accumulation of cloned genes and polymorphic DNA fragments, this chromosome has become an excellent substrate for molecular genetic studies. PMID- 3290497 TI - Defective estrogen receptors in human mammary cancers: their significance in defining hormone dependence. AB - Neither estrogen dependence nor clinical response to hormone therapy of the tumor is guaranteed by the mere presence of receptors for estrogens (ERs) or progesterones (PRs). Immunohistochemical staining of ER with polyclonal anti-ER antibodies after in vitro transformation has enabled the identification of two types of defective ER among human breast cancers: those that are unable to bind to the nucleus in a hormone-filled state and those that bind to the nucleus as naked ER. Preliminary clinical correlation studies demonstrate that a subclassification of ER(+) tumors based on functional abnormalities of ER may predict refractoriness to hormone therapy. PMID- 3290496 TI - Immunoregulation of carcinogenesis: past, present, and future. AB - Twenty years ago the concept that immunological mechanisms might regulate carcinogenesis was highly controversial. Today this concept survives in modified form and continues to evolve as our knowledge of the immune system, the etiology of cancer, and tumor antigens expands. This review illustrates how our ideas about immune surveillance have changed in recent years and considers the significance of these changes for the future directions of cancer immunobiology. PMID- 3290498 TI - Efficacy of 2'-deoxycoformycin in hairy-cell leukemia: a study of the National Cancer Institute of Canada Clinical Trials Group. AB - Thirty-one patients with hairy-cell leukemia were treated with 2'-deoxycoformycin (DCF) in a National Cancer Institute of Canada multicenter trial. The DCF was administered in a cycle (4 mg/m2 iv weekly X 3), which was repeated every 8 weeks. Following a complete remission, consolidation was done with two further cycles of DCF. Of 28 patients evaluable for response, 25 obtained a complete remission; 3 had a partial response. To date there has been only one relapse; the median time with no therapy was 429.5 days (range 99-743 days). Toxicity was moderate and included nausea and vomiting, lethargy, and skin rash; with the first cycle of treatment, neutropenia and an increased incidence of fever or infection were also observed. We conclude that low-dose DCF is highly effective in treating hairy-cell leukemia. PMID- 3290499 TI - Directional effects of acute total-body x-irradiation: exposure rate versus homogeneity of exposure. AB - Survival patterns of NBL/Up mice exposed to 675-800 R of total-body x-radiation depended on direction and rate of exposure. Homogeneous dual exposures administered at 126 R/minute were more effective than those administered at 63 R/minute. Dorsal and dual exposures at 63 R/minute were equally effective, while absorption reduced the effectiveness of ventral exposures. Since cellular repair of hematopoietic tissue was initiated only during exposure, increased homogeneity without increased exposure rate would not increase effectiveness. With rate, direction, and homogeneity influencing the effectiveness of total-body exposures, fallacies inherent in converting total-body exposures to absorbed tissue dose became apparent. PMID- 3290500 TI - The status of black students in medical education. PMID- 3290501 TI - Update in cancer chemotherapy: genitourinary tract cancer, Part 4: Testicular cancer. AB - An update of the state of the art of cancer chemotherapeutic treatment of genitourinary tract cancer is described in this multi-part series: included are cancers of the kidney, bladder, prostate, testicle, ovary, uterus, vulva, and gestational trophoblastic neoplasms. Part 4 is a review of treatments for cancer of the testicles.Testicular cancer is highly curable and responds well to both surgery and chemotherapy. Patients with stage I and stage II nonseminomatous germ cell tumors may be cured by surgery alone or in combination with chemotherapy. In patients with pathologic stage II disease, the use of adjuvant chemotherapy with two courses of platinum-based combination drugs has been successful in preventing relapse. Further refinements in management and research could banish the problem of testicular cancer. PMID- 3290503 TI - Treatment of myocardial infarction: a review. AB - An overview of the problems and management of acute myocardial infarction is presented. Certain factors that are pertinent to the problem of differential mortality in various population subgroups have been identified. These factors include race, sex, and socioeconomic background. PMID- 3290502 TI - Garlic revisited: therapeutic for the major diseases of our times? AB - Garlic may play an invaluable role in the prevention and therapy of the major causes of death. Anecdotal, basic, and clinical research data are confirming the efficacy of this herb in the treatment of hyperlipemia, cancer, heavy-metal intoxication, infectious diseases, hypertension, free-radical damage, and immune deficiency states. Garlic's broad antimicrobial spectra and its ability to modulate immunity may play a strategic role in the acquired immunodeficiency syndrome pandemic. A review of the literature supports a greater scrutiny of this herb's therapeutic potential. PMID- 3290504 TI - Medical education in Atlanta and health care of black minority and low-income people. AB - In this W. Montague Cobb lecture, the author addresses the status of hospitals for the black minority and the poor in Atlanta, the founding of Morehouse School of Medicine, health care for the disadvantaged, the need for minority health care professionals, and the lack of health insurance among the poor. A greater educational effort is needed to bring about change in the high incidence of homicide, the unhealthy lifestyles, and the disproportionate number of AIDS cases in the black population. PMID- 3290505 TI - Microskin grafting in the treatment of extensive burns: a preliminary report. AB - Microskin grafting has proved to be an effective new procedure for the treatment of extensive burns, in which only a minimum amount of autogenous skin is needed for coverage of a large full-thickness burn wound. The technique has been improved and applied in 17 major burn patients. All patients survived. The wound covered with microskin grafts ranged from 6% to 45% TBSA, with a mean area of 24.1% TBSA. The expansion ratio of micrografts in this series reached up to 1:18, and can be greater. The wound healing was accomplished in three ways. 1) Wounds were completely resurfaced by micrografts in 24 limbs (58.5%). 2) Wounds were not totally healed with micrografts by the time the homograft was rejected, leaving only small raw areas which needed re-grafting in 12 limbs (29.3%). 3) The micrografts did not take on four limbs and one chest wall (12.2%). The improved technique, which has become more simple and feasible, is discussed in detail. PMID- 3290506 TI - Rehabilitation concerns in electrical burn patients: a review of the literature. AB - Patients with electrical burns have problems which are unique to their type of injury. In the acute stage, amputations, peripheral neuropathy, and entrapment syndromes occur more commonly in electricity-induced trauma than in thermal burns. In addition, clinicians must be vigilant because peripheral neuropathy, quadriplegia, paraplegia, and entrapment syndromes may have an insidious onset and become manifest days to months after the original injury. Both electrical and thermal burn patients are subjected to two types of trauma: the insult caused by the acute event, and complications which occur because of poor positioning, bulky dressings, intramuscular injections, and neurotoxic medications. PMID- 3290507 TI - Detection of diaphragmatic disruptions by peritoneoscintigraphy using technetium 99M diethylene-triamine pentacetic acid. AB - Intraperitoneal injection of a selected radiopharmaceutical results in the diffusion of radioactive material throughout the peritoneum. A diaphragmatic injury should theoretically result in the diffusion of the radioactive material into the chest. To test this hypothesis, Technetium-99m diethylene-triamine pentacetic acid (Tc-99m DTPA) was administered intraperitoneally by either direct needle injection or catheter into 18 rabbits. Four of the rabbits served as controls and did not have any diaphragmatic injury. Fourteen rabbits had surgically induced diaphragmatic tears of varying size (1/4 to 1 cm) after thoracotomy. Four of the 14 rabbits were dropped from the study because they had inadequate peritoneal injections of the radiopharmaceutical. The remaining ten rabbits showed peritoneoscintigraphic evidence of diaphragmatic injury either by showing passage of the radiotracer into the chest, demonstrating the site of injury as a focal region of increased radiotracer uptake, or showing both of these features. Peritoneoscintigraphy appears to be a potentially useful modality in the detection of diaphragmatic injury. PMID- 3290508 TI - Nonunion of intercondylar eminence fracture of the tibia. AB - An unusual case of symptomatic nonunion of an intercondylar eminence fracture in an adult is presented. The nonunion was successfully treated using internal fixation and bone grafting. PMID- 3290509 TI - Environmental lead exposure and the kidney. AB - Lead and its components remain widely distributed in the environment and in some workplaces. Lead serves no useful physiological function, yet is potentially toxic to several organ systems. For many years human health effects have been recognized after heavy lead exposure. Recently more subtle human effects have been suggested invoking nervous system, reproductive and kidney function. Assessing lead body burden and dose-response relationships of this metal by blood lead determination, porphyrin assessments, chelation testing or bone lead studies may be difficult. Quantitative assessment of subtle changes in kidney function by routine BUN, creatinine, or urinalysis also poses problems. There is now mounting evidence that chronic low level environmental lead exposure may subtly effect kidney function. This paper first examines the history of lead and kidney function and then examines critically the evidence associating low-level environmental lead exposure and effects on renal function. PMID- 3290510 TI - Poisoning with the North American Jack O'Lantern mushroom, Omphalotus illudens. AB - Ingestion of Jack O'Lantern mushrooms by fourteen people led to vomiting in 8, diarrhea in 5, weakness in 2. Tiredness, the feeling of weakness and being cold occurred in 8. Recovery was complete within 18 hours. PMID- 3290511 TI - [A studying of the hospitalized children's stress by a projective technic]. PMID- 3290512 TI - A study of the structure and pathogenesis of ascaris and clonorchis stones. PMID- 3290514 TI - Peripheral venous bullet embolization to the heart. Case report and review of the literature. AB - Peripheral venous bullet embolization to the heart is a rare event. We report our experience with one patient who suffered peripheral venous bullet embolization to the right ventricle and review the 38 patients with this phenomenon previously reported in the literature. The clinical presentation of patients with peripheral venous bullet embolization to the right ventricle is discussed. In addition, the indications for surgery and the therapeutic approaches available to patients with bullet embolization are discussed. PMID- 3290513 TI - Management of hemangiomas of the head and neck in children. AB - Hemangiomas occur in approximately 1% of Caucasian children, and the head and neck is a common site of presentation. Lesions in this region may cause morbidity and occasionally mortality by virtue of complications such as ulceration, infection, hemorrhage, hemodynamic change, aerodigestive tract obstruction and disfigurement. The majority of hemangiomas regress spontaneously. Those with impending complications may require treatment with several modalities. Embolization, surgery, laser therapy, cryotherapy and medical therapy with steroids and antifibrinolytic agents may be used in selected situations. Radiotherapy is now rarely favored due to potential induction of late malignancies. The natural history of these lesions is discussed along with the treatment modalities available and indications for use. Several representative cases are presented. PMID- 3290515 TI - Late patency of the carotid artery after endarterectomy. Problems of definition, follow-up methodology, and data analysis. AB - To determine the relative incidence of recurrent carotid stenosis (RCS) and the effect of methodology on data analysis and interpretation, late results were obtained for 232 patients (270 procedures) from 1 to 51 months (mean 22 months) after carotid endarterectomy (group A). Patency of the carotid artery was confirmed by postoperative intravenous digital subtraction angiography (DSA) for most of the series, and a subset (subgroup A1) of 113 patients (129 procedures) also received DSA studies at later intervals of 4 to 49 months (mean 26 months). There were 23 late deaths and five late strokes. Only two of the strokes were ipsilateral to previous endarterectomy, and both of these patients had normal follow-up DSA studies. Late DSA imaging revealed either no RCS or only trivial defects (20% diameter or less) in 111 arteries, moderate (36% to 60%) RCS in nine, severe (70% to 90%) RCS requiring secondary procedures in eight, and internal carotid occlusion in one. Depending on the definition of RCS (secondary operation vs greater than or equal to 30% angiographic lesions), the cohort selected for analysis (group A vs subgroup A1), and the approach to calculations (crude vs cumulative), the incidence of recurrent stenosis after carotid reconstruction in this single study could be expressed within the extraordinary wide range of 3% to 32%. Although carotid endarterectomy was associated with uniformly low risk for late stroke, these results confirm that the reported recurrence rate may be substantially influenced by the method in which data are grouped and manipulated. Consistently presented data are essential to any comparisons concerning the surgical therapy for extracranial disease. PMID- 3290516 TI - Clinical alert gives breast cancer data, revises recommendations. PMID- 3290517 TI - Long-term acyclovir suppression of frequently recurring genital herpes simplex virus infection. A multicenter double-blind trial. AB - Normal adults with six or more episodes of genital herpes in the previous year were enrolled in a one-year, multicenter, double-blind trial comparing placebo with 400 mg of acyclovir administered orally twice daily. Patients with episodes during the study were offered 200 mg of acyclovir administered orally five times daily for five days; this allowed comparison of suppressive and episodic treatment. After one year, 227 (44%) of 519 patients receiving suppressive treatment and seven (2%) of 431 receiving placebo (episodic) treatment remained free of recurrences, and the mean numbers of recurrences per year were 1.8 and 11.4, respectively. Among 67 patients who had received suppressive therapy for one year, the mean duration of lesions in the first episode following the discontinuation of treatment was 9.3 days compared with 7.3 days among 45 patients who had received episodic therapy for one year. Treatment was well tolerated, and no changes were noted in the in vitro susceptibility to acyclovir of herpes simplex virus cultured during or after the one-year trial. Continuous or episodic oral acyclovir therapy for one year remained safe and effective. PMID- 3290519 TI - The fire-safe cigarette. AB - Fires caused by cigarettes through the ignition of upholstered furniture and mattresses are a serious public health problem, accounting for more than 1500 deaths and 7000 serious injuries per year in the United States. Fire-resistant fabrics and stuffings, public education, and smoke detectors have had a limited impact on this problem. The federal government recently has completed a three year study of possible modifications in cigarette design. The study has demonstrated the technical feasibility of product design changes that would substantially reduce the propensity of cigarettes to ignite fires. Legislation currently is pending in Congress and in three state legislatures to mandate a cigarette fire safety standard. This legislation deserves strong support by the medical profession. PMID- 3290518 TI - The public cost of motorcycle trauma. AB - Despite the effectiveness of motorcycle helmet legislation, many states have repealed these laws during the last decade. Aspects often neglected by policymakers are who pays for the care of these victims and how much of this cost is subsidized by public funds. To determine the extent of this subsidy, we studied the cost of care of 105 motorcyclists hospitalized at a major trauma center during a 12-month period. Total direct costs for these 105 patients, followed up for a mean of 20 months, were more than $2.7 million, with an average of $25,764 per patient. Only 60% of the direct costs were accounted for by the initial hospital care; 23% of costs were for rehabilitation care or readmission for treatment of acute problems. The majority (63.4%) of care was paid for by public funds, with Medicaid accounting for more than half of all charges. PMID- 3290520 TI - Rhabdomyolysis and renal injury with lovastatin use. Report of two cases in cardiac transplant recipients. AB - Hyperlipidemia, particularly hypercholesterolemia, occurs in cardiac transplant recipients both as a preexisting condition and as a consequence of immunosuppressive therapy. Lovastatin (Mevacor) has emerged as an agent that may effectively manage this condition. Few serious side effects of this drug have been observed. We describe two cardiac transplant recipients treated with lovastatin in conjunction with their other medications, including cyclosporine, who developed acute renal failure and rhabdomyolysis. Resolution of muscle damage followed discontinuation of cyclosporine and lovastatin therapy. We postulate that hepatic dysfunction secondary to cyclosporine predisposed these patients to lovastatin-induced muscle damage. Use of this drug in cardiac and other organ transplant recipients should be accompanied by close surveillance of creatine kinase, hepatic transaminases, and cyclosporine levels. PMID- 3290521 TI - Gastroenterology comes of age. PMID- 3290522 TI - Beyond the Supreme Court ruling on alcoholism as willful misconduct: it is up to Congress to act. PMID- 3290523 TI - Diagnostic and therapeutic technology assessment. Radial keratotomy for simple myopia. AB - There was a lack of consensus among DATTA panelists about the safety and, especially, the effectiveness of radial keratotomy. For patients with a preoperative refractive error greater than -6.00 D, DATTA panelists believed that radial keratotomy has not been established as safe or effective. Concerns about effectiveness focused on the lack of predictability of the results and the continuing change in the refractive error following surgery. Daily fluctuations in visual acuity and the occurrence of anisometropia were other reported adverse events that contributed to the concern expressed by DATTA panelists. Concern over the safety and effectiveness of the procedure became greater as the magnitude of the preoperative refractive error increased. Nevertheless, there is a subpopulation of myopic patients who regard their myopia as a sufficiently severe handicap for them to undergo radial keratotomy. Such carefully chosen patients who have the procedure performed may achieve emmetropia and be free of corrective lenses. PMID- 3290524 TI - Rapid latex agglutination assay using recombinant envelope polypeptide for the detection of antibody to the HIV. AB - Unscreened blood transfusions continue to be one of the major modes of transmission of the human immunodeficiency virus (HIV) in developing countries, such as in Central Africa, where 5% to 18% of blood donors are HIV seropositive. We evaluated a rapid latex agglutination assay using a novel recombinant envelope polypeptide of HIV for the detection of HIV antibodies among 2820 blood donors and clinical patients from diverse geographic regions, including on-site testing in Central Africa of 1600 blood donors. Overall, 29.2% of the serum samples were positive by Western blot assay. On a single determination, the latex agglutination slide test was found to be highly sensitive and specific compared with Western blot results in these populations with a relatively high prevalence of infection. Use of this assay will allow the immediate implementation of serologic screening for HIV in developing areas of the world, where standard screening procedures are impractical or not available, and in many other clinical settings, such as sexually transmitted diseases clinics and hospitals, where testing and counseling could be promptly implemented. PMID- 3290526 TI - Posttraumatic multisystem organ failure. PMID- 3290525 TI - The impact of AIDS on the medical care system. PMID- 3290527 TI - Psychiatric aspects of organ transplantation. PMID- 3290528 TI - What is inappropriate care? PMID- 3290529 TI - Rapid screening tests for HIV infection. PMID- 3290530 TI - Alteration of left ventricular geometry during preload reduction and afterload increment. AB - To ascertain whether or not left ventricular geometry changes during preload reduction and afterload increment, the shortening characteristics of small segments in the left ventricular free wall were examined using 4 pairs of ultrasonic crystals in 10 dogs. Three pairs of ultrasonic crystals were circumferentially implanted in the basal, the midventricular and the apical portion of the left ventricle. Another pair of crystals were longitudinally placed in the midventricle. In the control state, the shortening at the apex was largest of all segments. During preload reduction, the end-diastolic length decreased significantly in each segment. The percent shortening decreased significantly at the apical and the longitudinal segment, but it remained unchanged at the midventricular and the basal segment. During afterload increment, the end-diastolic length increased significantly, but the percent shortening remained unchanged in each segment. We concluded that left ventricular geometry was altered during preload reduction and that the apical part is more responsive to preload change than the other portion. PMID- 3290531 TI - [Analysis of non-Hodgkin's lymphomas of 210 patients with nodular and favorable histologies--report of the Japanese Lymphoma Radiation Therapy Study Group]. AB - Between 1972 and 1985, 210 patients with nodular poorly differentiated lymphocytic (NPDL), nodular mixed lymphocytic and histiocytic (NM), nodular histiocytic (NH), or diffuse well differentiated lymphocytic (DWDL) lymphoma according to Rappaport classification were treated among the 7 hospitals belonging to JLRTG (Japanese Lymphoma Radiation Therapy Study Group). Age greater than 50 years adversely affected overall survival. But no obvious survival differences were seen by sex and the primary site. Patients with NH had a significantly poorer survival (P less than 0.01), while there were no differences among the other histologic groups. Aggressive combination chemotherapy is advisable for patients with stages II, II and IV NH. But radiotherapy along may be treatment choice for patients with stage I NH. Because among stage I, over all survival and relapse-free survival of patients with NH were similar to those with the other histologic types. Five-year and 10-year relapse-free survival of stage I patients with the other 3 histologic types by radiotherapy alone were 85% and 67%, respectively. Those of stage II patients were both 58%. These data suggest cure of more than 50% of stages I and II patients with favorable lymphoma by radiotherapy alone. PMID- 3290532 TI - [Results of the treatment of localized non-Hodgkin's lymphoma originated in the thyroid gland]. AB - A total of 38 cases of localized non-Hodgkin's lymphoma originated in the thyroid gland were treated at the Department of Radiology, Osaka University Hospital from 1967 through 1986. There were 18 males and 20 females, and age ranged from 15 to 78, averaging 58 years. Fifteen cases were classified as clinical stage I and 23 as stage II. All cases were histologically confirmed, 15 by total or partial resection and 23 by open biopsy, and diffuse histiocytic was most common (18 cases) and diffuse lymphocytic, poorly differentiated was the next (15) after Rappaport classification. Those were further classified into intermediate grade after Working Formulation in 76% of the cases. In all patients local were controlled by radiotherapy by 40-50 Gy in 5 to 6 weeks. Local lesion was assessed as uncontrolled in only one patient at dose of 33 Gy, who was immunoblastic in histology, and with infiltration to local skin. No local relapse occurred after treatment. The relapse outside the treatment field was seen in 9 patients, all of which occurred in the abdomen. Overall 5 year survival rate and relapse-free rate were 72% and 64%, respectively. Five-year survival rate for Stages I and II were 84% and 63%, respectively (Z = 0.7445, N.S.). Five-year survival rate for thyroidal swelling with longer diameter less than 11 cm is 83%, whereas that with more than 12 cm is 61% (z = 0.7525, N.S.). PMID- 3290535 TI - [The treatment of acute non-lymphocytic leukemia in patients 30 years of age and younger]. PMID- 3290534 TI - [Late complications of radiation therapy in patients with malignant lymphoma]. AB - The improvement on the treatment of malignant lymphoma have led to prolonged survival for many patients. However, they are at risk of late complications of the disease and treatment. Impaired function due to radiation-induced injury of normal tissues, such as cardiac, pulmonary, or thyroid dysfunction, becoming manifest at few months to years after treatment. Fortunately, only a small portion of these are major complications, causing severe, or permanent disability. The frequency of secondary leukemia (AML) occurring in patients treated for malignant lymphoma is highest in those patients receiving many courses of combination chemotherapy and is low in those receiving radiation therapy alone. PMID- 3290533 TI - [The role of radiation therapy in the management of the Hodgkin's disease]. AB - Radiation therapy has curative potential for patients with stage I-II disease, and five-year relapse-free survival rate in excess of 80% can be expected. Despite an advantage of chemotherapy combined with radiation therapy in improving relapse-free survival, no significant advantage has yet been demonstrated in allover survival. Patients with stage IIIA1 may also be treated radiation therapy alone with results of five-year survival rate of 53-60%. However, patients with stage IIIA2 should be treated with chemotherapy with or without radiation therapy combined. PMID- 3290536 TI - [Allogeneic bone marrow transplantation for acute leukemia in children]. PMID- 3290537 TI - [Late relapse of acute promyelocytic leukemia (FAB M3) in childhood- characteristic therapeutic results of M3 compared to other types of non lymphocytic leukemia]. PMID- 3290539 TI - [inv(11) (p15q23) in a case of childhood myelodysplastic syndrome]. PMID- 3290538 TI - [Allogeneic bone marrow transplantation for Burkitt's lymphoma (stage IV)]. PMID- 3290541 TI - [The first case of autoimmune hemolytic anemia in a patient with ovarian carcinoma in Japan]. PMID- 3290540 TI - [Acquired von Willebrand syndrome associated with late onset systemic lupus erythematosus--a case report]. PMID- 3290542 TI - [Applications of SPECT for pulmonary medicine and radionuclide study of interstitial lung diseases]. PMID- 3290543 TI - [Ultrasonographic findings of parathyroid tumor with primary hyperparathyroidism]. PMID- 3290544 TI - [Primary malignant lymphoma of the brain]. PMID- 3290545 TI - [Graft vs host disease of the gastrointestinal tract--report of three cases]. PMID- 3290546 TI - [Production of CA19-9 in cultured human gastric cancer cell lines]. PMID- 3290547 TI - [Effect of upper abdominal autonomic denervation on glucagon secretion after intraduodenal glucose administration in dogs]. PMID- 3290548 TI - [5 cases of Cowden's disease]. PMID- 3290549 TI - [A case of eosinophilic colitis in the aged]. PMID- 3290550 TI - [Qualitative analysis of gallstones based on their ultrasonic properties]. PMID- 3290551 TI - [A case of ischemic lesion in the large intestine associated with Buerger's disease]. PMID- 3290552 TI - [Studies of urine protein components of orthostatic proteinuria--changes in forced lordosis]. PMID- 3290553 TI - [Prostaglandin in the macula densa mechanism of renin release]. PMID- 3290554 TI - [Effect of combination therapy of low protein diet and captopril on proteinuria of diabetic nephropathy (DN)]. PMID- 3290555 TI - Ectopic goiters of the mediastinum: presentation of two cases and review of the literature. AB - Two cases of ectopic goiters located in the anterior mediastinum are presented. These comprise 5.1 per cent of our cases of intrathoracic goiters and 1.3 per cent of mediastinal tumors. These benign tumors have been rarely reported in the literatures, however, excision by thoracotomy is the surgical procedure advocated for these cases and the diagnosis is generally established operatively. Angiography and tomography have proved useful in diagnosing and localising these lesions prior to the surgical procedure. PMID- 3290556 TI - Postoperative acute cholecystitis: a collective review of 494 cases in Japan. AB - The clinical course and management of 494 patients with postoperative acute cholecystitis, encountered at 122 hospitals in Japan during the last decade, were reviewed. The incidence of the disease from the total operations was 0.06 per cent, and 445 patients (90 per cent) were acalculous. The mean age of the patients was 60 years, and the ratio of male to female was 2.8:1. Total gastrectomy, subtotal gastrectomy, and esophagectomy were the most common operations precipitating postoperative acute cholecystitis. Vagotomy, dissection of the upper abdominal lymph nodes, and prolonged fasting were prevalent among the risk factors. Clinical diagnosis was confirmed in most patients by ultrasonography. Among the various treatments, cholecystectomy brought the lowest mortality rate; the overall mortality rate being 23 per cent. When this disease is suspected, ultrasonography should be performed repeatedly and percutaneous transhepatic gallbladder drainage or cholecystectomy are recommended as being the treatments of choice. PMID- 3290557 TI - Haemorrhagic adrenal pseudocyst: a case report. AB - A case of a non-functioning adrenal pseudocyst is reported herein. The key role of sonography and abdominal CT in the diagnosis of this rare retroperitoneal cystic lesion is highlighted. A possible etiological relationship with the trauma of parturition is proposed in our patient. PMID- 3290558 TI - [Two cases of supravalvular aortic stenosis corrected by extended aortoplasty]. PMID- 3290559 TI - [Right atrial myxoma--report of 2 cases]. PMID- 3290560 TI - Presence of less heavily encapsulated Klebsiella pneumoniae capsular type 1 in semen of healthy stallions and cervical swabs of mares suffering from metritis and comparison of virulence between heavily and less heavily encapsulated strains. PMID- 3290561 TI - Distribution and morphology of the renin-containing cells in the amphibian kidneys. PMID- 3290562 TI - Monoclonal antibodies to Chlamydia psittaci: characteristics and antigenic analysis. PMID- 3290563 TI - Cell-bound toxin of Clostridium botulinum type C and its pathogenic significance. PMID- 3290564 TI - Appendicitis complicating pregnancy. PMID- 3290565 TI - Aminoglycoside nephrotoxicity. PMID- 3290567 TI - [Sepsis in patients with terminal chronic kidney failure (a review of the literature)]. PMID- 3290566 TI - [Internal dermatoautoplasty (a review of the Soviet and foreign literature)]. PMID- 3290568 TI - [Use of selective proximal vagotomy with targetted resection of the ischemic segment of the stomach in treating peptic ulcer]. PMID- 3290570 TI - [Gunshot peritonitis]. PMID- 3290569 TI - [Use of triangular anastomoses in surgery of the gastrointestinal tract]. PMID- 3290571 TI - [Methods increasing the effectiveness of anti-glaucoma filtering operations]. PMID- 3290572 TI - [Reconstruction of full thickness of the eyelid in eyelid defects with preservation of the eye]. PMID- 3290574 TI - 1987 CAP Toxicology Proficiency Survey. PMID- 3290573 TI - [Embryopathy and diabetic fetopathy in a premature stillborn infant. Case report and review of the disease picture]. AB - The diabetic embryopathy syndrome comprises a number of developmental anomalies among fetuses of diabetic mothers. Fetopathia diabetica, on the other hand, is characterized by typical, hormonal, and metabolic dysfunctions and their morphological sequelae in fetuses and offsprings of diabetic mothers. We observed the combination of both these conditions in an immature stillborn fetus. The 34 year-old diabetic mother, who had been treated by insulin since age 16, was first seen at 27 weeks of gestation. Sonography revealed severe congenital malformations of the fetus, and a late abortion was induced. The stillborn female revealed the typical congenital malformations of the diabetic embryopathy syndrome, such as abnormalities of face and skull, skeletal malformations of the thorax, spine, and lower extremities, and malformations of the heart, great vessels and the genitourinary system. We, too, found the characteristic features of fetopathia diabetica, i.e. obesity, macrosomia, increased weight and size of the internal organs, polynesia and macronesia of the pancreas, increased extramedullary hematopoiesis and cellular depletion of lymphoid tissues. A review of the literature revealed various hypotheses about the etiology and pathogenesis of both conditions. PMID- 3290575 TI - Metabolic bone disease: a review. PMID- 3290576 TI - Comparative analysis of estrogen receptors covalently labeled with an estrogen and an antiestrogen in several estrogen target cells as studied by limited proteolysis. AB - Estrogen receptors covalently labeled with the estrogen affinity label [3H]ketononestrol aziridine (KNA) or with the antiestrogen affinity label [3H]tamoxifen aziridine (TAZ) were subjected to limited proteolysis with trypsin, alpha-chymotrypsin, and Staphylococcus aureus V8 protease and then analyzed on 10 20% sodium dodecyl sulfate-polyacrylamide gradient gels followed by fluorography. The similar molecular weights of intact receptors (Mr 66,000 daltons) and the proteolytic digest patterns indicate extensive homology among estrogen receptors from MCF-7 human breast cancer cells, GH4 rat pituitary cells and rat uterus when liganded with estrogen or antiestrogen. Each protease generated a distinctive ladder of estrogen receptor fragments, and the fragmentation patterns were virtually identical for estrogen receptors labeled with estrogen (KNA) or antiestrogen (TAZ). Each protease yielded a relatively "resistant" receptor fragment of about 28,000-35,000 daltons. Trypsin and chymotrypsin at higher concentrations generated a much smaller 6,000-8,000 dalton digest product that still contained the [3H]KNA- or [3H]TAZ-labeled receptor binding site. Moreover, the receptor digest patterns were similar for estrogen receptors from the three different target cells. Our studies suggest considerable structural relatedness among these three estrogen receptors and also indicate that these two affinity labels bind to a similar, perhaps identical, region of the receptor molecule. PMID- 3290577 TI - Comparison of enzyme immunoassay and dextran-coated charcoal techniques for progesterone receptor determination in human breast cancer cytosols. AB - We have compared a new enzyme immunoassay for progesterone receptors (Abbott PgR EIA, monoclonal) with our standard radioligand binding-assay (PgR-RBA). For both assays cytosols were freshly prepared from human breast cancer specimens that had been stored frozen for up to 1 year, and predominantly tissues were used which contained critically low amounts of progesterone receptors. A highly significant correlation was observed between the PgR-EIA and PgR-RBA (Spearman: Rs = 0.85, n = 100). Using a cut-off point of 10 fmol PgR/mg protein, 87% of the values were in accordance with each other (52% negative, and 35% positive in both assays), whereas 13% scored positive (median: 16, range 11-38 fmol PgR/mg protein) in one assay and negative (median: 7, range 0-10 fmol PgR/mg protein) in the other. Also in cytosols from human ovarian and endometrial carcinoma tissues immunoreactive PgR could be detected, and significant correlations with PgR-RBA were observed (Rs = 0.94, n = 6) for both tissues. PMID- 3290578 TI - Combination therapy with flutamide and castration (LHRH agonist or orchiectomy) in previously untreated patients with clinical stage D2 prostate cancer: today's therapy of choice. AB - One hundred and ninety-nine patients with clinical stage D2 prostate cancer who had not received previous endocrine therapy or chemotherapy were treated with the combination therapy using the pure antiandrogen Flutamide and the LHRH agonist [D Trp6]LHRH ethylamide for an average of 26 months (3-59 months). The objective response to the treatment was assessed according to the criteria of the U.S. NPCP. There was a 5.7-fold increase (26.3 vs 4.6%) in the percentage of patients who achieved a complete response compared with the results obtained in five recent studies limited to removal (orchiectomy) or blockade (DES or Leuprolide) of testicular androgens. Only 12 of the 186 evaluable patients (6.5%) did not show an objective positive response at the start of the combination therapy compared with an average of 18% in the same five studies using monotherapy. The duration of response was also significantly improved in the patients who received the combination therapy while the death rate was decreased by approximately two fold during the first 4 yr of treatment. In fact, while an approximately 50% death rate is observed at 2 yr in all studies using monotherapy, the same 50% death rate is delayed by 2 yr in the present study. It should be mentioned that at the time of relapse under combination therapy, the treatment is continued and, in addition, further blockade of adrenal androgen secretion is achieved with aminoglutethimide. The marked (5.7-fold) improvement in the rate of complete objective responses coupled with the three-fold decrease in the number of non responders, the increased duration of the positive responses and the two-fold decrease in the death rate during the first 4 yr of treatment are obtained with the combination therapy using Flutamide and castration, thus improving the quality and duration of life with no or minimal side-effects. By blocking the androgen receptors in the prostatic cancer tissue, the antiandrogen decreases the action of the androgens of adrenal origin and thus inhibits the growth of a large number of tumors which, otherwise, would continue to be stimulated by the adrenal androgens left after medical or surgical castration. PMID- 3290579 TI - Oestrogen and progesterone interactions in the control of gonadotrophin and prolactin secretion. AB - Oestrogen and progesterone have marked effects on the secretion of the gonadotrophins and prolactin. During most of the oestrous or menstrual cycle the secretion of gonadotrophin is maintained at a relatively low level by the negative feedback of oestrogen and progesterone on the hypothalamic-pituitary system. The spontaneous ovulatory surge of gonadotrophin is produced by a positive feedback cascade. The cascade is initiated by an increase in the plasma concentration of oestradiol-17 beta which triggers a surge of luteinizing hormone releasing hormone (LHRH) and an increase in pituitary responsiveness to LHRH. The facilitatory action of oestrogen on pituitary responsiveness is reinforced by progesterone and the priming effect of LHRH. How oestrogen and progesterone exert their effects is not clear but the facilitatory effects of oestrogen take about 24 h, and the stimulation of LHRH release is produced by an indirect effect of oestradiol on neurons which are possibly opioid, dopaminergic or noradrenergic and which modulate the activity of LHRH neurons. In the rat, a spontaneous prolactin surge occurs at the same time as the spontaneous ovulatory gonadotrophin surge. The prolactin surge also appears to involve a positive feedback between the brain-pituitary system and the ovary. However, the mechanism of the prolactin surge is poorly understood mainly because the neural control of prolactin release appears to be mediated by prolactin inhibiting as well as releasing factors, and the precise role of these factors has not been established. The control of prolactin release is further complicated by the fact that oestradiol stimulates prolactin synthesis and release by a direct action on the prolactotrophes. Prolactin and gonadotrophin surges also occur simultaneously in several experimental steroid models. A theoretical model is proposed which could explain how oestrogen and progesterone trigger the simultaneous surge of LH and prolactin. PMID- 3290580 TI - Gonadal steroids and neuropeptide Y-opioid-LHRH axis: interactions and diversities. AB - We report that the two classes of regulatory neuropeptides, neuropeptide Y (NPY) and endogenous opioid peptides (EOP), modulate luteinizing hormone (LH) release in diverse fashion in gonad-intact rats. Each neuropeptide acts at two loci, the hypothalamus and pituitary, to excite (NPY) or inhibit (EOP) LH release. At the hypothalamic level, NPY stimulates luteinizing hormone releasing hormone (LHRH) release, a response mediated by alpha 2-adrenoreceptors and amplified in the presence of adrenergic agonists. At the pituitary level, NPY acts in concert with LHRH to amplify the LH response. In contrast, EOP inhibit LHRH release by decreasing the supply of excitatory adrenergic signals in the vicinity of LHRH neurons in the preoptic-tuberal pathway, and at the pituitary level, they decrease LH release in response to LHRH. Further, the gonadal steroidal milieu facilitates NPY neurosecretion and postsynaptic expression of NPY in concert with adrenergic system; a similar clear-cut facilitatory effect of gonadal steroids on EOP secretion is not yet obvious. Our additional studies imply that the EOP system has the potential to increase sensitivity towards gonadal steroids and that to induce the preovulatory LH surge the neural clock may decrease the inhibitory EOP tone prior to the critical period on proestrus. This antecedent neural event allows the excitatory adrenergic and NPY signals to evoke LHRH secretion at a higher frequency approximating that seen in ovariectomized rats. Further studies are under way to delineate the steroid-induced subcellular events that integrate the action of these regulatory peptides in the control of the episodic LHRH secretion pattern which sustains basal and cyclic gonadotropin release in the rat. PMID- 3290581 TI - The cellular effects of estrogens on neuroendocrine tissues. AB - Estrogen action on sensitive neurons in the rat diencephalon has been studied by morphologic techniques; evidence of estrogen action at every level is presented, including tracts, cells, circuitry and subcellular organelles. The demonstration in the arcuate nucleus of estrogen-induced synaptic remodelling, estrogen-induced postsynaptic membrane phenotypes, changes in intracellular membranes and rapid estrogen actions on neuronal endo-exocytosis indicates that cellular estrogen actions may underlie the neuronal control of reproduction. PMID- 3290583 TI - Microsomal receptor for steroid hormones: functional implications for nuclear activity. AB - Target tissues for steroid hormones are responsive by virtue of and to the extent of their content of functional intracellular receptors. Recent years have seen a shift in considerations of the cellular dynamics and distribution of these receptors, with current views favoring predominant intranuclear localization in the intact cell. This paper summarizes our analyses of the microsomal estrogen and androgen binding capability of rat uterine and ventral prostate tissue, respectively; these studies have revealed a set of high affinity sites that may act as a conduit for estrogen traversing the cell en route to the nucleus. These sites have many properties in common with cytosolic receptors, with the salient difference of a failure to activate to a more avid DNA-binding form under conditions which permit such activation of cytosolic receptors. The microsomal estrogen-binding proteins also have appreciable affinity for progesterone, another distinction from other known cellular estrogen receptor species. Various experimental approaches were employed to demonstrate that the microsomal receptors were not simply cytosol contaminants; the most convincing evidence is the recent successful separation of the cytosolic and microsomal forms by differential ammonium sulfate precipitation. Discrete subfractionation of subcellular components on successive sucrose gradients, with simultaneous assessments of binding capability and marker enzyme concentrations, indicates that the major portion of the binding is localized within the vesicles of the endoplasmic reticulum free of significant plasma membrane contamination. The microsomal receptors are readily solubilized by extraction with high- or low-salt containing buffers or with steroid. The residual microsomes following such extraction have the characteristics of saturable acceptor sites for cytosolic estrogen-receptor complexes. The extent to which these sites will accept the cytosolic complexes is equal to the concentration of microsomal binding sites extracted. These observations suggest three possible roles for the microsomal receptor-like proteins: (a) modulation of estrogen access to nuclear binding sites; (b) formation of functional complexes which diffuse to other extranuclear sites to alter non-genomic cellular processes; (c) regulation of nuclear concentration of estrogen-receptor complexes by virtue of producing microsomal acceptor sites for uptake of free or loosely associated nuclear complexes, previously thought to exist in the cytoplasm. PMID- 3290582 TI - Glucocorticoid receptor structure as probed by endogenous proteases. AB - Transformation of the glucocorticoid-receptor complex by heating the cytosol in the presence of calcium is accompanied by formation of a series of truncated complexes, of which DI and DIIc are the major members. Formation of DIIc (but not of DI) is inhibited by leupeptin, and the intact transformed complex DIIa appears instead. Estimation of the molecular weights and Stokes' radii of all major complexes revealed that forms DI and DIIc have the same Mr, 48 kDa, but differ in shape, and appear to be digestion products generated by cleavage at the same site. Proteolysis of glucocorticoid receptor, covalently labelled with [3H]dexamethasone mesylate in rat thymus and brain cytosol, corroborated these findings and further implied that DI is the product of digestion of the non transformed form of the receptor. Covalently labelled receptor fragments, related to the products formed when cytosol is heated, are detected in the nuclei of thymocytes, implying that the same proteolytic cleavages sites are involved in receptor turnover. Cleavage sites in the non-transformed covalently labelled receptor were identified in the "stepladder" of fragments of Mr, 85, 65, 49, 35, 27-30 kDa, generated in the absence of calcium, with an additional 78 kDa fragment in its presence. In the transformed conformation, two of the cleavage sites giving rise to the 65 and 35 kDa fragments, appear to be protected. It is speculated that the change in the proteolytic susceptibility of the cleavage site for the 35 kDa fragment relates to the "unmasking" of enhancer-activating and/or DNA-binding receptor functions previously postulated. PMID- 3290584 TI - Growth regulatory peptide production by human breast carcinoma cells. AB - The mechanisms by which human breast cancers regulate their own growth have been studied by us in an in vitro model system. We showed that specific growth factors (IGF-I, TGF alpha, PDGF) are secreted by human breast cancer cells. A variety of experiments suggest that they are involved in tumor growth and progression. These activities are induced by estradiol in hormone-dependent breast cancer cells and secreted constitutively by estrogen-independent cells. Concentrates of conditioned medium derived from breast cancer cells can induce the growth of hormone-dependent cells in vivo in athymic nude mice. Hormone-dependent breast cancer cells also secrete TGF beta. TGF beta is growth inhibitory. Growth inhibitors such as antiestrogens or glucocorticoids increase TGF beta secretion. An antiestrogen-resistant mutant of MCF-7 cells does not secrete TGF beta when treated with antiestrogen, but is growth inhibited when treated with exogenous TGF beta. Thus, TGF beta functions as a negative autocrine growth regulator and is probably responsible for some of the growth inhibitory effects of antiestrogens. PMID- 3290586 TI - Congenital bifid sternum. Report of an unusual case. AB - This article presents the case of a child with an unusual type of cleft sternum characterized by fusion superiorly between the clavicles and inferiorly at the xiphoid with wide intervening separation. The defect was successfully corrected at age 17 months by surgical closure of the cleft primarily, which had not been achieved previously in a patient at this late age. PMID- 3290587 TI - Trachea-innominate artery fistula. PMID- 3290585 TI - Postoperative hypertension: a comparison of diltiazem, nifedipine, and nitroprusside. AB - In previous studies, the treatment of postoperative hypertension with sodium nitroprusside induced ischemic metabolism without a decrease in coronary sinus blood flow. In contrast, the calcium antagonists diltiazem and nifedipine reduce blood pressure and may improve myocardial metabolism. A prospective randomized trial was performed in 62 patients, in whom hypertension developed (mean arterial pressure greater than 95 mm Hg) after coronary bypass procedures, to compare diltiazem (n = 22), nifedipine (n = 20), and nitroprusside (n = 20). All three agents reduced blood pressure equally (p less than 0.0001, by analysis of variance). Heart rate decreased with diltiazem (p = 0.006) but increased with nifedipine and nitroprusside (p less than 0.05). Left ventricular diastolic function (the relation between left atrial pressure and left ventricular end diastolic volume) was not changed with the three drugs. Systolic function (the relation between systolic blood pressure and left ventricular end-systolic volume) was depressed with diltiazem (p = 0.05 by analysis of covariance) and nifedipine (p = 0.05) but not with nitroprusside. Myocardial performance (the relation between left ventricular stroke work index and end-diastolic volume) was depressed most by diltiazem (p = 0.001 by analysis of covariance), and to a lesser extent with nifedipine (p = 0.03), but not with nitroprusside. Myocardial lactate flux in response to the stress of atrial pacing decreased with nitroprusside but not with diltiazem or nifedipine (p = 0.03 by analysis of variance). Diltiazem and nifedipine are effective agents for treating postoperative hypertension after coronary artery bypass operations. PMID- 3290588 TI - Long-term neonatal heart preservation. AB - Donor availability is a major limiting factor in neonatal heart transplantation. Prolonging donor heart preservation would facilitate distant heart procurement. Forty-two neonatal (1 to 5 days) piglet hearts in seven groups were arrested with cold cardioplegic solutions, stored for 12 hours at 4 degrees C in storage solutions, and reperfused with blood from an adult support pig. The cardioplegic solutions used were a crystalloid solution with potassium chloride 30 mEq/L and bicarbonate (Stanford), the Stanford cardioplegic solution with the addition of calcium (1.2 mmol/L), or an intracellular solution (Sacks) with added glucose. Storage solutions were normal saline, Sacks II, or Sacks II with glucose 20 gm/L. Reperfusion was done with normal blood or modified blood for 20 minutes with superoxide dismutase, catalase, aspartate, glutamate, citrate-phosphate-dextrose, potassium, tromethamine, and 50% dextrose followed by normal blood. Evaluation of stroke work index after 60 minutes of recovery (as percent of control) was performed using the isolated, blood perfused, working heart preparation in all groups: Group I (Stanford cardioplegia, saline storage, normal blood reperfusion) had a recovery of 11%; group II (Stanford + calcium, saline, normal blood) 8%; group III (Stanford + calcium, saline, modified blood, superoxide dismutase 35,000 U/L, catalase 35,000 U/L) 37%; group IV (Stanford + calcium, Sacks II, modified blood, superoxide dismutase 35,000 U/L, catalase 35,000 U/L), 47%; group V (Stanford + calcium, Sacks + glucose, modified blood, superoxide dismutase 35,000 U/L, catalase 105,000 U/L) 89%; group VI (Stanford + calcium, Sacks + glucose, modified blood, superoxide dismutase 150,000 U/L, catalase 150,000 U/L) 107%; group VII (Sacks + glucose, Sacks + glucose, modified blood, superoxide dismutase 35,000 U/L, catalase 105,000 U/L) 115%. CONCLUSIONS: The neonatal heart stored hypothermically for 12 hours tolerates normal blood reperfusion poorly. Modified blood reperfusion markedly improves the recovery. Complete functional recovery was achieved by the intracellular Sacks plus glucose storage solution and modified blood reperfusion with oxygen-derived free radical scavengers (high catalase). Extended preservation of the neonatal heart is feasible. PMID- 3290589 TI - Isolated left ventricular assist as bridge to cardiac transplantation. AB - The electrically driven Novacor implantable left ventricular assist device has been implanted in six patients (four men and two women) since Sept. 7, 1984. In four of the six patients (67%) the device was a successful bridge to cardiac transplantation. One patient died of multiple organ failure and Candida sepsis after 16 days of support with the device. One patient died in the operating room of uncontrollable hemorrhage and biventricular failure caused by severe cardiac rejection. Three patients are alive with cardiac transplants 38, 17, and 10 months after transplantation. One patient died after cardiac transplantation of presumed sepsis. The Novacor left ventricular assist device performed in all cases without mechanical or electrical failure. Excluding the intraoperative death, assist duration ranged from 2 to 16 days. The cardiac index (synonymous with device output) ranged from 2.4 to 3.4 L/min/m2. No embolic events (cerebrovascular or systemic) occurred during assistance with the device. Minimal red cell hemolysis was documented during the period of support. The Novacor left ventricular assist device is a safe and effective bridge to cardiac transplantation in patients with refractory cardiogenic shock. PMID- 3290591 TI - Effective control of hypertension. PMID- 3290592 TI - Francisco Hernandez: personal physician to Philip II of Spain. PMID- 3290590 TI - Transesophageal echocardiography: technique, anatomic correlations, implementation, and clinical applications. AB - The introduction of transesophageal echocardiography has provided a new acoustic window to the heart and mediastinum. High-quality images of certain cardiovascular structures [left atrial appendage, thoracic aorta, mitral valvular apparatus, and atrial septum] can be obtained readily (average examination, 15 to 20 minutes). In this article, we discuss the technique of image acquisition, image orientation, and anatomic validation. In addition, we describe our experience with the first 100 awake patients who underwent transesophageal echocardiography at our institution. The procedure was well accepted by the patients and associated with no major complications. The clinical indications for this procedure have included thoracic aortic dissection, prosthetic cardiac valve dysfunction, detection of an intracardiac source of embolism, endocarditis, cardiac and paracardiac masses, and mitral regurgitation. Transesophageal echocardiography also proved to be useful in assessment of critically ill patients in whom standard transthoracic echocardiographic images did not provide complete assessment. In these patients (who had extensive chest trauma, had undergone an operation, or were in an intensive-care unit), rapid assessment of the cardiovascular status at the bedside was possible with transesophageal echocardiography. On the basis of our initial experience, we conclude that transesophageal echocardiography complements standard two-dimensional Doppler and color flow examinations and will considerably improve the care of patients with cardiovascular disorders by providing high-quality unique images. PMID- 3290593 TI - [Diagnosis of systemic candidiasis in parenteral drug addicts by detection of antimycelial antibodies]. PMID- 3290594 TI - [25 years of psychogenic rheumatism]. PMID- 3290595 TI - [The quality of clinical information (III): Statistically significant or clinically important?]. PMID- 3290596 TI - [Primary pulmonary hypertension]. PMID- 3290597 TI - Analysis of bronchomotor tone in anesthetized guinea pigs by impedance plethysmography: a simple method for the evaluation of bronchodilator action. AB - The transthoracic impedance method for measurement of bronchomotor tone was studied in anesthetized guinea pigs. Impedance change (delta Z) recorded from the 2nd to the 6th rib level increased linearly in accordance with the increment of inspirated volume (delta V); the maximum ratio of delta Z to delta V with the least cardiac artifact was measured at the level of the 6th rib. Histamine (5 micrograms/kg, i.v.) caused an increase in intratracheal pressure and a decrease in delta Z in guinea pigs. The fact that the delta Z peak lagged behind that of intratracheal pressure indicated that air flow movement was disturbed at the restricted bronchioles. In anesthetized dogs, the waveform of DC-impedance was similar to that of both flow volume and intraesophageal pressure. The waveform of AC-impedance, the signals of which are differentiated from DC-impedance, was similar to that of the flow rate. Following histamine administration (10 micrograms/kg, i.v.), the flow rate amplitude increased during inspiration and decreased during expiration. In passively immunized guinea pigs, antigen challenge induced a rapid increase in intratracheal pressure and a concomitant decrease in the amplitude of AC -impedance. Pretreatment with fenoterol (5-20 micrograms/kg, i.v.) inhibited these changes dose-dependently. It was concluded that delta Z measurement is a beneficial method for investigating respiratory dynamics in guinea pigs and is especially useful for evaluating the efficacy of bronchodilating action of test compounds. PMID- 3290598 TI - [BBB--a Swedish multicenter study. Can hypertension be better treated?]. PMID- 3290599 TI - [Advances in the analysis of genetic linkage with family data]. PMID- 3290600 TI - [Reversed genetics--isolation of disease genes by a round about way]. PMID- 3290601 TI - [Molecular genetic diagnostics--experiences from Uppsala]. PMID- 3290602 TI - [The woman behind the syndrome: Cornelia de Lange. A successful scientist--a popular pediatrician]. PMID- 3290603 TI - [Pioneers Bordley and Kallos showing the way. Lung-selective glucocorticoids may be drugs of first choice in asthma]. PMID- 3290604 TI - Head and neck cancer associated with Bloom's syndrome. AB - Bloom's syndrome (BS) is an autosomal recessive growth disorder associated with chromosomal breaks and rearrangements. Affected individuals exhibit a significantly elevated rate of cancer at an early age. Twenty-seven percent of patients with BS have malignant neoplasms at a mean age of 20.7 years. Since the first description of BS in 1954, five cases of primary head and neck cancer have been identified in the first 103 patients, including two tongue carcinomas and three laryngeal carcinomas. The patients ranged in age from 26 to 34 and included smokers and nonsmokers. The presenting symptoms and histology were identical with those of non-Bloom's syndrome patients. Head and neck cancer represents approximately 6% of all human tumors. This is in contrast with an 18% incidence rate of head and neck cancer among all cancers observed in BS patients. The head and neck surgeon should consider BS in the differential diagnosis of young cancer patients. PMID- 3290605 TI - Inhibitory effect of GnRH on isolated rat uterine muscle contractility. AB - The effect of GnRH upon uterine contractions of both non-pregnant and pregnant rats was examined in vitro. In the non-pregnant rat uterus, GnRH inhibited in a concentration-and-time dependent manner the contractions induced by acetylcholine and oxytocin, but not those caused by bradykinin and angiotensin II. GnRH also inhibited the rhythmic contractions induced by oxytocin in uterine strips from late pregnant rats. These findings show that GnRH has a direct inhibitory effect on the rat uterine contractions, suggesting that GnRH-like substances may exert modulatory influences upon rat uterine contractility. PMID- 3290606 TI - Effects of desglycinamide9, (Arg8) vasopressin and vasopressin antiserum on the acquisition of intravenous cocaine self-administration in the rat. AB - The effect of the vasopressin neuropeptide desglycinamide9, (Arg8) vasopressin (DGAVP) on the acquisition of intravenous cocaine self-administration was studied. Rats were tested under conditions of reduced body weight in a continuous reinforcement operant procedure, during five daily 3 h sessions. Under these conditions, the rate of self-administration obtained with 0.125 and 0.25, but not 0.063 mg.ml-1 cocaine, exceeded the rate obtained with saline. Daily pretreatment with DGAVP (5 micrograms/rat, s.c.) decreased self-administration of 0.125 and 0.25 mg.ml-1 cocaine to the level obtained with saline, but had no effect on self administration of 0.063 mg.ml-1 cocaine and saline. Using a similar procedure, it was shown that daily intracerebroventricular pretreatment with vasopressin antiserum significantly increased self-administration of 0.125 mg.ml-1 cocaine, without affecting self-administration of 0.063 and 0.25 mg.ml-1 cocaine and saline. The results support previous findings obtained with vasopressin neuropeptides in drug self-administration studies and suggest that DGAVP decreases the acquisition of cocaine self-administration by attenuating the reinforcing effects of cocaine and that endogenous vasopressin may be involved in the acquisition of cocaine self-administration. PMID- 3290607 TI - Growth hormone receptors. AB - The receptor for rabbit liver growth hormone (GH) has recently been purified and cloned. Sequencing data demonstrates that this site represents a new class of transmembrane receptor proteins containing covalently linked ubiquitin and N linked oligosaccharides. Homology with the human GH liver receptor is estimated to be 84%. GH receptors are also present on non-liver cells, however, their function is poorly understood, and it is not yet known if there is homology with the liver site. Direct stimulation of differentiation of preadipocytes to adipocytes by GH has been demonstrated. In bone, binding of GH to the resting cell zone, but not the proliferative layers has been reported. Taken together, these data support the hypothesis of Green and colleagues that GH has a dual mechanism of action which includes direct stimulation of differentiation of precursor cells and a secondary effect of enhancing the clonal proliferative response. PMID- 3290608 TI - The parotid gland is the main source of human salivary epidermal growth factor. AB - To clarify the production of human epidermal growth factor (EGF) by different salivary glands, we measured its concentration by radioimmunoassay separately in whole saliva, in parotid gland (PG) saliva and in mixed submandibular (SMG) and sublingual gland (SLG) saliva. Also, we studied the presence of EGF in PG and SMG by immunohistochemistry. The mean (geometric) concentrations of EGF in PG saliva (2704 pg/ml, +/- SEM interval 2393-3056 pg/ml, n = 20) was higher (p less than 0.001) than in whole saliva (864 pg/ml, +/- 733-1019 pg/ml, n = 29), which in turn was higher (p less than 0.001) than in mixed SMG + SLG saliva (357 pg/ml, +/ 296-430 pg/ml, n = 16). No sex difference existed in any salivary gland EGF. Immunohistochemistry revealed EGF in the acinar cells of both PG and SMG, but only in PG there were prominent EGF deposits in luminal spaces. Our data suggest that EGF is produced by both PG and SMG, but that more of it is secreted from the PG. This result is new and challenges the general view that human salivary EGF is mainly from SMG. In mouse almost all salivary EGF comes from SMG and its amount is androgen dependent. Thus there are great differences in sources and regulation of salivary EGF between man and mouse. PMID- 3290609 TI - Alcohol and hypertension. PMID- 3290610 TI - [Phlebography of the mediastinum in lung cancer]. AB - The state of the major mediastinal veins was studied in 113 patients with central cancer of the right lung upper lobe with metastases to the regional lymph nodes. Routine angiography was performed in 92 patients, digital subtraction angiography -in 21 patients. Vascularization was shown to be more common in and adenocarcinoma. The authors identified 2 groups of angiographic signs: marked and doubtful ones. They have been of opinion that only the presence of marked signs can be a contraindication for surgical intervention. The informative value of routine angiography was compared with that of digital subtraction angiography. PMID- 3290611 TI - [A system for the automatic processing of radionuclide research (the SAORI-01) in clinical practice]. AB - The author described the results of clinical testing of a system CAOPH-01 designed for automated collection, storage and processing of data on radionuclide investigations. He gave examples of automated processing of RCG and the results of positive scintigraphy of tumors of different sites using 67Ga-citrate and 99mTc-pertechnetate in statistical and dynamic investigations. Short-comings and ways for updating 4 the system during its serial production were pointed out. The introduction of the system into clinical practice on a wide scale was shown to hold promise. PMID- 3290612 TI - [Choice of method for determining the individual clearance of the kidneys]. AB - Some criteria for assessment of the adequacy of various radionuclide methods of determination of the separate renal clearance were proposed. Some methods were analyzed according to these criteria: one of them was proposed by S. U. Schlegel et al. and used in the paper by M. E. Karaev and R. N. Samedov, and the other one was proposed by V. Kh. Frenkel' and V. B. Shushkovskii. Both methods were shown to be insufficiently substantiated from physiological and mathematical view points. A method of assessment of the separate renal clearance in the form of a circulation model was proposed. It was based on the minimal possible number of simplifying allowances and made it possible to define the state of secretory excretory (or filtration) function and the state of hemodynamics of each kidney as a result of single administration of a transit nephrotropic radiopharmaceutical. PMID- 3290613 TI - Cyberlog. PMID- 3290614 TI - Criminality in the elderly and psychiatric disorder: a review of the literature. PMID- 3290615 TI - The role of white blood cells in post-mortem wounds. PMID- 3290616 TI - Hypothermia in the elderly. PMID- 3290617 TI - Werewolves, vampires and cannibals. PMID- 3290618 TI - [V. I. Lenin and Soviet public health]. PMID- 3290619 TI - [Bioginseng. A new direction in the production of the preparation]. PMID- 3290620 TI - [History of the Staro-Ekaterininskaia Hospital]. PMID- 3290622 TI - Glucagon responses to intravenous arginine and oral glucose in insulin-dependent diabetic patients during six months conventional or continuous subcutaneous insulin infusion. AB - To elucidate the impact of subcutaneous insulin infusion (CSII) treatment on the glucagon response to intravenous (IV) arginine and to oral glucose a 6-month prospective randomized study in insulin-dependent diabetics was carried out. The effects were investigated of CSII (7-patients) and conventional insulin treatment (UCT) (9 patients) on the changes in glucagon, growth hormone, glucose, lactate, glycerol, 3-hydroxybutyrate, and alanine to IV arginine and to oral glucose in insulin-dependent diabetics who were made euglycemic and isoinsulinemic using the artificial pancreas (Biostator, Miles, Elkhart, IN). HbA1c was significantly lower in the group treated by CSII. Despite the improved glycemic control no significant change in the responses of A-cell secretion to arginine or glucose challenges was found. In addition, there were no significant differences in hormone or metabolite values between the two groups at entry to the study or after 6 months of either therapy. Thus, normalization of the A-cell sensitivity to glucose in insulin-dependent diabetic subjects requires further amelioration of the intermediary metabolism than can be achieved with insulin pump treatment. PMID- 3290621 TI - Insulin effect on thyroid hormone uptake in rat skeletal muscle. AB - Previous work has indicated that thyroid hormone entry into cells includes an energy-dependent, saturable process. In this study we investigated the effect of insulin on T3 uptake in rat skeletal muscle. Intact soleus muscles were preincubated for 30 minuted at 37 degrees C, pH 7.4, in modified Krebs-Ringer bicarbonate buffer in the presence or absence of insulin and then for 60 minutes after adding 50 pmol/L [125I] T3. The results showed a stimulatory effect of insulin that was half maximal at 33 nmol/L and maximal at 100 nmol/L. Addition of 10 mumol/L T3 to the incubation medium completely blocked the effect, showing that the action of insulin is exerted only on the specific component of T3 uptake. The substitution of extracellular sodium with an equimolar amount of lithium also prevented the insulin effect. [125I] T4 uptake was unaffected by insulin. These results indicate that T3 uptake in skeletal muscle is sensitive to insulin, that insulin stimulates the specific component of T3 uptake in a dose dependent manner, and that its action requires extracellular sodium. In contrast, T4 uptake is insensitive to insulin action in accordance with previous results that indicated passive diffusion as its major pathway for cell entry. PMID- 3290623 TI - Nocturnal regulation of free fatty acids in healthy young and elderly men. AB - To determine the effects of age on nocturnal fuel regulation, we measured spontaneous plasma glucose and free fatty acid (FFA) levels as well as counterregulatory hormones in healthy young (n = 9, mean age 26 +/- 3 years) and old (n = 10, mean age 69 +/- 3 years) men from midnight to 8 AM. FFA levels rose from midnight (660 +/- 80 mEq/L for young subjects, 545 +/- 55 mEq/L for old) to a peak mean level of 866 +/- 110 mEq/L at 3 AM in young and 713 +/- 120 mEq/L at 1:30 AM in old (P less than .05). FFA levels declined thereafter for both groups. FFA levels were lower in older subjects (P less than .05) but integrated glucose (P less than .05) and insulin (P less than .05) levels were higher. FFA levels were inversely related to integrated insulin (r = -0.46, P less than .05) and glucose concentrations (r = -0.66, P less than .05). Integrated insulin levels were significantly higher in older subjects, which may explain the lower FFA levels as may lower growth hormone levels in the older subjects. While fasting glucose responsivity to endogenous insulin is impaired in healthy older men, the FFA response appears to be preserved. PMID- 3290625 TI - Plasma amino acids and insulin levels in obesity: response to carbohydrate intake and tryptophan supplements. AB - We assessed the plasma amino acids, glucose, and insulin responses of obese and lean control subjects to midafternoon carbohydrate snacks. After a standard 400 kcal lunch, eight lean and nine obese subjects received, at 2PM, a 30 g sucrose snack; blood samples were obtained at hourly intervals until 6 PM. Each subject participated in four similar studies in which the carbohydrate snack was consumed alone or with 250, 500, or 1,000 mg of L-tryptophan (Trp), offered as a capsule. The obese group exhibited elevated plasma levels of the branched-chain amino acids, phenylalanine and tyrosine, and the levels of these amino acids declined much less in response to carbohydrate intake than in lean controls. As a consequence, the plasma ratio of Trp:large neutral amino acids (Trp/LNAA ratio), which normally rises after carbohydrate consumption, showed virtually no change in the obese group. The plasma Trp/LNAA response of this group did not reach control values even when carbohydrate intake was increased to 50 or 75 g. Peak plasma Trp concentrations and Trp/LNAA ratios after 250, 500, and 1,000 mg Trp doses were also significantly lower in the obese. Since brain Trp uptake is strongly correlated with the plasma Trp/LNAA ratio, which in turn determines the rate of brain serotonin synthesis, the blunted Trp/LNAA response to carbohydrate intake in the obese could contribute to alterations in the serotonin-mediated regulation of food intake. PMID- 3290624 TI - Insulin injection in the fetal rat: accelerated intrauterine growth and altered fetal and neonatal glucose homeostasis. AB - Fetal hyperinsulinemia is a well-known correlate of accelerated fetal growth; the consequences of fetal hyperinsulinemia upon fetal and neonatal glucoregulation are less well understood. We injected rat fetuses of a litter on day 18 of gestation with either 5 units of long acting insulin (I) or 154 mmol/L NaCl. Twelve hours after injection, the wet and dry mass of total body and liver of I fetuses significantly exceeded that of controls. At birth (day 21.5), newborn I pups weighed 5.86 +/- .08 g, and controls, 5.48 +/- .05 g, (P less than .001). On day 18, within one hour of injection, fetal plasma insulin concentrations were significantly elevated and remained so for 24 hours. Mothers of I fetuses had significant elevations of plasma insulin at 1, 3, and 6 hours, and they developed transient hypoglycemia. Plasma glucose concentrations in I fetuses were significantly diminished at 1, 3, and 6 hours and then achieved control levels by 12 hours. Fetal hypoglycemia resulted from an apparent direct effect of insulin upon fetal tissue and from the maternal hypoglycemia. Hypoglycemic I fetuses demonstrated a sluggish alpha-cell response; they failed to increase plasma glucagon one hour after insulin injection. Values were significantly increased three hours after injection. At birth, I pups became hypoglycemic relative to controls. This was, in part, due to their significantly elevated plasma insulin concentrations at 120 and 240 minutes (120 minutes, 43.8 +/- 8 v 17.5 +/- 6 microU/mL, P less than .001). Plasma glucagon was significantly increased in I pups at 240 minutes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290626 TI - The relationship of sex hormones to hyperinsulinemia and hyperglycemia. AB - Mexican-Americans, a high-risk population for non-insulin-dependent diabetes mellitus (NIDDM), have been previously reported to have decreased levels of sex hormone-binding globulin (SHBG). We measured total testosterone, total estradiol and SHBG, glucose and insulin in premenopausal women (58 Mexican-Americans and 38 non-Hispanic whites) as part of the San Antonio Heart Study, a population-based study of cardiovascular risk factors. Although total estradiol and total testosterone were, in general, not correlated with metabolic variables, SHBG was negatively correlated with glucose and insulin. After adjustment for body mass index (BMI), ratio of waist-to-hip circumference (WHR) and ratio of subscapular to-triceps skinfold (Centrality Index), SHBG was still significantly correlated with insulin concentrations (P less than .001). Since Mexican-Americans were previously reported to be more hyperinsulinemic than non-Hispanic whites, we examined the effect of adjusting for SHBG on insulin levels in this small population. While unadjusted insulin concentrations in Mexican-Americans were higher than in non-Hispanic whites (354 microU/mL v 236 microU/mL, respectively, P = .009), adjustment for BMI, WHR, and centrality index reduced the ethnic difference in insulin levels considerably (P = .014). However, only after adjusting for SHBG as well, did the ethnic difference in insulin levels became nonsignificant. Our data suggest that alterations in sex hormones and SHBG in particular may be related to the hyperinsulinemia and the high rates of NIDDM in Mexican-Americans. PMID- 3290627 TI - Control of spontaneous glucose intolerance, hyperinsulinemia, and islet hyperplasia in nonobese C3H.SW male mice by Y-linked locus and adrenal gland. AB - An inbred strain predisposition to maturity-onset impairment of glucose tolerance was discovered in C3H.SW/SnJ inbred male mice. Males were group-caged from weaning and subjected to repetitive handling stress; deterioration of glucose tolerance developed between 5 and 8 months of age in association with extreme hyperinsulinemia. Some males developed transient chemical diabetes in which plasma glucose concentrations were inappropriately high in relation to the high levels of plasma insulin. By 12 months of age, males previously glucose intolerant had regained a normal glucose tolerance. At death, a massive hypertrophy and hyperplasia of the islet beta-cells was documented in these mice. The impaired glucose tolerance could be circumvented by adrenalectomy at weaning. Although these finding suggested the presence of an obesity gene, the C3H.SW group-caged males were not obese when compared with C3HeB/FeJ males which, although moderately hyperinsulinemic, did not develop the glucose intolerance syndrome. Transfer of the Y chromosome from the C3HeB/FeChp background into the C3H.SW inbred background led to a reduction in the hyperinsulinemic and hyperglycemic stress on the pancreatic islets. Thus the extrinsic environment (caging and handling stress), mediated in part via the adrenal gland, could interact with sex-linked genetic susceptibility modifiers to stimulate hyperplasia of the pancreatic islets and produce a transient insulin resistant state of impaired glucose tolerance in the absence of obesity. PMID- 3290628 TI - AIDS Health Services Research bibliography available. PMID- 3290630 TI - Technology assessment and forecasting of medical expert systems (MEST). PMID- 3290631 TI - Management of the woman in normal second stage of labour: a review. PMID- 3290629 TI - New trends of image analysis in the medical field. PMID- 3290632 TI - Obituary: Mrs Margaret Fraser Myles 1892-1988. PMID- 3290633 TI - Current management of liver hydatid cysts: results of a 10-year study. AB - During the 10-year period July 1977 to June 1987, 23 patients were referred to one surgical department with hepatic hydatid cysts. Accurate diagnosis in all but one case was possible by hydatid serology (hydatid immunoelectrophoresis and enzyme-linked immunosorbent assay), and ultrasonography or computed tomography which showed the presence of daughter cysts. Endoscopic retrograde cholangiography demonstrated the presence of hepatic-duct hydatid cysts in one case. The probable source of the hydatid infection was identified in all 23 cases. The surgical management was standardized and included the use of a suction cone to prevent spillage; the closure of biliary communications under vision; 0.5% silver nitrate solution as the scolicidal agent; primary closure of the residual cavity without drainage; omentoplasty for infected cysts; and bile-duct exploration and operative choledochoscopy for choledochal hydatid cysts. Two hepatic wedge resections were performed for hydatid cysts in a Riedel's lobe, but formal liver resection, in which normal liver tissue was sacrificed, was not necessary. There was no mortality and there were no postsurgical hepatobiliary complications such as biliary fistulas, biliary sepsis or jaundice. Three (13%) recurrences were recognized; all three recurrences occurred about five years after the removal of hydatid cysts with numerous daughter cysts, which were located in multiple cavities in both lobes of the liver. Postsurgical surveillance for several years by annual clinical review, hydatid immunoelectrophoresis testing and ultrasonography is recommended. PMID- 3290634 TI - Current perspectives in the study of human mitochondriopathies. AB - Recent advances in the study of human mitochondriopathies are discussed, and the impact that modern molecular-biology techniques are likely to have on the understanding of both the disease mechanisms and the basic mechanisms of mitochondrial assembly are reviewed. PMID- 3290636 TI - Paediatric cadaveric renal transplantation: 25 years' experience. PMID- 3290635 TI - Acute anaphylactic reactions. AB - Anaphylactic shock may be provoked by a diverse group of substances and stimuli, which range from large molecular weight proteins and small drug molecules to some colloids, emulsions and even exercise. The underlying mechanism may be immunological or non-immunological but, regardless of the mechanism, the physiological effects and the observable symptoms of anaphylaxis are due to the release of potent pharmacologically-active mediators, including histamine. Although a number of predisposing factors are recognized, the appearance of most of the reactions cannot be predicted. Reactions occur suddenly and dramatically and progress rapidly. Cardiovascular collapse is the most common life-threatening clinical feature, while bronchospasm is the most difficult to treat. The primary aim of treatment should be to treat the underlying cause and to improve cellular oxygenation. The pharmacological agent of choice for treatment is adrenaline. It is direct-acting and is effective for both bronchospasm and cardiovascular collapse. It is imperative that the provoking substance or stimulus be identified in patients and there is no substitute for a carefully-gathered and detailed case history in the diagnosis of anaphylaxis. Patients should be issued with some form of warning identification together with written details concerning their reaction. PMID- 3290637 TI - Haemolytic-uraemic syndrome and verocytotoxigenic Esch. coli. PMID- 3290638 TI - Tretinoin for aging skin. PMID- 3290639 TI - [Plasmacytoma of the thyroid gland. Case report and review of over 32 cases in the literature]. PMID- 3290640 TI - [Subclinical hypothyroidism--a disease requiring treatment?]. PMID- 3290641 TI - [Identification of C. botulinum spores in a case of sudden infant death in Italy. Description of a clinical case]. PMID- 3290642 TI - [Concepts underlying the analysis of late evoked potentials applied to the study of information processing and its disturbances in psychopathology]. AB - This paper gives a rapid overview of the information processing approach taken when recording and analysing endogenous event-related potentials (ERPs) with psychiatric patients, and its theoretical framework, born from information theory and cognitive psychology. The triarchic model of P 300 amplitude recently proposed by Johnson (1986) is given as an example of a particularly coherent framework that should help determine the various sources of the P 300 amplitude reduction usually observed in psychiatric patients, probably related to the impairment of a number of different processes. The concept of "functional component" is underlined and some examples are given concerning different ERP components reflecting normal and abnormal attention processes of either automatic or controlled mode of processing. The difference between this information processing approach of the cognitive electro-physiologist, aiming at shedding some light on the strategies utilized by patients in order to cope with the experimental situation, and the electro-clinical approach seeking chiefly for a diagnostic, is emphasized. PMID- 3290643 TI - [Electrophysiological studies in the assessment of polyneuropathies]. AB - In many cases, one encounters great difficulties in finding causes of polyneuropathies among some 100 etiologies. However, in current practice, the diagnostic span is not so large. At this point, it is usual to get some aid from electrophysiologic tests in order to determine the nature of the peripheral nerve disorder. Examination with needle electrodes is mainly useful to detect fibrillation potentials or positive sharp waves which are indicative of an acute or subacute axonal neuropathy in which the process of degeneration is more important than the capacities of regeneration. Studies of sensory and motor nerve conduction velocities is of a more important utility to separate the different types of peripheral neuropathies: axonopathies in which nerve conduction velocities are normal or slightly decreased but in which muscular evoked potentials and sensory potentials are reduced, myelin disorders in which nerve conduction velocities are markedly decreased and in which finding of conduction blocks allows to individualize two forms, motor and sensory neuronopathies, where the pure lesion of the motor or sensory cell bodies correlate with the normality of sensory and motor pathways respectively. PMID- 3290644 TI - Regulation of expression and activity of the yeast transcription factor ADR1. AB - Disruption of ADR1, a positive regulatory gene in the yeast Saccharomyces cerevisiae, abolished derepression of ADH2 but did not affect glucose repression of ADH2 or cell viability. The ADR1 mRNA was 5 kilobases long and had an unusually long leader containing 509 nucleotides. ADR1 mRNA levels were regulated by the carbon source in a strain-dependent fashion. beta-Galactosidase levels measured in strains carrying an ADR1-lacZ gene fusion paralleled ADR1 and ADR1 lacZ mRNA levels, indicating a lack of translational regulation of ADR1 mRNA. ADH2 was regulated by the carbon source to the same extent in all strains examined and showed complete dependence on ADR1 as well. The expression of ADR1 mRNA and an ADR1-beta-galactosidase fusion protein during glucose repression suggested that the activity of the ADR1 protein is regulated at the posttranslational level to properly regulate ADH2 expression. The ADR1-beta galactosidase fusion protein was able to activate ADH2 expression during glucose repression but showed significantly higher levels of activation upon derepression. A similar result was obtained when ADR1 was present on a multicopy plasmid. These results suggest that low-level expression of ADR1 is required to maintain glucose repression of ADH2 and are consistent with the hypothesis that ADR1 is regulated at the posttranslational level. PMID- 3290645 TI - Single-amino-acid substitutions within the signal sequence of yeast prepro-alpha factor affect membrane translocation. AB - We used a genetic approach to identify point mutations in the signal sequence of a secreted eucaryotic protein, yeast alpha-factor. Signal sequence mutants were obtained by selecting for cells that partially mistargeted into mitochondria a fusion protein consisting of the alpha-factor signal sequence fused to the mature portion of an imported mitochondrial protein (Cox IV). The mutations resulted in replacement of a residue in the hydrophobic core of the signal sequence with either a hydrophilic amino acid or a proline. After reassembly into an intact alpha-factor gene, the substitutions were found to decrease up to 50-fold the rate of translocation of prepro-alpha-factor across microsomal membranes in vitro. Two of three mutants tested produced lower steady-state levels of alpha factor in intact yeast cells, although the magnitude of the effect was less than that in the cell-free system. PMID- 3290647 TI - p53 increases experimental metastatic capacity of murine carcinoma cells. AB - Transfection of a cloned p53 gene into a murine bladder carcinoma cell with a low metastatic capacity led to elevated levels of p53 protein in clonal transfectants. After intravenous inoculation into syngeneic mice, p53-transfected clones showed significantly increased metastatic potential in comparison with control transfectants. The observed change did not seem to be due to a change in growth potential per se since the cell lines showed similar growth properties in vitro. PMID- 3290646 TI - The COUP transcription factor binds to an upstream promoter element of the rat insulin II gene. AB - Band-shifting and DNase I-footprinting assays have been used to study the trans acting factor(s) binding to an important promoter element (-53 to -46 relative to the transcription start) of the rat insulin II gene. A binding activity which footprints a region between -60 and -40 was found in both HIT, a hamster insulinoma cell line, and HeLa cells. A mutation within this region which drastically decreases promoter activity in vivo also greatly reduces binding activity in vitro. This binding activity was purified from HeLa cells and identified by competition and renaturation analyses as being the same as the COUP (chicken ovalbumin upstream promoter) transcription factor, a DNA-binding protein required for efficient transcription of the ovalbumin gene in vitro. Interestingly, the binding sequences of the COUP transcription factor in the ovalbumin and the insulin promoters have only limited similarities. PMID- 3290648 TI - Partially transformed, anchorage-independent human diploid fibroblasts result from overexpression of the c-sis oncogene: mitogenic activity of an apparent monomeric platelet-derived growth factor 2 species. AB - A human c-sis cDNA in an expression vector was introduced into human diploid fibroblasts by transfection or electroporation. Fibroblast clones showing an aberrant, densely packed colony morphology were isolated and found to overexpress a 3.6-kilobase sis mRNA species and associated immunoprecipitable platelet derived growth factor (PDGF) 2 proteins. Parallel analyses in cell clones of sis mRNA expression and colony formation in agar indicated that, above a threshold, a linear, positive correlation existed between sis overexpression and acquired anchorage independence. The sis-overexpressing cells formed transient, regressing tumor nodules when injected into nude mice, consistent with the finite life span which they retained. Protein products generated from the transfected c-sis construct in two overexpressing clones were immunoprecipitated with anti-human PDGF antibodies. One clone contained an apparent PDGF dimer of 21 kilodaltons; the second clone contained only an apparent PDGF monomer of 12 kilodaltons, which was shown to account for all of the mitogenic activity present in the cells, essentially all of which was concentrated in the membrane fraction. The results demonstrate a clear link between sis overexpression and acquisition of a partially transformed, anchorage-independent phenotype, and when combined with previous observations of sis overexpression in human tumors, clearly implicate sis overexpression as a genetic mechanism which contributes to human cell transformation. PMID- 3290650 TI - Identification of functional regions in the yeast transcriptional activator ADR1. AB - The transcriptional activator ADR1 from Saccharomyces cerevisiae is a postulated DNA-binding protein that controls the expression of the glucose-repressible alcohol dehydrogenase (ADH2). Carboxy-terminal deletions of the ADR1 protein (1,323 amino acids in length) were used to localize its functional regions. The transcriptional activation region was localized to the N-terminal 220 amino acids of ADR1 containing two DNA-binding zinc finger motifs. In addition to the N terminus, a large part of the ADR1 sequence was shown to be essential for complete activation of ADH2. Deletion of the putative phosphorylation region, defined by ADR1c mutations that overcome glucose repression, did not render ADH2 expression insensitive to glucose repression. Instead, this region (amino acids 220 through 253) was found to be required by ADR1 to bypass glucose repression. These results suggest that ADR1c mutations enhance ADR1 function, rather than block an interaction of the putative phosphorylation region with a repressor molecule. Furthermore, the protein kinase CCR1 was shown to affect ADH2 expression when the putative phosphorylation region was removed, indicating that CCR1 does not act solely through this region. A functional ADR1 gene was also found to be necessary for growth on glycerol-containing medium. The N-terminal 506 amino acids of ADR1 were required for this newly identified function, indicating that ADH2 activation and glycerol growth are controlled by separate regions of ADR1. PMID- 3290649 TI - Intracellular sorting and processing of a yeast vacuolar hydrolase: proteinase A propeptide contains vacuolar targeting information. AB - An inactive precursor form of proteinase A (PrA) transits through the early secretory pathway before final vacuolar delivery. We used gene fusions between the gene coding for PrA (PEP4) and the gene coding for the secretory enzyme invertase (SUC2) to identify vacuolar protein-sorting information in the PrA precursor. We found that the 76-amino-acid preprosegment of PrA contains at least two sorting signals: an amino-terminal signal peptide that is cleaved from the protein at the level of the endoplasmic reticulum followed by the prosegment which functions as a vacuolar protein-sorting signal. PrA-invertase hybrid proteins that carried this sequence information were accurately sorted to the yeast vacuole as determined by cell fractionation and immunolocalization studies. Hybrid proteins lacking all or a portion of the PrA prosegment were secreted from the cell. Our gene fusion data together with an analysis of the wild-type PrA protein indicated that N-linked carbohydrate modifications are not required for vacuolar sorting of this protein. Furthermore, results obtained with a set of deletion mutations constructed in the PrA prosegment indicated that this sequence also contributes to proper folding of this polypeptide into a stable transit competent molecule. PMID- 3290651 TI - Transcriptional-translational regulatory circuit in Saccharomyces cerevisiae which involves the GCN4 transcriptional activator and the GCN2 protein kinase. AB - GCN4 protein mediates the transcriptional activation of amino acid biosynthetic genes in Saccharomyces cerevisiae by specifically binding to DNA sequences in their 5'-regulatory regions. GCN4 expression is regulated at the level of translation, with translational derepression occurring under conditions of amino acid starvation. The product of the GCN2 gene is essential for translational derepression of GCN4. Sequence analysis of the GCN2 gene reveals that the GCN2 protein has a domain highly homologous to the catalytic domain of all known protein kinases. Furthermore, gcn2 strains are deficient in a protein kinase activity corresponding to a protein with the calculated molecular weight deduced from the GCN2 open reading frame. Therefore it is likely that GCN2 encodes a protein kinase, which may be directly involved in translational regulation of the GCN4 mRNA. Transcription of the GCN2 gene is increased when cells are cultured in amino acid starvation medium. This transcriptional activation is mediated by the GCN4 protein, which binds to the promoter region of the GCN2 gene. Thus, this system is modulated by a transcriptional-translational regulatory circuit, which is activated by amino acid starvation. Activation is not the result of a simple quantitative increase of either one of the identified components of the circuit. PMID- 3290652 TI - Transcription interferes with elements important for chromosome maintenance in Saccharomyces cerevisiae. AB - Transcription directed into a Saccharomyces cerevisiae autonomously replicating sequence (ARS) causes high-frequency loss of minichromosomes. Conditionally stable artificial yeast chromosomes were constructed that contain an inducible GAL promoter upstream of ARS1. Under growth conditions in which the promoter was inactive, these chromosomes were mitotically stable; however, when the GAL promoter was induced, the chromosomes became extremely unstable as a result of transcriptional impairment of ARS function. This interference by the GAL promoter occurred only in cis but can occur from either side of ARS1. Transcriptional interference of ARS function can be monitored readily by using a visual colony color assay (P. Hieter, C. Mann, M. Snyder, and R.W. Davis, Cell 40:381-392, 1985), which was further developed as a sensitive in vivo assay for sequences which rescue ARS from transcription. DNA fragments from the 3' ends of genes, inserted downstream of the GAL promoter, protected ARS function from transcriptional interference. This assay is expected to be independent of both RNA transcript stability and processing. Philippsen et al. have shown that transcription into a yeast centromere inhibits CEN function in vivo (L. Panzeri, I. Groth-Clausen, J. Shepard, A. Stotz, and P. Philippsen, Chromosomes Today 8:46 58, 1984). We identified two 200- to 300-base-pair DNA fragments flanking CEN4 that rescued ARS1 from transcription. Both of these fragments protected ARS from transcription when inserted in either orientation. The 3' ends of stable transcripts are encoded by fragments that protected the ARS from transcription, suggesting that the protection was achieved by transcription termination. It is suggested that protection of elements important for the replication and segregation of eucaryotic chromosomes from transcription is necessary for their proper function in vivo. PMID- 3290653 TI - Concomitant K- and N-ras gene point mutations in clonal murine lymphoma. AB - We have surveyed a panel of induced murine lymphomas for c-ras gene mutations. The K-ras gene seems to be preferentially activated in our system, and there are at least two examples of concomitant K- and N-ras gene mutations in the same tumor. This indicates that in some cases additional ras mutations may contribute to tumorigenesis and is evidence for a role of ras activation in tumor progression. PMID- 3290654 TI - Distribution of telomere-associated sequences on natural chromosomes in Saccharomyces cerevisiae. AB - Pulsed-field gel electrophoresis was used to examine the distribution of telomere associated sequences on individual chromosomes in four strains of Saccharomyces cerevisiae. The pattern of X and Y' distribution was different for each strain. At least one chromosome in each strain lacked Y', and in some strains, chromosome I, the smallest yeast chromosome, lacked detectable amounts of both X and Y'. PMID- 3290655 TI - IgG subclasses. A historical perspective. PMID- 3290656 TI - The cellular basis of selective defects in IgG subclass responses. PMID- 3290658 TI - Immunochemical quantitation of IgG subclass proteins and IgG subclass antibodies: status and perspectives. PMID- 3290657 TI - Serum IgG subclasses in secondary immunodeficiencies. PMID- 3290659 TI - IgG subclasses to group B streptococci in normals, colonized woman and IgG2 subclass-deficient patients. PMID- 3290660 TI - [Diagnosis and therapy of hyponatremic syndromes]. AB - Hyponatremia is the most common abnormality in electrolyte and water metabolism. In adult patients it is related to high morbidity and mortality. The degree of CNS-damage depends 1st on the absolute serum sodium concentration (NaS) and 2nd on the rapidity with which NaS is lowered. The most frequent etiology of hyponatremia in pediatric patients is dilutional hyponatremia (SIADH, infusion therapy). Nephrotic syndromes and congestive heart insufficiency associated with cardiac low output are further causes. Being aware of the different pathophysiological mechanism prevention of hyponatremia is easily achieved by monitoring serum electrolytes, water balance and compensating renal factors in critically ill patients. Hyponatremias accompanied by neurological symptoms should be corrected by rapid infusion of hypertonic saline (514 mmol/l). NaS concentration should increase at a rate of 2 mmol/1 hour. Symptoms of central pontine myelinolysis in hyponatremia were not yet described in pediatric patients. PMID- 3290661 TI - [Acute epiglottitis: therapeutic consequences of change in the resistance of Haemophilus influenzae serotype B]. AB - From July 1977 to May 1987, 27 children with acute epiglottitis were treated in our intensive care unit. Haemophilus influenzae type b was identified by positive blood culture in 14 of 27 cases. Until 1983 the first 11 children were treated with ampicillin (100 mg/kg) for a mean duration of 10 days according to the standard therapeutic regimen and/or proven sensitivity from blood cultures (5 of 11 cases). The first finding of an ampicillin resistant Haemophilus influenza type b strain dates from January 1984. From this date on initial antibiotic therapy consisted of cefotaxime (100 mg/kg). Blood cultures proved good sensitivity to cefotaxime (100%) but an increasing rate of resistance to ampicillin (3 of 9 identified strains). Haemophilus influenzae septicemia in acute epiglottitis is verified by the isolation of Haemophilus influenzae type b from blood cultures (14/27) and the additional pneumonias (14/27). Additional meningitis as seen is a very rare complication. Facing these potentially life threatening secondary foci of this invasive infection, an effective antibiotic therapy is mandatory. Our experiences confirm recommendations from US, UK, Australia, and Spain, where ampicillin was replaced by third generation cephalosporins as initial antibiotic therapy due to the increasing rate of resistance of Haemophilus influenzae type b. PMID- 3290663 TI - [Metastasis from a latent thyroid cancer diagnosed by aspiration cytology]. PMID- 3290662 TI - [Doppler sonographic measurement of normal values of flow velocities in the internal carotid artery of premature infants, newborn infants and infants]. AB - In 121 healthy premature born infants, full-term newborns and older infants (gestational age: 29 to 45 weeks; weight at investigation: 1070 g to 3750 g), the flow velocities in the internal carotid arteries were measured by pulsed doppler sonography. All infants were investigated by computer sonography (Acuson 128) with a 5 MHz transducer. The following parameters were measured: The maximal systolic velocity, the end-systolic and end-diastolic velocity as well as the mean flow velocities, the pulsatility-index and the resistance-index. For all parameters the relationship to the gestational age and weight were analysed. All flow velocities increased linearly with increasing gestational age and weight. In contrast to the flow velocities neither the pulsatility-index nor the resistance index changed with increasing gestational age and weight. As flow velocities in the internal carotid arteries increase with increasing gestational age and weight these parameters must be taken into consideration when pathologic flow velocities are analysed. PMID- 3290665 TI - [Comparative electron microscopy study of the stages of ulcerative colitis. I. Changes in the epithelial cells]. PMID- 3290664 TI - [Clear cell carcinoma of the thyroid gland. Immunohistochemical and electron microscopy studies]. PMID- 3290666 TI - [Subcellular localization of nickel ions (an overview)]. PMID- 3290667 TI - HMOs: an answer to fee-for-service? PMID- 3290668 TI - Neural control of the exocrine pancreas: an analysis of the cholinergic, adrenergic, and peptidergic pathways and their positive and negative components. 2. Integration of neural and hormonal mechanisms. PMID- 3290669 TI - Breast size, endogenous estrogens, and breast cancer: a review with hypothesis. PMID- 3290670 TI - Systemic lupus erythematosus of the central nervous system: 1. Classification, epidemiology, pathology, diagnosis, and therapy. PMID- 3290671 TI - Dysplasia in dermatology. PMID- 3290672 TI - Lumpy jaw due to Actinomyces meyerii: report of the first case and review of the literature. PMID- 3290673 TI - Septic complications of procainamide-induced agranulocytosis: report of two cases. PMID- 3290674 TI - Surgery in an era of constrained resources. PMID- 3290676 TI - A synoptical approach to the diagnosis of candidosis, relying on serological antigen and antibody tests, on culture, and on evaluation of clinical data. PMID- 3290675 TI - Cellular responses to DNA damage in the yeast Saccharomyces cerevisiae. PMID- 3290677 TI - Proteinases released by the parasitic larval stages of Ascaris suum, and their inhibition by antibody. AB - The tissue-invasive infective and lung-stage larvae of the nematode Ascaris suum were found to release proteinases during culture in vitro. This activity contained multiple proteolytic enzyme activities, as defined by pH optima, substrate specificities, and inhibitor profiles. Chymotryptic, tryptic collagenolytic and elastolytic activities were produced by both developmental stages, with major pH optima at pH 6 and 9, and there were indications of unusual interactions between the enzymes. The set of proteinases released was found to be specific to each stage of the parasite, although these included some activities which were indistinguishable between the products of the two. The in vitro released materials of the tissue-parasitic stages of Ascaris are already known to be potently antigenic. Here, we found that this antigenicity was reflected by inhibition of the proteinases of both stages by serum antibody from infected animals. This inactivation of major secreted enzymes of this parasite could presumably contribute to impairment of survival and migratory potential in sensitised hosts. PMID- 3290680 TI - Malaria vaccines. The shape of things to come. PMID- 3290678 TI - Characterization of a surface antigen of Eimeria tenella sporozoites and synthesis from a cloned cDNA in Escherichia coli. AB - An antigenic surface protein of Eimeria tenella sporozoites has been identified that is the target of two neutralizing monoclonal antibodies Ptn 7.2A4/4 and Ptn 9.9D12. The antigen as isolated from the parasite is composed of a 17 kDa polypeptide and a 8 kDa polypeptide linked by a disulfide bridge. De novo synthesis of the antigen does not begin until approximately 16-20 h after the initiation of oocyst sporulation. A cDNA library was constructed using mRNA from sporulated oocysts and a clone encoding the antigen was isolated. The Ta4 gene encodes a single polypeptide of 25 kDa which contains the 17 and 8 kDa polypeptides. The protein has been synthesized in Escherichia coli either directly or as part of a beta-galactosidase fusion protein. The products synthesized in E. coli are single polypeptides and are not cleaved to two polypeptides as is seen in the parasite. The products accumulate in bacteria in an insoluble form which can be solubilized and renatured to an immunoreactive form. PMID- 3290679 TI - Variations induced by different methodologies in Trypanosoma cruzi surface antigen profiles. AB - An attempt was made to reconcile published data on the cell surface profile of Trypanosoma cruzi epimastigotes. Cloned parasites were used to compare the effects of centrifugal forces, radioiodination catalyst and protein solubilization methods on the autoradiographic profile of putative surface antigens. Harvesting and washing procedures, and antigen extraction methods, greatly influenced the results obtained, whilst the iodination catalyst was not of critical importance. Mobility in different gel electrophoresis systems, Western blots and partial proteolysis maps indicated that two previously described epimastigote-specific surface antigens (GP72 and Mr 75,000) possibly are distinct molecules. PMID- 3290681 TI - Duchenne muscular dystrophy. Localizing the gene product. PMID- 3290682 TI - Transcription of the dystrophin gene in human muscle and non-muscle tissue. AB - The gene that is defective in patients with Duchenne and Becker muscular dystrophy consists of about 60 short exons scattered along a gigantic DNA region that spans some 2 megabase pairs. The encoded protein, dystrophin, was recently characterized as a component of muscle intracellular membranes of low abundance. The dystrophin messenger RNA is difficult to study in both normal and pathological tissue specimens because it is large (14 kilobases) and scarce (0.01 0.001% of total muscle mRNA). We report here that efficient in vitro co amplifications of the mRNAs of the dystrophin gene and of a reporter gene, aldolase A, by the polymerase chain reaction procedure enables us to obtain a quantitative estimate of the dystrophin gene transcript. A processed, transcribed segment was thus detected in 13 different human tissues. It ranged from 0.02 0.12% of total mRNA in skeletal muscle to 25,000 times less in lymphoblastoid cells. PMID- 3290683 TI - Immunostaining of skeletal and cardiac muscle surface membrane with antibody against Duchenne muscular dystrophy peptide. AB - Duchenne muscular dystrophy (DMD) is a debilitating X-linked muscle disease. We have used sequence information from complementary DNA clones, derived from the gene that is deleted in DMD patients, to generate an antiserum that stains the surface membrane of intact human and mouse skeletal muscle, but not that of DMD patients and mdx mice. Here we identify the protein reacting with this antiserum as a single component of relative molecular mass 210,000 (Mr = 210K) that fractionates with a low-ionic strength extract of intact human and mouse skeletal muscle. It is therefore distinct from the 400 K protein found in the heavy microsomal fraction of normal muscle and identified as a putative product of the DMD gene. We also analyse further the disease specificity of the antiserum. Positive staining is seen in normal controls, and in samples from patients with a wide range of muscular dystrophies other than DMD. Becker muscular dystrophy, which is allelically related to DMD, was the only other exception, and gave a sporadic staining pattern. The demonstration of a specific defect in the surface membrane of DMD muscle fibres substantiates the hypothesis that membrane lesions may initiate muscle degradation in DMD. PMID- 3290684 TI - Immunoelectron microscopic localization of dystrophin in myofibres. AB - Duchenne muscular dystrophy, a common X-linked recessive human disease, has recently been shown to be caused by the deficiency of a large, low abundance protein called 'dystrophin'. Biochemical techniques have shown dystrophin to be membrane-associated in skeletal muscle, with enrichment of dystrophin in the t tubules of 'triads'. Other studies using immunohistochemistry on thick (10 micron) sections have shown dystrophin to be located at the periphery of muscle fibres, possibly at the plasma membrane. These results have been interpreted as being either consistent and complementary, or contradictory. To localize dystrophin more precisely relative to these membrane systems we have employed highly sensitive and spatially accurate immuno-gold electron microscopy of ultra thin (70-100 nm) cryosections. The major distribution of dystrophin was on the cytoplasmic face of the plasma membrane of muscle fibres, and possibly on the contiguous t-tubule membranes. The presented data, taken together with recently accumulated information regarding the primary structure of dystrophin, suggests that dystrophin is a component of the membrane cytoskeleton in myogenic cells. Thus, myofibre necrosis in patients affected with Duchenne muscular dystrophy is likely the result of plasma membrane instability. PMID- 3290685 TI - The structure of trp pseudorepressor at 1.65A shows why indole propionate acts as a trp 'inducer'. AB - The trp repressor is a small dimeric regulatory protein which controls the expression of three operons in Escherichia coli. The inactive aporepressor protein must bind two molecules of L-tryptophan to form the active repressor. If desamino analogues of L-tryptophan such as indole propionate (IPA) are substituted for L-tryptophan, an inactive pseudorepressor is formed. Because the desamino analogues thus cause derepression of operons under control of the trp repressor, they appear to be 'inducers'. We have determined the crystal structure of the pseudorepressor and refined it to 1.65 A. The molecular structure was compared to that of the nearly isomorphous orthorhombic form of the repressor. Surprisingly, the indole ring of IPA is in the same position as the indole ring of L-tryptophan in the repressor, but is 'flipped over'. As a result, the carboxyl group of IPA is oriented toward the DNA-binding surface of the protein and is in a position where it sterically and electrostatically repels the phosphate backbone of both operator and non-operator DNA. This explains why IPA acts as an apparent trp inducer. PMID- 3290686 TI - The human oestrogen receptor functions in yeast. PMID- 3290687 TI - Function of a yeast TATA element-binding protein in a mammalian transcription system. AB - Saccharomyces cerevisiae contains a protein which is functionally similar to the mammalian TATA element-binding transcription factor, TFIID. The yeast factor substitutes for TFIID in a mammalian RNA polymerase II in vitro transcription system, forms a stable preinitiation complex on the Adenovirus-2 major late promoter, and binds specifically to the TATA boxes of the viral promoter and the yeast CYC1 promoter. Interestingly, the yeast factor promotes initiation at a distance from the TATA element typical of a mammalian system. PMID- 3290689 TI - From egg to ascus. PMID- 3290688 TI - A yeast activity can substitute for the HeLa cell TATA box factor. AB - Most class B (II) promoter regions from higher eukaryotes contain the TATA box and upstream and enhancer elements. Both the upstream and enhancer elements and their cognate factors have regulatory functions, whereas the TATA sequence interacts with the TATA box factor BTF1 to position RNA polymerase B and its ancillary initiation factors (STF, BTF2 and BTF3) to direct the initiation of transcription approximately 30 base pairs downstream. In many respects, class B promoter regions from the unicellular eukaryote Saccharomyces cerevisiae are similarly organized, containing upstream activating sequences that bear many similarities to enhancers. Although they are essential for initiation, the yeast TATA sequences are located at variable distances and further from the start sites (40-120 base pairs), whose locations are primarily determined by an initiator element. The basic molecular mechanisms that control initiation of transcription are known to be conserved from yeast to man: the yeast transcriptional transactivator GAL4 can activate a minimal TATA box-containing promoter in human HeLa cells, and a human inducible enhancer factor, the oestrogen receptor, can activate a similar minimal promoter in yeast. This striking evolutionary conservation prompted us to look for the presence in yeast of an activity that could possibly substitute for the human TATA box factor. We report here the existence of such an activity in yeast extracts. PMID- 3290690 TI - Cell-division sequence motif. PMID- 3290691 TI - The homologue of the Duchenne locus is defective in X-linked muscular dystrophy of dogs. AB - Duchenne muscular dystrophy (DMD) is the most common and the most severe of the muscular dystrophies in man. It is inherited as an X-linked recessive trait and is characterized by ongoing necrosis of skeletal muscle fibres with regeneration and eventually fibrosis and fatty infiltration. Although the gene and gene product which are defective in DMD have recently been identified, the pathogenesis of the disease is still poorly understood. A myopathy has been described in the dog which has been shown to be inherited as an X-linked trait and which is therefore a potential model of the human disease. We have studied the phenotypic expression of the disease, canine X-linked muscular dystrophy (CXMD), and have examined the molecular relationship between it and DMD. We report here that dogs with CXMD faithfully mimic the phenotype of Duchenne muscular dystrophy and that they lack the Duchenne gene transcript and its protein product, dystrophin. PMID- 3290692 TI - Phosphatidylglycerol is involved in protein translocation across Escherichia coli inner membranes. AB - Newly synthesized proteins to be exported out of the cytoplasm of bacterial cells have to pass across the inner membrane. In Gram-negative bacteria ATP, a membrane potential, the products of the sec genes and leader peptidases (enzymes which cleave the N-terminal signal peptides of the precursor proteins) are required. The mechanism of translocation, however, remains elusive. Important additional roles for membrane lipids have been repeatedly suggested both on theoretical grounds and on the basis of experiments with model systems but no direct evidence had been obtained. We demonstrate here, using mutants of Escherichia coli defective in the synthesis of the major anionic membrane phospholipids, that phosphatidylglycerol is involved in the translocation of newly synthesized outer membrane proteins across the inner membrane. PMID- 3290693 TI - [Season-related forms of depression. I. Principles and clinical description of the syndrome]. AB - Seasonal changes in behavior und physiology have been recognized in humans since ancient times. Their relevance to psychiatry was described in further detail at least as early as in the middle of the last century. However, it was only in the past six years that clinical studies were undertaken systematically to describe the profile of a syndrome that was called seasonal affective disorder (SAD) by Rosenthal et al. It emerged, that this condition is characterized by changes in affect with depressed mood, anxiety and irritability and decreased energy. In contrast to major affective disorder these patients exhibit increased appetite with carbohydrate craving, weight gain and an increased duration of sleep. Seasonality of mood and behavior appears to be a dimension affecting many different people including normal individuals and those with conditions other than SAD. In vulnerable individuals these changes may reach symptomatic levels whereas in normals they may be regarded as acceptable fluctuations. PMID- 3290694 TI - [Predictor research in psychiatry. Neurophysiological examples]. PMID- 3290695 TI - Enkephalin binding systems in human plasma. III: Comparative protection of different peptides. AB - We have investigated the hydrolysis and protection from hydrolysis of several peptides by plasma enzymes and by the plasma components previously described as inhibitors of enkephalins' hydrolysis. The results shown indicate that all the peptides actually hydrolyzed are also partially protected from hydrolysis by the enkephalin-protecting substances. Protection is fairly uniform for all the peptides tested, but considerably higher in the case of leu- and met-enkephalin, suggesting a partial specificity of the protecting substances towards opioid peptides. PMID- 3290696 TI - [A case of tentorial cavernous angioma]. AB - A case of tentorial cavernous angioma is reported. A 61-year-old woman was admitted because of left auditory disturbance and left hemifacial spasm. CT scan and angiography, MRI revealed a dumb-bell typed tumor extended above and below the left tentorium cerebelli. Under the preoperative diagnosis of tentorial meningioma, a craniotomy was performed and the tumor was removed totally with minimal bleeding by left subtemporal approach. The tumor was well capsulated and spongy, attached to the tentorium cerebelli. Histologically, the tumor had many various vascular cavities with the wall lined with a single layer of endothelial cell, had neither glial cell nor meningeal cells. Some of cavities were thrombosed. Pathological diagnosis was a cavernous angioma. We discussed the characters of this rare tumor with a review of 4 cases. PMID- 3290697 TI - Numbers of neurotensin-immunoreactive neurons selectively increased in rat ventral striatum following acute haloperidol administration. AB - The effect of haloperidol (HAL) on neurotensin (NT) levels in various structures of the rat brain was evaluated using an immunoperoxidase method. Adult, male Sprague-Dawley rats were given intraperitoneal injections of either HAL (2 mg/kg) or vehicle at twenty-four and four hours prior to sacrifice. The brains were fixed, cut at 50 micron on the vibratome, and prepared to demonstrate NT immunoreactivity, or its absence following appropriate control incubations. The distributions of NT-immunoreactive (IR) cell bodies were plotted using the camera lucida, and the numbers of NT-IR neurons in various structures were recorded. The numbers of NT-IR perikarya in striatal and ventral striatal structures of HAL treated rats greatly exceeded those observed in the same structures of control animals. In other NT-IR rich regions including the bed nucleus of the stria terminalis, central amygdala, hypothalamus and septum, HAL and control values did not differ. Conversely, HAL treatment appeared to effect a decrease in the number of immunoreactive perikarya in the medial amygdala and caudal part of the endopiriform area. It was noted that in brain regions where D-2 receptors are reported to be numerous, the number of NT-stained cells increased following HAL treatment, whereas in regions where D-1 receptors predominate, the number remained stable or decreased. Subjective evaluation of axon terminal immunoreactivity revealed a change only in the globus pallidus, where the proportional area of that structure exhibiting NT-immunoreactivity expanded following HAL. PMID- 3290698 TI - Comparison of brachiocephalic angiography and IVDSA in the same group of patients. AB - In this investigation for the first time conventional angiography (CA) and intravenous digital subtraction angiography (IVDSA) of the aortic arch and brachiocephalic vascular territory is compared in the same group of 25 patients. The quality of the image derived from IVDSA is inferior to that of CA and, moreover, varies with the location. If sufficiently good, IVDSA has an accuracy of 81 to 91% in comparison to CA for stenotic lesions depending on the site. Ulcerations are missed more frequently than with CA. Discrepancies between IVDSA and CA are caused mainly by misregistration. According to our investigation there are multiple stenotic lesions in the brachiocephalic territory in 84% of the patients. Adequate assessment of the need for surgery in symptomatic patients can therefore only be made after complete visualization of the aortic and brachiocephalic vascular territory. If non-invasive methods, like duplex scanning, cannot fulfill this requirement, IVDSA is the only semi-invasive method that can provide the information. It is therefore desirable to improve IVDSA technique in the near future instead changing to intra-arterial DSA (IADSA). Now already the advantages outweight the drawbacks. PMID- 3290699 TI - The efficacy of EC-IC anastomoses: evaluation by directional c-w Doppler sonography. AB - We report the results obtained by means of directional c-w Doppler sonography on 33 patients with superficial temporal-to-middle cerebral artery anastomoses. The efficiency of the anastomosis was evaluated by the modified Pourcelot indices (relative end-diastolic flow velocities) of the preauricular superficial temporal artery and of the bypass-supplying branch at the edge of the burr-hole. The influence of intermittent compression of the bypass-supplying branch on the modified Pourcelot index of the ipsilateral common carotid was used as a further criterion in the sonographic evaluation. All efficient anastomoses, defined by a modified Pourcelot index of at least 0.20 at the edge of the burr-hole, exhibited a reduction of the relative end-diastolic flow velocity of 0.08 on the average in the common carotid during compression. In the 18 cases with unilateral occlusion of the internal carotid, bypass surgery was predominantly efficacious in those patients who showed a reduction in the sum of the modified Pourcelot indices of the remaining brain-supplying arteries of at least two standard deviations with respect to the mean of age-matched controls. The subgroups of patent and absent collaterals through the ophthalmic artery did not show any difference with respect to the percentage of efficient anastomoses. In all 4 patients with bilateral internal carotid artery occlusion, bypass surgery was effective, while 50% of the patients with intracranial carotid artery disease exhibited an insufficient anastomosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290700 TI - A variant of the anti-Purkinje cell antibody in a patient with paraneoplastic cerebellar degeneration. AB - An anti-Purkinje cell antibody was found in the serum and CSF of a man with adenocarcinoma of the lung and paraneoplastic cerebellar degeneration (PCD). This antibody differed from the autoantibodies found in patients with gynecologic cancer and PCD in that it produced a different pattern of Purkinje cell cytoplasmic staining, did not react with PCD antigens in Purkinje cell Western blots, and the antigen had a different species distribution. Unlike the antinuclear antibody found in patients with PCD and small-cell lung carcinoma, the antigen was restricted to the cytoplasm of Purkinje cells. If autoantibodies are important in the pathogenesis of PCD, this case illustrates that they can recognize different antigenic epitopes in the nervous system, but cause similar clinicopathologic syndromes. PMID- 3290701 TI - Creutzfeldt-Jakob disease without periodic sharp wave complexes: a clinical, electroencephalographic, and pathologic study. AB - A comparison of clinical, EEG, and pathologic features was carried out on all cases of autopsy-proven Creutzfeldt-Jakob disease (CJD) studied over the last 10 years. Periodic sharp wave complexes (PSWCs) were present in three but absent in seven patients. Myoclonus was documented in two of the three with and in only one of the seven without PSWCs. The three with PSWCs had severe neocortical and at least mild thalamic involvement; those without PSWCs had more variable disease topography. The diagnosis of CJD should not be rejected if PSWCs are absent. PMID- 3290702 TI - A new case of Creutzfeldt-Jakob disease associated with human growth hormone therapy in New Zealand. AB - A clinically atypical, neuropathologically verified case of Creutzfeldt-Jakob disease is described in a 32-year-old New Zealand woman with idiopathic hypopituitarism who had been treated in late adolescence (1970 to 1973) with human growth hormone processed from pooled cadaveric pituitary glands. PMID- 3290703 TI - Creutzfeldt-Jakob disease following pituitary-derived human growth hormone therapy: a new American case. AB - A fourth histologically-confirmed American case of Creutzfeldt-Jakob disease (CJD) related to human growth hormone (hGH) therapy is reported. Like kuru, the illness was dominated by cerebellar signs and relatively little mental deterioration. The diagnosis was strongly supported premortem by the presence of two abnormal 30 kDa proteins in the CSF that are seen almost exclusively in CJD. The characteristic clinical picture coupled with such biochemical data allow a reasonably accurate premortem diagnosis of hGH-related iatrogenic CJD to be made. PMID- 3290704 TI - Preclinical Creutzfeldt-Jakob disease discovered at autopsy in a human growth hormone recipient. AB - An adolescent girl with idiopathic hypothalamic dysfunction and hypopituitarism was treated with human growth hormone between 1969 and 1979, dying of parainfluenza pneumonia 2 months after her last hormone treatment. Although she had no signs of progressive neurologic disease, reexamination of autopsy material revealed a focus of spongiform change and astrogliosis in the corpus striatum. Thus, this growth hormone recipient, who died of intercurrent infection, was unexpectedly found to be in an early, preclinical phase of Creutzfeldt-Jakob disease. PMID- 3290705 TI - The decline and fall of Creutzfeldt-Jakob disease associated with human growth hormone therapy. PMID- 3290707 TI - In memoriam T.R. Johns (1924-1988). PMID- 3290706 TI - Controlled-release carbidopa/levodopa (CR4-Sinemet) in Parkinson's disease patients with and without motor fluctuations. AB - Sixteen patients with advanced Parkinson's disease (PD) and motor fluctuations were evaluated throughout 12 months of open label therapy on CR4-Sinemet. Reduced dosage frequency and significant motor improvement with reduced fluctuation occurred and were maintained with CR4-Sinemet compared with baseline on Sinemet. In a double-blind protocol using CR4-Sinemet in 20 stable PD patients, CR4 Sinemet was given twice daily and compared with Sinemet given four times daily. Patients remained stable without improvement or deterioration when the long acting drug was substituted at 50% frequency. Plasma levodopa levels with CR4 Sinemet were smoother than with Sinemet. Although some patients receiving CR4 Sinemet found they functioned more slowly in the morning, the easier dosing schedule and improved amount of "on" time in fluctuators suggest that this formulation may become increasingly useful in managing PD. PMID- 3290708 TI - Experience with cyclophosphamide in multiple sclerosis: the cons. AB - Neurologists in the Kaiser-Permanente Medical Care Program recently designed a study to evaluate the utility of intensive immunosuppression with cyclophosphamide compared with folic acid in 44 patients with chronic progressive multiple sclerosis (MS). Although preliminary results based on incomplete data suggest cyclophosphamide may be safely administered in an outpatient clinic setting and modest benefits cannot be ruled out, it is doubtful that there are very substantial benefits to that therapy. Although several other studies have been cited as evidence of cyclophosphamide's favorable effect on the clinical course of patients with MS, many of these studies have had design shortcomings. If these flaws are considered, the hypothesis that cyclophosphamide has a favorable effect on the course of MS must be considered weak. PMID- 3290709 TI - Clinical experience with azathioprine: the pros. AB - We performed a randomized, placebo-controlled, double-blind, comparative clinical trial of 36 weeks of methylprednisolone and 3 years of azathioprine in 98 patients in the chronic progression phase of multiple sclerosis (MS). We demonstrated a trend in favor of the combination therapy for limiting progression. The relapse rate in the azathioprine recipients was half that of the control group, and visual evoked potential latencies were stabilized in those who received the combination. We think that a therapeutic trial of continuous use of the combination of adrenal steroids with azathioprine would be worthwhile if administered early in the course of the disease. PMID- 3290710 TI - Azathioprine in multiple sclerosis: the cons. AB - Azathioprine has the longest continuing history of clinical use in the treatment of multiple sclerosis (MS) of any immunosuppressive therapy besides corticosteroids. To date, 19 clinical trials of azathioprine in MS have been reported, and another eight are under way. A review of the reported trials indicates little evidence for a therapeutic effect in MS. This and the lack of evidence for a specific immune alteration in the pathogenesis of MS are relative contraindications for the use of high risk immunosuppressive therapies in this disease. A further caveat is raised by a recent report suggesting that azathioprine may have contributed to an increased incidence of carcinomas in MS patients treated with this drug. In view of these considerations, perhaps the best position to take at the present time is to encourage investigators already engaged in controlled clinical trials of azathioprine to complete their work, so that this data can be considered before new studies of azathioprine in MS are undertaken. PMID- 3290711 TI - Comparative clinical trial of cyclosporine in multiple sclerosis: the pros. AB - In a German multicenter study (L. Kappos, U. Patzold, D. Dommasch, S. Poser, et al) the effects of cyclosporine A on multiple sclerosis (MS) were compared to those of azathioprine in a blind controlled trial of 194 patients. At the time of this report, each of the patients had completed at least 2 years of treatment, and several had been treated for 3 years. Included in the study were patients with MS diagnosed according to Schumacher criteria, who had one or more cerebrospinal fluid changes typical for this disease. We admitted only patients between the ages 18 and 50, who had not had an acute relapse within 10 weeks of entrance to the study and whose Kurtzke Disability Status Scale (DSS) rating was below 6.5. Our findings indicate that the drug was well tolerated; however, elevated serum creatinine values and elevated blood pressures (not always related to each other) were the main side effects, despite a meticulous monitoring of cyclosporine A blood levels. There was only a minor overall clinical deterioration in both groups. PMID- 3290712 TI - Cyclosporine and multiple sclerosis: the cons. AB - Although the pathophysiologic cause of multiple sclerosis (MS) is unknown, there is a considerable body of evidence that immunologic factors play a part. As experimental allergic encephalomyelitis (EAE), particularly its relapsing and remitting forms, has some similarities to MS, and because EAE can be modified by immunosuppression, a large number of immunomodulating drugs have been given to patients with MS. None of these therapies has been dramatically successful, but immunosuppression with azathioprine, mercaptopurine, and cyclophosphamide have been of marginal benefit to the patients. The reason for this relative failure of such therapy in MS might be because these conventional immunosuppressants do not sufficiently modify the immunologic abnormalities in the patients. Cyclosporine A is the first of a new generation of immunosuppressants that appear to be more potent, at least in the field of transplantation. For this reason, it is logical to determine its efficacy in MS. Based on the hypothesis that MS is an immunopathologic disease, many immunosuppressive therapies have been tried for this condition. Cyclosporine is the newest such agent. Studies in animals with EAE indicate that the drug suppresses the disease, but when the drug is stopped the disease exacerbates. This may also happen in MS. Furthermore, our studies indicate that cyclosporine has a low therapeutic index, so that in doses that are well tolerated the drug is not effective and in doses that are effective there is significant toxicity. For these reasons, we reluctantly conclude that cyclosporine should not be used in MS. PMID- 3290713 TI - Effect of total lymphoid irradiation on functional status in chronic multiple sclerosis: importance of lymphopenia early after treatment--the pros. AB - To determine whether immunosuppression by total lymphoid irradiation (TLI) slowed deterioration of chronic progressive multiple sclerosis (MS), functional impairment score and blood lymphocyte counts were compared at 6-month intervals through 4 years following treatment of MS patients by either TLI (n = 27) or sham irradiation (n = 21). At each interval, 20 to 30% fewer TLI-treated patients had deteriorated (p less than 0.05 at 6, 12, and 18 months), and the difference in mean functional impairment score between groups became progressively greater (p less than 0.01 at 42 and 48 months). Benefit accrued principally to the 17 TLI treated patients with absolute blood lymphocyte counts less than 900/mm3 3 months after treatment, whose mean functional impairment score remained within 0.6 units of baseline (p = NS), whereas the ten TLI patients with higher post-treatment lymphocyte counts had progressive deterioration (p less than 0.05 to p less than 0.001 versus TLI-treated patients with lower lymphocyte counts at all intervals except 30 months) and had deteriorated by more than 5 functional scale units by 42 and 48 months. Side effects were minor and complications rare in TLI-treated patients, but one TLI-treated patient developed staphylococcal sepsis. Thus, TLI slows deterioration of chronic progressive MS, with what appears to be enduring benefit through 4 years compartmented to patients with greater induced lymphopenia. Modification of lymphoid irradiation regimens to increase the proportion of MS patients who achieve a favorable degree of lymphopenia and to avert functional hyposplenism may further improve the benefit/risk ratio. PMID- 3290714 TI - Overview of the rationale for immunomodulating therapies in multiple sclerosis. AB - The presence of mononuclear inflammatory cells within the nervous system first led to the hypothesis that an immunopathologic mechanism is involved in the pathogenesis of multiple sclerosis (MS). While there is now quite convincing evidence that MS is an immunologically mediated disease, many questions relevant to the use of immunomodulating therapy remain to be answered. These pertain to both the etiology and the exact immunopathologic mechanism involved. In addition, the inability to identify a specific target antigen for MS has implications for therapy. Despite these considerations, however, a rationale exists for the further evaluation of immunosuppressive therapies in this disease. However, it is prudent to limit use of such therapy to agents that can be shown to clearly produce sufficient clinical benefit in controlled studies to offset potential long-term risks in this chronic disease. PMID- 3290716 TI - A closer look at plasmapheresis in multiple sclerosis: the cons. AB - Plasmapheresis has been associated with clinical benefit in autoimmune disorders such as Guillain-Barre syndrome and myasthenia gravis, and this has generated interest in its use in patients with multiple sclerosis (MS). However, clinical trials of plasmapheresis in MS have shown little or no benefit from this intervention. The rationale for using plasmapheresis is the removal of an autoimmune antibody from the circulation. However, this approach relies on the assumption that a pathologic autoantibody is present in the vascular compartment and is in transit to the CNS to sites of MS plaques. In addition, for plasmapheresis to be an expedient therapy, it is essential that the target organ recover its biologic function rapidly following removal of circulating autoantibody. Our own study results and the findings of others have indicated that the cost-benefit ratio of plasmapheresis does not favor its use in patients with MS, alone or in combination with other immunosuppressive therapy. Very little sustained clinical benefit attributable to plasmapheresis has been observed. PMID- 3290717 TI - Clinical experience with COP-1 in multiple sclerosis. AB - COP-1 is one of a series of polypeptide preparations developed to stimulate myelin basic protein (MBP), a natural component of the myelin sheath. MBP in Freund's complete adjuvant induces experimental allergic encephalomyelitis (EAE), an animal model of multiple sclerosis (MS). In saline, MBP suppresses EAE. This is the rationale for the use of COP-1 in MS. PMID- 3290715 TI - Experience with use of plasmapheresis in chronic progressive multiple sclerosis: the pros. AB - Based on the assumptions that multiple sclerosis (MS) is an autoimmune disorder and that plasmapheresis (PP) is an effective means of removing antibodies and other proteins from the circulation, several uncontrolled studies were undertaken to ascertain the role of PP in MS. Since MS is a chronic and persistent rather than monophasic illness, PP has been used in MS in conjunction with a variety of immunosuppressive drug regimens, theoretically to prevent the rebound reformation of the offending protein being removed. Careful analysis of the uncontrolled studies shows wide variance in the types of patients treated; the extent, duration and activity of their disease; and the methodology of PP and the adjunctive immunosuppressive treatment. Nevertheless, the conclusion we reached from this analysis was that prolonged treatment with PP, in conjunction with corticosteroid and other immunosuppressive drug treatment, may have a major clinical effect in patients severely disabled with chronic progressive MS. This in itself is a remarkable conclusion, since it is drawn from data about a form of MS which, by definition, rarely if ever improves spontaneously: more than one half of the patients reported improvement. PMID- 3290718 TI - Alternatives to randomized clinical trials. AB - Data bases describing the natural history of patients with multiple sclerosis or the clinical course of patients treated with placebos might serve as "historical controls" in future clinical therapeutic trials. The results of clinical trials with such controls can be misleading. There is a strong tendency for the new treatment to appear efficacious when historical controls are the comparison group. Therefore, claims of efficacy deduced from trials using such controls should be closely questioned. Thus, such comparison groups probably would be useful for preliminary and early phase II (pilot) trials rather than in more definitive phase III (full) trials. PMID- 3290719 TI - There are no alternatives to double-blind, controlled trials. PMID- 3290720 TI - [Physical activity as primary and secondary prevention of cardiovascular diseases]. PMID- 3290721 TI - [Primary disorders of the T wave and S-T tract consequent to the regression of ventricular anomalous activation]. PMID- 3290722 TI - [Heart stimulators. Technical problems and social reflexions]. PMID- 3290725 TI - The information seeker's guide to health policy news. PMID- 3290724 TI - [The association of gastroesophageal reflux and asthma: possible implicated mechanisms]. PMID- 3290723 TI - [Campylobacter pyloridis: a new pathogenetic hypothesis and new guidelines in the therapy of gastritis and peptic ulcer]. PMID- 3290726 TI - Baccalaureate and Master's Degree Programs in nursing accredited by the NLN 1988 89. PMID- 3290728 TI - Women in medicine. PMID- 3290727 TI - Infectious disorders of the parotid gland. PMID- 3290729 TI - Not feminized but humanized. PMID- 3290731 TI - New Jersey Medical Women's Association. PMID- 3290730 TI - A century of women physicians. PMID- 3290733 TI - A day in the life. PMID- 3290732 TI - She's a doctor: Palma Formica. PMID- 3290734 TI - Women in academic medicine. PMID- 3290735 TI - Researching women physicians. PMID- 3290737 TI - Princeton's first pediatrician. PMID- 3290736 TI - Our first woman dermatologist. PMID- 3290738 TI - A pioneer endocrinologist. PMID- 3290739 TI - The life of Lena Edwards. PMID- 3290741 TI - Kashin-Beck disease: current status. PMID- 3290740 TI - The story of Sarah Mackintosh. PMID- 3290742 TI - The Journal of Biological Chemistry, Volume 238, 1963: Benzoate derivatives as intermediates in the biosynthesis of coenzyme Q in the rat. By Robert E. Olson, Ronald Bentley, A.S. Aiyar, G. Hossein Dialameh, Philip H. Gold, Virginia G. Ramsey, and C.M. Springer. PMID- 3290743 TI - Kidney senescence: a modal for aging. PMID- 3290744 TI - Parental health beliefs may cause failure to thrive. PMID- 3290745 TI - The American Journal of Pathology, Volume XV 1939: The effect of diet on the pathological changes in rats with nephrotoxic nephritis. By Joseph E. Smadel and Lee E Farr. PMID- 3290746 TI - Hormonal regulation of the differentiation of rat preadipocytes. PMID- 3290748 TI - Software guide. PMID- 3290747 TI - Computer assistance with information needs in clinical medicine. PMID- 3290749 TI - Functional radionuclide imaging of renal mean transit time and glomerular filtration rate. AB - A technique for functional radionuclide imaging of renal mean transit time and glomerular filtration rate from the results of gamma camera renography with a computer is described. The method uses deconvolution analysis on each pixel time activity curve. The images of both parameters are of good quality except in cases of very low glomerular filtration rate. They effectively summarize the transit and uptake information available from the renogram and should prove a valuable adjunct in its routine analysis. PMID- 3290750 TI - Intravenous administration of morphine sulfate in hepatobiliary imaging for acute cholecystitis: a review of clinical efficacy. AB - Morphine sulfate has been used by several investigators in the cholescintigraphic diagnosis of acute cholecystitis. A review of the available literature indicates that morphine sulfate significantly reduces the total time required for the hepatobiliary examination, while retaining both high sensitivity (98.8%) and specificity (88.9%). PMID- 3290751 TI - Where to go for OH training. PMID- 3290753 TI - Ohio's Medicaid drug formulary: (what you need to know). PMID- 3290752 TI - [Diagnostic value of ultrasonic examinations in retinoblastoma]. PMID- 3290754 TI - Phase II trial of mitoxantrone in advanced gastric cancer. AB - A Phase II trial of mitoxantrone was performed in patients with advanced adenocarcinoma of the stomach. All patients had measurable or evaluable disease, and none had received prior chemotherapy. Mitoxantrone was administered intravenously at a dose of 14 mg/m2 every 3 weeks. The major toxicity seen was myelosuppression. The drug was, in general, well tolerated. No major objective responses were seen. We conclude that mitoxantrone has less than 20% activity in this patient population. No further studies are planned. PMID- 3290755 TI - Angioimmunoblastic lymphadenopathy with disproteinemia associated with carcinoma. Case report and review of the literature. AB - Angioimmunoblastic lymphadenopathy with disproteinemia (AILD) is a rare lymphoproliferative disorder. The clinical course varies and about 15-20% of the patients develop a malignant lymphoma. The association of AILD and carcinoma is very rare: only 4 cases have been reported in the literature. They are reviewed here and 1 case is described. This case is of special interest for the following reasons: (1) the exceptional length of time which elapsed between the diagnosis of AILD and the onset of an adenocarcinoma of the colon (118 months); (2) the long survival (the patient is still alive and well 140 months after the diagnosis of AILD); (3) unlike the cases reviewed, in our patient the carcinoma was diagnosed when AILD was in clinical remission, so a radical treatment was possible. In the cases previously reported, carcinomas arose in the lung (2 patients), pancreas (1 case), and stomach (1 case). The rare association of AILD and carcinoma is probably coincidental; however, the growth of solid tumors of nonlymphoid nature may be related to the impaired T cell function, and should be kept in mind in the management of patients with AILD. PMID- 3290756 TI - [Treatment of chronic hematogenic osteomyelitis of the bones of the forearm and its sequelae in children]. PMID- 3290757 TI - [A method of applying skin sutures]. PMID- 3290758 TI - [NMR tomography of the osteoarticular system (review of the literature)]. PMID- 3290759 TI - [Use of demineralized and formalinized transplants in posterior spondylodesis in experiments]. PMID- 3290760 TI - [Systems of evaluating outcome and control of the course of traumatic diseases]. PMID- 3290761 TI - [Development of antibiotic therapy: results and hazards]. PMID- 3290762 TI - [Neurosurgical comparison of nuclear magnetic resonance and computer tomography in a group of patients with brain tumors]. PMID- 3290763 TI - [Value of the Syndromselect microcomputer diagnostic program in the differential diagnosis of patients with multiple morphological abnormalities]. PMID- 3290764 TI - [Organization and foreign relations of the Hungarian Medical Association]. PMID- 3290765 TI - [The systematic reporting of drugs is 50 years old]. PMID- 3290766 TI - [Changes in the characteristics of cervical mucus after cryosurgical therapy of chronic cervicitis]. PMID- 3290767 TI - [The value of a simple screening test using thin layer chromatography for the analysis of fecal lipids in patients with malabsorption]. PMID- 3290768 TI - [In vitro proven glucocerebrosidase defect: a non-neuronal type of Gaucher's disease in adults]. PMID- 3290769 TI - [The Nobel prize. (Pro memoria Albert Szent-Gyorgyi). The University of Szeged Medical School named after Albert Szent-Gyorgyi]. PMID- 3290770 TI - [The house-poet of the Balassa Society: Lajos Csatary (Grosz)]. PMID- 3290771 TI - [Hungarian and foreign literature on primary multiple malignant tumors]. PMID- 3290772 TI - [New trends and results in metastasis research]. PMID- 3290774 TI - [Changes in trends in research on the neuroendocrine regulation of thyroid function]. PMID- 3290773 TI - [Comparative study of the effect of kreon and cotazyme forte in children with cystic fibrosis]. PMID- 3290775 TI - [Prognosis of patients with testicular tumors since the introduction of combined therapy]. PMID- 3290776 TI - [Determination of serum creatine kinase and myoglobin in neuromuscular diseases]. PMID- 3290777 TI - [A case of multiple myeloma, associated with terminal plasma cell leukemia, following recovery from Hodgkin's disease]. PMID- 3290778 TI - [Commemorating Hugo Richter]. PMID- 3290779 TI - [The last illness of Liszt]. PMID- 3290780 TI - [The history of Basedow-Graves disease]. PMID- 3290781 TI - [Late potentials in myocardial infarct registered by body surface leads]. PMID- 3290782 TI - [Pneumonia caused by Mycoplasma pneumoniae]. PMID- 3290783 TI - [The present and future of vaccination]. PMID- 3290784 TI - [Coronarography during the acute phase of myocardial infarction]. PMID- 3290785 TI - [Recurrence of colorectal tumors]. PMID- 3290786 TI - [Laboratory diagnosis of rabies by the immunofluorescence method]. PMID- 3290787 TI - [The importance of the work of Kalman Balogh (1835-1888) in the history of experimental neurology]. PMID- 3290788 TI - [Arpad Matrai, M. D. (1949-1988)]. PMID- 3290789 TI - [Preventive health care in 1799 (additional information on the history of school health)]. PMID- 3290790 TI - [Significance of epidemiologic studies of caries, periodontal diseases and carcinoma of the oral cavity]. PMID- 3290791 TI - [Tick-borne Borrelia burgdorferi--frequent causative agent of peripheral facial paralysis]. PMID- 3290792 TI - [Thoughts on the centenary of asepsis]. PMID- 3290793 TI - [Dome Argenti and homeopathy in Hungary]. PMID- 3290794 TI - [Interdisciplinary detection of soft tissue sarcomas. Diagnosis, grading and staging]. AB - The collaboration between the clinician and the pathologist is necessary for an optimal diagnosis and management of patients with soft tissue sarcoma. The clinician provides information about the patient and about the clinical aspect of the tumor. The pathologist gives a histological diagnosis, a grading of the tumor and information on the surgical margins. A staging of the tumor is then possible that will provide a prognosis for each tumor and will allow a stratification of patients with a similar prognosis and a comparison between treatments. A modification of the AJC (American Joint Committee on Cancer) staging system is proposed according to a better understanding of the different prognostic factors achieved during the last decade. PMID- 3290795 TI - [Ultrasonic diagnosis of soft tissue tumors]. AB - Ultrasonography is relatively simple to manage, has no known risks to be patient, and is quickly available, all of which makes it a valuable tool, among the imaging techniques, in the primary diagnosis and initial work-up of soft-tissue tumors. Ultrasonography can reveal the extent of a tumor. Preoperative examination of a tumor in any number of planes gives the clinician a spatial idea of its size. Additionally, the internal architecture and structure of the tumor can be assessed. Sonography can distinguish whether lesions are predominantly cystic, solid, or more complex. Calcium deposits or foreign bodies can be demonstrated in some cases. It is difficult to delineate the margins of a tumor by sonography. Expanding and displacing tumor growth or infiltration cannot be diagnosed with certainty. Perifocal edema can make tumors appear larger than they in fact are. Ab type-specific differences of soft tissue tumors are demonstrable by sonography. Tissue differentiation is not possible. PMID- 3290796 TI - [Computerized tomography and magnetic resonance tomography in soft tissue tumors]. AB - The modern cross-sectional imaging techniques, e.g. CT and MR, have brought about a significant improvement in the diagnosis of soft tissue tumors. CT allows these neoplasms to be detected with relatively high sensitivity and their extension to be assessed. MR has proved to be superior to CT owing to the high soft tissue contrast it provides and its multi-planar imaging capabilities. Gadolinium-DTPA, a paramagnetic agent, can be utilized to good advantage as contrast material in MR; it yields further information as to the malignancy or otherwise of particular tumors. In addition, differentiation of tumor recurrences from other postoperative alterations seems to be feasible. PMID- 3290797 TI - [Classification, clinical aspects and diagnostic pathology of soft tissue tumors]. AB - Soft tissue tumors often present a clinical problem, and their histology is heterogeneous. It is only in the last 15 years that an internationally accepted classification has been widely used to assess prognosis and determine therapy. In the present article the important clinical aspects of treatment are presented in combination with new therapeutic and diagnostic discoveries. Immunohistochemistry is now more widely used as an accepted diagnostic method than electron microscopy. PMID- 3290798 TI - [Soft tissue tumors in childhood]. AB - Soft-tissue tumours and soft-tissue sarcomas are different in children and in adults, and therapy varies significantly according to histology, age and stage of disease. The most common soft-tissue sarcoma in children, rhabdomyosarcoma, can be cured in about 60% of cases by a combined therapy involving surgery, chemotherapy and radiotherapy. All children with soft-tissue sarcomas should be treated according to multi-center treatment protocols and should be referred to specialized oncology units. Modern diagnostic techniques and new treatment modalities will increase our knowledge and further raise the cure rate. PMID- 3290799 TI - [Surgical treatment concepts in soft tissue tumors of the locomotor system]. AB - Soft tissue tumors of the extremities require a definitive histopathological diagnosis and adequate treatment unless they are known to have been present for years without any clinical change. For lesions with a straightforward clinical diagnosis (ganglion of the wrist) and for superficial tumors smaller than 3 cm, excisional biopsy is adequate. For all other lesions an open incisional biopsy should be performed. If the lesion is potentially malignant, all the appropriate staging studies must be performed before biopsy; if the tumor has been biopsied without prior staging and unexpectedly reveals a malignant lesion, complete staging must be performed before definitive surgery is undertaken. Soft tissue sarcomas extend rapidly within the tissue of the compartment they originated in, but tend to respect compartmental boundaries. Radical resection of the entire compartment containing the sarcoma is thus the surgical treatment of choice. Adjuvant radio- and/or chemotherapy are necessary in the majority of these cases and should be integrated into the treatment strategy. PMID- 3290800 TI - [Radiotherapy of soft tissue sarcomas of the extremities]. AB - Radiotherapy is fully integrated in the treatment of soft tissue sarcomas. Nonamputative limb salvage is combined with large-volume, high-dose (65 Gy), pre- or postoperative radiotherapy. The survival rate for the conservative, combined approach to tumors of the extremities is no worse than that of radical or amputative surgery alone. It is better for large tumors to receive irradiation preoperatively, as there is then a higher probability that the limb can be spared at surgery. For tumors less than 10 cm, at doses of greater than 64 Gy radiotherapy alone can attain a local control rate of as much as 50%. With neutron irradiation, half of the patients with nonresectable tumors can be successfully treated locally. Conformal and dynamic treatment techniques will increase the probability that local tumors can be controlled by irradiation alone. The pion treatment technique at SIN is described in some detail. PMID- 3290801 TI - [Chemotherapy of soft tissue tumors]. AB - The use of chemotherapy in the treatment of patients with advanced soft tissue sarcoma and as adjuvant and neoadjuvant therapy is reviewed. In advanced disease a response rate of up to 35% can be achieved with combination chemotherapy, but these are mainly partial remissions; few complete remissions are attained. The median survival for patients in partial remission is 2 years. The most active cytotoxic drug is adriamycin, with a remission rate of 30%. The addition of dacarbazine can increase the remission rate; however, this has no significant impact on survival and the toxicity is more pronounced. The activity of neoadjuvant or adjuvant chemotherapy is still controversial. Some studies indicate a positive effect on disease-free or overall survival with adriamycin containing regimens. Other studies have not confirmed these results. More controlled trials with adequate numbers of patients stratified for tumor subtype, tumor localization and grading are needed to define the value of adjuvant or neoadjuvant chemotherapy in soft tissue sarcomas. Optimal interdisciplinary treatment can only be realized at specialized centers. PMID- 3290802 TI - [Soft tissue tumors of the hand]. AB - This paper is based on the author's experience and a review of the most recent literature. First, the five most common tumors are discussed: ganglia, giant cell tumor, mucous cyst, hemangioma, and epithelial inclusion cyst. The less-common lesions are then discussed that present special problems in the hand, such as the glomus tumor or recurring digital fibromatosis of childhood among others. Lastly, the general guidelines for treatment of malignant tumors of the soft tissue tumors of the hand are presented, followed by a description of a selection of lesions (epitheloid sarcoma, subungual malignant tumors, Kaposi's sarcoma). PMID- 3290803 TI - [Synovial chondromatosis]. AB - Synovial chondromatosis is a rare, mostly benign, and monoarticular disorder of unknown cause, and it is characterized by multiple calcified bodies. It mostly affects the knees, the hips, the elbows, or the shoulders of adult men. The radiographic appearance is characteristic, but the presence of cartilaginous metaplasia on histological examination is conclusive. Excision of the chondral bodies and synovectomy is the treatment of choice and usually gives good results with a low risk of recurrence. PMID- 3290804 TI - Interaction of myb proteins with nuclear matrix in vitro. AB - Fractionation studies of isolated nuclei have shown that the proteins encoded by the retroviral oncogene v-myb and its cellular homologue c-myb are associated to a variable extent with the nuclear matrix, suggesting that the nuclear matrix might contain a cellular target for myb proteins. I have explored the possible existence of such a target by incubating soluble v-myb and c-myb protein with nuclear matrix prepared from a separate source. The results presented here suggest that nuclear matrices from various cells contain binding sites for myb proteins. Matrix-binding appears to be an intrinsic property of myb proteins. In addition to myb proteins I have demonstrated the existence of a small group of proteins possessing nuclear matrix binding activity. These findings suggest that the nuclear matrix serves as a target for a specific set of proteins, including the products of myb genes. PMID- 3290805 TI - Interactions of growth factors and retroviral oncogenes with mitogenic signal transduction pathways of Balb/MK keratinocytes. AB - Balb/MK epidermal keratinocytes require epidermal growth factor (EGF) for growth in serum-containing medium and terminally differentiate in response to high Ca++ concentration. Several oncogenic retroviruses have been shown to relieve the EGF requirement and to block calcium-induced terminal differentiation. We developed a chemically defined medium to investigate the minimum growth factor requirements for Balb/MK cells, as well as how such requirements might be altered by retroviral oncogenes. In this medium insulin, apparently acting as IGF-1, and EGF supported cell growth in a manner comparable to serum and EGF. Acidic as well as basic fibroblast growth factor (FGF) substituted for EGF but not insulin in supporting Balb/MK proliferation. Infection with retroviruses containing v-ras oncogenes (v-H-ras, v-Ki-ras), oncogenes derived from growth factor receptors (v erbB, v-fms) or the v-mos oncogene permitted growth in defined medium containing insulin but lacking EGF. The v-fgr oncogene, a member of the src subfamily, was unique in conferring independence from both insulin and EGF. Our findings establish the applicability of this system for biologic assay of epithelial cell growth factors as well as identification of specific growth factor requirements that can be altered or complemented by the actions of specific oncogenes. PMID- 3290806 TI - The intracellular distribution of the transformation-associated protein p53 in adenovirus-transformed rodent cells. AB - The intracellular distribution of the transformation-associated cellular protein p53 was studied by indirect immunofluorescence in a series of adenovirus transformed rodent cells. In most adenovirus 2 or 5 (group C) transformed cell lines p53 was detected in discrete areas in nuclei and in all cell lines p53 was also present in a perinuclear structure. The adenovirus 2 or 5 E1B-58 kD protein, previously found to form molecular complexes with p53 in group C transformed cells, colocalized with p53 in both intracellular locations. Further studies on the region of the cell corresponding to the perinuclear body containing p53 showed that it frequently included the centrosomes of the transformed cell. The intranuclear p53 was released by mild DNAase I digestion. PMID- 3290807 TI - Expression of c-sis (PDGF B-chain) and PDGF A-chain genes in ten human malignant mesothelioma cell lines derived from primary and metastatic tumors. AB - Ten human malignant mesothelioma cell lines from primary and metastatic sites were studied for the expression of c-sis (PDGF B-chain) and PDGF A-chain genes. Malignant mesothelioma cell lines expressed strongly the c-sis oncogene which is barely detectable in normal mesothelial cells. The PDGF A-chain gene expression was slightly elevated in malignant mesothelioma cell lines compared to the expression in normal mesothelial cells. Cytogenic and Southern blot analysis did not provide evidence for genomic amplification or rearrangement of the c-sis oncogene. These results suggest that malignant mesothelioma cell lines show constitutively enhanced expression of the c-sis and PDGF A-chain genes that could play a role in the etiology of this type of malignancy. PMID- 3290809 TI - The science of medical care. PMID- 3290808 TI - Loss of a highly conserved domain on p53 as a result of gene deletion during Friend virus-induced erythroleukemia. AB - We have investigated a mutation in the p53 gene leading to expression of a truncated 46,000-dalton protein in a Friend virus-induced erythroleukemia cell line. cDNA sequence analysis revealed a deletion of nucleotide sequences in exon 7 and part of exon 8; 17 additional nucleotides, derived from intron 6, were present in the cDNA and served to maintain the reading frame of the encoded protein. Comparison with p53 protein from other species indicated that the region of the molecule missing in p46 included a highly conserved region. In addition, p46 failed to bind SV40 large T antigen in vitro under conditions which promoted binding of p53 to large T. It seems likely, therefore, that an important functional property of p53 may be affected by the mutation. PMID- 3290810 TI - [Progress of ecological parasitology--parasite communities]. AB - Many of the major development in the field of parasite community ecology have been due to a switch in focus from a search for pattern to investigation of the processes that produce those patterns. This switch has been accompanied by a recognition that different processes operate at the scale of the individual host (processes determining host specificity and attributes of the niches of the parasites), within the unit of habitat (processes determining population dynamics, exchange of parasites, and transmission), and among units of habitat (processes determining colonization, extinction, or local speciation of parasites). Further developments are likely to depend upon the coordinated use of models, experimental approaches, and field observations aimed at clarifying the conditions under which the processes at each scale became particularly important. PMID- 3290811 TI - Pseudoneoplastic lesions of the urinary bladder. PMID- 3290812 TI - W. Horsley Gantt--an archivist's perspective. PMID- 3290813 TI - Rhabdomyosarcoma of childhood. PMID- 3290814 TI - Neuroblastoma. AB - The identification of prognostic factors has greatly facilitated the rational choice of therapies in individual patients. Intensive chemotherapy, supplemented with radiation and surgery, has increased the remission rate of patients with widespread disease. The persistence of microscopic foci of malignant cells, however, remains a difficult hurdle for long-term disease-free survival. Highly toxic myeloablative therapies have had at most a modest impact on the overall cure rate of poor-risk patients. The use of novel biological therapies has provided new information on the mechanisms and potentials of immune-mediated tumor cytotoxicity. Timely clinical trials are needed to test their role in adjuvant treatment of occult microscopic disease. PMID- 3290815 TI - Osteosarcoma. AB - Osteosarcoma is the most common bone tumor of children and adolescents. The peak incidence of the disease is in the 15 to 19 year age group. The disease is more commonly seen in males than females. While several factors, including exposure to radiation, genetic disorders such as retinoblastoma, and high rate of bone growth, have been associated with osteosarcoma, in most cases no definite etiology can be established. Osteosarcoma usually originates in the metaphyseal region of long bones and extends through the cortex, causing varying degrees of bone destruction and expansion of periosteum. The radiographic appearance caused by this process is often referred to as "sun burst" sign. Positive diagnosis of osteosarcoma is made by histopathology. The histopathological classification of osteosarcoma can also predict the degree of aggressive behavior of this tumor and thus has prognostic significance. Surgery, including amputation or limb-salvage procedure, is the mainstay of treatment of osteosarcoma. It is now unequivocally established that adjuvant chemotherapy will prolong the survival of patients with this disease. Chemotherapy agents often used include platinum derivates, methotrexate, vincristine, cyclophosphamide, adriamycin, actinomycin D, bleomycin and DTIC. Depending on surgical decision, these agents can be used prior to or after the operation. Immediate fitting with prosthesis and provision of appropriate medical and psychological support in the care of these patients is essential. PMID- 3290816 TI - Tourette's syndrome: an overview. PMID- 3290818 TI - Literature in pediatric radiology. PMID- 3290817 TI - Sonographically detectable cysts in polycystic kidney disease in newborn and young infants. AB - Autosomal dominant (adult type) and autosomal recessive (infantile type) polycystic kidney disease are 2 distinct forms of hereditary cystic renal disease with differing pathologic and clinical features. Glomerulocystic kidney disease is probably a separate entity, whose pathologic features may closely resemble those of autosomal dominant polycystic kidney disease, especially in small infants. An example of each of these conditions in a small infant is presented, all of which had sonographically detectable cysts. Pathologic correlation was available in each case. While there are typical sonographic features of autosomal dominant and autosomal recessive polycystic kidney disease in newborn and young infants, there is no specific appearance of either condition, and glomerulocystic kidney disease can apparently resemble either one. Other investigations, particularly family studies and pathologic verification, are important in order to establish the correct diagnosis. PMID- 3290819 TI - Ultrasonic evaluation of gastric clearing in young infants. AB - Gastric emptying was determined using ultrasound in young infants. Gastric volume was calculated from anteroposterior, craniocaudal and laterolateral antral diameters. There was a linear decline of the logarithm of a gastric filling index over time in normal subjects. The mean clearing angle in normal subjects was 52 degrees (range 45-59). Examples of significantly different clearing rates could be demonstrated in a variety of clinical conditions. In several subjects gastric emptying rate was not exponential. Ultrasound seems very promising for the study of gastric emptying, especially in young children. PMID- 3290820 TI - Frusemide-induced nephrocalcinosis in very low birth weight infants. AB - Three very low birth weight infants, treated with frusemide for broncho-pulmonary dysplasia are described. They all developed medullary nephrocalcinosis identifiable by real time ultrasound. The sonographic findings of diffuse medullary hyper-echogenicity appears to be specific for nephrocalcinosis. PMID- 3290821 TI - Ultrasonic diagnosis of a bronchogenic cyst in a child with persistent stridor. PMID- 3290822 TI - Alexander's disease: cranial ultrasound findings. AB - This is thought to be the first report of the recognition by cranial ultrasound of the abnormal pattern of cerebral tissues which occurs in Alexander's disease. This finding suggests that cranial ultrasound could be a useful adjunct in the diagnosis of this cerebral leukodystrophy, particularly in those infants presenting with megalencephaly. PMID- 3290823 TI - Ultrasound demonstration of pericardial empyema in an infant with pyrexia of undetermined origin. AB - An infant with pyrexia of unknown origin presented to the Paediatric Unit. The initial infection screen was unhelpful and he was, therefore, referred for abdominal ultrasound to look for occult sepsis. During epigastric scanning, a large loculated fluid collection was demonstrated in the pericardium. A pericardial empyema should not be forgotten as a possible source of infection in the infant with undetermined pyrexia. PMID- 3290824 TI - "Pseudocatheter" due to inadvertent ventricular catheter placement. AB - Ultrasound is frequently used in the routine follow-up of patients who have been shunted for obstructive hydrocephalus. We report a case with "pseudocatheter" appearance due to the initial incorrect placement of the ventricular catheter. To our knowledge, such an appearance has not been previously described. PMID- 3290825 TI - Transient opacification of the urinary pathways by amorphous debris in children with leukemia. AB - Our index patient, a 14-year-old male on chemotherapy for acute lymphatic leukemia had extensive opacification of the urinary tract on the preliminary film for an intravenous urogram. Sonography and computed tomography also demonstrated dense material in the calyces, renal pelves and ureters. Since then, we have found another patient, a 9-year-old female with acute lymphatic leukemia who was not receiving chemotherapy, with a similar pattern on sonography and computed tomography. These densities unlike those in our first patient were not visible on a plain film of the abdomen. All of the material disappeared spontaneously in both patients. PMID- 3290826 TI - The effect of euglycemic hyperinsulinemia on cerebral cortical glucose metabolism in newborn beagles. AB - There is a paucity of information on the significance of insulin on neonatal cerebral glucose metabolism. The effect of insulin on neonatal cerebral glucose uptake and cerebral cortical metabolic intermediates was investigated with the euglycemic hyperinsulinemic clamp in unanesthetized beagles during the first day of life. Insulin was infused at various rates to sustain an elevated steady state plasma insulin concentration in individual pups. Furthermore, blood glucose and 2 deoxyglucose levels were also maintained ("clamped") in a steady state by infusion of glucose and 2-deoxy-[14C]-glucose. Mean (+/- SD) plasma insulin levels were 20 +/- 12 and 2971 +/- 3386 (33-14330) microU/ml in control and hyperinsulinemic pups. Blood glucose concentration was 4.43 +/- 2.64 mM during basal periods and 4.54 +/- 2.87 mM during the clamp period in study pups. Basal fasting glucose utilization in study pups was 43.9 +/- 24 mumol/kg/min and increased to 60.9 +/- 35.2 mumol/kg/min (p less than 0.001) during hyperinsulinemia. Immediately after the euglycemic hyperinsulinemic clamp or fasting in control pups, the cerebral cortex was frozen to the temperature of liquid nitrogen. No differences were noted for any cerebral cortical intermediate between the two pup groups. In addition, there was no relationship between the cerebral intermediates concentration when analyzed as a function of plasma insulin levels. The uptake of cerebral 2-deoxyglucose was analyzed as a function of plasma insulin concentration (120-6900 microU/ml). Brain tissue demonstrated a positive linear relationship for 2-deoxyglucose uptake as a function of plasma insulin concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290827 TI - Glucose utilization by the placenta and fetal tissues in fed and fasted pregnant rabbits. AB - Glucose utilization by the placenta and individual fetal tissues was studied in vivo in conscious pregnant rabbits at 29 days of gestation. In the fed state, the rate of glucose utilization was similar in the placenta and the gravid uterus, suggesting that the rate of fetal glucose utilization was approximately 40 nmol/min/g. A 96-h maternal fast induced a significant decrease in glucose utilization by the myoendometrium and in the glucose utilization index by fetal liver and brown adipose tissue. No modification was observed in other fetal tissues. These results indicate that glucose utilization by the placenta and the whole fetus from 96-h fasted rabbits does not decrease despite profound changes in endocrine and metabolic maternal parameters. PMID- 3290828 TI - Decreased fasting free fatty acids with L-carnitine in children with carnitine deficiency. AB - At the time of acute presentation, children with carnitine deficiency may have increased free fatty acid concentrations and hypoglycemia. However, whether carnitine replacement affects the plasma concentration of these substrates remains to be determined. Therefore, to evaluate the effect of carnitine replacement on plasma substrate and hormone concentrations, five children with carnitine deficiency (two idiopathic, two secondary to long-chain acyl coenzyme A dehydrogenase deficiency, one secondary to isovaleric acidemia) were fasted overnight before and after treatment with oral carnitine (80 +/- 7 mg.kg-1.day 1). During carnitine supplementation, plasma total carnitine (19 +/- 4 versus 45 +/- 6 nmol/ml, pretreatment versus treatment, respectively) and free carnitine (11 +/- 3 versus 31 +/- 6 nmol/ml), as well as red blood cell total carnitine (0.057 +/- 0.019 versus 0.130 +/- 0.019 nmol/mg of hemoglobin) increased (p less than 0.05). Fasting plasma glucose (83 +/- 4 versus 85 +/- 3 mg/dl) and ketone body (0.54 +/- 0.18 and 0.56 +/- 0.20 mM) concentrations did not change with carnitine supplementation, but plasma free fatty acids (1.28 +/- 0.32 versus 0.77 +/- 0.07 mM) decreased (p less than 0.05). No differences in fasting insulin, growth hormone, or cortisol concentrations were observed. Urinary excretion of free carnitine (0.1 +/- 0.0 versus 2.4 +/- 0.7 mumol/mg creatinine), total carnitine (0.3 +/- 0.1 versus 3.4 +/- 0.9 mumol/mg creatinine) and acyl carnitine (0.2 +/- 0.1 versus 0.9 +/- 0.3 mumol/mg creatinine) increased (p less than 0.05) with carnitine supplementation. The decreased plasma free fatty acid concentrations with carnitine supplementation may be due to more efficient fatty acid oxidation and/or increased urinary excretion of fatty acids as acylcarnitines. PMID- 3290829 TI - [Bone marrow transplantation in pediatrics. Perspectives]. PMID- 3290830 TI - [Prenatal diagnosis. The era of molecular biology]. AB - The advent of molecular genetic engineering has major implications in the diagnosis of genetic diseases by allowing a direct approach of the gene. The purpose of this article is to recall the techniques of molecular biology and to survey their potential and their applications which affect several fields of medical genetics: direct diagnosis of point mutations and deletions, indirect diagnosis by polymorphic linkage, indirect diagnosis of X linked recessive diseases (diagnosis of female carriers or recent mutations, prenatal diagnosis), autosomal recessive diseases (21 hydroxylase deficiency and cystic fibrosis) and autosomal dominant diseases, and finally diagnosis of sex and of chromosomal abnormalities. PMID- 3290831 TI - [Moebus syndrome: apropos of a case]. AB - The authors describe one case of Moebius syndrome in a neonate; the syndrome is uncommon. It includes congenital oculofacial palsy and limb malformations; other cranial nerves are sometimes involved. The etiology is unknown: genetic or embryopathic (infection or toxic). Pathogeny is unclear: nervous or muscular aplasia; neurocristopathy or dysgenesis of the two first branchial arches. The treatment is medical and chirurgical. PMID- 3290832 TI - [Tumors of the liver in children]. AB - This paper is a concise review of tumors of the liver, which represent 2 to 5% of all tumors in children. Both benign and malignant forms are reviewed. The relationship between hepatitis virus B and carcinoma, cirrhosis, toxic agents and cancer is discussed. PMID- 3290833 TI - [New treatments for Raynaud's syndrome]. AB - Raynaud's phenomenon, either idiopathic or secondary is often severe. It is due to a vasospasm in response to cold, and an increase in sympathetic tone, hyperviscosity and sometimes hyperactivation of platelets and erythrocytes have been reported. New drugs have been developed such as ketanserin, which is a specific inhibitor of serotonin S2 receptors, and has led to a positive response in 38%-80% of patients. The prostaglandins PGE1 and PGI2 were given i.v. in refractory patients and led to a beneficial effect in 50%-70% of cases. These data seem to justify the development of prostaglandin analogues. PMID- 3290834 TI - [Hemostasis tests as markers of hepatic and endothelial toxicity in chemotherapy]. AB - Two short-lived vitamin K-dependent factors, factor VII and protein C, were measured by both functional and antigenic techniques in 3 hematological conditions known for their risk of hepatotoxicity: Following use of asparaginase and bisantrene, and patients at high risk of hepatic veno-occlusive disease after allogenic bone marrow transplantation for relapse of acute leukemia of accelerated phase of evoluted chronic myelogenic leukemia. In these 3 conditions functionally measured levels of protein C and factor VII, and antigenically measured levels of both these factors proved to be early markers of incipient hepatic involvement. These tests were easy to use routinely were reproducible, and proved to be predictive of veno-occlusive disease in grafted patients at the preconditioning stage. In the follow-up of bone marrow grafted patients plasma markers of endothelial function (von Willebrand's factor, tissue type plasminogen activator, and plasma activity of angiotensin converting enzyme) were significantly altered at the time of overdose with cyclosporin A, probably due to a drug-induced in vivo lesion of the endothelium. In the search for cytoprotective drugs for the prevention of veno-occlusive disease in bone marrow grafted patients prostaglandin E1 (PGE1) was given prior to and for at least 4 weeks after transplantation and proved to be effective by biological criteria (the level of protein C mainly). This deserves further study in a prospective clinical trial of the potential usefulness of PGE1 in preventing liver veno occlusive disease in bone marrow grafted patients. PMID- 3290836 TI - [Interactions between HIV virus and the nervous system: recent pathogenic data and hypotheses]. AB - Disorders of the nervous system frequently complicate Acquired Immune Deficiency Syndrome (AIDS). They may be related to the development of opportunistic agents (toxoplasmosis, cryptococcossis, cytomegalovirus, JC Virus), or primary CNS lymphoma. There is also a constellation of neurologic disorders which may result from direct Human Immunodeficiency Virus (HIV) replication in the CNS and HIV has been found in brain and CSF of numerous patients suffering from AIDS. The precise cellular localization of HIV is not known, but the macrophage seems to be a strong candidate for HIV replication in CNS. PMID- 3290835 TI - [Organoplatinum compounds. 1987 update]. AB - Cisplatin is one of the best available cytotoxic agents particularly in testicular, ovarian and head and neck cancer. However gastrointestinal and renal toxicities preclude greater utilisation. High dose cisplatin (200 mg/m2) has serious neurological side effects. Carboplatin gives the same therapeutic results as cisplatin in ovarian, small cell lung and head and neck cancers with a better tolerance, the main toxicity being haematological. Iproplatin seems to have no advantage over carboplatin. New derivates such as diaminocyclo-hexane-platinum seem to be promising in preclinical and phase I studies. PMID- 3290837 TI - Cytogenetic evolution after bone marrow transplantation for chronic myeloid leukaemia. AB - In patients with chronic myeloid leukaemia in chronic phase treated by allogeneic transplantation using unmanipulated donor marrow cells the incidence of cytogenetic or haematological relapse is low. Occasional Ph positive metaphases have been identified in the marrow without subsequent evolution to haematological or clinical relapse. In contrast in patients transplanted with marrow depleted of T-cells Ph-positive cells are found frequently in the marrow and subsequent progression to haematological relapse is relatively common. These observations strongly support the concept of a graft-versus-leukaemia effect mediated by T lymphocytes or by cells with a similar membrane phenotype. PMID- 3290838 TI - [T lymphocyte receptors after allogenic bone marrow transplantation]. AB - Following allogeneic bone marrow transplantation, prominent expansion of peripheral T cells (40%) bearing gamma T cell receptor was observed in some patients. Biochemical, functional and molecular analyses were performed to characterize this T cell receptor and to understand its role in the immunodeficient state after transplantation. PMID- 3290839 TI - Modern image analysis methods in hematology. AB - Image analysis instrumentation presently includes multiparameter microscopy and fast processing. One type of image analysis microscope uses only 1 objective and 2 TV cameras, thereby obtaining 2 magnifications simultaneously: a low magnification for cell selection and a high magnification for further cell analysis. Image analysis is very capable of detecting rare cells among a large population of normal cells. This recognition of very rare events becomes increasingly important in biomedical applications. Investigations such as the detection of mutant cells in the peripheral blood and the detection of rare cancer cells in bone marrow as a sign of early metastases, are described to illustrate the potentialities of image analysis in hematology. PMID- 3290840 TI - [Host-graft interactions after allogenic bone marrow transplantation; choice of donor]. AB - The complexity of host-graft interactions after bone marrow transplantation explains the criteria of choice of the donor. Graft rejection, graft-versus-host disease, graft-versus-leukemia, delayed immune reconstitution, often associated or mutually exclusive are observed even with an HLA identical sibling donor. Syngeneic transplants may be complicated by leukemic relapse related to the loss of the graft-versus-leukemia effect. The compilation of files of unrelated donors increases the possibility of finding a matched unrelated donor. Preliminary results suggest that clinical results may be equivalent to those achieved with HLA identical sibling donors. Overall results of HLA mismatched transplants are disappointing because of the increase of immunological complications. Attempts at preventing graft-versus-host disease with T cell depletion led to an increase of immunological complications: rejection and leukemic relapse. Modifications of the conditioning regimen and use of in vivo monoclonal antibodies are currently being investigated. Ethical, legal, and psychological considerations have also to be taken into account in the donor choice especially with the increase of the donor pool. PMID- 3290841 TI - [Acute leukemia with translocation (8;16)]. AB - Three cases of M5 acute leukemia, 1 with a t(8;16)(p11;p13), 2 with variant translocations, both with a breakpoint at band 8p11, t(6;8)(q27;p11) and t(8;19)(p11;q13) are reported and 12 other published cases reviewed. This is a rare new entity, of variable but rather poor prognosis, seen from birth to 75 years of age, with several cases in infants. Leukemic cells, which often show conspicuous phagocytic activity on bone marrow smears, bear both monocytic and granulocytic markers in at least some cases. The best therapeutic regimen is not well-defined. The molecular basis of the disorder remains to be elucidated. PMID- 3290842 TI - [Strategies in the treatment of acute granulocytic leukemias]. PMID- 3290843 TI - Circular DNA of 3T6R50 double minute chromosomes. AB - In pulsed field gradient gel electrophoresis (PFGE) the intact deproteinized circular DNA of Mycoplasma (800 kb) and Escherichia coli (4700 kb) remains trapped in the slot. We show here that gamma-irradiation of the DNA in agarose plugs is a convenient method to partially convert these circles into full-length linears, migrating with the expected mobility in PFGE. We have used this method to study the structure of Double Minute chromosomes (DMs) from the methotrexate (MTX)-resistant mouse cell line 3T6R50. Intact deproteinized DM DNA is immobile in these gels, but is converted into a single band of about 2500 kb by either gamma-irradiation, DNaseI in the presence of Mn2+, or restriction enzymes. We conclude that the DM DNA in 3T6R50 cells consists of a homogeneous population of 2500-kb circles. PMID- 3290844 TI - d(GATC) sequences influence Escherichia coli mismatch repair in a distance dependent manner from positions both upstream and downstream of the mismatch. AB - The role of d(GATC) sites in determining the efficiency of methyl-directed mismatch repair in Escherichia coli was investigated. Transfection of host bacteria, both proficient and deficient in mismatch repair, with a series of artificially constructed M13 heteroduplexes showed that a decrease in the total number of d(GATC) sequences within these vectors lowered the efficiency of repair in vivo. Single hemimethylated d(GATC) sequences were still able to direct the correction event to the unmethylated strand, providing that the mismatch to d(GATC) site distance was shorter than approximately 1 kb. In excess of this distance, the effect of hemimethylated d(GATC) sites on mismatch correction was almost unnoticeable. The directionality of the repair event could be dictated by d(GATC) sequences situated both upstream and downstream of the mispair, suggesting that this important antimutagenic pathway can proceed bidirectionally. PMID- 3290846 TI - The oriC unwinding by dam methylation in Escherichia coli. AB - It has been shown that dam methylation is important in the regulation of initiation of DNA replication in E.coli. The question then arises as to whether dam methylation in the oriC region mediates any structural changes in DNA involved in the regulation of initiation of DNA replication. We demonstrate that the thermal melting temperature of the oriC region is lowered by adenine methylation at GATC sites. The regulation of initiation of DNA replication by dam methylation may be attributed to the ease of unwinding at GATC sites in oriC. PMID- 3290847 TI - Selection of DNA binding sites by regulatory proteins: the LexA protein and the arginine repressor use different strategies for functional specificity. AB - The DNA sequences in the operator sites of the arginine regulon and of the SOS regulon have been subject to a statistical analysis. A quantitative correlation is found between the statistics of sequence choice and the activity at individual operator sites in both systems, as expected from theoretical considerations [Berg & von Hippel, J.Mol.Biol. (1987) 193, 723-750]. Based on these correlations it is possible to predict the effect of various sequence mutations. There is a significant difference in the slopes of the correlation lines between sequence and activity for the two systems. From this difference it can be expected that individual point mutations in the ARG boxes will have a much smaller effect on activity than similar changes in the SOS boxes. This difference may be related to a strong cooperative activity at tandem ARG boxes while the binding at SOS boxes appears to be mostly noncooperative. PMID- 3290848 TI - Improved screening for oligonucleotide-directed mutant M13 phage. PMID- 3290845 TI - Intron sequences and the length of the downstream second exon affect the binding of hnRNP C proteins in an in vitro splicing reaction. AB - The proteins that are in direct contact with the pre-mRNA in an in vitro splicing reaction were analyzed by UV cross-linking experiments. Six major proteins (120, 55, 44, 42, 39 and 38 KD) and three minor polypeptides (84, 72 and 63 KD) were detected. The predominant proteins 44, 42 KD belong to the class of hnRNP C proteins since they were immunoprecipitated by monoclonal antibodies directed against hnRNP C proteins. The cross-linked proteins were not detected in the absence of Mg2+, ATP or when RNA lacking introns were used as substrates in the splicing reactions. The effect of exon sequences on the binding efficiency for the photocrosslinked proteins was investigated. Transcripts containing a second exon of 24 nucleotides for the beta-globin or 107 nucleotides for the mouse insulin, yielded a reduced amount of cross-linked proteins when compared with "full length" pre-mRNAs. Sequences within the first exon of the beta-globin pre mRNA did not affect the binding efficiency of these proteins. The reduced binding efficiency of the cross-linked proteins for the truncated beta-globin or mouse insulin pre-mRNAs correlated with the lower efficiency for in vitro splicing. Substitutions with unrelated sequences in the beta-globin second exon restore the binding of the cross-linked proteins indicating that the length of the second exon and not specific sequences are relevant for the binding efficiency of these proteins. The SP6/mouse insulin oligonucleotides cross-linked to the hnRNP C proteins were isolated and sequenced. A 17-mer was located in the second exon (134 nucleotides downstream from the 3' splice site) and a 14-mer in the intron region (25 nucleotides downstream the 5' splice site). The beta-globin oligonucleotides cross-linked to the hnRNP C proteins were a 13-mer in the second exon (28 nucleotides downstream the 3' splice site) and an 8-mer in the first exon (81 nucleotides downstream the 5' end of the pre-mRNA). Our results indicate that the hnRNP C proteins interact with those oligonucleotides located in different regions of the pre-mRNA. The binding efficiency of those proteins, however, depends on the length of the second exon and the presence of intron sequences (secondary and/or tertiary pre-mRNA structure). PMID- 3290849 TI - A Plasmodium falciparum gene encoding a heat shock-like antigen related to the rat 78 Kd glucose-regulated protein. PMID- 3290850 TI - Nucleotide sequence of the nifE and nifN genes from Klebsiella pneumoniae. PMID- 3290851 TI - Evolution and mutagenesis of the mammalian excision repair gene ERCC-1. AB - The human DNA excision repair protein ERCC-1 exhibits homology to the yeast RAD10 repair protein and its longer C-terminus displays similarity to parts of the E. coli repair proteins uvrA and uvrC. To study the evolution of this 'mosaic' ERCC 1 gene we have isolated the mouse homologue. Mouse ERCC-1 harbors the same pattern of homology with RAD10 and has a comparable C-terminal extension as its human equivalent. Mutation studies show that the strongly conserved C-terminus is essential in contrast to the less conserved N-terminus which is even dispensible. The mouse ERCC-1 amino acid sequence is compatible with a previously postulated nuclear location signal and DNA-binding domain. The ERCC-1 promoter harbors a region which is highly conserved in mouse and man. Since the ERCC-1 promoter is devoid of all classical promoter elements this region may be responsible for the low constitutive level of expression in all mouse tissues and stages of embryogenesis examined. PMID- 3290852 TI - The core region of human glutaminyl-tRNA synthetase homologies with the Escherichia coli and yeast enzymes. AB - We have isolated from a Lambda-gt 11 library a human cDNA clone with one open reading frame of about 2400 bases. A stretch of about 350 amino acids in the deduced amino acid sequence is up to 40 percent identical with parts of the known amino acid sequences of E. coli and yeast glutaminyl (Gln)-tRNA synthetase. The isolated cDNA sequence corresponds to an internal section of a 5500 bases long mRNA that codes for a 170 kDa polypeptide associated with Gln-tRNA synthetase. Thus, the human enzyme is about three times larger than the E. coli and two times larger than the yeast Gln-tRNA synthetase. The three enzymes share an evolutionarily conserved core but differ in amino acid sequences linked to the N terminal and C-terminal side of the core. PMID- 3290853 TI - Sequence and genetic analysis of a dispensible 189 nucleotide snRNA from Saccharomyces cerevisiae. AB - The structure of a Saccharomyces cerevisiae gene that encodes a small nuclear RNA (snRNA) of 189 nucleotides is described. This gene, designated SNR189, is located 400 base pairs upstream of the CRY1 gene on yeast chromosome III. Gene replacement analysis revealed the SNR189 gene to be dispensable for growth under a variety of culture conditions. The snR189 sequence lacks homology with other sequenced yeast or metazoan snRNAs. PMID- 3290855 TI - Nucleotide sequence of the barley chloroplast psbA gene for the QB protein of photosystem II. PMID- 3290854 TI - Phosphotriester formation by the haloethylnitrosoureas and repair of these lesions by E. coli BS21 extracts. AB - The alkylation of phosphates in DNA by therapeutically active haloethylnitrosoureas was studied by reacting N-chloroethyl-N-nitrosourea (CNU) with dTpdT, separating the products by HPLC, and identifying them by co chromatography with authentic markers. Both hydroxyethyl and chloroethyl phosphotriesters of dTpdT were identified; a similar reaction between CNU and dTR yielded 3-hydroxyethyl and 3-chloroethyl dTR as the major products of ring alkylation. A DNA-like substrate for repair studies was synthesized by reacting 14C-labelled N-(2-chloroethyl)-N'-cyclohexyl-N-nitrosourea (14C-CCNU) with poly dT and annealing the product to poly dA. An extract of E. coli strain BS21 selectively transferred a chloroethyl group from one of the chloroethyl phosphotriester isomers in this substrate to the bacterial protein; chemical instability of the hydroxyethyl phosphotriesters precluded definite conclusions about the repair of this product. PMID- 3290856 TI - Nucleotide sequence of the barley chloroplast psbD gene for the D2 protein of photosystem II. PMID- 3290858 TI - DNA cyclobutane pyrimidine dimers with a cleaved internal phosphodiester bond can be photoenzymatically reversed by Escherichia coli PhrB photolyase. PMID- 3290857 TI - Nucleotide sequence of the aceA gene coding for isocitrate lyase in Escherichia coli. PMID- 3290860 TI - The PhD: the ultimate nursing doctorate. PMID- 3290859 TI - Quality, access, and costs: public policy and home health care. PMID- 3290862 TI - [Respiratory symptoms in connective tissue diseases]. PMID- 3290861 TI - Effects of salt and Savlon bath concentrate post-partum. PMID- 3290863 TI - [History of the discovery of adrenal hormones]. PMID- 3290864 TI - [Clinical evaluation of the local use of flunisolide in the treatment of allergic rhinitis]. PMID- 3290865 TI - Pituitary gland. AB - This review summarizes current knowledge on pathology of proliferative lesions of the human pituitary. The morphologic classification of pituitary adenomas--based on histology, immunohistochemistry and electron microscopy--has now been firmly established. It has been conclusively proven that all presently recognized adenohypophysial cell types give rise to adenoma and all known pituitary hormones may be secreted in excess. Evidence is accumulating that hyperplasia of various adenohypophysial cell types can lead to hypersecretory syndromes similar to those associated with the corresponding adenomas. Owing to the rarity of studies on pituitary hyperplasia, the condition is still incompletely defined. The difficulties regarding morphologic diagnosis of pituitary hyperplasia are discussed. Despite major advances in the field of pituitary pathology, several problems concerning structure-function relationship, as well as pathogenesis of proliferative lesions are still unresolved. There is strong circumstantial evidence suggesting that the cytological mapping of the pituitary is incomplete and there are still cell types waiting to be discovered. PMID- 3290866 TI - Neuroendocrine tumors of the gastrointestinal tract. AB - Neoplastic proliferations of neuroendocrine cells (NE) may occur throughout the entire GI tract but affect particularly appendix and ileum ("midgut carcinoids"), rectum ("hindgut carcinoids"), as well as stomach and the duodenum ("foregut carcinoids"). Only more exceptionally, they arise in the esophagus, jejunum and colon. The NE tumors encompass a heterogeneous gross and microscopic structural spectrum, ranging from inconspicuous microproliferations ("mucous membrane nevi") to bulky tumor masses. Their growth patterns are usually characteristic and easily recognized. In doubtful cases their NE differentiation becomes established by a characteristic silver affinity, by the ultrastructurally observed presence of characteristic "endocrine" secretion granules, and by immunohistochemically detectable occurrence of "pan-NE markers" (neuron-specific enolase, chromogranins, and synaptophysin), biogenic amines (mainly serotonin), and neurohormonal peptides. Foregut carcinoids usually contain serotonin, gastrin, and somatostatin, midgut carcinoids often only serotonin and tachykinins, whereas the hindgut carcinoids as a rule are multihormonal with a wide spectrum of hormonal peptides, including even insulin. Most GI NE tumors are found in the appendix (50%) and the ileum (30%). Practically all (98%) of the appendiceal NE tumors are benign. They have recently been proposed as arising from apparently Schwann-cell-related NE cells in the submucosa, whereas the ileal--and probably also all the other non-appendiceal NE tumors--are derived from the totipotential cells in epithelial crypts of the mucosa. Among the ileal NE neoplasms a large number can metastasize and result in a fatal outcome. The ability to metastasize is related to the size and to the multiplicity of the primary tumors at the time of initial diagnosis and, to some extent, to their histopathologic growth pattern. Now, some relationship between the prognosis and the cytochemically assessed nuclear DNA content of the NE tumor cells has also been established; not less than about 1/4 to 1/3 seem to be aneuploid. Almost 90% of the rectal carcinoids are benign. Exceptionally, a highly malignant NE neoplasms can arise from the colon/rectum--as well as from the esophagus--composed of NE cells of small and intermediate size. The NE tumors of the stomach are often composed of ECL (enterochromaffin-cell-like) cells; such ECL cell carcinoids are related to atrophic gastritis with pernicious anemia; experimentally, they can be induced by hypergastrinemia in rats. Duodenal carcinoids often contain psammoma bodies and can be associated with neurofibromatosis. PMID- 3290867 TI - Neuroendocrine neoplasms of the thymus. AB - Neuroendocrine tumors of the thymus bear many similarities to "carcinoids" and "oat-cell carcinomas" in other organs, and are clinicopathologically distinct from thymomas, thymic seminomas, and other primary tumors of this gland. They are associated with Cushing's syndrome or multiple endocrine neoplasia in 35% of cases, and are often locally aggressive. Approximately 30-40% of patients have distant metastases of their tumors that ultimately result in fatality, since the response of thymic neuroendocrine neoplasms to irradiation and chemotherapy is poor. Ultrastructural studies and immunohistochemical stains for chromogranin, protein gene product 9.5, and synaptophysin are effective tools for the diagnosis of thymic carcinoid and oat-cell carcinoma. PMID- 3290868 TI - Immunohistochemical evaluation of neuroendocrine cells and neoplasms of the lung. AB - The dispersed neuroendocrine (NE) system is represented in the bronchopulmonary tract by submucosal nerves and ganglion cells and, in the mucosal lining by solitary NE cells and neuroepithalial bodies (NEB's). The latter two components variably express pan-NE markers including NSE, chromogranin (s) and, notably, synaptophysin. The expression of serotonin, bombesin, calcitonin and leu enkephalin has been well established; additional eutopic materials include somatostatin and calcitonin gene-related peptide. Solitary NE cells and NEB's are epithelial structures as defined by their consistent cytokeratin expression. Hyperplasia and dysplasia of NE cells may be found in association with various forms of chronic injury; they have been noted in chronic bronchiectasis and in the vicinity of neoplasms of various types. Hyperplastic and dysplastic pulmonary NE cells frequently express ectopic materials particularly ACTH. NE neoplasms of the bronchopulmonary tract comprice a spectrum that includes a) carcinoids, b) well differentiated NE carcinomas, c) intermediate cell NE carcinomas and d) small cell NE carcinomas. The precise pathologic criteria defining these entities are discussed in detail as are their clinical implications. The entire spectrum of lung NE neoplasms express NE markers demonstrable by immunocytochemistry; these include pan-NE markers, serotonin and numerous neuropeptides. The expression of multiple hormonal materials is frequent. Within any given tumor, some variation in expression may be noted in different sites and in different periods of the "normal" or therapeutically modified lifespan of the tumor. The entire spectrum of lung NE neoplasms is epithelial for they express cytokeratin polypeptides and desmoplakin; subsets of the tumors coexpress cytokeratins and neurofilament proteins. Also, subsets of these NE neoplasms may be immunostained with monoclonal antibodies to antigens related to exocrine phenotype suggesting focal amphicrine features. PMID- 3290869 TI - Neuroendocrine differentiation in breast lesions. AB - A review of neuroendocrine features in breast carcinomas is presented and markers for neuroendocrine cells are discussed. Immunostaining for neuron specific enolase is the best screening marker for neuroendocrine cells in breast carcinomas, but immunoreactivity for hormones is not present in all neuron specific enolase (NSE) positive cases. Normal myoepithelial cells are also NSE positive. Thirty per cent of breast carcinomas are NSE positive. Biochemical demonstration of ACTH, PTH and calcitonin, and immunohistochemical demonstration of ACTH, bombesin, serotonin, prolactin, gastrin, VIP, leu-enkephalin, pancreatic polypeptide, beta-endorphin and sub P has been reported in breast carcinomas. Neuroendocrine cells have not been convincingly demonstrated in the normal breast or in benign breast lesions. PMID- 3290870 TI - Naproxen sodium: comparative efficacy and tolerability of two dosages for pain after joint surgery. AB - In a multicenter, randomized, double-blind, parallel trial, the efficacy and tolerability of two regimens of naproxen sodium were compared in a two-day treatment of moderate to severe pain following open surgery of the hip, shoulder, knee, and ankle joints. Of 147 patients enrolled, the data of 99 were valid for efficacy analysis, 45 in the low-dose regimen (day 1, 1,100 mg; day 2, 825 mg) and 54 in the high-dose regimen (1,650 mg/day). At 12 interviews each day, patients evaluated intensity of pain using numerical scales and recorded complaints. At the end of the study, overall efficacy was evaluated. Although there were no statistically significant differences between the two regimens for efficacy or tolerability, the high-dose regimen achieved greater pain relief in patients who had hip or shoulder surgery, suggesting that this regimen had greater cumulative efficacy for these patients. PMID- 3290871 TI - Aneurysmal bone cyst of the distal thumb phalanx. A case report and review of the literature. AB - Although aneurysmal bone cysts are a well-known, well described clinical entity, their presence in small bones of the hand are not a common occurrence. Only 13 previous cases involving the bones of the hand have been reported in the English literature. Of these 13, only seven involved the phalanges and no previous case has been described involving the distal phalanx of the thumb. Because these lesions may demonstrate aggressive local biologic behavior, when the diagnosis of aneurysmal bone cyst of the small bones of the hand is considered, prompt diagnostic and therapeutic intervention should be performed. Early recognition and management of this lesion is essential to prevent amputation. PMID- 3290872 TI - Septic arthritis: process, etiology, treatment outcome. A literature review. AB - Septic arthritis is a serious infection that can lead to truly devastating complications. The key to minimizing irreversible damage is rapid initiation of treatment. The best results are obtained when treatment is instituted within 1 week of the onset of symptoms. Effective treatment involves antibiotics, joint drainage and decompression, and immobilization followed by rehabilitation of the affected joint. The best choice of empiric antibiotics can be made by considering the patient's age, the synovial fluid gram stain results, and any preexisting conditions (eg, alcoholism, hypogammaglobulinemia). An episode of septic arthritis requires long-term follow up to check for relapses and to assess the outcome of any residual joint damage. PMID- 3290873 TI - Ligament-tendon fixation: analysis of a new stitch and comparison with standard techniques. AB - A newly devised locking loop tendon-ligament suture was evaluated for its clinical application. The suture is relatively simple to use and is particularly suited to flat structures such as the medial collateral ligament, joint capsule, and patellar tendon. It affects tension and resistance to pull out without exerting major purse stringing or bunching. In a laboratory setting, this suture technique has been compared to fixation by individual sutures and several varieties of staple fixation. Simple suture fixation was quite weak, measuring 100 newtons (N). Staple fixation is not only weaker than the ligament suture, but is more highly dependent on bone quality and is generally more variable. When employed with strong suture material, a doubled ligament suture was found to be nearly twice as strong (392 N) as staple fixation into bone (208 N) and demonstrated a mean pullout strength close to the forces observed on human anterior cruciate ligaments. In combination with a well placed ligament staple into good quality bone, fixation was further enhanced (482 N) and statistically significantly improved (P greater than .05). PMID- 3290874 TI - Osteolysis of the pubic bone simulating malignancy. A case report and review of literature. AB - A 78-year-old white female presented with groin pain of 3 months' duration. Radiographs revealed an osteolytic lesion in the pubic bone, simulating a malignancy or infection. A closed needle biopsy was performed and pathological findings were consistent with post-traumatic osteolysis, showing avascular necrotic tissues. A review of the literature found 16 previous cases presenting with groin pain and a radiographic lesion in the pubic bone that appeared malignant. All of the patients reported in the literature were postmenopausal women most with a recent history of trauma or increased physical activity. All of the lesions were benign and, when treated conservatively, usually resolved within 6 months. PMID- 3290875 TI - Oxalosis: cause of degenerative spinal stenosis. A case report and review of the literature. AB - The case presented illustrates an unusual entity. The differential diagnosis of degenerative spinal stenosis is voluminous, although incomplete without including oxalosis. Oxalosis as a cause of spinal stenosis has not yet been reported in the orthopedic literature. PMID- 3290877 TI - Ultrasound: a useful tool. PMID- 3290878 TI - Development of public health nursing literature. By Ada M. Carr, 1926. PMID- 3290876 TI - Streptococcal pharyngitis. What's new. AB - Group A beta-hemolytic streptococcal pharyngitis continues to be a major problem and accounts for a large number of physician visits. The recent resurgence of acute rheumatic fever in several areas in the United States underlines the need to accurately diagnose and correctly treat streptococcal pharyngitis. Appropriate treatment with antibiotics effectively prevents rheumatic fever. Early institution of treatment also leads to prompt alleviation of symptoms. The "gold standard" for diagnosing group A streptococcal pharyngitis is the throat culture. Newer rapid diagnostic tests may be used, but the clinician must recognize that there are a substantial number of false-negative tests (low sensitivity). Therefore, patients with negative rapid tests should have standard throat cultures as well. Patients with positive rapid tests should be treated with appropriate antibiotics, as should patients with positive throat cultures. Patients with signs and symptoms that are highly suggestive of streptococcal pharyngitis can also be treated, pending throat culture results. Penicillin continues to be the drug of choice for treatment, and American Heart Association guidelines suggest the use of oral penicillin V for ten days or intramuscular benzathine penicillin G. Alternative antibiotics commonly used include erythromycin and various cephalosporins. Throat cultures need not be obtained from most patients after therapy. However, some patients may seem to be having frequent streptococcal infections or may be recognized as asymptomatic carriers. Carriers may be considered for therapy with intramuscular benzathine penicillin G plus oral rifampin. PMID- 3290879 TI - A new profession: the evolution of public health nursing. PMID- 3290881 TI - [Significance of environmental and individual factors in autoaggression]. PMID- 3290880 TI - Insulin clearance from plasma in type I (insulin-dependent) diabetic patients: influence of glycaemic level. AB - The influence of the actual glycaemic level on the kinetics of insulin disappearance from plasma was studied in 16 type I diabetic patients. Constant intravenous infusion of insulin (1-5 mU.kg-1.min.-1) was used to achieve different levels of steady state plasma free insulin concentrations, while the blood glucose level was clamped at normoglycaemia, 4.1 +/- 0.1 mmol/l (mean +/- S.E.M.), and mild hyperglycaemia, 8.2 +/- 0.1 mmol/l. The experimentally determined data were compared using a previously validated model of first order kinetics for insulin disappearance from plasma in diabetic patients. At the physiological insulin concentration range the median clearance rate of insulin was 23 ml.kg-1.min-1 (range 16-26) at normoglycaemia and 23 ml.kg-1.min-1 (19-35) at hyperglycaemia (P = 0.45). At supraphysiological levels, insulin was cleared at a lower rate at normoglycaemia than at hyperglycaemia. No correlation was observed between the insulin clearance rate and the duration of diabetes or the haemoglobin A1C level (both Spearman's rho = 0.08). In conclusion, the insulin clearance rate from plasma is independent of the actual glycaemic level and hardly influenced by the long-term glycaemic level in type I diabetic patients. PMID- 3290882 TI - [Biosynthesis of nicotinamide dinucleotide (NAD) in microorganisms (review of the literature)]. AB - Data on the biosynthesis of nicotinamide adenine dinucleotide (NAD) and mechanisms of its regulation in microorganisms are reviewed, and the reasons and conditions of NAD overproduction are discussed. PMID- 3290883 TI - [Biosynthesis of vitamins B by the fungus Pleurotus ostreatus in a submerged culture]. AB - The intra- and extracellular contents of vitamins were studied in the course of submerged cultivation of the higher basidial mushroom Pleurotus ostreatus (Jacq.: Fr.) Kummer st. IMBF-1300 on liquid nutrient media. This strain was found to be autotrophic in respect of thiamin (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B5), pyridoxine (vitamin B6) and biotin (vitamin B7), but it failed to synthesize cyanocobalamin (vitamin B12). The composition and pH of the culture medium, containing such complex biostimulating supplements as maize extract and concentrated potato sap noticeably influence the contents of vitamins B1, B5 and B7 in the mycelium, and to a less degree they change the level of the intracellular biosynthesis of vitamins B2 and B6. Higher excretion of vitamins B5, B7 and especially B6 was observed on the semisynthetic media during the postexponential growth. Under experimental conditions vitamins B1 and B2 were accumulated only in the cells. The dry mycelium of P. ostreatus obtained by submerged cultivation on liquid media is a valuable source of B vitamins and, especially, of niacin. Thus the oyster mushroom and other edible mushrooms can be put at one of the top places among food-stuffs by the content of niacin. PMID- 3290884 TI - [Effect of surface-active agents (tween-21) on indices of energy metabolism in oleandomycin producers]. AB - The specific growth rate of Streptomyces antibioticus, a producer of oleandomycin, and the specific rate of the antibiotic accumulation in the culture medium during fermentation were investigated. On the basis of the results obtained the fermentation period was divided into 7 phases of development. The culture treated with the surfactant (Tween-21) is characterized by a higher specific growth rate during the whole fermentation and a higher specific rate of the antibiotic accumulation at the stage of the highest production as compared to the control. The ATP content, the value of the adenylate energy charge and the contents of high-molecular weight polyphosphates in the mycelium were examined. In the phase of the intensive growth St. antibioticus was characterized by a higher ATP level and a higher energy charge. More active accumulation of polyphosphates was observed in the late intensive growth phase. It was also found that after the treatment of the culture with Tween-21 it utilized polyphosphates more actively during the antibiotic biosynthesis. PMID- 3290885 TI - [Antibiotic activity and heterogeneity of a population of Azotobacter chroococcum]. AB - Antibiotic activity of Azotobacter chroococcum was determined depending on the morphological composition of the population. The population was divided by the sedimentary properties into 2 fractions: heavy (H) and light (L). A higher amount of azochroomycin (up to 170%) could be extracted from the H-fraction consisting mainly of medium size cells (1.3-1.9 nm in diameter) as compared to that from the L-fraction consisting predominantly of the cells of 0.7-1.3 nm in diameter; the activity of the L-fraction counted as 100%. PMID- 3290887 TI - [Treatment of patients with pulmonary tuberculosis with antitubercular preparations and levamisole]. PMID- 3290886 TI - [Specificity of hydrolysis of S. aureus 209P cell walls by a lytic preparation of Pseudomonas lytica]. AB - Specificity of Staphylococcus aureus 209P cell wall hydrolysis by a lytic preparation isolated from the culture liquid filtrate of Pseudomonas lytica VKM V 1454D was studied by the dansylation method. The lytic preparation was found to contain the lytic proteinase lysing the cells of Gram-positive microorganisms. The enzyme hydrolysed the cell walls of S. aureus 209P releasing N-terminal glycine and alanine in amounts of 0.73 and 0.34 mumoles per 1 mumole of lysine, respectively, which indicated the cleavage of the bonds in the pentaglycine bridge and, apparently, of the bond between N-acetylmuramic acid. PMID- 3290888 TI - [Ia antigens on the cellular elements of bronchoalveolar washings from patients with pulmonary tuberculosis]. PMID- 3290889 TI - [Effect of riboxine, levamisole and sodium oxybutyrate on the course of experimental tuberculosis]. PMID- 3290890 TI - [Immunological aspects of the pathogenesis of sarcoidosis]. PMID- 3290891 TI - Effects of dimethylsulfoxide and the deep-freezing process on the infectivity, motility, and ultrastructure of Trypanosoma cruzi. AB - The effects of dimethylsulfoxide (DMSO, final concentration 5%) and the deep freezing process on the infectivity (ID50), motility, and ultrastructure of nontreated and DMSO-treated Trypanosoma cruzi suspensions (PSG-3 buffer with 10% horse serum) were investigated prior to and after cryopreservation in liquid nitrogen. DMSO equilibration caused distinct suppression of motility and characteristic, fine structural alterations in numerous organelles, such as myelin-like structures in the cytoplasm and/or inside the mitochondrial apparatus, enlargement of the perinuclear space, endoplasmic reticulum, and mitochondrial cristae, as well as condensation of the kinetoplast with loss of its lamellar structure. There was no evidence of loss of infectivity in DMSO treated parasites. DMSO-treated and deep-frozen organisms showed, however, very similar fine structural alterations, although damage occurring during freezing and thawing was more pronounced. Apart from the frequently enlarged kinetoplast and the loosening of its mitochondrial matrix, numerous trypanosomes revealed total disintegration of the kinetoplast-mitochondrion complex with loss of its whole matrix. Deep-frozen trypanosomes were significantly less infective to mice than nontreated organisms, and their motility was strongly suppressed. These results suggest that cryopreservation and thawing of T. cruzi may lead to severe damage of the mitochondrial apparatus and thus to heavy disorders of metabolic function, exhaustion of the metabolic pool, and finally, to death of such damaged trypanosomes, despite the use of DMSO as a cryoprotective agent. PMID- 3290892 TI - A 46,000 dalton Plasmodium falciparum merozoite surface glycoprotein not related to the 185,000-195,000 dalton schizont precursor molecule: isolation and characterization. AB - A 46,000 dalton glycoprotein was isolated by extraction of freshly harvested P. falciparum merozoites (FCB1 strain), followed by gel electrophoresis of the extract and electroelution. The antigen is present in the late ring, trophozoite, schizont, and segmenter stages and is localized on the merozoite surface at the end of schizogony. It is not related to the 185,000-195,000 dalton schizont antigen. An antiserum against the 46,000 dalton antigen inhibits invasion of erythrocytes by merozoites. The isolated antigen is identical to the antigen against which monoclonal antibody (mcab) 13.4 is directed. PMID- 3290893 TI - Immunocytochemical demonstration of 5-hydroxytryptamine (serotonin) and vertebrate neuropeptides in the nervous system of excysted cysticercoid larvae of the rat tapeworm, Hymenolepis diminuta (Cestoda, Cyclophyllidea). AB - The localisation and distribution of 5-hydroxytryptamine (5-HT, or serotonin) and a number of vertebrate neuropeptides in the nervous system of excysted (0-24 h) cysticercoid larvae of Hymenolepis diminuta were determined by an indirect immunofluorescence technique in whole-mount preparations. In the central nervous system, cell bodies and nerve fibres immunoreactive to 5-HT are present in the main commissure, lateral and rostellar ganglia, and the longitudinal nerve cords and their connectives. In the peripheral nervous system, immunoreactive nerve fibres occur in a poorly developed nerve plexus within each sucker. Among the vertebrate peptides tested, antisera to pancreatic polypeptide (PP), polypeptide YY (PYY), peptide histidine isoleucine (PHI) and gastrin-releasing peptide (GRP) gave positive results. Immunoreactivity to PP and PYY paralleled that of 5-HT, with greater numbers of cell bodies present in the different locations within the scolex nervous system, and the sucker plexus being more prominent. The number of PP-reactive cells in the lateral ganglia and main lateral, longitudinal nerve cords increased over the 24-h period in culture. Results with antisera of different specificities to PP and PYY suggest that the immunoreactivity may be due to a peptide with closer structural affinity to PYY than to PP. Immunoreactivity to PHI is restricted to the main lateral nerve cords in the body of 0-h worms, extending into the median nerve cords by 12 h and 24 h. Immunoreactivity to GRP became evident after 12 h in culture and was confined to the longitudinal nerve cords, in particular the median nerve cords. The results are discussed in relation to the proposed transmitter and regulatory roles of 5 hydroxytryptamine and the neuropeptides. PMID- 3290894 TI - Immunocytochemical and biochemical evaluation of pancreatic lipase in acinar cells of control and streptozotocin-induced diabetic rats. AB - Pancreatic lipase was revealed by immunocytochemistry and analyzed biochemically in pancreatic tissue from control, diabetic, and insulin-treated diabetic rats. In the three groups of animals, lipase antigenic sites were detected with high resolution in the acinar cells in the compartments involved in protein secretion: rough endoplasmic reticulum, Golgi apparatus, and secretory zymogen granules. The quantitative evaluation of the intensities of labeling has demonstrated that, in contrast to other pancreatic proteins, lipase is concentrated only at the transition between the Golgi apparatus and the condensing vacuoles. This indicates that, although sharing the same secretory pathway as amylase and chymotrypsinogen, lipase may in fact be processed differently. On the other hand, when compared with controls, lipase immunolabelings in tissues with diabetic condition were higher in all the cellular compartments. Treatment of diabetic animals with insulin was found to restore these levels to those obtained in control condition. The biochemical determination of lipase activities in pancreatic tissues confirmed the immunocytochemical data. These results, together with those obtained previously for amylase and chymotrypsinogen, indicate that in diabetic condition secretion from the acinar cells is significantly altered, which may influence intestinal digestion and absorption processes. These modifications, and the enhancement of lipase in particular, could play a role in the pathogenesis of the hyperlipidemic condition present in diabetes. PMID- 3290895 TI - The Opie century. PMID- 3290896 TI - Nonparallel pancreatic secretion: its meaning and implications. PMID- 3290897 TI - Human renal carcinoma expresses two messages encoding a parathyroid hormone-like peptide: evidence for the alternative splicing of a single-copy gene. AB - A peptide secreted by tumors associated with the clinical syndrome of humoral hypercalcemia of malignancy was recently purified from human renal carcinoma cell line 786-0. The N-terminal amino acid sequence of this peptide has considerable similarity with those of parathyroid hormone (PTH) and of peptides isolated from human breast and lung carcinoma (cell line BEN). In this study we obtained the nucleotide sequence of a 1595-base cDNA complementary to mRNA encoding the PTH like peptide produced by 786-0 cells. The cDNA contains an open reading frame encoding a leader sequence of 36 amino acids and a 139-residue peptide, in which 8 of the first 13 residues are identical to the N terminus of PTH. Through the first 828 bases the sequence of this cDNA is identical with one recently isolated from a BEN cell cDNA library; however, beginning with base 829 the sequences diverge, shortening the open reading frame by 2 amino acids. Differential RNA blot analysis revealed that 786-0 cells express two major PTH-like peptide mRNAs with different 3' untranslated sequences, one of which hybridizes with the presently described sequence and the other one with that reported for the BEN cell PTH-like peptide cDNA. Primer-extension analysis of 786-0 poly(A)+ RNA together with Southern blot analysis of human DNA confirmed the presence of a single-copy gene coding for multiple mRNAs through alternate splicing. In addition, the 3' untranslated sequence of the cDNA described here has significant similarity to the c-myc protooncogene. PMID- 3290898 TI - One-dimensional diffusion of Escherichia coli DNA-dependent RNA polymerase: a mechanism to facilitate promoter location. AB - The mechanism of promoter location by DNA-dependent RNA polymerase of Escherichia coli was investigated. The occupancies of DNA fragments carrying the A1 promoter of bacteriophage T7 were analyzed as a function of the length of flanking sequences adjacent to the promoter. Competition between the promoters on different fragments showed qualitatively that DNA sequences downstream of the promoter enhanced promoter occupancy, whereas upstream flanking sequences had little or no influence on occupancy. This was studied quantitatively by using a set of DNA fragments with four identical A1 promoters (I-IV) equidistant from each other, but with different lengths of flanking sequences upstream from promoter I and downstream from promoter IV. The relative occupancies of these promoters showed that downstream DNA sequences of up to 250 base pairs increased the occupancy of the adjacent promoter, whereas upstream sequences longer than 70 base pairs had little or no effect on occupancy. Promoter occupancies measured as a function of the length of the downstream flanking DNA sequences were fit by a published theory that takes into account an enhancement of signal-sequence location by linear diffusion. PMID- 3290899 TI - FLP recombinase is an enzyme. AB - The FLP protein of the yeast 2-microns plasmid catalyzes intermolecular site specific recombination with a turnover number of approximately equal to 0.12 min 1 (per FLP monomer) for relaxed DNA substrates. Under conditions that enhance its stability, the protein can be used in catalytic rather than stoichiometric amounts. The reaction rate exhibits a strong dependence on FLP protein concentration even when the protein is present in excess relative to available recombination sites. PMID- 3290900 TI - Posttranslational modification of the Ha-ras oncogene protein: evidence for a third class of protein carboxyl methyltransferases. AB - The ras oncogene products require membrane localization for their function, and this is thought to be accomplished by the addition of a palmitoyl group to a cysteine residue near the carboxyl terminus of the nascent chain. A lipidated carboxyl-terminal cysteine residue is also found in sequence-related yeast sex factors, and in at least two cases, the alpha-carboxyl group is also methyl esterified. To determine if ras proteins are themselves modified by a similar type of methylation reaction, we incubated rat embryo fibroblasts transformed with p53 and activated Ha-ras oncogenes with L-[methyl-3H]methionine under conditions in which the isotope was converted to the methyl donor S-adenosyl-L [methyl-3H]methionine. By using an assay that detects methyl ester linkages, we found that immunoprecipitated ras proteins are in fact esterified and that the stability of these esters is consistent with a carboxyl-terminal localization. This methylation reaction may be important in regulating the interaction of ras proteins with plasma membrane components. The presence of analogous carboxyl terminal tetrapeptide sequences in other proteins may provide a general recognition sequence for lipidation and methylation modification reactions. PMID- 3290901 TI - Active human immunodeficiency virus protease is required for viral infectivity. AB - Retroviral proteins are synthesized as polyprotein precursors that undergo proteolytic cleavages to yield the mature viral proteins. The role of the human immunodeficiency virus (HIV) protease in the viral replication cycle was examined by use of a site-directed mutation in the protease gene. The HIV protease gene product was expressed in Escherichia coli and observed to cleave HIV gag p55 to gag p24 and gag p17 in vitro. Substitution of aspartic acid residue 25 (Asp-25) of this protein with an asparagine residue did not affect the expression of the protein, but it eliminated detectable in vitro proteolytic activity against HIV gag p55. A mutant HIV provirus was constructed that contained the Asn-25 mutation within the protease gene. SW480 human colon carcinoma cells transfected with the Asn-25 mutant proviral DNA produced virions that contained gag p55 but not gag p24, whereas virions from cells transfected with the wild-type DNA contained both gag p55 and gag p24. The mutant virions were not able to infect MT-4 lymphoid cells. In contrast, these cells were highly sensitive to infection by the wild type virions. These results demonstrate that the HIV protease is an essential viral enzyme and, consequently, an attractive target for anti-HIV drugs. PMID- 3290902 TI - The copper, zinc-superoxide dismutase gene of Saccharomyces cerevisiae: cloning, sequencing, and biological activity. AB - The gene for copper, zinc-superoxide dismutase (Cu,Zn-SOD; EC 1.15.1.1) from the yeast Saccharomyces cerevisiae has been cloned, sequenced, and shown to have physiological activity. The gene was isolated from a lambda gt11 library by using a long, unique deoxyoligonucleotide probe. The probe sequence was deduced from the known amino acid sequence by using a computer-generated yeast codon preference table. The sequence of the coding and flanking regions is reported. The cloned gene was expressed and shown to be active in vivo. A 3.2-kilobase fragment containing the coding region and 160 upstream bases, subcloned in a yeast/Escherichia coli shuttle vector, was used to transform a yeast strain lacking Cu,Zn-SOD activity. The presence of the Cu,Zn-SOD gene-containing plasmid corrected the characteristic dioxygen sensitivity of this strain. Electrophoretic transfer blots with antibody to yeast Cu,Zn-SOD showed the presence of the protein in transformants and wild-type yeast but not in the mutant. The role of Cu,Zn-SOD in defense against dioxygen toxicity is discussed in the light of these findings. PMID- 3290904 TI - Influence of prostacyclin and two metabolites on the contractility of cultured rat heart cells. AB - Heart cells were cultured from newborn rats, and the contractile activity (CA) and beating frequency (BF) were recorded using an electrooptical technique. Myocardial cells were found to be highly sensitive to Prostacyclin (PGI2) since a 10(-11) M concentration increased the BF and CA. Increasing the concentration (2.7 x 10(-10) to 2.7 x 10(-8) M) resulted in a dose-dependent decrease in CA and BF. The stable product of the non-enzymatic degradation of PGI2 (6 Keto PGF1 alpha) was found to be completely ineffective, and the stable product of the enzymatic PGI2 metabolism (6 Keto PGE1) exerted only a dose-dependent (10(-6) to 10(-5) M) positive inotropic effect. PGI2 was also effective in the presence of serum instead of culture medium but the decrease in CA was less marked than in culture medium, probably due to protein-binding of the drug. When the CA was decreased by PGI2, perfusion with the intracellular calcium-releasing and phosphodiesterase inhibiting agent, caffeine, reversed the PGI2-induced negative inotropic effect. These results suggest that PGI2 participates in the regulation of the heart cell contractility. Its metabolite 6 Keto PGEI could also influence heart cell contractility but higher concentrations are needed. Moreover myocardial intracellular calcium availability seems to be influenced by PGI2. PMID- 3290903 TI - Human HST1 (HSTF1) gene maps to chromosome band 11q13 and coamplifies with the INT2 gene in human cancer. AB - The human HST1 gene, previously designated the hst gene, and now assigned the name HSTF1 for heparin-binding secretory transforming factor in human gene nomenclature, was originally identified as a transforming gene in DNAs from human stomach cancers by transfection assay with mouse NIH 3T3 cells. The amino acid sequence of the product deduced from DNA sequences of the HST1 cDNA and genomic clones had approximately 40% homology to human basic and acidic fibroblast growth factors and mouse Int-2-encoded protein. We have mapped the human HST1 gene to chromosome 11 at band q13.3 by Southern blot hybridization analysis of a panel of human and mouse somatic cell hybrids and in situ hybridization with an HST1 cDNA probe. The HST1 gene was found to be amplified in DNAs obtained from a stomach cancer and a vulvar carcinoma cell line, A431. In all of these samples of DNA, the INT2 gene, previously mapped to human chromosome 11q13, was also amplified to the same degree as the HST1 gene. PMID- 3290905 TI - Prostacyclin degradation in patients with quantitative platelet disorders. AB - Plasma prostacyclin (PGI2) degradation rates were measured at 1, 5, 15 and 30 min in a group of patients with platelet quantitative disorders of various pathogeneses, including 13 with thrombocytosis, 16 with thrombocytopenia from impaired production in the bone marrow, 11 with thrombocytopenia from peripheral destruction, and 28 normal, healthy persons. Patients with thrombocytosis had a low PGI2 degradation rate, whereas patients with thrombocytopenia due to impaired production had a high PGI2 degradation rate. Of the patients with thrombocytopenia caused by peripheral destruction, six with idiopathic thrombocytopenia purpura (ITP) had a slow PGI2 degradation in contrast to five with systemic lupus erythematosus (SLE) - four concurrently had cryoglobulinemia who had a rapid PGI2 degradation. The findings suggest that: (1) a platelet derived substance in the human plasma may have a PGI2 stabilising activity; (2) presence of cryoglobulin or immune complex in plasma may interfere with PGI2 stability. PMID- 3290906 TI - Effects of fibrates on serum lipids and atherosclerosis. PMID- 3290908 TI - Glutathione, free radicals and chemotherapeutic agents. Mechanisms of free radical induced toxicity and glutathione-dependent protection. PMID- 3290907 TI - Human drug metabolism in vitro. PMID- 3290909 TI - Antidromic vasodilatation and neurogenic inflammation. PMID- 3290910 TI - Metabolism of oxazaphosphorines. PMID- 3290911 TI - Muscarinic receptor differentiation. PMID- 3290912 TI - Metabolism of plant-derived anticancer agents. PMID- 3290913 TI - Sensitivity and reliability of force tracking and joint-movement tracking scores in healthy subjects. AB - The purpose of this study was to examine the sensitivity and reliability of two tracking tests designed to measure control of handgrip force and finger movement. In one test, the subject exerts careful control of handgrip force on a dynamometer, which is interfaced with a computer, and attempts to guide a cursor as accurately as possible along a stationary target track displayed on the computer screen. In the second test, the subject attempts to trace a different target track by precise flexion-extension movement of the metacarpophalangeal joint of the index finger to which an electrogoniometer is attached. For both tests, the computer quantifies the subject's performance with an accuracy index. Fourteen healthy subjects participated in the force tracking test (FTT), which involved three pretest tracking trials, a 20-minute inactivity period, and three posttest trials. Thirteen different healthy subjects participated in the joint movement tracking test (JMTT) using the same testing format. One-tailed, paired t tests of the pretest-posttest tracking scores showed significant (p less than .01) improvement in tracking accuracy for both the FTT and the JMTT. Additionally, intraclass correlation coefficients for both the pretest and the posttest trials showed acceptable reliability in the FTT and the JMTT. We concluded, for healthy subjects, that 1) these tracking tests are sensitive to small changes in force control and joint-movement control, and 2) the tracking scores are reliable. We believe that these tests could be very useful in documenting objectively the effects of treatment applied to the hand. PMID- 3290914 TI - Dietary protein and carbohydrate effects on blood parameters related to stress in cat. AB - Adult cats were adapted to hypoglucidic semi-purified diets containing casein or soya as the protein source to study the effects of a 2 hr immobilization period. Body weight of cats fed hypoglucidic diets was significantly decreased. The control casein group showed higher plasma dopamine-beta-hydroxylase activity but lower pyridoxal 5'-phosphate level than control soya group. Cats fed hypoglucidic casein diet, plasma glucose, insulin and pyridoxal 5'-phosphate levels were increased whereas cats fed hypoglucidic soya diet, pyridoxal 5'-phosphate levels were decreased and dopamine-beta-hydroxylase activity increased when data were compared to their respective control groups. A 2 hr immobilization period induced hyperglycemia in all groups whereas cats fed soya diets, plasma insulin level and dopamine-beta-hydroxylase activity were significantly increased and pyridoxal 5' phosphate content significantly decreased. These results demonstrate that dietary casein and soya protein might be differentiated on a physiological basis and immobilization emphasized the biochemical disturbances observed between the groups thus suggesting a greater resistance to stress in casein groups than in soya groups. PMID- 3290915 TI - Effects of experience and available cues on estrous versus diestrous preferences in male prairie voles, Microtus ochrogaster. AB - Male prairie vole preferences for estrous versus diestrous females and associated stimuli were investigated. The role of sexual experience in engendering preferences proved more complex than reported for other species. Naive males did not display preferences. Neither males receiving sexual experience through monogamous cohabitation, nor males housed with two females displayed preferences. Males exposed to both estrous and diestrous females, and males housed with other males and females in a semi-naturalistic setting, displayed preferences. Thus, preferences seem to be "tuned" by experiential manipulations. Cues available for discrimination also influenced the display of preferences, as different results were obtained using apparatus that differed in cue availability. The observed pattern of responsiveness to sex odors may be related to the social organization and mating system of the prairie vole, a mammal that is believed to be monogamous. PMID- 3290917 TI - Incidence, prevalence and risk factors for non-insulin-dependent diabetes mellitus. AB - Non-insulin-dependent diabetes is a worldwide disease. In the United States nearly 10 million persons are affected and the prevalence is increasing. Considerable advances in the understanding of the pathogenesis and determinants of non-insulin-dependent diabetes have occurred in recent years. Genetic and environmental determinants are associated with the development of diabetes, but the mode of inheritance of the genetic determinants is unknown. Obesity, particularly if it is centrally distributed and of long duration, is the most prominent environmental risk factor for non-insulin-dependent diabetes. Although it has long been suspected as an etiological factor, evidence that physical activity is a predictor of the disease is now emerging. The adoption of a western lifestyle and improvements in socioeconomic conditions are at least partially responsible for the very high rates of diabetes among several ethnic and racial groups, although the specific components of these changes that contribute to development of non-insulin-dependent diabetes are still uncertain. Other factors that worsen insulin resistance are likewise predictive of the development of disease. An understanding of the risk factors for non-insulin-dependent diabetes may lead to more specific intervention, and possibly to prevention of this disease. PMID- 3290916 TI - Classification and diagnostic criteria for diabetes mellitus and other categories of glucose intolerance. AB - Diabetes mellitus is composed of a heterogeneous group of disorders characterized by high blood glucose levels. Four major types of diabetes have been defined by the National Diabetes Data Group. Insulin-dependent diabetes (IDDM), also called type I diabetes, is characterized by abrupt clinical onset, insulinopenia, proneness to ketosis even in the basal state, and dependence on exogenous insulin to sustain life. Non-insulin-dependent diabetes (NIDDM), also called type II diabetes, may remain relatively asymptomatic for years. Insulin levels may be normal, lower than normal, or elevated as a consequence of insulin resistance. Ketosis is not part of the general clinical picture except in times of metabolic stress, although the classic complications of diabetes can be expected to develop in long-duration diabetics. Gestational diabetes (GDM) refers to the recognition of abnormal glucose intolerance in pregnancy, although unrecognized abnormal tolerance may indeed have predated the pregnancy. Rates of macrosomia are higher than in non-GDM pregnancies, but fetal mortality and congenital anomalies appear to be no greater than in the general population. Other types of diabetes include a number of diverse conditions in which glucose intolerance is a feature and in which it may be etiologically related. Impaired glucose tolerance (IGT) is a class that encompasses persons whose glucose tolerance is intermediate between normal and diabetic. These individuals do not manifest the microvascular complications of diabetes, but they appear to have higher rates of macrovascular disease associated with the known cardiovascular risk factors. Two statistical risk categories have also been defined that replace the older terms prediabetes, potential diabetes, and latent diabetes. Diabetes can be diagnosed by the presence of classical signs and symptoms of diabetes and unequivocally elevated blood glucose levels; by a fasting plasma glucose greater than or equal to 140 mg/dl; or by an abnormal oral glucose tolerance test, with a venous plasma glucose value greater than or equal to 200 mg/dl at 2 hours after 75 grams oral glucose, being a hallmark criterion for diabetes. For the latter two criteria, the abnormality should be reconfirmed at a later occasion before a definitive diagnosis of diabetes is made. The oral glucose tolerance test has been standardized at a 75-gram glucose (or carbohydrate equivalent) load, given in the morning after an overnight fast. Glucose should be determined for two hours after administration of the challenge. PMID- 3290918 TI - Diabetes, hypertension and other associated diseases. AB - Coexisting hypertension and diabetes mellitus is common particularly in the obese, minorities, and the socioeconomically disadvantaged. Hypertension contributes substantially to the vascular complications of diabetes mellitus and to the increased mortality of diabetes mellitus. Nondrug treatment of both conditions consists of cardiovascular risk factor reduction, emphasizing weight management, salt restriction, smoking cessation, and alcohol moderation. With observing a few precautions the drug treatment of hypertension in diabetes mellitus is similar to that of the nondiabetic. PMID- 3290920 TI - Screening for non-insulin-dependent diabetes mellitus. AB - The major obstacle to a recommendation for screening adults for NIDDM is the conflicting evidence that early detection and treatment reduce future complications. Because obesity is a risk factor for NIDDM, and hypertension in conjunction with NIDDM leads to early atherosclerosis, treatment is indicated for both hypertension and obesity whether or not NIDDM is present concurrently. It is clear that there are those who accept and those that reject the use of oral hypoglycemic agents. Accordingly, there are those who believe that the goal of NIDDM treatment is zealous glycemic control and those who are not so inclined. Whether or not to screen for NIDDM ultimately depends upon which view is adopted. While it may seem prudent to screen for and insist upon "tight" control of NIDDM, we should consider the effect of labeling asymptomatic persons from a positive test result. What are the repercussions regarding status of employment and insurance eligibility as compared to benefits of treatment? What is the psychosocial impact? Although no studies on the effect of labeling patients non insulin-dependent diabetics could be located, a study of hypertension in an industrial setting demonstrated that patients labeled hypertensive had an increased absenteeism from work. Interestingly, the main factors associated with increased absenteeism were awareness of the condition and low compliance with treatment. Although the parallel to NIDDM is evident, additional studies are needed. PMID- 3290921 TI - Functional assessment of families with a diabetic person. AB - Recent studies have revealed that family functioning affects diabetic control, compliance behavior, and treatment of obesity, all of which are issues important to the care of the NIDDM patient. By assessing a few important family dynamics and intervening where appropriate, primary care physicians cannot only improve family functioning, but the health of their patients as well. Family therapy may be necessary when families are resistant to practitioner interventions. PMID- 3290919 TI - Prevention of the complications of diabetes. AB - Until drugs that will prevent metabolic derangements that cause the complications of diabetes have been developed, the best approach to their prevention is control: of hyperglycemia, of hypertension, of obesity, and of smoking. Intensive insulin therapy, although demonstrably effective, must be approached with caution because hypoglycemia is a potentially life-endangering threat. Conversely, a Danish study has demonstrated a decrease in hypoglycemic episodes with intensive insulin therapy (Parving HH. Personal communication, 1988). With this in mind, it may be essential to bring blood glucose levels into a reasonable range shortly after the diagnosis of diabetes mellitus has been made. Insulin therapy is required for type I diabetic patients, and it may also be an appropriate therapy for all type II patients who do not become rapidly normoglycemic following diet and oral sulfonylurea treatment. Some physicians believe that a frontal "attack" of a split-mixed program of insulin therapy when type II diabetes is diagnosed is of psychologic as well as physiologic benefit, impressing the patient with the importance of control and vigilance. Compliance to rigid dietary change is notoriously unsuccessful, and the "trial-and-failure" approach, often ending in insulin therapy in any case, may not be the most effective. The advent of easy-to use blood glucose monitoring devices and convenient and discreet insulin delivery systems has made maintenance of glycemic control less difficult for the insulin using patient. New antihypertensive agents, lipid-reducing drugs, and second generation sulfonylureas that do not affect the quality of life are now available and should be used in the person with diabetes as necessary.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3290922 TI - Glycemic control: arguments for and against. AB - There is substantial evidence that hyperglycemia does play a role in the development of long-term complications, although a genetic predisposition to these complications seems to be important. Also the literature seems to suggest that the degree of hyperglycemia correlates well with both the severity and incidence of long-term complications. However, looking at recent studies in the attempt to answer the question of "can we prevent or minimize complications," we must conclude that there is no definitive evidence that the typical long-term complications of microvascular or macrovascular disease can be prevented with tight control. Hopefully, the current study under way at the NIH will help clarify this issue. It seems likely after reviewing all the evidence that future studies will show tight control to be beneficial. The clinician must weigh the costs of tight control against the potential benefits, particularly in the type II diabetic. It seems prudent to strive for the best control that can be achieved within the confines of the patient's resources, to pay meticulous attention to all factors contributing to complications, such as hypertension and smoking, and to avoid subjecting the patient to undue risks. PMID- 3290923 TI - The dietary management of non-insulin-dependent diabetes mellitus in the obese patient. AB - This article reviews current research about the pathogenesis of obese NIDDM relevant to its dietary management. It summarizes the findings about four dietary interventions: fasting; very low-calorie diets; hypocaloric balanced-deficit diets; and variation of constituents within a diet. The review recommends a specific primary care strategy: induce an extended remission of NIDDM in the obese patient in the short-term; and treat the cause of NIDDM and the behaviors that promote obesity in the long-term with group competition programs. PMID- 3290924 TI - Oral hypoglycemic agents. AB - This article reviews the history of oral hypoglycemic agents in the treatment of patients with non-insulin-dependent diabetes mellitus. It chronicles the rise and fall of the use of these agents as the major treatment modality for NIDDM, from their initial success in the late 1950's, to their being abandoned after the controversial findings of the University Group Diabetes Program, to their eventual resurgence as important agents in the management of hyperglycemia in NIDDM patients. PMID- 3290925 TI - Gestational diabetes mellitus. AB - Gestational diabetes is an asymptomatic disease of pregnant women, which results in significant morbidity and mortality. However, prompt diagnosis and treatment of this disorder have been found to be effective in decreasing complications. The increased risk for eventual diabetes in the patient and obesity or glucose intolerance in her off-spring suggests that long-term weight control and medical follow-up for both are important. PMID- 3290926 TI - Monitoring techniques in non-insulin-dependent diabetes mellitus. AB - Monitoring of the diabetic patients' own blood sugar is now an important component in the management of diabetes of all degrees of severity. Education in proper monitoring techniques, attention to the continued quality of testing, and utilization of the information achieved by testing are important responsibilities of primary care physicians and their health care teams. PMID- 3290927 TI - A biopsychosocial approach to the management of the diabetic patient. AB - Among the psychosocial variables to be considered by the primary care physician in dealing with a diabetic patient are the effects of stressful life events, social support, and the patient's locus of control. Literature relevant to each of these is explored. A practical approach is discussed for the primary care doctor to consider in utilizing these psychosocial variables in diabetes management. PMID- 3290930 TI - [Forensic psychiatry: contradictions between clinical practice and justice]. AB - All the different branches in forensic psychiatry have to face identical handicaps resulting from the difficulties in cooperation with the law-court. For the psychiatrist, his identity as a therapist is contradictory to his forensic tasks. The paper deals with the resulting dilemmata (partiality v. neutrality; diagnostic approach v. legal consequence; psychiatric v. legal methodology and scientific standard). The best way for both sciences to cooperate is by reflecting these handicaps and dilemmata rather than denying them. PMID- 3290928 TI - Economic impact of type II diabetes mellitus. AB - Diabetes is a dangerous, expensive disease with a major economic impact. The cost to the nation in 1984 was estimated to be $14 billion. We now believe the total costs approach $20 billion. Of this, $10.5 billion is guesstimated to be direct cost due to the diagnosis and treatment of the disease, while indirect costs (due to complications, work days lost, decreased productivity, and premature death) are about $9.5 billion. A typical patient with NIDDM and hypertension spends about $1000 per year for doctor visits, lab tests, oral diabetes tablets, blood pressure medications, lancets and blood test strips (4 per week), and miscellaneous expenses. NIDDM is clearly the major diabetes cost to the nation because it represents 85 to 90 per cent of all diabetes and because half the patients are undiagnosed and untreated. We believe the morbidity, mortality, and economic burden of NIDDM can be favorably affected by a concerted national effort as defined by the National Diabetes Advisory Board in its 1987 National Long Range Plan to Combat Diabetes. Finally, one must not forget the "other costs" of NIDDM, which are statistically unmeasurable: emotional costs, loss of freedom, inconvenient life style changes, and the permanent dependence on "others" (family, professionals, and so on) for help. PMID- 3290929 TI - [A study of ganglioside alterations in the nervous system of Creutzfeldt-Jakob disease--analysis in two human cases and experimentally affected rodents]. PMID- 3290932 TI - The power of analysis: statistical perspectives. Part 2. AB - A discussion of the importance of statistical power in research is presented accompanied by nomograms for determining sample size and statistical power for the Student's paired and unpaired t tests with a Type I error of 5%. A brief review of statistical inference is presented. Some findings from Part I are reviewed. PMID- 3290931 TI - The power of analysis: statistical perspectives. Part 1. AB - Failure to consider statistical power when achieving apparently "negative" results prevents accurate interpretation of the results. A nonsignificant result can be obtained when one includes an insufficient number of subjects to permit observation of a true effect (low power to detect an effect), or when one has an adequate number of subjects, but a meaningful effect does not exist (high power, no effect); one can also have a situation of lower power and no real effect. Without considering power, one is unable to distinguish a "negative" experiment from an inadequate one. This article examines 154 published nonsignificant t-test results. When power is calculated with an effect size equal to a standardized difference of unity, over 50% of the tests have inadequate power. PMID- 3290934 TI - The semistructured BPRS interview and rating guide. PMID- 3290933 TI - Metabolism and endocrine secretion in response to a test meal in normal-weight bulimic women. AB - This study assessed metabolism and endocrine secretion in normal-weight bulimic women by monitoring several digestion-related measures in the fasting state and in response to two test meals that were isocaloric but varied in degree of forbiddenness. No consistent physiological disturbances were apparent in bulimics. Their fasting electrolytes, plasma glucose, insulin, and free fatty acids were normal. Furthermore, while the two test meals resulted in different profiles of postabsorptive glucose and postprandial secretion, the two groups did not differ in their profiles. The results suggest that physiological disturbances such as disturbed glucose homeostasis or insulin secretion generally attributed to populations with eating disorders may not be apparent in normal-weight bulimics. The relevance of these findings to the etiology and treatment of normal weight bulimia is discussed. PMID- 3290935 TI - A pilot study of serotonergic system responsivity in Alzheimer's disease. PMID- 3290936 TI - Phosphatidylserine in the treatment of Alzheimer's disease: results of a multicenter study. PMID- 3290937 TI - Predictors of placebo response in depression. PMID- 3290938 TI - Effects of captopril on psychosis and disturbed water regulation. PMID- 3290939 TI - Carbamazepine vs. propranolol for rage outbursts. PMID- 3290940 TI - Low-dose fluoxetine therapy for depression. PMID- 3290941 TI - Sertraline, a selective inhibitor of serotonin uptake, for the treatment of outpatients with major depressive disorder. PMID- 3290942 TI - Cortisol differentially predicts response to imipramine and alprazolam. PMID- 3290943 TI - DSM-III-R anxiety classification: impact on psychopharmacology clinical trials. PMID- 3290944 TI - Neuroleptic malignant syndrome. PMID- 3290945 TI - Pharmacotherapy of cognitive deficits in Alzheimer's disease and age-associated memory impairment. PMID- 3290946 TI - Treatment of agitation, anxiety, and depression in dementia. PMID- 3290947 TI - Methods and models for placebo use in pharmacotherapeutic trials. PMID- 3290948 TI - The nature and management of sleep/wake disturbance in Alzheimer's dementia. PMID- 3290949 TI - Agitation associated with dementia: a systematic approach to treatment. PMID- 3290950 TI - Clozapine in treatment-resistant schizophrenics. PMID- 3290952 TI - Pharmacological treatment of adolescents with affective disorders and attention deficit disorder. PMID- 3290951 TI - Drug therapy strategies for treatment-resistant depression. PMID- 3290953 TI - Is loss of antidepressant effect during continuation therapy related to placebo effect? PMID- 3290954 TI - Treatment of childhood obsessive compulsive disorder with clomipramine and desmethylimipramine: a double-blind crossover comparison. PMID- 3290955 TI - Public Health in England. PMID- 3290956 TI - A voice from the past. 'Influence of meteorological conditions on health'. PMID- 3290957 TI - The history of immunisation. PMID- 3290958 TI - 'Progress, difficulties, suggestions and reforms':"Public Health" 1888-1974. PMID- 3290960 TI - [Preprosthetic preparation of post supported individually articulated models]. PMID- 3290959 TI - Henry Wyldbore Rumsey and the case for state medicine. PMID- 3290961 TI - [Set up stump model and its significance to function and esthetics]. PMID- 3290962 TI - [Telescope for undercut alveolar process]. PMID- 3290963 TI - [Construction conditions for artificial teeth]. PMID- 3290964 TI - [Individual denture parts]. PMID- 3290965 TI - [Interdisciplinary result (I)]. PMID- 3290966 TI - [Tooth colored wax modelling: more information and safety in crown and bridge technic]. PMID- 3290967 TI - [Tooth set-up in wax (I)]. PMID- 3290968 TI - [Error analysis in sample constructions of maxillary and mandibular dentures]. PMID- 3290970 TI - [Repair of an orthodontic appliance]. PMID- 3290969 TI - [Interdisciplinary result (II)]. PMID- 3290971 TI - Enhancement of radioprotective effectiveness of adenosine monophosphate by magnesium aspartate in mice. PMID- 3290972 TI - Post-irradiation intestinal mucosal kinetics in Indian desert gerbil (Meriones hurrianae Jerdon) after internal 32P beta-irradiation. PMID- 3290973 TI - Effect of gamma radiation on haematology of chick (Gallus gallus domesticus). PMID- 3290976 TI - [Pediatric radiology. 24th meeting of the East German Society of Medical Radiology. 14-17 January 1987, Leipzig. Proceedings]. PMID- 3290974 TI - [A new method for the treatment of tumors in the oral cavity in man]. PMID- 3290975 TI - [Dose-time studies in radiogenic pneumopathy. V. Character and quantitative determination of radiogenic lung reactions]. PMID- 3290977 TI - [Diuresis sonography and its significance for pre- and postoperative determination of obstructive urination disorders]. PMID- 3290978 TI - [Monosymptomatic enuresis--diagnostic procedure and study results for 350 patients]. PMID- 3290979 TI - [Pediatric ultrasonic diagnosis]. PMID- 3290980 TI - [Brain tumor diagnosis using ultrasonics in childhood]. PMID- 3290981 TI - [Sonographic detection of intracerebral pericranial processes in comparison with CT]. PMID- 3290982 TI - [Echocardiographic diagnosis of congenital heart defects]. PMID- 3290984 TI - [The place of imaging methods in the diagnosis of retroperitoneal neuroblastomas in infants]. PMID- 3290983 TI - [The thymus from premature birth to adolescence: new aspects of diagnostic imaging]. PMID- 3290985 TI - [Diagnostic imaging of the inferior vena cava in retroperitoneal tumors in childhood--cavography or sonography?]. PMID- 3290986 TI - [X-ray diagnosis of occipito-cervical malformations. I. The basilar impression]. PMID- 3290987 TI - [Scrotal sonography with special reference to testicular tumors]. PMID- 3290988 TI - [Role of ultrasonic diagnosis in Kawasaki syndrome]. PMID- 3290989 TI - Comparison of 99mTc lymphoscintigraphy, ultrasonography and lymphangiography in patients with malignant lymphoma. PMID- 3290990 TI - [Ultrasonic tomography in the diagnosis of diseases of the skeletal system in childhood]. PMID- 3290991 TI - Automatic exposure control: a primer. AB - AEC is a radiographic density control device that terminates the exposure when a predetermined amount of radiation has been reached. Newer systems control kVp and mA as well as exposure time. The primary goal of AEC is to produce high-quality radiographs consistently with minimal technical factors set by the radiographer. AEC can be a helpful device, but only if the radiographer understands the principles governing its operation, applies them properly, and knows how to compensate for variations. There are certain decisions that must be made by the radiographer, such as proper sensor selection, appropriate kVp and mA selection, density control adjustment, and correct patient positioning both anatomically and relative to the proper sensor. Quality control procedures must be followed to be certain that the entire imaging chain is functioning properly. Although there are similarities among the various systems, there can be wide variations in their design and operation. If the radiographer appreciates the benefits and limitations of the equipment, many problems can be avoided. Understanding the concepts of minimum response and backup time is important because many of the problems that occur when AEC is used can be traced back to them. Although AEC is not a cure-all, in the hands of a skilled radiographer it can aid in the production of high quality radiographs. PMID- 3290992 TI - Apomorphine in the evaluation of dopaminergic function in man. AB - 1. Apomorphine (Apo), a short acting dopamine (DA) receptor agonist, stimulates growth hormone (GH) secretion, decreases prolactin secretion, induces yawning, penile erections and other physiological effects in man. An effect on behavior, movement disorders and alcoholism has also been described. 2. Apo-mediated responses are used to evaluate DA function in psychiatric and neurological disorders. Many of the studies in schizophrenia using the GH response to Apo as an index of central DA function are difficult to interpret because of failure to control for key variables. 3. The GH response to Apo is a useful system to evaluate the effects of various drugs including peptides which may not cross the blood brain barrier on DA function in man. 4. Apo is a potent sedative. Specific antimanic, antischizophrenic, and anticraving effects in alcoholics have not been convincingly demonstrated. Side effects of Apo and failure to use active placebo make double-blind studies difficult. 5. Apo improves parkinsonian symptoms and certain forms of reflex epilepsy but beneficial effects in other involuntary movement disorders requires further documentation. 6. Apo may be a useful agent to evaluate DA function in impotent patients and predict a therapeutic response to long-acting dopaminergic agents. 7. Impairment of DA function may play a role in diabetic impotence. 8. The development of a simple polygraphic method to monitor the yawning response to Apo may facilitate clinical studies on the basic physiology of yawning in man and the use of the yawning response as a measure of central DA function in schizophrenia and other clinical disorders. 9. The use of Apo with 18F-fluorodeoxyglucose positron emission tomography to examine regional DA function in man opens up a promising area of research. 10. Though long-acting orally active aporphine DA agonists and antagonists have been developed the problem of tolerance may limit their therapeutic potential. PMID- 3290993 TI - Dopamine receptors in Parkinson's disease. AB - 1. Parkinson's disease is associated with profound decreases in striatal dopamine concentrations. 2. There are significant increases in the densities of striatal D1 and D2 receptors as part of the compensatory mechanism. 3. Levodopa therapy induces a down-regulation of both D1 and D2 receptors to normal densities. 4. Positron emission tomography detects striatal changes in early Parkinson's disease or toxin-induced parkinsonism. PMID- 3290994 TI - Neuropsychophysiological correlates of lactate-induced panic. AB - 1. One of the simplest and most direct applications of neuropsychophysiological techniques is to anxiety disorders. 2. The physiological changes accompanying the lactate induction of panic appear, for most response systems, to be similar to those found spontaneously in anxious patients and are characteristic of a state of hyperarousal. 3. Patients vulnerable to lactate-induced panic exhibit higher than normal pre-panic autonomic activity, elevated autonomic-somatic activity during lactate-induced panic and an EEG response to provoked panic which appears to be comprised of a "paradoxical" shift towards slow wave delta activity and an altered brainstem evoked response. 4. Additional studies are warranted to determine the relationship of these physiological changes to the triggering of panic and preliminary attempts in this direction are discussed. PMID- 3290995 TI - Regional specialization of motor functions in the rat striatum: implications for the treatment of parkinsonism. AB - 1. Behavioral studies of rats with ibotenic acid-induced lesions of distinctive regions of the rostral striatum demonstrated clearcut motoric impairments after lesions of the lateral striatum, but not after lesions of the medial striatum. 2. Differential effects of dorsolateral and ventrolateral lesions on segmental bodily movements indicated a somatomotor map in the lateral region. 3. Neurotoxic lesions of the lateral striatum produced deficits of motor energizing analogous to those of human parkinsonism. 4. These results support the hypothesis that neurodegenerative processes affecting the lateral striatum (putamen) in humans may specifically account for parkinsonian symptoms. 5. The implications of this hypothesis for the treatment of parkinsonism using the grafting technique are discussed. PMID- 3290996 TI - Anticholinergic side effects of tricyclic antidepressants and their management. AB - Side effects associated with tricyclic antidepressant (TCA) therapy often leads to premature drug discontinuation. The most common side effects associated with TCA's are those related to the anticholinergic activity of these medicines. The peripheral anticholinergic complaints of dry mouth, constipation, ocular side effects and urinary hesitancy are described and specific clinical guidelines for their effective management are provided. PMID- 3290997 TI - Lithium and the retina. AB - Recent interest in light therapy for depression has stimulated consideration of the nature of the biological defect in affective disorder. One line of thinking suggests that manic-depressive patients are supersensitive to light and that lithium may act by altering light sensitivity and hence entrainment of biological rhythms. This paper focuses on possible mechanisms whereby lithium may influence retinal physiology and the ability to perceive light. Preliminary data were generated using the Dark Adaptation Threshold procedure with a repeated measure protocol. When depressed and unmedicated the patient was found to have significantly lowered thresholds for light detection compared to control values. This supersensitivity was alleviated following lithium treatment. Data are interpreted as suggesting that some of the therapeutic effects of lithium are localized in the retina. It is proposed that: (1) lithium primarily alters the ability of the retina to detect light and not visual acuity; (2) lithium influences sensitivity to light by modulating the functional environment of the rod photoreceptors in the retina and (3) future research should focus on the effect of lithium on the function of rod photoreceptors and the pigmented epithelial cells in patients with affective disorder. PMID- 3290998 TI - Effects of antidepressants on thinking styles in depressed inpatients. AB - 1. Clinical and empirical evidence point to distorted negative thinking during depressive episodes. 2. The present study, utilizing the Cognitions Questionnaire, examined the thinking styles in depressed inpatients prior to antidepressant pharmacotherapy and again 3-4 weeks after treatment. 3. Across the 5 dimensions of thinking assessed, only generalization across situation changed significantly in the drug-respondent group. 4. While clinically, short-term antidepressant treatment was shown to be efficacious, it only changed cognitions in a limited way. PMID- 3291000 TI - [Introduction to the experiments of genetic engineering. V. Structural analysis of animal genes]. PMID- 3290999 TI - [Clinical trial of local immunomodulation with DNCB in cases of advanced melanoma of the skin]. PMID- 3291001 TI - [Equipment and instruments for use in radiological protection. VIII. Characteristics and use of radiation protection apparatus (2)]. PMID- 3291003 TI - [Echographic aspect of the diaphragm]. AB - The authors investigated the sonographic patterns of the right hemidiaphragm, with high-resolution real-time equipments. Sixty healthy subjects and two patients were examined; the patients suffered from ascites and pleural effusion, and ascites and pulmonary emphysema, respectively. Even though the muscle is generally described as a thin, highly echogenic line surrounding the liver, in a large number of cases the diaphragm could be demonstrated as a hypoechoic layer, bordered by thin echogenic lines (pleural and peritoneal membranes). This pattern was observed in the lateral part of the muscle in 81% of cases, and along the whole border of the liver in 37% of cases. Such findings were detected in pathological cases too. Thus, the patterns described in previous experimental works on specimens of human diaphragm were confirmed in vivo. As the perfect knowledge of normal appearance is the first step towards diagnosis, the above peculiarities of the normal diaphragm should become more widely known. PMID- 3291002 TI - [Computerized tomography in surgically treated lumbar disk hernia. Multicenter study]. AB - Results are reported of a multicenter analytic-statistical CT study on 128 postoperative lumbar herniated disk (HD) cases (50 at L4-L5, 64 at L5-S1, 2 at L3 L4, 12 multiple). CT was performed from 10 days to 204 months (47.7 months of mean) after surgery, in 51 patients without and in 77 with intravenous contrast medium (42 in bolus, 35 in perfusion). In 59 cases (38%) a recurrent hernia was found, and in 8% a new hernia. In 81% of patients epidural fibrous scars were demonstrated, in a rough 50% of cases associated with recurrent/new hernia: posterior fibrosis was found in 81% of cases, while unilaterally, bilaterally, or anteriorly extended fibroses were present in 20%, in 4.7%, and in 29% of cases respectively. In 72% of the patients injected with contrast medium, various kinds of fibrosis contrast enhancement were detected. In 8% neither fibrosis nor recurrent herniation was found. In 22% of cases lateral and/or central bony canal stenosis was present, in 26% vacuum disk, in 9% intracanalar calcifications, in 39% and in 19.5% dural sac stretching and compression respectively. In 5 cases a pseudomeningocele was found, and in 3 only a postoperative diskitis. Fibrosis is an almost inevitable postoperative consequence (4 out of 5 cases); it can be demonstrated by CT with high sensitivity and good specificity. A series of diagnostic criteria, such as the post-contrast media reaction, allow fibrosis to be discriminated from recurrent hernia. However, the possible association must be kept in mind of both diseases and/or of included roots in the scar. Myelography is hardly ever able to supply further resolutive diagnostic elements, while Myelo CT is sometimes more useful. The importance of bone changes is questionable, with the exception of evident cases of canal stenosis, also because in most cases the radiologist cannot count on a preoperative CT study. Furthermore, the correlation between CT and clinical findings (possible asymptomatic fibrosis) is often difficult, which gives way to contrasting therapeutic attitudes. PMID- 3291004 TI - [Malpositions and complications following central venous catheterization in relation to the access site]. AB - Malpositions and complications following central venous catheterization largely depend on the site of venous approach. Malpositions are very common after subclavian vein catheterization, and even more common after left jugular vein catheterization. On the contrary, their incidence after right jugular puncture is very low. Among complications, pneumothorax is quite common after subclavian vein catheterization, and migration of the catheter towards the heart after right jugular puncture. Vascular damages may occur in any approach: their early detection on chest radiographs very much depends on a rigorous technique. Radiology plays an important role in the early detection of malpositions and complications, which is greatly facilitated by a few ml of contrast medium injected through the catheter. PMID- 3291005 TI - [Hepatic echography in acute viral hepatitis]. AB - Reports on cholecystic alterations during acute viral hepatitis are more and more frequent; the pathogenesis and clinical meaning of these alterations are still debated. Consensual periportal lymphnode enlargement has been not yet reported. The authors describe four cases of acute viral hepatitis in which US showed alterations of cholecystic walls and/or contents; in two cases enlarged periportal lymphnodes were demonstrated too. Later US exams showed a complete regression of both cholecystic and lymphnodal lesions. Clinical findings and laboratory out-comes are evaluated; the connection of US results with hepatitis and its meaning are discussed. The causes of cholecystic alterations are still questionable; they might be related to blood disorders or to an increased portal pressure, or else they might be considered as phlogistic lesions. The authors conclude that both cholecystic and lymphnodal alterations have a phlogistic nature; moreover, they are not related to a particular evolution of hepatitis. The importance of distinguishing cholecystic alterations from different pathologies is stressed. PMID- 3291007 TI - [Definitive radical radiotherapy in tumors of the prostate. Analysis of statistics]. AB - The records were analyzed of 50 patients treated by definitive external beam irradiation for carcinoma of the prostate in the Oncologic Radiotherapy Department of the "Ospedali Riuniti" of Bergamo, Italy, from January 1981 to December 1985. Our series of patients included 22 cases of stage B and 28 cases of stage C tumors. The actuarial 5-year survival rates, according to the Kaplan Meier method, were for the whole group 69.9%; 79.5% and 54.9% for stage B and stage C tumors respectively. Relationships were also analyzed of tumor control and survival to stage, grading, and total dose of radiations. The recent increasing interest is explained in the use of radiation therapy in the treatment of this kind of patients. A special emphasis is put on the role of CT in determining both field size and dose distribution, and on the use of high-voltage energy in order to make treatment more technically reliable and reduce its morbidity. PMID- 3291006 TI - [Ureteral obstruction secondary to aortofemoral bypass]. AB - Hydroureteronephrosis is reported as a frequent late complication of aorto femoral bypass grafts in patients with aorto-iliac obstruction. To define the actual incidence of this potentially critical complication, renal ultrasonography (US) was performed on 79 asymptomatic patients who had previously undergone aortic reconstruction, after a mean interval of 71.6 months. Unilateral hydronephrosis was found in 6 cases (7.6%). Dilatation was mild or moderate (grade I or II) in 4 cases, and severe (grade III) in 2. Ivp was performed in this selected group: hydronephrosis was mild in 3 patients with ureteral stenosis where the iliac limb of the graft crossed the ureter. In 2 cases nonfunctioning kidneys were demonstrated corresponding to severe sonographic hydronephrosis. These 2 patients underwent anterograde and retrograde pyelography, that showed the site and extent of the obstruction. One patient was a false positive because of obstruction of pyelo-ureteral junction. Even though X-rays showed high sensitivity and specificity in detecting this complication of aorto-femoral reconstruction, US is noninvasive and less expensive and does not require contrast medium. A routine pre- and post-operative ultrasound study is suggested in patients undergoing by-pass surgery to early recognise ureteral obstruction and to avoid irreversible renal damage. PMID- 3291008 TI - [Sequential or alternate chemo-radiotherapy in the treatment of advanced head and neck tumors. Results of a randomized study]. AB - Between 1983 and 1986, a multicenter randomized study was conducted to compare a sequential program of induction chemotherapy (CT) followed by radiotherapy (RT), Arm A, with an alternation of 4 cycles of CT with 3 courses of RT (20 Gy/10 fractions up to a total dose of 60 Gy), Arm B, in advanced head and neck cancer patients. The same CT (VBM: Vinblastine, Bleomycin, Methotrexate) was used on both arms; one hundred and sixteen patients (pts) entered the study, 55 in Arm A, 61 in Arm B. Fourty-five pts had stage III and 71 stage IV cancers. The two arms are fully comparable. Up to October 1987, 116 pts are evaluable for survival, while 112 are evaluable for toxicity and 105 for response. In 21 patients (10 in Arm A, 11 in B) the association CT-RT was followed by surgery. Response analysis shows 14 complete responses in Arm A and 30 in Arm B (p less than or equal to 0.03). The median disease-free survival and median overall survival are also statistically different, with an advantage for Arm B (33 vs 22 weeks, p less than or equal to 0.0007, and 59 vs 38 weeks, p less than 0.03 respectively). The actuarial overall survival of complete responders at 50 months is 43% (B) and 21% (A). Toxicity (mainly stage III-IV mucositis) is superior in Arm B (30% vs 4%). Our experience demonstrates the advantages of alternate over sequential CT-RT. A comparison of this cyclic association with RT alone is in progress. PMID- 3291009 TI - [Giant Baker's cyst. Description of a case]. PMID- 3291010 TI - [Occasional echographic finding of a voluminous accessory lobe of the liver]. PMID- 3291011 TI - [Cystic dilatation of the common bile duct. Echotomographic findings]. PMID- 3291012 TI - [Possible cardiotoxicity of bupivacaine in 2 cases of epidural block]. PMID- 3291013 TI - [Obstruction of the upper airways by a foreign body]. PMID- 3291014 TI - [Experimental anesthesiology: a bibliographical note]. PMID- 3291015 TI - [Ischemic cardiopathy (III). Echocardiography in ischemic cardiopathy]. PMID- 3291016 TI - [Use of the right hepatic artery of the receptor in the arterial reconstruction of the clinical liver transplant]. PMID- 3291017 TI - [Histomorphometric analysis of hepatocyte changes in hypothyroidism: experimental study in male albino mice]. PMID- 3291018 TI - [Choledochoduodenostomy in lithiasis of the common bile duct]. PMID- 3291019 TI - [Significance of intestinal metaplasia and dysplasia]. PMID- 3291020 TI - [Radioscopy and radiography in digestive pathology]. PMID- 3291021 TI - [Menetrier disease. Clinicotherapeutic considerations: apropos of a case]. PMID- 3291022 TI - [Liver lesion caused by cyanamide. Study of a case and review of the bibliography]. PMID- 3291023 TI - [The antropyloric zone, duodenogastric reflux and pyloroplasty in surgery]. PMID- 3291024 TI - [Blood folates in pregnancy and therapy with high-dose folinic acid]. PMID- 3291025 TI - [A case of rubella arthritis with Tietze syndrome with variable common hypogammaglobulinemia]. PMID- 3291026 TI - [Effect of a purified glycoprotein substance extracted from Klebsiella pneumoniae in the clinical course of acute infections of the airways in patients with chronic bronchitis. Italian Group for the Study of Biological Immunomodulators]. PMID- 3291027 TI - [Pathology of the upper digestive system: arguments on the diagnostic interview]. PMID- 3291028 TI - [Chronic neutrophil leukemia. Modern nosographic aspects]. PMID- 3291029 TI - Identification of Leishmania donovani amastigotes in canine tissues by immunoperoxidase staining. AB - This paper describes the demonstration of Leishmania donovani amastigotes in canine tissues by immunoperoxidase staining. An indirect immunoperoxidase method was applied to the organs of 20 dogs in which leishmaniasis was previously diagnosed. Haemosiderin pigment was eliminated with 5 per cent oxalic acid. Amastigotes of L donovani appeared as dark brown stained bodies which contrasted with haematoxylin stained host cells. No positively stained amastigotes could be seen in any of the sections incubated with control serum. The organs which more frequently showed leishmanids were: skin (macrophages and fibroblasts), liver, spleen, lymph nodes and bone marrow. In a few cases amastigotes were seen in kidneys, gut, adrenal glands, eyes and testicles. This technique is simple to perform, gives consistent results and allows unequivocal histopathological diagnosis of canine leishmaniasis. PMID- 3291031 TI - Use of immunosorbent-purified antigens of Fasciola hepatica in enzyme immunoassays. AB - A monoclonal antibody specific for the T1 tegumental antigen of Fasciola hepatica was used as a solid-phase immunosorbent for the purification of T1 antigen from homogenised mature F hepatica. Material fractionated by this technique was successfully used in enzyme-linked immunoassays to detect antibodies to F hepatica in sera from sheep and cattle. Species differences in response to infection by F hepatica were demonstrated. PMID- 3291030 TI - Fasciola hepatica: studies on vaccination of rats and mice with a surface antigen prepared from fluke homogenate by means of a monoclonal antibody. AB - T1 tegumental antigen was isolated from a homogenate of eight- to 10-week-old Fasciola hepatica using a T1-specific monoclonal antibody bound to sepharose in an antibody-affinity column. Rats and mice were vaccinated with T1 antigen in Freund's complete adjuvant, and control groups received equivalent amounts of non T1 antigen (eluted from the antibody-affinity column) or ovalbumin. On completion of the immunisation programme, serum samples were collected for ELISA and IFA testing. The animals were challenged by oral infection with F hepatica metacercariae or, for several vaccinated rats, by intraperitoneal transplantation of live adult flukes. At autopsy, worm-burden and liver damage was assessed for each animal and the condition of transplanted flukes was examined. Comparison of test and control groups of animals showed that neither T1 nor non-T1 antigens provided significant protection against challenge, although specific antibody responses against the appropriate sensitising antigen were engendered. Flukes transplanted to the peritoneal cavity of immunised rats survived without damage, although they became encased in hollow fibrous capsules of host origin. The results lend support to the pre-existing concept that glycocalyx turnover by discharge of T1 secretory bodies at the apical surface of migrating flukes provides an efficient means of protection for the parasite against host immunity. PMID- 3291032 TI - Freeze-fracture analysis of the respiratory cilia from the bronchial mucosa of a patient with primary ciliary dyskinesia. AB - Respiratory cilia of the bronchial mucosa from a 5-year-old boy with clinical evidence of classical Kartagener's syndrome (situs inversus, bronchiectasis and sinusitis) were first examined by means of transmission electron microscopy for identification of the axonemal defects described as typical for primary ciliary dyskinesia (PCD). Additional oscillography was performed on the cilia in vitro, which showed absence of a coordinated ciliary beat frequency. After clear classification of the case as PCD, a freeze-fracture examination of the respiratory cilia was performed, which revealed a higher density of intramembrane particles on the outer fracture face (E-face) than on the inner fracture face (P face). The results were discussed with regard to probable pathogenetic aspects on PCD. PMID- 3291033 TI - [Late ventricular potential]. PMID- 3291035 TI - [A case of left atrial myxoma complicated with acute myocardial infarction]. PMID- 3291034 TI - [Acute effects of prostaglandin I2 analogue (OP-41483, alpha-CD) on the disturbances of pulmonary circulation with right ventricular failure]. PMID- 3291036 TI - [Cerebral amyloid angiopathy]. PMID- 3291038 TI - [Thrombosis of the central vein of the retina and cerebral ischemia]. PMID- 3291040 TI - [Epidemiology of cerebral aging and the influence of this on the health of aged subjects]. PMID- 3291039 TI - [Cerebral manifestations of necrotizing angiitis]. PMID- 3291037 TI - [Experimental models in cerebral ischemia: application to the study of duxil]. PMID- 3291041 TI - Terodiline in the treatment of diurnal enuresis in children. AB - Efficacy and tolerance of the anticholinergic and calcium antagonistic drug terodiline (Mictrol) were investigated in comparison to placebo in 42 children with diurnal enuresis. The study was double-blind with a modified cross-over design with 2 treatment periods of 4 weeks. Terodiline in a daily dose of 25 mg was well tolerated. A statistically significant decrease in the number of wet episodes per day was found with terodiline when compared to placebo. In addition a high patient preference for terodiline was observed. This study shows that terodiline is effective in the treatment of daytime enuresis in children. The low incidence of side-effects also favours the use of terodiline in children. PMID- 3291042 TI - Multiple reading procedures: the performance of diagnostic tests. AB - This paper examines the effects on sensitivity and specificity of various multiple reading procedures. Multiple reading procedures entail the performance of a diagnostic test several times and consequent assignment of the subject to an 'affected' or 'unaffected' group. A Unanimity rule (that is, all tests must be positive) leads to the largest predictive value positive, but may have unacceptably low sensitivity. The rule which classifies the subject as positive based on the majority of the tests increases both the sensitivity and specificity of the individual test. Variability of subjects' sensitivity and specificity (that is, case of correct diagnosis on a test) affects the performance of these rules. We also study alternative procedures in which the final test is a better, but more expensive, test. PMID- 3291043 TI - The relative value of cytometry and cytology in the management of bladder cancer: the Memorial Sloan-Kettering Cancer Center experience. AB - The flow cytometric studies presented herein are based almost entirely on DNA measurements and represent an early application of this diagnostic test. Nevertheless, the MSKCC experience with FCM has demonstrated that it is technically feasible and clinically useful. The sensitivity of FCM is in the range of 80% to 85% overall, and is superior to that of conventional voided or bladder wash cytology. In the absence of inflammation secondary to infection, calculi, or intravesical agents such as BCG, the specificity is greater than 90%. In the presence of inflammation, FCM appears to be less specific than conventional cytology. A potential advantage of FCM over cytology is the quantitative nature of the examination permitting comparisons of sequential examinations. Also, there are refinements in technique that hold promise of increasing the accuracy or clinical usefulness of FCM, eg, the joint measurements of DNA and differentiation antigens defined by monoclonal antibodies. Yet, despite the current and potential advantages of FCM, voided urinary cytology continues to be the procedure of choice for detection and monitoring urothelial carcinoma, not only because of our long experience and better understanding of this test, but because of its proven high specificity, because it is noninvasive, widely available, and may help to detect upper tract or urethral tumors. PMID- 3291044 TI - Immunopathology--new help for the clinician. PMID- 3291045 TI - Flow cytometry in genitourinary malignancies using paraffin-embedded material. AB - This review summarizes the current state of flow cytometric analysis of GU neoplasms using paraffin-embedded materials. Future investigation using this method should take advantage of the ability to examine laboriously generated clinical series retrospectively. It will be important for investigators to control for covariance of all other clinical parameters with multivariate analysis. In addition, patient groups preferably should be clearly and somewhat narrowly defined, and uniformly treated. From carefully performed studies we may learn ways in which flow cytometric measurements may be used to prognosticate with greater precision, and to more objectively stratify patients to appropriate treatments. PMID- 3291046 TI - A newer form of bladder substitute based on historical perspectives. PMID- 3291047 TI - [Asthma and sports]. PMID- 3291048 TI - [Calcium antagonists in the treatment of arterial hypertension]. PMID- 3291049 TI - [The clinical value of anorectal manometry]. PMID- 3291050 TI - [Endoscopic treatments. Etiopathogenesis and medical treatment of cholesterol lithiasis]. PMID- 3291052 TI - [Streptococcal tonsillitis: bacteriological and epidemiological problems in pediatric practice]. PMID- 3291053 TI - [Prognostic and therapeutic aspects of prostatic carcinoma]. PMID- 3291054 TI - [The elucidation of acute lower intestinal bleeding]. PMID- 3291055 TI - [Doppler blood flow velocity registration in obstetrics]. PMID- 3291056 TI - [Comparative effectiveness of long-term treatment of patients with rheumatoid arthritis by using gold salts and D-penicillamine]. PMID- 3291057 TI - [Comparative effectiveness of methotrexate, azathioprine and cyclophosphamide in the treatment of rheumatoid arthritis]. PMID- 3291058 TI - [Arthrographic evaluation of the pathology of soft tissues in the complex examination of the shoulder joints with different degrees of motor dysfunction in patients with rheumatoid arthritis]. PMID- 3291059 TI - [Functional state of the musculo-ligament system of the knee joint in patients with gonarthrosis]. PMID- 3291051 TI - Possible mechanisms of the anaerobic threshold. A review. AB - The anaerobic threshold consists of a lactate threshold and a ventilatory threshold. In some conditions there may actually be 2 ventilatory thresholds. Much of the work detailing the lactate threshold is strongly based on blood lactate concentration. Since, in most cases, blood lactate concentration does not reflect production in active skeletal muscle, inferences about the metabolic state of contracting muscle will not be valid based only on blood lactate concentration measurements. Numerous possible mechanisms may be postulated as generating a lactate threshold. However, it is very difficult to design a study to influence only one variable. One may ask, does reducing F1O2 cause an earlier occurrence of a lactate threshold during progressive exercise by reducing oxygen availability at the mitochondria? By stimulating catecholamine production? By shifting more blood flow away from tissues which remove lactate from the blood? Or by some other mechanism? Processes considered essential to the generation of a lactate threshold include: (a) substrate utilisation in which the ability of contracting muscle cells to oxidise fats reaches maximal power at lactate threshold; and (b) catecholaminergic stimulation, for without the presence of catecholamines it appears a lactate threshold cannot be generated. Other mechanisms discussed which probably enhance the lactate threshold, but are not considered essential initiators are: (a) oxygen limitation; (b) motor unit recruitment order; (c) lactate removal; (d) muscle temperature receptors; (e) metabolic stimulation; and (f) a threshold of lactate efflux. Some mechanisms reviewed which may induce or contribute to a ventilatory threshold are the effects of: (a) the carotid bodies; (b) respiratory mechanics; (c) temperature; and (d) skeletal muscle receptors. It is not yet possible to determine the hierarchy of effects essential for generating a ventilatory threshold. This may indicate that the central nervous system integrates a broad range of input signals in order to generate a non-linear increase in ventilation. Evidence indicates that the occurrence of the lactate threshold and the ventilatory threshold may be dissociated; sometimes the occurrence of the lactate threshold significantly precedes the ventilatory threshold and at other times the ventilatory threshold significantly precedes the lactate threshold. It is concluded that the 2 thresholds are not subserved by the same mechanism. PMID- 3291060 TI - [Condition of the kallikrein, coagulation and fibrinolytic systems of the blood in patients with osteoarthrosis]. PMID- 3291061 TI - [Effectiveness of the method of ultraphonophoresis of sex hormones in osteoarthrosis deformans]. PMID- 3291063 TI - [Neurologic disorders in patients with psoriatic arthropathy]. PMID- 3291062 TI - [Clinical aspects, prognosis and effectiveness of glucocorticoid therapy of glomerulonephritis in adults with hemorrhagic vasculitis]. PMID- 3291065 TI - [Dysphagia lusoria in a patient with systemic scleroderma]. PMID- 3291064 TI - [Current status of the problem of seronegative rheumatoid arthritis]. PMID- 3291066 TI - [Diagnostic value of various hematological indicators in juvenile rheumatoid arthritis]. PMID- 3291067 TI - [The methods of studying the motor function of the arm in the shoulder girdle]. PMID- 3291068 TI - [Classification of systemic vasculitis and elaboration of its clinical diagnosis]. PMID- 3291069 TI - [Problem of classification and nomenclature of rheumatic diseases]. PMID- 3291070 TI - [The blood protein system in therapeutic plasmapheresis in patients with rheumatoid arthritis]. PMID- 3291071 TI - [Complications of tracheotomy]. AB - The complications of tracheotomy are reviewed and divided into two categories: early and late complications depending on whether the cannula has been removed or remains in situ. In the acute period, severe haemorrhages (0.3 to 2%) and oesophagotracheal fistulae (0.5 to 2%) result from a conflict between cannula and trachea during prolonged intensive care. Cardiac arrhythmia is frequent during aspiration (35%) but rarely lethal. Various technical problems related to the tracheotomy material are common (4 to 6%) and often very serious. Air leakage is represented mainly by severe pneumothorax (1 to 5%) under artificial ventilation. Tracheotomy wound infections (0.5 to 3.5%) may facilitate pulmonary superinfections (15 to 30%) which have a 5 to 8.5% mortality rate. In the acute phase, the overall mortality rate due to the tracheotomy itself is 1.7% (40 deaths in the 2,692 tracheotomies reviewed). The main post-decannulation complication is tracheal stenosis. The incidence of severe stenosis (more than two-thirds of the tracheal diameter) varies from 8 to 12%. Stenosis is difficult to diagnose unless endoscopic examination is routinely performed. The classical treatment is surgical, but laser is helpful in this as in granulomas. In patients with in-dwelling cannula, granulomas may be responsible for pain, obstruction and bleeding which can be avoided by using an adequate equipment. Chronic invasion of the bronchi by Gram-negative organisms is almost constant and results in episodes of superinfection. Finally, patients with a permanent cannula often have psychological and social problems influencing their quality of life. PMID- 3291073 TI - Echinococcus strains in Europe: a review. AB - In European countries the following final/intermediate host assemblages of Echinococcus granulosus are known to occur: (a) dog/sheep; (b) dog/horse; (c) dog/cattle; (d) dog/pig, (e) dog/reindeer (= "northern form" of E. granulosus). The parasites involved in cycles a-d have been identified as distinct strains in various countries. Epidemiological aspects relevant to intraspecific variations and strain characteristics are described. In E. multilocularis there are some indications for intraspecific variability but it is yet unknown whether or not they are of epidemiological or other significance. There is clear evidence that E. multilocularis, the dog/sheep strain and the "northern form" of E. granulosus are infective for humans; the status of the other strains regarding infectivity to man is still unclear. PMID- 3291072 TI - [Reduction using an immunomodulator of the level of respiratory infections in chronic bronchitis]. AB - Fifty-six patients with recurrent bronchopulmonary infections associated with chronic bronchitis were randomly allocated to 2 groups, to assess whether treatment with an immunomodulator, Diribiotin CK, could enhance resistance to infection. The double-blind, placebo-controlled prospective trial over a 9 month period showed that this immunomodulator was well tolerated and significantly reduced the rate of respiratory tract infection. The drug also significantly reduced the prescribing of antibiotic medication and the rate of absenteism from work. These effects have been demonstrated in a rigorously designed clinical study. This is the first time that a clear clinical activity has been attributed to an inducer of soluble mediators of immunity. PMID- 3291075 TI - The use of human plasmas and plasma-depleted blood fractions in the in vitro cultivation of the malaria parasite Plasmodium falciparum. AB - The decreasing availability of whole blood and serum from blood banks led us to investigate the suitability of untreated and heat-treated human plasma, as well as of plasma-depleted blood fractions, for routine culturing of P. falciparum. The practical problems of using plasma instead of serum were addressed and the effect of storage conditions tested. We conclude that plasma is a convenient and effective substitute for serum, and that plasma-depleted blood fractions are as receptive to parasite infection as unprocessed blood. PMID- 3291074 TI - Chemotherapy of onchocerciasis with high doses of diethylcarbamazine or a single dose of ivermectin: microfilaria levels and side effects. AB - Fifty adult male subjects with moderate to heavy onchocerciasis from the Liberian rain forest were selected for a double-blind placebo-controlled chemotherapy study. The effects of high doses of diethylcarbamazine (DEC) - 30 mg/kg/d - over one week preceded by a one week initial treatment with normal oral doses of DEC or DEC lotion were compared with a single dose of ivermectin (150 micrograms/kg) and placebo. During the initial treatment DEC tablets or lotion caused distinctly more frequent and severe reactions than did invermectin. The reactions to ivermectin did not differ from those of the placebo patients. High doses of DEC caused, in about half of the patients, headache, dizziness, nausea or vomiting. DEC markedly increased the number of corneal microfilariae and of corneal opacities compared to ivermectin. All changes resolved with a return to pretreatment findings two months after treatment. The three treatment groups showed no differences at the ten months follow-up. In all treated patients skin microfilaria counts fell almost to zero by the end of the two week therapy. In the ivermectin group microfilaria counts remained significantly lower than in the DEC patients at the two and ten months examinations. In summary, ivermectin was much better tolerated than DEC and had a longer lasting effect on the microfilariae in the skin. Since high doses of DEC were less effective and caused more frequent and severe side effects, this approach cannot be recommended for treatment of onchocerciasis. PMID- 3291077 TI - [Kidney metastases in computerized tomography]. AB - The CT image of renal metastases is described for 29 patients. The most frequent primary tumour was the bronchial carcinoma, followed by melanoma and cervical carcinoma. In 12 of 29 patients (41%) the metastases occurred bilaterally, in 17 (59%) unilaterally. 9/29 (31%) had solitary, 20/29 (69%) multiple renal metastases. In 19 (66%) these had a size of up to 3 cm and were situated intraparenchymally. Space-occupying growths up to a size of 10 cm which grew exophytically were seen in melanoma and carcinoma of the larynx and chorion. In the plain CT the metastases presented isodense or slightly hypodense in 25 of 27 examinations (93%). After application of contrast medium all presented hypodense with the exception of metastases of a chorionic carcinoma. PMID- 3291076 TI - Isoenzyme characterisation of 15 stocks of Trypanosoma evansi isolated from camels in the Sudan. AB - Fifteen stocks of T. evansi isolated in Sudan were compared using isoenzyme banding patterns. Differences between the stocks were found but overall they formed a homogeneous group. The results were similar to those obtained for other stocks of T. evansiisolated from Kenya, W. Africa, S. America and Kuwait and indicate that little genetic variation occurs in T. evansi over its geographical range. This low variation may have important implications in the development of new methods of controlling trypanosomiasis caused by T. evansi. PMID- 3291078 TI - [Unusual size and growth rate of a hypernephroma]. AB - No reports have so far been published on hypernephroma sizes of more than 20 cm. We report on a histologically confirmed hypernephroma of an unusual size of almost 40 cm as identified both by CT and sonography that had developed within a period of three years. PMID- 3291079 TI - [Visceral manifestations of diffuse scleroderma]. PMID- 3291080 TI - [Epidemiology and its use in assessing the practice of diabetology]. PMID- 3291081 TI - [Methods of measuring the mechanical stresses on the human lumbar spine and their results]. AB - The authors in a review of the literature and their personal studies, report the various measurements methods of the stresses exerted on the lumbar spine, with their results. This study comprises three chapters: study of an isolated spinal segment, static study of the lumbar spine and dynamic study of the lumbar spine. PMID- 3291082 TI - [Innervation of the ligaments of the lumbar spine in man]. PMID- 3291083 TI - Sleep-induced GH release in otherwise GH deficient children having short stature; a possibly new variant of GH neurosecretory dysfunction (GHND). AB - Sleep and exercise are considered physiologic stimuli of growth hormone (GH) release from the pituitary. They were used to some extent for the assessment of GH reserve in growth disorders of supposedly pituitary origin. In order to better establish the diagnostic value of the sleep test, we studied 34 children of both sexes aged 6-14 having various degrees of shortness of stature associated with bone age retardation (range of the latter: 3-10 years). Eight healthy controls of the same age were also subjected to the sleep test. The latter was begun at 10:00 11:00 a.m. generally in a dark room under polygraphic control. The subjects were fed a standard breakfast at 8:00-8:30 a.m. After thirty minutes of steep or after reaching the IVth stage of slow-wave sleep, the children were awakened and samples of venous blood for GH determinations were drawn. Two other GH reserve tests were also performed in other days, usually insulin-induced hypoglycemia and glycine intravenous loading. Except sleep, no other GH provocative tests were performed in controls. In normal GH reserve children (21/34) according to other tests, the sleep test was positive (i.e. peak values greater than 15 microU/ml) in 7 cases and the mean GH response was not significantly smaller than the peak recorded after insulin-induced hypoglycemia. In abnormal GH reserve, presumably hypopituitary children (13/34) according to other tests, the sleep confirmed the other tests in 8 cases. In five cases of clinically and endocrinologically "hypopituitary" dwarfism, the sleep test revealed a normal response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291085 TI - Cimetidine responders in non-ulcer dyspepsia. AB - The effect of cimetidine and placebo was examined in 123 patients with non-ulcer dyspepsia (NUD) by means of a 12-day multi-crossover model with 5 regular interchanges between cimetidine and placebo. The evaluation of effect in individual patients was based on the number of times cimetidine was associated with less symptoms than the preceding or following placebo period. If cimetidine had no effect, the probability of being defined as a cimetidine responder was 25%. In general, cimetidine was associated with less symptoms than placebo (p less than 0.0001). Forty patients were identified as cimetidine responders (R) and the remaining patients were termed non-responders (NR). Symptoms compatible with gastroesophageal reflux were significantly more frequent in R than in NR, whereas the opposite was true for symptoms of the irritable colon syndrome. The ability of symptoms selected by stepwise logistic regression to predict response to cimetidine showed at best a sensitivity of 75% and a specificity of about 65%. No differences were found between R and NR with regard to acid secretion, endoscopic and histologic findings, or the result of an acid perfusion test. The present study supports the existence of a subgroup of cimetidine responders among patients with NUD characterized by symptoms suggestive of gastroesophageal reflux disease in the absence of confirmatory objective evidence. PMID- 3291084 TI - Serum cathodic trypsin-like immunoreactivity, pancreatic lipase, and pancreatic isoamylase as diagnostic tests of chronic pancreatitis or pancreatic steatorrhea. AB - We compared serum concentrations of cathodic trypsin-like immunoreactivity, pancreatic lipase, and pancreatic isoamylase as diagnostic tests of chronic pancreatitis (and of pancreatic steatorrhea in the 41 patients with steatorrhea) in 105 patients (57 men, 48 women) consecutively investigated because of clinical suspicion of chronic pancreatitis. Chronic pancreatitis (36 patients), pancreatic steatorrhea (24 patients), and other diseases were diagnosed without knowledge of the serum levels of the three enzymes. When evaluated by means of receiver operating characteristic curves, no differences were found in diagnostic performance of the enzymes with regard to chronic pancreatitis or pancreatic steatorrhea. The sensitivity and specificity for recognition of chronic pancreatitis ranged from 0.306 to 0.444 and from 0.942 to 0.986 when the discrimination values were chosen to give highest efficiencies. The similar ranges for pancreatic steatorrhea were 0.500-0.708 and 0.882-0.941. In conclusion, none of the three enzymes had any advantage over the others as diagnostic tests of chronic pancreatitis or of pancreatic steatorrhea. Only positive test results have clinical importance because of the low sensitivities of the three enzymes. PMID- 3291086 TI - Suppression of emotions in essential dyspepsia and chronic duodenal ulcer. A case control study. AB - It remains controversial whether psychologic factors contribute to the onset or chronicity of non-ulcer dyspepsia (NUD) and duodenal ulcer. Although such patients on conventional psychologic testing have no clearly defined specific personality type, an inability to express emotion, which may result in excessive autonomic arousal, has been suggested to be important on theoretic grounds. The aim of this study was to assess whether the latter defect is associated with the subgroup of NUD patients with essential dyspepsia and with patients with chronic duodenal ulcer. Eighty-one patients with essential dyspepsia and 53 patients with duodenal ulcer studied after endoscopy were compared with 82 randomly selected dyspepsia-free community controls. All were assessed with the Courtauld emotional control scale, a valid and objective self-report measure. Control of anger, anxiety, unhappiness, and total emotional control over negative reactions were similar in all three groups. It is concluded that patients with essential dyspepsia and duodenal ulcer who present for investigation are unlikely to repress emotional reactions consciously. PMID- 3291087 TI - Reduction in early recurrence of variceal bleeding by propranolol. AB - Survival after variceal bleeding depends greatly on the outcome of the immediate posthaemorrhagic period. This may in turn depend on the recurrence of bleeding. We therefore prospectively evaluated the influence of propranolol on the recurrence of variceal haemorrhage during the early period after the acute bleeding episode. Twenty consecutive patients with acute variceal haemorrhage and liver disease were randomly assigned to treatment either with propranolol or placebo orally for 14 days. Propranolol significantly decreased the rate of recurrence of variceal haemorrhage during this early period (p = 0.0028; 95% confidence interval in the placebo group, 90 +/- 20%; in the beta blocker group, 20 +/- 26%). Whereas a recurrence of variceal bleeding occurred in 9 of 10 patients in the placebo group, only 2 of 10 rebled during treatment with propranolol. These results suggest that propranolol may prevent rebleeding in the crucial early period after acute haemorrhage from oesophageal varices. PMID- 3291089 TI - The sweat chloride concentration and prolactin activity in cystic fibrosis. AB - The purpose of this study was to elucidate the possible relationship between defective PRL and elevated sweat Cl in CF patients. Full thickness human skin was grafted onto the back of immunoincompetent, nude congenitally athymic mice. This study indicated: 1) that when skin from CF patients with high sweat chloride concentrations was grafted, the chloride concentration of sweat from the grafts was the same as of sweat from grafts of normal skin; and 2) that administration of anti-hPRL to the mice bearing the CF grafts did not increase the chloride concentration of the sweat as it had in normal skin grafts. 3) that CF may involve defective PRL production leading to failure of regulation of Cl channels in affected epithelia, 4) that the athymic mouse is a useful model for studying PRL activity in the pathophysiology of sweating of CF patients. PMID- 3291088 TI - The effect of positive expiratory pressure versus forced expiration technique on tracheobronchial clearance in chronic bronchitics. AB - In a randomized cross-over trial, including a control measurement the effect of positive expiratory pressure (PEP) and forced expiration technique (FET) on tracheobronchial clearance was evaluated in eight chronic bronchitics with abundant sputum production (mean, 32 g/day). PEP consisted of PEP-mask breathing interspersed with breathing exercises, huffing, and coughing. FET consisted of postural drainage, breathing exercises, huffing, and coughing. Clearance was measured with a radio-aerosol technique. At 40 min after the start of therapy the mean clearance, expressed as percentage of the amount of radioactivity present at the start of therapy, was 32% after PEP, 53% after FET, and 15% in the control run. The difference between PEP, FET, and control was statistically significant (p less than 0.02). Sputum production during PEP and FET was larger than during the equivalent period of time in the control run. It is concluded that FET is more effective than PEP in enhancing tracheobronchial clearance. PMID- 3291090 TI - Evaluation of time interval difference digital subtraction fluoroscopy in patients with cystic fibrosis. AB - In this study the potential of thoracic subtraction fluoroscopy has been evaluated on the basis of our experience with this functional imaging modality in patients presenting with cystic fibrosis. The method, which consists of subtracting dynamic digital fluoroscopic images of the breathing chest in the time interval difference (TID) mode, applies to the study of the lucency variations during the respiratory cycle and provides dynamic functional information about ventilation and/or perfusion and diaphragmatic kinetics, without any injection and with minimal irradiation. To assess the validity of the TID procedure, our results were compared with standard roentgenography, clinical data, and scintigraphic findings, with emphasis on the latter. The limitations and advantages of TID compared with scintigraphy are discussed. Three groups of discrepancies emerge which do not discredit TID. TID offers rather the advantage of providing anatomic pictures and unique dynamic information, which is emphasized. PMID- 3291091 TI - Operative and postoperative non-surgical complications in diabetic patients undergoing renal transplantation. AB - Eighty-one insulin-dependent diabetic (19.7%) and 330 non-diabetic patients (80.3%) underwent renal transplantation between September 1977 and September 1981. Preoperatively, the diabetics had a higher incidence of ST-T-changes in ECG (62.2 vs. 39.8%) (p less than 0.001) as well as pulmonary congestion (14.5 vs. 5.2%) (p less than 0.05) and pleural effusion (10.1 vs. 4.5%) in chest X-rays than non-diabetic patients. The incidences of marked blood pressure changes and cardiac arrhythmias during anaesthesia did not differ between the groups, nor did the incidences of ischaemic heart attacks, pneumonia and pulmonary atelectasis in the chest X-rays during the first postoperative week. Diabetic patients had higher mortality during the first postoperative month (6/81; 7.4% vs. 4/330; 1.2%) (p less than 0.01) than non-diabetic patients. PMID- 3291092 TI - Haemostatic aspects of renal transplantation. AB - Platelet function and protein C activity and antigen level was studied in 31 renal transplant recipients and 10 healthy controls. The patients were divided into three groups: (I) cyclosporin treated, (II) azathioprine treated, and (III) azathioprine treated patients with chronic rejection. The platelet function in the renal transplant patients was normal and there was no difference between groups I and II. The specific activity of protein C was decreased in patients after renal transplantation and decreasing protein C activity and progressive renal failure was found to be positively correlated in the azathioprine treated groups. PMID- 3291093 TI - The value of computed tomography and ultrasound in assessment of pelvic lymph node metastases in patients with clinically locally confined carcinoma of the prostate. AB - With the aim of detecting any metastases in pelvic lymph nodes, computed tomography (CT) was performed in 42 patients with clinically localized prostatic carcinoma, and ultrasound (US) examination in 35 of them, prior to pelvic lymphadenectomy. CT was positive in only one patient, and US was negative in all examined patients. At lymph node dissection macrometastases were found in four patients and histopathologic examination revealed micrometastases in a further ten patients. It is concluded that in clinically locally confined prostatic carcinoma CT and US are insensitive in diagnosing pelvic lymph node metastases, and that lymph node dissection remains the only method for staging of the regional lymph nodes. PMID- 3291094 TI - Late-onset schizophrenia: an overview. AB - Onset of schizophrenia after the age of 40 has been a controversial topic. We reviewed more than 30 publications (mainly from Europe) on this subject. Many of the studies had methodological shortcomings, including problems in precisely dating the onset of schizophrenia. Nonetheless, it appears that a certain proportion of patients present for the first time with diagnosable schizophrenia after age 40. Late-onset schizophrenia is characterized by paranoid symptomatology, a high female:male ratio, an elevated prevalence of hearing loss and ocular pathology, schizoid or paranoid traits in premorbid personality, a tendency toward chronicity, and symptomatic improvement with neuroleptics. Family studies suggest that the prevalence of schizophrenia in relatives of late-onset schizophrenic probands is higher than that in the general population, but lower than that in relatives of earlier-onset schizophrenic probands. We believe that late-onset schizophrenia is a valid entity (or group of entities). Studies of the course, biological associations, neuropsychological performance, and pharmacological characterization of late-onset schizophrenia are warranted. PMID- 3291095 TI - Deficits in facial-affect recognition and schizophrenia. AB - It has been widely demonstrated that schizophrenic patients show a broad range of deficits in interpersonal skills. Recently, considerable attention has been focused on the ability of these patients to decode affective cues. This article reviews findings about facial-affect recognition in schizophrenia. While the literature on this topic is extensive, many investigations have suffered from significant methodological shortcomings. Strategies to resolve these shortcomings are presented. Possible relationships between problems of affect recognition and other symptoms that characterize schizophrenia are discussed. Neurological mechanisms of facial-affect recognition are reviewed and related to data on lateralized neurological impairment in schizophrenia. Suggestions for future research emphasize careful consideration of affect-recognition deficits in relation to other parameters of schizophrenia. PMID- 3291096 TI - Physical disease and schizophrenia. AB - Researchers have long speculated about the existence of a relationship between physical disease and schizophrenia. Psychodynamic and life-stress theories offer opposing predictions about the nature of this relationship. Unfortunately, the empirical research on this topic is often contradictory and frequently plagued by various methodological inadequacies. Despite the theoretical controversy and methodological problems, the present review of the empirical literature suggests that patients with schizophrenia may be at increased risk for breast cancer and possibly for cardiovascular disease. On the other hand, patients with schizophrenia seem to be at reduced risk for developing either rheumatoid arthritis or lung cancer. The epidemiological investigations are worth pursuing since the convincing demonstration of a relationship between schizophrenia and a particular physical disease would yield valuable information about the pathogenesis of both disorders. Future research on this topic will need to consider the possible mediating effects of third variables, such as smoking habits, which may be associated with schizophrenia and which also are, independently, recognized as risk factors for particular physical disorders. PMID- 3291097 TI - REHAB: a new assessment instrument for chronic psychiatric patients. AB - The renewed interest in the care and treatment of chronic psychiatric patients has led to an awareness of the need for improved assessment methods for this group. This article describes the development of REHAB, a behavior rating scale for use with people with chronic psychiatric disability, which has been carefully designed with respect to content, format, and ease of use. The article also draws together the various factor-analytic, reliability, validity, and sensitivity-to change studies that provide the basic psychometric evidence for the scale's value. REHAB is presented as an integrated package of materials with special attention paid to training of raters and simplicity of interpretation. It has been used for a variety of different assessment purposes, in both research and clinical settings. PMID- 3291098 TI - Behaviour of cancellous bone graft with and without periosteal isolation in striated muscle. An experimental study. AB - The capacity of the periosteum to inhibit resorption of cancellous bone grafts into muscle was investigated in 34 four- to six-week-old rabbits. In 17 experiments the periosteum was wrapped around the grafts with the cambium layer facing the bone, and in seven experiments with the cambium layer facing the muscle. In the control group of 10 experiments there was no periosteal wrapping around the bone grafts. In Series 1 with the cambium layer of the periosteum facing the bone, after 20 weeks a tubular bone with Haversian system and bone marrow was seen. The transplants were surrounded by normal-looking periosteum. Bone formation from the periosteum occurred through enchondral ossification. Inductive bone growth was observed from the cancellous graft. In Series 2 with the cambium layer facing the surrounding muscle tissue, after 20 weeks two laminar bone blocks with periosteum in between and surrounding each block was observed. In the control series without periosteal covering, after 20 weeks only fibrous tissue remained in the transplantation site. It is obvious that periosteal isolation of cancellous bone grafts inhibits their resorption when transplanted into muscle in young animals. PMID- 3291100 TI - Xerostomia due to Sjogren's syndrome. Diagnostic criteria, treatment and outlines for a continuous dental care programme and an open trial with Sulfarlem. AB - The initial evaluation of 25 patients suspected of suffering from Sjogren's syndrome (SS) disclosed that sialopenia and glandular atrophy without focal sialo adenitis was the second most common cause, after SS itself, of patient complaints. This emphasizes the importance of conclusive diagnostic criteria to prevent overdiagnosis and to form a sound basis for management of xerostomia patients. We found that at the time of diagnostic evaluation, the dental status of our SS patients did not differ from that of the normal Finnish population. This suggests that SS patients can greatly benefit from adequate dental care, assuming that attention is paid to early diagnosis and management. Accordingly, the diagnostic and therapeutic approach needs to be multidisciplinary. We present our current programme for oral and dental care of xerostomia patients and the results of an open trial with Sulfarlem (trithioparamethoxyphenylpropene) which was found not to be the drug of choice in the treatment of dry mouth associated with SS. PMID- 3291101 TI - AIDS epidemics--part two. PMID- 3291099 TI - Timegadine: more than a non-steroidal for the treatment of rheumatoid arthritis. A controlled, double-blind study. AB - Timegadine is a tri-substituted guanidine derivative which inhibits both arachidonate cyclo-oxygenase and lipoxygenase activity. In a 24-week randomized double-blind controlled trial, timegadine 500 mg/day was compared with naproxen 750 mg/day in two groups of 20 patients with active rheumatoid arthritis. In the timegadine group, significant improvements were seen in both biochemical and clinical markers of disease activity, i.e. ESR, serum IgG and IgM, leukocyte and platelet counts, duration of morning stiffness, Ritchie index, number of swollen joints, pain, and general condition. In the naproxen group, only the Ritchie index improved. Differences between treatments, when present, were always in favour of timegadine. Serum alkaline phosphatase rose during the first 8 weeks of treatment in the timegadine group. A transient rise was also seen in the naproxen group. The side effects reported were mainly gastrointestinal and allergic, the latter being more frequently found in the timegadine group. Timegadine is superior to naproxen in controlling disease activity in rheumatoid arthritis, and appears to possess disease-modifying properties. PMID- 3291102 TI - Passive smoking and lung cancer. The Ipsen lecture 1987. PMID- 3291103 TI - Chylothorax as a complication of aortocoronary bypass. Two case reports and a review of the literature. AB - Iatrogenic chylothorax is a well-recognized complication following thoracic surgery, but is a rare occurrence after aortocoronary bypass. Only two cases have been previously reported. Two additional cases from our hospital are presented. All four male patients responded to conservative management within two weeks of initiation of treatment. Only 12 cases of chylothorax following median sternotomy have been reported (nine women and three men). Five of the nine women required surgical exploration after a course of unsuccessful management ranging from 14 to 26 days. The cause of the chylothorax was considered to be injury to lymphatic collaterals in the anterior mediastinum, which resulted in a retrograde chyle flow; the main duct remained intact. This article reviews the normal anatomy of the thoracic duct and variations of chylothorax, and describes the mechanism of injury in aortocoronary bypass, the prevention of this complication, and the results of treatment. PMID- 3291104 TI - [Induction of myelogenous differentiation: a therapeutic possibility for preleukemia and acute leukemia?]. AB - Human acute myelogenous leukemia often arises from a transformation at the stem cell level leading to a block in differentiation. The malignant cell, therefore, remains in the proliferative pool and rapidly accumulates. In preleukemia, also known as myelodysplastic syndromes, the malignant clone is already established, leading to disturbed hematopoiesis. One therapeutic approach, therefore, might be to overcome this block in differentiation and thus shift the cell from the proliferative into the differentiating pool. For several years now research in leukemia has focused on study of the proliferation and differentiation of normal and leukemic hematopoietic cells. Numerous substances have been identified which are able to trigger differentiation in myeloid cells, including the retinoids, vitamin D, tumor necrosis factor and hematopoietic hormones. The possible role of these agents in the treatment of preleukemia and acute myelogenous leukemias is discussed. PMID- 3291105 TI - [Cystic adventitial degeneration of the popliteal artery: an unusual cause of intermittent claudication]. AB - The case is reported of a 44-year-old patient without cardiovascular risk factors who complained of typical intermittent claudication. Arteriography and echography led to the diagnosis of cystic adventitial disease of the popliteal artery. Percutaneous puncture under CT control was unsuccessful and surgical resection of the cystic formation was performed. This rare etiology is discussed in relation to the differential diagnosis of intermittent claudication, with particular reference to young patients. PMID- 3291106 TI - [Pyogenic sacroiliitis. Review of 8 personal cases and 200 cases from the literature]. AB - Eight patients with a pyogenic infection of the sacroiliac joint are compared to 200 published cases. In all our patients the disease began with fever and immobilizing low back and buttock pain. All had bacterial growth in the blood cultures. Five out of 6 patients did not show inflammatory signs in the initial plain roentgenogram. Tc-99m scan was initially positive in 4 out of 6 patients. In 2 patients only the second scan, at 13 and 15 days respectively, was positive. All but one patient had a 4-6 week course of intravenous antibiotics. Three patients underwent surgery for abscesses or intraarticular sequestra. One patient with a small psoas abscess had only medical treatment under CT monitoring. All the patients recovered. From our observations and the literature we conclude that pyogenic sacroiliitis is often not recognized initially. Wrong diagnoses such as sepsis of unknown origin, appendicitis, discal hernia etc. can be avoided if pyogenic sacroiliitis is sought in a systematic fashion. The clinical diagnosis can be confirmed by bone scan, to be repeated at a later stage of disease (i.e. two weeks after onset) if the first examination is inconclusive. PMID- 3291107 TI - [Friedrich Theodor Althoff (1859-1908) and the German universities around 1900]. AB - Usually the diplomat Wilhelm von Humboldt (1767-1835) is regarded as the creator of German supremacy in academic, especially medical education. Actually this role was played by the "bureaucrat" Friedrich Althoff (1839-1909), who directed German education from 1882 to 1907. His greatest accomplishment was the selection of the best professors. PMID- 3291108 TI - [Blood sedimentation--a simple and useful test?]. AB - The erythrocyte sedimentation rate is one of the most frequently used laboratory tests in clinical medicine. The sedimentation rate is determined by the aggregation of erythrocytes, in which plasmatic and erythrocytic factors are involved. Plasmatic factors include high-molecular proteins such as fibrinogen, globulins (immunoglobulins, especially IgM, alpha 2-globulins) and immune complexes (e.g. cryoglobulins). Albumin, a smaller protein with a spherical structure, decreases erythrocyte aggregation. Erythrocytic factors play an equally important role. Anemia and macrocytosis lead to an increase in sedimentation rate, whereas the presence of abnormal red cell shapes and deformability decrease the sedimentation rate. The diversity of factors involved often renders the interpretation of sedimentation rates difficult. Normal values for females are higher than for males and increase with age. The sedimentation rate is not useful for screening of asymptomatic subjects, e.g. the detection or exclusion of a malignant tumor. It is appropriate in monitoring the course of diseases such as arteritis temporalis or polymyalgia rheumatica. The sedimentation rate should therefore be used in a more restrictive and selective manner. PMID- 3291109 TI - [Clinical epidemiology: definitions, uses and reasons for development in Switzerland]. AB - Clinical epidemiology is the most currently used name for a comparatively new branch of medicine covering a certain number of activities related to the practice of clinical medicine, but using epidemiological techniques and methods. Clinical epidemiology has only just begun to be known in Europe, whereas units are being increasingly developed and expanded in North America, particularly within the clinical departments of hospitals. The methods it offers are valid for both practicing physicians and hospital doctors (or those being trained in hospitals) and serve the purpose of promoting a better quality medical service, especially where a more adequate evaluation of the effectiveness of diagnostic methods, therapy and prognosis in medicine is concerned. Clinical epidemiology proposes a methodology of medical reasoning and of decision-making, as well as techniques intended to facilitate the indispensable task of keeping up with advances in medical knowledge. PMID- 3291110 TI - [The role of various forms of ribomunyl in recurrent respiratory tract infections]. AB - Ribomunyl was administered in an open clinical trial for the treatment of chronic repetitive infectious diseases of the upper respiratory tract. Two groups of patients were treated with either Ribomunyl aerosol (n = 19) or with Ribomunyl aerosol and injections (n = 17); a third group of 17 patients, serving as a control group, did not receive treatment with either form of Ribomunyl. The treatment lasted two months and was followed by an observation period of another four months. The patients treated with Ribomunyl showed a distinct improvement compared to the untreated group. Ribomunyl was generally well tolerated. Plasma antibodies determined before, during and after the trial showed a clear-cut relationship between the increase in plasma antibody levels and improvement of clinical picture. PMID- 3291112 TI - Crohn's disease? PMID- 3291111 TI - [Dental care of patients with bone marrow transplants. Preventive program and initial results]. PMID- 3291113 TI - The Lister steam spray in Aberdeen. AB - A Lister 'steam spray producer' in the possession of Aberdeen University is described. The introduction of antiseptic surgery to Aberdeen by Alexander Ogston and the subsequent adoption of the spray and its enthusiastic use by him is recounted, with emphasis on the final years of its employment as part of the antiseptic ritual. PMID- 3291114 TI - The expert witness in psychology and psychiatry. AB - The involvement of psychologists and psychiatrists within the legal arena continues to grow rapidly but remains highly controversial. Extensive research on clinical judgement provides a scientific basis for clarifying the growing disputes about the values of such professional activities. Studies show that professionals often fail to reach reliable or valid conclusions and that the accuracy of their judgements does not necessarily surpass that of laypersons, thus raising substantial doubt that psychologists or psychiatrists meet legal standards for expertise. Factors that underlie the research findings and implications for courtroom testimony are discussed. PMID- 3291115 TI - The protein kinase family: conserved features and deduced phylogeny of the catalytic domains. AB - In recent years, members of the protein kinase family have been discovered at an accelerated pace. Most were first described, not through the traditional biochemical approach of protein purification and enzyme assay, but as putative protein kinase amino acid sequences deduced from the nucleotide sequences of molecularly cloned genes or complementary DNAs. Phylogenetic mapping of the conserved protein kinase catalytic domains can serve as a useful first step in the functional characterization of these newly identified family members. PMID- 3291116 TI - Specification of cerebral cortical areas. AB - How the immense population of neurons that constitute the human cerebral neocortex is generated from progenitors lining the cerebral ventricle and then distributed to appropriate layers of distinctive cytoarchitectonic areas can be explained by the radial unit hypothesis. According to this hypothesis, the ependymal layer of the embryonic cerebral ventricle consists of proliferative units that provide a proto-map of prospective cytoarchitectonic areas. The output of the proliferative units is translated via glial guides to the expanding cortex in the form of ontogenetic columns, whose final number for each area can be modified through interaction with afferent input. Data obtained through various advanced neurobiological techniques, including electron microscopy, immunocytochemistry, [3H]thymidine and receptor autoradiography, retrovirus gene transfer, neural transplants, and surgical or genetic manipulation of cortical development, furnish new details about the kinetics of cell proliferation, their lineage relationships, and phenotypic expression that favor this hypothesis. The radial unit model provides a framework for understanding cerebral evolution, epigenetic regulation of the parcellation of cytoarchitectonic areas, and insight into the pathogenesis of certain cortical disorders in humans. PMID- 3291117 TI - Yeast KEX2 endopeptidase correctly cleaves a neuroendocrine prohormone in mammalian cells. AB - Mammalian cell lines (BSC-40, NG108-15, and GH4C1) that cannot process the murine neuroendocrine peptide precursor prepro-opiomelanocortin (mPOMC) when its synthesis is directed by a vaccinia virus vector were coinfected with a second recombinant vaccinia virus carrying the yeast KEX2 gene, which encodes an endopeptidase that cleaves at pairs of basic amino acid residues. mPOMC was cleaved intracellularly to a set of product peptides normally found in vivo, including mature gamma-lipotropin and beta-endorphin1-31. In GH4C1 cells (a rat pituitary line), product peptides were incorporated into stored secretory granules. These results suggest that the inability of any particular cell line to process a prohormone precursor is due to the absence of a suitable endogenous processing enzyme. PMID- 3291118 TI - Eye cancer gene linked to new malignancies. PMID- 3291119 TI - Soar: a unified theory of cognition? PMID- 3291120 TI - The RAD9 gene controls the cell cycle response to DNA damage in Saccharomyces cerevisiae. AB - Cell division is arrested in many organisms in response to DNA damage. Examinations of the genetic basis for this response in the yeast Saccharomyces cerevisiae indicate that the RAD9 gene product is essential for arrest of cell division induced by DNA damage. Wild-type haploid cells irradiated with x-rays either arrest or delay cell division in the G2 phase of the cell cycle. Irradiated G1 and M phase haploid cells arrest irreversibly in G2 and die, whereas irradiated G2 phase haploid cells delay in G2 for a time proportional to the extent of damage before resuming cell division. In contrast, irradiated rad9 cells in any phase of the cycle do not delay cell division in G2, but continue to divide for several generations and die. However, efficient DNA repair can occur in irradiated rad9 cells if irradiated cells are blocked for several hours in G2 by treatment with a microtubule poison. The RAD9-dependent response detects potentially lethal DNA damage and causes arrest of cells in G2 until such damage is repaired. PMID- 3291121 TI - [Surgical or conservative treatment of recent rupture of the lateral ligament of the upper ankle joint. Randomized clinical study]. PMID- 3291122 TI - [Storage-induced changes in autologous spongioid bone]. PMID- 3291124 TI - [Sonography of the abdomen in polytraumatized patients. Value of the method]. PMID- 3291125 TI - Complications of fractures and their healing. AB - The role of nuclear medicine studies in diagnosing late complications of fractures is described. Static bone scintigraphy is not helpful in predicting delayed or non-union of fractures. Several investigators have developed simple formulae comparing uptake in fracture site with adjacent or contralateral normal bone and described criteria that will predict problems with healing. These types of tests should only be used in patients who are at risk for delayed union. The scintigraphic diagnosis of infection complicating a fracture is difficult. Bone scintigraphy alone is not useful and combined 67Ga/99mTc MDP scanning has been disappointing. Most published series support the role in 111In WBC in this situation, but not all cases are correctly diagnosed. 111In (Chloride) cannot differentiate an infected from a delayed-healing fracture. Bone scintigraphy has a significant role in determining whether a bone graft is viable or not. Reflex sympathetic dystrophy is a rare complication of a fracture; it can be diagnosed by increased periarticular uptake on bone scan in all the joints of the affected part. Bone scintigraphy, especially when done with SPECT, is a very sensitive test for the diagnosis of avascular necrosis (AVN). PMID- 3291123 TI - [Ultrasound diagnosis of blunt soft tissue trauma]. PMID- 3291126 TI - Evaluation of metallic osseous implants with nuclear medicine. AB - Nuclear medicine has proven to have a valuable role in the evaluation of osseous metallic implants, particularly with joint prostheses, but can assist with evaluation of other appliances as well. The nuclear arthrogram has become an invaluable adjunct to simultaneously performed radiographic contrast arthrography. This application has been best evaluated in what is one of the most common of orthopedic prosthesis problems, namely, loosening of total hip prostheses. Experience indicates that both sensitivity and specificity of loosening of the femoral component can be increased to over 90% through combined use of nuclear with radiographic contrast arthrography. Furthermore the combination of routine skeletal scintimaging with the nuclear arthrogram adds a significant dimension to precise localizing of the nuclear arthrographics agent In-111 chloride. Nuclear medicine also plays an important role in further evaluating the presence of infection associated with metallic implants with In 111 WBC preparations being superior to Ga-67 as the radiopharmaceutical tracer. Infection has been detected with a sensitivity of 73% and a specificity of 93% in our series using combined In-111 WBC and simultaneous skeletal imaging with conventional Tc-99m MDP. Acute infections are more readily identifiable than chronic in association with prostheses. PMID- 3291127 TI - The child with acute leg pain. AB - Diagnostic imaging is an essential component in the evaluation of a child with acute lower extremity pain or limp. Most, but not all, of the etiologies are traumatic. Frequently, the history and clinical examination are not specific. Radionuclide bone imaging is extremely rewarding in these circumstances. It represents the most useful examination used in evaluating the pathophysiology and full extent of the disorder. This article discusses the clinical presentation, pathophysiology, and characteristic imaging observations in the more common problems associated with hip and/or leg pain. PMID- 3291128 TI - Options in camera technology for the bone scan: role of SPECT. AB - Planar imaging with current generation gamma cameras and tomographic imaging with current generation rotating camera single photon emission computed tomography (SPECT) systems provide excellent spatial resolution and good fidelity between image quantitation and activity levels. Their use in imaging the localization and clearance of skeletal imaging agents such as the Tc-99m labeled diphosphonates, Ga-67 citrate, and In-111 leukocytes offers a sensitive and accurate means to detect occult disease and to investigate skeletal blood flow, metabolism, and pathology. SPECT progressively plays an increasingly important role in imaging studies of joint disease, infection, avascular necrosis, bone growth, developmental abnormalities and the effects of weight bearing, exercise, and other forms of treatment on skeletal repair processes. PMID- 3291129 TI - Basic principles of nuclear medicine techniques for detection and evaluation of trauma and sports medicine injuries. AB - Nuclear medicine skeletal imaging is a very sensitive technique for evaluating bone and muscle abnormalities because it can detect minor changes in metabolism and blood flow. The specificity of bone imaging, however, depends on the ability of the nuclear medicine physician to make a differential diagnosis. To aid in making a specific diagnosis, this article describes the various patterns of abnormality in stress fractures, tibial stress syndrome (shin splints), compartment syndrome, enthesopathy, and traumatic fractures. The characteristic scintigraphic appearance of joint injuries, muscle injuries (rhabdomyolysis), and radionuclide arthrography is discussed and the way the scan patterns change with time in these various disorders is described. A brief summary of the basic anatomy and physiology of bone and muscle in normal and injured tissue is presented and the basic mechanisms which cause the various abnormal scan patterns is postulated. In addition, a staging system for stress fractures is presented to help direct the referring physician toward the proper management of the injured patient. In most cases, nuclear medicine skeletal imaging can be used to differentiate between acute muscle injury, tibial stress syndrome, skeletal injury (periosteal reaction, stress fracture, and traumatic fracture) or an abnormality that is entirely associated with the joint or connective tissue. This differential diagnosis is easier if the nuclear medicine procedure is performed within a few days after the onset of injury. PMID- 3291130 TI - Hematological complications of antiinfectious agents. PMID- 3291132 TI - Thrombohemorrhagic phenomena associated with infectious diseases. PMID- 3291131 TI - Clinical uses of intravenous immunoglobulins. AB - Immunoglobulins are an important component of host defense against infections. They also play a central role in immune regulation. A wide spectrum of human diseases is associated with decreased or abnormal regulation of immunoglobulin levels. Recently IV preparations of immunoglobulin have become available for clinical studies. There are already substantial data indicating a useful role for IV immunoglobulin in patients with primary hypogammaglobulinemia, neonates predisposed to group B streptococcal infections, individuals with ITP, children with Kawasaki disease, and bone marrow transplant patients predisposed to CMV infections. Promising data have been reported in burn patients and in individuals with CLL; these data require confirmation. Potential areas for future investigation include AIDS, autoimmune disorders, and viral disorders other than CMV. PMID- 3291133 TI - [Study of neuronal circuitry in the lateral geniculate nucleus of the rabbit]. PMID- 3291134 TI - [Effects of thyroxine on plasma luteinizing hormone levels and pituitary responsiveness to LHRHa in male castrated rats]. PMID- 3291136 TI - [Combined immunosuppressive therapy of autoimmune bullous dermatoses]. PMID- 3291135 TI - The evolution of selective primary health care. AB - This paper traces the evolution of the selective primary health care (SPHC) concept, from its presentation at a meeting in Bellagio, Italy, and its subsequent publication in the New England Journal of Medicine in 1979. It reviews the early debate between those in favor of selectivity and those in favor of comprehensive primary health care (CPHC). While this debate was going on, a breakthrough in terms of implementation came with UNICEF's launching of its Children's Revolution in 1982/83, promoting four specific 'social and scientific advances' for improving the health and nutrition of the world's children. They were growth monitoring, oral rehydration therapy, breastfeeding and immunization. Meanwhile the interest of a number of people for achieving 'Health For All' by targeting for action an essential short list of diseases was the impetus for another conference in 1985, Good Health at Low Cost. Through analysis of the achievements of four societies (Cost Rica, China, Kerala and Sri Lanka) efforts were made to define further a prioritized health development strategy, and a number of measures were identified as helping countries achieve good health. While some have argued that SPCH and CPHC are irreconcilable and diametrically opposed, this paper suggests that both SPCH and CPHC are both acceptable. Technology has its place. The field of view of SPHC has enlarged drastically, from individual diseases to the role of other sectors such as education and agriculture. The concept of SPHC has broadened to accept Rifkin's and Walt's assertion that "developmental processes need further exploration and research strengthening capabilities within countries".(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291137 TI - [Acute obstructive suppurative cholangitis]. PMID- 3291138 TI - [Iatrogenic hemobilia]. PMID- 3291139 TI - Harrington-Bobechko instrumentation in the treatment of scoliosis: a preliminary report. AB - A dual hook system devised by Bobechko for use with Harrington and Moe distraction rods to eliminate postoperative orthotic support was employed in the surgical treatment of 57 patients with progressive scoliosis. Mean follow-up time was 33 months (range 15 to 56 months). Average correction was 51%, with an average loss of correction of 8 degrees. Five patients required reinstrumentation, two of whom had dislodgement of both upper hooks during the first postoperative week; the other three had rod breakage which occurred 3 to 20 months after surgery. The results indicate that the dual hook system provides greater security of fixation than a single hook construct, but has the disadvantage of bulkiness, making it prominent in thin patients. Postoperative protection with bracing for 6-9 months continues to be recommended to guard against instrument failure. PMID- 3291140 TI - Direct current electrical bone growth stimulation for spinal fusion. AB - An electronic bone growth stimulator (EBGS) had been devised to facilitate lumbosacral fusion in the early 1970s, using a totally implanted device which delivers a steady 5 microA at each of four cathodes. The use of the device is reserved for patients in whom painful and abnormal motion is demonstrated to be the major cause of low-back pain. An initial series (I-A) of 82 patients demonstrated a successful fusion rate of 91.5% compared with a 80.5% fusion rate in 159 patients treated without the EBGS. A second prospective randomized controlled trial series (II) was begun using only "difficult patients," that is, patients who had either one or more previous failed fusions, a grade II or worse spondylolisthesis, a multiple-level fusion or the presence of another high-risk factor such as obesity. These patients were randomized by protocol as to whether they received a stimulator or not. The fusion rates of the two groups were assessed radiographically by the operating surgeon and by an independent radiologist 12 to 18 months postoperatively. Statistical review confirmed the comparability of the groups. Success, defined as radiographic fusion, was achieved in 15 of 28 control patients (54%) compared with 25 of 31 EBGS treated patients (81%). This result is statistically significant (P = 0.026, one-tailed Fisher's Exact test). Meanwhile, a continuing nonrandomized study (I-B) has continued and at this point the success rate is 90.5% in an additional 116 patients, confirming the results of the earlier nonrandomized series (I A).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291142 TI - [Secretory otitis media]. PMID- 3291141 TI - Anterior lumbar interbody fusion. AB - This is a report of 85 patients who underwent anterior lumbar interbody fusion (ALIF) for treatment of painful disc disruption (PDD) or symptomatic pseudarthrosis. The fusion rate was 80% by disc. The pseudarthrosis rate increased from 16% at L5-S1 to 21% and 31% at L4-5 and L3-4, respectively. There was a significant increase in pseudarthrosis rate in patients who smoked more than one pack per day. There was no difference in the fusion rate whether autogenous or cadaveric iliac crest graft or dowel versus tricortical block graft was used. Sixty-eight percent of patients were "able to work" after ALIF. The complication rate was low and retrograde ejaculation occurred in only one patient. PMID- 3291143 TI - [The effect of aircraft noise on the health of an exposed population]. PMID- 3291144 TI - [Roentgen radiation dosage using the 2-pulse technic]. PMID- 3291145 TI - [The value of nuclear spin tomography in inflammatory kidney diseases]. PMID- 3291146 TI - [Sonography as a complementary study method in mammography]. PMID- 3291147 TI - [Roentgenologic activities of scientists at the outset of the Roentgen era and in military medical establishments in Austria-Hungary]. PMID- 3291148 TI - [Clinical significance of microalbuminuria in patients with collagen diseases- with special reference to rheumatoid arthritis]. PMID- 3291149 TI - Behavioural changes after closed head injury. A neuropsychological issue. AB - The long-term behavioural consequences of moderate to severe closed head injury (CHI) have been examined within a neuropsychological framework. It is argued that neuropsychological assessment must be considered if the behavioural sequelae of a brain injury are to be fully appreciated and assessment and rehabilitation modules appropriately formulated. Functioning of the frontal lobes is emphasised because this is the area most at risk when a head injury occurs. The meaning of 'executive functions' is examined, and the behavioural and rehabilitation implications of an impaired 'executor' are discussed. It is demonstrated that traditional individual and family-based psychotherapeutic techniques are inappropriate for people with impaired executive functions. PMID- 3291151 TI - The concept of cytoprotection. PMID- 3291150 TI - Beta-blockade by sotalol in early myocardial infarction decreases ventricular arrhythmias without increasing left ventricular volume. AB - Although early beta-blockade in acute myocardial infarction (AMI) may have potential benefits owing to an anti-arrhythmic effect and limitation of infarct size, the haemodynamic effects are not well characterised. Accordingly, we studied the effects of intravenous beta-blockade by sotalol in AMI, commencing a mean of 6 hours after the onset of chest pain, with particular reference to systemic haemodynamic changes and left ventricular (LV) volumes. Thirty patients were randomised to a control group or to sotalol therapy starting with 40 mg and increasing to 120 mg, followed by the maximal dose tolerated every 6 hours for 72 hours. Sotalol reduced heart rate and mean blood pressure without elevating pulmonary wedge pressure or increasing enzymatic infarct size. Sotalol also decreased the incidence of ventricular tachycardia (P less than 0.001). An important new finding was that there was no increase in the LV volume measured by radionuclide techniques. Therefore intravenous sotalol safely achieved its beneficial effects without causing LV dilatation. PMID- 3291152 TI - Bicarbonate, mucus and mucosal protection. PMID- 3291153 TI - Receptors involved in the regulation of gastric acid secretion. PMID- 3291154 TI - Campylobacter pylori. PMID- 3291155 TI - Histamine H2-receptor antagonists in the treatment of peptic ulcer disease. PMID- 3291156 TI - Omeprazole and ranitidine in duodenal ulcer healing. PMID- 3291157 TI - The current status of sucralfate in ulcer therapy. PMID- 3291158 TI - Colloidal bismuth subcitrate. PMID- 3291159 TI - Antacids--acid neutralisation and/or mucosal protection? PMID- 3291160 TI - [Breast-sparing therapy of breast cancer: on the combination of radiation therapy with adjuvant chemotherapy]. AB - From January, 1975 through June, 1986, 426 patients with mammary carcinomas were submitted to primary, breast-preserving therapy at the Gynecological Hospital of the University of Heidelberg. 212 women with a minimum observation time of twelve months fulfilled the criteria of a "typical" treatment: tumor size up to 3 cm, segment/quadrant resection and axillary lymphonodectomy with at least eight lymph nodes removed, radiotherapy of the residual breast with greater than or equal to 45 Gy, in case of histological lymph node manifestation adjuvant hormonal and/or chemotherapy. The average observation time was 38 months, the medium age 48 years. Patients with histological lymph node manifestations were compared with a matched control group of women treated treated by modified radical therapy. According to the error estimation of Kaplan and Meier (1958), no differences were found for local recurrence rate, disease-free survival, and overall survival. Patients treated by organ-preserving therapy with adjuvant chemotherapy were opposed to a matched control group of women treated only by surgical/radiological, organ-preserving therapy. In patients with chemotherapy, the incidence of cutaneous erythema (29% versus 24%), telangiectasia (34% versus 24%), hyperpigmentation (41% versus 34%) showed an upward tendency, but was not significantly increased. There was no difference in the incidence of clinically palpable fibroses (37% versus 42%) and fibroses shown by mammography (54% versus 51%). The frequency of pneumonitis/fibrosis of the retromammary lung area (22% versus 10%) after chemotherapy was two times higher than in the matched control group not treated by chemotherapy. PMID- 3291161 TI - Radiation therapy combined with or without chemotherapy for limited extent of non small cell lung carcinoma. AB - From July 1977 to December 1983, 130 patients with limited extent of non-small cell lung carcinoma received radiotherapy of more then 30 Gy combined with or without chemotherapy at the Center for Adult Diseases, Osaka, Japan. Four treatment arms were evaluated: RT alone, RT following chemotherapy, RT following low dose concurrent irradiation with chemotherapy (LDC-RT), and RT concurrently used with chemotherapy. Complete regression of local and regional tumor was produced in 5% and partial regression 58%. Among these four treatment arms LDC-RT showed the highest response rate (88%), while no difference in long-term survival was apparent. According to the RT dose, survival of cases who received RT doses above 50 Gy was better than that of cases under 50 Gy in spite of the combination with chemotherapy. These data suggest that adjuvant chemotherapy has no favorable impact against the survival. Concerning the prognostic factor, tumor response after treatment, general performance status and N stage were important. PMID- 3291162 TI - [The total person and the attitude of the physician in cancer therapy]. AB - For us, the diagnosis of a cancer is now as before an extraordinary challenge. This is reflected in the great efforts we are making to search for the causes of this disease and to find new and better healing methods. Since its foundation, the German Cancer Research has raised enormous sums of money in order to finance this research. Within the last few decades, the science of psycho-oncology has been developing, too, and it has profited from this scientific impetus. Psycho oncologic departments have been built at Heidelberg and other tumor centers, and extensive retrospective and prospective studies on epidemiology have been conducted in order to investigate the psychic background of the cancer disease. However, the personal behavior towards cancer patients is now as before a special and rather problematic task for the physician. The suffering caused by such a disease confronts us with our own anxieties and makes us aware of our helplessness in view of the psychic situation of the patient which is often characterized by hopelessness and a ceased dynamism. PMID- 3291163 TI - Optimal setting of multileaf collimators in stationary beam radiation therapy. AB - The new generation of high resolution double focused multileaf collimators is an important step towards true three-dimensional radiation treatment techniques. The principal advantages include increased flexibility in beam shaping and dose delivery using static radiation fields as well as the possibility to do conformation therapy employing dynamic computer controlled patient individual collimation in each CT slice and lateral dose plan. Beside the increased efficiency and flexibility and reduced set-up time, it is shown that multileaf collimation will often reduce the treated volume by as much as 20% or more in single fields and more than 30% when multiple fields are used instead of ordinary rectangular fields. When compared to conventional beam blocks the greater simplicity and flexibility will probably increase the use of individualized blockings by about the same percentages. The optimal rotation and setting of a multileaf collimator for static radiation fields is derived both for convex and for convex concave target volumes. Generally, the smallest cross-section or diameter of the target should be aligned with the direction of motion of the leaves. PMID- 3291164 TI - Bone vitality in the cat's irradiated jaw. Histological study. AB - The vitality of the mandible in cats was studied from two to 15 months after irradiation. Dose of 80 Gy in three days was delivered using three hairpin shape iridium-192 wires surrounding the mandibula. The osseous vitality was assessed from the percentages of lacunae inhabited by osteocytes (IL). The results are compared with those obtained by microradiography. At two months, a small reduction of vitality is already observed, it becomes progressively more important. At one year, vitality is recovered nearly fully in the ventral part of the mandibula, mainly at the level of the alveolar crest. Vitality remains reduced in the dorsal part. Microradiographic lesions appear more slowly; they are apparent at six months. PMID- 3291165 TI - A contribution to the study of damage and regeneration of hemopoiesis during fractionated irradiation and repeated bone marrow transplantation. AB - The experiment was aimed at studying two contradictory actions: damage to hemopoietic organs during application of radiation doses per fraction and regenerative efforts of the organism supported by repeated bone marrow transplantation. The mice received doses of 3 Gy of 60Co-gamma rays total body irradiation at four-day intervals up to a total dose of 18 Gy. After each dose per fraction half of the animals were injected with 10(6) bone marrow cells. At four-day intervals evaluations were made of the blood count, bone marrow and spleen cellularities, and spleen mass. In animals subjected only to irradiation the damage to hemopoietic organs was becoming deeper until the end of observation. In bone marrow recipients the decrease in bone marrow cellularity and the number of leukocytes stopped after day 16, and there was a steep growth of splenic cellularity and mass; the decrease in erythrocyte count stopped on day 20. Obviously a certain recovery of hemopoiesis occurred after the total dose of 12 Gy between days 12 and 16. The lodging of injected hemopoietic stem cells and their proliferation had to be preceded by a regeneration of the hemopoietic microenvironment. PMID- 3291166 TI - A new method of segmental orthotopic liver transplantation in children. AB - Orthotopic liver transplantation requires matching of the donor and recipient for size. The rarity of suitable pediatric and infant donors in many countries has resulted in the acceptance of the principle of a reduced-sized adult liver graft for children. A new method of segmental orthotopic liver transplant is described. This method involves resecting the recipient liver off the inferior vena cava, which is left in situ, and the donor hepatic vein is anastomosed end to side to the inferior vena cava. The technique allows orthotopic liver transplantation with widely mismatched sizes from adults to infants. PMID- 3291167 TI - Management of suspected catheter sepsis. PMID- 3291168 TI - Biliary cholesterol and lithogeneity of bile in patients after ileal resection. AB - For determination of the factors that regulate biliary cholesterol secretion and the lithogenity of bile in ileal dysfunction, plasma and biliary lipids and fecal excretion of bile acids were studied in 29 patients who had undergone ileal resection. Seven patients with ileal resection had normal bile acid excretion (less than 10 mg/kg/day), and 22 had various degrees of bile acid malabsorption. None of the patients had gallstones when examined with abdominal sonography. LDL cholesterol levels were decreased in bile acid malabsorption and demonstrated a positive correlation with the molar percentage of biliary cholesterol. Biliary cholesterol (mol percent) was inversely correlated with fecal bile acid excretion. This finding suggests that biliary cholesterol secretion decreases with increasing loss of bile acids to feces in ileal dysfunction, leading to an actual decrease in the lithogenic index and to hyposaturation of cholesterol in bile. The reduction in biliary cholesterol, regarded as protecting the gallbladder mucosa against the detergent properties of bile acids, may play an important role in the pathogenesis of increased gallstone formation in ileal dysfunction. PMID- 3291169 TI - Evaluation of cytoprotective drugs for liver preservation by pyridine nucleotide fluorometry. AB - The cytoprotective effects of membrane-stabilizing drugs, such as chlorpromazine, allopurinol, dibucaine, phenoxybenzamine, and OP41483 (prostacyclin analogue), administered to perfusate and preservation medium were studied in rat liver, after 24 hours' preservation, by assessment of pyridine nucleotide fluorescence. On the fluorometric trace curve, amplitude (RxA) and velocity (RxV) from oxidation to reduction were determined. Percent decrease of RxA (%RxA) and that of RxV (%RxV) after 24 hours' preservation were calculated. At the end of preservation, the concentration of total adenine nucleotides of the liver, hepatic adenylate energy charge, and prepared mitochondrial oxidative phosphorylative activity were also measured. In the groups given phenoxybenzamine, dibucaine, and allopurinol, there was no significant difference among these parameters. In the chlorpromazine group, energy charge and %RxV were higher than in the drug-free group (p less than 0.05). In the OP41483 group, both energy charge and phosphorylation rate were significantly higher (p less than 0.05) and %RxV was significantly high (p less than 0.01) at concentrations of more than 3 nmol/L, compared with the values for those without drugs. These results suggest that the Redoximeter can provide accurate information on the effectiveness of cytoprotective drugs. It is also suggested that OP41483 has potential application for maintaining graft viability for human liver transplantation. PMID- 3291171 TI - [Expert system for practical nursing and for education]. PMID- 3291170 TI - [Reflections on the role and place of sonography]. PMID- 3291172 TI - [50 years is no age for a lady]. PMID- 3291173 TI - [Pulmonary hemoptysis and hemorrhages in rarely encountered diseases]. PMID- 3291174 TI - [New aspects in the etiology and pathogenesis of chronic gastritis and peptic ulcer]. PMID- 3291175 TI - [Erosive lesions of the gastric and duodenal mucosa]. PMID- 3291176 TI - [Characteristics of the immunological reactivity of patients with chronic bronchitis working in the manufacture of proteolytic enzymes]. PMID- 3291177 TI - [Reactivity of the blood phagocytes in patients with chronic bronchitis]. AB - Bactericidal and migration activity of neutrophils was investigated in 53 patients with chronic bronchitis by means of a spontaneous and induced (6 stimulators) NBT-test and in 18 patients by means of skin fenestrae. A spontaneous NBT-test (sNBT-test) was shown to reflect the activity of an inflammatory bronchial process and to decrease by the end of therapy indicating complete remission. A stimulation index was in reverse correlation with sNBT-test indices. Response of neutrophils to various stimuli leveled down with an increase in sNBT-test indices. In an inflammatory bronchial process inhibition of neutrophil migration into a zone of inflammation was noted, particularly in patients with lingering exacerbation. Dependence of a stimulating effect on a sNBT-test value and disorder of neutrophil migration activity should be taken into account in administration of one or another immunostimulator. PMID- 3291178 TI - Trends of contraceptive research. PMID- 3291179 TI - Army hygiene in the 17th century. PMID- 3291180 TI - Confusion over the therapeutic range for monitoring oral anticoagulant therapy in North America. PMID- 3291181 TI - Prostacyclin release in the coronary circulation during sustained stimulation in in vitro and in in vivo experimental systems. AB - Prostacyclin release from rat isolated perfused hearts and from dog coronary circulation was studied by measuring immunoreactive 6-keto-PGF1 alpha (6-keto PGF1a) in heart perfusate and in plasma obtained from the great cardiac vein respectively. Continuous infusion of arachidonic acid at constant concentration in isolated perfused hearts induced an increased prostacyclin release. This release showed a rapid peak within 10 min and a subsequent decrease. Low-flow ischemia induced an increased perfusate concentration of 6-keto-PGF1a but, considering the decreased flow, prostacyclin release was actually reduced. During the whole period of ischemia (60 min) prostacyclin release was constant. In open chest anesthetized dogs 6-keto-PGF1a concentration in the great cardiac vein was increased after ligation of the left anterior descending coronary artery. A prolonged period of coronary occlusion (4.5 hours) resulted in a progressive rise of prostacyclin release. 6-keto-PGF1a determinations in the femoral vein and in the aorta did not show relevant variations during the observation period. PMID- 3291182 TI - Organic nitrates: direct antiplatelet effects and synergism with prostacyclin. Antiplatelet effects of organic nitrates. AB - Isosorbide dinitrate inhibits platelet function in vivo at concentrations about 10 times lower than in vitro (10(-7)-10(-6) vs. 10(-6)-10(-5) M). We investigated two possible reasons for this difference. Isosorbide dinitrate and its in vivo longer-lived metabolites, isosorbide-2- and isosorbide-5-mononitrate were incubated for 5 min with human platelet-rich plasma or washed platelets; irreversible aggregation was induced with threshold doses of ADP, adrenaline, collagen, arachidonic acid and thrombin, and thromboxane (TX) B2 production was measured by radioimmunoassay. Moreover, the concentration of exogenous prostacyclin required to inhibit platelet aggregation by 50% (IC50) after preincubation with isosorbide dinitrate or vehicle was determined. At 10(-7) M, only isosorbide-2-mononitrate inhibited aggregation (-12%, p less than 0.05) and TX production (-36%, p less than 0.01) by ADP. At 10(-6) M isosorbide-2 mononitrate inhibited aggregation by adrenaline more than the dinitrate (-41% vs. -25%, p less than 0.05). In addition, at supra-threshold doses of all the aggregating agents, isosorbide dinitrate decreased IC50 of prostacyclin from 2.7 +/- 1.2 to 0.36 +/- 0.2 nM. Generation of a platelet-active metabolite and synergism with prostacyclin are new properties of isosorbide dinitrate that may account for antiplatelet effects in vivo. PMID- 3291183 TI - Epidermal growth factor stimulates prostacyclin production by cultured human vascular endothelial cells. AB - Epidermal growth factor (EGF) stimulated prostacyclin (PGI2) production by cultured human umbilical vein endothelial cells, as measured by radioimmunoassay of its stable metabolite 6-keto-prostaglandin F1 alpha. This effect of EGF was dose-dependent, the lowest stimulatory concentration of EGF was 1.0 ng/ml and 100 ng/ml caused a 2.7 +/- 0.3 (mean +/- SEM) fold increase in the PGI2 synthesis. The stimulation appeared at 3-6 h of incubation and lasted at least 24 h. It was suppressed by EGF antibodies and blocked by protein synthesis inhibitor cycloheximide. Cells preincubated 12 h with EGF released also higher amounts of PGI2 when incubated with thrombin for 5 min. It is concluded that EGF liberated from platelets during aggregation may prevent local thrombogenesis and atherogenesis by stimulating the release of the antiaggregatory, vasodilatory PGI2 from vascular endothelial cells. PMID- 3291184 TI - Comparison of the platelet aggregation induced by three thrombin-like enzymes of snake venoms and thrombin. AB - Platelet aggregation induced by three thrombin-like enzymes of snake venoms was compared with that by thrombin. Acutin was isolated from Agkistrodon acutus venom and thrombocytin and batroxobin were from Bothrops atrox venom. The fibrinogen clotting activities were 700, 170 and 7 U/mg for batroxobin, acutin and thrombocytin, respectively. They induced aggregation and ATP release of washed rabbit platelets. The aggregating activity of thrombin was 10(2), 10(4) and 10(5) times more potent than those of thrombocytin, acutin and batroxobin, respectively. Platelet-activating potency of the thrombin-like enzymes was correlated with their effectiveness on the retractility and elasticity of the clots. Platelet aggregation induced by thrombin or thrombocytin could be inhibited by heparin with antithrombin III while that by acutin or batroxobin could not. Indomethacin showed weak inhibition on the aggregation while the ADP scavenging system, creatine phosphate/creatine phosphokinase, inhibited the aggregation induced by the three thrombin-like enzymes but not that by thrombin. Platelet aggregation induced by the thrombin-like enzymes could not be inhibited by PAF antagonists-BN 52021, kadsurenone or L-652,731. In the presence of EGTA, only thrombin could induce ATP release from platelets. Thrombin-like enzymes and low concentration of thrombin did not form thromboxane B2. Nitroprusside and prostaglandin E1 completely inhibited the aggregation, mepacrine and imipramine showed marked inhibition while verapamil had only weak inhibition. It is concluded that the aggregation induced by the thrombin-like enzymes is different from that of thrombin and mainly due to ADP released from platelets. PMID- 3291185 TI - No relationship in the expression of Mo-1 on monocytes and GP IIb-IIIa on platelets in Glanzmann's thrombasthenia. PMID- 3291186 TI - Streptokinase-plasminogen activator complex (BRL 26921) in the treatment of venous thromboembolism. PMID- 3291187 TI - [Ultrasonography in ophthalmology]. PMID- 3291188 TI - [Treatment of infertility]. PMID- 3291190 TI - [Cancer and immune defense]. PMID- 3291189 TI - [Tetracycline sclerotherapy in hydrocele and epididymal cysts]. PMID- 3291191 TI - [Pneumomediastinum and pneumopericardium. A complication of positive pressure ventilation in meconium aspiration]. PMID- 3291192 TI - [Cellular oncogenes. Role in normal cell growth and activation in neoplasms]. PMID- 3291193 TI - [Immuno-filtration. A new principle of analysis exemplified by the determination of HCG]. PMID- 3291194 TI - [Iron in biological systems--known and unknown]. PMID- 3291195 TI - [Improvements in insulin therapy]. PMID- 3291196 TI - [Mortality in cattle due to Clostridium botulinum type D caused by using chicken manure in stable litter]. PMID- 3291197 TI - Aortic arch replacement by posterolateral exposure. AB - Aortic arch replacement was carried out in a 54 year old male patient with an unexpected type A-dissection, using partial femoro-femoral bypass and hypothermic arrest, through a left side posterolateral thoracotomy. After the replacement of the aortic arch from the ascending to the descending aorta a warm-up perfusion was done through an 8 mm side arm Dacron prosthesis attached to the descending segment of the 30 mm Dacron graft. This technique was demonstrated to be safe and protective in our patient and can be used as an alternative surgical method in the treatment of aortic arch dissection or aneurysms of the transverse aortic arch. PMID- 3291198 TI - Significance of early angiographic follow-up after internal thoracic artery anastomosis in coronary surgery. AB - The authors report about the radiological checking of the patency of the internal thoracic artery transplant in 75 patients with coronary artery disease, using intraarterial DSA in the early postoperative phase (between 6th and 8th postoperative day). The left or the right brachial artery was punctated and the contrast medium was injected at a dosage of 50 ml in counter-current. Only one angiogram series per patient was necessary to appraise the anastomosis and the perfusion of the bypass applied. In 5 patients a stenosis and in 4 patients an occlusion of the transplant could to be diagnosed. Early postoperative angiography enables quality control. In case of occlusion reoperation may be indicated. PMID- 3291200 TI - Aspartame: review of recent experimental and observational data. AB - In this report the neurotoxicity of aspartame and its constituent amino acids aspartic acid and phenylalanine is reviewed. The adverse reactions ascribed to the consumption of aspartame-containing products, as reported in the U.S.A., are discussed and placed in perspective with the results of recent behavioural studies in humans and animals. The issue of common intake levels associated with proposed uses of aspartame is addressed. In brief, the following conclusions can be drawn: When aspartame is consumed at levels within the ADI-limit of 40 mg/kg body wt, there is no significant risk for an aspartate-induced neurotoxic effect in the brain. When aspartame is consumed at levels within the ADI-limit by normal subjects or persons heterozygous for phenylketonuria (PKU) the resultant plasma phenylalanine concentrations are practically always within the normal postprandial range; elevation to plasma concentrations commonly associated with adverse effects has not been observed. Persons suffering from phenylketonuria (PKU-homozygotes) on a phenylalanine-restricted diet should avoid consumption of aspartame. PKU-homozygotes on the (less strict) phenylalanine-liberalized diet should be made aware of the phenylalanine content of aspartame. In the available behavioural studies in humans with acute dosing, no adverse effects were observed. Long-term studies on behaviour and cognitive function in (sensitive) humans are lacking. Analyses of adverse reaction reports made by consumers in the U.S.A. have not yielded a specific constellation of symptoms clearly related to aspartame that would suggest a widespread public health hazard associated with aspartame use. Focussed clinical studies are now being carried out in the U.S.A.; the results should provide additional evidence concerning the interpretation of the reports on adverse reactions ascribed to aspartame. In the regulation of admitted uses for aspartame the possibility of intake levels exceeding the ADI limit in some groups of consumers should be a point of attention. PMID- 3291199 TI - Induction of cytochrome P-450 mRNA in rainbow trout: in vitro translation and immunodetection. AB - The time course of induction of the rainbow trout microsomal hepatic monooxygenase (MO) system was examined by determination of levels of mRNA and corresponding levels of catalytic activity. Animals were pretreated with beta naphthoflavone (beta-NF, ip, 100 mg/kg) and terminated at 0, 2, 6, 18, and 48 hr postinjection. Levels of mRNA were determined by immunoprecipitation of in vitro translation products. Levels of mRNA coding for the cytochrome P-450 LM4b isozyme were maximally increased (13-fold) at 18 hr and had decreased almost to pretreatment levels by 48 hr post-treatment. This was in contrast to the catalytic activity in which ethoxyresorufin-O-deethylase (EROD) and ethoxycoumarin-O-deethylase (ECOD) were significantly elevated at both 18 hr (25- and 5-fold, respectively) and 48 hr (46- and 8-fold, respectively). Pretreatment with beta-NF (ip, 100 mg/kg) or 2,4,5,2',4',5'-hexachlorobiphenyl (6-CB, ip, 150 mg/kg) for 18 hr resulted in significant differences in levels of mRNA in only the beta-NF-treated group. The LM2 P-450 isozyme could not be detected by immunoprecipitation with anti-LM2 IgG in trout treated with these same inducers. The results suggest a difference between the time course of induction of the mRNA for cytochrome P-450 LM4b isozyme and the induction of catalytic activity. Under the detection system utilized, the results suggest that the phenobarbital-like inducer, 6-CB, does not induce cytochrome activity nor does it induce the mRNA for cytochrome P-450 LM4b isozyme. PMID- 3291201 TI - The acute toxicity and mutagenic potential of 3-methyl-2-benzothiazolinone hydrazone. AB - 3-Methyl-2-benzothiazolinone hydrazone (MBTH), widely used in analytical laboratories, was investigated for potential handling hazards. Tested as the hydrochloride, it was found to be of moderately high acute peroral toxicity with LD50 values in rabbits of 177 mg/kg (males) and 268 mg/kg (females), and in the rat 308 mg/kg (males) and 149 mg/kg (females). The major signs of toxicity, seen at peroral doses of 125 mg/kg and above, were convulsions. Although of low acute lethal percutaneous toxicity in rats (LD50 greater than 16 g/kg), rabbits were more sensitive with one of five males dying at an applied dose of 16 g/kg, and females having an LD50 of 12.3 g/kg; convulsions were seen in rabbits having applied cutaneous doses of 4 g/kg and above. There was no evidence for cutaneous inflammation after a 4 hour occluded contact with MBTH in rabbits, although following 24 hour occlusive contact in the acute percutaneous toxicity study there was erythema, edema, desquamation and, in a few animals, local necrosis. Ocular studies in rabbits indicated that, depending on the degree of contamination, MBTH produced mild to moderate eye irritation. In keeping with its low vapor pressure, there were no adverse effects from a 6 hour exposure of rats to an atmosphere saturated with any vapor produced from solid MBTH at ambient temperature. MBTH was positive in an Ames bacterial mutagenicity assay, particularly in the absence of metabolic activation. These studies indicate MBTH to be of moderately high acute peroral toxicity, of moderate percutaneous toxicity, a mild primary skin irritant, a mild to moderate eye irritant, and produced mutations in Salmonella. There is a need for skin and eye protection, and avoidance of swallowing, when handling MBTH. PMID- 3291202 TI - Health effects of the alkylbenzenes. I. Toluene. AB - The alkylbenzenes, toluene being the most common example, represent a class of six-membered ring aromatic compounds that have a variety of alkyl groups attached. These chemicals are liquids with relatively low boiling points and are used primarily as solvents or as starting materials in the synthesis of other chemicals and drugs. They are also integral components of gasoline, distillate fuels and other petroleum products. These substituted aromatics are economically important in the chemical, petroleum, pharmaceutical, polymer, paint and dye industries. Alkylbenzenes such as toluene, xylene, ethylbenzene, styrene and cumene are toxicologically important since they are produced, used or disposed of in the largest quantities and therefore might pose significant and potential health risks to man and the environment. In general, the toxicity of alkylbenzenes has been found to be relatively low. Also, for the most part, human and environmental risks are low; however, there may be a few operations where the potential for high exposure could exist. These exposures are minimized by workplace controls or personal protective equipment. Furthermore, health risks for humans are minimized by guidelines for maximum allowable exposure concentrations which have been established for the workplace. This present paper reviews the toxicology and disposition of toluene in animals and humans. PMID- 3291203 TI - Epidemiology of chronic occupational exposure to formaldehyde: report of the Ad Hoc Panel on Health Aspects of Formaldehyde. Universities Associated for Research and Education in Pathology, Inc. AB - An independent, international panel of scientists reviewed and evaluated the relevant literature on occupational and environmental exposure to formaldehyde and subsequent epidemiology of cancer in exposed populations. Studies of topical sites (respiratory tract and skin) were considered separately from non-topical sites (other major organ systems) and individual assessments were made of evidence of site-specific cancer risk within the broader categories. In addition to the studies per se, the Panel also took into account critiques and reviews of the published reports. The Panel concluded that: 1) for no malignancy in man is there convincing evidence of a relationship with formaldehyde exposure and 2) furthermore, that if a relationship does exist, the excess risk, in absolute terms, must be small. An apparent lack of consistency among the studies in site specific cancer risk and uncertainty resulting from unresolved confounding by known risk factors were identified by the Panel as significant obstacles to more definitive conclusions. PMID- 3291204 TI - Modern biotechnology: a review of current regulatory status and identification of research and regulatory needs. AB - Modern biotechnology encompasses many technologies. The one that has generated the most public interest is that of genetic engineering. The field has advanced dramatically since the early 1970's, when concern was so high that a moratorium was declared on research using recombinant DNA. Today there are numerous products such as human growth hormone, interferon and monoclonal antibody diagnostic kits on the market. Despite the obvious benefits of these products, there are still concerns over the environmental application of genetically engineered organisms. Many countries have assessed their existing legislation to ascertain its adequacy to regulate such intended releases. Numerous international organizations are becoming involved as well, and optimistically, regulations that are being developed in various countries may be harmonized. These activities have identified several areas where more information is required, including microbial taxonomy and classification, pathogenicity in target and non-target species, environmental behavior and risk assessment processes. Consensus at this time appears to be that our predictive capabilities are still developing and that new organisms should be evaluated on a case-by-case basis. PMID- 3291206 TI - Some reflections of a founder. PMID- 3291205 TI - The four-vessel occlusion rat model: method for complete occlusion of vertebral arteries and control of collateral circulation. PMID- 3291207 TI - Founder's perspectives--then and now. PMID- 3291208 TI - Why a new standard to prevent Creutzfeldt-Jakob disease. PMID- 3291209 TI - Proceedings of the Second International Congress on Cyclosporine. November 4-7, 1987, Washington, DC. II. Therapeutic use in transplantation. PMID- 3291210 TI - Pathologic alterations in the skin component of composite tissue and skin allografts treated with cyclosporine. PMID- 3291211 TI - Cyclosporine coverage during the risk period leads to 100% long-term graft acceptance in the rat. PMID- 3291212 TI - Cyclosporine provides better success rates for both higher- and lower-risk cadaveric kidney transplant recipients. PMID- 3291213 TI - Unresponsiveness to class I antigens is not equal to tolerance to class I antigens induced by cyclosporine A. PMID- 3291214 TI - Frequency of T cytotoxic cells after perioperative treatment with extracted antigen and cyclosporine in rat cardiac transplantation. PMID- 3291215 TI - Cyclosporine A in orthotopic rat liver transplantation: influence on major histocompatibility complex antigen expression and graft adaptation. PMID- 3291217 TI - The effect of low-dose cyclosporine A and multiple blood transfusions on heart graft survival in highly sensitized rats. PMID- 3291216 TI - Donor-specific transfusions add only in a minor degree to the effect of cyclosporine A. PMID- 3291219 TI - Donor-specific blood transfusion reduces cyclosporine effect on the survival of canine renal allografts. PMID- 3291218 TI - An update on the use of low-dose maintenance cyclosporine A therapy after renal transplantation. PMID- 3291220 TI - Cyclosporine regulation of blood transfusion sensitizing and enhancing potential in rabbit skin allograft recipients. PMID- 3291221 TI - Comparison of kidney, composite tissue, and skin allograft survival in rats prolonged by donor blood and concomitant limited cyclosporine. PMID- 3291222 TI - Renal transplants maintained on low-dose cyclosporine and prednisolone. PMID- 3291223 TI - Cyclosporine mono-drug therapy. AB - In two sequential controlled clinical trials, patients undergoing cadaveric kidney transplantation was allocated to receive Cs alone (8 to 10 mg/kg/d) or combination therapy, which consisted of either Cs, azathioprine, and prednisolone, or Cs and azathioprine. The two trials have been combined, and the 58 patients that received Cs alone have been compared with the 52 that received Cs in combination with other drugs. Although rejection episodes were more frequent with Cs monotherapy, graft survival was not compromised and 80% of first grafts were functioning at 1 year. The monotherapy group had significantly fewer serious infections, and 75% of the patients in this group are still taking no steroids. Cs monotherapy is much cheaper than double, triple, or quadruple regimens and we believe that it should be the treatment of choice for the majority of patients undergoing kidney transplantation. PMID- 3291224 TI - Prospective controlled trial of steroid withdrawal after six months in renal transplant patients treated with cyclosporine. PMID- 3291225 TI - Is withdrawal of steroids hazardous to cadaveric renal transplants under treatment with cyclosporine? PMID- 3291226 TI - Triple therapy with low-dose cyclosporine, azathioprine, and steroids: long-term results of a randomized study in cadaver donor renal transplantation. PMID- 3291228 TI - The effect of triple therapy on graft outcome in renal transplantation. PMID- 3291227 TI - A randomized study comparing high- and low-dose regimens of cyclosporine in renal transplantation. PMID- 3291229 TI - Combination therapy of cyclosporine and azathioprine in living-related kidney transplant recipients compared with patients converted totally from cyclosporine to azathioprine. PMID- 3291230 TI - Combined immunosuppression with low-dose cyclosporine, mizoribine, and prednisolone. PMID- 3291231 TI - Conversion from cyclosporine to azathioprine after renal transplantation: long term effects on renal function, rejection, and allograft survival. PMID- 3291232 TI - Results of conversion immunosuppression in 193 cadaver and 42 living-related donor renal allografts. PMID- 3291233 TI - Late cyclosporine conversion carries risk of irreversible rejection. PMID- 3291234 TI - Cyclosporine treatment with conversion after three months is a safe treatment protocol in renal allograft recipients. PMID- 3291235 TI - A prospective study of conversion from cyclosporine to azathioprine: comparison of clinical and morphologic findings. PMID- 3291236 TI - Long-term results of cadaveric renal transplantation after conversion from cyclosporine to azathioprine: a controlled randomized trial. PMID- 3291237 TI - Conversion of long-term renal allograft recipients from prednisolone/azathioprine to cyclosporine monotherapy. PMID- 3291238 TI - How to improve results for second renal allografts. PMID- 3291239 TI - The outcome of repeat cadaveric kidney transplants in recipients managed with cyclosporine. PMID- 3291242 TI - Renal transplantation for older patients. PMID- 3291240 TI - Predictors of outcome in cyclosporine-treated recipients of second renal transplants. PMID- 3291241 TI - Low-dose cyclosporine and antithymocyte globulin improve renal allograft survival in highly sensitized patients. PMID- 3291243 TI - Decreasing initial hospitalization of the cyclosporine-treated renal allograft recipient is safe. PMID- 3291244 TI - The effect of cyclosporine A on renal graft function is dependent on donor age. PMID- 3291245 TI - Improved results using pediatric cadaver donor kidneys with cyclosporine immunosuppression. PMID- 3291246 TI - Pediatric cadaveric kidneys in recipients treated with cyclosporine. PMID- 3291247 TI - Cyclosporine A induces decreased blood flow in cadaveric kidney transplants. PMID- 3291248 TI - Cyclosporine immunosuppression and early kidney graft function. PMID- 3291249 TI - First month cyclosporine A sparing in renal transplantation. PMID- 3291250 TI - Cyclosporine A and histocompatibility in kidney transplantation. PMID- 3291251 TI - Effects of HLA matching in cadaver renal transplants. PMID- 3291252 TI - Impact of blood transfusions and HLA matching on national kidney transplant programs: the first Swedish-Norwegian Study of cyclosporine. PMID- 3291253 TI - No effect of blood transfusions or HLA matching on renal graft success rate in recipients treated with cyclosporine-prednisolone or cyclosporine-azathioprine prednisolone: the Scandinavian experience. PMID- 3291254 TI - Impact of blood transfusions and HLA on cyclosporine-treated renal transplant recipients. PMID- 3291255 TI - Donor-specific transfusion with and without cyclosporine A--a controlled clinical trial. PMID- 3291256 TI - Four years' experience with cyclosporine A in pediatric kidney transplantation. PMID- 3291258 TI - Cyclosporine-associated encephalopathy in childhood transplant patients. PMID- 3291257 TI - Five years' experience with cyclosporine in children. PMID- 3291259 TI - Renal transplantation. PMID- 3291260 TI - Immunosuppressive agents--a personal historical perspective. PMID- 3291262 TI - Use of cyclosporine by constant-rate intravenous infusion immediately after heart transplantation. PMID- 3291261 TI - Intravenous cyclosporine to induce immunosuppression in cardiac allograft recipients. PMID- 3291263 TI - Prevention of early postoperative renal dysfunction in cardiac transplantation. AB - Fifty six patients undergoing cardiac transplantation were immunosuppressed with a multi-drug induction regimen in which Cs administration was delayed postoperatively until satisfactory hemodynamics and renal function were achieved. The advantage of this approach is the absence of acute renal dysfunction in the early postoperative period. This immunosuppressive regimen was well tolerated and without significant detrimental effects on patient survival, graft rejection, or infection. PMID- 3291264 TI - Cardiac transplantation with cyclosporine and steroids: medium and long-term results. PMID- 3291266 TI - Cyclosporine A pharmacokinetics in a cardiac allograft recipient with a jejuno ileal bypass. AB - A 41-year-old man with a 13-year history of JI bypass for morbid obesity developed idiopathic cardiomyopathy. A pretransplant CsA pharmacokinetic profile demonstrated inadequate PO absorption with no appreciable enterohepatic recirculation. Inadequate levels occurred after three hours and became undetectable after 18 hours. The patient's status did not permit JI bypass reversal before transplantation. IV CsA was administered before cardiac transplantation, and a continuous IV CsA infusion was maintained for 72 days through episodes of CMV reactivation infection and complications common to the immunosuppressed patient. JI bypass reversal was subsequently performed and IV CsA converted to oral form as intestinal function improved. A repeat PO CsA pharmacokinetic profile demonstrated a threefold rise in peak concentration, delayed smaller peak concentrations representing enterohepatic recirculation, and a steady-state blood level that persisted for 23 hours. We have found that pretransplant CsA pharmacokinetic analysis predicts CsA bioavailability and serves as a guide for achieving optimal CsA serum concentrations; adequate PO absorption and enterohepatic recirculation of CsA depends on the anatomical and functional integrity of the jejunum and ileum; continuous IV CsA infusion can be precisely adjusted for optimal therapeutic efficiency; and long-term CsA infusion can benefit critically ill transplant patients without increased morbidity. PMID- 3291265 TI - Cyclosporine does not abrogate donor-specific class II expression in allografted human heart. PMID- 3291268 TI - Cyclosporine A monitoring by radioimmunoassay (RIA) and high-performance liquid chromatography (HPLC) after liver transplantation: influence of route of administration and of liver function on the RIA:HPLC ratio. PMID- 3291267 TI - New approaches in the use of cyclosporine: with particular reference to the liver. AB - Liver transplantation in the highly practical form that exists today has been made possible by multiple agent immunosuppression of which the most important component is CsA. Present day practices of immunosuppression are certain to be changed and probably in the near future in order to increase the effectiveness of therapy and to reduce the nephrotoxicity and other side-effects that until now have inhibited further applications. The introduction of new drugs such as FK 506, some of which are clearly synergistic with CsA, could ameliorate past problems with drug toxicity. With such improvements, and possibly even with more clever use of therapy that already is available, wider and more complex use of liver transplantation will be possible. PMID- 3291269 TI - Use of cyclosporine A in combination with low-dose corticosteroids and azathioprine in liver transplantation. PMID- 3291270 TI - Cyclosporine in pediatric liver transplantation: is there a therapeutic blood level that abrogates rejection? PMID- 3291271 TI - Incidence and outcome of acute rejection in liver transplantation. PMID- 3291272 TI - Fine-needle aspiration biopsy in liver grafted patients under cyclosporine therapy. PMID- 3291273 TI - Conjugated and delta bilirubin determinations in early liver allograft rejection. PMID- 3291274 TI - Blood cyclosporine concentrations in liver transplant recipients: assay method and influence of changed hepatic and renal function. AB - In 154 blood samples from adult and pediatric liver transplant recipients with variable degrees of hepatic and renal dysfunction, the specific monoclonal antibody-based Sandimmune RIA kit gave CsA results that were highly correlated with HPLC values. In contrast, assay of CsA levels with the PARIA in 213 samples showed values that varied between 1.8 and 18.8 times those determined by HPLC. In adults, the extent of this variation in the CsA HPLC/PARIA ratio was highly correlated with values of BIL and to a lesser extent with serum ALP; additionally, in children, correlations with AST and GGT were noted. PMID- 3291275 TI - Cyclosporine in auxiliary partial liver transplantation. PMID- 3291276 TI - Cyclosporine nephrotoxicity in orthotopic liver transplantation. PMID- 3291277 TI - The management of liver transplant recipients treated with cyclosporine. PMID- 3291278 TI - Whole organ pancreas transplantation. PMID- 3291279 TI - Low-dose cyclosporine A and donor-specific blood transfusions in pancreas transplantation in rats. PMID- 3291280 TI - Is cyclosporine toxic for human pancreas? PMID- 3291281 TI - Immunosuppression in pancreas transplantation. PMID- 3291282 TI - Use of cyclosporine for prevention of graft-versus-host disease after allogeneic bone marrow transplantation. PMID- 3291283 TI - Decreased incidence and severity of graft-versus-host disease in HLA matched and mismatched marrow recipients of cyclosporine and methotrexate. PMID- 3291284 TI - De novo accelerated hypertension during sequential cyclosporine and prednisone therapy in normotensive bone marrow transplant recipients. PMID- 3291286 TI - Economic impact of cyclosporine in transplantation. PMID- 3291285 TI - Syngeneic graft-versus-host disease after allogeneic bone marrow transplantation and cyclosporine treatment. PMID- 3291287 TI - Syngeneic graft-versus-host disease: failure of autoregulation in self/non-self discrimination. PMID- 3291288 TI - Influence of infusion duration on the efficacy and toxicity of intravenous cyclosporine in bone marrow transplant patients. PMID- 3291289 TI - Critical hypotheses on cyclosporine in bone marrow transplantation. PMID- 3291292 TI - Renin-aldosterone system and renal function under cyclosporine A. PMID- 3291290 TI - An interim analysis of the on-going long-term safety study of cyclosporine in renal transplantation. PMID- 3291291 TI - A retrospective analysis of long-term renal allograft function associated with cyclosporine-prednisone immunosuppressive therapy. PMID- 3291293 TI - Cyclosporine impairs the renal response to volume depletion. PMID- 3291294 TI - Effect of cyclosporine A on post-ischemic acute renal failure in conscious dogs: role of vasoactive renal hormones. PMID- 3291295 TI - Cyclosporine-associated posttransplant hypertension incidence and effect on renal transplant function. PMID- 3291296 TI - Controlled trial of the protective effect of dihydroergotoxine (Hydergine) on cyclosporine-associated nephrotoxicity in renal graft recipients. PMID- 3291297 TI - The influence of antihypertensive drug therapy on renal transplant function and outcome. PMID- 3291298 TI - Elevated arterial blood pressure in survivors of liver transplantation treated with cyclosporine and corticosteroids. PMID- 3291299 TI - Patient noncompliance: a major cause of late graft failure in cyclosporine treated renal transplants. PMID- 3291302 TI - Mechanism of inhibition of prostacyclin synthesis by cyclosporine in cultured human umbilical vein endothelial cells. PMID- 3291301 TI - Cyclosporine and urinary prostaglandins. PMID- 3291303 TI - Impaired fractional excretion of lithium: an early marker of cyclosporine-induced changes in renal hemodynamics. PMID- 3291300 TI - Stimulation of intrinsic prostacyclin synthesis and inhibition of thromboxane production to minimize cyclosporine nephrotoxicity. PMID- 3291304 TI - The influence of cyclosporine A on proximal tubular function in renal allografts. PMID- 3291305 TI - Usefulness of fractional excretion of sodium as index of cyclosporine nephrotoxicity in renal transplantation. PMID- 3291307 TI - Tubular vacuolization in kidney graft biopsies in different cyclosporine protocols. PMID- 3291306 TI - Clinical prevalence and significance of electrolyte disorders in cyclosporine A treated patients. PMID- 3291308 TI - The effects of long-term, low-dose cyclosporine A on renal tubular function in humans. PMID- 3291309 TI - Cyclosporine in cadaveric renal transplantation: five-year follow-up results of the European Multicentre Trial. PMID- 3291310 TI - The nephrotoxic effects of cyclosporine metabolites. PMID- 3291311 TI - Histopathology of cyclosporine nephrotoxicity. PMID- 3291312 TI - One hundred eighty graft biopsies in cyclosporine-treated kidney transplants. PMID- 3291313 TI - Cyclosporine chronic nephrotoxicity: histologic follow-up at 6 and 18 months after renal transplantation. PMID- 3291314 TI - Efficacy of a low-dose two-drug regimen of oral cyclosporine and delayed alternate day prednisone for immunosuppression in cadaver kidney transplantation. PMID- 3291315 TI - Comparative pathophysiology and histopathology of cyclosporine nephrotoxicity. PMID- 3291316 TI - Adjunctive azathioprine and antilymphocyte serum immunosuppression with cyclosporine. PMID- 3291317 TI - Morphologic and phenotypic analysis of cellular infiltration in renal allograft biopsies after long-term cyclosporine A therapy. PMID- 3291318 TI - Cyclosporine therapy and the development of interstitial fibrosis in renal allografts. PMID- 3291319 TI - Five-year serial renal graft biopsy study in cyclosporine-treated patients. PMID- 3291320 TI - Long-term results of cyclosporine in cadaveric renal transplantation from a single center. PMID- 3291321 TI - Cyclosporine therapy or dietary protein manipulation in chronic renal allograft rejection. PMID- 3291322 TI - Interleukin 2 levels and urine cytology distinguish between cyclosporine toxicity and rejection in renal and liver allograft recipients. PMID- 3291323 TI - Cyclosporine nephrotoxicity: a workshop to discuss mechanisms, diagnosis, and treatment. PMID- 3291324 TI - The effect of cyclosporine on one-center long-term multivariate analysis of kidney transplants. PMID- 3291325 TI - Cyclosporine immunosuppression for more than three years in kidney transplants. PMID- 3291326 TI - Infection patterns in cyclosporine-treated cadaveric renal transplant patients. AB - Immunosuppression with Cs regimens has not significantly altered infection patterns relative to earlier modalities. However, reports of increased infection, especially with CMV/PCC, are not borne out in our experience both in numbers and timing of infections. Patients on low-dose Cs immunosuppression do continue to acquire infectious complications but, in general, rarely will lose their grafts or lives. PMID- 3291327 TI - Occurrence of Kaposi's sarcoma in renal transplant recipients treated with low doses of cyclosporine. PMID- 3291328 TI - Mutagenicity of cyclosporine in vivo. PMID- 3291329 TI - The etiology of seizures after cardiac transplantation. PMID- 3291330 TI - "Erythrocytosis" in renal transplantation patients treated with cyclosporine. PMID- 3291331 TI - Erythrocytosis and thromboembolic complications after renal transplantation: results from a randomized trial of cyclosporine versus azathioprine antilymphocyte globulin. PMID- 3291332 TI - Cyclosporine A-induced arteriolopathy. PMID- 3291333 TI - Toxic effects of cyclosporine A and G in Wistar rats. PMID- 3291334 TI - Effect of cyclosporine on glucose metabolism in kidney transplant recipients. PMID- 3291335 TI - Peripheral insulin resistance and decreased insulin secretion after cyclosporine A treatment. PMID- 3291336 TI - Use of cyclosporine in cadaveric renal transplantation in China. PMID- 3291337 TI - [Polyps of the gallbladder]. PMID- 3291338 TI - [Preventive local ampicillin and intravenous cephotaxime in colorectal surgery]. PMID- 3291339 TI - [Extrauterine pregnancy. Erroneous diagnosis by ultrasonic scanning]. PMID- 3291340 TI - [Pulsoximetry. A review and trial of transcutaneous measurement of arterial oxygen saturation]. PMID- 3291341 TI - [Ultrasonically guided cholecystectomy--an alternative treatment of acute cholecystitis in high-risk patients]. PMID- 3291342 TI - [Postoperative nausea and vomiting. Occurrence, etiology, prevention and treatment]. PMID- 3291343 TI - [Familial hypercholesterolemia]. PMID- 3291344 TI - [Tuberculous meningitis]. PMID- 3291346 TI - [Ultrastructural markers in patients with AIDS]. PMID- 3291345 TI - [Function of the callosum in apoplexy. The anterior cerebral artery syndrome]. PMID- 3291347 TI - [Migration of osteosynthesis material]. PMID- 3291348 TI - [The effects of nicotine and carbon monoxide on peripheral tissue function and wound healing]. PMID- 3291349 TI - [Myositis ossificans]. PMID- 3291350 TI - [Oxygen-derived free radicals and acute pancreatitis]. PMID- 3291351 TI - [Music during surgery for patients with spinal anesthesia]. PMID- 3291352 TI - [Etretinate (Tigason) and bone changes]. PMID- 3291353 TI - [Vaccination against malaria]. PMID- 3291354 TI - [Iliac crest as the donor site for bone transplantation]. PMID- 3291355 TI - Three-dimensional matching of macromolecular structures obtained from electron microscopy: an application to the 70S and 50S E. coli ribosomal particles. AB - In this work we present a general computational method capable of finding the relative orientation of two structures represented by samples on a three dimensional grid. It is shown that the three-dimensional shift and the three independent rotations necessary for the correct relative spatial placement of the two volumes can be obtained either from the auto-correlation function of the volumes or from a direct cross-correlation, depending on the specific problem to be solved. This method has been applied to the problem of fitting the 50S ribosomal subunit into the 70S monosome from E. coli, structures that were available as three-dimensional reconstructions from electron microscopical data. PMID- 3291356 TI - [History of the treatment of paralyzed patients in West Germany]. AB - Based on the fundamental work of Sir Ludwig Guttmann coping with the comprehensive treatment of sufferers from spinal cord injuries, the Federal Republic of Germany developed a network of specialized Spinal Injuries Units after the second world war. This is described. There is no problem to admit this people by specialized services in time, regardless whether of traumatic or non traumatic origin. According to the prolonged life expectancy there may occur some difficulties in providing adequate aftercare for lifetime. Some tasks for the future are briefly mentioned. PMID- 3291357 TI - [Anatomy of the wrist joint and carpus]. AB - A systematic anatomical representation of the carpal area is not an adequate means to show its way of function. This paper describes the functional correlations between the distal radio-ulnar joint and the wrist joint. The proximal wrist joint is composed of two mechanically equivalent compartments. Within the ulnocarpal joint, the disk fulfills a most important function as a surface adapting and pressure transmitting element. Its perforation is a pre arthrotic deformity. The column conception of the carpus is supported by cinematic studies as well as by analyses of the subchondral bone density and the spongy structure of the ossa carpi. This conception presumes a radial scaphoid column, a central lunate column, and an ulnar triquetrum column. PMID- 3291359 TI - Primary malignant melanoma of the female urethra: a case report with immunohistochemical findings. AB - A case of primary malignant melanoma of the female urethra is presented and the usefulness of an immunohistochemical diagnostic approach is discussed. PMID- 3291358 TI - [Distal radius fracture: principles of conservative treatment]. AB - The safe conservative treatment of distal radial fractures, aiming at excellent results, is based on a differentiating classification of fracture types. The main crucial implication is that there are instabile fractures that per se are not suit for conservative treatment. The timing of radiologic follow ups as well as of reposition maneuvers, if late dislocation should occur, the classical techniques (R. Jones, J. Charnley, L. Bohler) and A. Sarmiento's functional approach are furthermore presented. PMID- 3291360 TI - Diagnosis and therapy of erectile dysfunction using papaverine and phentolamine. AB - The introduction in 1982 of vasoactive agents for intracavernous injection represents a milestone in the diagnosis and treatment of erectile dysfunction. Two preparations, the single drug papaverine hydrochloride and the combination of phentolamine mesylate and papaverine hydrochloride, hold great promise. In the last few years, the use of vasoactive drugs for evaluation and treatment of erectile dysfunction has become accepted worldwide. This paper explores the diagnostic and therapeutic possibilities and hazards implied in the method, assessing the advantages and drawbacks of papaverine and the combination product. PMID- 3291361 TI - Arterially originated erectile disturbances: surgical possibilities and their alternatives--some personal thoughts. AB - The arterially originated erectile disturbances are the most common form of impotence due to morphological reasons. The concepts of therapy range from the surgical revascularization, to the intracavernous self-injection of vasoactive substances and to the implantation of penis prostheses. The advantages and disadvantages are discussed and weighed against each other. PMID- 3291362 TI - Treatment of superficial bladder tumors with intravesical recombinant interferon alpha-2a. AB - In a prospective study, the toxicity and efficacy of an instillation therapy with recombinant interferon alpha-2a (rIFN-alpha-2a) were evaluated in 12 patients with superficial bladder tumors. Treatment consisted of 8 weekly instillations of 54 X 10(6) IU rIFN-alpha-2a in 50 ml saline. Two weeks after completion of the instillation therapy, the tumor status was assessed with cystoscopy, biopsy and bladder wash-out cytology. Two partial responses, 1 no change and 2 progressive disease were seen in the 5 patients with TA tumors. In the 4 patients with carcinoma in situ, 1 complete response, 1 partial response and 2 no change were observed. Three patients suffered from carcinoma in situ and superficial papillary tumors, 1 showed complete response of the carcinoma in situ but no change of the TA tumor, the other 2 patients showed progressive disease. Three patients with partial response received a follow-up combination therapy with interferon intravesically and etretinate orally (25 mg/day). These patients presented progressive disease or no change 10 weeks after starting the follow-up combination therapy. During the treatment period, no side effects of interferon or changes of the serum interferon levels were observed. The treatment results are considered unsatisfactory; nevertheless, some activity after intravesical administration of interferon (mainly in patients with carcinoma in situ) could be demonstrated. Since the cytotoxic and antiproliferative effects seem to be dose dependent, further studies might be done using higher interferon dosages and shorter treatment intervals. PMID- 3291363 TI - [Ultrasonic diagnosis of inflammatory diseases and trauma of the organs of the scrotum]. PMID- 3291364 TI - [Use of the hepatic artery and its branches for revascularization of the right kidney]. PMID- 3291365 TI - Phase aberration measurements in medical ultrasound: human studies. AB - Using a modified real-time phased array sector scanner, phase aberrations and amplitude fluctuations across the imaging aperture have been measured in a number of human subjects. Data from these subjects were classified into two categories based on the quality of conventional longitudinal images of the liver. Measured phase aberrations were very small in all subjects exhibiting high quality images. In contrast, large phase aberrations were measured in subjects producing low quality images. However, there were no significant amplitude variations across the array for all subjects studied. These results suggest that the absence of significant phase aberrations is a necessary condition for high quality phased array imaging. If so, improvements in clinical image quality in such subjects may be possible. PMID- 3291366 TI - Properties of acoustical speckle in the presence of phase aberration. Part I: First order statistics. AB - The first order statistical properties of acoustical speckle patterns are studied as a function of several types of random and structured phase error. Such errors may arise from tissue velocity inhomogeneities or limitations in the acoustical imaging system. In this paper, we review the theory describing the statistical properties of speckle, describe a computer model which predicts the mean speckle brightness in the presence of phase aberrations, and report experiments in which we measure the effect of these aberrations on speckle brightness and variance. We find that the average speckle brightness is significantly reduced by even mild phase aberrations. The phase aberrations studied include focal point errors, random phase errors, and structured errors. Good agreement is found between experiment and computer simulation. We then discuss the implications of these results for imaging through aberrating media, tissue characterization and phase compensation methods. PMID- 3291367 TI - Properties of acoustical speckle in the presence of phase aberration. Part II: Correlation lengths. AB - In recent years, analysis of the second order statistics of ultrasound speckle has led to accurate prediction and measurements of the average speckle size in the transducer focal zone. In this paper, that work has been extended to the average speckle size as determined by the normalized autocovariance in the presence of transducer phase aberrations. In general, a phase aberration causes a narrowing of the main lobe of the normalized autocovariance in the lateral direction. However, the lateral speckle autocovariance also showed significant side lobes in the presence of phase aberrations, indicating that individual speckles in a region of interest are not independent but are correlated so that less information is present for the task of signal detection when a transducer phase aberration exists. The same evidence of correlated speckle was found in the near field of a transducer in the region of fine speckle texture. This explanation satisfies the quandary of poor detectability in the near field region where the speckle is fine but the lateral resolution is quite degraded. The axial speckle in the presence of phase aberrations showed a small increase in main lobe widths and no evidence of side lobes. Beginning in 1978, the analysis of the second order statistics of speckle images for the purpose of spatial compounding led to accurate measurement and prediction of the cross-correlation curve as a function of transducer aperture translation for purposes of spatial compounding. In this paper, that work has been extended to the presence of transducer phase aberrations. The existence of transducer phase aberrations causes significant increases in the rate of decorrelation of speckle interference patterns as a transducer is translated. This indicates that spatial compounding will result in quite significant improvements in area-wise SNR and low contrast lesion detection for the case of severe random aberrators or focal point errors. PMID- 3291368 TI - Thirteenth International Symposium on Ultrasonic Imaging and Tissue Characterization. June 6-8, 1988, Alexandria, VA. Abstracts. PMID- 3291369 TI - Modified high varicocelectomy: outpatient microsurgical procedure. AB - Fifty patients underwent modified high varicocelectomy as outpatients. Twelve of the 22 unilateral varicocelectomies were performed under local anesthesia. All patients tolerated the procedures well, and none required admission to the hospital. The modified high approach, which exposes the area above the internal inguinal ring and of the posterior spermatic cord, is straightforward and insures that both internal spermatic and cremasteric veins can be ligated. Use of the operating microscope prevents the inadvertent ligation of the testicular artery and lymphatics. PMID- 3291370 TI - Percutaneous reanastomosis of transplant kidney. AB - A successful percutaneous reanastomosis of a transplanted kidney is reported. The kidney already had been operated on several times. The kidney-ureter anastomosis was occluded. Using a combination of ureteroscopy and the percutaneous technique, the old anastomosis was bypassed, and a new one was made. PMID- 3291372 TI - CT findings in emphysematous cystitis. PMID- 3291373 TI - Nitrofurantoin--current concepts. AB - Bacterial drug resistance has become a major concern for urologists in the treatment of urinary tract infection (UTI). One drug which has managed to avoid such resistance problems in its thirty years of use is nitrofurantoin. Nitrofurantoin is effective therapeutically for the treatment of acute lower tract infections, chronic UTI, and for the suppression of catheter-associated bacteria. On a prophylactic basis it is used to sterilize urine before TURP and to prevent chronic reinfection. Its unique mechanism of action, site specificity, achievement of high urinary levels and low serum concentrations, and its effectiveness against both gram-negative and gram-positive bacteria provide many advantages in UTI therapy that many of the newer agents do not. Adverse drug reactions, especially pulmonary toxicity, are extremely rare, and nitrofurantoin maintains an excellent safety profile. PMID- 3291371 TI - Hormone-refractory metastatic prostatic cancer treated with methotrexate, cyclophosphamide plus adriamycin, cis-platinum plus 5-fluorouracil plus cyclophosphamide. National Prostatic Cancer Project randomized trial. AB - From 1982 to 1985, the National Prostatic Cancer Treatment Group conducted a randomized prospective trial of single-agent or combination chemotherapy in 180 patients with metastatic prostatic disease refractory to hormonal therapy. All three of the treatment regimens, methotrexate, Adriamycin plus cyclophosphamide, cis-platinum plus 5-fluorouracil plus cyclophosphamide, showed similar survival and progression-free survival intervals. Future studies utilizing these or other agents, in similar or modified dosage schedules or delivery mechanisms, should note these results. Protocols designed to address subjective quality of life measures and other benefit ratios can be effectively employed considering this report. PMID- 3291374 TI - [The effectiveness of bromhexine in the complex treatment of chronic subatrophic and atrophic pharyngitis]. PMID- 3291375 TI - [Magnetic resonance tomography in otorhinolaryngology]. PMID- 3291376 TI - [Methods of restoring intestinal continuity after the Hartmann operation]. PMID- 3291377 TI - [Diagnosis of bullous pulmonary emphysema]. PMID- 3291378 TI - [Syndrome of acute respiratory insufficiency in adults in severe mechanical injuries (shock lung) (review of foreign literature)]. PMID- 3291379 TI - [Ultrasonic examination of the patency of proximal venous splenorenal anastomoses]. AB - The ultrasonic investigation has established patency of splenorenal anastomoses in 13 of 19 patients examined. When the examination failed to surely estimate the patency the percutaneous transhepatic portography is indicated. PMID- 3291380 TI - [Autoplasty in nerve injuries in children]. AB - A comparative assessment of results of autoplasty and the epineural suture in 32 cases was made on the basis of a well-known scores system. It was established that under similar or close conditions influencing the regeneration the results proved to be the same in both groups. It suggests that the epidural suture is the method of choice in those children where it is not associated with technical difficulties. Autoplasty is indicated in cases where putting the epidural suture is impossible or difficult. PMID- 3291381 TI - [Primary dermatoplasty in open injuries of the hand and fingers in ambulatory conditions]. AB - An experience with the treatment of 158 patients with open lesions of hands and fingers under conditions of traumatological unit is described. The authors recommend such operations of skin plasty as plasty by means of translocation of local tissues including insular triangle flaps on a vascular pedicle, free skin plasty, plasty on a temporary feeding pedicle from neighbour finger or hand, plasty after Krasovitov, replantation of not completely torn terminal finger phalanges. Skin plasty operations resulted in shorter terms of treatment and better functional and cosmetic results. PMID- 3291382 TI - Immunization of dogs with a Leishmania infantum-derived vaccine. AB - A partially-purified extract of Leishmania infantum has been administered to healthy dogs. Post-immunization sera were found to neutralize the infectivity of L. infantum and to abate the development of L. major. Muramyl dipeptide and one of its derivates, murabutide, were the best adjuvants. PMID- 3291383 TI - Indirect fluorescent antibody test for the detection of antibodies to Echinococcus granulosus in experimentally infected pups. AB - Adult parasites of Echinococcus granulosus of buffalo origin were used as antigen in the indirect fluorescent antibody test (IFA) for detection of antibodies to E. granulosus in experimentally infected pups. The technique permitted detection of antibodies on Day 5 post-infection (p.i.) and up to Day 80 p.i. in infected animals. The antigen-antibody reaction was characterized by the appearance of a specific brilliant greenish yellow fluorescence on the embryophore of mature eggs present within and outside the gravid segment of the cestode. A maximum antibody titre of 1:320 at Day 50 p.i. was observed in the infected pups, coinciding with maturation of adult worms in the intestine of the host. PMID- 3291384 TI - Characterization of tick antigens inducing host immune resistance. II. Description of rabbit-acquired immunity to Amblyomma americanum ticks and identification of potential tick antigens by Western blot analysis. AB - Feeding by adult Amblyomma americanum ticks induced a level of immunity in rabbits to subsequent tick feeding that resulted in a significant decrease in tick feeding success and fecundity. Histological analysis of tick feeding sites in hosts expressing resistance revealed a predominant eosinophil response, with weak basophil and neutrophil infiltrates. While the basophil was never the dominant granulocyte at the tick feeding sites in resistant hosts, this cell exhibited the greatest increase in density (tenfold) over levels observed in hosts experiencing their first infestation; eosinophils and neutrophils exhibited increases of five- and twofold, respectively. Serum from animals that expressed resistance was tested for the presence of anti-tick antibodies to tick-derived salivary gland substances (SGA) by Western blotting. Western blot analysis of female-derived SGA compared to male-derived SGA, using the Avidin/Biotin technique, resulted in the identification of approximately 25 proteins from the female preparation, but only seven from the male. The use of 125I labeled protein A as the probe for anti-tick antibody in Western blot analysis resulted in fewer recognized proteins. Serum from rabbits immunized with A. americanum-derived SGA emulsified with complete (CFA) Freund's adjuvant recognized most of the proteins identified by active serum, whereas serum from animals immunized with SGA in incomplete (IFA) Freund's adjuvant did not. Furthermore, both sera recognized a multiplicity of proteins from extracts of larval A. americanum Dermacentor variabilis and Boophilus microplus ticks, suggesting the presence of common antigens between these distantly related ticks. The results from this study demonstrate that rabbits acquire a strong immunity to A. americanum ticks characterized by the production of antibody. Furthermore, ticks secrete a number of substances into rabbits during feeding, as seen by Western blot analysis but only three may be crucial to the induction of host immunity; proteins at 41, 40 and 39 kDa. The purified anti-tick antibody will be used for subsequent isolation and characterization of crucial antigens. PMID- 3291385 TI - Mycotoxicoses in domestic animals: a review. PMID- 3291386 TI - Selected incidents of illnesses and injuries related to exposure to pesticides reported by physicians in California in 1986. AB - California collects data on most occupational and many non-occupational illnesses and injuries related to pesticide exposure. Most of the occupational incidents are investigated by local agencies. A thorough investigation is conducted on all pesticide-related cases that meet "priority" guidelines: death; hospitalization of 1 or more persons for more than 24 hours with treatment; or 5 or more people with symptoms seeking medical care as a result of the same incident. This report summarizes the priority cases determined to be related to pesticide exposure during 1986. Of the 67 described incidents, involving 583 people ill, 26 (38%) were related to exposure to pesticides applied indoors (residences, offices), either by commercial pest control companies, employees or homeowners. Nearly 200 people (33%) became ill and more than 200 people were evacuated as a result of these types of applications. Most of these incidents were a result of careless application techniques and not following label instructions. Four other incidents, with 33 people ill, were the result of spills in retail stores. In all 4 cases, store employees tried to clean the spill without wearing protective clothing. Two other cases involved exposure via a pesticide being put in a food container. Nineteen of these type of incidents involved a pesticide product containing an organophosphate; most often chlorpyrifos (8 incidents), diazinon (3 incidents), and malathion (5 incidents). There were also 10 cases that resulted from suicide; eight different pesticides were involved. Five incidents involving agricultural workers, as well as 4 incidents involving non-agricultural workers, were primarily the result of allowing pesticides to drift from the target field.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291387 TI - The arginine-stimulated insulin response is impaired in congenital duck hepatitis B virus infection. AB - Duck hepatitis B virus (DHBV) infects both A (glucagon-containing) and B (insulin containing) islet cells. To examine the effect of this infection on islet cell function, baseline and secretagogue-augmented plasma insulin and glucagon levels as well as the pancreatic content of insulin and glucagon were compared in congenitally DHBV- and noninfected ducks. No difference in baseline plasma levels or the pancreatic content of insulin or glucagon was detected. However, the magnitude of the second phase of the biphasic arginine-stimulated insulin response was markedly diminished in infected ducks. PMID- 3291389 TI - [Nikolai Alekseevich Molodtsov (on the centenary of his birth)]. PMID- 3291388 TI - Successful oral rabies vaccination of raccoons with raccoon poxvirus recombinants expressing rabies virus glycoprotein. AB - Two infectious raccoon poxvirus (RCN) recombinants for expressing rabies virus surface spike glycoprotein (G) were produced by homologous recombination between raccoon poxvirus DNA and chimeric plasmids previously used for production of vaccinia virus recombinants. Expression of G protein was controlled by vaccinia virus promoter P7.5 (early/late class) or by P11 (late class). Immunoprecipitation of infected cell extracts indicated that both of the RCN recombinants directed faithful expression of G protein. Raccoons that were fed polyurethane baits loaded with either recombinant quickly developed high levels of rabies virus neutralizing antibodies and were protected when challenged with lethal raccoon rabies street virus. PMID- 3291390 TI - [Experience of the organization of gynecological care in the Soviet Army during World War II]. PMID- 3291391 TI - [Effect of exogenous zinc deficiency on the duration of skin graft functioning]. AB - The influence of alimentary zinc deficiency on duration of skin allograft functioning was studied in experiments on guinea pigs. Feeding the animals with a ration deprived of zinc results in significant prolongation of the skin graft functioning period. Thus, in the test group animals that received the ration deprived of zinc the mean time of the graft functioning comprised 24.0 +/- 1.4 days, while in the guinea pigs of the control group that were fed with full value ration, this parameter was 9.9 +/- 0.42 days. At the same time the number of circulating lymphocytes was decreased and their capacity for spontaneous rosette formation was suppressed in the peripheral blood of the test group animals, as well as manifest inhibition of zinc-dependent enzymes (lactate dehydrogenase, alkaline phosphatase, carbonic anhydrase) in the blood was recorded. Zinc deficiency in the ration induces significant diminution of this trace element content in the muscles, bones, liver, skin and blood, under conditions of its daily negative balance in the body. PMID- 3291393 TI - [Analysis of core polysaccharides of the Escherichia coli cell wall and receptor sites of bacteriophage E-4]. PMID- 3291392 TI - [Biomedical aspects of the problem of utilizing fungal mycelial protein in human nutrition]. PMID- 3291394 TI - En-plaque subdural sarcoidosis. A rare neurological entity. PMID- 3291395 TI - 'Silk route disease' (Behcet's disease) AB - Behcet's disease is a multisystem disorder in which orogenital ulceration is associated with troublesome generalized uveitis, erythema nodosum, pyoderma, dermatographism, seronegative arthritis, and neurologic and cardiovascular symptoms. There is no diagnostic laboratory test; the diagnosis is based on the disorder's multisystem clinical features. A points scoring system is helpful in distinguishing it from other multisystem disorders that mimic it. It occurs most frequently in an area coinciding with the old Silk Route, between latitudes 30 degrees and 45 degrees north, in Asian and Eurasian populations, and it has an HLA-B51 affinity. The cause remains unknown, but a postulated trigger factor is a herpesvirus with cofactors that include ethnic group, human leukocyte antigen affinities, T-cell and autonomic imbalance, circulating immune complexes, autoimmunity, blood viscosity, decreased fibrinolysis, and zinc deficiency. Treatment includes administering corticosteroids, azathioprine, chlorambucil, cyclosporine, and colchicine, and fibrinolytic therapy. PMID- 3291397 TI - [The centenary of "Wiener klinische Wochenschrift" 1888-1988]. PMID- 3291396 TI - Medical risks of cocaine use. AB - This discussion was selected from the weekly Grand Rounds in the Department of Medicine, Oregon Health Sciences University School of Medicine, Portland. Taken from a transcription, it has been edited by George A. Porter, MD, Professor and Chair, Department of Medicine. PMID- 3291398 TI - [The centenary of the Wiener Klinische Wochenschrift]. PMID- 3291399 TI - [Wiener Klinische Wochenschrift, 1888-1970]. PMID- 3291401 TI - Transcatheter treatment of heart disease in infancy and childhood. PMID- 3291400 TI - [Methanol--an up-to-now neglected constituent of all alcoholic beverages. A new biochemical approach to the problem of chronic alcoholism]. AB - Alcoholism is usually understood as ethanolism. There is some evidence that its oxidation product acetaldehyde may condense with endogenous amines to form tetrahydroisoquinoline (TIQ) and - tetrahydro-beta-carboline (THBC) alkaloids which ultimately might be responsible for addiction. In most animal experiments pure ethanol solutions were fed, but chronic alcoholics prefer normal alcoholic beverages, and it is widely ignored that all these beverages without exception also contain methanol. Its metabolite formaldehyde is a much more potent reaction partner for TIQ and THBC formation than acetaldehyde. As our findings in chronic alcoholics proved that these persons in contrast to healthy subjects are able to oxidize methanol despite high ethanol levels, there must be a continuous leakage of formaldehyde. And it seems possible that methanol plays a more significant role in the pathophysiology and possibly the etiology of chronic alcoholism than ethanol. PMID- 3291402 TI - Taking control of MAACs. PMID- 3291403 TI - SMS monitors Medigap policy sales. PMID- 3291404 TI - What shall we do? PMID- 3291405 TI - Sequential 5-fluorouracil, methotrexate, and calcium leucovorin in metastatic colorectal cancer. PMID- 3291406 TI - Systemic therapy of colorectal cancer. PMID- 3291407 TI - Dr. Steevens' Hospital: a history. The end of 254 years of service. PMID- 3291408 TI - [Contraception in adolescents]. PMID- 3291409 TI - [Errors in the assessment and treatment of injuries of the hand]. PMID- 3291411 TI - [Indications for the determination of blood lipids]. PMID- 3291410 TI - [Current problems in the diagnosis and therapy of urinary tract infections from the general medicine viewpoint]. PMID- 3291412 TI - [The vascular surgery emergency--recognition and logical initial treatment]. PMID- 3291413 TI - [Selected contributions to the history of pediatric endocrinology. 2: The adrenal cortex]. PMID- 3291414 TI - Long-term prognosis of thromboembolic disease. AB - Recent reports and personal experience on thromboembolic disease with regard to different clinical manifestations, pulmonary circulation, pulmonary arterial pressure, therapy, and its influence on long-term prognosis are described. PMID- 3291415 TI - Methods of assessment of respiratory muscle fatigue (RMF). AB - Methods to assess fatigue of respiratory muscles, technical conditions and possibilities of practical application are discussed. PMID- 3291416 TI - [Therapy of asthma with theophylline preparations]. AB - Theophylline, 1.3-dimethylpurindione-(2.6), is a common component as well of the basic treatment of obstructive lung disease as of the emergency therapy of asthma. Until now, the mode of action of the bronchodilating effect is not elucidated. Probably, the antagonistic action upon adenosine plays a central role. The clearance of theophylline is decisive for the serum level. It varies inter- and intraindividually, depending upon different factors, e. g. simultaneous application of other drugs, coexisting diseases, and circadian rhythms. Slow-release preparations are a progress in the basic treatment of bronchial asthma and chronic obstructive bronchitis. Among other items, they are especially advantageous in the treatment of bronchial obstructions during night time. Theophylline-ethylendiamine (aminophylline) can be given intravenously and thus is the drug of choice in severe attacks of asthma. For optimal therapeutic effects, serum levels between 8 and 20 micrograms/ml are necessary. Side effects are observed mainly with serum levels above 15 micrograms/ml, concerning gastrointestinal tract, central nervous system, and cardiovascular system. Mild side effects are frequent. The most serious adverse reaction are epileptiform reactions. In perspective, by differentiation of adenosine-receptor-subtypes, the development of new xanthine-derivatives with most favourable action could be feasible. PMID- 3291417 TI - [Clinical use of theophylline retard Oranienburg]. AB - Theophylline retard "Oranienburg" has been applied in mild and intermediate forms of bronchial asthma as monotherapy (n = 40), and in severe forms of the disease in combination with other antiasthmatics (n = 21). With a dose of 560 mg twice daily the drug showed effective antiasthmatic activity which was especially evident from the possible reduction of corticosteroid requirement. The relative high rate of side effects from the drug can be lowered by stepwise increase and individual adjustment of the dose. In general, treatment should start with 2 tablets per day, given with 12 hours interval. To preserve the slow-release action, tablets should not be cut in half. In individual cases, determination of serum level of the drug may be required. The narrow therapeutic margin and the influence of numerous factors upon the clearance of theophylline require a thorough dosage and observation of the patients. Thus, the favourable properties of the preparation (lasting serum levels, improved compliance by patients) can be fully used. PMID- 3291418 TI - [Diagnosis of anaerobic bacteria in bronchial secretions in pulmonary diseases]. AB - In 50 bronchoscopic examinations the microflora of bronchial secretions has been investigated especially in order to detect anaerobic microbes with the use of the glove-box-method. In 19 patients we found the bronchial secretions steril (particularly carcinomas). Eight patients showed anaerobic gramnegative rods (Bacteroides and Fusobacteria) as predominant germs. Also in eight patients we found a mixed culture consisting in several anaerobic gram-negative rods, anaerobic gram-positive sporeless rods, anaerobic cocci, partly Clostridia and aerobes (carcinomas, pneumonias). A contamination can be excluded. In a series of patients anaerobes must be considered as infectious agent, in abscessed pneumonias particularly Bacteroides and Fusobacteria. Repeatedly an impressive clinical improvement has been established under the treatment by Metronidazol. The evidence of anaerobes especially succeeded in cases with copious mucopurulent or pure purulent secretions. The accumulation of anaerobes in bronchial secretions in alcoholics is evident. PMID- 3291419 TI - [Development of mucoviscidosis management in East Germany]. AB - The development of cystic fibrosis care in the GDR is reported by the activities of the "Working Group for Combatting Cystic Fibrosis" in the Pediatric Association of the GDR during the last 20 years. The mean incidence of the disease amounts to 1:4,100. It could be demonstrated that both the number of patients and their mean life expectancy have been increased continuously. At the end of 1985 803 patients were under care in the GDR, 10.6 per cent of them have reached the age of 18 years or more. New problems in medical care and psychological guidance arise in adolescents and in young adults with cystic fibrosis. By using linkage analysis of genetic markers new possibilities have been revealed in the field of prenatal diagnosis and of heterozygote detection. PMID- 3291420 TI - [Possible sources of infection in leisure bathing and swimming]. PMID- 3291421 TI - [Therapeutic concepts of the 18th century]. PMID- 3291422 TI - [Scientific history of medical pedagogy]. PMID- 3291423 TI - [Relations between general pathology and clinical medicine]. AB - After two preliminary remarks concerning the kind of approach in modern scientific research and the relations which exist between structure and life the author at first deals with the present state of the general and special pathology as well as the modern clinical medicine. Following this the change is discussed, which is outlined in the correlations between clinical medicine and pathology, and possibilities for a repeated closer cooperation are investigated. PMID- 3291424 TI - [Rare causes of decreased thromboplastin values]. AB - Rare causes of decreases of the thromboplastin time value are hereditary coagulopathies, coagulation inhibitors and application of acetyl salicylic acid. They require a special diagnostic approach including other global and group tests, functional tests of thrombocytes, analyses of individual factors as well as methods of inhibitor proofs. PMID- 3291425 TI - [Etiology and pathogenesis of autoimmune diseases of the thyroid gland]. AB - As for other autoimmune diseases it is discussed also for immune hyperthyroidism (Basedow's disease) and immune thyroiditis, whether factors such as stress and infections with viruses and bacteria may lead to a disturbance of the immune tolerance in persons genetically predisposed. In Basedow's disease antibodies against the TSH-receptor cause an uncontrolled stimulation of the function of the thyroid gland. One year after the end of an antithyroid drug treatment, e.g. with thiamazol, a recidivation rate of circa 50% develops. There are no criteria which may predict the clinical development of an individual after the end of the treatment with a sufficient reliability. This applies particularly also to the measurement of the TSH receptor antibodies and the suppression test at the end of treatment (Alexander's test). According to the experiences of author moreover patients with small and large goitres and with different degrees of Basedow's orbitopathy do not show any difference in the frequency of the recidivations. In the immune thyroiditis a series of antibody-dependent and lymphocyte-dependent processes may lead to a decreased function of the thyroid gland. This includes the interaction of antibodies with the complement system or with the killer cells (ADCC), the direct decomposition of the cells of the thyroid gland by certain subgroups of lymphocytes and the occurrence of blocking antibodies against the TSH receptor. In patients in whom antibodies were made evident may develop a hypothyroidism. But many patients also for ever remain euthyroid. These observations and experimental data suggest that the cell of the thyroid gland also itself must be "susceptible" to the destruction by the antibodies and lymphocytes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291426 TI - [Imaging procedures in the diagnosis of thyroid diseases]. AB - The image-producing examination techniques used in the morphological diagnostics of the thyroid gland are demonstrated. Their application must deliberately be done dependent upon the clinical findings and the therapeutic questioning. For the various thyropathies in this sense a diagnostic step programme is reported with the aim of a rational application of the individual techniques. These are conventional x-ray diagnostics, computed tomography, ultrasound tomography, scintigraphy (fluorescence scintigraphy), fine needle aspiration biopsy and cytology. Most frequently a combination of ultrasound and scan is recommended for the combined assessment of morphology and function. PMID- 3291427 TI - [Therapy of hyperthyroidism]. AB - The symptoms called hyperthyroidosis are caused by a thyroid hormone intoxication, which may have various causes. More than 95% of the hyperthyroidosis are caused by an autoimmune thyropathy (Basedow's disease) or autonomy (autonomous adenoma, disseminated autonomy). Other causes are rare. The therapy has 2 aims: the normalisation of the supply of the thyroid hormone and the removal or influence of the cause. Thus apart from an exact functional diagnostics the etiopathogenetic coordination must be done which has an essential influence on the differential-therapeutic decision. Beside the general therapeutic measures the thyrostatic long-term therapy, the subtotal thyroid resection and the radioiodine therapy are at our disposal. Diagnosis, performance, advantages and disadvantages are demonstrated. PMID- 3291428 TI - [Thyroid cancer: new knowledge and therapeutic strategy in an endemic area]. AB - The epidemiological data of thyroid carcinoma are difficult to evaluate. Several variables influence the biologic behaviour and the great number of occult papillary carcinomas obscure the picture. Among our 1116 patients we found as first symptoms solitary nodules in 41,4% being localized in differentiated carcinomas significantly more frequently in the right than is the left lobe. Multinodular goiter was seen in 24,2%, cervical lymph nodes in 10,9% and distant metastases in 3,2%. In medullary carcinoma cervical lymph nodes were seen in 27% and thus the second most frequent leading symptom. Together with sonography, thyroid scan and fine needle biopsy it is possible today to assure preoperatively at a high degree the diagnosis. A differentiated therapy is generally applied taking into account the particular prognosis of the patient, especially in papillary carcinoma. A more radical initial treatment is necessary in follicular carcinoma. In medullary carcinoma only the thyroidectomy without radiation has been proven as effective means. PMID- 3291429 TI - [Diagnosis and therapy of thyroiditis]. AB - In general a heterogeneous group of diseases of the thyroid gland which have a common histological picture of an inflammatory infiltration is referred to as thyroiditis. In the last years increasingly is paid attention to these diseases, since they apparently become more frequent and diagnostics and also therapy have improved. In a review the diagnostic and therapeutic possibilities are discussed, whereby the most frequent forms, the Hashimoto and de Quervain thyroiditis, are described in detail. The individual forms of thyroiditis and particularly the thyroid malignoma are to be distinguished differential-diagnostically. PMID- 3291430 TI - [Thyroid diseases in advanced age]. AB - Nearly all diseases of the thyroid, such as nodular goitre, thyroid carcinoma, non-immunogenic hyperthyroidism and idiopathic hypothyroidism, exhibit an increase in frequency with age. Their recognition is rendered more difficult by the often oligosymptomatic, ambiguous clinical picture, but it is the timely treatment that is of particular prognostic importance to an organism weakened due to polymorbidity. In all hard nodular alterations, a malignoma must be ruled out by sonography, scintigraphy and cytopuncture. In all iodine-deficient regions such as the GDR, a frequent occurrence of thyroid autonomy with manifestation of hyperthyroidism following iodine contamination has to be taken into account. Hypothyroidism is often misinterpreted as age-related changes. By employing adequately modern in vitro methods and imaging procedures it will be possible to further improve diagnosis and prognosis of the thyreopathy in the old age ranges. PMID- 3291431 TI - [Thyroid diseases in pregnancy]. AB - Knowledge about the physiology of the fetal and maternal regulating circle of the thyroid gland is the prerequisite for the right valuation of thyroidal parameters and for a risk-poor treatment of diseases of the thyroid gland during pregnancy. The conditions of the passage at the fetoplacental unit require particular attention in the use of thyroid depressants. Hyperthyreoses as well as bland strumae may be increased in their distinction by a pregnancy. Maternal hyperthyroidism has often a mild course. While thyreostatic drugs must be applied in their least effective dosage, for the substitution with thyroid hormones there is a higher demand than in non-pregnant women. Fetus and newborn as well as the mother need a narrow-mashed control which should be performed interdisciplinarily in a special consulting. PMID- 3291432 TI - [Computerized tomography in the assessment of myocardial function--possibilities, limits and indications for the method]. AB - The theoretical and methodical base of computed tomography evaluation of the myocardial function are demonstrated. The possibilities and limits of this investigation method are discussed and compared with the results of numerous own examinations and the literature. Present indications for cardiacomputed tomography are deduced with consideration of other noninvasive imaging techniques in cardiology. PMID- 3291433 TI - [Determination of global left ventricular functional parameters with intraventricular digital subtraction angiography in coronary disease]. AB - Left heart catheterisation, coronarography and conventional angiocardiography of the left ventricle (ACG) [30 degrees right anterior oblique; 45 ml contrast medium (Visotrast) with a flow of 12 ml per sec.] was performed in 86 patients with coronary heart disease. Additionally intraventricular digital subtraction angiography (DSA) was performed, using a Philips-device (DVI 2 CV). For DSA 15 ml contrast medium (Visotrast) was injected with a flow of 8 ml per sec. 73 examinations were selected for the study. The aim of the study was to compare the usefulness and applicability of ACG und DSA for ventriculography. There were no significant differences between enddiastolic (EDV) and endsystolic (ESV) volumes as well as ejection fractions (EF) determined by ACG and DSA. Results of the analysis of correlation were rEDV = 0.85;rESV = 0.93;rEF = 0.80. The increase of the end-diastolic pressure after ACG was determined with 7 Torr (mean), after DSA with less than 2 Torr (mean). According to these results we would prefer intraventricular DSA to conventional ACG, provided the technical equipment is available. This is concluded despite the fact that in single cases considerable differences were found between the volumes estimated by ACG and those determined by DSA. These differences were analysed in detail. The main advantages of the DSA are the by far smaller inconvenience for the patients, the rare occurrence of provoked extrasystoles and the fast and easy analysis of the ventriculographies by means of the implemented image processing programmes. PMID- 3291434 TI - [Roentgenmorphologic findings in systemic dermatoses]. AB - Skeleton and soft tissue findings in systemic dermatoses sometimes allow early differentiation between diseases affecting the skin only and those involving other organs too. Rarely, ossious alterations can be detected even before any cutaneous manifestations have shown up. Apart from a tabular survey, we refer in detail to the frequency as well as the diagnostic value of ossious and soft tissue findings in dermatomyositis, lupus erythematosus, systemic sclerosis, psoriasis, Reiter's disease, sarcoidosis, neurofibromatosis (Recklinghausen's disease), histiocytosis X, and pretibial myxedema. Particular attention is paid to the problems of differential diagnosis with special regard to rheumatoid arthritis. PMID- 3291435 TI - [Statistical relations between blood and cerebrospinal fluid serology in patients with syphilis]. AB - In any case of latent syphilis without conclusive history, an examination of the cerebrospinal fluid (CSF) is generally recommended. The present paper deals with the question whether particular findings obtained by serologic tests on the blood can supply sufficient proof to rule out any specific involvement of the central nervous system in an individual patient. Serologic investigation on 148 blood-CSF sample pairs revealed striking correlations between several blood and CSF parameters on a high level of statistical significance. Based on blood serology data alone, a multi-dimensional, non-parametric statistical test (the k-nearest neighbor method) was able to rule out specific involvement of the CSF in more than one third of the patients. We consider our approach useful in certain cases where CSF examination should rather be avoided, especially in patients with impaired general condition due to other diseases. Yet, in any case of neurological irregularity, CSF examination should generally be carried out regardless of the results of blood serology. PMID- 3291436 TI - [On the 100th anniversary and 35th congress of the German Society of Dermatology, the 2d congress in Munich]. PMID- 3291437 TI - [Porphyria cutanea tarda (chronic hepatic porphyria): new aspects on pathogenesis, diagnosis and therapy with a review of the workshop, "Cutaneous porphyrias" at the 17th World Congress of Dermatology in Berlin 1987]. AB - Porphyria cutanea tarda (PCT) is the most frequent type of porphyria. As a rule, it is associated with chronic liver disease. The disturbance of the hepatic porphyrin metabolism is regarded as the cause and center of the disease. Thus PCT is also designated as chronic hepatic porphyria. Reduced activity of hepatic uroporphyrinogen decarboxylase is considered the most important prerequisite for the development of PCT. The cutaneous manifestations are preceded by non cutaneous latent phases of various degrees. These phases may be proved by urinary porphyrin studies, especially by the increase of uro- and heptacarboxyporphyrins. The hereditary form of PCT can be identified by the determination of the uroporphyrinogen decarboxylase in erythrocytes. The enzyme deficiency in red blood cells follows dominant autosomal inheritance. Alcohol and estrogens are the predominant factors of clinical manifestation. The application of chloroquine in low doses has proved an effective treatment. The present review includes a report on the workshop "Cutaneous Porphyrias", which reflects the clinical, toxic, pharmacogenetic, pathophysiological, enzymologic, and molecular aspects from the authors' point of view. PMID- 3291438 TI - [Skin changes, pathophysiology and therapy in deficiency of essential fatty acids]. AB - Linoleic acid (C18: 2n-6) is a free fatty acid considered as essential in man; this is mainly based on the fact that man is incapable of its synthesis and that its deficiency accounts for a defined clinical picture. Linoleic acid (LA) is an essential component of cellular membranes and plays, therefore, an important role in cells; moreover, it plays a functional part on account of its precursory position of eicosanoids. For these reasons, the skin is a preferential target in case of LA deficiency, which alters the barrier function of the skin as well as the immunoregulation of the epidermic homeostasis. Man's requirement of LA has been estimated 4% of the total energy supply, i.e. 7-10 g daily. Deficiency of LA may arise from various factors: insufficient supply; metabolic anomalies (mostly due to advanced age and hepatopathies which may particularly alter the metabolic process of desaturation). Symptoms due to LA deficiency are xerosis and erythematosquamous dermatitis. The clinical picture being non-specific may be confused with other vitamin deficiencies, all the more because of metabolic interactions between these vitamins and various trace elements. Thus--in order to make the diagnosis--plasmatic fatty acid fractioning by means of gaseous phase chromatography is indicated in case of therapy-resistant eczematous dermatitis associated with malnutrition. These findings may be confirmed by measuring either the ratio of eicosatrienoic acid vs. arachidonic acid or the ratio of LA vs. arachidonic acid (in case of a disturbed metabolism of fatty acids). The treatment consists of regular oral, parenteral or topical application of essential fatty acids. Topical administration is especially indicated, because these patients, although often suffering from impaired intestinal absorption, reveal a tenfold percutaneous absorption rate of fatty acids. PMID- 3291440 TI - [Clinical aspects of erythema migrans (Lyme) borreliosis]. AB - Erythema migrans or Lyme borreliosis may be classified according to 3 stages. Erythema migrans is the typical initial lesion of the disease, often associated with general symptoms. Carditis, meningitis, musculoskeletal symptoms including arthralgia may develop in stage 2; arthritis (arthralgia), acrodermatitis chronica atrophicans (ACA), and encephalomyelitis may occur in stage 3. Borrelial lymphocytoma may be seen either in the early phase of the disease or along with the ACA. However, there is no definite therapeutical concept, so far. We recommend tetracyclines during the first stage, and high doses of penicillin G during stages 2 and 3 as well as for pregnant women. PMID- 3291439 TI - [Effect of topical glucocorticoids on endogenous cortisol production]. AB - In a randomized double blind study, we investigated the systemic effects of 3 different ointments containing corticoids. Every 7 patients out of a total of 21 patients suffering from various skin diseases were daily treated with 40 g of one of the 3 corticoid preparations over 8 days (group A: 0.05% clobetasol-17 propionate; group B: 0.25% fluocortolone trimethyl acetate; group C: 0.25% fluocortolone trimethyl acetate + 0.25% fluocortolone capronate). The plasma cortisol levels were determined by radioimmune assay. In group B and C, we did not observe any effect on the pituitary-adrenal axis, whereas in group A the plasma cortisol levels were extremely low already after 1 day of corticoid application. This adrenal suppression did not return to normal within 4 days after discontinuation of the corticoid. Our results suggest that highly potent topical corticoids are capable of adrenal suppression even without occlusive dressing and even in healthy persons. PMID- 3291441 TI - [Bullous systemic lupus erythematosus]. AB - Bullous lupus erythematosus (BLE) is an uncommon variant of systemic lupus erythematosus (SLE). We present a 23-year-old man with SLE, who developed a bullous eruption associated with a flare of the systemic disease. Differential diagnosis and problems of diagnosis are discussed. PMID- 3291442 TI - [Urogenital chlamydial infections: significance and diagnosis]. AB - Chlamydia are common agents of sexually transmitted diseases and in this country more frequent than Neisseria gonorrhoeae. Approximately 10% of all infections with chlamydia trachomatis are followed by complications, which can lead to infertility and other sequelae. Therefore, early recognition of the infection and subsequent effective therapy are important. The dermatologist is often the first physician consulted and the outcome of the infection may depend on his diagnostic and therapeutic measures. The experienced microbiologist can provide an etiologic diagnosis. For this, isolation of Chlamydia trachomatis in optimally performed tissue culture still is the most sensitive and specific method. Currently available commercial IF- and ELISA-tests for direct detection of the agent in secretions are less sensitive and less specific. PMID- 3291443 TI - [Fungal involvement of the intestinal tract in HIV-positive males]. AB - In a retrospective study on 21 HIV-positive patients (aged between 18 and 28) in stage WR 1 CDC II and WR 2 CDC III, we looked for yeast in tongue swabs and stool samples. About 2/3 of the cultures of stage WR 1 CDC II and nearly all cultures of stage WR CDC III revealed infection with yeasts. PMID- 3291444 TI - [Comparison of the acute hemodynamic effect of nisoldipine (Bay k 5552) and nifedipine in patients with ischemia-induced left ventricular impaired function]. AB - Calcium channel blockers of the dihydropyridine type have different sites of action that may cause negative inotropic effects in some patients; therefore, their use as systemic vasodilators in left heart failure may be limited. In 10 patients with coronary heart disease we compared the acute peripheral and central hemodynamic effects of i.v. nisoldipine vs. i.v. nifedipine intraindividually, using a sequential crossover protocol. All patients were subjected to right heart catheterization, arterial pressure monitoring, and simultaneous radionuclide angiography. The infusion of either calcium channel blocker was titrated to a similar steady-state reduction of mean arterial pressure by 15 +/- 3% and 15 +/- 2%, respectively, which reduced systemic vascular resistance by 25 +/- 5% and 17 +/- 2%, respectively. The required equally effective dosage was 0.17 +/- 0.06 micrograms/min/kg for nisoldipine and 0.58 +/- 0.1 micrograms/min/kg for nifedipine. In contrast to nifedipine, the administration of nisoldipine was associated with an increase in cardiac index by 0.45 +/- 0.33 l/min/m2 (p less than 0.05), stroke volume index by 3.91 +/- 3.0 ml/m2 (p less than 0.05), and left ventricular ejection fraction by 4.6 +/- 2.8% (p less than 0.05). Mean pulmonary capillary wedge pressure decreased with nisoldipine from 11.8 +/- 3.4 to 8.0 +/- 3.4 mm Hg (p less than 0.005) and mean pulmonary artery pressure decreased from 20.4 +/- 4.06 to 16.1 +/- 3.2 mm Hg (p less than 0.005), but was unaffected by nifedipine. Left and right ventricular endsystolic and enddiastolic volumes were not significantly altered by either drug.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291445 TI - [Brain morphology of Microtus brandti (Radde, 1861) and Alticola argentatus semicanus (Allen, 1924) (Rodentia, Cricetidae). Results of the Mongolian-German biological expeditions since 1962, No. 189)]. PMID- 3291446 TI - A competitive inhibition enzyme immunoassay for detection and quantification of organophosphorus compounds. AB - A sensitive and specific method for detection and quantification of methyl phosphonic acid, p-aminophenyl 1,2,2-trimethyl-propyl diester (MATP) as a model substance for organophosphorus compounds is described. Different procedures for coupling the haptenic group for immunization, purification and immobilization allowed the detection of hapten-specific antibodies. The competitive inhibition enzyme immunoassay (CIEIA), using purified chicken and rabbit IgG-antibodies, was able to detect MATP-concentrations as low as 10(-10) mol/l. Based upon our results, we postulate that the CIEIA represents a good alternative to the customary diagnosis of organophosphate intoxications, measuring blood cholinesterase activity. PMID- 3291447 TI - The main obstacle to a malaria vaccine: the malaria parasite. AB - The challenge to development of a malaria vaccine will be the variability of the sequences of target antigens. We discuss the variability in the T cell epitopes on the circumsporozoite protein of Plasmodium falciparum and the rapid selection of mutants after immunization with a protein from the asexual erythrocytic stage of P. knowlesi. PMID- 3291448 TI - Type b capsular polysaccharide as a virulence factor of Haemophilus influenzae. AB - The capsular polysaccharide of Haemophilus influenzae serotype b [(3)-beta-D ribose-(1-1)-ribitol-5-phosphate] is a major virulence factor and a target for serum antibodies which protect individuals against invasive infections. Studies in an experimental rat model of meningitis, using genetically defined H. influenzae transformants, provide evidence that chromosomal genes within or limited to a region (cap b) containing genes necessary for type b capsule are critical for efficient intravascular survival of H. influenzae. Within cap b there is a duplication of a 17 kb region organized as direct repeats separated by a smaller (1-2 kb) region of non-repeated DNA. Homologous recombination between the direct repeats is rec dependent and results in high-frequency loss of capsule expression and virulence. PMID- 3291449 TI - Analysis and genetic manipulation of Shigella virulence determinants for vaccine development. AB - Shigellosis is a major public health problem in developing countries. Current epidemics of Shigella dysenteriae serotype 1 strains are particularly serious and are characterized by high mortality rates. A high proportion of the isolates are resistant to many of the antibiotics currently in use in these countries, a feature which seriously compromises clinical treatment of the infections. Efficacious vaccines are thus urgently needed. Basic studies on Shigella virulence factors, infections in laboratory models, and host responses has led to the development of several strategies for the production of vaccines. All of these are live oral vaccines involving bacteria capable of at least limited survival in the animal intestine and of carrying selected antigens to the mucosal immune system. One type of vaccine involves non-pathogenic shigellae, attenuated either by introduction of a requirement for aromatic amino acids (aroD) or by loss of the large plasmid that specifies bacterial invasion of the mucosal epithelium. S. dysenteriae 1 strains under development as vaccines need to be engineered to eliminate high level Shiga toxin production, and a rapid and effective method to achieve this was recently elaborated. The second type of vaccine is represented by hybrid strains consisting of a carrier organism, such as an attenuated Salmonella or an Escherichia coli K-12 strain carrying the Shigella invasion plasmid, and the selected foreign antigen that it produces, in all cases so far the Shigella O antigen polysaccharide. PMID- 3291450 TI - Vaccine development reconsidered. AB - This paper briefly reviews work on vaccine development since the early 1950s with special emphasis on identification of immunogens and their presentation to the host so as to elicit an immune response. This is illustrated primarily by a discussion of the development of a candidate meningococcal B vaccine based on a capsular carbohydrate outer membrane protein complex. Work on malaria and living Salmonella typhi vaccine is also discussed. PMID- 3291451 TI - Auxotrophic Salmonella typhi as live vaccine. AB - Salmonella typhi 541Ty has deletions at aroA and purA, causing requirement for aromatic metabolites (including p-aminobenzoate) and for adenine. None of 36 volunteers who drank 10(8) to 10(10) bacteria of 541Ty or its Vi-negative mutant 543Ty showed any adverse effect; all gave evidence of cellular immune response but only a few had serum titre increases. S. typhimurium experiments (at the Wellcome Research Laboratories and at Stanford) show that adenine requirement may reduce both bacterial survival in mouse tissues and live-vaccine efficacy. S. typhi attenuated only by block(s) in aromatic biosynthesis may be more effective as oral-route live vaccine. PMID- 3291452 TI - Avirulent Salmonella typhimurium delta cya delta crp oral vaccine strains expressing a streptococcal colonization and virulence antigen. AB - Salmonella typhimurium SR-11 strains lacking adenylate cyclase and the cyclic AMP receptor protein (CRP) due to deletion (delta) mutations in the cya and crp genes, respectively, are avirulent for mice and induce high level protective immunity against subsequent challenge with wild-type virulent S. typhimurium SR 11 cells. The avirulence of these delta cya delta crp mutants has been enhanced by elimination of the 100 kb virulence plasmid pStSR100 without impairing immunogenicity. The present report confirms the avirulence and immunogenicity of these mutant strains, demonstrates that immunization of both four- and eight-week old mice has no adverse effect on weight gain, and that immunity lasts at least ninety days following initial immunization. Avirulent S. typhimurium strains have been endowed with the ability to produce several streptococcal colonization and virulence antigens for the purpose of constructing recombinant bivalent oral vaccine strains. Important antigenic determinants of the Streptococcus sobrinus surface protein antigen A (SpaA), presumed to be a critical colonization antigen of S. sobrinus, are expressed at high level by the delta cya delta crp S. typhimurium strains. The recombinant vaccine strains are stable in vitro and in animals (for a period of at least eight days) where they localize to the gut associated lymphoid tissue (GALT). PMID- 3291453 TI - Roles of vaccinia virus in the development of new vaccines. AB - Vaccinia virus is an efficient expression vector with broad host range infectivity and large DNA capacity. This vector has been particularly useful for identifying target antigens for humoral and cell-mediated immunity. With increased levels of gene expression, obtained either with stronger vaccinia promoters or through incorporation of the bacteriophage T7 RNA polymerase gene into the vaccinia genome, proteins may be synthesized in mammalian cells for use as subunit vaccines. For use as a live recombinant vaccine, efforts are being made to attenuate vaccinia virus further, either by inactivating genes contributing to virulence or by introducing human lymphokine genes into the vaccinia genome. PMID- 3291454 TI - Application of recombinant DNA techniques in the development of viral vaccines. AB - The wide repertoire of methods developed for the construction and manipulation of recombinant DNA molecules enable viral genomes to be cloned and their genes expressed, in whole or in part, in microbial or animal cells in culture. This provides a ready source of many viral components that are otherwise difficult to obtain and in some cases were previously unknown. Although immediate applications for vaccine development have concentrated principally upon envelope proteins, the immunological importance of other viral components is being increasingly recognized. Hepatitis B virus is used here to exemplify the application of recombinant DNA technology to the development of subunit vaccines and to illustrate their value in studies of other viral proteins with particular emphasis on the role of the core antigen in providing protection against viral infection and hence its potential in vaccine development. PMID- 3291455 TI - Hepatitis B and AIDS and the promise for their control by vaccines. AB - Human hepatitis B virus and human immunodeficiency virus (HIV), that causes AIDS, share attributes and possible evolutionary relationships. The specific requirements for inducing effective immunity against hepatitis B and HIV are discussed. Lessons learned in studies of hepatitis B and its vaccine may find application in creating a vaccine against HIV. PMID- 3291456 TI - Prospects for overcoming maturational and genetic barriers to the human antibody response to the capsular polysaccharide of Haemophilus influenzae type b. AB - The isolated capsular polysaccharide induces antibody protective against invasive infections by H. influenzae b. Maturation of responsiveness is slow such that infants are not protected. Several protein-coupled versions of the antigen are being tested for immunogenicity in early infancy. The relation of structure to immunogenicity is not completely defined, but all induce a booster-type antibody response with protective potential. Primary vaccination in infancy appears to mimic natural priming, activating clones of B lymphocytes that can later be restimulated by uncoupled polysaccharide. Prospects appear good for immunizing normal infants and also children with immunoregulatory defects predisposing to infection. PMID- 3291458 TI - What to expect of a good vaccine and how to achieve it. AB - Vaccines have been used almost exclusively to prevent or control infectious diseases with the aim of long-lasting immunity. Some, composed of attenuated viruses, have been highly successful and this may be due to the generation of high levels of B memory cells and their steady recruitment to form antibody secreting cells. Some diseases, notably AIDS, are a much greater challenge and it will need all the expertise of molecular biologists and immunologists to devise a vaccine which may control the disease. Vaccination to enhance or decrease the action of hormones is now being actively explored as a practical way of controlling fertility in mammals or enhancing selected properties of other hormones. In this situation, the desired effect is for a defined period, possibly one year or less. These requirements underline further the need for controlled release formulations for vaccine delivery. PMID- 3291457 TI - Protective and autoimmune epitopes of streptococcal M proteins. AB - Several rheumatogenic serotypes of streptococcal M protein have been shown to contain both protective and cardiac tissue crossreactive epitopes. By synthesizing peptides copying different regions of M protein polypeptides, we were able to localize the protective and heart crossreactive epitopes. Some epitopes are only opsonic, some are only crossreactive, whereas others are both opsonic and tissue crossreactive. Multivalency of vaccines can be obtained by synthesizing protective peptides of one M serotype in tandem with protective peptides of other M serotypes. Such hybrid peptides evoke protective immune responses against the related streptococci without evoking tissue crossreactive immunity. PMID- 3291459 TI - Criteria to define anti-idiotypic antibodies carrying the internal image of an antigen. AB - Anti-idiotypic antibodies which carry the internal image of a foreign antigen, i.e. so-called Ab2 beta antibodies, have been successfully used as vaccines to pathogens, as tools to isolate cellular receptors or as reagents in cancer therapy. An attempt is made to establish structural, immunochemical and and functional criteria to define anti-idiotypic antibodies of the Ab2 beta type. PMID- 3291460 TI - Conformational restriction of peptidyl immunogens with covalent replacements for the hydrogen bond. AB - A new strategy for designing synthetic vaccines is presented. In this approach synthetic peptides are conformationally restricted by replacing putative hydrogen bonds with covalent mimics. The chemistry for substituting a hydrazone-ethane link (N-N = CH-CH2-CH2) for an (i + 4)----i hydrogen bond in a pentapeptide with alpha-helical potential is reported. Chemically shaping peptides to mimic the three-dimensional surfaces of proteins may enhance their immunogenicity. To test this strategy, a potential synthetic vaccine for malaria, Cys-(Asn-Pro-Asn-Ala)3 NH2, was conformationally restricted by replacing putative hydrogen bonds between asparagine side chains with a covalent replacement, an ethylene bridge, to give first generation chemically shaped immunogens. Antibodies to one of the shaped malarial peptides show a strong reaction with living Plasmodium falciparum sporozoites, a form of malaria which infects hundreds of millions of people yearly. PMID- 3291461 TI - Treatment of seizures in childhood. PMID- 3291462 TI - Sesquicentennial. PMID- 3291463 TI - Pheromones in mammals with special emphasis on the boar scent steroids, also occurring in humans and truffles. PMID- 3291464 TI - [The debulking operation for advanced ovarian carcinoma. Surgical experience of an oncological problem]. PMID- 3291465 TI - [Specific antibodies, modulators of the effects of physiologically active substances and xenobiotics: the mechanisms of antibiotic mediation of the functions of the modulators]. PMID- 3291466 TI - [The methods of scientific and metric analysis of the means of developing medico biological research]. PMID- 3291467 TI - Sensitivity of fructose-1,6-biphosphatase from yeast, liver and skeletal muscle to fructose-2,6-biphosphate and 5'-adenosine monophosphate. AB - As a prerequisite for future studies on the possible effect of sulphite, an anti microbial agent, on gluconeogenesis in yeast, a comparative study of fructose-1,6 bisphosphatase (FBPase), a key enzyme of gluconeogenesis, from yeast, liver and skeletal muscle is reported. In contrast to FBPase from yeast or liver, FBPase from skeletal muscle is approximately 1000-fold more sensitive to inhibition by 5' adenosine monophosphate and 30 to 250-fold less sensitive to inhibition by fructose-2,6-bisphosphate. The kinetic properties of the FBPases, determined by the ratios R(Mg2+/Mn2+) and R (pH 7/9) of the enzyme activities, measured at 10 mM Mg2+ and 2 mM Mn2+ and at pH 7.0 and 9.0, respectively, show a drastic difference between the skeletal muscle and the yeast or liver enzymes. The data support the idea that the enzymes from yeast and liver function in gluconeogenesis, whereas the enzyme from skeletal muscle is involved in other biological functions. PMID- 3291468 TI - [Rare spherical duplication of the rectum--simulation of a tumor]. AB - Case report on a spheric duplication of the rectum in the infralevator segment. The rare incidence is underlined by an inquiry in 23 clinics in our country: 5 clinics reported about 7 cases. In a review further 17 cases are presented. In our case report we point out the differentiation between presacral rectal duplication and presacral teratoma. PMID- 3291470 TI - Discordant findings in extrahepatic bile duct atresia in 6 sets of twins. AB - Discordant findings in biliary atresia in 6 sets of twins are discussed regarding the current concepts in aetiology of biliary atresia. Although a genetic, inflammatory, immunological or toxic origin cannot be excluded, peri- or even postnatal ischaemia seems more likely. PMID- 3291469 TI - [Perineal transposition of the penis]. AB - A male infant displayed a congenital malformation of the genitourinary system manifested by rectoscrotal translocation of the penis with hypospadias and a bipartial urinary bladder with a suprapubical fistula and right kidney agenesis. In a first operation performed when he was 6 years of age, the urinary fistula was excised, and a broad anastomosis between the two parts of the urinary bladder was performed. In a second operation two years later, the longitudinal axis of the penis was transposed in frontal direction. PMID- 3291471 TI - Liver transplantation for biliary atresia: indications and results. AB - This report reviews the results of some paediatric surgical departments and points out the unsolved problems in biliary atresia disease. The authors conclude that a 5-year survival rate of 60% may be achieved in long-term follow-up, but a complete cure is observed only in 30%. Children who develop a cirrhosis and portal hypertension without or in spite of bile flow can benefit only by liver transplantation. As a result of long-term clinical experience conditions are defined that should be taken in consideration in the surgical treatment of bile duct atresia. In respect of liver transplantation the disadvantages of an external bile draining fistula to prevent cholangitis, an extensive mobilisation of the liver for HPE procedure, and the disadvantages of reoperation are discussed. By avoiding these disadvantages liver transplantation procedure will be facilitated and a 1-2 year survival rate of 80% may be achieved. PMID- 3291472 TI - [Behavioral analysis and methods of intervention in self mutilation behavior]. PMID- 3291473 TI - [Dental synthetics--overview and clinical applications]. PMID- 3291474 TI - [The silicoater process in a clinical test--results and reasoning from the viewpoint of a 3-year study]. PMID- 3291475 TI - [Study of molecular coupling of synthetics to metals]. PMID- 3291476 TI - [Knowledge of the properties of elastomeric impression materials and their significance for the routine impression--an overview (I)]. PMID- 3291477 TI - [Impressionless, optical procedures for inspection and duplication of tooth forms]. PMID- 3291478 TI - [Philipp Pfaff--privy councilor, court dentist--founder of German dentistry--born 275 years ago]. PMID- 3291479 TI - [In memoriam Hanns Lindner. Recollections on the first meeting of the German Society for Connective Tissue Research, Bad Waldsee. October 22-24,1987]. PMID- 3291480 TI - [The temporomandibular joint from the rheumatologic viewpoint]. AB - Temporomandibular joint affections in rheumatic disease are described. They were seen in inflamed joint diseases, mostly in rheumatoid arthritis, and less so in juvenile rheumatoid arthritis, psoriatic arthritis, Reiter's syndrome, ankylosing spondylitis, and collagen vascular disease. In osteoarthrosis, the temporomandibular joint affection occurs frequently but pain seems to occur most infrequently. We must bear in mind that a painful temporomandibular joint could be a symptom of myalgia, especially fibrositis syndrome with its painful tendon. PMID- 3291481 TI - [The Ro/SS-A antigen-antibody system]. AB - First described in 1969 by Clark et al., the Ro/SS-A antibody system has proved most important in the evaluation of lupus patients possessing prominent photosensitive cutaneous lesions. Ro antibodies are also seen in patients with primary Sjogren's syndrome, neonatal lupus erythematosus, congenital heart block and ANA-negative LE. The most recent data of biochemical characterization have led to the supposition that these antibodies may exert a direct pathogenic effect. In this review the current knowledge concerning the Ro-antigen-antibody system is summarized. PMID- 3291482 TI - [Ectopic ureterocele--diagnosis and therapy]. AB - The ectopic ureterocele is a relatively frequent congenital abnormality of the urinary tract. Its clinical signs are often uncharacteristic. Therefore the sometimes discrete changes in the diagnostic evaluations have to be looked for. The various procedures of which the excretory urography still plays a central role are discussed with their possibilities and limitations. The removal of the mostly dysplastic upper segment with its ureter is usually the most sensible treatment. Only in rare cases, where scintigraphically and clinically the segment seems preservable, a ureteropyelostomy is indicated. The different indications for primary and secondary excision of the ureterocele itself are outlined. A minimal therapy, that does not correct the underlying anatomical abnormality like the endoscopic incision should be reserved for uroseptic emergencies. PMID- 3291483 TI - [Reconstruction of the proximal ureter by small intestine interposition]. AB - In 2 patients with a solitary kidney it was impossible to repair an obstruction of the upper ureteral part by conventional methods. Therefore, in the first case a calico-ileo-ureterostomy and in the second patient a calico-jejuno-ureterostomy were performed. The advantages of high ureteral substitution by a short small bowel segment are the reduction of the mucosal surface area, the avoidance of a vesicoureteric reflux, the lower operative trauma, and the realization of the operation also in patients with impaired renal function. PMID- 3291484 TI - [Problems of metabolic control in type I diabetic patients with chronic renal failure]. AB - The aetiopathogenesis of the diabetic nephropathy today is still unknown. Uncontested is the contribution of chronic hyperglycemia in the pathogenesis of diabetic nephropathy. For this, there are convincing evidences from clinical and experimental experiences including transplantation surgery. The quality of the metabolic adjustment of the diabetics from the first time of diabetes manifestation is important to prevent the development of diabetic nephropathy. For this, an almost normoglycemic compensation of the glucose metabolism is mandatory. More problematically is the management of the diabetic metabolism during chronic renal insufficiency. Considerable fluctuations of the blood glucose concentration are predominately in the daily profile. The intensive conventional metabolic therapy by multiple insuline injections under self control of the blood glucose level are indicated absolutely in those patients. The therapeutic aim is a smoothing of the blood glucose fluctuation. With that it is possible--together with the elimination of hemodynamic risk factors--to delay effectively a progradient decline of the glomerulo-filtration rate and to improve the assumption to an invasive therapy. PMID- 3291485 TI - [Glomerulonephritis in sarcoidosis]. AB - The renal involvement in sarcoidosis can be demonstrated as nephrocalcinosis, nephrolithiasis, granulomatous nephritis, and glomerulonephritis. The clinical signs of a renal manifestation are inferior than the morphological findings, so that the reported frequency of 9-25% is an approximate value. In the literature the glomerular changes are rare. In the case of glomerulonephritis the membranous form is dominating; an extracapillar-proliferative glomerulonephritis is described in only 3 cases in the literature. The course of a 16-year-old male patient with an extracapillar-proliferative glomerulonephritis and M. Boeck is described in detail. After a prednisolone therapy for 2 years, which was introduced by methylprednisolone at 1000 mg for 3 days, the renal function was improved continuously. PMID- 3291486 TI - [Caroli syndrome. Clinical aspects--diagnosis--therapy]. AB - The Caroli syndrome is a rare autosomal-recessively inherited disease with cystic dilatation of the intrahepatic bile ducts. Cystic bile duct dilatations are usually accompanied by cholelithiasis and subsequent cholangitis. This is the most substantial danger implied in the Caroli syndrome. It has often been left unconsidered as a cause in differential diagnosis of cholangitis, resulting in undetected protracted course of the disease. Once an unambiguous diagnosis has been established, the authors, by their own experience from three cases and with reference to the literature, recommend subtotal hepatectomy as optional therapy. PMID- 3291487 TI - [Meckel's diverticulum. Pro and co routine removal]. AB - The following points are made against the background of experience recorded by the author from 115 cases of Meckel's diverticulum: Active intra-operative search for Meckel's diverticulum continues to be justified in the course of all operations in which such search appears to be practicable without traumatisation of the intestine due to the given surgical access route and which would not imply the risk of germ transmission. It is, of course, necessary to remove any macroscopically changed Meckel's diverticulum. Removal of the macroscopically inconspicuous Meckel's diverticulum is recommended, as well, since grave microscopic pathology may be concealed under the surface and because possible damage would be clearly outweighed by the benefit achieved from removal of an even macroscopically inconspicuous Meckel's diverticulum. Any Meckel's diverticulum accidentally discovered in a patient in somewhat advanced age should be removed, since the author's own experience against reports by other authors is likely to suggest that the rate of diverticular complications is relatively high in advanced age groups. It is absolutely imperative to look for Meckel's diverticulum in all cases in which intra-operative findings are in disagreement with clinical examinations prior to surgery, particularly in cases in which signs of acute appendicitis were pre-operatively recorded, whereas bland appendix was found on surgery. PMID- 3291488 TI - [Planned reoperation following perforation of peptic ulcer with a simple suture. A differentiated treatment concept]. AB - Even after perforation of chronic peptic ulcer with simple closure, patients continue to be in danger for additional complications of the ulcer ailment. Postoperative conditions of patients with perforated ulcer were analysed for a period of ten years. Classical indications for re-operation were recorded from 60 per cent. A differentiated concept for treatment of ulcer perforation is presented in this paper. PMID- 3291489 TI - [Our surgical heritage. In memory of the 30th anniversary of the death of Professor Nikolai Guleke. A contribution to the history of medicine]. PMID- 3291490 TI - [Stress as an explanatory model for spontaneous abortions and recurrent spontaneous abortions]. AB - In this reviews uterine article stress shall be outlined as a possible psychobiological model for interpretation of spontaneous and recurrent spontaneous abortions by emphasis on physiological explanation theories. Results refer to the fact that stress can cause via neuro-endocrinologic processes in the uteroplacental area a rejection of the fetus. The role of neurotransmitters adrenaline, noradrenaline and acetylcholine on uterine vascularization and contractility and fetal oxygenation and the influence of progesterone, glucocorticoids and other hormones have been discussed. Stress induces in loading situations a changing action of elevated stress hormones adrenaline, noradrenalin++ and cortisol on the metabolism of other hormones, e.g. a decrease of serum progesterone and an increase of estrogen and thyroxine-level. Therefore the physiological balance of the organism is disturbed. Because informations of the nervous system are transmitted to the utero-placental unit in this way there are disturbances e.g. reduction of fetal oxygenation, advancement of uterine contractility and possible stimulation of labor. Troubles of the immunologic protection of pregnancy by stress have been considered. Nevertheless the question for the reason of elevated abortion tendency caused by stress is still open. Constitutional factors as motility and other uterine and feto-placental factors may be explanations for interindividual differences in this area. Additionally stress modulation factors like efficient stress coping and social support are able to reduce stress effects. PMID- 3291491 TI - [Sensitivity test in labor induction with prostaglandin E2 vaginal tablets]. AB - The study was designed to evaluate whether an oxytocin sensitivity test in addition to pelvic scoring would increase the predictive value concerning successful induction in cases of elective induction by means of prostaglandin (PG) E2 vaginal tablets. Furthermore we investigated if this test could lead to a further reduction in the already low rate of protracted labour and operative deliveries. In order to establish the optimal dosage we compared the endocervical application of 1.5 ml PG E2 with 3 mg intravaginal. 160 pregnant women without any risks were included at due date; 73% decided spontaneously to have labour induced by means of PG E2 tablets. In these induction groups the delivery intervals were significantly shorter and the rate of operative deliveries was reduced. The fetal outcome, however, was the same as in those women who decided to await spontaneous onset of labour. The endocervical application did not prove any better. The oxytocin sensitivity test yielded additional information about the chances of inducing labour successfully. The results confirmed again the efficacy and acceptance of this method of labour induction. PMID- 3291492 TI - [Cerebral malaria and maternal deaths--a study of 13,141 deliveries at the Maputo Central Hospital, People's Republic of Mozambique]. AB - In the Central Hospital of Maputo we registered 1986 6 maternal deaths during delivery caused by cerebral malaria. Clinical and histopathological findings have been discussed. In endemic districts of malaria convulsions during delivery are hints to cerebral malaria. Following postpartal infections cerebral malaria together with eclampsia has the second position in the reasons of maternal death. PMID- 3291493 TI - Hyperparathyroidism in a pregnant woman with previous thyroid carcinoma. Case report and review of the literature. AB - A 29 year old woman, primipara, at 26 weeks' gestation had been undergone, five years before, a total thyroidectomy owing to a mixed papillary-follicular carcinoma of thyroid. After thyroidectomy the patient was placed on suppressive thyroxine treatment. Since she was 22 years old she suffered from recurrent renal colics and cholelithiasis. For these reasons she underwent, at the age of 27, an operation to remove bilateral renal calculi and a cholecystectomy owing to gall stones. During her pregnancy biochemical determinations revealed slight and persistent hypercalcemia, hypophosphatemia, elevated urine calcium besides elevated serum parathyroid hormone (PTH) levels. Thus a diagnosis of primary hyperparathyroidism was taken into consideration. It was considered, but temporarily delayed, the surgical exploration of the neck. A strict clinic overseeing of the patient, which allowed her to carry out the pregnancy happily, was undertaken. Any thyroid carcinoma repercussion on pregnancy was not noted. A left inferior parathyroid adenoma was removed five months after the woman's delivery. The child psychosomatic development, at one year of age, was absolutely normal. A review of the literature indicates that when a pregnancy is complicated by hyperparathyroidism its prognosis is improved by parathyroidectomy, if possible during the second trimester. In patients with asymptomatic hypercalcemia and/or in late pregnancy surgical treatment may be postponed until after delivery. It is also demonstrated that thyroid carcinoma is not aggravated by pregnancy and that the latter can develop without any worry for mother and fetus. PMID- 3291494 TI - [Assessment of fetal growth using the humerus and femur in ultrasound fetometry]. AB - In a prospective study process curves of fetal development were done for 1618 patients using humerus and femur with at least 5 ultrasound investigations per patient. These prenatal ultrasound values were divided in 7 groups and compared with the postnatal values of newborns to get a reliable statement. Typical curve processes have been demonstrated for low-profile development, mild and severe intrauterine growth-retardation, a macrosomy, and for a diabetic fetopathy. The following results have been gained from ultrasound values of prospective staging of fetal development. From 1618 cases 1263 cases (78.0%) have been staged exactly. 333 cases (20.6%) were not total exact. 22 cases (1.4%) have been evaluated wrong. From 121 cases of IUGR 95 cases (78.5%) have been staged correctly. Humerus and femur values are below the normal range in for IUGR group. 77 cases (62.1%) from the 124 macrosomal newborns have been detected right. Only 2 cases (4.9%) from the 41 cases of diabetic fetopathy have been evaluated lower. Humerus and femur values in severe macrosomia were over the normal range in contrast to the diabetic fetopathy. Our scheme for control of fetal development which use humerus and femur as additional parameters shows higher precision. PMID- 3291495 TI - [Congenital type I diabetes]. AB - This is a case report about a connatal type I diabetes in a offspring of a diabetic mother. In series of 904 deliveries of diabetic women we found one case of connatal insulin-dependent diabetes. Insulin treatment has been necessary from the 7th day of life on. The need of insulin was up to 17 IE/d (mean blood glucose values between 5.5 and 6 mmol/l, acetone was negative). Genetic and immunologic reasons have been discussed. PMID- 3291496 TI - [2 cases of symmetrical double abnormality]. AB - Two cases of symmetric incomplete two-headed four-handed conjoined twins who were delivered in the 37th and the 32nd gestational week have been demonstrated. The first case was delivered by caesarean section and the other one was delivered by forceps. These malformations are very seldom. Questions about teratogenicity and diagnosis are discussed. PMID- 3291497 TI - [Antibody affinity, methods for its determination and its use]. PMID- 3291498 TI - [Enterotoxigenicity of Salmonella strains of various origins]. AB - The study of the enterotoxigenicity of S. typhimurium with the use of the skin test on rabbits (to detect the delayed permeability factor) has revealed that these strains produce an enterotoxin similar to Escherichia coli thermolabile enterotoxin (TLE). Study of the enterotoxic activity of lysates obtained from 39 S. typhimurium strains and 5 S. dublin strains by sonication has revealed that 87% of S. typhimurium strains and all S. dublin strains produce an enterotoxin similar to E. coli TLE, as demonstrated by all tests used in this investigation, while 59% of S. typhimurium cultures and all S. dublin strains have been positive when tested for the capacity of producing the rapid permeability factor. "Hospital" strains and polyresistant cultures isolated from the environment (phagovar 20) are characterized by a higher rate of producing an enterotoxin similar to E. coli TLE, detected by the tests used in this investigation (90%), than antibiotic-sensitive strains of different origin (78%). PMID- 3291499 TI - [Analysis of the potentials of molecular hybridization of nucleic acids as a method of the laboratory diagnosis of influenza]. AB - The possibilities of using the DNA copies of different genes of influenza A virus for the detection of virus-specific RNa by molecular dot hybridization have been studied. High specificity and sensitivity of the RNA determination techniques have been demonstrated, as well as the efficacy of using DNA probes with the sequences of conservative genes (polymerase, nucleoprotein and matrix genes) for the detection of influenza A virus subtypes H1N1, H2N2, H3N2 and probes with the copies of the corresponding hemagglutinin genes for the differential determination of subtypes H3N2 and H1N1. The complex analysis of nasopharyngeal washings has confirmed the efficacy of the dot hybridization method for epidemiological investigations, particularly for deciphering influenza outbreaks, especially those of mixed etiology. PMID- 3291500 TI - [The antigen-antibody reaction and its inhibition]. AB - The sera of intact and immune animals contain factors capable of inhibiting the interaction of antibodies with the homologous antigen. These agglutination inhibiting (AI) factors not only block the antigen, thus competing with antibodies, but may induce the dissociation of the antigen-antibody complex. Heating of antisera at 60-63 degrees C leads to an increase in the activity of AI factors. The phenomenon of "prozone" in the agglutination test appears to be explained by the presence of AI factors in sera. PMID- 3291501 TI - [Vaseline-peptone mixture as a stimulant of ascites formation in mouse hybridoma carriers]. AB - A preliminary injection of vaseline oil with 3% of peptone in a dose of 0.5 ml induced ascitic tumors with a high taking rate in mice used as recipients of hybridomas. The dependence of the amount of ascitic fluid produced in such animals and the content of monoclonal antibodies on the time of the preliminary injection of the above-mentioned mixture, the number of cells introduced into the recipient animal, and the time of ascites collection has been studied. The optimal scheme of obtaining ascites with the use of the proposed mixture is presented. The comparison of the mixture with other stimulants of ascites production has been made. PMID- 3291502 TI - [The categories of general epidemiology in relation to the problem of sapronoses]. PMID- 3291503 TI - [Surgical treatment of voluminous structures in the 3d ventricle]. AB - The method and the advantages and shortcomings of various approaches in surgical treatment of volume structures in the third ventricle are discussed. Best visualization of its cavity is provided by the group of "superior" approaches: transcallosal and transfrontal. Various methods of direct penetration into the third ventricle are also considered: through the foramen of Morno, subchoroidal, interfornical. The results of 30 operations conducted through the interfornical approach prove its efficacy in removal of colloidal and cysticercus cysts, craniopharyngiomas, gliomas, and other new growths of the third ventricle. A transient amnestic syndrome was the only complication in the postoperative period. The neurophysiological mechanisms of its origin are discussed in detail. Stereotaxic interventions based on computed-tomographic calculations were carried out successfully in 150 patients. This method makes it possible to conduct ventriculoscopy, aspiration of cysts, biopsy of the tumor, and brachytherapy. PMID- 3291504 TI - [Military field neurosurgery. Gunshot wounds of the skull and brain]. PMID- 3291506 TI - [Pathogenesis and treatment of chronic subdural hematoma]. PMID- 3291505 TI - [Surgical treatment of tumors of the spine with compression of the spinal cord]. AB - The long-term results of surgical treatment of various tumors of the vertebral column in 53 patients are analysed. Treatment of malignant tumors, both primary and solitary metastatic, should be combined. Porous allografts filled with a chemical agent are suggested for use. Radio- and chemotherapy can be applied both before and after the operation. Primary decompression and stabilization, and if necessary--radiotherapy, are recommended in benign spinal tumors. PMID- 3291507 TI - [Surgical approach to tumors of the anterior parts of the 3d ventricle]. AB - In analysis of 216 operations for removing tumors of the anterior parts of the third ventricle it was established that the transcallosal approach with access to the tumor through the foramen of Monro or between the columns of the fornix was most adequate for radical removal of the tumor. Combined approaches are necessary in removal of extra-intraventricular tumors. The choice of the approach is guided by precisely determined topography of the tumor, the extent of its spread beyond the third ventricle in particular. A subfrontal approach fails to provide for inspection of all parts of the third ventricle. PMID- 3291508 TI - Diabetes mellitus and atherosclerosis. PMID- 3291509 TI - Calcium and hypertension. PMID- 3291510 TI - Stress, physical activity and hypertension. PMID- 3291511 TI - Obesity and hypertension. AB - In adults of Western societies the positive relationship between blood pressure and body weight has often been demonstrated, both cross-sectionally and longitudinally. This correlation is even stronger in children and early adulthood. In most studies in children, the association between age and blood pressure disappears after controlling for weight. Association must be differentiated from causation. It has however been shown in several intervention studies that treatment of obesity by weight loss decreases blood pressure substantially both in hypertensive and normotensive subjects. Although combining results from several intervention trials is difficult this is the only practical way to get an overall estimate of the hypotensive response to be expected from weight reduction. In the studies presently reviewed, a decrease in weight by 1 kg resulted in a reduction in blood pressure by 3.4/1.3 mm Hg in hypertensive patients and in normotensive subjects the corresponding reductions averaged 1.4 mm Hg and 0.6 mm Hg for systolic and diastolic pressure, respectively. PMID- 3291512 TI - Implications of the main therapeutic trials conducted in hypertension. AB - An impressive number of patients has been followed in intervention trials, some of them carefully designed and executed. The different intervention trials in hypertensives are compatible with the hypothesis that hypotensive drug treatment can decrease cardiovascular mortality mainly by decreasing cerebrovascular mortality. A decrease in fatal and non-fatal cardiovascular event rate is mainly due to the decrease in cerebrovascular events. On the basis of these trials the expert committee of the WHO and ISH recommend first general hygienic measures. When the blood pressure remains above 100 mm Hg after 3 months or above 95 mm Hg after 6 months follow-up, hypotensive drugs should be considered. It is not established whether the hypotensive drug treatment is advisable in: --symptomless patients with isolated systolic hypertension, --hypertensive patients above age 80. Sudden reduction in blood pressure should be avoided but whether a progressive reduction of the systolic blood pressure below 140 mm Hg and a diastolic blood pressure below 85 mm Hg is dangerous or advantageous remains to be established. PMID- 3291513 TI - Primary cardiac tumors. AB - From 1970 to 1986, 3 males and 6 females, ranging in age from 13 to 69 years (median 45 years), underwent heart surgery for a primary cardiac tumor. Six patients had a left atrial myxoma; a lipofibroma, a lymphosarcoma and a rhabdomyosarcoma were found each in 1 patient. The following complaints were present: congestive heart failure in 8, fatigue in 7, cardiac arrhythmia in 3, palpitations in 3, fever in 2 and finally weight loss, nocturnal perspiration and clubbing were each in one patient. The duration of symptoms ranged from 6 weeks to more than 2 years (median 10.8 months). All patients were operated with the aid of extracorporeal circulation as soon as they were diagnosed. One patient with extensive tumor growth died at the end of the procedure. During the follow up period all patients with a primary malignant tumor died within 3 months. Those with myxoma or fibroma are still alive with a follow-up period extending to 13 years (median 7 years). All surviving patients are asymptomatic and well. Malignant cardiac tumors do have a very poor prognosis, they are only amenable for palliative resection and even then prognosis remains poor. When an endocardial biopsy confirms the diagnosis of a cardiac malignancy, the indication for operation is questionable, although there is an absolute indication in case of obstruction. Cardiac myxoma should be resected after diagnosis because the potential embolic complications may be debilitating or lethal. The operative risk is small, and the long term results are excellent. PMID- 3291514 TI - [Pancreatic transplantation]. AB - Pancreas transplantation. Combined kidney and pancreas transplantation is one valuable treatment of patients with type I diabetes who developed the long-term secondary complications of the diabetes, with pre-end or end-stage renal disease. Thirteen patients underwent that procedure in our Institution. Technical modifications - such as whole pancreas transplantation with urinary drainage of the exocrine secretion by a pancreatico-duodenocystostomy - allow the monitoring of the exocrine secretion which is a pertinent immunological parameter. In the next future, pancreas transplantation alone should be considered safely using the same procedure, in non uremic diabetic recipients in whom secondary complications would predictably otherwise be more serious than the potential side effects of chronic immunosuppression. PMID- 3291515 TI - Intraperitoneal chemotherapy: application to upper gastrointestinal neoplasms. PMID- 3291516 TI - Cytostatic modifiers: current status and considerations for the future. PMID- 3291517 TI - Radiation therapy in upper GI tract tumours. AB - Radiation therapy, with or without chemotherapy, may at moderate dose levels palliate more than half of the patients with unresectable upper gastrointestinal cancer. It appears as if this therapy prolongs the median survival in these patient groups, particularly if concomitant chemotherapy is given for at most a few months. However, controlled studies are lacking. Extremely few patients will be long-term disease-free survivors even if higher dose levels are used. Since local recurrences are common after apparently radical surgery, additional radiotherapy could increase the number of long-term survivors provided the dose level is sufficiently high. This has, however, never been properly investigated. Apart from palliation in symptomatic patients with non-resectable disease, radiation therapy should be "investigational", preferably in comparison with a "no-active treatment" arm. The effects of combinations of radiation and chemotherapy should be the object of further controlled studies. Local non resectable disease is a major problem in all upper gastrointestinal tumours. It is common both primarily and after apparent radical surgery and it causes much suffering for these patients. Radiotherapy is a local therapy and has therefore gained considerable interest in these diseases. The possibilities of contributing significantly to the treatment is, at least to a certain extent, hampered by several factors, such as the often large size of the tumour and the radiosensitivity of the surrounding tissues. PMID- 3291518 TI - Current attempts to cure cancer of the esophagus. AB - The current attempts to cure cancer of the esophagus have been reviewed. Evaluating the results of treatment is an exercise in assessing varying degrees of failure. Furthermore, selection biases make meaningful comparison of the results difficult. The results of surgical, radiotherapeutical, and chemotherapeutical treatment as single modality treatment seem quite similar, although a reduction of the postoperative mortality has been reported from various centres. The results of combined modality treatment indicate that it is possible to render some patients tumorfree at the time surgery by preoperative treatment, but this therapeutical gain has not so far increased the 5-year survival of the entire treated group. The results of combined modality treatment without surgery is favoured by absence of postoperative mortality. PMID- 3291519 TI - Gastric cancer--an update. PMID- 3291520 TI - The frontiers of exocrine pancreatic cancer research. PMID- 3291521 TI - Liver cancer--present status. PMID- 3291522 TI - Neuroendocrine tumours of the upper gastrointestinal tract and pancreas. AB - Neuroendocrine tumours of upper gastrointestinal tract fall into two main categories. First carcinoid tumours of the stomach and duodenum and secondly endocrine pancreatic tumours. The endocrine tumours of the gastric mucosa include two main types, so called ECL-oma of the corpus and fundic region and gastrin producing carcinoids or hyperplasia of the antrum and duodenum. The endocrine tumours of pancreas include entopically secreting insulinomas, glucagonomas, somatostatinomas, PP-omas, and ectopically secreting tumours, such as gastrinomas and tumours producing ACTH, GHRH, and calcitonin. The diagnosis of a neuroendocrine tumour of the upper gastrointestinal tract is based on the recognition of certain clinical syndromes and the determination of certain humoral products. A broad battery of radioimmunological assays for determination of different peptides is mandatory for the diagnosis and follow up of these patients. The diagnosis is also based on histological and immunocytochemical investigation of tissue specimens obtained at operation or by biopsy. Ultrasound investigation is the best non-invasive technique to detect metastases from neuroendocrine gut and pancreatic tumours, but angiography might unveil metastases down to a size of less than 5 mm. Surgery is still the primary treatment procedure but other treatments are needed because many patients have metastases already at the time of diagnosis. Chemotherapy with streptozocin combined with 5-fluorouracil or adriamycin and human leucocyte interferon has demonstrated objective response rate of about 70%. The new somatostatin analogue SMS 201-995 is an important adjunct in controlling clinical symptoms in patients with neuroendocrine gut and pancreatic tumours. A combination of different treatment procedures is needed for long-term management of these patients. PMID- 3291523 TI - Intermediary metabolism, insulin sensitivity and insulin receptor status under comparable long-term therapy with insulin injections and continuous subcutaneous insulin infusion. AB - We have compared metabolic parameters, insulin sensitivity and insulin receptor status in 12 patients with insulin-dependent diabetes after 6 months treatment with insulin injection therapy and continuous subcutaneous insulin infusion therapy (CSII) in random order. Mean 24-h blood glucose, intermediary metabolite, plasma free insulin and counter-regulatory hormone concentrations were equivalent on the two regimes despite a significantly lower insulin dose on CSII (49.8 +/- 4.0 vs 39.3 +/- 2.2 U/24 h, P less than 0.01). When compared with a group of matched normal subjects, mean blood glucose and M-value, blood 3-hydroxybutyrate and free insulin concentrations were significantly higher on both regimes whilst blood alanine levels were depressed. Peripheral insulin sensitivity as assessed by the euglycemic clamp, basal hepatic glucose output, glucose carbon recycling, adipocyte insulin binding, adipocyte insulin sensitivity and lipogenesis were all similar after the two treatments. Insulin-stimulated initial rates of glucose uptake by adipocytes were higher after CSII (1.78 +/- 0.16 vs 2.35 +/- 0.27 pmol per cm2 cell membrane per 20 sec, P less than 0.005). PMID- 3291524 TI - The sonographical and functional sequelae of de Quervain's subacute thyroiditis: long-term follow-up. AB - Fifty-three patients with subacute thyroiditis (SAT) were seen during the acute stage of the disease. HLA-Bw 35 was positive in 33 out of 39 tested patients. At first presentation, all examined patients (N = 23) had ultrasound abnormalities (generalized hypodensity, single or multiple hypodense areas). Serum T4 and/or T3 were increased in 24/52, free T4 in 11/23, and the TSH response to TRH was flat in 8/11 patients. Six of 12 in whom volumetry was performed had goitres. Thirty seven patients were re-examined after a mean follow-up interval of 46.5 months. At this follow-up, serum T4, free T4 and T3 levels as well as the sonographically determined thyroid volume had decreased, but there was still abnormalities by ultrasound detected in 14/36 patients; 19.4% had focal sonolucent lesions, whereas the prevalence of such lesions was only 3.1% in asymptomatic controls. Three patients were subclinically hypothyroid at the follow-up, whereas all others were euthyroid. Patients with abnormal ultrasound findings were of the same age and had a similar thyroid size, but a slightly higher TSH and a significantly (P less than 0.02) lower free T4 than those with normal ultrasound findings. They also had a higher prevalence of thyroid autoantibodies in low titres. Serum thyroglobulin was elevated in more than half of the patients during the acute phase, but only in 1 out of 11 patients during follow-up. Thyroglobulin at the follow-up was not related to TSH, but there was a correlation with thyroid volume (r = 0.57).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291525 TI - The synthetic human growth hormone fragment (32-38) increases glucose uptake in the conscious dog. AB - hGH32-38 was tested to determine if the peptide could affect hepatic glucose production in the conscious dog under basal conditions (euglycemia) or if it could enhance glucose uptake when hyperglycemia was induced. hGH32-38 (1.6 nmol.kg-1.min-1) or vehicle was infused in a cross-over design study into each of 4 conscious 16 h-fasted dogs for 3 h (0-180 min) following a 40 min control period. At 90 min, plasma glucose was raised to and maintained at 9.4 mmol/l by glucose infusion for 3 h (until 270 min). Neither hGH32-38 nor vehicle infusion had a significant effect on insulin and glucagon levels or on tracer determined [( 3-3H]glucose) glucose production. As a result, neither treatment changed plasma glucose (5.72 +/- 0.17 to 5.78 +/- 0.17 mmol/l with hGH32-38; 5.50 +/- 0.22 to 5.50 +/- 0.17 mmol/l with vehicle). Induction of hyperglycemia (9.4 mmol/l) caused glucagon concentrations to fall similarly to about 50 ng/l with and without hGH32-38. Insulin rose to similar levels in both protocols, yet more glucose was required to maintain the same hyperglycemia with hGH32-38 (135-180 min) (74.9 +/- 12.7 vs 43.7 +/- 7.1 mumol.kg-1.min-1, P less than 0.05). In summary, hGH32-38 significantly increased glucose disposition during hyperglycemia and this effect may be attributed to enhanced insulin action or to an insulin independent action of the peptide. PMID- 3291526 TI - Management of early postoperative diabetes insipidus with parenteral desmopressin. AB - Management of early postneurosurgical diabetes insipidus (DI) requires parenteral vasopressin before intranasal administration of desmopressin-1 desamino-8 D arginine vasopressin (dDAVP) can be initiated. We have evaluated in 15 neurosurgical patients the effect and the tolerance of a 3-day regimen of dDAVP administered im every 12 h. Patients were randomly ascribed to one of 3 treatment groups: 1 microgram (N = 6), 2 micrograms (N = 5) or 4 micrograms (N = 4) were administered twice daily. dDAVP was effective whatever the dose, and DI was corrected by the 6th h of treatment. Effects were maximal on diuresis and urinary osmolality from the 18th h onwards. The effects were sustained throughout the treatment period. Reversal to pretreatment status occurred 24 h after the last injection. Moreover, 72 h after the last injection, natremia and osmolality reached values significantly below pretherapeutic values. The tolerance was excellent: hyponatremia which occurred in 11 patients, either occasionally or throughout the treatment period, remained mild and never had clinical consequences. In conclusion, before initiation of intranasal dDAVP, a 3-day treatment by 1, 2 or 4 micrograms of dDAVP injected im twice daily in neurosurgical patients corrected DI. Mild overhydration owing to a positive fluid balance was a side-effect which is also encountered in other therapeutic methods necessitating meticulous control of water intake. PMID- 3291527 TI - Sexual differentiation of oxytocin stress responsiveness: effect of neonatal androgenization, castration and a luteinizing hormone-releasing hormone antagonist. AB - The plasma OT increment following stress in rats is sexually dimorphic, females exhibiting greater responses than males. We have investigated the role of neonatal androgen secretion in determining the sex-typical level of response. Castration of male pups either surgically or functionally (GnRH antagonist treatment) within either 2 h or 5 days of birth did not elevate the OT responses of adult males. In contrast, androgenization of female pups (testosterone, 1.25 mg/pup) within 5 days of birth markedly reduced the OT stress responses of adults to a level insignificantly different to males. The results show that neonatal androgens can exert organizational effects on OT regulatory mechanisms. Since neonatal castration was ineffective it would appear that a prenatal defeminization or masculinization event determines OT stress responsiveness in males. PMID- 3291528 TI - Cholecystokinin-33 potentiates and vasoactive intestinal polypeptide inhibits gastric inhibitory polypeptide--induced insulin secretion in the perfused rat pancreas. AB - Gastric inhibitory polypeptide (GIP), cholecystokinin (CCK), and vasoactive intestinal polypeptide (VIP) stimulate insulin secretion. In this study we investigated whether CCK-33 and VIP could influence the insulinogenic effect of simultaneously administered GIP and 6.7 mmol/l glucose in the perfused rat pancreas. We found that at 0.1 nmol/l, GIP markedly potentiated glucose-induced insulin release whereas CCK-33 and VIP had a weak stimulatory effect and only during the late phase. At this low dose level, CCK-33 potentiated but VIP inhibited the late phase of insulin release stimulated by glucose and GIP. At 1.0 nmol/l, GIP, CCK-33, and VIP markedly potentiated both phases of glucose-induced insulin secretion. At this dose level CCK-33 and GIP exerted additive stimulatory effects on the late phase of insulin release triggered by glucose. In contrast, 1.0 nmol/l VIP inhibited insulin secretion augmented by glucose and GIP. In summary 1) GIP, CCK-33 and VIP all potentiate glucose-induced insulin secretion from the perfused rat pancreas, and 2) CCK-33 potentiates and VIP inhibits GIP induced insulin secretion. We suggest that interactions of this kind are of importance for the precise regulation of insulin secretion. PMID- 3291529 TI - CQP 201-403, a new dopamine agonist in the treatment of hyperprolactinemia. AB - Current drugs used for hyperprolactinemia may have severe side effects. Effects and side effects of a new propylergoline derivate (CQP 201-403 SANDOZ) have been evaluated. Twenty-four otherwise healthy women (21-44 years) with hyperprolactinemia (35-318 micrograms/l) without extrasellar extension of pituitary adenomas took part in a randomized, double-blind study. Fasting prolactin levels measured on day 7 was significantly decreased when compared with day 1 (P less than 0.05) in all CQP groups, to 78% with 0.005 mg daily, to 40% with 0.015 mg daily, and to 27% with 0.025 mg CQP per day for one week. The levels in the control group did not change (96%). The area under the curve of the prolactin day curve (1-8 h after drug administration) decreased significantly (P less than 0.05) at all doses when day 7 was compared with day 1, to 77% with 0.005 mg, to 51% with 0.015 mg, and to 37% with 0.025 mg CQP. No change was seen in the control group (96%). Four patients (one on 0.005 mg, one on 0.015 mg, and two on 0.025 mg) experienced orthostatic hypotension while standing blood pressure was to be measured on the first day of treatment, and they had to lie down. CQP 201-403 lowers prolactin levels in hyperprolactinemic women at all doses employed. The effect was seen after the first dose of treatment, and lasted for at least 24 h. The adverse reactions are few and tolerable, and might be less than with current bromocriptine therapy. PMID- 3291530 TI - Biological characterization of charge isomers of human growth hormone. AB - Since deamidation of the human GH molecule may alter the manner and extent to which the hormone is cleaved by proteases, and since it has been repeatedly suggested that proteolytic processing is required for the expression of certain of the activities of GH, the present study was conducted to determine whether the biological activity profiles of more acidic forms of human GH are altered. Three charge isomers, GH-b, GH-c and GH-d, representing primarily deamidated forms, were isolated from a native human GH preparation (Crescormon) in amounts adequate for characterization of their biological activities. All three were essentially equipotent in a radioimmunoassay for human GH. When assessed for growth-promoting activity in the hypophysectomized rat, the isomers were again equipotent with each other and with the GH preparation from which they were derived. The charge isomers also had significant in vitro insulin-like activity on isolated rat adipose tissue and diabetogenic activity in the ob/ob mouse. Thus, the biological activity profiles of these charge isomers of human GH do not differ greatly from one another. PMID- 3291531 TI - Urinary excretion rate of C-peptide in fed and fasted obese humans. AB - The aim of the study was to evaluate the reliability of urinary excretion rate of C-peptide as a marker of B-cell function during fasting. Ten obese subjects of both sexes fasted for 5 days. Diurnal serum C-peptide was collected before and on the 5th day; morning serum samples (for glucose, insulin and C-peptide) and 12-h urine samples (7.00 to 19.00 h) were collected daily. Body weight decreased from 138.7 +/- 15.9 to 132.9 +/- 15.6 kg. Morning glucose, insulin (-40%) and C peptide (-50%) fell significantly throughout the study. Mean diurnal C-peptide values were 2.19 +/- 0.69 nmol/l before and 0.60 +/- 0.19 nmol/l after fasting (P less than 0.0001) and its secretion rate was 909.4 +/- 297.9 and 244.4 +/- 83.9 nmol/12 h (P less than 0.005), respectively. Excretion rate of C-peptide fell progressively from basal (11.2 +/- 4.2 nmol/12 h) to a nadir value of 1.3 +/- 0.8 nmol/12 h (P less than 0.0005); similarly, the C-peptide to creatinine clearance ratio fell from 0.062 +/- 0.035 to 0.028 +/- 0.015 (P less than 0.05). These results indicate that fasting modifies renal metabolism of C-peptide thus creating several complications in the quantitative interpretation of urinary levels as an index of its secretion rate from the B-cell. PMID- 3291532 TI - Morphology, yield and functional integrity of islet-like cell clusters in tissue culture of human fetal pancreata obtained after different means of abortion. AB - Morphology, yield and function were studied in cultured islet-like cell clusters (ICC) from 140 human fetal pancreata obtained after abortions of different types performed at 11-23 weeks of gestation (12 by hysterotomy, 75 by mechanical dilation and extraction, and 53 induced with prostaglandin). After collagenase digestion and culture in medium supplemented with 10% human serum, up to 2000 free-floating ICC were formed from a single pancreas. Randomly scattered insulin- and glucagon-immunoreactive cells were found in the medullary part of the ICC. More than 100 ICC developed in 100% of the hysterotomies and 87% of the mechanical abortions, but in only 53% of the prostaglandin-induced abortions. Insulin and glucagon levels in the culture medium decreased rapidly during the first 7 days of culture, but then remained stable for at least 31 days. The hysterotomy-derived ICC responded to 10 mmol/l theophylline plus 20 mmol/l glucose by a 12.2 +/- 3.1 (SEM, N = 7) fold increase in insulin release, as compared with a 5.4 +/- 0.9 fold response of the prostaglandin ICC (N = 16; P less than 0.02). Despite the low proportion of B-cells, (pro)insulin biosynthesis accounted for 10% of the total protein biosynthesis in low (2 mmol/l) glucose. In conclusion, the yield and viability of the ICC were clearly better, if prostaglandin had not been used for the induction of the abortion. PMID- 3291533 TI - The return to ovulation following early abortion: a comparison between vacuum aspiration and prostaglandin. AB - The return to ovulation following early abortion (less than or equal to 56 days amenorrhea) has been assessed after both vacuum aspiration under general anesthesia (N = 14) and menstrual induction with 16,16 dimethyltrans-delta 2PGE1 methyl ester in pessary form (N = 18). The urinary excretion of hCG, total estrogen and pregnanediol was similar in each group. There was an initial rapid decline in hCG excretion (t1/2 48 h), reaching 10% of the pre-treatment value after 6 days. Twenty-nine (91%) women showed a luteal phase rise in pregnanediol excretion, with ovulation occurring on day 29 (16-37) and 24 (16-32) in the vacuum aspiration and prostaglandin groups, respectively (median (range) NS). The wide range in the return of ovarian activity was related to the variation in decline of progesterone secretion (as reflected by excretion of pregnanediol) by the corpus luteum. Asynchrony between the ovarian and menstrual cycles resulting from a delay to ovulation presents a major constraint to the use of early pregnancy interruption as a routine method of fertility control. PMID- 3291534 TI - Progesterone does not inhibit the increase in pituitary content of luteinizing hormone after removal of estradiol in the ewe. AB - During late gestation in the ewe, the pituitary content of LH is reduced by about 95%, presumably due to the presence of high concentrations of ovarian steroids. The aim of this study was to determine whether the pituitary content of LH in the ewe can increase after long-term administration of ovarian steroids, when only estradiol (E) is removed or if both E and progesterone (P) must be withdrawn to allow synthesis of LH to occur. Ten ovariectomized ewes were treated with implants containing E and P. After 3 weeks of treatment, the E implants were removed from 5 ewes (-E+P) and both steroid implants were removed from the remaining 5 ewes (-E-P). Five ovariectomized ewes received P implants at the beginning of the experiment and these implants were left in place for the duration of the study; 5 ovariectomized ewes served as controls (C). All animals were injected with 100 micrograms GnRH iv 3, 6 and 9 weeks after the initiation of treatment. The area under the LH-response curve was used as an indication of the pituitary content of LH. All steroid treatments markedly reduced basal levels of LH. LH levels increased only in -E-P ewes, beginning 6 weeks after initiation of the study. After 3 weeks, -E+P and -E-P ewes released less LH (P less than 0.05) in response to GnRH than did C ewes, whereas P animals did not differ from controls. LH release in response to GnRH in -E+P and -E-P groups had increased by 6 and 9 weeks and was not different from that of C ewes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291535 TI - Possible involvement of diacylglycerol-activated, Ca2+-dependent protein kinase in glucose memory of the rat pancreatic B-cell. AB - Exposure to high concentrations of glucose potentiates insulin release from the pancreatic B-cell stimulated by various secretagogues after an interval under basal condition. We studied the role of diacylglycerol-activated, Ca2+-dependent protein kinase (protein kinase C) in this priming effect of glucose in rat pancreatic islets, using 12-O-tetradecanoyl phorbol-13-acetate (TPA), 1-(5 isoquinolinesulfonyl)-2-methylpiperazine (H-7),N-(2-guanidinoethyl)-5 isoquinolinesulfonamide (HA-1004) and forskolin. The priming effect of glucose was mimicked by 10 nmol/l of TPA, an activator of protein kinase C, but not by 5 mumol/l of forskolin, which increases cAMP via activating adenylate cyclase. When pancreatic islets were exposed to glucose (10 mmol/l) together with 50 mumol/l of H-7, an inhibitor of protein kinase C, the secretory response to glucose (10 mmol/l) after a 30-min interval was significantly reduced compared with that in the islets previously exposed to 10 mmol/l glucose alone. In contrast, this was not the case for HA-1004, its inhibitory activity against protein kinase C being less potent than H-7. These findings suggest that protein kinase C may play an important role in the priming effect of glucose on the pancreatic B-cell. PMID- 3291536 TI - Opposing effects of glucose and tolbutamide on the sodium content of rat pancreatic islets. AB - Integrating flame photometry was employed for measuring sodium in rat pancreatic islets incubated in media buffered with HEPES or bicarbonate. The sodium content decreased by nearly 40% when the islets were exposed to 5 mmol/l glucose, no further reduction being seen with additional rise of the concentration to 20 mmol/l. Whereas the depressing effect of glucose was mimicked by 100 mumol/l quinine, increased sodium contents were noted after inhibition of the Na/K pump (removal of extracellular K+ or addition of 1 mmol/l ouabain) or exposure of the islets to 1 mmol/l tolbutamide. Although promoting sodium accumulation in the islet cells, tolbutamide counteracted the increase in sodium obtained on withdrawal of K+ from the incubation medium. It is suggested that tolbutamide in addition to its major effect in promoting the entry of Ca2+ also facilitates insulin release by suppressing the outward transport of this ion. PMID- 3291538 TI - Urinary metabolites of thromboxane and prostacyclin in diabetes mellitus. AB - The in vivo synthesis of thromboxane A2 and prostacyclin was estimated in 23 diabetics through measurements of the major urinary metabolites 2,3-dinor thromboxane B2 and 2,3-dinor-6-keto-PGF 1 alpha utilizing gas chromatography-mass spectrometry. Mean excretion was similar to that in non-diabetic subjects. The possible influence of hyperglycemia on the excretion of 2,3-dinor-thromboxane B2 and 2,3-dinor-6-keto-PGF 1 alpha was evaluated in three ways: by measuring excretion before and during an acute 9-h normalization of hyperglycemia through an artificial pancreas (Biostator) as well as by comparing excretion before and 7 12 days or 40-180 days after the initiation of insulin treatment. Despite significant reducing effects on hyperglycemia or on levels of hemoglobin A 1c, no effects on the excretion of the thromboxane and prostacyclin metabolites could be found. Abnormal formation of thromboxane or prostacyclin is not a generalized feature of the diabetic state. PMID- 3291537 TI - Effects of fasting on blood plasma levels, metabolism and metabolic effects of epinephrine and norepinephrine in steers. AB - Experiments were designed to study effects of 3 days of fasting on blood plasma levels, metabolic clearance rates (MCR) and effects of norepinephrine (NE) and epinephrine (E) on levels of glucose, nonesterified fatty acids (NEFA) and immunoreactive insulin (IRI) in 12 steers. During fasting, levels of E, NE and protein did not change, whereas IRI, T3 and glucose decreased and NEFA, acetoacetate and beta-hydroxybutyrate increased. Before and at the end of fasting, NE or E were iv infused for 120 min. NE and E were elevated after 15 min and to the end of the infusion. The increase in E, but not in NE, was significantly greater after 3 days of fasting than before fasting (P less than 0.05). MCR for E was lower after fasting (299 +/- 17 vs 204 +/- 10 ml.kg-0.75.min 1; P less than 0.001), whereas MCR for NE was not significantly different (455 +/ 37 vs 400 +/- 27 ml.kg-0.75.min-1). MCR was higher for NE than for E, both before and after fasting (P less than 0.05). After the infusion, E and NE decreased within minutes to pre-infusion concentrations. During E infusions, NEFA increased significantly more, whereas glucose increased less in fasted than in fed animals. During NE infusions, NEFA increased in fasted, but not in fed animals, and glucose increased less at the end than before fasting. IRI decreased during E infusions only in fed animals, and transiently increased after the infusion, except after NE infusion in fasted steers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291539 TI - Autoimmune thrombocytopenia after allogeneic bone marrow transplantation: a case report. PMID- 3291540 TI - Comparison between bone marrow transplantation and immuno-suppressive therapy in treatment of patients younger than 20 years with severe aplastic anemia. PMID- 3291541 TI - Pathophysiology of brain ischaemia. AB - The main data concerning the pathophysiology of cerebral ischaemia are reviewed and subdivided into five chapters: elementary cellular changes, elementary circulatory disturbances, pathology at the cellular and tissular levels, causes of ischaemia, and topography of ischaemic brain lesions. Local, regional and general factors are discussed and the prominent role played by the haemodynamic factors is emphasized. PMID- 3291542 TI - Dopplersonography of the brain supplying arteries. PMID- 3291543 TI - Brain ischaemia. PMID- 3291544 TI - Intraarterial thrombolytic therapy in acute stroke. AB - Intraarterial thrombolytic therapy by means of urokinase has proved to be effective and safe in certain instances of acute thromboembolic occlusion of the vertebral and/or the basilar artery. Small hemorrhages have not led to deterioration in the patients' neurological state. In the territory of the carotid artery local thrombolytic therapy may be effective in very selected cases of acute thromboembolic occlusion. There is a high risk of intracerebral hemorrhage. Possibly intravenous administration of tPA will replace local intraarterial thrombolysis, provided a strict regimen is established for selection of patients, determination of dosage and time constraints for the application of this therapy. PMID- 3291545 TI - Secondary prevention of brain ischaemia. PMID- 3291546 TI - Lisuride in de novo parkinsonian patients: a four-year follow-up. AB - Lisuride at a mean daily dose of 3.2 mg was given to 15 untreated idiopathic Parkinson's disease patients. There were 10 dropouts, due mainly to inefficacy in the first months of therapy. The parkinsonian pattern in the patients who remained in the study for the full 4 years showed distinct improvement, which was maintained for less than 2 years. The patients did not develop "on-off" phenomena or abnormal involuntary movements during follow-up. PMID- 3291547 TI - Acta ophthalmologica 1923-1988. PMID- 3291548 TI - Treatment versus no treatment in chronic open angle glaucoma. AB - In a controlled randomized study 15 patients (20 eyes) with chronic open angle glaucoma and visual field defects were followed by greater than 1 year, 12 of them were followed for 3 years. Half of the group were untreated controls, the other half treated with pressure reducing medical therapy. At least 5 consecutive computerized visual fields were recorded (COMPETER) on each eye, and the linear regression coefficient was calculated. With the reservation for uncontrolled compliance no significant difference in the line of favourable effect of pressure reduction could be spotted, in spite of an average pressure reduction in the treated group of 4 mmHg. More important than this result, which is open to criticism for the smallness of the material, uncontrolled compliance etc, is the lesson that a randomized experiment with treated and non-treated glaucoma cases carried out in accordance with the Helsingfors convention is hardly feasible. PMID- 3291549 TI - Protein content of infant formula--how much and from what age? PMID- 3291550 TI - Contrasting features of insulin dependent diabetes mellitus associated with neuroectodermal defects and classical insulin dependent diabetes mellitus. AB - The Wolfram, or DIDMOAD, syndrome is a rare congenital disease that is associated with diabetes insipidus, insulin dependent diabetes mellitus of an early onset, bilateral optic atrophy and deafness. Urological disorders are usually present as well. We have studied nine patients belonging to five different families. All of the family members were HLA typed (including DR), and islet cell as well as antinuclear antibody determinations were carried out. Although individuals with insulin dependent diabetes mellitus are very prone to have either HLA-DR3 or -DR4 antigens, none of our patients had DR3 antigens and only one was DR4 positive. On the other hand, three of our patients were typed as HLA-DR2 positive. This antigen is uncommon in classical insulin dependent diabetes. In one of the families, the affected siblings did not share the same HLA haplotype. Islet cell and antinuclear antibodies were not found in any of the cases and six of the patients had a small, but significant, insulin secretory reserve. On the basis of some of the clinical features it was also possible to further distinguish between the DIDMOAD syndrome and the classical insulin dependent diabetes mellitus. The differences encountered between classical and DIDMOAD insulin dependent diabetes mellitus--the presence/absence of HLA linkage, HLA-DR2, -DR3 and -DR4 associations, islet cell or antinuclear antibodies, the tendency to ketosis and diabetic retinopathy--indicate that their etiopathogenies are triggered by distinct mechanisms. PMID- 3291551 TI - Are there tests predictive for prolonged apnoea and SIDS? A review of epidemiological and functional studies. AB - Sudden infant death syndrome (SIDS) remains the predominant cause of postneonatal mortality. Epidemiological studies have led to the definition of populations with an increased risk for SIDS: subsequent siblings of SIDS victims, infants with near miss for SID episodes, prematurely born infants with perinatal risk factors, and infants of drug dependent mothers. Furthermore, a variety of additional although rarely independent factors regarding both mothers and infants have been found to be associated with an increased risk for SIDS. Despite of this, the majority of infants still dying from SIDS do not belong to one or more of these risk groups and even within a group considered to be at increased risk it is impossible so far to identify individual infants at highest risk on the basis of an infant's history and clinical data. Therefore, different methods have been applied during the last several years in order to detect functional abnormalities of cardiorespiratory control during sleep with the aim of obtaining more specific and sensitive predictors of subsequent severe apnoea and SIDS. In an attempt to evaluate the predictive power of these various methods the present article reviews their results in relation to the follow up data of the infants under study. The results of the meanwhile innumerous studies were found to be at variance and often controversial. At the present time, none of these tests may be looked at as virtually improving our ability to predict the risk for prolonged apnoea and SIDS. One of the reasons for this may be the lack of standardisation of the particular methods with respect to both definition of study groups and conditions of testing infants. Since all of these tests have mainly been performed in infants of epidemiological risk groups, the definition of which is an indispensable prerequisite for the evaluation of both the indication and the results of such tests, an updated survey of the more recent epidemiological studies is given as an introduction. PMID- 3291552 TI - Stage (Ia) cervical cancer recurring 13 years after hysterectomy and causing small intestinal perforation. A case report with a review of the literature. AB - A rare case of recurrent cervical cancer presenting multiple metastases to the small intestine is reported. A 69-year-old Japanese woman with a past history of early-stage (Ia) cervical cancer 13 years previously suffered sudden onset of panperitonitis caused by perforation of the small intestine. In the perforated lesion, squamous cell carcinoma, which was histologically similar to that of the primary lesion, was observed, and was diagnosed as a late recurrence of the cervical cancer. Perforation of the small intestine caused by tumor metastasis, especially metastasis from cervical cancer, rerely occurs. Furthermore, recurrence of an early cervical cancer presenting 13 years after hysterectomy is extremely rare. The present case draws attention to the possibility of late recurrence of cervical cancer, even in cases treated at the early-stage. PMID- 3291553 TI - Physiological and biochemical implications of prostaglandins from the perspective of developing safer first and second-trimester obstetrics. AB - Hungary has experienced one of the highest prematurity rate of the world due to the large number of induced abortions carried out by rapid mechanical dilation of the cervix during the last three decades. With the pioneering work of Professor Sune Bergstrom in the identification and isolation of the primary, naturally occurring prostaglandins and in elucidating their chemical structure, it became possible also in Hungary to start research with the help of the Swedish investigators and WHO assistance on the clinical application of PGs. Recently growing understanding of cervical physiology promotes their use for cervical dilatation and for pharmacological uterine stimulation which is especially important in Hungary from the perspective of changing the recent situation, i.e. preventing cervical incompetence and subsequent "short-gestations" in future pregnancies. The physiologic importance of the development of the PG-analogues with slowed-down metabolic degradation is outlined here. The implications of the PGs in cervical ripening is reviewed, and the role of the cervix,--as an endocrine gland, playing a biochemically preprogrammed role in controlling a wide array of physiological processes throughout human gestation--, is discussed. PMID- 3291555 TI - Effect of inhibition of endocytosis, recycling and lysosomal activity on the insulin binding capacity and imprintability of Tetrahymena. AB - Dinitrophenol (DNP), an inhibitor of endocytosis of hormone receptors, Tris, an inhibitor of recycling and chloroquine, an inhibitor of lysosomal degradation, all decreased the binding of insulin and inhibited the development of hormonal imprinting in Tetrahymena. The effects of DNP and Tris seemed to be similar even quantitatively. The effect of chloroquine proved to be somewhat different, it appeared later, was more pronounced after 24 hours and more marked when insulin was also administered. Combined administration of Tris + DNP inhibited the binding of insulin but this inhibition was the one which disappeared most completely after 24 hours and the one where the inhibition of imprinting was the most pronounced. Tris + chloroquine led to severe destruction of the cells. The conclusion has been drawn that the inhibition of membrane circulation inhibits not only the hormone binding but also the development of imprinting in Tetrahymena. PMID- 3291554 TI - Antihypertensive treatment in spontaneously hypertensive rats with streptozotocin induced diabetes mellitus. AB - Recent clinical reports have suggested that hypertension accelerates the progress of diabetic nephropathy and retinopathy, whereas antihypertensive treatments may retard them. Thus, the effect of antihypertensive treatment in diabetes mellitus with hypertension was evaluated in rats. A model of diabetes mellitus with hypertension has been developed in spontaneously hypertensive (SHR) rats by unilateral nephrectomy and streptozotocin (STZ, 30 mg/kg, i.v. treatment). The rats were treated with four antihypertensive drugs orally for 12 weeks thereafter. STZ treatment induced chronic hypeglycaemia (300-400 mg/dl), decreased body weight and heart rate, and caused vascular changes of ophthalmic fundi and cataracta. The kidney of these rats showed proliferative changes such as periarteritis nodosa, hyperplasia, or fibronecrosis of the arterioles, exudative changes, mesangial proliferation, or thickening of the basement membrane of the glomeruli. Enalapril (10 mg/kg per day) and remipril (Hoe 498) (1 mg/kg per day), converting enzyme inhibitors, or arotinolol (20 mg/kg per day), a beta-adrenoceptor blocking drug, decreased blood pressure, prevented the development of renal and ocular lesions, and tended to increase creatinine clearance. Nisoldipine (3 mg/kg per day), a calcium-entry blocking drug, tended to decrease blood glucose, and prevented the decrease of body weight and development of ocular lesions. In conclusion, antihypertensive treatments were effective in preventing the progress of diabetic retinopathy and nephropathy, and renal insufficiency in this animal model. PMID- 3291556 TI - Prolongation of cardiac allograft survival in rats by treatment with anti interleukin 2 antiserum. AB - Interleukin-2 (IL2) is the obligatory signal for both T cell mitogenesis and in vitro generation of alloreactive cytotoxic T lymphocytes (CTL). An investigation was made to determine whether an antibody directed against IL2 would suppress the rejection reaction of rat cardiac allografts. Rabbit anti-interleukin 2 (anti IL2) antiserum was obtained by immunizing at 2 week intervals over a period of 8 weeks with 10(6) U of recombinant human IL2 along with complete Freund's adjuvant. The bioassay for inhibition of IL2 activity by anti-IL2 antiserum was carried out in conjunction with the IL2-dependent cytotoxic T cell (CTLL cell) assay. Cardiac allografts of F344 rats were heterotopically transplanted into ACI rats. Seven daily doses of 1 ml of anti-IL2 antiserum were administered intravenously following transplantation. IL2-driven [3H]thymidine incorporation in CTLL cells was significantly inhibited by rabbit anti-IL2 antiserum. Graft survival in the anti-IL2 serum-treated group was significantly prolonged in a dose-dependent fashion compared to control groups. In conclusion, these results indicate that rabbit anti-IL2 antiserum may prove to be of significant value as an immunosuppressive agent in clinical organ transplantation. PMID- 3291557 TI - Propafenone versus disopyramide for treatment of chronic symptomatic ventricular arrhythmias. A multicenter study. AB - The efficacy and safety of propafenone, 150 mg four times daily, were compared with those of disopyramide, 100 mg four times daily, in a randomized single blind, cross-over study in 38 patients with symptomatic premature ventricular complexes (PVCs). The 24-hour ambulatory ECG, employed for assessing antiarrhythmic efficacy, was analyzed blindly. The median reduction in the number of PVCs was higher with propafenone than with disopyramide (91.4% vs. 63.5%, respectively, p less than 0.01). A reduction of at least 80% was achieved by propafenone in 22 (59%) and by disopyramide in 16 patients (43%) (NS). Ventricular tachycardias (VTs) were abolished by propafenone in eight out of 11, and by disopyramide in five out of nine patients with VTs (NS) a possible proarrhythmic effect was seen in three patients during disopyramide and in one patient during propafenone treatment. Micturition disturbances (p less than 0.001) and a dry mouth (p less than 0.01) were more commonly associated with disopyramide than with propafenone. In conclusion, in the given dosages, propafenone was superior to disopyramide in suppressing PVCs and had fewer side effects. PMID- 3291558 TI - Melatonin secretion related to side-effects of beta-blockers from the central nervous system. AB - In two studies of hypertensive patients the relationship between beta-blocker induced CNS side-effects and the nightly urinary secretion of melatonin was analysed. In one group (n = 10) placebo, atenolol (mean dose 86 mg/day) or propranolol (mean dose 305 mg/day) were given in a double-blind, randomised design. In the other (n = 13) 100-400 mg metoprolol was given daily (mean dose 197 mg). After 4 weeks of treatment all beta-blockers reduced melatonin excretion, but the effect was significant only for metoprolol. Sleep disturbance records revealed more disturbed nights in the metoprolol group compared with the propranolol and the atenolol groups, even when the difference in age between the groups was controlled for. In the metoprolol group a significant relationship (p less than 0.05) was found between the fall in melatonin and the percentage of disturbed nights. Severe CNS side-effects, such as nightmares, occurred only in patients treated with metoprolol (21%), which in all cases were accompanied by low levels of melatonin. Our data suggest that the CNS side-effects during beta blockade are related to a reduction of melatonin levels. PMID- 3291559 TI - Are effects of antihypertensive treatment on lipoproteins merely "side-effects"? A comparison of prazosin and metoprolol. AB - Thirty-seven patients with a supine systolic blood pressure greater than 160 and/or a diastolic blood pressure greater than 95 mmHg were enrolled in the study and treated for 6 months with prazosin and 6 months with metoprolol (in random order). Neither the systolic nor the diastolic blood pressures differed after the two types of treatment (median difference 0/0 mmHg). The mean and median differences in serum cholesterol, however, were 0.4 and 0.3 mmol/l respectively, which were 9 and 5% of the pretreatment values. The corresponding differences in the atherogenic index (in which cholesterol in high density lipoproteins is integrated) were 10 and 8% of the pretreatment values. This difference in the metabolic response to the two drugs at the same blood pressure level is most probably of importance in the long-term prevention of ischaemic heart disease, for which high levels of serum cholesterol and atherogenic index are major risk factors. PMID- 3291560 TI - Non-respondents in a post-myocardial infarction trial: characteristics and reasons for refusal. AB - We surveyed the 270 survivors of acute myocardial infarction who refused to participate in the Warfarin Re-Infarction Study (WARIS). Information on medical variables were derived from registration forms completed by hospital staff upon discharge, whereas data on a variety of health conditions and reasons for refusal were gathered by mailed questionnaires, 178 (66%) of which were returned. Some disparities were found when comparing non-respondents and participants, the former showing more potential bad risk factors. The diversities between participants and non-respondents are of yet unknown prognostic importance. However, the presence of such differences imply that information on characteristics of non-respondents in clinical trials is desirable in terms of generalizability of the trial results. Reasons stated for non-participation reflect poor motivation, low mobility and saturation with focusing on disease. A slight co-variation between social status and reasons for refusal was noted. PMID- 3291562 TI - [What...about tumor markers]. PMID- 3291561 TI - Incidence of nocturnal hypoglycaemia in insulin-dependent diabetic patients on intensive therapy. AB - The frequency of nocturnal hypoglycaemia, i.e. blood glucose concentration (BG) less than 3.0 mmol/l, was evaluated in consecutively selected insulin-dependent patients on multiple insulin injections (MII), n = 23, or continuous subcutaneous insulin infusions (CSII), n = 25. Blood was sampled hourly from 23.00 to 07.00. Seven patients (30%) on MII had at least one BG less than 3.0 mmol/l during the night. Eleven patients (44%) on CSII had hypoglycaemia (NS). The total number of BGs less than 3.0 mmol/l was higher on CSII, 42 of 225, versus 16 of 207 on MII (p less than 0.025). The duration of hypoglycaemia was 2 hours (range 1-6) on MII and 4 hours (range 1-7) on CSII with a maximal prevalence at 4 hours and between 5 and 7 hours, respectively (p = less than 0.05). The frequency of nocturnal hypoglycaemia is high in patients on intensified insulin regimens. Nocturnal hypoglycaemia occurs later in the night and is of longer duration on CSII than on MII. HbA1c, BG before bedtime and in the morning might be useful in the evaluation of nocturnal hypoglycaemia. PMID- 3291563 TI - [Aneurysm of the renal artery. Report of 2 clinical cases and review of the literature]. PMID- 3291564 TI - [Perirenal pancreatic pseudocyst]. PMID- 3291565 TI - [Bladder leiomyoma]. PMID- 3291566 TI - [Idiopathic thrombosis of the renal vein in adults, apropos of a case. Importance of conservative treatment and review of the literature]. PMID- 3291567 TI - Retraction pocket and development of cholesteatoma in children. PMID- 3291568 TI - Allografts and congenital aural atresia. PMID- 3291569 TI - Definition and character of acute and secretory otitis media. PMID- 3291570 TI - Incidence and risk factors of acute otitis media and otitis media with effusion in children of different age groups. PMID- 3291571 TI - The toxicity of paraquat. PMID- 3291572 TI - Toxicity of tin and its compounds. AB - Inorganic tin salts are poorly absorbed and rapidly excreted in the faeces; as a result they have a low toxicity. Only about 5 per cent is absorbed from the gastrointestinal tract, widely distributed in the body, then excreted by the kidney. Some tin is deposited in lung and bone. Some tin salts can cause renal necrosis after parenteral doses. Mutagenic studies on metallic tin and its compounds have been negative. Long-term animal carcinogenic studies have shown fewer malignant tumours in animals exposed to tin than in controls. Human volunteers developed mild signs of toxicity with tin, given in fruit juices, at a concentration of 1400 mg per litre. The WHO 1973 permissible limit for tin in tinned food is 250 micrograms per kg. The adult daily intake of tin was about 17 mg per day in 1940, but it has now decreased to about 3.5 mg, due to improvements in technique of tinning with enamel overcoat and crimped lids to minimize exposure to tin and lead solder. This level is well below the level of 5-7 mg per kg body weight shown to give rise to toxic symptoms. Tin deficiency has not been described in man. Amounts in excess of 130 mg per day have been shown to accumulate in liver and kidneys. Many of the organotin compounds are toxic; the most toxic being trimethyltin and triethyltin, which are well absorbed from the gastrointestinal tract. Most of the other alkyl and aryltin compounds are poorly absorbed from the gastrointestinal tract, and are therefore less toxic when given orally than when given parenterally. The main results of toxicity are skin and eye irritation; cholangitis of the lower biliary tract, and later hepatotoxicity; and neurotoxicity, which has been shown to be due to intramyelin oedema induced by triethyltin, and neuronal necrosis caused by trimethyltin. Many of the organotin compounds affect mitochondrial oxidative phosphorylation and alter membranes, but the contribution of these biochemical and membrane effects in the cause of intramyelin oedema and neuronal necrosis has not been fully clarified. Widespread degeneration results, especially with trimethyltin. Peripheral neuropathy has not been reported as occurring with either inorganic or organic tin in humans. Certain dialkyltin compounds have been shown to cause adverse effects on cell-mediated immunity, specifically on the T cell lymphocyte. Experimental studies have failed to reveal any evidence of carcinogenicity, mutagenicity, or teratogenicity. Recent studies suggest that tin compounds exhibit some antitumour activity and may have a future role in cancer diagnosis and chemotherapy, and in controlling hyperbilirubinaemia. PMID- 3291573 TI - Knot-holding scissors. PMID- 3291574 TI - Small incision otoplasty for prominent ears. AB - A 5-cm incision and an elliptical skin excision are part of almost all surgical techniques designed to correct prominent ears. It is proposed that two 0.5-cm incisions be used that give access to the lateral surface of the auricular cartilage, which is thinned with a rasp along the antihelix and concha. The skin is not removed at all. Results obtained with this technique are presented. PMID- 3291576 TI - Oral mucosal disorders in institutionalized elderly people. AB - The aim of the study was to investigate the type and incidence of oral mucosal disorders in the elderly, any relationship between these disorders and the wearing of dentures, and the associated subjective symptoms of pain. The subjects were 480 residents of 24 municipal old people's homes in different parts of Finland: 153 males and 327 females, age range 65-100 years. The methods used were clinical examination and interview. Clinical examination showed about 60% of the elderly to have one or more oral mucosal disorders. Altogether, 431 pathological conditions were recorded, with changes of the surface of the tongue the most frequent. Hyperplasia and/or denture-related ulcerations and press-points were found in 43% of denture wearers. The interviews revealed that only 17% of those with oral mucosal disorders had symptoms of pain, most frequently caused by press points and ulcerations. The absence of subjective symptoms emphasizes the importance of frequent oral examinations, especially of the oral mucosa. PMID- 3291575 TI - Augmentation rhinoplasty with soft tissue and cartilage. AB - Augmentation rhinoplasty using soft tissue and cartilage was performed on 120 patients and the results were reexamined. They were found to be satisfactory and without complication. To narrow a round tip, a resection of two-thirds of the lateral crus cephalad portion and a transection of the caudal portion with a strip resection was done. To elevate the tip, septal cartilage was sutured to one third of the upper part of medial crus to form a columella cartilage strut. To maintain the strut and to prevent pointing, a fibrous muscle tissue stretching from the medial crus to the upper cartilage or a dermis was transplanted into the area surrounding the septal cartilage tip. For a simple elevation of the dorsum, an onlay graft of dermis was applied, but where further elevation was required, further dermis and conchal cartilage was added for suture and attachment to the dermis. PMID- 3291577 TI - [A case of spontaneous orbital hematoma in a child]. PMID- 3291578 TI - [Optic nerve disorders--the experimental models and the clinical findings]. PMID- 3291579 TI - [Titer of anti-streptococcal antibody in Behcet's disease]. PMID- 3291580 TI - [Velo-palatine disorders. An extensive review. 1]. PMID- 3291581 TI - [Post-radiation bone complications. Data in the literature on mandibular osteoradionecrosis]. PMID- 3291582 TI - [Adrenal incidentaloma: report of eight cases]. AB - Since 1983, eight cases of adrenal incidentaloma were experienced at the Department of Urology, Wakayama Medical College and affiliated hospitals. Six adrenal masses were incidentally detected by computed tomography, and two were first noted by either ultrasonography or intravenous pyelography. Surgical exploration was performed in all cases as the final diagnostic measure. Of them, three had adrenocortical adenomas, three had adrenal cysts, one had adrenal metastasis and one had pheochromocytoma. Preoperative evaluation revealed that all patients except one with pheochromocytoma had no endocrinological abnormality. The management of the adrenal incidentaloma, which will be discovered more frequently accompanied with the increasing use of computed tomography, was discussed with special references to its precise indication of surgical treatment. PMID- 3291583 TI - [Two cases of acute renal failure associated with non-typhoid Salmonella infection]. AB - Two cases of acute renal failure associated with non-typhoid Salmonella infection are reported. Case 1: A 49-year-old man was admitted with the complaint of severe watery diarrhea and oliguria. Stool culture revealed Salmonella typhimurium. Laboratory data showed hyponatremia and acute renal failure. Hemodialysis was performed 3 times and renal failure was improved. Case 2: A 63-year-old woman was admitted with complaint of severe watery diarrhea, nausea, and fever. Stool culture revealed Salmonella E group. Septic shock appeared after admission, and anti-shock therapy was immediately carried out. Acute renal failure was cured without hemodialysis, even though multiple organ failure had occurred concomitantly. We discussed the management of patients with Salmonella infection, especially those with acute renal failure. PMID- 3291584 TI - [Angiomyolipoma of the kidney with regional lymph node involvement]. AB - A 44-year-old male was admitted with complaints of gross hematuria and high fever. An excretory urogram and renal angiography revealed a massive lesion in the right kidney. A computed tomographic scan showed bilateral renal tumors with low-density areas. Transperitoneal right radical nephrectomy, regional lymph node dissection and left renal biopsy were performed on September 5, 1984. The tumor was 14.5 X 7 X 6 cm in size and yellowish in cross section. The pathological diagnosis was bilateral angiomyolipomas and the same in the right hilar lymph node and the surrounding tissue. There was no evidence of malignancy. PMID- 3291585 TI - [Pelvio-ureteral tumor 5 years after uretero-cutaneostomy]. AB - A 70-year-old woman visited our hospital with the chief complaint of intermittent gross hematuria from right ureterocutaneostoma. She had received total cystectomy and bilateral ureterocutaneostomy because of bladder tumor (transitional cell carcinoma, grade 3, stage T2) 5 years earlier. Urine cytology showed transitional cell carcinoma (TCC). The right retrograde pyelogram showed shadow defects of right pelvis and upper ureter, computed tomographic scan showed fatty density mass of right pelvis. Preoperative diagnosis was right pelvic and ureteral tumors. Right nephroureterectomy was performed on May 26, 1986. Histology revealed TCC, grade 3 on the pelvis and upper ureter. Cases of pelvio-ureteral tumors of ureterocutaneostomy were collected from the literature and reviewed. PMID- 3291586 TI - [A case of ureteral stenosis caused by ureteral endometriosis]. AB - A case of ureteral endometriosis is reported A 42-year-old woman visited our clinic on December 3, 1985, with the complaint of right lumbago. Intravenous pyelography showed right hydronephrosis and retrograde pyelography revealed ureteral stenosis at 11 cm from right ureteral orifice and 2 cm long. Primary right ureter tumor was suspected. The operation was performed on January 16, 1986 and revealed periureteral mass. The mass was removed with ureter and ureteroureterostomy was performed. The pathological diagnosis was extrinsic ureteral endometriosis. Ureteral endometriosis has rarely been described and only 17 cases have been reported previously in Japan. PMID- 3291587 TI - [A case of paraureteral neurilemmoma causing ureteral obstruction: report of a case]. AB - Retroperitoneal neurilemmomas are rare tumors. They are usually asymptomatic, and often become quite large before they are discovered. A case is reported of a 75 year-old man with complaints of general malaise and left lumbar pain. Intravenous pyelography showed left renal nonfunctional and retrograde pyelography revealed the stenosis of the left ureter. The ultrasonogram demonstrated a cystic mass, and it was diagnosed as a retroperitoneal tumor with central necrosis by computerized tomography and magnetic resonance imaging. The tumor was removed with the left nonfunctioning kidney and ureter. The tumor was 3 x 3 x 4 cm, and the histological diagnosis was neurilemmoma (Antoni A + B type). There was a tight fibrous adhesion between the tumor and the left ureter, and the tumor was concluded to have originated from the adventitia of ureter. To date, 120 benign cases have been reported in Japan. They are reviewed and discussed. PMID- 3291588 TI - [Ectopic ureteral opening with common urogenital sinus. Review of the literature of 648 cases in Japan]. AB - A 3-year-old girl was admitted with continuous enuresis. Urological examination and operation disclosed the left upper ureter ectopically opened into the vagina, and the vagina opened into the urethra (common urogenital sinus). Vesicoureteroneostomy was performed, and after the operation, incontinence disappeared. The 648 cases reported in Japan were discussed. PMID- 3291589 TI - [A case of incarceration of the penis]. AB - A 38-year-old male patient had been suffering from incarceration of penis with a milk-bottle for about seventeen hours. It was successfully removed by means of a glass cutter and hammer without any complication. Fifty-seven Japanese cases of this entity including our case were reviewed and discussed. PMID- 3291591 TI - The future of American medicine. PMID- 3291590 TI - [Metastatic tumor of the spermatic cord from renal cell carcinoma]. AB - The patient was a 54-year-old man with a hard nodule (25 x 15 mm) in his left scrotum. His left spermatic vein had been ligated 6 months earlier because of a varicocele. Preoperative diagnosis was left renal tumor with multiple lung metastasis. The intrascrotal nodule was considered to be a metastatic tumor from renal cell carcinoma. Left nephrectomy was performed and the metastatic lesion of spermatic cord was also removed. Pathological examination showed that the left renal tumor was renal cell carcinoma (clear cell type). The spermatic cord nodule was tumor embolus in dilated veins and consisted of the same clear cells as renal cell carcinoma. Judging from these results, in this case renal cell carcinoma retrogradely metastasized through the spermatic vein to the intrascrotal lesion. PMID- 3291592 TI - Cellular mechanisms in congestive heart failure. AB - There is substantial, although not yet conclusive, evidence that the failing heart is in an energy-depleted state. Such an imbalance between energy production and energy utilization would have important implications for the management of patients with congestive heart failure (CHF), most important of which is that therapeutic measures that increase myocardial energy demand could have long-term detrimental effects on the heart. By increasing energy expenditure, vasoconstrictors and positive inotropic agents could worsen cell damage, exacerbate relaxation abnormalities and promote arrhythmias. Conversely, therapy that improved the balance between energy delivery and energy expenditure might be expected to improve prognosis in CHF. For this reason, vasodilators and reduced inotropic drive to the failing heart could prolong survival in these patients. Further understanding of the energetics of the failing heart will be of considerable importance in the formulation of hypotheses regarding long-term therapy that could be evaluated in controlled clinical trials. PMID- 3291593 TI - Causes of symptoms in chronic congestive heart failure and implications for treatment. AB - The most common symptoms of patients with heart failure are shortness of breath and fatigue. The causes of these symptoms may be different in various entities encompassed by the general term heart failure, such as acute pulmonary edema, circulatory collapse and chronic heart failure. In patients with acute heart failure, shortness of breath is closely related to left atrial pressure. In patients with chronic heart failure, optimally treated with diuretics, the body fluid compartments are usually of normal size. Recent work strongly suggests that, in such patients, central hemodynamic abnormalities are not the sole determinants of symptoms. Impaired vasodilation and altered metabolism in skeletal muscle, circulating metabolites and pulmonary ventilation-perfusion mismatch with consequent increased physiologic dead space may all contribute to the genesis of symptoms. Consequently, it may be possible to alleviate symptoms by treatments that are not aimed directly at improving central hemodynamics. Whether such an approach could also modify prognosis is unknown. PMID- 3291594 TI - Vasodilator therapy in chronic congestive heart failure. AB - Benefits from vasodilator therapy in patients with chronic heart failure are partly related to the severity of functional derangements. Agents with an arteriolar-dilating effect are more likely to be effective in patients with higher left ventricular outflow resistance. Vasodilators with primary venodilating properties are more likely to be effective in the presence of an increased ventricular preload. The mechanisms by which preload and left ventricular outflow resistance increase in patients with cardiac insufficiency are not well understood and may not be similar in all patients. Vasodilators also have the capacity to ameliorate myocardial metabolic functional abnormalities by influencing myocardial energetics, but the effects of different agents on coronary hemodynamics may not be uniform. Effects on renal hemodynamics may also vary, as may neurohumoral changes after therapy. Angiotensin-converting enzyme inhibitors have been shown to exert beneficial effects on both coronary and renal hemodynamics in patients with chronic heart failure, while producing favorable neurohumoral changes. These agents provide some advantages over direct-acting vasodilators in that myocardial oxygen consumption is decreased, myocardial metabolic function is improved, and norepinephrine and aldosterone levels are reduced. Further controlled studies are needed to assess the efficacy of angiotensin-converting enzyme inhibitors in relation to other vasodilators for the long-term management of these patients. PMID- 3291595 TI - Arrhythmias, catecholamines and electrolytes. AB - The prognosis in patients with heart failure secondary to left ventricular dysfunction is poor. Although survival can be related to the extent of cardiac functional impairment, many patients die suddenly rather than in refractory heart failure. Ambulatory electrocardiography has revealed a high prevalence of simple and complex ventricular arrhythmias in these patients, which was the most important predictor of subsequent mortality in our patients. Factors predisposing to arrhythmias are many, but increased catecholamines and electrolyte abnormalities are among the more obvious. In patients who have undergone treatment for congestive heart failure, serum and total body potassium are reduced, and this is closely and inversely related to the state of activation of the renin-angiotensin system. Renin and noradrenaline are also closely and directly correlated, while both are inversely related to the arterial pressure. Treatment with angiotensin-converting enzyme inhibitors tends to reverse these neuroendocrine and electrolyte abnormalities and reduces the frequency of ventricular arrhythmias. Whether this will have a favorable impact on mortality, and, in particular, on sudden death, remains to be seen. PMID- 3291596 TI - Neuroendocrine manifestations of congestive heart failure. AB - Congestive heart failure is a complex clinical syndrome characterized by a number of neuroendocrine responses. These responses are probably an evolutionary vestige of mechanisms designed to defend volume and maintain circulatory homeostasis. Activation of the sympathetic nervous system and renin-angiotensin-aldosterone system and the release of vasopressin have been clearly documented in patients with heart failure. Unlike the normal ventricle, the failing ventricle responds to peripheral vasoconstriction and sodium retention with further hemodynamic embarrassment and circulatory congestion. Certain vasorelaxant natriuretic substances are also released during heart failure, perhaps in an attempt to offset excessive peripheral constriction and sodium retention. Prostaglandin E2, atrial natriuretic peptide (or atrial natriuretic factor) and plasma dopamine are found to be increased in some patients with heart failure. However, peripheral constriction and sodium retention appear to be dominant, particularly in the advanced stages of heart failure. An understanding of these neuroendocrine responses has led to new developments in therapy. Angiotensin-converting enzyme inhibitors have emerged as distinctly useful drugs in the treatment of heart failure. Agents designed to block excessive sympathetic drive and inhibit vasopressin are under investigation. Infusion of atrial natriuretic factors and the use of selective dopamine agonists are also undergoing clinical trials in patients with heart failure. Increased knowledge of the neuroendocrine responses will likely result in even newer and more imaginative therapy. PMID- 3291597 TI - Mechanoreceptors in articular tissues. AB - The morphology, distribution, and function of mechanoreceptors in joint capsules, ligaments, knee-joint menisci, and articular disks of the temporomandibular joints of animals, including humans, have been reviewed. In addition to free nerve endings, three types of joint receptors are present in most animal joints: 1) a Ruffini-like receptor situated in the capsule, 2) a Golgi tendon organ situated in a ligament; and 3) the encapsulated Pacinian-like corpuscle. In the anterior cruciate ligament, nerve fibers enter from the subsynovial connective tissue and terminate in receptors. Most of the receptors are found in the distal portion of the ligament. In the meniscus, nerves penetrate the outer and middle one-third of the body and the horns from the perimeniscal tissue, with a greater concentration at the horns. In the temporomandibular articular disk, the mechanoreceptor density is greatest at the periphery and progressively decreases toward the center. If a joint has an intra-articular structure, mechanoreceptors undoubtedly are present within it. The concentration of mechanoreceptors appears greater in areas related to the extremes of movement and probably represents the first line of defense in sensing these extremes. These afferent discharges elicit support from discharging mechanoreceptors located in the joint capsule and subsequently from those in the surrounding muscles. This total afferent output alerts the central nervous system of impending injury, which can then be averted through reflex mechanisms. PMID- 3291598 TI - Fine structure and immunocytochemistry of cells within the endocrine pancreas of larval and adult sea lampreys, Petromyzon marinus L. AB - Immunocytochemistry with protein A-gold and routine electron microscopy were used to identify cell types within the endocrine pancreas of larvae, juvenile adults, and upstream-migrant adults of the sea lamprey, Petromyzon marinus. The larval pancreatic islets are composed only of insulin-immunoreactive B-cells, which are uniform in their fine structure. The cranial and caudal pancreatic tissue in both adult periods contains three cell types: B-cells, somatostatin-immunoreactive D cells, and a third cell type of unknown content. No glucagon-immunoreactive cells are present in lampreys, but B- and D-cells exist in equal numbers in the pancreatic tissue of adults. The B-cells of adults have a fine structure similar to those in larvae. D-cells have secretory granules that are distinctly different from those both in B-cells and in the third cell type. Although B- and D-cells in lamprey pancreatic tissues have a basic morphological similarity to these cells in other vertebrates, their granules are generally of smaller dimensions. The inclusion of granules within large pleomorphic bodies in many D-cells indicates that granule turnover is common. Immunocytochemistry will be a useful tool for showing the relationship between the cells in the degenerating bile ducts and those of the developing adult pancreas. PMID- 3291599 TI - Splanchnic exchange of amino acids after amino acid ingestion in patients with chronic renal insufficiency. AB - Splanchnic exchange (net uptake or release) of amino acids (AAs) was evaluated by measuring arterial-hepatic venous differences for AAs and hepatic blood flow in patients with chronic renal insufficiency (CRI) and control subjects before and for 70 min after the ingestion of an AA mixture simulating an animal protein meal. In CRI after AA ingestion, splanchnic exchange area for total nonessential AAs (NEAAs) is increased 135% over control subjects because of an augmented escape of proline, glutamate, serine, glycine, alanine, and cyst(e)ine; contrarily, glutamine shows an increased splanchnic uptake. Splanchnic exchange area for total essential AAs (EAAs) is increased only by 67% over controls because of a higher escape of threonine, isoleucine, phenylalanine, and histidine. Abnormalities in arterial areas for AAs parallel those in splanchnic areas except for glutamine and isoleucine. Data indicate that in CRI, at least for 70 min after an AA meal, splanchnic organs metabolize abnormally ingested AAs and export an increased and unbalanced bulk of AAs, severely affecting postprandial arterial profile of AAs. PMID- 3291600 TI - Complex carbohydrates in the dietary management of patients with glycogenosis caused by glucose-6-phosphatase deficiency. AB - Carbohydrates with digestion characteristics between those of lente uncooked starches and rapidly digestible oligosaccharides were administered in a dose of 1.5 g/kg body weight to five patients with glycogenosis from glucose-6 phosphatase deficiency. Postprandial duration of normoglycemia and concentrations of blood insulin and lactate were determined. Uncooked barley groats in water, or incorporated in a meal turned out to behave as lente carbohydrates. Uncooked couscous in water, couscous incorporated in a meal, and partially cooked macaroni given as a meal behaved as semilente carbohydrates as compared with uncooked cornstarch and glucose. The in vitro determination of the digestibility index along with the in vivo tolerance test enables us to choose and incorporate semilente carbohydrates in the day-time treatment of patients. PMID- 3291602 TI - Pharmacological studies on androgen suppression in therapy of prostate carcinoma. AB - In hormone-dependent prostate carcinoma, androgens can be suppressed into the castrate range by LHRH agonists. Testosterone secretion is blocked at two levels: testicular androgens and adrenal androgens. In humans, the contribution of testicular androgens is about 95%, whereas in the rat, the adrenal androgen secretion is negligible. Pharmacological studies were performed on the suppressive effect of the LHRH agonist, buserelin on androgen-dependent organs in adult rats. The reduction in pituitary and testicular binding capacity was monitored during treatment by injection, or by long-term infusion. Marked differences in suppressive mechanisms activated by the different regimens were observed. Changes in testicular steroid biosynthesis were analysed by incubation of testes after treatment with HCG, measuring the spectrum of C21/C19-steroids in incubation media. In particular, the levels of intraprostatic androgens were determined during treatment with daily buserelin injections, or with sustained release formulations of buserelin. The tissue content of testosterone and 5-alpha dihydrotestosterone (DHT) were both markedly lowered. In castrate rats, stimulation of adrenal function by ACTH infusion had no effect on the prostate weight or intratesticular T/DHT content. Combination therapy during the initial phase of treatment by an androgen receptor blocker (cyproterone acetate) and buserelin (infusion or implants) was more effective to suppress prostate weight and intra-prostatic T/DHT content than therapy with the single compounds alone. Spermatogenesis and fertility were suppressed after prolonged treatment periods of 6-12 months; the testicular atrophy was not reversible in these long-term injection studies. Similar studies in dogs and monkeys have shown a different result: inhibition of spermatogenesis was fully reversible. It is concluded that studies on the mechanism of androgen suppression by LHRH agonists and the effects on androgen dependent organs provide useful information for the improvement in therapy of hormone-dependent prostate carcinoma. PMID- 3291601 TI - Glucose and lipid metabolism and insulin sensitivity in type 1 diabetes: the effect of guar gum. AB - The effect of guar gum on glucose and lipid metabolism and on body insulin sensitivity was examined in nine type 1 diabetic patients treated with continuous subcutaneous insulin infusion. The study was done in a randomized, double-blind, crossover fashion with either guar gum or a placebo added to the usual diet four times per day for 4 wk each. Blood glucose levels after breakfast and lunch and daily insulin requirements were significantly lower during the guar-gum than the placebo diet. After a 4-wk guar-gum supplementation, blood glucose response to a test meal was significantly reduced by guar gum compared with the placebo. Hemoglobin A1 (HbA1) and insulin sensitivity remained unchanged. Serum total cholesterol fell by 21% (p less than 0.025). Thus, guar gum can reduce postprandial blood glucose, insulin requirements, and serum total cholesterol levels in type 1 diabetic patients. PMID- 3291605 TI - Need for operational research in clinical microbiology. PMID- 3291603 TI - Pre-B-cell non-Hodgkin's lymphoma in childhood. Report of a case and review of the literature. AB - The authors studied a six-year-old girl with a cervical lymphoblastic lymphoma. Initial blood study results were within normal ranges, and no evidence of leukemia was found. Immunophenotype analysis of this lymphoma was consistent with a pre-B-cell non-Hodgkin's lymphoma. Other notable histopathologic findings were the fascicular growth pattern of the tumor and the very convoluted nuclei of the lymphoblasts. At present, only few cases of this rare immunophenotype of non Hodgkin's lymphoma have been reported in children. A panel of monoclonal antibodies is suggested to be applied on frozen tissue sections in order to establish a precise diagnosis in childhood non-Hodgkin's lymphomas, which should ultimately have therapeutic and prognostic impact. PMID- 3291604 TI - Intestinal anisakiasis. A case diagnosed by morphologic and immunologic methods. AB - The diagnosis of the fourth reported case of intestinal anisakiasis in the United States was based on the morphologic characteristics of the worm in histologic sections of resected ileum. Detection of antibodies to the worm by a radioallergosorbent test (RAST), enzyme-linked immunosorbent assay (ELISA), and an immunofluorescent antibody assay (IFA) support the diagnosis. IgE antibodies in patient serum reacted specifically to larval Anisakis antigens but not to larval Ascaris antigens in the RAST. IgG and IgM antibodies to larval Anisakis antigen could be detected by ELISA up to six months after infection. IFA findings demonstrated that patient serum recognized the excretory-secretory products produced by the worm and showed their presence in vivo. These products appear to originate from the excretory pore and dorsal esophageal gland of the larval parasite. PMID- 3291606 TI - Detection of estrogen receptors with monoclonal antibodies in paraffin sections. PMID- 3291607 TI - Contamination of perfused donor kidneys by starch from surgical gloves. AB - Starch induces a variety of inflammatory reactions in humans and may contaminate surgical procedures from surgical gloves. Using polarized microscopy and electron microscopy, the authors observed starch particles in renal perfusate and in glomeruli of perfused donor kidneys. Group 1 consisted of 10 unusable kidneys handled with standard concern of glove sterility. Eight other kidneys (Group 2) were perfused with particular attention toward avoidance of starch contamination. The gloves were rinsed five times, and the cuffs were not dipped into the perfusate. Two kidneys (Group 3), deemed unsuitable for transplantation, were perfused for 24 hours with perfusate swished with unwashed sterile gloves. Group 4 consisted of five transplant biopsies performed within one week after transplantation. Perfusates alone were also circulated through the Waters Perfusion Machine continuously for 24, 72, and 188 hours with and without the use of gloves. The number of birefringent crosses were counted in each of 25 glomeruli per specimen. Group 1 displayed a mean of 1.8 birefringent crosses per glomerulus; Group 2, 0; Group 3, 5.3; and Group 4, 4.4. Groups 1 and 3 also exhibited birefringent crosses in peripheral renal vessels. Perfusate alone, handled without gloves, showed no birefringent crosses; by contrast, perfusate handled with gloves showed numerous birefringent crosses. The authors conclude that starch from surgical gloves can enter the perfusate and lodge in glomeruli and other sites of donor kidneys. Rinsing gloves five times and avoiding contact of the perfusate with the glove cuff effectively eliminates the contamination. PMID- 3291608 TI - Detection of positive blood cultures by the Bactec NR660. The clinical importance of five versus seven days of testing. AB - The Bactec Model NR660 device for detection of bacteremia can sample cultures for either five or seven days before the culture is called normal. The authors studied organisms recovered daily during the seven-day cycle of testing and compared isolates recovered on days 6 and 7 with those recovered earlier. They also reviewed patient clinical charts to determine the clinical impact of the organisms recovered on days 6 and 7. Of 9,062 blood culture vials processed in a nine-week period, 547 had positive results (6% of vials and 10.3% of culture sets). Isolates on day 6 or 7 accounted for 19 (3.5%) of the total; 4 of these were believed to be clinically important by the patients' attending physicians. Detection of these four cultures required processing of 9,062 vials twice each. These data suggest that in our patient population the clinical benefit of testing on days 6 and 7 does not justify its cost. Whether this would be true in other settings would have to be determined by the individual hospital. PMID- 3291609 TI - Renal transplantation of the infant and young child and the use of pediatric cadaver kidneys for transplantation in pediatric and adult recipients. AB - Transplantation of infants less than 1 year of age with kidneys from live-related parental donors has recently led to good results, whereas cadaver donor renal transplantation in this recipient age group has led to a high mortality rate (11/13). Similarly, the results of cadaver donor renal transplantation in infants and young children less than 5 years of age has been suboptimal in the past, although recent data are more encouraging. With recent availability of long-term peritoneal dialysis for the infant and young child with end-stage renal disease (ESRD), it is possible to defer transplantation until an optimal donor becomes available. Because of the possible immunologic hyperactivity of such recipients, the immunosuppressive regimen may need to be modified if improved cadaver donor survival rates are to be obtained. The use of anencephalic kidneys for transplantation has been associated with a high incidence of primary nonfunction and few recipients with long-term functioning grafts. Harvesting of kidneys from anencephalic donors declared "brain-dead" at birth may reduce the incidence of primary nonfunction and increase the availability of anencephalic kidneys for transplantation. Reports of the use of pediatric cadaver kidneys for transplantation into pediatric and adult recipients yields discrepant results. Analysis of the data indicates that if pediatric cadaver kidneys from donors less than 6 years of age are used, the potential for decreased graft survival rates and an increased incidence of technical complications exists. However, the use of pediatric cadaver kidneys can provide adequate graft function in both pediatric and adult recipients and the use of such kidneys should increase the number of kidneys available for transplantation. PMID- 3291610 TI - Nephrotic range proteinuria with "minimal change glomerulopathy" in human renal allografts: report of four cases. AB - Four patients who received renal allografts developed nephrotic range proteinuria 2 to 16 months after renal transplantation. Twenty-four-hour urine protein excretion at the time of renal allograft biopsy ranged from 5.9 to 17.0 g/24 hours. The serum creatinine at the time of renal allograft biopsy ranged from 2.0 to 3.9 mg/dl (180 to 350 mumol/L). Biopsies of the allografts demonstrated minimal glomerular abnormalities by light microscopy, immunomicroscopy, and electron microscopy. Two biopsies exhibited severe interstitial fibrosis. These four cases illustrate the unusual finding of "minimal change glomerulopathy" in renal allograft recipients exhibiting nephrotic range proteinuria. All four patients progressed to dialysis 4, 36, 46, and 53 months after transplantation. Transplant nephrectomy was performed in three patients. One showed acute cortical necrosis. Two showed glomerular, vascular, and tubular-interstitial features of chronic rejection. PMID- 3291611 TI - Favorable prognosis of patients with prosthetic valve endocarditis caused by gram negative bacilli of the HACEK group. PMID- 3291612 TI - Early and long-term effects of acute caloric deprivation in obese diabetic patients. AB - PURPOSE: It is generally assumed that diet therapy can ameliorate the metabolic derangements experienced by obese type 2 diabetic patients, thereby leading to discontinuation of insulin or oral sulfonylurea drug therapy. We decided to retrospectively investigate which clinical and biochemical parameters affect therapeutic responses. PATIENTS AND METHODS: Sixty-four poorly controlled obese diabetic patients were hospitalized and placed on a precisely defined, hypocaloric diet. Known duration of diabetes, type of pharmacologic therapy, body weight, weight loss, fasting plasma glucose concentrations, C-peptide levels, hemoglobin A1C, and plasma lipid levels were assessed, as were nitrogen and electrolyte balances. RESULTS: Average weight loss was 13 pounds in a mean of 23 days. During hospitalization, the mean fasting plasma glucose value for the group fell from 221 +/- 10 to 122 +/- 5 mg/dl. In 45 patients (73 percent), the final fasting plasma glucose level was less than 125 mg/dl (mean: 102 +/- 2 mg/dl). Oral glucose tolerance even in those patients in whom fasting plasma glucose levels normalized was still grossly diabetic at the end of the hospital stay, deteriorating further after three days of liberalized caloric intake. In part this may have been due to decreased insulin secretory reserve as reflected by blunted plasma C-peptide response. Forty of 42 patients who entered the study taking insulin were able to discontinue the drug within one to seven days of hospitalization. After a mean follow-up period of 19 months, only 10 of 50 patients continued to maintain fasting euglycemia; five were on diet alone, and five were receiving oral hypoglycemic agents. Thirteen patients were receiving insulin therapy. CONCLUSION: Diet therapy in these patients resulted in short term improvement of glycemic control and, in the majority, normalization of fasting plasma glucose levels. However, long-term outpatient follow-up revealed that relapse occurred in most patients. PMID- 3291613 TI - Iliofemoral thrombophlebitis presenting as an acute abdomen: report and literature review. AB - Iliofemoral thrombophlebitis characteristically presents as acute inflammation and swelling of the affected extremity. We report a patient in whom the presenting complaints of high fever, nausea and left lower quadrant pain mimicked an acute abdomen. The diagnosis was confirmed by venogram after gallium scan and computer tomographic scan revealed abnormalities consistent with iliofemoral thrombophlebitis. This is the first report of abnormal gallium uptake in iliofemoral thrombophlebitis. Current methods of diagnosing this disorder are discussed and the literature reviewed. PMID- 3291614 TI - Analgesic nephropathy. AB - Analgesic nephropathy has been a recognized clinical problem for the past three decades. The association between chronic renal insufficiency and habitual analgesic consumption initially focused on combination analgesics containing phenacetin. Most recently, the increased popularity of nonsteroidal anti inflammatory drugs has led to the recognition that these agents are capable of producing several distinct clinical syndromes. This review discusses both of these disorders from a clinical perspective. PMID- 3291615 TI - Lack of secular change in male adult stature in rural Mali (West Africa). AB - A study has been carried out on a sample of 2,158 male subjects between 20 and 50 years old representative of the rural Malian population (West Africa), and the results are compared with historic data obtained since 1885. This comparison suggests that there has been no modification in stature during this century. The analysis of each ethnic group does not show any disparity. Our results are in agreement with the theory that certain factors lead to the secular increase of stature in developed countries. These etiologic factors are not found in our West African population. PMID- 3291617 TI - A case of chondrodystrophic dwarfism in the Italian late Upper Paleolithic. AB - During excavations by P. Graziosi at Romito Cave near Papasidero (Cosenza) in Calabria, Italy, two skeletons (Romito 1 and 2) were discovered in a common grave. Although the specimens were briefly described by Messeri (Atti X Riuniuone Scientifica Ist. Ital. Preist. Protost., pp. 301-307, 1966), it is generally unknown in the anthropological literature that one of these individuals is a chondrodystrophic dwarf. As such, the specimen provides the earliest known case of dwarfism in the human skeletal record, extending the time span of this genetically determined growth abnormality to approximately 10,000 years ago. The specimen (Romito 2) exhibits features typical of chondrodysplasia, including a high domed skull, compressed cranial base, and in the postcranial skeleton extremely shortened diaphyseal lengths. The unique combination of these features suggests this pathological condition is acromesomelic dysplasia. Besides providing evidence for a greater antiquity of dwarfism than previously known, the fact that this individual reached late adolescence attests to tolerance of Upper Paleolithic groups for severely abnormal individuals and their ability to support members who were of limited economic value to the social group. PMID- 3291616 TI - Two possible cases of trephination from Australia. AB - Cranial surgery has been performed for thousands of years among a wide range of cultures. Although the extent of its use has varied, ethnographically the operation has almost always been used as a form of medical treatment following cranial trauma or as a remedy for head pain. This paper describes two cases of cranial trauma on Australian Aboriginal remains from widely separated areas of the continent. The position and morphology of the trauma, as well as other associated features, suggest that these individuals underwent some form of surgical procedure. The features are similar to those found on accepted cases of trephination from elsewhere. If these individuals did undergo some sort of trephination, they are the first to be reported from Australia. Confirmation of the diagnosis would also increase our understanding of the geographical range of the technique in this part of Oceania, which was known previously only from parts of Melanesia. PMID- 3291619 TI - Uptake and intracellular fate of [14C]sucrose-insulin in perfused rat livers. AB - Insulin was covalently linked to [14C]sucrose by means of cyanuric chloride to provide a label that would remain entrapped within the vacuolar system. The uptake of the conjugate by the perfused rat liver was rapid (half-life = 2.9 min), competitively inhibited by native insulin, and abolished by alkali denaturation. As assessed by its distribution on self-generating gradients of colloidal silica-povidone, label in lysosome-enriched samples of liver taken at different times after the addition of the conjugate moved progressively during 15 min from the plasma membrane into an intermediate peak and then to dense lysosomal fractions. After 30-60 min, the label had equilibrated throughout the lysosomal-vacuolar system. The initial movement from the plasma membrane to the intermediate peak occurred between 2 and 5 min. Because label in the peak could be physically separated from the lysosomal marker, beta-acetylglucosaminidase, by dispersing the sample through the gradient mixture before centrifugation rather than layering it, we concluded that the intermediate particles in question were not lysosomal in nature. On gel-filtration chromatography, label extracted from the intermediate peak did not move with insulin but rather as a broad band of lower molecular weight products, suggesting that insulin is subject to early proteolytic attack within a nonlysosomal compartment. PMID- 3291618 TI - Different physiological signatures of sweat gland secretory and duct cells in culture. AB - Human eccrine sweat gland cells grown in culture were found to lose their characteristic shape, becoming flattened and organized into multilayers. The resting membrane potentials of the cultured secretory cells (-35 +/- 2 mV, n = 36) were significantly higher than those measured for cultured duct cells (-22 +/ 1 mV, n = 58, P less than or equal to 0.01). When the cholinergic agonist methacholine (10(-5) or 10(-6) M) was administered, the cultured secretory cells could be distinguished unequivocally by their atropine-sensitive hyperpolarizing response (-20 +/- 2 mV, n = 43), whereas no cultured duct cells responded. When the sodium conductance antagonist amiloride (10(-5) or 10(-6) M) was administered, 44% of cultured secretory cells responded by hyperpolarization (-8 +/- 1 mV, n = 8), whereas 87% of cultured duct cells hyperpolarized (-15 +/- 1 mV, n = 46) and by a significantly greater margin (P less than or equal to 0.01). Substitution of chloride with gluconate in the bathing medium caused membrane potential depolarization in both cultured secretory and duct cell populations, which is consistent with the presence of a chloride conductance in the plasma membrane. The beta-adrenoceptor agonist isoproterenol induced a transient hyperpolarization of 5-10 mV in three out of six cultured secretory cells tested but had no effect on cultured duct cells. PMID- 3291620 TI - Circadian rhythm in sensitivity of glucose metabolism to insulin in rat soleus muscle. AB - This study determined whether the sensitivity of glucose metabolism to insulin in skeletal muscle varies during a 24-h period. Soleus muscles were isolated from ad libitum-fed rats killed at 0900, 1600, 2100, and 0300. The animal house was illuminated between 0800 and 2000. The sensitivities of glycolysis (which is an excellent index of glucose transport) and glycogen synthesis to insulin were greatest in muscles isolated at 0900 and 2100. Marked decreases in sensitivities of both processes to insulin were observed in muscles isolated at 0300 and 1600, which are times halfway through the feeding and postabsorptive periods, respectively. Hence, this study demonstrates circadian changes in the sensitivity of glucose utilization by skeletal muscle to insulin, which may be important in control of blood glucose concentration. Glycogen levels in skeletal muscles were highest at 0300 and lowest at 2100; hepatic glycogen content reached a peak at 0900, and the lowest content was measured at 2100. The liver glycogen level was increased by only 15% midway into the feeding period (i.e., 0300). This suggests that muscle glycogen may act as a temporary store of glucose residues during the feeding period; it stores glycogen in the first half of the feeding period but during the second half some muscle glycogen is converted to lactate, which acts as a precursor for hepatic gluconeogenesis. PMID- 3291621 TI - The perfectibility of public programs: real lessons from large-scale demonstration projects. PMID- 3291622 TI - Service use and costs for Medicare beneficiaries in risk-based HMOs and CMPs: some interim results from the National Medicare Competition Evaluation. AB - The Health Care Financing Administration (HCFA) initiated the Medicare Competition Demonstration in 1982 in anticipation of congressional intent to establish a national program. Interim results on the 1984 service use and cost experience of the health maintenance organizations (HMOs) and competitive medical plans (CMPs) participating in the demonstrations indicate that Medicare enrollees in the demonstration experienced a median of 1,951 hospital days per 1,000 person years, 57 per cent of the median of 3,432 days per 1,000 in the local markets from which the plans drew enrollment. Independent practice association (IPA) HMOs experienced higher hospital use rates than staff and group model HMOs. These comparisons are not adjusted for various risk factors, the absence of which were likely to favor the demonstration plans. Plans with lower hospital service use were federally qualified and had been operating for more than five years. The median total annual revenue per enrollee across all plans was $2,312, compared to median annual expenses per enrollee of $2,250. The distribution of median annual expenses per enrollee by major category of expense was: institutional expenses ($1,038/enrollee), medical expenses ($720/enrollee), supplemental services expenses ($154/enrollee), and administrative and other expenses ($295/enrollee). Future analysis, using beneficiary-level data, will examine the impact of the demonstration and the nature and extent of evident biased selection and will compare the quality of care in the demonstrations to that in the fee-for-service sector. PMID- 3291624 TI - The testicular "tumor" of the adrenogenital syndrome. A report of six cases and review of the literature on testicular masses in patients with adrenocortical disorders. AB - The clinical and pathological features of 40 cases in which testicular masses developed in patients with the adrenogenital syndrome are reviewed; this study was based on six personally observed cases and 34 other cases in the literature. The adrenal disorder was of the salt-losing form in two-thirds of the cases and the non-salt-losing form in the other third. Although the clinical diagnosis of the adrenogenital syndrome had been established prior to the discovery of the testicular lesion in most of the patients, in 18% of them the diagnosis was not made until or after the development of a testicular mass. Two-thirds of the masses were palpable (up to 10 cm); these cases were usually discovered in early adult life (average, 22.5 years). The remaining one-third were small (under 2 cm) and were usually found in children either at autopsy or on testicular biopsy. Eighty-three percent of the masses were bilateral. Eighty-six percent of the small lesions were located in the hilus. The larger lesions involved the testicular parenchyma in all but one case. They formed well-demarcated but unencapsulated brown-green masses, typically separated into lobules by prominent bands of fibrous tissue. Microscopical examination revealed sheets, nests, and (rarely) cords of cells with abundant eosinophilic cytoplasm separated by bands of fibrous tissue. Lipochrome pigment was identified in the cytoplasm in many cases, but crystals of Reinke were uniformly absent. The major pathological differential diagnosis is Leydig cell tumor; the associated clinical and laboratory features--including the high frequency of bilaterality and a decrease in the size of the tumor with corticosteroid therapy--are diagnostic of a testicular "tumor" of the adrenogenital syndrome. Although a variety of origins have been suggested for these lesions, in our opinion an origin from hilar pluripotential cells, which proliferate as a result of the elevated level of adrenocorticotropic hormone, is most likely. PMID- 3291623 TI - Eradication of head lice with a single treatment. AB - Single application of Nix (permethrin 1% creme rinse) and Rid were compared as treatments for Pediculosis capitis in 435 patients, the majority of whom were children. Seven days after the treatment, 98 per cent of the permethrin-treated and 85 per cent of the Rid-treated patients were free of lice. At 14 days, prior to nit removal, 96 per cent of the permethrin-treated and 62 per cent of the Rid treated patients were still lice free. Seventeen (7 per cent) permethrin-treated and 32 (16 per cent) Rid-treated patients were reported to have adverse experiences. PMID- 3291625 TI - Choriocarcinoma-like lesions in patients with testicular germ cell tumors. Two histologic variants. AB - Nine men with testicular germ cell tumors developed one of two types of histologically similar cystic lesions that had features of choriocarcinoma. In five cases, these choriocarcinoma-like lesions (CCLL) were felt to represent an unusual proliferation of teratomatous epithelium (teratomatous CCLL); whereas in four cases, the CCLL was felt to represent a nonbiphasic and cystic form of choriocarcinoma similar to the atypical choriocarcinoma described by Mazur et al. except for its cystic nature. Both types usually occurred as focal findings associated with teratomas. Eight of nine patients had received chemotherapy prior to excision of the CCLL. Teratomatous CCLLs often had a lacelike arrangement of atypical epithelium around cysts that contained homogeneous secretion. Mucicarmine stains were positive in four of five cases of teratomatous CCLLs. Cystic atypical choriocarcinoma consisted of stratified mononucleated cells lining cysts containing a coagulum of eosinophilic material. Stains for human chorionic gonadotropin (HCG) were positive in three of four cases of cystic atypical choriocarcinoma, although serum HCG elevations were either negative or just slightly elevated preoperatively. Five patients with a CCLL who were clinically free of disease following surgical excision and who received no additional chemotherapy remained well on follow-up (average, 1.9 years). We encourage the separate recognition of these lesions so that future studies may determine their clinical significance more precisely. PMID- 3291626 TI - Regional and local anesthesia in Alabama before World War I. PMID- 3291627 TI - The importance of seizure-inducing factors in youth. AB - Of over forty known epileptogenic mechanisms, some eight involve transient conditions, the regulation of which necessarily involves the understanding cooperation of the patient/parents. Tension states, alterations of the wake-sleep cycle, fatigue and sleep deprivation, CNS stimulation by sensory or drug means, and shifts of the water and acid-base balances constitute the bulk of such seizure-inducing factors. The relative lack of CNS homeostatic control, due to immature development of the blood-brain barrier and cerebral maturation, serve to exaggerate these problems in childhood. In a referred group of 150 refractory epileptic children, the seizure-inducing mechanisms were found to be important (50% reduction of seizure incidence) in 20% and to be of "crucial" importance (complete control) in an additional 14%. These results indicate the importance of such mechanisms in selected children with epilepsy, who were only marginally or inadequately controlled by drug therapy. Reviews of the literature have suggested that this more comprehensive approach to the therapeutic management of epilepsy has not been adequately exploited. PMID- 3291628 TI - Neuronal ceroid-lipofuscinoses in childhood. AB - Neuronal Childhood types of ceroid-lipofuscinoses (NCL) are reviewed. All three main types, infantile, late infantile and juvenile, are progressive encephalopathies characterized by neural and extraneural accumulation of ceroid- and lipofuscin like storage cytosomes. The pathogenesis of NCL is unknown. A disturbance of the peroxidation of polyunsaturated fatty acids and a defect in the processing and turn-over of the glycoproteins in the lysosomal membrane are those hypotheses which have been most widely investigated. Reduced membrane lipids and reduced membrane fluidity have recently been detected. Prenatal diagnosis, based on the characteristic ultrastructural findings, is possible in all types. PMID- 3291630 TI - History of medicine in Alaska. Gloria Loree Knowles Park, M.D. PMID- 3291629 TI - A multisystemic disease caused by adulterated rapeseed oil. AB - Intoxication caused by adulterated rapeseed oil was observed in Madrid (Spain) and adjacent areas in the spring of 1981. The toxic syndrome affected about 25,000 people. Thereafter a multisystemic disease developed that has caused about 600 deaths and 300 invalids. Although almost all organs of the body are affected, the peripheral nervous system shows the most severe alterations. Today, seven years after the onset of the disease, nothing is yet known about the etiopathogenesis or the nature of the causative agent. PMID- 3291631 TI - Glimpses of Alaskan medical history. A desperate winter in Prince William Sound (1786-87). PMID- 3291632 TI - Albrecht honored as circumpolar health medical pioneer. PMID- 3291633 TI - Veterans' Administration plans changes--can Alaska's health care system survive? PMID- 3291634 TI - Prevention of mite infestation of bedding by means of an impregnated sheet. A randomized controlled trial. AB - A randomized controlled trial was conducted to test the effect of a sheet impregnated with benzyl benzoate in preventing mite infestation of new bedding. Impregnated sheets were placed on the mattresses of 17 subjects, while 19 subjects received placebo sheets. Over the following 2 years infestation occurred more commonly, and tended to be heavier, in the beds with inactive sheets than in those with impregnated sheets; among the 27 beds with three items of new bedding sampled on four occasions, a mite count of five or more occurred significantly more often where the sheet was inactive than where it was active (11 of 13 and 5 of 14 respectively). The application of a sheet impregnated with benzyl benzoate appears to prevent mite infestation and may be useful for patients with mite allergy who obtain new bedding as part of a mite-avoidance regimen. PMID- 3291635 TI - Serotonin in nasal secretion. AB - The aim of this study was to investigate the serotonin content in nasal secretion. Histamine- and methacholine-induced nasal secretions were collected during a 5-min period after challenge in 33 normal subjects. Serotonin was determined radioenzymatically and was found in 66% of pure, blown secretions. The median concentration of serotonin in histamine- and methacholine-induced secretions was 6.3 nmol/l (range less than 1.6-52.0) and 2.3 nmol/l (range 1.6 140.0) (NS), respectively. The serotonin concentration in allergen-induced nasal secretions in 7 rhinitis patients was 0.8 to 159 nmol/l, median 10.4 nmol/l which did not differ from the serotonin levels in the normal subjects. The serotonin concentration in nasal lavage fluids in 5 subjects was low (below the detection limit in 78% of the samples). Further studies of serotonin in patients with nasal hypersecretion are indicated. PMID- 3291636 TI - [Epidemiology of pharyngolaryngeal cancer in the province of Salamanca. II. Results]. PMID- 3291637 TI - [Results of an analytical and sociometric study of books and articles on otology. The sixteenth to twentieth centuries (1932)]. PMID- 3291638 TI - Optimal conditions for hybridization with oligonucleotides: a study with myc oncogene DNA probes. AB - We present a study on the refinement of filter-hybridization conditions for a series of synthetic oligonucleotides in the range from 17 to 50 base residues in length. Experimental conditions for hybridization and the subsequent washing steps of the filter were optimized for different lengths of the synthetic oligonucleotides by varying the formamide concentration and washing conditions (temperature and monovalent cation concentration). Target DNA was immobilized to the nitrocellulose filter with the slot blot technique. The sequences of the synthetic oligonucleotides are derived from the third exon of the human oncogene c-myc and the corresponding viral gene v-myc and the G + C content was between 43 and 47%. Optimal conditions for hybridization with a 82% homologous 30-mer and 100% homologous 17-, 20-, 25-, 30-, and 50-mers were found to be a concentration of formamide of 15, 15, 30, 30, 40, and 50%, respectively. Optimal conditions for washing were 0.5X standard sodium citrate (SSC) at 42 degrees C for 2 X 15 min. The melting temperature for these optimal hybridization and washing conditions was calculated to be up to 11 degrees C below the hybridization temperature actually used. This confirms that the duplexes are more stable than expected. The melting points for 17-, 20-, and 30-mers were measured in the presence of 5X SSC and found to be 43, 58, and 60 degrees C, respectively. Competition between double- and single-stranded DNA probes to the target DNA was investigated. The single-stranded DNA probes were about 30- to 40-fold more sensitive than the double-stranded DNA probes. PMID- 3291639 TI - A general procedure for screening inhibitory antibodies: application for identifying anti-protein kinase C antibodies. AB - In this communication we describe a microfiltration assay to identify monoclonal antibodies that interfere with the activity of enzymes. This method is quick and sensitive to small changes in the activity of the enzyme and does not require highly purified enzyme or large quantities of antibodies. It has been applied to identify anti-protein kinase C antibodies which would have been impossible to identify by classical assays such as enzyme-linked immunosorbent assay. PMID- 3291640 TI - Arterial blood supply to the stomach of the muskrat (Ondatra zibethicus). PMID- 3291641 TI - Immunocytochemical localization of a kallikrein-like serine protease (esterase A) in rat salivary glands. AB - Light and electron microscopic (EM) immunocytochemical methods have been used to localize arginine esterase A, a kinin-generating enzyme immunologically similar to tissue kallikrein, in rat salivary glands. Both polyclonal and monoclonal antibodies to arginine esterase A were used in these studies. By means of a polyclonal antiserum, esterase A was found in granular tubules of submandibular glands and in striated ducts of all three major salivary glands, in a distribution similar to that of tissue kallikrein. With recently developed specific monoclonal antibodies to esterase A, this enzyme was localized in the granules of some (but not all) granular convoluted tubule cells (GCT) and along the basal membranes (but not in apical granules) of striated ducts. By an EM immunoperoxidase method, esterase A was localized subcellularly in granules of some GCT cells and along the basal cell membranes of the tubule and duct system. Thus, this enzyme is found in some sites (GCT granules) shared with tissue kallikrein, but in some unique sites, i.e., basal membranes of striated ducts. The polyclonal antibody used in the present study cross-reacted with tissue kallikrein, but when absorbed with kallikrein, it gave the staining pattern characteristic of monoclonal antibody to esterase A. PMID- 3291642 TI - Accessory limb production by nerve-induced cell proliferation. AB - The deviation of large limb nerves to a more proximal skin wound yielded a high proportion of accessory limb responses in different age groups of Ambystoma mexicanum (axolotls). In some instances the deviated nerve was positioned on skin previously grafted from an animal of different age and pigmentation from that of the host. Grafts were found not to be a necessary prerequisite for accessory limb induction, but the presence of wound epithelium was required. The rule of distal morphogenesis was expressed in reference to the level at which the nerve was cut, not in reference to the wound site where the accessory actually developed. The upper arm proved to be a more favorable site for accessory limb production than the flank or the leg under the conditions of the present experiments, in which little or no damage was done to the underlying muscles. The orientation of the accessory limb was extremely varied despite the uniformity of the surgical procedure. PMID- 3291643 TI - Paracrine factors in adult rat testis gonadotrophin control of opioids and LHRH like peptide. AB - A paracrine regulation involves agents which are produced by one cell type and act on an other one within an organ. In rodent testis, local control mechanisms modulate the actions of the gonadotrophins according to local requirements. Two groups of peptides-opioids and testicular LHRH are defined as paracrine factors and in vivo they are both modified by HCG. In vitro, after HCG exposure, we first localized an opioid like material in Sertoli cells cytoplasma by immunohistochemistry. This material is detected in freeze dried homologous culture media using a dot immunobinding technique. With a longer HCG exposure, an LHRH like material is then visualized in the basal compartment of the Sertoli cells and it is detected in freeze dried homologous culture media by the same technical procedure than for opioid material. By adding synthetic enkephalins to culture medium, we obtain the same results as with the endogenous opioid material, excreted after HCG addition. If naloxone a potent opiate antagonist, is added to the culture medium previously to HCG or enkephalins, the Sertoli cells cytoplasma are no more immunoreactives with the anti-enkephalin serum and no LHRH material is neither visualized by immunohistochemical technique neither detected in culture media. We conclude that testicular opioids, synthetized by the Leydig cells and which have specific Sertoli cells receptors are one Leydig-Sertoli paracrine communication factor. One way of response to their receptor fixation is the synthesis and excretion by Sertoli cells of testicular LHRH. This one is known to act on Leydig cells via specific receptors and it is one Sertoli-Leydig cells paracrine communication factor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291644 TI - Bupivacaine for caudal analgesia in infants and children: the optimal effective concentration. PMID- 3291645 TI - CPAP or CPP? PMID- 3291647 TI - Malocclusion and the temporomandibular joint--an historical perspective. AB - A review of changing attitudes and information on temporomandibular joint disorders, with a compilation of clinical conditions that can contribute to such problems. PMID- 3291646 TI - Propofol-nitrous oxide versus thiopental-isoflurane-nitrous oxide for general anesthesia. AB - One hundred and twenty patients undergoing elective operations were randomly assigned to receive anesthesia with either thiopental, 4 mg/kg-isoflurane, 0.2-3% nitrous oxide, 60-70% (control) or propofol, 2 mg/kg-propofol infusion, 1-20 mg/min-nitrous oxide, 60-70% (propofol). Although anesthetic conditions were similar during the operation, differences were noted in the recovery characteristics. For non-major (superficial) surgical procedures, the times to awakening, responsiveness, orientation, and ambulation were significantly shorter in the propofol group (4 +/- 3, 5 +/- 4, 6 +/- 4, and 104 +/- 36 min) than in the control group (8 +/- 7, 9 +/- 7, 11 +/- 9, and 142 +/- 61 min, respectively). In addition, less nausea and vomiting (20 vs. 45%) and significantly less psychomotor impairment was noted in the non-major propofol (vs. control) group. Following major abdominal operations, recovery characteristics did not differ between propofol and control groups. Delayed emergence (greater than 20 min), significant psychometric impairment, and a high overall incidence of postoperative side effects (55-60%) were noted in both drug treatment groups. The authors conclude that propofol-nitrous oxide compares favorably to thiopental isoflurane-nitrous oxide for maintenance of anesthesia during short outpatient procedures. However, for major abdominal operations, propofol anesthesia does not appear to offer any clinically significant advantages over a standard inhalational anesthetic technique. PMID- 3291648 TI - Histamine and airway caliber. AB - Since Dale and Laidlaw first produced airway obstruction in animals by infusing histamine, much has been done to understand the role of histamine in hyperreactive airway diseases. Histamine has been found to activate three subtypes of receptors: the H1 subtype, which mediates a number of cellular events resulting in airway obstruction; the H2 subtype, which plays an unclear and perhaps variable role in mediating airway caliber changes; and the newly described H3 subtype, which has not yet been studied in relation to airway caliber. The mechanisms involved in the synthesis, storage, and release of histamine from mast cells and basophils have been described. Pulmonary cells responsible for airway obstruction via H1 receptor stimulation have been identified and include bronchial smooth muscle, epithelial, endothelial, and pulmonary macrophage cells. Radioligand binding studies have begun to characterize the density and affinity of pulmonary H1 receptors. Intracellular events following H1 receptor stimulation have been shown to include calcium influx, phosphatidyl-inositol turnover, increases in cGMP, and the synthesis of prostaglandins. Despite a great deal of effort to define the relation between histamine and the parasympathetic nervous system, their exact interactions leading to changes in airway caliber remain to be resolved. Many pathologic conditions and mediators related to inflammation have been shown to increase histamine-induced airway responsiveness. A few endogenous mediators and a number of pharmacologic agents have been shown to decrease histamine-induced airway responsiveness. Although much has been done to elucidate the role of histamine and the H1 receptor system in modulating airway caliber, much more needs to be done to fully understand the complexities and significance of the H1 receptor system in normal and pathologic states of the airway.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291649 TI - [Biology of glucose-6-phosphate dehydrogenase deficiency]. AB - G-6-PD deficiency is predominant in the entire history of haemolytic anemias secondary to enzyme deficiency, since its represents, by far, the most frequent erythro-enzymopathy; it is also the most studied and the best known from the clinical as well as biological standpoints. Because of the ethnic groups particularly affected, this deficiency is essentially, in France, an imported pathology, even if there are a few true european cases. The biological diagnosis of the deficient patient is simple and well codified, but the interpretation of numerous variants of the enzyme remains quite complex. The recent cloning of the gene should provide a decisive progress in understanding these various deficiencies. PMID- 3291650 TI - [Qualitative and quantitative hemoglobin anomalies. Fundamental concepts, recent advances ]. AB - The presence, in metropolitan France, of large foreign communities originating from Maghreb and from Black Africa, introduces hereditary haemoglobinopathies diagnosis in the routine work of the clinical laboratory. On the other hand, the sustained interest of the medical staff and of biologists arises principally from the dramatic progresses acquired since twenty years in the field of molecular anatomy and physiology of the oxygen carrier. Recent studies concerning human haemoglobin genes and their expression resulted in a new classification of haemoglobinopathies and in new possibilities in the prenatal diagnosis of these disease. PMID- 3291651 TI - [Hematologic characteristics in Black Africa]. AB - Although the physiology and pathology of blood are similar in western countries and in tropical areas, some clear differences in blood constants and in haematological disorders are characteristics of latter regions. Haemoglobinopathy, G6PD deficiency and nutritional anemias predominant among red blood cells diseases; Burkitt's lymphoma is particular among lymphomas; in haemostatic abnormalities the frequency of intravascular coagulation and the rarity of thrombosis should be emphasized. PMID- 3291652 TI - [Principles and methods of immunological diagnosis in infectious and parasitic pathology]. AB - Immunological methods have always represented a major contribution to the diagnosis of infectious diseases. Recent technical advances in immunochemistry make this contribution even more essential than in the past. The author reviews the classic principles of immunological diagnosis in infectious pathology. In the best cases, this diagnosis is based on parasite identification (in the broad sense), or identification of specific products from the parasite. It is also possible to consider shortening culture time, when necessary, by performing an early immunological identification. The most recent developments in this field are presented. When the identification of the parasite or its secretion products is not feasible, one must be content to demonstrate the occurrence of a specific immune response, essentially of humoral nature. The author reminds of the basic theoretical difficulties preventing a real analytic antibody titration. The importance of the expression of the results as well as the predictive value of the tests, is stressed. Finally, the author analyzes some of the recent advances such as the development of immuno-enzymatic techniques, rapid testing which can be performed by non-biologists, the contribution of monoclonal antibodies and the possibility of using them in a new detection diagram of antibodies. The author reminds of the difficulty in the standardization of immunological methods, especially the determination of antibodies. PMID- 3291653 TI - [Application of bidimensional electrophoresis in the determination of genetic variants]. AB - Study of the polymorphism of human plasma proteins presents a major advantage in clinical biology to discover abnormal or rare forms, associated with risks or involved with well-specified pathological conditions. If this polymorphism corresponds to structural differences causing a variation of the isoelectric point (Ip) or the molecular weight, it is easily visualized with bidimensional electrophoresis, starting with a few microliters of plasma. On a single mapping per patient, we were able to establish the frequency of various isoforms of Gc globulin, transferrin, haptoglobin, alpha-1-antitrypsin and apolipoproteins E as well as A-IV, in a Lorraine population consulting for a health check-up. This method has already enabled us to demonstrate the effect of polymorphic apolipoproteins on the cholesterol and triglycerides level: patients carrying the epsilon 2 allele of the Apo E, have a mean cholesterol level which is lower than that of the carriers of allele epsilon 3. Patients carrying allele epsilon 4 have the highest mean cholesterol level. PMID- 3291654 TI - [Comparative study of various API galeries for the identification of gram negative bacteria]. AB - 116 strains of Gram negative bacteria were identified with the use of API ATB 32 GN and Rapid 20 E galeries, in order to evaluate their performance as compared with API 20 E or API NE galeries used as reference. The identification concur (bacterial genus and species) in approximately 80 per cent of the cases. There are only 2 major discrepancies with ABT 32 GN galleries and only one with Rapid 20 E. In other cases, the profile that is obtained only permits identification of the genus but without a sufficient differentiation, requiring a study of additional characteristics or repetition of the test. These galeries enable to solve most routine diagnosis problems due to Gram negative bacteria, with the advantage of Rapid (Rapid 20 E) or automatized reading (ATB 32 GN). PMID- 3291655 TI - [Professor Pierre Metais (1922-1987)]. PMID- 3291656 TI - Clinical stage I testicular cancer: orchiectomy without node dissection. PMID- 3291658 TI - Risk factor modification after myocardial infarction. AB - Modification of risk factors in patients who have had myocardial infarctions has received little attention in the literature. Yet, major modifiable risk factors for recurrent coronary heart disease, including hypertension, smoking, increased serum cholesterol levels, sedentary lifestyle, and obesity are the same risk factors for its development. Although coronary atherosclerosis is already established in patients who have had a myocardial infarction, evidence suggests that important reductions in recurrent coronary heart disease and death can be achieved through secondary prevention programs that modify risk factors. The high risk for recurrence and mortality in patients who survive a heart attack means that substantial reductions in the rates of these events can be achieved with relatively small reductions in risk factors. Patients who have had a myocardial infarction are also active participants in health care and are likely to be highly motivated to modify their risks for cardiac disease. PMID- 3291659 TI - Tamoxifen in the treatment of breast cancer. AB - Tamoxifen, an antiestrogen, is a competitive inhibitor of estradiol, blocking its effects on the target organs. During the 10 years it has been used in the United States it has become preferred over estrogens for treating postmenopausal women with metastatic breast cancer. Recently, tamoxifen has been used in treating premenopausal women with recurrent breast cancer, and its efficacy has been proved equal to that of ovarian ablation. In comparative trials, tamoxifen has been as effective as alternative endocrine treatments, and has greatly reduced toxicity and no irreversible side effects. Because of the high risk for systemic relapse in patients with breast cancer with regional lymph node metastases, (stage II), tamoxifen has been evaluated as adjuvant therapy after local treatment of the tumor. The results of these trials have shown a significant increase in the disease-free survival of postmenopausal women treated with tamoxifen, particularly in patients with hormone-receptor-positive tumors. Tamoxifen has not been as useful as adjuvant treatment in premenopausal women, for whom combination chemotherapy is the treatment of choice. PMID- 3291657 TI - Intercurrent death after Hodgkin disease therapy in radiotherapy and adjuvant MOPP trials. AB - STUDY OBJECTIVE: To assess long-term differences in mortality associated with initial Hodgkin disease therapy. DESIGN: Retrospective review of patients treated in prospectively randomized clinical trials. PATIENTS: Three hundred twenty-six patients with pathologic stage I, II, or III, A or B Hodgkin disease treated between 1967 and 1980 with median follow-up exceeding 14 years. INTERVENTIONS: Patients at the same stage of disease were randomized to receive radiation alone (167 patients) or radiation followed by 6 cycles of mechlorethamine hydrochloride, vincristine, procarbazine, and prednisone (MOPP) chemotherapy (159 patients) with additional therapy for progression or recurrence. MEASUREMENTS AND MAIN RESULTS: No significant differences between treatment regimens for actuarial survival, intercurrent disease, or Hodgkin disease mortality were seen. Thirty three patients who received radiation alone and 30 patients who received adjuvant chemotherapy died without evident Hodgkin disease. Death was caused by second neoplasms in 28 patients (relative risk, 2.35; 95% CI, 1.46 to 3.24). Six patients developed acute myelogenous leukemia or a myeloproliferative disorder after treatment including MOPP. Chemotherapy exposure varied among the 8 patients with lung cancers, 6 with gastrointestinal and 3 with other adenocarcinomas, 3 with sarcomas, 1 with diffuse large cell lymphoma, and 1 with melanoma. Acute myocardial infarction caused 9 of 17 cardiovascular disease deaths with 5 occurring in patients between the ages of 33 and 43. Nonetheless, the risk for acute myocardial infarction was not clearly increased (relative risk, 0.86; 95% CI, 0.42 to 1.57). Fifteen patients died from infection: 5, opportunistic; 5, asplenic sepsis; and 5, other pneumonias. Two patients died in accidents, and 1 died from radiation pneumonitis. CONCLUSIONS: Adjuvant MOPP chemotherapy improved freedom from relapse without significant survival benefit or impairment. Leukemogenesis was the only lethal complication associated with MOPP. Survivors of Hodgkin disease had an increased risk for death from a second neoplasm, but no apparent increased risk for death from acute myocardial infarction. PMID- 3291660 TI - Minimizing malpractice risks by role clarification. The confusing transition from tort to contract. AB - The purposes and applications of informed consent are the subject of confusion and controversy according to a President's Commission report. The Commission suggests shared decision making as the new ideal for physician-patient relationships, but notes that such a changed ideal will not be initiated by court action. The four models of decision making are the traditional model, informed consent, collaboration, and patient choice. Misunderstandings about these and other terms arise when they are implied; therefore, they should be defined expressly. Mutual expectations should be ascertained and common misunderstandings that erode relationships and lead to litigation should be clarified. Without agreements, different models may be selected and expectations about responsibility may differ. Such agreements may be documented by notes in patients' charts, supported by intake procedures that teach patients about defining responsibility, and questionnaires that elicit values, needs, and preferences. The literature on the evolution of contract principles in health care is reviewed, with informed consent viewed as a judicial stepping stone from tort to contract. A framework for defining mutual expectations is presented. Physicians' patterns of allocating responsibility by express and implied agreements should be evaluated and changes made where needed. PMID- 3291661 TI - Asymptomatic Salmonella enteritidis bacterial ascites. PMID- 3291662 TI - Renal transplantation and active lupus erythematosus. PMID- 3291663 TI - The development of grooming and its expression in adult animals. AB - We have seen that grooming is a class of heterogeneous activities, widely represented in animal taxa, yet sufficiently homogeneous within some phyletic groups to generate and test phylogenetic hypotheses. In the life of the grooming animal, the functions served by these activities are also diverse. Similar acts of grooming may serve different functions in different species or in different contexts. Sometimes these different functions can be discovered by careful attention to variations in the spatiotemporal patterning or sequencing of grooming elements. In several species a general cephalocaudal progression has been noted during both the ontogeny of grooming and during its expression in adults. During early development and in adulthood, the components or functional units of grooming appear to be hierarchically organized. Scratching with the hindpaw, for example, appears in rodents to be separate from the hierarchical branches in which one finds licking and face wiping. At least some transitions between functional units can be predicted from changes in the temporal patterning of one grooming unit (e.g., eye wipe) just prior to the onset of another unit (e.g., ear wipe). Analyses of genital and other types of grooming during two forms of sexual activity (copulation and the display of penile erections ex copula) were used to demonstrate once again that the stimulus regulation of grooming is context dependent. Among the implications of this review for the physiological study of grooming are the following: 1. Careful attention should be given to the spatiotemporal patterning of grooming, in order to reduce errors of "lumping" and "splitting" in classifying grooming acts, and also to detect alterations in the patterning when they occur. Such changes in patterning may be assumed to reflect changes in the physiological state of the animal. 2. Grooming acts that appear formally similar in different contexts may operate under rather different physiological systems. 3. Experimental manipulations may affect grooming directly, that is, by generating grooming efference without changing afference, or indirectly, by altering the "motivational state" or by creating stimulation that potentiates grooming, as from itching or from reafference due to provoking other behavior patterns. PMID- 3291664 TI - Expressive contexts, fine structure, and central mediation of rodent grooming. PMID- 3291665 TI - Bombesin and ceruletide-induced grooming and inhibition of ingestion in the rat. AB - Peptides of diverse structure stimulate grooming in rodents and other mammals. Peptide-induced grooming may be observed in several motivational contexts, with or without strong alternative response tendencies. Bombesin-like peptides elicit grooming route dependently in the rat and hamster, independently of, or concomitantly with, changes in ingestive behaviors or resting. The pattern of body surfaces groomed after i.c.v. BBS is in proportion to the representation of body surfaces in somatosensory but not motor cortex of rat. A bombesin-like peptide may be a neurotransmitter in somatosensory afferent processing, and grooming after i.c.v. BBS may reflect a response to alteration of cutaneous sensation. Bombesin is a putative satiety signal in the control of feeding and ethanol intake, but the satiation effects of systemic BBS can be dissociated from the grooming effect of central BBS. Thus, bombesin may perform independent and site-specific functions in the control of behavior. Grooming produced by BBS is not affected by naloxone, involves a different proportion of motor acts than is observed in normal or ACTH-induced grooming, and no cross-tolerance has been reported between ACTH and BBS in the rat. These properties of bombesin-induced grooming indicate multiple, separable mechanisms of peptide-induced grooming and scratching. Cholecystokinin-like peptide-induced grooming is observed after central injection in the rat and is unaccompanied by changes in feeding or resting. The well-documented satiety action of systemic CCK-like peptides is not accompanied by excessive grooming, so multiple, site-specific behavioral roles are also indicated for CCK-like peptides in control of behavior. CCK-8 exhibits short-term cross-tolerance with ACTH in elicitation of grooming, and central CCK 8 is co-localized with CRF and stimulates ACTH and corticosterone release in the rat. Thus, CCK-8 may induce grooming by increasing CRF or ACTH activity. These properties of CCK-like peptide-induced grooming indicate convergent neuroendocrine mechanisms that may explain some, but not all, peptide-induced grooming syndromes. Further characterization of the qualitative topographic, neuropharmacological, and neuroanatomical differences and species specificities of peptide-induced excessive grooming should provide a basis for understanding how brains coordinate grooming. Knowledge of the processes of neuropeptide control of grooming may provide potential peptide-based controls of grooming related clinical disorders such as pruritus and allergic reactions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3291666 TI - Grooming behavioral effects of oxytocin. Pharmacology, ontogeny, and comparisons with other nonapeptides. PMID- 3291667 TI - Body temperature and grooming in the Mongolian gerbil. AB - The Mongolian gerbil, Meriones unguiculatus, like many other rodents, releases a complex mixture of pigments and lipids from the Harderian gland during a self groom. The material exits from the external nares of the nose, is mixed with saliva, and spread widely over the pelage. Cold temperatures, especially, are effective in initiating grooming. A self-groom is associated with an increase in body temperature (compensatory thermogenesis in the cold). In addition to acting as a chemosignal, the Harderian material serves two major homeostatic functions: (1) the lipids on the pelage act to insulate the animal against cold and wetness, and (2) the lipids and pigments darken the pelage and increase radiant absorption. Body temperature is thus maintained at a higher level than would otherwise be the case. The amount of Harderian material found on the pelage varies with Harderianectomy, sandbathing, and ambient temperatures. Animals prevented from sandbathing accumulate excess lipids on the pelage, and cold temperatures facilitate the acquisition of lipids on the pelage. Under hot temperatures the grooming of Harderian substances is repressed and the frequency of sandbathing is increased. Thus pelage lipids are reduced in two ways. The amount of Harderian material released during an autogroom is inversely related to the ambient temperature, whereas the amount of saliva used for evaporative cooling is positively related to ambient temperature. The net effect is that pelage lipids are increased and maintained during cold conditions, and are reduced during hot conditions. In hot environments the gerbil switches from the spread of Harderian material for insulation to the spread of saliva for evaporative cooling. The gerbil optimizes its body temperature by varying the frequency of grooming and sandbathing, and by altering the amount of Harderian material and saliva released. Other species living in arid environments may use similar mechanisms to stabilize body temperature. Self-grooming is a critical behavior for meeting thermal needs, and is complexly integrated with related processes. PMID- 3291668 TI - Grooming reflexes in the cat: endocrine and pharmacological studies. PMID- 3291669 TI - Brainstem systems and grooming behaviors. PMID- 3291670 TI - Differential thermosensor control of thermoregulatory grooming, locomotion, and relaxed postural extension. AB - The rat displays three behaviors when surface and/or deep body temperatures rise above their normal levels: grooming, which spreads saliva over the fur to cool by evaporation; locomotion, which results in escape to a cooler environment; and relaxed postural extension, which reduces heat production by muscle activity and increases heat dissipation by increasing body surface area. Each of these behaviors can be elicited in pure or nearly pure form by localized warming of thermosensors in different brain areas. In addition, localized warming of superficial and deep peripheral thermosensors elicits grooming and locomotion, but little or no postural extension. Because of the marked differences in the behaviors induced by localized warming of different sets of thermosensors, it is concluded that sensors are linked to the effector mechanisms for these behaviors by relatively separate and independent pathways rather than a master controller through which sensory signals are integrated to produce a unitary error signal that drives all responses. When more generalized hyperthermia in natural heat stress situations affects mainly superficial thermosensors, as during the initial phase of exposure to ambient heat, grooming and locomotion are predominant and extension is absent or weak. When deep hyperthermia is predominant and superficial hyperthermia is relatively weak, as occurs after escape from ambient heat to thermoneutrality or during and following exercise in a thermally neutral environment, the resulting predominant activation of deep sensors elicits marked postural extension, but little or no grooming or locomotion. When both superficial and deep sensors are hyperthermic, as in the later stages of exposure to ambient heat, all three behaviors are present, although locomotion is somewhat greater and grooming is somewhat less than during predominantly superficial hyperthermia, and extension is somewhat less than during predominantly deep hyperthermia. As a consequence, grooming is maximal during predominantly superficial hyperthermia, locomotion during mixed deep and superficial hyperthermia, and extension during predominantly deep hyperthermia. It is concluded that the relatively fractionated control of the rat's thermoregulatory behaviors by different groups of central and peripheral thermosensors makes possible a differentiation of responses to different distributions of hyperthermia between superficial and deep sensors that optimizes cost-benefit trade-offs in different kinds of heat stress. PMID- 3291671 TI - Behavioral and electrophysiological effects of intracranially applied neuropeptides with special attention to DC slow potential changes. PMID- 3291672 TI - Effect of perinatal exposure to therapeutic doses of chlorimipramine on grooming behavior in the adult rat. PMID- 3291673 TI - Historical overview of hemochromatosis. PMID- 3291674 TI - Ferritin and cellular iron metabolism. PMID- 3291675 TI - Genetics of hemochromatosis: HLA association and mode of inheritance. PMID- 3291676 TI - The ferritin genes: structure, expression, and regulation. PMID- 3291677 TI - Regulation of the distribution of tissue iron. Lessons learned from the hypotransferrinemic mouse. PMID- 3291678 TI - Mechanisms and regulation of intestinal iron absorption. PMID- 3291679 TI - Observations on the release of iron from cells. PMID- 3291680 TI - Lipid peroxidation in experimental hemochromatosis. PMID- 3291681 TI - Experimental iron overload. Ultrastructural studies. PMID- 3291682 TI - Noninvasive methods for the early detection of hereditary hemochromatosis. PMID- 3291683 TI - Abnormalities in estrogen, androgen, and insulin metabolism in idiopathic hemochromatosis. AB - Of 44 male patients with idiopathic hemochromatosis who were diagnosed at an early stage without morphological or biochemical evidence of liver disease, 25% suffered from impotence and 34% manifested glucose intolerance. Impotence was correlated with a 50% reduction in plasma testosterone, resulting from a 63% decrease in testosterone production. Testicular atrophy was caused by insufficient secretion of gonadotropins due to the selective accumulation of iron in gonadotropic cells of the pituitary gland. However, peripheral sexual hormone metabolism, in particular the conversion of androgens to estrogens, remained unaltered. It was therefore possible to employ substitution therapy successfully with testosterone in these men, and hyperestrogenism was not observed as a side effect. The pathogenetic factors in the development of diabetes mellitus in patients with idiopathic hemochromatosis include impaired insulin secretion caused by the selective deposition of iron in B-cells of the pancreas and insulin resistance due to iron accumulation in the liver. In particular, the insulin resistance is markedly improved after depletion of body iron stores by phlebotomy treatment, resulting in lower insulin requirements in patients with insulin dependent diabetes as well as improvement of carbohydrate metabolisms in about half of the patients with non-insulin-dependent diabetes. We have concluded that hypogonadism and carbohydrate intolerance are caused by the specific distribution pattern of excess iron in the organism, accompanied by functional impairment of affected parenchymal cells. PMID- 3291684 TI - The arthropathy of hemochromatosis. Recent studies. PMID- 3291685 TI - Iron, iron-binding proteins and immune system cells. AB - In summary, the work reviewed in the present paper indicates that 1. Iron and the iron-binding proteins can act as regulators of immune function, and not only as a result of a nutritional dependence of lymphoid cells on transferrin and transferrin-iron. Subsets of cells of the immune system respond differently to increases in iron concentration in vitro and in vivo. 2. Macrophages and lymphocytes differ in the H and L subunit content of the ferritins synthesized in response to increases in iron concentration in vitro. 3. NK activity by adherent and nonadherent cells differ in their susceptibility to the enhancing effect of lactoferrin in vitro. 4. Responses to mitogen stimulation by PHA and Con A are diminished, while the PWM response remains unaffected by exposure to acidic ferritins or by increasing concentrations of iron in vitro and in vivo. 5. Pretreatment of effector but not target cells with iron results in diminished responses in the MLR, an effect that appears to be related to the HLA-A locus. 6. In situ hybridization studies indicate that transferrin is synthesized by a specific subset of the T lymphocytes. 7. Transient increases in serum iron concentration above the full saturation of transferrin, reproducing the clinical situation frequently seen in hereditary hemochromatosis, are followed by a series of cellular changes in the synovium that can be correlated to changes in the course of an experimental model of arthritis in the rat. PMID- 3291686 TI - Idiopathic hemochromatosis: significance and implications of linkage and association to HLA. PMID- 3291687 TI - Role of transferrin receptors and endocytosis in iron uptake by hepatic and erythroid cells. PMID- 3291688 TI - The role of liver endothelium in the transfer of iron from transferrin to the hepatocyte. PMID- 3291689 TI - Functional implications of the radial organization of VIP-containing neurons in the neocortex. PMID- 3291690 TI - Vasoactive intestinal peptide in the peripheral nervous system. PMID- 3291692 TI - Helodermin-like peptides. PMID- 3291691 TI - Glucagon and related peptides. Molecular structure and biological specificity. PMID- 3291693 TI - Synthesis of vasoactive intestinal peptide and related peptides. PMID- 3291694 TI - Vasoactive intestinal peptide and other peptides as neuromodulators of colonic motility in the guinea pig. PMID- 3291695 TI - Vasoactive intestinal polypeptide and the reproductive system. PMID- 3291696 TI - Vasoactive intestinal peptide in the heart. PMID- 3291697 TI - Vasoactive intestinal peptide as a coronary vasodilator. PMID- 3291699 TI - The role of vasoactive intestinal peptide and other neuropeptides in the regulation of the immune response in vitro and in vivo. PMID- 3291698 TI - Vasoactive intestinal peptide and renin secretion. AB - VIP has now been shown to produce an increase in renin release in a number of species, including humans. Our work suggests that VIP is capable of producing this effect by a direct action on the renin-secreting juxtaglomerular cells of the kidney. We have found no evidence to support the possibility that VIP produces this effect as a neurotransmitter in the kidney. In this regard, it should be noted that VIP has been identified as a cotransmitter primarily in cholinergic neurons. The kidney is thought to lack cholinergic innervation, and acetylcholine has no effect on renin secretion. We have explored two conditions where renin secretion is known to increase and found that circulating levels of VIP did not increase along with the increase in PRA. Thus, at least in hemorrhage and dietary sodium restriction, VIP does not appear to affect renin secretion through a humoral mechanism. There could be other untested situations where a humoral effect of VIP might come into play since we have shown that the whole animal is capable of increasing plasma VIP to levels that affect renin release. Studies employing recently developed VIP antagonists have the potential to determine in which physiological or pathological situations VIP contributes to the control of renin secretion. For example, in endotoxic shock, plasma levels of both VIP and PRA are significantly elevated. Could the increase in PRA be partly dependent on an action of circulating VIP? PMID- 3291700 TI - Vasoactive intestinal peptide in sepsis and shock. PMID- 3291701 TI - Vasoactive intestinal peptide as a regulator of exocrine function and as a possible factor in cystic fibrosis. PMID- 3291702 TI - Biosynthesis and regulation of expression. The vasoactive intestinal peptide gene. PMID- 3291703 TI - Carcinogenesis studies: results of 398 experiments on 104 chemicals from the U.S. National Toxicology Program. PMID- 3291704 TI - Bernardino Ramazzini and occupational lung medicine. PMID- 3291705 TI - Can chemical carcinogenicity be predicted by short-term tests? PMID- 3291706 TI - Relationships between in vitro genetic toxicity and carcinogenicity studies in animals. AB - In vitro genetic toxicity assays currently in use cannot be used to unambiguously define all potential carcinogens. The relationship between the various in vitro endpoints (mutation, cytogenetic effects, transformation) and the patterns of tumorigenicity is quite complex. Additional data, particularly for noncarcinogens, are needed to better understand the inconsistencies and to define the limits of predictability. For example, we must empirically define the concordance and discordance between in vivo and in vitro systems related to chemical classes or structures. At this time, since there are no nontrivial generalizations and no general predictivity is possible, we must use judgment in applying short-term test results. There is a clear need to identify as soon as possible the minimum number of in vitro systems that can be used, nonredundantly, to discriminate between carcinogens and noncarcinogens. However, we must continue to address the sources of discordance in order to understand the ways in which short-term test results can and cannot be used. Many trans-sex/trans-species carcinogens show the capacity to induce multiple endpoints of genetic toxicity and this class of rodent carcinogens may have the greatest implications for potential human health effects. A much more selective use of short-term test results to identify potential carcinogens such as these will achieve many of the goals for which these tests were developed. PMID- 3291707 TI - The value and limitations of short-term genotoxicity assays and the inadequacy of current cancer bioassay chemical selection criteria. PMID- 3291708 TI - Short-term tests--relevance for human cancer risk. Discussion paper. PMID- 3291709 TI - The contribution of the IARC monographs program to the identification of cancer risk factors. AB - The differences between cancers that occur as a consequence of occupational exposure and other cancers are not only their preventability but, more importantly, their social unacceptability. Occupational cancer occurs, by definition, among individuals who have been exposed to carcinogens because of their occupation, and most, if not all, of these individuals are drawn from the less favoured social classes. This is probably one reason why mortality from cancer and from all causes is greater in people in classes IV and V than in those in I and II. We cannot precisely quantify the proportion of cases, among the total number of cancer cases observed, attributable to occupational exposures. It is very likely, however, in some of the most industrialized countries, although not in certain developing countries, that the number of those cancers that are indisputably due to occupational exposure is not increasing and is perhaps decreasing. This is due to the combined effect of two factors: the banning of certain chemicals, as, for instance, aromatic amines--even if this did not take place in all countries and, where it did, not at the same time; and improved working conditions, as, for instance, in the case of vinyl chloride. We do not know, however, to what extent low levels of exposure to which the general population is commonly exposed, as well as workers in occupations where levels of exposure to carcinogens have recently been significantly reduced, play a role in the causation of human cancer. While it is important to stress that a large proportion of the chemicals to which humans are exposed, either because of their occupation or in the general environment, and for which experimental evidence of carcinogenicity is available, have not been the object of epidemiological surveys, it is also important to realize that epidemiological methods are generally insufficient to provide reliable information on risks generated by low levels of exposure. It is certainly important to encourage epidemiological surveillance, but it should at the same time be made clear that the epidemiological approach will never entirely replace the considered use of experimental data in the implementation of primary prevention. PMID- 3291710 TI - Metal carcinogenesis. PMID- 3291712 TI - IARC evaluations in the light of limitations of human epidemiologic data. AB - Considerable human data are available that would causally associate human cancer with occupational exposures through the identification of substantial workplace risks. Much additional data are available, indicating lesser risks, that have not achieved widespread acceptance because of the limitations of epidemiologic techniques. Limitations of epidemiologic techniques also limit the associations that can be made, using general population data, between cancer mortality and occupation. These same uncertainties, however, also affect assertions of absence of effect. Apparently "negative" results must be evaluated with the same critical view as are most "positive" results. PMID- 3291711 TI - Occupational cancer in metalworking and transportation equipment industries. AB - Hazardous chemical exposures may be a more important public health problem in chemical-using industries, such as the metalworking and transportation equipment industries, than in chemical manufacturing plants. Recent studies have identified excess mortality from cancer among groups of workers in model and patternmaking, plating and die-cast, foundry, machining, electronics operations and vehicle assembly plants. The chemical agents or levels of exposure associated with these findings have not previously been thought to pose a cancer risk. Therefore, estimates of the fraction of cancers associated with workplace exposure may understate the importance of exposure in this setting. PMID- 3291714 TI - Carcinogenicity of mineral oils. PMID- 3291713 TI - Gasoline toxicology. Implications for human health. PMID- 3291715 TI - Yeast-mating-type switching: a model system for the study of genome rearrangements induced by carcinogens. PMID- 3291716 TI - Control of exposure to chemicals. Scientific basis and social compromise. PMID- 3291717 TI - Nitrate exposure and the carcinogenic process. PMID- 3291718 TI - Incidence of pancreatic tumors and tumor precursors in Sprague-Dawley rats after administration of olive oil. AB - We studied the pancreata of 280 (140 males and 140 females) olive-oil-treated and 240 (120 males and 120 females) untreated Sprague-Dawley rats of the breed used at the BT Experimental Unit of the Bologna Institute of Oncology. Extra-virgin olive oil was administered by stomach tube, once daily, for 4-5 days weekly, for 2 years. The animals were kept under observation for as long as 130 weeks. Only a borderline increase in acinar cell adenomas and adenocarcinomas was observed. We found no increase in endocrine oncologic lesions. PMID- 3291719 TI - Vitamin intervention on precancerous lesions of the esophagus in a high-risk population in China. PMID- 3291720 TI - Common goals of prevention and treatment of cancer. PMID- 3291721 TI - Direct-acting alkylating and acylating agents. DNA adduct formation, structure activity, and carcinogenesis. PMID- 3291723 TI - Environmental carcinogens. Using pesticides and nitrosamines as paradigms. PMID- 3291722 TI - Chronic toxicity results and ongoing studies of 1,3-butadiene by the National Toxicology Program. PMID- 3291724 TI - Mutagenicity studies on styrene and vinyl acetate. PMID- 3291725 TI - Carcinogenicity and genotoxicity of the herbicide 2,4,5-trichlorophenoxyethanol (TCPE) contaminated with dioxin. AB - In an earlier study 2,4,5-trichlorophenoxythanol (TCPE) contaminated with dioxin, a component of the Hungarian herbicide Buvinol, was found to be hepatocarcinogenic. In the present work, the hepatocarcinogenicity of TCPE was compared to its possible genotoxicity in vitro, using the Salmonella/microsome test for mutagenicity and for its DNA-damaging effect, the induction of sister chromatid exchanges (SCE) in Chinese hamster cells in vitro. It was found that purified TCPE (with 0.1 ppm dioxin content) was under no conditions mutagenic by the Ames test, i.e., it belongs to the group of false-negative chemicals. TCPE was, however, genotoxic; its DNA-damaging effect was demonstrated by an increase in the frequency of SCE, while pure dioxin of corresponding amount was ineffective. However, elevated SCE frequency and the toxicity on bacteria and mammalian cells by TCPE were significantly decreased by the metabolic activation system (S-9 mix) isolated from liver. This observation indicates that in the detoxication of TCPE in vitro, a key role is to be attributed to the hepatic microsomal enzymes. It is presumed that TCPE is hepatocarcinogenic only in a dose range which has exhausted the detoxicating capacity of the liver. PMID- 3291726 TI - Pulmonary carcinogenic effects of ozone. PMID- 3291727 TI - Laboratory animal toxicity and carcinogenesis testing. Underlying concepts, advantages and constraints. PMID- 3291728 TI - Cancer risk evaluation in an area with a high density of chemical plants. An interdisciplinary approach. PMID- 3291729 TI - Mutagenicity screening/in vitro testing--the end of an era; animal and human studies--the direction for the future. PMID- 3291730 TI - Are there thresholds for carcinogenesis? The thorny problem of low-level exposure. PMID- 3291731 TI - Metabolic activation of chemical carcinogens in animal and human tissues. DNA binding. PMID- 3291732 TI - Mutation and neoplastic transformation. Correlations and dissociations. PMID- 3291733 TI - Induction of focal and nodular liver lesions in rodents as an indication of human carcinogenic risk. PMID- 3291734 TI - [Summary of current knowledge on Escherichia coli, agents of diarrhea]. PMID- 3291735 TI - [Systemic neonatal candidiasis]. PMID- 3291736 TI - [Cysts of the ovary during the neonatal period and the first months of life]. PMID- 3291737 TI - The caissons and the foundation. AB - The article and photographs cover a period of contemporary history spanning fifty years. The author writes from his own experiences with plastic surgeons he met, knew, and worked with. Several of the photographs are the last pictures taken before the subjects' deaths. The brevity of the verbal portraits is governed by space in the journal. Other than microsurgery, craniofacial surgery, free flaps, and lately, liposuction, most of what we do now was known and practiced decades ago. PMID- 3291739 TI - The effect of ethanol and its metabolites on carbohydrate, protein, and lipid metabolism. AB - The metabolic effects of ethanol are due to a direct action of ethanol or its metabolites, changes in the redox state occurring during its metabolism, and modifications of the effects of ethanol by several nutritional factors. Ethanol causes hyperglycemia or hypoglycemia depending whether or not glycogen stores are adequate, inhibits protein synthesis, and results in a fatty liver and elevations in serum triglyceride levels. Increases in serum lactate, results from the increased reduced nicotinamide-adenine dinucleotide/nicotinamide-adenine dinucleotide + (NADH/NAD+) ratio, and hyperuricemia probably occurs owing to the increased turnover of adenine nucleotides after ethanol ingestion. Ethanol decreases thiamine absorption and decreases the enterohepatic circulation of folate. Acetaldehyde, the major metabolite of ethanol, increases the degradation of pyridoxal 5'-phosphate by displacing it from its binding protein and making it susceptible to hydrolysis by membrane-bound alkaline phosphatase. Chronic ethanol administration also results in decreased vitamin A stores and reduced bone mass and blood levels of 25-hydroxyvitamin D. The mechanism whereby ethanol affects these vitamins and their associated enzymes is unknown. PMID- 3291738 TI - Congenital cardiac tumors in association with orofacial clefts. AB - The case of an infant with a complete cleft of the primary and secondary palate (class III) and right unilateral complete cleft lip who demonstrated failure to thrive due to a primary congenital cardiac fibroma is described. This tumor required cardiac transplantation for effective treatment. A review of the literature, although replete with associations of cleft lip/palate and congenital heart disease, does not reveal a congenital cardiac tumor/orofacial cleft association or syndrome. Failure to thrive, however, which is common in such infants, may well be associated with congenital cardiac anomalies and should be carefully ruled out. Treatment of cardiac fibromas is discussed along with the usefulness of two-dimensional echocardiography and the importance of the team approach in the management of these infants. PMID- 3291740 TI - Drug induced morphologic changes in the liver. AB - The pathologic evaluation of hepatic changes secondary to drug ingestion is a difficult task because of the limited histologic response of the liver to hepatotoxins. The majority of these pharmacologic agents produce cholestasis, hepatitis, or both. Some drugs will produce damage if given for a sufficient time and in sufficient amount; this reaction is termed predictable. Other agents cause injury only in a small number of individuals; this reaction is unrelated to dosage or duration of administration and is termed unpredictable. In time, after discontinuing the offending agent, morphologic alterations of the liver and clinical findings will revert to normal except in certain conditions. Some drugs will produce cirrhosis as a sequelae while others may progress to chronic hepatitis. The accurate and complete evaluation of hepatic morphology requires a thorough clinical history since the histologic changes of certain illnesses may mimic the changes of drug-induced hepatic damage. For the clinician, drug-induced hepatic injury is important because of the central function the liver plays in drug metabolism and its susceptibility to damage. PMID- 3291741 TI - Non-steroidal anti-inflammatory nephrotoxicity. AB - Non-steroidal anti-inflammatory drugs have a wide range of use in clinical practice because of their analgesic and anti-inflammatory properties. However, their potential nephrotoxicity has been noted. The case histories were studied, retrospectively, in 13 patients who were taking non-steroidal anti-inflammatory drugs as follows: four on fenoprofen (Nalfon), three on naproxen (Naprosyn), two on ibuprofen (Motrin), two on sulindac (Clinoril), one on tolmetin (Tolectin), and one on indomethacin (Indocin) and who exhibited abnormal urinalysis or a deterioration in renal function. Nine of the patients underwent renal biopsies, and eight of these biopsies were positive for interstitial nephritis. In addition to the presentation of additional cases of non-steroidal anti-inflammatory drug nephrotoxicity, a brief review of the current theories of the nephrotoxic mechanism is presented. PMID- 3291742 TI - Endotoxin in newborn septic shock: significance, metabolic, and cardiovascular changes. AB - The role of endotoxin in newborn septic shock is reviewed. Metabolic and cardiovascular changes, as known to us, are described with special emphasis that the newborn is not a "small adult." Developmental or maturational changes are hypothesized to be the major cause of these differences between age groups. Finally, it is our belief that newborn septic shock is an important topic for further investigation. PMID- 3291743 TI - Cholesterol embolism causing bleeding gastric ulcers. AB - Two cases of atheromatous embolism of the small arteries of the stomach are reported. Insofar as has been ascertained, they are the first reported cases in the literature which presented symptoms of severe gastric bleeding and were found to have bleeding gastric ulcers on endoscopy. Both patients were successfully treated surgically, and their ulcers were found to be secondary to small arteriolar occlusions owing the atherosclerotic embolization. Awareness of clinicians as well as pathologists of this phenomenon in elderly males with symptoms of abdominal pain and other upper gastrointestinal symptoms unrelated to the ingestion of food is stressed. Pathophysiology of atherosclerotic emboli is also discussed. PMID- 3291744 TI - [Study of the small bowel and mesentery in Crohn's disease: comparison of ultrasonics, x-ray computed tomography and small bowel transit in 18 patients]. AB - The advantages of tomodensitometry and ultrasonography were compared with those of small bowel series in Crohn's disease of the small bowel in 18 patients. These two examinations give results which are inferior to those of small bowel series, for the positive diagnosis and the evaluation of the intraluminal extension of the disease, since their sensitivity was only 60 p. cent in identifying the pathological loop. On the contrary, their advantage lies in the evaluation of the intraluminal extension of the disease, which was correctly demonstrated with ultrasonography in 22 p. cent of cases, and tomodensitometry in 45 p. cent. This confirms the supplementary value of these two examinations in the study of the mesenteric involvement of the disease, screening of abscesses, and makes desirable a prospective evaluation of the influence of mesenteric abnormalities on the prognosis and surgical indications. PMID- 3291745 TI - [Physiopathology of gastroesophageal reflux]. PMID- 3291746 TI - Ovarian cancer (review). Etiology, diagnosis, prognosis, surgery, radiotherapy, chemotherapy and endocrine therapy. AB - The increased incidence of ovarian cancer in women whose ovulations were not suppressed by pregnancy or oral contraceptives and the increase in the incidence of the disease with the onset of climacterium support the hypothesis that ovarian cancer is an endocrine-related disease. Animal experimental results further support this contention. However, identification of a population at risk, prevention, and early detection is difficult. At present, tumor markers are useful in monitoring the disease, though cannot be used for screening. Most of the diagnosed cases are of advanced stages. Besides staging, tumor histology, and residual tumor load are of prognostic importance. The need for accurate initial surgical staging with optimal tumor cytoreduction and the importance of second look surgery to confirm the response to therapy are emphasized. The precise role for radiotherapy in the treatment of ovarian cancer is still to be established. Presently, response rates of 80% are achieved using cisplatin based combination chemotherapy. In spite of this, long term survival has not improved. Endocrine therapy has hitherto been used empirically and mainly as a last resort in the treatment of advanced ovarian cancer. Response rates of about 10% have been reported. Information on tumor predisposition related to hormonal control should be a key parameter in selecting the appropriate therapy. Tumor analysis has shown that androgen receptors predominate in ovarian cancer, compared to estrogen and progestin receptors. A clinical trial based on endocrine parameters is warranted. PMID- 3291747 TI - Steroid hormones as regulators of the proliferative activity of normal and neoplastic intestinal epithelial cells (review). AB - Glucocorticoid and mineralocorticoid receptors are present in normal epithelial cells of both the small and large intestine and there have also been contentious reports of androgen, oestrogen and progesterone receptors in the epithelium of the normal large intestine. The majority of reports suggest that stimulation of the intestinal glucocorticoid receptors results in increased proliferation of epithelial cells in the small bowel, as does stimulation of androgen receptors and possibly mineralocorticoid receptors. The proliferative response of the normal intestine to oestrogens is difficult to evaluate and that to progestigens appears not to have been reported. Epidemiological studies reveal a higher incidence of bowel cancer in premenopausal women than in men of the same age and yet there is a lower incidence of these tumors in women of higher parity. These findings have been atributted to a variety of non-epithelial gender characteristic such as differences in bile metabolism, colonic bacterial and fecal transit times. In experimental animals, androgens have also been shown to influence carcinogenesis and this could well be attributed to changes in food intake etc. However, many studies have now revealed steroid hormone receptors on colorectal tumor cells and thus a direct effect of the steroid hormones on the epithelium during and after malignant transformation must now be considered. PMID- 3291748 TI - In vitro immunosuppressive activities of recently developed anthracycline cytostatics. AB - The effects of a series of seven anthracycline cytostatics on various human leukocyte functions, namely the production of Migration Inhibition Factor (MIF) by lymphocytes and the production of chemiluminescence by activated polymorphonuclear leukocytes (PMNs), as well as on classical and alternative pathways of activation of human complement were investigated. In addition, lipophilic and electrochemical properties of the compounds were determined, by measuring their High Performance Liquid Chromatography (HPLC) capacity ratio (k') and half-wave reduction potential (E1/2). The antitumor agents under investigation suppressed, in most cases, lymphocyte and PMN functions, whereas complement activity remained unaffected. The extent of suppressive effects showed a good correlation with the lipophilicity of the compounds, while no correlation with reduction potentials was found. PMID- 3291750 TI - Confinia Neurologica/Applied Neurophysiology. 50 years. PMID- 3291749 TI - [The problem of "benign macrocephaly"]. AB - 24 families of probands with a high head circumference/height ratio greater than the 97th percentile were investigated for head circumference and height. It is concluded that "benign macrocephaly" represents rather the upper extreme of the normal distribution of head circumference than--as has been suggested by some authors--a discrete and autosomal dominant entity. PMID- 3291751 TI - Computed-tomography-directed stereotaxis for movement disorder with postoperative magnetic resonance imaging confirmation. AB - Movement disorders may respond dramatically to properly placed lesions in thalamic and subthalamic areas. Proper location of lesions may be verified postoperatively by magnetic resonance imaging (MRI). Herein is reported a case of stereotactically placed bilateral lesions under computed tomography control using the Leksell apparatus, with successful clinical outcome, and the verification of lesion placement by subsequent MRI images. PMID- 3291752 TI - The role of monopolar stimulation during computed-tomography-guided stereotactic biopsies. AB - 44 patients underwent intraoperative stimulation with a monopolar electrode prior to computed tomography (CT)-guided stereotactic biopsy. Stimulation at 2-100 Hz resulted in functional responses in 6/21 patients with subcortical or callosal lesions, 4/6 with basal ganglion lesions, 8/10 with thalamic and 4/4 with brainstem lesions. In all but 2 patients with mesencephalic lesions, where limited biopsy sites were available, an alternative biopsy site was used if a functional response was obtained. No morbidity was seen among these patients, although postbiopsy CT scans demonstrated small 3- to 7-mm hematomas in 5/11 patients. Retrospective review of 79 patients who underwent biopsies without stimulation demonstrated hematomas in 6/10 patients and a 3.3% transient surgical morbidity. These data indicate that postbiopsy hematomas are a relatively common occurrence, that intraoperative electrical stimulation within abnormal lesions can identify functional potential, and that avoidance of biopsies within these functional areas may be associated with reduced morbidity. PMID- 3291754 TI - As I saw it. PMID- 3291753 TI - Confinia Neurologica/Applied Neurophysiology. 50 years later. PMID- 3291755 TI - Deafferentation pain in man. AB - Pains of various etiologies are described in so many overlapping ways that verbal descriptions alone do not permit a valid distinction between those pains associated with neurological injury (with or without sensory loss) and those associated with neurological compression. Nor does the fact of some sensory loss plus pain constitute a useful classification to determine either the mechanism of the pain or its treatment. Progress is more likely to ensue if we seek to characterize in detail each type of painful lesion. Evidence for these conclusions is drawn from cases of brachial plexus injury, trigeminal rhizotomy and tractotomy, postcordotomy dysesthesia and central pain treated by regional guanethidine block. Examples of the value of totally innovative approaches are drawn from the physics of elementary particles. PMID- 3291756 TI - Experimental deafferentation syndromes. AB - Animal models of dysesthesias have been established, and reveal the following major points. Dysesthesias of peripheral nerve or dorsal root origin have a central neural cause. Chronic dysesthesias of spinal origin have a cause which resides in the brain. The origins of these effects are lesions in the spinothalamic system. The causes of these effects are abnormal functionings among opiate, catecholamine, and purine pathways. Denervation supersensitivity is suggested. PMID- 3291757 TI - Neurosurgical technique of the dorsal root entry zone operation. AB - The dorsal root entry zone operation was introduced in 1976 to relieve the pain of brachial plexus avulsion. Since then it has been applied to pain treatment in paraplegia, postherpetic pain, phantom limb pain and other types of of deafferentation pain. Over 400 operations have been done at the Duke University Medical Center with overall good results in 60% of pain patients. PMID- 3291758 TI - Frederick W.L. Kerr: comments on his life with notes on his contributions to the understanding of facial neuralgias. PMID- 3291759 TI - Normal anatomy and physiology of the spinal cord dorsal horn. AB - The dorsal horn of the spinal cord receives afferent input from innocuous primary afferent neurons via collaterals from the dorsal columns. This input is integrated and relayed primarily by neurons in laminae III-VI. Dorsal horn neurons which encode innocuous inputs project to the medulla and the cervical spinal cord via the dorsal columns and the dorsolateral funiculus. Nociceptive primary afferent neurons enter the spinal dorsal horn via collaterals from Lissauer's tract. Nociceptive input is integrated and relayed by neurons in laminae I, II and V which project to the reticular formation and thalamus via the anterolateral tract. PMID- 3291760 TI - Anti-Candida albicans activity of Pichia anomala as determined by a growth rate reduction assay. AB - Killer toxin activity of Pichia anomala WC65 appeared fungicidal for P. bimundalis WC38 and fungistatic for Candida albicans RC1. Inhibitory activity against sensitive C. albicans showed a linear relationship between toxin concentrations and the inverse of the reduced growth rates. The plot of toxin concentrations against growth rates was hyperbolic, as is characteristic of saturation kinetics. Sensitivity of C. albicans to the toxin decreased with increased cell age. The measurement of growth rate reduction provided a simple and accurate method for quantitation of toxin. PMID- 3291761 TI - Effects of alkaline hydrogen peroxide treatment on in vitro degradation of cellulosic substrates by mixed ruminal microorganisms and Bacteroides succinogenes S85. AB - The effects of sodium hydroxide (NaOH) and alkaline hydrogen peroxide (AHP) treatments on wheat straw (WS) and various cellulosic substrates were determined by measuring susceptibility to degradation by mixed ruminal organisms or Bacteroides succinogenes S85. In vitro incubations were used to measure differences in fermentation resulting from each successive step in the AHP treatment process. In vitro incubations through 48 or 108 h were conducted to measure these differences. The AHP treatment of WS increased (P less than 0.05) dry matter, neutral detergent fiber, and acid detergent fiber degradation over control WS when these substrates were incubated with mixed ruminal microorganisms or B. succinogenes S85. Fermentations containing AHP-treated WS had greater (P less than 0.05) microbial purine (RNA) and volatile fatty acid concentrations by 12 h compared with those containing untreated or NaOH-treated WS. Xylose in AHP treated WS was utilized more extensively (P less than 0.05) by 12 h compared with the xylose of untreated or NaOH-treated WS. Treatment with AHP removed 23% of the alkali-labile phenolic compounds from WS. When substrates with high levels of crystalline cellulose (raw cotton fiber, Solka floc, and Sigmacell-50) were treated with NaOH or AHP and incubated for 108 h with B. succinogenes S85, extent of acid detergent fiber degradation of cotton fiber and Sigmacell-50 was similar to that of their respective controls. Sodium hydroxide and AHP treatments were effective in increasing acid detergent fiber degradation of the Solka floc which contained, on average, 3.3 and 4.8 percentage units more acid detergent lignin and hemicellulose, respectively, than cotton fiber and Sigmacell-50.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291762 TI - Selective stabilization by the bacteriophage 434 repressor of the plasmid expressing bovine growth hormone in Escherichia coli. AB - The maintenance of a plasmid vector-host system that selects for bacteria carrying the plasmid without the need for antibiotics is described. In this system, the bacteriophage 434 repressor gene cloned on the plasmid protects the host from lysis by a lambda imm434 cI- prophage. Cells that occasionally lose the plasmid are killed by prophage induction and therefore do not accumulate in the growing culture. The presence of the phage 434 repressor in the cells does not interfere with the process of lambda repressor inactivation and the high-level production of bovine growth hormone. PMID- 3291763 TI - [Mechanism of action of antineoplastic agents in the DNA synthesis of tumor cells]. AB - The overall process of DNA biosynthesis can be divided into two major steps, one consisting essentially of nucleotide synthesis from low-molecular-weight metabolites and the other of polymerization of the nucleotides to form the duplicated DNA. Some antineoplastic agents are structural analogues of bases or nucleosides of intermediate metabolites, and are converted to their ribotides by enzymes catalyzing nucleotide metabolism. With some of these agents, the resulting ribotides then act as inhibitors of nucleotide synthesis. With others the resulting ribotides are subjected to stepwise enzymatic reactions and are then incorporated into DNA during its synthesis, thus rendering it inactive. Some antineoplastic agents, on the other hand, affect the DNA chain apparently through intercalation in double-stranded DNA, binding to DNA or nuclear protein, or interstrand linkage, or else through activation of endonuclease or inhibition of topoisomerase. The former effects result in inhibition of DNA double-strand dissociation, while the latter result in double-stranded DNA scission and apurinic acid formation. Antineoplastic agents thus vary widely, with respect to both the processes of their activation and inactivation and their effects on DNA synthesis. Their mechanisms of action and effects also tend to differ among various types of tumor cells and host organs. Investigation of the action mechanisms of these agents and determination of their appropriate utilization will be required in order to achieve better results in cancer chemotherapy. PMID- 3291765 TI - [Drug-carrier complex in targeted cancer chemotherapy]. AB - To achieve the targeting of anticancer drugs, a variety of drug-carrier complexes such as conjugates with macromolecules, particulates or oils has been widely investigated, experimentally or clinically. These are classified into 1) topical (intratumoral and intracavital) use, 2) systemic (intravenous and per oral) use, and 3) intra-arterial (chemoembolization) use. A drug delivery system (DDS) should be designed for the complex or the drug itself to accumulate at target areas (1st-order targeting), to be directed to tumor cells (2nd-order targeting), and finally to be incorporated by tumor cells (3rd-order targeting). The first order targeting will be the gateway to targeted therapy. Our experiences in 759 patients treated with arterial chemoembolization by microencapsulated drugs showed the benefits of this prototype of first-order drug targeting, in terms of enhanced drug effects with decreased drug toxicity and improved survival in combination with surgical or systemic treatments. Further studies on DDS contributed by pharmaceutical science and biophysiology will establish the place of targeted chemotherapy, for a definite improvement in the low therapeutic index of anticancer drugs. PMID- 3291764 TI - [Mechanism of action of anti-cancer drugs from the viewpoint of RNA metabolism]. AB - The mechanism of action of anti-cancer drugs, especially 5-FU, was discussed on the basis of RNA metabolism. After its incorporation into cells, 5-FU is metabolized through the uracil pathway, and finally incorporated into various species of RNA. On the other hand, 5-FU metabolized to FdUMP forms a covalent ternary complex among TS and mTHF, and inhibits de novo TMP synthesis, resulting in the inhibition of DNA synthesis. However, 5-FU was found to exert an effect on TS- mutant FM3A cells which was almost as lethal as the effect on wild-type FM3A cells in the presence of thymidine. Therefore, this lethal effect could be attributable to the inhibition of RNA metabolism, rather than DNA metabolism. The effects of 5-FU on RNA metabolism in L1210 cells are as follows: (1) inhibition of the processing of preribosomal RNA to ribosomal RNA (2) inhibition of the synthesis of poly(A) RNA of mRNA (3) inhibition of tRNA methylation (4) impaired synthesis of snRNA, U4, U6. (5) inhibition of pre-rRNA methylation (6) enhancement of poly(A) RNA translation. With reference to the items listed above, a discussion was made on the basis of our experimental results. PMID- 3291766 TI - [Application of monoclonal antibodies to cancer therapy: idiotype mapping of monoclonal antibodies to tumor-associated antigens]. AB - Polyclonal and monoclonal anti-idiotypic antibodies were prepared against several monoclonal antibodies which reacted with high molecular-weight melanoma associated antigens. Idiotype mapping was proposed from the serological data obtained from these anti-idiotypic antibodies. This mapping will be of use for applying the anti-idiotypic monoclonal antibodies for cancer therapy. PMID- 3291767 TI - [Tumor-oriented anti-cancer agent with estrogen as a carrier]. AB - Tumor oriented anticancer agents with estrogen as a carrier have been extensively studied since 1950's. Only Estracyt and bestrabucil have been evaluated to be useful in clinical trials. Although the use of estrogen as a carrier for anticancer agents aimed at the development of the anticancer drug for the receptor mediated chemotherapy, these two drugs did not show any affinity to estrogen receptor. The history tells us that the development of anticancer agents for the estrogen receptor mediated chemotherapy is extremely difficult. Estracyt is reported to exert its anticancer effect on prostate cancer through the specific binding to the estramustine binding protein (EMBP) which is present only in the prostate gland and cancer. Bestrabucil shows the selective uptake by the various malignant cells and is indicated that bestrabucil exerts its anti-cancer effects on various malignant tumors including breast cancer and hematopoietic malignancy, through the affinity to malignant cells. The mechanism is unknown and to be elucidated. PMID- 3291768 TI - [Current problems and future perspectives in drug delivery systems for cancer therapy]. AB - The current problems and future perspectives in DDS and targeting therapy for the treatment of cancer patients were reviewed on the basis of the following experimental data obtained in our laboratory. 1) IgG fractions isolated from the serum of a patient with systemic lupus erythematosus showed marked accumulation in cancer cells, indicating that certain serum IgGs may be useful as carriers of anticancer agents. 2) Lipid microspheres were also incorporated within cancer cells to enhance the anti-tumor activities of anti-cancer agents. In addition, this material may be applied for prevention of lymph node metastasis because of its lymphotrophic property. 3) Lipid microspheres including non-steroidal analgesics were quite effective for the management of cancerous pain, suggesting its efficacy as a DDS in this direction, besides its usefulness with anti-cancer agents. PMID- 3291769 TI - [Oncofetal proteins--new developments]. AB - Adenocarcinoma-associated antigens which were newly detected by our monoclonal antibodies YH206 and MUSE 11 were characterized. The simultaneous determination of these novel antigens with CA19-9 was found useful for serodiagnosis of pancreatic cancer. Recently, the cDNAs corresponding to mRNA encoding a polypeptide of CEA were successfully cloned by Oikawa et al., and the amino acid sequence was determined. Topics on the research advance of the CEA gene family and carbohydrate structure of CEA molecule were reviewed. In addition, we have prepared anti-idiotypic monoclonal antibodies to anti-CEA specific MoAb, anti YH206 MoAb as well as anti-melanoma MoAb. Clinical applications of these anti idiotypic antibodies to serodiagnosis and new immunotherapy were discussed. PMID- 3291770 TI - [In vivo application of monoclonal antibodies in the management of human carcinomas]. AB - Murine monoclonal antibody (MAb) B72.3 was prepared using a membrane-enriched fraction of breast carcinoma as the immunogen. MAb B72.3 has been previously shown, by in vitro assay, to have a high degree of specificity for carcinomas of the colon, ovary, breast and stomach versus normal adult tissues. The reactive antigen (termed TAG-72) has been purified and characterized. B72.3 IgG was radiolabeled with 131I and utilized for the in situ detection of colorectal cancer metastases. The radiolocalization of MAb B72.3 administered intravenously (i.v.) into colorectal cancer patients was sufficient to allow detection of more than 50% of the lesions by gamma-scanning. Radiolocalization indices (RI) (i.e., cpm 131I-labeled MAb/g of tumor versus cpm/g of normal tissue) were obtained by direct analyses of biopsy materials. Using an RI of greater than 3 to indicate positive localization, tumor lesions at various sites from 17/20 patients were positive. Seventy percent (99/142) of the tumor lesions had RIs of greater than 3, while only 12 of 210 normal tissues had RIs of greater than 3. 131I-B72.3 IgG was also intraperitoneally (i.p.) administered to 10 patients with colorectal cancer. Specific tumor localization via gamma-scanning (confirmed at surgery) was observed in 7/10 patients. Three of the 7 patients were negative for tumor detection by both CAT scan and X-ray but were positive for tumor localization via gamma-scanning of i.p.-administered MAb B72.3. Direct analyses of biopsy specimens of carcinoma and normal tissues demonstrated ratios greater than 70:1 for tumor MAb localization versus normal tissues. No clinical toxicity or adverse reactions were observed with the MAb when administered i.v. and i.p. These results thus demonstrate the efficacy of i.v. and i.p.-administered MAb B72.3 for the radiolocalization as well as potential use of MAb B72.3 in protocols aimed at tumor targeting and in MAb-guided therapy for human epithelial malignancies. PMID- 3291771 TI - [Immunotherapy of gastric cancer]. AB - Two immunotherapeutic methods were developed as adjuvant therapy for gastrointestinal malignancies, one using oral administration of a streptococcal preparation, OK-432, and the other with adoptive immunotherapy (AIT), local transfer of IL2-cultured and autologous lymphocytes, combined with local preadministration of OK-432. Tsuchitani and Nio in our laboratory have revealed experimentally that oral OK-432 stimulates tumor-specific and non-specific immune mechanisms of gut-associated lymphoid tissues and inhibits the growth of some murine syngeneic tumors that were transplanted into cecal patches. The clinical efficacy of oral OK-432 on gastric cancer patients has been examined by a controlled randomized trial involving a total of about 1000 cases. Oral OK-432 (5KE, once a week) was revealed to be significantly effective in curatively resected group but not effective in non-curatively resected group. Ten consecutive patients with peritoneal dissemination of gastric cancer were treated with intraperitoneal OK-432 and AIT. AIT was performed by transferring autologous lymph node-lymphocytes cultured for 13 days with crude IL2 and tumor-extract. The survival of the treated patients was significantly longer (50% survival period exceeded 1 year) than that of historical control (95 cases, 50% survival period was 5 months). These immunotherapeutic methods are expected to be useful for multidisciplinary therapy of gastric cancer by a combination of each method with other therapeutic methods. PMID- 3291772 TI - [Anti-tumor effect of human recombinant TNF]. AB - In this article, the clinical effects of rH-TNF on various cancer patients and the mechanism of self-induction of defense against rH-TNF cytotoxicity in tumor cells and the counter measures against this are reviewed. 1) Clinical effects of rH-TNF Intratumoral administration of rH-TNF was performed in 7 patients and clinical efficacy (PR + MR) was observed in 3/7 (42.9%). Also a reduction of leukemia cells in peripheral blood was observed in all 4 leukemia patients following intravenous (i.v.) administration of rH-TNF. Furthermore, in 2 multiple myeloma patients, the myeloma protein and plasma cells in bone marrow were reduced by i.v. administration of rH-TNF. 2) Self-induction of defense against rH TNF cytotoxicity Investigation of the effect of TNF on RNA and protein synthesis by tumorigenic and normal cell lines showed that their synthesis in tumor cells was increased at 12 h and peaked at 24 h of incubation with TNF, while that in normal diploid fibroblast (HEL) cells was apparently unaffected by the presence of TNF. Artificial inhibition of either RNA or protein synthesis by L-M cells, upon addition of Act D or CHI increased the cytotoxic effect of TNF, thus suggesting that the elevated RNA and protein synthesis is related not to the cytotoxic reaction itself but rather to a defense mechanism. Similar incubation of HEL cells with TNF in the presence of either inhibitor resulted in the occurrence of cytotoxicity not observed with TNF alone, thus suggesting the existence of a defense mechanism in normal, TNF-resistant cells which is absent or greatly weakened in tumor cells. 3) Combination therapy of rH-TNF with various anticancer drugs. A synergistic increase in the cytotoxic effects of rH-TNF and anti-cancer drugs was demonstrated in vitro The cytotoxicity of rH-TNF against L M cells in combination with MMC, ADM, Ara-C, ACD, DM, CDDP, VCR and 5-FU was 4 to 347 times as high as that of rH-TNF alone. These results suggest that combination therapy including rH-TNF and anti-cancer drugs may be of value in the treatment of malignancy in human patients. PMID- 3291773 TI - [Interferon-alpha]. AB - Among interferon (IFN)-alpha, beta, gamma, there are no differences in its clinical effects and toxicities. As to IFN-alpha, there are leukocyte IFN, lymphoblastoid IFN, recombinant IFN-alpha 2a, 2b, and 2c. Now we have largely completed the process of surveying for anticancer effects over the broad range of malignancies. However, the adequate method of administration, route, dose, and interval are not yet fully established. Dose response remains unanswered question with some contradictory results in in vitro and clinical reports. The actual mechanism responsible for its anticancer activity is still not known. The question of what variables to monitor in assessing adequate dosages of IFN remains unsolved. Several trials have examined the possibility of combining IFN with other treatment modalities including anticancer agents, BRMs, radiation, etc. It should be acknowledged that we remain at a very early stage in our understanding of IFN. In future, IFN may play an even larger role when used in an adjuvant setting or as part of multimodality cancer treatment. PMID- 3291775 TI - [Endoscopic sonography in cancer diagnosis]. AB - Endoscopic ultrasonography (EUS) is the method to investigate sonographically tissue architecture by intraluminal scanning using the endoscope mounted a mechanical or electronic scanning device. The method is very effective in visualizing GI tract as well as organs present in the vicinity of digestive hollow organs as high resolution sonographic images. The method can be applied also to investigate various intraperitoneal organs, especially the liver by means of sonolaparoscopy. The most obvious application of the method is the staging of malignant neoplasms of the GI tracts especially of the stomach, esophagus and rectum. EUS mostly reveals five layer structure as layers different in echogenicity and it is considerably accurate to assess extents of wall involvement in malignancy, ulceration and inflammation of the digestive tract. It is effective in differentiating between carcinoma and submucosal tumors simply by ultrasonic localizations of the tumor masses. Involvement of regional lymph-nodes can be assessed is fairly accurate thus giving precise indication in the treatment, either medical or surgical means. Agreements between EUS staging of gastric cancer and histopathological determination were considerably accurate over various stages of gastric cancer, however, the presence of concomitant ulceration sometimes caused slight over-reading on the side of EUS. Laparoscopic sonography has also proven a considerable accuracy over existing imaging methods in terms of differential diagnosis of minute liver masses. These results seem to support the view that EUS, which is only slightly invasive, has opened up new area in cancer diagnosis, especially in the diagnosis of deeply sitting neoplasms, in which other sophisticated imaging technique are not yet available. PMID- 3291774 TI - [Potential use of positron-emission tomography in clinical oncology]. AB - Positron-emission tomography (PET) is an excellent technique, utilizing positron labeled radiopharmaceuticals which provide a quantitative image of tissue metabolism in the living body. Cancer tissue is characterized by increased forms of metabolism, such as glycolysis and protein synthesis. Consequently, PET makes it possible to evaluate the metabolic activity of cancer tissue. Such information is useful not only for a better understanding of human cancer biology but for utilization in cancer clinics. The potential use of the PET technique for clinical oncology are cancer detection, cancer grading, biological characterization of tumors, and evaluation of therapeutic effectiveness. From this viewpoint, much clinical research has been done and good results obtained in both the characterization of hepatoma and lung cancer, and the grading of brain tumor, showing good correlation with prognosis after cancer therapy. However, PET is not commonly available and has not yet been established as a diagnostic technique in cancer clinics. Further extensive studies will thus be necessary in order to achieve these aspects. PMID- 3291776 TI - Cultured skin grafts. Past, present, future. PMID- 3291777 TI - Bacteriology and antibiotic treatment of perineal suppurative hidradenitis. AB - A plausible bacterial pathogen (Streptococcus milleri, Staphylococcus aureus, anaerobic streptococcus, or Bacteroides species) was isolated at least once in 26 of 32 patients with active perineal suppurative hidradenitis. The main pathogen was S milleri, whose presence was significantly associated with disease activity and whose disappearance significantly correlated with clinical improvement; S aureus nd anaerobic streptococci were also implicated. PMID- 3291778 TI - Immunohistologic studies in Schamberg's disease. Evidence for cellular immune reaction in lesional skin. AB - We studied eight cases of Schamberg's disease immunohistologically by using monoclonal antibodies. The dermal infiltrate was composed of Leu-1-reactive T cells, OKT6-reactive Langerhans' cells, and Leu-M5-reactive (Leu-M5+) macrophages. Among them, the major population consisted of T cells with the predominance of Leu-3a-reactive (Leu-3a+) T cells over Leu-2a-reactive (Leu-2a+) T cells. On the other hand, the epidermotropic mononuclear cells consisted of Leu 2a+ and Leu-3a+ T cells without any predominant pattern, and Leu-M5+ macrophages. Furthermore, note that a pemphiguslike intercellular staining pattern was observed in the epidermis in most of the cases, when the sections were stained either with anti-HLA-DR antibody or with OKT6, suggesting the HLA-DR antigen expression on the keratinocyte surface and possibly an enlargement of Langerhans' cells. Based on these immunohistologic findings, we think that Langerhans' cells play an important role in the pathomechanism of Schamberg's disease, and that cellular immune reactions are taking place in the lesional skin. PMID- 3291779 TI - Subungual keratoacanthoma. Report of a case and review of the literature. AB - Subungual keratoacanthoma (SUKA) is an uncommon and clinically distinctive tumor of the nail bed. It can easily be confused with well-differentiated subungual squamous cell carcinoma. Distinguishing features of SUKA include pain, rapid growth, and early underlying bony destruction. Unlike keratoacanthomas arising from sun-exposed skin, SUKAs seldom resolve spontaneously and are more locally destructive. Of 18 cases reported in the literature, five patients have developed recurrent disease, all within five months of the initial surgery. We describe a patient with SUKA initially treated by curettage followed two days later by a conservative amputation that revealed conspicuous residual keratoacanthoma. The deep, burrowing tendency of SUKA and the intimate association with underlying bone may explain the reported tendency for recurrence after curettage. PMID- 3291781 TI - Urticarial vasculitis progressing to systemic lupus erythematosus. AB - We encountered a patient with urticarial vasculitis. The lesions were urticarial target-shaped, lasting approximately 48 to 72 hours, accompanied by burning, photophobia, fever, and arthralgia. Initially, all studies for thyroid disease and lupus erythematosus were negative. However, after 20 months of follow-up, the patient developed autoimmune thyroidosis and systemic lupus erythematosus. We describe an unusual progression of this disease. PMID- 3291780 TI - Systemic lupus erythematosus presenting as a bullous eruption in a child. AB - An 8-year-old girl presented with a generalized bullous eruption clinically resembling bullous pemphigoid or chronic bullous disease of childhood. Further study revealed immunopathologic findings seen in patients with epidermolysis bullosa acquisita or bullous systemic lupus erythematosus (SLE). Although she did not fulfill the American Rheumatism Association (Atlanta) criteria for SLE at her presentation, one year later she went on to do so. As well as being the youngest patient reported with bullous SLE, our patient is noteworthy because the bullous eruption was the initial manifestation of her SLE. Bullous SLE should be considered in the differential diagnosis of children presenting with generalized bullous eruptions. PMID- 3291782 TI - Auditory brainstem response in paediatric audiology. PMID- 3291783 TI - Malaria vaccines. PMID- 3291784 TI - Circumcision and periurethral carriage of Proteus mirabilis in boys. AB - Swabs were taken for culture from the periurethral area and urethral meatus in 124 uncircumcised and 60 circumcised boys. Proteus mirabilis was grown from 28 (22.6%) swabs from uncircumcised boys and from only one (1.7%) swab from circumcised boys. This supports the idea that the prepuce may be the source of proteus urinary tract infection. PMID- 3291785 TI - Clinical significance of IgA deficiency. PMID- 3291786 TI - Food additives. PMID- 3291788 TI - Radionuclide cystography in vesicoureteric reflux. AB - We investigated 47 children in whom vesicoureteric reflux was clinically suspected by both conventional radiological and indirect radionuclide cystography. Comparison of the two methods showed no significant difference in their accuracy in detecting vesicoureteric reflux. The advantages and disadvantages of, and indications for, indirect radionuclide cystography are discussed. PMID- 3291787 TI - Serological evaluation of a measles, mumps, and rubella vaccine. AB - Combined measles, mumps, and rubella vaccination is soon to become available in Britain in the routine immunisation programme. A controlled study was performed in 319 children, aged 13 months, to assess the antibody response and clinical reactions to a new combined measles, mumps, and rubella vaccine in comparison with a single component measles vaccine. In the children who received the combined vaccine, seroconversion was established in 93% for measles, 99% for rubella, and 100% for mumps. In the children who received the single measles vaccine, seroconversion was established in 92% for measles and in none for rubella and mumps. There was no increase in clinical reactions after the measles, mumps, and rubella vaccine compared with the measles vaccine. These results suggest that this combined vaccine would be effective and safe in a British population and give further support for the introduction of the combined measles, mumps, and rubella vaccine to Britain. PMID- 3291789 TI - Relation between height velocity and fasting insulin concentrations. AB - A linear relation between fasting serum insulin concentration and height velocity was found in 47 normal children. This suggests that doubling of growth velocity at puberty is accompanied by a two to threefold rise in insulin. This implies that insulin dosage should be increased by a similar magnitude in pubertal diabetic children during their growth spurt. PMID- 3291790 TI - Reduction of the surface charge of blood polymorphonuclear cells by rheumatoid sera and heat induced aggregated human IgG (HAGG). AB - Cell electrophoresis identifies two main subpopulations of blood polymorphonuclear cells (PMNs), which in terms of the speed of their anodic migration are referred to as the fast and slow population. When blood PMNs from normal healthy subjects were incubated in medium containing 20% RA serum there was a decrease in the percentage of fast cells with a corresponding increase in the slow population that was directly related to the levels of circulating immune complexes present in the sera. Similar results were obtained when using heat induced aggregated human IgG (HAGG) or Candida albicans instead of RA serum. The 'slowing' effect of HAGG, which was transient and time dependent, appeared to be due to its internalisation by the PMNs. These results suggest that in RA the large number of blood PMNs with a low surface charge (i.e., the slow population) may arise as a result of the constant interaction of these cells with circulating immune complexes. PMID- 3291791 TI - B27 positive diseases versus B27 negative diseases. PMID- 3291793 TI - One hundred years of surgical management of hyperthyroidism. PMID- 3291794 TI - Development of current concepts for the treatment of breast diseases as documented by the Transactions of the Southern Surgical Association. AB - The development of current concepts in the treatment of breast diseases during the last 100 years is well documented in the Transactions of the Southern Surgical Association. Fellows of the SSA have been on the cutting edge of these developments and chose the SSA as the forum to describe and debate their new observations. PMID- 3291792 TI - Is total pelvic exenteration reasonable primary treatment for rectal carcinoma? AB - Total pelvic exeneration (TPE) is reasonable primary surgical therapy in select patients with large bulky locally invasive rectal cancers that can be removed en bloc. Many do not have either nodal or distant metastasis. Furthermore, TPE can be curative and often is palliative for similar lesions that are recurrent or nonresponsive to radiation therapy. Operative mortality rates should be under 10% and can be under 5% for primary cases. Although improvement in preoperative management and operative technique, especially with urinary conduits and postoperative care is clear, both early and late complications are significant. Unfortunately, preoperative identification of those patients requiring TPE rather than abdominoperineal or low anterior resection remains poor. Furthermore, recent improvements in techniques for pelvic slings to prevent small bowel entrapment and protection from irradiation or myocutaneous flaps to obliterate the massive dead space are not yet clearly established as preventors of either early or later complications. PMID- 3291795 TI - Abdominal trauma at the Southern Surgical Association, 1888-1987. AB - Since 1888 98 papers have been presented to the Southern Surgical Association (SSA) dealing directly or indirectly with abdominal trauma. The papers reflect the progress over the century in the management of this injury. Almost two-thirds of the papers have originated from the major city hospitals of the south. An interest in abdominal trauma has been manifest among the officers of SSA. Twenty two presidents have presented papers or taken part in discussions. Four 25-year eras were identified. In the earliest, exploration of abdominal wounds was firmly established as a principle. The second period was characterized by consolidation of principles and strengthening of supportive care. The third era encompassing World War II marked a nadir in productivity. In the last 25 years a reawakened interest has resulted in a marked increase in the number and quality of presentations, which have increasingly focused on specific organ injuries. PMID- 3291796 TI - Gastroduodenal ulcer. Overview of 150 papers presented before the Southern Surgical Association 1888-1986. AB - By the early part of this century, members of the Southern Surgical Association as well as others began to realize that gastroenterostomy alone was unacceptable for the treatment of gastric ulcer. Ulcer excision and some type of limited resection was advised. At a later date, gastric resection of varying extent, depending on ulcer size and location, became the appropriate treatment for complications of this disease. For treatment of complications of duodenal ulcer, gastroenterostomy was widely used from the latter part of the 19th century until the late 1930s. Adequate gastric resection slowly but cautiously replaced gastroenterostomy during the 1940s. Vagotomy with drainage and vagotomy with antrectomy slowly developed and replaced adequate resection by the early 1970s. Beginning in the 1970s and extending into the 1980s, fewer duodenal ulcers were seen, and many of those encountered were being adequately managed using the H2 receptor blockers. For the intractable duodenal ulcer there is currently an increasing trend to use the less invasive operation of parietal cell vagotomy. Vagotomy with antrectomy for such cases is being used less frequently. Vagotomy and drainage has lost much of its appeal. Lesser procedures have been advocated recently for treatment of marginal ulcer after incomplete vagotomy irrespective of the original operation for ulcer. Massive bleeding and acute perforation are still frequently encountered as complications but are being seen more frequently in elderly high-risk patients, some of whom will tolerate only a lesser procedure as suture ligation, vagotomy with drainage, or simple ulcer closure. It appears that we are now seeing a different duodenal ulcer pattern in the good-risk patient. The ulcers are usually small, less virulent, and less likely to be found penetrating into the pancreas and adjacent organ structures. As Claude Welch so aptly stated recently before the Association, "We are seeing a trend in ulcer surgery that is currently being seen in other areas of surgical endeavors as well." He emphasized that we must be alert to changing disease patterns and adapt our procedures to new requirements. PMID- 3291797 TI - Plastic surgery. The first 100 years of the Southern Surgical Association. PMID- 3291798 TI - Transplantation of tissues and organs. Review of the first 100 years of the Southern Surgical Association. PMID- 3291799 TI - Cancer cachexia. AB - Despite recent advances in the delivery of nutritional support, cachexia continues to contribute to the morbidity and mortality of cancer patients. This impasse has called for a review of the many factors that are believed to be associated with weight loss in the cancer host. This article reviews the topic with a view to past problems and areas for investigation in the future. PMID- 3291800 TI - Effects of a stable prostacyclin analog on experimental ischemic acute renal failure. AB - The effect of OP-41483, a stable prostacyclin (PGI2) analog, on ischemic acute renal failure (ARF) was investigated in dogs. Administration of OP-41483 for three days after ischemia significantly increased renal cortical blood flow (RCBF) when compared with dogs treated with the saline vehicle. In the OP-41483 treated group, serum creatinine levels remained relatively low during postoperative days 1-3 and mean survival time was prolonged. Injection of a silicone rubber vascular casting compound (Microfil) revealed increased numbers of visible renal cortical glomeruli and microvessels compared to the saline vehicle group. Histologic sections showed only very limited tubular necrosis, whereas sections of kidneys treated with saline showed extensive tubular necrosis. In conclusion, this stable prostacyclin analog provided a significant degree of protection for the kidneys from ischemic injury and may be useful in a clinical setting. PMID- 3291801 TI - Decreased neutrophil thromboxane A2 and endothelial PGI2 production in the postoperative period. An in vitro assay for detection of neutrophil and plasma dysfunction. AB - Severe trauma results in reversible abnormalities in neutrophil function, but the specific role in the pathogenesis of postoperative sepsis is undetermined. Twenty adult patients undergoing elective surgical procedures were studied. Blood samples were obtained prior to and 24 hours after operation. Blood neutrophils were isolated and incubated (10(7) cells/mL) on bovine vascular endothelial cell monolayers. Untreated plasma or zymosan-activated plasma (ZAP) or 65 C inactivated plasma was added, and TxB2 and 6-keto PGF1 alpha production measured after 2 hours. Endothelial damage was detected by light and scanning electron microscopy beginning 2 and 4 hours after treatment. Preoperatively, neutrophil TxB2 release was less than 200 pg/mL; following ZAP it was 2153 pg/mL (p less than 0.001), with untreated plasma 1055 pg/mL (p less than 0.005) and inactivated plasma 764 pg/mL (p less than 0.01). Neutrophil TxB2 release on a plastic dish was not different from incubation on endothelium. Endothelial 6-keto PGF1 alpha release following addition of untreated plasma preoperatively was 1308 pg/mL (p less than 0.01), and with ZAP 1305 pg/mL (p less than 0.01). Activated neutrophils did not alter 6-keto PGF1 alpha production. Postoperatively, neutrophil TxB2 production in response to ZAP was 1092 pg/mL, which was significantly reduced compared to the preoperative response (p less than 0.01). Endothelial damage by activated neutrophils in the postoperative period demonstrated on scanning electron microscopy was also reduced; 6-keto PGF1 alpha release in the postoperative period inducted by ZAP was 569 pg/mL and by untreated plasma 549 pg/mL, which was significantly lower than in the preoperative period (p less than 0.05 and p less than 0.05, respectively). No difference in chemotaxis was demonstrated. It is concluded that operative trauma is followed by lowered neutrophil TxB2 release, appearance of a plasmatic factor that depresses endothelial 6-keto PGF1 alpha production, as well as decreased neutrophil-induced endothelial damage. The neutrophil-endothelial monolayer system is a sensitive method for detection of neutrophil and plasmatic dysfunction. PMID- 3291802 TI - [Dynamics of drug resistance in Proteus mirabilis cultures 1970-1985]. AB - Resistance of 669 clinical strains of Proteus mirabilis to 18 chemotherapeutic drugs was studied in dynamics within 1970-1985. An increase in the number of cultures resistant to ampicillin and carbenicillin was noted while the number of cultures resistant to cephalosporines did not change. Within the period from 1970 to 1975 there was observed a marked increase in the number of Proteus strains resistant to aminoglycoside antibiotics. After that period their number gradually lowered and in 1985 reached the level of 1970. Beginning from 1973 there were observed a decrease in the number of Proteus chloramphenicol resistant strains and simultaneous occurrence of cultures sensitive to this antibiotic. The predominating number of the tested strains preserved during the whole observation period their resistance to tetracycline, doxycycline, rifampicin, novobiocin, furazolidone and furagin. No increase in the number of Proteus strains with multiple drug resistance including those resistant to 5-7 drugs was noted in the observation periods of 1970-1975, 1980 and 1985. The most frequent were Proteus strains resistant to 2-4 drugs. Among them cultures resistant to chloramphenicol and aminoglycoside antibiotics of the first generation predominated. Grouping of the strains by the same resistance spectra provided dividing the rested cultures of Proteus mirabilis into 69 variants. PMID- 3291803 TI - [Effect of antibiotics on the population variability of bacteria]. PMID- 3291804 TI - [Biotechnological aspects of the use of bacterial bioluminescence in medicine]. PMID- 3291806 TI - [Septicemia, portal thrombosis and congenital protein C deficiency]. AB - The authors report a case of Bacteroides fragilis septicemia with left portal vein thrombosis secondary to a liver abscess discovered by ultrasonography. This thrombosis was in relation with hereditary protein C deficiency. The authors emphasize the importance of assaying for C protein along with the other physiological coagulation inhibitors in the child presenting with venous thrombosis. PMID- 3291805 TI - [Hypersensitivity pneumopathies ("bird fancier's lung") in children. Diagnostic value of bronchoalveolar lavage]. AB - A current view of "pigeon fancier's lung" in children is reported through a familial case presenting as a severe denutrition in a 9 year-old boy. Cellular and biochemical analysis of broncho-alveolar lavage fluid is essential to proper diagnosis. Treatment is based upon the eviction of inhaled antigenic organic materials issued from pigeon's droppings, corticosteroid treatment being only additional. Pulmonary fibrosis is a rare but possible complication in the outcome of the disease. PMID- 3291807 TI - [Infantile polycystic disease. Renal pseudotumoral growth in the postnatal period]. AB - In the most common clinical expression of infantile polycystic disease, the kidneys are greatly enlarged in the neonatal period. When the child gets older the kidneys become smaller. In this case report, both kidneys kept growing after birth causing abdominal distention and respiratory distress. The differential diagnosis was a bilateral massive nephroblastomatosis, but the renal pathology showed characteristic features of infantile polycystic disease. PMID- 3291808 TI - [Systemic neonatal Escherichia coli infections (excepting urinary infections). I. Epidemiology, prognosis and physiopathology]. PMID- 3291809 TI - [Does breast feeding prevent the later occurrence of allergic manifestations?]. PMID- 3291810 TI - [Names, emblems and signboards of Upper Silesian pharmacies in historical review]. PMID- 3291811 TI - [95th anniversary of the birth of Prof. Stanislaw Konopka (1896-1982)]. PMID- 3291812 TI - [40 years of history of medicine in Gdansk (1946-1986)]. PMID- 3291814 TI - [Teodor Heryng (1847-1925), the pioneer of Polish laryngology in the eyes of the contemporary medical world]. PMID- 3291813 TI - [Various problems of clinical medicine in the "Logic of medicine" and "Differential diagnosis of internal diseases" by Wladyslaw Bieganski]. PMID- 3291815 TI - [Medical exlibris book plates in the Young Poland period (1890-1918)]. PMID- 3291816 TI - [The forgotten professor of the Warsaw Medico-Surgical Academy and the Medical Department of the Central School, Jozef Konstanty Rose]. PMID- 3291817 TI - [Medical Department of the University of Lwow during World War I]. PMID- 3291818 TI - [Contribution of Ignacy Zielewicz to the development of surgery]. PMID- 3291819 TI - [Marcin Kacprzak and the development of social medicine in Poland]. PMID- 3291820 TI - Residual urine volumes in patients with spinal cord injury: measurement with a portable ultrasound instrument. AB - Spinal cord injured (SCI) patients are often placed on an intermittent catheterization (IC) program during their initial rehabilitation in an effort to establish a catheter-free state. A noninvasive method to quantitatively determine residual urine volumes would decrease unnecessary catheterizations and be useful in the management of an IC program. This study was undertaken to determine if bladder volumes could be accurately determined in a group of SCI patients using a portable ultrasound scanner. Fifteen SCI patients underwent a total of 224 ultrasonic bladder volume determinations and 57 urethral catheterizations. Immediately prior to catheterization, two investigators alternately performed a total of four ultrasound readings on each patient using a hand-held portable instrument, the BVI 2000. The first ultrasound volume determination was comparable to the average ultrasound volume (r2 = 0.956). For catheterized volumes versus the initial ultrasound volume determination, r2 = 0.80. The average error was 18% for catheterized volumes within the range 50-700ml. Our results compare favorably with both real-time scanning using standard equipment and other portable instruments. The noninvasive nature, negligible risks, and reasonable estimates of volume warrant consideration of portable ultrasound scanning for the determination of bladder volumes in SCI patients. PMID- 3291822 TI - Electromyographic abnormalities in neurologic injury associated with pelvic fracture: case reports and literature review. AB - The incidence of neurologic injury associated with pelvic fractures is estimated at 10%. Studies have demonstrated that patients with double vertical pelvic fractures (combined injury to the anterior third of the pelvic ring and the sacroiliac area) are most at risk, with a 46% incidence of neurologic injury. Patients with pelvic fractures usually have many other associated injuries and medical complications, making the patients' neurologic deficits difficult to assess and thus easy to overlook in the acute setting. Three such patients are described. Electromyography was useful in confirming their diagnoses, thus allowing appropriate management. PMID- 3291821 TI - Fibrositis, fibromyalgia, and musculoskeletal disease: the current status of the fibrositis syndrome. AB - Fibrositis (fibromyalgia) is a common disorder, but is often not considered or diagnosed by clinicians. It is characterized by widespread musculoskeletal pain and aching, disturbed sleep, fatigue, morning stiffness, and local tenderness. The presence of multiple (seven or more) tender points and widespread pain or aching are necessary and sufficient conditions for diagnosis. Fibrositis occurs in a "primary" form, but most commonly in association with other rheumatic diseases where it is a concomitant condition. The designation "myofascial pain syndrome" has replaced older concepts of localized fibrositis, and is considered a separate entity. PMID- 3291823 TI - Rate of increase and critical amount of nuclear polyhedrosis virus in lepidopterous larvae estimated from survival time assay data with a birth-death model. AB - A birth-death model developed for pathogens of vertebrates was used to estimate the in vivo rate of increase (alpha) and the doubling time (td) from survival time assay data. Host-pathogen combinations used in this study were two Autographa californica nuclear polyhedrosis virus isolates in Trichoplusia ni and Heliothis zea NPV in H. zea. The alpha's, estimated as he negative reciprocal of the slope of the linearly decreasing section of the plot of median survival times against the logarithm of inoculum concentration, were calculated in two ways. First, simple regression was used to fit a line through the linearly decreasing part using data points selected by eye; secondly, a three-phase segmented linear regression model was used and alpha was estimated from the slope of the middle segment. Estimates of alpha (and td) were 0.338 (2.05), 0.274 (2.53) and 0.243 h 1 (2.85 h) using the simple regression method, and 0.385 (1.80), 0.305 (2.27) and 0.223 h-1 (3.11 h) using the 3-phase segmented linear regression model for AcMNPV 1A, AcMNPV-HOB and HzSNPV, respectively. Although AcMNPV-HOB killed larvae faster (6 to 13 h) than AcMNPV-1A, it multiplied more slowly. Estimates for the critical number ranged from 4.8 x 10(9) to 4.5 x 10(14) genome copies for HzSNPV in H. zea larvae and AcMNPV-1A in T. ni larvae, respectively. The significance of the calculated critical numbers is discussed. PMID- 3291825 TI - [The sequential changes in respiratory resistance during the inhalation of cold air and bronchial hyperresponsiveness]. PMID- 3291826 TI - [A study of specific antibody levels in a guinea pig late phase bronchoconstriction model]. PMID- 3291824 TI - Characterisation of multimeric DNA forms associated with tomato golden mosaic virus infection. AB - Homodimeric and trimeric double-stranded DNA forms of both components of the genome of the geminivirus, tomato golden mosaic virus have been isolated from infected Nicotiana tabacum plants and characterised. PMID- 3291827 TI - The pathology of hemodialysis as seen in the long-surviving patient: consequences of hemodialysis to the human body. PMID- 3291828 TI - Absence of effect of heparin on insulin secretion. AB - Bioartificial pancreatic devices containing isolated islets of Langerhans have been designed, in which the blood of the recipient circulates in contact with an artificial membrane, protecting the islets against immune rejection. This system assumes that heparin, required to prevent blood clotting, does not alter insulin secretion. However, heparin has been reported to inhibit in vitro insulin secretion by rat islets and to suppress in vivo insulin secretion in dogs. Therefore, the following evaluation was made on the effect of different heparin preparations on insulin secretion. (a) Isolated rat islets of Langerhans were perfused or incubated in the absence or presence of 20 micrograms/ml heparin; insulin secretion in response to a stimulation by glucose 20 mM was not altered by the presence of heparin. (b) Insulin secretion by an insulin-secreting cell line (RINm5F) in response to leucine and theophylline was not suppressed by heparin up to 100 micrograms/ml concentration. However, an inhibitory effect was observed at 200 micrograms/ml, which is 100 times higher than the heparin concentration commonly used for therapeutic use. (c) Neither in normal rats nor in dogs did heparin alter portal plasma insulin levels and the increase in plasma insulin following an intravenous injection of glucose. In conclusion, these data do not confirm the formerly observed inhibitory effect of heparin, which can therefore be used for the in vivo evaluation of a bioartificial pancreas. PMID- 3291829 TI - In vitro development of automatic control for the actively filled electrohydraulic heart. AB - The in vitro development of automatic control of the actively filled, alternately pumped, volumetrically coupled, electrohydraulic total artificial heart was the goal of this investigation. Control features under study were (a) cardiac output (CO) response to preload; (b) CO relationship to mean aortic pressure (AoP); and (c) control of balanced ventricular outputs. A modified pulmonic valve to increase backflow was used as a balancing mechanism. Hydraulic fluid pressure transducers monitored diastolic pressures, and microprocessor control of motor speed maintained in a mild suction to yield filling rate dependent on atrial pressure. Results indicated a rise in CO from 5 to 9 L/min, with a change in mean right atrial pressure (RAP) from 0 to 7 mm Hg. No significant difference in CO was found as AoP was varied from 80 to 120 mm Hg with a maximum variation of +/- 0.5 L/min on CO and +/- 1 mm Hg on RAP. Balance was maintained for bronchial flows up to 50% with mean left atrial pressure never exceeding 15 mm Hg. An alternately pumped electrohydraulic heart was automatically controlled to respond sensitively to preload changes. Afterload changes did not alter the CO response curve. Automatically controlled, balanced ventricular outputs were maintained. PMID- 3291830 TI - Comparison of rapid in situ, regular in situ, and ex vivo flushing on hepatic function. AB - The efficacy of three flushing techniques on subsequent liver function was assessed using the in vivo isolated liver perfusion model (ILPM). Livers from brain-dead mongrel dogs were flushed with cold Euro-Collins as follows: Group I, rapid in situ flushing (10 min); Group II, regular in situ flushing (45 min); Group III, ex vivo flushing (10 min). All livers were then heterotopically transplanted into recipients, using the ILPM, by anastomosis of the portal vein, vena cava, and hepatic artery to the recipient's portal vein, iliac vein, and iliac artery. Reperfusion followed for 30 min. Laboratory samples collected at 0, 5, 15, and 30 min showed that hepatic function was not altered by ex vivo flushing and was only slightly altered by rapid in situ flushing. Regular in situ flushing proved to be damaging to livers. Histological analysis confirmed these findings. Therefore, either rapid in situ or ex vivo flushing can be safely used by the transplant specialist. PMID- 3291831 TI - Prevalence and causes of long-lasting hepatic dysfunction after heart transplantation: a series of 80 patients. AB - The long-term follow-up of 80 heart transplant patients (70 men, 10 women) from January 1982 to July 1985 who had received cyclosporine (CsA) showed a high incidence of mild to severe liver dysfunction. Fifty patients (62.5%) had long lasting postoperative biological disturbances (alanine amino transferase greater than 2N and/or alkaline phosphatase greater than 1.5N for 3 months or more). Most patients were asymptomatic; eight were icteric, and one had arthralgia. The most common biological feature consisted of isolated elevation of ALAT (27 cases). Assessment of causes led to a definite etiology in 42 patients: 7 cardiac failure, 13 HBsAg-positive liver disease (26%) (chronic persistent hepatitis 8, chronic active hepatitis 2, subacute necrosis 2). Fourteen patients (28%) sustained non-A, non-B (NANB) hepatitis (chronic persistent hepatitis 5, chronic active hepatitis 1, cirrhosis 1), and 7 (14%) sustained a drug-related hepatitis. Liver biopsy and complete virus screening was contributive to the diagnosis in nearly all patients. Additionally, prolonged impairment of liver function tests occurred in 62% of heart transplant recipients, mostly during the first 6 postoperative months. Hepatitis B virus (HBV) and NANB hepatitis accounted for 26% and 28% of the cases of liver dysfunction, respectively; drug-induced hepatitis may have been involved in 14% of the cases. Complete hepatitis virus screening should be performed before heart transplant and in any case of abnormal liver function posttransplantation. HBV vaccination prior to heart transplant is recommended in HBsAg- and HBcAb-negative candidates for heart replacement. Long term follow-up of these patients is mandatory to assess the severity of these liver dysfunctions. PMID- 3291832 TI - Drug delivery systems in biotechnology. PMID- 3291833 TI - Neurocysticercosis. Two hundred thirty-eight cases from a California hospital. AB - Neurocysticercosis is no longer a medical curiosity in the United States. Two hundred thirty-eight patients with neurocysticercosis were studied between 1981 and 1986 at the Los Angeles County-University of Southern California Medical Center, Los Angeles. Presenting signs and symptoms were protean--ranging from a single convulsion to coma and death. Fifty-one patients (21%) presented with an acute increase in intracranial pressure. There were 71 patients who ultimately required a shunting procedure or craniotomy. Presentation, diagnosis, management, and laboratory adjuncts (the role of cysticercosis titers and the electroencephalogram) are discussed. Mortality and morbidity can be reduced by maintaining a high degree of suspicion in populations at increased risk for cysticercosis. PMID- 3291834 TI - Vascular dementia is overdiagnosed. PMID- 3291835 TI - J. Russell Reynolds and the study of interictal symptoms in epilepsy. AB - Sir John Russell Reynolds (1828-1896) was a prominent English neurologist who was among the first to carefully study interictal behavior in patients with epilepsy. He challenged the prevailing dogma that severe mental illness was nearly always concomitant of epilepsy. Studying the cognitive and emotional functions of 62 patients with essential (idiopathic) epilepsy, he found that 39% of the patients were normal, 32% had only mild impairment of recent memory, and 29% had moderate to severe psychopathologic findings. His study of interictal behavior in epilepsy is one of the earliest attempts to avoid selection bias and represents an important contribution to the study of this problem. PMID- 3291836 TI - Dangers from methylprednisolone acetate therapy by intraspinal injection. AB - Clinical trials first began in 1960 with methylprednisolone acetate (Depo-Medrol) administered intrathecally, in an attempt to treat both disk disease and multiple sclerosis. After a few reports of salubrious results, there began an outpouring of contradictory data, which continues in 1988. During this time span, researchers who cautiously tested the different theses of improvement began to publish serious warnings of many complications. For ten years prior to the intraspinal use of methylprednisolone acetate, basic scientists in anesthesiology and neurochemistry had published the following facts: (1) Methylprednisolone acetate's content of polyethylene glycol raises the risks of using it near the central nervous system. (2) Deleterious effects follow the use of glycols when they are placed into or near the neuraxis. (3) Methylprednisolone acetate contains approximately 30 mg of polyethylene glycol per milliliter. (4) When that glycol, which is both alcohol and detergent, is injected intraspinally, sterile meningitis, arachnoiditis, or pachymeningitis will occur. It has also been recognized since the 1960s that the epidural space is not wholly separate from the subdural and/or subarachnoid space. Many thousands of arachnoid villi subtend all the membranes from the intrathecal space, and many of these end in the large epidural veins. Therefore, the various spaces and membranes are not only contiguous, but continuous. It follows that an injection of methylprednisolone acetate into the epidural space does not guarantee that it will remain isolated there. Finally, the inadvertency of injections by the epidural route occurs with the following frequency: 40% of injections can be inadvertently made into interspinous ligaments, and 2.5% into the subarachnoid space. PMID- 3291837 TI - A combination of levobunolol and dipivefrin for the treatment of glaucoma. AB - This double-masked prospective study compared the ocular hypotensive efficacy and the safety of 0.5% and 1% levobunolol hydrochloride with 0.5% timolol maleate when each was administered topically twice daily in combination with 0.1% dipivefrin hydrochloride. Forty-three patients whose intraocular pressure was previously controlled by concomitant treatment with timolol and dipivefrin were randomly assigned to receive 0.5% or 1% levobunolol and 0.1% dipivefrin, or to continue to receive 0.5% timolol and 0.1% dipivefrin for three months. In the groups receiving levobunolol and dipivefrin concurrently, continued intraocular pressure control was achieved equal to that attained with timolol and dipivefrin before study entry. We concluded that concomitant treatment with levobunolol and dipivefrin is equal in both efficacy and safety to concomitant treatment with timolol and dipivefrin. PMID- 3291838 TI - Corneoscleral autotransplant. AB - We describe the clinicopathologic features of a corneoscleral autotransplant in place for 18 years, with excellent visual results. Donor and some recipient trabecular meshwork was present in some areas. Donor trabecular meshwork was hypocellular and partially covered by an overgrowth of uveal melanocytes. A cyclodialysis cleft was present and closed only by loose connective tissue. It is likely that aqueous outflow was, in part, to the supraciliary space. PMID- 3291839 TI - Corneal graft survival in the cat with prolonged preservation in McCarey-Kaufman and K-Sol media. AB - The effects of extended preservation on transplanted corneas were investigated using McCarey-Kaufman (M-K) and K-Sol media. Cat corneas were preserved in either M-K or K-Sol at 4 degrees C for 5, 10, 15, or 20 days and were subsequently transplanted. Postoperatively, transplants were observed via slit-lamp biomicroscopy and pachymetry and at postmortem examination by light and scanning electron microscopy. In this study, we found no difference in the corneal graft clarity, thickness, endothelial cell count, or morphologic features of corneal transplants preserved in either M-K or K-Sol media. Storage for more than ten days in either M-K or K-Sol media led to primary graft failure. This study demonstrated equivalent results in corneal preservation using either M-K or K-Sol media. The development of better preservation media may require changes in essential nutrients rather than changes in osmotic constituents. PMID- 3291840 TI - Optimizing immunofluorescence for the testing of autoantibodies in inner ear disorders. AB - A method is described for the immunofluorescent testing of autoantibodies in the sera of patients with vestibulo-cochlear disorders, using fixed decalcified inner ear tissue preparations from guinea pigs. Fixation in cold ethanol and decalcification in EDTa at 4 degrees C preserved the immunological reactivity of the inner ear tissue in use and allowed excellent delineation of its structural details. Counterstaining of the sections with Evans-blue dye aided in a better identification of the inner ear anatomical structures and in a more precise location of the antibodies present. By mounting the sections in p phenylenediamine-PBS-glycerin solution, the rapid extinction of the fluorescence seen during photomicroscopy was retarded and the intensity of the immunofluorescence was enhanced. Preservation of the slides for documentation was improved by fixing the intermediate layer of the antigen and the labeled antibody in cold ethanol. The inner ear tissue preparations retained their fluorescent staining up to 6 months. Our method is convenient for screening patients with inner ear disorders for autoantibodies against the different cellular elements and for testing the possible presence of antibodies against the inner ear tissue. So far, we believe that the antibodies detected are not tissue (inner ear) specific. PMID- 3291841 TI - Dazoxiben-induced changes in the thromboxane/prostacyclin balance in the lateral cochlear wall of the guinea pig. AB - Dazoxiben, a thromboxane synthetase inhibitor, was infused i.v. in a first group of guinea pigs. Saline was given to a second group of animals as controls. Subsequently, the lateral cochlear walls of each animal were prepared and analyzed for thromboxane (TXA) and prostacyclin (PGI) using radioimmunoassay. These studies showed that dazoxiben crosses the blood-labyrinth barrier and shifts the TXA2/PGI2 balance in favor of the latter. The effects demonstrated are discussed with respect to the relevance of prostanoids in cochlear physiology. PMID- 3291842 TI - Anatomical studies and a correlative management of facial skeleton and skull base injuries with bone plate fixation. AB - Miniplate osteosynthesis is an osteoplastic procedure that achieves secure stabilization of the midface, even following extensive fractures of the midface and the floor of the anterior cranial fossa. This procedure can be considered a satisfactory operative treatment in terms of cosmetic and functional results. Correlative osteology is discussed and clinical experiences are reviewed. PMID- 3291843 TI - Complications of submucous resections of the nasal septum. AB - We studied retrospectively 263 patients, who had previously undergone submucous resection of their nasal septa. Unsatisfactory septal corrections, perforations, and dorsal saddling were looked for and could be correlated with the skills of the ten surgeons who performed the procedures. Three of the surgeons were attending physicians, while the other seven were resident trainees at different stages of their specialty education. From the total number of the patients, 17 (6.4%) were noted to have persistent septal perforations, 10 (3.8%) had residual deviations of their nasal septa, and 1 (0.4%) had a saddle nose deformity. These findings differed significantly among the different surgeons. The incidence varied from 0% to 30.4% in septal perforations, from 0% to 10.4% in unsatisfactory corrections of the septum, and from 0% to 2.6% in saddle nose. Our findings show that a well-executed submucous resection of the nasal septum by a skilled surgeon yields a low incidence of complications, while in unskilled hands, it may carry a high incidence of complications. PMID- 3291844 TI - Growth promotants in cattle in Australia. PMID- 3291845 TI - Specificity of the anti-inflammatory effect of a staphylococcal cell wall extract in the bovine udder. AB - The cell wall of Staphylococcus aureus (strains 21 and Glaxo) was treated with deoxycholate and the insoluble residue was solubilised with lysozyme. The effect of the extract in modulating the inflammatory response due to infection of the lactating bovine udder was evaluated. Cows were infected with S. aureus strain 21 or Streptococcus agalactiae, with or without the cell wall extracts. The clinical response to infection was assessed, and milk samples collected up to 30 h were assayed for antitrypsin and NAGase levels, somatic cell count, and for the ability of whey to support bacterial growth. The extracts markedly reduced the inflammatory response elicited by both S. aureus and S. agalactiae, indicating the effect was non-specific. The extract from strain 21 was generally more effective than that from strain Glaxo. PMID- 3291846 TI - Control of left ventricular function during acceleration-induced blood volume shifts. AB - Peripheral pooling of blood was produced in chronically instrumented, sedated dogs (n = 7) by subjecting them to a +2 Gz force (along their spinal axis) for 3 min. The acceleratory force was then quickly removed, thereby mobilizing blood toward the thoracic cavity. Left ventricular volume, calculated from ultrasound measurements of major and minor axes and wall thickness, increased (p less than 0.05) from 21.7 +/- 3.6 ml (diastolic, mean +/- S.E.M.) and 14.1 +/- 3.3 ml (systolic) during the peripheral pooling of blood to 28.2 +/- 4.1 ml (diastolic) and 16.0 +/- 2.9 ml (systolic) as measured at 2 min after release of the acceleratory force. The d(LVP)/dt was essentially unchanged (i.e., from 3415 +/- 482 mm Hg.s-1 to 3536 +/- 249 mm Hg.s-1). The experiment was repeated after total pharmacologic autonomic blockade (propranolol, atropine, phenoxybenzamine). Left ventricular volumes during +2 Gz after blockade were 27.7 +/- 2.5 ml (diastolic) and 21.2 +/- 2.9 (systolic). The acceleration-induced changes in cardiovascular function, including the changes in ventricular volume, were not significantly different from those of the reflexive state. These results, therefore, do not reveal a substantial role for the autonomic nervous system in the regulation of left ventricular volume responses to the sudden cessation of G-induced peripheral blood pooling. Since the cessation of the G force induced essentially identical increases in left ventricular volumes and stroke volumes both before and after the autonomic blockade, it is concluded that the heart relied mainly upon the Frank-Starling mechanism to adapt to the changes in load. PMID- 3291847 TI - The development of the nation's oldest operating civilian hospital-sponsored aeromedical helicopter service. AB - The Vietnam War heightened civilian awareness as to the use of helicopters for medical evacuations. This led to the initiation of federally funded projects aimed at determining whether helicopters were practical for civilian aeromedical transports. In 1972, a Department of Transportation (DOT) summary concluded that helicopters for civilian medical transports were largely economically prohibitive and provided limited medical benefits in limited locales. Despite this report, in 1972 St. Anthony Hospital initiated a hospital-based emergency medical helicopter service (HEMS). This paper provides a historical review of the individuals and events responsible for the early success of the nation's longest operating civilian hospital-sponsored helicopter service. The author concludes that the early success of this program was due in part to the selection of an affordable, high altitude, helicopter; rapid response times to the scene of injury; the development of excellent EMS communications systems; the use of specialty trained flight crewmembers; and integration of HEMS into the existing EMS system. PMID- 3291849 TI - The prenatal development of alkaline phosphatase activity in the hypothalamus of the rat. AB - The localization of alkaline phosphatase (E.C. 3.1.3.1.) positivity during prenatal development of the hypothalamus of the rat is described. At E12 all layers of the prosencephalon display alkaline phosphatase (AP) positivity. The AP positivity increases from dorsal to ventral. Within the hypothalamic area a second, rostro-ventral gradient exists from E14 onwards. At E18 both gradients have decreased. At E20 almost all AP positivity has disappeared from the hypothalamus, with the exception of some reaction product in the dorsal ventricular matrix of the hypothalamus. The significance of this pattern in relation to the differentiation of the hypothalamus and to the formation of hypothalamic connections is discussed. It is suggested that AP activity is related to the formation of connections. PMID- 3291848 TI - Resolutions of the Aerospace Medical Association from 1929-41: Part I. 1929-33. AB - The resolutions of the Aerospace Medical Association (formerly the Aero Medical Association of the United States) have been obtained and reviewed in detail for the period 1929-41. They provide a perspective on what Association members considered priority matters during that period. The resolutions cover subjects such as pilot fatigue, aviation medical examiner selection, military flight pay for flight surgeons, and other important issues, including medical standards. These resolutions had a significant impact during the early growth of civil aviation, and a number still influence today's aeromedical practice as well as certain flight operations. PMID- 3291850 TI - The human suprachiasmatic nucleus; neuropeptide changes in senium and Alzheimer's disease. PMID- 3291851 TI - Pattern of peptidergic neurons in the avian brain: clusters--local circuitries- projections. PMID- 3291852 TI - The LH-RH system of the male European starling: photoperiod induces changes to a possible multifunctional peptide system. AB - In many birds reproduction is triggered by long daylengths but, paradoxically, continued exposure to long days leads to photorefractoriness and a complete shut down of the reproductive system. As these effects are thought to be mediated through the secretion of LH-RH, immunocytochemical techniques were used to investigate changes in the LH-RH system when European starlings were exposed to different photoperiods. Starlings exposed to 11L:13D and with mature testes show strong immunostaining both of LH-RH perikarya and fibers. Photosensitive short day (8L:16D) starlings with undeveloped testes show an almost identical distribution of strongly immunoreactive perikarya but with less dense fibre staining. However, long-day (18L:6D) photorefractory starlings with fully regressed testes, show a profound reduction in LH-RH immunostaining. Perikarya have the same distribution but show a much reduced intensity of staining and fibers had almost entirely disappeared from all regions of the brain. Preliminary observations on the ultrastructure of immunocytochemically identified LH-RH neurones are also reported. PMID- 3291854 TI - Benzyl alcohol dehydrogenase and benzaldehyde dehydrogenase II from Acinetobacter calcoaceticus. Purification and preliminary characterization. AB - A quick, reliable, purification procedure was developed for purifying both benzyl alcohol dehydrogenase and benzaldehyde dehydrogenase II from a single batch of Acinetobacter calcoaceticus N.C.I.B. 8250. The procedure involved disruption of the bacteria in the French pressure cell and preparation of a high-speed supernatant, followed by chromatography on DEAE-Sephacel, affinity chromatography on Blue Sepharose CL-6B and Matrex Gel Red A, and finally gel filtration through a Superose 12 fast-protein-liquid-chromatography column. The enzymes co-purified as far as the Blue Sepharose CL-6B step were separated on the Matrex Gel Red A column. The final preparations of benzyl alcohol dehydrogenase and benzaldehyde dehydrogenase II gave single bands on electrophoresis under non-denaturing conditions or on SDS/polyacrylamide-gel electrophoresis. The enzymes are tetramers, as judged by comparison of their subunit (benzyl alcohol dehydrogenase, 39,700; benzaldehyde dehydrogenase II, 55,000) and native (benzyl alcohol dehydrogenase, 155,000; benzaldehyde dehydrogenase II, 222,500) Mr values, estimated by SDS/polyacrylamide-gel electrophoresis and gel filtration respectively. The optimum pH values for the oxidation reactions were 9.2 for benzyl alcohol dehydrogenase and 9.5 for benzaldehyde dehydrogenase II. The pH optimum for the reduction reaction for benzyl alcohol dehydrogenase was 8.9. The equilibrium constant for oxidation of benzyl alcohol to benzaldehyde by benzyl alcohol dehydrogenase was determined to be 3.08 x 10(-11) M; the ready reversibility of the reaction catalysed by benzyl alcohol dehydrogenase necessitated the development of an assay procedure in which hydrazine was used to trap the benzaldehyde formed by the NAD+-dependent oxidation of benzyl alcohol. The oxidation reaction catalysed by benzaldehyde dehydrogenase II was essentially irreversible. The maximum velocities for the oxidation reactions catalysed by benzyl alcohol dehydrogenase and benzaldehyde dehydrogenase II were 231 and 76 mumol/min per mg of protein respectively; the maximum velocity of the reduction reaction of benzyl alcohol dehydrogenase was 366 mumol/min per mg of protein. The pI values were 5.0 for benzyl alcohol dehydrogenase and 4.6 for benzaldehyde dehydrogenase II. Neither enzyme activity was affected when assayed in the presence of a range of salts. Absorption spectra of the two enzymes showed no evidence that they contain any cofactors such as cytochrome, flavin, or pyrroloquinoline quinone. The kinetic coefficients of the purified enzymes with benzyl alcohol, benzaldehyde, NAD+ and NADH are also presented. PMID- 3291855 TI - Effects of nutritional status and acute variation in substrate supply on cardiac and skeletal-muscle fructose 2,6-bisphosphate concentrations. AB - We examined the long-term effects of nutritional status and the acute effects of changes in exogenous carbohydrate- and lipid-substrate supply and utilization on fructose 2,6-bisphosphate (Fru-2,6-P2) concentrations in heart, gastrocnemius and soleus. Starvation decreased Fru-2,6-P2 concentrations in all three muscles. The acute administration of insulin and glucose increased skeletal-muscle Fru-2,6-P2 in the fed, but not in the starved, state, but cardiac Fru-2,6-P2 was unchanged. Cardiac and skeletal-muscle Fru-2,6-P2 concentrations were unaffected by acute increases in fatty acid supply produced by the administration of corn oil plus heparin, or by acute decreases in fatty acid supply produced by inhibition of lipolysis. Differences in cardiac and skeletal-muscle Fru-2,6-P2 concentrations observed in response to starvation were not reversed by administration of glucose or glucose plus insulin, or by inhibition of lipolysis, even though changes in citrate (heart), acylcarnitine (heart) and glycogen (skeletal muscle) were observed. Concentrations remained low for at least 8 h after chow re-feeding, but the fed value was restored by 24 h. PMID- 3291856 TI - Purification and characterization of [acyl-carrier-protein] acetyltransferase from Escherichia coli. AB - A multi-step procedure has been developed for the purification of [acyl-carrier protein] acetyltransferase from Escherichia coli, which allows the production of small amounts of homogeneous enzyme. The subunit Mr was estimated to be 29,000 and the native Mr was estimated to be 61,000, suggesting a homodimeric structure. The catalytic properties of the enzyme are consistent with a Bi Bi Ping Pong mechanism and the existence of an acetyl-enzyme intermediate in the catalytic cycle. The enzyme was inhibited by N-ethylmaleimide and more slowly by iodoacetamide in reactions protected by the substrate, acetyl-CoA. However, the enzyme was apparently only weakly inhibited by the thiol-specific reagent methyl methanethiosulphonate. The nature of the acetyl-enzyme intermediate is discussed in relationship to that found in other similar enzymes from E. coli, yeast and vertebrates. PMID- 3291857 TI - Proteus mirabilis urease. Partial purification and inhibition by boric acid and boronic acids. AB - Urease was purified 800-fold and partially characterized from Proteus mirabilis, the predominant microorganism associated with urinary stones. Boric acid is a rapid reversible competitive inhibitor of urease. The pH-dependence of inhibition exhibited pKa values of 6.25 and 9.3, where the latter value is probably due to the inherent pKa of boric acid. Three boronic acids also were shown to inhibit urease competitively. PMID- 3291858 TI - Interaction of the trp repressor from Escherichia coli with a constitutive trp operator. AB - The interaction of the trp repressor from Escherichia coli with a 20 bp fragment of DNA (CGTACTGATT.AATCAGTACG) corresponding to a mutant trp operator was studied by c.d. in the presence and absence of the co-repressor, L-tryptophan, and as a function of the concentration of K+ and Na+ ions. The affinity of the repressor for the mutant operator in the presence of tryptophan is about three orders of magnitude lower than the wild-type sequence. Binding in the absence of tryptophan is about 100-fold weaker than to the wild-type. The dependence of the dissociation constant on the concentration of K+ or Na+ is weak [d(log Ks)/d(log[M+]) = 2.5], and independent of the cation, indicating that electrostatic interactions are not as important for this repressor as for others. PMID- 3291853 TI - The biochemistry of diabetes. PMID- 3291859 TI - The biological role of dolichol. PMID- 3291860 TI - The unfolding and refolding of glutamate dehydrogenases from bovine liver, baker's yeast and Clostridium symbosium. AB - The unfolding behaviour of the hexameric glutamate dehydrogenases from bovine liver, Clostridium symbosium and baker's yeast in solutions of guanidinium chloride (GdnHCl) was studied. Changes in Mr studied by light-scattering indicate that, in each case, the hexamer dissociates to form trimers, which then dissociate to monomers at higher concentrations of GdnHCl. Dissociation to trimers is accompanied by a reversible loss of enzyme activity, but no gross structural changes can be detected by fluorescence or c.d. Dissociation to monomers is accompanied by large structural changes, and the loss of activity cannot be reversed by dilution. The parallel behaviour of all three enzymes shows that the previously noted inability of the isolated subunits of the bovine liver enzyme to refold [Bell & Bell (1984) Biochem. J. 217, 327-330] is not a result of any modification of the enzyme as a result of import into mitochondria, since the C. symbosium and baker's-yeast enzymes do not undergo any such post-translational translocation. PMID- 3291861 TI - The intracellular handling of insulin-related peptides in isolated pancreatic islets. Evidence for differential rates of degradation of insulin and C-peptide. AB - Islets of Langerhans isolated from adult rats were maintained in tissue culture for 3 days in the continued presence of [3H]leucine. Labelled proinsulin, C peptide and insulin were measured by quantitative h.p.l.c., a method which also allowed for resolution of C-peptide I and II, and of insulin I and II (the products of the two rat insulin genes). The results showed that: (1) at early times, proinsulin was the major radiolabelled product; with progressive time in culture, intra-islet levels of [3H]proinsulin decreased, despite continuous labelling with [3H]leucine, indicating that the combined rates of proinsulin conversion into insulin and of proinsulin release, exceeded the rate of synthesis; (2) insulin I levels were always greater than those of insulin II, both in the islets and for products released to the medium; (3) the molar ratio of [3H]insulin I and II to their respective 3H-labelled C-peptides increased with time for products retained within islets, reaching a value close to 3:1 by 3 days; by contrast, for products released to the medium during the culture period, the ratio was always close to unity; (4) when islets were incubated with [3H]leucine for 2 days, and then left for a further 1 day without label (chase period), the intra-islet [3H]insulin/[3H]C-peptide ratios rose to values as high as 9:1. Again, for material released to the medium, the values were close to 1:1; (5) it is concluded that C-peptide is degraded more rapidly than insulin within islet cells, thereby accounting for the elevated insulin/C-peptide ratios. The difference between the ratios observed in the islets and those for material released to the medium is taken to indicate that degradation occurs in a discrete cellular compartment and not in the secretory granule itself. PMID- 3291862 TI - Thrombin-stimulated elevation of human endothelial-cell cytoplasmic free calcium concentration causes prostacyclin production. AB - Endothelial cells are known to release prostacyclin (PGI2) in response to agonists, and this has generally been assumed to be caused, at least in part, by activation of a phospholipase A2 by elevated concentrations of cytoplasmic free calcium ([Ca2+]i). However, it has been shown in the blood platelet that agonists can cause arachidonate release without elevating [Ca2+]i. In the present study, rigorous analysis is made of the [Ca2+]i-dependence of PGI2 production in the human umbilical-vein endothelial cell. Thrombin caused a rapid increase in [Ca2+]i from the resting basal value of 0.1 microM to a peak, within 10-15 s, of approx. 2 microM. In the absence of extracellular Ca2+, [Ca2+]i then declined back to the resting value within 2-3 min. In the presence of extracellular Ca2+, [Ca2+]i partly decreased to a new steady-state value of approx. 1 microM. The elevated [Ca2+]i was maintained while the stimulus and the source of extracellular Ca2+ were present, suggesting that it was dependent on influx of Ca2+ across the plasma membrane. Thrombin stimulated the production of PGI2 in the presence or in the absence of extracellular Ca2+. However, the production of PGI2 was more prolonged in the presence of extracellular Ca2+. Total accumulated amounts of 6-oxo-prostaglandin F1 alpha on stimulation with thrombin without extracellular Ca2+ were only 65% of those accumulated with extracellular Ca2+ present. Cells depleted of extracellular and intracellular sources of Ca2+ by incubation with 1 mM extracellular EGTA and exposing them to ionomycin to discharge intracellular stores produced no elevation of [Ca2+]i on stimulation with thrombin or production of PGI2. The threshold [Ca2+]i required to support the production of PGI2 was measured to be 0.8-1.0 microM by using different doses of ionomycin selectively to increase [Ca2+]i. This relationship between [Ca2+]i and PGI2 production was similar to that produced by using different doses of thrombin. Our results show that the major and probably exclusive intracellular stimulus for the production of PGI2 by the vascular endothelial cell in response to thrombin is the elevation of [Ca2+]i. PMID- 3291864 TI - Quantitative characterization of diet effects on glucose tolerance in rabbits. AB - Normal, atherogenic and butter-enriched diets were given to three groups of rabbits during six months. The effects of the three forms of diet after six months were examined with the intravenous glucose tolerance test, which was evaluated by computer-aided model-fitting and parameter identification. Long-term effects are reflected in parameters such as pancreas sensitivity and the glucose utilization rate constant as a measure of peripheral insulin sensitivity. In these terms, the atherogenic diet caused a diminution of both pancreatic and peripheral sensitivity, whereas the butter-enriched diet led to an increase in glucose utilization and a decrease in pancreatic sensitivity relative to the system parameters of the normally fed control animals. Related to the findings about metabolic regulation are indications for an endocrinological approach to the problems of cholesterogenesis and atheroma formation. PMID- 3291863 TI - Peptidyl-glycine alpha-amidating mono-oxygenase activity towards a gonadotropin releasing-hormone C-terminal peptide substrate, in subcellular fractions of sheep brain and pituitary. AB - The amidation of a synthetic peptide D-Tyr-Pro-Gly-Gly by sheep hypothalamic and pituitary preparations was measured. This substrate was designed as a glycine extended C-terminal peptide analogue of gonadotropin-releasing hormone (GnRH) to test the ability of these tissues to convert the product produced by cleavage of the GnRH prohormone into the active amidated decapeptide. An alpha-amidating activity capable of converting D-125I-Tyr-Pro-Gly-Gly into D-125I-Try-Pro-Gly-NH2 was identified in crude synaptosomal and neurosecretory-granule fractions from hypothalamus and anterior-pituitary secretory-granule preparations. This activity was stimulated by the addition of Cu2+ and reduced ascorbate, and was maximal at neutral pH in sulphonic acid buffers. Highest activity was measured in synaptosomes from the median eminence and medial basal hypothalamus and in pituitary granules. Lower activity was found in synaptosomes prepared from anterior hypothalamic tissue. Negligible activity was measurable in cerebral cortex and none in pineal synaptosomes. Direct comparison of alpha-amidation with D-125I-Try-Pro-Gly-Gly and a previously reported substrate D-125I-Tyr-Val-Gly showed that, although the latter was 15-20-fold more reactive, the optimal concentration of Cu2+ for amidation was similar with both substrates in medial basal-hypothalamic synaptosomes and pituitary granules. Activity measured with 1 microM-D-125I-Tyr-Val-Gly was inhibited by increasing concentrations of D-Tyr-Pro Gly-Gly, with 50% inhibition at 25 microM-D-Tyr-Pro-Gly-Gly, whereas activity with 3.3 microM-D-125I-Tyr-Pro-Gly-Gly was abolished by addition of 1 microM-D Tyr-Val-Gly, evidence that the two substrates were competing for the same enzyme activity. Synaptosomal preparations demonstrated Michaelis-Menten kinetics for D Tyr-Pro-Gly-Gly as substrate, with values of Km and V decreasing upon removal of ascorbate. We conclude that D-Tyr-Pro-Gly-Gly-directed alpha-amidation in sheep hypothalamic synaptosomes resembles the activity with D-Tyr-Val-Gly as substrate, as well as that demonstrated by others with D-Tyr-Val-Gly as substrate in rat hypothalamic and pituitary tissue. Although reactivity towards D-Tyr-Pro-Gly-Gly cannot be assumed to assess amidation solely of GnRH, the negligible D-Tyr-Pro Gly-Gly-directed activity in the pineal gland and cerebral cortex, areas that are known to synthesize other alpha-amidated peptides, suggests some substrate specificity in alpha-amidating enzymes from different tissues. PMID- 3291865 TI - The functional role of thiol groups of pyruvate decarboxylase from brewer's yeast. AB - Pyruvate decarboxylase purified from brewer's yeast has been modified by the thiol specific reagents 4-hydroxy-mercuri-benzoate and 3-bromo-pyruvamide. The kinetic properties of the thiol-modified enzyme derivatives were investigated by stopped-flow technique. The enzyme--inactive in the absence of its substrate--is activated by binding pyruvate to the regulatory sites. This activation behaviour is lost after modification of six thiol groups per PDC molecule. The thiol groups have been subdivided into two classes according to their modification rates. Two of these six thiol groups are involved in the mechanism of enzyme activation. PMID- 3291866 TI - Phosphorylation activity associated with plasma membrane-cortical granule complex of Xenopus laevis oocytes. AB - Plasma membrane-cortical granule complexes from Xenopus laevis oocytes were isolated by a differential centrifugation procedure. Membrane preparations incorporated 32P from [gamma-32P]ATP predominantly into three protein bands of Mr 128,000, 54,000 and 29,000, as determined by sodium dodecyl-polyacrylamide gel electrophoresis. Progesterone and insulin, added in vitro to membranes, did not produce any change in this phosphorylation pattern, contrary to some previously published results. The availability of enriched membrane complexes should permit further biochemical dissection of signal transduction pathways that are activated during oocyte maturation and fertilization. PMID- 3291867 TI - Insulin-like growth factors stimulate chemotaxis in human melanoma cells. AB - Insulin and insulin-like growth factors stimulate motility in the highly metastatic human melanoma cell line, A2058. Insulin-like growth factor-I (IGF-I) is the most potent with a maximal response at a concentration of 10 nM compared to the activities of insulin and insulin-like growth factor-II (IGF-II) which peak at 300-400 nM. Using checkerboard analysis, the responses to IGF-I and insulin are predominantly chemotactic, although insulin had a significant chemokinetic component. Pertussis toxin does not inhibit the response to any of these polypeptides. However, in previous studies, it was shown that the motile response to autocrine motility factor from these same A2058 cells was markedly inhibited by pertussis toxin. 125I-labelled IGF-I binds saturably and specifically to the A2058 cells. Scatchard analysis indicates a high binding affinity (Kd approximately 3 x 10(-10) M) and an estimated 5000 receptors/cell. These studies indicate that in addition to their mitogenic properties, certain growth factors may profoundly enhance metastasis of tumor cells by their ability to induce motility. PMID- 3291868 TI - High level of c-fos mRNA accumulation is not obligatory for renewed cell proliferation. AB - We have examined the expression of the c-fos gene and the formation of inositol phosphates with respect to the reentry of inducible C2 myoblasts into the cell cycle. GI arrested myoblasts were stimulated to proliferate by addition of fresh medium containing either 20% foetal calf serum (FCS) or 1.6 10(-6) M insulin and 7 microM Na+ vanadate. Our results show that renewed proliferation, which occurred in the presence of insulin + vanadate, was neither preceded by increased inositol phosphate formation, nor by high level of c-fos mRNA accumulation, while, as classically observed, FCS induced proliferation was. These results suggest that increased inositol phospholipids breakdown and transient accumulation of c-fos mRNA at a high level, are not obligatory for renewed cell proliferation. PMID- 3291869 TI - The production of anorexigenic substances by intestinal flora. AB - The role of intestinal flora in the production of anorexigenic substance was investigated. Proteus mirabilis (P. mirabilis) and Escherichia coli (E. coli) were found to produce an anorexigenic substance, while Enterococcus faecalis (E. faecalis, type 1 and 2) and Staphylococcus intermedius (S. intermedius) did not. The anorexigenic substance was purified and was detected as, a single though broad band by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE). The specific activity of the final form of the purified substance was 120 units/mg carbohydrate. The substance contained no protein residue and appeared to be a lipopolysaccharide. The evidence that intestinal flora produces an anorexigenic substance leads to an interesting assumption that the intestinal flora may be responsible for regulating food intake. PMID- 3291871 TI - The radiation inactivation method provides evidence that membrane-bound mitochondrial creatine kinase is an oligomer. AB - Lyophilized suspensions of rabbit heart mitochondria have been irradiated with varying doses of gamma rays. Mitochondrial creatine kinase activity was inactivated exponentially with a radiation inactivation size of 352 or 377 kDa depending upon the initial medium. These values are in good agreement with the molecular mass previously deduced from by permeation experiments: 357 kDa. This is the first direct evidence showing that the native form of mitochondrial creatine kinase is associated to the inner membrane as an oligomer, very likely an octamer. PMID- 3291870 TI - Characterization of multiple fumarase proteins in Escherichia coli. AB - Two different types of fumarase were found in sonic extracts of Escherichia coli; one required Fe-S for the enzyme activity, and the other did not. When the cells were grown without aeration, the Fe-S-independent enzyme occupied over 80% of the overall fumarase activity. Highly purified Fe-S-independent enzyme was suggested to be composed of four subunits (Mr = 48 kDa) by SDS-polyacrylamide gel electrophoresis and gel filtration. Amino acid and N-terminal sequence analyses supported the possibility that the enzyme is a product of fumC gene (FUMC). In aerobically grown cells, however, the content of FUMC was low and the Fe-S dependent fumarase occupied over 80% of the overall activity. The Fe-S-dependent enzyme appeared to be labile and the activity was rapidly lost during purification. Although the spontaneous inactivation was previously ascribed to thermal lability (S.A. Woods & J.R. Guest (1987) FEMS Microbiol. Lett. 48, 219), the activity could be restored by anaerobic incubation with ferrous ions and SH compounds. PMID- 3291872 TI - Excretion of cholera toxin from Escherichia coli: a potential oral vaccine for cholera. AB - Escherichia coli strain N100 has been mutagenized by transposon mutagenesis and mutants with a cell surface leaky phenotype have been isolated. The mutant designated as E. coli N100::Tn5 excreted periplasmic proteins like ribonuclease and alkaline phosphatase. When this mutant strain was transformed with plasmids containing cloned cholera toxin genes, the toxin protein synthesized in the cells were excreted. The potentiality of this strain as a live oral vaccine for cholera has been discussed. PMID- 3291873 TI - Dual effect of glucose on cytoplasmic free Ca2+ concentration and insulin release reflects the beta-cell being deprived of fuel. AB - Influence of basal glucose concentration on the response evoked by subsequent stimulation with the sugar, was evaluated by investigating changes in free cytoplasmic Ca2+ concentration, [Ca2+]i, and insulin release, using beta-cells isolated from obese hyperglycemic mice. When increasing the glucose concentration from 0 to either 11 or 20 mM, there was a transient decrease in both [Ca2+]i and insulin release. The decrease was followed by a pronounced increase in both of the parameters. When increasing the basal glucose concentration, the initial decrease gradually disappeared, being abolished already at 5 mM of the sugar and the subsequent increase appeared more rapidly. It is suggested that the observed decrease in [Ca2+]i and thereby insulin release reflects a phenomenon associated with fuel deprived beta-cells. PMID- 3291874 TI - Beta cell contact and insulin release. AB - Insulin secretion by intact islets, dispersed islet cells and dispersed cells allowed to reaggregate was compared in perifusion. Although single cells and aggregates showed basal insulin secretion and a prompt response to glucose challenge, basal secretion, peak insulin secretion and total insulin secretion during a 60 minute stimulation were profoundly less than those activities of intact islets. These results suggest that dispersed beta cells are responsive to glucose as a secretagogue, but the magnitude of the response is greatly diminished and not restored by simple cell contact. PMID- 3291875 TI - Effect of sodium oleate on the hydrolysis of human plasma fibronectin by proteinases. AB - Oleic acid binds in a saturable fashion to human plasma fibronectin (FN). Analysis of the binding indicated the presence of a high affinity binding site with nKa approximately equal to 10 uM-1. Furthermore, it was found that binding of sodium oleate to FN modulated its susceptibility to degradation by various proteinases. FN saturated with sodium oleate was hydrolysed at a higher rate by trypsin, cathepsin D, thermolysin and pancreatic elastase than native FN. In contrast, sodium oleate inhibits the activity of two human granulocyte proteinases, human leucocyte elastase (HLE) and cathepsin G on either FN or on their respective specific synthetic substrates (at concentrations ranging from 10(-6) mM to 10 mM). Cathepsin G inhibition was non-competitive and gave a Ki in the 10 uM range similar to the previously reported inhibitory constant of oleic acid toward HLE. PMID- 3291876 TI - Immunological identification of rat urinary inactive kallikrein as a proform of tissue kallikrein. AB - Antibody was raised against a synthetic undecapeptide (PS 11) which corresponds to the prosegment of the rat tissue kallikrein precursor. The potential to recognize rat urinary active or inactive kallikrein was assessed by an enzyme immunoassay method for PS 11, using beta-D-galactosidase as the labeling enzyme. The active kallikrein failed to compete with the enzyme-labeled PS 11 in binding to the antibody. The inactive kallikrein displaced the enzyme-labeled PS 11 in this enzyme immunoassay, and the displacement curve was in parallel with that of PS 11. These results indicate that rat urinary inactive kallikrein contains a prosequence recognized by the antibody to PS 11. This inactive kallikrein is probably a proform of tissue kallikrein. PMID- 3291877 TI - The cloning and over-expression of PABA synthase in E. coli. AB - Both the genes encoding E. coli p-aminobenzoic acid synthase have been cloned and an overproducing strain has been obtained. The partial purification of the large subunit is described. The kinetic properties of the cloned enzyme, while similar to those reported for the B. subtilis enzyme, show some differences to those reported for the S. griseus enzyme. PMID- 3291878 TI - G2 block induced by DNA crosslinking agents and its possible consequences. PMID- 3291879 TI - Endothelium-derived relaxing factor. Identification as nitric oxide and role in the control of vascular tone and platelet function. PMID- 3291880 TI - Enhancement by alloxan-induced diabetes of the rate of metabolic activation of three pyrolysate carcinogens via increase in the P-448-H content in rat liver. PMID- 3291882 TI - Alcohol decreases insulin sensitivity in healthy subjects. AB - To study the effect of alcohol on glucose and insulin metabolism, a simultaneous infusion of glucose and insulin was given for 150 min to healthy volunteers, once during alcohol and once during calorie-free gingerale (control) ingestion. During alcohol intake, the average steady-state (between 100 and 150 min) glucose of 5.44 +/- 0.39 mmol/l. and the average steady-state insulin of 6.3 +/- 1.1 ng/ml were significantly higher than those (4.0 +/- 0.39 mmol/l. of glucose and 4.4 +/- 0.6 ng/ml of insulin) observed during the control state. Despite the higher steady-state insulin concentrations, the glucose metabolism was significantly less during alcohol ingestion. These findings suggest alcohol-induced impairment in glucose metabolism is caused by a decreased tissue sensitivity to insulin. PMID- 3291881 TI - Characterization of cholinergic muscarinic receptors in the rabbit iris. AB - The sphincter smooth muscle of the iris is innervated by excitatory parasympathetic nerve fibers, and the activation of these fibers results in the breakdown of phosphatidylinositol 4,5-bisphosphate into its derived second messengers, myosin light chain phosphorylation and muscle contraction. The present study characterizes the muscarinic acetylcholine receptors (mAChRs) of the rabbit iris employing [3H]N-methylscopolamine ([3H]NMS) and L [3H]quinuclidinyl benzilate ([3H]QNB) as probes. Binding studies indicated that [3H]NMS and [3H]QNB bound to homogeneous populations of mAChRs with apparent Bmax values of 0.67 and 1.09 pmol/mg protein respectively. Binding of radioligands was rapid, saturable, stereospecific, reversible, and inhibited by specific muscarinic agonists and antagonists in a competitive manner. [3H]NMS displayed a lower amount of nonspecific binding and a faster association and dissociation rate than [3H]QNB. The relative potencies for displacement of both radioligands, based on their Ki values, were (-)QNB greater than atropine greater than (+)QNB greater than pirenzepine greater than pilocarpine. Antagonist displacement of the radioligands appeared to obey the law of mass action, indicating interaction with a single binding site. However, displacement of the radioligands by the agonists carbamylcholine and methacholine indicated interaction with both high and low affinity binding sites. Comparison of the displacement of [3H]NMS and [3H]QNB by pirenzepine in microsomal fractions from rabbit iris, ileal muscle and cerebral cortex revealed the presence of a single subtype of mAChR in the iris which had an affinity for PZ that was slightly higher than that of ileal M2 receptors, but lower than that of brain M1 receptors. This suggests that the mAChRs in the iris may represent a subclass of receptors within the M2 subtype, or they may constitute an entirely different subtype of mAChRs. PMID- 3291883 TI - Biological effects of chronic ethanol consumption: a reappraisal of the Lieber-De Carli liquid-diet model with reference to skeletal muscle. AB - This paper responds to the recent article by Rao et al. (Alcohol and Alcoholism 21, 369-373, 1986) which suggested that the Lieber-De Carli liquid diet for chronic ethanol-feeding studies may not be suitable for the rat because of the changes in carbohydrate content. The viability of the Lieber-De Carli model was, therefore, re-examined. The content of the liquid diet was shown to be nutritionally adequate, when compared to a solid laboratory chow. However, rats on an alcohol feeding regime had sub-optimal growth rates, because of a reduction in the amount of liquid diet consumed. When compared to pair fed controls, rats fed the ethanol-containing diet showed marked changes in skeletal muscle. These observations are similar to those in man and we conclude that the use of the Lieber-De Carli feeding regime in experimental animals is a suitable means of investigating the mechanism of skeletal myopathy. PMID- 3291884 TI - An NMR study of cerebral oedema and its biological correlates during withdrawal from alcohol. AB - Five chronic alcoholic patients admitted for detoxification were studied. During the first 24-48 hr of abstinence raised levels of cerebral water (as measured by NMR), vasopressin, renin and supine aldosterone were recorded. Initial vasopressin concentration was correlated (r = 0.88, P less than 0.05) with alcohol consumption in the week prior to admission and was over three times higher in the patients measured after 24-48 hr as compared to less than 24 hr. After one week only supine aldosterone was still raised (P less than 0.05). The results suggest that cerebral oedema occurs during the early stages of abstinence. The role of these changes in the aetiology of withdrawal symptoms, delirium tremens and brain damage remains to be elucidated. PMID- 3291886 TI - Delayed diagnosis of coin ingestion in children. AB - Diagnosis of coin ingestion with esophageal impaction may be delayed if appropriate history is lacking. This delay may lead to mistreatment and complicate management. A series of illustrative cases are reported and relevant literature is reviewed. Guidelines for radiographic evaluation of potential ingestions are provided. PMID- 3291885 TI - Pneumoperitoneum as a complication of cardiopulmonary resuscitation. AB - A case of pneumoperitoneum following cardiopulmonary resuscitation (CPR) is reported and 11 cases in the literature are reviewed. Four patients had laparotomies failing to demonstrate any visceral perforation or evidence of peritonitis in spite of the massive pneumoperitoneum present. Operative intervention immediately after resuscitation is associated with potentially high morbidity and mortality. Several diagnostic tools are used, including peritoneal lavage and contrast media tests, to accurately diagnose perforated viscus. To avoid an unnecessary celiotomy a clinical treatment protocol has been developed for patients with pneumoperitoneum secondary to CPR. Such diagnostic tools as peritoneal lavage and water-soluble contrast medium test are reviewed and included in this protocol. A nonsurgical approach to patient management may be reasonable if certain criteria are met. PMID- 3291887 TI - Emergency department management of retained rectal foreign bodies. AB - A plastic toothbrush case was removed from the rectum of a prison inmate in the emergency department using a rigid sigmoidoscope and a fogarty catheter. The patient was subsequently discharged from the emergency department. Previous literature regarding rectal foreign bodies has emphasized inpatient treatment and tended to ignore the potential value of the emergency service. Guidelines for selecting appropriate patients for emergency department management are presented and basic principles for safe outpatient removal are reviewed. PMID- 3291888 TI - Psychologic, physical, nutritional, and technologic aspects of intravenous infusion during labor. PMID- 3291889 TI - Food and beverages in labor. Part I: Cross-cultural and historical practices. PMID- 3291890 TI - Food and beverages in labor. Part II: The effects of cessation of oral intake during labor. PMID- 3291891 TI - Correlation of Doppler and cardiac catheterization gradients in children with ventricular outflow obstruction. PMID- 3291892 TI - Colonic lesion expert system. Performance evaluation. AB - A computer-based expert system for diagnosing colonic sections as normal, adenoma or adenocarcinoma is described, along with an evaluation of its performance. On the basis of its knowledge base, consisting of the values of diagnostic clues and their associated certainty factors for the possible diagnoses, the system will suggest the diagnosis for new cases presented to it. Using the data provided for 16 diagnostic clues, the system arrived at correct diagnoses for all cases of normal colon, for 49 of 50 cases of adenoma and for 48 of 49 cases of adenocarcinoma. Sample outputs from the expert system are presented and discussed, and the effects of possible alterations in the data base are considered. PMID- 3291893 TI - Patients with congenital dopamine beta-hydroxylase deficiency. A lesson in catecholamine physiology. AB - We recently described a case of congenital dopamine beta-hydroxylase (DBH) deficiency. The syndrome is characterized by noradrenergic denervation, adrenomedullary failure, but intact baroreflex afferents, cholinergic innervation, and adrenocortical function. Norepinephrine, epinephrine, and their degradation products were undetectable in plasma, urine, and cerebrospinal fluid, whereas dopamine and its degradation products were elevated. Plasma DBH was not detectable. Studies in this novel syndrome showed evidence for the peripheral production of dopamine from sympathetic nerve terminals noradrenergic in nature. Tyrosine hydroxylase is probably induced in this syndrome, since plasma levels of L-DOPA were also elevated. Absence of hemodynamic effects of sympathicolytic agents in the face of an increase in blood pressure after dopamine antagonists suggest that intrasynaptic concentrations of dopamine are in the range of its plasma concentrations. Hypoprolactinemia, reduced REM sleep, increased slow wave sleep and sodium loss, despite low blood pressure, are further evidence for the biological role of dopamine in man. PMID- 3291894 TI - Contrasting acute effects of captopril and nifedipine on renal function in renovascular hypertension. AB - In order to assess the determinants of renal function deterioration induced by angiotensin-converting enzyme inhibition (ACEI) in renovascular hypertension, studies were performed in patients with bilateral stenosis (BS; n = 12) and stenosis of a solitary kidney (SK; n = 10). Acute administration of captopril was associated with a consistent fall in glomerular filtration rate in 5 of 12 patients with BS and 8 of 10 with SK. Overall, glomerular filtration rate decreased by 22 +/- 7%, while mean arterial pressure decreased by only 8 +/- 2% and renal plasma flow remained unaltered. The ACEI-induced change in glomerular filtration rate was unrelated to blood pressure or basal plasma renin activity, but it was inversely related to pre-ACEI filtration fraction. In a comparative study conducted in 6 BS and 4 SK patients, acute administration of nifedipine was associated with a change in glomerular filtration rate of 13 +/- 5% and no change in renal plasma flow, despite a marked decrease in mean arterial pressure of 19 +/- 4%. In contrast, in the same patients, glomerular filtration rate fell by 23 +/- 12%, renal plasma flow did not change and mean arterial pressure fell slightly by 7 +/- 3% after ACEI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291895 TI - Effect of calcium-channel blockade on the aldosterone response to sodium depletion and potassium loading in man. AB - Angiotensin II (Ang II) and potassium (K+) increase aldosterone (Aldo) production in vitro via Ca2+-dependent mechanisms. To determine the effects of Ca2+ antagonism in vivo, we examined the influence of nifedipine on the Aldo response to Na+ depletion and K+ loading in 11 healthy subjects. On the fifth day of a low Na+/high-K+ diet (10 mmol Na+/100 mmol K+) the subjects were randomly given either nifedipine 30 mg po or placebo, and on the sixth day they received the alternative drug. KCl in 5% glucose was infused on days 5 and 6 from 10:00 to 12:00 AM (0.6 mmol/kg over 2 hours). Dexamethasone was given to suppress adrenal corticotrophic hormone. Plasma renin activity (PRA) and plasma Aldo were determined every 20 minutes. Nifedipine induced a rise in heart rate at 60 minutes but did not change blood pressure. During KCl/glucose infusions, plasma glucose increased significantly, but plasma K+ remained stable. PRA, but not baseline plasma Aldo, was stimulated by nifedipine. KCl provoked a significant and similar Aldo rise (P less than .01) under placebo and nifedipine. Baseline Aldo/PRA ratio was reduced under nifedipine when compared to placebo (P less than .01), whereas during KCl infusions this ratio was similarly elevated under placebo and nifedipine. We conclude that acute inhibition of slow Ca2+ channels does not interfere with K+-induced Aldo secretion in man, suggesting that adaptive mechanisms operate in vivo. PMID- 3291896 TI - Cardiopulmonary receptor reflex in hypertension. AB - Several studies have described the modifications of the arterial baroreceptor reflex in hypertension. Whether this condition alters the other major cardiovascular reflex (ie, that originating from receptors in the cardiopulmonary region) is less well known, however. Herein we describe the importance of the inhibitory control of sympathetic vasomotor and renin influences exerted by the cardiopulmonary reflex in normotensive humans as assessed by deactivating and stimulating heart and lung receptors through reductions and increases in central venous pressure respectively obtained via lower-body negative pressure and passive leg raising. Observations on this reflex obtained in experimental animal models are summarized. Finally, we report recent evidence showing that the cardiopulmonary reflex is only slightly affected by mild or moderate essential hypertension but impaired in hypertension with left ventricular hypertrophy in a fashion positively related to the degree of this cardiac structural alteration. This may further worsen the severity of hypertension. However, the impairment of the cardiopulmonary reflex is reversible with regression of hypertrophy obtained by antihypertensive treatment which is thus beneficial for cardiovascular homeostasis. PMID- 3291897 TI - Pill count measures of compliance in a drug trial: variability and suitability. AB - To evaluate pill counts as a compliance measure for drug trials, we followed 121 ambulatory hypertensives selected for good compliance over less than or equal to 12 months. The medication regimens consisted of either pinacidil or hydralazine as monotherapy or with propranolol and/or hydrochlorothiazide. Pill counts for the two primary drugs were obtained at each of the 20 return visits. The population was characterized by chronic uncomplicated hypertension and sociodemographic diversity; mean age was 53 years. Despite excellent average weekly pill counts (overall mean compliance rate [+/- SD] = 96.0 +/- 13.2%), we observed large intersubject and intrasubject variance in weekly pill count assessment: individuals' mean standard deviation = 13.7% (range = 0%-86%) and mean coefficient of variation = 0.138 (range = 0.001-0.410). By pill count, 35% of individuals exhibited greater than 110% compliance on at least 1 visit. We conclude that (a) pill count variability is large, even among highly selected subjects, (b) traditional reports of overall pill counts are suboptimal, and (c) pill counts may unreliably measure medication-taking behavior because "supranormal" compliance by this method is improbable but common. PMID- 3291898 TI - The mineralocorticoid hormones in human hypertension. Remarks after receiving the Robert Tigerstedt award. PMID- 3291899 TI - Does hypertension predispose to coronary disease? Conflicting epidemiological and experimental evidence. AB - Hypertension is associated with an increased risk of coronary events. Treatment of hypertension in controlled trials has not reduced the incidence of coronary events, although the risk of stroke is reduced. In untreated hypertension, about one-half the deaths were due to hypertensive heart failure, whereas myocardial infarction caused 10%-12% of deaths. In treated hypertension, coronary events cause about 40% of deaths. Although in autopsy serious coronary atherosclerosis is commonly found in hypertension, in severe hypertension, dilated coronary vessels free of atheroma were a common finding. No correlation was noted between the height of blood pressure and degree of coronary atherosclerosis. The relationship between coronary disease and hypertension is consistent with an association between them rather than hypertension being a causal factor. The factors that cause acute myocardial infarction may differ from those which predispose to coronary atherosclerosis. PMID- 3291900 TI - Pathologic quiz case 2. Pemphigoid. PMID- 3291901 TI - Split-course versus continuous radiotherapy. Analysis of a randomized trial from 1964 to 1967. AB - A randomized clinical trial was performed from 1964 to 1967 to compare the therapeutic results of split-course external beam radiotherapy with those of continuously fractionated treatment. Altogether 439 consecutive patients with carcinoma of larynx, nasopharynx, hypopharynx, oropharynx, oral cavity, oesophagus and urinary bladder were included in the series. 227 patients received split-course treatment and 212 were treated by the continuous-course method. In the split-course treatment there was a 2-3 weeks' interruption after 25-30 Gy. This break was compensated by a 10% increase in the total dose. For each tumour site local control and failure rates for the 2 treatment techniques were similar. No significant differences in 5- and 10-year survival were noted. Acute side effects were milder in all patients treated with split-course. The occurrence of late reactions was similar in both treatment groups. However, severe late reactions in the urinary bladder were somewhat more frequent in patients treated with split-course technique; the difference was not statistically significant. We conclude that there were no significant differences in local control, long-term survival and late normal tissue reactions between the treatment groups. The acute normal tissue reactions were milder in the split-course treated groups. We still regard split-course as a useful treatment modality provided the interruption is compensated with about 10% increase in total dose. However, more studies are needed to show which tumours proliferate during prolonged radiotherapy. PMID- 3291902 TI - Accelerated fractionation in the radiation treatment of head and neck cancer. A critical comparison of different strategies. AB - There is strong clinical and radiobiological evidence that protraction of overall treatment time has an adverse influence on the radiocurability of certain human tumors. Overall treatment time can be reduced without recourse to large dose fractions by the use of accelerated fractionation, but in patients with head and neck cancer acute mucosal reactions limit the extent to which treatment can be accelerated. Three different prototypical schedules for accelerated fractionation have been devised to avoid exceeding acute mucosal tolerance. Type A consists of an intensive short course in which the overall duration of treatment is markedly decreased with a corresponding substantial reduction of total dose; type B achieves a modest decrease in overall time without reduction of total dose by using a split-course technique; type C also achieves a modest decrease in overall time without reduction of total dose by means of the concomitant boost technique. A hybrid schedule combining features of types B and C allows additional shortening of overall treatment time without reduction of total dose. Available radiobiological and clinical data suggest that schedules of types B or C which do not compromise total dose are generally preferable to those of type A in which there is a trade-off between total dose and overall time. For a given total dose and overall time, a continuous treatment of type C is likely to produce more cell kill than a split-course of type B, although the latter will be better tolerated. Because of the increased acute toxicity associated with all schedules of accelerated fractionation, rational selection of patients for such treatment is important. New techniques to measure the potential doubling time of human tumors in vivo offer this prospect. PMID- 3291903 TI - Repopulation in human tumors. A biological background for fractionation in radiotherapy. AB - Tumor repopulation plays a major role in the response of tumors to radiotherapy or chemotherapy but its degree varies widely among human tumors. Its mechanism has not been elucidated, however it is unlikely that repopulation can be simply explained by the greater availability of oxygen and nutrients resulting from the reduction in tumor mass. In normal tissues, such as bone marrow, treated cells release stimulating factors which are able to recruit quiescent cells into proliferation. Similar mechanisms have been observed in experimental tumors and their existence is probable in human tumors. A low pretreatment proliferation index and low cell density indicate that the control mechanisms which regulate cell proliferation in normal tissues are still partially operating in these tumors. In such tumors an increase in the level of cell proliferation during or after treatment has often, but not always, been observed. There is not yet a clear guide for predicting tumor proliferation rate under treatment and further investigations are needed. PMID- 3291904 TI - Early fractionation methods and the origins of the NSD concept. AB - The concept of the time factor in radiotherapy originated in the controversy surrounding single-dose and fractionated treatments during the first 20 years of this century. The success of Coutard's fractionated treatments of larynx tumors was an important factor in the abandonment of single-dose treatments. There was considerable research afterwards into the influence of dose rate and overall time of treatment on the responses of normal tissues. Recovery was modeled in terms of the Schwarzschild law of photochemistry, as exemplified by the analysis of Strandqvist in log dose-log time coordinates. Different conventions were followed in defining the time for a single-dose treatment. Subsequently the concept arose that the slopes of isoeffect lines relating dose and treatment time for normal tissues and tumors were different and moreover that the effects of fraction number and overall time could be separated; these developments constituted the foundation of the Ellis NSD model. It had an important influence on clinical practice and was reasonably successful in predicting isoeffective regimens for acute effects. It failed to predict severe late effects after large dose fractions. The dissociation between acute and late effects with altered fractionation led to recognition of the importance of the ratio alpha/beta in characterizing the fractionation sensitivity of tissues. PMID- 3291906 TI - Benign tumors and pseudotumors of the liver. AB - The pathologic and clinical aspects of benign tumors and pseudotumors of the liver are reviewed. They are classified according to the tissue of organ into epithelial (further subclassified into tumors of hepatocellular and cholangiocellular origin), mesenchymal or mixed derivation, and a miscellaneous group. Some of the tumors and pseudotumors, e.g. bile duct adenoma, small focal nodular hyperplasias and cavernous hemangiomas, and focal fatty change, are of no clinical significance. Others, such as nodular regenerative hyperplasia, hepatocellular adenoma and giant hemangioma, can be manifested by portal hypertension, hemoperitoneum or a hemorrhagic diathesis respectively. Cognizance of the histopathologic criteria for diagnosis, the radiologic features and the varied clinical manifestations are essential for management. The malignant potential of some of the benign tumors is briefly touched upon. PMID- 3291905 TI - Instrumentation for single-photon-emission computed tomographic studies of the brain. PMID- 3291907 TI - [Agenesis of the corpus callosum and its associated anomalies as pathological background in Aicardi syndrome]. PMID- 3291908 TI - Relaxation. PMID- 3291909 TI - Psychiatric-mental health nursing education. PMID- 3291910 TI - Community health nursing education. PMID- 3291911 TI - Men in nursing. PMID- 3291912 TI - Women's health. PMID- 3291913 TI - Human information processing. PMID- 3291914 TI - Nursing research in the Philippines. PMID- 3291916 TI - Touch. PMID- 3291915 TI - Patient education. AB - The 120 studies included in this review were grouped in relation to five categories of variables basic to a theory of instruction in patient education. Findings in the studies related to the characteristics of the patient as learner support the following variables as significant for a theory of instruction: demographic characteristics including age, race, duration and type of illness, educational level, and family preparedness. Selected psychological variables are significant as they interact with teaching approaches. Given only two studies in which the characteristics of the nurse as teacher were the main variables, no inferences for a theory of instruction could be drawn. However, the findings from those studies combined with results from studies in which characteristics of the nurse were secondary variables support the importance of this category of variables. The educational preparation, motivation, values, and job description of the nurse implementing patient teaching appear to be significant variables for a theory of instruction. Investigators explored a wide range of teaching strategies in the studies of patient teaching. The setting for teaching, group and individual teaching, and a variety of instructional strategies all prove promising at the operational level. The instructional strategies were too diverse to allow analysis at a level of abstraction beyond the operational. Findings in this review also support characteristics of the health care setting as an important category of variables for a theory of instruction. The organizational structure, a quality assurance framework, and valuing patient teaching appear to be significant variables. Patient education research provides a rich data source for future developments in theory, practice, and research. The effectiveness of patient education as a nursing intervention is clearly established. Furthermore, positive learning outcomes are associated with a broad range of teaching strategies, content areas, and patient populations. Systematic explorations of the characteristics of the patient as learner, the nurse as teacher, and the health care setting as a learning environment are still necessary for developing a theory of instruction for patient education. Future researchers should attend to phenomena unique to patient education rather than to duplicating general educational research. Instead of the investigator-driven research approach that characterizes research to date, replication should be encouraged. Future research should be designed to link theory and research and thereby contribute to the further development of a theory of instruction in patient education. PMID- 3291917 TI - The physical environment and patient care. PMID- 3291918 TI - Social support. PMID- 3291919 TI - Essentials of case planning for osseointegrated implants. PMID- 3291920 TI - Resin-based restoratives. PMID- 3291922 TI - Loss of polymorphic A and B locus HLA antigens in colon carcinoma. AB - In the present study we have confirmed that approximately one third of human colorectal carcinomas fail to express the HLA - A,B,C monomorphic determinant reactive with the W6/32 MAb, and 44% express class II HLA antigens as shown by reactivity with NFK-1 MAb. Reduced staining with the W6/32 MAb was not always associated with the loss of beta 2m. In addition, the expression of HLA-A2 and Bw4 class I specific haplotypes on normal colon epithelium and tumour biopsy tissue was assessed. All normal colonic epithelia stained positively with MAb against A2 and Bw4 antigens, but a loss of these determinants was shown on tumour biopsies from patients tissue typed for the respective specificities. Loss of the A2 haplotype was shown in 4 of 15 tumour tissue samples, and loss of Bw4 specificities in 5 out of 7 tissue samples. The failure to detect specific loci determinants was not necessarily associated with loss of reactivity with W6/32 MAb. PMID- 3291921 TI - Vimentin and p53 expression on epidermal growth factor receptor-positive, oestrogen receptor-negative breast carcinomas. AB - The coordinate expression of the nuclear p53 protein, cytoplasmic intermediate filament vimentin (VIM) and membrane epidermal growth factor receptor (EGF-R) was significantly associated with oestrogen receptor immunocytochemical nuclear stain (ER-ICA) negative breast carcinomas. Twenty-three (51.1%), 26 (57.8%) and 27 (60%) of 45 ER-ICA -ve cancers were respectively p53 +ve, VIM +ve and EGF-R +ve; whereas of 151 ER-ICA +ve tumours 8 (5.3%) were p53 +ve (P less than 0.0001), 23 (15.2%) VIM +ve (P less than 0.001) and 40 (26.5%) EGF-R +ve P less than 0.001). Thirty-six of 45 (80%) ER-ICA -ve carcinomas were positive for at least one of the markers versus 55/151 (36.4%) ER-ICA +ve cases (chi 2 = 28.92, P less than 0.001). A prevalence of high grade carcinomas was found among p53 +ve, VIM +ve cases; the latter subset of tumours also had a larger mean diameter. These results suggest that ER -ve breast carcinoma cells display a coordinate expression of cell cycle-related proteins and marked changes of both the cytoskeleton and the membrane receptor repertoire. PMID- 3291923 TI - Induced type-B reticulum cell neoplasia in mice III. The importance of T-cell proliferation and cellular relocation in accessory cell transformation. AB - After the transfer of spleen cells from old CBA/T6T6 mice (greater than 75 weeks) into young syngeneic CBA/Ca recipients there usually follows a selective expansion of the donor T-cell population and the emergence of type B reticulum cell neoplasms (RCN-B), also of donor origin though probably derived not from the T-cells but from lymphoid dendritic accessory cells. As few as one million injected cells led to significant donor T-cell hyperplasia and tumour induction. Injection of cells from young donors did not have such consequences. Similar tumours were induced by transferring syngeneic cells in both C57BL and DBA/2 mice, although in the latter strain there was no requirement for the injected cells to derive from old donors. It appeared that T-cell proliferation was independent of donor accessory cells or RCN-B induction, since injection of enriched T-cells led to few tumours, although the T-cell chimaerism was indistinguishable from that in recipients of unseparated spleen cells. Development of tumours, however, seemed to be dependent upon stimulated T-cells. Recipients of spleen cells from old T-cell-deprived mice did not develop tumours; conversely, tumours, mostly of donor origin, were induced in recipients of young syngeneic cells when an extrinsic stimulus to T-cell proliferation was provided by continued allostimulation. The apparent selectivity of tumorigenesis for donor cells has led to the proposal that cellular relocation, as a result of transfer, may be an important predisposing factor in malignant transformation in circumstances of T-cell stimulation provided by antigenic challenge or by transfer of T-cells from old donors. PMID- 3291924 TI - Localization of denatured enzyme molecules in rat lenses. AB - Immunohistochemical localization of altered enzyme molecules was detected by the use of antibodies to denatured enzymes (ADE) conjugated with fluorescein. Denatured aldolase, glucose 6-phosphate dehydrogenase and superoxide dismutase are mostly located in the subcortical region and in the nucleus of the rat lens. In the nuclear fibres the enzyme is located near the membrane of the fibres. This study provides additional evidence that altered enzyme molecules accumulate in the lens, and indicates their exact localization. ADE antibody can distinguish between inactive enzyme molecules and active ones, using immunohistochemical techniques. PMID- 3291925 TI - An investigation into the mechanism of collagenolytic activity in colonic mucosa by a tissue culture method. AB - The process of collagenolysis and the source of collagenase liberated from different cell types in the colonic mucosa has been investigated by the lysis of collagen gels in vitro. The reconstituted collagen gel strongly reacted to periodic acid Schiff (PAS) when stained with combined alcian blue-PAS, indicating the presence of glycoprotein with neutral sugars in the collagen gel. Colonic explants of rabbits produced visible collagenolysis. An area of alcian blue stained gel was seen replacing the usual PAS staining around the area of the lysis. Several histochemical methods revealed that the columnar cells had multiplied with high enzymatic activity and penetrated the collagen gel where collagenolysis took place. The action of several proteolytic enzymes on collagen gel showed that ficin caused lytic activity, even though collagen is resistant to most proteolytic enzymes. Papain, pepsin and trypsin altered composition of collagen gel from neutral mucopolysaccharide to acid mucopolysaccharide. Collagenase and pronase at low concentration were found to cause extensive collagenolysis. The synthesis and breakdown of collagen is a desirable balanced process in the remodelling of connective tissue. This dynamic equilibrium may be achieved through the subtle interplay of cells liberating and inhibiting collagenase. PMID- 3291926 TI - Fibrin deposition in the kidney in post-ischaemic renal damage. AB - To investigate whether fibrin deposition in the kidney occurs in ischaemic acute renal failure, rats were subjected to a left renal artery occlusion (RAO) for 1 h and contralateral nephrectomy. The animals were killed 0, 5, 15 and 60 min after re-establishment of the circulation. Kidney tissue was snap-frozen for immunofluorescence microscopy and scanning electron microscopy, and immersion fixed for light microscopy and transmission electron microscopy. Immunofluorescence studies showed small amounts of immune reactive fibrinogen/fibrin deposits in the peritubular capillaries. Substantial amounts of fibrinogen/fibrin positive material was observed in Bowman's space and in the tubular lumina. Scanning electron microscopy of freeze-dried tissue disclosed granular and fibrillar material in Bowman's space. A temporary enlargement of Bowman's space was noted; it may have been caused by tubular obstruction. No deposits were found in the control (right) kidneys and in kidneys of heparinized rats subjected to RAO. The results indicate that fibrin deposition occurs in the ischaemic model of acute renal failure in rat, both intravascularly and in the urinary space. Its importance for the development of renal functional impairment remains to be studied. PMID- 3291927 TI - Tumour necrosis factor. PMID- 3291928 TI - Cytokine activity after human bone marrow transplantation. II. Production of macrophage procoagulant activity and the cytokine regulating its production, macrophage procoagulant inducing factor. AB - The production of procoagulant activity by circulating monocytes and its regulation by a cytokine secreted by mitogen-stimulated peripheral blood mononuclear cells was investigated in recipients of HLA-identical sibling bone marrow transplants. Blood monocyte numbers reached the normal range within 3 weeks of transplant. After stimulation with lipopolysaccharide, macrophage procoagulant activity was found to be within the normal range in all patients at all times post transplant. It did not appear to correlate with the presence or absence of graft-versus-host disease. Surprisingly, and in marked contrast to our previously documented severe depression of interleukin 2 production by transplant recipients' peripheral blood mononuclear cells, the mitogen-induced production of the cytokine that induces procoagulant activity production (macrophage procoagulant inducing factor, MPIF) was also normal in the majority of patients when assayed using the responsive myelomonocytic cell line RC-2A. These findings suggest firstly that monocyte differentiation and function normalize rapidly post transplant; and secondly, when taken together with previous studies, that the ability of peripheral blood mononuclear cells to synthesize cytokines post transplant varies greatly according to the specific cytokine involved. PMID- 3291929 TI - Comparative histology of malignant lymphomas in lymph node and bone marrow. AB - Lymph node and bone marrow biopsies of 226 patients with malignant lymphomas were available for evaluation and comparison. 120 of the 226 lymphoma patients had classifiable infiltration in both lymph node and bone marrow and these were used for comparison. Congruence in the histologic subtypes in lymph node and bone marrow was found in 91 patients (76%). The majority of the 29 cases with divergent histologies showed ML of low grade malignancy in the bone marrow even with long time intervals between the two biopsies. The most notable in this group were seven cases who had ML centroblastic/centrocytic in the lymph node biopsy and ML immunocytic in the bone marrow, although none had a serum M-component. 65 of the 106 patients excluded from comparison had involvement in only one organ, the others had unclassifiable or equivocal histologies in either lymph node or bone marrow or in both. The findings are discussed with respect to the histologic behaviour of the lymphomas. The results show that comparison between lymph node and bone marrow findings in patients with ML is feasible and clinically relevant. PMID- 3291930 TI - Bone marrow transplantation for chronic myeloid leukaemia in first chronic phase: importance of a graft-versus-leukaemia effect. AB - We analysed the incidence of graft failure, graft-versus-host disease (GVHD) and relapse of leukaemia in 208 patients undergoing allogeneic bone marrow transplantation (BMT) for chronic myeloid leukaemia in chronic phase in eight transplant centres in Europe and the United States. 106 patients received unmanipulated donor bone marrow (Group 1) and 102 patients received marrow depleted of T-cells by incubation with the monoclonal antibodies Campath-1 or CT 2 and complement (Group 2). The incidence of graft failure was higher and of GVHD was lower in Group 2 than in Group 1. Relapse of leukaemia occurred more frequently in patients in Group 2 than in Group 1 (17 v. 2, P less than 0.001). Multivariate analysis showed that the following factors were associated with an increased risk of relapse: the use of T-cell depletion, the absence of GVHD and a high platelet count at the time of admission for transplant. The findings support the concept that a graft-versus-leukaemia effect mediated by T-lymphocytes is important for cure of leukaemia after BMT. PMID- 3291931 TI - Diagnostic and prognostic factors in acute monocytic leukaemia: an analysis of 51 cases. AB - Diagnostic features (cytochemistry, immunophenotyping and serum biochemistry) were examined in 51 cases of acute monocytic leukaemia (AMoL). Peroxidase, Sudan black B and alpha naphthyl acetate esterase (ANAE) cytochemical reactions were unrelated to morphological (FAB groups M5a and M5b) or immunological subtype. ANAE cytochemistry, however, indicated that AMoL cases could be subdivided into those with typical (M-type) reactions and those with insignificant staining or monocytic ANAE isoenzymes (defined by IEF). All cases were phenotypically CD13/CD33 positive and, with one exception, had greater than 30% HLA-DR positive cells. Membrane CD14 expression was insignificant or variable in 33% of M5a cases in contrast to 23/24 M5b cases which showed high proportions of CD14-staining cells with at least two monoclonal antibodies. Serum lysozyme, LDH and beta-2 microglobulin (beta 2m) were increased in 88%, 68% and 81% of cases respectively but, with the exception of statistically higher lysozyme levels in CD14+ cases, were unrelated to the morphological, cytochemical or immunological diagnostic subgroups. Clinical and diagnostic features were also examined as possible prognostic indicators. The morphological, cytochemical and immunological subgroups of AMoL were not found to be of prognostic relevance but age (P = 0.004), renal failure (P = 0.005) and serum beta 2m levels (P = 0.002) were related to patient survival. Moreover, renal failure and serum beta 2m remained significant (P = 0.012 respectively) when age was taken into account and were shown to be independent prognostic variables. PMID- 3291933 TI - Is routine antenatal booking vaginal examination necessary for reasons other than cervical cytology if ultrasound examination is planned? AB - Sixteen ovarian cysts, including one borderline ovarian malignancy, and ten trichomonal vaginal discharges but no cases of cervical incompetence or ectopic pregnancy had been detected at booking vaginal examination in 11,622 consecutive antenatal case records abstracted retrospectively. In an attitude survey of pregnant women 77% believed that vaginal examination was reassuring, 55% found it unpleasant, and 18% thought it could cause miscarriage. This, and a review of the literature, suggests that routine vaginal examination if ultrasound is planned has few advantages beyond the taking of a cervical smear. PMID- 3291932 TI - Transferrin receptor expression of AML blasts is related to their proliferative potential. AB - Expression of the transferrin receptor (TfR) was studied on peripheral blood blast cells from 11 patients with acute myeloid leukaemia (AML). Using a monoclonal anti-TfR antibody (OKT9) and a polyclonal antibody against surface membrane-bound transferrin, a proportion of blasts from all the patients was found to express receptors for transferrin. Further analysis of OKT9 expression using a fluorescent activated cell sorter (FACS) showed that the TfR was heterogeneously distributed in the blast cell population. In five out of six samples studied, stimulation of DNA synthesis following short-term culture induced a several-fold increase in TfR display as analysed by flow cytometry using OKT9 or FITC-conjugated transferrin. Blasts from seven patients stained with OKT9 were separated on the FACS into positive and negative or weakly positive fractions. Culture of the TfR negative population in a blast cell colony assay produced no colonies in either of two patients. In a further five patients the colony forming cells were predominantly associated with the TfR strongly positive fraction (52 +/- 25 colonies/10(4) cells) rather than the TfR weakly positive fraction (12 +/- 11 colonies/10(4) cells). Analysis of colony size showed that clones derived from the weakly positive fraction were smaller than clones from the TfR strongly positive fraction. These results suggest that TfR display by AML blasts is related to their proliferative capacity and is expressed by the leukaemic stem cell fraction. PMID- 3291934 TI - Daily variability of umbilical and lateral uterine wall artery blood velocity waveform measurements. AB - The daily variability of umbilical artery and lateral uterine wall artery velocity-time waveforms recorded by continuous wave Doppler ultrasound was determined by making three observations in each of 97 women on different days within a 7-day period. There were no significant changes in the maximal:minimal Doppler shift frequency (A/B ratio) or the pulsatility index in either artery over the period of study. Common pregnancy complications did not influence the variability of the recordings. The variability of uterine artery recordings was not affected by gestational age between 17 and 41 weeks but the degree of variability of the umbilical artery recordings was greater before 30 weeks. We conclude that after 30 weeks gestation this technique has an acceptable range of daily variability for clinical and research applications. PMID- 3291935 TI - Doppler assessment of the cardiac and uteroplacental circulations in normal and complicated pregnancies. AB - Blood flow velocity waveforms were recorded in four sites in the fetal circulation in a series of 271 normal and 71 complicated pregnancies. The sites were the umbilical artery, the uterine artery branches in the placental bed, and distal to the two arterial valves in the heart. The blood flow through the arterial valves was added to estimate combined cardiac output. Normal ranges for values in all sites were established in our own series, and were similar to other published results. Abnormality of the waveform in the umbilical artery proved the most useful predictor of perinatal morbidity. Reversal of the normal pattern of increasing diastolic flow in the umbilical artery with advancing gestation was an important prognostic finding in the pregnancies studied serially. The combined cardiac output did not fall until late in the course of fetal compromise, and low values were seen only with an abnormal umbilical artery tracing. PMID- 3291936 TI - Doppler ultrasound waveform indices: A/B ratio, pulsatility index and Pourcelot ratio. AB - Three different indices, the A/B ratio, the pulsatility index (PI) and the Pourcelot ratio (PR), are in common use for quantitative analysis of umbilical artery Doppler ultrasound waveforms. A detailed examination of the similarities and differences between these indices, together with the expected errors for each, was undertaken to enable informed comparisons and choices to be made. The indices were calculated from 133 last trimester recordings using an objective and very reliable computer analysis technique. The PI is more difficult to calculate than the other two quantities and the extra computation does not provide any extra information. The A/B ratio appears the simplest index to use but the values are not normally distributed. With the PR a normal distribution of values can be assumed. A theoretical consideration of errors showed that none of the indices is intrinsically less error prone for last trimester waveforms overall. The errors in the A/B ratio increase as the value of the index increase, whereas the converse holds for the PI and PR. PMID- 3291937 TI - Umbilical artery velocity waveforms: normal reference values for A/B ratio and Pourcelot ratio. AB - Normal reference values for the umbilical artery Pourcelot ratio and A/B ratio are reported. Thirty-five normal patients were studied serially from 20 weeks to term. The A/B ratio centiles were corrected for non-normality of the underlying distribution by transforming from the Pourcelot ratio values. The correction needed was small during the last trimester, but larger for second trimester data. Of the 35 patients 24 were nulliparous and there was a slight tendency for the waveform indices to be higher in the nulliparae, but the numbers in this study were too small to be conclusive about the effect of parity. PMID- 3291938 TI - The effect of epostane, a 3-beta hydroxy steroid dehydrogenase inhibitor, on maternal and fetal steroid levels during mid-gestation. AB - A double-blind, placebo-controlled trial was conducted to assess the maternal and fetal endocrine effects of epostane, an inhibitor of progesterone synthesis, in mid-pregnancy. Although present in the maternal circulation, epostane was not detected in cord blood or amniotic fluid. Maternal and fetal progesterone levels fell by 80% and 95% respectively with maintenance of the fetal arterio-venous difference while oestradiol and aldosterone levels were affected to a lesser extent. The mechanism of 3-beta hydroxy steroid dehydrogenase suppression and the relation between fetal and maternal progesterone levels are discussed. PMID- 3291939 TI - Indomethacin retinopathy: case report and review. AB - The case of a 33-year-old man with probable indomethacin retinopathy is presented. The relevant literature is reviewed and the differences between our case and those previously reported are noted. Our patient appears to have suffered severe and irreversible ocular damage due to the very high dose of indomethacin ingested over a prolonged period. PMID- 3291941 TI - A study of the effects of four concentrations of D-timolol, 0.25% L-timolol, and placebo on intraocular pressure on patients with raised intraocular pressure. AB - The intraocular pressure lowering effect in 30 patients with raised intraocular pressure and open angles following a single application in a randomised double masked fashion of four concentrations of D-timolol (0.25%, 0.5%, 1.0%, and 2.0%), 0.25% L-timolol, and placebo are presented. The percentage reduction in intraocular pressure after four hours following single-drop instillation range from 20% to 25% in the D-timolol group, 32% in the L-timolol group, and only 8% in the placebo group of treated eyes. PMID- 3291940 TI - A single-blind randomised trial comparing adrenaline 1.0% with dipivalyl epinephrine (propine) 0.1% in the treatment of open-angle glaucoma and ocular hypertension. AB - The results of this single-blind randomised trial comparing adrenaline 1% with dipivalyl epinephrine (Propine) 0.1% confirm that both have a significant effect in lowering the intraocular pressure in patients with open-angle glaucoma and ocular hypertension, but it is generally insufficient to warrant their use as the first line medical treatment of these two conditions. There was no significant difference between the intraocular lowering effect of the two preparations, and 60% of patients receiving Propine and 66% of those receiving adrenaline noted side effects. PMID- 3291942 TI - Molecular analysis of signal transduction by growth factors. PMID- 3291943 TI - The epidermal growth factor receptor as a multifunctional allosteric protein. PMID- 3291944 TI - Efficient synthesis of a supercoiled M13 DNA molecule containing a site specifically placed psoralen adduct and its use as a substrate for DNA replication. AB - We report a simple method for the in vitro synthesis of large quantities of site specifically modified DNA. The protocol involves extension of an oligonucleotide primer annealed to M13 single-stranded DNA using part of the T4 DNA polymerase holoenzyme. The resulting nicked double-stranded circles are ligated and supercoiled in the same tube, producing good yields of form I DNA. When the oligonucleotide primer is chemically modified, the resultant product contains a site-specific lesion. In this study, we report the synthesis of an M13 mp19 form I DNA which contains a psoralen monoadduct or cross-link at the KpnI site. We demonstrate the utility of these modified substrates by assessing the ability of the bacteriophage T4 DNA replication complex to bypass the damage and show that the psoralen monoadduct poses a severe block to the holoenzyme when attached to the template strand. PMID- 3291945 TI - A monomer-dimer model explains the results of radiation inactivation: binding characteristics of insulin receptor purified from human placenta. AB - The technique of radiation inactivation has been used on highly purified human placental insulin receptor in order to determine the functional molecular size responsible for the insulin binding and to evaluate the "affinity regulator" hypothesis, which has been proposed to explain the increase in specific insulin binding to rat liver membranes observed at low radiation doses [Harmon, J. T., Hedo, J. A., & Kahn, C. R. (1983) J. Biol. Chem. 258, 6875-6881]. Three different types of inactivation curves were observed: (1) biphasic with an enhanced binding activity after exposure to low radiation doses, (2) nonlinear with no change in binding activity after exposure to low radiation doses, and (3) linear with a loss in the binding activity with increasing radiation exposures. A monomer-dimer model was the simplest model that best described the three types of radiation inactivation curves observed. The model predicts that an increase in insulin binding activity would result after exposure to low radiation doses when the initial dimer/monomer ratio is equal to or greater than 1 and a monomer is more active than a dimer. The monomer size of the binding activity was estimated to be 227,000 daltons by this model. This value most likely reflects the size of the monomeric alpha beta form. To substantiate this model, the purified receptor was fractionated by Sepharose CL-6B chromatography. The insulin binding profile of this column indicated two peaks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291946 TI - Racemization of alanine by the alanine racemases from Salmonella typhimurium and Bacillus stearothermophilus: energetic reaction profiles. AB - Alanine racemases are bacterial pyridoxal 5'-phosphate (PLP) dependent enzymes providing D-alanine as an essential building block for biosynthesis of the peptidoglycan layer of the cell wall. Two isozymic alanine racemases, encoded by the dadB gene and the alr gene, from the Gram-negative mesophilic Salmonella typhimurium and one from the Gram-positive thermophilic Bacillus stearothermophilus have been examined for the racemization mechanism. Substrate deuterium isotope effects and solvent deuterium isotope effects have been measured in both L----D and D----L directions for all three enzymes to assess the degree to which abstraction of the alpha-proton or protonation of substrate PLP carbanion is limiting in catalysis. Additionally, experiments measuring internal return of alpha-3H from substrate to product and solvent exchange/substrate conversion experiments in 3H2O have been used with each enzyme to examine the partitioning of substrate PLP carbanion intermediates and to obtain the relative heights of kinetically significant energy barriers in alanine racemase catalysis. PMID- 3291947 TI - Dissociation of yeast hexokinase by hydrostatic pressure. AB - The pressure-induced dissociation of the isozymes P1 and P2 of hexokinase was investigated by studies of the spectral shift of the intrinsic protein fluorescence and by the fluorescence polarization of dansyl conjugates. The free energy of association of the monomers at atmospheric pressure, Katm, was -14.2 kcal mol-1 at 20 degrees C and -11.4 kcal mol-1 at 0 degrees C. The positive enthalpy indicates that the association of the monomers is entropy-driven, overcoming the negative enthalpy of hydration of the subunit interfaces. At 0 degrees C and 1 bar, glucose stabilizes the association by -1.1 kcal mol-1 and the binding of both adenosine 5'-(beta, gamma-methylenetriphosphate) (AMPPCP) and glucose by an even larger amount, -1.34 kcal mol-1. Paradoxically, adenosine 5' triphosphate (ATP), or AMPPCP, in the absence of glucose destabilizes the association by +0.34 kcal mol-1, while adenosine 5'-diphosphate (ADP) stabilizes it by -0.6 kcal mol-1. Comparison of dV0, the apparent standard volume of association, at different pHs and temperatures indicates that its value (115-160 mL mol-1) is strongly dependent upon the ionization of a group at the subunit interface with a pK near neutrality. Under dissociating pressures, trypsin action results in permanent dissociation of the dimer, confirming earlier observations of Colowick by less direct methods. The P1 and P2 enzymes differ in Katm and dV0 and markedly so in the effects of salt upon the stability of the dimer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291948 TI - Nitrogen isotope effects on glutamate decarboxylase from Escherichia coli. AB - The nitrogen isotope effect on the decarboxylation of glutamic acid by glutamate decarboxylase from Escherichia coli has been measured by comparison of the isotopic composition of the amino nitrogen of the product gamma-aminobutyric acid isolated after 10-20% reaction with that of the starting glutamic acid. At pH 4.7, 37 degrees C, the isotope effect is k14/k15 = 0.9855 +/- 0.0006 when compared to unprotonated glutamic acid. Interpretation of this result requires knowledge of the equilibrium nitrogen isotope effect for Schiff base formation. This equilibrium isotope effect is k14/k15 = 0.9824 for the formation of the unprotonated Schiff base between unprotonated valine and salicylaldehyde. Analysis of the nitrogen isotope effect on decarboxylation of glutamic acid and of the previously measured carbon isotope effect on this same reaction [O'Leary, M.H., Yamada, H., & Yapp, C.J. (1981) Biochemistry 20, 1476] shows that decarboxylation and Schiff base formation are jointly rate limiting. The enzyme bound Schiff base between glutamate and pyridoxal 5'-phosphate partitions approximately 2:1 between decarboxylation and return to the starting state. The nitrogen isotope effect also reveals that the Schiff base nitrogen is protonated in this intermediate. PMID- 3291949 TI - Cross-linked amino acids in the protein pair S13-S19 and sequence analysis of protein S13 of Bacillus stearothermophilus ribosomes. AB - The 30S ribosomal subunits from Bacillus stearothermophilus were cross-linked under native conditions with the bifunctional reagent diepoxybutane. The dominant protein-protein cross-link in the 30S ribosomal subunit between proteins S13 and S19 [Brockmoller, J., & Kamp, R.M. (1986) Biol. Chem. Hoppe-Seyler 367, 925-935] was isolated on a preparative scale. The presence of a single cross-link site between cysteine-83 of protein S13 and histidine-68 of protein S19 was established by microsequence analysis of isolated cross-linked peptides. This cross-link site was further confirmed by different analytical methods including fast atom bombardment mass spectrometry of the cross-linked peptide. The cross linking site is located in the highly conserved C-terminal regions of proteins S13 and S19. In addition, the complete amino acid sequence of protein S13 from B. stearothermophilus is determined. Sequence comparison with the homologous Escherichia coli protein S13 revealed 58% identical amino acid residues. PMID- 3291950 TI - Effects of an anti-beta monoclonal antibody on the interaction of the Escherichia coli RNA polymerase with the lac and TAC promoters. AB - The effects of an inhibitory monoclonal antibody (mAb) raised against the beta subunit of the Escherichia coli RNA polymerase were determined on the kinetics and structural interactions during formation of the open promoter complex (RPo). Analysis of the kinetics of abortive initiation on linear and supercoiled templates of the lac and TAC16 promoters showed that abortive synthesis by mAb 210E8-RNA polymerase varied as a function of DNA topology. A kinetic analysis of RPl formation on the supercoiled lac UV5 promoter showed that mAb 210E8 effected a slight alteration in the isomerization rate and no effect on the initial rate of RNA polymerase binding to the promoter. The potent inhibition of initiation with linear promoters by mAb 210E8 was not apparent when the promoters were assayed in their supercoiled forms. Abortive synthesis with the TAC16 promoter was accompanied by an mAb 210E8 induced hindrance of ApUpU but not UpGpU synthesis. The data indicate that the inhibition by mAb 210E8 with the supercoiled TAC16 promoter is further alleviated when the spacer length is shifted from 16 base pairs (ApUpU formation) to 18 base pairs (UpGpU formation). When DNase I and dimethyl sulfate were used to probe DNA structure, mAb 210E8 was found to alter polymerase interactions with the lac promoter. DNase I footprinting indicated that the structural interactions for lac P+ promoter-RNA polymerase complexes were slightly altered in the presence of mAb 210E8. Treatment of the RNA polymerase-lac UV5 complex with dimethyl sulfate revealed an alternate mode of RNA polymerase interaction with essential guanine contacts which was intermediate between a fully protected and free promoter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3291951 TI - Interaction of bovine mitochondrial ribosomes with Escherichia coli initiation factor 3 (IF3). AB - Mammalian mitochondrial ribosomes are distinguished from their bacterial and eukaryotic-cytoplasmic counterparts, as well as from mitochondrial ribosomes of lower eukaryotes, by their physical and chemical properties and their high protein content. However, they do share more functional homologies with bacterial ribosomes than with cytoplasmic ribosomes. To search for possible homologies between mammalian mitochondrial ribosomes and bacterial ribosomes at the level of initiation factor binding sites, we studied the interaction of Escherichia coli initiation factor 3 (IF3) with bovine mitochondrial ribosomes. Bacterial IF3 was found to bind to the small subunit of bovine mitochondrial ribosomes with an affinity of the same order of magnitude as that for bacterial ribosomes, suggesting that most of the functional groups contributing to the IF3 binding site in bacterial ribosomes are conserved in mitochondrial ribosomes. Increasing ionic strength affects binding to both ribosomes similarly and suggests a large electrostatic contribution to the reaction. Furthermore, bacterial IF3 inhibits the Mg2+-dependent association of mitochondrial ribosomal subunits, suggesting that the bacterial IF3 binds to mitochondrial small subunits in a functional way. PMID- 3291952 TI - The constitutive K+ pump in Serratia marcescens. AB - Transport of K+ and H+ in the anaeronically and aerobically grown bacterium Serratia marcescens has been studied. The volumes of one cell of the anaerobically and aerobically grown bacterium were 3.7 X 10(-13) cm3 and 2.4 X 10(-13) cm3, respectively. Irrespective of the growth conditions the bacteria manifested the same respiration rate. However, the values of membrane potential for the anaerobically and aerobically grown bacterium were different and equal to -130 mV and -175 mV (interior negative), respectively, in the absence of an exogenic energy source. KCN + DCCD decreases delta psi down to almost zero in both species. DCCD alone decreases delta psi partially in anaerobes and increases delta psi in aerobes, whereas KCN alone reduces delta psi partially in both species. The introduction of glucose into the medium containing K+ reduces the absolute value of delta psi to [-160] mV in aerobes and to [-20] mV in anaerobes. The effect is not observed without external K+. In the presence of arsenate a delta psi is not reduced after the addition of glucose. At pH 7.5-7.8 the ATP level in aerobes grows notably faster than in anaerobes. The H+ extrusion becomes intensified when K+ uptake is activated by the increase in external osmotic pressure. Apparent Km and Vmax for K+ accumulation are 1.2 mM and 0.4 mM.min-1.g 1. The decrease of delta psi by glucose or KCN + DCCD have no effect on the K+ uptake whereas CCCP inhibits potassium accumulation. At the same time, arsenate stabilizes the delta psi value, but blocks K+ uptake. The accumulation of K+ correlates with the potassium equilibrium potential of -200 mV calculated according to the Nernst equation, whereas the delta psi measured was not more than [-25] mV. The calculated H+/ATP stoichiometry was 3.3 for aerobes. It was assumed that a constitutive K+ pump having a K+/ATP ratio equal to 2 or 3 operates in S. marcescens membranes. PMID- 3291953 TI - Yeast cell debris and protein partitioning in the poly(ethylene glycol) poly(vinyl alcohol) biphasic system. AB - Yeast cells, cell debris and protein partitioning have been investigated in the poly(ethylene glycol) (PEG) 8000/poly(vinyl alcohol) (PVA) 10,000 system. Cells and cell debris partition into the lower (PVA) phase over the pH range 4.8-7.5, and with up to 0.37 M KCl at pH 5.9. Protein partitioning is more pH-dependent in the PEG/PVA system than in the PEG/dextran system, and a significant fraction of the total protein is found at the interface at lower pH values. Significant, rapid purification of overproduced pyruvate kinase in a PEG/PVA system containing Blue Sepharose CL-6B particles is demonstrated. PMID- 3291954 TI - Escherichia coli isocitrate lyase: properties and comparisons. AB - The glyoxylate cycle was first discovered during studies on bacteria and fungi with the ability to grow on acetate or ethanol as the sole carbon source. Isocitrate lyase, the first enzyme unique to the glyoxylate cycle, has been studied in numerous prokaryotic and eukaryotic organisms. However, information on this enzyme from Escherichia coli is limited. We have recently reported the purification and in vitro phosphorylation of this enzyme. In the present study we have examined and characterized a variety of inhibitors, the divalent cation requirement and the amino acid composition of E. coli isocitrate lyase and compared these results to those obtained with other organisms. PMID- 3291955 TI - Is there a neuropathology of schizophrenia? PMID- 3291956 TI - Haloperidol alters rat CNS cholinergic system: enzymatic and morphological analyses. AB - Chemical and morphological changes in cholinergic marker enzymes, acetylcholinesterase (AChE), and choline acetyltransferase (ChAT) of striatum, hippocampus, and cerebral cortex were studied following haloperidol treatment of rats. After short-term (7-21 days) haloperidol treatment, the levels of both enzymes (AChE and ChAT) were increased in striatum and hippocampus (greater than 25%), but not in cortex. After long-term (+40 days) haloperidol treatment, the level of AChE activity returned to control levels in all brain areas, whereas the levels of striatal and hippocampal ChAT decreased by 26% and 29%, respectively. No change in levels of both enzymes was detected after acute treatment (single dose) of haloperidol or chronic treatment with either clozapine or imipramine. Morphological analysis of cholinergic neurons and their processes using monoclonal antibody to ChAT showed two types of changes following 40 days of haloperidol treatment. First, parallel to the observed decrease in the levels of ChAT activity there was a visual decrease in the immunoreactivity in neurons as well as in their processes in striatum and hippocampus. Second, there was an apparent reduction in the size and number of stained neurons and their processes. No changes were seen in immunoreactivity after an acute treatment with haloperidol. These results indicate that the chronic haloperidol treatment in rats causes changes in central cholinergic systems that may be relevant to the pathophysiology of schizophrenia and its treatment. PMID- 3291957 TI - Approximate interval estimation of the ratio of binomial parameters: a review and corrections for skewness. AB - Various methods for finding confidence intervals for the ratio of binomial parameters are reviewed and evaluated numerically. It is found that the method based on likelihood scores (Koopman, 1984, Biometrics 40, 513-517; Miettinen and Nurminen, 1985, Statistics in Medicine 4, 213-226) performs best in achieving the nominal confidence coefficient, but it may distribute the tail probabilities quite disparately. Using general theory of Bartlett (1953, Biometrika 40, 306 317; 1955, Biometrika 42, 201-203), we correct this method for asymptotic skewness. Following Gart (1985, Biometrika 72, 673-677), we extend this correction to the case of estimating the common ratio in a series of two-by-two tables. Computing algorithms are given and applied to numerical examples. Parallel methods for the odds ratio and the ratio of Poisson parameters are noted. PMID- 3291958 TI - Estimators and tests in the analysis of multiple nonindependent 2 x 2 tables with partially missing observations. AB - We present methods for the analysis of a K-variate binary measure for two independent groups where some observations may be incomplete, as in the case of K repeated measures in a comparative trial. For the K 2 X 2 tables, let theta = (theta 1,..., theta K) be a vector of association parameters where theta k is a measure of association that is a continuous function of the probabilities pi ik in each group (i = 1, 2; k = 1,..., K), such as the log odds ratio or log relative risk. The asymptotic distribution of the estimates theta = (theta 1,..., theta K) is derived. Under the assumption that theta k = theta for all k, we describe the maximally efficient linear estimator theta of the common parameter theta. Tests of contrasts on the theta are presented which provide a test of homogeneity Ha: theta k = theta l for all k not equal to l. We then present maximally efficient tests of aggregate association Hb: theta = theta 0, where theta 0 is a given value. It is shown that the test of aggregate association Hb is asymptotically independent of the preliminary test of homogeneity Ha. These methods generalize the efficient estimators of Gart (1962, Biometrics 18, 601 610), and the Cochran (1954, Biometrics 10, 417-451), Mantel-Haenszel (1959, Journal of the National Cancer Institute 22, 719-748), and Radhakrishna (1965, Biometrics 21, 86-98) tests to nonindependent tables. The methods are illustrated with an analysis of repeated morphologic evaluations of liver biopsies obtained in the National Cooperative Gallstone Study. PMID- 3291959 TI - Methods of molecular modelling of protein-protein interactions. AB - This article reviews briefly theoretical methods attempting to predict the structure of protein aggregates from the structural features of their subunits. The authors discuss the problems of the solvent effect and the formation of protein structure. The existing methods of quaternary structure prediction are presented and an attempt at their classification is made at the end of this review. PMID- 3291960 TI - Adsorption of human beta 2-microglobulin at a water/mercury interface. AB - Adsorption of human beta 2-microglobulin from a neutral solution of 0.15 M NaCl on a mercury surface was studied at 25 degrees C by measurement of the differential capacity of the electrical double layer. From the diffusion controlled adsorption kinetics, the surface concentration and hence the area occupied by the adsorbed beta 2-microglobulin molecule were determined at various potentials of the mercury surface. The results indicate unfolding or flattening of beta 2-microglobulin molecules adsorbed in particular on the electrically uncharged surface. The extent of this interfacial conformational rearrangement was reduced with growing positive or negative surface charge density. PMID- 3291961 TI - Forms of iron in plants. PMID- 3291962 TI - Plasma renin activity in patients with beta-thalassemia hemoglobin E. PMID- 3291963 TI - Gallstones in thalassemia. PMID- 3291964 TI - Iron metabolism in thalassemia. PMID- 3291965 TI - Marrow transplantation for thalassemia major. PMID- 3291966 TI - Allogeneic marrow transplantation for thalassemia. PMID- 3291967 TI - Bone marrow transplantation in beta-thalassemia major with prevention of graft-vs host disease. PMID- 3291968 TI - Erythropoiesis following bone marrow transplantation for thalassemia major. PMID- 3291969 TI - Approaches to gene therapy for beta-thalassemia. PMID- 3291970 TI - Biologic screens for iron chelators. PMID- 3291971 TI - Pyridoxal isonicotinoyl hydrazone (PIH): a promising new iron chelator. PMID- 3291972 TI - [Spatial distribution and activity of excited neurons after penicillin administration to the nucleus gigantocellularis]. AB - The central part of the nucleus reticularis gigantocellularis was examined in experiments on white anesthetized rats by microelectrodes in the constant stereotaxic coordinates before and after penicillin microinjection. It has been established that normal spatial distribution of gigantocellular neurons was characterized by irregular disposition of the active neurons, i.e. most of them were observed in caudo-medial and central regions. Penicillin microinjection produced enhancement of the number of excited neurons and spatial redistribution of the density of active neurons in caudo-lateral and ventral regions. Correlation changes between three main types of neurons were found in nonsequential interval histograms (unimodal, bimodal and exponential). PMID- 3291973 TI - [Solid-phase immunoenzyme analysis of human placental alkaline phosphatase]. PMID- 3291974 TI - [Ultrastructural mechanisms of the effect of myelopeptides on brain lesions in rats receiving endotoxin and the role of receptor-mediated endocytosis]. AB - It has been demonstrated that myelopeptide is capable of preventing some ultrastructural alterations that take place in the brain in response to intravenous lipopolysaccharide injection by neuronal receptor blockade. PMID- 3291975 TI - The pathophysiology and clinical relevance of platelet heterogeneity. AB - Recent studies on platelet heterogeneity support the hypothesis that platelet production is regulated to maintain a constant functional platelet mass. In concept this form of regulation is analogous to the manner by which RBC production is controlled to maintain the oxygen-carrying capacity of blood. The platelet mass appears to correlate more closely with platelet function than the platelet count alone, since several factors in addition to the platelet count have been shown to influence the platelets' hemostatic function. These factors include platelet size, density, age, and previous hemostatic interactions. Application of these concepts to clinical problems has provided important insights into platelet physiology and reactivity. Failure to account for differences in platelet heterogeneity among individuals may introduce significant errors in the interpretation of data from laboratory and clinical investigations. However, despite advances, a number of practical issues remain to be resolved before measurements of platelet heterogeneity become accepted as routine clinical tests and are used in the diagnosis of pathologic states. PMID- 3291976 TI - Stimulation of hematopoiesis in patients with bone marrow failure and in patients with malignancy by recombinant human granulocyte-macrophage colony-stimulating factor. AB - Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a multipotential hematopoietin. To assess the toxicity and biological activity of recombinant human GM-CSF (rhGM-CSF) in vivo, 25 patients with malignancy or bone marrow failure were treated with rhGM-CSF (specific activity approximately 5 x 10(7) U/mg) as part of a phase 1 trial. The treatment was administered by continuous intravenous (IV) infusion daily for 2 weeks at fixed dose levels and repeated after a 2-week rest period. Over the entire dose range tested (15 to 500 micrograms/m2/d), rhGM-CSF treatment was associated with dramatic increases (two- to 70-fold) in total leukocyte counts, which consisted predominantly of neutrophils, bands, eosinophils, and monocytes. Furthermore, six of the 14 patients with one or more cytopenias that received at least two cycles of treatment had multilineage responses characterized by twofold or greater increases in platelet count to a level above 100,000, twofold or greater increases in corrected reticulocyte count, and a reduced requirement for red cell transfusions. Three of these patients became independent of both red cell and platelet transfusions for 17 to 37 weeks of follow-up. Treatment was associated also with an increase in bone marrow cellularity and frequency of cycling progenitor cells. The treatment was well tolerated; side effects included constitutional symptoms and bone pain. These results demonstrated that rhGM-CSF has a significant impact on hematopoiesis in patients with advanced malignancy and also in patients with bone marrow failure. PMID- 3291977 TI - Transforming growth factor beta inhibits the proliferation of the blast cells of acute myeloblastic leukemia. AB - The effect of transforming growth factor beta (TGF beta) on proliferation and differentiation of peripheral blast precursors in acute myeloblastic leukemia (AML) was investigated. TGF beta induced a dose-dependent inhibition of blast clonogenic cells in suspension and methylcellulose cultures in the presence of optimal concentrations of stimulators provided by conditioned media from the bladder cell line HTB9 (HTB9-CM) or the recombinant granulocyte-macrophage colony stimulating factor (GM-CSF). On removal of TGF beta, blast clonogenic cell proliferation recovers to the same level as that observed in control cultures, indicating that the effect is reversible. There was no induction of cell differentiation, as indicated by morphological and functional studies (production of superoxyde anions). Cell cycle analysis by thymidine uptake and flow cytometry with a DNA binding dye indicated that TGF beta caused a delay in progression into S and G2/M phases of the cell cycle without affecting cell viability. Thus, TGF beta appears to have a cytostatic rather than cytolytic effect on blast precursors and might therefore play a role as a negative regulator in hematopoiesis. PMID- 3291978 TI - KRDS--a tetrapeptide derived from lactotransferrin--inhibits binding of monoclonal antibody against glycoprotein IIb-IIIa on ADP-stimulated platelets and megakaryocytes. AB - Short peptides isolated from fibrinogen and K-casein have been shown to inhibit platelet aggregation and fibrinogen binding to stimulated platelets. We studied the effects of synthetic peptides occurring in milk proteins (bovine K-casein, KNQDK, and human lactotransferrin, KRDS) and in fibrinogen (RGDS and L10) on subsequent binding of monoclonal antibodies (MoAb) against the glycoprotein (GP) IIb-IIIa complex (AP2 and P2) on adenosine diphosphate (ADP)-stimulated and unstimulated human platelets and megakaryocytes (MKs) by using an immunoperoxidase method to visualize antibody binding. Only KRDS (900 mumol/L) inhibited the binding of AP2 and P2 on ADP (5 mumol/L)-stimulated platelets, but not on unstimulated platelets. However, the binding of P2 was considerably more inhibited than that of AP2 as judged by immunoperoxidase intensity. Radiolabeled AP2 binding was inhibited by 30% with KRDS on ADP-stimulated platelets as compared with platelets incubated in the absence of ADP. KRDS did not inhibit the binding of MoAbs against GP IIIa (SZ 21), GP IIb (SZ 22), and GP Ib (SZ 2) on ADP stimulated human platelets. Inhibition of P2 binding by KRDS was also observed in a section of MKs isolated from human bone marrow and stimulated by 15 or 20 micron ADP. A lower concentration of ADP (5 or 10 mumol/L) failed to produce any inhibition of binding. This indicates that MKs may not be equally responsive to agonists as platelets. Moreover, P2 binding inhibition was observed in a larger (P less than .001) percentage of mature MKs (29%) as compared with younger, maturing MKs (11%). The observations suggested that a functional ability possessed by platelets, namely, agonist-induced exposure of the site of interaction of KRDS, may occur at a late stage of MK development. PMID- 3291979 TI - Chemotherapy v marrow transplantation for adults with acute nonlymphocytic leukemia: a five-year follow-up. AB - We previously published the results of a prospective comparison of continued chemotherapy or marrow transplantation for adults with acute nonlymphocytic leukemia (ANL) who had achieved a first remission. This report updates that study now that greater than 5 years have passed since the last patient was entered. Among 86 patients eligible for comparison, 43 had no donors and were treated with continued chemotherapy, 43 had donors, but 10 declined transplantation and 33 were transplanted. Five-year disease-free survivals are 21% for the chemotherapy group, 48% for the transplant group, and 10% for the group with matched siblings who declined transplantation. PMID- 3291980 TI - Stimulation of murine colony-forming cells with high proliferative potential by the combination of GM-CSF and CSF-1. AB - Granulocyte-macrophage colony-stimulating factor (GM-CSF) has previously been shown to stimulate granulocyte, macrophage, and megakaryocyte lineages to act as an erythroid burst-promoting activity and to stimulate limited replication of spleen colony-forming cells. Here we demonstrate that murine GM-CSF alone or in combination with macrophage colony-stimulating factor (CSF-1) can stimulate colony-forming cells in bone marrow (BM) that have a high proliferative capacity. In cultures of BM from mice treated with 5-fluorouracil (FU) eight days before sampling, GM-CSF alone or in combination with CSF-1 stimulated the formation of large macrophage colonies with diameters greater than 0.5 mm. CSF-1 alone, at 800 units or greater, also stimulated larger colonies; however, these colonies were always less than 1.1 mm in diameter, whereas GM-CSF in combination with CSF-1 stimulated many colonies with diameters between 1 and 4 mm. At all doses of CSF-1 tested, the combination of factors resulted in a synergistic increase in colonies with diameters greater than 1.0 or 2.0 mm. Analysis of the incidence of colony forming cells in the BM of normal mice and mice 2, 4, 6, and 8 days after FU treatment demonstrated that the progenitor cells stimulated by GM-CSF alone or in combination with CSF-1 were depleted by FU treatment in vivo and regenerated more rapidly than did the macrophage progenitors (M-CFC) stimulated by CSF-1 alone. This is similar to the properties of the previously described high-proliferative potential, colony-forming cell (HPP-CFC) that is responsive to interleukin-3 plus CSF-1 but not the HPP-CFC stimulated by hematopoietin 1 plus CSF-1. These data suggest that GM-CSF plus CSF-1 act synergistically to stimulate a population of progenitor cells that have a high proliferative potential and have properties similar to those of the population of HPP-CFC stimulated by interleukin-3 plus CSF-1. PMID- 3291981 TI - The effect of stem cell proliferation regulators demonstrated with an in vitro assay. AB - Spleen colony formation after transplantation of bone marrow cells into irradiated mice has been used as an assay for hematopoietic stem cells (CFU-S), but has serious limitations intrinsic to an in vivo assay. In this report we describe experiments using an in vitro clonogenic assay that is especially suitable for studies of stem cell regulation as defined growth factors and normal untreated bone marrow can be used. We have demonstrated that the colony-forming cells have proliferative properties in common with CFU-S and respond to specific proliferation regulators previously detected using the spleen colony assay. PMID- 3291982 TI - Value of beta 2-microglobulin level and plasma cell labeling indices as prognostic factors in patients with newly diagnosed myeloma. AB - Beta 2-microglobulin (beta 2M) has been proposed as a prognostic factor in multiple myeloma (MM), but beta 2M levels are reported to correlate with other prognostic indicators such as stage and creatinine level. This study addressed the independent prognostic values of these and other variables, including plasma cell labeling indices (LI), in patients with newly diagnosed MM. beta 2M levels were measured with an enzyme-linked immunosorbent assay. LI were determined with a [3H]thymidine autoradiography method. By multivariate analysis and Kaplan-Meier survival analysis, the uncorrected beta 2M level remained the most significant prognostic factor after adjustment for age. Stage and creatinine level were closely related to beta 2M level and were no longer predictive of outcome after adjustment for age and beta 2M. Plasma cell LI varied independently of beta 2M level and remained predictive. A subset of patients with plasma-blastic myeloma had poor survival since beta 2M level and plasma cell LI were high. By using beta 2M level and LI, three risk groups were defined: low (beta 2M less than 4 micrograms/mL and LI less than 0.4%, median survival 48 months); intermediate (beta 2M less than 4 micrograms/mL and LI greater than or equal to 0.4%, median survival 29 months); and high (beta 2M greater than or equal to 4 micrograms/mL, median survival 12 months). Such grouping may better identify MM patients who might benefit from new treatment regimens. PMID- 3291983 TI - Asynchronous antigen expression in B lineage acute lymphoblastic leukemia. AB - Cell surface phenotypes of 113 B lineage acute lymphocytic leukemia (ALL) cases, defined by the presence of HLA-DR and at least one B-cell-specific antigen (either CD19, CD20, or CD22), were compared with antigen-defined stages of normal B lymphocyte development. The cases were first evaluated for expression of HLA DR, CD19, CD34, CD10, CD20, and CD22 by indirect one-color immunofluorescence. Pairwise comparisons of cell surface marker expression were performed for each leukemic sample: no correlations were observed for paired antigen expression on the leukemic samples using antigens expressed either early or late during normal B lymphoid development. Complete immunophenotypes of the cases were then compared with normal B-cell developmental stages. Sixteen different complete immunophenotypes were observed on the leukemias that were not found in normal marrow; at least 78% of the cases demonstrated such "asynchronous" combinations of B lymphoid-associated differentiation antigens. Several samples were subsequently studied by two-color immunofluorescence, and the presence of doubly labeled cells with "asynchronous" antigen combinations was confirmed. These results indicate that the majority of B lineage leukemias exhibit "developmental asynchrony," as compared with normal marrow B cells. The data further suggest that ALL cases do not accurately represent cells arrested at the stage where the leukemogenic event occurred. Rather, ALL appears to be a disease in which there may be maturation of leukemic blasts; but this maturation is "asynchronous" when compared with the normal developmental process. PMID- 3291984 TI - Antimalarial properties of orally active iron chelators. AB - The appearance of widespread multiple drug resistance in human malaria has intensified the search for new antimalarial compounds. Metal chelators, especially those with high affinity for iron, represent one presently unexploited class of antimalarials. Unfortunately the use of previously identified chelators as antimalarials has been precluded by their toxicity and, in the case of desferrioxamine, the necessity for parenteral administration. The investigators now report that a new class of orally active iron chelators, namely the derivatives of alpha-ketohydroxypyridines (KHPs), are potent antimalarials against cultured Plasmodium falciparum. The KHPs evidently exert this effect by sequestering iron because a preformed chelator:iron complex has no antimalarial action. The pool(s) of iron being sequestered by the chelators have not been identified but may not include serum transferrin. Preincubation of human serum with KHPs followed by removal of the drug results in the removal of greater than 97% of total serum iron. Nonetheless, this serum effectively supports the growth of P falciparum cultures. Therefore the KHPs may exert antimalarial effect through chelation of erythrocytic rather than serum iron pool(s). The investigators conclude that these powerful, orally active iron chelators may form the basis of a new class of antimalarial drugs. PMID- 3291985 TI - A test for Fanconi's anemia. PMID- 3291986 TI - Effects of insulin and insulin-like growth factor I on growth of human leukemia cells in serum-free and protein-free medium. AB - Human myeloid leukemia cells (HL60) and malignant lymphocytes (Namalwa) were grown in protein-free, Fe-supplemented media and used to study growth responses to insulin and insulin-like growth factor 1 (IGF-I). HL60 cells previously grown in serum-free medium containing microgram quantities of insulin showed an 18-fold reduction in cumulative cell production when grown without insulin. However, the same cells showed reduced or absent growth stimulation with 1 to 100 ng/mL insulin or IGF-I for at least four days following insulin deprivation, indicating that culture conditions modified insulin and IGF-I responses. When the same cells were grown in Fe-supplemented, protein-free medium (RPMI-Fe), insulin and IGF-I caused dose-dependent stimulation of HL60 cell growth with half-maximal stimulation at nanogram concentrations. Namalwa cells grown in protein-free medium showed no response to either hormone. Radioligand binding showed the presence of insulin and IGF-I receptors on both HL60 and Namalwa cells grown in RPMI-Fe. HL60 cells grown in fetal bovine serum had higher, and cells grown with microgram quantities of insulin dramatically reduced, insulin binding. Competitive binding studies and cultures with anti-IGF-I receptor antibody showed insulin and IGF-I stimulated growth through their respective specific receptors. Both insulin and IGF-I stimulate growth of some cultured human leukemia cells, but the presence of insulin or IGF-I receptors alone does not predict growth responses. Culture conditions affect both cellular responses and ligand binding by these hormones and must be closely controlled to study growth responses. PMID- 3291987 TI - Partial chimerism after T-cell-depleted allogeneic bone marrow transplantation in leukemic HLA-matched patients: a cytogenetic documentation. AB - We evaluated serially by cytogenetics the blood and marrow chimerism of 38 leukemic recipients of HLA-matched bone marrow transplants (BMT) who were prepared by high doses of alkylating agents and fractionated total-body irradiation (2.2 Gy X 5). Donor or host mitoses were identified by examination of sex chromosomes in 32 patients or by evaluation of the polymorphism of other chromosomes after specific banding in six patients. Twenty-four patients were recipients of untreated BMT, and 14 were recipients of T-cell-depleted BMT. In the 24 patients who received untreated BMT, all showed successful engraftment, and only three had a transient mixed chimera. In the 14 recipients of T-cell depleted BMTs, four rejected their grafts, and seven had mixed chimeras; these mixed chimeras were more frequent in blood lymphocytes than in marrow cells and could be detected up to 26 months after BMT. This high frequency of partial chimerism after T-cell-depleted BMT by comparison with a control group suggests that the donor's T cells play an important role in the eradication of host residual hematopoiesis after allogeneic BMT. PMID- 3291988 TI - Bone marrow origin of a B-cell lymphoma. AB - To search for precursors of the neoplastic B cells in a patient with a nodular lymphoma, we produced a monoclonal antibody to a variable region idiotope on the lymphoma IgM heavy chain. Clonal ancestors of the lymphoma cells were identified by this marker among bone marrow pre-B cells (5% to 26%). A second antiidiotype (anti-Id) antibody specific for the complete lymphoma IgM kappa recognized 10% of B cells in bone marrow and blood and greater than 95% of B cells in lymphomatous lymph nodes, including one obtained after tumor conversion to a diffuse large cell lymphoma. Immunoglobulin gene analysis surprisingly revealed expansion of multiple clones of early B lineage cells in bone marrow, including members of the neoplastic clone. The data suggest that this lymphoma arose through a progression of transformational events beginning in bone marrow: first, creation of an oligoclonal pre-neoplastic pool of pre-B cells, subsequent conversion of a single subclone into low grade neoplastic B cells that homed to the lymph node follicles, and later progression to a more invasive form of the B-cell lymphoma. PMID- 3291989 TI - Retrovirus mediated gene transfer into hemopoietic cells. PMID- 3291990 TI - Lymph node morphology after allogeneic bone marrow transplantation for chronic myeloid leukemia: a histological and immunohistological study focusing on the phenotype of the recovering lymphoid cells. AB - A histological and immunohistological analysis of lymph nodes after allogeneic bone marrow transplantation (BMT) was performed to investigate the microarchitecture of the lymphatic tissue and the phenotype of the recovering lymphoid cells. The study included four patients with chronic myeloid leukaemia who had died between 0.5 and 12 months after transplantation. The study yielded the following results: 1. All lymph nodes, irrespective of length of the survival period, exhibited severe atrophy of the lymphoreticular tissue with marked depletion of lymphocytes and dilatation of the sinuses. The number of lymphoid cells increased considerably with time after transplantation. 2. The main constituents of the recovering immune system were mature T lymphocytes (CD4+ and CD8+ cells in nearly equal numbers) and macrophages. The earliest signs of recovery of the immune system could already be detected 0.5 month after BMT. 3. Extreme paucity of B lymphocytes was a prominent finding in all lymph nodes studied. True lymphatic follicles and germinal centres were never detected. 4. Polytypic plasma cells were seen in low or moderate numbers mainly in the lymph node sinuses, while neither marked plasmacytic hyperplasia nor even a monotypic pattern were found. 5. Immune-accessory reticulum cells were detected only in the lymph nodes of the patient who survived 12 months. 6. Natural killer cells occurred only in low numbers irrespective of the duration of survival after BMT. Altogether, the histopathological lymph node findings clearly reflect the marked long-standing depression of the immune responses seen after allogeneic bone marrow transplantation. Since three of the four patients had shown signs of acute or chronic graft-versus-host disease, the histological findings presumably do not fully reflect the normal reconstitution of the immune system, but may have been modified by phenomena related to graft-versus-host disease. PMID- 3291992 TI - Index: Volumes 31-40. PMID- 3291993 TI - Endocrine changes in the critically ill. AB - The onset of critical illness is associated with profound changes in the endocrine system. Stress hormones, particularly the catecholamines, mediate characteristic compensatory responses which increase the probability of survival in the short term. However, adverse metabolic effects may occur when the stress response is prolonged. This article describes the hormonal response to critical illness. PMID- 3291991 TI - Fractionated total body irradiation and high dose cyclophosphamide: a preparative regimen for bone marrow transplantation for patients with hematologic malignancies in first complete remission. AB - We treated 73 patients with hematologic malignancies in first complete remission (acute lymphoblastic leukemia = 23 patients; acute non-lymphoblastic leukemia = 25 patients; chronic myelogenous leukemia in first chronic phase = 20 patients, and high grade lymphoma = five patients) with a uniform preparative regimen consisting of fractionated total body irradiation (1,320 cGy) and high dose cyclophosphamide (100 mg/kg), followed by allogeneic bone marrow transplantation. By radiation dosimetry we demonstrated that the calculated doses were delivered accurately and reproducibly. Actuarial survival rates (+/- SEM) in complete remission were as follows: Acute lymphoblastic leukemia = 74 +/- 9%; acute nonlymphoblastic leukemia = 50 +/- 11%; and chronic myelogenous leukemia = 55 +/- 11%. Actuarial relapse rates for these three diagnoses were 19 +/- 9%, 17 +/- 11%, and 0% respectively. Three of the five lymphoma patients are alive in complete remission at 22+, 28+, and 54+ months. Overall probability of survival for the 73 patients was 59 +/- 7%. Interstitial pneumonia, usually associated with cytomegalovirus infection and graft-versus-host disease, and relapse of the underlying malignancy were the major causes of death. PMID- 3291994 TI - Paediatric radiology 1: gastrointestinal tract. AB - Clinical symptoms in the infant differ from those in the adult in that they are most likely to have a congenital or developmental cause. These symptoms are discussed together with the history and imaging techniques most likely to reveal their cause in the gastrointestinal tract. (The genitourinary and respiratory tracts will be dealt with separately in future articles in this series.) PMID- 3291995 TI - Carbon monoxide poisoning: forgotten not gone! AB - Carbon monoxide causes one third of all poisoning deaths in Britain. In this paper a modern scheme for the assessment and management of victims of carbon monoxide poisoning is outlined, the importance of the direct cellular toxicity of carbon monoxide and the rationale behind hyperbaric oxygen therapy are discussed, and a list of currently available hyperbaric facilities is given. PMID- 3291996 TI - Vancomycin. AB - Vancomycin is an important antibiotic for the treatment of severe Gram-positive infection, especially in cases with resistant organisms or when the patient is allergic to penicillin. Because of its mode of action, pharmacokinetics and side effects, close liaison with the medical microbiologist is necessary. PMID- 3291997 TI - Anger control. AB - Anger is a poorly understood but very common emotion. When it is misdirected or uncontrolled it becomes dangerous. An analysis of anger and a treatment paradigm is presented, and we outline a research project in which we are using the approach with a group of mentally handicapped adults. PMID- 3291998 TI - Prostacyclin biosynthesis and reduced 5-HT uptake after complement-induced endothelial injury in the dog isolated lung. AB - 1. Pulmonary prostacyclin (PGI2) biosynthesis was evaluated in relation to endothelial integrity before and after complement activation in isolated plasma perfused lung lobes of the dog. 2. The plasma was activated with zymosan (ZAP, n = 4), yeast cells (YAP, n = 4) or yeast with 3 microM indomethacin (Indo + YAP, n = 3). Immunoreactive 6-oxo-prostaglandin F1 alpha (i-6-oxo-PGF1 alpha) and thromboxane B2 (iTXB2) were measured to monitor PGI2 and TXA2 biosynthesis. 3. The kinetic parameters Km and Vmax of 5-hydroxytryptamine (5-HT) uptake were calculated on the basis of multiple indicator diffusion data to evaluate endothelial integrity. 4. YAP and ZAP induced a biphasic increase of the arterial perfusion pressure. The immediate pressure peak was partly mediated by TXA2 and the TXB2 was subsequently cleared by the lung. 5. The apparent Vmax of 5-HT uptake remained constant throughout the experiment. Thus, complement activation did not affect the number of endothelial 5-HT carrier sites available to the perfusate. 6. The apparent Km of 5-HT uptake was enhanced in 9 lungs exposed to activated plasma complement for 20 min. This decreased affinity for 5-HT probably reflects endothelial injury. It was transient as the apparent Km had returned to the baseline value after 60 min. 7. PGI2 clearance and biosynthesis were virtually absent in the control period. PGI2 formation increased drastically after infusion of ZAP or YAP and was proportional to the endothelial injury expressed as elevated Km or pulmonary oedema. Thus, PGI2 biosynthesis might be a marker of severe endothelial distress. PMID- 3291999 TI - Quantitative autoradiography of [3H]-MK-801 binding sites in mammalian brain. AB - 1. An in vitro receptor autoradiography procedure is described for visualizing binding sites for the excitatory amino acid antagonist radiolabelled MK-801, in rat and gerbil brain sections. 2. Ten micron sections were labelled by incubation at room temperature for 20 min in 30 nM [3H]-MK-801. This was followed by 2 rinses for 20 s in fresh buffer solution. Specifically bound ligand determined with 100 microM unlabelled MK-801 amounted to 55-60% of total. 3. Phencyclidine, (+/-)-SKF 10047, ketamine and 2-aminophosphonovaleric acid (APV) (all 100 microM) prevented the specific binding of [3H]-MK-801. L-Glutamate and N-methyl D aspartate (NMDA) (100 microM) had no effect. However, L-glutamate prevented the inhibition by APV. 4. The highest concentrations of [3H]-MK-801 binding sites occurred in the hippocampal formation, cerebral cortex, olfactory bulb and thalamus. Very low levels were detected in the brain stem and cerebellum. 5. The distribution of [3H]-MK-801 binding sites was comparable to that of NMDA sites and phencyclidine sites (labelled with [3H]-TCP) but not with high-affinity sigma sites labelled with [3H]-3-PPP. 6. The density of [3H]-MK-801 binding sites in the gerbil hippocampus was examined 1, 2, 6 and 22 days after unilateral carotid artery occlusion for 10 min. Only at 6 and 22 days was the binding reduced (by 36% and 46% respectively) in the CA1 region whereas a significant neuronal loss was apparent at day 2. In CA2 a decrease in binding was only evident at day 22. 7. These results indicate that binding sites for [3H]-MK-801 can be detected in mammalian brain sections by receptor autoradiography. Their distribution supports an association with the NMDA receptor complex and the loss in the hippocampus after carotid artery occlusion indicates their presence on pyramidal cells is vulnerable to ischaemic insult. PMID- 3292000 TI - Modification by steroids of pulmonary oedema and prostaglandin E2 pharmacokinetics induced by endotoxin in rats. AB - 1. A single i.p. injection of bacterial endotoxin in rats (3.5 mg kg-1) caused lung injury assessed as changes in lung dry:wet weight ratio and leukopaenia over the subsequent 28 h. 2. This treatment also slowed the efflux of 14C from [14C] prostaglandin E2 (PGE2), i.e., increased t1/2 and increased the survival of PGE2 in isolated perfused lungs over the same period. 3. These effects of endotoxin were reversed by methylprednisolone (30 mg kg-1), given 30 min after the endotoxin. 4. Another synthetic corticosteroid, budesonide (1.2 mg kg-1) given 1 h before endotoxin partially prevented the lung injury and leukopaenia but did not affect the increased t1/2 for PGE2 nor its survival. 5. The reversal by methylprednisolone of both the physical signs of lung injury and the changes in PGE2 pharmacokinetics caused by endotoxin suggests that changes in PGE2 pharmacokinetics could serve as an index of acute lung injury following sepsis. PMID- 3292001 TI - The young Moynihan. PMID- 3292002 TI - No-touch isolation technique in colon cancer: a controlled prospective trial. AB - In order to assess the effect of the no-touch isolation technique, in the treatment of large bowel cancers, on the site of first recurrence and disease free and overall survival, 236 patients were prospectively and randomly assigned to either the no-touch isolation technique (117 patients) or to a conventional resection technique (119 patients). No patient with distant metastases or unresectable disease entered the study. The two treatment groups were comparable with regard to patient characteristics. Pre- and postoperative complications (including mortality within 30 days) were similar in both groups. After a complete follow-up of 5 years, a tendency for reduction in the number of, and time to, occurrences of liver metastases was seen in the no-touch isolation group (P = 0.14). This effect was most obvious in the sigmoid colon with angio-invasive growth. Overall (P = 0.42) and corrected (P = 0.25) survival did not differ significantly among the treatment groups although in every analysis the survival data of the no-touch isolation group were superior. The data do suggest a limited benefit of the no-touch isolation technique. This observation is important since the morbidity and mortality of surgery were equal in both groups. PMID- 3292003 TI - Cerebral angiography for cerebrovascular disease: the risks. AB - Cerebral angiography is still suggested as a first line investigation for patients with putative transient ischaemic attacks (TIA) and it is considered by most surgeons as a necessary prelude to carotid endarterectomy. That conventional cerebral angiography involves risk is well known, although the magnitude of this risk is not. Prospective studies of cerebral complications from this technique, published over the last decade, have been analysed to show that the major stroke rate after conventional cerebral angiography for patients with TIAs is likely to be about 2.4 per cent. This must be taken into account if the true morbidity of carotid endarterectomy is to be appreciated (assuming conventional angiograms have been used). Furthermore, since many sufferers are assessed by angiography but not submitted to surgery, a policy of conventional angiography for patients with TIAs puts a far greater number at risk than that actually having carotid endarterectomy. PMID- 3292004 TI - Clinical application of the cholecystokinin provocation test. AB - This paper reviews the value of administration of cholecystokinin (CCK) in the assessment of patients thought to have acalculous biliary pain. The literature contains conflicting reports and there is no unequivocal evidence to support the use of CCK provocation tests as a basis for deciding the need for cholecystectomy. PMID- 3292005 TI - Subcostal incision versus midline laparotomy in gallstone surgery: a prospective and randomized trial. AB - We report the results of a prospective and randomized trial designed to study the incidence of abdominal and pulmonary complications in gallstone surgery comparing subcostal (SI) with midline incision. The need for postoperative analgesia was lower in the SI group. There was no difference in the degree of hypoxaemia in the first two postoperative days, but there was less impairment of pulmonary function in terms of vital capacity and forced expiratory volume in 1 s (P less than 0.0001) in the SI group. SI patients also had a lower incidence of pulmonary or abdominal complications but the difference was not significant. Finally, we found a reduced hospital stay for the SI patients (P less than 0.01), probably related to a reduced postoperative analgesic requirement and an improved pulmonary function. We conclude that subcostal incision is a better approach for biliary tract surgery and should be used whenever possible. PMID- 3292006 TI - Identification of the hypothalamic site through which locus coeruleus axons decussate to reach and stimulate contralateral LH-RH neurons. AB - Recently we reported that locus coeruleus (LC) electrical stimulation (ES) amplifies the quantity of LH released after prior medial preoptic nucleus (MPN) electrochemical stimulation (ECS). In these studies we also observed that amplification of LH release occurred only when we activated those LC neurons whose cell bodies reside contralateral to the site of MPN-ECS. Seemingly, stimulatory LC axons decussate to reach contralateral hypothalamic regions which contain LH-RH neurons. The purpose of the present study was to identify the site(s) at which such decussation(s) occur. To accomplish this we used a special knife blade to make gross transsections in hypothalamic regions previously described by others as regions where LC decussations occur. Transection 1 (T1) interrupted axons coursing through the medial forebrain bundle (MFB) in the region of the posterior lateral hypothalamus. This transection was placed ipsilateral to the side of LC-ES and it had no effect on LH patterns or concentrations which were released by MPN-ECS. However, T1 completely blocked the amplifying effects of LC stimulation on LH secretion after MPN-ECS. Transection 2 (T2) was placed in the region of the MPN, parallel to the superior sagittal sinus. The knife blade was lowered in midline to the top of the 3rd ventricle and transected all fibers which cross midline within and around the anterior commissure. LH release following MPN-ECS was not appreciably affected in these rats nor did T2 alter the amplifying effects of LC-ES on LH. However, while plasma LH peaked between 60 and 75 min and then declined towards baseline in MPN + LC-stimulated rats, it remained significantly elevated throughout the remainder of the blood collection periods (180 min) in rats receiving combined MPN + LC and T2. Transection 3 (T3) also was placed in the MPN region and differed from T2 only in that we lowered the knife to the base of the sphenoid bone. Thus, T3 disrupted all fibers which cross midline in the AC region and dorsal to the optic chiasm (dorsal supraoptic decussation of LC axons). This transection did not affect LH release evoked by MPN-ECS but completely eliminated the amplifying effects of LC stimulation after MPN-ECS on LH secretion. These data indicate that stimulatory LC axons which affect LH-RH neuronal activity enter the hypothalamus ipsilateral to the site of LC-ES and then project rostrally in the MFB to the lateral preoptic area.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3292007 TI - Visualisation of CGRP and ChAT-like immunoreactivity in identified trigeminal neurones by combined peroxidase and alkaline phosphatase enzymatic reactions. AB - We report here a method that allows simultaneous visualisation of two antigens within single neurones. In essence this involves the combined use of horseradish peroxidase and alkaline phosphatase reactions to visualise two markers. Using this method we show that ChAT-and CGRP-like immunoreactivity can be co-localised within single neurones of the V to VII motor nuclei. In the case of the V motor nucleus, we show that each marker can be localised in motoneurones labelled with horseradish peroxidase. PMID- 3292008 TI - N-methyl-D-aspartic acid-induced lethality in mice: selective antagonism by phencyclidine-like drugs. AB - N-Methyl-D-aspartic acid (NMDA) produced a dose-related increase in lethality in mice, with 200 mg/kg (i.p.) effecting 100% lethality. Upon daily dosing, acutely sublethal doses of NMDA produced deaths. This NMDA-induced lethality was stereoselective; N-methyl-L-aspartic acid had no effects at doses as high as 400 mg/kg. Moderate doses of phencyclidine (PCP) and drugs having PCP-like behavioral effects blocked the NMDA-induced lethality. Other classes of psychoactive drugs, including opioids, anticonvulsants and antipsychotics, were ineffective in preventing NMDA-induced lethality. The potency of PCP-like drugs to block the NMDA-induced lethality correlates highly with the dose necessary to produce PCP like catalepsy and PCP-like discrimination in pigeons. These data support the hypothesis that PCP-like drugs produce many of their effects by impairing the normal functioning of the NMDA-defined excitatory neurotransmitter receptor in the central nervous system. PMID- 3292009 TI - Estimating the number of granule cells in the dentate gyrus with the disector. AB - A practical example is given of how a newly developed stereological estimator of particle number, the disector, can be used to make estimates of neuron number in the dentate gyrus of rats. The estimates are free of biases related to lost caps, overprojection and assumptions about size, shape and orientation of the objects that are counted. The disector principle and the practical considerations relating to histological preparations and sampling are presented. PMID- 3292010 TI - Some properties of membrane current fluctuations induced by kainate, quisqualate, and NMDA in cultured septal neurons of rat. AB - Ionic currents induced by glutamate, kainate, quisqualate, and N-methyl-D aspartate (NMDA) in cultured septal neurons were analyzed by fluctuations analysis. The power spectrum (PWS) of NMDA current fluctuations always fitted a single Lorentzian. PWSs of the other agonists fitted the sum of two Lorentzians; however, the slopes of PWSs became larger and the PWSs became closer to single Lorentzians as the number of drug application increased. This may be explained in such a way that, in multiple conductance channels activated by these agonists, the high frequency component decreases the gating activity in later recordings, whereas the low frequency component keeps its gating kinetics. PMID- 3292011 TI - Possible origins of cerebrovascular nerve fibers showing vasoactive intestinal polypeptide-like immunoreactivity: an immunohistochemical study in the dog. AB - Changes of vasoactive intestinal polypeptide-like immunoreactivity (VIP-LI) in perivascular nerve fibers of the major cerebral arteries were examined immunohistochemically in the dog. The density of cerebrovascular nerve fibers showing VIP-LI (the average number of nerve fibers with VIP-LI in a unit area of the major cerebral arteries) was estimated, by using whole-mount preparations after extirpation of the pterygopalatine, otic or superior cervical ganglion. After pterygopalatine ganglionectomy, the density was markedly decreased in major cerebral arteries of both anterior circulation (the anterior cerebral and middle cerebral arteries) and posterior circulation (the basilar, superior cerebellar, posterior cerebral and posterior communicating arteries). After otic ganglionectomy, the density was moderately reduced in the major arteries of the posterior circulation, but was not decreased in those of the anterior circulation. After superior cervical ganglionectomy, the density was decreased markedly in the major cerebral arteries of the posterior circulation, and moderately in those of the anterior circulation. The results also indicate that the pterygopalatine, otic and superior cervical ganglia supply perivascular nerve fibers showing VIP-LI to the major cerebral arteries bilaterally with an ipsilateral dominance. PMID- 3292012 TI - [Morphologic variants of IgA nephropathy]. PMID- 3292013 TI - [A professional literature archive using a personal computer]. PMID- 3292014 TI - A study of renal damage in seriously burned patients. AB - The incidence of acute renal failure (ARF) in severely burned patients ranges from 1.3 per cent to 38 per cent and this complication has always been associated with a high mortality rate, of between 73 and 100 per cent. At present the exact mechanisms responsible for the onset of this complication are not well known. In order to elucidate some of these mechanisms, 20 patients with severe burns were studied for 1 year in an attempt to assess the prevailing glomerular or tubular localization of renal damage; the organic or functional pattern of renal damage and the reliability and possible prognostic significance of some renal function indices. These included the fractional excretion of sodium (FeNa), the alpha glucosidases, the leucine aminopeptidases (LAP) and the serum and urine beta 2 microglobulin. The incidence of ARF in the patients studied was 26 per cent and in all cases it was of polyuric type. We believe that renal damage very often remains undetected when the traditional testing methods are used and that only in some patients does it become severe enough to result in ARF. In contrast, some of the tests considered in our study are extremely useful and reveal an impairment of renal function long before it becomes clinically apparent. PMID- 3292015 TI - Morphological changes of intermingled skin transplants on rats. AB - Experiments with rats demonstrate that free skin transplants between genetically distinct strains become totally rejected after no longer than 3 weeks. In intermingled skin transplants, however, the autogenic epidermis directly covers the allodermis, which results in a definitively covered wound with a mostly normal skin texture. It seems that during the first phase after the burn the allodermis is accepted as donor skin. In the second phase it becomes covered by the epidermis and surrounded by the connective tissue of the recipient. During this process all structures of ectodermal origin like skin adnexa are rejected. Since for the most part the elastic fibres in the allograft remain unchanged after a successful intermingled skin transplantation, the transplant shows elasticity similar to a mesh autograft, but it is incapable of regenerating skin adnexa. After complete healing cellular and humoral infiltrates, as in the case of immunological rejections, could no longer be detected. PMID- 3292016 TI - Burns and the toxic effects of a derivative of hydrazine. AB - Comments are presented on a case history of extensive burns associated with 1,1 dimethylhydrazine (UDMH) toxicity in a 31-year-old man. Neurological symptoms dominated early developments. Specific treatment with pyridoxine, while begun late, effected a quite rapid resolution and the subsequent progression of treatment was straightforward. In reviewing previous reported findings, the authors have clarified the distinctive characteristics of UDMH toxicity, the methods for its detection and modes of treatment. They draw conclusions, based on problems encountered, linked to the exceptional character of acute UDMH toxicity especially in its association with extensive burns. PMID- 3292017 TI - The toxic shock syndrome in a burn victim. AB - A case of toxic shock syndrome (TSS) in a 6-year-old boy with a 5 per cent body surface area partial thickness scald burn is reported. Biobrane was the wound dressing used initially. The clinical and laboratory characteristics of the syndrome are listed. The syndrome is caused by an exotoxin of Staph. aureus and can occur in the absence of invasive infection. The syndrome, first described in menstruating women who used tampons, has occurred in patients with a variety of wounds. Reports of the TSS syndrome in burn victims are limited to children whose wounds were covered. Children are most vulnerable to the development of TSS because of their limited prior exposure to the toxin. PMID- 3292018 TI - Warfarin-induced skin necrosis: an entity occasionally requiring burn wound expertise. AB - We describe a severe case of warfarin-induced skin necrosis with extensive full thickness tissue loss involving approximately 12 per cent of the body surface area. The early management was conservative, with wound observation only, and no aggressive debridement was attempted. Wound and associated systemic sepsis followed, and the patient was transferred to our burn unit. The wounds were then managed with aggressive therapy including surgical excision, temporary coverage with allograft, and final closure with split-thickness autograft. This case illustrates important principles of appropriate surgical management of extensive skin lesions of this type. PMID- 3292019 TI - 'Baby-walker' frames: a preventable factor in infant burns. PMID- 3292021 TI - Current considerations in respiratory and acid-base management during cardiopulmonary resuscitation. PMID- 3292022 TI - Pathophysiology and assessment of sepsis and septic shock. PMID- 3292020 TI - Tangential excision of scalp burns: experience from the Bradford fire disaster. AB - Tangential excision of deep dermal scalp burns does not appear to be widely practised. During the Bradford Football fire victims sustained mixed depth scalp burns. These were mainly as a result of radiant heat, although falling molten bitumen was the cause of injury in a few patients. Deep dermal or full thickness burns of the scalp were tangentially excised and skin grafted. One patient did not have a graft applied after tangential excision. The early results of graft take were satisfactory. Subsequently, however, 56 per cent required further grafting; the reasons for this are discussed. Ten months after the incident there is no difference in appearance between areas of primary grafting and areas of secondary healing. PMID- 3292023 TI - Oral manifestations of human immunodeficiency virus infection. Recognition and diagnosis. PMID- 3292024 TI - Oral management of individuals with human immunodeficiency virus infection. PMID- 3292025 TI - Increase in Quebec dental manpower and demand for dental care from 1971 to 1985. PMID- 3292026 TI - Permanent mesiodistal tooth size of French-Canadians. PMID- 3292027 TI - Magnification devices for the presbyopic dentist. PMID- 3292028 TI - Wounds of the abdomen. Part 1: In war. AB - Until the turn of the 20th century, penetrating wounds of the abdomen in war were treated conservatively, with a very high death rate. Survivors were those who recovered from or escaped hemorrhage and shock, were fortunate enough to avoid vital organ injury and lived in spite of wounds of the viscera complicated by a high incidence of sepsis. Laparotomy could not be justified as the treatment of choice until World War I when anesthesia, intravenous administration of fluids, blood for transfusion and antisepsis were available. Even so, death rates at the close of that war were 60%. It has become increasingly apparent with each successive war that the progressive reduction in morbidity and mortality in penetrating abdominal wounds depends not only on the quality of the surgery but also on advanced life support on the battlefield and early, direct evacuation to field hospitals where intensive resuscitation, skilled anesthesia and comprehensive postoperative care are available. PMID- 3292029 TI - French contribution to vascular surgery. PMID- 3292030 TI - Snapping scapula: a review of the literature and presentation of 14 patients. AB - The syndrome of pain at the vertebral edge of the scapula and snapping associated with movement of the shoulder that occurs spontaneously after trauma or surgical procedures to the shoulder girdle is relatively common. The snapping is described in the literature as being due to an exostosis on the undersurface of the vertebral angle of the scapula, which rides across the rib cage. The pain has been reported to be the result of inflamed bursae located between the scapula and adjacent thorax or over the scapular exostosis. This retrospective study of a small group of patients with the syndrome attempts to define, by detailed x-ray studies, the presence or absence of exostosis at the vertebral angle. In none of these cases was a bony abnormality or exostosis identified clinically or radiologically. The irritating symptoms can be relieved by physiotherapy; surgery is unnecessary. PMID- 3292031 TI - Aneurysm of a common digital artery: case report and literature review. AB - The authors' recent experience of a 46-year-old woman with an aneurysm of a common digital artery led them to review the appropriate treatment for this rare condition. They found only one other reported case. In most reports on aneurysms of hand vessels, the aneurysm is of traumatic origin, but this was not the case in their patient. For such a rare condition, the authors emphasize the need for acute awareness of its possibility, angiography to evaluate the collateral circulation and early excision to relieve symptoms and avoid neurologic damage. PMID- 3292032 TI - Management of general surgical problems after cardiac transplantation. AB - Over a 6-year period at the University Hospital in London, Ont., 101 patients underwent heart transplantation and 5 heart-lung transplantation. The authors review the general surgical problems identified from the charts of 13 of these patients. In the early postoperative period (within 30 days), laparotomy was required for pancreatitis (one), perforated peptic ulcer (two), cholecystectomy (one), pancreatic cyst (one) and appendicitis (one). In addition, a spontaneous colocutaneous fistula and spontaneous pneumoperitoneum occurred; both were managed conservatively. Later, three patients required cholecystectomy; one underwent a below-knee and a Symes amputation for dry gangrene and one surgical correction of a lymphocele. The incidence of surgical problems (13%) indicates an increased susceptibility in this group of patients. Four of the 13 patients died. Pancreatitis is a well-recognized complication of cardiac surgery; it is frequently associated with a normal or only slightly elevated serum amylase level, making a definitive diagnosis without laparotomy almost impossible. Persistence of abdominal signs should signal the need for exploratory surgery. During the early postoperative period and in the absence of multiorgan failure, immediate operation for an acute abdomen is usually successful. Despite the additional risk, cardiac transplantation does not preclude later surgery, but immunosuppression must be continued and carefully monitored. PMID- 3292033 TI - Eosinophilic granuloma of bone. AB - This is a review of 48 patients registered in the University of British Columbia Bone Tumour Registry as having eosinophilic granuloma, with emphasis on the historical development, treatment and results. Comments on the place of scintigraphic imaging are included. Eosinophilic granuloma in its solitary form is a self-limiting disease requiring no treatment. It can, however, progress to multifocal disease or the historically important triad known as Hand-Schuller Christian syndrome. There is some evidence that it may have an immunologic basis, but the authors have little new to offer with respect to its etiology. PMID- 3292034 TI - The use of vitamin K in the perinatal period. Fetus and Newborn Committee, Canadian Paediatric Society. AB - The incidence of hemorrhagic disease of the newborn (HDNB) can be expected to increase in Canada as breast-feeding becomes more popular. There are three clinical patterns of hemorrhagic disease: early HDNB (usually related to maternal drug ingestion), classic HDNB (related to breast-feeding) and late hemorrhagic disease of infancy (related to the combination of breast-feeding and diseases that cause fat malabsorption). Despite the knowledge that the disease can virtually be prevented by the administration of vitamin K, not all newborns are being routinely considered for such treatment. The Canadian Paediatric Society has made several recommendations: (a) women who take drugs that interfere with vitamin K1 metabolism should receive oral doses of vitamin K1 daily for a minimum of 2 weeks before expected delivery; (b) all healthy term infants should receive a single dose of vitamin K1, orally or intramuscularly, within 6 hours after birth; (c) all other newborns, including preterm, low-birthweight and sick infants, should receive a single intramuscular dose of vitamin K1 within 6 hours after birth; and (d) infants at high risk for secondary late-onset hemorrhagic disease due to fat malabsorption should receive vitamin K1 orally every day or intramuscularly once a month. PMID- 3292036 TI - B lymphocytic lymphoma (large cell) of possible splenic marginal zone origin presenting with prominent splenomegaly and unusual cordal red pulp distribution. AB - Two cases of large cell lymphoma, B-cell type, primarily involving the red pulp of the spleen rather than the white pulp are described. A number of unusual features suggest that this may be a lymphoma originating from a distinct splenic B-cell lymphocyte whose origin may be the marginal zone of the spleen or the splenic cords. The patients presented with splenomegaly, cytopenias, and no peripheral lymphadenopathy. The gross appearance of the spleens was beefy red without tumor nodules. The tumor cells were primarily in the splenic cords and surrounding residual normal white pulp. There was a minimal hemic phase. The tumor cells had abundant cytoplasm, surface IgM, IgD, kappa, and FC receptors, tartrate-resistant acid phosphatase, but no alkaline phosphatase or interleukin-2 receptors. They had a similar DNA aneuploidy. The most unusual feature was that tumor cells in both cases had phagocytic properties. These lymphomas may be clinically more indolent than their follicular center counterparts. PMID- 3292035 TI - Augmentation of anticancer effect with angiotensin II in intraarterial infusion chemotherapy for breast carcinoma. AB - We investigated the effect of angiotensin II (AT II) on blood flow in breast cancer patients using 81mKr and found that it increased tumor blood flow 2.3-fold while decreasing blood flow in adjacent normal tissue 0.7-fold. We, then, used AT II in conjunction with intraarterial infusion chemotherapy (IAC) for locally advanced breast cancer in order to increase drug delivery to the tumor and enhance its anticancer effect. Eleven patients (from 1976-1981) received IAC with doxorubicin through the internal thoracic and subclavian arteries, alternately, for 10 days (AT II- group). Twenty-four patients (from 1981-1985) received IAC with doxorubicin and concomitant infusion of AT II (1.3 micrograms/min through the internal thoracic artery and 2.6 micrograms/min through the subclavian artery) (AT II+ group). The response rate of the primary breast tumor was higher in the AT II+ group (92%) than in the AT II- group (73%) (P = 0.66). Complete tumor necrosis was 46% in the AT II+ group, but only 27% in the AT II- group (P = 0.51). These preliminary results suggest that the anticancer effect of IAC for breast cancer can be enhanced with concomitant infusion of AT II. PMID- 3292037 TI - Extraovarian pelvic yolk sac tumors. AB - The clinical and pathologic features of four extraovarian pelvic yolk sac tumors (YST) are described. The women, 17 to 39 years of age, were found to have a pelvic mass on physical examination, or in one case, at cesarean section. The tumors were bulky and arose within, or in close proximity to, the uterus. One tumor involved the endometrial cavity and myometrium extensively, another was attached to the anterior uterine serosa, another was in the cul-de-sac, and one lay between the lower uterine segment and urinary bladder. The ovaries were grossly unremarkable in all cases. Peritoneal metastases were present at the time of operation in two patients and were documented on histologic examination in a third. The serum alpha fetoprotein (AFP) level was elevated postoperatively in the three patients in whom it was determined. Three of the YST were pure and had a typical histologic appearance, whereas the fourth had an endometrioid-like glandular pattern and was associated with a teratoma. Immunohistochemical stains performed in three cases all showed AFP and alpha-1-antitrypsin (AAT). All patients received postoperative combination chemotherapy. Two of them died of tumor 14 and 24 months, respectively, postoperatively and two were disease-free 6 and 8.5 years, respectively, postoperatively. PMID- 3292038 TI - Screening and rescreening for colorectal cancer. A controlled trial of fecal occult blood testing in 27,700 subjects. AB - All inhabitants of the city of Goteborg who in 1982 were between 60 and 64 years of age (27,700) were randomly divided into a test and a control group. The 13,759 subjects in the test group were invited to perform Hemoccult II (Smith Kline Diagnostic, Sunnyvale, CA) fecal occult blood testing over 3 days and to repeat the testing after 16 to 22 months. At the first screening 9,040 (66%) completed the test, and 7,770 (58%) completed the test at the second screening. In the first screening the test group was divided into two subgroups in which the tests were rehydrated and unhydrated before development. All tests were rehydrated in the second screening; 1.9% and 5.8% of the tests were positive in the unhydrated and rehydrated subgroups, respectively. The number of diagnosed neoplasms in the first screening was significantly larger (P less than 0.01) in the rehydrated group compared to the unhydrated group, 50 and 24 neoplasms, respectively. Sixteen of 61 carcinomas in the test group were found in the interval between the two screenings, 19 of the carcinomas at the second screening, and ten among the nonresponders. Rehydration of the Hemoccult II test is a necessity. Significantly more carcinomas (61) were found in the test group compared to the control group (20). There was a trend toward favorable tumor staging in the test group compared to the control group. PMID- 3292039 TI - DNA viruses and human cancer. AB - This review examines some of the evidence which aetiologically implicates various DNA viruses (primarily papillomavirus, hepatitis B virus and Epstein-Barr virus) in certain human cancers (cervical carcinoma, primary liver cell carcinoma, Burkitt's lymphoma and nasopharyngeal carcinoma, respectively). The evidence includes: presence of viral DNA, RNA and proteins in tumours (and cell lines derived from them); occurrence of viruses with apparently different oncogenic potential; their ability to transform cell lines in vitro or cause tumours in animals; epidemiological and serological data. Factors which affect the progression to cancer are briefly considered as they illustrate that there are several stages in tumorigenesis. These factors include the immune system, irradiation, presence of other viruses or carcinogens and treatment. The lack of a single unique characteristic which defines a transformed cell would be expected from the multistep hypothesis and is related to the possible virus-cell interactions that can occur. These form a continuous spectrum ranging from productive infection of a permissive cell, through infection of a non-permissive cell, to the inability of a virus to infect a cell. This spectrum may reflect the absence of increasing numbers of cellular functions necessary for productive virus infection, with cell transformation occurring as a rare type of abortive infection. The evidence, especially for human papillomavirus, indicates that it is quite probable that particular DNA viruses are the causative agents for certain human cancers. Even so other factors can play decisive roles in tumorigenesis. Final aetiological proof will only be obtained when an anti-virus vaccine eradicates one form of human cancer. PMID- 3292040 TI - The origins of human cancer: molecular mechanisms of carcinogenesis and their implications for cancer prevention and treatment--twenty-seventh G.H.A. Clowes memorial award lecture. AB - Epidemiological studies provide evidence that environmental factors (external agents such as chemicals, radiation, and viruses) play a major role in the causation of the majority of human tumors. This is a highly optimistic message, since it implies that cancer is largely a preventable disease. To meet this challenge we must, however, understand the mechanisms of cancer causation at the cellular and molecular levels and, in a parallel effort, develop new laboratory methods that can be used to identify specific causative agents in humans. The approach must be comprehensive since it is likely that human cancers are due to complex interactions between multiple factors, including the combined actions of chemical and viral agents. This paper reviews recent studies from our laboratory and studies by other investigators related to these themes. A major principle in studies on mechanisms of carcinogenesis is that the process proceeds through multiple discernible stages, including initiation, promotion, and progression. It is likely that the transition between these stages is driven by different environmental and endogenous factors and involves different biochemical mechanisms and genetic elements. Several types of chemicals initiate the carcinogenic process by yielding highly reactive species that bind covalently to cellular DNA. Our group has elucidated the details of this process with two groups of compounds, aromatic amines and polycyclic aromatic hydrocarbons, emphasizing how these agents distort the conformation of DNA and its functions during DNA replication and transcription. The implications of these findings with respect to oncogene activation, DNA amplification, gene transposition, and chromosome translocations are discussed. Our studies on tumor promotion have concentrated on the mechanisms of action of the potent tumor promoter 12-O tetradecanoylphorbol-13-acetate. Studies from several laboratories indicate that this agent and related compounds produce their effects by activating a specific cellular enzyme, protein kinase C (PKC). This produces a cascade of events which include alterations in the function of membrane-associated ion channels and receptors, alterations in gene expression and, ultimately, changes in cellular differentiation and proliferation. Recent studies on the isolation and stable overexpression of a cloned DNA sequence that encodes PKC are described. The results obtained provide direct evidence that PKC plays a critical role in growth control. The possible role of PKC, and other mediators of signal transduction pathways, in the origin of certain human cancers is also discussed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3292041 TI - Viruses, oncogenes, and cancer. AB - Our current theories of virus-induced cellular transformation have changed with the emerging recognition that all normal cells contain proto-oncogenes which convert to oncogenes and induce transformation when activated and/or amplified. Cellular oncogenes have been identified by homology to the transforming genes of acute retroviruses and by the transforming activity of tumor cell DNA in transfection assays. More than two dozen cellular oncogenes identified to date constitute a heterogeneous group of genes which are remarkably conserved among highly diverse species. Expression of proto-oncogenes is linked to normal growth and development; whereas their expression as oncogenes due to gene mutation, rearrangement, amplification or other processes leading to altered or overexpression is associated with the development of tumors. Functions of oncogene proteins are being identified. These include unique protein kinase activity, growth factor/growth factor receptor properties, and the presence of DNA-binding polypeptides. It also appears that cooperation between several activated cellular oncogenes may be required in the multistep process of oncogenesis. Our recent in vitro experimental evidence supports that human cell carcinogenesis is indeed a multistep process. In addition, the involvement of the activated cellular transforming genes met and H-ras in chemically induced human cell carcinogenesis has been shown. Advancement in molecular biology of oncogenes and their products is likely to result in improvements in cancer diagnosis and cancer therapy. PMID- 3292042 TI - Determination of a constitutional neuroendocrine factor probably influencing tumor development in man: prophylactic and therapeutic aspects. AB - Slow recovery from stress may be one of the factors associated with the development of certain forms of cancer. In rabbits with slow recovery from stress, the growth rate of inoculated tumor cells was greater than those with rapid recovery. In cancer patients, the rate of recovery from stress was determined by the cortisol level in the blood after a stressful situation. Patients operated for breast and stomach carcinoma had a poorer prognosis if, after stress, the morning cortisol level of greater than 31 micrograms % did not decrease to less than or equal to 31 micrograms % during the next 2 weeks. It is suggested that slow recovery from stress is a genetically determined risk factor for certain diseases, including some malignant tumors. In healthy subjects a Rorschach test with form/color perception only was associated with a higher incidence of malignant neoplasms among their relatives than individuals with more movement than form/color perception. PMID- 3292043 TI - Factors associated with cancer of the oesophagus: an overview. AB - The incidence pattern of oesophageal cancer varies across the world with roughly a 500-fold difference in rates (truncated) between the highest and lowest areas. The incidence rate of this disease is rising in many countries, especially in males. Although ethnicity is a strong indicator of risk of this disease, no specific genetic factor except the occurrence of this cancer among the members of families with tylosis has been identified. The frequency of oesophageal cancer varies among the native and immigrant populations in different countries. Oesophageal cancer was found to be strongly associated with the consumption of alcohol and tobacco, especially in combination. A low socioeconomic level and poor diet, particularly deficiencies of vitamins A, C, and riboflavin, are other characteristics of the regions of highest incidence. Physical damage of the oesophagus caused by ingesting hard foods and/or hot liquids could be another factor. Intensive research in high-risk regions failed to reveal the presence of nitrosocompounds except at a very low level or other known carcinogens. The mutagenicity of pickled vegetables commonly consumed in the high-risk regions of China and high frequency of oesophageal cancer among chickens in the same regions suggest the existence of "common" carcinogens. It seems probable that in Iran an initiating carcinogenic factor may be the custom of eating opium dross, which has been shown to be mutagenic, as well as consumption of contaminated bread with extraneous seeds containing a large quantity of silica fibres, which is a strong stimulant of growth. PMID- 3292044 TI - Inhibition of E rosetting and of OKT 11 in patients with oral dysplasia and neoplasia. AB - A group of patients with oral dysplastic or early neoplastic lesions has been followed for 6 years to examine the change in ALS (antilymphocyte serum) induced 25% E rosette inhibition during the course of their disease. Control patients with other oral problems were examined similarly. The E rosette inhibition titer differences seen in our previous studies between control and diseased patients do not appear to persist with a longitudinal examination of these patients. While at early examination the patients exhibit higher inhibition titers than controls, later analysis shows that they seem to return to normal. To improve methodology, inhibition of OKT 11 uptake was substituted for E rosette inhibition and it is clear that both methods measure the same phenomenon. Thus, the former is more accurate and quantitative than the latter and will be used in future work. Continuation of these studies with the examination of more patients will be of value in assessing possible T lymphocyte changes in patients with oral lesions. PMID- 3292045 TI - Biochemical detection of recurrent breast cancer. AB - When clinically obvious recurrence develops in breast cancer patients, a large tumor burden is usually present. The development of biochemical techniques to detect recurrence may allow early diagnosis and therapeutic benefit. Reviewed in detail is the use of 10 biochemical parameters, as well as chest x-rays and physical examinations. Present data indicate that serial chest x-rays, physical examinations, liver enzymes, and CEA are the most sensitive means of detecting recurrence. PMID- 3292046 TI - Histological changes caused by intralesional injection of a streptococcal preparation into bladder cancer. AB - OK-432, a lyophilized preparation of Streptococcus pyogenes, was cystoscopically injected into bladder cancer to destroy cancer cells and to prevent recurrences. Marked reactions occurred such as stromal edema, vascular dilation, cancer cell exfoliation, and polymorphonuclear cell infiltration, succeeded by monocyte and lymphocyte infiltration with occasional lymph follicle formation. Cancer cells were sometimes intermingled in microscopic necrotic foci. Foamy granuloma was another characteristic finding. The postoperative follow-up study showed a significantly low recurrence rate. PMID- 3292047 TI - Cellular interactions in autoimmunity. PMID- 3292048 TI - Lupus-like autoimmunity in murine graft-versus-host disease. PMID- 3292049 TI - Graft-versus-host disease: allo- and autoimmunity after bone marrow transplantation. PMID- 3292050 TI - Autoimmunity and aging. PMID- 3292051 TI - Determinants of B cell hyperactivity in murine lupus. PMID- 3292052 TI - [Approaches to testing the effects of chemical substances on the immune system]. PMID- 3292053 TI - [Nostalgia in the Czech homeland. Comments on the occasion of the 300th anniversary of Hofer's dissertation on nostalgia]. PMID- 3292054 TI - The role of tumor necrosis factor (cachectin) in cachexia. PMID- 3292055 TI - Degradation from the endoplasmic reticulum: disposing of newly synthesized proteins. AB - We have characterized a pre-Golgi, proteolytic pathway for rapid degradation of newly synthesized T cell receptor (TCR) subunits which is insensitive to drugs that block lysosomal proteolysis. The site of degradation in this pathway is either part of or closely related to the endoplasmic reticulum (ER). This "ER" degradative pathway very likely plays an important role in many cells in the removal of unassembled or incompletely assembled membrane protein complexes from the secretory pathway. It is the sole pathway followed by TCR alpha chains and alpha-beta complexes in transfected fibroblasts. In T cells treated with ionophores, which disrupt transport of the TCR from the ER to the Golgi, all newly synthesized alpha, beta, and delta chains are destroyed by this pathway. A variety of biochemical and morphological techniques have been used to distinguish the "ER" degradative pathway from an alternative, lysosomal pathway. PMID- 3292057 TI - Alphabetical directory. PMID- 3292058 TI - Geographical listings. PMID- 3292056 TI - Antibodies to cell surface ganglioside GD3 perturb inductive epithelial mesenchymal interactions. AB - Most epithelial sheets emerge during embryogenesis by a branching and growth of the epithelium. The surrounding mesenchyme is crucial for this process. We report that branching morphogenesis and the formation of a new epithelium from the mesenchyme in the embryonic kidney can be blocked by a monoclonal antibody reacting with a surface glycolipid, disialoganglioside GD3. In contrast, a more than 10-fold excess of antibodies to adhesive glycoproteins (N-CAM, L-CAM, fibronectin) fails to inhibit morphogenesis. Although the anti-GD3 antibody affected epithelial development, the disialoganglioside GD3 was expressed not in the epithelium, but in the mesenchyme surrounding the developing epithelia. The data raise the intriguing possibility that the anti-GD3 antibody inhibits epithelial development by interfering with epithelial-mesenchymal interactions. PMID- 3292059 TI - Laboratories and types of services offered. PMID- 3292060 TI - Provisional restorations. PMID- 3292062 TI - Immunolocalization of muscle and nonmuscle isoforms of actin in myogenic cells and adult skeletal muscle. AB - In vertebrate skeletal muscle, the proliferating myoblasts synthesize nonmuscle isoforms of actin, and the cells begin to express muscle-specific actin isoforms during their myogenic differentiation. To study the distributions of the actin isoforms in myogenic cells and fully differentiated skeletal muscle, we prepared a peptide antibody specific for the skeletal alpha isoform of actin and used this antibody along with an antibody specifically reactive with nonmuscle gamma actin to stain cultured myotubes and adult skeletal myofibrils by double-indirect immunofluorescence. At this level of resolution, no differences in isoform localization were seen: Both muscle and nonmuscle actins were detected in the myotubes and in the striations of mature myofibrils. Myotubes were also double stained using immunogold electron microscopy, and the isoform distributions were determined quantitatively by counting the two sizes of gold particles that corresponded to labeling with each antibody. A quantitative analysis of immunoreactivity revealed that, although both forms were present in all actin containing structures, nonmuscle actin was relatively more prevalent along the edges (cortical microfilaments) of the myotubes, whereas the muscle isoform predominated in the interior regions (containing forming myofibrils). Thus, we have found evidence of a heterogeneous distribution of muscle and nonmuscle actin isoforms in differentiating myogenic cells, and we have demonstrated that a nonmuscle actin isoform is a component of the muscle contractile apparatus. PMID- 3292061 TI - Developmental organization of the intestinal brush-border cytoskeleton. AB - At the terminal web of chicken intestinal epithelial cell, the actin bundles are cross-linked by a fine filamentous network of actin-associated cross-linkers. Myosin, fodrin, and TW 260/240 have been identified as major components of the cross-linkers. We studied the development of the cross-linkers by quick-freeze, deep-etch electron microscopy, and the expression of cross-linker proteins (myosin, fodrin 240, and TW 260) by immunofluorescence and immunoblotting analysis during the embryogenesis. Microvilli start to form at 5-7 days, and the rootlets begin to elongate at 10 days. At an early stage of the development of the terminal web (13 days), fodrin 240 and a small amount of myosin are expressed, and a few actin-associated cross-linkers are present between the rootlets. However, TW 260 is not expressed at this stage. At an intermediate stage (19 days), the amount of myosin increases, and TW 260 begins to be expressed. The number of cross-linkers associated with the unit length of the rootlets is 24/microns. At the final stage of the terminal web formation (2 days after hatching), the amount of fodrin 240, myosin, and TW 260 is similar to the adult level, and the number of the actin-associated cross-linkers per unit length of the rootlet is 27/microns (approximately 85% of the adult). These results suggest that the synthesis of cross-linker proteins may be intricately regulated to achieve the desired density of cross-linkages at each developmental stage: at early and intermediate stages, sufficient and not an excess of cross-linkages are formed; and at a final stage, a higher complexity of cross-linkages is achieved. In addition, there is a differential expression of the components of the actin associated cross-linkers: myosin and fodrin could be early components of the cross-linkers involved in the basic stabilization of the terminal web structure, whereas TW 260/240 becomes incorporated later, possibly involved in the stabilization preparatory to the rapid elongation of microvilli, which occurs after the formation of the terminal web. PMID- 3292063 TI - Epidemiology of tennis, squash, and racquetball injuries. AB - This article enumerates and examines the existing epidemiologic data on racquet sports injuries. A framework is provided for the evaluation and interpretation of future studies and research. PMID- 3292064 TI - Eye protection in racquet sports. AB - This article summarizes the clinical and experimental data leading to the Canadian Standards Association (CSA) certification of six eyeguards for racquet sports in Canada in November 1986. A parallel approach involving the American Standard of Testing and Materials (ASTM) is discussed and eyeguards meeting specifications are illustrated. PMID- 3292065 TI - Prevention and treatment of elbow and shoulder injuries in the tennis player. AB - Tennis injuries are common in both the upper and lower extremities. The most common, and often most difficult, upper extremity injuries are shoulder tendinitis and tennis elbow (lateral and medial). Key considerations in the treatment of tendinitis include an understanding of the injury process and the resultant character and quantity of the pathologic spectrums. Tendon degeneration rather than tendon repair is the primary pathologic entity secondary to intrinsic muscle-tendon overload. For best treatment results, the protocols of treatment, both surgical and nonsurgical, must be individualized. PMID- 3292066 TI - Shoulder pain in the competitive tennis player. AB - Shoulder pain in the elite tennis player is of the overuse variety and is usually attributable to impingement symptoms. Nonoperative approaches favor the quickest return to competitive tennis, and when surgery is necessary, arthroscopic procedures are preferred. PMID- 3292067 TI - Soft-tissue injuries of the hand and wrist in racquet sports. AB - Participants in racquet sports are prone to a host of soft-tissue injuries to their hands and wrists owing to the direct impact of the handle as well as the repetitive stretching that occurs as the wrist is forcefully whipped into extremes of position. Tendinitis can occur in all tendons but is most common in the first dorsal compartment, flexor carpi ulnaris, flexor carpi radialis, and extensor carpi ulnaris. Ligamentous tears can produce instability patterns that, if unrecognized, can become chronic disabilities. Vessels and nerves can be compromised by repetitive blunt trauma to the structures themselves or by entrapment by surrounding structures. Prompt diagnosis will allow for the appropriate treatment and eliminate the need for vague terms such as "wrist sprain." The goal of early recognition and treatment is to allow the player to get back to the court and prevent the development of chronic discomfort or permanent impairment. PMID- 3292068 TI - Fitness evaluations and fitness findings in competitive junior tennis players. AB - Elite tennis players, as well as a large number of active recreational players, are involved in a sport that applies high repetitive loads that can create tension overload situations in certain key anatomic areas of the body and add to possible overload situations in other areas of the body. This results in patterns of inflexibility and weakness that can be demonstrated on a tennis-specific musculoskeletal exam, and that can be correlated with areas of increased injury occurrence. These players report conditioning programs that are, for the most part, inadequate to confer total conditioning of all the muscular parameters important in playing tennis. All of these factors, in addition to the frequency and type of playing, contribute to the occurrence of the overload injuries noted. These aspects need to be addressed in a preventative program for injury reduction. We do not believe that major changes in the way that tennis is played should be implemented until the effects of a proper preventative conditioning program are evaluated. The "ideal" conditioning program has not yet been found. While the exact composition of the program is in doubt, our studies allow us to recommend flexibility, strength, and endurance training for all athletes playing tennis at frequent intervals. This program should be guided by the findings on the preparticipation exam. PMID- 3292069 TI - Exercise training for competitive tennis. AB - This article reviews the muscle physiology underlying various forms of activity, as well as the adaptive responses induced by specific forms of training, and thus provides a rational basis for the design of a training program for competitive tennis. PMID- 3292070 TI - Knee injuries in tennis. AB - Racquet sports involve sharp, side-to-side movements and impose significant valgus and rotatory stresses on the knee. Most knee injuries are indirect as a result of these acute stresses and overuse. Some of the more common racquet sport injuries include tennis leg, jumper's knee, patello-femoral pain, meniscal injuries, bursitis, and tendinitis. PMID- 3292071 TI - [Possible uses of visual evoked responses in ophthalmology]. PMID- 3292072 TI - [Arlt's years in Prague]. PMID- 3292073 TI - [The beginnings of ophthalmology in southern Bohemia]. PMID- 3292074 TI - [The health care system in Cuba: a retrospective from 1953]. PMID- 3292075 TI - Effects of chronic endotoxaemia on oxygen consumption at different ambient temperatures in the unanaesthetised rat. AB - Oxygen consumption has been measured at different ambient temperatures at intervals during the intravenous infusion of endotoxin (1 mg/kg.day-1) from a subcutaneously implanted osmotic minipump in unanaesthetised rats. On day 1 of the infusion oxygen consumption was elevated at ambient temperatures of 10, 28, and 31 degrees C but not at 20 degrees C, compared with pair-fed saline-infused controls. There was a significant negative correlation between oxygen consumption on days 1 and 3 and environmental temperature (10, 20, and 28 degrees C) in both groups, but the regression line describing the relation in endotoxin-infused rats was displaced above that for the saline-infused control without a change in slope. The "minimal observed" oxygen consumption, which is taken as an estimate of basal metabolic rate, was elevated by the infusion of endotoxin. The endotoxin induced increase in "minimal observed" oxygen consumption was removed by indomethacin (5 mg/kg.sc) on day 1 of the infusion but was ineffective on days 3 and 7. PMID- 3292077 TI - Amrinone administration in endotoxin shock. AB - This study explored the hemodynamic effects of amrinone, a phosphodiesterase inhibitor, in association with intravenous fluids, in the treatment of endotoxin shock. Mongrel dogs were anesthetized with pentobarbital and mechanically ventilated with room air. Treatment was started 30 min after slow intravenous administration of 3 mg/kg of E. coli endotoxin. In the first part of the study, ten dogs were resuscitated for 30 min with intravenous saline alone (10 ml/kg) and for the next 3 h by saline (10 ml/kg/h) and amrinone 40 micrograms/kg/min. During this latter period, arterial pressure remained stable while cardiac output significantly increased from 3.1 +/- 0.5 to 5.2 +/- 0.7 l/min (P less than 0.01), and oxygen delivery increased from 616 +/- 92 to 983 +/- 156 ml/min (P less than 0.01). Comparison with control animals revealed that amrinone infusion prevented the decrease in left ventricular stroke work and markedly increased oxygen delivery. In the second part of the study, 18 dogs were treated by saline infusion titrated to maintain pulmonary artery balloon-occluded pressure at baseline level. In ten dogs, amrinone was added 60 min after endotoxin administration at a dose of 40 micrograms/kg/min. Total amount of fluids infused averaged 87 +/- 14 ml in the amrinone-treated dogs and 64 +/- 15 ml in the control dogs (differences nonsignificant). Oxygen delivery and oxygen consumption increased significantly in the amrinone-treated dogs (from 541 +/- 36 to 1063 +/- 176 ml/min, P less than 0.01, and from 145 +/- 23 to 202 +/- 38 ml/min, P less than 0.01, respectively) but not in the control dogs. The amrinone-treated dogs had lower PaO2 and higher venous admixture than the control dogs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292076 TI - Cardiopulmonary changes with intermittent endotoxin administration in sheep. AB - Chronic sepsis was induced by administering endotoxin (lipopolysaccharide--LPS) at 12-hr intervals to sheep. The animals (n = 7) responded to the first dose of LPS with increased pulmonary arterial pressure (PAP), systemic vascular resistance, plasma and lymph thromboxane B2 (TxB2) concentrations, and lung lymph flow rate concurrent with a reduction in the cardiac index (CI). Subsequent doses of LPS produced an elevation of PAP and TxB2 which was progressively attenuated and eventually disappeared. With LPS the lung lymph flow was markedly elevated and CI increased. This latter was transient and associated with a reduction in systemic vascular resistance. Concomitant with the cardiopulmonary changes prekallikrein levels were not diminished, but there was a statistically significant reduction in C1-esterase inhibitor. The administration of LPS was discontinued after 5 days and the cardiopulmonary variables rapidly returned to baseline levels. Chronic endotoxemia appears to be associated with an elevated pulmonary microvascular permeability and a tendency toward a hyperdynamic circulation but with an appreciable degree of refractoriness associated with regional hemodynamics and eicosanoid biosynthesis. PMID- 3292078 TI - Effect of the thrombolytic agent, streptokinase, on the responses to endotoxemia in conscious rats. AB - The potential role of coagulation defects as a pathologic mediator in septic shock is well documented, especially as it relates to increased thromboxane formation, thrombocytopenia, and disseminated intravascular coagulation. The present study was designed to determine the effect of the thrombolytic agent streptokinase on the sequelae of endotoxemia in the rat. Conscious male Sprague Dawley rats were given a bolus intravenous dose of Salmonella enteritidis endotoxin (20 mg/kg; LD90 dose) 5 min after the intravenous administration of streptokinase (10,000 U/kg bolus + 1,000 U/kg/hr infusion), or heparin (100 U/kg bolus + 30 U/kg/hr infusion). The effects of streptokinase or heparin on blood clotting were determined by measuring ex vivo clot formation 1 hr after the administration of endotoxin. In naive and endotoxemic animals, both agents significantly reduced clot formation (P less than 0.05). In endotoxemic animals, streptokinase or heparin improved survival to 70%, compared to 8% survival in the endotoxin + vehicle group (P less than 0.05). The improvement in survival with streptokinase was dose-dependent. Neither streptokinase nor heparin prevented the thrombocytopenia or hemoconcentration which developed in endotoxemic animals. These results demonstrate the potential utility of streptokinase for improving survival in endotoxemia and further confirm the deleterious contribution of coagulation disorders in endotoxic mortality. PMID- 3292079 TI - Preparation and applications of monoclonal antibodies to different collagen types. AB - Monoclonal antibodies have recently been developed against all of the major collagen types isolated from both human and other species. These antibodies have several potential advantages over polyclonal antibodies, and a brief survey will be made of the different antibodies that have so far been developed. In addition, various successful applications of these antibodies to biological investigations will be briefly discussed. PMID- 3292080 TI - Immunoassays with time-resolved fluorescence spectroscopy: principles and applications. AB - This review deals with the application of time-resolved fluorescence spectroscopy in the field of immunoassay. The advantages of time-resolved fluorescence over conventional fluorometry are discussed and it is explained why the fluorescent lanthanide chelates, and especially the Eu3+ chelates, are the labels of choice in such applications. A brief description of commercially available time-resolved fluorometers is given. The principles of phase-resolved fluorometry are described. The relative merits and disadvantages of the two time-resolved assay principles currently available commercially are critically discussed. General assay designs by using either Eu3+ or a new Eu3+ chelate as the label are also discussed in some detail. A personal view of future trends in the field of immunoassay concludes this review. PMID- 3292081 TI - A review on the methodology for assessing diagnostic tests. AB - Evaluation of diagnostic tests by the following principles are reviewed: error rates, scores based on posterior probabilities, and the excess loss considered in a decision theoretic context. Error rates or the complementary non-error rates, specificity and sensitivity, are simple measures which provide a rough indication of the discriminative value. In clinical practice, where a test serves as a decision support together with other information, conversion of test results to posterior probabilities is recommended. An aggregate score of these probabilities expresses the value of the test. Finally, in simple, well-defined cases--for example, screening situations, where the prevalence of disease and the relative consequences of false-positive and -negative classifications can be estimated--a Bayesian decision analysis is appropriate. The optimal discrimination limit is selected, and the total loss is minimized. The likelihood ratio LR(x) plays a central role in probability calculations and in the decision analysis. An example illustrates application of the procedures. PMID- 3292082 TI - Particle counting immunoassay of S100 protein in serum. Possible relevance in tumors and ischemic disorders of the central nervous system. AB - S100 protein (S100) was assayed by particle counting immunoassay in serum samples from 50 healthy individuals, 325 patients with various neurological disorders, and 20 patients with malignant melanoma. The detection limit for this protein was 0.3 microgram/L. We detected none in healthy individuals or in 50 patients with multiple sclerosis, 23 with dementia, or 20 with meningitis. S100 was detectable in serum of only a few patients with meningoradiculitis (2/20), peripheral neuropathy (2/30), encephalitis (1/14), Guillain-Barre syndrome (1/25), or AIDS (2/20). In contrast, we observed high concentrations in 29 of 75 patients with tumors of the central nervous system, especially in meningioma (6/9), glioblastoma (9/23), and neurinoma (5/5). Values for S100 were mainly abnormally high (greater than 0.3 microgram/L) in serum from patients with cerebrovascular disorders (43/48) or with metastases of melanoma (9/11). PMID- 3292083 TI - IgG2 subclass deficiency: IgG subclass assays and IgG2 concentrations among 8015 blood donors. AB - Among the four IgG subclasses in humans, IgG2 is preferentially expressed in antibodies to carbohydrate antigens whereas IgG1 subclass is commonly associated with antibodies to protein antigens. Because of this association with carbohydrate antigens, values for IgG2 in serum are often used as an index of immunocompetence against carbohydrate antigens. To investigate the value of IgG2 measurements in a general population, we have developed a convenient IgG subclass assay, using monoclonal antibodies and particle concentration fluorescence immunoassay. Our assay is specific, precise, convenient, and accurate. When IgG2 concentrations were determined in the serum samples from 8015 adult blood donors, there were more individuals with low IgG2 concentrations than predicted by the log-normal distribution. The observed distribution suggested the presence of a subpopulation with low IgG2 concentration. Because apparently healthy individuals in a general population have low IgG2 concentrations, IgG2 measurements alone may have a limited clinical usefulness as an index of immune function against carbohydrate antigens. PMID- 3292084 TI - Fiber optic immunochemical sensor for continuous, reversible measurement of phenytoin. AB - This fiber optic sensor, based on a homogeneous fluorescence energy-transfer immunoassay, operates in a continuous, reversible manner to quantify the anticonvulsant drug phenytoin. B-Phycoerythrin-phenytoin and Texas Red-labeled antibody to phenytoin were sealed inside a short length of cellulose dialysis tubing, which was cemented to the distal end of an optical fiber. When the sensor was alternately placed into solutions with various concentrations of free phenytoin, the drug crossed the dialysis membrane and displaced a fraction of the B-phycoerythrin-phenytoin from the antibody. The resulting change in fluorescence signal was measured with a fiber optic fluorometer. A typical competitive-binding calibration curve was seen between 5 and 500 mumol of phenytoin per liter. Equilibrium response time ranged from 5 to 30 min for different sensors. Replicate equilibrium measurements with one sensor, alternated eight times between two solutions of phenytoin, gave a CV of 2.1% (n = 16) at 0 mumol/L and 2.4% (n = 13) at 100 mumol/L. A reversible immunochemical sensor can be made that has a response time suitable for continuous concentration measurements. PMID- 3292085 TI - Improved liquid-chromatographic determination of cyclosporine and its metabolites in blood. AB - We describe a liquid-chromatographic assay for cyclosporine (CyA) and four of its metabolites in blood. The method is sensitive and specific for this drug and its metabolites. The use of flow programming shortens total chromatographic run time to 30 min, resulting in acceptable separation of metabolites at a lower flow rate and yielding narrower peaks for CyA and the internal standard at the higher flow rate. CyA and metabolites Met 17 and Met 1 were measured in seven heart transplant patients who were undergoing chronic therapy with CyA in oral doses ranging from 3 to 13 mg/kg body wt per day. For the individual patients, the mean trough concentrations in blood of CyA, Met 17, and Met 1 ranged from 111 to 221, 159 to 334, and 36 to 90 micrograms/L, respectively. Met 8 and Met 21 were not observed in any of these patients' blood specimens. PMID- 3292086 TI - Salivary immunoreactive insulin: a new entry in clinical chemistry? AB - The distribution of salivary immunoreactive insulin (S-IRI) and its relation to plasma insulin (P-IRI) and other clinical and metabolic variables were investigated in 93 nondiabetic subjects (60 males, 33 females, ages 11-70 y). S IRI was measured by RIA, with monoiodinated insulin as labeled antigen and with standards consisting of serial dilutions in saliva of known amounts of native insulin. The sensitivity of the method was 12.1 pmol/L. The intra- and between assay CVs were near 10%, and analytical recovery exceeded 93% for various insulin concentrations added to saliva. S-IRI, measured after overnight fast, showed a nonguassian distribution in males (skewness 1.18, kurtosis 1.41) and females (skewness 1.71, kurtosis 1.18); mean and median values were higher in males (14.3 and 12.1 nmol/min) than in females (12.1 and 7.15 nmol/min), but not significantly so. S-IRI was significantly correlated with P-IRI both in males (r = 0.75, P less than 0.0001) and females (r = 0.72, P less than 0.0001). These results, particularly the correlation between S-IRI and P-IRI, indicate the possibility of using S-IRI measurement in clinical practice. PMID- 3292087 TI - A manual immunoturbidimetric method for low concentrations of albumin adapted to the IL "Multistat 3 Plus". PMID- 3292088 TI - Simplified monoclonal immunoassay for pulmonary surfactant 35-kDa apoprotein in human amniotic fluid. PMID- 3292089 TI - Sepiapterin reductase in human amniotic and skin fibroblasts, chorionic villi, and various blood fractions. AB - Sepiapterin reductase activity has been measured in amniotic fibroblasts by two procedures: one photometric and the other HPLC-fluorimetric. Both can be used for quantitative measurements, but the latter has considerable advantages including smaller standard deviation, much lower detection limit, and less volume of sample required. Sepiapterin reductase activity was also assayed in skin fibroblasts, chorionic villi and various blood fractions including stimulated mononuclear blood cells. Red blood cells have a low specific activity compared to unstimulated mononuclear blood cells, although the latter have a mean value with a high standard deviation. When the mononuclear blood cells were cultured for 5 days, the mean specific activity increased and the range became tighter. Enzyme stability and N-acetylserotonin inhibition were also studied. PMID- 3292090 TI - A pepstatin-immunometric assay for active renin in human plasma. PMID- 3292091 TI - Bile acid malabsorption. Clinical presentations and diagnosis. PMID- 3292092 TI - Current status of hydatid disease. Report of a case and review of the literature. PMID- 3292093 TI - Sarcoidosis presenting as progressive myelopathy. AB - A case of intramedullary spinal cord sarcoidosis with slowly progressing symptoms and signs attributable solely to the spinal cord is reported. Biopsy disclosed granulomatous foci but was not diagnostic of sarcoidosis. However, autopsy showed numerous minute granulomas compatible with those of sarcoidosis disseminated in the lower cervical and upper thoracic cord in addition to a few in the hilar lymph nodes and papillary muscle of the heart. Clinical and pathological features of eight cases of sarcoidosis without symptoms other than those of the spinal cord are reviewed from the literature and clues to the diagnosis are discussed. PMID- 3292095 TI - An autopsy case of idiopathic superficial hemosiderosis of the central nervous system: a microscopic and immunohistochemical study. AB - The brain of a patient with idiopathic superficial hemosiderosis of the central nervous system was examined by light and electron microscopy. A histopathological study revealed massive, symmetrically situated necrosis in the temporal and insular lobes, which has not been described in previous reports. In addition, immunohistochemistry revealed ovoid bodies in the astroglia. Electron microscopy showed that these bodies were composed of fine granules, 50-60 A in diameter, and electron-dense amorphous material. Based on detailed histopathological and ultrastructural findings, the mechanism of ovoid body formation is discussed. PMID- 3292094 TI - Degeneration of the thalamus and inferior olives associated with spongiform encephalopathy of the cerebral cortex. AB - We describe a 37-year-old man with a 30-month history of progressive dementia, myoclonus and prominent ataxia with the additional clinical features of dysautonomia and delirious psychomotor excitement and with relatively preserved verbal responses. The pathological changes include 1) severe neuronal loss and gliosis without spongiform change of the thalamus and inferior olives associated with gliosis of the midbrain tegmentum, and demyelination and gliosis of the central tegmental tract, olivo-cerebellar fibers and spino-olivary tract, and 2) mild spongiform encephalopathy of the cerebral cortex. Although the latter implies that the present case may be an example of the rare thalamic form of Creutzfeld-Jakob disease, the preferential and severe involvement of the thalamus and inferior olives without spongiform change as well as the clinical features are quite reminiscent of primary thalamic degeneration [Stern 1939]. This case draws further attention to the relationship between spongiform encephalopathy and degeneration without spongiform change of the thalamus and olivary system. PMID- 3292096 TI - Acute intrahepatic biliary obstruction caused by hydatid cysts. Correlation between various imaging techniques. AB - An 18-year-old male was evaluated for recurrent attacks of right abdominal pain and intermittent jaundice caused by hydatid cysts of the liver. The case illustrates the value of dynamic functional information provided by Tc-99m-HIDA imaging over noninvasive modalities that demonstrate structural changes, such as ultrasound, computed tomography, and tin colloid liver imaging. PMID- 3292097 TI - Atypical radionuclide scan appearance in cellulitis due to group A streptococcus. AB - The scintigraphic manifestations of cellulitis consist of a diffuse increase in activity in the affected soft tissues without a focal increase in activity in the bone. The radionuclide images in two children with Group A streptococcal cellulitis were atypical, as no increased activity was noted in the soft tissues. The false-negative radionuclide images in these children is attributed to the marked amount of edema present at the sites of infection. PMID- 3292098 TI - Radionuclide measurement of bladder emptying rate. Simultaneous comparison with urinary flow rate obtained by uroflowmetry. AB - Mean and peak bladder emptying rates were measured by a radionuclide method using a gamma camera and Tc-99m DTPA and were compared with average and maximum urinary flow rates obtained by a uroflowmeter in 24 simultaneous measurements. A good correlation was found between the two methods. Average urinary flow rate correlates better with mean bladder emptying rate (r = 0.96, y = 1.04X + 0.14, s.e.e. = 1.2) than maximum urinary flow rate with peak bladder emptying rate (r = 0.83, y = 0.78X + 4.5, s.e.e. = 4.2). The results suggest that the radionuclide method can be used to measure the urinary flow rate, and has the advantage of establishing the postvoid residual urine. PMID- 3292099 TI - The removable hot spot. PMID- 3292102 TI - Pharmacokinetics of captopril in healthy subjects and in patients with cardiovascular diseases. AB - Captopril, the first orally active inhibitor of angiotensin-converting enzyme, is used widely in the treatment of hypertension and congestive heart failure. The pharmacokinetics of this agent have been studied extensively in healthy subjects and in patients with hypertension, congestive heart failure, and chronic renal failure. Captopril contains a sulphydryl group and binds readily to albumin and other plasma proteins. The drug also forms mixed disulphides with endogenous thiol-containing compounds (cysteine, glutathione), as well as the disulphide dimer of the parent compound. These components in blood and urine are measured collectively as total captopril. Because of the reversibility of the formation of these inactive disulphides, total captopril may serve as a reservoir of the pharmacologically active moiety, and thus contribute to a duration of action longer than that predicted by blood concentrations of unchanged captopril. To measure free or unchanged captopril concentrations, a chemical stabiliser must be added to the biological samples to prevent the formation of captopril disulphides ex vivo. In healthy subjects given captopril intravenously, the body clearance of captopril and steady-state volume of distribution were about 0.7 L/h/kg and 0.8 L/kg, respectively. The elimination half-life of unchanged captopril was approximately 2 hours. The primary route of elimination of captopril is the kidney. The renal clearance of unchanged captopril exceeds the glomerular filtration rate, due to active tubular secretion of the drug. In healthy subjects, about 70 to 75% of an oral dose is absorbed and the bioavailability of captopril is approximately 65%. Peak blood concentrations are reached about 45 to 60 minutes after oral administration. The bioavailability of captopril is not altered by age or concomitant medications including diuretics, procainamide, allopurinol, cimetidine or digoxin. However, the co-administration of food or antacids, or probenecid with captopril has been shown to diminish the bioavailability of the latter and decrease its clearance, respectively. The decreased bioavailability of captopril when taken with meals does not significantly alter clinical responses to the drug. Over a wide range of oral (10 to 150 mg) and intravenous doses (2.5 to 10 mg) captopril had linear kinetics in healthy volunteers. In healthy subjects with normal renal function and patients with congestive heart failure given captopril 3 times daily, blood concentrations of total captopril accumulated, whereas those of unchanged captopril did not. Severe renal insufficiency was associated with an accumulation of both unchanged and total captopril.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3292103 TI - AIDS education in the schools: a literature review as a guide for curriculum planning. AB - As plans for massive public AIDS education grow, pediatricians will become increasingly involved with school systems as consultants and leaders. A review of relevant literature on students' current level of knowledge about AIDS and on educational efforts to date with high-risk groups (homosexuals and intravenous drug users) provides the rationale for school-based AIDS education. Literature describing the approaches used and the impact of programs for sex education, drug abuse prevention, and reduction of prejudice towards the disabled is reviewed to extrapolate that which applies to AIDS education. Important developmental characteristics of adolescents are discussed insofar as they have implications for the planning of AIDS curricula. PMID- 3292104 TI - Aldosterone-producing adenoma presenting with hypokalemic myopathy. Case report and review. AB - A 9-year-old boy who complained of fatigue, myalgias, and progressive weakness was found to have a markedly elevated serum creatine phosphokinase (CPK). He developed polyuria with polydipsia and was noted to be hypertensive and severely hypokalemic. Treatment with potassium and spironolactone alleviated his signs and symptoms and normalized the blood pressure and CPK. Initial studies revealed low plasma renin activity that did not increase with change from supine to upright position. Plasma aldosterone was consistently elevated in the supine position, decreased with upright posture, and was not suppressed by administration of dexamethasone. Plasma 18-hydroxycorticosterone also was elevated. Enhanced computerized tomography (CT) revealed a mass in the left adrenal that had not been seen on the initial unenhanced scan. Adrenal vein catheterization confirmed elevated plasma aldosterone on that side. Adrenalectomy was performed, and a well encapsulated adenoma was found at examination of the surgical specimen. Postoperatively, suppression of plasma renin activity continued for many months without signs of aldosterone deficiency. PMID- 3292105 TI - Vasodilator monotherapy in the treatment of hypertension: comparative efficacy and safety of pinacidil, a potassium channel opener, and prazosin. AB - We compared antihypertensive effects of monotherapy with pinacidil (N = 197) or prazosin (N = 204) in a randomized, parallel, double-blind dose-titration study in which hydrochlorothiazide or propranolol could be added for adverse events or lack of efficacy. Pinacidil (12.5 to 75 mg b.i.d.) was a more potent vasodilator, producing a mean decrease in supine diastolic blood pressure (baseline = 102 to 103 +/- 9 mm Hg) of 18.8 +/- 10.0 (SD) mm Hg compared with 15.5 +/- 9.2 mm Hg with prazosin (1 to 10 mg b.i.d.; p less than 0.001). Patients responding to each drug had similar average blood pressure levels during 12-hour monitoring (137/85 mm Hg). More patients taking pinacidil required hydrochlorothiazide for edema (p = 0.008) and more taking prazosin required hydrochlorothiazide and propranolol for lack of efficacy (p less than 0.001). Tachycardia (15% to 20%) and palpitation (13% to 15%) were frequent events with both drugs. Edema (38.2% vs 22.3%) was more frequent with pinacidil (p less than 0.001) and postural hypotension (4.7% vs 1.0%) and asthenia (20.2% vs 13.2%) were more frequent with prazosin (p = 0.025; 0.062). No significant laboratory toxicity was noted. In conclusion, both pinacidil and prazosin are effective as monotherapy for hypertension. Monotherapy with pinacidil is limited by adverse events related to vasodilatation and monotherapy with prazosin is limited by lack of efficacy. PMID- 3292106 TI - Altered vancomycin dose vs. serum concentration relationship in burn patients. AB - Drug elimination in patients sustaining serious thermal injury may be altered, resulting in an increased clearance and shortened half-life. Nine burn and eight medical/surgical patients with normal renal function were studied prospectively. Doses were adjusted to achieve peak and trough vancomycin serum concentrations within a narrow range. No significant difference between the groups was noted in terms of demographic characteristics, creatinine clearance, or vancomycin serum concentrations. However, the difference in daily dose needed to maintain the specified serum concentrations was significantly greater for burn patients (p less than 0.02). Burn patients also had to be dosed significantly more often than medical/surgical patients to achieve peak and trough vancomycin serum concentrations within the desired range (p less than 0.02). The elimination half life in burn patients was significantly shorter than that in control patients (p less than 0.001). Because of the unusually high dosage requirements in burn patients, along with their poor predictability, individualization of therapy with vancomycin serum concentrations is recommended to ensure a successful therapeutic outcome. PMID- 3292107 TI - The new era of hypospadias surgery. AB - The authors review four current techniques in hypospadias surgery that yield superior functional and aesthetic results to those obtained in the older, multi stage repairs. If the repair is performed before the age of memory recall, there will be less psychological trauma to both the patient and his parents. PMID- 3292108 TI - Vascularized urethroplasty flaps. The use of vascularized flaps of preputial and penopreputial skin for urethral reconstruction in hypospadias. AB - The long-term growth potential offered by vascularized urethroplasty flaps has allowed the author to operate on patients with hypospadias between 8 months and 2 years of age with excellent morphofunctional and psychological results and a short hospitalization. The author argues that the one-stage procedure is the best approach, supported by an analysis of more than 5000 cases treated in the Plastic Surgery Department of the Bambino Gesu Hospital in Rome since 1972. PMID- 3292101 TI - Drugs in human milk. Clinical pharmacokinetic considerations. AB - Drugs ingested by a lactating mother would be expected to appear in human milk to some extent and be ingested by a breast-feeding infant. Drugs pass from maternal plasma into milk by passive diffusion and are distributed within the aqueous, protein and lipid phases of milk. Distribution into milk will be affected by physiochemical characteristics of the drug: acid-base characteristics, relative protein binding in plasma and milk, and lipid solubility, as well as milk composition. The milk-to-plasma concentration ratio is the most commonly quoted index of drug distribution into human milk. However, calculation of the daily infant dose of drug ingested in milk, and from this the dose in milk relative to the maternal dose on a weight-adjusted basis, is a more relevant indicator of infant exposure to a drug. This is particularly true for drugs with a high volume of distribution, for which only a small proportion of the mother's dose is contained within the plasma and available for distribution into milk. A better indication of infant exposure to a drug is the steady-state plasma drug concentration in a breast-feeding infant, the major determinants of which are the dose rate (via milk) and the oral availability and clearance in the infant. Although in neonates the rate of absorption may be different from adults, there is little evidence that its extent is significantly different. Clearance, however, is impaired in very young infants, particularly if premature. The decreased clearance would result in a proportional increase in steady-state plasma concentrations in the breast-feeding infant. Consideration of the dose ingested in milk and the approximate clearance in infants of different ages allows estimation of likely steady-state plasma concentrations in breast-feeding infants. From these considerations, recommendations regarding the safety of drugs during breast-feeding can be made. Drugs which are very toxic or have dose independent toxicity should be considered separately. Recommendations regarding 'social' drugs such as nicotine, alcohol, caffeine and theobromine are particularly difficult, as doses are uncontrolled and vary variable. PMID- 3292109 TI - Repair of secondary genital deformities of epispadias/exstrophy. AB - The aim of secondary genital surgery in epispadias/exstrophy patients is to produce a dangling penis of satisfactory length and shape. The penis should be able to function sexually as well as serve as a conduit for the passage of urine and sperm. The systematic approach to the correction of this defect as outlined in this article should enhance the possibility of a successful result and lessen the need for secondary genital repair. PMID- 3292110 TI - Perioperative nursing care of the pediatric hypospadias patient. AB - Advances in the management of the pediatric hypospadias patient have greatly improved his outcome. This article discusses the many facets of nursing care of the pediatric hypospadias patient. Preoperative teaching and postoperative care are defined and explored. PMID- 3292111 TI - Peyronie's disease. AB - For patients with Peyronie's disease requiring surgery, the authors' treatment is to excise the plaque and replace the diseased area of the tunica with a dermal graft. The goal of the surgery is to create a functional penis without prosthesis. For the first few months, sexual therapy and counseling are very important to help the patient and partner work together toward rehabilitation. PMID- 3292100 TI - Principles of drug biodisposition in the neonate. A critical evaluation of the pharmacokinetic-pharmacodynamic interface (Part I). AB - Rational pharmacotherapy is dependent upon an understanding of the clinical pharmacokinetic and pharmacodynamic properties of the drugs employed. Although the available data on drug biodisposition and action in the neonate have increased considerably in the last few years, pharmacokinetic-pharmacodynamic interactions for many drugs remain poorly understood. The ontogeny of drug absorption, distribution, metabolism, and elimination are addressed in this review. Drug absorption from any site depends upon both the physicochemical properties of the drug and a variety of patient factors. Absorption of orally administered drugs may be affected by changes in gastric acidity and emptying time as well as by bile salt pool size, bacterial colonisation, and extraintestinal disease states such as congestive heart failure. Factors affecting drug absorption following intramuscular, percutaneous, and rectal administration are also discussed. Drug distribution in the neonate is influenced by a variety of important and predictable age-dependent factors. The developmental aspects of protein binding and body water compartments are described. Additionally, hepatic drug metabolism assumes an important role in understanding the pharmacokinetic and pharmacodynamic properties of many compounds. Certain biotransformation pathways, including hydroxylation by the P450 mono-oxygenase system and glucuronidation, demonstrate only limited activity at birth, while other pathways, such as sulphate or glycine conjugation, appear very efficient at birth. Elimination of drugs excreted unchanged in the urine is dramatically reduced in the newborn, compared with older infants and children, due to immaturity of both glomerular filtration and tubular secretory processes. The glomerular filtration rate remains markedly reduced prior to 34 weeks gestational age, increasing as a function of post-conceptual age until adult values are achieved by approximately 2.5 to 5 months of age. Tubular secretory capacity is also limited at birth, approaching adult values by approximately 7 months of age. Published reports describing the pharmacokinetics and pharmacodynamics of commonly used drugs in the neonatal period, as well as differences in drug biodisposition among premature infants, full term neonates, and older infants and children, are reviewed. Our recommendations for neonatal drug therapy are based upon a critical interpretation of these data, an understanding of fetal development and maturational processes, and an understanding of how disease states may affect drug biodisposition in the neonate. PMID- 3292112 TI - An evaluation of skin grafts for reconstruction of the penis and scrotum. AB - Skin grafting remains a primary modality for reconstruction of genitourinary defects. Many of these conditions are discussed and emphasis has been placed on the different indications for full-thickness, split-thickness, and dermal grafts. Complications have been few, and long-term results excellent. This experience has allowed the formulation of a number of surgical principles, which are presented. Refinements in reconstruction are currently being evaluated to obtain the optimal result. PMID- 3292113 TI - Male genital trauma. AB - We have attempted to discuss genital trauma in relatively broad terms. In most cases, patients present with relatively minimal trauma. However, because of the complexity of the structures involved, minimal trauma can lead to significant disability later on. The process of erection requires correct functioning of the arterial, neurologic, and venous systems coupled with intact erectile bodies. The penis is composed of structures that are compliant and distensible to the limits of their compliance. These structures therefore tumesce in equal proportion to each other, allowing for straight erection. Relatively minimal trauma can upset this balance of elasticity, leading to disabling chordee. Likewise, relatively minimal injuries to the vascular erectile structures can lead to significantly disabling spongiofibrosis. The urethra is a conduit of paramount importance. Whereas the development of stricture is generally related to the nature of the trauma, the extent of stricture and of attendant complications is clearly a function of the immediate management. Overzealous debridement can greatly complicate subsequent reconstruction. A delicate balance between aggressive initial management and maximal preservation of viable structures must be achieved. PMID- 3292114 TI - Utilizing full-thickness skin grafts for vaginal reconstruction. AB - Full-thickness skin grafts are superior for certain types of vaginal reconstruction. The advantages of this procedure are decreased contraction, reduced time for postoperative stenting, correction at an earlier age, a lower risk of vaginal stenosis, and improved donor site cosmesis. In addition, the patient has the psychological assurance that she is externally normal as she develops through puberty and adulthood. PMID- 3292115 TI - Vaginoplasty for gender confirmation. AB - Male-to-female surgery for properly diagnosed gender dysphoria, conducted as an interdisciplinary rehabilitation program, may be a valid endeavor in many cases. Successful surgical results have been obtained by those skilled in this type of surgery. PMID- 3292116 TI - Transsexual surgery in the genetic female. AB - The increasing acceptance of the transsexual patient by society as well as a willingness of insurance companies to compensate for associated surgical procedures will result in an increase in patients presenting for sex reassignment. Data from gender identity centers suggest that the multidisciplinary approach leads to the best therapeutic results. Significant advances in phalloplasty techniques are yielding genitalia with more normal function and appearance. PMID- 3292117 TI - Epithelioid sarcoma of the penis. AB - A case of epithelioid sarcoma of the penis is reported with a review of the current treatment modalities. A new method of reconstructing the penis involved with malignancy is presented. Pertinent literature is cited. Cases of epithelioid sarcoma should be published to improve the understanding of the potential of different treatments available. This case represents the fifth epithelioid sarcoma of the penis reported in the literature. PMID- 3292118 TI - Management of urethral stricture disease. AB - With the advent of modern tissue transfer techniques, most cases of urethral reconstruction can be approached with confidence that an excellent functional and cosmetic result is probable. The authors present a logical approach to urethral stricture disease predicated on the anatomy of the stricture disease. Only those procedures believed to offer a maximal chance of success are offered to the patients. Should a patient present with complex stricture disease, initially a flap procedure would be employed. PMID- 3292119 TI - Lymphedema of the penis and scrotum. AB - The problem of genital lymphedema is commonly secondary to filariasis in most regions of the world. In the Western Hemisphere surgical manipulations usually exacerbate this significant problem. Lower leg edema may also result from these interventional procedures. PMID- 3292120 TI - Gallstones. PMID- 3292121 TI - Broadband ultrasonic attenuation and bone mineral density. PMID- 3292122 TI - Functional anatomy of the respiratory muscles. AB - To keep arterial blood gases within acceptable limits, air must be moved rhythmically in and out of the lungs. Such a displacement is accomplished through the expansion/deflation of the chest wall, which results normally from the action of a number of skeletal muscles. To understand how this vital pump works, it is necessary to have a clear understanding of the anatomy and the function of these muscles. PMID- 3292123 TI - Diaphragm muscle: structural and functional organization. AB - The structural and functional organization of the diaphragm muscle is described in terms of the essential units for neuromotor control. These motor units in the diaphragm vary markedly in their metabolic, contractile, and fatigue properties. Thus, the forces generated by the diaphragm during different ventilatory and nonventilatory behaviors will depend on the number and type of motor units recruited. It is therefore important to understand the basic properties of diaphragm motor units and the mechanisms underlying their recruitment. PMID- 3292124 TI - Respiratory muscle blood flow. AB - Respiratory muscle fatigue appears to be the cause of hypercapnic respiratory failure in many patients with lung disease. Recent studies have suggested that the rate of development of respiratory muscle fatigue largely depends on the balance between the level of respiratory muscle blood flow and the metabolic demands of these muscles. Physiological factors that alter muscle blood flow (for example, cardiogenic or septic shock, alterations in muscle length) or respiratory muscle metabolic demands (for example, increases in the work of breathing) may influence this balance, affecting the rate of development of respiratory muscle fatigue in these patients. Therapeutic measures that augment respiratory muscle blood flow (restoration of normal arterial pressure in patients in shock) or reduce the work of breathing (for example, mechanical ventilation) may prevent or reverse respiratory muscle fatigue. PMID- 3292125 TI - Respiratory muscles and dyspnea. AB - This article reviews the classical basis on which dyspnea is identified and quantified. The sensation or sensations of discomfort experienced during breathing are then viewed using a background of sensory physiology. Exploiting psychophysical techniques, the origin of the sensation of discomfort is viewed within the constraints of the presently-known sensory structures. The contribution of these sensory structures to the quality and quantity of discomfort is suggested, indicating the central role played by the respiratory muscles. PMID- 3292126 TI - Tests of respiratory muscle function. AB - Respiratory muscle strength and endurance should be assessed when dyspnea, respiratory failure, or poor performance on routine pulmonary function tests are unexplained. Respiratory muscle strength can be measured non-invasively from maximal mouth pressures, but measurement of transdiaphragmatic pressure refines the assessment. The maximal voluntary ventilation test is the only simple index of ventilatory or respiratory muscle endurance. Other tests for endurance and fatigue are more difficult, but some newer techniques may be applicable to the clinical laboratory. Some patients who exhibit tachypnea, marked use of neck inspiratory muscles, and chest-abdomen asynchrony may be developing respiratory muscle fatigue. PMID- 3292127 TI - Respiratory muscles in disease. AB - The respiratory muscles play an important role in the clinical manifestations of different disease states. Respiratory muscle dysfunction plays a primary role in the development of ventilatory failure in patients with neuromuscular disorders. Although the respiratory muscles are placed at a mechanical disadvantage in patients with obstructive lung disease, there is little clinical evidence to suggest that respiratory muscle dysfunction plays a primary role in the development of ventilatory failure. PMID- 3292128 TI - Respiratory muscle training. AB - The application of skeletal muscle training principles to the respiratory muscles is a relatively new field. Strength and endurance training of the respiratory muscles can be achieved in normal humans and in patients with neuromuscular and chronic obstructive pulmonary diseases. Careful monitoring is required throughout a training program to ensure that the respiratory muscles are, in fact, being trained. This is a promising area, although further research is necessary to determine the indications for respiratory muscle training. Furthermore, it is still necessary to determine the optimal mode of training. PMID- 3292129 TI - Respiratory muscle rest therapy. AB - This article discusses the role of respiratory muscle rest therapy in hypercapnic ventilatory failure and/or inspiratory muscle fatigue associated with primary lung disease, diseases of the chest wall, and neuromuscular diseases. Some animal data on the role of ventilatory muscle rest therapy in states characterized by a low cardiac output and arterial hypotension are also reviewed. Additionally, a method for quantitating the degree of respiratory muscle rest elicited by negative pressure ventilation devices is presented. PMID- 3292130 TI - Pharmacotherapy of respiratory muscles. AB - This article assesses the role of pharmacotherapy in the management of respiratory muscle dysfunction. It focuses on two classes of drugs, the methylxanthines and the sympathomimetic agents. A prospective section focuses also on the particularities of the diaphragm among the skeletal striated muscles. In addition, a new approach to respiratory pharmacotherapy, which may be beneficial in patients with respiratory muscle dysfunction, is suggested. PMID- 3292131 TI - Aminophylline and the respiratory muscles: an alternative view. AB - The respiratory muscles constitute a pump as vital to life as the heart. In patients with severe lung disease, the work of breathing is increased greatly, whereas the capacity of the respiratory muscles to generate tension and ventilation is impaired. In these circumstances, respiratory muscle fatigue may occur. When the cardiac pump fails, it often is possible to improve its performance by drug therapy with inotropic agents. In recent years, attention has been focused on the possibility of enhancing respiratory muscle function with drugs. The agents most studied have been the methylxanthines, theophylline and aminophylline. In vitro studies have demonstrated an inotropic effect of theophyllines on all skeletal muscles tested, including the diaphragm. The effect of theophyllines on skeletal muscle is dose related and animal studies show that any effect in humans, where dosage is limited by toxicity, is likely to be small. Early studies in humans showed a substantial positive inotropic effect on the diaphragm, but subsequently, a large number of studies have yielded mixed results. Up to the present time, most studies have failed to demonstrate a positive action of theophyllines. Although is it possible that these drugs may have a very small beneficial effect on contractility, not easily detected by the methods of some investigators, such as small effect of potentially toxic drugs is likely to be of limited clinical value. PMID- 3292132 TI - Nutrition and the respiratory muscles. AB - Malnutrition may be an important complicating factor in acute and chronic lung disease. Animal studies have demonstrated significant atrophy of diaphragm muscle fibers following prolonged undernutrition resulting in a marked reduction in diaphragm muscle strength as well as alteration in other contractile and fatigue properties of the muscle. In severe chronic obstructive pulmonary disease (COPD), malnutrition is common and may, in conjunction with the influences of hyperinflation on diaphragm performance, predispose to respiratory muscle fatigue and failure. The course of progressive weight loss in patients with COPD is not known but may, in part, be related to a "hypermetabolic" state arising from an increased oxygen consumption of the respiratory muscles secondary to enhanced resistive loads and impaired mechanical efficiency of the respiratory muscles. Reports of the impact of nutritional repletion on respiratory muscle performance in critically ill patients, as well as in patients with COPD, are preliminary. Further studies are necessary to establish whether such measures impact meaningfully on both the morbidity and mortality of these patients. PMID- 3292133 TI - Electrical activation of the diaphragm. AB - The physiology of electrical activation of the diaphragm is reviewed, with emphasis upon the respiratory mechanics of the diaphragm and its action upon other respiratory structures. The application of diaphragm pacing is discussed in terms of candidate selection, evaluation, and its future as a treatment modality for respiratory insufficiency. PMID- 3292135 TI - Diagnosis and management of vulvar carcinoma. AB - With the steady increase in life expectancy, invasive cancer of the vulva is now becoming more prominent among gynecologic malignancies. Early, careful examinations and informed patients can aid in early diagnosis. Carcinoma in situ, verified by biopsy, is best treated with wide local excision. Invasive vulvar carcinoma should be treated with radical vulvectomy and bilateral groin node dissection. The major source of morbidity is wound breakdown. The use of modified incision techniques and sartorius muscle transplantation have significantly decreased these postoperative complications. The clinical staging system for vulvar carcinoma is approved by the International Federation of Gynecology and Obstetrics (FIGO). The disease usually spreads systematically from the vulva to superficial groin nodes, to deep groin nodes, and then to pelvic nodes. Survival rates of 84% for stage I disease can be achieved. Evidence of positive groin nodes indicates a poor prognosis. However, even patients with advanced disease can be surgically cured by radical surgery. Five of ten patients (50%) with stage IV disease were alive and free of disease at five years with exenterative surgery. Any patient who is a reasonable medical risk, with a vulvar lesion that is resectable, should be treated surgically. Otherwise, the patients not only die, but they die in abject misery. PMID- 3292134 TI - Malignant melanoma and pigmented lesions: a review. AB - We have described the epidemiology and clinical characteristics of malignant melanoma and its precursors in the hope that this discussion will help physicians to recognize suspicious pigmented lesions earlier, thus helping to decrease avoidable cancer deaths from melanoma. PMID- 3292136 TI - Diagnosis and management of carcinoma of the ovary. PMID- 3292137 TI - Magnetic resonance imaging in cancer management. PMID- 3292139 TI - Laser surgery in the treatment of cancer. AB - Research on the medical applications of the free electron laser is being carried out in several institutions, including our own. The initial studies point to many new wavelengths and a higher output of the various wavelengths that are presently being used. The search continues for chromophores that may be administered orally or intravenously that will concentrate in tumors. Thus, medical laser technology, just over 25-years-old, is expanding rapidly. Research will doubtless lead to its increased refinement and to improved patient care in the future. PMID- 3292138 TI - Chemotherapy of malignant disease: an update. PMID- 3292140 TI - Quality of life during and after cancer treatment. PMID- 3292141 TI - Alcohol intake and risk of breast cancer. PMID- 3292142 TI - The power of purgatives. PMID- 3292143 TI - Beneficial and adverse effects of correction of anaemia by recombinant human erythropoietin in patients on maintenance haemodialysis. PMID- 3292144 TI - Blood pressure changes during treatment with recombinant human erythropoietin. PMID- 3292145 TI - In vitro and in vivo effects of recombinant human erythropoietin on human hemopoietic progenitor cells. PMID- 3292146 TI - Correction of renal anaemia by recombinant human erythropoietin: effects on myocardial function. PMID- 3292147 TI - Effect of treatment with recombinant human erythropoietin on peripheral hemodynamics and oxygenation. AB - Slow progressive improvement of renal anemia from 21 up to 33% hematocrit by rhEPO treatment results in an increase of tissue oxygenation as indicated by a rise of the transcutaneous oxygen pressure. In normotensive patients this was accompanied by an increase in MAP (delta 6 mm Hg) within the normal range and a significant fall of the regional blood flow. These hemodynamic changes are caused by increases of the regional and presumably also of the total peripheral vascular resistance. Most likely the increase in total peripheral vascular resistance represents an autoregulatory event triggered by the rising tissue oxygenation. From the present data it is difficult to estimate to what extent the observed rise in hematocrit affects peripheral vascular resistance also via an increase of blood viscosity. PMID- 3292148 TI - Erythropoietin assays and their use in the study of anemias. PMID- 3292149 TI - Modern aspects of the pathophysiology of renal anemia. PMID- 3292150 TI - Specific problems of renal anemia in childhood. PMID- 3292151 TI - Dose-related effects of recombinant human erythropoietin on erythropoiesis. Results of a multicenter trial in patients with end-stage renal disease. PMID- 3292152 TI - Analysis of initial resistance of erythropoiesis to treatment with recombinant human erythropoietin. Results of a multicenter trial in patients with end-stage renal disease. PMID- 3292153 TI - Hemodynamic characteristic of the common carotid arteries in diabetic atherosclerotic patients. AB - Early detection of stenosis is an important task in noninvasive examinations. The authors analyzed 50 patients with diabetic macroangiopathy in lower limbs, but without signs, or symptoms of brain ischemia, and 50 supposedly healthy subjects of similar sex and age composition as control. Eight hemodynamic parameters were measured in the common carotid artery using Doppler ultrasound with spectral analysis. Only 6% of the control group, but 64% of the diabetic patients had two or more altered parameters. The authors conclude that persons with high risk of cerebrovascular disease could be identified by Doppler ultrasound examination of common carotid artery. PMID- 3292154 TI - Myocardial contrast echocardiography. A review of clinical studies. AB - A review is presented of to date published studies devoted to contrast echocardiography of the myocardium and covering a total of 169 patients. No complications occurred during investigations; slight transient ECG and haemodynamic changes of less than 30 s duration were not as pronounced as during coronary arteriography. Intracoronary administration of a 3-4 ml solution containing microbubles close to erythrocyte size leads to opacification of the perfused part of the myocardium in echocardiographic image, whereas the echogenity of nonperfused parts remains unchanged. With the use of this method it might be possible to evaluate the significance of coronary stenosis, to diagnose the "disease of small arteries", to assess the collateral circulation, myocardial infarction size, and to quantify the blood flow in various parts of the myocardium in real time. The method is promising for the assessment of myocardial microcirculation as a complement of coronary arteriography. PMID- 3292156 TI - Hypertension in the elderly. PMID- 3292155 TI - Diagnosis and management of the preexcitation syndromes. PMID- 3292157 TI - Nephrotic syndrome in children. PMID- 3292158 TI - Infant and toddler development: active organization of the social world. PMID- 3292160 TI - New antiparasitic agents. III. Comparison between trypanocidal activities of some acridine derivatives against Trypanosoma cruzi in vitro. AB - Some acridine compounds referred to as 9-imino, 9-oxo and 9-thio derivatives were screened for activity against Trypanosoma cruzi in vitro. The results are discussed here with reference to the structure of the compounds tested. Attempts to elucidate the mode of action of active acridines are also included. The most active compounds that were tested were 9-thioacridanones and 9-thio-1,2,3,4 tetrahydroacridanones Added to this, the dialkylaminoalkylthio group seems to be the most convenient molecular moiety for trypanocidal activity in the 9 substituted acridine series. PMID- 3292159 TI - 3 percent topical minoxidil compared with placebo for the treatment of chronic severe alopecia areata. AB - The efficacy of a 3 percent topical minoxidil solution (2,4-diamino-6 piperidinopyrimidine-3-oxide) in a propylene glycol-water-ethanol base applied twice daily for one year to half the scalp was evaluated in patients with severe chronic alopecia areata. A randomized, double-blind, bilateral comparison controlled study design was used. Of the twenty-one patients, thirteen were women and eight were men; their ages ranged from nineteen to fifty-five years. All the patients had alopecia totalis or alopecia universalis, except for two who had lost two-thirds of their scalp hair. The mean disease duration was 11.5 years (range, one to forty years). Transient regrowth of sparse vellus hair occurred in twelve patients, bilaterally in eight, but it was not significant in any. No cosmetically acceptable results were achieved. No significant side effects were noted, except for a moderately severe bilateral dermatitis in one patient. The results indicate that 3 percent topical minoxidil solution is ineffective as treatment for severe chronic alopecia areata. PMID- 3292161 TI - Theories of carcinogenesis and their impact on surgical treatment of colorectal cancer. A historical review. AB - From the time of Hippocrates until the late 19th century, physicians and surgeons were convinced that surgical attempts at treating colorectal cancers were doomed to failure. This opinion stemmed from prevailing views on carcinogenesis. The three dominant theories, the humoral, mineral, and lymph theories, held that all cancers developed in tissue that had a diseased disposition. Thus, excision of the gross tumor mass alone seemed unlikely to cure the patient. Consequently, surgical treatment of all cancers, and in particular colorectal cancer, was vehemently condemned. The 19th century represented a transition period. Advances in surgical technique made excision of rectal cancers feasible. Unfortunately, classical views that resection of cancer was futile delayed the development of surgical treatment for colorectal cancer. Indeed, it was not until the late 19th century that a few individuals ignored these tenets of classical medicine and attempted local resections of rectal cancers. By the second quarter of the 20th century, a radical change occurred in the prevailing theories of carcinogenesis. Wide acceptance of the unicellular origin of cancer and the mucosal origin of colorectal cancers washed away admonitions against surgical treatment of colorectal cancers. It became axiomatic that all cancers, including colorectal cancers, could be cured surgically if treated while still local diseases. PMID- 3292162 TI - Effect of a new prostacyclin analogue on anastomosis of ischemic colon in dogs. AB - The effect of a new prostacyclin analogue OP-41483 on ischemic colonic anastomosis was investigated in dogs. Colonic ischemia was produced by devascularization of the marginal vessels in the left colon and graded into three degrees by measuring colonic blood flow with a hydrogen gas clearance method. The agent was administered intravenously after devascularization using a continuous infusion pump. The parameters studied were colonic blood flow in the submucosal layer, rate of anastomotic leakage, beta-glucuronidase activity and protein content of the colonic mucosa, and histologic changes. After administration of the agent, blood flow increased significantly and beta-glucuronidase activity at the anastomotic site was well preserved at a relatively high level in spite of ischemic change. The anastomotic leakage rate was significantly decreased. The present study proved that administration of this new prostacyclin analogue minimizes ischemic damage, and may be of considerable importance in ischemic colonic anastomoses. PMID- 3292163 TI - Rectal perforation during barium enema. Report of a case. AB - Perforation of the colon or rectum during the course of barium-enema examination is estimated to occur in approximately 500 patients annually in the United States. It has been over 30 years since the last collective review on this subject reported a prohibitively high mortality and morbidity. Since that time, much has been learned about the treatment of patients with peritonitis and bowel perforation, many new and more effective antibiotics have become available, and the management of shock has become infinitely more sophisticated. A review of recently reported cases suggests that the mortality rate and possibly the early morbidity have fallen markedly. Late complications such as adhesive small-bowel obstruction and retroperitoneal fibrosis with ureteral stenosis are well described, but data on the incidence of these long-term sequelae are still not available. PMID- 3292164 TI - Effects of graded alpha-glucosidase inhibition on sugar absorption in vivo. AB - The effect of inhibition of disaccharidases on the degree of absorption of glucose, lactose, and sucrose was examined utilizing an in vivo model in the rat. Acarbose, a competitive alpha-glucosidase inhibitor was utilized to selectively inhibit small intestinal mucosal enzymes. Adult rats (250-350 g body weight) were the subjects of intraduodenal bolus infusion experiments with either sugar alone or sugar plus acarbose. All sugars were infused at a dose of 0.5 g/kg body weight. Portal venous blood glucose was determined at 30-min intervals from 0 to 150 min. Glucose (monosaccharide) and lactose (beta-galactoside) absorption were not altered by the presence of acarbose. In contrast, sucrose (alpha-glucosidase) absorption was significantly diminished in the presence of acarbose. Sucrose absorption in the presence of increasing acarbose doses (0.7-5.6 mg/kg body weight) was depressed in a dose-dependent fashion. Linear regression analysis revealed a high degree of correlation between residual sucrase activity and area under blood glucose curve (r = 0.9837). Similar degrees of correlation were found between acarbose dose and area under blood glucose curve (r = -0.9322), and between residual sucrase activity and acarbose dose (r = -0.9695). These data confirm that acarbose is a selective alpha-glucosidase inhibitor that does not affect monosaccharidase transport. In the presence of acarbose, alpha-glucosidase absorption is diminished in a dose-dependent fashion. Postprandial glucose rise following an alpha-glucosidase meal seems to be determined, in the presence of graded acarbose inhibition, by residual mucosal alpha-glucosidase activity. PMID- 3292165 TI - Choledochal fungal ball. An unusual cause of biliary obstruction. AB - A 31-year-old patient with sickle-cell disease who had previous cholecystectomy developed acute onset of jaundice and abdominal pain. An endoscopic retrograde cholangiography demonstrated multiple filling defects within the bile ducts. Microscopic examination of "calculi" removed at surgery revealed that a fungal ball composed of Candida was the cause of biliary obstruction in this case. The patient eventually recovered after removal of the fungal masses and intrabiliary instillation of amphotericin. PMID- 3292166 TI - Concurrent collagenous colitis and multiple ileal carcinoids. AB - A case of collagenous colitis in a patient with ileal carcinoid is described. Considerable fibrofatty thickening of the small bowel mesentery was present. The association of these findings appears to be unprecedented. Further observations are required to ascertain that collagenous colitis is one of the protean manifestations of carcinoid tumor. PMID- 3292169 TI - Absence of dawn phenomenon in normal children and adolescents. AB - The dawn phenomenon consists of a rise in plasma glucose levels or insulin requirements in the early morning. This phenomenon has been observed in normal adults and in patients with diabetes mellitus. To determine whether this phenomenon also occurs in normal children and adolescents, we evaluated plasma glucose, insulin, C-peptide, and growth hormone levels during the early morning in 31 normal children between the ages of 8 and 18 yr. Blood samples were obtained through an indwelling catheter every 20 min for growth hormone and hourly for glucose, insulin, and C-peptide from 2100 to 0900 h. Glucose levels decreased slowly overnight from 2100 to 0900 h, despite increases in growth hormone levels. No significant rise in insulin or C-peptide levels was detected in the early morning in these normal subjects. There were no significant differences between prepubertal and pubertal children. We conclude that glucose, insulin, and C-peptide levels remain stable overnight, suggesting that the dawn phenomenon is not observed in normal children. PMID- 3292168 TI - Electrogastrography. Current assessment and future perspectives. PMID- 3292167 TI - Cytoprotective effect of acetaminophen against taurocholate-induced damage to rat gastric monolayer cultures. AB - Acetaminophen has recently been reported to protect against drug damage to gastric mucosa in vivo. The present study tested acetaminophen protection in cultured rat gastric mucous cells against sodium taurocholate-induced damage and assessed the role of endogenous prostaglandins. Cell damage was assessed by phase contrast microscopy and quantitated by Chromium-51 release assay which positively correlated with the trypan blue dye exclusion test (r = 0.98). The effect of acetaminophen on the production of PGE2 and 6-keto-prostaglandin F1a (6KF) was also studied. Sodium taurocholate caused cell death in a dose-dependent manner as indicated by increased 51Cr release. Preincubation with 5 mM acetaminophen significantly reduced 51Cr release caused by 5 mM sodium taurocholate, producing a 40% increase in cell survival. This cytoprotection was not blocked by indomethacin. PGE2 and 6KF of the media did not change after preincubation with nondamaging concentrations of acetaminophen or taurocholate. These results indicate that: (1) acetaminophen exerts a direct protective effect on gastric mucous cells cultured in vitro independent of indirect factors such as blood flow and (2) this protection is not associated with increased prostaglandin production. PMID- 3292170 TI - Can ICA be predictive marker for IDDM. PMID- 3292171 TI - Glucose-to-insulin ratio in intravenous tolbutamide test predicts long-term therapeutic outcome in NIDDM. PMID- 3292172 TI - No cyclosporin A to diabetic children. PMID- 3292173 TI - Diabetic retinopathy: a clinical overview. PMID- 3292174 TI - Basement membrane abnormalities in diabetes mellitus: relationship to clinical microangiopathy. PMID- 3292175 TI - Brittle diabetes: strategies, diagnosis, and treatment. PMID- 3292176 TI - Growth hormone and metabolism. PMID- 3292177 TI - Esophageal motility disorders. AB - Esophageal motility disorders consist of a complex array of disturbances in normal esophageal function associated with dysphagia, gastroesophageal reflux, and noncardiac chest pain. A thorough knowledge of normal esophageal anatomy and physiology is important to a full understanding of these motility derangements. Through a complicated interaction of neuromuscular and hormonal influences, the voluntary act of swallowing transforms into an automated sequence of peristaltic waves propelling food and liquids into the stomach in concert with coordinated relaxation of the sphincters. Anatomic and physiologic barriers exist within the esophagus protecting against gastroesophageal reflux and aspiration. With improvements in diagnostic tools such as barium contrast radiography, scintigraphy, pH measurements, and esophageal manometrics with provocative testing, motility disorders have become better defined and understood. Primary motility disorders consist of achalasia, diffuse esophageal spasm (DES), "nutcracker esophagus," hypertensive lower esophageal sphincter, and nonspecific esophageal motility dysfunction (NEMD). A host of secondary and miscellaneous motility disorders also affect the esophagus, including scleroderma and other connective tissue diseases, diabetes mellitus, Chagas' disease, chronic idiopathic intestinal pseudo-obstruction, and neuromuscular disorders of striated muscle. Gastroesophageal reflux disease (GERD) may also be promoted by associated motility disturbances. Treatment modalities include surgical myotomy; dilatation; and pharmacologic manipulations, including use of nitrates, calcium-channel blockers, H2-blockers, and psychotropic drugs where appropriate. PMID- 3292178 TI - [Partial homology of the sequences of structural genes for yeast secretory and membrane proteins; identification of probable sorting-transport sites of these proteins]. PMID- 3292179 TI - Monobactam antibiotics in subinhibitory concentrations enhance opsonophagocytosis and serum bacteriolysis in certain Escherichia coli strains. AB - Capsular polysaccharides are known to protect Gram-negative bacteria from complement-mediated killing and opsonophagocytosis. Monobactam antibiotics selectively inhibit penicillin-binding protein 3 (PBP3), resulting in abnormally structured peptidoglycan, causing defective cell surface structures. The authors studied the influence of subinhibitory concentrations of the monobactam antibiotics aztreonam and carumonam on serum bacteriolysis and opsonophagocytosis of four K-encapsulated and five non-K-encapsulated Escherichia coli strains. It was observed that monobactam antibiotics in subinhibitory concentrations enhanced opsonophagocytosis of the four K-encapsulated and one non-K-encapsulated E. coli strains tested. Opsonophagocytosis of the other four non-K-encapsulated E. coli strains was not enhanced. Serum bacteriolysis studies revealed that of the four K encapsulated strains tested only one strain showed a significant enhancement of bacteriolysis after treatment with subinhibitory concentrations of monobactam antibiotics. None of the unencapsulated strains showed a significant change in percentage lysis after treatment with either aztreonam or carumonam. PMID- 3292180 TI - Experience with antimicrobial combinations in urinary tract infections. AB - Four antimicrobial combinations were tried in the management of recurrent upper urinary tract infections: (i) rifampicin + trimethoprim (50 patients); (ii) amoxycillin + clavulanic acid (50 patients); (iii) ampicillin + sulbactam (10 patients); and (iv) pivampicillin + pivmecillinam (50 patients). The initial and final microbiological success rate was excellent with all four drug combinations; all were well tolerated. Although monotherapy should be the rule in antimicrobial chemotherapy, there are certain indications that may necessitate combination therapy; for example, to cover a wider spectrum of activity with mixed infections or before the causative pathogen is isolated and its antimicrobial sensitivity defined, to delay the emergence and to avoid selection of resistant strains, to convert a bacteriostatic into a bactericidal effect and to obtain a synergistic (or at least an additive) antimicrobial effect by the combination. PMID- 3292181 TI - In-vitro activity of antifungal agents in combination with four quinolones. AB - The antifungal activity of amphotericin B (AMB), mepartricin (MEPA), 5 fluorocytosine (5FC) and three imidazoles was tested in combination with each of four quinolones against 60 clinical yeast isolates. The inhibitory activity of AMB and MEPA was marginally enhanced by the azaquinolones, nalidixic acid (NAL) and enoxacin (ENO), but there was antagonism when combined with the fluorinated quinolones ciprofloxacin (CIP) and norfloxacin (NOR). All quinolones except NAL partially antagonised 5FC. Miconazole (MCZ), ketoconazole (KTZ) and itraconazole (ITZ) were each found to be synergistic with low concentrations of the quinolones, and also with high concentrations of NAL and ENO, but were strongly antagonised by high concentrations of CIP and NOR. PMID- 3292182 TI - Treatment of adult respiratory distress syndrome. AB - Adult respiratory distress syndrome (ARDS) culminates in inadequate oxygen delivery to the tissues. There are numerous inciting factors for this syndrome. Several therapies including the prophylactic use of antibiotics and steroids are controversial; even mechanical ventilatory support has controversial elements. The cornerstone of treatment remains supportive care until the cause of ARDS has resolved. PMID- 3292183 TI - Pharmacoepidemiology: the future. AB - Like all other futures, the future of pharmacoepidemiology is not entirely clear. Major forces exist that are driving the agenda for pharmacoepidemiology. This article reviews and weighs these factors and the roles of the major related actors. Like all health futures, that of pharmacoepidemiology can be positively influenced by responsible contributions, particularly by the pharmaceutical community. PMID- 3292184 TI - Fibrinolytic drugs in acute myocardial infarction. PMID- 3292186 TI - [Orthotopic liver transplantation in Wilson's disease and acute liver failure]. AB - Liver histology demonstrated progressive cirrhosis in a 19-year-old girl with a subacute form of Wilson's disease. Despite D-penicillamine administration her liver functions rapidly deteriorated further. Orthotopic liver transplantation was performed. Postoperatively there were two mild rejection episodes, an organic psychiatric syndrome and generalized tremor. Copper metabolism and clinical symptoms became normal postoperatively. Five months after the transplantation she was in a good general condition, able to continue her education. PMID- 3292185 TI - [Endocarditis prophylaxis with amoxicillin, clindamycin or erythromycin? Serum bacteriostatic and bactericidal effect against Streptococcus viridans]. AB - The effectiveness of antibiotic prophylaxis against endocarditis was assessed by testing the bactericidal and bacteriostatic action in serum of 12 healthy volunteers who had taken the recommended antibiotics according to laid down guidelines. Blood was obtained from these subjects every two hours for 12 hours after oral intake of amoxicillin (3 g as a single dose), clindamycin (600 mg a single dose) or erythromycin (1.5 g plus another 0.5 g after six hours), the serum being tested against three Strep. viridans strains. Two of the three strains were "tolerant", i.e. in relation to the minimal inhibition concentration (MIC) their growth was inhibited, but--in relation to the minimal bactericidal concentration (MBC)--they were not killed. A bacteriostatic effect by amoxicillin and clindamycin was demonstrated by a micromethod against all three strains during the 12-hour period. But erythromycin did not achieve bacteriostasis in all serum samples. A bactericidal effect was demonstrated only in those samples that contained amoxicillin, and then only against the non-tolerant of the three strains. These results support the view that amoxicillin and clindamycin are effective in the prophylaxis against Strep. viridans bacteraemia because of their constant bacteriostatic effect, as measured in serum. PMID- 3292187 TI - [Allergic bronchopulmonary aspergillosis with hay dust-induced alveolitis and bronchial asthma]. AB - A 55-year-old female farmer had all the clinical, biochemical and radiological signs diagnostic of allergic bronchopulmonary aspergillosis. Remarkably she also had symptoms of farmer's lung and exogenous allergic bronchial asthma with specific types I and III sensitisation due to Aspergillus antigens inhaled with straw-dust. In addition to the usual asthma treatment she also received antimycotic agents and corticosteroids. Antigen exposure was strictly avoided. These measures brought about lasting regression of the disease manifestations and of the high concentrations of IgE and IgG antibodies against many Aspergillus antigens. PMID- 3292188 TI - [Ultrasonic diagnosis of the thyroid gland]. PMID- 3292190 TI - [Modified ureterocystostomy: a low rate of urological complications in kidney transplantation]. AB - A total of 31 urological complications (4.6%) were noted between January 1974 and July 1987 among 670 renal transplantations: ureteral stenoses (n = 18), ureteral leaks (n = 8), vesicorenal reflux in the transplant with chronic urinary-tract infection (n = 1), and urolithiasis in the area of the transplant (n = 4). There were six ureteral leaks among 110 extravesical ureterocystoneostomies, while there were only two leaks among 560 anastomoses done by a modified method of Leadbetter and Politano. Restoration of urinary flow integrity was achieved without organ loss or functional impairment. PMID- 3292189 TI - [Current status of the therapy of malignant testicular tumors]. PMID- 3292191 TI - [Anaphylactic reaction to human insulin. Successful desensitization]. AB - A 48-year-old woman with diabetes mellitus (type IIb) had to be treated with insulin because of poor blood-sugar control. Infiltrates at the sight of injection occurred with two different porcine insulin preparations, necessitating a switch to human insulin. After the third injection of the latter an anaphylactic reaction developed within minutes. During a pregnancy in 1968 the patient had briefly received bovine insulin. Tests now revealed an immediate-type allergy against all three available species insulins, which was successfully treated by hyposensitisation. PMID- 3292192 TI - [Psychosocial findings in transsexuals. Diagnosis, etiology and treatment]. PMID- 3292193 TI - [Acetylsalicylic acid therapy in vascular diseases]. PMID- 3292194 TI - [Ultrasonography in acute appendicitis]. PMID- 3292195 TI - [Bile acid determination in blood serum and its significance for the diagnosis of liver diseases in cattle]. PMID- 3292196 TI - [The effect of citric acid on nutrient digestibility and N-balance in piglets]. PMID- 3292197 TI - [Comparative studies of the seasonality of the sexual cycle in Rhon and Merino sheep]. PMID- 3292198 TI - [The neuromyodysplasia syndrome (NMD syndrome) of calves]. PMID- 3292199 TI - [Quantitative characterization of a chromosomal translocation in sheep]. PMID- 3292200 TI - [The relation between parameters of the immune system, secretion disorders and milk production in cattle]. PMID- 3292202 TI - [The relation between disease susceptibility and milk production characteristics in Norwegian red cattle]. PMID- 3292201 TI - [The morphology, including nuclear row structure, of heart muscle cells in swine breeds of different degrees of growth]. PMID- 3292203 TI - [The problems of PMSG superovulation treatment of Merino sheep in relation to an embryo transfer program: relation between PMSG plasma concentration and superovulation reaction]. PMID- 3292205 TI - [The dynamics of wool growth in goats]. PMID- 3292204 TI - [Sexual periods in the Karakul sheep]. PMID- 3292206 TI - [Criteria for the selection of Polish Merino ewes]. PMID- 3292207 TI - Relapse rate as a major determinant of drug selection in peptic ulcer therapy. PMID- 3292208 TI - Propofol. A review of its pharmacodynamic and pharmacokinetic properties and use as an intravenous anaesthetic. AB - Propofol is an intravenous anaesthetic which is chemically unrelated to other anaesthetics. Induction of anaesthesia with propofol is rapid, and maintenance can be achieved by either continuous infusion or intermittent bolus injections, with either nitrous oxide or opioids used to provide analgesia. Comparative studies have shown propofol to be at least as effective as thiopentone, methohexitone or etomidate for anaesthesia during general surgery. The incidence of excitatory effects is lower with propofol than with methohexitone, but apnoea on induction occurs more frequently with propofol than with other anaesthetics. Additionally, a small number of studies of induction and maintenance of anaesthesia have found propofol to be a suitable alternative to induction with thiopentone and maintenance with halothane, isoflurane or enflurane. Propofol is particularly suitable for outpatient surgery since it provides superior operating conditions to methohexitone (particularly less movement), and rapid recovery in the postoperative period associated with a low incidence of nausea and vomiting. When used in combination with fentanyl or alfentanil, propofol is suitable for the provision of total intravenous anaesthesia, and comparative studies found it to be superior to methohexitone or etomidate in this setting. Infusions of subanaesthetic doses of propofol have been used to sedate patients for surgery under regional anaesthesia, and also to provide sedation of patients in intensive care. In the latter situation it is particularly encouraging that propofol did not suppress adrenal responsiveness during short term studies. If this is confirmed during longer term administration this would offer an important advantage over etomidate. Thus, propofol is clearly an effective addition to the limited range of intravenous anaesthetics. While certain areas of its use need further study, as would be expected at this stage of its development, propofol should find a useful role in anaesthetic practice. PMID- 3292212 TI - [Comutagenic action of sodium selenite and caffeine on S. typhimurium TA 1535 with its subsequent treatment by N-nitrosomethylurea]. AB - The comutagenic activity of sodium selenite and caffeine was studied by the Ames test. Reproduction of S. typhimurium TA1535 for 4 h at 37 degrees C in the nutrient broth with sodium selenide (5 micrograms/ml) significantly increased sensitivity of bacterial cells to the mutagenic action of 2-3 mM N nitrosomethylurea (NMU). When using threshold concentrations of NMU the potentiation of mutagenesis reached 625.2%. The addition of 0.19 mg/ml of caffeine to the nutrient medium also led (though the action was less pronounced) to an increase in sensitivity of bacterial cells to the NMU mutagenic action. Reproduction of S. typhimurium TA1535 in the medium containing sodium selenide and caffeine did not cause an increase in the frequency of spontaneous his+ revertant mutations. PMID- 3292210 TI - Drug treatment of stroke. Current status and future prospects. AB - Despite advances in the understanding of the mechanism of cerebral injury during focal ischaemia, the best treatment of cerebral ischaemia is still prevention. The pathophysiological mechanisms that contribute to cerebral ischaemia are discussed relative to the many therapeutic interventions that have been attempted. It is our impression that the treatment of such a complex multifactor process will require multimodal therapy, as most of the unifactorial therapies used to date have proven relatively unsuccessful in improving neurological outcome and survival. PMID- 3292213 TI - [Specificity of the interaction of carcinogenic and cytostatic agents with the elements of the genome at different levels of its organization]. AB - The analysis of the literature permits drawing a conclusion that according to DNA binding site-specificity carcinogens and antitumour drugs can be divided into GC- and AT-binding compounds. When interacting with eucaryotic DNA such specificity leads to an increased binding of carcinogens and antitumour drugs to the repeat rich DNA (satellite DNA, alpha-DNA, flanking regions of genes). It is supposed that specificity of the binding of chemical compounds on higher levels of genome organization (active and inactive chromatin, nuclear matrix-bound DNA) is also defined by the affinity of compounds to GC- or AT-rich repeats. PMID- 3292215 TI - [Clonogenic cultivation of bone marrow fibroblast precursors in human myeloproliferative diseases]. AB - Techniques of clonogenic cultivation with the application of xenogenous feeder (rabbit irradiated bone marrow) were used to study a number of bone marrow colony forming cells (CFU-F) in 70 patients. A significant increase of CFU-F is observed in chronic myelocytic leukemia and in hepatosplenomegalies of non-leukemic origin CFU-F decreases considerably in the cases of myelofibrosis. Trypsinisation of the bone marrow taken from the cases of myelofibrosis results in a sharp CFU-F increase. PMID- 3292214 TI - [Determination of subpopulations of normal and malignant transformed lymphocytes in blood smears by an immunoenzyme histochemical method using monoclonal antibodies]. AB - The data on lymphocyte subpopulations in blood smears are presented. They can be revealed by the double PAP-method and monoclonal antibodies ICO--1.02, 10, 11, 13, LT--1.8, 1B4, IPO--3, 4, 5, 10 and BL--TH4, DR 1, DR 4. PMID- 3292216 TI - [Biological aspects of the recurrence of malignant tumors]. AB - Certain aspects of the differences between primary and recurrent tumours, such as the causes of the origin of recurrences, kinetic of the growth, characteristic of the recurrences as nonidentical population with primary tumour, immunological aspects, different changes in the tumour host have been reviewed. The prospects of the treatment of tumour recurrences have been discussed. PMID- 3292217 TI - Genitourinary emergencies: a prehospital perspective. AB - Genitourinary emergencies present unique assessment and treatment challenges in the prehospital setting. Common chief complaints and patient presentations are listed in Table 3. Serious cases may involve hypovolemia, shock, severe pain, infection, or autonomic hyperreflexia. Prehospital management should focus on maintaining an adequate cardiovascular status, preventing excessive blood loss, relieving urinary retention, and alleviating pain. With these priorities in mind, prehospital treatment should have as its goals to treat pain, to reduce fear, and to minimize the complications of genitourinary emergencies. PMID- 3292211 TI - Current concepts in the treatment of disorders of micturition. AB - Disorders of micturition may be divided into disturbances of the storage function of the bladder, and disturbances of the emptying function. The main symptoms of disturbances of storage function are frequency, urgency and incontinence. Hyperactivity of the bladder may lead to urge incontinence, and incompetence of the urethral closure mechanism to stress incontinence. There are many drugs available for treating bladder hyperactivity, but their efficacy as judged from controlled clinical trials (when available) is often limited. Bladder contraction in man is mediated by stimulation of muscarinic receptors, and when given parenterally anticholinergic drugs have been shown to depress bladder hyperactivity irrespective of the underlying cause. Clinically, however, treatment of urge incontinence with anticholinergic drugs is often unsatisfactory. Lack of effect of oral treatment and systemic side effects limit the use of available agents. Drugs with "mixed" actions (anticholinergic and 'direct' muscle effects), for example oxybutynin and terodiline, have well documented efficacy in bladder hyperactivity. Side effects are common with oxybutynin; terodiline seems to be well tolerated. The aim of drug treatment of stress incontinence is to increase outflow resistance. Although there is only limited possibility of improving the condition with drugs, beneficial effects can be obtained in some patients by use of orally active alpha-adrenoceptor agonists (e.g. phenylpropanolamine) and/or oestrogens. The main symptom of disturbed bladder emptying is urinary retention. Drug therapy is aimed at improving the contractile activity of the detrusor or reducing urethral outflow resistance. Drugs used for improving bladder contractility include parasympathomimetic agents, e.g. bethanechol or carbachol, and intravesical instillation of prostaglandins. Although the efficacy of both types of treatment is open to question, bethanechol seems to be widely used. Increased outflow resistance may be seen in patients with parasympathetic decentralization of the lower urinary tract or in patients with benign prostatic hypertrophy. These patients may respond favourably to alpha-adrenoceptor blockers such as phenoxybenzamine or prazosin. PMID- 3292218 TI - Prostatitis. AB - Prostatitis is a poorly defined group of syndromes with multiple causes, some of which are not yet determined. Although treatment of acute prostatitis is well defined and almost uniformly successful, chronic prostatitis, either of bacterial or undetermined etiology, remains a perplexing problem in both diagnosis and treatment. Identification of the etiologic agent of chronic "nonbacterial" prostatitis, if one exists, has not yet been accomplished. Undoubtedly, more than one organism may be responsible for these cases. Treatment is ineffective for a high percentage of patients with chronic prostatitis, both from proven bacterial and nonbacterial causes. Few drugs penetrate the prostatic tissues well, and few of those that do have an appropriate antimicrobial spectrum. An excellent, or even adequate, antibiotic for chronic prostatic infections has yet to be developed. Prostatodynia remains as a "wastebasket" syndrome of miscellaneous pains, aches, and pelvic discomforts. With this collection of symptoms, no easy approach to diagnosis or treatment is possible. Only when more detailed diagnosis has been developed can one hope for better therapy of this condition. PMID- 3292219 TI - Pyelonephritis and female urinary tract infection. AB - Urinary tract infections are a common problem for women and frequently result in a visit to the Emergency Department. Most of these infections are easily diagnosed and treated; however, subclinical pyelonephritis is a recently recognized entity and signs of upper tract involvement should always be sought, especially in compromised hosts and patients who are at risk for developing complicated infections. Each of these situations demands a more thorough evaluation and more prolonged and aggressive treatment to minimize the possibility of renal damage. Fortunately, there is a narrow spectrum of organisms responsible for most urinary tract infections, and they respond well to a wide range of commonly used antibiotics. Newer diagnostic techniques, the acceptance of short-course therapy for lower tract infections, and the development of new antibiotics have increased our diagnostic and therapeutic options. Further developments in these areas, as well as the possibility of nonantibiotic prevention of urinary tract infections, predict a brighter future for patients with complicated or frequently recurring urinary tract infections. PMID- 3292220 TI - Acute urinary retention. AB - Acute urinary retention is a common emergency genitourinary symptom. The etiology of acute retention includes obstructive, neurogenic, pharmacologic, and psychogenic causes. The emergency management of acute urinary retention is bladder decompression, which is usually accomplished with a Foley catheter. PMID- 3292221 TI - Sexually related trauma. AB - Many men and women practice a broad range of voluntary sexual activities, most of which are harmless. The only erotic activities that have an unacceptable risk for injury are vaginal insufflation during pregnancy, and fist fornication. Many minor injuries of the genital, oral, and anal areas do occur but most require only symptomatic therapy. Vaginal lacerations focus primarily around the posterior fourchette, although the few most serious ones tend to be high in the vault. Following anal sex, minor rectal bleeding from anal fissures or small mucosal tears is neither uncommon nor serious. Although retained rectal foreign bodies may present a challenge to the physician's imagination, most can be removed in the Emergency Department, and laparotomy rarely is required. Rectal perforations and sphincter injuries are uncommon but may be caused by foreign objects. Rape is a common crime of violence in which a man uses sex as a weapon. A post-traumatic psychological syndrome, with both short-term and long-term dysfunctional elements, almost uniformly follows the attack. Oral and anal sex are part of the assault in many cases. Nongenital injuries may be documented in 40 per cent, but only 4 per cent are serious, and fewer than 1 per cent require hospitalization. Genital injuries can be found with special staining in almost 50 per cent of cases, but only 1 per cent will need repair. Men represent only 5 per cent of the adult sexual assault cases, but they tend to suffer more physical injury. Both rape and sexual child abuse are grossly underreported. Sexual misuse of children has a family focus and is appallingly common. The emotional impact on the child is largely a function of the family's reaction. When strangers are involved in the abuse there is more chance of injury. Significant fresh injury will be found in only 8 per cent and is most likely to be anogenital. Findings of chronic sexual abuse will be present in one third, however. Boys are the victims in 15 per cent of cases. Physicians must be educated and vigilant for sexually related injuries because people frequently will delay treatment and then provide misleading histories because of embarrassment. PMID- 3292209 TI - Ciprofloxacin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. AB - Ciprofloxacin is one of a new generation of fluorinated quinolones structurally related to nalidixic acid. The primary mechanism of action of ciprofloxacin is inhibition of bacterial DNA gyrase. It is a broad spectrum antibacterial drug to which most Gram-negative bacteria are highly susceptible in vitro and many Gram positive bacteria are susceptible or moderately susceptible. Unlike most broad spectrum antibacterial drugs, ciprofloxacin is effective after oral or intravenous administration. Ciprofloxacin has been most extensively studied following oral administration. It attains concentrations in most tissues and body fluids which are at least equivalent to the minimum inhibitory concentration designated as the breakpoint for bacterial susceptibility in vitro. The results of clinical trials with orally and intravenously administered ciprofloxacin have confirmed the potential for its use in a wide range of infections, which was suggested by its in vitro antibacterial and pharmacokinetic profiles. It has proven an effective treatment for many types of systemic infections as well as for both acute and chronic infections of the urinary tract. Ciprofloxacin generally appeared to be at least as effective as alternative orally administered antibacterial drugs in the indications in which they were compared, and in some indications, to parenterally administered antibacterial therapy. However, further studies are needed to fully clarify the comparative efficacy of ciprofloxacin and standard antibacterial therapies. Bacterial resistance to ciprofloxacin develops infrequently, both in vitro and clinically, except in the setting of pseudomonal respiratory tract infections in cystic fibrosis patients. The drug is also well tolerated. Thus, as an orally active, broad spectrum and potent antibacterial drug, ciprofloxacin offers a valuable alternative to broad spectrum parenterally administered antibacterial drugs for use in a wide range of clinical infections, including difficult infections due to multiresistant pathogens. PMID- 3292223 TI - Evaluation of male external genital diseases in the emergency room setting. AB - This article briefly discusses various diseases of the external genitalia as they pertain to the emergency physician. Conditions emphasized include penile and scrotal trauma, Fournier's gangrene, and the "acute" scrotum. Practical advice regarding diagnosis and treatment is offered. PMID- 3292222 TI - Asymptomatic bacteriuria in the elderly. AB - Asymptomatic bacteriuria is a condition in which a urine culture has more than 100,000 colonies per ml and in which the patient has no symptoms. There is a startling prevalence of this condition in the elderly population. Uncertainty exists about both the need and the nature of possible therapy for asymptomatic bacteriuria in the elderly. Adequate studies do not define well the associated morbidity or mortality of this condition in the patient without obstruction. When obstruction is present, therapy is necessary until the obstruction is relieved. PMID- 3292225 TI - Priapism. AB - The evaluation of priapism is unfamiliar to many emergency physicians. Rapid assessment and treatment are essential in the hope of preserving sexual function. A thorough history and physical examination reveal an underlying vascular or neurologic etiology in most cases. Treatment generally consists of adequate oxygenation, hydration, and analgesia, with early urologic consultation. PMID- 3292224 TI - Sexually transmitted urogenital diseases. AB - Patients with sexually transmitted diseases (STDs) frequently present for care to the Emergency Department. Some of the more common STDs are increasing in number despite public health efforts to control their spread. Relatively simple diagnostic modalities for several of the more common STDs are presented. In addition, the most current treatment regimens for each STD discussed are described in detail. PMID- 3292226 TI - The acute scrotum. AB - In boys and adolescents, the acute scrotum usually results from one of three diseases: torsion of the spermatic cord, torsion of the appendix testis, or epididymitis. A rapid diagnosis of torsion of the cord, if present, is essential, and as soon as this diagnosis is made, arrangements must be made for timely surgical correction. Although a diagnosis for the acute scrotum in this age group can sometimes be made on the basis of the history, pathognomonic signs, and basic laboratory analysis of the urine and a urethral discharge, in the usual case diagnosis requires a Doppler ultrasound examination (which if positive for torsion makes the diagnosis), a radionuclide scan (for cases negative or indeterminate for torsion on the Doppler examination), or, as a last resort, scrotal exploration. In men, by far the most common cause of the acute scrotum is epididymitis, with the torsions being much less common. In heterosexual young men with epididymitis, N. gonorrhoeae and C. trachomatis are the most likely etiologic organisms; in homosexual men and older men (and boys), E. coli, Pseudomonas sp., and the gram-positive cocci are the most common pathogens. Ceftriaxone plus tetracycline is the initial antimicrobial regimen of choice in heterosexual young men; in the absence of evidence of a sexually transmitted pathogen, one of the antimicrobials effective against common urinary tract pathogens is the initial antimicrobial of choice in all other patients. When torsion of the cord is suspected in adult male patients, the Doppler examination and the radionuclide scan (if the Doppler is negative or indeterminate) can again make the diagnosis or rule it out. PMID- 3292227 TI - Diagnostic and therapeutic urologic procedures. AB - Urologic procedures useful to the emergency physician in the diagnosis and management of urinary tract disorders are presented in this article. Discussed are urinalysis, diagnostic radiologic modalities (KUB film, intravenous pyelography, retrograde cystourethrography, computerized tomography, angiography, ultrasonography, and renal scintigraphy), and urologic procedures (urethral catheterization, percutaneous suprapubic cystostomy, suprapubic bladder aspiration, dorsal-slit procedure, and meatotomy). Where appropriate, indications, contraindications, method, and complications are presented for the various procedures. PMID- 3292228 TI - Emergency management of urologic trauma. AB - Emergency management of urologic trauma can be expeditiously transected by reliance upon radiographic information and awareness of emergency priorities. Attention can be confidently focused on the area of maximal injury (upper versus lower urinary tract), and definitive or temporizing measures instituted according to circumstances. Although specialty management is ultimately required, diagnostic and therapeutic efforts initiated by emergency personnel are important to efficient appraisal and disposition. PMID- 3292229 TI - Radiologic contrast-induced renal failure. AB - RCIRF is a complex syndrome resulting in acute renal dysfunction following exposure to radiologic contrast media. It accounts for 10 per cent of all cases of acute renal failure. The pathogenesis appears multifactorial but most probably involves contrast-mediated renal ischemia and direct tubular toxicity. Significant risk factors include preexisting renal insufficiency, diabetes mellitus, advanced age, volume depletion, and presence of multiple myeloma. The diagnosis should be suspected with acute renal dysfunction temporally related to radiologic contrast administration. The prognosis for recovery is good in most cases. Key preventive measures include identification of high-risk patients, ensuring adequate hydration prior to contrast agent administration, avoiding excessive and repeated contrast exposure, and instituting prophylactic therapy in selected cases. PMID- 3292230 TI - Nephrolithiasis. AB - The management of the patient presenting to the Emergency Department with nephrolithiasis or renal colic should include evaluation of the patient for concurrent diseases, risk factors for stone formation, and possible etiologies for stones. Suspicion of ureterolithiasis is based on a cogent history and physical examination and reinforced by a finding of hematuria. Diagnosis should be based upon a promptly performed intravenous pyelogram, unless the patient is truly allergic to contrast media or has substantial risk of a contrast-induced renal failure. A solitary flat plate of the abdomen adds no useful information and is an unnecessary expense to the patient. Essential laboratory data include a urinalysis, CBC, and electrolyte, BUN, creatinine, and serum calcium levels. A urine culture should be obtained in all patients because urinalysis alone may not be sufficient to exlude a urinary tract infection. Initial treatment of the patient with an uncomplicated renal colic should include hydration, relief of pain, and reassurance. Evaluation by a consultant may be done as an outpatient on a nonemergent basis. If the colic has not resolved after 72 hours, hospitalization generally is recommended. If the patient has vomiting, dehydration, a complete obstruction, or a solitary kidney, hospitalization in indicated and urgent consultation recommended. If the patient has fever or other signs of infection, emergent consultation and immediate hospitalization are essential. Retained obstructing stones are generally managed by urologic consultants. It is in the care of the patient with the retained stone that greatest advances have been made in the past 10 years. Patients should be counseled that the retained stone no longer calls for extended hospitalization and convalescence. PMID- 3292231 TI - Seizure susceptibility in DBA and C57 mice: the effects of various convulsants. AB - Convulsive dose 50s (CD50s) for various convulsive drugs and minimal and maximal electroshock seizure thresholds were determined in DBA and C57 mice. DBA mice had lower maximal electroshock seizure thresholds (MESTs, 15%) and CD50s for homocysteine thiolactone (HTL, 23%) and bicuculline (69%), and a higher CD50 for pentylenetetrazol (PTZ) at 3 weeks of age, the age of maximal audiogenic seizure (AGS) susceptibility. At 8 weeks, when DBA mice are not susceptible to AGSs, significant differences were a lower minimal electroshock seizure threshold (mEST, 37%) and maximal EST (MEST) (19%), lower CD50s for N-methyl-D-aspartate (NMDA) (39%), kainic acid (KA, 50%), HTL (32%), strychnine (37%), and a higher CD50 for nicotine (55%) in DBA mice. Based on these data it is suggested that pathways involving NMDA and KA receptors are responsible for increased susceptibility to seizure initiation (mEST), and are opposed by glycine pathways, and that opposing GABA and cholinergic systems at higher CNS levels are involved in seizure spread (AGSs and MEST) in these mice. Latency patterns indicate that nicotine, strychnine, PTZ and bicuculline have high blood-brain barrier (BBB) penetrability. Picrotoxin and the excitatory amino acid receptor agonists had longer latencies, suggesting low BBB penetrability. Age-related changes in latency, however, give evidence that difficulty in drug penetration of the BBB is not responsible for differences observed in CD50s between strains. PMID- 3292232 TI - Neurological morbidity of severe epilepsy. AB - The "severity" of a disease is a relative expression and its definition will vary depending on the perspective of the observer. The patient's subjective perception of the disease, the way it is regarded socially by the community, and the doctor's objective assessment rarely coincide. In fact, they are frequently diametrically opposed. As far as the patient's personal perception of epilepsy is concerned, there has apparently been no satisfactory attempt thus far at a systematic grading of the subjective handicap, despite the growth of interest in psychological matters and the self-help movement. Similarly, social ability or disability cannot be adequately assessed on the basis of medical criteria such as frequency and type of seizures. We present a grading system which will serve as an example of an appropriate method of assessing social abilities, and which will permit the patient's occupational potential to be estimated in relation to the risk of accidents resulting from seizures. From the medical point of view, the impairment of a patient's abilities due to epilepsy is a function of the patient's responsiveness to treatment. We present a critical review of the factors which have an effect on the therapeutic prognosis: the causes of epilepsy, underlying structural lesions, the incidence of convulsive status epilepticus, various types of attacks, and the different epileptic syndromes. Taking two examples--epilepsy presenting in the form of absence and epilepsy with complex focal seizures--we show that ultimately the "severity of epilepsy" can only be defined from the medical standpoint on the basis of several factors whose value is of a predictive nature. PMID- 3292233 TI - Cognitive hazards of seizure disorders. AB - The relationship of a number of epilepsy variables to cognitive decline is reviewed. Underlying brain damage, seizure age of onset, type and frequency, and anticonvulsant drugs are all considered. Two investigations in which subgroups of patients with intellectual deterioration have been compared to those without such deterioration are presented, and certain conclusions are reached with respect to the most important factors that relate to decline. Recurrent tonic-clonic seizures, head injury, the prescription of phenytoin, and low folic acid levels were all related to cognitive decline in one or both of the studies, and the implications of this for the management of epilepsy are noted. PMID- 3292234 TI - Adjunctive therapy in resistant epilepsy. AB - It is now established that the overall prognosis for epilepsy is good and that remission will occur in at least 75% of patients following adequate treatment with monotherapy. Patients who fail to respond to monotherapy, who are not suitable for surgery, and who continue to have frequent seizures may have to be considered for an alternative drug regimen. A review of the literature indicates that complete seizure control with adjunctive treatment is rare, but improved seizure control can be obtained in up to 40% of patients. In a study of clobazam as adjunctive treatment, 60% (N = 20) of our patients responded to treatment initially and 33% maintained an improvement over an 18-month period. In 31 patients who failed to respond to carbamazepine as monotherapy, primidone (N = 16) or valproate (N = 15) were prescribed as adjunctive treatment. One patient obtained complete freedom from seizures and 14 (45%) had a greater than 50% reduction in seizure frequency. Suggested indications for the use of additive treatment in epilepsy are discussed. PMID- 3292235 TI - Epilepsy in developing countries: a review of epidemiological, sociocultural, and treatment aspects. AB - In this report, aspects of epilepsy that differ in developing and in developed countries are reviewed. This is inevitably an incomplete and impressionistic survey, because data on many aspects in developing countries are scarce, and because it is difficult to generalise meaningfully about the enormous diversity of countries and populations that make up the developing world. Epidemiological studies of prevalence and incidence are reviewed with an emphasis on the problems inherent in work in this area in developing countries. Data concerning seizure type, aetiology, and severity of seizures in the Third World are contrasted with those from developed countries. Sociocultural aspects of epilepsy have been poorly studied, and yet are fundamental to effective medical management. The social effects of epilepsy and the local perceptions of cause and of treatment are discussed from work in Africa, Asia, and South America. The principles and success of treatment in the Third World may differ considerably in developing and developed countries. In the Third World, medical manpower is scarce, and epilepsy is managed essentially by primary care resources, without specialised investigations or personnel. The principles of drug therapy may not be understood by patients, and the supply of drugs is often erratic; and these are major reasons for poor compliance with treatment. World Health Organisation (WHO) initiatives have stressed the extensive use of paramedical personnel and of an essential drugs list, but this emphasis may be misdirected, and in practice neither proposal has achieved much success. The recommendation that phenobarbital be extensively used in the Third World, because of its cheapness and efficacy, is also of doubtful merit, as there are well-known and major drawbacks to the widespread use of this drug. Computations of treatment gap figures in three developing countries suggest that between 80-94% of patients with active epilepsy are not receiving anticonvulsant therapy, and cost is only one of a number of reasons for this. The key to improvements in medical treatment lie with a better understanding of the patients' cultural concepts of epilepsy and its treatment, improved drug supply and availability, and efforts to improve education amongst general practitioners and other primary care medical personnel. PMID- 3292236 TI - Purification and properties of 4-hydroxycyclohexanecarboxylate dehydrogenase from Corynebacterium cyclohexanicum. AB - 4-Hydroxycyclohexanecarboxylate dehydrogenase, which requires NAD as a cofactor, was detected in crude soluble extracts of Corynebacterium cyclohexanicum grown on cyclohexanecarboxylic acid as the sole carbon source. The dehydrogenase was purified from extracts to an electrophoretically homogenous state by ammonium sulfate precipitation and chromatography on DEAE-650s, agarose-NAD and hydroxyapatite. The enzyme consisted of two identical subunits and had a native relative molecular mass of 53,600. There were two residues each of cysteine and tryptophan in the enzyme molecule. Oxo acid rather than hydroxy acid was routinely used as substrate for assay of the enzyme. The enzyme is highly specific for 4-oxocyclohexanecarboxylic acid: the carboxyl group is essential and the position of carbonyl group is important; neither the 2-oxo nor the 3-oxo homologue was used as substrate. A methyl substitution on the ring of 4 oxocyclohexanecarboxylate resulted in an almost complete loss of its activity. The reduction product was identified as trans-4-hydroxycyclohexanecarboxylic acid by gas-liquid chromatography and mass spectrometry. It was used as a substrate for the reverse reaction in the presence of NAD but not its cis-isomer. The enzyme was specific for the B-side (pro-S) hydrogen of NADH in the hydrogen transfer from NADH to 4-oxocyclohexanecarboxylate. The Km values for 4 oxocyclohexanecarboxylate and NADH in the reduction reaction at pH 6.8 were 0.50 mM and 0.28 mM, respectively, whereas those for trans-4 hydroxycyclohexanecarboxylate and NAD in the oxidation reaction at pH 8.8 were 0.51 mM and 0.23 mM, respectively. The equilibrium constant of the reaction was 1.79 x 10(-10) M. The enzyme was strongly inhibited by N-bromosuccinimide. PMID- 3292238 TI - Conformational alterations detected by circular dichroism induced in the normal ras p21 protein by activating point mutations at position 12, 59, or 61. AB - Activation of the oncogenic potential of ras oncogenes occurs by point mutations at codons 12, 13, 59, 61, and 63 of the sequences that codify for its product, a 21-kDa protein designated as p21. This activation has been postulated by computer models as modifiers of the structure of the protein, which may alter its biochemical and biological activities. We have expressed in bacteria the normal ras p21 and five mutated p21 proteins with mutations at positions 12, 59, 61, 12 plus 59, and 12 plus 61. Purification was carried out by solubilization from bacterial pellets in 7 M urea and chromatography through a Sephadex G-100 column to obtain greater than 95% purified proteins. Circular dichroic (CD) spectra showed that the normal protein and that activated by substitution of Ala59 to Thr59 are very similar in their overall structure. By contrast, point mutations affecting either 12 or 61 residues substantially altered the structure of the proteins. When the parameters of Chen et al. [Biochemistry II, 4120-4131 (1972)] were applied to the CD spectra, both normal and thr59-mutated ras proteins showed a less organized structure than mutated proteins at position 12 or 61. Since the Thr59 mutant has more similar transforming activity than other activated proteins, but a GTPase activity similar to that of the normal protein, our results support the hypothesis that there is more than one mechanism of activation of the ras p21 protein. One of these mechanisms involves important structural alterations by point mutations at position 12 or 61 which reduce the GTPase activity of the protein. Another mechanism will be that induced by a substitution of Ala59 to Thr59 which does not substantially alter the protein conformation. A putative alternative mechanism for the activation of this mutant is discussed. PMID- 3292237 TI - The dihydrolipoyltransacetylase component of the pyruvate dehydrogenase complex from Azotobacter vinelandii. Molecular cloning and sequence analysis. AB - The gene encoding the dihydrolipoyltransacetylase component (E2) of the pyruvate dehydrogenase complex from Azotobacter vinelandii has been cloned in Escherichia coli. A plasmid containing a 2.8-kbp insert of A. vinelandii chromosomal DNA was obtained and its nucleotide sequence determined. The gene comprises 1911 base pairs, 637 codons excluding the initiation codon GUG and stop codon UGA. It is preceded by the gene encoding the pyruvate dehydrogenase component (E1) of pyruvate dehydrogenase complex and by an intercistronic region of 11 base pairs containing a good ribosome binding site. The gene is followed downstream by a strong terminating sequence. The relative molecular mass (64913), amino acid composition and N-terminal sequence are in good agreement with information obtained from studies on the purified enzyme. Approximately the first half of the gene codes for the lipoyl domain. Three very homologous sequences are present, which are translated in three almost identical units, alternated with non homologous regions which are very rich in alanyl and prolyl residues. The N terminus of the catalytic domain is sited at residue 381. Between the lipoyl domain and the catalytic domain, a region of about 50 residues is found containing many charged amino acid residues. This region is characterized as a hinge region and is involved in the binding of the pyruvate dehydrogenase and lipoamide dehydrogenase components. The homology with the dihydrolipoyltransacetylase from E. coli is high: 50% amino acid residues are identical. PMID- 3292239 TI - Post-translational translocation of polypeptides across the mammalian endoplasmic reticulum membrane is size and ribosome dependent. AB - The translation and translocation of two yeast glycoproteins, invertase and carboxypeptidase Y, were studied in a heterologous cell-free translation system from reticulocytes supplemented with dog pancreas microsomes. Using in vitro synthesized mRNA transcripts, encoding complete or truncated invertase forms, the influence of polypeptide size and ribosome dependence was studied. It was found that C-terminal truncated fragments of 25 kDa, i.e. a size larger than the average size of a domain structure, are translocated and processed post translationally with a similar efficiency to the cotranslational events. Post translational import decreases with increasing peptide chain, mature polypeptide (60 kDa) being no longer translocated. Post-translational competence is only maintained as long as the peptide remains associated with ribosomes. Translocation of invertase depends on the presence of the leader peptide and requires energy independent of protein synthesis. Size dependence of post translational import could also be demonstrated for carboxypeptidase Y. PMID- 3292240 TI - Hormonal and surgical treatment of endometrial adenocarcinoma. AB - From January 1st 1980 up to December 31st 1986, 93 endometrial adenocarcinomas were treated at the Chair B of the Institute of Gynecology and Obstetrics. Full anatomopathological and hormonal data are available for 81 cases on whom diagnostic and therapeutic protocols were applied. In this selected group, positive lymph nodes were shown in 10 cases. Lymph node positivity was compared with miometrial infiltration grade: there were only two cases of lymph nodal positivity among 49 adenocarcinomas in which the invasion was more than 10 mm from the serosa, 8 lymph nodes metastases out of 32 adenocarcinomas with a distance between 10 and 5 mm and with distance less than 5 mm. PMID- 3292241 TI - Echopatterns of the ovarian dermoid tumor. AB - The authors report the ovarian dermoid echopatterns observed in 189 cases. The ultrasonic key of the diagnosis is a particular "pearly-gray" colour. The early diagnosis by USG gives the Gynecologist some advantages in: a) avoiding the operation in those cases of small mass; b) making a pfammenstiel incision in the surgical operation; c) trying a conservative surgery. PMID- 3292242 TI - Lung uptake of 131I-metaiodobenzylguanidine in sheep. An in vivo measurement of pulmonary metabolic function. AB - Circulating biogenic amines are known to be cleared by the mammalian lung. Their lung uptake is considered as an indicator of pulmonary endothelial integrity. Unfortunately, their use as markers of pulmonary metabolic function in human pathology is precluded by their biological effects and by the type of radiolabeling (3H and 14C), making them harmful for repeat injections and unfit for scintigraphy. Metaiodobenzylguanidine (MIBG) is structurally related to the neuron blocking agent guanethidine, devoid of significant biological effects, and has been shown to be extracted by the same active sodium dependent, saturable transport as norepinephrine in perfused rat lungs in vitro. We studied the single pass lung extraction of 131I-MIBG in five awake and five anaesthetised sheep using the standard double indicator dilution technique with 99mTc-human serum albumin (HSA) as an intravascular reference tracer. Intravenous bolus injection of increasing doses of MIBG up to 400 nmol resulted in a significant (F ratio = 7.778, P less than 0.0001) dose dependent decrease of MIBG extraction in both awake and anaesthetised sheep, without significant differences of extraction values between the two groups. For the 10 sheep, the averaged percentage single pass pulmonary uptake of MIBG at the peak of the dilution curve decreased from 32% +/- 3% (mean +/- SE, n = 27 measurements) with 20 nmol to 18% +/- 2% (n = 32) with 400 nmol. Estimates of the apparent Michaelis-Menten constant (Km) averaged 2 +/- 1.2 microM (n = 7), whereas estimates of the apparent maximum velocity of removal (Vmax) was 1.1 +/- 0.5 mumol/min (n = 7).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292243 TI - The use of 99mTc-DTPA for detection and localization of site of acute gastrointestinal bleeding. AB - Intravenously injected 99mTc-DTPA was evaluated in 64 patients for its efficiency in detecting and localizing sites of acute upper and lower gastrointestinal (G.I.) bleeding. These studies were correlated with endoscopic and surgical findings. There were 34 bleeders and 30 non bleeders giving a sensitivity of 90%, specificity of 82% and accuracy of 86%. Of these, 49 were upper G.I. studies (stomach 21 and duodenum 28) and 15 were lower G.I. studies (small intestine 8, large bowel 7). Of the 49 upper G.I. studies, 27 showed active bleeding while 22 showed no bleeding at the time of the study resulting in a sensitivity of 87.5%, specificity of 76% and accuracy of 82%. Of the 15 lower G.I. studies, 7 were bleeders while 8 were non bleeders. All the lower G.I. bleeding sites were accurately localized with the 99mTc-DTPA. An incidental finding of these studies was the localization of 99mTc-DTPA in the site of inflammatory and malignant lesions of the G.I. tract. Of the 64 studies, 18 inflammatory and malignant lesions were detected with the IV injected 99mTc-DTPA; 10 were bleeders while 8 were non bleeders. Image subtraction of early from delayed images was helpful to differentiate bleeding from non bleeding cases in this last group of studies. PMID- 3292244 TI - Glycogen storage disease: recommendations for treatment. AB - A workshop was held on "Aspects of treatment of patients with glycogen storage disease" within the framework of the Concerted Action "Inborn errors of metabolism" of the European Communities. Consensus was reached on the main issues of treatment of patients with deficiency of glucose-6-phosphatase, glucose-6 phosphate translocase, debranching enzyme, liver phosphorylase and phosphorylase b-kinase. The resulting recommendations are reported. PMID- 3292245 TI - Antibacterial capacity of buccal epithelial cells from healthy donors and children with recurrent urinary tract infections. AB - The effect of buccal epithelial cells (BEC) on bacterial growth was investigated in healthy subjects as well as in patients with recurrent urinary tract infections (UTI) and compared to the antibacterial capacity of uroepithelial cells (UEC) of the same individuals. Epithelial cells were obtained from the following groups: healthy female controls; females without further UTI after reflux operation; females with asymptomatic bacteriuria (ABU); females with further UTI despite successful reflux operation; and patients with meningomyelocele (MMC) and recurrent UTI due to significant residual urinary volume. Cocultivation of Escherichia coli with BEC as well as UEC from healthy females or patients with MMC resulted in significant suppression of bacterial growth. However, neither type of epithelial cell showed an antibacterial effect when they were obtained from patients with recurrent UTI in the absence of urological abnormalities (ABU patients; reflux-corrected patients with further UTI). From these results it is concluded that a generalised epithelial defence defect is one important pathogeneic factor for recurrent idiopathic UTI. PMID- 3292246 TI - Effectiveness of growth hormone (GH) therapy in GH-deficient children and non-GH deficient short children. AB - The growth response during short-term growth hormone (GH) treatment was evaluated in eight prepubertal non-GH-deficient (non-GHD) children and compared with six prepubertal GH-deficient (GHD) patients. Standard doses of GH can improve growth rate in GHD and in some non-GHD patients. In neither group the growth response can be predicted by the acute increase in Thymidine Activity or Somatomedin-C levels. A diagnostic trial of GH treatment may be the only certain method of selecting the short non-GHD patients who may benefit from long-term GH therapy. PMID- 3292247 TI - Sensitivity, specificity and predictive value of clinical findings, m-mode echocardiography and continuous-wave Doppler sonography in the diagnosis of symptomatic patent ductus arteriosus in preterm infants. AB - By means of probability analysis we have compared the diagnostic value of clinical symptoms, m-mode echocardiographic measurements and peripheral arterial flow, assessed by continuous-wave Doppler, in preterm infants with symptomatic patent ductus arteriosus (PDA). Data were obtained in 29 infants with PDA and in 29 controls. The most sensitive clinical finding was a hyperactive precordium. Bounding pulses and a heart murmur were absent in 15% and 20%, respectively of the patients with PDA. M-mode echocardiographic measurements were rather specific for the detection of a PDA but less sensitive. Diastolic backflow in the brachial and femoral arteries was present in the majority of patients with PDA and absent in about 67% of the controls. The values in probability analysis, however, were too low to base a therapy on these findings. The highest sensitivity and specificity (100% each) was found for a disturbed cerebral blood flow with absent or retrograde diastolic perfusion estimated by Doppler sonography. PMID- 3292248 TI - Investigations of renal artery blood flow velocity in preterm and term neonates by pulsed Doppler ultrasonography. AB - So far, echo-Doppler studies of the renal arteries have only been performed in adult subjects. They dealt with qualitative parameters of blood flow, but absolute velocity values could not be determined. This paper presents a method for measurement of absolute values of renal artery blood flow velocity in infancy with a well-defined steep angle of insonation of less than 25 degrees by using a range-gated Doppler system with Duplex-scan. The renal blood flow patterns were studied at specified sites by placement of the transducer below the costal arches on the right flank and left flank, respectively. Thus, a reference collective of 65 infants (26-40 weeks of gestational age, 650-3990 g body weight and 1-145 days of postnatal age at the time of examination) were studied. The time mean of maximum velocity significantly increased with the body weight from 17 cm/s below 1000 g to 29 cm/s above 3000 g of body weight. Whereas the pulsatility indices were independent of body weight. The reproducibility of the method, coefficient of variation (CV) 3%-9%, is comparable with the studies of cerebral vessels. PMID- 3292249 TI - Does caffeine prevent hypoxaemic episodes in premature infants? A randomized controlled trial. AB - Fifty spontaneously breathing, preterm infants 48 h old, of 32 weeks' gestation or less, were assigned randomly to receive caffeine citrate (loading dose 20 mg/kg, maintenance dose 10 mg/kg per day) or a placebo (NaCl 0.9%). The study hypothesis was that caffeine reduces the proportion of infants with recurrent hypoxaemic episodes (decrease in transcutaneous PO2 of 20% within 20 s) from 50% to 25%. Transcutaneous oxygen tension (tcPO2) and heart rate were recorded continuously for 50 h and analysed by computer. The two groups were similar in gestational age, birth weight, delivery mode, sex distribution, and Apgar scores. The mean serum concentration (+/- SD) of caffeine 2 h after the second maintenance dose was 96.0 (+/- 34.5) mumol/l in the group receiving caffeine and 9.3 (+/- 12.8) mumol/l in the group receiving a placebo. The mean proportion of infants with more than six hypoxaemic episodes per 12 h in the caffeine groups was higher (57%) than in the control group (51%). The mean proportion of infants with more than six episodes of bradycardia per 12 h was not statistically different in the caffeine group (79%) from the control group (86%). Our results suggest that prophylactic caffeine has little if any effect on the risk of developing hypoxaemic episodes and bradycardia in small preterm infants and the supposed 50% reduction which was considered clinically important at the start of the trial can be rejected with confidence. PMID- 3292250 TI - Development of the nervous and cardiovascular systems in low-birth-weight infants fed a taurine-supplemented formula. AB - An adapted cow's milk formula with or without supplemental taurine (480 mumol/l) was fed for 16 weeks to 20 low-birth-weight infants. In the 2nd and 16th weeks of life, respectively, the following parameters were determined: growth, sonography of heart and brain, ECG, EEG, neurological development and the taurine concentration of plasma and urine. None of the parameters investigated was influenced by taurine supplementation except the urinary taurine excretion. At least according to these data, the addition of taurine to whey-predominant infant formulae seems to be unnecessary for the development of heart and brain function in low-birth-weight infants. PMID- 3292252 TI - Menetrier disease in a child of 18 months: diagnosis by ultrasonography. AB - We present an 18-month-old infant with Menetrier disease diagnosed by ultrasonography. The sonographic changes are illustrated and the possibility of early diagnosis of this disorder is suggested. PMID- 3292251 TI - Incidence of ras gene mutations in neuroblastoma. AB - Using a rapid dot-blot screening procedure based on DNA amplification and hybridization to synthetic oligonucleotide probes, we investigated 18 neuroblastomas in various clinical stages for the presence of ras mutations. In none of the samples was a mutation in the relevant codons 12, 13 or 61 of Ha-ras, Ki-ras or N-ras found. These data virtually exclude the participation of mutated ras genes in the genesis of neuroblastoma. PMID- 3292253 TI - Assessment of prostacyclin and thromboxane A2 release during reperfusion after global ischemia induced by crystalloid cardioplegia--comparison between warm and cold ischemia. AB - The metabolites of prostacyclin (PGI2) and thromboxane A2 (TxA2), 6-keto-PGF1 alpha and thromboxane B2 (TxB2), were investigated during reperfusion (RP) following warm (37 degrees C, 60 min, n = 9) or cold (15 degrees C, 120 min, n = 11) ischemia induced by cold (4 degrees C) or normothermic (30 degrees C) K+ cardioplegia (CP) in isolated canine hearts subjected to global ischemia and RP. 6-Keto-PGF1 alpha flux was significantly higher (p less than 0.025) in the warm group at 1, 5, and 10 min of RP (4,202 +/- 1,412, 2,475 +/- 1,875, and 1,255 +/- 633 pg/g.min, mean +/- SD) compared to those in the cold group (1,504 +/- 1,245, 434 +/- 641, and 370 +/- 329 pg/g.min). TxB2 flux was small in amount compared to 6-keto-PGF1 alpha in both groups. Regarding the coronary hemodynamics, the cold group alone showed statistically significant relationships of coronary sinus blood flow to TxB2 level and TxB2/6-keto-PGF1 alpha ratio in coronary sinus blood. Also, coronary vascular resistance showed linear relations to these two parameters of the metabolites. In a supplementary experiment only with cold ischemia for 180 min, 6-keto-PGF1 alpha was released at each coronary flush-out by CP and the incremental amount showed a gradual increase during ischemia. These results indicated that significant production and release of PGI2 occurred during ischemia and RP following CP arrest and these related to the degree of myocardial damage while the response of TxA2 seemed less significant. The role of PGI2 release during RP following cardioplegic arrest was discussed. PMID- 3292254 TI - Changes in energy metabolism of allografts after liver transplantation. AB - To evaluate the function of energy metabolism in allografts after liver transplantation, changes in hepatic energy charge levels, oxidative and phosphorylative activities of mitochondria and arterial blood ketone body ratio (acetoacetate/3-hydroxybutyrate; KBR) were studied in piglets. Hepatic energy charge levels decreased to 0.831 +/- 0.010 at 3 days and 0.836 +/- 0.009 at 3 weeks after operation compared to the preoperative value of 0.868 +/- 0.006 (p less than 0.01), and returned to 0.856 +/- 0.007 at 6 weeks. Mitochondrial oxidative and phosphorylative activities were moderately enhanced to 19.14 +/- 2.07 (10(-10) mol ATP/mg of mitochondrial protein/s) at 3 days and 20.89 +/- 1.72 at 3 weeks compared to the preoperative value of 16.74 +/- 2.36, and returned to 16.65 +/- 1.54 at 6 weeks. There was no significant difference in the concentrations of mitochondrial respiratory components, except in cytochrome c + c1. KBR decreased immediately at the beginning of the anhepatic phase and rapidly recovered to the preoperative level within 60 min after revascularization of allografts. There was no change in KBR during the postoperative course except in cases with clinical deterioration. From these results, it is suggested that the mitochondrial capacity for ATP synthesis was enhanced to compensate for the decreased energy charge level and that a decreased KBR is a sign of a critically deranged metabolic function in allografts. PMID- 3292255 TI - Hot air coagulation: an animal study. AB - Aerothermotherapy with a Leister hot air coagulator was tested in a simulated operation field followed by a prospective double-blind animal pilot study to examine hemostasis and tissue reactions. Two symmetrical incisions were made on the back of 5 rabbits. One of the two wounds was randomised to aerothermotherapy. The temperature rise in the wound was registered by thermistors. No wound complications were observed. Five days postoperatively all wounds were excised for histological examination. A superficial muscular cell necrosis was observed in 3 of the 5 hot-air-coagulated back wounds. Liver resection was performed in 2 of the rabbits. The bleeding from the resection surface was stopped effectively by aerothermotherapy. Combination of the hot air temperature, the distance to the tissue and the application time was crucial for avoiding burns. If these factors are observed, the hot air coagulator may be used as a supplement to conventional methods of hemostasis. PMID- 3292256 TI - Force sensation in fresh and fatigued human skeletal muscle. PMID- 3292257 TI - Semilunar cartilage of the knee: function and pathology. PMID- 3292258 TI - Common and uncommon dermatologic diseases related to sports activities. AB - The athlete is exposed to a whole spectrum of skin diseases that may or may not be unique to the particular sport or activity. Although the athlete is usually a healthy young adult and sports-related skin diseases are often minor, it is important for these disorders to be recognized by physicians, nurses, coaches, and trainers. Prevention, early diagnosis, and treatment will enable the athlete to resume participation as early as medically possible. PMID- 3292259 TI - Endocrinological responses to exercise in stressful environments. PMID- 3292260 TI - Exercise and type I diabetes mellitus. PMID- 3292261 TI - Exercise in end-stage renal disease. PMID- 3292262 TI - Exercise and the elderly. AB - Data from cross-sectional studies suggest that VO2max declines in adulthood at a rate of 0.40-0.45 ml.kg-1.min-1 per year in males and 0.30 ml.kg-1.min-1 per year in females. Longitudinal studies suggest that the loss is much greater for males, approximating 1.0 ml.kg-1.min-1 per year or more. The rate of loss may be greater in sedentary compared to active individuals. The decline in VO2max with age appears to be inevitable, and a major contributing factor may be the decline in maximal cardiac output. A reduced maximal heart rate is a consistent finding, and this may be due to decreased end-organ sensitivity to catecholamines. Maximal stroke volume may or may not decrease, and physical training status may be a determining factor. The most recent evidence suggests increased dependence upon the Frank-Starling mechanism, resulting in an increased stroke volume to offset the decline in maximal heart rate. Cardiac output is thought to be maintained in this manner. Use of this mechanism may depend upon the absence of underlying disease. Therefore, investigators who vigorously screen potential subjects for occult coronary disease may report findings different from those who do not. Maximal a-vO2 difference may or may not decline in the elderly. The research is divided, and there is support for both beliefs. Several factors typical of the elderly, including a decline in muscle mass, increased blood distribution to the skin during exercise, and a potentially lower capillary/fiber ratio, would contribute to a lower a-vO2 difference. On the other hand, in those subjects with reduced cardiac output, there may be greater dependence upon a-vO2 difference during maximal exercise. Pulmonary function does not appear to limit VO2max, although the elderly may be less efficient while breathing during exercise. However, the higher ventilation and higher ventilatory equivalent for oxygen observed during submaximal exercise could be due to higher relative stress in the elderly. Elderly males and females are capable of demonstrating a training effect in response to endurance training regardless of previous physical activity patterns and current training status. The degree of change with training, expressed in relative terms, appears to be comparable to that demonstrated by younger subjects. Physiological factors contributing to an increased VO2max as a result of training appear to be similar in elderly and younger subjects, with the possible exception of no change in maximal a-vO2 difference in the elderly. This point is somewhat controversial.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3292263 TI - Biofeedback applications in exercise and athletic performance. PMID- 3292264 TI - Self-confidence and sports performance. PMID- 3292265 TI - Discourses on the gender/sport relationship: from women in sport to gender relations. AB - In any developing field such as the one that began as "women in sport," key developments can be traced through the evolution of the language we use and the concepts we develop to express our new understandings. Thus the discourse has moved from considerations of sex differences and sex roles, to gender differences and gender roles, to the sex/gender system, and finally to patriarchy and gender relations, and we have progressed from seeing gender as a variable or as a distributive category to conceiving of it as a set of relations created through human agency and sustained or reproduced through cultural practices including, but not limited to, sport. At the same time, our understanding of sport has grown from seeing it as a static social institution, defined in terms of its separation from the real world, to the comprehension of sport as a social practice produced through human agency and reproduced through ideological work. Finally, our view of gender relations has moved from a focus on sex differences, conceived as relatively innate, to an outraged response to sexism, to a deeper understanding of just how complex and culturally situated are the relations of domination and subordination that characterize gender relations in partriachal cultures. As our consciousness has grown, our questions have changed from "why aren't more women involved in sport?" to "why are women excluded from sport?" to "what specific social practices accomplish the physical and ideological exclusion of women from sport?", "how and why have women managed to resist the practices that seek to incorporate them?", and "how do women work to transform sport to an activity that reflects their own needs as women?" The study of gender relations and sport has come a long way in a short time. In less than 20 years, the field has transformed itself from often angry, always well-intentioned, but generally atheoretical investigations of the patterns of women's involvement and the psychological factors that kept women from full participation, to a theoretically informed, critical analysis of the cultural forces that work to produce the ideological practices that influence the relations of sport and gender. Clearly, the direction for the future lies in the development and application of more critical analyses capable of capturing the complexity of the gender/sport relation. PMID- 3292266 TI - Growth and physical performance relative to the timing of the adolescent spurt. PMID- 3292267 TI - Disuse atrophy of skeletal muscle: animal models. PMID- 3292268 TI - Concepts and models of functional architecture in skeletal muscle. PMID- 3292269 TI - Maxillary development in six unilateral cleft lip and palate children treated with passive orthopaedic plates. PMID- 3292270 TI - Immunofluorescent localization of histone H10 in the nuclei of proliferating and differentiating Friend cells. AB - By using affinity-purified antibodies to H10 and to H1AB the localization of these histones was studied by indirect immunofluorescence in the nuclei of proliferating (EAT and uninduced Friend cells) and of differentiating (induced Friend cells) cell populations. While with H1AB antibodies a bright fluorescence all over the chromatin was obtained, the localization of H10 varied depending on the state of the cell population. In the proliferating EAT cells it was localized strictly in the nucleoli. The Friend cell population revealed a heterogeneous picture with two types of H10 localization-nucleolar predominating in uninduced cell populations and peripheral predominating in induced cells. A comparison with literature data suggests that H10 seems to be associated with chromatin regions containing active genes. PMID- 3292271 TI - Regulation of proteins in the VLA cell substrate adhesion family: influence of cell growth conditions on VLA-1, VLA-2, and VLA-3 expression. AB - Cell quiescence resulting from culture of normal human fibroblasts in low serum (0.5%) was associated with a subsequent gradual increase in the expression of the cell-surface glycoprotein VLA-1, and a corresponding decrease in the expression of extracellular matrix adhesion receptors VLA-2 and VLA-3. Quantitation using either flow cytometry or immunoprecipitation showed that both the VLA-1/VLA-2 and VLA-1/VLA-3 ratios increased 10- to 28-fold and were still rising when cells remained quiescent for 20-30 days. Although induced by cell quiescence, changes in the levels of VLA-1, VLA-2, and VLA-3 continued to occur well after cell proliferation had stopped and thus do not directly correlate with cell cycle transition events. Despite prolonged serum deprivation resulting in elevated VLA 1/VLA-2 and VLA-1/VLA-3 ratios, growth-arrested cells remained viable and were fully capable of proliferating when restimulated. The increases in VLA-1/VLA-2 and VLA-1/VLA-3 ratios observed on quiescent cells were readily reversible, since after restimulation with 10% serum, these ratios quickly returned within 1-2 days to a level near that found on normal exponentially grown cells. Elevation of VLA 1/VLA-2 and VLA-1/VLA-3 ratios is generally associated with quiescence and is not due just to serum deprivation since density arrest of cells at confluence had similar effects on these ratios. PMID- 3292272 TI - Cell cycle-associated change in the expression of the proliferation-sensitive and heat-shock protein hs x 70 (IEF14): increased synthesis during mitosis. AB - The major heat-inducible protein of transformed human amnion cells (AMA) has been identified as the proliferation-sensitive polypeptide IEF14 (Mr 66 kDa; HeLa protein catalogue). From its mobility in two-dimensional gels (Mr and pI) as well as from the fact that this protein is immunoprecipitated by mAb C92 F3-5 (W. J. Welch, and J. P. Suhan, (1986) J. Cell Biol. 103, 2035-2052), we concluded that this polypeptide is either closely related or identical to the 72 kDa inducible stress human protein hs X 70 (H. R. B. Pelham (1986) Cell 46, 959-961). It is further shown that in AMA cells the rate of synthesis of this protein increases preferentially during mitosis. These results provide further evidence suggesting that the levels of hs X 70 can be modulated by mechanisms independent of heat shock. PMID- 3292273 TI - Effect of insulin on sulfated proteoglycan synthesis in cultured smooth muscle cells from pig aorta. AB - The effect of insulin upon proteoglycan synthesis was studied in cultured smooth muscle cells from pig aorta blocked in the G0 phase by serum deprivation. Insulin enhanced [35S]sulfate incorporation into cell layer and medium-secreted proteoglycans. The increase in incorporation of the precursor was not due to a mitogenic response by smooth muscle cells to the hormone and the specific radioactivity of proteoglycans showed that the stimulation reflected a real increase in sulfated proteoglycan synthesis. Maximal stimulation was observed, for the cell layer as well as for the medium, 40 h after the addition of 1.7 x 10(-7) M insulin and reached respectively 65 and 53%. This stimulation was about 80 and 60% of the level achieved with 10% fetal calf serum for cell layer and medium-secreted proteoglycans, respectively. The half-maximal effect was attained, for both the cell layer and the medium, in the presence of 2.1 x 10(-9) M insulin. Proteoglycans secreted into the medium, in the presence of 1.7 x 10( 8) M insulin for 40 h, showed a higher proportion of complexes (24%) than those synthesized in control medium (11%) and at least 95% of the monomers from culture treated with insulin were characterized by a smaller hydrodynamic size than those synthesized by cells maintained in control medium. This decrease in the size of proteoglycans was partly due to a decrease in the size of their glycanic chains. PMID- 3292274 TI - Localization and quantitation of hsp84 in mammalian cells. AB - In order to investigate the function of heat shock protein 84 (hsp84) we have isolated the protein from mouse neuroblastoma cells and raised a polyclonal antiserum which was affinity-purified. The specificity of the antibody was established by immunoprecipitation and immunoblotting. Immunofluorescence studies revealed both a cytoplasmic and a nuclear localization of hsp84 in five different mammalian cell lines (mouse neuroblastoma cells and fibroblasts, rat hepatoma cells, and HeLa cells). In none of the five cell lines were found significant differences in the total cellular levels of hsp84 before and immediately after a heat shock (4 h, 42 degrees C) by immunoblot quantification. Furthermore after heat shock the fluorescence of anti-hsp84-labeled nuclei was increased relative to that of the surrounding cytoplasm. The increased fluorescence disappeared upon reincubation at 37 degrees C. The heat-induced increase in contrast between cytoplasmic and nuclear fluorescence could be explained by a combination of three factors: (a) decrease in nuclear projection area, (b) increase in cytoplasmic projection area, and (c) translocation of hsp84. The contribution of these factors to the increase after heat treatment was different for the cell lines. PMID- 3292275 TI - Automated spectrophotometric assay for cell division regulation in yeast. AB - A spectrophotometric assay is presented for monitoring the regulation of cell division by the polypeptide alpha-factor in cultures of living cells of Saccharomyces cerevisiae yeast. This assay is simple, automated, and may have wider application in the study of other eucaryotic cells that do not require anchorage for cell growth. The kinetics of absorbance change were monitored continuously over time in yeast cell cultures that were mixed and aerated in cuvettes fitted with top-loading propeller stirrers. The absorbance doubling time. TD(Abs), was identical to the cell number doubling time in the absence of cell division arrest by alpha-factor. alpha-Factor lengthened the TD(Abs) during division arrest. At pH 5.8, 10(5) 381G cells/ml, the Khalf-maximal was 250 +/- 50 nM alpha-factor for the TD(Abs) increase during arrest, with a maximum increase of five-fold. After a period of time the TD(Abs) abruptly shortened. This is defined as the spectrophotometric recovery time (RTspec) and was compared to the time of recovery that is due to the reinitiation of cell division monitored by bud emergence (RTBE). RTBE occurred 40 +/- 5 min prior to RTspec when recovery was spontaneous or was artificially induced by the removal of alpha-factor (pH 5.8, 381G). The difference between RTBE and RTspec was independent of alpha factor concentration between 0.05 and 1 microM and cell concentration between 1 and greater than or equal to 25 x 10(5) cells/ml (pH 5.8, 381G) but was both pH and cell strain dependent. At pH 5.8 and 2.7 the recovery from arrest occurred by inactivation of alpha-factor. The TD(Abs) increase during arrest appears to be due to an alpha-factor-induced inhibition of net cell mass increase, an effect that has not been reported previously. Evidence is presented that this process is also correlated with the formation of cell projections. PMID- 3292276 TI - Copper(II)2(3,5-diisopropylsalicylate)4 stimulates hemopoiesis in normal and irradiated mice. AB - We have previously reported that copper(II)2(3,5-diisopropylsalicylate)4 (Cu DIPS) significantly increased the survival rate of mice exposed to lethal irradiation. To examine whether Cu-DIPS affected hemopoietic activity, groups of mice were treated with Cu-DIPS or vehicle and assayed for in vitro interleukin 3 (IL-3)-dependent colony-forming units (CFU-C) and for committed progenitor granulocyte-macrophage CFU (GM-CFU). Cu-DIPS increased the number of splenic IL-3 CFU-C by five- to sixfold 7 days after treatment and splenic GM-CFU by 12-fold on day 24. These increases were accompanied by a 50% increase in spleen weight. Bone marrow IL-3 CFU-C and GM-CFU were not affected at 7 or 14 days after treatment, but were somewhat depressed at 24 days. In irradiated (8.0 Gy) mice treated with Cu-DIPS or vehicle, splenic IL-3 CFU-C and GM-CFU were undetectable 7 days after irradiation, but recovered more rapidly in Cu-DIPS-treated mice. By 24 days splenic IL-3 CFU-C in Cu-DIPS-treated mice recovered to 150% of normal (unirradiated) values and GM-CFU recovered to 270% of normal, whereas irradiated control values remained at 25% and 7%, respectively. The recovery of bone marrow hemopoiesis was slower than spleen, but 42 days after irradiation Cu-DIPS-treated mice had higher levels of bone marrow IL-3 CFU-C (eightfold) and GM-CFU (4.6 fold) than vehicle-treated mice. Cu-DIPS stimulated sixfold increases in renewable, pluripotent stem cells as measured by the in vivo assay of endogenous colony-forming units (CFU-Se). PMID- 3292277 TI - Increased expression of adhesive proteins on leukocytes by TNF alpha. AB - To further elucidate the role of tumor necrosis factor alpha (TNF alpha) in cell adhesion, we investigated the effect of TNF alpha on the expression of surface adhesive protein. After treatment with TNF alpha for 1 h, the increased expression of surface adhesive proteins (beta subunit) was observed on granulocytes but not on monocytes or lymphocytes. The expression of Mac-1 (3,4 fold increase) was consistently enhanced more than p 150,95 (1.4-fold increase) and LFA-1 expression was unchanged. Dose-response and time course studies indicated a parallel relationship between TNF alpha-increased expression of surface adhesive proteins and TNF alpha-induced granulocyte adhesion. The anti inflammatory drug Dexamethasone suppressed both TNF alpha-induced granulocyte adhesion and TNF alpha-induced expression of surface adhesive proteins. The inhibition of granulocyte adhesion correlated with the reduction of surface adhesive protein expression. The data suggest that one contributing factor in the mechanism by which Dexamethasone inhibited TNF alpha-induced granulocyte adhesion may be diminished expression of surface adhesive proteins. PMID- 3292279 TI - Growth of erythroid burst-forming units (BFU-E) in cultures of canine bone marrow and peripheral blood cells: effect of serum from irradiated dogs. AB - Erythroid burst-forming units (BFU-E) from canine bone marrow and peripheral blood could be grown in methylcellulose in the presence of an appropriate batch of fetal calf serum (FCS), transferrin, and erythropoietin (Epo). However, improved colony formation (size and number of bursts) was obtained when serum from total body irradiated dogs was present in the culture. This serum, obtained from dogs at day 9 after total body irradiation with a dose of 3.9 Gy, reduced markedly the Epo requirement of BFU-E. Furthermore, it allowed the omission of FCS from the culture medium if cholesterol and bovine serum albumin (BSA) were used as FCS substitutes. BFU-E concentrations were found to be rather different in the peripheral blood and in bone marrow samples from different sites (i.e., iliac crest, sternum, and humerus) of normal beagles. The studies further show that canine bone marrow BFU-E can be cryopreserved in liquid nitrogen. PMID- 3292278 TI - Suppression of genetic resistance to bone marrow grafts and natural killer activity by administration of fat emulsion. AB - Graft rejection is one of the major obstacles to successful bone marrow transplantation (BMT). If resistance to marrow grafting could be avoided, BMT could be used widely in treatment of hematological and immunological disorders. There has been evidence that natural killer (NK) cells play a major role in genetic resistance to BMT and that macrophages are also involved in genetic resistance. Agents toxic to macrophages such as silica and carrageenan have been found to have a suppressive effect on genetic resistance to BMT. Parenteral fat emulsions are known to accumulate in macrophages and to impair various functions of macrophages and those of the reticuloendothelial system. We show here that the administration of a fat emulsion, Intralipos 20%, to recipient mice can suppress genetic resistance to bone marrow grafts and NK cell activity probably through the impairment of the macrophage function. The administration of the fat emulsion might be a new tactic in conditioning protocols for human BMT in the future. PMID- 3292280 TI - Purification of a putative Na+/D-glucose cotransporter from pig kidney brush border membranes on a phlorizin affinity column. AB - Phlorizin, a potent inhibitor of the Na+/D-glucose cotransporter, was derivatised to 3-aminophlorizin and subsequently coupled to Affi-Gel 15. Affinity chromatography of pig kidney brush border membranes solubilised in Triton X-100 allowed the purification of a 60 kDa protein on this resin. We consider this protein to be the Na+/D-glucose cotransporter, or part of it, for the following reasons: (i) binding of this protein to Affi-Gel 15 specifically requires phlorizin covalently attached to the resin and is lowered when phlorizin is replaced by phloretin; (ii) binding of the 60 kDa protein to a phlorizin affinity column requires the presence of Na+; (iii) polyclonal as well as monoclonal antibodies against the 60 kDa protein inhibit binding of phlorizin to brush border membranes from rabbit and pig kidney. PMID- 3292281 TI - Isolation of two cDNA sequences which encode cytotoxic cell proteases. AB - Two cDNAs which cross-hybridized with cytotoxic cell protease genes were identified in a library generated from a cytotoxic T cell line. Sequence analysis revealed that the two new members of the family contained the three catalytic triad residues which characterize the active sites of serine proteases. A comparison of the protein sequences revealed not only a high degree of homology but also the conservation of some unusual structural features. These include the lack of a disulphide bond which spans the active site serine, the presence of a signal sequence and the inference of a dipeptide activation sequence. PMID- 3292282 TI - Inaccurate protein synthesis in a mutant of Salmonella typhimurium defective in transfer RNA pseudouridylation. AB - Protein synthesis was studied comparatively in a wild-type strain of Salmonella typhimurium and in hisT mutant cells defective in the pseudouridylation of transfer RNA. From a quantitative point of view, no significant differences between the two types of strain was observed when measuring the rate of protein synthesis during either exponential growth or starvation for histidine. In contrast, the qualitative analysis of proteins by two-dimensional gel electrophoresis showed that histidine-starved hisT cells mistranslate the genetic program at a higher frequency than exponentially growing hisT cells or either starved or unstarved hisT+ cells. PMID- 3292283 TI - Recombinant human interleukin 6 (B-cell stimulatory factor 2) is a potent inducer of differentiation of mouse myeloid leukemia cells (M1). AB - Recombinant human interleukin 6 (IL-6), a lymphokine involved in the final differentiation of activated B-cells into antibody-forming cells, greatly suppressed proliferation and induced differentiation of murine myeloid leukemia cells (M1) into mature macrophage-like cells. When M1 cells were treated with IL 6, their growth was completely arrested as early as on day 2, and they were induced to differentiate morphologically into macrophage-like cells. Differentiation-associated properties such as phagocytic activity, adherence to the dish surface, Fc and C3 receptors, were also induced within 24 h by IL-6, and they reached their respective maximal levels on day 2 or 3. The potency of IL-6 in suppressing proliferation and inducing differentiation was much greater than that of 1 alpha,25-dihydroxyvitamin D3 one of the most potent inducers of M1 cells. The present report indicates that IL-6 is involved in the differentiation of not only B-cells but also myeloid leukemia cells. PMID- 3292284 TI - Phospholipid flippases. AB - Protein mediated phospholipid translocation through membranes has been observed in rat liver endoplasmic reticulum and in the plasma membrane of erythrocytes as well as in a few other cell membranes. Lipid translocation in plasma membranes is ATP dependent and selectively accumulates aminophospholipids on the inner monolayers. PMID- 3292285 TI - Type I protein is a slow isoform of troponin T. AB - Type I protein, a myofibrillar protein thought to be specific to slow-twitch skeletal muscle fibers, was purified. Two-dimensional electrophoresis indicated its identity with the purified slow troponin-T1s isoform. Immunochemical analyses using antibodies raised against type I protein and slow Tn-T1s, further substantiated the identity of the two proteins. PMID- 3292286 TI - Synthesis of Saccharomyces cerevisiae invertase by Schizosaccharomyces pombe. AB - In order to gain information on the ability of the glycosylation system of Schizosaccharomyces pombe to process heterologous glycoproteins, the expression of Saccharomyces cerevisiae invertase in the former yeast was studied. Sc. pombe cells are able to produce enzymatically active invertase from the S. cerevisiae SUC2 gene introduced by transformation and the enzyme is glycosylated and secreted into the cell wall. However, Sc. pombe transformants do not glycosylate the heterologous enzyme as their own invertase since it is not bound by the lectin from Bandeiraea simplicifolia seeds, which indicates the absence of terminal galactose residues. Moreover, the electrophoretic mobility of the heterologous invertase is similar to that of the large enzyme from S. cerevisiae, both in its native form and after being deglycosylated with Endo H. These results suggest that the polypeptide chain of S. cerevisiae invertase is the primary factor for the glycosylation in Sc. pombe cells. PMID- 3292288 TI - Proline residues in the maturation and degradation of peptide hormones and neuropeptides. AB - The proteases involved in the maturation of regulatory peptides like those of broader specificity normally fail to cleave peptide bonds linked to the cyclic amino acid proline. This generates several mature peptides with N-terminal X-Pro sequences. However, in certain non-mammalian tissues repetitive pre-sequences of this type are removed by specialized dipeptidyl (amino)peptidases during maturation. In mammals, proline-specific proteases are not involved in the biosynthesis of regulatory peptides, but due to their unique specificity they could play an important role in the degradation of them. Evidence exists that dipeptidyl (amino)peptidase IV at the cell surface of endothelial cells sequesters circulating peptide hormones which are then susceptible to broader aminopeptidase attack. The cleavage of several neuropeptides by prolyl endopeptidase has been demonstrated in vitro, but its role in the brain is questionable since the precise localization of the protease is not clarified. PMID- 3292287 TI - Finger proteins and DNA-specific recognition: distinct patterns of conserved amino acids suggest different evolutionary modes. AB - Finger proteins, the first example of which was Xenopus TFIIIA, share Zn2+ finger like folded domains capable of binding to nucleic acids. A large number of this type of protein have been characterised from diverse organisms, indicating a wide evolutionary spread of the DNA-binding fingers. At least two classes of finger proteins may be distinguished. Class I proteins contain variable numbers of the tandemly repeating TFIIIA-like finger motif, (Y/F-X-C-X2-4-C-X3-F-X5-L-X2-H-X3 H). Class II finger proteins display a single (C-X2-C-X13-C-X2-C) motif and a facultative second putative finger. The relation between the structure of finger proteins and their recognised DNA sequences is discussed. PMID- 3292289 TI - Calmodulin-binding profiles for nebulin and dystrophin in human skeletal muscle. AB - Nebulin and dystrophin are two high-molecular-mass skeletal muscle proteins that have both been associated with the defective gene in Duchenne muscular dystrophy, although the function of neither protein is known. Other high-molecular-mass, calmodulin-binding proteins have recently been implicated in regulating calcium release from skeletal muscle. Western blots of human skeletal muscle biopsy samples were probed with biotinylated calmodulin; nebulin was identified as a prominent high-molecular-mass calmodulin-binding protein but dystrophin did not bind detectable amounts of biotinylated calmodulin. Dystrophin was absent in a Duchenne muscle biopsy. PMID- 3292290 TI - Fc receptor-mediated transcytosis of IgG-coated liposomes across epithelial barriers. AB - Drug carriers such as liposomes are not readily transported across cellular barriers that constitute epithelia. However, certain epithelia (rabbit yolk sac endoderm and enterocytes of suckling rat gut proximal small intestine) are well known to transcytose maternal IgG by Fc receptor-mediated endocytic events. We have shown that coating liposomes with appropriate IgG enhances their transport across these epithelia, as measured both by radioactivity indicative of liposomal membrane or entrapped 125I-PVP and [3H]inulin, and by the hypoglycemic effect of entrapped insulin. It is suggested that these transported liposomes follow a pathway of transcytosis in clathrin-coated vesicles, thus escaping lysosomal degradation. PMID- 3292292 TI - Quantification of DNA-dependent RNA polymerase subunits and initiation factor(s) by antibody-linked polymerase assays. AB - The antibody-linked polymerase assay is a method which allows one to assign RNA polymerase activity to SDS-denatured polypeptides on nitrocellulose membranes using antibodies which were raised against only partially purified polymerase preparations. Here we show that with this method not only enzyme subunits but also initiation factor(s) can be determined in crude homogenates. Moreover the determination is quantitative. Therefore changes in the amount of individual polymerase subunits and factor(s) can be visualized within different crude homogenates. PMID- 3292291 TI - Thyroxine and testosterone transcriptionally regulate renin gene expression in the submaxillary gland of normal and transgenic mice carrying extra copies of the Ren2 gene. AB - Expression of the mouse renin genes (Ren1 and Ren2) in the submaxillary gland of female mice has been analyzed following administration of thyroxine (T4) or dihydrotestosterone (DHT). Both hormones appear to act independently on mRNA accumulation which increases about 5 fold over basal level. In vitro transcription assays in isolated nuclei demonstrate that both hormones act at the transcriptional level. The effects of DHT and T4 were also analyzed in transgenic mice obtained by microinjection of the Ren2 gene. We show that T4 is as efficient as DHT in promoting renin mRNA accumulation in these transgenic animals, in spite of their low basal level of Ren2 mRNA. Structural comparison of the Ren1 and Ren2 promoters with those of other genes regulated by T4 shows the conservation of two discrete regions. PMID- 3292293 TI - Oncogenic ras protein induces meiotic maturation of amphibian oocytes in the presence of protein synthesis inhibitors. AB - Microinjection of the activated ras oncogenic protein can induce the meiotic maturation of Xenopus laevis oocytes, a process that can also be triggered by progesterone or high concentrations of insulin. Cycloheximide and puromycin, well known inhibitors of protein synthesis, block the maturation process induced by progesterone and insulin but do not affect the maturation caused by H-raslys12 protein microinjection. Theophylline, an inhibitor of cAMP phosphodiesterase that also affects oocyte protein synthesis, does cause a partial inhibition of ras protein-induced maturation. These findings indicate that ras protein acts on the oocyte maturation process at a point that is downstream of the protein synthesis requirement, a characteristic shared with the maturation promoting factor, an activity that appears in oocytes and mitotic cells at the onset of cell division. PMID- 3292294 TI - The Kluyveromyces lactis KEX1 gene encodes a subtilisin-type serine proteinase. AB - KEX1 is a chromosomal gene required for the production of the killer toxin encoded by the linear DNA plasmid pGKL-1 of Kluyveromyces lactis. The nucleotide sequence of the cloned KEX1 gene has been determined. The deduced structure of the KEX1 protein, 700 amino acids long, indicated that it contained an internal domain with a striking homology to the sequences of the subtilisin-type proteinases, and a probable transmembrane domain near the carboxyl terminus. The results confirm the hypothesis that the product of the gene KEX1 of K. lactis is a proteinase involved in the processing of the toxin precursor. PMID- 3292296 TI - [Malaria]. PMID- 3292295 TI - Effects of t-butyl-4-hydroxyanisole and other phenolic antioxidants on tumoral cells and Trypanosoma parasites. AB - The antioxidant food additives 2(3)-tert-butyl-4-hydroxyanisole (BHA), 2,6 di(tert-butyl)-p-cresol (BHT) and the methyl and propyl esters of gallic acid inhibited Trypanosoma cruzi culture growth and oxygen consumption. The I50 values for growth and oxygen uptake with BHA were 0.284 and 0.400 and for BHT 0.083 and 0.235 mM, respectively. Moreover, BHA inhibited the respiration of several tumor cells, as well as of the procyclic and bloodstream trypomastigote forms of T. brucei brucei, with I50 in the range 0.29-0.52 mM. Inhibition of the parasites' oxygen uptake by BHA was not of the pure Michaelis-Menten type, but may be of a mixed form. It is postulated that these compounds are inhibitors because they resemble ubiquinone. PMID- 3292297 TI - [The "local" immune system of the brain]. PMID- 3292298 TI - [Quantitative assessment of the effect of ethmozine and ethacizine on the interval-force relationship in myocardial biopsy material from patients with heart disease]. PMID- 3292299 TI - [Evaluation of the functional state of the heart transplant 20 to 24 hours after biological preservation]. PMID- 3292300 TI - Dental radiography. A review for dental hygiene practitioners. PMID- 3292301 TI - A new method of bolt construction for sectional dentures. PMID- 3292302 TI - Oxidative and nonoxidative glucose metabolism following graded doses of oral glucose in man. AB - The oxidative and nonoxidative glucose metabolism represent the two major mechanisms of the utilization of a glucose load. Eight normal subjects were administered oral loads of 50, 100 and 150 g glucose and gas exchange measurements were performed for eight hours by means of computerized continuous indirect calorimetry. The glycemic peaks were almost identical with all three doses with a rise to between 141 and 147 mg/dl at 60 min. The fall back to basal level was reached later with the high than with the low glucose doses. The glucose oxidation rate rose to values between 223 and 253 mg/min after the three glucose doses, but while falling immediately after the peak at 120 min following the 50 g load, the glucose oxidation rate remained at its maximum rate until 210 min for the 100 g glucose load and plateaued up to 270 min for the 150 g glucose dose. The oxidation rates then fell gradually to reach basal levels at 270, 330 and 420 min according to the increasing size of the load. Altogether 55 +/- 3 g glucose were oxidized during the 8 hours following the 50 g glucose load, 75 +/- 3 g after the 100 g load and 80 +/- 5 g after the 150 g load. The nonoxidative glucose disposal, which corresponds essentially to glucose storage, varied according to the size of the glucose load, with uptakes of 20 +/- 1, 60 +/- 1 and 110 +/- 1 g glucose 180 min after the 50, 100 and 150 g glucose loads respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292304 TI - Metabolic studies in lipoatrophic diabetes: mechanism of hyperglycemia and evidence of resistance to insulin of lipid metabolism. AB - We determined in 5 control subjects and in one patient with total congenital lipoatrophy (LA) the effect of insulin infusion on glucose flux and some aspects of lipid metabolism. In the post-absorptive state LA had moderate hyperglycemia (9.2 versus 3.80 +/- 0.07 mmol.l-1) and hyperinsulinemia (19 vs 12 +/- 3 mU.l-1) and a massive increase in glucose production (7.51 mg.kg.-1.min-1) and disappearance (7.40 mg.kg-1.min-1) rates (control subjects: 2.29 +/- 0.14 mg.kg-1 min-1). Raising peripheral insulin levels to 28 +/- 3 mU.l-1 suppressed endogenous glucose production in the control subjects whereas in LA significant (2.01 mg.kg-1.min-1) production persisted even when peripheral insulinemia was raised to 58 mU.l-1. Insulin infusion in control subjects increased progressively glucose utilization to a final value of 15.7 +/- 0.7 mg.kg-1.min-1 (corresponding plasma insulin: 482 +/- 44 mU.l-1). Insulin infusion in LA initially lowered glucose level near to normal values and exogenous glucose was infused for an insulin infusion rate of 10 mU.kg-1.min-1; at this insulin infusion rate glucose utilization rate (6.52 mg.kg-1.min-1) was decreased relative to control subjects in spite of higher insulin levels (750 mU.l-1). NEFA, glycerol and ketone bodies (KB) levels were decreased to undetectable levels by insulin infusion in the normal subjects whereas NEFA and glycerol were decreased only in part and KB were not modified in LA. In addition glycerol and KB appearance rates determined in LA were not suppressed by insulin infusion as expected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292303 TI - Effect of long term acarbose (Bay g 5421) therapy on metabolic control of non insulin dependent (type II) diabetes mellitus. AB - The ability of Acarbose to improve the metabolic control of type II diabetics has been studied in a double blind study. 28 patients, poorly controlled despite maximal oral treatment and diet received 4 months of Acarbose (n = 15) or Placebo (n = 13). After 4 months of Acarbose post prandial blood glucose levels were significantly reduced at 10 and 14 hours compared to baseline values (p less than 0.05). Nevertheless, the metabolic control of Acarbose and Placebo groups was not statistically different at the end of the study. The beneficial effect of Acarbose appears to be slight but this may be due to 1) the relatively low dosage of acarbose used, 2) the importance of carbohydrate restriction, or, more probably, 3) the selection of the patients as most of them might have been classified as insulin requiring diabetics. PMID- 3292305 TI - The intra-nasal administration of insulin induces significant hypoglycaemia and classical counterregulatory hormonal responses in normal man. AB - The present study aimed at investigating the metabolic and hormonal consequences of intra-nasal administration of insulin in normal man. Lyophylisated regular porcine insulin (Insuline Ordinaire Organon) diluted with a non ionic detergent (Laureth-9 0,25%) was administered intra-nasally in 8 overnight fasted healthy volunteers using a calibrated aerosol delivery device (90 microliters = 9 U of insulin/spray) up to a total insulin dose close to 1 U/kg body weight. After intra-nasal insulin administration, plasma insulin levels rose from 5 +/- 1 to 38 +/- 10 mU/l (2p less than 0.01) at min 15, blood glucose concentrations decreased from 4.4 +/- 0.2 to 3.2 +/- 0.3 mmol/l (2p less than 0.01) at min 45, plasma C peptide levels diminished from 327 +/- 31 to 174 +/- 28 mumol/l (2p less than 0.01) at min 60 and plasma free fatty acids concentrations fell from 336 +/- 109 to 130 +/- 31 mumol/l (2p less than 0.05) at min 30. The fall in blood glucose resulted in a prompt increase in plasma glucagon levels (from 78 +/- 28 to 150 +/ 24 ng/l at min 45; 2p less than 0.05) and in later rises in plasma growth hormone and cortisol concentrations. There was a close relationship between the individual maximal decreases in blood glucose levels and the individual maximal increases in plasma insulin (r = 0.81), glucagon (r = 0.88), cortisol (r = 0.87) and growth hormone (r = 0.76) concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292306 TI - [Auto-immune physiopathology of diabetes type 1 (insulin-dependent)]. PMID- 3292307 TI - [Is there a prediabetic state in children?]. PMID- 3292309 TI - Blood supply to the uterus in preeclampsia. AB - Uterine fundal and low segment arcuate artery velocimetry was studied in normal pregnant women and in severe preeclamptic patients. The waveform velocity of the preeclamptic group revealed large differences between systole and diastole, as well as an increased resistance index. Furthermore, the abnormality was more severe in the fundal than in the low segment arcuate measurement. PMID- 3292310 TI - The physiological significance of heme oxygenase. PMID- 3292308 TI - Phospholipid metabolism of A-cell enriched pancreatic islets. AB - Glucose exerts different effects on the hormone secretion from pancreatic B- and A-cells. In order to assess whether this can be linked to a difference in the effects of glucose on the phospholipid metabolism of these two cell types, islets were isolated from streptozotocin-treated (A-cell enriched islets) or normal guinea-pigs (B-cell rich islets). A-cell enriched islets contained more phospholipids when correction was made for the difference in size. Glucose stimulated (16.7 mM) phospholipid and diacylglycerol biosynthesis, as estimated from 14C-glucose incorporation, was somewhat more stimulated in normal islets as compared with that of A-cell enriched islets. Triacylglycerol biosynthesis was, however, stimulated to the same extent. The pattern of 14C-glucose incorporation into the different phospholipid classes was very similar in both kinds of islets. Despite their smaller size, A-cell enriched islets incorporated, however, as much 14C-glucose as normal islets into most phospholipid classes. The present results are in line with previous findings of differences in glucose handling between the two cell types. PMID- 3292311 TI - Protein synthesis in yeast. PMID- 3292312 TI - Hexose metabolism in pancreatic islets stimulation by D-glucose of [2-3H]glycerol detritiation. AB - 1. In pancreatic islets, a rise in glucose concentration is known to increase the ratio between D-[6-14C]glucose oxidation and D-[5-3H]glucose utilization. The opposite situation was found to prevail in parotid cells. 2. In rat pancreatic islets, D-glucose caused a concentration-related stimulation of 3H2O production from [2-3H]glycerol, but failed to affect 3H2O production from [1(3)-3H]glycerol or 14CO2 production from [U-14C]glycerol. At the low concentration used in most of these experiments (i.e. 1.0 mM), glycerol failed to affect D-[U-14C]glucose oxidation. 3. These findings suggest that the preferential stimulation by D glucose of mitochondrial oxidative events in pancreatic islets represents an unusual situation in secretory cells and involves an accelerated circulation in the glycerol phosphate shuttle. PMID- 3292313 TI - Frequency and specificity of protamine antibodies in diabetic and control subjects. AB - Protamines are cationic fish chromosomal proteins that retard absorption of isophane (NPH) insulins. Protamines are also administered in large doses for heparin neutralization in cardiac procedures. This study used a rapid enzyme linked immunosorbent assay to examine frequency of protamine antibodies in diabetic and control populations. Antigen specificity of the IgG binding to protamine-coated plates was verified by competitive inhibition with other protamines, histone, glucagon, thyroid-stimulating hormone, arginine, and lysine. All antibodies tested cross-reacted completely with all protamines. Only 4 of 18 had any cross-reactivity with histones. None cross-reacted with the other inhibitors. In population surveys, 122 (38%) of 319 NPH insulin-treated diabetic subjects, 3 (8%) of 39 diabetic subjects treated with protamine-free lente insulins, and 5 (2.5%) of 202 normal control subjects had protamine antibody. No correlation was found between insulin and protamine antibodies. Because more than one-third of insulin-treated diabetic subjects have circulating IgG specific for protamine, they are potentially at risk for acute immunologic or anaphylactoid reactions when protamine is administered for heparin neutralization. PMID- 3292315 TI - Induction of insulitis by adoptive transfer with L3T4+Lyt2- T-lymphocytes in T lymphocyte-depleted NOD mice. AB - To clarify the pathogenesis of insulitis in the nonobese diabetic (NOD) mouse, an animal model for human insulin-dependent diabetes mellitus, T-lymphocyte-depleted NOD mice (B mice) were adoptively transferred with spleen and lymph node cells from cyclophosphamide-treated NOD mice after separating the cells with monoclonal antibodies against various T-lymphocyte surface antigens plus complement. Light microscopic and immunohistochemical studies were also performed to investigate the lymphocytic infiltrations. The incidence of insulitis detected in B mice was much lower when compared with that of the lesion naturally occurring in the NOD mouse. However, higher incidence of insulitis was inducible in B mice by transferring unfractionated lymphoid cells from NOD mice. When the Thy1+ cell depleted fraction was transferred into the B mice, no increase in the incidence of insulitis was observed. The Lyt1+ or L3T4+ cell-eliminated fraction was also unable to transfer insulitis. Conversely, donor cells depleted of Lyt2+ components successfully induced insulitis in the recipient B mice. These data were consistent with the immunohistochemical study, which showed that the main phenotype of the cells infiltrating the islets was L3T4+. These results suggest the importance of L3T4+Lyt2- T-lymphocytes in the pathogenesis of insulitis in NOD mice. PMID- 3292314 TI - Incretin effect due to increased secretion and decreased clearance of insulin in normal humans. AB - To assess the contribution of changes in insulin secretion and clearance to the incretin effect (greater insulinemia after oral than after intravenous glucose), 10 healthy subjects were studied after oral glucose (1 g/kg body wt) and again when glucose was infused intravenously at rates to match arterialized plasma glucose concentrations after oral glucose. Although basal and integrated plasma glucose did not differ between oral and intravenous glucose, integrated responses of insulin (3.3 +/- 0.5 vs. 1.8 +/- 0.4 mU ml-1.240 min-1, P less than .001), C peptide (456.5 +/- 58.5 vs. 327.9 +/- 46.3 ng.ml-1.240 min-1, P = .002), gastric inhibitory polypeptide, (16.8 +/- 3.5 vs. -2.8 +/- 1.0 micrograms.ml-1.240 min-1, P less than .001), and insulin secretion (6.6 +/- 1.1 vs. 4.7 +/- 0.7 U.240 min 1, P = .003) were greater with oral than intravenous glucose. However, insulin clearance, whether calculated as the molar ratio of integrated C-peptide to integrated insulin responses (6.9 +/- 0.7 vs. 14.2 +/- 3.8, P = .005) or from the formula insulin clearance equals insulin secretion divided by integrated insulin responses (1.1 +/- 0.2 vs. 2.5 +/- 0.7 L.min-1.m-2, respectively, P = .002), was less for oral than for intravenous glucose. Therefore, the incretin effect is mediated both by increased secretion and decreased clearance of insulin. PMID- 3292316 TI - Evolution of abnormal insulin secretory responses during 48-h in vivo hyperglycemia. AB - Recent in vitro studies have shown that insulin release caused by continuous exposure to high glucose concentration markedly falls within a few hours. We wanted to determine if a similar effect occurs in vivo with chronic intravenous infusions in normal rats. Male CD rats (200-250 g) were infused with 50% glucose at 2 ml/h for 6, 14, 24, or 48 h, whereas controls received 0.45% NaCl, and insulin responses were tested with the in vitro isolated perfused pancreas. Plasma glucose averaged 352 +/- 20 mg/dl after 4 h and 396 +/- 11 mg/dl after 24 h versus 137 +/- 5 mg/dl in controls; plasma insulin at the same times was 8.94 +/- 1.44 and 12.1 +/- 2.62 ng/ml versus 1.69 +/- 0.19 ng/ml in controls. The incremental insulin response caused by an increase in perfusate glucose from 2.8 to 16.7 mM was not significantly reduced after 24 h of glucose infusion; in contrast, paradoxical suppression was seen after 48 h. A second protocol examined glucose potentiation by giving 10 mM arginine at 2.8 and 16.7 mM glucose; a hyperresponse to arginine at the lower glucose level was present after just 14 h of infusion. Therefore, these results do not support the hypothesis that beta cells lose their sensitivity to glucose within hours of being exposed to higher than normal glucose concentrations. PMID- 3292317 TI - Insulin secretion and hepatic extraction in humans by minimal modeling of C peptide and insulin kinetics. AB - Methods for measuring insulin secretion and hepatic insulin extraction in vivo, e.g., hepatic vein catheterization, are invasive, and can be applied during steady state only. We introduce a noninvasive method for measuring in vivo insulin secretion and its extraction by the liver during an intravenous glucose tolerance test (IVGTT). This method is based on a minimal model of C-peptide secretion and kinetics that is used for interpreting plasma C-peptide concentration data during an IVGTT in normal humans. The model allows the reconstruction of the time course of insulin secretion and, used in conjunction with a minimal model of insulin delivery and kinetics (described in a previous study), provides a noninvasive measure of the time course of hepatic insulin extraction [H(t)]. The C-peptide model also provides a direct prehepatic measure of beta-cell sensitivity to glucose, expressed by two parameters related to first (phi IC)- and second (phi IIC)-phase insulin secretion. In the 11 healthy volunteers we studied, these parameters were 61 +/- 11 pM.min-1.mg-1.dl and 0.0154 +/- 0.0034 pM.min-2.mg-1.dl, respectively. H(t) showed an initial decrement for approximately 30-50 min (from a fasting value of 63 +/- 8% to a nadir of 53 +/- 9%) after the glucose stimulus, then a steady value of approximately 62% was reestablished and maintained throughout the experiment. The validity of the C-peptide model was further assessed by comparing its estimate of the fractional plasma clearance rate (k01) with that obtained in experiments in which biosynthetic human C-peptide was administered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292318 TI - Discordance of exocrine and endocrine growth after 90% pancreatectomy in rats. AB - As we have previously shown, by 8 wk after 90% pancreatectomy (PX) in the rat, there is considerable regeneration of both exocrine and endocrine pancreas. In this study we examine the growth of both the exocrine and endocrine tissue 3, 7, 14, and 21 days after PX by following the pancreatic content of insulin, glucagon, and amylase as well as the mitotic indices for exocrine and islet beta cells. By 7 days the pancreatic remnant weighed more than the anatomically equivalent tissue in the sham, the remnant equivalent. The growth of the exocrine tissue and the endocrine beta-cells was discordant during these initial weeks after PX, as shown by the mitotic index. The mitotic index, measured as accumulated mitotic figures after a 4-h colchicine treatment, for both the exocrine and beta-cells in the sham animals was low and unchanging at the different time points (approximately 0.5%). At 3 and 7 days after PX, both the exocrine and beta-cells had mitotic indices three- to fourfold that of the sham animals. At 14 days after PX, the exocrine cells had a slightly, albeit significantly, elevated mitotic index, whereas that of the beta-cells was still double that of the shams. By 21 days there was no difference in mitotic index for exocrine tissue, but the beta-cells on the PX animals had a mitotic index still double that of the shams. Another index of growth, the cell birthrate, was estimated at 7 days from the slope of regression lines of the mitotic frequency accumulated 1, 2, 3, and 4 h after colchicine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292319 TI - Splanchnic amino acid and glucose metabolism during amino acid infusion in dogs. AB - With the organ-balance technique, we studied amino acid and glucose metabolism by hepatic and extrahepatic splanchnic tissues in awake dogs in the postabsorptive state and during a 3-h intravenous amino acid infusion. Dogs received a high (1.4 g/kg body wt, n = 5) or low (0.7 g/kg body wt, n = 8) dose of amino acids. In four of the latter dogs, the dose was delivered into a mesenteric vein. During the basal period there was a net removal of gluconeogenic amino acids (particularly alanine), but not branched-chain amino acids, and a net production of glucose by the liver in all dogs. During this time there was a net removal of glucose and production of alanine by the extrahepatic splanchnic tissues. During either high- or low-dose amino acid infusion, net hepatic glucose release increased; despite this, arterial plasma glucose declined due to an increase in tissue glucose uptake at extrasplanchnic sites. The net amount of glucogenic amino acids removed by the liver during high-dose (9.1 +/- 1.0 mmol.kg-1.3 h-1) and low-dose (4.8 +/- 0.6 mmol.kg-1.3 h-1) infusion equaled or exceeded the infused load of these amino acids. In addition, the liver contributed to the net disposal of branched-chain amino acids during high-dose (536 +/- 147 mumol.kg-1.3 h-1) and low-dose (341 +/- 70 mumol.kg-1.3 h-1) infusion. During high-dose infusion, extrahepatic splanchnic tissues participated in the net removal of branched-chain amino acids (436 +/- 162 mumol.kg-1.3 h-1) but not glucogenic amino acids, and net alanine production continued (410 +/- 91 mumol.kg-1.3 h 1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292320 TI - New approach for oral administration of insulin with polyalkylcyanoacrylate nanocapsules as drug carrier. AB - Polyalkylcyanoacrylate nanocapsules (mean size 220 nm), composed of spheric polymeric structures, have been used as a drug carrier for insulin. The rate of encapsulation of insulin is 54.9%, and we studied the therapeutic efficiency of the nanocapsules in diabetic and normal rats. When administered subcutaneously, insulin-loaded nanocapsules prolonged the hypoglycemic effect of insulin; the duration of this effect increased with the doses. When administered orally by force-feeding to diabetic rats, insulin nanocapsules (12.5, 25, and 50 U/kg) decreased fasted glycemia 50-60% by day 2. This effect was maintained for 6 or 20 days with 12.5 or 50 U/kg, respectively. Only the dose of 100 U/kg decreased fed glycemia by 25% in diabetic rats. In normal rats, hyperglycemia induced by an oral glucose load was reduced by 50% with the same dose of oral insulin nanocapsules. We concluded that polyalkylcyanoacrylate nanocapsules preserve the therapeutic effect of insulin when administered orally and prolong this effect when administered subcutaneously and orally. PMID- 3292321 TI - HLA and genetics of IDDM. Holism vs. reductionism? AB - Analysis of HLA-associated susceptibility to insulin-dependent diabetes mellitus (IDDM) has largely focused on identifying the susceptibility gene. Adherents of a countertrend have long suggested the importance of analysis of HLA haplotypes (combinations of alleles on 1 chromosome) rather than individual genes. Accumulating data suggest that the relationship between IDDM susceptibility and HLA is much more complex than a single susceptibility gene. Consideration of this question should include the possibilities that 1) more than one HLA gene is involved in determining susceptibility or resistance; 2) different alleles of the same gene may be associated with different pathogenetic mechanisms; and 3) different susceptibility-associated haplotypes, even if they share an allele at an IDDM-relevant locus, may behave differently in IDDM. A better understanding of the genetics, and perhaps the pathogenesis, of IDDM may be obtained by following up the clues offered by analysis of the association of HLA haplotypes (rather than individual alleles) with one another, with clinical features of IDDM, and with possible non-HLA-linked susceptibility factors. PMID- 3292322 TI - Measurement of plasma glucose, free fatty acid, lactate, and insulin for 24 h in patients with NIDDM. AB - Fasting and postprandial plasma glucose, free fatty acid (FFA), lactate, and insulin concentrations were measured at hourly intervals for 24 h in 27 nonobese individuals-9 with normal glucose tolerance, 9 with mild non-insulin-dependent diabetes mellitus (NIDDM, fasting plasma glucose less than 175 mg/dl), and 9 with severe NIDDM (fasting plasma glucose greater than 250 mg/dl). In addition, hepatic glucose production (HGP) was measured from midnight to 0800 in normal individuals and patients with severe NIDDM. Plasma glucose concentration was highest in patients with severe NIDDM, lowest in those with normal glucose tolerance, and intermediate in those with mild NIDDM (two-way ANOVA, P less than .001). Variations in plasma FFA and lactate levels of the three groups were qualitatively similar, with lowest concentrations seen in normal individuals, intermediate levels in the group with mild NIDDM, and the highest concentration in those with severe NIDDM (two-way ANOVA, P less than .001). Of particular interest was the observation that plasma FFA concentrations were dramatically elevated from midnight to 0800 in patients with severe NIDDM. The 24-h insulin response was significantly increased in patients with mild NIDDM, with comparable values seen in the other two groups. Values for HGP fell progressively throughout the night in normal individuals and patients with severe NIDDM, despite a concomitant decline in plasma glucose and insulin levels. Although the magnitude of the fall in HGP was greater in NIDDM, the absolute value was significantly (P less than .001) greater than normal throughout the period of observation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292323 TI - Modeling error and apparent isotope discrimination confound estimation of endogenous glucose production during euglycemic glucose clamps. AB - We previously demonstrated that conventional tracer methods applied to euglycemic hyperinsulinemic glucose clamps result in substantially negative estimates for the rate of endogenous glucose production, particularly during the first half of 180-min clamps. We also showed that addition of tracer to the exogenous glucose infusate resulted in nonnegative endogenous glucose production (Ra) estimates. In this study, we investigated the underlying cause of negative estimates of Ra from conventional clamp/tracer methods and the reason for the difference in estimates when tracer is added to the exogenous glucose infusate. We performed euglycemic hyperinsulinemic (300-microU/ml) clamps in normal dogs without (cold GINF protocol, n = 6) or with (hot GINF protocol, n = 6) tracer (D-[3-3H]glucose) added to the exogenous glucose infusate. In the hot GINF protocol, sufficient tracer was added to the exogenous glucose infusate such that arterial plasma specific activity (SAa) did not change from basal through the clamp period (P greater than .05). In the cold GINF studies, plasma SAa fell 81 +/- 2% from the basal level by the 3rd h of clamping. We observed a significant, transient, positive venous-arterial difference in specific activity (SAv-SAa difference) during the cold GINF studies. The SAv-SAa difference reached a peak of 27 +/- 6% at 30 min and diminished to a plateau of 7 +/- 1% between 70 and 180 min. We also observed a positive but constant SAv-SAa difference (4.6 +/- 0.2% between 10 and 180 min) during the hot GINF studies. The observations of a difference between hot and cold GINF endogenous Ra estimates and a positive but transient SAv-SAa difference during the cold GINF studies are consistent with the interpretation that a portion of the underestimation of Ra is due to insufficient mixing of endogenous and exogenous glucose for the one-compartment, fixed-pool volume model to be applicable. Alternatively, our results suggest that the one-compartment, fixed-pool volume model of glucose kinetics is insufficient to account for the complex dynamics of labeled and unlabeled glucose during euglycemic hyperinsulinemic clamps. Improved mixing through addition of tracer to the exogenous glucose infusate or improved modeling by allowing for a variable-pool volume appears to improve the accuracy of the tracer methods; however, these approaches remain to be validated. The constant positive SAv-SAa difference observed during the hot GINF studies is consistent with the interpretation that an additional contributor to underestimation of endogenous Ra is apparent isotope discrimination.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3292324 TI - Cyclosporin A suppresses insulin autoantibodies and heterologous insulin antibodies in type I diabetic children. AB - We report that cyclosporin A (CsA) suppresses the insulin autoantibodies that are present before insulin therapy in the sera of one-third of studied type I (insulin-dependent) diabetic children. CsA also reversibly blocks the production of antibodies after exogenous insulin injection, whereas high titers of heterologous insulin antibody are observed in all type I patients not receiving CsA. PMID- 3292325 TI - Preferential infiltration of macrophages during early stages of insulitis in diabetes-prone BB rats. AB - The subpopulation of lymphoid cells at the different stages of insulitis in BB rats was determined by immunohistochemical techniques with various monoclonal antibodies, including the recently developed OX41, which distinguishes macrophages from T-lymphocytes, OX19 for pan-T-lymphocytes, W3/25 for both helper T-lymphocytes and macrophages, OX8 for cytotoxic T-lymphocytes and natural killer cells, and OX12 for B-lymphocytes. The major population of infiltrated cells found during the early stages of insulitis appeared to be macrophages. This preceded invasion by a mixed population of cells, including both T- and B lymphocytes and/or natural killer cells. The preferential infiltration of macrophages during the early stages of insulitis strongly suggested that there might be an initial change in the target beta-cells that precedes their immune destruction, although the amplification of immune response by activated T lymphocytes and natural killer cells at a later stage seemed to be required for the clinical expression of the disease. PMID- 3292326 TI - Pharmacokinetic model of circulating covalent aggregates of insulin. AB - Covalent aggregates of insulin in blood of insulin-treated diabetic patients account for as much as 70% (mean 28 +/- 3.6%) of serum insulin immunoreactivity. These aggregates may originate in therapeutic insulin, because similar substances account for 0.1-3% of these preparations. Larger amounts in blood imply that aggregates accumulate as a result of delayed clearance. To test and quantify this speculation, we calculated the plasma kinetics of this material in four normal volunteers who received large intravenous doses (30 mU.kg-1.min-1) of beef-pork crystalline zinc insulin for 120 min. Insulin aggregate and monomer concentrations were measured in blood samples obtained at regular intervals throughout the infusion and during 4 h after discontinuation of insulin. Pharmacokinetic parameters were calculated from the data. Insulin aggregate and monomer serum t 1/2 were 63.6 +/- 6.9 and 34.3 +/- 2.8 min, respectively, and clearances were 101 +/- 10 and 232 +/- 47 ml/min. Volume of distribution (V beta) and volume at steady state (Vss) were 9.1 +/- 1.8 and 8.2 +/- 2.2 L for insulin aggregate and 11.6 +/- 2.8 and 12.2 +/- 3.6 L for insulin monomer, respectively. Mean residency time was 141 +/- 14 and 114 +/- 10 min for insulin aggregate and monomer, respectively [P less than .01 for all parameters except V beta (.014) and Vss (.012), aggregate vs. monomer]. Thus, in relation to insulin monomer, calculated pharmacokinetic parameters of the aggregate predict accumulation after insulin injection. Plasma t 1/2 of the aggregate was almost double that of monomeric insulin; total-body clearance and the corresponding volumes of distribution were smaller. PMID- 3292327 TI - Effects of insulin on vasoconstrictive responses to norepinephrine and angiotensin II in rabbit femoral artery and vein. AB - To determine whether insulin has a vasodilator action on the artery and vein, the effects of insulin at varying concentrations (120 microU/ml, 1.2 mU/ml, 12 mU/ml, and 120 mU/ml) on vasoconstriction by norepinephrine (NE) and angiotensin II (ANG II) were studied in the isolated rabbit femoral artery and vein. Helical strips were suspended in an organ bath filled with modified Krebs solution (pH 7.4), were gassed with 95% O2/5% CO2 at 36 degrees C, and isotonic contractions were measured. Insulin significantly and dose dependently inhibited the vasoconstriction induced by NE (10(-8) M for the artery and 10(-7) M for the vein) at greater than or equal to 1.2 mU/ml for both the artery and vein and the vasoconstriction induced by ANG II (3 x 10(-10) M for the artery and 3 x 10(-9) M for the vein) at greater than or equal to 1.2 mU/ml for the artery and greater than or equal to 12 mU/ml for the vein. The results indicate that insulin has an inhibitory effect on NE- and ANG II-induced contraction in both the artery and vein, and this appeared to be a contributory factor in the hypotensive effect observed in diabetic patients treated with insulin. PMID- 3292328 TI - Identification of nucleotide substitution in gene encoding [LeuA3]insulin in third Japanese family. AB - We previously described a new case of abnormal insulinemia in Japan. In one allele, nucleotide-sequence analysis revealed a substitution in the codon for the third position of insulin A chain (GTG----TTG), causing [LeuA3]insulin. This point mutation is the same as that found in insulin Wakayama. In this family, the mutant insulin allele cosegregated with an 850-base pair PvuII allele of the hypervariable region 5'-flanking the insulin gene. PMID- 3292329 TI - Insulin deficiency decreases lipoprotein lipase secretion by murine macrophages. AB - We investigated the effects of insulin deficiency and insulin treatment on the secretion of lipoprotein lipase (LPL) by murine macrophages. Streptozocin-induced insulin deficiency caused hyperglycemia and hypertriglyceridemia in mice. Peritoneal macrophages isolated from insulin-deficient mice secreted 70% less LPL activity than control mice. A 65% decrease in LPL activity in epididymal adipose tissue, without any changes in heart LPL activity, was also seen with insulin deficiency. One week of insulin treatment lowered plasma glucose and triglyceride levels in insulin-deficient mice. Additionally, 1 wk of insulin treatment increased LPL secretion by macrophages, but to only one-half of control, while normalizing adipose tissue LPL activity. One injection of insulin also increased LPL secretion by macrophages to one-half of control and normalized adipose tissue LPL activity, even though plasma glucose and triglyceride levels were not affected. In vitro insulin treatment of macrophages isolated from control or insulin-deficient mice had no effect on LPL secretion. The results suggest that insulin does not exert a direct effect on the LPL secretion by macrophages but that deficiency of insulin indirectly causes a profound decrease in macrophage LPL secretion. These changes in macrophage LPL secretion may contribute to the atherosclerotic process in diabetes mellitus. PMID- 3292330 TI - Progression from insulitis to beta-cell destruction in NOD mouse requires L3T4+ T lymphocytes. AB - The identity of the cells responsible for beta-cell destruction in type I (insulin-dependent) diabetes is still uncertain. L3T4+ T-lymphocytes have a role in the initiation of insulitis and in damaging transplanted allogeneic islets in nonobese diabetic (NOD) mice. The role of L3T4+ T-lymphocytes in destruction of beta-cells of the NOD mouse was studied in cyclophosphamide (CY)-induced diabetic NOD mice with a rat anti-L3T4 monoclonal antibody (MoAb). After administration of CY, most untreated animals became diabetic, whereas all antibody-treated animals remained normoglycemic. Insulitis was still present in MoAb-treated animals, but immunocytochemical staining showed rat antibody blocking the L3T4 antigen on T lymphocytes. This study provides further evidence that L3T4+ T-lymphocytes are critical to the process of beta-cell destruction in NOD mice. The means by which L3T4+ cells exert their effect remains to be clarified. PMID- 3292331 TI - Use of liposomes to introduce substances into pancreatic islet cells. AB - The liposome technique is widely used to transport substances that cannot normally traverse the plasma membrane into the cell. The interactions of liposomes with the plasma membrane of pancreatic islet cells have not previously been studied. We evaluate the suitability of the liposome technique for introducing substances into the pancreatic beta-cell to which the cell membrane is impermeable. Liposomes were synthesized with an ether-injection method, and the cell-liposomal interactions were investigated by means of radioactive labeling and the fluorescent aqueous space marker 6-carboxyfluorescein. Experiments were performed on freshly isolated mouse pancreatic islets and on free islet cell preparations. With fluorescence microscopy, liposomes were observed to fuse spontaneously with islet cells, and the corresponding internalized volumes were quantified with spectrofluorometric measurements. The liposome association with islets and islet cell suspensions, as assessed by radioactive labeling, was found to increase with the liposome concentration. The effects of liposome membrane lipid composition on the fusion rate were found to be decreased in the presence of glucolipid. In addition, polyethylene glycol failed to affect the liposomal uptake. Freshly isolated islets incubated with liposomes containing glucose 6-phosphate were observed to release slightly more insulin than islets incubated with "empty" liposomes. In conclusion, liposomes fuse spontaneously with islet cells in vitro, and the uptake of liposomes is regulated by the lipid composition of the liposomal bilayer and the amount of liposomes present. The function of the beta-cell can be altered with the liposome technique, e.g., by addition of biologically active molecules such as glucose 6 phosphate. PMID- 3292332 TI - Islet cell antigens. Extraction studies and ELISA analysis. AB - Whole human and bovine pancreases were extracted in 20 mM Tris-HCl buffer without detergents and fractionated by high-speed centrifugation. The 80,000 x g supernatant was used to coat microtiter plates at a concentration of 5 micrograms protein/ml in phosphate-buffered saline. This solid-phase ELISA system was used for the detection of islet cell antigens defined by a series of monoclonal islet cell antibodies (HISL-1, -4, -5, -8, -14, and -19 and 4F2, 3G5, and A2B5). Both glycoprotein and glycolipid islet cell antigens in the total pancreatic extracts were detected by the monoclonal islet cell antibody in the ELISA system, indicating that epitope preservation had occurred during the extraction procedure. There was a good correlation between islet cell antigen quantitated by the ELISA system and the corresponding islet immunohistochemical reaction. Studies along these lines have the potential to facilitate the design of large scale protocols for the purification of diabetes-related islet cell antigens to homogeneity. PMID- 3292333 TI - Diagnostic ultrasound in general practice. AB - A three-year diagnostic ultrasound training project for generalists is described. Specific applications and a rationale for the use of ultrasound by general physicians are presented. The current status of training programmes, credentialing strategies, and desirable equipment characteristics are also discussed. Finally, benefits, liabilities and controversies in diagnostic ultrasound imaging are reviewed. PMID- 3292334 TI - Aspartic proteinases in gastric mucosa of the rat: absence of pepsinogen I, genetic polymorphism of pepsinogen II, and presence of slow-moving proteinase. AB - We have examined relationships among the aspartic proteinases in rat and human gastric mucosa by electrophoretic analysis in polyacrylamide gel and by immunoblotting and immunohistochemical staining using rabbit antisera to human pepsinogen I (PG I), pepsinogen II (PG II), and slow-moving proteinase. By electrophoretic analysis, the major proteolytic bands in mucosal extracts from each of three strains of rats had rates of anodal migration that were similar to the fastest migrating isozymogens of human PG I. However, immunoblots revealed that these bands and several minor proteolytic bands with slower rates of anodal migration reacted with antiserum to PG II. Two proteolytic bands in rat gastric mucosa that migrated concurrently with human slow-moving proteinase reacted with antihuman slow-moving proteinase reacted with antihuman slow-moving proteinase. None of the proteolytic bands in rat gastric mucosa reacted with anti-PG I. By immunohistochemical staining, anti-PG I failed to stain any cells in rat fundic gland or antral mucosa. By contrast, anti-PG II stained mucus neck and chief cells in fundic gland mucosa and pyloric gland cells in antral mucosa, and anti slow-moving proteinase stained surface and foveolar epithelial cells throughout the stomach. The results indicate that the gastric mucosa of the rat does not contain PG I. PMID- 3292335 TI - Alterations in mucosal content of colonic glycoconjugates in inflammatory bowel disease defined by monoclonal antibodies. AB - The presence of several glycoconjugates in colonic mucosa of patients with inflammatory bowel disease was assessed through indirect immunofluorescent staining using a collection of 23 monoclonal antibodies directed against human colonic mucin glycoproteins (anti-HCM MAbs). Intensity and distribution of staining by three anti-HCM MAbs were significantly altered in mucosa from patients with ulcerative colitis (UC) (n = 14) when compared with normal tissue (n = 15) and with tissue from patients with Crohn's disease as well as other inflammatory disorders (n = 15). Staining by anti-HCM MAb 17, which binds to colonic mucin glycoprotein species IV and V, was absent or diminished in 86% of samples from patients with active UC in contrast to 14% of normal and disease control specimens. Reduction in anti-HCM MAb 17 staining was less marked in mucosal biopsy specimens from patients with UC lacking acute inflammatory activity (n = 8). In contrast to the apparent loss of the MAb 17-defined epitopes, staining with anti-HCM MAbs 10 and 22 was enhanced in UC tissue compared with normal and disease controls. Increased staining with MAb 10 was present in 93% of samples from UC patients demonstrating active inflammation. Increased MAb 10 staining was not apparent in noninvolved mucosa from UC patients, indicating that increased expression of the specified epitope is related to the acute inflammatory process. In contrast, indirect immunofluorescent staining with MAb 22 was apparent in both involved (78%) and uninvolved (67%) UC mucosa in contrast to normal and disease controls (less than 12%). In addition, staining with several other anti-HCM MAbs (MAbs 3, 11, 15) was modestly and variably diminished (14%-28%) in UC, Crohn's disease, and other inflammatory disorders. These findings demonstrate the presence of alterations in mucosal content of specific glycoconjugate structures in association with UC. Inflammatory processes may also result in broad changes in glycoconjugate determinants generally. PMID- 3292336 TI - Formation of extracellular matrix in normal rat liver: lipocytes as a major source of proteoglycan. AB - Proteoglycans are a major component of the normal hepatic extracellular matrix and undergo quantitative and qualitative changes in hepatic fibrosis. The cellular sources of proteoglycans are as yet incompletely defined. We examined this question using primary cultures of hepatocytes and lipocytes isolated from normal rat liver. Proteoglycan synthesis was assessed by measuring production of sulfated glycosaminoglycan, the polysaccharide moiety of proteoglycans. The findings indicate that lipocytes produce sixfold more glycosaminoglycan, per cell, than do hepatocytes. Two-thirds of the newly synthesized material is cell- or matrix-associated. Of the individual glycosaminoglycan species produced by lipocytes, dermatan sulfate represents 60% of the total; heparan sulfate and chondroitin sulfate are measurable but relatively minor. In hepatocyte cultures, heparan sulfate accounted for essentially all of the glycosaminoglycan detected. We conclude that lipocytes are an important source of proteoglycan in normal liver and may be the principal source of dermatan sulfate associated with hepatic fibrosis. PMID- 3292338 TI - Ultrasound-assisted percutaneous liver biopsy: superiority of the Tru-Cut over the Menghini needle for diagnosis of cirrhosis. AB - A total of 1192 consecutive patients with diffuse liver disease were randomized to have percutaneous liver biopsy specimens taken with the Menghini or the Tru Cut needle, to compare tissue yield, safety, and accuracy of the two needles for diagnosing cirrhosis. The sites of puncture were determined by prebiopsy ultrasound scans. Adequate samples were obtained from 94% with the Tru-Cut needle and from 79.2% with the Menghini needle (p less than 0.001). Accuracy in diagnosing cirrhosis was 89.5% for the Tru-Cut needle and 65.5% for the Menghini needle (p less than 0.05). Complication rates were very low and similar for both needles. Under these conditions, the Tru-Cut needle is superior to the Menghini needle for diagnosing cirrhosis. PMID- 3292337 TI - Diffuse small intestinal lymphoid infiltration in nonimmunodeficient adults from Western Europe. AB - In two white adults born, raised, and living in central France and presenting with long-lasting malabsorption, massive and diffuse lymphoid infiltrate of the lamina propria associated with crypt scarcity was found along the whole small bowel. It was mostly composed of mature lymphocytes, focally mixed with plasma cells and reactive germinal centers. There was no evidence of celiac disease, systemic or intestinal immune deficiency or alpha-chain disease, overt lymphoid malignancy, or stagnant-loop syndrome. By immunofluorescence the infiltrate was constituted in 1 case of polyclonal B cells and, in the other, of a large majority of T11, T8, T10, and class II-positive T cells associated with a population of monotypic B cells. A gluten-free diet and parenteral nutrition proved ineffective. A dramatic and protracted clinical response was observed in both patients after the onset of oral tetracycline therapy, and still persists after 8 and 5.5 yr, respectively, together with morphologically unchanged small bowel infiltrate. These cases may be the equivalents, in people from Western developed countries, of the predominantly lymphocytic variety of the immunoproliferative small intestinal disease described in people from developing countries. PMID- 3292339 TI - Role of sigmoidoscopy in screening for colorectal cancer: a critical review. AB - The use of sigmoidoscopy as a screening method for colorectal cancer is controversial. Evidence regarding its efficacy is reviewed critically, with special attention given to potential biases in screening studies. The vast majority of studies are uncontrolled and without follow-up information and thus shed little light on the actual benefits of sigmoidoscopy. Two uncontrolled studies with follow-up and one randomized trial suggest a colorectal cancer mortality reduction because of the use of sigmoidoscopy, but all three studies have major shortcomings. The authors conclude that the currently available data are insufficient to establish a national recommendation for screening with sigmoidoscopy. To establish such a recommendation, a properly conducted randomized trial with colorectal cancer mortality as an outcome is needed. PMID- 3292340 TI - Prospects for management of gastrointestinal injury associated with the acute radiation syndrome. AB - The effect of total-body ionizing radiation on the digestive tract is dose dependent and time-dependent. At low doses (1.5 Gy), one observes only a short prodromal syndrome consisting of nausea, vomiting, and gastric suppression. At doses greater than 6 Gy, the prodromal syndrome is more marked, and it is followed after a 2-5-day remission period by a subacute syndrome, characterized by diarrhea and hematochezia. This gastrointestinal syndrome is superimposed onto a radiation-induced bone marrow suppression. The combination of intestinal and hemopoietic syndromes results in dehydration, anemia, and infection, leading eventually to irreversible shock and death. The treatment of prodromal symptoms is based on the administration of antiemetics and gastrokinetics, although an effective treatment devoid of side effects is not yet available for human therapy. The treatment of the gastrointestinal subacute syndrome remains difficult and unsuccessful after exposure to total body doses greater than 8-10 Gy. Supportive therapy to prevent infection and dehydration may be effective if restoration or repopulation of the intestinal and bone marrow stem cells does occur. In addition, bone marrow transplantation may improve the prospect of treating the hemopoietic syndrome, although the experience gained in Chernobyl suggests that this treatment is difficult to apply in the case of nuclear accidents. Administration of radioprotectants before irradiation decreases damage to healthy cells, while not protecting cancerous tissues. In the future, stimulation of gastrointestinal and hemopoietic progenitor cells may be possible using cell growth regulators, but much remains to be done to improve the treatment of radiation damage to the gastrointestinal tract. PMID- 3292341 TI - Whither biliary sludge? PMID- 3292342 TI - Gastrointestinal reflexes. PMID- 3292343 TI - Sigmoidoscopy: case finding versus screening. PMID- 3292344 TI - Midazolam versus diazepam as premedication for upper gastrointestinal endoscopy: a randomized, double-blind, crossover study. AB - The effectiveness of midazolam as premedication for upper gastrointestinal endoscopy was examined and compared with that of diazepam in a double-blind crossover study involving 23 patients. The degree of sedation and cooperation of patients during the procedure and the speed of recovery from sedation were comparable for the two drugs. The effects of both compounds on arterial blood pressure and heart rate were quite similar. However, midazolam induced significantly more amnesia than diazepam (91% vs. 39%). Also, patients' acceptability for the procedure was significantly higher in the midazolam than in the diazepam group (78% vs. 26%). Therefore, when amnesia is desirable, as in the case of repeated endoscopies, midazolam should be the drug of choice. PMID- 3292346 TI - ERCP--the first twenty years. PMID- 3292345 TI - The effectiveness of simethicone in improving visibility during colonoscopy: a double-blind randomized study. AB - The effect of simethicone in improving visibility during colonoscopy was randomly studied in 97 patients receiving either simethicone (N = 49) or placebo (N = 48) in a colon lavage solution. Visibility was assessed by the amount of bubbles and the degree of haziness noted during colonoscopy. The degree of bubbles was scored on a scale of 0 to 3, and haziness was scored on a scale of 0 to 2. Patients receiving simethicone had significantly less bubbles (p less than 0.001) and less haziness (p less than 0.01) in the colon when compared to placebo-treated patients. These data indicate that the addition of simethicone to the colonic lavage solution results in improved colonic visibility and may result in technically easier and more accurate colonoscopy. PMID- 3292348 TI - Insulin-induced changes in mechanical characteristics of lipid bilayers modified by liver plasma membrane fragments. AB - Insulin interaction with BLM with incorporated fragments of rat liver plasma membranes, containing hormone receptors, was studied by determining Young modulus of elasticity of bilayer lipid membranes in direction perpendicular to the surface, E. The presence of membrane proteins in a concentration of 60 micrograms.ml-1 induced a significant decrease in parameter E (to approx. 50%) as compared with values obtained in non-modified membranes during insulin action (concentration interval 10(-11)-10(-9) mol.l-1). The extent of the effect was dependent on the initial phase state of the membrane, on cholesterol content in BLM as well as on membrane proteins concentration in lipid bilayer. PMID- 3292347 TI - Endoscopic cannulation of the ampulla of Vater: a preliminary report. By William S. McCune, Paul E. Shorb, and Herbert Moscovitz, 1968. PMID- 3292349 TI - Some theoretical and practical aspects of the disturbances of consciousness with special reference to akinetic mutism. PMID- 3292351 TI - Ultrasonic evaluation of fallopian tube carcinoma. AB - Primary malignant neoplasms of the fallopian tube are the least common of all the gynecologic malignancies, and constitute only about 0.1-1% of all such malignancies. The actual 5-year survival is 64% in those with stage I, 60% in cases of stage II, and 18% and 25% for stages III and IV, respectively. Therefore, early detection of these neoplasm stages is most important to attain a cure. The preoperative diagnosis of this neoplasm has rarely been reported because these lesions are not common. We present herein the clinical and sonographic features in 4 Japanese women with fallopian tube carcinoma. While the sonographic features alone are not distinct enough to establish a definite preoperative diagnosis, the findings as seen in our patients suggest inclusion of tubal carcinoma in the differential diagnosis. PMID- 3292350 TI - Verrucous carcinoma of the female genital tract: report of a case and review of the literature. AB - Verrucous carcinoma (VC) of the female genital tract is a rare lesion, primarily affecting postmenopausal women. A case of VC of the vulva is reported, bringing the total number of VC of the female genital tract to 89. VC is a slowly growing, locally "pushing" tumor with a rather benign histologic appearance, and the clinical and histologic characteristics are described on the basis of the present report and a review of the literature. The treatment of VC is still a matter of discussion. It seems logical to treat the tumor by wide local excision, taking the lack of proof of spontaneous metastasis into consideration. Radiation therapy should be contraindicated, and local application of podophyllin, bleomycin therapy, and cryosurgery are ineffective methods in the treatment of VC. PMID- 3292352 TI - Social services for deaf and hearing-impaired clients: a review of the literature. AB - Emphasis on the social service needs of the deaf and hearing impaired has increased in the past decade. The literature that resulted from this attention is fragmented, however, and does not always offer the structure and direction that is needed. This review of the literature identifies issues related to effective service delivery with the objective of enhancing practitioners' understanding and awareness of the social service needs of the deaf community. A second objective is to stimulate interest and action in service delivery, program development, and direct service for the deaf. PMID- 3292353 TI - A tribute to Professor Eduard Klika, Dr. Sc., head of the Department of Histology of the Faculty of Medicine, Charles University, Prague and prorector of Charles University. On the occasion of his sixtieth birthday. PMID- 3292354 TI - Cell types in the principal islets of two hillstream catfishes from India. PMID- 3292355 TI - [Significance of transplantation antigens in keratoplasty]. PMID- 3292356 TI - [Quality control of the current use of ultrasound in ophthalmology]. PMID- 3292357 TI - [Differential diagnosis of endocrine orbitopathy]. PMID- 3292358 TI - Calcium antagonists, a new class of antihypertensive agents. AB - The mechanism of action of Ca++ antagonists remains debatable. Not all voltage sensitive calcium channels have the same sensitivity to organic calcium blockers. Those in smooth muscle are clearly more sensitive than those in heart, and at least some of those in brain are not blocked at all. It is possible that in vascular smooth muscle, calcium antagonists act essentially on receptor-operated channels. In any case, calcium antagonists are potent antihypertensive agents, but in clinical practice they have limitations. A second generation of dihydropyridines may provide a higher degree of therapeutic selectivity. PMID- 3292359 TI - [Hemophilia and HIV]. PMID- 3292360 TI - [Transition of occurrence of anisakiasis and its paratenic host fishes in Japan, with pathogenesis of anisakiasis]. AB - The number of anisakiasis according to a nation-wide statistical survey totaled 4682 cases until June 1987 in Japan. Of these 4296 cases are gastric anisakiasis (including 215 cases of gastric terranovasis), 375 intestinal anisakiasis and 11 extra-gastrointestinal anisakiasis. Pseudoterranova larva does not invade the intestine, and worms are vomited in most cases. Clinical diagnosis of intestinal anisakiasis is more difficult than that of gastric anisakiasis, and it also is hard to find the worm itself in histopathological examination. Therefore the number of actual intestinal anisakiasis is probably 3 times more than that of the reported cases. The cases of gastrointestinal-wall perforation by worms are increasing, which means immune response by granuloma formation is important. The catches of paratenic hosts and the rate of infection vary with year. In addition, the kind of paratenic host fishes are different between the southern and northern areas of Japan. The paratenic hosts reported by patient are closely related to the catches of kinds of those fishes in the respective areas. Recently, cases by eating sardine are increasing in the southern area. Urticaria as a complication is related to the diagnostic rate, and intraperitoneal bacterial infection by the gastrointestinal perforation by worms is closely related to the prognosis. PMID- 3292361 TI - [Hemostatic effect of an endoscopic local injection of hypertonic saline epinephrine (HS-E) solution on upper gastrointestinal bleeding--comparative study of this effect with and without visible vessel detection]. AB - One hundred and ninety seven patients with upper gastrointestinal bleeding were each administered and endoscopic local injection of hypertonic saline epinephrine (HS-E) solution at our hospital over a 5-year period, from the Spring of 1981 to March of 1986. Peptic ulcers were found in 162 of the patient. Vessels could be visibly detected in the 148 (91.4%)-A group, but not in the 14 (8.6%)-B group. A comparison of the number of endoscopic local injections to each of these groups indicated no significant differences in types of bleeding, systemic complications, or sites of bleeding. The excellent hemostatic effect of HS-E is due to the fact that local injection of its solution can be repeated in large quantities for various types of bleeding. PMID- 3292362 TI - In vitro transmission of duck hepatitis B virus to primary duck hepatocyte cultures. AB - An attempt was made to infect primary duck hepatocyte cultures with duck hepatitis B virus in vitro in order to clarify the biology of hepatitis B virus. Livers of ducklings, 0 to 17 days posthatch, without viremia were digested ex situ by perfusion of collagenase solution through the portal or hepatic vein. Homogeneous hepatocyte suspensions were seeded into plastic dishes in L-15 medium containing 10(-8) M insulin, 2 X 10(-8) M glucagon and 10(-8) M dexamethasone and were subsequently inoculated with sufficient numbers of duck hepatitis B virus. As a result, duck hepatitis B virus multiplication started weakly on Day 2, gradually increased and reached the maximum level approximately on Day 10 postinoculation. Viral replication was revealed by duck hepatitis B virus DNA in the cell pellet and in the culture medium and duck hepatitis B virus DNA-specific transcripts in the cell pellet. Immunostaining demonstrated duck hepatitis B virus core antigen in approximately 10% of cultured hepatocytes, and an increase in numbers of positive cells was not observed with time for up to 18 days of culture. Viral particles were found within the endoplasmic reticulum, and the inoculation of culture medium provoked viremia in the ducklings. The age of ducklings did not influence the numbers of cells infected. The in vitro infection system was similar to the in vivo one; however, the former seemed to be age independent and to allow replication of duck hepatitis B virus in the limited number of hepatocytes. PMID- 3292363 TI - Maintenance of remission in autoimmune chronic active hepatitis with azathioprine after corticosteroid withdrawal. AB - Forty-seven patients with autoimmune chronic active hepatitis in remission on azathioprine and/or prednisolone were entered into a randomized controlled trial to assess the value of azathioprine alone in maintenance of remission. The trial design involved administering azathioprine at a dose of 2 mg per kg to one-half of the patients, in whom prednisolone was then gradually withdrawn, whereas the remaining patients, the "control" group, were maintained on the conventional combination regimen of azathioprine (1 mg per kg) with prednisolone. At 1 year there was no significant difference in respect of standard liver function tests or histological appearances between the two groups. Two patients in the azathioprine group required dosage reduction because of myelosuppression and both subsequently relapsed. Following withdrawal of corticosteroids Cushingoid features were lost with a return of weight and blood pressure to normality. In 75% of the patients, corticosteroid withdrawal was marked by arthralgias and myalgias which lasted for up to 12 months: no other major side effects of corticosteroid withdrawal were noted. Thus in the majority of cases, remissions in autoimmune chronic active hepatitis which are induced by corticosteroids can be maintained with azathioprine alone. PMID- 3292364 TI - Autoantibodies against nuclear envelope-associated proteins in primary biliary cirrhosis. AB - An antinuclear immunofluorescence pattern displaying a thin ring confined to the nuclear envelope was assessed in sera from 38 patients with primary biliary cirrhosis and in sera from a control group of 277 patients with other antinuclear antibody-positive diseases. This rim-like antinuclear reactivity was present in sera from 20 primary biliary cirrhosis patients (52.6%) but in only two patients from the control group (0.7%) (p less than 0.001). Furthermore, this autoantibody was present in three of four primary biliary cirrhosis patients without antimitochondrial antibodies. Presence of this rim-like pattern in primary biliary cirrhosis did not correlate with the presence of associated autoimmune diseases nor with other clinical, biochemical, nor histological features of the disease. The antigenic specificity of sera displaying this antinuclear immunofluorescence pattern was characterized by Western blot analysis using an antigenic extract containing nuclear envelope proteins purified from rat liver. Sixteen of the 20 positive sera showed a common pattern of reactivity with a set of nuclear envelope-associated proteins approximately 200 kD in size. In conclusion, sera from primary biliary cirrhosis patients showing a rim-like fluorescent nuclear pattern have antinuclear autoantibodies that react specifically with components of the nuclear envelope. The high specificity of these new autoantibodies in primary biliary cirrhosis indicate that they might be a serological marker of the disease, particularly useful in patients without antimitochondrial antibodies. PMID- 3292366 TI - Liver transplantation: an overview. PMID- 3292367 TI - The emergence of biliary sludge, a new clinical entity. PMID- 3292368 TI - Wilson's disease: transplantation when all else has failed. PMID- 3292365 TI - Pathologic analysis of liver transplantation for primary biliary cirrhosis. AB - A retrospective histopathologic review of all pathologic specimens from 394 adult liver transplant patients was undertaken with clinical correlation to determine if primary biliary cirrhosis has affected the posttransplant course compared to all other indications for liver transplantation and if recurrent primary biliary cirrhosis has occurred after liver transplantation. We also compared the histopathologic features seen in native livers with primary biliary cirrhosis to failed allografts with chronic rejection. One hundred six of the 394 adult patients transplanted during this time (1981 to July, 1986) fulfilled clinicopathologic criteria for a diagnosis of primary biliary cirrhosis. Neither the incidence nor any qualitative pathologic feature of histologically documented acute cellular rejection differentiated subjects transplanted for primary biliary cirrhosis vs. other diseases. No correlation between the titers of antimitochondrial antibody and the presence of posttransplant hepatic dysfunction based on liver enzyme profiles or the development of chronic rejection was seen in patients transplanted for primary biliary cirrhosis. Minor differences noted in the posttransplant course of primary biliary cirrhosis patients as compared to other conditions (higher incidence of chronic rejection as a cause of graft failure) was seen, but this did not significantly affect graft or patient survival. Recurrent primary biliary cirrhosis could not be diagnosed with certainty in any patient. A comparison of failed chronically rejected allografts vs. native hepatectomies obtained from patients with primary biliary cirrhosis revealed the presence of chronic obliterative vasculopathy, centrilobular cholestasis, and lack of granulomas, cirrhosis, cholangiolar proliferation, copper-associated protein deposition and Mallory's hyalin in specimens with chronic rejection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292369 TI - Ascitic fluid culture technique. PMID- 3292370 TI - Prognostic factors and staging systems for multiple myeloma: comparisons between the Medical Research Council studies in the United Kingdom and the Southwest Oncology Group studies in the United States. PMID- 3292371 TI - Chemotherapy of myeloma: Southwest Oncology Group studies. PMID- 3292373 TI - Chemotherapy of myeloma: drug combinations versus single agents, an overview, and comments on acute leukemia in myeloma. PMID- 3292372 TI - Results of the MRC myelomatosis trials for patients entered since 1980. PMID- 3292374 TI - High dose melphalan for refractory myeloma--the M.D. Anderson experience. PMID- 3292375 TI - The development of high dose melphalan and of autologous bone marrow transplantation in the treatment of multiple myeloma: Royal Marsden and St Bartholomew's Hospital studies. PMID- 3292376 TI - Allogeneic bone marrow transplantation in 24 patients with multiple myeloma reported to the EBMT registry. AB - Twenty-four patients with multiple myeloma received an allogeneic bone-marrow graft from HLA-compatible sibling donors (n = 23), or a twin donor (n = 1). Eighteen patients are alive, 1-36 months post bone-marrow transplantation (median 14 months). Ten of these patients had no signs of multiple myeloma as judged by immunoglobulins in serum, light chains in urine, or the percentage of plasma cells in bone-marrow aspirate. Bone lesions on X-ray were mainly unchanged. Six patients died from transplant-related complications 3 weeks to 5 months post transplantation. One of these patients had severe acute graft-versus-host disease (aGVHD). In other patients aGVHD was a minor problem. Allogeneic bone-marrow transplantation appears to be a promising method for treatment of a selected group of patients with multiple myeloma. PMID- 3292377 TI - Treatment of multiple myeloma with natural alpha-interferon. PMID- 3292378 TI - A review of the place of radiotherapy in myeloma with emphasis on whole body irradiation. PMID- 3292379 TI - The biology of multiple myeloma. PMID- 3292380 TI - Biology of multiple myeloma--host-tumour interactions and immune regulation of disease activity. PMID- 3292381 TI - Animal models for human myeloma. PMID- 3292382 TI - HHS issues patient-transfer regulations. PMID- 3292383 TI - HCFA to propose ending Medicaid donation programs. PMID- 3292384 TI - Catastrophic plan bodes well for home i.v. use. PMID- 3292385 TI - Days revenue in Medicare accounts receivable fall. PMID- 3292386 TI - Implementing plan is the key to survival. Interview by Howard Larkin. PMID- 3292387 TI - A study of isonymic relationships in Fylingdales Parish from marriage records from 1654 through 1916. PMID- 3292388 TI - [Preliminary study of IL-2 activity in mice infected with Mycobacterium lepraemurium by incorporation of 3H-TdR in CTLL assay]. PMID- 3292389 TI - [Effects of different durations of CAPD prior to renal transplantation on graft survival]. PMID- 3292390 TI - [Nature of urinary protein in diabetic nephropathy and its early diagnosis]. PMID- 3292391 TI - The ras-related ral gene maps to chromosome 7p15-22. AB - Human cDNAs coding for the new protein ral that shares 50% homology with the ras proteins have been recently isolated. A 600-bp fragment carrying mainly the coding region was used to localize the ral gene by hybridization with sorted chromosomes and in situ hybridization. Direct molecular hybridization on sorted chromosomes using a single laser illumination allowed the assignment of the ral gene to a region of the flow karyotype containing chromosomes 7, 8 and X. With dual laser analysis ral was assigned to the fraction containing chromosome 7. In the 331 human metaphases hybridized with the 3H-labelled insert, the silver grain distribution showed a unique major signal on chromosome 7p15-22. PMID- 3292392 TI - Small metacentric marker chromosomes, particularly isochromosomes, in cancer. AB - At least two types of small metacentrics, which are isochromosomes for 12p and either 4p or 5p, respectively, are significantly associated with certain types of cancer and their formation may represent important stages in the development of these tumours. The specificity of the i(12p) for testicular cancer is now well established (it may also be present, however, in dysgerminomas and mixed Mullerian tumours of the ovary). This review is therefore mainly concerned with another marker, probably an i(5p) although an i(4p) should also be considered. Recent data suggest that this marker represents a significant chromosomal change occurring with a fairly high frequency in a variety of cancers, including carcinomas of the cervix, ovary, breast, bladder and bronchus (excluding small cell carcinomas). These isochromosomes may contribute to tumour development through gene amplification; consistent with this is the frequent presence of these markers in two or more copies. PMID- 3292394 TI - Structure, function and expression of murine and human perforin 1 (P1). PMID- 3292393 TI - Perforin-dependent and -independent pathways of cytotoxicity mediated by lymphocytes. AB - There is little doubt at the present time that both perforin-dependent and independent pathways are important in mediating the cytotoxicity associated with lymphocytes. The cell distribution of perforin, initially thought to include both CTL and NK cells, now must be viewed with caution because all previous biochemical studies on CTL have been conducted with cell lines propagated in long term cultures in the presence of T cell growth factors (IL-2 and perhaps some still undefined factors). Under these conditions, CTL are known to assume a broader, NK-like specificity in target cell killing and may thus differ significantly from primary CTL generated in the body. Accordingly, perforin does not seem to be present in primary CTL activated directly through mixed lymphocyte reactions. It remains to be shown how primary CTL lyse target cells in vivo. Initial studies conducted in several laboratories have already provided some clues. It now seems that even in cultured, perforin-containing CTL, the perforin pathway is not an obligatory mechanism required for target cell killing. Other pathways, possibly involving TNF/lymphotoxin-like molecules, may play a direct role in this type of cytotoxicity. Other still unidentified factors now also need to be sought, including membrane polypeptides that may develop cytotoxicity directly upon cell contact and binding. Although from the studies reviewed here it is clear now that perforin has a more limited role in cell killing than originally proposed, it is still intriguing that it should share structural and functional homologies with complement proteins, drawing paradoxical analogies between two systems (the cellular and the humoral immune systems) which have evolved to become specialized to carry out separate immunological tasks. The cloning of the genes for perforin and for all the C proteins that comprise the MAC should reveal important information on how these genes originated and then diverged during evolution. The cellular distribution of other granule products, such as serine esterases, also must be viewed with caution. A serine esterase activity was initially thought to be CTL-specific. This information stimulated an intensive research activity in many laboratories that resulted in both the purification of a serine esterase family and the cloning of several serine esterase transcripts. It is becoming clear from recent evidence that this group of enzymes is not truly CTL-specific and therefore would not be expected to develop any function rendered absolutely necessary for cytolysis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3292395 TI - Molecular mechanisms of CTL-mediated lysis: a cellular perspective. PMID- 3292396 TI - Granzymes, a family of serine proteases released from granules of cytolytic T lymphocytes upon T cell receptor stimulation. AB - The cytolytic potential of T effector cells appears to be intimately related to the presence of proteins stored in specialized cytoplasmic granules. A striking biological property of isolated granules is their lytic activity for a variety of target cells in a nonrestricted manner. Proteins contained within these granules of CTLs are specifically released upon target cell recognition. We have isolated and characterized six granule-associated proteins in two murine CTL lines in addition to the pore-forming and target membrane-disrupting perforin. Six full length cDNA clones have been identified in a CTL-specific cDNA expression library which code for the granule-associated serine esterases, designated as granzymes A to F. Granzymes A and B represent the genuine proteins encoded by the H factor/CTLA-3 cDNA and the CTLA-1/CCPI cDNA, respectively. The covalent amino acid structures of all six granzymes show the hallmarks for serine proteases and are highly related to that of rat mast cell protease I and II and cathepsin G, which have been found in granules of mast cells and neutrophilic granulocytes, respectively. The primary translation products are processed by removal of a hydrophobic signal peptide and a two residue-long propeptide at the amino terminus. Immuno-electron microscopy shows that granzymes and perforin are stored together within secretory granules of CTLs. Simultaneous release of at least two of these granzymes has been observed during degranulation of a murine CTL line by anti-T3 antibodies. The biological role, particularly the proteolytic events elicited by granzyme A and other granzymes in the context of target cell recognition, are not known at present. It is unlikely that they form a proteolytic activation cascade together with pore-forming proteins analogous to the complement system. The strictly regulated secretion of granzymes and the lack of measurable enzymatic activity in the case of granzymes B, C, E and F towards a variety of synthetic substrates suggest a highly specific function for each of them. PMID- 3292397 TI - Activation of CTL-specific genes during cell-mediated cytolysis in vivo: expression of the HF gene analyzed by in situ hybridization. PMID- 3292398 TI - The molecular basis of target cell killing by human lymphocytes and of killer cell self-protection. AB - The cytolytic protein (C9RP) of human cytotoxic lymphocytes was isolated from large granular lymphocytes (LGL) and anti-CD3 activated cytotoxic T cells (CTL). It is immunochemically related to the channel-forming proteins of complement. Whereas LGL constitutively contain C9RP, peripheral resting CTL do not. C9RP synthesis is induced, however, in CD8+ cells upon stimulation of the T cell antigen receptor-CD3 structure. Comparison of cellular cytotoxicity and C9RP content at various times during anti-CD3 activation of CTL yielded a coefficient of correlation, r = 0.92. Isolated C9RP (Mr approximately 70,000) readily lysed a large variety of metabolically active cells tested. Certain monoclonal antibodies to C9RP inhibited target cell killing by LGL or activated CD8+ lymphocytes. Homologous restriction factor (HRF) is a normal membrane protein of blood cells that inhibits transmembrane channel formation by the membrane attack complex of complement. It has recently been found that isolated HRF (Mr approximately 65,000), bound to sheep erythrocytes, inhibited their lysis mediated by the antibody-dependent cellular cytotoxicity reaction or by isolated C9RP. Further, stimulation of resting peripheral lymphocytes with anti-CD3 resulted in increased expression of cell surface HRF. Acquisition of HRF expression conferred upon CTL relative resistance to lysis by C9RP. A soluble form of HRF (Mr approximately 65,000) was isolated from the cytoplasmic granules of LGL, which also contain C9RP, and shown to inhibit cytotoxicity of LGL and CTL. It is conceivable that HRF is opertive in self-protection of cytotoxic lymphocytes. PMID- 3292399 TI - Possible involvement of CTL granule proteases in target cell DNA breakdown. AB - We have carried out experiments to test whether the granule exocytosis model for lymphocyte cytotoxicity can account for the rapid target DNA breakdown seen during CTL-induced cytotoxicity. Dense granules isolated from cloned mouse CTL and from rat NK tumor cells cause target DNA breakdown during granule cytolysin mediated lysis of tumor cells, while the purified granule cytolysin caused lysis without DNA breakdown. When target cells are permeabilized with detergent, granule extracts have the ability to release 125I-DNA from nuclei in the absence of detectable cytolysin activity. This activity formed the basis for a nuclear DNA release (NDR) assay; this activity was a property of dense granules of cytotoxic lymphocytes but generally not of other types of lymphoid cells. NDR activity in NK tumor granules had a pH optimum of 7 and was inhibited by micromolar levels of Zn+2, and could be purified away from the granule cytolysin by column chromatography. NDR activity in CTL dense granules could be inactivated by submillimolar concentrations of the protease inhibitors PMSF and DFP (but not soybean trypsin inhibitor or TLCK). In support of the relevance to CTL cytotoxicity of these findings with the NDR assay, pretreatment of CTL with PMSF in the presence of agents raising the intragranular pH inactivated 125I-DNA release from target cells (but not the 51Cr release). These results suggest that a CTL granule component(s), probably a protease, is required for target DNA breakdown. PMID- 3292401 TI - [Campylobacter pylori: significance, diagnosis and treatment]. AB - The association between colonization of the antrum mucosa by Campylobacter pylori and antrum gastritis as well as peptic ulcers has been documented in a number of studies. The ability of these bacteria to produce a cytotoxin and a protease that hydrolyzes the mucosa-protecting mucin assigns pathogenetic properties to this species that suggest an etiological role for C. pylori in the pathogenesis of peptic ulcers and gastritis. This concept is supported by some preliminary results of therapeutic trials which have shown that successful eradication of the organism leads to histologic improvement of the gastritis and markedly reduced relapse rates regarding peptic lesions. Best results were achieved using combinations of a bismuth salt with an antibiotic such as amoxicillin. Diagnosis of C. pylori infection is based on culturing the organism from antral biopsies. Detecting the urease activity directly in the biopsy has also been shown to be an effective and reliable method. As a noninvasive method serologic testing for C. pylori may also be employed. An IgG-ELISA used by us showed a good correlation with cultural and histological results. PMID- 3292400 TI - [Mechanism of cell damage by E. coli hemolysin]. AB - Many strains of E. coli elaborate a hemolysin which is responsible for the zone of beta-hemolysis surrounding bacterial colonies on blood agar. The significance of this cytolysin as a determinant of bacterial pathogenicity has been established in animal models with the use of genetically engineered, isogenic bacterial strains. An analogous role in human infections has been inferred from the high association of hemolysin production with disease. Studies at a molecular genetical level have defined 4 genes that are required for the synthesis, post translational modification and secretion of the hemolysin. The structural gene hlyA encodes for a 107-110,000 polypeptide which must be modified in an unknown manner to its active form by the product of the neighboring hlyC gene. Genes hlyB and hlyD encode for proteins that export the molecule to the extracellular medium. The signal for secretion is contained in the C-terminal portion of the toxin molecule. The secreted hemolysin attacks plasma membranes of target mammalian cells by inserting as a monomer into the bilayer and generating a hydrophilic transmembrane pore of approximately 2 nm effective diameter. The pore displays a marked selectivity for cations over anions and pore-opening is dependent on the presence of a correct transmembrane potential. Binding to a membrane target does not require the presence of a specific receptor, and pores may be generated in planar lipid membranes consisting solely of phosphatidylcholine. Pore formation in nucleated cells can trigger secondary reactions such as stimulation of arachidonate metabolism with release of lipid mediators, probably initiated by passive influx of extracellular Ca2+.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292402 TI - [Bronchial hyperreactivity--provocation tests and their standardization]. AB - Asthma is characterized by attacks of bronchial obstruction due to bronchial hyperreactivity which are reversible spontaneously or as a result of therapy. Therefore, the demonstration of bronchial hyperreactivity is essential for diagnosing and grading of bronchial asthma. The different provocation tests with allergenes and spasmogenes which do not lead to delayed reaction are considered as well as medicaments which increase or decrease bronchial hyperreactivity. The chronic inflammation which is the underlying process of bronchial hyperreactivity in asthmatic patients can be assessed by mucociliary clearance measurements. The essentials of standardizations of bronchial provocation tests from the clinical point of view are mentioned. PMID- 3292404 TI - Quantitative immunocytochemical characterization of four murine macrophage-like cell lines. AB - The aim of the present study was to obtain quantitative data on the expression of seven cell-surface antigens by the murine macrophage-like cell lines WEHI-3, P388 D1, J774.1, and PU5-1.8, and to compare these data with those obtained for various mononuclear phagocytes. Binding of monoclonal antibodies F4/80, M1/70, 2.4.G.2., 30.G.12, M3/38, M3/84, and 59AD2.2 to cells from these four cell lines was detected by the biotin-avidin immunoperoxidase staining method and quantified by cytophotometry. The results are expressed as the percentage cells expressing a given antigen and the mean specific integrated absorbance per 0.25 micron2 cell surface area. The results revealed that the phenotypes of the four macrophage like cell lines differ markedly. Expression of the cell antigens by the cells of the various cell lines did not follow a normal distribution. Although the cell lines divide continuously and have certain characteristics in common with mature mononuclear phagocytes, none of the macrophage-like cell lines accurately resembles any of the mononuclear phagocyte populations. The strongest correlations for membrane were found between on the one hand WEHI-3 and P388-D1 cells and monoblasts and promonocytes (P greater than 0.011) on the other. P388 D1, J774.1 and PU5-1.8 cells expressed four of the six antigens to the same extent as skin macrophages (P greater than 0.012). With respect to expression of antigens recognized by antibodies 2.4.G.2., 30.G.12, M3/38, and M3/84 PU5-1.8 cells resembled activated peritoneal macrophages (P greater than 0.031). It is concluded that WEHI-3 is the most immature cell line, followed by the P388-D1 cell line, while J774.1, and PU5-1.8 are the most mature cell lines. PMID- 3292403 TI - [Neuron-specific enolase and beta 2-microglobulin in the serum of patients with melanoma]. AB - Both neuron-specific enolase (NSE) and beta 2-microglobulin were detected immunohistologically in malignant melanomas. In addition, serum NSE and beta 2 microglobulin were reported to be elevated in patients with malignant melanoma. The radioimmunoassay results presented did neither reveal any elevation of serum neuron-specific enolase nor of serum beta 2-microglobulin in more than 30 serum samples of patients with malignant melanoma in different tumour stages. PMID- 3292405 TI - Lipid requirements of human T lymphocytes stimulated with mitogen in serum-free medium. Membrane "fluidity" changes are an artefact of lipid (AL721) uptake by monocytes. AB - A correlation has been sought between the effects of lipids on membrane fluidity and mitogen responsiveness of human peripheral blood lymphocytes (PBL). Cholesterol and the reputedly potent membrane fluidizing agent AL721 (1) were used for these studies. However, the large AL721 induced increase in membrane "fluidity", assessed by steady state polarization of the probe 1,6-diphenyl-1,3,5 hexatriene (DPH), was found to be an artefact arising from lipid uptake by monocytes. Mitogen responses were enhanced by AL721 but unaffected by cholesterol. It is concluded that AL721 does not exert its effect through enhanced triggering of cells by altered membrane fluidity but rather that lymphocytes require an exogenous source of phospholipids/triglycerides for optimal growth in vitro, although they can synthesize sufficient cholesterol to meet their own needs. PMID- 3292406 TI - Characterization of the IgA receptor from human polymorphonuclear leucocytes. AB - Human polymorphonuclear leucocytes (PMNs) will phagocytose yeasts opsonized with specific affinity-purified human serum IgA. PMNs also bind to Sepharose beads coated with IgA or IgG, but not to beads coated with bovine serum albumin (BSA) or horseradish peroxidase (HRP). Binding to IgA-Sepharose stimulates the cells to release lysozyme. Affinity chromatography of 125I-labelled PMN membrane proteins on IgA-Sepharose results in isolation of a polypeptide of apparent 60,000 MW. The protein, which is not bound to IgG-Sepharose under the same conditions, appears as a diffuse band on SDS-PAGE, suggesting it is heavily glycosylated. PMID- 3292407 TI - The identification and partial characterization of a human mononuclear cell derived neutrophil chemotactic factor apparently distinct from IL-1, IL-2, GM CSF, TNF and IFN-gamma. AB - We have identified a neutrophil chemotactic factor (NCF) in supernatants from human blood mononuclear cells (MNC) cultured in the presence of phytohaemagglutinin (PHA). Maximal activity was observed 48 hr after culture. Following gel filtration, NCF eluted as a single major peak, together with proteins, having a molecular size of approximately 10,000 MW. The material gave a single band on SDS-PAGE but was heterogeneous following chromatofocusing (pIs approximately 6.8-7.0, 5.5-6.0 and 5.0). The biological activity of the partially purified material was abolished by trypsin and chymotrypsin treatment. NCF was heat stable (70 degrees, 60 min) and promoted both directional migration (chemotaxis) of neutrophils and, to a lesser extent, stimulated random locomotion (chemokinesis). The factor was not associated with detectable amounts of IL-1, IL 2 or interferon-gamma (IFN-gamma). MNC-derived NCF had a molecular size lower than recombinant granulocyte-monocyte colony-stimulating factor (rGM-CSF) and recombinant tumour necrosis factor (rTNF), and was considerably more active in chemotaxis. Optimal chemotactic concentrations of partially purified MNC-derived NCF were of comparable potency to FMLP and LTB4 and had about 60% of the activity of optimal concentrations of C5a, C5a-des-Arg and platelet-activating factor (PAF). These experiments indicate that the human MNC-derived NCF is a potent chemo-attractant distinct from other cytokines previously reported to promote neutrophil locomotion. PMID- 3292408 TI - Malarial parasites induce TNF production by macrophages. AB - Mouse peritoneal macrophages incubated with erythrocytes infected with non-lethal or lethal variants of Plasmodium yoelii or with P. berghei, in the presence of polymyxin B to exclude the effects of any contaminating endotoxin, secreted a cytotoxic factor into the supernatant that was shown to be tumour necrosis factor (TNF). No differences were observed in the ability of the three types of parasite to induce TNF production, which was maximal in the range of 0.2-5 infected erythrocytes per macrophages. TNF production was equivalent to that induced by lipopolysaccharide (LPS) and was enhanced by pretreatment of the macrophages with interferon-gamma (IFN-gamma) or with indomethacin. Culture media containing parasite products also induced macrophages to secrete TNF. The activity withstood boiling and was inhibited by malaria-specific antisera. Since heat-stable antigens are present in the circulation of patients with malaria, they may induced the secretion of TNF, a mediator of endotoxic shock, which could contribute to the pathology of the disease. PMID- 3292410 TI - Mechanisms of transplantation tolerance induced by liver grafting in rats: involvement of serum factors in clonal deletion. AB - An adoptive transfer assay system was used to investigate the ability of serum from tolerant, liver-grafted rats to inactivate normal thoracic duct lymphocytes. PVG rats were rendered tolerant of DA alloantigens by liver grafting. Serum taken from such rats was used to treat normal PVG thoracic duct lymphocytes (TDL) in vitro and the transplant reactivity of the cells then tested in an adoptive transfer assay. Specific decreased responsiveness compared with TDL treated with normal sera was observed, indicating the functional elimination of alloreactive clones by agents in liver-graft serum. PMID- 3292409 TI - Human monoclonal antibodies to phenolic glycolipid-I derived from patients with leprosy, and production of specific anti-idiotypes. AB - Human monoclonal antibodies (mAb) were produced by hybridomas derived from fusion of the GM4672 lymphoblastoid cell line and peripheral blood mononuclear cells from leprosy patients. Hybridoma supernatants were screened for immunoglobulin (Ig) secretion, binding to Mycobacterium leprae, phenolic glycolipid-I (Phen GL I), the unique M. leprae glycolipid and single-stranded(ss)DNA by ELISA. On the basis of direct-binding ELISAs, two IgMk mAb (PR4 and TH3) were selected for characterization. PR4 and TH3 bound to M. leprae, Phen GL-I and ssDNA; PR4 also bound to M. avium and M. kansasii and TH3 to M. kansasii. Inhibition assays demonstrated that these antibodies did not bind to the terminal disaccharide of Phen GL-I. In addition, both PR4 and TH3 bound to several autoantigens: ssDNA, double-stranded(ds)DNA and poly(ADP-ribose) but not RNA. PR4 and TH3 were used for preparation of rabbit anti-idiotype antisera. Inhibition studies demonstrated that the affinity purified rabbit anti-idiotype antisera were specific for their respective idiotype and that both Phen GL-I and ssDNA inhibited binding of idiotype to its anti-idiotype. PR4, but not TH3, was found to be similar but not identical to the 16/6 idiotype originally identified on a human monoclonal anti DNA antibody derived from a patient with systemic lupus erythematosus (SLE). PMID- 3292411 TI - The relationship between induced and spontaneous autoantibodies in MRL mice: the role of Ly-1 B cells? AB - The murine response to bromelain-treated mouse red blood cells (BrMRBC) is derived from Ly-1 B cells. It has been proposed that this B-cell subset produces a variety of other autoantibodies and is elevated in autoimmune mouse strains. We have studied the ability of MRL lpr/lpr and the non-autoimmune congenic MRL +/+ mice to make autoantibodies to BrMRBC and immunoglobulin (rheumatoid factors, RF). Following lipopolysaccharide (LPS) stimulation we found the numbers of autologous plaque-forming cells (PFC) to be low in both lpr and MRL +/+ mice, suggesting low Ly-1 B-cell numbers. This observation is consistent with the view that Ly-1 B cells in the mouse may not give rise to pathologically relevant RF. PMID- 3292412 TI - Immune response studies in relation to protection induced by using MDP as an adjuvant in malaria. AB - Muramyl dipeptide (MDP) was an important compound conferring protection to mice against the lethal malaria parasite Plasmodium berghei. The mode of protection of this compound was studied using different humoral and cellular parameters. The observations indicate that MDP boosts both humoral antibody response as well as delayed type hypersensitivity reactions, but as far as phagocytosis by macrophages is concerned, malarial mice are already maximally stimulated and MDP makes a marginal difference in immune phagocytosis only. PMID- 3292413 TI - Production and specificity of antibodies against the central region of type II collagen. AB - Collagen type-specific antibodies as well as antibodies to particular portions of the molecule are extremely useful tools especially for the quantification of collagens and for immunohistochemical examinations in developing embryos. Quantification of collagens in CNBr-solubilized tissue samples presupposes the production of antibodies against CNBr-derived collagen fragments. For the first time, as antigens for the immunization of rabbits, cyanogen-bromide derived fragments of collagen type II were used, obtained by direct digestion of tissue (Swarm chondrosarcoma from rat) and separation by gel filtration chromatography. Antisera were applied to affinity chromatography and the eluted antibodies were characterized by ELISA, immunoblotting, inhibition studies and immunohistochemistry. The antibodies from five different rabbits show high specificity for type II collagen and are directed against sequential determinants in the central portion of the type II collagen molecule. The easy way of obtaining the fragments directly from tissue, combined with their immune response in rabbits, gives the possibility of producing type II collagen-specific, fragment-directed antibodies in a convenient and rapid way. PMID- 3292414 TI - Effects of the renin inhibitor A-64662 in monkeys and rats with varying baseline plasma renin activity. AB - The efficacy of the potent, primate selective renin inhibitor A-64662 was studied in monkeys and rats with varying baseline plasma renin activity (PRA) to elucidate the relationship between PRA and the hypotensive response induced by this compound. The effect of a single bolus of vehicle or A-64662 at 0.001, 0.01, 0.1, 1.0, and 10.0 mg/kg i.v. was compared in 30 normal and 30 salt-depleted, anesthetized monkeys (n = 5/dose). Baseline mean arterial pressure (MAP) was similar among all groups, but baseline PRA was elevated in salt-depleted monkeys. A-64662 induced a comparable dose-related fall in MAP, affecting the magnitude and duration of action, accompanied by inhibition of PRA, the duration of which was dose-related in both the normal and salt-depleted groups. However, the minimum effective doses required to reduce MAP by approximately 10% were 0.01 mg/kg for the salt-depleted monkeys and 0.1 mg/kg for the normal monkeys. In a second study, three consecutive boluses of vehicle or A-64662 at 0.1, 1.0, and 10.0 mg/kg were administered to anephric monkeys, human renin-infused anephric monkeys, and normal monkeys (n = 4/group). A dose of 0.1 mg/kg was ineffective, but the 1.0 mg/kg dose lowered MAP by 11 +/- 3% (mean +/- SE) in the anephric monkeys. The infusion of renin into anephric monkeys restored the efficacy of A 64662 at the 0.1 and 1.0 mg/kg doses to responses comparable to those of the normal monkeys. A-64662 at 10.0 mg/kg caused a similar fall in MAP of 50 to 60% in anephric, renin-infused anephric, and normal monkeys in the absence of detectable PRA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292415 TI - Characterization of recombinant human prorenin and renin. AB - A cell line that secretes substantial quantities of recombinant human prorenin was prepared by transfecting Chinese hamster ovary cells with a gene encoding preprorenin. The prorenin was purified to homogeneity and was found to have a single amino terminus, reflecting cleavage after a typical 23 amino acid signal sequence. The purified inactive prorenin was not a substrate for active renin and was not capable of self-activation. Prorenin could be converted to renin by addition of exogenous protease, and deglycosylation of the prorenin did not alter the sensitivity to protease activation. The enzymatic activity of deglycosylated renin was kinetically identical to that of the native protein. Multimilligram quantities of recombinant human renin and prorenin were purified, providing suitable material for studies directed toward greater understanding of the function of these proteins and for structural studies such as x-ray diffraction for use in design of renin inhibitors. PMID- 3292416 TI - Sodium sensitivity in human subjects. Hemodynamic and hormonal correlates. AB - To investigate factors associated with sodium sensitivity, 157 subjects were studied while receiving 10 and 200 mEq sodium diets. Measurements included blood pressure (BP), forearm vascular resistance, plasma renin activity (PRA), and plasma aldosterone. Sodium repletion was associated with a greater than 5% increase in mean BP in 16% of the normotensive subjects and 29% of the borderline hypertensive subjects. Sodium-sensitive subjects were compared with sodium resistant subjects in both the normotensive (n = 92) and borderline hypertensive (n = 65) groups. Forearm vascular resistance was significantly higher (p less than 0.05) during sodium loading in the sodium-sensitive subgroups of both the normotensive and borderline hypertensive groups (35.8 +/- 29 vs 23.8 +/- 20 [SD] and 37.5 +/- 29 vs 22.5 +/- 14 mm Hg/ml/min/100 g, respectively. Venous capacitance was lower in the sodium-sensitive than in the sodium-resistant borderline hypertensive subjects (0.8 +/- 0.21 vs 1.69 +/- 0.24 ml/100 g). During sodium restriction, PRA was significantly lower (p less than 0.01) in the sodium sensitive subsets (2.56 +/- 1.6 vs 4.04 +/- 2.6; 2.65 +/- 2.1 vs 3.88 +/- 2.6 ng angiotensin I/ml/hr). Aldosterone was lower (p less than 0.01) during sodium depletion in the sodium-sensitive subsets (17.3 +/- 12 vs 26.3 +/- 16; 18.5 +/- 18 vs 27.9 +/- 17 ng/ml). A significant inverse correlation existed between change in BP with sodium repletion and change in PRA or level of PRA during sodium depletion (p less than 0.003).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292417 TI - Mechanisms underlying pressure-related natriuresis: the role of the renin angiotensin and prostaglandin systems. State of the art lecture. AB - It has long been known that increments in renal perfusion pressure can induce an elevation of urine sodium excretion without changing renal blood flow or glomerular filtration rate. The mechanism underlying this pressure-related natriuresis remains undefined, although the interest in its elucidation has been stimulated by the notion that it may constitute the central phenomenon through which the kidney regulates blood volume and, thereby, blood pressure. Recently, the use of novel experimental techniques has disclosed some important clues about changes in renal hemodynamics that, along with changes in renal humoral regulators, allow us to visualize a possible sequence of events responsible for pressure-related natriuresis. According to this hypothesis, the autoregulatory responses responsible for maintaining glomerular filtration rate are elicited in preglomerular vasculature by changes in renal perfusion pressure. These myogenic responses are coupled through Ca2+ entry in juxtaglomerular cells with inversely related changes in the release of renin and, consequently, with the amount of angiotensin II generated in renal interstitium. The release of renin from juxtaglomerular cells is modulated by the synthesis of prostaglandin I2 from the adjacent endothelial cells. Interstitial angiotensin II could influence sodium tubular reabsorption directly by stimulating sodium transport in proximal renal tubules and indirectly by altering medullary blood flow and, thereby, medullary interstitial pressure. In the renal medulla, the effects of interstitial pressure on sodium reabsorption can be amplified by the release of prostaglandin E2 from interstitial cells. A deficient regulation of this relationship could result in a shift of the pressure-natriuresis curve, leading to hypertension. PMID- 3292418 TI - The Council for High Blood Pressure Research. Its origin and purposes. PMID- 3292419 TI - CIBA award for hypertension research 1987 to Donald J. Reis. PMID- 3292420 TI - Fourth annual Marion Hypertension Research Clinical Fellowship Award. 1987: Christopher M. Rembold. PMID- 3292422 TI - Liver transplantation. PMID- 3292423 TI - Diagnostic and interventional radiology in liver transplantation. AB - Diagnostic and interventional radiology play major roles in the evaluation and management of liver transplant patients. This article begins with a discussion of imaging techniques used in the preoperative evaluation of transplant candidates. Surgical approaches and normal posttransplant anatomy are presented. An in-depth discussion of the radiologic evaluation of posttransplantation complications follows, with numerous illustrative cases. Finally, the role of interventional radiology in the nonoperative management of certain complications, especially biliary problems, is discussed. PMID- 3292424 TI - Liver transplantation for chronic cholestatic liver disease in adults and children. AB - Liver transplantation has provided individuals with cholestatic disorders a chance for long-term near-normal quality and quantity of survival. The experience at the University of Pittsburgh with hepatic transplantation for chronic cholestatic liver disease is presented in brief in this article. PMID- 3292421 TI - Liver transplantation: where it's been and where it's going. AB - The ultimate therapeutic step in the treatment of hepatic disease is the provision of a new liver with or without removal of the affected native organ. As of the writing of this manuscript, nearly 2000 liver transplants have been performed in the United States alone. Probably another 1000 have been performed in other parts of the world. Two approaches to liver transplantation have been utilized. The first consists of the insertion of an extra liver (auxiliary liver transplantation) at an ectopic location. This approach leaves the recipient's diseased liver intact. The alternative approach to auxiliary hepatic transplantation is orthotopic liver transplantation. With this operation, the diseased liver is removed, creating a space into which the allograft is transplanted with as normal an anatomic reconstruction as is possible based upon the specific liver pathology and the prior surgical history of the recipient. PMID- 3292425 TI - Orthotopic liver transplantation for fulminant and subacute hepatic failure. AB - The fulminant hepatic failure (FHF) is a condition characterized by massive hepatocyte necrosis and one that is associated with severe liver and/or other organ-systems insufficiency leading to death in up to 85 per cent of the cases with medical treatment only. Although various expedients have been tried in order to save these patients, the necrosis is usually so massive that it is beyond regeneration. At present, the only hope lies with orthotopic liver transplantation (OLTx), which has become progressively more successful during the last few years. Various considerations pertaining to OLTx are discussed, as well as our series of 40 patients who were transplanted for FHF, with a survival of 57 per cent. PMID- 3292426 TI - Liver transplantation for metabolic disease of the liver. AB - Hepatic transplantation for metabolic or genetic diseases of the liver produces a definite cure of the liver disease and also effectively cures the underlying metabolic abnormalities of the genetic disease in question. Liver transplantation is highly likely to become the current treatment of choice for a wide variety of metabolic disorders based predominantly in the liver. This is true not only for those that produce grossly evident hepatic disease with cirrhosis, but also for those that are free of obvious hepatocellular injury but are based either predominantly or exclusively within the liver. PMID- 3292427 TI - Medical problems before and after transplantation. AB - Before and after liver transplantation in patients, medical complications are frequent. In this article, the occurrence of medical complications in liver transplant patients as well as their management are reviewed. PMID- 3292428 TI - The patient coordinator in a liver transplant program. AB - The specific role of patient coordinator varies among different transplantation centers. Their role is often dependent upon the total number of patients that are being followed at a given center. With continued success of a program and continued patient survival, the functions of the patient coordinator will increase. However, the coordinator's primary mission will remain principally that of patient educator and liaison with the transplant center. PMID- 3292429 TI - The quality of life following liver transplantation: a preliminary report. AB - Quality of life is a multidimensional construct that encompasses functional behavioral and cognitive capacities, health status, emotional well-being, and psychosocial adjustment. A program of interdisciplinary investigation at the University of Pittsburgh Health Sciences Center has been directed at studying the outcome of liver transplantation with respect to the impact of such surgery on improving life quality. The data obtained have been subjected only to descriptive and univariate analyses but indicate that liver transplantation surgery results in a sharp improvement in quality of life relative to one's pretransplant status, although it does not return the recipient to their premorbid baseline. Following transplantation, a substantial reversal of identified pretransplant neuropsychological impairments also occurs, although performance does not appear to return to normal levels. Specifically, visuopractic impairments, which are the most salient neuropsychologic concomitants of hepatic encephalopathy, are still detectable 3 years after transplantation. Nonetheless, normal or near normal functioning on measures of cognitive capacity, health status, emotional well being and social, vocational, and behavioral competency are found in liver transplant survivors. PMID- 3292430 TI - Surgical technique of orthotopic liver transplantation. AB - Although significant strides have been made in the surgical technique of orthotopic liver transplantation, numerous problems and nuisances are still encountered. Further surgical refinements will certainly evolve. The development of better preservation techniques, the use of intraoperative flowmeters, and the availability of new technologies, such as an artificial liver, should impact and advance the techniques of liver transplantation significantly and improve the overall results even further. PMID- 3292431 TI - Immunological factors influencing liver graft survival. AB - Donor-recipient ABO blood group mismatching is associated with a decreased graft survival rate in liver transplantation. We have been unable to demonstrate an effect of high levels of panel reactive antibody or a positive donor-specific cytotoxic antibody cross-match on graft survival. A limited analysis of HLA matching for the A, B, and DR loci suggests a paradoxical effect, but much more experience is needed before the true effect of HLA matching on graft outcome can be reliably evaluated. PMID- 3292432 TI - A liver transplant center information management system. AB - A comprehensive microcomputer-based data management system has been developed to facilitate candidate selection and to track clinical performance for the liver transplant program at the University of Pittsburgh. A relational database manager, dedicated statistical analysis software, and presentation graphics are all elements that have been integrated into the system. PMID- 3292433 TI - Postoperative surgical complications. AB - Results of liver transplantation have dramatically improved since the introduction of cyclosporine. Most deaths occur within the first 3 postoperative months. Morbidity and mortality can be minimized by early diagnosis and aggressive management of postoperative surgical complications. PMID- 3292434 TI - The role of the pathology department in a liver transplant program. AB - This article gives an overview of the role of the anatomic pathologist in a liver transplant program. The effect of such a program on the workload in each of the pathology subdisciplines is discussed. Differential diagnoses where the anatomic pathologist is of particular assistance, as well as diagnosis in which histopathology may be of little help, are described. Methods of tissue handling for optimal utilization of pathology services are outlined. PMID- 3292435 TI - Characteristics of the induction phase of antithymocyte-globulin-induced heart allograft tolerance in the rat. AB - Transplantation tolerance was induced in 50% of Wky rats treated with antithymocyte globulin (ATG) 2 days prior to transplantation of a PVG/c heart. The induction period immediately following ATG treatment and transplantation was characterized by instability, with 50% of the allografts being lost in rejection within 30 days after transplantation. Second syngeneic transplantation to ATG treated recipients 5 days after the first transplantation facilitated tolerance induction and permanent acceptance of both transplants. Thirty days after ATG treatment and the primary transplantation, 50% of second syngeneic allografts were accepted. During the early period after transplantation a continuous antigen presence together with ATG was necessary. Graft removal and absence of the transplant for 3 days, close to ATG administration, resulted in rejection of a second PVG/c transplant. Furthermore, the induction phase could easily be manipulated by the addition of sensitized or tolerized spleen cells to the recipient, causing allograft rejection or tolerance, respectively. Sixty days after ATG treatment and transplantation, a longer period between graft removal and retransplantation was required to break tolerance. Injection of sensitized spleen cells at this time did not affect graft survival, indicating an increased stability of the unresponsive state 60 days after ATG treatment and transplantation. PMID- 3292436 TI - Trypanosoma cruzi: fibronectin promotes uptake of epimastigote culture forms by human neutrophils and monocytes. AB - Treatment of human neutrophils and monocytes with human plasma fibronectin (Fn) enhanced their association with Trypanosoma cruzi epimastigote culture forms, a stage of parasite which activates the alternative complement pathway, and this related to the concentration of Fn in the culture medium. By increasing the incubation time, the parasite interiorization by phagocytic cells was observed. An enhancing effect of this latter phenomenon was obtained in the presence of Fn, while the addition of anti-Fn antibodies exerted an inhibitory effect. Moreover, the velocity of phagocytosis of complement-coated epimastigotes in the presence of Fn appeared greater than that observed using non-coated epimastigotes or parasites preincubated in the presence of heat-inactivated C6-deficient rabbit serum. In addition, as a consequence of cell-Fn parasite interaction, cell activation was also seen. This has been demonstrated by a chemiluminescence assay. Using radiolabeled epimastigotes (3H-uridine), we demonstrated that a proportion of ingested parasites in the presence of Fn were killed. When neutrophils were used as effector cells, the cytotoxicity was greater than that observed with monocytes. This finding of increased trypanosome uptake by phagocytic cells in the presence of fibronectin suggests that this glycoprotein could act as a ligand or cofactor to mediate parasite-cell interaction. PMID- 3292437 TI - Further biochemical characterization of human basophil-like cell-promoting activity and its distinction from human interleukin-3-like activity. AB - Supernatants from lectin-stimulated human peripheral blood mononuclear cells contained two activities; basophil-like cell-promoting activity (BaPA) and a growth factor for murine interleukin-3-dependent cell lines (IL-3-like activity). BaPA had a MW of 24,000 and a pI of 6.0-7.5, while human IL-3-like activity had a MW of 18,000 and a pI of 5.0-5.9. Beside the biochemical differences between the two activities, supernatants from a T cell line were found that contained BaPA and GM-CSF but no IL-3-like activity. These data suggest that BaPA and IL-3-like activity are two different molecular entities. PMID- 3292438 TI - Isolation and characterization of a relevant Aspergillus fumigatus antigen with IgG- and IgE-binding activity. AB - An immunologically relevant antigen fraction was isolated from a cytoplasmic extract of Aspergillus fumigatus mycelium. The fraction was obtained by concanavalin-A affinity chromatography and hydrophobic interaction chromatography. Two protein bands were discernible in polyacrylamide gel electrophoresis while two precipitin peaks were detected in crossed immunoelectrophoresis. When tested against sera from patients with Aspergillus induced diseases, the fraction showed both IgG and IgE antibody-binding activity. All of the sera studied from patients with allergic bronchopulmonary aspergillosis (ABPA) showed high IgG and IgE antibody titers, while sera from patients with aspergilloma and cystic fibrosis with ABPA demonstrated high IgG titers and only a moderate increase in IgE titers. None of the other groups showed any significant antibody titers against this antigen in their sera. Because of its binding to both IgG and IgE antibodies this fraction was found to be useful in the immunodiagnosis of Aspergillus-induced diseases. PMID- 3292439 TI - Improved ELISA for thyroid microsomal auto-antibodies. Comparison with haemagglutination and immunofluorescent techniques. AB - Thyroid microsomal antibodies (TMA) and thyroglobulin antibodies (TGA) are strongly associated with auto-immune thyroid disease. TMA and TGA have been mostly detected by means of either immunofluorescence (IF), tanned red cell haemagglutination (TRCH), or radio-immunoassay (RIA) until the recent development of the enzyme-linked immunosorbent assay (ELISA). The ELISA has not been as extensively used in TMA detection as in the assay for TGA. The RIA method, though more sensitive, is technically and materially very demanding while the TRCH and IF are simpler to perform but are less sensitive. The main problem with the ELISA for the detection of TMA appears to be the interference of TGA present in some test sera reacting with thyroglobulin present as a contaminant in the thyroid microsomal preparation. In this study, we compared the TMA results from an ELISA system designed to eliminate TGA interference with those of IF and TRCH. The ELISA system in which TGA interference was eliminated without concurrent inhibition of the test reaction that gives rise to false negatives was more sensitive than either IF or TRCH. A significant number of samples was falsely reported as negative by both TRCH and IF. The correlation of the degree of positivity between TRCH and ELISA was moderate and was higher than that between ELISA and IF, though both were highly significant. The ELISA technique for TMA detection described here is a more efficient, more sensitive and also more cost effective system than either TRCH or IF, both of which should now be replaced by ELISA, provided steps are taken to avoid false positives and false negatives. PMID- 3292441 TI - Inhalant allergies to fungi: reactions to bakers' yeast (Saccharomyces cerevisiae) and identification of bakers' yeast enolase as an important allergen. AB - Forty-seven subjects diagnosed as having inhalant allergies to fungi were tested for allergic sensitivity to bakers' yeast. Skin prick tests with yeast extract showed that 35 subjects responded with wheal reactions that were at least 3 mm while 32 subjects were regarded as clearly RAST-positive to bakers' yeast antigens. Skin and RAST testing with purified enolase from bakers' yeast and comparisons with the whole yeast extract showed that the enzyme is a major allergenic component of the extract. This conclusion was supported by results of electroblotting studies. RAST inhibition experiments demonstrated allergenic cross-reactivity between bakers' yeast, bakers' yeast enolase and Candida albicans. PMID- 3292440 TI - Natural cytotoxicity in adult acute leukemia. AB - Natural cytotoxic activity was studied in 32 adult patients with acute non lymphoid leukemia (ANLL) and 27 adult patients with acute lymphoblastic leukemia (ALL). Thirteen patients with active ANLL had a significantly reduced natural cytotoxicity in peripheral blood compared with that of healthy controls, 5.0 +/- 3.4 versus 27.1 +/- 11.5 (p less than 0.0005). Patients with ANLL in remission had a normal natural cytotoxicity (p greater than 0.05). Patients with active ANLL had a significantly reduced number of Leu-7-positive cells (p less than 0.001), while patients in remission had normal proportions of these cells (p greater than 0.05). Peripheral blood from patients with ALL showed reduced natural killer (NK) cell activity, both in active disease and in remission (p less than 0.0005). The percentage of Leu-11b (CD 16)-positive cells was increased in patients in remission from ALL (p less than 0.05). Bone marrow cells from patients with ALL in remission had a reduced natural cytotoxicity, 2.8 +/- 4.0 versus 16.3 +/- 9.0 in bone marrow controls (p = 0.01). In contrast, patients with ANLL in remission showed a normal bone marrow cytotoxicity (p greater than 0.05) while patients with active ANLL had a reduced NK cell activity (p less than 0.03). The low NK activity observed in leukemic patients may be of importance for the pathogenesis of the diseases. Acute non-lymphoid leukemia (ANLL) is a malignant disease of the multipotential hemapoietic stem cell. The stem cell is capable of differentiating into various cell lineages, i.e. erythroid, granulocytic, monocytic and megacariocytic cell lineages.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292443 TI - Characterization of a human ovarian carcinoma cell line, OTN 14, derived from a mucinous cystadenocarcinoma. AB - A human ovarian carcinoma cell line, OTN 14, has been established from malignant ascitic fluid of a patient with a well-differentiated mucinous cystadenocarcinoma of the left ovary. The cell line has been maintained in vitro for 6 months through 23 passages, growing in monolayers as well as in 3-dimensional clusters, with a population doubling time of 28 1/2 hr. The number of chromosomes per cell varied from 67 to 88, with a modal number of 86. Two characteristic marker chromosomes were recognized, consisting of partially deleted chromosome I. With a DNA index of 1.934 the tumour cell line was near tetraploid. The epithelial character of the OTN 14 cells was confirmed by a positive immunofluorescence reaction with monoclonal antibodies (MAbs) against different keratins, and when (immuno)electron microscopy was used, keratin filaments and small junctional complexes were observed. Vimentin was also expressed in these cells, while desmin was not detected. Cultured tumour cells reacted (weakly) positive with MAb OV-TL 3 as a marker for ovarian carcinomas, while reactivity with the anti-ovarian carcinoma MAb OC 125 was limited to a few cells, not permitting the detection of shed CA 125 antigen in the culture supernatant. Cells stained heterogeneously positive for CEA marker BW 431/31, the presence of which was confirmed by detection of CEA shed into the culture medium. The cell line released estradiol at a concentration of 130,000 pmol/L in the culture medium, while no progesterone or dehydroepiandrosterone sulphate were found. Electron microscopical evidence for steroid production was suggested in some cells showing "dense-core" vesicles near the Golgi areas. The OTN 14 tumour cells formed poorly differentiated tumour nodules in nude mice, and metastatic cells were also found in blood capillaries. Cell types with mucinous as well as endocrine characteristics were found. PMID- 3292442 TI - Short-term sensitizing antibodies in bakers' asthma. AB - In a prospective study the occurrence of rye-specific IgG4 was investigated. We compared 17 bakers with clinical symptoms of bakers' asthma and a more than 100% increase in specific airway resistance following rye dust provocation to 16 bakers who showed neither symptoms of asthma nor an increase in specific airway resistance following rye dust provocation. In the group of patients with allergic type I responses, specific IgG4 was found in 15 cases by an indirect immunofluorescent test on rye grains. In none of the asymptomatic bakers was rye specific IgG4 detected. In 15 symptomatic subjects rye-specific IgE alone or together with rye-specific IgG4 was found. In 2 cases only rye-specific IgG4--the so-called short-term sensitizing antibody--was demonstrated to explain the allergic bronchial response. PMID- 3292444 TI - Serotherapy of cancer: cellular changes in primary rat mammary carcinomas after infusion of syngeneic sera absorbed with protein A-Sepharose. AB - Serotherapy and plasma therapy have proved to be effective in the treatment of diverse neoplasms. The mechanisms of the tumoricidal or growth-inhibitory effects are unknown. We previously reported that activation of the alternative pathway of complement in absorbed sera correlated with the presence of anti-tumor activity. Complement components generated during absorption may serve as the initial mediators of cytotoxicity; for example, C5a may function in its role as a chemo attractant. To further investigate the anti-tumor mechanisms, we undertook a series of sequential histological studies of in vivo changes in tumors following i.v. serotherapy. We found diffuse inflammatory cellular infiltrates in the interstitial compartments of primary mammary carcinomas of rats within 3-4 hr of administration of protein A-Sepharose absorbed syngeneic serum. The number of inflammatory cells was significantly higher in tumors from treated rats: total infiltrating cells (p = 0.002), eosinophils (p = 0.001), neutrophils (p = 0.001), macrophages (p = 0.001), lymphocytes (p = 0.004) and plasma cells (p = 0.001). Also, the mitotic index of tumor cells was significantly lower 4 hr after serotherapy when compared with that of untreated rat tumor cells. C3 in tumor tissue was decreased at 4 hr following serotherapy. Fibrosis was present in tumor nodules with retarded growth 5 weeks after the start of serotherapy. Localization of the infiltrating cells to tumor interstitial compartments prevents direct contact between inflammatory cells and neoplastic cells, making it unlikely that direct cell-cell killing occurs. Indirect cell killing within the tumor bed apparently occurs through several mechanisms involving interactions between serotherapy-initiated humoral mediators and inflammatory cells. The resulting anti-tumor effects include microvascular injury leading to localized ischemia, tumor infarction, and fibroblastic reactions obstructing tumor invasion and growth. PMID- 3292445 TI - Exogenous and endogenous factors in skin irritation. PMID- 3292446 TI - Cowden's disease. A marker for malignancy. PMID- 3292447 TI - Possible pathogenetic mechanisms in allergic cutaneous vasculitis. PMID- 3292448 TI - Syphilis and AIDS. PMID- 3292449 TI - Amniotic band syndrome. AB - The amniotic band syndrome (ABS) refers to the infrequent occurrence of congenital deformities presumably due to fetal entanglement in strands of ruptured amniotic sac. The most commonly associated anomalies include amputations, constriction bands, syndactyly, craniofacial defects, club feet, and cleft lip. We present a typical case and short literature review of ABS. The infant reported also had a connective tissue nevus and a cutaneous striated muscle hamartoma. PMID- 3292451 TI - English-French dictionary. PMID- 3292450 TI - Distally metastasizing melanoma on a skin graft. PMID- 3292452 TI - Applications of bone marrow transplantation. PMID- 3292454 TI - Effect of diisopropylfluorophosphate on the antibody response. AB - The impact of the in-vivo administration of diisopropylfluorophosphate (DFP) on the antibody response in mice was examined. The antigen-specific plaque-forming cell (PFC) response of mice injected with DFP (4 mg/kg) at the time of immunization with a macrophage-dependent T-cell antigen, trinitrophenylated keyhole limpet hemocyanin (TNP-KLH) or sheep red blood cells (SRBC), was significantly depressed. In contrast, the injection of a similar dose of DFP had no effect on the PFC response of mice immunized with a macrophage-independent B cell antigen, lipopolysaccharide (LPS). This differential effect suggests a possible detrimental effect of DFP on cells involved in antigen processing and/or presentation which are required for the antibody response to SRBC and TNP-KLH. These results, however, do not exclude T cells as a possible target and the cellular targets of DFP action remain to be established. The DFP-mediated depression of the PFC response to SRBC was still evident when DFP was given as early as 1 day before, but not 1 day after, the injection of antigen, suggesting that DFP may well affect an early event of the antibody response. For the secondary TNP-specific IgM PFC response, a significant depression was observed only when DFP was administered at the time of antigen challenge. The injection of DFP at the time of antigen priming, however, was effective in depressing the IgG, but not the IgM, PFC response. Therefore, DFP may also interfere with the generation of antigen-specific memory cells for the secondary IgG response. PMID- 3292453 TI - Current concepts of vascular occlusive disease. The significance of endothelial trauma and smooth muscle cell proliferation. PMID- 3292456 TI - The politics of physicians' responsibility in epidemics: a note on history. PMID- 3292455 TI - Airway cholinergic responsiveness in rabbits in relation to antigen sensitization and challenge. AB - The development of bronchial hyperresponsiveness to cholinergic agents in relation to antigen sensitization and repeated antigen challenge was investigated in a rabbit model. Rabbits immunized to produce preferentially specific IgE antibodies had a modest enhancement of their bronchoconstrictive response (measured as an increase in pulmonary resistance) to aerosolized methacholine compared to sham-immunized and unimmunized controls. A further enhancement was observed subsequent to a series of seven antigen challenges given transtracheally, such that the geometric mean dose of methacholine required to increase pulmonary resistance by 100% (PD100 RL) was 89 cumulative breath units (CBU) compared to 372 CBU for sham-immunized controls and 871 CBU for unimmunized controls (p less than 0.05 for ANOVA). Although methacholine also decreased dynamic compliance, the changes were not different among the three groups. Isolated intrapulmonary bronchi from the three groups did not differ in log concentration of methacholine yielding a half-maximal contraction (log EC50). The range of EC50 values was 15-fold compared to a 90-fold range of PD100 RL. In vivo cholinergic responsiveness of the pupillary muscle did not correlate with bronchial responsiveness. Thus, pulmonary antigen challenge of IgE-producing rabbits produced a marked increase in bronchial responsiveness which did not correlate with in-vitro bronchial responsiveness or with in vivo pupillary responsiveness. PMID- 3292457 TI - Special issue: Hawaii Medical Library and Charles S. Judd, Jr., MD. PMID- 3292458 TI - History of the Hawaii Medical Library. PMID- 3292459 TI - Dr. Charles Sheldon Judd Jr. in memoriam. PMID- 3292460 TI - Standard measurement techniques and strategies for indoor 222Rn measurements. PMID- 3292461 TI - Anaerobic wound infection: Bacteroides mediastinitis after cardiovascular surgery. AB - A case of postoperative anaerobic mediastinitis after coronary artery bypass grafting is reviewed. One of the causative organisms, Bacteroides oralis, has never previously been described as a pathogen causing mediastinitis after median sternotomy incision. There was associated Bacteroides fragilis bacteremia. Only three cases of Bacteroides species mediastinitis after open heart surgery have been reported. This anaerobic bacterium remains a rare pathogen in median sternotomy infections despite the increasing number of cases of mediastinitis seen in association with the burgeoning number of patients undergoing cardiac surgery. Multiple risk factors may contribute to mediastinal infections, which occur in about 2% of patients undergoing coronary artery surgery. When infection occurs, aerobic and anaerobic wound cultures should be made and appropriate antimicrobial and surgical therapy instituted. PMID- 3292462 TI - Stress ulceration: a serious complication in critically ill patients. AB - The incidence of gastrointestinal bleeding in critically ill patients appears to have declined over the past decade; however, it has not been shown that the incidence of stress ulceration has declined as well. The pathophysiology of stress ulceration is not totally understood, although various factors have been implicated: mucosal barrier breakdown, decreased mucosal blood flow, increased intraluminal acid, decreased epithelial regeneration, and lowered intramural pH. It is widely accepted that prevention is the cornerstone of management for stress ulceration. The critical care nurse must be aware of the importance of monitoring and maintaining a gastric pH greater than 3.5. Antacids, histamine receptor antagonists, sucralfate, and prostaglandins have all been shown to play a role in the treatment of stress ulcerations. PMID- 3292463 TI - Iliac vein to pulmonary artery missile embolus: case report and review of the literature. AB - Intravascular foreign body emboli, although first reported in 1834, are rare sequelae of penetrating injuries. We report a case of missile embolus to the pulmonary artery after penetrating injury to the left iliac vein and artery. A review of the literature and discussion of appropriate management are presented. PMID- 3292464 TI - Escherichia coli sacroiliitis: report of a case and review of the literature. AB - Pyogenic sacroiliitis is rare and usually occurs in patients with an underlying illness. Typically, the responsible organisms are Staphylococcus aureus or Streptococcus pneumoniae. We describe a healthy 17-year-old boy with bacterial sacroiliitis caused by Escherichia coli. This case illustrates the importance of considering this diagnosis in febrile patients with no obvious source of infection. PMID- 3292465 TI - Effect of progressive relaxation on dyspnea and state anxiety in patients with chronic obstructive pulmonary disease. AB - The symptom of dyspnea and the associated anxiety is a primary concern of millions of patients with chronic obstructive pulmonary disease (COPD). An experimental study was conducted of 20 outpatients with COPD to measure the effect of progressive muscle relaxation (PMR) on dyspnea and anxiety. Patients were divided into a treatment group (n = 12) and a control group (n = 8). Patients in the treatment group underwent four weekly sessions of live PMR plus daily home practice with taped instructions. The effect of the independent variable, PMR, was measured during each session and at the end of 4 weeks. Measurements were made before and after treatment of the dependent variables, dyspnea and anxiety. Instruments used were Spielberger's State Anxiety Inventory for anxiety and a 20 cm visual analogue scale for dyspnea. Heart rate (HR), respiratory rate (RR), forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) were also measured. Data analysis was done by using two-tailed t tests and Pearson's correlation coefficient. Reductions in anxiety and dyspnea were positively correlated during each session (r = 0.37) and at the end of 4 weeks (r = 0.60). PMR was shown by t tests to be more effective than the control in reducing dyspnea (p = 0.04), anxiety (p = 0.001), RR (p = 0.000), and HR (p = 0.05) during each session but only RR (p = 0.04) at the end of the 4-week period. Dyspnea and RR were correlated positively during each session (r = 0.21). Dyspnea and state anxiety were correlated positively at the end of 4 weeks with RR (r = 0.62) and HR (r = 0.50). PMID- 3292466 TI - Cardiac transplantation: the changing faces of immunosuppression. AB - Many advances have been made in immunosuppressive therapy and other aspects of cardiac transplant management since the first cardiac transplantation was performed in the late 1960s. The cellular immune response and rejection process are better understood. This knowledge changed the way existing drugs were used to control rejection and led to the development of new drugs that could more effectively control the rejection process. Early drug protocols used combinations of azathioprine, antilymphocyte globulin, and steroids. Later protocols used combinations of cyclosporine, steroids, and antithymocyte globulin. After problems related to cyclosporine were identified, protocols came full circle. They now include drugs that were used in earlier protocols, as well as cyclosporine. The purpose of this article is to describe how protocols for immunosuppressive therapy have evolved based on our expanded knowledge of immunosuppression and methods of best using new and old drugs to achieve this goal. PMID- 3292467 TI - Amphotericin B-induced shivering in patients with cancer: a nursing approach. AB - Shivering is a common and distressful reaction associated with administration of amphotericin B, a systemic antifungal agent. Shivering occurs as a result of the drug's intrinsic pyrogenicity, and thus resembles febrile shivering. This heat loss phenomenon has metabolic as well as psychologic costs. The intervention approach to amphotericin B-induced shivering includes reporting the phenomenon, restoring lost heat, modifying the rate of heat loss, altering the physiologic determination of heat loss, and giving drugs to suppress shivering. Specific suggestions for interventions are discussed. Supportive care of the patient with cancer who is receiving this drug is briefly mentioned as it relates to thermoregulatory principles. Possible areas of future inquiry into shivering suppression are mentioned. PMID- 3292468 TI - International Clinical Trials in Radiation Oncology. Intraoperative trials. PMID- 3292469 TI - International Clinical Trials in Radiation Oncology. Head and neck: cancer research plan. PMID- 3292470 TI - International Clinical Trials in Radiation Oncology. Lung sites. AB - The lung studies of the RTOG have been among the most productive of any in the group. The development of studies has been predicated upon failure pattern analyses from previous trials. Multiple approaches to attacking these diseases have been taken, including dose/fraction studies and high LET irradiations to improve local-regional control, prophylactic irradiation of sites of frequent, distant metastases, systemic chemotherapy and radioimmunoglobulins to control distant metastases, and biologic response modifiers to restore or enhance host defense mechanisms. All studies have been predicated upon making incremental advances in improving treatment outcome in these common disease, based on the philosophy that small improvements in survival will save thousands of lives. PMID- 3292472 TI - International Clinical Trials in Radiation Oncology. Breast sites. PMID- 3292471 TI - International Clinical Trials in Radiation Oncology. Brain sites. PMID- 3292473 TI - International Clinical Trials in Radiation Oncology. Genito-urinary sites. PMID- 3292475 TI - An outline of research activities in radiotherapy of the Medical Research Council's (U.K.) Cancer Therapy Committee. PMID- 3292474 TI - International Clinical Trials in Radiation Oncology. Gastrointestinal sites. PMID- 3292477 TI - International Clinical Trials in Radiation Oncology. Gynecology: combined radiotherapy and chemotherapy in gynecologic oncology. PMID- 3292476 TI - International Clinical Trials in Radiation Oncology. Lymphoma: radiation therapy in lymphoma treatment. PMID- 3292478 TI - International Clinical Trials in Radiation Oncology. Quality assurance/physics/dosimetry. PMID- 3292479 TI - International Clinical Trials in Radiation Oncology. The late effects of toxicity scoring. PMID- 3292480 TI - The Radiation Therapy Oncology Group: an outline of clinical research activities. PMID- 3292481 TI - International Clinical Trials in Radiation Oncology. Chemical modifiers. PMID- 3292482 TI - International Clinical Trials in Radiation Oncology. Time/dose/fractionation trials. PMID- 3292483 TI - International Clinical Trials in Radiation Oncology. Brachytherapy trials. PMID- 3292484 TI - International Clinical Trials in Radiation Oncology. Large field trials. PMID- 3292486 TI - International Clinical Trials in Radiation Oncology. Hyperthermia trials. PMID- 3292485 TI - International Clinical Trials in Radiation Oncology. Isotopic immunotherapy: radiolabelled antibody. AB - The radiolabeled antibody studies of RTOG have introduced a new class of agents in cancer therapy and demonstrated the transport ability of a new technology using agents that cause no acute symptoms, that can be administered in some instances on an out patient basis and that remit active disease in a variety of sites. The potential for new results has been amplified by the recent accomplishment of the chelation of 111-Indium and 90-Yttrium as both dosimetric and therapeutic isotopes linked to antibodies for systemic therapy (Table 2). These developments by a commercial corporation to produce large quantities of radiolabeled antibody agents allow a greater freedom of investigation with these new agents. Once appropriate identification of antibody and dosimetric evaluations are carried out, their additive or singular effects can be studied in a number of malignancies. The need for development of centers to carry out such studies and group-wide dissemination are potential limiting factors. A variety of new combinations of antibody and isotope, increasing specific activity in a number of ways, needs to be investigated in laboratories and in clinics by integrated teams. Radiolabeled antibody therapy has at present the potential to contribute to conventional therapies with both radiation and chemotherapy in a variety of malignancies while not increasing the need for hospitalization and yet minimizing patient discomfort. PMID- 3292487 TI - Radical radiation alone versus radical radiation plus microwave hyperthermia for N3 (TNM-UICC) neck nodes: a prospective randomized clinical trial. AB - Between September 1985 and December 1986, 44 N3 (TNM-UICC) metastatic squamous cell cervical lymph-nodes were randomized to receive conventionally fractionated radical irradiation (RT) to a total dose of 64-70 Gy, or conventionally fractionated radical irradiation plus twice a week local microwave hyperthermia (Ht). The two major end points of this study were (a) local control rates evaluated at 3 months after the end of combined therapy and (b) incidence of acute local toxicity. Thirty-six nodes (82%) were evaluable as of December 1986, at which time there was a premature closure of this study due to ethical reasons. An interim analysis had revealed a statistically significant difference in complete response rates in favor of the combined arm (p = 0.0152). The complete response rates were 82.3% (14/17) for the combined treatment arm versus 36.8% (7/19) for the control irradiation arm, leading to an iso-dose thermal enhancement ratio (TER) value of 2.23. Both arms are comparable in average total RT dose delivered (RT: 67.05 Gy; RT + Ht: 67.85 Gy) and in average maximum node diameter (RT arm: 4.81 cm; RT + Ht: 4.88 cm). Acute local toxicities were similar in irradiated and heated plus irradiated neck regions; only one skin burn was observed. As possible treatment related death, one patient in the RT + Ht arm died 2 months after completion of therapy with a carotid rupture associated with extensive tumor necrosis. These results confirm previous non-randomized reports suggesting that hyperthermia in combination with full dose conventionally fractionated irradiation significantly enhances the chance of early local control of fixed N3 neck nodes without exhibiting an increase of acute local toxicity. PMID- 3292488 TI - Radiation-induced pulmonary endothelial dysfunction in rats: modification by an inhibitor of angiotensin converting enzyme. AB - The ability of the angiotensin converting enzyme (ACE) inhibitor Captopril to modify radiation-induced pulmonary endothelial dysfunction was determined in male rats sacrificed 2 months after a single dose of 10-30 Gy of 60Co gamma rays to the right hemithorax. Half of each dose group consumed feed containing 0.12% w/w Captopril (60 mg/kg/day) continuously after irradiation, and half consumed control feed. Four markers of endothelial function were monitored: ACE activity, plasminogen activator (PLA) activity, and prostacyclin (PGI2) and thromboxane (TXA2) production. All data were plotted as dose-response curves, and subjected to linear regression analysis. The Captopril modifying effect was expressed as the ratio of isoeffective doses at a common intermediate response (DRF), or as the ratio of the response curve slopes. Right lung ACE and PLA activity decreased linearly, and PGI2 and TXA2 production increased linearly with increasing radiation dose. Captopril exhibited DRF values of 1.4-2.1, and slope ratios of 1.4-5.1 for all four functional markers (p less than 0.05). Thus, the ACE inhibitor Captopril ameliorates radiation-induced pulmonary endothelial dysfunction in rats sacrificed 2 months postirradiation. Although the mechanism of Captopril action is not clear at present, these data suggest a novel application for this class of compounds as injury-modifying agents in irradiated lung. PMID- 3292489 TI - Effects of a sonographic technique for determining chest wall thickness in treatment planning for breast carcinoma. AB - This study investigated the use of a sonographic technique of determining chest wall thickness and the impact of dosimetric correction for lung inhomogeneity on treatment planning for breast irradiation after lumpectomy or partial mastectomy. The thickness of the chest wall in three planes of the radiation field was obtained using a B-mode ultrasound scanner and the location of the pleura-lung interface was marked on the contour of the chest wall in each plane. Treatment plans for 88 patients were developed with and without correction for the lung tissue included in the radiation volume. All patients were irradiated with an opposing pair of tangential fields to the breast with a 6 MV X ray beam using an isocentric set-up. Within the treatment volume, dose variation of +/- 5% of the prescribed tumor dose was aimed for in the treatment planning. With correction for lung tissue, the proportion of treatments given with a wedge filter was found to be on the average 20% less than it would be without lung correction. The described sonographic technique is simple to perform and reproducible. It improves the accuracy of dosimetry in treatment planning for breast carcinoma. PMID- 3292490 TI - High-risk Ewing's sarcoma: end-intensification using autologous bone marrow transplantation. AB - Because of retrospective analysis showing survival to be related to primary tumor size, in February 1982 a study to test this hypothesis prospectively was begun at the University of Florida. Patients with primary tumors 8 cm or less in maximum diameter and no metastases received adjuvant chemotherapy consisting of vincristine, cyclophosphamide, doxorubicin, and dactinomycin plus radiotherapy or surgery (standard-risk protocol). All others received a similar regimen followed by end-intensification with high-dose melphalan and autologous bone marrow transplantation (Protocol HR-2). Because of poor results of HR-2, another high risk protocol (HR-3) was initiated in January 1985. Patients on HR-3 received 2 cycles of chemotherapy containing vincristine, cyclophosphamide, and doxorubicin followed by local radiation therapy and maintenance chemotherapy. At the end of this therapy, autologous bone marrow transplantation (ABMT) was performed, using a preparatory regimen of total body irradiation and intensive chemotherapy. The 2 year disease-free survival rate was 70% for the standard-risk protocol, 20% for HR-2, and 80% for HR-3. The follow-up on HR-3 is still short, but the results are promising enough to warrant further clinical trials. PMID- 3292491 TI - Rabies. PMID- 3292493 TI - Bacteremia and septic arthritis in a West African dwarf crocodile. AB - An anorectic, adult West African dwarf crocodile was examined because of bilateral hind limb paresis. Clinical findings included multiple skin wounds, osteomyelitis of the distal portions of the right radius and ulna, severe anemia, and Serratia marcescens bacteremia. The crocodile died after a blood transfusion. At necropsy, hemorrhage in the subarachnoid space, suppurative polyarthritis, and gastric ulceration were found. Serratia marcescens and Morganella morganii were isolated from multiple tissues and body fluids. It was concluded that the bilateral paresis was caused by severe septic arthritis secondary to bacteremia, and that the crocodile died from spinal injury caused by the blood transfusion into the supravertebral vein. PMID- 3292492 TI - Topically applied furazolidone or parenterally administered oxytetracycline for the treatment of infectious bovine keratoconjunctivitis. AB - The effectiveness of topically applied furazolidone (FZ) or parenterally administered oxytetracycline (OTC) for treatment of infectious bovine keratoconjunctivitis was determined in a field study. Between June 13 and Aug 6, 1985, a study was conducted on a ranch in northern California. Eyes of Hereford calves (n = 103) were examined 3 times each week for 7 weeks. After daily examinations on June 13 and 14, calves were allotted randomly to 3 groups. On June 17, calves (that had corneal ulcers) of groups 1 (n = 35) and 2 (n = 35) were treated with OTC and FZ, respectively. Treatments were administered again only if new ulcers were observed, if an existing ulcer worsened, or if a healed ulcer recurred. Calves of group 3 remained untreated (controls). Corneal ulcers developed in 35 of the FZ-treated calves, in 33 of the OTC-treated calves, and in 33 of the untreated calves. Corneal perforations were observed in 3 untreated and 2 FZ-treated calves but were not observed in any OTC-treated calves. Panophthalmitis developed in one eye of an untreated calf. Corneal ulcers in the OTC-treated calves were smaller and healed more rapidly than did corneal ulcers in calves of the other groups. By the 22nd day of the study (July 3), the number of OTC-treated calves with corneal ulcers was less than that of the other 2 groups. Calves of the OTC treatment group had the fewest multiple corneal ulcer recurrences, but calves of all 3 groups had a similar number of single corneal ulcer recurrences.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292495 TI - The gutta-percha/eucapercha technique: a review. PMID- 3292494 TI - Natural disease resistance in domestic animals. PMID- 3292496 TI - Antibiotic prophylaxis in cardiac surgery. PMID- 3292497 TI - Selection of netilmicin resistance, associated with increased 6' aminoglycoside acetyltransferase activity, in Serratia marcescens. AB - Eight aminoglycoside-sensitive clinical strains of Serratia marcescens were serially passaged through broth containing increasing sub-inhibitory concentrations of netilmicin. Before each subculture the aminoglycoside acetyltransferase activity of the bacteria was determined. After up to eight transfers all the strains showed an increase in resistance to netilmicin (MIC greater than 32 mg/l) and MICs for two of the strains exceeded 1000 mg/l. Six of the eight strains showed significant increases in aminoglycoside acetylating activity in accompaniment with the development of resistance. The greatest rises in enzyme activity (eight- and four-fold) were in the strains where the netilmicin MICs for the resistant derivatives exceeded 1000 mg/l. The aminoglycoside acetylating enzyme present was identified as AAC 6'-I by two methods. After five subcultures in antibiotic-free medium, the two derivatives with the highest resistance to netilmicin remained highly resistant and continued to produce AAC 6'-I copiously. These results suggest that exposure of some aminoglycoside sensitive strains of Ser. marcescens to netilmicin leads to the development of high level netilmicin resistance associated with the production of AAC 6'-I. The implication of these findings for the study of aminoglycoside resistance in Ser. marcescens are discussed. PMID- 3292498 TI - Possible interaction of ciprofloxacin with cyclosporin A. PMID- 3292499 TI - Ofloxacin in treatment of typhoid fever: a preliminary study. PMID- 3292500 TI - Chloramphenicol assay by EMIT. PMID- 3292501 TI - Chloramphenicol assay by EMIT. PMID- 3292503 TI - Effect of tidal volume and PEEP on rate of edema formation in in situ perfused canine lobes. AB - The effects of raising tidal volume and positive end-expiratory pressure (PEEP) on rate of edema formation were studied in in situ canine left upper lobe preparations. Edema was induced by increasing blood flow to the left upper lobe (4-8 times normal). In the same animal, at equivalent flows and microvascular hydrostatic pressures, rate of edema formation observed with larger tidal volumes was significantly higher than that observed with smaller tidal volumes (0.73 +/- 0.29 vs. 0.58 +/- 0.30, P less than 0.001). Edema was also induced under static conditions (i.e., flow = 0) over a wide range of vascular pressures. Rate of edema formation was plotted against pressure and the best-fit linear regression was obtained. The slopes (g.min-1.mmHg-1.100 g-1) of the regression lines were significantly higher with larger tidal volumes compared with smaller tidal volumes [0.106 +/- 0.010 (SE) vs. 0.081 +/- 0.009, P less than 0.01]. The pressure intercepts were not different (16.1 +/- 1.6 vs. 15.7 +/- 1.8). When mean airway pressures were increased to levels equivalent to those obtained with larger tidal volumes, but by raising end-expiratory pressures, rate of edema formation dropped to levels below base line. We conclude that increasing the amplitude of cyclic changes in lung volume increases edema formation through mechanisms that are independent of changes in operating (i.e., mean) lung volume. PMID- 3292502 TI - Chloramphenicol assay by EMIT. PMID- 3292504 TI - Influence of fasting on carbohydrate and fat metabolism during rest and exercise in men. AB - Metabolic effects of an overnight fast (postabsorptive state, PA) or a 3.5-day fast (fasted state, F) were compared in eight healthy young men at rest and during exercise to exhaustion at 45% maximum O2 uptake. Glucose rate of appearance (Ra) and disappearance (Rd) were calculated from plasma glucose enrichment during a primed, continuous infusion of [6,6-2H]glucose. Serum substrates and insulin levels were measured and glycogen content of the vastus lateralis was determined in biopsies taken before and after exercise. At rest, whole-body glucose flux (determined by the deuterated tracer) and carbohydrate oxidation (determined from respiratory exchange ratio) were lower in F than PA, but muscle glycogen levels were similar. During exercise, glucose flux, whole body carbohydrate oxidation, and the rate of muscle glycogen utilization were significantly lower during the fast. In the PA state, glucose Ra and Rd increased together throughout exercise. However, in the F state Ra exceeded Rd during the 1st h of exercise, causing an increase in plasma glucose to levels similar to those of the PA state. The increase in glucose flux was markedly less throughout F exercise. Lower carbohydrate utilization in the F state was accompanied by higher circulating fatty acids and ketone bodies, lower plasma insulin levels, and the maintenance of physical performance reflected by similar time to exhaustion. PMID- 3292505 TI - Effects of exercise and lack of exercise on insulin sensitivity and responsiveness. AB - Insulin action is enhanced in people who exercise regularly and vigorously. In the present study, the hyperinsulinemic, euglycemic clamp procedure was used to determine whether this enhanced insulin action is due to an increased sensitivity and/or an increased responsiveness to insulin. To avoid the variability that exists between individuals and complicates cross-sectional studies, the same subjects were studied in the trained exercising state and again after 10 days of physical inactivity. When the plasma insulin concentration was maintained at approximately 78 microU.ml-1 (a submaximal level), glucose disposal rate averaged 8.7 +/- 0.5 mg.kg-1.min-1 before and 6.7 +/- 0.6 mg.kg-1.min-1 after 10 days of activity (P less than 0.001). When the plasma insulin concentration was maintained at approximately 2,000 microU.ml-1 (a maximally effective concentration), the rate of glucose disposal was not significantly different before (15.3 +/- 0.5 mg.kg-1.min-1) compared with after (14.5 +/- 0.4 mg.kg-1.min 1) 10 days without exercise. These results provide evidence that the reversal of enhanced insulin action that occurs within a few days when exercise-trained individuals stop exercising is due to a decrease in sensitivity to insulin, not to a decrease in insulin responsiveness. PMID- 3292506 TI - Effects of nitroprusside on lung mechanics and hemodynamics after endotoxemia in awake sheep. AB - We examined the effects of intravenous sodium nitroprusside (NP) infusion on pulmonary arterial pressure (Ppa), pulmonary vascular resistance (PVR), dynamic compliance (Cdyn), resistance to airflow across the lungs (RL), and alveolar arterial O2 pressure gradient (PAO2-PaO2) (room air) after endotoxemia in awake sheep. NP infused 2.5 h after endotoxin administration immediately reduced mean Ppa from 30 +/- 3 to 17 +/- 3 (SE) cmH2O, PVR from 6.3 +/- 0.7 to 4.8 +/- 0.5 cmH2O.l-1.min, and RL from 340 +/- 48 of base line to 205 +/- 73% and increased Cdyn from 54 +/- 5 of base line to 80 +/- 14% without affecting PAO2--PaO2. Ppa and lung mechanics returned immediately to preinfusion levels when NP was stopped. In vitro experiments with NP showed a dose-dependent relaxation of preconstricted pulmonary artery and vein, carbachol-preconstricted sheep tracheal strips, and bronchial rings. We conclude that NP reverses pulmonary hypertension and lung mechanics abnormalities after endotoxin and that this is due to effects of NP on airway and vascular smooth muscle. The return of these abnormalities after NP cessation suggests the continued presence of vascular and airway constricting factors late after endotoxin. The lack of effect of NP on blood oxygenation suggests that deleterious effects on hypoxic vasoconstriction are offset by improved lung mechanics. PMID- 3292507 TI - Cytochrome b-245 and its involvement in the molecular pathology of chronic granulomatous disease. AB - Cytochrome b-245 is an integral, and probably the terminal, component of the microbicidal oxidase electron transport chain of phagocytic cells. Current knowledge of the biochemistry and cell and molecular biology of this molecule is described. The molecular basis of chronic granulomatous disease, in which defective electron transport down this chain predisposes to infection and impaired digestion by phagocytes, is explained in terms of anomalies of the cytochrome b and related molecules. PMID- 3292508 TI - Chronic granulomatous disease. Molecular genetics. AB - Chronic granulomatous disease is an inherited disorder of microbial killing characterized by the failure of phagocytic cells to produce superoxide due to a lesion in a membrane-associated NADPH-oxidase. The components of the oxidase have been incompletely characterized and, therefore, a genetic approach has been used to identify the gene affected in the common X-linked form of CGD without reference to a specific protein product. The X-CGD gene was first mapped to Xp21.1. A phagocyte-specific RNA transcript derived from Xp21 was identified and shown to be deficient (or disrupted) in patients with X-CGD. Antisera directed toward the predicted protein product of the X-CGD gene have established its identity as a 90-kD membrane glycoprotein and a component of the phagocyte cytochrome b, recently purified as a heterodimer of a 90-kD species and a 22-kD polypeptide. The more recent genetic and biochemical findings now provide an explanation for the consistent absence of the phagocyte cytochrome b spectrum in X-CGD (now termed "X- -CGD"). Both subunits of the cytochrome b heterodimer are absent in X- -CGD, despite a genetic deficiency of only the larger polypeptide, which indicates that a complete understanding of cytochrome biosynthesis and function will require further characterization of the small subunit. We should anticipate that identification of other functionally associated proteins will aid in analysis of the phagocyte oxidase. Molecular reagents prepared from the cloned X-CGD cDNA or gene may prove to be clinically useful in prenatal diagnosis and may provide a basis for somatic gene therapy in the future. PMID- 3292509 TI - In vitro models of differentiated Sertoli cell structure and function. AB - Primary cultures of Sertoli cells maintained in conventional cultures on plastic culture vessels do not retain many of the structural and functional properties of their in vivo counterparts. Sertoli cell phenotype is better maintained by incorporating certain environmental parameters, intrinsic to the testis, into the Sertoli cell culture system. These environmental parameters include a) high cell density, b) a unique extracellular matrix, c) a semipermeable support between the basal plasma membrane of the cells and blood-derived nutrients in the interstitium, d) chemically distinct microenvironments at the apical and basal surfaces of the cells, and e) cell-to-cell interactions among Sertoli cells and other testicular cell types. Using three variations of Sertoli cell culture we have demonstrated the importance of each of these environmental parameters in obtaining a better Sertoli cell culture model. PMID- 3292510 TI - Update on peripheral nerve injuries. AB - Experimental work relating to factors affecting nerve regeneration is reviewed. There is increasing evidence that the nerve sprouts are preprogrammed for their peripheral reinnervation; old endoneurial tubes being discarded. Fascicular suture shows no significant improvement in function compared with epineural suture. The importance for sensory re-education and the need for repeatable sensory function tests is emphasized. Recent experimental work on the mechanisms of causalgia is reviewed and management of painful peripheral nerve disorders discussed. Striking advances have been made in the diagnosis, surgical treatment and rehabilitation of traction lesions of the brachial plexus. These are discussed with special reference to electrodiagnosis, functional splinting and management of pain. Surgery for obstetric palsies is now being undertaken and similar lesions to those in the adult being repaired with success. Reconstructive procedures for permanent paralysis are reviewed. Postirradiation plexus lesions present a formidable challenge but surgery can sometimes alleviate pain. PMID- 3292511 TI - Identification of Escherichia coli from shellfish and related environments by automicrobic system. AB - A total of 463 fecal coliform positive isolates obtained from shellfish and related samples gave typical Escherichia coli IMViC reactions. E. coli identifications for 458 (99%) of these isolates were confirmed using a combination of the Automicrobic System (AMS) and the API 20E system (reference system). The AMS (test system) identified 433 isolates as E. coli; the remaining 25 (5%) isolates were identified as E. hermanii by the test system and as E. coli by the reference system. Additional tests performed on the isolates identified as E. hermanii confirmed those AMS identifications to be incorrect. PMID- 3292512 TI - Fluorogenic assay for rapid detection of Escherichia coli in chilled and frozen foods: collaborative study. AB - A collaborative study was conducted to compare a proposed LST-MUG method with the AOAC official method for Escherichia coli detection. E. coli produces an enzyme, beta-glucuronidase, which cleaves the substrate, 4-methyl-umbelliferyl-beta-D glucuronide (MUG), to yield a fluorescent end product. Incorporation of the MUG substrate into lauryl tryptose broth (LST) enables a rapid quantitative method for screening E. coli, which is detected by fluorescence of the medium under longwave UV light. In this collaborative study, 5 food samples, 2 frozen (entree sauce/gravy and dairy topping) and 3 chilled (hamburger, pork sausage, and cheese), were tested for E. coli detection by 17 collaborating laboratories. Results indicate that the LST-MUG method is equal to or better than the current AOAC method for detecting E. coli. The LST-MUG method has been adopted official first action. PMID- 3292513 TI - Methodology for isolation of Listeria from foods--a Canadian perspective. AB - A previously described monoclonal antibody-enzyme immunoassay system for dairy products was examined to determine its potential for detecting Listeria in naturally contaminated ground meats. In addition, a microtiter plate system was developed which has potential in the rapid detection of Listeria species in foods. Experience in Canada with the U.S. Food and Drug Administration procedure for dairy products, the cold enrichment procedure, and the U.S. Department of Agriculture procedure for meats is discussed. Also, the status on attempts to devise improved selective media for the isolation of Listeria species from foods is described. PMID- 3292514 TI - An interview with Maria Ikenberg Lindberg. Interview by Sylvan Stool. PMID- 3292515 TI - Rediscovering the wheel or Check your references. PMID- 3292517 TI - Hypercholesterolemia and atherosclerosis: present and future therapy including LDL-apheresis. AB - Atherosclerosis-induced coronary heart disease remains the major cause of death and disability in industrialized countries. Hypercholesterolemia is recognized as a causative factor in the development of atherosclerosis. While the lowering of cholesterol levels as a treatment goal has met with general agreement and acceptance, the preferred methods for doing so are still open to conjecture. This literature review discusses various factors in the hypercholesterolemia atherosclerosis link and surveys a variety of treatment protocols including diet modification, drug therapy, surgical intervention, and plasmapheresis. Evidence is accumulating to prove that the ideal hypercholesterolemia therapy is one that reduces LDL levels while maintaining or increasing HDL levels. Because LDL apheresis has this potential, this paper also reviews the various LDL-apheresis methods, including immunoadsorption, chemical affinity, and double-membrane filtration. PMID- 3292516 TI - Pharmacotherapy of social phobia: an interim report of a placebo-controlled comparison of phenelzine and atenolol. AB - Forty-one patients meeting DSM-III criteria for social phobia completed a randomized comparative trial of the monoamine oxidase inhibitor phenelzine, the cardioselective beta-adrenergic blocker atenolol, and placebo. No significant differences were seen after 4 weeks of treatment in this preliminary trial. At the end of 8 weeks, however, phenelzine demonstrated greater efficacy than atenolol or placebo on dimensional ratings of overall severity of social phobia. No atenolol-placebo differences were observed. The authors shall present maintenance and discontinuation findings in a final report. Phenelzine may act in patients with social phobia by directly reducing interpersonal hypersensitivity. PMID- 3292518 TI - X-ray study of baker's yeast lipoamide dehydrogenase at 4.5 A resolution by molecular replacement method. AB - The molecular structure of lipoamide dehydrogenase from baker's yeast has been determined at 4.5 A resolution by molecular replacement techniques using the known structure of human erythrocyte glutathione reductase as a starting model. The enzyme crystallizes in the space group P2(1)2(1)2(1) with a = 98.6(2), b = 162.0(2), c = 69.4(2) A. There is one molecule per asymmetric unit. The enzyme is a dimeric protein of identical subunits related by a local two-fold symmetry. Comparison of the tertiary structures between glutathione reductase and the present enzyme shows that the folding is almost the same except for the N and C termini, although some slight shortening or shifting of alpha-helices was found in the electron density map. FAD molecules are found at similar positions to those of glutathione reductase. Since the amino acid residues around FAD and NAD binding sites and at the reaction centers of the two enzymes are strongly conserved, the lipoamide dehydrogenase may catalyze the opposite reaction through a similar mechanism to that proposed for glutathione reductase. The newly found C terminus is located near the edge of a deep cave at the interface between the two subunits. These additional 18 residues form a narrow entrance to the cave, in which the long chain of the dihydrolipoyl moiety of lipoate acetyltransferase will be bound. PMID- 3292519 TI - Purification and characterization of a signal peptide, a product of protein secretion across the cytoplasmic membrane of Escherichia coli. AB - A signal peptide, a processing product of the precursor of the lipoprotein in the cytoplasmic membrane of Escherichia coli, has been purified through extractions with butanol and ethyl ether and chromatographies with a Sephadex LH-60 column and Sep-pak C18. Analysis of the amino acid composition and sequencing of the N- and C-termini indicate that the signal peptide was intact, suggesting that the first step of the signal peptide catabolism in the cytoplasmic membrane is the cleavage of the intact signal peptide. During the purification, the signal peptide exhibited unique features, including strong interaction with phospholipids. The possible importance of such features in the process of protein translocation across membranes is discussed. PMID- 3292520 TI - RNA polymerases B and C are more closely related to each other than to RNA polymerase A. AB - Amino acid sequence comparison of the largest subunit of the three forms of yeast nuclear RNA polymerase disclosed six major conserved regions that are partly retained in the cognate subunits from bacteria, viral, and insect enzymes (Memet, S., Gouy, M., Marck, C., Sentenac, A., and Buhler, J.-M. (1988) J. Biol. Chem. 263, 2830-2839). Within these conserved domains, the high sequence similarity of B220 and C160 subunits (52% identity) sets them apart from yeast enzyme A subunit A190. Parsimony analysis at the gene and protein levels suggests the existence of a transient ancestor to eukaryotic RNA polymerases B and C. These results are discussed in the light of the recent finding of class C genes containing RNA polymerase B promoter elements. PMID- 3292521 TI - The composition of the murein of Escherichia coli. AB - Escherichia coli murein, the polymer from which the shape-maintaining structure of the cell envelope is made, shows unexpected complexity. The separation of murein building blocks with high performance liquid chromatography reveals about 80 different types of muropeptides. Their behavior in high performance liquid chromatography and their chemical structure are described. The complexity of E. coli murein is due to the free combination of seven different types of side chains (L-Ala-D-Glu-R with R = -OH, -m-A2pm, -m-A2pm-D-Ala, -m-A2 pm-Gly, -m-A2pm D-Ala-D-Ala, -m-A2pm-D-Ala-Gly, -m-A2pm-Lys-Arg) with two types of cross-bridges (D-Ala-m-A2pm, -m-A2pm-m-A2pm). The novel type of cross-bridge, A2pm-A2pm, contains an L,D-peptide bond, as shown by Edman degradation and chemical analysis of the reaction products. The A2pm-A2pm cross-bridge is assumed to play a role in the adaptation of the cross-linkage of murein to different growth conditions of the cell. The structural data of E. coli murein agree best with a model of a thin, however multilayered, murein sacculus. PMID- 3292522 TI - The characterization of yeast mitochondrial RNA polymerase. A monomer of 150,000 daltons with a transcription factor of 70,000 daltons. AB - Transcription in organelles is regulated by both organellar and nuclear mechanisms. In order to study further the control of organellar transcription, we have purified and characterized the RNA polymerase from mitochondria of Saccharomyces cerevisiae and identified a transcription factor required for promoter recognition. The RNA polymerase can be separated into two forms, selective and nonselective. The nonselective form was purified over 11,000-fold and appears to be active as a monomer with a molecular weight of 150,000. The Mr 150,000 polypeptide acts as a core RNA polymerase, and an Mr 70,000 polypeptide appears to confer selectivity for the promoter upon this core. The Mr 70,000 transcription factor binds specifically to the mitochondrial initiation site in the absence of polymerase and decreases nonselective initiation by the polymerase. The Mr 150,000 polymerase is immunologically related to an Mr 145,000 protein purified from yeast as a primase, although it is thought to be a functional unit of mitochondrial RNA polymerase (Kelly, J. L., and Lehman, I. R. (1986) J. Biol. Chem. 261, 10340-10347). Antibodies to the Mr 145,000 protein inhibit transcription by the mitochondrial RNA polymerase purified here. PMID- 3292523 TI - Signal peptidases recognize a structural feature at the cleavage site of secretory proteins. AB - The cloning of the gene for staphylococcal nuclease A in the pIN-III-OmpA secretion vector results in a hybrid protein which is processed by signal peptidase I, yielding an active form of the nuclease that is secreted across the cytoplasmic membrane (Takahara, M., Hibler, D., Barr, P. J., Gerlt, J. A., and Inouye, M. (1985) J. Biol. Chem. 260, 2670-2674). Using oligonucleotide-directed site-specific mutagenesis, we have constructed a set of mutants at the cleavage site area of the precursor hybrid protein designed to alter progressively the predicted secondary structure of the cleavage site. Our results show that processing becomes increasingly defective as the turn probability decreases. These results are consistent with the structural requirement that we found for the processing of lipoprotein by signal peptidase II (Inouye, S., Duffaud, G., and Inouye, M. (1986) J. Biol. Chem. 261, 10970-10975). We conclude that secretory precursor proteins have a distinct secondary structural requirement at their cleavage site for processing by signal peptidase I, as well as by signal peptidase II. PMID- 3292524 TI - An N-terminally fused Xenopus transcription factor IIIA synthesized in Escherichia coli is biologically active. AB - A 1.5-kilobase DNA fragment containing the Xenopus transcription factor IIIA (TFIIIA) gene was inserted into the prokaryotic expression vector pIN-III(A) containing the lpp/lac promoter. The recombinant DNA was introduced into Escherichia coli K-12 strain SB221. The expression TFIIIA gene was induced by isopropyl-beta-D-thiogalactopyranoside, which resulted in the synthesis of a recombinant TFIIIA with an extra 17 amino acids fused to its N terminus as predicted from the nucleotide sequence. The engineered gene product, purified to at least 90% homogeneity, retained its binding affinity to the intragenic control region of the 5 S RNA gene, as well as its activity to stimulate 5 S RNA gene transcription in vitro. PMID- 3292525 TI - Modulation of the effects of mutations in the basic region of the OmpA signal peptide by the mature portion of the protein. AB - Oligonucleotide-directed site-specific mutagenesis was used to study the structure-function relationship of the positively charged amino terminus of the Escherichia coli outer membrane protein OmpA signal peptide. Mutations were isolated which reduced the overall charge of the amino-terminal region from +2 (wild type) to +1, 0, and -1, as well as one mutation from Thr to Ser at position 4. DNA encoding the wild type and mutant OmpA signal peptides was then fused in frame to DNA encoding the mature regions of Staphylococcus aureus nuclease A and TEM beta-lactamase. In the case of both the beta-lactamase and nuclease fusions, normal processing was no longer observed when the charge at the amino terminus was reduced to zero or made negative. Differences between the two hybrid proteins were observed in the case of the Thr to Ser mutation. As expected, this mutation had no effect on the beta-lactamase hybrid; however, the processing rate of the nuclease hybrid protein was reduced to nearly one-half. Furthermore, this effect was essentially reversed when a Lys residue at position 3 was deleted. A model is presented which explains the differing effects of a signal peptide mutation on the secretion of different hybrid proteins based on kinetic differences in the translocation of the nuclease and beta-lactamase proteins. PMID- 3292526 TI - Kinetics of the formation and isomerization of methotrexate complexes of recombinant human dihydrofolate reductase. AB - The kinetics of inhibitor binding to highly purified recombinant human dihydrofolate reductase (rHDHFR) have been examined. Methotrexate (MTX) binds rapidly (kon = 1.0 x 10(8) M-1 s-1) and tightly (koff/kon = 210 pM) to the preformed complex of rHDHFR with NADPH. The initial association reaction between rHDHFR.NADPH and MTX is followed by an isomerization of the resulting complex (kiso = 0.4 s-1) leading to a new conformer in which MTX is bound even more tightly (Ki = 3.4 pM). Similar results have been obtained with a major metabolite of MTX having four additional glutamate residues for which Ki = 1.4 pM. 7 HydroxyMTX, another major metabolite of MTX, is a weak inhibitor of rHDHFR (Ki = 8.9 nM), and a polyglutamate form of this metabolite is an equally weak inhibitor (Ki = 9.9 nM), so that the addition of glutamate residues to MTX or 7-hydroxyMTX has little effect on their binding. It follows that the significance of MTX polyglutamate formation relates to other roles such as increasing the cytotoxicity of MTX by prolonging intracellular retention of the drug. Another antifolate, trimethoprim, binds tightly to dihydrofolate reductases from bacterial sources, but weakly to rHDHFR in the ternary complex (KD = 0.5 microM). Although the association step is rapid (kon = 0.4 x 10(8) M-1 s-1), the dissociation rate is also rapid (koff = 15 s-1). Furthermore, there is no isomerization of the ternary complex of trimethoprim with rHDHFR, in contrast to the known isomerization of complexes of trimethoprim with bacterial dihydrofolate reductases. PMID- 3292527 TI - Cell surface proteolysis and down-regulation of the hepatic insulin receptor. Evidence for selective sorting of intact and degraded receptors after internalization. AB - Insulin binding to rat liver plasma membranes promotes proteolysis of the Mr 135,000 alpha subunit of the insulin receptor to a fragment of Mr 120,000 (Lipson, K. E., Yamada, K., Kolhatkar, A. A., and Donner, D. B. (1986) J. Biol. Chem. 261, 10833-10838). The enzyme that catalyzes this degradation copurifies with plasma membranes and cannot be identified in any other cellular organelle or in cytosol. The proteinase has optimal activity above pH 7 and is an integral protein based upon its resistance to extraction with 2 M NaCl. After affinity labeling, degraded insulin receptors were identified in plasma membranes isolated from a liver perfused with 1 nM 125I-insulin for 10 min at 37 degrees C, indicating that proteolysis occurs in the hepatocyte cell membrane under physiological conditions. Microsomes do not contain the receptor degrading activity or a detectable amount of degraded receptors under basal conditions. After perfusion of a liver with 125I-insulin, Mr 135,000 and Mr 120,000 complexes were detected in microsomes, suggesting that both intact and degraded receptors can be internalized. The initial absence of degraded receptors in plasma membranes suggests that, following internalization, such sites do not recycle. Thus, hormone-induced proteolysis of the insulin receptor begins at the surface of the rat hepatocyte and can lead to loss of receptors from the plasma membrane. PMID- 3292529 TI - Structure-function relationships in the transposition protein B of bacteriophage Mu. AB - The B-protein of phage Mu, which is required for high frequency intermolecular transposition in vivo, shows ATPase activity in vitro, binds nonspecifically to DNA, and stimulates intermolecular strand transfer. To elucidate the structural bases for B-protein function, it was subjected to limited proteolysis with two different proteases, trypsin and chymotrypsin. The resulting fragments were mapped by amino acid sequencing. These data show that the B-protein is organized in two domains: an amino-terminal domain of 25 kDa and a carboxyl-terminal domain of 8-kDa. A fragment analogous to the amino-terminal domain, produced by deleting the 3' end of a cloned B gene, proved to be insoluble and had to be renatured after elution from a sodium dodecyl sulfate gel. The renatured protein retains ATP-binding activity and to a lesser extent the DNA-binding activity of the MuB protein, but is unable to hydrolyze ATP or function in transposition. We also show in this study that efficient DNA-strand transfer by the B-protein occurs even in the absence of a detectable ATPase activity or in the presence of adenosine 5'-O-(thio)triphosphate (ATP gamma S). PMID- 3292528 TI - Peroxisomal integral membrane proteins in control and Zellweger fibroblasts. AB - An entire organelle, the peroxisome, appears to be missing in Zellweger syndrome, causing profound neurological problems and neonatal death. One hypothesis for the molecular cause of this defect is a failure in the assembly of the peroxisomal membrane. An alternative is that the peroxisomal membrane is assembled, but the post-translational import of the matrix proteins is defective. We have investigated these possibilities by analytical cell fractionation, immunoblotting, and immunoelectron microscopy of fibroblasts. We identified four integral membrane proteins that can serve as markers for the human peroxisomal membrane. In Zellweger fibroblasts, peroxisomal membranes were found but they were abnormal; they had an equilibrium density of 1.10 g/cm3 instead of the normal density of 1.17 g/cm3, their diameters were generally 2-4 times greater than normal, and they lacked most content. The existence of these peroxisomal ghosts in Zellweger syndrome fibroblasts supports the hypothesis that the defect in this disease is in the protein import machinery. PMID- 3292530 TI - Effects of phosphorylation, MgATP, and ionic strength on the rates of papain degradation of heavy and light chains of smooth muscle heavy meromyosin at the S1 S2 junction. AB - The effects of ionic strength, MgATP, and phosphorylation on the degradation rates of heavy meromyosin (HMM) by papain have been compared to their effects on the sedimentation coefficient (s20,w) to determine the relationship of the degradation rate to the equilibrium between the flexed and the extended forms (Suzuki, H., Stafford, W. F., Slayter, H. S., and Seidel, J. C. (1985) J. Biol. Chem. 260, 14810-14817). At 0.025 M NaCl, where HMM is predominantly in the flexed form, MgATP, Mg-adenylyl imidodiphosphate or MgADP reduce kH by 80-90%. MgATP exerts its optimal effect at this ionic strength, where at least 70% of HMM is flexed in the presence or absence of MgATP, suggesting that nucleotides reduce kH by decreasing the proteolytic susceptibility of the flexed form. At 0.5 M NaCl, where HMM is in the extended form, MgATP has no effect on kH. At low ionic strengths phosphorylation decreases kH but increases it in the presence of MgATP. Plots of kH against s20,w determined at various ionic strengths are linear, the data for phosphorylated and dephosphorylated HMM falling on the same line. Thus, raising the ionic strength or phosphorylating the 20-kDa light chain appears to alter kH by increasing the fraction of HMM in the extended form. The degradation rate of the 20-kDa light chain (kL) of dephosphorylated HMM responds to changes in ionic strength in essentially the same way as does kH, suggesting that the response of kL to changes in ionic strength can also be attributed to conversion of HMM to the extended form. However, kL for phosphorylated HMM measured in the presence of MgATP exhibits very little dependence on ionic strength. PMID- 3292531 TI - Deep-wound infection after total hip replacement under contemporary aseptic conditions. AB - The role of the combination of perioperative antibiotics, laminar air-flow operating rooms, and body-exhaust systems in reducing the incidence of deep-wound sepsis after total hip replacement remains controversial. We evaluated the incidence of deep-wound infection as associated with the magnitude of the operation in 575 patients (659 procedures) who had all three methods of prophylaxis. The same surgeon performed all of the operations. The procedures were divided into five groups, according to the complexity of the operation and the need for major bone-grafting. Only one patient (who had previously had an infection) had early sepsis. After the 376 standard primary operations, the over all incidence of sepsis (early and late) was 0.38 per cent. No infection occurred after fifty-four complex primary operations without femoral-head autografting. After fifty-nine complex primary operations with femoral-head autografting, three patients had a late deep infection. No infection occurred within two years after the 170 revision operations. There was no late infection after the 104 revisions without major bone-grafting, but late sepsis developed in two patients after the sixty-six revisions with major bone-grafting. Of the total of six cases of late infection in five patients, five had an identifiable source of infection that was extrinsic to the wound. The incidence of early postoperative sepsis after total hip replacement, even complex primary total hip replacement and revision, was extremely low when using the three contemporary methods of prophylaxis for infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292532 TI - The enhancement of fixation of a porous-coated femoral component by autograft and allograft in the dog. AB - Revision total arthroplasty of the hip, without cement, was done in dogs to compare the abilities of autologous grafts and allografts of bone to enhance histological ingrowth of bone and biomechanical strength. Six weeks after primary total hip arthroplasty with cement, the femoral component was revised to a titanium fiber-metal prosthesis. On the basis of the type of graft that was impacted into the voids around the ingrowth surface at revision, three study groups were created: no graft (control), four dogs; fresh autograft, six dogs; and frozen allograft, six dogs. Twelve weeks after revision, histological analysis revealed the greatest amount of ingrowth proximally in the grafted specimens. A mean of 22.3 per cent ingrowth was observed in the dogs that had an autograft; this was not significantly different from the mean of 17.5 per cent in those that had an allograft. The non-grafted specimens showed little ingrowth, the values being significantly less than those for the grafted specimens. Push out testing showed greater ultimate shear strength proximally than distally in the grafted specimens, and at the proximal level there was a significant difference between the group that had an autograft and the control group (mean, 4.03 and 1.22 megapascals, respectively). Ultimate strength correlated positively with ingrowth of bone (r = 0.82). Radiographically, subsidence of the components and lucent lines were observed more frequently in the nongrafted specimens, and if both were present, significantly less ingrowth of bone and strength were observed. PMID- 3292533 TI - Total elbow arthroplasty. PMID- 3292534 TI - Immediate nailing of open fractures of the femoral shaft. AB - Debridement of the wound and immediate reamed nailing were performed on sixty seven patients who had an open fracture of the femoral diaphysis. Forty-two of these patients were followed for a minimum of twelve months (average, twenty three months). Using the classification system of Gustilo and Anderson, there were fifteen (36 per cent) Grade-I, nineteen (45 per cent) Grade-II, and eight (19 per cent) Grade-III soft-tissue injuries. All of the fractures healed within four months after injury. The average flexion of the knee was 127 degrees and that of the hip, 129 degrees. At least 90 degrees of flexion was achieved in both joints of all patients. Perioperative complications included loss of fixation in four patients (10 per cent), infection of the wound in two patients (5 per cent), a wound seroma in two patients (5 per cent), and thrombophlebitis in one patient (2 per cent). Late complications were angular malunion in three patients (7 per cent), limb-length discrepancy in three patients (7 per cent), external rotation malunion in one patient (2 per cent), and sciatic-nerve palsy in one patient (2 per cent). We concluded that immediate intramedullary nailing of an open femoral fracture can be accomplished safely, with an acceptable rate of complications, given thorough debridement of the wound, proper equipment, and an experienced surgical team. PMID- 3292535 TI - Failure of carbon fiber-reinforced polyethylene total knee-replacement components. A report of two cases. PMID- 3292536 TI - Increased amounts of HMG-CoA reductase induce "karmellae": a proliferation of stacked membrane pairs surrounding the yeast nucleus. AB - Overproduction of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase in yeast resulted in striking morphological effects on the structure of intracellular membranes. Specifically, stacks of paired membranes closely associated with the nuclear envelope were observed in strains that over-produced the HMG1 isozyme, one of two isozymes for HMG-CoA reductase in yeast. These nuclear-associated, paired membranes have been named "karmellae." In strains that overproduced the HMG1 isozyme, HMG-CoA reductase was present in the karmellar layers. At mitosis, karmellae were asymmetrically segregated: the mother cells inherited all of the karmellae and the daughter cells inherited none. A membranous structure of different morphology was occasionally found in cells that overproduced the HMG2 isozyme. These observations further establish the existence of cellular mechanisms that monitor the levels of membrane proteins and compensate for changes in these levels by inducing synthesis of particular types of membrane. PMID- 3292537 TI - Yeast vacuoles fragment when microtubules are disrupted. AB - To identify whether microtubules are involved in the maintenance of vacuolar morphology, we treated Saccharomyces cerevisiae with nocodazole and methyl benzimidazole-2-yl-carbamate, drugs which inhibit the polymerization of microtubules. Treated cells arrest with a single large bud in the G2/prophase portion of the cell cycle. Labeling the vacuole with either quinacrine or FITC dextran revealed vacuole fragmentation that was not found in untreated cells or in cells arrested in G2 by unrelated means. A drug-resistant mutant in beta tubulin does not show vacuolar fragmentation when treated with drug. We propose that microtubules are involved in the regulation of vacuole morphology. PMID- 3292538 TI - Purification and characterization of a basal body-associated Ca2+-binding protein. AB - Isolated basal body complexes from the unicellular alga, Chlamydomonas reinhardtii were found to contain a low molecular mass acidic polypeptide, distinct from calmodulin, but with biochemical features in common with members of the calmodulin family of calcium-binding proteins. These common characteristics included a relative low molecular mass of 20 kD, an experimentally determined acidic pI of 5.3, an altered electrophoretic mobility in SDS-polyacrylamide gels in the presence of added calcium, and a calcium-dependent binding to the hydrophobic ligand phenyl-Sepharose which allowed its purification by affinity chromatography. The relatedness of the basal body-associated 20-kD calcium binding protein (CaBP) to calmodulin was confirmed by amino acid compositional analysis and partial peptide sequencing of the isolated protein. A rabbit antibody specific for the 20-kD CaBP was raised and used to determine by indirect immunofluorescence the cellular localization of the protein in Chlamydomonas cells. In interphase cells the antibody stained intensely the region between the paired basal bodies, two fibers extending between the basal bodies and the underlying nucleus, and an array of longitudinal filaments surrounding the nucleus. The two basal body-nuclear connecting fibers were identified in thin section electron micrographs to be narrow striated fiber roots. In mitotic cells the 20-kD CaBP was specifically associated with the poles of the mitotic spindle at the sites of the duplicated basal body complexes. PMID- 3292539 TI - Identification and characterization of a yeast nucleolar protein that is similar to a rat liver nucleolar protein. AB - We have produced monoclonal antibodies against purified nuclei from the yeast Saccharomyces cerevisiae and have characterized three different antibodies that recognize a protein with an apparent molecular weight of 38,000, termed p38. Subcellular fractionation shows that virtually all of p38 occurs in the nuclear fraction. High concentrations of salt (1 M) or urea (6 M) effectively solubilize p38 from a nuclear envelope fraction prepared by digestion of nuclei with DNase. Indirect immunofluorescence demonstrates a crescent shaped distribution of p38 at the inner periphery of the nucleus, with p38 extending between dividing pairs of cells during (closed) mitosis. Postembedding immunogold electron microscopy shows decoration of the densely stained "crescent" region of the yeast nucleus, confirming the localization of p38 to the nucleolus. One of the monoclonals, D77, cross reacts on immunoblots with a single protein of molecular weight 37,000 from purified rat liver nuclei. Indirect immunofluorescence localizes this protein to the nucleolus, and shows that it is dispersed throughout the cell during mitosis. The yeast and rat liver nucleolar proteins behave similarly when electrophoresed in two dimensions, and appear to have basic pI values. Analysis of immunological cross-reactivity using D77, and antibodies specific for nucleolar proteins from other sources, suggests that the rat liver protein is fibrillarin, and demonstrates that p38 shares epitopes with fibrillarin, as well as with other vertebrate nucleolar proteins. PMID- 3292540 TI - Monoclonal antibodies directed against the sexual binding site of Chlamydomonas eugametos gametes. AB - Monoclonal antibodies were raised against the mt- sexual agglutinin of Chlamydomonas eugametos gametes. Those that blocked the agglutination site were selected. They were divided into two classes dependent upon whether they gave a weak (class A) or clear positive (class B) reaction with mt- flagellar membranes in an ELISA and an indirect immunofluorescence test using glutaraldehyde-fixed mt gametes. Class A antibodies were shown to be specific for the agglutinin in an extract of mt- gametes, based on results from immunoblotting, immunoprecipitation, affinity chromatography, and the absence of a reaction with nonagglutinable cells. Surprisingly, class A mAbs also recognized two mt+ glycoproteins, one of which is the mt+ agglutinin. Class B antibodies were shown to bind to several glycoproteins in both mt- and mt+ gametes, including the mt- agglutinin. Fab fragments from class A mAbs blocked the sexual agglutination process, but those from class B did not, even though the parent antibody did. We conclude that the class A epitope lies in or close to the agglutination site of the mt- agglutinin, whereas the class B epitope lies elsewhere on the molecule. We also conclude that the mt- agglutinin is the only component on the mt- flagellar surface directly involved in agglutination. Class A mAbs were found to elicit several reactions displayed by the mt+ agglutinin. They bound to the mt- agglutinin on gamete flagella and induced most of the reactions typical of sexual agglutination, with the exception of flagellar tip activation. None of these reactions was induced by Fab fragments. High concentrations of class A mAbs completely repressed the sexual competence of live mt- gametes, but low concentrations stimulated cell fusion. PMID- 3292541 TI - Penetration of Salmonella through a polarized Madin-Darby canine kidney epithelial cell monolayer. AB - Many intracellular parasites are capable of penetrating host epithelial barriers. To study this process in more detail we examined the interactions between the pathogenic bacteria Salmonella choleraesuis and polarized epithelial monolayers of Madin-Darby canine kidney (MDCK) cells grown on membrane filters. Association of bacteria with the MDCK cell apical surface was an active event, requiring bacterial RNA and protein synthesis, and was blocked by low temperatures. Salmonella were internalized within a membrane-bound vacuole and exhibited penetration through, but not between MDCK cells. A maximum of 14 Salmonella per MDCK cell crossed the monolayer per hour to the basolateral surface yet the monolayer remained viable and impermeable to Escherichia coli. Apical S. choleraesuis infection resulted in an increase in paracellular permeability but the MDCK intercellular contacts were not significantly disrupted. Basolateral S. choleraesuis infection was inefficient, and only small numbers of S. choleraesuis penetrated to the apical medium. PMID- 3292544 TI - Endogenous lectins as mediators of tumor cell adhesion. AB - Endogenous carbohydrate-binding proteins have been found in various normal tissues and cells. Although lectins with different sugar-binding specificities have been described, the most prevalent ones are those that bind beta galactosides. The ability of some normal and malignant cells to bind exogenous carbohydrate-containing ligands suggested that lectinlike activity is associated with the cell surface and that carbohydrate-binding proteins might mediate intercellular recognition and adhesion. We found that extracts of various cultured murine and human tumor cells exhibit a galactoside-inhibitable hemagglutinating activity. This activity was associated with two proteins of molecular weights of 34,000 and 14,500 daltons, which were purified by affinity chromatography by using immobilized asialofetuin. That these lectins are present on the cell surface was indicated by the binding of monoclonal antilectin antibodies to the surface of various tumor cells and by the immunoprecipitation of 125I-labeled lectins from solubilized cell-surface iodinated cells by polyclonal antilectin antibodies. That these cell surface lectins are functional was demonstrated by the ability of the galactose-terminating asialofetuin to enhance cell aggregation and of asialofetuin glycopeptides to block this homotypic aggregation as well as to suppress cell attachment to substratum, and by the inhibition of both asialofetuin-induced cell aggregation and cell attachment to substratum by the binding of monoclonal antilectin antibodies to the cell surface. These findings implicate cell surface lectins as mediators of cell-cell and cell-substratum adhesion. Some of these cellular interactions might be important determinants of tumor cell growth and metastasis. PMID- 3292542 TI - A novel methodology for analysis of cell distribution in chimeric mouse organs using a strain specific antibody. AB - Chimeric animals are very useful for analysis of cell lineage, homeostasis in tissue architecture, and cell-cell interactions during both organogenesis and carcinogenesis. However, there is not a generally effective means for marking cells of chimeric mice. We have therefore developed a polyclonal antibody that is useful for this purpose. This antibody specifically recognizes those cells derived from C3H strain mice. The specificity of this antibody was checked by both immunoblotting and immunoadsorption methods. The antigens were immunohistochemically detected in cytoplasm of both epithelial and mesenchymal cells of C3H/HeN strain mouse in many different organs, but not the corresponding cell types from BALB/c or C57BL/10 or several other mouse strains. The validity of these antibodies as markers for C3H cells was further checked by tissue recombination experiments and in mixed cultures of mouse and rat cells. In each case the antibody recognized only the C3H mouse cells. Next, chimeric mice were prepared between strains C3H/HeN and BALB/c, and C3H/HeN and C57BL/10 mice. Chimeras 2-mo old were examined for antigen distribution using the indirect immunofluorescence method. Many tissues in chimeric mice were composed of cells that were both stained and unstained by the anti-C3H specific antigen. The chimeric patterns were classified into four types, A-D. In well-defined structural units such as intestinal crypts, small intestinal villi, kidney convoluted tubules, exocrine gland acini, ovarian follicles, thyroid gland follicles, stomach glands, adrenal cortex, lingual papillae, etc., (A) each unit was composed entirely of either positive or negative cells, or else (B) in some organs each unit was composed of both types of cells. In the uniform tissues without such distinguishable units, such as stratified squamous epithelium, mesenchymal tissue, corpora lutea, pituitary gland, Islets of Langerhans, adrenal medulla etc., (C) the tissue was composed of definite small cell groups made entirely of either positive or negative cells, or else (D) the tissue was composed of both types of cells which were intermingled with one another. These findings strongly suggest that the chimeric patterns demonstrated here reflect the cell proliferative unit in each tissue. This cell marker system has proven useful for analysis of cell lineage and cell renewal systems in many organs of chimeric mice. PMID- 3292545 TI - Detection of GD3 ganglioside in childhood acute lymphoblastic leukemia with monoclonal antibody to GD3: restriction to immunophenotypically defined T-cell disease. AB - We have recently reported that the disialoganglioside GD3 is found in cellular lipid extracts of T-cell acute lymphoblastic malignancies (T-ALL) but is not detectable by resorcinol staining in extracts of non-T acute lymphoblastic leukemia blasts (non-T-ALL). We have now extended this study to assess the detectability of GD3 in T-ALL vs non-T-ALL utilizing an anti-GD3 antibody, R24. Gangliosides isolated from T-ALL and non-T-ALL blasts by two different methods were separated by thin-layer chromatography and stained with anti-GD3 and a control antibody specific for GM3 and sialosylparagloboside (SPG). Anti-GD3 reactivity was observed in extracts from T-ALL cells in all cases, whereas GD3 was not detected in any of the non-T-ALL samples. The anti-GM3/SPG antibody stained GM3 in all of the leukemic samples analyzed as well as SPG in the non-T ALL samples. Indirect immunofluorescence was used to assess the expression of GD3 at the surface of leukemic blasts. Fluorescence-activated cell sorting analysis with R24 showed that whereas T-ALL blasts were highly reactive with this antibody, non-T-ALL blasts were totally unreactive. In an analysis of a larger number of leukemia patients by fluorescence microscopy, 20 out of 28 samples with the T-ALL phenotype were positive for R24, whereas zero out of 11 non-T-ALL samples were reactive. These results confirm our earlier finding of the specificity of GD3 to the T-ALL subclass of childhood leukemias and furthermore suggest the potential value of anti-GD3 as an immunological tool for the diagnosis and therapy of T-cell ALL. PMID- 3292543 TI - Studies of adhesion molecules mediating interactions between cells of peripheral nervous system indicate a major role for L1 in mediating sensory neuron growth on Schwann cells in culture. AB - The involvement of the adhesion molecules L1, N-CAM, and J1 in adhesion and neurite outgrowth in the peripheral nervous system was investigated. We prepared Schwann cells and fibroblasts (from sciatic nerves) and neurons (from dorsal root ganglia) from 1-d mice. These cells were allowed to interact with each other in a short-term adhesion assay. We also measured outgrowth of dorsal root ganglion neurons on Schwann cell and fibroblast monolayers. Schwann cells (which express L1, N-CAM, and J1) adhered most strongly to dorsal root ganglion neurons by an L1 dependent mechanism and less by N-CAM and J1. Schwann cell-Schwann cell adhesion was mediated by L1 and N-CAM, but not J1. Adhesion of fibroblasts (which express N-CAM, but not L1 or J1) to neurons or Schwann cells was mediated by L1 and N-CAM and not J1. However, inhibition by L1 and N-CAM antibodies was found to be less pronounced with fibroblasts than with Schwann cells. N-CAM was also strongly involved in fibroblast-fibroblast adhesion. Neurite outgrowth was most extensive on Schwann cells and less on fibroblasts. A difference in extent of neurite elongation was seen between small- (10-20 microns) and large- (20-35 microns) diameter neurons, with the larger neurons tending to exhibit longer neurites. Fab fragments of polyclonal L1, N-CAM, and J1 antibodies exerted slightly different inhibitory effects on neurite outgrowth, depending on whether the neurites were derived from small or large neurons. L1 antibodies interfered most strikingly with neurite outgrowth on Schwann cells (inhibition of 88% for small and 76% for large neurons), while no inhibition was detectable on fibroblasts. Similarly, although to a smaller extent than L1, N-CAM appeared to be involved in neurite outgrowth on Schwann cells and not on fibroblasts. Antibodies to J1 only showed a very small effect on neurite outgrowth of large neurons on Schwann cells. These observations show for the first time that identified adhesion molecules are potent mediators of glia-dependent neurite formation and attribute to L1 a predominant role in neurite outgrowth on Schwann cells which may be instrumental in regeneration. PMID- 3292546 TI - Major O-glycosylated sialoglycoproteins of human hematopoietic cells: differentiation antigens with poorly understood functions. AB - All human hematopoietic cells seem to contain a major, heavily O-glycosylated sialoglycoprotein. Glycophorin A is specific for the erythroid lineage of cells, and leukocytes have a major sialoglycoprotein, also called leukosialin or sialophorin. Cell differentiation results in patterns of O-glycosylation in these proteins, which reflect the stage of differentiation within a cell lineage as well as lineage specificity. The altered carbohydrate compositions may influence the interactions of the cells with external ligands. Healthy individuals lacking glycophorin A in their red cells are known, whereas a deficiency of the leukocyte sialoglycoprotein may result in immunological disease. Although little is known about the physiological functions of these proteins, they form interesting models for studies on regulation of glycosylation, biosynthesis of O-glycosylated glycoproteins, and function of cell surface receptors. PMID- 3292547 TI - Quantitative multiple tracer autoradiography: considerations in optimizing precision and accuracy. PMID- 3292548 TI - Thick brain slices model the ischemic penumbra. AB - Hypothalamic brain slices, varying in thickness from 400 mu to 1,000 mu, were assessed by studying 2-deoxyglucose (2DG) metabolism, lactate accumulation, inulin spaces, and morphology at the light and ultrastructural levels. Evidence of increased glycolytic flux due to anaerobic metabolism is found at thickness greater than 600 mu in association with a progressive increase in the inulin exclusion space. The metabolic profiles, as a function of depth into the slices, reveal that 700-mu slices function in a manner similar to 540-mu slices at the surfaces, but with a core of increased 2DG phosphorylation at the slice center. In contrast, the 1,000-mu slices show significant reduction of 2DG and increases in 2DG6P relative to the 540-mu slices at the slice surface as well as in the slice interior, suggesting impaired transport of 2DG into cells and spread of ischemic injury from the slice interior to the slice surface. Despite these metabolic changes, only minor morphologic changes of ischemic injury were found at the center of thicker slices, and in vitro glucose utilization of 1000-mu slices remained constant for up to 15 h. These three slice thicknesses should provide a useful model for studying the neurochemistry and neuropharmacology of the ischemic penumbra. PMID- 3292549 TI - Clinical assessment of an enzyme immunoassay (EMIT) for measurement of serum salicylate. AB - Salicylic acid concentrations in serum were compared using a homogenous enzyme immunoassay (EMIT) and an automated colorimetric analysis (ACA) technique. Analysis of samples showed similar within-day and day-to-day coefficients of variation (CV): 1.3% and 4.6% by EMIT and 1.0% and 2.6% by ACA, respectively. Quantification of serum containing added salicylate and serum from patients receiving salicylate therapy showed a slight positive bias towards the ACA method over the range of 0-600 mg/l. No significant difference in reliability was found between the two methods. The EMIT assay showed no interference from other antiflammatory drugs being taken by patients who were not taking salicylates. If decisions to alter salicylate dosage are made with due regard to the drug's saturation kinetics, measurements using either EMIT or ACA should allow the clinician to titrate patients' serum concentrations accurately within the narrow therapeutic range. PMID- 3292550 TI - Nitrates: do they have a role in the treatment of asthma? PMID- 3292551 TI - Methotrexate and rheumatoid arthritis. PMID- 3292552 TI - Therapeutic progress--review. XXXII. Cytotoxic drug therapy with reference to childhood malignancy. PMID- 3292553 TI - [Experimental esophageal transsection. Application to the treatment of hemorrhage in portal hypertension]. AB - Nineteen of twenty dogs undergoing experimental esophageal transection with mechanical suturing were followed up over 1 to 120 days by means of light and electron microscopy examinations to evaluate changes in suture line. Histology showed few reactions to the metallic clips, the absence of new vessel formation with early healing from the 4th day, development of collagen fascicles after 1 week and consolidation after 2 weeks with reparation by the end of 1st month. Stability of healing process was apparent between 3 and 4 months, without evidence of stenosis due to scar tissue. PMID- 3292554 TI - [Technic of percutaneous anterior colpopexy under endoscopic control for orthostatic and urinary stress incontinence in women (Stamey's operation)]. AB - Percutaneous anterior colpopexy, as described by Stamey, constitutes a simple, reliable method for treatment of orthostatic and stress incontinence of urine in women. As with all operations destined to correct this infirmity, its aim is to replace the bladder neck and initial part of urethra into spaces subject to pelvic pressure. The principle of the operation consists of solidly attaching the whole thickness of particularly the para-cervicourethral vagina fibrous layer to the anterior abdominal wall by means of two solid monofilament threads of caliber 2, scissoring on the threads being prevented by insertion of a 1 X 0.5 cm vascular prosthesis. The operation mainly involves a vaginal approach: the vaginal incision in T exposing the bladder neck. Two abdominal incisions 2 cm in length and avoiding the aponeurosis are made 1 cm above the pubis from one side of the median line to the other. These allow Stamey's needles to be passed behind the symphysis up to the vaginal incision under endoscopic control. Cystoscopy is an essential part of surgery since it allows verification of good positioning of thread exactly at the bladder neck level and of the quality of the hyperelevation of posterior lip of bladder neck obtained. As effective as other retropubic anterior colpopexies, this procedure under endoscopic control has the major advantage of avoiding opening of Retzius space, with its inevitable morbidity, and of being possible without difficulty in previously operated patients. It should undoubtedly be included in the therapeutic armament used for this frequent infirmity. PMID- 3292555 TI - Rapid high-performance liquid chromatographic method to measure plasma leucine: importance in the study of leucine kinetics in vivo. PMID- 3292556 TI - Fat calories may be preferentially stored in reduced-obese women: a permissive pathway for resumption of the obese state. AB - We previously demonstrated in unpaired studies that corn oil ingestion at the beginning of a euglycemic insulin clamp study decreased the responsiveness of gluteal adipose tissue lipoprotein lipase (ATLPL) to glucose/insulin in lean subjects. In this investigation, we performed paired euglycemic insulin clamp studies with glucose/insulin with or without oral corn oil in each of six lean [mean, 64 +/- 3 (+/- SE) kg] normal women and nine moderately obese (91 +/- 3 kg) women before and after 12.4 +/- 1.4-kg weight loss and 3 months of weight maintenance to determine if the inhibitory effect of fat calories existed in each of these states. In the obese women the fasting ATLPL activity [5.6 +/- 1.1 (+/- SE) neq FFA/10(6) cells.min] was greater than in the normal women (1.6 +/- 0.2) and did not change after weight loss and maintenance (5.0 +/- 0.7). As expected, in normal women corn oil ingestion diminished the responsiveness of ATLPL to glucose/insulin [change (delta), 0.2 +/- 0.2 vs. 3.3 +/- 0.8; P less than 0.02] during a 6-h euglycemic insulin (40 mU/m2.min) clamp. In obese women ATLPL activity did not change under either experimental condition (glucose/insulin with or without corn oil). However, after weight reduction ATLPL activity increased not only in response to glucose/insulin alone (delta, 7.7 +/- 2.4), but also in response to glucose/insulin when corn oil was ingested (delta, 7.9 +/- 2.8). Moreover, the response of ATLPL activity to glucose/insulin and corn oil was greater than that in lean women (P less than 0.05). Thus, in reduced-obese women not only did fasting ATLPL activity remain elevated and ATLPL responsiveness to glucose/insulin increase, but fat ingestion failed to blunt the ATLPL response. This inability of dietary fat to diminish the responsiveness of ATLPL to glucose/insulin and, therefore, the effect of the lipase on triglyceride deposition in adipose tissue could contribute to the resumption of the obese state that so commonly occurs after successful weight reduction. PMID- 3292557 TI - Testosterone prevents complete suppression of spermatogenesis in the gonadotropin releasing hormone antagonist-treated nonhuman primate (Macaca fascicularis). AB - We studied the effects of administration of a GnRH antagonist combined with testosterone (T) as an approach to male contraception as well as the role of intratesticular androgens in spermatogenesis using a nonhuman primate model. Three groups of five adult cynomolgus monkeys (Macaca fascicularis) received daily sc injections of 420-460 micrograms/kg GnRH antagonist ([Ac D2Nal1,D4ClPhe2,DPal3,Arg5,DGlu6(AA), DALa10]GnRH) for a period of 15 weeks. T supplementation, commencing on the first day of GnRH antagonist administration, was provided by single im injection of 40 mg (group 2) or 200 mg (group 3) of the long-acting testosterone ester testosterone-trans-4-n-butylcyclohexancarboxylate (20-Aet-1). Serum LH bioactivity was undetectable within 1 week of GnRH antagonist administration in all monkeys. GnRH antagonist administration alone (group 1) reduced serum T levels into the castrate range. Forty milligrams of 20 Aet-1 maintained serum T levels in the upper range of normal monkeys, while 200 mg 20-Aet-1 maintained serum T levels about 1.5-fold above normal. The response to electroejaculation was fully maintained in all T-treated monkeys. Sperm counts in the ejaculates dropped to zero among group 1 animals within 7-10 weeks of GnRH antagonist administration. In groups 2 and 3 consistent azoospermia could not be induced, and the sperm counts were significantly (P less than 0.05) higher in group 3 than in group 2. Histologically, spermatogenesis in group 1 was arrested at the spermatogonial level in 75% of seminiferous tubules. In group 2, spermatogenesis proceeded to spermatocytes in 50% of tubules and to elongated spermatids in 10% of tubules, while in group 3 elongation of spermatids occurred in 75% of tubules. The mean T and dihydrotestosterone concentrations in baseline testicular biopsies (n = 15) were 43.8 +/- 6.8 (+/- SE) and 5.7 +/- 1.5 ng/g, respectively. After GnRH antagonist with or without T administration, the mean (n = 15) intratesticular T and dihydrotestosterone levels were reduced to 20.3 +/- 4.9 and 3.2 +/- 0.5 ng/g, respectively, and differed little among the three groups. No correlation, however, could be established between testicular androgen levels and spermatogenic status (P greater than 0.30) or sperm counts (P greater than 0.60). These results demonstrate that administration of a GnRH antagonist in the presence of constant serum T levels does not induce consistent azoospermia, and that the supporting effects of T on spermatogenesis cannot be explained exclusively on the basis of the testicular androgen concentrations. PMID- 3292558 TI - Oscillations in insulin secretion during constant glucose infusion in normal man: relationship to changes in plasma glucose. AB - Peripheral plasma or serum concentrations of glucose, insulin, C-peptide, glucagon, and cortisol and insulin secretory rates (ISR) were determined at 15 min intervals in eight normal subjects during a constant iv infusion of 4.5 mg glucose/kg.min for a 24-h period. During each sampling interval, the secretory rate of insulin was calculated by deconvolution of the peripheral plasma C peptide concentration using C-peptide kinetic parameters derived after bolus injections of C-peptide in individual subjects. Periodogram analysis of the individual glucose curves demonstrated a circadian rhythm in all subjects, with a major nocturnal acrophase occurring at an average clock time of 0228 h (range, 0045-0350 h). In five of the eight subjects, a minor acrophase occurred at an average time of 1774 h (range, 1530-2045 h). This diurnal variation in plasma glucose levels was not paralleled by a similar pattern in insulin secretion. Although glucose was infused at a constant rate, significant pulses were found in glucose, insulin, and C-peptide levels and ISR; the pulse durations of these parameters were 182 +/- 30 (+/- SE), 89 +/- 5, 100 +/- 8, and 85 +/- 5 min, respectively, and their periodicities were 208 +/- 33, 106 +/- 7, 114 +/- 10, and 106 +/- 7 min. The durations and frequencies for pulses of insulin, C-peptide, and ISR were not significantly different, whereas glucose pulses had a longer duration and were less frequent (P less than 0.05, by analysis of variance). On the average, 54 +/- 9% of the C-peptide pulses and 47 +/- 8% of the ISR pulses were concomitant with a pulse in glucose levels. Moreover, approximately half of the C-peptide and ISR pulses that were not concomitant with a glucose pulse occurred in synchrony with a shoulder on the up-stroke or down-stroke of glucose pulses. Analysis of glucagon and cortisol profiles revealed no significant associations with the insulin and glucose oscillations. In conclusion, during a constant glucose infusion in normal subjects, regular oscillations of insulin secretion occur at 80- to 120-min intervals. Their tight coupling with glucose oscillations and the lack of association with fluctuations of glucagon and cortisol suggest that these oscillations represent a dynamic property of the insulin-glucose feedback loop. PMID- 3292559 TI - Partial characterization of a uteroglobin-like protein in the human uterus and its temporal relationship to prostaglandin levels in this organ. AB - During the past decade several corticosteroid-dependent, low mol wt proteins with phospholipase-A2 (PLA2) inhibitory activity have been described. This family of proteins is collectively known as lipocortins. Blastokinin or uteroglobin (utg), a progesterone-induced protein, first discovered in the pregnant rabbit uterus, is also a potent PLA2 inhibitor, but genetically distinct from lipocortins. Although utg has been found in rabbits, its presence in humans has not been well established. Here, we present biochemical, immunological, and immunohistological evidence for the detection of a utg-like protein in the human uterus. Since inhibition of PLA2 may modulate tissue eicosanoid levels and since rabbit utg has been reported to be a potent PLA2 inhibitor, we also studied the temporal relationship between utg and tissue prostaglandin E2 and F2 alpha levels in estrogen- and progesterone-dominated endometrial tissue. We found an inverse temporal relationship between utg-like protein and eicosanoid levels in this organ. Since some eicosanoids (e.g. prostaglandins, leukotrienes, etc.) are known to be involved in smooth muscle contractility and inflammatory processes, our findings may help to understand the pathogenesis of some human disorders in which abnormal eicosanoid production occurs. PMID- 3292560 TI - Role of gestational hormones in the induction of insulin resistance. AB - Pregnancy is associated with insulin resistance. We studied insulin binding and postbinding function in isolated adipocytes from pregnant and nonpregnant rats. We also used a primary culture system for female virgin rat adipocytes to assess the effects of gestational hormones in vitro on insulin binding and postbinding function. Insulin binding to adipocytes was normal during pregnancy, but [14C]3-O methylglucose transport was reduced. When hCG or estradiol was added to the culture medium, no change in maximum [14C]3-O-methylglucose transport was found; however, maximum insulin binding was increased with estradiol. Progesterone and cortisol both decreased maximum insulin binding and [14C]3-O-methylglucose transport. PRL and placental lactogen decreased maximum [14C]3-O-methylglucose transport, but did not change insulin binding. When these hormones were added concurrently no change in insulin binding was found, but maximum [14C]3-O methylglucose transport was reduced. We conclude that the insulin resistance of pregnancy is associated with a postbinding defect in insulin action. Estradiol increased insulin receptor binding, but during pregnancy this effect may be offset by the reduction in insulin binding induced by progesterone and cortisol. The postbinding defect in insulin action during pregnancy is probably related to increasing amounts of progesterone, cortisol, PRL, and placental lactogen. PMID- 3292561 TI - Two-site assay of intact parathyroid hormone in the investigation of primary hyperparathyroidism and other disorders of calcium metabolism compared with a midregion assay. AB - We compared the utility of measurements of serum intact human PTH-(1-84) and midregion human PTH-(44-68) in patients with disorders of extracellular calcium metabolism. Serum midregion PTH was determined by RIA, and serum intact PTH was measured by a sensitive and specific immunoradiometric two-site assay. The serum intact PTH concentrations in 70 patients with primary hyperparathyroidism were above the normal range in 69, and thus widely separated from the levels in 40 patients with hypercalcemia of malignancy, in whom serum intact PTH values were usually below normal. In contrast, both groups had overlapping serum midregion PTH values. In patients after renal transplantation and those with chronic renal failure, serum intact PTH levels were in the normal range twice as often as were serum midregion PTH values. The intact PTH assay was also superior in detecting venous gradients of the hormone and changes in PTH secretion caused by altered serum calcium concentrations, and serum intact PTH was remarkably low in hepatic venous effluent. We conclude that this new assay for serum intact PTH is superior to the midregion RIA in investigating parathyroid function in several different clinical conditions. PMID- 3292562 TI - Resumption of puberty after long term luteinizing hormone-releasing hormone agonist treatment of central precocious puberty. AB - To determine whether puberty resumes normally after long term LHRH agonist (LHRHa) treatment, we studied 16 children with central precocious puberty treated with LHRHa (D-Trp6,Pro9,NEt-LHRH) for 1-4 yr (mean, 3.3 yr). Treatment was discontinued at a mean age of 11.6 +/- 1.3 (+/- SD) yr. Plasma hormone levels, growth velocity, rate of bone maturation, and pubertal stage were assessed at the end of treatment and 3 and 12 months later. Basal plasma sex steroid and basal and LHRH-stimulated gonadotropin levels returned to near-pretreatment levels 3 months after discontinuation of therapy and were fully restored to pretreatment levels at 12 months. Growth velocity, which had been 7.8 cm/yr before treatment, was stable after discontinuation of treatment at approximately 2.6 cm/yr. The predicted height, which had increased during treatment (P less than 0.01), remained stable at approximately 5 cm above the pretreatment predicted height. The rate of bone age advancement (delta bone age/delta chronological age) increased gradually from 0.4 at the end of treatment to the normal value of 0.9 12 months posttreatment. Breast and pubic hair pubertal stages, which were stable throughout treatment and were 4.0 +/- 0.8 (+/- SD) and 3.6 +/- 1.0 at the end of treatment, increased to 4.9 +/- 0.2 and 4.5 +/- 1.0. This approximated the normal rate of 1 stage/yr. Menses occurred in 8 of 12 girls within 1 yr after treatment and in an additional 3 by 20 months after treatment. Six of the girls had menstruated before treatment, and all of these menstruated within 14 months after discontinuing therapy. We conclude that gonadotropin and sex steroid secretion and the clinical progression through puberty appear to resume normally after discontinuation of long term LHRHa treatment of central precocious puberty. Long term follow-up will be required, however, to determine whether the improvement in predicted height of these patients will be achieved, and whether adult reproductive function will be normal. PMID- 3292563 TI - The acute effect of ethanol on counterregulatory response and recovery from insulin-induced hypoglycemia. AB - We examined the acute effect of moderate ethanol administration (oral and iv) on the counterregulatory response and recovery from insulin-induced hypoglycemia after an overnight fast in eight normal men, aged 26 +/- 6 yr. While ethanol increased fasting plasma glucose and serum insulin concentrations, after insulin administration plasma glucose concentrations fell to similar nadirs in the ethanol [2.5 +/- 0.2 (+/- SE) mmol/L] and control studies (2.3 +/- 0.1 mmol/L). The hypoglycemia-induced serum GH, cortisol, and glucagon responses were all reduced (P less than 0.05-0.005) during the ethanol study, while the rises in plasma epinephrine and norepinephrine concentrations were similar in both studies. After discontinuation of the insulin infusions, the initial recovery from hypoglycemia occurred sooner in the presence than in the absence of ethanol. These data indicate that ethanol facilitates the recovery from insulin-induced hypoglycemia in the face of reduced counterregulatory hormones responses. Thus, other mechanisms, such as ethanol-induced insulin resistance, may be important in facilitating the recovery from insulin-induced hypoglycemia during ethanol administration. PMID- 3292564 TI - The heterogeneity of IgA deficiency. PMID- 3292565 TI - Evaluation of B-cell immunity in patients with pretransplant sensitization. AB - The influence of presensitization (blood transfusions) on B-cell immunity as reflected in the serum of two groups of candidates for cadaveric donor renal allografts was examined. The first group initially had a high level of panel reactive antibody (PRA) greater than 72% but experienced a large decrease in PRA (greater than 70%) 6-34 months prior to transplantation. In contrast, the second group maintained a high PRA (100%) for up to 28 months after sensitization and before transplantation. Three blood Three blood samples from each patient, representing a maximum time span of 34 months, were analyzed. Levels of IgG, IgM isohemagglutinins, and antitetanus antibody were used as indicators of B-cell function. There were no significant differences between the individual values of a single patient with regard to each parameter. However, Group II patients had elevated values of total IgG relative to Group I patients. Total serum IgG subclass levels (IgG1, IgG2, IgG3, IgG4) were measured and the relationship between a specific IgG subclass and the PRA activity was determined. IgG1 values in Group II were higher than those found for Group I. The other IgG subclasses were all within normal levels and were not significantly different between Group I and Group II. When IgG-subclass typing of PRA was performed, IgG1 accounted for most of the activity in both groups and a fall in PRA-specific IgG1 was associated with the reduced PRA observed in Group I. The data indicate that humoral immunity, as reflected by total and specific immunoglobulin levels, is intact in general in the two groups of presensitized renal allograft candidates examined and that any loss of PRA activity reflects a reduction in a specific immune response. PMID- 3292567 TI - International Neuropsychological Society. List of members. PMID- 3292566 TI - Recent rubella virus infection indicated by a low avidity of specific IgG. AB - Rubella-specific IgG in acute-phase sera produces a characteristically altered zone termed "soft hemolysis" in the radial hemolysis test. Here, the soft hemolysis was shown to be a product of the purified IgG1 subclass isolated from acute-phase sera. In contrast, ordinary hemolysis was produced by IgG1 isolated from sera of previous rubella immunity, indicating that the subclass composition of IgG was not involved in the mechanism of soft hemolysis. A novel type of solid phase immunoassay was developed for the avidity of virus-specific IgG. Acute phase IgG (with soft hemolysis) was dissociated from rubella antigen in an enzyme immunoassay (EIA) test by hydrogen-bond disrupting agents under conditions where IgG of previous immunity (showing ordinary hemolysis) remained mostly bound. These data suggest that the mechanism of soft hemolysis is the avidity of rubella specific IgG. The new quantitative avidity EIA was tested with sera taken from 169 subjects. Recent infection could be shown from sera taken weeks or months after primary rubella. PMID- 3292568 TI - IQ: R.I.P. AB - In the early decades of this century, "IQ," as score and concept, not only satisfied psychology's need for metrical respectability, but it caught the public's fancy and rapidly became a household word. Reified in many popular tests, it has withstood onslaughts from factor analysis, from concerned social scientists, from judicial fiat, and from scientific knowledge about mental abilities, brain functions, and neuropathology. In neuropsychological practice its use--and that of any scores representing sums or averages of disparate data obtained from tests of brain functions and mental abilities--can obscure specific facets of a subject's neuropsychological status or misrepresent it generally. This 70-year-old concept has outlived its usefulness. Neuropsychology needs to seek more appropriate alternatives to the IQ for describing and conceptualizing mental functioning. PMID- 3292569 TI - The value of serum human placental lactogen and Schwangerschaftsprotein 1 to determine gestation in an ante-natal population. AB - Single assays of Schwangerschaftsprotein 1 (SP1) and serum human placental lactogen (HPL) were performed in 500 consecutive patients attending a routine ante-natal clinic for their first visit. All samples were taken before 112 days gestation. Of these 500 patients, 233 had a regular menstrual cycle, were certain of last menstrual period (LMP) and delivered a normal infant after spontaneous labour. Regression equations were calculated from these results to assess their value for correcting gestation. Regression equations from previous publications were also applied to our data. The gestation and estimated date of delivery were calculated using SP1 and HPL and were compared with the actual gestation and date of delivery. The correlation was poor and did not indicate that SP1 or HPL could be used to calculate these values in the normal ante-natal population. PMID- 3292570 TI - The neuroendocrine control of ovulation. AB - In all species studied to date, follicular development is the consequence of pulsatile gonadotrophin stimulation occasioned by a GnRH pulse generator located in the mediobasal hypothalamus. This pulse generator operates within a narrow frequency range established by a neuronal system which, in the higher primates including man, discharges with a period of approximately 1 h. This frequency does not appear to change significantly as the follicular phase of the menstrual cycle progresses and plasma oestradiol concentrations rise. When these exceed a defined threshold for approximately 36 h, the pre-ovulating gonadotrophin surge is initiated and ovulation ensues some 24 h later, the so-called positive feedback action of oestrogen. This sequence of events can be replicated experimentally in subjects with various hypothalamic lesions which abolish endogenous GnRH production, simply by the administration of exogenous GnRH at an unchanging physiological frequency. This implies that the site of the positive feedback action of oestradiol is the pituitary gland and that GnRH plays but a permissive role in the initiation of the mid-cycle gonadotrophin surge. This process can be disrupted by a number of inputs which perturb the proper functioning of the hypothalamic GnRH pulse generator. PMID- 3292571 TI - Inhibition of ovulation: comparison between the mechanism of action of steroids and GnRH analogues. AB - The pulsatile secretion of GnRH is achieved by the fine regulation of oestrogens and progesterone. Progesterone is mainly responsible for a negative feedback effect at the hypothalamic level which decreases GnRH pulse frequency. Oestradiol exerts both a positive and a negative feedback effect, mostly at the pituitary level, and the use of steroids to prevent ovulation combines both effects. Recent developments in steroid research suggest a potential interest in the use of non androgenic progestins which reproduce the negative feedback effect of progesterone with fewer metabolic side effects. GnRH agonists, although responsible for low plasma levels of oestradiol, may be useful in women at risk for steroid contraception. GnRH antagonists suppress transient gonadotrophin dependent events in the menstrual cycle. Studies with the second generation GnRH antagonist, Nal--Glu, suggest a potential use of these compounds in suppressing ovulation. PMID- 3292572 TI - Pathophysiology of anovulation. AB - Anovulatory disorders are physiological during puberty, postpartum period and just before the menopause. In pathology, they are one of the earliest symptoms of different diseases: functional or organic hypothalamic diseases, pituitary destruction or inappropriate feedback by the peripheral hormones and, obviously, primary ovarian insufficiency. Their real interest lies in their pathophysiology. Functional hypothalamic disorders are defined as the inability to liberate GnRH in a physiological way. The role of endogenous opioids, as essential factors of gonadotrophin regulation will be discussed. Hyperprolactinaemias, which represent 20% of the anovulations, have an antigonadotrophic effect at the hypothalamic level, but the very mechanism of the inhibitory effect of prolactin on GnRH is still open to discussion. Although polycystic ovarian disease is one of the most common endocrine abnormalities in women, its pathophysiology remains far from fully understood. The relative parts played by hypothalamic disturbances and by abnormal feedback of gonadal steroids will be discussed. PMID- 3292573 TI - RU486 (an anti-steroid hormone) receptor structure and heat shock protein mol. wt 90,000 (hsp 90). AB - Anti-steroid hormones compete for hormone binding at the receptor level and prevent the hormonal response. A new parameter is proposed for explaining both anti-progesterone and anti-glucocorticosteroid activities of RU486, a synthetic derivative of high receptor affinity. It is based on its ability to stabilize the heterooligomeric 8S form of the glucocorticosteroid (in the chick oviduct system) and progesterone (in the rabbit uterus system) receptors. These 8S complexes involve the interaction of the approximately 94,000 and approximately 120,000 mol. wt receptors with the heat shock protein of the mol. wt approximately 90,000 (hsp 90). It is proposed that hsp 90 caps the DNA binding site of the receptor and that this would prevent it from binding to the DNA of hormone regulatory elements (HRE) and modifying transcription of regulated genes. In contrast, hormone agonists induce the dissociation of the oligomer, thus unmasking the functional DNA binding domain of the receptor. Whether other differences between agonist- and antagonist-receptor complexes are involved in the expression of hormone and anti-hormone effects also is discussed in this paper. PMID- 3292574 TI - New advances in human embryology: implications of the preimplantation diagnosis of genetic disease. AB - The diagnosis of genetic disease in preimplantation embryos is discussed. The typing of spermatozoa may be feasible for factors such as the presence of an X and Y chromosome. Embryos might be typed by non-invasive methods, by assessing their uptake of metabolites although the widest opportunities may arise by the use of invasive methods which involve the removal of one or a small number of cells. The methods of diagnosis are discussed, including enzyme assays and the use of DNA probes, preliminary results with human embryos are presented and the difficulties related to these techniques are debated. The low rate of implantation of replaced embryos will mean that many embryos will have to be diagnosed, and certain embryological factors such as the high incidence of chromosomal imbalance and the problems of 'imprinting' might obscure certain diagnoses. The advantages and disadvantages of the method are discussed. PMID- 3292575 TI - Ovarian programming and GIFT. AB - The procedures used for programming and ovarian stimulation in GIFT are identical to those used for in-vitro fertilization. At the Baudelocque Hospital, the hypophyseal gonadal axis is suppressed by administering a gonadotrophin-releasing hormone analogue (Decapeptyl, D-Trp-6-LHRH). Programming for the week of GIFT is then possible by controlling three stages: the beginning of treatment, which is independent of the date of the patient's period, the duration of treatment, which has 5 days' maximum variation, and an end-point of suppressing the spontaneous LH surge. PMID- 3292576 TI - Perspectives in human reproduction. AB - In-vitro fertilization and embryo transfer represent only one of the rapidly emerging applied advances in reproductive medicine beginning in the late 1950s; these include 'the pill' and the IUD for contraception, and hormones for the infertile requiring gonadal stimulation by gonadotrophins, clomiphene citrate or bromocryptine, to mention but a few. But from where and when did the biological basis for these sweeping changes derive? Virtually all the recent applications grew out of imaginative basic research. Fundamental animal studies by pioneers, such as Chang, Thibault and Edwards, taught us nature's axioms for gametogenesis, fertilization, development and differentiation. Millions are now seeking voluntary manipulation of their intrinsic reproductive capabilities to gain quality of life benefits for themselves and their children. Although not universal, the popularity of such options sparked industrial investment, governmental policies and international agencies to promote development of safer, more effective drugs and devices. Increased advocacy of aggressive treatment for infertile couples was a spontaneous outgrowth of this movement. Thus, the right of individuals to procreate, even to pursue the extraordinary means required, arose from the diverse events of the nascent reproductive revolution. PMID- 3292578 TI - "Growing pains" in childhood--a proposal for treatment. AB - "Growing pains" is a benign clinical entity of unknown etiology. This study examines a muscle stretching treatment based on a theory that the etiology of these pains is related to fatigue. The experimental group (18 children) showed a more rapid resolution of their symptoms over an 18 month period when compared to the control group (16 children). PMID- 3292579 TI - The value of a new ultrasound stress test in assessment and treatment of clinically detected hip instability. AB - Fifty patients with clinical suspicion of hip dislocation were investigated prospectively with a dynamic ultrasound stress test. A posterior force was applied to hips in flexion and any movement between the femoral head and the acetabulum was measured. The results of this test showed that posterior movement ranged from 0 to 13.0 mm. Hips that were clinically normal had a mean movement of 1.4 mm, hips with minor clinical instability had a mean movement of 0.6 mm, hips with moderate instability had a mean movement of 4.5 mm, and those with major instability had a mean movement of 5.1 mm. This was statistically significant to a 1% confidence interval. We propose two groups of ultrasound-detected movement: group A less than 5.0 mm representing physiologic laxity, and group B greater than or equal to 5.0 mm being pathological and requiring treatment. PMID- 3292577 TI - Molecular analysis of muscular dystrophy. AB - It is now possible to map almost any disease locus to a chromosomal region in the human genome by family studies with restriction fragment length polymorphisms. Duchenne and Becker muscular dystrophies have been shown to be localized within the same small region of Xp21 on the human X chromosome. Myotonic dystrophy has been localized to a region close to the centromere of chromosome 19. Technologies are now available to identify candidate genes for the diseases. Autosomal recessive muscular dystrophies are more difficult to study, but even these will be amenable to analysis in the very near future. The next decade should witness some exciting advances in the molecular analysis and clinical management of human muscular dystrophies. PMID- 3292580 TI - Kingella kingae infection in healthy children. AB - Kingella kingae is a gram-negative occasional, but normal, inhabitant of the nasopharynx. We present two new cases of this infection that occurred in previously healthy children, and compare and contrast them to other cases reported in the literature. K. kingae osteomyelitis generally has an insidious, subacute onset, whereas septic arthritis has an acute presentation. To date, all strains of K. kingae have been sensitive to penicillin, and no residual damage has been reported following osteomyelitis or septic arthritis, except that residual disk space narrowing did occur after K. kingae discitis. PMID- 3292581 TI - Medial discoid meniscus with cyst formation in a child. AB - A medial discoid meniscus with cystic formation was found in a 9-year-old girl. The cyst was located in the anterolateral part of the meniscus, mechanically blocking knee extension. The presenting symptom was knee flexion contracture. Total meniscectomy was followed by full recovery. PMID- 3292582 TI - Unreduced anterior dislocation of the hip in a child. AB - A case of unreduced anterior hip dislocation from trauma is reported, and the literature is reviewed. This is the fourth such case reported in a child. PMID- 3292583 TI - Hypercalcemia of malignancy revisited. PMID- 3292584 TI - Relationship between plasma glucose and insulin concentration, glucose production, and glucose disposal in normal subjects and patients with non-insulin dependent diabetes. AB - The changes in hepatic glucose production (Ra), tissue glucose disposal (Rd), and plasma glucose and insulin concentration that took place over a 16-h period from 10 to 2 p.m. were documented in 14 individuals; 8 with non-insulin-dependent diabetes mellitus (NIDDM) and 6 with normal glucose tolerance. Values for Ra were higher than normal in patients with NIDDM at 10 p.m. (4.73 +/- 0.41 vs. 3.51 +/- 0.36 mg/kg per min, P less than 0.001), but fell at a much faster rate throughout the night than that seen in normal subjects. As a consequence, the difference between Ra in normal individuals and patients with NIDDM progressively narrowed, and by 2 p.m., had ceased to exist (1.75 +/- 0.61 vs. 1.67 +/- 0.47 mg/kg per min, P = NS). Plasma glucose concentration also declined in patients with NIDDM over the same period of time, but they remained quite hyperglycemic, and the value of 245 +/- 27 mg/dl at 2 p.m. was about three times greater than in normal individuals. Plasma insulin concentrations also fell progressively from 10 to 2 p.m., and were similar in both groups throughout most of the 16-h study period. Thus, the progressive decline in Ra in patients with NIDDM occurred despite concomitant falls in both plasma glucose and insulin concentration. Glucose disposal rates also fell progressively in both groups, but the magnitude of the fall was greater in patients with NIDDM. Consequently, Rd in patients with NIDDM was higher at 10 p.m. (3.97 +/- 0.48 vs. 3.25 +/- 0.13 mg/kg per min, P less than 0.001) and lower the following day at 2 p.m. (1.64 +/- 0.21 vs. 1.97 +/- 0.35 mg/kg per min, P less than 0.01). These results indicate that a greatly expanded pool size can exist in patients with NIDDM at a time when values for Ra are identical to those in normal subjects studied under comparable conditions, which suggests that fasting hyperglycemia in NIDDM is not simply a function of an increase in Ra. PMID- 3292585 TI - Hemopoietic colony growth-promoting activities in the plasma of bone marrow transplant recipients. AB - Plasma samples were obtained from 34 bone marrow transplant (BMT) recipients before and after administration of the preparative regimen and tested for their ability to promote and/or support growth of hemopoietic colonies. The ability of plasma samples to promote colony formation on their own was tested on normal nonadherent target cells without addition of exogenous growth factors. The growth supporting activity was examined in the presence of medium conditioned by phytohemagglutinin-stimulated leukocytes (PHA-LCM) and/or erythropoietin (EPO). A series of kinetic changes was routinely observed. Pretransplant samples rarely gave rise to colonies without addition of exogenous growth factors. Plasma samples obtained after completion of the preparative regimen demonstrated increments of growth-promoting activities for megakaryocyte and granulocyte macrophage progenitors (CFU-Meg and CFU-GM), respectively, that peaked between 7 and 21 d after transplantation. By day 30, activity levels of some patients had returned to pretransplant values, whereas in other patients, activities remained elevated. Persisting activity levels were associated with delayed engraftment. In contrast, activities for progenitors committed to erythropoiesis (BFU-E) and pluripotent precursors (CFU-GEMM) were only rarely observed. The activities were independent of febrile episodes. Their growth-promoting influence on CFU-GM could be neutralized completely by anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) antibodies. These data suggest that at least some of the observed activities in post-BMT plasma are related to GM-CSF. The growth-supporting activities of pretransplant plasma samples are lower than normal plasma when tested on CFU-Meg and CFU-GM. The growth-supporting activities improved transiently within the first month after BMT. A decline during the second and third month was followed by a gradual return to activity levels that were comparable to normal plasma. The effects of these plasma samples on BFU-E and CFU GEMM were assessed with PHA-LCM and EPO. Similar to CFU-Meg- and CFU-GM supporting capabilities, they improved transiently after BMT with a return of normal support function after 5-6 mo. The observed endogenous production of growth-promoting and growth-supporting activities for hemopoietic progenitors may serve as a background to design clinical trials for the timely administration of recombinant hemopoietic growth factors to BMT recipients. PMID- 3292586 TI - Diurnal changes in sympathetic activity. Relation to food intake and to insulin injected into the ventromedial or suprachiasmatic nucleus. AB - The present study was designed to test whether there are diurnal changes in the firing rate of sympathetic nerves to brown adipose tissue and whether these diurnal rhythms influenced the response to insulin injected into the suprachiasmatic nucleus or ventromedial hypothalamic nucleus (VMH). Food intake was highest at the beginning of the dark period (1800-2200 hours) and lowest during the daylight hours (0600-1000 and 1200-1600 hours). The basal sympathetic firing rate was highest at noon (1000-1200 hours) when food intake was lowest. At midnight, when food intake was highest, sympathetic firing rate was lowest. Injection of insulin (77, 144, and 288 pmol) into the VMH produced a dose dependent depression of sympathetic firing rate at each of the four measurement periods (0400-0600 hours, 1000-1200 hours, 1600-1800 hours, and 2200-2400 hours), but the magnitude of the effect was greater at noon than at night. In contrast, insulin injections into the suprachiasmatic nucleus decreased the sympathetic firing rate at noon but produced a significant increase in the sympathetic firing rate at night. These data show that a diurnal rhythm exists for the sympathetic firing rate. The decrease in firing rate in response to insulin when injected into the VMH is in the same direction but varies in magnitude throughout the day, whereas the responsiveness of the suprachiasmatic nucleus to injections of insulin shows a reversal of response in relation to day/night cycles. The highly significant inverse relationship between basal sympathetic firing rate and food intake suggests that sympathetic activity may be part of an important control system for energy balance. PMID- 3292587 TI - Effects of nonesterified fatty acid availability on tissue-specific glucose utilization in rats in vivo. AB - The pathophysiological significance of the glucose-fatty acid cycle in skeletal muscle in vivo is uncertain. We have examined the short term effects of increased availability of nonesterified FFA on tissue-specific glucose uptake and storage in rat tissues in vivo basally and during a hyperinsulinemic (150 mU/liter) euglycemic clamp. Circulating FFA were elevated to 2 mmol/liter (FFA 1) or 4 mmol/liter (FFA 2). Elevated FFA produced a dose-dependent inhibition of myocardial glucose utilization in both basal (FFA1, 42%; FFA2, 68%; P less than 0.001, by analysis of variance) and clamp groups (FFA1, 39%; FFA2, 49%; P less than 0.001) and also suppressed brown adipose tissue glucose utilization during the clamp (-42%, P less than 0.001). In contrast to heart, glucose utilization in skeletal muscle was suppressed by FFA only in the FFA1 basal group (-36%, P less than 0.001); in other groups (e.g., FFA2 clamp) elevated FFA produced increased skeletal muscle glucose utilization (+68%, P less than 0.001) that was directed toward glycogen (+175%, P less than 0.05) and lipid deposition (+125%, P less than 0.005). FFA stimulated basal glucose utilization in white (e.g., FFA2, +220%, P less than 0.005) and brown adipose tissue (e.g., FFA2, +200%, P less than 0.005). Thus elevated FFA can acutely inhibit glucose utilization in skeletal muscle in addition to cardiac muscle in vivo supporting a possible role for the glucose-fatty acid cycle in skeletal muscle in acute insulin resistance. However, at high levels or with elevated insulin, FFA stimulates glucose utilization and storage in skeletal muscle. By promoting accumulation of glucose storage products, chronic elevation of FFA may lead to skeletal muscle (and therefore whole body) insulin resistance. PMID- 3292588 TI - Erythropoietin stimulates a rise in intracellular free calcium concentration in single early human erythroid precursors. AB - Erythropoietin and granulocyte-macrophage colony-stimulating factor (GM-CSF) stimulate the differentiation and proliferation of erythroid cells. To determine the cellular mechanism of action of these growth factors, we measured changes in intracellular free calcium concentration [( Cac]) in single human erythroid precursors in response to recombinant erythropoietin and GM-CSF. [Cac] in immature erythroblasts derived from cultured human cord blood erythroid progenitors was measured with fluorescence microscopy digital video imaging. When stimulated with erythropoietin, [Cac] in the majority of erythroblasts increased within 3 min, peaked at 5 min, and returned toward baseline at 10 min. The percentage of cells that responded to erythropoietin stimulation increased in a dose-dependent manner. Additional stimulation with GM-CSF in cells previously exposed to erythropoietin resulted in a second [Cac] increase. Immature erythroblasts treated with GM-CSF followed by erythropoietin responded similarly to each factor with a rise in [Cac]. The source of transient calcium is intracellular since erythroblasts were incubated in medium devoid of extracellular calcium. Our observations suggest that changes in [Cac] may be an intracellular signal that mediates the proliferative/differentiating effect of hematopoietic growth factors. PMID- 3292590 TI - The regulated-breathing method for stuttering: an experimental evaluation. AB - The regulated-breathing method of Azrin and Nunn (1974) appears to be one of the most promising treatments of stuttering in adults. Their study, however, has some methodological limitations. In particular no operational definition of stuttering is provided, and all measures of stuttering are based on self-report. The present study is an experimental evaluation of the regulated-breathing method. Thirty-two subjects were randomly assigned either to treatment or to a waiting-list control group. The treatment was completed during one single session of 2-3 hours. Both frequency of stuttering and rate of speech were measured before and after treatment, and on follow-ups 2, 3 and 8 months later. The dependent variables were assessed under conditions of both phrase reading and spontaneous speech. Both obtrusive and unobtrusive measures of speech were recorded. At the 8 month follow-up, stuttering in the treatment group was significantly less than in the control group, and also significantly less than before treatment. PMID- 3292591 TI - Substituting behavioural treatment for drugs in the treatment of insomnia: an exploratory study. AB - There is need to investigate directly the generalizability of psychological treatment effects to clinical populations of insomniacs; especially to those who are chronic hypnotic users and are drug-dependent. This paper present two methodological models, based upon the pharmacological literature, which permit the selection of such subjects for research studies. The usefulness of the models is discussed with reference to a preliminary investigation based on 10 cases, and recommendations are made both for further research and clinical practice. PMID- 3292589 TI - Effects of nonketotic streptozotocin diabetes on apolipoprotein B synthesis and secretion by primary cultures of rat hepatocytes. AB - The effects of hypoinsulinemic nonketotic streptozotocin diabetes on hepatic apo B synthesis and secretion was studied in primary cultures of rat hepatocytes. Diabetic rats were characterized by their significantly elevated serum glucose, apo B, and triglyceride levels, while serum insulin levels were less than a third of normal. Serum transminase activities of diabetic rats were significantly elevated when compared with control rats, which was attributed to an increase in liver transaminase activity in diabetic rats. The pattern of enzyme activities of hepatocytes reflected that observed in livers of donor rats and the pattern was retained by primary cultures of hepatocytes over the culture period. Hepatocytes from diabetic rats secreted only one third of the apo B secreted by hepatocytes from control rats, which was determined by monoclonal immunoassay of rat total apo B. Decreases in secretion were confirmed by measurement of secretory [35S]methionine-labeled lipoprotein apo B radioactivity. The decreased apo B content of media of hepatocytes from diabetic rats was not due to increased apo B catabolism since hepatocytes from diabetic rats were shown to degrade less lipoprotein-apo B than hepatocytes from normal rats in control experiments. In addition, the apo B content of detergent-solubilized hepatocytes from diabetic rats was significantly less than that of hepatocytes from control rats. These results suggest that insulin is necessary for normal hepatic apo B synthesis and secretion and that the hyperlipidemia associated with hypoinsulinemia in vivo is primarily of intestinal origin. PMID- 3292592 TI - Detection of high-risk groups and individuals for periodontal diseases. Evidence for the existence of high-risk groups and individuals and approaches to their detection. AB - It is argued that the periodontal diseases can no longer be regarded as universally prevalent conditions to which all members of the world's population are at equal risk if they fail to practise good oral hygiene. Rather, they should be regarded as a range of different diseases for each of which certain individuals, which together comprise certain minority groups, are at relatively high risk. The epidemiological evidence for the existence of high-risk groups is reviewed, from which it is concluded that world-wide the prevalence of severe destructive periodontitis is of the order of only 7-15% of the adult dentate population. A working classification of the different types of gingivitis and periodontitis is offered, as is a summary of the theoretically possible approaches to the detection of high-risk groups and individuals which are explored in detail in subsequent papers. Successful identification of such individuals will permit scientifically valid, rational and targetted prevention and treatment. PMID- 3292593 TI - Crevicular and salivary fibronectin before and after gingivitis treatment. AB - The aims of this study were to assess crevicular fibronectin concentrations before and after conventional gingivitis treatment and to determine whether fibronectin concentration in whole saliva would be affected concomitantly. 10 subjects with generalized gingivitis were selected. Examinations were made before and after treatment and included measurements of clinical parameters as well as collection of samples of unstimulated saliva, stimulated saliva and crevicular material. The concentration of fibronectin was studied by an ELISA assay. Fibronectin was found in gingival crevices and in unstimulated as well as paraffin-stimulated whole saliva in pre- and post-treatment samples. There were no statistically significant differences between pre- and post-treatment concentrations of fibronectin, whether expressed as micrograms fibronectin/micrograms protein or as micrograms fibronectin/ml saliva. PMID- 3292594 TI - Root surface debridement--an in vitro assessment. AB - Root planing has been advocated to render periodontally involved root surfaces 'biologically compatible' with the surrounding soft tissues and thus promote healing. However, recent work has shown that only small amounts of cytotoxic material are likely to be incorporated within the root surfaces, thereby questioning the rationale for the traditional emphasis that is placed upon the removal of 'diseased cementum'. This investigation assessed by limulus amoebocyte lysate (LAL) assay and Polymyxin B affinity chromatography the extent of residual lipopolysaccharide (LPS) following root surface instrumentation in vitro. A conservative regime was carried out, consisting of 15 instrument strokes per surface designed to ensure complete overlapping of the strokes. This harvested varying amounts of LPS from 18 single-rooted teeth while leaving behind less than 0.24 ng of LPS per tooth in the majority (72%) of cases. This finding endorses the growing belief that extensive root planing may not be warranted. PMID- 3292595 TI - The predominant cultivable microbiota of active and inactive lesions of destructive periodontal diseases. AB - Subgingival plaque samples were taken from active and inactive lesions in 33 subjects exhibiting active destructive periodontal diseases. Active diseased sites were those which showed a significant loss of attachment within a 2-month interval as computed by the "tolerance method". The predominant cultivable species from 100 active sites were compared with those found in 150 inactive sites of comparable pocket depth and attachment level loss. Among the 33 subjects, W. recta, B. intermedius, F. nucleatum, B. gingivalis and B. forsythus were elevated more often in active sites; whereas, S. mitis, C. ochracea, S. sanguis II, V. parvula and an unnamed Actinomyces sp. were elevated in inactive sites. The likelihood of a site being active was increased if B. forsythus, B. gingivalis, P. micros, A. actinomycetemcomitans, W. recta, or B. intermedius were detected in that site, and decreased if S. sanguis II, the Actinomyces sp., or C. ochracea were detected. PMID- 3292596 TI - Epoprostenol (prostacyclin) in unstable angina. AB - The purpose of this randomized, double-blind multicenter trial was to investigate the potential therapeutic effect of epoprostenol (prostacyclin, PGI2) in patients with unstable angina, as compared with placebo, and to investigate the safety of this agent. Of the 184 patients enrolled, 28 did not fit the study criteria; of the remaining 156 patients, 30 received prostacyclin in an open-label fashion. In the double-blind portion of the study, 63 patients each received prostacyclin or placebo. The drug or its vehicle was infused intravenously up to 5 ng/kg/min dose for 72 hours with a tapering off period for the last 12 hours. Both treatment groups from the double-blind portion were comparable in regard to the demographic data, length of infusion, and total dose received. There were no significant differences between the placebo and prostacyclin group in the following clinical endpoints: levels of cardiac enzymes throughout hospitalization period (with the exception of lower SGOT level in the prostacyclin group at day 2), and severity of angina (throughout the study), and at the end of the study (day 30). The number of patients who had congestive heart failure, new myocardial infarction, balloon pump insertion, coronary artery bypass grafting, or percutaneous coronary angioplasty was similar in both groups. Similar results in regard to the efficacy endpoints were also apparent in the prostacyclin group that was treated under open-label fashion. There was also no difference in the New York Heart Association (NYHA) functional status at the end of the double-blind study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292597 TI - Antihypertensive efficacy of cetamolol: a dose-titrated study. AB - This double-blind, placebo-controlled, randomized multicenter study evaluated the antihypertensive efficacy and safety of cetamolol hydrochloride in 108 patients diagnosed as having mild to moderate hypertension. After a placebo lead-in period, patients received either cetamolol 5-10-15 mg/d (low dose), cetamolol 15 25-50 mg/d (high dose), or placebo, once daily for four weeks. Patients began at the lowest dose and were titrated to higher doses based on the first two assessments of diastolic blood pressure and heart rate, which were conducted each week after double-blind treatment was dispensed. After four weeks of treatment 82.4%, 81.3%, and 93.3% of the low-dose group, high-dose group, and placebo group, respectively, were titrated to the maximum dose level. After four weeks of treatment and 24 hours since the patient's last dose, both cetamolol groups showed a significantly greater (P less than or equal to .05) reduction in supine systolic/diastolic blood pressure (-18.1 +/- 2.3/-9.2 +/- 1.5 mm Hg [low dose] and -17.3 +/- 2.3/-8.3 +/- 1.6 mm Hg [high dose]) than the placebo group (-9.9 +/ 2.5/-3.5 +/- 1.7 mm Hg). In general, the changes in standing (stabilized) systolic and diastolic blood pressure were similar to those seen in supine measurements. Significantly more patients receiving cetamolol than those receiving placebo showed a "good response" (a decrease in diastolic blood pressure of 10 mm Hg or more or measuring less than 90 mm Hg with a decrease of at least 4 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292599 TI - Basic concepts in pharmaco-dynamic modeling. PMID- 3292598 TI - Effects of chronic antihypertensive treatment with ketanserin versus metoprolol on blood pressure and large arteries' compliance in humans: a cross-over double blind study. AB - The antihypertensive efficacy of a serotonin-receptor antagonist, ketanserin, was compared with that of a well-established antihypertensive drug, metoprolol, and their cardiac and forearm hemodynamic effects were investigated using echocardiography and bidimensional pulsed Doppler flowmetry, respectively. Twenty hypertensive subjects completed a double-blind, cross-over, randomized study using ketanserin and metoprolol. Two 5-week courses with ketanserin or metoprolol were preceded by a placebo period; the total duration of the study was 15 weeks. Despite a comparable efficacy in reducing systolic and diastolic blood pressure (about 10% of the basal value), the two drugs showed quite different effects on forearm hemodynamics. Ketanserin increased forearm blood flow and induced a significant decrease in forearm vascular resistance (from 141 +/- 16 to 75 +/- 11 mm Hg/mL/sec, P less than .01). Furthermore, this treatment was able to improve brachial artery compliance (from 1.89 +/- .3 to 3.2 +/- .3 cm4/dyne 10(-7), P less than .01). On the contrary, metoprolol did not modify forearm hemodynamics. Both drugs did not significantly modify cardiac performance, as evaluated by left ventricle circumferential fiber shortening. Cardiac output was increased by ketanserin (from 5.9 +/- .3 to 6.6 +/- .5 L/min, P less than .05) and fell during treatment with metoprolol (from 5.9 +/- .4 to 4.9 +/- .3 L/min P less than .01). Thus, the two drugs reduce blood pressure through different hemodynamic mechanisms and the effects of ketanserin on systemic and peripheral circulation seem more favorable. PMID- 3292600 TI - Anorectic drugs: drug policy making at the state level. AB - This study outlines the attempts of four states (Louisiana, Kansas, Wisconsin, and Michigan) to restrict anorectic prescriptions. The actions in these four states exemplify the various mechanisms used in regulating anorectics, ranging from educational efforts to legislative enactments. We examine the evidence used in promulgating these policies and review some of the current literature on the safety and efficacy of anorectics. Despite the existence of evidence demonstrating the safety and efficacy of anorectics, the states seem to be moving toward more severe restrictions, in contrast to the federal regulatory agencies. PMID- 3292601 TI - Superactivated charcoal versus cholestyramine for cholesterol lowering: a randomized cross-over trial. AB - To evaluate the relative abilities of superactivated charcoal (20 g twice daily) and cholestyramine (8 g twice daily) to lower plasma cholesterol concentrations acutely, six hypercholesterolemic patients were studied using a randomized cross over design. After a 1-week dietary control period, each subject received 3 weeks of each treatment regimen on separate occasions. Superactivated charcoal and cholestyramine reduced total plasma cholesterol by 21.8 +/- 3.8% and 16.2 +/- 2.4%, respectively. Side effects were mild and similar for both treatments. At the dosage regimens studied, superactivated charcoal and cholestyramine have comparable ability to lower plasma cholesterol concentrations. PMID- 3292602 TI - The development of studies on the determinants of bacterial pathogenicity. PMID- 3292603 TI - Veterinary neurology--past, present and future. PMID- 3292604 TI - Focal lesions of the spleen: preliminary results with fast MR imaging at 1.5 T. AB - Sixteen patients with splenic lymphoma and six with nonlymphomatous splenic lesions underwent magnetic resonance (MR) imaging, ultrasound (US), and dynamic CT. All patients were studied at 1.5 T with gradient echo sequences using a repetition time of 80 ms, echo time of 16 ms, and two pulse angles of 30 and 60 degrees. In 14 patients with lymphomatous lesions fast MR showed circumscribed areas of low signal intensity at both pulse angles. The lesion-to-spleen contrast was better on images acquired with a pulse angle of 30 degrees. For fast MR with pulse angles of 30 degrees, the mean lesion-to-spleen contrast was similar to US and contrast-enhanced CT. However, with fast MR the contrast showed a lower variability and was considerably better than with unenhanced CT. In one patient fast MR showed splenic involvement that was missed on both CT and US. The signal characteristics of lymphomatous, leukemic, and sarcoid involvement and of healed infarcts were similar and indistinguishable on fast MR images. Recent splenic infarctions (three cases) were, however, distinctly different, characterized by regions of high signal intensity at both pulse angles. The results of this preliminary study suggest that fast MR imaging is a promising diagnostic tool for the assessment of splenic disorders. PMID- 3292605 TI - Multilevel thoracic disk herniations: CT and MR studies. AB - Thoracic disk herniation is a disorder that can present clinically perplexing problems for physicians. The true incidence of thoracic disk herniation is difficult to assess with various authors reporting an incidence ranging between 0.15 and 1.8% of all disk herniations. Multiple thoracic disk herniations are rare and, to the best of our knowledge, have received little attention in the orthopedic, neurosurgical, and radiological literature. A retrospective review of 680 myelograms performed at our institution was carried out and only three cases of multilevel thoracic disk herniations were found. We analyze these cases, discuss the relative value of the imaging modalities used in their diagnosis, and review the literature dealing with this interesting disorder. PMID- 3292606 TI - Angiomyolipoma of the liver: CT, MR, and ultrasound imaging. PMID- 3292607 TI - Myelolipoma of the liver: CT features. AB - A case of myelolipoma of the liver is reported. Computed tomography, ultrasound, and angiography of the lesion is described and compared with previous reports. PMID- 3292608 TI - CT characteristics of a hyperdense renal mass due to Richter syndrome. AB - A case of Richter syndrome (histiocytic lymphoma or Hodgkin disease complicating chronic lymphocytic leukemia) presented as a hyperdense renal mass on CT. PMID- 3292609 TI - A multi-valved milking machine cluster to control intramammary infection in dairy cows. AB - A milking machine claw incorporating valves to prevent movement of milk between teats during milking, and its contribution to the prevention of udder infection under experimental and field conditions, is described. Under experimental conditions a suspension of Streptococcus agalactiae and Str. dysgalactiae was introduced into the milking cluster during milking; 11 of 40 quarters became infected using a conventional claw piece whereas none of 40 quarters milked with the multi-valve claw developed intramammary infection. In a 12-month experiment in ten commercial herds, each split into two equal susceptibility groups, the multi-valved cluster reduced the incidence of new infection with coliforms and Str. uberis by 17% (P less than 0.1). The incidence of all new infections and new clinical cases was 14 and 25% lower compared to conventional clusters but these reductions were not significant. PMID- 3292610 TI - Changes in blastogenic activity of bovine blood mononuclear cells throughout the nonlactating period. AB - Mononuclear cells were isolated from bovine blood by density gradient centrifugation to determine variation in mitogen-induced mononuclear cell activity throughout the nonlactating period. In a preliminary study, optimum concentrations of Concanavalin A, phytohemagglutinin, Salmonella typhimurium lipopolysaccharide, and three Escherichia coli lipopolysaccharides were determined using six cows as blood donors. Concanavalin A, phytohemagglutinin, and E. coli 0111:B4 lipopolysaccharide were selected for further studies. Mitogenic responses of blood mononuclear cells from five cows were evaluated at drying off, 14 to 16 and 28 to 30 d of involution, 12 to 14 d prepartum, and at parturition. Concanavalin A-treated cells exhibited greater blastogenic activity than phytohemagglutinin-treated cells. Response of cells to Concanavalin A increased slightly through 28 to 30 d of involution and decreased markedly at parturition. Blastogenic activity of cells treated with phytohemagglutinin decreased throughout the nonlactating period and was lowest at parturition. Activity of lipopolysaccharide-treated mononuclear cells increased through 28 to 30 d of involution. However, response of mononuclear cells to lipopolysaccharide was minimal compared with response to Concanavalin A and phytohemagglutinin. Variation in peripheral blood mononuclear cell activity throughout involution may parallel mammary gland mononuclear cell activity, affecting susceptibility of the mammary gland to new intramammary infections. PMID- 3292611 TI - The single-pedicle retroauricular advancement flap. AB - The single-pedicle retroauricular advancement flap is very useful for defects of the posterior ear surface and along the helical rim. Design elements are simple, vascular support excellent, and the aesthetic reconstruction of involved areas highly acceptable. Several cases are demonstrated photographically along with appropriate commentary. PMID- 3292612 TI - One variety of a long, nondelayed temporo-parieto-occipital flap. AB - A design of a very long temporo-parieto-occipital flap that can be transposed nondelayed and in local anesthesia is presented. The benefits of such a flap are presented and discussed. PMID- 3292613 TI - Pigmented Bowen's disease and review of 420 Bowen's disease lesions. AB - Pigmented Bowen's disease is rare. We report an unusual case of pigmented Bowen's disease of the ring finger, which clinically presented as a superficial, spreading melanoma. Records of 420 lesions of Bowen's disease were reviewed; 7 lesions (1.67%) were pigmented and all occurred outside the anogenital area. We conclude that Bowen's disease should be considered in the differential diagnosis of pigmented lesions. PMID- 3292614 TI - Zosteriform metastasis: case presentation and review of the literature. AB - In contrast to benign tumors, malignant tumors, by definition, are characterized by the potential of giving rise to metastases. Albeit infrequently, skin metastases do occur, and their clinical appearance varies over a wide morphologic spectrum. We present the case of a 65-year-old male with zosteriform metastasis secondary to bronchogenic adenocarcinoma. A review of cutaneous metastasis is presented with emphasis on dermatomal distribution and possible mechanisms of dissemination. PMID- 3292615 TI - Report of a multicenter clinical trial of the performance characteristics of two occlusive hydrocolloid dressings in the treatment of noninfected partial thickness wounds. PMID- 3292616 TI - Fractionation of epidermal keratinocytes by counterflow centrifugal elutriation (CCE). PMID- 3292617 TI - Depigmenting potency of hydroquinone fatty acid esters on the skin. PMID- 3292618 TI - Comparison of serum gastrin levels during topical and systemic administration of corticosteroids. PMID- 3292619 TI - Sebaceous carcinoma--with special reference to histopathologic differential diagnosis. PMID- 3292620 TI - Grouping prurigo. PMID- 3292621 TI - Combination of photochemotherapy (PUVA) and ultraviolet B (UVB) in the treatment of psoriasis vulgaris. PMID- 3292622 TI - The presidents. Frank F. Shuler 1976-1977. PMID- 3292623 TI - National Institute of Dental Research: 40 years of progress. PMID- 3292624 TI - The growing practice. PMID- 3292626 TI - Dentistry on stamps. PMID- 3292625 TI - Oral manifestations of AIDS: a study of 84 patients. AB - Early diagnosis of AIDS is vital in providing appropriate referral for medical care and counseling. Subtle intraoral signs and symptoms identified by the dental practitioner can aid in the diagnosis of the disease. Because the role of the practitioner in detection and treatment of AIDS patients is becoming greater, signs found in 84 patients are described. PMID- 3292627 TI - Pain as a learned response: a review of behavioral factors in chronic pain. AB - This review of the literature on pain behavior suggests that learning factors may have a critical role in shaping an individual's response to pain. Understanding these pain behaviors becomes especially helpful in diagnosis and treatment of patients with chronic pain. PMID- 3292628 TI - Dentistry on stamps (Anders Sandvig). PMID- 3292629 TI - Accelerated coronary vascular disease in the heart transplant patient: coronary arteriographic findings. AB - Annual coronary arteriograms have been obtained from all heart transplant recipients at Stanford University Medical Center since 1969. Angiographic lesions in 81 transplant patients exhibiting coronary vascular disease were classified into three categories: type A, discrete or tubular stenoses; type B, diffuse concentric narrowing; and type C, narrowed irregular vessels with occluded branches. The 81 arteriograms showing transplant coronary vascular disease were contrasted with 32 from nontransplant patients with coronary artery disease analyzed in a similar fashion. The nontransplant angiograms showed 178 lesions, all of type A (discrete or tubular) morphology, 75% of which were located in primary epicardial coronary vessels and 25% in secondary branch vessels. In the patients with transplant coronary vascular disease, 349 (76%) of 461 lesions were type A: 57% in primary vessels, 42% in secondary branches and 1.4% in tertiary branches. Of the 112 type B and C lesions (diffuse narrowing, tapering and obliteration), 25% were in primary vessels, 44% in secondary vessels and 31% in tertiary branches (p less than 0.05 for patients with transplant coronary vascular disease versus patients with nontransplant coronary artery disease). Total vessel occlusion was found in proximal or middle vessel segments in 96% and distally in 4% of patients with "ordinary" coronary artery disease versus 49% distally in patients with transplant coronary disease (p less than 0.002). In the presence of total vessel occlusion, collateral vessels were poor or absent in 92% of transplant versus 7% of nontransplant patients with coronary disease (p less than 0.002). Therefore, coronary artery disease in transplant patients represents a mixture of typical atheromatous lesions and unique transplant-related progressive distal obliterative disease that occurs without collateral vessel development. PMID- 3292630 TI - Prophylactic versus selective lidocaine for early ventricular arrhythmias of myocardial infarction. AB - A total of 333 patients arriving within 6 h of the onset of suspected or proven but uncomplicated myocardial infarction were randomized to treatment by either the prophylactic or the selective lidocaine strategy. Patients were monitored for 24 h. The major end points were sustained ventricular tachycardia or fibrillation and emergent adverse effects of lidocaine. There were four episodes of emergent adverse effects of lidocaine, all in patients treated by the prophylactic strategy (2.4%, p = NS). There were two episodes of nonagonal, sustained ventricular tachycardia or fibrillation, both in patients treated by the selective strategy (1.2%, p = NS). The difference between major end points was 1.2% in favor of the selective strategy (p = NS). There were significant differences in lesser ventricular arrhythmias and lesser lidocaine adverse effects but no difference in mortality rate (selective = 3%, prophylactic = 5%, p = NS). Potentially lethal ventricular arrhythmias occurred only in patients with myocardial infarction. Nonlethal but complex ventricular arrhythmias were rare in patients without infarction. However, toxicity occurred in patients with and without infarction. The major conclusion of this study is that there is no important overall advantage of either strategy for lidocaine use in such patients. The advantage of one is the risk of the other. The strategy used should be selected for individual patients, and the use of one strategy for all patients would seem inappropriate. PMID- 3292632 TI - Reply to an editorial concerning magnesium therapy in premature infants with apnea neonatorum. PMID- 3292631 TI - Franz Groedel, Bruno Kisch and the founding of the American College of Cardiology. PMID- 3292633 TI - Aluminum and bone disorders: with specific reference to aluminum contamination of infant nutrients. AB - Aluminum (Al) impairment of bone matrix formation and mineralization may be mediated by its direct effect on bone cells or indirectly by its effect on parathyroid hormone and calcium metabolism. Its toxic effects are proportional to tissue Al load. Al contamination of nutrients depends on the amount of Al present naturally in chemicals or from the manufacturing process. Intravenous calcium, phosphorus, and albumin solutions have high Al (greater than 500 micrograms/L), whereas crystalline amino acid, sterile water, and dextrose water have low Al (less than 50 micrograms/L) content. Enteral nutrients including human and whole cow milk have low Al, whereas highly processed infant formulas with multiple additives, such as soy formula, preterm infant formula, and formulas for specific disorders are heavily contaminated with Al. Healthy adults are in zero balance for Al. The gastrointestinal tract excludes greater than 95% of dietary Al, and kidney is the dominant organ for Al excretion. However, even with normal renal function, only 30-60% of an Al load from parenteral nutrition is excreted in the urine, resulting in tissue accumulation of Al. The risk for Al toxicity is greatest in infants with chronic renal insufficiency, recipients of long term parenteral nutrition, i.e., no gut barrier to Al loading, and preterm infants with low Al binding capacity. The rapid growth of the infant would theoretically potentiate Al toxicity in all infants, although the critical level of Al loading causing bone disorders is not known. To minimize tissue burden, Al content of infant nutrients should be similar to "background" levels, i.e., similar to whole milk (less than 50 micrograms/L). PMID- 3292634 TI - Prostaglandin D2 and histamine during the immediate and the late-phase components of allergic cutaneous responses. AB - With a skin blister technique in which the mediators generated by the trauma of forming the blister are allowed to subside, we have collected human interstitial skin fluid during the course of allergic reactions to ragweed, and measured levels of histamine and prostaglandin D2 (PGD2). Of 18 ragweed-allergic individuals tested, 11 developed both an immediate and a late-phase reaction (LPR) with fivefold-elevated levels of histamine (40 ng/ml) at 30 minutes and a peak level of PGD2 (6.5 ng/ml) later at 2 1/2 hours after ragweed challenge. The other seven allergic individuals had immediate reactions without an LPR lesion and demonstrated somewhat smaller elevations of histamine (25 ng/ml) but much lower levels of PGD2 (1.6 ng/ml; p less than 0.05). The time course of appearance of these mediators was identical in both groups of patients. The fluids from unchallenged blisters of allergic and nonallergic patients and the fluids of nonallergic patients challenged with ragweed had similar levels of histamine, at the lower limit of detection, and undetectable PGD2 levels. The peak levels of PGD2 in allergic individuals correlated with the size of the LPR lesion (p less than 0.05). These data suggest that the LPR involves the secondary elaboration of mediators different from mediators responsible for the immediate manifestations of the allergic skin reaction. PMID- 3292635 TI - Relative responsibility laws and the Medicaid law. PMID- 3292636 TI - Desmin distinguishes cultured fat-storing cells from myofibroblasts, smooth muscle cells and fibroblasts in the rat. AB - To differentiate cultured rat liver myofibroblasts, fat-storing cells, aortic smooth muscle cells and skin fibroblasts from each other, desmin and vimentin stainings were undertaken by indirect immunofluorescence using monoclonal antibodies. In myofibroblasts, the reaction with antibodies to vimentin was positive but that with antibodies to desmin was virtually negative. In primary cultures as well as subsequent passage of fat-storing cells, reactions with antibodies to both desmin and vimentin were positive. In primary culture of smooth muscle cells, both reactions were positive, but in the first passage, smooth muscle cells lost the reactivity with antibodies to desmin. Fibroblasts showed a positive reaction with antibodies to vimentin and a negative one with antibodies to desmin. Thus, immunohistochemistry of intermediate filaments allows for the differentiation between fat-storing cells, which are desmin- and vimentin positive, and myofibroblasts or fibroblasts, which are desmin-negative but vimentin-positive. Smooth muscle cells are also vimentin-positive and become desmin-negative after the first passage. PMID- 3292637 TI - Immunochemical characterization of anti-acetylcholine receptor antibodies in primary biliary cirrhosis. AB - Although the presence of anti-mitochondrial antibodies is the main characteristic of primary biliary cirrhosis (PBC), other autoantibodies have been described in this disease. This study employs immunoblot methods to test whether the sera of PBC patients also contain antibodies directed against nicotinic acetylcholine receptors (AChR). We show that the majority of patients' sera indeed react with AChR just as sera of myasthenic patients do. In contrast, however, these anti AChR antibodies do not lead to significant clinical symptoms of myasthenia. In all cases studied, PBC sera recognized a protein with the molecular weight of the alpha-chain of acetylcholine receptor (40 kDa). In addition, with both liver mitochondria and AChR-rich membranes as antigens, PBC sera reacted with proteins with apparent molecular weights around 68 kDa and the same pI values. This protein is not present in purified AChR preparations. These data suggest structural, if not functional, relationships between membrane components of liver mitochondria and muscle endplates. PMID- 3292639 TI - Antipyrine as a model drug to study hepatic drug-metabolizing capacity. PMID- 3292638 TI - Plasma lipid and lipoprotein response to carbohydrate feeding in cirrhotic patients. AB - Serum lipids and lipoproteins, and glucose and insulin, were measured after an overnight fast, and during 3 days of a eucaloric diet rich in carbohydrate, in 15 patients with cirrhosis and seven normal subjects. Following the high carbohydrate diet triglyceride rose in all groups but the increase in cirrhotics was lower than in normals. In normals and in cirrhotics with good liver function most of the triglyceride increment was carried in VLDL; in cirrhotics with poor liver function only 31% of the increment was found in VLDL, and 56% in triglyceride-rich LDL. In an earlier study on fat feeding, our cirrhotic patients with poor liver function had an impaired chylomicron and VLDL response; they also carried most of the triglyceride increment in triglyceride-rich LDL. The markedly impaired response of triglyceride-rich lipoproteins to both carbohydrate and fat feeding suggests that sick cirrhotics may have a problem with storage of dietary energy and that this contributes to loss of their adipose tissue. PMID- 3292640 TI - Cholesterol nucleation and gallstone formation. PMID- 3292641 TI - Selection for the inviability of sterile hybrids. AB - Complementary lethal, semilethal, and dwarfing genes whose effects appear to be expressed only in (usually sterile) interspecific hybrids are not uncommon in plants. Accounting for these genes by Darwinian selection has been somewhat puzzling. However, if luxuriant, sterile hybrid progeny compete with and tend to eliminate their pure-species half-sibs, genes that are detrimental to the growth and development of hybrid progeny will be favored by Darwinian selection; the selective advantage lies in the improved fertility of parental plants. This account, which deals largely with the corky gene of New World cotton species, contrasts events that may occur in plant and animal species. PMID- 3292642 TI - Demonstration of antigens at both sides of plasma membranes in one coincident electron microscopic image: a double-immunogold replica study of virus-infected cells. AB - We present here a procedure for obtaining high-resolution topographical information about the spatial distribution of antigens at both sides of isolated plasma membranes. HeLa cells grown on coverslips and infected with measles virus served as a model system. Virus glycoproteins appearing at the cell surface were demonstrated by tagging them with rabbit anti-measles antibodies and protein A gold probes. Cells were stabilized with tannic acid, covered with a cationized coverslip, and then split in potassium-containing buffer. Membranes adherent to the cationized coverslip were fixed in formaldehyde-glutaraldehyde and reacted with mouse monoclonal antibodies against various structural proteins of measles virus. Antibody binding sites at the cytoplasmic surface were visualized either by the antibody bridge method, using normal mouse Ig coupled to gold colloid of different sizes, or by the peroxidase-antiperoxidase procedure. After osmication and critical point-drying, the cytoplasmic surfaces were replicated by platinum carbon evaporation and examined by TEM without prior cleaning from biological material. This new method permits concomitant localization of antigens present at the inner and outer leaflets of the plasma membrane, and provides high-resolution information about the three-dimensional organization of the cytoplasmic surface. PMID- 3292643 TI - Monoclonal antibodies as probes for plasma membrane domains in the exocrine pancreas. AB - Monoclonal antibodies (mAb) were generated as probes for the plasma membrane domains of pancreatic acinar cells. Primary monolayer cultures of mouse pancreatic acinar cells, which have an expanded apical surface relative to normal pancreas, were used to immunize rats. With conventional immunization and fusion protocols, 3% of the hybridomas were positive against the acinar lumen by indirect immunofluorescence of mouse pancreas cryosections. Culturing of spleen cells from an immunized rat on the apical surface of acinar cell monolayer cultures before fusion with the myeloma (an in vitro boost) doubled the percentage of hybridomas producing apical membrane-specific mAb. Monoclonal antibodies were characterized by immunofluorescence, ultrastructural immunoperoxidase cytochemistry, immunoprecipitation, and immunoblotting. One antibody, acinar-1 (IgG2a), labeled the apical membranes of pancreatic acinar cells, hepatocytes, salivary and lacrimal gland acinar cells, and the brush border of small intestine enterocytes. This mAb precipitated and blotted a protein of 94 KD. Acinar-2 (IgM) also labeled pancreatic acinar cell apical membranes but did not label other tissues and did not precipitate or blot. Acinar 3 labeled pancreatic acinar cell lateral membranes. Duct-1 (IgM) labeled pancreatic duct apical membrane and ducts in liver and salivary glands but did not precipitate or blot. These domain-specific mAb demonstrate that common antigenic determinants occur in the apical surfaces of several exocrine epithelia and may be important in secretion. PMID- 3292644 TI - Localization of protein disulfide isomerase on plasma membranes of rat exocrine pancreatic cells. AB - We investigated immunocytochemically the ultrastructural localization of protein disulfide isomerase (PDI) in rat pancreatic exocrine cells by use of the post embedding protein A-gold technique. We found that not only the endoplasmic reticulum (ER) and nuclear envelope but also the trans-Golgi cisternae, secretory granules, and plasma membranes were heavily labeled with gold particles. Labeling density of the gold particles in the rough ER and plasma membranes of the exocrine pancreatic cells was twofold and twentyfold greater, respectively, than that of hepatocytes. In the acinar lumen, amorphous material presumably corresponding to the secreted zymogens was also labeled with gold particles. These results suggest that in rat exocrine pancreatic cells a significant amount of PDI is transported to the plasma membrane and secreted to the acinar lumen. PMID- 3292646 TI - Desmin immunoreactivity in pericapillary cells of rat. PMID- 3292645 TI - Multiple-reaction cycling: a method for enhancement of the immunochemical signal of monoclonal antibodies. AB - Most current studies using immunochemical and immunohistochemical procedures to detect antigen-antibody complexes employ some type of indirect method. Such procedures afford signal amplification because several marker-conjugate molecules can bind to each primary antibody molecule. We have observed that for monoclonal antibodies an even greater amplification can be afforded simply by performing two (or more) reaction cycles (i.e., primary antibody, secondary antibody-primary antibody, secondary antibody-etc). In the present report, we demonstrate the utility of this method for immunohistochemical (immunofluorescence) and immunochemical (ELISA: enzyme-linked immunosorbent assay) procedures employing well-characterized monoclonal antibodies directed against avian type IV (basement membrane) collagen. PMID- 3292647 TI - Immunocytochemical identification of bovine Langerhans cells by use of a monoclonal antibody directed against class II MHC antigens. AB - We undertook a study to develop a reliable light microscopic technique for identifying Langerhans cells (LC) in bovine epidermis. Monoclonal antibodies (MCA) detecting bovine class II MHC antigens were used in conjunction with an avidin-biotin-peroxidase complex (ABC) immunocytochemical staining method. The specificity of the MCA for LC was confirmed ultrastructurally by use of gold labeled second antibody. Epidermal sheets and epidermal single-cell suspensions examined by light microscopy confirm that bovine epidermal LC express class II antigens. Anti-bovine class II MCA is a dependable reagent for identification of LC in normal bovine epidermis. PMID- 3292648 TI - Correlation between immunochemical characteristics and immunohistochemical applicability of nine lines of monoclonal antibodies against rat brain glutaminase. AB - Nine lines of monoclonal IgM antibodies to rat brain glutaminase were produced from a mouse. The antibodies were named MAb-19, -21, -45, -48, -51, -55, -59, 97, and -120. Immunotitration tests revealed that six of the nine antibodies (MAb 19, -21, -45, -48, -97, and -120) absorbed dose-dependently more than 75% of glutaminase activity in rat brain. By immunoelectroblotting after gel electrophoresis of the homogenate, all antibodies showed a positive band at the same position as that of the purified enzyme. However, MAb-55, -59, and -97 crossreacted with other proteins. Despite the difference in their specificities, all of the antibodies except MAb-51 competed with one another for determinants on the enzyme. The competition test further indicated that the affinities of the antibodies were in the order MAb-120 greater than -21 greater than -48 greater than -19 not equal to -45 greater than or equal to -97 greater than or equal to 55 greater than or equal to 59. When applied to immunohistochemical staining of cerebral cortex of rat brain, the five specific antibodies (MAb-19, -21, -45, 48, and -120) produced essentially the same pattern of neuronal labeling; they labeled specifically pyramidal neurons, which are reportedly glutamatergic. The most intense labeling was obtained with MAb-120. PMID- 3292650 TI - Purification of murine IgG3 and IgM monoclonal antibodies by euglobulin precipitation. AB - We describe a simple and efficient non-chromatographic method for the purification of murine IgG3 and IgM monoclonal antibodies (MAbs) which takes advantage of their euglobulin properties. Following filtration, ascitic fluid is dialysed against demineralized water and centrifuged at 22,000 X g for 30 min. The resulting precipitate is dissolved in a high salt buffer (0.1 M Tris-HCl, 1 M NaCl, pH 8). A second cycle of dialysis and centrifugation yields a product of high purity. Nine IgG3 MAbs and eight IgM MAbs were purified by this procedure. Recovery was greater than 90% for seven of nine IgG3 MAbs. It was less reproducible for IgM MAbs and ranged from 40% to greater than 90% depending on antibody and batch. Purity was assessed by SDS-polyacrylamide gel electrophoresis. The purified immunoglobulin was essentially free of albumin, transferrin, and other mouse ascites proteins. No loss of antibody function was observed. PMID- 3292649 TI - Efficient inhibition of endogenous peroxidase without antigen denaturation in immunohistochemistry. AB - The immunoperoxidase technique is commonly used for the antigenic characterization of cells and tissues. However, the occurrence of endogenous peroxidase-positive cells frequently complicates such evaluations. In some instances it is impossible to distinguish between these cells and antibody stained cells. Methods so far described for inhibiting the endogenous peroxidase, are not always satisfactory - either the endogenous peroxidase is not satisfactorily blocked, or the cellular antigens lose their reactivity. A new two step method is described which involves transient inhibition of endogenous peroxidase by sodium azide and hydrogen peroxide and a final blocking of this enzyme by lowering the pH to 2.3, while antigens remain undamaged. This method may be of value in immunohistochemical studies of various tissues, especially inflammatory tissues which contain many endogenous peroxidase-positive cells. PMID- 3292651 TI - Rapid procedure for coupling protein antigens to red cells to be used in plaque assays, by prewashing in chromium chloride. AB - A rapid and efficient procedure is described for the coupling of proteins (protein A, ovalbumin, albumin and chicken gamma globulin) to sheep red blood cells (SRBC) to be used in antigen-specific or protein A plaque assays. This modification of the original procedure has three distinct features: prewash of the red cells with a low concentration of essentially freshly prepared CrCl3, use of a relatively high concentration of CrCl3 in the reaction mixture and a coupling time of only 4 min. Protein A plaque assays performed with such target cells have the same sensitivity as those employing red cells coupled with protein A according to the original procedure. Studies with hybridomas secreting antibody specific for a protein antigen showed that antigen-specific plaque assays employing target red cells coupled with the protein antigen according to the modified procedure have the same sensitivity as the protein A plaque assay. The modified procedure greatly facilitates cellular studies on antibody formation after immunization with protein antigens. PMID- 3292652 TI - Elucidation of non-parallel EIA curves. AB - Quantitative determinations by EIA can be only obtained by reverse regression when linear portions of sample and standard curves are parallel. However, analysis of complex biological fluids often yields sigmoid curves displaying lower slopes, thus invalidating any quantitative interpretation. We hypothesized that this phenomenon was due to a competition effect between the target (for example an antigen) and related molecules for the binding sites (for example a capture antibody) immobilized onto the solid phase. This has been confirmed experimentally using various target-to-competitor ratios and formulated as a mathematical model. The slope decrease in target detection was related to the proportion of competitor, not in a linear, but in an exponential manner. This mathematical model has been computerized and can be used to correct aberrant sample curves provided the relevant parameters have been previously determined in the same systems. PMID- 3292653 TI - [Conservative treatment with high anastomosis in duplications with lesions of the upper kidney pelvis]. AB - High anastomoses (ureteropyelic or uretero-ureteral) were performed in 14 patients for either ectopic ureter (7 cases) or uterocele (7 cases). This simple operation (one benign complication) allows conservation of a still functioning upper segment. In cases of ureterocele, aspiration of the latter eradicates it but the high operation does not treat the possibly associated reflux. Certain secondary operations are therefore necessary (2 of the 7 cases). Means for assessing upper segment function (particularly renal scan) are discussed, the presence of function justifying the conservation of this segment even if it is dysgentic and sometimes the site of nodular renal blastema. The respective indications for high anastomosis and total bladder surgery are discussed. PMID- 3292654 TI - [Role of direct transcutaneous puncture cytology in the diagnosis of adrenal metastases of urological cancers]. AB - The authors present their technique for the demonstration of adrenal metastases of urological cancers by direct percutaneous aspiration biopsy of the adrenal glands under ultrasound or CT control. Aspiration cytology appears to be a safe and reliable technique. The authors were surprised by the frequency of these metastases as, out of the 11 adrenal aspirations, cytology confirmed the diagnosis of metastasis in 9 cases. PMID- 3292655 TI - [Malignant non-functioning adrenal cortex carcinoma. Apropos of a case]. AB - A rare case of non-functional carcinoma of adrenal cortex is reported. After a review of the relevant literature, clinical characteristics and diagnostic methods are discussed and surgical treatment and chemotherapy prescribed in this case outlined. Based on personal experience, limitations of diagnostic imaging technics are presented and the importance of conventional radiologic investigations (urography and selective arteriography) re-evaluated, while emphasizing the reciprocal complementarity of all these methods for exploration of retroperitoneal lesions. PMID- 3292657 TI - Bladder augmentation in the pediatric age group. AB - In summary, enterocystoplasty has become an effective, safe and very useful addition to management of vesical dysfunction in children. The use of bladder augmentation has become more universally accepted with the recognition of the safety of clean intermittent catheterization and the development of efficient antireflux mechanisms when ureteral reimplantation into the bowel is required. However, the surgeon who wishes to participate in this endeavor must have a solid foundation and understanding of vesical urodynamics and must be committed to offering these children an ongoing program to manage their life-long problems associated with their primary disease as well as the special need associated with augmentation procedures. PMID- 3292656 TI - [Renal hemangiopericytoma. Review of the literature apropos of a case]. AB - Regard to a new case of renal hemangiopericytoma, the authors have reviewed the literature, in order to specify the main features of this uncommon entity. Because of the lack of correlation between the clinical behavior and the histologic pattern, hemangiopericytomas should be treated as potential low grade malignancies and followed carefully. Surgery seems to be actually the only form of treatment to propose. PMID- 3292658 TI - What price success? The continuing saga of the toxic:therapeutic ratio in the use of aminoglycoside antibiotics. PMID- 3292659 TI - Internalization of Escherichia coli into human renal tubular epithelial cells. PMID- 3292661 TI - The Eagle effect revisited: efficacy of clindamycin, erythromycin, and penicillin in the treatment of streptococcal myositis. AB - We investigated the relative efficacies of penicillin, clindamycin, and erythromycin in a mouse model of myositis due to Streptococcus pyogenes. Penicillin was ineffective unless given at the time of bacterial injection, and treatment delays of 2 h reduced its efficacy such that survival was no better than that of untreated control animals (P less than .05). Survival of erythromycin-treated mice was greater than that of both penicillin-treated mice and untreated controls, but only if treatment was begun within 2 h. Mice receiving clindamycin, however, had survival rates of 100%, 100%, 80%, and 70% even if treatment was delayed 0, 2, 6, and 16.5 h, respectively. Thus, clindamycin demonstrated superior efficacy to penicillin among all the various treatment groups (P less than .05). Our results corroborate the failure of penicillin in this model of streptococcal infection and suggest that, unlike penicillin, the efficacy of clindamycin is not adversely altered by the "Eagle effect." PMID- 3292660 TI - Use of DNA probes and HEp-2 cell adherence assay to detect diarrheagenic Escherichia coli. PMID- 3292662 TI - Early syphilitic hepatitis after renal transplantation. PMID- 3292663 TI - Varicella mimicking a vesiculobullous sun eruption. PMID- 3292664 TI - Actinomycetoma of the hand caused by Nocardia asteroides. PMID- 3292665 TI - Bacterial attachment and inflammation in the urinary tract. AB - The mechanism whereby attachment enhances Escherichia coli virulence in the urinary tract was studied by a detailed analysis of the host response to bacteriuria. Episodes of bacteriuria in 1473 children were followed prospectively from 1970 to 1984. To study the inflammatory response to the bacteriuric epidoses, we recorded body temperature, C-reactive protein, microsedimentation rate, urinary leukocyte count, and renal concentrating capacity. Bacterial isolates from each episode were identified and saved, and the adhesive capacity of 2669 E. coli strains was defined by their binding to galactose alpha 1--- 4galactose beta-containing receptors. Inflammatory response was significantly higher and renal concentrating capacity significantly lower during episodes caused by attaching strains. There was a linear relation between the number of indicators of inflammation and the proportion of galactose alpha 1----4galactose beta-binding strains present. Vesicoureteric reflux potentiated the inflammatory response. Attaching strains of E. coli thus appeared to be more capable of causing inflammation than were other bacteria. The potentiating effect of attachment on inflammation explains the over-representation of galactose alpha 1- --4galactose beta-recognizing bacteria in patients with acute pyelonephritis. PMID- 3292666 TI - Fibronectin-cleaving activity in bronchial secretions of patients with cystic fibrosis. AB - In cystic fibrosis, colonization of the airways with Pseudomonas aeruginosa follows colonization with Staphylococcus aureus and is related to accelerated deterioration of pulmonary function. Because P. aeruginosa adheres better to cell surfaces devoid of fibronectin, we searched for fibronectin-cleaving activity in bronchial secretions and saliva from 24 patients with cystic fibrosis who were followed up for 4.5 y and from two control groups. Proteolytic activity against 125I-labeled fibronectin was continuously present in cystic fibrosis bronchial secretions; significantly higher fibronectin-cleaving activity was found in older vs. younger patients, in patients with advanced disease stages determined by a five-stage scoring system, and in those colonized with P. aeruginosa. The fibronectin-cleaving activity was due to neutrophil elastase and cathepsin G. Cystic fibrosis bronchial secretions had proteolytic activity against surface fibronectin of airway mucosal cells. Thus fibronectin-cleaving activity of bronchial secretions rather than of saliva may favor P. aeruginosa colonization of the upper respiratory tract in individuals with cystic fibrosis. PMID- 3292667 TI - Perfusion analyses in advanced breast carcinoma during hyperthermia. AB - Blood flow in tumours and healthy tissue determines the ability of obtaining satisfactory temperature distributions in clinical hyperthermia, as well as the success of hyperthermia and radiation treatment. During the hyperthermia treatment, diagnostic data related to tissue blood flow can be determined by analysing the relationship between the amount of power absorbed in the tissue and the resulting temperature rise. The interpretation of the perfusion data (PERF) is highly complicated by the lack of an adequate theory to describe the heat transport in vascularized tissues. In vascularized breast tissues about 10 times as much power is needed to maintain therapeutic temperatures as is necessary in a stationary breast phantom. This large difference in maintenance power levels indicates the extreme importance of blood flow in tissue heat transport. PERF has been determined in 23 patients with advanced breast tumours. In this series (a) perfusion typically did not change during the stationary part of the individual hyperthermic sessions, (b) minimum tumour PERF was not related to tumour volume, and (c) there was no relation between tumour PERF and the ability to heat tumours. PERF can both increase and decrease after successful hyperthermia. PMID- 3292669 TI - New culture tube with an inside wall devised for studies of short-term hyperthermia. AB - We devised a new kind of culture tube with which a cell suspension could be warmed through both the inside and outside walls. Use of this tube makes it possible to measure the effects of short-term hyperthermia more accurately than with the conventional tubes, which is heated through the outside wall only. Temperature curves rose significantly faster in the double-walled tube than in the conventional one. The accelerated heating efficiency of the new tube was also seen by the enhanced inhibition of [3H]thymidine incorporation into the DNA of Ehrlich ascites tumour cells grown in these tubes at the same final temperature as in a conventional tube. PMID- 3292668 TI - Effect of irradiation on thermal sensitivity of bone marrow progenitors. AB - The heat sensitivity of murine CFU-GM and CFU-E following 2.5 Gy of total body irradiation (TBI) was studied. C3H f/Sed female mice were treated with 2.5 Gy TBI and femoral bone marrow was heated in vitro at 43 degrees C. CFU-GM show heat radiosensitization when bone marrow was heated immediately following irradiation. There was a brief decline in heat and radiation interaction when cells were heated 3 hours following 2.5 Gy of TBI, but heat radiosensitization returned to its maximum from 1 to 2 days following irradiation and remained significantly different from the control on days 5 and 7 following irradiation. The heat and radiation interaction disappeared by 30 days. CFU-E shows significant heat radiosensitization only on day 2 following 2.5 Gy of TBI. Total nucleated cells per femur showed a decrease by 70 per cent in days 1 to 2 following TBI, recovered to control values by day 5, and did not correlate with the changes in heat radiosensitization. Cell cycle analysis of CFU-GM using hydroxyurea showed no significant changes in cell cycle parameters on days 1 and 2 following 2.5 Gy, when maximum heat sensitization was observed. It is concluded that bone marrow progenitors may respond in a different way from other normal tissues to heat and irradiation sequencing, and that these differences must be considered when designing clinical trials. PMID- 3292670 TI - [The functional significance of the carbohydrate moiety of plasma glycoproteins]. PMID- 3292671 TI - [Active oxygens generated by photosensitization]. PMID- 3292674 TI - [Plasma concentration of estrogens and androgens in postmenopausal women with or without endometrial cancer]. AB - Plasma estrone (E1), 17 beta-estradiol (E2), delta 4-androstenedione (delta 4-A) and testosterone (T) levels in the peripheral vein were measured in 28 postmenopausal women with endometrial cancer and 19 control subjects without cancer matched to the cancer patients for age and weight. In the cancer patients, the mean +/- SD plasma E1, E2, delta 4-A and T levels were 53.0 +/- 29.0pg/ml, 31.3 +/- 28.9pg/ml, 1.92 +/- 0.96ng/ml and 0.71 +/- 0.24ng/ml, respectively. In the controls, the mean +/- SD plasma E1, E2, delta 4-A and T levels were 51.2 +/- 27.5pg/ml, 22.4 +/- 10.1 pg/ml, 1.70 +/- 0.6ng/ml and 0.84 +/- 0.24ng/ml, respectively. Similar concentrations were found in the control subjects. The correlation of each steroids with the percentage of ideal weight was examined. The percentage of ideal weight showed no correlation with E1, E2, delta 4-A and T in either group. Insulin response during glucose administration in the cancer patients was examined, and showed no correlation with each steroids. It was concluded that there is no differences between E1, E2, delta 4-A and T levels in cancer patients and control subjects matched to the cancer patients for age and weight. No correlation of insulin with ovarian steroid production was seen in the cancer patients. PMID- 3292676 TI - [Computer-aided perinatal monitoring system]. PMID- 3292675 TI - Effect of a traditional herbal medicine (shakuyaku-kanzo-to) on testosterone secretion in patients with polycystic ovary syndrome detected by ultrasound. AB - In 20 infertile Japanese with polycystic ovary syndrome Shakuyaku-Kanzo-To was used to lower plasma testosterone levels and hence to induce pregnancy. The polycystic ovary was classified into two types; general cystic and peripheral cystic patterns. Plasma testosterone was decreased in 18/20 (90%) and 5/20 (25%) became pregnant. The plasma testosterone concentration in the case of the general cystic pattern was significantly higher than that of peripheral cystic pattern, and the pregnancy rate in those with the general cystic pattern was lower. The efficacy of Shakuyaku-Kanzo-To therefore seems to vary according to the type of polycystic ovary syndrome treated. PMID- 3292672 TI - Studies of surface immunoglobulin-dependent B cell activation. AB - Studies from a number of laboratories have firmly established the potential of surface immunoglobulin-generated signals in B lymphocyte activation. While clearly there are multiple ways of activating B lymphocytes, some of which may not involve surface immunoglobulin, it is clear that crosslinking of surface immunoglobulin whether by antigen or antireceptor antibody can generate signals relevant to B cell activation. Although considerable insight into the mechanism of transduction of mIg-generated signals across the plasma membrane has been realized, a molecular explanation for linking inositol phospholipid hydrolysis to changes within the cytoplasm and nucleus of the B cell is still speculative. A more rigorous definition of the PKC and calcium components of the mIg signal transduction pathway are critical for a thorough understanding of the mechanism of signal transduction by this receptor. The use of tumor cell models allowing selection of mutants within the signalling pathway(s) will be invaluable to fully defining the critical molecular and biochemical events involved in B cell activation. PMID- 3292677 TI - [Incidence and location of synovitis in the metatarso-phalangeal joints of the fore and hindlimbs of rabbits immunized with Escherichia coli]. AB - Arthritis of the metatarso-phalangeal joints resembling rheumatoid arthritis was produced by immunization of rabbits with heat-killed Escherichia coli 0: 14. In all of fifteen rabbits immunized for 4 months, hyperplasia of synovial lining cells was observed: 108/240 joints, synovial edema in 15 rabbits: 126/240, lymphoid cell infiltration in 12: 110/240 and fibrinoid deposition in 15: 115/240. Inflammatory findings were induced in each of 14 rabbits immunized for 10 months, 14 rabbits: 113/224 joints, 14: 97/224, 12: 66/224, 14: 88/224 respectively. The lymphfollicle was noted in 7 joints of only one rabbit after 10 months immunization. Lymphoid cell infiltration of the perichondral synovium was observed in 13 joints of 11 rabbits after 4 month immunization and in 33 joints of 10 rabbits after 10 months immunization. The incidence of the inflammatory findings in the volar synovium was significantly higher than that in the dorsal one (p less than 0.01). PMID- 3292679 TI - Frank Billings (1854-1932). PMID- 3292678 TI - Insulin receptor tyrosine kinase activity is abnormal in circulating cells and cultured fibroblasts but normal in transformed lymphocytes from a type A insulin resistant patient. AB - The function of the insulin receptor subunits isolated from cells of a patient with the type A syndrome of insulin resistance was examined. Iodine 125-labeled insulin binding, insulin-stimulated phosphorylation of both endogenous and exogenous substrates, and internalization of 125I-insulin were evaluated. 125I insulin binding to intact peripheral monocytes and erythrocytes, cultured skin fibroblasts, and cultured Epstein-Barr virus-transformed lymphocytes, as well as to partially purified receptor preparations from these cells, was entirely normal. In contrast, the insulin-stimulated receptor autophosphorylation and tyrosine kinase activity of the partially purified monocyte, erythrocyte, and fibroblast receptor preparations were markedly diminished. Solubilized, lectin purified receptors from virally transformed cultured lymphocytes, however, demonstrated normal insulin-sensitive kinase activity. The patient's peripheral monocytes did not internalize 125I-insulin at 37 degrees C, but her transformed lymphocytes internalized it normally, as assessed by electron microscopic autoradiography. Our findings suggest that the discordance between the functions of the alpha-subunits and beta-subunits of the insulin receptor from monocytes of this insulin-resistant patient (Science 1984;223:932-4) extends to other freshly isolated cell types and persists in her cultured cells. Viral transformation of her cells results directly or indirectly in normal expression of the receptor kinase activity. Whether the defective kinase activity of the insulin receptor and the impaired receptor internalization exhibited by her monocytes ultimately cause the patient's insulin resistance awaits further studies. PMID- 3292673 TI - Recognition of multiple class II signals by murine T cell antigen receptors. Speculation regarding the relationships among autoreactive, antigen-specific and alloreactive T cells. PMID- 3292680 TI - Specific binding of Staphylococcus aureus to cultured porcine cardiac valvular endothelial cells. AB - Infective endocarditis usually occurs in patients who have had previous cardiac damage or who have congenitally abnormal hearts. However, this infection may afflict otherwise normal individuals, and it is often caused by Staphylococcus aureus. In these individuals, interactions between circulating microorganisms and resident cardiac endothelial cells may initiate the infection. In the present studies we established an assay to measure in vitro binding of S. aureus to porcine cardiac valve endothelial cells. We found that this interaction was specific and saturable with respect to time. In contrast, there was no specific binding of Escherichia coli, an organism that rarely causes endocarditis. Exogenous fibronectin had no effect on specific binding of S. aureus, and heat killed organisms adhered equally well as viable bacteria. Fixation of the endothelial cells with formalin abolished all specific binding. Soluble components from bacterial extracts inhibited S. aureus binding in dose-dependent fashion. These observations suggest that circulating S. aureus may interact with specific sites on cardiac endothelial cells, thereby potentially initiating infective endocarditis. PMID- 3292681 TI - Insulin action in insulin-dependent diabetes mellitus (type I): measurement during constant and changing insulin concentrations. AB - To test the hypothesis that insulin resistance in type I diabetes mellitus is characterized by a decrease in the rate as well as the amplitude of response to insulin, seven patients with diabetes mellitus and 12 subjects without diabetes were given an identical amount of insulin on two occasions: once as a primed constant and once as a variable eight-step infusion. On both occasions plasma glucose concentrations were maintained in the euglycemic range by means of an exogenous glucose infusion. The amplitude of stimulation of glucose utilization was decreased (p less than 0.05) in the type I patients compared with the subjects without diabetes during both a constant and a variable insulin infusion, whether measured as the peak (2.24 +/- 0.11 mg/kg/min vs 3.18; +/- 0.18 mg/kg/min constant and 2.80 +/- 0.30 mg/kg/min vs 3.54 +/- 0.23 mg/kg/min variable) or integrated response above basal (54 +/- 2 mg/kg vs 115 +/- 26 mg/kg constant and 60 +/- 26 mg/kg vs 147 +/- 21 mg/kg, variable). In addition, the rate of activation of glucose utilization (slope 0 to 90 minutes) was decreased (p less than 0.02) in the type I patients compared with subjects without diabetes during both the constant (0.003 +/- 0.001 mg/kg/min 2 vs 0.008 +/- 0.002 mg/kg/min 2) and variable (0.006 +/- 0.002 mg/kg/min 2 vs 0.015 +/- 0.002 mg/kg/min 2) insulin infusions. Insulin antibody binding did not correlate with the severity of insulin resistance. We conclude that insulin resistance in patients with insulin dependent diabetes mellitus is attributable to a decrease in both the rate and amplitude of response to insulin. PMID- 3292682 TI - Diabetes mellitus and insulin effect on glucose metabolism. PMID- 3292683 TI - The molecular biology of alcohol dehydrogenase: implications for the control of alcohol metabolism. PMID- 3292684 TI - Generation of neutrophil chemotactic activity by phorbol ester-stimulated calf pulmonary artery endothelial cells. AB - Chemotactic activity for human polymorphonuclear leukocytes (PMNL) was detected in serum-free conditioned media 1 to 4 hr after monolayers of calf pulmonary artery endothelial cells were pretreated with phorbol myristate acetate (PMA). Chemotactic activity was increased in conditioned media following pretreatment with either PMA or the less lipophilic active phorbol ester, 4-beta-phorbol-12,13 dibutyrate (P(Bu)2) in a dose-dependent manner. Chemotactic activity of conditioned media from PMA-treated endothelial cells was confirmed by checkerboard analysis. The chemotactic activity in conditioned media from PMA pretreated endothelial cells was completely inhibited by pretreating endothelial cells with either cycloheximide, actinomycin D, or the lipooxygenase inhibitor, diethylcarbamazine. Furthermore, the chemotactic activity was heat-stable, inhibited by trypsin treatment, and present in both aqueous and lipid phases after ether extraction. The data demonstrate that pulmonary artery endothelial cells exposed to active phorbol esters release potent chemotactic factor(s) for PMNL. These findings suggest a role for activators of protein kinase C in mediating endothelial cell release of chemotactic factor(s) that may be important in the directed migration of circulating leukocytes to sites of vascular injury. PMID- 3292685 TI - Cytokines induce an L-arginine-dependent effector system in nonmacrophage cells. AB - Treatment of EMT-6 mammary adenocarcinoma cells with gamma interferon (rMuIFN gamma) plus tumor necrosis factor (rMuTNF alpha) and/or interleukin-1 (rHuIL-1 alpha) causes release of iron-55 label, inhibition of DNA replication, and inhibition of aconitase activity. In addition, the same combinations of cytokines induce EMT-6 cells to synthesize L-citrulline, nitrite, and nitrate directly from L-arginine. Lipopolysaccharide (LPS) can act as a cofactor in the induction of these metabolic effects when added to EMT-6 cells in the presence of rMuIFN gamma. The results show that increased levels of cytokines in the microenvironment can induce a novel effector pathway in somatic cells not specialized for host defense, resulting in specific metabolic effects as well as the inhibition of cellular proliferation. PMID- 3292686 TI - Genetic factors affecting blood lipoproteins: the candidate gene approach. PMID- 3292687 TI - Urodynamic feedback therapies for retentive dysfunctions. AB - In the past decade a growing integration of behavioral and urological methods has produced a small quantitative literature of urodynamic biofeedback. This paper reviews reports of urodynamic retraining for retentive dysfunctions of the lower urinary tract. Cases are grouped according to types of feedback. The relative invasiveness of the various techniques are considered, and implications for conservative practitioners are suggested. The limitations of available data are detailed, and suggestions for future research are offered. PMID- 3292688 TI - Degenerative spondylolisthesis of C7 and L4 in same patient. AB - The incidence of a C7 spondylolisthesis has never been reported, and this paper shows the presence of C7 and L4 degenerative spondylolisthesis in a 66-yr-old female. No report of this combined problem has been reported. The clinical findings of the patient are given as well as treatment protocol. PMID- 3292689 TI - Popper-Kuhn debate: a consideration of some of the implications for the philosophy of science, and the chiropractic investigative community. PMID- 3292690 TI - Subclavian to carotid artery bypass for occlusion of the common carotid artery. A report of two cases and review. PMID- 3292691 TI - The atypical mycobacteria: five year hospital experience and review. PMID- 3292692 TI - Hyperparathyroidism and pregnancy. Case report and therapy update. PMID- 3292693 TI - Neonatal pneumococcal pneumonia. Case report and literature review. PMID- 3292695 TI - Variations in content of care in a family medicine residency relating to types of insurance coverage. AB - The content of care in a family practice residency program was analyzed using a microcomputer information system. The distribution of recorded diagnoses in the training program was found to be very similar to results of two national studies of family medicine. Despite this overall similarity, important differences were found when distributions for patients with six types of insurance coverages were analyzed separately. This study demonstrates the potential effect of insurance coverage on the clinical content of family medicine. As the health care system changes, residency programs will need to remain adaptable to maintain patient bases reflecting the broad content of family medicine. PMID- 3292694 TI - Gonadotrophin-releasing hormone secretion (GnRH) in anoestrous ewes and the induction of GnRH surges by oestrogen. AB - Anoestrous ewes were studied to determine the pattern of secretion of gonadotrophin-releasing hormone (GnRH) in the resting state and following a single i.m. injection of 50 micrograms oestradiol benzoate. In three out of four untreated ewes, two or three GnRH pulses were observed over a 6-h sampling period. In the fourth sheep the GnRH pulse frequency was higher (six pulses/6 h), but GnRH pulse amplitudes were lower. Following oestrogen treatment, GnRH pulses continued until the occurrence of an LH surge 12 h later. In five out of six sheep sampled during the oestrogen-induced LH surge a marked rise in GnRH secretion was seen. In the sixth ewe a large pulse of GnRH was seen at the start of the LH surge followed by increased GnRH secretion. It is concluded that GnRH pulse frequency is lower, generally, during anoestrus than during the mating season, and that oestrogen treatment of anoestrous ewes causes a surge in GnRH secretion unlike that seen in similarly treated ovariectomized ewes or the natural cyclic preovulatory changes in GnRH secretion. PMID- 3292696 TI - Medical management of pressure sores. AB - The pressure sore is a common clinical problem that is frequently seen by family physicians. Prevention is the best treatment, but once the condition occurs, adherence to several principles makes treatment easily standardized. These principles include improvement in the general health of the patient, relief of pressure, cleanliness, disinfection, and stimulation of granulation tissue. Any treatment regimen that is to be considered for use should achieve these goals. This article reviews the treatment options available and gives recommendations for the medical management of pressure sores based on these principles and the available data. PMID- 3292697 TI - Immune serum increases arenavirus replication in monocytes. AB - The U937 monocytic cell line was used to determine whether antibodies could facilitate infection and replication of the arenaviruses, Pichinde virus (PV) and Lassa fever virus (LFV). When high dilutions of PV-immune serum were added to cultures simultaneously with PV inoculum, virus replication was dramatically (1000-fold) increased. Low dilutions of this antiserum neutralized the virus. LFV also replicated in U937 cells. The presence of LFV-specific immune serum in the growth medium increased the viral titre as much as 10,000-fold. Addition of heat aggregated IgG partially inhibited antibody-mediated enhancement, probably by inhibiting the binding of immune complexes to the monocytic cells. PMID- 3292698 TI - Hepatitis B vaccine produced in yeast. AB - A gene encoding the 226 amino acid hepatitis B surface antigen (HBsAg), subtype adw, was cloned into a generalized vector for the expression of heterologous genes in Saccharomyces cerevisiae. The 5' end of the genomic HBsAg gene was replaced with a chemically synthesized DNA segment that conserved the amino acid sequence of the protein but utilized DNA sequences that optimize translation initiation in yeast. High-cell-density fermentations of laboratory strains of Saccharomyces cerevisiae have been developed in which HBsAg production increases linearly with respect to cell mass. The HBsAg is present as a lipoprotein particle in cell lysates and has been purified to homogeneity. The evidence presented indicates that the HBsAg particles may be formed during lysis of the yeast cells. The purified HBsAg particles have a morphology similar to that of the 22 nm particles present in the serum of human chronic carriers of hepatitis B. The reactivity of the yeast-derived HBsAg particles with a series of monoclonal antibodies is essentially identical to that of human plasma HBsAg. By this analysis, therefore, the structure of the HBsAg protein is similar in yeast and in human particles. The purified yeast HBsAg particles were formulated with alum adjuvant and subsequently were shown to confer immunity in chimpanzees to challenge with two heterologous serotypes (adr, ayw) of hepatitis B virus. PMID- 3292699 TI - A placebo-controlled dose response study of the reactogenicity and immunogenicity of a live cold-recombinant influenza B virus vaccine in healthy volunteers. AB - A live cold-recombinant influenza B virus vaccine (RB77) was given intranasally in a placebo-controlled, double blind study to volunteers in dosages of 10(7.9) EID50/ml, 10(7.25) EID50/ml, 10(5.7) EID50/ml. The tolerability, safety, and immunogenicity of the vaccine were investigated. No revertant virus was found in nasal swabs taken after immunisation. Local reactions were mild and showed a significant increase over the placebo only in the highest dose group. Systemic reactions were not different from the placebo. A significant increase in haemagglutinin inhibition titre was found in the highest dose group against the immunising strain (RB77) and the two wild strains B/TEC and B/Sing. PMID- 3292700 TI - Heart transplantation: the Louisiana experience. PMID- 3292701 TI - Surgical management of impotence: new modalities. PMID- 3292702 TI - Comparison of 125I-SCH 23982 and [3H]SCH 23390 as ligands for the D-1 dopamine receptor. AB - 125I-SCH 23982, an antagonist with high affinity and selectivity for the D-1 subtype of dopamine receptors, has recently been synthesized. Densities of D-1 receptors in rat brain obtained from autoradiographic studies using this iodinated ligand are 5- to 10-fold less than densities reported with tritiated analogues such as [3H]SCH 23390. A direct comparison of these two ligands using striatal homogenates confirmed this discrepancy. One explanation for this difference is that 125I-SCH 23982 labels a subset of the sites labeled by [3H]SCH 23390. However, the distributions of sites labeled by the ligands in autoradiograms of horizontal sections of rat brain were virtually identical. Furthermore, 127I-SCH 23982 displaced 100% of the specifically bound [3H]SCH 23390 in striatal homogenates with a Hill coefficient of approximately 1. These results are not consistent with the existence of a subset of receptors recognized by 125I-SCH 23982 and suggest that both ligands label the same population of receptors. An alternative explanation for the discrepancy in Bmax values is that an unlabeled inhibitor is present in commercial preparations of 125I-SCH 23982. When all of the solvent (including any volatile inhibitors) was removed from commercial preparations of 125I-SCH 23982 prior to use in radioligand binding experiments, the discrepancy in Bmax values was eliminated. PMID- 3292703 TI - Preparation and characterisation of a monoclonal antibody to an antigen enriched in chick brain postsynaptic densities. AB - The preparation and characterisation of a monoclonal antibody to an antigen enriched in day-old chick brain postsynaptic densities (PSDs), with respect to other subcellular loci, are described. Immunolabelling with this antibody produced a dendritic immunoprecipitate that was markedly stronger in PSDs than in other subcellular loci. Thus, the antiserum could be used as a marker for PSDs during their purification by subcellular fractionation, as well as in the study of PSD assembly. Monoclonal antibody 411B has already been shown to be a useful tool in the chemical determination of changes in synapse density after various experimental manipulations in both the chick and rat. In the present study, we have used the antiserum to monitor the appearance and maintenance or redundancy of synaptic components in the developing chick forebrain. PMID- 3292704 TI - Antibodies to cholinergic neurons in Alzheimer's disease. AB - Alzheimer's disease (AD) is associated with degenerative changes in nuclei of the basal forebrain which provide most of the cholinergic input to the cortex and hippocampus and with a reduction in presynaptic cholinergic parameters in these areas. Although the etiology and pathogenesis of AD are not known, several reports indicate the involvement of immunological mechanisms. In the present work we examined the existence of antibodies in sera of AD patients that bind specifically to cholinergic neurons. As antigens we employed the purely cholinergic electromotor neurons of the electric fish Torpedo which are chemically homogeneous and cross-react antigenically with human and other mammalian cholinergic neurons. Our findings show that immunoglobulins from sera of AD patients bind to a specific antigen (molecular mass 200 kilodaltons) in the cell bodies and axons of Torpedo electromotor neurons and that the levels of such antibodies are significantly higher in AD patients than in controls. The possible role of these antibodies in the cholinergic dysfunction in AD and their diagnostic potential are discussed. PMID- 3292705 TI - Endopeptidase-24.15 is the primary enzyme that degrades luteinizing hormone releasing hormone both in vitro and in vivo. AB - The concentration of luteinizing hormone releasing hormone (LHRH) (pGlu-His-Trp Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2), which reaches the anterior pituitary via the hypothalamo-hypophyseal portal system, appears to be controlled in part by the rate of LHRH degradation within the hypothalamus and/or pituitary. Specific, active site-directed endopeptidase inhibitors synthesized in our laboratory were used to identify the enzyme(s) involved in LHRH degradation by hypothalamic and pituitary membrane preparations, and by an intact anterior pituitary tumor cell line (AtT20). Incubation of LHRH with pituitary and hypothalamic membrane preparations led to the formation of pGlu-His-Trp (LHRH1-3) as the main reaction product. Under the same conditions, addition to the incubation mixtures of captopril, an inhibitor of the angiotensin converting enzyme, led to accumulation of pGlu-His-Trp-Ser-Tyr (LHRH1-5) and, to a lesser extent, pGlu-His-Trp-Ser-Tyr (LHRH1-6). The degradation of LHRH and the formation of the N-terminal tri- and pentapeptides was blocked by N-[1-(R,S)-carboxy-3-phenylpropyl]-Ala-Ala-Phe-p aminobenzoate (cFP-AAF-pAB), a specific, active site directed inhibitor of endopeptidase-24.15. Some inhibition of LHRH degradation and formation of the N terminal hexapeptide was also obtained in the presence of N-[1-carboxy-2 phenylethyl]-Phe-p-aminobenzoate (cFE-F-pAB), an inhibitor of endopeptidase 24.11. Similar results were obtained with AtT20 cell membranes and with intact AtT20 cells in monolayer culture. Following cleavage by endopeptidases the C terminal part of LHRH was rapidly degraded by aminopeptidases. Superactive analogs of LHRH in which Gly6 was replaced by a D-amino acid are resistant to degradation by both endopeptidase-24.11 and -24.15. In vivo, when LHRH was injected directly into the third ventricle of rats, the presence of cFP-AAF-pAB inhibited LHRH degradation. It is concluded that LHRH degradation is primarily initiated by the membrane-bound form of endopeptidase-24.15 to yield pGlu-His-Trp Ser-Tyr and to a lesser extent by endopeptidase-24.11 to yield pGlu-His-Trp-Ser Tyr-Gly. PMID- 3292706 TI - Differences between vascular and plaque core amyloid in Alzheimer's disease. AB - The predominant protein of cerebrovascular and plaque core amyloid in Alzheimer's disease, Down's syndrome, hereditary hemorrhage with amyloidosis--Dutch type, sporadic cerebral amyloid angiopathy, and age-related amyloidosis is a unique polypeptide, called beta protein. The length of the plaque amyloid protein was reported to be 42-43 residues, but the complete length of the cerebral vascular amyloid is not known. To clarify this issue, amyloid fibrils from the leptomeninges of an Alzheimer's disease patient were isolated and the primary structure determined. The complete sequence of cerebrovascular beta-amyloid protein, although homologous to the plaque core amyloid protein previously reported, has 39 residues instead of 42. Amino terminal heterogeneity is present but minimal, and it is three residues shorter at the carboxy terminus. These differences are similar to those found in two cases of hereditary hemorrhage with amyloidosis--Dutch type. The differences between vascular and plaque beta-amyloid may reflect diverse processing of the beta protein precursor in the vessel wall and brain parenchyma due to tissue-specific endopeptidases. PMID- 3292708 TI - Cardiovascular disease in pregnancy: a nursing approach. PMID- 3292707 TI - Isolation of a nonendotoxic antitumor preparation from Serratia marcescens. AB - White-type polysaccharide preparation (WPS) obtained from Serratia marcescens bacteria by hot 0.2 N acetic acid extraction was shown to have antitumor effects. These were manifested by enhanced resistance to the take of TA3 transplantable murine adenocarcinoma and by the induction of regression of Meth A sarcoma in mice. Optimal conditions for the liberation and isolation of these substances were sought to achieve the highest antitumor activity and the lowest endotoxin (ET) content. Simultaneously, the activities of the WPS preparations were tested in various tests which are frequently used as in vitro correlates of in vivo antitumor effects, such as the activation of macrophage cytotoxicity, activation of natural killer (NK) cells, and tumor necrosis factor (TNF) generation. We found that the enhanced resistance to the take of TA3 tumor correlated with ET content of the WPS preparations. Preparations with reduced or no ET content showed diminishing activity in this assay or were without any measurable effect. The induction of TNF production and NK activation did not show such close relationship with the ET content. This was particularly evident if testing WPS samples obtained after 60 or 120 min hydrolysis at 90 degrees C. The greatest discrepancy was found between ET content and the Meth A regression induction. Samples with no detectable ET content and no activity in the macrophage, NK, or TNF tests were potent inducers of Meth A regression. Partial purification of such WPS samples could be achieved and a preparation was obtained with high Meth A regression capacity. Preliminary chemical analysis of this preparation showed 25.5% amino acid, 53.7% neutral carbohydrate, less than 0.4% KDO, 0.8% hexosamine, less than 0.1% phosphorous, and less 1.0% long-chain carboxylic acid content. The above chemical analytical data are not consistent with designating such preparations as ET or ET derivatives, such as Lipid A or its split products. This conclusion was confirmed by the lack of endotoxic properties as determined by biological assays on this preparation. PMID- 3292709 TI - Perceptions of factors influencing the coping of wives of myocardial infarction patients. PMID- 3292711 TI - Identification of a subgroup of patients with breast cancer and histologically positive axillary nodes receiving adjuvant chemotherapy who may benefit from postoperative radiotherapy. AB - Risk factors for isolated local-regional (LR) recurrence following mastectomy for breast cancer were analyzed in a review of 627 women entered into Eastern Cooperative Oncology Group (ECOG) adjuvant chemotherapy trials between 1978 and 1982. Premenopausal patients were randomized to cyclophosphamide, methotrexate, and fluorouracil (5-FU) (CMF), cyclophosphamide, methotrexate, 5-FU, and prednisone (CMFP), or cyclophosphamide, methotrexate, 5-FU, prednisone, and tamoxifen (CMFPT). Postmenopausal patients were randomized to observation, CMFP, or CMFPT. Median follow-up time was 4.5 years. At 3 years, 225 patients relapsed and in 70 (31% of failures, 11% of all patients) the initial site was LR without distant metastases. In a multivariate analysis, the risk of an isolated LR recurrence significantly correlated with the number of positive axillary nodes, the primary tumor size, the presence of tumor necrosis, and the number of axillary nodes examined. Factors that significantly discriminated between an isolated LR recurrence and distant metastasis were the number of positive nodes and primary tumor size. Patients with four to seven positive nodes or tumor size greater than or equal to 5 cm had a chance of developing an isolated LR recurrence almost equal to the risk of distant metastases. These findings suggest a potential for improved survival in this subset of patients with the addition of postmastectomy radiation to chemotherapy, and continue to emphasize the presence of a group of patients at high risk for isolated LR recurrence despite adjuvant chemotherapy. PMID- 3292710 TI - Megestrol acetate versus tamoxifen in advanced breast cancer: 5-year analysis--a phase III trial of the Piedmont Oncology Association. AB - One hundred thirty-eight patients with recurrent or metastatic breast cancer were randomized to receive megestrol acetate 40 mg orally four times daily or tamoxifen 10 mg orally twice a day. Upon treatment failure patients were crossed over to the alternate treatment. Eligibility required that either the estrogen receptor (ER) or progesterone receptor (PR) be positive or that both values be unknown, and that the patients be at least 2 years post-spontaneous menopause or over 50 years of age. Pretreatment characteristics including performance status (PS), disease-free interval (DFI), receptor status, and prior treatment were similar for both groups. Only three patients had previous hormonal therapy while one third had prior chemotherapy. Objective response was determined using strict International Union Against Cancer (UICC) criteria. Seventeen of 61 patients achieved complete response (CR) or partial response (PR) on megestrol (28%) while 20 of 64 patients achieved CR or PR on tamoxifen (31%). Responses of skin and bone lesions were similar for both agents; however, more patients with visceral disease responded to tamoxifen. Response did not correlate with the level of ER or PR but was correlated with age. Both unadjusted and adjusted analysis of time to progression and adjusted analysis (for pretreatment variables) of survival showed significant differences favoring tamoxifen. Six of 44 patients (14%) crossed from megestrol to tamoxifen achieved CR or PR while only two of 38 patients (5%) crossed from tamoxifen to megestrol achieved response. Only one of the original patients randomized to megestrol remains on study, while 12 patients still remain on tamoxifen. These data indicate similar response rates for megestrol and tamoxifen; however, time to progression and overall survival significantly favor tamoxifen when used as first-line therapy in this trial. PMID- 3292712 TI - High-dose therapy and autologous bone marrow transplantation in partial remission after first-line induction therapy for diffuse non-Hodgkin's lymphoma. AB - Seventeen patients received high-dose therapy with autologous bone marrow transplantation (ABMT) when in partial response after induction therapy. There were 11 children and six adults between 3 and 57 years old. Twelve patients were determined to have high-grade lymphoma (ten Burkitt's and two lymphoblastic), and five had intermediate-grade diffuse lymphoma. Ten patients had surgically proven active disease in the abdomen, two had active disease in the bone marrow, and five persistent neurological symptoms. The time interval between diagnosis and ABMT was 2-10 months (median 4 months). Two patients died of progressive disease and two others died while in complete remission (CR) because of toxicity. Thirteen of 17 are still alive and disease free with a median observation time of 2 years. Morbidity was high with 6/17 life threatening reversible complications but overall survival is 75% at 24 months in a group of patients clearly defined as having a very bad prognosis in previous studies. PMID- 3292713 TI - Early intensification of chemotherapy for childhood acute nonlymphoblastic leukemia: improved remission induction with a five-drug regimen including etoposide. AB - We tested the value of early intensification of chemotherapy in 68 consecutive children with acute nonlymphocytic leukemia (ANLL) who were admitted to St. Jude Children's Research Hospital from November 1983 through March 1987. Fifty-eight patients (85%) entered complete remission after treatment with etoposide (VP 16)/cytarabine (ara-C) (A), followed by daunorubicin (Dauno)/ara-C/thioguanine (6 TG) (B) and then VP-16/azacytidine (5-AZ) (C). Thirty percent of the complete responders, mainly those with an M4 or M5 leukemia subtype, attained M1 marrow status after component A, 60% after A + B, and 10% after A + B + C. Induction failures resulted primarily from absolute or relative drug resistance; there was only one death during this phase of therapy. Postremission treatment consisted of three pairs of drugs (vincristine [VCR]/amsacrine [m-AMSA], or doxorubicin [Doxo]/6-TG/ara-C, and VP-16/cyclophosphamide [CTX]) administered sequentially in 6-week cycles for 22 months. Despite the high rate of remission induction, only 33% +/- 7% SE of the patients are expected to be failure-free survivors at 2 years. Remission durations were not significantly affected by the majority of factors examined in this study, with the exception of marrow cellularity after VP 16/ara-C induction therapy. Patients with less than or equal to 5% leukemic cells survived relapse-free for a median of 36.1 months, compared with 11.3 months for the group with a larger infiltrate (P = .01). Although postremission therapy did not improve the percentage of long-term failure-free survivors, the induction regimen we used appears highly effective, and its components should be considered for inclusion in other treatment programs. PMID- 3292714 TI - An intensive, five course, alternating combination chemotherapy induction regimen used in patients with advanced, unresectable head and neck cancer. AB - Progress in the treatment of advanced squamous cell cancer (SCC) of the head and neck (H & N) has included the development of combination chemotherapeutic regimens that achieve impressive complete response (CR) rates using two to three courses therapy with minimal toxicity and good patient tolerance. Further improvements in these results will require intensification of induction regimens. Therefore, a five course, alternating combination chemotherapy induction trial was initiated in an attempt to test the feasibility and toxicity of a prolonged, intensive induction regimen in patients with advanced SCC of H & N. Courses 1, 3, and 5 consisted of fluorouracil as a 120-hour infusion (5FU-I) with cisplatin (CACP) as an intravenous (IV) bolus. Courses 2 and 4 consisted of 3 weekly doses of high-dose methotrexate (HDMTX) followed by 5FU (5FU-b) and leucovorin rescue (LR). Forty-six stage IV patients with SCC of H & N (85% T4 and 58% N3) were entered. Thirty-one patients completed the study and 15 did not. Twenty-one of the 46 patients (46%) achieved a CR. Twenty-five of the 46 patients had N3 neck disease, ten of these 25 achieved a CR (40%), and eight did not complete therapy. Of the 15 patients not completing this study, one patient achieved a CR and eight achieved a partial response (PR). Eight of 46 (17%) were removed from study for reasons of toxicity (6% to 13%) or tumor progression (2% to 4%). The remaining seven were removed due to intercurrent medical conditions (four uncomplicated pneumonias and one gun shot wound) or lost to follow-up (2). Myelosuppression, mucositis, and skin toxicity increased in frequency by the end of the trial but were acceptable and reversible. The activity of this five-course regimen is promising given the advanced disease status of patients treated. Consideration of concurrent medical conditions, patient compliance, intensity of medical, nutritional and social support, and levels of acceptable toxicity will be necessary in the design of future, intensive induction trials. PMID- 3292715 TI - Elevated beta-2-microglobulin in Epstein-Barr virus lymphoproliferative disease after bone marrow transplantation. PMID- 3292716 TI - The extracellular matrix of the central and peripheral nervous systems: structure and function. AB - The extracellular matrix (ECM) is the naturally occurring substrate upon which cells migrate, proliferate, and differentiate. The ECM functions as a biological adhesive that maintains the normal cytoarchitecture of different tissues and defines the key spatial relationships among dissimilar cell types. A loss of coordination and an alteration in the interactions between mesenchymal cells and epithelial cells separated by an ECM are thought to be fundamental steps in the development and progression of cancer. Although a substantial body of knowledge has been accumulated concerning the role of the ECM in most other tissues, much less is known of the structure and function of the ECM in the nervous system. Recent experiments in mammalian systems have shown that an increased knowledge of the ECM in the nervous system can lead to a better understanding of complex neurobiological processes under developmental, normal, and pathological conditions. This review focuses on the structure and function of the ECM in the peripheral and central nervous systems and on the importance of ECM macromolecules in axonal regeneration, cerebral edema, and cerebral neoplasia. PMID- 3292718 TI - Management of extensive and difficult cranial defects. AB - The procedure of split-skull cranioplasty was first investigated at the turn of the century. The present authors first reported their technique of split-skull cranioplasty in 1983, and describe here their experience with this procedure in the management of extensive and difficult cranial defects. Twenty-nine patients (11 females and 18 males) are reviewed. Ten patients had histories of infection before reconstruction surgery. Eleven patients received radiation therapy at the grafted areas. The postoperative follow-up period ranged from 6 months to 4 1/2 years. There was no evidence of bone resorption during that time, and minor complications occurred in only two of the patients. This procedure offered several advantages: 1) the bone graft, an autogenous material, can be used in previously infected areas; 2) the reconstruction contour is smooth and natural; 3) there was no morbidity or scarring at the donor site; 4) surgery time is much shorter than with split-rib cranioplasty. The primary disadvantage of split-skull cranioplasty is the decreased thickness of the skull at the donor site. PMID- 3292717 TI - Stereotaxic surgery in the treatment of multiple brain abscesses. AB - Controversy exists regarding the optimal treatment for patients with multiple brain abscesses. These lesions are often small and located deep in the brain and close to vital structures, making surgery difficult. With this in mind the authors review their experience in treating multiple abscesses using computerized tomography (CT)-guided stereotaxic aspiration. From 1983 to 1985, 15 patients were treated for multiple brain abscesses, of whom eight underwent stereotaxic aspiration. There were a total of 28 abscesses in these eight patients: 11 abscesses were aspirated and two excised using CT-guided techniques. Most were cortical in location, although there were 12 in the deep white matter, one in the thalamus, and two in the caudate nucleus. All patients received a total of 6 weeks of antibiotic therapy. Follow-up CT showed resolution of the abscesses in all patients. Currently, four are neurologically normal, one has a mild hemiparesis, one has a well-controlled seizure disorder, and one requires supportive care. A single death occurred 5 weeks postoperatively of unrelated causes. Location, size, and age of an abscess all have bearing upon the response to management and outcome of the patient. Stereotaxic surgery is a procedure with minimal morbidity and mortality. Stereotaxic aspiration should be considered in patients with small, multiple, or deep-seated abscesses, in those who are poor operative candidates, and in those who have failed prior therapy. PMID- 3292719 TI - Results of a randomized trial of vancomycin prophylaxis in craniotomy. AB - A single prophylactic dose of vancomycin was given in 143 supratentorial craniotomies with a bone flap and 26 suboccipital craniotomies. No antimicrobial agents were given to two similar groups of patients: 172 with supratentorial craniotomy and 19 with suboccipital craniotomy. The infection rate in the vancomycin groups was significantly lower (p less than 0.013), and bone-flap infections alone, the most common infection after supratentorial craniotomy, were significantly fewer (p less than 0.042). Antimicrobial prophylaxis is recommended only for selected high-risk groups. Since a bone flap is devascularized, its resistance to infection is reduced and, once infected, it usually requires surgical removal. Patients undergoing craniotomy with a bone flap therefore form a high-risk group, and antimicrobial prophylaxis is justified. PMID- 3292720 TI - Stereotaxic implantation of dispersed cell suspensions into brain. A systematic appraisal of cell placement and survival. AB - The application of several recent advances in cell biology, brain implantation, and cell-mediated tumor immunotherapy requires successful and reproducible placement of viable cell suspensions into brain. Stereotaxic implantation is being used to inject cytotoxic lymphocytes into gliomas and to replace dopaminergic cells in parkinsonian models. Systematic assessment of the factors that influence success in implantation of cell suspensions into solid tissues is needed. A model was developed for investigation of stereotaxic implantation using radiolabeled rat lymphokine-activated killer (LAK) cells. Anesthetized rats received microliter injections of cell suspension into the right caudate nucleus. The injection volume, cell concentration, infusion rate, and needle size were varied systematically. The animals were sacrificed 1 hour after injection; the brain was removed and sectioned, and the radioactivity was counted. Three aliquots of the suspension were injected into counting tubes for control analysis. Recovery of radioactivity was expressed as the percent of mean counts per minute (cpm) in the right frontal lobe/mean cpm in the three control tubes. To assess the viability of implanted cells, the right frontal region was mechanically dissociated in media and centrifuged, and the pellet and supernatant were counted. By using small needles and slow infusion of volumes of 10 microliters or less, 85% to 90% of the radioactivity was recovered in the caudate nucleus. At least half of the implanted cells were viable. Consistent, accurate implantation of dispersed cells into brain over a range of volumes, cell concentrations, infusion rates, and needle sizes was achieved. PMID- 3292721 TI - The stereotaxic retractor in computer-assisted stereotaxic microsurgery. Technical note. AB - The authors describe a cylindrical retractor that is attached to a standard stereotaxic frame. This retractor provides a route for stereotaxic procedures and exposure of and a reference structure for the computer-assisted removal of deep seated intracranial lesions defined stereotaxically by computerized tomography and magnetic resonance imaging. PMID- 3292722 TI - Sabah S. Tumeh receives 8th Tetalman Memorial Award. PMID- 3292723 TI - Detection of rejection of canine orthotopic cardiac allografts with indium-111 lymphocytes and gamma scintigraphy. AB - Previous studies have demonstrated the feasibility of detecting canine heterotopic cardiac allograft rejection scintigraphically after administration of 111In lymphocytes. To determine whether the approach is capable of detecting rejection in orthotopic cardiac transplants in which labeled lymphocytes circulating in the blood pool may reduce sensitivity, the present study was performed in which canine orthotopic cardiac transplants were evaluated in vivo. Immunosuppression was maintained with cyclosporine A (10-20 mg/kg/day) and prednisone (1 mg/kg/day) for 2 wk after transplantation. Subsequently, therapy was tapered. Five successful allografts were evaluated scintigraphically every 3 days after administration of 100-350 microCi 111In autologous lymphocytes. Correction for labeled lymphocytes circulating in the blood pool, but not actively sequestered in the allografts was accomplished by administering 3-6 mCi 99mTc autologous erythrocytes and employing a previously validated blood-pool activity correction technique. Cardiac infiltration of labeled lymphocytes was quantified as percent indium excess (%IE), scintigraphically detectable 111In in the transplant compared with that in blood, and results were compared with those of concomitantly performed endomyocardial biopsy. Scintigraphic %IE for hearts not undergoing rejection manifest histologically was 0.7 +/- 0.4. Percent IE for rejecting hearts was 6.8 +/- 4.0 (p less than 0.05). Scintigraphy detected each episode of rejection detected by biopsy. Scintigraphic criteria for rejection (%IE greater than 2 s.d. above normal) were not manifest in any study in which biopsies did not show rejection. Since scintigraphic results with 111In-labeled lymphocytes were concordant with biopsy results in orthotopic cardiac transplants, noninvasive detection of graft rejection in patients should be attainable with the approach developed. PMID- 3292724 TI - Nuclear medicine in pediatric urology and nephrology. AB - Renal scintigraphy is a diagnostic procedure of choice or a complementary imaging modality in the work up of infants and children with urologic or nephrologic problems. New radiopharmaceuticals and techniques and expert interpretation provide unique renal parenchymal and collecting system functional and anatomical information, which helps in the diagnosis and follow up of congenital or acquired kidney disorders and the quantitation of renal function. Education of the user and the referring physician, further clinical experience, and comparative studies should help increase utilization of renal scintigraphy in the neonatal and pediatric age for the benefit of the patient and the better understanding of urologic and nephrologic disorders. PMID- 3292725 TI - Effect of sera from control and overfed rats on preadipocyte growth in culture. AB - Increased body lipid was induced in 4-wk-old rats through oral gavage. Rats were either fed ad libitum, tube-fed 100% or tube-fed 150% of the ad libitum intake. After 1 wk of tube-feeding animals were killed and sera collected. Sera were used to support the growth of rat stromal-vascular cells in culture. Sera were also analyzed for growth hormone and insulin concentrations. In rats that were tube fed, levels of adiposity were greater but sera from these rats decreased stromal vascular and preadipocyte proliferation in culture when compared with sera from ad libitum-fed rats. Sera from tube-fed animals promoted an increase in preadipocyte differentiation as revealed by esterase staining. Results indicate that overfeeding in juvenile rats causes sera changes that support fat cell differentiation but not fat cell hyperplasia. PMID- 3292726 TI - Basis of the stereospecific preference of porcine kidney fibroblasts for D-2 hydroxy-4-methylthiobutanoic acid as a source of methionine. AB - In previous studies we have found that porcine kidney fibroblasts will grow in medium containing D-2-hydroxy-4-methylthiobutanoic acid (D-methionine hydroxy analogue, D-MHA) as the sole source of methionine but not in medium containing the L-isomer (L-MHA) alone. The fibroblasts have been found to have both D-2 hydroxy acid dehydrogenase (EC 1.1.99.6), which uses D-MHA as substrate (Km = 6.0 mM) and L-2-hydroxy acid oxidase (EC 1.1.3.1), which uses L-MHA as substrate (Km = 7.1 mM). These two activities should make it possible for the fibroblasts to grow on either isomer. Only one protein band with L-2-hydroxy acid oxidase activity can be detected with enzyme-specific staining of protein profiles obtained after polyacrylamide gel electrophoresis. The enzyme L-2-hydroxy acid oxidase from porcine kidney has properties that are different from the two porcine isozymes reported previously by others. Passage of DL-[14C]MHA at tracer levels into the porcine kidney fibroblasts in culture is reduced to 31% of control in the presence of 3.75 mM D-MHA, 86% of control with 3.75 mM L-MHA and 65% with 3.75 mM D-lactate but is not affected by up to 3.75 mM L-lactate. It appears that the transport specificity is the basis for the growth promotion of kidney fibroblasts by the D-isomer of MHA as opposed to L-MHA when each is used as the sole source of methionine. PMID- 3292727 TI - Effects of various combinations of omega 3 and omega 6 polyunsaturated fats with saturated fat on serum lipid levels and eicosanoid production in rats. AB - The effects of varying the ratio of polyunsaturated/saturated fatty acids (P/S) and omega 3/omega 6 polyunsaturated fatty acids (PUFA) of dietary fats on lipid metabolism were studied in rats using safflower oil (SFO), linseed oil (LSO), palm oil (PLO), and a 1:1 combination of these oils. The hypocholesterolemic and hypotriglyceridemic effects depended on the P/S ratio of dietary fats, LSO (omega 3 PUFA) being more effective than SFO (omega 6 PUFA). A similar pattern of the response was observed on liver cholesterol and triglyceride. The liver cholesterol-lowering effect of LSO, but not SFO, remained even when they were combined with PLO. The activity of liver delta 6-desaturase tended to be higher while that of liver phospholipase A2 was significantly lower in the LSO group than in the SFO or PLO groups. The aortic PGI2 production and the production by platelets of thromboxane A2 were significantly low in rats fed LSO accompanying a distinct reduction of arachidonate in tissue phospholipids. The depressing effect of LSO disappeared when it was combined with SFO but not with PLO. There were no significant differences in enzyme activities and eicosanoid production between SFO and PLO in spite of a large difference in their P/S ratio. Thus, lipid parameters examined were complicatedly regulated by the ratios of omega 3/omega 6 as well as P/S, suggesting an existence of an appropriate ratio for these variables. PMID- 3292729 TI - Measurement of fundal height. AB - Fundal height should not be assessed by comparing the uterus with anatomic landmarks on the maternal abdomen because of the following reasons: 1) the inability to assess fundal growth accurately when the uterus is measured in finger breadths or as a fraction of the distance between two landmarks; 2) biologic variability in the placement of anatomic landmarks on the maternal abdomen; 3) disagreement among clinicians and researchers on the precise relationship between the fundus and anatomic landmarks at each stage of gestation; and 4) variability among women in the number of gestational weeks at which the uterine fundus reaches the umbilicus. A rational basis for continuing the practice of comparing fundal height with anatomic landmarks on the maternal abdomen does not exist. Inexpensive and more accurate techniques of measuring fundal growth are readily available. PMID- 3292728 TI - Ethical issues in genetic screening for susceptibility to chronic lung disease. AB - The extent, severity, and irreversible nature of chronic lung disorders associated with occupation dictate careful review of any potentially mitigating measure. A genetic predisposition to lung injury is known to occur in the small percentage of individuals who are homozygous for alpha-1-antitrypsin (AAT) deficiency, a defect in the protein needed for inactivating proteolytic enzymes released after lung injury. It was found that the contribution of homozygous affected individuals to the total population at risk for chronic lung disease is too small (0.5% to 2.0%) to warrant screening. Screening could be justified if the more prevalent heterozygous AAT-deficient individuals were also at greater risk. A literature review demonstrated that up to 27.2% of persons of Spanish and 12.3% of Anglo-Saxon heritage but virtually no blacks or persons of Eastern origin are heterozygous for AAT alleles. Some heterozygous phenotypes are statistically overrepresented in hospitalized populations and among workers with impaired lung function, suggesting that they are statistically at slightly greater risk for developing lung disease than are homozygous normal individuals. These data suggest that a screen for AAT carriers would be marginally acceptable scientifically, but would pose ethical questions of discrimination and equity in use of disease-detecting resources. Review of ethical criteria for screening, particularly the availability of experimental therapies, increases the cogency and reinforces the acceptability of performing occupational tests for both homozygous and heterozygous AAT-deficient persons. Currently, programs directed at early detection of symptomatic workers coupled with reduction or elimination of offending agents are scientifically and ethically more warranted than full scale genetic screening for AAT deficiency. PMID- 3292730 TI - Mandibular bone grafts for reconstruction of alveolar clefts. AB - This study evaluated the effect of mandibular bone grafts for reconstruction of alveolar clefts. The study included 25 patients with cleft lip and alveolar process only and three patients with unilateral cleft lip and palate, with a median postoperative follow-up of 8 months (range, 6 to 17 months). The bone grafts were obtained from below the mandibular incisors and canines through an intraoral approach. The marginal bone level achieved was satisfactory in all cases evaluated by occlusal radiographs; the radiographs also demonstrated that the bone grafts were totally integrated after 6 months in all cases. The morphology of the reconstructed alveolar process was satisfactory in all cases evaluated and no periodontal complications were seen. The donor site appeared healed radiologically in all cases 6 months after surgery. The advantages gained by using a mandibular bone graft as compared to an iliac crest graft include reduced morbidity, reduced hospitalization time, reduced operating time, and avoidance of scarring at the donor site. The results of the present study demonstrate that the mandibular symphysis can be used as donor site for reconstruction of small alveolar clefts. PMID- 3292731 TI - Oral melanoma with oral squamous carcinoma: report of a case. AB - A case of an oral melanoma occurring simultaneously with an oral squamous carcinoma has been presented. This combination is not thought to have been reported in the literature before. The histologic diagnosis is discussed as are the incidence, prognosis, and possible treatment of oral melanoma. PMID- 3292732 TI - The effect of a series of fixatives on the AgNOR technique. AB - With increasing interest being shown in nucleolar organizer regions (NORs) in pathology, it was considered of great importance to evaluate the effect of some of the more commonly used and more specialized fixatives on the demonstration of these moieties. NORs can be demonstrated in paraffin sections by a silver technique (AgNOR method) which was developed from a method used by cytogeneticists for the demonstration of NORs in chromosome spreads. The degree of staining is dependent on the fixation regime employed and results may vary greatly from one fixative to another. The fixative schedules and post-treatments used in this study were based on standard sequences from the literature. We have shown that, in general, alcohol-based fixatives give optimal results, Carnoy's fluid being especially recommended. Mercurial and dichromate-containing fixatives were found to have highly detrimental effects on NOR staining. 'Routine' 10 per cent formol saline fixation gave adequate results whereas 10 per cent neutral buffered formalin gave optimal staining, similar to alcohol-based fixation. PMID- 3292733 TI - Class II MHC expression in normal adrenal cortex and cortical cells in autoimmune Addison's disease. AB - It has been proposed that aberrant expression of class II major histocompatibility complex (MHC) molecules by target cells may be an initiating factor in some forms of organ specific autoimmunity. This hypothesis was tested in relation to the autoimmune form of Addison's disease by studying autopsy adrenal glands from eight patients who had died of recent onset idiopathic Addison's disease. Using an immunohistochemical technique, class II MHC expression was found in a minority of adrenal cortical cells in the zona reticularis in 25 normal and four hyperplastic glands, while in Addison's disease almost all residual cortical cells expressed class II MHC. Three tuberculous adrenals showed increased staining of cortical cells around areas of chronic inflammation. It is concluded that since adrenal cortical cells of the normal gland express class II MHC, aberrant expression of this product cannot be invoked as an initiating mechanism in autoimmune adrenalitis. The increased cortical expression of class II MHC seen in idiopathic Addison's disease and tuberculosis may be due to local release of lymphokines by inflammatory cells. PMID- 3292734 TI - Monoclonal S-100 immunocytochemistry of pigmented naevi with tactile-like corpuscles. AB - We examined 12 cases of pigmented naevi with tactile-like corpuscles by immunohistochemistry using polyclonal and monoclonal antibodies against S-100 protein. Naevus cells, the tactile-like corpuscles, and the attached lamellae and fibroblastic cells gave a strong reaction with S-100 protein and the beta-subunit antibodies. The same cells gave only a weak reaction with the alpha-subunit antibody with the exception of about 4 per cent of corpuscles and 1-1.5 per cent of naevus cells, whether pigmented or not, which gave a strong reaction with this antibody. These results suggest that the non-pigmented naevus cells and the constituent cells of the corpuscles are closely related and the latter might derive from the former by organoid differentiation. PMID- 3292735 TI - Relationships between oestrogen receptor,epidermal growth factor receptor, ER-D5, and P24 oestrogen regulated protein in human breast cancer. AB - Proteins regulated by or related to the oestrogen receptor (ER) may prove to be more reliable indicators of prognosis and hormone sensitivity then expression of the receptor itself. It has been shown recently that expression of epidermal growth factor receptor (EGFR) is associated with a poor prognosis in breast cancer. In a series of 60 breast cancers, we have studied relationships between ER, ER-D5 oestrogen receptor related protein, P24 oestrogen regulated protein, and EGFR using an immunohistochemical technique employing monoclonal antibodies in each case. In addition, radioligand binding assays for ER and EGFR were carried out and tumour histological grade was determined. Seventy-one per cent and forty-three per cent of tumours stained for ER-D5 and P24, respectively, but there was no relationship between staining for these and ER or EGFR status. There was a significant correlation between staining for ER and EGFR, and the respective biochemical assays. Relating ER to EGFR, very few ER-positive cases expressed EGFR, but this relationship fell short of significance. The prognostic significance of expression of the epitopes recognized by the ERD5 and P24 antibodies must await assessment of clinical outcome. PMID- 3292736 TI - Cellular composition of the spleen after human allogeneic bone marrow transplantation. AB - The cellular composition of the spleen has been assessed in 18 patients who died 15-326 days after receiving allogeneic marrow for leukaemia. The white pulp showed marked lymphocyte depletion with no germinal centres, very few B cells, and rare plasma cells. The marginal zone was unrecognizable but there were moderate numbers of T cells in the periarteriolar lymphatic sheaths (PALS), showing great variation in CD4/CD8 ratio. The percentage of CD4+ cells decreased with time post transplant. CD8+ cells were reduced in patients with graft-versus host disease (GvHD) who also showed no increase in cells staining for activation markers. No T cells were detected expressing immature phenotypes and no differences were detected between patients who received marrow purged or unpurged of T cells. Macrophage numbers appeared normal. Extramedullary haemopoiesis (EMH) was predominantly in the red pulp greater than 30 days after transplantation but more commonly in the white pulp before then. Pyknotic cells were common in seven cases and appeared to be associated with EMH rather than GvHD. Chimaeric studies demonstrated small numbers of donor cells in the PALS at 26 days and larger numbers at 56 days. PMID- 3292738 TI - Nucleolar organizer regions as diagnostic discriminants for malignancy. PMID- 3292737 TI - Studies on cell proliferation and tracer localization in the kidneys of guinea pigs with experimental autoimmune anti-tubular basement membrane nephritis. AB - The mitotic activity in kidneys of guinea pigs with experimental autoimmune anti tubular basement membrane (TBM) nephritis was investigated using autoradiographic techniques to determine the uptake of [3H]thymidine by actively dividing cells. It was observed in these animals that cells of proximal tubules, distal tubules, cortical and medullary interstitium, medullary collecting ducts, and loops of Henle took up significantly greater amounts of [3H]thymidine when compared with normal animals. In addition, the behaviour of horseradish peroxidase (HRP) and goat anti-HRP IgG in extraglomerular sites in the kidneys of these animals was studied. Contrary to what was expected, these tracers appeared to be less concentrated in the tubules and interstitium of animals with anti-TBM disease, with tracer movement restricted in areas of disrupted TBM. The significance of these observations is discussed. PMID- 3292740 TI - Bite mark evidence: its worth in the eyes of the expert. PMID- 3292739 TI - Clones and X-chromosomes. PMID- 3292741 TI - Jonathon Boyd Chase (1939-1987). PMID- 3292742 TI - Strategies for breaking marijuana dependence. PMID- 3292744 TI - Cannabis 1988. Old drug, new dangers. The potency question. AB - Observation of the real world of social marijuana use, where autotitration is the norm, renders the scare tactics of the new marijuana proponents not only inaccurate but irrelevant. There is much published evidence about the availability of highly potent varieties of cannabis from the nineteenth century through the present day. The effects attributed to the new marijuana are the same ones debated for centuries in many different cultures. The assertion that "all marijuana research to date has been done on 1 or 2 percent THC material" (Cohen 1968) ignores several thousand years of human experience with the drug. The old medical cannabis extracts were stronger than most of the forms now available, though the potency of illicit hash oils by the mid-1970's was approaching the level of medicinal preparations available before their removal from the USP. While it may be true that sinsemilla is more widely available than 10 or 15 years ago, its potency has not changed significantly from the 2.4 to 9.5 percent THC materials available in 1973-1974 (see Table I), or the five to 14 percent sinsemilla of 1975 (Perry 1977). The range of potencies available then (marijuana at 0.1% to 7.8% THC, averaging 2.0% to 5.0% THC by 1975) was approximately the same as that reported now. With such a range, the evidence simply cannot support the argument by Cohen (1986) that marijuana is "ten or more times more potent than the product smoked ten years ago." And to say that marijuana potency has increased 1,400 percent since any date in history is patent nonsense.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292743 TI - Marijuana and immunity. AB - Despite the fairly large literature that developed during the past 15 years or so, the effect of cannabinoids on the immune system is still unsettled. The evidence has been contradictory and is more supportive of some degree of immunosuppression only when one considers in vitro studies. These have been seriously flawed by the very high concentrations of drug used to produce immunosuppression and by the lack of comparisons with other membrane-active drugs. The closer that experimental studies have been to actual clinical situations, the less compelling has been the evidence. Although the topic was of great interest during the 1970's, as indicated by the preponderance of the references from that period, interest has waned during the present decade. This waning of interest suggests that perhaps most investigators feel that this line of inquiry will not be rewarding. The AIDS epidemic has also diverted the attention of immunologists to the far more serious problem of the truly devastating effects a retrovirus can have on a portion of the immune system. The relationship between the use of social drugs and the development of clinical manifestations of AIDS has been of some interest, however. Persons infected with the virus but not diagnosed as AIDS have been told to avoid the use of marijuana and/or alcohol. This advice may be reasonable as a general health measure, but direct evidence that heeding this warning will prevent the ultimate damage to the immune system is totally lacking. PMID- 3292745 TI - Marijuana and the law in California: a historical and political overview. PMID- 3292746 TI - Savings in California marijuana law enforcement costs attributable to the Moscone Act of 1976--a summary. PMID- 3292747 TI - Marijuana, driving, and accident safety. PMID- 3292748 TI - Bone densitometry in infants. AB - Bone mineral mass and density can be measured noninvasively by various absorptiometric procedures. Two methods, dual-photon absorptiometry (DPA) and quantitative computed tomography, have widespread application in adults but only limited use in children. One method, single-photon absorptiometry (SPA), has been used extensively in adults and children and has been modified for use in infants. The radius shaft has been used for most research on infants. However, the difficulty of using older SPA methods on this small bone (4 to 7 mm width) has led a few investigators to measure the shaft of the humerus. The typical precision of measurement in a newborn is about 5% with the use of computerized rectilinear scanners for the radius; older linear scanners have a precision error of 5% to 10% on the humerus. Linear scanners cannot measure precisely the radius in individual neonates. The SPA scans typically take about 5 minutes. The DPA technique using 153Gd has been modified for use on smaller animals (5 to 10 kg monkeys and dogs), but it has not been used on infants because DPA scans take 20 minutes. New methods using x-ray absorptiometry allow rapid (1 minute), precise (1%) measurements in the perinate. The need for a soft tissue bolus is eliminated, and both the axial and peripheral skeletons can be measured with dual energy x-ray absorptiometry. Ultrasonic measurements do not yet offer adequate precision in the neonate, given the limited biologic range of values. PMID- 3292749 TI - Bone mineral content: data analysis. AB - We reviewed the literature related to intrauterine bone mineral content (BMC) curves and the expression of BMC measurements in infants. From this review, it appears that the curves developed by Greer and by Minton for the radius are extremely similar and that both should be used as the reference curve. It also appears that expression of assessment results in terms of BMC and bone width (BW) permits an evaluation of growth of bone mass versus growth of size of the bone scanned. Although the BMC/BW ratio might be a useful but unproved conceptual adjunct, expression of photon absorptiometry results in terms of the BMC/BW ratio alone does not confer any specific advantage and theoretically could mask important specific information about bone mass and size. PMID- 3292750 TI - Bone mineral content measurement in small infants by single-photon absorptiometry: current methodologic issues. AB - Single-photon absorptiometry (SPA), developed in 1963 and adapted for infants by Steichen et al. in 1976, is an important tool to quantitate bone mineralization in infants. Studies of infants in which SPA was used include studies of fetal bone mineralization and postnatal bone mineralization in very low birth weight infants. The SPA technique has also been used as a research tool to investigate longitudinal bone mineralization and to study the effect of nutrition and disease processes such as rickets or osteopenia of prematurity. At present, it has little direct clinical application for diagnosing bone disease in single patients. The bones most often used to measure bone mineral content (BMC) are the radius, the ulna, and, less often, the humerus. The radius appears to be preferred as a suitable bone to measure BMC in infants. It is easily accessible; anatomic reference points are easily palpated and have a constant relationship to the radial mid-shaft site; soft tissue does not affect either palpation of anatomic reference points or BMC quantitation in vivo. The peripheral location of the radius minimizes body radiation exposure. Trabecular and cortical bone can be measured separately. Extensive background studies exist on radial BMC in small infants. Most important, the radius has a relatively long zone of constant BMC. Finally, SPA for BMC in the radius has a high degree of precision and accuracy. PMID- 3292751 TI - Determination of radial bone mineral content in low birth weight infants by photon absorptiometry. AB - Studies at the University of Wisconsin have demonstrated that photon absorptiometry is a precise, accurate, and reproducible technique for measuring bone mineral content in premature infants and can be used to establish an "intrauterine" curve of bone mineralization in the fetus. Photon absorptiometry can also be used to measure bone width, thereby documenting appositional bone growth. The bone mineral content/bone width ratio may be helpful in identifying disorders of bone mineral metabolism in premature infants. The technique has been used to demonstrate that relatively poor bone mineralization (compared with the intrauterine curve) occurs in very low birth weight infants after birth, regardless of the type of feeding or the presence or absence of bronchopulmonary dysplasia. PMID- 3292752 TI - A longitudinal study comparing scaling, osseous surgery and modified Widman procedures. Results after one year. AB - The purpose of this study was to compare, longitudinally, the effectiveness of scaling and root planing, osseous surgery, and the modified Widman procedures. The study was carried out in a private practice setting. Sixteen adult patients with moderate to advanced adult periodontitis were treated with initial scaling and oral hygiene procedures. Posthygiene data were used for comparison of changes in probing depth, clinical attachment levels and gingival recession. The initial examination data were used to compare changes in plaque and gingival indices. Frequency distributions were used to compare changes that occurred at individual sites. At one year, plaque and gingival indices were significantly reduced when compared with the initial examination. At one year, shallow pockets (1-3 mm) were reduced when compared to posthygiene. Four- to six-millimeter pockets were significantly reduced by the three procedures. Osseous surgery and modified Widman had significantly greater pocket reduction when compared with scaling. For pockets greater than 7 mm, osseous surgery and the modified Widman had significantly greater reduction when compared with scaling. For pockets 1-3 mm at one year osseous surgery had significantly greater clinical attachment loss when compared with scaling. For 4-6 mm pockets at one year, the three procedures had slight gains in clinical attachment levels. The results were similar for pockets with greater than 7 mm. Interproximal soft tissue craters were measured for six postoperative weeks. Initially, the modified Widman had a higher percentage of soft tissue craters when compared with osseous surgery. At six weeks, however, there were no significant differences when the surgical procedures were compared. Recession was measured at each examination. Recession for 1-3 mm pockets at one year was greater for osseous surgery when compared with scaling and the modified Widman. Recession for 4-6 mm and greater than 7 pockets was greater for the surgical procedures than scaling. The results from this study indicate that with three-month maintenance recalls, both the modified Widman and osseous surgery are effective for pocket reduction, and each will produce a slight gain of clinical attachment over one year. Scaling was effective at maintaining attachment levels but was not as effective in reducing pocket depth. PMID- 3292753 TI - Evaluation of preoperative diflunisal for postoperative pain following periodontal surgery. AB - The effectiveness of diflunisal as a preoperative medication to reduce pain following periodontal surgery was evaluated. Fifty patients were divided into two groups in a double-blind random manner: Group one received preoperative difunisal and Group two received preoperative placebo. The preoperative diflunisal group reported significantly less discomfort (P less than 0.05) than the preoperative placebo group and used rescue medication significantly less often (P less than 0.01). Therapeutic doses of diflunisal, given presurgically, are significantly more effective than placebo in limiting postoperative pain associated with periodontal surgery. PMID- 3292754 TI - Hand versus ultrasonic instrumentation in the removal of endotoxins from root surfaces in vitro. AB - The goal of this study was to determine whether ultrasonic scalers are as effective as curettes in providing fibroblast attachment to the scaled root surfaces. Extracted, peridontally involved teeth were cut along the sagittal plane; then one half of the root was curetted, the other half ultrasonically scaled. In addition, monkey kidney fibroblasts were suspended in a petri dish containing root fragments of the tooth halves. At the same time, control dishes without fragments were mounted. All dishes were treated with radioisotopic techniques. There was no significant difference in fibroblast growth between peridontally involved root surfaces treated using curettes or ultrasonic scalers. Both treatments caused the roots to lose their toxicity. The limitations of ultrasonic scalers in terms of shape, size and awkward handling need to be considered when choosing the approach that best suits each case. PMID- 3292755 TI - Scanning electron microscopy observations of initial clot formation on treated root surfaces. AB - This study presents the morphological sequence of events in initial blood clot formation on various root surfaces of freshly extracted human teeth. Four teeth with periodontal disease (PD) and three teeth without PD were extracted and the roots sectioned into halves. Those root surfaces with PD had four treatment areas: (1) intact periodontal ligament (PDL), (2) unplanned PD, (3) PD plus planed, (4) PD plus planed plus application of pH 1 citric acid (CA). The roots with no PD had three treatment areas: (1) intact PDL, (2) planed, (3) planed plus CA. Both root halves were reinserted together into the original extraction site. Each root half was then removed at either zero, one, two or four minutes and prepared for scanning electron microscope (SEM) evaluation. SEM observations suggested that plasma proteins were deposited initially on all root surfaces. Platelets and erythrocytes enmeshed in fibrin deposited most rapidly and consistently over the plasma protein layer where intact PDL was present. Similar observations were noted on the planed plus CA surfaces and appeared to occur at an earlier time than on the planed-only surfaces. A constant feature at all time periods was the absence of organized clot formation over the plaque-free zone of the PD root surfaces. By two minutes all surfaces, except the plaque-free zone of the PD area, appeared to have clot lysis occurring. While clot formation appeared to occur more rapidly over surfaces in the non-PD roots, no marked morphological differences in clot formation were observed between PD and non-PD teeth with similar root surface treatments. PMID- 3292756 TI - Evidence that drug metabolites are involved in cyproheptadine-induced loss of pancreatic insulin. AB - The effects of pretreatment with inhibitors of drug metabolism on the biotransformation of cyproheptadine (CPH) and the ability of the drug to deplete pancreatic insulin were investigated. CPH (45 mg/kg p.o.) or water was given once daily for 2 days to rats. SKF-525A (beta-diethylaminoethyl-2,2 diphenylpentanoate) (40 mg/kg i.p.) or water was administered 0.5 hr before the CPH treatment, and the animals were sacrificed 6 hr after the second dose of CPH. The pancreatic insulin concentration was determined, and the levels of CPH and its metabolites in pancreas, liver and lung were measured. It was found that SKF 525A pretreatment significantly protected rats from the insulin loss induced by CPH; SKF-525A alone had no effect on pancreatic insulin. The tissues from animals pretreated with SKF-525A, when compared with those of the control, had 10-fold higher levels of CPH, significantly lower concentrations of the metabolite desmethylcyproheptadine-10,11-epoxide (DMCPH-epoxide) and no change in the levels of desmethylcyproheptadine (DMCPH). The in vivo N-demethylation of N-[methyl 14C]CPH, as measured by the excretion rate of 14CO2, also was inhibited by SKF 525A pretreatment. Similar experiments were performed with another inhibitor of drug metabolism, 3,5-diethoxycarbonyl-2,6-dimethyl-4-ethyl-1,4-dihydropyridine (DDEP, 50 mg/kg i.p.); and the same results were obtained. In other experiments using DMCPH as the insulin-depleting compound, SKF-525A or DDEP pretreatment also afforded significant protection against chemical-induced insulin loss.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292757 TI - Identification of putative high affinity nicotinic receptors on cultured cortical neurons. AB - Primary cell cultures containing predominantly neurons or glia were prepared from fetal rat cerebral cortex. The presence of nicotinic receptor sites in neuronal cultures was indicated by the specific binding of L-[3H]nicotine to cell membrane preparations. No binding was observed with membrane preparations derived from glial cell cultures. Binding to neuronal membranes was saturable, reversible and stereoselective. Scatchard analysis revealed a single class of high affinity sites with a Kd of 3 nM and an average maximum number of binding sites of 25 fmol/mg of protein. The affinity of the sites was the same as that in adult cortical tissue, but the maximum number of sites was 25% of adult levels. The time course of binding exhibited complex kinetics that were consistent with the conversion of the sites to a high affinity state. The apparent equilibrium dissociation constant calculated from the kinetic rate constants for association (0.014 min-1 nM-1) and dissociation (0.03 min-1) was 2 nM, in good agreement with the results of equilibrium binding studies. In general, the pharmacological specificity of the sites, as judged from inhibition binding studies, was similar to that in adult brain. Nicotinic agonists were the most potent competitive inhibitors of [3H]nicotine binding and antagonists were the least effective. The D-isomer of nicotine was about 30-fold less potent than the L-isomer. The results show that cortical neurons contain high affinity nicotinic binding sites and that the properties of these sites are similar to those attributed to putative nicotinic cholinergic receptors in adult rat brain tissue. PMID- 3292758 TI - The effect of stimulation of the atrial receptors on plasma renin activity in the dog. AB - 1. To determine whether stimulation of atrial receptors reflexly results in a consistent change in plasma renin activity experiments were performed in dogs anaesthetized with alpha-chloralose. Either a large balloon in the lumen of the left atrium or small balloons positioned at the upper and middle pulmonary vein atrial junctions and atrial appendage were distended. Plasma samples obtained from these dogs during control periods and during periods of stimulation were assayed for plasma renin activity. 2. In the first series of experiments, stimulation of left atrial receptors by either large or small balloon distension was shown to result in an increase in urine flow and a decrease in plasma renin activity. 3. In a second series of experiments, cooling of the cervical vagosympathetic nerve trunks abolished the response of an increase to balloon distension in urine flow and decrease in plasma renin activity. 4. It was shown that a decrease in plasma renin activity resulted in response to stimulation of atrial receptors, and that this decrease is reflex in nature and is likely to involve only atrial receptors discharging into myelinated vagal fibres. PMID- 3292759 TI - [Ultrasonic diagnosis of non-calculous intraluminal obstruction in the extrahepatic bile ducts. Apropos of 8 cases]. AB - Ultrasound examination in 8 patients with occlusive jaundice demonstrated non lithiasic extrahepatic intracanalar obstacles, a malignant tumor in 4 and a non tumoral process (granuloma on suture thread, ball sludge, hemobilia in 2 cases) in the other 4. Analysis of echographic data suggested possible differential diagnosis criteria for these two types of occlusion. PMID- 3292760 TI - [Lateral tracheal indentation or compression by the brachiocephalic arterial trunk in children]. AB - Three cases of compression of the right wall of the trachea by buckling of the innominate artery in childhood are described. A coarctation of the thoracic aorta is associated in two cases, and a left cervical aortic arch in the third one. In one case, a severe tracheomalacia occurs following the surgical repair of the associated coarctation. This lateral indentation of the trachea is suggestive of right aortic arch but the absence of posterior oesophageal indentation excludes the diagnosis. Angiography is helpful and echography is unable to demonstrate the vascular origin of the tracheal compression. The authors analyse the correct diagnostic approach, emphasize the risk of tracheomalacia and the high rate of associated cardio-vascular malformations. PMID- 3292762 TI - [Idiopathic laryngotracheobronchial calcifications in children. Apropos of 2 cases]. AB - Calcifications of cartilage in the larynx, trachea and bronchi are rare in children. Two cases reported and listed with 5 similar cases of the literature. Such calcifications are generally discovered in young children and congenital stridor is commonly associated with. Calcifications of bronchi are not present in every case. The blood calcium is normal. Laryngoscopic examination shows in two cases a laryngeal stiffness. The prognosis is good. In two cases, one of the parents of under 40 years old, also had calcifications of the trachea and of the bronchi. PMID- 3292761 TI - [Evaluation of the myocardial ischemic and arrhythmogenic risk of digitalized angiography by venous route. Apropos of a comparative trial of ioxaglate and iopamidol]. AB - Cardiac tolerance to digital subtraction angiography by venous route (DSAV) was evaluated during a prospective study of a continuous series of 100 patients of both sexes investigated for various arterial diseases, and classified previously as "cardiac" and "non-cardiac". A permanent 12 lead ECE recording by sequences of 3 allowed study of ischemic and rhythmic changes provoked by randomly allocated injections of contrast media, Ioxaglate or Iopamidol. Major cardiac complications were not observed in the 98 patients studied (2 excluded), but in 32.6% auricular extrasystoles (AES) and/or ventricular extrasystoles (VES) were noted and in 19.4% a painless widening of the ST segment of 0.5 mm or more. The and ST widening were more frequent in the VES 40 patients classed as "cardiac" than in the 58 "non cardiac" (35% against 8.6%, p less than 0.01 and 37.5% against 6.9%, p less than 0.001 respectively). The two products did not differ with respect to their effect on frequency of repolarization anomalies, whereas Ioxaglate provoked more VES than Iopamidol (30% against 8%, p less than 0.02). It is concluded that cardiac tolerance to DSAV is good, but that the frequency of VES and painless repolarization ischemic disorders observed, even with only weakly hypertonic contrast media of non ionic type, suggests that their indications be limited and that certain precautions are necessary in cardiac patients. PMID- 3292763 TI - Is laser nerve repair comparable to microsuture coaptation? AB - Efforts to improve functional recovery following nerve injury and repair have included studies of sutureless repairs. The rat sciatic nerve was used as an experimental model to compare the efficacy of laser nerve repairs with standard microsuture repairs. Electrophysiologic (Compound Action Potential), quantitative morphometric, and behavioral (toe spread) measurements were used for assessment, and tensile strength of the repairs was also determined. Electrophysiologic studies showed that microsuture-repaired nerves had significantly faster conduction velocities, but the areas of the waveforms and peak amplitudes showed no significant differences between the two repair groups. Axon counts revealed significant differences in the suture group proximal to the repair site, contrasted with laser repairs. Toe spread evaluations, carried out at three day intervals, demonstrated a significant difference between the two methods of repair in only three out of 22 test dates: in these isolated cases, the suture group measurements were superior. The tensile strength findings confirmed that, at four days, microsuture repair was significantly stronger but thereafter, there was no difference between the two nerve repair techniques. PMID- 3292764 TI - Skin graft including subcutaneous vein: experimental study and clinical applications. AB - Skin grafting, using full and split thickness techniques, may yield poor results when satisfactory circulation is not restored in the recipient bed. Using a rabbit ear model with a vein located in the center of the graft, donor skin and subcutaneous vein were raised simultaneously, and the vein was preserved, resulting in a viable passage for inflow and outflow. Grafts were shown to survive in this experimental group when circulation was satisfactory after venous preservation. In the control group with no vein preservation, all grafts became necrotic. These results were clinically applied for cases in which skin defects, caused by finger trauma, resulted in poor circulation in the recipient bed. Skin and subcutaneous vein were simultaneously taken from the forearm and grafted successfully, resulting in excellent prognoses. PMID- 3292765 TI - Innervation of the microcirculation. AB - Neurogenic control of the peripheral circulation is accomplished by alterations in nerve discharge to the pre- and postcapillary vascular network in the various organs. The postganglionic sympathetic adrenergic nerves constitute the most important efferent pathway for neural control. The physiologic response of the microvasculature to neural influences depends on a number of factors: the pattern of distribution of the innervation to the microvessels is one of the more important determinants. In addition to its influence on the contractile state of vascular smooth muscle, the adrenergic nerves also have a trophic influence on the smooth muscle cells. Following surgical denervation of a vascular bed, the adrenergic nerve terminals degenerate, and subsequently reinnervate, the vasculature. During the period following denervation, a number of functional and morphologic changes occur in the smooth muscle. This review emphasizes those aspects of the structure and function of adrenergic nerves that may have particular relevance for microsurgery. PMID- 3292766 TI - [Energy and protein requirements of dogs and cats]. AB - The latest research findings published on the energy and amino acid requirements of dogs and cats are reviewed. Special attention was paid to research results, applicable to working dogs, which have not as yet been incorporated into the recommended requirement standards of the National Research Council. PMID- 3292767 TI - New Danish law: human life begins at conception. AB - A new law has been passed by the Danish Parliament, establishing an ethical council. The law has caused considerable debate in Denmark, particularly because it states that 'the work of the council shall build on the basis that human life takes its beginning at the time of conception'. PMID- 3292768 TI - Current problems in meningococcal disease. PMID- 3292769 TI - Evaluation of electrophoretic methods for typing methicillin-resistant Staphylococcus aureus. AB - Three electrophoretic methods of typing methicillin-resistant Staphylococcus aureus (MRSA) strains--plasmid profiles (PP), whole-cell protein profiles (WCPP) and immunoblotting profiles (IP)--were evaluated and compared with phage typing. The results obtained with isolates from 12 outbreaks were compared both within the outbreaks, to determine the consistency of results, and between outbreaks. There was generally good agreement between the typing methods but in only six outbreaks did all four methods indicate the same relationship between isolates. WCPP comprised more than 50 bands; when differences occurred, they were seen in only a few bands. In contrast, IP comprised only one or two major bands and the differences were much easier to interpret. The PPs of many of the isolates were similar; many isolates contained a plasmid of mol. wt (18-25) x 10(6). In several outbreaks both WCPP and IP showed minor differences between isolates that were not apparent with phage typing. When comparisons were made between the 12 index strains and an isolate representing the London epidemic MRSA strain, phage typing and WCPP were the most discriminatory methods; both gave nine distinct patterns, whereas there were eight IPs and only six PPs amongst the 13 strains. It was concluded that both WCPP and IP could provide valuable epidemiological data on MRSA and that IP was the easiest of the three methods to interpret. PMID- 3292771 TI - From dental chair...to Mayor's chair. PMID- 3292770 TI - Characteristics of cysteine-requiring strains of Klebsiella isolated from urinary tract infections. AB - Clinical and bacteriological findings in seven cases of urinary tract infection with cysteine-requiring strains of Klebsiella are described. The organisms were isolated from patients with long-standing urinary tract abnormalities and grew as small (c. 1 mm) colonies on MacConkey agar. The organisms failed to grow in a minimal medium supplemented with sodium sulphate but grew when the medium was supplemented with cysteine sulphinic acid, sodium sulphide or L-cysteine. The smallest amount of cysteine required for optimal growth in a chemically defined medium was 20 mg/L. Cysteine-requiring strains of Escherichia coli had previously been shown to require a similar amount of cysteine and to be unable to reduce sulphate to sulphite; this suggests a common influence in the selection of cysteine auxotrophs in vivo. However, the amino acid inhibited the growth of E. coli at concentrations which only slightly altered growth of the Klebsiella strains. Problems with the isolation, identification and sensitivity testing of cysteine-requiring Klebsiella were also observed and methods by which these may be minimised are suggested. PMID- 3292772 TI - Nonrandomized clinical trials of cancer chemotherapy: phase II or III? PMID- 3292773 TI - Aspects of the rationale for the Women's Health Trial. AB - A 5.5-fold range in breast cancer incidence rates in 21 countries shows strong correlation with national estimates of per capita intake of dietary fat, but not with other caloric sources (proteins and carbohydrates). It is argued that certain breast cancer and hormone factors may contribute little to the explanation of such international variations in incidence of this neoplasm. It is further argued that experimental studies in animals support a specific role for dietary fat in the promotion of mammary tumors, but the effects of calories alone seem to be largely restricted to tumor initiation. Finally, data from international, migrant-population, and analytic epidemiologic investigations are used to motivate the basic relative risk assumption of study designs thus far proposed for the Women's Health Trial, and some continuing motivations for a dietary intervention (low-fat diet) trial are discussed. PMID- 3292774 TI - Alcoholism in a black urban area. PMID- 3292775 TI - Treating the black female alcoholic: clinical observations of black therapists. AB - Empirical observations from a decade of treating economically deprived black female alcoholics at the Lincoln Community Health Center in Durham, North Carolina, indicate that recognition of the social and cultural determinants of alcoholism is crucial to treatment. Scrutiny of the approach suggests that the psychopathology of these patients was inextricably intertwined with issues of racism, unemployment, poverty, and substandard housing. It is concluded that a comprehensive health care approach that utilizes the input of a black female therapist as the case manager has distinct advantages. PMID- 3292777 TI - The wandering bullet. AB - The phenomenon of bullet embolization has been documented in various organs or major organ systems. A case report of a gunshot wound injury to the left hemithorax with penetration of the esophagus and embolization to the stomach is presented. Diagnostic evaluation and therapy are discussed. PMID- 3292776 TI - Update in cancer chemotherapy: genitourinary tract cancer, Part 6: Cancer of the uterus and vulva. AB - An update of the state of the art of cancer chemotherapeutic treatment of genitourinary tract cancer is described in this multi-part series: included are cancers of the kidney, bladder, prostate, testicle, ovary, uterus, vulva, and gestational trophoblastic neoplasms. Part 6 is a review of treatment for cancers of the uterus and vulva. PMID- 3292778 TI - Studies in REST. II. An overview of REST technology. AB - This paper briefly summarizes current knowledge about Reduced Environmental Stimulation Therapy (REST). Major effects consistently produced by REST include (a) superlearning, (b) optimal physiological and psychological functioning, and (c) diminished denial and defensiveness. Persons showing greatest impairment or psychological disturbance prior to REST typically show the greatest "improvement" or change toward optimal levels of functioning afterward. REST facilitates natural homeostatic processes. Despite three decades of overwhelmingly positive research findings, REST technology has thus far received little understanding or acceptance. Common misconceptions about REST (formerly known as "sensory deprivation") are critically assessed and shown to be unfounded. PMID- 3292779 TI - Ultrastructural aspects of pulmonary edema. AB - The alveolar septa are designed for gas exchange as well as for the exchange of water and solutes. The organization of the tissue elements and the ultrastructural architecture of the alveolar septa minimize the interference between gas and liquid exchange even when excess water begins to accumulate in the septal interstices and the alveoli. Larger amounts of alveolar edema fluid, however, profoundly alter both function and structure of the lung parenchyma. As to the routes of abnormal fluid movement, the ultrastructural findings are not always conclusive, though in some types of permeability edema frank anatomic disruptions of the endothelial and epithelial barriers can be observed. On the other hand, in hemodynamic edema the permeability barriers appear to be intact. However, experiments involving macromolecular tracers and the presence of numerous red blood cells in the interstitial and alveolar spaces indicate that transient separations of cell junctions have taken place. PMID- 3292780 TI - Lung clearance of 99mTc-DTPA in patients with acute lung injury and pulmonary edema. AB - Several acute and chronic conditions that alter the integrity of the pulmonary epithelium increased the rate of absorption or clearance into the circulation of small solutes deposited in the alveoli. Technetium 99m diethylenetriamine pentaacetic acid can be deposited in the lungs as a submicronic aerosol and its rate of clearance measured with a gamma camera or simple probe. This clearance technique is currently being used to evaluate patients who have developed pulmonary edema and also to detect those patients from a high risk group who are likely to develop adult respiratory distress syndrome (ARDS). Its role in the evaluation of patients with pulmonary edema is still under active investigation. It is clear that a single measurement in patients who smoke is not useful, but repeated measurements may provide important information. The lung clearance measurement is very sensitive to changes in epithelial integrity but is not specific for ARDS. It may be most useful in combination with other predictive tests or when the clearance rate is normal. PMID- 3292781 TI - Theoretical and practical considerations of measuring extravascular lung water. AB - The volume of extravascular lung water is currently measured in vivo from the difference in mean transit times of the extrapolated first-pass dilution curves of two indicators, one diffusible and the other confined to the intravascular space. To overcome the limitations of this method, one can prolong the measurement interval, introduce a highly diffusible indicator, or both. In the first case, recirculating indicators are measured and included in the computation by deconvolution of the mean transit time through the lung. In the second case, heat is used as the water indicator. In the third case, not yet explored, recirculating heat would be measured and long thermal transit times uncovered. In view of the complexity of the deconvolution method and the pitfalls of the thermal dilution method, a radiographic score of pulmonary edema may be more useful clinically to assess the volume of extravascular lung water in patients with heart disease or adult respiratory distress syndrome. PMID- 3292782 TI - Positron emission tomography in pulmonary edema. AB - Positron emission tomography (PET) enables the concentration of positron-emitting isotopes to be measured quantitatively in vivo. It is also possible to measure the physical density of the lung with an external source of radiation. Several investigative procedures have been described for studying the distribution of the intravascular and extravascular water pools in the lung with PET. Clinical applications of these procedures have shown that acute hydrostatic pulmonary edema in humans has characteristics similar to experimentally induced hydrostatic edema. In chronic interstitial pulmonary edema, on the other hand, the relationship between the intravascular and extravascular water pools is different, and experimental models of acute pulmonary edema may not be relevant to this category of patients. The possible effects of these differences on lung function, such as gas exchange, may be studied with PET in the future. Microvascular permeability to proteins may also be studied. PMID- 3292783 TI - Quantitative assessment of pulmonary edema by nuclear magnetic resonance methods. AB - Considerable progress has been made in the application of nuclear magnetic resonance (NMR) imaging and nonimaging techniques to the quantitative assessment of pulmonary edema. NMR measurements offer the advantages of being noninvasive, relatively rapid, and easily repeatable. In addition, NMR imaging is suitable for the determination of lung water distribution. Studies of various animal models have shown that NMR techniques can adequately detect and quantify relative changes in lung water content and distribution in various types of experimental lung injury. Preliminary observations in humans suggest that NMR measurement of relative lung water changes in clinical pulmonary edema should be feasible. Although the application of NMR to the assessment of pulmonary edema appears to be very promising, it also poses significant problems that must be solved before it can be established as a standard experimental and clinical method. PMID- 3292784 TI - Inflammatory pulmonary edema and positive end-expiratory pressure: correlations between imaging and physiologic studies. AB - The anatomic and physiologic response to positive end-expiratory pressure (PEEP) was investigated using computed tomography (CT) in patients with adult respiratory distress syndrome (ARDS). The lesions (densities) in ARDS are distributed inhomogeneously but tend to concentrate in the dependent regions. The estimated lung weight (by CT scan, quantitative analysis, and lung gas volume measured with helium dilution) is, on the average, 200% higher than expected. Changing the body position from supine to prone causes a change in the density distribution in response to gravitational forces. The main effect of PEEP is to clear the densities through alveolar anatomic recruitment. Anatomic recruitment changes the mechanical characteristics of the lung and parallels the improvement in gas exchange. The effects of PEEP on pulmonary arterial pressure appear to be related to anatomic recruitment. PMID- 3292785 TI - Practical aspects of gated magnetic resonance imaging of the pulmonary artery. AB - A practical clinical evaluation of the role of gated magnetic resonance imaging (GMRI) for the evaluation of congenital and acquired diseases of the pulmonary artery is presented, comparing GMRI to the already established usefulness of other various noninvasive and invasive imaging modalities. PMID- 3292786 TI - New concepts about the pathophysiology of pulmonary edema. AB - Three new concepts concerning lung liquid and protein exchange are considered. The first is that the microvascular surface area is as important as the microvascular hydrostatic pressure in assessing filtration in the lung. One of the problems in differentiating hemodynamic from increased permeability edema is the inability to determine whether the microvascular surface area has changed. Several agents, as well as exercise, affect liquid filtration. A new, dynamic procedure that is more sensitive for the detection of increased permeability than static measurements of lung water content is described, along with its limitations. The second concept is that water and electrolytes are cleared from the alveoli by a separate mechanism from protein. Water clearance is fast and occurs mainly by an active process, which can be inhibited by amiloride or phloridzin and accelerated by beta-agonists. The mechanism appears to depend on metabolically regulated sodium transport across the alveolar epithelium. Protein clearance is very slow and is relatively independent of alveolar concentration. The protein clearance mechanism is unknown but may involve transcytosis. The third concept is that during edema formation there are two pathways for liquid clearance in addition to the lymphatic system: into the pleural space and along the bronchovascular connective tissue into the mediastinum. During recovery from edema, reabsorption into blood is important if the edema liquid has a low protein osmotic pressure. Clearance into the mediastinum may be the major pathway for liquid sequestered in the loose, binding connective tissue. PMID- 3292787 TI - Hepatobiliary disorders presenting as fever of unknown origin in Cairo, Egypt: the role of diagnostic ultrasonography. AB - Among 130 patients with fever of unknown origin (FUO) studied from 1981 to 1985, 34 were diagnosed as having hepatobiliary disorders: amoebic liver abscess (11), pyogenic liver abscess (4), hepatic hydatid cysts (2), hepatic fascioliasis (2), tuberculous hepatic granulomas (1), chronic calcular cholecystitis with recurrent cholangitis (2), chronic active hepatitis (2), hepatocellular carcinoma (3), lymphoma involving the liver (4) and hepatic metastasis in (3) cases. Hepatobiliary disorders were the cause in 27% of FUO seen during 4 years. PMID- 3292788 TI - Glucose-6-phosphate dehydrogenase deficiency in Thailand: the influence on the clinical presentation of malaria in male adult patients. AB - One hundred and ninety-two male malaria patients admitted to two different hospitals within 1 year, were studied. There were 74 malaria cases with glucose-6 phosphate dehydrogenase (G-6-PD) deficiency and 118 G-6-PD normal malaria cases, randomly selected as a control group. History of dark urine, and the presence of jaundice, haematocrit, total bilirubin and parasite count on day of admission were not significantly different comparing both groups. The number of observed complications did not differ either. Distinctions were detected in abnormal symptoms and in some laboratory parameters in patients with Plasmodium falciparum infection. G-6-PD deficient patients had significantly less gastrointestinal disturbances (P = 0.006), higher serum glutamic oxalacetic transaminase (P = 0.009) and significantly lower blood urea nitrogen (P = 0.007) when compared with the control group. These findings indicate that G-6-PD deficiency when the variants are aggregated, in male adult patients has no significant influence on the clinical presentation of malaria. PMID- 3292790 TI - High-level eucaryotic in vivo expression of biologically active measles virus hemagglutinin by using an adenovirus type 5 helper-free vector system. AB - The entire measles virus (MV) hemagglutinin (HA)-coding region was reconstructed from cloned cDNAs and used as part of a hybrid transcription unit to replace a region of the adenovirus type 5 genome corresponding to the entire E1a transcription unit and most of the E1b transcription unit. The resulting recombinant virus was stable and able to replicate to high titers in 293 cells (which constitutively express the complementary E1a-E1b functions) in the absence of helper virus. During infection of 293 cells, the hybrid virus expressed MV HA protein which was indistinguishable from that expressed in MV-infected cells in terms of immunoreactivity, gel mobility, glycosylation, subcellular localization, and biologic activity. Infection of 293 cells with the hybrid virus led to high level synthesis of the MV HA protein (equivalent to 65 to 130% of the level seen in MV-infected cells). At late times after high-multiplicity hybrid virus infection of HeLa and Vero cells (which do not express E1 functions), the level of HA protein synthesis was at least 35% of that seen in 293 cells. This MV adenovirus recombinant will be useful in the study of the biologic properties of the MV HA protein and in assessment of the potential usefulness of hybrid adenoviruses as live-virus vaccine vectors. PMID- 3292789 TI - Molecular characterization of gag proteins from simian immunodeficiency virus (SIVMne). AB - A simian immunodeficiency virus (SIV) designated SIVMne was isolated from a pig tailed macaque with lymphoma housed at the University of Washington Regional Primate Research Center, Seattle. To better establish the relationship of SIVMne to other immunodeficiency viruses, we purified and determined the partial amino acid sequences of six structural proteins (p1, p2, p6, p8, p16, and p28) from SIVMne and compared these amino acid sequences to the translated nucleotide sequences of SIVMac and human immunodeficiency virus types 1 and 2 (HIV-1 and HIV 2). A total of 125 residues of SIVMne amino acid sequence were compared to the predicted amino acid sequences of the gag precursors of SIV and HIVs. In the compared regions 92% of the SIVMne amino acids were identical to predicted residues of SIVMac, 83% were identical to predicted residues of HIV-2, and 41% were identical to predicted residues of HIV-1. These data reveal that the six SIVMne proteins are proteolytic cleavage products of the gag precursor (Pr60gag) and that their order in the structure of Pr60gag is p16-p28-p2-p8-p1-p6. Rabbit antisera prepared against purified p28 and p16 were shown to cross-react with proteins of 60, 54, and 47 kilodaltons present in the viral preparation and believed to be SIVMne Pr60gag and intermediate cleavage products, respectively. SIVMne p16 was shown to contain covalently bound myristic acid, and p8 was identified as a nucleic acid-binding protein. The high degree of amino acid sequence homology between SIVs and HIV-2 around proven proteolytic cleavage sites in SIV Pr60gag suggests that proteolytic processing of the HIV-2 gag precursor is probably very similar to processing of the SIV gag precursor. Peptide bonds cleaved during proteolytic processing of the SIV gag precursor were similar to bonds cleaved during processing of HIV-1 gag precursors, suggesting that the SIV and HIV viral proteases have similar cleavage site specificities. PMID- 3292791 TI - Characterization of an early gene accelerating expression of late genes of the baculovirus Autographa californica nuclear polyhedrosis virus. AB - The region of the Autographa californica nuclear polyhedrosis virus (AcMNPV) encompassing the EcoRI T fragment (29.0 to 30.1 map units) was characterized by DNA sequencing, transcriptional mapping, and site-directed mutagenesis. The largest transcript from this region, an early 1.7-kilobase (kb) poly(A)+ RNA, encompassed three tandem, nonoverlapping open reading frames (ORFs). The largest of these ORFs, ETL, was proximal to the 5' end of the transcript and had the capacity to encode a 28-kilodalton (kDa) polypeptide. A recombinant virus, vETL beta gal, containing the Escherichia coli beta-galactosidase (beta gal) gene fused to the N-terminal two-thirds of the ETL ORF, produced blue plaques in the presence of a chromogenic indicator of beta gal and wild-type levels of polyhedra in cell culture. This recombinant was also infectious in insect larvae by oral administration of occluded virus. Comparison of vETL beta gal and wild-type viral proteins pulse-labeled at various times postinfection (p.i.) revealed (i) absence of a virus-induced 28-kDa polypeptide, (ii) early expression of a large (approximately 130-kDa) polypeptide which may be the ETL-beta gal fusion protein, (iii) a delay in expression of early 35 and 40-kDa polypeptides, and (iv) a 4- to 6-h delay in the expression of late proteins in vETL beta gal-infected cells. Cycloheximide did not inhibit synthesis of the 1.7-kb RNA but did inhibit its shutoff, which occurs at 12 h p.i. in the absence of inhibitors. Thus, the ETL gene product is apparently an early 28-kDa protein which is necessary, directly or indirectly, for timely expression of many other AcMNPV genes. The promoter leader regions of the 1.7-kDa transcript showed significant sequence similarities to the leader of the AcMNPV IE-1 gene. The middle ORF within the 1.7-kb transcript, ETM, would encode a hydrophobic polypeptide of 113 amino acid residues. ETS, a small ORF within and proximal to the 3' end of the 1.7-kb transcript, was also transcribed as a set of smaller (approximately 0.5-kb) RNAs initiated heterogeneously in the region between ETL and ETS and persisting throughout infection. PMID- 3292792 TI - Length and shape variants of the bacteriophage T4 head: mutations in the scaffolding core genes 68 and 22. AB - The shape and size of the bacteriophage T4 head are dependent on genes that determine the scaffolding core and the shell of the prohead. Mutants of the shell proteins affect mainly the head length. Two recently identified genes (genes 67 and 68) and one already known gene (gene 22), whose products are scaffold constituents, have been investigated. Different types of mutants were shown to strongly influence the proportion of aberrantly shaped particles. By model building, these shape variants could be represented as polyhedral bodies derived from icosahedra, through outgrowths along different polyhedral axes. The normal, prolate particle is obtained by elongation along a fivefold axis. The mutations of the three core genes (genes 67, 68, and 22) affect the width mainly by lateral outgrowths of the prolate particle, although small and large isometric particles are also found. Many of the aberrant particles are multitailed, suggesting a correlation between tail attachment sites and shape. PMID- 3292793 TI - Purification and structural characterization of the putative gag-pol protease of human immunodeficiency virus. AB - We have purified a 10,774-dalton protein from human immunodeficiency virus (HIV) type 1 that is encoded in the protease domain of the pol open reading frame (ORF). Radiochemical amino acid microsequencing identified 12 amino acids from the stretch of 39 N-terminal residues of this protein, beginning with a PQITLW sequence at position 69 of the pol ORF. Radiosequencing of selected tryptic peptides of the protein identified 11 additional residues (Leu-9 and Val-2) in six peptides encompassing the entire molecule of 99 residues. A protein of similar size and identical N-terminal sequence (determined through the first 39 residues) was present among the processed HIV pol gene products in Escherichia coli which expressed the entire HIV pol ORF. The C terminus of both the viral and E. coli-expressed proteins was inferred to be contiguous with the N terminus of the p64-p51 reverse transcriptase on the basis of tryptic mapping and specific immunoreactivity with an antiserum against a dodecapeptide located upstream of the reverse transcriptase. Thus, the initial processing of the pol precursor that generates the native protease is apparently preserved across phylogenetic barriers. Although the purified viral protease lacked measurable proteolytic activity, the bacterial extracts were capable of processing an HIV gag precursor protein synthesized in E. coli. PMID- 3292795 TI - Serological diagnosis of human immunodeficiency virus infection by Western blot testing. The Consortium for Retrovirus Serology Standardization. PMID- 3292794 TI - Clinical applications of fish oils. AB - Fish oil supplements are currently being nationally advertised, and many physicians are being queried about their clinical utility. Epidemiologic studies reveal a low incidence of cardiovascular disease in people, such as the Eskimos, who eat large amounts of seafood. Cardiovascular health may be improved because fish and fish oil supplements lower plasma lipid levels (especially triglycerides), inhibit platelet aggregation, and may decrease blood pressure and viscosity and increase high-density lipoprotein (HDL) levels. Preliminary observations also suggest a potential future role for fish oils in the treatment of some autoimmune diseases, such as atopic dermatitis, psoriasis, and rheumatoid arthritis. Patients with serum triglyceride levels greater than 5.64 mmol/L and/or cholesterol levels greater than 7.75 mmol/L refractory to dietary management may benefit from a medically supervised trial of fish oil supplements. Data currently available are insufficient to recommend fish oil supplements for the general public, or for patients with other diseases, and side effects must also be considered. These include occasional adverse lipid changes, potential for bleeding and vitamin E deficiency, and, with some preparations, vitamin A and D toxicity. PMID- 3292796 TI - Physicians and the organizational evolution of medicine. AB - Within medicine there is growing uneasiness and debate about changes in medical care delivery. Much of this concern centers on the evolution of organizations and the role of physicians. The emergence of multi-institutional organizations, the rise of investor-owned health care corporations, and the expansion of group medical practice illustrate the increasing organizational influence in medicine. Added to these trends are new financial incentives confronting both physicians and organizations so that the environment increasingly favors conflict. This article reviews the primary strategies for resolving physician-organization conflicts, including cooperation between physicians and organizations, having physician representatives in governance and management, restructuring incentives, and restructuring organizations. Although these strategies have various merits, we suggest that every physician has a personal responsibility to become more involved in organization and management issues. Physicians can play an important role in guiding the evolution of medicine. PMID- 3292797 TI - Artificial beta-cell promotes positive nitrogen balance and whole body protein synthesis in insulin-dependent diabetic subjects. AB - To assess the effects of artificial beta-cell-directed insulin therapy on protein metabolism in patients with diabetes mellitus, nitrogen balance, urea production, and whole body protein turnover were determined in five type I insulin-dependent subjects and five age- and sex-matched controls. Each diabetic participant was studied over two 4-day periods while receiving conventional insulin therapy (one or two daily injections of short and intermediate acting insulin) or insulin delivered by the artificial beta-cell. While the diabetic participants received conventional insulin therapy, nitrogen balance, urea production, whole body protein turnover, and protein synthesis and breakdown rates did not differ significantly from the control group. However, when the same subjects were on artificial beta-cell-directed insulin therapy, they manifested a significant net positive nitrogen balance of over 2 g/day. This change in nitrogen balance was largely due to a fall in urea nitrogen production from 174 +/- 6 to 140 +/- 13 mg/kg body weight per day (p less than 0.05). In addition, while artificial beta cell therapy did not affect whole body protein turnover or breakdown rates, a significant rise (2.1 +/- 0.2 to 2.4 +/- 0.1 g/kg per day) in whole body protein synthesis was observed (p less than 0.05). Thus when compared to conventional insulin treatment, artificial beta-cell-directed insulin therapy was associated with a 14% increase in the rate of protein synthesis and a decrease of 20% in urea nitrogen production, leading to a net positive nitrogen balance. PMID- 3292798 TI - Cancer cachexia. AB - Cancer cachexia describes a syndrome of progressive weight loss, anorexia, and persistent erosion of host body cell mass in response to a malignant growth. Although often associated with preterminal patients bearing disseminated disease, cachexia may be present in the early stages of tumor growth before any signs or symptoms of malignancy. A decline in food intake relative to energy expenditure (which may be increased, normal, or decreased) is the fundamental physiologic derangement leading to cancer-associated weight loss. In addition, abnormalities of host carbohydrate, protein, and fat metabolism lead to continued mobilization and ineffective repletion of host tissue, despite adequate nutritional support. Mediators of cancer anorexia and associated abnormalities are unknown. Cachectin/TNF or other host-derived cytokines (produced as a defense against malignancy) have been implicated as signal molecules in cachexia, based upon similar metabolic derangements produced by these cytokines in other chronic wasting illnesses. Nutritional support is effective in maintaining body weight of cachectic cancer patients, but ineffective in maintaining lean body mass. Although in one study parenteral nutritional support has improved operative morbidity and mortality in cancer patients, it has not yet improved response to chemotherapy or radiation therapy. Because of metabolic derangements seen in cancer cachexia, effective nutritional treatment regimens will probably require manipulation of host intermediary metabolism in addition to feeding. Insulin therapy or exercise are two such methods which appear to preserve host composition by preferential feeding of the host at the expense of the tumor. Future studies which more clearly define the role of signal molecules in producing cancer cachexia syndrome may lead to new treatment strategies, possibly involving modulation of the effects of such molecules on host metabolism. PMID- 3292799 TI - Nutrition, operations, and intestinal adaptation. PMID- 3292800 TI - Phosphate depletion syndrome: case report with bone and muscle histology findings and review of the literature. AB - A 44-yr-old woman with a 16-yr history of heavy antacid ingestion was evaluated for severe weight loss, weakness, bone pain, and multiple fractures. Laboratory investigation revealed severe hypophosphatemia with undetectable phosphate in the urine. Serum parathyroid hormone (PTH), 25-hydroxyvitamin D, and 1,25 dihydroxyvitamin D levels were normal. Transiliac bone biopsy revealed evidence of mineralization defect compatible with hypophosphatemic osteomalacia. Bone densitometry documented decreased bone density with a low mineral content. Management included withdrawal of antacids and provision of phosphate supplemented enteral nutrition, which resulted in prompt weight gain and resolution of the clinical and biochemical abnormalities. The pathogenesis, diagnosis and histological features of hypophosphatemic osteomalacia are discussed. PMID- 3292801 TI - [Ultrasonographic study on ramification patterns of right intrahepatic third portal vein branches]. PMID- 3292802 TI - [Scintigraphic presentation: malignant neurilemmoma positively visualized by 99mTcDTPA]. PMID- 3292803 TI - [Primary malignant lymphoma of the spleen: report of a case]. PMID- 3292804 TI - [Sonographic features of renal malrotation--a case report]. PMID- 3292805 TI - Development of clinical immunosuppression for organ transplantation. AB - The progress in the understanding of allograft rejection since the first modern kidney transplantation is enormous. The concept of the histocompatibility complex (HLA system) was born and the loci for the related genes are now identified. The actual structure of HLA antigens and the molecules (lymphokines) released by them are being understood. A population of lymphocytes (suppressor cells) which reduces the host immune response to tissue allografts has also been identified. With advanced understanding, ideas and methods for immunosuppression have been developed. Hyperacute rejection due to presensitization (secondary to preformed HLA antibody) ought to be avoided or attenuated, if it were to happen. The significance of previous blood transfusion or multiple pregnancies were clarified in this regard. The tests to determine such immunological reactivity were devised. Steroids, azathioprine and cyclosporine which are presently in use for immunosuppression were reviewed as to their actions, effects and side-effects. Total lymphoid irradiation presently appears as a potential effective immunosuppressive procedure and is currently being tried in certain transplant centers. The superiority of monoclonal antibodies against polyclonal antilymphocyte antibodies has been confirmed, although the latter also has various useful actions. Finally, the need and possible means to facilitate donor specific unresponsiveness are mentioned in perspectives for the future management of clinical organ transplantation. PMID- 3292806 TI - The effect of cyclosporine on mortality and renal function in living related pediatric kidney transplant recipients. AB - The outcome, incidence of acute rejection episodes, complications and cyclosporine (CyA) induced nephrotoxicity were studied in 10 pediatric kidney transplant recipients who were grafted from one-haplotype indentical parent with immunosuppression of CyA and prednisolone (Pred). Excellent patient and graft survival could be achieved in this population with low incidences of acute rejection or serious complications as when compared with the results of azathioprine (AZ) treated pediatric patients. With a mean follow-up of 12.9 months (range 1 to 50 months), the patient survival rate was 100 per cent and the graft survival rate was 100, 84, 84 and 84 per cent at 1, 2, 3 and 4 years post transplantation, respectively. Serum creatinine levels in the group were 0.97, 1.17, 1.14 and 1.2 mg/dl at 3, 6, 12 and 24 months post transplantation, respectively. The incidence of treated acute rejection episodes was 20 per cent (2 out of 10) in the CyA-treated children, whereas it was 53 per cent (9 of 17) in the Az-treated children. Five children who had undergone transplant surgery before they were 11 years old displayed linear growth in height after their transplantation. There have been no opportunistic infections, aseptic necrosis or peptic ulcers in this group and cyclosporine nephrotoxicity has not been a serious problem in the pediatric recipients. Only 10 per cent (1 out of 10) of the recipients displayed acute nephrotoxicity and only one recipient has converted from CyA + Pred to CyA + AZ + Pred (Three drug therapy) due to persistent nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3292807 TI - A kidney transplant recipient with renal cell carcinoma derived from a native kidney. AB - A case of renal cell adenocarcinoma which originated from a left native kidney following kidney transplantation, with widespread metastases, including multiple bone and liver metastases, is presented herein. An extensive clinical investigation, including bone marrow biopsy, liver biopsy, abdominal computerized tomography, excretory urography and examination of the gastrointestinal tract failed to determine the site of the primary lesion in this patient. Examination at autopsy revealed a small adenocarcinoma of the left native kidney with lobulated nodular capsular invasion and metastases to the bone and liver. PMID- 3292808 TI - [Alcoholic lesion of the heart]. PMID- 3292809 TI - [Cardiotoxic effect of adriamycin]. PMID- 3292810 TI - ["Signal averaging technic" and "high resolution ECG": the methods of non invasive recording of late ventricular potentials]. PMID- 3292811 TI - [Long-term use of the calcium antagonist nifedipine (corinfar) in the treatment of patients with primary pulmonary hypertension]. AB - Sixteen patients on long-term treatment for primary pulmonary hypertension were studied. The results were compared after a single 20 mg dose, a two-week course and long-term (13.9 months on the average) use of the drug (40 mg/day). Pulmonary arterial catheterization, thermodilution and occlusion plethysmography were used. Changes in central and peripheral hemodynamic parameters were unidirectional and similar at all stages of the study. Nifedipine improved hemodynamics, as evidenced by selected criteria, in 80% of patients exposed to acute tests, in 91% after a course of treatment and in 58% after long-term use. Therefore, considering the ability of nifedipine to improve pulmonary hemodynamics as well as stable effect over more than one year of treatment, and the absence of marked side effects, this drug can be regarded as the most effective vasodilating agent for the treatment of primary pulmonary hypertension. PMID- 3292812 TI - [Effect of captopril on hemodynamics and physical exertion tolerance in patients with arterial hypertension]. AB - The hypotensive effect of captopril was assessed in patients with essential hypertension. Captopril-induced fall in arterial blood pressure was shown to be due to a decrease in total peripheral resistance. Treatment with captopril improved considerably physical stress tolerance, its combinations with a diuretic agent being particularly effective. PMID- 3292813 TI - A method for superfusion of the isolated perfused tubule. PMID- 3292814 TI - Early history of uremia. PMID- 3292815 TI - Overview of pediatric nephropathology. AB - I have given a brief overview of the morphologic basis of renal disease in children. Obviously I have been unable to include all the important and well-done studies of various conditions, which together cover the entire spectrum of pediatric renal disease. It is evident from the many studies that the renal biopsy has been, is, and will be quite helpful in elucidating the histologic pattern and severity of injury in the child with clinical evidence of renal disease. As therapy becomes more effective for renal diseases known to cause progressive renal insufficiency, the impact of the renal biopsy will become even greater. Because of the frequent discordance between clinical laboratory findings and renal histologic severity, an initial or baseline biopsy is often the only way to stage the alterations in renal structure. Present tests of renal function are imperfect and are insensitive parameters of insidious and progressive renal disease. The capacity of the kidney to compensate for nephron loss by hypertrophy and modification of the remaining nephrons can mask progressive renal disease and thus impair our ability to detect meaningful differences in therapeutic results. A repeated biopsy or "second look" allows detailed comparison and study of the effects of various therapeutic regimens on the renal disease process. Continued, detailed clinical-morphologic correlations and studies using improved techniques hopefully will provide us with better profiles or predictors of the type, severity, and pathogenesis of the renal disease in the individual patient. Determination of the histologic pattern by renal biopsy at present remains one of the, if not the, most important and reliable prognostic indicators in the individual patient and allows us a unique look at the host response to the varying types of injuries leading to pediatric renal disease. PMID- 3292816 TI - Focal and segmental glomerulosclerosis: analogies to atherosclerosis. AB - In summary, both the developing atherosclerotic and FSGS lesions seem to share certain postulated pathophysiologic mechanisms, including endothelial cell injury, macrophage infiltration, hyperlipoproteinemia, and hypertension. As depicted in Figure 1, any initial glomerular injury results in flux of macromolecular substances into the glomerular mesangium. As an adjunct to increased glomerular barrier dysfunction, hyperlipoproteinemia is believed to secondarily develop from the dramatic losses of albumin, stimulating increased hepatic lipoprotein synthesis and the loss of lipoprotein lipase-activating substance into the urine which would effectively produce a reduction in circulating chylomicra and triglyceride catabolism. Certain elevated circulating lipoproteins could, theoretically, pass through the damaged glomerular filter into the mesangium, thereby enhancing the flux of macromolecules. Also associated with certain experimental glomerular disorders is the development of glomerular hypertension, as manifested by an elevated glomerular capillary hydrostatic pressure (PGC), which can further augment macromolecular flux into the mesangium. Overloading of the glomerular mesangium by the above mechanisms is believed to be an injurious stimulus for MC to both proliferate and produce excess mesangial matrix substance. Both of these events are thought to be pathologic harbingers of glomerulosclerosis. Glomerular hypertension is also capable of damaging endothelial cells within the glomerular microcirculation, and this purportedly can activate platelets and result in glomerular thrombosis. At present, it is unclear how glomerular thrombosis produces increased mesangial cell injury; however, this process is believed to cause both systemic and glomerular hypertension which may serve as intermediary mechanisms producing the untoward effects of mesangial cell proliferation and matrix overproduction. PMID- 3292818 TI - Cyclosporine A enhances renin secretion and production in isolated juxtaglomerular cells. AB - Stimulation of the renin-angiotensin system is a major side effect of the fungoid immunosuppressant cyclosporine A (CyA). The aim of this study was to find out whether or not this effect of CyA results from a direct interaction with renal juxtaglomerular (JG) cells, which are the site of renal renin synthesis and release. Using primary cell cultures from rat renal cortex containing more than 80% JG cells, we found that CyA (0.01 to 10 micrograms/ml) stimulated renin secretion threefold. This stimulation was paralleled by a dose-dependent twofold increase of inactive renin within the cells, while the active intracellular renin remained the same. In order to identify a possible second messenger which could mediate the effects of CyA on JG cells, we examined the simultaneous effects of a single concentration of CyA (1 microgram/ml) on renin secretion, prostaglandin formation and intracellular cAMP concentration. However, prostaglandin formation and cAMP were not detectably altered by CyA in experiments where renin secretion was significantly enhanced. Our results indicate that cyclosporine A stimulates renin secretion and renin synthesis by a direct effect on renal juxtaglomerular cells. This action of CyA is not mediated by changes in cellular prostaglandin or intracellular cAMP. PMID- 3292817 TI - The effect of saline loading on uranium-induced acute renal failure in rats. AB - Studies were performed to examine the effect of saline loading on uranium-induced acute renal failure (ARF) in rats. Forty-eight hours after the i.v. injection of uranyl acetate (UA, 5 mg/kg), inulin clearance rate (Cin) decreased to approximately 43% of the control value in water drinking rats (P less than 0.005). Animals receiving continuous isotonic saline infusion following UA showed higher urine flow and Cin (60% of control, P less than 0.01), and lessened intratubular cast formation when compared with water-drinking ARF rats. A short term saline infusion following UA did not attenuate the decline in Cin (43% of control). An inverse relationship was found between Cin and the number of casts (r = -0.75, P less than 0.01). Multiple regression analysis showed that standardized partial regression coefficient is statistically significant between Cin and cast formation (-0.69, P less than 0.05), but not between Cin and tubular necrosis (-0.07, P greater than 0.05). Renin depletion caused by DOCA plus saline drinking did not attenuate the decline in Cin in ARF (47% of control). No significant difference was found in urinary uranium excretion between water drinking and saline-infused ARF rats. The findings suggest that continuous saline infusion following UA attenuates the decline in Cin in ARF rats; and that this beneficial effect of saline loading is associated with lessened cast formation rather than with suppressed renin-angiotensin activity or enhanced urinary uranium excretion. PMID- 3292819 TI - Hemodynamic factors in the pathogenesis of diabetic nephropathy. AB - The pathogenesis of the diabetic glomerular lesion is unknown. However, cumulative indirect evidence favors hemodynamic factors associated with the abnormal endocrine environment as the cause of diabetic angiopathy. Experimental evidence suggests that the increased hydrostatic pressures in capillary beds, a hallmark of the early stages of insulin-dependent diabetes, are associated with macromolecular leakage leading to the typical thickening of glomerular capillary basement membrane and increased glomerular mesangial matrix even prior to the occurrence of systemic hypertension. Patients with renal or carotid artery stenosis seem to be protected against diabetic nephropathy and retinopathy on the stenosed side. The first signal of diabetic nephropathy even before deterioration of the renal function is microalbuminuria detected by sensitive methods such as radioimmunoassay. Not only in hypertensive, but even in normotensive diabetic patients with microalbuminuria antihypertensive therapy has been shown to reduce albumin excretion rate and to slow the progression of diabetic nephropathy. Once overt diabetic nephropathy has been established, hypertension is a constant accompaniment of the disease. Thus, hypertension may be a cause as well as a result of diabetic nephropathy. Tight control of blood sugar in close association with antihypertensive treatment reducing blood pressure to a lower normal limit, possibly with agents that specifically decrease glomerular capillary hydraulic pressure are the corner stone in protection against progression of the diabetic angiopathy. PMID- 3292820 TI - Age-related occurrence of simple renal cysts studied by ultrasonography. AB - Three hundred forty-eight outpatients without evidence of renal disease were examined by ultrasound. Their ages ranged from 18 to 83 years. Unexpected renal cysts of more than 1 cm were found in 47 patients (13.5%). No cysts were demonstrated in patients less than 23 years old; thereafter the number of patients with cysts increased significantly with age. The cyst diameter also tended to increase with age, but the correlation with age was not significant. There was no statistical difference of cyst occurrence between the right and left kidney, or between males and females. The upper portion of the kidney was most often affected in the equally divided three portions along the long axis. These results confirm that the development of simple renal cysts is age-related. PMID- 3292821 TI - [Evoked potentials and intravenous anesthetics]. AB - In contrast to the electroencephalogram, which is a collection of the spontaneous brain electrical potentials generated by the cerebral cortex, evoked potentials are the electrical signals generated by the nervous system in response to brief extrinsic sensory stimuli. They can be used to establish objective evidence of an abnormality when clinical signs and symptoms are equivocal. Moreover they prove useful to define the anatomical level of lesions in the afferent pathway tested. They have been successfully applied during anesthesia and operations when pathways amenable to evoked potential recording were at risk. The most practical techniques in common intraoperative evoked response monitoring involve stimulation of visual, auditory and somatosensory pathways. As could be clearly demonstrated alterations of evoked responses can not only be found with diminished regional blood flow but in a graded manner depend on the used anesthetics as well. The potential application of evoked responses to monitor depth of anesthesia has been demonstrated by several groups. In contrast to visual, auditory and somatosensory cortical evoked potentials which show a large inter- and intraindividual variance acoustical evoked brainstem and somatosensory evoked subcortical potentials are very robust under general anesthesia. Drug induced effects on shape, amplitude and latencies of evoked responses during balanced anesthesia must be well documented in order to establish evoked responses as sensitive indicators of systemic problems that may threaten the viability of the central nervous system. There is evidence that the effects on evoked responses during deep anesthetic states can be mimicked by several life threatening conditions (e.g.: hypoxia, ischemia). This review describes the effects of intravenously used anesthetic drugs on visual, auditory and somatosensory evoked potentials and the alterations in evoked responses by abnormal systemic conditions as seen under hypotension, hypoxia, ischemia. PMID- 3292822 TI - [Evoked potentials and inhalation anesthetics]. AB - Intraoperative monitoring of evoked potentials can be affected by various factors including volatile anaesthetics. These effects have to be considered in order to give correct interpretations of the obtained data. Visual evoked potentials (VEP) and auditory evoked potentials (AEP) will show strong alterations under general anaesthesia whereas brainstem auditory evoked potentials (BAEP) are slightly affected. The effects of nitrous oxide, halothane, enflurane, and isoflurane on somatosensory evoked potentials (SEP) after median nerve stimulation were studied in 35 healthy adult patients. pCO2 and tympanic membrane temperature were held constant. Simultaneous cervical and cortical SEP recording was performed using surface electrodes. After induction of anaesthesia SEP were recorded during normoventilation with 100% oxygen and after inhalation of 66.6% nitrous oxide. 10 patients received halothane at inspired concentrations of 0.5, 1.0, 1.5, and 2.0%. After nitrous oxide had been replaced by oxygen, halothane was reduced in steps of 0.5%. SEP were recorded at the end of each period (15 min). Equipotent doses of enflurane or isoflurane were administered to 15 and 10 patients, respectively. Nitrous oxide depressed early cortical SEP amplitude. Halothane, enflurane, and isoflurane caused dose dependent increases of latencies. Reduction of amplitude was most pronounced with isoflurane. Using high doses of enflurane in oxygen cortical SEP showed unusual high amplitudes associated with marked increases of latencies. Even under high concentrations of volatile anaesthetics cervical SEP were minimally affected. The effects of anaesthetic gases have to be considered when SEP are recorded intraoperatively. PMID- 3292823 TI - [Intraoperative monitoring with visual and auditory evoked potentials]. AB - Intraoperative monitoring techniques concerning evoked potentials have been used during operations on the spinal cord as well as in carotid endarterectomy and in aneurysm surgery. The monitoring of early acoustic evoked potentials during surgery of the posterior fossa and the registration of the visually evoked potentials in patients suffering from pituitary adenoma or other space occupying lesions of the sella region seem to provide information about function of nerves and brain stem structures. This paper deals with positive and negative aspects of intraoperative monitoring of visual and acoustic evoked potentials. PMID- 3292824 TI - [Bronchopulmonary aspergillosis]. PMID- 3292825 TI - [Hereditary hemochromatosis]. PMID- 3292826 TI - [Neurogenic amenorrhea]. PMID- 3292827 TI - [In memoriam Vladimir Kharitonovich Vasilenko (1897-1987)]. PMID- 3292828 TI - [Current aspects of the problem of primary hyperparathyroidism]. PMID- 3292830 TI - [Surgical treatment in bullous disease of the lungs]. PMID- 3292829 TI - [Functional activity of alveolar macrophages in patients with chronic bronchitis]. PMID- 3292831 TI - [Infectious-allergic bronchial asthma]. PMID- 3292832 TI - [Do we learn from history?]. PMID- 3292833 TI - [Change-over to insulin U-100 by 1 October 1988. What you absolutely have to know]. PMID- 3292834 TI - Malignant Leydig cell tumour in a Tupaia belangeri: case report and literature review of male genital tumours in non-human primates. AB - After a short summary of the few reported tumours of the male genital system in non-human primates, a malignant Leydig cell tumour is described in an adult male Tupaia belangeri. The tumour had metastasized in the omentum probably by haematogenous spread enabled by the peculiar perivascular growth pattern of the tumour cells. Its differential diagnosis versus seminomas and Sertoli cell tumours is discussed. PMID- 3292835 TI - Retinoids, growth factors, and the tracheobronchial epithelium. PMID- 3292836 TI - From Africa to South Carolina: a brief review of the contributions of Africans and African-Americans to medicine. PMID- 3292837 TI - Black physicians, South Carolina medicine, and the SCMA. PMID- 3292838 TI - Edward Francis Darby, M.D. PMID- 3292839 TI - The nature of biosensor technology. AB - The biosensor exploits the unique specificity of biological recognition events by coupling an enzyme, antibody or other biorecognition species to a transducing device. Interaction of the biocomponent with substrate or antigen is thus converted into a suitable quantitative output. The development of these biosensors is a multidisciplinary effort, exploiting many of the emerging semiconductor and optics technologies and integrating many traditional assay techniques. The impact of these biosensors is likely to be wide-ranging, with applications in medical and industrial environments as well as a variety of other fields. PMID- 3292840 TI - Recombinant granulocyte-macrophage colony-stimulating factor improves hematopoietic recovery after 5-fluorouracil. AB - Antitumor chemotherapy is often limited by hematopoietic toxicity. In an attempt to determine if it is possible to attenuate the myelosuppressive effects of chemotherapy, we administered recombinant murine granulocyte-macrophage colony stimulating factor (rmGM-CSF), a multilineage hematopoietic growth factor, to mice receiving 5-fluorouracil (5-FU). Mice receiving injection of 5-FU followed 24 hr later by a single 1-microgram injection of rmGM-CSF had significantly increased femoral bone marrow granulocyte-macrophage colony-forming cells (GM CFC) 48 hr after 5-FU injection compared to animals receiving 5-FU alone. Animals receiving rmGM-CSF twice daily beginning 24 hr after 5-FU had significantly elevated white blood cell counts and increased granulocyte and monocyte counts at Day 7 following 5-FU injection, compared to those of 5-FU animals. The total reserve of GM-CFC was also expanded initially in the femoral marrow and later in the spleen of animals receiving rmGM-CSF following 5-FU. A means of accelerating bone marrow recovery and restoration circulating granulocytes and monocytes could allow more frequent doses of chemotherapy to be administered or shorten the time period that patients are leukopenic. PMID- 3292842 TI - Fundamental restorative dentistry. PMID- 3292841 TI - In vitro generated allospecific cytolytic T lymphocytes injure pancreatic islets. AB - The role of cytotoxic T lymphocytes in the rejection of pancreatic islet allografts remains poorly defined. The present study was designed to assess the ability of in vitro generated cytolytic T lymphocytes to produce allospecific functional and structural damage of mouse pancreatic islets. A mixed lymphocyte islet coculture model (MLIC) has been developed, in which islets from DBA/2J mice (H-2d) stimulate the generation of allospecific cytolytic T lymphocytes (C57B1/6, H-2b), as measured by lysis of allospecific chromium-labeled tumor targets. Responder C57B1/6 splenocytes sensitized to DBA/2J islets were harvested from the MLIC on Day 5 and cocultured with either freshly isolated DBA/2J or B10.BR (H-2K) islets. Islet injury was determined by assessment of beta cell function after 8 hr (as measured by insulin release in response to a glucose challenge) and islet destruction after 24 hr of coculture with the sensitized splenocytes. Whereas coculture of third party B10.BR islets with MLIC-sensitized C57B1/6 anti-DBA splenocytes had no effect on insulin release or structure, incubation of allospecific DBA/2J islets with these splenocytes resulted in inhibition of insulin release after 8 hr and disintegration of the islets by 24 hr. The depletion of MLIC-sensitized C57B1/6 anti-DBA splenocytes with anti-Lyt2 monoclonal antibody, but not anti-L3T4 monoclonal antibody, prevented the allospecific destruction of fresh islets by the splenocytes in culture. This study suggests that allospecific, cytotoxic T lymphocytes may play an important role in the effector mechanism of pancreatic islet allograft destruction. PMID- 3292843 TI - Demonstration of a well-characterized tumor-associated antigen on melanoma cell surface. AB - We have isolated and characterized a melanoma tumor-associated antigen (TAA) from the spent culture medium of a melanoma cell line. Its presence has been detected in 72% of different melanoma specimens but not in normal tissues. Because tumor antigens may stimulate or perhaps block immune reactions to cancer cells, their presence on the cell surface may be a critical factor influencing tumor growth. Therefore, to define further the immunobiological characteristics of melanoma TAA, this antigen was investigated by membrane immunofluorescence. Serum from a melanoma patient known to have a high anti-TAA antibody titer was absorbed quantitatively with lymphoblastoid cells autologous to the target melanoma cells to remove non-anti-TAA antibodies. The absorbed serum was reacted with three cultured melanoma cell lines, UCLA-SO-10 (M10), UCLA-SO-14(M), and UCLA-SO-24 (M24). Of these cell lines, M10 and M14 are known to express the antigen as assessed by radioimmunoassay. Reaction of the antibody(s) to the antigen(s) on the melanoma cell surface was detected by fluorescein-conjugated goat anti-human IgG. The reactivity of the absorbed serum was inhibited by preincubation with purified melanoma TAA. These results clearly demonstrate that melanoma TAA is expressed on the cell surface of cultured melanoma cells. PMID- 3292844 TI - Anticandidal activity of plants used for the treatment of vaginitis in Guatemala and clinical trial of a Solanum nigrescens preparation. AB - An ethnobotanical survey detected 71 plants used for the treatment of vaginitis by traditional healers, health promoters and midwives. Extracts prepared by maceration of plants in 50% methanol were impregnated on absorbent paper disks and placed over plates with Candida albicans. Eight (11.3%) of these plants showed some degree of inhibition. Solanum nigrescens was chosen for further studies. A cream containing a 50% ethanolic maceration was applied daily to the vagina of female guinea pigs for 15 days and observed for another 15 days. Since no inflammatory changes were observed, this preparation was used for clinical trials. Two groups of 50 non-pregnant women with confirmed C. albicans vaginitis were treated for 15 days, one group with intra-vaginal suppositories containing S. nigrescens maceration and the other with nystatin suppositories. By statistical analysis it was demonstrated that both groups behaved in a similar beneficial way suggesting that this plant may be effective for the treatment of candidal vaginitis. PMID- 3292845 TI - Progress in the study on the medical effects of apocynum venetum (A. lancifolium). PMID- 3292846 TI - The earliest monograph on pharmaceutics in China. PMID- 3292847 TI - A poet who compiled a herbal (Li Xun). PMID- 3292848 TI - Coincidence of a myeloproliferative and a lymphoproliferative disorder--a random event? AB - A patient with coinciding polycythemia vera and chronic lymphocytic leukemia is reported. Based on a literature review and vital statistics it is concluded that the coincidence is probably fortuitous. PMID- 3292850 TI - The combined bite impression technique. PMID- 3292849 TI - Cell stimulation by interleukin 3 is a novel process of signal transduction: the rolling cell cycle and its implications for leukemic transformation. PMID- 3292851 TI - Meta-analysis of correlates of provider behavior in medical encounters. AB - This article summarizes the results of 41 independent studies containing correlates of objectively measured provider behaviors in medical encounters. Provider behaviors were grouped a priori into the process categories of information giving, questions, competence, partnership building, and socioemotional behavior. Total amount of communication was also included. All correlations between variables within these categories and external variables (patient outcome variables or patient and provider background variables) were extracted. The most frequently occurring outcome variables were satisfaction, recall, and compliance, and the most frequently occurring background variables were the patient's gender, age, and social class. Average correlations and combined significance levels were calculated for each combination of process category and external variable. Results showed significant relations of small to moderate average magnitude between these external variables and almost all of the provider behavior categories. A theory of provider-patient reciprocation is proposed to account for the pattern of results. PMID- 3292852 TI - [Serratia marcescens bacteremia: a study of 83 cases]. PMID- 3292853 TI - [Blood glycosylated hemoglobin and fructosamine and C-peptide in the amniotic fluid of diabetic pregnant patients: relation to fetal weight]. PMID- 3292854 TI - [Usefulness of angiotensin converting enzyme inhibitors in the treatment of diabetic nephropathy]. PMID- 3292855 TI - [The risk of anesthesia]. PMID- 3292856 TI - [Hemophagocytic syndrome associated with brucellosis]. PMID- 3292857 TI - [Validity of dip culture in the quantification of bacteriuria]. PMID- 3292858 TI - [Nosocomial bacteremia in adults. Epidemiology and identification of modifiable factors in 497 episodes]. PMID- 3292860 TI - [Effect of the angiotensin I-converting enzyme inhibitor captopril in hypertensive diabetics without nephropathy]. PMID- 3292859 TI - [Non-hospital acquired bacteremia in adults. Prospective analysis of 333 episodes]. PMID- 3292861 TI - [The value of clodronate (C12MDP) in the treatment of primary postmenopausal hyperparathyroidism]. PMID- 3292863 TI - [Adenosine deaminase: biochemical characteristics and clinical significance of an enzyme key to cellular immunity]. PMID- 3292862 TI - [Muckle-Welles syndrome (urticaria, deafness and amyloidosis). A new familial case]. PMID- 3292864 TI - [Pseudo-Cushing syndrome caused by alcohol: un infrequent cause of failure of suppression by high doses of dexamethasone]. PMID- 3292865 TI - [Effectiveness of radioactive iodine in the treatment of toxic adenoma: results of our experience with a group of 17 patients and review of the literature]. PMID- 3292866 TI - [Interstitial pneumonitis caused by herpes simplex virus in an allogeneic bone marrow transplant successfully treated with acyclovir]. PMID- 3292867 TI - [Evaluation of a new technic for determination of blood theophylline]. PMID- 3292868 TI - Age-related susceptibility to the insulin-depleting action of 4 diphenylmethylpiperidine in young rats. AB - Studies were undertaken to investigate age-related changes in the ability of 4 diphenylmethylpiperidine (4-DPMP) to reduce levels of pancreatic insulin in young rats. Oral doses of 4-DPMP (5.0 or 10.0 mg/kg) were given once daily for two days to 9-, 15- and 21-day-old rats. Twenty-four hours after the last dose, pancreatic insulin content, non-fasting serum glucose, and the amount of unchanged 4-DPMP present in the whole body were estimated. 4-DPMP treatment produced a decline in pancreatic insulin and the extent of this action was greater in younger animals. The observed changes in pancreatic insulin were not reflected in altered serum glucose levels, showing this parameter is a relatively poor indicator of pancreatic insulin loss. Younger animals had a larger fraction of the total dose of 4-DPMP in the body at the end of the experimental period when compared to the fraction retained by older rats. The age-related susceptibility of young rats to the diabetogenic action of 4-DPMP may be related to the differences in the rate of elimination of the chemical at different ages. PMID- 3292869 TI - Effect of experimental hyperinsulinemia on sympathetic nervous system activity in the rat. AB - Since insulin acutely stimulates the sympathetic nervous system, a role for sympathetic overactivity has been hypothesized to underlie the association between chronic hyperinsulinemia and hypertension. To assess the effect of sustained hyperinsulinemia on sympathetic function, [3H]norepinephrine (NE) turnover was measured in rats injected with insulin for 14d. NE turnover in insulin-treated animals given free access to lab chow and a 10% sucrose solution was compared with that obtained in rats fed chow alone or chow plus sucrose. Sucrose ingestion increased NE turnover in heart, brown adipose tissue, and liver, but exogenous insulin did not augment turnover beyond that seen in animals given sucrose alone. This study, therefore, provides no evidence that chronic hyperinsulinemia, sufficient to induce peripheral insulin resistance, stimulates sympathetic activity more than that produced by chronic sucrose ingestion. PMID- 3292870 TI - Obesity: thermodynamic principles in perspective. AB - The energy balance equation applicable to all living organisms was used as a framework on which to construct a critical review of some of the more controversial aspects of the obesity problem. The equation matches energy intake against all the known forms of work that the body does in utilizing that energy, including external and internal work and the work of adipose tissue synthesis (stored energy). Equations representing everyday living conditions, resting, fasting and basal conditions were constructed. The equation applicable to everyday living (working, non-fasting) was used to develop a set of model paradigms to illustrate some of the devices that can be invoked to decrease expenditure and conserve energy. These served as models of how obesity can arise in the absence of calorie overconsumption. The same equation was then used to create a set of opposite paradigms showing how obesity can be prevented by increasing expenditure to waste energy and stabilize body weight when challenged by hyperphagia. In order to see caloric intake and the various work terms in their proper quantitative relationships it was necessary to assign numerical values to the equation. These were selected from published reports of caloric values representative of a non-obese adult of average size engaged in a typical white collar occupation. It was then easy to adjust these assigned values commensurate with the objectives described in the preceding paragraph. Since obesity research is hampered by a confusing array of metabolic interactions it was essential to alter only one of the energy terms at a time, excluding all metabolic interactions except for those unavoidable ones dictated by the laws of thermodynamics. Only in this way could we see the body's multiple energy forms in clear perspective with regard to their real quantitative significance in the energy balance sheet and their potential impact on body weight. Creating these models gave us the added advantage of enabling us better to evaluate the scientific literature because the data we generated, although theoretical, served as excellent standards against which to compare the real data that have emanated from research laboratories.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3292872 TI - A surgical algorithm for the management of facial palsy. PMID- 3292871 TI - The effects of intravenous prostacyclin in a model of microsurgical thrombosis. AB - Numerous agents have been administered in an attempt to achieve specific biochemical antiplatelet activity. A model of microsurgical trauma was utilized to create a nonocclusive thrombus, similar to what occurs in the postoperative period. Prostacyclin (PGI2) was given in a high intravenous dose which caused in vitro inhibition of platelet aggregation in rats and rabbits. Although hematological and cardiovascular side effects of PGI2 were tolerated, in vivo platelet thrombus formation persisted and constituted 25-75% of the postoperative thrombus. Even though platelets were inhibited by PGI2, other significant stimuli remained at the site of injury for activation and participation of platelets in the formation of a thrombus. PMID- 3292874 TI - Quantitative determination of Escherichia coli from faecal coliforms in seawater. AB - A simple rapid method was developed for counting Escherichia coli in sea water using a membrane filter procedure. Following filtration the membrane filter was incubated on mFC agar medium for 24 +/- 2 h at 44.5 +/- 0.2 degrees C for determination of faecal coliforms. An in situ test for the determination of E. coli was carried out by transferring the membrane filter to nutrient agar containing 4,methyl-umbiliferyl-B-D, glucoronide, followed by incubation for 3 h at 35 degrees C. The E. coli colonies were detected by fluorescence under long wavelength UV light. Extensive biochemical confirmation tests on the isolates showed that all the fluorescence colonies which were either lactose positive or negative were E. coli. PMID- 3292873 TI - Vasculitis associated with malignancy. Experience with 13 patients and literature review. AB - Vasculitis is a syndrome which may complicate certain infectious, rheumatic, and allergic diseases. We identified 13 patients, over the past 17 years, who had both vasculitis and lympho- or myeloproliferative disorders and relate their clinical, laboratory, histologic, and immunologic features, course, therapy, and outcome. Nine patients were male, 4 female; ages ranged from 28 to 82 years. Ten of 13 patients presented with cutaneous vasculitis antedating malignancy by an average of 10 months. Three of 13 developed cutaneous vasculitis after malignancy. A statistically significant association between cutaneous vasculitis and lympho- or myeloproliferative malignancies was noted when compared with all other tumors. Dermatologic manifestations included palpable purpura (5 patients), maculopapular eruptions (4), urticarial and petechial lesions (3), and ulcers (1). Hepatitis B surface antigen, Coombs antibodies, rheumatoid factor and antinuclear antibodies were not found. Serum cryoglobulins were detected in 3 patients; serum C3 and C4 were normal in 8 of 9 patients evaluated. Histologic examinations revealed necrotizing leukocytoclastic vasculitis with disruption of endothelial integrity, destruction of endothelium, and neutrophil infiltration. Occasional perivascular mononuclear cell invasion was also noted in 4 patients. Immunofluorescent staining for IgG, IgA, IgM, C3, and C4 was negative in all patients studied. Symptoms were, in general, poorly responsive to therapy, which included nonsteroidal antiinflammatory drugs, antihistamines, antiserotonin agents, and corticosteroids. Chemotherapy directed at the underlying malignancy was also generally ineffective, although the vasculitis appeared to lessen in severity. Vasculitis appeared to lessen in severity as bone marrow function deteriorated. Ten patients died, all as a direct result of their malignancy. We have described a unique clinical syndrome of lympho- and myeloproliferative disease presenting with small-vessel vasculitis. Recognition that rheumatic symptoms may reflect or antedate malignancy may permit early diagnosis, aggressive treatment, and elucidation of pathogenesis. PMID- 3292875 TI - The surface charge of cells of Mycobacterium bovis BCG vaccine, Tice substrain. AB - The zeta potential of cells of an attenuated vaccine Mycobacterium bovis, BCG, Tice substrain, was measured over a pH range of 1.5-11.0 at low electrolyte concentration. There was a marked electro-positive charge at low pH, the zero charge point, pH 4.4, being similar for viable and heat killed vaccine. At pH 6.5 the addition of sodium dodecyl sulphate or sodium tauroglycolate made little difference to the zeta potential. However, progressive addition of cetylpyridinium chloride reduced and finally reversed the charge to a maximum of +60 mV at a concentration of 1.5 x 10(-2) mol dm-3 surfactant. Higher concentrations reduced the charge although it remained positive. The nature of the adsorbing species on the cell surface is discussed since the Tice substrain has both cationic and anionic surface charges whereas the Glaxo strain is reported to only possess electro-negative phosphate surface groups. Some hydrophobic interaction involving lipid within the surface may also be involved. PMID- 3292876 TI - Factors affecting protoplast release from some mesophilic, thermophilic and thermotolerant species of filamentous fungi using Novozym 234. AB - Factors affecting the release of protoplasts from mycelia of Aspergillus fumigatus, Aspergillus niger, Penicillium ochrochloron and Geosmithia emersonii were investigated. Protoplast yields were found to be greatly dependent on the growth temperature, incubation conditions, lytic enzyme system, mycelial age and mycelial concentration. High yields of protoplasts were obtained from all four organisms after a 3 h incubation with 1 mg/ml Novozym 234 in 0.1 M 2-N [morpholino] ethane sulphonic acid (MES) buffer at pH 5.0, containing 0.6 M sodium chloride. Supplementation of the incubation medium with 0.03 M calcium chloride enhanced protoplast release in P. ochrochloron but not in the other three fungi. PMID- 3292877 TI - The American Microcirculatory Society Landis Award lecture. Endothelial cells, inflammatory edema, and the microvascular barrier: comments by a "free radical". PMID- 3292878 TI - Preferential expression of a 130,000-Da cell surface protein by vascular wall cells in vitro and in vivo. AB - Monoclonal antibodies have been raised against cell surface proteins of cultured bovine retinal pericytes. One antibody was selected, designated PC4, which preferentially stained primary cultures of bovine pericytes and smooth muscle cells, but not endothelial cells and fibroblasts. In freshly plated cells a homogeneous cell surface staining was observed, whereas in well-spread cells the antigen was concentrated at cell attachment sites. The antigen remained at these sites after spontaneous detachment of the cells. PC4 monoclonal antibodies reacted with a major protein of 130,000 Da and two minor antigens of 75,000 and 70,000 Da in immunoblots of extracts from cultured pericytes and smooth muscle cells and from fibroblasts cultured for an extended period of time. In frozen sections of bovine tissues the antigen was found in the vascular wall. There was no staining of skeletal muscle cells or duodenal smooth muscle cells, indicating that the antigen may be a specific component of the vascular wall. PMID- 3292879 TI - Immunotyping of Chlamydia psittaci by indirect immunofluorescence antibody test with monoclonal antibodies. AB - Monoclonal antibodies against pigeon and budgerigar strains of Chlamydia psittaci were used to classify the immunotypes of C. psittaci strains by an indirect immunofluorescence antibody (IFA) test. Thirty-three C. psittaci strains from pigeons and 24 from budgerigars were divided into three immunotypes (P-I, P-II, and P-III) and (B-I, B-II, and B-III), respectively. Two strains from human psittacosis patients were identified as P-III and B-I, coinciding with the epidemiological evidence of each human infection. Two strains from psittacine birds, a parrot and a parakeet, were identical to the B-II immunotype. Other mammalian strains were quite distinct from avian strains in their IFA reaction with the monoclonal antibodies. PMID- 3292880 TI - Differentiation between genera Rhodococcus and Nocardia by susceptibility testing to kanamycin and some other antituberculosis agents. AB - The test for susceptibility to kanamycin is useful for differentiating between the genera Rhodococcus and Nocardia. All rhodococci except R. equi, R. erythropolis, and R. aurantiacus are susceptible to kanamycin, whereas all nocardiae except N. otitidis-caviarum are resistant to kanamycin. Tests for susceptibility to rifampicin, streptomycin, and minocycline also are useful for differentiating among the species of each genus. PMID- 3292881 TI - Mycotic aneurysm of the thoracic aorta caused by Salmonella typhimurium. AB - A fatal case of mycotic aneurysm of the thoracic aorta is described. Salmonella typhimurium was isolated from blood cultures and from cultures of a post-mortem sample of the aneurysm. A review of the literature showed that while endovascular infection is a recognized complication of salmonellal septicaemia in the elderly, infection of the thoracic aorta by Salmonella spp. is rare. A combination of surgery and antibiotic therapy always is required for a successful outcome. PMID- 3292883 TI - Diagnostic tests for AIDS. PMID- 3292882 TI - Salmonellal mycotic abdominal-aortic aneurysm. AB - A patient is described with a mycotic abdominal-aortic aneurysm that was caused by Salmonella typhimurium, who presented to hospital four months after a urinary tract infection that was caused by the same organism. The urinary-tract infection may have resulted from an episode of transient salmonellal bacteraemia, the significance of which was not appreciated. The pathogenesis, clinical features, treatment and prognosis of arteritis due to Salmonella species are reviewed. The early diagnosis and appropriate treatment of salmonellal mycotic aortic aneurysm is vital for a satisfactory outcome. PMID- 3292885 TI - The use of ultrasound as an imaging technique in the diagnosis of sinusitis. AB - In recent years the high prevalence of chronic sinusitis has been noted in association with bronchial asthma, perennial rhinitis, aspirin sensitivity and on its own. Diagnosis conventionally requires use of radiographs, especially to detect ethmoid and sphenoid sinus disease. To limit radiation exposure, alternative diagnostic tests have been sought. The currently available tests will be reviewed and their advantages and disadvantages will be discussed. One imaging technique, that of A-mode ultrasound, has appeared as a promising adjunct to plain radiographs for diagnosis of maxillary and frontal sinus disease. The data utilizing ultrasound has been mixed and needs to be interpreted with care. This data will be reviewed and guidelines will be presented on the current use of the technique. Data obtained in the author's laboratory comparing the use of A-mode ultrasound and mucosal thickening as seen on plain radiographs will be presented. Further studies using the technique are suggested to better define patients who may be followed on a serial basis. Ultrasound is one of a number of new imaging techniques that are being applied to paranasal sinus disease. Early studies from Europe showed considerable promise, and instruments have been actively marketed in the U.S. before there has been much published experience here. The data are as yet incomplete, and the precise role of ultrasound either as a screening test or as a tool to monitor progress in chronic sinusitis is as yet undetermined. PMID- 3292884 TI - Effect of selective decontamination of the digestive tract of donor and recipient on the occurrence of murine delayed-type graft-versus-host disease. AB - In the present study we investigated the occurrence of delayed-type graft-versus host disease (DT-GvHD) after allogeneic bone marrow transplantation (BMT) between two H-2 incompatible mouse strains. BMT was performed on mice with a conventional intestinal microflora as well as on mice in which the Enterobacteriaceae were selectively eliminated from the intestinal microflora by oral antibiotic treatment. None of the conventional or the selectively decontaminated (SD) chimaeric mice suffering from DT-GvHD died of bacteraemia. While DT-GvHD was mitigated when C3H/He recipient mice were SD-treated, this was not the case when C57B1/6J recipient mice were SD-treated. SD-treatment of the digestive tract of donor mice only mitigated DT-GvHD when the recipients were also SD-treated. We conclude that Enterobacteriaceae in the digestive tract may only play a minor role, if any, in the occurrence of DT-GvHD. Instead, we postulate that in this study DT-GvHD was determined by differences in the composition of the resident intestinal microflora (IM) of both mouse strains together with the cellular composition of the bone marrow graft. The interaction between antigenic components of the recipient's IM and the developing donor immune system in the recipient as a possible cause for DT-GvHD is discussed. PMID- 3292887 TI - Laboratory tests for total and allergen-specific immunoglobulin E. AB - The principles of measurement of IgE by enzyme-immunoassay are given. A Bayesian approach is taken for the clinical interpretation of serum total IgE. Application of Bayes' Theorem to serum total IgE can significantly influence the probability of a clinical diagnosis of allergy. There is a correlation between allergen specific IgE measured by enzyme-immunoassay, by radioallergosorbent test and by skin tests for immediate hypersensitivity. However, there is a need to standardize the reagents used for allergy skin testing, as well as the reagents and methods used for the laboratory measurement of allergen-specific IgE. PMID- 3292888 TI - [Diagnosis and timing of operation for strangulation ileus--especially concerning the usefulness of ultrasonography]. AB - This is a clinical report on the usefulness of ultrasonography in the diagnosis of strangulation ileus and the timing of operation for this entity. Fifty-eight cases of strangulation ileus were investigated retrospectively and twenty-five cases had undergone ultrasonography. Ultrasonography delineated the strangulated intestinal tract as an akinetic distended intestinal tract and the intestinal tract on the oral side of the strangulated part as a movable distended tract with peristalsis and to-and-fro movement of the intestinal content. Retention of ascites was seen in many cases. Utilization of ultrasonography improved the rate of accurate preoperative diagnosis of strangulation ileus to 92%, resulting in timely surgery. Consequently, the number of cases requiring enterectomy because of intestinal necrosis sharply decreased. Shock, peritoneal irritation sign, leukocytosis, roentgenographic findings were inferior to ultrasonography in the preoperative diagnosis for the prediction of intestinal necrosis in strangulation ileus. PMID- 3292886 TI - Inhalation challenge. AB - Inhalation challenge with methacholine is now a standardized procedure using a drug specifically approved for the purpose of determining the nature and extent of airways hyperreactivity. The methodology described involves the intermittent administration of graduated concentrations of methacholine by aerosol inhalation followed by routine spirometry after each incremental dose thereby enabling the construction of a dose response curve. The PD20FEV1, the provocation dose of agonist necessary for a 20% decrease in FEV1, is interpolated from the curve and is the accepted index of airways sensitivity. Clinically, the procedure has been widely used to implement the diagnosis of asthma in such atypical cases as when the physical exam and pulmonary function tests are equivocal. In such a setting, a positive test often justifies the use of therapeutic bronchodilators whereas a negative test would lead the examiner away from the alternative of hyperactive airways. Other applications include the evaluation of antigen sensitivity for diagnostic and research purposes including occupational asthma, epidemiology, and investigational drug trials. PMID- 3292889 TI - [Changes of plasma amino acid profiles following total hepatectomy under veno veno bypass in dogs]. AB - Patients with advanced liver disease demonstrate characteristic plasma amino acid abnormalities. The response of plasma amino acid patterns after liver transplantation in those patients is unknown. Mongrel dogs were subjected to two experimental models, that is, one is total hepatectomy under veno-veno bypass as an assumption of an hepatic phase in liver transplantation and the another is splenectomy as control. In control group, BCAA/AAA ratio rose gradually during operation. The levels of methionine, glycine and alanine were significantly lower at 4 hours. In hepatectomized dogs, BCAA/AAA ratio fell gradually after total hepatectomy. The levels of amino acids except BCAA were higher than preoperative value. Increase of alanine was the most remarkable early after total hepatectomy. It was derived not only from the lack of glucose-alanine cycle but also from increased synthesis due to degradation of the BCAA in muscle. PMID- 3292890 TI - [A case of right adrenal myelolipoma diagnosed preoperatively and review of literature in Japan]. AB - Fifty-nine years old female who complained of right back pain was diagnosed as having right adrenal myelolipoma preoperatively by ultrasound, CT and other examinations. The patient was cured by surgery. The resected tumor was 11.5 X 10.5 X 8.5 cm in size and 470 g in weight. Histopathological diagnosis was myelolipoma of Soos's type 1. Sixteen cases of myelolipoma, including our case have been reported in Japanese literature. The age of patients ranged from 20 to 60 (average 49.1) and male-female ratio was 11:5. Most patients presented with abdominal pain and abdominal mass, and had complication of obesity and hypertension. The lesion was more common on the right side (11:5). Their size was 3-21 cm (average 10.9 cm) and their weight was 10-1, 930 g (average 823 g). Adrenal myelolipoma can be certainly diagnosed preoperatively by ultrasound, CT and other examinations. Adrenal tumors showing normal adrenal endocrine function and fat density on CT examination indicate that they could be myelolipoma in their nature. PMID- 3292891 TI - [Orthotopic liver transplantation in the rat--The effect of blood group (RT2) matching on the survival of liver allografts]. PMID- 3292892 TI - [Recombination between RNA genomes]. AB - Evidence for the intermolecular recombination between the RNA genomes of picornaviruses and coronaviruses as well as current models of the mechanisms of these phenomena are reviewed. Biological implications of the recombination between RNA genomes are briefly discussed. Examples of the recombinant analysis of the viral genome functions are given. PMID- 3292893 TI - [Structural-functional organization of DNA in the interphase nucleus. Functional aspects]. AB - The functional organization of DNA in the interphase nucleus is considered. The interconnection of residual nucleic structures with replication and transcription processes is discussed from the standpoint of loop-domain and rosette-like patterns of DNA organization in the nucleus. PMID- 3292894 TI - [RNA polymerase of a rifampicin-resistant mutant of Escherichia coli has an altered selectivity to phage T7 DNA promoters]. AB - The formation of complexes of RNA polymerases from E. coli W12 and its rpoB409 rifampicin resistant mutant with A1 and D promoters of T7 delta D111 DNA was studied by an abortive RNA synthesis technique. The mutation was shown to affect RNA synthesis initiation at these two promotors differentially so that the efficiency of D promotor utilization is enhanced but the use of A1 promotor is unchanged. The mutation does not interfere with the affinity of the enzyme for both initiating substrates. The results show that the change in RNA polymerase beta-subunit structure has a differential effect on the enzyme interaction with different promotors. The necessity of a classificatory approach to structure functional analysis of promotors was proposed. PMID- 3292895 TI - [Modification of tyrosine residues of the Klenow fragment of DNA-polymerase I from Escherichia coli by acetylimidazole]. AB - The modification of tyrosine residues of DNA polymerase I Klenow fragment from E. coli by acetylimidazole has been investigated. This reagent was shown to inactivate both polymerization and 3',5'-exonuclease activities but with different velocity. The poly(dT)-template and r(pA)10-primer each added separately to the enzyme have no notable influence on the rate of enzyme inactivation. Simultaneous presence of both template and primer increases the rate of inactivation. In the presence of poly(dT).r(pA) 10 there is not effect of dCTP and dTTP (noncomplementary to the template) on the rate of inactivation of polymerization activity. However, dATP complementary to the template, provides a complete protection. A weak protective action is detected in the presence of dADP. Orthophosphate, pyrophosphate and dAMP each taken separately increase the rate and the level of the enzyme inactivation. dAMP together with either ortho- or pyrophosphate have the same protective action as ATP. All data obtained allow to suggest the functional significance for polymerization activity of tyrosine located in the dNTP binding site of DNA polymerase I. PMID- 3292896 TI - [Symmetry-regulated dynamics of multi-enzyme complexes. A model of a pyruvate dehydrogenase complex from Escherichia coli]. AB - A dynamic model for quaternary structure of a multienzyme complex is considered. The model is based on the supposition of simultaneously existing similar subunits in a number of different conformational states in the "core" of the multienzyme complex. It is supposed that cyclic conformational transitions of the "core" subunits conserve the symmetry of the entire complex. Such transitions drive the core dynamics as well as the suprastructural multienzyme dynamics. The dynamic model is constructed for the pyruvate dehydrogenase complex from E. coli in a supposition of three different conformers existing in its "core" which correspond to the three steps of the cyclic catalytic process. The model is in accordance with the data from the literature. PMID- 3292897 TI - Chloramphenicol: magic bullet or double-edge sword? AB - The genetic and genotoxic potentials of chloramphenicol are reviewed and analyzed. Although this widely used antimicrobial agent appears to cause chromosomal effects in somatic cells, in view of the consistent absence of other genetic effects, these cytogenetic abnormalities are ascribed to non-genotoxic causes. It is pointed out that despite its widespread use in human medicine, chloramphenicol has not been systematically tested for genotoxicity. PMID- 3292898 TI - A review and analysis of the Chinese hamster ovary/hypoxanthine guanine phosphoribosyl transferase assay to determine the mutagenicity of chemical agents. A report of phase III of the U.S. Environmental Protection Agency Gene Tox Program. AB - Published literature on the Chinese hamster ovary cell/hypoxanthine guanine phosphoribosyl transferase (CHO/HGPRT) assay from mid-1979 through June 1986 was reviewed and evaluated. Data from the papers considered acceptable include test results on 121 chemicals belonging to 25 chemical classes. A total of 87 chemicals were evaluated positive, 3 negative, and 31 inconclusive. Mutagenicity data on 49 of the 121 chemicals evaluated could also be compared with in vivo animal carcinogenicity data. 40 of the 43 reported animal carcinogens were considered mutagenic. Caprolactam, the only definitive noncarcinogen in the group of 49, was not mutagenic. The CHO/HGPRT assay was concluded to be an appropriate assay system for use in the screening of chemicals for genotoxicity. PMID- 3292899 TI - Review of the genotoxicity of formaldehyde. PMID- 3292900 TI - The mutagenic activity of selected compounds at the TK locus: rodent vs. human cells. AB - The mutagenic (TFT resistance) and toxic responses of mouse lymphoma (MOLY) L5178Y cells and human lymphoblast (HULY) TK6 cells were compared for 13 chemicals. The mutagenic activities of 8 of the 13 chemicals (62%) examined in the HULY and MOLY assays are in agreement - the results being judged positive in both assays. However, a dramatic difference is observed when the two conditions of metabolic activation are considered separately; the overall concordance of 8/13 has been achieved by combining a 13/13 (100%) agreement in the absence of S9 with a 1/6 (17%) agreement in the presence of S9. In the absence of S9, the concentration ranges, lowest significant doses, and shapes of the concentration response curves for both toxicity and mutagenicity were similar in spite of the differences in exposure times (4 h for MOLY, 20 for HULY) and expression times (2 days for MOLY, 3 days for HULY). The general agreement observed in the absence of S9 contrasted with the differences manifested in its presence. 6 compounds which were negative in the absence of S9 were tested in both the MOLY and HULY assays in the presence of S9. Of the 6 chemicals, only 1 was positive in both MOLY and HULY under the latter condition; 4 others were positive in MOLY and negative in HULY whereas 1 was positive in HULY and negative in MOLY. PMID- 3292901 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC working paper No. 5. Genotoxicity tests as predictors of carcinogens: an analysis. AB - Differences between the results of numerical validation studies comparing in vitro and in vivo genotoxicity tests with the rodent cancer bioassay are leading to the perception that short-term tests predict carcinogenicity only with uncertainty. Consideration of factors such as the pharmacokinetic distribution of chemicals, the systems available for metabolic activation and detoxification, the ability of the active metabolite to move from the site of production to the target DNA, and the potential for expression of the induced lesions, strongly suggests that the disparate sensitivity of the different test systems is a major reason why numerical validation is not more successful. Furthermore, genotoxicity tests should be expected to detect only a subset of carcinogens, namely genotoxic carcinogens, rather than those carcinogens that appear to act by non-genetic mechanisms. Instead of relying primarily on short-term in vitro genotoxicity tests to predict carcinogenic activity, these tests should be used in a manner that emphasizes the accurate determination of mutagenicity or clastogenicity. It must then be determined whether the mutagenic activity is further expressed as carcinogenicity in the appropriate studies using test animals. The prospects for quantitative extrapolation of in vitro or in vivo genotoxicity test results to carcinogenicity requires a much more precise understanding of the critical molecular events in both processes. PMID- 3292902 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC topic No. 2. Heterozygous effects of multilocus deletions. PMID- 3292903 TI - Mutagenesis and deoxyribonucleotide pool imbalance. AB - Numerous studies have demonstrated that DNA-precursor pool imbalances are mutagenic and can modulate the lethality and mutagenicity of DNA-damaging agents. In addition, physical and chemical mutagens can induce alterations in DNA precursor levels. Such findings suggest that regulation of intracellular concentrations of DNA precursors may be an important factor in environmental mutagenesis. In this article, results linking mutation and disturbances in DNA precursor pools are reviewed. PMID- 3292904 TI - Mutational specificity of thymine deprivation-induced mutation in the lacI gene of Escherichia coli. AB - LacI- mutants obtained following 2 and 6 h of thymine deprivation were cloned and sequenced. The mutational spectra recovered were dissimilar. After 2 h of starvation the majority of mutations were base substitutions, largely G:C----C:G transversions. Frameshift mutations but not deletions were observed. In contrast, following 6 h of starvation, with the exception of the G:C----C:G transversion, all possible base substitutions were recovered. Moreover, several deletions but no frameshift events were observed. The differences in the mutational spectra recovered after the two periods of thymine deprivation highlight the role of altered nucleotide pools and the potential influence of DNA replication and repair mechanisms. PMID- 3292905 TI - Genotoxicity of excess thymidylate in thymidylate low-requiring Saccharomyces cerevisiae is associated with changes in phosphate metabolism. AB - When dTMP in concentrations greater than 100 microM is offered to growing cells of thymidylate low-requiring yeast strains it is both mutagenic and toxic. At exposure concentrations greater than 1 mM dTMP interferes significantly with the low-affinity phosphate permease even in the presence of exogenous phosphate concentrations of 6 mM. Chemical analysis and 31P NMR spectroscopy reveal that excess dTMP disturbs phosphate metabolism in thymidylate low-requiring strains but not in the wild type. The most prominent changes in phosphorus-containing molecules are found in polyphosphates of which up to 20% are broken down within a 20-min time span with a concomitant increase in orthophosphate pools. PMID- 3292906 TI - Consequences of the depletion of cellular deoxynucleoside triphosphate pools on the excision-repair process in cultured human fibroblasts. AB - DNA excision repair requires the insertion of bases into gaps in the DNA which arise during the removal of damaged sites from the chromatin. The number of bases required is dependent on the amount of damage and the patch size of repair in response to the particular type of damage. In cells in which the ability to synthesize deoxynucleoside triphosphates (dNTPs) has been compromised, repair cannot proceed to completion following doses of DNA-damaging agents which induce repair that requires greater than the steady-state level of dNTPs. Repair is thus not equally sensitive to depletion of dNTPs when measured in rapidly cycling cells with relatively high dNTP pools or in non-cycling cells with significantly smaller pools. Critical depletion of dNTPs results in the production of long lived DNA strand breaks at repairing sites and reduction in the number of sites initiating repair. On the other hand, elevation of dNTP pools to 10-50-fold normal levels did not inhibit repair. This indicates that dNTP pool depletion but not general pool-imbalance affects DNA excision repair. PMID- 3292907 TI - The role of nucleotides in human fragile site expression. AB - Fragile sites are points on chromosomes which tend to break non-randomly when exposed to specific chemical agents or conditions of tissue culture. There are 3 groups of rare fragile sites, and carriers of these range in incidence from about 1 in 20 to 1 in several thousand individuals. Rare fragile sites are essentially chromosome variants with no known phenotypic consequence, except for the fragile X which is associated with the commonest inherited form of mental retardation in man. There are also 3 groups of common fragile sites, carried by all or most individuals. These are part of normal chromosomal architecture. Expression of most of the groups of fragile sites is mediated by perturbations of the nucleotide pool and these, as they relate to each group of fragile sites, are discussed. The rare folate-sensitive fragile sites are expressed when thymidylate or deoxycytidine are in limited supply during DNA synthesis. Other rare fragile sites are induced by bromodeoxyuridine (BrdU). Sets of common fragile sites are induced by BrdU, 5-azacytidine and aphidicolin. Various hypotheses on the molecular nature of fragile sites are considered. PMID- 3292908 TI - Metaphysics of regulated deoxyribonucleotide biosynthesis. PMID- 3292909 TI - The role of blood platelets in nucleoside metabolism: regulation of megakaryocyte development and platelet production. AB - In higher vertebrates, different types of blood cells develop from common precursors. Mammals are unique in possessing two types of blood cells- erythrocytes and platelets--which lack nuclei. Although platelets display consistent and easily-recognisable morphological and ultrastructural characteristics and show extreme metabolic and functional versatility, they are not true cells, being produced by fragmentation of giant polyploid precursors called megakaryocytes. At present, the physiological mechanisms which regulate megakaryocyte development and platelet production are not well understood. Platelets are actively involved in metabolism of purine derivatives and a significant platelet role in pyrimidine metabolism has also been demonstrated (see previous papers). Here an attempt is made to integrate information about platelet involvement in nucleic acid precursor metabolism with current concepts of haematopoiesis, particularly megakaryocyte development and platelet production. It is concluded (i) that megakaryocytic cells are immediate descendents of haematopoietic stem cells which have become polyploid as a result of genetic damage or metabolic imbalances, (ii) megakaryocytes and platelets are the ultimate regulators of stem cell development because they control the availability of thymidine and (iii) that the production of megakaryocytes and platelets is a physiological safety mechanism which prevents fixation of genetic damage and protects other cells from potentially cytotoxic and genotoxic stimuli. PMID- 3292910 TI - Cryptococcus neoformans in Quebec (1985-1986). PMID- 3292911 TI - In vitro activity of enilconazole against Aspergillus spp. and its fungicidal efficacy in a smoke generator against Aspergillus fumigatus. PMID- 3292912 TI - A more sophisticated method of determining the fungicidal effect of water insoluble preparations with a cell harvester, using miconazole as an example. PMID- 3292913 TI - Thromboxane biosynthesis and platelet function in type I diabetes mellitus. AB - It has been speculated that platelet activation may contribute to the evolution of vascular complications in patients with Type I diabetes mellitus. To address this hypothesis, we measured the plasma and urinary metabolites of thromboxane, presumably of platelet origin, and of prostacyclin, derived from endothelial cells, in addition to more conventional indexes of platelet function. Urinary excretion of the metabolites 2,3-dinor-thromboxane B2 and 2,3-dinor-6-keto prostaglandin F1 alpha did not differ between diabetics with or without retinopathy and nondiabetic controls. Furthermore, measurement of platelet granule constituents, the aggregation responses to ADP or arachidonic acid, and levels of serum thromboxane B2 failed to discriminate between the groups. The institution of tight diabetic control with multiple daily injections of insulin failed to alter either urinary metabolite excretion or plasma levels of 11 dehydro-thromboxane B2. Conversely, insulin-induced hypoglycemia failed to alter the concentrations of plasma or urinary thromboxane metabolites in nondiabetic volunteers, despite a mean 60-fold increase in plasma epinephrine. These studies suggest that platelet activation does not precede the development of microvascular complications in patients with Type I diabetes who lack clinical evidence of macrovascular disease and have normal renal function. Furthermore, it is unlikely that platelet activation due to intermittent hypoglycemia contributes to the reportedly accelerated development of retinopathy in such patients, when they are subject to tight diabetic control. PMID- 3292914 TI - Corticotropin-releasing hormone. PMID- 3292916 TI - Progression of diabetic retinopathy after pancreas transplantation. PMID- 3292915 TI - Successful pregnancy despite placental cystine crystals in a woman with nephropathic cystinosis. PMID- 3292917 TI - Nimodipine in acute ischemic stroke. PMID- 3292918 TI - Heterotopic prosthetic ventricle as a bridge to cardiac transplant. PMID- 3292919 TI - Pregnancy after nonsurgical ultrasound-guided gamete intrafallopian transfer. PMID- 3292921 TI - Single cell protein as food and feed. AB - This review pertains the current knowledge concerned with the application of SCP in human and animal nutrition. General factors limiting the utilization of microbial proteins in human nutrition, such as toxicological barriers, nutritive value and functional properties, are discussed. Special attention is paid to several modern procedures of protein extraction from microbial cells, reduction of nucleic acids level as well as preparation of protein isolates. According to the data presented the latter can be considered as valuable protein substitutes. Significantly less nutritive problems are being concerned with the application of SCP in animal nutrition. Successful feeding experiments with chicken and pigs are discussed. Under these experimental conditions 10-20% of the protein in the feedstuff can be replaced by SCP. Moreover, several in Poland obtained protein vitamin preparations are described. These originated from selected yeast and propionic acid bacteria grown in whey and its ultrafiltrates and can be considered as valuable food and feed supplements. PMID- 3292920 TI - Clinical and biochemical manifestations of depression. Relation to the neurobiology of stress (1) PMID- 3292923 TI - Individual programme planning. PMID- 3292924 TI - Politics and plaster. PMID- 3292922 TI - The meningitis menace. PMID- 3292925 TI - What do mental handicap nurses do? PMID- 3292926 TI - Food for thought. Interview by Daloni Carlisle. PMID- 3292928 TI - Nursing in Saudi. PMID- 3292927 TI - The big screen. PMID- 3292929 TI - Changing patterns of care. PMID- 3292930 TI - Playing away. Interview by Pauline Chudley. PMID- 3292931 TI - Redressing the balance. PMID- 3292932 TI - Back to nursing: an essential guide to plan your return to the profession. PMID- 3292933 TI - Radiation: exposing the facts. PMID- 3292934 TI - Inside radiology. PMID- 3292935 TI - Blood simple. PMID- 3292936 TI - Multiple sclerosis. PMID- 3292937 TI - Taking heart. PMID- 3292938 TI - A bill of contention. Interview by Pauline Chudley. PMID- 3292939 TI - Caring for body and soul. Interview by Jane Salvage. PMID- 3292940 TI - Soldiering on. Interview by Pauline Chudley. PMID- 3292941 TI - The other side of the fence. PMID- 3292942 TI - Eliminating incontinence. PMID- 3292943 TI - Protest and the professional. PMID- 3292944 TI - Care of the patient on ventilation. PMID- 3292945 TI - Reflex zone therapy. PMID- 3292947 TI - Uniforms--your chance to choose! PMID- 3292946 TI - Cancer care. PMID- 3292948 TI - The whole truth. Interview by Pauline Chudley. PMID- 3292949 TI - AIDS--safety first. PMID- 3292950 TI - Crossing the boards. Interview by Pauline Chudley. PMID- 3292951 TI - Breaking down the barrier. PMID- 3292952 TI - A good death. PMID- 3292953 TI - Reconstructive approach. PMID- 3292955 TI - Choosing nursing. PMID- 3292954 TI - Second sight. PMID- 3292956 TI - Clinical grading--taking it from the top. PMID- 3292957 TI - Healthy management. Interview by Bronwen Jones. PMID- 3292958 TI - An eye for adventure. Interview by Bronwen Jones. PMID- 3292959 TI - If it's two o'clock it must be Stockport. PMID- 3292960 TI - A menace of modern surgery. PMID- 3292962 TI - Renal effects of angiotensin-I converting enzyme inhibitors. PMID- 3292961 TI - HMG-CoA reductase inhibition: the start of a new age in the treatment of hypercholesterolaemia. PMID- 3292963 TI - Postsplenectomy sepsis. PMID- 3292964 TI - [Sodium transport and renal hemodynamics in arterial hypertension of genetic origin: primary or secondary changes?]. AB - Essential hypertension develops from the interaction of genetic and environmental factors. In the Milan hypertensive strain (MHS) rat before the development of hypertension, there is a genetically inherited increase of tubular reabsorption which is the cause of the following increase of blood pressure. Also in young normotensive humans, predisposed to develop essential hypertension later in life, there is an abnormal pattern of renal function that may be explained by increase of tubular reabsorption. The studies of the erythrocyte membrane transport support these data and suggest that at least a subset of essential hypertensive humans may develop a form of hypertension that has pathogenetic mechanisms similar to the ones of MHS rats. PMID- 3292965 TI - Insulin receptors in the brain: structural and physiological characterization. AB - The present study was conducted to characterize insulin receptors and to determine the effects of insulin in synaptosomes prepared from adult rat brains. Binding of 125I-insulin to synaptosome insulin receptors was highly specific and time dependent: equilibrium binding was obtained within 60 minutes, and a t1/2 of dissociation of 26 minutes. Cross-linking of 125I-insulin to its receptor followed by SDS-PAGE demonstrated that the apparent molecular weight of the alpha subunit of the receptor was 122,000 compared with 134,000 for the liver insulin receptor. In addition, insulin stimulated the dose-dependent phosphorylation of exogenous tyrosine containing substrate and a 95,000 MW plasma membrane associated protein, in a lectin-purified insulin receptor preparation. The membrane associated protein was determined to be the beta subunit of the insulin receptor. Incubation of synaptosomes with insulin caused a dose-dependent inhibition of specific sodium-sensitive [3H]norepinephrine uptake. Insulin inhibition of [3H]norepinephrine uptake was mediated by a decrease in active uptake sites without any effects in the Km, and was specific for insulin since related and unrelated peptides influenced the uptake in proportion to their structural similarity with insulin. These observations indicate that synaptosomes prepared from the adult rat brain possess specific insulin receptors and insulin has inhibitory effects on norepinephrine uptake in the preparation. PMID- 3292966 TI - Neuropeptide Y immunoreactivity in the locus coeruleus of the rat brain. AB - The detailed distribution of neuropeptide Y immunoreactive neurons and fibres is given for the rat locus coeruleus. The studies were carried out using indirect immunofluorescence and avidin-biotin-peroxidase techniques. It was shown that in colchicine pretreated rats, about 15-20% of locus coeruleus neurons contain neuropeptide Y immunoreactivity. Neuropeptide Y immunoreactive neurons form two populations: (1) medium-sized or large neurons, poorly immunostained, situated mainly in the dorsal and central locus coeruleus nucleus, and (2) small, strongly immunostained neurons in ventromedial parts of the nucleus. Neuropeptide Y immunoreactive fibres and terminals are scattered throughout the locus coeruleus, but are more numerous in its ventromedial and ventrorostral parts. PMID- 3292967 TI - Delayed treatment with dextromethorphan and dextrorphan reduces cerebral damage after transient focal ischemia. AB - The N-methyl-D-aspartate (NMDA) antagonists dextromethorphan (DM) and dextrorphan (DX) were found to reduce significantly neocortical severe ischemic neuronal damage (SIND) when administered in a delayed fashion after the ischemic insult. Rabbits underwent occlusion of the left internal carotid artery and anterior cerebral artery for 1 h, followed by 4 h of reperfusion. Immediately after the completion of the 1 h arterial occlusion, animals were blindly treated intravenously with 20 mg/kg loading dose followed by 10 mg/kg/h of DM, 15 mg/kg loading dose followed by 15 mg/kg/h of DX, or an equivalent volume of normal saline (NS) alone. The area of neocortical SIND was 3.7% in the DM group, 4.4% in the DX group, and 41.3% in the normal saline controls. These drugs may have considerable therapeutic potential in clinical stroke. PMID- 3292968 TI - Acetylcholinesterase undergoes autolysis to generate trypsin-like activity. AB - Acetylcholinesterase (AChE) is one of the most highly studied enzymes, although its function in many tissues has remained obscure. AChE purified from eel or foetal bovine serum possesses proteolytic activity in addition to esterase activity. The presence of trypsin-like and metallocarboxypeptidase-like activities associated with AChE accounts for its ability to convert enkephalin peptide precursors into enkephalins. Several lines of evidence indicate that AChE's trypsin-like activity is an integral component of the molecule and that it is activated by autolysis. Incubation of affinity-purified eel AChE generated several fragments of low relative molecular mass (Mr). One of these low Mr fragments (Mr = 25,000 Da, 25K) cleaved from the 70K form of AChE, possessed considerable sequence similarity to the N-terminal sequence of pancreatic trypsin. Autolysis of eel AChE may give rise to a neuropeptide processing enzyme. PMID- 3292969 TI - A blueprint for change: what's ahead for nursing in the age of A.I.D.S.? PMID- 3292970 TI - Massive hydrothorax in continuous ambulatory peritoneal dialysis: diagnosis, management and review of the literature. AB - Recurrent massive hydrothorax is an uncommon but serious complication in patients on continuous ambulatory peritoneal dialysis (CAPD). Accurate confirmative diagnostic procedures of the pleuroperitoneal communication is lacking and the management remains difficult. We reported three patients who developed massive hydrothorax at different periods after commencement of CAPD treatment (1.5-9 months). These patients underwent different investigatory procedures for demonstrating the pleuroperitoneal communication. We conclude that both technetium 99m-tagged macroaggregated albumin intraperitoneal radionuclide scan and stereoisomeric analysis of lactate in the peritoneal and pleural fluid are safe and reliable procedures to demonstrate the pleuroperitoneal communication. The massive hydrothorax was successfully treated in two patients by pleurodesis induced by intrapleural administration of oxytetracycline combined with 10-days small volume intermittent peritoneal dialysis. The clinical findings of 18 other cases previously reported in the literature are also reviewed. PMID- 3292972 TI - Neurofibroma of the vagina presenting with urinary retention. Review of the literature and report of a case. PMID- 3292971 TI - Management of stab wounds to the pregnant uterus: a case report and a review of the literature. AB - Only 18 cases of stab wounds to the pregnant uterus have been reported to date. This paper presents an additional case--a patient at 26 weeks' gestation with multiple voluntary stab wounds to the abdomen and lower chest resulting in fetal death. The literature is reviewed and management of abdominal stab wounds in pregnancy is discussed. PMID- 3292973 TI - Modifications to selective conservative management in preterm premature rupture of the membranes. AB - Selective conservation in preterm premature rupture of the membranes (PPROM) reduces risks of infection and pulmonary hypoplasia associated with expectant management by delivering those at greatest risk, while permitting continuation of pregnancy in the remainder. Although patient selection has traditionally been a clinical decision, more accurate criteria are now available. The role of biochemical, biophysical and microbiological predictors of chorioamnionitis and fetal pulmonary status in PPROM is reviewed, and the resultant modifications to selective conservative management discussed. PMID- 3292974 TI - Autologous blood storage in obstetrics. AB - Autologous transfusion, storage of one's own blood for subsequent infusion if needed, is safe and effective in a variety of scheduled operative procedures. Obstetric involvement in such programs is very limited, however. Thirty pregnant women with placenta previa or other potential complications underwent 55 phlebotomies in an autologous transfusion program. Phlebotomies were performed at an average gestational age of 32.4 weeks (range 13-40). Changes in mean diastolic blood pressure and pulse were minimal. Electronic fetal monitoring tracings were normal during the 34 procedures in which it was used. The frequency of mild donor reactions (4%) was consistent with that in nonpregnant donors. After entry into this program, 15 patients received a total of 29 U of packed red blood cells (23 autologous; six homologous). Homologous transfusion was avoided in 86.7% of patients receiving blood. Selected pregnant women can participate safely in autologous blood collection programs, minimizing the need, and therefore the risks, of homologous transfusion. PMID- 3292975 TI - The fetal femur/foot length ratio: a new parameter to assess dysplastic limb reduction. AB - The relationship between growth of the fetal femur and foot length was examined between 14-40 weeks' gestation in 182 normal singleton pregnancies. A significant correlation was demonstrated (r = 0.98; P less than .0001). The femur/foot length ratio was found to be approximately 1 throughout this age range. The fifth and 95th percentile confidence intervals of the femur/foot length ratio versus gestational age were then defined. The femur/foot length ratio was also measured directly in 12 fetuses after second-trimester abortion; these measurements compared favorably with the ultrasound femur/foot length ratio nomogram. The discriminatory power of the femur/foot length ratio chart to differentiate fetuses with skeletal dysplasias from those with pseudo-limb reduction due to constitutional factors or intrauterine growth retardation (IUGR) was tested in 16 sequential cases with femur measurements below the fifth percentile. Two cases suspected of having symmetrical IUGR and five cases suspected of being constitutionally small were found to have femur/foot length ratios within the 90th percentile range. Limb reduction deformities were suspected in the nine remaining cases, and the femur/foot length ratios in these fetuses were all found to be less than the fifth percentile. The femur/foot length ratio nomogram appears to be a useful parameter to help differentiate fetuses that have dysplastic limb reduction from those whose limbs are short because of constitutional factors or IUGR. PMID- 3292977 TI - Very early pregnancy detection with endovaginal ultrasound. AB - There are many situations in which the earliest possible detection of an intrauterine pregnancy would enhance clinical management. Current radioimmunoassays for hCG can detect pregnancy as early as eight to 12 days post conception. The ability to document an intrauterine pregnancy with ultrasound has lagged behind by two to three weeks. New high-frequency endovaginal transducers offer the promise of narrowing this gap. This study was undertaken prospectively on 235 patients all amenorrheic for seven weeks or less and requesting either pregnancy testing or termination. All had endovaginal ultrasound scans. We obtained hCG levels when no sac was seen or when the sac was less than 1.0 cm (initial experience revealed that all sacs over 1.0 cm were associated with hCG levels over 6000 mIU/mL) (International Reference Preparation). Ultrasound findings were correlated with pathology specimens and/or hCG levels where appropriate. Results indicated that normal pregnancies can be imaged when: 1) The sac is greater than 0.4 cm; 2) hCG is greater than 1025 mIU/mL (International Reference Preparation); and 3) the uterus is normal with a homogeneous echo pattern. This was not true in three of our cases with diffuse myomatous changes or a coexisting intrauterine device. PMID- 3292976 TI - Choroid plexus cysts in the fetus: a benign anatomic variant or pathologic entity? Report of 41 cases and review of the literature. AB - During a 22-month period, 6288 women undergoing prenatal sonographic studies in the second and third trimesters were evaluated prospectively to determine the incidence of choroid plexus cysts in the fetus, to follow the natural course of these cysts in intrauterine life, and to determine the association of chromosomal and anatomic anomalies in these fetuses. We diagnosed choroid plexus cysts in 41 fetuses, an incidence of 0.65%. Unilateral and bilateral cysts were equally frequent, and in most cases diagnosed by 21 weeks' gestation. On follow-up scans, the cysts had completely disappeared by 23-24 weeks in 80% of the cases, and by 28 weeks in another 10%. Once resolved, the cysts did not recur, and a normal sonogram in the late second trimester predicted normal scans in late pregnancy and in the neonate. One fetus had a chromosomal abnormality (trisomy 18). Associated anatomic anomalies were detected in three fetuses, including the one with trisomy 18. We believe that in the great majority of cases, fetal choroid plexus cysts are benign transient variants of normal intracranial anatomy. It is, however, important to conduct a careful sonographic search for associated anomalies. Chromosomal studies are strongly recommended whenever associated anatomic abnormalities are detected and when the choroid plexus cysts are large, bilateral, and persistent beyond 20-22 weeks' gestation. PMID- 3292978 TI - Umbilical arterial systolic/diastolic values in normal twin gestation. AB - Linear regression analysis was used to describe the relationship of umbilical arterial systolic/diastolic values to gestational age in 65 twin gestations. This relationship (y = 6.18 - 0.11x) was then compared with a previously described regression for singleton pregnancies using a multiple regression model. This comparison revealed that the relationship between the systolic/diastolic ratio and gestational age is the same in singleton and twin gestations. PMID- 3292979 TI - Maternal and fetal blood flow velocity waveforms in patients with preterm labor: effect of tocolytics. AB - The effect of tocolytics on systolic to diastolic (S/D) ratios used to assess downstream vascular resistance and obtained from umbilical and uterine velocity waveforms has not been studied to date. Continuous-wave Doppler studies were performed on the umbilical and uterine arteries of 60 consecutive patients with the diagnosis of preterm labor. Forty patients receiving intravenous magnesium sulfate and 20 patients receiving intravenous ritodrine tocolysis underwent Doppler studies before therapy, during incremental therapy, and four hours post therapy. There was a statistically significant (P less than .001) progressive decrease in the uterine and umbilical S/D ratios along with a concomitant increase in maternal and fetal heart rate associated with increasing infusion doses of ritodrine. Both the S/D ratios and heart rates returned to pretherapy range four hours after discontinuing therapy. Magnesium sulfate tocolysis was not associated with any significant change in S/D ratios or maternal and fetal heart rate. We conclude that intravenous ritodrine affects umbilical and uterine vascular resistance as measured by S/D ratios. This response may be secondary to changes in maternal and fetal heart rate. PMID- 3292981 TI - Prospective comparison of Dilapan and laminaria for pretreatment of the cervix in second-trimester induction abortion. AB - Fifty-four women presenting for second-trimester induction abortion received either Dilapan synthetic dilators or laminaria for pretreatment of the cervix before induction abortion using intra-amniotic prostaglandin (PG) F2 alpha. The two groups were similar with respect to age, parity, previous abortion, and gestational age. Neither group experienced any unusual complications. The same protocol for intraamniotic PGF2 alpha (40 mg) was used in all patients except for three with histories of asthma, in whom PGE2 vaginal suppositories (20 mg) were used as the induction agent. For the Dilapan group, an average of three devices was used, compared with an average of six in the laminaria group. The mean (+/- SEM) induction-abortion time for Dilapan patients was 10.9 +/- 1.3 hours, compared with 16.1 +/- 1.4 hours in the laminaria group, a statistically significant difference (P less than .05). When nulliparous women were examined separately, the mean times were 11.0 +/- 1.7 for Dilapan and 16.5 +/- 1.6 for laminaria, a medically relevant and statistically significant difference (P less than .05). Dilapan appears to be an effective alternative to laminaria that results in shorter induction-abortion intervals. PMID- 3292982 TI - An immunoperoxidase study of laminin and type IV collagen distribution in carcinoma of the cervix and vulva. AB - Basement membrane immunostaining was performed on pepsin-digested, paraffin embedded blocks of 29 squamous cell carcinomas of the cervix (invasive and in situ) and 13 of the vulva, using polyclonal rabbit antibodies to human laminin and type IV collagen, both staining identically. Laminin with varying defectiveness surrounded invasive foci, whereas adjacent carcinoma in situ or normal epithelium had intact laminin. The amount of laminin usually reflected the degree of tumor differentiation. Absence of laminin around totally keratinized or necrotic tumor nests indicated its dependency on viable cells. New buds from established invasive tumor nests were often more laminin-defective than the parent nest and suggested a cyclic invasive process, with laminin loss during a growth surge followed by laminin reformation during quiescence. In cases of questionable early stromal invasion, deficient laminin could sway the decision toward making a positive diagnosis. The tendency of laminin gaps and tumor buds to contain large malignant cells with pleomorphic nuclei supports the concept of a change in tumor cell metabolism during active invasion. Laminin also appeared around metastatic tumor within lymph nodes. The relationship of inflammation to tumor laminin defectiveness varied. PMID- 3292984 TI - Crown margins--a rational approach. PMID- 3292983 TI - Fetal Board: a multidisciplinary approach to management of the abnormal fetus. AB - A Fetal Board was established in our institution, patterned after the traditional Tumor Board, to provide prospective clinical management and comprehensive care of the pregnant woman and her abnormal fetus before, during, and after delivery. One hundred one cases qualified for registry by the Fetal Board. The diagnoses included an abnormality discovered on ultrasound evaluation from the referral source, a documented abnormal chromosomal pattern, a fetus at predictable risk for a genetic disorder, or a fetus with a known teratogenic exposure. The multidisciplinary group reviewed each case, refined the diagnoses, established management plans, and scheduled delivery timing when appropriate. The Fetal Board encouraged the collection, sharing, and comparing of information gained on abnormal fetuses before and after delivery. It also became a resource for assistance to the affected families. PMID- 3292980 TI - Fetal cystic hygroma: prenatal diagnosis and management. AB - Seventeen cases of fetal cystic hygroma detected during ultrasound examination are reported. In nine instances, associated abnormalities were recognized, such as fetal hydrops and a two-vessel cord. All diagnoses were confirmed at autopsy. Karyotyping revealed normal findings in six cases, Turner's syndrome in eight cases, and Edwards' syndrome in one case; culture failure occurred in the remaining two cases. An ultrasound diagnosis of cystic hygroma should be followed by a careful search for other anomalies and by fetal karyotyping. Afterward, genetic counseling is indicated. PMID- 3292985 TI - 100 years of dentistry. PMID- 3292986 TI - An investigation into alternative methods for the serodiagnosis of dourine. AB - The complement fixation test (CFT), indirect fluorescent antibody test (IFAT), card agglutination test for trypanosomiasis (CATT) and enzyme-linked immunosorbent assay (ELISA) were compared in their application to the serological diagnosis of Trypanosoma equiperdum infection in 43 horses. The CFT remains a reliable test for dourine, especially in countries where other members of the subgenus Trypanozoon do not occur. The IFAT is a good 'back-up' test, but, requiring skilled operators it has the disadvantage of making it labour intensive, and interpretation of results subjective. This makes it more suited to small numbers of samples. The ELISA is suitable for large numbers of samples and could readily be used in routine diagnostic procedures. The CATT could be of value in field situations, although it does not appear to be as sensitive as the CFT. Its possible application under these conditions should be further investigated. PMID- 3292987 TI - Mycoplasma mycoides recovered from the frontal sinus of an ox. AB - The isolation of M. mycoides from the frontal sinus of an ox is recorded. The possibility that this observation may reflect a true carrier state and be responsible for field outbreaks of obscure origin is considered. PMID- 3292988 TI - [The effect of hormones and endocrine diseases on bone tissue in adults]. PMID- 3292989 TI - [Diastolic function and dynamics of the interventricular septum and lateral wall in patients with hypertrophic obstructive cardiomyopathy]. PMID- 3292991 TI - [Acute pancreatitis as a complication of leptospirosis]. PMID- 3292990 TI - [Significance of testicular scintigraphy in the diagnosis and differential diagnosis of acute intrascrotal processes]. PMID- 3292992 TI - [Percutaneous pancreatic pseudocysto-gastrostomy using a double pigtail catheter]. PMID- 3292993 TI - [The miraculous "resurrection" of Anne Green. Resuscitation attempts in England at the time of the founding of the Royal Society]. PMID- 3292994 TI - [Hospital orders in Esztergom during the Arpad dynasty]. PMID- 3292995 TI - How OBRA '87 will affect your reimbursement. The Health Care Group. PMID- 3292996 TI - Effects on respiration of CPAP immediately after extubation in the very preterm infant. AB - The effects of continuous positive airway pressure (CPAP) on pulmonary function during weaning from ventilator treatment were examined immediately after extubation in 17 very preterm infants, who had been ventilator-treated because of hyaline membrane disease (15 infants) and chronic pulmonary insufficiency of prematurity (two infants). Seven infants had bronchopulmonary dysplasia. Median birthweight was 920 g and median gestational age 26 completed weeks. The median duration of ventilator treatment was 10 days. Application of CPAP by means of a face chamber device after endotracheal extubation significantly lowered the frequency of apnea (P = 0.02) and enhanced oxygenation (P = 0.001). The respiratory mechanical indices derived from flow rate and juxta-diaphragmatic esophageal pressure measurements showed a reduced elastic (P = 0.03) and resistive (P = 0.02) load on the diaphragm. Even if the measured values do not accurately represent absolute resistances and compliances, the relative values of end-inspiratory and end-expiratory pressures differed significantly with and without CPAP (P = 0.001 and 0.002, respectively). We found CPAP applied via the face chamber technique immediately after extubation to be beneficial and to facilitate weaning from ventilator treatment in very preterm infants. PMID- 3292997 TI - Rimantadine prophylaxis in children: a follow-up study. AB - In a randomized, double-blind placebo-controlled clinical trial, we evaluated the prophylactic effectiveness of rimantadine in children (ages 1 to 18 years) against infection with influenza A (H3N2) and associated illness and the prevention of transmission of infection to adult members of the child's family. One hundred ten volunteers from 29 families completed this study during a naturally occurring outbreak of influenza A (H3N2). Influenza infections, defined as a positive viral throat culture or a 4-fold increase in antibody titer, occurred in 31.0% of children in the placebo group and 7.4% in the rimantadine group (P = 0.026). Clinical illness with laboratory evidence of influenza infection occurred in 24.1% of children in the placebo group and none in the rimantadine group (P = 0.007). Rimantadine was well-tolerated by the children, with no significant difference in reported adverse effects between the placebo and rimantadine groups. A combined analysis by families of these data and those of our similarly designed 1984 study, revealed that families in whom the children were given rimantadine had a significantly lower rate of influenza A infection and influenza-like illness compared with the families in whom the children were given placebo (68.8% vs. 18.8%, P less than 0.001) and (56.3% vs. 12.5%, P less than 0.001), respectively. We conclude that rimantadine prophylaxis of children appears to be an effective method to prevent influenza A (either H1N1 or H3N2) infection and illness in children. PMID- 3292998 TI - Performance of a solid phase enzyme immunoassay for detection of group A streptococci in a pediatric office laboratory as refereed by a hospital laboratory. AB - We evaluated the performance of a new rapid solid phase enzyme immunoassay, SUDS Group A Strep (MUREX Corp., Norcross, GA) for the detection of Group A beta hemolytic streptococci in a pediatric office practice. Duplicate throat swabs were obtained from 341 children with pharyngitis. One swab was used in the SUDS test and the other was cultured in the office laboratory. Office SUDS and culture (sheep blood agar plate, aerobic 24-hour incubation) were compared with culture using reference techniques (sheep blood agar plate, anaerobic 48-hour incubation) in a hospital laboratory. Compared with hospital laboratory culture, the sensitivity of office SUDS (73.8%) was superior to that of office culture (66.6%) at P = 0.05. Specificities were 93.1 and 98.6%, respectively; positive predictive values were 86.1 and 96.6%; and negative predictive values were 85.9 and 83.5%. The sensitivity and specificity of SUDS compared with office culture were 88.5 and 87.8%, respectively, but would have been 93 and 94% had hemolyzed media not been used on several occasions in the office culture procedure. We conclude that SUDS Group A Strep was significantly more sensitive than throat cultures as performed in a typical pediatric practice although the performance of office cultures could have been improved by standard quality control techniques. PMID- 3292999 TI - Lyme disease: the latest great imitator. AB - Lyme disease is caused by the spirochete B. burgdorferi. Like its counterpart syphilis, it causes multisystem disease particularly affecting the skin, nervous system, heart and musculoskeletal system. It is endemic in several areas of the United States as well as in Europe. The prompt recognition of this disease and its diverse manifestations should lead to early treatment and resolution. Prevention is aimed at avoidance of the tick vector. PMID- 3293001 TI - Klebsiella pneumoniae arthritis in a child. PMID- 3293000 TI - Suppurative thrombophlebitis of the internal jugular vein: report of three cases and review of the pediatric literature. PMID- 3293003 TI - A practical method to incubate bacterial cultures: "human incubator". PMID- 3293002 TI - Ceftriaxone-associated cholecystitis. PMID- 3293004 TI - Recovery of group A beta-hemolytic streptococci from both tonsillar surfaces. PMID- 3293005 TI - Management of acute otitis media with effusion. PMID- 3293006 TI - Chronic suppurative otitis media. PMID- 3293007 TI - Management of sinusitis in infants and children. PMID- 3293008 TI - The child with pneumonia: diagnostic and therapeutic considerations. PMID- 3293009 TI - [Chlamydia trachomatis in pediatrics]. AB - In developed countries, Chlamydia trachomatis (CT) is found on the cervix of the uterus in 2-8% of pregnant women. Two thirds of neonates from infected mothers are contaminated at delivery at the level of ocular, respiratory and digestive mucosal surfaces. This infection is responsible for 40% of neonatal conjunctivitis and afebrile pneumonitis in the second and third month after birth. In older children and adolescents, CT is responsible for genital infections contracted by venereal contact. The treatment requires taking a macrolide orally for 15 days. Prevention requires the detection of high-risk women, and hygiene in sexual intercourse. PMID- 3293010 TI - [Pulmonary and cerebral aspergillosis in Burkitt's lymphoma]. AB - Multiple intracerebral aspergillus abscesses in a 5 year old boy with a Burkitt's lymphoma are described. The disease was fatal despite antifungal treatment. The diagnostic and therapeutic problems, the risk factors and preventive care are discussed. PMID- 3293011 TI - [Child proctology. Practical aspects]. AB - This review analyses the clinical and therapeutic bases of the various affections of child proctology. The authors emphasizes the need for a careful clinical examination. PMID- 3293012 TI - [Thrombosis and antiprothrombinase in children. Apropos of 2 cases]. AB - Two cases of arterial and venous thrombosis associated with lupus anticoagulant are reported. The first case was observed in the context of a systemic lupus erythematosus. In the second case, no underlying disease was found. From these 2 cases and a review of the literature, the particularities of this association in children is discussed. PMID- 3293013 TI - On the absence of revolutions in biology. PMID- 3293015 TI - Idealist biology. PMID- 3293014 TI - An artificial heart revives a corpse: Sir Ronald Ross's unpublished story of 1882, "The Vivisector Vivisected". PMID- 3293016 TI - Hereditary themes in Shakespeare's poetry. PMID- 3293017 TI - The hunt for a manuscript on cinchona. PMID- 3293019 TI - The actual extent of mastectomy: a key to survival. PMID- 3293018 TI - Tooth decay in the developing world: could a vaccine help prevent cavities? PMID- 3293020 TI - Baccalaureate education in nursing: key to a professional career in nursing 1988 89. PMID- 3293021 TI - State-approved schools of nursing R.N. 1988. PMID- 3293022 TI - A tribute to dental educator Douglas Yock. PMID- 3293023 TI - Robert Uppgaard: the dedicated naturalist. PMID- 3293024 TI - Barriers: a critical review of recent literature. AB - Recent literature regarding barriers to care is reviewed, beginning with a discussion and comparison of the definitions of the barrier concept drawn from the health belief model and Andersen's model of health services utilization. The research literature which includes the barrier concept as a determinant in testing those models is reviewed, as well as research studies examining utilization behavior which do not have a well-articulated theoretical framework. Both nonempirical and empirical articles are reviewed to ascertain how the concept barriers to care is, or might be, operationalized. Although similar indicators are used from study to study, the review uncovers considerable confusion regarding the barrier variable both theoretically and empirically, which apparently results from lack of methodological rigor in defining and operationalizing the concept. PMID- 3293025 TI - Effects of educational interventions in diabetes care: a meta-analysis of findings. AB - Forty-seven studies on the effects of patient teaching on knowledge, self-care behaviors, and metabolic control were analyzed using meta-analysis. Variables, such as type of patient instruction, type of research design, and overall quality of the study, also were analyzed. The 236 effect sizes had an unweighted mean of 0.91 (SD = 0.75) and a weighted mean of 0.33 (SD = 0.01). The weighted mean effect size for studies with control groups (N = 27) was 0.40 (SD = 0.05), and the weighted mean effect size for studies using the one group pretest-posttest design (N = 20) was 0.53 (SD = 0.05). Homogeneity analyses resulted in weighted mean effect size estimates for knowledge subvariables ranging from 0.41 to 0.91; for skill performance, 0.25 to 0.38; for compliance, 0.24 to 1.01; and for metabolic control, 0.06 to 0.84. Experimental mortality was the only variable significantly correlated with the overall weighted mean effect size, r = .52, p = .002. The results of this study clearly support the notion that patient teaching has positive outcomes in diabetic adults. Furthermore, methodological issues were important factors which influenced these findings. PMID- 3293026 TI - Effect of relaxation therapy on post-myocardial infarction patients' rehabilitation. AB - This research measured the physical and psychosocial effects of the practice of Benson's relaxation technique by male postmyocardial infarction patients enrolled in a cardiac rehabilitation program and determined if the patient's behavioral style (Type A or Type B) was related to the outcomes. Twenty-seven subjects completed the experimental condition; 30, the control condition. Outcome measures included blood pressure, heart rate, aerobic conditioning level (MET level), and psychosocial functioning, as measured by the Sickness Impact Profile. Repeated measures analysis of variance was used to determine if relaxation therapy and/or behavior style had an effect on measures of the effectiveness of cardiac rehabilitation. The practice of relaxation was found to have a significant effect on diastolic blood pressure. Behavior style was unrelated to the outcome measures. PMID- 3293028 TI - Retraction. PMID- 3293027 TI - Positive AIDS. PMID- 3293029 TI - [Pathogenetic relationship between insulin resistance, insulin secretion and impaired glucose tolerance in patients with obesity]. AB - The distribution of obese patients without diabetes based on the results of the oral glucose tolerance test (OGTT) made it possible to define 2 groups of patients: with normal (the 1st group) and disturbed (the 2nd group) OGTT. A moderate increase in the levels of insulin and C-peptide after GTT and almost unchanged sensitivity to insulin were observed in the 1st group. A considerable increase in the levels of insulin and C-peptide after glucose intake and a considerable decrease in the sensitivity to insulin were observed in the 2nd group. In obese patients with diabetes mellitus the levels of insulin and C peptide after the GTT were significantly lower than those in the 1st and 2nd groups. A conclusion has been made that whereas certain stages of pathogenesis of diabetes mellitus in obesity are associated with hyperinsulinemia and GTT disorder, obvious diabetes mellitus is characterized by a decrease in secretory potentialities of the insular apparatus in parallel with glucose intolerance. PMID- 3293030 TI - [Fluorescent immunoassay of thyroxine in blood serum]. AB - A method of solid-phase fluoroimmunoassay of thyroxine (T4) on polystyrene 96 microtiter plates using coproporphyrin III-labeled antibodies was developed; 0.02 ml of blood serum without preliminary treatment was required. Thimerosal was added to lessen the T4-binding effect of the serum on the results of T4-binding effect of the serum on the results of the immunoassay. A calibration curve was obtained to determine T4 covering the entire physiological range of concentrations (from 3 to 21 micrograms of thyroxine in 100 ml of the serum). A variation coefficient within this range did not exceed 15%. For 14 unknown blood serum samples of patients the coefficient of correlation with the results obtained using a commercial kit for T4 determination (Abbott, USA) was 0.960. The time of the assay was 2-2.5 h. This method is simple and easy for use on a large scale. PMID- 3293031 TI - [Mechanisms of insulin resistance in pregnancy]. AB - The causes of insulin resistance were studied in rats at late terms of pregnancy. A decrease in the sensitivity to insulin dependent incorporation of glucose in total lipids and CO2 of isolated fatty tissue of pregnant rats was shown. The maximum tissue reaction to insulin (reactivity) did not lessen indicating together with hyperinsulinemia after a glucose tolerance test and a rise of the activity of blood serum insulin-like growth factors the absence of postreceptor defects. An increase in the pregnant rats blood levels of cholesterol, triglycerides and lipoprotein atherogenic fractions was revealed. The latter in physiological concentrations made an inhibitory effect on respiration of liver and thyroid sections of intact rats. Together with the action of hormones of the fetoplacental system it was considered as one of the mechanisms of development of insulin resistance at late terms of pregnancy. PMID- 3293032 TI - [Androgenic function of the adrenals in women with hyperprolactinemia]. PMID- 3293033 TI - [Pathogenesis, clinical aspects and treatment of uremic hypogonadism]. PMID- 3293034 TI - The efficacy of mouthrinses. PMID- 3293035 TI - Determination of rejection using noninvasive parameters after cardiac transplantation in very early infancy: The Loma Linda experience. PMID- 3293036 TI - Periodic distribution of homologous genes or gene segments on the Escherichia coli K12 genome. AB - A computer search for homologous relationships among Escherichia coli proteins has been carried out with the use of databases. Homologous genes or gene segments thus identified at the amino acid sequence level have a tendency to lie on the genome separated by distances of multiples of 7 min. This relatively regular pattern of gene distribution on the E. coli genome is interpreted as reflecting the early history of multiple genome doublings. Evolutionary advantages of duplications of the total genome are discussed in relation to the acquisition of new multistep pathways such as the Krebs cycle and to the generation of a variety of proteins in existence today. PMID- 3293037 TI - Drugs as chemical stimuli. AB - Analogies can be drawn at many levels between psychoactive drug effects as discriminative stimuli and stimulus control by traditional exteroceptive stimuli. The most useful analogy may be between drug stimuli and the chemical senses. At the behavioral level, drug discrimination studies have already drawn heavily from behavioral science research on stimulus control. Training of a drug discrimination is operationally identical to training discriminations based on exteroceptive stimuli. Concepts from generalization studies and research with compound stimuli have also been used in drug discrimination research. At the cellular level, a parallel can also be drawn between the study of mechanisms for drug stimulus effects and research on olfactory transduction. One theory of olfactory transduction proposes receptor-mediated actions of odorants, with subsequent biochemical events involving the cyclic nucleotide cascade, that is very similar to theories of receptor-mediated drug action. There is a broad basis for cross-fertilization between the study of drug stimuli and behavioral and cellular studies in classical sensory systems. PMID- 3293039 TI - Site-selective serotonin agonists as discriminative stimuli. AB - Various direct- and indirect-acting serotonin (5-HT) agonists serve as training drugs in tests of stimulus control of behavior; such agents include: 5 hydroxytryptophan, 5-methoxy-N,N-dimethyltryptamine, and fenfluramine. However, with the recent discovery of multiple populations of central 5-HT binding sites, the concept of site-selective serotonergic agents needs to be addressed. Certain 4-substituted 1-(2,5-dimethoxyphenyl)-2-aminopropanes such as DOM (4-methyl), DOB (4-bromo), and DOI (4-iodo) appear to be 5-HT2-selective agonists and serve as effective training drugs in rats. Stimulus generalization occurs among these agents regardless of which is used as the training drug, although stimulus generalization does not occur with 5-HT1A-selective agonists [e.g., 8-hydroxy-2 (di-n-propylamino)tetralin (8-OH DPAT)] or with 5-HT1B-selective agonists [e.g., 1-(3-trifluoromethylphenyl)piperazine (TFMPP)]. 8-OH DPAT and TFMPP also serve as training drugs; the 8-OH DPAT-stimulus generalizes to other 5-HT1A agonists, but not to 5-HT1B or 5-HT2 agonists, whereas the TFMPP-stimulus generalizes to other 5-HT1B agonists, but not to 5-HT1A or 5-HT2 agonists. Classical serotonin antagonists, most of which are rather selective for 5-HT2 sites, and 5-HT2 selective antagonists are able to block the stimulus effects of DOM, DOB, and DOI, but not those of 8-OH DPAT or TFMPP. The results of such studies reveal that, in rats, site-selective 5-HT agonists produce stimulus effects that are also selective; although generalization may occur with nonselective 5-HT agonists, animals trained to discriminate site-selective 5-HT agonists apparently do not recognize other 5-HT agonists that are selective for a different site. Animals trained to discriminate such agents from saline might be useful for the identification and/or investigation of novel site-selective agonists and antagonists (for example, the 8-OH DPAT-stimulus generalizes to members of a new class of anxiolytics that display high affinity for 5-HT1A binding sites), and might also aid in the overall understanding of central serotonergic mechanisms. PMID- 3293038 TI - Neural mechanisms of drug stimuli: experimental approaches. AB - Drug discrimination methodology affords a behavioral end point that reflects actions of a drug at the cellular level. The stimulus control of behavior by drugs of many pharmacological classes satisfies criteria for a receptor-mediated phenomenon. Within many classes of drugs, order of relative of potency for discriminative effects correlates highly with the order of potency of the drugs in other procedures that involve interactions with a defined population of receptors. Examples include the morphine-like opioids and the benzodiazepines. Specific competitive antagonists are of paramount importance for defining neuronal substrates that subserve the discriminative effects of a drug. Quantitative pharmacological approaches can be used not only to define the receptor mediating the discriminative effects of a drug but also to assess the intrinsic activity of the drug at the receptor. The primary site of stimulus control of behavior by most drugs can be shown by indirect and direct means to be of central rather than peripheral origin; however, neuronanatomical localization of specific sites of drug action remains elusive. Attention is starting to be focused on endogenous neuropeptides, their discriminative stimulus properties and potential role in modulating discriminative effects of drugs. Some of the most important contributions of drug discrimination methodology may arise in the rapidly emerging area of peptide neuropharmacology. PMID- 3293040 TI - Intrinsic activity and discriminative effects of drugs. AB - A conceptual framework has been proposed which coherently specifies the transduction mechanisms of opiate drug stimuli at the behavioral, pharmacological, and molecular levels. One assertion that is inherent in a one receptor theory of opiate drug discrimination is that the different magnitudes of intrinsic activity that can be produced at the receptor are associated with discrimination effects that differ qualitatively. A number of theoretical inferences are made here concerning the apparent training drug-like agonist and training-drug antagonist effects of compounds that differ in the maximal intrinsic activity which they produce at the receptor. The predicted patterns of mixed and partial agonist and antagonist effects are consistent with available data on the effects of prototype opiate compounds. PMID- 3293041 TI - Relationship between the discriminative stimulus properties and subjective effects of drugs. AB - Behavioral pharmacologists have assumed that the properties of drugs that mediate their discriminative stimulus effects are related to aspects of drug actions that result in their subjective effects in humans. The basis of this assumption is examined in this chapter. Evidence to support this assumption includes the formal properties of the learning process involved in acquiring both behaviors. Although the procedures used to train animals to learn a drug discrimination are explicit, an analysis of how humans learn to attach verbal responses to unobservable internal subjective states appears to involve a similar learning paradigm. Additional evidence of the commonality of the two effects is that the results from drug discrimination studies in animals and studies evaluating subjective effects in humans yield similar drug classifications. However, when subjective drug effects are analyzed in more detail, it is clear that the concordance between the two approaches is not always good. On the other hand, when drug discrimination and subjective effects are both measured in humans, an examination of the results generated when individuals respond differently to the same drug indicates that the hypothesis that their discrimination is based upon a profile of subjective effects is supported. PMID- 3293043 TI - Discrimination strategies in animal psychophysics and their role in understanding sensory receptor function. AB - Discrimination is defined in a restricted sense here as a precise and specifiable relation between stimuli and responses. Experimenter control of stimulation is one significant feature of this relation. It is suggested that there may be some important differences between discrimination of drugs and exteroceptive stimulation. However, a discussion of current strategies in animal psychophysics might uncover similarities between these two discrimination formats useful in formulating questions and designing future research. Traditionally animal psychophysics has focused on basic questions of acuity and sensitivity (threshold). Beyond their obvious value in the study of comparative sensory function and evolutionary development, these experiments have provided particularly important new insights into the understanding of peripheral sensory transduction and processing and their relation to perception. Our experiments have been carried out in animals whose hearing has been impaired by drugs and cryolesions, and relations have been sought between the subsequent hearing loss and the histopathological changes occurring in the auditory receptor cells of the inner ear. But threshold sensitivity is only one of many perceptual dimensions and tells us nothing of the discriminations that are made among stimuli which are clearly above minimum detectable levels. For example, discriminations occur along stimulus dimensions such as wavelength of light, sound pressure, acoustic frequency, and so on. Sensory systems also permit the accurate location of the source of stimulation at a distance, the selection of certain frequencies or wavelengths and the rejection of others, and finally the discrimination among very complex but biologically useful signals such as speech. Prototypical experiments are described; the results suggest significant and orderly relations with peripheral sensory processing mechanisms. The power of operant behavior to examine perception from a variety of perspectives is discussed. PMID- 3293044 TI - Discriminative stimulus effects of cholinergic agonists and the actions of their antagonists. AB - Both muscarinic- and nicotinic-cholinergic agonists have been used for discrimination training, but only nicotine has been studied extensively. The limited information available suggests that the discriminative stimulus effects of drugs classified as muscarinic-cholinergic agonists are blocked competitively by atropine but not by ganglion-blockers. The discriminative effects of nicotine are blocked non-competitively by ganglion-blocking drugs that penetrate into the CNS (e.g. mecamylamine), but they are not blocked by atropine. The specificity of the block is shown by the failure of mecamylamine to block several non-nicotinic drugs. The ganglion-blocking drug chlorisondamine penetrates poorly into the CNS when injected systemically; when injected intraventricularly, it is a potent and specific nicotine antagonist with a 4-week duration of effect. Haloperidol attenuates discriminative effects of nicotine but this is not a specific block; there are marked reductions in response rate, the morphine stimulus is also attenuated, and other neuroleptics have much weaker effects. The results support the view that the discriminative effect of nicotine involves predominantly cholinoceptive sites, and they suggest that it is not mediated primarily by the dopamine system. The transduction mechanisms for the nicotine stimulus may include the receptor sites that mediate many of its other CNS effects, but more information is needed about possible subtypes of nicotinic receptors before definitive conclusions are possible. PMID- 3293045 TI - Stimulus properties of dopaminergic drugs: comparisons involving selective agonists and antagonists. AB - Rats were trained to discriminate the putatively selective dopamine (DA) receptor agonists SKF 38393 (10 mg/kg) or Ly 171555 (0.025 mg/kg) from saline in a two lever situation involving fixed-ratio (FR 20), extinction schedules of water reinforcement. During substitution tests, no dose of any compound [apomorphine, Ly 171555, lisuride, LSD, amphetamine, cocaine, (-) 3-PPP, or SKF 82526] mimicked SKF 38393, the effects of which were blocked by the D1 antagonist Sch 23390 but not by haloperidol. Postsynaptic and DA "autoreceptor" agonists [apomorphine, (-) 3-PPP], as well as dopaminergic ergot derivatives (bromocriptine, lergotrile, lisuride) and Sch 23390, substituted for Ly 171555, a partial ergoline which has behavioral effects that are blocked by haloperidol and molindone, but not by either Sch 23390 or serotonin (5-HT) antagonists (ketanserin, pizotifen). Amphetamine and cocaine did not substitute for either SKF 38393 or Ly 171555. These results suggest that the stimulus properties of a variety of neuropharmacologically important and clinically useful compounds are transduced at (pre- or postsynaptic) D2 receptors. However, this conclusion must be tempered by evidence that actions at D1 and D2 receptors may not be entirely independent. The behavioral effects of abused psychomotor stimulants probably involve mechanisms other than "direct" agonist activity at either D1 or D2 receptors. PMID- 3293042 TI - Similarities and differences between behavioral control by drug-produced stimuli and by sensory stimuli. AB - Drug-induced state-dependent learning and drug discriminations may be based on sensory stimuli induced by drug actions, or at least on events in the brain that have properties analogous to those of sensory stimuli. A variety of comparisons between behavioral control by drug-induced stimuli and by classically defined interoceptive and exteroceptive stimuli are possible. These allow inferences to be made about the nature of drug stimuli, the properties of behavioral paradigms that we use to investigate them, and the mechanisms by which drugs achieve behavioral control in drug discrimination and state-dependent learning paradigms. Each of these topics is selectively reviewed in this paper. PMID- 3293046 TI - Transmitter and receiver modules in bacterial signaling proteins. AB - Prokaryotes are capable of sophisticated sensory behaviors. We have detected sequence motifs in bacterial signaling proteins that may act as transmitter or receiver modules in mediating protein-protein communication. These modules appear to retain their functional identities in many protein hosts, implying that they are structurally independent elements. We propose that the fundamental activity characterizing these domains is specific recognition and association of matched modules, accompanied by conformational changes in one or both of the interacting elements. Signal propagation is a natural consequence of this behavior. The versatility of this information-processing strategy is evident in the chemotaxis machinery of Escherichia coli, where proteins containing transmitters or receivers are linked in "dyadic relays" to form complex signaling networks. PMID- 3293047 TI - Purification of ras GTPase activating protein from bovine brain. AB - In cytosolic extracts of bovine brain, we detected ras GTPase activating protein (GAP) activity that stimulated the GTP hydrolytic activity of normal c-Ha-ras p21 but not that of the oncogenic [Val12]p21 variant. GAP was purified 19,500-fold by a five-column procedure involving DEAE-Sephacel, Sepharose 6B, orange dye and green dye matrices, and Mono Q resins. A single major protein band of 125 kDa was observed on NaDodSO4/polyacrylamide gels that correlated with the elution of GAP activity on Mono Q. Purified GAP was devoid of inherent GTP hydrolytic activity, suggesting that it was a regulator of ras intrinsic GTPase activity. Under submaximal velocity conditions, the second-order rate constant of GTP hydrolysis at 24 degrees C for p21-GTP + GAP (4.5 X 10(6) M-1.sec-1) was at least 1000-fold greater than that for [Val12]p21-GTP + GAP (less than 3 X 10(3) M-1.sec-1). PMID- 3293048 TI - Bypass and termination at apurinic sites during replication of single-stranded DNA in vitro: a model for apurinic site mutagenesis. AB - Mutations produced in Escherichia coli by apurinic sites are believed to arise via SOS-assisted translesion replication. Analysis of replication products synthesized on depurinated single-stranded DNA by DNA polymerase III holoenzyme revealed that apurinic sites frequently blocked in vitro replication. Bypass frequency of an apurinic site was estimated to be 10-15%. Direct evidence for replicative bypass was obtained in a complete single-stranded----replicative form replication system containing DNA polymerase III holoenzyme, single-stranded DNA binding protein, DNA polymerase I, and DNa ligase, by demonstrating the sensitivity of fully replicated products to the apurinic endonuclease activity of E. coli exonuclease III. Termination at apurinic sites, like termination at pyrimidine photodimers, involved dissociation of the polymerase from the blocked termini, followed by initiations at available primer templates. When no regular primer templates were available, the polymerase underwent repeated cycles of dissociation and rebinding at the blocked termini and, while bound, carried out multiple polymerization-excision reactions opposite the apurinic sites, leading to turnover of dNTPs into dNMPs. From the in vitro turnover rates, we could predict with striking accuracy the specificity of apurinic site mutagenesis, as determined in vivo in depurinated single-stranded DNA from an M13-lac hybrid phage. This finding is consistent with the view that DNA polymerase III holoenzyme carries out the mutagenic "misinsertion" step during apurinic site mutagenesis in vivo and that the specificity of the process is determined primarily by the polymerase. SOS-induced proteins such as UmuD/C might act as processivity-like factors to stabilize the polymerase-DNA complex, thus increasing the efficiency of the next stage of past-lesion polymerization required to complete the bypass reaction. PMID- 3293049 TI - T24 human bladder carcinoma cells with activated Ha-ras protooncogene: nontumorigenic cells susceptible to malignant transformation with carcinogen. AB - A comparative analysis of T24 human bladder carcinoma cells and N-methyl-N'-nitro N-nitrosoguanidine (MeNNG)-transformed derivatives (MeNNG-T24 cells) revealed the following: (i) The presence of an activated c-Ha-ras gene (in the absence of the normal allele) is insufficient to confer upon T24 cells a tumor-associated phenotype. (ii) MeNNG-transformed T24 cells not only acquire tumor-associated (in vitro) traits (growth in soft agar and rhodamine retention) but, are highly tumorigenic in nude mice. (iii) It is possible to render T24 cells tumorigenic by chemical transformation; therefore, the reason that T24 cells lack tumorigenicity is not because of possible incompatibilities between these cells and nude mice but, in fact, because T24 cells are not malignant. (iv) The loss of expression of a transformation-related Mr 67,000 phosphoprotein by MeNNG-T24 cells after explantation of these cells from nude mouse tumors to in vitro culture indicates that culture conditions can be responsible for rapid phenotypic conversion of human tumor cell lines. PMID- 3293050 TI - Comparative evolution: latent potentials for anagenetic advance. AB - One of the principles that has emerged from experimental evolutionary studies of microorganisms is that polymorphic alleles or new mutations can sometimes possess a latent potential to respond to selection in different environments, although the alleles may be functionally equivalent or disfavored under typical conditions. We suggest that such responses to selection in microorganisms serve as experimental models of evolutionary advances that occur over much longer periods of time in higher organisms. We propose as a general evolutionary principle that anagenic advances often come from capitalizing on preexisting latent selection potentials in the presence of novel ecological opportunity. PMID- 3293052 TI - Lovastatin, an inhibitor of cholesterol synthesis, induces hydroxymethylglutaryl coenzyme A reductase directly on membranes of expanded smooth endoplasmic reticulum in rat hepatocytes. AB - Lovastatin is a potent competitive inhibitor of the rate-limiting enzyme of cholesterol synthesis, 3-hydroxy-3-methylglutaryl-coenzyme A reductase (NADPH) [HMG-CoA reductase; (S)-mevalonate:NADP+ oxidoreductase (CoA-acylating), EC 1.1.1.34]. We determined the subcellular distribution of HMG-CoA reductase at high resolution by means of immunoelectron microscopy on ultrathin frozen liver sections of rats treated with lovastatin and cholestyramine. High concentrations of reductase were located on the outer (cytoplasmic) surfaces of smooth endoplasmic reticulum (SER) membranes induced in hepatocytes by acute drug administration. The enzyme was specifically localized over the whorled SER membranes and was absent from nonwhorled SER, rough endoplasmic reticulum, and peroxisomes. Intense HMG-CoA reductase labeling was only observed in hepatocytes containing high levels of HMG-CoA reductase activity; no staining was detected in untreated livers. These observations show that HMG-CoA reductase is induced as an integral component of the SER membranes that form in rat hepatocytes subsequent to lovastatin treatment and suggest that the formation of SER whorls in rat hepatocytes is due to mechanism-based effects of lovastatin. PMID- 3293051 TI - Identification of two integral membrane proteins of Plasmodium falciparum. AB - We describe the isolation and cloning of two integral membrane protein antigens of Plasmodium falciparum. The antigens were isolated by Triton X-114 temperature dependent phase separation, electrophoretically transferred to nitrocellulose, and used to affinity-purify monospecific human antibodies. These antibodies were used to isolate the corresponding cDNA clones from a phage lambda gt11-Amp3 cDNA expression library. Clone Ag512 corresponds to a Mr 55,000 merozoite rhoptry antigen, and clone Ag513 corresponds to a Mr 45,000 merozoite surface antigen. Both proteins can be biosynthetically labeled with [3H]glucosamine and [3H]myristic acid, suggesting that they may be anchored in membranes via a glycosylphosphatidylinositol moiety. Similarities in the C-terminal sequences of the Mr 45,000 merozoite surface antigen and the Trypanosoma brucei variant surface glycoproteins provides further evidence that this antigen has a glycosylphosphatidylinositol anchor. PMID- 3293054 TI - B-cell growth and differentiation factors. PMID- 3293053 TI - Lateral geniculate lesions block circadian phase-shift responses to a benzodiazepine. AB - Several pharmacological treatments, including application of an excitatory neurotoxin to the lateral geniculate nucleus (LGN) and systemic administration of triazolam, a clinically effective benzodiazepine, can elicit large phase shifts in a circadian rhythm according to the time of administration. The hypothesis that the LGN might mediate the effect of triazolam on circadian clock function was tested. Bilateral lesions of the LGN, which destroyed the connection from the intergeniculate leaflet to the suprachiasmatic nucleus, blocked phase-shift responses to triazolam. The requirement of an intact LGN for triazolam to shift circadian phase suggests that the LGN may be a site through which stimuli gain access to the circadian clock to modulate rhythm phase and entrainment. PMID- 3293055 TI - The development of humoral immunity to tissue-specific tubular basement membrane alloantigens after renal transplantation across the major histocompatibility barrier in rats immunomodulated with blood transfusions and cyclosporin. AB - The development of a humoral immune response to the tubular basement membrane (TBM) alloantigen of Brown-Norway (BN) rat kidneys was studied after transplantation of BN rat kidneys into bilaterally nephrectomized Lewis (LEW) rats. The LEW rat recipients consisted of four groups receiving no form of immunosuppression, pretransplantation cyclosporin alone, or pretransplantation donor-specific or donor-nonspecific transfusions combined with cyclosporin. The latter two regimens induce indefinite allograft survival in the majority of recipients. Circulating antibody to collagenase-solubilized BN rat renal basement membrane (CS-BN-RBM) was present in all four groups of transplant recipients within 1 week after transplantation, and no significant differences in antibody levels were noted between rats receiving no immunosuppression (survival of 1-2 weeks) and the groups of rats who received various immunosuppressive regimens and survived longer. Circulating antibody to BN-CS-RBM continued to increase in quantity in the cyclosporin-treated group until the time of death (2-10 weeks post-transplantation). In the much longer lived combined transfusion and cyclosporin-treated groups, circulating antibody to BN-CS-RBM generally attained a maximum at approximately 2 to 4 months post-transplantation and then plateaued or decreased somewhat before the time of death (3-16 months post transplantation). No correlation was found between quantity of circulating anti BN-CS-RBM antibody and post-transplantation survival. Comparative study of the quantity of circulating antibody to BN-CS-RBM (the presumed nephritogenic antigen of experimental tubulointerstitial nephritis in the BN rat) in serum from transplant recipients as compared to serum from BN rats with severe experimental tubulointerstitial nephritis (TIN) (as induced by immunization with heterologous TBM antigens) demonstrated a greater quantity of potentially nephritogenic antibody circulating in transplant recipients than in BN rats with experimental TIN. Histologically, the transplanted kidneys in immunomodulated recipients demonstrated focal chronic interstitial inflammatory infiltrates with tubular atrophy and relative sparing of the glomeruli. The development of immune responses to tissue-specific alloantigens may become of clinical significance as graft-survival times are increased. PMID- 3293057 TI - Dominant and recessive oncogenes in carcinogenesis. PMID- 3293058 TI - Is chemotherapy ready for clinical use in prostatic cancer patients? PMID- 3293056 TI - Altered interleukin production during Friend leukemia virus infection. AB - Spleen cells from BALB/c mice, infected 14 to 28 days earlier with Friend leukemia virus (FLV), were shown to be inhibited in their ability to produce interleukin 2 (IL-2) when stimulated with mitogen. Likewise, these spleen cell populations failed to respond following mitogenic stimulation or exogenous addition of recombinant IL-2. By contrast, the FLV-infected spleen cell populations produced normal levels of interleukin 1 (IL-1) and thymocytes from FLV-infected mice responded normally to addition of exogenous IL-1. This suggests that FLV infection selectively affects the ability of spleen cells to produce cytokines. Spleen cell populations enriched for T lymphocytes and depleted of tumor cells by density gradient centrifugation in Ficoll were unable to produce IL-2. This indicates that the failure to detect IL-2 in cells from FLV-infected mice was not due to a dilution of T lymphocytes by tumor cells but was a functional inability to produce IL-2. Furthermore, enriched T lymphocytes from FLV-infected mice failed to respond blastogenically to exogenous IL-2. Additional studies indicate that tumor cells, but not macrophages or T lymphocytes from FLV infected spleens, suppressed the blastogenic response to mitogens and IL-2 production by normal splenic T lymphocytes. PMID- 3293059 TI - The management of advanced prostatic cancer. AB - The Urologic Cooperative Oncology Group (UCOG) has taken sight of the various disease factors that influence either high risk or low risk evaluation in newly diagnosed or hormonally refractory patients with disseminated prostate cancer. The previous studies of the National Prostatic Cancer Project (NPCP) with regard to the role of prostate antigen and other disease-free interval variations must be at least considered in designing new trials. The recent results of the EORTC Genitourinary Group regarding hormones must also similarly in my opinion, be reviewed for the same factors. If we agree on factors, we perhaps may even agree on the design of trials and our results may indeed in the future be comparable. PMID- 3293060 TI - Transrectal aspiration biopsy and punch biopsy in the diagnosis of prostate carcinoma--a comparative study and literature review. AB - It can be concluded from the data presented here, that perineal punch biopsy is able to supply more reliable results than fine needle aspiration biopsy in the diagnosis of prostate cancer. The advantage of aspiration biopsy, however, is its low incidence of complications. Since the application of both methods, namely transrectal aspiration biopsy and perineal punch biopsy, offers an additional factor of reliability, it appears worth-while to utilize both procedures in the diagnosis of carcinoma of the prostate. PMID- 3293061 TI - Lymph node staging in potentially curable prostatic carcinoma. PMID- 3293062 TI - The staging of M1 disease: the role of bone scan, Xray and other imaging techniques. AB - Patients with newly diagnosed prostatic cancer should be investigated with regard to the presence or absence of distant metastases by (1) Taking a history especially of weight loss and recent onset backache (2) Examining them, looking especially for hepatic enlargement or peripheral lymph nodes (3) Performance status (4) Hemoglobin, Bilirubin, Liver enzymes, Alkaline and Acid phosphatase (5) Chest Xray. (6) Bone scan with specific Xrays directed at hot spots. (7) Ultrasound scan of liver if liver function tests are abnormal. Ultrasound scan of lymph nodes and kidneys is optional. (8) Any other tests indicated in special circumstances. Follow-up, 3-monthly as a rule, should include (1) The presence of pain and analgesic requirements (2) Weight (3) Performance status (4) Hemoglobin, Alkaline phosphatase, Acid phosphatase (5) Chest Xray, three monthly if abnormal. Annually otherwise. (6) Bone scan with Xray of new hot spots, 6-monthly. If there is doubt about the presence of a new hot spot, repeat the bone scan and Xray at 3 months. PMID- 3293063 TI - Objective response criteria in phase II and phase III studies. PMID- 3293065 TI - Prognostic factors for randomization and stratification and endpoints for the evaluation of trials. PMID- 3293064 TI - Subjective response criteria and quality of life. PMID- 3293067 TI - Prognostic factors in renal adenocarcinoma. PMID- 3293066 TI - Immunodiagnosis and immunoimaging. PMID- 3293069 TI - BCG in carcinoma in situ and superficial bladder tumors. PMID- 3293068 TI - The role of radiotherapy and chemotherapy in advanced seminoma. PMID- 3293070 TI - Progress and controversies in chemotherapy of advanced unresectable and/or metastatic carcinoma of the bladder. PMID- 3293071 TI - Intra-arterial chemotherapy for bladder cancer: its results and future role. PMID- 3293072 TI - Survival and neo-adjuvant chemotherapy in invasive bladder cancer. PMID- 3293073 TI - Transrectal ultrasonography and CT scanning of the primary tumour in the follow up of patients with prostatic carcinoma. PMID- 3293074 TI - The role of intestinal endotoxins in gastrointestinal and liver diseases. PMID- 3293075 TI - Structure, endotoxicity, immunogenicity and antigenicity of bacterial lipopolysaccharides (endotoxins, O-antigens). PMID- 3293076 TI - Immune responses in liver and bile to Escherichia coli 0111:B4 lipopolysaccharide. PMID- 3293077 TI - The influence of the gut flora on graft versus host disease (GvHD) following allogeneic bone marrow transplantation--experimental observations and possible mechanisms. PMID- 3293078 TI - The complex challenge of bacteremia and endotoxemia. PMID- 3293079 TI - Immunological intervention in endotoxin shock. PMID- 3293080 TI - Immunoglobulin therapy in patients with endotoxemia and postoperative sepsis--a prospective randomized study. PMID- 3293081 TI - Observations on the role of endotoxin in graft-versus-host disease. AB - We have used a conventional murine model of bone marrow transplantation (BMT) to make a detailed study of the histological features of graft-versus-host disease (GvHD), and to study the effects of oral antibiotic decontamination of the gut flora. Comparison of the histological appearances of the small and large bowel indicated that the features of the GvHD were more severe in the large bowel. Bowel sterilisation caused a striking reduction in the severity of GvHD, both in the gut and at a distant site (the skin of the ear). The different effects of GvHD in the large as compared to the small bowel suggested that a factor was operative locally, and the effect of sterilisation linked this to the bacteria in the bowel. The fact that sites remote from the bowel were also affected suggested that a diffusible factor from the bowel produced by the bacteria of the gut was responsible. Studies elsewhere have suggested that the factor involved is likely to be endotoxin. In these experiments however it was evident that systemic administration of endotoxin did not aggravate the disease process and that in some instances the reverse was obtained. If therefore endotoxin is important the dose and its mode of its administration are likely to be critical. PMID- 3293082 TI - Clinical studies on administration of taurolin in severe sepsis: a preliminary study. PMID- 3293083 TI - Clinical studies of monoclonal anti-lipid A antibody XMMEN-0E5. PMID- 3293084 TI - Cachectin/TNF mediates the pathophysiological effects of bacterial endotoxin/lipopolysaccharide (LPS). PMID- 3293085 TI - [Insulin polyamino acid complexes--a variable principle in the preparation of sustained-release forms]. AB - Polyglycine, polyalanine, polyleucine, poly-alpha-glutamic acid, poly-gamma glutamic acid and poly-alpha-lysine were complexed with insulin under non denaturating conditions. The liberation behaviour of the hormone was investigated in vivo and in vitro in dependence of the insulin content, mole mass, ionic interaction and hydrophobicity of the polyamino acid. The in vitro results were mainly confirmed by animal experiments and indicated distinct effects of the physiochemical parameters to the bioavailability of insulin. The complex of poly alpha-lysine and polyglycine were shown to be the most suited retard form, producing significant blood glucose lowering effects up to 12 hours. PMID- 3293086 TI - [Urologic agents--chemical and pharmacologic aspects]. PMID- 3293087 TI - [Biopharmacy of urologic agents]. PMID- 3293088 TI - Pharmacokinetic-pharmacodynamic modeling of CNS drug effects: an overview. PMID- 3293089 TI - Dietary effects on drug metabolism by the mixed-function oxidase system. PMID- 3293091 TI - The role of corticotropin-releasing factor in the pathogenesis of major depression. AB - It is well established that corticotropin-releasing factor (CRF), a peptide comprised of 41 amino acids, is the major physiological regulator of the pituitary-adrenal axis by virtue of its role as the hypothalamic hypophysiotropic hormone that modulates the secretion of adrenocorticotropin (ACTH) from the anterior pituitary gland. In addition to its neuroendocrine role, CRF appears to function as a neurotransmitter or neuromodulator in extrahypothalamic brain areas. The peptide and its receptors are distributed throughout the central nervous system (CNS), and CRF is released by depolarizing concentrations of potassium in a calcium-dependent manner. After direct CNS administration, CRF produces a number of behavioral and physiological effects that are reminiscent of both an organism's response to stress and to the symptoms of patients with major depression. These include: diminished food consumption, decreased sexual behavior, disturbed sleep, alterations in locomotor activity and sympathetic nervous system activation. Alterations in regional brain CRF concentration in rats were observed after acute and chronic stress, i.e. decreased hypothalamic and increased locus coeruleus CRF concentrations. To test the hypothesis that CRF is hypersecreted in patients with major depression, the concentration of CRF in cerebrospinal fluid (CSF) in drug-free depressed patients and age- and sex matched controles was measured in two studies. The depressed patients exhibited a clear group-related increase in CSF CRF concentrations. To further test this hypothesis that CRF is chronically hypersecreted in depressed patients, the number and affinity of CRF receptors in frontal cortex was measured in a group of suicides and age-matched controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293090 TI - The metabolic basis for combination chemotherapy. PMID- 3293092 TI - Effect of naloxone on acute stroke. AB - Naloxone was administered intravenously in a dose of 1.2 mg to 24 patients in the first 24 hours after they had suffered a stroke. Twenty patients were treated with placebo. In the naloxone-treated group a dose as low as 0.8 mg produced a slight but statistically significant improvement in neurologic status, and this improvement continued until the end of the observation period (two weeks). In the placebo group neurologic improvement was slower and less pronounced. The present results support a previous observation that naloxone may be a valuable drug in the early stage of acute cerebrovascular disease. PMID- 3293093 TI - Cell adhesion molecules in vertebrate neural development. PMID- 3293094 TI - The structure and function of cartilage proteoglycans. PMID- 3293095 TI - The renal handling of amino acids and oligopeptides. PMID- 3293096 TI - Ventriculomegaly in schizophrenia: is the choice of controls important? AB - The issue of adequate controls for the study of ventriculomegaly in schizophrenia has been explored initially by Andreasen et al. (1982), who proposed that healthy volunteers, a group with presumably smaller ventricles than medical controls, be considered the optimal comparison group in this area of research. Recently, Smith and Iacono (1986) suggested that group differences may appear to be greater when controls who are patients are used, as a result of the systematic exclusion of medical patients with large though normal ventricles. We conducted a meta analysis of 37 studies of lateral ventriculomegaly in schizophrenia to clarify this issue. The results indicate that the average effect size in studies with healthy controls does not differ significantly from that obtained in studies employing medical, neurological, or psychiatric (nonpsychotic) controls. Thus, any group without gross neurological damage or severe psychopathology may be used for establishing ventriculomegaly in schizophrenia. PMID- 3293097 TI - Papers dedicated to Prof. Dr. Wolfgang Jacobi on the occasion of his sixtieth birthday. PMID- 3293098 TI - Use of antibiotics in the management of postirradiation wound infection and sepsis. AB - Ionizing gamma irradiation depresses the host defenses and enhances the susceptibility of the immunocompromised host to local and systemic infection due to endogenous or exogenous microorganisms. Trauma and wounding act synergistically and decrease the survival after exposure to irradiation. The current antimicrobial agents suitable for controlling serious infections and their use in post irradiation local and systemic infection with and without trauma are discussed. The experience gained in managing immunocompromised patients following chemotherapy is reviewed. Empiric single agent or combination agent therapy should be directed at the eradication of potential gram-negative as well as gram-positive pathogens. The most important organisms known to cause these infections are Pseudomonas sp. and Enterobacteriaceae. Management of intra abdominal infections following trauma should include early surgical correlation and antimicrobials directed against the Bacteroides fragilis group and Enterobacteriaceae. Staphylococcus aureus and Streptococcus pyogenes cause most skin and soft tissue infections following trauma. Chemoprophylaxis of enteric sources of systemic infection can be achieved by antimicrobials that selectively inhibit the Enterobacteriaceae sp. and preserve the anaerobic flora. The management of infection in the injured and irradiated host includes supportive and restorative therapy. Supportive therapy includes debridement and cleansing of wounds, fluids, immunoglobulin, and antimicrobials. Restorative therapy includes definite surgery repair and replenishment of the immune system by use of immunomodulators, growth factors, and bone marrow transplantation. Further studies are needed to examine the usefulness of presently available drugs and experimental agents in the irradiated and traumatized host. PMID- 3293099 TI - Regenerative effects of tetrachlorodecaoxide in BD IX rats after total-body gamma irradiation. AB - Tetrachlorodecaoxide (TCDO) was tested for its effects in BD IX rats when combined with a single dose nearing LD50 of total-body irradiation (gamma rays, 60Co). In pilot tests we found that TCDO administrations prior to or immediately after irradiation led to a very high mortality rate (up to 90%), whereas the initiation of TCDO treatment on Day 2, 3, or 4 after irradiation lowered the death rate noticeably, with optimum results when TCDO application was started on Day 4. In our major experiment on 100 BD IX rats, it was demonstrated that the following treatment schedule considerably decreased the death rate (from 44 to 4%): 15.5 mumol TCDO/kg body wt/day on Days 4-6 after irradiation and 7.75 mumol/kg body wt/day on Days 7-11. The animals treated with TCDO showed only mild anemia in the peripheral blood, accompanied by reticulocytosis and low-grade leukocytopenia. Examination of the bone marrow on Day 12 after irradiation revealed X-ray-induced agranulocytosis in the animals that had received only physiological saline solution, whereas in the bone marrow of the animals treated with TCDO there was erythropoiesis as well as myelopoiesis. In addition, the degree of hair loss and depigmentation occurring about 1 month after irradiation was considerably reduced by TCDO. From these results it can be postulated that TCDO has two different effects: as an oxygen donator it causes radiosensitization in the tissue when given before or immediately after irradiation; as an agent stimulating phagocytes and tissue regeneration, it promotes regeneration very effectively when damage is already evident in the tissue. PMID- 3293101 TI - Hepatic CT: state of the art. PMID- 3293100 TI - Health effects of low-level irradiation during development: experimental design and prenatal and early neonatal mortality in beagles exposed to 60Co gamma rays. AB - As part of a long-term study of the effects of irradiation during development, prenatal and early neonatal mortality were evaluated for beagles exposed in utero at 8 days postcoitus (dpc), 28 dpc, 55 dpc, or 2 days postpartum. Mean doses used were 0,0.16, or 0.83 Gy. A decrease in whelping rates was observed for female breeders irradiated at 8 dpc. There was a significant decrease in litter sizes from female breeders irradiated at 8 and 28 dpc. Both of these findings are indicative of increased embryonic mortality. There was a significant decrease in the percentage of females born after exposures given at 28 dpc, indicating a differential radiosensitivity by sex. A significant increase in early neonatal mortality up to 14 days of age was observed for beagles exposed 8 or 28 dpc, again with an excess mortality in females. PMID- 3293102 TI - MR imaging of focal liver masses. PMID- 3293103 TI - Hepatic MR imaging at 1.5 T. PMID- 3293104 TI - Solvent dissolution of gallstones. PMID- 3293105 TI - Gallstone lithotripsy: a preview. PMID- 3293106 TI - Biliary lithotripsy: preliminary experience and prospects. PMID- 3293107 TI - Peripheral pseudoaneurysms: evaluation with duplex US. AB - The prospectively generated results of 64 duplex sonographic examinations in 59 patients being evaluated for peripheral pseudoaneurysms over a 2-year period were reviewed. Subsequently, two groups of patients were identified. Group 1 (45 examinations) presented with relatively acute symptoms after arterial puncture, and group 2 (19 examinations) had undergone previous vascular surgical procedures and were usually asymptomatic. Duplex sonography demonstrated high sensitivity (94%) and specificity (97%) for the diagnosis of pseudoaneurysm in group 1. Of the 19 studies in group 2, duplex sonography allowed correct identification of pseudoaneurysms in four studies and exclusion of this entity in six examinations. The duplex sonographic findings in nine studies in this group did not allow differentiation of pseudoaneurysm from true aneurysm or oversize graft anastomosis. Duplex sonography is suggested as a primary radiologic method for evaluating possible pseudoaneurysms after arterial puncture, and it may provide valuable information and a means of postsurgical follow-up of selected patients as well. PMID- 3293108 TI - Prostate cancer: comparison of transrectal US and digital rectal examination for screening. AB - The authors examined 784 self-referred men over age 60 years to compare clinical usefulness of transrectal ultrasound (US) and digital rectal examination in a screening program for prostate cancer. Biopsy was performed in 77 cases, 83% (64 of 77) for abnormalities detected with transrectal US and 38% (29 of 77) because of findings at digital examination. Twenty-two cancers were detected, 20 with transrectal US and ten at digital examination. Overall detection rate for prostate cancer with transrectal US was two times higher than that with digital examination (2.6% vs 1.3%). Sensitivity, specificity, and negative predictive value for transrectal US and digital examination were calculated for a range of prevalences (0.028-0.1543). Sensitivity was two times higher for transrectal US than for digital examination. Transrectal US demonstrated 100% (17 of 17) of tumors with the most favorable prognosis (less than or equal to 1.5 cm in diameter) compared with 41% (seven of 17) for digital examination. The authors conclude that transrectal US is more sensitive than digital examination in the detection of prostate cancer, and they advocate broader implementation and evaluation of transrectal US as a tool for early detection. PMID- 3293110 TI - Thickening of the renal collecting system: a nonspecific finding at US. AB - The records of 22 patients in whom wall thickening of the renal collecting system was seen at ultrasound (US) were retrospectively reviewed. Wall thickening was found in 15 patients with renal transplants and seven with native kidneys. Severe thickening occurred with transplant rejection, but thickening also occurred with urinary tract infection, reflux, or chronic obstruction in both transplanted and native kidneys. As such, thickening of the renal collecting system seen at US is a nonspecific finding that must be correlated with the clinical and laboratory findings. PMID- 3293109 TI - Continent urinary diversions: review of current surgical procedures and radiologic imaging. AB - Continent urinary diversions are currently gaining wide acceptance as alternatives to the ileal conduit following cystectomy for neoplasm or bladder dysfunction. Clean, intermittent catheterization of the reservoir (pouch) at regular intervals obviates the inconvenience of wearing an external stomal appliance. A variety of surgical techniques have been described for continent pouches. These techniques make use of the small bowel alone (Camey and Kock techniques) or a combination of cecum and terminal ileum (Indiana, Mainz, Penn, and King techniques). The optimum pouch protects the upper tracts by prevention of reflux, provides urinary continence, and has sufficient capacity to require catheterization no more frequently than every 3-6 hours. Simplified construction techniques for the commonly encountered pouches are graphically presented, and a method is suggested for the study of continent diversions. PMID- 3293111 TI - The cat's meow: the most frequently cited papers in Radiology 1955-1986. PMID- 3293112 TI - Intracranial vascular malformations: imaging of charged-particle radiosurgery. Part I. Results of therapy. AB - Twenty-four patients with intracranial vascular malformations were examined before and after helium ion radiosurgical treatment with angiography, computed tomography (CT), and magnetic resonance (MR) imaging. Twenty patients had high flow arteriovenous malformations (AVMs). After treatment 18 of 20 AVMs (90%) showed a significant reduction in size on angiograms or MR images. Eleven of 20 (55%) had complete resolution on angiograms or MR images, 35% had partial resolution, and 10% showed no size change. Before treatment, the size range of the AVMs was 0.86-383 cm3 (median, 21.7 cm3). Smaller AVMs (less than 8 cm3) were more likely to resolve completely than medium-sized AVMs (8-64 cm3) or larger AVMs (greater than 64 cm3). Four additional patients had slow-flow vascular malformations: One had a venous angioma; one, a probable cavernous hemangioma; and two, malformations that were not seen on angiograms. CT proved inaccurate in demonstrating the boundaries of the AVM after treatment because it showed persistent contrast enhancement even when the AVM was completely obliterated on angiograms. MR imaging and angiography were complementary in the evaluation of therapeutic results and should be the primary modalities in the examination of patients with AVMs. PMID- 3293113 TI - Intracranial vascular malformations: imaging of charged-particle radiosurgery. Part II. Complications. AB - Seven of 24 patients with intracranial vascular malformations who were treated with helium-ion Bragg-peak radiosurgery had complications of therapy. New symptoms and corresponding radiologic abnormalities developed 4-28 months after therapy. Five patients had similar patterns of white matter changes and mass effect on computed tomographic scans and magnetic resonance images. The abnormalities were centered in the radiation field. Gray matter changes and abnormal enhancement in the thalamus and hypothalamus outside the radiation field developed in one patient. This patient also had vasculopathic changes on angiograms. Rapidly progressive large vessel vasculopathy developed in another patient and caused occlusion of major vessels. Thus, different mechanisms may be involved in the complications of heavy-ion radiosurgery. PMID- 3293114 TI - Depth determination on stereoscopic digital subtraction angiograms. AB - The determination of depth on stereoscopic digital subtraction angiographic (DSA) images was evaluated. A "plus" phantom that contained simulated blood vessels of various sizes with various concentrations of contrast medium was used for the study. The vessels ranged in diameter from 0.46 to 1.35 mm, with concentrations of contrast material of 1.6%-25%. The images were evaluated by seven radiologists and six radiologic technologists. The detectability of depth separation increased as the iodine concentration and the vessel size increased. With stereoscopic DSA, correct identification of depth is possible more than 80% of the time for vessels approximately 1 mm in diameter and containing 3.1% contrast medium when the vessels are separated by more than 2.8 mm. PMID- 3293115 TI - Transrectal US of the prostate: is the technology leading the science? PMID- 3293116 TI - Diagnosis and treatment of anxiety in the elderly. PMID- 3293117 TI - Coronary capacitance. PMID- 3293119 TI - Assessing the physiologic significance of coronary obstructions in patients: importance of diffuse undetected atherosclerosis. PMID- 3293118 TI - Small vessel phenomena in the coronary microcirculation: phasic intramyocardial perfusion and coronary microvascular dynamics. AB - To place the characteristics of the coronary microcirculation in perspective to another muscular organ system, we have compared various parameters from exchange vessels in the heart and red skeletal muscle. The major differences between cardiac and skeletal muscle microcirculations relate to the larger density of capillaries in the heart. This increased density is responsible primarily for a greater capillary filtration coefficient-permeability-surface area product to various solutes, surface area, and decreased intercapillary distances. These features most likely represent an adaptation of the microcirculation of the heart to the very high, continual metabolic demands. Interestingly, capillary permeabilities and reflection coefficients of different solutes are in the same range (although the heart tends to have higher capillary permeabilities). Thus, the adaptation of the coronary circulation to facilitate exchange of nutrients and solutes is mediated via an increase in the numbers of exchange vessels, rather than modifications of the membrane characteristics of these exchange vessels. Within the last decade, there has been much information assimilated on the regulation of the coronary microcirculation. Most of the knowledge has been the result of many indirect approaches to studying the coronary microcirculation (indicator-dilution techniques, nuclide-labeled microspheres, plasma-lymph concentration of solutes). There are relatively few direct observations on regulation of the coronary microcirculation. This is primarily due to difficulties in techniques. Exploration of the phasic nature of intramyocardial perfusion is handicapped by the location of these intramuscular vessels. Visualization of the coronary microcirculation is hampered by movements of the heart, and such measurements are restricted to the superficial layers of the myocardium. It is worth emphasizing that direct observations of red cell velocities in epicardial capillaries, measurements of microvascular caliber, and the pressure profiles in the coronary microcirculation are restricted to the superficial, epicardial layer. It is not unreasonable to speculate that microvascular events and regulation occurring in the subepicardium may be quite different than that in the subendocardium. There are several salient points in this review that are worth emphasizing.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3293120 TI - The collateral circulation of the heart. PMID- 3293121 TI - [Molecular biology of influenza virus--dissociation, restructure and transfection of the RNA polymerase-virus RNA complex]. PMID- 3293122 TI - [Molecular mechanism of the variation of influenza virus hemagglutinin and neuraminidase, and their recognition of sialylglycoconjugates]. PMID- 3293124 TI - Sharp-edged tools are instrumental to efficient scaling and root planning. PMID- 3293123 TI - [Immunostimulants and antitumor immunity]. PMID- 3293125 TI - [Introduction to the experiments of genetic engineering. IV. cDNA library(2): Principles and applications]. PMID- 3293126 TI - [Present state and future of functional imaging]. PMID- 3293127 TI - [Apical pulmonary fibrosis and rheumatoid polyarthritis]. AB - The authors report a case of apical pulmonary fibrosis associated with rheumatoid arthritis. The pulmonary lesions were clearly different from the classical features of pleuro-pulmonary disease in rheumatoid arthritis. They were identical to those described in ankylosing spondylitis. A review of the literature reveals recent report on ten similar cases. The authors discuss a possible relationship with bronchiolitis obliterans. PMID- 3293129 TI - [Immunological studies in hypersensitivity pneumopathies]. AB - In immunological investigations in hypersensitivity pneumonia some have a diagnostic value for the clinician but many others are essentially of interest in research and in analysing the pathophysiology. Unfortunately, skin tests with the responsible antigens are often positive in patients but also in exposed subjects without the lung disease. Studies on peripheral blood require a search for IgE immediate hypersensitivity which is rarely positive and above all a search for precipitating antibodies by the different standard tests available: there again, positive findings occur often enough in exposed but asymptomatic subjects; the sensibility and specificity of cell-mediated hypersensitivity tests seem much more reliable. The study of cell populations in broncho-alveolar lavage fluid generally shows an inverted T4:T8 lymphocyte ratio; a functional analysis seems to show a high degree of lymphocyte activation, which may be of T4 or T8 phenotype whilst cytotoxic lymphocyte activity would be exclusively found in the patients and not in asymptomatic exposed subjects. The provocation test, as long as it is positive, is one of the firmest elements in a diagnosis, above all if one takes care to couple this with a study of the lavage. Finally, the satisfaction of the immuno-histological criteria is currently rarely required to confirm the presence of hypersensitivity pneumonitis. PMID- 3293128 TI - [Thymomas and associated diseases. Apropos of a series of 255 surgically treated thymomas]. AB - The authors report on a series of 255 thymomas and the associated diseases most often auto-immune, myasthenia is the disease most frequently encountered (61% of cases). Next, but with a much reduced frequency of around 2%, come other diseases such as hypogammaglobulinaemia, erythroblastopenic anaemia, and disseminated lupus erythematosis. The authors analyse the effect of ablating the thymoma on the associated disease; those with myasthenia are the principal beneficiaries of thymic ablation, 83% in this series experiencing a good response. Besides myasthenia only erythroblastopenic anaemia obtained some benefit from thymic ablation; in all the other cases surgery to the thymic tumour had no benefit on the associated disease. In the light of their own experience the authors made a review of the literature of the different diseases associated with thymomas and made the point of the efficacy of thymectomy in the different diseases. PMID- 3293130 TI - [Invasive pulmonary aspergillosis]. AB - Invasive pulmonary aspergillosis is an opportunistic pneumonia which is particularly common in immuno-depressed subjects. The most frequent risk factors are the intensity and duration of leucopaenia, cytotoxic drugs and steroid therapy. In the respiratory tract, the proliferation of Aspergillus fumigatus becomes possible when there is a failure of the reticulo-endothelial system and of the polymorphonuclear leucocytes. There is no typical clinical picture: one sees an acute febrile pneumonia resistant to antibiotics. However, the radiological signs are more suggestive with nodules and bilateral infiltrates with a tendency to cavity formation and sequestration. The prognosis is clinically linked to the rapidity of diagnosis. Broncho-alveolar lavage offers a new and non-invasive diagnostic method to search for Aspergillus mycelia or specific antigens. A direct examination and culture of sputum expectoration are both insensitive and non-specific but remain useful in some patients with leukaemia in a phase of agranulocytosis. Treatment rests on Amphotericin B taken orally. PMID- 3293131 TI - [Paroxysmal nocturnal hemoglobinuria. Recent findings]. PMID- 3293132 TI - [Rational and prospective bases for the therapy of chronic pancreatitis]. PMID- 3293133 TI - Simultaneous infection with Cryptococcus neoformans and Legionella pneumophila. In vivo expression of common defects in cell-mediated immunity. AB - We describe 3 patients with simultaneous infection by Cryptococcus neoformans and Legionella pneumophila. Legionnaires' disease (pneumonia) occurred shortly after onset of cryptococcal meningitis in a cardiac transplant patient receiving ciclosporin, a second patient with chronic lymphocytic leukemia and a third patient with Hodgkin's disease and autoimmune hemolytic anemia. Defects in cell mediated immunity have been identified in patients with hematologic malignancies and in those who have received organ transplants. Clinical and experimental data suggest that the primary host defense mechanism against cryptococcal and Legionella infection involves cell-mediated immunity. Thus, the simultaneous occurrence of cryptococcal and L. pneumophila infection in these 3 patients supports experimental studies which have demonstrated common host defense mechanisms against both pathogens. PMID- 3293134 TI - Does chloride play an independent role in the pathogenesis of metabolic alkalosis? PMID- 3293135 TI - Role of cellular sodium and calcium metabolism in the pathogenesis of essential hypertension. AB - The differences observed among rat strains in both basal [Na+]i and the several cation transport systems seem to be due to the different genetic background as clearly shown in F2 populations or after bone marrow transplantation in MHS. The same may be true for humans. In spite of all the caution taken in interpreting the data, because of the great possibility of methodological errors, it is likely that the differences observed in many laboratories are due to uneven genetic or ethnic composition of the samples studied, as shown by Dagher and Canessa. One intriguing observation is that most reports of "low Na-K cotransport" values in hypertensive patients are from Mediterranean countries (Italy, France, and Spain), whereas most reports of "high," or "not low Na-K cotransport," or very high values of countertransport came from populations originating from North Europe (Denmark, USA, South African whites). We are not aware of any study on erythrocyte Na-K cotransport performed in Great Britain (the greatest source of American immigrants). Indeed the difference in cotransport values between North and South European hypertensives might be due to different environmental factors, but if this is so, the difference does not depend on the salt consumption or plasma lipids that are similar in our high and low Na-K cotransport hypertensives (Cusi D et al, submitted). The picture seems relatively less confusing for calcium. The most consistent alterations in different models of hypertension is a decreased Ca-pump in SHR, MHS, and DOCA rats, reduced calcium binding in SHR and MHS, and reduced microsomal ATP dependent calcium uptake in SHR and DOCA rats. [Ca++]i, which is increased in established hypertension in man and rats, is normal in young prehypertensive rats and humans, and returns to normal values after pharmacological treatment of hypertension. This pattern of changes suggests that genetic control of these transport systems is weaker, and probably much influenced by different environmental conditions. However, because of the pivotal role of calcium in vascular smooth muscle cell concentration, its intracellular increase may be the common pathway of the different forms of hypertension. What remains unclear is the relation, if any, between calcium and sodium. Blaustein tried to find a link between them, but his hypotheses have yet to be confirmed. PMID- 3293136 TI - The role of the renin-angiotensin system in hypertension. PMID- 3293137 TI - Hormonal mechanisms in human essential hypertension. PMID- 3293138 TI - Mechanism and treatment of malignant hypertension. PMID- 3293139 TI - Pathogenesis of hypertension in chronic renal disease. PMID- 3293140 TI - Nonpharmacological treatment of hypertension. PMID- 3293141 TI - Calcium and potassium in the treatment of essential hypertension. PMID- 3293143 TI - [Abbreviations--a glossary. Cytostatics, hormones and other drugs used in treating cancer]. PMID- 3293142 TI - Rational treatment of essential hypertension. PMID- 3293144 TI - [Health education trends in postprosthetic treatment in relation to the type of denture]. PMID- 3293146 TI - Computer support for medical decision-making. PMID- 3293145 TI - [Urotropin salts from the oxazole series with antibacterial activity]. PMID- 3293148 TI - [Leprosy in Ardeal 1500-1700]. PMID- 3293147 TI - [Sclerosing of esophageal-gastric varices by percutaneous transhepatic embolization]. PMID- 3293149 TI - [Gynecomastia]. PMID- 3293150 TI - [Escherichia coli O157: H7 isolated from a child with an enteral infection]. PMID- 3293151 TI - [Prof. Petru Condrea: the centenary of his birth]. PMID- 3293152 TI - [Current trends in liver surgery]. PMID- 3293154 TI - Renal cell carcinoma: surgical management of regional lymph nodes and inferior vena-caval tumor thrombus. AB - Aggressive surgical management is the primary effective treatment of renal cell carcinoma, even with regional spread to lymph nodes or the vena cava. The extent of regional lymphadenectomy with radical nephrectomy and excision of vena-caval tumor thrombi are defined. In the future, with increasingly effective adjuvant therapy, these adjuncts to radical nephrectomy will continue to be important in the treatment of renal cell carcinoma. PMID- 3293153 TI - Surgery of metastatic renal cell carcinoma and use of renal infarction. AB - Surgery can play an important role in selected patients with metastatic renal cell carcinoma although nephrectomy alone neither promotes regression of metastases nor improves survival. However, nephrectomy preceded by renal infarction and followed by medroxyprogesterone acetate produced ten complete responses, nine partial responses, and 22 stabilizations among 145 patients (CR + PR = 13%; overall response rate = 28%). Only patients with parenchymal pulmonary metastases without adenopathy, pleural effusion, or other organ involvement responded consistently (23% objective, 41% overall), and we currently recommend this combination therapy only for this group. However, infarction alone is an easy way to palliate symptoms due to primary or secondary tumors. PMID- 3293155 TI - Survey of chemotherapy of metastatic renal cancer. AB - A critical survey is made of cytotoxic chemotherapy of metastatic renal cancer. On the basis of representative summaries, only a few substances such as vinblastine, CCNU, hydroxyurea, and ifosfamide seem to act with some degree of success, but no specific antirenal cancer agent has as yet become available. This outline should provide a more realistic view of the therapeutic possibilities and of the limits of cytostatic chemotherapy in the metastatic phase of renal cancer. It is postulated that chemotherapy should feature more prominently in future therapeutic strategies. Newer cytostatic substances, i.e., second-generation alkylating agents and anthracyclines as well as platinum analogues, may present an advance with regard to side effects and tolerance but are discouraging with regard to their therapeutic efficiency in metastatic renal cancer. PMID- 3293156 TI - Chemotherapy of metastatic renal cancer. AB - The appearance of metastatic disease heralds disaster for the vast majority of patients with renal carcinoma. A few spontaneous regressions of established metastases have been reported but no systemic chemotherapeutic treatment withstood the test of time or critical analysis. This analysis requires objective remissions in measurable metastatic disease evaluated against well-defined prognostic factors in relation to survival with quality of life for the patient. No single agent chemotherapy achieved a desired 20% response rate and only a few combination studies, especially with immunotherapy, reported significant clinical results. We recommend that the variable biological potential of renal metastatic disease be harnessed in prospective multicentric phase I/II trials with strict response and prognostic criteria to search for new antineoplastic agents for this disease. PMID- 3293157 TI - Ciprofloxacin: in vitro activity, mechanism of action, and resistance. AB - Ciprofloxacin is a new fluoroquinolone that is highly active against many diverse microorganisms. At concentrations of less than 1 microgram/mL it is active against most gram-negative bacteria, including Enterobacteriaceae, Haemophilus, Neisseria, and other Pasteurellaceae, Vibrionaceae, and various species of Pseudomonas and Acinetobacter. Most staphylococci, including strains resistant to methicillin, are also susceptible to ciprofloxacin. Streptococci are not highly susceptible to ciprofloxacin, and obligate anaerobes are generally resistant to this and other quinolones. Ciprofloxacin, like other quinolones, inhibits DNA gyrase, but its bactericidal effects are not completely reversible by inhibitors of protein or RNA synthesis. Thus, unlike many other quinolones, ciprofloxacin may have multiple lethal effects. Resistance is less readily selected in vitro by ciprofloxacin than by nalidixic acid, and single-step mutants usually remain susceptible to clinically achievable concentrations. Resistance mediated by mutations in genes altering DNA gyrase and expression of outer membrane proteins has been described for ciprofloxacin and other quinolones. The antimicrobial spectrum and potency of ciprofloxacin, coupled with its rapid bactericidal effects, make this fluoroquinolone a promising new antimicrobial agent. PMID- 3293158 TI - Efficacy, safety, and potential economic benefits of oral ciprofloxacin in the treatment of infections. AB - Ciprofloxacin is a new 4-quinolone carboxylic acid derivative with a broad spectrum of activity against gram-positive and gram-negative bacteria, chlamydiae, rickettsiae, and related organisms. The drug has been administered orally to 2,018 patients, primarily in the United States. In open trials oral ciprofloxacin has been shown to constitute effective therapy for osteomyelitis, gonorrhea, and infections of the urinary and gastrointestinal tracts, respiratory tree, and skin and soft tissues. In controlled comparative trials, most of which were doubly blinded, oral ciprofloxacin was equal in terms of safety and therapeutically equal or superior to oral trimethoprim-sulfamethoxazole in urinary and gastrointestinal infections, to oral ampicillin in respiratory infections, and to parenteral cefotaxime in skin and soft tissue disease. Adverse reactions were infrequent and generally mild. The emergence of resistance was encountered rarely; the organisms implicated were usually those for which initial minimal inhibitory concentrations were high, albeit in the sensitive range (such as Pseudomonas aeruginosa). Ciprofloxacin potentiates the toxicity of theophylline. Concurrent administration of antacids may diminish gastrointestinal absorption of the drug. PMID- 3293159 TI - Condyloma acuminatum in the oral cavity: four cases and a review. AB - The number of reported cases of condyloma acuminatum has increased rapidly in recent years. While the viral etiology of these lesions has been established, differentiation from other papular growths is often difficult. Reports of condyloma acuminatum lesions in the oral cavity are appearing more frequently, although they still are sparse. Four cases of oral condyloma are described, and the English-language literature on other such cases is reviewed. Presumably, as the incidence of this type of infection continues to increase, oral condylomata will become a commoner diagnosis. Physicians and dentists should be aware of the necessity of recognizing wart-like eruptions in and around the oral cavity. PMID- 3293160 TI - Chemotherapy for leishmaniasis: biochemical mechanisms, clinical efficacy, and future strategies. AB - The 1980s have seen significant advances in the treatment of cutaneous, mucosal, and visceral leishmaniasis. Safe regimens of pentavalent antimony in the form of Pentostam (Wellcome Foundation, London; 20 mg of antimony/[kg.d] for 20-30 days) have produced initial cure rates of greater than 90% in these diseases. Biochemical investigations have demonstrated at least three parasite-specific features relevant to the mechanism of action of chemotherapeutic agents: (1) Organization of glycolytic enzymes and some enzymes of fatty acid catabolism into organelles (glycosomes) occurs in Leishmania but not in mammalian cells. Since antimony inhibits both amastigote catabolism of glucose via glycolytic enzymes and catabolism of fatty acids, the mechanism of action of antimony may relate to alteration of glycosomal structure or function. (2) Purine analogues can be utilized by the salvage pathway of purine biosynthesis in amastigotes to a greater extent than in mammalian cells, and allopurinol and allopurinol ribonucleoside are metabolized into presumably toxic nucleotides by these means. (3) Amastigote sterol biosynthesis is akin to that of such fungi as Candida in that the major demethylated sterol is of the ergostane series and in that ketoconazole inhibits its synthesis. Preliminary clinical studies suggest that the purines and the sterol inhibitors may have clinical utility as oral agents against cutaneous leishmaniasis. Possible treatment strategies for the classic and experimental agents have been proposed. PMID- 3293161 TI - Do the beta-hemolytic non-group A streptococci cause pharyngitis? AB - Implication of the beta-hemolytic non-group A streptococci (BHNAS) as pharyngeal pathogens has been based predominantly on reports of a few outbreaks, small case clusters, and anecdotes. These organisms have long been noted to constitute a significant number of the beta-hemolytic streptococcal isolates from throats of symptomatic and asymptomatic patients in a variety of populations. Laboratory studies have demonstrated the usefulness of anaerobic atmosphere and prolonged incubation in maximizing isolation of the BHNAS. More recently, genetic studies have furthered our appreciation of the taxonomy and have defined two major groups: Streptococcus anginosus-milleri group and large-colony BHNAS; the latter can be further separated on the basis of serogrouping and biotyping. Recognition of this diversity gives justification to the reexamination of the epidemiology and disease course of BHNAS pharyngitis. Treatment studies will also be required if all or subsets of these organisms can be confirmed as pharyngeal pathogens. PMID- 3293162 TI - Nongenitourinary infections caused by Mycoplasma hominis in adults. AB - Eleven new cases of Mycoplasma hominis infection occurring outside the genitourinary tract in adults not in the puerperium were evaluated in relation to the 25 cases previously reported. Cases of bacteremia (n = 14) were commonly associated with trauma or manipulation of the genitourinary tract and were often self-limited. Wound infections (n = 14) followed surgery by 4-14 days in most cases and may have arisen from contamination from the genitourinary or respiratory tract. Joint infections (n = 5) appeared to have resulted from bacteremic seeding in some cases and affected prosthetic joints in particular. Least frequent were central nervous system infections (one case of meningitis and two of brain abscess) and respiratory tract infections (three cases of empyema). The large majority of patients had fever, and infected fluid collections were commonly purulent. The response to therapy was difficult to assess in many cases, but responses to tetracycline, clindamycin, and drainage alone were observed. Identification of M. hominis requires clinical suspicion and alertness on the part of the bacteriology laboratory. PMID- 3293163 TI - Vibrio vulnificus: did Hippocrates describe a fatal case? AB - In the fifth century B.C., Hippocrates described a fatal illness in a man who lived on an island in the Aegean Sea. This acute infection was characterized by black bullous skin lesions, rapidly progressive septicemia, and death on the second day. It is hypothesized that this disease was caused by Vibrio vulnificus. PMID- 3293164 TI - Fatal endocarditis due to Listeria monocytogenes. AB - Three fatal cases of listerial endocarditis were studied. The first case occurred in an apparently healthy 58-year-old man, who presented with symptoms of pneumonitis. The second case developed in a 75-year-old woman with adenocarcinoma of the lung and aortic stenosis. In the third patient, an 83-year-old woman, aortic valve vegetations with perforations were found at necropsy. A colonic adenocarcinoma was found in the first and third cases. Ampicillin, alone or with an aminoglycoside, was the antibiotic used. Urgent valve replacement was performed in the first case. Listeria monocytogenes was isolated from blood cultures in all three cases. A review of 41 other patients with listerial endocarditis showed a nonspecific clinical picture, but septic complications occurred in one-half of the cases. Thirty-nine patients had at least one predisposing factor, which was underlying heart disease in 25 cases. The mortality rate was 48%. PMID- 3293165 TI - Infections caused by Penicillium marneffei in China and Southeast Asia: review of eighteen published cases and report of four more Chinese cases. AB - One accidental and 17 natural human infections caused by Penicillium marneffei have been reported in the literature. The accidental infection, in Paris, followed inoculation of a culture from a Vietnamese bamboo rat into the finger of a mycologist. All patients with natural infections had lived or traveled in the Far East. Nine of these patients were Chinese, all from Guangxi Zhuang Autonomous Region. The four additional infections from Guangxi reported herein bring the total to 21 natural infections. P. marneffei is a primary pathogen of humans, causing two clinical types of disease: focal infection and fatal, progressive, disseminated infection. There are three histopathologic reactions: (1) granulomatous; (2) suppurative; and (3) anergic and necrotizing. The first two reactions are seen in patients with "normal" immunity and the third in patients with compromised immunity. P. marneffei is unique among species of Penicillium because of its thermal dimorphism, its recognized ecologic niche (restricted to the Far East), and its propensity to infect the lungs and the reticuloendothelial system and to proliferate within histiocytes. PMID- 3293166 TI - Paul de Kruif's Microbe Hunters and an outraged Ronald Ross. AB - Paul de Kruif's book, Microbe Hunters, published in New York in 1926, was a romanticized medical "history," written in a breathless style, that describes the lives and works of a dozen famous figures, ranging from Leeuwenhoek to Sir Ronald Ross. Ross, who received the Nobel Prize in 1902 for his discovery that certain mosquitoes transmit malaria, resented de Kruif's personal remarks and his version of the malaria story, especially concerning the disputes with Italian workers over priorities. In a little-known polemic "review" of Microbe Hunters, Ross castigated de Kruif for statements he considered libelous. While Ross could not sue for libel across the Atlantic, his threatened action for libel forced the publisher of the British edition of Microbe Hunters to delete the chapter about Ross and one about David Bruce, Ross's countryman. de Kruif's book, a best-seller in its day and influential among the young for a generation, now seems gauche and anachronistic. While Ross seems to have been justified in some of his complaints about Microbe Hunters, the bitter tone of his reactions all but confirms de Kruif's opinion of him. Ross died in 1932 with a permanent niche in medical history; de Kruif died in 1971 and is little remembered except, perhaps, for Microbe Hunters. PMID- 3293168 TI - [The history of obstetrics at Saint Anthony's Hospital 1897-1987]. PMID- 3293167 TI - On murder by tropical infection. PMID- 3293169 TI - [The forceps. History. Current indications]. PMID- 3293170 TI - [The history of cesarean section. Its implications in current obstetrical management]. PMID- 3293171 TI - [Obstetrical hemostatic ligation of the uterine arteries and hypogastric arteries]. AB - The author studies haemostatic vascular ligations in obstetrics, in order to codify the indication of BLUA and BLHA in obstetrical haemorrhages uncontrollable with classic therapeutic means. He comes to the following conclusions: in severe post-partum haemorrhages defined by a hypotonic uterus and resistant to classic therapy, BLUA is a simple, fast, harmless procedure when carried out on the ascending branches and providing a favorable result; in severe post-partum haemorrhages originating in the segmento-cervical area, one may resort: either to BLHA; or the BLUA, at their origin (but information is not yet available concerning clinical experiment). In severe haemorrhages originated in the parauterine areas, or the hypogastric arterial system, only BLHA may be effective; in severe obstetrical haemorrhages caused by coagulation disorders and untractable with classic methods, BLHA may be useful and prevent a haemostatic hysterectomy or a least decreases bleeding intra- or even post-operatively. PMID- 3293172 TI - New low fusing synthetic porcelain: a solution to ceramo-metal problems. PMID- 3293173 TI - The bar retained dental prostheses. PMID- 3293174 TI - Magnets--myth and magic. PMID- 3293175 TI - [Profile: Virginia Henderson. A whole life dedicated to nursing]. PMID- 3293176 TI - [10 years with a positive balance for nursing]. PMID- 3293177 TI - [Colorectal carcinoma--diagnostic requirements from the clinical point of view]. AB - More than 90% of colorectal cancers develop from adenomas (adenoma-cancer sequence). An adequate preoperative diagnosis must include the tumour classification: 1. Typing = identification of the tumour type (by histology), 2. Grading = degree of differentiation and malignancy (by histology), 3. Staging = anatomical spreading of the tumour (preoperative: clinically, postoperative: following the TNM classification). Therefore, an exact preoperative tumour classification needs an endoscopic and histologic examination. Radiology does not fulfil these criteria and remains a complementary method only. In adenomas with severe cell atypia and in adenomas with invasive cancer with few exceptions (degree of malignancy 3, signet ring cell carcinoma, undifferentiated cancer) polypectomy (by snare or surgically) is the method of choice. Only when the excision cannot be performed totally or a lymphatic infiltration is proven radical operation has to be done subsequently. In cases of advanced colorectal cancer only total colonoscopy with forceps-biopsies ( = typing, grading) and clinical staging with ultrasonography (liver metastases) is essential. Examination of the entire colon is decisive for preoperative diagnosis (metachronous cancer in 1,6%, additional premalignant lesions up to 20%). PMID- 3293178 TI - [Colorectal carcinoma--endoscopic diagnosis and therapy]. AB - Endoscopic diagnosis and therapy of colorectal carcinomas comprise their early and late forms. In adenomas with invasive carcinoma, polypectomy is at the same time a complete therapy if the site of removal is histologically free from any tumour. In case of established invasion of the submucous lymphatic vessels and a low degree of differentiation subsequent segmental resection is generally recommended. Advanced carcinomas do not present any special problem in respect of identification by endoscopy. Biopsy can also be performed at the same time. In case of inoperable tumours, endoscopy offers by means of the YAG laser an additional palliative treatment method for extending the lumen or haemostasis. PMID- 3293179 TI - [X-ray diagnosis of colorectal carcinoma today--a determination of where we stand]. AB - Long-term prognosis of this malignant and frequent disease can be improved only by early diagnosis of small polyps and of carcinomas in the early stage. It is necessary to coordinate high-quality colon contrast medium enemas (double contrast method) and hypotension with coloscopy and endoscopic removal of polyps. If a colon carcinoma is identified, it is additionally also necessary--probably mostly by colon enema--to exclude preoperatively a metachronous second carcinoma which can be expected in about 5% of the cases. Ultrasound and computed tomography will help in visualising advanced carcinomas that have already passed the wall and are borderline cases in respect of operability, as well as in identifying lymph node and liver metastases, besides in identifying complicating local perforations. Proof, however, is only rendered by a positive finding. It will be necessary to determine at what extent magnetic resonance can be useful in this context. PMID- 3293180 TI - [Colorectal carcinoma--intracavitary sonography]. AB - Staging of rectal carcinoma effected in 32 patients via ultrasound was re examined on the basis of histological findings. One patient was classified in T3 by ultrasound, although histologically he belonged to the T2 stage. In no case was the spread of the tumour underestimated. Other indications for endosonography of the rectum are: aftercare of patients subjected to deep resection, and diagnosis of extraluminal processes. PMID- 3293181 TI - [Colorectal carcinoma: significance of the tumor marker]. AB - The comparison between carcinoembryonic antigen (CEA) and novel mucin or mucin like tumour markers in colorectal cancer still favours CEA with regard to sensitivity and specificity. While not contributing to screening and primary diagnostic procedures, its value as a prognostic marker including preoperative staging and post-surgical follow-up, has been well established. PMID- 3293182 TI - [Surgical possibilities in recurrence of colorectal carcinoma]. AB - Locoregional recurrences occur in 10 to 15% of curatively operated rectal carcinomas. Technically conditioned relapses can be largely avoided by proper procedure, such as taking into consideration the localisation, staging, grading, safety zones and step-by-step procedure, e.g. "no-touch-isolation" technique, radicular approach and rinsing with cytocides. In this manner, locoregional relapses can be reduced to about 10%. Only technically conditioned relapses can be cured by surgery, but, as already stated above, these should be avoided by an appropriate technique. It is quite out of place to indulge in euphoria in respect of treating locoregional recurrences, as shown by long-term examination of actual survival rates; calculated survival rates are certainly inappropriate for spreading euphoria. Such locoregional relapses can be recognised relatively early and reoperated "curatively" only if aftercare follow-up is regular and intensive. It seems that endorectal sonography is of special diagnostic importance for the early detection of relapses while being a relatively simple method. It must be stated quite clearly that efficient preventive measures during the first operation will be much more effective than any efforts put into follow-up or aftercare. Every surgeon should therefore know that it is imperative to proceed subtly and carefully during the first operation so as to avoid any relapses due to faulty technique, the more so since all relapses have a poor prognosis even with so-called "curative" operations. PMID- 3293183 TI - [Radiotherapy of rectal carcinoma]. AB - Indication for radiotherapy as a complementary measure to surgery has become considerably wider ever since the introduction of high-volt therapy and CT assisted radiation planning, plus the radiobiological experience made in recent years. The article highlights the possibilities of preoperative radiotherapy and postoperative radiation; in addition, attention is also drawn to the very restricted possibilities of palliation in relapse of carcinoma of the rectum. Finally, preoperative radiotherapy as short-term preliminary radiation is emphasised, supplemented by postoperative radiotherapy series in advanced carcinoma, as the therapy of choice. PMID- 3293185 TI - [Daily life in utero]. PMID- 3293184 TI - [Radiologic diagnosis of injuries of the wrist]. AB - To visualise the rupture of the scaphoid bone it will be sufficient--as has been proven--to perform two additional projections from the navicular series besides the standard x-rays of the wrist joint, namely, with the hand in writing-pen position and in hyperpronation. With this procedure, almost all (99%) of fractures detected during first examination can be diagnosed. To prove the occurrence of fractures of the wrist besides those of the os naviculare, specific x-rays are employed in accordance with the results of an on-target clinical examination. Such x-rays are, in particular: lateral radioulnar x-ray rotated by 10 degrees in volar direction to assess the os triquetrum; lateral radioulnar x ray in 10-30 degrees supination to visualise the os pisiforme; carpal tunnel x ray to assess the entire hollow of the hand, in particular the volar parts of os pisiforme, os hamatum (hamulus) and os trapezium. Although such fractures can partly also be diagnosed by means of a navicular series, as already stated, it is not permissible to exclude the presence of a fracture if there are no abnormal findings in the navicular quartet whereas clinical findings are positive. PMID- 3293186 TI - [Normal and pathological dynamics of the amniotic fluid]. PMID- 3293187 TI - [Prenatal cerebral lesions of circulatory origin. Anatomo-ultrasonic correlations]. PMID- 3293188 TI - [Ayurvedic medicine. Conceptual and philosophical aspects]. PMID- 3293189 TI - Oral function in subjects with overdentures supported by osseointegrated implants. AB - Nine subjects treated with overdentures on osseointegrated implants in the mandible were functionally evaluated before and after treatment. The last recordings were performed 1 yr after treatment. The evaluation comprised a subjective and a clinical examination. Measurements of bite force and of chewing efficiency were also performed. The bite force was measured during gentle biting, biting as when chewing and biting with maximal effort. Almonds were used as test food. All subjects improved subjectively as well as clinically after treatment. The bite force during gentle biting increased on average from 17.3 N before treatment to 24.0 N 1 yr after treatment. A corresponding improvement of biting as when chewing was also found, from on average 24.0 N before to 38.7 N after treatment. The maximal bite force increased from on average 74.6 N at the baseline examination to 131.5 N at the 1-yr follow-up. The chewing efficiency improved from Ci = 4 (Median value) before treatment to Ci = 2.8 (Median value) after treatment. It is concluded that treatment with an overdenture supported by osseointegrated implants in the mandible improves oral function compared to the situation before treatment. PMID- 3293190 TI - Effect of postponed polishing on marginal adaptation of resin used with dentin bonding agent. AB - Dentin cavities, prepared in extracted human teeth, were treated with two different dentin-bonding agents and filled with a light-activated microfilled resin. The maximum width of the contraction gap (MG) and the extent of the gap (GP) were then measured, using a light microscope, approximately 0.1 mm below the original free surface of the filling. The contraction gap was measured 30 s, 10 min or 60 min, and remeasured 65 min, after stop of irradiation. A positive correlation was found between the two variables, MG and GP. The product of MG and GP was chosen as basis for the statistical analyses. This "marginal index" was significantly reduced when polishing of the marginal area was postponed for 10 min with one of the dentin-bonding agents and for 60 min with the other. Even though the improvement in marginal adaptation was statistically significant, this improvement was considered clinically irrelevant. It is concluded that polishing of the marginal area should not be done before the hygroscopic expansion of the resin restoration has closed the contraction gap. PMID- 3293191 TI - John H. Humphrey 1915-1987. PMID- 3293192 TI - Major histocompatibility complex (MHC) class II antigen (HLA-DR, DQ, and DP) expression in human fetal endocrine organs and gut. AB - Monoclonal antibodies were used to analyse adrenal, pancreas, thyroid, and gut samples from human fetuses (14-19 weeks estimated gestational age; EGA) for the presence of class II major histocompatibility complex (MHC) antigens (HLA-DR, DQ, DP) by immunohistochemistry. In the adrenal definitive and fetal cortex, HLA-DR+, DP-, DQ- cells were clearly demonstrated. These DR+ cells were identified, phentotypically, as predominantly tissue macrophages and a small population of CD45R+, IgM+ lymphoid cells. Within the pancreas, numerous cells throughout the tissue were strongly DR+ but DQ-; DP+ cells were not observed until 17 weeks EGA. Using a double-labelling procedure, minor proportions of these DR+ cells were identified as macrophages or as (CD19+) B cells, while endocrine and endothelial cells were negative. Throughout the thyroid, small numbers of DR+ macrophages and small lymphoid cells were detected, although the thyroid epithelial cells were DR , DP-, and DQ-. Large numbers of DR+, DP+, DQ- cells were observed in the stomach wall and mucosa. In the intestine, DR+, DP+, DQ+ cells positive for all MHC class II loci products were abundant throughout the lamina propria and lymphoid aggregates. The class II antigens appeared in the proportion DR greater than DP greater than DQ and expression was most prevalent in the mid-gut region. A small proportion of epithelial cells of the villi along the gut were weakly DR+ but DQ , DP-. These results show that DR+ cells in fetal endocrine tissue are mainly 'passenger leucocytes' and that, in contrast to recent reports concerning normal adult tissue, the adrenal and pancreatic endothelial cells are DR-. PMID- 3293193 TI - Further evidence of nonasbestos-related mesothelioma. A review of the literature. AB - Asbestos is not the only cause of malignant mesothelioma. An updated review of the literature is presented with reports on mesothelioma with unknown causes (spontaneous cases) in animals and humans and on mesothelioma in man in association with exposure to erionite-zeolite, exposure to ionizing radiation, and chronic inflammation and in animals in association with biological (viral), chemical, physicochemical, and physical agents. PMID- 3293194 TI - [Body weight and athletic activities of the Swiss adult population: an evaluation of national trends 1977-1985]. AB - Based on available data, an attempt is made to describe 10-year trends in body weight and exercise in the Swiss population. There appears to have been a steady but rather small increase in mean body weight among both genders. The health risks of this modest increase cannot readily be evaluated, since in the light of recent studies it may be necessary to raise the threshold level for the suggested negative effects of overweight. Further, the importance of fat distribution has not yet been investigated appropriately in a sufficient number of epidemiologic surveys. The increase in exercise, which was paralleled by a decrease in the sedentary population segment during the same period is probably relevant to prevention. Men aged 45-64 and women aged 25-44 increased their physical activity most. However, only a cohort study could document the true importance of obesity and physical inactivity as etiological factors in chronic diseases among the Swiss population. PMID- 3293195 TI - [Pulmonary gas exchange and hemodynamics]. AB - The purpose of investigating pulmonary gas exchange and pulmonary circulation is detection of functional abnormalities of the cardiorespiratory system. Other than clinical features, a number of specialized methods used today are of high accuracy and therefore serve to recognize early disorders and to quantify functional impairment. In clinical practice arterial blood gas analysis and the measurement of diffusing capacity are sensitive screening tests for patients with acute and chronic respiratory failure and thus have important diagnostic and therapeutic implications (e.g. indication for oxygen therapy, mechanical ventilation, chest physiotherapy, specific drug regimen etc.). Spiroergometry and right heart catheterization, as the more invasive methods, are useful tests in evaluating overall cardiopulmonary function to detect limiting factors in physical performance (e.g. thoracic surgery, occupational diseases, sport medicine). PMID- 3293197 TI - [Zinc and pregnancy]. PMID- 3293196 TI - Observations on the pathology of experimental salmonellosis (S. typhimurium) in calves, with special consideration of the haematopoietic organs (thymus, mesenteric lymph nodes, spleen and bone marrow). PMID- 3293198 TI - [Advances in nerve regeneration research]. PMID- 3293200 TI - [Effect of epidemic growth factor on cell growth and proliferation]. PMID- 3293199 TI - [Inactive renin]. PMID- 3293201 TI - [Mechanism of microembolism-induced lung injury]. PMID- 3293202 TI - [Discriminative stimulus properties of drugs; development and application]. PMID- 3293204 TI - [Surface antigens on multipotent hematopoietic stem cells]. PMID- 3293203 TI - [A survey of enzyme thermostability studies]. PMID- 3293205 TI - [Do the peripheral-type benzodiazepine binding sites have any physiological function?]. PMID- 3293206 TI - [Atherosclerosis and cholesterol oxides]. PMID- 3293207 TI - [Calorimetry and its applications in biomedical sciences]. PMID- 3293208 TI - Photochemical ozone pollution in Britain. PMID- 3293209 TI - Some new developments in anaerobic bacterial metabolism and its genetic regulation. PMID- 3293210 TI - On seeing a butterfly: the physiology of vision. PMID- 3293211 TI - Sexual selection and the evolution of animal behaviour. PMID- 3293212 TI - Development and testing of AIDS vaccines. AB - Recent advances in delineating the molecular biology of human immunodeficiency virus type 1 (HIV-1) have led to innovative approaches to development of a vaccine for acquired immunodeficiency syndrome (AIDS). However, the lack of understanding of mechanisms of protective immunity against HIV-1, the magnitude of genetic variation of the virus, and the lack of effective animal models for HIV-1 infection and AIDS have impeded progress. The testing of AIDS vaccines also presents challenges. These include liability concerns over vaccine-related injuries; identification of suitable populations for phase 3 efficacy studies; balancing the ethical obligation to counsel research subjects to avoid high-risk behavior with the necessity to obtain vaccine efficacy data; and the effect of vaccine-induced seroconversion on the recruiting and welfare of trial volunteers. Several candidate AIDS vaccines are nevertheless currently under development, and some are undergoing phase 1 clinical trials. Rapid progress will depend on continued scientific advancement in conjunction with maximum use of resources, open information and reagent exchange, and a spirit of international collaboration. PMID- 3293213 TI - Site-specific oligonucleotide binding represses transcription of the human c-myc gene in vitro. AB - A 27-base-long DNA oligonucleotide was designed that binds to duplex DNA at a single site within the 5' end of the human c-myc gene, 115 base pairs upstream from the transcription origin P1. On the basis of the physical properties of its bound complex, it was concluded that the oligonucleotide forms a colinear triplex with the duplex binding site. By means of an in vitro assay system, it was possible to show a correlation between triplex formation at -115 base pairs and repression of c-myc transcription. The possibility is discussed that triplex formation (site-specific RNA binding to a DNA duplex) could serve as the basis for an alternative program of gene control in vivo. PMID- 3293214 TI - Ovarian carcinoma: the role of chemotherapy. AB - Maximum surgical effort will yield improved survival and response to subsequent therapy in patients with minimal residual disease (less than 2 cm diameter of any remaining nodule). Systemic therapy is the mainstay of later management. Studies have focused on single-agent v combination chemotherapy, optimal combination, dose intensity, and route of administration. In advanced disease, studies of the Gynecologic Oncology Group (GOG) demonstrate the superiority of cisplatin based combination chemotherapy over a single alkylating agent in regard to overall response, clinical complete response, response duration, and survival. Subsequent GOG and other studies suggest that a two-drug combination of cisplatin and cyclophosphamide is therapeutically equivalent to more toxic three- and four-drug combinations. Whether continued escalation of drug dose intensity beyond usual clinical schedules yields incremental gain in benefit remains under study. Administration of drug, particularly cisplatin, via the intraperitoneal (IP) route produces objective responses in patients who have progressed after prior cisplatin based therapy. Whether IP therapy is superior to IV therapy as first line treatment is under investigation. In limited disease, patients can be assigned to low- and high-risk groups based on careful surgical staging. Patients with low-risk limited disease have a 5-year disease-free survival exceeding 95% with no adjuvant therapy. Those with high-risk disease, even with IP chromic phosphate or systemic melphalan, have a relapse rate of 20% or more after a similar period. The potential role of cisplatin based combination therapy in such patients is under study. Future improvement in results depends on current investigations of noninvasive methods for diagnosis and evaluation, better definition of the value of greater dose intensity and alternate route of administration, the value of methods for choosing appropriate drugs, the development of new agents, and methods to overcome drug resistance. PMID- 3293215 TI - Management of malignant pleural effusion: an overview. AB - Exudative effusions in the pleural space are a significant cause of morbidity in patients with advanced cancer. Although the quantity of patients' lives is more often determined by the progress of their systemic cancer, the quality of their lives can be improved significantly by successful management of their effusions. The differential diagnosis of a malignant effusion often can be difficult in a newly diagnosed, asymptomatic patient. However, the diagnosis is rarely difficult in the patient with advanced cancer. In the symptomatic patient, a trial of thoracentesis only is rarely warranted. Tube thoracostomy with subsequent introduction of a sclerosing agent is the treatment of choice, but it initially requires almost complete removal of the fluid (less than 100 mL drainage in 24 hours) and reexpansion of the lung. When systemic therapy is not likely to cause prompt resolution of the effusion, the two most commonly employed intrapleural agents are bleomycin and tetracycline. Although there are a number of reports describing the relative merits of each of these agents, the data are inconclusive, primarily due to difficulty in the design and interpretation of the studies. A current pleural effusion study is being conducted in 13 American centers. It compares intrapleural tetracycline (1,000 mg) with intrapleural bleomycin (60 U). Full drainage and reexpansion are required, as is the lack of a change in therapy just before thoracostomy. Effusions that cannot be drained effectively may require pleurectomy, although recently intrapleural cytarabine and cisplatin have been proposed as a nonsclerosing alternative. When all of the elements required for successful management are attended to, the majority of patients with malignant pleural effusions can be palliated successfully. PMID- 3293216 TI - Adjuvant chemotherapy of head and neck cancer: the past, the present, and the future. AB - In the past two decades, overall survival of head and neck cancer patients has not improved significantly, despite improvements in surgery and radiotherapy techniques. In the early stages, head and neck cancer can be cured with surgery and/or radiotherapy. However, in patients who present with locally advanced lesions after combined surgery and radiation treatment, local recurrences develop in 50% to 60%, distant metastases in 20% to 30%, and a second primary neoplasm in 10% to 40%. Five-year survival for patients with stages III or IV disease who undergo standard treatment ranges from 0 to 60%. Traditional chemotherapy has been used for those patients with recurrent disease after surgery and/or radiotherapy, but the results have been disappointing. Therefore, chemotherapy as an induction regimen has been incorporated into combined modality treatment. The following specific issues of adjuvant chemotherapy will be addressed: (1) rationale for theoretic advantages of induction chemotherapy in head and neck cancer; (2) critical review of controlled and uncontrolled studies of adjuvant chemotherapy; (3) sequential chemotherapy and radiotherapy; (4) simultaneous chemotherapy and radiotherapy in head and neck cancer; (5) issues of surgical and radiotherapy complications following induction chemotherapy; (6) ongoing clinical trials of chemotherapy in head and neck cancer in the United States; (7) development of effective induction regimens in head and neck cancer; (8) future directions of adjuvant chemotherapy in head and neck cancer. PMID- 3293217 TI - Complicated problems in testicular cancer. AB - Although testicular cancer is a relatively rare disease, it nevertheless is extremely important, as it has become a model for a curable neoplasm. Cisplatin combination chemotherapy has revolutionized the cure rate in this once highly lethal disease: Today over 90% of all patients are cured of their disease, including an 80% cure rate in disseminated testicular cancer. However, these dramatic advances have created a new set of questions relating to the proper management of clinical stage I disease, challenging the role of retroperitoneal lymph node dissection (RPLND) in such patients. Despite the potential value of a surveillance policy, we continue to advocate routine RPLND for clinical stage I nonseminomatous germ cell tumors. Salvage chemotherapy has been refined and improved with the availability of new active agents such as ifosfamide. Dosage intensity is very important in oncology, and this concept is also being tested in refractory testicular cancer with very high-dose carboplatin plus etoposide with autologous bone marrow transplantation. We are currently in the enviable position in testicular cancer where we can now concentrate on small subsets of patients with advanced disseminated disease and evaluate innovative aggressive regimens. We expect future fine-tuning to provide continued improved therapeutic index in testicular cancer patients. PMID- 3293218 TI - Chemotherapy of advanced gastric cancer: present status, future prospects. AB - The chemotherapy of gastric carcinoma is at an important point in its evolution. Multiple studies with a variety of agents have demonstrated that combination chemotherapy appears to be superior to single-agent chemotherapy in regard to response rate but not survival rate. The typical single agent results in response rates of 20% or less, whereas the typical combination chemotherapy regimen results in response rates of 30% to 50%. The FAM (5-fluorouracil [5-FU], doxorubicin, mitomycin C) chemotherapy regimen, widely used during the last 10 years, produces partial responses (PRs) in 35% of patients. However, the overall complete response (CR) rate is only 2%. Long-term survival of patients with disseminated malignancy is only achieved when treatments produce CR of disease. Because available combination chemotherapy approaches to gastric cancer only produce PRs, it is not surprising that there has been no impact on patient survival from these approaches. There are several newer approaches that hold promise in the treatment of gastric cancer. For example, the role of cisplatin in gastric cancer has not been completely defined. A recent study of FAP (5-FU, doxorubicin, cisplatin) has reported a 50% response rate with a significant number of CRs. The FAP regimen needs further exploration. The drug triazinate appears to have activity in gastric cancer, and in combination with mitomycin C produces a 28% response rate in patients who had failed chemotherapy regimens containing fluorinated pyrimidine. Thus, the efficacy of this drug needs further exploration in stomach cancer therapy. There is no clear definition of the future role of hepatic arterial infusion in gastric cancer. There is no question that, in colon cancer, response rates with fluorinated pyrimidine alone or fluorinated pyrimidine with mitomycin C are in the range of 50% when hepatic arterial infusion is used. This approach needs to be explored in gastric cancer. Finally, the use of intraperitoneal (IP) therapy in patients with minimal disease should be explored, because a common form of relapse in carcinoma of the stomach is IP dissemination. PMID- 3293219 TI - Chemotherapy in gastrointestinal malignancies. AB - The frequency of gastrointestinal (GI) cancers mandates innovative and individualized therapies. Chemotherapy used as sole treatment for these diverse malignancies has not been generally successful in providing palliation or improving patient survival. Radiotherapy has been more successful at controlling local manifestations of disease, but the high incidence of systemic metastases in most malignancies limits the impact of this modality on curability. Combinations of radiotherapy and chemotherapy may prove to be more valuable than single modality treatment in improving local control of tumors, decreasing systemic disease, and improving patient tolerance to treatment. A model for this approach is the current management of anal cancer, in which combined modality therapy has largely supplanted primary surgery. Data from trials in other primary tumor sites strongly suggest further exploration of combined treatments--surgical, radiotherapeutic, and chemotherapeutic--in GI malignancies. Nearly 25% of all malignancies diagnosed in the United States each year involve the GI tract; thus, there is a powerful imperative for the development of new therapeutic strategies in these diseases. Any discussion of the role of chemotherapy in GI cancers must necessarily be broad, because assessment must include diseases with highly variable surgical curability, histologies, and sensitivities to chemotherapeutic agents. In addition, whereas it has been quite easy to perform standard phase II trials in colorectal cancer, other disease sites, such as the esophagus, the pancreas, and the biliary tract, have been much less extensively studied. In spite of these limitations, there is a wealth of data in the literature concerning the use of chemotherapy in GI malignancies. This article, while not exhaustive, describes the current status of chemotherapy for these diverse diseases, with emphasis on the role of mitomycin C. PMID- 3293220 TI - Chemotherapeutic approaches to advanced breast cancer. AB - Choices of treatment for patients with estrogen receptor (ER) positive metastatic breast cancer refractory to first-line endocrine therapies include progestins, antiadrenal drugs, and androgens. These treatments should be administered sequentially to achieve maximum palliation of the disease. For ER positive patients with disease that is refractory to endocrine therapies, chemotherapy of choice includes either CMF (cyclophosphamide, methotrexate, fluorouracil) or FAC (fluorouracil, doxorubicin, cyclophosphamide), which is CMF with doxorubicin substituted for methotrexate. Choices of therapy for those with disease refractory to CMF combinations include doxorubicin and vinca alkaloids or mitomycin C combinations. These combinations result in 45% to 55% response rates. For those who do not respond to FAC, the combinations active in refractory disease include vinca alkaloids and mitomycin C combinations. Other drugs with 15% to 25% antitumor activity include mitoxantrone, elliptinium acetate, CHIP (cis-dichloro-transdihydroxy-bis-isoprophylamine platinum), peptichemio, and fluorouracil infusion. PMID- 3293221 TI - Onset of breathing and control of respiration. PMID- 3293222 TI - The role of surfactant in neonatal adaptation. AB - The fetal lung has complex mechanisms for surfactant accumulation and secretion that prepare the fetus for an uncomplicated transition to air breathing. Recent experiments indicate that this transition is not just a process of secretion of accumulated stores, but involves dynamic processes of mobilization of intracellular pools, alveolar surfactant reuptake, and complex changes in alveolar surfactant fractions. The intricacies of these processes and the relative importance of the various proposed secretagogues remain to be further explored. Surfactant is necessary, but not sufficient for normal neonatal pulmonary adaptation. Without adequate central respiratory drive, respiratory muscles, and lung structural maturation, normal respiratory adaptation will not occur. PMID- 3293223 TI - Lung liquid clearance before and after birth. PMID- 3293224 TI - Perinatal fluid and electrolyte regulation: role of arginine vasopressin. AB - Not many years ago, the fetus was perceived to exert little impact on amniotic fluid homeostasis. It is now clear that the fetus plays an integral role in modulating fluid flux between the maternal, fetal, and amniotic fluid compartments. Moreover, fetal AVP secretion and the associated renal and cardiovascular responses represent important aspects of the potential to adapt to changes in the intrauterine environment. Although the physiologic significance of the increased AVP secretion observed in response to labor and delivery remain speculative, AVP regulation also is an essential aspect of neonatal adaptation. Still, many questions remain regarding both the regulation of fetal and neonatal fluid dynamics and the ontogeny of AVP receptor systems. PMID- 3293226 TI - Thyroid hormone effects on neonatal thermogenesis. AB - It is clear that thyroid hormones modulate non-shivering heat production of the newborn mammal. While some obvious thyroid hormone effects on thermogenesis can be demonstrated in adult, cold-acclimated or hibernating animals, these findings cannot be directly applied to the newborn, in which changes in amount and composition of brown adipose tissue, as well as sympathetic and thyroid system maturational events, are occurring. Thyroid hormones do influence the prenatal development and subsequent responses of brown adipose tissue in neonates through primary actions on brown adipose tissue iodothyronine 5'monodeiodinase and mitochondrial uncoupling protein. Secondary effects involving brown adipocyte growth, lipid composition, oxidation proteins, and sympathoadrenal activity are of lesser importance in thyroid hormone modulation of newborn thermogenesis. The acute surge in thyroid hormones that occurs at birth seems of limited significance with regard to neonatal thermogenesis. The stimulation of sympathoadrenal activity at the time of birth, as well as continued in situ conversion of T4 to T3 in the brown adipocyte, are of critical importance in stimulating and modulating heat production in the newborn. PMID- 3293225 TI - Renal hemodynamics and functional adjustments to postnatal life. PMID- 3293227 TI - Sympathoadrenal system activity at birth: integration of postnatal adaptation. AB - In this article we have reviewed available information characterizing an increase in SAS activity at birth, in the so-called "catecholamine surge." Also, we have described the sources of circulating CA in the sheep fetus at birth and reviewed recent data on the significance of the CA surge at birth with regard to vital events of postnatal metabolic and cardiovascular adaptations. The results available to date suggest a unique, early neonatal dependence on circulating catecholamines for maintenance of physiologic homeostasis. The duration of this dependence and the ability of newborn animals or humans to sustain such high circulating catecholamine levels is not known. Further studies will clarify the relative importance of circulating and neuronally released CA in these adaptive events in various organ systems and test the applicability of a wide variety of adrenergic agents for therapeutic intervention. PMID- 3293228 TI - Circulatory adjustments to postnatal life. AB - Dramatic changes occur in the cardiovascular system at birth. The circulation changes from one characterized by the presence of central shunts, a relatively low combined ventricular output, right ventricular dominance, and pulmonary vasoconstriction, to a circulation in series with a high cardiac output equally divided between the two ventricles, and a greatly dilated pulmonary vascular bed. To understand the mechanisms that initiate these profound changes, studies that separate the components of the birth process in the chronically instrumented fetus must be continued, along with biochemical studies of isolated tissues to determine the cellular and subcellular events that mediate these changes. Understanding the many processes that control perinatal cardiovascular development will assist the physician in treating those infants in whom the transition from the fetal to the neonatal circulation is abnormal. PMID- 3293229 TI - Naturopathy in Canada: changing relationships to medicine, chiropractic and the state. AB - It is said that we can learn as much about social processes from so-called 'deviant' institutions than from the more legitimate. 'Deviant' medical occupations have not attracted much attention from social scientists. Naturopathy is one of these nonconventional health occupations. It emerged in the 18th and 19th centuries and moved to Canada from the United States and Europe early in the 20th. The social history of naturopathy in Canada illustrates the importance of processes of occupational formation and organization as well as state recognition or legitimation. Furthermore, the development of naturopathy shows the importance of state-occupation and naturopathy-chiropractic relationships as well as the often noted relationships with the dominant health occupation of medicine. Incidentally noted are the changing relationships with the state and the dominance of the ideology of science. PMID- 3293230 TI - The AIDS crisis: a United States health care perspective. AB - The unanticipated onset of Acquired Immunodeficiency Syndrome in the United States, followed by its gradual progression into a full-blown, uncontrollable epidemic, has had severe economic and organizational consequences for the American health care system. AIDS has taken its toll on the health workforce as well in terms of stress, anxiety and workload demands. In the absence of adequate community-based treatment and care resources for persons with AIDS, hospitals had to assume the major burden for providing basic medical care and developing the needed range of services required. This expansion of responsibilities strained hospitals and other health care agencies beyond their capabilities. Some hospitals have faced economic and allocation dilemmas because of high occupancy rates by AIDS patients since there are no specialized reimbursement rates for the intensive resource utilization required for their care. These substantial burdens underscored the need for coordinated long-term planning for a continuum of in patient, out-patient and community support services. A major response to the epidemic has been a restructuring of the health and social service delivery systems. Hospitals have had to maintain patients beyond their need for an acute level of care, develop infrastructures to manage the increasing numbers of patients, alter physical facilities, provide educational programs and support groups to increase staff's knowledge and decrease fears of AIDS, consider alternatives to in-patient medical management, and lobby with local, state and federal governments to obtain increased public monies for AIDS treatment and care. In the past year, there has been a discernible shift to widening the network of ambulatory medical services and community-based social and health care supports. A major focus of this paper is the social and organizational impact of this epidemic on the hospital and health care system and the systems' responses. Alternatives to an acute care treatment locus for persons with AIDS are explored. Recommendations for future directions for a comprehensive, coordinated health and social services delivery network are presented. PMID- 3293231 TI - Ethnicity, gender, and utilization of mental health services in a Medicaid population. AB - This study examines gender and ethnic differences in mental health utilization and expenditures in a fee-for-service Medicaid eligible population in Monroe County, New York. The analyses demonstrate that Medicaid poor are not a homogeneous population in terms of mental health utilization, and that their patterns of care use are quite unlike those generally attributed to the middle class patients. For example, Medicaid eligible males are more likely to be mental health users than females, although they are less likely to use medical services. Ethnicity appears to be a strong determinant of ambulatory mental health utilization, but not of inpatient care. Whites experience significantly higher levels of psychiatric ambulatory use than do the nonwhites. Nonwhites, on the other hand experience greater utilization of alcohol ambulatory services than do the whites. The data indicate that although mental health care cost represents at least 20% of total expenditures in this population, this cost is predictable and stable from year to year. Other analyses dealing with the cost of medical care for mental health users, and with the impact of a 'gate keeper' on mental health utilization patterns, are presented. Both clinical and public policy implications are discussed. PMID- 3293232 TI - A game-theoretic approach to donor kidney sharing. AB - Graft survival in renal transplantation is a function, amongst other things, of the degree of histocompatibility lymphocyte-A (HLA) tissue matching achieved between donor and recipient. Yet a donor procured at centre A might match a transplant candidate at centre B and vice versa. This raises the question of whether, and under what circumstances, surgeons will offer and exchange donor kidneys and gain from such trade in terms of graft survival. We analyse the problem in a game-theoretic framework where the choice of strategy 'to offer or not?' is evaluated in the context of the uncertainty of reciprocation by the other player(s) in the game. The equilibrium solution to a number of variations of the game is predicted to be non-cooperation resulting in collectively sub optimal graft survival rates. Some policy options for improving cooperation are considered including exchange incentives and coercive measures. PMID- 3293233 TI - Communities, self-causation and the natural lottery. AB - This paper examines the various notions of community, and of the 'natural lottery' as well as investigating the role that 'self-causation' plays in communal obligations. In examining community, two opposing views are juxtaposed: (1) the view that community consists merely of persons united by duties of refraining from harm one to another, resulting in autonomy based justice which makes freedom an absolute condition of mortality; and (2) a broader view which sees the concept of community as entailing obligations of beneficence, resulting in beneficence based justice and which, therefore, sees freedom as a value to be cautiously traded with other values. In examining the 'natural lottery' in the light of community, the various consequences of viewing the lottery in various ways and the impact that our view of community has on these consequences, is explored. A third option, the option that the 'natural lottery' as the cause of illness and health is a shaky concept, is offered. Self-causation of illness and its linkage to concepts of community and of the 'natural lottery' is then briefly examined. It is concluded that (1) community implies a social contract which, in order to be conceived in the first place, necessitates more than a minimalist ethic: to come about, a degree of beneficence inspiring trust is presupposed; (2) conceiving community narrowly is neither what we ordinarily do when we think of the term nor, for that matter, workable in our world.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293234 TI - Campylobacter gastritis and associated disorders. AB - Our review of evidence that Campylobacter pylori is an important factor in gastritis, peptic ulcer disease, and "nonulcer dyspepsia" suggests that C pylori is the most common cause of chronic active gastritis. The association between C pylori gastritis and duodenal ulcer, which approaches 100%, leads to the suggestion that this infection plays an important role in the pathogenesis of duodenal ulcer. Evidence supporting a central role in the pathogenesis of gastric ulcer and nonulcer dyspepsia is less compelling. PMID- 3293235 TI - Conventional immunosuppressive therapy in modern renal transplantation. AB - Conventional immunosuppression has been replaced by cyclosporine protocols for renal transplantation in most centers. Some centers have continued using conventional immunosuppression in certain instances. In our series, 104 patients received 105 kidney allografts (58 cadaver, 47 living donor) in 1983 and 1984. No patients was treated with cyclosporine. Patient survival was 95% and 92% at six months and one year, respectively. Eight deaths were caused by sudden cardiorespiratory events (four), liver failure (one), and suicide (one); fatal infection occurred after regrafting in two asplenic patients. Actuarial graft functional survival was 80% at 12 months; living related donor graft survival of 94% at one year was comparatively better than the 66% with cadaveric grafts. Death from excessive pharmacologic immunosuppression did not occur. Graft survival was excellent with living donor and acceptable with cadaveric grafts, especially with good tissue matching. Conventional immunosuppression may remain applicable in renal transplantation under conditions of low risk for graft loss. PMID- 3293236 TI - Cancer of the esophagus: the environmental connection. AB - Cancer of the esophagus poses a unique challenge for students of cancer prevention. The role of nutritional determinants and other environmental factors in modulating esophageal cancer has received increasing support from data collected during the last decades. Ecologic, geographic, economic, and cultural variables appear to be collectively operational in determining the nutritional profiles of high-risk populations in the Asian esophageal cancer belt and discrete hyperendemic pockets throughout the world. Altering dietary staples, preventing food contamination by mycotoxins, using molybdenum as a chemical fertilizer, modifying social habits, and adding deficient micronutrients to diets of high-risk groups will potentially avert the development of this devastating malignant neoplasm. PMID- 3293237 TI - Old Parr: or how old is old? AB - In 1635, the noted physician Sir William Harvey performed an autopsy on the body of Thomas Parr who was reported to have been 152 years old. Although there is little evidence to support Parr's age, historians agree that he had indeed reached an advanced age and was probably a centenarian. In his writings, Dr. Harvey left an interesting account of the autopsy, presenting a detailed description of the condition of Parr's body. He concluded that Parr's simple, active life-style probably contributed to his longevity and that the rich diet and polluted air of London probably contributed to his demise. PMID- 3293238 TI - Successful single lung transplantation. AB - We have presented a successful case of lung transplantation in a man with pulmonary fibrosis. We believe it is the first successful attempt in the United States, following demonstration of its feasibility in Toronto, Canada. Twenty years after the first lung transplantation, several factors have evolved that help to secure a successful outcome, including a strong, dynamic organ procurement system; static, hypothermic lung preservation; omental wrapping of the bronchial anastomosis; improved immunosuppressive agents; and improved postoperative care. PMID- 3293240 TI - [Personal concept of collecting and processing alloplastic bone grafts for reconstructive surgery]. PMID- 3293239 TI - [Case report of the migration of a Kirschner wire into the lungs]. PMID- 3293241 TI - Abdominal surgical complications of anticoagulant drugs. PMID- 3293242 TI - Treatment of high-grade soft-tissue sarcomas of the extremities. PMID- 3293243 TI - Sydney John Peerless. PMID- 3293244 TI - Prefrontal lobotomy--author replies. PMID- 3293245 TI - Alternatives to high noble dental casting gold alloys type 3. An in vitro in vivo study. AB - For economic reasons a large number of cheaper alternatives to the high noble dental casting gold alloys have been introduced on the market. The main problem with these alternative alloys is their chemical stability. This is a most important property as degradation of an alloy may release substances which can be harmful to the wearer. Thus, the corrosion behavior of four dissimilar alternative dental casting alloys together with a high-gold reference alloy was evaluated in the as-cast, hardened, and annealed conditions by means of potentiodynamic polarization analysis, partly supplemented by electron spectroscopy for chemical analysis. In order to facilitate interpretation of the results of the corrosion study, the composition and metallographic structure of specimens in the specimens in the dissimilar conditions had to be determined. The methods used were light microscopy, electron probe microanalysis, and X-ray diffractometry. Biocompatibility, which is related to the release of metal ions, was evaluated by subcutaneous implantation of specimens from the five alloys in guinea-pigs. Thus, the in vivo toxicity of the different alloys could be assessed. The chemical stability of an alloy also determines its tarnish resistance and as tarnish apart from creating esthetic problems, also may result in changes in the wetting characteristics of the alloy surface the in vivo tarnish of as-cast and annealed specimens inserted into complete mandibular dentures was estimated after up to 16 weeks. Castability, an important factor in an alloy's clinical performance, was measured as the marginal sharpness of cast simulated crowns from the five alloys. Finally, the clinical performance of crowns and bridges made from one low-gold and one silver-palladium alloy as experimental materials together with a high-gold alloy as a reference material was evaluated using specific periodontal parameters, a tarnish index, and CDA's guidelines for the assessment of clinical quality. The findings may be summarized as follows: The metallographic evaluation for the low-gold alloys Midas and Rajah indicated that these alloys may contain more than one phase. The two silver palladium alloys Albacast and Alba V were heterogeneous in the three conditions studied. In most cases, the pre-treatment of the alloys had a decisive influence on their proneness to corrosion. The castability of the silver-palladium alloys was inferior to that of the gold-based alloys. The biocompatibility as revealed by subcutaneous implantation showed that one of the silver-palladium alloys (Albacast) produced the least tissue response, while the other one (Alba V) exhibided the worst tissue response.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3293246 TI - The tissue-integrated prosthesis in the treatment of edentulous patients. A follow-up study. AB - This paper reports the results of clinical series of osseointegrated implants (BiotesTM) at the Karolinska Institute, Stockholm. From 1980 to 1985, 350 implants were installed in 68 upper jaws and 440 implants in 83 lower jaws. After observation periods of 1 to 6 years, 307 (88%) maxillary implants and 434 (99%) mandibular implants were fully functional. Of 128 bridges and 23 overdentures 124 (97%) and 21 (91%) respectively were in function at the end of the observation time. The most frequent tissue complications were fistulae (8 cases) and mucosal hyperplasia adjacent to abutments (11 cases). The most frequent prosthetic complications were phonetic problems in the maxilla only (10 cases), acrylic fractures in bridges (3 cases) and fractures or distortion of the metallic framework (2 cases). The results indicated that treatment with osseointegrated implants (BiotesTM) is a safe method with predictable long-term prognosis for rehabilitation of the edentulous patient. PMID- 3293247 TI - Surgical approach in severe cases of maxillonasal dysplasia (Binder's syndrome). AB - Binder's syndrome or maxillonasal dysplasia is a malformation characterized by an extremely flat and retruded nose. Severe cases of the syndrome do also have a retrognatic maxilla often combined with an open bite deformity which demands a combined surgical solution with both maxillary osteotomy and secondary nose correction. The two-stage surgical procedure in the advanced cases of maxillonasal dysplasia has in our opinion been preferable to a Le Fort II osteotomy. Two cases with severe Binder's syndrome where the two-stage procedure has been performed will be presented and the surgical approach discussed. PMID- 3293248 TI - Human jaw muscle motor behaviour. II. Reflex and receptor mechanisms. AB - The stretch reflex is much more complicated than the simple tendon jerk with a monosynaptic reflex pathway. Muscle stretch is not a necessary prerequisite to elicit the short latency EMG excitatory response. Long latency EMG responses are probably of greater functional importance. The silent period (SP) following the jaw jerk is prolonged in patients with symptoms of mandibular dysfunction. In the individual case, however, measurement of the SP may not be of diagnostic value. The Golgi tendon organs are highly sensitive tension receptors which play a much larger role in the proprioceptive regulation of muscle tension than has been believed in the past. So-called type P mechanoreceptors which like a large part of the periodontal receptors have their cells of origin in the mesencephalic nucleus V, have been found in the hard palate. The majority of periodontal mechanoreceptors are slowly adapting and thus able to respond with sustained discharge to long lasting stimulation, as during chenching or bruxing. The postural position has been assigned great clinical significance. It has been assumed that this position is constant throughout life. It has, however, been observed that the postural position rapidly adapts to changes of the vertical occlusal dimension. PMID- 3293249 TI - Odontogenic keratocysts. A follow-up study of 29 cases. AB - This study reports the incidence and recurrence rate of odontogenic keratocysts in a series of 531 jaw cysts treated at the Department of Oral Surgery, Karolinska Institute, Stockholm, from 1977 to 1984. Each case of a histologically verified odontogenic keratocyst was analysed and registered with respect to patient's age and sex, type of cyst, location and rate of recurrence. Twenty-nine odontogenic keratocysts were found (5.4% of all cysts). The most frequent locations were in the mandibular angle, ramus and third molar regions. During the observation period (1-8 years) 7 keratocysts (24%) recurred. These findings support previous observations. PMID- 3293250 TI - [Nursing's dilemma. Having to justify the values of caring]. PMID- 3293251 TI - [Comparative evaluation of the effectiveness of intra-articular administration of orgotein and hydrocortisone in rheumatoid arthritis]. PMID- 3293252 TI - [Piroxicam in the treatment of rheumatoid arthritis]. AB - Open and double blind trials in 80 patients with proved and definite rheumatoid arthritis have shown that piroxicam possesses marked analgesic and antiinflammatory action, is well tolerated producing a therapeutic effect only at high doses exceeding the mean ones recommended in the literature. PMID- 3293253 TI - [Effectiveness of laser therapy in Bechterew's disease]. AB - Altogether 33 patients with Bekhterev's disease were given external irradiation of the spine and joints using He-Ne laser: 20 patients received laser therapy combined with indomethacin at a daily dose of 75-100 mg, 13 patients received laser therapy alone without indomethacin as a result of its intolerance. A course included 20 sessions of irradiation. Therapeutic efficacy was assessed by a number of clinicolaboratory indices. The most noticeable effect was observed in the combination of nonsteroid antiinflammatory drugs with laser therapy. The use of the latter as monotherapy was less effective, and its effect was comparable with that of indomethcin at a daily dose of 75 mg. PMID- 3293254 TI - [The 40th anniversary of the World Health Organization and the contribution of Soviet specialists to its activities]. PMID- 3293255 TI - [Comparative evaluation of the treatment of Sjogren's syndrome with anti rheumatic preparations]. AB - The paper is devoted to comparative assessment of combined therapy of prednisolone, chlorambucil, chloroquine phosphate and ibuprofen at small doses and its effect on clinicolaboratory signs of Sjogren's disease in 80 patients in the course of 1 and 5 years. Patients of the control group received only local therapy of the parotid glands. The results have demonstrated that combined therapy at small doses of prednisolone and chlorambucil (5 mg + 4 mg) is an effective method of treatment of the stomatological, ophthalmological and articular manifestations of SD and is also capable of preventing the systemic signs of disease. Combined therapy with chloroquine phosphate and ibuprofen neither influenced the clinicolaboratory signs of disease nor prevented disease progression with the development of systemic signs of diseases of various degrees. Disease progression was observed in 80% of patients receiving no basic drugs or receiving chloroquine phosphate+ibuprofen while in groups of patients receiving small doses of prednisolone and chloambucil disease progression was observed in 20% only. PMID- 3293256 TI - [Treatment of Sjogren's syndrome with protease inhibitors]. AB - The authors reported the results of therapy of 28 patients with primary and secondary Sjogren's syndrome by iv injections of protease inhibitors (contrykal and trasylol). Findings of clinical and laboratory tests showed a significant increase in salivation and lacrimation. The elimination of concomitant oral candidosis raised the efficacy of treatment of xerostomia in many patients. PMID- 3293257 TI - [Effectiveness and safety of using cyclosporin A in the treatment of primary Sjogren's syndrome]. AB - We used oral cyclosporine-A (CyA) (5 mg/kg/day) initially in a double blind study for 6 mos. 10 patients received CyA and 10 placebo. At the end of this study it was observed that CyA improved subjective xerostomia, while subjective xerophthalmia, parotid gland enlargement, Schirmer-I-test and parotid flow rate did not show any significant differences in the two study groups. 9 of 10 patients who had received CyA for 6 mos and 9 of 10 in the placebo group continued in an open trial (CyA at the same dose) for an additional 6 mos. At the end of the study the only efficacy of CyA observed was improvement of subjective xerostomia. The side-effects observed were hypertrichosis (14 persons), mild hypertension (4), infections (5) and 3 dropped out because of nausea, tremor, paresthesias and infections. In conclusion, small doses of CyA for 12 mos are rather ineffective for Sjogren's syndrome. PMID- 3293258 TI - [Determining the level of the rheumatoid factor associated with polyclonal and monoclonal human serum IgA]. AB - The authors studied the activity of the rheumatoid factor (RF) associated with polyclonal and monoclonal IgA contained in the sera of patients with chronic diseases of noninfectious etiology and A-paraproteinemia. IgA-RF-activity was determined by an enzyme immunoassay. In most of the patients' sera IgA had a high level of RF-activity. The frequency of RF-activity detection did not depend on the level of polyclonal IgA but correlated with the level of monoclonal serum IgA. During a study of the chromatographic fractions of sera containing monoclonal IgA, RF-activity was mainly revealed in the fraction of IgA polymers; IgA monomers forming the bulk of serum IgA, demonstrated no RF-activity. The inclination of curves reflecting the correlation between the level of IgA-RF and dilutions of tested sera made it possible to assess function of the affinity of such molecules which was growing with an increase in IgA molecular mass. PMID- 3293259 TI - The developmental pathology of maternally derived Thp fetuses. AB - The Thair pin (Thp) mutation is a deletion of 5 centimorgans of chromosome 17 in the mouse. When the mutant chromosome is passed to the fetus through the female, the heterozygous fetuses (Thp/+) die in utero. If the chromosome is passed through the male, the heterozygotes are viable and display a short-tailed phenotype. These maternally derived mutant embryos provide an excellent model system to study the effects of an incomplete female genome on development. The results reported here describe the findings of a pathological study of the affected fetuses from day 14 of development to birth. These observations indicate that the maternally derived Thp fetuses die in utero of congestive heart failure. The mutant fetuses displayed an enlarged heart, primarily the right side, and other cardiovascular abnormalities including ventricular septal defects, aortic stenosis, pulmonary artery dilation, and dilation of the venous circulatory system. The fetuses also displayed abnormal accumulation of extrafetal fluid in the visceral yolk sac and amion, as well as massive subcutaneous edema and ascites. The Thp fetuses were often pale and anemic, and they showed a decreased number of red blood cells per unit volume of blood and an increase in circulating nucleated red blood cells. Defects in the development of the labyrinthine and spongiotrophoblast regions of the placenta were also observed. The pathogenesis of the defects is discussed. PMID- 3293260 TI - Histological comparison of the effects of the splotch gene and retinoic acid on the closure of the mouse neural tube. AB - The splotch gene (Sp) and all-trans retinoic acid (RA) interact to cause spina bifida in mouse embryos. To investigate the mechanisms of action of the two, the spinal regions of Sp homozygotes, RA-treated wild-type, and control wild-type embryos were examined histologically by light microscopy on day 9 of gestation. The mean numbers of cells per section in the neural tube, mesoderm, and notochord were determined, along with the percentages of mitotic and pyknotic nuclei and the numbers of migrating neural crest cells. As well, the effect of Sp and RA on the extracellular matrix was studied histochemically with Alcian blue staining for glycosaminoglycans. The main defect in Sp homozygotes was a marked reduction in the number of migrating neural crest cells and the amount of extracellular matrix around the neural tube. Retinoic acid, on the other hand, caused a number of disruptions in the embryo, including abnormalities in the position of the notochord and the shape of the neural tube. Sp and RA delay neural tube closure and thus cause neural tube defects, through different mechanisms. However, the combined effects of the gene and teratogen on the embryo lead to a greater inhibition of neural tube closure than when either is present separately. PMID- 3293261 TI - May Owen's hand in the future. PMID- 3293262 TI - Diabetic retinopathy diagnosis and treatment. PMID- 3293263 TI - Effects of low-dose aspirin on endogenous eicosanoid formation in normal and atherosclerotic men. AB - We have investigated the effects of a low-dose aspirin regimen (120 mg orally, then 20 mg twice daily) on the in vivo synthesis of prostacyclin, thromboxane and prostaglandin E in man by measurement of their urinary metabolites (PGI2-M, TxB2 M, PGE-M) using gas chromatography-mass spectrometry. A comparison was made between the selectivity of low-dose aspirin for thromboxane vs prostacyclin synthesis in patients with atherosclerosis, age-matched controls without vascular disease, and young healthy volunteers. After one week of treatment, aspirin reduced TxB2-M synthesis to a similar extent in the three groups (mean declines of 86, 84 and 78% respectively), while there was an unexpected difference in effect on PGI2-M, with only a 27% fall in the young volunteers but 53% and 54% declines in the patients with vascular disease and their age-matched controls. Serum TxB2 was reduced greater than 98% in all groups while PGE-M excretion was unchanged. These results indicate that bioselectivity for inhibition of Tx synthesis by aspirin is more difficult to achieve in older subjects than in the young volunteers previously studied and that very low, frequent dosing, or a sustained-release preparation of aspirin would be needed to achieve bioselectivity for Tx inhibition in patients with vascular disease. PMID- 3293265 TI - Geographical variation in India in the composition and lethal potency of Russell's viper (Vipera russelli) venom. AB - Venom samples of Russell's viper (Vipera russelli) from three localities in India were analysed for their composition and toxicity. Column chromatographic fractionation on CM-Sephadex C-25 showed the absence of three fractions in the venom samples of southern India compared with the samples from northern and western India. The SDS-PAGE pattern of southern Indian venom samples also showed lack of three protein bands corresponding to molecular weights of 66,000, 39,000 and 9000. Venom samples from northern and western India possessed high acidic phospholipase activity while acidic phospholipase activity was absent in the samples from southern India, which in contrast showed large basic fractions with phospholipase activity. Proteolytic activity was present in all the venom samples; however, this activity, as well as trypsin inhibitor activity, was very low in the southern Indian samples. The ratio of proteolytic activity to inhibitor activity remained constant in most of the venom samples studied. LD50 values for most of the venom samples from northern and western India were twice as high as that of the samples from southern India. High phospholipase activity correlated with high lethal potency in the venom samples studied. PMID- 3293266 TI - [Construction of clasps and plaque development]. PMID- 3293264 TI - Are the toxicological effects of scorpion envenomation related to tissue venom concentration? AB - The pharmacokinetics of 125I-labelled Androctonus amoreuxi venom and its lethal fraction was studied in rabbits. Comparative pharmacokinetic studies of labelled A. amoreuxi, Leisurus quinquestriatus and Buthotus judaicus venoms were carried out in guinea-pigs. The pharmacokinetics of A. amoreuxi venom was also studied in rats. Groups of rats were injected with labelled A. amoreuxi venom and killed at frequent time intervals for the determination of the relative tissue venom concentration as a function of time. Several groups of rabbits were injected with A. amoreuxi venom and serial blood samples withdrawn at time intervals comparable with those used in the pharmacokinetic studies for the determination of serum glucose, insulin, cortisol, total proteins, albumin, globulins, cholesterol, total bilirubin, urea, uric acid, bicarbonate, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase, sodium, potassium, calcium and phosphorus. The packed cell volume, and total and differential leucocyte counts were also determined. In another series of experiments continuous monitoring of the electrocardiograms of rabbits following venom injection was made to correlate any abnormalities with tissue venom concentration. All three venoms and the lethal fraction showed an open two compartment behaviour with rapid distribution half-lives ranging between 4 and 7 min and overall elimination half-lives of 4.2 to 13.4 hr. The behaviour of A. amoreuxi venom was not markedly different in the three species of animals used. In a given species (guinea-pigs) the behaviour of the three venoms was not markedly different. Correlation of the ECG changes with cardiac venom concentration showed that arrhythmias and infarction occurred at times when cardiac concentration was very low, indicating that the cardiac abnormalities might result from indirect factors. Comparison of the course of the biochemical changes with venom concentration in the central compartment indicated that the site of action of the venom is not located in the central compartment. Correlation of the intensity of the biochemical effects with venom concentration in the peripheral compartment revealed an apparent delay in the onset and peak of action. This was explained by assuming that the tissue compartment could be divided into a rapidly accessible and a slowly accessible compartment with the venom acting through the slowly accessible compartment. There was also the possibility of the venom acting indirectly through the release of other substances or transformation to an intermediate.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3293268 TI - [Scaling by manual and turbine instruments--experimental and clinical examinations]. PMID- 3293267 TI - [Exactness of measurement of the sulcus-fluid flow rate (SFFR) by means of the Periotron]. PMID- 3293269 TI - [Splinting in periodontology by adhesive technique]. PMID- 3293270 TI - [Root stump construction and root crown stabilizer. Alternatives to conventional prosthetic therapy of pulp devitalized teeth?]. PMID- 3293271 TI - [The confusion relating to the concept of dementia and Alzheimer's disease]. AB - Much confusion exists about the definition of the term dementia and about diagnostic criteria of dementing diseases. This confusion not only forms an impediment in the progress of scientific research, but is also potentially harmful for patient care. Recently, considerable improvements are made by consensus conferences in designing operational diagnostic criteria. However, application of these in daily practice is still not optimal. In this publication, differences in meaning of the concept of dementia and Alzheimer's Disease are discussed. A proposal is made how to overcome misunderstandings in daily practice. PMID- 3293272 TI - Xenogeneic transplantation. A review. PMID- 3293273 TI - Immunosuppressive activity of class I antigens in the absence of antigen presenting cells that are MHC-compatible with the host. AB - Pretransplant transfusions of heat-treated spleen and lymph node cells were shown to prolong the survival of DA strain heart grafts in 3 allogeneic host strains: BS, HS, and AS2. To examine whether MHC incompatibility was necessary for immunosuppression mediated by heat-treated cells, AS strain skin-graft recipients were pretreated with fresh or heated inocula from either MHC compatible or incompatible congenic donor strains, AS2.1L(AS) and AS.1F(AS2) prior to transplanting donor strain skin. Prolonged survival was observed only in the MHC incompatible strain combination, and in this MHC-incompatible strain combination, and in this instance heated cells were conspicuously more immunosuppressive than fresh cells. To determine the effect of intra-MHC differences between donor and host on graft survival, cells from a recombinant donor strain (r22), which shared class II antigens with the graft donor strain and class I antigens with the host, were transfused prior to heart transplantation. Neither fresh nor heated r22 cells prolonged graft survival. Our data accord with the suggestion that in the absence of MHC-compatible antigen-presenting cells, foreign class I antigen is immunosuppressive. PMID- 3293275 TI - Invasive Trichosporon cutaneum (beigelii) infection in a patient with relapsed acute myeloid leukemia undergoing bone marrow transplantation. PMID- 3293274 TI - Failure of intravenously infused spleen cells bearing a minor histoincompatibility to delay rejection of skin grafts bearing additional antigens. AB - Intravenous infusions of spleen cells bearing single minor H antigens have been shown to induce an antigen-specific prolongation of survival of subsequently applied skin grafts bearing the infused antigen. In this report it is shown that i.v. infusion of spleen cells bearing only H-Y as an alloantigen fails to prolong the survival of subsequently applied skin grafts bearing H-Y and additional H antigens. In contrast, others have shown that the i.v. infusion of alloantigen bearing cells can inhibit DTH reactions, CTL generation, or organ allograft rejection directed against additional alloantigens, provided they are present in the challenge inoculum or graft together with the i.v.-infused antigens. Several possible reasons for the discrepancy between the results with skin grafts, and the results of others using different assays of responsiveness to H antigens are examined. PMID- 3293276 TI - Two major serologic events in a successful cardiac transplant recipient- circumvention of hyperacute rejection despite a positive donor T lymphocyte crossmatch and late appearance of probable antiidiotypic antibody. PMID- 3293277 TI - Renal transplantation in early pregnancy. PMID- 3293278 TI - Primary adenocarcinoma in a transplanted cadaveric kidney. PMID- 3293279 TI - Raised hematocrit--a contributing factor to hepatic artery thrombosis following liver transplantation. PMID- 3293280 TI - Severe reversible cyclosporine-induced acute renal failure. A role for urinary PGE2 deficiency? PMID- 3293281 TI - Cellular basis of transplantation tolerance induced by liver grafting in the rat. Extent of clonal deletion among thoracic duct lymphocytes, spleen, and lymph node cells. PMID- 3293282 TI - Match prognosis index. PMID- 3293283 TI - Long-term duct-occluded segmental pancreatic autografts. Does fibrosis lead to graft loss? AB - In clinical pancreas transplantation, duct-occluded segmental allografts are often used. There is concern that fibrosis following duct-occlusion may lead to progressive graft failure. In this study, sequential histology and endocrine function in long-term (up to 5 years) canine autografts were assessed. Segmental pancreatic autografts with residual pancreatectomy were performed, and the pancreatic duct was occluded with cyanoacrylate glue. Serial i.v. glucose tolerance tests (IVGTT) and percutaneous needle-core biopsies of the grafts were performed as long as grafts functioned. Ten dogs were long-term (greater than 18 months) survivors: 8 dogs had functioning grafts for a median of 48 months (range 18-60) after transplantation, and 3 dogs had graft failure at 21, 27, and 60 months. The mean 40-min blood glucose concentration (BGL-40') after i.v. glucose injection did not increase with time up to 5 years after grafting. Graft biopsies showed a universal picture of aggregated islet cells and fibrous replacement of acinar tissue. The total amount of fibrosis did not change with time, but the existing fibrosis became less cellular and more dense. This long-term study showed that in autografted animals, adequate endocrine function was maintained in the majority of cases, and progressive replacement of islet tissue by fibrosis could not be demonstrated in serial biopsies taken between 18 months and 5 years after autotransplantation. We therefore conclude, that while duct-occlusion results in extensive fibrosis, the process is not progressive, and although fibrosis may contribute to late graft failure this is not inevitable. PMID- 3293284 TI - Fine-needle aspiration biopsy in the monitoring of liver allografts. I. Correlation between aspiration biopsy and core biopsy in experimental pig liver allografts. AB - We have used allogeneic pig liver transplants to investigate the structure of inflammation in acute liver allograft rejection. An inflammatory episode of acute cellular rejection was observed in 9/10 allografts in nonimmunosuppressed recipients, when monitored with simultaneous fine-needle aspiration biopsies (FNAB) and core needle biopsies (NB). The intensity of inflammation in FNAB was quantitated using the corrected increment method and correlated with NB findings. In FNAB, all inflammatory episodes were detected on the 4th day after transplantation with lymphoid blast and lymphocyte infiltration, later accompanied by monocytes and macrophages. Maximal intensity of inflammation was recorded in FNAB on day 14. In NB, histology demonstrated distinct inflammation in the portal area on day 4. The predominantly lymphocytic infiltration, also containing varying numbers of plasma cells, eosinophils, neutrophils and macrophages, reached its maximum 7-14 days after transplantation. With the indirect immunoperoxidase technique, lymphoid cell subpopulation analysis of FNAB demonstrated an increase of both T4 and T8 cells during rejection. The T4/T8 ratio was first low, and increased at the beginning of the episode, on day 4, but decreased again on days 7 and 14. The number of B cells in the graft was also elevated during rejection. The cellular changes in the corresponding blood specimens followed approximately the same lines, although the changes were less prominent. NB immunohistology, using immunoperoxidase and frozen sections, correlated well with FNAB results, and demonstrated a T4 predominance in the portal area on day 4 but a T8 predominance on days 7 and 14. In addition to lymphoid cells, macrophages/granulocytes were also frequent in the portal area and scattered in the parenchyma on days 7 and 14. An additional inflammatory cell component in liver allograft rejection, detectable only in the NB, was eosinophils in the portal area, recorded in maximum on day 14. Taken together, the inflammatory changes in the FNAB and NB were similar, and time-related changes of cellular infiltrate in FNAB and NB correlated closely. PMID- 3293286 TI - The use of ranitidine in bone marrow transplantation. A review of 223 cases. AB - To determine the incidence of ranitidine-induced myelosuppression in the bone marrow transplant setting, we reviewed the records of all patients at our institution (223) who received ranitidine while undergoing bone marrow transplantation. We identified 37 cases in which a myelosuppressive episode was temporally associated with ranitidine use. In-depth analysis of the 37 cases showed 12 in which no alternative cause could be found and in which strong evidence for a ranitidine effect existed. Three of these cases are included herein as case reports. Based on this series, the overall incidence of ranitidine induced myelosuppression in bone marrow transplant patients was approximately 5% (12/223). PMID- 3293285 TI - Fine-needle aspiration biopsy in the monitoring of liver allografts. II. Applications to human liver allografts. AB - Serial fine-needle aspiration biopsies (FNAB) were used for clinical monitoring of human liver allografts. Nine liver allograft recipients were monitored with FNAB at 1-3 day intervals. No complications were recorded. All patients underwent at least 1 inflammatory episode of acute rejection; altogether 11 episodes, all reversible, were recorded. The inflammatory infiltrate consisted mainly of lymphoid cells, including lymphoid blasts, with minor involvement of monocytes, monoblasts, and macrophages. Further analysis of lymphoid cell subpopulations by immunoperoxidase techniques demonstrated an increase of T cells during rejection, both the CD4 (T4) and CD8 (T8) subsets were increased. A slight increase of B cells in the graft was also seen. The CD4/CD8 (T4/T8) ratio was first low, peaked at the onset, and decreased toward the end of the episode. No clear correlations to the intragraft cellular events were recorded in corresponding blood specimens. However, an episode of eosinophilia was seen in the blood at the beginning of rejection, correlating with fever in the recipient. Degenerative changes in the parenchymal cells and bile droplets in the hepatocytes, indicating cholestasis and hepatocyte damage, were seen during all episodes of rejection, and these changes persisted even 10 days after the inflammation had subsided. The FNAB findings correlated well with biochemical laboratory parameters, but the diagnosis of rejection could be established by the FNAB already 1-5 days earlier than elevated serum values indicated liver dysfunction. PMID- 3293288 TI - Sex of the parental donor and cellular rejection of renal allografts in children. AB - The survival of renal allografts of maternal and paternal origin has been assumed to be identical, and in reports concerning graft survival the outcome of parental transplants is not analyzed by sex of the donor. Fifty-five children received a parental kidney between January 1973 and March 1987 at one institution. There were 6 technical failures. Analysis of renal graft survival in the remaining 49 children indicates a disparity between maternal and paternal graft survival, with an increased propensity for loss of paternal grafts from cellular rejection. Nine of 22 parental grafts are no longer functioning; 7 were lost from cellular rejection. In comparison, cellular rejection resulted in the loss of only 2 of 27 maternal grafts. This disadvantage of paternal grafts is most conspicuous in patients followed for 2 or more years; 7 of 15 paternal but only 1 of 20 maternal grafts were lost because of cellular rejection (P = 0.01). With causes of graft loss other than cellular rejection treated as withdrawal, actuarial survival of the 27 maternal grafts at 1 and 5 years is 96% and 91%, respectively, while that of the 22 paternal grafts is 83% and 58% (P = 0.017). Analysis of data from other centers will help determine whether our observation is of clinical significance. PMID- 3293287 TI - Altered immunologic reconstitution after standard-dose chemotherapy or high-dose chemotherapy with autologous bone marrow support. AB - Altered immunologic reconstitution is observed in patients treated with high-dose chemotherapy consisting of cyclophosphamide, cisplatin, and carmustine, melphalan, or etoposide with autologous bone marrow support, and it is similar to that seen in patients treated with high-dose chemoradiotherapy and allogeneic bone marrow transplantation. A decrease in the absolute number and percentage of B cell and CD4 antigen-positive cells and an increase in the absolute number and percentage of CD8 and Ia antigen-positive cells occur along with a decrease in the CD4/CD8 ratio that persists for 6-12 months after high-dose chemotherapy and autologous bone marrow support. These changes have been associated with four serious infectious episodes usually seen only in immunocompromised patients. The above changes were not seen in patients treated with high-dose busulfan, a drug that has relatively specific effects on granulocytes. It is postulated that these alterations result from effects of chemotherapy on the residual lymphocytes or on the environment of repopulating lymphocytes. Functional studies of lymphocyte populations during immunologic reconstitution after standard-dose combination chemotherapy and high-dose chemotherapy with autologous bone marrow support are needed. PMID- 3293289 TI - Effect of cyclosporine on the renal tubular amino acid handling after kidney transplantation. AB - The renal tubular handling of free amino acids was studied 5-6 weeks after successful renal transplantation (tx) in 20 children treated with CsA and in 10 children treated with azathioprine (Aza). The results were compared with those of 34 control children. The amino-acid clearance studies were performed in combination with short-term inulin clearance. The CsA group revealed a mean inulin clearance of 49 +/- 16.8 ml/min/1.73 m2, the Aza group of 76.9 +/- 18.2, and the controls of 114 +/- 15.6. The plasma amino-acid concentrations were not different between CsA- and Aza-treated groups; however, most of the essential amino acids were lower in transplanted children than in controls. The decrease was correlated with the GFR. The amino-acid-clearance rates were statistically not different between both transplanted groups, but lower values than in controls were found for alanine, glycine, histidine, lysine, and phenylalanine, and significantly higher values for methionine. The fractional clearance rates of most amino acids were significantly elevated in transplanted children compared to controls. In CsA-treated patients, the fractional clearance rates of arginine, glycine, and serine were higher than in Aza-treated patients. No influence of CsA blood levels or rejection episodes on the amino-acid handling were detectable. We conclude that CsA has no specific influence on the renal handling of amino acids. Most disturbances observed depend on the graft function or may be caused by injuries to the graft following the tx procedure. PMID- 3293290 TI - Failure of cyclosporine-treated renal allograft recipients to increase glomerular filtration rate following an amino acid infusion. AB - Renal allograft recipients treated with cyclosporine (CsA) have increased renal vascular resistance that falls when CsA is stopped. With the aim of identifying whether CsA-treated patients with excellent renal function also have an alteration in renal vascular tone and to investigate which vessels are affected, we have studied the response of GFR and effective renal plasma flow (ERPF) to an infusion of an amino acid solution in a group of 9 CsA-treated renal transplant recipients with a normal plasma creatinine concentration (104 +/- 3.8 mumol/L [mean +/- SEM]). A similar group of 9 azathioprine-treated patients with good renal function (91 +/- 3.6 mumol/L) were used as controls. The azathioprine group had significant increases in both GFR (22%, P less than 0.05) and ERPF (19%, P less than 0.05) following a protein load, whereas there was no increase in either function in the CsA group. Amino acid infusions increase GFR and ERPF in normal kidneys--at least in part by producing afferent glomerular arteriolar dilatation. The difference we found between the two groups indicates a direct effect of cyclosporine on intrarenal vascular tone, even when renal function is considered to be normal. PMID- 3293291 TI - Medicare Part B: Unraveling the mystique. PMID- 3293292 TI - [Methods of determining the activity of proteolytic enzymes]. AB - The present methods for determination of the proteinases activity based on the protein, low-molecular weight, fluorescent and radioactive substrates, also active-site titration have been analyzed. The comparative evaluation of its effectiveness which depends on duration, pH range, possible errors, caused by concomitant proteinases are considered. The influence of this factors on the choice of assay for measuring the proteinases activity and its efficiency are discussed. PMID- 3293293 TI - [Protein substrates of proteinases with fluorescent labels]. AB - Protein substrates for proteinases with double fluorescent fluorophors are synthesized. Pyridoxal-5'-phosphate, dansyl chloride and fluorescein isothiocyanate were used as fluorescent sounds for modification of globin. Phosphoyridoxyl fluorophor was present in the both substrates. The second label was either fluoresceinthiocarbamyl or dansyl fluorophor. Spectral characteristics and ability to hydrolysis of obtained substrates have been studied. The influence of some salts on fluorescent characteristics of those substrates have been analyzed. Differentiation of the hydrolyzed substrate from the initial one by ammonium sulphate is shown to be possible. PMID- 3293294 TI - [Localization and functional role of gangliosides from nerve tissue of vertebrates]. AB - Gangliosides in the animal organism are typical components of plasma membranes of nerve cells in which the concentration of polysialogangliosides is especially high. The high concentration of tri- and tetrasialoganyliosides and ganglioside GD1b is peculiar to primary cultures of nerve cells, whereas these gangliosides are practically not present in the culture of the transformed nerve cells which have lost their ability to sinaptogenesis, they are not found in cultures of oligodendro- and astroglia as well. The addition of exogenic gangliosides to nerve cells cultures stimulates the formation of processes in these cells and promotes their survivability. The neuritogenic and neuronotrophic effect of gangliosides, their participation in the processes of neurons' regeneration are shown in the in vivo experiments. Gangliosides are carriers of antigenic determinants typical of the cellular surface of neurons (or other cells) as well as of cells of different malignant tumours; typical carcinoembryonal antigenes are revealed among them. Such functions of gangliosides as participation in the processes of intercellular interaction, adhesion, pneuritogenic effect, possible participation to memorize one or another habit are, probably, interrelated and mutually conditioned. Recently the data, being in controversy with the notion that gangliosides are components of receptors of hormones and mediators, are obtained. Evidently, it ought to speak about the modulation of cell response by them on the action of these effectors. PMID- 3293295 TI - Adrenal magnetic resonance imaging in Addison's disease. AB - Magnetic resonance imaging of the adrenal glands was performed in 9 patients with Addison's disease to evaluate the role of magnetic resonance (MR) in this entity. All patients had bilateral adrenal masses demonstrated by computed tomography (CT); etiologies included adrenal hemorrhage (2 patients), granulomatous disease (1 patient), adrenal lymphoma (3 patients), and adrenal metastases (3 patients). Spin-echo axial images were obtained at repetition times (TR) 0.5, 2.0 s and TE 28, 56 ms, using a Diasonics superconducting magnet operating at 0.35 T. In the patients with lymphoma, metastases, and granulomatous disease, the adrenal masses appeared hypointense or isointense with liver on the T1-weighted images (TR 0.5 s, TE 28 ms). In cases of adrenal hemorrhage, areas of hyperintensity were seen on TR 0.5, TE 56 ms sequences, due to shortening of T1 values. In both groups of patients the masses were hyperintense on T2 weighted sequences. Mean calculated T1 of the hemorrhagic glands was 449 ms, compared with a mean of 782 ms for metastases and lymphoma. While MR is not capable of distinguishing between acute inflammatory and metastatic diseases of the adrenal glands, it may be equally efficacious as CT in suggesting the diagnosis of adrenal hemorrhage in patients with Addison's disease. PMID- 3293296 TI - Venous invasion in renal cell carcinoma: a correlative clinical and radiologic study. AB - Angiography, cavography, ultrasound (US), computed tomography (CT), and low-field magnetic resonance imaging (MRI) were used to explore venous tumor invasion in 86 patients with renal cell carcinoma. The findings confirm previous experience that ultrasound and dynamic CT are reliable methods for the evaluation of venous invasion. Low-field magnetic resonance imaging does not improve tumor staging. In case of equivocal findings, vena cavography should be used as a complementary examination. PMID- 3293297 TI - Percutaneous endourologic approach for transitional cell carcinoma of the renal pelvis. AB - A small mass was detected in the renal pelvis during investigation for hypertension and diminished renal function. Its presence was confirmed by computed tomography. Since the patient was not a candidate for nephrectomy, interventional percutaneous techniques were used to confirm the diagnosis of transitional cell carcinoma and ultimately permit endourologic access for resection and cure. PMID- 3293298 TI - Postnephrectomy pseudoaneurysm with arteriovenous fistula. AB - Sonography detected a paraaortic pulsatile tubular mass in a patient 10 years after "stump" nephrectomy, which was subsequently confirmed as a renal artery renal vein fistula by computed tomography, angiography, and laparotomy. PMID- 3293299 TI - Bilateral ectopic pheochromocytomas: computed tomographic and sonographic correlation. AB - We describe a case of clinically unsuspected bilateral ectopic pheochromocytomas in a young woman. The bilateral retroperitoneal masses were located in the lower sympathetic ganglia at the level of the organ of Zuckerlandl. Computed tomography (CT) accurately identified the location and vascular characteristics of these neoplasms and provided access for percutaneous biopsy. Sonographic correlation is also presented. PMID- 3293300 TI - Scrotal enlargement following inguinal herniorrhaphy: ultrasound evaluation. AB - Although sonography has become an established modality in the evaluation of acute and chronic scrotal abnormalities, its role in the post-herniorrhaphy patient with scrotal swelling has not yet been defined. We present 5 patients with immediate and delayed complications of herniorrhaphy in which sonography provided useful clinical information. Immediate complications included scrotal hematomas, scrotal wall and septal thickening, epididymitis, and testicular displacement. Delayed complications included an infected hydrocele demonstrating a fluid-debris level. The etiology of scrotal swelling in postherniorrhaphy patients can be determined with sonography. PMID- 3293301 TI - [A technic for closed iridoplasty]. PMID- 3293302 TI - [Gray-scale B-scanning in the diagnosis of orbital diseases]. PMID- 3293303 TI - Double labeling immunohistological study of African swine fever virus-infected spleen and lymph nodes. AB - To identify cells in situ in which African swine fever (ASF) virus is present, a double immunohistological labeling technique was used on sections of ASF-infected spleen and lymph nodes. Cells were identified by an indirect immunoalkaline phosphatase technique using monoclonal antibodies (MoAb) reactive against different leukocyte subsets. ASF virus, detected by a direct immunoperoxidase method using swine immunoglobulin G (IgG) anti-ASF virus antigens, was not present in T helper or in T cytotoxic/suppressor lymphocytes, whereas it was detected in tissue macrophages that reacted with different MoAb (74-22-15, C4, A7, and F2). A large number of cells strongly reactive with MoAb 74-12-4 (T helper lymphocytes) were found in the marginal zone in infected spleen. In infected lymph nodes, these intensely stained cells were found in small numbers. Cells reactive with MoAb 76-2-11 (T cytotoxic/suppressor lymphocytes) were less stained in infected spleen and lymph nodes than in non-infected organs. PMID- 3293305 TI - Flow cytofluorimetric analysis of lymphocyte subset alterations in cattle infected with bovine viral diarrhea virus. AB - Clinically normal, bovine viral diarrhea virus (BVDV)-seronegative, 7 to 9-month old steers were inoculated intranasally with NY-1, a noncytopathic strain of BVDV, or exposed intramuscularly to killed BVDV. Indirect immunofluorescence staining with monoclonal antibodies specific for bovine leukocyte subsets followed by flow cytometric analysis was used to monitor subsequent hematologic alterations. Infection with BVDV resulted in a transient leukopenia which was characterized by decreases in the absolute numbers of circulating T lymphocytes, including BoT4+ ("helper") and BoT8+ ("cytotoxic/suppressor") subsets, B lymphocytes, and neutrophils. There was no significant variation in numbers of non-T, non-B ("null") lymphocytes or monocytes. Exposure to inactivated BVDV in a combination vaccine did not cause significant alteration in the circulating numbers of any major leukocyte subset; however, significant variation was seen in the BoT4/BoT8 ratios and in the numbers of cells expressing major histocompatibility complex (MHC) class II antigens. PMID- 3293304 TI - Comparison in gnotobiotic pigs of lesions caused by verotoxigenic and non verotoxigenic Escherichia coli. AB - To compare the pathogenesis of calf and rabbit strains of E. coli, gnotobiotic pigs were infected with 10(10) colony forming units (cfu) of verotoxigenic strain RDEC-1 or S102-9, or a non-verotoxigenic E. coli (X114/83). Pigs were killed 4 days later, and intestinal tissue was fixed and examined by light, scanning, and transmission electron microscopy. Strains S102-9 and RDEC-1 caused diarrhea, attached to enterocytes, and effaced microvilli, confirming that the calf and rabbit strains possessed similar mechanisms of pathogenicity. Non-verotoxigenic strain X114/83 did not cause diarrhea, but in 5/5 piglets it was detected in histological sections adherent to enterocyte surfaces. Exfoliated enterocytes were seen in 4/5. Bacteria attached to enterocytes by "cups" and "pedestals," with effacement of microvilli, were seen by electron microscopy in 1/5 piglets. It was concluded that strain S102-9 appears to be an animal equivalent of human enterohemorrhagic E. coli, that verotoxin is not essential in the pathogenesis of attaching and effacing lesions, and that the lesions induced by S102-9 are more severe in gnotobiotic pigs than in gnotobiotic or conventional calves. PMID- 3293306 TI - Persistence of S typhimurium in calf rearing premises. PMID- 3293307 TI - Rarity of tylosin resistance in human pathogenic bacteria. AB - Of 3812 human cultures of Staphylococcus aureus, Streptococcus pyogenes and Campylobacter species only 1.0 per cent were resistant to tylosin, an antibiotic used extensively in animals but not in man. There was no evidence for a significant animal source of these resistant cultures, a result which provides further evidence for the rarity of the flow of resistant organisms (or their genes) from animal sources to human beings. PMID- 3293308 TI - Preliminary observations of bovine ovarian structures using B-mode real time ultrasound. PMID- 3293309 TI - Preparation and characterization of monoclonal antibodies against bovine B lymphocyte surface antigens. AB - Two monoclonal antibodies (MoAbs; BLMo-4 and BLMo-10) were prepared by immunizing with a cell line established from peripheral blood mononuclear cells (PBMC) of enzootic bovine leukosis (EBL) cattle. The specificities of these MoAbs were assayed using bovine PBMC. BLMo-4 reacted with all surface immunoglobulin positive cells (SIg+ cells; B lymphocytes) and also recognized monocytes, but did not react with T lymphocytes. BLMo-10 recognized a majority, although not all, B lymphocytes, but did not react with either T lymphocytes or monocytes. The antigens recognized by BLMo-4 and BLMo-10 were not Ig, Fc or C3 receptors on the surface of B lymphocytes. The reactivity of the MoAbs with mononuclear cells from the lymphoid organs of adult cattle was studied. BLMo-4 and BLMo-10 did not react with any bone marrow cells. BLMo-10 reacted with 7.4% of thymocytes, and stained the medulla of the thymus in the immunoperoxidase assay. In the case of PBMC, spleen and lymph node cells, the percentage of cells positive for BLMo-4 was slightly higher than that of SIg+ cells, but BLMo-10 showed a slightly lower value. PMID- 3293310 TI - Immune response of sheep to oral and subcutaneous administration of live aromatic dependent mutant of Salmonella typhimurium (SL1479). AB - The major objective of the present study was to determine whether oral immunization with a live aromatic-dependent strain of Salmonella typhimurium (SL1479) was capable of stimulating an intestinal immune response in sheep similar to that induced by combined intraperitoneal injection followed by oral boosting. The results showed that repeated oral immunization was incapable of stimulating an anti-flagella antibody containing cell (ACC) response in the lamina propria of the intestine even though primary oral administration of 5 x 10(9) live SL1479 gave rise to an ACC response in intestinal lymph which was predominantly of the IgM isotype. ACC reached a peak 9-10 days after oral administration when ACC comprised 0.5-1% of total lymphocytes in lymph. An ACC response of similar isotope specificity also occurred in popliteal prefemoral lymph of unprimed sheep following regional subcutaneous injection of SL1479. Oral administration of SL1479 to orally primed sheep did not reinvoke an ACC response in lymph although IgG1-ACC were observed in medullary cords of mesenteric lymph nodes of sheep 6-8 days after the booster dose of SL1479. The results suggest that the protective immunity elicited by oral administration of SL1479 cannot be attributed to induction of a local intestinal antibody production. PMID- 3293311 TI - [Personal experience with monitoring the hormone response to insulin hypoglycemia and chlorpromazine in controls and in patients with diencephalo-pituitary disorders]. PMID- 3293312 TI - [The role of low-energy protein diets in the treatment of obesity]. PMID- 3293313 TI - [Carcinogenic action of radioactive isotopes of iodine]. PMID- 3293314 TI - [A non-specific marker of cancer--pregnancy-associated alpha2-glycoprotein]. PMID- 3293315 TI - [Priorities in the directions of prevention of malignant tumors]. PMID- 3293316 TI - [Use of the UT-40 STsP device for determining the thickness of the human subcutaneous fat layer]. PMID- 3293317 TI - [Biological properties and clinical significance of plasma fibronectin (review of the literature)]. PMID- 3293318 TI - [Morphometric characteristics of rectal tumors]. PMID- 3293319 TI - [Thrombocyte function and the prostacyclin-thromboxane system in patients with acute myocardial infarct]. PMID- 3293320 TI - [Diet therapy in chronic cholecystitis with obesity (a review of the literature)]. PMID- 3293322 TI - [Importance of echography in the diagnosis of endocrine diseases (review of the literature)]. PMID- 3293321 TI - [Pathogenesis, diagnosis and treatment of the disseminated intravascular coagulation syndrome (a review of the literature)]. PMID- 3293323 TI - [Smoking and the respiratory tract]. AB - Diseases of the airways increase and are of eminent social- and public health care interest. As essential exogen noxious substance for cause in etiology is smoking considered. Incidence for bronchitis, emphysema, and lung cancer due to smoking is between 85 to 90%. Changes in the respiratory tract through smoking are also measureable function disturbances. They are more intensely than in dust exposed nonsmoking workers. Also in passive smokers you can find such disturbances, the additional cancer risk is increased. Smoking is further one cause for centrilobular emphysema. Great international studies refer smoking as essential noxious substance for lung cancer. The minimal therapeutic success underlines the importance of early diagnosis, risk groups, significant etiologic factors, operability, chemo- and radiation-therapy. The early mortality for heavy smokers was ascertained up to 12.3 years lifetime-shortening. Overall the reason is adequate and serious enough to draw the attention to the effects of smoking to the respiratory tract besides tobacco-associated diseases of other organs with all emphasis and to make all efforts against this noxious substance. PMID- 3293324 TI - [Homesick in Capricorn's Woods. Remarks on the 300th anniversary of the dissertation on nostalgia and the 700th anniversary of "dolor de dampno"]. AB - Nostalgia (homesickness) was introduced to the domain of medicine only in 1688, but mental suffering corresponding to it was described already in ancient poetry; in Central Europe, it appeared for the first time 700 years ago in the Chronicle of the Zdar monastery, written by Henry the Woodsculptor (= von Heimburg?). In the woodlands between Moravia, Lower Austria and Bohemia, mentioned by Ptolemaios under the Celtic name "Gabreta" (wild goats' wood, cf. Irish "gabrach"), also other behaviour patterns reflecting unusual mental anchorage patterns of the inhabitants appeared between the 13th and 17th centuries. Even if the content of the term "nostalgia" nowadays dissipated to vague "spleen" feelings, its descendant concepts flourish in modern philosophical ("thrownness", "alienation"), psychoanalytical ("existential frustration", "birth trauma," "object loss"), psychiatrical ("agoraphobia", "deprivation", "anaclitic depression") and social psychological ("cataclysmatic fears and anxieties") thought. PMID- 3293325 TI - Surgical treatment of Crohn's disease of the small bowel or ileocecum. PMID- 3293328 TI - [Here Swedes wait for a new heart with Stefan as support. Interview by Anne Jonsson]. PMID- 3293326 TI - Management of perianal Crohn's disease. PMID- 3293327 TI - [Animal experiment research on the application of a human bone collagen substance]. AB - The possibility of the application demineralised human cortical substance with a particle size of 315 micron was investigated on the filling of artificial defects at the tibial diaphysis in rabbit. A clear induction of the bone healing was observed histologically on the transplant side already after 4 weeks and the absence of a periosseous callus formation radiologically. PMID- 3293329 TI - [Regulatory factors of the vaginal microecologic system]. AB - Physical, chemical and biological regulatory factors of the vaginal microecological system are described. The variety of these factors leads to new conceptions for diagnosis and therapy of vaginal infects, which however can only be implemented within the framework of interdisciplinary cooperation. PMID- 3293331 TI - Production and characterization of monoclonal antibodies against secretory proteinase of Candida albicans CBS 2730. AB - We describe the production and characterization of three murine monoclonal antibodies (M1-M3) which are directed against different epitopes of the secretory aspartic proteinase of Candida albicans CBS 2730. All antibodies belonged to the IgM class, and they recognized denatured enzyme. Only antibody M1 was capable to react with the active proteinase. Differential reactivity was also observed with a large fragment of the proteinase of C. albicans. All antibodies recognized the corresponding proteinase of C. tropicalis 293 both in the active, and in the denatured state. Denatured porcine pepsin was also recognized by all three antibodies. However, active pepsin was recognized only by antibodies M1 and M2. The antibodies did not inhibit enzymatic activity, and they were not suited for immunofluorescence detection of proteinase on fungal cells. However, employing Western blot analysis, proteinase antigen was detected by antibody M 1 in the serum of a patient suffering from candidal pneumonia. The circulating proteinase antigen was found to be bound to patient's IgM. Implications for the use of monoclonal antibodies in the serodiagnosis of candidosis, and first experiences with other monoclonal anti-proteinase antibodies are discussed. PMID- 3293332 TI - Structure-activity relationships of bacterial lipopolysaccharides (endotoxins). Current and future aspects. PMID- 3293330 TI - [Risk of thrombosis in irradiation of uterine cancer. A review with new results of studies]. AB - Malignomas of the uterus predispose to thromboembolism. Local application of radium increases the activation of hemostasis. In newer examinations there are hints, that impairment to thrombocyte function and prostacyclin metabolism may have a pathogenetic meaning. Thrombocyte aggregation and prostacyclin sensitivity of thrombocytes have been examined in two groups of patients: 21 patients following hysterectomy because of endometrium cancer stage I, treated with one vaginal application for the vaginal cuff and 10 patients with cervical carcinoma Stage IIa-IIIb treated combined intrauterine-intravaginally. The first group was prophylactically treated with low-dose-heparin, the second one with acenocoumarol (Sintrom). A slight, but significant increase of thrombocyte aggregation by 4.8 per cent respectively 5.0 per cent could be observed in both groups. Prostacyclin sensitivity of thrombocytes (PST) was significantly reduced by 20 per cent before irradiation in all patients compared with patients without carcinomas. In cases of intravaginal radium application we saw immediately after removal of the radioactive source a further reduction of PST by 12.5 per cent. 24 hours later a significant decrease of PST by 18.5 per cent could be observed. Contrary to this no significant changes were induced by combined intrauterine and intravaginal radium insertion. Therefore reduction of PST may be interpreted as a possible change of thrombocyte function in vivo caused by irradiation. It may be likely that these disturbances of thrombocyte function combined with radiogenic vessel wall damages and plasmatic hypercoagulability are responsible for the high thromboembolic risk of radium therapy. These patients should be treated prophylactically. Probably the efficiency of this prophylaxis can be improved by additional application of selective inhibitors of thrombocyte aggregation or inductors of prostacyclin synthesis. PMID- 3293333 TI - Purification and partial characterization of two proteinases from Clostridium butyricum M 55. AB - Clostridium butyricum M55 proteinases were purified by application of a multistep procedure involving ethanol precipitation, DEAE cellulose chromatography and molecular sieving. The purified enzymes obtained were called proteinase I and proteinase II. They appeared to be homogeneous when examined by molecular sieving and polyacrylamide gel electrophoresis. The highly purified proteinases were studied for their physico-chemical properties. The influences of pH, temperature, ionic strength and amino acids composition were investigated. The effects of metal ions and of protein-structure-modifying agents support views suggesting the character of these enzymes. PMID- 3293335 TI - Changes in heparin level in experimental liver transplantation in dog. AB - Changes in heparin level during orthotopic liver transplantation were studied in experiments without the administration of heparin in dogs. It was established that the changes in heparin level might probably not play a role in giving rise to coagulopathy observed during liver transplantation. Their data also indicated that the rise in heparin level had originated not from the re-perfused liver but from the release of endogenous heparin. PMID- 3293334 TI - Purification of Clostridium botulinum type G progenitor toxin. AB - Clostridium botulinum type G cultured for 6 days at 30 degrees C in proteose peptone-yeast extract-glucose medium produced toxin of 1.3 x 10(4) LD50/ml. The toxin was precipitated at pH 4.0, extracted with 0.2 M phosphate buffer, pH 6.0, and activated with trypsin. Sonic treatment and trypsinization of the residual precipitate released additional toxin, the toxicity of which corresponded to that detected in whole culture. Activated toxin obtained from the first extract and that from the residual precipitate were combined and purified by salting out, acid precipitation, gel filtration on Sephadex G-200, chromatography on SP Sephadex, and a second gel filtration on Sephadex G-200. The yield of purified toxin from 10 liters of culture was 22.9 mg an 1.1 X 10(8) mouse ip LD50 with a specific toxicity of 3.0 X 10(7) mouse ip LD50/mg nitrogen. The molecular weight of the toxin was about 500,000, corresponding to that of L toxin of the other types. No M nor LL toxin was detected. PMID- 3293336 TI - The role of ultrasonography in treating polycystic ovary syndrome. AB - Repeated ultrasound imaging was performed in 23 cases of polycystic ovary syndrome (PCO). Diagnosis was established on the basis of the clinical picture, the endocrine parameters and on that of ultrasonographic findings. Almost all patients presented with oligomenorrhoea and also hirsutism, and obesity appeared in more than half of the cases. The hormonal picture was characterized by elevated LH and testosterone, by a higher than the upper limit of the normal range of oestradiol and low progesterone levels. In 18 cases, ultrasonography documented enlarged bilateral ovaries containing several small cysts. Repeated examinations proved the permanent absence of follicular maturation and ovulation. In additional five patients, the size of ovaries was slightly larger than normal with no microcystic change being present. According to the authors, ultrasonography is particularly useful in the noninvasive diagnostics of PCO syndrome, in judging better the borderline cases and in adjusting the ovulation induction therapy. If a combined chemotherapy administered in a gradually increasing dose keeps on being ineffective in eliminating chronic anovulation, the only possible procedure is surgical solution, that is bilateral wedge resection of the ovaries. PMID- 3293337 TI - Echographic evaluation of the incrustation of intrauterine contraceptive devices (IUD). AB - The ultrasonographic study of Intrauterine Contraceptive Devices (IUD) is reported. In their earlier investigations authors have shown that, after a prolonged use of IUD, incrustation develops over the surface of the IUD. The presence of an incrustate could be observed both during in vitro as well as in vivo ultrasonographic studies. PMID- 3293338 TI - [Transpedicular osteosynthesis using plates in unstable injuries of the thoracolumbar spine. Preliminary report]. PMID- 3293339 TI - Improved beta-cell function after intensive insulin treatment in severe non insulin-dependent diabetes. AB - In Type II, non-insulin-dependent diabetes, insulin secretion is often reduced to the point where oral hypoglycaemic agents fail to control the plasma glucose level. We studied 12 patients (age 41-66 years; 4 lean, 8 obese) with Type II diabetes mellitus for 1-25 years who were uncontrolled despite maximal dose glibenclamide and metformin. After withdrawal of medication, blood glucose control was determined by measuring glucose before and 2 h after each meal for 48 h, and beta-cell function by insulin or C-peptide response to glucagon and to iv glucose. Following these tests, intensive insulin treatment (CSII) was initiated, and near-euglycaemia (mean of 7 daily glucose determinations less than 7.7 mmol/l) was maintained for 16.6 +/- 1.5 days, at which time the tests were repeated. Mean daily insulin requirement was 61 +/- 9 IU (0.81 +/- 0.09 IU/kg). Glucose control was improved after cessation of CSII (mean glucose 12.7 +/- 0.6 mmol/l after vs 20 +/- 1.5 mmol/l before, P less than 0.005). Maximum incremental C-peptide response improved both to glucagon (214 +/- 32 after vs 134 +/- 48 pmol/l before, P = 0.05) and to glucose iv bolus injection (284 +/- 53 vs 113 +/- 32 pmol/l, P less than 0.05). Peak insulin response, measured after iv glucose infusion, also tended to be higher in the post-CSII test (42 +/- 18 vs 22 +/- 5.6 mU/l). Basal and stimulated proinsulin concentrations were high relative to C peptide levels during the pre-treatment period, but returned to normal after CSII.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293340 TI - Bacterial translocation in dianhydrodulcitol-treated mice. AB - Escherichia, Proteus, Klebsiella and Streptococcus strains were isolated from mesenteric lymph nodes, spleens and livers of conventional mice treated with dianhydrodulcitol (DAD), indicating that intestinal bacteria had appeared in organs usually containing no bacteria. The frequency of bacterial translocation showed direct relation to the dose of the drug and appeared simultaneously with the spleen atrophy caused by DAD. PMID- 3293341 TI - A simple identification system for rapidly growing mycobacteria (a note). AB - Based on a ten-year experience, a simple identification system for rapidly growing mycobacteria has been presented for clinical laboratories not specialized in this work. The system consists of 12 tests (8 media and 2 micromethods). PMID- 3293342 TI - Biotyping of Shigella sonnei (a note). AB - One thousand and fifty-nine Shigella sonnei strains were submitted to biotyping and colicine typing. Simultaneous use of biotyping and colicine typing may be considered of value in epidemiological tracing. PMID- 3293345 TI - The surgery of congenital deafness. The Oxford, England series of 235 ears. AB - This paper outlines the indications for surgery of congenital ears in complete meatal aplasia and an operative technique used in 35 ears. It is felt that otologic surgery should be done before the pinna reconstruction as it is very important to try and introduce sound into these children at an early age. Most of the patients in this series were 2 to 3 years' old. In addition, the position of the new auricle can be made more satisfactorily around an already established meatus. The value of radiology of the internal as well as the middle ear is stressed and the necessity for providing a stable and uninfected meatus emphasised with regard to the possible fitting of a hearing aid. Failure to achieve a permanent unaided hearing improvement is due to fibrosis at the bottom of the meatus, a problem which is yet to be solved. PMID- 3293344 TI - [Computer-assisted vestibular tests]. AB - The labyrinth is a sensor of vibration. Therefore, multifrequency vestibular stimulation proves indispensable in obtaining a more accurate study of the VOR. We chose to use a pseudo-random binary sequence, generated on a mini computer. The angular velocity instructions are made up of eight repetitive sequences, the spectrum of energy in which is adapted to the frequency range of VOR. A process eliminating the quick phases, the blinking and other artefacts is applied to the nystagmic response, in order to observe only the slow phase velocity. The velocity of eye and chair are compared and the transfer function of VOR is performed. Gain, phase, coherence function and predominance of the mean slow phase velocity between left and right responses are the four indices which define VOR function. The multifrequency rotatory test is interesting for topographic diagnosis, and makes out three diagnostic ranges: a mechanical peripheral, a neurosensory peripheral and a central one. Two practical measures could help the propagation of this method: a simpler vestibular stimulation in order to suppress the rotatory chair, a simplified method of data processing using a personal computer. PMID- 3293343 TI - Observations on exsudation of fibronectin, fibrinogen and albumin in the brain after carotid infusion of hyperosmolar solutions. An immunohistochemical study in the rat indicating longlasting changes in the brain microenvironment and multifocal nerve cell injuries. AB - An immunohistochemical study was carried out on rat brain to determine if a transient opening of the blood-brain barrier (BBB), leading to extravasation of serum albumin, is also associated with exudation and cellular uptake of fibronectin and fibrinogen. Both of them might exert important biological effects provided that they pass the BBB and come into contact with cells of the brain parenchyma. Hyperosmolar solutions of urea or mannitol were infused in the carotid artery for 30 s to open the BBB and the animals were killed at various time intervals thereafter. Formaldehyde-fixed, paraffin-embedded material was used for immunohistochemical demonstration of extravasated proteins by an avidin biotin peroxidase technique. Multifocal, often confluent areas of widely different sizes with signs of albumin extravasation were observed both in the grey and the white matter of the cerebral hemispheres exposed to the hyperosmolar solutions. Much less pronounced changes were observed in rats given an intracarotid saline infusion alone. Immunoreactive material indicating extravasation of fibronectin and fibrinogen was present in the infused cerebral hemispheres but albumin immunoreactivity was much more widespread. Reaction product was observed in vascular walls, presumably in extracellular spaces and in nerve cells. Immunoreactivity in the perikaryon of neurons formed different patterns in various cells. A granular type most probably represents accumulation of the proteins in lysosomal organelles after pinocytotic uptake into the neuron. The second so-called diffuse variety is presumably the result of a severe nerve cell injury with an uncontrolled leakage of proteins into the cytoplasm. Our results indicate that vascular walls, extracellular spaces, glial cells and neurons will be exposed to extravasated fibronectin and fibrinogen as well as to albumin and that antigenic sites in such compounds remain for a long period after the BBB opening. In addition, there are indications that carotid infusions of hyperosmolar solutions may cause nerve cell injuries in regions with BBB opening. These findings have obvious clinical and experimental significance. PMID- 3293346 TI - [Anomalies of the first branchial cleft]. AB - These are cysts and fistulae which closely adherent to the external auditory canal and drain through the high lateral cervical suprahyoid site. Misdiagnosis is common with these lesions and inadequate removal leads to surgical failure. A review of the embryology of this region is necessary since we intend to explain the clinical aspects and the variable relationship to the facial nerve. Eight cases are described and the literature pertaining to first branchial cleft syndrome is reviewed. Diagnostic and management problems will be discussed. A full exposure of the parotid gland and facial nerve is essential to complete removal and facial nerve preservation. PMID- 3293347 TI - Plasmacytoma of the parotid gland. Report of a case and review of the world literature. AB - Extramedullary plasmacytoma (EP) is a relatively rare neoplasm; about 90% of cases are localized in the head and neck area. EP has been considered a precursor of multiple myeloma but cases showing long disease free intervals or cure by surgery alone have been reported. A research of the world literature pointed out the extremely rare localization of solitary plasmacytoma in the salivary glands. Only 9 cases have been reported until now, 6 in the parotid gland, 2 in the submandibular glands and 1 in both the parotid and submandibular gland. PMID- 3293349 TI - Hypoglycaemia in childhood diabetes. I. Clinical signs and hormonal counterregulation. AB - Hypoglycaemia (blood glucose 1.3-2.5 mmol/l) was induced in twenty-eight diabetic children by reduction of their morning meal. Fatigue and pallor were the most common signs of hypoglycaemia. Compared to findings during normoglycaemia, plasma concentrations of adrenalin, noradrenalin and cortisol were significantly higher at glucose nadir. Plasma glucagon concentration at glucose nadir was correlated to the fasting C-peptide concentration and inversely to the duration of diabetes. Children who lacked C-peptide also lacked glucagon response to hypoglycaemia. The parents' opinion of the need to give carbohydrates corresponded to the blood glucose level. The presence of adrenergic signs correlated to the plasma adrenalin and the neuroglucopenic signs to blood glucose. The lowest glucose level correlated inversely to the concentration of free insulin. When facilities for glucose infusion are lacking, a rational step in treating the unconscious hypoglycaemic child seems to be the injection of glucagon, considering the blunted or absent glucagon secretion. PMID- 3293348 TI - Growth, growth hormone and sex steroid secretion in girls with central precocious puberty treated with a gonadotrophin releasing hormone (GnRH) analogue. AB - We have treated 14 girls with central precocious puberty for a mean period of 2.3 years (range, 0.5-3.9) with intranasal (D-Ser6) GnRH analogue administered in a mean dose of 28 micrograms/kg/day (range, 15-56). With the onset of treatment there was an initial increase in sitting height compared to subischial leg length, but overall there was no significant change in height standard deviation score for bone age. In this respect our results were indistinguishable from untreated children with central precocious puberty. There was a decrease in physiological GH secretion, associated with decreased sex steroid secretion, which probably accounts for the growth deceleration which has been described during GnRH analogue therapy. The effect of this growth deceleration combined with slowing of the rate of epiphyseal maturation may explain the absence of alteration in height prognosis. PMID- 3293350 TI - Circulating class II transplantation antigen-expressing T lymphocytes in children with insulin-dependent diabetes mellitus at diagnosis. AB - The occurrence of circulating class II antigen-expressing T lymphocytes was examined in 25 children with insulin-dependent diabetes mellitus using an indirect double immunofluorescence assay on prefixed cell samples. In order to exclude sensitization to heterologous insulin as a possible factor affecting the results, the patients were investigated at the day of clinical onset, before receiving insulin. An increased percentage of T cells (CD3+ cells) expressing class II antigens was seen in 19 out of 25 patients and class II expression was observed on cells within both the CD4+ and CD8+ T cell subsets. No correlation was found between the levels of class II expressing T cells and the individual degree of metabolic derangement or indicators of recent infection. Re-testing of 16 patients after one year on insulin treatment revealed a significant decrease of class II expressing T cell levels. Our data suggest that the increased levels of class II expressing T cells seen in IDDM of recent onset directly reflects immune reactions that are related to the disease process. PMID- 3293351 TI - Haemolytic uraemic syndrome associated with Salmonella dysentery. PMID- 3293352 TI - A double-blind clinical trial on diphenhydramine in pertussis. PMID- 3293353 TI - Intrahepatic periductal glands in graft-versus-host disease. AB - Degenerative epithelial changes with cytoplasmic eosinophilia and nuclear pleomorphism were found in the intrahepatic periductal glands in two patients who died following allogeneic bone marrow transplantation. These changes, which have not been described in the literature to our knowledge, were closely associated with clinicopathologic signs of graft-versus-host disease (GVHD), and histologically they resembled small bile ductal lesions, a characteristic finding of hepatic GVHD. In addition, periductal glandular and small bile ductal lesions frequently coexisted. Neither livers from patients given autologous marrow transplantation nor other control livers including those from patients given abdominal irradiation revealed such glandular lesions. These results suggest that the observed changes in the intrahepatic periductal glands were a manifestation of GVHD. PMID- 3293354 TI - Predicting repetition of deliberate self-harm: a review of the literature in the light of a current study. AB - Three hundred and sixty-five patients exhibiting deliberate self-harm (DSH) were rated for DSH repetition on the six-item predictive scale of Buglass & Horton and on a five-point predictive scale developed from a previous study by the author. The Buglass & Horton scale was more sensitive and more specific overall and for female patients, but the five-point scale predicted better for males, especially those aged under 35. The results are discussed in relation to previous work on the prediction of DSH repetition. PMID- 3293355 TI - The temporal lobe epilepsy syndrome elucidated through Soren Kierkegaard's authorship and life. AB - In 1975 American scientists postulated the existence of the temporal lobe epilepsy syndrome. The authors of this paper demonstrate that the Danish philosopher Soren Kierkegaard in "The Book on Adler" 140 years ago has given an eminent phenomenological description of this syndrome. The authors at the same time state the hypothesis that Soren Kierkegaaard's description of Magister Adler actually might be a disguised self portrait. PMID- 3293356 TI - The associations between obesity, adipose tissue distribution and disease. AB - Recent research has shown the marked differences in association with disease between obesity localized to the abdominal respectively to the gluteal-femoral regions. In this review systematic analyses were performed of the associations between obesity (body mass index, BMI) or abdominal obesity (increased waist-over hip circumference ratio, WHR) on the one hand, and a number of disease end points, and their risk factors, as well as other factors on the other, WHR was associated with cardiovascular disease, premature death, stroke, non-insulin dependent diabetes mellitus and female carcinomas. In contrast, BMI tended to be negatively correlated to cardiovascular disease, premature death, and stroke, but positively to diabetes. The established risk factors for these end points were found to correlate to WHR, while this was often not the case with BMI. BMI was positively correlated only to insulin, triglycerides and blood pressure. Together with diabetes mellitus, this seems to constitute a metabolic group of conditions which are thus associated with BMI. Androgens (in women), and perhaps cortisol, seem to be positively, and progesterone negatively correlated to WHR. The WHR was also positively associated with sick leave, several psychological maladjustments, psychosomatic and psychiatric disease. Attempts were made to interpret these findings. In a first alternative an elevation of FFA concentration, produced from abdominal adipose tissue, was considered to be the trigger factor for the pathologic aberrations associated with abdominal distribution of body fat. When obesity is added, the metabolic aberrations may be exaggerated. In a second alternative adrenal cortex hyperactivity was tested as the cause. When combined with the FFA hypothesis, this might explain many but not all of the findings. It seems possible to produce an almost identical syndrome in primates by defined experimental stress. Women with high WHR were found to have a number of symptoms of poor coping to stress. It was therefore suggested that part of the background to this syndrome might be a hypothalamic arousal syndrome developing with stress. It was concluded that obesity and abdominal distribution of adipose tissue constitute two separate entities with different pathogenesis, clinical consequences and probably treatment. PMID- 3293357 TI - Genetic factors in the regulation of adipose tissue distribution. AB - This paper reviews current data concerning the role of the genotype in human variation in fat distribution and its contribution in regulating fat deposition in various regions of the body, primarily the lower trunk area. After statistical control over age, gender and total amount of subcutaneous fat, one finds an additive genetic effect of about 20-25% of remaining human variance in amount of lower trunk fat and in the relative proportion of lower trunk versus extremity fat. In spite of such a moderate genetic effect in fat distribution, the preferential site of fat deposition when exposed to chronic overfeeding is largely determined by one's genotype. Characteristics of regional adipose tissue metabolism and morphology are probably involved in mediating some of these genetic effects but other regulatory mechanisms are undoubtedly implicated. PMID- 3293358 TI - Hormonal abnormalities in obesity. AB - We have found a number of interesting hormonal abnormalities in obese men and women: 1) Obese women have normal levels of estrone, total estradiol, and total testosterone, but as a consequence of their subnormal levels of SHBG, their levels of free estradiol and free testosterone are significantly elevated. 2) Massive weight loss in obese women (to still elevated weight) results in normalization of the previously elevated free estradiol and free testosterone. 3) Obese women have normal plasma DHEA levels, but a significant, age-invariant decrease of the plasma DHEA/T ratio, which could be due to increased tissue activity of 3 beta-hydroxysteroid dehydrogenase. 4) Massive weight loss produces an age-dependent effect on DHEA levels in obese women: the levels increase to supranormal values in women around age 20, with diminishing increases at higher premenopausal ages and no increase at all at perimenopausal age. 5) Obese men have elevated levels of estrone and both free and total estradiol, and subnormal levels of free and total testosterone and of FSH; all these abnormalities are proportional to the degree of obesity. They also have relatively subnormal LH levels, i.e. normal in the face of hypotestosteronemia. The combination of these findings represents a state of mild hypogonadotropic hypogonadism (HHG), which we believe to be induced by the hyperestrogenemia. 6) Normalization of the estrogen levels of obese men, by suppression of adrenocortical secretion of aromatase substrates or by inhibition of aromatase, tends to normalize the HHG. 7) Massive weight loss in obese men normalizes their HHG without any decrease in plasma estrogen levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293359 TI - Physical training and changes in regional adipose tissue distribution. AB - Obesity has been associated with numerous metabolic complications, such as changes in the concentration and/or composition of plasma lipoproteins, glucose intolerance and hyperinsulinemia leading to diabetes and hypertension. The relation of obesity to cardiovascular disease has not, however, been consistently reported. Recent prospective studies have clearly indicated that the distribution of adipose tissue was a significant cardiovascular risk factor and numerous studies have shown that metabolic disturbances were more closely associated with the level of abdominal fat than excess adiposity per se. As obese men generally store their energy excess in the abdominal region and women in the peripheral fat depots, the metabolic complications of obesity seem to be more closely related to adiposity in men than in women. It is suggested that the sex dimorphism observed in adipose tissue localization could partly explain the greater cardiovascular risk associated with obesity in men than in women. Indeed, obese women with a "male" (abdominal) distribution of body fat have greater metabolic complications than women with lower body fat. When aerobic exercise-training is used to induce weight loss, men generally lose more fat than women. In men, the loss of adipose tissue appears to be central, potentially reducing the risk of cardiovascular disease, whereas a relative resistance to fat loss is observed in women compared to men. Although resistance to fat loss is noted in women, those with a "male" distribution of adipose tissue (high waist-to-hip ratio and high intra-abdominal fat deposition) and with associated metabolic complications greatly benefit from aerobic exercise-training.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293360 TI - Mechanisms associating body fat distribution to glucose intolerance and diabetes mellitus: window with a view. PMID- 3293361 TI - Potential role of adipose tissue for the development of insulin resistance in obesity. PMID- 3293362 TI - Potential importance of the muscles for the development of insulin resistance in obesity. PMID- 3293363 TI - Cerebral arteriovenous malformations (C. AVM) and associated arterial aneurysms (AA). Analysis of 101 C. AVM cases, with 37 AA in 23 patients. AB - We report a series of 101 patients with cerebral arteriovenous malformations (CAVM), in which 23 cases presented with one or several arterial aneurysm(s) (AA). Each AA could be classified into distal intra-lesional, proximal or remote. Patients with CAVM + AA tend to be older and more frequently present with epilepsy, haemorrhage events and neurological deficits. Of these 23 patients, 16 had their AVM treated partially or totally by embolization. In our series, the endovascular treatment of the arteriovenous shunt with a proximal AA on the same vessel has resulted in at least a regression, and sometimes a disappearance of the arterial ectasia. Although partial treatment of the AVM does no erase the risk of haemorrhage from the malformation itself, it may diminish the chance of developing a flow-related AA or any other expression of the high-flow angiopathy. PMID- 3293365 TI - Improvements of a method for testing autoantibodies in sensorineural hearing loss. PMID- 3293364 TI - Recent concepts in ORL. A scientific colloquium in honor of Prof. Dietrich Plester on the occasion of his 65th birthday. Tubingen, January 24, 1987. Proceedings. PMID- 3293367 TI - Modern surgical concepts in the treatment of chronic middle ear disease. PMID- 3293366 TI - Advances in middle ear surgery. PMID- 3293369 TI - Malcolm Hanson memorial lecture. MR of the heart: anatomy, physiology, and metabolism. AB - During the initial years, the use of MR imaging focused on the display of normal and abnormal cardiac anatomy. ECG-gated spin-echo imaging provides high-quality static images that clearly depict cardiac anatomy and a variety of anatomic abnormalities. However, it is now becoming clear that, with the addition of recent innovations, MR also is capable of evaluating cardiovascular physiology. With the use of fast imaging techniques, we can acquire images with essentially high temporal resolution so that cardiac function can be quantitated. Moreover, the use of proton and 31P MR spectroscopy provides additional information, which should enable the sequential monitoring of both cardiac function and metabolism. PMID- 3293368 TI - Changes in plasma histamine during orthotopic liver transplantation in the pig. AB - Hypotension and cardiac arrhythmia are commonly seen during liver transplantation both in man and in experimental animals. The cardiovascular changes may be explained by release of vasoactive substances, e.g. histamine, into the systemic circulation. Abdominal operations are followed by an increased histamine concentration in portal blood. If the liver clears excess histamine from the splanchnic system, an increased histamine concentration should not be found in the systemic circulation. We measured plasma histamine in peripheral arterial blood, blood from the right atrium and portal blood in different phase of liver transplantation in ten pigs. Histamine concentration increased in the portal vein in the anhepatic phase (basal 15.85 pmol/ml to 34.67 pmol/ml, median, p less than 0.05) but no changes were found in arterial or right atrium samples. Venous and later arterial revascularisation were not followed by any changes in histamine concentration in arteria and right atrium samples. We conclude that the transplanted liver can eliminate splanchnic histamine and that histamine is unlikely to be involved in the cardiovascular changes which are seen after revascularisation of the liver. PMID- 3293370 TI - Radiology--then and now. PMID- 3293371 TI - Treatment of reactions to radiographic contrast material. PMID- 3293372 TI - IV contrast material for abdominal CT: comparison of three methods of administration. AB - Despite a decade of experience, there is still no consensus as to the optimal IV contrast regimen for use in combined abdominal and pelvic CT scanning. In order to determine which regimen is most effective, 90 patients undergoing CT were prospectively randomized into one of three groups, depending on the method by which IV contrast material was administered: (1) a single bolus (150 ml or 175 ml, depending on the patient's weight) started when scans were made at the level of the dome of the diaphragm; (2) a split bolus delivered by means of a power injector, with the first bolus (100 or 125 ml) given when scans were made at the level of the dome of the diaphragm and the second bolus (50 ml) given when scans were made at the level of the iliac crest; (3) an initial hand-delivered bolus (100 or 125 ml) given when scans were made at the level of diaphragm, followed by rapid IV drip infusion of 50 ml throughout the remainder of the study. Quantitative comparison of pre- and postcontrast scans was performed at two levels: at the mid-liver to assess hepatic enhancement and 1 cm above the sacrosciatic notch to assess pelvic vascular enhancement. The single bolus provided better mean liver enhancement (46 H) than did either the split-bolus (36 H) or the bolus-drip (32 H) method (p less than .05). The last two methods achieved a sufficient aortocaval difference (greater than 10 H) to allow for evaluation of the liver in the nonequilibrium phase of contrast enhancement in which lesion detection is thought to be optimal. Mean enhancement of pelvic vessels was significantly better with the split bolus (arterial enhancement of 56 H, venous enhancement of 47 H) than with the single bolus (34 H, 31 H) or bolus drip infusion (38 H, 35 H) (p less than .05). We conclude that the split-bolus method is optimal for routine combined abdominal and pelvic CT scanning. The bolus-drip method is the least effective method for administering the contrast material. PMID- 3293373 TI - MR imaging of portal vein thrombosis. AB - MR imaging is emerging as a potential means of detecting portal venous thrombosis (PVT). Therefore, we attempted to establish specific criteria with which to diagnose PVT on conventional spin-echo images. In a retrospective review of 342 consecutive abdominal MR scans performed with a 0.5-T magnet, we identified nine patients with persistent signal in the portal vein and used the findings in these patients to establish criteria with which to diagnose PVT. We subsequently applied these criteria to 109 additional consecutive abdominal MR scans performed with the same magnet. Fifteen cases were found in which all images showed either (1) signal involving the entire width of the portal vein lumen, which approximated (with T1 weighting) and exceeded (with T2 weighting) the intensity of the hepatic parenchyma in images in which the hepatic veins showed a complete flow void or (2) complete nonvisualization of the portal vein and its major branches in images that showed a flow void in portal venous collaterals and hepatic veins. All patients had unequivocal findings of PVT on at least one other imaging study (CT or sonography) or at surgery. Although the sensitivity of these signs could not be calculated, their specificity was 100%. We conclude that in the presence of these signs, the diagnosis of PVT can be made with confidence. PMID- 3293375 TI - Bowel obstruction caused by gastric balloons. PMID- 3293374 TI - Focal spared areas in fatty liver caused by regional decreased portal flow. PMID- 3293377 TI - The variable sonographic appearances of ovarian teratomas: correlation with CT. AB - To better understand how the internal composition of ovarian teratomas influences their sonographic features, we compared their sonographic and CT appearances in 23 cases. Sixteen lesions had a mixed echo texture, with hypoechoic as well as echogenic components; two were anechoic and five were entirely echogenic. Correlation with the CT images showed that the fat present in most teratomas had variable sonographic appearances. Pure sebum was anechoic or hypoechoic, but fat intermixed with hair strands was echogenic and often attenuated the sound beam because of the numerous tissue interfaces created within the mass. The hypoechoic component of the teratoma corresponded, on CT, to low-attenuation fat in 12 tumors and to fluid in five. Most teratomas contained a dermoid plug, a protuberance arising from the tumor wall and containing hair follicles and often fragments of bone or teeth. On sonography, all dermoid plugs were seen as an echogenic mass, often associated with distal acoustic shadowing and protruding into the hypoechoic portion of the teratoma. When the dermoid plug was large and occupied most of the tumor, the entire teratoma appeared echogenic, with no discernible anechoic component. We found that three factors greatly affected the sonographic appearance of ovarian teratomas: the size of the dermoid plug, the presence and location of calcified elements, and the histologic composition of the fatty component. PMID- 3293376 TI - The inability to detect kidney disease on the basis of echogenicity. AB - With the use of new sonographic technology, we have observed that the echogenicity of kidneys is often equal to that of the liver in patients in whom there is no evidence of renal disease; this observation conflicts with the generally accepted notion that a normal kidney is always less echogenic than the liver. In order to reassess renal echogenicity as an indicator of disease, three experienced radiologists blindly reviewed the sonograms of the right kidney and liver in 153 patients. The prevalence of renal disease was 26% (40/153). Accepted sonographic criteria for abnormal renal echogenicity (kidney echogenicity greater than or equal to liver) were neither sensitive (62%) nor specific (58%) for renal disease, with a positive predictive value of 35%. Most of these inaccuracies occurred because 43 (72%) of 60 patients in whom renal echogenicity was equal to that of liver had normal renal function. If stricter criteria for abnormality were adopted (kidney echogenicity greater than liver), specificity (96%) and positive predictive value (67%) rose; however, sensitivity was only 20%. We conclude that renal echogenicity equal to the echogenicity of liver is not a good indicator of disease. Use of stricter criteria (kidney echogenicity greater than liver) provides a specific but insensitive test. PMID- 3293378 TI - Erosive arthritis of the temporomandibular joint caused by Teflon-Proplast implants: plain film features. AB - Six patients had osseous destructive changes of the temporomandibular joint after placement of Teflon-Proplast implants for treatment of internal derangements. The implants were surgically removed from all six joints, and foreign-body reactions were found to account for the radiographic appearance. The plain film radiographic features included single or multiple osseous erosions of the mandibular condyle in all cases and the temporal bone of the glenoid fossa in two cases. Some erosions were poorly defined, whereas others were well defined, either with or without sclerotic margins. Radiologists must be aware of this possible complication of alloplastic temporomandibular joint implants in order to suggest the diagnosis in the appropriate clinical setting. PMID- 3293379 TI - Diagnosis of deep-vein thrombosis. PMID- 3293380 TI - Prevention of migration of breast biopsy localization wire. PMID- 3293382 TI - Fibrositis. AB - Fibrositis is a common clinical syndrome characterized by diffuse musculoskeletal pain and multiple tender points on physical examination. The symptoms wax and wane but do not produce severe disability. Although no single treatment is curative, a comprehensive program of patient education, drug therapy and appropriate physical activity is beneficial in many patients. PMID- 3293381 TI - Serum neutrophil chemotactic activity (NCA) during aspirin-induced bronchoconstriction. AB - In order to determine mast cell involvement in aspirin-induced bronchoconstriction, 16 aspirin-sensitive asthmatics and 18 control patients were studied for serum neutrophil chemotactic activity, using Nelsons method, before and after oral aspirin administration. A significant increase in NCA was observed in 6 aspirin-sensitive asthmatics during aspirin bronchoconstriction. In two persons the increase was lower. In the remaining 8 persons, no increase in NCA was observed during aspirin bronchoconstriction. None of the control patients exhibited an increase in NCA. The authors assume that, in some of the patients with aspirin-induced bronchoconstriction mast cells are really involved. PMID- 3293383 TI - Current pharmacologic management of narcolepsy. AB - Narcolepsy is an incurable sleep disorder characterized by attacks of sleepiness and a series of auxiliary symptoms: cataplexy, sleep paralysis and hypnagogic hallucinations. Classic treatment has included stimulants to control sleepiness and tricyclic antidepressants to control the auxiliary symptoms. Polysomnography is necessary to confirm the diagnosis and to detect other sleep disorders. Recent developments in treatment include the use of codeine for sleepiness and gamma hydroxybutyrate for auxiliary symptoms. PMID- 3293384 TI - Food allergy. AB - Although common, food allergy is vastly overestimated by patients. The main food allergens include cow's milk, eggs, nuts, shellfish and whitefish. Other types of adverse food reactions are numerous; their cause represent a spectrum of toxins, infectious organisms and pharmacologic agents. A definitive diagnosis may be difficult. Recommended measures include prevention through breast feeding, avoidance of known offenders and symptomatic therapy when reactions occur. PMID- 3293385 TI - Common thyroid disorders. PMID- 3293386 TI - Carnitine deficiency. PMID- 3293387 TI - Harvard's RBRVS formula offers better alternative. PMID- 3293388 TI - Pacemaker follow-up and adequacy of Medicare guidelines. AB - The time of occurrence of cardiac pacemaker problems after implantation was identified to assess the adequacy of published federal guidelines for clinic and transtelephonic follow-up. One hundred eighty-nine pacemaker patients' charts were examined retrospectively to identify pacemaker problems: inadequate sensing, non-capture, battery failure, myoinhibition, muscle stimulation, and inadequate threshold safety margin. Twenty-nine patients (15%) were identified as having pacemaker problems. A total of 41 problems were identified, of which 28 (68%) were corrected by reprogramming. Sixty-one percent of the problems were found during a clinic visit. Problems occurred more frequently during the first year in dual-chamber devices (62%) vs single-chamber devices (35%). During years 1 to 4, when few problems are expected, 30% of all problems of single-chamber devices occurred and 39% of all problems of dual-chamber devices occurred. This is a period of time that Medicare guidelines allow for one clinic visit per year for single- and two visits per year for dual-chamber devices. These data suggest: (1) Many pacemaker problems will be missed with transtelephonic follow-up alone. (2) The majority of problems involving dual-chamber devices occurred in the first year. (3) For both dual- and single-chamber devices, an unexpected significant percentage of problems occurred in 1 to 4 years. (4) Medicare guidelines may be inadequate for follow-up during this time period. PMID- 3293389 TI - Reversibility of prolonged chronotropic dysfunction with theophylline following orthotopic cardiac transplantation. PMID- 3293390 TI - Mild hypertension, diuretics, and cardiac arrhythmias: consensus amid controversy? PMID- 3293391 TI - The role of arrhythmogenic auditory stimuli in sudden cardiac death. PMID- 3293393 TI - Effects of nicardipine on coronary blood flow. AB - Nicardipine, a new 1,4 dihydropyridine calcium antagonist, has chemical properties that permit both oral and stable intravenous preparations. These preparations have prominent effects on indices of myocardial ischemia, coronary blood flow, and myocardial oxygen consumption. Data are reviewed from animal models of myocardial ischemia and patient studies that suggest that nicardipine has very prominent effects acting to increase coronary blood flow and reduce myocardial oxygen demand, in addition to favorable effects on myocardial metabolism and function. PMID- 3293392 TI - Clinical utility of exercise, pacing, and pharmacologic stress testing for the noninvasive determination of myocardial contractility and reserve. AB - The ability of the left ventricle to modulate its performance is an important and integral component in the cardiovascular system's adaptive response to increased workload. Abnormalities in ventricular contractility can blunt this response and thus significantly limit the patient's functional capacity. The accurate determination and quantitation of cardiac contractility and reserve is a difficult task in the symmetrically contracting ventricle and more so when regional contraction abnormalities are present. Moreover, derangements in other physiologic variables, such as ventricular loading conditions, heart rate, systemic vascular tone, cardiac autonomic function, and pulmonary gas exchange, can diminish cardiopulmonary reserve. This report relates the determinants of myocardial oxygen demand and efficiency to the currently available forms of exercise, pacing, and pharmacologic stress testing. Within this framework, commonly used as well as newer approaches to the noninvasive assessment of stress induced changes in left ventricular performance and contractility are addressed. In addition, several examples are presented in which noninvasive techniques for assessing intracardiac structures, pressures, and flows (eg, echo/Doppler, radionuclide angiography, rapid acquisition computed tomography, and magnetic resonance imaging) are combined with various cardiovascular stress tests to achieve more reliable measures of myocardial contractility and reserve. PMID- 3293394 TI - Therapy for angina pectoris: comparison of nicardipine with other antianginal agents. AB - Nicardipine is a new dihydropyridine calcium channel blocking drug with actions that suggest considerable usefulness as an agent for chronic stable angina. Hemodynamic studies in patients with coronary artery disease confirm major coronary vasodilator actions, perhaps even exceeding its considerable systemic vasodilator properties with little or no negative inotropic effect. Three recent controlled clinical trials that used nicardipine alone suggest approximately 20% to 30% increase in exercise time, and at least that much decrease in anginal episodes and sublingual nitroglycerin consumption when compared with placebo in doses of 90 to 120 mg daily. Five trials comparing nicardipine with other calcium channel blockers, and three with beta blockers, suggest equivalent efficacy, including decrease in angina and increase in exercise time. Adverse effects of nicardipine generally relate to its potent vasodilatory capability and are usually minor. Side effects are frequent at the beginning of many trials, usually do not cause undue withdrawals, and are quite rare after 6 to 12 months on the drug in most studies. PMID- 3293395 TI - The hypertensive patient with concomitant cardiovascular disease. AB - Many drugs for the treatment of hypertension are available in the United States today. Of the various factors that determine the appropriate treatment for a particular patient, the presence of concomitant heart disease requires specific tailoring of the antihypertensive therapy. Coronary artery disease, aortic insufficiency, congestive heart failure, left ventricular hypertrophy, premature ventricular contractions, supraventricular arrhythmias, mitral valve prolapse, orthostatic hypotension, and aortic dissection are some of the conditions that influence the choice of treatment. Diabetes places hypertensive patients at increased risk of heart disease, and exercise and sexual function are other considerations that govern the selection of treatment for the hypertensive person. For all of these conditions, more than one drug choice is often possible, but usually hypertensive patients can be treated with a beta-blocker or a calcium channel blocker in these special circumstances. PMID- 3293396 TI - New concepts in the treatment of elderly hypertensive patients. AB - Present evidence from several secondary and primary prevention trials indicates that if antihypertensive treatment is initiated with a cardioselective beta blocker such as metoprolol, a better preventive effect on total mortality, cardiovascular mortality, and atherosclerotic complications can be expected than if diuretics are used as initial therapy. Results from a large-scale, multicenter international study have shown that a regimen in which antihypertensive treatment is initiated with metoprolol once daily is effective, safe, and well tolerated in elderly hypertensive patients. This might be of particular importance since a steep increase in cardiovascular mortality and other atherosclerotic complications is seen with age. In many elderly hypertensive patients, symptoms of heart failure might be caused by poor filling in stiff hearts rather than ineffective systolic contractions. By reducing heart rate with use of a cardioselective beta-blocker, diastole will be prolonged; this will improve filling and hence stroke volume and will increase coronary flow. Long-term treatment with metoprolol has also been found to reduce left ventricular systolic wall stress, reverse hypertrophy, improve left ventricular compliance, decrease the stiffness of large arteries, reduce total peripheral resistance, and reduce albuminuria. The improvement in the stiffness of the large arteries might be of particular clinical importance in elderly patients who have isolated systolic hypertension. PMID- 3293397 TI - The Safety After Fifty Evaluation trial: evaluation of the safety and efficacy of antihypertensive therapy with metoprolol in patients 50 to 75 years of age: study design. AB - Hypertension increases in prevalence with advancing age and is a major risk factor for the development of cardiovascular disease in elderly patients. However, the presence of coexisting illness, altered drug metabolism, enhanced susceptibility to drug side effects, and physiologic changes such as reduced plasma volume and lower plasma renin levels make treatment of hypertension in elderly patients more difficult. Nonetheless, several studies have now demonstrated the beneficial effects of antihypertensive drug therapy in older patients. The Safety After Fifty Evaluation trial was designed to determine the short-term efficacy and tolerability of once-daily therapy with the cardioselective beta-blocker metoprolol alone or in combination with hydrochlorothiazide in the treatment of mild hypertension in patients 50 to 75 years of age. A total of 24,816 patients were enrolled in the trial by 2821 practicing physicians from across the United States. This article describes the details of the Safety After Fifty Evaluation study design. Results of the trial will be reported separately. PMID- 3293398 TI - Overview: hypertension and atherosclerosis. AB - Many large-scale trials of drug treatment for hypertension have shown an apparent lack of benefit with regard to the incidence of complications related to atherosclerosis. Recent experimental evidence has contributed to an understanding of the pathogenesis of hypertensive vascular disease, although exact mechanisms by which hypertension and antihypertensive drugs influence the atherosclerotic process are still poorly defined. In animal models, hypertension appears to induce a sequence of changes in endothelial cells, smooth muscle cells, and endothelial permeability. However, increased lipid deposition in the intima and acceleration of atherosclerosis appear to require elevation of plasma lipid levels. Some beta-blockers have been found to retard the development of atherosclerosis in the cholesterol-fed rabbit model. The clinical applicability of these interesting research findings awaits further investigation. PMID- 3293399 TI - Thromboatherosclerotic complications in hypertensives: results of the Stockholm Metoprolol (secondary prevention) Trial. AB - The outcome of postinfarction patients with a history of hypertension who participated in a randomized, double-blind, secondary prevention study with metoprolol or placebo treatment for 3 years has been evaluated. There were 41 patients in the placebo group and 35 patients in the metoprolol group. Elevated blood pressure was treated primarily by the addition of thiazide diuretics. Blood pressures were nearly identical in the two treatment groups. During the 3 years, 11 patients died in the placebo group and seven died in the metoprolol group. Occurrence of nonfatal events was also higher in the placebo than in the treated group: 12 patients vs one patient for reinfarction (p less than 0.005), three patients vs no patients for coronary artery bypass grafting, four patients vs no patients for cerebrovascular events, and one patient vs no patients for lower limb amputation. The total number of patients with any event was 24 vs eight (p less than 0.01). The present results may imply that treatment after infarction with metoprolol reduces nonfatal thromboatherosclerotic complications, especially nonfatal reinfarctions, in patients with a history of hypertension. However, inasmuch as the results were obtained from a retrospective subgroup analysis, they must be interpreted with caution. PMID- 3293401 TI - The dynamics of hypertension--an overview: present practices, new possibilities, and new approaches. AB - Contemporary clinical evaluation of hypertensive patients must include observations encompassing the impact of environment, behavior, and sociologic factors on metabolism and physiology. As evidenced by animal and human studies, catecholamines are an important mediator between psychologic factors and cardiovascular physiology, but direct measurement of catecholamine levels has not proved useful. Measurement of hemodynamic variables--blood pressure, heart rate, and stroke volume--during standardized psychophysiologic challenges is advocated. With low-challenge standardized stressors that include alpha- and beta-adrenergic stimuli, inappropriate reactors can be classified according to whether blood pressure is elevated primarily by cardiac output, total systemic resistance, or a combination of both. Hypertensive patients can be similarly distinguished, and medication can then be custom-tailored to the underlying physiology. Extensive laboratory and clinical evidence points to significant interrelationships between the central nervous system and the cardiovascular system. Furthermore, cardiovascular physiologic and metabolic perturbances are distinctly different under conditions of mental vs physical stress. Most clinical testing assesses physical performance whereas the real-life challenges of today are primarily mental. PMID- 3293400 TI - Primary prevention in patients with hypertension: comments on the clinical implications of the MAPHY Study. Metoprolol Atherosclerosis Prevention in Hypertensives Study. AB - The MAPHY Study was conducted to investigate whether metoprolol, a relatively beta 1-selective beta-blocker, given as initial antihypertensive treatment, would lower cardiovascular complications of high blood pressure to a greater extent than do thiazide diuretics as initial treatment at similar blood pressure control. In a controlled, randomized, stratified primary prevention study (n = 3234; 16,180 patient-years) in white men (40 to 64 years old) with mild to moderate uncomplicated hypertension, a treatment schedule starting antihypertensive treatment with metoprolol was compared with treatment starting with a thiazide diuretic. The two treatment groups were well matched in blood pressure and other major clinical characteristics at randomization, as well as at the last follow-up during treatment. Total mortality was significantly lower in patients randomized to metoprolol. At the median follow-up time (4.2 years) 28 deaths occurred in the metoprolol group and 54 in the diuretic group--a difference of 48% in total mortality (95% confidence limit, ranging from 68% to 17%), mainly because of a highly significant reduction in coronary heart disease at this point in time. The benefit demonstrated with metoprolol seems to have important implications for clinical practice and public health policy, since hypertension and coronary heart disease are major health problems worldwide. PMID- 3293402 TI - The heterogeneity of essential hypertension: hemodynamic aspects. AB - Numerous studies over the past few years have indicated that mechanisms of pressure elevation are not uniform in all patients with essential hypertension. Simple clinical findings such as age, sex, body habitus, and race often allow us to define the predominant pathogenetic mechanism. Not only is the hemodynamic and biochemical pattern of essential hypertension different in patient subgroups, but manifestations of target organs and therefore the risk of cardiovascular disease also vary distinctly from one group to another. Identifying the predominant hemodynamic, biochemical, and target organ disease pattern in a given patient will help the physician to select more specific antihypertensive therapy and thereby, it is hoped, prevent or reverse target organ disease and improve the quality of life. PMID- 3293403 TI - The importance of hemodynamic considerations in essential hypertension. AB - Hypertension is a major risk factor for cardiovascular morbidity and mortality. Antihypertensive therapy consistently reduces complications from stroke and congestive heart failure, whereas benefits from the treatment of ischemic heart disease events are variable. Several plausible explanations, including hemodynamic hypotheses, have been put forth to account for the failure of treatment to more favorably influence mortality from ischemic heart disease. The effect of hypertension on coronary heart disease is probably much more complex than a simple elevation of arterial pressure. Some of these complexities include the potential separate risks of high total peripheral resistance, high cardiac output, increased myocardial power that reflects pressure times flow, and several structural and functional vascular changes. These factors may act in concert to unfavorably alter the balance between myocardial oxygen supply and demand. Several of these factors will be highlighted in an attempt to offer alternative or adjunctive pathophysiologic examinations for the high-risk subgroups of obesity and the failure of antihypertensive therapy to normalize the rate of coronary heart disease events. PMID- 3293404 TI - Transition from high cardiac output to elevated vascular resistance in hypertension. AB - The early phase of hypertension (borderline hypertension) is characterized by a hyperkinetic circulation caused by excessive sympathetic drive and decreased parasympathetic inhibition to the heart. In later phases the cardiac output becomes normal, but the hypertension is still neurogenic, as demonstrated by the fact that continued pharmacologic parasympathetic, beta- and alpha-adrenergic inhibition normalizes the blood pressure. In both of these phases of the process, plasma norepinephrine values are elevated. These patients also show characteristic behavioral patterns; they are outward oriented, submissive, but experience unexpressed anger and frequently harbor hostile feelings. In late phases of hypertension the cardiac output is normal and the total peripheral resistance is elevated. This hemodynamic transition can be explained by a secondary response to elevated blood pressure. The heart becomes less responsive as a result of altered receptor responsiveness and decreased cardiac compliance, whereas the responsiveness of arterioles increases because of vascular hypertrophy, which leads to changes in the wall-to-lumen ratio. However, one observation eludes explanation: the absence of plasma norepinephrine elevation in later phases of hypertension. We propose a new conceptual framework to explain the disappearance of elevated plasma norepinephrine in the course of hypertension. The concept is based on a wide range of observations with the use of various receptor-blocking agents during neurogenic pressor responses. Invariably, the blood pressure response is preserved, but the hemodynamic pattern can be altered from a high cardiac output to high total peripheral resistance or vice versa.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293405 TI - Interaction between renin and the autonomic nervous system in hypertension. AB - The abnormal distribution of plasma renin values described in established essential hypertension are also found in patients with very early, borderline hypertension. In established hypertension, renin values have been used to draw inferences about the pathophysiology of blood pressure elevation. Within this concept, the low-renin state is considered a volume-dependent (volume expanded) form of hypertension. The high-renin state is viewed as high-resistance hypertension caused by a renin-dependent vasoconstriction. However, the pathophysiology of high- and low-renin borderline hypertension does not follow the prediction from the volume-vasoconstriction theory. The high-renin state is often associated with an increase in cardiac output and normal values of vascular resistance. Even when the cardiac output is normal and the total peripheral resistance is elevated in high renin, the vasoconstriction is not renin angiotensin dependent. The high-renin borderline and mild hypertension is a state of generalized, increased, sympathetic drive to the heart, blood vessels, and kidneys. After the influence of the autonomic nervous system is removed by pharmacologic blockade, blood pressure in patients with high-renin values becomes normal. To the contrary, pharmacologic antagonization of angiotensin II with a converting enzyme inhibitor does not lead to normal blood pressure values in patients with high-renin. Patients with borderline hypertension with low renin have normal plasma and blood volume values. However, because of decreased compliance of the peripheral capacitance space, the blood volume is shifted from the peripheral to the central (cardiopulmonary) portion of the circulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293406 TI - Quality of life issues in hypertension: consequences of diagnosis and considerations in management. AB - Most patients with mild to moderate hypertension are asymptomatic. Any adverse response to nonpharmacologic or pharmacologic therapies can negatively influence some aspect of the patient's sense of well-being and life satisfaction; this will likely limit the compliance with and the resultant benefits of therapy. The diagnosis of hypertension itself is associated with psychological consequences, termed the "labeling effect," that impair life quality. A number of life-style modifications and a variety of highly effective and safe classes of antihypertensive agents can satisfactorily control blood pressure in most patients. Evaluation of the patient's response to an antihypertensive regimen should, in addition to measurement of the level of blood pressure and review of laboratory test values, include assessment of quality of life outcomes: impact of therapy on the patient's daily routine, fatigue or activity limitation, sexual dysfunction, impairment of memory, alertness, mood, or cognitive ability, sleep dysfunction, work performance and satisfaction, and satisfaction with family, social, and leisure time activities. PMID- 3293407 TI - Psychological factors in hypertension: an overview. PMID- 3293409 TI - Stress management in the treatment of hypertension. PMID- 3293408 TI - Behavioral vs beta-blocker therapy in patients with primary hypertension: effects on blood pressure, left ventricular function and mass, and the pressor surge of social stress anger. AB - We compared the relative effects of relaxation therapy, conventional hygienic techniques, and a beta-receptor blocker, atenolol, on control of arterial pressure, left ventricular mass, and diastolic function in patients with mild primary hypertension. Furthermore, we related these effects to baseline neural tone and its changes and assessed the efficacy of relaxation or the pressor surge of "social stress" anger. In group I left ventricular mass index was related to both systolic and diastolic blood pressure (r = 0.46; p less than 0.05). Plasma norepinephrine was related to age (r = 0.33; p less than 0.01). Slope was inversely related to both plasma norepinephrine (r = -0.29; p less than 0.05) and age (r = -0.31; p less than 0.05). Relaxation therapy reduced both supine systolic and diastolic blood pressures, 4.5% and 7.6%, respectively, but did not affect plasma norepinephrine. Hygienic informational therapy reduced plasma norepinephrine by 18%, (p less than 0.05) and did not change blood pressure. Blood pressure responders to nondrug therapy (i.e., diastolic blood pressure reduction of 7% or more) had a 7% reduction of left ventricular mass index (p less than 0.02). On the other hand, atenolol reduced systolic and diastolic blood pressure by 10% and 15%, respectively, (p less than 0.01) and improved left ventricular function by 17% (p less than 0.05) without a significant change in left ventricular mass index. Finally, relaxation therapy but not hygienic therapy reduced systolic blood pressures 4% and 6%, respectively (p less than 0.01), both before and during social stress anger.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293410 TI - Application of noninvasive techniques for measuring cardiac output in hypertensive patients. AB - The hemodynamic hallmark of hypertension is increased systemic vascular resistance, although this variable is usually not determined in hypertensive patients because it has generally required invasive procedures to measure cardiac output. Reliable, totally noninvasive methods are now available that measure cardiac output accurately enough under a variety of conditions, including rest, exercise, and pharmacologic interventions. These methods include echocardiography, Doppler echocardiography, CO2 rebreathing, and impedance cardiography. Their serial application to large numbers of patients offers the opportunity to significantly broaden our understanding of the spectrum and course of hemodynamic alterations associated with hypertension. A more complete knowledge of underlying hemodynamics could improve our diagnostic and prognostic accuracy in hypertensive patients and enhance our understanding of the pathophysiology of hypertension and the mechanism of action of antihypertensive interventions. PMID- 3293411 TI - Ambulatory blood pressure monitoring and cardiovascular reactivity testing for the evaluation of the role of psychosocial factors and prognosis in hypertensive patients. AB - This article reviews the contributions of laboratory-based reactivity testing and ambulatory blood pressure monitoring in the evaluation of the role of psychosocial factors in hypertension. Reactivity testing is ideally suited for evaluating individual differences in susceptibility to the acute effects of stressors but cannot resolve the question regarding whether stressors in everyday life contribute to a sustained elevation of pressure. Although several associations between increased reactivity and hypertension have been demonstrated, they do not necessarily imply a primary role for behavioral factors. Ambulatory monitoring is ideally suited for studying the effects of everyday stressors and has shown that blood pressure may increase as a result of occupational stress. On the grounds that hypertension results from an interaction of genetic and environmental factors, it is argued that both techniques have their place and that the role of psychosocial factors can best be demonstrated by prospective studies of persons exposed to different levels of stress. PMID- 3293412 TI - Women in pharmacy education: the pioneers. PMID- 3293413 TI - Current concepts in tuberculosis. Part II. PMID- 3293414 TI - The probucol experience: a review of the past and a look at the future. PMID- 3293416 TI - Probucol Quantitative Regression Swedish Trial: new angiographic technique to measure atheroma volume of the femoral artery. AB - The Probucol Quantitative Regression Swedish Trial is studying the development of atherosclerosis in hyperlipidemic patients through the use of digitized femoral arteriographic examinations. In a 20-cm segment of the femoral artery, cross sectional areas are calculated using an algorithm that was introduced by Hilal and Crawford. Changes in atheroma volume are measured in repeat arteriographic examinations. This report describes the radiologic technique, the scanning procedure and the image analysis. PMID- 3293415 TI - Development of femoral atherosclerosis in hypercholesterolemic patients during treatment with cholestyramine and probucol/placebo: Probucol Quantitative Regression Swedish Trial (PQRST): a status report. AB - The Probucol Quantitative Regression Swedish Trial is being performed to investigate the effects of probucol on atherosclerosis in the femoral artery. Probucol is combined with cholestyramine and dietary management in hypercholesterolemic patients, and the effects of atheroma developing in the femoral artery will be followed by a quantitative angiographic technique. A randomly selected control group is also being managed by dietary therapy and cholestyramine, but receives placebo instead of probucol. The treatment time in this double-blind trial is 3 years, and femoral angiography is performed yearly. Detailed lipoprotein and apolipoprotein analysis are performed at monthly intervals. The basic study design is described here, and some results from the open prerandomization phase of the study are presented. PMID- 3293418 TI - Immunohistochemical study of mantle zone lymphoma. AB - Lymph nodes from four cases of mantle zone lymphoma (MZL) were studied immunohistochemically. All the cases had serum M proteins. Immunostaining with paraffin-embedded specimens revealed that proliferating cells of neoplastic nodules possessed the same monoclonal immunoglobulins as those in the serum (IgM, kappa in three and IgM, gamma in one). The plasma cells around neoplastic nodules contained the same monoclonal immunoglobulins as those in the nodules in two cases. In the remainder, most plasma cells around the nodules possessed the same immunoglobulins as those in the nodules. The authors consider these plasma cells to be the cause of paraproteinemia. Immunostaining with paraffin and frozen tissue sections revealed that the neoplastic cells (or neoplastic nodules) were positive for sIgD, sIgM, dendritic reticulum cell antigen (DRC-1), and LN-2 and weakly positive for common acute lymphocytic leukemia antigen (CALLA), and LN-1. These results indicate that the neoplastic cells of MZL have both phenotypes of mantle zone lymphocytes (sIgD, sIgM, and LN-2 positive) and of germinal center cells (sIgM, DRC-1, CALLA, and LN-1 positive). MZL is thus considered to be a neoplasma of B-cells differentiating from mantle zone lymphocytes to germinal center cells. PMID- 3293417 TI - Changes in high-density lipoprotein subfraction distribution and increased cholesteryl ester transfer after probucol. AB - The effects of probucol (500 mg twice daily) on high-density lipoprotein (HDL) subfractions and cholesteryl ester transfer from HDL to lower density lipoproteins were tested in a series of patients with Type II hypercholesterolemia. In this placebo-controlled crossover trial, patients received probucol or placebo for 8 weeks, then switched to the other agent for another 8 weeks. Probucol significantly lowered total, low-density lipoprotein and HDL cholesterol levels. HDL subfractions, separated by rate zonal ultracentrifugation, showed a dramatic reduction in HDL2, whereas changes in HDL3 were not significant. Both subfractions eluted at a characteristically lower volume, indicating a reduced flotation rate. These findings were confirmed by gradient gel electrophoretic separation, which showed a typical reduction or disappearance of HDL2b particles and the prevalence of particles in the HDL3a HDL3b electrophoretic range in almost all patients. After treatment, cholesteryl ester transfer from HDL to lower density lipoproteins was significantly increased in all patients. These data suggest that probucol may accelerate HDL particle conversion, leading to improvement in reverse cholesterol transport from the periphery to the liver, through HDL and very low density lipoprotein. PMID- 3293419 TI - Immunotypic and genotypic characterization of non-Hodgkin's lymphomas of the ovary. AB - Ovarian non-Hodgkin's lymphomas (NHLs) are rare, and accurate diagnosis is frequently problematic. Previous studies have not provided either complete immunotypic or genotypic analyses. The authors report immunotyping and genotyping of three cases of ovarian NHL, including both primary and secondary types. Immunotyping disclosed all three were B-cell lymphomas composed of secretory blast stage lymphocytes showing kappa immunoglobulin (Ig) light chain clonal excess. DNA extracted from frozen tissue of each tumor was subjected to restriction endonuclease digestion and hybridized to probes for Ig genes, C kappa, C lambda, JH, and the T-cell receptor beta-chain gene. Rearrangements of the heavy chain and light chain Ig genes were observed in all three cases, confirming the monoclonal B-cell origin of the neoplastic population. No detectable rearrangements were observed in DNA extracted from three nonlymphoid ovarian tumors (dysgerminoma, granulosa cell tumor, and fibrothecoma). This study documents the potential value of immunotyping and genotypic analysis in the study of ovarian tumors. PMID- 3293420 TI - The "diff-if". Use of microcomputer analysis to triage blood specimens for microscopic examination. AB - Increasingly, all automated blood counts are not accompanied by a microscopic white blood cell differential. A popular strategy is to obtain a manual differential if any part of the automated blood count and differential is outside specified limits (the "diff-if" strategy). The authors compared two sets of criteria to triage blood counts for manual differentials: previously recommended numeric values, and the analysis of a microcomputer program. In a population of subjects with a high percentage of hematologic disorders, the microcomputer program and the numeric criteria were equally specific (excluding normal blood smears); the program was more sensitive for bands, immature granulocytes, monocytes, nucleated red blood cells, reticulocytosis, teardrops, red blood cell fragments, and hypersegmented neutrophils. The numeric criteria were more sensitive for eosinophilia (less than 1.0 X 10(9)/L) and mandated fewer manual differentials. In a population of predominantly normal subjects, the program was more sensitive for increased bands and equally sensitive for eosinophilia, the only abnormalities observed on the smear. In a population of subjects with predominantly abnormal blood counts, but excluding most primary hematologic disorders, there were few blood smears with abnormalities beyond eosinophilia or increased bands. In both of these groups, the computer program mandated more manual differentials than did the numeric criteria. The authors conclude that microcomputer analysis by the program tested was more sensitive than numeric criteria to identify specimens with abnormal blood smears. Specificity depended on the patient population. The choice of a triage strategy should be based on the individual laboratory's patient population. PMID- 3293421 TI - Evaluation of two commercially available test methods to determine the feasibility of testing for respiratory syncytial virus in a community hospital laboratory. AB - The feasibility of performing respiratory syncytial virus (RSV) testing in a community hospital laboratory was assessed. The Abbott RSV EIA Kit, an enzyme immunoassay (EIA), and the Ortho Respiratory Syncytial Virus Identification Reagent, a direct fluorescent antibody (DFA) technique, were evaluated in terms of technologist time, result time, cost, and agreement of results. There was little difference in the amount of technologist time required for either method. The DFA technique was shown to be much less expensive than the EIA method and also required at least 50% less time to generate a final result. When compared with an indirect fluorescent antibody technique, the EIA technique was more sensitive (87%) than the DFA method (81%). Both methods showed 100% specificity. Based on the findings of this study, the DFA technique was determined to be the more feasible method for a community hospital laboratory to use for the rapid detection of RSV. PMID- 3293422 TI - Laboratory diagnosis of Chlamydia trachomatis using two immunodiagnostic methods. AB - Seven hundred seventy-seven endocervical specimens collected from symptomatic and asymptomatic women in a low-prevalence population were examined for the presence of Chlamydia trachomatis by both enzyme immunoassay (EIA) and by direct immunofluorescence assay (DFA). Overall, 49 (6.2%) of specimens had positive results, however, only 26 had positive results by both assays. Concordant positivity was significantly higher in specimens from symptomatic women not taking antibiotics as compared with all other groups. Test discordance was not influenced by order of specimen collection, number of days of delay before the specimen was processed by EIA, cervical cytologic results, amount of mucopurulence, or presence of a particular bacterial species in simultaneously collected cervical swabs. The EIA optical density (OD) reading appeared to discriminate between the different test result groups more reliably than the number of elementary bodies seen on the DFA slide. Specimens with an OD reading greater than 0.300 and less than 0.060 can be interpreted with assurance as positive and negative, respectively. Caution may be necessary with specimens with intermediate values. PMID- 3293423 TI - Negative BACTEC 460-TB cultures. How long to incubate? AB - Current guidelines for all mycobacterial cultures require at least eight weeks of incubation. Thirty months' experience of 3,662 specimens with the BACTEC TB was reviewed. At the end of four weeks of incubation, 96.8% of the 343 isolates were detected and by the end of the fifth week, 98.8%. The additional three weeks' incubation cost estimates were $1,016.20 for 92 hours of labor. Of the four late yields, only one may have had any clinical significance. The authors' recommendation is that the eight weeks' incubation guidelines for all mycobacterial cultures and especially for the BACTEC TB be comprehensively reviewed to determine clinical relevance and cost effectiveness of incubation of the BACTEC TB vial beyond five weeks. PMID- 3293424 TI - Group A beta-hemolytic streptococci as a cause of bacteremia in children. AB - The clinical manifestations of patients with group A beta-hemolytic streptococcal (GAS) bacteremia presenting to an urban children's hospital were reviewed. Group A beta-hemolytic streptococci were isolated from blood cultures from 17 children over a three-year period. Systemic illnesses that may have predisposed these children to GAS bacteremia were identified in seven patients: preceding varicella infection (four patients) or malignant neoplasm/immunosuppressive therapy (three patients). Possible sources of GAS included compromised integument (seven patients), the oropharynx (six patients), or the lower respiratory tract (two patients). The clinical manifestations of GAS sepsis included the following: fever (15 patients); arthritis or arthralgias (four patients); cellulitis (three patients); maculopapular eruption (one patient); petechial or pustular exanthems (three patients); osteomyelitis (two patients); cervical adenitis (one patient); empyema (one patient); and meningitis with multiple brain abscesses (one patient). Two patients died of apparent overwhelming GAS sepsis while at home. Group A beta-hemolytic streptococcal bacteremia can present with a wide range of clinical manifestations and cause mild to fulminant disease in children. PMID- 3293426 TI - Neuropathologic documentation of prenatal brain damage. AB - Neuropathologic evidence of prenatal brain damage, chiefly in cerebral white matter, was found in 25% of infants who died at 7 days of age or less, with a total of ten preterm (16%) and 12 term (48%) infants among the 89 subjects studied. Few clinical features distinguished infants with prenatal injury from those without such injuries. Apgar scores were low, seizures were rare, and acute intracranial hemorrhage occurred equally often in both groups. Few pregnancies were entirely normal, but hydramnios was the only factor that occurred more often in prenatally injured infants, a statistically significant difference only among term infants. Oligohydramnios was not associated with prenatal brain injury. Unless fetal/maternal abnormalities in late gestation are identified and corrected, improved neonatal care will increase survival for prenatally damaged infants and the incidence of cerebral palsy may rise. PMID- 3293425 TI - Periorbital cellulitis. Clinical and laboratory findings in 146 episodes, including tear countercurrent immunoelectrophoresis in 89 episodes. AB - Medical records of 144 children hospitalized for 146 episodes of periorbital cellulitis were reviewed. During 44 episodes, systemically administered antibiotics were given before hospitalization. Bacterial pathogens were isolated in only two (5%) of 44 episodes in pretreated patients compared with 33 (32%) of 102 episodes in patients who were not pretreated. Thirty-one children who were not pretreated were bacteremic. Compared with nonbacteremic children who were not pretreated, bacteremic children were younger, more often had a history of upper respiratory tract infection and fever, had a higher white blood cell count and temperature at admission, and more often had a violaceous cellulitis. No difference between groups existed in the frequency of a history of trauma or a local lesion near the affected eye. Tear specimens from 13 of 89 children tested by countercurrent immunoelectrophoresis (CIE) to detect Haemophilus influenzae type b capsular polysaccharide were positive. Compared with positive blood culture results, tear CIE has a sensitivity of 50% and a specificity of 93%. Streptococcus pneumoniae infections were not detected by CIE. PMID- 3293428 TI - Radiological case of the month. Coexisting duodenal and esophageal atresia without tracheoesophageal fistula. PMID- 3293427 TI - American Journal of Diseases of Children, Volume 1, 1911: Some anatomic features of the child's thorax and their practical application in physical diagnosis. By George Fetterolf and J. Claxton Gittings. PMID- 3293429 TI - Small bowel enteroscopy in 1988: pros and cons. AB - Endoscopic visualization of the small bowel is now feasible with a recently developed long, small-caliber, transnasal endoscope. Previously, with standard instruments, endoscopic views of the small intestine were limited to the most proximal and distal portions or required laparotomy and intraoperative endoscopy. Small bowel enteroscopy with the new transnasal sondetype flexible endoscope now allows most of the small bowel to be examined as a relatively short, ambulatory procedure. The literature pertaining to endoscopic evaluation of the small intestine is reviewed. PMID- 3293430 TI - What is the role of gastric emptying tests in a patient with nausea and vomiting? PMID- 3293431 TI - A critical analysis of the Sacks-Vine gastrostomy tube: a review of 120 consecutive procedures. AB - Results from 120 patients managed with a Sacks-Vine gastrostomy tube were analyzed. In our experience, this device can be successfully placed in almost all cases (96%), and has a low rate for procedure-related mortality (0.8%) and major (4.4%) and minor (12.4%) complications. Advantages and problems associated with this feeding catheter are discussed. The Sacks-Vine gastrostomy tube is a reasonable alternative to other catheters placed by different methods. PMID- 3293432 TI - Motility of the sphincter of Oddi and pancreatic main ductal pressure in patients with alcoholic, gallstone-associated, and idiopathic chronic pancreatitis. AB - We endoscopically measured pressures of the pancreatic duct (PP) and the sphincter of Oddi (SO) in patients with alcoholic (ALCP, n = 10), gallstone associated (GSCP, n = 7), and idiopathic chronic pancreatitis (ICP, n = 21), and in 20 controls. The PP was significantly higher in the patients with ALCP (55.7 +/- 28.9 mm Hg), GSCP (33.6 +/- 16.2 mm Hg), or ICP (44.5 +/- 25.8 mm Hg) than in the controls (16.2 +/- 8.7 mm Hg), but there was no significant difference between ALCP, GSCP, and ICP. There was no significant difference between control subjects and ICP in the motility of SO. In ICP, there was no correlation between the PP and the motility of SO. In ALCP and GSCP, the frequencies of the papillary sphincter waves were significantly higher than in normal subjects, and there were correlations between the PP and the motility of SO. These data suggest that increased pancreatic ductal pressure in GSCP with papillitis or ALCP may be due in part to papillary dysfunction, but not in ICP. PMID- 3293433 TI - Chronic pancreatitis and the sphincter of Oddi: which is the numerator and which the denominator? PMID- 3293434 TI - Perioperative considerations in esophageal replacement for epidermolysis bullosa: report of two cases successfully treated by colon interposition. AB - Esophageal stricture commonly occurs in patients with epidermolysis bullosa dystrophica recessive (EBDR), but esophageal replacement is considered a high risk procedure because of limited exposure of the airway, malnutrition, and postoperative skin bullae to secondary infection. Recent innovations in care, including preoperative parenteral nutrition, topical care for bullae and skin ulceration, fiberoptic tracheal intubation, electrocardiogram monitoring with metallic pacer leads, and an overall concern to protect the fragile intact skin, have improved the results of esophageal replacement. Utilizing these adjunctive measures, ileocolonic substernal interposition has been successfully performed in a 26-yr-old male and a 19-yr-old female at our institution. Despite cervical anastomotic stricture requiring resection in one, and an obstructive cervical esophageal bullous developing acutely 5 yr after operation in the second, both patients now gum or chew a solid diet. The first patient also benefited from total esophagectomy for squamous dysplasia detected at the time of esophageal replacement. Multidisciplinary management by the surgeon, gastroenterologist, anesthesiologist, and dermatologist makes esophageal replacement available for younger patients with epidermolysis bullosa dystrophica recessive and esophageal strictures. PMID- 3293435 TI - Spontaneous group B Salmonella enteritidis peritonitis in cirrhotic ascites and acquired immune deficiency syndrome. AB - Salmonella represents an infrequent cause of spontaneous bacterial peritonitis in cirrhotic ascites. A cirrhotic patient, an alcoholic and former intravenous drug abuser, developed spontaneous group B Salmonella enteritidis (undetermined serotype) bacterial peritonitis. The isolation of this pathogen, a common cause of bacteremia in acquired immune deficiency syndrome, led to the serological determination of infection with human immune deficiency virus (HIV). PMID- 3293436 TI - Diabetic retinopathy and cardiovascular disease in type II diabetics. The Framingham Heart Study and the Framingham Eye Study. AB - Data from the Framingham Heart Study and the Framingham Eye Study were used to examine the association between diabetic retinopathy and the occurrence of cardiovascular events (coronary heart disease, intermittent claudication, congestive heart failure, and stroke). Among the 206 persons with Type II diabetes in the Framingham Eye Study, the odds ratios for diabetic retinopathy and cardiovascular disease were 14.3 (95% confidence interval (CI) = 2.7-101.9), 2.0 (95% CI = 0.5-8.1), and 0.3 (95% CI = 0.05-1.3) for ages 52-64, 65-74, and 75 85 years, respectively. The test for homogeneity indicated highly significant differences for the odds ratios across age groups. The associations were similar when sex, duration of diabetes, age at diagnosis of diabetes, and history of insulin treatment were accounted for by logistic regression. Our data suggest an association in younger diabetics between diabetic retinopathy, a small vessel complication of diabetes, and a group of cardiovascular events commonly thought to result from large vessel disease. The finding may merely indicate that diabetics with large vessel disease are also more likely to have small vessel disease. However, it is also consistent with the hypothesis, suggested by histologic data, that a more generalized microangiopathy affecting not only the eye but also organs such as the heart may play a role in the pathogenesis of cardiovascular disease in diabetics. PMID- 3293437 TI - Absence of circulating natural killer (NK) cells in a child with erythrophagocytic lymphohistiocytosis lacking NK cell activity. AB - A 5-year-old girl who was diagnosed as having erythrophagocytic lymphohistiocytosis died at age 9 years. Peripheral lymphocytes from the patient persistently lacked natural killer (NK) cell activity during the 4-year observation period: the percent lysis values as measured by a 4-hr 51Cr release assay at a 40:1 effector:target ratio were below 1.0% against K562 and Molt-4 cells as compared with the normal lymphocyte value (mean +/- SD) of 46.2% +/- 5.8% and 43.9% +/- 6.7%, respectively. The patient's lymphocytes never developed NK cell activity by their incubation with target cells for longer time periods or by their stimulation with interferon-alpha, interleukin-2, or polyinosinic polycytidilic acid. Single cell-in-agarose assay showed the absence of target binding cells (TBCs): TBC numbers were below 0.3% as compared with the normal lymphocyte value of 8.1% +/- 1.3% (mean +/- SD). Flow cytometry showed a marked decrease in Leu-7+ cells (1.7%) and the absence of Leu-11+ cells (0.4%) in the peripheral blood. These results first demonstrate a case of erythrophagocytic lymphohistiocytosis in which there is the lack of NK cell activity due to the absence of circulating NK cells. PMID- 3293439 TI - Absence of immunoglobulin and T-cell receptor gene rearrangements in myelodysplastic syndromes and acute nonlymphocytic leukemias. AB - The arrangement of the immunoglobulin and T-cell receptor genes has been analysed in 72 cases of primary myelodysplastic syndrome and 17 cases of acute nonlymphocytic leukemia. DNA was extracted from bone marrow aspirates, digested with at least two restriction enzymes, and hybridised with probes for the joining region of the immunoglobulin heavy chain gene, the constant region of the T-cell receptor beta chain gene, and the joining region of the T-cell receptor gamma chain gene. All cases showed germline arrangements of the immunoglobulin and the T cell receptor genes. Thus, true interlineage infidelity, myeloid to lymphoid, is a rare occurrence in myelodysplasia and in myeloid leukemias. PMID- 3293438 TI - Use of differentiation-inducing agents in the myelodysplastic syndrome and acute non-lymphocytic leukemia. AB - The use of chemical agents that induce differentiation of malignant cells to normal cells has held great promise as an adjunct to standard chemotherapy. In vitro data has shown that 13-cis-retinoic acid can differentiate certain leukemia cell lines (e.g., HL-60) into stable granulocyte cells. In this study, oral 13 cis-retinoic acid was administered to four patients with the myelodysplastic syndrome (MDS) and to four patients with acute nonlymphocytic leukemia (ANLL). None of the MDS patients showed an hematologic response to the drug, while three of four ANLL patients responded with normalized peripheral blood counts. The side effects of the drug at 80-120 mg/d (dry skin, cheilitis, epistaxis) were self limiting. PMID- 3293440 TI - Neonatal alloimmune thrombocytopenia: spontaneous in utero intracranial hemorrhage. AB - Neonatal alloimmune thrombocytopenia is an uncommon but important cause of thrombocytopenia in infants. Because of the severity of the thrombocytopenia, some of these infants will have intracranial hemorrhage with resultant long-term disability. Obstetricians and neonatologists have recommended delivery by caesarean section and the rapid institution of appropriate treatment for the infant; however, it is theoretically possible that a hemorrhagic event could precede the delivery and consequently not be prevented by these perinatal interventions. In this report we describe a neonate in whom the diagnosis of alloimmune neonatal thrombocytopenia was suspected because of antenatal ultrasound evidence of intracerebral hemorrhage. This case demonstrates the importance of antenatal fetal assessment and indicates the need for the development of therapeutic strategies to maintain fetal hemostasis. PMID- 3293441 TI - Focal and diffuse membranoproliferative glomerulonephritis in children. AB - Characteristic deposition of C3 has been reported in type I membranoproliferative glomerulonephritis (MPGN). Immunofluorescence microscopy shows diffuse granular deposition of C3 along the majority of capillary loops with lobular pattern. To determine the specificity of this immunofluorescence finding which might aid in distinction between type 1 MPGN, particularly focal MPGN, and the other glomerulopathies, 530 renal biopsies from 437 children were studied retrospectively. Nineteen patients showed diffuse granular deposits of C3 along the capillary walls with lobular distribution. Three patients had lupus nephritis. Nine patients showed the light microscopic changes of diffuse type I MPGN with the characteristic double-walled capillaries. Six patients showed the changes of focal MPGN, and 1 had diffuse mesangial proliferation but without double contours, and they were regarded as examples of a mild or early form of MPGN. A similar deposition of C3 was not seen in the 418 patients with other conditions. We concluded that diffuse granular deposits of C3 along the capillary walls with a lobular distribution appear to be confined to type I MPGN and lupus nephritis and are seen in all patients with diffuse and focal type I MPGN. PMID- 3293443 TI - Cure of mucormycosis in a renal transplant patient receiving ciclosporin with maintenance of immunosuppression. AB - Rhinocerebral mucormycosis in renal transplant recipients is associated with high mortality and allograft rejection. We report the first case of successful treatment of mucormycosis in a renal transplant recipient receiving ciclosporin and corticosteroids with maintenance of renal function. It is postulated that the relatively specific immunosuppression caused by ciclosporin, together with aggressive medical and surgical intervention, may enable the cure of this life threatening fungal infection without loss of donor kidney function. PMID- 3293442 TI - An extracorporeal model of biofilm-adherent bacterial microcolony colonization for the study of peritonitis in continuous ambulatory peritoneal dialysis. AB - We have developed an extracorporeal system for investigating in vitro the biofilm adherent bacterial microcolonies (BABM) that grow on Tenckhoff catheters (TC), to study peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). A modified Robbins' device, attached to sampling plugs with TC discs and connected to the dialysate via a peristaltic pump, is run for 24 h; scrapings from pairs of TC discs are processed for assessment of viable BABM, one of each pair for culture by routine microbiology techniques and the other for examination by scanning and transmission electron microscopy (EM). No colonization was noted with fresh dialysis solutions and spent dialysates from patients without clinical peritonits; but, when bacterial suspensions were added to aliquots of the same dialysates, BABM were noted on both culture and EM. In a study of 4 patients on CAPD treatment, who had clinically evident peritonitis, routine cultures of spent dialysate were positive in only 2, but BABM were found in cultures and EM preparations of disc scrapings in all 4 cases. We conclude from these preliminary findings that this extracorporeal system is reliable, and well suited for studying the role of BABM in CAPD-associated peritonitis in vitro. PMID- 3293444 TI - Peritonitis in childhood renal disease. PMID- 3293445 TI - Pitfalls in diagnosis and management of preeclampsia. AB - Hundreds of reports deal with the subject of preeclampsia. A review of the world literature highlights the confusion and controversy regarding terminology, blood pressure measurements, diagnosis, and populations studied. More than 100 clinical, biophysical, and biochemical tests have been recommended to predict the future development of the disease. Results of the pooled data and the wide scatter therein suggest that none of these tests is sufficiently sensitive or specific for use as a screening test in clinical practice. There is some evidence that nutritional supplementation or antithrombotic agents might reduce the incidence of preeclampsia, but the data are not conclusive. In addition, the data do not suggest any benefit in perinatal outcome from the use of antihypertensive therapy in such pregnancies. The findings suggest that there is a definite need for standardization regarding definition, terminology, and diagnosis and for large multicenter clinical trials. Finally, there is an urgent need to identify a marker of preeclampsia. PMID- 3293446 TI - Abdominal ultrasound examination of the first-trimester fetus. AB - The first-trimester fetus can now be comprehensively studied with ultrasound. Various biometric measurements correlate well with gestational age, such as crown rump length (r2 = 0.938) and cranial apex to ear diameter (r2 = 0.983). On the other hand, yolk sac diameter (r2 = 0.129) and abdominal perimeter (r2 = 0.58) correlate poorly with gestational age. By 10 weeks' gestation, kidneys can be visualized in 60% of cases; 98% will be seen at 11 weeks; and 100% of cases will be visible by 12 weeks. The bladder appears later, and by 12 weeks' gestation this organ can be identified in 50% of cases. It is likely that renal agenesis can be diagnosed (or excluded) reliably in the first trimester. With improving technology, prenatal diagnosis of some fetal anomalies is now possible in the first trimester. PMID- 3293447 TI - Prenatal ultrasonographic diagnosis of osteogenesis imperfecta. AB - Between 1982 and 1986, osteogenesis imperfecta was diagnosed by ultrasound in seven fetuses. The known heterogeneity of osteogenesis imperfecta was confirmed by the prenatal ultrasonographic findings. Dependent on the type of osteogenesis imperfecta, the appearance of the limbs varied from severely shortened and broad, with very low echogeneity and absent acoustic shadow (type IIA), to only moderately shortened and thin, with almost normal echogeneity and acoustic shadow but clearly visible fractures causing angulation of the bone (types IIC and III). Ultrasonography offers the possibility to detect or exclude the lethal and severe forms of osteogenesis imperfecta early (type IIA) or halfway (types IIB, IIC, and III) through the second trimester. Prenatal diagnosis of the disease allows the option of elective abortion or may prevent unnecessary obstetric intervention. PMID- 3293448 TI - Antenatal diagnosis of partial agenesis of the corpus callosum: a benign cause of ventriculomegaly. AB - Dilation of the posterior horns of the cerebral ventricles may be an early finding of fetal hydrocephalus, but it is also the hallmark of partial agenesis of the corpus callosum. Reported is the first precise prenatal diagnosis of posterior agenesis of the corpus callosum. Accurate diagnosis allows for appropriate obstetric management. PMID- 3293449 TI - Production of a phosphatidylglycerol-like substance by genital flora bacteria. AB - Bacteria contaminating amniotic fluid have anecdotally been shown to produce a phosphatidylglycerol-like substance, thus giving false positive tests for phosphatidylglycerol in vaginal pool fluid from patients with premature rupture of the membranes. Isolates of Escherichia coli, Proteus mirabilis, Acinetobacter calcoaceticus, Klebsiella pneumoniae, Staphylococcus aureus, coagulase-negative Staphylococcus, Streptococcus faecalis, and Streptococcus agalactiae (group B streptococcus) were grown in broth and analyzed for the presence of phosphatidylglycerol-like material by one-dimensional thin-layer chromatography and also by a polyclonal, immunologic slide agglutination test (Amniostat-FLM). All species demonstrated a positive test result for phosphatidylglycerol by either thin-layer chromatography, slide agglutination, or both. The material migrated separately from cardiolipin and phosphatidylethanolamine as determined by chromatography, but identically with the phosphatidylglycerol control. Gram negative species were more strongly positive than gram-positive organisms. Colony counts on the order of 10(8) colony-forming units per milliliter were necessary to give positive test results for phosphatidylglycerol. The possible clinical implications of these findings are discussed. PMID- 3293450 TI - The reproductive autoimmune failure syndrome. AB - The association between reproductive failure and abnormal autoimmune function has been recognized for decades in association with such established autoimmune diseases as systemic lupus erythematosus. Recent investigations have expanded this association to women who demonstrate similar humoral abnormalities as patients with defined autoimmune diseases but do not express any of the clinical symptoms required for the diagnosis of an autoimmune disease. The observation that abnormal autoimmune function in clinically asymptomatic patients can lead to reproductive failure has led us to define the reproductive autoimmune failure syndrome as a diagnostic entity. The present article summarizes evidence suggesting that the occurrence of reproductive autoimmune failure syndrome may be teleologically related to the woman's need for increased self-tolerance in face of antigenic exposure to the maternal haplotype of the fetus during normal pregnancy. This need for increased self-tolerance is documented by higher normal autoantibody levels in women than in men and may also be responsible for the highly increased incidence of autoimmune diseases in women in comparison with men. Under this concept, abnormal autoimmune function may lead to reproductive failure at different stages of the reproductive process, depending on the quality and possibly quantity of the abnormal autoimmune response. PMID- 3293451 TI - In utero ischemic injury: sonographic diagnosis and medicolegal implications. AB - The antenatal diagnosis of fetal neurologic injury has profound medical and legal implications. We report a case of antenatally diagnosed intracranial lesions including parenchymal hemorrhage in an otherwise physically normal infant. Computerized tomography in the newborn period demonstrated diffused ischemic damage with secondary cystic changes in addition to intracranial hemorrhage. PMID- 3293452 TI - Chronic hyperglycemia and insulin concentrations in fetal lambs. AB - Insulin concentrations were measured in 20 chronically instrumented fetuses of 10 sheep with alloxan-induced chronic hyperglycemia and 10 control sheep to examine if the hyperglycemia resulted in high fetal insulin concentration. Additionally, in six neonatal lambs of three chronically hyperglycemic ewes and three control sheep, insulin concentrations were measured after intravenous glucose injection. After a 2-month period of significant maternal hyperglycemia, no relationship between concentrations of fetal glucose and insulin could be detected. The mean fetal glucose concentration was 3.5 +/- 0.5 mmol/L in the hyperglycemic group and 0.6 +/- 0.1 mmol/L in the control group. Mean fetal insulin levels were 12.5 +/- 1.4 and 10.7 +/- 1.3 microU/ml, respectively. The neonatal lambs of the hyperglycemic and control ewes showed comparable concentrations of glucose and insulin after infusion of glucose. It is presumed that persistent high glucose levels depress the insulin secreting capacity of the fetal pancreas. PMID- 3293453 TI - Fundamental and clinical research and patient care: a triad for progress in reproductive medicine. AB - This essay reviews select instances in the modern history of reproductive medicine, with particular emphasis on the past 25 years since the establishment of the National Institute of Child Health and Human Development. It considers five examples of how fundamental and clinical research have contributed to patient care and, in turn, received stimulus from them; that is, fertility regulation and reproductive endocrinology, prematurity and the initiation of parturition, antenatal testing of fetal maturity, antenatal diagnosis, and neonatal intensive care. Finally, some lessons regarding the interrelationships between research and clinical obstetrics and gynecology are considered. PMID- 3293454 TI - Sonographic assessment of the distal femoral and proximal tibial ossification centers in the prediction of pulmonic maturity in normal women and women with diabetes. AB - A noninvasive method for the assessment of fetal pulmonic maturity via the sonographic characterization of fetal distal femoral and proximal tibial epiphyseal ossification centers was evaluated. The study population included 82 patients in the third trimester of pregnancy, 47 of whom had uncomplicated gestations, while 35 had insulin-dependent diabetes. In uncomplicated pregnancies a distal femoral epiphysis measuring greater than or equal to 3 mm in the axial plane or the sonographic identification of a proximal tibial epiphysis of any dimension correlated with pulmonic maturity. The combination of a distal femoral epiphysis greater than or equal to 3 mm and the presence of a proximal tibial epiphysis was highly correlated with a lecithin/sphingomyelin ratio greater than or equal to 2:1 (sensitivity 100%, specificity 63%, negative predictive value 100%, and false-negative rate 0%). The Kappa value (K) for testing the agreement between ultrasound results and amniocentesis results was 0.39 (p less than 0.002). In diabetic pregnancies neither a distal femoral epiphysis greater than or equal to 3 mm nor a proximal tibial epiphysis of any dimension correlated precisely with the presence of phosphatidyl glycerol in the amniotic fluid. However, the combination of a distal femoral epiphysis greater than or equal to 3 mm and a proximal tibial epiphysis greater than or equal to 2 mm improved the prediction of phosphatidyl glycerol (sensitivity 83%, specificity 79%, negative predictive value 96%, false-negative rate 17%). The K value in this instance was 0.36 (p greater than or equal to 0.19). It is concluded that the sonographic assessment of the distal femoral and proximal tibial epiphyses and their dimensions in the axial plane may be useful as markers for pulmonic maturity in uncomplicated pregnancies. PMID- 3293455 TI - Effect of exercise on glucose metabolism in postmenopausal women. AB - A cross-sectional study was conducted to examine the effect of treadmill and muscle resistance training on glucose tolerance and insulin levels in a group of 25 normal-weight, naturally menopausal women. Subjects trained 20 minutes three times per week for at least 6 months to 70% to 85% of maximum heart rate on a treadmill, or to maximum effort for all major muscle groups on Nautilus equipment. A nonexercising age-height-weight--matched group was monitored as a control. All three groups were of above-average fitness for age as measured by aerobic capacity during initial testing. The treadmill group significantly increased its maximal oxygen uptake over the training period. Glucose tolerance and insulin response, measured as areas under the curve after a 75 gm oral glucose load, were improved in both exercise groups compared with controls, with more marked improvement in the treadmill group. The only difference achieving statistical significance was the insulin levels 30 minutes or less after glucose ingestion, representing the first phase of insulin release. Long-term exercise training that increases aerobic power thus maintains normoglycemia with lower insulin values than in otherwise physically fit postmenopausal women. PMID- 3293456 TI - A randomized trial of hydroxyurea versus misonidazole adjunct to radiation therapy in carcinoma of the cervix. A preliminary report of a Gynecologic Oncology Group study. AB - Between June 1981 and December 1985, 296 evaluable patients with carcinoma of the cervix (stages IIB, III, or IVA) were randomized to radiation therapy and either hydroxyurea (139 patients) or misonidazole (157 patients). All patients had undergone clinical, radiographic, and surgical staging. Patients with metastasis to periaortic nodes were ineligible for study. Patients received external radiation therapy to the pelvis and either one or two intracavitary applications. Hydroxyurea was given in a dose of 80 mg/kg each Monday and Thursday during external radiation therapy. Misonidazole was given in a dose of 1 gm/m2 in the same schedule, not to exceed 12 gm/m2. Of the evaluable patients, 60.8% had stage IIB disease and 33.8% had stage IIIB disease. Negative pelvic lymph nodes were found in 79.2% of the patients. Median age was 49 years (first and third quartiles 40 and 60, respectively). There were 51 patients who had severe and 15 patients who had life-threatening adverse effects (including two treatment related deaths). As of February 1987 half the patients have either failed or been followed-up for at least 43 months. The group treated with hydroxyurea had a longer progression-free interval, bordering on statistical significance, than those treated with misonidazole (p = 0.08). The median progression-free interval for all patients randomized to hydroxyurea is 42.9 months and for misonidazole it is 40.4 months. The median progression-free interval for patients with stage III and IV disease who received hydroxyurea has not been reached and for the misonidazole group it was 10.1 months. There have been 120 recurrences, 51 (36.7%) in the hydroxyurea group and 69 (43.9%) in the misonidazole group; 51.7% of the recurrences have been limited to the pelvis or vagina. Failure limited to the pelvis occurred in 18.0% of patients receiving hydroxyurea and 23.6% of patients receiving misonidazole. There were 108 deaths, 47 (33.8%) in the hydroxyurea group and 61 (38.9%) in the misonidazole group; survival does not differ statistically between the two regimens at this point in follow-up (p = 0.25). Hydroxyurea has more short-term gastrointestinal and marrow toxicity, but is free of long-term neurotoxicity. Preliminary analyses indicate that there is no role for radiation therapy with misonidazole in cervical carcinoma. PMID- 3293457 TI - Use of collagen absorbable hemostat in dacryocystorhinostomy. PMID- 3293459 TI - Visual results after keratoplasty in patients with posterior chamber intraocular lenses. AB - We performed penetrating keratoplasty in 20 consecutive patients who had posterior chamber intraocular lenses and who developed pseudophakic bullous keratopathy. All patients received 8.0-mm grafts placed in 7.5-mm recipient beds. None of the intraocular lenses were removed. Final visual acuity was 20/40 or better in eight (40%) and 20/80 or better in 15 (75%) of the patients. Senile macular degeneration (one case), corneal graft rejection (two cases), and wound infection (one case) contributed to poor visual results in the remaining patients. PMID- 3293458 TI - Immunohistochemical evidence of heterogeneity in macular corneal dystrophy. AB - We used the avidin-biotin complex immunoperoxidase technique to test the reactivity of the abnormal corneal accumulations with five different monoclonal antibodies that recognize specific determinants on keratan sulfate. Eighty-eight corneas from 67 patients with macular corneal dystrophy were immunolabeled with the antibodies. In 31 corneas the abnormal accumulations did not react with any of the antikeratan sulfate antibodies, but 18 corneas reacted with all of the antibodies. The remaining corneas reacted with various combinations of the antibodies. The data suggest that the accumulations in macular corneal dystrophy are not always identical and that keratan sulfate is present in some cases but not in others. Thus, based on differences in the storage material, macular corneal dystrophy appears to manifest heterogeneity with at least two distinct varieties: keratan sulfate negative (type 1) and keratan sulfate positive (type 2). PMID- 3293460 TI - Expulsive choroidal hemorrhage following suture removal after penetrating keratoplasty. PMID- 3293461 TI - Ethical considerations in clinical reasoning: the impact of technology and cost containment. AB - This article raises, but does not answer, the kinds of questions that need to be asked by responsible occupational therapists in the 1980s--ethical questions that deal with technological advances on the one hand and limited resources on the other. The article examines moral dilemmas that practitioners and students face when making clinical decisions in a climate where technology and cost containment may overshadow the needs of the individual patient. A review of the literature on clinical reasoning, technology, and cost containment provides the background for a discussion of specific issues of quality of life for the occupational therapist. Implications for education and practice are presented, with suggestions for further consideration. PMID- 3293462 TI - Appealing Medicare denials. AB - Because of the government's recent emphasis on controlling health care costs, health care providers have been receiving many more denials for payment of services rendered to Medicare beneficiaries than in the past. Often the denials are not justified and should be appealed. This article explains the step-by-step procedure in the Medicare appeals process and gives suggestions for presenting a case so that a denial will have a good chance of being overturned. PMID- 3293463 TI - beta-amyloid protein of Alzheimer's disease is found in cerebral and spinal cord vascular malformations. AB - Congo/Red deposition with birefringence to polarized light was demonstrated focally in cerebrovascular malformations removed surgically from 4 older patients (ages 85, 74, 74, and 63), and in a spinal cord vascular malformation in a 76 year-old patient. Lesser degrees of Congophilic change were observed in cerebrovascular malformations screened from 4 of 10 patients between the ages of 30 and 59. No Congophilic change was seen in 10 cerebrovascular malformations removed from patients under 30 years of age. Congophilic areas in all cases decorated with W-2 and 85/45 polyclonal antibodies raised to peptide sequences of cerebrovascular beta-amyloid and beta-amyloid of senile plaques from patients with Alzheimer's disease. Thus, the amyloid in these vascular malformations is immunologically related to beta-amyloid protein. This finding provides another indication that vascular beta-amyloid deposition is not specific for Alzheimer's disease and suggests that an existing abnormality of vessels may be a predisposing factor. PMID- 3293465 TI - Do osmotic forces play a role in renin secretion? AB - Secretory granules swell during exocytosis. Swelling may follow fusion and assist in extrusion of the granular content, or swelling may cause granular fusion with the plasmalemma. A granular proton gradient has been suggested to be involved in such preexocytic granular swelling. Exocytosis of renin from juxtaglomerular cells of isolated preparations is very sensitive to changes in the extracellular osmolality. Extracellular hyposmolality causes swelling of secretory granules, fusions between peripherally located granules and plasmalemma, and an increased number of release episodes. Induction of granule swelling at constant extracellular osmolality also stimulates renin release. Newly recruited renin granules are osmosensitive, and a high extracellular osmolality blocks secretion induced by other means (low calcium). Dissipation of granular proton gradients inhibits renin release without affecting the osmosensitivity. Thus, in renin release in vitro, a granular swelling precedes fusion and exocytosis, and a granular proton gradient may contribute to preexocytic swelling when extracellular osmolality is constant. The osmosensitivity may be important for macula densamediated renin release. PMID- 3293464 TI - Depletion of bronchus-associated lymphoid tissue associated with lung allograft rejection. AB - Pulmonary infections remain one of the major complications of lung transplantation. The bronchus-associated lymphoid tissue (BALT) forms a local immune system that normally protects the lung from infection. The effects of lung transplantation and lung allograft rejection on the BALT were examined using immunoperoxidase techniques. The BALT was evaluated by quantifying the number of immunoglobulin-bearing plasma cells in the lamina propria of sections of trachea and mainstem bronchus. Sections of donor mainstem bronchus from 2 patients with allograft rejection were compared with sections of native trachea from these same patients, and with sections of mainstem bronchus from 2 transplanted lungs without rejection and 20 controls. Lung allografts from the 2 patients with rejection had a marked depletion of submucosal IgA-bearing and IgG-bearing plasma cells. Two sets of transplanted lungs without evidence of rejection showed only a mild reduction of the BALT. The depletion of BALT associated with allograft rejection may contribute to the increased incidence of pulmonary infections seen in these patients. PMID- 3293466 TI - Localization and secretion of newly synthesized and stored renin: two compartments and secretory mechanisms. AB - Intracellular pathways of renin secretion were examined by use of rat renal cortical slices. Renin was labeled with [35S]methionine by incubating the cortical slices for 2 h. The labeled immunoprecipitable renin was found in microsomal fraction (F1) but not in the renin granule fraction (F2). The newly synthesized and radiolabeled renin was secreted from the incubated slices into the medium. The rate of secretion of the labeled renin activity was not increased by 10(-6) M isoproterenol, whereas secretion of total renin activity was markedly stimulated. The isoelectric focusing patterns of renin in F1 and F2 were compared with those secreted with or without isoproterenol. The pattern of F1 was similar to that secreted in the medium without stimulation. These studies suggest that a constitutive pathway exists for renin secretion from the kidney and that the constitutive (nonstimulable) pathway is responsible for the secretion of newly synthesized renin and that it is not stimulated by a beta-adrenergic mechanism. PMID- 3293467 TI - Evidence for active dipeptide transport in isolated proximal straight tubules. AB - Transport of the dipeptide glycylsarcosine (Gly-Sar) was examined in isolated proximal straight tubules of the rabbit kidney by an in vitro microperfusion technique to determine whether it can be actively transported intact. The unidirectional lumen-to-bath flux of Gly-Sar was measured by two separate methods, namely its appearance rate (JA) in the bathing fluid and its disappearance rate (JD) from the luminal fluid. In addition, the cell Gly-Sar concentration was measured immediately after the last flux period. Mean luminal fluid Gly-Sar concentration was 0.22 mM. Transepithelial Gly-Sar flux (260.0 fmol.min-1.mm-1) was greater than could be accounted for by passive leakage, whereas cellular Gly-Sar accumulation (2.72 mM) was greater than could be attributed to passive equilibration across the luminal membrane. High-pressure liquid chromatographic analysis of cellular extract indicated that 63% of the transported Gly-Sar was hydrolyzed within the cell. Analysis of the bath solution revealed that 47% of the radioactivity that crossed the tubule cell was in the form of intact dipeptide, whereas the remainder of the radioactivity was in the form of hydrolytic and metabolic products of Gly-Sar. This indicates that the dipeptide Gly-Sar is actively transported intact at the luminal membrane into the cytosol of proximal straight tubule cells with subsequent hydrolysis. It then exits across the basolateral membrane as intact Gly-Sar and its hydrolytic and metabolic products. PMID- 3293468 TI - Acute saline loading in normal and bilaterally atrial-resected conscious dogs. AB - Acute isotonic saline volume loads (400 ml) were intravenously administered to conscious, renal-denervated dogs before and after bilateral removal of the atrial free walls and atrial appendages to determine the role of atrial-mediated hormonal factors in the renal excretory response. In one group of dogs (n = 11), the volume was given in 10 min; in another group (n = 5), the volume was given in 30 min while arginine vasopressin (AVP) was infused to maintain plasma AVP at a fixed, normal level (3 pg/ml). Sodium and water excretion, mean arterial pressure, and plasma hormone levels were determined before and for 5 h after volume loads. Atrial resection resulted in a 40-50% reduction of sodium and water excretion in both groups during the first 2 h after volume expansion. The blunted renal excretory responses could not be explained by differences in arterial pressure, renal sympathetic nerve activity, or by hormonal differences of plasma immunoreactive atrial natriuretic factor (iANP), plasma AVP, plasma renin activity, or plasma aldosterone. Plasma iANP was not significantly increased by the volume load in either the normal or atrial-resected state. Atrial-resected dogs exhibited normal plasma levels of iANP. The data indicate the presence of an unidentified diuretic and natriuretic substance, which is released with volume expansion from either the cardiac atria or via the central nervous system, and that the release of this factor is removed by atrial resection. PMID- 3293469 TI - Excretion of prostacyclin and thromboxane A2 metabolites during leg exercise in humans. AB - Urinary levels of 2,3-dinorthromboxane B2 (Tx-M) and 2,3-dinor-6 ketoprostaglandin F1 alpha (PGI-M), measured by gas chromatography-negative ion chemical ionization mass spectrometry, accurately reflect in vivo biosynthesis of thromboxane A2 (TxA2) and prostacyclin (PGI2), respectively. Although the basal excretion of Tx-M and PGI-M is adequately documented, no systemic data on the excretion during controlled exercise have been presented. We studied the effect of maximal tolerated exercise (2 h of bicycle ergometry) on the excretion of Tx-M and PGI-M in healthy humans. In addition, their urinary levels of epinephrine (E) and norepinephrine (NE) were analyzed. To address the impact of locally formed adenosine, all subjects were reinvestigated after administration of theophylline. Exercise did not affect the excretion of Tx-M (47 +/- 21 vs. 34 +/- 9 pg/mg creatinine) but increased the excretion of PGI-M (74 +/- 14 vs. 267 +/- 70 pg/mg creatinine; P less than 0.02). Theophylline augmented urinary NE and E but did not significantly change the PGI-M response to exercise. We suggest that the normal cardiovascular eicosanoid response to exercise is a platelet-independent increase in vascular PGI2 formation. PMID- 3293470 TI - Effects of altered left atrial pressure on pulmonary vascular pressure-flow relationships. AB - We studied the effects of changes in pulmonary capillary wedge pressure (PCWP) on the slope (incremental resistance) and the extrapolated pressure intercept (PI) of the mean pulmonary artery pressure (PAP)-cardiac output (CO) relationship. Multipoint plots of PAP against CO were obtained in intact anesthetized dogs. Group 1 consisted of six dogs entirely in West zone 3 and group 2 of four dogs with mixed West zone 2-3. The four conditions studied were the following: 1) fixed low PCWP, 2) fixed high PCWP, 3) variable PCWP, and 4) time-control repeat of condition 1. The PI significantly exceeded PCWP at fixed low PCWP (group 1, 9.3 vs. 11.1 mmHg, group 2, 6.6 vs. 3.9 mmHg). PI became identical to PCWP only at fixed high PCWP in group 1 (19 +/- 2.0 vs. 19 +/- 1.1 mmHg). Thus PCWP reflects the effective vascular outflow pressure when PCWP is fixed and high. For both groups of dogs in condition 3, when PCWP was varied with CO, the slope of the resulting PAP-CO plot was significantly greater than when PCWP was constant. Also in 9 of 10 dogs, PI was less than PCWP when PCWP was varied. These findings demonstrate that when changes in PCWP are allowed to occur during the generation of a pulmonary artery pressure-flow plot, the resulting slope and intercept, as defined by a Starling resistor model, do not accurately represent the incremental resistance and outflow pressure of the pulmonary vasculature. PMID- 3293471 TI - Energy balance in adrenalectomized ob/ob mice: effects of dietary starch and glucose. AB - Effects of different carbohydrate types on energy balance, fatty acid synthesis, and plasma insulin concentrations in adrenalectomized ob/ob mice were investigated. Obese (ob/ob) and lean mice adrenalectomized at 4 wk of age received one of four high-carbohydrate powdered diets for 3 wk: stock, glucose, starch, or starch plus wheat bran. Adrenalectomy reduced energy intake of ob/ob mice equally independent of diet type, whereas energetic efficiency, in vivo rates of fatty acid synthesis in liver and white adipose tissue, and plasma insulin concentrations were substantially reduced to approach values in lean mice in all adrenalectomized ob/ob mice except those fed glucose. The ability of adrenalectomy to normalize energy balance in ob/ob mice depends on factors other than the reduced circulating concentration of glucocorticoids alone. Diet composition is a crucial factor, and striking differences exist between semipurified diets containing a simple sugar (glucose) and those containing a complex carbohydrate (starch), with no additional effect of dietary fiber (wheat bran). PMID- 3293472 TI - Comparison of hormonal responses to hypotension in mature and immature fetal lambs. AB - We studied norepinephrine (NE) and plasma renin activity (PRA) responses to sodium nitroprusside (NP)-induced hypotension in seven chronically catheterized fetal lambs 0.79-0.94 gestation (mature) and in seven fetuses 0.64-0.72 gestation (immature) 4 or 5 days after surgery. We infused intravenously 5% dextrose in water (DW) or NP in DW to reduce arterial pressure 30% in fetuses for 10 min. Initial infusion choice was random, and the two infusions were separated by 24-48 h. In both groups, basal NE levels were similar and doubled in response to hypotension. In mature fetuses, PRA basal levels were 6.89 +/- 1.80 ng.ml-1.h-1 and increased two- to threefold with hypotension. In immature fetuses, PRA basal levels were 2.42 +/- 0.86 ng.ml-1.h-1 and did not change with hypotension. No changes were observed with DW infusion in either group. Arterial blood gases were normal and remained unchanged. We conclude that in the lamb fetus, NE responses to hypotension are present before and are independent of the development of PRA responses and that before 0.72 gestation there is a functional deficit in the renin-angiotensin system. PMID- 3293473 TI - Psychiatric decision making in the emergency room: a research overview. AB - In an overview of the research on psychiatric decision making in the emergency room, the authors discuss studies done between 1963 and 1977, which suffered from an overreliance on univariate statistical techniques, problems with the reliability and validity of the instruments used for data collection, and the lack of alternatives to hospitalization for emergency room patients. More recent studies of emergency room decision making are then reviewed, with particular attention to those that had multivariate statistical designs. The article concludes with a synthesis of the research findings to date and recommends multivariate approaches and choices of variables for future studies. PMID- 3293474 TI - The heterogeneity of schizoaffective disorder: implications for treatment. AB - Until the 1970s, schizophrenia tended to be broadly defined in the United States, and the diagnosis subsumed patients who had affective as well as schizophrenic symptoms. With the introduction of lithium, however, manic-depressive illness became susceptible to treatment and gained attractiveness as a diagnosis. The ambiguous position of patients with schizoaffective disorder became clear. Cross sectionally they were seen to resemble schizophrenic patients, but longitudinally they were more akin to patients with affective disorder. Numerous studies have attempted to establish that they are diagnostically distinct, but without clear results. The authors suggest that schizoaffective disorder is heterogeneous and that its treatment should be determined by specific indices as to its subtype. PMID- 3293475 TI - Surgery, recall antigens, immunity, and bacillus Calmette-Guerin vaccination. PMID- 3293476 TI - Early diagnosis of iliofemoral venous thrombosis by Doppler examination. AB - The diagnosis of iliofemoral venous thrombosis prior to its progression to phlegmasia cerulea dolens can be difficult and, at times, confusing. The Doppler ultrasound examination in experienced hands can be extremely reliable and rapid in diagnosing the condition. During an 18 month period, we used the Doppler examination to diagnose iliofemoral venous thrombosis in 21 patients, 15 of whom had corroboration by venogram. The key to successful treatment and avoidance of significant complications was early and accurate diagnosis by the Doppler examination. No patient underwent operation or progressed to venous gangrene. Six were treated with streptokinase and the rest, with intravenous heparin, leg elevation, and stockings. We believe that iliofemoral venous thrombosis is a much more common disease than previously recognized and should be vigorously diagnosed and treated when a patient presents with a symptomatic extremity. The Doppler ultrasound examination represents a rapid, reliable alternative to the venogram in the early diagnosis of iliofemoral venous thrombosis. PMID- 3293477 TI - Use of serum drug concentrations in surgical patients. AB - Surgical patients frequently require drug treatments that can be assessed with serum drug concentrations. Of the agents for which serum drug concentrations are routinely available, the aminoglycosides theophylline, vancomycin, digoxin, and phenytoin are used most frequently in surgical patients. When using serum drug concentrations, the clinician should have an understanding of the relationships (or lack of) between drug concentrations and therapeutic or toxic effects. When blood is collected for serum concentration determinations, the exact timing of the sample in relation to the dose must be considered. For some drugs, (such as the aminoglycosides, it is necessary to determine peak and trough concentrations, whereas for other agents, like theophylline, the average or mid-dose level may be more important to consider. There are many factors that affect serum drug concentrations. Among these are various disease states, obesity, fluid imbalances, the drug dosage form used, and concurrent drug use. Not all patients require serum drug concentration monitoring; however, with each drug there are high-risk patients who may benefit. When used properly, serum drug concentrations may be helpful in maximizing therapeutic benefits, minimizing or diagnosing drug toxicity, and assessing patient compliance with drug regimens. PMID- 3293478 TI - [The Laborit rhapsody of knowledge]. PMID- 3293479 TI - [Endocrine reaction pattern: midazolam-fentanyl anesthesia versus inhalation anesthesia]. AB - In a randomised controlled study in 16 orthopaedic patients, the influence of midazolam-fentanyl-N2O/O2 anesthesia (group A) resp. halothane-N2O/O2 anesthesia (group B) on the plasma concentrations of the endocrine parameters ACTH, aldosterone, cortisol, 17-DHEA, insulin, prolactin, T3, T4, TBG (thyroxine bounded globuline) as well as adrenaline, noradrenaline, and dopamine was investigated. Additionally the metabolites glucose, lactate, free glycerin, and acetacetate were measured. Beside prolactin values, only the values for ACTH, aldosterone, cortisol, and 17-DHEA differed with respect to both anesthesia methods. Under halothane-N2O/O2 anesthesia free T4 rose initially also, here represented by T4/TBG-ratio (= FTI). However, the fall of T3 concentration showed no phase - resp. anesthesia-specific changes. Catecholamine levels reached highest values towards the end of operation resp. one hour after extubation in both groups. The insulin secretion, however, was not significantly raised in either group during acute stress phases. As an expression of modified metabolic regulation comparable rises of plasma levels of glucose, lactate, free glycerin, and acetacetate were observed under midazolam-fentanyl-N2O/O2 anesthesia as well as under halothane-N2O/O2. According to presented data, both methods of anesthesia modulated the endocrine metabolic response of the organism to surgical stress, without showing any clinically relevant advantages or disadvantages attributable to either method. PMID- 3293480 TI - The prevention of gastric inflation--a neglected benefit of cricoid pressure. AB - The ability of cricoid pressure to prevent inflation of the stomach during mask ventilation of a patient was studied. Fifty patients were randomly allocated to either have or not have cricoid pressure applied during a three-minute period of standardised mask ventilation. Patients who had had cricoid pressure applied had less gas in the stomach after mask ventilation (P less than 0.001). However, in a subgroup of patients considered difficult to ventilate, cricoid pressure seemed less successful in preventing gastric inflation. Cricoid pressure is a useful technique for reducing gastric inflation during mask ventilation, particularly in patients who are relatively easy to ventilate. PMID- 3293481 TI - Low volume processing of protein blots in rolling drums. AB - We have evaluated an improved method for processing protein blots on nitrocellulose or nylon membranes using cylindrical plastic containers. The method, which is directly analogous to the commonly used method of photographic processing in rolling drums, uses small values of reagents which are constantly washed over the blotting membrane by rotating the drum horizontally on a roller mixer. Volumes of reagents used are typically less than one-10th of those required for conventional methods using plastic bags or trays. The efficiency of probing and washing steps are greatly improved, giving an all-round increase in sensitivity, ease of processing, and economy of reagents. PMID- 3293482 TI - Purification of ornithine aminotransferase by immunoadsorption. AB - Ornithine aminotransferase was purified by conventional biochemical methods from rat kidney, rat liver, and human liver. Affinity-purified antibodies raised to the rat kidney enzyme were used to produce an immunoadsorbent enabling a one-step purification of ornithine aminotransferase to be made from crude human liver extracts. The harsh chemical conditions often required to desorb immunoadsorbents were avoided by isolating antibodies with low functional affinity and employing an electrophoretic desorption method which allowed the enzyme activity to be retained. The close structural similarity between human and rat ornithine aminotransferase was demonstrated by immunodiffusion reactions. It was therefore possible to purify the enzyme from human liver using immobilized antibodies raised against rat kidney ornithine aminotransferase. Furthermore, desorption was more readily achieved due to the lower affinity for the human enzyme. PMID- 3293484 TI - Ultrasound versus culdocentesis in the evaluation of early and late ectopic pregnancy. AB - A retrospective study of patients found to have ectopic pregnancy was undertaken to determine the relative usefulness of culdocentesis and ultrasound in the evaluation of early and late presentations. The patient's history was used as the sole determinant of gestational age, and results of culdocentesis and/or ultrasound were reviewed. In early presentations (less than 42 days gestation), 38% of ultrasound examinations and 89% of culdocenteses performed were positive. In late presentations, 93% of ultrasound examinations and 70% of culdocenteses performed were positive. The difference between the modalities' performance was significant (P less than .05) for both early and late presentations. These data could provide the basis for a prospective study to test the hypothesis that culdocentesis is the diagnostic test of choice in early suspected ectopic pregnancy, whereas ultrasound is more likely to yield clinically useful information in patients presenting after six weeks gestation. PMID- 3293483 TI - Hemodynamic profiles of prostaglandin E1, isoproterenol, prostacyclin, and nifedipine in vasoconstrictor pulmonary hypertension in sheep. AB - Patients with pulmonary hypertension challenge the anesthesiologist with complex alterations of hemodynamic function. To study the effects of multiple therapeutic interventions, a stable model of pulmonary hypertension in sheep was developed using continuous infusion of the vasoconstrictor U46619, a thromboxane A2 mimetic. The pulmonary and systemic effects of four pulmonary vasodilators (prostaglandin E1, isoproterenol, prostacyclin, and nifedipine) were compared at doses producing equivalent reduction in systemic blood pressure. Although all four drugs decreased pulmonary artery pressure and resistance, distinct differences in drug hemodynamic profiles were found. Prostaglandin E1 and isoproterenol demonstrated the greatest pulmonary specificity, increased cardiac output significantly, and decreased pulmonary vascular resistance. Prostaglandin E1 produced the largest decrease in pulmonary artery pressure (from 31 +/- 1 to 22 +/- 2 mm Hg). Isoproterenol markedly increased heart rate (from 119 +/- 6 to 182 +/- 10 beats/min) and resulted in significant dysrhythmias that necessitated limiting infusion of this drug; isoproterenol did not affect stroke volume. Prostacyclin demonstrated intermediate pulmonary specificity and produced the largest increase in cardiac output (from 1.7 +/- 0.2 to 3.1 +/- 0.3 L/min). Nifedipine exhibited the least pulmonary specificity and was the least effective agent in decreasing pulmonary artery pressure. In this model different pulmonary vasodilators exerted different hemodynamic effects, suggesting that appropriate drug selection for treatment of pulmonary hypertension should depend on baseline heart rate and rhythm, pulmonary artery pressure, systemic artery pressure, arterial oxygenation, and cardiac output. PMID- 3293485 TI - Painless aortic dissection presenting as spinal cord ischemia. AB - A 67-year-old woman developed a transient paraplegia as the initial manifestation of acute aortic dissection. Chest or abdominal pain was not present. Magnetic resonance imaging of the thorax demonstrated dissection of the aortic root, aortic arch, and descending aorta as well as pericardial effusion. Ultrasonography of the abdomen revealed an intimal flap in the region of the artery of Adamkiewicz. During aortic dissection, temporary obstruction of spinal arteries may result in transient paraplegia. Painless aortic dissection should be considered in patients who present with transient myelopathy. PMID- 3293486 TI - Pharmacokinetics of gentamicin in cats given Escherichia coli endotoxin. AB - Nineteen cats were given 3 mg of gentamicin sulfate/kg of body weight by rapid IV, SC, or IM injection for baseline values. Serum concentration of gentamicin vs time data were analyzed using a noncompartmental model based on statistical moment theory. One week later, each cat was given 0.5 microgram of Escherichia coli endotoxin/kg, IV. After cats had an increase in rectal temperature of at least 1 C, 3 mg of gentamicin/kg was administered by the same route used the previous week. Serum concentration of gentamicin vs time data were analyzed, and pharmacokinetic values were compared with base-line values. For IV studies, the half-life (t1/2) of gentamicin and the mean residence time were significantly different (P less than 0.05) compared with base line, whereas the total body clearance and apparent volume of distribution at steady state were not. The harmonic mean +/- pseudo SD for the t1/2 of gentamicin after IV administration was 76.8 +/- 12.6 minutes for base line and was 65.2 +/- 12.2 minutes in the same cats given endotoxin. The t1/2 of gentamicin after SC administration was 74.6 +/- 6.2 minutes for base line and was 65.2 +/- 13.6 minutes in the same cats given endotoxin. After IM administration, the t1/2 of gentamicin was 60.3 +/- 10 minutes for base line and was 59.7 +/- 13.6 minutes in the same cats given endotoxin. After IV administration of gentamicin, the arithmetic mean +/- SD for the mean residence time was 102.4 +/- 16.1 minutes for base line vs 79.2 +/- 18.4 minutes in the same cats given endotoxin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293487 TI - Pathologic changes and tissue gentamicin concentrations after intravenous gentamicin administration in clinically normal and endotoxemic cats. AB - Hematologic and serum biochemical values, tissue gentamicin concentrations, and renal pathologic changes were determined in clinically normal and endotoxemic cats given 3 mg of gentamicin/kg of body weight, IV. Endotoxemia was induced by IV administration of 0.5 microgram of Escherichia coli endotoxin/kg of body weight. In experiment 1, 6 cats were given endotoxin. After rectal temperature increased at least 1 degree C, cats were given gentamicin. Blood samples were collected before and at 1 and 3 hours after administration of gentamicin. With the exception of severe leukopenia, other hematologic changes or changes in serum biochemical values were not observed. In experiment 2, 24 cats were allotted to 4 groups and were given gentamicin, endotoxin, gentamicin plus endotoxin, or neither substance. Three hours later, cats were euthanatized, and tissue and body fluid specimens were obtained and were assayed for gentamicin concentration. Kidney specimens were examined microscopically. Endotoxemic cats had more gentamicin in the renal medulla than did control cats, but none of the cats had detectable renal lesions. The possible nephrotoxic synergism between gentamicin and severe endotoxemia and the lack of major differences in gentamicin concentration in extrarenal tissues indicated that the dosage of gentamicin in endotoxemic cats does not have to exceed the dosage recommended for clinically normal cats. A single dose of gentamicin administered IV did not cause renal damage in mildly endotoxemic cats, but nephrotoxicity ascribed to multiple doses of gentamicin in more severely endotoxemic cats needs to be evaluated. PMID- 3293488 TI - Duration of immunity and efficacy of an oil emulsion Escherichia coli bacterin in cattle. AB - An oil emulsion Escherichia coli bacterin administered in 1- and 2-dose vaccination regimens was evaluated in beef cattle. Serologic responses to the K99 pilus antigen were monitored, and suckling offspring from vaccinated and nonvaccinated cows were inoculated with virulent, K99-positive, enterotoxigenic Escherichia coli. The degree of protection and duration of immunity conferred were determined in 2 respective studies. In the first study (study A), titers of pregnant cattle were determined from time of vaccination through calving (a 6- to 20-week period). Titers of 24 cows vaccinated with a single 2-ml dose of bacterin were compared with those of 24 cows given a 2-dose regimen and with those of 23 nonvaccinated cattle (contemporary controls). Inoculum consisting of 1.2 X 10(12) viable enterotoxigenic E coli/dose administered to nursing calves from these dams yielded 0% mortality (0 deaths/20 calves) in calves from 1-dose vaccinates, 6% mortality (1 death/18 calves) in calves from 2-dose vaccinates, and 37% mortality (7 deaths/19 calves) in calves from nonvaccinated dams. Study B was an extended evaluation conducted in cattle that were kept in the study up to 87 weeks from initial vaccination until calving. Serologic titers to the K99 pilus antigen were compared in 1-dose, 2-dose, and nonvaccinated cattle in groups of 8, 6, and 6, respectively. Calves from these dams were inoculated with 8.1 X 10(11) viable enterotoxigenic E coli/dose, which resulted in 0% mortality (0 deaths/5 calves) in calves from 1-dose vaccinates, 0% mortality (0 deaths/5 calves) in calves from 2-dose vaccinates, and 80% mortality (5 deaths/6 calves) in calves from nonvaccinated dams. PMID- 3293489 TI - Function of phagocytes obtained from lacteal secretions of lactating and nonlactating cows. AB - Phagocytes, macrophages and neutrophils, were obtained from lacteal secretions of lactating (n = 13) and nonlactating cows (n = 14). Secretions from nonlactating cows were collected at 7 and 14 days after cessation of lactation. Phagocytes were incubated in vitro with Staphylococcus aureus or Escherichia coli, and function was assessed by fluorescent microscopy of cell suspensions stained with acridine orange and crystal violet. A greater percentage of macrophages from nonlactating cow secretions collected on day 14 phagocytized bacteria than did those collected on day 7. A greater percentage of macrophages from nonlactating cow secretions collected on days 7 and 14 phagocytized bacteria than did neutrophils obtained from the same secretions. A similar percentage of phagocytes from nonlactating cow secretions phagocytized bacteria, compared with phagocytes from lactating cow secretions. Results indicated that the intramammary macrophage may be most important in defense of the mammary gland during the early nonlactating period, because it was more phagocytic than the neutrophil and was more active at 14 days than at 7 days into the nonlactating period. PMID- 3293490 TI - Investigation of passive venovenous shunts during the anhepatic period of canine hepatic transplantation. AB - The anhepatic period of canine orthotopic hepatic transplantation is usually accompanied by cardiovascular instability due to occlusion of both the portal and inferior systemic venous systems. The present study was undertaken in order to determine some of the hemodynamic and renal alterations that occur during a 2 hour anhepatic period in the dog and to investigate the use of a passive endoportal, endocaval venovenous shunt that places both the portal and infrahepatic vena caval limbs of the shunt directly into the divided ends of these vessels. Three groups of experimental animals were studied. One group had hepatectomy without a shunt and was compared with two other groups which had hepatectomy with some form of venovenous shunting. Systemic arterial blood pressure, portal and inferior vena caval pressure, urinary output, and renal histology were all better maintained when a shunt was used. PMID- 3293491 TI - Vibrio vulnificus--a new monster of the deep? PMID- 3293492 TI - Monoclonal antibodies in the treatment of B-cell malignancies. PMID- 3293493 TI - A novel antinuclear antibody associated with a lupus-like paraneoplastic syndrome. AB - The association of malignancy with lupus-like syndromes is rare, and the relation between these two processes is uncertain. A 71-year-old woman who presented with serositis, Raynaud phenomenon, and positive results on an antinuclear antibody test was initially thought to have systemic lupus erythematosus but was found to have ovarian adenocarcinoma. A unique sparsely speckled antinuclear antibody pattern was seen. The patient's sera reacted to novel antigens with six bands of 100, 80-78, 48, and 17 kD on Western blots not typical of reactivity for sera from patients with systemic lupus erythematosus. PMID- 3293495 TI - Intraoperative ketoacidosis and malnutrition. PMID- 3293494 TI - Silent myocardial ischemia. AB - Silent myocardial ischemia has emerged from a subject of mainly research interest to one with important clinical implications for practicing physicians. Although the pathophysiologic mechanisms responsible for the absence of pain are still not clear, it is apparent that episodes of silent myocardial ischemia are frequent and occur in many patients with coronary artery disease; episodes occur both in asymptomatic and symptomatic patients; episodes are detectable by various noninvasive and invasive techniques; and episodes appear to have important prognostic implications when combined with the extent of anatomic disease and degree of left ventricular dysfunction. It is expected the rapidly accumulating prognostic data, especially in patients after infarctions and patients with unstable angina, will have a profound effect on the way physicians treat their patients with coronary artery disease. PMID- 3293496 TI - Nonsteroidal anti-inflammatory drugs, and hypertension. PMID- 3293497 TI - [Acute interstitial nephritis caused by drug hypersensitivity. Current controversies]. AB - Acute interstitial nephritis (AIN) due to drug hypersensitivity represents 0.8 to 8 p. 100 of all causes of acute renal failure. Two thirds of cases are due to antibiotics, mainly beta-lactamines, and to non-steroidal anti-inflammatory drugs. Blood hypereosinophilia, fever, arthralgias and/or hepatocellular damage are suggestive of an allergic drug reaction in patients with AIN, with a sensitivity of 0.75 and a specificity of 0.76. Examination of an early renal biopsy specimen is a clue to the diagnosis of AIN due to drug hypersensitivity if it discloses a diffuse or focal interstitial infiltration with lymphocytes, plasma cells, and mainly by eosinophils and/or epithelioid cell granulomas. These findings suggest a delayed hypersensitivity reaction, although many cases seem to be also mediated by humoral immune factors. Renal recovery is frequent when the responsible drug is promptly withdrawn. The value of steroid therapy in preventing residual renal damage has to be assessed by controlled studies. PMID- 3293498 TI - Acute renal disease in vasculitis. AB - Vasculitis is commoner than supposed, since its manifestations are Protean. A simple classification of vasculitis is outlined and an approach to renal vasculitis described. Recent papers on the subject are summarized, and recent advances in understanding of the role of cell-mediated immunity in the pathogenesis of vasculitis outlined. The treatment of renal vasculitis accompanied by renal insufficiency is summarized, with a note on Henoch-Schonlein purpura. The prognosis for patients with severe renal vasculitis, whether Wegener's granuloma or microscopic polyarteritis, has improved considerably over the past three decades, using immunosuppression with corticosteroids, orally or intravenously, cytotoxic agents, and plasma exchange backed up by dialysis as necessary. The principal problems now relate to the management of immunosuppression in the long term survivors. PMID- 3293499 TI - The advantages of immunosuppressive therapy in renal disease. AB - The beneficial effects of steroids and/or immunosuppressive drugs in idiopathic nephrotic syndrome are rarely disputed. On the other hand, there are contrasting ideas on the usefulness of this therapy in some forms of glomerulonephritis (GN) such as rapidly progressive GN and membranous GN with nephrotic syndrome. Many observations suggest that methylprednisolone pulse and/or plasma exchange associated with cyclophosphamide may significantly improve the natural course of rapidly progressive GN. Moreover, our treatment schedule consisting of methylprednisolone and chlorambucil alternatively given for 6 months significantly increases the chances of a complete remission of the disease in patients with membranous GN and nephrotic syndrome. PMID- 3293500 TI - Correlation between complement-fixing islet-cell antibodies and the clinical onset of insulin-dependent diabetes. PMID- 3293501 TI - [Advantages of pulsatile administration of human insulin on endogenous pancreatic secretion in the normal subject and in type 1 diabetics]. PMID- 3293502 TI - [Rectal administration of insulin]. PMID- 3293503 TI - Prevention of exercise-induced hypoglycaemia in type 1 (insulin-dependent) diabetic patients on conventional intensified insulin therapy: timing of exercise and role of counter-regulatory hormones. PMID- 3293505 TI - Antiviral chemotherapy today and tomorrow. AB - Antiviral chemotherapy has come of age. Several compounds, i.e. amantadine, rimantadine, idoxuridine, trifluridine, vidarabine, acyclovir, ribavirin and azidothymidine, have been licensed for clinical use and other promising compounds may follow soon. The search for new antiviral agents has been boosted by the advent of AIDS, but the activity spectrum of the newly developed antivirals not only spans retroviruses but also various other virus infections, i.e. herpes-, adeno-, pox- and rhinovirus infections. Clinical trials have been started with a variety of these new compounds and the prospects for an effective chemotherapy of several viral diseases certainly look bright. PMID- 3293504 TI - Serological markers in HIV infection. AB - HIV antigenaemia can be detected at or possibly before the onset of clinical symptoms of primary HIV infection. Approximately one week after the onset of HIV antigenaemia, a primary anti-HIV IgM response may occur. A week later, generally within 3 to 6 weeks after infection, anti-HIV IgG can be detected. After primary infection, most persons enter an asymptomatic stage, often with generalized lymphadenopathy of varying duration. Disease progression is associated with the appearance of persistent HIV antigenaemia and with a decline of antibody reactivity to the viral core proteins p17 and p24. PMID- 3293506 TI - Aspects of diabetes care in Britain, 1987. AB - The prevalence of diagnosed diabetes in Britain is rising rapidly. Hospital clinics are overcrowded and may only provide a rudimentary service. Various schemes have been devised to improve community care by involving hospital physicians and nurses. Trends towards increasing usage of human insulin, fixed ratio insulin mixtures and the Novopen, the declining popularity of CSII, and current attitudes towards diet are briefly summarised. Diabetic care in Britain has improved markedly over the past decade due particularly to improved patient education and the appointment of diabetes specialist nurses, but enormous logistical problems remain. PMID- 3293507 TI - Brain endothelium and interstitium as sites for effects of lead. PMID- 3293508 TI - Endothelial cell-astrocyte interactions. A cellular model of the blood-brain barrier. AB - Microvascular endothelial cells in the brain have a number of special properties that underlie formation of the blood-brain barrier (BBB) and contribute to control of the neuronal microenvironment. Evidence from transplantation experiments indicates that signals arising within brain rather than a programmed commitment of the endothelial cells are responsible for the expression of blood brain barrier properties. The close anatomic relationship between brain endothelial cells and the foot processes of astrocytes suggests a role for astrocytes as a source of the differentiation signals. It is now possible to isolate and separately culture populations of brain-derived endothelial cells and astrocytes. When the two cell types are grown together, a characteristic morphologic organization occurs that is associated with induction of enzymes and tight junctions similar to those found in vivo. Endothelial cells and astrocytes in culture differ in their production of and response to specific polypeptide growth factors. These findings provide the basis for a model of endothelial cell astrocyte interaction that may explain several aspects of BBB behavior. PMID- 3293510 TI - New directions in blood-brain barrier research. Studies with isolated human brain capillaries. PMID- 3293509 TI - Regional transport of some essential nutrients across the blood-brain barrier in normal and diseased states. PMID- 3293511 TI - [Current role of total esopharyngo-laryngectomy in cervico-facial cancerology. Apropos of 11 cases]. AB - Eleven patients underwent total esophagopharyngolaryngectomy for cancer, with colic or gastric digestive reconstructive surgery. Postoperative course is analyzed, contraindications and indications outlined and other methods of pharyngeal reconstruction discussed. An extension to the technique is proposed to include tumors requiring a circular pharyngolaryngectomy. Improvement in the very poor prognosis of these tumors can only be envisaged by the use of enlarged surgery combined with chemotherapy and radiotherapy. PMID- 3293512 TI - [Immunologic changes in linear scleroderma in children. Apropos of 11 cases]. AB - Immunologic data collected in 11 children (6 girls and 3 boys under fourteen) presenting with linear scleroderma were analysed in a retrospective study: 2 children presented with superficial linear scleroderma, 6 with monomelic scleroderma, 1 with dimelic scleroderma, 1 with the "en coup de sabre" variety associated with dimelic homolateral involvement, and another with "en coup de sabre" scleroderma combined with facial hemiatrophy: Antinuclear antibodies (ANA) were demonstrated in 9/11 cases (i. e. 81 p. 100). The immunofluorescence staining pattern was homogeneous in all nine with a low titer (less than 250 in 5 of them). ANA to single stranded DNA was present in 1/3. The demonstration of ANA in these 9 children was correlated with deep or extensive sclerosis with muscular involvement in 7. But neither the presence nor the titer of ANA were correlated with the subsequent development of osteoarticular sequelae. The level of total complement appeared to be lowered in 3/8 cases. No renal involvement was demonstrated. Blood tests for circulating immune complexes were positive in 4/8 patients. Skin biopsy for direct immunofluorescence was performed in 6 children and demonstrated immunoglobulin deposits in 4: three had IgM fixation on the dermo-epidermal junction, and one had speckled fixation of IgG on epidermal nuclei (this has not previously been reported in localized scleroderma). There data highlight: a--the high frequency of ANA in linear scleroderma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293513 TI - [Neurotrophic ulcerations in the area of the trigeminal nerve in Wallenberg's syndrome]. AB - We report two new cases of neurotrophic ulceration of the trigeminal nerve associated with Wallenberg syndrome, and we present the six cases published since the first description of the neurologic syndrome, in 1895. This peculiar etiology supports the argument for the dominant physiopathologic hypothesis: ulcerations due to multiple microtraumatisms caused by the thermoalgic anesthesia. PMID- 3293514 TI - [Photosensitivity after treatment with captopril]. PMID- 3293515 TI - [Acute inoculation Pasteurella infection. Contribution of ultrasonics]. PMID- 3293517 TI - [Acquired lymphedema]. PMID- 3293516 TI - [B19 parvovirus in human pathology]. PMID- 3293518 TI - The role of computed tomography in the study of vascular pathology. PMID- 3293519 TI - [Surgical treatment of chronic pancreatitis: improvement of drainage technics]. PMID- 3293520 TI - [Cancers of the rectum in local advanced stage. Results in 29 treated cases in 25 years]. PMID- 3293521 TI - [Aorto-enteral fistulae following aortic prostheses. Apropos of 5 cases]. PMID- 3293522 TI - Therapeutic implications of bacteriologic findings in mixed aerobic-anaerobic infections. PMID- 3293524 TI - Comparative in vitro activity of a new fluorinated 4-quinolone, T-3262 (A-60969). AB - The in vitro activity of a new quinolone, T-3262 [A-60969; DL-7-(3-amino-1 pyrrolidinyl)-1-(2,4-difluorophenyl)-6-fluoro-1-, 4-dihydro-4-oxo-1,8 naphthyridine-3-carboxylic acid monohydrate], was compared with those of ciprofloxacin, ofloxacin, ceftazidime, imipenem, and gentamicin. T-3262 inhibited 90% of isolates of the family Enterobacteriaceae at a concentration of less than or equal to 0.25 micrograms/ml. It was two to four times more active than ofloxacin and similarly or slightly less active than ciprofloxacin. Ninety percent of isolates of Pseudomonas aeruginosa were inhibited at 0.5 micrograms/ml. It was 4- to 8-fold more active than ciprofloxacin and 8- to 16 fold more active than ofloxacin against Pseudomonas cepacia and Pseudomonas maltophilia, which were resistant to imipenem and gentamicin. Most Haemophilus influenzae, Neisseria gonorrhoeae, and Branhamella catarrhalis isolates were inhibited at concentrations of less than or equal to 0.008 micrograms/ml. The MIC for 90% of the Staphylococcus aureus isolates, including methicillin-resistant S. aureus, was 0.12 micrograms/ml; that for Staphylococcus epidermidis was 0.5 micrograms/ml, as was that for Enterococcus faecalis. It inhibited 90% of Bacteroides fragilis isolates at 2 micrograms/ml, considerably more active than ciprofloxacin and ofloxacin. The frequency of spontaneous point mutational resistance was less than 10(-10) for members of the family Enterobacteriaceae and Pseudomonas spp. Resistant strains could be selected by repeated subculture. Similar to other quinolones, its activity could be affected by culture conditions. T-3262 showed a postantibiotic suppressive effect on Escherichia coli, P. aeruginosa, and S. aureus. PMID- 3293525 TI - Role of cell defense against oxidative damage in the resistance of Candida albicans to the killing effect of amphotericin B. AB - A laboratory-derived mutant of Candida albicans B311 (L) and a clinical isolate (C) of C. albicans, both lacking membrane ergosterol, were less susceptible to amphotericin B (AmB)-induced cell membrane permeability to K+ and lethality than was the wild-type laboratory strain (B311) which contained ergosterol. The resistance of L and C to AmB-induced killing was much greater than the level of resistance to AmB-induced cell membrane permeability. L and C were also less susceptible to killing by H2O2 than was B311, and when treated with menadione, they each produced less H2O2 than did B311. In addition, their levels of catalase activity were 3.8-fold (L) and 2-fold (C) higher than that of B311. The ergosterol deficiency in L and C probably impaired AmB binding to the cells, thereby lowering AmB effectiveness as measured by both cell membrane permeability and killing. Resistance of strains L and C to oxidation-dependent damage likely contributed to a diminished response to AmB-induced lethality. PMID- 3293526 TI - Evaluation of 500- and 1,000-mg doses of ciprofloxacin for the treatment of chancroid. AB - A randomized, double-blind study was performed comparing ciprofloxacin in a 500 mg single dose with 1,000 mg (500-mg doses given 12 h apart) for the treatment of chancroid in Thailand. Haemophilus ducreyi was isolated from 87 (48%) of 180 men with a clinical diagnosis of chancroid. For men with ulcers that were culture positive for H. ducreyi, rates of cure were 100% in the 500-mg group and 98% in the 1,000-mg group. For men with ulcers that were culture negative for H. ducreyi, rates of cure were 93% in the 500-mg group and 96% in the 1,000-mg group. The MIC of ciprofloxacin for 50% of isolates among 85 isolates of H. ducreyi was 0.007 micrograms/ml (range, 0.002 to 0.03 micrograms/ml). No significant adverse effects were detected in either group. These data indicate that both of these treatment regimens are equally effective therapies for chancroid in Thailand. PMID- 3293523 TI - Novel plasmid-mediated beta-lactamase in clinical isolates of Klebsiella pneumoniae more resistant to ceftazidime than to other broad-spectrum cephalosporins. AB - Multiresistant Klebsiella pneumoniae strains isolated from three patients in the same intensive care unit were more resistant to ceftazidime than to cefotaxime and aztreonam but remained susceptible to moxalactam and imipenem. Resistance to beta-lactams, kanamycin, streptomycin, sulfonamides, and tetracyclines was transferable to Escherichia coli by conjugation and was lost en bloc after treatment with ethidium bromide. Agarose gel electrophoresis of wild types and transconjugants indicated that these resistances were mediated by a 150-kilobase plasmid, pCFF14. The strains constitutively produced a beta-lactamase with isoelectric point close to 5.6 and which had a higher Vmax for ceftazidime and cephalothin than for cefotaxime. The substrate profile and isoelectric point of this enzyme thus differ from those of other known plasmid-mediated beta lactamases, including the broad-spectrum enzyme CTX-1. Hybridization studies support the derivation of the novel enzyme from a TEM-type beta-lactamase. PMID- 3293527 TI - Ribavirin small-particle-aerosol treatment of influenza B virus infection. AB - In a randomized double-blind trial of aerosolized ribavirin for the treatment of influenza B virus infection, no significant difference was found in the febrile course or symptom score of the ribavirin-treated versus placebo-treated patients. The apparent lack of efficacy in this study as compared with that in previous studies is unexplained. PMID- 3293528 TI - Radiochemical method for evaluating the effect of antibiotics on Escherichia coli biofilms. AB - A simple radiochemical method for evaluating the action of antibiotics on Escherichia coli cells in biofilms is reported. After growth, biofilms of E. coli ATCC 25922 on disks of urinary catheter material were suspended in fresh medium containing or lacking an antibiotic, incubated for 4 h at 37 degrees C, and pulse labeled with [3H]leucine for 5 min. Radioactivity in trichloracetic acid precipitable material in the biofilm and in the surrounding medium (planktonic E. coli) was then measured. Antibiotic-induced inhibition of incorporation of [3H]leucine into the cells in the biofilm was far less pronounced than incorporation into planktonic cells and, furthermore, correlated well with loss in viable counts. The method is simple, inexpensive, and extremely timesaving. PMID- 3293529 TI - Instability of protease production in a rel+/rel- -pair of Bacillus licheniformis and associated morphological and physiological characteristics. AB - A naturally occurring relaxed/protease-producing (A-type) versus stringent/not protease-producing (B-type) pair of an industrial Bacillus licheniformis has been characterized; either of the two types can convert into the other. Both types can sporulate, grow anaerobically, grow at 56 degrees C and reduce nitrate; morphologically, they can easily be distinguished by cell- and colony-shape. They differ in the ability to use 12 substrates, as determined in API-tests. The two types are remarkably different in their content of extrachromosomal elements (A type: 2; B-type: 4); furthermore, they differ in their rel-status (A-type: relaxed; B-type: stringent). We propose that the differences in the ability of the two types to use different substrates probably are due to integration/extrusion of the extrachromosomal elements in and out of the chromosome, distorting or restoring a number of genes, together with induction of certain catabolic genes that are under control of the rel-system. PMID- 3293530 TI - Antidepressants and weight gain. AB - Weight gain is an often reported, but incompletely understood, side effect of many antidepressant medications. We will discuss the literature with respect to the following issues: weight gain as a pharmacological effect of antidepressants or as an effect of recovery from depression; the incidence of antidepressant induced weight gain and possible reasons for individual variability in its occurrence; possible mechanisms of antidepressant-induced weight gain; and options for clinical management. Further elucidation of these issues may contribute to our understanding of the neurobiology of affective disorders and appetitive mechanisms. PMID- 3293531 TI - Initial characterization of a polyclonal antibody to an insulin-sensitive glycophospholipid. AB - This paper describes the production of a rabbit polyclonal antibody against an insulin-sensitive glycophospholipid from rat liver membranes. The immunogen was a highly purified glycophospholipid-tetanus toxoid conjugate. Immunoglobulin purified from immune serum reacted with a glycophospholipid-ovalbumin conjugate, indicating specificity for the glycophospholipid hapten and not the protein carrier. By radioimmunoassay the antibody recognized the purified glycophospholipid antigen but not other phospholipids including phosphatidylethanolamine, phosphatidylcholine, phosphatidylserine, and phosphatidylinositol. The antigenic site appears to be the carbohydrate portion of the glycophospholipid. The antibody also reacted with glycophospholipid purified from two rat hepatoma cell lines. Analysis of partially purified liver glycophospholipid by thin-layer chromatography revealed over 20 orcinol- or fluorescamine-positive bands, but immunostaining identified only 1 band. The latter had an Rf identical to those of the original glycophospholipid isolated from rat liver and metabolically labeled material isolated from hepatoma cells. The antibody should prove useful in determining the role of the glycophospholipid and its metabolites in insulin action. PMID- 3293532 TI - Purification and characterization of (+)dihydroflavonol (3-hydroxyflavanone) 4 reductase from flowers of Dahlia variabilis. AB - Individual flowers from inflorescences of Dahlia variabilis (cv Scarlet Star) in young developmental stages contained relatively high activity of (+) dihydroflavonol (DHF) 4-reductase. The DHF reductase was purified from such flowers to apparent homogeneity by a five-step procedure. This included affinity adsorption on Blue Sepharose and elution of the enzyme with NADP+. By gel filtration and by sodium dodecyl sulfate-polyacrylamide gel electrophoresis it was shown that DHF reductase contains only one polypeptide chain with a Mr of about 41,000. The reductase required NADPH as cofactor and catalyzed transfer of the pro-S hydrogen of NADPH to the substrate. Flavanones and dihydroflavonols (3 hydroxyflavanones) were substrates for DHF reductase with pH optima of about 6.0 for flavanones and of about 6.8 for dihydroflavonols. Flavanones were reduced to the corresponding flavan-4-ols and (+)-dihydroflavonols to flavan-3,4-cis-diols. Apparent Michaelis constants determined for (2S)-naringenin, (2S)-eriodicytol, (+)-dihydrokaempferol, (+)-dihydroquercetin, and NADPH were, respectively, 2.3, 2, 10, 15, and 42 microM. V/Km values were higher for dihydroflavonols than for flavanones. Conversion of dihydromyricetin to leucodelphinidin was also catalyzed by the enzyme at a low rate, whereas flavones and flavonols were not accepted as substrates. DHF reductase was not inhibited by metal chelators. PMID- 3293533 TI - Glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides: ligand-induced conformational changes. AB - Glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides is inactivated by trypsin, chymotrypsin, pronase E, thermolysin, 4.0 M urea, and by heating to 49 degrees C. It is protected, to varying degrees, against all these forms of inactivation by glucose 6-phosphate, NAD+, and NADP+. When these ligands are present at 10 times their respective KD concentrations, protection by NAD+ or glucose 6-phosphate is substantially greater than protection by NADP+. A detailed analysis was undertaken of the protective effects of these ligands, at varying concentrations, on proteolysis of glucose-6-phosphate dehydrogenase by thermolysin. This study confirmed the above conclusion and permitted calculation of KD values for NAD+, NADP+, and glucose 6-phosphate that agree with such values determined by independent means. For NADP+, two KD values, 6.1 microM and 8.0 mM, can be derived, associated with protection against thermolysin by low and high NADP+ concentrations, respectively. The former value is in agreement with other determinations of KD and the latter value appears to represent binding of NADP+ to a second site which causes inhibition of catalysis. A Ki value of 10.5 mM for NADP+ was derived from inhibition studies. The principal conclusion from these studies is that NAD+ binding to L. mesenteroides glucose-6-phosphate dehydrogenase results in a larger global conformational change of the enzyme than does NADP+ binding. Presumably, a substantially larger proportion of the free energy of binding of NAD+, compared to NADP+, is used to alter the enzyme's conformation, as reflected in a much higher KD value. This may play an important role in enabling this dual nucleotide-specific dehydrogenase to accommodate either NAD+ or NADP+ at the same binding site. PMID- 3293534 TI - [Prognostic factors of bone and soft tissue sarcomas]. AB - Prognostic factors of bone and soft tissue sarcomas were analyzed and common factors observed were the size of tumor, histological malignancy and metastasis. When these factors were viewed in advance of treatment, however, the prognosis of the sarcomas has definitely improved with chemotherapy and radical surgery of primary and metastatic lesions, combined and not combined with radiotherapy. Preoperative adjuvant chemotherapy now plays an important role in the whole strategic regimen of cancer treatment. Of various prognostic factors, the dominance of the sensitivity of each patient to preoperative adjuvant chemotherapy was indicated. PMID- 3293535 TI - [Combination chemotherapy with adriamycin, cyclophosphamide, vincristine, prednisolone (VEPA) in non-Hodgkin's lymphoma, with special reference to correlation of surface phenotype with response and survival]. AB - Thirty-seven previously untreated patients with advanced non-Hodgkin's lymphoma were treated with VEPA therapy. The complete remission (CR) rate was higher in the patients with diffuse B-cell lymphoma (75%) than in those with follicular B cell lymphoma (20%) and T-cell lymphoma (42%). Two characteristics, i.e., elevated LDH and bone marrow involvement, were negatively associated with response rate in patients with diffuse lymphoma (B-, T-). The median duration of CR has not yet been reached, and the 2-year relapse-free rate was 64% for cases of diffuse B-cell lymphoma, while for T-cell lymphoma patients, the median duration of CR was 7 months. For diffuse B-cell lymphoma patients, the median survival has not yet been reached, and the 2-year survival rate was 57%. On the other hand, median survival for T-cell lymphoma patients was 12 months. VEPA therapy was less effective for the treatment of T-cell lymphoma, and a more intensive regimen should therefore be designed to overcome the potential aggressiveness of T-cell lymphoma. PMID- 3293536 TI - [Phase II study of carboplatin in head and neck cancer]. AB - To evaluate the clinical efficacy and safety of carboplatin for head and neck cancer, a phase II study was conducted in 21 institutions. Eighty-eight patients were entered into this trial, of which 70 were evaluable. Carboplatin was administered intravenously over 0.5-1 hr at the dose of 400 mg/m2 in good risk cases and 300 mg/m2 in poor risk cases. One patient achieved complete response(CR) and 13 achieved partial response(PR) with an overall response rate of 20%. In terms of response by histology, the response rate was 22% in cases of squamous cell carcinoma. The response rate was 26% in previously untreated patients and 16% in previously treated patients. One CR and 2 PR were achieved in 14 patients with prior cisplatin treatment. Toxicity was observed in 47% of the 70 evaluable patients. Nausea and vomiting were the most common toxicity observed (36%) followed by anorexia in 27%. Concerning hematologic toxicity, thrombocytopenia was noted in 32% and leukopenia in 29%. Elevation of BUN and creatinine was observed in only 2 cases and 1 case, respectively. It was concluded that carboplatin suggested activity similar to cisplatin, and also could be safely used at the outpatient level. PMID- 3293537 TI - [Phase II study of carboplatin in malignant lymphoma]. AB - A phase II study of carboplatin for malignant lymphoma was conducted. Thirty-nine patients with malignant lymphoma were entered into this study, and 6 of them were excluded from evaluation due to violation of selection criteria. The remaining 33 cases were studied to assess the effectiveness and safety of this drug. Two CR and 11 PR were obtained with this medication (effective rate 39%). The significant affecting factors were previous treatment, disease stage and P.S. score. Many cases suffered from gastrointestinal symptoms and reduced hematopoiesis. The former complication was self-limited without any fatal episodes. However, the latter included severe cases, especially thrombocytopenia, which is suggested to be a dose limiting factor (DLF) of this drug. PMID- 3293538 TI - [Experimental study on carboplatin toxicity--a comparison with cisplatin]. AB - The toxic potencies of cisplatin and carboplatin were compared in male Wistar rats. The tissue concentration of platinum in rats was 5- to 13-fold larger with cisplatin treated group than carboplatin treated one. The histopathologic examination of various organs revealed severe myelosuppression and mild toxicity in the kidney, testis, spleen and intestine of rats treated with carboplatin. The toxicity of carboplatin was milder than cisplatin in all organs except bone marrow. This reduced toxicity of carboplatin can be accounted for by the presence of a stable dicarboxylate chelate ring structure of this drug, resulting in a much slower rate of hydrolysis to the active form, and the differences in nuclear protein phosphorylation between normal cells and tumor cells. The decreased nephrotoxicity of carboplatin may be due in part to lower drug accumulation in the renal tubular epithelium via the basement transport mechanism. PMID- 3293539 TI - Absence of anti-Ro and anti-La antibodies in pemphigus and pemphigoid sera. PMID- 3293540 TI - Deinstitutionalization: could the process have been better for patients? PMID- 3293541 TI - Effects of sesame and cod liver oils on prostacyclin synthesis by the rat thoracic aorta. AB - The influence of sesame and cod liver oils (0.5 and 1 g/kg/day s.c. for 2 weeks) on arterial PGI2 synthesis in the rat was investigated using a rat platelet antiaggregatory bioassay and HPLC methods. Smaller doses did not affect PGI2 synthesis. However, sesame oil at a dose of 1 g/kg/day significantly stimulated PGI2 synthesis, whereas cod liver oil at the same dose significantly decreased the synthesis. Incubation of control tissues in presence of exogenous arachidonic acid (33 microM) significantly stimulated PGI2 synthesis, however, incubation of cod liver oil-treated tissues in presence of arachidonic acid resulted in PGI2 synthesis, similar to that observed in the nontreated controls. The changes observed in PGI2 synthesis in the tissues from oil-treated rats may have resulted from modulation in arachidonic acid release and/or direct effects on the enzymes involved in PGI2 synthesis. The oil-induced changes in PGI2 synthesis may partly contribute towards better understanding of the biochemical mechanisms that underly some of the in vivo actions of these oils. PMID- 3293542 TI - Antihypertensive action of a novel orally active angiotensin converting enzyme inhibitor altiopril calcium (MC-838) in several hypertensive models of rats: comparison with captopril. AB - The antihypertensive effects of altiopril calcium (MC-838), calcium(-)-N-[(S)-3 [(N-cyclohexylcarbonyl-D-alanyl)thio]-2-methyl- propionyl]-L-prolinate, a novel inhibitor of angiotensin converting enzyme, compared with captopril, were evaluated in conscious rat models of experimental hypertension. MC-838 (3-30 mg/kg p.o.) as well as captopril (3 and 10 mg/kg p.o.) dose-dependently lowered systemic blood pressure (SBP) with no consistent changes in heart rate (HR) in two-kidney renal hypertensive rats (2 KG-RHRs) and spontaneously hypertensive rats (SHRs). However, MC-838 and captopril, unlike hydralazine, did not significantly produce hypotension in DOCA-salt hypertensive rats. The antihypertensive effect of MC-838, compared with captopril, was characterized by a slower onset and longer duration. When compared on a weight basis of 3 mg/kg, the antihypertensive effect of MC-838 was comparable to that of captopril in magnitude, but the duration of action was approximately 2 times longer than that of captopril. MC-838, like captopril, attenuated angiotensin-I (A-I)-induced pressor response, and augmented bradykinin (BK)-induced depressor one in SHRs. However, no correlation was observed between the modification of the SBP response to exogenous i.v. A-I or BK, and the SBP lowering caused by MC-838 or captopril given orally. In contrast, there was a close correlation between inhibition of lung angiotensin converting enzyme (ACE) (but not plasma ACE) and SBP reduction induced by the 2 ACE inhibitors in SHRs. When administered orally once a day for 9 weeks in 2 KG-RHRs and SHRs, MC-838 dose-dependently reduced SBP throughout the treatment period. After withdrawal of treatment with MC-838 there was no rebound increase in SBP. These studies indicate that MC-838 is a promising antihypertensive agent. PMID- 3293543 TI - Comparative cardiovascular effects of a novel angiotensin converting enzyme inhibitor altiopril calcium (MC-838) and captopril in spontaneously hypertensive rats. AB - The cardiovascular effects of a newly developed angiotensin converting enzyme (ACE) inhibitor, calcium(-)-N-[(S)-3-[(N-cyclohexylcarbonyl-D-alanyl)thio]-2- methylpropionyl]-L-prolinate (MC-838, altiopril calcium), were examined in anesthetized spontaneously hypertensive rats and isolated donor-perfused, rat heart preparations, and compared with those of captopril. Equidepressor doses of MC-838 (0.3 and 3 mg/kg) and captopril (0.03 and 0.3 mg/kg) given i.v. induced dose-dependent decreases in systemic blood pressure, left ventricular systolic pressure (LVSP), LVdP/dT max, and femoral, renal and mesenteric vascular resistance. MC-838 as well as captopril had no significant effects on femoral blood flow (except for 3 mg/kg MC-838) and heart rate (HR). Marked and sustained increases in renal blood flow were observed with the ACE inhibitors. These agents caused two-phase changes in mesenteric blood flow: initial increase followed by decrease. In isolated, donor-perfused rat heart preparations, MC-838 (0.01-1 mg) injected locally into the coronary artery resulted in positive inotropic effects, as indicated by dose-dependent increases in LVSP and LVdP/dT max, with no significant changes in HR, while captopril (0.01-1 mg) had negative inotropic effects. The positive inotropic response to MC-838 appears to be due to Ca++ in the MC-838 solution. PMID- 3293544 TI - Aerobactin-positive Escherichia coli as causative agents of extra-intestinal infections among animals. PMID- 3293545 TI - [Dentition anomalies and pathologic anatomical changes in animal bones from the Germanic settlement in Mulberg, Gotha district]. PMID- 3293546 TI - [Indications for liver transplantation in Wilson's disease]. AB - We report the case of a 12 year-old boy with Wilson's disease, presenting with decompensated liver cirrhosis. Medical treatment failed to prevent fulminant liver failure in less than one month. Emergency liver transplantation was successfully performed. This report led us to review the prognosis of Wilson's disease with liver failure according to the present results of liver transplantation. PMID- 3293547 TI - [Systemic neonatal Escherichia coli infection (excluding urinary infections). II. Symptomatology, diagnosis and treatment]. PMID- 3293548 TI - The brains of the Vogt collection. PMID- 3293550 TI - Immunoassay. Innovations in label technology. AB - The history and recent developments in label technology are reviewed. Because the new labels generally are used in both classic immunoassays and immunometric assays, a brief review of the advantages and disadvantages of each type of assay is included. Recent developments in enzyme labels, such as channeling techniques, enzyme acceptor-donor systems, and apoenzyme reactivation assays, are discussed. Fluorescence polarization immunoassay and time-resolved fluorescence using the lanthanides are two of the newer fluorescence techniques. Luminescent labels, such as acridinium esters, show promise because of their stability, sensitivity, and ease of detection. Several new particle label techniques have been introduced, perhaps two of the most interesting of which are sol particle and liposome labels. Advantages and disadvantages of the newer labels are compared with those of radioactivity. PMID- 3293549 TI - Comment: On the deaths of Ernst and Klaus H. PMID- 3293551 TI - Subxiphoid pericardial window and penetrating cardiac trauma. AB - Between 1982 and 1986, 108 patients with penetrating wounds in proximity to the heart and no obvious signs of cardiac injury underwent a diagnostic subxiphoid pericardial window procedure. Eighty-four patients had stab wounds, 22 had gunshot wounds, and two had shotgun wounds. The subxiphoid pericardial window procedure produced positive results in 30 patients (28%) and negative results in 78 patients (72%). There were two false-positive subxiphoid pericardial window procedures. Eleven patients (39%) with cardiac injuries were not hypotensive and did not have signs or symptoms of cardiac injuries prior to the subxiphoid pericardial window procedure. When they were obtained (n = 80), electrocardiograms were abnormal in 57% and 21% of patients with and without cardiac injuries, respectively. At thoracotomy, 28 patients had injuries (ventricle, 20; atrium, three; and pericardium, five) and 21 required suture repair. Thirty-nine patients underwent a concomitant laparotomy. Forty-six abdominal visceral injuries were identified in 28 patients, including 21 hollow viscus injuries. There was no significant short-term or long-term morbidity (eg, pericarditis, tamponade, or post-pericardiotomy syndrome) attributable to the subxiphoid pericardial window procedure. There were no known missed cardiac injuries, and there were no deaths in the series. Some patients with penetrating wounds to the heart have no overt signs or symptoms of cardiac injury. A subxiphoid pericardial window procedure quickly identifies or excludes cardiac injuries and can be performed with minimal morbidity, even when there is contamination from the gastrointestinal tract. PMID- 3293552 TI - Current concepts of protein turnover and amino acid transport in liver and skeletal muscle during sepsis. AB - The metabolic response to trauma and sepsis is characterized by a negative nitrogen balance, accelerated muscle proteolysis, increased ureagenesis, and stimulated acute-phase protein synthesis in liver. Inhibited uptake of amino acids and accelerated protein breakdown in muscle increase the flux of amino acids from the periphery to the liver. Concomitantly, hepatic uptake of amino acids is stimulated and protein synthesis and gluconeogenesis in the liver are enhanced. These events are important to the survival of patients with sepsis. Stimulated ureagenesis resulting in nitrogen loss from the body is another important aspect of hepatic nitrogen metabolism following trauma and sepsis. The mediator(s) initiating metabolic changes is not yet exactly defined, although regulatory protein(s) released from stimulated macrophages (particularly interleukin 1 and tumor necrosis factor) may play a major role in altered amino acid and protein metabolism in muscle and liver during sepsis. However, these factors alone are probably not responsible for the metabolic disturbances, since the catabolic hormones cortisol, glucagon, and the catecholamines can simulate the metabolic pattern observed in sepsis. Other possible mediators include prostaglandins and thyroid hormones. It is possible that the interaction between different types of mediators is necessary for the full manifestation of host responses to severe injury and sepsis. PMID- 3293553 TI - Pharmacokinetics and efficacies of obidoxime and atropine in paraoxon poisoning. AB - The efficacies (ED50) of obidoxime and atropine against paraoxon poisoning in mice were determined by administering the antidotes 5, 20, 40 and 60 min before administration of the organophosphate. With increasing time intervals t between the administration of the antidote and paraoxon, the dose of antidote (ED50), that reduced the lethality of 2 LD50 of paraoxon to 50% increased. The standardized log ED50/t plot was linear and yielded the "efficacy half-life". In addition, the blood concentrations c of the antidotes were measured, resulting in a linear log c/t plot. The "efficacy half-life" was approximately twice the half life of the antidote in blood. The possible reasons for this phenomenon are discussed. PMID- 3293554 TI - Childhood adrenoleukodystrophy. Failure of intensive immunosuppression to arrest neurologic progression. AB - Cyclophosphamide in a dosage of 350 to 700 mg/m2/d was administered for five to 11 days to four patients with childhood adrenoleukodystrophy (ALD) and to one patient with the adult cerebral form of the disease. The rate of neurologic progression in the four patients with childhood ALD did not differ from that of 167 untreated patients with childhood ALD surveyed previously. PMID- 3293555 TI - Cognitive and motor dysfunction in Parkinson's disease. Clinical, performance, and computed tomographic correlations. AB - The neuropathologic and pathophysiological relationship of specific to more generalized cognitive dysfunction in Parkinson's disease (PD) remains incompletely understood. This issue was examined in a study of 39 patients with PD, utilizing standardized clinical measures, computerized neuropsychological tests, and quantitative computed tomography. Disorders of visuospatial discrimination and perceptual-motor function closely paralleled motor scores, suggesting a common neuropathologic basis. Caudate nuclear and mesocortical dopamine depletion play a role in this context. More generalized cognitive dysfunction occurred in older patients with a somewhat longer disease duration, more advanced parkinsonism, and computed tomographic evidence of subcortical and frontal cortical atrophy but without significant cerebral atrophy when compared with age-matched controls. Further prospective clinicopathologic studies will be required to clarify the relative contribution of the primary dopaminergic dysfunction, age-related changes, Alzheimer-type pathologic condition, and other coexisting neurotransmitter deficits to the dementia seen in PD. PMID- 3293556 TI - Shakespeare in Charcot's neurologic teaching. AB - Charcot frequently used Shakespearean references in his neurologic teaching sessions. With these citations, he emphatically stressed how objective observation and an attention to detail were essential to expert clinical diagnosis. At the same time, Charcot presented his personal credentials as a cultured man. Charcot's interest in Shakespeare permeated many aspects of his professional work, and also his private and family life. PMID- 3293557 TI - Tennessee's Pitts, a model delegate. PMID- 3293558 TI - Neural mechanisms underlying the sensation of breathlessness: kinesthetic parallels between respiratory and limb muscles. PMID- 3293559 TI - The prevention of preterm birth: unresolved problems and work in progress. PMID- 3293560 TI - Poliomyelitis epidemic 1937: a recollection. PMID- 3293561 TI - Arterial blood pressure and its measurement. AB - Pressure is defined as force per unit area. The actual value of the recorded pressure depends on dynamic influences, like acceleration and friction in a moving fluid, and on static influences like the effect of a gravitational field. In the arterial system, four mechanisms exert the main influence on the measured pressure: (1) cardiac output and peripheral resistance, on which the mean value of the pressure depends; (2) the flow amplitude and the characteristic impedance of the artery, on which the pressure amplitude depends; (3) the orthostatic pressure component; (4) the local velocity of flow, on which the recorded pressure depends, and is described by the Bernoulli equation. Under normal conditions, this influence is rather small. The measurement of arterial pressure can be done either invasively or with one of the following noninvasive methods: occlusive cuff method, vascular unloading, arterial tonometry, or measurement of the arterial pulse wave velocity. Each of these methods has certain advantages and disadvantages. It seems necessary to point out the fact that due to wave reflections in the arterial system, pressure values depend on local influences and differ from location to location. Most markedly, the influence of wave reflection can be demonstrated proximally, as well as distally, to the occlusive cuff in the Riva Rocci method. Once the blood pressure has been measured in a person, the problem of the assessment and interpretation of the measured values has to be considered. According to the decision of the WHO, certain limits are defined which permit a distinction between normotension and hypertension. In each case, of course, a physician has to consider the importance of individual conditions. PMID- 3293563 TI - Evidence that phorbol ester-activated pathways are not directly involved in the action of insulin in rat adipocytes. AB - The effects of 12-phorbol 13-myristate acetate (PMA) on glucose transport, glucose metabolism and lipolysis in rat adipocytes were examined. Alone, PMA (100 ng/ml) stimulated 2-deoxyglucose transport, glucose oxidation and lipogenesis by an amount corresponding to about 30-50% of the maximal insulin effect. The effect of PMA on the insulin-stimulated processes was additive at all insulin concentrations. Adenosine deaminase-stimulated lipolysis was enhanced by about 50% by PMA (100 ng/ml). Thus, in contrast to insulin, PMA had a lipolytic effect. The antilipolytic effect of insulin was unaffected by the presence of PMA, both ED50 and maximal inhibition of insulin were unchanged. In conclusion, it is suggested that phorbol esters may activate pathways other than those activated by insulin in rat adipocytes. PMID- 3293565 TI - Biphasic activation of cytosolic free calcium and LH responses by gonadotropin releasing hormone. AB - Gonadotropin-releasing hormone (GnRH) stimulates rapid peak increases in [Ca2+]i and LH release, followed by lower but sustained elevations of both [Ca2+]i and hormone secretion. Omission of extracellular Ca2+ only slightly decreased the peak of [Ca2+]i, but reduced the peak LH response by 40% and prevented the prolonged increases in [Ca2+]i and LH release. Dihydropyridine calcium antagonists did not affect the peak [Ca2+]i and LH responses, but reduced the sustained increases by up to 50%. Whereas GnRH-induced mobilization of intracellular calcium initiates the LH peak, and Ca2+ entry through dihydropyridine-insensitive channels contributes to the peak and plateau phases of LH release, dihydropyridine-sensitive L-type Ca2+ channels participate only in the sustained phase of gonadotropin secretion. PMID- 3293562 TI - Intracoronary superoxide dismutase for the treatment of "reperfusion injury", A blind randomized placebo-controlled trial in ischemic, reperfused porcine hearts. AB - The effect of recombinant human superoxide dismutase (rh-SOD) on infarct size was investigated in porcine hearts. The left anterior descending coronary artery was occluded in each of 24 anesthetized pigs for 45 min and reperfused for 24 h. The animals were randomly assigned to either rh-SOD (n = 12) or placebo treatment (n = 12). 2 min before reperfusion, an intracoronary (i.c.) infusion of rh-SOD (total dose: 2000 U/kg) or placebo was started which lasted for up to 45 min reperfusion. At the end of the experiment, the infarcted myocardium was assessed using a tetrazolium stain (NBT) and related to the risk region which was determined with a fluorescent dye. Two pigs of the SOD group and one of the control group died before the end of the experiments. Except for a lower calculated myocardial oxygen consumption and a lower dp/dtmax in the SOD group during ischemia, hemodynamic parameters of the two groups did not differ significantly. rh-SOD i.c. treatment during reperfusion did not reduce infarct size significantly. Infarct size amounted to 74 +/- 13% in the control group and to 66 +/- 19% in the treated group. The incidence of reperfusion arrhythmias was not affected by rh-SOD treatment. It is concluded that i.c. rh-SOD treatment at the beginning of reperfusion neither significantly reduces infarct size nor diminishes the incidence of reperfusion arrhythmias in this preparation. PMID- 3293564 TI - Compartmentalization of catalases in Escherichia coli. AB - Escherichia coli possess three catalase genes: katG codes for protein HPI and katE codes for HPII; katF is also needed for HPII but may be a positive regulatory gene for katE. We have assayed for HPI and HPII in the outer cell membrane, the periplasmic space, the inner membrane, and in the cytoplasm of E. coli. Following synthesis of catalase in the cytoplasm the active katG gene product (HPI) was found in the periplasmic and in the cytoplasmic membrane fractions. HPII remained in the cytoplasm. PMID- 3293566 TI - Alpha-sarcin cleaves ribosomal RNA at the alpha-sarcin site in the absence of ribosomal proteins. AB - alpha-Sarcin is capable of specifically cleaving the single phosphodiester bond in the "alpha-sarcin site" of both Escherichia coli and Saccharomyces cerevisiae large rRNAs in the absence of ribosomal proteins. With both sources of rRNA, the rate of cleavage was comparable with and without ribosomal proteins but more complete cleavage was observed in the absence of ribosomal proteins. These observations contrast with earlier findings and indicate that ribosomal proteins are not essential to the unique specificity of the cleavage of rRNA by alpha sarcin. PMID- 3293568 TI - Insulin effect on [14C]-valine incorporation and its relation to hexokinase activity in developing brain. AB - Using minced brain cortex from fetal and postnatal rats, we studied the incorporation of [14C]-valine into protein in the presence of insulin. We also assayed the "particle bound" and soluble hexokinase in these tissues. Insulin significantly stimulated the incorporation of [14C]-valine into brain proteins from fetal stage upto 2 days of life. After this period the insulin effect was minimal, with no effect by day 5. The "particle bound" (40,000g pellet) brain hexokinase, on the other hand, remained low till about 2 days of life and then increased to almost adult level by 5 days. Our results show that there is an inverse relation between this anabolic effect of insulin and the "particle bound" hexokinase activity in the cortex of developing rat brain. PMID- 3293567 TI - Comparative effects of insulin and proinsulin in vitro on pathways of glucose utilization and lipid synthesis in the lactating rat mammary gland. AB - The effects of insulin and proinsulin have been measured on the rates of glucose oxidation via the pentose phosphate pathway and incorporation into lipid in slices of lactating rat mammary gland. Half-maximal stimulation of glucose oxidation was observed with 1-3 x 10(-8)M insulin while 1 x 10(-7)M proinsulin was required to achieve half-maximal stimulation. A similar, approximately 10 fold, difference in potency was observed in relation to lipid synthesis. The present results appear to indicate that the maximum stimulation of either glucose oxidation via the pentose phosphate pathway or lipid synthesis by proinsulin did not reach the same level as that found for insulin. PMID- 3293569 TI - Glucosphingolipids as sites of action in the chemotherapy of cancer. PMID- 3293570 TI - Measurement of systemic lupus erythematosus activity in clinical research. PMID- 3293571 TI - Network regulation in rheumatoid arthritis. Studies of DR+ T cells, anti-DR, antiidiotypic antibodies, and clinical disease activity. AB - We prospectively studied rheumatoid arthritis patients with various degrees of clinical disease activity, for the presence of DR+ T cells by flow cytometry, for anti-DR using immunoblot analysis, and for antiidiotypic (anti-id) antibodies by enzyme-linked immunosorbent assay using F(ab')2 monoclonal antibody anti-DR L243 as idiotype. DR+ T cells correlated positively with anti-DR, and anti-id correlated negatively with both DR+ T cells and anti-DR. Active clinical disease correlated positively with both DR+ T cells and anti-DR, and correlated negatively with anti-id. This DR antigen/anti-DR/anti-id network may control disease activity in rheumatoid arthritis patients. PMID- 3293572 TI - Hybridoma lupus autoantibodies can bind major cytoskeletal filaments in the absence of DNA-binding activity. AB - A panel of 65 systemic lupus erythematosus (SLE) and 61 normal-derived human hybridoma auto-antibodies was studied for cytoskeletal reactivity, using an indirect immunofluorescence method. Reactivity with the cytoskeleton was expressed 3 times more frequently in the SLE-derived antibody group and included intermediate filaments, microfilaments, microtubules, and centrioles. By immunoblot analysis, the antigenic specificity of intermediate filament-reactive SLE hybridoma antibodies was not restricted to vimentin, but included cytokeratins and desmin. The antibodies were also studied for their DNA-binding, lupus anticoagulant, and rheumatoid factor activities. These autoantibody activities were expressed 3-5 times more frequently in the SLE-derived group. The ability to bind DNA was not a prerequisite for reactivity with intermediate filament proteins. Our findings suggest that there are at least 2 subsets of cytoskeletal-reactive hybridoma antibodies: those that recognize epitopes found only on cytoskeletal proteins, and those that recognize epitopes common to both DNA and certain cytoskeletal proteins. In addition, we hypothesize that there may be a third subset of antibodies that recognize a phosphate-containing moiety (phospholipid or phosphoprotein) associated with cytoskeletal filaments. PMID- 3293573 TI - [Gene technology at the threshold of clinical medicine. 21st Deidesheimer lecture. 2-3 May 1987]. PMID- 3293574 TI - Gene technology at the threshold of clinical applications. Introduction to the subject. PMID- 3293575 TI - [Monoclonal antibodies--new probes for diagnosis and therapy. Their use as an example of the micrometastasizing of solid tumors]. AB - Monoclonal antibody CK2, recognizing component No. 18, appeared to be the most suitable reagent for the detection of epithelial tumor cells in bone marrow. Its specificity was confirmed in a double-marker staining procedure (combination of APAAP-technique and radioautography). CK2 positive cells were demonstrated not to reveal any cross-reactivity with an antibody directed against the "leucocyte common antigen". A significant correlation between the presence of epithelial tumor cells in bone marrow and certain conventional risk factors was found. A more detailed phenotypic characterisation could demonstrate the expression of proliferation associated antigens on these cells. Furthermore in an immunotherapeutic approach with monoclonal antibody 17-1A, labelling of the disseminated tumor cells in bone marrow after infusion of the antibody was shown. PMID- 3293576 TI - [The replication cycles of viruses and possibilities of therapeutic modification]. AB - This paper presents an introduction into basic principles of antiviral therapy. At the outset, the essential features of virus-host cell interactions have been described to facilitate a discussion of possibilities for antiviral therapy. Subsequently, the most important groups of viruses are evaluated according to the underlying mechanisms of replication (Baltimore classification). The rather limited examples of successful antiviral therapy have been documented. Elementary problems remain unresolved: How can viral replication steps be intercepted without afflicting host mechanisms? Finally, hypothetical approaches towards the elimination of persisting viral genomes from the cellular genome have been reviewed. PMID- 3293577 TI - [Chordomas]. AB - Chordomas are slowly growing malignant tumors arising from notochordal rests. They are occurring in adults (50 to 60 year old) and are mainly (85%) located in sacrococcygeal or spheno-occipital regions; other main localization is cervical spine. Chordomas are usually discovered in patients with pain or symptoms due to compression of surrounding viscera. Radiologically it is characterized by association of osteolysis and soft tissues opacity. On macroscopic examination tumoral tissue has mucoid appearance; under microscope it is made up with lobules of epithelial-appearing cells surrounded by acid mucosubstances. Tumorous cells contain glycogen and neutral mucosubstances. They are surrounded by argyrophilic rim due to pericellular condensation of intercellular matrix, well viewed on electron microscope examination. When their cytoplasm is filled with vacuoles, cells take up typical physaliphorous appearance. Chordomas cells express epithelial differentiation antigens (low molecular weight cytokeratins, EMA, CAM 52, HFM 62, even CEA), Vimentin and S-100 Protein: this triple positivity allow differentiation between chordomas and numerous others tumors. Correct treatment of chordoma is achieved with an initially complete excision. Local recurrences are frequent and sometimes inoperable: in this cases radiotherapy alone may be performed (70 grays). Sarcomas (fibroblastic or Malignant fibrous histiocytoma) may occur after radiotherapy or without it. Hematogenous metastasis occur in 10% to 15% of patients. Survival rate at five years is included between 50% and 75%. Chondroid chordoma is a special entity occurring in younger patients (35 year old) and located in spheno-occipital region. In addition to chordomas it contain chondroid (benign or malignant) islands. Mean survival rate (16 years) is far better than for chordoma or chondrosarcoma. PMID- 3293578 TI - [Pathology of the cytoskeleton]. AB - In the last years, considerable advances have been made in the study of the proteins and polypeptides of the cytoskeleton, and its three main components: microfilaments (MF), intermediate filaments (IMF) and microtubules (MT). The principal properties of these elements and those of many associated proteins are recalled. The actin MF are mainly involved in cell contractility, the IMF in cell shape, while the MT and their associated proteins are involved in intracellular transport. Some pathological modifications of the cytoskeleton will be considered. In the liver, accumulations of keratin result in the formation of Mallory's hyalin, found in several types of cirrhosis and hepatomas. In muscle, accumulations of desmin are observed in various myopathies. An accumulation of alpha-actinin at the Z bands characterizes nemalin myopathy. In several forms of hemolytic anemias, alterations of the membranous cytoskeletal components of the red blood cells--spectrin, ankyrin, actin--may explain their abnormal shape and excessive fragility. In the nervous system, many pathological conditions are related to abnormal cytoskeletal components. In Parkinson's disease, Lewy bodies are an accumulation of neurofilaments (IMF). In Alzheimer's disease, and some related conditions, the intraneuronal tangles are associated with modifications of MT and neurofilaments. The role of MT and in particular of the MT-associated protein tau, as demonstrated recently, confirms the involvement of the MT. The observed disturbances of MT-related axonal flow may explain some of the known functional changes in these forms of dementia. PMID- 3293580 TI - [Histological study of a case of chondrocostal aspergillosis]. AB - Histological study of biopsy specimens successively taken from the 7th, 5th and 6th right chondrocostal regions in a 33 year-old man; the patient was under chemotherapy for a diffuse lymphoma and has been operated for an aspergilloma of the right lung superior lobe. Non-specific chronic osteomyelitis was observed as well as Aspergillus fumigatus perichondritis (acute and chronic) which had lead to cartilage fragmentation. Cartilage fragmentation could be attributed to an enzymatic chondrolysis induced by polymorphonuclears inflammation. Such matrix degradation seems to favour the penetration of aspergillus into the cartilage surface. This case report recalls that fungi (including Aspergillus despite it appears exceptional) must be considered as a possible cause of osteomyelitis, particularly in immunosuppressed patients. PMID- 3293579 TI - [Oncocytoma of the kidney and oncocytic adenocarcinoma. 10 cases of oncocytoma]. AB - Having studied 484 previously reported and 10 personal cases of oncocytomas we believe that the main controversies surrounding this tumor are related to the fact that the term oncocytoma is wrongly applied to all tumors with oncocytic cells. The term oncocytoma must be restricted to well encapsulated tumors, sometimes very large ones, made up solely from regular oncocytic cells. The benign clinical behavior of oncocytomas thus defined, is supported by numerous well documented observations in medical literature. Thanks to the progress made in radiology investigations and to better defined histological criteria, it is possible, by means of diagnosis with frozen sections, to practice partial surgery. PMID- 3293581 TI - Focal myositis and its differential diagnosis. A case report and review of the literature. AB - A 55 year-old woman underwent a wide surgical excision because a left thigh mass. The histopathological study showed a focal myositis of the vastus lateralis muscle. The patient remains asymptomatic after four years follow-up. The differential diagnosis with soft tissue sarcomas and other inflammatory myopathies is discussed. PMID- 3293582 TI - A critical evaluation of methods for prediction of protein secondary structures. PMID- 3293583 TI - Secondary structure of proteins through circular dichroism spectroscopy. PMID- 3293584 TI - Sensory rhodopsins of halobacteria. PMID- 3293585 TI - Assembly processes in vertebrate skeletal thick filament formation. PMID- 3293586 TI - Myosins of nonmuscle cells. PMID- 3293587 TI - Computer methods for analyzing sequence recognition of nucleic acids. PMID- 3293588 TI - Flexibility of DNA. AB - Both microscopic and macroscopic models of DNA flexibility should lead to the same quantitative description of the elastic properties of the DNA helix. This belief is reinforced by the fact that essentially all experimental (solution) studies to date support the macroscopic, elastic model. The performance of microscopic models can therefore be checked by their ability to produce the correct macroscopic quantities (P and C). To most carefully address the influence of such factors as base sequence, DNA damage, and drug or protein interaction on the flexibility of DNA, methods are required that are most sensitive for DNA molecules of less than 500-1000 bp. The use of molecules in this size range will maximize the signal due to the structural alteration as well as facilitate the construction of DNA sequences of any desired arrangement. I have emphasized three such methods and summarized their strengths and weaknesses; however, their concurrent application to the determination of DNA flexibility provides an important check of self-consistency. These studies have indicated that the persistence length of DNA in buffers of moderate salt concentration is 450-500 A. Synthetic DNA is now readily available, and many procedures for the construction and cloning of DNA molecules of defined length and sequence (107-108a) are in common use. The availability of restriction fragments of precisely defined length has transformed the study of the physical (particularly hydrodynamic) properties of such molecules, since the hitherto pervasive problem of length polydispersity has been eliminated. Sheared, sonicated, or otherwise abused calf thymus (or other) DNAs should no longer be considered acceptable materials for physical studies. Many studies of bending and torsional fluctuations in DNA have been excluded from this discussion because the DNA samples used were not precisely defined. The torsional elastic constant of DNA has been fairly well established as approximately 3.0 x 10(-19) erg-cm, mainly through a combination of elegant theoretical and experimental studies of topoisomer distributions in circular DNA molecules. The other general approach to the determination of the torsional elastic constant, luminescence decay, is still burdened by the poor characterization of the DNA used in many of the experimental studies as well as by some continued theoretical uncertainties.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3293589 TI - Pulsed-field gel electrophoresis of very large DNA molecules. PMID- 3293590 TI - Structural and microanalytical imaging of biological materials by scanning microscopy with heavy-ion probes. PMID- 3293591 TI - Structure-function correlations in the small ribosomal subunit from Escherichia coli. PMID- 3293592 TI - The submicroscopic properties of cytoplasm as a determinant of cellular function. PMID- 3293593 TI - Cellular mechanics as an indicator of cytoskeletal structure and function. PMID- 3293594 TI - The forces that move chromosomes in mitosis. PMID- 3293595 TI - Conformational substates in proteins. PMID- 3293596 TI - Eye lens proteins and transparency: from light transmission theory to solution X ray structural analysis. PMID- 3293597 TI - Genetic studies of protein stability and mechanisms of folding. AB - In the past few years, analysis of mutationally altered proteins has joined more traditional biophysical methods as an important experimental approach to the study of protein folding. Single amino acid substitutions have been found to reduce the stability of the native state by as much as 3 kcal mol-1, a significant fraction of the marginal stability of the folded conformation, and to significantly alter the rates of folding or unfolding. Mutations can also significantly affect the ability of a protein to fold in vivo. However, at present there is great uncertainty in accounting for or predicting the effects of mutations on stability and folding, even qualitatively. Future studies of mutant proteins are likely to provide further insights into the roles of individual residues and interactions in determining the three-dimensional structures of proteins. For the full potential of this approach to be realized, however, many mutant proteins will have to be systematically studied using structural, thermodynamic, and kinetic methods. The results of these experiments may aid in developing and refining improved theoretical treatments of the energetics of protein conformation. PMID- 3293599 TI - Fourier transform infrared techniques for probing membrane protein structure. PMID- 3293598 TI - DNA packing in filamentous bacteriophages. PMID- 3293600 TI - Mechanoelectrical transduction by hair cells. PMID- 3293601 TI - Arthroscopic staple capsulorrhaphy for recurrent anterior shoulder instability. AB - Beginning in 1983, the principles of staple capsulorrhaphy of the shoulder utilizing arthroscopic techniques were applied to the treatment of patients with recurrent anterior shoulder instability. This paper describes the results of arthroscopic staple capsulorrhaphy of the shoulder in the first 25 consecutive cases in which these techniques were utilized. The patient population includes 4 females and 19 males, 2 of whom underwent bilateral staged procedures. Eleven of the patients had documented recurrent anterior dislocations while the remaining 12 patients were determined to have subluxation of the shoulder. The average age of the patient population was 23 years. Follow-up averaged 36 months. Results were determined by utilizing a strict 100 point rating scale as described by Rowe. Utilizing this scale, 67% of patients achieved good or excellent results. Five patients came to undergo additional surgical procedures. There were no complications of infection or neurovascular injury, but one patient suffered staple impingement upon the humeral head leading to excoriation thereof and secondary pain. An average loss of external rotation of 9 degrees, as compared to the contralateral shoulder, was noted postoperatively. PMID- 3293603 TI - [Medicare: reimbursement of doctors for services rendered]. PMID- 3293602 TI - [The first woman doctors of medicine in Puerto Rico]. PMID- 3293604 TI - IgG subclasses to food antigens. AB - Involvement of sub-classes of IgG that are specific for food allergens in anaphylactoid reactions and some manifestations of atopy no longer needs to be shown. Accordingly, sub-classes of IgG specific for ovalbumin (OVA) and beta lactoglobulin (BLG) were compared in healthy subjects and those who presented with an intolerance or food allergy to OVA and BLG to decide whether a restrictive diet was necessary. The four sub-classes of IgG1, IgG2, IgG3 and IgG4 were isolated in all the groups. IgG4 was highest in the allergic subjects and the IgG sub-class values were modified by the diet differently in each group. Unfortunately, the small number of subjects does not allow the formation of a definite conclusion to this study. PMID- 3293606 TI - [Elaboration of the abstract for clinical research articles: a new proposal]. PMID- 3293605 TI - Food allergy diagnosis protocol. AB - The protocol is proposed in a definite way for recurrent or chronic symptoms. In the first case, the diagnosis is made by PRICK, RAST and provocation tests with suspect foods. On 100 patients, the reliability of PRICK and RAST has been shown. In the second case, a non-allergenic diet and the recurrence of symptoms on the re-introduction of certain foods has permitted isolation of the causative foods and the differentiation of food allergy and intolerance. This has been done with 386 cases of urticaria and angio-oedema, where it has been shown that 1.9% of the reactions had a food-linked origin. PMID- 3293607 TI - [Production of Shiga-1-type (SLT) cytotoxin in strains of Escherichia coli isolated from children with diarrhea in a rural community]. PMID- 3293608 TI - [Comparative study of throat culture and latex agglutination in streptococcal pharyngitis]. PMID- 3293609 TI - [Adrenoleukodystrophy, infantile variety. Study of 4 cases and review of the literature]. PMID- 3293610 TI - [Metabolism of bilirubin. II. Primary changes in the metabolism of bilirubin]. PMID- 3293611 TI - [Appendicitis in children]. PMID- 3293612 TI - Ventromedial hypothalamic and paraventricular nucleus lesions damage a common system to produce hyperphagia. AB - We investigated the anatomical basis of paraventricular (PVN) and ventromedial (VMH) hypothalamic hyperphagia. Asymmetrical electrolytic lesions, damaging the VMH and PVN contralaterally, produced significant hyperphagia and weight gains (mean = 257.2 g) almost three times those of controls (89.8 g) during 56 postsurgical days. Weight gain in these rats was not significantly different from that in rats with bilateral lesions of the VMH (277.2 g) or PVN (188.2 g). Combined bilateral destruction of the PVN and VMH produced weight gain (272.8 g) almost identical to that seen after bilateral VMH lesions alone. The lack of additivity of these combined lesions and the effectiveness of the asymmetrical lesions are consistent with the hypothesis that lesions of either of these two regions damage a longitudinally running system to produce elevated food intake and body weight. Cell bodies of this system may lie within the PVN and send efferent projections through the VMH. Hyperinsulinemia developed only in rats with bilateral damage in the VMH. Thus, hypothalamic hyperphagia and hyperinsulinemia appear to be dissociable, reflecting damage to separate neural systems. PMID- 3293613 TI - Glucose, the key substrate in the microbiological changes occurring in meat and certain meat products. AB - The literature dealing with the role of glucose in the microbiological changes of meat and certain meat products is reviewed. Discussion is centered on two aspects. First, glucose plays a part in the selection of the dominant spoilage organisms, Pseudomonas fragi, Ps. lundensis, and Ps. fluorescens, on red meat stored aerobically under chill (2-7 degrees C) conditions. It is concluded that the pseudomonads flourish because they convert glucose to the less commonly used substrate, gluconate. The latter serves as an extracellular energy store. With its depletion, the pseudomonads utilize amino acids, thereby producing the characteristic off-odors of spoiled meat. Storage of meat in a modified atmosphere (viz., 20% CO2:80% O2) selects Gram-positive flora (lactobacilli and Brochothrix thermosphacta) which impart a "cheesy odor" through acid production from glucose and volatile fatty acids from amino acids. The first mentioned organisms produce the same off-odors in "acid" meat (pH 5.5) from which oxygen is excluded. So too does the less acid-tolerant Br. thermosphacta in less acid meat (pH greater than 5.8), especially if trace amounts of O2 are present. Such meat may be colonized by Shewanella putrefaciens also, with green discoloration resulting from the release of H2S from amino acids. The addition of glucose and NO2- to, and the exclusion of oxygen from, comminuted meat selects a flora dominated by Lactobacillus spp. and staphylococci such as Staphylococcus carnosus. Second, sulfite, the preservative of British-style sausages, has a sparing action on glucose. As a consequence of its curtailed breakdown there is only a meager acid drift with storage even though a fermentative flora of lactobacilli and Br. thermosphacta is selected. Yeasts also contribute to the microbial association in sausages; members of four of the six commonly occurring genera bind sulfite through acetaldehyde production. Glucose appears to be essential for acetaldehyde synthesis. The role of glucose in spoilage and the conditions which select particular groups of spoilage organisms are considered in the context of chemical probes and/or instrumental methods for routine assessment of the "freshness" of meat and meat products. PMID- 3293614 TI - Long-term variations of serum beta 2-microglobulin levels in hemodialysed uremics according to permeability and bioincompatibility of dialysis membranes. AB - Hemodialysis (HD) amyloidosis is due to beta 2-microglobulin (beta 2M) storage, the importance of which could vary with the permeability of dialysis membranes. We studied long-term variations of beta 2M in 52 patients who had been dialyzed over 1.5-20 years (mean +/- SD = 7.5 +/- 5.2), 3 X 4 h weekly. Serum samples had been stored at 30 degrees C and RIAs were done in one run with the same kits (Immunotech). At least 2 assays were done for each patient in samples collected 1 9.5 years apart. Mean beta 2M concentration in 26 ESRF patients was 31 +/- 18 mg/l. According to duration of HD and membranes used, Cuprophan (CUP) versus polyacrylonitrile (AN69), mean concentrations of beta 2M were (mg/l +/- SD): at 6 months, 55 +/- 36 vs. 54 +/- 20 (n.s.); 2 years, 55 +/- 24 vs. 61 +/- 23 (n.s.); 4 years, 79 +/- 18 vs. 64 +/- 19 (n.s.); 6 years, 69 +/- 17 vs. 55 +/- 17 (n.s.); 8 years, 76 +/- 18 vs. 54 +/- 12 (less than 0.01); 10 years, 77 +/- 17 vs. 54 +/- 14 (less than 0.02). The effect of changing membranes was also studied: CUP-AN69 (69 +/- 28 months), 79 +/- 21 vs. 54 +/- 14 (less than 0.01). Serum beta 2M (1) increased rapidly after the beginning of HD; (2) reached a plateau after 2 years in patients treated with AN69 and 4 years with CUP; (3) were significantly lower after 8 years with AN69 than with CUP, and (4) decreased significantly after changing CUP for AN69.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293615 TI - Chronic renal failure treatment duration and mode: their relevance to the late dialysis periarticular syndrome. PMID- 3293616 TI - Carpal tunnel syndrome and beta 2-microglobulin-related amyloidosis in chronic hemodialysis patients. PMID- 3293618 TI - Beta-2-microglobulin-derived amyloid--problems and perspectives. PMID- 3293617 TI - Dialysis amyloidosis: beta-2-microglobulin in the context of other amyloidogenic proteins. PMID- 3293619 TI - Development of new immunologic approaches to cancer therapy. AB - New approaches to the immunotherapy of cancer have been developed based on the adoptive transfer of activated lymphoid cells in conjunction with interleukin-2. This approach is successful in mediating the regression of established pulmonary and hepatic metastases in experimental animal models. The results of preliminary clinical trials in patients with advanced cancer have shown that this treatment approach is capable of mediating regression of cancer in humans as well. PMID- 3293620 TI - Anticoagulation for continuous arteriovenous hemofiltration in children. AB - Continuous arteriovenous hemofiltration requires continuous anticoagulation to prevent early hemofilter clotting. We used heparin given continuously in the arterial line of the extracorporeal circuit as anticoagulant in children with initially normal coagulation status, and heparin and/or prostacyclin in high-risk bleeding patients with preexisting coagulopathy. Heparin infusion enabled a mean running time of 22.2 +/- 9.6 h, with the 0.1-m2 hemofilter and of 26.6 +/- 4.7 h with the 0.25-m2 hemofilter. The mean filter running time with combined heparin/prostacyclin infusion was 31 +/- 8.8 h. Prostacyclin as the sole antithrombotic agent provided good filter function only in 1 patient with preexisting coagulopathy. No adverse effects such as bleeding thrombosis, or hypotension were observed. PMID- 3293621 TI - Removal, generation and adsorption of beta-2-microglobulin during hemofiltration with five different membranes. AB - Removal of beta 2-microglobulin (B2MG) from uremic plasma during hemofiltration in 5 patients using polysulfone (F60), acrylonitrile (AN69), polyamid (FH77), polyacrylonitrile (PAN200) and cellulose-acetate (Duo-Flux) membranes was investigated. The reduction in plasma concentration of B2MG (corrected for hemoconcentration during treatment) was greatest for the F60 hemofilter (61%, sieving coefficient 0.55 at end of treatment) and the AN69 (48%, sieving coefficient 0.45 at end of treatment, while the PAN200 membrane showed no reduction in plasma concentration of B2MG during treatment. Mass balance for B2MG showed that there was a continued net adsorption of B2MG in the AN69 membrane (about 120 mg) throughout the treatment, while insignificant amount of B2MG was absorbed by the F60 membrane. The results with the PAN200 showed a 'negative adsorption', indicating release of B2MG from cells into the plasma as blood passed through this filter. Comparison of reduction in plasma concentrations, sieving coefficients, plasma clearances and filter mass balances showed that the question of B2MG removal during hemofiltration is a complex issue where adsorption to the membrane, 'shedding' from blood cells, membrane pore size and possibly also 'redistribution' of B2MG in the body must be considered. PMID- 3293622 TI - Interleukin-1--its multiple biological effects and its association with hemodialysis. AB - It has been proposed that monocyte activation during hemodialysis involves the release of interleukin-1 (IL-1) and related cytokines. In this review, the biological properties of recombinant human IL-1 are discussed with particular emphasis on hemodialysis. Models of monocyte activation which likely occur during hemodialysis are presented. We conclude that pyrogens, solutes, complement components and the physical nature of the dialysis membrane itself contribute to monocyte activation and cytokine release. PMID- 3293624 TI - Determination of endotoxin levels and their impact on interleukin-1 generation in continuous ambulatory peritoneal dialysis and hemodialysis. AB - Endotoxins represent a family of ubiquitous bacterial lipopolysaccharides found in water and raw materials. These substances have the ability to generate interleukin-1 (IL-1) and induce fever, as well as other acute phase phenomena. A study was undertaken to determine levels of background endotoxin in (1) continuous ambulatory peritoneal dialysis solution, (2) spent dialysate subsequent to overnight dwell, (3) hemodialysis solution, and (4) Limulus amebocyte lysate-reactive material (LAL-RM) in hemodialyzers and patient plasma. Levels of endotoxin in all of the above cases were less than thought to be required to induce biological activity, such as pyrogenicity, through IL-1 generation. Although nanogram amounts of LAL-RM are associated with some hollow fiber membranes as well as the plasma of patients on those membranes, this material per se does not appear to produce IL-1 in vitro. PMID- 3293623 TI - Beta-2-microglobulin synthesis is increased during activation of human monocytes. AB - We have investigated the regulation of beta 2-microglobulin (beta 2-M) synthesis by monocytes. Recent interest in beta 2-M has developed since the discovery that this protein forms amyloid fibrils in patients undergoing long-term, chronic hemodialysis. The beta 2-M amyloidosis is linked to the greatly elevated levels of monomeric beta 2-M in their circulation. Since factors that govern beta 2-M release from plasma membranes are not known, we endeavored to evaluate beta 2-M release during monocyte activation. Utilizing a human monocyte-like cell line, U937, we studied the effect of bacterial toxin stimulation on levels of membrane, cell surface, and supernatant beta 2-M. We now present a novel method to purify beta 2-M, a solid-phase radioimmunoassay to measure soluble beta 2-M, and an ELISA to measure membrane beta 2-M. Using these methods we found that the levels of beta 2-M in the cell membrane or on the cell surface did not change during monocyte activation. However, activation did induce a significant increase in the concentration of beta 2-M in monocyte supernatants, indicating that beta 2-M synthesis by monocytes is increased during monocyte activation. These results suggest that monocyte activation by hemodialysis membranes may be a contributing factor to the observed increase in circulating beta 2-M levels. PMID- 3293626 TI - The detection of measles specific immunoglobulin M antibodies using biotinylated antigens. AB - The methods of reverse type enzymeimmunoassay (EIAs) with biotinylated antigens were used to determine IgM antibodies to measles virus in human sera. These antigens, either purified measles virus antigen or lysate type measles-vero antigen with lysate vero control antigen, were used in the two separate IgM tests. Paired sera from 15 measles patients as well as 456 sera from patients with viral infections other than measles, with mycoplasma pneumoniae infections, from rheumatoid arthritis patients and blood donors, were assayed in a dilution of 1:200. Both the test systems detected all the 30 serum specimens from the measles patients as measles IgM positive, but the sera of all the other groups proved to be measles IgM negative. These tests developed for measles specific IgM antibodies, avoiding the interference of IgM-class rheumatoid factor, offer valuable tools for routine virus serology. PMID- 3293625 TI - The polypeptide hormone-derived amyloid forms: nonspecific alterations or signs of abnormal peptide-processing? PMID- 3293627 TI - Glucagon and glucagon-like immunoreactive cells in mid- and hindgut carcinoids. AB - The occurrence of glucagon/glucagon-like immunoreactivity in 31 small intestinal, 34 rectal and 18 appendiceal carcinoids were investigated immunocytochemically using, sequence specific antisera. Glucagon/GLI immunoreactive cells were found in five small-intestinal and five rectal carcinoids, but none were observed in any of the appendiceal carcinoids examined. Glucagon/GLI immunoreactive cells constituted a minor cell population, except in one rectal carcinoid, where most of the tumour cells were of this type. Glucagon/GLI immunoreactive cells were detected with only some sequence-specific antisera, and not with antisera directed against the rest of the glucagon/glicentin molecule. This might indicate that these cells contain a molecule which shares some antigenic binding sites with glucagon/glicentin rather than genuine glucagon/glicentin. It is concluded that this finding contributes to explain why hindgut carcinoids rarely give rise to symptoms related to neuro-endocrine product(s). PMID- 3293628 TI - Thomsen-Friedenreich-related antigen in human endometrium. An immunohistochemical study employing the monoclonal antibody 49H.8. A preliminary report. AB - The Thomsen-Friedenreich antigen (T-antigen) Gal beta 1-3Ga1NAc, is a cryptic disaccharide structure on human erythrocytes. It is masked by sialic acid and uncovered by sialidases as neuraminidase. T-antigen is a tumor-associated antigen in epithelial tissues. This study reports preliminary immunohistochemical findings on the expression of the blood group related T-antigen in human endometrium. Dewaxed sections of 10 proliferative-, 6 interval-, 14 secretory endometrium, and 16 endometrial carcinomas, either untreated or pretreated with neuraminidase, were subjected to an indirect immunoperoxidase technique using the monoclonal antibody 49H.8. The monoclonal antibody 49H.8 did not bind to normal cyclic endometrium, unless pretreated with neuraminidase. Neuraminidase treatment revealed staining of apical membranes of glandular- and surface epithelium in early or manifest secretory endometrium only. Thirteen of sixteen carcinomas stained without neuraminidase treatment, while all carcinomas stained after pretreatment with neuraminidase. Staining was more widespread than in untreated carcinomas, resembling that of secretory endometrium. Our results suggest: 1) That the sialylated 49H.8 antigen seems to be a marker of cellular differentiation in the endometrium, 2) that the antigen defined by the monoclonal antibody 49H.8 might be a tumor-associated antigen in endometrial epithelial tissue. PMID- 3293629 TI - Physiologic considerations in radionuclide imaging of the extrahepatic biliary tract. AB - Scintigraphy of the biliary system using 99mTc-labeled radiopharmaceuticals enables the clinician to assess kinetics of bile flow through the gallbladder, common bile duct, and sphincter of Oddi. We review some aspects of biliary tract physiology and imaging which may be of interest to the physicians ordering and performing these studies. PMID- 3293630 TI - Regional pulmonary perfusion estimated by high-speed volume scanning CT. AB - Three pigs with surgically created aortopulmonary shunts and two pigs who had sham operation were scanned in a fast computed tomography (CT) scanner, the dynamic spatial reconstructor (DSR). Each pig was scanned during injection of a bolus of roentgen contrast medium in the right atrium and during injection into the left ventricle. In addition to these DSR scans, radiolabeled, 15-micron diameter microspheres were injected into the right atrium and into the left ventricle. The quantitative distribution of roentgen contrast agent was used to estimate regional pulmonary blood flow independently from the right and left circulations using analysis of the indicator dilution curves derived from the DSR images (Y). These values were compared to the regional values of pulmonary perfusion based on the microsphere distribution (X). The correspondence between the two methods (for all pigs together) was Y = 0.83X + 0.52 with r = 0.964. The less than unity slope is attributed to the partial collapse of the lung at the time of sectioning (for counting of tissue radioactivities). As regional air content of the lung also was measured from the DSR images, these data support the contention that regional ventilation and perfusion can be estimated from a fast CT scan of the thoracic contents during the passage of a bolus of contrast medium. PMID- 3293631 TI - Relation of life events to blood pressure control in the SHEP pilot trial. AB - The Systolic Hypertension in the Elderly (SHEP) pilot trial was a five-center study in which 551 persons aged 60 years or older with isolated systolic hypertension were given antihypertensive drugs or placebos in order to determine the effects on blood pressure control and possible side effects of therapy. A life events inventory was administered to the cohort one year into the study. Results of this inventory were then compared to blood pressure and changes in blood pressure in the placebo and active therapy groups. One or more of the life events assessed were present in about 65% of the population. Although the sample was too small to detect very subtle effects, there was no evidence in this study that either individual or groups of life events play a major role in blood pressure regulation of persons with isolated systolic hypertension. PMID- 3293632 TI - Neonatal herpes: incidence, prevention, and consequences. AB - The incidence, prevention (by cesarean section), and severe consequences (particularly mortality) of neonatal herpes were appraised. The incidence rate of neonatal herpes should be around one in every 15,000 deliveries with a range of one in 7,500 to 30,000 deliveries. Cesarean section for pregnancies exposed to herpes simplex virus fails to prevent newborns from acquiring neonatal herpes. The mortality rate of herpes patients could be around 25% if a better reporting and diagnostic system were available. PMID- 3293633 TI - Decrease in the overall costs of the Medicare program. PMID- 3293634 TI - Evaluations of workplace smoking cessation programs: a critique. AB - This article reviews 21 published evaluations of workplace smoking cessation programs. Its purpose is to assess the quality of these evaluations and outline recommendations that may benefit such smoking cessation efforts. Issues that should be considered during the planning and evaluation of these smoking cessation programs include research design, behavior measurement and verification, employee recruitment strategies, nonsmoking behavior maintenance, and ethics. PMID- 3293635 TI - Characterization of an intracellular insulin-degrading enzyme in human erythrocytes. AB - Using conventional techniques of ammonium sulfate fractionation and Sephadex gel column chromatography, insulin-degrading enzyme was partially purified from lysate of human erythrocytes. The enzymatic activity was measured by the trichloroacetic acid precipitation method. Compared to trypsin, the enzyme was highly specific for insulin. The apparent molecular weight of the enzyme was 160,000 Da, the optimum pH was the 7.4 to 7.8 range, and the Km value for insulin for the partially purified enzyme was 162 nM. Bacitracin and N-ethylmaleimide were potent inhibitors, while chloroquine, ethylenediaminetetraacetate, antipain, and soybean trypsin inhibitor failed to inhibit the activity of the enzyme. Like most nucleated cells, human erythrocytes not only have the membranal insulin receptors, but also possess the cytosolic specific insulin-degrading enzyme. Insulin internalization and degradation are shown to be due to the receptor and the enzyme acting in concert as in many nucleated cells. Anucleated erythrocytes have both these entities for possible internalization and degradation of insulin. PMID- 3293637 TI - [Persistent primitive first cervical intersegmental artery (proatlantal artery II) with occlusion of the basilar artery--a case report]. AB - A rare case of persistent primitive first cervical intersegmental artery (proatlantal artery II) is reported. A 58-year-old man was admitted to our hospital with dysarthria and left hemiparesis. On admission he was stuporous with bilateral gaze palsy and left hemiparesis. CT scan on admission showed low density areas in the right cerebellar hemisphere and ventricular part of the pons. Right retrograde brachiography revealed occlusion of the basilar artery, aplasia of the right vertebral artery and an abnormal vessel connecting the right external carotid artery and the right vertebral artery. This anastomotic vessel was thought to be a persistent primitive first cervical intersegmental artery (Proatlantal artery II). Left carotid angiography revealed the left posterior cerebral artery was visualized through the posterior communicating artery, leading from the internal carotid artery. Left retrograde brachial angiography showed that the left vertebral artery terminated just distal from the branching of the left posterior inferior cerebellar artery. After admission the left hemiparesis deteriorated gradually and tracheotomy was done due to respiratory difficulties. The patient was then transferred to the rehabilitation center on his 34th day in hospital with neurological deficits. PMID- 3293636 TI - Detrimental effect of hyperosmolality on insulin-stimulated glucose metabolism in adipose and muscle tissue in vitro. AB - To better understand impairment of glucose utilization in diabetics during a hyperosmolal state, in vitro models were established to evaluate the interdependence of hyperosmolality on basal as well as insulin-dependent glucose uptake by rat epididymal fat pads and diaphragms. Using the epididymal fat pad it was shown that NaCl and urea induced hyperosmolality of 400 and 500 mOsm/kg diminished insulin-stimulated glucose uptake by 35 and 90%, as well as 29 and 68%, respectively. Using rat diaphragm as target tissue for insulin action instead a transient rise in basal (non-insulin-dependent) glucose uptake was seen at 400 but not at 500 mOsm/kg. Associated impairment of insulin-dependent glucose uptake was 30 and 79%, respectively. These in vitro data support our previous clinical contention that a hyperosmolal state, which corresponds to a loss of fluid in excess of solutes, is able to impair basal glucose utilization as well as hormone action on glucose metabolism. PMID- 3293639 TI - Viruses in the aetiology of cancer. PMID- 3293638 TI - [Non-clostridial gas-producing brain abscess in a brain death patient--report of a case]. AB - A 46 year old female was admitted to our emergency room because of cardiopulmonary arrest by hanging. After ten minutes cardiopulmonary resuscitation, she was resuscitated but her consciousness did'nt recover. CT scans on the day of admission showed no abnormalities but on the second hospital day it showed symmetrical low density areas within the basal ganglia, the thalamus, the hippocampus, and the occipital lobe. There were marked enhanced effect in cerebral sulci due to cytotoxic edema of hypoxic encephalopathy. She was comatose for a week, her pupils were dilated, light reflex and other brain stem reflex were absent. CT-scans on the sixth hospital day showed marked brain swelling with disappearance of the ventricular systems (so called brain tamponade). Brain death was confirmed on the basis of Japanese Criteria on the seventh and tenth day of admission. She had been suffering from pneumonia and urinary tract infection with an elevation of temperature since the fourth hospital day. We detected Enterobacter Cloacae (E. Cloacae), Klebsiella Oxytoca from the cultures of sputum and urine. On the tenth hospital day her temperature was running up to 39.4 degrees C and blood count revealed a peripheral blood leucocytosis of 40,300/mm3 with a shift to the left. E. Cloacae was also detected from the cultures of blood. Skull roentgenogram showed multiple gas collections in the ventricular systems. CT-scans on the fourteenth hospital day showed multiple gas-containing brain abscess. The etiology of this infection was considered due to septicemia of E. Cloacae. She died from acute renal failure on the fifteenth hospital day. Consent for autopsy was not accepted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293640 TI - Ventricular arrhythmias in long term survivors of orthotopic and heterotopic cardiac transplantation. AB - Fourteen long term survivors with orthotopic (recipient heart replaced by donor heart) and nine with heterotopic cardiac transplants (recipient heart retained) had 24 hour ambulatory electrocardiographic monitoring to detect ventricular arrhythmias. Arrhythmia was uncommon in the patients with orthotopic transplants; none of them had more than one extrasystole per hour. In the patients with heterotopic cardiac transplants the recipient's own heart showed significantly more frequent ventricular arrhythmias than the corresponding donor heart: abnormal complexes (mean/24 h) 4583 vs 42.7; extrasystoles 1772 vs 17.8; pairs 121 vs 0.8. There was no relation between the abnormal ventricular activity of the two hearts in the patients with heterotopic transplants on a beat by beat, hourly, or 24 hour basis. There was no consistent diurnal variation in the frequency of the abnormal ventricular beats after cardiac transplantation. The occurrence of ventricular arrhythmia was unrelated to the interval from operation to the study. In long term survivors of cardiac transplantation the denervated heart shows a little ventricular ectopic activity even when compared with normal hearts. In patients with heterotopic transplants ventricular arrhythmias commonly occur in the recipient's own heart; these are probably related to the underlying severity of the original disease. PMID- 3293641 TI - Prediction of favourable responses to long term vasodilator treatment of pulmonary hypertension by short term administration of epoprostenol (prostacyclin) or nifedipine. AB - Eighteen patients with moderate to severe pulmonary hypertension were studied, nine with intracardiac shunts and nine without. The effects of an incremental infusion of epoprostenol (prostacyclin) (0.5-8 ng/kg per minute) or sublingual nifedipine (20-30 mg) were compared with the response to three months' treatment with oral nifedipine. Both epoprostenol and sublingual nifedipine caused a fall in pulmonary vascular resistance and pressure and a rise in cardiac output. Patients with intracardiac shunts had higher systemic blood flows than those without shunts. Exercise in the shunt group was accompanied by systemic desaturation and hyperventilation. Analysis of individual results showed that the size of the response was inversely related to the severity of the pulmonary vascular disease. A good long term response to nifedipine seemed to be as readily predicted by the resting control values for haemodynamic variables as by values after short term treatment. A favourable response was likely if the pretreatment mean pulmonary artery pressure was less than 50 mm Hg, the ratio of total pulmonary to systemic resistance was less than 0.7, or the ratio of mean pulmonary artery pressure to systemic artery pressure was less than 0.6. Short term vasodilator protocols may do harm. If such studies are carried out, an adequate dose range must be tried before the long term efficacy of an individual drug can be forecast. PMID- 3293642 TI - Subarachnoid anaesthesia produced by hyperbaric lignocaine in elderly patients. Prolongation of effect with adrenaline. AB - The effects of adrenaline on the duration of spinal anaesthesia induced with hyperbaric lignocaine were investigated in 60 elderly patients in a double-blind study. Each patient received 5% lignocaine 2 ml in 7.5% dextrose to which was added physiological saline 1 ml, 1:1000 adrenaline 0.2 ml (0.2 mg) plus normal saline 0.8 ml, or adrenaline 0.4 ml with normal saline 0.6 ml. The duration of sensory block (measured by two- and four-segment regression times, and times to regression to T12 and L2 dermatomes) was prolonged significantly by both doses of adrenaline. The addition of adrenaline also produced a significant increase in the duration of complete motor block. PMID- 3293643 TI - Postoperative analgesia by continuous extradural infusion of bupivacaine and diamorphine. AB - Three solutions administered by continuous extradural infusion for postoperative analgesia were compared in a randomized, double-blind manner. All patients underwent major abdominal gynaecological surgery and received 0.125% bupivacaine in 0.9% saline, diamorphine in 0.9% saline (0.5 mg in 15 ml) or diamorphine mixed with 0.125% bupivacaine (0.5 mg in 15 ml), at a rate of 15 ml h-1. The bupivacaine-diamorphine mixture provided significantly superior analgesia compared with either bupivacaine or diamorphine alone. No major side effects were encountered. PMID- 3293644 TI - Structure and expression of oncogenes in surgical specimens of human breast carcinomas. AB - We have performed an analysis of ras, c-myc, c-myb, c-erbB1 and c-erbB2 oncogenes in 100 surgical samples of human breast carcinomas. No point mutations have been detected at the 12th codon of c-Ha-ras and c-Ki-ras in 40 and 65 breast cancer DNAs, respectively. One out of 65 samples showed a 50-fold amplification of c-Ha ras that, however, was not overexpressed. Alterations in the structure of c-myc, c-myb c-erbB1 and c-erbB2 oncogenes were sporadically observed. In 20 tumour samples, the study of expression of a series of oncogenes revealed that c-Ha-ras was the predominantly transcribed gene among the ras gene family whereas c-fos appeared the most constantly and significantly expressed nuclear oncogene. PMID- 3293645 TI - Constitutional frequency of rare alleles of c-Ha-ras in breast cancer patients. PMID- 3293646 TI - Expression of a pemphigoid gestationis-related antigen by human placenta. AB - We studied the antigen binding of sera from 25 patients with pemphigoid gestationis (PG) using skin and amnion as substrates in an indirect immunofluorescence technique. In addition, skin was studied after prior incubation with I M NaCl which allows BMZ cleavage through the lamina lucida. Linear BMZ staining was obtained with sera from patients with PG using human amnion as substrate. This was seen with both full-term and second trimester placentae, but not with first trimester placentae. In NaCl incubated skin all sera bound to the epidermal aspect of the separated tissue. The pattern of staining in skin, chemically split skin and amnion was identical to that previously seen with the sera of patients with bullous pemphigoid suggesting that the antigen against which circulating anti-BMZ antigens are directed may be the same in the two conditions. PMID- 3293647 TI - Acanthosis nigricans, insulin resistance and cutaneous virilism. AB - Thirteen patients with the syndrome of acanthosis nigricans and insulin resistance are described. They all had a combination of dermatoses related to hyperandrogenism (cutaneous virilism): hirsuties (II), acne vulgaris (6), hidradenitis suppurativa (5) and androgenic alopecia (4). In addition, 9 out of 13 had keratosis pilaris. The patients had raised fasting plasma insulin levels compared with matched normal controls (P less than 0.01) and increased insulin resistance (P less than 0.02). Insulin resistance correlated with total serum testosterone (rs = 0.65; P less than 0.02). PMID- 3293648 TI - Kaposi's sarcoma in kidney transplant recipients treated with cyclosporin. AB - We report the clinical and histological features and the course of Kaposi's sarcoma in three transplant patients treated with cyclosporin. Four months after cyclosporin treatment was stopped the lesions in all three patients had completely healed. PMID- 3293649 TI - Dust-like particles: a specific direct immunofluorescence pattern in sub-acute cutaneous lupus erythematosus. PMID- 3293651 TI - Fungal infection in renal transplant patients. PMID- 3293650 TI - Failure of neutrophils to migrate into psoriatic lesions. PMID- 3293652 TI - Lens thickness in early cataract. AB - The search for environmental factors associated with cataract has produced conflicting evidence and one possible reason may be that environmental influences are initiating events occurring perhaps for short periods many years before loss of sight from cataract. It is important, therefore, to be able to detect the earliest changes of cataract formation so that epidemiological studies have a better chance of detecting environmental factors. Two possible indicators of early cataract are delayed growth of the lens and abnormalities of the anterior subcapsular clear zone of the lens as observed on slit-lamp microscopy. A series of patients with early lens changes was compared with control subjects in respect to these two factors. Lens thickness was measured by a simple optical method. The mean thicknesses of the lens in patients with early cortical or posterior subcapsular lens changes were significantly less than that of age matched controls. 60% of lenses with early cataract of all types were found to have a deficient or absent anterior subcapsular clear zone. Lens thickness and the appearance of the anterior subcapsular clear zone are easy to measure and observe through an undilated pupil. Although the prognostic value of the results is uncertain in individual cases owing to the rather wide scatter of results in normal eyes, such observations could be of value in comparative studies of populations. PMID- 3293654 TI - Multiple odontogenic keratocysts in a patient with type II (mitis) Ehlers-Danlos syndrome. AB - Ehlers-Danlos syndrome (EDS) is now considered to be a heterogeneous collection of fundamentally distinct disorders. The many and varied sub-types of EDS have been distinguished using clinical, genetic and in some cases biochemical criteria and this has important implications as regards prognosis and the prediction of inheritance patterns. The major clinical features of EDS are reviewed, with particular emphasis placed on the possible complications encountered in the practice of oral surgery. A case of Type II mitis EDS is described, that presented with multiple odontogenic keratocysts. PMID- 3293653 TI - Experimental epikeratophakia using tissue lathed at room temperature. AB - This report presents for the first time the results of carrying out epikeratophakia with tissue lathed at room temperature. Using an experimental model of epikeratophakia in the rabbit, we evaluated tissue handling techniques for the preparation of donor lenticules. Details of the technique are described and the in-vivo and histopathological findings reported. PMID- 3293655 TI - Congenital epulis: a case report. AB - An unusual case of a double congenital epulis involving the alveolar mucosa of both the maxilla and mandible is reported. The authors discuss the clinical picture, histological findings, etiology and treatment of this rare lesion. PMID- 3293656 TI - A conversion to flatter archwires. AB - Clinical and practical features are described for an operator changing fixed appliance technique from a standard edgewise system to one using pretorqued and preangulated brackets, with generally flat archwires. PMID- 3293657 TI - Application of a video image subtraction system to measure and control head position in cephalometry. AB - Variation in head position in the cephalostat is a potential source of error in cephalometrics as it causes distortion of the radiographic projection of the head. Image subtraction is an electronic technique enabling images to be superimposed and which highlights any differences. Using this method, a study was carried out to assess the reproducibility of the position of the head in the cephalostat. It was also used to find out whether subjects could improve their own head relocation by looking at the monitor and trying to achieve the best possible fit on the original image. PMID- 3293658 TI - Favourable spontaneous eruption of severely displaced maxillary canines with associated follicular disturbance. AB - Cases of severely displaced unerupted maxillary canines are presented, related to disturbance of the follicle. Removal of the deciduous predecessor produced favourable eruption of the permanent canine and should be considered as a treatment option in similar cases. PMID- 3293659 TI - Factors influencing the development of molar occlusion: a longitudinal study. AB - Longitudinal records, in the form of study casts, of 35 Class I cases were examined for factors associated with changes of sagittal molar relationship during childhood. These were studied at two phases: between the deciduous and mixed dentitions, and between the mixed and permanent dentitions. During the first of these periods, there was a small, but general move to a less post-normal occlusion, although some cases were found to show a slight reverse trend. In the second period, the permanent molar relationship became less post-normal, but this was reflected only weakly in that of the canines. Throughout development, asymmetry of occlusal relation became more marked with age, an unexplained bias towards less post-normal occlusion on the left side developing in the second phase. The amount of change in this period was related to variations of deciduous molar size, especially that of the upper second molar. PMID- 3293660 TI - Modifications of gastric inhibitory polypeptide (GIP) secretion in man by a high fat diet. AB - 1. Five healthy volunteers (usual fat intake 103 (SE 9) g/d and energy intake 9855 (SE 937) kJ/d were given on two separate occasions (a) 100 g oral glucose and (b) sufficient intravenous (IV) glucose to obtain similar arterialized plasma glucose levels to those after oral glucose. 2. Subjects increased their fat intake by 68 (SE 9.6)% for 28 d by supplementing their diet with 146 ml double cream/d (fat intake on high-fat diet (HFD) 170 (SE 8) g/d; energy intake 12347 (SE 770)). 3. The 100 g oral glucose load was repeated and IV glucose again given in quantities sufficient to obtain similar arterialized blood glucose levels. Immunoreactive plasma insulin, C-peptide and gastric inhibitory polypeptide (GIP) were measured. 4. Plasma GIP levels were higher following oral glucose after the HFD (area under plasma GIP curve 0-180 min 1660 (SE 592) v. 2642 (SE 750) ng/l.h for control and HFD respectively; P less than 0.05). Both insulin and C-peptide levels were significantly higher after oral than after IV glucose (P less than 0.01) but neither were affected by the HFD. Glucose levels were lower following the HFD after both oral and IV glucose (area under plasma glucose curve 0-180 min, following oral glucose 6.7 (SE 0.3) mmol/l.h for control and 4.2 (SE 0.6) mmol/l.h for HFD; P less than 0.01). 5. Glucose-stimulated GIP secretion was thus enhanced by the HFD. Insulin secretion in response to oral glucose was unchanged, in spite of an improvement in glucose tolerance. 6. The improvement in glucose tolerance post-HFD could possibly be due to a GIP-mediated inhibition of hepatic glycogenolysis, or a decreased rate of glucose uptake from the small intestine. PMID- 3293661 TI - The role of insulin and thyroid hormones in the regulation of muscle growth and protein turnover in response to dietary protein in the rat. AB - 1. We have investigated the relations between changes in plasma insulin and 3,5,3'-triiodothyronine (T3), and muscle growth and protein turnover in the rat in response to diets of varying protein concentrations. 2. Young rats were fed ad lib. on a control (180 g casein/kg) diet or low-protein diets containing 80, 45 and 0 g casein/kg in four separate experiments. Measurements were made of food intakes, muscle and body-weight growth rates, muscle protein turnover in vivo, plasma insulin, and plasma free and total T3. 3. The food intakes of the 80 and 45 g casein/kg diet groups were variable, with the 80 g casein/kg diet group consuming either the same or more than the controls, and the 45 g casein/kg diet group consuming less or more than the controls. Body-weight and skeletal-muscle growth rates varied with the protein but not energy intakes, which in turn reflected both dietary composition and the food intake, with the hyperphagic 80 g casein/kg diet group of rats growing almost normally and the 0 g casein/kg diet group losing body-weight and muscle mass. 4. Changes in rates of muscle growth were accompanied by parallel changes in rates of protein synthesis and degradation, as well as parallel changes in concentrations of plasma insulin and free T3, to the extent that all these variables were highly correlated with each other. 5. Partial correlation analysis was used to separate interactions between variables. This indicated that dietary energy had no identifiable influence on muscle growth. In contrast dietary protein appeared to stimulate muscle growth directly by increasing muscle RNA content and inhibiting proteolysis, as well as increasing insulin and free T3 levels. Insulin and free T3 stimulated each other as well as muscle protein turnover; insulin stimulating the RNA activity particularly at low insulin levels, free T3 stimulating the RNA content and both hormones stimulating proteolysis. 6. These apparent relations are shown to be consistent in the main part with previous studies of the mechanism of action of insulin and T3, but the possibility cannot be discounted that other anabolic hormones not measured in these studies are involved, particularly in the apparent direct influence of dietary protein on muscle. PMID- 3293663 TI - Acetylator genotype and arylamine-induced carcinogenesis. AB - A diverse array of arylamine chemicals derived from industry, diet, cigarette smoke and other environmental sources are carcinogenic. These chemicals require metabolic activation by host enzymes to chemically reactive electrophiles to initiate the carcinogenic response. Genetic regulation of activation and/or deactivation pathways are thought to account in large measure for corresponding differences in tumor incidence from these chemicals between tissues, between species, or between individuals within a species. Various acetyltransfer reactions are involved in arylamine metabolism and much has been learned regarding their enzymology, genetic regulation, and toxicological significance. The small amount of human data are supported by systematic investigations carried out in animal models characterized with respect to the acetylation polymorphism. Enzymological and genetic investigations suggest that common enzymes encoded by the acetyltransferase gene carry out a diverse set of acetyltransferase reactions. Thus, the acetylation polymorphism can influence both activation and deactivation pathways in arylamine metabolism. Of particular significance recently have been reports documenting the O-acetylation of N-hydroxyarylamine carcinogens and its genetic coregulation with the well-characterized arylamine N acetylation polymorphism. The toxicological consequences of this polymorphic pathway have yet to be fully explored. Epidemiological investigations show associations between acetylator phenotype and the incidence and/or severity of tumors in the urinary bladder, colon and larynx. Associations between acetylator phenotype and breast cancer are more equivocal and require further study. The divergent influence of acetylator phenotype on the incidence of tumors in different organ sites suggests an important role for extrahepatic acetyltransferases, and further characterization of them in human and animal tissues is needed. The advent of newer methodologies to monitor chemical exposures and to measure acetylator phenotype (rapid, intermediate and slow) using less invasive and more standardized protocols should soon result in a much more definitive understanding regarding the role of acetylator status in arylamine-induced carcinogenesis. PMID- 3293662 TI - Human teratocarcinomas. AB - Teratocarcinomas are one of the commonest forms of cancer in young adult men. Cell lines derived from these tumors, and particularly the cell lines composed of their embryonal carcinoma (EC) stem cells, may provide useful information concerning the development and subsequent pathology of teratocarcinomas in humans. In addition, it is likely that human EC cells resemble early embryonic cells and can be used as an in vitro counterpart of such cells from the human embryo. Several common properties of human EC cells have been identified, and a human EC cell line, TERA-2, that is capable of extensive somatic differentiation has been cloned. In nude mice, TERA-2 EC cells form tumors containing neural elements and glandular structures that resemble primitive gut. In culture, these EC cells can be induced to differentiate by exposure to retinoic acid and hexamethylenebisacetamide (HMBA). Differentiation is marked by the disappearance of several cell surface antigens characteristic of human EC cells, and the appearance of other antigens on the various subsets of differentiated derivatives. In retinoic acid-induced cultures, these differentiated derivatives include neurons and cells permissive for the replication of cytomegalovirus, a virus that can cause birth defects in humans. On the other hand, HMBA appears to activate an alternative pathway of differentiation for TERA-2 EC cells, although the identity of the resulting cells remains to be elucidated. In addition to providing a tool for analyzing the evolution of teratocarcinomas in human patients, the TERA-2 EC cells may provide us with insights into the mechanisms of cellular differentiation in the human embryo and a model in which to investigate how teratogenic agents such as HCMV can disrupt these processes. PMID- 3293664 TI - Degradation of thymopentin by human lymphocytes: evidence for aminopeptidase activity. AB - Thymopentin (Arg-Lys-Asp-Val-Tyr) was shown to be degraded in vitro by human lymphocytes into two main fragments; the tetrapeptide Lys-Asp-Val-Tyr and the tripeptide Asp-Val-Tyr. Degradation products were identified by HPLC and amino acid analysis. Analysis of the time-course of degradation revealed a 'stepwise' degradative event beginning at the N-terminal. The degradation of thymopentin after the first 10 min, as well as the formation of the tetrapeptide (5-30 min) were essentially curvilinear. Degradation of the tripeptide, was linear. Upon screening a panel of compounds that inhibit enzymatic activity, bestatin, amastatin and 1,10-phenanthroline were shown to be the most effective. Bestatin and amastatin caused an 85-90% inhibition of thymopentin degrading activity with IC50 values of 7.1 x 10(-6) M and 4.5 x 10(-9) M, respectively. 1,10 Phenanthroline completely inhibited the degradative process with an IC50 of 2 x 10(-4) M. When the tetrapeptide Lys-Asp-Val-Tyr was used as the starting substrate, similar IC50 values were seen for amastatin, bestatin and 1,10 phenanthroline. The importance of divalent metal ions in the degradative event was demonstrated not only by the effect of 1,10-phenanthroline, but also by the ability of Zn2+ and Co2+ to reverse the inhibition of 1,10-phenanthroline (at its IC50) to activities near control values (no inhibitor). These data strongly suggest that an aminopeptidase(s) is responsible for the degradative activity. PMID- 3293666 TI - Ribosomal RNA and the major lines of evolution: a perspective. AB - Does the "universal tree" based on small-subunit ribosomal RNA sequences show the phylogenetic relationship of all modern organisms? The answer is "yes" only if all these rRNAs are orthologous. Herein I argue that the major rRNA lineages (e.g. eubacterial, one or more archaebacterial and eukaryotic nucleocytoplasmic) probably arose from a divergent population of rRNAs in the progenote, antedating the universal common ancestral organism. Thus the major lineages of rRNA are probably not orthologous, but paralogous. The extrapolated date for the origin of the common ancestral small-subunit rRNA (3.6-4.7 x 10(9) years ago) is consistent with major rRNA lineages being paralogous. This perspective on the early evolution of genes and organisms rationalizes the presence of unexpected ribosomal characters in microsporidia, and bears on xenogenous and endogenous theories of the origin of the organelles in eukaryotes. PMID- 3293665 TI - Cell surface effects of human immunodeficiency virus. AB - Cell killing by human immunodeficiency virus (HIV) is thought to contribute to many of the defects of the acquired immunodeficiency syndrome (AIDS). Two types of cytopathology are observed in HIV-infected cultured cells: cell-cell fusion and killing of single cells. Both killing processes appear to involve cell surface effects of HIV. A model is proposed for the HIV-mediated cell surface processes which could result in cell-cell fusion and single cell killing. The purpose of this model is to define the potential roles of individual viral envelope and cell surface molecules in cell killing processes and to identify alternative routes to the establishment of persistently-infected cells. Elucidation of HIV-induced cell surface effects may provide the basis for a rational approach to the design of antiviral agents which are selective for HIV infected cells. PMID- 3293667 TI - [Imaging of sarcomas of soft tissue]. AB - Modern imaging of soft tissue sarcomas now includes ultrasounds, CT and MRI. These new techniques allow a better evaluation of initial local extension, of the response to treatment and are able to detect local recurrences early. PMID- 3293668 TI - [Sarcomas: principles of surgery]. AB - Surgery is the most important treatment for local control of sarcomas. The main difficulty is in the appreciation for each individual patient, of the solution which is expected to give the best control and the minimal functional impairment. In osteosarcoma, preoperative chemotherapy and technological advances have dramatically changed the local treatment, with more and more limb-sparing procedures being performed. The good results which have been obtained with such procedures in terms of tumor control as well as function lead now to consider an increase in the role of surgery in Ewing's sarcomas also. For soft tissue sarcomas, possibilities and results of radical surgery depend mainly on local extension and tumor localization. A good alternative can be less-than-radical tumor removal combined with post-operative radiotherapy. In extensive tumors, preoperative radiotherapy or chemotherapy may be considered. PMID- 3293669 TI - Stable isotope dilution method using thermospray liquid chromatography/mass spectrometry for quantification of daily cortisol production in humans. AB - A thermospray high-performance liquid chromatography/mass spectrometry method for the separation and quantification of cortisol in human serum has been developed. The technique does not require derivatization, allows for both qualitative and quantitative determinations, provides increased specificity not available from conventional high-performance liquid chromatography, and has a detection limit of 5 pmol on-column. This isotope dilution mass spectrometry method, using d3 cortisol as an internal standard, allows precise determinations even at low isotopic ratios (2%-5 mole%). Evidence that this technique can be applied to the quantification of serum cortisol and to the determination of daily cortisol production in humans is presented. PMID- 3293670 TI - What's happened to the cannabis debate? PMID- 3293672 TI - Arterioenteric fistulas. AB - Any patient with an abdominal aortic aneurysm, aortic graft or previously resected infected graft who presents with gastrointestinal bleeding or sepsis must be assumed to have an arterioenteric fistula. Warning bleeds are common. Oesophagogastroduodenoscopy may be diagnostic and should exclude other causes of upper gastrointestinal haemorrhage. Urgent investigation and surgery are essential for a successful outcome. PMID- 3293671 TI - Counselling carers of the elderly at home: a preliminary study. AB - A comparative study of two different methods of counselling for informal carers of elderly people with dementia was carried out in their own homes over an 18 week period. Carers were randomly allocated to short-term emotional support, information-provision or no-treatment control groups. Carers were assessed for mood, stress (Beck Depression Inventory and General Health Questionnaire), degree of burden and knowledge of problems of dementia. Carers receiving emotional support experienced the greatest reduction in stress, whereas those receiving information only showed an increase in knowledge, but no reduction in stress. PMID- 3293673 TI - Radiation enteritis. AB - Damage to the intestine occurs frequently as a result of abdominal or pelvic radiation treatment, and chronic radiation enteritis is a cause of significant morbidity and mortality. This review focuses on advances in knowledge which may be applied to the treatment and prevention of radiation enteritis. PMID- 3293675 TI - Paediatric radiology 3: genitourinary tract. PMID- 3293674 TI - Rational fluid therapy during surgery. AB - Administration of intravenous fluids during surgery is commonplace, yet there is enormous variation in the type and quantity of fluid given. That so few problems have been encountered is testimony to the body's ability to deal with extreme variations in hydration. A considerable amount of research would be required to achieve a rational approach to fluid balance in every patient; some guidelines can, however, be provided. PMID- 3293676 TI - Psychological sequelae of head injury. AB - Psychological disturbances are common after head injuries. A constellation of factors--organic, psychosocial and legal--may contribute to disability. Behavioural problems are not uncommon in children after head injuries. Developments in understanding the mechanisms that might lead to these complications have brought about improved management techniques. PMID- 3293677 TI - Current practice in clinical neurophysiology. AB - In recent years the range of investigations performed in the EEG laboratory has expanded, greatly extending the scope well beyond conventional ink-on-paper tracings. Although these still form the bulk of the output, both their value and that of the newer techniques available are discussed. PMID- 3293678 TI - A new feature of the ablepharon macrostomia syndrome: zygomatic arch absence. AB - The ablepharon macrostomia syndrome is an extremely rare congenital anomaly. It is characterised by bilateral absence or hypoplasia of lower eyelids, macrostomia and multiple other congenital anomalies. Three cases have been reported (McCarthy and West, 1977; Hornblass and Reifler, 1985). In addition to ablepharon and macrostomia, other anomalies common to all patients include auricular deformity, nasal alar deformity, absence of lanugo hair, dry, ichthyotic skin and ambiguous genitalia. A new feature of the syndrome is described--absence of the zygomatic arches. In addition, an expanded and revised classification of the ablepharon macrostomia syndrome and related disorders is presented. Skin graft pigmentation in this black patient has been prevented by prolonged application of sun block. PMID- 3293680 TI - A history of the Queen Victoria Hospital, East Grinstead. PMID- 3293679 TI - Squamous cell carcinoma of skin developing in a skin graft donor site. AB - We report a case of squamous cell carcinoma of the skin of the right ring finger which was treated by excision and split skin grafting. Three months later the patient presented with a further lesion at the margin of the skin graft donor site on the right thigh. Excision biopsy of this second lesion revealed a squamous cell carcinoma of a similar pathological appearance to the original lesion. We have been unable to trace any previous similar reports. A possible pathological basis for the sequence of events is discussed. PMID- 3293681 TI - Calcium alginate as a temporary recipient bed dressing prior to the delayed application of split skin grafts. PMID- 3293682 TI - Cardiovascular effects of the novel arteriovenous dilator agent, flosequinan in conscious dogs and cats. AB - 1. Flosequinan (BTS 49 465, 7-fluoro-1-methyl-3-methylsulphinyl-4-quinolone) a novel arteriovenous dilator agent was orally effective in conscious renal hypertensive dogs and normotensive cats. The hypotensive potency of flosequinan was approximately ten times less than that of hydralazine in renal hypertensive dogs, 10 mg kg-1 and 20 mg kg-1 flosequinan causing similar falls in mean blood pressure to 1 mg kg-1 and 3 mg kg-1 hydralazine respectively. In normotensive cats, 5 mg kg-1 flosequinan caused similar falls to 0.5 and 1.0 mg kg-1 hydralazine. The onset of hypotensive effect after flosequinan appeared to be slightly slower than after hydralazine in the dog and slightly faster than hydralazine in the cat. 2. The degree of tachycardia and increase in plasma renin activity (PRA) for equivalent falls in mean blood pressure in both species was significantly less for flosequinan than for hydralazine (P less than 0.05). 3. In normotensive dogs, flosequinan, 10 and 20 mg kg-1 orally, caused a small but non significant increase in sodium and chloride excretion and had little effect on urine volume whereas hydralazine, 1 and 3 mg kg-1 orally, caused a marked retention of sodium and chloride ions and a reduction in urine volume (P less than 0.01). 4. Neither flosequinan, 10 mg kg-1 orally, nor hydralazine 1 mg kg-1 orally, affected either glomerular filtration rate measured as creatinine clearance or effective renal plasma flow measured as p-aminohippuric acid clearance in normotensive dogs. 5. The lesser degree of tachycardia and increase in plasma renin activity together with a lack of sodium retaining activity associated with flosequinan suggest that this agent may have potential advantages over existing therapy as an antihypertensive in man. PMID- 3293683 TI - pA2 values for antagonists of platelet activating factor on aggregation of rabbit platelets. AB - 1. The relative potencies, and equilibrium dissociation constants, for nine antagonists of platelet activating factor (Paf) have been determined on rabbit platelets (in diluted platelet-rich plasma (PRP)) in experiments in which the aggregatory response to Paf was measured. 2. Log concentration-response (% maximum) curves to Paf were obtained in the absence (controls) and presence of different concentrations of each Paf antagonist drug. The antagonists shifted the Paf curves to a higher concentration range and the slopes of the Schild plots, constructed from these data, suggested that the drugs were competitive antagonists of Paf. The slopes of the Schild plots for CV-3988 and SRI 63-119 were greater than 1. 3. The pA2 values (pKB values in parentheses) were: WEB 2086 7.31 (7.63); SRI 63-119 6.95; L-652,731 6.71 (6.73); BN 52021 6.38 (6.47); SRI 63 072 6.36 (6.43); CV-3988 5.87; 48740 RP 4.97 (5.07); ketotifen 4.94 (4.95); thiazinamium 4.73 (4.76). 4. This study provides, for the first time, some functional response data for Paf antagonists (pKB values) which are in an appropriate form for use in classifying putative Paf receptors. The study also provides the comparative potencies of these Paf antagonists in inhibiting Paf induced platelet aggregation. WEB 2086 was the most potent of the drugs examined. PMID- 3293685 TI - Issues of representation and limited capacity in the auditory short-term store. AB - This article makes several related claims about the auditory short-term store (ASTS) tested by immediate ordered recall. The first claim is that the representation in ASTS is uncategorical and unparsed. The second claim is that there is a stage of recovery just prior to recall, in which the information in ASTS is parsed and categorized. Finally, it is proposed that the amount of representational medium in ASTS is fixed and allocated proportionally to each item in the presentation. When too many items are presented, the items are not represented with sufficient fidelity to be recovered, leading to the phenomenon of limited capacity. These claims are contrasted to the predictions of a slot model, in which ASTS is hypothesized to store a fixed number of categorical and parsed items. Novel explanations are given for several phenomena in immediate ordered recall, including the Hebb effect, the correlation between perceptibility and capacity, and serial position curves. PMID- 3293684 TI - Antagonism of N-methylaspartate and synaptic responses of neurones in the rat ventrobasal thalamus by ketamine and MK-801. AB - 1. Extracellular single neurone recordings were made in the ventrobasal thalamus of urethane-anaesthetized rats. 2. Iontophoretically and intravenously administered ketamine and MK-801 were found to be selective antagonists of responses of neurones to iontophoretically applied N-methylaspartate. 3. Both antagonists, administered in N-methylaspartate-selective quantities, reduced the synaptic responses of ventrobasal thalamus neurones to a two-second air jet directed at the peripheral receptive field. PMID- 3293686 TI - Management of posterior urethral rupture: a personal view. AB - The management of urethral injury continues to be controversial and no one policy has received universal acceptance. This review describes the current three-step approach which we use for the investigation and management of this serious injury. This approach has evolved during the management of a large number of these injuries over the past 22 years. It is relatively simple and can be expected to give a high success and low complication rate. We believe that many of the complications encountered following the management of this injury are avoidable. PMID- 3293687 TI - Renal dysplasia--a clinicopathological review. AB - A review of 15 cases of unilateral renal dysplasia is presented. Seven patients came to medical attention with urinary tract infection. Only 4 presented with an abdominal mass. Eight patients were found to have ipsilateral ureteric anomalies and 4 of these also had contralateral ureteric problems. Five patients had extra renal anomalies and these included Turner's syndrome, scoliosis and congenital dislocation of the hip. Histological examination, in all cases, revealed the presence of primitive ducts surrounded by concentric layers of cellular mesenchyme. Metaplastic cartilage was noted in only 7 of the 15 cases. PMID- 3293688 TI - Pelviureteric junction obstruction. The value of a post-micturition view in 99mTc DTPA diuretic renography. AB - Eighty-one 99mTc DTPA renograms were performed in 31 children who had previously undergone pyeloplasty for pelviureteric junction obstruction (PUJ). A post micturition image following a diuretic stimulus excluded obstruction in 50% of the patients in whom the frusemide T75 was abnormally prolonged beyond 10 min. Evaluating the 99mTc DTPA renogram and the response to a diuretic without both changing the patient's position and ensuring an empty bladder may lead to incorrect diagnosis of PUJ obstruction. PMID- 3293690 TI - The older Moynihan. PMID- 3293689 TI - Fournier's gangrene in Khartoum. AB - Nine patients with Fournier's gangrene are presented and the relevant literature is reviewed. Fournier's gangrene is secondary to other predisposing conditions, the commonest causes being urethral and perianal sepsis. Local excision and antibiotics are the treatment of choice. PMID- 3293691 TI - Hepatic metastases from colorectal cancer: resection or not. AB - This review evaluates the available evidence dealing with the natural history of hepatic metastases in patients with colorectal cancer. Methods of detection of such metastases are discussed and the factors influencing survival after surgical resection are reviewed. PMID- 3293692 TI - Lack of necessity for corrections for pyloric losses and duodenogastric reflux in the performance of gastric secretory studies. AB - Gastric secretory studies are subject to considerable error owing to incomplete collections and to contamination by reflux of alkaline duodenal contents. Corrections for these sources of error have been defined, and they have been extensively applied in a research setting. In order to assess their utility in the performance of routine gastric secretory studies, the value of such corrections was assessed in 56 studies in patients with duodenal ulceration (10), previous surgical vagotomy (8), reflux oesophagitis (30) and primary oesophageal motility disorders (8). The effect of such corrections was small, and there were close correlations between uncorrected and corrected acid outputs in all four groups. The status of the vagal efferent gastric fibres was assessed by comparing the acid output after insulin hypoglycaemia with the maximal acid output after pentagastrin (insulin: pentagastrin ratio). The application of the corrections did not alter the conclusion regarding the assessment of vagal status in 55 of the 56 studies performed. It is concluded that such corrections are not necessary in the routine performance of gastric secretory studies. PMID- 3293693 TI - Effect of epidural analgesia on postoperative insulin resistance as evaluated by insulin clamp technique. AB - The influence of epidural neural blockade on postoperative insulin resistance was studied using the euglycaemic insulin clamp technique. Eighteen patients undergoing elective upper abdominal surgery of moderate severity were allocated to two groups: group G patients underwent operation under general anaesthesia, and postoperative pain was relieved by systemic administration of analgesia; and group E patients received epidural analgesia during surgery and epidural morphine postoperatively. In each patient the euglycaemic insulin clamp test was performed twice: several days before surgery and on postoperative day 1. Peroperative catecholamine and cortisol responses were also measured to investigate possible endocrine mechanisms of the insulin resistance. Glucose disposal (M) decreased in both groups on postoperative day 1 at plasma insulin concentrations ranging from 1.2 to 10.0 milliunits ml-1, resulting in the downward shift of dose-response curves. However, this downward shift was significantly smaller in group E than in group G patients. Urinary adrenaline excretion increased markedly on the day of operation in group G, but was significantly inhibited in group E. Urinary noradrenaline excretion increased mainly on postoperative day 1 in group G, but was significantly inhibited in group E. Plasma cortisol response was lower in group E than in group G during and shortly after operation, and was significantly inhibited in group E on postoperative day 1. These results indicate that insulin resistance after elective abdominal surgery is due to a postreceptor deficit in glucose utilization, as indicated by the downward shift of the dose-response curves. This disturbance in glucose metabolism was reduced by epidural analgesia, the results being associated with inhibited catecholamine and cortisol responses. PMID- 3293694 TI - Surgical management of substernal goitre. AB - This paper presents the clinical features and problems in the management of 34 patients with substernal goitre. Complete evaluation of the mediastinum relied on computed tomography. Thyroid function tests were performed routinely and showed a clinically underestimated incidence of hyperthyroidism (44 per cent). The incidence of occult malignancy in substernal goitres was high (12 per cent). In the majority of patients (88 per cent) the substernal goitres were removed by a collar incision. Four cases of goitres located in a retrotracheal position required a combined cervical and sternotomy approach. None of the 34 patients died. Transient postoperative hypocalcaemia was found in 41 per cent of our patients. The presence of a substernal goitre is an indication for resection based on the risk of malignancy, the risk of acute respiratory distress, the high incidence of thyrotoxicity and a low surgical morbidity. PMID- 3293695 TI - Renal transplantation: the non-starters. AB - Renal transplants do not always function immediately and this non-function may be related to poor long-term graft survival. The causes of this primary non-function (PNF) are poorly understood. The incidence of PNF in 106 consecutive renal transplants was found to be 57 per cent. Using stepwise logistic regression analysis of 20 prospectively collected variables for each transplant two have been found to be positively associated with PNF of the transplant: (1) the use of cyclosporin as an immunosuppressant and (2) a second warm ischaemia (anastomosis) time of more than 30 min. It is proposed that the use of cyclosporin be restricted in the early post-transplant period until initial function of the transplant is established. The surgical procedure of kidney transplantation should be planned to minimize the anastomosis time prior to recirculation of the graft. PMID- 3293697 TI - Comparison of polyglactin 910 and nylon in skin closure. PMID- 3293696 TI - Non-operative management of retroperitoneal fibrosis. AB - It is generally recognized that in many patients the ureteric obstruction and other manifestations of non-malignant retroperitoneal fibrosis will respond to treatment with corticosteroids. However, most surgeons are reluctant to use steroids as the primary treatment for patients with this condition, mainly because of the risk of mismanagement of malignant retroperitoneal fibrosis. Our experience in the care of 17 patients with non-malignant retroperitoneal fibrosis has led us to believe that an initial non-surgical approach is both safe and preferable. PMID- 3293698 TI - 'Button-hole' incisional hernia. PMID- 3293699 TI - Rational decisions in managing sore throat: evaluation of a rapid test. AB - Sixty nine general practitioners recorded what they had prescribed for a total of 1189 episodes of sore throat. Antibiotics were prescribed in 763 (64%) episodes and broad spectrum antibiotics in 161 (21%) of these. If there was dysphagia, hoarseness, cervical adenopathy, and inflamed or purulent tonsils a prescription was more likely to be written. An enzyme immunoassay rapid test was evaluated as a means of rationalizing prescribing. Among 23 general practitioners and 250 patients the sensitivity of the test was 63% and the specificity 91.7% compared with 74% and 58% for clinical assessment alone. Test results rarely caused previous prescribing decisions (34 [corrected] (13%) episodes) to be altered. We suggest that the time is not ripe for the use of the enzyme immunoassay rapid test on a wide scale in the routine assessment of sore throats. PMID- 3293700 TI - An electrophysiological laminar analysis of single somatosensory neurons in partially deafferented rat hindlimb granular cortex subsequent to transection of the sciatic nerve. AB - A sample of 302 neurons in rat hindlimb granular cortex was studied between 2 and 3 weeks after transection and ligation of the sciatic nerve. These neurons were compared to a control sample obtained from normal rats under similar experimental conditions. After sciatic nerve transection the proportion of neurons driven by somatic stimuli applied to the hindlimb (29.1%) was not significantly different from the proportion observed in the control sample (25.8%). The proportion of neurons with cutaneous receptive fields was also the same before and after nerve transection although the proportion of neurons responding to higher threshold taps was reduced. Spontaneously active neurons were encountered more frequently after sciatic nerve transection than in the control (45% vs 32%) and their mean discharge frequency was higher (8.6 vs 6.4 imp/s). Twice as many (10.2% vs 5.2%) spontaneously active neurons whose discharge was modulated by afferent stimuli were found after sciatic nerve transection. This and several other lines of evidence suggest that the cortical neurons were released from inhibition by the sciatic nerve transection. The number of spontaneously active neurons and the mean discharge rate were increased in each cortical lamina suggesting that the increased excitability seen after deafferentation occurred in all cortical layers. Neurons throughout the portion of the hindlimb representation studied could be driven from the remaining innervated region of the hindlimb, including one and sometimes two digits, part of the palm and most of the dorsum of the foot. More neurons were driven by receptive fields on the ankle than was the case for normal rats. Most neurons with cutaneous receptive fields were distributed in the same layers as those in the control group and had normal shapes and appearances. However, there were few of small size. Most were of moderate dimensions well within the normal range. Seven examples were found with unusually large proportions of their field extending from the foot onto the ankle and covering most of the posterior quadrant of the animal. In normal cortex the largest receptive fields were found in the middle layers. This distribution was not as clear after sciatic nerve section and a mixture of large and medium-sized receptive fields occurred at each depth. Further, some neurons with cutaneous receptive fields were found above 300 micron and below 1000 micron, depths where receptive fields were uncommon in the normal sample. PMID- 3293701 TI - M2 muscarinic receptors mediate pressor responses to cholinergic agonists in the ventrolateral medullary pressor area. AB - Microinjections of cholinergic agonists into the ventrolateral medullary pressor area (VLPA) evoke increase in blood pressure (BP) and heart rate (HR). Recently two major subtypes of muscarinic receptors (M1 and M2) have been identified. This investigation was designed to study the role of these muscarinic receptor subtypes in pressor responses of cholinergic agonists in the VLPA. Male Wistar rats were anesthetized with pentobarbital or decerebrated at mid-collicular level. The rats were artificially ventilated and BP and HR were recorded. Ventral medulla was exposed and the VLPA identified bilaterally by microinjections of L glutamate. Microinjections of cis-methyldioxolane (CD, a specific agonist of M2 receptors) in the doses of 0.004-4 nanomol (nmol)/site into the VLPA evoked an increase in BP (13-56 mm Hg) and HR (7-24 bpm) which lasted for 10-50 min. Intravenous injections of the same doses of this agent failed to evoke a response. AFDX-116 (a specific M2 muscarinic receptor antagonist) microinjected into the VLPA (0.2-1.6 nmol-/site) evoked depressor responses (6-20 mm Hg). Microinjections of this agent into the VLPA prevented the pressor responses to subsequent microinjections of CD at the same sites, indicating that AFDX-116 blocked M2 receptors. AFDX-116 rendered neurons in the VLPA unresponsive to L glutamate but this effect lasted for 30-40 min while the hypotensive and M2 receptor blocking effect lasted for 60-150 min. McN-A343 (a specific agonist for M1 receptors) or pirenzepine (PZ, a specific antagonist of M1 receptors) injected into the VLPA (0.4-4 nmol/site) failed to evoke any response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293702 TI - Microtubule-associated protein 2 (MAP 2) immunoreactivity in human fetal neocortex. AB - We used a monoclonal antibody to study the immunocytochemical distribution of microtubule-associated protein 2 (MAP 2) in human fetal neocortex between the ages of 16 and 22 weeks gestation. The staining pattern was lamina-specific. Neuronal somata and dendrites in all cortical layers and in the intermediate zone were labelled. Cajal-Retzius cells of layer I, large pyramidal neurons in the inner cortical plate and neurons in the subplate were most strongly immunoreactive. Separate from the underlying cortical plate a thin sheet of small neurons in the inner marginal zone was highlighted by MAP 2 immunoreactivity. The morphologic diversity, density and regional distribution of the interstitial neurons in the subplate was emphasized by MAP 2 staining. In general, the intensity of MAP 2 immunoreactivity in cell somata and dendrites correlated with the degree of neuronal differentiation but the pattern of intracellular staining also varied as a function of laminar position, and presumably cell type. PMID- 3293703 TI - Dopamine modifies the balance of rod and cone inputs to horizontal cells of the Xenopus retina. AB - Dopamine (greater than or equal to 2 microM) increased the cone input and suppressed the rod input to axon-bearing horizontal cells of the Xenopus retina. Dopamine (10 microM) also depolarized the horizontal cell by about 9 mV. The D2 dopamine antagonists spiperone and metoclopramide had the opposite action to dopamine, whereas the D1-dopamine antagonist SCH 23390 was without effect. None of the agents tested modified the light-evoked responses of rods. PMID- 3293704 TI - Survey of neuropeptide-like immunoreactivity in supramedullary neurons of Coris julis (L.). AB - The supramedullary neurons of the marine teleost Coris julis (L.) were surveyed for neuropeptide-like immunoreactivity using antisera against 12 peptides. These neurons exhibit positive immunoreactivity to CCK-8, CCK-39 and gastrin(18-34). The presence of gastrin/CCK-like peptides in the supramedullary neurons is discussed. PMID- 3293705 TI - Calcitonin gene-related peptide containing autonomic efferent pathways to the pelvic ganglia of the rat. AB - Indirect immunofluorescence method was employed to investigate the involvement of calcitonin gene-related peptide (CGRP) in the autonomic efferent innervations of the pelvic visceral organs of the rat. Cells labeled with Fast blue (FB) injected into the pelvic ganglia were observed in the sacral parasympathetic nucleus; about 30% of these neurons showed CGRP-like immunoreactivity. These CGRP-like immunoreactive neurons were located in the dorsomedial part of the sacral parasympathetic nucleus, extending their dendrites mediolaterally. FB-labeled cells were also found in the upper lumbar level (L1, L2) of the spinal cord. Some of these neurons also showed CGRP-like immunoreactivity. CGRP-like immunoreactive varicose fibers were seen in the pelvic ganglia surrounding individual ganglion cells. Considerable amount of these fibers were not affected by sensory deafferentation, so they probably originated from autonomic efferent neurons. PMID- 3293706 TI - Sympathetic activity following paraventricular or ventromedial hypothalamic lesions in rats. AB - The present experiment was designed to measure the sympathetic firing rate of nerve filaments to interscapular brown adipose tissue in rats with acute and chronic lesions in the ventromedial hypothalamus or paraventricular nucleus. Female rats received injections of kainic acid into either the paraventricular nucleus or the ventromedial hypothalamus. The sympathetic activity was measured by recording the firing rate of nerve filaments to interscapular brown adipose tissue after mounting the filaments on silver wire electrodes connected to an amplifier and rate meter. In acute experiments performed 30 minutes after the lesion, the basal firing rate was reduced in both groups and was significantly lower in the VMH-lesioned rats than in those with PVN lesions. In the chronic experiment kainic acid was injected into the VMH or PVN and the sympathetic firing rate was measured 7 to 9 days later. Both lesioned groups gained more weight than controls, but the VMH-lesioned rats gained more weight than the PVN lesioned rats. The basal firing rate of sympathetic nerve filaments in the VMH lesioned rats was lower than in the other groups. There was no significant difference in the sympathetic activity between PVN-lesioned and control rats. These experiments support the hypothesis that lesions of the ventromedial hypothalamus reduce the sympathetic activity but that lesions in the paraventricular nucleus do not. PMID- 3293707 TI - Excitant amino acid projections from rat amygdala and thalamus to nucleus accumbens. AB - High affinity uptake of D-[3H]aspartate, [3H]choline and [3H]GABA was examined in synaptosomal-containing preparations of rat nucleus accumbens septi 7 to 10 days after unilateral or bilateral N-methyl-D-aspartate lesions confined to the parataenial nucleus of the thalamus or the basolateral nucleus of the amygdala. Uptake of both D-[3H]aspartate and [3H]choline was significantly reduced (11% and 14% less than control, respectively) by unilateral lesion of the thalamus, whereas [3H]GABA uptake was unaffected. Bilateral thalamic lesions significantly reduced D-[3H]aspartate uptake (11% less than control) into homogenates of the nucleus accumbens, whilst [3H]GABA uptake was unaltered. D-[3H]aspartate uptake was significantly reduced (26% less than control) following unilateral lesion of the amygdala, whereas both [3H]GABA and [3H]choline uptake were unaffected. Bilateral amygdaloid lesions significantly increased D-[3H]aspartate uptake (39% greater than control), whilst uptake of [3H]GABA was not affected. The results implicate glutamate and/or aspartate as putative neurotransmitters in afferent projections from the basolateral amygdala and the parataenial thalamus to the nucleus accumbens. Thalamic afferents to the nucleus accumbens may also utilize acetylcholine as their transmitter. PMID- 3293708 TI - [Personal experience in the diagnosis and therapy of mycotic colpitis]. PMID- 3293709 TI - [A national figure in the arts: Dr. Ivan Stodola--organizer of health care]. PMID- 3293710 TI - [Oxygen therapy at home, a therapy often misused]. PMID- 3293711 TI - [Atrophic polychondritis and its pathologic accompaniments]. PMID- 3293712 TI - [Evolution of gynecologic surgery. The place of vaginal and endoscopic procedures. Technical and economic considerations]. PMID- 3293713 TI - [Eulogy for Jean Jacquet (1914-1987)]. PMID- 3293714 TI - [Sexually transmitted diseases and the place of the antivenereal clinic]. PMID- 3293715 TI - [At what point should one operate on a ruptured intracranial arterial aneurysm?]. PMID- 3293716 TI - [Permanence of the microbial risk in view of the various contaminants in foods]. PMID- 3293717 TI - [Eulogy for Robert Merger (1903-1986)]. PMID- 3293718 TI - [The pediatric surgeon: a daring conservationist]. PMID- 3293719 TI - [Segmental cerebral angiopathy of drug addicts. Physiopathological significance. Possible role of spasms]. PMID- 3293720 TI - [Use of sorbic acid (E 200) and its potassium (E 202) and calcium (E 203) salts for the preservation of vegetable pastes destined for baked products]. PMID- 3293721 TI - [Occupational deafness. Its indemnification]. PMID- 3293723 TI - The dental condition of mentally handicapped adults attending adult training centres in Hull. PMID- 3293722 TI - Treatment of children in foster care: issues of collaboration. AB - Therapists assessing and treating children in foster care face unique issues, due to the complicated relational system generated by a foster placement. At a minimum, the mental health clinician must negotiate a role relative to the foster family, especially the foster parents, biological parents, and the Child Protective Service Agency (CPS) represented by the caseworker. The system of relationships and the ambiguous status of the child in foster care affects both the range of issues that need to be assessed to identify factors contributing to a child's problems and the context of possible interventions. The therapeutic relationship with the child is also affected by the child's understanding of and feelings about the connections, or lack of them, between the therapist and other meaningful adults in the child's life. This paper considers issues affecting the role of the therapist relative to each relationship and then considers the broader role of the therapist as an intervener in the foster care and protective service system. PMID- 3293724 TI - Can plasma catecholamine levels be a useful index of sympathetic nervous system activity? AB - The hemodynamic responses of the sympathetic nervous system to the Valsalva maneuver were related to changes in circulating levels of catecholamines, aldosterone and plasma renin activity. Fourteen healthy normotensives (aged 27 +/ 8 years) took part. A catheter was inserted in the forearm then the subject was rested quietly (supine) for 30 mins. The Valsalva maneuver was performed (duration 40 s, intrathoracic pressure 40 mmHg) with continuous recording of supine heart rate. Blood was sampled before the maneuver (basal state) and at the bradycardic post maneuver phase for measurement of plasma noradrenaline, adrenaline, renin activity and aldosterone. In six subjects the procedure was repeated for durations of 10, 20, 30 and 40 s with a 30-min rest between each maneuver. Plasma catecholamines increased consistently (P less than 0.001) from pre- to post bradycardic phases of the maneuver. No changes in plasma renin activity or aldosterone were observed. The maximum tachycardia observed during each maneuver and the increments in catecholamine concentrations were each linearly related to the duration of straining but there was no overall correlation between the tachycardia and catecholamine concentrations. In conclusion under controlled conditions, plasma catecholamine concentrations can be useful indices of the stimulation of the sympathetic nervous system; the Valsalva maneuver does not appear to affect significantly the peripheral renin angiotensin system; and the heart rate response to the Valsalva maneuver does not appear to be mediated solely by the sympathetic nervous system. PMID- 3293725 TI - Canadian National Institute for the Blind: 70 years of caring. PMID- 3293728 TI - Genetic basis of racial differences. AB - The purpose of this paper is (a) to present brief historical notes on the concept of race, (b) to define race in the context of evolutionary biology, (c) to quantify the extent of human genetic variation, (d) to estimate genetic differences within and between races, and (e) to comment on the implications of these concepts for racial differences in sport performance. Research shows that genetic variation in gene products and in the non-coding sequence of DNA is quite extensive in humans. Variation is found more frequently in non-coding DNA sequences than in coding exons, and while this variation does not influence the primary structure of the proteins, it may have considerable impact on gene expression. However, much of that genetic variation is shared by all human beings, and only about 10% is specific to races or populations within races. At this time, it is not possible to conclude satisfactorily the significance of these modest racial differences in genetic variation for racial differences in performance. It may turn out that this low level of genetic heterogeneity may have considerable implication for performance. PMID- 3293726 TI - Efficacy of twice-daily levobunolol in the treatment of elevated intraocular pressure. AB - The efficacy of twice-daily treatment with 0.5% levobunolol hydrochloride was compared with that of 0.5% timolol maleate in 27 patients with open-angle glaucoma or ocular hypertension in a double-blind randomized trial. At all follow up visits the patients in both groups had significantly decreased intraocular pressure (p less than 0.05); there was no significant difference between the groups. Levobunolol produced significant decreases in mean heart rate (p less than 0.05). One patient with an undisclosed history of childhood asthma experienced bronchospasm related to an acute upper respiratory tract infection while receiving levobunolol. Neither drug caused any significant ocular problems. The results show a clear ocular hypotensive effect with twice-daily 0.5% levobunolol. PMID- 3293727 TI - Bilateral sino-orbital pseudotumour. AB - The authors present a case of histopathologically proved bilateral idiopathic inflammatory pseudotumour of the orbits with involvement of the paranasal sinuses in a child. Clinically, the bilateral proptosis was manifest at the age of 5 years. While extraorbital manifestations are rare, orbital pseudotumour should be considered in such cases. PMID- 3293729 TI - Racial differences in sports performance. AB - The purpose of this paper is twofold: (a) to present data on racial differences in sport performance and (b) to comment briefly on theories, hypotheses and studies, whether they be biological, psychological or sociological in nature, that have attempted to explain the observed differences. Available data are mainly drawn from studies focusing on American professional sports. The results indicate that Afro-American athletes largely dominate the sport scene in a few sports and across a wide range of performance indicators. Although it is impossible at this time to conclude with satisfaction on the causes of racial differences, sociological explanations seem best to explain the observed performance differentials. PMID- 3293730 TI - Racial variation in physique and body composition. AB - Racial variation in physique and body composition are of interest to sport scientists because these characteristics may be related to athletic performance, fitness, strength and injury. There is clearly variation among groups in mean somatotypes and the sitting height-stature relationship. Although differences are often emphasized, racial group distributions of variables describing physique often overlap to a considerable extent. Environment may be a factor in group differences in physique. Consistent Black-White differences are found in mean levels of variables related to bone mineralization, with Blacks exceeding Whites. It may be that the lean body mass of Blacks is of greater density than that of Whites. Gross morphological variation among groups is probably only a concomitant of variation in performance rather than a determinant of performance. PMID- 3293731 TI - Racial variation in work capacities and powers. AB - Large interindividual variation in work capacities and powers are often reported in the literature. The variations are attributed to such varied factors as age, sex, exercise training, and heredity, among others. Ethnic/racial origin as a putative causal factor of such variations has also been considered. Studies of subjects from various countries report aerobic power generally between 40 and 50 mL O2/kg.min-1, with a mean around 45 mL. Differences between groups are generally small and genuine racial differences in maximal aerobic power are lacking when allowance is made for other factors. There are, on the other hand, differences between racial groups in submaximal work efficiency and endurance performance. These differences, however, appear to result from differences in mechanical efficiency owing to test mode and/or level of habituation to the ergometer. Performances on maximal tests of short duration demonstrate some variation among racial groups, but again differences in mechanical efficiency cannot be ruled out. Thus there does not appear to be valid and reliable evidence to support the concept of clear racial differences in work capacities and powers. PMID- 3293732 TI - Racial/ethnic variation in the motor development and performance of American children. AB - The literature on the motor development and performance of American children from several racial and ethnic groups is reviewed. The evidence suggests that Black infants are advanced in motor development during the first two years of life, and that Black children of school age, particularly boys, perform consistently better than White and Mexican-American children in running speed (dashes) and the vertical jump, with somewhat less consistent results for the standing long jump and softball throw for distance. In contrast, differences in the motor development and performance of Mexican-American and White children are generally inconsistent and slight. Environmental factors are most often cited as underlying racial or ethnic variation, but have not been systematically investigated. A biocultural approach is essential if an understanding of racial and ethnic variation in motor performance is to be attained. PMID- 3293734 TI - [Profile of childrens' hockey coaches and motives of participation and resignation]. AB - The purpose of this study was twofold: (a) to outline a demographic profile of Quebec minor hockey coaches and (b) to identify their motives of involvement and resignation. A questionnaire was completed by 333 current coaches and by 175 former coaches from the Quebec City area. Results showed that these volunteers are very similar on all counts. They are fathers of at least one boy who is a hockey player, and they come from all socio-economic strata. They are former hockey players and are well aware of the activities of the professional teams. They perceive themselves as being competent coaches and are satisfied with their results. They highly value hockey as a means of education and perceive their own role of volunteer as being an unselfish one geared toward youth education. On the other hand, they perceive the other volunteers' involvement as being self interested and mainly due to the child's primary participation. PMID- 3293733 TI - Enhancement of exercise performance with inhaled albuterol. AB - The use of bronchodilators in athletic competition has allowed asthmatics to participate successfully in competitive events. Little information exists regarding possible bronchodilator use by non-asthmatic competitive athletes. Fifteen non-asthmatic cyclists participated in a double-blind, randomized, cross over protocol involving a simulated race, i.e., one-hour heavy continuous exercise (minute ventilation (VE) 81 L/min BTPS) followed by maximal effort workload to exhaustion, with/without prior inhalation of albuterol to see if their exercise performance would be acutely altered. Each study day metabolic parameters were obtained four times. Pulmonary function tests were performed prior to and after the inhalant (albuterol/placebo) and following exercise. There was a significant increase in forced expiratory flow parameters following albuterol. Although not significant, oxygen uptake (VO2) and VE were smaller during the one-hour submaximal test following albuterol and VO2max and VEmax were higher. There was an increased ride time (196 vs. 159 s; p less than 0.05). Albuterol may provide a competitive advantage for non-asthmatic athletes who might use it. PMID- 3293736 TI - Polymyositis/dermatomyositis. Festschrift to Professor James N. Gilliam. PMID- 3293735 TI - Guidelines for stabilizing the condition of the critically ill child before transfer to a tertiary care facility. AB - The initial resuscitation and stabilization provided to a critically ill or injured child is often an important determinant of outcome. Before transfer to a tertiary care facility the initial care may be provided by physicians unaccustomed to managing critically ill children. The authors outline the unique aspects of resuscitation and stabilization of the critically ill child and give guidelines for the initial management of diseases affecting the central nervous system and respiratory tract (the most frequent indications for transfer to a tertiary care facility) and other, less frequent but important problems. In many situations it is worth while to enlist the expertise of the tertiary care centre, either by telephone consultation or by dispatch of a specially trained transport team. PMID- 3293737 TI - Festschrift to Professor James N. Gilliam. PMID- 3293738 TI - Questions pertaining to the etiology and pathophysiology of polymyositis/dermatomyositis. PMID- 3293739 TI - Animal models of polymyositis/dermatomyositis. PMID- 3293740 TI - A rheumatologist's view of polymyositis/dermatomyositis: extracutaneous and extramuscular involvement and overlap syndromes. PMID- 3293741 TI - The neurologist's approach to polymyositis. PMID- 3293743 TI - Childhood polymyositis/dermatomyositis. AB - Children with PM/DM differ in many respects from adults with PM/DM. The most characteristic and distinctive feature is the presence of a widespread vasculopathy. Although the pathogenesis is unknown, roles for both humoral and cell-mediated immunity have been proposed. Most intriguing is the evidence for a viral agent that is capable of precipitating an ongoing, immunologically mediated reaction damaging muscles and endothelial cells. Much remains to be discovered, however, regarding the pathogenesis of this disease. PMID- 3293742 TI - History and classification of polymyositis and dermatomyositis. PMID- 3293744 TI - Malignancy in polymyositis/dermatomyositis. PMID- 3293745 TI - Pathology and immunopathology of polymyositis/dermatomyositis. PMID- 3293746 TI - Laboratory manifestations of polymyositis/dermatomyositis. PMID- 3293747 TI - A dermatologist's view of polymyositis/dermatomyositis. PMID- 3293749 TI - Applied biomechanics of bone: functional and clinical perspectives. AB - Proper locomotion depends on the presence of a strong, intact skeletal system that is able to withstand the stresses and strains of everyday life. In this article, the authors discuss the function of force on bones from a clinical and biomechanical viewpoint. As is presented, bone is a living, viable organ that responds to both external and internal stimuli. PMID- 3293748 TI - Prognosis and therapy of polymyositis/dermatomyositis. PMID- 3293751 TI - Force, pressure, and motion measurements in the foot: current concepts. AB - Modern foot-pressure measurement studies have successfully debunked the tripod theory; on the contrary, the highest peak loads under the forefoot occur as often as not under the third metatarsal head and not the first and fifth. This does not necessarily mean that the first metatarsophalangeal joint does not sustain the highest pressures; calculations based on the measured pressures under the metatarsals and digits show that it does. One must bear in mind that the hallux consistently bears significantly more pressure than any of the other toes. It is likely that the pressure borne by the first metatarsal head and hallux combined consistently exceed that for the other four metatarsal heads and their respective digits. In other words, the first ray probably has the consistently highest load in normal feet, even when the second or third metatarsal head achieves a greater peak pressure than the first metatarsal head. Three lines of evidence suggest the role that pressure plays in forefoot pathology. First, metatarsalgia is commonly associated with hallux valgus. It often arises following or is exacerbated by hallux valgus surgery (especially arthroplastic procedures). Patients with hallux valgus demonstrate increased peak pressure under the lateral metatarsal heads that actually increases following the Keller procedure. Second, the peak pressure under callosities are, on the average, higher than normal. Third, diabetic plantar ulcers occur at sites of high pressure. The correlations between peak loads on the lateral column and both age and weight merit some attention, since it is common experience that the prevalence of symptomatic foot lesions is higher in older populations. The correlation with body weight may be unexpected. One would expect that, on the average, body weight would correlate with the weight bearing surface area of the foot and, therefore, the pressure would be relatively constant. The increased pressure under the medial column suggests a relative instability of the medial column with advancing age and weight. Pressure should not be construed as the only factor. The large overlap in peak pressures found under diabetic ulcers and intact skin in both normal and diabetic feet makes this apparent. However, while peak pressures have been extensively studied, there has been no attempt to measure the duration or frequency of loading on a day-to-day basis. According to Brand, it is not the absolute loads applied to a part but repetitive pressure that is responsible for tissue breakdown, especially when such repetitive loads are applied without any interim period for the tissues to recover.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3293750 TI - Anatomy of motion. AB - Review of muscle function during the walking gait cycle suggests that once the body is put in motion, its own kinetic force tends to keep it moving. This progression, however, must be controlled and stabilized by muscles acting on the limb segments during weight bearing. Primary, accelerating muscle action is most important during swing phase when the iliopsoas and quadriceps femoris bring the limb forward to maintain continuity of the gait cycle. Once the limb is in stance phase, most muscles exert controlling forces on the limb by decelerating movement of the limb segments and stabilizing the joints. PMID- 3293752 TI - Functional and structural limb length discrepancies: evaluation and treatment. AB - The examining physician should have a high index of suspicion when evaluating patients with lower extremity and/or back pain so that the diagnosis of leg length inequality is not overlooked. If an organized and systematic physical examination is performed, the practioner will become more comfortable and competent in the diagnosis of limb asymmetry. Once the diagnosis of limb length asymmetry is made the further classification of functional versus structural limb length discrepancy will dictate what treatment will be indicated. The structural asymmetries are evaluated by the indirect method of measurement and treatment with a heel lift approximately half the measured asymmetry initially. The functional asymmetries are evaluated by the flexion and pronation tests and treated with a properly posted orthotic. PMID- 3293753 TI - Habitual toe-walking: evaluation and approach to treatment. AB - Habitual toe-walking has been presented as a prolongation of a normal stage of development that requires conservative treatment to prevent or ameliorate associated gait abnormalities such as tripping and falling. An approach to the evaluation of a child with toe-walking should include (1) medical history (prenatal, intrapartum, and postnatal), (2) gait evaluation, (3) musculoskeletal examination, and (4) neurologic examination. Pathologic entities producing toe walking have been explored in order to differentiate those conditions from idiopathic (habitual) toe-walking. The most common etiologies of toe-walking (nonhabitual) would include gastrosoleus equinus, clubfoot, or cerebral palsy. Treatment of habitual toe-walkers might include shoe therapy, orthosis therapy, auditory feedback, and surgery. PMID- 3293754 TI - Common sports injuries to the knee. AB - The evaluation and treatment of knee injuries is common in the practice of sports medicine. The knee is the most commonly injured joint of the lower extremity. Therefore, the podiatrist should have an adequate knowledge and skill in the knee examination, anatomy, pathology, and biomechanics to properly diagnose and treat disorders of the joint. The etiologies of knee pain can be divided into five categories: (1) anterior, (2) posterior, (3) medial, (4) lateral, and (5) general for simplicity of description. The doctor can easily evaluate the painful knee in the athlete by remembering the major pathologies within each anatomic quadrant. Attention should be directed at those deformities of the knee that have biomechanical origins in the foot, in part or in toto. This biomechanical relationship when balanced into the treatment plan will increase the success of the management of the patient. PMID- 3293755 TI - Alterations of gait in neuromuscular disease. AB - Individuals affected with neuromuscular disorders have multisystem pathologies. Among the systems most affected are those involving muscle function and integration of moving leading to both subtle and obvious changes in the individual's gait. An ability to recognize the characteristic changes in gait of many neuromuscular problems is helpful in recognizing these disorders leading to improved referrals and timely diagnoses. The characteristic gait changes of neuromuscular and neurologic diseases is reviewed. PMID- 3293756 TI - Biomechanical concepts of forefoot surgery. AB - There are many types of compensations that occur in the foot. The body is a unique organism that does what "it" does best, not what it "should" do. The compensatory motions that occur to balance the abnormal structural or positional problems that we see must be neutralized for surgery to be successful. The complete process includes evaluation and observation of what is mechanically happening, which leads to correcting the anatomic deformity that is present, and finally treating the biomechanical forces so surgical correction is long lasting and satisfying. PMID- 3293758 TI - Prostheses and orthoses for the foot and ankle. AB - The general nature and function of the AFO has been presented. These devices encompass the foot and leg crossing the ankle joint. They may insert into the shoe or attach to the shoe. The more recent AFOs are made of polypropylene and were formerly composed of steel. The indications for an AFO are for a basically ambulatory patient with problems walking, including various pathologic gaits especially drop-foot and spastic equinus. Other primary indications include ankle arthritis, Charcot foot, fractures, and post-surgery. Given the basic employment of AFOs to treat problems directly related to the foot, it is hoped that this introduction has stimulated practitioners to begin using this essential tool as an integral component of their practice. PMID- 3293757 TI - TEMPER: an acronym for ankle sprain rehabilitation. AB - As has been previously discussed, the incidence and resultant associated disabilities of ankle sprains have been well documented in the literature. The staggering statistics on long-term disability show that there is no such thing as a simple ankle sprain. The degree of disability is related to the extent of the initial injury as well as the follow-up medical care provided. It is this fact that requires a complete understanding of the injury as well as a proper treatment and rehabilitation program. One of the reasons cited for the long-term disability or lack of consistently good results in treating ankle sprains is the lack of uniformity in treatment. One possible reason is the lack of agreement in diagnostic techniques as well as the end diagnosis of a particular grade of ankle sprain. If a sprain is managed correctly, resultant disability will be kept to a minimum. A proper rehabilitation program may be the most important factor in preventing chronic instability. The acronym RICE falls short of complete ankle management. RICE primarily addresses the ankle edema. Thus, the patient's ankle is only partially rehabilitated. A rational approach to the management of ankle sprains is given. Upon reviewing a complete protocol for ankle sprain rehabilitation, the acronym TEMPER can be used judiciously to remember the key steps in the treatment plan. Through the use of this acronym, one can institute a complete rehabilitation program. PMID- 3293759 TI - Biomechanical foot therapy. AB - The podiatrist specializing in biomechanical therapy must begin with a solid foundation of standardized definitions in order to discuss theories of mechanical foot treatment as they have been presented and developed over the past century. Equally important, is the building of a working knowledge and familiarity with the wide variety of available materials and their diverse properties. In addition, in order to arrive at an accurate biomechanical diagnosis, the clinician must evaluate the patient from static, dynamic, and radiographic perspectives. One must also keep current in regard to various technological advances in casting and fabrication of orthotic devices, as well as in new developments in biomechanical theory and associated therapy. It also must be kept in mind that functional foot orthoses are not 100 per cent efficient, therefore, their shape, fabrication, and composition should all be devised and prescribed with specific goals for total body mechanics. PMID- 3293760 TI - Chemotherapy for metastatic Merkel cell carcinoma. Review of the M.D. Anderson Hospital's experience. AB - Thirteen patients with regional or distant metastases from Merkel cell carcinoma were treated with combination chemotherapy. Three patients had a complete response to therapy. In two patients with nodal disease the duration of response was 10+ and 4+ years. In addition, three patients had a partial response, and six patients had minor responses. Chemotherapy using a combination of drugs that are active against small cell carcinoma of the lung is recommended in the treatment of unresectable disease in patients with Merkel cell carcinoma; it may produce prolonged responses. While tumor regressions as a result of chemotherapy were often dramatic, once the disease progressed, the course of the disease often moved rapidly downhill and proved to be fatal. PMID- 3293761 TI - Glucocorticoid-induced growth inhibition with enhanced expression of ductal epithelium of human salivary gland adenocarcinoma cells transplanted into athymic nude mice. AB - The effect of glucocorticoid on growth and the histologic features of adenocarcinoma induced in nude mouse by the inoculation of neoplastic epithelial cells of salivary duct origin (HSG) were studied. Subcutaneous injection of dexamethasone (low-dose group: 0.05 micrograms/g, high-dose group: 0.25 micrograms/g) four times a week for 8 weeks significantly (P less than 0.05) inhibited tumor growth, and in one mouse the tumor had almost completely disappeared by the middle of the sixth week of treatment. In addition, dexamethasone induced an apparent luminal structure in the tissue section of the tumor and enhanced the immunoperoxidase reaction to epithelial membrane antigen. The results indicate that dexamethasone inhibited the proliferation of HSG cells in the nude mouse transplantation system probably by inducing the cellular differentiation of the HSG cells toward the more differentiated ductal epithelia via glucocorticoid receptors. PMID- 3293762 TI - A prospective randomized trial of HLA-matched versus mismatched single-donor platelet transfusions in cancer patients. AB - The use of histocompatability antigen (HLA)-matched platelets has been advocated for the support of thrombocytopenic cancer patients. We randomized 78 newly diagnosed cancer patients prospectively (before thrombocytopenia) to receive either HLA-matched or mismatched single-donor platelet transfusions. Three hundred forty-one platelet transfusions were given for 80 separate episodes of therapy-induced thrombocytopenia in 33 patients. Forty-five patients receiving intensive chemotherapy did not develop significant (less than 20,000 platelets/mm3) thrombocytopenia and did not receive a platelet transfusion. No marked difference was observed between the matched and mismatched groups in regard to number of total platelet transfusions per patient (median, 3 vs. 5, respectively; P = 0.076), number of platelet transfusions per episode (median, 3.0 vs. 3.5, respectively; P = 0.28), or days between transfusions (median, 2 vs. 2, respectively, P greater than 0.4). Bleeding episodes, although rare, tended to be of increased severity in the mismatched group. Febrile patients receiving mismatched platelets tended to have a lower posttransfusion increment increase than their nonfebrile counterparts (P = 0.068), although a similar trend could not be demonstrated between febrile and nonfebrile patients who received matched platelets (P = 0.22). Patients treated as outpatients had significantly higher posttransfusion increments than when transfused as inpatients when they were given mismatched platelets (P less than 0.0005). Development of antiplatelet antibody did not appear to affect response to platelet transfusions. Only one patient developed sustained high-level antibody titers. In patients where thrombocytopenia was significant, the transfusion of HLA-matched platelets did not appear to offer a significant advantage. However, HLA-matched platelet transfusions tended to be associated with higher posttransfusion increments in febrile patients and a trend toward fewer severe bleeding episodes. A multi institution trial containing a large number of patients is needed to evaluate trends observed in this study. PMID- 3293763 TI - Treatment of malignant pleural effusions with intracavitary Corynebacterium parvum. AB - Fifty-three cases of metastatic pleural effusion (30 haemorragic and 23 serofibrinous) were treated with 4 mg of Corynebacterium parvum (CP) injected weekly into the pleural cavity after total thoracentesis. Of the 53 effusions, 24 were metastases from lung cancer and 29 from breast cancer. Complete response (CR) was assessed as total resolution of pleural effusion after explorative thoracentesis. The results were as follows: 15 CR after two injections of CP, 30 CR after three, and 5 CR after the fourth administration. Three of 53 cases could not be evaluated because of early death. Of the 30 clearly haemorragic effusions, 25 turned into serofibrinosis after the first intrapleural injection of CP and the other five after the second. These findings indicate that intracavitary CP is the most adequate treatment for the control of neoplastic pleural effusion because it induces a significant clinical improvement with milder side effects with respect to other drugs and/or physical agents commonly used. PMID- 3293764 TI - Complete pathologic maturation and regression of stage IVS neuroblastoma without treatment. AB - Spontaneous maturation of Stage IVS neuroblastoma has been postulated as a mechanism for its favorable prognosis, but this has rarely been documented pathologically. We report on a patient with congenital Stage IVS neuroblastoma who had extensive subcutaneous and bone-marrow involvement. Serial photographs, biopsies, and vanillomandelic acid determinations documented the tumor's initial progression which was followed by spontaneous maturation and involution of the patient's disease over a 6-year period. No cytotoxic therapy was administered. Favorable biologic prognostic factors were documented, including tumor DNA and protein analyses for N-myc amplification or overexpression and analysis for serum neuron-specific enolase and ferritin. Implications for management and therapy of Stage IVS neuroblastoma are discussed with reference to this case and the recent literature. PMID- 3293766 TI - Hemangiopericytoma of bone. AB - Primary hemangiopericytoma of bone is a rare malignant tumor. Forty-one cases from the literature were reviewed, and four additional cases are reported. The peak incidence is in fourth and fifth decades. The pelvis and lower extremities are the most common locations. The radiographic features are nonspecific, although angiography may aid in the diagnosis. Based on a limited number of evaluable cases, the prognosis seems to correlate with the histologic grade of the tumor. Late recurrence and distant metastases are common. PMID- 3293765 TI - Mesothelioma of childhood. AB - Malignant mesothelioma (MM) of childhood is a rare but important neoplasm. Eighty children with a previous diagnosis of MM were identified. Four of the 80 children had exposure to known risk factors (two had history of exposure to asbestos, one had received radiation therapy, and one had been exposed in utero to isoniazid). Tissue slides were available for independent and joint review by a panel of three pathologists in 22 of the cases. Ten were accepted as MM, nine were reclassified as other malignancies, and three were considered tumors of uncertain nature. Six of the ten children with MM were boys, and four were girls. Eight had pleural tumors, and two had peritoneal tumors. Four died at 7, 8, 18, and 48 months after diagnosis; three remained alive at 19, 20, and 59 months; and three had no follow up. This review suggests that MM of childhood is a valid entity with a grave prognosis. The tissue diagnosis is difficult and is best made by a panel of pathologists. The available evidence does not support a causal relationship between MM and asbestos, radiation, or isoniazid. PMID- 3293767 TI - Electromagnetic-field exposure and cancer. AB - Electromagnetic fields are a ubiquitous part of man's environment. Natural sources of energy have been present, and possibly have contributed to the processes of the evolution of living forms. In very recent time, however, exploitation of the properties of the electromagnetic spectrum, has added variables in intensity, frequency, modulation frequency, and alterations in contributions of electrical and magnetic components. Biological impact has been little studied and poorly defined. Animal carcinogenesis studies and human epidemiological data indicate that exposure to nonionizing radiation can play a role in cancer causation. Numerous effects at the physiological and biochemical level have been reported; many are of such a nature that a relationship to the causation of neoplastic transformation can rationally be hypothesized. Many bioeffects of electromagnetic fields can be adequately and economically explained in terms of heat effects alone. However, observations of frequency-, pulse form or modulation-, and intensity-specificity as well as effects opposite to that known for temperature-rise, imply direct interaction of radiant energy with biomolecules. The possibility of such direct interaction has been shown in quantum mechanical models. PMID- 3293768 TI - Genetic instability of cancer. Why a metastatic tumor is unstable and a benign tumor is stable. AB - It is theorized that tumors may be initiated by two methods: by an error affecting one or several oncogenes, or by an error affecting one or several of the genes controlling the stability of the genome. The majority of cells that misexpress an oncogene(s) and that later form a tumor probably form nonevolving benign tumors. A minority of these cells with an activated oncogene(s) (or one of the descendant cells) may also come to misexpress a stability gene(s). A normal cell that misexpresses only a stability gene(s) may form an evolving and genetically unstable cell line that may later misexpress an oncogene(s). A cell or cell line that misexpresses both an oncogene(s) and a stability gene(s) may form a genetically unstable tumor that creates diverse variants, allowing for extensive tumor cell evolution and the acquisition of malignant and metastatic properties. PMID- 3293769 TI - Sewall Wright, 98, top geneticist. PMID- 3293770 TI - Two further cases of acute myeloid leukemia with trisomy 4. AB - Two cases of acute myeloid leukemia (FAB M1 and M2) with trisomy 4 are described. Morphologic abnormalities were confined to the granulocytic monocytic lineage with no evidence of erythroid or megakaryocytic involvement. One of the cases, who also had trisomy 13, presented initially with skin infiltration without bone marrow involvement. PMID- 3293772 TI - Biochemistry and clinical activity of N-(phosphonacetyl)-L-aspartate: a review. PMID- 3293771 TI - Childhood myelodysplastic syndromes with 11p15 translocation. AB - Two cases of childhood myelodysplastic syndrome with chromosome abnormalities involving band 11p15 are described. The first case, with inv(11)(p15q23), had a complex clinical course; the initial diagnosis was aplastic anemia, then refractory anemia with excess of blasts in transformation (RAEB-t), and finally, before death, chronic myelomonocytic leukemia with hematologic features similar to those of chronic myelogenous leukemia (CML). The second case, with t(4;11)(p13;p15), progressed from RAEB to acute myelogenous leukemia (M2). In the literature, we found 12 patients with nonlymphocytic leukemia and chromosome abnormalities involving band 11p15, including seven cases with t(7;11)(p13 p15;p15); four cases (including the present case 1) showed CML-like hematologic features. It is suggested that translocations involving 11p15 are a nonrandom chromosome abnormality in nonlymphocytic leukemia. PMID- 3293773 TI - Influence of neighboring base sequence on the distribution and repair of N-ethyl N-nitrosourea-induced lesions in Escherichia coli. AB - N-Ethyl-N-nitrosourea-induced mutations occurring within a 180-base pair target in the lacI gene of Escherichia coli were characterized by DNA sequencing. In total, 109 mutations were characterized in a wild-type background and 100 in an excision-repair-deficient (UvrB-) background. The majority of mutations induced in the two backgrounds (77 and 85%, respectively) were G:C = greater than A:T transitions, presumably resulting from miscoding O6-ethylguanine lesions. A significant proportion of the mutations (17 and 15%, respectively) were A:T = greater than G:C transitions, which probably result from miscoding O4 ethylthymine lesions. An analysis of the distribution of both types of mutation in the two backgrounds reveals two distinct influences of neighboring base sequence. These effects apply equally to both the G:C = greater than A:T and A:T = greater than G:C transitions. Firstly, miscoding lesions are most likely to occur at 5'-purine-G-3' or 5'-purine-T-3' sites. Secondly, the excision-repair machinery is less efficient at removing both O6-ethylguanine and O4-ethylthymine lesions which are flanked on both sides by G:C base pairs. Thus, in the wild-type spectrum an overabundance of transitions occurs at a 5'-G-G-G/C-3' or 5'-G-T-G/C 3' sequence (where the mutated base is underlined). PMID- 3293774 TI - Activated ras oncogenes in human thyroid cancers. AB - Human thyroid epithelial (follicular) cells give rise to two malignant tumors- "follicular" carcinomas, which metastasize almost exclusively via the bloodstream, and "papillary" carcinomas, which metastasize predominantly via lymphatics (Williams, E. D. In: W. Duncan (ed.), Recent Results in Cancer Research: Thyroid Cancer, pp. 47-55. Berlin: Springer-Verlag, 1980). We have investigated whether this contrast in biological behavior might be associated with different patterns of oncogene activation. DNA transfection analysis of five follicular and ten papillary cancers indeed showed a statistically significant difference in the pattern of genes responsible, activated ras oncogenes being found in 80% of follicular tumors but only 20% of papillary tumors. In addition, in follicular cancers we have found activation of all three ras oncogenes (H-ras, K-ras, and N-ras), the first time that this has been demonstrated in a primary human tumor type (as opposed to cell lines). We suggest therefore that ras activation may be an important determinant of metastatic capability in these epithelial cancers. PMID- 3293775 TI - Quantitative transplantation assays of spontaneous tumors of the C3H mouse as allografts in athymic NCr/Sed-nu/nu nude mice and isografts in C3Hf/Sed mice. AB - Three spontaneous tumors of the C3H mouse have been used in a comparison of their transplantability and radiation response (local control) in syngeneic C3Hf/Sed mice and in allogeneic athymic NCr/Sed-nu/nu nu nude mice. The tumors were: MCaIV, a moderately well-differentiated mammary carcinoma; FSaII, a poorly differentiated fibrosarcoma; and SCCVII, a moderately well differentiated squamous cell carcinoma. The tumors were studied as fourth to seventh generation transplants. Assays to determine the number of tumor cells that, on the average, transplant the tumor to half of the recipients or transplant sites (TD50) demonstrated that these 3 tumors transplanted into the s.c. tissue of the NCr/Sed nu/nu as readily as of C3Hf/Sed mice. The TD50 for MCaIV was slightly but significantly lower in 4-week-old NCr/Sed-nu/nu mice which had received 6 Gy whole body irradiation (WBI) 24 h before transplantation, namely, 5.8 x 10(4) (95% confidence limits, 4.5-7.6) versus 7.8 x 10(4) (6.0-10.0). The 6-Gy WBI did not affect the TD50 for 8- to 10-week-old mice. Similarly, the TD50 for SCCVII was lower in 6-Gy WBI NCr/Sed-nu/nu recipients (1.5 x 10(4) versus 3.9 x 10(4)). The TD50 for FSaII was not affected by 6-Gy WBI. Further, the TD50 for FSaII following i.v. injection of tumor cells (transplant to lung) was the same for C3Hf/Sed and NCr/Sed-nu/nu mice (this obtained for normal or 6-Gy WBI-treated subjects). The radiation doses which on the average achieve control of half of the MCaIV, FSaII, and SCCVII tumors were lower, higher, and the same in NCr/Sed nu/nu than in C3Hf/Sed mice, respectively. The radiation doses which achieve control of half of the MCaIV and SCCVII tumors were not affected by 6-Gy WBI before transplantation. PMID- 3293776 TI - Transformation of human mammary epithelial cells by oncogenic retroviruses. AB - We have introduced viral oncogenes into human mammary epithelial cells through the use of murine retroviruses. A continuous cell line (184A1N4) derived from benzo(a)pyrene treatment of normal breast epithelial cells was used as a recipient for the ras, mos, and T-antigen oncogenes. Each of these oncogenes enabled the 184A1N4 cells to grow in a selective medium, thus demonstrating the potential utility of these cells for oncogene detection and isolation. 184A1N4 cells transformed by T-antigen were nontumorigenic in athymic mice, but v-ras transformants were weakly tumorigenic. Transformants bearing both the T-antigen and ras oncogenes were strongly tumorigenic, however. The karyotype of these double transformants shows a high degree of stability. These results demonstrate the stepwise acquisition of the fully malignant phenotype by normal human epithelial cells in vitro. PMID- 3293777 TI - A randomized trial of vitamins C and E in the prevention of recurrence of colorectal polyps. AB - Because supplements of vitamins C and E had been associated with reduction of fecal mutagen levels, a double-blind randomized trial was designed to examine the effects of these vitamins on the rate of recurrence of colorectal polyps, presumed precursors for colorectal cancer. Two hundred patients believed to be free of polyps after removal of at least one colorectal polyp were randomized to receive a supplement of 400 mg each of ascorbic acid and alpha-tocopherol, or a placebo. Fifteen patients had to be excluded because a review of pathology indicated that their polyps were not adenomatous. A second colonoscopic examination was planned after 2 yr of supplementation. One hundred thirty-seven people (75% of eligible subjects) completed the study; polyps were observed in the second colonoscopy in 41.4% of 70 subjects on vitamin supplements and in 50.7% of 67 subjects on placebos. After adjustment for differences between groups in demographic and dietary factors before study entry, the relative risk of polyp occurrence was 0.86, with 95% confidence limits from 0.51 to 1.45, in an analysis of 129 subjects with complete information on demographic and dietary factors who had completed the trial. Of the 48 patients who had not completed the study, 7 had died, 33 had not returned to their physician for an examination, and 8 had had a follow-up colonoscopy or sigmoidoscopy. Inclusion of the three polyps found in these eight examinations led to an estimate of relative risk of 0.86 (95% confidence limits, 0.51 to 1.43). The findings of this investigation suggest that any reduction in the rate of polyp recurrence associated with vitamin supplementation is small, and a larger study would be required to ensure that an effect of this size was not a chance finding. PMID- 3293780 TI - [The history of medical reports]. PMID- 3293779 TI - Antibody directed targeting of methotrexate-containing small unilamellar vesicles. AB - The potential of antibody-linked SUVs containing MTX in anticancer therapy was investigated. The SUVs, mean diameter 50 +/- 20 nm, were prepared by probe sonication of MTX-containing MLVs and were covalently linked either to a RAMG or NRG. After incubation with M21 melanoma cells for 2 h, RAMG-linked SUVs showed 2 and 4 times more binding than NRG-linked MTX-containing SUVs or MTX-containing SUVs unlinked to any Ig. Furthermore, on incubating M21 melanoma cells with RAMG linked 3H MTX-containing SUVs for 2, 4, and 8 h at 4 degrees C or 37 degrees C, a higher radioactivity was associated with cells at 37 degrees C than at 4 degrees C. Membrane immunofluorescence revealed aggregation of and cap formation by RAMG linked SUVs after 2 h (37 degrees C) and endocytosis at 4 and 8 h at 37 degrees C. Electron microscopic and autoradiographic studies confirmed aggregation of 3H MTX-containing SUVs around and on the surface of M21 cells. Electron microscopy also revealed these SUVs inside invaginations of and under the plasma membrane of melanoma cells. A colony inhibition assay showed that RAMG-linked, MTX-containing SUVs were 60 times, 8 times, and 4.5 times more growth inhibitory than free MTX, NRG-linked MTX-containing SUV, and MTX-containing SUVs unlinked to any Ig, but not toxic to a human kidney cancer line (that did not react with RAMG). PMID- 3293781 TI - [Immunoreactive insulin in patients with cerebrovascular stroke]. PMID- 3293778 TI - Intracranial arterial duplex Doppler waveform analysis in infants. AB - Duplex sonography of the brain was performed on 130 pediatric patients: 53 with normal brains, 22 with intracranial hemorrhage, 15 with hypoxic-ischemic encephalopathy, 29 with hydrocephalus requiring ventricular shunting, and 11 with ventriculomegaly without hemorrhage or shunting. Doppler arterial waveforms from the Circle of Willis showed increased pulsatility in 82% of patients with intracranial hemorrhage, 53% of patients with hypoxic-ischemic change, and in only 31% of patients with hydrocephalus requiring shunt and 36% of patients with ventriculomegaly without shunt or hemorrhage. Mean pulsatility was increased (p less than 0.05) in all groups except ventriculomegaly without hemorrhage or shunt. No statistical difference was found in the diagnostic efficiency of three indices of pulsatility (frequency index profile, pulsatility index, systolic to diastolic ratio). PMID- 3293782 TI - [The effect of compensation in diabetes mellitus on energy metabolism in conventionally treated insulin-dependent diabetics]. PMID- 3293783 TI - [Scientific medical information. Search and retrieval]. PMID- 3293784 TI - [The physicians of Czech kings]. PMID- 3293785 TI - [Essential phospholipids in the treatment of alcohol-induced steatosis and hepatitis]. PMID- 3293786 TI - [From an old prescription book]. PMID- 3293787 TI - [Paracelsus]. PMID- 3293789 TI - [Stomatologic care of older persons]. PMID- 3293788 TI - [The history of Czech endocrinology]. PMID- 3293790 TI - [Experimental chemotherapy of AIDS]. PMID- 3293791 TI - [The role of J. E. Purkinje in the founding of the Society of Czech Physicians]. PMID- 3293792 TI - Cell specificity of nuclear protein antigens in the development of Xenopus species. AB - Protein antigens accumulated in the oocyte nucleus of Xenopus spp. are found later in all nuclei of the embryo. During and after organogenesis, the fate of different nuclear antigens diverges: Some are permanently expressed in all nuclei, some are no longer detectable in any nuclei, and some show a high degree of specificity relative to cell type. Of the class of antigens permanently expressed in all cells, a nucleolar antigen has been studied that is relatively enriched in the gonia of both sexes. A possible correlations of its occurrence with ribosomal DNA amplification and transcription is examined. The cell-specific expression of 4 antigens has been analyzed in detail, using indirect immunofluorescent staining methods as well as conventional histology. The tissue specificity of 2 of these antigens does not change during metamorphosis, whereas the pattern of others is dynamic until after metamorphosis. We conclude that the observed tissue-specificity does not correlate with descendence from one of the 3 primary germ layers: Some antigens appear to accumulate in the nucleus when a cell takes up its specific function. PMID- 3293793 TI - Immunochemical and immunocytochemical characterization of a novel monoclonal antibody recognizing a 140 kDa protein in cerebral pericytes of the rat. AB - A monoclonal antibody that recognizes a 140 kDa peripheral plasma membrane protein in pericytes of nervous tissues of the rat is described. Microvessels of brain cortex and perineurium of peripheral nerves are shown to react positively to this antibody. The antigen is absent in brain regions that lack a blood-brain barrier, i.e., choroid plexuses and area postrema. Antigen expression starts as early as day 18 of embryonic development. By means of immunoelectron microscopy the 140 kDa antigen was detected as clusters along the entire circumference of cerebral pericytes. The same antigenic determinant is also expressed in apical domains of plasma membranes of a variety of transporting epithelia, such as hepatocytes, enterocytes of the small intestine, and epithelial cells of proximal tubules of the kidney. We postulate the 140 kDa protein as being a constituent of the pericytes involved in regulative functions of the blood-brain barrier. PMID- 3293794 TI - Ultrastructural localization of fibronectin in bone marrow of the embryonic chick and its relationship to granulopoiesis. AB - Fibronectin was immunolocated in embryonic chick bone marrow by the use of both a direct peroxidase conjugated antiserum and an indirect Streptavidin bridge technique. Fibronectin is located in the extravascular granulopoietic compartment and, to a lesser extent, in the vascular, erythropoietic compartment. There is no evidence of fibronectin being associated with blood-stromal cell interactions involving either erythropoiesis or thrombopoiesis. However, mature thrombocytes display a substantial surface coat containing fibronectin. Much of the fibronectin appears to be situated on surfaces of those fibroblastic stromal cells which support granulopoiesis. Fibronectin containing extracellular material connects surfaces of developing granulocytes with surfaces of stromal cells. Fibronectin is a surface component of granulocytes as well as nearby stromal cells. However, there appear to be fewer ferritin particles per unit of surface on granulocytic cells. Many of the ferritin particles are not clearly associated with amorphous matrix material at cell surfaces. Immunocytochemical attempts to identify laminin were unsuccessful. These studies indicate that fibronectin is situated at sites where it could mediate adhesive interaction between granulopoietic cells and their stromal cells. Furthermore, cell surface-matrix interaction involving fibronectin could mediate migration of blood cells within the extravascular spaces. PMID- 3293795 TI - Retention of carboxypropeptides in type-II collagen fibrils in chick embryo chondrocyte cultures. AB - An antibody reacting with the C-propeptide of chick type-II procollagen was used in an attempt to localize this terminal extension of the procollagen molecule (by immunogold labelling) during early collagen fibrillogenesis in chondrocyte cultures. After 2 days in culture the chondrocytes were surrounded by pericellular type-II collagen, as demonstrated by an indirect immunofluorescence labelling technique. An electron microscopy study of these cultures showed that the collagen fibrils were thin (approximately 15 nm diameter), with a poorly visible cross striation, sometimes enhanced by slight thickenings. The antibody against the C-propeptide of type-II procollagen labelled most of the collagen fibrils, according to a very regular pattern constituting a 60 nm periodicity. After 3 days the label was still present on the pericellular collagen fibrils but disappeared from the collagen fibrils of the extracellular matrix. Our results indicate that the C-propeptide of type-II procollagen is retained in the newly formed fibrils. PMID- 3293797 TI - Managing transplant cases. PMID- 3293796 TI - Hypothetical interpretation of the calcium paradox in renin secretion. AB - Most renin-positive cells of the preglomerular arteriole are intermediate in morphological appearence between smooth muscle cells and epithelioid cells. Intermediate cells contain, in addition to secretory granules, contractile proteins arranged as a sublemmal network. The paradoxical (inhibitory) role of calcium in renin secretion is explained, on the basis of these findings, by an increased tone of the sublemmal network; this might impair the preexocytotic access of renin granules to the cell membrane. PMID- 3293798 TI - DNA in the nucleosome. PMID- 3293799 TI - Reconstitution of SEC gene product-dependent intercompartmental protein transport. AB - Transport of alpha-factor precursor from the endoplasmic reticulum to the Golgi apparatus has been reconstituted in gently lysed yeast spheroplasts. Transport is measured through the coupled addition of outer-chain carbohydrate to [35S]methionine-labeled alpha-factor precursor translocated into the endoplasmic reticulum of broken spheroplasts. The reaction is absolutely dependent on ATP, stimulated 6-fold by cytosol, and occurs between physically separable sealed compartments. Transport is inhibited by the guanine nucleotide analog GTP gamma S. sec23 mutant cells have a temperature-sensitive defect in endoplasmic reticulum-to-Golgi transport in vivo. This defect has been reproduced in vitro using sec23 membranes and cytosol. Transport at 30 degrees C with sec23 membranes requires addition of cytosol containing the SEC23 (wild-type) gene product. This demonstrates that an in vitro inter-organelle transport reaction depends on a factor required for transport in vivo. Complementation of sec mutations in vitro provides a functional assay for the purification of individual intercompartmental transport factors. PMID- 3293800 TI - brlA is necessary and sufficient to direct conidiophore development in Aspergillus nidulans. AB - The brlA gene of A. nidulans mediates the developmental switch from the indeterminate, apical growth pattern of vegetative cells to the budding growth pattern of conidiophores. brlA encodes a 432 amino acid polypeptide containing two directly repeated motifs resembling the Zn(II) coordination sites first recognized in Xenopus TFIIIA. Misscheduled expression of brlA in vegetative cells results in transcriptional activation of developmentally regulated genes, cessation of unidirectional hyphal growth, initiation of cellular transformations resembling those that occur during normal conidiophore development, and production of viable conidiospores. We propose that BRLA is a nucleic acid binding protein whose expression in vegetative cells is sufficient to induce sporulation through its role in regulating expression of conidiation-specific genes. PMID- 3293801 TI - Enzymatic activity of a synthetic 99 residue protein corresponding to the putative HIV-1 protease. AB - A protein corresponding to the putative protease of the human immunodeficiency virus 1 (HIV-1) has been prepared by total chemical synthesis. This 99 residue synthetic enzyme showed specific proteolytic activity on fragments of the natural gag precursor and on synthetic peptide substrates, two of which released fragments corresponding to the N terminus and C terminus of the protease molecule itself. The observed substrate specificity was not restricted to cleavage at Phe/Tyr-Pro bonds. Inhibition studies provided direct evidence that the HIV-1 protease belongs to the family of aspartic proteases. The availability of the HIV 1 protease as a defined molecular species has important implications for the design of specific inhibitors that do not interfere with the host cell metabolism as a possible route to antiviral agents against acquired immunodeficiency syndrome (AIDS). PMID- 3293802 TI - The Xenopus cdc2 protein is a component of MPF, a cytoplasmic regulator of mitosis. AB - In Xenopus, a cytoplasmic agent known as MPF induces entry into mitosis. In fission yeast, genetic studies have shown that the cdc2 kinase regulates mitotic initiation. The 13 kd product of the suc1 gene interacts with the cdc2 kinase in yeast cells. We show that the yeast suc1 gene product (p13) is a potent inhibitor of MPF in cell-free extracts from Xenopus eggs. p13 appears to exert its antagonistic effect by binding directly to MPF. MPF activity is quantitatively depleted by chromatography on a p13 affinity column. Concomitantly, the Xenopus counterpart of the yeast cdc2 protein is adsorbed to the column. A 42 kd protein also binds specifically to the p13 affinity matrix. These findings suggest that the Xenopus cdc2 protein and the 42 kd protein are components of MPF. PMID- 3293803 TI - Purified maturation-promoting factor contains the product of a Xenopus homolog of the fission yeast cell cycle control gene cdc2+. AB - In the fission yeast S. pombe, the Mr = 34 kd product of the cdc2+ gene (p34cdc2) is a protein kinase that controls entry into mitosis. In Xenopus oocytes and other cells, maturation-promoting factor (MPF) appears in late G2 phase and is able to cause entry into mitosis. Purified MPF consists of two major proteins of Mr approximately equal to 32 kd and 45 kd and expresses protein kinase activity. We report here that antibodies to S. pombe p34cdc2 are able to immunoblot and immunoprecipitate the approximately equal to 32 kd component of MPF from Xenopus eggs. The Mr approximately equal to 32 kd and 45 kd proteins exist as a complex that expresses protein kinase activity. These findings indicate that a Xenopus p34cdc2 homolog is present in purified MPF and suggest that p34cdc2 is a component of the control mechanism initiating mitosis generally in eukaryotic cells. PMID- 3293805 TI - Exclusion of red cell membrane cytoskeleton from the parasitophorous vacuole membrane of the internalised malaria parasite. PMID- 3293804 TI - Immunoelectron microscopic localization of circumsporozoite antigen in the differentiating exoerythrocytic trophozoite of Plasmodium berghei. AB - The distribution of the circumsporozoite (CS) antigens in the 24 hour exoerythrocytic trophozoite of P. berghei was studied using Lowicryl immunogold electron microscopy. These antigens were present on the plasmalemma of the parasite, in disrupted areas of the host cell cytoplasm adjacent to the trophozoite and around inclusions of the host cell cytoplasm. There was evidence of a redistribution of the CS antigens away from the pellicular region of the sporozoite. PMID- 3293806 TI - Polyalkylcyanoacrylates as colloidal drug carriers. AB - A considerable amount of energy has been spent in creating new colloidal drug delivery systems that are acceptable for general systemic use. Among these new systems, nanoparticles made with biodegradable polymers are gaining more and more interest. The aim of this paper is to describe the preparation and characterization of these nanoparticles and their in vivo behavior and to show the possibilities of using them in various fields of human medicine. The interaction of polyalkylcyanoacrylate nanoparticles with cells in culture is also discussed, as well as the possibility of improving the specificity of the carrier by coating it with monoclonal antibodies. PMID- 3293808 TI - [Oncogenes, AIDS, carcinogens and carcinostatic agents]. PMID- 3293807 TI - Binding of acrylic polymers to mucin/epithelial surfaces: structure-property relationships. AB - Bioadhesion, and more specifically mucoadhesion, is becoming an important strategy for drug delivery. As a result, it is important to understand the various mechanisms that govern attachment of polymeric substances to the glycoproteins on epithelial surfaces, along with the associated structure activity relationships of the polymer. This article reviews fundamentals of mucoadhesion, with special emphasis on structural features of the polymer as they contribute to the process of mucoadhesion. There are four possible general interactions between mucoadhesive polymers and glycoproteins: (1) covalent attachment; (2) electrostatic interaction, which requires matching of charge groups between the polymer and mucus; (3) hydrogen bonding; and (4) hydrophobic interactions. Aside from covalent attachment, which is not presently a prominent mechanism for mucoadhesion, the remaining mechanisms require maximum contact between the polymer and mucin for optimum adhesion. With polyelectrolyte polymers, the charged groups are important in controlling the degree of hydration of both the polymer and the mucous network. The expanded nature of the swollen polymer and mucus enhances the interdiffusion process and permits both a mechanical entanglement and an increase in surface contact for hydrogen bonding and/or electrostatic interaction between the polymer and the mucous network. A number of techniques are available to study mucoadhesion. Some of these are better suited to study the kinetics of the mucoadhesion process whereas others are more useful for equilibrium studies. To date, the major deficiency in basic studies of mucoadhesion is the lack of suitable information on the organization and physicochemical properties of the mucin layer. PMID- 3293809 TI - [Monophasic action potentials of the cardiac muscle--theoretical and clinical aspects]. PMID- 3293810 TI - [Changes in energy metabolism in damaged liver tissue and possible effect of lipid and saccharide metabolism on liver regeneration]. PMID- 3293811 TI - [Study of carbohydrates in cells and tissues using labeled lectins]. PMID- 3293812 TI - [History of the building of psychiatric facilities in the area of Presov]. PMID- 3293813 TI - [Changes in tetanus antibody levels after the administration of tetanus antigen in children]. PMID- 3293814 TI - [Modern diagnostic imaging from the viewpoint of the pediatric radiodiagnostician]. PMID- 3293815 TI - [Congenital interruption of the continuity of the aortic arch and originating arteries]. PMID- 3293816 TI - [Ultrasonic examination of soft surface tissue]. PMID- 3293817 TI - [Anomalous pulmonary veins]. PMID- 3293818 TI - Comparative in vitro activity of amoxycillin/clavulanate (augmentin), ceftazidime and ceftriaxone against hospital strains of gram-negative and -positive bacteria. AB - The in vitro antibacterial activities of amoxycillin/clavulanate (Augmentin), ceftazidime and ceftriaxone were compared against 330 gram-negative and gram positive strains isolated from clinical specimens received at the King Abdulaziz University Hospital (KAUH) in Saudi Arabia. The antibacterial susceptibility was determinated by Stokes method and by the minimal inhibitory concentration (MIC) using an agar dilution method. Ceftazidime and ceftriaxone were the most active antibiotics, inhibiting 90% of the tested strains by obtainable serum concentrations. Augmentin, on the other hand, had much lower activity against most of the strains tested. Ceftazidime's activity was superior to that of ceftriaxone especially against Klebsiella spp., Enterobacter spp., Citrobacter diversus, indole positive Proteus, Providencia stuartii, Acinetobacter calcoaceticus and Pseudomonas aeruginosa. Ceftriaxone had better activity against Serratia orderefera, Morganella morganii and Staphylococcus aureus. Beta lactamase stable cephalosporins are therefore a potential replacement for aminoglycosides in the antimicrobial therapy of serious Gram-negative infections and alternative agents in the treatment of some Gram-positive infections. PMID- 3293819 TI - Importance of inoculum growth phase when using an in vitro pharmacokinetic model to evaluate beta-lactam antibiotics. AB - The bactericidal activity of cefuroxime, cephaloridine and cephalexin is evaluated in an in vitro model. The inocula are derived from an overnight static culture, or after a pre-incubation period of 1 or 2 hours to allow cell re growth. The early bactericidal effect of the antibiotics is more evident using pre-incubated cells, especially for Staphylococcus aureus 663. At hour 8, with Escherichia coli 851/E, there is re-growth using the static inoculum, while the antibiotic effect is still evident using the pre-incubated one. The importance arises therefore for considering the phase of growth of the inoculum as a critical parameter when using in vitro models with varying concentrations of beta lactam antibiotics. PMID- 3293820 TI - [Historical evolution of the process of preparing radix Astragali]. PMID- 3293821 TI - [Outline of gymnosperm medicinal plants in China]. PMID- 3293822 TI - [Laparoschisis. Hypotrophy and intestinal lesions]. AB - 37 cases of gastroschisis were operated on at Saint-Vincent-de-Paul's Hospital from january 1983 to july 1987. They were more frequently premature by birth weights (70% below the 10 th percentile), than by period of gestation (40%). The comparison of their weights plotted on the centile charts with 28 neonates with omphaloceles and 25 neonates with upper intestinal atresia (esophageal atresia without tracheoesophageal fistula and complete duodenal and proximal jejunal atresia) shows that the 2 groups of laparoschisis and anomalies of the alimentary tract are quite similar. The authors suggest that the amniotic fluid may play a role in the fetal growth so that the alteration of the herniated bowel is responsible of the fetal growth retardation observed in gastroschisis. PMID- 3293823 TI - [Spontaneous epiphyseal separation in children with spina bifida. Apropos of a series of 12 cases]. AB - Unknown complication but nevertheless frequent, the spontaneous slipped epiphyseal injury in child with spina bifida states the problem for its diagnosis and its treatment. The authors give their experience about 12 cases in 10 children, insisting on the problem of the pseudo-infected and the pseudo-tumoral cases with an early diagnosis. A review of the literature is made about this subject. The treatment is generally orthopaedic excepted at the hip where it is surgical. A physiopathogenic study is made; explaining the mechanism, the frequency of this pathology and its complications. PMID- 3293824 TI - [The use of the laser knife for excision grafting of deep burns in children under 3]. AB - Surgical excision of deep burns followed immediately by skin grafting justifies itself by the reduction of delay of wound healing and by the same token of the improved functional and morphological results obtained. Its draw-back is that it is very hemorrhagic and is thus difficult to apply to children. Out of 120 children under 3 years old, hospitalised over two years for widespread burns, 29 of them fulfilled the conditions of excision of deep burns followed by grafting. In the first three in whom the excision was performed with a scalpel, the blood loss ranged from 140 to 500 ml. But in the fourth case also done with a scalpel, the blood loss was dramatic and required a blood compensation of 3,600 ml. The technique was therefore abandoned and we reverted to the classic technique in the 10 following patients, before we could dispose of a laser knife in the last twelve patients. The blood loss was minimal or ranged between 10 to 20 ml with a maximum of 40 ml in one case. The draw-back is that the graft cannot be performed immediately and a delay of 8 days at least is required until the tissue-bed is appropriate to a successful grafting. Analysis of the results show that, there exists a significant difference in the length of wound healing treated traditionally as compared to that of excision followed by immediate grafting. The recourse to the laser-knife, by eliminating the risk of hemorrhage, allows the use of the technique of excision-immediate grafting in young children. PMID- 3293825 TI - [Cubital dimelia. Apropos of a case with review of the literature]. AB - Cubital or ulnar dimelia is a very rare congenital abnormality involving almost perfect duplication of the ulnar with absence of the radius, thumb and polydactyly. An eleven week old child was seen in the Department of Pediatric Surgery for a malformation of the left upper limb including deformity of the forearm with almost doubling of the hand and seven fingers. Radiological investigation revealed duplication of the ulna as well as of the metacarpals and fingers with absence of the radius and thumb. This type of abnormality remains controversial but clinical and radiological examination led to the conclusion of primary ulnar dimelia. We report a new case of this very rare congenital abnormality which was not accompanied by any other malformation. PMID- 3293826 TI - Development of recommendations for the protection of short-stay travellers to malaria endemic areas: Memorandum from two WHO Meetings. AB - In the past, since malaria chemoprophylaxis was assumed to be of benefit and with no serious complications, it was recommended to all travellers who were at risk of acquiring the disease. The current epidemiological situation of malaria is marked by the increasing spread of Plasmodium falciparum resistance to chloroquine and by problems due to the toxicity of other drugs. Recommendations for malaria prophylaxis should therefore be based on an epidemiological approach which takes into account the risk of acquiring the infection, the toxicity and effectiveness of the available antimalarial drugs, the traveller's perception of these risks, and the human factors that influence the use of all possible protective measures against malaria.This Memorandum describes the epidemiological approach and the data bases required for the development of recommendations on prophylaxis for short-stay visitors in malaria endemic areas, and gives guidelines on the protective measures and drugs that may be used in defined situations. PMID- 3293827 TI - Evaluation of four therapeutic regimens for falciparum malaria in Mozambique, 1986. AB - A randomized study on the effect of the following four treatment regimens on Plasmodium falciparum parasitaemia was carried out on 200 asymptomatic schoolchildren in Maputo, Mozambique: chloroquine (25 mg/kg body weight), amodiaquine (25 mg/kg), sulfadoxine-pyrimethamine (25 mg/kg and 1.25 mg/kg), or amodiaquine (25 mg/kg) + sulfadoxine-pyrimethamine (25 mg/kg and 1.25 mg/kg) administered on the third day of the study. The results of in vivo tests indicated that 94% of the infections were resistant to chloroquine, 76% to amodiaquine, and 16% to sulfadoxine-pyrimethamine. The cure rate with amodiaquine + sulfadoxine-pyrimethamine was 100%, which was not significantly different from that with sulfadoxine-pyrimethamine alone; the latter regimen was the most rapidly acting of the treatments studied. It is concluded that amodiaquine is not an appropriate substitute for chloroquine, but that the effect of the combination amodiaquine + sulfadoxine-pyrimethamine may be superior to that of sulfadoxine pyrimethamine alone, although this requires further study. PMID- 3293828 TI - Malaria: treatment efficacy of halofantrine (WR 171,669) in initial field trials in Thailand. AB - Halofantrine (WR 171,669) hydrochloride was administered orally to 82 patients infected with Plasmodium falciparum malaria on the Thai-Kampuchean border between June 1982 and December 1983 in a randomized double-blind treatment trial which compared the efficacy of halofantrine with that of mefloquine. Halofantrine was curative with oral treatment on a single day in 65% of patients (13/20) who received 1000 mg followed 6 hours later by an additional 500 mg, and in 88% of patients (53/60) who received 500 mg every 6 hours for 3 doses. Mefloquine was curative in 88% of patients (22/25) given a single oral dose of 1000 mg and in 97% of patients (38/39) given a single oral dose of 1500 mg. The difference in cure rates between the 3-dose halofantrine regimen and either of the mefloquine regimens was not significant. The mean parasite clearance time for all regimens ranged from 75 to 84 hours. The mean fever clearance time for all four treatment groups was in the range 50-60 hours, with no significant differences between groups. Post-dosing side-effects in patients treated with halofantrine consisted of nausea, vomiting, abdominal pain and diarrhoea and were not significantly different from those treated with mefloquine. Halofantrine therefore appeared to be of comparable efficacy to mefloquine in the treatment of multidrug-resistant P. falciparum malaria. PMID- 3293829 TI - Diagnostic technology in cardiovascular disease: review of noninvasive methods for population studies. AB - To aid the selection of appropriate diagnostic technologies, the literature on noninvasive methods for population studies of cardiovascular diseases was reviewed. Indications, limitations and cost-effectiveness are discussed. Most widely applicable are the standardized medical history, blood pressure and other measurements, resting electrocardiogram, chest X-ray, and selected tests of blood and urine. Useful in specialized studies are exercise testing, ambulatory monitoring, and peripheral arterial flow measurements. Ultrasound is valuable in the study of hypertensive and other myocardial diseases. Further methodological research is needed. PMID- 3293830 TI - Magnetic resonance imaging of head and neck tumors. AB - Magnetic resonance imaging has revolutionized the imaging of head and neck malignancies and is now rapidly replacing computed tomography as the study of choice in the majority of lesions in the head, neck, larynx, hypopharynx, oropharynx, paranasal sinuses, paranasopharynx, and skull base. CT scanning can be used in the same region; however, inflammation obtained in CT is not as clearly demonstrated and in some situations, such as malignancies of the tongue, the lesions may be missed entirely. There are still occasional difficult clinical problems when the two studies are complementary, but this situation will definitely be rare. PMID- 3293831 TI - Proteoglycans and neoplasia. AB - There is a growing realization that the whole tumor cell-matrix complex must be investigated in order to fully understand the process of cancer growth and metastasis. Proteoglycans are intrinsic constituents of the cell surface, extracellular matrix, and basement membrane, three logistically and functionally important structures involved in most cellular interactions. Proteoglycans influence the behavior of normal and malignant cells by virtue of their expanded configuration, polyanionic nature and, most of all, by their ability to interact with a variety of cellular products. Consequently, they have been implicated in a number of biological processes including proliferation, recognition, adhesion, and migration. They can serve as links between the extracellular and intracellular environment and thus transduce key biological signals. They can act as receptors for interstitial collagens and other matrix proteins and thus contribute to the organization of pericellular matrix. During neoplastic development there is a profound structural rearrangement of these macromolecules at both the plasma membrane and the pericellular level. Qualitative and quantitative abnormalities in proteoglycan metabolism may contribute to the establishment of some well-known neoplastic properties, including lack of cohesiveness, abnormal assembly of extracellular matrix, abnormal growth, and invasion. The present work will focus on recent advances in our understanding of these complex macromolecules and on some of the alterations associated with the neoplastic phenotype, and will then attempt to elucidate some of the mechanisms regulating these changes. PMID- 3293832 TI - Multistage carcinogenesis: implications for risk estimation. AB - In undertaking a quantitative estimation of carcinogenesis risk, it is essential to keep in mind that carcinogenesis is a multistage process, and that each stage can be affected by different classes of risk factors. Furthermore, different mechanisms are involved in the various stages of carcinogenesis. Thus, a dose response analysis of one given factor cannot provide an accurate estimation of carcinogenic risk. Carcinogenic risk estimation is usually undertaken for a specific chemical or group of chemicals; however, the concept of multistage carcinogenesis is based on biological processes and not on the mechanisms of action of the agents involved. It is therefore important to consider three related, but different, factors involved in carcinogenesis: stage, agent, and activity of agent. This is especially important in developing a short-term test for stage-related risk factors, such as tumor-promoting agents. For this reason, carcinogens should not be classified according to only one chemical activity. This article briefly reviews the cellular and molecular mechanisms involved in multistage carcinogenesis, and discusses their implications for risk estimation. Special consideration is given to the effect of treatment frequency on the response of tumor-promoting agents, as seen in long-term tests in experimental animals. It is proposed that exposure frequency be taken into account together with exposure dose. PMID- 3293833 TI - The 4S binding protein acts as a trans-regulator of the polycyclic hydrocarbon inducible cytochrome P450. AB - A model has been proposed for the induction of cytochrome P450c in liver by polycyclic hydrocarbons such as benzo(a)pyrene (BaP) and 3-methylcholanthrene (3MC). The polycyclic hydrocarbon interacts in specific, saturable, and high affinity fashion with a rat liver cytosolic 4s binding protein. The latter enters the nucleus, complexes to 5' upstream regions of the cytochrome P450c gene, and stimulates the transcription. The 4s binding protein has been purified from rat liver and its substrate specificity has been determined. The affinity for 3MC or BaP is 1-2 mM. The binding protein has been demonstrated to complex with specific 5'-upstream regions of the P450c gene by using a filtration assay as well as exonuclease footprinting. In addition, the binding protein stimulates in vitro transcription with upstream regions of the P450c gene as template; these data confirm the hypotheses. PMID- 3293834 TI - Advances in platinum cancer chemotherapy. Advances in the design of cisplatin analogues. AB - In the past 4 years substantial progress has been made in the development of platinum cancer chemotherapy. A number of drug candidates have undergone clinical trials and one 'second generation' platinum drug, carboplatin, has been approved for use in the treatment of ovarian and small cell lung cancer. This review covers the major developments since the last international conference on Platinum Chemotherapy in Vermont, and attempts to highlight the primary factors that appear to be influencing the synthesis and screening of potential third generation platinum drugs. A predominant feature in the evaluation of analogues has been the emphasis on chelating diamine complexes, in particular those of diaminocyclohexane, which show activity in L1210 tumours that are resistant to cisplatin, and the use of a wide range of carboxylate ligands as a means of circumventing solubility and toxicity problems inherent in the parent compounds. There has also been an increased effort in studies relating to complexes containing mixed amines and functionalised amines, building on the assumption, which remains valid to date, that two amines are a necessary requirement for anti tumour activity. Efforts have also been made to address the use of complexes containing biologically active ligands, and the concept of targeting compounds to specific organs and formulating drugs to achieve more specific activity or controlled release of drugs with lower toxicities. These may provide a viable route to drugs that can be administered more easily, for example by an oral route, or show a different spectrum of activity. However, it may prove difficult to adequately characterise these more complex systems. The major problem encountered in evaluating cisplatin analogues, as with other prospective cancer drugs, is finding reproducible anti-tumour screens that are predictive of the behaviour of the drugs in the clinic. Progress is being made in the development of sensitive and resistant human tumour xenograft lines and this area should be monitored with interest, as it may provide a key to the development of a future platinum drug, hopefully with a wider range of activity than either cisplatin or carboplatin. PMID- 3293835 TI - PET in clinical oncology. AB - Positron Emission Tomography (PET) is an imaging technique that produces cross sectional images based on tissue biochemical and physiological processes. PET complements other anatomic imaging techniques such as x-ray CT and magnetic resonance imaging (MRI). Fundamental processes such as glucose metabolism, oxygen metabolism, and blood flow can be imaged and quantified with PET, in addition to many other processes of both clinical and investigative interest. PET is now emerging as a clinical tool in oncology and is useful in noninvasively grading tumors, in determining tumor activity and recurrence, and in monitoring the effects of a variety of therapeutic interventions with tumors. While most of the applications of PET in oncology to date have been in brain tumors, the technique is now being applied in tumor evaluations outside of the central nervous system. PMID- 3293838 TI - The comparative tissues distribution of platinum and 14C in mice receiving 14C labelled carboplatin. AB - Since the reactivity of carboplatin depends on the rate of removal of the 1,1 cyclobutanedicarboxylate ligand, the time course of this dissociation has been determined in various tissue and body fluids using 14C-labelled carboplatin (cis diammine[1,1-cyclobutane-1-14C-dicarboxylate]platinum II). Mice received 14C carboplatin (80 mg/kg; 1.1 mCi/kg, i.v.), and tissue was removed at times ranging from 5 min to 5 days posttreatment. Following solubilization, tissue aliquots were analyzed for platinum and 14C contents. Carboplatin remained intact for up to 2 h posttreatment, since the ratio of 14C: Pt in tissues (nmol/g) was unity. Thereafter, the 14C ligand was released from the molecule and preferentially removed from tissues, indicated by decreasing 14C: Pt ratios. The elimination half-lives for Pt varied between tissues (40-156 h). In contrast, the corresponding half-lives for the 14C species were similar in most types of tissue (18-35 h), although those in the liver and spleen were exceptional (210 and 90 h, respectively). At 5 days a maximum of 4%-24% of the total Pt in tissue might exist as intact drug. Thus, the metabolic handling of carboplatin varies according to the tissue, since the elimination of the 14C cyclobutane dicarboxylate species from most tissue was similar and Pt elimination was slower and tissue-dependent. PMID- 3293839 TI - Penetration of substances into tumour tissue. Model studies using saccharides, thymidine and thymidine-5'-triphosphate in cellular spheroids. AB - In order to achieve a better understanding of factors involved in drug penetration into poorly vascularized tumour tissue, the penetration of some model substances was studied in vitro. Multicellular human tumour spheroids were used as model system. The test substances were [3H]thymidine and [14C]glucose, both of which are capable of passing easily through cell membranes, and [3H]thymidine-5' triphosphate, [3H]sucrose and [3H]inulin, all of which are unable to pass directly through cell membranes. The penetration of these substances was studied using a dry histological and autoradiographical method preserving the distribution of water-soluble substances. The two thymidine compounds penetrated very efficiently into the spheroids, and their penetration patterns were rather similar. The saccharides differed somewhat in their penetration properties. Glucose had the fastest penetration and inulin the slowest. After 15 min, however, inulin was also found isotropically distributed within the spheroids. Thus, extracellular penetration seemed to be a possible way for a substance to reach the central parts of a spheroid. The differences between the saccharides could be due to some extent to differences in molecular weight and solubility. PMID- 3293841 TI - In vitro chemosensitivity of brain tumors to cisplatin and its analogues, iproplatin and carboplatin. AB - The human tumor stem-cell assay was used to investigate the in vitro chemosensitivity of 27 evaluable samples to cisplatin and its analogues, iproplatin and carboplatin, as well as to BCNU, teniposide, vindesine, and dibromodulcitol. All agents exhibited some antitumor activity with the exception of dibromodulcitol (zero response out of 19 evaluable samples). Vindesine, BCNU, and carboplatin were the three most active compounds, with response rates of 29%, 23%, and 22%, respectively. There was a lack of complete cross-resistance between carboplatin and cisplatin as well as between carboplatin and BCNU. Our data suggest that clinical studies with carboplatin and combinations of vindesine plus cisplatin and its analogues may be worthwhile. PMID- 3293840 TI - Resistance and cross-resistance of the IgM immunocytoma in the LOU/M Wsl rat for cisplatin, carboplatin, and iproplatin. AB - We investigated the antitumor activity of cis-diammine[1,1 cyclobutanedicarboxylato]platinum(II) (CBDCA, JM8) and cis-dichloro-trans dihydroxybis(isopropylammine)platinum(IV) (CHIP, JM9) for the cis-DDP-sensitive and -resistant IgM immunocytoma in the LOU/M Wsl rat. The optimal dose for the antitumor effect of cis-diamminedichloroplatinum (cis-DDP) in this tumor model is 1 mg/kg body weight. In order to determine the dose range for antitumor activity of JM8 and JM9, tumor-bearing rats were treated i.p. (twice weekly) with 2, 4, 8, 16, or 32 mg/kg JM8 or with 2, 4, or 8 mg/kg JM9. The maximal antitumor activity of JM8 was found at a dose of 4-8 mg/kg and that of JM9, at 4 mg/kg. Doses of 16 or 32 mg/kg JM8 did not increase the antitumor activity. Recurrence of tumors was observed in JM8- and JM9-treated rats. It was demonstrated that these relapses during treatment with JM8 or JM9 involved tumor cell populations almost completely resistant against therapy with the respective drugs. The growth of cis DDP-resistant tumors was not influenced by the analog JM9 (4 and 8 mg/kg). Only a high dose of JM8 (32 mg/kg) caused growth retardation of the cis-DDP-resistant IgM subline. The JM8-resistant tumor was resistant to treatment with cis-DDP (1 and 2 mg/kg). The JM9-resistant tumor was also resistant to this treatment (1 mg/kg); however, at a dose of 2 mg/kg cis-DDP, growth retardation of the tumor occurred. We conclude that cis-DDP, JM8, and JM9 induce resistance in the IgM immunocytoma tumor system; tumors resistant for cis-DDP were not sensitive to the treatment with JM8 or JM9. Although JM9 reacts in vitro distinctly differently with DNA than cis-DDP and JM8, no differences were found in the induction of Pt resistance. In this study tumor cells were readily made resistant, which allows us to study in more detail the induction of (cross-) resistance by cis-DDP, JM8, and JM9. PMID- 3293842 TI - Identifying and measuring severity of coronary artery stenosis. Quantitative coronary arteriography and positron emission tomography. PMID- 3293843 TI - The margin of safety of polyquaternium-1 preserved lens care solutions: a phase I clinical study. PMID- 3293844 TI - Diet and atopic eczema. PMID- 3293845 TI - Hay fever, a post industrial revolution epidemic: a history of its growth during the 19th century. AB - Although other forms of allergic disease were described in antiquity, hay fever is surprisingly modern. Very rare descriptions can be traced back to Islamic texts of the 9th century and European texts of the 16th century. It was only in the early 19th century that the disease was carefully described and at that time was regarded as most unusual. By the end of the 19th century it had become commonplace in both Europe and North America. This paper attempts to chart the growth of hay fever through the medical literature of the 19th century. It is hoped that an understanding of the increase in prevalence between 1820 and 1900 may provide an insight for modern researchers and give some clues into possible reasons for the epidemic nature of the disease today. PMID- 3293837 TI - The natural history of a family of transplantable melanomas in hamsters. AB - We have characterized a family of transplantable melanomas in Syrian (golden) hamsters, which originated in 1959 as a spontaneous melanoma of hamster skin, and which has been maintained since then by serial passage. Emphasis has been placed on using the same method of transplantation, keeping strict records on all passages, and applying the same investigative techniques, in order to trace tumor behavior over long periods of time. This tumor family consists of five variants linked by common origin, but which differ with respect to differentiation level, malignancy, intermediary metabolism, chromosome number, and cell surface properties. Once established, these melanomas possessed a considerable degree of phenotypic stability over decades of passaging. One tumor line in this family is emphasized. The Ab amelanotic melanoma lost its differentiated functions (the ability to synthetize melanin) a quarter of a century ago, and since then has remained dedifferentiated in serial passage in hamsters. After transfer to primary cell culture, the Ab melanoma cells differentiate readily and lose much of their proliferative potential. This process is reversible by reimplantation of the cells into a hamster. Inasmuch as this hamster melanoma system meets many of the conditions required for an experimental tumor model, five melanoma variants are characterized concisely and compared to other melanomas in humans and animals. Mechanisms by which new melanoma variants arise are discussed and compared to some phenomena in the evolution of the species. PMID- 3293846 TI - Intractable epilepsy: etiology, risk factors and treatment. AB - The data emerging from our study are the following: the presence of an identifiable cause is important: complications like tuberous sclerosis or signs of marked cerebral damage represent an adverse risk factor for IE. The presence of epilepsy among relatives, evidence of pre- or perinatal cerebral damage, mental retardation, and early onset, long periods of uncontrolled seizures before starting an adequate therapy and frequency of seizures appear to be indicative of an adverse prognosis, since differences between the two groups of responsive or unresponsive patients are statistically significant. On the contrary, the occurrence of febrile convulsions in the past history does not seem to have an adverse prognosis. Temporal lobe epilepsy and IS bear the worst prognosis. ME, CPS, GTCS, SPS, LGS and PM have a progressively better outcome in responsiveness to AEDs. Concerning therapy in patients with IE, studies indicate the results of high dose monotherapy appear to be equal or better than with polypharmacy. Because of the gravity of the situation, trials with unconventional drugs have been performed, but it is too early to draw definite conclusions about the long term usefulness of most of them. In conclusion, our data indicate that the appearance of an IE can be predicted utilizing the above mentioned criteria, considered either alone or in combination. The issue of IE remains undoubtedly an important one among the group of convulsive disorders. Further studies considering a greater number of patients and new therpeutic strategies are to be recommended. PMID- 3293836 TI - Organ specificity of tumor metastasis: role of preferential adhesion, invasion and growth of malignant cells at specific secondary sites. AB - The locations of distant secondary tumors in many clinical cancers and animal tumors are nonrandom, and their distributions cannot be explained by simple anatomical or mechanical hypotheses based on the simple lodgment or trapping of tumor cell emboli in the first capillary bed encountered. Evidence from certain experimental tumor systems supports Paget's 'seed and soil' hypothesis on the nonrandom distributions of metastases, in which the unique properties of particular tumor cells ('seeds') and the different characteristics of each organ microenvironment ('soil') collectively determine the organ preference of metastasis. Experimentally, differential tumor cell adhesion to organ-derived microvessel endothelial cells and organ parenchymal cells, differential invasion of basement membranes and organ tissues, and differential responses to organ derived growth-stimulatory and -inhibitory factors all appear to be important determinants in explaining the organ preference of metastasis. Each tumor system may achieve organ specificity because of its own unique set of multiple metastasis-associated properties and responses to host microenvironments. As neoplasms progress to more highly malignant states multisite metastases are more likely and organ-specific metastases may be masked or circumvented owing to stochastic events, tumor cell diversification, host selection processes, and increased production of tumor autocrine molecules that may modulate adhesion, invasion, growth, and other properties important in metastasis. The importance of each of these properties, however, appears to vary considerably among different metastatic tumor systems. These and other tumor cell and host properties may eventually be used to predict and explain the unique metastatic distributions of certain human malignancies. PMID- 3293847 TI - Mechanisms of autoimmunity in insulin-dependent diabetes mellitus. PMID- 3293849 TI - Plasmodium falciparum: inhibition/reversal of cytoadherence of Thai isolates to melanoma cells by local immune sera. AB - The effect of sera on the cytoadherence in vitro of Plasmodium falciparum infected erythrocytes to melanoma cells was examined. Sera from 19 healthy individuals living in endemic malarious areas in Thailand and 24 patients with P. falciparum malaria were tested against four local P. falciparum isolates. Out of 57 sera examined, 12 (21%) showed significant inhibition (greater than 50%) of cytoadherence for at least one isolate. Anti-malarial IgG antibody titres were determined for all 57 sera and although 11 of the 12 inhibitory sera had relatively high titres, 36 out of 47 sera with similarly high titres showed no significant inhibitory activity. Convalescent sera were no more effective than corresponding acute sera in inhibiting the cytoadherence of erythrocytes infected with any of the four heterologous isolates examined. Sera which significantly inhibited cytoadherence were also capable of reversing cytoadherence, and pooled plasma, from healthy individuals living in malarious areas, was effective in significantly reversing the in vitro cytoadherence of all the five parasite isolates examined. The results confirm the antibody mediated strain-specific nature of the inhibition of cytoadherence and stress the difficulty in selecting immune sera potentially useful for the immunotherapy of cerebral malaria patients in Thailand. PMID- 3293848 TI - Accelerated development of immunity following transplantation of maternal marrow stem cells into infants with severe combined immunodeficiency and transplacentally acquired lymphoid chimerism. AB - Transplacentally acquired lymphoid chimerism was detected in two infants with severe combined immunodeficiency (SCID) by two-colour cytofluorographic studies. These cells had no demonstrable function in studies in vitro. Following T cell depleted maternal bone marrow stem cell transplantation, evidence of T cell function was detected 20 and 50 days later, and transient B cell function was detected 50 days later. These immune functions appeared much sooner than the 90 120 days usually required for T cell function and the 2-2.5 years for B cell function to develop after haplo-identical stem cell transplants into SCID infants without transplacental engraftment. The presence of maternal lymphoid chimerism did not interfere with haplo-identical marrow cell engraftment, even though no pre-transplant immunosuppression was given. This observation suggests that the transplanted maternal marrow stem cell in some way conferred reactivity on the engrafted but apparently non-functional mature T cells that had entered the fetal circulation transplacentally. PMID- 3293850 TI - Monoclonal antibodies to salmonella lipopolysaccharide: functional analysis of anti-lipid A antibodies. AB - We have produced monoclonal antibodies (MoAb) to the Rb core and lipid A regions of Salmonella lipopolysaccharide (LPS) and have assessed their ability to inhibit LPS-mediated mitogenic responses in vitro, and to protect against LPS toxicity and lethal Salmonella infection in vivo. Monoclonal antibodies RC-8 and RC-16 were specific for LPS Rb core determinants, and MoAb LA-1, LA-2, LA-3, LA-4 and LA-5 were specific for lipid A. Anti-lipid A MoAb LA-2, LA-3 and LA-5 were found to abrogate mitogenic responses of C3H/HeN spleen cells to smooth S. typhimurium LPS (S LPS) and to rough S. minnesota R595 LPS (Re LPS). Monoclonal antibody LA-5 was effective in extending the median length of survival of C3H/HeN mice challenged with a lethal dose of either S LPS or Re LPS. Antibody LA-2 could extend the median length of survival of C3H/HeJ mice challenged with Re LPS but not with S LPS, and failed to extend significantly the length of survival of S LPS-challenged C3H/HeN and DBA/2 mice. Neither 20 micrograms of anti-Rb core or anti-lipid A MoAb nor 200 micrograms of anti-lipid A MoAb were able to protect C3H/HeN or BALB/c mice, respectively, against lethal infection with S. typhimurium SR-11. These results suggest that the importance of anti-lipid A antibodies in host defence may lie more in their ability to neutralize pathological effects of LPS, than in their ability to protect against bacterial infection. PMID- 3293851 TI - Mononuclear phagocytes from patients with active systemic lupus erythematosus down-regulate the specific in vitro reactivity of autologous lymphocytes to double-stranded DNA. AB - Peripheral mononuclear cells (MNC) from patients with systemic lupus erythematosus (SLE) are hyporesponsive in vitro. In order to study the role of mononuclear phagocytes (m phag) in regulating the in vitro responses of autologous lymphocytes, the MNC from 16 SLE patients (eight active, eight inactive) and 14 healthy controls were stimulated in vitro with PHA or dsDNA. The proliferative response to PHA was tested by 3H-thymidine incorporation on day 4 and the response to dsDNA using a specific haemolytic plaque assay. Indomethacin, an inhibitor of prostaglandin (PG) synthesis by m phag, was added into the cultures to test the presence of suppressive m phag acting through a PG-mediated pathway. Indomethacin augmented the proliferative response to PHA in active SLE cultures and not in inactive SLE or controls. In six of 13 SLE cultures, dsDNA totally or partly suppressed anti-dsDNA plaque-forming cell (PFC) generation. Indomethacin restored or enhanced the PFC response to dsDNA in active SLE and not in inactive SLE or controls. M phag depletion by plastic adherence prevented the effects of indomethacin. These results show that m phage exerting a suppressive activity on PHA-induced lymphocyte proliferation and on anti-dsDNA antibody production are found in cultures from active SLE and generally not in inactive SLE or healthy individuals. PHA being primarily a T-cell stimulator, the m phag suppressive activity observed in PHA-stimulated cultures is exerted on T cells. On the other hand, in two active SLE cultures depleted of T cells by OKT3 antibody, indomethacin still could enhance the PFC response to dsDNA, showing that in vitro suppressive m phag can act directly on B cells from patients with active SLE. PMID- 3293852 TI - Reaction of bacterium-primed murine T cells to cartilage components: a clue for the pathogenesis of arthritis? AB - Although different models for rheumatoid arthritis have been studied, the pathogenesis in humans remains unknown. A possible mechanism is the crossreactivity between bacterial components and the target-tissue, the cartilage. The existence of this crossreactivity is supported by various data from clinical and experimental studies. Here we provide direct evidence that priming in vivo with cell wall fragments of Streptococcus pyogenes or Escherichia coli can induce a cellular and humoral anti-cartilage response in Balb/c mice in vitro. T cells isolated from these mice can be stimulated in vitro to proliferate by a variety of antigens among which are the priming bacterium, an unrelated bacterium, small bacterial components and diverse antigens of cartilagenous origin. In bacterium-primed mice antibodies were also detected that displayed a reactivity to cartilage extract besides the reactivity to bacteria. A crossreactive response occurred in vivo in certain circumstances: a delayed type hypersensitivity reaction could be elicited in cell-wall-primed mice by challenge with cartilage extract. For the expression of this crossreactive response in vivo however, it was obligatory to attenuate the mouse's suppressor-circuit. In this paper we would suggest a mechanism for the pathology of chronic arthritis, based on repeated challenges with different bacterial stimuli. PMID- 3293853 TI - Features of renal vasculitis in autoimmune MRL lpr/lpr mice: phenotypes and functional properties of infiltrating cells. AB - MRL lpr/lpr (MRL/1) mice spontaneously develop a widespread renal vasculitis. The majority of the cells in vasculitic lesions are bright Ly-1, L3T4 and la-positive in contrast to the cells found in lymph nodes and spleens of the old MRL/1 mice. However, despite differences in phenotypical patterns, B and T cells from arteritic lesions do not differ from mononuclear cells (MNC) eluted from MRL/1 lymph nodes with regard to the frequency of IgG secreting cells and the proliferative responses to Concanavalin A (Con A). Co-culture experiments with congeneic MRL+/+ (MRL/n) spleen cells indicate that the poor response to Con A of the MNC eluted from vasculitic lesions is, unlike the case of lymph node MNC, due to suppressive action of vasculitic cells on the indicator cell population. Further support for the activation status of infiltrating MHC in kidney vasculitic lesions, expressed by high in vivo uptake of 3H-thymidine, was obtained by autoradiography performed on frozen sections. The observed differences in phenotypic patterns and functional features between lymph node MNC and infiltrating vasculitic MNC indicate that different immune mechanisms may be responsible for the development of lymphadenopathy and vasculopathy, respectively in MRL/1 mouse. PMID- 3293854 TI - Strong association between IgA nephropathy and hepatitis B surface antigenemia in endemic areas. AB - The frequency of hepatitis B surface antigen (HBsAg) was studied in the sera of 122 patients with primary IgA nephropathy. Hepatitis B surface (HBs) antigenemia was detected in 21 patients (17.2%) and this was significantly higher than the prevalence of HBsAg carrier in the general population (p less than 0.01). These patients had no clinical or laboratory findings to suggest acute or chronic liver diseases. Two glomerulopathic entities: mesangial proliferative glomerulonephritis with predominant mesangial IgA deposits and a mixed picture of membranous nephropathy with capillary IgG deposits and mesangial proliferative glomerulonephritis with mesangial IgA deposits, were observed in this group of patients. Glomerular deposits of HBsAg, hepatitis B core antigen (HBcAg), and both HBsAg and HBcAg were detected in three, five and four renal biopsy specimens respectively. Replication of hepatitis B virus (HBV) was suggested in two of the six renal biopsy specimens examined by HBV DNA gene probe. During the mean study period of 40 months (range 12-84), 19% of these patients with hepatitis B virus associated IgA nephropathy developed progressive renal deterioration and one required maintenance dialysis therapy. Our study suggests that hepatitis B virus antigenemia may play a significant pathogenetic role in the development of IgA nephropathy in areas of high HBV endemicity and these HBV-associated IgA nephropathies can run an indolent but relentless slowly progressive clinical course. PMID- 3293855 TI - Comparison of serum neopterin levels and urinary neopterin excretion in renal allograft recipients. AB - Determination of serum and urinary neopterin levels was performed daily in 30 patients undergoing kidney transplantation for treatment of end-stage renal failure. Neopterin serum levels were determined by RIA and urinary excretion by HPLC. In parallel, the same samples were tested for creatinine content. Results indicated a strong correlation between the clearance of neopterin and creatinine. This correlation was independent of the extent of functional impairment as well as of the different causes of renal insufficiency. As a consequence, a strong relationship between serum and urinary neopterin levels was only obtained when values were corrected for different renal function by dividing them by the creatinine levels. It thus appears that major attention has to be paid to the functional state of the kidney when studying neopterin serum and/or urine values. It also appears that under these prerequisites both methods of detection as well as both sample sources yield comparable results. PMID- 3293856 TI - The role of desferrioxamine in dialysis-associated mucormycosis: report of three cases and review of the literature. AB - We report 3 patients on maintenance hemodialysis who developed a fulminant, disseminated and fatal form of mucormycosis. The diagnosis was made by microscopy and culture in 1 case, yielding Rhizopus rhizopodiformis, and by post-mortem microscopy in the two other cases. These patients were receiving desferrioxamine (DFO) for aluminum overload and had no iron-overload. Ten similar patients, all (with only one possible exception) receiving DFO, have been reported from American centers. The mechanism by which DFO could precipitate mucormycosis is unsettled. The explanation might be that DFO acts as a siderophore to the Mucorales fungi. High serum levels of DFO in renal failure could enhance this mechanism. Epidemiological data, provided from an inquiry in 25 Flemish dialysis centers, support the association between DFO treatment and dialysis-associated mucormycosis. PMID- 3293857 TI - Reversible acute renal toxicity by toxic sinergic effect between gentamicin and cyclosporine. PMID- 3293858 TI - Persistent painless ST-segment depression after exercise testing and the effect of age. AB - The relation between the duration of ischemic ST-segment depression (1 mm or more 60 ms after the J point) and the clinical awareness of chest pain was studied in 31 patients (aged 39-73 years) undergoing symptom-limited, graded treadmill exercise testing. The response of these patients to nitrate therapy (spray or sublingual tablet) given immediately on cessation of exercise was also studied. During exercise, angina pectoris appeared at an estimated workload of 4.6 +/- 2.2 metabolic equivalents (METS) (mean +/- SD), and pathological ST-segment depression at 4.9 +/- 1.9 METS (p = NS.) On cessation of exercise, angina disappeared after 3.0 +/- 1.9 min, but ST-segment depression persisted for more than twice as long (6.6 +/- 4.1 min) (p less than 0.0001). The ratio of time to ST-segment recovery/time to relief of pain (a quantitative measure of silent ischemia during recovery) increased with age (r = 0.49, p = 0.002), and in 16 patients over 60 years of age was higher than in 15 younger patients (3.6 +/- 2.5 vs. 2.1 +/- 1.4) (p less than 0.04). The silent ischemia ratio after exercise tended to decrease, although not significantly so (p = 0.2), in patients who received oral nitrates; there was no difference in the response to spray or tablet in this regard. We conclude that ST-segment depression frequently persists after relief of exercise-induced angina pectoris and more so in elderly patients. PMID- 3293859 TI - Etiology and prognostic implications of a large pericardial effusion in men. AB - To assess the etiology and prognosis of a large pericardial effusion, we reviewed 25 consecutive patients who presented with a large pericardial effusion and underwent a drainage procedure. Large pericardial effusion was defined as: (1) an echo-free space greater than or equal to 10 mm anteriorly and posteriorly by M mode echocardiography and (2) removal of greater than or equal to 350 ml of fluid at pericardial drainage. The etiologies of large pericardial effusion were: neoplastic (36%), idiopathic (32%), uremic (20%), postmyocardial infarction (8%), and acute rheumatic fever (4%). Of our patients, 44% presented with cardiac tamponade, while 25% of patients with idiopathic pericarditis had hemorrhage effusion and cardiac tamponade. At follow-up, 37 +/- 17 months after pericardial drainage, 68% had died from complications of their underlying disease. There were no deaths attributed to pericardial disease. While 88% of patients with idiopathic large pericardial effusion were alive at follow-up, none of the neoplastic large pericardial effusion patients survived longer than 5 months after initial pericardial drainage (p less than 0.001). Additionally, the survival of patients with uremic large pericardial effusion was better than patients with neoplastic large pericardial effusion (p less than 0.05). We conclude: (1) neoplastic, idiopathic, and uremic pericarditis are the most common causes of large pericardial effusion in men, (2) idiopathic pericarditis can be hemorrhagic and cause cardiac tamponade, and (3) the prognosis of large pericardial effusion is related to patients' underlying disease. PMID- 3293860 TI - Extraction of an intracardial catheter embolus using combined radiography and transesophageal echocardiography. AB - Embolism of a fragment of a central venous catheter is a serious clinical complication, especially when the fragment cannot be made visible by radiological methods. We report a case where such a fragment could only be localized by transesophageal echocardiography (TEE). With combined use of x-rays and TEE, the catheter embolus was successfully extracted using a conventional Dormia catheter. For similar situations the described procedure is recommended. PMID- 3293861 TI - Aspergillus endocarditis in association with a false aortic aneurysm. AB - A 32-year-old man was admitted with an intracerebral hematoma and subsequently with bilateral femoral emboli five months after aortic valve replacement. Blood cultures for bacteria and fungi were negative but microscopy of the embolus revealed Aspergillus fumigatus. At operation a large false aneurysm of the ascending aorta and vegetations on the prosthetic aortic valve were found. Aspergillus endocarditis is diagnosed antemortem in only 23% of fatal aortic aneurysms: blood cultures are positive in only 8%. Clinically a large vessel embolus is characteristic, being present in 83% and microscopy and culture of such an embolus if present are vital investigations. PMID- 3293862 TI - Demetrio Sodi-Pallares: the man and his thought. PMID- 3293864 TI - Evidence implicating infectious agents in rheumatoid arthritis and juvenile rheumatoid arthritis. PMID- 3293863 TI - Cellular immune responses to cartilage components in rheumatoid arthritis and osteoarthritis: a review and report of a study. AB - Proliferative responses of peripheral blood mononuclear cells of rheumatoid or osteoarthritis patients and normal controls stimulated with cartilage components were studied. Two components not studied in previous cellular studies, matrix proteins (fraction A4) and lipoproteins, were used as well as whole extract of cartilage, native and denatured collagen, and proteoglycans. In general, osteoarthritis cells responded less well than the other two groups; this was statistically significant for fraction A4-matrix protein (normal p less than .02, rheumatoid arthritis p less than .025). Fraction A4 sterilized by filtration rather than irradiation gave higher responses in both arthritic groups, but not controls. Antigenic alteration by radiation may explain this difference and, perhaps, the low level of proliferation to all the components seen. The possible role of such cell-mediated responses in chronic arthritis is discussed, and the current and previous reports of cartilage component-induced cellular responses are reviewed. PMID- 3293865 TI - Effect of cyclosporine on insulin binding to erythrocytes in type 1 diabetes mellitus of recent onset. AB - The effect of cyclosporine (Cyclosporin A) on insulin binding to erythrocytes was investigated in Type 1 diabetes mellitus of recent onset. The subjects were drawn from a pilot study (The Canadian Open Study on the effects of immunosuppression with Cyclosporine in Type 1 Diabetes Mellitus) in which 50% of the patients demonstrated remission during one year of cyclosporine administration. Specific binding of 125I-insulin was examined before and after 3, 6, or 12 months of cyclosporine in different groups of patients. Those who maintained target control of blood glucose without exogenous insulin for two or more weeks were designated non-insulin requiring. Basal and intravenous glucagon-stimulated immunoreactive plasma C-peptide rose in all groups but to higher levels in non-insulin requiring groups. Insulin binding at tracer concentration, reflecting the number of insulin receptors, was initially normal but tended to decrease with duration of cyclosporine administration. This decrease was significant especially in groups which remained insulin-requiring throughout the study. The affinity of erythrocyte receptors was assessed by determining the insulin concentration required for 50% inhibition of 125I-insulin binding, the ID50. These values suggested that the affinity of insulin receptors was not affected in subjects attaining non-insulin requiring remission; however, in subjects remaining dependent on exogenous insulin, receptor affinity appeared to be adversely affected. Even in subjects who demonstrated complete remission, affinity was decreased during periods of dependence on exogenous insulin. After discontinuation of cyclosporine for one month or more, the mean daily insulin dosage increased and plasma C-peptide decreased. Insulin binding at tracer concentration was not affected but the apparent affinity was decreased after withdrawal of cyclosporine. These results suggest that insulin action at the receptor may be affected by the administration of cyclosporine. The number of insulin receptors appears to be decreased but whether this effect has an impact on insulin sensitivity remains to be seen. Receptor affinity appears to be affected mainly by exogenous insulin. Thus immunosuppression with cyclosporine in newly diagnosed Type 1 diabetes mellitus may have a modest adverse effect on insulin receptors; whether the benefits of cyclosporine treatment outweigh this risk is difficult to assess. PMID- 3293866 TI - Excessive growth of cultured beta cells from an adult patient with beta cell hyperplasia. AB - We have studied a 25-year-old female with frequent, severe hypoglycemic episodes. Concurrent with low serum glucose levels, the concentrations of C-peptide and insulin were markedly elevated. Tests for sulfonylurea hypoglycemic agents were negative. Special tests did not disclose any neoplasm. Biopsy of the pancreatic tail revealed islet cell hyperplasia and adenomatosis. About two-thirds of the pancreas was resected, resulting in correction of all metabolic abnormalities. Specific fluorescein-labeled anti-insulin antibodies revealed staining in 60-80% of the cultured cells isolated from the patient's pancreas, while electron microscopy disclosed insulin storage granules in about 80%. By comparison, for each of these findings, the range for cells from normal pancreases was 30-50%. In contrast to these control cells, cells from the patient grew about 2 and 2.6 times more rapidly during the first two cell cycles, and the growth persisted through four cycles. The greater and more enduring growth of the patient's cells in culture must have been at least partly independent of circulating factors. Paracrine/autocrine principles from the beta cells or other islet cells may have been responsible. PMID- 3293869 TI - Amiodarone therapeutic plasma concentration monitoring. Is it practical? PMID- 3293868 TI - Clinical pharmacokinetics of clonidine. AB - Clonidine is a centrally active antihypertensive agent effective in the treatment of mild, moderate and severe hypertension, alone or in combination with other drugs. Use of oral clonidine has often been limited by side effects which include dry mouth and drowsiness. Transdermal clonidine was therefore developed as an alternative to oral therapy. Ideally, a drug administered at a constant rate into the systemic circulation should attain steady-state concentrations with less peak to-trough fluctuation than that associated with intermittent oral dosing. In theory, transdermal administration should thus minimise the adverse effects associated with peak plasma drug concentration, while avoiding the potential for decreased efficacy associated with trough levels. Clonidine has been incorporated into a small, pliable adhesive cutaneous delivery device designed to provide therapeutically effective doses of drug at a constant rate for at least 7 days. The transdermal therapeutic system is a laminate consisting of an external film impermeable to moisture and to the drug, a thin layer of active drug dispersed within a highly drug-permeable matrix, a membrane with a controlled intrinsic permeability regulating the rate of delivery of drug to the skin, and an adhesive coating that attaches the system to the skin surface. The permeation of drug through the skin occurs primarily by diffusion. Application of the clonidine transdermal system to both normotensive and hypertensive subjects has consistently reduced systolic and diastolic blood pressures. Maximum reduction in blood pressure occurs 2 to 3 days after initial application, and is maintained for at least 7 days or until the system is removed. The rate at which clonidine is presented to the skin surface is controlled by the microporous membrane: this rate is the same for all strengths of transdermal clonidine, the amount of clonidine released being proportional to its surface area. Thus, the daily dose is regulated by the area of skin covered. Typically, steady-state plasma concentrations are reached on the fourth day after initial transdermal system application. The lack of dose dependency in half-life and renal clearance estimates emphasise that the transdermal absorption of clonidine is linear. The plasma clonidine concentration produced by a particular transdermal dose varies considerably between individuals as a result of interindividual variation in renal clearance. For this reason, it is recommended that dosages be titrated up from the smallest system (3.5 cm2) until the desired pharmacological effect has been obtained.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3293871 TI - Psychopharmacology: the bridge between psychiatry and biology. AB - The current enthusiasm for biologic approaches to psychiatric problems stems from the practical applications of clinical psychopharmacology. Effective drugs led to more efficient and humane treatment of patients with such disorders. Still, our present drugs leave much to be desired. As we have learned more about how they may ameliorate various types of mental disorders, we generate hypotheses about the possible causes of the disorders we treat. Thus we try to lift ourselves by our bootstraps; drugs generate hypotheses that one hopes will lead to better drugs. Although at times progress seems to be agonizingly slow, if we consider the great progress of the past 35 years one cannot be less than enthusiastic about the prospects for the next three decades. It has been my good fortune to have been connected closely with the developments of the past, a few of which have been discussed in this personal odyssey. It will be the good fortune of my younger colleagues to see the future realization of many of our hopes for better treatment and understanding of psychiatric disorders. PMID- 3293872 TI - Evaluation of methods of administering tyramine to raise systolic blood pressure. AB - To compare the relative merits of two different administration regimens, tyramine was administered intravenously in ascending doses to 12 healthy subjects to raise systolic blood pressure slightly more than 30 mm Hg. Six subjects received tyramine by bolus injection and six other subjects received tyramine by infusion. The bolus dose of tyramine needed was 4.34 +/- 1.51 mg (X +/- SD) and the infusion rate needed was 1.11 +/- 0.33 mg/min. Four blood pressure response patterns to continuous tyramine infusion were observed. Because different units were measured for the quantity of tyramine administered, the between-subject variance estimate to within-subject variance estimate ratios were calculated. The two techniques had equivalent consistency. With the bolus method, in contrast to the infusion procedure, the dose-response relationship was obvious in most subjects. Therefore the bolus method was judged to be more useful than the infusion method. PMID- 3293873 TI - The effect of trimoprostil (trimethyldesoxy prostaglandin E2) on the intrauterine pressure in women. AB - Prostaglandin E2 is uterotonic. Trimoprostil, a prostaglandin E2 analog, is a gastric antisecretory and cytoprotective agent. The effects of single doses of 0, 0.125, 0.75, and 3.0 mg trimoprostil on intrauterine pressure were measured in a double-blind, crossover study in eight surgically sterile women. The 3 mg dose was not tolerated because of abdominal cramps. The other doses caused a dose related increase in resting uterine tone and peak pressure with peak effect occurring between 30 and 60 minutes after administration with a duration of about 120 minutes. No effects on the frequency of uterine contractions occurred. Peak mean tone increased from 11.0 to 71.2 mm Hg (p less than 0.01) and peak pressure from 24.6 to 125.1 mm Hg (p less than 0.01) after placebo compared with the 1.5 mg dose. Adverse reactions included abdominal pain that correlated with an increase in intrauterine pressure and tone. PMID- 3293874 TI - Serum concentration and dose-response relationships for carprofen in rheumatoid arthritis. AB - Thirty-eight patients with active, definite, or classical rheumatoid arthritis were tested in a double-blind, 3-week-per-arm, multiple-crossover, randomized, block-design comparison of 100, 300, 600, and 800 mg/day carprofen given b.i.d. A linear dose-response relationship was demonstrated for six of nine efficacy measures (p less than 0.052). A plasma concentration to therapeutic response relationship was shown just before or 1 to 2 hours after a dose (p less than 0.05) for seven efficacy parameters for the patients with at least three serum carprofen concentrations. By nonparametric analysis, with the patients divided into three equal groups, the percent of responders rose from 38.1% to 50% to 59.1%. Sixty-nine percent of patients responded when carprofen concentrations were greater than 10 micrograms/ml, whereas only 9% responded when they were below 1.9 micrograms/ml. Although only seven patients had limiting side effects, there was a tendency toward a dose-toxicity relationship through 600 mg daily carprofen. PMID- 3293875 TI - Forearm and finger hemodynamics, blood pressure control, and lipid changes in patients with diabetic hypertension treated with atenolol and prazosin. AB - Hypertension and diabetes mellitus frequently coexist and are independent risk factors for reduced peripheral perfusion. Antihypertensive medications that reduce blood pressure and improve peripheral perfusion would have advantages in diabetic patients with hypertension. In a randomized, two-placebo period, single blind, two-way crossover study, we determined finger and forearm blood flow, lipid levels, and blood pressure control in 19 diabetic patients with hypertension, with each atenolol or prazosin and placebo period of 4 weeks' duration. Both drugs reduced blood pressure (sitting: 157/95 to 142/84 mm Hg, atenolol; 155/95 to 138/82 mm Hg, prazosin; standing: 154/94 to 144/84 mm Hg, atenolol; 154/94 to 133/81 mm Hg, prazosin). Lipid levels did not change except that low-density lipoprotein levels fell from 148 to 127 mg/dl with prazosin. Atenolol did not change forearm or finger blood flow or vascular resistance. Prazosin increased blood flow and reduced vascular resistance in both finger and forearm. In conclusion, prazosin has a potentially more appropriate hemodynamic profile than has atenolol in diabetic patients with hypertension. PMID- 3293876 TI - Human buccal absorption of flurbiprofen. AB - The buccal absorption of flurbiprofen was studied in normal men to quantify the transport from the oral cavity in humans and to evaluate the closed-perfusion cell apparatus as a means to study drug transport across externally accessible biologic membranes. Flurbiprofen was buccally absorbed by a passive diffusional mechanism and the rate of absorption was pH dependent. Membrane permeability coefficients for flurbiprofen were 4.3 x 10(-4) cm/sec at pH 5.5 and 2.1 x 10(-5) cm/sec at pH 7.0. These findings are in agreement with the pH relationship for buccal transport observed in dog experiments. Delineation of the effective permeability coefficients into components for the aqueous boundary layer and the lipoidal buccal membrane allowed for the prediction of the extent of absorption of the drug over a period of time. It was concluded that the buccal membranes of the human and dog were essentially lipoidal membranes with equivalent permeabilities and no evident aqueous pore pathways. PMID- 3293877 TI - An evaluation of optimal sampling strategy and adaptive study design. AB - We have evaluated the utility of optimal sampling strategy coupled with adaptive study design in the determination of individual patient and population pharmacokinetic parameter values. In 9 patients with cystic fibrosis receiving a short (1 minute) infusion of ceftazidime pharmacokinetic parameter values were determined with a nonlinear least-squares estimator analyzing a traditional, geometrically spaced set of 12 postinfusion serum samples drawn over 8 hours. These values were compared with values generated from four sample subsets of the 12 obtained at optimal times and analyzed by nonlinear least-squares estimator, as well as a maximum a posteriori probability Bayesian estimator with prior distributions placed on beta and clearance. The four sampling times were determined according to an adaptive design optimization technique that employs sequential updating of population prior distributions on parameter values. Compared with the 12-point determination, the four optimal points analyzed with the maximum a posteriori probability Bayesian estimator faithfully reproduced both microscopic and hybrid pharmacokinetic parameter values for individual patients and, consequently, also produced accurate measures of population central tendency and dispersion. This has important implications in being able to more efficiently derive target patient population pharmacokinetic information for new drugs. This should also allow generation of better concentration-effect relationships in populations of interest. PMID- 3293878 TI - Total insulin levels in type 1 diabetic patients with insulin antibodies and their effect on insulin requirement and metabolic control. AB - In 158 type 1 diabetic patients the relations between insulin antibodies and total insulin and between total insulin and insulin requirement, mean blood glucose, post-prandial change in blood glucose, mean deviation factor of blood glucose, M-value and frequency of hypoglycemias were investigated. Forty-eight patients were antibody negative (antibody level less than or equal to 0.4%) and 110 patients had various levels of insulin antibodies and elevated levels of total insulin, but not of free insulin. After having made all necessary efforts to stabilize metabolism, parameters of metabolic control were determined. No effect of the elevated total insulin levels in patients with insulin antibodies could be demonstrated on insulin requirement, mean blood glucose, postprandial rise in blood glucose, mean deviation factor of blood glucose and M-value. The efforts needed to reach acceptable blood glucose levels were not greater in patients with elevated total insulin. The frequency of hypoglycemias during the night was increased in patients with total insulin levels higher than 2 mmol/l which, although not statistically significant, may be of clinical relevance. PMID- 3293879 TI - Evidence for increased absorption of glucose and decreased hepatic extraction of insulin in South African Indians. AB - It has been previously demonstrated that Indians have an exaggerated insulin response to oral glucose when compared to Africans. In an attempt to determine the reasons for this phenomenon matched groups of Indian and African volunteers were subjected to oral and intravenous glucose tolerance testing. It was concluded that the increased absorption of glucose and reduced hepatic extraction of insulin contributed to the hyperinsulinism in Indians. PMID- 3293870 TI - The altered pharmacokinetics and pharmacodynamics of drugs commonly used in critically ill patients. AB - The critically ill patient occupies an increasing amount of time and bed space in modern hospital practice, and also commands increasing expenditure. Drug therapy in these patients has, in the past, been based on data derived from healthy volunteers, fit anaesthetised patients undergoing minor operative procedures, or patients with single organ failure. Alterations in pharmacokinetics and pharmacodynamics have not been studied in depth in critically ill patients who often have multisystem failure. This paper reviews the currently available information on drugs in common usage in these patients. The studies that have been performed have usually shown delayed drug clearance, altered volumes of distribution and prolonged elimination half-lives. The sedative and analgesic drugs, in particular, have shown marked accumulation which may confuse the clinical picture, and prolonged periods of assisted ventilation may be required until the drugs are eliminated. PMID- 3293880 TI - Insulin autoantibodies in non-obese diabetic (NOD) mice and streptozotocin induced diabetic mice. AB - Similar to Insulin-dependent diabetes mellitus (IDDM) in man, diabetes in the non obese diabetic (NOD) mouse and that induced by low-dose of multiple injections of streptozotocin (low-dose SZ) develop in conjunction with the presence of insulitis. We measured insulin autoantibodies (IAA) in NOD and low-dose SZ mice and compared the levels with mice given a single diabetogenic dose of streptozotocin (high-dose SZ) as well as control CD-1 mice. The mean insulin binding in female NOD mice was 3.08 +/- 1.49 (mean + SD)% and that in male NOD mice was 2.86 +/- 3.70%, as compared with 1.10 +/- 0.35% in the control CD-1 mice (p less than 0.01, p less than 0.05). Sera from low-dose SZ and high-dose SZ mice showed 1.07 +/- 0.23% and 0.93 +/- 0.45% of IAA which did not differ from controls. The number of mice with IAA above the mean + 2SD value of CD-1 mice were 8/9 female NOD mice and 9/20 male NOD mice. Insulitis was found in all NOD and low-dose SZ mice but not in any high-dose SZ mice and control CD-1 mice. These results suggest that (a) IAA are markers for islet autoimmunity in the NOD mouse, (b) presence of IAA does not reflect insulitis, and (c) the appearance of IAA may reflect a difference of the immune response genotype. PMID- 3293867 TI - Principles of drug biodisposition in the neonate. A critical evaluation of the pharmacokinetic-pharmacodynamic interface (Part II). PMID- 3293881 TI - Fibrocalculous pancreatic diabetes in Papua New Guinea. AB - Fibrocalculous pancreatic diabetes of the tropics has not been previously identified in Papua New Guinea where the prevalence of Type 2 (non-insulin dependent) diabetes is increasing. Four patients with this syndrome:--onset of diabetes before the age of 30 years, low body mass index, radiologic pancreatic calcification and marked hyperglycaemia with resistance to ketosis were recognized over three years at Port Moresby General Hospital. Two patients had a history of recurrent abdominal pain in childhood, and two patients had documented insulin requirement greater than 1.5 U/kg daily, and insulin resistance confirmed by intravenous insulin tolerance test. Plasma C-peptide was present in the three cases tested. In the two patients tested islet cell antibodies were not detected but in both there was a prominent diffuse acinar stain suggestive of antibodies to acinar tissue. PMID- 3293882 TI - One haplotype matched bone marrow grafts: an investigation using the HLA system as a marker of cellular origin. AB - HLA antigens were used as markers to study the lymphocyte population in 31 patients with leukaemia, treated with a one-haplotype matched bone marrow transplant (BMT). In 24 patients substained engraftment was achieved and the recipient was repopulated with B and T lymphocytes of donor HLA type. Repopulation occurred at the same rate for lymphocytes of the B and T cell classes, usually within 2 weeks of grafting. In two additional cases bone marrow engraftment was successful but the lymphocyte population was chimeric and cells of both donor and host HLA type were present in the recipient for many weeks. Three patients relapsed after engraftment and peripheral blood lymphocytes were exclusively of host or donor HLA type, or a chimeric population was present. In one chimeric case, peripheral blood T lymphocytes were of donor origin, and B lymphocytes were of host origin. Mononuclear cells in the bone marrow were of host HLA type. The use of the HLA system as a marker is a useful additional approach to determine engraftment or chimerism following an allogeneic one haplotype matched bone marrow transplant. PMID- 3293884 TI - Ultrasound scanning of post-operative wounds--the risks of cross-infection. AB - Ultrasound scanning of surgical wounds is an established procedure for the detection of abscesses. The possible risks of cross-infection resulting from this technique were examined by testing the sterility of the ultrasound probes, the coupling gel and the stand-off medium Kitecko (3 M). The coupling gel was also assessed for any bactericidal properties. Sixty-six per cent of swabs taken from machines in constant use and 33% of the total number of swabs taken were contaminated with skin flora including Staphylococcus aureus. Sterility was achieved using a 70% alcohol wipe. The coupling gel was inherently sterile but had no bactericidal action. The solid stand-off medium Kitecko grew Enterobacteriaceae and Pseudomonas species. The implications of these findings in relation to scanning post-operative wounds are discussed. PMID- 3293885 TI - 'Inflammatory' abdominal aortic aneurysms. AB - The term 'inflammatory aneurysm' is used to describe a variant of atherosclerotic abdominal aortic aneurysms in which the wall of the aneurysm is unusually thick and surrounded by extensive fibrosis and adhesions. Repair of these aneurysms is associated with a higher mortality and morbidity than repair of those which are non-inflammatory, so that diagnosis prior to surgery is desirable. The use of computed tomography (CT) and ultrasound in this differentiation is discussed. The correct diagnosis was made in 16 out of 17 by CT, but in only three of nine cases who had ultrasound scans. PMID- 3293883 TI - Magnetic resonance imaging of renal transplants: its value in the differentiation of acute rejection and cyclosporin A nephrotoxicity. AB - The purpose of this study was to determine the value of magnetic resonance imaging (MRI) in the differentiation of acute rejection and cyclosporin A nephrotoxicity in renal transplant kidneys. Fifty-six magnetic resonance examinations in 46 patients were prospectively and independently evaluated by two radiologists. MRI was performed with a 0.5 T superconducting scanner (Gyroscan S5, Philips) applying both T1 and T2 weighted pulse sequences. Biopsies were performed in 22 cases and histology was reviewed. Fifteen normally functioning transplant kidneys and 41 kidneys with graft dysfunction due to cyclosporin A nephrotoxicity, acute rejection, chronic rejection or acute tubular necrosis were studied. Absence or reduction in cortico-medullary demarcation proved to be a sensitive, but non-specific indicator of parenchymal disease. In cases of cyclosporin A nephrotoxicity the allograft was diagnosed as being normal in 90%. The magnetic resonance appearance of acute rejection may be very similar to that of the combination of acute rejection and cyclosporin A nephrotoxicity, chronic rejection or acute tubular necrosis. However differentiation between acute rejection and cyclosporin A nephrotoxicity was possible according to the following statistical data: sensitivity 100%, specificity 75%, positive predictive value 86%, negative predictive value 100%, accuracy 90%. PMID- 3293886 TI - Graft versus host disease: findings on plain abdominal radiography. AB - The plain abdominal radiographs of 31 patients who had undergone bone marrow transplantation were reviewed retrospectively to determine the radiological abnormalities caused by intestinal graft versus host disease. Abnormal radiological signs were observed in 95% of patients with acute graft versus host disease but none were sufficiently characteristic to differentiate between patients with and without acute intestinal graft versus host disease. PMID- 3293888 TI - Radiographic and ultrasound appearances of an intra-mural haematoma of the pylorus. AB - The case of a haemophilic baby boy who developed a pyloric haematoma due to trauma caused by a feeding gastrostomy catheter balloon is presented. Intramural gastric haematomas are rare and the authors are not aware of any previous reports of intramural haematomas affecting the pylorus alone in this age group. The barium meal appearances of the pyloric haematoma were identical to those seen in hypertrophic pyloric stenosis but ultrasound demonstrated a circumferential pyloric haematoma. PMID- 3293887 TI - The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation. AB - A variety of mouthwashes are frequently used in the management of irradiation induced mucositis. Benzydamine has recently been introduced for alleviating this condition. Its efficacy as a mouthwash was compared with chlorhexidine in two groups of patients receiving radiotherapy for oral carcinoma. Mucositis and pain were recorded over a 6 week period and oral carriage of Candida species, coliforms and Staphylococcus aureus was assessed using an oral rinse technique. There was no significant difference in the mucositis scores, overall pain scores or the yeast and bacterial species isolated between the two treatment groups. However, 58% (7 out of 12) and 92% (12 out of 13) patients reported oral discomfort when rinsing the mouth with chlorhexidine and benzydamine, respectively. In both groups, the most common coliform isolated was Klebsiella pneumoniae and the carriage of yeasts was significantly greater than that of coliforms. These results indicate that, although the individual patient acceptance of chlorhexidine is better than benzydamine, there is little difference between the two mouthwashes both in controlling pain and mucositis or in the oral carriage of the micro-organisms studied. PMID- 3293889 TI - Ultrasound in the follow-up of spinally-injured patients. PMID- 3293890 TI - Neutrophil chemotaxis in bronchiectasis: a study of peripheral cells and lung secretions. AB - 1. Some bronchiectatic patients persistently expectorate purulent secretions containing many polymorphonuclear leucocytes (PMN) and bacteria, suggesting ineffective microbial clearing from the lung. We have therefore studied several aspects of PMN recruitment to the lung by chemotaxis. 2. Circulating PMN from patients with bronchiectasis show a variable chemotactic response to the synthetic peptide N-formyl-L-methionyl-L-leucyl-L-phenylalanine. This is similar to the response of PMN from healthy controls and suggests that failure to clear microbial organisms is not due to defective chemotaxis as measured here. 3. Purulent sputum solphase demonstrates chemotactic activity against control PMN. This activity is greater (P less than 0.001) than that found with mucoid sputum solphase, which is consistent with the neutrophil content of the secretions in vivo. 4. Successful antibiotic therapy reduces the chemotactic activity of purulent sputum solphase from a median value of 183 (range 28-201) cells/high power field to 33.5 (range 0.7-64) cells/high power field (P less than 0.0025). This indicates that the chemotactic activity is largely associated with bacterial load. PMID- 3293891 TI - A randomized controlled trial of the effect on blood pressure of dietary non-meat protein versus meat protein in normotensive omnivores. AB - 1. A randomized, controlled trial was carried out to examine whether changes in type and amount of dietary protein were responsible for earlier observations of blood-pressure-lowering effects of lacto-ovo-vegetarian diets. 2. Sixty-four subjects were pair-matched for sex, age, weight and sitting systolic blood pressure, and were randomly allocated to receive one of two types of protein supplement: one containing proteins from meat, the other proteins from non-meat sources. The supplements were balanced in terms of other nutrients. Consumption of other meat, poultry or fish was prohibited. 3. Sitting and standing blood pressures, weight, dietary intakes and plasma and urinary electrolytes were measured at regular intervals during the 12 weeks of trial. Urinary 3 methylhistidine was used as a measure of compliance. 4. Fifty subjects completed the trial. There were no statistically significant blood pressure differences between groups either at baseline or at end-of-trial, neither were there any substantive differences in mean blood pressure changes between baseline and end of-trial. 3-Methyl-histidine excretion was significantly lower in subjects on the non-meat diet. 5. The results suggest that the protein components of the lacto ovo-vegetarian diet are not responsible for the blood-pressure-lowering effects of that diet. PMID- 3293892 TI - Susceptibility testing of Nocardia species for the clinical laboratory. AB - Not all patients are able to tolerate or show a favorable response to the treatment of choice for Nocardia, the sulfonamides. Many new drugs are available with good activity against N. asteroides, the most common pathogenic species, although susceptibility to these agents, including amikacin, amoxicillin/clavulanic acid, and the third generation cephalosporins, is variable. For these and other reasons, we recommend routine susceptibility testing of Nocardia. Disk diffusion testing on Mueller Hinton agar is the best currently available clinical method. A suggested control strain and tentative susceptible and resistant breakpoints for 12 antimicrobial agents are provided. This includes agents not previously evaluated, including cefotaxime, amikacin, ciprofloxacin, and doxycycline. The zones of inhibition were all larger than those currently used by the NCCLS for rapidly growing bacteria, and the disk breakpoints generally fit best with the MIC breakpoints used with the dilution susceptibility method (M7-T). A broth microdilution MIC method is described that showed good correlation with disk diffusion results, but need additional study. Because of limited experience in most laboratories with this species, reliance on a good reference laboratory for confirmatory susceptibility testing is recommended. Beta-lactamase testing is not helpful, as almost all Nocardia produce beta-lactamase, although many isolates retain susceptibility to selected beta-lactams. PMID- 3293893 TI - Instrumentation for antimicrobic susceptibility testing: yesterday, today, and tomorrow. PMID- 3293894 TI - Comparison of cell culture and three enzyme-linked immunosorbent assays for the rapid diagnosis of respiratory syncytial virus from nasopharyngeal aspirate and tracheal secretion specimens. AB - A total of 211 specimens, including 144 nasopharyngeal aspirates and 67 tracheal secretions, were evaluated for the rapid detection of Respiratory Syncytial Virus (RSV) antigen by three commercial enzyme-linked immunosorbent assays (ELISA; Kallestad Diagnostic, Austin, TX; Ortho Diagnostics, Raritan, NJ, and Abbott Laboratories, North Chicago, IL) and by isolation of RSV in cell culture. Of the 61 RSV culture positive specimens, Kallestad ELISA, Ortho ELISA, and Abbott ELISA detected RSV antigen in 80%, 95%, and 92% of the specimens, respectively. An additional 28 specimens were found to be positive only by one or more RSV ELISA tests. A blocking assay confirmed the specificity of ELISA in 71% (20/28) of the RSV ELISA positive and the culture-negative specimens, and 29% were found to be false positive. Through the use of cell culture, with the resolution of ELISA positive and culture negative specimens by blocking assay, 81 specimens (61 + 20) were considered to be true positive. The sensitivity, specificity, and diagnostic accuracy were, for cell culture, 75%, 100%, and 91%; for Kallestad ELISA, 79%, 98%, and 91%; for Ortho ELISA, 95%, 99%, and 98%; and for Abbott ELISA, 93%, 96%, and 95% respectively. In our study, commercial ELISA tests have been shown to be rapid, reliable tests for the detection of RSV. Ortho ELISA and Abbott ELISA showed better sensitivity than the Kallestad ELISA for RSV detection directly in the clinical specimens. PMID- 3293895 TI - The pyrazine-binding protein and olfaction. AB - 1. The present results provide circumstantial evidence, but not a proof, that the Pyrazine-binding Protein is an odorant carrier molecule of fundamental importance. 2. At first sight a role for a secretory protein in olfaction is not obvious. 3. Odorants freely diffuse in air, in water and in lipids, and the use of carrier proteins, would seem superfluous unless a very special combination with the odorant occurs [Gaupp E. (1902) In Anatomie des Frosches, 2nd Edn, pp. 673. Vieweg-Verlag, Braunschweig]. 4. The possibility should be considered that the Pyrazine-binding Protein and the urinary proteins belong to a large family of species-specific secretory molecules which, with the odorant bound, directly stimulate the receptor cell. PMID- 3293896 TI - Mitochondrial malic enzyme from crustacean and fish muscle. AB - 1. In contrast to mammalian skeletal muscle mitochondria, the only substrate that crustacean and fish mitochondria oxidize at a high rate is malate. 2. The mitochondria isolated from muscles of fish and crayfish exhibit a high activity of malic enzyme. 3. Assuming that malic enzyme is responsible for the conversion of malate to pyruvate in animal muscle, it could be expected that the mitochondria which possess high activity of this enzyme should oxidize malate very rapidly when oxygen is available. 4. Some properties of different molecular forms of malic enzyme are reviewed. PMID- 3293897 TI - Quantification of age pigments (lipofuscin). AB - 1. Three methods have hitherto been applied for age pigment quantification: (a) numerically from micrographs; (b) fluorimetrically from histological sections; (c) spectrofluorimetrically from dissolved age pigments. 2. The spectrofluorimetric method is at present the most commonly used technique for quantification of age pigments. 3. By comparing the related publications since introduction of the spectrofluorimetric method, it has become apparent that few authors specify fluorimetrically significant factors, such as temperature and pH which influence the sample fluorescence during measurement. 4. Recent developments in fluorimetrical age pigment quantification using chloroform/methanol as solvent have additionally revealed the necessity to measure and present the age pigments dissolved in both phases: the polar and non polar solvents. PMID- 3293898 TI - Microcomputer management of a vaccine trial. AB - A microcomputer system used for the management of a trial of rotavirus vaccine in The Gambia is described. This system facilitated call and recall of infants due for vaccination. The resulting compliance is reported and compared retrospectively with vaccination records in the same community. PMID- 3293899 TI - [Questions on modern medicine (1). I. Criticism on the physiological theory by Guyton. 1]. PMID- 3293900 TI - [On "Notes on Nursing" (11)]. PMID- 3293901 TI - [The world of Hildegard von Bingen (2). Depth of her observation]. PMID- 3293902 TI - [Nightingale's biographies published in modern Japan]. PMID- 3293903 TI - Head injury: management in children. PMID- 3293904 TI - Staging workup of breast carcinoma in the community hospital. PMID- 3293905 TI - The Connecticut State Medical Society Medical Courtesy Card Program. PMID- 3293906 TI - Norman A. Zlotzky, M.D. PMID- 3293907 TI - A novel method to study directed cell migration in culture. AB - Directional migration of gingival fibroblasts was elicited in a cell culture system using reconstituted type I collagen fibers as a source of the putative chemoattractant. The rate of migration was expressed as Migration Index which turned out to be dependent on and directly related to the distance between the cells and the collagen. It is believed that this method enables one to study many different phenomena associated with extracellular matrix and cell interactions. PMID- 3293909 TI - Perusing the literature. PMID- 3293910 TI - In memoriam: Max Halperin (1917-1988). PMID- 3293908 TI - Lack of metabolic effects of a triphasic formulation containing norethindrone in normal women studied prospectively. AB - The glucose and insulin responses to oral glucose tolerance tests and lipid values in normal women taking a triphasic pill containing norethindrone (Ortho 7/7/7) were performed. After three months, no significant changes in these metabolic indices were found. These results confirm and expand the knowledge regarding the metabolic safety of norethindrone-containing triphasic formulations. PMID- 3293911 TI - Methionine biosynthesis in Enterobacteriaceae: biochemical, regulatory, and evolutionary aspects. AB - The genes coding for the enzymes involved in methionine biosynthesis and regulation are scattered on the Escherichia coli chromosome. All of them have been cloned and most have been sequenced. From the information gathered, one can establish the existence (upstream of the structural genes coding for the biosynthetic genes and the regulatory gene) of "methionine boxes" consisting of two or more repeats of an octanucleotide sequence pattern. The comparison of these sequences allows the extraction of a consensus operator sequence. Mutations in these sequences lead to the constitutivity of the vicinal structural gene. The operator sequence is the target of a DNA-binding protein--the methionine aporepressor--which has been obtained in the pure state, for which S adenosylmethionine acts as the corepressor. Mutations in the corresponding gene lead to the constitutive expression of all the methionine structural genes. The physicochemical properties of the methionine aporepressor are being investigated. PMID- 3293912 TI - DNA strand exchanges. AB - Biochemical and electron microscopic studies of the strand exchange reactions catalyzed by the RecA protein of Escherichia coli and the UvsX protein of T4 phage reveal that these reactions proceed in three distinct steps. The first step, termed joining, involves the assembly of RecA (or UvsX) protein onto a single-stranded DNA (ssDNA) molecule and the subsequent search for homology with a double-stranded DNA (dsDNA) partner and formation of a stable synapsis. In the second step (envelopment/exchange), the exchange of DNA strands occurs fueled by the hydrolysis of ATP. The third step (release of products) entails the resolution of the complexes and dissociation of the protein from the DNAs. The structure of the intermediates in the in vitro reactions catalyzed by the RecA and UvsX proteins is emphasized in this review. The results of pairing different DNA molecules in vitro (such as linear ssDNA pairing with linear or supertwisted dsDNA) are described. Paranemic joints represent a major pathway of joining between two DNA molecules which may involve, in some cases, most of the DNA substrate molecules. Since the nature of paranemic joints has only recently begun to be understood, the nature, role, and possible in vivo function of paranemic joining are considered. PMID- 3293913 TI - Models of the electrical activity of the heart and computer simulation of the electrocardiogram. AB - This paper reviews models of the electrical activity of the heart and their use for simulations of the surface electrocardiogram. As such, it focuses on the forward problem of electrocardiography. The paper starts with an overview of the biophysical background that forms the underpinning of most heart models and surface potential computations. The basic volume-conductor equations and the different techniques used to solve them, the bidomain characterization of the myocardium, propagation in cardiac tissue, and equivalent source formulations for the electrical activity of the heart are all reviewed. Following this, a review of heart models conceived for cardiac rhythm simulations is presented. These models do not represent the heart geometry accurately, and hence ECG simulations with such models are, at best, first approximations. Next, realistic-geometry heart models, but without propagation, are described. Since the activation isochrones in such models are fixed, they are essentially suited only for the study of normal activation or for ischemia and infarction simulations. Finally, realistic-geometry models which use element-to-element propagation are described. Because of their ability to alter activation patterns, such models may also be used to study conduction disturbances and arrhythmias. Surface potential simulations realized with both types of realistic-geometry models are also reviewed. The paper concludes with a section on heart models of the future. PMID- 3293914 TI - High-resolution electrocardiography. AB - The electrocardiogram (ECG) is arguably the most common noninvasive diagnostic test performed by physicians. The instrumentation for recording the ECG has followed technological trends but the addition of new information has not generally been forthcoming from these advances. Instead, the elucidation of the standard waves P, QRS, T, and U is still the primary focus of electrocardiographic recording and interpretation. High-resolution electrocardiography can be defined as the use of methods to record physiological information not measurable with the standard ECG while still maintaining a noninvasive approach. Often these newer methods require digital signal processing for enhancing very low-level signals, deriving parameters from stored waveforms, or adaptively changing filter characteristics to record the normal wave when contaminated with high levels of noise. This review examines most of these approaches but concentrates on the methods which allow the recording of new information which may have significant diagnostic and, perhaps, prognostic value. PMID- 3293915 TI - Restrictive pulmonary dysfunction caused by the grafted chest and abdominal burn. AB - We report on the effect of the excised and grafted chest and abdominal burn on lung function. Six consecutive patients with 3 degree burns to the entire chest and abdomen (72 +/- 10% total body surface area 3 degree burns) were studied. A severe restrictive lung dysfunction due to the noncompliant nature of the excised and grafted chest and abdominal wound was identified; this was most evident when inspiratory pressure (IP) was even modestly impaired with general anesthetics. Measured vital capacity (VC) was 12 to 14 ml/kg at 6 to 8 wk postburn, in the absence of any significant parenchymal injury. The measured VC was identical to the tidal volume (VT) used during the extended period of mechanical ventilatory support. Dynamic compliance (or characteristic) (Cdyn) decreased dramatically from 35 +/- 8 to 15 +/- 9 ml/cm H2O when the positive pressure VT was increased by as little as 100 ml above prior VT settings, indicating the noncompliant nature of the combined chest and abdominal excised and grafted burn. Major cardiopulmonary complications developed in the first two patients after onset of the restrictive process when general anesthesia was used for grafting procedures (n = 8) and the limits of chest wall excursion were unrecognized. Patients received only continuous positive airway pressure preoperatively. A modest but significant decrease in IP from -45 +/- 8 to -33 +/- 5 cm H2O and 30% decrease in spontaneous VT were noted in the early postoperative period. These changes, however, resulted in a dramatic decrease in pulmonary function leading to hypercarbia, PCO2 greater than 50 torr.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3293916 TI - Cardiopulmonary effect of various inspiratory flow profiles during controlled mechanical ventilation in a porcine lung model. AB - We studied the influence of inspiratory flow (VI) patterns on gas exchange and hemodynamics after metacholine inhalation challenge (MIC) in seven swine mechanically ventilated with a constant, sinusoidal, accelerating, and decelerating flow pattern. Blood gas and expired CO2 tensions, pulmonary mechanics, and hemodynamics were measured during each pattern. Flow pattern sequence was randomized and MIC was repeated at 30 to 45-min intervals. MIC reliably reduced PaO2, and increased PaCO2 and peak tracheal pressure (PT). There was no significant difference in gas exchange or hemodynamics between various VI curves. Insufflation with an accelerated VI manifested a significantly higher PT than any other pattern. We conclude that no VI contour studied offers a unique advantage for gas exchange after MIC in swine. However, since accelerated gas flow generates significantly higher PT values, it is not recommended in the presence of significant airway resistance. PMID- 3293917 TI - The tailored double-contrast pharyngogram. AB - When high-density barium coats the intrinsically smooth squamous mucosa of the pharynx, many nodules are seen at the base of the tongue and valleculae and many longitudinally oriented lines are seen in the lateral and posterior pharyngeal walls. This normal radiographic appearance reflects the lymphoid tissue and longitudinal muscle layer which intimately underlie the squamous mucosa. This paper discusses the gross and microscopic anatomy pertinent to interpretation of double-contrast films of the pharynx. The techniques for achieving a high-quality double-contrast examination of the pharynx are presented. PMID- 3293918 TI - Lumbar vertebral pedicles: radiologic anatomy and pathology. AB - With the advancement of high-resolution computed tomography (CT) scanning the spine has added new knowledge to the various conditions affecting the pedicles. We wish to review the entire spectrum of pedicular lesions: the embryology, normal anatomy, normal variants, pitfalls, congenital anomalies, and pathological conditions are discussed. Different imaging modalities involving CT, isotope bone scanning, and Magnetic Resonance Imaging (MRI) are used to complement plain films of the lumbar spine. This subject review is an excellent source for future reference to lumbar pedicular lesions. PMID- 3293919 TI - Preparation and use of liposomes in the treatment of microbial infections. AB - The potential application of liposomes to drug delivery has been apparent since 1965, when these phospholipid vesicles were first described by Bangham. Since then, experiments on animals have shown that liposome encapsulation can dramatically alter the distribution of drugs in the body and their rate of clearance. These pharmacokinetic differences, as well as other less well understood effects, can result in reduced toxicity and enhanced efficacy of the encapsulated drug. The vast majority of studies on the therapeutic use of liposomes have involved the delivery of drugs used in cancer chemotherapy and metabolic storage diseases, but there is now more literature on the use of liposomes for the delivery of antimicrobial drugs and immunomodulating agents. This review briefly discusses the general properties of liposomes and the rationale for their use in antimicrobial drug delivery and immunomodulation, as well as the encapsulation of specific agents and the effect of encapsulation on the treatment of infectious diseases. PMID- 3293921 TI - Development of a passive device for freezing large amounts of transplantable skin at one time in a -70 degrees C mechanical refrigerator. AB - A simple device has been developed for the simultaneous cooling of up to 9120 cm2 of allograft skin in a flat package format. The device, named an insulated alternating-offset heat sink device, is composed of a stack of interleaved layers of 2.0-mm-thick packets of skin and 3.18-mm-thick aluminum heat sinks (each 33.0 cm long by 22.9 cm wide). Four skin packets are placed in a single layer on each heat sink plate, and the number of plates can be varied to accommodate different numbers of skin packets. Every heat sink protrudes 6.3 cm of its 33.0-cm length beyond the skin packets to make a fin for heat convection, but adjacent plates alternate the direction of their fin protrusion so that the layers of plates alternate in their 6.3-cm offset. Insulation layers of 2.54-cm-thick expanded polystyrene are placed on the exposed surfaces of the top and bottom heat sinks in the stack, and the stack is held together by rubber bands. The device is cooled in a -70 degrees C mechanical refrigerator. Maximal cooling rates of -1.8 degrees C min-1 are obtained for both 6- and 11-plate devices, and -3.0 degrees C min-1 for a 2-plate device. The exothermic temperature plateaus associated with skin cooled in these devices are 1.5-1.8 min in duration. Skin cooled by this technique maintains levels of glucose oxidation similar to those associated with skin cooled by liquid nitrogen vapor at a controlled rate of -1 degree C min-1, provided rapid warming is employed after -70 degrees C storage. The development of this device provides a method for the simple, low-cost cryopreservation of the large amounts of allograft skin obtained from a cadaveric donor. PMID- 3293922 TI - Natural astringency in foodstuffs--a molecular interpretation. AB - The structures of plant polyphenols (vegetable tannins) are briefly reviewed. Their interactions with proteins, polysaccharides, and the alkaloid caffeine are discussed at the molecular level, and these fundamental properties are related to the quality of astringency that polyphenols possess. The various ways in which astringency may be modified and ultimately lost are outlined in relation to the aging of red wines, the formation of nonbiological hazes in beers and lagers, and the ripening of fruit. PMID- 3293920 TI - The acetone-butanol-ethanol fermentation. AB - Renewed interest in the acetone-butanol-ethanol (ABE) fermentation as a route for industrial production of butanol has been evident since the oil crisis of the 1970s. The present review includes an historical recap of the traditional industrial process and culturing practices useful in maintaining viable solvent producing cultures, and then summarizes new and exciting research on the physiology and genetics of the microorganisms as well as process design. Most of these reports relate to improvements in solvent yield and the overall process, since traditional production is not efficient under present economic conditions. Conclusions are then made on future developments necessary for the establishment of an economically viable industrial process. PMID- 3293923 TI - Molecular aspects, physiological function, and clinical significance of metallothioneins. AB - Metallothioneins (MTs) are well-characterized low molecular weight, heat-stable cytosolic proteins with exceptional high content of cysteinyl sulfur and are known to bind heavy metals like cadmium (Cd), zinc (Zn), and copper (Cu). Since these proteins are induced on exposure to heavy metals, it is now accepted that they have a detoxifying role during heavy metal toxicity. It has also been suggested that the primary function of Mt is in the homeostasis of the essential metals Zn and Cu. Recently, a role MT in selenium metabolism in primates has been established. Further, MT has gained considerable importance in the clinical disorders related to trace metal metabolism. PMID- 3293924 TI - Control of metabolism by dynamic macromolecular interactions. PMID- 3293926 TI - Function and regulation of the pentose phosphate pathway in brain. AB - Although the quantitative contribution of the pentose phosphate pathway to glucose metabolism in adult brain is small, numerous experiments using specific inhibitors and developmental studies (Table VI) confirm the importance and the "functional" role of this pathway in brain (for details, see reviews by Baquer et al., 1975, 1977). In this article, an attempt has been made to bring together the important findings regarding the localization, operation, and functional significance of the pentose phosphate pathway in nervous tissue. The presence of these enzymes in synaptosomes and their linkage with peroxidative mechanisms, monoamine oxidase, and glutathione pathways suggest that they may be serving an important role in brain in vivo. There are a number of aspects that require further study for an understanding of the role of the pentose phosphate pathway in brain, including its role in inhibitory and excitatory synapses, in the control of synaptic plasticity, and the relationship between the electroencephalogram and the pentose phosphate pathway in various neural populations. PMID- 3293925 TI - The glycogen storage disease (gsd/gsd) rat. PMID- 3293927 TI - Regulation of carotenoid biosynthesis. PMID- 3293928 TI - Ligand binding and multienzyme complex formation between ornithine carbamoyltransferase and arginase from Saccharomyces cerevisiae. PMID- 3293929 TI - Blinded comparison of an "ultrasound stethoscope" and standard echocardiographic instrument. AB - We evaluated blinded readings by a physician using a miniature real-time "ultrasound stethoscope" compared with a "standard" echo instrument used by an independent physician. Size of all four cardiac chambers, wall motion, all four valves, thickness of interventricular septum and left ventricular posterior wall, and pericardial effusion were assessed in 66 patients. Each physician estimated whether he had answered the referring question and gave a final diagnosis. The physician using the ultrasound stethoscope correctly assessed chamber size in 87 percent of cases, segmental left ventricular wall motion in 71 percent of segments studied, and wall thickness in 88 percent of cases, and the diagnosis by the ultrasound stethoscope agreed with that made by the standard instrument in 68 percent of cases. The physician with the ultrasound stethoscope detected structural valvular problems (eg, stenosis) in 70 percent of cases but only detected flow abnormalities (eg, regurgitation) in 14 percent of cases. We conclude that (1) an experienced echocardiographer using an ultrasound stethoscope can detect most structural abnormalities found by a standard echocardiographic instrument; (2) chamber size, valvular stenosis, and pericardial effusions were accurately assessed; (3) the ultrasound stethoscope cannot be used to detect valvular regurgitation; and (4) limitations include the lack of freeze-frame, M-mode, hard copy, and Doppler. PMID- 3293930 TI - Airway hyperreactivity in cystic fibrosis. Clinical correlates and possible effects on the course of the disease. AB - To evaluate whether increased airway reactivity affected the course of patients with cystic fibrosis (CF), we categorized 40 CF patients as to methacholine sensitivity and then evaluated their disease activity and natural history. Twenty methacholine reactors had more severe lung disease (lower S-K clinical scores and more impairment of pulmonary function) than did 16 nonreactive patients, and acute bronchodilator response was greater in the methacholine reactors. Thirty four patients were followed prospectively over a 17- to 24-month period. Among 19 methacholine reactors, there were more pulmonary exacerbations and a more rapid decline in FEV1. In general, increased obstruction was associated with increased reactivity. Although the data are subject to differing interpretations, they are consistent with the hypothesis that in patients with CF, airway hyperreactivity occurs secondary to bronchial damage, age, is associated with more rapid pulmonary deterioration, and is an unfavorable prognostic finding. PMID- 3293931 TI - Current perspectives on clinical and experimental single lung transplantation. PMID- 3293932 TI - Organ interactions in the adult respiratory distress syndrome during sepsis. Role of the liver in host defense. PMID- 3293933 TI - Recurrent pleural effusion as manifesting feature of primitive chest wall Hodgkin's disease. AB - Recurrent, cytologically benign pleural effusion was, for a long time, the only clinical manifestation of Hodgkin's disease involving the inner thoracic wall in the reported case. It is the first case reported in literature. PMID- 3293935 TI - Recurrent paroxysmal complete heart block induced by vomiting. AB - A woman had a 40-year history of vomiting associated with syncope. Spontaneous and induced vomiting was predictably associated with sinus bradycardia, paroxysmal atrioventricular block, and ventricular asystole. The clinical and laboratory studies carried out to illustrate the mechanism of this unusual complication of vomiting demonstrated it to be due to a vagovagal reflex initiated by distension of upper esophagus. PMID- 3293936 TI - Pharmacokinetics of antimicrobial drugs in cystic fibrosis. Beta-lactam antibiotics. AB - The pharmacodynamics and pharmacokinetics of beta-lactam antibiotics in patients with cystic fibrosis are discussed. A hypothetical dosing regimen based on these principles is considered. The usual dosing regimens may be suboptimal. New dosage regimens should be studied using prospective, controlled, randomized and blinded clinical trials. PMID- 3293934 TI - Fatal aspergillosis associated with smoking contaminated marijuana, in a marrow transplant recipient. AB - A 34-year-old man presented with pulmonary aspergillosis on the 75th day after marrow transplant for chronic myelogenous leukemia. The patient had smoked marijuana heavily for several weeks prior to admission. Cultures of the marijuana revealed Aspergillus fumigatus with morphology and growth characteristics identical to the organism grown from open lung biopsy specimen. Despite aggressive antifungal therapy, the patient died with disseminated disease. Physicians should be aware of this potentially lethal complication of marijuana use in compromised hosts. PMID- 3293937 TI - Pharmacokinetics of antimicrobial drugs in cystic fibrosis. Aminoglycoside antibiotics. AB - Patients with cystic fibrosis (CF) show abnormal aminoglycoside pharmacokinetics. After a conventional dose, the serum concentrations in CF patients are lower than those in nonCF patients. The lower serum concentrations in CF might be explained by increased total body clearance and/or a larger volume of distribution. The therapeutic range of aminoglycosides is narrow due to oto- and nephrotoxicity. The changed pharmacokinetics and the narrow therapeutic range make it difficult to ensure that patients with CF are adequately and safely treated with aminoglycosides. The mode of administration of aminoglycosides influences the antibacterial effect of these agents on Pseudomonas aeruginosa and the development of possible side effects. The therapeutic implications of these facts are discussed. PMID- 3293938 TI - Comparison of two nonculture techniques for detection of Hemophilus influenzae in sputum. In situ hybridization and immunoperoxidase staining with monoclonal antibodies. AB - Two nonculture methods, in situ hybridization and immunoperoxidase staining with monoclonal antibodies, were compared for the detection of Hemophilus influenzae in 184 sputa. For in situ hybridization, a biotin-labeled probe of total genomic DNA of H influenzae type b was prepared that hybridizes specifically with H influenzae, H parainfluenzae, H hemolyticus, and H parahemolyticus DNA. Immunoperoxidase staining was done with monoclonal antibody 8BD9 directed against outer membrane protein P6 of H influenzae. Both techniques detected Hemophilus in sputum equally well and were superior to culture: all 30 sputum samples culture positive for H influenzae were positive on both nonculture tests, and 13 additional positive sputum samples were detected from which Hemophilus was not cultured. The higher sensitivity of the nonculture tests was mainly attributed to culture failure because of overgrowth of H influenzae by other bacteria, especially in patients with cystic fibrosis. The immunoperoxidase staining technique appeared slightly easier and quicker to perform than the in situ hybridization test. For the in situ DNA hybridization probe, DNA can be prepared from any strain of H influenzae. The immunoperoxidase test requires monoclonal antibody 8BD9 but has a higher specificity than the hybridization technique. Both techniques can be reliably applied, especially for the detection of Hemophilus in sputum of patients with cystic fibrosis. PMID- 3293939 TI - Antibacterial therapy in cystic fibrosis. A review of the literature published between 1980 and February 1987. PMID- 3293940 TI - Antimicrobial therapy against Staphylococcus aureus, Pseudomonas aeruginosa, and Pseudomonas cepacia. AB - The aims of antimicrobial therapy extend beyond short-term bacterial killing to long-term maintenance of weight and lung function. A review of antimicrobial drug trials shows that empiricism is still ahead of science and more studies are needed both to justify current practice and to make future changes logical. PMID- 3293941 TI - Hemophilus influenzae, Staphylococcus aureus, Pseudomonas cepacia, and Pseudomonas aeruginosa in patients with cystic fibrosis. PMID- 3293942 TI - [Significance of immunodiagnosis in surgery of metastases and recurrences]. PMID- 3293943 TI - [Immunotherapy in surgical cancer patients]. PMID- 3293944 TI - [Indications for intracavitary afterloading radiotherapy combined with surgical intervention]. PMID- 3293945 TI - [Endotoxinemia and bacteremia in manual oral decompression of ileus]. AB - In the framework of the present clinical prospective study using a randomly selected patient collective, the question was pursued whether manual oral decompression (MOD), done in connection with surgical intervention in severely ill patients with ileus of the large and small intestine, leads to detectable bacteremia or higher concentrations of endotoxin in serum. From October, 1985 to March, 1987, bacteriological tests were conducted and the endotoxin concentrations in serum were measured in a total of 31 patients. 71% of the patients were female and 29% were male, aged 18-89. The endotoxin measurement was conducted with the aid of the limulus-amoebocyte-lysate (LAL) test, modified according to Piotrowicz. Additionally, bacteriological tests were done of the operation sites and the decompressed gastro-intestinal secretions. Simultaneously, cultures from the central blood stream were prepared. The tests showed that bacteremia and endotoxinemia occur in connection with manual oral decompression (MOD). Neither of the two, however, has any clinically relevant influence on the further post-operative course. Thus, manual oral decompression continues to represent an indispensable maneuver in the surgical management of an ileus. PMID- 3293946 TI - [Treatment of extensive bone defects of the tibia by the Ilizarov displacement osteotomy]. PMID- 3293947 TI - Treatment of the diabetic patient with end-stage renal failure. PMID- 3293948 TI - Pathogenesis and prevention of diabetic neuropathy. AB - Diabetic neuropathy, long-recognized as an important but complex and poorly understood clinical complication of diabetes, is finally yielding to more than a decade of intense clinical and laboratory investigation. At least one basic biochemical mechanism involving sorbitol and MI metabolism, phosphoinositides, protein kinase C, and the (Na,K)-ATPase has been identified that can rationally account for the neurotoxicity of glucose. This biochemical sequence has been examined in some detail in vitro, but some of its elements, such as the link between abnormal sorbitol and MI metabolism, and between protein kinase C and the (Na,K)-ATPase, remain the subject of ongoing investigation. Through its effect on the (Na,K)-ATPase, this metabolic sequence can explain both the rapidly reversible functional impairment and the early structural lesions of nerve fibers, such as paranodal swelling in acute diabetes. Extrapolation of early paranodal swelling to the more advanced stages of nerve fiber damage remains somewhat speculative, although axo-glial dysjunction is a likely intermediate step. Impaired axonal transport or microvascular dysfunction may be additional contributing factors, possibly also related to abnormal sorbitol and MI metabolism. Blunted phosphoinositide-mediated signal transduction could potentially explain a putative insensitivity to neurotrophic factors and a diminished regenerative response in diabetic neuropathy. Human morphometric studies and ARI trials support the relevance of these pathogenetic processes to human diabetic neuropathy, and suggest that specific metabolic therapy with agents such as ARIs hold promise as important new elements in the treatment and possibly prevention of diabetic neuropathy. PMID- 3293949 TI - Clinical aspects of diabetic neuropathies. AB - Diabetic neuropathy is a common complication of diabetes that may be associated both with considerable morbidity (painful polyneuropathy, neuropathic ulceration) and mortality (autonomic neuropathy). The epidemiology and natural history of diabetic neuropathy is clouded with uncertainty, largely due to confusion in the definition and measurement of this disorder. We have reviewed a variety of the clinical manifestations associated with somatic and autonomic neuropathy and discussed current views related to the management of the different abnormalities. Although unproven, the best evidence suggests that near normal control of blood glucose in the early years following onset of diabetes may help delay the development of clinically significant nerve impairment. Intensive therapy to achieve normalization of blood glucose may also lead to reversibility of early diabetic neuropathy, but again this is unproven. Our ability to manage successfully the many different manifestations of diabetic neuropathy depends ultimately on our success in uncovering the pathogenic processes underlying this disorder. The recent resurgence of interest in the vascular hypothesis, for example, has opened up new avenues of investigation for therapeutic intervention. Paralleling our increased understanding of the pathogenesis of diabetic neuropathy, there must be refinements in our ability to measure quantitatively the different types of defects that occur in this disorder. These tests must be validated and standardized to allow comparability between studies and more meaningful interpretation of study results. PMID- 3293950 TI - RR-variation: the autonomic test of choice in diabetes. AB - RR-variation is a sensitive, reproducible, and noninvasive autonomic test. It is simple to perform and easy for both the operator and the subject. Furthermore, RR variation correlates to known physiologic function. It therefore fulfills many of the characteristics of a practical diagnostic test. Many of the confounding factors are known, and with proper standardization the test may not only have diagnostic capabilities but also predictive value. RR-variation should be included in clinical research trials of diabetic neuropathy and should be considered in routine clinical management of the diabetic patient. PMID- 3293951 TI - Diabetic cardiopathy: is it a real entity? PMID- 3293952 TI - p1B15: a cDNA clone of the rat mRNA encoding cyclophilin. AB - We present the complete nucleotide sequence of a cDNA encoding rat cyclophilin. The 743-nucleotide sequence contains a 42-nucleotide 5' noncoding region, a 492 nucleotide open reading frame corresponding to a translation product of 164 amino acids with a molecular weight of 17,874, and a 3' noncoding region of 209 nucleotides. Primer extension studies reveal the presence of one minor and two major transcription start sites. Southern blot analyses are consistent with as many as 20 copies of the cyclophilin gene and possible pseudogenes. Cyclophilin mRNA is expressed in virtually all types of tissues of rat and monkey and appears to have been highly conserved during mammalian evolution. PMID- 3293953 TI - Flavin-containing monooxygenases: catalytic mechanism and substrate specificities. PMID- 3293954 TI - The metabolic activation of nitroheterocyclic therapeutic agents. PMID- 3293955 TI - Highlights of drug metabolism research in China. AB - In the past 30 years, the study of drug metabolism in China has followed a zigzag path, from the initial uprising stage to devastation, and then to regeneration. In the reviving decade of 1976-1985, studies have extended to various aspects of the field of drug metabolism and pharmacokinetics. There are rapid increases both in modern facilities and trained personnel. Therefore, it is expected that in the coming decade drug metabolism research in China will be carried out at much higher levels with more interesting results. PMID- 3293956 TI - Systemic hypertension associated with cyclosporine: a review. AB - Use of the immunosuppressive agent cyclosporine has been associated with an increased incidence of hypertension. The incidence, onset, duration, and severity of the associated blood pressure elevation varies greatly depending on the therapeutic indication for cyclosporine use. This paper reviews the disparity in the reports of cyclosporine-associated hypertension and the factors evaluated for possible association. Possible mechanisms involved in the blood pressure elevation as well as treatment approaches that have been employed are discussed. Further research efforts are needed to clarify conflicting information regarding mechanisms, associated factors, and rational treatment. PMID- 3293957 TI - Stress ulcers: current understanding of pathogenesis and prophylaxis. AB - Stress-related gastrointestinal bleeding is known to occur in approximately 25 percent of untreated seriously ill patients, but with appropriate prophylaxis is largely preventable. Since the treatment of stress bleeding is generally unsatisfactory and has a high mortality, routine prophylaxis should be instituted for susceptible patients. Multiple mechanisms contribute to stress ulcer formation, the most important of which appear to be mucosal ischemia and the inability to control back-diffused hydrogen. Antacids and histamine2-blocking agents are presently the cornerstone of effective prophylaxis, but because they have been implicated as contributors to nosocomial pneumonias due to bacterial overgrowth in the stomach, investigation is ongoing into such alternative prophylactic agents as sucralfate and prostaglandins that do not alter the normal gastric acidity. This article presents a review of the literature on the development and prevention of stress ulcer disease. PMID- 3293959 TI - Are estrogens indicated for the treatment of postmenopausal women? AB - A woman in the U.S. can now expect to live for 30 years or more past the menopause in a state of estrogen deprivation. Hypoestrogenic-associated conditions can be managed by a variety of medical regimens and lifestyle changes, but estrogen replacement therapy (ERT) is the most specific and universal treatment for all of the above conditions. Although concern for potential risks has limited its acceptance, the benefits of ERT extend beyond the amelioration of estrogen deprivation symptoms. Evidence is accumulating that ERT may offer protection from cardiovascular atherogenic disease. Several of the risks that have been associated with continuous ERT, such as endometrial cancer and breast cancer, are significantly reduced with the use of cyclic progestogens. Moreover, any concern arising from the use of conjugated estrogens and synthetic progestogens are being addressed by the recent introduction of orally active natural estrogen and soon, progesterone. With the demonstrated efficacy and safety of ERT, such therapy should be considered for all postmenopausal women. PMID- 3293958 TI - Use of vancomycin and tobramycin polymethylmethacrylate impregnated beads in the management of chronic osteomyelitis. AB - Over the past several years there has been a growing interest in the use of locally implanted beads containing antibiotics for the treatment of chronic osteomyelitis. This method has been popularized in Europe and, with few exceptions, gentamicin has been the only antibiotic used. There have been only a few reports from the U.S. and there is little information regarding the pharmacokinetics of antibiotics used in this fashion. To our knowledge this is the first report using vancomycin. Three patients with chronic osteomyelitis were treated with vancomycin and/or tobramycin polymethylmethacrylate beads. These beads were extemporaneously compounded and implanted for up to six weeks. From the site of bead implantation local fluid aliquots were collected for the measurement of antibiotic concentrations. In two patients, initial tobramycin concentrations exceeded 400 mg/L. In one patient receiving vancomycin, initial localized concentrations were approximately 100 mg/L. In all three patients therapeutic concentrations of localized antibiotic were maintained with immeasurable systemic concentrations throughout the period of bead placement. Localized antibiotic therapy for the management of chronic osteomyelitis represents a potential therapeutic alternative to long-term parenteral therapy. Data presented here suggest that other antibiotics, such as vancomycin and tobramycin, can be used successfully in polymethylmethacrylate beads and provide preliminary facts for future investigations of such applications. PMID- 3293960 TI - Cyclosporine interactions with metronidazole and cimetidine. PMID- 3293961 TI - Determination of free disopyramide concentrations using fluorescence polarization immunoassay. PMID- 3293962 TI - [Spontaneous dissection of the extracranial arteries supplying the brain]. PMID- 3293963 TI - [Therapy as science. Remarks on the problem of the comparative evaluation of therapy exemplified by cytostatics]. PMID- 3293964 TI - [Blood studies of the vitamin A and beta-carotene content of the blood plasma of infertile cows]. PMID- 3293965 TI - [The effect of benzoyl peroxide in a model study of the mouse epidermis]. PMID- 3293966 TI - [A quasi-stationary balance model for the simulation of stable climate]. PMID- 3293967 TI - Laboratory studies on the efficacy of some molluscicides on Egyptian snails. PMID- 3293968 TI - [Pasteurella anatipestifer sp.i.c. in Pekin ducks: pathogenicity tests and immunization with an inactivated, homologous, monovalent (serotype 6/B) oil emulsion vaccine]. PMID- 3293969 TI - Nabumetone. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in rheumatic diseases. AB - Nabumetone is a new non-steroidal anti-inflammatory drug advocated for use in the symptomatic treatment of rheumatic and inflammatory conditions. Unlike most other drugs of its class it is non-acidic and a prodrug, which after absorption forms an active metabolite. Published data suggest that nabumetone 1 to 2g daily is comparable with therapeutic dosages of aspirin, diclofenac, ibuprofen, indomethacin, naproxen and sulindac for the treatment of pain and inflammation associated with rheumatoid arthritis, osteoarthritis and acute soft tissue injuries. While nabumetone produced fewer side effects than aspirin, results have generally shown tolerability to be similar to that of other nonsteroidal anti inflammatory drugs. If further definition of its efficacy and tolerability relative to other non-steroidal anti-inflammatory drugs confirms these initially favourable results, then nabumetone would appear to offer a useful alternative in the treatment of painful rheumatic and inflammatory conditions. PMID- 3293972 TI - Evaluation of the in vitro susceptibility of gram-negative bacilli to cefotaxime, over a period of 3 years. PMID- 3293971 TI - Breast cancer. Advances in management. PMID- 3293970 TI - Clinical pharmacology of antibiotics and other drugs in cystic fibrosis. AB - The disposition of many drugs in cystic fibrosis is abnormal. In general, changes in pharmacokinetics include: increased volume of distribution, decreased plasma concentration, and enhanced renal and sometimes non-renal elimination of drugs. Pathophysiology of the disease important for drug disposition includes: (a) hypersecretion of gastric acid and duodenal secretions which are of small volume, viscous and low in bicarbonate; (b) increased intestinal permeability to some sugars and probe substances; (c) hypergammaglobulinaemia and sometimes hypoalbuminaemia; (d) significant elevation of free fatty palmitoleic acid level and decreased low-density and high-density serum lipoproteins; (e) an average increase by 30 to 45% in plasma volume in patients with cystic fibrosis who have moderately severe pulmonary disease, right ventricle hypertrophy and dilatation, which occurs in 15 to 35% of patients with a Shwachman score of 81 to 100; (f) abnormal bile acid metabolism and enterohepatic recirculation; and (g) enlarged kidneys and glomerulomegaly with increased glomerular filtration rate, tubular clearance and urine flow rate in some patients with cystic fibrosis. Delayed absorption from the gastrointestinal tract has been reported in patients with cystic fibrosis for cloxacillin, epicillin, clindamycin, ciprofloxacin and probably for cephalexin, para-aminobenzoic acid and chloramphenicol. A possible increased absorption was reported for cimetidine. Of 7 drugs studied only theophylline had significantly decreased plasma protein binding. An increased volume of distribution and increased renal clearance reported for several drugs is caused mainly by increases in plasma volume and urine flow rate in many of these patients. Possible increased elimination of some drugs in bile (which probably results from bile acid malabsorption) and in bronchial secretions (which are abundant in some cystic fibrosis patients with acute pulmonary infection) may explain enhanced non-renal elimination of these drugs. The metabolism of cimetidine in cystic fibrosis was reported not to be changed significantly compared to control subjects. PMID- 3293973 TI - A randomised prospective comparison of cefotaxime versus netilmicin/penicillin for treatment of suspected neonatal sepsis. AB - In an open prospective study performed in 2 neonatal units, infants with suspected neonatal sepsis (SNS) of unknown microbial cause were randomly allocated to receive treatment with either cefotaxime (CTX) or netilmicin plus penicillin (N + P). 236 patients were entered into the trial, of whom 222 were evaluable. The number of 'definitely' and 'probably' infected babies was similar in both groups. There was no difference in clinical outcome between patients in the 2 treatment groups and no side effects were recorded for either of the antibiotic regimens. Antibiotic sensitivity testing of bacterial isolates from peripheral sites showed almost universal sensitivity of potential pathogens to both antibiotic regimens at the start of treatment in all infants. Thereafter, organisms resistant to CTX were isolated from patients in both treatment groups, possibly reflecting the antibiotic sensitivity profile of the colonising bacteria in both neonatal units. The results of this study indicate that either CTX or N + P are suitable, in our units, for the 'blind' treatment of early SNS. In units where listerial infections are prevalent, specific cover should be added to CTX. For SNS developing after admission, the choice of antibiotics will depend upon the background antibiotic sensitivity profile of the colonising bacteria. PMID- 3293974 TI - Studies of enzymuria and beta 2-microglobulinuria in patients receiving prophylactic cefotaxime in obstetric and gynaecological surgery. AB - Increased urinary excretion of beta 2-microglobulin and certain enzymes, for example leucine aminopeptidase (LAP) and N-acetyl-beta-D-glucosaminidase (NAG), produces sensitive markers of damage to renal tubular cells. These markers were monitored in patients undergoing obstetric and gynaecological surgery who received cefotaxime for 5 days. Slight increased activity in NAG and beta 2 microglobulin was observed in some patients 3 to 5 days after surgery. However, no changes of significance were found in levels of urinary LAP and NAG. During cefotaxime treatment, urinary beta 2-microglobulin in the group of abdominal hysterectomy increased slightly. In most cases renal side effects are negligible and cannot be detected by these tests. These results indicate that administration of cefotaxime in obstetric and gynaecological surgery does not produce cumulative renal tubular toxicity. PMID- 3293975 TI - Cefotaxime treatment of gram-negative enteric meningitis in infants and children. AB - 18 infants and children (1 week to 3 months of age) were treated with cefotaxime 200 mg/kg/day for Gram-negative enteric bacillary meningitis. 17 of these patients (94.4%) survived, with a complication rate of 23.5% (4/17 patients). The follow-up cerebrospinal fluid cultures at 24 hours were sterile in all patients. Cefotaxime was safe and effective in treating Gram-negative enteric bacillary meningitis in infants and children and should be considered as a potential drug of choice in Gram-negative neonatal meningitis due to susceptible organisms. PMID- 3293976 TI - Cefotaxime in the treatment of severe bacterial pneumonia in paediatric patients. PMID- 3293977 TI - Cefotaxime optimal dosage in adult patients. A reappraisal. AB - Cefotaxime, a third generation cephalosporin, is used throughout the world over a wide range of doses. The purpose of this paper is to discuss the rationale for determination of the optimal dosage and of adequate modes of administration. Among the factors determining in vivo activity, the most important are: (1) the time dependence of the antibacterial effect of cephalosporins, (2) the limited effect of increasing the drug concentration in contact with the bacteria and (3) the absence of a significant post-antibiotic effect. Combined with the rather short elimination half-life of cefotaxime, these factors argue for the use of a unitary dose of 1g in adult patients and for a 6- or 8-hour interval between doses. Information obtained from various animal models of infection are discussed. Clinical and bacteriological studies published in the international literature report a high rate of cure (between 80 and 100%) according to the type of infection and to the criteria of efficacy, with daily doses ranging from 2 to 4g bid or qid. The results obtained with the lowest doses are detailed, particularly for infections permitting the use of a low dosage. The necessity for increasing the dose is discussed in the following situations: (1) in specific infections requiring high local drug concentrations such as meningitis and endocarditis, (2) against micro-organisms exhibiting moderate susceptibility to cefotaxime (MIC greater than or equal to 1 mg/L) and (3) in immunocompromised patients. It is now well established that third generation cephalosporins have to be combined with other antimicrobial agents (e.g. aminoglycosides) for the treatment of patients with infections caused by bacteria able to become resistant. For susceptible strains, it has not been established that a synergistic effect of cefotaxime with another agent allows a reduction of the dosage of each member of the combination. PMID- 3293978 TI - Evaluation of bactericidal activity of cefotaxime and other beta-lactams by a novel method. AB - In previous studies on Streptococcus faecium we proposed that the minimum beta lactam concentration killing 99.9% of a bacterial population within 3 hours be defined as the minimum directly bactericidal concentration (MDBC) of that drug. In the present study we first evaluated the kinetics of cellular killing by various beta-lactams as related to penicillin-binding-protein (PBP) binding in Escherichia coli DC2, a hyperpermeable mutant. We concluded that in E. coli the MDBC for beta-lactams coincides with the minimum concentration capable of saturating PBPs 1b, 2 and 3. Of the antibacterial drugs we studied, cefsulodin, mecillinam and aztreonam had a much greater affinity for one essential PBP (PBP 1b, 2 and 3, respectively) than for all others, whereas cefotaxime had close affinities for all the above PBPs. MDBC values of greater than 500, 500, greater than 50, 10 and 1.5 mg/L were obtained for cefsulodin, mecillinam, aztreonam, ampicillin and cefotaxime, respectively. On the basis of the pharmacokinetic properties of these drugs, our results indicate that mecillinam, ampicillin and cefsulodin may be bactericidal in urine but not at other body sites; aztreonam is probably bactericidal in urine and blood, but not elsewhere; and cefotaxime is bactericidal in all the biological fluids we studied. PMID- 3293979 TI - Effects of prostaglandin F2 alpha and a gonadotropin-releasing hormone agonist on inositol phospholipid metabolism in isolated rat corpora lutea of various ages. AB - The sensitivity of rat corpora lutea to luteolytic agents increases with luteal age. We examined the effect of prostaglandin F2 alpha (PGF2 alpha) and [D Ala6,Des-Gly10]GnRH ethylamide (GnRHa) on inositol phospholipid metabolism in day 2 and day 7 corpora lutea from PMSG-treated rats. Isolated corpora lutea were incubated with 32PO4 or [3H]inositol and were treated with LH, PGF2 alpha, or GnRHa. Phospholipids were purified by TLC, and the water-soluble products of phospholipase-C activity (inositol phosphates) were isolated by ion exchange chromatography. In day 2 corpora lutea, PGF2 alpha, (10 microM) and GnRHa (100 ng/ml) significantly increased 32PO4 incorporation into phosphatidic acid (PA) and phosphatidylinositol (PI), but not into other fractions. LH provoked slight increases in PA. Results were similar with 30 min of prelabeling or simultaneous addition of 32PO4 and stimulants. In other experiments, PGF2 alpha and GnRHa provoked rapid increases (1-5 min) in the accumulation of inositol mono-, bis-, and trisphosphates. LH did not significantly increase inositol phosphate accumulation, but stimulated cAMP accumulation in 2-day-old corpora lutea. Inositol phospholipid metabolism was increased in day 7 corpora lutea compared to that in day 2 corpora lutea. This increase was associated with increased incorporation of 32PO4 into PA and PI and increased accumulation of [3H]inositol phosphates. In day 7 corpora lutea, which are very sensitive to the luteolytic effect of PGF2 alpha, the PG-induced increase in PA labeling was small and inconsistent, whereas PI labeling was unaffected in 30-min incubations. GnRHa was without effect in such corpora lutea. LH, PGF2 alpha, or GnRHa did not increase inositol phosphate accumulation in 7-day-old corpora lutea. These studies demonstrate that the transformation of young (day 2) to mature (day 7) corpora lutea is associated with an increase in luteal inositol phospholipid metabolism. The results also show that PGF2 alpha and GnRHa stimulate phospholipase-C activity in young corpora lutea, but are ineffective in mature corpora lutea, and suggest that an increase in inositol phospholipid metabolism by itself is not sufficient to explain the acute luteolytic action of PGF2 alpha and GnRH in vitro. However, phospholipase-C-derived second messengers may be involved in the action of hormones that control luteal function. PMID- 3293980 TI - Effects of human growth hormone on insulin-stimulated glucose metabolism in 3T3 F442A adipocytes. AB - GH is believed to play a role in promoting insulin resistance in patients with diabetes and with GH excess. The means by which GH produces insulin resistance may be through direct suppression of glucose metabolism in target cells (insulin independent) or by interfering with the ability of insulin to stimulate glucose metabolism (insulin-dependent). In 3T3-F442A adipocytes, long term incubation (24 72 h) with GH directly inhibits glucose oxidation and lipid synthesis in the absence of insulin. To distinguish the insulin-independent effects of GH on glucose metabolism from the insulin-dependent effects of GH, we examined the effect of GH on insulin-stimulated lipid accumulation in cultured 3T3-F442A adipocytes. Cells were incubated for 48-72 h with GH and then treated with insulin. Insulin stimulated lipid accumulation in GH-pretreated and control cells. Compared to control, GH-treated cells had lower absolute levels of lipid accumulation in the absence of insulin and at each insulin concentration tested. Thus, GH directly suppresses basal lipid accumulation and lowers the response to insulin. In addition, a 10 times higher insulin concentration was required to reach maximum stimulation of lipid accumulation in GH-treated cells (50 ng/ml) than in control cells (5 ng/ml). When cells were exposed simultaneously to insulin and GH for 72 h, GH treatment inhibited the ability of insulin to stimulate lipid accumulation, and the degree of suppression by GH was related to the GH concentration present. These observations suggest that GH suppresses glucose metabolism not only in the absence but also in the presence of insulin. Since short term (4-h) incubation with GH increases glucose metabolism transiently in GH-deficient preparations, we also examined the influence of short term incubation with GH on insulin responses. Cells were incubated for 4 h with varying concentrations of insulin in the simultaneous presence or absence of GH. Insulin stimulated the conversion of glucose to lipid when tested alone or in the presence of GH. Short term exposure to GH alone also stimulated glucose metabolism. The stimulation of lipid accumulation at insulin concentrations less than 5 ng/ml was greater with GH, but responses were comparable above 5 ng/ml insulin. The ability of insulin to bind to its receptor was not affected by prior treatment with GH for either short or prolonged time periods.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3293981 TI - Immunocytochemical and pharmacological evidence for an intrinsic cholinomimetic system modulating prolactin and growth hormone release in rat pituitary. AB - Pituitary cells were cultured as three-dimensional reaggregates in serum-free chemically defined medium supplemented with different concentrations of dexamethasone. Immunostaining of the cells using a polyclonal antiserum and three monoclonal antibodies raised against choline acetyl transferase (CAT), revealed the presence of CAT immunoreactivity in 4-10% of anterior pituitary cells depending on the antibody used. CAT immunoreactivity was also found in freshly dispersed anterior pituitary cells. CAT-immunoreactive cells could be enriched on BSA and Percoll gradients and codistributed with ACTH-immunoreactive cells in these gradients. Perifusion of the aggregates with the potent muscarinic receptor antagonist atropine (Atr) resulted in a dose-dependent (0.1-100 nM) increase in both basal PRL and GH secretion; the response was dependent on the dexamethasone concentration in the culture medium. A similar response to Atr was observed in organ-cultured pituitaries. The specificity of the Atr effect was supported by the findings that the potent and highly specific muscarinic receptor blocker dexetimide showed a similar action, whereas its inactive enantiomer levetimide and the nicotinic receptor blocker hexamethonium failed to do so. Two other muscarinic antagonists, benzatropine and pirenzepine, showed a dose-dependent hormone-releasing action similar to that of Atr, but were less potent than the latter. Pirenzepine was only effective at high molar concentrations, suggesting that an M2 muscarinic receptor subtype was mediating the present phenomenon. Atr also potentiated GH release stimulated by the beta-adrenergic agonist isoproterenol and PRL release stimulated by vasoactive intestinal peptide, but had no effect on GRF-stimulated GH release. The choline uptake blocker hemicholinium abolished the effect of Atr on GH and PRL release. These data suggest that certain pituitary cells can express CAT activity and that these cells exert a tonic inhibitory activity on GH and PRL release which is mediated by a cholinomimetic substance, possibly acetylcholine, through a muscarinic receptor. PMID- 3293983 TI - Defective bone formation by transplanted Hyp mouse bone cells into normal mice. AB - The hypophosphatemic (Hyp) mouse is a model for human X-linked hypophosphatemia (XLH). To test the hypothesis of an abnormal osteoblast function in XLH, periostea and osteoblasts isolated from normal and Hyp mice were transplanted im into normal and mutant mice. The thickness of the osteoid seams at the periphery of the bone nodules and the osteoid volume were measured in transplants as an index of bone formation. Impaired mineralization was evidenced in transplants of Hyp cells into Hyp mice by excessive osteoid thickness and volume compared with transplants of normal cells into normal mice. When normal cells were transplanted into mutant mice, the osteoid thickness and volume were markedly increased, demonstrating that the extracellular environment is critical for bone formation. In contrast, when Hyp cells were transplanted into normal mice, reduction, but not normalization, of the osteoid thickness and volume was observed. This abnormal bone formation supports the hypothesis of an osteoblast defect in the Hyp mouse. PMID- 3293982 TI - Evidence that neuropeptide Y (NPY) released into the hypophysial-portal circulation participates in priming gonadotropes to the effects of gonadotropin releasing hormone (GnRH). AB - NPY exhibits modulatory activity at both the adenohypophysial and the central levels of the rat hypothalamic-pituitary-gonadal axis. In the present studies, the secretion and physiological activity of endogenous irNPY was examined. We have shown that: (i) irNPY is secreted into the hypophysial-portal circulation, (ii) hypophysial-portal concentration profiles of irNPY and irGnRH are parallel throughout the rat estrous cycle, and (iii) removal of endogenous NPY via immunoneutralization inhibits the steroid-induced LH surge in ovariectomized rats. From these observations, we speculate that NPY secreted into the hypophysial-portal circulation participates in priming of gonadotropes to the actions of GnRH on the afternoon of the preovulatory surge. PMID- 3293984 TI - Attenuation of endogenous opioid peptide inhibition of [Gln8]luteinizing hormone releasing hormone secretion during sexual maturation in the cockerel. AB - Opiatergic inhibition of [Gln8]LHRH secretion from the mediobasal hypothalamus of the cockerel (Gallus domesticus) was studied during sexual maturation in a hypothalamic superfusion system. The basal and depolarization-induced release of [Gln8]LHRH in the presence and absence of the opiate agonists [D-Ala2,N-Phe4-Gly ol5]enkephalin (DAGO), which binds selectively to the mu-receptor subtype, and [D Thr2,L-Leu5] enkephalyl-Thr (DTLET), which binds selectively to the delta receptor subtype, and of the opiate antagonist naloxone was assessed in tissue obtained from birds at 4, 8, 12, 16, 20, and 24 weeks of age. Concentrations of LH and testosterone in plasma obtained from cockerels at the same ages rose progressively from 8-16 weeks of age. Between 16 and 20 weeks of age testosterone increased about 3-fold, whereas LH decreased significantly. Thereafter, LH rose in the face of sustained plasma testosterone concentrations. The initial rise in plasma LH concentrations was associated with a rise in the basal release of [Gln8]LHRH and a decrease in the ability of DAGO to inhibit and of naloxone to stimulate [Gln8]LHRH release. The delta-agonist DTLET did not affect secretion at any time. The fall in plasma LH at 20 weeks occurred despite an increased release of [Gln8]LHRH, whereas the subsequent rise in LH release occurred at a time when the pattern of [Gln8]LHRH release remained unchanged. These observations support the proposition that a decrease in tonic opioid inhibition of [Gln8]LHRH secretion during sexual maturation may explain why plasma LH concentrations rise in the face of sustained plasma testosterone concentrations. The changes in plasma LH concentrations that occur in the immediate pubertal period may be due, however, to a direct action of testosterone on the anterior pituitary lobe. PMID- 3293985 TI - Effect of insulin-like growth factor I on deoxyribonucleic acid synthesis and galactopoiesis in bovine undifferentiated and lactating mammary tissue in vitro. AB - We have demonstrated that insulin-like growth factor I (IGF-I), at physiological concentrations, is a potent mitogen of bovine undifferentiated mammary epithelial cells cultured in collagen in serum-free medium. Its activity is independent of insulin, although at pharmacological concentrations insulin may substitute for IGF-I. The maximal [3H]thymidine incorporation stimulated by either IGF-I or insulin was only 25-40% of that in medium supplemented with 10% fetal calf serum (FCS) only. Epidermal growth factor (EGF) exhibited low mitogenic activity which was not synergistic with IGF-I in serum-free medium. IGF-I and EGF had low synergistic activity when added separately to 10% FCS-supplemented medium. Strong synergism (100% or more) was observed, however, when both factors were added simultaneously, indicating that their maximum mitogenic effect is dependent on a simultaneous presence of other factors existing in FCS. The galactopoietic effect of IGF-I was tested in organ culture of bovine lactating mammary gland. Neither fatty acid synthesis nor alpha-lactalbumin secretion was stimulated by IGF-I, even at 2000 ng/ml. These results indicate that, at least in our in vitro system, galactopoiesis is not affected by IGF-I. PMID- 3293986 TI - Effects of pulsatile and continuous luteinizing hormone (LH) infusions on testosterone responses to LH in rams actively immunized against gonadotropin releasing hormone. AB - Yearling rams actively immunized against GnRH were used as a hypogonadotropic model for studies of the significance of the pulsatility of LH secretion in determining the trophic actions of the hormone on testicular steroidogenesis. GnRH-immunized rams, in which testicular regression was complete, were infused iv for 12-20 days with ovine LH (NIDDK oLH 24) in three different regimens, delivering a total daily dose of 60 micrograms/100 kg: 1) 1-min pulses of 5 micrograms/100 kg every 2 h (low amplitude, high frequency), 2) 1-min pulses of 30 micrograms/100 kg every 12 h (high amplitude, low frequency), or 3) continuous infusion of 2.5 micrograms/100 kg.h. Serum testosterone levels and acute responses to LH challenges were monitored at intervals throughout the infusion periods. Acute responses to LH were evaluated in terms of the area under the curve for serum testosterone vs. time after LH and the lag time between the infusion of LH and attainment of maximum serum testosterone levels. At the beginning of the experiments, serum testosterone was at castrate values, and testosterone responses to LH were of low magnitude with a long lag time. LH infusion in the low amplitude, high frequency regimen consistently increased the magnitude and decreased the lag time of acute responses to LH; these effects were significant by the sixth day of treatment and persisted for the duration of the experiments. This regimen also had positive effects on morphological features of testes and Leydig cells. Infusion of the high amplitude, low frequency regimen, however, had neither of the positive effects on responsiveness to LH, but did seem to improve testicular and Leydig cell morphology. Continuous infusion of LH also increased the magnitude and decreased the lag time of responses to low amplitude pulses of LH, at least as well as the high frequency infusion regimen did. These results suggest that the high frequency, low amplitude pattern of LH secretion characteristic of reproductively active animals has trophic actions on the testes, increasing their responsiveness to acute gonadotropic stimulation, but the pulsatility of that pattern of LH secretion is not necessary for its trophic actions. The efficacy of high frequency LH secretion may depend only on the elevation of basal or mean LH concentrations, rather than on the low amplitude peaks or the dynamic changes in LH concentrations to which the testes are exposed. PMID- 3293987 TI - Identification and localization of 7B2 protein in human, porcine, and rat thyroid gland and in human medullary carcinoma. AB - The novel, highly conserved polypeptide 7B2, which belongs to a new protein superfamily, was isolated from human and porcine hypophysis. The availability of a specific antibody to a synthetic fragment enabled 7B2 localization in a number of neurocrine and endocrine tissues and revealed its secretory character. 7B2 was purified from thyroid homogenates by HPLC chromatography and characterized by gel permeation chromatography (dimeric mol wt, approximately 40,000) and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (monomeric mol wt, 20,750). By immunocytochemistry 7B2 was colocalized with calcitonin in parafollicular cells and identified within secretory granules by electron microscopy. Three of nineteen human medullary carcinoma cases showed immunoreactive 7B2 within the early and late hyperplasia stages and neoplasia. Results suggest that 7B2 may play a role in endocrine function, possibly as a secretory substance, and may be a histochemical marker in addition to calcitonin for medullary carcinoma. PMID- 3293988 TI - Effect of electrical stimulation of the vagus nerve on insulinemia and glycemia in Acomys cahirinus mice. AB - To investigate the parasympathetic regulation of the endocrine pancreas in spiny mice (Acomys cahirinus), unilateral electrical stimulations of the left cervical vagus nerve were performed in these animals and their controls, the albino mice. Plasma insulin and glucose levels were measured before and after the stimulation. The stimulation parameters were: 2-2.5 V, 14 Hz, 1 msec for the albino mice and 3 V, 14 Hz, 1 msec or 15-20 V, 20 Hz, 1 msec for the spiny mice. Already 2 min after the start of the stimulation, the acomys as well as the albino mice showed a significant increase in plasma insulin levels which was accompanied by a weak but significant increase in glycemia. However, the total insulin output in the acomys mice was half than that of the albino mice. Carbachol administration had no effect on insulin secretion in the acomys mice, while it increased that of the controls. Atropine pretreatment failed to abolish the insulin release elicited by electrical stimulation of the vagus nerve in the acomys mice, while it abolished it in the albino ones. It is proposed that the vagus-nerve mediated insulin release that is present in the acomys mice is exerted, not via muscarinic receptors as in controls, but possibly via other neurotransmitter(s). PMID- 3293989 TI - Sex difference in prolactin and growth hormone cells in mouse adenohypophysis: stereological, morphometric, and immunohistochemical studies by light and electron microscopy. AB - PRL and GH cells in the adenohypophysis of adult mice were studied with immunohistochemistry and stereological morphometry by light and electron microscopy. We compared findings for males and females. In female mice, most PRL immunoreactive cells (43% of all parenchymal cells) and most GH-immunoreactive cells (33% of all parenchymal cells) were classical PRL cells (type I PRL cells) or GH cells (type I GH cells), respectively. Besides these classical types of cells, we found PRL- and GH-immunoreactive (type II PRL and GH) cells that contained small (approximately 100-200 nm in diameter) and round secretory granules. However, in female mice type II PRL or GH cells accounted for less than 3% of all parenchymal cells, as was also true for type II GH cells in the males. The percentages of type I and type II PRL cells in male mice were about the same (approximately 10% of all parenchymal cells). Only a few mammosomatotropes (0 0.6% of all parenchymal cells) were found in the mouse adenohypophysis of either sex. All mammosomatotropes were type II cells; none were PRL or GH cells of the classical type. This immunohistochemical study confirmed our previous findings by conventional electron microscopy that there are marked sex differences in the proportions of PRL and GH cells in the adult mouse adenohypophysis; PRL cells are more abundant in the female mice, and GH cells are more abundant in the males. PMID- 3293990 TI - Development of a primary culture system for rainbow trout corpuscles of stannius and characterization of secreted teleocalcin. AB - A primary culture system has been established for rainbow trout corpuscles of Stannius (CS). A RIA has also been developed to monitor and characterize the teleocalcin secreted by these cultures. The primary cultured CS cells actively synthesized and secreted teleocalcin for up to 39 days when maintained in amphibian and mammalian culture media. Numerous teleocalcin cells were also evident after immunocytochemical staining of the CS cultures. When the cultures were labeled with L-[35S]methionine, de novo synthesized and secreted teleocalcin was judged to be a glycosylated protein on the basis of Concanavalin-A-Sepharose binding and was similar in size to the intracellular form of the hormone. This culture system may prove to be ideal for identifying those factors that regulate teleocalcin secretion. PMID- 3293991 TI - Estrogenic regulation of uterine 90-kilodalton heat shock protein. AB - Recently two lines of evidence have implicated that cellular heat shock proteins (hsp) may play a role in steroid hormonal regulation of target tissues. One is the demonstration that cellular 90K hsp (hsp-90) can complex with steroid receptors in vitro and inhibit their ability to interact with DNA, and second, the demonstration that in avian oviduct sex steroids can regulate the synthesis of hsp-108. As yet, there is no report that sex steroids can regulate hsp-90 synthesis, especially in mammalian tissues. In these studies we have examined the estrogenic regulation of murine uterine hsp-90. We report that ovariectomy reduces the uterine concentration of hsp-90, and estradiol causes a time dependent increase in uterine hsp-90 as early as 4 h after steroid administration, reaching a maximum increase of 4-fold between 18-24 h. The effect is specific to estrogens and not elicited by other steroid hormones. It is also target tissue specific, such that it is seen with uterus and vagina and does not occur in nontarget tissue for estradiol, such as spleen. The possible physiological significance of estrogenic stimulation of uterine hsp-90 has been discussed. PMID- 3293992 TI - Inhibitory actions of keoxifene on luteinizing hormone secretion in pituitary gonadotrophs. AB - The effect of keoxifene (LY 156 758) on GnRH-stimulated LH release and its ability to antagonize estrogen actions were investigated in rat anterior pituitary cells. Estrogens exert either stimulatory or inhibitory effects on GnRH induced LH secretion in rat pituitary cells depending on the incubation time with the steroid. When pituitary cells were treated for 24 h with 10(-9) M estradiol, the LH response to GnRH was clearly enhanced, and this effect was completely inhibited by 300 nM keoxifene. Short term treatment (4 h) of pituitary cells with 10(-9) M estradiol inhibits GnRH-stimulated LH release, and this effect was also blocked by keoxifene in a dose-dependent manner. In the absence of exogenous estrogen the treatment of pituitary cells for 4 h with increasing concentrations of keoxifene reduced the LH response to 10(-9) M GnRH only at very high concentrations (10(-5) M) of the antiestrogen. After treatment for 24 h, the inhibitory effect of keoxifene was evident at concentrations greater than or equal to 10(-8) M, with a reduction of GnRH-induced LH release by up to 60%. The effects of the antiestrogen were also analyzed in a dynamic culture system, in which pituitary cells grown on microcarrier beads were continuously perifused with medium and stimulated with GnRH in a pulsatile fashion. The LH response to a 2 min pulse of 10(-9) M GnRH was reduced in magnitude after 40 min of perifusion with 10(-9) M estradiol. When keoxifene (300 nM) was present at the same time, the LH response was identical to that observed in vehicle-treated cells. At the concentration of 300 nM, keoxifene per se did not change the responsiveness of the pituitary cells to the GnRH stimulus. These findings show that keoxifene is a potent antagonist of both positive and negative estrogen actions in the pituitary gonadotroph. In addition, after short term treatment with high concentrations or after long term treatment, keoxifene itself exerts an inhibitory effect on GnRH induced LH secretion. PMID- 3293994 TI - Insulin receptors on hepatocytes from spontaneously diabetic Chinese hamsters. AB - Insulin receptors on hepatocytes were studied in spontaneously diabetic Chinese hamsters, which are the animal models for insulin deficient diabetes. Insulin binding in diabetic animals increased mainly due to an increase in the number of receptors. Although binding affinity of diabetic animals was similar to that of control animals, a kinetic study revealed that both the association rate constant and the dissociation rate constant decreased in diabetic animals. Negatively cooperative interactions between receptors were demonstrated in control and diabetic animals, and both the magnitude and sensitivity of this effect was the same in both types of animals. A significant inverse correlation between insulin binding and the plasma insulin concentration was found in these animals. These results therefore suggest that there is an increase in the insulin binding in the insulin deficient diabetic state mainly due to an increase in the number of receptors with a decrease in both the association and dissociation rate constants, and these changes may be important in the altered metabolic state. PMID- 3293993 TI - Use of minoxidil to demonstrate that prostacyclin is not the mediator of bone resorption stimulated by growth factors in mouse calvariae. AB - Growth factors, such as human transforming growth factor-alpha (hTGF alpha) and epidermal growth factor, as well as human tumor necrosis factor (hTNF) stimulate the resorption of bone in neonatal mouse calvariae in organ culture via a prostaglandin (PG)-mediated pathway. In response to such factors mouse calvariae produce substantial quantities of prostaglandin E2 (PGE2) and prostacyclin (PGI2). We have selectively inhibited the production of PGI2, but not PGE2, using the drug minoxidil and have measured the effects on stimulated bone resportion and arachidonic acid metabolism. The increased production of 6-keto-PGF1 alpha (6k-PGF1 alpha), the hydrolytic product of PGI2, stimulated by recombinant hTGF alpha and hTNF as well as murine epidermal growth factor was inhibited by minoxidil. There was no inhibition by minoxidil of PGE2 production. Despite essentially complete inhibition of stimulated 6k-PGF1 alpha formation, there was no inhibition of bone resorption. The possibility was investigated that growth factors and TNF enhanced enzymatic conversion of PGI2 to 6k-PGE1, which stimulates bone resorption in mouse calvariae with a potency about one fourth that of PGE2. Enzymatic conversion of PGI2 to 6k-PGE1 is inhibited by rutin. Rutin did not inhibit bone resorption stimulated by hTGF alpha or hTNF. We conclude, on the basis of these new results and previously published data, that the cyclooxygenase product that acts as the mediator of bone resorption enhanced by growth factors and TNF in mouse calvariae is probably PGE2. PMID- 3293995 TI - Sensitive sandwich enzyme immunoassay of human growth hormone (hGH) in serum and urine using monoclonal antibody-coated polystyrene balls. AB - A sensitive sandwich enzyme immunoassay for human growth hormone (hGH) using monoclonal antibody is described. A monoclonal anti-hGH IgG-coated polystyrene ball was incubated with hGH and subsequently with affinity-purified rabbit anti hGH Fab'-horseradish peroxidase conjugate. Peroxidase activity bound to the polystyrene ball was assayed by fluorimetry using 3-(4-hydroxyphenyl) propionic acid as a substrate. The detection limits of hGH in serum and urine were 1.5 ng/l using 20 microliters of serum and 0.2 ng/l using 0.15 ml of urine, respectively. The specificity and assay precision were satisfactory. hGH levels in serum and urine determined by the present sandwich enzyme immunoassay using monoclonal anti hGH IgG-coated polystyrene balls were well correlated to those determined by the previous sandwich enzyme immunoassay using rabbit anti-hGH IgG-coated polystyrene balls. Levels of hGH in urine collected as first morning voids from healthy subjects aged 19-28 yr were 6.4 +/- 3.2 (SD) ng/g creatinine. However, the present assay gave lower hGH levels than the previous assay. This was at least partly explained by the fact that hGH in urine was less efficiently bound to monoclonal anti-hGH IgG-polystyrene balls than standard hGH, while the binding of hGH in urine and standard hGH to rabbit anti-hGH IgG-coated polystyrene balls was equally efficient. In addition, gel filtration showed that 22K hGH, a major component, in urine was less efficiently bound to monoclonal anti-hGH IgG-coated polystyrene balls than standard 22K hGH. The nature of hGH in serum and urine remains to be investigated. PMID- 3293996 TI - Riboflavin deficiency and severity of malaria. AB - The riboflavin status of 64 children suffering from malarial infection was assessed by measuring the activation coefficient of erythrocyte glutathione reductase. Thirty-five children were found to be deficient in riboflavin whereas in 29 children riboflavin status was within the normal range. The median parasite count and its range on admission in the deficient group (2.7 per cent, range 0.3 13.6) was lower than that in the non-deficient group (5.3 per cent, range 0.6 30.2). The correlation between activity coefficient and parasite count was significant (R = -0.49). The recovery process was slower in the deficient group even though they had a relatively lower parasite count. It is inferred that riboflavin deficiency leads to inhibition of growth and multiplication of plasmodia. Its beneficial effects in malaria infection needs further evaluation. PMID- 3293997 TI - The nutritional role of indispensable amino acids and the metabolic basis for their requirements. AB - Short-term balances and metabolic studies suggest that current estimates of adult indispensable amino acid (IAA) requirements are too low. In addition, the observed biological value of protein is less than that predicted from its amino acid score. We propose that these discrepancies reflect the fact that IAA requirements are complex, and can only be defined under specific artificial conditions. This is because consumption of protein usually results in oxidative losses of IAA and nitrogen, which are important to the organism and variable according to dietary composition. It is likely that the age-related fall in the current values for IAA requirement primarily reflects different dietary designs in the original balance studies, which induced different rates of oxidative losses. A new model for amino acid utilization is proposed which takes account of such losses, and factors that influence them are reviewed. We propose that dietary IAAs serve an important transient function prior to their oxidation, exerting a regulatory influence on maintenance and growth which we call the anabolic drive. The model also allows for diurnal cycling of body protein, in which oxidative losses of amino acids occurring during the postabsorptive phase must be balanced by net protein deposition during feeding if overall balance is to be attained. Diurnal cycling is likely to be nutritionally sensitive, influenced by the anabolic drive and could affect the relationship between total protein and IAA requirements. We argue that oxidative losses should be included in the requirement; this will account for apparent discrepancies in the observed efficiency of protein utilization. We propose that IAA requirements (R) can only be unambiguously defined in terms of Rmin, a value obtainable under artificial conditions when oxidative losses, Lr, are minimal (Lr min); current estimates of adult requirements may be close to this level. An operative requirement of practical value, Rop, will only be defineable when the value to the organism of the oxidative losses induced by usual diets, (Lr op), can be evaluated. PMID- 3293998 TI - Expression of the FGF-related proto-oncogene int-2 during gastrulation and neurulation in the mouse. AB - The proto-oncogene int-2 has been implicated in the formation of mouse mammary tumour-virus-induced mammary tumours. Analysis of the predicted coding sequence indicates that int-2 is a member of the fibroblast growth factor family. Previous studies using Northern blot analysis suggested that normal expression of int-2 may be confined to extra-embryonic endoderm lineages of embryonic stages of mouse development. We have used in situ hybridization and Northern blot analysis to examine directly int-2 expression in embryo stem cells and in the developing embryo from early gastrulation to midsomite stages. Complex patterns of accumulation of int-2 RNA were observed in embryonic and extra-embryonic tissues. The data suggest multiple roles for int-2 in development which may include migration of early mesoderm cells and induction of the otocyst. PMID- 3294000 TI - Resolution of ColE1 dimers requires a DNA sequence implicated in the three dimensional organization of the cer site. AB - Plasmid ColE1 specifies a recombination site (cer) which participates in the conversion of plasmid dimers to monomers. The uncontrolled accumulation of dimers (and higher oligomeric forms) would otherwise lead to plasmid instability. Exonuclease III-generated deletions have been used to define the left-hand boundary of the cer site. Deletions which have lost up to 60 bp adjacent to the boundary no longer mediate the conversion of plasmid dimers to monomers, but still recombine with a wild-type site. Although this boundary region is essential for dimer resolution, its DNA sequence is poorly conserved among multimer resolution sites in related plasmids. We present evidence that its function is to influence the three-dimensional organization of the site and suggest that it may be required for the formation of a condensed nucleoprotein complex. PMID- 3293999 TI - Identification in chickens of an evolutionarily conserved cellular ets-2 gene (c ets-2) encoding nuclear proteins related to the products of the c-ets proto oncogene. AB - In chicken cells, we previously identified a set of proteins (p58-64) structurally related to, but distinct from, the products encoded by the c-ets proto-oncogene. We report here the isolation and nucleotide sequence of a cDNA encoding nuclear products of mol. wt 58, 60, 62 and 64 kd, indistinguishable from those detected in chicken cells. The p60 and p64 species appear to represent phosphorylated versions on serine and threonine residues of p58 and p62. The homology of p58-64 to other ets-related proteins, including the v-ets encoded domain of the transforming protein of avian leukemia virus E26 and p54c-ets, the translation product of the chicken (Ck) c-ets gene, is confined to two regions of 175 and 96 amino acid residues localized respectively at the carboxy-terminal domain and close to the amino-terminal domain of these molecules. This cDNA corresponds to a gene localized in a locus distinct from that of c-ets which is transcribed as a 4.0-kb RNA species in most chicken tissues. We also identified the human (Hu) c-ets-2-encoded products as two proteins of 60 and 62 kd, highly related to chicken p58-64. This, together with the fact that the amino acid sequence of the cDNA encoding p58-64 is 95% identical to the reported partial sequence of a Hu-c-ets-2 cDNA, indicates that p58-64 are the translation products of the Ck-c-ets-2 gene. PMID- 3294001 TI - Anaesthesia and the gastro-intestinal system. PMID- 3294002 TI - Carbohydrate ingestion and muscle glycogen depletion during marathon and ultramarathon racing. AB - Two studies were undertaken to characterize the effects of carbohydrate ingestion on fuel/hormone response to exercise and muscle glycogen utilization during prolonged competitive exercise. In study 1, eighteen subjects were divided into three groups, matched for maximum oxygen consumption (VO2max) and blood lactate turnpoint. All subjects underwent a 3-day carbohydrate (CHO) depletion phase, followed by 3 days of CHO loading (500-600 g.day-1). During the race, the groups drank either 2% glucose (G), 8% glucose polymer (GP), or 8% fructose (F). Muscle biopsies were performed before and after the race and venous blood was sampled before and at regular intervals during the race. In study 2, eighteen subjects divided into 2 matched groups ingested either a 4% G or 10% GP solution during a 56 km race. Despite significantly greater CHO ingestion by GP and F in study 1 and by GP in study 2, blood glucose, free fatty acids and insulin concentrations, muscle glycogen utilization and running performance were not different between groups. These studies show (i) that hypoglycaemia is uncommon in athletes competing in races of up to 56 km provided they CHO-load before and ingest a minimum of 10 g CHO.h-1 during competition; (ii) that neither the amount (10 g vs 40 g.h-1) nor the type of carbohydrate (G vs GP vs F) has any effect on the extent of muscle glycogen depletion or running performance in matched subjects racing over distances up to 56 km. PMID- 3294003 TI - Characterization of a glycoprotein expressed on the basolateral membrane of human intestinal epithelial cells and cultured colonic cell lines. AB - A protein from the basolateral domain of adult human intestinal epithelial cells has been identified and characterized by the monoclonal antibody technique in combination with immunocytochemical and biochemical methods. The protein is found preferentially on the lateral surface of the cells. Extraction of intestinal membranes with Triton X-114 or their treatment with hydrolases indicated that the protein is an integral membrane glycoprotein of apparent molecular weight 38 kDa by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). In the adult this protein is restricted to intestine, pancreas and gallbladder, consistent with their common embryonic origin. It was also expressed in the intestine of a 24-week-old human embryo and was found as a basolateral marker in cultured cell lines originating from human colonic adenocarcinomas. PMID- 3294004 TI - The intermediate-filament proteins vimentin and desmin are phosphorylated in specific domains. AB - Analysis of specific fragments of vimentin and desmin from 32P-labeled BHK-21 cells indicated that these intermediate-filament subunit proteins are phosphorylated in specific regions or domains. High performance liquid chromatography and sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis of lysine-specific protease-generated fragments demonstrated that both molecules were phosphorylated in their amino terminal or "head" domains. While this was the predominant site of phosphorylation for vimentin, additional phosphorylated fragments from desmin were observed. Chemical cleavage of [32P]desmin and subsequent examination of the phosphorylated peptides indicated that the major site of desmin phosphorylation was located within the "tail" domain. Analysis of vimentin and desmin from non-mitotic and mitotically selected cells indicated that the increased phosphorylation of intermediate-filament proteins observed during cell division occurs within the amino terminal domains of both molecules. These studies indicate that the increased phosphorylation of filament proteins during mitosis may involve the function of the amino terminal domain. In addition, filament proteins may be phosphorylated in a subunit-protein specific manner which may reflect subunit-specific functions. PMID- 3294005 TI - An immunoreactive form of erythrocyte protein 4.9 is present in non-erythroid cells. AB - Using immunoblots and an affinity-purified antibody prepared against human erythrocyte protein 4.9, we have demonstrated and quantified the presence of an immunoreactive form of this protein in avian and bovine brain and lens tissues, avian heart, as well as in human platelets and mammalian, avian, piscine, and amphibian erythrocytes. Both the 48 kDa and the 52 kDa variants were observed in human erythrocytes, whereas 50 kDa and 54 kDa immunoreactive forms were observed in human platelets. As reported for erythroid protein 4.9, platelet protein 4.9 was phosphorylated in response to treatment with phorbol ester. Bovine brain showed five cross-reactive polypeptides in the 47 to 52 kDa range while avian brain and avian and bovine lens exhibited predominantly a 49-kDa band. Cross reactivity was not observed in a number of cell lines and tissues including leukocytes, liver, kidney, pancreas, and skeletal muscle. Immunofluorescence indicated that protein 4.9 was present in cortical fiber cells of avian lens and in neurons of avian cerebrum. PMID- 3294006 TI - Immunogold localization of circumsporozoite protein of the malaria parasite Plasmodium falciparum during sporogony in Anopheles stephensi midguts. AB - The occurrence of the circumsporozoite (CS) proteins of Plasmodium falciparum sporozoites was monitored during sporogonic development in Anopheles stephensi mosquitoes. Using a monoclonal anti-CS protein antibody (3Sp2) and immunogold labeling on ultrathin cryosections it was found that CS protein is synthesized in immature oocysts from day 6 onwards when there are not yet signs of sporozoite formation. The CS protein is rapidly incorporated in the oocyst plasmalemma, which subsequently invaginates into the parasite. In the oocyst only the external sporozoite membrane contains CS protein. The inner pellicle membranes, rhoptries and micronemes do not react with monoclonal antibody (MoAb) 3Sp2. PMID- 3294007 TI - Identification of centromere proteins in different mammalian cells. AB - The characterization of centromeric proteins is facilitated using anti-centromere antibodies present in the sera of patients with the CREST variant of scleroderma. We have employed these sera to determine whether or not those proteins are present in different mammalian species, as well as to study their tissue distribution. Here, we describe the immunofluorescent pattern and the proteins recognized by CREST sera in dividing and resting cells from mouse, rat, swine, hamster, rabbit, and man. In nuclear preparations from cultured cells, thymocytes and spermatozoa from these species, the antigens recognized by CREST sera are proteins of 18 to 20 kDa in all species tested, except in rat. Additionally, two peptides of 80 and 140 kDa were observed in human preparations. In contrast, a 50 kDa peptide is the primary protein detected by the sera in rat nuclei. PMID- 3294008 TI - The fate of the circumsporozoite antigens during the exoerythrocytic stage of Plasmodium berghei. AB - There has been considerable interest in the circumsporozoite proteins due to their potential use in anti-malarial vaccines. Previous authors have shown that these proteins persist from the invading sporozoite throughout the growing exoerythrocytic or liver stage. We show that the different distributions of these proteins seen during the development of the exoerythrocytic parasite of Plasmodium berghei closely follow morphological changes, which can be recognized under the light microscope. At the end of the exoerythrocytic cycle, the majority of the remaining circumsporozoite proteins were associated with the spongy stroma in which the emerging exoerythrocytic merozoites lay. Cell-mediated immunity originally directed against sporozoites might recognize the stroma as a second target resulting in the indirect destruction of the exoerythrocytic merozoites. PMID- 3294009 TI - The parasitophorous vacuole membrane of Plasmodium falciparum: demonstration of vesicle formation using an immunoprobe. AB - We have applied several immunolabeling techniques using a monoclonal antibody to a Plasmodium falciparum antigen to differentiate morphologically dissimilar membranous structures present in infected erythrocytes. Evidence is presented that cytoplasmic clefts, multimembranous structures and vesicles within the infected cell originate from the parasitophorous vacuole membrane by a process described as budding off. The parasitophorous vacuole membrane and related structures in infected, parasitized erythrocytes reacted with the cyanine dye Merocyanine 540, demonstrating that they are accessible to molecules from the extracellular environment. Immunogold labeling of freeze-fractured preparations and of thin sections of parasitized cells using pre- and post-embedding techniques revealed that each of the membranous structures carried a common parasite antigen, QF 116, which was identified by monoclonal antibody 8E7/55. PMID- 3294010 TI - Marino Ortolani (1904-1983). PMID- 3294011 TI - Knemometry, a new tool for the investigation of growth. A review. AB - Cross-sectional and longitudinal studies of human growth have revealed almost every detail of the typical human growth pattern. Yet, the description of this pattern is still limited to the traditional vocabulary of "growth rates", i.e. height or length differences divided by certain time intervals such as months or years. Almost no information is yet available on finer details of this pattern. This review concerns the existing experimental and clinical data collected by a novel and non-invasive technique of accurate lower leg length measurement named "knemometry" that has been used for the study of short-term growth. This technique estimates the distance between heel and knee of the sitting child with an accuracy (technical error) of 0.09-0.16 mm. Several authors have presented evidence that lower leg growth is non-linear. There is not only a marked day-to day variation of the lower leg length which far exceeds the error of the measurement itself, but there is also a characteristic up-and-down pattern of lower leg growth consisting of sharp growth spurts ("mini-growth-spurts") alternating with periods of decreased growth velocity every 30-55 days in 45 out of 73 healthy children. This pattern can be visualized by the calculation of "mean daily lower leg growth velocities", an approach that gives information on the kinetic properties of the growth process. In spite of much initial criticism, knemometry has opened a fascinating new dimension of the physiology of human growth and provided finer details of growth than hitherto obtainable by conventional techniques of growth measurement. PMID- 3294012 TI - Kawasaki disease: monitoring of circulating immune complexes. AB - We followed the levels of circulating immune complexes (CIC) in 27 patients with Kawasaki disease (KD) from the acute stage of the disease through convalescence, using the test for platelet-reactive IgG-IC, and C1q-binding and conglutinin binding enzyme immunoassays. CIC were detected by one or more techniques in all but one patient. Positive results were obtained most often with the test for platelet-reactive IgG-IC. Measurement of complement components C3 and C4 in 14 patients revealed an increase in C3 levels during the first few weeks of the disease and normal levels of C4. The blood platelet count correlated directly with the level of platelet-reactive IgG-IC. The highest levels of CIC were found during weeks 3 through 7 after the onset of disease. Measurement of CIC is, however, not applicable to the clinical follow-up of patients with KD. PMID- 3294013 TI - Intermittent microalbuminuria in children with type 1 diabetes mellitus without clinical evidence of nephropathy. AB - Microalbuminura (MA) was determined in 127 children and adolescents (age 3-21 years) with type 1 (insulin-dependent) diabetes mellitus. Patients with clinical evidence of long-term complications or macroproteinuria were excluded. Urinary albumin excretion was measured in a nocturnal 12-h collection and correlated with the albumin/creatinine ratio of a urine sample freshly voided on the morning immediately following the collection. The patients were divided into group A (n = 83, age less than 16 years, duration of diabetes 1-13 years, mean 4.4) and group B (n = 44, age greater than 16 years, duration of diabetes 1-19 years, mean 8.7) and compared with appropriate controls. MA above 15 micrograms/min was present in 11 of 83 (13.3%) patients in group A and in 7 of 44 (15.9%) in group B. In a repeat urine collection at least 3 months later elevated MA persisted in 1 of 11 (group A) and in 4 of 7 (group B) patients. There was no correlation between increased MA in a 12-h urine collection and the albumin/creatinine ratio in a subsequently voided urine sample. MA was not strictly dependent on age, sex, duration of diabetes, haemoglobin A1, mean arterial blood pressure, plasma creatinine, creatinine clearance or serum beta-2-microglobulin. Further systematic studies and careful follow up are necessary to appraise whether intermittent MA is indeed an early manifestation of incipient kidney disease in children with type 1 diabetes. PMID- 3294016 TI - Congenital malignant mesothelioma. A case report and electron-microscopic study. AB - Malignant mesothelioma was diagnosed in a 16-day-old boy. As far as we know this is the first report of a congenital case of this disease. PMID- 3294015 TI - Comparison of serum concentrations of ceftazidime and tobramycin in newborn infants. AB - Peak and trough serum concentrations of ceftazidime and tobramycin were determined in neonates with suspected septicaemia in an open randomized study. Mean peak serum levels were 85 (+/- 4.4 SE) mg/l for ceftazidime and 5.8 (+/- 0.3 SE) mg/l for tobramycin. The peak serum levels of ceftazidime were well above the reported minimal inhibitory concentration (MIC)90 values of pathogenic bacteria encountered in neonates, while peak serum levels of tobramycin were lower than reported MIC90 values for Klebsiella, Pseudomonas, Enterobacter and Serratia species. Nine of 33 tobramycin-treated patients had potentially toxic trough serum levels (greater than 2 mg/l) and nine had subtherapeutic peak serum levels (less than 4 mg/l). The dosage of this antibiotic had to be changed frequently. In comparison only 2 of 29 ceftazidime-treated patients had subtherapeutic peak levels (less than 40 mg/l) and none had potentially toxic trough levels (greater than 40 mg/l). Ceftazidime, in comparison with tobramycin, has a more favourable antibacterial spectrum and routine determinations of peak and trough serum levels should not be necessary. PMID- 3294017 TI - The neonatal pseudo-hydrocephalic progeroid syndrome (Wiedemann-Rautenstrauch). Report of a new patient and review of the literature. AB - A boy with the pseudo-hydrocephalic progeroid syndrome (McKusic 26409) is presented and compared to five previously reported children. The boy presented with major skeletal abnormalities, which receded during the first few months of life. Special investigations like studies on collagen, electron microscopy, and growth studies of fibroblasts did not contribute to our knowledge of the pathogenesis of this rare disease. PMID- 3294014 TI - High-frequency oscillatory ventilation combined with intermittent mandatory ventilation in critically ill neonates: 3 years of experience. AB - A heterogeneous group of 45 neonates with severe pulmonary disease and inadequate gas exchange on conventional intermittent mandatory ventilation (IMV) was treated with a high-frequency oscillator combined with an IMV (HFO-IMV) system (Emerson Airway Vibrator connected to a BABYBird 1 ventilator). The mean gestational age was 33 weeks (25.5-43) and mean birth weight 2.02 kg (0.66-4.24). Primary diagnoses included respiratory distress syndrome (RDS; 23), pneumonia (12), persistent fetal circulation (PFC; 6), diaphragmatic hernia/hypoplastic lungs (4). The IMV rate was reduced from 78 to 29 BPM (P less than or equal to 0.0005), while maintaining lower partial pressure of carbon dioxide (PaCO2) (P less than 0.005) and higher partial pressure of oxygen (PaO2) (P less than or equal to 0.0025). Active air leaks were present in 20 infants and these infants responded most favourably to HFO-IMV. HFO-IMV failed to improve ventilation in neonates with diaphragmatic hernia/hypoplastic lungs. Complications during HFO-IMV were increased pulmonary secretions (11), worsening or recurrence of pre-existing air leaks (11), or occurrence of new air leaks (10). In 4 patients death was related to major air leak complications. Twenty-four infants died, 18 of them of a respiratory cause. Twenty-one infants finally survived. We assembled a well tolerated system to provide HFO-IMV and to successfully ventilate neonates with severe respiratory disease, who failed to respond to conventional IMV. Initiation of HFO-IMV earlier in the course of the disease in this type of infant may improve survival. PMID- 3294018 TI - Caffey disease responding to high-dose immunoglobulin. PMID- 3294019 TI - Pharmacokinetics of enantiomers of chiral non-steroidal anti-inflammatory drugs. PMID- 3294021 TI - Verapamil and bendrofluazide in the treatment of hypertension: a controlled study of effectiveness alone and in combination. AB - The effects of verapamil and bendrofluazide used singly and in combination were examined in patients with primary hypertension in a patient blind, partly observer blind placebo controlled study of parallel group design; there were ten subjects in each arm of the trial. Verapamil 160 mg twice daily caused supine mean arterial pressure to fall by 21 mmHg; this reduction was significantly greater (p less than 0.05) than that induced by bendrofluazide 5 mg daily which caused a fall of only 10 mmHg. The addition of verapamil 160 mg twice daily to bendrofluazide 5 mg daily caused a further fall in pressure of 18 mmHg (p less than 0.005), but the reduction in pressure when bendrofluazide was added to verapamil was only 1 mmHg and not significant. Bendrofluazide therapy caused a fall in plasma potassium concentration and an increase in plasma urate concentration; urinary calcium excretion was reduced. Verapamil caused no detectable biochemical alterations in plasma or urine. PMID- 3294022 TI - Falsely raised plasma theophylline concentrations in renal failure. AB - We studied the validity of plasma theophylline measurements in renal failure. Patients with increased serum creatinine receiving theophylline had drug measurements by four methods: high pressure liquid chromatography (HPLC) fluorescence polarization immunoassay (FPIA), enzyme immunoassay (EIA) and dipstick immunoassay (DI). The mean +/- SD (mumol/l) for plasma theophylline in the 18 patients with renal impairment was: HPLC 63.4 +/- 36.7; EIA 64.4 +/- 35.9; FPIA 70 +/- 3.43; DI 122 +/- 65.9. A significant correlation (r = 0.94, p less than 0.01) was obtained between serum creatinine and the difference in theophylline concentrations between HPLC and DI. Plasma theophylline results should be interpreted with caution in patients with renal failure. PMID- 3294020 TI - Effect of bepridil on metabolic control and insulin secretion in diabetics. AB - In a double-blind cross-over study bepridil 900 mg followed by 300 mg daily for 11 days was given to 37 insulin (Type I) or non-insulin (Type II)-dependent diabetic patients. It did not modify the metabolic control of the patients as levels of glucose in blood and urine, doses of insulin and oral hypoglycaemic drugs, energy intake, and the number of hypoglycaemic attacks during therapy were unchanged. The serum concentration of C-peptide was not modified in either type of diabetic patient, and serum insulin in the Type I but not in the Type II patients was slightly higher during active drug treatment. No adverse organotoxic or arrhythmogenic effects or changes in possible atherogenic lipid fractions in serum could be demonstrated during bepridil therapy. PMID- 3294023 TI - Molecular biology of malaria parasites. PMID- 3294025 TI - Plasmodium vivax: in vitro growth and reinvasion in red blood cells of Aotus nancymai. AB - Plasmodium vivax was maintained in experimentally infected Aotus nancymai. Positive monkeys were used as donors for culture material. After leucocyte removal with two different methods, including the classic CF11 method and a commercially available filter, parasites were grown under continuous shaking conditions in standard RPMI 1640, containing 20% human AB + serum. When mature schizonts were present, artificially induced reticulocytes from monkeys pretreated with the hemolytic drug phenylhydrazine HCl were added. Addition of reticulocytes and shaking were both necessary to realize a significant reinvasion under in vitro conditions. A strong positive correlation between the percentage of reticulocytes and in vitro invasion was demonstrated, and a preferential invasion into reticulocytes was demonstrated in vivo and in vitro using blood films stained with brilliant cresyl blue and counterstained with Giemsa. PMID- 3294024 TI - Plasmodium falciparum: ingested anti-sporozoite antibodies affect sporogony in Anopheles stephensi mosquitoes. AB - In endemic areas, malaria-infected mosquitoes may feed upon humans who possess antibodies against malaria sporozoites. Therefore, we examined the effect that ingested anti-sporozoite antibodies have upon Plasmodium falciparum sporogony within Anopheles stephensi mosquitoes. Anti-sporozoite antibodies (IgG) traversed the midgut into the hemocoel within 3 hr following ingestion and, depending upon the titer, persisted for 6-24 hr. When fed to infected A. stephensi at 12 days postinfection (p.i.), anti-sporozoite antibodies bound to sporozoites in the hemocoel, but not to sporozoites residing in the salivary glands of the same mosquitoes. Anti-sporozoite antibodies also bound to developing oocysts when fed to infected A. stephensi at 5 days p.i. Oocysts in mosquitoes that had been fed anti-sporozoite antibodies on Day 5 p.i. produced significantly more sporozoites than did oocysts in nonimmune-fed (Day 5 p.i.) mosquitoes. In addition, the sporozoites from Day 5 immune-fed mosquitoes were significantly more infective to cultured human hepatoma cells than were sporozoites from nonimmune-fed controls. Use of hetereologous immune feedings at Day 5 p.i. did not result in an enhanced production of sporozoites, suggesting that enhancement is related to the specificity of the antibody and is not merely a nutritional effect. PMID- 3294026 TI - Trypanosoma cruzi: an in vitro cycle of cell differentiation in axenic culture. AB - The operation of an in vitro cycle of cell differentiation of Trypanosoma cruzi in axenic culture was obtained. When epimastigote forms, grown in LIT medium, were transferred to a modified LIT medium (E. Chiari, 1981, "Diferenciacao do Trypanosoma cruzi em cultura." Ph.D. dissertation, Universidade Federal de Minas Gerais, Brazil), metacyclic trypomastigotes were generated. The latter, upon treatment with fresh human serum, and subsequent incubation in LIT medium gave origin to clusters of spheromastigote cells. The spheromastigotes were resistent to lysis mediated by the complement system and possess a morphology shown by optical and electron microscopy to be very similar to spheromastigotes derived from tissues of infected vertebrates. Blood-like trypomastigotes, or epimastigotes, could be obtained from spheromastigotes depending on the incubation conditions: at high serum concentration (55%) at 37 C, blood-like trypomastigotes were generated; by aging or heating (37 C), at low serum concentration (10%), epimastigotes were formed, closing the whole sequence of cell differentiation of T. cruzi. The molecular characterization of the different cell forms by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of metabolic pulse labeled proteins showed that the in vitro differentiated cells were distinct, not only by morphological criteria, but by differential gene expression as well. All the forms described could be obtained in large amounts (6 x 10(7) to 1 x 10(8)/ml), making it possible to perform preparative biochemical, molecular biological, and immunological experiments. PMID- 3294027 TI - Embryopathic risks of cigarette smoking. AB - Cigarette smoking has been associated with infertility, a higher frequency of spontaneous abortions, intrauterine growth retardation and an increased incidence of birth defects. Nicotine is the major pharmacological component of cigarette smoke. Its potential reproductive and teratological risks are critically reviewed. PMID- 3294029 TI - A historical review of the problem of mitogenetic radiation. AB - The 'miracle of caryokinesis' was the starting point that stimulated Alexander G. Gurwitsch to carry out his famous 'mitogenetic' experiments in 1923. The results obtained confirmed his hypothesis of a weak radiation from cells, which is able to trigger the growth of other cells. Extensive experimental work within the first two decades after this discovery indicated that the problem of mitogenetic radiation is generally related to the biological significance of UV-radiation. Both 'energetic' and 'informational' aspects have to be considered, namely radiation effective in activating molecules, and that involved in arranging them into larger units. The molecular organization of biological structures is evidently governed by nonequilibrium conditions needing the uptake or emission of radiation. These concepts of A. G. Gurwitsch can be linked with modern approaches based on hypotheses of coherence in biology, 'synergetics' and 'dissipative structures'. However, the question of causal interrelationships between this part of non-equilibrium radiation and biological matter on different levels of evolution has to be solved now. PMID- 3294028 TI - The effect of oxygen toxicity and cigarette smoking on the binding of heterologous antibodies to alveolar basement membrane in the rat. AB - It has been suspected that pulmonary lesions of the Goodpasture type may be the result of circulating antibodies to alveolar basement membrane and that environmental factors such as cigarette smoke may influence antibody binding. Carefully designed experiments in this study have shown that exposure to cigarette smoke for 3 weeks or 100% oxygen for 65 h did not influence the binding of heterologous antibodies to alveolar basement membrane in Wistar rats, nor did these regimes increase any pathological changes associated with the antibody binding as detected by light microscopy. The results which are at variance with other reported findings are discussed with reference to reported animal models of antibody mediated pneumonitis and Goodpasture's syndrome in man. PMID- 3294030 TI - Super-high sensitivity systems for detection and spectral analysis of ultraweak photon emission from biological cells and tissues. AB - In this paper we summarize and discuss the modern technology and systems, studied and established by our research group, for performing the detection and special analysis incorporated with the super-high sensitivity photon counting method for the study of ultraweak photon emission; for example, extra-weak bioluminescence and chemiluminescence from living cells and tissues, closely related to biochemical and biophysical processes and activities. An excellent sensitivity of the basic photon counting system, making it possible to achieve count rates in the very low range of one photoelectron per second to one per minute, allowed us to carry out in vivo as well as in vitro measurements, and analyses of ultraweak bioluminescence and chemiluminescence. Recent results concerning ultraweak photon emission from blood samples and organ homogenates of rats are presented and reviewed as one of the interesting and valuable applications of our modern technology for studying ultraweak cell and tissue radiation. PMID- 3294031 TI - Luminescence research and its relation to ultraweak cell radiation. AB - The fundamental laws of photochemistry and the essential results of experimental research on ultraweak cell radiation are presented. By comparing all the facts it can be concluded that the phenomena discussed may arise from a variety of possible reactions and sources. Recombination reactions of certain radicals actually do release sufficient energy to generate UV-photons of the intensity under consideration. On the other hand, stimulated emission cannot be excluded in view of the distinct deviation of the radiation field from thermal equilibrium. There exist, however, various other candidates, such as direct emitters like flavins, indoles, porphyrins, carbonyl derivatives and aromatic compounds, and molecular oxygen and its various species, as well as collective molecular interactions, e.g. dimole or exciplex transitions, triplet-triplet annihilation, collective hydrolysis, electric field effects in membranes, etc. Careful biochemical and biophysical experiments are still necessary to find answers to all the questions that remain; not only individual problems have to be solved, but it is important to keep in mind the interrelationships between certain reactions. PMID- 3294032 TI - Photobiochemistry without light. AB - Efficient excited state formation - much higher than that hitherto expected - may occur in organelles and in intact cells. Excited triplet states can be enzymatically generated in high yields by different routes. An example is the oxidation of isobutanal to acetone and formic acid, catalyzed by horseradish peroxidase. Other enzymatic systems that generate triplet carbonyls are linear aliphatic aldehydes when oxidized by peroxidase/O2, or the indole-3-acetic acid/peroxidase/O2-reaction. The latter is widespread in plants. This new field - photobiochemistry without light - has led to a growing awareness of the idea that cells may utilize excited states to trigger photochemical processes even in the dark. Such phenomena are of considerable importance, also for the understanding of weak photon emission from biological systems. PMID- 3294033 TI - Physical aspects of biophotons. AB - By comparing the theoretically expected results of photon emission from a chaotic (thermal) field and those of an ordered (fully coherent) field with the actual experimental data, one finds ample indications for the hypothesis that 'biophotons' originate from a coherent field occurring within living tissues. A direct proof may be seen in the hyperbolic relaxation dynamics of spectral delayed luminescence under ergodic conditions. A possible mechanism has to be founded on Einstein's balance equation and, under stationary conditions, on energy conservation including a photochemical potential. It is shown that the considered equations deliver, besides the thermal equilibrium, a conditionally stable region far away from equilibrium, which can help to describe both 'biophoton emission' and biological regulation. PMID- 3294035 TI - Effective pulmonary capillary pressure. PMID- 3294034 TI - Regulatory aspects of low intensity photon emission. AB - Photon emission from unicellular and multicellular organisms has been a subject of study for many decennia. In contrast to the well-known phenomenon of bioluminescence originating in luciferin-luciferase reactions, low intensity emission in the visible region of the electromagnetic spectrum has been found in almost every species studied so far. At present, the nomenclature of this phenomenon has not crystallized and it is referred to by a variety of names, such as mitogenetic radiation 29, dark luminescence 7, low-level chemiluminescence 20,36, and biophotons 57. Particular attention has been focussed on the relationship between photon emission and the regulation of various aspects of cellular metabolism, although in many cases quantitative data are still lacking. Throughout the history of this field of research the question of a functional biological role of the low intensity emission has been repeatedly raised; this is reflected, for instance, in the heterogeneity of the terms used to describe it. The discussion concerns the possible participation of photons of low intensity in intra- and intercellular communication. This paper reviews literature on the metabolic regulation of low intensity emission, as well as the regulation of photon emission initiated by external light. Furthermore, recent data are discussed with respect to a possible biocommunicative function of low intensity photon emission. PMID- 3294037 TI - Respiratory epithelial permeability is unrelated to bronchial reactivity and small airway function in young smokers and nonsmokers. AB - We studied eight young smokers and ten nonsmokers, to determine whether respiratory epithelial permeability to radiolabelled diethylenetriamine penta acetate (99mTcDTPA) was related to small airway function or bronchial reactivity. Permeability was measured in inner (containing central airways) and outer lung zones by gamma camera. Lung-to-blood half-time (LB-T1/2) was corrected for blood background. Histamine was inhaled tidally (2 min inhalations) using doubling concentrations from 2 to 64 mg.ml-1. Results of small airway function tests, and of bronchial reactivity (expressed as the threshold concentration (reducing forced expiratory volume in one second (FEV1) by 2 SD), and as the percentage reduction in FEV1 after histamine 16 mg.ml-1) were similar in smokers and nonsmokers. LB-T1/2 was shorter in smokers than in nonsmokers in both inner (median (range) 21 (5.5-33) vs 63.5 (41-115) min; p less than 0.004) and outer (20.5 (5.5-30) vs 58.5 (39-105) min; p less than 0.004) zones. Neither inner nor outer zone LB-T1/2 was related to small airway function or bronchial reactivity. Bronchial reactivity and small airway tests may be abnormal in middle-aged smokers, but neither is related to the increased respiratory epithelial permeability of young smokers, in whom it appears too sensitive an index of airway integrity. PMID- 3294036 TI - Nocturnal asthma: slow-release terbutaline versus slow-release theophylline therapy. AB - In a double-blind cross-over study, the effects of slow release (S-R) terbutaline tablets (b.i.d. 0.25 mg/kg per day) and S-R theophylline (5.31 mg/kg morning and 10.62 mg/kg evening) were compared in eleven patients with nocturnal asthma. On day seven of each treatment period, drug serum concentrations and peak expiratory flow (PEF) were measured every 2h over a 24-h period. During daytime, terbutaline concentrations ranged from 1.6-14.1 (median 4.5) microgram/l and during the night from 2.1-18.7 (median 4.9) micron/l. Theophylline concentrations ranged from 3.9 24.3 (median 11.5) mg/l during the day and from 3.3-20.9 (median 10.4) mg/l at night. Nocturnal wheezing occurred during theophylline treatment in four patients 7 times and during terbutaline treatment in six patients 22 times. Daytime PEF values were 472 +/- 161 l/min during theophylline therapy versus 445 +/- 169 l/min during terbutaline therapy (p less than 0.05). In the night and early morning there was no significant difference between PEF values with the two treatment forms. During theophylline treatment, fewer inhalations of beta 2 sympathomimetics were used, and there were fewer side effects. One patient experienced severe asthmatic attacks during the terbutaline treatment period. The patients preferred theophylline for the treatment of nocturnal asthma. PMID- 3294038 TI - Reduction in days of illness after long-term treatment with N-acetylcysteine controlled-release tablets in patients with chronic bronchitis. AB - The clinical effect of N-acetylcysteine (NAC) controlled-release tablets, 300 mg b.i.d., and placebo, in chronic bronchitis was investigated. The study was performed as a double-blind six month comparison between active drug and placebo in two parallel groups, with statistical evaluation after four and six months. The patients were chosen from nine centres. One hundred and sixteen out-patients were included and ninety one of them completed the six month study. The acetylcysteine-treated group had a significantly reduced number of sick-leave days caused by exacerbations of chronic bronchitis after the four winter months December-March compared with the control group (NAC 173, placebo 456). The number of exacerbation days was also very much reduced, however, not significantly (NAC 204, placebo 399). At the end of the six month trial, including also two spring months, the absolute numbers of sick-leave days and exacerbation days were still fewer in the acetylcysteine-treated group, (NAC 260, placebo 739) and (NAC 378, placebo 557) respectively. This study demonstrates a significant reduction in sick-leave days after four months of NAC-treatment. A constant tendency to reduction in the number of exacerbations and exacerbation days was also registered after four and six months. The differences in these parameters were, however, not statistically significant. This was probably due to the small number of patients participating. PMID- 3294039 TI - Open and closed adoption: a developmental conceptualization. AB - Given the annual increase in the multiple forms of adoptive practices within contemporary American society, research aimed at assessing the effects on the adoptees, their families, and the community of "open" versus "closed" adoption (communication versus no communication between biologic and adoptive parents) of healthy infants is sorely needed. Before this can be done, researchers and mental health professionals need to make sense of the myriad of findings in the adoption literature. With the goal of stimulating such research, the present article is comprised of: (a) a review of the contemporary, social scientific literature on adoption, which has focused for the most part on traditional, closed adoption; and (b) a description of a program of research on adoption that is generated from a theoretical orientation, which has already proven valuable in the examination of other developmental life transitions. Based on a holistic, developmental, systems orientation to person-in-environment functioning, this approach provides a developmental conceptualization of both open and closed adoption. Hopefully, the literature review and the research program described here will stimulate other investigators to conduct research on this important problem from their own perspective or from variations of research described in this article. PMID- 3294040 TI - Synthesis and biological activity of some pyrrole derivatives. I. AB - The synthesis of some 5-substituted 2-amino-3-cyano (and 3-carboethoxy)pyrroles is described starting from the cyano- and carboethoxyacetomidines and the alpha halogeno ketones. The compounds tested in vitro as antimicrobial agents did not show any significative activity. PMID- 3294041 TI - Chemotherapeutic agents with an imidazole moiety. II. Synthesis and biological activities of new 1,4-diarylimidazoles. AB - The synthesis, antifungal and pharmacological activities of new 1,4 diarylimidazoles are reported. Antimicrobial data in comparison with antifungal antibiotic pyrrolnitrin pointed out that the 1,4-diaryl-2-mercaptoimidazole derivatives were inactive and all 1,4-diarylimidazoles exhibited a weak antifungal activity. Some compounds showed a selective activity against strains of Candida sp. Instead pharmacological data did not evidence any significant antiinflammatory activity. The tested compounds were prepared by reacting appropriate phenacylanilines with potassium thiocyanate in acidic medium to afford 1,4-diaryl-2-mercapto imidazoles which were then transformed into title compounds by treatment with nitric acid. PMID- 3294042 TI - The role of hyperinsulinemia in the pathogenesis of ovarian hyperandrogenism. AB - The evidence that supports the hypothesis that insulin and LH both regulate ovarian androgen production was presented. The most dramatic clinical example of the association between hyperinsulinemia and hyperandrogenism is the HAIR-AN syndrome. Our hypothesis is that, in the HAIR-AN syndrome, the severe insulin resistance causes a compensatory hyperinsulinemia, which stimulates ovarian androgen production if adequate LH is present. The acanthosis nigricans is an epiphenomenon of the syndrome. Acanthosis nigricans is a dermatologic manifestation of severe insulin resistance. In vitro evidence suggests that insulin and IGF-I stimulate androgen production in incubations of human stroma and theca. The stromatropic effects of insulin may sensitize the stroma to the stimulatory effects of LH. In some hyperandrogenic-insulin-resistant women, a glucose load appears to produce an acute rise in circulating androgens. The magnitude of the rise in circulating androgens is proportional to the magnitude of the insulin response to the glucose load. These data suggest that hyperinsulinemia may play a central role in the development of ovarian hyperandrogenism. PMID- 3294043 TI - Characterization of leukocyte subpopulations in the peritoneal fluid of women with endometriosis. AB - Monoclonal antibodies identifying leukocytes subpopulations were applied to smears of laparoscopically collected peritoneal fluid leukocytes and parallel samples of peripheral blood leukocytes from women with endometriosis (n = 33), those with unexplained infertility (n = 9), and fertile controls (n = 8). Peripheral blood leukocyte profiles in all groups were indistinguishable from reported normal values. Peritoneal fluid leukocyte profiles were observed to be different between groups. The most significant elevations in total leukocytes, macrophages, helper T lymphocytes and natural-killer cells were observed in women with stage I and II endometriosis. Significantly elevated levels of total leukocytes, macrophages, and T lymphocytes were also observed in peritoneal fluid from women with unexplained infertility. The results from this study indicate that the peritoneal environment is immunologically dynamic and suggest that cellular immune mechanisms may contribute to reproductive failure in women with endometriosis and unexplained infertility. PMID- 3294044 TI - Successful gamete intrafallopian transfer following failed artificial insemination by donor: evidence for a defect in gamete transport? AB - Gamete intrafallopian transfer (GIFT) was offered as an alternative treatment to 48 women who failed to conceive after artificial insemination with donor semen (AID) in numerous attempts (9 to 24 cycles). The evaluation of these women showed no major cause of infertility as evidenced by normal endocrine, cervical, uterine, and tubal factor studies. Their partners were either azoospermic or severely oligoasthenospermic. During the GIFT cycle, follicular development was induced with (1) clomiphene citrate (days 3 to 7) plus human menopausal gonadotropins (hMG) from day 6 on or (2) human follicle-stimulating hormone (days 3 to 4) plus hMG (day 5 on), until ultrasound revealed 2 follicles 16 mm and serum estradiol (E2) was greater than 700 pg/ml. Human chorionic gonadotropin (hCG) 10,000 IU was administered, and 36 hours later follicular aspiration was performed. One to three oocytes and 100,000 motile sperm were transferred to each fallopian tube through the fimbria via laparoscopy or minilaparotomy. Twenty seven clinical pregnancies were achieved (56%) per GIFT cycle. Eight miscarriages occurred during the first trimester (29% of all pregnancies), whereas no ectopic pregnancies were observed. These data conclusively show the value of the GIFT procedure in the treatment of cases with failed AID. PMID- 3294045 TI - Fertilization of human oocytes in relation to varying delay before insemination. AB - Fertilization and pregnancy rates in an in vitro fertilization and embryo transfer program were studied after a range of insemination times of between 1 and 26 hours after oocyte recovery. There was no significant variation in fertilization rate across this range. The pregnancy rate showed no significant variation for insemination between 3 and 16 hours after aspiration. However, it was disappointing at 2 hours (3%), and no pregnancies were achieved from the nine patients whose ova were inseminated 20 or more hours after aspiration. It is concluded that mature oocytes can be inseminated in vitro at any time between 3 and 16 hours after aspiration and still retain the same potential to produce a pregnancy. PMID- 3294046 TI - Effectiveness of varicocelectomy in varicoceles diagnosed by physical examination versus Doppler studies. AB - The purpose of this study is to compare the effectiveness of varicocelectomy for improving the spermogram in treating varicoceles diagnosed by physical examination and those diagnosed by Doppler but with a negative physical examination. The charts of 112 patients were retrospectively analyzed and the patients divided in two groups: group A, where the varicocele was detected by physical examination, and group B, where physical examination was negative but Doppler studies revealed the presence of stasis or backflow in the pampiniform plexus of the spermatic veins. In subjects complaining of infertility, the two groups were similar with regard to age distribution and duration of infertility. After varicocelectomy, 85% of patients in group A had improved spermogram, compared with only 27% in group B. This difference was statistically significant (P less than 0.0001). PMID- 3294048 TI - [Hemodynamics at the time of sleep and two-dimensional distribution of its physiological parameters]. PMID- 3294047 TI - Ultrasonography in the differential diagnosis of "double" uteri. AB - A total of 43 infertile patients with hysterosalpingographic diagnosis of bifid uterus underwent sonography and subsequent laparoscopy/hysteroscopy to evaluate the capacity of ultrasound to demonstrate the peritoneal profile of the malformed uteri correctly. Sonographic visualization was adequate in 39 cases (90.7%) and the following were identified correctly: 1 of 2 didelphic uteri, all of 11 bicornuate uteri, all of 4 complete septate uteri, and all of 22 partial septate uteri. The sensitivity of ultrasound in detecting the presence of a perimetrial fundal notch was 92.3% and its specificity 100%. Thus, a precise differential diagnosis of "double" uteri was possible with this technique, which may in some clinical situations provide an alternative to laparoscopy. PMID- 3294049 TI - Anti-L3T4 monoclonal antibodies prolong survival of Ia-antigen disparate skin allografts. AB - Administration of monoclonal antibodies against L3T4 determinant significantly prolongs survival of Ia antigen-disparate skin allografts in mice. On the contrary, anti-Lyt-2 monoclonal antibodies had no suppressive effect on the rejection of skin allografts in the same model. These findings are different from the previous observations made in the strain combinations with disparities only in the class I antigens, in which anti-Lyt-2, but not anti-L3T4, antibodies were effective in suppression of allotransplantation reactions, and show that different cell populations are responsible for rejection of skin allografts disparate in class I or class II antigens. PMID- 3294050 TI - Polyclonal B cell anergy induced by bacterial lipopolysaccharide and cyclophosphamide. AB - Tolerogenic treatment of mice by successive injections of lipopolysaccharide (LPS) from E. coli or S. marcescens and cyclophosphamide (CY) decreased both the specific and polyclonal responses to tolerogen and to irrelevant LPS from Br. abortus as well as the specific immune response to sheep red blood cells. Splenocytes of tolerant mice were unresponsive to polyclonal challenge when transferred to irradiated syngeneic recipients. Spleen cells or blood serum from tolerant mice did not suppress the polyclonal response of intact mice to LPS. Possible reasons for the polyclonal B cell anergy were analyzed. PMID- 3294051 TI - [Pancreatic polypeptide response to oral glucose load in patients with liver cirrhosis--interrelationship between PP and other pancreatic endocrine hormones]. AB - The purpose of the present study was to elucidate the interrelationship between pancreatic polypeptide (PP) and other pancreatic endocrine hormones. For this purpose, a radioimmunoassay (RIA) system of plasma PP was established and the changes in plasma PP, plasma immunoreactive insulin (IRI), plasma C-peptide reactivity (CPR) and plasma immunoreactive glucagon (IRG) following oral administration of glucose were examined in ten normal subjects and twenty-five patients with liver cirrhosis. Patients with liver cirrhosis were classified into a normal glucose tolerance group (NGT), an impaired glucose tolerance group (IGT), and a diabetes mellitus group (DM) on the basis of the glucose tolerance curves obtained after the oral administration of glucose. In the IGT and DM groups, fasting plasma PP levels were significantly elevated when compared with those in the control and NGT groups. Also oral administration of 75g glucose elicited an exaggerated rise in plasma PP in the IGT and DM groups when compared with the response in the control and NGT groups. On the other hand, PP response to glucose in the NGT group was similar to that in the control group. Plasma IRI increased markedly before and after oral administration of glucose in the IGT and DM groups when compared with the control groups. In these patients, plasma levels of CPR almost paralleled those of IRI. No significant difference was noted between the NGT group and the control group with regard to plasma IRI and CPR levels before and after oral glucose loading. Accordingly, insufficient insulin action was considered to exist in the IGT and DM groups. This insufficiency in insulin action was expressed in terms of the indices of increase in plasma IRI and CPR, delta IRI/delta BS and delta CPR/delta BS, which corresponded to the elevated blood glucose levels, being significantly lower in the IGT and DM groups than in the control and NGT groups 30 minutes after oral administration of glucose. No significant difference was noticeable between the NGT group and control group with regard to these indices. In the patients with liver cirrhosis, the delta PP value, obtained by subtracting the plasma PP level during fasting from the PP level 30 minutes after oral glucose loading, was inversely correlated with the values of both delta IRI/delta BS and delta CPR/delta BS.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3294054 TI - Old people and surgery. PMID- 3294052 TI - [Perifusion of monolayer-cultured B cells of the infant rat: a comparative study of the effects of 2-deoxy-2-fluoroglucose and iodoacetic acid]. AB - Cell culture techniques for monolayer islets of 3-week-old rat pancreases and the responsiveness of B cells are described. In this procedure, whole pancreatic tissues from 3-week-old rats were enzymatically dispersed and then cultured in a medium with 5.5 mM glucose plus 1 mM 2-deoxy-2-fluoroglucose or with 5.5 mM glucose following a 3-day exposure to a medium with 5.5mM glucose plus 5 microM iodoacetic acid. The use of 2-deoxy-2-fluoroglucose or iodoacetic acid allowed a selective deletion of fibroblasts, yielding large clusters that consisted mostly of islet cells. The immunocytochemical evaluation of the islet cells in these cultures showed that approximately 70% are B-cells, 20% A-cells, and 10% D-cells. On day 0, the response to 16.7 mM glucose included only a small rise in insulin secreted during the first and the second phase, and the response to 10 mM of leucine or 2-ketoisocaproate was monophasic. After being cultured for 7 days, all three secretagogues markedly stimulated insulin secretion by B cells cultured in both media, resulting in an enhancement of the biphasic pattern. However, quantitative relationships differed. Thus, the total response from B cells in 2 deoxy-2-fluoroglucose during a 30-min stimulation with glucose and leucine was significantly higher (1.6- and 1.9-fold respectively) than that from B cells in 5.5 mM glucose, although there was no significant difference in insulin secretion evoked by 2-ketoisocaproate. Furthermore, in the former B cells, the amount of insulin secreted during the second phase was 84-94% of the total insulin secretion, and in the latter it was 66-76%. Addition of 1 mM 3-isobutyl-1 methylxanthine and 10 microM forskolin resulted in a significant increase in insulin secretion by B cells in 2-deoxy-2-fluoroglucose, whereas there was no difference in the increase of insulin secretion induced by 16.7 mM glucose and 200 nM 12-o-tetradecanoyl phorbol-13-acetate. In monolayer cultures that had been maintained in both media for 15 days, the second phase of insulin secretion due to the secretagogues was slightly decreased, but the biphasicity in the response was well preserved. In conclusion, the present results suggest that B cells of 3 week-old rats may be still immature, and that the medium with 2-deoxy-2 fluoroglucose is beneficial to the continued maturation of the B-cell function in vitro. PMID- 3294055 TI - Health care of the elderly: infinite promise in a world of limited resources. PMID- 3294053 TI - The dietary effects of gellan gum in humans. AB - Following a 7-day control period, five female and five male volunteers consumed a weight of gellan gum corresponding to 175 mg/kg body weight for 7 days, followed by 200 mg gellan gum per kg body weight for a further 16 days. Measurements before and at the end of the 23-day test period showed that the gellan gum acted as a faecal bulking agent for the male volunteers and for four of the females. Dietary transit time increased for 2 females and 2 males, and decreased for 3 females and 3 males. Faecal bile acid concentrations increased for 4 females and for 4 males; the average increases were from 0.69 to 0.83 mmol/24 h (females) and from 1.22 to 1.44 mmol/24 h (males). Gellan gum ingestion had no significant effect on (a) plasma biochemistry parameters; (b) haematological indices; (c) urinalysis parameters; (d) blood glucose and plasma insulin concentrations; (e) breath hydrogen concentrations. There were no significant changes in HDL cholesterol, triglyceride or phospholipid concentrations. Serum cholesterol concentrations decreased significantly (P less than 0.1) by 13% on average for females, and by 12%, on average, for males. The data indicate that the ingestion of gellan gum at a high level for 23 days caused no adverse dietary or physiological effects in any of the volunteers. In particular, the enzymatic and other indicators of adverse toxicological effects remained unchanged. PMID- 3294056 TI - Infant mortality by father's occupation from the 1911 census of England and Wales. AB - Infant mortality in England and Wales only began its secular decline at the beginning of this century, although mortality among those aged 1-4 began to decline earlier. The 1911 Census of Fertility provides the basis for estimates of infant mortality among occupational groups. A diagrammatic model of decline is elaborated, using fertility decline, social class, income, and urban/rural distribution as explanatory variables. Results of the analysis suggest that infant mortality decline, whose average value was 35 percent from a peak of 132 per 1,000, was increased by improvements in the urban environment and advanced by high or regular income, whereas fertility decline had only a small effect. PMID- 3294058 TI - Sexual dimorphism of pituitary gonadotropes during postnatal development in the rat. AB - In the present study both the reverse hemolytic plaque assay for detecting luteinizing hormone (LH) secretion from single cells and LH immunocytochemistry (ICC) were applied to conduct quantitative studies on sexual differences in the gonadotrope population during postnatal development. Pituitary glands from both sexes at different ages were monodispersed with 0.1% trypsin. Freshly dispersed cells were incubated in Cunningham chambers in the presence of 10(-7) M gonadotropin-releasing hormone (GnRH) for measurement of the fraction of plaque forming cells and the mean size of plaque formed, or attached to glass slides for measurement of the fraction of cells staining for LH by ICC. The percentage of immunostained LH cells increased with age in both sexes from about 5% of the total pituitary cell population at 5 days of age to a plateau of about 10% by 15 days and then fell to the adult level of about 5%. There were no significant sexual differences except at 30 and 40 days of age. In female rats the fraction of LH-secreting cells detected by plaque assay matched closely with that of LH containing cells detected by ICC. However, there were significant sexual differences in the percentage of LH-secreting cells at day 15 through day 40. The mean LH output from individual cells of both sexes as indicated by the mean size of plaques also increased with age and reached a peak around 50 days. The sexual differences were first seen around 30 days of age with greater amounts in the female than in the male.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294057 TI - Stimulation of glucose transport in cultured uterine cells by rat and rabbit uterine extracts. AB - Estradiol-17 beta was previously shown to stimulate glucose transport (as measured by phosphorylation of 2-deoxyglucose) in rat uterine tissue in vivo (Meier, D.A. and Garner, C.W. (1987) Endocrinology 121, 1366-1374) but attempts to demonstrate this in uterine organ strips in vitro, in uterine tumor cell lines or in uterine cells in primary culture have been unsuccessful. However, aqueous uterine extracts and uterine luminal fluid did stimulate glucose transport in uterine tumor cells and uterine cells in primary culture. Estradiol in vivo and uterine extracts in vitro each increased the initial rate of glucose transport 1.5- to 3-fold. In each case, 2-3 h were required for the stimulation to be fully expressed. The stimulation was not inhibited by cycloheximide suggesting that protein synthesis was not required. Uteri from ovariectomized rats injected daily for 4 days with 10 micrograms estradiol contained 4-fold more activity than uteri from saline-injected control animals. The activity was acid- and heat-stable, inactivated by trypsin treatment but not removed by dextran-coated charcoal treatment, suggesting that the activity is (or is associated with) a protein. The activity eluted in the 6-12 kDa range upon chromatography on Sephadex G-50. Insulin (1-1000 ng/ml) and epidermal growth factor (1-100 ng/ml) stimulated glucose transport, but only less than 50% of the stimulation by extracts. The substance(s) present in the extracts, possibly a known growth factor, may be involved in the estradiol stimulation of glucose transport and other estradiol actions in vivo. PMID- 3294059 TI - Role of proteoglycans in renal development. AB - The role of proteoglycans (PGs) in morphogenesis was investigated. Fetal kidneys were obtained from 13-day-old mouse embryos and maintained for 7 days in culture. The biosynthesis of PGs was perturbed by addition of p-nitrophenyl-beta-D xylopyranoside in the culture medium. The kidneys were processed for morphological and biochemical studies. The morphological studies included staining of tissues with anti-basement membrane antibodies and ruthenium red. [35S]sulfate was used as the precursor product for biosynthetic and autoradiographic studies. The kidneys treated with xyloside had loose mesenchyme, inhibition of ureteric bud branching, diminution in the population of developing nephron elements, decreased immunofluorescence with anti-proteoglycan antibodies and staining with ruthenium red, and a reduced [35S]sulfate incorporation into poorly organized extracellular matrices. The biochemical studies included characterization of PGs/glycosaminoglycans (GAGs) by Sepharose CL-4B, -6B, and DEAE-Sephacel chromatographies and cellulose acetate electrophoresis. Under the influence of xyloside, the total radioactivities decreased 2 to 4-fold in tissues and increased 18 to 42-fold in media fractions. A reduction in the size of macromolecular form of PGs, i.e., from MW approximately 2.5 X 10(6) to approximately 2.5 X 10(4), was noted. The PGs/GAGs synthesized were mainly made up of heparan sulfate and small amounts of chondroitin sulfate. They eluted at a lower salt concentration as compared to the controls. A similar diminution in the size of media PGs, i.e., from MW approximately 1.8 X 10(5) to approximately 2.8 X 10(4), was observed. Additional studies with [3H]xyloside indicated that the chains initiated on xyloside residues were similar in size and composition to GAG chains. These findings indicate that a perturbance in the biosynthesis of PGs/GAGs leads to abnormalities in renal organogenesis. PMID- 3294060 TI - Morphological differentiation of embryonic rat sympathetic neurons in tissue culture. I. Conditions under which neurons form axons but not dendrites. AB - We have examined the morphology of fetal rat sympathetic neurons grown in serum free medium in the absence of nonneuronal cells. Because cell density can affect phenotypic expression in vitro, the morphological analysis was subdivided into the study of isolated neurons (neurons whose somata were at least 150 micron from their nearest neighbor) and of more highly aggregated neurons. When isolated neurons were injected with intracellular markers, it was found that most (79%) had a single process emanating from their somata and that this unipolar state persisted for at least 8 weeks in vitro. The processes of unipolar sympathetic neurons had the appearance of axons in that they were thin and long, had a constant diameter, and were relatively unbranched. Cytochemical methods revealed that such processes had other axonal characteristics: (1) they were more reactive with a monoclonal antibody against phosphorylated forms of the M and H neurofilament subunits than with an antibody to nonphosphorylated forms of these proteins; (2) they also reacted with antibodies to the tau microtubule-associated protein and to the phosphorylated forms of the H neurofilament subunit; and (3) they contained only small amounts of RNA as determined by [3H]uridine autoradiography. These data indicate that neurons which normally form dendrites in vivo need not express this capacity in vitro and that axonal and dendritic growth can be dissociated under some conditions in culture. While most isolated neurons were unipolar, neurons in regions of high neuronal cell density were usually multipolar. In addition to axons, multipolar neurons had processes with some of the characteristics expected of rudimentary dendrites: they ended locally (usually within 100 micron), were often highly branched, and reacted with an antibody to nonphosphorylated forms of the M and H neurofilament subunits. The effects of density were most prominent when neurons were within aggregates in which the somata were in close apposition. Density-dependent changes in morphology were less frequently observed when neuronal somata were separated by greater distances (30-100 micron). These data indicate that the morphology of sympathetic neurons is subject to environmental regulation and that neuron-neuron interactions can promote the extension of rudimentary dendrites in vitro. PMID- 3294062 TI - Acquisition of type IX collagen by the developing avian primary corneal stroma and vitreous. AB - Previous investigations from our laboratory and others have demonstrated that type II collagen, once thought to be a cartilage-specific molecule, is also a component of both the primary corneal stroma and the vitreous of embryonic chickens. In the present immunohistochemical study we have examined the expression in these embryonic matrices of another "cartilage-specific" collagen, type IX, along with type II. In the cornea, type IX collagen is in the primary stroma, but is not detectable in the mature, secondary stroma. Even within the primary stroma this collagen has a brief, transitory existence. It first appears in the peripheral stroma at the time the endothelial cells begin to migrate along its posterior surface, and spreads throughout the stroma during the following 24 36 hr. The epitopes on type IX collagen then suddenly become undetectable just before this matrix swells and becomes populated by the periocular mesenchymal cells (future keratocytes). In comparison, collagen type II (along with type I) is present in the stroma before and long after these events. Deposition of immunodetectable type IX collagen in the developing corneal stroma thus seems to be independent of type II. In the vitreous, we observed type IX collagen along with type II as soon as authentic vitreous could be identified and at all subsequent stages of development. In this tissue, therefore, the expression of collagen types IX and II appears to be coordinate. PMID- 3294061 TI - Morphological differentiation of embryonic rat sympathetic neurons in tissue culture. II. Serum promotes dendritic growth. AB - In the preceding paper, we reported that embryonic rat sympathetic neurons formed axons, but not dendrites, when they were maintained in the absence of serum and nonneuronal cells. To assess the effects of serum-derived factors on cellular morphology, cultures were initially maintained in serum-free medium while nonneuronal cells were eliminated. Subsequently some cultures were chronically exposed either to fetal calf serum (10%) or to a high-molecular-weight ammonium sulfate fraction of serum (P40 material, 500 micrograms/ml). Phase-contrast microscopy revealed that serum and P40 material did not alter neuronal survival, but did cause flattening of the somata and fasciculation of processes. When neurons exposed to serum or P40 material were injected with Lucifer Yellow, it was found that the majority (greater than or equal to 90%) had local, tapered processes that could be identified as dendrites by light microscopic criteria. These local processes also exhibited other dendritic characteristics in that (1) they reacted with monoclonal antibodies to nonphosphorylated forms of the M and H neurofilament subunits and to microtubule-associated protein 2; and (2) they had substantial amounts of RNA as determined by [3H]uridine autoradiography. Quantitative measurements of the effects of serum and P40 material on dendritic morphology revealed that (1) an 8-day exposure caused most neurons (greater than 80%) to form dendrites; (2) neurons typically had more than one dendrite (mean of 4.1 +/- 0.2 dendrites/cell after a 28-day exposure); and (3) the dendrites were relatively short with the maximum extent of the dendritic arbor being 110 +/- 13 micron after 4 weeks. Serum and P40 material did not routinely cause the formation of supernumerary axons, did not alter radial axonal outgrowth from ganglion explants, and did not significantly increase [3H]leucine incorporation. Thus, serum contains a factor (or factors) which selectively stimulates the extension of dendrites, but not axons. If such a factor were operative in situ, it could play an important role in determining the morphology of sympathetic neurons. In examining the mechanism of serum-induced dendritic growth, we found that even high concentrations (5 micrograms/ml) of nerve growth factor failed to promote dendritic growth in the absence of serum; thus, nerve growth factor by itself is not a sufficient condition for the extension of dendrites.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3294063 TI - Developmental regulation of a conidiation specific beta-tubulin in Aspergillus nidulans. AB - A beta-tubulin gene previously suggested to participate in conidial development in the filamentous fungus Aspergillus nidulans is shown to be developmentally regulated in its expression. A quantitative S1 assay was used to show that the abundance of the tubC messenger RNA increases during conidial development relative to the benA messenger RNA. Morphological analysis of cultures, used to prepare RNA for the S1 analysis, demonstrated that the increase in tubC messenger RNA was directly correlated with the appearance of conidiating cell types and structures and that as these cell types become more prevalent in the culture, the level of the messenger RNA increases. Two-dimensional gel electrophoresis of labeled proteins showed that the relative increase in tubC messenger RNA was reflected in an increase in the tubC protein beta 3. RNA blot hybridization analysis and in vitro translation of total RNA from mycelia and conidia were used to demonstrate that both benA and tubC beta-tubulin messenger RNAs are absent from conidia. PMID- 3294065 TI - Differential expression of the Ca2+-binding protein parvalbumin during myogenesis in Xenopus laevis. AB - We have used immunocytological techniques to examine the developmental expression of the Ca2+-binding protein parvalbumin in Xenopus laevis embryos. Western blot experiments show that at least three different forms of parvalbumin are expressed during embryogenesis; the tadpole tail expresses one form, adult brain expresses another, mylohyoid muscle expresses both, and gastrocnemius and sartorius muscles express these two plus a third form. Parvalbumin (PV) is first detectable by immunofluorescence at stages 24-25 of development, a time when myotomal muscles are differentiating and contractile activity occurs spontaneously in embryos. At metamorphosis, PV is expressed in developing limb muscles. While the majority of skeletal muscle fibers express high levels of PV in both embryos and adults, a second fiber type has no detectable PV. The arrangement of PV-containing fibers is stereotyped in each muscle group examined. Histochemical staining of tadpole muscles indicate that PV-containing fibers correspond to fast-twitch skeletal muscles, whereas those without PV correspond to slow-twitch muscles. During tail resorption at metamorphosis, PV appears to be extruded from dying tail muscle cells and taken up by phagocytic cells. PMID- 3294064 TI - The expression of transthyretin mRNA in the developing rat brain. AB - Specific cDNA and oligonucleotide probes were used to study the appearance of transthyretin mRNA in developing rat brain using Northern gel analysis, cytoplasmic dot hybridization, and in situ hybridization. Transthyretin mRNA in embryonic rat brain was found to be confined to the epithelial layer of the choroid plexus primordia appearing first in the fourth ventricle, followed by appearance in the lateral ventricles, and subsequently in the third ventricle. Transthyretin mRNA was localized in these cells from early stages of neuroepithelium differentiation, showing that it is a sensitive marker for the differentiation of the choroid plexus within the fetal brain. PMID- 3294067 TI - No effect of Pindolol on postural hypotension in type 1 (insulin-dependent) diabetic patients with autonomic neuropathy. A randomised double-blind controlled study. AB - Orthostatic hypotension is one of the most troublesome symptoms in diabetic autonomic neuropathy. Some reports have suggested Pindolol - a beta-adrenoceptor antagonist with intrinsic sympathomimetic activity - to be effective in the treatment of this condition. In order to elucidate the value of this therapy we performed a double-blind placebo controlled cross-over study with Pindolol (15 mg/day). Eight Type 1 (insulin-dependent) diabetic patients with autonomic neuropathy and signs and symptoms of orthostatic hypotension (systolic blood pressure decrease greater than 30 mm Hg when standing) participated in the study. Patients were treated for 10 weeks. Clinical examinations were performed every fortnight and patients registered postural symptoms twice daily on a visual analog scale. No significant changes were seen in blood pressure recordings, heart-rate or visual analog scale registration during treatment with Pindolol compared to placebo. Our study does not support the suggestion that Pindolol is a valuable drug for treatment of diabetic patients with autonomic neuropathy and postural giddiness. PMID- 3294066 TI - Lack of insulinotropic effect of endogenous and exogenous cholecystokinin in man. AB - Intraduodenal phenylalanine administration (333 mg/min over 60 min) released endogenous cholecystokinin in healthy young subjects as demonstrated radioimmunologically and by intraduodenal bilirubin and pancreatic enzyme output. Concomitantly, there was only a small increase over basal in circulating immunoreactive-insulin and immunoreactive-C-peptide concentrations. In healthy volunteers intraduodenal infusions of saline (10 ml/min), glucose (333 mg/min) or phenylalanine (333 mg/min) were performed for 60 min when plasma glucose was clamped at approximately 8 mmol/l. Phenylalanine enhanced immunoreactive-insulin and immunoreactive-C-peptide responses three-fold more than did the same amount of glucose. Immuno-reactive gastric inhibitory polypeptide responses were small and not different after glucose and phenylalanine administration. Immunoreactive cholecystokinin was significantly stimulated to 9.4 +/- 1.4 pmol/l only by intraduodenal phenylalanine. Plasma phenylalanine concentrations increased into the supraphysiological range (approximately 1.5 mmol/l). Intravenous infusions of phenylalanine achieving plasma concentrations of 1.2 mmol/l stimulated insulin secretion at elevated plasma glucose concentrations (approximately 8 mmol/l clamp experiments), but had no effect at basal plasma glucose concentrations. A small increase in cholecystokinin also was observed. Intravenous infusions of synthetic sulphated cholecystokinin-8 leading to plasma concentrations in the upper postprandial range (8-12 pmol/l) did not augment the immunoreactive-insulin or immunoreactive-C-peptide levels during hyperglycaemic clamp experiments, in the absence or presence of elevated plasma phenylalanine concentrations. It is concluded that the augmentation of the glucose-induced insulin release by intraduodenal administration of phenylalanine cannot be related to cholecystokinin release, but rather is explained by the combined effects of elevated glucose and phenylalanine concentrations. In man, cholecystokinin does not augment insulin secretion caused by moderate hyperglycaemia, elevations of phenylalanine concentrations, or combinations thereof. PMID- 3294068 TI - Artificial induction of intravascular lipolysis by lipid-heparin infusion leads to insulin resistance in man. AB - Although extensive evidence indicates that free fatty acids can decrease glucose utilization in vitro, it is still controversial how an increase in lipolysis affects glucose metabolism in man. To test the hypothesis that an increase in lipolysis is related to insulin resistance, we examined the effect of lipid heparin infusion on glucose metabolism in ten normal subjects by the euglycaemic glucose clamp technique and isotopic determination of glucose turnover. In the control euglycaemic clamp studies with insulin infusion at 0.2 and 1.0 mU.kg 1.min-1, endogenous glucose production was suppressed from the basal rate of 2.0 +/- 0.3 mg.kg-1min-1 to 1.1 +/- 0.7 mg.kg-1.min-1 and -0.4 +/- 0.7 mg.kg-1min-1 respectively. Glucose utilization increased from the basal rate of 2.0 +/- 0.3 mg.kg-1min-1 to 2.3 +/- 0.5 mg.kg-1min-1 and 5.9 +/- 1.8 mg.kg-1min-1 respectively. When the euglycaemic clamp studies were coupled with lipid-heparin infusion at comparable low and high rates of insulin infusion, endogenous glucose production increased (1.8 +/- 0.7 mg.kg-1.min-1, p less than 0.001, and 0.3 +/- 0.6 mg.kg-1.min-1, p less than 0.05, respectively), and glucose utilization decreased (2.1 +/- 0.3 mg.kg-1.min-1, not significant, and 3.2 +/- 0.7 mg.kg 1.min-1, p less than 0.001 respectively). These data suggest that the artificial induction of intravascular lipolysis by lipid-heparin infusion leads to a state of insulin resistance in man. PMID- 3294069 TI - Ontogeny of islet cell antibodies, insulin autoantibodies and insulitis in the non-obese diabetic mouse. AB - The predictive value of insulitis, islet cell cytoplasmic antibodies and insulin autoantibodies for insulin-dependent diabetes was studied in young female non obese diabetic mice. The ontogeny of the three markers was examined cross sectionally at days 15, 25, 40 and 90 while islet cell antibodies and insulin autoantibodies were studied longitudinally from day 35 or day 144-168 until approximately day 250. Insulitis was first observed at day 40 (50%) and subsequently at day 90 (70%). Islet cell antibodies and insulin autoantibodies were present at day 15 in 46% and 54% of the animals respectively. The rate of islet cell antibodies was slightly higher at day 25 (60%) than at day 40 (40%) and day 90 (54%) whereas antibodies to insulin were present in all samples from day 25-90. At day 40 and day 90 insulitis and insulin autoantibodies were present together in 42% and 70% of the animals, respectively, while insulitis and islet cell antibodies had a lower rate of concordance (17% and 42%, respectively; diabetes rate, 30%). The concordance rates for islet cell antibodies and insulin autoantibodies were 42% at day 40 and 54% at day 90. Concordance for all three markers was first observed at day 40 (17%) which increased to 38% at day 90. In longitudinal studies, islet cell antibodies and insulin autoantibodies were often present together whether or not diabetes supervened. In the islet cell antibody procedure, immunoreactive cells were shown immunohistochemically to correspond with insulin and/or glucagon cells. However, this staining was not suppressible with insulin- or glucagon- absorbed sera, implying the presence of non-hormonal autoantigens. We conclude that the three markers investigated are expressed early after birth and well before clinical symptoms appear in this animal model. Both islet cell antibodies and insulin autoantibodies preceded insulitis but the prevalence rate for each marker or their degree of concordance was different from the anticipated rate of diabetes in our colony. Consequently, the early expression of the three markers alone is not predictive of diabetes although concordance for the two, or all three markers may be of some value. However, no animal developed diabetes without the prior appearance of both islet cell antibodies and insulin autoantibodies. PMID- 3294071 TI - Motor gasoline toxicity. AB - The toxicology of motor gasoline is reviewed and the subject considered in two ways. First is as a problem involving a widely used commodity material and the second as a model for the study of complex mixtures. Previously reported subchronic and chronic inhalation studies showing primarily nephrotoxicity in male rats are summarized. Questions of experimental design are discussed including sample verification, species, and dose selection and choice of exposure circumstances. Low boiling, highly branched hydrocarbons primarily in the 6 to 10 carbon number range are implicated. Still unanswered is the basis for the response in male rats only and the precise mechanism of action. PMID- 3294070 TI - Altered tissue content of trace metals in diabetic hyperinsulinaemic sand rats (Psammomys obesus). AB - The concentrations of zinc, copper, and chromium in liver, kidney, muscle, bone and serum from control normoinsulinaemic and hyperinsulinaemic sand rats (Psammomys obesus) and from untreated spontaneously hyperinsulinaemic hyperglycaemic sand rats were compared. A chronic hyperinsulinaemic hyperglycaemic state was associated with a significant reduction (p less than 0.01) of zinc concentration in the liver, kidney and muscle but an elevation of zinc content in bone and of chromium in the liver. A hyperinsulinaemic-nor moglycaemic state was not associated with similar changes in zinc concentration in the liver, kidney, muscle and bone. We conclude that in hyperinsulinaemic hyperglycaemic sand rats there is a tendency to zinc depletion in several tissues. This depletion is not solely the result of a hyperinsulinaemic state but may be related to accompanying hyperglycaemia. PMID- 3294072 TI - Experimental evaluation of haloalkanes and liver injury. AB - Potentiation of haloalkane-induced hepatotoxicity by ketones and ketogenic substances is used to illustrate questions that are raised when considering biological interactions involving toxicants. The following characteristics are considered: The effect of the potentiator (ketone or ketogenic agent) on the dose response characteristics of the haloalkane toxicant; the recovery process of the potentiated tissue injury; dose-response characteristics of the potentiators (minimally effective dosages); correlation of the potentiation with blood levels of the potentiator (threshold concentrations). The relative specificity of the haloalkanes for interaction are discussed, as well as the potentiation of various forms of hepatic injury (acute, chronic, necrogenic, and cholestatic). Enhanced bioactivation of the haloalkane toxicant is a major mechanism of action for the potentiator; other possible contributing mechanisms, however, require consideration. Mixtures of haloalkanes, leading to enhanced liver injury, can also be potentiated by ketones. PMID- 3294073 TI - Genotoxicity of complex mixtures: strategies for the identification and comparative assessment of airborne mutagens and carcinogens from combustion sources. AB - Two strategies for assessment of the toxicity of complex mixtures are described and illustrated with examples from genotoxicity studies of complex combustion mixtures. The first, a strategy for identifying biologically active compounds or compound classes in complex mixtures, is called bioassay-directed fractionation and characterization. The identification and assessment of mutagens and potential carcinogens in complex mixtures has been significantly advanced by the use of short-term genetic bioassays. Bioassay-directed fractionation coupled with new analytical characterization methods has provided the tools needed to more efficiently identify potential carcinogens in complex combustion emissions and urban air samples. These studies have shown that a significant portion of the mutagenicity in combustion emissions and urban air is found in fractions more polar than polynuclear aromatic hydrocarbons (PAHs). A second strategy, the comparative potency method, provides an approach to evaluating the relative toxicities of a series of mixtures. The comparative mutagenicity and carcinogenicity of a series of combustion emissions has been assessed using dose response studies in bacteria, mammalian cells, and rodents. Comparative mutagenic and tumorigenic emission rates or emission factors provide a means to directly compare the relative hazard of the sources. This data base has also been used to develop a comparative risk assessment methodology for combustion emissions. PMID- 3294074 TI - Aetiology of acute pharyngitis and clinical response to empirical therapy with erythromycin versus amoxicillin. AB - One hundred and eighty-nine adults with acute pharyngitis had culture and serological evaluation for group A beta haemolytic streptococci (GABHS), Mycoplasma pneumoniae, and Branhamella catarrhalis. Sixteen patients had evidence for infection with GABHS, none for M. pneumoniae, and one for B. catarrhalis. For those with GABHS, there was no significant difference between empirical treatment by erythromycin or amoxicillin. For those without GABHS, empirical treatment with erythromycin appeared to result in a statistically significant reduction in cough and a noticeable but less than significant reduction of other symptoms when compared to empirical treatment with amoxicillin. The new formulation of erythromycin utilized in this study (PCE) may be associated with a reduction in gastrointestinal intolerance from that reported with other erythromycin products. PMID- 3294075 TI - Physiology for general practitioners. 1. Central nervous and endocrine systems. PMID- 3294076 TI - Nutritional disorders in Saudi Arabia: a review. AB - The article reviews the literature on the problem of nutritional disorders in Saudi Arabia. Most of the studies reveal problems of anaemia and a mild to moderate degree of stunting and wasting among preschool children. The causes are, apparently, ignorance and misconception rather than purely economic. Recently, overnutrition has been observed as a problem among the middle and upper class of urban societies. In general, an improvement in the nutritional status of the Saudis has been observed over the last two decades. This is a repercussion of socioeconomic development and improvement in education, dietary habits, and environmental conditions. The time is ripe to create Saudi standards for health and nutrition. These will be used as yardsticks for planning and evaluation of health and nutritional programmes. PMID- 3294077 TI - CAMP-dependent protein kinase: prototype for a family of enzymes. AB - Protein kinases represent a diverse family of enzymes that play critical roles in regulation. The simplest and best-understood biochemically is the catalytic (C) subunit of cAMP-dependent protein kinase, which can serve as a framework for the entire family. The amino-terminal portion of the C subunit constitutes a nucleotide binding site based on affinity labeling, labeling of lysines, and a conserved triad of glycines. The region beyond this nucleotide fold also contains essential residues. Modification of Asp 184 with a hydrophobic carbodiimide leads to inactivation, and this residue may function as a general base in catalysis. Despite the diversity of the kinase family, all share a homologous catalytic core, and the residues essential for nucleotide binding or catalysis in the C subunit are invariant in every protein kinase. Affinity labeling and intersubunit cross-linking have localized a portion of the peptide binding site, and this region is variable in the kinase family. The crystal structure of the C subunit also is being solved. The C subunit is maintained in its inactive state by forming a holoenzyme complex with an inhibitory regulatory (R) subunit. This R subunit has a well-defined domain structure that includes two tandem cAMP binding domains at the carboxy-terminus, each of which is homologous to the catabolite gene activator protein in Escherichia coli. Affinity labeling with 8N3 cAMP has identified residues that are in close proximity to the cAMP binding sites and is consistent with models of the cAMP binding sites based on the coordinates of the CAP crystal structure. An expression vector was constructed for the RI subunit and several mutations have been introduced. These mutations address 1) the major site of photoaffinity labeling, 2) a conserved arginine in the cAMP binding site, and 3) the consequences of deleting the entire second cAMP binding domain. PMID- 3294078 TI - Repair of DNA-containing pyrimidine dimers. AB - Ultraviolet light-induced pyrimidine dimers in DNA are recognized and repaired by a number of unique cellular surveillance systems. The most direct biochemical mechanism responding to this kind of genotoxicity involves direct photoreversal by flavin enzymes that specifically monomerize pyrimidine:pyrimidine dimers monophotonically in the presence of visible light. Incision reactions are catalyzed by a combined pyrimidine dimer DNA-glycosylase:apyrimidinic endonuclease found in some highly UV-resistant organisms. At a higher level of complexity, Escherichia coli has a uvr DNA repair system comprising the UvrA, UvrB, and UvrC proteins responsible for incision. There are several preincision steps governed by this pathway, which includes an ATP-dependent UvrA dimerization reaction required for UvrAB nucleoprotein formation. This complex formation driven by ATP binding is associated with localized topological unwinding of DNA. This same protein complex can catalyze an ATPase-dependent 5'----3'-directed strand displacement of D-loop DNA or short single strands annealed to a single stranded circular or linear DNA. This putative translocational process is arrested when damaged sites are encountered. The complex is now primed for dual incision catalyzed by UvrC. The remainder of the repair process involves UvrD (helicase II) and DNA polymerase I for a coordinately controlled excision resynthesis step accompanied by UvrABC turnover. Furthermore, it is proposed that levels of repair proteins can be regulated by proteolysis. UvrB is converted to truncated UvrB* by a stress-induced protease that also acts at similar sites on the E. coli Ada protein. Although UvrB* can bind with UvrA to DNA, it cannot participate in helicase or incision reactions. It is also a DNA-dependent ATPase. PMID- 3294080 TI - Effect of gastric bubble as a weight reduction device: a controlled, crossover study. AB - In spite of the widespread use of the Garren-Edwards gastric bubble as an adjuvant device in weight reduction, its efficacy has not been established. Therefore, our purpose was to conduct a randomized, double-blind, crossover study of this device in the management of exogenous obesity. The study group consisted of 23 patients, 21 women and 2 men, ranging in age from 21 to 53 yr. Patients were 25%-111% above their ideal body weight. They were studied for 24 wk, consisting of two separate 12-wk evaluation periods. Patients were randomly assigned either to receive the gastric bubble or to have a sham procedure. After the first 12-wk evaluation period, the gastric bubble and sham were administered in crossover fashion, so that those who had received the gastric bubble initially received the sham later and vice versa. The study coordinator remained blind to the kind of treatment, weighed each patient biweekly, enforced dietary counseling, and provided behavior modification. Those who had passed or were found to have a deflated bubble at the end of the treatment period were excluded from the study. Mean weight reduction in the two evaluation periods did not differ significantly. Patients lost 5.4 +/- 1.7 kg (mean +/- SE) during the gastric bubble period and 5.20 +/- 0.8 kg during the sham period. The order of administration of the gastric bubble and sham did not significantly affect the result. The time-course of mean biweekly values, however, revealed that with the gastric bubble, weight loss was significantly greater only during first (p less than 0.005) and second (p less than 0.025) 2-wk evaluation periods. This difference, however, disappeared after the initial 4 wk of treatment. These observations suggest that although gastric bubble implantation reduced weight significantly more than the sham procedure initially, the mean weight loss during 12 wk of evaluation was not different between the two periods. In our opinion, the gastric bubble is of no value as an adjuvant device in weight reduction. PMID- 3294079 TI - Double-blind controlled trial of the Garren-Edwards gastric bubble: an adjunctive treatment for exogenous obesity. AB - Since its approval by the Food and Drug Administration in September 1985, the Garren-Edwards gastric bubble has been extensively used as an adjunct to diet and behavioral modification in the treatment of exogenous obesity. In an attempt to evaluate the efficacy of the Garren-Edwards gastric bubble, a double-blind crossover study was undertaken. Ninety patients were randomized into three groups: bubble-sham, sham-bubble, and bubble-bubble in two successive 12-wk periods. Sixty-one patients completed the entire 24-wk study. All groups participated in ongoing diet and behavioral modification therapy in a free standing obesity program, the members of which were blinded to randomization arms. All patient groups lost weight during this study. The mean cumulative weight loss in pounds at 12 wk was as follows: bubble-sham = 19, sham-bubble = 12, and bubble-bubble = 8; and at 24 wk: bubble-sham = 23, sham-bubble = 16, and bubble-bubble = 18. The mean cumulative change in body mass index (kg/m2) at 12 wk was as follows: bubble-sham = -3.1, sham-bubble = -2.3, and bubble-bubble = 2.9; and at 24 wk: bubble-sham = -3.1, sham-bubble = -3.0, and bubble-bubble = 3.3. Although weight loss occurred more consistently in patients with a Garren Edwards gastric bubble, there were no significant differences between any of the three groups at 12 or 24 wk with respect to weight loss or change in body mass index. The major part of the weight loss noted during this study occurred during the first 12-wk period, irrespective of therapy (bubble or sham). Side effects observed during this study included gastric erosions (26%), gastric ulcers (14%), small bowel obstruction (2%), Mallory-Weiss tears (11%), and esophageal laceration (1%). We conclude that, in this study, the use of a Garren-Edwards gastric bubble did not result in significantly more weight loss than diet and behavioral modification alone in the management of exogenous obesity, and it may result in significant morbidity. PMID- 3294081 TI - Antacids reduce Campylobacter pylori colonization without healing the gastritis in patients with nonulcer dyspepsia and erosive prepyloric changes. AB - Antral biopsy specimens from 89 consecutive patients with nonulcer dyspepsia and erosive prepyloric changes included in a prospective, randomized, double-blind 4 wk study of the effect of an aluminum-magnesium antacid (120 mmol/day) or pirenzepine (50 mg b.i.d.) vs. placebo were examined histologically. Campylobacter pylori (CP) was found by light microscopy of silver-stained sections in 25 patients (28%). Campylobacter pylori-positive patients were on average older than CP-negative patients (p = 0.02). There was a strong association between CP colonization and acute inflammation (p less than 0.001), both being rare in the absence of chronic inflammation. During treatment with antacids, the density of CP decreased (p less than 0.001) without any improvement of the inflammatory reaction. On the contrary, the number of patients with gastritis tended to increase after antacids as compared with placebo (p less than 0.10). A separate analysis showed no symptomatic effect of the drugs. Thus, neither nonulcer dyspepsia nor erosive prepyloric changes are strongly associated with antral CP colonization or acute inflammation. Aluminum-magnesium antacids may suppress antral CP infection without healing the gastritis or relieving symptoms. PMID- 3294082 TI - Liver transplantation for protoporphyria. Evidence for the predominant role of the erythropoietic tissue in protoporphyrin overproduction. AB - Protoporphyria is an inherited disorder of heme biosynthesis characterized by an overproduction of protoporphyrin in the erythropoietic and hepatic tissues, the relative contribution of which in the metabolic disorder has not been directly quantitated. Excess protoporphyrin is eliminated solely by the liver into the bile and feces. We describe the case of a patient with protoporphyria complicated by severe cirrhosis in whom liver transplantation was performed and resulted in almost complete disappearance of skin photosensitivity manifestations and reduction in the level of protoporphyrin in erythrocytes. However, the level of protoporphyrin in feces was not markedly different before and after liver transplantation, which suggests that overproduction of protoporphyrin was unchanged. These findings are consistent with the view that the diseased liver and ensuing low hepatic clearance of protoporphyrin contributed to accumulation of protoporphyrin in the body and that, at least in this patient, the role of the hepatic tissue in the overproduction of protoporphyrin was small in comparison with that of the erythropoietic tissue. PMID- 3294083 TI - [Legal aspects of the sterilization of mentally handicapped patients]. PMID- 3294084 TI - [Immunocytochemical detection of the estrogen receptor and lectin binding sites in tumor cell colonies growing in vitro]. AB - Since it became clear that tumor cell colonies growing in soft agar are closely related to embryonic tumor cells, it has been possible to examine, with the aid of immunohistochemical methods, the behavior of estrogen receptors (ER) and lectin binding sites on those tumor components which determine malignant growth. With this aim in mind, 14 breast cancers, four ovarian cancers, and one corpus cancer with ER concentrations known from DCC studies were cultured in a colony assay. Using immunohistochemical techniques it was possible, after preparing permanent cultures, to demonstrate the estrogen receptors and lectin binding sites on the tumor cell colonies cultured in vitro. PMID- 3294085 TI - [Myocutaneous latissimus dorsi flaps for covering defects in local recurrences of breast cancers or radiation ulcers]. AB - The pedicled myocutaneous latissimus dorsi flap is suitable for covering defects following excision of breast cancer recurrencies or irradiation ulcerations. From its bed it may be extended as far as to the shoulder, the axilla, neck and to the chin. We report on experiences on 12 patients with local breast cancer recurrencies or radiation ulcers. The defects were: 8 times thoracic, twice axillary and one each on the upper arm and supraclavicular area. They could always be covered without tissue tension. Complications occurred with 3 marginal or partial flap necroses with secondary wound healing. All other flaps healed primarily. Flap beds could almost always be closed directly. All patients were free from recurrencies during the follow-up period. The procedure meets the standards of radical tumour surgery, is safe even in poorly vascularised soft tissue areas, and yields acceptable cosmetic results. PMID- 3294086 TI - [Preoperative diagnosis, pathologic anatomy and clinical significance of mucoceles of the appendix from the gynecologic viewpoint]. AB - Owing to their proximity to the true pelvis and their topography, mucoceles of the appendix frequently cause clinical symptoms which call a gynecologic condition to mind. Sonographically, the structures of mucoceles are often similar to those of ovarian tumors. Within 12 months four patients with mucoceles underwent surgery at Heidelberg University Gynecological Clinic following diagnosis of a gynecologic disease (two tentative diagnoses of ovarian carcinoma, one of advanced ovarian carcinoma, one chance finding during Wertheim's operation). The problems of this rare condition are discussed with reference to the clinical findings, the intraoperative site, and the different morphology and maturity. Pathoanatomically and biologically, however, the clinical picture is not uniform. In mucoceles there is an accumulation of mucus with cystic dilatation of the lumen of the appendix. This is usually due to a tumor, which may be anything from a simple mucous membrane hyperplasia with extreme mucous formation, or an adenoma, to a mucilaginous adenocarcinoma. The rupture of a mucocele or metastasization of a carcinoma often lead to peritoneal mucous spread or peritoneal metastasization: in their patterns of distribution these are similar to a pseudomyxoma peritonei or a metastasizing ovarian carcinoma. PMID- 3294087 TI - [Endosonography in extrauterine pregnancy]. AB - 70 women were examined by transvaginal scanning after a pelvic gynecological examination revealed the suspicion of an ectopic pregnancy. In 32 cases a pelviscopy confirmed an extrauterine pregnancy, 29 of those were detected previously by transvaginal scanning. In 29 other patients the suspected diagnosis could be excluded. In 7 women the suspicion of an ectopic pregnancy could neither be confirmed nor excluded by means of transvaginal scanning. However, in those cases controls of beta-HCG presented values less than 5 mU/ml pleading for the non-existance of pregnancy. From the total number of patients examined 10 cases turned out to provide false results, this is equivalent to a failure rate of 13.1%. Transvaginal scanning is a powerful diagnostic tool to detect ectopic pregnancies, potentially helping to avoid the procedure of a pelviscopy in a number of cases. PMID- 3294088 TI - [Vascular abnormalities of the umbilical cord--incidence, significance and possibility for prenatal ultrasonic detection]. AB - Vascular anomalies of the umbilical cord are amongst the most frequent congenital malformations, their incidence being 0.2% to 1.4%. As a result of the latter the risk of occurrence of other malformations and chromosomal anomalies is markedly elevated. Between January 1977 and July 1987 a total of 78 cases (0.51%) of umbilical cord vascular anomalies were recorded at the Department of Gynaecology of the University of Heidelberg. Malformations occurred in 37% of the foetuses involved. 28% showed retarded growth and 9% had an abnormal set of chromosomes. Anomalies of the urinary tract and malformations of the thoracic organs were very frequent. Total mortality after the 28th pregnancy was about 14%. Currently available high-resolution real-time ultrasound equipment can show up even prenatally pathological variations of the umbilical vascular pedicle (e.g. a single umbilical artery). Because of the manifold risk involved, routine ultrasound control is recommended. If this anomaly is diagnosed, the pregnancy should be classified and treated immediately as a high-risk pregnancy. PMID- 3294089 TI - [Length of the cervix in the 2d and 3d trimester: vaginal study versus measurement by perineal scan--an improved indication guide for cerclage?]. AB - In a study made at the Department of Gynaecology of the University of Heidelberg, the cervical length, as measured by vaginal examination, was compared in 100 impatients between the 16th and 40th week of pregnancy with a special ultrasonic examination method termed "perineal scan". Examination results can be considerably simplified, corrected and, above all, increased in objectivity through the use of perineal scan. As a result, in 53 patients in which, clinically, a definite shortening of the cervix was apparent (portio-length 0.5-1 cm), 12 cases (23%) were found by sonography to exhibit a normal finding with a cervical length greater than or equal to 3 cm. Conversely, from 47 patients with either clinically normal findings or clinically minimal cervical shortening (portio-length 1.5-2 cm), 25 cases (53%) were established as pathological by ultrasonic methods (cervical length less than 3 cm). The superior objectivity of the results obtained by perineal scan when compared to vaginal examination could be statistically established, primarily through the number of premature births occurring during the further course of pregnancy. The incidence of premature births was not significantly increased in clinically established cervical shortening of less than 1.5 cm, whereas a significant result was obtained if sonography revealed cervical shortening below 2.5 cm (p less than 0.01). Perineal scan is however also recommended for controlling therapeutic success of tocolytic treatment and for confirming and/or detecting premature rupture of the foetal membranes, as well as in cases of suspected cervical insufficiency or incompetent cervix.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294090 TI - [A full-term tubal pregnancy with survival of mother and child]. AB - We report a case of non-ruptured tubal pregnancy at 38 weeks of pregnancy with the survival of mother and baby. Following salpingotomy a 1860 gr and 43 cm normal healthy male infant was delivered. The fallopian tube with placental tissue was removed by salpingectomy. Fetal development post partum and recovery of the mother were normal. PMID- 3294092 TI - [Iosif Abramovich Kassirskii (on the 90th anniversary of his birth)]. PMID- 3294091 TI - [Spontaneous rupture of the kidney pelvis in pregnancy]. AB - A case of spontaneous rupture of the renal pelvis during pregnancy is presented. Diagnosis was made sonographically showing a perirenal extravasation. Early detection of this rare complication saved the kidney. After ureteral indwelling the extension of the extravasation and the clinical symptomatic improved rapidly. Further pregnancy was free of complications and the patient delivered two healthy infants without experiencing any problems during labour or delivery. PMID- 3294093 TI - [Effect of blood transfusions on the survival of cadaveric kidney transplants]. PMID- 3294094 TI - In vivo studies of the relationship between the activation of lipid metabolism, postirradiation bone marrow cell proliferation and radioresistance of mice. AB - The effect of adaptation to intermittent feeding on the in vivo biosynthesis of fatty acids and total lipids in the epididymal adipose tissue, the liver and the bone marrow was studied in adult male mice (CBA/JPh x C57BL@10 ScSnPh)F1. At the same time the effects of the same experimental stimulus on the rate of regeneration (proliferation) of bone marrow cells after sublethal irradiation of animals and on the overall radioresistance of mice expressed as 30 days survival after whole-body gamma irradiation were determined. Intermittent feeding in mice has been shown to have a significant effect on the biosynthesis of fatty acids and total lipids in all the tissues studied, including bone marrow cells, the intensity of the effect being closely dependent on the duration of the experimental stimulus. Maximum stimulation of lipogenesis during realimentation was observed approximately within 1 week of adaptation, with a reduction of the metabolic responses thereafter. The intensity of bone marrow cell proliferation in mice irradiated in the realimentation phase was inversely proportional to the preirradiation degree of biosynthesis of fatty acids and total lipids: in a period of lower lipogenetic capacity of cells in the tissue studied (around the weeks 2-5 of adaptation) an increase in the regeneration potential of bone marrow cells was observed together with increased radioresistance of the mice. During the 1-week of adaptation the opposite proved to be the case. Attention is drawn to the possible participation of prostaglandins and lipid peroxides in the responses observed. PMID- 3294095 TI - Prostaglandin E2 and F2 alpha induced calcium transport across lipid bilayers. PMID- 3294096 TI - Sewall Wright (1889-1988). PMID- 3294097 TI - Multiple new genes that determine activity for the first step of leucine biosynthesis in Saccharomyces cerevisiae. AB - The first step in the biosynthesis of leucine is catalyzed by alpha isopropylmalate (alpha-IPM) synthase. In the yeast Saccharomyces cerevisiae, LEU4 encodes the isozyme responsible for the majority of alpha-IPM synthase activity. Yeast strains that bear disruption alleles of LEU4, however, are Leu+ and exhibit a level of synthase activity that is 20% of the wild type. To identify the gene or genes that encode this remaining activity, a leu4 disruption strain was mutagenized. The mutations identified define three new complementation groups, designated leu6, leu7 and leu8. Each of these new mutations effect leucine auxotrophy only if a leu4 mutation is present and each results in loss of alpha IPM synthase activity. Further analysis suggests that LEU7 and LEU8 are candidates for the gene or genes that encode an alpha-IPM synthase activity. The results demonstrate that multiple components determine the residual alpha-IPM synthase activity in leu4 gene disruption strains of S. cerevisiae. PMID- 3294099 TI - Cytogenetics and Karl Sax. PMID- 3294098 TI - Differential mismatch repair can explain the disproportionalities between physical distances and recombination frequencies of cyc1 mutations in yeast. AB - Recombination rates have been examined in two-point crosses of various defined cyc1 mutations that cause the loss or nonfunction of iso-1-cytochrome c in the yeast Saccharomyces cerevisiae. Recombinants arising by three different means were investigated, including X-ray induced mitotic recombination, spontaneous mitotic recombination, and meiotic recombination. Heteroallelic diploid strains were derived by crossing cyc1 mutants containing a series of alterations at or near the same site to cyc1 mutants containing alterations at various distances. Marked disproportionalities between physical distances and recombination frequencies were observed with certain cyc1 mutations, indicating that certain mismatched bases can significantly affect recombination. The marker effects were more pronounced when the two mutational sites of the heteroalleles were within about 20 base pairs, but separated by at least 4 base pairs. Two alleles, cyc1 163 and cyc1-166, which arose by G.C----C.G transversions at nucleotide positions 3 and 194, respectively, gave rise to especially high rates of recombination. Other mutations having different substitutions at the same nucleotide positions were not associated with abnormally high recombination frequencies. We suggest that these marker effects are due to the lack of repair of either G/G or C/C mismatched base pairs, while the other mismatched base pair of the heteroallele undergoes substantial repair. Furthermore, we suggest that diminished recombination frequencies are due to the concomitant repair of both mismatches within the same DNA tract. PMID- 3294100 TI - Unlinked noncomplementation: isolation of new conditional-lethal mutations in each of the tubulin genes of Saccharomyces cerevisiae. AB - Mutations in genes of Saccharomyces cerevisiae that code for proteins that interact with beta-tubulin were sought by screening for unlinked mutations that fail to complement mutations in the single beta-tubulin-encoding gene (TUB2). Among the first three noncomplementing mutations examined, two are linked to TUB2 while one is unlinked. The unlinked mutation was shown to be a conditional-lethal allele of the major alpha-tubulin-encoding gene (TUB1) and represents the first such mutation in that gene. The tub1-1 mutation itself causes a cold-sensitive cell-cycle arrest, and confers supersensitivity to the antimicrotubule drug benomyl. These phenotypes occur in the presence of a wild-type copy of the minor alpha-tubulin-encoding gene, TUB3; the combination of tub1-1 and a tub3 null mutation is inviable in haploids. Through further application of this method, new mutations in TUB2 and TUB3 were isolated as unlinked noncomplementers of tub1-1. The noncomplementation between tub1 and tub2 mutations is gene specific and allele specific, suggesting that the phenotype is due to an interaction at the protein level. We conclude that isolation of unlinked noncomplementing mutations is likely to be a generally useful method for isolating mutations in interacting gene products. PMID- 3294101 TI - DIS1: a yeast gene required for proper meiotic chromosome disjunction. AB - Mutants at a newly identified locus, DIS1 (disjunction), were detected by screening for mutants that generate aneuploid spores (chromosome VIII disomes) at an increased frequency. Strains carrying the partially dominant alleles, DIS1-1 or DIS1-2, generate disomes at rates up to 100 times the background level. Mitotic nondisjunction is also increased 10- to 50-fold over background. Half tetrad analysis of disomes for a marked interval on chromosome VIII yields wild type map distances, indicating that a general recombination deficiency is not the cause of nondisjunction. Meiotic nondisjunction in DIS1 mutants is not chromosome specific; 5% of the spores disomic for chromosome VIII are also disomic for chromosome III. Although only one disomic spore is found per exceptional ascus most of the disomes appear to be generated in the first meiotic division because recovered chromosome VIII disomes contain mostly nonsister chromosomes. We propose that disome generation in the DIS1 mutants results from precocious separation of sister centromeres. PMID- 3294102 TI - Meiotic disjunction of homologs in Saccharomyces cerevisiae is directed by pairing and recombination of the chromosome arms but not by pairing of the centromeres. AB - We explored the behavior of meiotic chromosomes in Saccharomyces cerevisiae by examining the effects of chromosomal rearrangements on the pattern of disjunction and recombination of chromosome III during meiosis. The segregation of deletion chromosomes lacking part or all (telocentric) of one arm was analyzed in the presence of one or two copies of a normal chromosome III. In strains containing one normal and any one deletion chromosome, the two chromosomes disjoined in most meioses. In strains with one normal chromosome and both a left and right arm telocentric chromosome, the two telocentrics preferentially disjoined from the normal chromosome. Homology on one arm was sufficient to direct chromosome disjunction, and two chromosomes could be directed to disjoin from a third. In strains containing one deletion chromosome and two normal chromosomes, the two normal chromosomes preferentially disjoined, but in 4-7% of the tetrads the normal chromosomes cosegregated, disjoining from the deletion chromosome. Recombination between the two normal chromosomes or between the deletion chromosome and a normal chromosome increased the probability that these chromosomes would disjoin, although cosegregation of recombinants was observed. Finally, we observed that a derivative of chromosome III in which the centromeric region was deleted and CEN5 was integrated at another site on the chromosome disjoined from a normal chromosome III with fidelity. These studies demonstrate that it is not pairing of the centromeres, but pairing and recombination along the arms of the homologs, that directs meiotic chromosome segregation. PMID- 3294103 TI - Cycloheximide-resistant temperature-sensitive lethal mutations of Saccharomyces cerevisiae. AB - We describe the isolation and preliminary characterization of a set of pleiotropic mutations resistant to the minimum inhibitory concentration of cycloheximide and screened for ts (temperature-sensitive) growth. These mutations fall into 22 complementation groups of cycloheximide resistant ts lethal mutations (crl). None of the crl mutations appears to be allelic with previously isolated mutations. Fifteen of the CRL loci have been mapped. At the nonpermissive temperature (37 degrees), these mutants arrest late in the cell cycle after several cell divisions. Half of these mutants are also unable to grow at very low temperatures (5 degrees). Although mutants from all of the 22 complementation groups exhibit similar temperature-sensitive phenotypes, an extragenic suppressor of the ts lethality of crl3 does not relieve the ts lethality of most other crl mutants. A second suppressor mutation allows crl10, crl12, and crl14 to grow at 37 degrees but does not suppress the ts lethality of the remaining crl mutants. We also describe two new methods for the enrichment of auxotrophic mutations from a wild-type yeast strain. PMID- 3294105 TI - [Suppression of dnaZ mutation during integration of factor F' into the chromosome of a mutant strain]. AB - The phenomenon of suppression of dnaZ mutation has been revealed in the course of F' factor integration into the chromosome of the mutant strain. We have shown that under non-permissive conditions (t = 43 degrees C), chromosome replication in dnaZts strains proceeds under control of the factor F' replicon stably integrated into the chromosome. Possible mechanism of suppression effect, based on the formation of a bireplicon replication system, is discussed. PMID- 3294104 TI - crl mutants of Saccharomyces cerevisiae resemble both mutants affecting general control of amino acid biosynthesis and omnipotent translational suppressor mutants. AB - Cyocloheximide resistant lethal (crl) mutants of Saccharomyces cerevisiae, defining 22 unlinked complementation groups, are unable to grow at 37 degrees. They are also highly pleiotropic at their permissive temperature of 25 degrees. The mutants are all unable to arrest at the G1 stage of the cell cycle when grown to stationary phase or when starved for a single amino acid, though they do arrest at G1 when deprived of all nitrogen. The crl mutants are also hypersensitive to various amino acid analogs and to 3-aminotriazole. These mutants also "tighten" leaky auxotrophic mutations that permit wild-type cells to grow in the absence of the appropriate amino acid. All of these phenotypes are also exhibited by gcn mutants affecting general control of amino acid biosynthesis. In addition, the crl mutants are all hypersensitive to hygromycin B, an aminoglycoside antibiotic that stimulates translational misreading. The crl mutations also suppress one nonsense mutation which is phenotypically suppressed by hygromycin B. Many crl mutants are also osmotically sensitive. These are phenotypes which the crl mutations have in common with previously isolated omnipotent suppressors. We suggest that the the crl mutations all affect the fidelity of protein translation. PMID- 3294106 TI - [Characteristics of the mutagenic and toxic effects of ethylene imine and its oligomers. Comparative study in the automated SOS-chromotest system and in standard bacterial test systems]. AB - Raising total positive charge of a chemical mutagen does increase its local concentration in the area of biological target-DNA, and, as a consequence, causes increase in the rate of interaction of a mutagen with the target. Experimental evidence of this idea has been obtained in three test systems: the Ames test, Trp+ reversions in Escherichia coli WP2 and in the automated "SOS-chromotest" system with E. coli PQ 37 ("Labsystems", Finland). PMID- 3294107 TI - Suppression of the btuB451 mutation by mutations in the tonB gene suggests a direct interaction between TonB and TonB-dependent receptor proteins in the outer membrane of Escherichia coli. AB - In cells of Escherichia coli, the function of the tonB gene is needed for energy dependent transport processes mediated by the outer-membrane receptors for iron siderophore complexes and vitamin B12. The btuB451 mutation has the same effect on vitamin B12 transport as does a tonB mutation. When a btuB451 strain carried a plasmid with the intact tonB gene, partial revertant strains were isolated which had acquired the ability to grow on 5 nM vitamin B12. This suppression activity was associated with the plasmid, suggesting that a mutation within the tonB gene on the plasmid allowed the mutant BtuB receptor to function in the transport of the vitamin. The nucleotide sequence of the entire tonB gene of ten independently isolated suppressing plasmids was determined. Only a single nucleotide change had occurred in each of the cases. The same codon was always affected resulting in the conversion of glutamine-165 to a leucine in seven of the ten isolates and to a lysine in the other three. The phenotype of strains carrying both types of altered tonB genes showed the retention of their function for other TonB dependent processes in addition to their suppressor properties with respect to the btuB451 mutation. The fact that mutations suppressing the btuB451 mutation occurred in the tonB gene suggests that there is a direct interaction between TonB and TonB-dependent receptors in the outer membrane of E. coli. PMID- 3294108 TI - Characterization of a high-molecular-weight phosphoprotein synthesized by the human malarial parasite Plasmodium falciparum. AB - During its intra-erythrocytic cycle, Plasmodium falciparum synthesizes a protein of apparent Mr 250,000-300,000. Its precise size is dependent on the P. falciparum isolate examined. This protein contains phosphate covalently bound to one or more serine residues and hence is termed PP300. Monoclonal antibody, McAb4 1F, binds to PP300 on immunoblots of protein extracts from all parasite isolates tested, both those exhibiting and those lacking the knob phenotype. Using McAb4 1F, the polypeptide was shown to be physically associated with the plasma membrane in a membrane-isolation procedure. However, in an indirect immunofluorescence assay the McAb appeared to bind to antigen associated with the erythrocyte plasma membrane in parasitized cells. However, it reacted only to fixed, not unfixed, parasitized erythrocytes indicating that the epitope is not normally exposed to extracellular antibodies. Clone 29-2 was isolated by a McAb4 1F immunoscreen of a P. falciparum complementary DNA (cDNA) expression library created in pUC8. Rat anti-clone serum which was raised to the purified protein encoded by the lacZ-29-2 fusion in pUC8 reacted with PP300 in immunoblots of parasite antigen. In Southern-blot analyses of parasite DNA digested with EcoRI, HindIII, or EcoRV, the 29-2 DNA insert hybridized to more than one fragment even though the insert lacked internal sites for these enzymes. In addition, hybridization studies were conducted using two oligodeoxy-nucleotides which were constructed based on the sequence of a cDNA clone which encoded part of a similar high-molecular-weight P. falciparum protein [Coppel et al., Mol. Biochem. Parasitol. 20 (1986) 265-277]. Analysis of these results indicates that the two cDNA sequences are parts of the same gene or a family of related genes. PMID- 3294109 TI - Construction of plasmids which lead to overproduction of yeast PHR1 photolyase in Saccharomyces cerevisiae and Escherichia coli. AB - The PHR1 gene of Saccharomyces cerevisiae encodes a DNA photolyase which is normally present in fewer than 300 copies per cell. We have constructed plasmids in which PHR1 expression in yeast and Escherichia coli is under the control of strong, inducible promoters thereby leading to the regulated overproduction of biologically active photolyase. Under inducing conditions, E. coli cells carrying the tac-PHR1 plasmid pCB1241 accumulate up to 8% of total cellular protein as yeast photolyase; similarly, the GAL10-PHR1 fusion plasmid pGBS107 directs the synthesis of at least 1800-2400 molecules of photolyase per log-phase yeast cell. In both plasmids translation begins at the first ATG in the PHR1 open reading frame (ORF). Constructs in which translation initiates at the second or third ATG fail to complement yeast and E. coli phr1 mutations, indicating that the first ATG in the PHR1 ORF is the translational start site in vivo and that all or part of the N-terminal 78 amino acids are required for activity. PMID- 3294110 TI - Transcript mapping using [35S]DNA probes, trichloroacetate solvent and dideoxy sequencing ladders: a rapid method for identification of transcriptional start points. AB - A simple method for RNA transcript mapping has been developed that combines the use of 35S-labeled M13 DNA probes and the presence of high concentrations of sodium trichloroacetate in the hybridization buffer. These hybridization conditions permit the use of M13 probes without purification from the template. The dideoxy sequencing ladders used for sizing the protected DNA fragments are obtained from the same M13 templates utilized to synthesize the DNA probes. The method was tested by analyzing the transcripts controlled by lac, ptr and trxA promoters. Comparison of the results with previously published data obtained with the conventional S1 nuclease mapping technique indicated that the present method is just as precise and at least 50 times more sensitive. Clones constructed for sequencing a gene of interest can be used directly to identify transcriptional start points. PMID- 3294111 TI - [Hygienic evaluation of polystyrene plastics]. PMID- 3294112 TI - [Determination of aldehydes in the air in hygiene research]. PMID- 3294113 TI - [Use of genetic methods in preventive medicine]. PMID- 3294114 TI - Historical terminology used to represent older people. PMID- 3294115 TI - Old age, the ancient military, and Alexander's army: positive examples for a graying America. PMID- 3294116 TI - Geriatric medical decisions: factors influencing allocation of scarce resources and the decision to withhold treatment. PMID- 3294117 TI - Impact of a geriatric consultation team on discharge placement and repeat hospitalization. PMID- 3294118 TI - Family caregiving: impact of patient functioning and underlying causes of dependency. PMID- 3294119 TI - Progress with the pouch--restorative proctocolectomy for ulcerative colitis. PMID- 3294120 TI - Present position of liver transplantation and its impact on hepatological practice. PMID- 3294121 TI - Calmodulin in normal and cystic fibrosis human intestine at different developmental stages. AB - Calmodulin concentrations and localisation have been analysed as a function of development in human intestinal epithelial cells from normal and cystic fibrosis individuals. In normal fetuses up to eight weeks of gestation intestinal epithelial cells which were still undifferentiated were not immunoreactive and their calmodulin content was low. From eight weeks onwards there was a significant overall increase in calmodulin content concomitant with its segregation to the apical side of epithelial cells. At 14 weeks of gestation calmodulin concentrations and localisation closely resembled those of adults. The developmental pattern of calmodulin appeared to parallel the morphological and functional maturation of brush borders which occurs during the first trimester of pregnancy. In the intestinal epithelial cells from a 19 weeks cystic fibrosis fetus and a cystic fibrosis newborn infant neither calmodulin concentration, nor its localisation were affected. Similarly, brush border calmodulin binding proteins and enzymatic activities were similar in normal subjects and the cystic fibrosis intestine. PMID- 3294122 TI - Cryptosporidial diarrhoea in AIDS and its treatment. AB - Of 234 patients with AIDS diagnosed at St. Stephen's Hospital between January 1981 and June 1987, 26 (11%) were found to have cryptosporidiosis. Stool examination was positive in all patients, but an average of three specimens (range 1-6) were required before a positive diagnosis was made. Other methods of diagnosis included jejunal and rectal biopsy and aspiration of the duodenal contents. Twenty three (89%) lived for six months from the time of diagnosis and 16 (60%) were alive at one year. Only five patients died as a direct result of cryptosporidial infection, while 10 other patients died from another complication of AIDS. Fifteen patients were enrolled in a prospective controlled study of erythromycin or spiramycin in the treatment of cryptosporidial diarrhoea. Most patients showed a significant response to antibiotic therapy but treatment was limited because of side effects. All patients responded to antidiarrhoeal agents, particularly long acting morphine sulphate. Three of our patients recently given zidovudine (AZT) have responded with a cessation of diarrhoea and cryptosporidia are no longer isolated from the stools. PMID- 3294123 TI - Cisapride restores the decreased lower oesophageal sphincter pressure in reflux patients. AB - The effect of the new prokinetic drug cisapride on the resting lower oesophageal sphincter pressure and on the strength of peristaltic contractions was studied in 10 healthy controls and in 10 reflux patients with abnormally low (less than 10 mm Hg) basal lower oesophageal sphincter pressure. A slow intravenous injection of cisapride 10 mg significantly increased the sphincter pressure in the controls but even more in the patients in whom it almost doubled the resting lower oesophageal sphincter pressure of 8.7 (0.5) mm Hg to between 15 and 20 mm Hg for at least 90 min. Results are expressed as mean (SE). Cisapride also significantly increased the amplitude of peristaltic contractions in controls and reflux patients. Therefore, cisapride might be useful in the treatment of reflux. PMID- 3294124 TI - Combined therapy with cisapride and cimetidine in severe reflux oesophagitis: a double blind controlled trial. AB - Combined treatment with cimetidine 1 g daily and cisapride 40 mg daily in patients with endoscopically diagnosed severe reflux oesophagitis was compared with single drug therapy (cimetidine and placebo). At the end of the six to 12 weeks treatment, 11 (46%) of the 24 patients under single drug therapy were endoscopically healed and three were improved. In contrast, 16 (70%) of the 23 patients under combined therapy were healed and all of the remainder were improved (p = 0.025). The severity of diurnal and nocturnal heartburn, decreased significantly more (p less than 0.05) on cimetidine + cisapride than on cimetidine + placebo. The combined treatment was well tolerated. These results suggest that combined therapy with cisapride and cimetidine may be useful in patients with severe reflux oesophagitis. PMID- 3294125 TI - Experimental studies of immunologically mediated enteropathy. Development of cell mediated immunity and intestinal pathology during a graft-versus-host reaction in irradiated mice. AB - The intestinal component of a graft-versus-host reaction (GvHR) provides a useful experimental model to elucidate the pathogenesis of clinical enteropathies which cause villus atrophy and crypt hyperplasia and which are associated with a local immune response. One to three days after induction of GvHR in heavily irradiated (CBAxBALB/c)F1 mice, a proliferative form of enteropathy developed. Compared with controls, these mice had increased counts of jejunal intraepithelial lymphocytes and had a four-fold increase in crypt cell production rate as well as an increase in crypt length. These changes were accompanied by a marked enhancement of splenic natural killer cell activity. After day three, the crypt cell production rate fell to zero and cytotoxic T lymphocytes (CTL) which could lyse targets of host origin appeared. In parallel, mice with GvHR developed significant villus shortening and their clinical condition deteriorated. Further experiments showed that increased counts of intraepithelial lymphocytes, villus atrophy and crypt hyperplasia also occurred in grafts of fetal CBA intestine implanted under the kidney capsule of (CBAxBALB/c)F1 mice with GvHR. As these grafts are syngeneic to the injected CBA spleen cells, they should not be attacked by anti-host cytotoxic T lymphocytes. We suggest that the proliferative and destructive components of enteropathy in GvHR are caused by lymphokines released by an anti-host delayed type hypersensitivity reaction. PMID- 3294127 TI - Relation of antifactor Xa activity of heparins and antithrombotic efficacy. AB - In the present paper some of the characteristics of the pharmacodynamics of low molecular-weight (LMW) heparin and the importance of the inhibition of the factor Xa are outlined. In summary, there is some evidence that the inhibition of factor Xa mediated fibrin formation and antithrombotic effects. However, there is a lot of experimental evidence that heparin and LMW heparins induce antithrombotic effects by releasing compounds from vascular endothelium, too. Thus, distinct interactions of heparin and LMW heparins with the cellular compounds of the blood may modulate the antithrombotic and hemorrhagic capacities. PMID- 3294126 TI - Histological response and antigen transmission in the lymph nodes of athymic nu/nu mice inoculated with Crohn's disease tissue filtrates. AB - Lymph node histology and antigen transmission in the nu/nu mouse in response to animal inoculation with Crohn's disease tissue filtrates were re-evaluated. We found that a hyperplastic lymph node response in nu/nu mice occurred with Crohn's disease (CD), ulcerative colitis (UC), or other intestinal disease (OID) tissue inoculations. In addition, antigen transmission to lymph nodes as detected by indirect immunofluorescence using CD sera was observed in all inoculation groups. The immunofluorescent reaction also occurred independently of lymph node histology. Thus, we confirm that CD sera recognize an antigen(s) expressed in lymph nodes of athymic mice inoculated with CD tissue filtrates. The antibody (or antibodies) in CD sera was not specific for this 'CD antigen or antigens', however, as tested in the nu/nu mouse system, because the CD sera antibodies also recognised antigens in UC inoculated and OID inoculated animals. PMID- 3294128 TI - [Application of recombinant DNA technology to detection of inherited defects]. PMID- 3294129 TI - [Presence of estrogen and progesterone receptors in meningioma tissue]. PMID- 3294130 TI - [Importance of mental and functional assessment in geriatric patients]. PMID- 3294131 TI - [Scleroderma-like disorders]. PMID- 3294132 TI - [Theophylline in chronic obstructive lung disease]. PMID- 3294133 TI - [The pendulum of the surgical treatment of arthritis]. PMID- 3294134 TI - [Ultrasonography in the diagnosis of transient synovitis of the hip]. PMID- 3294135 TI - [Diagnosis and management of childhood asthma--update]. PMID- 3294136 TI - [Hypertension in aortic coarctation: pathophysiologic, therapeutic and prognostic aspects]. PMID- 3294137 TI - [The clinical significance of IgA deficiency]. PMID- 3294138 TI - [Pharmacotherapy of juvenile rheumatoid arthritis]. PMID- 3294139 TI - [Hypoglycaemia]. PMID- 3294140 TI - [Primary prevention in children of atherosclerosis]. PMID- 3294141 TI - [Endomyocardial biopsy]. PMID- 3294142 TI - [Pseudodementia: a review]. PMID- 3294143 TI - [Brain concussion]. PMID- 3294144 TI - [Acquired syphilis]. PMID- 3294145 TI - Adherence of group B streptococci to human buccal epithelial cells, its dependence on the biological state of the culture. AB - The adherence activity of Streptococcus agalactiae (group B) strains is directly dependent on the biological state of cultures. The aim of the present paper was to consider the effect of repeated transfers of cultures alternately on solid and liquid media and the effect of the growth phase. The strains, adhering weakly, strongly and variably to epithelial cells were employed in studies on the effect of repeated transfer. The percentage of adherent epithelial cells differed significantly after the first or the second transfer. On storage of the strains after the 3rd transfer at 4 degrees C for 4 d, the adherence activity decreased to the level of non-transferred strains. Ultrastructural analysis revealed in all strains the presence of capsular material, its character being similar both in strongly and in weakly adhering cultures. In weakly adherent strains, the structure of the capsular layer has not changed during transfer whereas the adherence of the strain increased considerably. The effect of the growth phase was studied during 3-48 h of incubation. The growth phase did not influence the adherence activity in strains that had been allowed to multiply for 3-24 h. After a long-term multiplication beyond 24 h, the adherence activity gradually decreased. PMID- 3294146 TI - Modified method of application of ethyl methanesulfonate for induction of Escherichia coli mutants. AB - An efficient modification of ethyl methanesulfonate mutagenic action is based on mutagenization of small volumes of cell suspensions in micro-sample tubes. This provides for a rapid and safe handling of solutions of cancerogenic mutagens. A 3 4-h exposition to 30-40 mmol/L of mutagen appeared optimal, inducing more than 20% auxotrophs or, after a simultaneous application of the penicillin method, 60% of auxotrophs. Moreover, the modification proved its value in repeated applications of ethyl methanesulfonate, resulting in an accumulation of various mutation types. Consecutive mutations were accompanied by an increase in sensitivity. Based on the distribution of nucleoids in the mutagenized population, the penicillin method was modified to allow detection of mutants segregated from cells with several nucleoids. PMID- 3294147 TI - [Sonography in internal medicine]. PMID- 3294148 TI - [Campylobacter pylori--a critical assessment]. PMID- 3294149 TI - [Psychiatric aspects of HIV infection]. PMID- 3294150 TI - [Effect of lecithin on health status and concentration. Placebo-controlled double blind study in healthy probands]. PMID- 3294151 TI - [Listeriosis--a current disease]. PMID- 3294152 TI - [Saving the spleen. Possibilities and clinical reality].